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Biomedical subjects

P Panigrahi

Publications and source records attributed to P Panigrahi.

At least 19 recordsLinked to original sources

Stool microflora in extremely low birthweight infants.

AIM: To serially characterise aerobic and anaerobic stool microflora in extremely low birthweight infants and to correlate colonisation patterns with clinical risk factors. METHODS: Stool specimens from 29 infants of birthweight <1000 g were collected on days 10, 20, and 30 after birth. Quantitative aerobic and anaerobic cultures were performed. RESULTS: By day 30, predominant species were Enterococcus faecalis, Escherichia coli, Staphylococcus epidermidis, Enterbacter cloacae, Klebsiella pneumoniae, and Staphylococcus haemolyticus. Lactobacillus and Bifidobacteria spp were identified in only one infant. In breast milk fed (but not in formula fed) infants, the total number of bacterial species/stool specimen increased significantly with time (2.50 (SE 0.34) on day 10; 3.13 (0.38) on day 20; 4.27 (0.45) on day 30) as did quantitative bacterial counts; Gram negative species accounted for most of the increase. On day 30, significant inverse correlations were found between days of previous antibiotic treatment and number of bacterial species (r=0.491) and total organisms/g of stool (r=0.482). Gestational age, birthweight, maternal antibiotic or steroid treatment, prolonged rupture of the membranes, and mode of delivery did not seem to affect colonisation patterns. CONCLUSIONS: The gut of extremely low birthweight infants is colonised by a paucity of bacterial species. Breast milking and reduction of antibiotic exposure are critical to increasing fecal microbial diversity.

Anti-Bacterial Agents↗

Vibrio cholerae O1 can assume a chlorine-resistant rugose survival form that is virulent for humans.

Vibrio cholerae can shift to a "rugose" colonial morphology associated with expression of an amorphous exopolysaccharide that promotes cell aggregation. Flow cytometric studies indicated that up to 3% of particles in rugose cultures represented aggregates of >5 bacterial cells. Rugose variants of our test strains displayed resistance to killing by chlorine, with viable cells persisting for >30 min in 2 mg/L free chlorine; strains also showed resistance to killing by complement-mediated serum bactericidal activity. Six volunteers fed 10(6) cfu of a rugose variant of V. cholerae O1 El Tor Inaba N16961 developed symptoms typical of cholera, with a mean diarrheal stool volume of 2.2 L (range, 1.4-4.3). Isolates recovered from the stool of infected volunteers retained the rugose phenotype. The data suggest that rugose strains cause human disease. The role of these strains in the epidemiology of cholera remains to be determined.

Adult↗

Loss of Helicobacter pylori hemagglutination with serial laboratory passage and correlation of hemagglutination with gastric epithelial cell adherence.

Adherence of Helicobacter pylori to gastric epithelial cells is thought to be important in the pathogenesis of infection and may be essential to maintain lifelong colonization. However, the factors responsible for adherence to gastric epithelial cells in vivo have not been characterized, and the significance of adherence to standard epithelial cell lines is unclear. Hemagglutination is also thought to be important in H. pylori adherence. However, no studies have clearly linked H. pylori hemagglutination or adherence to cultured epithelial cells to primary gastric epithelial cell adherence. Furthermore, it is not clear whether laboratory strains which have undergone multiple passages lose potential colonization factors. In this study, we examined the effect of serial laboratory passage on hemagglutination and correlated the hemagglutination characteristics of H. pylori strains to primary gastric cell adherence. Variable expression of hemagglutination was seen with serial laboratory passage of 15 strains. After 100 serial laboratory passages, all strains had lost hemagglutination activity. Hemagglutination was seen in association with adherence to primary gastric cells in vitro isolated from 2 patients. An association with ultrastructural intimate adherence was seen with HEp-2 cells, but not with gastric adenocarcinoma cells. Ultrastructural adherence was seen in corresponding antral biopsies of patients whose strains were hemagglutination positive, but hemagglutination was not associated with gastric inflammation. These data indicate that H. pylori hemagglutination is lost with serial passage and that hemagglutination may play a role in the attachment of H. pylori to gastric epithelial cells, but the role of adherence to chronic gastric inflammation is unclear.

Adenocarcinoma↗

Escherichia coli transcytosis in a Caco-2 cell model: implications in neonatal necrotizing enterocolitis.

