Campylobacter upsaliensis isolated from a giant hepatic cyst.

Campylobacter upsaliensis is an enteropathogenic bacterium in animals, and is also rarely isolated from humans, where it can cause enteritis and bacteremia. This report describes the first case of isolation of C. upsaliensis from an infected giant hepatic cyst. This bacterium could not be cultured from abscess punctuate in a usual Campylobacter-selection medium (charcoal cefoperazone deoxycholate agar medium), because of high concentration of cefoperazone as a selection agent. It could not identified by matrix-assisted laser desorption ionization-time of flight mass spectrum. Rather, it was identified as C. upsaliensis by whole genome sequencing, including by multilocus sequence typing.

Lactobacillus johnsonii ameliorates intestinal, extra-intestinal and systemic pro-inflammatory immune responses following murine Campylobacter jejuni infection.

Campylobacter jejuni infections are progressively increasing worldwide. Probiotic treatment might open novel therapeutic or even prophylactic approaches to combat campylobacteriosis. In the present study secondary abiotic mice were generated by broad-spectrum antibiotic treatment and perorally reassociated with a commensal murine Lactobacillus johnsonii strain either 14 days before (i.e. prophylactic regimen) or 7 days after (i.e. therapeutic regimen) peroral C. jejuni strain 81-176 infection. Following peroral reassociation both C. jejuni and L. johnsonii were able to stably colonize the murine intestinal tract. Neither therapeutic nor prophylactic L. johnsonii application, however, could decrease intestinal C. jejuni burdens. Notably, C. jejuni induced colonic apoptosis could be ameliorated by prophylactic L. johnsonii treatment, whereas co-administration of L. johnsonii impacted adaptive (i.e. T and B lymphocytes, regulatory T cells), but not innate (i.e. macrophages and monocytes) immune cell responses in the intestinal tract. Strikingly, C. jejuni induced intestinal, extra-intestinal and systemic secretion of pro-inflammatory mediators (such as IL-6, MCP-1, TNF and nitric oxide) could be alleviated by peroral L. johnsonii challenge. In conclusion, immunomodulatory probiotic species might offer valuable strategies for prophylaxis and/or treatment of C. jejuni induced intestinal, extra-intestinal as well as systemic pro-inflammatory immune responses in vivo.

Fatal Campylobacter jejuni ileocolitis.

Campylobacter infection usually starts in the jejunum and ileum and progresses distally. The case fatality rate is low and most occur in elderly or patients with comorbidity as in this case. Antibiotics should be used in severe cases or patients at risk. The choices are macrolides and fluoroquinolones. However, in some countries quinolone resistance is increasing, as in Spain. We shouldn´t forget this fact for the proper treatment approach and specifically in refractory cases.

Infección extraintestinal debida a bacterias del género Campylobacter / Extraintestinal infections due to Campylobacter SPP

Campylobacter jejuni causa principalmente enteritis disenteriforme; los casos debidos a C. fetus son raros, mayormente bacteriemiaen inmunosuprimidos. Presentamos dos casos de enfermedad diarreica con bacteriemia, ambos con hemorragia digestiva,debida a C. jejuni, un caso inusual de infección de anerurisma de la arteria femoral y un caso de bacteriemia recurrente conprobable foco en marcapasos en un anciano sin otro factor de inmunosupresión, los dos últimos debidos a C. fetus. Todos lospacientes tuvieron evolución favorable. Recomendamos prestar atención a los hemocultivos que resulten positivos para efectuarlos subcultivos adecuados para recuperar, identificar y determinar la sensibilidad a los antimicrobianos de este tipo de bacterias microaerofílicas.

Campylobacter jejuni often causes enteritis; cases due to C. fetus are rare: it causes mostly bacteremia in patients with immunosuppression.We present two cases of diarrheal disease with bacteremia, both with gastrointestinal bleeding due to C. jejuni, an unusual case ofC. fetus infection of an aneurysm in the femoral artery, and one case of recurrent C. fetus bacteremia with probably focus in apacemaker in an elderly patient without another cause of immunosuppression. All patients had a favorable evolution. We recommendspecial attention to the positive blood cultures in order to recover and identify this type of microaerophilic bacteria, and determineantimicrobial susceptibility.

