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[toxic megacolon due to shigella: a report of a new case].a new case of shigella-caused megacolon is described in detailed form. some considerations are made about frequency, pathology, clinic and prognostic features.19921340679
[shigellosis in children of the ix region of chile: clinical and epidemiologic aspects and antibiotic sensitivity].ninety four children with diarrhea and a positive stool culture for shigella, hospitalized at the hospital regional de temuco, were studied. forty six percent of patients were less than two years old. forty two percent of microorganisms were resistant to ampicillin, 45% to trimethoprim/sulfamethoxazole, 8% to tetracycline and none to chloramphenicol. isolated species were shigella flexneri 83% and shigella sonnei 17%. seventy nine percent of patients had fever, 60% dysentery and 21.3% seizures. ...19921340946
[bacteriology of shigella isolated in a tropical zone chu].from 1981 to 1991, five hundred eighty one shigella's strains were isolated in the laboratories of the chu fann of dakar. they represent 24.8 per cent of enteropathogen agents and 4.3 per cent of diarrhoeae causative agents. shigella flexneri was predominant (71%), following by shigella dysenteriae (14.5%), shigella sonnei (11.4%) and shigella boydii (2.5%). in pediatric hospital 90 per cent of strains were isolated between 1 and 5 years age; in adults, the pic was found from 20 to 30 years. fiv ...19921345084
effect of overproduction of heat shock chaperones groesl and dnak on human procollagenase production in escherichia coli.the effect of overexpression of the heat shock chaperone genes dnak and groesl on heterologous protein production in escherichia coli was examined, using a set of related human procollagenase proteins. a diverse range of effects on protein solubility, secretion, and accumulation was observed, and these effects were highly dependent on the particular chaperone/procollagenase pairing involved. both chaperones caused a large increase in the apparent solubility of a fusion of the lamb signal peptide ...19921346610
brain somatostatin receptor-g protein interaction. g alpha c-terminal antibodies demonstrate coupling of the soluble receptor with gi(1-3) but not with go.somatostatin (sst) receptors activate potassium channels, stimulate protein phosphatases, inhibit adenylate cyclase and close calcium channels. these multiple effects are controlled by guanine nucleotide binding (g) proteins of the pertussis toxin-sensitive gi and go types. in the present study we have identified the g proteins coupling with brain sst receptors. to this end, brain sst receptors were solubilized in g-protein coupled form. binding of the sst analogue mk 678 to the solubilized rece ...19921346612
calcium utilization coupled to stimulation of postjunctional alpha-1 and alpha-2 adrenoceptors in isolated human resistance arteries.human s.c. resistance arteries (internal diameters 158-353 microns) were mounted in a microvascular myograph, and experiments were designed to examine the calcium pools utilized by selective stimulation of alpha-1 and alpha-2 adrenoceptors. in a concentration-dependent manner, phenylephrine and b-ht 933 evoked contractions mediated by alpha-1 and alpha-2 adrenoceptors, respectively, both in calcium-containing and in calcium-free saline. with respect to the maximum response to potassium in calciu ...19921346639
sexual transmission of htlv infections in southern india. 19921346809
medial vestibular nucleus in the guinea-pig: nmda-induced oscillations.we have recently shown in vivo that n-methyl-d-aspartate (nmda) receptors are present in the guinea-pig vestibular complex and demonstrated that they are involved in the regulation of the resting discharge of vestibular neurones. a parallel in vitro study has identified in the guinea-pig medial vestibular nuclei (mvn) two main neuronal cell types, a and b mvnn, differing by their intrinsic membrane properties. one subtype of b mvnn was further characterized by the presence of a low threshold cal ...19921347271
purification and determination of glutamine synthetase by high-performance immunoaffinity chromatography.high-performance immunoaffinity chromatography (hpiac) with anti-glutamine synthetase polyclonal antibodies bound to epoxy-activated silica was used to purify and determine this enzyme from the cyanobacterium synechocystis. a single-step hpiac procedure with cell-free extracts yielded electroporetically homogeneous glutamine synthetase. in the determination of glutamine synthetase by hpiac a linear response in the range 10-60 micrograms of enzyme was observed. recoveries of 70% of the loaded enz ...19921347294
phenotypic and functional studies on ocular t cells during herpetic infections of the eye.herpetic stromal keratitis an inflammatory disease of the eye resulting from herpes simplex virus type 1 infection, is a common cause of blindness. the disease is generally considered to represent an immunopathologic response, but the exact mechanism remains in doubt and is subject to debate. we have investigated the nature of inflammatory cells in the eye and have isolated ocular cells to establish their phenotype and determine some of their functions. by means of immunocytochemistry and cytofl ...19921347309
[h2-receptor antagonist-refractory ulcer--its pathophysiology and role of proton-pump inhibitors].among h2-receptor antagonist (h2ra)-refractory ulcers, non-responders that did not heal after 5 months therapy had high intraluminal ph in the basal condition and high sensitivity to inhibition of acid secretion by h2ra but possessed gastric mucosa to generate less prostaglandins. combination therapy of pge1-analogue with h2ra healed these ulcers by 60%. proton-pump inhibitor (ppi) exerted a complete inhibition of acid secretion in these patients and the rate of healing was 88%. helicobacter pyl ...19921347325
testing an anti-hiv trio. 19921347353
modification of dena-induced hepatocarcinogenesis by ccl4 cirrhosis. comparison of the marker enzyme patterns.the modifying action of chronic liver injury on the process of hepatocarcinogenesis was investigated. to induce cirrhosis or fibrosis f344 rats received ccl4 alone or in combination with phenobarbital, either before (model 1) or after (model 2) the application of initiator, diethylnitrosamine (dena). in these models, morphology, tumor incidence as well as polysubstrate monooxygenase system, gamma-glutamyltransferase (ggt) and glucose-6-phosphatase (g-6-pase) were studied. the data presented show ...19921350234
a model of interaction between entamoeba histolytica and shigella flexneri.the establishment of a relationship between entamoeba histolytica and certain bacteria may contribute to the expression and/or enhancement of the pathogenicity of this parasite. recent experiments have shown that bacteria expressing mannose-binding lectins on their surface could attach to mannose-containing molecules on the surface of amoebae. in this study, we established a model of interaction between. e. histolytica and shigella flexneri. using well-characterized mutants of s. flexneri, we st ...19921353632
