Acute Enterocolitis Research Articles

Diversity of Campylobacter spp. circulating in a rhesus macaque (Macaca mulatta) breeding colony using culture and molecular methods.

Gastrointestinal disease is one of the most common reasons for hospitalization in non-human primate colonies and accounts for over one-third of non-research related euthanasia. In rhesus macaques, this manifests as both acute diarrhea and chronic enterocolitis (CE), a syndrome of chronic diarrhea resulting in poor weight gain or weight loss which is minimally responsive to treatment. Campylobacter spp. are major causes of acute enterocolitis in rhesus macaques and may predispose individuals to the development of CE, similar to post-infectious irritable bowel syndrome in humans. Despite these concerns, there are few studies characterizing Campylobacter in rhesus macaque colonies, in particular utilizing whole genome sequencing and assessing findings with respect to the health status of the host. Our findings provide insight into Campylobacter strains circulating in rhesus macaque colonies, which can improve clinical monitoring, assist in treatment decisions, and provide new avenues of investigation into campylobacteriosis as a catalyst for CE.

Therapeutic approaches in Hirschsprung's disease: clinical cases.

Hirschsprung's disease is a congenital disorder characterized by the absence of ganglion cells in the myenteric and submucosal plexuses of the colon, resulting in impaired peristalsis and functional intestinal obstruction. This condition affects approximately 1 in 5,000 newborns, with a higher prevalence in boys. Although first identified in the 17th century, its connection to chronic constipation was clearly established by Harald Hirschsprung in 1886. Contemporary treatment strategies emphasize early diagnosis, surgical excision of the aganglionic segment, and specialized postoperative care to restore normal colonic function and improve the quality of life for affected individuals. This article reviews current therapeutic strategies, highlighting advanced surgical techniques, diagnostic methods, and postoperative management. Two clinical cases illustrate the impact and treatment of the disease. The first case involves a 5-month-old male with severe malnutrition, dehydration, and acute enterocolitis, who underwent a right-side colostomy and later a Duhamel-type extramucosal sphincter-rectal-myotomy, showing favorable progress. The second case is a 1.5-year-old patient with a history of colostomy and ileostomy, requiring further surgery. Histopathological examinations in both cases revealed the absence of ganglion cells, confirming the diagnosis of Hirschsprung's disease.

Clinical-Hematological Changes and Predictors of Severity in Acute Food Protein–Induced Enterocolitis Syndrome Reactions at Oral Food Challenge: A Multicenter Observational Study

BackgroundOral food challenge (OFC) is the gold standard for diagnosis of acute Food Protein-Induced Enterocolitis Syndrome (FPIES). No diagnostic/prognostic biomarkers are available, and OFC assessment criteria are not validated. Objective. To assess clinical-haematological changes and predictors of severity of FPIES reactions at OFC. MethodsObservational multicentre prospective study. Children aged 0-18 years diagnosed with acute FPIES were recruited at follow-up OFC in 12 tertiary centres in Spain and Italy. OFC Outcomes (as positive/negative/inconclusive and mild/moderate/severe) were assessed based on published ‘2017 FPIES Consensus’ criteria. Clinical characteristics were recorded, and full blood count was done at baseline, reaction onset and 4 hours later. Regression analysis was performed to assess predictors of severe reactions at OFC. Results81 children had positive OFC (mild in 11% (9/81), moderate in 61% (49/81), severe in 28% (23/81)). Increase in neutrophils and reduction in eosinophils, basophils and lymphocytes was observed (P-value<0.05). OFC was inconclusive in 19 cases despite objective signs or neutrophilia. Regression analysis showed a 2-day OFC protocol where only 25% of an age-appropriate portion is given on day 1 (not gender, age, culprit food, cumulative dose and previous reaction severity) was associated with reduced odds of severe reaction compared to giving multiple doses in a single day. ConclusionDistinct haematological changes may help support FPIES diagnosis. Current OFC assessment criteria may not capture the broad spectrum of acute FPIES presentations. This 2-day protocol may associate a reduced risk of severe reactions. Future work should aim to develop safer OFC and non-OFC diagnostics for FPIES.

