1
|
Westra D, Volokhina EB, van der Molen RG, van der Velden TJAM, Jeronimus-Klaasen A, Goertz J, Gracchi V, Dorresteijn EM, Bouts AHM, Keijzer-Veen MG, van Wijk JAE, Bakker JA, Roos A, van den Heuvel LP, van de Kar NCAJ. Serological and genetic complement alterations in infection-induced and complement-mediated hemolytic uremic syndrome. Pediatr Nephrol 2017; 32:297-309. [PMID: 27718086 PMCID: PMC5203860 DOI: 10.1007/s00467-016-3496-0] [Citation(s) in RCA: 36] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/17/2016] [Revised: 08/10/2016] [Accepted: 08/11/2016] [Indexed: 01/13/2023]
Abstract
BACKGROUND The role of complement in the atypical form of hemolytic uremic syndrome (aHUS) has been investigated extensively in recent years. As the HUS-associated bacteria Shiga-toxin-producing Escherichia coli (STEC) can evade the complement system, we hypothesized that complement dysregulation is also important in infection-induced HUS. METHODS Serological profiles (C3, FH, FI, AP activity, C3d, C3bBbP, C3b/c, TCC, αFH) and genetic profiles (CFH, CFI, CD46, CFB, C3) of the alternative complement pathway were prospectively determined in the acute and convalescent phase of disease in children newly diagnosed with STEC-HUS or aHUS. Serological profiles were compared with those of 90 age-matched controls. RESULTS Thirty-seven patients were studied (26 STEC-HUS, 11 aHUS). In 39 % of them, including 28 % of STEC-HUS patients, we identified a genetic and/or acquired complement abnormality. In all patient groups, the levels of investigated alternative pathway (AP) activation markers were elevated in the acute phase and normalized in remission. The levels were significantly higher in aHUS than in STEC-HUS patients. CONCLUSIONS In both infection-induced HUS and aHUS patients, complement is activated in the acute phase of the disease but not during remission. The C3d/C3 ratio displayed the best discrepancy between acute and convalescent phase and between STEC-HUS and aHUS and might therefore be used as a biomarker in disease diagnosis and monitoring. The presence of aberrations in the alternative complement pathway in STEC-HUS patients was remarkable, as well.
Collapse
Affiliation(s)
- Dineke Westra
- Department of Pediatric Nephrology (804), Radboud University Medical Center, P.O. Box 9101, 6500 HB, Nijmegen, The Netherlands.
| | - Elena B Volokhina
- Department of Pediatric Nephrology (804), Radboud University Medical Center, P.O. Box 9101, 6500 HB, Nijmegen, The Netherlands
| | - Renate G van der Molen
- Department of Laboratory Medicine, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Thea J A M van der Velden
- Department of Pediatric Nephrology (804), Radboud University Medical Center, P.O. Box 9101, 6500 HB, Nijmegen, The Netherlands
| | - Annelies Jeronimus-Klaasen
- Department of Pediatric Nephrology (804), Radboud University Medical Center, P.O. Box 9101, 6500 HB, Nijmegen, The Netherlands
| | - Joop Goertz
- Department of Laboratory Medicine, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Valentina Gracchi
- Department of Pediatric Nephrology, University Medical Center Groningen, Groningen, The Netherlands
| | - Eiske M Dorresteijn
- Department of Pediatric Nephrology, Erasmus MC - Sophia Children's Hospital, Rotterdam, The Netherlands
| | - Antonia H M Bouts
- Department of Pediatric Nephrology, Academic Medical Center, Amsterdam, The Netherlands
| | - Mandy G Keijzer-Veen
- Department of Pediatric Nephrology, University Medical Centre Utrecht, Utrecht, The Netherlands
| | - Joanna A E van Wijk
- Department of Pediatric Nephrology, VU University Medical Center, Amsterdam, The Netherlands
| | - Jaap A Bakker
- Department of Clinical Chemistry and Laboratory Medicine, Leiden University Medical Centre, Leiden, The Netherlands
| | - Anja Roos
- Department of Medical Microbiology and Immunology, Sint Antonius Hospital, Nieuwegein, The Netherlands
| | - Lambert P van den Heuvel
- Department of Pediatric Nephrology (804), Radboud University Medical Center, P.O. Box 9101, 6500 HB, Nijmegen, The Netherlands
- Department of Pediatrics, Department of Growth and Regeneration, University Hospital Leuven, Leuven, Belgium
| | - Nicole C A J van de Kar
- Department of Pediatric Nephrology (804), Radboud University Medical Center, P.O. Box 9101, 6500 HB, Nijmegen, The Netherlands
| |
Collapse
