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Philip N, Ahmed K. Leptospirosis in Malaysia: current status, insights, and future prospects. J Physiol Anthropol 2023; 42:30. [PMID: 38087323 PMCID: PMC10714552 DOI: 10.1186/s40101-023-00347-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Accepted: 11/16/2023] [Indexed: 12/18/2023] Open
Abstract
Among zoonotic infections, leptospirosis has a worldwide distribution and high prevalence in tropical regions. It has a broad clinical presentation from mild to severe, life-threatening infection. Leptospires, the etiological agent of leptospirosis, are found in varied ecological niches and animal species, providing a significant source of human infection. This review aims to provide the current status of leptospirosis in Malaysia and the direction for future studies. The literature search for this review was performed using PubMed, Web of Sciences, and Google Scholar databases. The incidence of leptospirosis in Malaysia from 2004 to 2020 varied; however, a large number of cases occurred during floods. Leptospira has been isolated from wild and domestic animals as well as from the environment; among them, several novel species have been identified. In Malaysia, leptospirosis infection and death were mostly associated with recreational and non-recreational water activities. Despite the endemicity of leptospirosis, the public's knowledge, attitude, and practice level are relatively low in this country. More studies are needed in Malaysia to explore the extent of leptospirosis in different settings and locations.
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Affiliation(s)
- Noraini Philip
- School of Biological Sciences, Universiti Sains Malaysia, Penang, Malaysia
| | - Kamruddin Ahmed
- Department of Pathology and Microbiology, Faculty of Medicine and Health Sciences, University Malaysia Sabah, Kota Kinabalu, Malaysia.
- Borneo Medical and Health Research Centre, Faculty of Medicine and Health Sciences, Universiti Malaysia Sabah, Kota Kinabalu, Malaysia.
- Research Center for Global and Local Infectious Diseases, Oita University, Oita, Japan.
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Charles JC, Jayarajah U, Subasinghe D. Clinical characteristics and outcomes of patients with leptospirosis complicated with acute pancreatitis: a systematic review. J Int Med Res 2023; 51:3000605231197461. [PMID: 37776529 PMCID: PMC10542321 DOI: 10.1177/03000605231197461] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2023] [Accepted: 08/08/2023] [Indexed: 10/02/2023] Open
Abstract
OBJECTIVES Acute pancreatitis (AP) is a severe complication of leptospirosis. This review focuses on the current evidence of AP in patients with leptospirosis. METHODS Data on clinical characteristics, biochemical parameters, diagnosis, complications, critical care, fluid management, operative management, and outcomes were analyzed. This study was registered in PROSPERO (CRD42022360802). RESULTS We included 35 individual case reports and 4 case series involving 79 patients. Sex was reported for 48 (60.7%) patients; 38 (48.1%) were male and 10 (12.6%) were female. The patients' mean age was 45.13 (15-83 years). Acute kidney injury, thrombocytopenia, hypotension, and liver injury were the most common complications reported. Complete recovery was reported for 36 (45.5%) patients. Biochemical and radiological recovery was reported for 10 (12.6%) and 9 (11.3%) patients, respectively. Death was reported in 18 (22.7%) patients. CONCLUSION A high degree of clinical suspicion and different modalities of investigations are essential in the diagnosis of AP in leptospirosis. AP can be easily missed in leptospirosis because both conditions share similar clinical presentations and complications. Because of the high prevalence of acute kidney injury, judicious fluid management and close monitoring are mandatory.
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Affiliation(s)
- James C Charles
- Department of Surgery, Teaching Hospital Jaffna, Jaffna, Sri Lanka
| | - Umesh Jayarajah
- Department of Surgery, Colombo South Teaching Hospital, Dehiwala, Sri Lanka
| | - Duminda Subasinghe
- Department of Surgery, Faculty of Medicine, University of Colombo, Sri Lanka
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Asoh T, Miyahara S, Villanueva SYAM, Kanemaru T, Takigawa T, Mori H, Gloriani NG, Yoshida SI, Saito M. Protective role of stratum corneum in percutaneous Leptospira infection in a hamster model. Microb Pathog 2023; 182:106243. [PMID: 37422175 DOI: 10.1016/j.micpath.2023.106243] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2023] [Revised: 06/28/2023] [Accepted: 07/05/2023] [Indexed: 07/10/2023]
Abstract
Leptospira enters humans and animals through injured skin or mucous membranes by direct or indirect contact with urine excreted from infected reservoirs. Individuals with cut or scratched skin are at high risk of infection and are recommended to be protected from contact with Leptospira, but the risk of infection via skin without apparent wounds is unknown. We hypothesized that the stratum corneum of the epidermis might prevent percutaneous invasion of leptospires. We established a stratum corneum deficient model of hamsters using the tape stripping method. The mortality rate of hamsters lacking stratum corneum that were exposed to Leptospira was higher than that of controls with shaved skin, and was not significantly different from an epidermal wound group. These results indicated that the stratum corneum plays a critical role in protecting the host against leptospiral entry. We also examined the migration of leptospires through the monolayer of HaCaT cells (human keratinocyte cell line) using Transwell. The number of pathogenic leptospires penetrating the HaCaT cell monolayers was higher than that of non-pathogenic leptospires. Furthermore, scanning and transmission electron microscopic observations revealed that the bacteria penetrated the cell monolayers through both intracellular and intercellular routes. This suggested that pathogenic Leptospira can migrate easily through keratinocyte layers and is associated with virulence. Our study further highlights the importance of the stratum corneum as a critical barrier against the invasion of Leptospira found in contaminated soil and water. Hence, preventative measures against contact infection should be taken, even without visible skin wounds.
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Affiliation(s)
- Tatsuma Asoh
- Department of Bacteriology, Graduate School of Medical Sciences, Kyushu University, Fukuoka City, Fukuoka, Japan; Hamanomachi Hospital, Fukuoka City, Fukuoka, Japan
| | - Satoshi Miyahara
- Department of Bacteriology, Graduate School of Medical Sciences, Kyushu University, Fukuoka City, Fukuoka, Japan; Department of Microbiology, School of Medicine, University of Occupational and Environmental Health, Japan, Kitakyushu City, Fukuoka, Japan
| | - Sharon Yvette Angelina M Villanueva
- Department of Bacteriology, Graduate School of Medical Sciences, Kyushu University, Fukuoka City, Fukuoka, Japan; Department of Medical Microbiology, College of Public Health, University of the Philippines, Manila, Philippines
| | - Takaaki Kanemaru
- Department of Morphology Core Unit, Kyushu University Hospital, Fukuoka City, Fukuoka, Japan
| | - Tomoya Takigawa
- Department of Microbiology, School of Medicine, University of Occupational and Environmental Health, Japan, Kitakyushu City, Fukuoka, Japan; Department of Cardiovascular Surgery, School of Medicine, University of Occupational and Environmental Health, Japan, Kitakyushu City, Fukuoka, Japan
| | - Hiroshi Mori
- Department of Microbiology, School of Medicine, University of Occupational and Environmental Health, Japan, Kitakyushu City, Fukuoka, Japan; Department of Obstetrics and Gynecology, School of Medicine, University of Occupational and Environmental Health, Japan, Kitakyushu City, Fukuoka, Japan
| | - Nina G Gloriani
- Department of Medical Microbiology, College of Public Health, University of the Philippines, Manila, Philippines; Department of Pathology, St. Luke's Medical Center, Quezon City, Philippines
| | - Shin-Ichi Yoshida
- Department of Bacteriology, Graduate School of Medical Sciences, Kyushu University, Fukuoka City, Fukuoka, Japan
| | - Mitsumasa Saito
- Department of Bacteriology, Graduate School of Medical Sciences, Kyushu University, Fukuoka City, Fukuoka, Japan; Department of Microbiology, School of Medicine, University of Occupational and Environmental Health, Japan, Kitakyushu City, Fukuoka, Japan.
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Galan DI, Schneider MC, Roess AA. Leptospirosis Risk among Occupational Groups in Brazil, 2010-2015. Am J Trop Med Hyg 2023; 109:376-386. [PMID: 37400068 PMCID: PMC10397431 DOI: 10.4269/ajtmh.21-0181] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2021] [Accepted: 05/20/2022] [Indexed: 07/05/2023] Open
Abstract
Leptospirosis is a zoonotic disease that is primarily transmitted through close contact with contaminated environments or infected animals. Brazil has the highest number of reported cases of leptospirosis in the Americas (approximately 4,000 annual cases). The purpose of this study is to identify the occupational groups with a higher risk of leptospirosis in Brazil from 2010 through 2015 among suspected cases reported to the national surveillance system. Confirmed and unconfirmed cases of leptospirosis with laboratory diagnosis, 20,193 and 59,034 respectively, were classified into 12 occupational groups. Confirmed cases were predominantly male (79.4%), between 25 and 59 years of age (68.3%), white (53.4%), illiterate or with incomplete primary education (51.1%), and participating in agricultural work (19.9%). After controlling for age, sex, race, and area of residency, the multivariate analysis identified that between confirmed and unconfirmed cases of leptospirosis reported to the Brazilian national surveillance system, five occupational groups are at higher risk for leptospirosis: garbage and recycling collectors (odds ratio [OR] = 4.10; 95% CI = 3.36-4.99); agricultural, forestry, and fishery workers (OR = 1.65; 95% CI = 1.49-1.84); prisoners (OR = 1.56; 95% CI = 1.04-2.35); building workers (OR = 1.36; 95% CI = 1.22-1.51); cleaners and mining workers (OR = 1.25; 95% CI = 1.07-1.45). This is the first nationwide study to examine leptospirosis risk by occupational group in Brazil using national surveillance data. Our results suggest that among suspected cases there was an increased risk among occupational groups with low income and low educational levels.
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Affiliation(s)
- Deise I. Galan
- Department of Environmental and Occupational Health, The George Washington University, Washington, District of Columbia
| | - Maria Cristina Schneider
- Department of International Health, Georgetown University, Washington, District of Columbia
- Institute of Studies in Collective Health, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Amira A. Roess
- Department of Global and Community Health, George Mason University, Fairfax, Virginia
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Philip N, Neela VK. Media composition to revive leptospires stored at -80 °C. Cryobiology 2022; 109:89-93. [PMID: 36179819 DOI: 10.1016/j.cryobiol.2022.09.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2022] [Revised: 09/21/2022] [Accepted: 09/24/2022] [Indexed: 01/16/2023]
Abstract
Leptospires are preserved by frequent sub-culturing in semisolid media due to the challenge of low recovery by freezing or liquid nitrogen methods. The present study evaluated three liquid EMJH medium compositions (Medium A: Leptospira medium base EMJH, Leptospira enrichment EMJH, 5-fluorouracil (3%), rabbit serum (1%) and calf serum (1%); Medium B: same as Medium A but without 5-fluorouracil; Medium C: same as Medium B but with the addition of sodium pyruvate) for the revival of leptospires after storage at -80 °C. A total of 18 Leptospira serovars cultured in Medium A was aliquoted into cryogenic vials and directly stored at -80 °C. A hundred microlitre from each serovar culture stored at -80 °C was sub-cultured on a selected time over a period of 30 months into Media A, B and C. Regrowth on Media B and C showed a better and faster recovery (89-100%) (p-value <0.05) compared to Medium A (67-100%). Leptospires can be stored longer at -80 °C and a good recovery could be obtained when sub-cultured on EMJH medium without 5-fluorouracil.
