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Query: UMLS:C0009319 (colitis)
 19,384 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The steady increase in the number of reported cases of Escherichia coli O157 infection is attributable to the proliferation of the organism, and to improved clinical and laboratory awareness. E. coli O157 is responsible for sporadic cases and outbreaks of diarrhoea, haemorrhagic colitis, haemolytic uraemic syndrome and thrombotic thrombocytopenic purpura. The pathogenesis of the organism is not fully understood, and the main virulence factors are thought to be the production of 'Shiga-like' toxin and adherence to intestinal mucosal cells. The majority of outbreaks have taken place in north America, Canada and the United Kingdom. The most important source of E. coli O157 infection is under-cooked ground beef and other bovine products. The infectious dose is low, person-to-person spread can occur, and direct transmission between calves and humans has been demonstrated. Infection has been acquired following contact with livestock at farm visitor centres. All diarrhoeal stools received in the laboratory should be examined for E. coli by culture and toxin detection methods. The presence of 'Shiga-like' toxin can be detected by demonstrating cytotoxicity, dot blotting, the polymerase chain reaction or by enzyme-linked immunosorbent assay. Serological techniques are useful in aiding and supporting a diagnosis. Contamination of meat by E. coli O157 probably occurs at slaughter or during processing, therefore, to prevent infection it is important to emphasise the dangers associated with the consumption of under-cooked beef products.
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PMID:Escherichia coli O157: occurrence, transmission and laboratory detection. 916 8

Infection with the enteric parasite Entamoeba histolytica can result in colitis and dysentery as well as abscesses at extra-intestinal sites. An effective vaccine must be able to protect against both mucosal and systemic disease. In this study an attenuated Salmonella strain that expressed a portion of the GalNAc lectin of E, histolytica was used to orally immunize gerbils. Animals were challenged by intrahepatic injection of amebic trophozoites. A significant decrease in size of amebic liver abscesses was observed in orally immunized animals. Oral immunization with a Salmonella-based vaccine was as effective as systemic immunization for protection against systemic challenge.
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PMID:Protection in a gerbil model of amebiasis by oral immunization with Salmonella expressing the galactose/N-acetyl D-galactosamine inhibitable lectin of Entamoeba histolytica. 917 67

A child with colitis was treated for Crohn's disease, diagnosed on history, clinical and colonoscopic findings, radiolabelled white cell bowel scan, and colonic histology. After septicaemia caused by an unusual organism, further investigation lead to a diagnosis of chronic granulomatous disease (CGD). The granulomatous colitis of CGD is clinically, histologically, and on white cell scanning, indistinguishable from that in Crohn's disease and should be considered in atypical cases. Infection with unusual 'pseudomonads' should prompt the exclusion of this disorder.
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PMID:Abnormal technetium labelled white cell scan in the colitis of chronic granulomatous disease. 927 52

Clostridium difficile infection is associated with broad-spectrum antibiotic therapy and is the most common cause of infectious diarrhea in hospital patients. Pathogenic strains of C. difficile produce two protein exotoxins, toxin A and toxin B, which cause colonic mucosal injury and inflammation. Infection may be asymptomatic, cause mild diarrhea, or result in severe pseudomembranous colitis. Diagnosis depends on the demonstration of C. difficile toxins in the stool. The first step in management is to discontinue the antibiotic that caused diarrhea. If diarrhea and colitis are severe or persistent, oral metronidazole is the treatment of choice. Oral vancomycin is also effective, but it is more expensive than metronidazole and its widespread use may encourage the proliferation of vancomycin-resistant nosocomial bacteria. Diarrhea and colitis usually improve within three days after a patient starts taking metronidazole or vancomycin, but 20% suffer a relapse of diarrhea when these agents are discontinued.
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PMID:Clostridium difficile infection. 950 70