characterization of serpulina (treponema) hyodysenteriae and related intestinal spirochetes by ribosomal rna gene restriction patterns.serpulina (treponema) hyodysenteriae strain a-1 partially purified rrna, labelled with photobiotin, was used as a non-radioactive probe to identify the rrna gene restriction patterns of s. hyodysenteriae strains and other spirochetes. sau3a restriction enzyme digests resulted in similar rrna gene restriction patterns in s. hyodysenteriae strains from five different countries. some s. hyodysenteriae strains could be differentiated by variations in their rrna gene restriction patterns after cleava ...19921354196
glutathione homeostasis in rats chronically treated with ethanol. evidence for an increased hepatic gsh export in vivo.the influence of chronic ethanol feeding to rats on the hepatic glutathione (gsh and gssg) system (synthesis, catabolism, export) and on the gsh and gssg concentrations in extrahepatic tissues was investigated. histological examination of livers from ethanol pretreated rats revealed a minor dilatation of the hepatic sinusoids. after ethanol administration the distribution pattern of gamma-glutamyltranspeptidase (enzymehistochemistry) was nearly unchanged, but the hepatic activity of this enzyme ...19921360286
hepatitis b virus infection among aboriginal children in eastern taiwan.hepatitis b virus (hbv) infection is endemic in taiwan, with 15-20% of the adult population carrying the surface antigen (hbsag). hualien in eastern taiwan is relatively isolated from other parts of the island by the central mountains. the status of hbv infection among mountain aborigines in hualien has not been studied on a large scale before. a survey of serum hbsag and its antibody (anti-hbs) was conducted in 1989. a total of 3,287 children from 27 primary schools in three mountainous countie ...19921360296
inhibitory effect of a microcystis sp (cyanobacteria) toxin on development of preimplantation mouse embryos.1. a soluble toxin, purified from the algae bloom of an eutrophic lake dominated by microcystis, is a very effective inhibitor of early embryo development in a dose-response relationship. 2. two- and 8-cell mouse embryos under the influence of microcystis toxin do not reach the developmental stages of morula and blastocyst, respectively. 3. actin cortex is disorganized without change in the microtubules structure. 4. results are discussed in terms of the possible mechanisms by which the toxin ar ...19921360361
transport characteristics of cephalosporin antibiotics across intestinal brush-border membrane in man, rat and rabbit.the uptake of orally active cephalosporins, ceftibuten and cephradine, by intestinal brush-border membrane vesicles isolated from man, rat and rabbit was studied. in the presence of an inward h+ gradient, ceftibuten but not cephradine was taken up into intestinal brush-border membrane vesicles of man and rat against the concentration gradient (overshoot phenomenon). in rabbit jejunal brush-border membrane vesicles, the uptake of both cephalosporins in the presence of an inward h+ gradient exhibi ...19921361560
studies on novel pili from shigella flexneri. i. detection of pili and hemagglutination activity.pili were detected using electron microscopy in clinical isolates of shigella flexneri which had been continuously subcultivated in liquid media. morphologically, the pili appeared as thin, flexible, cylindrical structures of up to 2-5 microns in length and about 3-5 nm in diameter. two strains showed mannose-resistant (mr) hemagglutination to fresh fowl erythrocytes (type 4), and one to tannic acid-treated horse erythrocyte (type 3) pili. these pili are novel and different from the mannose-sens ...19921361958
effect of enterovirus infection on susceptibility of hela cells to shigella flexneri invasivity.invasiveness of shigella flexneri m90t in hela cells was significantly increased when cells were preinfected with poliovirus 1, coxsackievirus b3 and echovirus 6. this effect was dependent on the dose of virus used, evident at early stages of viral infection and lasted hours before the appearance of a cytopathic effect. an increase of bacterial invasion ability was also noticed when hela cells were incubated with uv-inactivated enteroviruses. this enhancing effect obtained with both viable and u ...19921364020
inhibited growth of common enteropathogenic bacteria in lactic-fermented cereal gruels.a natural lactic fermentation of mixtures of water and whole flour of either maize or high-tannin sorghum was obtained either before or after cooking to a weaning gruel: the preparations had a final ph of about 3.8 (range 3.67 to 4.00) and a ratio of lactic acid to acetic acid of 9∶1 (w/w). the growth of added (about 10(7) c.f.u./g gruel) gram-negative intestinal pathogenic bacteria, enterotoxigenicescherichia coli, campylobacter jejuni, shigella flexneri andsalmonella typhimurium, was strongly ...199224425608
molecular mimicry: any role in the pathogenesis of spondyloarthropathies?ankylosing spondylitis and reactive arthritis are seronegative spondyloarthropathies, which are strongly associated with hla-b27. despite intensive investigation, the basis for this association is not clear. however, in recent years one favored hypothesis to explain this linkage has been that of molecular mimicry, i.e., sharing of linear or conformational epitopes common to microbial antigens and host structures. during the past few years several examples of molecular mimicry between hla-b27 and ...19937504716
genetic and biosynthetic aspects of shigella flexneri o-specific lipopolysaccharides. 19937680623
the synthesis of chemically modified disaccharide derivatives of the shigella flexneri y polysaccharide antigen.disaccharide analogs related to the 2-acetamido-2-deoxy-3-o-(alpha-l- rhamnopyranosyl)-beta-d-glucopyranose element of the shigella flexneri y polysaccharide antigen have been synthesized and used to map the binding site of murine monoclonal antibodies gc-4 and sya/j6 by solid-phase inhibition assays. n-acetyl, n-trifluoroacetyl and n-benzyloxycarbonyl derivatives of methyl-2-amino-4,6-o-benzylidene-2-deoxy-beta-d-glucopyranoside 1, 3, and 4 were glycosylated by rhamnopyranosyl bromide and thiog ...19937681359
[reactive arthritis associated bacteria as the etiology of undifferentiated oligoarthritis].undifferentiated oligoarthritis (uoa) resembles clinically reactive arthritis (rea), but does not fulfill the diagnostic criteria. in 46 patients with uoa, in 16 with rea, and in 15 with rheumatoid arthritis (ra) the humoral and cellular immune response to the rea-associated bacteria chlamydia trachomatis, yersinia enterocolitica, shigella flexneri, salmonella enteritidis, campylobacter jejuni and borrelia burgdorferi was investigated in paired samples of synovial fluid and peripheral blood. an ...19937682746
