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importance of the producer on retail broiler meat product contamination with campylobacter spp.campylobacter spp. are a leading cause of human bacterial gastroenteritis worldwide, with poultry meat being considered the most important source of the infection. to obtain data on broiler meat contamination with campylobacter spp. in lithuania, the occurrence, counts and genotypes of these pathogens on raw broiler meat products from different producers were examined.201323400735
antimicrobial susceptibilities of campylobacter jejuni and campylobacter coli strains isolated from two early stages of poultry production.our aim was to monitor the resistance of campylobacter isolates from two initial stages of broiler production in 5 grandparent breeder broiler farms (gpbfs) and 12 parent breeder broiler farms (pbfs) in which no antimicrobials were used during the study. susceptibility tests were carried out for 805 strains (697 campylobacter jejuni and 108 campylobacter coli) against nalidixic acid, ciprofloxacin, erythromycin, amoxicillin, amoxicillin plus clavulanic acid, tetracycline, gentamicin, and chloram ...201323391315
non-stochastic sampling error in quantal analyses for campylobacter species on poultry products.using primers and fluorescent probes specific for the most common food-borne campylobacter species (campylobacter jejuni and campylobacter coli), we developed a multiplex, most probable number (mpn) assay using quantitative pcr (qpcr) as the determinant for binomial detection: i.e., number of p positive pathogen growth responses out of n = 6 observations each of 4 ml (v) per dilution. working with media washes of thrice frozen-thawed chicken pieces which had been spiked with known levels of c. j ...201323380949
prevalence, quantitative load, and antimicrobial resistance of campylobacter spp. from broiler ceca and broiler skin samples in thailand.this study was conducted to determine the prevalence of campylobacter spp. in broiler flocks by testing cecal contents at slaughter and to detect and quantify campylobacter on broiler carcass skin samples of the corresponding slaughter batches, to determine antimicrobial resistance patterns of the campylobacter isolates, and to genotype selected campylobacter jejuni isolates using multilocus sequence typing analysis. ninety-eight broiler flocks were included in the study. intact ceca were random ...201323300314
resistance to bile salts and sodium deoxycholate in macrolide- and fluoroquinolone-susceptible and resistant campylobacter jejuni and campylobacter coli strains.campylobacter are the most commonly reported bacterial causes of human gastroenteritis, and they are becoming increasingly resistant to antibiotics, including macrolides and fluoroquinolones, those most frequently used for the treatment of campylobacteriosis. active efflux mechanisms are involved in resistance of campylobacter to a broad spectrum of antimicrobials, and are also essential for campylobacter colonization in the animal intestine, through mediation of bile resistance. acquisition of ...201323289436
absence of tetracycline resistance in campylobacter coli isolates from finnish finishing pigs treated with chlortetracycline.to determine whether therapeutic treatment of pigs with chlortetracycline affects the susceptibility of their campylobacter isolates for tetracycline, ciprofloxacin and erythromycin.201323282197
molecular characterization and genotypic antimicrobial resistance analysis of campylobacter jejuni and campylobacter coli isolated from broiler flocks in northern italy.genetic variability and genotypic antimicrobial resistance (amr) of campylobacter jejuni and campylobacter coli from commercial broiler farms were investigated in this study. campylobacter isolates were genetically characterized by random amplified polymorphic dna (rapd)-polymerase chain reaction (pcr) and flaa-svr and flab-svr sequence-based typing. eight rapd types were identified in c. jejuni and three in c. coli, while 16 fla profiles were detected among all isolates. further, 13 flaa-svr an ...201223237371
screening for lactic acid bacteria capable of inhibiting campylobacter jejuni in in vitro simulations of the broiler chicken caecal environment.thermotolerant campylobacter spp., specifically campylobacter jejuni and campylobacter coli, are the most common bacterial causes of human gastroenteritis in developed countries. consumption of improperly prepared poultry products and cross contamination are among the main causes of human campylobacteriosis. the aim of this study was to identify lactic acid bacterial (lab) strains capable of inhibiting c. jejuni growth in initial in vitro trials ('spot-on-lawn' method), as well as in batch ferme ...201223234730
comparative genotypic and antimicrobial susceptibility analysis of zoonotic campylobacter species isolated from broilers in a nationwide survey, portugal.campylobacter is a major cause of human foodborne disease worldwide and has been associated with the consumption of contaminated poultry. the prevalence of campylobacter species in broiler flocks from more than 200 producers widespread in mainland portugal was assessed in 2008 in response to commission decision 2007/516/ec. campylobacter isolates were obtained from 83.3% of 424 pooled cecal samples, with a higher prevalence of campylobacter coli (61.2%) than campylobacter jejuni (38.8%). restric ...201223212005
campylobacter coli isolates from finnish farrowing farms using aminopenicillins: high prevalence of bla(oxa-61) and β-lactamase production, but low mic values.antimicrobial treatment of animals may select resistance in campylobacter to antimicrobial agents belonging to several classes of compounds. we investigated the effect of widely used aminopenicillin therapy on the minimum inhibitory concentration (mic) levels in porcine campylobacter coli isolates and investigated the presence of a β-lactamase gene and β-lactamase production. epidemiological cut-off values (ecoffs) were applied to detect decreased susceptibility. fifty-three isolates were obtain ...201222924522
[simple and rapid detection methods for campylobacters].campylobacter jejuni and campylobacter coli have been leading cause of food poisoning in terms of both number of patients and cases in japan. therefore these bacteria are recognized as one of the most important food-borne pathogens. since campylobacters are microaerobic, slow growing, biochemically unreactive, not only it takes some time but also there are several problems regarding isolation and identification of campylobacter spp. we found that cytolethal distending toxin (cdt) genes are ubiqu ...201222894063
short-term and medium-term clinical outcomes of campylobacter concisus infection.there are only sparse data on the short-term and medium-term clinical impacts of campylobacter concisus infection. a clinical study was performed during a 2-year period to determine the clinical manifestations in c. concisus-positive adult patients. a case patient was defined as an adult patient (≥18 years) with a c. concisus-positive stool sample during the study period. clinical data were obtained with use of a questionnaire supplemented with the patients' medical records, if any. the short-te ...201222882347
bacteremia caused by antimicrobial resistant campylobacter species at a medical center in taiwan, 1998-2008.this study was intended to delineate the clinical and microbiological characteristics of patients with bacteremia caused by campylobacter species.201222771419
