Intestinal Bacterial Infections Research Articles

Travelers' Diarrhea: Resolved and Unresolved Issues

Relevance. Travel diarrhea is the most common health problem in travelers, affecting up to 70% of travelers, especially when traveling to developing countries. Research and development of scientific and practical approaches to the prevention, risk assessment and treatment of travelers' diarrhea continues to be the focus of attention of specialists in the field of epidemiology, infectious diseases and travel medicine around the world.Aim of the study: systematization and synthesis of new data on various clinical and epidemiological aspects of travelers' diarrhea.Conclusion. Analysis of modern scientific literature has made it possible to identify the risks for travelers associated with the direction of travel and the state of their own health. The highest risk of developing traveler's diarrhea (from 20% to 90%) is recorded in people visiting the countries of the Middle East, South and Southeast Asia, Central and South America, and Africa. There is a high risk of developing traveler's diarrhea in children under 4 years of age. The causative agents of acute bacterial intestinal infections can account for up to 80% -90% of all cases of travelers' diarrhea. In most cases, travelers' diarrhea is mild. Seeking medical care is observed from 5% to 15% of cases. For etiotropic therapy, the use of azithromycin, ciprofloxacin and other drugs is recommended. Recommendations for self-management of traveler's diarrhea have been formulated. Pre-trip travel advice will help reduce the risks of travelers' diarrhea.

Associations between the spatiotemporal distribution of Kawasaki disease and environmental factors: evidence supporting a multifactorial etiologic model

The etiology of Kawasaki Disease (KD), the most common cause of acquired heart disease in children in developed countries, remains elusive, but could be multifactorial in nature as suggested by the numerous environmental and infectious exposures that have previously been linked to its epidemiology. There is still a lack of a comprehensive model describing these complex associations. We present a Bayesian disease model that provides insight in the spatiotemporal distribution of KD in Canada from 2004 to 2017. The disease model including environmental factors had improved Watanabe-Akaike information criterion (WAIC) compared to the base model which included only spatiotemporal and demographic effects and had excellent performance in recapitulating the spatiotemporal distribution of KD in Canada (98% and 86% spatial and temporal correlations, respectively). The model suggests an association between the distribution of KD and population composition, weather-related factors, aeroallergen exposure, pollution, atmospheric concentration of spores and algae, and the incidence of healthcare encounters for bacterial pneumonia or viral intestinal infections. This model could be the basis of a hypothetical data-driven framework for the spatiotemporal distribution of KD. It also generates novel hypotheses about the etiology of KD, and provides a basis for the future development of a predictive and surveillance model.

BACTERIAL TRANSLOCATION: MICROBIOTA-INTESTINE-LUNG AXIS AND PRO-INFLAMMATORY STATUS IN THE SEVERITY OF COVID-19

Although severe acute respiratory syndrome coronavirus – 2 (SARS-CoV-2), causing coronavirus disease 2019 (COVID-19) pandemic, is primarily associated with a respiratory infection, it has also been linked to multisystem involvement that includes the digestive tract. Gastrointestinal (GI) manifestations are common in patients with COVID-19 due to the high viral load lodged in the small intestine's mucosa. As a result, it causes an increase in the permeability of the intestinal barrier that favours the passage and translocation of bacteria, from the lumen of the intestine, towards the internal environment, with the appearance of sepsis, with evidence that SARS-CoV-2 has been found in faeces. This article highlights epidemiology, clinical symptoms, and mechanisms related to manifestations of disease in the GI tract and its pathogenesis in patients with COVID-19. It highlights bacterial translocation and COVID-19, mechanisms that control bacterial translocation, intestinal infection and feco-oral transmission, defense

NHR-49/PPAR-α and HLH-30/TFEB cooperate for C. elegans host defense via a flavin-containing monooxygenase