characterization of b-cell epitopes on ipab, an invasion-associated antigen of shigella flexneri: identification of an immunodominant domain recognized during natural infection.the invasion plasmid antigen b (ipab), a 62-kda plasmid-encoded protein associated with the ability of shigellae to invade epithelial cells, is the bacterial antigen most strongly and consistently recognized by the host during infection. the strong systemic and mucosal immune responses observed against this invasin prompted us to map its b-cell epitopes. for this purpose, ipab was first overexpressed in shigella flexneri and used to raise rabbit polyclonal antiserum and murine monoclonal antibod ...19937689541
transcriptional control of the invasion regulatory gene virb of shigella flexneri: activation by virf and repression by h-ns.expression of invasion genes encoded by the large 230-kb plasmid of shigella flexneri is controlled by the virb gene, which is itself activated by another regulator, virf. transcription of the invasion genes is temperature regulated, since they are activated in bacteria grown at 37 but not at 30 degrees c. recently, we have shown that the thermoregulated expression of invasion genes is mediated by thermal activation of virb transcription (t. tobe, s. nagai, b. adler, m. yoshikawa, and c. sasakaw ...19937691791
[synovial cellular immune response to bacterial pathogens in patients with chronic juvenile arthritis].juvenile chronic arthritis is a heterogenous disease with an ill-defined pathogenesis. in our study, synovial fluid (sf) and peripheral blood (pb) of 70 children with oligoarthritis were investigated; bacteria-specific lymphocyte proliferation and antibodies to arthritogenic bacteria were determined. specific cellular immune responses in sf but not in pb were found in 4/7 patients with either lyme- or reactive arthritis (60%). in comparison, in subgroup jca ii (n = 45) encompassing mainly elder ...19937692686
association between reactive arthritis and antecedent infection with shigella flexneri carrying a 2-md plasmid and encoding an hla-b27 mimetic epitope.to determine whether shigella flexneri strains that cause enteric infection and are associated with reactive arthritis (rea) carry a 2-md plasmid, phs-2, which encodes an hla-b27 mimetic epitope.19937692858
synthesis of chlorodeoxy trisaccharides related to the shigella flexneri y polysaccharide.chloromethoxylation of di-o-acetyl-l-rhamnal has been employed as a convenient route to methyl 3,4-di-o-acetyl-2-chloro-2-deoxy-alpha-l-rhamnopyranoside 7, which was converted into an ethyl thioglycoside 10, suitable for use as a glycosyl donor. it and a disaccharide analogue 20 were effective donors in n-iodosuccinimide-triflic acid promoted glycosylations of a 2-acetamido-2-deoxy-d-glucopyranoside acceptor 22. chlorodeoxy saccharides have previously been shown to be suitable derivatives to pro ...19937693346
hyper-invasive mutants define a novel pho-regulated invasion pathway in escherichia coli.we have isolated two transposon insertion mutations of the pst-phou operon which result in the constitutive expression of the phoa gene product, alkaline phosphatase. the two mutations also render escherichia coli invasive towards cultured hep-2 cells and define a novel pho-regulated invasion pathway. the presence of the large 'invasion' plasmid derived from an entero-invasive e. coli (eiec) clinical isolate in these mutants leads to enhanced invasiveness toward cultured hep-2 cells, a phenomeno ...19937934862
plasmid profiles of shigella and salmonella spp. isolated from diarrhoeic humans in ibadan, nigeria.clinical isolates of shigella flexneri, s. dysentariae, s. boydii and salmonella spp. were screened for the presence of plasmids. most of the isolates harboured more than one plasmid ranging in molecular size from 1.3 to 36.1 x 10(6) daltons. very large plasmids were not encountered.19937839920
[the infectious etiology of acute diarrheal diseases in the republic of cuba, 1991].this study was carried out in 1991 to learn the behavior of enteropathogenic agents causing acute diarrheal diseases in cuba. 30 children, admitted in hospitals or seen in outpatient services for acute diarrheal diseases, were selected in each province taking into account that they had not received antibiotic or chemotherapy treatments in the previous 72 hours. feces samples were taken from all patients for virological, bacteriological, and parasitological studies, and results were sent to the p ...19937984819
[l-transforming effect of biseptol on cells of shigella sonnei and flexneri].possible l-transformation of shigella under the action of biseptol on an artificial nutrient medium was investigated. the l-forms were isolated from 6 out of 35 cultures. by the morphological properties the isolates were similar to the l-forms of shigella flexneri induced by furazolidone. the growth of the l-forms proceeded by the pattern of the rapid mass l-conversion of bacteria and was accompanied by the development of resistance to biseptol. it was inhibited by folic acid added to the medium ...19938037576
an outbreak of shigellosis in a slum colony of delhi-1990. 19938014439
[the role of secondary immunodeficiencies in the development of a protracted course of acute dysentery].an opinion on the expediency of working out criteria for dividing acute dysentery patients into risk groups, depending on the development of immune deficiency, has been put forward. the results of the study of some characteristics of t-cell immunity system in 228 acute dysentery patients in relation to their clinical state are presented. measurements of total active t lymphocytes, t helpers and t suppressors have been made. disturbances in the immunity characteristics under study, more pronounce ...19938059562
[a morphological evaluation of the protective properties of noninvasive recombinant strains of shigella].in 2-3 weeks after the oral immunization of rabbits, made in one or two administrations, with attenuated two-marker s. dysenteriae 1 strain vs-12 and recombinant s. dysenteriae vs-12/s. sonnei nr-18 and s. flexneri y433/s. sonnei nr-18 pronounced immunological reaction developed in the mucous membrane of the small intestine: blast transformation follicles of peyer's patches, an increase in the number of lymphoblasts and plasmocytes in the cupolae of follicles and in intestinal villi, and an incr ...19938059565
[a morphological evaluation of the harmlessness of noninvasive recombinant shigella strains].the interaction of shigella recombinant strains (with attenuating chromosomal mutations, with transposon-neutralized plasmid gene mutations, the hybrids of both strains), incapable of inducing keratoconjunctivitis in guinea pigs, with cells hep-2 and enterocytes in the ligated loop of the small intestine of rabbits was studied. these strains retained, to varying extent, pronounced adhesiveness, but practically lost their invasiveness (though in peyer's patches the translocation of bacteria by m- ...19938067094
[an immunoenzyme method for determining iga antibodies to lipopolysaccharide in secretions in the diagnosis of shigellosis].iga antibodies to s. sonnei and s. flexneri lipopolysaccharides (lps) in secretions, as well as escherichia coli lps in coprofiltrates of children with acute diarrhea, were determined with the use of enzyme immunoassay (eia). in adult patients with dysentery serum and salivary anti-lps antibodies were assayed. the results of eia showed that children aged up to 18 months had an elevated level of lps of the causative agent in their coprofiltrates. the specificity of this assay permitted its use fo ...19938067099