prevalence of opportunistic intestinal parasitic infections among hiv-infected patients with low cd4 cells counts in france in the combination antiretroviral therapy era.the use of combination antiretroviral therapy (cart) has dramatically reduced the prevalence of opportunistic infections, however data on the prevalence of intestinal parasitic infections in hiv-infected patients with low cd4 cell counts in the cart era are scarce.201222771183
effects of efflux pump inhibitors on erythromycin, ciprofloxacin, and tetracycline resistance in campylobacter spp. isolates.the aim was to assess the potency of the efflux pump inhibitors (epis) phenylalanine-arginine ß-naphthylamide (paßn) and 1-(1-naphthylmethyl)-piperazine (nmp) and the putative natural epi phenolic (-)-epigallocatechin gallate (egcg) for the reversal of erythromycin, ciprofloxacin, and tetracycline resistance in campylobacter jejuni and campylobacter coli isolates. we investigated target mutations and resistant genes involved in erythromycin and tetracycline resistance and determined the roles of ...201222741576
prevalence of multidrug resistance campylobacter jejuni and campylobacter coli in chickens slaughtered in selected markets, malaysia.the objectives of this study were to determine the occurrence of campylobacter spp. in live chickens sold at wet markets in selangor, malaysia and the multidrug resistance (mdr) profiles of the isolates. cloacal swabs were taken from the chickens before slaughter and their caecal mucosae were swabbed after slaughter. of the 90 chickens examined, 68 (75.6%) were positive for campylobacter. campylobacter were recovered from caecal swabs (53/90) and cloacal swabs (34/90) and campylobacter coli (46 ...201222735845
antimicrobial susceptibility, pulsed-field gel electrophoresis, and multi-locus sequence typing of campylobacter coli in swine before, during, and after the slaughter process.the objective of this study was to determine persistence of clonal strains from farm to retail by assessing the clonal relatedness of campylobacter coli isolated on farm, peri-harvest, and at processing from 11 individually identified pigs. phenotypic (antimicrobial susceptibility) and genotypic (pulsed field gel electrophoresis [pfge] and multi-locus sequence typing [mlst]) characterization of isolates was conducted. there was high genetic diversity of campylobacter isolates from on-farm fecal ...201222663186
prevalence of human pathogens and indicators in stormwater runoff in brisbane, australia.elevated numbers of enteric pathogens in the receiving waters following a storm event can be a serious public health concern. the purpose of this study was to conduct a preliminary investigation into the presence of human pathogens of concern in urban stormwater runoff. the involvement of a human sewage as a potential source of contamination was also investigated by using microbial source tracking methods. water samples (20 l) were collected after storm events and during the dry weather from six ...201222572123
incidence and antimicrobial resistance profiling of campylobacter in retail chicken livers and gizzards.campylobacter species are one of the leading causes of foodborne disease in the united states. campylobacter jejuni and campylobacter coli are the two main species that are of concern to human health, and they cause approximately 95% of human infections. the number of studies investigating campylobacter in chicken livers and gizzards is very limited in the literature. the objective of this study was to determine the prevalence of campylobacter jejuni and campylobacter coli in retail chicken live ...201222545960
associations of antimicrobial use with antimicrobial resistance in campylobacter coli from grow-finish pigs in japan.to determine associations between antimicrobial use and antimicrobial resistance in campylobacter coli, 155 isolates were obtained from the feces of apparently healthy grow-finish pigs in japan. in addition, data on the use of antibiotics collected through the national antimicrobial resistance monitoring system in japan were used for the analysis. logistic regression was used to identify risk factors to antimicrobial resistance in c. coli in pigs for the following antimicrobials: ampicillin, dih ...201222521447
trend analysis of antimicrobial resistance in campylobacter jejuni and campylobacter coli isolated from belgian pork and poultry meat products using surveillance data of 2004-2009.the purpose of this study was to analyze and compare antimicrobial resistance in campylobacter spp. isolated from pork and poultry carcasses, and pork and poultry meat (at slaughterhouse level, during meat cutting, and at retail) in belgium, using available surveillance data over the period 2004-2009. the susceptibilities of 1724 campylobacter isolates for ampicillin, ciprofloxacin, nalidixic acid, tetracycline, erythromycin, and gentamicin were tested by e-test. gentamicin resistance was low (n ...201222510058
isolation of campylobacter from feral swine (sus scrofa) on the ranch associated with the 2006 escherichia coli o157:h7 spinach outbreak investigation in california.we report the isolation of campylobacter species from the same population of feral swine that was investigated in san benito county, california, during the 2006 spinach-related escherichia coli o157:h7 outbreak. this is the first survey of campylobacter in a free-ranging feral swine population in the united states. campylobacter species were cultured from buccal and rectal-anal swabs, colonic faeces and tonsils using a combination of selective enrichment and antibiotic-free membrane filtration m ...201222405465
involvement of efflux mechanisms in biocide resistance of campylobacter jejuni and campylobacter coli.active efflux has an important role in the antimicrobial resistance of campylobacter jejuni and campylobacter coli. the effects of two putative efflux pump inhibitors (epis), phenylalanine-arginine β-naphthylamide and 1-(1-naphthylmethyl)-piperazine, and the effects of inactivation of the cmeb,cmef and cmer genes on resistance to a broad range of antimicrobials were studied using the broth microdilution method. the antimicrobials tested in c. jejuni and c. coli were the biocides triclosan, benza ...201222361460
fitness of macrolide resistant campylobacter coli and campylobacter jejuni.the aim of this study was to investigate the fitness of macrolide resistant campylobacter coli and campylobacter jejuni. the in vitro growth, the survival on food matrix, and the in vivo colonization of c. jejuni and c. coli susceptible isolates and their isogenic resistant mutants were studied. in vitro experiments demonstrated that macrolide resistance imposed a fitness cost when the susceptible strains and their isogenic resistant mutants were cultured in competition. when inoculated in food ...201222324770
prevalence, antibiotic resistance and rapd typing of campylobacter species isolated from ducks, their rearing and processing environments in penang, malaysia.we report for the first time on the prevalence, antibiotic resistance and rapd types of campylobacter species in ducks and duck related environmental samples in malaysia. samples were examined by enrichment in bolton broth followed by plating onto modified charcoal cefoperazone deoxycholate agar (mccda) and/or plating directly onto mccda. a total of 643 samples were screened, and the prevalence of campylobacter spp. in samples from different sources ranged from 0% to 85%. the method of isolation ...201222285201
