Historically, non-combat injuries and illnesses have had a significant impact on military missions. We conducted an anonymous cross-sectional survey to assess the prevalence and impact of common ailments among U.S. military personnel deployed to Iraq or Afghanistan during 2003-2004. Among 15,459 persons surveyed, diarrhea (76.8% in Iraq and 54.4% in Afghanistan), respiratory illness (69.1%), non-combat injuries (34.7%), and leishmaniasis (2.1%) were commonly reported. For all causes, 25.2% reported that they required intravenous fluids, 10.4% required hospitalization, and 5.2% required medical evacuation. Among ground units, 12.7% reported that they missed a patrol because of illness, and among air units, 11.7% were grounded because of illness. The incidence of diarrhea and respiratory infections doubled from the pre-combat to combat phases, and the perceived adverse impact of these illnesses on the unit increased significantly during the combat phase. Despite technologic advances in warfare and preventive medicine, illness and non-combat injuries have been common during operations in Iraq and Afghanistan, resulting in frequent transient decreases in operational efficiency.

A role for DnaK, the major E. coli Hsp70, in chaperoning de novo protein folding has remained elusive. Here we show that under nonstress conditions DnaK transiently associates with a wide variety of nascent and newly synthesized polypeptides, with a preference for chains larger than 30 kDa. Deletion of the nonessential gene encoding trigger factor, a ribosome-associated chaperone, results in a doubling of the fraction of nascent polypeptides interacting with DnaK. Combined deletion of the trigger factor and DnaK genes is lethal under normal growth conditions. These findings indicate important, partially overlapping functions of DnaK and trigger factor in de novo protein folding and explain why the loss of either chaperone can be tolerated by E. coli.

Cj0859c, or FspA, is a small, acidic protein ofCampylobacter jejunithat is expressed by a σ28promoter. Analysis of thefspAgene in 41 isolates ofC. jejunirevealed two overall variants of the predicted protein, FspA1 and FspA2. Secretion of FspA occurs in broth-grown bacteria and requires a minimum flagellar structure. The addition of recombinant FspA2, but not FspA1, to INT407 cells in vitro resulted in a rapid induction of apoptosis. These data define a novelC. jejunivirulence factor, and the observed heterogeneity amongfspAalleles suggests alternate virulence potential among different strains.

The urea breath test and HpSTAR stool antigen kit are reliable tests for the noninvasive diagnosis of H. pylori among children living in the Middle East.

Antimicrobial susceptibility testing was performed on 48 isolates of Helicobacter pylori recovered from Egyptian children undergoing routine endoscopies. The isolates were universally highly resistant to metronidazole, but resistance to other tested antimicrobial agents was rare (4% for clarithromycin, erythromycin, and azithromycin resistance versus 2% for ciprofloxacin and ampicillin resistance). Use of metronidazole for the treatment of H. pylori in Egypt should be avoided.Helicobacter pylori is currently recognized as one of the most common chronic bacterial infections worldwide (6). While the majority of infections are asymptomatic (12, 13), the association of H. pylori colonization of the stomach with chronic gastritis, peptic ulcer disease, and gastric malignancies is now well documented in both adults and children (11,18). Eradication of bacteria is effective in healing peptic ulcers, preventing ulcer relapses, and potentially decreasing the risk of progression to gastric carcinoma (7,9,16). Current practice dictates treatment of symptomatic individuals with a regimen containing two antimicrobial agents along with a proton pump inhibitor (18). For successful eradication of bacteria, it is imperative that the clinician be aware of the current antimicrobial susceptibility profiles of isolates within the region. Therefore, this study was initiated to determine antimicrobial susceptibility patterns among H. pylori isolates recovered from children in Egypt.Children aged 2 to 17 years requiring endoscopy for evaluation of their gastrointestinal complaints were enrolled in this study. Prior to endoscopy, written informed consent was obtained from the parent of the study subject allowing their child to be enrolled. Children who had taken antimicrobials, antacids, H 2 blockers, proton pump inhibitors, or bismuth subsalicylate within the 4 weeks prior to endoscopy were excluded from the study. Similarly, children with a history of infection with H. pylori, a known bleeding disorder, or previous endoscopy were also excluded from the study. At the time of endoscopy, a gastric antral biopsy sample was obtained for culture and stored in normal saline on ice until delivered to the laboratory within 2 to 3 h of collection. The biopsy sample was ground using a sterile, disposable plastic pestle and inoculated onto Columbia agar (Campy-Pak Systems; Becton Dickinson, BBL, Cockeysville, Md.) plates enriched with 5% sheep blood, one of which was supplemented with antimicrobials to selectively inhibit growth of bacteria other than H. pylori. Cultures were incubated at 37°C under microaerophilic conditions. H. pylori isolates were harvested, suspended in tryptic soy broth with 15% glycerol, and stored frozen at Ϫ70°C pending further testing.Antimicrobial susceptibilities to erythromycin, clarithromycin, azithromycin, ciprofloxacin, ampicillin, and metronidazole were tested by using antimicrobial impregnated strips (E-test; AB Biodisk, Solna, Sweden). H. pylori isolates were thawed, inoculated onto Columbia agar, and incubated ...