Unexplained diarrhoea in HIV-1 infected individuals

Oude Munnink, Bas B; Canuti, Marta; Deijs, Martin; de Vries, Michel; Jebbink, Maarten F; Rebers, Sjoerd; Molenkamp, Richard; van Hemert, Formijn J; Chung, Kevin; Cotten, Matthew; Snijders, Fransje; Sol, Cees JA; van der Hoek, Lia

To isolate Salmonella and Shigella species, fresh stool specimens (within 4 hours after specimen collection) were plated on cystine lactose electrolyte-deficient medium (Brocalin agar; Merck, Darmstadt, Germany), Salmonella-Shigella agar (Merck), Hektoen enteric agar (Difco, Detroit), Rappaport medium (Difco), MacConkey agar (Becton Dickinson, Cock-eysville, MD) and gram-negative broth (Hajna; Difco) as enrichment. A selective cefsulodin-irgasan-novobiocin medium (Oxoid, Basingstoke, Hampshire, England) and a glucose broth enrichment medium were used to isolate Yersinia species. Isolates were further characterized by using conventional bacteriologic methods, as outlined [35] . A cell-culture assay was used to detect Clostridium difficile toxin [36] . The Campylobacter-selective medium (modified Butzler medium) consisted of a solid 7% hemolyzed sheep blood-based agar (nutrient broth no.