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Cardoso TL, de Freitas SB, Seixas Neto ACP, Balassiano IT, Hartwig DD. Advancing serologic diagnosis: assessing the efficacy of rErpY-like protein in human leptospirosis detection. Braz J Microbiol 2024:10.1007/s42770-024-01364-4. [PMID: 38805148 DOI: 10.1007/s42770-024-01364-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2024] [Accepted: 04/29/2024] [Indexed: 05/29/2024] Open
Abstract
Leptospirosis is a globally distributed infectious disease caused by pathogenic spirochetes of the Leptospira genus, often overlooked. It is estimated that the disease affects approximately one million people annually, resulting in more than 58,900 deaths. The gold standard for serodiagnosis of leptospirosis is the Microscopic Agglutination Test (MAT). However, the limitations of this technique necessitate the exploration of alternative diagnostic methods. In this study, we evaluated the ErpY-like recombinant protein (rErpY-like) in the development of a serologic diagnostic assay for human leptospirosis. Eighty-six human sera samples, characterized by MAT, underwent evaluation through indirect IgM-ELISA and IgG-ELISA. The sensitivity and specificity values obtained from IgM-ELISA were 60% and 76%, respectively, while those from IgG-ELISA were 96.4% and 100%, respectively. The use of the rErpY-like protein in both IgM-ELISA and IgG-ELISA proves to be a sensitive and specific method for antibody detection. This could potentially serve as a valuable alternative tool in the diagnosis of human leptospirosis.
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Affiliation(s)
- Thayná Laner Cardoso
- Laboratory of Bacteriology and Bioassays, Department of Microbiology and Parasitology, Institute of Biology, Federal University of Pelotas, Pelotas, RS, Brazil
| | - Stella Buchhorn de Freitas
- Laboratory of Bacteriology and Bioassays, Department of Microbiology and Parasitology, Institute of Biology, Federal University of Pelotas, Pelotas, RS, Brazil
| | - Amilton Clair Pinto Seixas Neto
- Laboratory of Bacteriology and Bioassays, Department of Microbiology and Parasitology, Institute of Biology, Federal University of Pelotas, Pelotas, RS, Brazil
| | - Ilana Teruszkin Balassiano
- Bacterial Zoonoses Laboratory, Leptospirosis National Reference Center/Leptospira Collection, WHO/PAHO Collaborating Center for Leptospirosis, Department of Bacteriology, Oswaldo Cruz Institute, FIOCRUZ, Rio de Janeiro, Brazil
| | - Daiane Drawanz Hartwig
- Laboratory of Bacteriology and Bioassays, Department of Microbiology and Parasitology, Institute of Biology, Federal University of Pelotas, Pelotas, RS, Brazil.
- Federal University of Pelotas, University Campus, Pelotas, RS, CEP 96010-900, Brazil.
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Delight EA, de Carvalho Santiago DC, Palma FAG, de Oliveira D, Souza FN, Santana JO, Hidano A, López YAA, Reis MGG, Ko AI, Marphatia AA, Cremonense C, Costa F, Eyre MT. Gender differences in the perception of leptospirosis severity, behaviours, and Leptospira exposure risk in urban Brazil: a cross-sectional study. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2024:2024.04.28.24306445. [PMID: 38746452 PMCID: PMC11092738 DOI: 10.1101/2024.04.28.24306445] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/16/2024]
Abstract
Background Vulnerability to climate hazards and infectious diseases are not gender-neutral, meaning that men, women, boys, girls, and other gender identities experience different health risks. Leptospirosis, a zoonotic climate sensitive infectious disease, is commonly transmitted to humans via contact with animals and the environment, particularly soil and flood water. Gender differences in leptospiral infection risk are reported globally, with men consistently found to be at higher risk than women. However, the drivers of this difference in risk are poorly understood. Previous studies suggest that the interplay of knowledge, perceptions, and behaviours may shape differential infection risk among genders. Methodology/Principal Findings To examine gender differences in Leptospira exposure risk we conducted a cross-sectional serosurvey among adult participants (n = 761) in four urban, marginalised, informal settlements in the city of Salvador, Brazil. We found that seroprevalence was 14.6% and 9.4% across men and women respectively. We then applied causal inference methodology to a two-part sex-disaggregated analysis to investigate: 1) the association of perceptions and behaviours with Leptospira seropositivity and 2) the association of perceptions with behaviours. We found that men who perceived leptospirosis as extremely serious had lower odds of seropositivity, walking through sewage water, or walking barefoot, suggesting an important link between perceptions, behaviours, and exposure risk. These associations were not found in women, and these behaviours were not associated with seropositivity in men or women. Conclusions Our results highlight perceived severity of disease as a potential driver of behaviour in men, and perceptions of disease may be an important target for health education programs. Furthermore, our study identifies evidence gaps in the understanding of infection risks in women. As the first sex-disaggregated study investigating Leptospira infection risks, we advocate for a gendered lens in future studies to further understand risks specific to different gender identities.
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Affiliation(s)
| | | | | | - Daiana de Oliveira
- Federal University of Bahia, Salvador, Collective Health Institute, Salvador, Bahia, Brazil
- Instituto Gonçalo Moniz, Fundação Oswaldo Cruz, Ministério da Saúde, Salvador, Bahia, Brazil
| | - Fábio Neves Souza
- Federal University of Bahia, Salvador, Collective Health Institute, Salvador, Bahia, Brazil
| | | | - Arata Hidano
- London School of Hygiene & Tropical Medicine, London, UK
| | | | | | - Albert I Ko
- Instituto Gonçalo Moniz, Fundação Oswaldo Cruz, Ministério da Saúde, Salvador, Bahia, Brazil
- Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, CT, USA
| | | | - Cleber Cremonense
- Federal University of Bahia, Salvador, Collective Health Institute, Salvador, Bahia, Brazil
| | - Federico Costa
- Federal University of Bahia, Salvador, Collective Health Institute, Salvador, Bahia, Brazil
- Instituto Gonçalo Moniz, Fundação Oswaldo Cruz, Ministério da Saúde, Salvador, Bahia, Brazil
| | - Max T Eyre
- London School of Hygiene & Tropical Medicine, London, UK
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Stammler R, Chevalier K, Benhamida S, Le Goff E, Lebut J, Lau N, Thyrault M, Paulet R. The other great imitator among infectious diseases: Leptospirosis. Rev Med Interne 2024; 45:132-137. [PMID: 38123370 DOI: 10.1016/j.revmed.2023.12.001] [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: 04/22/2023] [Revised: 11/27/2023] [Accepted: 12/02/2023] [Indexed: 12/23/2023]
Abstract
INTRODUCTION Leptospirosis is a worldwide zoonosis responsible for highly diverse clinical presentations with a wide range of severity. Variable environment exposures to infected urines of rodents have been described. OBSERVATION We report five cases of serologically confirmed leptospirosis leading to hospitalization in an intensive care unit (ICU) of a French center. These patients displayed neurological, respiratory, and abdominal presentation of leptospirosis with variable level of severity. Either professional, leisure related, or daily living exposures have been retrieved. CONCLUSION These cases underline the diversity of clinical presentation and environmental exposure of this infectious disease. They highlight the interest of an exhaustive anamnesis with collection of professional activity, environmental exposures, and leisure activities.
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Affiliation(s)
- R Stammler
- Intensive care unit, Longjumeau Hospital, Longjumeau, France.
| | - K Chevalier
- Intensive care unit, Longjumeau Hospital, Longjumeau, France
| | - S Benhamida
- Intensive care unit, Longjumeau Hospital, Longjumeau, France
| | - E Le Goff
- Intensive care unit, Longjumeau Hospital, Longjumeau, France
| | - J Lebut
- Intensive care unit, Longjumeau Hospital, Longjumeau, France
| | - N Lau
- Intensive care unit, Longjumeau Hospital, Longjumeau, France
| | - M Thyrault
- Intensive care unit, Longjumeau Hospital, Longjumeau, France
| | - R Paulet
- Intensive care unit, Longjumeau Hospital, Longjumeau, France
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Suwannin P, Jangpatarapongsa K, Polpanich D, Alhibshi A, Errachid A, Elaissari A. Enhancing leptospirosis control with nanosensing technology: A critical analysis. Comp Immunol Microbiol Infect Dis 2024; 104:102092. [PMID: 37992537 DOI: 10.1016/j.cimid.2023.102092] [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: 09/19/2023] [Revised: 11/07/2023] [Accepted: 11/09/2023] [Indexed: 11/24/2023]
Abstract
Leptospirosis is a serious health problem in tropical areas; thus, animals shed leptospires in the environment. Humans are accidental hosts infected through exposure to contaminating bacteria in the environment. One health strategy can be applied to protect and eliminate leptospirosis because this cooperates and coordinates activities between doctors, veterinarians, and ecologists. However, conventional methods still have limitations. Therefore, the main challenges of leptospirosis control are the high sensing of detection methods to screen and control the pathogens. Interestingly, nano sensing combined with a leptospirosis detection approach can increase the sensitivity and eliminate some limitations. This article reviews nanomaterial development for an advanced leptospirosis detection method, e.g., latex beads-based agglutination test, magnetic nanoparticles enrichment, and gold-nanoparticles-based immunochromatographic assay. Thus, nanomaterials can be functionalized with biomolecules or sensing molecules utilized in various mechanisms such as biosensors. Over the last decade, many biosensors have been developed for Leptospira spp. pathogen and others. The evolution of biosensors for leptospirosis detection was designed for high efficiency and might be an alternative tool. In addition, the high-sensing fabrications are useful for leptospires screening in very low levels, for example, soil or water from the environment.
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Affiliation(s)
- Patcharapan Suwannin
- Center for Research Innovation and Biomedical Informatics, Faculty of Medical Technology, Mahidol University, Bangkok 10700, Thailand; Univ Lyon, University Claude Bernard Lyon-1, CNRS, ISA-UMR 5280, Villeurbanne 69622, France
| | - Kulachart Jangpatarapongsa
- Center for Research Innovation and Biomedical Informatics, Faculty of Medical Technology, Mahidol University, Bangkok 10700, Thailand
| | - Duangporn Polpanich
- National Nanotechnology Center (NANOTEC), National Science and Technology Development Agency (NSTDA), Pathum Thani 12120, Thailand
| | - Amani Alhibshi
- Department of Neuroscience Research, Institute of Research and Medical Consultations, Imam Abdulrahman Bin Faisal University, P.O. Box 1982, Dammam 31441, Saudi Arabia
| | - Abdelhamid Errachid
- Univ Lyon, University Claude Bernard Lyon-1, CNRS, ISA-UMR 5280, Villeurbanne 69622, France
| | - Abdelhamid Elaissari
- Univ Lyon, University Claude Bernard Lyon-1, CNRS, ISA-UMR 5280, Villeurbanne 69622, France.
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Kedia YS, Thorve SM, Waghmare SR, Mishra H, Karpe SP, Nair JP. Outcome of severe leptospirosis presenting with ARDS in respiratory ICU. Lung India 2023; 40:502-506. [PMID: 37961957 PMCID: PMC10723208 DOI: 10.4103/lungindia.lungindia_160_23] [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: 04/04/2023] [Revised: 07/18/2023] [Accepted: 07/30/2023] [Indexed: 11/15/2023] Open
Abstract
Introduction Acute Respiratory Distress Syndrome (ARDS) is a rare presentation and a major complication of leptospirosis associated with high mortality despite advances in management. Methods We conducted a retrospective observational study, in 48 patients presenting with ARDS due to leptospirosis. Clinical presentation, risk factors, management and outcome of patients were noted. Factors associated with survival and mortality were studied. Results Our study showed a male preponderance (87%) with a mean age of presentation of 31.5 years. All patients presented with multiorgan failure. PaO2/FiO2 ratio less than 100 on 3rd day was associated with 90% mortality. The requirement for invasive mechanical ventilation carried a mortality risk of 70.4%. Overall mortality was 39.6%. Conclusion Leptospirosis can cause serious ARDS with a high case fatality. Prompt treatment with non-invasive mechanical ventilation to maintain haemodynamic stability and intravenous steroids can improve the outcome.
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Affiliation(s)
| | | | | | - Harshita Mishra
- Respiratory Medicine, LTMMC, Sion, Mumbai, Maharashtra, India
| | - Sonal P. Karpe
- Respiratory Medicine, LTMMC, Sion, Mumbai, Maharashtra, India
| | - Jairaj P. Nair
- Respiratory Medicine, LTMMC, Sion, Mumbai, Maharashtra, India
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Zheng X, He P, Zhong R, Chen G, Xia J, Li C. Weil's Disease in an HIV-Infected Patient: A Case Report and Literature Review. Diagnostics (Basel) 2023; 13:3218. [PMID: 37892039 PMCID: PMC10606346 DOI: 10.3390/diagnostics13203218] [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: 09/07/2023] [Revised: 09/27/2023] [Accepted: 10/12/2023] [Indexed: 10/29/2023] Open
Abstract
Weil's disease, an icterohemorrhagic infection, is the most severe and fatal form of leptospirosis and is characterized by jaundice, renal dysfunction, and hemorrhagic predisposition. Weil's disease with HIV infection has rarely been reported. A 68-year-old male with HIV infection presented to our hospital with fever and dyspnea that progressed to severe hemoptysis and systemic multiple organ failure, necessitating a tracheal intubation ventilator. A diagnosis of Weil's disease was made after Leptospira interrogans was identified via metagenomic next-generation sequencing (mNGS) in bronchoalveolar lavage fluid (BALF). After immediately receiving supportive therapy and targeted antimicrobial agents, the patient achieved complete recovery upon discharge. The co-infection of HIV infection and leptospirosis resulting in systemic multi-organ failure is rare, but awareness should be raised of the differential diagnosis. mNGS can help identify pathogens and facilitate the use of targeted and efficacious antimicrobial therapy in unusual clinical environments.
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Affiliation(s)
| | | | | | | | - Jinyu Xia
- Infectious Disease Prevention and Treatment Center, the Fifth Affiliated Hospital of Sun Yat-sen University, Zhuhai 519000, China; (X.Z.); (P.H.); (R.Z.); (G.C.)
| | - Chunna Li
- Infectious Disease Prevention and Treatment Center, the Fifth Affiliated Hospital of Sun Yat-sen University, Zhuhai 519000, China; (X.Z.); (P.H.); (R.Z.); (G.C.)
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Fonseka CL, Dahanayake NJ, Mihiran DJD, Wijesinghe KM, Liyanage LN, Wickramasuriya HS, Wijayaratne GB, Sanjaya K, Bodinayake CK. Pulmonary haemorrhage as a frequent cause of death among patients with severe complicated Leptospirosis in Southern Sri Lanka. PLoS Negl Trop Dis 2023; 17:e0011352. [PMID: 37844119 PMCID: PMC10602373 DOI: 10.1371/journal.pntd.0011352] [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: 05/04/2023] [Revised: 10/26/2023] [Accepted: 09/11/2023] [Indexed: 10/18/2023] Open
Abstract
BACKGROUND Leptospirosis is a tropical disease associated with life threatening complications. Identifying clinical and investigation-based parameters that predict mortality and morbidity is vital to provide optimal supportive care. METHODS We conducted an observational study in an endemic setting, in the southern Sri Lanka. Consecutive patients having complicated leptospirosis were recruited over 18 months. Clinical, investigational and treatment data were collected and the predictors of mortality were analysed. RESULTS Out of 88 patients having complicated leptospirosis, 89% were male. Mean age was 47yrs (±16.0). Among the total major complications 94.3% had acute kidney injury, 38.6% pulmonary haemorrhages, 12.5% fulminant hepatic failure, 60.2% hemodynamic instability and 33% myocarditis. An acute significant reduction of haemoglobin (Hb) was observed in 79.4% of patients with pulmonary haemorrhage. The mean of the highest haemoglobin reduction in patients with pulmonary haemorrhage was 3.1g/dL. The presence of pulmonary haemorrhage (PH) and hemodynamic instability within first 48 hours of admission significantly predicted mortality (p<0.05) in severe leptospirosis. Additionally, within first 48 hours of admission, elevated SGOT (AST), presence of atrial fibrillation, presence of significant haemoglobin reduction, higher number of inotropes used, prolonged shock, invasive ventilation and admission to ICU significantly predicted mortality. Out of major complications during the first week after admission, pulmonary haemorrhage and fulminant hepatic failure (FHF) combination had significant adjusted odds of mortality (OR = 6.5 and 4.8, p<0.05). Six patients with severe respiratory failure due to PH underwent ECMO and four survived. The overall mortality in complicated leptospirosis was 17%. In PH and FHF, the mortality rate was higher reaching 35.4% and 54.5%, respectively. CONCLUSIONS Within first 48 hours of admission, major complications such as pulmonary haemorrhage and haemodynamic instability and other parameters such as atrial fibrillation, acute haemoglobin reduction, elevated SGOT level could be used as early parameters predictive of mortality in severe leptospirosis. PH and FHF during the first week of admission in leptospirosis are associated with high morbidity and mortality requiring prolonged ICU care and hospitalisation. Above parameters could be used as parameters indicating severity for triaging and intensifying treatment. Using ECMO is a plausible treatment option in patients with severe pulmonary haemorrhage.