The model organism Caenorhabditis elegans mounts transcriptional defense responses against intestinal bacterial infections that elicit overlapping starvation and infection responses, the regulation of which is not well understood. Direct comparison of C. elegans that were starved or infected with Staphylococcus aureus revealed a large infection-specific transcriptional signature, which was almost completely abrogated by deletion of transcription factor hlh-30/TFEB, except for six genes including a flavin-containing monooxygenase (FMO) gene, fmo-2/FMO5. Deletion of fmo-2/FMO5 severely compromised infection survival, thus identifying the first FMO with innate immunity functions in animals. Moreover, fmo-2/FMO5 induction required the nuclear hormone receptor, NHR-49/PPAR-α, which controlled host defense cell non-autonomously. These findings reveal an infection-specific host response to S. aureus, identify HLH-30/TFEB as its main regulator, reveal FMOs as important innate immunity effectors in animals, and identify the mechanism of FMO regulation through NHR-49/PPAR-α during S. aureus infection, with implications for host defense and inflammation in higher organisms.

Transcription factors NHR-49/PPARα and HLH-30/TFEB promote host defense in C. elegans via a flavin-containing monooxygenase

Abstract During bacterial infection, the host is confronted with multiple overlapping signals that are integrated at the organismal level to produce defensive host responses. How multiple infection signals are sensed by the host and how they elicit the transcription of host defense genes is much less understood at the whole-animal level than at the cellular level. The model organism Caenorhabditis elegans is known to mount transcriptional defense responses against intestinal bacterial infections that elicit overlapping starvation and infection responses, but the regulation of such responses is not well understood. Direct comparison of C. elegans that were starved or infected with Staphylococcus aureus revealed a large infection-specific transcriptional signature. This signature was almost completely abrogated by the deletion of transcription factor hlh-30/TFEB, except for six genes including a flavin-containing monooxygenase (FMO) gene, fmo-2/FMO5. Deletion of fmo-2/FMO5 severely compromised infection survival, thus identifying the first FMO with innate immunity functions in animals. Further, fmo-2/FMO5 was specifically induced by Gram-positive pathogens and Gram-positive natural microbiota of C. elegans. Moreover, the mechanism of fmo-2/FMO5 induction required the nuclear receptor, NHR-49/PPARα, which induced fmo-2/FMO5 and host defense cell non-autonomously. These findings for the first time reveal an infection-specific host response to S. aureus, identify HLH-30/TFEB as its main regulator, reveal that FMOs are important innate immunity effectors in animals, and identify the mechanism of FMO regulation through NHR-49/PPARα in C. elegans, with important implications for innate host defense in higher organisms.

Porophyllum Genus Compounds and Pharmacological Activities: A Review

The genus Porophyllum (family Asteraceae) is native to the western hemisphere, growing in tropical and subtropical North and South America. Mexico is an important center of diversification of the genus. Plants belong of genus Porophyllum have been used in Mexican traditional medicine to treat kidney and intestinal diseases, parasitic, bacterial, and fungal infections and anti-inflammatory and anti-nociceptive activities. In this sense, several trials have been made on its chemical and in vitro and in vivo pharmacological activities. These studies were carried on the extracts and isolated compounds and support most of their reported uses in folk medicine as antifungal, antileishmanial, anti-inflammatory, anti-nociceptive and burn repair activities, and as a potential source of new class of insecticides. Bio guided phytochemical studies showed the isolation of thiophenes, terpenes and phenolics compounds, which could be responsible for the pharmacological activities. However, more pre-clinical assays that highlight the mechanisms of action of the compounds involved in pharmacological function are lacking. This review discusses the current knowledge of their chemistry, in vitro and in vivo pharmacological activities carried out on the plants belonging to the Porophyllum genus.

Effects of goat milk enriched with oligosaccharides on microbiota structures, and correlation between microbiota and short-chain fatty acids in the large intestine of the mouse

In this study, we explored the effects of combining goat milk and oligosaccharides on the large intestine environment of mice. A combination of goat milk with each of 3 oligosaccharides-stachyose, fructo-oligosaccharide (FOS), and a prebiotics mix-were independently fed to mice. We investigated composition changes in the microbiota of the large intestine using 16S rRNA gene sequencing; measured short-chain fatty acid content using gas chromatography-mass spectrometry; and performed a Spearman correlation analysis between microorganisms and short-chain fatty acids. Our results showed that microbial diversity in the large intestine decreased significantly in the FOS group. In terms of α diversity, microbial richness significantly declined in all 3 treatment groups; in terms of β diversity, the intestinal microbial structures clearly changed in the FOS group. The abundance of Bifidobacterium and Lactobacillus increased markedly in the FOS group compared with the other groups. Functional predictions showed that FOS reduced intestinal bacterial infections and improved the endocrine and immune systems. Spearman correlation analysis showed that propionic, isobutyric, and valeric acids were all positively correlated with certain microbiota. Our findings suggest that FOS-enriched goat milk is beneficial for improving the large intestine environment in the host.

