Arcobacter species in humans (1).During an 8-year study period, Arcobacter butzleri was the fourth most common Campylobacter-like organism isolated from 67,599 stool specimens. Our observations suggest that A. butzleri displays microbiologic and clinical features similar to those of Campylobacter jejuni Campylobacter jejuni Vibrio jejuni, Campylobacter fetus ssp jejuni A curved or spiral gram-negative bacillus with a single polar flagellum Epidemiology Linked to contact with domestic and farm animals, unpasteurized milk, primates, day care ; however, A. butzleri is more frequently associated with a persistent, watery diarrhea. Campylobacter Campylobacter Genus of gram-negative spiral-shaped bacteria infecting mammals. Many species, especially C. fetus, cause miscarriage in sheep and cattle. C. jejuni is a common cause of food poisoning. Sources include meats (particularly chicken) and unpasteurized milk. is the most common cause of acute bacterial enteritis enteritis (ĕn'tərī`tĭs), inflammation of the gastrointestinal tract. Acute enteritis is not usually serious except in infants and older people, in whom the accompanying diarrhea can cause dehydration through the loss of fluids. in the United States and many other industrialized in·dus·tri·al·ize v. in·dus·tri·al·ized, in·dus·tri·al·iz·ing, in·dus·tri·al·iz·es v.tr. 1. To develop industry in (a country or society, for example). 2. countries (1,2). When the diagnosis of infection is based exclusively on culturing on selective media, >95% of Campylobacter infections are caused by Campylobacter jejuni or C. coli. However, with refinements in isolation and identification methods, other related species such as C. upsaliensis, C. jejuni subsp. doylei, C. fetus subsp fetus, C. concisus, Arcobacter butzleri, Helicobacter fennelliae, and H. cinaedi, have emerged as potential enteric enteric /en·ter·ic/ (en-ter´ik) within or pertaining to the small intestine. en·ter·ic adj. 1. Of, relating to, or within the intestine. 2. human pathogens (3). Since most laboratories do not use appropriate culture conditions to detect all Campylobacter spp. and related organisms or do not identify isolates to species level, data on the incidence and clinical importance of these non-C. jejuni/coli organisms are scarce. During the past decade, improvements in isolation techniques in veterinary medicine veterinary medicine, diagnosis and treatment of diseases of animals. An early interest in animal diseases is found in ancient Greek writings on medicine. Veterinary medicine began to achieve the stature of a science with the organization of the first school in the have led to the discovery of Arcobacter spp. as animal pathogens. Members of the genus Arcobacter are aerotolerant Campylobacter-like organisms. They were first isolated from aborted bovine fetuses by Ellis in 1977 (4). Arcobacter spp. differ from Campylobacter spp. by their ability to grow at lower temperatures and in air (5). Later, Arcobacter infections in humans were also described. Two species, A. butzleri and, more rarely, A. cryaerophilus, have been associated with enteritis and occasionally bacteremia bacteremia: see septicemia. bacteremia Presence of bacteria in the blood. Short-term bacteremia follows dental or surgical procedures, especially if local infection or very high-risk surgery releases bacteria from isolated sites. (6-9). Patients with A. butzleri infections report diarrhea associated with abdominal pain; nausea and vomiting Nausea and Vomiting Definition Nausea is the sensation of being about to vomit. Vomiting, or emesis, is the expelling of undigested food through the mouth. or fever also occur (10,11). A third species, A. skirrowii, has recently been isolated from a person with chronic diarrhea (12). Despite these occasional reports, the contribution of Arcobacter species to human diarrhea is still unknown. The aim of our study was to compare the prevalence and the clinical features of A. butzleri isolated from stools with those of C. jejuni. The Study From January 1995 to December 2002, all stool samples submitted to two hospital laboratories serving the Brugmann, Queen Fabiola, and Saint-Pierre University Hospitals in Brussels, Belgium, were examined macroscopically for consistency, gross blood, and mucus and microscopically for parasites, leukocytes, and erythrocytes Erythrocytes Red