PFGE, Lior serotype, and antimicrobial resistance patterns among Campylobacter jejuni isolated from travelers and US military personnel with acute diarrhea in Thailand, 1998-2003

<p>Abstract</p> <p>Background</p> <p><it>Campylobacter jejuni </it>is a major cause of gastroenteritis worldwide. In Thailand, several strains of <it>C. jejuni </it>have been isolated and identified as major diarrheal pathogens among adult travelers. To study the epidemiology of <it>C. jejuni </it>in adult travelers and U.S. military personnel with acute diarrhea in Thailand from 1998-2003, strains of <it>C. jejuni </it>were isolated and phenotypically identified, serotyped, tested for antimicrobial susceptibility, and characterized using pulsed-field gel electrophoresis (PFGE).</p> <p>Results</p> <p>A total of 312 <it>C. jejuni </it>isolates were obtained from travelers (n = 46) and U.S. military personnel (n = 266) in Thailand who were experiencing acute diarrhea. Nalidixic acid and ciprofloxacin resistance was observed in 94.9% and 93.0% of the isolates, respectively. From 2001-2003, resistance to tetracycline (81.9%), trimethoprim-sulfamethoxazole (57.9%), ampicillin (28.9%), kanamycin (5.9%), sulfisoxazole (3.9%), neomycin (2.0%), and streptomycin (0.7%) was observed. Combined PFGE analysis showed considerable genetic diversity among the <it>C. jejuni </it>isolates; however, four PFGE clusters included isolates from the major Lior serotypes (HL: 36, HL: 11, HL: 5, and HL: 28). The PFGE analysis linked individual <it>C. jejuni </it>clones that were obtained at U.S. military exercises with specific antimicrobial resistance patterns.</p> <p>Conclusions</p> <p>In summary, most human <it>C. jejuni </it>isolates from Thailand were multi-resistant to quinolones and tetracycline. PFGE detected spatial and temporal <it>C. jejuni </it>clonality responsible for the common sources of <it>Campylobacter </it>gastroenteritis.</p

Hand-assisted laparoscopic subtotal colectomy with cecorectal anastomosis for chronic idiopathic colonic pseudo-obstruction: report of a case

Chronic idiopathic colonic pseudo-obstruction (CICP) is characterized by the chronic disturbance of colonic motility without mechanical obstruction, any underlying disease or medication. Currently, there are no established medical treatments for CICP. A 62-year-old female who had undergone right hemicolectomy for splenic flexure syndrome caused by idiopathic megacolon was referred to our hospital with relapse, experiencing palpitation and abdominal fullness. She was diagnosed with CICP according to findings of marked dilation of the colon without mechanical obstruction, dilation of other parts of the gastrointestinal tract, or underlying disease. The dilated colon was surgically removed by hand-assisted laparoscopic subtotal colectomy, followed by cecorectal anastomosis. Histopathologically, there was no degeneration or lack of ganglion cells in Auerbach\u27s plexus. The patient has experienced no severe symptoms after undergoing the present operation