[a mathematical model of the seasonal morbidity of shigellosis].a new epidemiologically significant mathematical model for the prognosis of seasonal morbidity in dysentery caused by s. flexneri and s. sonnei has been developed. this model may be used for solving problems on the epidemiology of shigella infections. in this model quantitative ratios are determined by means of the system of nonlinear integral-differential equations in partial derivatives of the first order with edge conditions of the integral type. this model makes it possible to make multiple ...19938067113
[the optimization of the technology for culturing vaccinal strains of shigella flexneri].the drainage-filling cultivation process for three shigella flexneri vaccine strains in small-capacity fermenters has been developed. the study has shown that after hydroxylamine treatment the yield of the antigenic component, calculated per 1000 million microbial cells, is tenfold higher in comparison with the traditional method.19938067146
[the therapeutic efficacy of sodium nucleinate and monoribonucleotides based on keratoconjunctival test data].the possibility of using sodium nucleinate for the treatment of acute dysentery has been confirmed in experiments on guinea pigs with the use of the keratoconjunctival test as an experimental model. the capacity of sodium nucleinate to enhance the antibiotic sensitivity of shigellae isolated from infected eyes to kanamycin, tetracycline and chloramphenicol has been established. the effect produced by individual ribonucleotides contained in sodium nucleinate have been studied and found to be diff ...19938067149
[molecular genetic studies on virulence-associated chromosomal loci of shigella flexneri 2 a]. 19938309077
homology between the hrpo protein of pseudomonas solanacearum and bacterial proteins implicated in a signal peptide-independent secretion mechanism.a region of approximately 22 kb of dna defines the large hrp gene cluster of strain gmi1000 of pseudomonas solanacearum. the majority of mutants that map to this region have lost the ability to induce disease symptoms on tomato plants and are no longer able to elicit a hypersensitive reaction (hr) on tobacco, a non-host plant. in this study we present the complementation analysis and nucleotide sequence of a 4772 bp region of this hrp gene cluster. three complete open reading frames (orfs) are p ...19938316211
cloning and sequencing of the glucosyl transferase-encoding gene from converting bacteriophage x (sfx) of shigella flexneri.shigella flexneri type y strains (-;3,4) are converted to type x (-;7,8) by bacteriophage x (sfx) that causes glucosylation of the o-antigenic polysaccharide chain. the gene (gtr) encoding glucosyl transferase from bacteriophage x has been cloned and sequenced. the protein encoded by gtr consists of 416 amino acids with a m(r) of 47,369. the cloned gtr product was able to convert a s. flexneri strain type y (sfl 124, a live attenuated candidate vaccine strain) to type x. the importance of the hy ...19938335266
immunization of mice with yersinia enterocolitica leads to the induction of antithyrotropin receptor antibodies.it is well established that autoimmune graves' disease, which is characterized by hyperthyroidism, is mediated by autoantibodies to the thyrotropin receptor (tshr). although what initially triggers this autoantibody response is not known, a number of studies have suggested that yersinia enterocolitica, an enterobacteria, could initiate the immune response against the tshr. in this study, we produced antibodies against purified extracellular domain of human tshr (etshr) and showed that anti-etshr ...19938335920
[characteristics of the shigella flexneri strains isolated from japanese monkeys (macaca fuscata)].shigella flexneri was isolated from 11 of 95 japanese monkeys (macaca fuscata) purchased by the animal research center, tokyo medical and dental university, during the period from 1988 through 1990. the serotypes of the isolates were 4a (5 isolates), 2a (4 isolates), 2b (1 isolate), and vary (1 isolate). although some of the strains in the same serotypes were similar, others were different in their antibiotic susceptibility patterns or the plasmid profiles. our results suggested that various typ ...19938336006
morpho-physiologic characteristics of escherichia coli and shigella flexneri 2a carrying the htpr15 gene.electron microscopic examination of the morphology of normal escherichia coli mc4100 and shigella flexneri cells and their htpr-defective recombinants has shown the presence in the latter of noncrystalline granules after growth at 37 degrees c. the defect of the htpr gene leads to some changes in ultrastructure of bacterial colonies and the intensification of the processes of development and aging of colonies as integral structures. these phenomena are manifested by early formation of intercellu ...19938336285
inactivation of beta-lactamase from shigella flexneri ucsf-129 by brl 42715, a potent inhibitor.the effect of a powerful inhibitor, brl 42715, on beta-lactamase from shigella flexneri ucsf-129, to overcome the problem of shigellosis and its resistance to ampicillin, was studied. the i50 was determined for brl 42715 [c6-(n1-methyl-1,2,3 triazolylmethylene)penem] as 0.0049 microgram/ml being 20-fold lower than the best inhibitor, 6-beta-iodopenicillanic acid, previously reported. the mic fell from 2,048 to 2 micrograms/ml in the presence of 1 microgram/ml of brl 42715. the synergism of the a ...19938336551
the possible role of shigella in sporadic enteric reactive arthritis.reactive arthritis (rea) occurs after a urogenital infection usually with chlamydia trachomatis or an enteritis due to yersinia, salmonella, campylobacter or shigella, shigella, except during epidemics, is not considered to be a frequent cause of enteric reactive arthritis. however this might be due to the lack of a reliable antibody test, which makes diagnosis difficult. we compared synovial and peripheral blood lymphocyte proliferation to various bacterial antigens in 19 consecutive patients w ...19938339129
diffuse adherence of enteropathogenic escherichia coli strains--processing of aida-i.the adherence of pathogenic escherichia coli to the mucosa of the small intestine is an important step in the development of diarrhoea. to study the molecular basis of the diffuse adherence (da) pattern of e. coli strains expressing the classical serotypes of enteropathogenic e. coli (epec), strain 2787 (o126:h27) was investigated. by expression cloning, a plasmid-derived 6.0 kb dna fragment was identified which conferred the da phenotype on recipient k-12 strains. this fragment encoded the 100 ...19938347926
arod deletion attenuates shigella flexneri strain 2457t and makes it a safe and efficacious oral vaccine in monkeys.the aromatic-dependent live shigella flexneri 2a vaccine strain sfl1070, with a deleted arod gene, had a much reduced intracellular growth in hela cells compared with its parent strain s. flexneri 2457t. s. flexneri sfl1070 gave no adverse effects in eight macaca fascicularis monkeys orally vaccinated with four doses of 1 x 10(11) live bacteria within a 5-week period, whereas s. flexneri 2457t caused dysentery in all eight non-vaccinated monkeys. thus the aromatic dependency rendered s. flexneri ...19938356844
