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Query: UMLS:C0017160 (gastroenteritis)
 11,398 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Infection is a major complication and the leading cause of death in thalassemia, especially E-beta thalassemia. The spectrum of infections in E-beta thalassemia include mild and severe infections, therapy-related infections such as Yersinia enterocolitica infection associated with desferrioxamine (DFO) therapy, and transfusion-transmitted disease, as well as unique infections such as with pythiosis. Prospective studies in Thailand indicate that patients with E-beta thalassemia had more frequent episodes of both mild and severe infections. The former included upper respiratory tract infection, acute gastroenteritis, cutaneous abscess, and gingivitis. Severe infections occurred more commonly in patients with splenectomy and included septicemia, pneumonia, biliary tract infection, salmonellosis, and urinary tract infection. Responsible organisms were Escherichia coli (26%), Klebsiella pneumoniae (23%), Salmonella (15%), and Streptococcus pneumoniae (13%). Other organisms included Pseudomonas, Staphylococci, Burkholderia pseudomallei (melioidosis), and Aeromonas. Patients undergoing DFO therapy are at risk for Y. enterocolitica infection which may be localized to mesenteric nodes and tonsils or occur as a generalized form such as septicemia. Recently, we have seen a unique infection so-called vascular pythiosis. Patients usually presented with clinical features of vascular occlusion of lower limbs from ascending arteritis and thrombosis. The causative organism, Pythium insidiosum, is fungus-like, in the kingdom Stramenopila, and in the class Oomycetes. The mortality rate is high and the only effective treatment has been early amputation or possibly immunotherapy. The predisposing factors of infections in thalassemia include splenectomy, iron overload, anemia, and granulocyte dysfunctions. General management of infections in thalassemia consist of prevention, i.e., immunization with pneumococcal and hepatitis vaccines, oral penicillins especially in patients with splenectomy, removal of predisposing factors such as gallstones, iron overload, and appropriate antibiotics.
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PMID:Infections in E-beta thalassemia. 1113 34

The sirA gene of Salmonella enterica serovar Typhimurium encodes a two-component response regulator of the FixJ family that has a positive regulatory influence on the expression of type III secretion genes involved with epithelial cell invasion and the elicitation of bovine gastroenteritis. SirA orthologs in Pseudomonas, Vibrio, and Erwinia control the expression of distinct virulence genes in these genera, but an evolutionarily conserved target of SirA regulation has never been identified. In this study we tested the hypothesis that sirA may be an ancient member of the flagellar regulon. We examined the effect of a sirA mutation on transcriptional fusions to flagellar promoters (flhD, fliE, fliF, flgA, flgB, fliC, fliD, motA, and fliA) while using fusions to the virulence gene sopB as a positive control. SirA had only small regulatory effects on all fusions in liquid medium (less than fivefold). However, in various types of motility agar plates, sirA was able to activate a sopB fusion by up to 63-fold while repressing flagellar fusions by values exceeding 100-fold. Mutations in the sirA orthologs of Escherichia coli, Vibrio cholerae, Pseudomonas fluorescens, and Pseudomonas aeruginosa result in defects in either motility or motility gene regulation, suggesting that control of flagellar regulons may be an evolutionarily conserved function of sirA orthologs. The implications for our understanding of virulence gene regulation in the gamma Proteobacteria are discussed.
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PMID:SirA orthologs affect both motility and virulence. 1124 64