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Affiliation(s)
- Noraini Philip
- Department of Medical Microbiology, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Selangor, Malaysia
| | - Vasantha Kumari Neela
- Department of Medical Microbiology, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Selangor, Malaysia.
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Biselli R, Nisini R, Lista F, Autore A, Lastilla M, De Lorenzo G, Peragallo MS, Stroffolini T, D’Amelio R. A Historical Review of Military Medical Strategies for Fighting Infectious Diseases: From Battlefields to Global Health. Biomedicines 2022; 10:2050. [PMID: 36009598 PMCID: PMC9405556 DOI: 10.3390/biomedicines10082050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2022] [Revised: 08/12/2022] [Accepted: 08/13/2022] [Indexed: 11/17/2022] Open
Abstract
The environmental conditions generated by war and characterized by poverty, undernutrition, stress, difficult access to safe water and food as well as lack of environmental and personal hygiene favor the spread of many infectious diseases. Epidemic typhus, plague, malaria, cholera, typhoid fever, hepatitis, tetanus, and smallpox have nearly constantly accompanied wars, frequently deeply conditioning the outcome of battles/wars more than weapons and military strategy. At the end of the nineteenth century, with the birth of bacteriology, military medical researchers in Germany, the United Kingdom, and France were active in discovering the etiological agents of some diseases and in developing preventive vaccines. Emil von Behring, Ronald Ross and Charles Laveran, who were or served as military physicians, won the first, the second, and the seventh Nobel Prize for Physiology or Medicine for discovering passive anti-diphtheria/tetanus immunotherapy and for identifying mosquito Anopheline as a malaria vector and plasmodium as its etiological agent, respectively. Meanwhile, Major Walter Reed in the United States of America discovered the mosquito vector of yellow fever, thus paving the way for its prevention by vector control. In this work, the military relevance of some vaccine-preventable and non-vaccine-preventable infectious diseases, as well as of biological weapons, and the military contributions to their control will be described. Currently, the civil-military medical collaboration is getting closer and becoming interdependent, from research and development for the prevention of infectious diseases to disasters and emergencies management, as recently demonstrated in Ebola and Zika outbreaks and the COVID-19 pandemic, even with the high biocontainment aeromedical evacuation, in a sort of global health diplomacy.
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Affiliation(s)
- Roberto Biselli
- Ispettorato Generale della Sanità Militare, Stato Maggiore della Difesa, Via S. Stefano Rotondo 4, 00184 Roma, Italy
| | - Roberto Nisini
- Dipartimento di Malattie Infettive, Istituto Superiore di Sanità, Viale Regina Elena 299, 00161 Roma, Italy
| | - Florigio Lista
- Dipartimento Scientifico, Policlinico Militare, Comando Logistico dell’Esercito, Via S. Stefano Rotondo 4, 00184 Roma, Italy
| | - Alberto Autore
- Osservatorio Epidemiologico della Difesa, Ispettorato Generale della Sanità Militare, Stato Maggiore della Difesa, Via S. Stefano Rotondo 4, 00184 Roma, Italy
| | - Marco Lastilla
- Istituto di Medicina Aerospaziale, Comando Logistico dell’Aeronautica Militare, Viale Piero Gobetti 2, 00185 Roma, Italy
| | - Giuseppe De Lorenzo
- Comando Generale dell’Arma dei Carabinieri, Dipartimento per l’Organizzazione Sanitaria e Veterinaria, Viale Romania 45, 00197 Roma, Italy
| | - Mario Stefano Peragallo
- Centro Studi e Ricerche di Sanità e Veterinaria, Comando Logistico dell’Esercito, Via S. Stefano Rotondo 4, 00184 Roma, Italy
| | - Tommaso Stroffolini
- Dipartimento di Malattie Infettive e Tropicali, Policlinico Umberto I, 00161 Roma, Italy
| | - Raffaele D’Amelio
- Dipartimento di Medicina Clinica e Molecolare, Sapienza Università di Roma, Via di Grottarossa 1035-1039, 00189 Roma, Italy
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Chaurasia R, Salovey A, Guo X, Desir G, Vinetz JM. Vaccination With Leptospira interrogans PF07598 Gene Family-Encoded Virulence Modifying Proteins Protects Mice From Severe Leptospirosis and Reduces Bacterial Load in the Liver and Kidney. Front Cell Infect Microbiol 2022; 12:926994. [PMID: 35837473 PMCID: PMC9274288 DOI: 10.3389/fcimb.2022.926994] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2022] [Accepted: 05/24/2022] [Indexed: 12/29/2022] Open
Abstract
The molecular and cellular pathogenesis of leptospirosis remains poorly understood. Based on comparative bacterial genomics data, we recently identified the hypothetical PF07598 gene family as encoding secreted exotoxins (VM proteins) that mediate cytotoxicity in vitro. To address whether VM proteins mediate in vivo leptospirosis pathogenesis, we tested the hypothesis that VM protein immunization of mice would protect against lethal challenge infection and reduce bacterial load in key target organs. C3H/HeJ mice were immunized with recombinant E. coli-produced, endotoxin-free, leptospiral VM proteins (derived from L. interrogans serovar Lai) in combination with the human-compatible adjuvant, glucopyranoside lipid A/squalene oil-in-water. Mice receiving full length recombinant VM proteins were protected from lethal challenge infection by L. interrogans serovar Canicola and had a 3-4 log10 reduction in bacterial load in the liver and kidney. These experiments show that immunization with recombinant VM proteins prevents leptospirosis clinical pathogenesis and leads to markedly reduced key target organ infection in this animal model. These data support the role of leptospiral VM proteins as virulence factors and suggest the possibility that a VM protein-based, serovar-independent, pan-leptospirosis vaccine may be feasible.
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Affiliation(s)
- Reetika Chaurasia
- Section of Infectious Diseases, Department of Internal Medicine, Yale University School of Medicine, New Haven, CT, United States
| | - Aryeh Salovey
- Section of Infectious Diseases, Department of Internal Medicine, Yale University School of Medicine, New Haven, CT, United States
| | - Xiaojia Guo
- Section of Nephrology, Department of Internal Medicine, Yale University School of Medicine, New Haven, CT, United States
| | - Gary Desir
- Section of Nephrology, Department of Internal Medicine, Yale University School of Medicine, New Haven, CT, United States
| | - Joseph M. Vinetz
- Section of Infectious Diseases, Department of Internal Medicine, Yale University School of Medicine, New Haven, CT, United States
- *Correspondence: Joseph M. Vinetz,
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8
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Chieng Raymond SC. Leptospirosis. WIKIJOURNAL OF MEDICINE 2022. [DOI: 10.15347/wjm/2022.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Leptospirosis is a blood infection caused by the bacterium Leptospira. Signs and symptoms can range from none to mild (headaches, muscle pains, and fevers) to severe (bleeding in the lungs or meningitis). Weil's disease, the acute, severe form of leptospirosis, causes the infected individual to become jaundiced (skin and eyes become yellow), develop kidney failure, and bleed. Pulmonary hemorrhage in association with leptospirosis is known as "severe pulmonary haemorrhage syndrome". More than ten genetic types of Leptospira, which are a type of a spirochaete, cause disease in humans. Both wild and domestic animals can spread the disease, most commonly rodents. The bacteria are spread to humans through animal urine, or water and soil contaminated with animal urine, coming into contact with the eyes, mouth, nose or breaks in the skin. In developing countries, the disease occurs most commonly in farmers and low-income people who live in areas with poor sanitation. In developed countries, it occurs during heavy downpours and can affect those involved in outdoor activities in warm and wet areas. Diagnosis is typically by testing for antibodies against the bacteria or finding bacterial DNA in the blood. Efforts to prevent the disease include protective equipment to block contact when working with potentially infected animals, washing after contact, and reducing rodents in areas where people live and work. The antibiotic doxycycline is effective in preventing leptospirosis infection. Human vaccines are of limited usefulness; vaccines for other animals are more widely available. Treatment when infected is with antibiotics such as doxycycline, penicillin, or ceftriaxone. The overall risk of death is 5–10%. However, when the lungs are involved, the risk of death increases to the range of 50–70%. It is estimated that one million people worldwide are infected by leptospirosis every year, causing approximately 58,900 deaths. The disease is most common in tropical areas of the world but may occur anywhere. Outbreaks may arise after heavy rainfall. The disease was first described by physician Adolf Weil in 1886 in Germany. Infected animals may have no, mild or severe symptoms. These may vary by the type of animal. In some animals Leptospira live in the reproductive tract, leading to transmission during mating.
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Olo Ndela E, Enault F, Toussaint A. Transposable Prophages in Leptospira: An Ancient, Now Diverse, Group Predominant in Causative Agents of Weil's Disease. Int J Mol Sci 2021; 22:13434. [PMID: 34948244 PMCID: PMC8705779 DOI: 10.3390/ijms222413434] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2021] [Revised: 12/06/2021] [Accepted: 12/11/2021] [Indexed: 12/24/2022] Open
Abstract
The virome associated with the corkscrew shaped bacterium Leptospira, responsible for Weil's disease, is scarcely known, and genetic tools available for these bacteria remain limited. To reduce these two issues, potential transposable prophages were searched in Leptospiraceae genomes. The 236 predicted transposable prophages were particularly abundant in the most pathogenic leptospiral clade, being potentially involved in the acquisition of virulent traits. According to genomic similarities and phylogenies, these prophages are distantly related to known transposable phages and are organized into six groups, one of them encompassing prophages with unusual TA-TA ends. Interestingly, structural and transposition proteins reconstruct different relationships between groups, suggesting ancestral recombinations. Based on the baseplate phylogeny, two large clades emerge, with specific gene-contents and high sequence divergence reflecting their ancient origin. Despite their high divergence, the size and overall genomic organization of all prophages are very conserved, a testimony to the highly constrained nature of their genomes. Finally, similarities between these prophages and the three known non-transposable phages infecting L. biflexa, suggest gene transfer between different Caudovirales inside their leptospiral host, and the possibility to use some of the transposable prophages in that model strain.
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Affiliation(s)
- Eric Olo Ndela
- Laboratoire Microorganismes: Genome Environment (LMGE), Université Clermont Auvergne, CNRS, F-63000 Clermont-Ferrand, France;
| | - François Enault
- Laboratoire Microorganismes: Genome Environment (LMGE), Université Clermont Auvergne, CNRS, F-63000 Clermont-Ferrand, France;
| | - Ariane Toussaint
- Microbiologie Cellulaire et Moléculaire, Université Libre de Bruxelles, IBMM-DBM, 12 Rue des Professeurs Jeneer et Brachet, B-6041 Gosselies, Belgium;
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Goarant C, Girault D, Thibeaux R, Soupé-Gilbert ME. Isolation and Culture of Leptospira from Clinical and Environmental Samples. Methods Mol Biol 2021; 2134:1-9. [PMID: 32632854 DOI: 10.1007/978-1-0716-0459-5_1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/18/2023]
Abstract
Leptospires, the etiological agents of leptospirosis, are fastidious slow-growing organisms. Here we describe the isolation and routine maintenance of leptospires from clinical (blood, urine, or tissue) and environmental (water or soil) samples. Using combinations of filtration, agar plating, and selective agents, leptospires can be isolated in pure cultures even from complex contaminated sources in standard EMJH culture medium.