blood cells. Mentioned in: Bartonellosis erythrocytes (ē·rithˑ·rō·sīts), n.pl red blood cells. . These samples were also cultured for common bacterial pathogens. Stool samples of patients <2 years of age were also evaluated for rotavirus rotavirus /ro·ta·vi·rus/ (ro´tah-vi?rus) any member of the genus Rotavirus. ro´taviral Rotavirus /Ro·ta·vi·rus/ (ro´tah-vi?rus and enteric adenovirus enteric adenovirus Virology A serotype–eg, type 40, 41–of adenovirus which produces gastroenteritis Clinical Diarrhea; keratoconjunctivitis and nasopharyngitis–typical of infection with other adenoviruses–do not occur Management Symptomatic since viral diarrhea is mainly seen in young children. A specific culture protocol for the recovery of Campylobacter spp. and related organisms consisting of one solid selective medium and a filtration method was systematically applied. In the selective agar method, the fecal suspension (approximately 1 g/mL of saline) was plated onto Butzler's medium comprising Mueller-Hinton agar (Oxoid Ltd, Basingstoke, United Kingdom) containing 5% sheep blood and the antimicrobial supplement cefoperazone 30 mg/L, rifampicin rifampicin /rif·am·pi·cin/ (rif´am-pi-sin) rifampin. rifampin, rifampicin a derivative of rifamycin; an antibacterial and antifungal agent used in the treatment of mycobacterial infections, actinomycosis and histoplasmosis. 10 mg/L, and amphotericin B amphotericin B (ăm'fətĕr`ĭsĭn), antibiotic that halts the growth of several disease-causing fungi. Discovered in 1956, it is produced by bacteria of the genus Streptomyces. 2 mg/L (Institute Virion virion Entire virus particle, consisting of an outer protein shell (called a capsid) and an inner core of nucleic acid (either RNA or DNA). The core gives the virus infectivity, and the capsid provides specificity (i.e., determines which organisms the virus can infect). , Ruschlikon, Switzerland) (13). The plates were incubated for 48 h at 42[degrees]C in a microaerobic atmosphere (5% [O.sub.2], 6% [H.sub.2], 10% C[O.sub.2], and 79% [N.sub.2]). The plates were examined daily for growth of Campylobacter species. The membrane filtration method was performed according to Lopez (14). Stool samples were diluted 1:5 in Brucella Brucella /Bru·cel·la/ (broo-sel´ah) a genus of schizomycetes (family Brucellaceae). B. abor´tus causes infectious abortion in cattle and is the most common cause of brucellosis in humans. B. broth. Cellulose acetate filters (50 mm in diameter) with a pore size of 0.45 [micro]m were placed on the surface of Mueller-Hinton agar plates containing 5% sheep blood. Eight drops of the fecal suspension were placed on the top of the membrane and allowed to filter passively for 30 min at 37[degrees]C in air. After filtration, the filters were removed, and the plates were incubated at 37[degrees]C in a microaerobic atmosphere for up to 10 days. Two specific procedures for isolating Arcobacter were used successively. Until April 1995, we used a membrane filtration technique (15). Subsequently, we switched to direct plating on Arcobacter selective medium (16), for which 0.5 g of stool samples was injected into an enrichment broth (Brucella broth + antimicrobial supplement consisting of piperacillin 75 mg/L, cefoperazone 25 mg/L, amphotericin B 10 mg/L, trimethoprim trimethoprim /tri·meth·o·prim/ (-meth´o-prim) an antibacterial closely related to pyrimethamine; almost always used in combination with a sulfonamide, primarily for the treatment of urinary tract infections. 20 mg/L, and cycloheximide cycloheximide an antibiotic produced by Streptomyces griseus that inhibits protein synthesis. It is too toxic and nonselective for common clinical use, but is used in treatment of cancers and management of graft-versus-host reactions following transplantation. 100 mg/L + 5% laked horse blood) and incubated for 24 h at 25[degrees]C in a microaerobic atmosphere. After incubation, 40 [micro]L of enriched broth was plated onto Arcobacter selective medium (16). The plates were then incubated for 3 days at 25[degrees]C in a microaerobic atmosphere and examined daily. Gram-negative, motile mo·tile adj. 1. Moving or having the power to move spontaneously. 