Single specimens of diarrhoeal stool from 676 patients, mostly aboriginals aged less than 5 years, admitted to Alice Springs Hospital, central Australia, for diarrhoea between Sept. 1988 and Feb. 1989, were examined for Campylobacter spp. by culture on a blood-free medium with selective supplement (BFM; Oxoid) and blood agar overlaid with a membrane filter (FM). Campylobacter spp. were isolated on either BFM or FM or both from 225 patients. Campylobacter spp. were isolated on BFM alone from 75 patients and on FM alone from 213 patients (p less than 0.001; chi 2 test). Most campylobacters isolated on BFM were C. jejuni. All C. jejuni subsp. doylei, all "C. upsaliensis" except one, all C. laridis, C. fetus subsp. fetus and several uncharacterised Campylobacter isolates were isolated on FM only. C. jejuni was isolated on BFM but not FM from several patients, and vice versa. Serotyping of C. jejuni and C. coli isolated from both media showed the serotypes recovered from the two media to be different in some patients. In some patients concurrent infection with several species or serotypes (up to five) of Campylobacter, or both, was shown for the first time by the use of FM. We conclude that the use in combination of a selective medium and a non-selective medium with a filtration technique are better than either medium alone for the isolation of Campylobacter spp.

To observe the prevalence, disease associations, and temporal trends in Trichuris trichiura (whipworm) infection in the Northern Territory between 2002 and 2012. Retrospective observational analysis of consecutive microbiologically confirmed cases of T. trichiura infection among members of the NT population from whom a faecal sample was obtained for testing by NT Government health care facilities between 1 January 2002 and 31 December 2012. Annual prevalence of T. trichiura infection; age, sex, Indigenous status and place of residence of infected patients; percentage of infected patients with anaemia (haemoglobin level, ≤ 110 g/L) and eosinophilia (eosinophil count, ≥ 0.5 × 10(9)/L). 417 episodes of T. trichiura infection were identified over the 11 years from 63 668 faecal samples. The median age of patients was 8 years (interquartile range [IQR], 3-36 years). Patients were predominantly Indigenous (95.3%; P = 0.001) and from three main geographical areas (Victoria Daly, East Arnhem Land and West Arnhem Land). Infections were associated with anaemia (40.2%) and eosinophilia (51.6%). There was a downward trend in the prevalence of T. trichiura infection diagnosed at NT Government health care facilities, from 123.1 cases (95% CI, 94.8-151.3 cases) per 100,000 Indigenous population in 2002 to 35.8 cases (95% CI, 21.8-49.9 cases) per 100,000 Indigenous population in 2011. T. trichiura is the most frequently identified soil-transmitted helminth infecting patients in NT Government health care facilities. Cases are identified predominantly in Indigenous patients in remote communities. We have observed a declining prevalence of whipworm infection in the NT.

Tree frogs commonly access drinking water tanks; this may have human health implications. Although amphibians might not be expected to host mammalian faecal indicator bacteria (FIB), it is possible that they may have human FIB on their skin after exposure to human waste. We collected faeces and skin wash from green tree frogs (Litoria caerulea) from a natural environment, a suburban site, and a suburban site near a creek occasionally contaminated with sewage effluent. We used molecular techniques to test for FIB that are routinely used to indicate human faecal contamination. Enterococci colonies were isolated from both faecal and skin wash samples, and specific markers (Enterococcus faecium and Bacteroides thetaiotaomicron) were found in frog faeces, demonstrating that these markers are not human- or mammalian-specific. Bacteroides thetaiotaomicron was detected in frogs from both natural and urban sites, but E. faecium was only associated with the sewage impacted site.

Parasitic infections can adversely impact health, nutritional status and educational attainment. This study investigated hookworm and other intestinal parasites in an Aboriginal community in Australia from 1994 to 1996. Seven surveys for intestinal parasites were conducted by a quantitative formol-ether method on faecal samples. Serological testing was conducted for Strongyloides stercoralis and Toxocara canis IgG by enzyme-linked immunosorbent assays. Of the 314 participants, infections were as follows: Trichuris trichiura (86%); hookworm, predominantly Ancylostoma duodenale (36%); Entamoeba spp. (E. histolytica complex [E. histolytica, E. dispar and E. moskovski], E. coli and E. hartmanni) (25%); S. stercoralis (19%); Rodentolepis nana (16%); and Giardia duodenalis (10%). Serological diagnosis for 29 individuals showed that 28% were positive for S. stercoralis and 21% for T. canis. There was a decrease in the proportion positive for hookworm over the two-year period but not for the other parasite species. The presence of hookworm, T. trichiura and Entamoeba spp. was significantly greater in 5-14 year olds (n = 87) than in 0-4 year olds (n = 41), while the presence of S. stercoralis, R. nana, G. duodenalis and Entamoeba spp. in 5-14 year olds was significantly greater than 15-69 year olds (n = 91). Faecal testing indicated a very high prevalence of intestinal parasites, especially in schoolchildren. The decrease in percentage positive for hookworm over the two years was likely due to the albendazole deworming programme, and recent evidence indicates that the prevalence of hookworm is now low. However there was no sustained decrease in percentage positive for the other parasite species.

To determine the prevalence of Salmonella in the environment of case and control houses, and compare serovars isolated from cases and their houses. From 2005 to 2008, we tested samples from houses of 0-4 year old cases and community controls in Darwin and Palmerston for Salmonella. Case isolates were compared with environmental isolates. S. Ball and S. Urbana isolates were compared using Multiple Amplification of Phage Locus Typing (MAPLT) and Multiple-Locus Variable number of tandem repeat Analysis (MLVA). Salmonella were found in 47/65 (72%) case houses and 18/29 (62%) control houses; these proportions were not significantly different. In 21/47 (45%) houses, case and environmental isolates (from animal faeces, soil and vacuums) were indistinguishable. Multiple serovars were isolated from 20 (31%) case and 6 (21%) control houses. All but one environmental isolate are known human pathogens in the Northern Territory (NT). Each of the four pairs of S. Ball and S. Urbana were indistinguishable. Animal faeces were the most likely source of salmonellosis in cases. The similar prevalence of house isolates suggests that Salmonella is ubiquitous in this environment. The distinction of S. Ball and S. Urbana subtypes enabled linkage of human illness to environmental exposure. Environmental contamination with Salmonella is an important source of sporadic infection in children in the tropics.

Campylobacter jejuni and/or Campylobacter coli was cultured from 218 of 1,078 patients of all age groups admitted to Alice Springs Hospital, Alice Springs, central Australia, between July 1988 and June 1989 for treatment of diarrhea. One hundred sixty-six Campylobacter colonies from 127 patients were subjected to O serotyping by using the Penner typing scheme. All except 29 colonies could be serotyped. A total of 46 serotypes were identified, and the predominant serotypes were O:8, 17, O:22, O:1,44, and O:19. A large proportion of colonies reacted with more than one antiserum, and nine serotypes had antigenic compositions not observed previously. Several patients had multiple infections with more than one serotype, and some patients were shown for the first time to be infected with up to three different serotypes. Repeated reinfections with different serotypes were seen in some patients. In some patients, provided it was not due to reinfection with the same serotype, long-term excretion of the same serotype was seen, and for the first time, one patient showed evidence of excretion of the same serotype for up to 73 days.