PREVALENCE OF ENTEROPATHOGENIC BACTERIA IN SURGICALLY TREATED CHRONICINFLAMMATORY BOWEL-DISEASE

BACKGROUND/AIMS: In order to assess the potential impact of bacterial eradication on recurrence rates, the prevalence of various enteropatho genic bacteria and toxins in chronic inflammatory bowel diseases (CIBD ) was prospectively examined. METHODOLOGY: Stool, sera and gut tissue samples from a total of 59 patients (33 males, 26 females; mean age: 4 2 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 det ect obligate pathogenic bacteria. By PCR, mycobacteria were found in 8 5% of all groups, with mycobacterium paratuberculosis not detected. Ye rsinia 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, on e of whom exhibited shiga-like-toxin as well. CONCLUSIONS: We conclude d that mycobacteria do ndt play a causative role in CIBD. Yersinia spe cies seem to persist in intestinal tissue in CIBD patients without ade quate immune response and might, thus, contribute to tissue destructio n. E. coli infections contribute to the disease process in a small gro up of patients with ulcerative colitis and their eradication might eli minate the need for immediate surgical intervention.