elucidation of colonization time and prevalence of thermophilic campylobacter species during turkey rearing using multiplex polymerase chain reaction.two turkey flocks (male and female) and the environment of their house were investigated for the presence of thermophilic campylobacter. sample dna was extracted directly from fecal material and environmental samples. bacterial identification was done using a modified campylobacter species specific multiplex pcr. the times needed for colonization and prevalence in male and female turkeys were determined independently. all environmental samples collected before restocking were negative in the pcr ...201222252360
an enhanced technique combining pre-enrichment and passive filtration increases the isolation efficiency of campylobacter jejuni and campylobacter coli from water and animal fecal samples.improved isolation techniques from environmental water and animal samples are vital to understanding campylobacter epidemiology. in this study, the efficiency of selective enrichment in bolton broth (bb) followed by plating on charcoal cefoperazone deoxycholate agar (ccda) (conventional method) was compared with an approach combining bb enrichment and passive filtration (membrane method) adapted from a method previously developed for testing of broiler meat, in the isolation of thermophilic camp ...201222985716
effects of lactic acid and commercial chilling processes on survival of salmonella, yersinia enterocolitica, and campylobacter coli in pork variety meats.current industry chilling practices with and without the application of 2% l-lactic acid were compared for their effectiveness at reducing levels of salmonella, yersinia enterocolitica, and campylobacter coli on pork variety meats. pork variety meats (livers, intestines, hearts, and stomachs) were inoculated individually with one of the three pathogens and subjected to five different treatment combinations that included one or more of the following: water wash (25°c), lactic acid spray (2%, 40 t ...201222947465
campylobacter sequence typing databases: applications and future prospects.human campylobacteriosis, caused by the zoonotic bacteria campylobacter jejuni and campylobacter coli, remains a major cause of gastroenteritis worldwide. for many countries the implementation of effective interventions to reduce the burden of this disease is a high priority. nucleotide sequence-based typing, including multilocus sequence typing (mlst) and antigen gene sequence typing (agst), has provided unified, comprehensive, and portable campylobacter isolate characterization, with curated d ...201222986295
antibiotic susceptibility of salmonella, campylobacter coli, and campylobacter jejuni isolated from northern german fattening pigs.this study was conducted to assess the antimicrobial susceptibility rate of salmonella and campylobacter spp. isolated from northern german fattening pigs. from 540 lymph node samples, 16 salmonella typhimurium, 1 salmonella brandenburg, 37 campylobacter coli, and 11 campylobacter jejuni strains were isolated. antibiotic susceptibility testing was carried out by the broth dilution method. the 14 tested antibiotics for salmonella were ampicillin, cefotaxime, ceftazidime, chloramphenicol, ciproflo ...201223043834
antibiotic resistance in bacterial pathogens from retail raw meats and food-producing animals in japan.to determine the prevalence and antimicrobial susceptibility profiles of campylobacter, salmonella, staphylococcus aureus, methicillin-resistant s. aureus (mrsa), and vancomycin-resistant enterococci (vre) in food-producing animals and retail raw meats in japan, raw meat samples as well as food-producing animal feces, cutaneous swabs, and nasal swabs collected from 2004 to 2006 were analyzed. isolation rates of campylobacter jejuni and campylobacter coli, salmonella, and s. aureus were 34.6% (36 ...201223043825
susceptibility of campylobacter to high intensity near ultraviolet/visible 395±5nm light and its effectiveness for the decontamination of raw chicken and contact surfaces.campylobacter is an important cause of human gastroenteritis worldwide. chicken meat is frequently contaminated with this organism and is considered to be a significant source of infection. it has been predicted that lowering the numbers of campylobacter on chicken meat can reduce the risk to public health. the aims of the current study were to investigate the susceptibility of campylobacter to high intensity near ultraviolet/visible (nuv-vis) 395±5nm light and to examine its potential for the m ...201223107507
antimicrobial resistance in campylobacter spp. isolated from ontario sheep flocks and associations between antimicrobial use and antimicrobial resistance.the objectives of this study were to determine the prevalence of antimicrobial resistance (amr) in faecal campylobacter spp. from lambs and adult sheep and associations between antimicrobial use (amu) and amr. a total of 275 faecal samples collected during initial and final visits from 51 sheep flocks, including one feedlot, across southern ontario were tested for the presence of campylobacter spp. campylobacter jejuni was detected in 52% (143/275) of the faecal samples, campylobacter coli in 7% ...201222273455
detection and quantification of campylobacter jejuni and campylobacter coli using real-time multiplex pcr.aims:  we describe a real-time multiplex pcr (qmpcr) assay to identify and discriminate between isolates of campylobacter jejuni and campylobacter coli. methods and results:  two novel sets of primers and hydrolysis probes were designed to amplify the unique dna sequences within the hipo, ccon and cadf genes that are specific to c. jejuni and c. coli. by using the designed optimized qmpcr assay conditions, the amplification efficiency is in range from 108 to 116%. these qmpcr assays are highly s ...201222256961
investigation of chemical rinses suitable for very small meat plants to reduce pathogens on beef surfaces.numerous antimicrobial interventions are capable of reducing the prevalence of harmful bacteria on raw meat products. there is a need to identify effective and inexpensive antimicrobial interventions that could, in practice, be used in very small meat plants because of limited financial, space, and labor resources. eight antimicrobial compounds (acetic acid, citric acid, lactic acid, peroxyacetic acid, acidified sodium chlorite, chlorine dioxide, sodium hypochlorite, and aqueous ozone) were app ...201222221350
efficacy of parenteral vaccination against porcine circovirus type 2 (pcv2) in seropositive piglets.this study investigated if parenteral administration of a prototype adjuvanted vaccine against porcine circovirus type 2 (pcv2) could override maternally derived antibodies and induce acquired immunity in young piglets. piglets with high levels of maternal pcv2 antibodies at 1 wk of age were randomly grouped into vaccinates and controls on the basis of body weight and inoculated with the vaccine or a control preparation twice, with an interval of 3 wk. both groups were challenged 3 wk after the ...201223543956
molecular characterization and antibiotic resistance profiling of campylobacter isolated from cattle in polish slaughterhouses.a total of 812 samples from bovine hides and the corresponding carcasses collected at the slaughterhouse level in the eastern part of poland were examined for the presence of campylobacter jejuni and campylobacter coli. recovered isolates were confirmed using species-specific pcr, characterized by the presence of 11 putative virulence genes and antimicrobial susceptibility was determined using a microbroth dilution method. furthermore, the genotypic relatedness of the isolates was determined by ...201223498189