Necrotizing enterocolitis (NEC) is a serious gastrointestinal disorder of preterm infants. Other than an association with prematurity and gastrointestinal feeding, no single factor or mechanism has been consistently linked to this disease. We have previously demonstrated that Escherichia coli isolates obtained from the stool of infants with NEC caused NEC-like injury in a weanling rabbit ileal loop model; this injury, in turn, could be blocked by coinfection with selected Gram(+) bacteria (Enterococcus faecium) isolated from asymptomatic controls. Using Caco-2 cells in a trans-well system, we now demonstrate that the same E. coli isolates can cross epithelial cell monolayers in the absence of ultrastructural change or damage. These results with E. coli contrast with those seen with Salmonella typhimurium, which passed through the monolayer at a higher rate and were associated with striking ultrastructural damage. Transcytosis of E. coli was reduced 3-5-fold in the presence of E. faecium previously shown to block NEC-like injury in the loop model. There was a mild increase in the rate of E. coli transcytosis when studies were conducted with younger, undifferentiated cells; these immature cells had no brush border, had decreased production of brush border-specific enzymes, but retained well defined tight junctions, as demonstrated by transepithelial electrical resistance and electron microscopy. A further reduction/ complete blockage of E. coli transcytosis was observed when E. faecium was used as the coinfectant in studies with these undifferentiated cells. We hypothesize that the ability of E. coli to cross epithelial cell layer is a critical initial step in the cascade of events which lead ultimately to NEC; blockage or reduction in E. coli transcytosis in the presence of certain Gram(+) organisms may play a significant role in prevention of NEC.

Analysis of Variance↗

Clinical and immunologic characteristics of Vibrio cholerae O139 Bengal infection in North American volunteers.

Vibrio cholerae O139 Bengal has recently emerged as a cause of epidemic cholera in Asia. To evaluate clinical and immunologic responses to infection, V. cholerae O139 Bengal AI1837 was administered to healthy adult North American volunteers. Two of 4 persons ingesting 10(4) cfu became ill (incubation period, 48 h; mean diarrheal stool, 1873 g), as did 7 of 9 persons receiving 10(6) cfu (incubation period, 28 h; mean diarrheal stool, 4548 g). Ill volunteers did not demonstrate a vibriocidal antibody response to the challenge strain or other V. cholerae. Three months later, volunteers were rechallenged with the homologous O139 Bengal strain. Only 1 of 6 persons who had been ill on initial challenge had diarrhea, compared with 11 of 13 controls (P = .01; protective efficacy = 80%). V. cholerae O139 Bengal can cause severe diarrhea typical of cholera, with clinical characteristics and a dose-response similar to those seen with V. cholerae O1 El Tor. A moderately high level of protection against subsequent disease is provided by initial clinical infection.

Adult↗

The capsule and O antigen in Vibrio cholerae O139 Bengal are associated with a genetic region not present in Vibrio cholerae O1.

Vibrio cholerae O139 Bengal, although closely related to V. cholerae O1 El Tor, produces a polysaccharide capsule and has a distinct O antigen. We have identified a chromosomal region of at least 11 kb, as defined by three TnphoA mutations, that is required for the expression of both polysaccharides. Electron microscopy and sodium dodecyl sulfate-polyacrylamide gel electrophoresis show that these TnphoA mutants have lost the abilities both to express capsule and to produce lipopolysaccharide beyond the core oligosaccharide. Reactivity with O139 typing serum and resistance to serum are also lost in the mutants. DNA probes for this region do not hybridize with O1 V. cholerae but do react with other vibrios, implying that the region was recently acquired.

Bacterial Capsules↗

Vibrio cholerae O139 synonym bengal is closely related to Vibrio cholerae El Tor but has important differences.

Although Vibrio cholerae O139 synonym Bengal strains, from the current epidemics in India and Bangladesh, are closely related to seventh-pandemic strains, as shown by multilocus enzyme electrophoresis, Bengal strains are encapsulated and portions of the O1 antigen biosynthetic complex genes found in O1 strains are altered or lacking. Encapsulated Bengal strains showed resistance to killing by normal human serum. The presence of the capsule suggests the potential for bloodstream invasion in susceptible hosts and has profound implications for vaccine development.

Animals↗

Occurrence of necrotizing enterocolitis may be dependent on patterns of bacterial adherence and intestinal colonization: studies in Caco-2 tissue culture and weanling rabbit models.

Necrotizing enterocolitis (NEC) is one of the leading causes of death in neonatal intensive care units. The underlying pathophysiology of NEC is poorly defined, although there is a suggestion that bacterial agents play an important role in the process. In this study, we evaluated bacterial isolates from 17 NEC cases and matched asymptomatic control infants. Isolates from NEC patients were no more likely than control isolates to be adherent to enterocytes, as assessed by a Caco-2 cell tissue culture model. Adherent Escherichia coli isolates, from both NEC cases and controls, were able to cause pathologic changes typical of NEC in a weanling rabbit ileal loop model. Adherence of E. coli strains to Caco-2 cells, and subsequent production of disease in weanling rabbits, could be blocked by coinfection with Gram-positive isolates from control children. In contrast, in three of four instances, adherent E. coli from NEC cases retained their adherence and caused illness in rabbits when coinfected with Gram-positive isolates from the homologous child. Our data suggest that patterns of intestinal adherence, as influenced by the underlying intestinal microbial ecology, play a role in the pathophysiology of NEC.

