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Volume 53,
Issue 12,
2004
Volume 53, Issue 12, 2004
- Pathogenicity And Virulence
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Evaluation of lipopolysaccharide and capsular polysaccharide as subunit vaccines against experimental melioidosis
Burkholderia pseudomallei is the causative agent of melioidosis, which is a major cause of morbidity and mortality in endemic regions. Currently there is no human vaccine against melioidosis. In this study, LPS or capsular polysaccharide was used to immunize BALB/c mice. The different polysaccharide antigens induced antibody responses. Mice vaccinated with LPS developed predominantly IgM and IgG3 responses. Contrastingly, mice vaccinated with capsular polysaccharide developed a predominantly IgG2b response. After immunization, mice were challenged by the intra-peritoneal route and an increased mean time to death was observed compared with unvaccinated controls. Immunization with LPS provided an optimal protective response. Mice challenged by the aerosol route showed a small increase in the mean time to death compared with the unvaccinated controls. The passive transfer of antigen from immunized into naïve mice provided protection against a subsequent challenge. This study is the first time antigens protective by active immunization have been identified and suggests that polysaccharides have potential as vaccine candidates against melioidosis.
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- Host Response
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Investigation of anti-Toxoplasma gondii antibodies in patients with neoplasia
More LessThis study aimed to determine the prevalence of anti-Toxoplasma gondii antibodies in patients with neoplasia. One hundred and eight patients with neoplasia and 108 healthy controls were studied for the presence of anti-T. gondii antibodies using a micro ELISA and peroxidase-labelled anti-human IgG (rabbit) and IgM (goat). Anti-T. gondii IgG antibodies were detected in 68 (63.0 %) patients and in 21 (19.4 %) of the controls, which was a statistically significant difference. In addition, anti- T. gondii IgM antibodies were detected in seven (6.5 %) patients and in one (0.9 %) control. A high percentage of positivity for Toxoplasma antibodies in patients with neoplasia was detected. Therefore, parasitological surveys of this patient group should be periodically performed.
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Chlamydophila pneumoniae induces p44/p42 mitogen-activated protein kinase activation in human fibroblasts through Toll-like receptor 4
More LessChlamydophila pneumoniae, an obligately intracellular Gram-negative bacterium and a common causative agent of respiratory tract infections, has been implicated in the induction and progression of atherosclerosis and coronary artery disease. In this study, the signalling mechanism of C. pneumoniae in human fibroblasts, a prominent cell population in chronic inflammation and persistent infection, contributing to plaque formation, was investigated. C. pneumoniae elementary bodies were demonstrated to up-regulate the phosphorylation of p44/p42 mitogen-activated protein kinase (MAPK) in human fibroblasts. The effect was independent of the chlamydial lipopolysaccharide and was likely to be mediated by a heat-labile chlamydial protein. Furthermore, an anti-Toll-like receptor 4 (TLR4) antibody was shown to abolish C. pneumoniae-induced cell activation, whereas an anti-TLR2 antibody had no effect, indicating the role of TLR4 in p44/p42 MAPK activation. Ca2+/calmodulin-dependent protein kinase inhibitor KN-62 and phosphodiesterase 4 (PDE 4) inhibitor Rolipram enhanced C. pneumoniae-induced MAPK phosphorylation and attenuated C. pneumoniae infectivity in vitro. Together the results indicate that C. pneumoniae triggers rapid TLR4-mediated p44/p42 MAPK activation in human fibroblasts and chemical enhancement of MAPK phosphorylation modulates in vitro infection at the molecular level.