a longitudinal study on thermophilic campylobacter spp. in commercial turkey flocks in northern italy: occurrence and genetic diversity.poultry are recognized as a main reservoir of thermophilic campylobacters, but few studies have been carried out on commercial meat turkeys. this study was aimed at assessing the occurrence of thermophilic campylobacter spp., their genetic diversity, and the trend of the infection during the whole production cycle of three turkey flocks from different farms in northern italy. flocks were monitored from the time of housing 1-day-old poults to slaughter time by collecting samples (meconium and clo ...201223397840
actinobaculum suis detection using polymerase chain reaction.actinobaculum suis is an important agent related to urinary infection in swine females. due to its fastidious growth characteristics, the isolation of this anaerobic bacterium is difficult, thus impairing the estimation of its prevalence. the purpose of this study was to develop and test a polymerase chain reaction (pcr) for the detection and identification of a. suis and then compare these results with traditional isolation methods. bacterial isolation and pcr were performed on one hundred and ...201223346017
development of antimicrobial resistance in campylobacter jejuni and campylobacter coli adapted to biocides.the potential for adaptive resistance of campylobacter jejuni and campylobacter coli after step-wise exposure to increasing sub-inhibitory concentrations of five biocides as triclosan, benzalkonium chloride, cetylpyridinium chloride, chlorhexidine diacetate and trisodium phosphate, was investigated, to identify the mechanisms underlying resistance. the biocide resistance and cross-resistance to the antimicrobials erythromycin and ciprofloxacin, and to sodium dodecyl sulphate, were examined accor ...201223290239
comparative characterization of the virulence gene clusters (lipooligosaccharide [los] and capsular polysaccharide [cps]) for campylobacter coli, campylobacter jejuni subsp. jejuni and related campylobacter species.campylobacter jejuni subsp. jejuni and campylobacter coli are leading causes of gastroenteritis, with virulence linked to cell surface carbohydrate diversity. although the associated gene clusters are well studied for c. jejuni subsp. jejuni, c. coli has been largely neglected. here we provide comparative analysis of the lipooligosaccharide (los) and capsular polysaccharide (cps) gene clusters, using genome and cluster sequence data for 36 c. coli strains, 67 c. jejuni subsp. jejuni strains and ...201223279811
comparative characterization of the virulence gene clusters (lipooligosaccharide [los] and capsular polysaccharide [cps]) for campylobacter coli, campylobacter jejuni subsp. jejuni and related campylobacter species.campylobacter jejuni subsp. jejuni and campylobacter coli are leading causes of gastroenteritis, with virulence linked to cell surface carbohydrate diversity. although the associated gene clusters are well studied for c. jejuni subsp. jejuni, c. coli has been largely neglected. here we provide comparative analysis of the lipooligosaccharide (los) and capsular polysaccharide (cps) gene clusters, using genome and cluster sequence data for 36 c. coli strains, 67 c. jejuni subsp. jejuni strains and ...201223279811
identification and characterization of a periplasmic trilactone esterase, cee, revealed unique features of ferric enterobactin acquisition in campylobacter.ferric enterobactin (feent) acquisition is a highly efficient and conserved iron scavenging system in gram-negative bacteria. recently, we have characterized two feent receptors (cfra and cfrb) in campylobacter jejuni and c. coli, the enteric human pathogens that do not produce any siderophores. in this study, whole-genome sequencing and comparative genomic analysis identified a unique ent trilactone esterase cee (cj1376) in c. jejuni. genomic analysis and biochemical assay strongly suggested th ...201223278903
identification and characterization of a periplasmic trilactone esterase, cee, revealed unique features of ferric enterobactin acquisition in campylobacter.ferric enterobactin (feent) acquisition is a highly efficient and conserved iron scavenging system in gram-negative bacteria. recently, we have characterized two feent receptors (cfra and cfrb) in campylobacter jejuni and c. coli, the enteric human pathogens that do not produce any siderophores. in this study, whole-genome sequencing and comparative genomic analysis identified a unique ent trilactone esterase cee (cj1376) in c. jejuni. genomic analysis and biochemical assay strongly suggested th ...201223278903
mutational and transcriptomic changes involved in the development of macrolide resistance in campylobacter jejuni.macrolide antibiotics are important for clinical treatment of infections caused by campylobacter jejuni. development of resistance to this class of antibiotics in campylobacter is a complex process, and the dynamic molecular changes involved in this process remain poorly defined. multiple lineages of macrolide-resistant mutants were selected by stepwise exposure of c. jejuni to escalating doses of erythromycin or tylosin. mutations in target genes were determined by dna sequencing, and the dynam ...201223274667
fecal indicators and zoonotic pathogens in household drinking water taps fed from rainwater tanks in southeast queensland, australia.in this study, the microbiological quality of household tap water samples fed from rainwater tanks was assessed by monitoring the numbers of escherichia coli bacteria and enterococci from 24 households in southeast queensland (seq), australia. quantitative pcr (qpcr) was also used for the quantitative detection of zoonotic pathogens in water samples from rainwater tanks and connected household taps. the numbers of zoonotic pathogens were also estimated in fecal samples from possums and various s ...201222020514
Inaccuracy of the Disk Diffusion Method Compared with the Agar Dilution Method for Susceptibility Testing of Campylobacter spp.The agar dilution method has been standardized by the CLSI for the susceptibility testing of Campylobacter species, and according to these standards, the disk diffusion method should be used only in screening for macrolide and ciprofloxacin resistance. Nevertheless, the disk diffusion test is currently widely used, since it is easy to perform in clinical microbiology laboratories. In this study, the disk diffusion method was compared to the agar dilution method by analyzing the in vitro activiti ...201222075583
Genotypes and Antibiotic Resistances of Campylobacter jejuni and Campylobacter coli Isolates from Domestic and Travel-Associated Human Cases.Multilocus sequence typing (MLST) extended with flaB typing of 425 Campylobacter jejuni isolates and 42 Campylobacter coli isolates revealed quite a low overlap between human isolates from travel-associated and domestic cases in Switzerland. Men were more frequently affected by Campylobacter than women, but strains from women and, overall, from travel-associated cases showed mutations conferring quinolone resistance more frequently than strains from men and domestic cases, respectively.201222020515