ompc is involved in invasion of epithelial cells by shigella flexneri.osmoregulation of the shigella flexneri ompc gene and the role of ompc in shigella virulence have been investigated. ompc was highly expressed when bacteria were grown in medium of either low or high osmolarity. this constitutive expression is in contrast with the regulation observed in escherichia coli, in which the expression of ompc is repressed at low osmolarity and induced at high osmolarity. in addition, the shigella ompc gene was barely expressed by a delta ompb (delta ompr and delta envz ...19938359885
synthesis, characterization, and clinical evaluation of conjugate vaccines composed of the o-specific polysaccharides of shigella dysenteriae type 1, shigella flexneri type 2a, and shigella sonnei (plesiomonas shigelloides) bound to bacterial toxoids.the theoretic basis for developing conjugate vaccines, to induce immunoglobulin g (igg) lipopolysaccharide (lps) antibodies for the prevention of shigellosis, has been described (j. b. robbins, c.-y. chu, and r. schneerson, clin. infect. dis. 15:346-361, 1992). the o-specific polysaccharides (o-sps) of shigella dysenteriae type 1, s. flexneri type 2a, and s. sonnei were covalently bound to carrier proteins. alone, the o-sps were not immunogenic in mice. conjugates of these o-sps, injected into y ...19938359890
characterisation of plesiomonas shigelloides strains that share type-specific antigen with shigella flexneri 6 and common group 1 antigen with shigella flexneri spp. and shigella dysenteriae 1.three strains of plesiomonas shigelloides isolated from patients with diarrhoea were agglutinated with shigella flexneri 6 antiserum in slide and tube tests. all the strains were also agglutinated with a monoclonal antibody to the common group 1 antigen shared between s. flexneri serotypes and s. dysenteriae type 1. further studies with one strain also showed sharing of antigenicity in an enzyme-linked immunosorbent assay. the results suggest that the strains share type-specific antigen with s. ...19938366520
necrotizing haemorrhagic colitis caused by resistant shigella flexneri. report of a case.a case of fatal infection with shigella flexneri is reported. the 19-year-old male patient who presented with fulminating haemorrhagic colitis died nine days after the onset of symptoms. the infecting strain of shigella flexneri was resistant to multiple antimicrobial agents, including amoxycillin, co-trimoxazole and chloramphenicol.19938367972
evaluation of alkaline phosphatase-labelled ipah probe for diagnosis of shigella infections.the presence of many enteropathogens which are not easily detectable by routine stool culture has led to the development of alternative diagnostic methods. one of these techniques, nucleic acid probe hybridization, has been used to identify shigella spp. and enteroinvasive escherichia coli (eiec) in stool specimens through the detection of genetic material encoded by a specific large approximately 200-kbp virulence-related plasmid. in the present study, an alkaline phosphatase-labelled oligonucl ...19938370736
the bacteriophage mu middle operon: essential and nonessential functions.transcription during the bacteriophage mu lytic cycle occurs in three phases: early, middle, and late. previous dna sequence analysis of the middle operon revealed five potential open reading frames (orfs) with lengths of 39, 42, 72, 120, and 140 amino acids. the distal 140-amino-acid orf encodes c, the activator of late transcription. expression of the middle operon under the control of a t7 promoter and t7 rna polymerase resulted in production of two polypeptides of 15 (orf 120) and 16.5 kda ( ...19938372443
nonpolar mutagenesis of the ipa genes defines ipab, ipac, and ipad as effectors of shigella flexneri entry into epithelial cells.a 31-kb fragment of the large virulence plasmid of shigella flexneri is necessary for bacterial entry into epithelial cells in vitro. one locus of this fragment encodes the ipaa, -b, -c, and -d proteins, which are the dominant antigens of the humoral immune response during shigellosis. to address the role of the ipa genes, which are clustered in an operon, we constructed a selectable cassette that does not affect transcription of downstream genes and used this cassette to inactivate the ipab, ip ...19938376337
tumor necrosis factor alpha binding to bacteria: evidence for a high-affinity receptor and alteration of bacterial virulence properties.human and murine receptors for tumor necrosis factor alpha (tnf-alpha) are present on most somatic cells and have been characterized and cloned. in contrast, very little is currently known about whether tnf-alpha can bind to pathogens and whether such binding results in important biological consequences for the infected host. we now report that a number of gram-negative bacteria have receptors for tnf-alpha. using 125i-labeled tnf-alpha, we show that shigella flexneri has 276 receptors for tnf-a ...19938381771
rotavirus-inhibitory activity in serial milk samples from mexican women and rotavirus infections in their children during their first year of life.a total of 75 children born in rural mexico were followed for diarrheal diseases and rotavirus (rv) excretion during the first year of life. for 18 children, an average of 14 serial breast milk samples were obtained between days 2 and 360 after delivery and were tested for rv-inhibitory activity. of these samples, 70, 62, and 85% showed inhibitory activity against serotype (st) 1 human rv, st4 human rv, and st3 simian rv, respectively; the median titers were 10, 10, and 20, respectively. some 89 ...19938384626
isolation and characterization of a topa mutant of shigella flexneri.shigella flexneri was shown to possess a homologue of the escherichia coli k-12 topa gene which encodes dna topoisomerase i. the s. flexneri topa gene was replaced by a copy of the e. coli k-12 topa gene which has been insertionally inactivated by transposon tn10. the topoisomer distribution of reporter plasmids showed that the presence of this topa lesion in s. flexneri correlated with an increase in the level of negative dna supercoiling in the mutant, indicating that topoisomerase i is requir ...19938384681
eight genes in region 5 that form an operon are essential for invasion of epithelial cells by shigella flexneri 2a.the 7-kb region 5 on the large 230-kb plasmid pmysh6000 in shigella flexneri 2a ysh6000 is one of the virulence-associated dna segments required for the invasion of epithelial cells (c. sasakawa, k. kamata, t. sakai, s. makino, m. yamada, n. okada, and m. yoshikawa, j. bacteriol. 170:2480-2484, 1988). to elucidate the functional organization of region 5 and to determine the virulence-associated genes encoded by region 5, we performed insertion and deletion mutagenesis, dna subcloning, and comple ...19938385666