2. Of or relating to mental imagery that arises primarily from sensations of bodily movement and position rather than from visual or auditory sensations. , spiral, or curved rods were identified as Campylobacter by morphologic and biochemical characteristics consistent with the genus Campylobacter, as recommended by Vandamme et al. (5). A complementary distinction between A. butzleri and A. cryaerophilus was achieved by using sodium dodecyl sulfate-polyacrylamide gel electrophoresis of whole-cell proteins and by a multiplex polymerase chain reaction polymerase chain reaction (pŏl`ĭmərās') (PCR), laboratory process in which a particular DNA segment from a mixture of DNA chains is rapidly replicated, producing a large, readily analyzed sample of a piece of DNA; the process is assay (17). To assess the pattern of clinical disease, patients with A. butzleri infection were matched against three randomly selected control patients with C. jejuni infection. To achieve this, all charts of patients with A. butzleri infection and controls were reviewed retrospectively by combining the records of the medical and microbiology departments. A structured, close-ended questionnaire was used to collect the patient's history, age, sex, status (outpatient or hospitalized for >48 h) and history of international travel. The clinical history included diarrhea within the preceding 3 months, duration of symptoms, nature of the diarrhea (watery or bloody and presence of cells), intensity of fever, nausea or vomiting, abdominal pains, asymptomatic carriage (routine screening of enteric pathogens in stools of HIV-infected persons, other immunocompromised immunocompromised /im·mu·no·com·pro·mised/ (-kom´pro-mizd) having the immune response attenuated by administration of immunosuppressive drugs, by irradiation, by malnutrition, or by certain disease processes (e.g., cancer). states, and patients from a foreign country referred for surgery), and underlying disease. Diarrhea was defined as at least three unformed or liquid stools per day for at least 3 days. Because of the study's retrospective nature, we could only classify diarrhea as acute (duration <15 days) or chronic (duration > 15 days). Treatment history included antimicrobial history and use of intravenous fluid therapy, and, finally, clinical status after 1 month of treatment (cure or persistent diarrhea). All parameters were compared between index patients and matched controls. Comparisons were made by Pearson [chi square chi square (kī), n a nonparametric statistic used with discrete data in the form of frequency count (nominal data) or percentages or proportions that can be reduced to frequencies. ] test for 1:3 control data. Odds ratios (OR) and 95% confidence intervals (CI) were calculated. From January 1995 to December 2002, a total of 67,599 stool specimens from 40,995 patients were submitted for bacteriologic bac·te·ri·ol·o·gy n. The study of bacteria, especially in relation to medicine and agriculture. bac·te stool culture Stool Culture Definition Stool culture is a test to identify bacteria in patients with a suspected infection of the digestive tract. A sample of the patient's feces is placed in a special medium where bacteria is then grown. . These cultures yielded Campylobacter and related organisms in 1,906 patients, Salmonella species in 1,720 patients, and Skigella species in 244 patients. Other identified pathogens include enteropathogenic enteropathogenic having pathogenicity for the intestine. enteropathogenic Escherichia coli strains of E. coli which cause enteritis by close association with enteric cells. Includes attaching and effacing E. coli. Escherichia coli Escherichia coli (ĕsh'ərĭk`ēə kō`lī), common bacterium that normally inhabits the intestinal tracts of humans and animals, but can cause infection in other parts of the body, especially the urinary tract. (137 patients), Yersinia enterocolitica Yersinia en·ter·o·co·lit·i·ca n. A bacterium that causes yersiniosis. (87 patients), Plesiomonas spp. (22 patients), and Aeromonas spp Aeromonas spp Microbiology A genus of gram-negative, facultatively anaerobic, nonspore-forming bacilli, which have been isolated from various foods, including dairy products, meats and vegetable; Aeromonas . (21 patients). Among the 1,906 Campylobacter and related organisms isolated during the study period, 77.2% were C. jejuni, 11.4% were C. coli, and 4.5% were C. upsaliensis (Table 1). Ninety-seven Arcobacter isolates were obtained from 77 patients. Among them, A. butzleri was the most