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Affiliation(s)
| | | | | | | | | | | | | | - Kelum Sanjaya
- Department of Limnology and Water Technology, Faculty of Fisheries and Marine Sciences & Technology, University of Ruhuna, Galle, Sri Lanka
| | - Champica K. Bodinayake
- Department of Internal Medicine, Faculty of Medicine, University of Ruhuna, Galle, Sri Lanka
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8
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Browne ES, Pereira M, Barreto A, Zeppelini CG, de Oliveira D, Costa F. Prevalence of human leptospirosis in the Americas: a systematic review and meta-analysis. Rev Panam Salud Publica 2023; 47:e126. [PMID: 37609525 PMCID: PMC10441551 DOI: 10.26633/rpsp.2023.126] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2022] [Accepted: 06/06/2023] [Indexed: 08/24/2023] Open
Abstract
Objective To describe the prevalence of leptospirosis in the Americas. Methods A systematic review and meta-analysis, in the period 1930 to 2017, performed on a search of six platforms: PubMed, Web of Science, Scopus, Lilacs, Embase, and Cochrane. Results The search found 77 publications of which 53 (68%) were from the period 2000-2017. Of the 77, 62 studies were included in the analysis, from North America (11, 17%), Central America (9, 14%), and South America (42, 67%), and 22 studies were from urban areas. Leptospirosis prevalence in the 62 studies analyzed corresponded to 28% (95% CI [23, 32]). Countries with higher prevalence were United States of America (41%), Colombia (29%), and Brazil (21%). The most frequent serovars found were Icterohaemorrhagiae (43 of 77 publications, 55%), Canicola (35, 45%), Pomona (28, 36%), and Grippotyphosa (26, 33%). Conclusions There is variability of Leptospira species and serovars with heterogenous distribution throughout the Americas, with high prevalence in some countries, highlighting the need for action to control the disease.
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Affiliation(s)
- Ericka Souza Browne
- Universidade Federal da BahiaCollective Health InstituteSalvadorBahiaBrazilUniversidade Federal da Bahia, Collective Health Institute, Salvador, Bahia, Brazil
| | - Marcos Pereira
- Universidade Federal da BahiaCollective Health InstituteSalvadorBahiaBrazilUniversidade Federal da Bahia, Collective Health Institute, Salvador, Bahia, Brazil
| | - Ana Barreto
- Universidade Federal da BahiaCollective Health InstituteSalvadorBahiaBrazilUniversidade Federal da Bahia, Collective Health Institute, Salvador, Bahia, Brazil
| | - Caio Graco Zeppelini
- Universidade Federal da BahiaCollective Health InstituteSalvadorBahiaBrazilUniversidade Federal da Bahia, Collective Health Institute, Salvador, Bahia, Brazil
| | - Daiana de Oliveira
- Oswaldo Cruz FoundationSalvadorBahiaBrazilOswaldo Cruz Foundation, Salvador, Bahia, Brazil
| | - Federico Costa
- Universidade Federal da BahiaCollective Health InstituteSalvadorBahiaBrazilUniversidade Federal da Bahia, Collective Health Institute, Salvador, Bahia, Brazil
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Sohn-Hausner N, Kmetiuk LB, Biondo AW. One Health Approach to Leptospirosis: Human-Dog Seroprevalence Associated to Socioeconomic and Environmental Risk Factors in Brazil over a 20-Year Period (2001-2020). Trop Med Infect Dis 2023; 8:356. [PMID: 37505652 PMCID: PMC10383893 DOI: 10.3390/tropicalmed8070356] [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: 05/21/2023] [Revised: 06/22/2023] [Accepted: 06/26/2023] [Indexed: 07/29/2023] Open
Abstract
Despite being considered a neglected, re-emerging and the most widespread zoonotic disease worldwide, human-dog leptospirosis has not been subjected to One Health approach, and neither were its socioeconomic and environmental risk factors, as well as concomitant spatial analysis over time. Accordingly, notified human leptospirosis cases, incidence rate and urban hotspot areas, in addition to a systematic review of dog leptospirosis cases, were performed nationwide from 2001 to 2020 in Brazil. Data on Gross Domestic Product (GDP), flooding and study areas were also assessed and tabulated. Human-dog leptospirosis cases were simultaneously mapped with overlapping flooding areas, along with the main circulant serovars. Comparative outcome has shown that dogs may be exposed similarly to humans, becoming important sentinels and/or reservoirs for human leptospirosis in larger geographic areas. Moreover, the study herein can help in the decision and implementation of public policies in Brazil and may serve as a model for other tropical countries worldwide.
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Affiliation(s)
- Natacha Sohn-Hausner
- Department of Cell and Molecular Biology, Federal University of Paraná, Curitiba 80035-050, PR, Brazil
| | - Louise Bach Kmetiuk
- Department of Cell and Molecular Biology, Federal University of Paraná, Curitiba 80035-050, PR, Brazil
| | - Alexander Welker Biondo
- Department of Cell and Molecular Biology, Federal University of Paraná, Curitiba 80035-050, PR, Brazil
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Zhu W, Passalia FJ, Hamond C, Abe CM, Ko AI, Barbosa AS, Wunder EA. MPL36, a major plasminogen (PLG) receptor in pathogenic Leptospira, has an essential role during infection. PLoS Pathog 2023; 19:e1011313. [PMID: 37486929 PMCID: PMC10399853 DOI: 10.1371/journal.ppat.1011313] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2023] [Revised: 08/03/2023] [Accepted: 07/10/2023] [Indexed: 07/26/2023] Open
Abstract
Leptospirosis, a zoonosis with worldwide distribution, is caused by pathogenic spirochetes belonging to the genus Leptospira. Bacterial outer membrane proteins (OMPs), particularly those with surface-exposed regions, play crucial roles in pathogen dissemination and virulence mechanisms. Here we characterized the leptospiral Membrane Protein L36 (MPL36), a rare lipoprotein A (RlpA) homolog with a C-terminal Sporulation related (SPOR) domain, as an important virulence factor in pathogenic Leptospira. Our results confirmed that MPL36 is surface exposed and expressed during infection. Using recombinant MPL36 (rMPL36) we also confirmed previous findings of its high plasminogen (PLG)-binding ability determined by lysine residues of the C-terminal region of the protein, with ability to convert bound-PLG to active plasmin. Using Koch's molecular postulates, we determined that a mutant of mpl36 has a reduced PLG-binding ability, leading to a decreased capacity to adhere and translocate MDCK cell monolayers. Using recombinant protein and mutant strains, we determined that the MPL36-bound plasmin (PLA) can degrade fibrinogen. Finally, our mpl36 mutant had a significant attenuated phenotype in the hamster model for acute leptospirosis. Our data indicates that MPL36 is the major PLG binding protein in pathogenic Leptospira, and crucial to the pathogen's ability to attach and interact with host tissues during infection. The MPL36 characterization contributes to the expanding field of bacterial pathogens that explore PLG for their virulence, advancing the goal to close the knowledge gap regarding leptospiral pathogenesis while offering a novel potential candidate to improve diagnostic and prevention of this important zoonotic neglected disease.
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Affiliation(s)
- Weinan Zhu
- Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, Connecticut, United States of America
| | - Felipe J. Passalia
- Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, Connecticut, United States of America
- Laboratory of Vaccine Development, Instituto Butantan, São Paulo, Brazil
| | - Camila Hamond
- Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, Connecticut, United States of America
| | - Cecília M. Abe
- Laboratory of Bacteriology, Instituto Butantan, São Paulo, Brazil
| | - Albert I. Ko
- Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, Connecticut, United States of America
- Gonçalo Moniz Institute, Oswaldo Cruz Foundation; Brazilian Ministry of Health; Salvador, Brazil
| | | | - Elsio A. Wunder
- Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, Connecticut, United States of America
- Gonçalo Moniz Institute, Oswaldo Cruz Foundation; Brazilian Ministry of Health; Salvador, Brazil
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Yang T, Yang W, Kuang G, Pan H, Han X, Yang L, Wang J, Feng Y. Prevalence and Characteristics of Novel Pathogenic Leptospira Species in Bats in Yunnan Province, China. Microorganisms 2023; 11:1619. [PMID: 37375121 DOI: 10.3390/microorganisms11061619] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2023] [Revised: 06/16/2023] [Accepted: 06/17/2023] [Indexed: 06/29/2023] Open
Abstract
Leptospirosis has been identified as a zoonotic disease caused by pathogenic spirochetes of the bacterial genus Leptospira. Rodents are considered the primary hosts of these bacteria, whereas many recent studies suggest that bats may serve as potential natural reservoirs. However, studies on pathogenic spirochetes hosted by bat populations still need to be completed in China. In this study, a total of 276 bats belonging to five genera collected in Yunnan Province (Southwest China) from 2017 to 2021 were included in the screening. Pathogenic spirochetes were detected by PCR amplification and sequencing targeting four genes (rrs, secY, flaB, and LipL32), resulting in 17 positive samples. Phylogenetic analysis based on multi-loci concatenated sequences, inferred by MLST approach, identified the strains as two novel Leptospira species within the pathogenic group. Of note, only Rousettus leschenaultii was found to harbor these spirochetes, suggesting it may be one of the potential natural reservoirs in circulating leptospires in this region. Nevertheless, the pathogenesis and transmission dynamics still need to be fully understood, requiring in-depth studies on other animals and the surrounding population.
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Affiliation(s)
- Tian Yang
- School of Public Health, Dali University, Dali 671000, China
- Yunnan Provincial Key Laboratory for Zoonosis Control and Prevention, Yunnan Institute of Endemic Disease Control and Prevention, Dali 671000, China
| | - Weihong Yang
- Yunnan Provincial Key Laboratory for Zoonosis Control and Prevention, Yunnan Institute of Endemic Disease Control and Prevention, Dali 671000, China
| | - Guopeng Kuang
- Yunnan Provincial Key Laboratory for Zoonosis Control and Prevention, Yunnan Institute of Endemic Disease Control and Prevention, Dali 671000, China
| | - Hong Pan
- Yunnan Provincial Key Laboratory for Zoonosis Control and Prevention, Yunnan Institute of Endemic Disease Control and Prevention, Dali 671000, China
| | - Xi Han
- Yunnan Provincial Key Laboratory for Zoonosis Control and Prevention, Yunnan Institute of Endemic Disease Control and Prevention, Dali 671000, China
| | - Lifen Yang
- Yunnan Provincial Key Laboratory for Zoonosis Control and Prevention, Yunnan Institute of Endemic Disease Control and Prevention, Dali 671000, China
| | - Juan Wang
- Yunnan Provincial Key Laboratory for Zoonosis Control and Prevention, Yunnan Institute of Endemic Disease Control and Prevention, Dali 671000, China
| | - Yun Feng
- School of Public Health, Dali University, Dali 671000, China
- Yunnan Provincial Key Laboratory for Zoonosis Control and Prevention, Yunnan Institute of Endemic Disease Control and Prevention, Dali 671000, China
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de Oliveira NR, Santos FDS, Dos Santos VAC, Maia MAC, Oliveira TL, Dellagostin OA. Challenges and Strategies for Developing Recombinant Vaccines against Leptospirosis: Role of Expression Platforms and Adjuvants in Achieving Protective Efficacy. Pathogens 2023; 12:787. [PMID: 37375478 DOI: 10.3390/pathogens12060787] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2023] [Revised: 05/29/2023] [Accepted: 05/29/2023] [Indexed: 06/29/2023] Open
Abstract
The first leptospiral recombinant vaccine was developed in the late 1990s. Since then, progress in the fields of reverse vaccinology (RV) and structural vaccinology (SV) has significantly improved the identification of novel surface-exposed and conserved vaccine targets. However, developing recombinant vaccines for leptospirosis faces various challenges, including selecting the ideal expression platform or delivery system, assessing immunogenicity, selecting adjuvants, establishing vaccine formulation, demonstrating protective efficacy against lethal disease in homologous challenge, achieving full renal clearance using experimental models, and reproducibility of protective efficacy against heterologous challenge. In this review, we highlight the role of the expression/delivery system employed in studies based on the well-known LipL32 and leptospiral immunoglobulin-like (Lig) proteins, as well as the choice of adjuvants, as key factors to achieving the best vaccine performance in terms of protective efficacy against lethal infection and induction of sterile immunity.
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Affiliation(s)
- Natasha Rodrigues de Oliveira
- Núcleo de Biotecnologia, Centro de Desenvolvimento Tecnológico, Universidade Federal de Pelotas, Pelotas 96010-610, RS, Brazil
| | - Francisco Denis Souza Santos
- Núcleo de Biotecnologia, Centro de Desenvolvimento Tecnológico, Universidade Federal de Pelotas, Pelotas 96010-610, RS, Brazil
| | | | - Mara Andrade Colares Maia
- Núcleo de Biotecnologia, Centro de Desenvolvimento Tecnológico, Universidade Federal de Pelotas, Pelotas 96010-610, RS, Brazil
| | - Thaís Larré Oliveira
- Núcleo de Biotecnologia, Centro de Desenvolvimento Tecnológico, Universidade Federal de Pelotas, Pelotas 96010-610, RS, Brazil
| | - Odir Antônio Dellagostin
- Núcleo de Biotecnologia, Centro de Desenvolvimento Tecnológico, Universidade Federal de Pelotas, Pelotas 96010-610, RS, Brazil
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Mišić-Majerus L, Kišek TC, Ružić-Sabljić E. Leptospirosis and characterization of Leptospira isolates from patients in Koprivnica-Križevci County, Croatia from 2000-2004. Access Microbiol 2023; 5:acmi000431. [PMID: 37223056 PMCID: PMC10202403 DOI: 10.1099/acmi.0.000431] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2022] [Accepted: 02/28/2023] [Indexed: 05/25/2023] Open
Abstract
Introduction Leptospirosis, caused by spirochetes of the genus Leptospira , is present in the Koprivnica-Križevci County area, Croatia. Clinical manifestation can range from asymptomatic, short-term mild, non-specific febrile disease, to severe forms with high mortality rates. Aim The aim of the study was to valuate culture in front of microscopic agglutination test (MAT) for diagnosis of infection, and to evaluate clinical and laboratory features of the disease. Moreover, we want to characterize Leptospira strains involved in infection in Koprivnica-Križevci County, Croatia. Methods We included 68 patients with clinical presentation consistent with leptospirosis collected in a 5-year period (2000-2004). Clinical samples (blood, urine and cerebrospinal fluid, CSF) were inoculated in Kolthoff's medium; species of isolated Leptospira strains was determined with Tm of real-time PCR, serogroup/serovar with MAT and NotI-RFLP analysis. Demonstration of specific antibodies in patients' sera was done using microscopic agglutination test. Results Leptospira was isolated from the blood of 14/51(27.5 %) patients and the most often identified serogroup/serovar was Icterohaemorrhagiae (8/10, 80%) followed by Grippotyphosa (10%). Regarding to species level, 8/10 isolated belonged to L. interrogans sensu stricto and one to L. kirschneri species. MAT was carried out on 51 patients with suspected leptospirosis, and was positive in 11/51(21.5 %) patients. Most of our patients presented with moderate severe symptoms, were hospitalized from August to October, and were infected mainly during the work or recreation in our county. The frequency of particular clinical features and pathological laboratory findings correlated with the severity of the clinical condition. Conclusions Leptospirosis can be confirmed microbiologically, culture and MAT contributed almost equally to the diagnosis of infection. Serovar Icterohaemorrhagiae was found as the dominant one, and L. interrogans sensu stricto as dominant species in our county. Epidemiological data shown that leptospirosis occurs seasonally, affects the rural population, and most commonly is presented with moderate severe clinical course.
