Contamination of the Small Intestine by Enterotoxigenic Coliform Bacteria among the Rural Population of Haiti

Klipstein, Frederick A.; Short, Helen B.; Engert, R F; Jean, Lionel; Weaver, Gary A.

doi:10.1016/s0016-5085(76)80305-8

Cited by 34 publications

(16 citation statements)

References 41 publications

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“…in these samples is not surprising as some of the Klebsiella species belong to human normal flora, especially found in skin, mouth and intestine [42]. Presence of enterotoxigenic Klebsiella species was reported in populations with gastrointestinal disorders in Haiti in reports published almost four decades ago [14]. …”

Section: Resultsmentioning

confidence: 99%

Microbial Diversity of Source and Point-of-Use Water in Rural Haiti – A Pyrosequencing-Based Metagenomic Survey

et al. 2016

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Haiti endures the poorest water and sanitation infrastructure in the Western Hemisphere, where waterborne diseases cause significant morbidity and mortality. Most of these diseases are reported to be caused by waterborne pathogens. In this study, we examined the overall bacterial diversity of selected source and point-of-use water from rural areas in Central Plateau, Haiti using pyrosequencing of 16s rRNA genes. Taxonomic composition of water samples revealed an abundance of Firmicutes phyla, followed by Proteobacteria and Bacteroidetes. A total of 38 bacterial families and 60 genera were identified. The presence of several Klebsiella spp. (tentatively, K. pneumoniae, K. variicola and other Klebsiella spp.) was detected in most water samples. Several other human pathogens such as Aeromonas, Bacillus, Clostridium, and Yersinia constituted significantly higher proportion of bacterial communities in the point-of-use water samples compared to source water. Bacterial genera traditionally associated with biofilm formation, such as Chryseobacterium, Fusobacterium, Prevotella, Pseudomonas were found in the point-of-use waters obtained from water filters or domestic water storage containers. Although the pyrosequencing method utilized in this study did not reveal the viability status of these pathogens, the abundance of genetic footprints of the pathogens in water samples indicate the probable risk of bacterial transmission to humans. Therefore, the importance of appropriate handling, purification, and treatment of the source water needed to be clearly communicated to the communities in rural Haiti to ensure the water is safe for their daily use and intake.

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Section: Resultsmentioning

confidence: 99%

Microbial Diversity of Source and Point-of-Use Water in Rural Haiti – A Pyrosequencing-Based Metagenomic Survey

et al. 2016

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“…79 On the other hand, a specific overgrowth of coliforms in the small intestine was described in rural Haitians with tropical sprue. 92 The organisms were Klebsiella, Enterobacter or Escherichia coli, and produced toxins that caused mucosal damage and secretion in intestinal loops of experimental animals. 93 Studies in rural southern India and in South Africa indicated that bacterial colonisation of the small intestine was present not only in patients with tropical sprue but also in apparently healthy people, and the two groups could not be distinguished on the basis of the numbers or kinds of bacteria isolated from the small bowel.…”

Section: Aetiologymentioning

confidence: 99%

Tropical malabsorption

Ramakrishna

Venkataraman

Mukhopadhya

2006

Postgraduate Medical Journal

124

100

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Malabsorption is an important clinical problem both in visitors to the tropics and in native residents of tropical countries. Infections of the small intestine are the most important cause of tropical malabsorption. Protozoal infections cause malabsorption in immunocompetent hosts, but do so more commonly in the setting of immune deficiency. Helminth infections occasionally cause malabsorption or protein-losing enteropathy. Intestinal tuberculosis, chronic pancreatitis and small-bowel bacterial overgrowth are important causes of tropical malabsorption. In recent years, inflammatory bowel disease and coeliac disease have become major causes of malabsorption in the tropics. Sporadic tropical sprue is still an important cause of malabsorption in adults and in children in South Asia. Investigations to exclude specific infective, immunological or inflammatory causes are important before considering tropical sprue as a diagnosis. This article briefly reviews the management of tropical sprue and presents an algorithm for its investigation and management.

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“…In healthy adults in a Western environment, it appears that colonization of luminal fluid (Drasar, Shiner & McLeod, 1969) and mucosa (Plautt, Gorbach, Nahas, Weinstein, Spanknebel & Levitan, 1967) is by an autochthonous flora in which streptococci and lactobacilli predominate but Enterobacteriaceae are rarely found. The majority of studies in Haiti (Klipstein, Short, Engert, Jean & Weaver, 1976), Costa Rica (Jarumilinta, Miranda & Villarejos, 1976) and North India (Gorbach et al, 1970) and with expatriates without malabsorption returning from India (Tomkins, Drasar & James, 1975) show similar microflora to those in Western communities. The exceptions are studies in South America (Cain, Mayoral, Lotero, Bolanos & Duque, 1976) where some enterobacteria were isolated and South India (Bhat et al, 1972) where both enterobacteria and anaerobic organisms were isolated.…”

Section: The Role Of Microbial Pathogensmentioning

confidence: 99%

“…If we are claiming that mild tropical malabsorption is the result of repeated upper intestinal infection, we have to explain why the majority of such subjects have no enterobacteria in the upper intestine (Klipstein et al, 1976). To do this it is helpful to examine data on bacterial colonization in acute adult gastroenteritis.…”

Section: The Role Of Microbial Pathogensmentioning

confidence: 99%

“…Therefore, the chances of finding an infective agent in mild tropical malabsorption are related to the timing of the microbiological study. If subjects with a recent onset of diarrhoea are excluded, as in the study in Haiti (Klipstein et al, 1976), it is not surprising that investigators failed to isolate the pathogen responsible for the mucosal lesion. By contrast, bacterial colonization, particularly, for Enterobacteriaceae, is present in most patients who developed tropical sprue in Haiti (Klipstein et aI., 1976), Puerto Rico (Klipstein, Holdeman, Corcino & Moore, 1973), North India (Gorbach et al, 1970), South India (Bhat et al, 1972), Nepal (Tomkins et aI., 1975) and Vietnam (Dickman et aI., 1974).…”

Section: The Role Of Microbial Pathogensmentioning

confidence: 99%

See 1 more Smart Citation

Tropical Malabsorption: Recent Concepts in Pathogenesis and Nutritional Significance

Tomkins

1981

Clinical Science

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Contamination of the Small Intestine by Enterotoxigenic Coliform Bacteria among the Rural Population of Haiti

Cited by 34 publications

References 41 publications

Microbial Diversity of Source and Point-of-Use Water in Rural Haiti – A Pyrosequencing-Based Metagenomic Survey

Microbial Diversity of Source and Point-of-Use Water in Rural Haiti – A Pyrosequencing-Based Metagenomic Survey

Tropical malabsorption

Tropical Malabsorption: Recent Concepts in Pathogenesis and Nutritional Significance

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