characterization of virulence genes of enteroinvasive escherichia coli by tnphoa mutagenesis: identification of invx, a gene required for entry into hep-2 cells.while enteroinvasive escherichia coli (eiec) and shigellae are genotypically nearly identical, a difference has been reported in the infective dose to humans: eiec is 10,000-fold less infectious than shigellae. a possible basis for this difference lies in the inherent invasiveness of these bacteria toward epithelial cells. thus, despite the high degree of homology between the invasion plasmids of eiec and shigellae, substantial differences in genetic organization and/or sequence may exist. we ha ...19938393007
cognate gene clusters govern invasion of host epithelial cells by salmonella typhimurium and shigella flexneri.the enteric pathogens salmonella typhimurium and shigella flexneri differ in most virulence attributes including infectivity, pathology and host range. we have identified a new assemblage of genes responsible for invasion properties of salmonella which is remarkably similar in order, arrangement and sequence to the gene cluster controlling the presentation of surface antigens (spa) on the virulence plasmid of shigella. in salmonella, this chromosomally encoded complex consists of over 12 genes, ...19938404849
shigella flexneri invasion of hela cells induces nf-kappa b dna-binding activity.although information about the genetic basis and mechanisms of shigella flexneri cellular invasion is accumulating, little is known about changes in cell signaling and their consequences following bacterium-host cell interactions. a general result of signal transduction is alterations in the levels and/or activities of transcription factors. alterations in transcription factor binding activities were observed following challenge with s. flexneri. changes in the dna-binding activities of cellular ...19938406833
prevalence of shigellosis and other enteric pathogens in a zoologic collection of primates.an epidemiologic study of shigellosis was the preliminary step in the formulation of a plan for the control of devastating infectious diseases in nonhuman primates at the national zoological park. data were collected from primate groups with enzootic shigellosis and included the following species: white-cheeked and siamong gibbons (hylobates concolor and h syndactylies); lion-tailed, celebes, and barbary macaques (macaca silenus, m nigera, and m sylvanus); black and white colobus monkeys (colobu ...19938407446
clearance of shigella flexneri carriers in a zoologic collection of primates.in 1990, a high prevalence of shigella flexneri was documented in the gibbon population at the national zoological park. the enzootic strain had been determined to be resistant to most antibiotics and had been responsible for animal deaths. prevalence of shigella spp was high in the entire primate population. to address the clinical problem, eradication was attempted by use of enrofloxacin. facilities disinfection comprised a large part of shigella clearance efforts. after the clearance protocol ...19938407447
cytokines in stools of children with inflammatory bowel disease or infective diarrhoea.to determine the concentrations of interleukin-6 (il-6) and tumour necrosis factor alpha (tnf alpha) in stools from children.19938408704
site of transcriptional activation of virb on the large plasmid of shigella flexneri 2a by virf, a member of the arac family of transcriptional activators.virb plays a central role in the regulation of virulence of shigella flexneri. it acts as a transcriptional activator and is itself transcriptionally activated by another virulence protein, virf. experiments were performed in order to identify the site upstream of virb at which virf binds in order to activate transcription. progressive 5' deletions of the dna upstream of the transcription start point of virb were constructed by subcloning and bal31 deletion. these deletion derivatives were clone ...19938412620
a pleiotropic reduced virulence (rvi-) mutant of erwinia carotovora subspecies atroseptica is defective in flagella assembly proteins that are conserved in plant and animal bacterial pathogens.erwinia carotovora subsp. atroseptica was mutagenized and assayed for virulence in planta. those mutants which exhibited reduced virulence (rvi-) were assayed for growth rate, auxotrophy and extracellular enzyme secretion and seven mutants were found to be wild type for all of these phenotypes. when screened for other phenotypes, two were found to be non-motile. one mutant was complemented for motility by a heterologous gene library. a 2.7kb xmaiii-clai complementing fragment was sequenced and t ...19938412685
the absence of a surface protease, ompt, determines the intercellular spreading ability of shigella: the relationship between the ompt and kcpa loci.a large plasmid-encoded protein, virg, on the bacterial surface is essential for the spreading of shigella by eliciting polar deposition of filamentous actin in the cytoplasm of epithelial cells. virg expression from the large plasmid is diminished greatly when it is introduced into escherichia coli k-12 from shigella. in an attempt to identify factors affecting virg expression, we found that the absence of the ompt gene, encoding outer membrane protease ompt, restored full production of virg pr ...19938412695
yopb and yopd constitute a novel class of yersinia yop proteins.virulent yersinia species harbor a common plasmid that encodes essential virulence determinants (yersinia outer proteins [yops]), which are regulated by the extracellular stimuli ca2+ and temperature. the v-antigen-encoding operon has been shown to be involved in the ca(2+)-regulated negative pathway. the genetic organization of the v-antigen operon and the sequence of the lcrgvh genes were recently presented. the v-antigen operon was shown to be a polycistronic operon having the gene order lcrg ...19938418066
enteric protein loss during shigellosis.to determine whether protein-losing enteropathy occurs during shigellosis, we measured concentrations of alpha 1-antitrypsin in sequential stool samples from 110 adults hospitalized with acute dysentery due to shigella infection. mean stool concentrations of alpha 1-antitrypsin on admission were 10.9 micrograms/mg dry weight of stool. stool alpha 1-antitrypsin concentrations were significantly (p < 0.001) lower on the 3rd and 5th study days (4.1 and 2.2 micrograms/mg, respectively) than on admis ...19938420274
detection of shigellae and enteroinvasive escherichia coli by amplification of the invasion plasmid antigen h dna sequence in patients with dysentery.detection of shigella organisms and enteroinvasive escherichia coli (eiec) by polymerase chain reaction (pcr) was evaluated in 20 patients with dysentery before and in 17 of the 20 after treatment with ciprofloxacin. dna sequences coding for ipah antigen, a multiple copy sequence found on the chromosome, and the invasion plasmid locus (ial) was detected after dna amplification in 13 stools from patients from whom shigellae or eiec were isolated but not in 21 nondysenteric stools containing other ...19938421181
