Reservoirs for human campylobacteriosis

The epidemiology of human enteric infection due to Campylobacter fetus subspecies jejuni is not well understood. To determine whether an endogenous human reservoir is present, the rate of isolation of C. fetus subspecies jejuni from several populations of diarrheal and asymptomatic adults and children were compared. C. fetus subspecies jejuni was recovered from 4.1% of patients with diarrhea and 66.7% of household contacts of the index patients who themselves had diarrhea. Carriage of organisms in most untreated patients lasted less than three weeks from onset of symptoms. C. fetus subspecies jejuni was rarely recovered from the feces of asymptomatic individuals and not at all from the vaginal flora of 272 women. Domestic animals, especially puppies with diarrhea, were frequently infected with Campylobacter and may represent a significant reservoir for human infection.

Survival of Campylobacter fetus subsp. jejuni in biological milieus

To provide new information on the epidemiology and pathophysiology of human infection with Campylobacter fetus subsp. jejuni, we studied its survival in several milieus. Standard inocula of organisms were placed in hydrochloric acid, human bile and urine, bovine milk, or stream water and kept at 4, 25, or 37 degrees C; viable organisms were then counted. Stools from humans infected with Campylobacter were similarly tested. Survival in acid was pH and time dependent, with 7-log kill within 5 min in solutions at pH 2.3. Organisms multiplied in bile at 37 degrees C and survived for 2 months. Organisms survived better in feces, milk, water, and urine kept at 4 degrees C than they did in these milieus at 25 degrees C. Maximal viabilities of Campylobacter organisms kept at 4 degrees C were 3 weeks in feces, 3 weeks in milk, 4 weeks in water, and 5 weeks in urine. Study results suggest that when these milieus are contaminated with C. fetus subsp. jejuni, they may be significant environmental reservoirs.

Acute colitis caused by Campylobacter fetus ss. jejuni

Campylobacter fetus ss. jejuni has been recently recognized as a common human enteric pathogen; however, the pathology and pathophysiology of the enteritis caused by this agent are still largely obscure. We report 4 patients who presented with acute abdominal pain and bloody diarrhea and who had C. fetus ss. jejuni isolated from fecal cultures. Each patient showed a fourfold rise in serum IgG titer to the organism isolated. In all 4 patients colonic involvement was noted on sigmoidoscopic examination. Biopsy specimens showed acute colitis with inflammatory infiltrates of the lamina propria and crypt abscesses. Clinical improvement was complete in all patients after therapy with erythromycin. These results suggest that clinicians should consider Campylobacter enteritis in the differential diagnois of acute colitis.

Campylobacter enteritis associated with unpasteurized milk

Campylobacter fetus ss. jejuni has recently been recognized as a human enteric pathogen. Laboratory isolation has been hindered by its fastidious nature. Methods for recovery of this organism from stool culture and a specific serologic test are described. An outbreak is reported in which three members of the same family became simultaneously ill with fever, severe abdominal cramps and diarrhea. C. fetus ss. jejuni was recovered from stool specimens from all three. A fourfold increase in serum immunoglobulin G (IgG) titer to this organism was demonstrated in each patient. All three patients had been consuming unpasteurized milk from a cow whose feces were infected with C. fetus ss. jejuni.

Campylobacter enteritis: clinical and epidemiologic features

Campylobacter fetus subspecies (ssp.) jejuni has been recently recognized to cause diarrheal disease in man. To assess its importance as an enteric pathogen, we prospectively studied 514 patients with diarrhea. Campylobacter fetus ssp. jejuni was isolated from the feces of 26 patients (5%) and seven of 11 of their symptomatic household contacts. This organism was isolated from the feces of only one of 18 asymptomatic household contacts and not at all from 157 other healthy persons. Seventeen of 20 patients from whom C. fetus ssp. jejuni was isolated from fecal culture showed at least a fourfold rise in specific IgG titers. Review of 35 cases of campylobacter enteritis identified a typical clinical syndrome with acute onset of diarrhea, abdominal pain, fever, and constitutional symptoms. Stool examination revealed blood in 60% and polymorphonuclear leukocytes in 78% of patients. Epidemiologic investigation strongly suggested an external source for the infection in 22 of 35 patients.

