Prevalence of enteropathogenic bacteria in surgically treated chronic inflammatory bowel disease.
OBJECTIVE
In order to assess the potential impact of bacterial eradication on recurrence rates, the prevalence of various enteropathogenic bacteria and toxins in chronic inflammatory bowel diseases (CIBD) was prospectively examined.


METHODS
Stool, sera and gut tissue samples from a total of 59 patients (33 males, 26 females; mean age: 42 years +/- 14; 21 Crohn's disease, 14 ulcerative colitis, 24 controls) were examined for the presence of enteropathogenic bacteria by culture, immunoblotting and PCR.


RESULTS
Conventional cultures failed to detect obligate pathogenic bacteria. By PCR, mycobacteria were found in 85% of all groups, with mycobacterium paratuberculosis not detected. Yersinia species were observed in 63% of patients with Crohn's disease, in 46% of patients with ulcerative colitis, and in 36% of the control patients. Pathogenic E. coli were identified in stool samples of three patients with ulcerative colitis (21%) by amplifying the EAE-gene, one of whom exhibited shiga-like-toxin as well.


CONCLUSIONS
We concluded that mycobacteria do not play a causative role in CIBD. Yersinia species seem to persist in intestinal tissue in CIBD patients without adequate immune response and might, thus, contribute to tissue destruction. E. coli infections contribute to the disease process in a small group of patients with ulcerative colitis and their eradication might eliminate the need for immediate surgical intervention.
Kallinowski
F
F
Department of General Surgery, University of Heidelberg, Germany.
Wassmer
A
A
Hofmann
M A
MA
Harmsen
D
D
Heesemann
J
J
Karch
H
H
Herfarth
C
C
Buhr
H J
HJ
D000328:Adult; D001419:Bacteria / Q000302:isolation & purification*; D003093:Colitis, Ulcerative / Q000382:microbiology / Q000601:surgery; D003110:Colonic Neoplasms / Q000382:microbiology; D003424:Crohn Disease / Q000382:microbiology / Q000601:surgery; D019453:Escherichia coli O157 / Q000302:isolation & purification; D005243:Feces / Q000382:microbiology; D005260:Female; D006801:Humans; D015151:Immunoblotting; D015212:Inflammatory Bowel Diseases / Q000382:microbiology* / Q000601:surgery*; D007422:Intestines / Q000382:microbiology*; D008297:Male; D008875:Middle Aged; D009161:Mycobacterium / Q000302:isolation & purification; D016133:Polymerase Chain Reaction; D011446:Prospective Studies; D015007:Yersinia / Q000302:isolation & purification