During an outbreak of gastroenteritis in 28 children living in a small neighbourhood of Cuernavaca city (Mexico), a survey was performed to evaluate the confidence in coliform bacteria as sole indicators of potability of drinking waters. A primary infection by E. coli and a secondary by Pseudomonas aeruginosa was diagnosed in five of the children and the drinking water provided by a well was suspected as a transmission source. General and household distribution systems, household filters and bottled waters were evaluated for total and faecal coliforms, family Enterobacteriaceae, P aeruginosa and residual chlorine. In every sample, pathogenic/opportunistic bacteria were isolated even in the absence of coliforms and in the presence of residual chlorine. Arbitrarily assigned "pollution/risk levels" indicated that the most elevated risk was most frequently associated with storage in tanks and with bacterial colonisation in the pipeline system and commercial household filters where high levels of P aeruginosa were determined. A probability of correspondence between the presence of this bacterium and the secondary gastrointestinal infection diagnosed was found pointing towards a need for the inclusion of other microorganisms, one of which may be P aeruginosa, as indicators of health risk associated with drinking waters in Mexico.
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PMID:Pseudomonas aeruginosa as an indicator of health risk in water for human consumption. 1146 68

An attempt to use treated wastewater for agriculture in the Chiang Mai area was made, but the re-use process had to be performed under a condition that limited the risks liable to leave pathogens present in the water. The objective of our study was to examine the intestinal parasites and enteric bacteria in the wastewater and treated wastewater from the Chiang Mai University campus as well as the treated wastewater from the Chiang Mai municipality. The raw wastewater (RW), primary treatment effluent water (PE), treated wastewater using the activated sludge system (AS) from the Chiang Mai University campus and treated wastewater using the aerated lagoon (AL) system from the Chiang Mai municipality were examined for intestinal parasites and enteric bacteria by using the centrifugal sedimentation and conventional methods respectively. The ground water (GW) and the irrigation water (IW) were used for comparison. All kinds of water were collected and examined twice a month for 6 months (February to July 2000). None of human intestinal parasites were found from any wastewater, whereas the RW and PE water contained hookworm larva, Ascaris egg and Taenia egg on some occasions. A small amounts of pathogenic bacteria that can cause severe diarrhea were detected. Salmonella enteritidis gr E was isolated from the AL water in April, while Vibrio cholerae type O139 was detected from the PE water in June. Some pathogenic bacteria that might cause gastroenteritis, such as Aerobacter spp, Citrobacter spp, Pseudomonas spp and Escherichia coli were also found in all kinds of water. Between the two types of treated wastewater, the bacteria found in AS water was less than that in AL water in terms of both amount and type of bacteria. The treated wastewater from the city of Chiang Mai, compared to natural water such as irrigation water, appears to be safe to use for agriculture.
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PMID:Examination for intestinal parasites and enteric bacteria in the wastewater and treated wastewater from the city of Chiang Mai, Thailand. 1204 97

Each year, between April and October, many children of school age and some young adults in Nsukka, Nigeria suffer from gastroenteritis. The period covers the rainy season in this part of Africa, when manured farmland occasionally is flooded. In view of the number of people suffering diarrhoea and occasionally low-grade fever, it became necessary to investigate the nature of the bacterial agents responsible. Between April and October (1996-1998), 500 loose or watery stools were collected from patients, the ages of which ranged from one month to 31 years. Stools that contained parasites were excluded from the study. Samples were cultured on 5% blood agar and 1% egg-yolk agar (both containing 10 microg/mL ampicillin), MacConkey agar, Shigella Salmonella agar and in alkaline peptone water. Bacterial growths were identified using standard bacteriological procedures. Drinking water and some fruit and vegetables prevalent during this period of the year also were cultured. Of the 500 stool samples tested, 138 (27.6%) grew a range of organisms including Aeromonas hydrophila (65 [13%]), Salmonella spp. (55 [11%]), Shigella spp. (9 [1.8%]) and enteropathogenic Escherichia coli (9 [1.8%]). Drinking water and some vegetables grew Pseudomonas aeruginosa and Enterococcus faecalis, respectively. The highest isolation rate occurred during June and July, corresponding to the period of greatest flooding of arable land. Although no enteropathogens were isolated from the fruit and vegetables examined, they contained E. faecalis--an organism found in faeces. Our findings failed to explain why 72% of the samples grew no bacterial enteropathogens.
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PMID:Bacterial enteropathogens and factors associated with seasonal episodes of gastroenteritis in Nsukka, Nigeria. 1211 7