Growth, survival, and resistance of the Legionnaires' disease bacterium

The Legionnaires' disease (LD) bacterium can now be readily cultured on artificial media. Studies were done to define the growth and survival of the LD bacterium in these media and ascertain its susceptibility to disinfecting agents. Growth-curve studies of the Philadelphia 1 strain using Mueller-Hinton broth with ferric pyrophosphate and L-cysteine (Feeley-Gorman broth) showed a lag phase of less than 24 h, a generation time of 3.8 h during the logarithmic phase, a plateau of 2 x 10(7) organisms per millilitre, and continued viability for as long as 110 d. Viability on chocolate agar with 1% hemoglobin and 2% IsoVitaleX added reached 150 d. This strain was susceptible to a variety of commonly recommended hospital and laboratory disinfectants, often in low concentrations. These investigations suggest that prolonged survival may occur in natural as well as artificial milieus and that low concentrations of phenolics, quaternary ammonium compounds, glutaraldehyde, formaldehyde, and hypochlorite could eradicate potential reservoirs for human infection.

Campylobacter enteritis associated with canine infection

Campylobacter fetus ss. jejuni has recently been recognised as a human enteric pathogen. Five cases of campylobacter enteritis are described. All five patients had abdominal pain and diarrhoea. Two of the five patients had bloody diarrhoea and relapses. All the patients had been in contact with young dogs which had had diarrhoea. Campylobacter fetus ss. jejuni was isolated from these dogs or from their litter-mates. Canine infection with Campylobacter fetus ss. jejuni may be an important source of infection causing diarrhoea in man.

Susceptibility of Clostridium perfringens isolated from human infections to twenty antibiotics

The proper choice of antibiotic for Clostridium perfringens infections in patients allergic to penicillin is not clear; the usual recommendations and recent in vitro studies disagree. We tested the susceptibility of 57 strains of C. perfringens to eight penicillins, seven cephalosporins, two tetracyclines, clindamycin, chloramphenicol, and rifampin by the agar dilution method. All strains were inhibited by (per milliliter) 4 mug or less of any of the penicillins, chloramphenicol, or clindamycin and 8 mug or less of any of the cephalosporins tested. Penicillin G and amoxicillin inhibited all strains at 0.12 mug or less per ml. Only 54% of the strains were inhibited by 1 mug of tetracycline per ml. Penicillin G remains the drug of first choice for infections with C. perfringens; it need not be added to a regimen containing a penicillinase-resistant penicillin given parenterally in high doses. The cephalosporins should be considered as alternative drugs for penicillin-allergic patients. Clindamycin and chloramphenicol are also effective. Tetracyclines cannot be depended upon in clostridial infections without in vitro testing, which is impracticable for initial empirical therapy.

Susceptibility of Propionibacterium acnes to seventeen antibiotics

The in vitro susceptibility of 96 isolates of Propionibacterium acnes to 17 antibiotics was determined by utilizing an agar dilution technique. With the exception of the aminoglycosides, these organisms are susceptible to virtually all of the commonly used antimicrobial agents.

Limulus amebocyte lysate test in neonates

The limulus amebocyte lysate test for endotoxin was done on samples of blood from 22 well babies and 33 neonates in an intensive-care nursery. The objective was to determine whether falsely positive test results occurred in samples from newborn infants during acquisition of usual bowel flora. One neonate had a transiently positive limulus amebocyte lysate test; he had clinical signs of spesis, but no bacteremia could be documented. Unlike the nitroblue tetrazolium test, the limulus amebocyte lysate test does not appear to be regularly positive in neonates. The sensitivity of the test in detection of endotoxemia associated with gram-negative spesis in the neonate remains to be determined in a large prospective study.