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Affiliation(s)
- Cyrille Goarant
- Leptospirosis Research and Expertise Unit, Institut Pasteur in New Caledonia, Institut Pasteur International Network, Noumea, New Caledonia.
| | - Dominique Girault
- Leptospirosis Research and Expertise Unit, Institut Pasteur in New Caledonia, Institut Pasteur International Network, Noumea, New Caledonia
| | - Roman Thibeaux
- Leptospirosis Research and Expertise Unit, Institut Pasteur in New Caledonia, Institut Pasteur International Network, Noumea, New Caledonia
| | - Marie-Estelle Soupé-Gilbert
- Leptospirosis Research and Expertise Unit, Institut Pasteur in New Caledonia, Institut Pasteur International Network, Noumea, New Caledonia
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Wunder EA, Adhikarla H, Hamond C, Owers Bonner KA, Liang L, Rodrigues CB, Bisht V, Nally JE, Alt DP, Reis MG, Diggle PJ, Felgner PL, Ko A. A live attenuated-vaccine model confers cross-protective immunity against different species of the Leptospira genus. eLife 2021; 10:e64166. [PMID: 33496263 PMCID: PMC7837694 DOI: 10.7554/elife.64166] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2020] [Accepted: 12/23/2020] [Indexed: 12/24/2022] Open
Abstract
Leptospirosis is the leading zoonotic disease in terms of morbidity and mortality worldwide. Effective prevention is urgently needed as the drivers of disease transmission continue to intensify. The key challenge has been developing a widely applicable vaccine that protects against the >300 serovars that can cause leptospirosis. Live attenuated mutants are enticing vaccine candidates and poorly explored in the field. We evaluated a recently characterized motility-deficient mutant lacking the expression of a flagellar protein, FcpA. Although the fcpA- mutant has lost its ability to cause disease, transient bacteremia was observed. In two animal models, immunization with a single dose of the fcpA- mutant was sufficient to induce a robust anti-protein antibodies response that promoted protection against infection with different pathogenic Leptospira species. Furthermore, characterization of the immune response identified a small repertoire of biologically relevant proteins that are highly conserved among pathogenic Leptospira species and potential correlates of cross-protective immunity.
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Affiliation(s)
- Elsio A Wunder
- Department of Epidemiology of Microbial Diseases; Yale School of Public HealthNew HavenUnited States
- Gonçalo Moniz Institute, Oswaldo Cruz Foundation; Brazilian Ministry of HealthSalvadorBrazil
| | - Haritha Adhikarla
- Department of Epidemiology of Microbial Diseases; Yale School of Public HealthNew HavenUnited States
| | - Camila Hamond
- Department of Epidemiology of Microbial Diseases; Yale School of Public HealthNew HavenUnited States
| | - Katharine A Owers Bonner
- Department of Epidemiology of Microbial Diseases; Yale School of Public HealthNew HavenUnited States
| | - Li Liang
- Department of Medicine, Division of Infectious Disease; University of California IrvineIrvineUnited States
| | - Camila B Rodrigues
- Department of Medicine, Division of Infectious Disease; University of California IrvineIrvineUnited States
- Institute of Technology in Immunobiology, Oswaldo Cruz Foundation; Brazilian Ministry of HealthRio de JaneiroBrazil
| | - Vimla Bisht
- Department of Epidemiology of Microbial Diseases; Yale School of Public HealthNew HavenUnited States
| | - Jarlath E Nally
- Infectious Bacterial Diseases Research Unit, National Animal Disease Center, Agricultural Research Service; United States Department of AgricultureAmesUnited States
| | - David P Alt
- Infectious Bacterial Diseases Research Unit, National Animal Disease Center, Agricultural Research Service; United States Department of AgricultureAmesUnited States
| | - Mitermayer G Reis
- Gonçalo Moniz Institute, Oswaldo Cruz Foundation; Brazilian Ministry of HealthSalvadorBrazil
| | - Peter J Diggle
- CHICAS, Lancaster Medical School; Lancaster UniversityLancasterUnited Kingdom
| | - Philip L Felgner
- Department of Medicine, Division of Infectious Disease; University of California IrvineIrvineUnited States
| | - Albert Ko
- Department of Epidemiology of Microbial Diseases; Yale School of Public HealthNew HavenUnited States
- Gonçalo Moniz Institute, Oswaldo Cruz Foundation; Brazilian Ministry of HealthSalvadorBrazil
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Flores B, Sheleby-Elias J, Pérez-Sánchez T, Fischer R, Múzquiz J, Fuertes H, Halaihel N, Jirón W, Duttmann C. Leptospira spp in Rodents from Peridomestic Sites in Endemic Regions of Nicaragua. ECOHEALTH 2020; 17:469-476. [PMID: 33834316 PMCID: PMC9645555 DOI: 10.1007/s10393-021-01520-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/23/2019] [Accepted: 11/24/2020] [Indexed: 06/12/2023]
Abstract
Leptospirosis is one of the most important zoonoses in tropical countries, including Nicaragua, where it is considered endemic. The aim of this study was to determine the frequency of Leptospira spp in rodents captured from peridomestic sites in leptospirosis endemic regions of Nicaragua. Using live traps, 191 rodents were captured in 2012 and 2013 between April and December. Kidney samples were collected and processed for Leptospira detection from 166 animals by direct culture and isolation. The isolates were tested by PCR for LipL32 and lfb1-F genes specific to pathogenic Leptospira species. The trapping success over all sites was 20.2%, with higher rates of success in rainy season (p < 0.05). Leptospira spp were detected in 22.3% of rodents by direct culture methods. Significant differences (p < 0.01) were found in the frequencies of Leptospira positive rodents per month as well as per region. Of the isolated Leptospira spp, 37.5% were positive for pathogenic species by PCR. The frequency of Leptospira positive rodents by isolation could be used as a predictive indicator for the risk of human leptospirosis in Nicaragua.
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Affiliation(s)
- Byron Flores
- Centro Veterinario de Diagnóstico e Investigación (CEVEDI), Escuela de Ciencias Agrarias y Veterinarias, Universidad Nacional Autónoma de Nicaragua-León, UNAN-León), Edificio Central, Contiguo a la Iglesia La Merced, Apartado Postal 68, León, Nicaragua.
| | - Jessica Sheleby-Elias
- Centro Veterinario de Diagnóstico e Investigación (CEVEDI), Escuela de Ciencias Agrarias y Veterinarias, Universidad Nacional Autónoma de Nicaragua-León, UNAN-León), Edificio Central, Contiguo a la Iglesia La Merced, Apartado Postal 68, León, Nicaragua
| | - Tania Pérez-Sánchez
- Department of Animal Pathology, Faculty of Veterinary Sciences, Universidad de Zaragoza, Zaragoza, Spain
| | - Rebecca Fischer
- System Health Science Center, Department of Epidemiology and Biostatistics, Texas A & M University, Bryan, USA
- Section of Tropical Medicine, Baylor College of Medicine, Houston, TX, USA
| | - José Múzquiz
- Department of Animal Pathology, Faculty of Veterinary Sciences, Universidad de Zaragoza, Zaragoza, Spain
| | - Héctor Fuertes
- Department of Animal Pathology, Faculty of Veterinary Sciences, Universidad de Zaragoza, Zaragoza, Spain
| | - Nabil Halaihel
- Department of Animal Pathology, Faculty of Veterinary Sciences, Universidad de Zaragoza, Zaragoza, Spain
| | - William Jirón
- Centro Veterinario de Diagnóstico e Investigación (CEVEDI), Escuela de Ciencias Agrarias y Veterinarias, Universidad Nacional Autónoma de Nicaragua-León, UNAN-León), Edificio Central, Contiguo a la Iglesia La Merced, Apartado Postal 68, León, Nicaragua
| | - Christiane Duttmann
- Centro Veterinario de Diagnóstico e Investigación (CEVEDI), Escuela de Ciencias Agrarias y Veterinarias, Universidad Nacional Autónoma de Nicaragua-León, UNAN-León), Edificio Central, Contiguo a la Iglesia La Merced, Apartado Postal 68, León, Nicaragua
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13
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Rocha BR, Martins G, Lilenbaum W. An historical view of the experimental leptospiral infection in ruminants. Comp Immunol Microbiol Infect Dis 2020; 73:101532. [PMID: 32980802 DOI: 10.1016/j.cimid.2020.101532] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2020] [Accepted: 08/13/2020] [Indexed: 10/23/2022]
Abstract
The first experimental infections with Leptospira in ruminants were conducted in the 1950s, primarily assessed the pathogenesis caused by serovar Pomona in cows. Throughout the decades, experimental infections have also demonstrated the clinical aspects of the infection by other strains, mainly Hardjo. Despite the important outcomes observed in experimental infections in ruminants, there is still a large discrepancy regarding the ideal dose, route, strain, model species or animal age that should be used to reproduce the acute and chronic leptospirosis in ruminants. In this context, the present study aimed to review the historical processes involved on the experimental leptospiral infection in ruminants. The inclusion criteria were papers that clearly described inoculation route, strain, dose, clinical signs and animal age. Overall, 37 experiments were noted. The most frequently reported clinical signs were fever, prostration, hematuria and death, with the majority of them occurring in young animals infected by incidental strains. Regarding reproductive problems, they occurred in the majority of the experiments and were also more related to incidental strains. In this context, abortions, retained placenta and weak fetuses were the most frequent symptoms. Noteworthy that although the mechanisms of the clinical acute disease either systemic or reproductive, is reasonably well understood, the physiopathology involved on reproductive problems due to the silent chronic infection is less discussed and remains to be elucidated. In this context, it is evident the need for studies focused on the genital infection and reproductive aspects of leptospiral infection in ruminants.
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Affiliation(s)
- Bruno Ribeiro Rocha
- Laboratório de Bacteriologia Veterinária, Departamento de Microbiologia e Parasitologia, Universidade Federal Fluminense, Niterói, Rio de Janeiro, Brazil
| | - Gabriel Martins
- Laboratório de Bacteriologia Veterinária, Departamento de Microbiologia e Parasitologia, Universidade Federal Fluminense, Niterói, Rio de Janeiro, Brazil.
| | - Walter Lilenbaum
- Laboratório de Bacteriologia Veterinária, Departamento de Microbiologia e Parasitologia, Universidade Federal Fluminense, Niterói, Rio de Janeiro, Brazil
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Hornsby RL, Alt DP, Nally JE. Isolation and propagation of leptospires at 37 °C directly from the mammalian host. Sci Rep 2020; 10:9620. [PMID: 32541841 PMCID: PMC7296004 DOI: 10.1038/s41598-020-66526-4] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2020] [Accepted: 05/19/2020] [Indexed: 11/20/2022] Open
Abstract
The causative agent of leptospirosis includes multiple serovars and species of pathogenic leptospires that are excreted via urine from reservoir hosts of infection. Primary isolation takes weeks to months, and is limited to semi-solid media at 28-30 °C. Here we present an alternative media formulation, HAN, compared to commercially available EMJH and the more specialized T80/40/LH media formulations, in semi-solid and liquid compositions, for the primary isolation of two diverse species and serovars of pathogenic leptospires directly from host kidney tissue. All three media types supported the isolation and propagation of L. interrogans serovar Copenhageni strain IC:20:001 in semi-solid media at 29 °C. However, only HAN and T80/40/LH supported the growth of L. borgpetersenii serovar Hardjo strain HB15B203 at 29 °C. In addition, HAN supported primary isolation at 37 °C. Both T80/40/LH and HAN supported primary isolation of strain IC:20:001 in liquid media at 29 °C but only HAN supported growth of strain HB15B203 in liquid media, at both 29 and 37 °C. HAN media supports the primary isolation of fastidious pathogenic leptospires directly from infected host tissue at either 29 or 37 °C: this formulation represents a more defined media for the continued optimization of growth factors required to support the primary isolation of the large and diverse range of species and serovars within the genus Leptospira circulating within domestic and wild animal populations.