Cell surface-associated aggregation-promoting factor from Lactobacillus gasseri†SBT2055 facilitates host colonization and competitive exclusion of Campylobacter jejuni.

Campylobacter jejuni, one of the most common causes of gastroenteritis worldwide, is transmitted to humans through poultry. We previously reported that Lactobacillus gasseri SBT2055 (LG2055) reduced C. jejuni infection in human epithelial cells in vitro and inhibited pathogen colonization of chickens in vivo. This suggested that the LG2055 adhesion and/or co-aggregation phenotype mediated by cell-surface aggregation-promoting factors (APFs) may be important for the competitive exclusion of C. jejuni. Here, we show that cell surface-associated APF1 promoted LG2055 self-aggregation and adhesion to human epithelial cells and exhibited high affinity for the extracellular matrix component fibronectin. These effects were absent in the apf1 knockout mutant, indicating the role of APF1 in LG2055-mediated inhibition of C. jejuni in epithelial cells and chicken colonization. Similar to APF1, APF2 promoted the co-aggregation of LG2055 and C. jejuni but did not inhibit C. jejuni infection. Our data suggest a pivotal role for APF1 in mediating the interaction of LG2055 with human intestinal cells and in inhibiting C. jejuni colonization of the gastrointestinal tract. We thus provide new insight into the health-promoting effects of probiotics and mechanisms of competitive exclusion in poultry. Further research is needed to determine whether the probiotic strains reach the epithelial surface.

Case of acute pancreatitis associated with Campylobacter enteritis.

A 25-year-old man was admitted with the chief complaints of right flank pain, watery diarrhea, and fever. Blood tests revealed high levels of inflammatory markers, and infectious enteritis was diagnosed. A stool culture obtained on admission revealed no growth of any significant pathogens. Conservative therapy was undertaken with fasting and fluid replacement. On day 2 of admission, the fever resolved, the frequency of defecation reduced, the right flank pain began to subside, and the white blood cell count started to decrease. On hospital day 4, the frequency of diarrhea decreased to approximately 5 times per day, and the right flank pain resolved. However, the patient developed epigastric pain and increased blood levels of the pancreatic enzymes. Abdominal computed tomography revealed mild pancreatic enlargement. Acute pancreatitis was diagnosed, and conservative therapy with fasting and fluid replacement was continued. A day later, the blood levels of the pancreatic enzymes peaked out. On hospital day 7, the patient passed stools with fresh blood, and Campylobacter jejuni/coli was detected by culture. Lower gastrointestinal endoscopy performed on hospital day 8 revealed diffuse aphthae extending from the terminal ileum to the entire colon. Based on the findings, pancreatitis associated with Campylobacter enteritis was diagnosed. In the present case, a possible mechanism of onset of pancreatitis was invasion of the pancreatic duct by Campylobacter and the host immune responses to Campylobacter.

Campylobacter fetus subspecies fetus spondylodiscitis.

Campylobacter spp. are common causes of gastrointestinal infections. Campylobacter fetus is a much rarer pathogen in humans, and usually causes bacteraemia and systemic complications in patients with predisposing conditions. We report a case of spondylodiscitis caused by C. fetus subsp. fetus as revealed by vertebral biopsy culture. This identification was confirmed by sequencing the 16S rRNA gene and by phylogenetic analysis. Treatment consisted of 6 weeks antimicrobial therapy combined with a strict initial immobilization, followed by a re-education program. The patient's recovery was uneventful.

Determinan la prevalencia y el perfil de resistencia de campilobacteriosis / Prevalence and susceptibility profiles in campylobacter spp isolated from diarrhea

