COMPARISON OF FAECAL FLORAE IN PATIENTS WITH RHEUMATOID ARTHRITIS AND CONTROLS

The faecal flora of 25 out-patients with active rheumatoid arthritis(RA) was compared with that of 25 age- and sex-matched controls.A comprehensive survey revealed a significantly higher carriagerate of Clostridium perfringens in the RA population (88%) thancontrols (48%) (p<0.01). Coliform counts also tended to behigher, but there were no other significant differences betweenpatients and controls. When the study was enlarged to include a further 113 RA patientswith variable disease activity and a further 38 controls, clostridiawere again more frequently carried by those with RA (70%) thancontrols (45%) (p<0.01) and clostridial counts were significantlyhigher in the patient group (p = 0.006). Moreover, counts inpatients with active or moderately active disease were significantlyhigher than in those with inactive disease (p < 0.001). These data are consistent with the hypothesis that Cl. perfringensplays a role in triggering or is otherwise associated with diseaseactivity in RA. The findings may be alternatively an effectof the disease or its treatment with, for example, anti-inflammatorydrugs. KEY WORDS: Rheumatoid arthritis, Faecal flora, Closiridium perfringens ^*Present address: Department of Bactenology, University MedicalSchool, Edinburgh, UK. Present address: Central P.H.L., Division of Hospital Infection,61 Colindale Avenue, London NW9 5HT, UK.