Enteropathogen carriage by healthy individuals living in an area with poor sanitation

Faecal carriage of bacterial enteropathogens (enteropathogenic Escherichia coli (EPEC), shigellae and salmonellae) was studied in 265 individuals: 65 infants 3-6 months of age (50 bottle-fed and 15 breast-fed), 100 school-age children 8-10 years of age and 100 adults 21-50 years of age. All were apparently healthy, did not have gastrointestinal symptoms, had not received antibiotics in the preceding fortnight and were not malnourished. Enteropathogens were isolated from the faeces of 24 individuals (9.1%). Cultures were positive for enteropathogens in 20% of the infants (both breast- and bottle-fed), 8% of school-age children and 3% of the adults. EPEC was the most frequent isolate. Twelve different serotypes were detected. The highest recoveries were E. coli 026:K60 and 044 . K74. Shigella was detected only in school-age children (2%) and salmonella only in adults (1%). Campylobacter jejuni and Yersinia enterocolitica were studied only in the school-age children: there was one isolate of each of them. Most enteropathogens isolated were susceptible to the majority of the antibiotics tested. Only four E. coli strains, isolated from bottle-fed infants, could be considered multi-resistant. Two of the strains wer E. coli 044:K74 and 020a020c:K61. The remainder were E. coli 0111:K58 and wee capable of transferring some of their antibiotic resistance traits to a recipient strain.

Characteristics and analysis of electropherotypes of human rotavirus isolated in Chile

Electropherotypes of human rotavirus from stool samples of hospitalized and ambulatory infants with acute diarrhea were analysed. Thirty-two different electropherotypes were observed in 142 cases in which the viral genome RNA was characterized. The seasonal distribution of the electropherotypes, from 1979 to 1981, showed that the same electropherotypes were detected throughout the period of study while others were found only occasionally. Electropherotypes were also analyzed depending on whether the patient from whom they had been obtained required hospitalization or was treated at home. The analysis shows that the electropherotypes were equally distributed in both groups of patients.

Fine structure of the small intestinal mucosa in infantile marasmic malnutrition

The jejunal mucosa was studied in infantile marasmic malnutrition in the early phase after treatment was begun and before the onset of significant weight gain. In 7 infants light microscopy before recovery showed that the mucosa was normal or mildly abnormal in 4, and moderately abnormal in 3 cases. The electron microscope disclosed abnormalities of the brush border, large autophagosomes and residual bodies, and the deposition of collagen, filaments, and a dense, finely granular material below the basal lamella. Three of the infants were studied again during recovery. Although the histology remained unchanged, electron microscopy revealed improvement of the brush border, disappearance of the autophagosomes, and smaller and fewer residual bodies. The dense material below the basal lamella was absent whereas the fibrillar components remained. It is postulated that the fine structural lesions observed may be due to the derangements in cell metabolism caused by the severe, prolonged restriction of protein and caloric intake.

Specificity of ultrastructural changes of small intestinal epithelium in early childhood

Electron microscopical features of the small intestinal mucosa in 30 consecutive biopsies from 14 newly diagnosed coeliac patients, and 16 patients with chronic intermittent diarrhoea due to different causes, were studied. An attempt to define specific changes in each condition was made. An abnormal brush border, increased number of free ribosomes, rich rough endoplasmic reticulum, poorly developed smooth endoplasmic reticulum, large Golgi complexes, and thickened basal lamina were the most frequent findings in the coeliac biopsies. These changes suggest abnormal cellular metabolism, but as they were also observed in children with a variety of clinical conditions, they could not be specifically related to coeliac disease. These observations suggest that in small children different causes leading to different degrees of abnormal small intestinal mucosa, as observed with the light microscope, produce nonspecific changes of the cellular ultrastructure, which cannot be related to the degree of abnormality observed at the light microscope level.

Bood vitamin levels in children with gastroenteritis

Clinical evaluation and estimation of blood levels of vitamins A, E, C, B1, B2, B6 and of total carotenoids were carried out in 52 consecutive children admitted to the Royal Alexandra Hospital for Children in Sydney during the winter epidemic of diarrhoea. The children included 37 Europeans and 15 Aboriginals, who were previously apparently healthy. Of these, 19 Europeans and ten Abororigines were studied also after recovery. The anthropometric, clinical, microbiological and biochemical data for each child is presented. Vitamin treatment, duration of symptoms, severity of diarrhoea, stool microbiology and the role of secondary malabsorption as a main cause of the depressed plasma vitamin levels found is discussed.