The Mixed Bacterial-viral Intestinal Infections in Children of Early Age

The aim of investigation to study the of some clinico-microbiological characterisrics of mixed intestinal infections in children of early age. Material and methods – the children under the age of 3 (infants and children), hospitalized in the Children’s Clinical Hospitals № 1 and 7 in Baku for the 2019 year have been examined. Bacteriological and serological studies were carried out to diagnose intestinal infections on the day of admission to hospital feces of sick children were take as material for analyses. Totally the 117 children have been observed. To convirm the diagnosis of bacterial intestinal infection feces were cultured with subsequent detection of sensitivity to antibiotics and for viral intestinal infection, immunochromatografic test was used. The bacteriological and serological investigations were arried out in the Scientific-Research Institute of Medical Prophylaxis named after V. Y. Akhundov during 2019 year. Results – As a result of our studies, 33,3% (39) of children had mixed infection: a combination of viruses, particularly rotaviruses with St.aureus, E.Coli and C.albicans. From observing children 25 were under 6 month (21,4%), 15 – 7-12 month (12,8%), 77 – 1-3 years (65,8%). The combination of rotaviruses with other viruses (adenovirus and astrovrus) were the most frequently observed ones (5,1±2,0% and 6,8±2,3% accordingly) (p=0,167; p=0,067). Among opportunistic microbes the S.albicans was a leader. (In 18 (15,4%) patients). C.albicans was with rotavirus (p=0,063), in 5 (4,3±1,9%) with St.aureus and rotavirus (p=0,118) and in 4 (3,4±1,7%) with rotavirus and E.Coli (p=0,056). The viral intestinal infection with 2 associates occured in 5 (4,3±1,9%) of patients – rotavirus + St.aureus + C.albicans and rotavirus + E.Coli + C.albicans (p=0,056).

Anti-inflammatory effects of purple sweet potato anthocyanin extract in DSS-induced colitis: modulation of commensal bacteria and attenuated bacterial intestinal infection.

Purple sweet potato anthocyanins have been acknowledged for their beneficial effects on human inflammatory bowel diseases (IBD). Although the ability of anthocyanins in modulating the gut microbiota has been reported, the relationship between the bacteria modulated by anthocyanins and intestinal inflammation has not been fully elucidated. We aimed to ascertain whether the purple sweet potato anthocyanin extract (PSPAE) modulation of gut microbiota in the dextran sodium sulphate (DSS) induced chronic colitis mouse model could result in the maintenance of intestinal homeostasis and protection against bacterial intestinal inflammation. Chronic colitis was induced by adding DSS in drinking water while administering the mice with PSPAE via gavage (20 mg kg-1). Effects on colon tissue damage, gut microbiota composition, tight junction protein, and cytokines were evaluated. PSPAE prevented the loss of Bifidobacterium and Lactobacillus and inhibited the increase of Gammaproteobacteria and Helicobacter upon DSS treatment. The non-pathogenic-dependent and pathogenic-dependent microenvironments were established upon treatment with broad-spectrum antibiotics. Both PSPAE treatment and non-pathogenic treatments modified the colonic expression of mouse tight junction proteins and maintained the architecture of the colon. However, the non-pathogenic treatment could not attenuate intestinal inflammation. Moreover, the pathogenic-dependent dysbiosis was exacerbated because of the increasing colonization of pathogens such as Helicobacter. The PSPAE exerted the modulation of gut microbiota to maintain the gut microbiome homeostasis in DSS-induced chronic colitis mice, which may help to propose a new treatment that combines efficacy and reduction of the possibility of bacterial intestinal infection.

Endocannabinoids Attenuate the Virulence of Certain Enteropathogenic Bacteria.

