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Biomedical subjects

I Kabir

Publications and source records attributed to I Kabir.

At least 19 recordsLinked to original sources

Sharing of virulence-associated properties at the phenotypic and genetic levels between enteropathogenic Escherichia coli and Hafnia alvei.

Seven strains of Hafnia alvei isolated from diarrhoeal stools of children resembled enteropathogenic Escherichia coli (EPEC) in that they produced attaching-effacing (AE) lesions in rabbit ileal loops and fluorescent actin staining in infected HEp-2 cells. In addition, a DNA probe from a chromosomal gene required by EPEC to produce AE lesions, hybridised to chromosomal DNA from all seven H. alvei strains. These findings indicate that there is a sharing of virulence-associated properties at the phenotypic and genetic levels by H. alvei and EPEC. H. alvei strains with these properties should be considered diarrhoeagenic.

Bacterial Adhesion

Effects of a protein-rich diet during convalescence from shigellosis on catch-up growth, serum proteins, and insulin-like growth factor-I.

Shigellosis in children can cause growth retardation, worsening of malnutrition, and hypoproteinemia. To assess the effects of ingestion of a protein-rich diet during convalescence, 22 children aged 2 to 4 y with culture-proven shigellosis were randomly assigned after 5 d of antibiotic treatment to 21-d feeding regimens of either a 150 kcal/kg/d high-protein diet with 15% of calories as protein or an isocaloric control diet with 6% of calories as protein. At the start and end of dietary treatment, weight, height, mid-arm circumference, skinfold thickness, serum protein concentrations, and serum IGF-I were measured. Means of weight gain and increases in mid-arm circumference were greater in children fed high-protein diets than those fed control diets (1.23 versus 0.76 kg; 1.40 versus 0.96 cm; p < 0.05). Mean increase in height in children fed high-protein diets (0.83 cm) was not significantly greater than with control diets (0.74 cm). Mean increases in serum concentrations of total protein, prealbumin, and retinol-binding protein were greater in the high-protein group than in controls (p < 0.05). Mean serum concentrations of IGF-I were low in both groups before treatment [4.2 +/- 2.6 nmol/L (31.9 +/- 19.6 ng/mL) in controls; 3.1 +/- 3.4 nmol/L (24.0 +/- 26.3 ng/mL) in the high-protein group] but increased more in the high-protein group [39.0 +/- 16.2 nmol/L (298 +/- 124 ng/mL)] than in the control group [16.7 +/- 9.2 nmol/L (128 +/- 70 ng/mL), p < 0.01].(ABSTRACT TRUNCATED AT 250 WORDS)

Blood Proteins

Decreased food intake in children with severe dysentery due to Shigella dysenteriae 1 infection.

Factors that affect food intake in acute shigellosis were studied in 82 children aged 24-59 months. Children were offered an energy-dense milk-cereal-oil-based diet every 2 h. Food intake was compared between children with Shigella dysenteriae 1 infection and those infected with other Shigella spp (predominantly S. flexneri). Mean energy intake in the first 48 h was 435 kJ/kg.d in children infected with S. dysenteriae 1 and 536 kJ/kg.d in children infected with other Shigella spp (P < 0.001). Febrile children ate significantly (P < 0.05) less food than afebrile ones (469 vs 517 kJ/kg.d). Food intake remained significantly (P < 0.001) less in children infected with S. dysenteriae 1 after controlling for the effect of fever. The results show that food intake is significantly reduced in dysentery due to S. dysenteriae 1 infection compared to that of other Shigella species; however, adequate calorie intake can be maintained by providing frequent energy-dense meals despite anorexia, fever, abdominal pain and diarrhoea.

Body Temperature

Campylobacter jejuni bacteraemia in children with diarrhoea in Bangladesh: report of six cases.

Campylobacter jejuni was isolated from blood cultures from 6 of 6,275 diarrhoeal children seeking treatment at the Clinical Research Centre of the International Centre for Diarrhoeal Disease Research, Bangladesh (ICDDR,B) between April 1989 and December 1990. The clinical records of these 6 children were reviewed. All children were male; 5 were less than 1-year old and were severely malnourished. Five patients presented with watery diarrhoea and one with bloody diarrhoea. Two children died in the hospital. All strains of Campylobacter isolated from the 6 children were negative for cell invasive properties as tested by the Sereny test. Of the two strains tested for serum bactericidal activity, one strain was serum sensitive (growth inhibition), and the other resistant. The ability of C. jejuni to cause bacteraemia suggests that the organisms may be responsible for diarrhoeal diseases especially in young and malnourished children. An early attempt to detect Campylobacter and start effective antimicrobial therapy is indicated.

