THE EFFECIENCY OF ENTERIC LACTOBACILLUS IN PREVENTING HEMORRHAGIC COLITIS AND BLOCKING SHIGA TOXINS PRODUCTIONS IN RATS MODELS INFECTED WITH ENTEROHEMORRHAGIC ESCHERICHIA COLI (EHEC)

The objective of this study was to investigate the prophylactic roles of human enteric derived Lactobacillus plantarum L1 (Ll) and Lactobacillus paracasei L2 (L2), on EHEC O157:H7 infection in rodent models (In vivo). The Lactobacillus suspensions (L1 and L2) were individually and orally administered to experimental rats at a daily two consecutives of 100 μl (108 CFU/ ml/rat) for up to two weeks. Thereafter, on the 8th day of experiment rats were orally challenged with one dose infection of EHEC (105 CFU/ml/rat). Animals mortality and illness symptoms have been monitored. There was no fatal EHEC infection in rats that had been pre‑colonized with the Lactobacillus strains, while most of EHEC infected rats were died (90%). The Stx1 and Stx2 levels were significantly lower (14 and 12 folds) in the L1and L2 pre-inoculated rates respectively, compared with those in the EHEC colonized group. Histological sections were proven the prophylactic roles of L1 and L2, whereas, no effective histological upsets were detected in Lactobacillus + EHEC- colonized rats. The cytopathic symptoms were predominant in kidney and intestinal sections of EHEC infected rats. The kidney sections cytopathy manifested to lining membrane ulceration, infiltration of mononuclear cells and glomerular and tubular epithelium necrosis. The striking attaching and effacing (A/E) lesions were prominent in intestinal sections of EHEC infected animal models.

Hemorrhagic colitis syndrome in children: the etiological structure in the infectious diseases clinic

The range of differential diagnostic search in the development of hemorrhagic colitis (hemocolitis) is wide enough and includes infectious and non-infectious factors. Purpose: clinical, laboratory and etiological analysis of bacterial diarrhea occurring with hemorrhagic colitis in the infectious diseases department.Materials and methods: a retrospective study of 141 case histories of those hospitalized in the infectious diseases department of the2 Children's City Clinical Hospital No. 9 named after G.N. Speransky of Moscow in 2019—2021 patients with clinical picture of hemocolitis. Hemocolitis was determined on the basis of macroscopic and microscopic signs (in scatology — mucus, leukocytes, erythrocytes) signs. All patients underwent routine laboratory examinations. The etiology was verified using modern methods of laboratory diagnostics (bacteriological analysis of feces, Latex test, ICA, ELISA, PCR, IHR).Results. There were 137 patients with infectious hemocolitis. Inflammatory bowel disease was diagnosed in 3 children, anus fissure — in 1 child. Young children under 3 years of age prevailed (77%). The etiology of infectious hemocolitis was deciphered in 47 patients (34%). Salmonellosis (36%) and shigellosis (36%) prevailed. Campylobacteriosis, clostridiosis-dificile and klebsiellosis accounted for 11%, 9% and 6% of cases, respectively. Yersiniosis was detected in 1 child at the age of 5 months. The severe form was found in 5.8% of cases, in most cases with shigellosis. Symptoms of intoxication and febrile fever were expressed in all patients, vomiting — in 28.5%, abdominal pain — in 94%, mesenteric adenitis on ultrasound — in 15%, diarrhea with a frequency of more than 5 times a day — in 84%, dehydration — in 64%, intercurrent diseases (ARVI, pneumonia) — in 41.3% of cases. Inflammatory changes in infectious hemocolitis were manifested by an increase in C-reactive protein in 71% (23.91 ± 24.17 mg/l), leukocytosis — in 69% (11.58 ± 3.52 х103 / μl), thrombocytosis — in 26%, an increase in the relative number of stab neutrophils in the general blood test in 78% of cases (10.95 ± 0.4%).Conclusions. Differential diagnostic search in the development of hemocolitis should include modern diagnostic methods, if necessary, additional instrumental studies and specialist consultations to exclude inflammatory bowel diseases.

First Experimental Evidence for the Presence of Potentially Virulent Klebsiella oxytoca in 14 Species of Commonly Consumed Aquatic Animals, and Phenotyping and Genotyping of K. oxytoca Isolates