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Affiliation(s)
- Ljiljana Mišić-Majerus
- Department of Infectious Diseases, General Hospital "Dr. Tomislav Bardek", Željka Selingera 1, Koprivnica, Croatia
| | - Tjaša Cerar Kišek
- Faculty of Medicine, Institute of Microbiology and Immunology, University of Ljubljana, Zaloška 4, Ljubljana, Slovenia
| | - Eva Ružić-Sabljić
- Faculty of Medicine, Institute of Microbiology and Immunology, University of Ljubljana, Zaloška 4, Ljubljana, Slovenia
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Chaurasia R, Vinetz JM. In silico prediction of molecular mechanisms of toxicity mediated by the leptospiral PF07598 gene family-encoded virulence-modifying proteins. Front Mol Biosci 2023; 9:1092197. [PMID: 36756251 PMCID: PMC9900628 DOI: 10.3389/fmolb.2022.1092197] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2022] [Accepted: 12/20/2022] [Indexed: 01/24/2023] Open
Abstract
Mechanisms of leptospirosis pathogenesis remain unclear despite the identification of a number of potential leptospiral virulence factors. We recently demonstrated potential mechanisms by which the virulence-modifying (VM) proteins-defined as containing a Domain of Unknown function (DUF1561), encoded by the PF07598 gene family-found only in group 1 pathogenic Leptospira-might mediate the clinical pathogenesis of leptospirosis. VM proteins belongs to classical AB toxin paradigm though have a unique AB domain architecture, unlike other AB toxins such as diphtheria toxin, pertussis toxin, shiga toxin, or ricin toxin which are typically encoded by two or more genes and self-assembled into a multi-domain holotoxin. Leptospiral VM proteins are secreted R-type lectin domain-containing exotoxins with discrete N-terminal ricin B-like domains involved in host cell surface binding, and a C-terminal DNase/toxin domain. Here we use the artificial intelligence-based AlphaFold algorithm and other computational tools to predict and elaborate on details of the VM protein structure-function relationship. Comparative AlphaFold and CD-spectroscopy defined the consistent secondary structure (Helix and ß-sheet) content, and the stability of the functional domains were further supported by molecular dynamics simulation. VM proteins comprises distinctive lectic family (QxW)3 motifs, the Mycoplasma CARDS toxin (D3 domain, aromatic patches), C-terminal similarity with mammalian DNase I. In-silico study proposed that Gln412, Gln523, His533, Thr59 are the high binding energy or ligand binding residues plausibly anticipates in the functional activities. Divalent cation (Mg+2-Gln412) and phosphate ion (PO4]-3-Arg615) interaction further supports the functional activities driven by C-terminal domain. Computation-driven structure-function studies of VM proteins will guide experimentation towards mechanistic understandings of leptospirosis pathogenesis, which underlie development of new therapeutic and preventive measures for this devastating disease.
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Weil's Disease-Immunopathogenesis, Multiple Organ Failure, and Potential Role of Gut Microbiota. Biomolecules 2022; 12:biom12121830. [PMID: 36551258 PMCID: PMC9775223 DOI: 10.3390/biom12121830] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2022] [Revised: 12/04/2022] [Accepted: 12/06/2022] [Indexed: 12/13/2022] Open
Abstract
Leptospirosis is an important zoonotic disease, causing about 60,000 deaths annually. In this review, we have described in detail the immunopathogenesis of leptospirosis, the influence of cytokines, genetic susceptibility on the course of the disease, and the evasion of the immune response. These data are combined with information about immunological and pathomorphological changes in the kidneys, liver, and lungs, which are most affected by Weil's disease. The review also suggests a possible role of the gut microbiota in the clinical course of leptospirosis, the main mechanisms of the influence of gut dysbiosis on damage in the liver, kidneys, and lungs through several axes, i.e., gut-liver, gut-kidney, and gut-lungs. Modulation of gut microbiota by probiotics and/or fecal microbiota transplantation in leptospirosis may become an important area of scientific research.
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do Couto AC, Gravinatti ML, Pellizzaro M, Kmetiuk LB, Yamakawa AC, da Silva EC, Felipetto LG, Langoni H, de Souza Leandro A, de Santi CE, dos Santos AP, Biondo AW. One health approach on serosurvey of anti-Leptospira spp. in homeless persons and their dogs in South Brazil. One Health 2022; 15:100421. [PMID: 36277102 PMCID: PMC9582539 DOI: 10.1016/j.onehlt.2022.100421] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2022] [Revised: 07/20/2022] [Accepted: 07/21/2022] [Indexed: 10/25/2022] Open
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Petakh P, Isevych V, Mohammed IB, Nykyforuk A, Rostoka L. Leptospirosis: Prognostic Model for Patient Mortality in the Transcarpathian Region, Ukraine. Vector Borne Zoonotic Dis 2022; 22:584-588. [PMID: 36445174 DOI: 10.1089/vbz.2022.0063] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
Background: Leptospirosis is a bacterial zoonosis of worldwide distribution with a wide spectrum of clinical presentations that range from subclinical or mild to severe and fatal outcomes. Identifying clinical predictors for the severe form of the disease is critical to reduce disease complications and death. As a result, we conducted a retrospective case-control study to identify clinical markers of mortality in leptospirosis patients from the Transcarpathian region. Materials and Methods: The study used 102 medical records of patients with leptospirosis in the period from 2009 to 2019. There were 26 fatal cases and 76 survivors. Predictors were examined using univariate and bivariate statistics. Results: Fatal and nonfatal groups did not differ in age or gender composition (p > 0.5), nor did they differ in signs or symptoms, except that oliguria occurred significantly more often in fatal cases (p < 0.001). Laboratory diagnostic tests, however, differed between outcomes in 7/9 recorded variables; primarily associated with liver and kidney function as well thrombocytopenia and elevated white blood cell counts for fatal cases (p < 0.01 for all variables). Conclusions: Logistic regression analysis indicated that a combination of creatinine levels and direct bilirubin levels were the best predictors of patient outcome. The specificity of the model was 90.9% and the area under the receiver operator characteristic function as 93.6%. This model can be used when a patient is admitted to a hospital to better characterize patient risk.
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Affiliation(s)
- Pavlo Petakh
- Department of Microbiology, Virology and Immunology, I. Horbachevsky Ternopil National Medical University, Ternopil, Ukraine.,Department of Biochemistry and Pharmacology, Uzhhorod National University, Uzhhorod, Ukraine
| | | | | | - Andriy Nykyforuk
- Department of Biochemistry and Pharmacology, Uzhhorod National University, Uzhhorod, Ukraine
| | - Larysa Rostoka
- Department of Biochemistry and Pharmacology, Uzhhorod National University, Uzhhorod, Ukraine
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Li D, Liang H, Yi R, Xiao Q, Zhu Y, Chang Q, Zhou L, Liu B, He J, Liu T, Fan Z, Cheng W, Wang W, Zhang Y, Pan P. Clinical characteristics and prognosis of patient with leptospirosis: A multicenter retrospective analysis in south of China. Front Cell Infect Microbiol 2022; 12:1014530. [PMID: 36325463 PMCID: PMC9618720 DOI: 10.3389/fcimb.2022.1014530] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2022] [Accepted: 09/29/2022] [Indexed: 01/18/2023] Open
Abstract
Purpose Leptospirosis is a zoonotic disease caused by pathogenic spirochetes of the genus Leptospira. However, there is currently no consensual definition or diagnostic criteria for severe and different forms of leptospirosis. Therefore, more insight on clinical manifestations, risk factors, and outcomes of leptospirosis is warranted. The identification of leptospirosis with distinct clinical manifestations and prognosis in our population. Methods Multiple correspondence analysis and hierarchical classification on principal components were presented to identify different clinical types of leptospirosis. The outcomes were clinical phenotypes, laboratory and imaging findings, and prognosis. Results The 95 enrolled patients had median values of 54.0 years (39.0-65.0) for age, 9.0 (7.0-14.0) for total hospital stay lengths, of whom 86.3% was male and 40.0% was transferred to ICU. Three clinical types were distinguished: mild leptospirosis (n=43, 45.3%) with less organ dysfunction and shorter hospital stays; respiratory leptospirosis (n=28, 29.5%) with hemoptysis, and respiratory and circulatory failure; and hepato-renal leptospirosis (n=24, 25.3%) with worst liver and kidney dysfunction. Total hospital mortality was 15.8% and was associated with dyspnea and high levels of neutrophil counts. Conclusions The identification of leptospirosis with distinct clinical manifestations and prognosis in our population may assist clinicians to distinguish leptospirosis-like disease. Moreover, dyspnea and neutrophil count were found to be independent risk factors for severe leptospirosis progression.
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Affiliation(s)
- Dianwu Li
- Department of Respiratory Medicine, National Key Clinical Specialty, Branch of National Clinical Research Center for Respiratory Disease, Xiangya Hospital, Central South University, Changsha, China
- Center of Respiratory Medicine, Xiangya Hospital of Central South University, Changsha, China
- Clinical Research Center for Respiratory Diseases in Hunan Province, Changsha, China
- Hunan Engineering Research Center for Intelligent Diagnosis and Treatment of Respiratory Disease, Changsha, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Changsha, China
| | - Huaying Liang
- Department of Respiratory Medicine, National Key Clinical Specialty, Branch of National Clinical Research Center for Respiratory Disease, Xiangya Hospital, Central South University, Changsha, China
- Center of Respiratory Medicine, Xiangya Hospital of Central South University, Changsha, China
- Clinical Research Center for Respiratory Diseases in Hunan Province, Changsha, China
- Hunan Engineering Research Center for Intelligent Diagnosis and Treatment of Respiratory Disease, Changsha, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Changsha, China
| | - Rong Yi
- Department of Pulmonary and Critical Care Medicine, Zhuzhou Central Hospital, Zhuzhou, China
| | - Qian Xiao
- Department of Anaesthesiology, Hunan Provincial People’s Hospital, Changsha, China
| | - Yiqun Zhu
- Department of Respiratory Medicine, National Key Clinical Specialty, Branch of National Clinical Research Center for Respiratory Disease, Xiangya Hospital, Central South University, Changsha, China
- Center of Respiratory Medicine, Xiangya Hospital of Central South University, Changsha, China
- Clinical Research Center for Respiratory Diseases in Hunan Province, Changsha, China
- Hunan Engineering Research Center for Intelligent Diagnosis and Treatment of Respiratory Disease, Changsha, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Changsha, China
| | - Qinyu Chang
- Department of Respiratory Medicine, National Key Clinical Specialty, Branch of National Clinical Research Center for Respiratory Disease, Xiangya Hospital, Central South University, Changsha, China
- Center of Respiratory Medicine, Xiangya Hospital of Central South University, Changsha, China
- Clinical Research Center for Respiratory Diseases in Hunan Province, Changsha, China
- Hunan Engineering Research Center for Intelligent Diagnosis and Treatment of Respiratory Disease, Changsha, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Changsha, China
| | - Lihua Zhou
- Department of Respiratory Medicine, Changsha Central Hospital, Changsha, China
| | - Bin Liu
- Department of Emergency, Xiangtan Central Hospital, Xiangtan, China
| | - Junjun He
- Department of General Surgery, Shaoyang Central Hospital, Shaoyang, China
| | - Tianxing Liu
- Department of Orthopaedic Surgery, Yongzhou Central Hospital, Yongzhou, China
| | - Zhijun Fan
- Department of Cardiothoracic Surgery, Liuyang People’s Hospital, Liuyang, China
| | - Wei Cheng
- Department of Respiratory, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Weizhong Wang
- Department of Respiratory, The First Affiliated Hospital of University of South China, Hengyang, China
| | - Yan Zhang
- Department of Respiratory Medicine, National Key Clinical Specialty, Branch of National Clinical Research Center for Respiratory Disease, Xiangya Hospital, Central South University, Changsha, China
- Center of Respiratory Medicine, Xiangya Hospital of Central South University, Changsha, China
- Clinical Research Center for Respiratory Diseases in Hunan Province, Changsha, China
- Hunan Engineering Research Center for Intelligent Diagnosis and Treatment of Respiratory Disease, Changsha, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Changsha, China
- *Correspondence: Pinhua Pan, ; Yan Zhang,
| | - Pinhua Pan
- Department of Respiratory Medicine, National Key Clinical Specialty, Branch of National Clinical Research Center for Respiratory Disease, Xiangya Hospital, Central South University, Changsha, China
- Center of Respiratory Medicine, Xiangya Hospital of Central South University, Changsha, China
- Clinical Research Center for Respiratory Diseases in Hunan Province, Changsha, China
- Hunan Engineering Research Center for Intelligent Diagnosis and Treatment of Respiratory Disease, Changsha, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Changsha, China
- *Correspondence: Pinhua Pan, ; Yan Zhang,
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Carlton JM, Eapen A, Kessler A, Anvikar AR, Hoffmann A, Singh OP, Sullivan SA, Albert S, Sahu PK, Mohanty S, Wassmer SC. Advances in Basic and Translational Research as Part of the Center for the Study of Complex Malaria in India. Am J Trop Med Hyg 2022; 107:97-106. [PMID: 36228919 PMCID: PMC9662212 DOI: 10.4269/ajtmh.21-1333] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2021] [Accepted: 07/06/2022] [Indexed: 11/07/2022] Open
Abstract
The Center for the Study of Complex Malaria in India (CSCMi) is one of 10 International Centers of Excellence in Malaria Research funded by the National Institutes of Health since 2010. The Center combines innovative research with capacity building and technology transfer to undertake studies with clinical and translational impact that will move malaria control in India toward the ultimate goal of malaria elimination/eradication. A key element of each research site in the four states of India (Tamil Nadu, Gujarat, Odisha, and Meghalaya) has been undertaking community- and clinic-based epidemiology projects to characterize the burden of malaria in the region. Demographic and clinical data and samples collected during these studies have been used in downstream projects on, for example, the widespread use of mosquito repellants, the population genomics of Plasmodium vivax, and the serological responses to P. vivax and Plasmodium falciparum antigens that reflect past or present exposure. A focus has been studying the pathogenesis of severe malaria caused by P. falciparum through magnetic resonance imaging of cerebral malaria patients. Here we provide a snapshot of some of the basic and applied research the CSCMi has undertaken over the past 12 years and indicate the further research and/or clinical and translational impact these studies have had.
