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A van der Ende

Publications and source records attributed to A van der Ende.

At least 37 records · Page 2Linked to original sources

Regulation of the HpyII restriction-modification system of Helicobacter pylori by gene deletion and horizontal reconstitution.

Helicobacter pylori, Gram-negative, curved bacteria colonizing the human stomach, possess strain-specific complements of functional restriction-modification (R-M) systems. Restriction-modification systems have been identified in most bacterial species studied and are believed to have evolved to protect the host genome from invasion by foreign DNA. The large number of R-Ms homologous to those in other bacterial species and their strain-specificity suggest that H. pylori may have horizontally acquired these genes. A type IIs restriction-modification system, hpyIIRM, was active in two out of the six H. pylori strains studied. We demonstrate now that in most strains lacking M.HpyII function, there is complete absence of the R-M system. Direct DNA repeats of 80 bp flanking the hpyIIRM system allow its deletion, resulting in an "empty-site" genotype. We show that strains possessing this empty-site genotype and strains with a full but inactive hpyIIRM can reacquire the hpyIIRM cassette and functional activity through natural transformation by DNA from the parental R-M+ strain. Identical isolates divergent for the presence of an active HpyII R-M pose different restriction barriers to transformation by foreign DNA. That H. pylori can lose HpyII R-M function through deletion or mutation, and can horizontally reacquire the hpyIIRM cassette, is, in composite, a novel mechanism for R-M regulation, supporting the general hypothesis that H. pylori populations use mutation and transformation to regulate gene function.

Base Sequence↗

Suppression of Helicobacter pylori infection during intensive care stay: related to stress ulcer bleeding incidence?

PURPOSE: To assess the prevalence of active Helicobacter pylori infection in patients admitted to the intensive care unit, to determine the effect of selective gut decontamination on the persistence of this organism, and to explore the possible relationship between H. pylori infection and stress ulcer bleeding incidence. MATERIALS AND METHODS: We determined in a prospective observational study of 300 consecutive, mechanically ventilated patients the activity of H. pylori infection and the incidence of stress ulcer-related upper gastrointestinal bleeding over time. H. pylori infection was detected by Laser-Assisted Ratio Analyzer (LARA)- (13)C-urea breath test (Alimenterics, Inc., NJ) and serology. Stress ulcer prophylaxis was not prescribed. Endoscopy was performed in cases of upper gastrointestinal bleeding. RESULTS: The prevalence of active H. pylori infection on admission was 38% as detected by urea breath test, and declined to 8% on the third day, and to 0% on the seventh day after admission as a result of antibiotic treatment. Stress ulcer-related upper gastrointestinal bleeding occurred in 1.0% (3 of 300) of the patients; none were infected with H. pylori on admission or at the time of bleeding. CONCLUSIONS: H. pylori infection monitored by LARA- (13)C-urea breath test was rapidly suppressed during intensive care treatment, which can be explained by the routine use of antibiotics for gut decontamination.The low incidence of stress ulcer-related bleeding might be related to the prevention of H. pylori-associated stress lesions by effective suppression of this microorganism, but further studies are warranted to test this hypothesis.

Breath Tests↗

Gut decontamination of critically ill patients reduces Helicobacter pylori acquisition by intensive care nurses.

The prevalence of Helicobacter pylori is increased in healthcare workers and in intensive care nurses. Exposure to H. pylori from gastric secretions and faeces are probably the main sources of transmission to healthcare workers. Routine use of selective decontamination of digestive tract (SDD) in an intensive care unit suppresses H. pylori in critically ill patients. It was questioned whether this suppression and the subsequent decreased exposure to H. pylori for intensive care nurses would lead to a lower prevalence of H. pylori infection. Helicobacter pylori infection prevalence in intensive care nurses from a unit routinely using SDD (group I) was compared to that of nurses from a unit not using SDD (group II). Heathcare workers from other departments of the hospital where no SDD was used (group III) served as a control group. Persons using proton pump inhibitors were excluded. Helicobacter pylori was detected by Laser Assisted Ratio Analyser(13)C-urea breath test (UBT) and serology. This could not be performed in three out of 64 in group I, five out of 55 in group II and five out of 55 in group III (total UBTs = 169). The prevalence of H. pylori infection was 11% (7/61) in group I and 25.5% (14/50) in group II (P= 0.027). In group III, the prevalence of H. pylori infection was 16% (8/45), which was not significantly different from both group I and II. Sero-prevalence in group I was 18.6%, 27% in group II (ns) and 24% in group III. Mean age in the three groups was 35.9, 37.8 and 36.6 years, respectively (ns). In conclusion, the prevalence of H. pylori infection among intensive care nurses is lower in nurses from a unit using SDD compared to a non SDD-using unit. Acquisition of H. pylori by transmission from critically ill patients appears to be diminished through SDD use.

