Campylobacter spp como causa de disentería: opciones diagnósticas: A propósito de dos casos clínicos / Campylobacter spp as a cause of dysentery: diagnostic options: Presentation of two clinical cases

En los últimos años se ha observado un aumento en la incidencia de Campylobacter spp (CSSP) como agente de diarrea, enteritis y disentería. Constituye una zoonosis así como una enfermedad trasmitida por alimentos. El diagnóstico de GEA por CSPP se realiza por identificación del agente etiológico en las heces del paciente. El objetivo de la siguiente observación es presentar dos casos clínicos de GEA en niños con diagnóstico etiológico de colitis causada probablemente por Campylobacter spp mediante la utilización de examen directo de materia fecal. El cultivo de la bacteria es el gold standard; en Uruguay sólo está disponible con fines de investigación. El método más fácil de poner en práctica en los laboratorios clínicos es la tinción y observación directa con un Gram modificado el cual sumado a la clínica, permite un diagnóstico con alto grado de presunción. En ambos pacientes el resultado motivó la instauración de un tratamiento antibiótico específico que determinó una buena evolución.

In recent years an increase in the incidence of Campylobacter spp (CSSP) as the agent of diarrhea, enteritis and dysentery was observed. It constitutes a zoonosis, as well as a food transmitted disease. Diagnosis of acute gastroenteritis by CSPP is done by identifying the etiological agent on the patients’ feces. The objective of the following observation is to present two clinical cases of acute gastroenteritis in children with an etiological diagnosis of colitis, probably caused by Campylobacter spp by means of a direct study of the stool. Culture of the bacteria is the gold standard, although in Uruguay it is only available for research purposes. The easiest method to put into practice in the clinical laboratories is staining and the direct observation with a modified Gram, which, together with the clinical examination, enables diagnosis with a high degree of presumption. In both patients, the result caused the adoption of a specific antibiotic, which determined a good evolution.

Campilobacteriose em humanos e o controle de qualidade em produtos de origem aviária / Campylobacteriosis in humans and quality control on products of poultry origin

A busca de novos mercados e alimentos mais seguros tem levado as indústrias de carnes a implementar uma melhoria contínua na qualidade microbiológica dos produtos. Entre os microrganismos patogênicos emergentes, encontra-se o Campylobacter jejuni, causador da campilobacteriose e ligado ao aparecimento da Síndrome de Guillian-Barre nos humanos. No abate de frangos, a escaldagem, a depenagem e o resfriamento têm sido apontados como as etapas de maior risco de contaminação. Diante disto, os pesquisadores têm testado diversos meios que inibam a proliferação ou a contaminação cruzada, com métodos físicos e agentes químicos. Para os diversos pesquisadores da área, os controles no campo, aliados aos adequados procedimentos no abatedouro, tais como BPF, PPHO, APPCC e controle de pragas, são os principais meios para inviabilizar a sobrevivência e disseminação do Campylobacter.

Guillain-Barré syndrome: association with Campylobacter jejuni and Mycoplasma pneumoniae infections in India.

BACKGROUND: Guillain-Barré syndrome is the most common cause of acute neuromuscular paralysis and is considered a post-infectious disease. METHODS: Twenty patients with Guillain-Barré syndrome admitted to the Neurosciences Centre at the All India Institute of Medical Sciences from November 1997 to August 1998 were investigated for evidence of antecedent infections. This case-control study included 2 controls for each patient, one a household control and the other an age- and sex-matched hospital control suffering from a neurological illness other than Guillain-Barré syndrome. Evidence of recent Campylobacter jejuni infection was investigated by culture and serology, and for Mycoplasma pneumoniae by serology. RESULTS: There was evidence of recent C. jejuni infection in 35% of the patients compared with 25% of household controls and none of the hospital controls. M. pneumoniae infection was seen in 50% of patients compared with 25% of household controls and 15% of hospital controls. About one-third of the patients (30%) had evidence of both infections. The association of both infections in patients was found to be statistically significant as compared to hospital controls. CONCLUSION: C. jejuni and M. pneumoniae may be important antecedent illnesses in patients with Guillain-Barré syndrome in India.

Dos casos de enteritis con bacteriemia por Campylobacter jejuni / Two cases of enteritis with bacteremia due to Campylobacter jejuni

Campylobacter es un importante agente causante de enfermedad en el ser humano en nuestro medio. Los casos de bacteriemia ocurren principalmente en pacientes inmunosuprimidos y sondebidos frecuentemente a C. fetus. Sin embargo la bacteriemia es un episodio que también se ha observado enpacientes con enteritis por C. jejuni. Referimos dos pacientes con enteritis grave y bacteriemia, ambos con enfermedades concomitantes compatibles con inmunodepresión: uno con síndrome nefrótico de larga data y otro con hepatopatía crónica con cirrosis. Destacamos que los dos casos presentaron hematemesis y uno de ellos,enterorragia. Sugerimos prestar atención a la coloración de Gram durante el subcultivo de los caldos conhemocultivos, en busca de formas características de esta especie, y en ese caso emplear medios de cultivo enmicroaerofilia a 37 y 42 °C

Campylobacter is an importantagent of illness in human beings. Bacteremia occurs principally in the immunocompromissed host and is frequently due to C. fetus. Nevertheless bacteremia also has been observed in patients with enteritis due to C. jejuni. We refer two cases of patients with severe enteritis and bacteremia, both of them with immunosupressive concomitant diseases such as nephrotic syndrome and chronic cirrotic hepatopathy. Both patients presented hemathemesis

Guillain-Barre syndrome and Campylobacter infection.

