Antibiotic resistance ofEscherichia coli in fecal samples of healthy people in two different areas in an industrialized country

Summary Fecal samples of 310 healthy persons, from two populations from different areas in the Netherlands, were examined for the presence ofEscherichia coli resistant to ampicillin, tetracycline, sulfamethoxazole, trimethoprim and nitrofurantoin. High prevalences of resistance were found in both populations, ranging from 28% for trimethoprim to 89% for ampicillin. The percentages of the fecal samples with a dominantly resistantE. coli flora (> 50% resistance) were distinctly lower, ranging from 1% for nitrofurantoin to 21% for tetracycline. No significant differences in the level of resistance were observed between these two comparable populations in two different areas. The susceptibilities to 11 antimicrobial agents of 456 at random isolatedE. coli were determined. The percentages of resistance varied widely: from 80% for chloramphenicol to 9% for nitrofurantoin. Only 19% of the isolates were susceptible to all antibiotics tested and 14% were resistant to more than four of the agents tested. Great differences in resistance rates between the two populations examined were seen for chloramphenicol (80% to 41%) and trimethoprim (16% to 36%). The results of this study underscore the presence of a human reservoir of antibiotic resistant microorganisms.

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Antibiotikaresistenz von Escherichia coli in Stuhlproben gesunder Personen in zwei verschiedenen Regionen eines Industrielandes

Zusammenfassung Escherichia coli-Resistenz gegen Ampicillin, Tetracyclin, Sulfamethoxazol, Trimethoprim und Nitrofurantoin wurde in Isolaten aus Stuhlproben von 310 gesunden Personen aus zwei Bevölkerungsgruppen verschiedener Regionen der Niederlande geprüft. In beiden Populationen fanden sich hohe Resistenzraten von 28% gegen Trimethoprim bis 89% gegen Ampicillin. Der Prozentsatz von Stuhlproben mit dominant resistenterE. coli-Flora (mehr als 50% resistente Stämme) war eindeutig geringer mit 1% für Nitrofurantoin und 21 für Tetracyclin. Der Grad der Resistenz war zwischen den vergleichbaren Populationen dieser zwei verschiedenen Regionen nicht signifikant verschieden. Die Empfindlichkeit der von 456 Personen isoliertenE. coli-Stämmen gegen 11 Antibiotika wurde untersucht. Die Resistenzraten zeigten erhebliche Unterschiede von 80% für Chloramphenicol bis 9% für Nitrofurantoin. Nur 19% der Isolate waren gegen alle Testantibiotika empfindlich, 14% waren gegen mehr als vier der Testsubstanzen resistent. Die beiden Populationen wiesen große Unterschiede in den Resistenzraten gegen Chloramphenicol (80% gegenüber 41%) und Trimethoprim (16% gegenüber 36%) auf. Die Ergebnisse dieser Studie bestätigen das Vorliegen eines Reservoirs an resistenten Mikroorganismen beim Menschen.

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The results of this study were presented in part at the 31st Interscience Conference on Antimicrobial Agents and Chemotherapy, Chicago 1991.     

Survival of the probiotic, L. plantarum 299v and its effects on the faecal bacterial flora, with and without gastric acid inhibition

INTRODUCTION: Probiotic bacteria have to survive passage through the gastrointestinal tract. In this placebo-controlled double-blind study, the effect of Lactobacillus plantarum 299v on the faecal flora was studied with and without gastric acid inhibition. METHODS: Thirty-two healthy volunteers were given pantoprazole (40 mg/day) or placebo for 3 weeks from week 2 until week 4. In addition, from week 3 until week 4, L. plantarum 299v in an oatmeal-fermented drink (10(9) CFU/ml) was given twice daily to both groups. From each healthy volunteer, faecal samples were collected at the end of week 1, 2, 4 and 8 (4 weeks after cessation of L. plantarum 299v and pantoprazole/placebo). Several aerobically and anaerobically growing bacteria were counted and short chain fatty acid concentrations were determined. RESULTS: In both the pantoprazole and the placebo group, median lactobacilli counts increased significantly in week 4 compared to week 1 (from log 4.5 to 8.0 CFU/g faeces in pantoprazole and from log 4.2 to 7.7 CFU/g faeces in placebo group) and decreased significantly in week 8 (to log 4.5 CFU/g faeces in pantoprazole and log 4.3 CFU/g faeces in placebo group). These lactobacilli were identified as L. plantarum 299v. No significant differences were observed in all other bacterial counts and short chain fatty acid concentrations. CONCLUSIONS: The comparable increase of faecal lactobacilli counts in both the pantoprazole and the placebo-treated group demonstrates that L. plantarum 299v survives passage through the gastrointestinal tract irrespective of gastric acidity. The increment of the intra-gastric pH in combination with L. plantarum 299v did not modulate bacterial composition and/or the production of short chain fatty acids.     

