Somatic Serogroups, Capsular Types, and Species of Fecal Klebsiella in Patients with Ankylosing Spondylitis

ABSTRACT The purpose of the present study was to find out whether patients with ankylosing spondylitis (AS) carry fecal Klebsiellastrains that belong to serotypes or species specific for AS. Somatic serotypes (O groups), capsular (K) serotypes, and biochemically identified species were determined for fecal klebsiellae isolated from 187 AS patients and 195 control patients. The controls were patients with fibromyalgia or rheumatoid arthritis. The 638 isolates ofKlebsiella that were obtained represented 161 strains; 81 from AS patients and 80 from the controls. The average number ofKlebsiella strains per patient was 1.7 for the AS group and 1.5 for the control group. The most common O group was O1, which was observed for isolates from 23 of 187 AS patients and 24 of 195 control patients. Next in frequency was group O2, which was observed for isolates from 17 AS patients and 15 control patients. Regarding the K serotypes, 59 different types were identified, revealing a heterogeneous representation of Klebsiella strains, without a predominance of any serotype. By biochemical identification,Klebsiella pneumoniae was the most frequently occurring species, being found in 45 AS patients and 45 control patients. Next in the frequency was K. oxytoca, which was observed in 26 AS patients and in 29 control patients. K. planticola andK. terrigena occurred in only a minority of patients. Altogether, when analyzed either separately or simultaneously according to O groups, K serotypes, and biochemically identified species, no evidence of the existence of AS-specific Klebsiella strains was obtained. These findings do not indicate participation ofKlebsiella in the etiopathogenesis of AS.

[1]  D. Hansen,et al.  Klebsiella pneumoniae Lipopolysaccharide O Typing: Revision of Prototype Strains and O-Group Distribution among Clinical Isolates from Different Sources and Countries , 1999, Journal of Clinical Microbiology.

[2]  M. Fielder,et al.  Antibodies to Klebsiella pneumoniae in Dutch patients with ankylosing spondylitis and acute anterior uveitis and to Proteus mirabilis in rheumatoid arthritis. , 1998, The Journal of rheumatology.

[3]  H. J. Kolmos,et al.  Epidemiology of Klebsiella bacteraemia: a case control study using Escherichia coli bacteraemia as control. , 1998, The Journal of hospital infection.

[4]  C. Whitfield,et al.  O-antigen seroepidemiology of Klebsiella clinical isolates and implications for immunoprophylaxis of Klebsiella infections , 1997, Clinical and diagnostic laboratory immunology.

[5]  R. Podschun,et al.  Clinical, bacteriological, and serological aspects of Klebsiella infections and their spondylarthropathic sequelae , 1997, Clinical and diagnostic laboratory immunology.

[6]  A. Cross,et al.  Evaluation of a competitive ELISA method for the determination of Klebsiella O antigens. , 1996, Journal of medical microbiology.

[7]  M. De Vos,et al.  The evolution of spondyloarthropathies in relation to gut histology. II. Histological aspects. , 1995, The Journal of rheumatology.

[8]  K. Meyer zum Büschenfelde,et al.  Klebsiella pneumoniae-reactive T cells in blood and synovial fluid of patients with ankylosing spondylitis. Comparison with HLA-B27+ healthy control subjects in a limiting dilution study and determination of the specificity of synovial fluid T cell clones. , 1995, Arthritis and rheumatism.

[9]  A. Toivanen,et al.  Role of micro-organisms in the pathogenesis of arthritis: lessons from reactive and Lyme arthritis. , 1995, Scandinavian journal of rheumatology. Supplement.

[10]  G. Burmester,et al.  Immunology of reactive arthritides. , 1995, Annual review of immunology.

[11]  B. Bröker,et al.  Serum antibodies to Klebsiella capsular polysaccharides in ankylosing spondylitis. , 1994, Arthritis and rheumatism.

[12]  D. Monnet,et al.  Method for differentiating Klebsiella planticola and Klebsiella terrigena from other Klebsiella species , 1994, Journal of clinical microbiology.

[13]  A. Ebringer Ankylosing spondylitis is caused by Klebsiella. Evidence from immunogenetic, microbiologic, and serologic studies. , 1992, Rheumatic diseases clinics of North America.

[14]  A. Russell,et al.  Ankylosing spondylitis is not caused by Klebsiella. , 1992, Rheumatic diseases clinics of North America.

[15]  N. Sharon,et al.  Lectinophagocytosis of encapsulated Klebsiella pneumoniae mediated by surface lectins of guinea pig alveolar macrophages and human monocyte-derived macrophages , 1991, Infection and immunity.

[16]  S. Jalkanen,et al.  Yersinia antigens in synovial-fluid cells from patients with reactive arthritis. , 1989, The New England journal of medicine.

[17]  R. Vuento,et al.  Association of persisting IgA response with yersinia triggered reactive arthritis: a study on 104 patients. , 1987, Annals of the rheumatic diseases.

[18]  S. Cryz,et al.  Seroepidemiology of Klebsiella bacteremic isolates and implications for vaccine development , 1986, Journal of clinical microbiology.

[19]  F. Matsubara,et al.  Latex Agglutination Text for O Serogrouping of Klebsiella Species , 1984, Microbiology and immunology.

[20]  I. Nakashima,et al.  Virulence for mice of Klebsiella strains belonging to the O1 group: relationship to their capsular (K) types , 1983, Infection and immunity.

[21]  J. Montgomerie Epidemiology of Klebsiella and hospital-associated infections. , 1979, Reviews of infectious diseases.

[22]  A. S. Edmondson,et al.  An investigation into the incidence and sources of klebsiella infections in hospital patients , 1979, Journal of Hygiene.

[23]  J. Palfreyman Klebsiella serotyping by counter-current immunoelectrophoresis , 1978, Journal of Hygiene.

[24]  R. E. Buchanan,et al.  Bergey's Manual of Determinative Bacteriology. , 1975 .

[25]  I. Orskov,et al.  Immunoelectrophoretic patterns of extracts from Escherichia coli O antigen test strains O1 to O157 examinations in homologous OK sera. Further comments on the classification of Escherichia K antigens. , 1972, Acta pathologica et microbiologica Scandinavica. Section B: Microbiology and immunology.

[26]  S. T. Cowan Bergey's Manual of Determinative Bacteriology , 1948, Nature.