Campylobacter infection of the gastrointestinal tract has been observed as an antecedent illness in some patients with Guillain-Barre syndrome (GBS); these patients have been reported to have poor prognosis. We investigated 29 patients with GBS, admitted to our hospital from January 1996 to December 1999 for recent Campylobacter enteritis by culture of their stool specimens. Campylobacter upsaliensis and C. jejuni were isolated from stools of one patient each with acute motor axonal neuropathy (AMAN) and acute inflammatory demyelinating polyradiculoneuropathy (AIDP) respectively. The patient with C. upsaliensis infection was a 7 year-old male child who developed features of AMAN, 7 days after onset of diarrhea. He recovered gradually within 24 days with residual deficit in the form of foot drop. This deficit has persisted for last three and half years. The other patient with C. jejuni infection was a 9 year-old boy, who developed AIDP after 9 days of acute diarrhea. This patient recovered completely within 28 days of illness without any deficit. None of the patients had relapse of GBS. The present findings indicate the need of planned systematic studies to explore the role of C. upsaliensis and other campylobacters as agents of antecedent diarrhea in patients of GBS with different clinical presentations and prognosis.

Aborto de 2º trimestre y campylobacter jejuni / Abort of second trimester and campylobacter jejuni

Campylobacter jejuni es agente frecuente de infecciones entéricas en todo el mundo. Ocasionalmente puede producir aborto en la mujer. Tiene un mecanismo de transmisión fecal-oral. Posee características de cultivo exigentes y requiere para su aislamiento incubación prolongada. La infección por este microorganismo en Chile es infrecuente y no representa un problema de Salud Pública, no obstante se comunica este caso clínico por las consecuencias que tiene en la gestación. Además se recuerdan las medidas a tomar frente a cuadro febril que aparece durante el embarazo

[Abortion and infertility due to bovine venereal campylobacteriosis in Tehran province]

Bovine Venereal Comylobacteriosis is still a serious problem of dairy herds in Tehran province. Most of these herds use natural service to breed cows. However, artificial insemination is also used in some herds. In a herd of 184 Holstein cows, located in southern part of Tehran, compylobacter fetujs var. venereal is was isolated from an aborted fetus and classified in veterinary organization central laboratory. Further investigations revealed that eight bulls had been used for natural service for several years in the herd. Manipulating data from reproductive records of the herd showed that nineteen pregnant cows [10.3%], being at different stages of pregnancy, experienced abortion and/or stillbirth during the period of one year. Mean days open was estimated to be 141 days, indicating a severe infertility in the herd. A high percentage of repeat breeders [37.5%] were observed. Cows had also a high incidence of endometritis and cystic ovarian disease [25.7% and 11.6% respectively]. The reproductive status of the herd was improved rapidly following the removal of bulls from the herd and starting A.I. Thirty four problem cows suffering from reproductive disorders such as repeat breeding, endometritis and cystic ovaries, responded promptly to appropriate treatments and conceived either to the first or the second A.I. Abortions were also stopped following the establishment of artificial insemination in the herd

Explosive Campylobacter jejuni diarrhea in immunoproliferative small intestinal disease.

Campylobacter jejuni is an infrequent cause of self limiting acute diarrheal disease in adults in the Indian subcontinent. We report the occurrence of a life threatening diarrhea due to C jejuni infection in a patient with immunoproliferative small intestinal disease. We postulate that immunosuppression due to malignancy, malnutrition and cancer chemotherapy was responsible for the unusually severe diarrhea.

Helicobacter Pylori y patología gastroduodenal en la República de Panamá / Helicobacter Pylori and gastroduodenal pathology in the República de Panamá

Se estudió prospectivamente la infección por Helicobacter pylori en 129 panameños y norteamericanos que tenían dispepsia crónica. Se correlacionó con la patología gastroduodenal diagnosticada por endoscopía e histología. Se comparó la utilidad de la prueba rápida de la urea con el método de cultivo. La infección por H. pylori aumentó con la edad. En menores de 30 años : 37 (por ciento); de 31 a 40 años : 61 (por ciento); de 41 a 70 : 75 (por ciento). Fué más común en los panameños (70 por ciento) que en los norteamericanos (54 por ciento). Se encontró en 81 (por ciento), 75 (por ciento), 54 (por ciento) y 29 (por ciento) de pacientes con ulcera duodenal, gastritis crónica, duodenitis y en pacientes con endoscopía e histología normales, respectivamente. La prueba rápida de la urea sirvió para producir la positividad de la enfermedad en 98 (por ciento). Se discuten los resultados y se revisa la literatura