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Affiliation(s)
- Jane M. Carlton
- Center for Genomics and Systems Biology, Department of Biology, New York University, New York, New York
- Department of Epidemiology, School of Global Public Health, New York University, New York, New York
- Address correspondence to Jane M. Carlton, Center for Genomics and Systems Biology, New York University, 12 Waverly Place, New York, NY 10003. E-mail:
| | - Alex Eapen
- National Institute of Malaria Research, Indian Council of Medical Research, IDVC Field Unit, National Institute of Epidemiology Campus, Chennai, Tamil Nadu, India
| | - Anne Kessler
- Center for Genomics and Systems Biology, Department of Biology, New York University, New York, New York
| | - Anupkumar R. Anvikar
- National Institute of Biologicals, Ministry of Health and Family Welfare, Government of India, Noida, Uttar Pradesh, India
| | - Angelika Hoffmann
- University Institute of Diagnostic and Interventional Neuroradiology, University Hospital Bern, University of Bern, Switzerland
| | - Om P. Singh
- National Institute of Malaria Research, Indian Council of Medical Research, Dwarka, Delhi, India
| | - Steven A. Sullivan
- Center for Genomics and Systems Biology, Department of Biology, New York University, New York, New York
| | - Sandra Albert
- Indian Institute of Public Health Shillong, Shillong, Meghalaya, India
- Martin Luther Christian University, Shillong, Meghalaya, India
| | - Praveen K. Sahu
- Department of Molecular and Infectious Diseases, Community Welfare Society Hospital, Rourkela, Odisha, India
| | - Sanjib Mohanty
- Department of Molecular and Infectious Diseases, Community Welfare Society Hospital, Rourkela, Odisha, India
| | - Samuel C. Wassmer
- Department of Infection Biology, London School of Hygiene and Tropical Medicine, London, United Kingdom
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Pertile AC, Lustosa R, Carvalho-Pereira T, Pedra GG, Panti-May JA, Oliveira U, Zeppelini CG, Souza FN, Oliveira DS, Khalil H, Reis MG, Childs J, Ko AI, Begon M, Costa F. Evaluation of the impact of chemical control on the ecology of Rattus norvegicus of an urban community in Salvador, Brazil. PLoS One 2022; 17:e0270568. [PMID: 35857771 PMCID: PMC9299319 DOI: 10.1371/journal.pone.0270568] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2021] [Accepted: 06/13/2022] [Indexed: 12/04/2022] Open
Abstract
BACKGROUND The presence of synanthropic rodents, such as Rattus norvegicus, in urban environments generates high costs of prophylaxis and control, in large part due to the environmental transmission of the pathogenic spirochete Leptospira interrogans, which causes leptospirosis. In Salvador, Brazil, The Center for Control of Zoonosis (CCZ) is responsible for planning and implementing Rodent Control Programs (RCP) which are based on chemical rodenticide. However, these strategies have not been standardized for use in developing countries. AIM This study aimed to identify the effect of a chemical control campaign on the demographic variables of urban R. norvegicus, analyzing relative abundance, sex structure, body mass, and age of the population, as well as the characterization of spatial distribution among households, rodent capture campaigns and interventions. METHODS This study was carried out during 2015 in three valleys of an urban poor community in Salvador. Individuals of R. norvegicus were systematically captured before (Pre-intervention) and three months (1st post-intervention) and six months (2nd post-intervention) after a chemical control intervention conducted by the CCZ in two valleys of the study area while the third valley was not included in the intervention campaign and was used as a non-intervention reference. We used analysis of variance to determine if intervention affected demographic variables and chi-square to compare proportions of infested households (Rodent infestation index-PII). RESULTS During the chemical intervention, 939 households were visited. In the pre-intervention campaign, an effort of 310 trap nights resulted in 43 rodents captured, and in the 1st and 2nd, post-intervention campaigns resulted in 47 rodents captured over 312 trap nights and 36 rodents captured over 324 traps-nights, respectively. The rodent infestation index (PII) points did not show a reduction between the period before the intervention and the two periods after the chemical intervention (70%, 72%, and 65%, respectively). Regarding relative abundances, there was no difference between valleys and period before and two periods after chemical intervention (trap success valley 1: 0,18; 0,19; 0,18 / Valley 3 0,15; 0,17; 0,13/ P>0,05). Other demographic results showed that there was no difference in demographic characteristics of the rodent population before and after the intervention, as well as there being no influence of the application of rodenticide on the areas of concentration of capture of rodents between the campaigns. CONCLUSION Our study indicates that the chemical control was not effective in controlling the population of R. norvegicus and provides evidence of the need for re-evaluation of rodent control practices in urban poor community settings.
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Affiliation(s)
- Arsinoê Cristina Pertile
- Programa de pós-graduação em Ecologia: Teoria, Aplicações e Valores, Instituto de Biologia, Universidade Federal da Bahia, Salvador, Brazil
- Instituto de Pesquisas Gonçalo Moniz, Fundação Oswaldo Cruz, Ministério da Saúde, Salvador, Brazil
| | - Ricardo Lustosa
- Instituto de Saúde Coletiva, Universidade Federal da Bahia, Salvador, Brazil
| | - Ticiana Carvalho-Pereira
- Instituto de Pesquisas Gonçalo Moniz, Fundação Oswaldo Cruz, Ministério da Saúde, Salvador, Brazil
- Instituto de Saúde Coletiva, Universidade Federal da Bahia, Salvador, Brazil
| | - Gabriel Ghizzi Pedra
- Instituto de Pesquisas Gonçalo Moniz, Fundação Oswaldo Cruz, Ministério da Saúde, Salvador, Brazil
- Institute of Integrative Biology, University of Liverpool, Liverpool, United Kingdom
| | - Jesus Alonso Panti-May
- Instituto de Pesquisas Gonçalo Moniz, Fundação Oswaldo Cruz, Ministério da Saúde, Salvador, Brazil
| | - Udimila Oliveira
- Instituto de Pesquisas Gonçalo Moniz, Fundação Oswaldo Cruz, Ministério da Saúde, Salvador, Brazil
| | - Caio Graco Zeppelini
- Programa de pós-graduação em Ecologia: Teoria, Aplicações e Valores, Instituto de Biologia, Universidade Federal da Bahia, Salvador, Brazil
| | - Fábio Neves Souza
- Programa de pós-graduação em Ecologia: Teoria, Aplicações e Valores, Instituto de Biologia, Universidade Federal da Bahia, Salvador, Brazil
- Instituto de Pesquisas Gonçalo Moniz, Fundação Oswaldo Cruz, Ministério da Saúde, Salvador, Brazil
- Instituto de Saúde Coletiva, Universidade Federal da Bahia, Salvador, Brazil
| | - Daiana S. Oliveira
- Instituto de Pesquisas Gonçalo Moniz, Fundação Oswaldo Cruz, Ministério da Saúde, Salvador, Brazil
| | - Hussein Khalil
- Swedish University of Agriculture Sciences, Umea, Sweden
| | - Mitermayer G. Reis
- Instituto de Pesquisas Gonçalo Moniz, Fundação Oswaldo Cruz, Ministério da Saúde, Salvador, Brazil
- Department of Epidemiology of Microbial Disease, Yale School of Public Health, New Haven, Connecticut, United States of America
- Faculdade de Medicina da Bahia, Universidade Federal da Bahia, Salvador, Brazil
| | - James Childs
- Department of Epidemiology of Microbial Disease, Yale School of Public Health, New Haven, Connecticut, United States of America
| | - Albert I. Ko
- Instituto de Pesquisas Gonçalo Moniz, Fundação Oswaldo Cruz, Ministério da Saúde, Salvador, Brazil
- Department of Epidemiology of Microbial Disease, Yale School of Public Health, New Haven, Connecticut, United States of America
| | - Mike Begon
- Institute of Integrative Biology, University of Liverpool, Liverpool, United Kingdom
| | - Federico Costa
- Instituto de Pesquisas Gonçalo Moniz, Fundação Oswaldo Cruz, Ministério da Saúde, Salvador, Brazil
- Instituto de Saúde Coletiva, Universidade Federal da Bahia, Salvador, Brazil
- Swedish University of Agriculture Sciences, Umea, Sweden
- Department of Epidemiology of Microbial Disease, Yale School of Public Health, New Haven, Connecticut, United States of America
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Comparative proteomic analysis of Leptospira interrogans serogroup Icterohaemorrhagiae human vaccine strain and epidemic isolate from China. Arch Microbiol 2022; 204:460. [DOI: 10.1007/s00203-022-02987-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2021] [Revised: 05/11/2022] [Accepted: 05/12/2022] [Indexed: 11/02/2022]
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Philip N, Priya SP, Jumah Badawi AH, Mohd Izhar MH, Mohtarrudin N, Tengku Ibrahim TA, Sekawi Z, Neela VK. Pulmonary haemorrhage as the earliest sign of severe leptospirosis in hamster model challenged with Leptospira interrogans strain HP358. PLoS Negl Trop Dis 2022; 16:e0010409. [PMID: 35584087 PMCID: PMC9116642 DOI: 10.1371/journal.pntd.0010409] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2022] [Accepted: 04/10/2022] [Indexed: 11/18/2022] Open
Abstract
Background Severe leptospirosis is challenging as it could evolve rapidly and potentially fatal if appropriate management is not performed. An understanding of the progression and pathophysiology of Leptospira infection is important to determine the early changes that could be potentially used to predict the severe occurrence of leptospirosis. This study aimed to understand the kinetics pathogenesis of Leptospira interrogans strain HP358 in the hamster model and identify the early parameters that could be used as biomarkers to predict severe leptospirosis. Methodology/Principal findings Male Syrian hamsters were infected with Leptospira interrogans strain HP358 and euthanized after 24 hours, 3, 4, 5, 6 and 7 days post-infection. Blood, lungs, liver and kidneys were collected for leptospiral detection, haematology, serum biochemistry and differential expression of pro- and anti-inflammatory markers. Macroscopic and microscopic organ damages were investigated. Leptospira interrogans strain HP358 was highly pathogenic and killed hamsters within 6–7 days post-infection. Pulmonary haemorrhage and blood vessel congestion in organs were noticed as the earliest pathological changes. The damages in organs and changes in biochemistry value were preceded by changes in haematology and immune gene expression. Conclusion/Significance This study deciphered haemorrhage as the earliest manifestation of severe leptospirosis and high levels of IL-1β, CXCL10/IP-10, CCL3/MIP-α, neutrophils and low levels of lymphocytes and platelets serve as a cumulative panel of biomarkers in severe leptospirosis. As the severe form of leptospirosis could progress rapidly and be potentially fatal if not treated earlier, deciphering the pathophysiology kinetics of infection is crucial to determine the parameters of disease severity. To understand this, we challenged hamsters with the highly virulent Leptospira interrogans strain HP358. Pulmonary haemorrhage was observed as the earliest pathological change followed by liver and kidneys damages. The increased expression of IL-1β, CXCL10/IP-10, CCL3/MIP-α, high neutrophils and low lymphocytes and platelets production observed in the present study indicate that these parameters could serve as a cumulative panel of biomarkers in severe leptospirosis.
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Affiliation(s)
- Noraini Philip
- Department of Medical Microbiology, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Selangor, Malaysia
| | - Sivan Padma Priya
- Department of Medical Microbiology, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Selangor, Malaysia
- RAK College of Dental Sciences, Ras Al Khaimah Medical and Health Sciences University, Ras Al Khaimah, United Arab Emirates
| | - Ahmad Hussein Jumah Badawi
- Department of Pathology, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Selangor, Malaysia
| | - Mohd Hafidz Mohd Izhar
- Comparative Medicine and Technology Unit, Institute of Bioscience, Universiti Putra Malaysia, Serdang, Selangor, Malaysia
| | - Norhafizah Mohtarrudin
- Department of Pathology, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Selangor, Malaysia
| | - Tengku Azmi Tengku Ibrahim
- Department of Veterinary Preclinical Sciences, Faculty of Veterinary Medicine, Universiti Putra Malaysia, Serdang, Selangor, Malaysia
| | - Zamberi Sekawi
- 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
- * E-mail:
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Turmel JM, Olive C, Bigeard B, Abel S, Banydeen R, Daoud L, Fayolle PM, Cabié A. Case Report: Pulmonary Leptospirosis Misdiagnosed as COVID-19. Am J Trop Med Hyg 2022; 107:tpmd211102. [PMID: 35576944 PMCID: PMC9294685 DOI: 10.4269/ajtmh.21-1102] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2021] [Accepted: 03/14/2022] [Indexed: 11/16/2022] Open
Abstract
We report the case of an 83-year-old woman with acute, febrile respiratory failure resulting from interstitial pneumonia that required high-flow oxygen therapy. This clinical picture, associated with the ongoing epidemiological situation, initially guided us toward a diagnosis of COVID-19. Based on SARS-CoV-2 reverse transcription-polymerase chain reaction negativity and the absence of anti-SARS-CoV-2 antibodies, a search for a differential diagnosis was conducted that led us to conclude a diagnosis of severe pulmonary leptospirosis This case highlights the need to engage in early discussions about differential diagnoses, including neglected tropical and subtropical diseases, during the COVID-19 era.
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Affiliation(s)
- Jean-Marie Turmel
- Department of Tropical and Infectious Diseases, Centre Hospitalier Universitaire de Martinique, Fort de France, France
| | - Claude Olive
- Bacteriology Laboratory, Centre Hospitalier Universitaire de Martinique, Fort de France, France
| | - Bastien Bigeard
- Department of Tropical and Infectious Diseases, Centre Hospitalier Universitaire de Martinique, Fort de France, France
| | - Sylvie Abel
- Department of Tropical and Infectious Diseases, Centre Hospitalier Universitaire de Martinique, Fort de France, France
| | - Rishika Banydeen
- Department of Clinical Research, Centre Hospitalier Universitaire de Martinique, Fort de France, France
| | - Laura Daoud
- Intensive Care Unit, Centre Hospitalier Universitaire de Martinique, Fort de France, France
| | - Pierre-Marie Fayolle
- Intensive Care Unit, Centre Hospitalier Universitaire de Martinique, Fort de France, France
| | - André Cabié
- Department of Tropical and Infectious Diseases, Centre Hospitalier Universitaire de Martinique, Fort de France, France
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Chaurasia R, Marroquin AS, Vinetz JM, Matthias MA. Pathogenic Leptospira Evolved a Unique Gene Family Comprised of Ricin B-Like Lectin Domain-Containing Cytotoxins. Front Microbiol 2022; 13:859680. [PMID: 35422779 PMCID: PMC9002632 DOI: 10.3389/fmicb.2022.859680] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2022] [Accepted: 02/08/2022] [Indexed: 12/29/2022] Open
Abstract
Leptospirosis is a globally important neglected zoonotic disease. Previous data suggest that a family of virulence-modifying (VM) proteins (PF07598) is a distinctive feature of group I pathogenic Leptospira that evolved as important virulence determinants. Here, we show that one such VM protein, LA3490 (also known as Q8F0K3), is expressed by Leptospira interrogans serovar Lai, as a secreted genotoxin that is potently cytotoxic to human cells. Structural homology searches using Phyre2 suggested that VM proteins are novel R-type lectins containing tandem N-terminal ricin B-chain-like β-trefoil domains. Recombinant LA3490 (rLA3490) and an N-terminal fragment, t3490, containing only the predicted ricin B domain, bound to the terminal galactose and N-acetyl-galactosamine residues, asialofetuin, and directly competed for asialofetuin-binding sites with recombinant ricin B chain. t3490 alone was sufficient for binding, both to immobilized asialofetuin and to the HeLa cell surface but was neither internalized nor cytotoxic. Treatment of HeLa cells with rLA3490 led to cytoskeleton disassembly, caspase-3 activation, and nuclear fragmentation, and was rapidly cytolethal. rLA3490 had DNase activity on mammalian and bacterial plasmid DNA. The combination of cell surface binding, internalization, nuclear translocation, and DNase functions indicate that LA3490 and other VM proteins evolved as novel forms of the bacterial AB domain-containing toxin paradigm.
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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
| | - Alan S Marroquin
- Section of Infectious Diseases, 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
| | - Michael A Matthias
- Section of Infectious Diseases, Department of Internal Medicine, Yale University School of Medicine, New Haven, CT, United States
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Cruz JS, Nery N, Sacramento GA, Victoriano R, Montenegro ALS, Santana JO, Costa F, Ko AI, Reis MG, Wunder EA. Biannual and Quarterly Comparison Analysis of Agglutinating Antibody Kinetics on a Subcohort of Individuals Exposed to Leptospira interrogans in Salvador, Brazil. Front Med (Lausanne) 2022; 9:862378. [PMID: 35492362 PMCID: PMC9048256 DOI: 10.3389/fmed.2022.862378] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2022] [Accepted: 03/21/2022] [Indexed: 11/13/2022] Open
Abstract
IntroductionLeptospirosis is a zoonosis with a worldwide spread that leads to clinical manifestations ranging from asymptomatic infection to a life-threatening disease. The immune response is predominantly humoral mediated limited to the infecting serovar. Individuals living in an area endemic for leptospirosis are often exposed to an environment contaminated with leptospires and there is a paucity of information on naturally acquired immunity. In the present study, we evaluated the kinetics of agglutinating antibodies in individuals from an endemic area for leptospirosis in Salvador, Brazil comparing two different intersample collection times.MethodsBetween 2017–2018, we carried out a biannual prospective cohort with 2,086 individuals living in an endemic area for leptospirosis in Salvador, Brazil. To compare agglutinating antibody kinetics using microscopic agglutination test (MAT) with different collection times, a subcohort of 72 individuals with quarterly follow-up was carried out in parallel.ResultsThe results revealed that using a shorter time for intersample collection led to the detection of a higher number of infections and reinfection events. Furthermore, we observed a higher rate of titer decay indicating partial and short protection. However, there was no indication of major changes in risk factors for the disease.ConclusionsWe evaluated antibody kinetics among residents of an endemic area for leptospirosis comparing two sample collection times. The constant exposure to the contaminated environment increases the risk for leptospirosis infection with reinfection events being more common than expected. This indicates that the burden of leptospirosis might be underestimated by serological surveys, and further studies are necessary to better characterize the humoral response after infection.