A new Salmonella enterica serovar that was isolated from a wild sparrow presents a distinct genetic, metabolic and virulence profile

Salmonella enterica is a ubiquitous and clinically-important bacterial pathogen, able to infect and cause different diseases in a wide range of hosts. Here, we report the isolation and characterization of a new S. enterica serovar (13,23:i:-; S. Tirat-Zvi), belonging to the Havana supper-lineage that was isolated from a wild house sparrow (Passer domesticus) in Israel. Whole genome sequencing and complete assembly of its genome indicated a plasmid-free, 4.7 Mb genome that carries the Salmonella pathogenicity islands 1–6, 9, 19 and an integrative and conjugative element (ICE), encoding arsenic resistance genes. Phenotypically, S. Tirat-Zvi isolate TZ282 was motile, readily formed biofilm, more versatile in carbon source utilization than S. Typhimurium and highly tolerant to arsenic, but impaired in host cell invasion. In-vivo infection studies indicated that while S. Tirat-Zvi was able to infect and cause an acute inflammatory enterocolitis in young chicks, it was compromised in mice colonization and did not cause an inflammatory colitis in mice compared to S. Typhimurium. We suggest that these phenotypes reflect the distinctive ecological niche of this new serovar and its evolutionary adaptation to passerine birds, as a permissive host. Moreover, these results further illuminate the genetic, phenotypic and ecological diversity of S. enterica pathovars.

A case report of acute food protein-induced enterocolitis syndrome to walnut

BackgroundFood protein-induced enterocolitis syndrome (FPIES) is a delayed, non-IgE-mediated food allergy. This syndrome was once thought to be rare, but emerging literature suggests an increasing incidence along with more foods being implicated. Also, with the introduction of guidelines on early peanut introduction, peanut-induced FPIES seems to be increasing in Australia and USA. Although most patients are diagnosed with FPIES within the first year of life, most commonly with food triggers to cow’s milk or soy, other phenotypes exist in comparison to this classic presentation. In this case report, we present a patient with late onset of acute FPIES at age 3 to walnut.Case PresentationWe describe a case of FPIES in a 12-year-old boy who had recurrent episodes of repetitive emesis, that began at age 3, each time after consuming walnuts. Mom does not give a history of intentional feeding (or avoidance) of walnut and/ or pecans. She also described possible reactions with pine nuts and macadamia. He was assessed with an oral food challenge to walnut, which triggered an episode of acute FPIES. He developed vomiting with onset 2 h post-ingestion, pallor, lethargy, and required an emergency department visit for anti-emetic medications and oral rehydration therapy. He improved on the therapy and now avoids cashew, pistachio, hazelnuts, walnuts, pecans, pine nuts, and macadamia nuts.ConclusionsThis case report adds to the limited literature that exists on culprit food allergens in FPIES. We present an acute FPIES triggered by the ingestion of walnuts. The diagnosis, common food triggers, and natural history of FPIES are described. There remains a lack of information on the natural history of FPIES, especially towards uncommon food triggers and on FPIES that present beyond infancy.

The use of amino acid formulas in pediatric patients with allergy to cow's milk proteins: Recommendations from a group of experts.

One of the most common food allergies in children is cow's milk allergy (CMA). In breast-fed infants with CMA, the mother is encouraged to avoid dairy products. If this is not possible, or in formula fed infants, use of hypoallergenic replacement formulas such as extensively hydrolyzed formulas (EHF) is recommended. However, in ∼5% of patients EHFs are not tolerated and/or allergy symptoms can persist. When EHFs are ineffective and in severe forms of CMA, amino acid-based formulas (AAF) should be considered. Six pediatric gastroenterologists with extensive experience in food allergy management reviewed scientific publications and international clinical practice guidelines to provide practical recommendations on AAF. The guidelines reviewed had discrepancies and ambiguities around the specific indications for using formulas as a milk substitute. The panel recommends AAFs as the first therapeutic option in anaphylaxis due to CMA, in acute and chronic severe food protein-induced enterocolitis syndrome, in CMA associated with multiple food allergy, and in cases of eosinophilic esophagitis not responding to an extended exclusion diet or not eating solids. The main benefit of AAF is its absence of residual allergenicity, making it a safe treatment option in severe CMA patients who do not tolerate or respond to an EHF.

