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Biomedical subjects

B Kaijser

Publications and source records attributed to B Kaijser.

At least 19 recordsLinked to original sources

Antimicrobial susceptibilities of Campylobacter jejuni and Campylobacter coli isolated in Sweden: a 10-year follow-up report.

Resistance to erythromycin and doxycycline and more recently to fluoroquinolones has been reported to occur in Campylobacter spp. both in vitro and in patients treated with these antibiotics. The frequency of resistance to 14 antimicrobial agents in Campylobacter jejuni and Campylobacter coli isolated from patients infected in Sweden or abroad is described. For some agents, a comparison of susceptibility in strains of Campylobacter spp. isolated in 1978 with those isolated in 1988 is made. No general increase in in vitro resistance to antibiotics commonly used for the treatment of human gastroenteritis caused by C. jejuni or C. coli has occurred during the last 10 years in Sweden, which might be a consequence of strict antibiotic control. The numbers of strains from 1988 to 1989 resistant to ciprofloxacin and to norfloxacin included in this study (0.7 and 1.4%, respectively) are still fewer than those that were resistant to erythromycin (7.3%) or doxycycline (12.4%). There is, however, since 1989 to 1990 an indication of increasing resistance to these antibiotics.

Anti-Bacterial Agents

Rapid emergence of quinolone resistance in Campylobacter jejuni in patients treated with norfloxacin.

15/60 subjects from one center, who all took part in a multicenter double-blind, placebo-controlled study to evaluate the effect of norfloxacin on acute enteritis, had norfloxacin sensitive strains of Campylobacter jejuni in pre-study stool specimens. Eight of the 15 subjects received active drug. In 3 of these 8, high-level quinolone resistant Campylobacter strains of the same serotype as in pre-treatment samples were isolated 4-90 days after the initiation of treatment.

Adult

Diagnosis of Lyme borreliosis by an enzyme immunoassay detecting immunoglobulin G reactive to purified Borrelia burgdorferi cell components.

An enzyme immunoassay (EIA) developed for the diagnosis of Lyme borreliosis was tested for its specificity and sensitivity in detecting IgG antibodies in patients at various stages of the disease. The EIA is based on a detergent extract of Borrelia burgdorferi which contains 12 proteins of defined molecular weights from Borrelia burgdorferi. The assay showed a specificity of 100% in control sera from 64 healthy individuals, using a cut-off optical density value of 0.13 (means +2- 3 SD). The sensitivity was 100% using sera from 22 Swedish patients with late stage Lyme borreliosis and 43% using sera from 30 patients with the initial stage of the disease. The reactivity of the sera against whole cell preparations, the outer surface proteins OspA and OspB, and the flagella of Borrelia burgdorferi was also tested and compared with the EIA. No cross-reactivity with treponemal antigens was observed when using the EIA.

Antibodies, Bacterial

Characterization of Escherichia coli isolated in blood, urine and faeces from bacteraemic patients and possible spread of infection.

Blood, faecal and urine isolates from patients with culture-verified E. coli bacteraemia were investigated with respect to biochemical phenotype, O and K serotype and P. fimbriae. In 10/16 bacteraemic episodes, the blood isolates were identical to the corresponding faecal strains. In four of the remaining infections, antimicrobial therapy was initiated more than two days before faecal samples were taken. Urine cultures revealed growth of E. coli in 12/16 samples. However, only three had clinical signs of symptomatic urinary tract infections. Eight of these E. coli were saved. Further analysis revealed that five of eight strains were identical to the corresponding isolates from blood and stool samples, two were only identical to the faecal strain, while one was different to the corresponding E. coli in the blood and stool samples. The isolated E. coli strains belonged to varying and, among previously healthy persons, normally less common serotypes. No epidemiological relationship was observed between the studied strains. The high incidence of identical strains in the blood, stool and urine indicates a bacterial spread from the faecal flora directly to the urine and possibly also, via the blood, to the urine.

Bacteriuria

Enterotoxigenicity and frequency of Campylobacter jejuni, C. coli and C. laridis in human and animal stool isolates from different countries.

Campylobacter jejuni and C. coli strains were collected during three different years from adult patients with enterocolitis in Sweden (n = 372) from 49 patients in Kuwait, and Campylobacter strains from hens from Mexico, Pakistan and Sweden (n = 107) and Swedish pigs (n = 47). C. jejuni was the predominant species in human and hen isolates, and C. coli in pigs C. coli was significantly more common in human isolates from Sweden, and more common in hen isolates from Pakistan, than in hens from Sweden and Mexico. C. laridis was only isolated from pigs (17%) and was in no case enterotoxigenic. Both in human and hen isolates, C. jejuni strains were more enterotoxigenic than C. coli strains. C. jejuni strains from Swedish hens were less enterotoxigenic than those from Pakistan and Mexico (P less than 0.001), and strains from pigs were less enterotoxigenic than those from hens (P less than 0.001). We conclude that C. jejuni are more often enterotoxigenic and possibly more virulent than c. coli and C. laridis. The relative frequency of C. jejuni and C. coli in humans and animals differs from one country to another.