Human oral defenses against gram-negative rods

Gram-negative rods are unusual pharyngeal isolates in normal man, which suggests the presence of effective oral defense mechanisms against these organisms. To understand this protection better, we studied the elimination of gram-negative rods from the mouth after gargle challenge. Suspensions of Escherichia coli, Klebsiella pneumoniae, and Proteus mirabilis (108 organisms per ml) were gargled by normal volunteers, and pharyngeal swabs for serial quantitative cultures were taken for 3 hours. Initial swabs yielded approximately 10(5) organisms. Bacterial counts rapidly decreased, and less than 1 per cent of the original inoculum was still recoverable 3 hours later. Studies of tongue, pharynx, and buccal mucosa samples showed the most rapid decrease in buccal mucosa samples and the slowest decrease in tongue swabs. To evaluate physical clearance, gargle challenges were performed using E. coli radiolabeled with technetium-99m. External counts of the oral cavity decreased rapidly, with 21.8, 14.7, 8.9, and 7.8 percent of the initial counts remaining at 30, 60, 120, and 180 min, respectively. Nonpiliated E. coli adhered poorly to buccal epithelial cells in vitro, in contrast to good adherence when piliated strains were tested. Despite these findings, no differences in radiolabel clearance was noted in vivo using piliated and nonpiliated E. coli for gargle challenges. Normal oral defenses against gram-negative rods are highly effective and seem to involve both physical clearance and local bactericidal activity.

Chloroplast genes in Chlamydomonas affecting organelle ribosomes. Genetic and biochemical analysis of analysis of antibiotic-resistant mutants at several gene loci

Six chloroplast gene mutants of Chlamydomonas reinhardtii resistant to spectinomycin, erythromycin, or streptomycin have been assessed for antibiotic resistance of their chloroplast ribosomes. Four of these mutations clearly confer high levels of antibiotic resistance on the chloroplast ribosomes both in vivo. Although one mutant resistant to streptomycin and one resistant to spectinomycin have chloroplast ribosomes as sensitive to antibiotics as those of wild type in vivo, these mutations can be shown to alter the wildtype sensitivity of chloroplast ribosomes in polynucleotide-directed amino acid incorporation in vitro. Genetic analysis of these six chloroplast mutants and three similar mutants (Sager, 1972), two of which have been shown to affect chloroplast ribosomes (Mets and Bogorad, 1972; Schlanger and Sager, 1974), indicates that in Chlamydomonas at least three chloroplast gene loci can affect streptomycin resistance of chloroplast ribosomes and that two can affect erythromycin resistance. The three spectinomycin-resistant mutants examined appear to be alleles at a single chloroplast gene locus, but may represent mutations at two different sites within the same gene. Unlike wild type, the streptomycin and spectinomycin resistant mutants which have chloroplast ribosomes sensitive to antibiotics in vivo, grow well in the presence of antibiotic by respiring exogenously supplied acetate as a carbon source, and have normal levels of cytochrome oxidase activity and cyanide-sensitive respiration. We conclude that mitochondrial protein synthesis in these mutants is resistant to these antibiotics, whereas in wild type it is sensitive. To explain the behavior of these two chloroplast gene mutants as well as other one-step mutants which are resistant both photosynthetically and when respiring acetate in the dark, we have postulated that a mutation in a single chloroplast gene may result in alteration of both chloroplast and mitochondrial ribosomes. Mitochondrial resistance would appear to be the minimal necessary condition for survival of all such mutants, and antibiotic-resistant chloroplast ribosomes would be necessary for survival only under photosynthetic conditions.

Genetic control of chlorophyll biosynthesis in Chlamydomonas. Analysis of mutants at two loci mediating the conversion of protoporphyrin-IX to magnesium protoporphyrin

In this report we describe two nonallelic Mendelian protoporphyrin accumulating mutants br(s)-1 and br(c)-1. Results of experiments with these mutants lead us to postulate that porphyrin biosynthesis branches into light and dark steps between protoporphyrin-IX and magnesium protoporphyrin. We hypothesize that the br(c) locus controls a dark step while the br(s) locus either controls a step in the main pathway before the branch or mediates the preparation of the magnesium ion for its insertion into protoporphyrin-IX. The br(s)-1 mutant is thought to be light sensitive because a block prior to the branch point in the porphyrin pathway prevents chlorophyll formation in either the light or the dark. The br(c)-1 mutant, which also accumulates protoporphyrin in the dark, forms chlorophyll and chloroplast lamellae when transferred to the light, showing that function of the porphyrin pathway is normal in the light.