Campylobacter fetus translocation across Caco-2 cell monolayers.

Campylobacter fetus is a recognized pathogen of cattle and sheep, though human infection has also been reported. Ingestion of contaminated food or water is a proposed route of transmission for both humans and animals. The subsequent detection of the organism from extra-intestinal and systemic locations implies an ability to translocate across epithelial barriers. To determine how C. fetus disseminates from the intestine, Caco-2 cells cultured on porous membrane supports, were used as model intestinal epithelial cell monolayers. C. fetus was found to translocate equally well in both apical-to-basolateral and basolateral-to-apical directions for up to 24 h without altering Caco-2 cell monolayer permeability as assessed by transepithelial resistance and absence of paracellular diffusion of FITC-inulin. Using modified antibiotic protection assays, C. fetus was also observed to invade and subsequently egress from Caco-2 cells. Caco-2 cell invasion and translocation occurred independently of C. fetus S layer expression. Scanning and transmission electron microscopy revealed the presence of C. fetus associated with both apical and basal surfaces as well as in intracellular locations. C. fetus was, however, never observed in paracellular locations nor associated with Caco-2 cells junctions. Neither C. fetus invasion nor translocation across Caco-2 cell monolayers was impacted by latrunculin A, though translocation was enhanced in the presence of cytochalasin D which disrupted tight junctions. Tubulin cytoskeleton disrupting agents, colchicine and vinblastine, did inhibit C. fetus translocation though entry into Caco-2 cells remained unaffected. Together, translocation without disrupting monolayer integrity, invasion and egression from Caco-2 cells, electron microscopy observations and the requirement of a functional tubulin cytoskeleton for translocation, support a transcellular mechanism of C. fetus translocation across Caco-2 cell monolayers. The ability to invade and subsequently egress would contribute to establishment of an infecting C. fetus population in the host, while the demonstrated ability to translocate across model intestinal epithelial barriers accounts for the observed in vivo recovery of C. fetus from extra-intestinal locations.

A comparison of the psychosocial needs of hospice patients with AIDS and those with other diagnoses.

We compared the amount of psychosocial support required and received by patients with AIDS and without AIDS at Cedar Valley Hospice, Waterloo, Iowa. Hospice patients with AIDS (N = 11) required significantly more psychosocial support than non-AIDS patients (N = 36) of the same average age. The amount of non-hospice social support--family, congregation, and neighbors--received by AIDS patients was significantly less than that received by those with other diagnoses due to a virtual lack of neighbor support. There were no significant differences in family or congregational support. The high level of family support and lack of neighbor support may have been a result of many (8) of the AIDS patients having moved back to the area to die. A survey of hospice staff showed they felt working with AIDS patients was both more time consuming and more stressful than working with patients with other diagnoses.