|
2
|
Zapata-Quintanilla LB, Palmeira P, Tino-De-Franco M, Amaral JA, Carbonare CB, Carbonare SB. Systemic antibody response to diarrheagenic Escherichia coli and LPS O111, O157 and O55 in healthy Brazilian adults. Scand J Immunol 2007; 64:661-7. [PMID: 17083623 DOI: 10.1111/j.1365-3083.2006.01848.x] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Enterohaemorrhagic Escherichia coli (EHEC) can cause a variety of human illnesses ranging from uncomplicated diarrhoea to haemorrhagic colitis and haemolytic uremic syndrome. The serotype O157:H7 has been associated with numerous outbreaks worldwide, but in Brazil the infection is rare. Brazilian adults present antibodies reactive with the principal virulence factors of enteropathogenic E. coli (EPEC) that have many genetic and antigenic similarities with EHEC. Lipopolysaccharides (LPS) are components of outer membranes and important virulence factors of Gram-negative bacteria. LPS O111 is present in EPEC and EHEC strains. LPS O157 is found only in EHEC strains, but it has some structural similarities with LPS O55 present in EPEC strains. This study investigates the levels of IgG and IgM seric antibodies reactive with EHEC O157:H7, EHEC O111:H-, EPEC O111:H- and the levels of anti-LPS O111, LPS O157 and LPS O55 antibodies in healthy adults living in São Paulo, Brazil. The antibody levels were determined by an enzyme-linked immunosorbent assay for 100 individual serum samples, and the presence of anti-bacterial and anti-LPS seric antibodies was confirmed. Positive correlations were found among the three kinds of antibodies. The concentrations of IgM anti-LPS were significantly higher than those of IgG, and surprisingly, the concentrations of anti-LPS O157 were high in view of the infrequent isolation of O157 bacteria in Brazil. Our results suggest that there is a cross-reacting immunity to EHEC in the Brazilian population, which may be a result of the immunity to EPEC antigens. Alternatively, Brazilians may be exposed to EHEC more frequently than has previously been thought.
Collapse
|
3
|
Sidjabat HE, Townsend KM, Lorentzen M, Gobius KS, Fegan N, Chin JJC, Bettelheim KA, Hanson ND, Bensink JC, Trott DJ. Emergence and spread of two distinct clonal groups of multidrug-resistant Escherichia coli in a veterinary teaching hospital in Australia. J Med Microbiol 2006; 55:1125-1134. [PMID: 16849734 DOI: 10.1099/jmm.0.46598-0] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Multidrug-resistant Escherichia coli (MDREC) expressing AmpC β-lactamases have emerged as a cause of opportunistic infections in dogs. Following a cluster of extraintestinal infections caused by two distinct clonal groups (CGs) of bla
CMY-producing MDREC, a 12-month infection control study was undertaken at a veterinary teaching hospital in Brisbane, Australia. Swabs from the rectum of hospitalized dogs (n=780), hospital staff (n=16) and the hospital environment (n=220) were plated onto selective agar to obtain multidrug-resistant (MDR) coliforms. These were then tested by multiplex PCR for E. coli uspA, bla
CMY and the class 1 integron-associated dfrA17-aadA5 gene cassette for rapid identification of MDREC CG 1 (positive for all three genes) and CG 2 (positive for uspA and bla
CMY only). A total of 16.5 % of the dog rectal swabs and 4.1 % of the hospital environmental swabs yielded MDREC, and on the basis of multiplex PCR, PFGE and plasmid profiling, these were confirmed to belong to either CG 1 or CG 2. Both CG 1 and CG 2 isolates were obtained from clinical cases of extraintestinal infection and rectal swabs from hospitalized dogs over the same period of time, whereas only CG 1 isolates were obtained from the hospital environment. Both CGs were prevalent during the first 6 months, but only CG 2 was isolated during the second 6 months of the study. Two isolates obtained from rectal swabs of staff working in the hospital belonged to CG 2, with one of the isolates possessing the same REDP as nine isolates from dogs, including six isolates associated with cases of extraintestinal infection. CG 1 isolates belonged to E. coli serotypes O162 : H−, OR : H− or Ont : H−, whereas CG 2 isolates belonged to O153 : HR, OR : HR or OR : H34. These results confirm that in this particular outbreak, canine MDREC were highly clonal and CG 2 MDREC may colonize both humans and dogs.