The mammalian endocannabinoid system modulates gastrointestinal physiology and immunity via lipid hormones (endocannabinoids). Ellermann et al. have recently revealed the effect of the endocannabinoid, 2-arachidonoyl glycerol (2-AG) on intestinal infection. They show that 2-AG directly modulates bacterial function by antagonizing the provirulence receptor QseC, thereby protecting mice against enteric infection. The endocannabinoid system has already been identified as a promising target in the treatment of inflammatory bowel diseases, but these new findings raise questions about the possible benefits of using cannabinoids to treat intestinal bacterial infections.

Prevalence of enteric pathogens, intestinal parasites and resistance profile of bacterial isolates among HIV infected and non-infected diarrheic patients in Dessie Town, Northeast Ethiopia.

Enteric pathogens like Salmonella and Shigella species as well as intestinal parasites (IPs) are among the main causative agents of diarrhea in people with human immunodeficiency virus (HIV)/acquired immune deficiency syndrome (AIDS), particularly in low income countries like Ethiopia. Antimicrobial resistance against commonly prescribed drugs has become a major global threat. This study, therefore, aimed at determining the magnitude of Salmonella, Shigella and IPs infections, their predicting factors, and antimicrobial susceptibility pattern among HIV infected and non-infected diarrheic patients in Dessie town, Northeast Ethiopia. A cross sectional study was conducted at three health facilities in Northeast Ethiopia between January 2018 and March 2018. Data on socio-demographic and associated risk factors were collected using structured questionnaire from 354 HIV infected and non-infected diarrheic outpatients. Fresh stool specimen was processed according to standard operating procedures. Data were entered and analyzed using SPSS version 22. Descriptive statistics was used to determine frequency, Bivariate and multivariate logistic regression analyses were performed to identify predicting factors associated with the outcome variable. P-value <0.05 were used to declare statistical significance. Among 354 diarrheic patients, 112 were HIV infected and 242 were HIV non-infected. The overall prevalence of intestinal parasite and bacterial infection among HIV infected versus non-infected, respectively, was 26 (23.2%) and 8 (7.1%) versus 50 (20.7) and 16 (6.6%). Salmonella was the highest in both groups, 6 (5.4%) vs 11 (4.5%). Most prevalent parasite was C. parvum, 9 (8%) among HIV+ while E. histolytica/dispar 39 (16.1%) among HIV-. Having bloody plus mucoid diarrhea, not utilizing latrine and drinking river or spring water were factors significantly associated with bacterial infection. Whereas, being illiterate or having primary level education, diarrhea lasting for 6-10 days, CD4 level between 200-500 cells/μl, not washing hand with soap showed significant association with IPs. The bacterial isolates were 100% susceptible to Ceftriaxone and 95.4% to Ciprofloxacin, while 100% resistant to Ampicillin and Amoxicillin. MDR was observed among 19 (79.2%) isolates. Preventing and controlling infection by enteric pathogens as well as IPs require strengthening intervention measures. The 100% resistance of isolates to commonly prescribed antibiotics calls for expanding antimicrobial susceptibility testing so as to select appropriate antimicrobial agent and prevent emergence of drug resistant bacteria.

ЭФФЕКТИВНОСТЬ НУТРИТИВНОЙ ПОДДЕРЖКИ У РЕБЕНКА РАННЕГО ВОЗРАСТА С ТЯЖЕЛОЙ КИШЕЧНОЙ ИНФЕКЦИЕЙ

The article presents a clinical observation of a child with severe, combined bacterial (opportunistic flora-associated) adenoviral intestinal infection characterized by symptoms of intoxication, gastrointestinal manifestations, symptoms of 1st and 2nd degree exicosis (vomiting, lethargy, weakness, dry skin and mucous membranes, soft tissue turgor decrease, tachycardia, a decrease in urine output), with the development of digestion and absorption disorders; laboratory changes in the protein status and electrolyte disorders. Positive treatment result, confirmed by clinical data and laboratory tests, allows to speak confidently about the effectiveness of nutritional support using enteral and parenteral nutrition.

Performance Evaluation of the Novodiag Bacterial GE+ Multiplex PCR Assay.

