Faecal flora in spondyloarthropathy

Enterobacteria, in particular Klebsiella spp., have been implicated in the aetiopathogenesis of ankylosing spondylitis. A comprehensive examination of the faecal flora of 82 patients with ankylosing spondylitis, either primary (67), or in association with inflammatory bowel disease (4), reactive arthritis (6) or psoriatic arthritis (5), was performed and compared with that of a control population (36) of healthy individuals. The range of flora identified was similar in both populations and there was no increased isolation rate of Klebsiella or other proposed arthritogenic organism in those with spondyloarthropathy. In those patients in whom Klebsiella was identified, its presence was not related to disease activity, the erythrocyte sedimentation rate or C-reactive protein.