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Affiliation(s)
- Richard L Hornsby
- Infectious Bacterial Diseases Research Unit, National Animal Disease Center, Agricultural Research Service, United States Department of Agriculture, Ames, IA, USA
| | - David P Alt
- Infectious Bacterial Diseases Research Unit, National Animal Disease Center, Agricultural Research Service, United States Department of Agriculture, Ames, IA, USA
| | - Jarlath E Nally
- Infectious Bacterial Diseases Research Unit, National Animal Disease Center, Agricultural Research Service, United States Department of Agriculture, Ames, IA, USA.
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15
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Caimi K, Ruybal P. Leptospira spp., a genus in the stage of diversity and genomic data expansion. INFECTION GENETICS AND EVOLUTION 2020; 81:104241. [PMID: 32061688 DOI: 10.1016/j.meegid.2020.104241] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/09/2019] [Revised: 02/09/2020] [Accepted: 02/10/2020] [Indexed: 12/14/2022]
Abstract
Leptospirosis is a widespread global zoonotic bacterial disease with a noteworthy human-animal-ecosystem interface. The disease presents different clinical manifestations and a high mortality and morbidity rates in humans and animals throughout the world. Characterization and correct classification of Leptospira isolates is essential for a better understanding the epidemiological properties of the disease. In the last ten years, molecular typing tools have been developed and applied to this field. These methods together with the availability of hundreds of new whole genome sequences that belong to known and new described species are shaping the understanding and structure of the entire genus.
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Affiliation(s)
- K Caimi
- Instituto de Agrobiotecnología y Biología Molecular (IABiMo), Instituto Nacional de Tecnología Agropecuaria (INTA), Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Buenos Aires, Argentina.
| | - P Ruybal
- Universidad de Buenos Aires, Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Instituto de Investigaciones en Microbiología y Parasitología Médica (IMPaM), Facultad de Medicina, Paraguay 2155 Piso: 12, CABA 1121, Argentina
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16
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Abstract
Leptospira spp. are morphologically and phylogenetically unique bacteria that are ubiquitous in the environment. Pathogenic species are the agents of leptospirosis, an emerging zoonotic disease transmitted to both human and animals from the environment contaminated with the urine of reservoir animals. The taxonomy of Leptospira has recently undergone extensive revisions with the use of whole-genome sequences, thus expanding considerably the number of species.
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Use of Golden Syrian Hamster as an Animal Model to Study Leptospirosis-Associated Immune Responses. Methods Mol Biol 2020; 2134:243-255. [PMID: 32632875 DOI: 10.1007/978-1-0716-0459-5_22] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Experimental infections greatly contribute to further deepen our knowledge of infectious diseases. In the case of leptospirosis, hamsters as well as gerbils and guinea pigs have been used as animal models of acute leptospirosis in studying the pathophysiology of the disease. Here we describe a typical Leptospira infection using golden Syrian hamsters. We will also present techniques we use to study the resulting bacterial burden and gene expression patterns in the host in order to decipher the innate immune response to leptospirosis.
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18
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Mishra PKK, Nimmanapalli R. In silico characterization of Leptospira interrogans DNA ligase A and delineation of its antimicrobial stretches. ANN MICROBIOL 2019. [DOI: 10.1007/s13213-019-01516-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
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19
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Tarantola A, Goarant C. Leptospirosis in French Historical Medical Literature: Weil's Disease or Kelsch's Disease? Am J Trop Med Hyg 2019; 99:1366-1368. [PMID: 30298813 DOI: 10.4269/ajtmh.18-0629] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
Early names for leptospirosis often indicate occupational or environmental exposure. Leptospirosis is hard to identify in the tropical setting because of co-circulating diseases. This is not the case in the temperate setting, such as Europe, where the few historical differential diagnoses were malaria, typhoid, and viral hepatitis. Leptospirosis presumably caused community epidemics in Europe before 1900 and military epidemiologists carefully documented outbreaks in "constrained settings." Achille Kelsch (1841-1911) synthesized available military data and epidemiological perspectives to define "epidemic jaundice" as a nosological continuum, caused by an infectious agent found in muds and water. He viewed Weil's disease as being only one form of that now well-identified disease continuum. The causative pathogen and epidemiological determinants were identified years later. The role of soils and muds as intermediate reservoirs, as suggested by Kelsch, deserves further investigation.
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Affiliation(s)
| | - Cyrille Goarant
- Institut Pasteur de Nouvelle-Calédonie, Nouméa, New Caledonia
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20
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Abstract
Leptospirosis is a widespread worldwide zoonosis. Human leptospirosis was first identified in the Korea in 1984 as the cause of “epidemic pulmonary hemorrhagic fever of unknown etiology” that occurred sporadically or in outbreaks. The major outbreaks, leading to some deaths, mainly involved rice field farmers who worked in wet and muddy rice paddies following floods or heavy rainfalls. Leptospirosis was designated a nationally notifiable disease in 1987. The Korean government introduced a supplementary immunization program to control the disease from 1988 to 1997, which provided people at risk in endemic areas with the inactivated vaccine prepared from a local strain Leptospira interrogans serovar Lai. In addition, the continuous promotion of education and awareness in the media played a role in improving personal hygiene management. Since then, the reported incidence of leptospirosis has been low. Leptospirosis is currently considered in the differential diagnosis of acute febrile illnesses occurring in fall. This study historically reviews clinical and epidemiological publications, scientific reports, and public health policies for recognition, identification, and infection control of human leptospirosis in the Korea.
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Affiliation(s)
- Min Ja Kim
- Division of Infectious Diseases, Department of Medicine, College of Medicine, Korea University, Seoul, Korea.,Institute of Emerging Infectious Diseases, Korea University, College of Medicine, Seoul, Korea.
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21
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Le Turnier P, Epelboin L. [Update on leptospirosis]. Rev Med Interne 2018; 40:306-312. [PMID: 30591382 DOI: 10.1016/j.revmed.2018.12.003] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2018] [Revised: 11/19/2018] [Accepted: 12/06/2018] [Indexed: 12/13/2022]
Abstract
Leptospirosis is a worldwide spirochetal zoonosis whose global incidence is increasing and is probably underestimated. Leptospirosis has long been associated with occupational contact with animals (rats and cattle) and has become in developed countries a pathology more related to recreational activities with exposure to fresh water (canoeing, swimming, canyoning) and to an environment contaminated by urine from leptospires excretory rodents. Leptospirosis should be one of the differential diagnoses to be considered when returning from travel to tropical areas, particularly Southeast Asia, and particularly during the rainy season. The clinical symptoms, particularly in the initial phase, are not specific and can limit to a flu-like syndrome or "dengue-like" making diagnosis often difficult. It is then necessary to look carefully for clinical (muscle pain, cough, conjunctival involvement, jaundice) and biological arguments (thrombocytopenia, cholestasis, rhabdomyolysis, frank elevation of CRP) that will help to diagnose leptospirosis and lead to quick antibiotic therapy before the progression to a severe icterohaemorrhagic (Weil's disease) or respiratory form associated with significant mortality. Treatment is based on injectable beta-lactams in severe forms (mainly cephalosporins) and amoxicillin, doxycycline or azithromycin in non-severe forms. Some atypical or delayed forms of leptospirosis occurring in the late immune phase of the disease are to know. Rapid diagnostic tools are currently being studied to improve diagnosis in remote areas and facilitate access to early treatment.
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Affiliation(s)
- P Le Turnier
- Inserm, service des maladies infectieuses et tropicales, centre hospitalier universitaire de Nantes et CIC 1413, 44000 Nantes, France.
| | - L Epelboin
- Unité des maladies infectieuses et tropicales, centre hospitalier Andrée-Rosemon, Cayenne, Guyane; Équipe EA 3593, ecosystèmes amazoniens et pathologie tropicale, université de la Guyane, Cayenne, Guyane
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22
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Chronic experimental genital leptospirosis with autochthonous Leptospira santarosai strains of serogroup Sejroe. Small Rumin Res 2018. [DOI: 10.1016/j.smallrumres.2018.04.015] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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23
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Mori M, Bourhy P, Le Guyader M, Van Esbroeck M, Djelouadji Z, Septfons A, Kodjo A, Picardeau M. Pet rodents as possible risk for leptospirosis, Belgium and France, 2009 to 2016. ACTA ACUST UNITED AC 2018; 22. [PMID: 29090679 PMCID: PMC5718388 DOI: 10.2807/1560-7917.es.2017.22.43.16-00792] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Leptospirosis is an under-reported and emerging zoonotic disease which is potentially fatal in humans. Rodents are the main reservoirs for pathogenic Leptospira spp., but diagnosis in these animals is difficult, and their infection, which does not induce symptoms, usually goes unoticed. Although the exposures of most human cases of leptospirosis are poorly documented, we were able to identify six human cases of leptospirosis which were associated with direct contact with pet rodents (mice or rats) in Belgium and France between 2009 and 2016. All cases had severe disease and for all, the presence of Leptospira spp. DNA in the kidneys of their pet animals was confirmed, strongly suggesting that excretion of leptospires in urine was the way of transmission. Half of the cases shared the serogroup Icterohaemorrhagiae, which is usually associated with severe disease, with the pet rats which they were in contact with. With the popularity of rats and mice as pets, this study should contribute to raising awareness on asymptomatic pet rodents as a source of Leptospira infections.
