- Volume 56, Issue 4, 2007

A PG1828 gene-encoded triacylated lipoprotein was previously isolated from a Porphyromonas gingivalis lipopolysaccharide preparation as a Toll-like receptor (TLR) 2 agonist and its lipopeptide derivatives were synthesized based on the chemical structure. In the present study, granulocyte–macrophage colony stimulating factor-differentiated bone marrow-derived dendritic cells (BMDDCs) were stimulated separately with the P. gingivalis synthetic lipopeptide N-palmitoyl-S-[2-pentadecanoyloxy, 3-palmitoyloxy-(2R)-propyl]-l-Cys-Asn-Ser-Gln-Ala-Lys (PGTP2-RL) and its glyceryl stereoisomer (PGTP2-SL). Only PGTP2-RL activated BMDDCs from wild-type mice to secrete tumour necrosis factor-α, interleukin (IL)-6, IL-10 and IL-12p40, whilst PGTP2-RL-induced cytokine production was eliminated in TLR2 knockout (−/−) BMDDCs. BMDDCs from wild-type mice but not TLR2−/− mice responded to PGTP2-RL as well as Pam3CSK4 by increasing the expression of maturation markers, including CD80 (B7-1), CD86 (B7-2), CD40, CD275 (B7RP-1/inducible T-cell co-stimulatory ligand) and major histocompatibility complex class II. Taken together, these results indicate that the fatty acid residue at the glycerol position in the P. gingivalis lipopeptide plays a pivotal role in TLR2-mediated dendritic cell activation.

The PE and PPE proteins of Mycobacterium tuberculosis form a source of antigenic variation among different strains of M. tuberculosis. One of the PE_PGRS proteins, Rv1818c, plays a role in the pathogenesis of mycobacterial infection and specifically influences host-cell responses to tuberculosis infection. Although little is known about these two classes of protein, an immunoinformatics approach has indicated the possibility of their participation in eliciting a major histocompatibility complex (MHC) class I-mediated immune response against tuberculosis, as peptides derived from Rv1818c are predicted to bind to MHC class I molecules with high affinity. In the present work, a DNA vaccine was constructed encoding the full-length Rv1818c protein of M. tuberculosis and its immunogenicity was analysed in BALB/c mice. Immunization with Rv1818c DNA induced a strong CD8+ cytotoxic lymphocyte and Th1-type response, with high levels of gamma interferon (IFN-γ) and low levels of interleukin-4. Two nonameric peptides (Peptide6–14 and Peptide385–393) from Rv1818c were identified by their ability to induce the production of IFN-γ by CD8+ T cells in mice immunized with Rv1818c DNA. An epitope-specific response was demonstrated by the lysis of peptide-pulsed antigen-presenting cells, release of cytotoxic granules and IFN-γ production. These peptides bound with high affinity to MHC H-2Kd and showed low dissociation rates of peptide–MHC complexes. These results could form the basis for testing the identified T-cell epitopes of PE_PGRS proteins in the induction of protective immunity against M. tuberculosis challenge in the mouse model.

Corynebacterium pseudotuberculosis is the aetiological agent of caseous lymphadenitis (CLA), a debilitating disease of sheep and goats. Accurate diagnosis of CLA primarily relies on microbiological examination, followed by biochemical identification of isolates. In an effort to facilitate C. pseudotuberculosis detection, a multiplex PCR (mPCR) assay was developed targeting three genes of this bacterium: the 16S rRNA gene, rpoB and pld. This method allowed efficient identification of 40 isolates of this bacterium that had been identified previously by biochemical testing. Analysis of taxonomically related species did not generate the C. pseudotuberculosis mPCR amplification profile, thereby demonstrating the assay's specificity. As little as 1 pg of C. pseudotuberculosis genomic DNA was detected by this mPCR assay, demonstrating the sensitivity of the method. The detection limit in clinical samples was estimated to be 103 c.f.u. C. pseudotuberculosis could be detected directly in pus samples from infected sheep and goats (n=56) with a high diagnostic sensitivity (94.6 %). The developed assay significantly improves rapid C. pseudotuberculosis detection and could supersede bacteriological culture for microbiological and epidemiological diagnosis of CLA.