Animals↗

Ribosomal RNA patterns identify additional strains of Campylobacter jejuni and C. coli among isolates serotyped by heat-stable and heat-labile antigens.

Heat-stable (HS, O-antigen) and heat-labile (HL) serotyping are the most common methods used to type Campylobacter jejuni and C. coli for epidemiologic purposes. In this study, we conducted RRNA analysis to differentiate strains of C. jejuni and C. coli that had been serotyped by use of the passive hemagglutination (heat-stable) and slide agglutination (heat-labile) methods. Ribotyping of isolates within HS and HL serotypes revealed further discrimination of strains. Four ribotypes were identified by Pvu II and Pst I digests of eight HS serotype-34 isolates. Ribotyping also differentiated strains within HL serotypes. Ribotyping also was conducted on 10 representative isolates of C. jejuni and C. coli isolated from an infant macaque. The eight ribotypes confirmed previous results of serotyping and other phenotypic analyses, which indicated that the infant was repeatedly reinfected with different strains of C. jejuni and C. coli. Results of the study indicated that ribotyping is a sensitive molecular marker for distinguishing strains of C. jejuni and C. coli. Furthermore, some isolates with similar ribotype patterns had variability in their HS and HL serotypes.

Animals↗

Endemic necrotizing enterocolitis: lack of association with a specific infectious agent.

We conducted a comprehensive analysis of bacterial, parasitic and viral agents present in stool samples of 23 necrotizing enterocolitis cases and 23 matched and 10 random controls. Enterococcus spp., Staphylococcus epidermidis, and Escherichia coli were the most common aerobic bacterial species isolated. Astrovirus was identified in a stool sample from one control. Eight infants were bacteremic; in 7 of 8 the same organism was also present in the stool. No one bacterial species or strain (as identified by plasmid profile analysis) was associated with occurrence of illness. Plasmid analysis further suggested that each infant was colonized with his or her own distinctive aerobic bacterial flora. With the exception of isolates from two control patients which hybridized with a probe for diffuse adherence, no diarrheagenic E. coli was identified. Five (45%) of 11 case infants were colonized with coagulase-negative staphylococci (all S. epidermidis) that produced delta-hemolysin in vitro, as compared with 13 (87%) of 15 control infants. Necrotizing enterocolitis was not associated with an increased ability to ferment carbohydrate, as measured by in vitro beta-galactosidase activity. Our data do not support the hypothesis that endemic necrotizing enterocolitis in our institution is caused by a single infectious agent, nor was there evidence that previously proposed virulence mechanisms such as production of delta-hemolysin or increased in vitro carbohydrate fermentation play a critical role in disease occurrence.

Bacteriological Techniques↗

Human immune response to Campylobacter jejuni proteins expressed in vivo.

Campylobacter jejuni 81-176 grown in vivo in rabbit ileal loops expresses novel proteins that are not expressed under standard laboratory culture conditions. A new protein with a molecular mass of ca. 180 kDa is expressed at 14, 24, and 48 h of infection. Three other proteins, with molecular masses of ca. 66, 43, and 35 kDa, are overexpressed during different phases of infection. Expression of these proteins stops immediately during the first passage in laboratory media, and they do not elicit a human immune response. Two other proteins, with molecular masses of ca. 84 and 47 kDa, expressed 48 h after infection can be identified by using convalescent sera from human volunteers who were immune to C. jejuni infection upon rechallenge; these proteins were not visualized on sodium dodecyl sulfate-polyacrylamide gel electrophoresis gels by Coomassie blue staining or silver staining. Antibodies to the 84- and 47-kDa proteins are of the immunoglobulin G class. Both preinfection and convalescent human sera react strongly to the C. jejuni flagellin (a 58-kDa protein), suggesting the presence of cross-reactive antibodies to this protein in healthy humans. Major outer membrane protein and flagella may play a role in providing protection against C. jejuni disease, but our data suggest that there are other proteins expressed only during in vivo growth of the organism that elicit a strong immune response in human C. jejuni infections.

Animals↗

Non-O1 Vibrio cholerae NRT36S produces a polysaccharide capsule that determines colony morphology, serum resistance, and virulence in mice.