Nosocomial diarrheas are an important problem in hospitals, and in critical care units in particular. Hospital-acquired diarrhea may be on an infectious or noninfectious basis. Common noninfectious causes of nosocomial diarrhea include medication-induced changes in the fecal flora or changes secondary to enteral hyperalimenation. Infectious causes of nosocomial diarrhea are due to enteric pathogens in outbreak situations and virtually all of the causes are due to Clostridium difficile. C. difficile is a resident of the human colon and does not cause disease if its toxins are not elaborated. Chemotherapeutic agents, and more commonly, antibiotics, induce the elaboration of toxin A and B from C. difficile in the distal gastrointestinal tract. The spectrum of disease of C. difficile in hospitalized patients includes asymptomatic carriage to mild watery diarrhea, fulminant and severe diarrhea, and pseudomembranous enterocolitis. The treatment of C. difficile diarrhea is usually with oral metronidazole or vancomycin, and C. difficile colitis is treated with intravenous metronidazole. Infection control measures are necessary to prevent the spread of this sporforming organism within the institution since it is capable of surviving in the hospital environment for prolonged periods.
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PMID:Nosocomial diarrhea. 956 20

Escherichia coli is a commonly occurring inhabitant of the intestine of humans and other animals, but there are several pathogenic types of E. coli which cause a variety of human diseases. One of these pathogenic types, E. coli O157:H7, belongs to the group of enterohaemorrhagic E. coli (EHEC) which produce potent toxins and cause a particularly severe form of disease, haemorrhagic colitis (HC). About 10% of patients with HC can go on to develop haemolytic uraemic syndrome (HUS), a life-threatening complication of E. coli O157:H7 infection that is characterized by acute renal failure, haemolytic anaemia, and thrombocytopenia. These sequelae are particularly serious in young children and older people. On average, 2-7% of patients with HUS die, but in some outbreaks among the elderly the mortality rate has been as high as 50%. This Memorandum reviews the growing importance of E. coli O157:H7 as a foodborne pathogen and reports on the issues of surveillance, outbreak investigation, and control strategies with respect to EHEC infections that were discussed at the WHO Consultation on Prevention and Control of EHEC Infections, held in Geneva on 28 April to 1 May 1997. Recommended measures for prevention and control include the following: use of potable water in food production; presentation of clean animals at slaughter; improved hygiene throughout the slaughter process; appropriate use of food processing measures; thorough cooking of foods; and the education of food handlers, abattoir workers, and farm workers on the principles and application of food hygiene.
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PMID:Prevention and control of enterohaemorrhagic Escherichia coli (EHEC) infections: memorandum from a WHO meeting. WHO Consultation on Prevention and Control of Enterohaemorrhagic Escherichia coli (EHEC) Infections. 974 44

The influence of recently published guidelines by the Surgical Infection Society (SIS) on current surgical practice are not well documented. The appropriateness of antibiotic administration in a cohort of surgical patients undergoing elective and emergency surgery in a department of surgery in an urban, community-based, private, 560-bed teaching hospital was retrospectively reviewed. The following were the criteria defining administration as appropriate as modified from SIS guidelines: Prophylactic use: (1) started prior to operation; (2) spectrum appropriate to the specific operation; (3) duration </= 24 hours. Therapeutic use: (1) started prior to operation; (2) spectrum appropriate to pathology; (3) Duration </= 24 hours for contamination or "resectable" infection and </= 5 days for established infection in the absence of clinical evidence of persisting infection. Any switchover from an appropriate agent to another appropriate or inappropriate agent in the same patient in the absence of microbiologic or clinical indication was considered inappropriate administration. We reviewed the charts of 211 randomly selected patients who underwent elective (n = 132) or emergency (n = 79) procedures during 1996. The operations included gastrectomy (n = 22), appendectomy (n = 27), open (n = 5) or laparoscopic (n = 27) cholecystectomy, colectomy (n = 28), hysterectomy (n = 8), laparotomy for intestinal obstruction (n = 11), mastectomy (n = 26), and ventral hernia repair (n = 37). A total of 17 antibiotics were used for prophylaxis and 21 for therapy. In 156 patients (74%) the administration was considered inappropriate. Eight patients in the inappropriate group developed diarrhea (two cases of Clostridium difficile-induced colitis) compared to two cases of diarrhea in the appropriate group (nonsignificant). The average duration of administration after elective and emergency operations was 3.3 and 5. 7 days, respectively. The total expense for excessive duration of administration was $18,533. Many surgeons are not familiar with the spectrum of antimicrobials and often do not distinguish between prophylactic and therapeutic administration. Antibiotic usage in current surgical practice is often inappropriate, excessive, and chaotic.
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PMID:Antibiotic administration in patients undergoing common surgical procedures in a community teaching hospital: the chaos continues. 1008 88

