Acta Pathologica Microbiologica ScandinavicaVolume 49, Issue 4 p. 515-522 STUDIES IN THE LABORATORY ESTIMATION OF THE RHEUMATOID ARTHRITIS SERUM FACTOR 2. Gamma Globulin Precipitation Test in Relation to Haemagglutination Test with Sensitized Sheep Cells and Acryiplast Fixation Test STEN WINBLAD, STEN WINBLAD INSTITUTE OF CLINICAL BACTERIOLOGY, UNIVERSITY OF LUND (HEAD: STEN WINBLAD, M.D.) GENERAL HOSPITAL OF MALMÖ, SWEDENSearch for more papers by this author STEN WINBLAD, STEN WINBLAD INSTITUTE OF CLINICAL BACTERIOLOGY, UNIVERSITY OF LUND (HEAD: STEN WINBLAD, M.D.) GENERAL HOSPITAL OF MALMÖ, SWEDENSearch for more papers by this author First published: September 1960 https://doi.org/10.1111/j.1699-0463.1960.tb01164.xCitations: 6AboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinked InRedditWechat Citing Literature Volume49, Issue4September 1960Pages 515-522 RelatedInformation

Several lines of evidence suggest that there might be immunologic cross-reactivity between the thyroid plasma membrane in humans and antigenic determinants in the enteric pathogen Yersinia enterocolitica . Studies were therefore performed to determine whether Y. enterocolitica , like the thyroid membrane, contains a thyrotropin binding site. A saturable binding site for bovine thyrotropin was indeed demonstrable, particularly in preparations of the organism that have been treated with ethylenediaminetetraacetate and lysozyme. Hormonal specificity of the binding site, as judged from the inhibition of binding of 125 I-labeled bovine thyrotropin, was similar to that of the thyrotropin receptor in human thyroid tissue.

Thirty-eight cases of suspected yersinia arthritis occurring in southern Sweden in 1975-6 were reviewed four to five years later. In 31 cases the diagnosis was confirmed. At follow-up three of the patients had definite ankylosing spondylitis, three radiologically confirmed sacroiliitis, three extensor tenosynovitis, five isolated articular joint disease, and 10 localised arthralgias; one patient had developed seropositive rheumatoid arthritis. Only six of the 31 patients were free of joint symptoms. These results suggest that although the acute symptoms of yersinia arthritis disappear within 12 months, the long-term prognosis may be less favourable than previously thought.

Journal Article Susceptibility to mecillinam and other antibiotics of 28 0-serotypes of Yersinia enterocolitica Get access Ingmar Juhlin, Ingmar Juhlin Department of Clinical Bacteriology, University of Lund, Malmö General HospitalS–214 01 Malmö, Sweden Search for other works by this author on: Oxford Academic PubMed Google Scholar Sten Winblad Sten Winblad Department of Clinical Bacteriology, University of Lund, Malmö General HospitalS–214 01 Malmö, Sweden Search for other works by this author on: Oxford Academic PubMed Google Scholar Journal of Antimicrobial Chemotherapy, Volume 8, Issue 4, October 1981, Pages 291–297, https://doi.org/10.1093/jac/8.4.291 Published: 01 October 1981 Article history Accepted: 06 May 1981 Published: 01 October 1981

Signs of damage to the glomerular basement membrane appearing as haematuria and proteinuria have been observed in 16 cases of proven acute yersiniosis. The infecting agent was Yersinia enterocolitica serotype O:3 in all. In a few cases a transient deterioration of the renal function was observed. The renal symptoms were not related to the acute febrile state, but seemed to appear about 14 days after the onset of yersiniosis and to be reversible in the observation period. Infection with other microorganisms known as nephritogenic was not found in spite of attempts to do so. Kidney biopsy was performed in one case and immunofluorescence microscopy showed deposits of immunoreactants. Based on these observations we suggest that acute glomerulonephritis can be included in the spectrum of complications of infection with Yersinia enterocolitica serotype O:3. The frequency of complicating glomerulonephritis in yersiniosis could not be estimated from this study.

