W. Hemelhof

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.

ENTEROPATHOGENIC AGENTS IN CHILDREN WITH DIARRHOEA IN RURAL ZAIRE

A systematic study of enteropathogenic agents in the stools of children was carried out in a rural area of Kivu Province in Zaire in June, 1979. 84 inpatients and 271 outpatients with diarrhoea were investigated together with 117 inpatient and 203 outpatient controls without diarrhoea. Campylobacter jejuni was the most frequently recovered pathogen in both inpatients (24%) and outpatients (13.7%). Enterotoxigenic Escherichia coli was the next most common among children presenting as outpatients with diarrhoea (10.3%). Yersinia enterocolitica was isolated for the first time in this region. Rotaviruses were found only in outpatients with diarrhoea, and usually in children under two years of age. C. jejuni and Vibrio cholerae could also be isolated from the faeces of domestic animals living in close contact with these village families. Analysis of the clinical features did not lead to the recognition of a pattern typical of any particular pathogen. Salmonella, Shigella, and enteropathogenic E. coli did not play a significant role in the cases studied.

A COMPETITIVE IMMUNOSORBENT ASSAY FOR THE DETECTION OF HEAT-STABLE ENTEROTOXIN OF ESCHERICHIA COLI

A competitive ELISA procedure for the detection of Escherichia coli heat stable enterotoxin (ST) with monoclonal antibody has been developed. This test is 10 times more sensitive than the suckling-mouse bioassay and it is specific, simple and cheap. A set of 882 strains of E. coli isolated from man were tested both by ST-ELISA and suckling-mouse bioassay, the latter serving as the reference method. Positive results in both tests were obtained with 152 strains. The remaining strains gave negative results in both tests, with the exception of two strains, known to be ST producers, that gave negative results in the suckling-mouse assay, but gave positive results by the ELISA method.