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Affiliation(s)
- Marcella Mori
- Veterinary and Agrochemical Research Center, CODA- CERVA, Unit "Bacterial Zoonoses of Livestock", Operational Direction Bacterial Diseases, Brussels, Belgium
| | - Pascale Bourhy
- Institut Pasteur, Unité Biologie des spirochètes, CNR de la Leptospirose, Paris, France
| | - Marine Le Guyader
- Campus Vétérinaire - VetAgro Sup, Laboratoire des Leptospires, Marcy l'Etoile, France
| | - Marjan Van Esbroeck
- Institute for Tropical Medecine, Department of Clinical Sciences, Antwerp, Belgium
| | - Zorée Djelouadji
- Campus Vétérinaire - VetAgro Sup, Laboratoire des Leptospires, Marcy l'Etoile, France
| | - Alexandra Septfons
- Santé publique France, French national public health agency, Saint-Maurice, France
| | - Angeli Kodjo
- Campus Vétérinaire - VetAgro Sup, Laboratoire des Leptospires, Marcy l'Etoile, France
| | - Mathieu Picardeau
- Institut Pasteur, Unité Biologie des spirochètes, CNR de la Leptospirose, Paris, France
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Mutoh Y, Koizumi N, Morino E, Hayakawa K, Kato Y, Ohmagari N. Leptospirosis Cases in the Tokyo Metropolitan Area, Japan. Jpn J Infect Dis 2017; 70:669-671. [PMID: 28890513 DOI: 10.7883/yoken.jjid.2017.108] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
In Japan, 20-50 cases of leptospirosis are reported annually, typically involving farmers or returnees from tropical areas. Here, we report on 5 indigenous leptospirosis cases that occurred in the Tokyo urban area. All patients were men (mean age, 66.4 ± 4.6 [SD] years) and presented with clinical features that included high fever, acute kidney injury, and jaundice. Three patients presented with pulmonary infiltration and ground-glass opacity on admission. Two of the 5 patients were intubated and underwent continuous hemodiafiltration. The mean length of hospitalization was 38.0 ± 17.0 days, and all patients were treated successfully with antibiotics. Notably, all patients had a history of exposure to rats prior to becoming symptomatic, suggesting that exposure to rats is a risk factor for urban leptospirosis. Although rare, even in metropolitan areas, leptospirosis should be considered by physicians when patients present with severe sepsis, acute kidney injury, and a history of exposure to rats.
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Affiliation(s)
- Yoshikazu Mutoh
- Disease Control and Prevention Center, National Center for Global Health and Medicine
| | - Nobuo Koizumi
- Department of Bacteriology I, National Institute of Infectious Diseases
| | - Eriko Morino
- Disease Control and Prevention Center, National Center for Global Health and Medicine
| | - Kayoko Hayakawa
- Disease Control and Prevention Center, National Center for Global Health and Medicine
| | - Yasuyuki Kato
- Disease Control and Prevention Center, National Center for Global Health and Medicine
| | - Norio Ohmagari
- Disease Control and Prevention Center, National Center for Global Health and Medicine
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25
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26
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Gomes-Solecki M, Santecchia I, Werts C. Animal Models of Leptospirosis: Of Mice and Hamsters. Front Immunol 2017; 8:58. [PMID: 28270811 PMCID: PMC5318464 DOI: 10.3389/fimmu.2017.00058] [Citation(s) in RCA: 62] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2016] [Accepted: 01/16/2017] [Indexed: 01/27/2023] Open
Abstract
Pathogenic Leptospira sp. are spirochetal bacteria responsible for leptospirosis, an emerging worldwide zoonosis. These spirochetes are very successful pathogens that infect a wide range of hosts such as fish, reptiles, birds, marsupials, and mammals. Transmission occurs when chronically infected animals excrete live bacteria in their urine, contaminating the environment. Leptospira sp. enter their hosts through damaged skin and mucosa. Chronically infected rats and mice are asymptomatic and are considered as important reservoirs of the disease. Infected humans may develop either a flu-like, usually mild illness with or without chronic asymptotic renal colonization, or a severe acute disease with kidney, liver, and heart failure, potentially leading to death. Leptospirosis is an economic burden on society due to health-care costs related to elevated morbidity of humans and loss of animals of agricultural interest. There are no effective vaccines against leptospirosis. Leptospira sp. are difficult to genetically manipulate which delays the pace of research progress. In this review, we discuss in an historical perspective how animal models have contributed to further our knowledge of leptospirosis. Hamsters, guinea pigs, and gerbils have been instrumental to study the pathophysiology of acute lethal leptospirosis and the Leptospira sp. genes involved in virulence. Chronic renal colonization has been mostly studied using experimentally infected rats. A special emphasis will be placed on mouse models, long thought to be irrelevant since they survive lethal infection. However, mice have recently been shown to be good models of sublethal infection leading to chronic colonization. Furthermore, congenic and transgenic mice have proven essential to study how innate immune cells interact with the pathogen and to understand the role of the toll-like receptor 4, which is important to control Leptospira sp. load and disease. The use of inbred and transgenic mouse models opens up the field to the comprehensive study of immune responses to Leptospira sp. infection and subsequent pathophysiology of inflammation. It also allows for testing of drugs and vaccines in a biological system that can avail of a wealth of molecular tools that enable understanding of the mechanisms of action of protective vaccines.
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Affiliation(s)
- Maria Gomes-Solecki
- Department of Microbiology, Immunology and Biochemistry, The University of Tennessee Health Science Center , Memphis, TN , USA
| | - Ignacio Santecchia
- Institut Pasteur, Unité Biologie et Génétique de la Paroi Bactérienne, Paris, France; INSERM, équipe Avenir, Paris, France
| | - Catherine Werts
- Institut Pasteur, Unité Biologie et Génétique de la Paroi Bactérienne, Paris, France; INSERM, équipe Avenir, Paris, France
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27
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Herath NJ, Kamburapola CJ, Agampodi SB. Severe leptospirosis and pancreatitis; A case series from a leptospirosis outbreak in Anuradhapura district, Sri Lanka. BMC Infect Dis 2016; 16:644. [PMID: 27821124 PMCID: PMC5100107 DOI: 10.1186/s12879-016-2010-4] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2016] [Accepted: 11/02/2016] [Indexed: 01/07/2023] Open
Abstract
Background Acute pancreatitis is identified as an atypical and rare presentation of leptospirosis. In this report, we discuss a case series of severe leptospirosis with pancreatitis as a main complication during an unusual outbreak of leptospirosis in Anuradhapura district, Sri Lanka. Case presentation We retrospectively reviewed clinical presentation, investigations, treatment and outcome of six confirmed cases of severe leptospirosis admitted to intensive care unit (ICU) of Teaching Hospital, Anuradhapura, within a three months period from November 2014 to January 2015. All six patients were previously healthy paddy farmers presented with fever, myalgia and arthralgia. Four patients had abdominal pain, nausea and vomiting on admission. Hypotension, Neutrophilic leukocytosis and thrombocytopaenia was detected in all patients in the initial stage. Four patients had serum amylase more than 900 (range 941–2420). All patients had acute kidney injury and hepatitis. Significantly elevated amylase and low serum calcium were present in 4 cases. Five patients recovered without any evidence of residual organ damage, but one succumbed to the illness. Conclusion This case series emphasizes the importance of identification of acute pancreatitis as a common complication of Leptospirosis, in order to reduce mortality and morbidity.
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Affiliation(s)
- N J Herath
- Teaching Hospital, Anuradhapura, Sri Lanka
| | | | - S B Agampodi
- Department of Community Medicine, Faculty of Medicine and Allied Sciences, Rajarata University of Sri Lanka, Saliyapura, 50008, Sri Lanka.
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Brockmann SO, Ulrich L, Piechotowski I, Wagner-Wiening C, Nöckler K, Mayer-Scholl A, Eichner M. Risk factors for human Leptospira seropositivity in South Germany. SPRINGERPLUS 2016; 5:1796. [PMID: 27803844 PMCID: PMC5069215 DOI: 10.1186/s40064-016-3483-8] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/06/2016] [Accepted: 10/06/2016] [Indexed: 11/25/2022]
Abstract
We analyzed risk factors for Leptospira seropositivity in humans, using data from a population-based cross-sectional zoonosis survey in South Germany (2008/9). Out of 1007 participants 42 (4.2 %) were sero-positive (19/446 men; 23/561 women), indicating that Leptospira exposure and sero-conversion is much more frequent than commonly assumed. Relative risks (RR) for seropositivity with exact 95 % confidence intervals (CI; adjusted for specificity and sensitivity of the ELISA test) were calculated for various exposure factors. Contact with pet rats (RR = 13.9 CI [4.8; 25.3]), guinea pigs (3.0[1.1; 7.4]), cattle (3.7[1.3; 9.6]), poultry (3.6[1.3; 8.6]) or livestock (2.3[1.1; 4.9]) as well as occupation as forestry worker (9.2[2.6; 21.4]) were identified as important exposure factors. None of the participants has ever been diagnosed with leptospirosis, yet 45 had experienced symptoms which may have been caused by Leptospira infection (12 with scleral icterus, 25 dark urine, 8 liver inflammation, 7 kidney failure). Three times as many participants with prior symptoms were seropositive as participants without symptoms (RR = 3.4[1.3; 8.3]), suggesting that sero-positive patients with severe symptoms may frequently not be diagnosed as leptospirosis cases. Physicians should consider leptospirosis as a differential diagnosis. Currently, the vast majority of symptomatic leptospirosis patients may neither be diagnosed nor reported.
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Affiliation(s)
| | - Lena Ulrich
- Department of Clinical Epidemiology and Applied Biometry, University of Tübingen, Silcherstr. 5, 72076 Tübingen, Germany
| | | | | | | | | | - Martin Eichner
- Department of Clinical Epidemiology and Applied Biometry, University of Tübingen, Silcherstr. 5, 72076 Tübingen, Germany
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Abstract
Adolf Weil defined the disease as a clinical entity in 1886, and Leptospira ictero-hæmorrhagiæ was found to be the causative organism in 1915 by Inada et al. in Japan, and confirmed by Hübener and Reiter in Germany. The infection has been found in most countries, and recently there has been a great increase in the number of instances reported. In most parts of the world rats and other small rodents harbour the organism and excrete it in the urine. This is almost always the direct or indirect source of infection of man, but natural infection of dogs and foxes takes place, and is at least a potential danger to human beings. Infection is usually related to occupation in coal-mines, field work of all sorts, sewers, fish-cleaning, and to bathing in fresh water. The organism quickly dies in an acid medium, in strong sunlight and in salt water. These facts accord with the presence of the disease in certain situations. The route of infection of man is usually by contact of the abraded or sodden skin with infected mud or water, but it may be by inhalation of water and by bites of rats, dogs, and ferrets. Men are much more exposed to infection than women, but in fish-cleaners the incidence is equal in the sexes. Children are sometimes infected by bathing and in houses. The incubation time may be four to nineteen days, and is usually seven to thirteen days. By serological methods many unjaundiced and subclinical infections can be detected among people who are often at risk, and these correct the rather high fatality rates which are derived from jaundiced cases only. During the last three and a half years 142 authenticated instances of the disease in an obvious clinical form have been reported in the British Isles. Twenty-one occupations or circumstances were involved, and the case fatality rate was 15 per cent.
