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NOSOCOMIAL OUTBREAK OF CAMPYLOBACTER JEJUNI MENINGITIS IN NEWBORN INFANTS

In a nosocomial outbreak of Campylobacter jejuni infection 11 newborn infants (7 female, 4 male) had meningitis. The outbreak was caused by a single strain of C jejuni, as demonstrated by biotyping (biotype I), serotyping (LAU 7/PEN 18 on heat-stable antigens, a new serotype on heat-labile antigens), and the identical susceptibility pattern and outer-membrane-protein profile on sodium dodecyl sulphate/polyacrylamide gel electrophoresis. Specific antibodies against the outbreak strain (enzyme-linked immunosorbent assay and Western blot) developed in all the babies. They were treated with gentamicin and ampicillin. All but one baby, who had a moderately dilated left lateral ventricle after the meningitis, recovered well. The source of infection could not be clearly determined. Thus, C jejuni can cause serious nosocomial infection; it should be considered as a possible agent of meningitis of unknown origin, particularly in newborn infants and other compromised hosts.

Accuracy of the API Campy system, the Vitek 2 Neisseria-Haemophilus card and matrix-assisted laser desorption ionization time-of-flight mass spectrometry for the identification of Campylobacter and related organisms

Biochemical identification of Campylobacter and related organisms is not always specific, and may lead to diagnostic errors. The API Campy, the Vitek 2 system and matrix-assisted desorption ionization time-of-flight mass spectrometry (MALDI-TOF MS) are commercially available methods that are routinely used for the identification of these microorganisms. In the present study, we used 224 clinical isolates and ten reference strains previously identified by multiple PCR assays, whole cell protein profiling and either DNA-DNA hybridization or sequencing analysis to compare the reliability of these three methods for the identification of Campylobacter and related pathogens. The API Campy accurately identified 94.4% of Campylobacter jejuni ssp. jejuni and 73.8% of Campylobacter coli, but failed to correctly identify 52.3% of other Epsilobacteria. The Vitek 2 Neisseria-Haemophilus card correctly identified most C. jejuni ssp.jejuni (89.6%) and C. coli (87.7%) strains, which account for the majority of campylobacterioses reported in humans, but it failed in the identification of all of the other species. Despite a good identification rate for both C. jejuni ssp. jejuni and C. coli, both methods showed poor sensitivity in the identification of related organisms, and additional tests were frequently needed. In contrast to API Campy and Vitek, MALDI-TOF MS correctly identified 100% of C. coli and C. jejuni strains tested. With an overall sensitivity of 98.3% and a short response time, this technology appears to be a reliable and promising method for the routine identification of Campylobacter and other Epsilobacteria.

Campylobacter enteritis in Portugal: Epidemiological features and biological markers

From 1984 to 1989, stool samples from 2811 gastroenteritis cases were examined for the presence ofCampylobacter jejuni andC. Coli, Salmonella, Shigella andYersinia species. Isolation rates were:Campylobacter jejuni andC. Coli, 5.3%,Salmonella spp., 14.8%,Shigella spp., 4.6% andYersinia enterocolitica, 1.1%.Age group distribution analysis shows a higherCampylobacter isolation rate in children under one year of age. Seasonal distribution revealed a peak incidence in winter as in other Meditteranean countries.Predominant biotypes wereC. jejuni I (51%),C. jejuni II (21.5%) andC. coli I (18.8%). Antimicrobial susceptibility testing did not reveal resistance to erythromycin. Thirty of the strains harboured plasmids with 7 different profiles.

Multiple typing for the epidemiological study of the contamination of broilers with Salmonella from the hatchery to the slaughterhouse.

Eighteen Belgian broiler flocks were followed from the hatchery to the slaughterhouse by a multiple typing approach (sero-, geno-, and phage types) for the investigation of the transmission of Salmonella and its subtypes. For 12 of the 18 flocks, there was no correlation between the serotypes found preharvest and those isolated from the feces in the transport crates and on the carcasses in the slaughterhouse. Serotypes found in the crates were usually also found on the carcasses. In 5 of the 10 flocks with Salmonella-positive broilers, complex contamination patterns with the involvement of different serotypes, genotypes, or both were revealed. In two of these flocks (flocks 8 and 9), the Salmonella Enteritidis contamination of the broilers could be traced to the hatchery. In flock 9, evidence was found for the acquisition, during rearing, of a megaplasmid in the Salmonella Enteritidis strain. In the other three positive flocks (flocks 6, 7, and 10), the environment and movable material (e.g., footwear) played a determining role in the infection and shedding pattern of the broilers. For flocks 6 and 7, reared consecutively in the same broiler house, a persistent Salmonella Hadar geno/phage type predominated in the preharvest period, while another Salmonella Hadar geno/phage type was found in the house or the environment but never in the broilers. Only for the above-mentioned five flocks were the same strains that were found preharvest also recovered from the carcasses, although these strains were not predominant on the carcasses, with the exception of one flock (flock 10). In conclusion, it can be said that most of the time, Salmonella strains that contaminate Belgian broiler carcasses do not predominate in the preharvest environment.

MALDI-TOF MS contribution to the diagnosis of Campylobacter rectus multiple skull base and brain abscesses

Campylobacter rectus is rarely associated with invasive infection. Both the isolation and the identification requirements of C. rectus are fastidious, probably contributing to an underestimation of its burden. We report the case of a 66-year-old man who developed several skull base and intracerebral abscesses after dental intervention. Campylobacter rectus was isolated from the brain biopsy. Within 45 minutes of reading the bacterial plate, the strain was accurately identified by MALDI-TOF MS. This rapid identification avoided the extra costs and delays present with 16S rRNA gene sequencing and allowed for a rapid confirmation of the adequacy of the empirical antibiotic treatment.

Performance of the chromID Salmonella Elite chromogenic agar in comparison with CHROMagar™ Salmonella, Oxoid™ Brilliance™ Salmonella and Hektoen agars for the isolation of Salmonella from stool specimens

chromID™ Salmonella Elite is compared with 3 culture media commonly used for Salmonella isolation from stool specimens. As results were equivalent to other chromogenic media (100% sensitivity, 98% specificity), only financial arguments should guide the choice for a medium with respect to another.

The role of Epsilonproteobacteria in children with gastroenteritis.

A polymerase chain reaction–denaturing gradient gel electrophoresis method was used to examine 50 stool samples from children in Belgium with gastroenteritis for an extensive range of Epsilonproteobacteria species. During the 3-month study period, Campylobacter concisus was the most common species. Our observations suggest that C. concisus displays similar microbiologic and clinical features as Campylobacter jejuni.