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- Diagnostics, Typing And Identification
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Evaluation of phenotypic methods for methicillin resistance characterization in coagulase-negative staphylococci (CNS)
Coagulase-negative staphylococci (CNS) are the major cause of nosocomial infections. Methicillin-resistant strains are particularly important because they narrow therapeutic options. Detecting methicillin resistance among CNS has been a challenge for years. The objective of this study was to determine the accuracy of an agar screening test (0.6 and 4 μg oxacillin ml−1), disc diffusion and the automated MicroScan system to characterize methicillin resistance among CNS. One hundred and seventy five strains were analysed: 41.1 % Staphylococcus epidermidis and 59.9 % other species; 69.1 % were mecA-positive. The results showed that the methods have optimal correlation with the detection of mecA gene for S. epidermidis, Staphylococcus hominis and Staphylococcus haemolyticus. However, accuracy of the tests is impaired when less common species are analysed. The only 100 % accurate test was agar screening with 4 μg oxacillin ml−1.
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Quantification and assessment of viability of Cryptococcus neoformans by LightCycler amplification of capsule gene mRNA
More LessCryptococcus neoformans is an opportunistic fungal pathogen. It infects the central nervous system causing meningitis, which is fatal if untreated, especially in AIDS and immunosuppressed patients. In this study a method of quantification and assessment of viability of C. neoformans by LightCycler RT-PCR amplification of the capsule gene mRNA is established. The sequence of primers and probes were derived from C. neoformans capsular CAP10 gene mRNA (GenBank accession number AF144574), and were species specific. Agarose gel electrophoresis analysis of LightCycler RT-PCR product showed a single band of 223 bp in length. In order to develop an internal control a 223 bp exon fragment of capsule mRNA was cloned in the pCR2.1 plasmid vector and RNA was generated by in vitro transcription. To determine the sensitivity of the assay, serial dilutions of in vitro-transcribed RNA with known concentrations and copy numbers, and serially diluted cultures of viable and nonviable C. neoformans were used. Under optimal conditions as little as 0.472 fg of capsule mRNA could be detected, corresponding to 1–10 c.f.u. ml−1 of the sample. No amplification was observed from up to105 heat/UV radiation-killed yeast cells and RNA of other bacterial and fungal pathogens and human genomic DNA or RNA. The amplification of capsule mRNA represents a sensitive, specific and quantitative means of detection of viable C. neoformans in clinical specimens and can be useful in the evaluation of the therapeutic efficacy of antifungal drugs in the treatment of C. neoformans meningitis.
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Rapid identification and differentiation of fungal DNA in dermatological specimens by LightCycler PCR
More LessThe aim was to develop a LightCycler PCR method for the rapid detection and differentiation of fungal DNA in dermatological specimens such as skin scales and skin swabs. LightCycler PCR assays were established for seven primer sets specific for fungal DNA. For each primer set LightCycler melting points were defined by amplification of DNA from 21 fungi and sensitivity was determined by amplification of serial dilutions of fungal DNA. A protocol was established that allows detection and differentiation of mould and yeast DNA with one highly sensitive PCR reaction by assessment of LightCycler melting points. Two subsequent LightCycler PCR reactions and one RFLP reaction allowed the differentiation of dermatophytes and non-dermatophyte moulds and the subclassification of yeasts. Analysis of clinical samples from 38 patients with fungal skin diseases provided conclusive new diagnostic information in 9/38 cases (23.7 %) by this PCR protocol that was not equally provided by direct microscopy and mycological culture. Thus the LightCycler PCR protocol established here represents a rapid diagnostic tool that aids in the diagnosis of fungal skin disease in a substantial number of patients.