phenotypic and genotypic methods for typing campylobacter jejuni and campylobacter coli in poultry.human campylobacteriosis, an infection caused by the bacterium campylobacter, is a major issue in the united states food system, especially for poultry products. according to the center for disease control, campylobacterosis is estimated to affect over 2.4 million people annually. campylobacter jejuni and campylobacter coli are 2 species responsible for the majority of campylobacterosis infections. phenotypic and genotypic typing methods are often used to discriminate between bacteria at the spe ...201222184452
Simultaneous Detection of Six Diarrhea-Causing Bacterial Pathogens with an In-House PCR-Luminex Assay.Diarrhea can be caused by a range of pathogens, including several bacteria. Conventional diagnostic methods, such as culture, biochemical tests, and enzyme-linked immunosorbent assay (ELISA), are laborious. We developed a 7-plex PCR-Luminex assay to simultaneously screen for several of the major diarrhea-causing bacteria directly in fecal specimens, including pathogenic Aeromonas, Campylobacter jejuni, Campylobacter coli, Salmonella, Shigella, enteroinvasive Escherichia coli (EIEC), Vibrio, and ...201222075596
reproductive clonality of pathogens: a perspective on pathogenic viruses, bacteria, fungi, and parasitic protozoa.we propose that clonal evolution in micropathogens be defined as restrained recombination on an evolutionary scale, with genetic exchange scarce enough to not break the prevalent pattern of clonal population structure, a definition already widely used for all kinds of pathogens, although not clearly formulated by many scientists and rejected by others. the two main manifestations of clonal evolution are strong linkage disequilibrium (ld) and widespread genetic clustering ("near-clading"). we hyp ...201222949662
rodents on pig and chicken farms - a potential threat to human and animal health.rodents can cause major problems through spreading various diseases to animals and humans. the two main species of rodents most commonly found on farms around the world are the house mouse (mus musculus) and the brown rat (rattus norvegicus). both species are omnivorous and can breed year-round under favourable conditions. this review describes the occurrence of pathogens in rodents on specialist pig and chicken farms, which are usually closed units with a high level of bio-security. however, wi ...201222957130
biophysical and bioinformatic analyses implicate the treponema pallidum tp34 lipoprotein (tp0971) in transition metal homeostasis.metal ion homeostasis is a critical function of many integral and peripheral membrane proteins. the genome of the etiologic agent of syphilis, treponema pallidum, is compact and devoid of many metabolic enzyme genes. nevertheless, it harbors genes coding for homologs of several enzymes that typically require either iron or zinc. the product of the tp0971 gene of t. pallidum, designated tp34, is a periplasmic lipoprotein that is thought to be tethered to the inner membrane of this organism. previ ...201223042995
progressive genome-wide introgression in agricultural campylobacter coli.hybridization between distantly related organisms can facilitate rapid adaptation to novel environments, but is potentially constrained by epistatic fitness interactions among cell components. the zoonotic pathogens campylobacter coli and c. jejuni differ from each other by around 15% at the nucleotide level, corresponding to an average of nearly 40 amino acids per protein-coding gene. using whole genome sequencing, we show that a single c. coli lineage, which has successfully colonized an agric ...201223279096
progressive genome-wide introgression in agricultural campylobacter coli.hybridization between distantly related organisms can facilitate rapid adaptation to novel environments, but is potentially constrained by epistatic fitness interactions among cell components. the zoonotic pathogens campylobacter coli and c. jejuni differ from each other by around 15% at the nucleotide level, corresponding to an average of nearly 40 amino acids per protein-coding gene. using whole genome sequencing, we show that a single c. coli lineage, which has successfully colonized an agric ...201223279096
diagnostic microbiologic methods in the gems-1 case/control study.to understand the etiology of moderate-to-severe diarrhea among children in high mortality areas of sub-saharan africa and south asia, we performed a comprehensive case/control study of children aged <5 years at 7 sites. each site employed an identical case/control study design and each utilized a uniform comprehensive set of microbiological assays to identify the likely bacterial, viral and protozoal etiologies. the selected assays effected a balanced consideration of cost, robustness and perfo ...201223169941
investigation of motility and biofilm formation by intestinal campylobacter concisus strains.motility helps many pathogens swim through the highly viscous intestinal mucus. given the differing outcomes of campylobacter concisus infection, the motility of eight c. concisus strains isolated from patients with crohn's disease (n=3), acute (n=3) and chronic (n=1) gastroenteritis and a healthy control (n=1) were compared. following growth on solid or liquid media the eight strains formed two groups; however, the type of growth medium did not affect motility. in contrast, following growth in ...201223241133
evaluation of the positive predictive value of a rapid immunochromatographic test to detect campylobacter in stools.the recently developed rapid immunochromatographic tests (ict) have the potential to provide a quick and easy diagnosis of campylobacter enteritis in comparison to culture. in a previous study we found them sensitive but lacking in specificity. the aim of the present study was to focus on the problem of specificity and determine the positive predictive value (ppv) of a positive result of the immunocard stat! campy (meridian bioscience, cincinnati, oh, usa). for this purpose, the stools positive ...201223206554
bioluminescent enzyme immunoassay for the detection of norovirus capsid antigen.an ultrasensitive and fully automated bioluminescent enzyme immunoassay (bleia) was developed for the detection of norovirus (nv) capsid antigen. in the evaluation tests with recombinant virus-like particles, the bleia demonstrated broad reactivity against several nv genotypes (genotypes 1, 3, 4, 7, 8, and 12 in genogroup i [gi] and genotypes 1, 2, 3, 4, 5, 6, 12, and 13 in gii), a wide dose-response range from 0.25 pg/ml to 10,000 pg/ml, and good reproducibility with low coefficients of variati ...201223081816
chromosomal tet(o)-harboring regions in campylobacter coli isolates from turkeys and swine.in turkey-derived campylobacter coli isolates of a unique lineage (cluster ii), the tetracycline resistance determinant tet(o) was chromosomal and was part of a gene cassette (transposon) interrupting a campylobacter jejuni-associated putative citrate transporter gene. in contrast, the swine-derived c. coli strain 6461 harbored a chromosomal tet(o) in a different genomic location.201223023744
live virus-free or die: coupling of antivirus immunity and programmed suicide or dormancy in prokaryotes.the virus-host arms race is a major theater for evolutionary innovation. archaea and bacteria have evolved diverse, elaborate antivirus defense systems that function on two general principles: i) immune systems that discriminate self dna from nonself dna and specifically destroy the foreign, in particular viral, genomes, whereas the host genome is protected, or ii) programmed cell suicide or dormancy induced by infection.201223151069
