[Pathogenic and epidemiologic aspects of Yersinia enterocolitica infections].
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Biomedical subjects
Publications and source records attributed to G Wauters.
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During an 8-year period 14,092 fecal specimens and 1,428 excised appendixes were examined for the presence of Yersinia enterocolitica, with different combinations of direct plating media and enrichment techniques. The combination of direct plating on SS agar and 2 days of enrichment in a modified Rappaport broth at room temperature resulted in the isolation of 100% of serotype 3 and 9 strains. Such strains were recovered from 3.7% of our fecal specimens. Cold enrichment in phosphate buffer further increased the isolation rate, but the additional isolates all belonged to biotype 1. Evidence is presented that biotype 1 strains, at least in Belgium, are not pathogenic for humans. There was a significant affinity of serotype 9 strains for patients suffering from an "appendicular syndrome."
Morphologic and functional studies have implicated islet microtubules in the transport of the B-cell secretory product form the endoplasmic reticulum to the peripheral pool of secretory vesicles. The participation of the microtubular apparatus in the insulin release mechanism appears to be mediated through an increased rate of tubulin synthesis and of tubulin polymerization, two possible sites for a physiologic and pharmacologic regulation of hormone discharge. It is conceivable that cytoplasmic microtubules from either a rigid cytoskeleton which facilitates hormone transport by establishing n intracellular organization or act as a motion generating system along which the secretory vesicles are actively transported to the cell periphery. The existence of an eventual interaction between secretory vesicles and islet microtubules has been examined by measuring I123-tubulin binding to various subcellular fractions. In working out the experimental procedure on liver tissue, tubulin was found to bind to all subcellular fractions being most pronounced in the microsomial fraction; in the cytosol, tubulin was incorporated into high molecular weight complexes. Similar results were obtained with islet subcellular fractions, binding per microgram protein being tenfold higher than in liver tissue. In view of the calcium-induced increase in tubulin binding to islet subcellular fractions, and of the high affinity of tubulin and secretory vesicles for calcium, it is suggested that a calcium stimulated bridge - eventually microfilamentous in nature - might link the growing microtubules to the secretory vesicles and could, as such, participate in the intracellular transport of the secretory product.
In the period from 1963 to 1975 data were collected on 1,781 isolates of Y. enterocolitica from human infections in Belgium. There was an uneven spread of the cases over the country, but this could simply reflect the distribution and activity of medical laboratories. Serotype 3 dominated (89.2%) followed by serotype 9 (8.6%). Less than 1% of all isolates were from nonenteral sources. Gastroenteritis was the diagnosis in 86.8% of patients, while 10.6% were suffering from an appendicitis-like syndrome. Gastroenteritis had its peak incidence in the under 5 year group, whereas the pseudo-appendicular syndrome was more frequent in the 10--19 years age group. There was a distinct seasonal peak in late autumn. The significant association with Salmonella isolation from the stool of the same patient has been confirmed.
Bacteriological cultures were made from pigs' tongues bought in several Belgian butchers' shops, for 3 years in succession. From 302 samples 168 Yersinia enterocolitica strains were isolated, all of serotype 3, except three strains belonging to serotype 9. The isolation rate ranged from 53 to 62.5%, depending on the year. The modified Rappaport broth supplemented with carbenicillin proved to be highly superior to the cold enrichment method for recovering the organism from this material. It is assessed that Y. enterocolitica of serotype 3 is a normal inhabitant of the oral cavity of pigs in some countries. This source of organism might play a prominent part in the epidemiology of human infections caused by these bacteria.
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The beta-lactamase isoelectric focusing patterns of 37 strains of Yersinia enterocolitica from various serological and biochemical groups were examined. Strains of different serological groups generally had different patterns, but those of serological groups 1, 2, 3 and 9 were identical.
It appears that miconazole is highly effective in reducing the incidence of systemic mycosis in patients suffering from malignant haemopathy and bone marrow failure. Three clinical infections (one stomatitis and two septicaemias due to candida) were easily cured. Autopsy findings never disclosed mycosis as the cause of death. The drug was completely atoxic and seems to offer major help in the treatment of malignant blood disease.
The method described by Krinvall, using antibodies adsorbed to "Protein-A" containing staphylococci, can be applied for the serological grouping of A, B, C, F and G streptococci. The results are improved by replacing the whole trypsinized cells, as reported by Christensen et al., by an enzymatic extract of the polysaccharide. The reaction is easy, specific, rapid and cheap.
The addition of L-phenylalanine to the lysine-iron agar described by Edwards and Fife ]1] allows a more valuable screening of the Proteus group based on its deamination properties. Some minor modifications of the indicator and thiosulfate content lead to improve and earlier recording of the results.
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