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Affiliation(s)
| | - H. C. Brown
- Wellcomne Bureau of Scientific Research, London
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Sivasankari K, Shanmughapriya S, Natarajaseenivasan K. Leptospiral renal colonization status in asymptomatic rural population of Tiruchirapalli district, Tamilnadu, India. Pathog Glob Health 2016; 110:209-15. [PMID: 27549577 DOI: 10.1080/20477724.2016.1222054] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023] Open
Abstract
Humans are known to excrete leptospires in their urine after recovery from illness and there are reports showing development of asymptomatic leptospiruria in settings of high disease transmission. In this regard, we sought to evaluate the asymptomatic renal carriage status of humans in the highly endemic region of Tiruchirapalli district, Tamilnadu, India. A total of 245 asymptomatic participants were included. Urine and blood samples were collected and the extent of leptospiral infection was characterized by MAT, qPCR, 16S rRNA, and dot blot assay. The qPCR screening with urine DNA identified 129 (52.7%) positive samples further confirmed by nested PCR. The dot blot assay marked 30.2% (74/245) as true positives. The phylogenetic analysis showed the sequences to cluster with pathogenic Leptospira spp. Serological results showed 50 people with urine positivity to be negative for MAT and can probably be classified as 'asymptomatic individuals.' In conclusion, it can be speculated that in endemic regions there is a greater possibility of humans as maintenance host rather than incidental hosts.
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Affiliation(s)
- Karikalacholan Sivasankari
- a Medical Microbiology Laboratory, Department of Microbiology , Centre of Excellence in Life Sciences, Bharathidasan University , Tiruchirappalli , India
| | - Santhanam Shanmughapriya
- a Medical Microbiology Laboratory, Department of Microbiology , Centre of Excellence in Life Sciences, Bharathidasan University , Tiruchirappalli , India
| | - Kalimuthusamy Natarajaseenivasan
- a Medical Microbiology Laboratory, Department of Microbiology , Centre of Excellence in Life Sciences, Bharathidasan University , Tiruchirappalli , India
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Real-Time PCR Reveals Rapid Dissemination of Leptospira interrogans after Intraperitoneal and Conjunctival Inoculation of Hamsters. Infect Immun 2016; 84:2105-2115. [PMID: 27141082 DOI: 10.1128/iai.00094-16] [Citation(s) in RCA: 58] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2016] [Accepted: 04/27/2016] [Indexed: 01/06/2023] Open
Abstract
The pathogen Leptospira interrogans is a highly motile spirochete that causes acute and fulminant infections in humans and other accidental hosts. Hematogenous dissemination is important for infection by the pathogen but remains poorly understood because few animal model studies have used sensitive tools to quantify the bacteria. We evaluated the kinetics of leptospiral infection in Golden Syrian hamsters by a sensitive quantitative real-time PCR (TaqMan) with lipl32 as the target gene. The dissemination and bacterial burden were measured after intraperitoneal infection with a high dose (10(8)) or low dose (2.5 × 10(2)) of leptospires. We also examined the conjunctival challenge route to mimic the natural history of infection. Quantification of leptospires in perfused animals revealed that pathogens were detected in all organs of intraperitoneally infected hamsters, including the eye and brain, within 1 h after inoculation of 10(8) virulent L. interrogans bacteria. Peaks of 10(5) to 10(8) leptospires per gram or per milliliter were achieved in blood and all tissues between day 4 and day 8 after intraperitoneal inoculation of high- and low-dose challenges, respectively, coinciding with macroscopic and histological changes. The conjunctival route resulted in a delay in the time to peak organ burden in comparison to intraperitoneal infection, indicating that although infection could be established, penetration efficiency was low across this epithelial barrier. Surprisingly, infection with a large inoculum of high-passage-number attenuated L. interrogans strains resulted in dissemination to all organs in the first 4 days postinfection, albeit with a lower burden, followed by clearance from the blood and organs 7 days postinfection and survival of all animals. These results demonstrate that leptospiral dissemination and tissue invasion occur. In contrast, development of a critical level of tissue burden and pathology are dependent on the virulence of the infecting strain.
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Binns C, Low WY. Leptospirosis: A Public Health Story Encircling the Globe. Asia Pac J Public Health 2016; 28:288-9. [PMID: 27161412 DOI: 10.1177/1010539516648021] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Colin Binns
- School of Public Health, Curtin University, Perth, Western Australia, Australia
| | - Wah Yun Low
- Research Management Center, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
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Benacer D, Thong KL, Verasahib KB, Galloway RL, Hartskeerl RA, Lewis JW, Mohd Zain SN. Human Leptospirosis in Malaysia. Asia Pac J Public Health 2016; 28:290-302. [DOI: 10.1177/1010539516640350] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
The history and epidemiology of human leptospirosis in Malaysia from 1925 to 2012 are described. Previous studies have demonstrated that leptospirosis is an endemic disease in Malaysia occurring in both urban and rural locations. The number of cases has risen dramatically since the Ministry of Health Malaysia highlighted leptospirosis as a notifiable disease in 2010, with reported cases increasing from 248 cases in 2004 to 3604 in 2012. The incidence of infection among the population suggests that occupation, sex, age, ethnic background, water recreational activities, and sporting events are risk factors. A robust surveillance system is now in place to monitor temporal and spatial changes in the incidence and prevalence of infection and to identify risk areas and disease behavior. Despite extensive studies over the past decade, there is a still a need to describe local serovars in host carriers and the human population, with the view to develop an effective vaccine against leptospirosis.
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Affiliation(s)
| | | | | | | | - Rudy A. Hartskeerl
- WHO/FAO/OIE and National Leptospirosis Reference Centre, KIT Biomedical Research, Amsterdam, Netherlands
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Breda LCD, Hsieh CL, Castiblanco Valencia MM, da Silva LB, Barbosa AS, Blom AM, Yung-Fu C, Isaac L. Fine Mapping of the Interaction between C4b-Binding Protein and Outer Membrane Proteins LigA and LigB of Pathogenic Leptospira interrogans. PLoS Negl Trop Dis 2015; 9:e0004192. [PMID: 26517116 PMCID: PMC4627802 DOI: 10.1371/journal.pntd.0004192] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2015] [Accepted: 10/05/2015] [Indexed: 12/20/2022] Open
Abstract
The complement system consists of more than 40 proteins that participate in the inflammatory response and in pathogen killing. Complement inhibitors are necessary to avoid the excessive consumption and activation of this system on host cells. Leptospirosis is a worldwide zoonosis caused by spirochetes from the genus Leptospira. Pathogenic leptospires are able to escape from complement activation by binding to host complement inhibitors Factor H [FH] and C4b-binding protein (C4BP) while non-pathogenic leptospires are rapidly killed in the presence of fresh serum. In this study, we demonstrate that complement control protein domains (CCP) 7 and 8 of C4BP α-chain interact with the outer membrane proteins LcpA, LigA and LigB from the pathogenic leptospire L. interrogans. The interaction between C4BP and LcpA, LigA and LigB is sensitive to ionic strength and inhibited by heparin. We fine mapped the LigA and LigB domains involved in its binding to C4BP and heparin and found that both interactions are mediated through the bacterial immunoglobulin-like (Big) domains 7 and 8 (LigA7-8 and LigB7-8) of both LigA and LigB and also through LigB9-10. Therefore, C4BP and heparin may share the same binding sites on Lig proteins.
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Affiliation(s)
- Leandro C. D. Breda
- Department of Immunology, Institute of Biomedical Sciences, University of São Paulo, São Paulo, Brazil
| | - Ching-Lin Hsieh
- Department of Population Medicine and Diagnostic Sciences, College of Veterinary Medicine, Cornell University, Ithaca, New York, United States of America
| | | | | | | | - Anna M. Blom
- Department of Translational Medicine, Division of Medical Protein Chemistry, Lund University, Malmo, Sweden
| | - Chang Yung-Fu
- Department of Population Medicine and Diagnostic Sciences, College of Veterinary Medicine, Cornell University, Ithaca, New York, United States of America
| | - Lourdes Isaac
- Department of Immunology, Institute of Biomedical Sciences, University of São Paulo, São Paulo, Brazil
- * E-mail:
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Saito M, Villanueva SYAM, Masuzawa T, Haraguchi Y, Ita S, Miyahara S, Ozuru R, Yamaguchi T, Yoshimura M, Ikejiri M, Aramaki N, Amran MY, Muslich LT, Iida KI, Yanagihara Y, Gloriani NG, Yoshida SI. The usefulness of semi-solid medium in the isolation of highly virulentLeptospirastrains from wild rats in an urban area of Fukuoka, Japan. Microbiol Immunol 2015; 59:322-30. [DOI: 10.1111/1348-0421.12260] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2015] [Revised: 03/17/2015] [Accepted: 04/10/2015] [Indexed: 11/25/2022]
Affiliation(s)
- Mitsumasa Saito
- Department of Bacteriology; Graduate School of Medical Sciences, Kyushu University; Fukuoka Japan
| | | | - Toshiyuki Masuzawa
- Laboratory of Microbiology and Immunology; Faculty of Pharmaceutical Sciences, Chiba Institute of Science; Choshi Chiba Japan
| | - Yusuke Haraguchi
- Department of Bacteriology; Graduate School of Medical Sciences, Kyushu University; Fukuoka Japan
| | - Shuhei Ita
- Department of Bacteriology; Graduate School of Medical Sciences, Kyushu University; Fukuoka Japan
| | - Satoshi Miyahara
- Department of Bacteriology; Graduate School of Medical Sciences, Kyushu University; Fukuoka Japan
| | - Ryo Ozuru
- Department of Bacteriology; Graduate School of Medical Sciences, Kyushu University; Fukuoka Japan
| | - Takayoshi Yamaguchi
- Department of Bacteriology; Graduate School of Medical Sciences, Kyushu University; Fukuoka Japan
| | - Michinobu Yoshimura
- Department of Bacteriology; Graduate School of Medical Sciences, Kyushu University; Fukuoka Japan
| | - Mami Ikejiri
- Department of Bacteriology; Graduate School of Medical Sciences, Kyushu University; Fukuoka Japan
| | - Natsumi Aramaki
- Department of Bacteriology; Graduate School of Medical Sciences, Kyushu University; Fukuoka Japan
| | - Muhammad Yunus Amran
- Department of Bacteriology; Graduate School of Medical Sciences, Kyushu University; Fukuoka Japan
| | - Lisa Tenriesa Muslich
- Department of Bacteriology; Graduate School of Medical Sciences, Kyushu University; Fukuoka Japan
| | - Ken-ichiro Iida
- Department of Bacteriology; Graduate School of Medical Sciences, Kyushu University; Fukuoka Japan
| | - Yasutake Yanagihara
- Laboratory of Microbiology and Immunology; Faculty of Pharmaceutical Sciences, Chiba Institute of Science; Choshi Chiba Japan
- Department of Medical Microbiology; College of Public Health, University of the Philippines-Manila; Ermita Manila Philippines
- University of Shizuoka; Shizuoka Japan
| | - Nina G. Gloriani
- Department of Medical Microbiology; College of Public Health, University of the Philippines-Manila; Ermita Manila Philippines
| | - Shin-ichi Yoshida
- Department of Bacteriology; Graduate School of Medical Sciences, Kyushu University; Fukuoka Japan
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Saito M, Y A M Villanueva S, Masuzawa T, Yanagihara Y, Yoshida SI. [Leptospirosis now-the centennial of the discovery of Weil's disease pathogen]. Nihon Saikingaku Zasshi 2014; 69:589-600. [PMID: 25447984 DOI: 10.3412/jsb.69.589] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
This year, 2014, marks the centennial of the discovery of Leptospira as the Weil's disease pathogen by Ryokichi Inada, Yutaka Ido and their colleagues. Leptospirosis is a worldwide zoonosis especially in countries with tropical and subtropical climates. Recently, the number of patients with leptospirosis dramatically decreased in Japan because public hygiene has greatly improved, the mechanization of agriculture was introduced, and farmers started using rubber boots and gloves while working in the field. The opportunities for percutaneous infection with Leptospira was reduced, but have not been totally eliminated in Japan.We previously reported a novel combination of five antimicrobial agents for selective isolation of Leptospira from contaminated samples. This cocktail, after being incorporated into Leptospira growth medium, inhibited the growth of contaminants and allowed successful detection of leptospires in environmental samples. We collected soil and environmental water and cultured them using this selective medium. It was revealed that not only saprophytic Leptospira but also pathogenic Leptospira are widely living in the environment. We hypothesized that soil serves as reservoir for Leptospira and infectious source for leptospirosis. In this review, we also discuss the Leptospira-rat-human relationship in the Philippines, natural defense of host against oral and percutaneous infection by Leptospira, the mechanism of jaundice in leptospirosis, and the development of immunochromatography-based methods for detection of leptospiral antigen in urine.