Combination of organic acids benzoate, butyrate, caprylate, and sorbate provides a novel antibiotics-independent treatment option in the combat of acute campylobacteriosis.

The food-borne Gram-negative bacterial pathogen Campylobacter jejuni may cause the acute enterocolitis syndrome campylobacteriosis in infected humans. Given that human C. jejuni infections are rising globally which hold also true for resistance rates against antibiotic compounds such as macrolides and fluoroquinolones frequently prescribed for the treatment of severe infectious enteritis, novel antibiotics-independent therapeutic strategies are needed. Distinct organic acids are well known for their health-beneficial including anti-microbial and immunomodulatory properties. In our present study, we investigated potential pathogen-lowering and anti-inflammatory effects of benzoic acid, butyric acid, caprylic acid, and sorbic acid either alone or in combination during acute murine campylobacteriosis. Therefore, secondary abiotic IL-10-/- mice were perorally infected with C. jejuni strain 81-176 and subjected to a 4-day-course of respective organic acid treatment. On day 6 post-infection, mice from the combination cohort displayed slightly lower pathogen loads in the duodenum, but neither in the stomach, ileum nor large intestine. Remarkably, the clinical outcome of C. jejuni induced acute enterocolitis was significantly improved after combined organic acid treatment when compared to the placebo control group. In support, the combinatory organic acid treatment dampened both, macroscopic and microscopic inflammatory sequelae of C. jejuni infection as indicated by less colonic shrinkage and less pronounced histopathological including apoptotic epithelial cell changes in the colon on day 6 post-infection. Furthermore, mice from the combination as compared to placebo cohort exhibited lower numbers of innate and adaptive immune cells such as neutrophilic granulocytes, macrophages, monocytes, and T lymphocytes in their colonic mucosa and lamina propria, respectively, which also held true for pro-inflammatory cytokine secretion in the large intestines and mesenteric lymph nodes. Notably, the anti-inflammatory effects were not restricted to the intestinal tract, but could also be observed systemically given pro-inflammatory mediator concentrations in C. jejuni infected mice from the combination organic acid treatment that were comparable to basal values. In conclusion, our in vivo study provides first evidence that an oral application of distinct organic acids in combination exhibits pronounced anti-inflammatory effects and hence, constitutes a promising novel antibiotics-independent therapeutic strategy in the combat of acute campylobacteriosis.

Pull-Through of Ganglionic Stoma in Children with Hirschsprung’s Disease Living in a Low Resource Context Spares Further Surgery for Colostomy Reversal: A Report from a Tanzanian Regional Referral Hospital

Abstract Background: One-step pull-through for Hirschsprung’s disease (HSCR) is already standard in many tertiary African paediatric surgical centres where radiology and frozen sections are available. However, limited resources in many peripheral areas associated with advanced age at referral or complicated presentation make recourse to colostomy often unavoidable with a consequent three-step surgery. To simplify these children’s clinical course and spare the burden of a third procedure for colostomy reverse, a direct pull-through of the proximal ganglionic stoma is proposed. Materials and Methods: Twenty children (male/female ratio 19/1) between 3 months and 13 years with a colostomy for a suspected HSCR were selected for stoma pull-through among patients admitted to a regional Tanzanian hospital between 2016 and 2022. Histological diagnosis was always confirmed by rectal biopsies and, in some cases, colonic specimens taken during the stoma confection or revision. A ganglionic stoma was always ascertained before the pull-through procedure (11 Transanal Endorectal, 4 Soave and 5 Duhamel). Results: One death was registered in a child with Down syndrome, unrelated to surgery, and another due to HSCR acute associated enterocolitis. One stenosis required stricturoplasty, and one anastomotic leakage needed temporary ileostomy. No relationship was found between complications and the procedure of choice. Passage of stools started on the 2nd day and became regular and without soiling in a week. Conclusions: Straightforward pull-through of the ganglionic stoma may be a feasible solution for patients with HSCR and a diverting colostomy to avoid a three-step procedure. The correct position of the stoma at the transition zone must be ascertained to avoid the risk of including in the resection segment of the ganglionic bowel.

Food protein-induced enterocolitis syndrome is an important differential diagnosis of vomiting in pediatric emergency.

