ADHERENCE OF ENTEROBACTERIA AS PATHOCENETIC MECHANISM IN DIARRHEA AND BLOCKAGE OF ADHERENCE

Abstract

Enterobacteria (E.coli, Pseudomonas aerug., Enterobacter) and Candida albicans have been isolated in concentrations of more than 105 organisms lml from the duodenum of 48 infants with longstanding severe diarrhea. Organisms have been investigated for their enterotoxin and cytotoxin production in tissue culture models and in the piglet ileal loop.All isolates showed the production of an ST-, half of them also the formation of an LT enterotoxin. The cytotoxic effect was established by hemolysis of sheep red blood cells and disruption of mouse fibroblast monolayers by the cell free supernatant of cultures.The majority of isolates showed hemagglutination of human red blood cells and adherence on isolated human and pig intestinal epithelial cells.Hemagglutination and adherence of some strains was blocked by mannose; Carob and carrot soup - in particular the mono-, oligosaccharide fraction isolated by gel permeation chromatography - was able to reduce adherence of the majority of these isolates by 75 to 90 %. The chemical composition of these carbohydrate fractions will be described.Bacterial contamination of the upper small intestinal tract with enterobacteria and Candida albicans is thought to be a major pathogenetic factor in longstanding severe diarrhea in infants. A strong adhering capacity aids bacteria in colonization of the upper small intestinal tract. Blockage of adherence by various carbohydrates may prove to be an important therapeutic and prophylactic measure.