Trimipramine and other antipsychotics inhibit Campylobacter pylori in vitro

A series of conventional anti-ulcer drugs, tricyclic antidepressants and neuroleptics (and some CNS non-active isomers) were tested in vitro for possible inhibition of Campylobacter pylori. These bacteria are claimed to play an etiological role in peptic ulcer disease, at least in gastritis B. While cimetidine, famotidine, ranitidine and pirenzepine were inactive, all the antipsychotic agents and their isomeric derivatives were active to various degrees with IC50 of 26-59 microM. Of special interest is trimipramine (Surmontil) that has been demonstrated to be effective against duodenal ulcers in some trials. The activity of the non-neuroleptic stereo-isomers of clopenthixol and chlorprothixene may lead to investigation in patients with peptic ulcer disease of this kind of agents. However, a firm connection between the antimicrobial activity of these compounds, their possible anti-ulcer effect and the etiological role of Campylobacter pylori in peptic ulcer disease must first be established.

Jejunal diverticulosis in a family

The presence of small intestinal diverticula was examined in a family of eight siblings. Six of the siblings had diverticula of the duodenum and/or the jejunoileal tract. Three of them had multiple jejunoileal diverticula, one had two jejunal diverticula, and two had duodenal diverticula. In addition, diseases of an immunologic nature were present in four of the siblings (rheumatoid arthritis, ulcerative colitis, myxoedema following thyroiditis, and non-viral hepatitis).

Campylobacter pylori in peptic ulcer disease. II. Endoscopic findings and cultivation of C. pylori

Specimens from 153 consecutive patients were cultivated for C. pylori, and findings were correlated to the endoscopic findings. C. pylori was cultivated more frequently from males than from females. Culture-positive males had a high frequency of prepyloric abnormalities. No correlation between age or pH in gastric juice and cultivation of C. pylori was found. C. pylori was found significantly more often in patients with peptic ulcer and/or duodenitis than in patients with normal endoscopic findings. No differences could be detected between patients with gastritis or esophagitis and patients with normal endoscopic findings. C. pylori was found most frequently in the antral part of the stomach. It was cultivated significantly more often from patients with duodenal abnormalities than from patients with normal endoscopic findings. In less than half of the culture-positive patients with duodenal abnormalities we cultivated C. pylori from duodenal specimens. This study also showed C. pylori in esophageal specimens, which has not been previously described. Our results suggest that cultivation of C. pylori from duodenal specimens or gastric fluid samples gives no additional information beyond that obtained from the cultivation of antral biopsy specimens. It is our opinion that C. pylori, at least in some cases, may be a secondary infection.

Campylobacter pylori detected by indirect immunohistochemical technique

An immunohistochemical assay for staining C. pylori is described. The method is compared with cultivation of C. pylori and observation of campylobacter-like organisms (CLOs) in hematoxyline-eosine (HE) stained sections. Eighteen biopsies from which C. pylori was cultivated but not seen in HE stained sections and three culture negative biopsies with CLOs seen in HE stained sections were selected from 331 biopsies including 113 culture positive biopsies. There were agreements between cultivation of C. pylori and CLOs seen in HE stained sections in the remaining 310 biopsies. Fourteen of the 18 and one of the three biopsies were found positive by the immunohistochemical assay. In addition 21 culture-positive control biopsies and one of 18 culture-negative control biopsies were also found positive. When the immunohistochemical assay was compared with cultivation the predictive value of positive result is 93% and of negative result 89%. By this method we were able to detect single organisms and no cross-reactions to other curved bacteria on the gastric epithelium were observed.

In vitro susceptibility of diarrhoea producing gram negative enteric bacteria to sulfasalazine, 5-aminosalicylic acid, sulfapyridine and four quinolones. Brief report

The in vitro susceptibility of diarrhoea producing Gram negative enteric bacteria to sulfasalazine, 5-aminosalicylic acid, sulfapyridine and four quinolones was investigated using an agar dilution method. All strains were resistant to 1600 micrograms/ml of sulfasalazine and 5-aminosalicylic acid. MIC range of sulfapyridine for Y. enterocolitica was 3.1-25 micrograms/ml (median:6.2) and for Salmonella 25-100 micrograms/ml (median: 100) Campylobacter jejuni/coli were less susceptible to sulfapyridine with MIC values ranging from 200 to 800 micrograms/ml. Shigella and three of five E. coli strains were resistant to 1600 micrograms/ml of sulfapyridine. Two strains of E. coli were inhibited by 25 micrograms/ml. All strains were fairly susceptible to enoxacin, ciprofloxacin, pefloxacin and ofloxacin. Cirpofloxacin was the most active drug on weight basis.