The aim of this study was to clarify the clinical characteristics and management of infants with suspected acute food protein-induced enterocolitis syndrome (FPIES) who presented to the pediatric emergency department (ED) before and after the guidelines were published. This was a retrospective cohort study. We classified the infants as "acute FPIES-like symptoms" who were younger than 12 months of age and visited the pediatric ED of the National Center for Child Health and Development due to vomiting 1-4 h after food ingestion without any causative disease, such as infection. The medical records of those infants in 2015 and 2021 were reviewed. We used the nonparametric Mann-Whitney U test to compare two groups for continuous variables, whereas chi-squared or Fisher's exact tests were used for nominal variables. The number of infants with acute FPIES-like symptomswas 15 (13%) in 2015 and 14 (15%) in 2021. The trigger foods were cow's milk or dairy products in half of the infants, and five as a result of ingestion of hen's eggs in 2021, compared to zero cases in 2015. Five in 2015 and 12 in 2021 required examination at the ED. Three in 2015 and six in 2021 met the diagnostic criteria for acute FPIES in the international consensus guidelines. The emergency physicians did not record at least four minor criteria for acute FPIES in seven in 2015 and five in 2021. No infants (0%) in 2015 and two (14%) in 2021 were referred to the allergy department by an emergency physician. Acute FPIES should be considered one of the differential diagnoses of vomiting, and pediatric medical staff should be aware of FPIES diagnostic criteria and appropriately refer suspected cases to a specialist.

The effects of rebamipide, sucralfate, and rifaximin against inflammation and apoptosis in radiation-induced murine intestinal injury

Background: Radiotherapy improves overall survival in patients with abdominopelvic malignancies. However, the toxic effects of radiation restrict the maximum dose that can be given, and there are no well-established preventive or therapeutic strategies. This study was conducted to evaluate whether rebamipide, sucralfate, and rifaximin have a suppressive effect on acute ionizing radiation (IR)-induced inflammation in the intestines of mice.Methods: Thirty-six ICR mice were divided into a vehicle-treated group with sham irradiation; a vehicle-treated group with irradiation; rebamipide, sucralfate, or rifaximin-treated groups with irradiation; and a rebamipide-treated group with sham irradiation. The expression of proinflammatory, anti-inflammatory, proapoptotic, and antiapoptotic factors was investigated.Results: The downregulated expression of nicotinamide phosphoribosyltransferase by IR was attenuated by all drugs (p&lt;0.05). All drugs suppressed the IR-induced activation of NF-κB and phosphorylation of MAPKs (p&lt;0.05) and attenuated the production of TNF-α, IL-1β, and IL-6 in response to IR (p&lt;0.05). The administration of all drugs markedly attenuated IR-induced increases in iNOS, COX-2, and PGE2 (p&lt;0.05), as well as [Ca2+] oscillations that were increased by IR. The expression of proapoptotic genes and antiapoptotic genes was suppressed and induced, respectively, by all drugs. IR treatment increased the release of cytochrome C, which was attenuated by all drugs (p&lt;0.05). All drug treatments resulted in a significant decrease in the expression of caspase-3 and caspase-7 (p&lt;0.05), which were both upregulated following IR treatment.Conclusions: The administration of rebamipide, sucralfate, or rifaximin prior to radiation therapy may prevent or attenuate acute radiation-induced enterocolitis.

Intestinal disorders after acute diarrhea in young children and their coprological predictors

