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Enterotoxigenic Bacteroides fragilis isolated from nondiarrheic adults.

From 220 fecal samples of nondiarrheic adults, 29 strains of Bacteroides fragilis were isolated. Nine percent of them were enterotoxigenic Bacteroides fragilis (ETBF) strains. That is the first isolation of ETBF strains from nondiarrheic adults in Poland. Isolated ETBT strains could not be distinguished from non-enterotoxigenic Bacteroides fragilis (NTBF) strains by means of agglutination test. The sensitivity to antimicrobial agents does not differentiate enterotoxigenic from nonenterotoxigenic B. fragilis strains.

Adult↗

Detection of enterotoxigenic Bacteroides fragilis (ETBF), among strains isolated between 1976 and 1995 in Poland.

Thirty five Bacteroides fragilis strains isolated from different, clinical specimens in 1976-1985 and in 1995, preserved in strains collection of Department of Clinical Bacteriology were studied. The cytotoxicity of 35 bacterial culture supernatants, were tested on the human carcinoma cell line HT29/C1. Two strains proved to be enterotoxigenic. One of those strains was isolated in 1985 from the human, before the existence of enterotoxin producing strain was reported. All 35 strains were metronidazol sensitive showing lack of correlation between enterotoxigenicity and metronidazol resistance.

Anti-Bacterial Agents↗

Association of enterotoxigenic Bacteroides fragilis with childhood diarrhoea.

This study was conducted in a hospital setting to determine whether enterotoxigenic strains of Bacteroides fragilis (ETBF) were associated with childhood diarrhoea. ETBF was isolated from 6 (2.6%) of 226 patients and 3 (1.7%) of 172 controls and was found mostly in children between 1-5 yr of age. The syndrome associated with ETBF was secretory in nature with watery diarrhoea and of mild severity. ETBF may be associated with diarrhoeal illness in children but is not a major problem in this part of the country.

Bacteroides Infections↗

Infected aneurysms--clinical study of 5 cases.

The infected aneurysm has been assumed to be a disease with a poor prognosis due to the occurrence of aneurysmal ruptures and sepsis, in contrast to the outcome of atherosclerotic aneurysms. In the present study, we conducted surgical treatment on five patients with infected aneurysms (infected abdominal aortic aneurysm in three cases and iliac artery aneurysm in two cases). In particular, two of the three patients suffering from infected abdominal aortic aneurysms underwent extra-anatomic bypass and the remaining one case underwent vascular graft replacement in situ. In the two patients who underwent an extra-anatomic bypass, an aneurysm was found at the site of aortic stump closure. In the patient who underwent in situ replacement, wrapping was carried out using the omentum after vascular graft replacement, and the postoperative course was uneventful. Accordingly, we consider that the optimum primary therapeutic intervention for infected aneurysms is in situ revascularization followed by wrapping with the omentum after removal of the aneurysm and debridement of the surrounding infected tissue to the maximum extent possible.

Adult↗

Cellular mechanism of intraabdominal abscess formation by Bacteroides fragilis.

We investigated the cellular mechanism by which Bacteroides fragilis promotes the development of intraabdominal abscesses in experimental models of sepsis. B. fragilis, as well as purified capsular polysaccharide complex (CPC) from this organism, adhered to primary murine mesothelial cells (MMCs) in vitro. The binding of CPC to murine peritoneal macrophage stimulated TNF-alpha production, which when transferred to monolayers of MMCs elicited significant ICAM-1 expression by these cells. This response resulted in enhanced polymorphonuclear leukocyte attachment to MMCs that could be inhibited by Abs specific for TNF-alpha or ICAM-1. Mice treated with TNF-alpha- or ICAM-1-specific Abs failed to develop intraabdominal abscesses following challenge with purified CPC. These results illustrated the role of the CPC in promoting adhesion of B. fragilis to the peritoneal wall and coordinating the cellular events leading to the development of abscesses associated with experimental intraabdominal sepsis.

Abdominal Abscess↗

Pelvic abscess. A sequela of first trimester abortion.

First trimester therapeutic abortions were performed in 6790 patients from January 1, 1972, through December 31, 1973. The infectious morbidity during an 18-month concurrent time period which required readmission to the hospital was 0.52 per 100 women. Four of these women were ultimately diagnosed as having a pelvic abscess thought to be related to the procedure. The cause was probably related to undiagnosed or inadequately managed uterine perforation. Initial management should consist of systemic antibiotics and, if possible, surgical drainage via colpotomy. Two special precautions which should be taken are the use of antibiotics specific for Bacteroides fragilis and the investigation of the possibility of bowel injury. Laparotomy should be considered in unresponsive cases because of the possibility of bowel injury and the necessity of adequate surgical drainage even with appropriate antibiotic coverage.

Abortion, Induced↗

Sternoclavicular joint infection due to Bacteroides oralis.

A 60-year-old man in good health with no history of intravenous drug abuse was hospitalized for sternoclavicular joint pain and swelling. His complicated course required extensive debridement of the sternoclavicular joint. An insidious course, negative blood culture and requirement for surgery is common in infections of this joint.

Abscess↗

Activity of ceftizoxime and comparative compounds against Bacteroides fragilis in a mouse model of anaerobic infection.

A new mouse model of anaerobic infection with Bacteroides fragilis alone or in a mixed infection with Escherichia coli is described. It is established by implantation under the skin of a filter paper disk saturated with the appropriate bacterial suspension. The penetration of antibiotics into the implantation site can be detected by assaying the disk. The local infection can be both standardized and evaluated by determining the bacterial count on the disk. The antimicrobial efficacy of ceftizoxime was compared with other commercially available antibiotics administered in a single dose, 40 mg/kg subcutaneously, one hour after implantation of the disk. Using such a regimen ceftizoxime was found to be superior to a clindamycin-gentamicin combination and equal to or superior to cefoxitin in these models.

Animals↗

Indirect serum haemagglutinating antibody response to black pigmented Bacteroides during experimental pure infections in rats.

The humoral immune response during experimental infection with black pigmented bacteroides was studied by the indirect haemagglutination test. Both Bacteroides melanimogenicus (ATCC 25845) and B. intermedius (ATCC 25611), grown in semi-solid agar culture, produced pure subcutaneous, intra-abdominal and lung infections. In each of these infection models, B. intermedius was found to be more pathogenic than B. melaninogenicus on the basis of gross pathology of the lesion, bacteriological and histopathological findings, and the capacity to produce persistent infection. Cytoplasmic extracts of these strains were used as an antigen for the indirect haemagglutination test. In all the infections, B. intermedius provoked a better and higher antibody response than did B. melaninogenicus, suggesting a potent immunogenic property of the former strain. Peak antibody titres in both groups during all the above infections were seen between the 10th and 15th days post infection (p.i.), which was precisely 3-5 days after peak lesion was achieved. A significant IHA antibody titre persisted up to days 30-37 p.i. These findings suggest that the antibodies to the black pigmented Bacteroides are not protective, but may play a role in the pathogenesis of the diseases.

Abscess↗