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Mitogen-activated protein kinase and activator protein-1 dependent signals are essential for Bacteroides fragilis enterotoxin-induced enteritis.

The approximately 20-kDa heat-labile toxin produced by enterotoxigenic Bacteroides fragilis is known to be associated with the development of enteritis. However, the molecular mechanism involved is not yet fully understood. In this study, we assessed whether B. fragilis enterotoxin (BFT)-induced enteritis is related to mitogen-activated protein kinase (MAPK) signaling pathways. In human colon epithelial cells, BFT activated three major MAPK cascades. The activation of p38 was sustained for a relatively long period, while the stimulation of extracellular signal-regulated kinases (ERK) and c-Jun N-terminal kinase (JNK) was transient. BFT stimulation also activated AP-1 signals composed of c-Jun/c-Fos heterodimers. The p38 inhibitor SB203580 and the ERK inhibitor U0126 reduced not only AP-1 activity, but also decreased IL-8 and MCP-1 expression. In addition, the overexpression of superrepressors for c-Jun and Ras induced by BFT stimulation decreased the levels of IL-8 and MCP-1 production. Furthermore, SB203580 prevented BFT-induced colitis in the mouse ileum, as evidenced by significant decreases in villous destruction, neutrophil infiltration, and mucosal congestion. These results suggest that a pathway, including Ras, MAPK, and subsequent AP-1 activation, is required for IL-8 and MCP-1 expression in intestinal epithelial cells exposed to BFT, and can be involved in the development of enteritis.

Animals↗

Chemotherapeutic aspects of anaerobic septicemia.

The author discusses the incidence as well as diagnostic and therapeutic aspects of Bacteroides septicemia. The disease is often polymicrobic and may be lethal even with optimum antibiotic treatment.

Anti-Bacterial Agents↗

Infections due to anaerobic bacteria: case reports.

Four typical case histories are presented to illustrate the clinical situation in which anaerobic infections may occur. In all conditions in which there is a risk of aspiration (anaesthetic, alcoholism etc.) anaerobes should be suspected as one of the causative organisms of infection. In such pulmonary infections transtracheal aspiration must be performed to collect material. Infections with anaerobes can occur in compromised patients undergoing treatment with antibiotics which are not effective against anaerobes (e.g. aminoglycosides).

Anaerobiosis↗

Capsular and 'O' serotype determinants of bacteroides fragilis.

Forty-one strains of Bacteroides fragilis, 20 strains of other Bacteroides species and 14 strains of other genera were examined by the indirect immunofluorescent assay (IFA) using anticapsular serum. The sixty-one Bacteroides strains were 'O' serotyped by direct agglutination tests using absorbed antisera raised against 23 strains, each with a different 'O' antigenic determinant. All 41 B. fragilis strains tested were positive by IFA with the anticapsular serum, but apart from one strain of B. distasonis, none of the remaining 19 strains of other bacteroides, i.e. B. thetaiotaomicron, B. distasonis, B. vulgatus, B. ovatus, B. melaninogenicus group and B. ureolyticus, and none of the 14 other bacterial species examined were positive. The majority of strains of saccharolytic bacteroides tested reacted with one of the 23 'O' antisera and were designated as a specific 'O' serotype; a few Bacteroides strains had multiple agglutination reactions indicating the presence of multiple antigenic determinants. All 'O' serotypes gave positive IFA tests with their homologous 'O' antisera. Common capsular determinants and 'O' antigenic determinants appear to exist on the same strains of B. fragilis. Serological typing of B. fragilis and related species would be useful in epidemiological studies.

Antigens, Bacterial↗

Bacteroides fragilis in acute salpingitis.

The bacteriology of acute salpingitis was studied in 87 patients. Gonococci were recovered from 18 patients. Lower yields of bacteria were isolated in the peritoneal fluid than from the vaginal cultures, and a poor correlation was observed between the peritoneal fluid and vaginal cultures. Anaerobic bacteria dominated in both sites. Staphylococci, streptococci, enterobacteria, peptostreptococci, peptococci, lactobacilli and bacteroides normally present in the vagina were the predominant isolates recovered from the culdocentesis. Paired acute and convalescent-phase sera obtained from patients with isolates of Bacteroides fragilis were assayed for antibody response to the polysaccharide antigen of B. fragilis. Significant titer increases were observed in sera from only two out of eight patients with non-gonococcal salpingitis and no titer changes were noticed in two patients with gonococcal. These findings suggest that B. fragilis only infrequently plays an etiologic role in acute salpingitis.