Background. After acute diarrhea in young children, intestinal disturbances and even chronic functional intestinal diseases may occur. To date, no pathogenetically based criteria have been found that would indicate the probability of chronic intestinal disorders, just as the mechanisms of their occurrence after acute diarrhea have not been fully elucidated. The objective: to evaluate the frequency and nature of bowel disorders in children of the younger age group within 6 months after a stay in hospital for acute diarrhea and to establish their relationship with coprological indicators — fecal calprotectin (FCР), the content of carbohydrates (reducing substances, RS), lactic acid (LA) and short-chain fatty acids (SCFA) — acetic, propionic and fatty (butyric). Materials and methods. The study involved 47 children aged 6–24 months who were hospitalized for acute diarrhea. Acute enterocolitis (group I) was diagnosed in 18 patients and was caused by Campylobacter jejuni in 12 cases, Escherichia coli O-18 and Escherichia coli O-44 in 3, Salmonella enteritidis in 2 and Yersinia enterocolitica in one case. Rotaviral gastroenteritis (group II) was diagnosed in 11 patients. Another 11 children had acute symptomatic (parenteral) diarrhea (group III) against the background of intestinal infection — acute otitis, pneumonia, pyelonephritis. In 7 children, diarrhea was classified as functional digestive disorder (group IV). Routine clinical tests were supplemented with an examination of feces for the presence of intestinal parasites, Clostridium difficile A/B toxins, adenoviruses, human hemoglobin, RS, FCP, SCFA and LA. Results. Six-month follow-up established that 14 of 18 children in group I had permanent or temporary loose stools. These complaints in 13 cases were combined with episodes of abdominal pain similar to intestinal colic. The same complaints were much less frequent in children of group II (6 and 3 of 11, respectively), group III (4 and 2 of 11) and group IV (only in 2 of 7 children). The rank correlation analysis did not reveal any significant relationships between the intensity and duration of complaints and FCP, RS, LA, and SCFA in patients of groups I and II. On the contrary, in group III, there were multiple correlations of complaints with FCP, RS, LA, and SCFA. In group IV, the association of loose stools with an increase in LA and acetic acid has been found. Conclusions. According to the 6-month follow-up, 57 % of young children with acute diarrhea complained of loose stools and/or recurrent abdominal pain after discharge from the hospital. Most often, intestinal disorders were detected in children who had acute bacterial enterocolitis. There were no correlations between the intensity of post-infectious (bacterial or viral) disorders with FCP, RS, LA and SCFA during hospitalization. In contrast, such associations were numerous in children with symptomatic (parenteral) and functional diarrhea. It was suggested that the studied coprological parameters can be used to predict the state of the intestine after acute diarrhea.

Remission of Acute Food Protein-Induced Enterocolitis Syndrome Confirmed by Oral Food Challenges in Japan.

The oral food challenge test (OFC) is the gold standard for evaluating the remission of food protein-induced enterocolitis syndrome (FPIES). Few acute FPIES remissions confirmed by OFC were reported. This study aimed to examine the OFC for Japanese children with acute FPIES to evaluate its remission. A retrospective cohort study was performed on children with acute FPIES with remission evaluation by OFC based on one food challenge dose (1/50, 1/10, 1/2, and full dose per day). Acute FPIES remission was observed in 65.2% of patients (15/23 patients). Vomiting episodes occurred with 1/50 full doses on the first day among 75% of positive patients. The median duration between the onset and OFC was 14 months (IQR, 8–24 months). Soy was the most common causative food, followed by egg yolk, milk, and wheat. All patients could receive OFC safely without intensive care unit care, based on the FPIES OFC protocol. The remission rate of acute FPIES was high. However, vomiting episodes commonly occurred with 1/50 full doses on the first day. This study suggested that our OFC protocol for acute FPIES was safe and feasible, but it might be safer for some patients to start at a minimal loading dose.

Results of a clinical study of the blood of service dogs with acute enterocolitis

The paper presents the results of a morphological study of the blood of healthy dogs and dogs with acute enterocolitis. Also, a physical examination was carried out on sick animals. On external examination, it was noted that the dogs with enterocolitis were mostly apathetic, some took a forced lying position. Of the studied 10 sick dogs, 7 had satisfactory fatness, 3 dogs had unsatisfactory fatness. In a significant part of dogs with enterocolitis, the coat is matte, the coat is ruffled and poorly retained in the hair follicles, the skin turgor is reduced. The color of the visible mucous membranes in dogs with enterocolitis varies from pale pink to grayish with an icteric tinge. The main revealed pathological changes in the study of the digestive system of dogs with enterocolitis were: increased defecation, diarrhea, feces of a mushy consistency with mucus admixtures, sometimes with blood, oligophagia or anorexia, abdominal wall tension, intestinal soreness with penetrating palpation, increased peristalsis with mediocre auscultation. In animals with signs of enterocolitis, erythrocytosis, leukocytosis and hyperchromemia were noted. At the same time, the hematocrit index was 20.9% higher in sick dogs, compared with this indicator in healthy animals. When analyzing the leukogram of animals of both groups, no significant changes were found.