Yersinia enterocolitica serotype 03 was isolated from the colon contents of 27 (4.5%) of 599 bacon pigs on slaughter. Two (1.7%) out of 115 dogs were positive by culture for this human-athogenic serotype of Y. enterocolitica. A number of other serotypes of Y. enterocolitica were also obtained both from porcine and canine enteric contents (4b, 5a, 6, 7, 11, 12, 15, 17, 19, 26b, and non-typeable strains). All these serotypes are supposedly non-pathogenic for man and may possibly originate from the microflora of the environment. Haemolysis on bovine blood agar was observed for strains belonging to O-serotype 3.

A system for the differentiation of Yersinia enterocolotica strains and Yersinia enterocolitica-like strains is introduced using the biochemical and O-serological characters of the strains and their sources. Seven subgroups are proposed. I--III are indole-negative strains. IV include strains which are indole-positive but lack the ability to split aesculin and to ferment salicin. These strains mostly belong to serotype 0:8 and are found in the USA or in Canada. In subgroups V--VII the strains are also indole-positive but they can also ferment salicin and split aesculin. Subgroup V strains cannot ferment rhamnose. Subgroups VI and VII include the strains which ferment rhamnose, and in subgroups VII, to which strains with serotype 0.17 belong, melibiose is also often fermented. Using cross-agglutination studies it has been possible to make a subdividing of the serotypes 0:4, 0:5, 0:6 and 0:7.

Departments of Infectious Diseases and Bacteriology, University of Lund, General Hospital, Malmö, Sweden

Eighty strains of Yersinia enterocolitica were examined for their ability to invade HeLa cells. The following O‐serotypes were found to be invasive: 1, 3, 4a, 4c, 5b, 8, 9, 15a, 18, 20, 21 and 22. Biochemically, these types are either indole‐, aesculin‐, and salicin‐negative, or indole‐positive but aesculin‐ and salicin‐negative. Other serotypes of Y. enterocolitica did not invade HeLa cells. Biochemically, these non‐invasive strains are indole‐, aesculin‐ and salicin‐positive. Also the non‐sucrose‐fermenting strains of O‐serotypes 11 and 12 were non‐invasive. The interaction with HeLa cells was not restricted to viable bacteria, since also bacterial cells inactivated by formalin or ultraviolet light could gain entrance to the HeLa cells. Heating of the bacteria to 100° C for 30 min. completely inhibited their invasiveness. Monolayer cultures of porcine kidney cells were also invaded by strains which invaded HeLa cells.

Abstract. In 1958–1974 altogether 46 cases of bacteriologically verified infection of Listeria monocytogenes were diagnosed during pregnancy and the neonatal period. Eight pregnancies resulted in abortion and three in stillbirth. Thirty‐seven children were born alive, 17 of whom died, all but one within a few days. These children were divided into three groups according to their age at the onset of illness: 22 cases with “Early disease” (≤2 days), four cases with “Intermediate disease” (3–5 days) and eight cases with “Late disease” (≤6 days). Three children were apparently healthy. Septicemia or “Granulomatosis infantiseptica” dominated in “Early disease” and claimed as many as 13 deaths. In “Late disease” all the children had meningo‐encephalitis, and only one of them died. The symptoms were typical of purulent meningitis. The group of “Intermediate disease” consisted of overlapping cases of the other two groups. Ampicillin alone or combined with gentamicin seemed to be the drug of choice in the therapy of neonatal listeriosis. Of the surviving children, two were seriously damaged and two had moderate injuries. Fifteen children are apparently healthy. In cases where pregnancy terminated in abortions, stillborns or children with “Early disease”, the mothers often showed signs of infection. The mothers of the children with “Late disease” were apparently healthy. These children were infected from other sources, some of them nosocomially. If listeriosis is diagnosed during pregnancy, the women should be treated with ampicillin.