Isolation of Neisseria gonorrhoeae is currently the gold standard for the definitive diagnosis of gonorrhoea and for use in medico-legal cases in the UK. Molecular detection methods are used increasingly but are untested as evidence of infection in a court of law. An isolate of N. gonorrhoeae was obtained from a child and an article of clothing from an adult male who was suspected of sexual abuse of the child. Biochemical and immunological tests were used to confirm the isolate as N. gonorrhoeae. Amplification by PCR using two targets, cppB and ompIII, was used both as further confirmation of the isolate and to detect the presence of gonococcal-specific DNA from the clothing. The relationship of the gonococcal DNA from the child and the adult was investigated using genotyping (N. gonorrhoeae multi-antigen sequence typing; NG-MAST), including a nested PCR for the por gene. Both samples were indistinguishable by NG-MAST and shared the same sequence type, 403. This is the first report of molecular detection and genotyping of N. gonorrhoeae on an article of clothing, which resulted in conviction of the man for sexual assault.

A novel chromogenic medium for the detection of meticillin-resistant Staphylococcus aureus (MRSA), MRSASelect (Bio-Rad), was evaluated with clinical samples in a public health laboratory in The Netherlands. In total, 3000 samples were tested in the period January to March 2005, including 972 nose, 972 throat, 968 perineum, and 88 wound or urine samples. Presumptive MRSA colonies appeared pink/mauve on the MRSASelect medium. The performance of MRSASelect medium was compared with the routine screening method. Evaluation of the colony morphology showed that all confirmed MRSA isolates grew as pink/mauve colonies. None of the white colonies were MRSA strains. The number of false-positive pink/mauve colonies increased after prolonged incubation from 20 to 48 h. The specificity decreased from 92 % after 20 h incubation to 89 % after 48 h incubation. In total 70 MRSA strains were isolated, 55 of which were detected by the MRSASelect medium and 55 were detected by the routine screening method. Sensitivity was 78.6 % for both test procedures, and specificities were 99.5 and 100 %, respectively for the MRSASelect medium and the routine screening method. The addition of an enrichment broth to the MRSASelect medium increased the number of MRSA strains detected by 12 %. In total, 18 patients were MRSA positive, 4 of these were detected by the MRSASelect medium only and 1 was detected by the routine screening method only. Sensitivity on patient level was 94.4 and 77.8 % for the MRSASelect medium and the routine screening method, respectively, while specificities were 99.7 and 99.0 %.

The rapid identification of pathogenic yeasts is a crucial step in ensuring that effective antifungal treatment is started as early as possible. CandiSelect 4 (CS4; Bio-Rad) is a new chromogenic medium for the isolation of fungi, the direct identification of Candida albicans and the presumptive identification of the major pathogenic Candida species. The performance of CS4 was compared with that of another chromogenic medium, CHROMagar Candida (CA; Becton Dickinson). For primary cultures, 502 of the 1549 (32 %) samples were culture-positive. A total of 542 yeasts were isolated including 465 monomicrobial and 37 mixed cultures: 392 C. albicans, 60 Candida glabrata, 25 Candida tropicalis, 12 Candida krusei and 53 other Candida species. The percentage of C. albicans isolates that could be identified directly after 24, 48 and 72 h culture was 31.6, 82.9 and 92.1 %, respectively, for CS4, and 32.9, 82.9 and 91.1 % for CA. The presumptive identification of C. glabrata, C. tropicalis and C. krusei was evaluated after 48 h incubation. The percentage of strains with morphologically typical colonies was 80, 68 and 84.6 %, respectively, for CS4 compared with 75, 76 and 76.9 % for CA. For pure subcultures, from 24 h, all isolates of C. albicans (n=21) were directly identifiable on the two chromogenic media CA and CS4. At 48 h, the proportion of typical strains observed on the two chromogenic media was identical for C. glabrata (85 %) and C. krusei (100 %). A slight difference in favour of CS4 was observed for C. tropicalis (100 vs 95 %). CS4 also allowed the growth of several other fungi. CS4 can be recommended as a primary isolation medium for the identification of C. albicans, and for the rapid and effective differentiation of the major pathogenic Candida species.

Meticillin-resistant Staphylococcus aureus (MRSA) are responsible for nosocomial and community-acquired infections. Detection of MRSA is of utmost importance for the adaptation of infection control and therapeutic strategies. To date, selective agar plates constitute the standard routine method for reliable detection of this worldwide infectious problem. The performance of four different chromogenic media was evaluated in this study for MRSA detection and identification on >240 consecutive swab samples. The results indicate that primary plating on MRSASelect or MRSA ID is more sensitive than screening with oxacillin-based culture media. In addition, the utilization of cefoxitin- or cephamycin-containing plates reduces significantly the number of required confirmatory tests. Several selective agar plates allowing the identification of S. aureus are commercially available. However, their respective performances under real conditions of utilization are heterogeneous, underlining the absence of a gold standard medium for MRSA screening.