The bacteriological diagnosis of intestinal bacterial infections has historically been based on culture on agar plates. However, culture may lack sensitivity, and some enteropathogens, such as pathovars of Escherichia coli, may escape routine diagnosis. Our goal was to evaluate the analytical performance of the Novodiag Bacterial GE+ kit for the detection of enteropathogenic bacteria in acute community diarrhea. We included 251 stools in this study (198 retrospective and 53 prospective). The analytical performance was calculated using a composite reference standard (CRS) in the absence of a perfect gold standard (lack of sensitivity of culture). The CRS was defined as positive if culture was positive or, in case of a negative culture, if the BD Max extended enteric bacterial panel and/or other real-time PCR (RT-PCR) tests were positive. Of the 251 samples, 200 were positive, and 51 were negative. Overall sensitivities of the Novodiag Bacterial GE+ kit for Campylobacter sp., Salmonella sp., Shigella sp./enteroinvasive E. coli (EIEC), Yersinia enterocolitica, enterohemorrhagic E. coli (EHEC), and enterotoxigenic E. coli (ETEC) ranged from 98.98 to 100%, specificities ranged from 98.08 to 100%, positive predictive values (PPVs) ranged from 88.24 to 100%, and negative predictive values (NVPs) ranged from 99.36 to 100%. The analytical performance of the Novodiag Bacterial GE+ kit is excellent. It can be used as a routine tool in the rapid diagnosis of bacterial gastroenteritis. Despite the eNAT tube dilution of the primary sample, the detection of Salmonella sp. and EHEC was perfect. The kit has the advantage of only detecting pathogenic Y. enterocolitica Its performance for Campylobacter is very satisfactory.

Modern Trends in Long-Term Dynamics of the Acute Intestinal Infectios Incidence of Bacterial and Viral Etiology

Relevance. According to the scientific literature in the Russian Federation (RF), over recent years there has been a decrease in the incidence of acute bacterial intestinal infections (AII) and, conversely, an increase in the incidence of AII of viral etiology. The reasons for these trends remain unclear in many respects. Goal. To study the trends in the long-term dynamics of the incidence of AII of bacterial and viral etiology among the population of the RF. Materials and methods. The work uses the materials of state reports of the Federal Service for Supervision of Consumer Rights Protection and Human Well-Being for 2000 - 2018. The incidence rates of bacterial AII (dysentery, salmonellosis, intestinal yersiniosis, Escherichiosis and intestinal infections caused by opportunistic bacteria) and viral AII (rota-, noro-, enterovirus infections), as well as the results of microbiological control of food and drinking water were studied compliance with sanitary regulations. Results. A tendency towards an increase in the incidence of acute intestinal infections with an average annual rate of 1,7% in population of the Russian Federation was revealed. At the same time, there was a decrease in the incidence of bacterial AII with an average annual rate of 3,8% and, conversely, an increase in the incidence of viral AII with an average annual rate of 384,1%. These changes were observed on the back of a decrease of samples` percent of food and drinking water that did not meet sanitary standards for bacteriological indicators, and an expansion of the range of virological methods for diagnosing viral AII. Conclusion. During 2000–2018 revealed a decrease in the incidence of bacterial OCI in the Russian Federation against the background of improved quality of food and drinking water according to microbiological indicators and, on the contrary, a sharp increase in the incidence of viral OCI associated with the expansion of the spectrum and scope of diagnostic virological studies.

The level of lipopolysaccharide-binding protein in acute intestinal infections, the effect of IL-1β and IL-10 on its production