Acute Disease↗

Meningitis due to enterotoxigenic Bacteroides fragilis.

An enterotoxigenic strain of Bacteroides fragilis was the sole organism isolated from the cerebrospinal fluid of a two-and-a-half-month neonate who had a medullary-colonic fistula as part of a complex congenital malformation, but no brain abscess. A rapid latex particle agglutination test for detection of bacterial antigen was positive for Haemophilus influenzae type b, suggesting that Bacteroides fragilis and Haemophilus influenzae type b might share some capsular antigens. In order to determine the role of the enterotoxin with respect to virulence of the strain, antibodies to a 20 kDa protein were sought in the patient's serum, but Western blot of the culture supernatant revealed only antibodies to a 45 kDa bacterial protein. The patient was successfully treated with metronidazole and imipenem.

Antibodies, Bacterial↗

An unusual case of hip septic arthritis due to Bacteroides fragilis in an alcoholic patient.

We describe a 53-year-old alcoholic man who presented with hip septic arthritis due to Bacteroides fragilis. This arthritis involved a severe destruction of the femoral head, which was completely devitalized. Recovery was achieved after 4 months of antimicrobial therapy with imipenem/cilastatin plus metronidazole, surgical debridement of the necrotic tissues and four sessions of hyperbaric oxygen.

Alcoholism↗

Serum antibody response to Bacteroides fragilis in experimental sinusitis.

Maxillary sinusitis was induced in New Zealand white rabbits by local inoculation of 10(6) colony-forming units of Bacteroides fragilis NCTC 9343, and the serum IgG, IgA and IgM antibody responses to cell wall antigens were studied. Prior to inoculation, and one, two, three and four weeks after induction, serum samples were obtained and analysed for antibodies to the lipopolysaccharide and the capsular polysaccharide. Capsular polysaccharide from B. fragilis ATCC 23745 was used as control. The rise in IgG activity against NCTC 9343 capsular polysaccharide and lipopolysaccharide was most marked and sustained throughout the four weeks. The increases in IgA concentration were moderate and sometimes transient, and a more pronounced IgA increase was seen with IFA than with EIA. The IgM peak levels were weak and usually declined within two to three weeks. The development of antibody to the lipopolysaccharide was similar to that of the NCTC 9343 capsular polysaccharide antibodies, though somewhat delayed in time. No significant increase in antibody to the control capsular polysaccharide was seen.

Animals↗

Susceptibility patterns and characterization of beta-lactamases in clinical isolates of Bacteroides fragilis.

Strains of Bacteroides fragilis isolated from clinical specimens are known to be frequently resistant to penicillins or cephalosporins. The production of beta-lactamases is the major mechanism in this resistance. Up to now at least five types of beta-lactamase enzymes have been described in the Bacteroides fragilis group. The purpose of this study was to evaluate the susceptibility to different antibiotics and the prevalence of the beta-lactamase types among 100 Bacteroides fragilis strains isolated from clinical specimens in Italy. MICs of 11 antibiotics were determined by the reference agar dilution method and by the new E test (AB Biodisk, Sweden). Results showed an acceptable correlation between the MICs determined for most strains, although those obtained by the E test tended to be lower. In the beta-lactam resistant strains the enzyme activity and isoelectric points were determined on crude enzyme extract.

Anti-Bacterial Agents↗

Toxic shock syndrome and necrotizing fasciitis complicating neglected sacrococcygeal pilonidal sinus disease: report of a case.

PURPOSE: This study was conducted to report the rare combination of necrotizing fasciitis and toxic shock syndrome, which both complicated neglected sacrococcygeal pilonidal sinus disease. METHODS: A case report is presented. RESULTS: We describe the rare case of a previously healthy adult male patient who developed necrotizing fasciitis and toxic shock syndrome associated with Streptococcus pyogenes and Bacteroides fragilis. Patient's response to emergency surgery followed by repeated debridements of necrotic tissue, together with aggressive fluid resuscitation, broad-spectrum antibiotic coverage, and hyperbaric oxygenation was good. CONCLUSION: This case serves again as a clear reminder that neglected pilonidal sinus disease can lead to unusual and life-threatening consequences.

Bacteroides Infections↗