Aspectos endoscópicos, histológicos e níveis sericos de gastrina em pacientes portadores de Campylobacter pylori / Endoscopic and histologic aspects and serum levels of gastrin in patients with Campylobacter pylori

Os autores apresentam uma comparaçäo entre os achados endoscópicos, histológicos e níveis séricos de gastrina em 59 pacientes que foram submetidos a endoscopia digestiva alta para elucidaçäo de sintomas dispépticos e nos quais foi encontrado o Campylobacter pylori. Os autores näo verificaram diferenças significantes entre a presença do bacilo em relaçäo ao achado endoscópico e nem em relaçäo aos nvieis de gastrina, estando a presença do bacilo associada ao achado de alteraçöes inflamatórias da mucosa n histologia (p = 0,000048). Chama a atençäo dos autores o achado do C. pylori em 20% dos pacientes que apresentavam quadro histopatológico normal

Infección intestinal por Campylobacter, Cryptosporidium y Treponema sp: comparación de las tres etiologias / Intestinal infection caused by Campylobacter, Cryptosporidium and Treponema sp: an etiological comparison

Se hizo un tamizaje de muestras de heces con escogencia abierta en cuanto a la edad de los pacientes, todos provenientes de Puntarenas Centro, con el fin de buscar la incidencia de enteritis campylobacteriana, cryptosporidiosis y enfermedad diarreica pro espiroquetas. El diagnóstico se efectuó únicamente por frotis. Las muestras no se cultivaron por Campylobacter o macroespirilurias, pues no contamos en nuestro laboratorio con los medios apropriados. Se encontró una incidencia de 12,5% para Campylobacter (niños y adultos), 5,5% para las espiruquetas tipo Treponema hydysenteriae (niños y adultos) y 1,5% con Cryptosporidium (casos solo se hallaron en niños)

Diarrea aguda asociada a Campylobacter y otros agentes patógenos in Quito, Ecuador / Acute diarrhea associated with Campylobacter and other pathogens in Quito, Ecuador

En Quito, Ecuador, de julio a diciembre de 1984 se examinaron las heces de 100 niños de 1 a 24 meses de edad que sufrían diarrea aguda, con el fin de determinar la presencia de agentes enteropatógenos. En el 50% de los niños se identificaron uno o más microorganismos. Se aisló Campylobacter fetus en el 23% y se identificaron rotavirus en el 21%; también se encontraron Shigella sonnei (8%), Shigella flexneri (3%), Shigella boydii (1%), Salmonella enteritidis (3%) y parásitos enteropatógenos (6%), predominantemente Giardia lamblia y Entamoeba histolytica. En el 24% se detectaron infecciones combinadas provocadas por dos o más agentes enteropatógenos. Se estableció una relación entre la incidencia de cada microorganismo y la edad de los niños. Campylobacter fue el más frecuente entre los niños de 19 a 24 meses, mientras que los rotavirus se identificaron con mayor frecuencia entre los de 13 a 18 meses. En el 52,8% de los niños de 1 a 12 meses no se identificó un agente etiológico y se encontraron parásitos enteropatógenos solo entre los de más edad. Se presentó enteritis inflamatoria en el 61% de los niños con diarrea aguda, caracterizada por la presencia de moco, leucocitos o eritrocitos detectables en el examen microscópico de las heces

Ocorrência de Campylobacter jejuni em crianças com e sem diarréia, em Belo Horizonte / Occurrence of Campylobacter jejuni in children with or without diarrhea, in Belo Horizonte

Campylobacter jejuni foi pesquisado nas fezes de 98 crianças com diarréia aguda e de 30 crianças sem diarréia, menores de 2 anos, em Belo Horizonte, no período de agosto/1982 a janeiro/1984. Amostras de Campylobacter jejuni foram isoladas de 11 pacientes (11,2%) e de 2 crianças do grupo controle (6,6%). Entre 10 amostras testadas, apenas uma (10%) revelou a capacidade de produzir enterotoxina termolábil, através do teste de imunohemólise passiva. Nenhuma amostra mostrou-se capaz de produzir enterotoxina termoestável (teste do camundongo recém-nascido), ou de invadir a mucosa do olho de cobaio (teste de Serény). As 11 amostras de Campylobacter jejuni, isoladas de crianças com diarréia, mostraram-se sensíveis à Eritromicina, Gentamicina, Amicacina, Canamicina, Neomicina e Cloranfenicol e resistentes à associaçäo Sulfametoxazol-trimetoprim. Apenas uma delas (9,1%) foi resistente à Tetraciclina e três (27,3%) à Ampicilina. De acordo com o esquema de biotipagem de Skirrow & Benjamin as 12 amostras de Campylobacter jejuni testadas foram classificadas no biotipo 1. Adotando-se o esquema de Hébert & col. classificou-se 10 amostras isoladas de crianças com diarréia como pertencentes ao biotipo 4 e duas amostras isoladas do grupo controle como pertencentes aos biotipos 3 e 4