Verotoxigenic escherichia coli 0157 among chronic renal failure patients

Escherichia coli 0157 has become an enteric pathogen of increasing importance. In this initial survey, which is confined to uraemic patients, the frequency of isolation of verotoxin [shiga-like toxin] producing E. coli 0157 from stools of 160 uraemic patients was 3.1%. The frequency of isolation rises to 4. 5% among uraemic patients with a prodroma of diarrheal illness and rises to 50% [P < 0.05] when uraemic patients were accompanied by a prodrome of diarrhea and bleeding tendencies in a syndrome known as haemolytic uraemic syndrome [HUS]. E. coli 0157 was isolated from stools of 4 out of 8 [50%] cases of HUS, thus it is considered the most important cause of diarrhea associated HUS. E. coli 0157 was found to be an infrequent enteric pathogen among other pathogenic bacterial organisms causing diarrheal prodroma in uraemic patients lout of 22 [4.5%]. Campylobacter spp., on the other hand was the commonest pathogen isolated 7 out of 22 [31.8%]. Rapid screening for E. coli 0157 was done by culturing on selective sorbitol MacConkey agar and non sorbitol fermenting colonies were tested by latex agglutination with E. coli 0157 antiserum. Shiga-like toxin production of E. coli 0157 was then assayed by verocytotoxicity because it is the better marker of the pathogenic potential of a strain than serotyping. Variations among strains of E. coli 0157 as regards shiga-like toxin production yield were noticed, with the highest titre obtained from strains isolated from HUS patients. Old age, female predominance, fever, ingestion of anti motility and antimicrobial drugs especially trimethoprim-sulfamethoxazole were the commonest risk factors observed for patients who developed HUS after a prodroma of E. coli 0157 diarrhea. We concluded that, it is the responsibility of microbiologists to make physicians and pediatricians aware about the importance of this newly discovered enteric pathogen and its greatest complication HUS

Purification and characterization of a shiga-like toxin from escherichia coli strain 0157 of human origin implicated in haemolytic uremic syndrome

A Shiga-like toxin [SLT] from enterohemorrhagic Escherichia coli strain 0157 isolated from the stools of patients with haemolytic uremic syndrome [HUS] was produced, partially purified and the biological properties have been characterized. The production of the toxin was done on Tryptone Soy Broth containing mitomycin C. The purification scheme involved polymyxin beta extraction of the toxin from bacterial cell, differential [NH[4]]2 SO[4]. Precipitation and desalting by passage through a Sephadex G50 column chromatography equilibrated with 10 mM. Tris hydrochloride [pH 7.6]. The purification scheme resulted in high recovery of SLT activity in comparison to crude culture supernatant and the recovered cytotoxicity to Vero cells were 4 x 10[4] CD[50]/mg protein for crude culture supernatant, 1.8 x 10[5] CD[50]/mg for polymyxin B extract and 5 x 10[5] for the material obtained by [NH[4][2] SO[4]. fractionation and gel filtration. The partially purified SLT or Verotoxin was [I] Paralytic-lethal to mice when injiected intraperitoneally and the 50% lethal dose was [16.000] verotoxin units [ii] enterotoxic to rabbit ileal loop, at a very high dose [256, 000] verotoxoin unit, The purified toxin preparation was Partially homogenous as judged by Sodium dodecyl sulphate-polyacrylamide gel electrophoresis [SDS-PAGE]. The SLT preparation, under non reducing condition, exhibited 2 bands on SDS-PAGE corresponding to a molecolar mass of 33,000 and 7,500 kb together with other protein band, These 2 protein bands were consistent with the expected MWs of A and B subunits of SLT respectively

Diagnostic problems in patients allergic to or chronically infected by Candida

The present work was carried out on 120 cases classified into 4 groups: Group I included 40 patients allergic to C and ida albicans, group II included 40 patients with current vaginal c and idiasis [RCV], group III included 20 nonallergic cases with one episode of vaginal c and idiasis and group IV included 20 nonallergic cases. All the cases were subjected to skin testing using 6 different antigenic extracts from C and ida albicans. Specific IgE was also determined using crude C and ida-allergen coupled to CNBr discs. All C and ida albicans extracts gave positive intradermal test [IDR] among patients allergic to C and ida albicans. Also, many female cases with RCV showed positive skin reactions with different extracts. The allergic patients [Group I] reacted more intensively to the polysaccharides extracts CCF and MAN-I-Ag. Enzyme Immune Assay [EIA] technique used to measure specific IgE to crude Ag was less sensitive than skin testing. This work confirmed the role of cell wall allergens of C and ida albicans in atopic patients and suggested the presence of specific allergens related to clinical allergy and others representative of infection with C and ida albicans

Genital chlamydia trachomatis infection and preterm labour

The genital carriage of Chlamydia trachomatis [C. trachomatis] was assessed in 50 women admitted to hospital in spontaneous preterm labor with premature rupture of the membrane [PROM] and 70 women in preterm labor without PROM. The incidence of C. trachomatis isolated from the endocervix by direct immunofluorescent was 4.41% among asymptomatic low risk group and 21.15% among the group presented with symptomatic endocervicitis [high risk group] with a total incidence 11.67%. C. trachomatis was found more associated with greater sexual activity, so its incidence was high among younger age group and early married. There was a significant [P < 0.05] association between endocervical carriage of chlamydia, spontaneous preterm PROM and perinatal death