The enhancer-like sequence 3' to the A gamma gene is polymorphic in human populations

Cloning and sequencing of the enhancer 3' of the A gamma globin gene of a particularly low G gamma and HbF sickle cell anemia (SCA) patient unexpectedly revealed three base changes (T----C, C----A, and A----G at sites +2285, +2460, and +2676) previously associated with the Seattle- type HPFH, thus leading the authors to suspect that the three mutations were polymorphic. The determination of the incidence of the mutations among various ethnic groups allowed the authors to conclude that this is a widely spread polymorphism, thus excluding any role of these base changes in the determination of the hereditary persistence of fetal hemoglobin (HPFH) phenotype. The origin of these three mutations is not clear because they appear linked, and the same bases (C, A, G) are found in homologous position in the 3' of the normal G gamma gene. As C, A, G at positions +2285, +2460, and +2676 are found with a 100% frequency in African SS patients and presumably among normal Africans (to explain the extremely high frequency among normal American blacks), it is likely that this was the sequence preceding the division of races. The presence of T, C, and A at the same positions apparently occurred after the divergence between blacks and the other races, that is, within the last 1 million years.     

The vascular effects of different arginase inhibitors in rat isolated aorta and mesenteric arteries

Background and purpose

Arginase and nitric oxide (NO) synthase share the common substrate L-arginine, and arginase inhibition is proposed to increase NO production by increasing intracellular levels of L-arginine. Many different inhibitors are used, and here we have examined the effects of these inhibitors on vascular tissue.

Experimental approach

Each arginase inhibitor was assessed by its effects on isolated rings of aorta and mesenteric arteries from rats by: (i) their ability to preserve the tolerance to repeated applications of the endothelium-dependent agonist acetylcholine (ACh); and (ii) their direct vasorelaxant effect.

Key results

In both vessel types, tolerance (defined as a reduced response upon second application) to ACh was reversed with addition of L-arginine, (S)-(2-boronethyl)-L-cysteine HCl (BEC) or N^G-Hydroxy-L-arginine (L-NOHA). On the other hand, N^ω-hydroxy-nor-L-arginine (nor-NOHA) significantly augmented the response to ACh, an effect that was partially reversed with L-arginine. No effect on tolerance to ACh was observed with L-valine, nor-valine or D,L, α-difluoromethylornithine (DFMO). BEC, L-NOHA and nor-NOHA elicited endothelium-independent vasorelaxation in both endothelium intact and denuded aorta while L-valine, DFMO and nor-valine did not.

Conclusions and implications

BEC and L-NOHA, but not nor-NOHA, L-valine, DFMO or nor-valine, significantly reversed tolerance to ACh possibly conserving L-arginine levels and therefore increasing NO bioavailability. However, both BEC and L-NOHA caused endothelium-independent vasorelaxation in rat aorta, suggesting that these inhibitors have a role beyond arginase inhibition alone. Our data thus questions the interpretation of many studies using these antagonists as specific arginase inhibitors in the vasculature, without verification with other methods.     

Eyebrow anomalies as a diagnostic sign of genomic disorders

Silengo M, Belligni E, Molinatto C, Baldassare G, Biamino E, Chiesa N, Zuffardi O, Girirajan S, Eichler EE, Ferrero GB. Eyebrow anomalies as a diagnostic sign of genomic disorders. Microdeletions and microduplications in the human genome, termed genomic disorders, contribute to a high proportion of human multisystemic neurodevelopmental diseases and are detected by array‐based comparative genomic hybridization (aCGH). In general, most genomic disorders are associated with craniofacial and skeletal features and behavioural abnormalities, in addition to learning disability and developmental delay (LD/DD). Specifically, recognition of a characteristic ‘acial gestalt’ has been the key to distinguish one genomic disorder from the other. Here, we report our experience concerning the relevance of abnormal eyebrow pattern as a diagnostic indicator of specific genomic disorders.     

Rectal nitric oxide and fecal calprotectin in inflammatory bowel disease

OBJECTIVE: The assessment of intestinal inflammation in patients with inflammatory bowel disease (IBD) remains a difficult challenge. Both rectal nitric oxide (NO) and fecal calprotectin can be measured using non-invasive methods and are emerging as promising inflammatory markers in IBD. In this study the aim was to compare calprotectin and NO levels in IBD patients. MATERIAL AND METHODS: Rectal NO was measured tonometrically in 23 healthy volunteers and 32 patients with IBD. In addition, we collected stool samples from all subjects for measurement of fecal calprotectin and nitrate/nitrite (NO metabolites). RESULTS: Patients with IBD had greatly increased NO and calprotectin levels compared to healthy volunteers (p <0.001). In addition, the nitrate levels were slightly increased in IBD patients. A weak correlation was found between rectal NO levels, disease activity and number of loose stools in IBD patients (Spearman's rho 0.37 and 0.51, respectively; p <0.05). Fecal calprotectin correlated only with age (Spearman's rho 0.51; p <0.01). However, no correlation was found between NO and calprotectin. CONCLUSIONS: Both rectal NO and fecal calprotectin are greatly increased during bowel inflammation, but they may reflect different parts of the inflammatory process. Future studies will elucidate the clinical usefulness of these two markers.