Increased Recovery of Klebsiella from the Gastrointestinal Tract of Reiter's Syndrome and Ankylosing Spondylitis Patients

Because of the known association between Gram-negative enteric bacteria and certain seronegative arthropathies. the bowel flora was examined in 59 Native Americans: 25 with ankylosing spondylitis. 18 with Reiter's syndrome and 16 healthy controls. Of the 43 ankylosing spondylitis and Reiter's syndrome patients, 35 (81%) were HLA-B27 positive. A significant difference in the isolation of Klebsiella from the stools of ankylosing spondylitis and Reiter's syndrome patients was noted only when the patients were divided on the basis of disease activity. Klebsiella was isolated from 14 of 26 (54%) patients with either active ankylosing spondylitis or active Reiter's syndrome, compared to two of 16 (13%) controls (p = 0.0077) and two of 17(12%)patients with inactive disease (p = 0.0055). The role of Klebsiella in the pathogenesis of HLA-B27 arthropathies is unknown, but recent literature would suggest an immunologic interaction between the antigens of Klebsiella and those of the histocompatibility complex.