immunogenomics for identification of disease resistance genes in pigs: a review focusing on gram-negative bacilli.over the past years, infectious disease has caused enormous economic loss in pig industry. among the pathogens, gram negative bacteria not only cause inflammation, but also cause different diseases and make the pigs more susceptible to virus infection. vaccination, medication and elimination of sick pigs are major strategies of controlling disease. genetic methods, such as selection of disease resistance in the pig, have not been widely used. recently, the completion of the porcine whole genome ...201223137309
association of campylobacter upsaliensis with persistent bloody diarrhea.campylobacter upsaliensis is a zoonotic, emerging pathogen that is not readily recovered in traditional stool culture. this case represents the first report of persistent bloody diarrhea with c. upsaliensis that was confirmed by filtration culture, pcr, and sequencing.201222915607
identification of cj1051c as a major determinant for the restriction barrier of campylobacter jejuni strain nctc11168.campylobacter jejuni is a leading cause of human diarrheal illness in the world, and research on it has benefitted greatly by the completion of several genome sequences and the development of molecular biology tools. however, many hurdles remain for a full understanding of this unique bacterial pathogen. one of the most commonly used strains for genetic work with c. jejuni is nctc11168. while this strain is readily transformable with dna for genomic recombination, transformation with plasmids is ...201222923403
prevalence and antimicrobial resistance of thermophilic campylobacter isolated from chicken in côte d'ivoire.thermophilic campylobacters are major causes of gastroenteritis in human. the main risk factor of infection is consumption of contaminated or by cross-contaminated poultry meat. in côte d'ivoire, gastroenteritis is usually observed but no case of human campylobacteriosis has been formally reported to date. the aims of this study were to determine prevalence and antimicrobial resistance of campylobacter jejuni and campylobacter coli isolated from chickens ceaca in commercial slaughter in abidjan. ...201223133454
bacterial toxin modulation of the eukaryotic cell cycle: are all cytolethal distending toxins created equally?the cytolethal distending toxins (cdts) comprise a family of intracellular-acting bacterial protein toxins whose actions upon eukaryotic cells result in several consequences, the most characteristic of which is the induction of g(2)/m cell cycle arrest. most cdts are hetero-tripartite assemblies of cdta, cdtb, and cdtc, with cdtb required for cdt-mediated cell cycle arrest. several lines of evidence indicate that cdta and cdtc are required for the optimal intracellular activity of cdtb, although ...201223061054
a longitudinal 6-year study of the molecular epidemiology of clinical campylobacter isolates in oxfordshire, united kingdom.temporal and seasonal trends in campylobacter genotypes causing human gastroenteritis were investigated in a 6-year study of 3,300 recent isolates from oxfordshire, united kingdom. genotypes (sequence types [st]) were defined using multilocus sequence typing and assigned to a clonal complex (a cluster of related strains that share four or more identical alleles with a previously defined central genotype). a previously undescribed clonal complex (st-464) was identified which, together with st-42, ...201222814466
identification of a novel genomic island conferring resistance to multiple aminoglycoside antibiotics in campylobacter coli.historically, the incidence of gentamicin resistance in campylobacter has been very low, but recent studies reported a high prevalence of gentamicin-resistant campylobacter isolated from food-producing animals in china. the reason for the high prevalence was unknown and was addressed in this study. pcr screening identified aminoglycoside resistance genes apha-3 and apha-7 and the aade-sat4-apha-3 cluster among 41 campylobacter isolates from broiler chickens. importantly, a novel genomic island c ...201222869568
regulation of energy metabolism by the extracytoplasmic function (ecf) σ factors of arcobacter butzleri.the extracytoplasmic function (ecf) σ factors are fundamental for bacterial adaptation to distinct environments and for survival under different stress conditions. the emerging pathogen arcobacter butzleri possesses seven putative pairs of σ/anti-σ factors belonging to the ecf family. here, we report the identification of the genes regulated by five out of the seven a. butzleri ecf σ factors. three of the ecf σ factors play an apparent role in transport, energy generation and the maintenance of ...201223028624
case-control study of the etiology of infant diarrheal disease in 14 districts in madagascar.acute diarrhea is a major cause of childhood morbidity and mortality worldwide. its microbiological causes and clinico-epidemiological aspects were examined during the rainy seasons from 2008 to 2009 in 14 districts in madagascar.201223028555
phylogenetic analysis reveals common antimicrobial resistant campylobacter coli population in antimicrobial-free (abf) and commercial swine systems.the objective of this study was to compare the population biology of antimicrobial resistant (ar) campylobacter coli isolated from swine reared in the conventional and antimicrobial-free (abf) swine production systems at farm, slaughter and environment. a total of 200 c. coli isolates selected from fecal, environmental, and carcass samples of abf (n = 100) and conventional (n = 100) swine production systems were typed by multilocus sequence typing (mlst). sequence data from seven housekeeping ge ...201222984540
a convenient and robust in vivo reporter system to monitor gene expression in the human pathogen helicobacter pylori.thirty years of intensive research have significantly contributed to our understanding of helicobacter pylori biology and pathogenesis. however, the lack of convenient genetic tools, in particular the limited effectiveness of available reporter systems, has notably limited the toolbox for fundamental and applied studies. here, we report the construction of a bioluminescent h. pylori reporter system based on the photorhabdus luminescens luxcdabe cassette. the system is constituted of a promoterle ...201222773640
detection of kudoa septempunctata 18s ribosomal dna in patient fecal samples from novel food-borne outbreaks caused by consumption of raw olive flounder (paralichthys olivaceus).kudoa septempunctata is a newly identified myxosporean parasite of olive flounder (paralichthys olivaceus) and a suspected causative agent of several food-borne gastroenteritis outbreaks in japan. here, we report the detection of k. septempunctata 18s ribosomal dna in fecal samples of outbreak patients using an efficient method based on real-time pcr. we first performed a spiking experiment to assess whether our previously developed real-time pcr assay was applicable to detect k. septempunctata ...201222760033
analysis of helicobacter pylori caga promoter elements required for salt-induced upregulation of caga expression.helicobacter pylori infection and consumption of a high-salt diet are each associated with an increased risk for the development of gastric cancer. to investigate potential synergism between these factors, we used a global proteomic approach to analyze h. pylori strains cultured in media containing varying salt concentrations. among the differentially expressed proteins identified, caga exhibited the greatest increase in expression in response to high salt concentrations. analysis of 36 h. pylor ...201222710874