Adult↗

Helicobacter pylori Stool Antigen test: a reliable non-invasive test for the diagnosis of Helicobacter pylori infection in children.

OBJECTIVE: To evaluate the Helicobacter pylori Stool Antigen (HpSA) test for the diagnosis of H. pylori infection in children. DESIGN AND SETTING: Prospective cohort study in an academic medical centre. PATIENTS AND METHODS: A total of 106 consecutive children who underwent gastroscopy were included. Biopsy specimens were sampled from the gastric antrum and corpus for the assessment of H. pylori infection by culture and histology. A patient was defined to be H. pylori positive if the results of culture and/or histology proved to be H. pylori positive; a patient was defined to be negative if both test results were negative. All children provided a stool sample within 2 days of gastroscopy. H. pylori antigens in faeces were assessed by an enzyme immunoassay (Premier HpSA, Meridian Diagnostics, Inc., Cincinnati, OH, USA). RESULTS: The mean age of included patients was 8.5 years (range 1-18.5). Thirty patients were H. pylori positive and 76 patients were H. pylori negative. Using the recommended cut-off values of 0.140 optical density (OD) and 0.159 OD, sensitivity and specificity of 100% and 92% were found. The positive and negative predicting values were 83% (30/36) and 100% (70/70), respectively. CONCLUSION: The HpSA test is an accurate test for the diagnosis of H. pylori infection in children, and might therefore be a good alternative for diagnostic tests such as the 13C-urea breath test (UBT).

Antigens, Bacterial↗

In vivo expression of Neisseria meningitidis proteins homologous to the Haemophilus influenzae Hap and Hia autotransporters.

The genome sequences of Neisseria meningitidis serogroup B strain MC58 and serogroup A strain Z2491 were systematically searched for open reading frames (ORFs) encoding autotransporters. Eight ORFs were identified, six of which were present in both genomes, whereas two were specific for MC58. Among the identified ORFs was the gene encoding the known autotransporter IgA1 protease. The deduced amino acid sequences of the other identified ORFs were homologous to known autotransporters and found to contain an N-terminal signal sequence and a C-terminal domain that could constitute a beta-barrel in the outer membrane. The ORFs NMB1985 and NMB0992, encoding homologs of the Hap (for Haemophilus adhesion and penetration protein) and Hia (for Haemophilus influenzae adherence protein) autotransporters of H. influenzae, were cloned from serogroup B strain H44/76 and expressed in Escherichia coli. Western blots revealed that all sera of patients (n=14) and healthy carriers (n=3) tested contained antibodies against at least one of the recombinant proteins. These results indicate that both genes are widely distributed among N. meningitidis isolates and expressed during colonization and infection.

Adhesins, Bacterial↗

NmeSI restriction-modification system identified by representational difference analysis of a hypervirulent Neisseria meningitidis strain.

Neisseria meningitidis is a gram-negative bacterium that may cause meningitis, sepsis, or both. The increase in the incidence of meningococcal disease in various countries in the past 2 decades is mainly due the genotypically related lineage III meningococci. The chromosomal DNA differences between lineage III strains and non-lineage III strains were identified using representational difference analysis. Thus, a 1.8-kb locus that is specific for lineage III meningococci was identified. The locus contains three open reading frames encoding the NmeSI restriction-modification system. The methyltransferase gene was cloned and expressed in Escherichia coli. Site AGTACT was found to be modified by the enzyme. In conclusion, lineage III strains differ from endemic strains by the presence of a specific restriction-modification system. This restriction-modification system may contribute to the clonal and hypervirulent character of lineage III strains by influencing horizontal gene transfer and transcription.