frequently isolated species (84 isolates from 67 patients), accounting for 3.5 % of the Campylobacter and related organisms bacterial group. Thirteen A. cryaerophilus isolates from 10 patients were obtained, but no A. skirrowii isolates were found. Other species, such as C. concisus, C. fetus, C. curvus, C. lari la·ri n. pl. lari See Table at currency. [Georgian.] Noun 1. lari - the basic unit of money in Georgia Georgian monetary unit - monetary unit in Georgia , and C. kyointestinalis, were also found in small numbers (Table 1). Medical records were available for 61 of the 67 patients with A. butzleri infection. Ages of patients with A. butzleri infection were 30 days-90 years; there were slightly more female than male patients. Fourteen patients were hospitalized for >48 h. Four patients had traveled abroad before onset of symptoms. Ten patients had underlying disease: 4 were HIV HIV (Human Immunodeficiency Virus), either of two closely related retroviruses that invade T-helper lymphocytes and are responsible for AIDS. There are two types of HIV: HIV-1 and HIV-2. HIV-1 is responsible for the vast majority of AIDS in the United States. seropositive seropositive /se·ro·pos·i·tive/ (-poz´i-tiv) showing positive results on serological examination; showing a high level of antibody. se·ro·pos·i·tive adj. , and 3 were immunocompromised (postrenal graft, celiac disease celiac disease: see sprue. celiac disease or nontropical sprue Digestive disorder in which people cannot tolerate gluten, a protein constituent of wheat, barley, malt, and rye flours. , and chemotherapy for cerebellar cerebellar /cer·e·bel·lar/ (ser?e-bel´ar) pertaining to the cerebellum. Cerebellar Involving the part of the brain (cerebellum), which controls walking, balance, and coordination. astrocytoma astrocytoma /as·tro·cy·to·ma/ (as?tro-si-to´mah) a tumor composed of astrocytes; the most common type of primary brain tumor and also found throughout the central nervous system, classified on the basis of histology or in order of ). Other chronic illnesses included dementia (n = 1), insulin-dependent diabetes mellitus insulin-dependent diabetes mellitus n. Abbr. IDDM See diabetes mellitus. (n = 1), and hepatitis C Hepatitis C Definition Hepatitis C is a form of liver inflammation that causes primarily a long-lasting (chronic) disease. Acute (newly developed) hepatitis C is rarely observed as the early disease is generally quite mild. (n = 1). Thirty-one patients complained of acute diarrhea ([greater than or equal to] 24 watery stools) lasting for 3 to 15 days, and 10 had persistent or recurrent diarrhea lasting >2 weeks-2 months. Six patients had abdominal pain without diarrhea. Twelve patients were asymptomatic. Sixteen patients received antimicrobial therapy, but only 7 were treated empirically with an antimicrobial agent for which the strain was susceptible. The symptoms resolved in all patients except one, regardless of the antimicrobial agent used. Among patients treated symptomatically, three patients had persistent or recurrent symptoms. Sixty-seven patients with A. butzleri infection were matched against 201 patients with C. jejuni infection. The age and sex distributions were similar for patients colonized Colonized This occurs when a microorganism is found on or in a person without causing a disease. Mentioned in: Isolation by each species. No significant differences in international travel were observed. However, proportionally fewer patients with A. butzleri (79.1%) were treated as outpatients than those with C. jejuni (90.5%) (OR 0.40, 95% CI 0.17-0.90) (Table 2). Rectal bleeding, inflammatory exudates, or both were significantly less common in A. butzleri than in C. jejuni infection (OR 0.15, 95% CI 0.05-0.46). A concomitant infection with another enteric pathogen occurred in a higher proportion of patients with A. butzleri infection than patients with C. jejuni infection, but the difference was not significant. Twelve patients with A. butzleri infection had a coinfection with one of the following enteric pathogens: Salmonella enterica (n = 4) (2 ser. Enteritidis, 1 ser. Typhimurium and 1 ser. Virchow), Rotavirus (n = 3), C. jejuni (n = 2), Giardia lamblia Giardia lamblia or G. intestinalis Single-celled protozoan parasite. Pear- or beet-shaped, the cells have two nuclei and eight flagella and attach with a