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[Human intestinal spirochetosis].

Alois Cízek1, Dana Lobová

  • 1Institute of Microbiology and Immunology, Faculty of Veterinary Medicine, University of Veterinary and Pharmaceutical Sciences Brno, 61242 Brno, Czech Republic. cizeka@vfu.cz

Klinicka Mikrobiologie a Infekcni Lekarstvi
|May 18, 2004
PubMed
Summary

Human intestinal spirochetosis (IS) involves Brachyspira bacteria colonizing the large intestine. Diagnosis and treatment, particularly for invasive IS, are discussed, with metronidazole and beta-lactams showing success.

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Area of Science:

  • Microbiology
  • Gastroenterology
  • Infectious Diseases

Context:

  • Human intestinal spirochetosis (IS) is characterized by Brachyspira colonization of the large intestine mucosa.
  • This colonization can mimic a false brush border histologically.
  • Invasive IS presents with various large gut symptoms.

Purpose:

  • To describe the characteristics, diagnosis, and treatment of human intestinal spirochetosis.
  • To highlight the isolation challenges and diagnostic methods for Brachyspira species.
  • To review effective antimicrobial therapies for invasive IS.

Summary:

  • Brachyspira aalborgii and B. pilosicoli are implicated in IS, with prevalence linked to socioeconomic factors and hygiene standards.
  • Diagnosis often relies on immunohistochemistry and 16S rRNA gene amplification, especially for B. aalborgii.

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  • B. pilosicoli isolation is simpler, requiring specific anaerobic incubation.

    • Impact:

    • Invasive IS can lead to spirochetemia, detectable with manual but not always automated hemoculture systems.
    • Metronidazole and beta-lactam antibiotics are effective in treating invasive IS.
    • In vitro studies show B. pilosicoli sensitivity to several antibiotics, with variable resistance to clindamycin and amoxicillin.