Bacteremia

Evaluation of indigenous plants in the treatment of acute shigellosis.

The clinical efficacy of three indigenous plants was compared with that of ampicillin and placebo in a randomized double blind clinical trial. Eighty-two men with shigellosis were studied. Sixteen patients received dried unripe fruit powder of 'bel' (Aegle marmelos), 19 received dried powdered plant of 'thankuni' (Hydrocotyle asiatica), 15 received a similar preparation of 'gandhavadulia' (Paederia foetida), 15 received ampicillin and 17 received a placebo. Treatment with indigenous plants did not show any clinical improvement or bacteriological cure as compared to ampicillin. The natural history of shigellosis was obtained by documenting the response of the indigenous plants and placebo treated groups.

Adolescent

Bacterial overgrowth by indigenous microflora in the phytohemagglutinin-fed rat.

Phytohemagglutinin lectin (PHA) derived from red kidney bean (Phaseolus vulgaris) causes bacterial and protozoal colonization of the rat small intestine. To provide additional insights into this phenomenon we have studied the time course and population dynamics of microbial colonization of the major aerobe--facultative anaerobe groups which characterize this microflora. Compared with controls, PHA caused proliferation of a consistent adherent microbial flora in the jejunum (P less than 0.01). The predominant bacteria identified were Escherichia coli. a Streptococcal sp., and Lactobacillus. Escherichia coli isolates expressed no predominant serotype or fimbriae; none elaborated heat-labile or heat-stable toxin. Both E. coli and Streptococcal sp. populations increased within 24 h of PHA feeding and were sustained during further exposure to PHA (P less than 0.05). On reversion to a control diet, coliform counts fell progressively within 24-48 h and continued to decline, whereas gram-positive rod and coccus flora became the more prominent colonizers through days 1 to 4 of the reversion.

Animals

Differential clinical features and stool findings in shigellosis and amoebic dysentery.

To obtain information that could assist the clinician to differentiate between shigellosis and amoebic dysentery, we compared clinical features and stool findings in 58 adult male patients in Bangladesh. Mean values indicated that patients with invasive amoebiasis were older and had a longer prehospital illness, a lower body weight, less frequent fever, a lower haematocrit and a higher white blood cell count than patients with shigellosis. The mean number of faecal leucocytes per mm3 was significantly higher in shigellosis than in amoebiasis (28,700 vs 10,300) and correlated with the estimated number of faecal leucocytes per microscopic high power field in a wet mount preparation. Patients with shigellosis more often had over 50 white blood cells per high power field. Although the mean stool pH in amoebiasis was lower than in shigellosis (6.26 vs 6.60), the difference was not statistically significant. Concentrations of stool electrolytes did not differ between the two diseases. These findings indicate that age, duration of illness, the presence of fever and the number of faecal leucocytes may help to differentiate between shigellosis and amoebic dysentery.

Adult

Colonic dysfunction during cholera infection.

To study the function of the colon in cholera, 12 patients with acute cholera diarrhea were subjected to measurements of ileocecal flow rates, fecal flow rates, and ionic compositions of stool and ileocecal fluid. Subtraction of fecal flow rates from ileocecal flow rates was taken as a measure of net fluid absorption by the colon. Additionally, these patients underwent colonoscopic perfusion of the colon that measured net colonic absorption rates of water and ions. The mean ileocecal flow rate was 7.9 ml/min compared with a mean fecal flow rate of 7.6 ml/min, indicating a small mean net fluid absorption by the colon of +0.30 ml/min. By colonoscopic perfusion, 6 patients showed net colonic absorption of water and 6 patients net secretion of water with a slight mean net fluid secretion of -0.03 ml/min. The handling of ions by the colon showed mean net absorption of sodium (100 mu Eq/min) and chloride (127 mu Eq/min), and net secretions of potassium (-42 mu Eq/min) and bicarbonate (-112 mu Eq/min). During convalescence, 5 patients who were studied again all showed net colonic absorption of water, and the handling of potassium changed significantly from net secretion in acute disease to net absorption (p less than 0.05). These results showed that the colon contributes to the clinical expression of cholera by failing to absorb water normally, and by secreting potassium at high rates.

Adult

Colonic dysfunction during shigellosis.