Heterotrophic plate counts (HPCs) are commonly used to assess the general microbiological quality of drinking water. Drinking water quality specifications worldwide recommend HPC limits from 100 to 500 cfu ml(-1). A number of recent studies revealed evidence that these bacteria may not be as harmless as generally accepted. It appears that immuno-compromised individuals are particularly at risk. This would include the very young and very old patients with diseases such as AIDS and patients on therapy for purposes such as organ transplantation and cancer treatment. In this study, 339 bacterial colonies were isolated at random from selected treated and untreated drinking water in South Africa using routine heterotrophic plate count tests. In a first step to screen for potentially pathogenic properties, 188 (55.5%) of the isolates showed alpha- or beta-haemolysis on human- and horse-blood agar media. Subsequent analysis of the haemolytic isolates for enzymatic properties associated with pathogenicity revealed the presence of chondroitinase in 5.3% of the isolates, coagulase in 16.0%, DNase in 60.6%, elastase in 33.0%, fibrinolysin in 53.7%, gelatinase in 62.2%, hyaluronidase in 21.3%, lecithinase in 47.9%, lipase in 54.8% and proteinase in 64.4%. Fluorescein and pyocyanin were not produced by any of the isolates. Among the haemolytic isolates, 77.7% were resistant to oxacillin 1 microg, 59.6% to penicillin G 2 units, 47.3% to penicillin G 10 units, 54.3% to ampicillin 10 microg and 43.1% to ampicillin 25 microg. Cell culture studies revealed that 96% of haemolytic isolates were cytotoxic to HEp-2 cells, and 98.9% of the 181 cytotoxic isolates adhered to HEp-2 or Caco-2 cells. HEp-2 cells were invaded by 43.6%, and Caco-2 cells by 49.7%, of the 181 cytotoxic isolates. The invasion index on HEp-2 cells ranged from 1.9 x 10(-1) to 8.9 x 10(-6), whereas the invasion index on Caco-2 cells varied between 7.7 x 10(-2) and 8.3 x 10(-6). The most commonly isolated genera with these potentially pathogenic features were Aeromonas, Acinetobacter, Aureobacterium, Bacillus, Chryseobacterium, Corynebacterium, Klebsiella, Moraxella, Pseudomonas, Staphylococcus, Tsukamurella and Vibrio. The results obtained in this study support earlier findings on potentially pathogenic features of bacteria detected by routine HPCs on drinking water. These findings are in agreement with some epidemiological studies, which indicated an association between HPCs in drinking water and the incidence of gastroenteritis in consumers. However, the extent of the health risk concerned needs to be defined in more detail for meaningful revision of quality guidelines for HPCs in drinking water.
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PMID:Potentially pathogenic features of heterotrophic plate count bacteria isolated from treated and untreated drinking water. 1514 86

A 14-month-old infant presented with gastroenteritis with febrile pancytopenia and was diagnosed with acute lymphocytic leukemia (ALL). Ten days post induction therapy, the patient developed hypertension that was ascribed to steroid therapy and treated with metoprolol and amlodipine. As leukocyte numbers began to recover the asymptomatic patient became anuric. Ultrasound showed echoic floating structures in the bladder. Following cystoscopy and retrograde pyelography examination, purulent debris was irrigated from the bladder and grew Pseudomonas aeruginosa. Ciprofloxacin therapy was initiated and renal function was restored within 2 days. The case highlights the potential for renal obstruction after neutropenia recovery in children undergoing induction therapy for ALL.
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PMID:Pseudomonas aeruginosa infection: an uncommon cause of post-renal obstruction following induction therapy for acute lymphoblastic leukemia. 1592 36