Adolescent

Infection with bacterial enteropathogens in Swedish travellers to South-East Asia--a prospective study.

Infection with potential bacterial enteropathogens was studied prospectively in 94 Swedish travellers. Three faecal samples were collected, regardless of diarrhoeal symptoms, after each of three 1-week stays in Singapore, Hong Kong and Japan. The specimens were analyzed for salmonella, shigella, yersinia, campylobacter and different enterotoxin-producing bacteria. A potential enteropathogen was identified in 30% (28/94) of the participants, i.e. in 26% of the healthy and in 39% of the travellers with diarrhoea. The most common isolates were enterotoxigenic bacteria of different species (14%), salmonella (11%) and campylobacter (7%). By performing enterotoxin-tests on six different colonies from the primary culture of each specimen enterotoxigenic Escherichia coli (ETEC) as well as enterotoxin-producing Klebsiella sp., Citrobacter sp. and Morganella morganii were identified. The latter strains were as prevalent as ETEC. In the 33 participants with diarrhoea enterotoxigenic bacteria (18%) and campylobacter (18%) were the most common isolates. Campylobacter-infected travellers developed symptomatic disease (6/7) significantly (P less than 0.02) more often than those infected with salmonella (3/10) or enterotoxigenic bacteria (6/13; 2 ETEC, 4 other species).

Adult

Serum antibody responses to bacterial enteropathogens in Swedish travelers to south-east Asia.

The possibility that serological analysis may be more sensitive than bacteriological examinations of stool samples to detect enteric infections was evaluated in 80 Swedish travellers to South-East Asia. Serum and faecal specimens were collected before, during and after their travel. Serological analyses of pre-travel and any later serum specimen identified infection with enterotoxinogenic Escherichia coli (ETEC), Salmonella or Campylobacter jejuni in 28% of the travellers. The seroconversion rate was 72% in travellers excreting the homologous pathogen in their stool; all symptomatic cases and half of those who had an asymptomatic infection seroconverted. Bacteriological examinations of stool samples collected repeatedly during travel identified an enteropathogen in 20% of the travellers. However, the isolation rate decreased to 11%, when only a single routine faecal specimen was examined. Our findings suggest that serological analyses of pre- and post-travel specimens are sufficiently specific and may be at least as sensitive as conventional bacteriology to identify infections with bacterial enteropathogens in travellers. However, reliable serodiagnosis requires collection of pre-travel sera and might therefore only be useful in prospective studies of travellers' diarrhoea.

Adult

Adherence, enterotoxigenicity, invasiveness and serogroups in Campylobacter jejuni and Campylobacter coli strains from adult humans with acute enterocolitis.

Two hundred Campylobacter jejuni and Campylobacter coli strains from the same number of adult Swedish patients with acute enterocolitis were tested regarding adherence to and invasiveness in HEp-2 cells and for enterotoxigenicity by the CHO-cell assay. The serogroup characteristics, heat-stable and heat-labile, for each strain were also investigated. Eighty-four percent of the strains were classified as C. jejuni and 16 percent as C. coli. All of the strains were adherent to HEp-2 cells, 39% were invasive and 31.5% enterotoxigenic. We found significantly more invasive strains in the non-enterotoxigenic group than in the enterotoxigenic one. There would seem to be no correlation between enterotoxigenicity or invasiveness and serogroup. The results of this study suggest the existence of multiple mechanisms for C. jejuni- and C. coli-induced diarrhoea and that the mechanisms may differ from one strain to another.

Acute Disease

The serotype distribution of Campylobacter in patients with diarrhoea in Kuwait.

Fifty one strains of Campylobacter jejuni/coli isolated from patients with diarrhoea, at the Amiri Hospital, Hawally, Kuwait were classified on the basis of the heatstable-HS-antigens and the heat-labile-HL-antigens, by using 20 and 23 hyperimmune antisera for the two methods, respectively. The ages of the patient ranged from 3 months to 60 years, and 72.6% of the strains were from children less than 4 years. With the number of antisera used 78.4% of the HS antigens and 96.1% of the HL antigens could be identified. About half of the strains had one of five HS antigens (4, 8, 13, 5 or 25) and 70.5% of the strains had one of five HL antigens (1, 36, 2, 6, or 21). The study shows that the most common HS and HL antigens among Campylobacter strains from Kuwait also are the most frequent antigens of strains from other parts of the world. A limited number of antisera are sufficient to identify the majority of the strains.

Adolescent

Hearing impairment in patients with antibody production against Borrelia burgdorferi antigen.