To study the pathogenesis of shigella diarrhea, we evaluated 11 patients for colonic fluid and electrolyte flux. Methods used were subtraction of the fecal flow rate from the ileocecal flow rate and colonoscopic perfusion of the colon. The mean ileocecal flow rate was 0.57 ml/min compared with a mean fecal flow rate of 0.48 ml/min, and the mean of the differences showed a slight net colonic water absorption of +0.09 ml/min. With use of perfusion, these patients showed an overall mean of slight net fluid secretion by the colon of -0.04 ml/min. Seven patients restudied during convalescence showed a mean net rate of colonic water absorption of +0.65 ml/min, which was significantly greater than in the acute phase (P less than .05), and a mean ileocecal flow rate of 0.56 ml/min. Ion transport by the colon during acute shigellosis showed net secretion of K+, which changed to net absorption in convalescence (P less than .05), and a decreased absorption of Cl-, which improved in convalescence (P less than .05). Patients with extensive colitis showed more impairment of net water absorption by the colon than did patients with colitis limited to the rectosigmoid colon. These findings demonstrate that shigella diarrhea results from colonic dysfunction, without evidence of increased small intestinal flow rate, and this colonic dysfunction consists of diminished net absorption of water and Cl- and increased secretion of K+.

Adolescent

Comparative efficacies of single intravenous doses of ceftriaxone and ampicillin for shigellosis in a placebo-controlled trial.

To evaluate ceftriaxone for the treatment of shigellosis, 94 adult males with acute dysentery were randomly assigned to receive ceftriaxone (1 g), ampicillin (4 g), or saline placebo intravenously in single doses in a double-blind design. Stool cultures were positive for Shigella dysenteriae in 52 patients, S. flexneri in 38 patients, and other species in 4 patients. Both ceftriaxone and ampicillin caused reductions in the mean duration of fever and the means of daily stool frequency 2 to 4 days after therapy versus placebo (P less than 0.05). The ability of ceftriaxone to reduce stool frequency during 6 days after treatment was significant in patients with S. flexneri infections (P less than 0.05), whereas S. dysenteriae infections were relatively refractory to improvement by both antibiotics. Neither drug had a significant effect on overall duration of diarrhea, blood in stool, or tenesmus. Ampicillin reduced the mean duration of positive stool cultures after treatment from 2.6 days in the placebo group to 1.1 days (P less than 0.05), whereas ceftriaxone did not affect the duration of Shigella sp. excretion. These results indicate that single intravenous doses of ceftriaxone and ampicillin caused some clinical improvement in acute shigellosis but only ampicillin exerted a bacteriological effect on Shigella sp. excretion.

Ampicillin

The treatment of Fasciolopsis buski infection in children: a comparison of thiabendazole, mebendazole, levamisole, pyrantel pamoate, hexylresorcinol and tetrachloroethylene.

Four relatively new broad spectrum anthelmintics (thiabendazole, mebendazole, levamisole and pyrantel pamoate) were compared with two older anthelmintics, (tetrachloroethylene and hexylresorcinol) to treat heavy Fasciolopis buski infections in 17 children aged 4-13 years in hospital. Tetrachloroethylene was the most effective drug in these 17 children and another 49. Large numbers of worms were expelled and faecal egg counts were markedly reduced (99%). The mean number of worms per child was 122 with a range of 7 to 818. All the other anthelmintics tested were ineffective; no worms or only a few were expelled after treatment. However, the oral administration of tetrachloroethylene and hexylresorcinol were associated with severe anaphylactic reactions which were prevented by prior treatment with antihistamines.

Adolescent

Shigella septicemia: prevalence, presentation, risk factors, and outcome.

The prevalence, presentation, and outcome of bacteremia due to Shigella and other gram-negative bacteria were determined by review of records of 2,018 inpatients with shigellosis who had their blood cultured in a Bangladeshi hospital in 1976-1983. Shigella bacteremia occurred in 82 (4.1%) patients; other bacteremia occurred in 102 (5.1%) patients. Patients with shigella sepsis more frequently (P less than .02) manifested severe dehydration, abdominal tenderness or ileus, agitation or lethargy, and leukocytosis than did nonbacteremic controls; they developed more frequently (P less than .05) renal failure (26%), leukemoid reaction (22%), thrombocytopenia (20%), and hemolytic-uremic syndrome (6%). The prevalence of all bacteremia was highest in the first year of life. Protein-energy malnutrition was a strong risk factor for shigella sepsis (P less than .01). The fatality rate in shigella bacteremia (21%) was higher (P less than .005) than in nonbacteremic shigellosis (10%) but lower (P less than .001) than in other bacteremia (51%). At highest risk of death from shigella bacteremia (P less than .01) were patients less than one year old, non-breast-fed, malnourished, and afebrile.

Adolescent