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Affiliation(s)
- Mitsumasa Saito
- Department of Bacteriology, Graduate School of Medical Sciences, Kyushu University
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Coutinho ML, Matsunaga J, Wang LC, de la Peña Moctezuma A, Lewis MS, Babbitt JT, Aleixo JAG, Haake DA. Kinetics of Leptospira interrogans infection in hamsters after intradermal and subcutaneous challenge. PLoS Negl Trop Dis 2014; 8:e3307. [PMID: 25411782 PMCID: PMC4239013 DOI: 10.1371/journal.pntd.0003307] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2014] [Accepted: 10/01/2014] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND Leptospirosis is a zoonosis caused by highly motile, helically shaped bacteria that penetrate the skin and mucous membranes through lesions or abrasions, and rapidly disseminate throughout the body. Although the intraperitoneal route of infection is widely used to experimentally inoculate hamsters, this challenge route does not represent a natural route of infection. METHODOLOGY/PRINCIPAL FINDINGS Here we describe the kinetics of disease and infection in hamster model of leptospirosis after subcutaneous and intradermal inoculation of Leptospira interrogans serovar Copenhageni, strain Fiocruz L1-130. Histopathologic changes in and around the kidney, including glomerular and tubular damage and interstitial inflammatory changes, began on day 5, and preceded deterioration in renal function as measured by serum creatinine. Weight loss, hemoconcentration, increased absolute neutrophil counts (ANC) in the blood and hepatic dysfunction were first noted on day 6. Vascular endothelial growth factor, a serum marker of sepsis severity, became elevated during the later stages of infection. The burden of infection, as measured by quantitative PCR, was highest in the kidney and peaked on day 5 after intradermal challenge and on day 6 after subcutaneous challenge. Compared to subcutaneous challenge, intradermal challenge resulted in a lower burden of infection in both the kidney and liver on day 6, lower ANC and less weight loss on day 7. CONCLUSIONS/SIGNIFICANCE The intradermal and subcutaneous challenge routes result in significant differences in the kinetics of dissemination and disease after challenge with L. interrogans serovar Copenhageni strain Fiocruz L1-130 at an experimental dose of 2×106 leptospires. These results provide new information regarding infection kinetics in the hamster model of leptospirosis.
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Affiliation(s)
- Mariana L. Coutinho
- Veterans Affairs Greater Los Angeles Healthcare System, Los Angeles, California, United States of America
- Centro de Desenvolvimento Tecnologico, Universidade Federal de Pelotas, Pelotas, Brasil
- Faculdade de Veterinária, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brasil
| | - James Matsunaga
- Veterans Affairs Greater Los Angeles Healthcare System, Los Angeles, California, United States of America
- Department of Medicine, David Geffen School of Medicine at UCLA, Los Angeles, California, United States of America
| | - Long-Chieh Wang
- Veterans Affairs Greater Los Angeles Healthcare System, Los Angeles, California, United States of America
| | - Alejandro de la Peña Moctezuma
- CEIEPAA Facultad de Medicina Veterinaria y Zootecnia, Universidad Nacional Autónoma de México, Tequisquiapan, Querétaro, México
| | - Michael S. Lewis
- Veterans Affairs Greater Los Angeles Healthcare System, Los Angeles, California, United States of America
| | - Jane T. Babbitt
- Veterans Affairs Greater Los Angeles Healthcare System, Los Angeles, California, United States of America
- Department of Medicine, David Geffen School of Medicine at UCLA, Los Angeles, California, United States of America
| | | | - David A. Haake
- Veterans Affairs Greater Los Angeles Healthcare System, Los Angeles, California, United States of America
- Department of Medicine, David Geffen School of Medicine at UCLA, Los Angeles, California, United States of America
- Department of Urology, David Geffen School of Medicine at UCLA, Los Angeles, California, United States of America
- Departments of Microbiology, Immunology and Molecular Genetics, UCLA, Los Angeles, California, United States of America
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Abstract
Leptospirosis outbreaks have been associated with many common water events including water consumption, water sports, environmental disasters, and occupational exposure. The ability of leptospires to survive in moist environments makes them a high-risk agent for infection following contact with any contaminated water source. Water treatment processes reduce the likelihood of leptospirosis or other microbial agents causing infection provided that they do not malfunction and the distribution networks are maintained. Notably, there are many differences in water treatment systems around the world, particularly between developing and developed countries. Detection of leptospirosis in water samples is uncommonly performed by molecular methods.
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40
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Asoh T, Saito M, Villanueva SYAM, Kanemaru T, Gloriani N, Yoshida SI. Natural defense by saliva and mucosa against oral infection by Leptospira. Can J Microbiol 2014; 60:383-9. [PMID: 24861456 DOI: 10.1139/cjm-2014-0016] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
Leptospirosis caused by drinking water has not been as frequently reported as percutaneous infection. Resistance to oral infection by pathogenic Leptospira was examined in an experimental hamster infection model. The results suggested some natural defenses against oral infection by Leptospira. First, we found that characteristic linear agglutination of Leptospira rapidly occurs when mixed with human saliva. That human saliva attenuated the infectivity of the treated leptospires by its agglutination activity suggested saliva to be the first line of defense against oral infection by leptospires. Second, only 10(1) Leptospira organisms caused death after submucosal injection into oral mucosa in hamsters, but oral infection with drinking water containing 10(5) organisms/mL did not cause death. This result showed that the mucosa plays the role of a physical barrier. Third, hamsters intragastrically infected by leptospires, with doses lethal to hamsters in oral infection, showed no signs of illness, which suggested that gastric acid plays an important role in preventing oral infection. Based on these results, saliva, mucosa, and gastric acid make up a natural defense, which confers high resistance to hosts against oral infection by leptospires.
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Affiliation(s)
- Tatsuma Asoh
- a Department of Bacteriology, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan
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Villanueva SYAM, Saito M, Tsutsumi Y, Segawa T, Baterna RA, Chakraborty A, Asoh T, Miyahara S, Yanagihara Y, Cavinta LL, Gloriani NG, Yoshida SI. High virulence in hamsters of four dominant Leptospira serovars isolated from rats in the Philippines. MICROBIOLOGY-SGM 2013; 160:418-428. [PMID: 24257815 DOI: 10.1099/mic.0.072439-0] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Leptospirosis is caused by pathogenic species of Leptospira. The aim of this study was to determine and characterize the pathogenicity of four dominant Leptospira isolates prevailing among rats in the Philippines. The isolates were Leptospira interrogans serovar Manilae strain K64, L. interrogans serovar Losbanos strain K37, L. interrogans serovar Ratnapura strain K5 and Leptospira borgpetersenii serovar Javanica strain K6. Pathogenicities were studied using hamsters, which reproduce severe human leptospirosis. The minimum lethal doses were 10(0) ( = 1) leptospires for K64, K37 and K5, and 10(1) leptospires for K6. Weight loss amongst the Leptospira-infected hamsters was observed from 1 day before death (K64-, K37- and K5-infected hamsters) to as much as 1 week before death for K6-infected hamsters. Similar and varied gross and microscopic lesions were observed amongst infected hamsters, even for strains belonging to the same species (i.e. L. interrogans). The most significant and common histopathological findings were congestion of the glomerulus, disarrangement of hepatic cords and erythrophagocytosis. Other findings were foamy splenic macrophages for K6, severe petechial pulmonary haemorrhage for K64, and hematuria and severe pulmonary congestion for K37. Immunostaining and culture revealed the presence of leptospires in different organs of the infected hamsters. Based on these results, Leptospira isolates from rats in the Philippines were shown to be highly virulent, causing pulmonary haemorrhage, severe hepato-renal damage and death in hamsters even at lower doses. The present findings on experimental leptospirosis support clinical data showing that patients with severe manifestations of leptospirosis, such as pulmonary haemorrhage, are increasing in the Philippines. These findings may serve as a basis to strengthen the early diagnosis and treatment of human leptospirosis.
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Affiliation(s)
- Sharon Y A M Villanueva
- Department of Bacteriology, Faculty of Medical Sciences, Kyushu University, Fukuoka 812-8582, Japan
| | - Mitsumasa Saito
- Department of Bacteriology, Faculty of Medical Sciences, Kyushu University, Fukuoka 812-8582, Japan
| | - Yutaka Tsutsumi
- Department of Pathology, Fujita Health University School of Medicine, Toyoake, Aichi 470-1192, Japan
| | - Takaya Segawa
- Department of Bacteriology, Faculty of Medical Sciences, Kyushu University, Fukuoka 812-8582, Japan
| | - Rubelia A Baterna
- Department of Medical Microbiology, College of Public Health, University of the Philippines-Manila, Manila 1000, Philippines
| | - Antara Chakraborty
- Department of Bacteriology, Faculty of Medical Sciences, Kyushu University, Fukuoka 812-8582, Japan
| | - Tatsuma Asoh
- Department of Bacteriology, Faculty of Medical Sciences, Kyushu University, Fukuoka 812-8582, Japan
| | - Satoshi Miyahara
- Department of Bacteriology, Faculty of Medical Sciences, Kyushu University, Fukuoka 812-8582, Japan
| | - Yasutake Yanagihara
- Department of Medical Microbiology, College of Public Health, University of the Philippines-Manila, Manila 1000, Philippines
| | - Lolita L Cavinta
- Department of Medical Microbiology, College of Public Health, University of the Philippines-Manila, Manila 1000, Philippines
| | - Nina G Gloriani
- Department of Medical Microbiology, College of Public Health, University of the Philippines-Manila, Manila 1000, Philippines
| | - Shin-Ichi Yoshida
- Department of Bacteriology, Faculty of Medical Sciences, Kyushu University, Fukuoka 812-8582, Japan
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Global stability of vector-host disease with variable population size. BIOMED RESEARCH INTERNATIONAL 2013; 2013:710917. [PMID: 23841089 PMCID: PMC3690646 DOI: 10.1155/2013/710917] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/26/2013] [Accepted: 05/22/2013] [Indexed: 12/03/2022]
Abstract
The paper presents the vector-host disease with a variability in population. We assume, the disease is fatal and for some cases the infected individuals become susceptible. We first show the local and global stability of the disease-free equilibrium, for the case when R0 < 1. We also show that for R0 < 1, the disease free-equilibrium of the model is both locally as well as globally stable. For R0 > 1, there exists a unique positive endemic equilibrium. For R0 > 1, the disease persistence occurs. The endemic equilibrium is locally as well as globally asymptotically stable for R0 > 1. Numerical results are presented for the justifications of theoratical results.