sucking organ to human intestinal mucous membranes. They cause the disease giardiasis. (n = 2), and Clostridium difficile Clostridium difficile A common cause of bacterial colitis; it is the causative agent in 99% of pseudomembranous colitis, and 20-30% of antibiotic-associated diarrhea toxin B positive (n = 1). In 24 patients with Campylobacter jejuni infection, we found a coinfection with one another enteric pathogen: S. enterica (7) (3 ser. Enteritidis, 3 ser. Typhimurium, and 1 ser.Virchow), Rotavirus (5), Adenovirus adenovirus Any of a group of spheroidal viruses, made up of DNA wrapped in a protein coat, that cause sore throat and fever in humans, hepatitis in dogs, and several diseases in fowl, mice, cattle, pigs, and monkeys. (4), Giardia lamblia (2), Shigella flexneri Shigella flex·ner·i n. Flexner's bacillus. (2), Yersinia enterocolitica (1), and Clostridium difficile toxin B positive (1). In two additional cases of campylobacteriosis, we found a coinfection with two other enteric organisms: one patient was infected with S. dysenteriae and Hymenolepis nana and the other patient with Rotavirus and Salmonella enterica serotype serotype /se·ro·type/ (ser´o-tip) the type of a microorganism determined by its constituent antigens; a taxonomic subdivision based thereon. se·ro·type n. See serovar. v. Typhimurium. To assess the prevalence of A. butzleri and Campylobacter jejuni in diarrheic stool specimens, we considered only stools with loose or liquid macroscopic macroscopic /mac·ro·scop·ic/ (mak?ro-skop´ik) gross (2). mac·ro·scop·ic or mac·ro·scop·i·cal adj. 1. Large enough to be perceived or examined by the unaided eye. 2. aspect as diarrhea. Among the 67,599 stool specimens received, 12,413 were solid stools, and 55,186 were diarrheic. Among the diarrheic stool specimens, we isolated A. butzleri and C. jejuni in 77 (0.14%) and 3,209 (5.81%) stools, respectively. Among the nondiarrheic stool specimens, we isolated A. butzleri and C. jejuni in 7 (0.06%) and 205 (1.65%) stools, respectively. A. butzleri was more frequently isolated from diarrheic stool specimens than from nondiarrheic stools specimens. This difference was significant (OR 2.48, 95% CI 1.10-5.86) (p = 0.0175). We observed a similar result for the recovery of C. jejuni from diarrheic stool specimens compared with nondiarrheic stools specimens. This difference was even more significant (OR 3.68, 95% CI 3.18-4.25) (p < 0.0001). Because medical records were unavailable for 6 patients with A. butzleri and 10 patients with C. jejuni, we compared the clinical features of 61 patients with A. butzleri matched against those of 191 patients with C. jejuni. Although diarrhea was a common clinical feature of both groups, it was more frequent in the C. jejuni-infected patients. The characteristics of the diarrhea differed significantly, however. Patients with A. butzleri were more likely to have persistent diarrhea (OR 3.97, 95% CI 1.4-11.3), or watery diarrhea (OR 2.20, 95% CI 1.18-4.13) than those with C. jejuni infection, but they were less likely to have acute diarrhea (OR 0.38 95%, CI 0.20-0.79). Other clinical features did not differ significantly. Asymptomatic carriage was more frequently encountered in patients with A. butzleri infection than in those with C. jejuni infection, but not significantly (OR 2.22, 95% CI 0.94-5.21). Proportionally more patients with C. jejuni infections were treated with antimicrobial agents (41.4%) than patients with A. butzleri infections (26.2%) (OR 0.50, 95% CI 0.25-1.0). Among them, only 43.8% of patients with A. butzleri infections were treated empirically with an antimicrobial agent for which the strain was susceptible, whereas 79.5% of patients with C. jejuni received an appropriate antimicrobial drug. Conclusions In this study, Arcobacter was the fourth most common Campylobacter or Campylobacter-like organism isolated from stool specimens in our laboratories. Our observations suggest that A. butzleri display similar microbiologic and clinical features as C. jejuni. However, compared with C. jejuni, A. butzleri are more frequently associated with a persistent and watery diarrhea and less associated with bloody diarrhea. This first study on Arcobacter in humans could be the beginning of future research to better understand the pathogenesis and epidemiology of these non-jejuni/coli Campylobacter.