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Prospective evaluation of BDProbeTec strand displacement amplification (SDA) system for diagnosis of tuberculosis in non-respiratory and respiratory samples
More LessNucleic acid amplification techniques (NAATs) have been demonstrated to make significant improvements in the diagnosis of tuberculosis (TB), particularly in the time to diagnosis and the diagnosis of smear-negative TB. The BD ProbeTec strand displacement amplification (SDA) system for the diagnosis of pulmonary and non-pulmonary tuberculosis was evaluated. A total of 689 samples were analysed from patients with clinically suspected TB. Compared with culture, the sensitivity and specificity for pulmonary samples were 98 and 89 %, and against final clinical diagnosis 93 and 92 %, respectively. This assay has undergone limited evaluation for non-respiratory samples and so 331 non-respiratory samples were tested, identifying those specimens that were likely to yield a useful result. These were CSF (n = 104), fine needle aspirates (n = 64) and pus (n = 41). Pleural fluid (n = 47) was identified as a poor specimen. A concern in using the SDA assay was that low-positive samples were difficult to interpret; 7.8 % of specimens fell into this category. Indeed, 64 % of the discrepant results, when compared to final clinical diagnosis, could be assigned as low-positive samples. Specimen type did not predict likelihood of a sample being in the low-positive zone. Although the manufacturers do not describe the concept of a low-positive zone, we have found that it aids clinical diagnosis.
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The Bartonella henselae sucB gene encodes a dihydrolipoamide succinyltransferase protein reactive with sera from patients with cat-scratch disease
More LessBartonella henselae is a recently recognized pathogenic bacterium associated with cat-scratch disease, bacillary angiomatosis and bacillary peliosis. A recombinant clone expressing an immunoreactive antigen of B. henselae was isolated by screening a genomic DNA cosmid library by Western blotting with sera pooled from patients positive for B. henselae IgG antibodies by indirect immunofluorescence (IFA). The deduced amino acid sequence of the 43.7 kDa encoded protein was found to be 76.3 % identical to the dihydrolipoamide succinyltransferase enzyme (SucB) of Brucella melitensis. SucB has been shown to be an immunogenic protein during infections by Brucella melitensis, Coxiella burnetii and Bartonella vinsonii. The agreement between reactivity with a recombinant SucB fusion protein on immunoblot analysis and the results obtained by IFA was 55 % for IFA-positive sera and 88 % for IFA-negative sera. Cross-reactivity was observed with sera from patients with antibodies against Brucella melitensis, Mycoplasma pneumoniae, Francisella tularensis, Coxiella burnetii and Rickettsia typhi.
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- Antimicrobial Agents And Chemotherapy
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Antimicrobial susceptibility testing of vancomycin-resistant Enterococcus by the VITEK 2 system, and comparison with two NCCLS reference methods
We evaluated the automated VITEK 2 system (bioMérieux) for antimicrobial susceptibility testing of vancomycin-resistant Enterococcus (VRE). The results obtained with the VITEK 2 system were compared to those obtained using two NCCLS reference methods. The VITEK 2 system produced MICs for penicillin G, erythromycin and vancomycin that were very similar to those of the reference agar-dilution test with all results being within a twofold dilution. When MICs of teicoplanin for these isolates were measured by the agar-dilution method and VITEK 2 system, there was one ‘very major’ error and seven ‘minor’ errors. There were no ‘major’ errors for any of the antibiotics tested. When the results obtained by the micro broth-dilution method were compared with those obtained by the VITEK 2 system, there was one ‘very major’ error for teicoplanin by the VITEK 2 system, as was the case with the agar-dilution method. There were two ‘minor’ errors for erythromycin and seven ‘minor’ errors for teicoplanin. There were no ‘major’ errors for any of the antibiotics tested. The 35 VRE strains identified phenotypically by the VITEK 2 Advanced Expert System included nine of Enterococcus faecalis and 23 of Enterococcus faecium. Neither Enterococcus avium nor Enterococcus hirae were identified. A total of 32 phenotypes were classified into 22 VanA and 10 VanB strains. PCR genotyping demonstrated 23 vanA + and nine vanB + strains. There were differences between the VITEK 2 system results and those of PCR. Overall, 54.3 % of the test results were obtained within 7 h. All MIC values for the 35 VRE isolates were determined within 13 h of completing incubation. The VITEK 2 system is a simple method for accurately detecting vancomycin-resistant strains of Enterococcus and can be used to rapidly determine MICs.