Proposal of a Questionnaire for Acute Food Protein-induced Enterocolitis Syndrome Diagnosis.

Sopo, Stefano Miceli∗; Mastellone, Francesco†; Sinatti, Dario†; Gelsomino, Mariannita† Author Information

Abstract P2-14-06: Durable responses with intratumoral electroporation of plasmid interleukin-12 plus pembrolizumab in patients with advanced triple-negative breast cancer: Cohort 1 update from KEYNOTE-890

Abstract BACKGROUND: Electroporated plasmid interleukin-12 (tavokinogene telseplasmid; TAVO-EP) delivered to accessible tumors by intratumoral injection induces sustained local expression of IL-12. IL-12 is a potent immunoregulatory cytokine that plays a key role in the crosstalk between innate (dendritic, macrophage, and natural killer) and adaptive (T and B) cells, promoting anti-tumor immune responses. TAVO-EP has been shown to induce activation of innate and adaptive tumor-infiltrating and peripheral immune cells, regression of treated and distant untreated lesions (abscopal effect), and expression of PD-L1 in patients with melanoma or triple-negative breast cancer (TNBC), without the systemic toxicity that limited therapeutic use of IL-12 historically. The combination of TAVO-EP and pembrolizumab has demonstrated durable responses in melanoma patients with immunologically “cold” tumors or with prior progression on anti-PD1 therapy. Anti-PD1 monotherapy has just over 5% overall response rate (ORR) in the second-line or later (2L+) treatment setting for advanced TNBC. New antibody-directed conjugate (ADC) chemotherapy has increased rates of responses compared with prior standard chemotherapy in 2L+ advanced TNBC; however, short duration of response (DOR), and toxicity are issues of concern. Therapies that can induce durable responses with limited toxicity are needed. METHODS: Cohort 1 of this Phase 2, open-label, multicenter study assessed the safety and efficacy of TAVO-EP in combination with pembrolizumab as 2L+ treatment for advanced TNBC. Eligible patients had at least 1 line of prior systemic therapy for advanced or metastatic disease, measurable disease by RECIST v1.1, and ≥1 lesion accessible for TAVO-EP treatment. Patients received pembrolizumab (200 mg IV) every 3 weeks and TAVO-EP (0.5 mg/mL at dose volume of ~1/4 lesion volume) on Days 1, 5, and 8 every 6 weeks. Tumor assessments were performed every 12 weeks. The primary endpoint was RECIST v.1.1 ORR by investigator review. Secondary endpoints included safety and tolerability, DOR, progression-free survival (PFS), immune-related RECIST (iRECIST) ORR and PFS, disease control rate, and overall survival (OS). ClinicalTrials.gov: NCT03567720. RESULTS: Between 01Nov2018 and 30Jan2020, 26 patients were enrolled and received at least one dose of study treatment (median follow up of 11.1 months). Patients had a median of 2 prior lines of systemic therapy for advanced disease (range 1-5). Among 23 patients evaluable for response, the ORR was 17.4% (4 with partial response [PR]). One responder with centrally confirmed PD-L1-negative disease and chest wall and bulky liver metastases had a sustained PR and an iRECIST complete response (CR). One responder had near complete regression of a large fungating chest wall skin lesion. The median DOR was 16.6 months. Median OS was 11.0 months (range 0.6-27.5+). The most common treatment-related adverse events (TRAEs) (all grades) were administration site pain and fatigue. Grade 3 TRAEs were reported in 6 patients (23%) including fatigue (11.5%); acute kidney injury, enterocolitis, and myocarditis (3.8% each). There were no Grade 4 or 5 TRAEs. CONCLUSIONS: The combination of TAVO-EP and pembrolizumab in pretreated patients with advanced TNBC resulted in durable RECIST v1.1 responses, including in PD-L1-negative disease, and was well tolerated. This novel immunotherapeutic regimen warrants further evaluation in 2L+ advanced TNBC. Cohort 2 exploring TAVO-EP + pembrolizumab + chemotherapy in frontline TNBC is currently enrolling. Citation Format: Melinda L. Telli, Irene Wapnir, Bianca Devitt, Katharine Cuff, Hatem Soliman, Shaveta Vinayak, David A. Canton, Christopher G. Twitty, Sunny Xie, Ying Lu, Donna Bannavong, Bridget O'Keeffe, Sandra Aung, Rohit Joshi. Durable responses with intratumoral electroporation of plasmid interleukin-12 plus pembrolizumab in patients with advanced triple-negative breast cancer: Cohort 1 update from KEYNOTE-890 [abstract]. In: Proceedings of the 2021 San Antonio Breast Cancer Symposium; 2021 Dec 7-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2022;82(4 Suppl):Abstract nr P2-14-06.