Collapse
Affiliation(s)
- Hanna E Sidjabat
- Medical Faculty of the Christian University of Indonesia (FK-UKI), Cawang Atas, Jakarta, Indonesia
- School of Veterinary Science, University of Queensland, Brisbane, QLD 4072, Australia
| | - Kirsty M Townsend
- School of Veterinary Science, University of Queensland, Brisbane, QLD 4072, Australia
| | - Michael Lorentzen
- School of Veterinary Science, University of Queensland, Brisbane, QLD 4072, Australia
| | - Kari S Gobius
- Food Science Australia, Tingalpa DC, QLD 4173, Australia
| | - Narelle Fegan
- Food Science Australia, Tingalpa DC, QLD 4173, Australia
| | - James J-C Chin
- Immunology and Microbiology, Elizabeth Macarthur Agricultural Institute, PMB 8, Camden, NSW 2570, Australia
| | - Karl A Bettelheim
- Microbiology Diagnostic Unit, Public Health Laboratory, Department of Microbiology and Immunology, University of Melbourne, Royal Parade, Parkville, VIC 3052, Australia
| | - Nancy D Hanson
- Center for Research in Anti-Infectives and Biotechnology, Department of Medical Microbiology and Immunology, School of Medicine, Creighton University, 2500 California Plaza, Omaha, NE 68178, USA
| | - John C Bensink
- School of Veterinary Science, University of Queensland, Brisbane, QLD 4072, Australia
| | - Darren J Trott
- School of Veterinary Science, University of Queensland, Brisbane, QLD 4072, Australia
| |
Collapse
|
4
|
Feng L, Senchenkova SN, Tao J, Shashkov AS, Liu B, Shevelev SD, Reeves PR, Xu J, Knirel YA, Wang L. Structural and genetic characterization of enterohemorrhagic Escherichia coli O145 O antigen and development of an O145 serogroup-specific PCR assay. J Bacteriol 2005; 187:758-64. [PMID: 15629947 PMCID: PMC543545 DOI: 10.1128/jb.187.2.758-764.2005] [Citation(s) in RCA: 58] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Enterohemorrhagic Escherichia coli O145 strains are emerging as causes of hemorrhagic colitis and hemolytic uremic syndrome. In this study, we present the structure of the E. coli O145 O antigen and the sequence of its gene cluster. The O145 antigen has repeat units containing three monosaccharide residues: 2-acetamido-2-deoxy-D-glucose (GlcNAc), 2-acetamidoylamino-2,6-dideoxy-L-galactose, and N-acetylneuraminic acid. It is very closely related to Salmonella enterica serovar Touera and S. enterica subsp. arizonae O21 antigen. The E. coli O145 gene cluster is located between the JUMPStart sequence and the gnd gene and consists of 15 open reading frames. Putative genes for the synthesis of the O-antigen constituents, for sugar transferase, and for O-antigen processing were annotated based on sequence similarities and the presence of conserved regions. The putative genes located in the E. coli O145 O-antigen gene cluster accounted for all functions expected for synthesis of the structure. An E. coli O145 serogroup-specific PCR assay based on the genes wzx and wzy was also developed by screening E. coli and Shigella isolates of different serotypes.
Collapse
Affiliation(s)
- Lu Feng
- TEDA School of Biological Sciences and Biotechnology, Nankai University, TEDA College, 23# HongDa St., TEDA, Tianjin 300457, People's Republic of China
| | | | | | | | | | | | | | | | | | | |
Collapse
|
5
|
HAZARIKA R, SINGH D, KAPOOR K, AGARWAL R, PANDEY A, RAJKUMAR D. DETECTION AND CHARACTERIZATION OF VEROTOXIN-PRODUCING ESCHERICHIA COLI (VTEC) ISOLATED FROM BUFFALO MEAT. J Food Saf 2004. [DOI: 10.1111/j.1745-4565.2004.00536.x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
|