Amino Acid Sequence↗

Normal IncA expression and fusogenicity of inclusions in Chlamydia trachomatis isolates with the incA I47T mutation.

To investigate the correlation between the incA I47T mutation in Chlamydia trachomatis and the nonfusogenic phenotype, the incA genes of 25 isolates were sequenced. Four major sequence types were identified. Seven isolates (28%) had the I47T mutation. Isolates representing the four sequence types expressed IncA in the membrane of one large single inclusion. In conclusion, the incA I47T mutation is not associated with the nonfusogenic phenotype.

Amino Acid Sequence↗

The susceptibility of Mycobacterium tuberculosis to isoniazid and the Arg-->Leu mutation at codon 463 of katG are not associated.

A mutation (CCG-->CTG [Arg-->Leu]) in codon 463 of katG (catalase peroxidase) of Mycobacterium tuberculosis has been found in isoniazid (INH)-resistant strains. A PCR restriction endonuclease analysis to detect this mutation was applied to 395 M. tuberculosis isolates from patients in The Netherlands. The proportion of isolates with a detectable mutation was 32% (32 out of 100) and 29% (85 out of 295) among INH-susceptible isolates and INH-resistant or -intermediate isolates, respectively. Sequencing of five INH-susceptible isolates with such mutations showed that all five had the Arg463Leu mutation. We conclude that the Arg463Leu mutation of katG of M. tuberculosis is not a reliable indicator of INH resistance.

Antitubercular Agents↗

Clarithromycin-susceptible and -resistant Helicobacter pylori isolates with identical randomly amplified polymorphic DNA-PCR genotypes cultured from single gastric biopsy specimens prior to antibiotic therapy.

Of the Helicobacter pylori populations from 976 patients, six contained clarithromycin-resistant as well as -susceptible colonies. In each heterogeneous H. pylori population, resistant H. pylori colonies harbored identical 23S ribosomal DNA (rDNA) mutations associated with clarithromycin resistance, while the susceptible H. pylori colonies all had wild-type 23S rDNA. The resistant and susceptible colonies of each of the heterogeneous H. pylori populations had identical randomly amplified polymorphic DNA-PCR genotypes. In conclusion, evaluation of antimicrobial susceptibility can be misinterpreted if only a single colony from the primary H. pylori population is used to test for clarithromycin susceptibility.

Anti-Bacterial Agents↗

Representational difference analysis of Neisseria meningitidis identifies sequences that are specific for the hyper-virulent lineage III clone.

Neisseria meningitidis may cause meningitis and septicemia. Since the early 1980s, an increased incidence of meningococcal disease has been caused by the lineage III clone in many countries in Europe and in New Zealand. We hypothesized that lineage III meningococci have specific DNA sequences, providing an opportunity to facilitate epidemiological studies by detecting lineage III isolates rapidly. Applying representational difference analysis on one lineage III tester strain and two non-lineage III driver strains, we identified three lineage III-specific sequences, probably part of a single locus encoding a restriction modification system. A PCR based on one of these sequences identified lineage III meningococcal isolates with a sensitivity of 100% and a specificity of 93%, which is superior to the serological identification of lineage III isolates.

Blotting, Southern↗

In vitro susceptibility of Helicobacter pylori to, and in vivo suppression by, antimicrobials used in selective decontamination of the digestive tract.

The incidence of bleeding related to stress ulcers is reduced in critically ill patients in whom gut decontamination has been performed; this may be a result of suppression of Helicobacter pylori infection. We determined the susceptibility of H. pylori to the applied antibiotics. In nine of 10 critically ill patients (using intravenous cefotaxime and topical polymyxin, tobramycin and amphotericin B (PTA) given by nasogastric tube) and all six volunteers (using PTA alone), H. pylori was suppressed as long as the topical antibiotics were ingested. The in vitro studies revealed that all strains were susceptible to cefotaxime and tobramycin. The strains were not susceptible to polymyxin or amphotericin B.