Sindrome da perdita di sali e infezione da Clostridium difficile nella fibrosi cistica

The present article describes the case of a child with cystic fibrosis who presented with acute enterocolitis with severe dehydration subsequently to prolonged antibiotic therapy with oral ciprofloxacin. The associated hypochloraemic metabolic alkalosis led to the diagnosis of salt loss syndrome, which was resolved with i.v. normal saline infusion. The cause of enterocolitis (associated with abdominal pain, hypoproteinemia and increased c-reactive protein) was Clostridium difficile infection, successfully treated with oral vancomycin.

Food-borne pathogens survival of Yersinia enterocolitica and molecular analysis of 16SrRNA sequencing of Salmonella typhi &amp; Salmonella enterica from frozen buffalo meat in India

French Bacteriologist Alexander Yersinia in 1894 first described Yersinia eniterocolitica as causative organisms for food-borne illness. Yersinia enterocolitica is an enteropathogenic organism and causes “yersiniosis” that denotes infections such as, gastroenteritis in infants and young children and it considered as bacillary dysentery or campylobacter - like enterocolitis with abdominal pain and diarrhea. Even it give rise to acute terminal ileitis or mesenteric lymphadenitis, cause septicemia with high fatality rate, abortion, pneumonia, ileocaecal appendix, proximal colon level, acute enterocolitis, immunological complications like erythema nodosum, polyarthritis, Reiter’s syndrome, some time leading to death etc. In frozen buffalo meat at very freezing temperature the organisms common and isolated can cause spoilage. Y. enterocolitica is gram negative, pleomorphic, asporogenous short, capsulated, motile with peritrichous flagella microscopically and grown at 22oC. Y. enterocolitica is aerobe and facultative anaerobe and actively porn to zoonosis. Salmonella species also a risky food borne pathogen and causes typhoid and salmonellosis. In present research investigation 51 samples of frozen buffalo meat processed microbiologically whereas 39 samples are positive and 11 samples are negative for Y. enterocolitica. Hence, It is observed load of tolerance are in littile higher in frozen meat. MacConkey agar showed as small, irregular, pinpointed, pinkish - reddish or pale pink or reject red color lactose negative colonies at 37oC and form pinpoint colonies at 22oC. Antibiotic assay test of Y. enterocolitica revealed that 10µg amoxyclave disc is sensitive to Y. enterocolitica but, 5µg methicillin disc is resistant to Y. enterocolitica. The positive Salmonella species colonies from specific media such as (e.g. XLD, BGA, BSA, HEA) isolated and subjected to molecular analysis of 16SrRNA sequencing identified as Salmonella typhi strain T9 16S ribosomal RNA gene, partial sequence and Salmonella enterica subsp. enterica serovar enteritidis strain DY60 16S ribosomal RNA gene, partial sequence, causes the spoilage in meat at low temperature and threaten public health safety. The overall result indicates poor management of hygiene at abattoir and inefficient cleaning condition can augment low temperature spoilage of meat and serious issue for the reassessment of public health importance.

PATHOMORPHOLOGICAL CHANGES IN PIGLETS WITH THE ASSOCIATIVE COURSE OF SALMONELLOSIS AND EIMERIOSIS

The article describes the pathomorphological macroscopic changes detected during the autopsy of piglets that died from the associative course of infectious pathology caused by Salmonella and Eimeria. In case of the associative course of salmonellosis and eimeriosis, three clinical forms of the disease were recorded: severe intestinal exicosis, an infectious-toxic form with a severe and very severe course, and a severe toxic-dystrophic form. During the course of the noted clinical forms, the animals showed signs of dehydration, acute catarrhal-fibrinous enterocolitis, hyperplasia of mesenteric lymph nodes, congestive hyperemia and granular degeneration of the liver and kidneys, milliary areactive dry necroses in the liver and kidneys, acute serous splenitis, chronic purulent and catarrhal bronchopneumonia, alveolar emphysema, alterative myocarditis, atrophy of the right ventricular myocardium, congestive hyperemia and cerebral edema.