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Affiliation(s)
- Jaqueline S. Cruz
- Laboratório de Patologia e Biologia Molecular, Instituto Gonçalo Moniz, Fundação Oswaldo Cruz, Ministério da Saúde, Salvador, Brazil
| | - Nivison Nery
- Laboratório de Patologia e Biologia Molecular, Instituto Gonçalo Moniz, Fundação Oswaldo Cruz, Ministério da Saúde, Salvador, Brazil
- Instituto de Saúde Coletiva, Universidade Federal da Bahia, Salvador, Brazil
| | | | - Renato Victoriano
- Instituto de Saúde Coletiva, Universidade Federal da Bahia, Salvador, Brazil
| | - Albino L. S. Montenegro
- Laboratório de Patologia e Biologia Molecular, Instituto Gonçalo Moniz, Fundação Oswaldo Cruz, Ministério da Saúde, Salvador, Brazil
| | - Juliet O. Santana
- Laboratório de Patologia e Biologia Molecular, Instituto Gonçalo Moniz, Fundação Oswaldo Cruz, Ministério da Saúde, Salvador, Brazil
- Departamento de Geografia, Instituto de Geociências, Universidade Federal da Bahia, Salvador, Brazil
| | - Federico Costa
- Laboratório de Patologia e Biologia Molecular, Instituto Gonçalo Moniz, Fundação Oswaldo Cruz, Ministério da Saúde, Salvador, Brazil
- Instituto de Saúde Coletiva, Universidade Federal da Bahia, Salvador, Brazil
- Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, CT, United States
| | - Albert I. Ko
- Laboratório de Patologia e Biologia Molecular, Instituto Gonçalo Moniz, Fundação Oswaldo Cruz, Ministério da Saúde, Salvador, Brazil
- Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, CT, United States
| | - Mitermayer G. Reis
- Laboratório de Patologia e Biologia Molecular, Instituto Gonçalo Moniz, Fundação Oswaldo Cruz, Ministério da Saúde, Salvador, Brazil
- Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, CT, United States
- Departamento de Medicina e Patologia Legal, Faculdade de Medicina da Bahia, Universidade Federal da Bahia, Salvador, Brazil
| | - Elsio A. Wunder
- Laboratório de Patologia e Biologia Molecular, Instituto Gonçalo Moniz, Fundação Oswaldo Cruz, Ministério da Saúde, Salvador, Brazil
- Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, CT, United States
- *Correspondence: Elsio A. Wunder Jr.
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Cunha M, Costa F, Ribeiro GS, Carvalho MS, Reis RB, Nery Jr N, Pischel L, Gouveia EL, Santos AC, Queiroz A, Wunder Jr. EA, Reis MG, Diggle PJ, Ko AI. Rainfall and other meteorological factors as drivers of urban transmission of leptospirosis. PLoS Negl Trop Dis 2022; 16:e0007507. [PMID: 35404948 PMCID: PMC9022820 DOI: 10.1371/journal.pntd.0007507] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2019] [Revised: 04/21/2022] [Accepted: 03/17/2022] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Leptospirosis is an important public health problem affecting vulnerable urban slum populations in developing country settings. However, the complex interaction of meteorological factors driving the temporal trends of leptospirosis remain incompletely understood. METHODS AND FINDINGS From March 1996-March 2010, we investigated the association between the weekly incidence of leptospirosis and meteorological anomalies in the city of Salvador, Brazil by using a dynamic generalized linear model that accounted for time lags, overall trend, and seasonal variation. Our model showed an increase of leptospirosis cases associated with higher than expected rainfall, lower than expected temperature and higher than expected humidity. There was a lag of one-to-two weeks between weekly values for significant meteorological variables and leptospirosis incidence. Independent of the season, a weekly cumulative rainfall anomaly of 20 mm increased the risk of leptospirosis by 12% compared to a week following the expected seasonal pattern. Finally, over the 14-year study period, the annual incidence of leptospirosis decreased significantly by a factor of 2.7 (8.3 versus 3.0 per 100,000 people), independently of variations in climate. CONCLUSIONS Strategies to control leptospirosis should focus on avoiding contact with contaminated sources of Leptospira as well as on increasing awareness in the population and health professionals within the short time window after low-level or extreme high-level rainfall events. Increased leptospirosis incidence was restricted to one-to-two weeks after those events suggesting that infectious Leptospira survival may be limited to short time intervals.
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Affiliation(s)
- Marcelo Cunha
- Escola Nacional de Saúde Pública, Fundação Oswaldo Cruz, Ministério da Saúde, Rio de Janeiro, Brazil
| | - Federico Costa
- Instituto de Pesquisas Gonçalo Moniz, Fundação Oswaldo Cruz, Ministério da Saúde, Salvador, Brazil
- Instituto de Saúde Coletiva, Universidade Federal da Bahia, Salvador, Brazil
- Faculty of Health and Medicine, University of Lancaster, Lancaster, United Kingdom
- Department of Epidemiology of Microbial Diseases, School of Public Health, Yale University, New Heaven, Connecticut, United States of America
| | - Guilherme S. Ribeiro
- Instituto de Pesquisas Gonçalo Moniz, Fundação Oswaldo Cruz, Ministério da Saúde, Salvador, Brazil
- Faculdade de Medicina, Universidade Federal da Bahia, Salvador, Brazil
| | - Marilia S. Carvalho
- Escola Nacional de Saúde Pública, Fundação Oswaldo Cruz, Ministério da Saúde, Rio de Janeiro, Brazil
| | - Renato B. Reis
- Instituto de Pesquisas Gonçalo Moniz, Fundação Oswaldo Cruz, Ministério da Saúde, Salvador, Brazil
| | - Nivison Nery Jr
- Instituto de Pesquisas Gonçalo Moniz, Fundação Oswaldo Cruz, Ministério da Saúde, Salvador, Brazil
- Instituto de Saúde Coletiva, Universidade Federal da Bahia, Salvador, Brazil
| | - Lauren Pischel
- Department of Epidemiology of Microbial Diseases, School of Public Health, Yale University, New Heaven, Connecticut, United States of America
| | - Edilane L. Gouveia
- Instituto de Pesquisas Gonçalo Moniz, Fundação Oswaldo Cruz, Ministério da Saúde, Salvador, Brazil
| | - Andreia C. Santos
- Instituto de Pesquisas Gonçalo Moniz, Fundação Oswaldo Cruz, Ministério da Saúde, Salvador, Brazil
| | - Adriano Queiroz
- Instituto de Pesquisas Gonçalo Moniz, Fundação Oswaldo Cruz, Ministério da Saúde, Salvador, Brazil
| | - Elsio A. Wunder Jr.
- Instituto de Pesquisas Gonçalo Moniz, Fundação Oswaldo Cruz, Ministério da Saúde, Salvador, Brazil
- Department of Epidemiology of Microbial Diseases, School of Public Health, Yale University, New Heaven, Connecticut, United States of America
| | - Mitermayer G. Reis
- Instituto de Pesquisas Gonçalo Moniz, Fundação Oswaldo Cruz, Ministério da Saúde, Salvador, Brazil
- Department of Epidemiology of Microbial Diseases, School of Public Health, Yale University, New Heaven, Connecticut, United States of America
- Faculdade de Medicina, Universidade Federal da Bahia, Salvador, Brazil
| | - Peter J Diggle
- Faculty of Health and Medicine, University of Lancaster, Lancaster, United Kingdom
- Department of Epidemiology of Microbial Diseases, School of Public Health, Yale University, New Heaven, Connecticut, United States of America
| | - Albert I. Ko
- Instituto de Pesquisas Gonçalo Moniz, Fundação Oswaldo Cruz, Ministério da Saúde, Salvador, Brazil
- Department of Epidemiology of Microbial Diseases, School of Public Health, Yale University, New Heaven, Connecticut, United States of America
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So RAY, Danguilan RA, Chua E, Arakama MHI, Ginete-Garcia JKB, Chavez JR. A Scoring Tool to Predict Pulmonary Complications in Severe Leptospirosis with Kidney Failure. Trop Med Infect Dis 2022; 7:tropicalmed7010007. [PMID: 35051123 PMCID: PMC8778471 DOI: 10.3390/tropicalmed7010007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2021] [Revised: 01/02/2022] [Accepted: 01/06/2022] [Indexed: 12/13/2022] Open
Abstract
Rapid identification of patients likely to develop pulmonary complications in severe leptospirosis is crucial to prompt aggressive management and improve survival. The following article is a cohort study of leptospirosis patients admitted at the National Kidney and Transplant Institute (NKTI). Logistic regression was used to predict pulmonary complications and obtain a scoring tool. The Kaplan-Meir method was used to describe survival rates. Among 380 patients with severe leptospirosis and kidney failure, the overall mortality was 14%, with pulmonary hemorrhage as the most common cause. In total, there were 85 (22.4%) individuals who developed pulmonary complications, the majority (95.3%) were observed within three days of admission. Among the patients with pulmonary complications, 56.5% died. Patients placed on mechanical ventilation had an 82.1% mortality rate. Multivariate analyses showed that dyspnea (OR = 28.76, p < 0.0001), hemoptysis (OR = 20.73, p < 0.0001), diabetes (OR = 10.21, p < 0.0001), renal replacement therapy (RRT) requirement (OR = 6.25, p < 0.0001), thrombocytopenia (OR = 3.54, p < 0.0029), and oliguria/anuria (OR = 3.15, p < 0.0108) were significantly associated with pulmonary complications. A scoring index was developed termed THe-RADS score (Thrombocytopenia, Hemoptysis, RRT, Anuria, Diabetes, Shortness of breath). The odds of developing pulmonary complications were 13.90 times higher among patients with a score >2 (63% sensitivity, 88% specificity). Pulmonary complications in severe leptospirosis with kidney failure have high mortality and warrant timely and aggressive management.
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Affiliation(s)
- Rizza Antoinette Yap So
- Department of Adult Nephrology, National Kidney and Transplant Institute, Quezon City 1101, Philippines; (R.A.D.); (E.C.); (M.-H.I.A.)
- Correspondence: ; Tel.: +63-32-8981-0300
| | - Romina A. Danguilan
- Department of Adult Nephrology, National Kidney and Transplant Institute, Quezon City 1101, Philippines; (R.A.D.); (E.C.); (M.-H.I.A.)
| | - Eric Chua
- Department of Adult Nephrology, National Kidney and Transplant Institute, Quezon City 1101, Philippines; (R.A.D.); (E.C.); (M.-H.I.A.)
| | - Mel-Hatra I. Arakama
- Department of Adult Nephrology, National Kidney and Transplant Institute, Quezon City 1101, Philippines; (R.A.D.); (E.C.); (M.-H.I.A.)
| | - Joann Kathleen B. Ginete-Garcia
- Department of Internal Medicine, National Kidney and Transplant Institute, Quezon City 1101, Philippines; (J.K.B.G.-G.); (J.R.C.)
| | - Joselito R. Chavez
- Department of Internal Medicine, National Kidney and Transplant Institute, Quezon City 1101, Philippines; (J.K.B.G.-G.); (J.R.C.)
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Barazzone GC, Teixeira AF, Azevedo BOP, Damiano DK, Oliveira MP, Nascimento ALTO, Lopes APY. Revisiting the Development of Vaccines Against Pathogenic Leptospira: Innovative Approaches, Present Challenges, and Future Perspectives. Front Immunol 2022; 12:760291. [PMID: 35046936 PMCID: PMC8761801 DOI: 10.3389/fimmu.2021.760291] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2021] [Accepted: 11/16/2021] [Indexed: 12/12/2022] Open
Abstract
Human vaccination against leptospirosis has been relatively unsuccessful in clinical applications despite an expressive amount of vaccine candidates has been tested over years of research. Pathogenic Leptospira encompass a great number of serovars, most of which do not cross-react, and there has been a lack of genetic tools for many years. These obstacles have hampered the understanding of the bacteria's biology and, consequently, the identification of an effective antigen. Thus far, many approaches have been used in an attempt to find a cost-effective and broad-spectrum protective antigen(s) against the disease. In this extensive review, we discuss several strategies that have been used to develop an effective vaccine against leptospirosis, starting with Leptospira-inactivated bacterin, proteins identified in the genome sequences of pathogenic Leptospira, including reverse vaccinology, plasmid DNA, live vaccines, chimeric multi-epitope, and toll- and nod-like receptors agonists. This overview should be able to guide scientists working in the field to select potential antigens and to choose the appropriate formulation to administer the candidates.
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Affiliation(s)
- Giovana C. Barazzone
- Laboratório de Desenvolvimento de Vacinas, Instituto Butantan, São Paulo, Brazil
- Programa de Pós-Graduação Interunidades em Biotecnologia, Instituto de Ciências Biomédicas, Universidade de São Paulo (USP), São Paulo, Brazil
| | - Aline F. Teixeira
- Laboratório de Desenvolvimento de Vacinas, Instituto Butantan, São Paulo, Brazil
| | - Bruna O. P. Azevedo
- Laboratório de Desenvolvimento de Vacinas, Instituto Butantan, São Paulo, Brazil
- Programa de Pós-Graduação Interunidades em Biotecnologia, Instituto de Ciências Biomédicas, Universidade de São Paulo (USP), São Paulo, Brazil
| | - Deborah K. Damiano
- Laboratório de Desenvolvimento de Vacinas, Instituto Butantan, São Paulo, Brazil
- Programa de Pós-Graduação Interunidades em Biotecnologia, Instituto de Ciências Biomédicas, Universidade de São Paulo (USP), São Paulo, Brazil
| | - Marcos P. Oliveira
- Laboratório de Desenvolvimento de Vacinas, Instituto Butantan, São Paulo, Brazil
- Programa de Pós-Graduação Interunidades em Biotecnologia, Instituto de Ciências Biomédicas, Universidade de São Paulo (USP), São Paulo, Brazil
| | - Ana L. T. O. Nascimento
- Laboratório de Desenvolvimento de Vacinas, Instituto Butantan, São Paulo, Brazil
- Programa de Pós-Graduação Interunidades em Biotecnologia, Instituto de Ciências Biomédicas, Universidade de São Paulo (USP), São Paulo, Brazil
| | - Alexandre P. Y. Lopes
- Laboratório de Desenvolvimento de Vacinas, Instituto Butantan, São Paulo, Brazil
- Programa de Pós-Graduação Interunidades em Biotecnologia, Instituto de Ciências Biomédicas, Universidade de São Paulo (USP), São Paulo, Brazil
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Yadav A, Sethia M, Jain R, Singh S, Tilak R. A study of clinical profile of 100 icteric leptospirosis cases. MEDICAL JOURNAL OF DR. D.Y. PATIL VIDYAPEETH 2022. [DOI: 10.4103/mjdrdypu.mjdrdypu_843_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Chen M, Lu W, Wu S, Wang S, Lu T, Peng C. Metagenomic next-generation sequencing in the diagnosis of leptospirosis presenting as severe diffuse alveolar hemorrhage: a case report and literature review. BMC Infect Dis 2021; 21:1230. [PMID: 34876042 PMCID: PMC8650322 DOI: 10.1186/s12879-021-06923-w] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2021] [Accepted: 11/30/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Leptospirosis is a common infectious disease in tropical and semitropical regions, and it is typically neglected. Leptospirosis-associated acute diffuse alveolar hemorrhage is one of its fatal complications. The use of bronchoalveolar lavage fluid (BALF) metagenomic next-generation sequencing in the diagnosis of Leptospira interrogans infection has rarely been reported. CASE PRESENTATION We present the case of a 62-year-old female who was transferred to our hospital with dyspnea, and severe hemoptysis and was supported by a tracheal intubation ventilator. Bronchoalveolar lavage fluid (BALF) metagenomic next-generation sequencing (mNGS) reported Leptospira interrogans. A diagnosis of diffuse alveolar hemorrhage caused by leptospirosis was made. After immediately receiving antibiotics and hormone therapy, the patient achieved a complete recovery upon discharge. CONCLUSION Leptospirosis presenting as severe diffuse alveolar hemorrhage is rare but should be considered in the differential diagnosis. mNGS can help identify pathogens and treat them early, which can improve prognosis.