Table 1. Distribution of Campylobacter spp. and related organisms
isolated from 1,906 patients, (a) January 1995-December 2002, and
comparison of recovery by isolation method used (b)
No. of patients positive
for Campylobacter
by one medium or a
combination of media
Species No. (%) BSM ASM FM
Campylobacterjejuni 1471 (77.2) 1,353 12 1,076
subsp. jejuni
C. coli 218 (11.4) 199 5 174
C. upsaliensis 85 (4.5) 7 0 85
Arcobacter butzleri 67 (3.5) (c) 3 65 5
C. concisus 27 (1.4) 0 0 27
C. fetus subsp. fetus 11 (0.6) 2 0 9
A. cryaerophilus 10 (0.5) 0 9 1
C. curvus 9 (0.5) 0 0 9
C. lari I 3 (0.2) 1 0 3
C. hyointestinalis 2 (0.1) 0 0 2
Helicobacter pullorum 2 (0.1) 0 0 2
C. sputorum 1 (0.1) 0 0 1
Total 1,906 (100.0) 1,565 91 1,394
No. of patients positive for Campylobacter
by one medium or a combination of media
Species BSM + FM BM + ASM ASM + FM All methods
Campylobacterjejuni 1,471 1,353 1,081 1,471
subsp. jejuni
C. coli 218 199 174 218
C. upsaliensis 85 7 85 85
Arcobacter butzleri 5 65 65 67
C. concisus 27 0 27 27
C. fetus subsp. fetus 11 2 9 11
A. cryaerophilus 1 9 10 10
C. curvus 9 0 9 9
C. lari I 3 1 3 3
C. hyointestinalis 2 0 2 2
Helicobacter pullorum 2 0 2 2
C. sputorum 1 0 1 1
Total 1,835 1,636 1,468 1,906
(a) At the Saint-Pierre, Brugmann, and
Queen Fabiola University Hospitals.
(b) BSM, Butzler selective medium; ASM, Arcobacter
selective medium; FM, filtration method.
(c) Two of the 67 A. butzleri isolated were recovered
by the filtration method (15) in use up to April 1995.
Table 2. Case-control study of microbiologic and
clinical features of patients with Arcobacter
butzleri and Campylobacter jejuni infection
No. patients No. patients
with A. butzleri with C. jejuni
Features/treatment/outcome infection (%) infection (%)
Microbiologic features
Erythrocytes in stool 4/67 (6.0) 59/201 (29.4)
Leukocytes in stool 2/67 (3.0) 36/201 (17.9)
Associated organisms 12/67 (17.9) 24/201 (11.9)
Clinical features
Diarrhea 41/61 (67.2) 149/191 (78.0)
Acute diarrhea 31/61 (50.8) 140/191 (73.3)
Persistent diarrhea 10/61 (16.4) 9/191 (4.7)
Watery diarrhea 31/61 (50.8) 61/191 (31.9)
Fever, temperature 20/61 (32.8) 83/191 (43.5)
>38.5 [degrees]C
Nausea, vomiting, or both 17/61 (27.9) 47/191 (24.6)
Abdominal pain 18/61 (29.5) 53/191 (27.7)
Asymptomatic carriage 12/61 (19.7) 19/191 (9.9)
Underlying disease 10/61 (16.4) 49/191 (25.7)
Treatment
Antimicrobial agents 16/61 (26.2) 79/191 (41.4)
Intravenous fluid therapy 1/61 (1.6) 8/191 (4.2)
Outcome
Relapse 4/61 (6.6) 6/191 (3.1)
OR (95% CI)
Microbiologic features
Erythrocytes in stool 0.15 (0.05-0.46)
Leukocytes in stool 0.14 (0.02-0.62)
Associated organisms 1.61 (0.71-3.63)
Clinical features
Diarrhea 0.58 (0.29-1.14)
Acute diarrhea 0.38 (0.20-0.79)
Persistent diarrhea 3.97 (1.40-11.33)
Watery diarrhea 2.20 (1.18-4.13)
Fever, temperature 0.63 (0.33-1.21)
>38.5 [degrees]C
Nausea, vomiting, or both 1.18 (0.59-2.37)
Abdominal pain 1.09 (0.55-2.15)
Asymptomatic carriage 2.22 (0.94-5.21)
Underlying disease 0.57 (0.25-1.27)
Treatment
Antimicrobial agents 0.50 (0.25-1.00)
Intravenous fluid therapy 0.38 (0.38-3.05)
Outcome
Relapse 2.16 (0.49-9.06)
OR, odds ratio; CI, confidence interval.