Association between ribotype and clinical form of enterocolitis with C. difficile in Western Romania: A 2-year study.

During the last decade, several changes in the epidemiology, clinical symptoms, and evolution of Clostridium difficile infection (CDI) have been reported. The number of diagnosed cases has increased, especially in individuals over 60 years of age. There has also been an increase in the share of severe forms of the disease, the number of patients with recurrent infections and the lethality caused by this condition. The aim of the present study was to determine the incidence of CDI over the past few years; to monitor the bacterial toxin by ribotyping; to observe the migration of circulating toxins; to correlate the ribotyping with the clinical form of the disease; and to correlate the treatment with the ribotyping and the clinical form. Therefore, we performed an observational retrospective study regarding the incidence of CDI at ‘Victor Babeș’ Hospital of Infectious Diseases and Pneumophtisiology of Timișoara, between January 2016 and December 2017. The results revealed that 210 patients were hospitalized with a diagnosis of acute enterocolitis with C. difficile. All patients tested showed C. difficile toxin A/B positivity. In 28 cases, the ribotyping was positive with binary toxin and hypervirulent strain 027. The tested patients were discharged or transferred from various medical/surgical clinics. In the study, we also ascertained the correlation between the clinical form of the disease and comorbidities and pre-hospital treatments as risk factors in the occurrence of the infection. In accordance with the rise of CDI during the last decade, it was possible to observe the increase in the number of infectious recurrences. From this point of view, highlighting of the ribotype in this pathology becomes a primary aspect both by increasing the success rate in curing the disease (with a reduction in the risk of recurrence) and by targeted and non-empirical administration of the antibiotic.

Ezrin Peptide Therapy from HIV to COVID: Inhibition of Inflammation and Amplification of Adaptive Anti-Viral Immunity.

Human Ezrin Peptides (HEPs) are inhibitors of expression of IL-6 and other inflammatory cytokines, amplifiers of adaptive B cell and T cell immunity and enhancers of tissue repair. The mutation stable C-terminus of HIV gp120, mimics 69% of the “Hep-receptor”, a zipped α-helical structure in the middle of the α domain of human ezrin protein. Synthetic peptides homologous to the Hep-receptor of ezrin of five to fourteen amino acids, activate anti-viral immunity against a wide range of viruses (HIV, HCV, herpes, HPV, influenza and other human respiratory viruses). Human Ezrin Peptide One (HEP1) TEKKRRETVEREKE (brand name Gepon, registered for human use in Russia from 2001) is a successful treatment for opportunistic infections in HIV-infected patients. That treats HEP1and prevents mucosal candidiasis, herpes zoster outbreaks and infection-induced chronic diarrhea. There are clinical publications in Russian on the successful treatments of chronic recurrent vaginal candidiasis, acute and chronic enterocolitis and dysbacteriosis, which are accompanied by normalization of the mucosal microbiome, and the decline or disappearance of inflammation. HEP1 is also an effective treatment and prevention for recurrent inflammation and ulceration in the stomach, duodenum and colon. HEP1 and RepG3 GEKKRRETVEREGG (a derivative of HEP1) have been used successfully as an inhaled spray peptide solution to treat a small number of human volunteers with mild-to-moderate COVID, resulting from SARS-CoV-2 infection, based on earlier successes in treating acute viral respiratory disease with inflammatory complications. Ezrin peptides seem to correct a dysregulation of innate immune responses to SARS-CoV-2. They are also adjuvants of B cell adaptive immunity and increase antibody titres, resulting in protection from lethal virus infection of mice. In a clinical study in Moscow, orally administered HEP1 was shown to enhance antibody-titres produced in response to hepatitis-B vaccination. These very preliminary but promising results with ezrin peptide treatment of COVID must be replicated in large-scale randomised placebo controlled clinical studies, to be verified.