21 samples of waters of 7 swimming pools in the province of Palermo were investigated for the presence of Giardia cysts and Cryptosporidium oocysts. Some chemio-physical parameters (chlorine, temperature, turbidity and pH) were also evaluated as well as the presence of bacterial indicators of faecal (total coliforms, Escherichia coli and enterococci), mucocutaneous and environmental (Staphylococcus aureus and Pseudomonas aeruginosa) contamination. All samples were negative for bacterial indicators of faecal contamination; 3 were positive for the presence of coagulase-negative staphylococci, 1 was positive for Alcaligenes spp. and 2 for Pseudomonas aeruginosa. 8 samples proved to be positive for Giardia and 6 also for Cryptosporidium. All but one of them were coming from waters of 2 swimming pools of the same recreational center. In all samples the concentration of Giardia was substantially higher than that of Cryptosporidium. This study shows that the disinfection and filtering plants are not always suitable to ensure a good level of the quality of the waters of swimming pools and suggests that should be necessary to check them also for the presence of protozoa like Giardia and Cryptosporidium, which may be responsible for gastroenteritis.
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PMID:[Occurrence of Giardia cysts and Cryptosporidium oocysts in swimming pools in the province of Palermo, Italy]. 1708 52

Escherichia coli O157:H7 is an important agent of haemorrhagic colitis and haemolytic uraemic syndrome in children less than five years old and elderly people. The objective of this study was to investigate the prevalence of verotocytoxin producing E. coli 0157 (VTEC O157) among human patients with diarrhoea in Morogoro, Tanzania. Faecal samples originating from 275 human patients with diarrhoea were screened for presence of E. coli O157:H7. A total of 96 E. coli isolate were identified. Of these, 10 isolates were grouped into sorbitol non-fermenting and glucuronide negative and 49 isolates were sorbitol positive and glucuronide positive. The remaining 37 were sorbitol negative and glucuronide positive. Using the polymerase chain reaction techniques, a total often verotocytocin producing E. coli isolated in this study were used. The overall two (15%) and one (7%) of the isolated of E. coli possessed both attaching and effacing (eae A) and enterohemolysin (ehly) A genes respectively. Other enterobacterial agents including Pseudomonas spp, Proteus spp and coliforms were also isolated. The VTEC O157 isolates were 100% resistant to oxytetracycline, chloramphenicol, streptomycin, and amoxyclav. In conclusion, the isolation of diarrhoeaogenic E. coli O157:H7 in this region suggests that the pathogen is an important aetiology of acute gastroenteritis in Tanzania. There is therefore, need to improve sewage and refuse disposal system, the provision of safe potable water, sanitation, personal hygiene and health education in order to reduce infection with this and other enteric pathogens.
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PMID:Prevalence and characterization of verotocytoxin producing Escherichia coli O157 from diarrhoea patients in Morogoro, Tanzania. 1902 40

Despite the high incidence of rotavirus gastroenteritis, secondary bacteraemia later in the course of the disease has rarely been reported. To date, the exact incidence of this complication has not been determined. A prospective study was conducted between January 2007 and December 2008 to determine the incidence of bacteraemia by organisms of the normal intestinal flora during severe rotavirus gastroenteritis. Rotavirus gastroenteritis was diagnosed by antigen detection in stool. A previously described 20-point numerical score system was used to determine the severity of disease. There were 289 cases (30%) of rotavirus gastroenteritis during the study period, 106 (36.7%) of which were accepted to be severe rotavirus gastroenteritis and hospitalized. On admission stool and blood cultures tested negative. In cases of persistent or recurrent fever, additional blood cultures were obtained. Among cases with severe rotavirus gastroenteritis, 4 (3.8%) had positive blood cultures (Klebsiella pneumoniae in 1 patient, Escherichia coli in 1 patient, Pseudomonas aeruginosa and Candida albicans in 1 patient, and Candida albicans in 1 patient). All patients were successfully treated with fluid replacement and antimicrobial therapy. Bacteraemia and candidaemia appear to be a considerable and underestimated complication of severe rotavirus gastroenteritis.
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PMID:Bacteraemia and candidaemia: a considerable and underestimated complication of severe rotavirus gastroenteritis. 1992 69


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