Infection with toxin-producing strains of Clostridium difficile is common and potentially life-threatening. It occurs mostly in patients in the hospital or nursing home who are taking or have recently taken antibiotics. Two toxins, A and B, damage the colonic mucosa, resulting in symptoms ranging from mild diarrhea to bloody diarrhea with fever and abdominal pain, colitis, or even pseudomembranous colitis. Severe cases may involve dehydration, toxic megacolon, or colonic perforation. This article reviews the microbiology, epidemiology, clinical manifestations, diagnosis, treatment, and prevention of this disease.
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PMID:Clostridium difficile diarrhea and colitis: a clinical overview. 1048 98

Infections in the digestive tract are due to multiple organism, which cause different syndromes. Escherichia coli O157:H7, already identified as a human pathogen in 1982, has been recognised as a major public health issue, being responsible for sporadic and epidemic cases of haemorrhagic colitis, often associated, in children and elderly, with the haemolytic uraemic syndrome. E. coli O157:H7 infection may occur everywhere, but is more frequent in North Europe, Canada, USA, Argentina and Japan, with annual incidence rates of 8 per 100,000 population. In Italy until 1997 the Italian National Institute of Health has identified 196 cases of haemolytic uraemic syndrome, in addition, an outbreak caused by E. coli O157:H7 occurred in 1993. In Italy the incidence of the haemolytic uraemic syndrome is 4-5 times lower than in Great Britain, Germany and other European countries. E. coli infection is more frequently associated with the ingestion of food from bovine and sheep origin and with infected water. The clinical spectrum includes an asymptomatic infection, non bloody diarrhoea, haemorrhagic colitis, haemolytic uraemic syndrome. When the E. coli infection is suspected, it is necessary to isolate the bacterium in a specialised laboratory. Treatment is essentially supportive in order to control anaemia and to maintain an adequate fluid and electrolyte balance, if necessary with the use of dialysis. The use of antimicrobial agents is currently under debate as there are controversial data on the risk of developing haemolytic uraemic syndrome.
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PMID:[Enterohemorrhagic Escherichia coli O157:H7 infection]. 1060 52

Amoebiasis caused by the enteric protozoan Entamoeba histolytica is a widespread parasitic disease, which causes 40,000 to 100,000 deaths per year. Cases diagnosed in Denmark are always imported. Infection results from ingestion of amoebic cysts, which after excystation form trophozoits in the small intestine, colonize the bowel lumen and invade the intestinal epithelium resulting in amoebic colitis. Spread to the liver and formation of amoebic liver abscesses occurs in one third of the cases, whereas other extraintestinal manifestations are rare. Amoebic colitis and liver abscess have a good prognosis when treated with metronidazole, whereas complications such as necrotizing colitis, peritonitis and pericarditis have a high mortality. An early diagnosis and treatment is therefore important. Intestinal amoebiasis is diagnosed by demonstration of E. histolytica cysts or amoebae in the stools, whereas serology is of value in diagnosing extraintestinal amoebiasis in nonendemic regions.
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PMID:[Amebiasis]. 1086 7


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