Non-O1 Vibrio cholerae produced two distinct colony types, designated as opaque and translucent. NRT36S, a clinical isolate shown to be virulent in volunteers, produced predominantly opaque colonies, but translucent colonies appeared on subculture. Opaque variants were recovered exclusively following exposure to normal human serum or animal passage. A nonreverting translucent mutant of NRT36S, JVB52, was isolated following mutagenesis with the transposon Tn5 IS50L::phoA (TnphoA). Only translucent colonies were produced by a nonpathogenic environmental isolate, A5. Electron microscopic examination of the opaque form of NRT36S revealed thick, electron-dense, fibrous capsules surrounding polycationic ferritin-stained cells. The ferritin-stained material around translucent NRT36S or A5 was patchy or absent. JVB52 had a thin but contiguous capsular layer. The amount of ferritin-stained capsular material correlated with the amount of surface polysaccharide determined by phenol-sulfuric acid assay: opaque NRT36S had approximately three times as much polysaccharide as translucent NRT36S or A5 and four times as much as JVB52. The encapsulated, opaque variant of NRT36S was protected from serum bactericidal activity, while translucent non-O1 V. cholerae was readily killed. The encapsulated form also had increased virulence in mice. Our data provide the first indication that non-O1 V. cholerae strains can have a polysaccharide capsule. This capsule may be important in protecting the organism from host defenses and may contribute to the ability of some non-O1 V. cholerae strains to cause septicemia in susceptible hosts.

Animals↗

Development of an in vitro model for study of non-O1 Vibrio cholerae virulence using Caco-2 cells.

Non-O1 Vibrio cholerae strains have been reported as a causative agent of diarrhea throughout the world. We recently reported that non-O1 V. cholerae strains cause diarrhea in human volunteers. In this study we evaluated the virulence of three strains of non-O1 V. cholerae in a Caco-2 cell adherence assay by light and electron microscopy. A-5 is an environmental isolate which failed to colonized volunteers and did not cause diarrhea. It exhibited low numbers of organisms adherent to Caco-2 cells, leaving the microvilli intact. Strain 2076-79, isolated from a patient with diarrhea, colonized human volunteers without producing disease. It adhered to Caco-2 cells in moderate numbers without producing any damage to the microvilli. Strain NRT36S, a clinical isolate, colonized human volunteers and produced significant diarrhea disease. This strain adhered in very large numbers to Caco-2 cells and caused damage to the brush borders. Membrane-bound bacteria were also seen within the cytoplasm of these cells. Scanning electron microscopy confirmed the generalized adherence of NRT36S to the microvilli of Caco-2 cells. The three strains did not appear to compete with each other for binding sites on Caco-2 cells and were not adherent when assays were conducted at 4 degrees C. Our results with strains A-5, 2076-79, and NRT36S correlate well with observations in human volunteer studies, suggesting that Caco-2 cells provide an appropriate in vitro system for further investigation of the pathogenesis of non-O1 V. cholerae gastroenteritis.

Analysis of Variance↗

Evidence of reinfection with multiple strains of Campylobacter jejuni and Campylobacter coli in Macaca nemestrina housed under hyperendemic conditions.

A prospective bacteriologic study of 18 infant pig-tailed macaques (Macaca nemestrina) housed in a nursery facility in which Campylobacter spp. are endemic was undertaken to determine the epidemiology of infection and reinfection. The isolates of Campylobacter jejuni and C. coli cultured from 8 of the 18 infants were characterized by serotyping, DNA hybridization, and polyacrylamide gel electrophoresis protein profiles. The chronology of infection was indicative of multiple reinfections with different strains of C. jejuni and C. coli during the 12-month study of each infant. The duration of infection with a particular strain was 3 to 4 weeks. Infants were also infected with nalidixic acid-resistant campylobacters. These observations indicated that long-term infections under endemic conditions are caused by continual reinfection. C. jejuni or C. coli infection correlated with diarrhea in 5 of the 18 infants at 1 to 4 months of age.

Animal Husbandry↗

Defective transport of hemagglutinin-neuraminidase glycoprotein of bovine parainfluenza-3 virus in interferon treated cell.

A defective transport of bovine parainfluenza-3 virus (PI-3V) hemagglutinin-neuraminidase (HN) glycoprotein was evidenced in interferon (IFN)-treated bovine turbinate (BTu) cells. Indirect immunofluorescence performed with monoclonal antibody to PI-3 HN glycoprotein demonstrated accumulation of this protein in the perinuclear cytoplasm of IFN-treated cells. Untreated, infected control cells had a generalized widespread fluorescence. Unfixed control cells showed a uniform surface fluorescence in contrast to a few specs of fluorescence on the plasma membrane of IFN-treated cells. Electron microscopic localization of HN protein was done by immuno-gold ultrastructural cytochemistry. Untreated cells had uniform gold label on the plasma membrane and around the budding virus particles with no label in the cytoplasm. In IFN-treated cells, however, there was an accumulation of gold particles in the cytoplasm with only a few particles on the cell surface. Quantitative analysis of HN protein on the cell surface by solid phase radioimmune-assay revealed a greater amount of this protein on the surface of control cells, than those on the IFN-treated cells.

Animals↗