La resistencia antibiótica de Campylobacter spp. se ha incrementado, con un patrón geográfico variable, sin embargo existen muy pocos datos con respecto a la situación en Argentina. Nuestro objetivo fue determinar la prevalencia de campilobacteriosis en nuestra población y su perfil de sensibilidad. Durante un período de dos años (2006-2008), se analizaron muestras de materia fecal de 1 321 pacientes en la Clínica Privada Universitaria Reina Fabiola, Córdoba, Argentina. Campylobacter spp. fue aislado a partir de la muestras de 258 pacientes (19.5%), Salmonella spp. en 74 (5.6%), Shigella spp. en 26 (2%) y Escherchia coli O157H7 en 5 (0.4%). Las muestras positivas fueron 363 (27%). La incidencia entre sujetos de sexo masculino fue consistentemente más alta que en el sexo femenino en todos los grupos etarios. Observamos un patrón bimodal en la incidencia por edad; el primer pico en la incidencia se dio en niños de 1-4 años y un segundo incremento se produjo en adultos jóvenes de 20-29 años de edad. Determinamos la sensibilidad de 93 cepas de Campylobacter spp. La prevalencia de cepas resistentes a ciprofloxacina fue de 74% (69 de 93); 2% (3 de 93) a eritromicina; 36% (34 de 93) a tetraciclina, y ninguno de los aislamientos estudiados presentó resistencia a cloranfenicol ni a furazolidona. El elevado nivel de resistencia de este microganismo a las fluorquinolonas debería hacernos reconsiderar el uso de estos antimicrobianos en el tratamiento empírico inicial de la diarrea invasiva.

Abdominal septic aortic pseudoaneurysm caused by Campylobacter jejuni infection: report of a case.

Campylobacter jejuni infection is one of the most common bacterial causes of acute gastroenteritis worldwide. An extraintestinal manifestation is rare and, to our knowledge, an aortic aneurysm has until now never been documented. We report a case of a 72-year-old patient with a septic aortic pseudoaneurysm caused by C. jejuni infection. Computed tomography and magnetic resonance imaging showed a pseudoaneurysm in the abdominal aorta. The preoperative blood culture indicated a Gram-negative bacillus, which was identified 7 days later as C. jejuni. An aneurysmectomy, extensive debridement, and an in situ graft wrapped with the omentum were done, and the patient was given a 6-week course of antibiotics. Despite readmissions for abdominal infection and Salmonella bacteremia, a graft infection did not develop. In the 3 years since the procedure the patient has shown no signs of a relapse.

Infected aneurysms of bilateral deep femoral arteries due to Campylobacter fetus subspecies fetus.

Infected aneurysms due to Campylobacter fetus subspecies fetus have rarely been reported. Here, we describe the first case of infected aneurysm of bilateral deep femoral arteries due to C. fetus fetus. We successfully treated this case by administration of antibiotics effective for C. fetus fetus and bilateral obturator bypass with complete resection of the infected aneurysms. The aneurysmal wall culture disclosed the presence of C. fetus fetus in a microaerobic atmosphere after the operation. A distinctive culture condition was necessary to detect C. fetus fetus. In the case of infected aneurysms, we should be aware of the possibility of infection with C. fetus fetus, and an appropriate culture for this organism may be needed.

[Acute pancreatitis - association with a Campylobacter coli-infection]. / Campylobacter coli-assoziierte akute Pankreatitis.

A 37-year-old male presented with intermittent abdominal pain and 9 kg weight loss within 3 weeks. Gastroscopy showed no pathological findings, coloscopy showed a colitis limited to the left flexure. Histology revealed a sustained infectious enterocolitis. A culture of the patient's stool was positive for CAMPYLOBACTER COLI. Because of the recurrent abdominal discomfort and weight loss the patient was admitted to the hospital. Ultrasound and multislice spiral computed tomography showed an acute oedematous pancreatitis. No other causes for the pancreatitis were found, the only remaining possibility was a CAMPYLOBACTER COLI-associated pancreatitis. Under symptomatic therapy the patient recovered definitively. An administration of antibiotics was not necessary.

Immunoproliferative small intestinal disease (IPSID): a model for mature B-cell neoplasms.

Immunoproliferative small intestinal disease (IPSID) was recently added to the growing list of infectious pathogen-associated human lymphomas. Molecular and immunohistochemical studies demonstrated an association with Campylobacter jejuni. IPSID is a variant of the B-cell lymphoma of mucosa-associated lymphoid tissue (MALT), which involves mainly the proximal small intestine resulting in malabsorption, diarrhea, and abdominal pain. Geographically, IPSID is most prevalent in the Middle East and Africa. IPSID lymphomas reveal excessive plasma cell differentiation and produce truncated alpha heavy chain proteins lacking the light chains as well as the first constant domain. The corresponding mRNA lacks the variable heavy chain (V(H)) and the constant heavy chain 1 (C(H)1) sequences and contains deletions as well as insertions of unknown origin. The encoding gene sequence reveals a deletion of V region and parts of C(H)1 domain. Cytogenetic studies demonstrated clonal rearrangements involving predominantly the heavy and light chain genes, including t(9;14) translocation involving the PAX5 gene. Early-stage IPSID responds to antibiotics (30%-70% complete remission). Most untreated IPSID patients progress to lymphoplasmacytic and immunoblastic lymphoma invading the intestinal wall and mesenteric lymph nodes, and may metastasize to a distant organ. IPSID lymphoma shares clinical, morphologic, and molecular features with MALT lymphoma, lymphoplasmacytic lymphoma, and plasma cell neoplasms.