concentrations of interleukin 6 and tumour necrosis factor in serum and stools of children with shigella dysenteriae 1 infection.serum interleukin 6 (il-6) and tumour necrosis factor (tnf) were measured in children with dysentery during an epidemic caused by shigella dysenteriae 1. il-6 and tnf were also measured in fresh stool filtrates from children with acute gastroenteritis. the median serum il-6 concentration was raised significantly in the children with complications (haemolytic uraemic syndrome, leukemoid reaction, thrombocytopenia, thrombocytosis, and severe colitis lasting more than one week) during the first wee ...19938432472
immune response against lipopolysaccharide and invasion plasmid-coded antigens of shigellae in vietnamese and swedish dysenteric patients.the peripheral immune responses of adult vietnamese patients infected with shigella dysenteriae 1 and shigella flexneri 1b and 2a and those of s. flexneri-infected swedish patients were studied against various lipopolysaccharide and invasion plasmid-coded antigens (ipa-s) and compared with the titers for the corresponding local healthy populations. both vietnamese and swedish patients reacted with significant (p, < 0.05) titer increases in the immunoglobulin a and g classes against the homologou ...19938432838
rectal histopathology in endemic shigella and salmonella diarrhea.rectal histopathology was evaluated in 34 cases (2 months-12 yrs old) of endemic "invasive diarrhea" [> 20 wbcs per high-power field on stool microscopy with (rbc positive) or without (rbc negative) associated rbcs] where s. dysenteriae (n = 9), s. flexneri (n = 11), and nontyphoidal salmonella were isolated as the sole identifiable enteropathogens. persistent diarrhea (> 14 days duration) was more common with salmonella infection whereas rbc-positive "invasive diarrhea" was more frequent with s ...19938433237
growth and survival of shigella flexneri in common bangladeshi foods under various conditions of time and temperature.survival and growth of shigella flexneri were assessed in various foods, including boiled rice, lentil soup, milk, cooked beef, cooked fish, mashed potato, mashed brinjal, and raw cucumber. growth at 25 and 37 degrees c and survival at 5 degrees c were observed by viable counts on macconkey agar. the organism grew well in all tested foods and growth increased from 10(5) to 10(8) to 10(10) cells per ml or g within 6 to 18 h after inoculation at 25 and 37 degrees c.19938434933
mxid, an outer membrane protein necessary for the secretion of the shigella flexneri lpa invasins.the invasive phenotype of shigella flexneri is conferred by a 220 kb virulence plasmid, pwr100, that encodes both the lpa proteins, which are involved in the entry process, and factors which are required for the export and correct localization of the lpa proteins. we have characterized the mxid gene, whose expression, like that of the ipa operon, is regulated by temperature. after inactivation of mxid, the mutant strain was unable to invade hela cells and to provoke keratoconjunctivitis in guine ...19938437520
safety and immunogenicity of the live oral auxotrophic shigella flexneri sfl124 in adult vietnamese volunteers.the live, auxotrophic dependent shigella flexneri y vaccine strain sfl124 with a deleted arod gene was tested in 30 healthy adult male vietnamese volunteers. a single dose of 2 x 10(9) live bacteria was given orally to 15 volunteers, whereas 15 received three doses every other day. none of the volunteers reacted with fever or diarrhoea and sfl124 was excreted by all for a mean of 2.8 (single dose) and 2.6 (three doses) days. a total of 27 of 30 (90%) and 26 of 30 (87%) responded with significant ...19938438616
evaluation of shigella vaccine safety and efficacy in an intranasally challenged mouse model.five shigella vaccine candidates (ecsf2a-1, ecsf2a-2, sfl124, t32-istrati and smd) were tested for safety and efficacy in balb/cj mice using an intranasal challenge model. experiments in this model suggest that (i) the relative attenuation of vaccines can be determined in mice by intranasal inoculation, (ii) all vaccines tested elicited antibacterial mucosal immunity protecting against pulmonary infection with shigella flexneri 2a, (iii) protection was associated with serum iga and/or igg antibo ...19938438617
shigella flexneri 2a and sonnei i vaccine with two attenuating markers: construction, tolerability and immunogenicity in 143 children aged 3-17 years.the vaccine candidates were constructed through stepwise incorporation of weakly attenuated purine auxotrophy with subsequent rifampicin resistance (rna polymerase) mutation to yield optimal attenuation. these strains showed a maintained invasiveness for conjunctival epithelia. therefore, while not causing keratoconjunctivitis, they were excreted for a short but marked period and provided partial protection in the sereny test. children tolerated the maximum dose of 1-3 x 10(9) colony-forming uni ...19938438618
an arginine residue at the active site of beta-lactamase from shigella flexneri ucsf-129.the role of a residue of arginine at the active site of beta-lactamase from shigella flexneri ucsf-129 was studied. it is a local pathogenic strain which produces intestinal problems, especially in children. purified enzymes were obtained by affinity chromatography on phenylboronic acid-agarose gels. the enzyme was serine dependent with a molecular weight of 23.6 kd. it was specifically modified with phenylglyoxal (1/830 molar ratio) and incubated for 20 min in the presence of 50 mm sodium phosp ...19938441355
characterization of a virg mutation that confers constitutive virulence gene expression in agrobacterium.transformation of plants by agrobacterium tumefaciens is mediated by a set of virulence (vir) genes that are specifically induced by plant signal molecules through the vira/virg two-component regulatory system. the plant signal is transmitted from vira to virg by a cascade of phosphorylation reactions followed by the sequence-specific dna binding of the virg protein to the vir gene promoters which then activates their transcription. in this report, we describe a virg mutant which is able to acti ...19938459774
rapid detection of shigella dysenteriae and shigella flexneri in faeces by an immunomagnetic assay with monoclonal antibodies.a rapid and sensitive method for the detection of shigella dysenteriae type 1 and shigella flexneri serotypes in faeces based on capture of the bacteria with immunomagnetic particles is described. the particles were coated with either of two different monoclonal antibodies specific for the o-antigens of shigella dysenteriae type 1 and shigella flexneri serotypes. captured bacteria were detected by an enzyme immunoassay with o-antigen specific rabbit antiserum. the whole assay required 2 to 3 hou ...19938462557
unipolar localization and atpase activity of icsa, a shigella flexneri protein involved in intracellular movement.shigella flexneri uses elements of the host cell cytoskeleton to move within cells and from cell to cell. icsa, an s. flexneri protein involved in this movement, was purified and studied in vitro. icsa bound the radiolabelled atp analog 3'(2')-o-(4-benzoyl)benzoyl-atp and hydrolyzed atp. in addition, the surface localization of icsa on both extracellular and intracellular shigellae was unipolar. further, in hela cells infected with shigellae, icsa antiserum labelled the actin tail throughout its ...19938468279