Campylobacter pylori in peptic ulcer disease. III. Symptoms and paraclinical and epidemiologic findings

Only a few publications have dealt with the subjective symptoms, the paraclinical findings, or the epidemiology in relation to cultivation of C. pylori. Seventy-two patients answered a questionnaire containing questions about symptoms, dietary habits, smoking, and animal contact. C. pylori was cultivated from the biopsy specimens of 41 of these patients, and 31 were culture-negative. In addition, leukocyte count, differential count, and blood immunoglobulins were measured. In many culture-positive patients a variation in symptoms during the year was found, and symptoms had lasted more than 5 years. This was statistically significant for non-ulcer patients. In addition, we found initial abdominal pain and present vomiting to be significant features, but they did not seem to have any clinical significance. Unlike Marshall & Warren, we did not find ructus to be related to infections with C. pylori. In all other respects we found no differences between culture-negative and culture-positive patients. It was not possible to detect any descriptive variables in patients with C. pylori infections.

Nasopharyngeal bacteriology and secretory otitis media in young children

A prevalence study was performed on the nasopharyngeal bacteriology of 112 young children, aged 4-6 years. During the preceding 2 years, 74 of these children had suffered from secretory otitis media (SOM) and 40 had had normal middle ear ventilation. At the examination, one-third of the children with SOM had improved their middle ear status (previous SOM group), whereas otomicroscopy and tympanometry remained unchanged in the healthy group. The nasopharyngeal swab sample was obtained from behind the soft palate by the oral route. The isolation rate of Streptococcus pneumoniae was significantly higher in the SOM group than in the two other groups of children (p less than 0.006). The most commonly isolated capsular types of pneumococci were 6, 19, and 23, corresponding to the types involved in acute otitis media. The isolation rate of Haemophilus influenzae was 50% and an even distribution was found among the three groups of children examined. Biotypes I, II, III and IV accounted for 75% of the isolated cases of H. influenzae. As in acute otitis media, S. pneumoniae also seemed to play an important role in the pathogenesis of tubal dysfunction and SOM, and the difference is probably caused by variations in the quantitative colonization of pneumococci in the nasopharynx.

In vitro susceptibility of Campylobacter pyloridis to cimetidine, sucralfate, bismuth and sixteen antibiotics

The in vitro susceptibility of recent Danish human clinical isolates of Campylobacter pyloridis to cimetidine, sucralfate, bismuth subsalicylate and sixteen antimicrobial agents was determined by an agar-dilution technique. Benzylpenicillin was the most active drug (MIC90 = 0.1 microgram/ml); ampicillin, erythromycin, gentamicin and ciprofloxacin were slightly less active. All strains were resistant to 100 micrograms sulfamethizole, and nalidixic acid also had little activity on weight basis. Of the three anti-peptic ulcer drugs, bismuth subsalicylate was most active (MIC90 25 micrograms/ml), but sucralfate and cimetidine also had antibacterial activity, although only little (MIC90 3200 micrograms/ml).

Campylobacter pyloridis in peptic ulcer disease. I. Gastric and duodenal infection caused by C. pyloridis: histopathologic and microbiologic findings

In this study 153 patients with dyspepsia were biopsied in the gastric antrum and duodenum. All specimens were investigated histopathologically and microbiologically for the presence of Campylobacter pyloridis, and the type of inflammation was recorded in accordance with Morson's criteria. C. pyloridis was found beneath the mucus close to the epithelial cells and mostly in connection with granulocytic infiltration (active gastritis). C. pyloridis was cultured from all of 10 patients with histologically active gastritis and active duodenitis, in 86% of 64 patients with active gastritis and morphologically normal duodenum, and in only 5% of 79 patients without morphologic gastric and duodenal changes. The close relation between active gastritis and C. pyloridis shows that C. pyloridis plays an important role in gastric inflammation, as it fulfils the criterion for a localized bacterial infection.