Groundwater impact of Danescourt Cemetery, Wolverhampton

This report presents the results of a joint investigation by the British Geological Survey (BGS) and the Environment Agency (EA) into the impact cemeteries on groundwater quality at the Danescourt cemetery, Wolverhampton. It has been carried out within the terms of the memorandum of understanding between the Environment Agency and the Natural Environment Research Council (British Geological Survey) which aligns research activities. The report is a contribution to the Environment and Health Project of the British Geological Survey which is looking into the main pathways of human exposure to anthropogenic contamination

Detection of Helicobacter pylori antigen in faeces by enzyme immunoassay

The detection of Helicobacter pylori antigen directly in faecal specimens may offer an alternative non-invasive method for determining the presence of H. pylori infection. This study compared the performance of the Premier Platinum HpSA enzyme immunoassay (HpSA) with histology and CLOtest, a rapid urease test. Of 134 patients undergoing upper gastrointestinal endoscopy, 37 (28%) were H. pylori-positive by histology and CLOtest. Using the HpSA test, H. pylori was detected in 35 H. pylori-positive patients (95% sensitivity) and one H. pylori-negative patient (99% specificity). The positive and negative predictive values for HpSA were 97 and 98%, respectively. HpSA is a rapid, easily performed, non-invasive method for detecting H. pylori

Proteome analysis of Helicobacter pylori: major proteins of type strain NCTC 11637

Proteome analysis involves the simultaneous resolution and display of proteins produced by an organism, followed by the quantitation, characterisation and identification of these proteins. As part of an ongoing study mapping and comparing the proteins expressed by various strains of the pathogenic bacterium Helicobacter pylori, we have resolved and identified 93 of the most abundant proteins expressed by type reference strain NCTC 11637. Proteins were separated by two-dimensional gel electrophoresis and stained with Coomassie G250. Intensely-stained spots were excised and digested with trypsin, and the resulting peptides were characterised by mass spectrometry. Proteins were then identified by correlating actual peptide profiles with theoretical profiles generated from published nucleotide sequences. Ninety-three of the most intensely-stained protein spots were identified as the products of 35 genes, giving a ratio of 2.7 protein gene-products per gene. The products of the tsaA, pfr, ureA and ureB genes were amongst several proteins present in multiple isoforms. Peptide mass fingerprinting data were used to identify probable post-translational protein modifications. These results suggest that H. pylori proteins are subject to a high degree of post-translational modification. Comparative proteomics of H. pylori strains should greatly assist in investigating the pathogenic properties of this bacterium

Short duration therapy for Helicobacter pylori in Western Australia: the impact of metronidazole resistance

Background: Limited Australian data are available on either short duration therapy for Helicobacter pylori infection, or the impact of metronidazole resistance on the outcome of treatment. Aim: To compare the efficacy of two treatment regimens and determine the influence metronidazole resistance has on clearing H. pylori infection. Methods: Eighty patients with H. pylori infection proven at upper gastrointestinal endoscopy, none of whom had previously received therapy for H. pylori, were randomised to one week therapy with either bismuth subcitrate one tablet qid, tetracycline 500 mg qid and metronidazole 400 mg tds (BTM), or lansoprazole 30 mg bd, amoxycillin 500 mg qid and metronidazole 400 mg tds (LAM). Effectiveness of therapy was measured by C14-urea breath test at six weeks. Results: On an intention-to-treat basis, clearance of infection was achieved in 17 of 32 (53%; 95% CI: 35–71%) evaluable patients receiving BTM and 32 of 46 (70%, 54–182%) patients receiving LAM (p=0.16). Metronidazole resistance was found in 32 of 65 (49%) patients in whom H. pylori was isolated by culture. On a per-protocol basis, of patients who had metronidazole sensitive strains of H. pylori 23 of 24 (96%) cleared infection after therapy with either BTM or LAM, compared with 14 of 24 (58%) who were metronidazole resistant (p=0.004). Clarithromycin resistance was not found in 45 patients tested. Conclusions: In Western Australia clearance rates H. pylori infection, after one week of BTM or LAM, are lower than in other published series. The high incidence of metronidazole resistance is the main determinant of our relatively poor eradication rates

Proteome analysis of highly immunoreactive proteins of Helicobacter pylori

Background. Identification of the immunoreactive proteins of Helicobacter pylori is important for the development of both diagnostic tests and vaccines relating to the organism. Our aim was to determine whether there are significant differences between human IgG and IgA reactivities to individual H. pylori proteins, and whether patterns of immunoreactivity are sustained across different strains of H. pylori. Method. The total complement of protein from seven strains of H. pylori was resolved by two-dimensional polyacrylamide gel electrophoresis (2D-PAGE). Proteins were transferred electrophoretically onto polyvinylene difluoride (PVDF) membranes, which were probed with sera pooled either from H. pylori-infected patients, or noninfected (control) patients. Highly immunoreactive proteins were detected using chromogenic enzyme-antibody conjugates recognising either serum IgG or IgA. These proteins were then characterised by tryptic peptide-mass fingerprinting using matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF MS). Results. Highly immunoreactive proteins were detected which were common to all seven strains, and recognised by both immunoglobulin subclasses. The proteins appear to be localised in five groups. Protein analysis established that these groups encompass multiple isoforms of chaperonin HspB (two subgroups); urease Β-subunit UreB; elongation factor EF-Tu; and flagellin FlaA. The pattern of highly immunoreactive proteins was strongly conserved across the seven strains. Conclusion. These results suggest that within a tightly defined region on the H. pylori proteome map there are five groups of proteins that are highly reactive to both IgG and IgA. Our analysis suggests it is unlikely that the highly immunoreactive clusters harbour any significant proteins other than isoforms of HspB, UreB, EF-Tu and FlaA, and that, with the partial exception of FlaA, these clusters are strongly conserved across all seven strains