In 1958-74 altogether 64 cases of bacteriologically verified infections of Listeria monocytogenes were diagnosed in Sweden in children, aged more than 27 days, and in adults. Immunosuppression predisposed to the disease. Thus, many patients had co-existing disorders, such as leukemia and alcoholism. Sixteen patients had been treated with corticosteroids, which were combined with cytostatic drugs in nine. Meningoencephalitis was diagnosed in 52 patients and was fatal in 16. The clinical symptoms did not differ from those in purulent meningitis caused by other bacteria. In the cerebrospinal fluid the cellular response was dominated by polymorphonuclear cells in 29 patients and by mononuclear cells in 20. Ten patients had septicemia, which was fatal in four. Clinical symptoms were dominated by chills, high fever and general prostration. One patient had pleurisy and one an abscess of the neck; both recovered. Serotypes 1 and 4b prevailed and were equally common. Many patients developed raised antibody titers in both the O-agglutination test and the complement fixation test. The titers were often not positive until after a month. Moderate granulocytosis was the rule and monocytosis was rarely seen. Ampicillin alone or combined with an aminoglycoside seemed to be the drug of choice in the treatment of listeriosis. An alternative drug was tetracycline. Most deaths occurred within six days of onset of the illness. Early diagnosis and treatment were imperative. Most patients recovered and serious sequelae were rare.

A new and simple routine method is described for detecting hidden rheumatoid factors in human serum. EDTA glycine and NaCl were used to liberate hidden rheumatoid factors and to inactivate complement before rheumatoid-factor activity was determined in a glycine--NaCl solution. Forty-nine out of 97 sera from individuals with seronegative rheumatoid arthritis gave positive reactions by this method. Rheumatoid sera with low titres by standard tests gave higher titres with the new method. The new method detects both IgM and IgG rheumatoid factors and is simple and suitable for use in routine medical laboratories. Used in parallel with the classical tests, it facilitates detection of hidden rheumatoid factors.

This chapter discusses the biochemical properties of Yersinia enterocolitica, which is a gram-negative rod, morphologically similar to Pasteurella. It grows on agar, blood agar, and on media such as endoagar, Salmonella–Shigella (SS)-agar, and desoxycholate agar. Y. enterocolitica is urease positive and phenylalanine negative, oxidase negative, catalase positive, usually sucrose positive, cellobiose positive and Voges–Proskauer positive only at 22°C. Y. enterocolitica is routinely isolated from stools or from extirpated appendices. A few cases have been described in which Y. enterocolitica was isolated from blood or urine. Routine cultivation may be carried out using ordinary media suitable for pathogenic enterobacteria. SS-agar seems to be suitable and better than endoagar. Cultivation demands incubation for 48 hours and is best at room temperature. A good selective method includes primary cultivation of the material in ordinary peptone broth at 4°C for 3–5 days. Y. enterocolitica grows well at this temperature.

An outbreak of infection with Salmonella typhi murium occurred in southern Sweden in the summer of 1974. About 330 persons were infected; 91 were hospitalized. 13 of the 91 patients (9 men and 4 women) had symptoms of aseptical polyarthritis. The 13 patients with arthritis were HLA typed with a standard microlymphocytotoxicity test. 13 salmonellosis patients from the same epidemic but without arthritis and 446 healthy blood donors served as controls. Nine (69%) of the 13 patients with arthritis had HLA-B27 compared to 1 (8%) of the control patients and 44 (10%) of the blood donors. The observed association between HLA antigen B27 and reactive arthropathy following salmonella infection could be due to a function of a disease predisposing gene closely linked to HLA-B27.

Tissue AntigensVolume 6, Issue 4 p. 366-367 HL-A27 and Reactive Arthritis in an Outbreak of Salmonellosis Ullaberit Håansson, Ullaberit Håansson Blood Bank, University Hospital, Lund., SwedenSearch for more papers by this authorB. Low, B. Low Blood Bank, University Hospital, Lund., SwedenSearch for more papers by this authorR. Ei'trem, R. Ei'trem Department oi Infectious Diseases, County Hospital, Karlskrona, SwedenSearch for more papers by this authorS. Winblad, S. Winblad Institute of Clinical Bacteriology, University of Lund, General Hospital, Malmo, SwedenSearch for more papers by this author Ullaberit Håansson, Ullaberit Håansson Blood Bank, University Hospital, Lund., SwedenSearch for more papers by this authorB. Low, B. Low Blood Bank, University Hospital, Lund., SwedenSearch for more papers by this authorR. Ei'trem, R. Ei'trem Department oi Infectious Diseases, County Hospital, Karlskrona, SwedenSearch for more papers by this authorS. Winblad, S. Winblad Institute of Clinical Bacteriology, University of Lund, General Hospital, Malmo, SwedenSearch for more papers by this author First published: October 1975 https://doi.org/10.1111/j.1399-0039.1975.tb00656.xCitations: 35AboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinked InRedditWechat No abstract is available for this article.Citing Literature Volume6, Issue4October 1975Pages 366-367 RelatedInformation

