Relationship of Campylobacter toxigenicity in vitro to the development of postinfectious irritable bowel syndrome

Campylobacter enteritis is associated with a significant risk of developing irritable bowel syndrome, but the mechanism is unknown. This study ascertained bowel symptoms in 93 patients 3 months after Campylobacter jejuni enteritis infection. The infecting organisms were cultured, and the effects of culture supernatants on toxin-sensitive epithelial cell monolayers (HEp-2, Green monkey kidney epithelial [Vero], and CHO-K1) were investigated. In all, 50, 43, and 41 of the isolates showed toxigenic effects on HEp-2, CHO-K1, and Vero cells, respectively. Persistently changed bowel habit was reported by 9 of 50 persons with HEp-2 toxin-positive infections but by only 2 of 43 with isolates negative for toxin (chi (2) = 4.0; P < .05). Toxicity to HEp-2 and Vero cells was associated with significantly increased numbers of days with loose stools 6 months after C. jejuni enteritis infection (both, P < .05). Thus, long-term symptoms that occur Campylobacter infection are significantly associated with bacterial toxicity.