Campylobacter jejuni enteritis mistaken for ulcerative colitis.

Campylobacter jejuni is the most common bacterial cause of gastroenteritis and is often missed by routine stool cultures. Patients may present with a clinical syndrome and endoscopic findings that are similar to acute ulcerative colitis. Ciprofloxacin is currently the recommended antibiotic therapy.

Helicobacter Pylori (Campylobacter Pylori) III. Revisión sobre su tratamiento y seguimiento / Helicobacter Pylori (Campylobacter Pylori) III. Review of treatment and follow-up

Helicobacter pylori, un nuevo agente infeccioso asociado con gastritis tipo B y ulceras pepticas ha fomentado el tratamiento antimicrobiano de esta patologia. Un tratamiento satisfactorio, utilizando bismuto coloidal, metronidazol y tetraciclina o amoxilina,, lleva a la erradicacion del agente con la consiguiente cura de la ulcera. Mientras que la monoterapia, con un antibiotico o bismuto coloidal, produce solo el aclaramiento de la bacteria. La erradicacion se define como la negativilizacion de los cultivos de biopsias al menos a las 8 semanas post tratamiento, y se asocia con una taza de reinfeccion anual menor del 10 por ciento. El aclaramiento del agente se define como su negativizacion solo 2 semanas post tratamiento, y se asocia con una alta tasa de reinfeccion.

[Campylobacter pylori: clinical correlations and prospective comparative studies of various diagnostic techniques]. / Campylobacter pylori: Klinische Korrelationen und prospektive vergleichende Untersuchungen zur Wertigkeit mehrerer Testverfahren.

The diagnostic performance of two different urease tests and of histologic search after modified Giemsa staining to detect Campylobacter pylori (CP) colonization of the upper gastrointestinal tract was prospectively investigated in 215 esophagogastroduodenoscopies, by using a sensitive culture technique as reference. Single antral urease tests had a high specificity of 95-96%, but a limited sensitivity of 78-83%, which increased to 91-94%, when one antral and one additional body biopsy were submitted to the biochemical tests. Giemsa stains were very sensitive, but less specific. The rate of colonization was similar in antrum and body biopsies, and increased with age. There was a close association of Campylobacter pylori colonization with duodenal and to a lower degree with gastric ulcer disease, but especially with gastritic mucosal changes. CP was never detected in patients without gastritis. Therefore, submitting one antral and one body biopsy specimen to validated urease tests represents a sensitive (91-94%) and specific (93%) method to detect Campylobacter pylori colonization, which appears to be a diffuse phenomenon affecting antral and body mucosae with similar frequency.

[Campylobacter pylori: significance, diagnosis and treatment]. / Campylobacter pylori: Bedeutung, Diagnostik und Therapie.

The association between colonization of the antrum mucosa by Campylobacter pylori and antrum gastritis as well as peptic ulcers has been documented in a number of studies. The ability of these bacteria to produce a cytotoxin and a protease that hydrolyzes the mucosa-protecting mucin assigns pathogenetic properties to this species that suggest an etiological role for C. pylori in the pathogenesis of peptic ulcers and gastritis. This concept is supported by some preliminary results of therapeutic trials which have shown that successful eradication of the organism leads to histologic improvement of the gastritis and markedly reduced relapse rates regarding peptic lesions. Best results were achieved using combinations of a bismuth salt with an antibiotic such as amoxicillin. Diagnosis of C. pylori infection is based on culturing the organism from antral biopsies. Detecting the urease activity directly in the biopsy has also been shown to be an effective and reliable method. As a noninvasive method serologic testing for C. pylori may also be employed. An IgG-ELISA used by us showed a good correlation with cultural and histological results.