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Diversity of aminoglycoside-resistance genes and their association with class 1 integrons among strains of pan-European Acinetobacter baumannii clones
More LessThe purpose of the present study was to investigate the diversity of the genes encoding aminoglycoside-modifying enzymes and their association with class 1 integrons in three pan-European clones of Acinetobacter baumannii. The study collection included 106 multidrug-resistant strains previously allocated to clone I (n = 56), clone II (n = 36) and clone III (n = 6) and a heterogeneous group of other strains (n = 8), using AFLP fingerprinting and ribotyping. The strains were from hospitals of the Czech Republic (n = 70; collected 1991–2001) and 12 other European countries (n = 36; 1982–1998). Using PCR, at least one of the following aminoglycoside-resistance genes was detected in 101 (95 %) strains: aphA1 (n = 76), aacC1 (n = 68), aadA1 (n = 68), aphA6 (n = 55), aadB (n = 31), aacC2 (n = 7) and aacA4 (n = 3). A combination of two to five different resistance genes was observed in 89 strains (84 %), with a total of 12 different combinations. PCR mapping revealed that aacC1, aadA1 and aacA4 were each associated with a class 1 integron, as was the case with aadB for six strains of clone III. Six different class 1 integron variable regions were detected in 78 strains (74 %), with two predominant regions (2.5 and 3.0 kb) in two sets of 34 strains each. The 3.0 kb region contained five gene cassettes (aacC1, orfX, orfX, orfX′, aadA1) and differed from the 2.5 bp region only by one additional orfX cassette. These two integron regions were confined to clones I and II and were found in strains isolated in seven countries between 1982 and 2001. The clone III strains were homogeneous both in resistance genes and in integron variable regions, whereas clones I and II showed a remarkable intraclonal diversity of these properties, with no clear-cut difference between the two clones. Yet, within the Czech clone I and II strains, the diversity of resistance genes and integron structures was limited as compared to those from other countries. The occurrence of identical resistance genes, gene combinations and class 1 integrons associated with these genes in clonally distinct strains indicates that horizontal gene transfer plays a major role in the dissemination of aminoglycoside resistance in A. baumannii.
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- Epidemiology
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Antimicrobial resistance of invasive Streptococcus pneumoniae isolates in a British district general hospital: the international connection
Between January 2000 and March 2001, Streptococcus pneumoniae were isolated from the blood of 56 patients admitted to a single district general hospital in the South-East of England. The serotype and antibiotic susceptibility were determined for all isolates and, for those resistant to erythromycin, the presence or absence of the mef(A) and erm(B) genes was determined by PCR. Multi-locus sequence typing, along with PFGE, was undertaken on all isolates resistant to penicillin or erythromycin and a group of antibiotic-susceptible isolates, to identify whether globally distributed pneumococcal clones, as described by the Pneumococcal Molecular Epidemiology Network (PMEN), were present in the study population. Three serotype 9V penicillin-resistant isolates were identified as belonging to the Spain9V-3 clone, while 14 erythromycin-resistant isolates of serotype 14 belonged to the England14-9 clone. A single multi-resistant isolate of serotype 6B, was found to be a single-locus variant of the Spain6B-2 clone. All 14 erythromycin-resistant serotype 14 isolates possessed the mef(A) gene, while the single multi-resistant isolate possessed the erm(B) gene. These findings confirm the wide distribution and clinical impact of PMEN clones, which accounted for all of the penicillin and erythromycin resistance observed amongst invasive isolates in a district general hospital over a 15-month period.