Administration, Topical↗

Epidemiology of meningitis and bacteraemia due to Streptococcus pneumoniae in The Netherlands.

In The Netherlands, accurate data on the epidemiology of pneumococcal meningitis are available through a clinical microbiology laboratory-based national surveillance of cerebrospinal fluid isolates. The Netherlands Reference Laboratory for Bacterial Meningitis receives isolates of about 80% of all meningitis cases and about 40% of bacteraemic cases. The incidence of pneumococcal meningitis has increased slowly from 1.0/100,000 in 1990 to 1.5/100,000 since 1996. The highest age-specific incidence of meningitis was observed in children < 5 y of age (8.2/100,000 in 1999). Of all isolates, 35% were from children < 5 y of age. The number of isolates from non-meningitis patients with bacteraemia increased considerably since the early 1990s, especially among the elderly. The highest incidence was found in 1996, probably owing to a relatively severe winter. During 1995-1999, pneumococcal meningitis in The Netherlands was caused mainly by serotypes 3, 6B, 7F, 9V, 14, 18C, 19F, and 23F. Of the cases in children < 15 y, almost half were caused by serotypes 6B, 14, 18C, and 19F. The serotypes present in the 23-valent polysaccharide and 7-valent conjugate vaccines accounted for 87% and 47% of all meningitis cases, respectively. Pneumococcal resistance to penicillin in The Netherlands is still low, at about 1%. Genotypically, resistant strains belong to many clones. Horizontal transfer of capsular genes occurs among these isolates. In The Netherlands, 45% of cases of pneumococcal meningitis have severe predisposing factors. The case-fatality rate was significantly higher among patients with impaired immunity than among those with a break in the integrity of the dura.

Adolescent↗

Multiple mechanisms of phase variation of PorA in Neisseria meningitidis.

Previously, we reported that PorA expression in Neisseria meningitidis is modulated by variation in the length of the homopolymeric tract of guanidine residues between the -35 and -10 regions of the promoter or by deletion of porA. To reveal additional mechanisms of variation in PorA expression, the meningococcal isolates from 41 patients and 19 carriers were studied. In addition, at least 3 meningococcal isolates from different body parts of each of 11 patients were analyzed. Sequence analysis of the porA promoter showed that the spacer between the -35 and -10 regions varies in length between 14 and 24 bp. PorA expression was observed in strains with a porA promoter spacer of 16 to 24 bp. All but one strain with a porA promoter spacer of 16 to 20 bp and undetectable PorA expression have a homopolymeric tract of 8 or 6 instead of 7 adenine residues in the porA coding region. The other PorA-negative strain had a single-base-pair deletion in the coding region. The highest level of PorA expression was observed in strains with a promoter spacer of 17 or 18 bp. PorA expression was reduced twofold in strains with a porA promoter spacer of 16 or 19 bp. Strains with a 16-bp promoter spacer with substitutions in the polyguanidine tract displayed increased levels of PorA expression compared to strains with a homopolymeric tract of guanidine residues in the porA promoter. In conclusion, meningococci display multiple mechanisms for varying PorA expression.

Base Sequence↗

PCR assessment of Chlamydia trachomatis infection of semen specimens processed for artificial insemination.

In order to ascertain the microbiological quality of stored semen specimens processed for artificial insemination by a donor (AID), we developed a PCR assay targeting the chlamydial plasmid to detect Chlamydia trachomatis in semen. The lower limit of detection of this assay corresponded to 2.5 to 5 elementary bodies per microl of semen. A total of 669 cryopreserved ejaculates from 97 asymptomatic donors were tested for C. trachomatis infection. Twelve ejaculates, originating from four donors, were found to be positive, indicating a 4% prevalence of C. trachomatis infection among the donor population studied. Cross-contamination between the cryopreserved specimens in the storage container was studied by typing using sequence analysis of PCR-amplified omp1 genes of the strains. Two donors were infected with serovar E, one was infected with serovar F, and one was infected with serovar K. For two donors, the duration of C. trachomatis positivity could be assessed. One donor donated C. trachomatis-positive semen for at least 4 successive months, and the other did so for at least 16 months. The occurrence of C. trachomatis infection in cryopreserved donor semen indicates that ejaculates from donors not tested for a C. trachomatis infection just prior to donation should be tested for infection by a direct test such as the PCR described here. Direct testing of semen specimens will detect not only donors with an active infection but also C. trachomatis-infected ejaculates already stored and will thus improve the microbiological quality of AID, since discrepancies in the presence of C. trachomatis in urine and semen specimens have been reported.