outcome of infection of c57bl/6 il-10(-/-) mice with campylobacter jejuni strains is correlated with genome content of open reading frames up- and down-regulated in vivo.human campylobacter jejuni infection can result in an asymptomatic carrier state, watery or bloody diarrhea, bacteremia, meningitis, or autoimmune neurological sequelae. infection outcomes of c57bl/6 il-10(-/-) mice orally infected with twenty-two phylogenetically diverse c. jejuni strains were evaluated to correlate colonization and disease phenotypes with genetic composition of the strains. variation between strains was observed in colonization, timing of development of clinical signs, and occ ...201222960579
outcome of infection of c57bl/6 il-10(-/-) mice with campylobacter jejuni strains is correlated with genome content of open reading frames up- and down-regulated in vivo.human campylobacter jejuni infection can result in an asymptomatic carrier state, watery or bloody diarrhea, bacteremia, meningitis, or autoimmune neurological sequelae. infection outcomes of c57bl/6 il-10(-/-) mice orally infected with twenty-two phylogenetically diverse c. jejuni strains were evaluated to correlate colonization and disease phenotypes with genetic composition of the strains. variation between strains was observed in colonization, timing of development of clinical signs, and occ ...201222960579
analysis of evolutionary patterns of genes in campylobacter jejuni and c. coli. 201222929701
campylobacter antimicrobial resistance in peru: a ten-year observational study.campylobacter jejuni and campylobacter coli are food-borne pathogens of great importance and feature prominently in the etiology of developing world enteritis and travellers' diarrhoea. increasing antimicrobial resistant campylobacter prevalence has been described globally, yet data from peru is limited. our objective was to describe the prevalence trends of fluoroquinolone and macrolide-resistant c. jejuni and c. coli stool isolates from three regions in peru over a ten-year period.201222898609
acid stress response and protein induction in campylobacter jejuni isolates with different acid tolerance.during the transmission route from poultry to the human host, the major foodborne pathogen c. jejuni may experience many types of stresses, including low ph caused by different acids. however, not all strains are equally sensitive to the stresses. the aim of this study was to investigate the response to acid stress of three sequenced c. jejuni strains with different acid tolerances using hcl and acetic acid.201222889088
the intermediate region of helicobacter pylori vaca is a determinant of toxin potency in a jurkat t cell assay.colonization of the human stomach with helicobacter pylori is a risk factor for peptic ulceration, noncardia gastric adenocarcinoma, and gastric lymphoma. the secreted vaca toxin is an important h. pylori virulence factor that causes multiple alterations in gastric epithelial cells and t cells. several families of vaca alleles have been described, and h. pylori strains containing certain vaca types (s1, i1, and m1) are associated with an increased risk of gastric disease, compared to strains con ...201222585965
the complete genome sequence of bacteriophage cp21 reveals modular shuffling in campylobacter group ii phages.campylobacter group ii phages described so far share a high degree of sequence similarity. we report the 182,833-bp genomic sequence of the closely related group ii phage cp21 and show that it has a completely different genomic organization. as in other group ii phages, the cp21 genome is composed of large modules separated by long dna repeat regions which obviously trigger recombination and modular shuffling.201222843857
ischaemic colitis associated with oral contraceptive and bisacodyl use.a woman with a history of hip replacement presented 3 days prior to revision of the hip with abdominal pain, diarrhoea and haematochezia. these symptoms began 6 h after she began taking bisacodyl in preparation for her upcoming surgery. she was on low-dose estradiol for hormone replacement therapy (hrt). subsequent colonoscopy and biopsies were consistent with acute colonic ischaemia (ci). she was treated with intravenous fluids and antibiotics and discharged and told to stop hrt and bisacodyl. ...201222843752
guillain-barré syndrome and anti-ganglioside antibodies: a clinician-scientist's journey.guillain-barré syndrome (gbs) is the most frequent cause of acute flaccid paralysis. having seen my first gbs patient in 1989, i have since then dedicated my time in research towards understanding the pathogenesis of gbs. along with several colleagues, we identified igg autoantibodies against ganglioside gm1 in two patients with gbs subsequent to campylobacter jejuni enteritis. we proceeded to demonstrate molecular mimicry between gm1 and bacterial lipo-oligosaccharide of c. jejuni isolated from ...201222850724
restricted gene flow among hospital subpopulations of enterococcus faecium.enterococcus faecium has recently emerged as an important multiresistant nosocomial pathogen. defining population structure in this species is required to provide insight into the existence, distribution, and dynamics of specific multiresistant or pathogenic lineages in particular environments, like the hospital. here, we probe the population structure of e. faecium using bayesian-based population genetic modeling implemented in bayesian analysis of population structure (baps) software. the anal ...201222807567
campylobacter epidemiology: a descriptive study reviewing 1 million cases in england and wales between 1989 and 2011.to review campylobacter cases in england and wales over 2 decades and examine the main factors/mechanisms driving the changing epidemiology.201222798256
estimating the relative roles of recombination and point mutation in the generation of single locus variants in campylobacter jejuni and campylobacter coli.single locus variants (slvs) are bacterial sequence types that differ at only one of the seven canonical multilocus sequence typing (mlst) loci. estimating the relative roles of recombination and point mutation in the generation of new alleles that lead to slvs is helpful in understanding how organisms evolve. the relative rates of recombination and mutation for campylobacter jejuni and campylobacter coli were estimated at seven different housekeeping loci from publically available mlst data. th ...201222767048
nutraceutical values of natural honey and its contribution to human health and wealth.the use of natural honey (nh) as a nutraceutical agent is associated with nutritional benefits and therapeutic promises. nh is widely accepted as food and medicine by all generations, traditions and civilizations, both ancient and modern. the nutritional profiles, including its use in infant and children feeding reported in different literatures as well as health indices and biomarkers observed by various researchers are illustrated in this manuscript. the review documents folk medicine, experim ...201222716101
