1998 Clinical and Scientific Meeting

Butt HL [1,2], Dunstan RH [2], McGregor NR [2,3], Roberts TK [2], Zerbes M [2], and Klineberg IJ [3].

1 Collaborative Pain Research Unit (CPRU)
Division of Microbiology & Infectious Disease
Hunter Area Pathology Service
John Hunter Hospital
2 Department of Biological Sciences
University of Newcastle
3 Faculty of Dentistry
University of Sydney
Westmead Hospital

Alteration of the Bacterial Microbial Flora in Chronic Fatigue/Pain Patients

Forty-six patients presenting with chronic orofacial muscle pain and eight age and sex matched control subjects were investigated for the carriage prevalence and exotoxin production of coagulase negative staphylococcus (CNS) in respiratory and genitourinary samples. There was a significantly higher prevalence and multiple carriage of four or more strains of CNS in patients with chronic pain than with control subjects (23 vs 9 isolates/10 subjects; p<0.01). Similarly there was a significantly higher prevalence of membrane damaging toxin production (p < 0.04) by CNS recovered from chronic pain patients compared with those from control subjects. None of the control subjects were colonized with CNS that produced significant amount of membrane damaging toxins.

In a separate study, chronic fatigue/pain (CFS) patients expressed frequent gastrointestinal symptoms (irritable bowel, constipation, abdominal pain, diarrhea, nausea) suggesting the possibility of an altered microbial flora in the gastrointestinal tract. Faecal samples from 27 polysymptomatic chronic fatigue/pain (CFS) patients and four control subjects were examined. Seventeen (62.9%) CFS patients had a low % distribution of Escherichia coli but only 7 (25.9%) had a low % distribution of Bacteroides spp..This difference is significant (p < 0.004). Investigation into the microbial metabolites produced by E.coli and other enteric microorganisms shown that these organisms were able to produce variable quantity of amino and organic acids previously demonstrated to be deficient in CFS patients. These results demonstrated the presence of an altered microbial flora in the respiratory and gastrointestinal tract of polysymptomatic CFS patients and may assist the understanding of the metabolic changes in these patients determined in previous studies.


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