Bacterial Outer Membrane Proteins↗

[Pathophysiology of Helicobacter pylori infections].

Helicobacter pylori is the causative factor of chronic gastritis and ulcers of duodenum and stomach and relates to mucosa-associated lymphoid tissue (MALT) lymphomas. Host factors, bacterial factors and dietary habits conceivably play a part in the more severe mucosal lesions induced by H. pylori. H. pylori is a heterogeneous bacterial species, the various types differing in possession of a locus with genes coding for products that may intensify the inflammatory reaction. The cytotoxin-associated gene (cagA) protein is a marker for this locus; this protein and the vacuolating-associated cytotoxin A are clearly related to the ulcerative disease. Patients may be colonized by a mixed population of H. pylori consisting of cagA-positive and cagA-negative H. pylori. Also, a patient may be infected by a mixed population of H. pylori sensitive and resistant to metronidazole. Accordingly, a substantial part of the H. pylori population in a patient should be examined to arrive at an adequate conclusion concerning the production of H. pylori factors that may relate to a particular clinical picture and to the sensitivity to antibiotics of the H. pylori.

Duodenal Ulcer↗

[Treatment of Helicobacter pylori infections].

H. pylori infection is a very common infection of the human stomach, related to various diseases such as gastritis, ulcerative disease of the duodenum and stomach, mucosa associated lymphoid tissue lymphomas and gastric cancer. It is generally accepted that the majority of related diseases is curable once H. pylori infection is successfully eradicated. H. pylori eradication will only be achieved after administration of combination therapies including antibiotics and antacids. Resistance to metronidazole and clarithromycin is an emerging problem, leading to impairment of eradication efficacy, irrespective of the regimen administered. Eradication regimens consisting of three or four anti-H. pylori drugs are the most efficacious. Given the easy use and high convenience to the patients and the high efficacy, 1-week proton pump inhibitor (PPI)-triple therapy is preferred as the first-line therapy. Alternatively, bismuth triple therapy or the combination of antacids and bismuth triple therapy can be prescribed; however, these regimens are less convenient to the patients, the course is prolonged or the side effects occur more frequently compared with PPI-triple therapy.

Clarithromycin↗

[Laser-assisted 13C-urea breath test; a new noninvasive detection method for Helicobacter pylori infection].

OBJECTIVE: To assess the laser assisted ratio analyser (LARA) system for detection of Helicobacter pylori infection in breath samples. DESIGN: Descriptive. METHOD: Diagnostic gastroscopy with biopsies for histopathology and culture was performed in consecutive dyspeptic patients in the Department of Gastroenterology of the Academic Medical Centre of Amsterdam in January-May 1996. Subsequently, a LARA test was carried out, which measures the degradation by H. pylori of 13C urea using the ratio of 12CO2/13CO2 in the exhaled air. The combination of the results of the examination of gastric biopsies was regarded as the golden standard for the demonstration of H. pylori infection. After this comparison, the cut-off level above which the LARA system demonstrated H. pylori infection was established in the basis of a receiver operator characteristics (ROC) analysis. An area was defined round this value within which the results were inconclusive and outside of which the reliability increased. RESULTS: 208 patients were included in the study; the data of nine of them could not be analysed (CO2 level in the exhaled air too low: 8; withdrawal: 1). The remaining 199 patients were 105 males and 94 females with a mean age of 48 years (range 19-75). Ninety-three of them (47%) were H. pylori positive according to the golden standard. With the breath analysis infection was detected in 86 of them, while in 97 patients breath analysis was correctly negative; it was false-negative in four, false-positive in three and unreliable in nine patients. The sensitivity was 96%, the specificity 97%. The positive and negative predictive values were 97% and 96%, respectively.

Adult↗