This study aimed to evaluate the extent to which hearing disorders may be a result of tick-borne Borrelia burgdorferi infection. 98 patients with different patterns of hearing dysfunction were studied. The patients had a history of sudden hearing loss, disorders similar to Menière's disease, or hearing loss in combination with acute facial palsy or with vertigo. Serum antibodies against the B burgdorferi antigen were determined during the acute and convalescent periods. 17 patients (17%) showed serological evidence of borreliosis (reciprocal titre of 320 or above). All but 3 of these patients also had vertigo and 3 subjects had peripheral facial palsy. All the 17 patients were treated with high doses of intravenous benzylpenicillin. The hearing of 5 patients improved on treatment. Although the specificity of antibody production against borrelia antigen has not been completely clarified, it is concluded that repeated serological examinations are worthwhile in patients with unexplained hearing disorders.

Adult

Campylobacter jejuni isolations from Mexican and Swedish patients, with repeated symptomatic and/or asymptomatic diarrhoea episodes.

The presence of different Campylobacter jejuni serotypes in Swedish patients with diarrhoea and in Mexican patients with or without diarrhoea was investigated with special reference to repeated isolations during the course of infection and to symptomatic and asymptomatic episodes. The study included 136 C. jejuni isolates from 62 Mexican children and 173 isolates from 68 Swedish patients. The bacteria were serotyped for heat-stable (HS) and heat-labile (HL) antigen. Swedish patients, all with symptoms, were in general only infected with one serotype and were rarely reinfected. Mexican patients on the other hand were in general infected with mixed serotypes and frequently reinfected without symptoms with new, different serotypes, a finding which is in concordance with a theory of an induced immunity to surface antigens.

Adolescent

Serotyping studies of Campylobacter from naturally colonized chickens.

Campylobacter jejuni/coli strains from 164 chickens were serotyped by the methods previously described by Penner et al. and Lior et al. The chickens were sampled during breeding from hatching to the age of 42 weeks. The birds were housed, in two separate groups, under different environmental conditions, (for comparison of the effect of hygienic precautions on the transmission of the bacteria during breeding). In the group where the hygienic conditions could be controlled to a greater extent, the chickens became colonized later in the breeding chain and with only one single campylobacter strain. Once campylobacter appeared in the group housed at the breeding farm, the birds were colonized with heterogenous antigenic strains. All birds in this group were colonized with more than one strain. By identifying campylobacter strains from chickens during breeding, it was shown that the hygienic conditions are very important for the production of chickens free from campylobacter, or for minimizing the number of colonizing strains.

Animal Husbandry

Enterotoxin production and serogroups of Campylobacter jejuni and Campylobacter coli from patients with diarrhea and from healthy laying hens.

Enterotoxin production, a possible virulence factor, was determined in Campylobacter jejuni and Campylobacter coli by two different techniques, the CHO cell test and the GM1 enzyme-linked immunosorbent assay. The frequency of enterotoxigenic Campylobacter strains was 32% in strains from both humans with acute enteritis and healthy laying hens, as measured by the CHO cell test. The CHO cell test was significantly more sensitive than the GM1 enzyme-linked immunosorbent assay in the detection of enterotoxigenic strains. Enterotoxin production was compared with the presence of heat-stable and heat-labile antigens. There was no significant correlation between enterotoxin production and serogroups for C. jejuni or C. coli. The difference in enterotoxigenicity between C. jejuni (34.1%) and C. coli (21.9%) was not significant.

Acute Disease

Plasmids and serogroups in Campylobacter jejuni.

For epidemiological purposes identification of Campylobacter strains is usually based on surface antigen characteristics. Two different systems, one for heat-stable (HS) and one for heat-labile (HL) antigen have dominated. In earlier studies we found a great variability in the two antigen systems. The aim of the present investigation was to analyse the frequency of plasmids in Campylobacter strains in the light of their possible use as an epidemiological tool as well as the relation between the presence of plasmids and surface antigens (HS and HL). Two hundred and forty-two strains from the same number of patients with diarrhea were analysed. In 70 (28.9%) plasmid(s) were found, in general one or two. Most of the plasmids were found in the molecular weight interval between 21-40 Md. There was no relation between the presence or size of plasmids and serogroup. We conclude that plasmid determination can be used as a complement to serotyping in epidemiological studies.

Adolescent

Campylobacter strains from Swedish patients with diarrhoea. Distribution of serotypes over a five year period.

Serotyping, HS antigen and HL antigen, was performed on 105 Campylobacter jejuni/coli isolates from the same number of consequtive patients seeking medical attention for diarrhoea. The results were compared to a similar study performed five years earlier. It was found that there were only minor differences in frequency of the serotypes commonly isolated during the two different periods.

Antigens, Bacterial