Aim. To determine the level of lipopolysaccharide-binding protein (LBP) in acute intestinal infection, depending on the etiology and severity of the disease, and the effect of interleukin (IL)-1 and IL-10 levels on the expression of LBP.&#x0D; Methods. Serum samples of 62 patients were assayed by solid phase enzyme-linked immunosorbent assay using a set of reagents ELISA (USA) and Vector-best (Novosibirsk) for levels of LBР, IL-1, IL-10. The first group included 33 patients with bacterial intestinal infection, the second group consisted of 29 patients with viral diarrhea, and the control group comprised 20 conditionally healthy patients. Analyses were performed using Microsoft Excel 2010 and Statistica version 6.0 software. Statistical differences were determined by using the MannWhitney U Test, the p-value 0.05 were regarded as statistically significant. Spearmans correlation coefficient was used to examine relationships. ShapiroWilk W test was used to check for normal distribution of the features.&#x0D; Results. We detected the presence of LBP in all the studied groups, with the content of LBP was significantly increased in the group of bacterial intestinal infections compared with other groups. With regard to disease severity, LBP level was the highest for mild acute intestinal infections caused by bacteria, and for viral diarrhea, fluctuations in LBP did not exceed the norm. In intestinal infections caused by bacteria, the levels of LBP were directly related to the levels of IL-1 and IL-10.&#x0D; Conclusion. Detection of LBP concentration can be used for the initial differential diagnosis of intestinal infections caused by bacteria, which would significantly narrow the diagnostic search and determine the tactics of etiotropic therapy; also, considering the relationship between the concentration of LBP and disease severity, this indicator can be used as a predictive sign of the course of the disease.

Different routes of Aeromonas hydrophila infection lead to differential grass carp interleukin-17 family gene expression patterns during intestinal inflammation

The genomic and coding sequences of four members of grass carp interleukin (IL)-17 cytokine family, IL-17A/F2, IL-17A/F3, IL-17C and IL-17N, were isolated using rapid amplification of cDNA ends and conventional PCR techniques. A phylogenetic analysis showed that grass carp IL-17 family genes, including previously identified IL-17A/F1 and IL-17D, clustered with their counterparts from other fish species. IL-17D had two exons and one intron, while all the other members were composed of three exons and two introns. A multiple sequence alignment revealed that grass carp IL-17 family cytokines shared a cystine-knot motif that was highly conserved in mammals. A quantitative real-time PCR analysis revealed that these genes were expressed in the different examined tissues at varying levels. Moreover, they displayed different tissue expression patterns in fish at 24 h after intraperitoneal injection (IP) or anal intubation (AI) of Aeromonas hydrophila, implying roles in inflammatory responses. Next, we compared disease activity status and histopathological changes in intestinal tissues over a 7 day period after IP or AI, and then examine the potential differential effects of different infection routes on the expression profiles of IL-17 family genes in inflamed intestinal tissues. The intraperitoneal route resulted in more pronounced pathological symptoms than the anal route in terms of the disease activity index (DAI). Changes in the DAI highly coincided with the severity of intestinal inflammation. The two infection routes resulted in differential IL-17 family gene expression patterns over time in grass carp intestine, which suggests that IL-17 family members may play differential roles in mucosal and systemic immune responses and that IL-17N and IL-17A/F1 might possibly function as pro-inflammatory cytokines that provide defense against bacterial infection in grass carp intestine.

Distribution and Epidemiological Aspects Associated with Enteric Bacterial Infections in Bulgaria

Abstract Enteric bacterial infections are characterized by the location of causative agents in the intestine and their distribution in the environment with excrements. Intestinal bacterial infections in Bulgaria are caused by Salmonella spp., Shigella spp., E. coli, Campilobacter spp., Yesinia enterocolitica. For the period 2016-2018, the incidence rate of salmonellosis in Bulgaria was close to that of the European Union (EU). It was 11,21 per 100 000 population in 2017 (14,6%ooo in the EU). The incidence rate of typhoid fever in Bulgaria was lower than that in the EU for the period 2016-2018 – 0.01-0.03 per 100 000 population. Bulgaria had the highest rate of shigellosis in the EU. For the period 2016-2018 it was between 3,33%ooo and 4,07 per 100 000. The incidence of Campylobacter infection in Bulgaria during the period 2016-2018 was between 2,72%ooo and 2,88%ooo and was lower than the EU average. Data on yersiniosis in Bulgaria is incomplete. For the period 2016-2018, 36 cases were reported. E. coli enteritis had a higher average annual notification rate in the 0 to 1 age group (142,65 cases per 100 000 population). The main means of controlling intestinal infection are sanitary measures that prevent the transmission of pathogenic microorganisms with food, water, insects, contaminated hands, etc.