detection of shiga toxin-producing escherichia coli by sandwich enzyme-linked immunosorbent assay using chicken egg yolk igy antibodies.enterohemorrhagic escherichia coli (ehec), a subset of shiga toxin producing e. coli (stec) is associated with a spectrum of diseases that includes diarrhea, hemorrhagic colitis and a life-threatening hemolytic-uremic syndrome (hus). regardless of serotype, shiga toxins (stx1 and/or stx2) are uniformly expressed by all ehec, and so exploitable targets for laboratory diagnosis of these pathogens. in this study, a sandwich elisa for determination of shiga toxin (stx) was developed using anti-stx2b ...201222919675
transmission of campylobacter coli in chicken embryos.campylobacter coli is an important species involved in human cases of enteritis, and chickens are carriers of the pathogen mainly in developing country. the current study aimed to evaluate the transmission of c. coli and its pathogenic effects in chicken embryos. breeder hens were inoculated intra-esophageally with c. coli isolated from chickens, and their eggs and embryos were analyzed for the presence of bacteria using real-time pcr and plate culture. the viability of embryos was verified. in ...201224031861
development and evaluation of a genus-specific, probe-based, internal-process-controlled real-time pcr assay for sensitive and specific detection of blastocystis spp.blastocystis is a common intestinal parasite of unsettled clinical significance, which is not easily detected by standard parasitological methods. the genus comprises at least 13 subtypes (sts) (which likely represent separate species), 9 of which have been found in humans. recent data indicate that at least one of the subtypes is associated with intestinal disease. a quantitative taqman 5' nuclease real-time pcr (taqman pcr) including an internal process control (ipc) was developed for the dete ...201222422846
selective pressure of antibiotic pollution on bacteria of importance to public health.many bacteria of clinical importance survive and may grow in different environments. antibiotic pollution may exert on them a selective pressure leading to an increase in the prevalence of resistance.201222571927
development of a novel genus-specific real-time pcr assay for detection and differentiation of bartonella species and genotypes.the genus bartonella includes numerous species with varied host associations, including several that infect humans. development of a molecular diagnostic method capable of detecting the diverse repertoire of bartonella species while maintaining genus specificity has been a challenge. we developed a novel real-time pcr assay targeting a 301-bp region of the ssra gene of bartonella and demonstrated specific amplification in over 30 bartonella species, subspecies, and strains. subsequent analysis o ...201222378904
characterization of the structurally diverse n-linked glycans of campylobacter species.the gram-negative bacterium campylobacter jejuni encodes an extensively characterized n-linked protein glycosylation system that modifies many surface proteins with a heptasaccharide glycan. in c. jejuni, the genes that encode the enzymes required for glycan biosynthesis and transfer to protein are located at a single pgl gene locus. similar loci are also present in the genome sequences of all other campylobacter species, although variations in gene content and organization are evident. in this ...201222389484
a gene-by-gene approach to bacterial population genomics: whole genome mlst of campylobacter.campylobacteriosis remains a major human public health problem world-wide. genetic analyses of campylobacter isolates, and particularly molecular epidemiology, have been central to the study of this disease, particularly the characterization of campylobacter genotypes isolated from human infection, farm animals, and retail food. these studies have demonstrated that campylobacter populations are highly structured, with distinct genotypes associated with particular wild or domestic animal sources, ...201224704917
xer recombinase and genome integrity in helicobacter pylori, a pathogen without topoisomerase iv.in the model organism e. coli, recombination mediated by the related xerc and xerd recombinases complexed with the ftsk translocase at specialized dif sites, resolves dimeric chromosomes into free monomers to allow efficient chromosome segregation at cell division. computational genome analysis of helicobacter pylori, a slow growing gastric pathogen, identified just one chromosomal xer gene (xerh) and its cognate dif site (difh). here we show that recombination between directly repeated difh sit ...201222511919
diversity in prokaryotic glycosylation: an archaeal-derived n-linked glycan contains legionaminic acid.vp4, the major structural protein of the haloarchaeal pleomorphic virus, hrpv-1, is glycosylated. to define the glycan structure attached to this protein, oligosaccharides released by β-elimination were analysed by mass spectrometry and nuclear magnetic resonance spectroscopy. such analyses showed that the major vp4-derived glycan is a pentasaccharide comprising glucose, glucuronic acid, mannose, sulphated glucuronic acid and a terminal 5-n-formyl-legionaminic acid residue. this is the first obs ...201222435790
longitudinal study of the persistence of antimicrobial-resistant campylobacter strains in distinct swine production systems on farms, at slaughter, and in the environment.the objectives of this study were to compare and characterize the prevalence of antimicrobial-resistant (ar) campylobacter in conventional and antimicrobial-free (abf) production systems on farms, at slaughter, and in the environment. fecal and environmental samples were collected from abf farms (pigs, 1,239; environment, 797) and conventional farms (pigs, 1,650; environment, 1,325). at slaughter, we collected samples from carcasses, including postevisceration swabs, postchill swabs, and mesente ...201222307299
molecular detection of campylobacter jejuni as a cause of culture-negative spondylodiscitis.spondylodiscitis caused by campylobacter species is a rare disease which is most often caused by campylobacter fetus. we report a case of culture-negative spondylodiscitis and a psoas abscess due to campylobacter jejuni in a 68-year-old woman, as revealed by 16s rrna gene and campylobacter-specific pcrs from biopsied tissue.201222259199
comparison of the microflex lt and vitek ms systems for routine identification of bacteria by matrix-assisted laser desorption ionization-time of flight mass spectrometry.this study compared the performance of three matrix-assisted laser desorption ionization-time of flight mass spectrometry systems: microflex lt (bruker daltonics, bremen, germany), vitek ms ruo (axima assurance-saramis database; biomérieux, marcy l'etoile, france), and vitek ms ivd (biomérieux). a total of 1,129 isolates, including 1,003 routine isolates, 73 anaerobes, and 53 bacterial enteropathogens, were tested on the microflex lt and axima assurance devices. the spectra were analyzed using t ...201222322345
effects of probiotics and antibiotics on the intestinal homeostasis in a computer controlled model of the large intestine.antibiotic associated diarrhea and clostridium difficile infection are frequent complications of broad spectrum antibiotic therapy. probiotic bacteria are used as therapeutic and preventive agents in these disorders, but the exact functional mechanisms and the mode of action are poorly understood. the effects of clindamycin and the probiotic mixture vsl#3 (containing the 8 bacterial strains streptococcus thermophilus, bifidobacterium breve, bifidobacterium longum, bifidobacterium infantis, lacto ...201222452835
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