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Affiliation(s)
- Meiqin Chen
- Department of Infectious Diseases, The Quzhou Affiliated Hospital of Wenzhou Medical University, Quzhou People's Hospital, Quzhou, 324000, Zhejiang, China
| | - Weili Lu
- Department of Infectious Diseases, The Quzhou Affiliated Hospital of Wenzhou Medical University, Quzhou People's Hospital, Quzhou, 324000, Zhejiang, China
| | - Shugen Wu
- Department of Infectious Diseases, The Quzhou Affiliated Hospital of Wenzhou Medical University, Quzhou People's Hospital, Quzhou, 324000, Zhejiang, China
| | - Shun Wang
- Department of Infectious Diseases, The Quzhou Affiliated Hospital of Wenzhou Medical University, Quzhou People's Hospital, Quzhou, 324000, Zhejiang, China
| | - Tao Lu
- Department of Infectious Diseases, The Quzhou Affiliated Hospital of Wenzhou Medical University, Quzhou People's Hospital, Quzhou, 324000, Zhejiang, China
| | - Chunxian Peng
- Department of Infectious Diseases, The Quzhou Affiliated Hospital of Wenzhou Medical University, Quzhou People's Hospital, Quzhou, 324000, Zhejiang, China.
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Casanovas-Massana A, Souza FN, Curry M, de Oliveira D, de Oliveira AS, Eyre MT, Santiago D, Santos MA, Serra RMR, Lopes E, Xavier BIA, Diggle PJ, Wunder EA, Reis MG, Ko AI, Costa F. Effect of Sewerage on the Contamination of Soil with Pathogenic Leptospira in Urban Slums. ENVIRONMENTAL SCIENCE & TECHNOLOGY 2021; 55:15882-15890. [PMID: 34767339 PMCID: PMC9302045 DOI: 10.1021/acs.est.1c04916] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Leptospirosis is an environmentally transmitted zoonotic disease caused by pathogenic Leptospira spp. that affects poor communities worldwide. In urban slums, leptospirosis is associated with deficient sanitary infrastructure. Yet, the role of sewerage in the reduction of the environmental contamination with pathogenic Leptospira has not been explored. Here, we conducted a survey of the pathogen in soils surrounding open and closed sewer sections in six urban slums in Brazil. We found that soils surrounding conventionally closed sewers (governmental interventions) were 3 times less likely to contain pathogenic Leptospira (inverse OR 3.44, 95% CI = 1.66-8.33; p < 0.001) and contained a 6 times lower load of the pathogen (0.82 log10 units difference, p < 0.01) when compared to their open counterparts. However, no differences were observed in community-closed sewers (poor-quality closings performed by the slum dwellers). Human fecal markers (BacHum) were positively associated with pathogenic Leptospira even in closed sewers, and rat presence was not predictive of the presence of the pathogen in soils, suggesting that site-specific rodent control may not be sufficient to reduce the environmental contamination with Leptospira. Overall, our results indicate that sewerage expansion to urban slums may help reduce the environmental contamination with the pathogen and therefore reduce the risk of human leptospirosis.
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Affiliation(s)
| | | | | | | | - Anderson S. de Oliveira
- Instituto Gonçalo Moniz, Fundação Oswaldo Cruz, Ministério da Saúde, Salvador, Bahia 40296-710, Brazil
| | - Max T. Eyre
- Instituto de Saúde Coletiva, Universidade Federal da Bahia, Salvador, Bahia 40110-040, Brazil; Centre for Health Informatics, Computing, and Statistics, Lancaster University Medical School, Lancaster LA1 4YW, United Kingdom
| | - Diogo Santiago
- Instituto de Saúde Coletiva, Universidade Federal da Bahia, Salvador, Bahia 40110-040, Brazil
| | - Maísa Aguiar Santos
- Instituto Gonçalo Moniz, Fundação Oswaldo Cruz, Ministério da Saúde, Salvador, Bahia 40296-710, Brazil
| | - Rafael M. R. Serra
- Instituto Gonçalo Moniz, Fundação Oswaldo Cruz, Ministério da Saúde, Salvador, Bahia 40296-710, Brazil
| | - Evelyn Lopes
- Instituto de Saúde Coletiva, Universidade Federal da Bahia, Salvador, Bahia 40110-040, Brazil
| | - Barbara IA Xavier
- Instituto de Saúde Coletiva, Universidade Federal da Bahia, Salvador, Bahia 40110-040, Brazil
| | - Peter J. Diggle
- Centre for Health Informatics, Computing, and Statistics, Lancaster University Medical School, Lancaster LA1 4YW, United Kingdom
| | - Elsio A. Wunder
- Department of Epidemiology of Microbial Diseases, School of Public Health, Yale University, New Haven, Connecticut 06511, United States; Instituto Gonçalo Moniz, Fundação Oswaldo Cruz, Ministério da Saúde, Salvador, Bahia 40296-710, Brazil
| | - Mitermayer G. Reis
- Department of Epidemiology of Microbial Diseases, School of Public Health, Yale University, New Haven, Connecticut 06511, United States; Instituto Gonçalo Moniz, Fundação Oswaldo Cruz, Ministério da Saúde, Salvador, Bahia 40296-710, Brazil; Faculdade de Medicina da Bahia, Universidade Federal da Bahia, Salvador, Bahia 40026-010, Brazil
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Nabity SA, Araújo GC, Hagan JE, Damião AO, Reis MG, Ko AI, Ribeiro GS. Anicteric Leptospirosis-Associated Meningitis in a Tropical Urban Environment, Brazil. Emerg Infect Dis 2021; 26:2190-2192. [PMID: 32818405 PMCID: PMC7454101 DOI: 10.3201/eid2609.191001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023] Open
Abstract
While studying aseptic meningitis in Salvador, Brazil, we diagnosed anicteric leptospirosis in 1.7% (5/295) of patients hospitalized for aseptic meningitis. Leptospirosis-associated meningitis patients had lower mean cerebrospinal fluid cell counts and protein than other-cause aseptic meningitis (p<0.05). Clinicians must consider leptospirosis-associated meningitis in appropriate clinical-epidemiologic contexts.
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Dong WH, Chen Z. Leptospirosis with pulmonary haemorrhage and multiple organ failure: a case report and literature review. J Int Med Res 2021; 49:3000605211019665. [PMID: 34044641 PMCID: PMC8165534 DOI: 10.1177/03000605211019665] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Pulmonary haemorrhage is an important complication of leptospirosis. We herein report an uncommon case of severe pulmonary haemorrhage and multiple organ failure caused by leptospirosis in a 49-year-old man who was previously healthy. He was a farm worker who was admitted to the hospital because of haemoptysis. He had worked in a paddy field 4 days prior to admission. Chest computed tomography revealed pulmonary haemorrhage, which rapidly deteriorated into haemorrhagic shock and multiple organ failure. Based on the patient’s possible history of contact with contaminated water and the DNA sequence of Leptospira detected in his bronchoalveolar lavage fluid, the patient was diagnosed with pulmonary haemorrhagic leptospirosis. Despite the administration of a fluid bolus, norepinephrine, broad-spectrum antibiotics, and haemostatics, and even with administration of a blood transfusion and extracorporeal life support, the pulmonary haemorrhage could not be controlled effectively. The patient eventually died of haemorrhagic shock. Leptospirosis can be a life-threatening disease despite aggressive treatment, even with extracorporeal life support. Next-generation sequencing can provide important diagnostic clues for patients with atypical leptospirotic symptoms.
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Affiliation(s)
- Wei-Hua Dong
- Department of Emergency, Jiangxi Provincial People's Hospital Affiliated to Nanchang University, Nanchang, Jiangxi, China.,Medical Department of Nanchang University, Nanchang, Jiangxi, China
| | - Zhi Chen
- Department of Emergency, Jiangxi Provincial People's Hospital Affiliated to Nanchang University, Nanchang, Jiangxi, China
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Shinya S, Muraoka Y, Negishi D, Koizumi N. Molecular epidemiology of Leptospira spp. among wild mammals and a dog in Amami Oshima Island, Japan. PLoS One 2021; 16:e0249987. [PMID: 33886632 PMCID: PMC8061989 DOI: 10.1371/journal.pone.0249987] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2021] [Accepted: 03/30/2021] [Indexed: 11/23/2022] Open
Abstract
Leptospirosis is a worldwide zoonosis caused by the pathogenic Leptospira spp. Canine and human leptospirosis sometimes occur on Amami Oshima Island, located in the Nansei Archipelago, southwestern Japan; however, information on the causative Leptospira spp. on this island is quite limited. This study aimed to investigate the molecular and serological characteristics of Leptospira spp. isolated from wild animals and a dog in Amami Oshima Island. We obtained seven Leptospira strains by culturing kidney tissues of wild animals, such as black rats (2), wild boars (3), and rabbit (1) as well as blood from a symptomatic dog. Using flaB sequencing and microscopic agglutination test with antisera for 18 serovars, the isolates were identified as Leptospira borgpetersenii serogroups Javanica (black rat), L. interrogans serogroup Australis (black rat and dog), and L. interrogans serogroup Hebdomadis (wild boar and rabbit). The sequence type (ST) of L. borgpetersenii serogroup Javanica was determined to be ST143 via multilocus sequence typing (MLST) using seven housekeeping genes. For L. interrogans, MLST and multiple-locus variable-tandem repeat analysis (MLVA) revealed identical ST and MLVA types in rat and canine isolates, whereas two STs and MLVA types were identified in wild boar isolates. The STs and MLVA types of rabbit and one of the wild boars were identical. Bacterial culture and flaB-nested polymerase chain reaction demonstrated a high rate of Leptospira infection in wild boars (58.3%, 7/12), whereas Leptospira spp. were detected in 4.8% of black rats (2/42). This study revealed diverse Leptospira genotype and serotype maintenance in wild mammals on Amami Oshima Island. MLST and MLVA indicated that black rats were a source of canine infection. Wild boars carry L. interrogans and are considered an important maintenance host because antibodies against serogroup Hebdomadis were detected in human and canine leptospirosis patients on this island.
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Affiliation(s)
- So Shinya
- Yuinoshima Animal Clinic, Amami-City, Kagoshima, Japan
- * E-mail: (SS); (NK)
| | | | - Daigo Negishi
- Yuinoshima Animal Clinic, Amami-City, Kagoshima, Japan
| | - Nobuo Koizumi
- Department of Bacteriology I, National Institute of Infectious Diseases, Shinjuku-ku, Tokyo, Japan
- * E-mail: (SS); (NK)
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Poverty, sanitation, and Leptospira transmission pathways in residents from four Brazilian slums. PLoS Negl Trop Dis 2021; 15:e0009256. [PMID: 33788864 PMCID: PMC8041187 DOI: 10.1371/journal.pntd.0009256] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2020] [Revised: 04/12/2021] [Accepted: 02/19/2021] [Indexed: 11/19/2022] Open
Abstract
Residents of urban slums suffer from a high burden of zoonotic diseases due to individual, socioeconomic, and environmental factors. We conducted a cross-sectional sero-survey in four urban slums in Salvador, Brazil, to characterize how poverty and sanitation contribute to the transmission of rat-borne leptospirosis. Sero-prevalence in the 1,318 participants ranged between 10.0 and 13.3%. We found that contact with environmental sources of contamination, rather than presence of rat reservoirs, is what leads to higher risk for residents living in areas with inadequate sanitation. Further, poorer residents may be exposed away from the household, and ongoing governmental interventions were not associated with lower transmission risk. Residents at higher risk were aware of their vulnerability, and their efforts improved the physical environment near their household, but did not reduce their infection chances. This study highlights the importance of understanding the socioeconomic and environmental determinants of risk, which ought to guide intervention efforts. Globally, more than 1 billion residents live in urban slums, where inadequate sanitation increases the spread of pathogens and their animal hosts. Leptospirosis is a globally distributed bacterial disease, and in urban areas the bacteria is spread by brown rats. Humans become infected upon exposure to water or soil/mud that was contaminated with the urine of infected rats. In four urban slums in the city of Salvador, Brazil, we used a range of individual, socioeconomic, and environmental variables to understand how they influence to one another and define o leptospirosis exposure in residents. Poverty and sanitation influenced the degree to which residents were exposed to sewer water and mud. Further, we found that while residents tried to improve the physical environment near their household, living in an area with poor sanitation mean that their infection risk remained high. This work highlight the importance of socioeconomic and environmental factors in determining disease risk, and suggests that governmental interventions should focus on improving sanitation changes in the poorest parts of the community.
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Jayasundara D, Senavirathna I, Warnasekara J, Gamage C, Siribaddana S, Kularatne SAM, Matthias M, Mariet JF, Picardeau M, Agampodi S, M. Vinetz J. 12 Novel clonal groups of Leptospira infecting humans in multiple contrasting epidemiological contexts in Sri Lanka. PLoS Negl Trop Dis 2021; 15:e0009272. [PMID: 33735202 PMCID: PMC8009393 DOI: 10.1371/journal.pntd.0009272] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2020] [Revised: 03/30/2021] [Accepted: 02/25/2021] [Indexed: 12/13/2022] Open
Abstract
Leptospirosis is a ubiquitous zoonotic disease and a major clinical challenge owing to the multitude of clinical presentations and manifestations that are possibly attributable to the diversity of Leptospira, the understanding of which is key to study the epidemiology of this emerging global disease threat. Sri Lanka is a hotspot for leptospirosis with high levels of endemicity as well as annual epidemics. We carried out a prospective study of Leptospira diversity in Sri Lanka, covering the full range of climatic zones, geography, and clinical severity. Samples were collected for leptospiral culture from 1,192 patients from 15 of 25 districts in Sri Lanka over two and half years. Twenty-five isolates belonging to four pathogenic Leptospira species were identified: L. interrogans, L. borgpetersenii, L. weilii, and L. kirschneri. At least six serogroups were identified among the isolates: Autumnalis (6), Pyrogenes (4), Icterohaemorrhagiae (2), Celledoni (1), Grippotyphosa (2) and Bataviae (1). Seven isolates did not agglutinate using available antisera panels, suggesting new serogroups. Isolates were sequenced using an Illumina platform. These data add 25 new core genome sequence types and were clustered in 15 clonal groups, including 12 new clonal groups. L. borgpetersenii was found only in the dry zone and L. weilii only in the wet zone. Acute kidney injury and cardiovascular involvement were seen only with L. interrogans infections. Thrombocytopenia and liver impairment were seen in both L. interrogans and L. borgpetersenii infections. The inadequate sensitivity of culture isolation to identify infecting Leptospira species underscores the need for culture-independent typing methods for Leptospira. There is a huge diversity in pathogenic Leptospira species worldwide, and our knowledge of the currently circulating species is deficient owing to limited isolation and identification of Leptospira species from endemic countries. This prospective study reveals the wide pathogen diversity that causes human leptospirosis in Sri Lanka, representing four species, more than six serogroups, and fifteen clonal groups. Further, the different geographic and climatic zone distributions and clinical manifestations observed underscores the need for prospective studies to expand the molecular epidemiological approaches to combat leptospirosis.