shigellosis due to occupational contact with non-human primates.a small cluster of dysenteric illness, due to shigella flexneri, was identified among technical assistants of a primate research unit. all of the affected individuals had been in regular contact with a colony of cynomolgus macaque monkeys, one of which was known to have suffered from acute haemorrhagic colitis in the preceding few weeks. four monkeys were found to be excreting s. flexneri bacilli of identical antigen type (1b) to that isolated from the human cases. investigation of working pract ...19938472767
characterization of the shigella flexneri ipgd and ipgf genes, which are located in the proximal part of the mxi locus.the shigella flexneri invasion process requires the synthesis of the ipa proteins and their secretion by specific factors encoded by the mxi and spa genes, which are clustered upstream from the ipa operon. we report here the characterization of the ipgd, ipge, and ipgf genes, which are located in the 5' end of the mxi locus. analysis of ipgf-phoa fusions endowed with high levels of alkaline phosphatase activity confirmed the functionality of a classical signal sequence detected in the sequence o ...19938478058
directional actin polymerization associated with spotted fever group rickettsia infection of vero cells.members of the spotted fever group (sfg) of rickettsiae spread rapidly from cell to cell by an unknown mechanism(s). staining of rickettsia rickettsii-infected vero cells with rhodamine phalloidin demonstrated unique actin filaments associated with one pole of intracellular rickettsiae. f-actin tails greater than 70 microns in length were seen extending from rickettsiae. treatment of infected cells with chloramphenicol eliminated rickettsia-associated f-actin tails, suggesting that de novo prote ...19938478082
plants used in guatemala for the treatment of gastrointestinal disorders. 3. confirmation of activity against enterobacteria of 16 plants.ethnobotanical surveys and literature review identified 408 plants used in guatemala for the treatment of gastrointestinal disorders. the screening of 84 showed that 34 inhibit one or more enterobacteria; 16 of these were selected for further investigation. extracts were obtained with three solvents of different polarity (n-hexane, acetone and alcohol) and the in vitro activity was demonstrated against enteropathogenic escherichia coli, salmonella enteritidis and shigella flexneri. the activity ...19938479202
genetic and biochemical analysis of salmonella typhimurium flii, a flagellar protein related to the catalytic subunit of the f0f1 atpase and to virulence proteins of mammalian and plant pathogens.flii is a salmonella typhimurium protein that is needed for flagellar assembly and may be involved in a specialized protein export pathway that proceeds without signal peptide cleavage. flii shows extensive sequence similarity to the catalytic beta subunit of the f0f1 atpase (a. p. volger, m. homma, v. m. irikura, and r. m. macnab, j. bacteriol. 173:3564-3572, 1991). it is even more similar to the spa47 protein of shigella flexneri (m. m. venkatesan, j. m. buysse, and e. v. oaks, j. bacteriol. 1 ...19938491729
preliminary crystallographic analysis of a fab specific for the o-antigen of shigella flexneri cell surface lipopolysaccharide with and without bound saccharides.the fab of a monoclonal anti-carbohydrate antibody, sya/j6 (igg3, kappa, murine), raised against the o-polysaccharide antigen of the cell surface lipopolysaccharide of variant y shigella flexneri, a gram negative bacterium, has been crystallized in the unliganded form and in complex with tri- and pentasaccharide antigens. the three crystal forms belong to the tetragonal space group p4(3)2(1)2, or p4(1)2(1)2, with very similar unit cell dimensions and an asymmetric unit that contains one molecule ...19938496958
immunogenicity and efficacy of oral or intranasal shigella flexneri 2a and shigella sonnei proteosome-lipopolysaccharide vaccines in animal models.immunity against shigellosis has been shown to correlate with the presence of antibodies specific for shigella lipopolysaccharide (lps). we here propose a new candidate vaccine for shigellosis composed of purified shigella flexneri 2a or shigella sonnei lps hydrophobically complexed with group c type 2b neisseria meningitidis outer membrane protein proteosomes. immunization of mice either orally or intranasally with this complex induced specific homologous anti-lps antibodies in both intestinal ...19938500877
[investigation on distribution and changes of shigella group in fengtai district, beijing from 1979 to 1991].a total of 386 strains of shigella were collected and identified by biochemistry and serotyping from 1978 to 1991. results showed that the strains were distributed in 4 groups which included 20 serotypes.s.flexner was predominant, mainly 2a and 3a serotypes, and s.sonnei the next. the ratio of b group to d group was 4.3.19938504452
antibacterial activity of the bryozoan electra bellula (hincks).the antibacterial activity of the extracts of bryozoan e. bellula (hincks) was tested against ten bacterial strains by antibiotic disc diffusion method. the maximum activity was observed against proteus vulgaris, while klebsiella pneumoniae and shigella flexneri were insensitive to the bryozoan.19938505081
epidemiologic and clinical aspects of shigellosis in american forces deployed to saudi arabia.i describe nine cases of shigellosis seen at a large navy field hospital in troops deployed to saudi arabia during the gulf war. eight cases were associated with consumption of food at civilian restaurants or civilian-contracted food services. two adults had "pseudomeningitis" syndromes, illustrating that shigellosis in adults may initially be misdiagnosed. all patients responded rapidly to rehydration and oral fluoroquinolone (ciprofloxacin) therapy. five patients received an antimotility agent ...19938506485
[study of genomic polymorphism of shigella flexneri strains, isolated in various geographic regions].strains of shigella flexneri isolated from patients in 4 geographic regions of the former ussr have been studied by plasmid analysis and fingerprinting techniques. it has been shown that these methods make possible to differentiate phenotypically identical strains for 9 genotypic patterns (7 different plasmid profiles and 3 specific hybridization patterns). strains of shigella flexneri isolated from each region possess the similar hybridization patterns independent of serovar and plasmid profile ...19938510684
shigella osteomyelitis in a fit young man.a case of shigella osteomyelitis in an apparently healthy young man is presented. pre-operative and intra-operative swabs taken from the septic focus grew shigella flexneri. patient was successfully treated with surgery and a course of ampicillin.19938511820
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