Klebsiella oxytoca is a recently emerging pathogen that can cause necrotizing enterocolitis, hemorrhagic colitis, sepsis-associated purpura fulminans, and infective endocarditis in humans. The bacterium is ubiquitous in water and soil environments. Nevertheless, current literature on K. oxytoca in aquatic products is rare. In this study, we surveyed K. oxytoca contamination in 41 species of consumable aquatic animals sold in July, August, and September of 2018 and 2019 in Shanghai, China, 40 of which had no history of carrying this bacterium. K. oxytoca was for the first time isolated from 14 species with high abundance in benthic animals. None of the K. oxytoca isolates (n = 125) harbored toxin genes mviM, tisB, and yqgB. However, a high occurrence of virulence-associated genes was observed, including brkB (73.6%), cdcB (66.4%), pduV (64.8%), and virk (63.2%). Resistance to sulphamethoxazole-trimethoprim (56.0%) was the most predominant among the isolates, followed by chloramphenicol (6.4%), tetracycline (5.6%), and kanamycin (3.2%). Approximately 8.0% of the isolates displayed multidrug resistant phenotypes. Meanwhile, high percentages of the isolates tolerated the heavy metals Cu2+ (84.8%), Pb2+ (80.8%), Cr3+ (66.4%), Zn2+ (66.4%), and Hg2+ (49.6%). Different virulence and resistance profiles were observed among K. oxytoca isolates in 3 types and 14 species of aquatic animals. The ERIC-PCR-based genome fingerprinting of the 125 K. oxytoca isolates revealed 108 ERIC genotypes with 79 singletons, which demonstrated the genetic diversity of the isolates. The results of this study fill gaps for policy and research in the risk assessment of K. oxytoca in consumable aquatic animals.

Gastrointestinal forms of allergic diseases, which are accompanied by hemorrhagic colitis syndrome, in young children

The article discusses the problem of the spread of allergic diseases among young children. Infant gastrointestinal disorders, caused by a range of allergens, but most often by exposure to cow’s milk proteins, are one of the most frequent and at the same time most difficult clinical problems for the pediatrician. Particular attention in this article is paid to the so-called non-IgE-mediated forms of allergy to cow’s milk proteins, that is, to such forms of allergy in which the epithelium of the child’s digestive tract is damaged in the absence of any skin and/or respiratory manifestations. Some of these forms of allergy are accompanied by hemorrhagic colitis syndrome, which is an alarming signal, or the so-called “red flag”, for pediatricians and family doctors, and which requires attention, differential diagnosis and competent adequate therapy. An essential (and in some cases the only) component of such therapy is elimination of the allergen from the diet of a child or a nursing mother and/or the use of a breast milk substitute that does not contain a causative allergen. To this end, according to the guidelines of the European Academy of Allergo­logy and Clinical Immunology, it is proposed to use in formula-fed children either extensively hydrolyzed formulas as the first choice formulas, or amino acid formulas, but only with intolerance of extensively hydrolyzed formulas.

Clinical and Pathological Characteristics of Amoxicillin Associated Hemorrhagic Colitis

Background and objective: Amoxicillin is an antibiotic with various benefits for patients. However, adverse reactionssometimes occur, and the clinical misdiagnosis rate is highbecause some clinicians have limited knowledge regarding this drug. Combined with literature review, this study explores the clinical pathological features of hemorrhagiccolitis caused by amoxicillin to improveits diagnosis and treatment. Methods: “Amoxicillin”, “hemorrhagiccolitis”, “antibioticassociated colitis (AAC) ”, “antibioticassociated hemorrhagic colitis (AAHC) ”were used as the index words to retrieve Pubmed, EMbase, Wanfang Database and Chinese national knowledge infrastructure (CNKI). Related articles were then selected and combined with thepatient information obtained from our department to complete the clinical pathological files.To summarize the clinicopathological data, diagnosis, treatmentof the disease.Results: A total of 19 articles were included in the study. Patients may have abdominal pain, bloody stools or blood in the stool, but generally no anemia.The laboratory tests for hemoglobin (HGB) and erythrocyte sedimentation rate (ESR) are normal, andC-reactive protein (CRP) is often elevated. Abdominal ultrasound and computed tomography (CT) findings revealed that the intestinal wall wasthickened and presented edema, and some partsexhibited peritoneal effusion.Upper gastrointestinal endoscopy usually has no bleeding changes. A colonoscope was used to reveal the mucosal erosion, mainly found on the right hemicolon and this finding was consistent with acute colitis. The pathology is consistent with acute hemorrhagic colitis.The symptoms were relieved after drug withdrawal and principally with supportive treatment. The patient’s gastrointestinal symptoms usually did not recur.Conclusion: Patients with acute colitis caused by amoxicillingenerally experienced abdominal cramps and bloody stools, but treatment response was good, and follow-up monitoring revealed norecurrence. The history of antibiotic therpy and early total colonoscopy examination are important to establish the correct diagnosis. Klebsiella oxytoca (K. oxytoca) were cultured in fourteen cases, which is described as a causative organism for AAHC.

Special Issue: Shiga Toxin-Producing Escherichia coli

Globally, Shiga toxin-producing Escherichia coli (STEC) is an important cause of diarrheal disease, most notably hemorrhagic colitis, and post-diarrheal sequela, such as hemolytic-uremic syndrome (HUS) [...]