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Affiliation(s)
- Dinesha Jayasundara
- Leptospirosis Research Laboratory, Department of Community Medicine, Faculty of Medicine and Allied Sciences, Rajarata University of Sri Lanka, Saliyapura, Sri Lanka
- Department of Microbiology, Faculty of Medicine and Allied Sciences, Rajarata University of Sri Lanka, Saliyapura, Sri Lanka
| | - Indika Senavirathna
- Leptospirosis Research Laboratory, Department of Community Medicine, Faculty of Medicine and Allied Sciences, Rajarata University of Sri Lanka, Saliyapura, Sri Lanka
- Department of Biochemistry, Faculty of Medicine and Allied Sciences, Rajarata University of Sri Lanka, Saliyapura, Sri Lanka
| | - Janith Warnasekara
- Leptospirosis Research Laboratory, Department of Community Medicine, Faculty of Medicine and Allied Sciences, Rajarata University of Sri Lanka, Saliyapura, Sri Lanka
| | - Chandika Gamage
- Department of Microbiology, Faculty of Medicine, University of Peradeniya, Peradeniya, Sri Lanka
| | - Sisira Siribaddana
- Department of Medicine, Faculty of Medicine and Allied Sciences, Rajarata University of Sri Lanka, Saliyapura, Sri Lanka
| | | | - Michael Matthias
- Section of Infectious Diseases, Department of Internal Medicine, Yale University School of Medicine, New Haven, Connecticut, United States of America
| | | | | | - Suneth Agampodi
- Leptospirosis Research Laboratory, Department of Community Medicine, Faculty of Medicine and Allied Sciences, Rajarata University of Sri Lanka, Saliyapura, Sri Lanka
- Section of Infectious Diseases, Department of Internal Medicine, Yale University School of Medicine, New Haven, Connecticut, United States of America
- * E-mail:
| | - Joseph M. Vinetz
- Section of Infectious Diseases, Department of Internal Medicine, Yale University School of Medicine, New Haven, Connecticut, United States of America
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Anti-Leptospira immunoglobulin profiling in mice reveals strain specific IgG and persistent IgM responses associated with virulence and renal colonization. PLoS Negl Trop Dis 2021; 15:e0008970. [PMID: 33705392 PMCID: PMC8007020 DOI: 10.1371/journal.pntd.0008970] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2020] [Revised: 03/29/2021] [Accepted: 02/23/2021] [Indexed: 12/14/2022] Open
Abstract
Leptospira interrogans is a pathogenic spirochete responsible for leptospirosis, a neglected, zoonotic reemerging disease. Humans are sensitive hosts and may develop severe disease. Some animal species, such as rats and mice can become asymptomatic renal carriers. More than 350 leptospiral serovars have been identified, classified on the basis of the antibody response directed against the lipopolysaccharide (LPS). Similarly to whole inactivated bacteria used as human vaccines, this response is believed to confer only short-term, serogroup-specific protection. The immune response of hosts against leptospires has not been thoroughly studied, which complicates the testing of vaccine candidates. In this work, we studied the immunoglobulin (Ig) profiles in mice infected with L. interrogans over time to determine whether this humoral response confers long-term protection after homologous challenge six months post-infection. Groups of mice were injected intraperitoneally with 2×107 leptospires of one of three pathogenic serovars (Manilae, Copenhageni or Icterohaemorrhagiae), attenuated mutants or heat-killed bacteria. Leptospira-specific immunoglobulin (IgA, IgM, IgG and 4 subclasses) produced in the first weeks up to 6 months post-infection were measured by ELISA. Strikingly, we found sustained high levels of IgM in mice infected with the pathogenic Manilae and Copenhageni strains, both colonizing the kidney. In contrast, the Icterohaemorrhagiae strain did not lead to kidney colonization, even at high dose, and triggered a classical IgM response that peaked at day 8 post-infection and disappeared. The virulent Manilae and Copenhageni serovars elicited high levels and similar profiles of IgG subclasses in contrast to Icterohaemorrhagiae strains that stimulated weaker antibody responses. Inactivated heat-killed Manilae strains elicited very low responses. However, all mice pre-injected with leptospires challenged with high doses of homologous bacteria did not develop acute leptospirosis, and all antibody responses were boosted after challenge. Furthermore, we showed that 2 months post-challenge, mice pre-infected with the attenuated M895 Manilae LPS mutant or heat-killed bacterin were completely protected against renal colonization. In conclusion, we observed a sustained IgM response potentially associated with chronic leptospiral renal infection. We also demonstrated in mice different profiles of protective and cross-reactive antibodies after L. interrogans infection, depending on the serovar and virulence of strains. Leptospira interrogans is a pathogenic spirochete responsible for leptospirosis, a neglected zoonotic reemerging disease. The immune response of hosts against these bacteria has not been thoroughly studied. Here, we studied over 6 months the antibody profiles in mice infected with L. interrogans and determined whether this humoral response confers long-term protection after homologous challenge six months after primary infection. Groups of mice were infected intraperitoneally with 2×107 bacteria of one of three different pathogenic serovars (Manilae, Copenhageni and Icterohaemorrhagiae) and some corresponding attenuated avirulent mutants. We measured by ELISA each type of Leptospira-specific immunoglobulin (Ig) (IgA, IgM, IgG and 4 subclasses) produced in the first weeks up to 6 months post-infection and studied their cross-reactivities among serovars. We showed different profiles of antibody response after L. interrogans challenge in mice, depending on the serovar and virulence of strains. However, all infected mice, including the ones harboring low antibody levels, like mice vaccinated with an inactivated, heat-killed strain, were protected against leptospirosis after challenge. Notably, we also showed an unusual sustained IgM response associated with chronic leptospiral colonization. Altogether, this long-term immune protection is different from what is known in humans and warrants further investigation.
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Galan DI, Roess AA, Pereira SVC, Schneider MC. Epidemiology of human leptospirosis in urban and rural areas of Brazil, 2000-2015. PLoS One 2021; 16:e0247763. [PMID: 33661947 PMCID: PMC7932126 DOI: 10.1371/journal.pone.0247763] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2020] [Accepted: 02/15/2021] [Indexed: 01/07/2023] Open
Abstract
Background Leptospirosis is one of the most widespread zoonosis in the world and Brazil has the highest number of cases in Latin America. Transmission occurs mainly through exposure to water and soil contaminated by the urine of infected animals. The goals of this study are to describe the geographic distribution, demographic characteristics and exposure factors of urban and rural cases of leptospirosis, and identify spatial clusters in urban and rural areas of Brazil. Methods/results A retrospective epidemiological study was carried out using 16 years (2000–2015) of surveillance data from the Brazilian Ministry of Health. Cases were described by age, sex and race, and exposure factors were characterized in urban and rural areas. A spatial autocorrelation analysis was conducted using local Moran’s I to identify urban and rural clusters of disease. On average 3,810 leptospirosis cases were reported annually with higher numbers in urban areas. National urban and rural incidence rates were the same (1.9 cases/100,000 population), however, regional differences were observed. Urban incidence rates were higher in the North and Northeast regions, while rural incidence rates were higher in the Southeast and South. The main exposure factor reported in urban and rural areas was exposure to places with signs of rodents, followed by flood in urban areas and agriculture and animal farming in rural areas. Clusters of leptospirosis were identified in densely populated urban areas of the North, Southeast and South regions, while rural clusters were concentrated in of the Southern region with large agriculture and animal farming practices. Conclusions This study highlights that leptospirosis is an important public health problem in both urban and rural areas of Brazil. The results provide decision-makers with detailed information about where disease incidence is high and can be used in the development of prevention and control strategies for priority areas and risk groups.
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Affiliation(s)
- Deise I. Galan
- Department of Environmental and Occupational Health, The George Washington University, Washington, District of Columbia, United States of America
- * E-mail:
| | - Amira A. Roess
- Department of Global and Community Health, George Mason University, Fairfax, Virginia, United States of America
| | | | - Maria Cristina Schneider
- Department of International Health, Georgetown University, Washington, District of Columbia, United States of America
- Institute of Studies in Collective Health, Federal University of Rio de Janeiro, Rio de Janeiro, Rio de Janeiro, Brazil
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Jilg N, Lau ES, Baker MA, Levy BD, Loscalzo J. A Treacherous Course. N Engl J Med 2021; 384:860-865. [PMID: 33657298 DOI: 10.1056/nejmcps2020668] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Affiliation(s)
- Nikolaus Jilg
- From the Department of Medicine, Brigham and Women's Hospital (N.J., E.S.L., M.A.B., B.D.L., J.L.), the Department of Medicine, Massachusetts General Hospital (N.J.), and the Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute (M.A.B.) - all in Boston
| | - Emily S Lau
- From the Department of Medicine, Brigham and Women's Hospital (N.J., E.S.L., M.A.B., B.D.L., J.L.), the Department of Medicine, Massachusetts General Hospital (N.J.), and the Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute (M.A.B.) - all in Boston
| | - Meghan A Baker
- From the Department of Medicine, Brigham and Women's Hospital (N.J., E.S.L., M.A.B., B.D.L., J.L.), the Department of Medicine, Massachusetts General Hospital (N.J.), and the Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute (M.A.B.) - all in Boston
| | - Bruce D Levy
- From the Department of Medicine, Brigham and Women's Hospital (N.J., E.S.L., M.A.B., B.D.L., J.L.), the Department of Medicine, Massachusetts General Hospital (N.J.), and the Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute (M.A.B.) - all in Boston
| | - Joseph Loscalzo
- From the Department of Medicine, Brigham and Women's Hospital (N.J., E.S.L., M.A.B., B.D.L., J.L.), the Department of Medicine, Massachusetts General Hospital (N.J.), and the Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute (M.A.B.) - all in Boston
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Niloofa R, Karunanayake L, de Silva HJ, Premawansa S, Rajapakse S, Handunnetti S. Development of in-house ELISAs as an alternative method for the serodiagnosis of leptospirosis. Int J Infect Dis 2021; 105:135-140. [PMID: 33556609 DOI: 10.1016/j.ijid.2021.01.074] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2020] [Revised: 01/23/2021] [Accepted: 01/25/2021] [Indexed: 10/22/2022] Open
Abstract
BACKGROUND Leptospirosis is most often diagnosed clinically, and a laboratory test with high diagnostic accuracy is required. METHODS IgM and IgG ELISAs using Leptospira antigens were established and evaluated in relation to the microscopic agglutination test (MAT). Antigen preparation consisted of saprophytic Leptospira biflexa to detect genus-specific antibodies (genus-specific ELISA) and a pool of the five most prevalent Leptospira interrogans serovars in Sri Lanka to detect serovar-specific antibodies (serovar-specific ELISA). IgM and IgG immune responses were studied in severe and mild leptospirosis patients (n = 100 in each group). RESULTS The ELISAs showed high repeatability and reproducibility. The serovar-specific IgM-ELISA showed a sensitivity of 80.2% and specificity of 89%; the genus-specific IgM-ELISA showed a sensitivity of 83.3% and specificity of 91%. The serovar- and genus-specific IgG-ELISAs showed sensitivities of 73.3% and 81.7%, respectively, and specificities of 83.3% and 83.3%, respectively. The commercial IgM-ELISA showed a sensitivity of 79.2% and specificity of 93%. The commercial IgG-ELISA showed a sensitivity of 50% and specificity of 96.7%. IgM levels observed in mild and severe leptospirosis patients were significantly higher than in the healthy control group, with mean absorbance values of 0.770, 0.778, and 0.163, respectively. Severe leptospirosis patients had significantly higher mean anti-leptospiral IgG levels compared to both mild leptospirosis patients and healthy control group subjects (0.643, 0.358, and 0.116, respectively; ANOVA, p < 0.001). The presence of anti-leptospiral IgG above an optical density of 0.643 at 1:100 could predict a high risk of severe disease. CONCLUSION The serovar-specific in-house ELISA could be used for the laboratory diagnosis of leptospirosis in endemic settings. The high levels of anti-leptospiral IgG observed suggest its value as a predictor of disease severity.
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Affiliation(s)
- Roshan Niloofa
- Institute of Biochemistry, Molecular Biology and Biotechnology, University of Colombo, Colombo, Sri Lanka.
| | | | | | | | - Senaka Rajapakse
- Tropical Medicine Research Unit, Faculty of Medicine, University of Colombo, Colombo, Sri Lanka
| | - Shiroma Handunnetti
- Institute of Biochemistry, Molecular Biology and Biotechnology, University of Colombo, Colombo, Sri Lanka
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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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Assessment of Risk Factors in Synanthropic and Wild Rodents Infected by Pathogenic Leptospira spp. Captured in Southern Chile. Animals (Basel) 2020; 10:ani10112133. [PMID: 33212843 PMCID: PMC7697743 DOI: 10.3390/ani10112133] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2020] [Revised: 10/22/2020] [Accepted: 11/03/2020] [Indexed: 11/17/2022] Open
Abstract
Simple Summary Leptospirosis is a zoonosis caused by pathogenic Leptospira, and synanthropic and wildlife species of rodents are an important source of infection; however, much of the information about the progression of the infection was obtained from lab murine models. The aim of this study was to assess infection status and risk factors by pathogenic Leptospira in synanthropic and wild rodent species and describe histopathological lesions in several organs from naturally infected animals. In this study, 121 rodents from three synanthropic species and two wild species were trapped within dairy farms in Southern Chile, where the bacteria were present. Liver, heart, kidney, and lungs from trapped animals were analyzed by different techniques to detect if the lesions present were produced by the bacteria. A large proportion of animals were identified as infected that were not detected by the microscopic agglutination test. There is a lower risk of infection in the fall compared to the rest of the seasons, and the synanthropic species has a lower risk of infection in comparison with wildlife species. Immunohistochemistry and quantitative real-time lipL32 polymerase chain reaction contributed to identifying the presence of pathogenic Leptospira in related histological lesions and 50% more infections than serology. Abstract Leptospirosis is caused by pathogenic Leptospira, and synanthropic and wildlife species of rodents are an important source of infection; however, much of the information about infection progression was obtained from murine models. The aim of this study was to assess infection status and risk factors associated with pathogenic Leptospira in synanthropic and wild rodent species and describe histopathological lesions in several organs from naturally infected animals. In a cross-sectional study, 121 rodents from three synanthropic species and two wild species were trapped in dairy farms in Southern Chile. Liver, heart, kidney, and lungs from trapped animals were fixed in formalin and stained with hematoxylin–eosin. Tissues with lesions consistent with Leptospira infection were tested by immunohistochemistry (IHC) and real-time polymerase chain reaction (qPCR) using the LipL32 antigen. Risk factors were assessed by a conditional mixed-logistic regression model. More than half (56.7%) of the negative reactors to the microscopic agglutination test were identified as infected either by IHC/qPCR. A lower risk of infection compared to the rest of the seasons was found in the fall, and the synanthropic species have a lower risk of infection in comparison with the wildlife species. IHC and qPCR contributed to the identification of pathogenic Leptospira in related histological lesions and 50% more infections than serology.
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Zaki AM, Hod R, Shamsusah NA, Isa ZM, Bejo SK, Agustar HK. Detection of Leptospira kmetyi at recreational areas in Peninsular Malaysia. ENVIRONMENTAL MONITORING AND ASSESSMENT 2020; 192:703. [PMID: 33057929 DOI: 10.1007/s10661-020-08639-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/18/2020] [Accepted: 09/24/2020] [Indexed: 06/11/2023]
Abstract
Humans can be infected by pathogenic Leptospira through contact with infected animals or contaminated environments. Recreational exposure has been associated with human leptospirosis; however, there is a lack of information on the distribution of Leptospira spp. in recreational areas. Thus, we conducted this study to detect and describe the distributions of Leptospira spp. and to determine the prevalence of pathogenic leptospires at recreational areas in Peninsular Malaysia. Soil and water samples were randomly collected from 33 recreational areas in Peninsular Malaysia from December 2018 to April 2019. Each culture was examined under dark-field microscopy prior to genus confirmation by polymerase chain reaction using primers for the 16S rRNA gene. A total of 390 water and soil samples were collected, and 131 cultures were positive for Leptospira under dark-field microscope examination. Leptospira was identified in most of the recreational areas sampled, and at least one pathogenic Leptospira species was isolated from 17 recreational areas. The prevalence of saprophytic, intermediate, and pathogenic Leptospira spp. was 19.7%, 5.6%, and 8.2%, respectively. The dominant pathogenic species found in the samples was Leptospira kmetyi. This study provides important data on the distribution and prevalence of Leptospira spp. from soil and water, as well as the dominant pathogenic species, at recreational areas in Peninsular Malaysia. Therefore, preventive measures should be taken to ensure the safety of visitors.