The feasibility of sequence analysis of the ribosomal 16S–23S intergenic spacer region (ITS) was evaluated for identification of 24 species of Streptococcus, one species of Abiotrophia, 18 species of Enterococcus and three species of Granulicatella. As GenBank currently lacks ITS sequence entries for many species of these four genera, the ITS sequences of 38 type strains were first sequenced and submitted to GenBank to facilitate species identification of these genera. Subsequently, the ITS sequences of 217 strains (84 reference strains and 133 clinical isolates) were determined and species identification was made by blast search for homologous sequences in public databases. Species other than Streptococcus contained multiple ITS fragments and only the shortest fragment was analysed. A total of 25 isolates (11.5 %) produced discrepant identification by ITS sequencing. The 25 discordant strains were analysed further by sequencing of the 16S rRNA gene for species clarification, and 21 were found to be identified correctly by ITS sequence analysis. The correct identification rate by ITS sequencing was 98.2 % (213/217). Several closely related enterococcal and streptococcal species/subspecies contained specific ITS signature sequences that were useful for differentiating these bacteria. In conclusion, ITS sequencing provides a useful approach towards identifying this group of pathogens on a molecular platform alongside 16S rRNA gene sequencing.

The aim of this study was to evaluate the effect of oregano essential oil, carvacrol and thymol on biofilm-grown Staphylococcus aureus and Staphylococcus epidermidis strains, as well as the effects of the oils on biofilm formation. For most of the S. aureus (n=6) and S. epidermidis (n=6) strains tested, the biofilm inhibitory concentration (0.125–0.500 %, v/v, for oregano, and 0.031–0.125 %, v/v, for carvacrol and thymol) and biofilm eradication concentration (0.25–1.0 %, v/v, for oregano and 0.125–0.500 %, v/v, for carvacrol and thymol) values were twofold or fourfold greater than the concentration required to inhibit planktonic growth. Subinhibitory concentrations of the oils attenuated biofilm formation of S. aureus and S. epidermidis strains on polystyrene microtitre plates.

In Taiwan, routine pertussis immunization has been implemented for more than 40 years and a low incidence of pertussis was maintained until an 80-fold increase in cases occurred in 1992. The unexpected increase emphasized the significance of pertussis. This study evaluated a total of 2452 reported cases of pertussis during 1993–2004 and surveillance data on incidence, age distribution and seasonality. The highest morbidity was in infants aged <1 year, and upward trends in the incidence of pertussis were significant for infants aged <1 year and adolescents aged 10–14 years. The highest mean number of cases was observed in August and upward trends were in colder months. This study indicates that the epidemiology of pertussis may have been changed by waning immunity in Taiwan. Increased surveillance activities, especially in older age groups, and additional booster doses of acellular pertussis vaccine for children aged 6–8 years and adolescents/young adults aged 15–20 years are necessary to control and prevent pertussis.

Nocardiosis has been believed to be caused by the members of the Nocardia asteroides complex and the Nocardia brasiliensis species. However, recent advances in genotypic identification have shown that the genus exhibits considerable taxonomic complexity and the phenotypic markers used in the past for its identification can be ambiguous. The aim of this study was to assess the species distribution of Nocardia isolates and to determine whether there are differences in pathogenicity or antimicrobial susceptibility between the different species identified. Nocardia isolates obtained over a 7 year period were retrospectively reviewed. The isolates were identified genotypically, their antibiotic susceptibility was tested and the clinical data of the 27 patients were retrieved. Eight different Nocardia species were identified: Nocardia farcinica (n=9), Nocardia abscessus (n=6), Nocardia cyriacigeorgica (n=6), Nocardia otitidiscaviarum (n=2), Nocardia nova (n=1), N. nova complex (n=1), Nocardia carnea (n=1) and Nocardia transvalensis complex (n=1). All species were susceptible to co-trimoxazole but different patterns of susceptibility to other agents were observed. All patients had active comorbidities at the time of infection. A total of 19 patients were immunosuppressed, due to human immunodeficiency virus infection, chronic corticosteroid therapy, immunosupressive therapy or haematological malignancies. Six patients displayed a Charlson comorbidity index score above 4. Global mortality was 50 % while attributable mortality was 34.6 %. Patients infected with N. farcinica – the most resistant species – had the highest Charlson index score and the highest mortality rate. Accurate identification of the species and susceptibility testing of Nocardia isolates may play an important role in diagnosis and treatment.