74 patients, 42 females, 32 men-all over 10 years of age, with acute arthritis associated with infection with Yersinia enterocolitica are presented. The diagnosis was based on serological evidence in all cases (an agglutinin titre of 320 or more), and in 18 of the cases also a positive culture of Y. ent. from faeces. The erythrocyte sedimentation rate was very high in most cases. Acute enteritis, sometimes with abdominal pain, preceded the acute arthritis with a latent period of about 1-14 days. In 50% of the cases only one or two joints were involved, most often large joints such as knee, ankle and wrist. The symptoms were long-standing (2 months or longer) in two-thirds of the cases. Arthritis in connection with yersiniosis must therefore be considered a serious complication to an otherwise rather benign infection.

ABSTRACT. Bergstrand, C. G. and Wmblad, S. (Department of Paediatrics and Clinical Bacteriology, Malmö General Hospital, Malmö, Sweden). Clinical manifestations of infection with Yersinia enterocolitica in children. Acta Paediatr Scand,63: 875, 1974.—The case records of 31 hospitalized children infected with Yersina enterocolitica during the period January 1967 to September 1973 were retrospectively analysed. Most of the children were under 4 years of age, and all had been admitted with a diagnosis of gastroenteritis. The clinical picture was essentially the same as in other types of acute or subacute gastroenteritis and specific signs permitting a clinical diagnosis of Yersiniosis were not observed. The symptoms were of mild to moderate degree, and all patients had an uneventful recovery. Erythema nodosum and arthritis were not observed, and more severe abdominal pains, usually considered typical for older children and adults with Yersiniosis, registered in only 4 of the 31 patients.

Staphylococci with cell‐bound protein A reacted with sensitized sheep red cells in a simple slide reaction with agglutination. Extracellular protein A proved capable of preventing the sensitized sheep red cells from reacting with cultures of Staph, aureus strains containing protein A. This confirms the reactivity of protein A with free Fc‐fragments of IgG on the surface of the sensitized sheep red cells as the cause of haemagglutination. The choice of culture medium proved important for demonstrating protein A. Peptone‐free media proved clearly unsuitable. 341 routinely isolated strains of Staph. aureus were examined for agglutination of sensitized sheep red cells in the slide test and for tube‐agglutination of sensitized sheep red cells with broth culture filtrate. 88.3 per cent of the strains were positive if examined on slides, while 6.7 per cent of the strains contained no cell‐bound or free protein A demonstrable by either method. Among the methicillin resistant strains, 50 per cent showed no agglutination on slide. Antibiotic‐sensitive strains belonging to phage group II tended to have weaker protein A reactivity than other groups.

Acta Pathologica Microbiologica Scandinavica Section B Microbiology and ImmunologyVolume 81B, Issue 1 p. 179-180 SERO-TYPING OF MYCOBACTERIA BY A NEW TECHNIQUE USING ANTIBODY GLOBULIN ADSORBED TO STAPHYLOCOCCAL PROTEIN A Ingmar Juhlin, Ingmar Juhlin Institute of Clinical Bacteriology, University of Lund, General Hospital, Malmö, Sweden.Search for more papers by this authorSten Winblad, Sten Winblad Institute of Clinical Bacteriology, University of Lund, General Hospital, Malmö, Sweden.Search for more papers by this author Ingmar Juhlin, Ingmar Juhlin Institute of Clinical Bacteriology, University of Lund, General Hospital, Malmö, Sweden.Search for more papers by this authorSten Winblad, Sten Winblad Institute of Clinical Bacteriology, University of Lund, General Hospital, Malmö, Sweden.Search for more papers by this author First published: September 1973 https://doi.org/10.1111/j.1699-0463.1973.tb02203.xAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinked InRedditWechat No abstract is available for this article. Volume81B, Issue1September 1973Pages 179-180 RelatedInformation