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Affiliation(s)
- Aznida Mohamad Zaki
- Department of Community Health, Faculty of Medicine, Universiti Kebangsaan Malaysia Medical Centre, Bandar Tun Razak, 56000, Kuala Lumpur, Malaysia
- Malaysia Ministry of Health, Complex E, Federal Government Administrative Centre, 62590, Putrajaya, Malaysia
| | - Rozita Hod
- Department of Community Health, Faculty of Medicine, Universiti Kebangsaan Malaysia Medical Centre, Bandar Tun Razak, 56000, Kuala Lumpur, Malaysia
| | - Nadia Aqilla Shamsusah
- Department of Earth Science and Environment, Faculty of Science & Technology, Universiti Kebangsaan Malaysia, 43600, UKM, Bangi, Selangor, Malaysia
| | - Zaleha Md Isa
- Department of Community Health, Faculty of Medicine, Universiti Kebangsaan Malaysia Medical Centre, Bandar Tun Razak, 56000, Kuala Lumpur, Malaysia
| | - Siti Khairani Bejo
- Department of Veterinary Pathology and Microbiology, Faculty of Veterinary Medicine, University Putra Malaysia, 43400, Serdang, Selangor, Malaysia
| | - Hani Kartini Agustar
- Department of Earth Science and Environment, Faculty of Science & Technology, Universiti Kebangsaan Malaysia, 43600, UKM, Bangi, Selangor, Malaysia.
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Karunanayake L, Gamage CD, Gunasekara CP, De Silva S, Izumiya H, Morita M, Muthusinghe DS, Yoshimatsu K, Niloofa R, Karunanayake P, Uluwattage W, Ohnishi M, Koizumi N. Multilocus sequence typing reveals diverse known and novel genotypes of Leptospira spp. circulating in Sri Lanka. PLoS Negl Trop Dis 2020; 14:e0008573. [PMID: 32841248 PMCID: PMC7473516 DOI: 10.1371/journal.pntd.0008573] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2020] [Revised: 09/04/2020] [Accepted: 07/07/2020] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Leptospirosis has gained much attention in Sri Lanka since its large outbreak in 2008. However, most of the cases were clinically diagnosed and information on Leptospira genotypes and serotypes currently prevailing in the country is lacking. METHODOLOGY/PRINCIPAL FINDINGS We retrospectively analyzed 24 Leptospira strains from human patients as well as isolated and characterized three Leptospira strains from black rats using the microscopic agglutination test with antisera for 19 serovars and multilocus sequence typing. The isolates were identified as Leptospira borgpetersenii sequence types (STs) 143 and 144; L. interrogans STs 30, 34, 43, 44, 74, 75, 80, 308, 313, 314, 316, and 317; and L. kirschneri ST318. Six of the 15 STs were identified for the first time in this study. Five serogroups such as Autumnalis, Grippotyphosa, Hebdomadis, Javanica, and Pyrogenes were detected among the isolates. Contrary to previous studies, various genotypes including novel STs were isolated during an outbreak in Southern Province. L. borgpetersenii serogroup Javanica ST143 was isolated both from a human and black rat. CONCLUSIONS/SIGNIFICANCE This study revealed that genetically diverse Leptospira strains currently circulate in Sri Lanka: some genotypes have been circulating and others have emerged recently, which may explain the recent surge of leptospirosis patients with varying clinical manifestations and frequent outbreaks of leptospirosis. Black rats were identified as the source of infection for humans, but reservoir animals for other genotypes remain unknown.
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Affiliation(s)
- Lilani Karunanayake
- National Reference Laboratory for Leptospirosis, Department of Bacteriology, Medical Research Institute, Colombo, Sri Lanka
| | - Chandika D. Gamage
- Department of Microbiology, Faculty of Medicine, University of Peradeniya, Kandy, Sri Lanka
| | - Chandima P. Gunasekara
- National Reference Laboratory for Leptospirosis, Department of Bacteriology, Medical Research Institute, Colombo, Sri Lanka
| | | | - Hidemasa Izumiya
- Department of Bacteriology I, National Institute of Infectious Diseases, Shinjuku, Tokyo, Japan
| | - Masatomo Morita
- Department of Bacteriology I, National Institute of Infectious Diseases, Shinjuku, Tokyo, Japan
| | | | - Kumiko Yoshimatsu
- Institute of Genetic Medicine, Hokkaido University, Sapporo, Hokkaido, Japan
| | - Roshan Niloofa
- Institute of Biochemistry, Molecular Biology and Biotechnology, University of Colombo, Sri Lanka
| | | | | | - Makoto Ohnishi
- Department of Bacteriology I, National Institute of Infectious Diseases, Shinjuku, Tokyo, Japan
| | - Nobuo Koizumi
- Department of Bacteriology I, National Institute of Infectious Diseases, Shinjuku, Tokyo, Japan
- * E-mail:
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Singh K, Maurice N. Isolated ARDS in a leptospirosis positive patient: An unusual sole presentation of anicteric leptospirosis. CARIBBEAN MEDICAL JOURNAL 2020. [DOI: 10.48107/cmj.2020.08.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Leptospirosis is generally a self-limiting zoonotic disease, although severe variants such as Weil’s disease often warrant organ support in the Intensive Care Unit (ICU). In most endemic regions, the disease may be suspected from its associated clinical features. We present a case of a young male with a history of swimming in a freshwater lake who then presented to us with predominantly pulmonary symptoms. None of the defining clinical features of leptospirosis was present. He was intubated and ventilated for seven days in our ICU for hypoxemia and pulmonary haemorrhage. During this time, he had repeated bouts of pulmonary haemorrhage and hypoxemia while all of the organ systems typically affected by leptospirosis remained normal (platelet count, renal and liver function). Where a possible clinical exposure has occurred, leptospirosis should be considered in cases of pulmonary haemorrhage and Acute Respiratory distress syndrome (ARDS) even if classic clinical features are absent, especially in endemic regions.
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Affiliation(s)
- Keevan Singh
- 1 Anaesthesia and Intensive Care Unit, Department of Clinical Surgical Sciences, University of the West Indies, St. Augustine, Trinidad and Tobago. 2 Anaesthesia and Intensive Care Department, San Fernando General Hospital, Trinidad and Tobago
| | - Nickilia Maurice
- 2 Anaesthesia and Intensive Care Department, San Fernando General Hospital, Trinidad and Tobago
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Heterologous Expression of the Pathogen-Specific LIC11711 Gene in the Saprophyte L. biflexa Increases Bacterial Binding to Laminin and Plasminogen. Pathogens 2020; 9:pathogens9080599. [PMID: 32707797 PMCID: PMC7460275 DOI: 10.3390/pathogens9080599] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2020] [Revised: 07/13/2020] [Accepted: 07/17/2020] [Indexed: 12/13/2022] Open
Abstract
Leptospirosis is a febrile disease and the etiological agents are pathogenic bacteria of the genus Leptospira. The leptospiral virulence mechanisms are not fully understood and the application of genetic tools is still limited, despite advances in molecular biology techniques. The leptospiral recombinant protein LIC11711 has shown interaction with several host components, indicating a potential function in virulence. This study describes a system for heterologous expression of the L. interrogans gene lic11711 using the saprophyte L. biflexa serovar Patoc as a surrogate, aiming to investigate its possible activity in bacterial virulence. Heterologous expression of LIC11711 was performed using the pMaOri vector under regulation of the lipL32 promoter. The protein was found mainly on the leptospiral outer surface, confirming its location. The lipL32 promoter enhanced the expression of LIC11711 in L. biflexa compared to the pathogenic strain, indicating that this strategy may be used to overexpress low-copy proteins. The presence of LIC11711 enhanced the capacity of L. biflexa to adhere to laminin (Lam) and plasminogen (Plg)/plasmin (Pla) in vitro, suggesting the involvement of this protein in bacterial pathogenesis. We show for the first time that the expression of LIC11711 protein of L. interrogans confers a virulence-associated phenotype on L. biflexa, pointing out possible mechanisms used by pathogenic leptospires.
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Faggion Vinholo T, Ribeiro GS, Silva NF, Cruz J, Reis MG, Ko AI, Costa F. Severe leptospirosis after rat bite: A case report. PLoS Negl Trop Dis 2020; 14:e0008257. [PMID: 32645040 PMCID: PMC7347098 DOI: 10.1371/journal.pntd.0008257] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
Affiliation(s)
- Thais Faggion Vinholo
- Department of Epidemiology of Microbial Disease, Yale School of Public Health, New Haven, Connecticut, United States
| | - Guilherme S. Ribeiro
- Instituto Gonçalo Moniz, Fundação Oswaldo Cruz, Ministério da Saúde, Salvador, Brazil
- Faculdade de Medicina, Universidade Federal da Bahia, Salvador, Brazil
| | - Nanci F. Silva
- Escola Bahiana de Medicina e Saúde Pública, Salvador, Brazil
| | - Jaqueline Cruz
- Instituto Gonçalo Moniz, Fundação Oswaldo Cruz, Ministério da Saúde, Salvador, Brazil
| | - Mitermayer G. Reis
- Department of Epidemiology of Microbial Disease, Yale School of Public Health, New Haven, Connecticut, United States
- Instituto Gonçalo Moniz, Fundação Oswaldo Cruz, Ministério da Saúde, Salvador, Brazil
- Faculdade de Medicina, Universidade Federal da Bahia, Salvador, Brazil
| | - Albert I. Ko
- Department of Epidemiology of Microbial Disease, Yale School of Public Health, New Haven, Connecticut, United States
- Instituto Gonçalo Moniz, Fundação Oswaldo Cruz, Ministério da Saúde, Salvador, Brazil
| | - Federico Costa
- Department of Epidemiology of Microbial Disease, Yale School of Public Health, New Haven, Connecticut, United States
- Instituto Gonçalo Moniz, Fundação Oswaldo Cruz, Ministério da Saúde, Salvador, Brazil
- Instituto de Saúde Coletiva, Universidade Federal da Bahia, Salvador, Brazil
- Institute of Integrative Biology, University of Liverpool, Liverpool, United Kingdom
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Barnacle J, Gurney S, Ledot S, Singh S. Leptospirosis as an important differential of pulmonary haemorrhage on the intensive care unit: a case managed with VV-ECMO. J Intensive Care 2020; 8:31. [PMID: 32351698 PMCID: PMC7183660 DOI: 10.1186/s40560-020-00447-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2020] [Accepted: 04/13/2020] [Indexed: 12/25/2022] Open
Abstract
Background Leptospirosis is a potentially fatal zoonosis. It can cause a wide range of symptoms, including diffuse alveolar haemorrhage which occurs in a minority of cases but carries a mortality of over 70%. These patients may present with severe acute respiratory failure. The differential diagnosis for diffuse alveolar haemorrhage is broad whereas prompt diagnosis and treatment can be lifesaving. Case presentation A 20-year-old previously fit and well trout farm worker presented with a 3-day history of malaise, fevers, diarrhoea, vomiting and jaundice. He developed haemoptysis, severe headaches, neck stiffness and photophobia on the day of emergency admission. He was anaemic and thrombocytopenic. Anuric acute kidney injury (urea 32, creat 507) required immediate haemofiltration. In view of progressive respiratory failure with four-quadrant lung infiltrates on imaging, he was given broad spectrum antibiotics and pulsed methylprednisolone empirically, in case of a vasculitic pulmonary-renal presentation. He was intubated within 48 h of admission. Despite attempted protective ventilatory management, he remained hypoxaemic and developed pneumomediastinum. He was retrieved to a specialist cardiorespiratory intensive care unit on femoro-femoral mobile VV-ECMO. Three days from admission, results showed positive Leptospira IgM and real-time PCR. Serial bronchoscopies showed old and fresh clots, but not the classical progressive late red tinge of the returned lavage fluid. After eight days, VV-ECMO was weaned, he was extubated three days later, and made a full recovery. At 9 months follow-up, he was clinically better, with resolution of the CT scan findings and near normal lung function, albeit with low normal gas transfer. Conclusions Leptospirosis is a rare but important differential to be considered in diffuse alveolar haemorrhage presenting to the ICU, especially in young males. A thorough history for occupational or recreational risk factors may offer the diagnostic clue. Most patients recover fully with antibiotics. However, resulting acute severe respiratory failure can ensue. In this situation, early consideration for respiratory ECMO support offers time for clearance of endobronchial clot, parenchymal recovery, and prevention of ventilator-induced lung injury. Steroids have no clear evidence but may be used to avoid delay in treating suspected vasculitic or autoimmune causes of diffuse alveolar haemorrhage.
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Affiliation(s)
- James Barnacle
- 1Department of Infectious Diseases, St Mary's Hospital, Imperial College Healthcare NHS Trust, London, UK
| | - Stefan Gurney
- 2Intensive Care Unit, Bristol Royal Infirmary, University Hospitals Bristol NHS Trust, Bristol, UK
| | - Stephane Ledot
- 3Adult Intensive Care Unit, Royal Brompton Hospital, Royal Brompton and Harefield NHS Trust, London, UK
| | - Suveer Singh
- 3Adult Intensive Care Unit, Royal Brompton Hospital, Royal Brompton and Harefield NHS Trust, London, UK
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Barbosa AS, Isaac L. Strategies used by Leptospira spirochetes to evade the host complement system. FEBS Lett 2020; 594:2633-2644. [PMID: 32153015 DOI: 10.1002/1873-3468.13768] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2019] [Revised: 02/27/2020] [Accepted: 02/28/2020] [Indexed: 12/19/2022]
Abstract
Leptospires are highly invasive spirochetes equipped with efficient strategies for dissemination in the host. The Leptospira genus currently comprises 64 species divided into two major clades: the saprophytes composed of nonpathogenic, free-living organisms, and the pathogens encompassing all the species that cause mild or severe infections in humans and animals. While saprophytes are highly susceptible to the lytic action of the complement system, pathogenic (virulent) strains have evolved virulence strategies that allow efficient colonization of a variety of hosts and target organs, including mechanisms to circumvent hosts' innate and acquired immune responses. Pathogenic Leptospira avoid complement-mediated killing by recruiting host complement regulatory proteins and by targeting complement proteins using own and host-expressed proteases. This review outlines the role of complement in eradicating saprophytic Leptospira and the stratagems adopted by pathogenic Leptospira to maneuver the host complement system for their benefit.
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Affiliation(s)
| | - Lourdes Isaac
- Laboratory of Complement, Department of Immunology, Institute of Biomedical Sciences, University of São Paulo, Brazil
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50
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Vieira ML, Herwald H, Nascimento ALTO. The interplay between host haemostatic systems and Leptospira spp. infections. Crit Rev Microbiol 2020; 46:121-135. [PMID: 32141788 DOI: 10.1080/1040841x.2020.1735299] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Hemostasis is a defence mechanism that protects the integrity of the vascular system and is comprised of the coagulation cascade, fibrinolysis, platelet aggregation, and vascular endothelium. Besides the primary function in preserving the vascular integrity, the haemostatic system cooperates with immune and inflammatory processes to eliminate invading pathogens during microbial infections. Under pathological manifestations, hemostasis must therefore interact in a coordinated manner with inflammatory responses and immune reactions. Several pathogens can modulate these host-derived countermeasures by specifically targeting certain haemostatic components for their own benefit. Thus, the ability to modulate host defence systems has to be considered as an essential bacterial virulence mechanism. Complications that bacterial pathogens can induce are therefore often the consequence of evoked host responses. A comprehensive understanding of the molecular mechanisms triggered in infectious processes may help to develop prophylactic methods and novel therapies for the patients suffering from a particular infectious disease. This review aims to provide a critical updated compiling of recent studies on how the pathogenic Leptospira can interact with and manipulate the host haemostatic systems and the consequences for leptospirosis pathogenesis.
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Affiliation(s)
- Monica L Vieira
- Department of Microbiology, Institute of Biological Sciences, Federal University of Minas Gerais, Belo Horizonte, Brazil
| | - Heiko Herwald
- Department of Clinical Sciences, Lund, Division of Infection Medicine, Lund University, Lund, Sweden
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