Acknowledgments We thank Regine De Koster and Francoise Mengal for their secretarial services; the personnel of the Department of Microbiology for their daily technical assistance; Jeanne-Marie Devaster for help preparing the article; Martin Skirrow, Richard Wenzel, and Jennifer Frost for their critical corrections; Dominique Monnet for his help in performing statistical analysis; and Patricia Retore, Chantal Vandenborre, and Linda Vlaes for their skilled technical assistance. This work was supported in part by grants from the Fondation Vesale Research fellowship (foundation for medical research) to Olivier Vandenberg. Dr. Vandenberg is a staff microbiologist at Saint Pierre University Hospital in Brussels, Belgium. He is responsible for the National Reference Center for Enteric Campylobacter. He is also an assistant at the Infectious Diseases Epidemiology Unit of the Public Health School of the Free University of Brussels The Free University of Brussels may refer to one of two Belgian universities, both located in Brussels, Belgium:
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Marinescu M, Collignon A, Squinazi F, Derimay R, Woodward D, Lior H. Two cases of persistent diarrhoea associated with Arcobacter species. In: Newell DG, Ketley JM, Feldman RA, editors. Campylobacter, Helicobacter and related organisms. New York: Plenum;1996. p. 521-3. (16.) de Boer E, Tilburg JJ, Woodward DL, Lior H, Johnson WM. A selective medium for the isolation of Arcobacter from meats. Lett Appl Microbiol. 1996;23:64-6. (17.) Houf K, Tutenel A, De Zutter L, Van Hoof J, Vandamme P. Development of a multiplex PCR PCR polymerase chain reaction. PCR abbr. polymerase chain reaction Polymerase chain reaction (PCR) assay for the simultaneous detection and identification of Arcobacter butzleri, Arcobacter cryaerophilus and Arcobacter skirrowii. FEMS Microbiol Lett. 2000;193:89-94 Address for correspondence: Olivier Vandenberg. Department of Microbiology, Saint-Pierre University Hospital, Rue Haute 322, B-1000 Brussels, Belgium; fax: 32-2-535.4656; email: olivier_vandenberg@ stpierre-bru.be Olivier Vandenberg,* ([dagger]) Anne Dediste,* Kurt Houf, ([double dagger]) Sandra Ibekwem, ([section]) Hichem Souayah,* Sammy Cadranel, [paragraph] Nicole Douat, (#) ** G. Zissis, * J.-P. Butzler, ([section]) and P. Vandamme ([double dagger]) * Saint-Pierre University Hospital, Brussels, Belgium; ([dagger]) Free University of Brussels, Brussels, Belgium; ([double dagger]) Ghent University, Ghent, Belgium; ([section]) Vrije Universiteit Brussel The Vrije Universiteit Brussel (VUB) is a Flemish university situated in Brussels, Belgium. The university title means "Free University of Brussels". However, there is another Free University of Brussels, namely the French-speaking Université Libre de Bruxelles (ULB). , Brussels, Belgium; ([paragraph]) Queen Fabiola University Hospital, Brussels, Belgium; (#) Brugmann University Hospital, Brussels, Belgium; and ** Queen Fabiola University Hospital, Brussels, Belgium (1) Presented in part at the 11th International Congress on Infectious Diseases, Cancun, Mexico, Mar 4-8, 2004. (Abstract P09.030); and at the 12th International Workshop on Campylobacter, Helicobacter and Related Organisms. Aarhus, Denmark, Sept 6-10, 2003 (Abstract K-07). |
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