THE LANCET • Vol 363 • June 12, 2004 • www.thelancet.com
Background Laribacter hongkongensis has been recovered
from several patients with gastroenteritis. However, the
causative role of this organism in human gastroenteritis is
still unproven, and sources of the bacterium are unknown.
We undertook a multicentre case-control study to investigate
the association of L hongkongensis with gastroenteritis.
Methods Faecal samples from patients with community-
acquired gastroenteritis and controls were cultured for
L hongkongensis. Targeted food surveillance was done to
identify potential sources of this bacterium. All isolates of this
organism from patients and food items were characterised by
pulsed-field gel electrophoresis and ribotyping.
Findings During a 4-month period, L hongkongensis was
recovered from 17 of 3788 patients with community-acquired
gastroenteritis, but was absent in 1894 controls (p=0·001).
Those who were culture-positive for this bacterium had a
recent history of travel (ten [59%] patients vs two [6%] of 34
matched controls, p<0·0001), of fish consumption (16 [94%]
vs 19 [56%], p=0·009), and of eating minced freshwater fish
meat (five [29%] vs one [3%], p=0·012). We recovered
25 L hongkongensis
isolates from intestinal samples of
freshwater fish and two from minced freshwater fish meat.
Bacteria with the same pulsed-field gel electrophoretic
pattern and ribotype were recovered from one patient and a
sample of minced freshwater fish meat, which was from the
same retail market recently visited by the patient. We did not
see this particular combination of electrophoretic pattern and
ribotype in any other isolates.
Interpretation L hongkongensis
is associated with
community-acquired gastroenteritis and traveller’s diarrhoea.
However, its causative role has not been shown. Freshwater
fish is one source of this bacterium.
Lancet 2004; 363: 1941–47
See Commentary page 1923
Laribacter hongkongensis, a novel genus and species, was
first isolated in Hong Kong in 2001 from