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- Clinical Microbiology And Virology
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Anaerobic, non-sporulating, Gram-positive bacilli bacteraemia characterized by 16S rRNA gene sequencing
More LessOwing to the difficulties in identifying anaerobic, non-sporulating, Gram-positive bacilli in clinical microbiology laboratories, the epidemiology and clinical spectrum of disease of many of these bacteria have been poorly understood. The application of 16S rRNA gene sequencing in characterizing bacteraemia due to anaerobic, non-sporulating Gram-positive bacilli during a 4-year period is described. The first case of Olsenella uli bacteraemia, in a patient with acute cholangitis, is also reported. Among 165 blood culture isolates of anaerobic, Gram-positive bacilli, 75 were identified as Propionibacterium acnes by phenotypic tests and 21 as members of other anaerobic, non-sporulating Gram-positive bacilli by 16S rRNA gene sequencing. Of these 96 isolates, 16 (17 %) were associated with cases of clinically significant bacteraemia, among which 10 (63 %) were caused by Eggerthella, four (25 %) by Lactobacillus and one (6 %) by each of Eubacterium tenue and O. uli. Five of the 10 Eggerthella isolates were Eggerthella lenta, whereas the other five belonged to two novel Eggerthella species, with Eggerthella hongkongensis being almost as prevalent as Eggerthella lenta. Underlying disease in the gastrointestinal tract, isolation of Eggerthella and Lactobacillus, and monomicrobial bacteraemia were associated with clinically significant bacteraemia, whereas isolation of P. acnes and polymicrobial bacteraemia were associated with pseudobacteraemia. Most patients with clinically significant bacteraemia had underlying diseases, with diseases in the gastrointestinal tract being most common. The overall mortality rate was 31 %. Immunocompromised patients with clinically significant bacteraemia due to anaerobic, non-sporulating, Gram-positive bacilli other than P. acnes should be treated with appropriate antibiotics. The unexpected frequency of isolation of Eggerthella from blood cultures and its association with clinically significant disease suggest that this genus is probably of high pathogenicity. Further studies to look for specific virulence factors are warranted.
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- Case Reports
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Splenic complications in malaria: report of two cases from Turkey
M F Ozsoy, O Oncul, Z Pekkafali, A Pahsa and O S YenenMalaria is still a major health problem in Turkey, where Plasmodium vivax malaria is endemic. Spontaneous rupture of the spleen is an important and life-threatening complication and occurs in up to an estimated 2 % of cases. Hence the small number of case reports suggests under-reporting or underdiagnosis. Review articles have reported only 18 malaria cases with spontaneous splenic rupture in the English language literature since 1960. Two cases of P. vivax malaria with splenic complications are reported here. One of them showed signs and symptoms of acute abdominal pain, then splenic rupture occurred.
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Percutaneous exposure resulting in laboratory-acquired leptospirosis – a case report
More LessA screw-capped glass tube containing a Leptospira culture accidentally broke and the laboratory worker who was handling the tube sustained a cut on his hand. The wound was flooded with the culture. The culture was that of strain MG 347 belonging to serovar Australis recovered from a patient, and it had undergone 52 passages in Ellinghausen McCullough Johnson Harris medium. The laboratory worker developed a headache 21 days after the accident and became febrile the next day. He was hospitalized for 5 days and was treated initially with doxycycline and later with ciprofloxacin. A blood sample collected on the second day of illness, after starting doxycycline therapy, yielded leptospires and the isolate, HZ 651, was identified as serovar Australis. Monoclonal antibody patterns and randomly amplified polymorphic DNA fingerprinting patterns of the isolate and strain MG 347 were identical, thus indicating that HZ 651 and MG 347 were clonal.
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- Correspondence
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Volumes and issues
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Volume 72 (2022 - 2023)
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Volume 71 (2022)
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Volume 70 (2021)
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Volume 69 (2020)
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Volume 68 (2019)
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Volume 67 (2018)
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Volume 66 (2017)
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Volume 65 (2016)
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Volume 64 (2015)
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Volume 63 (2014)
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Volume 62 (2013)
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Volume 61 (2012)
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Volume 53 (2004)
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Volume 14 (1981)
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Volume 12 (1979)
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Volume 10 (1977)
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Volume 8 (1975)
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Volume 7 (1974)
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Volume 6 (1973)
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Volume 5 (1972)
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Volume 4 (1971)
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Volume 3 (1970)
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Volume 2 (1969)
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Volume 1 (1968)
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