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Etymologia: Leptospira. Emerg Infect Dis 2013. [DOI: 10.3201/eid1903.et1903] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
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Saito M, Villanueva SYAM, Kawamura Y, Iida KI, Tomida J, Kanemaru T, Kohno E, Miyahara S, Umeda A, Amako K, Gloriani NG, Yoshida SI. Leptospira idonii sp. nov., isolated from environmental water. Int J Syst Evol Microbiol 2012. [PMID: 23203626 DOI: 10.1099/ijs.0.047233-0] [Citation(s) in RCA: 45] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Strain Eri-1(T) was isolated from a water sample on the campus of Kyushu University, Fukuoka, Japan. The motility and morphology of the isolate were similar to those of members of the genus Leptospira, but the spiral structure of the isolate was sharper under dark-field microscopy. Cells were 10.6 ± 1.3 µm long and 0.2 µm in diameter, with a wavelength of 0.9 µm and an amplitude of 0.4 µm. Strain Eri-1(T) grew in Korthof's medium at both 13 and 30 °C, and also in the presence of 8-azaguanine. 16S rRNA gene-based phylogenetic analysis placed strain Eri-1(T) within the radiation of the genus Leptospira where it formed a unique lineage within the clade of the known saprophytic species of the genus Leptospira. The strain was not pathogenic to hamsters. Strain Eri-1(T) exhibited low levels (11.2-12.6 %) of similarity by DNA-DNA hybridization to the three most closely related species of the genus Leptospira. The DNA G+C content of the genome of strain Eri-1(T) was 42.5 ± 0.1 mol%. These results suggest that strain Eri-1(T) represents a novel species of the genus Leptospira, for which the name Leptospira idonii sp. nov. is proposed. The type strain is Eri-1(T) ( = DSM 26084(T) = JCM 18486(T)).
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Affiliation(s)
- Mitsumasa Saito
- Department of Bacteriology, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka 812-8582, Japan
| | - Sharon Y A M Villanueva
- Department of Bacteriology, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka 812-8582, Japan
| | - Yoshiaki Kawamura
- Department of Microbiology, Aichigakuin University, School of Pharmacy, 1-100 Kusumoto-cho, Nagoya 464-8650, Japan
| | - Ken-Ichiro Iida
- Department of Bacteriology, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka 812-8582, Japan
| | - Junko Tomida
- Department of Microbiology, Aichigakuin University, School of Pharmacy, 1-100 Kusumoto-cho, Nagoya 464-8650, Japan
| | - Takaaki Kanemaru
- Department of Morphology Core Unit, Kyushu University Hospital, 3-1-1 Maidashi, Higashi-ku, Fukuoka 812-8582, Japan
| | - Eri Kohno
- Department of Bacteriology, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka 812-8582, Japan
| | - Satoshi Miyahara
- Department of Bacteriology, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka 812-8582, Japan
| | - Akiko Umeda
- Department of Basic Laboratory Sciences, Graduate School of Medicine, Yamaguchi University, 1-1-1 Minami-Kogushi, Ube, Yamaguchi 755-8505, Japan
| | - Kazunobu Amako
- Department of Bacteriology, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka 812-8582, Japan
| | - Nina G Gloriani
- Department of Medical Microbiology, College of Public Health, University of the Philippines-Manila, 625 Pedro Gil St, Ermita, 1000, Manila, The Philippines
| | - Shin-Ichi Yoshida
- Department of Bacteriology, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka 812-8582, Japan
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Comparative analysis of Leptospira strains isolated from environmental soil and water in the Philippines and Japan. Appl Environ Microbiol 2012; 79:601-9. [PMID: 23144130 DOI: 10.1128/aem.02728-12] [Citation(s) in RCA: 69] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
Abstract
There have been few reports on the epidemiological analysis of environmental Leptospira isolates. This is probably because the isolation of leptospires from the environment was usually unsuccessful due to the overgrowth of contaminants and the slow growth of Leptospira. In this study, we collected a total of 88 samples of soil and water from three sites: Metro Manila and Nueva Ecija, Philippines (an area where Leptospira is now endemic), and Fukuoka, Japan (an area where Leptospira was once endemic). We succeeded in isolating Leptospira from 37 samples by using the novel combination of five antimicrobial agents reported in 2011. The frequencies of positive isolation of Leptospira in the Philippines and Japan were 40 and 46%, respectively. For Leptospira-positive samples, five colonies from each sample were isolated and analyzed by pulsed-field gel electrophoresis (PFGE). The isolates from each area showed their respective characteristics in phylogenetic trees based on the PFGE patterns. Some isolates were closely related to each other across borders. Based on 16S rRNA gene-based phylogenetic analysis, four isolates in Fukuoka were identified as a pathogenic species, L. alstonii; however, its virulence had been lost. One isolate from Nueva Ecija was identified as the intermediate pathogenic species Leptospira licerasiae. Most of the isolates from the environment belonged to nonpathogenic Leptospira species. We also investigated the strain variation among the isolates in a puddle over 5 months. We demonstrated, using PFGE analysis, that Leptospira survived in the wet soil on dry days and appeared in the surface water on rainy days. These results showed that the soil could be a reservoir of leptospires in the environment.
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Dellagostin OA, Grassmann AA, Hartwig DD, Félix SR, da Silva ÉF, McBride AJA. Recombinant vaccines against leptospirosis. HUMAN VACCINES 2011; 7:1215-24. [PMID: 22048111 DOI: 10.4161/hv.7.11.17944] [Citation(s) in RCA: 59] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Leptospirosis is an important neglected infectious disease that occurs in urban environments, as well as in rural regions worldwide. Rodents, the principal reservoir hosts of pathogenic Leptospira spp., and other infected animals shed the bacteria in their urine. During occupational or even recreational activities, humans that come into direct contact with infected animals or with a contaminated environment, particularly water, are at risk of infection. Prevention of urban leptospirosis is largely dependent on sanitation measures that are often difficult to implement, especially in developing countries. Vaccination with inactivated whole-cell preparations (bacterins) has limited efficacy due to the wide antigenic variation of the pathogen. Intensive efforts towards developing improved recombinant vaccines are ongoing. During the last decade, many reports on the evaluation of recombinant vaccines have been published. Partial success has been obtained with some surface-exposed protein antigens. The combination of protective antigens and new adjuvants or delivery systems may result in the much-needed effective vaccine.
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Affiliation(s)
- Odir A Dellagostin
- Unidade de Biotecnologia, Centro de Desenvolvimento Tecnológico, Salvador, BA, Brazil.
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Martin CJ. CONCERNING THE PATHOLOGY AND ETIOLOGY OF THE INFECTIOUS JAUNDICE COMMON AT THE DARDANELLES, 1915. BRITISH MEDICAL JOURNAL 2011; 1:445-7. [PMID: 20768534 DOI: 10.1136/bmj.1.2936.445] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Giuseppe PO, Von Atzingen M, Nascimento ALTO, Zanchin NIT, Guimarães BG. The crystal structure of the leptospiral hypothetical protein LIC12922 reveals homology with the periplasmic chaperone SurA. J Struct Biol 2010; 173:312-22. [PMID: 20970503 DOI: 10.1016/j.jsb.2010.10.009] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2010] [Revised: 10/11/2010] [Accepted: 10/18/2010] [Indexed: 12/22/2022]
Abstract
Leptospirosis is a world spread zoonosis caused by members of the genus Leptospira. Although leptospires were identified as the causal agent of leptospirosis almost 100 years ago, little is known about their biology, which hinders the development of new treatment and prevention strategies. One of the several aspects of the leptospiral biology not yet elucidated is the process by which outer membrane proteins (OMPs) traverse the periplasm and are inserted into the outer membrane. The crystal structure determination of the conserved hypothetical protein LIC12922 from Leptospira interrogans revealed a two domain protein homologous to the Escherichia coli periplasmic chaperone SurA. The LIC12922 NC-domain is structurally related to the chaperone modules of E. coli SurA and trigger factor, whereas the parvulin domain is devoid of peptidyl prolyl cis-trans isomerase activity. Phylogenetic analyses suggest a relationship between LIC12922 and the chaperones PrsA, PpiD and SurA. Based on our structural and evolutionary analyses, we postulate that LIC12922 is a periplasmic chaperone involved in OMPs biogenesis in Leptospira spp. Since LIC12922 homologs were identified in all spirochetal genomes sequenced to date, this assumption may have implications for the OMPs biogenesis studies not only in leptospires but in the entire Phylum Spirochaetes.
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Affiliation(s)
- Priscila O Giuseppe
- Brazilian Biosciences National Laboratory (LNBio), Brazilian Center of Research in Energy and Materials (CNPEM), Giuseppe Máximo Scolfaro 10000, 13083-970 Campinas, SP, Brazil
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O'Guinn ML, Klein TA, Lee JS, Richards AL, Kim HC, Ha SJ, Shim SH, Baek LJ, Song KJ, Chong ST, Turell MJ, Burkett DA, Schuster A, Lee IY, Yi SH, Sames WJ, Song JW. Serological surveillance of scrub typhus, murine typhus, and leptospirosis in small mammals captured at firing points 10 and 60, Gyeonggi province, Republic of Korea, 2001-2005. Vector Borne Zoonotic Dis 2010; 10:125-33. [PMID: 19402761 DOI: 10.1089/vbz.2008.0123] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Soldiers from the Republic of Korea and the United States conducting peacetime military operations at various training sites and multiple range complexes located near the demilitarized zone separating North and South Korea are exposed to rodents and their potentially disease-carrying ectoparasites. These diseases include scrub typhus, murine typhus, and leptospirosis. Many of the training sites are rural or semi-rural, surrounded or co-located with various forms of agriculture, and are infested with rodents and insectivores (as well as their ectoparasites), which are commonly found in association with unmanaged tall grasses, scrub, and crawling vegetation habitats. For 5 years, rodents and insectivores were collected seasonally (spring, summer, fall, and winter) at firing points 10 and 60 near the demilitarized zone and serologically tested for the presence of scrub typhus, murine typhus, and leptospirosis antibodies. Of the nine species of small mammals collected, Apodemus agrarius, the common striped field mouse and known reservoir of scrub typhus, was the most frequently collected (90.6%). Only four of the nine species captured, A. agrarius (60.9%), Micromys minutus (100%), Mus musculus (55.6%), and Rattus norvegicus (46.7%), were positive for scrub typhus. Of all the small mammals captured, only A. agrarius was positive for murine typhus (0.3%) and leptospirosis (1.3%). Seasonal and annual prevalence rates based on weight and sex are presented.
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Affiliation(s)
- Monica L O'Guinn
- Virology Division, U.S. Army Medical Research Institute of Infectious Diseases, Fort Detrick, Maryland, USA
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