In feces of six patients with antibiotics-associated colitis,
Klebsiella oxytoca was purely detected without culture of
Clostridium difficile. Representative strains of
K. oxytoca from each patient were reserved. Endoscopic biopsy-specimens in active stage showed significant decrease of secreting component (SC) and IgA in the diseased portions but not in the healthy portions, according to the immunofluorescent method. At the same time, the same specimens in active stage showed significant decrease of mucus (glycoproteins) in the diseased portions but not in the healthy portions using the anti-human mucusantisera in the indirect immunofluorescent method. After recovery, further endoscopic biopsy-specimens in the previously diseased portions were obtained; epithelial cells were then scraped from the specimens and were suspended in the phosphate buffer.
K. oxytoca from each patient and the corresponding epithelial cells were incubated. Adherence of bacteria on cells was observed under a phase-contrast microscope and numbers of adhesive bacteria were counted. Compared with control bacteria,
K. oxytoca showed remarkable attachment on colonic epithelial cells. The fluorescent microscopic examination of the colonic lesions of the patients showed remarkable decrease in SC, IgA, and mucus. These results suggested the possibility of colonization of the bacteria on the epithelial cells as an offensive factor and breakdown of mucosal barriers as a defensive factor. Whether initiation of breakdown of barriers is produced by the bacteria is not conclusive. However,
K. oxytoca might have a relationship with pathogenesis of antibioticsassociatedcolitis.
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