Сравнительная клинико-эпидемиологическая характеристика ротавирусной инфекции у детей раннего возраста

This article gives a comparative description of the clinical and epidemiological characteristics of rotavirus infection in children under 1 year and 1–3 years old. An analysis of 83 case histories of the examined children for rotavirus infection under the age of 3 years was carried out. Patients were divided into 2 groups: group 1 — children under 1-year-old (48 patients), group 2 — children from 1 to 3 years old (35 patients). As a result of the study, it was found that in children of the 1st group, rotavirus infection proceeded predominantly (Р˂0.01) in the form of severe enteritis (71.0%), in combination with bacterial intestinal infection (75.0%), with significant (P ˂0.05) frequent (31.3%) bloating due to profuse watery diarrhea. In children of this group in 4.0% of cases, the disease was fatal. In the vast majority (96.7%) of children of the 2nd group, rotavirus infection proceeded in the form of gastroenteritis, with almost the same ratio of moderate to severe forms (47.0, 50.0%). Due to large losses with repeated vomiting and loose stools, significantly (Р˂0.01) more often (53.3%) there was a decrease in urine output and an increase in creatinine level (40.0%).

Fecal Calprotectin as a Biomarker Distinguishing Infectious Cause in Acute Intestinal Infections, Comparing Different Age Groups of Children

BackgroundFecal calprotectin (FC) measurement has a potential in distinguishing the cause of acute intestinal infections, but its distribution is age dependent.ObjectivesWith this study we wanted to investigate FC values in different age groups of children with acute intestinal infections.MethodsOne hundred and three children with acute intestinal infections were enrolled in this study. Seventy two had viral pathogens, 31 bacterial test subjects were divided into 3 groups: ≤ 1 y, 1 - 3 y, 3 - 7 y. Stool samples from test and control subjects (n = 17) were tested for FC with fluorescence enzyme immunoassay.ResultsViral and bacterial pathogen groups had significantly greater FC concentrations, compared to healthy controls. Overall, bacterial pathogen group presented with greater FC values, compared to viral pathogen group (1299.0 mg/kg vs 297.0 mg/kg, P = 0.002). The cut-off value for acute viral intestinal infections was > 70.0 mg/kg (78.2% sensitivity and 100% specificity), bacterial intestinal infections: > 201.0 mg/kg (88% sensitivity and 100% specificity). There was no difference in FC concentration between bacterial and viral pathogen groups in children under one-year-old (391.0 mg/kg vs 399.5 mg/kg, P = 0.945). Differences were significant comparing bacterial and viral pathogen groups of children from 1 to 3 (316.0 mg/kg vs 1799.75 mg/kg, P = 0.001) and from 3 to 7 years old (99.0 mg/kg vs1299.0 mg/kg, P = 0.04).ConclusionsFC is a valuable biomarker for distinguishing bacterial and viral pathogens, except for children under one-year-old.

Intestinal displacements in older harbour and grey seals.

Intestinal displacements including volvulus, torsion and invagination have been reported in various terrestrial and marine mammals. We conducted pathological investigations on 157 seals that had either stranded on the coasts of the North or Baltic Sea between 1996 and 2015 (115 harbour seals, >19 mo old; 21 grey seals, >13 mo old) or died while in human care (18 harbour seals, >19 mo old; 3 grey seals, >13 mo old). Intestinal displacements were found in 23% of the examined free-living harbour seals, in 5% of the stranded grey seals and in 17% of the harbour seals in human care. Intestinal volvulus, found in 24 cases, was characterized by twisting of the intestine along the mesenteric axis (180-540°) resulting in vascular obstruction and haemorrhagic infarction. In harbour seals, the sex ratio of individuals suffering from volvulus tended to be biased towards females during April to June, suggesting an elevated risk for pregnant females around birth time. Invagination was detected in 11 cases, 5 of which suffered from additional volvulus. Pathological findings associated with intestinal volvulus and invagination were sero-haemorrhagic effusions in the abdominal cavity. Enteritis, parasitic infection with gastric nematodes and intestinal acanthocephalans and bacterial infection with predominantly Clostridium perfringens and Escherichia coli were observed in most of the affected animals. In total, 30 investigated harbour and grey seals suffered from intestinal displacements. Pregnant females seemed to be more vulnerable around birth time. Causes of intestinal displacements remain undetermined, but are likely multifactorial.