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Nienhold R, Mensah N, Frank A, Graber A, Koike J, Schwab N, Hernach C, Zsikla V, Willi N, Cathomas G, Hamelin B, Graf S, Junt T, Mertz KD. Unbiased screen for pathogens in human paraffin-embedded tissue samples by whole genome sequencing and metagenomics. Front Cell Infect Microbiol 2022; 12:968135. [PMID: 36204644 PMCID: PMC9530700 DOI: 10.3389/fcimb.2022.968135] [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: 06/13/2022] [Accepted: 08/29/2022] [Indexed: 11/15/2022] Open
Abstract
Identification of bacterial pathogens in formalin fixed, paraffin embedded (FFPE) tissue samples is limited to targeted and resource-intensive methods such as sequential PCR analyses. To enable unbiased screening for pathogens in FFPE tissue samples, we established a whole genome sequencing (WGS) method that combines shotgun sequencing and metagenomics for taxonomic identification of bacterial pathogens after subtraction of human genomic reads. To validate the assay, we analyzed more than 100 samples of known composition as well as FFPE lung autopsy tissues with and without histological signs of infections. Metagenomics analysis confirmed the pathogenic species that were previously identified by species-specific PCR in 62% of samples, showing that metagenomics is less sensitive than species-specific PCR. On the other hand, metagenomics analysis identified pathogens in samples, which had been tested negative for multiple common microorganisms and showed histological signs of infection. This highlights the ability of this assay to screen for unknown pathogens and detect multi-microbial infections which is not possible by histomorphology and species-specific PCR alone.
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Affiliation(s)
- Ronny Nienhold
- Institute of Pathology, Cantonal Hospital Baselland, Liestal, Switzerland
| | - Nadine Mensah
- Institute of Pathology, Cantonal Hospital Baselland, Liestal, Switzerland
| | - Angela Frank
- Institute of Pathology, Cantonal Hospital Baselland, Liestal, Switzerland
| | - Anne Graber
- Institute of Pathology, Cantonal Hospital Baselland, Liestal, Switzerland
| | - Jacqueline Koike
- Institute of Pathology, Cantonal Hospital Baselland, Liestal, Switzerland
| | - Nathalie Schwab
- Institute of Pathology, Cantonal Hospital Baselland, Liestal, Switzerland
| | - Claudia Hernach
- Institute of Pathology, Cantonal Hospital Baselland, Liestal, Switzerland
| | - Veronika Zsikla
- Institute of Pathology, Cantonal Hospital Baselland, Liestal, Switzerland
| | - Niels Willi
- Institute of Pathology, Cantonal Hospital Baselland, Liestal, Switzerland
| | - Gieri Cathomas
- Institute of Pathology, Cantonal Hospital Baselland, Liestal, Switzerland
| | - Baptiste Hamelin
- Institute of Pathology, Cantonal Hospital Baselland, Liestal, Switzerland
| | - Susanne Graf
- Central Laboratory, Cantonal Hospital Baselland, Liestal, Switzerland
| | - Tobias Junt
- Autoimmunity, Transplantation and Inflammation, Novartis Institutes for BioMedical Research (NIBR), Basel, Switzerland
| | - Kirsten D Mertz
- Institute of Pathology, Cantonal Hospital Baselland, Liestal, Switzerland
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Expression of NLRP3 and AIM2 inflammasome in Peripheral blood in Chinese patients with acute and chronic brucellosis. Sci Rep 2022; 12:15123. [PMID: 36068262 PMCID: PMC9448728 DOI: 10.1038/s41598-022-19398-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2022] [Accepted: 08/29/2022] [Indexed: 01/18/2023] Open
Abstract
Brucellosis is a zoonotic disease caused by Brucella abortus. An efficient immune response is crucial for curing brucellosis. The inflammasome plays a significant role in the immune response. It is unclear which inflammasome is active in acute and chronic brucellosis and how its levels relate to inflammatory cytokines. A total of 40 patients with acute or chronic brucellosis and 20 healthy volunteers had peripheral blood samples collected. The expression levels of AIM2, NLRP3, ASC, and Caspase-1 were determined by a real-time polymerase chain reaction from RNA and serum samples, and IL-1β, IL-18, and IFN-γ were measured by enzyme-linked immunosorbent assay. In the acute brucellosis group, AIM2 expression was significantly higher, while ACS expression was significantly lower than that of healthy volunteers. In patients with chronic brucellosis, AIM2 expression was significantly lower, while Caspase-1 expression was significantly higher than that of healthy volunteers. Serum IL-18 and IFN-γ levels were significantly higher in patients with acute brucellosis than in healthy controls. The IFN-γ level was also significantly higher in patients with chronic brucellosis than in healthy controls. The inflammasome responds differently in different stages of brucellosis. The inflammasome may be the site of action of immune escape in brucellosis.
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KC O, Dahal PH, Koirala M, Ntem‐Mensah AD. Acute cholecystitis associated with Brucella melitensis bacteremia: A rare intraabdominal manifestation of brucellosis. Clin Case Rep 2022; 10:e05765. [PMID: 35474997 PMCID: PMC9020169 DOI: 10.1002/ccr3.5765] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2022] [Revised: 03/25/2022] [Accepted: 04/03/2022] [Indexed: 11/10/2022] Open
Affiliation(s)
- Ojbindra KC
- Department of Hospital Medicine Faith Regional Health Services Norfolk Nebraska USA
| | - Punya Hari Dahal
- Department of Hospital Medicine Faith Regional Health Services Norfolk Nebraska USA
| | - Manisha Koirala
- Department of Hospital Medicine Faith Regional Health Services Norfolk Nebraska USA
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Allen AR, Milne G, Drees K, Presho E, Graham J, McAdam P, Jones K, Wright L, Skuce R, Whatmore AM, Graham J, Foster JT. Genomic epizootiology of a Brucella abortus outbreak in Northern Ireland (1997-2012). INFECTION GENETICS AND EVOLUTION 2020; 81:104235. [PMID: 32035245 DOI: 10.1016/j.meegid.2020.104235] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/10/2019] [Revised: 01/28/2020] [Accepted: 02/04/2020] [Indexed: 12/18/2022]
Abstract
BACKGROUND In the recent past (1997-2012), Northern Ireland in the United Kingdom suffered an outbreak of Brucella abortus, which at its height affected over 200 cattle herds. Initially, isolates were characterized using multi-locus variable number tandem repeats analysis (MLVA). While informative in this setting, hyper-variability in some loci limited the resolution necessary to infer fine-scale disease transmission networks. Consequently, we applied whole-genome sequencing to isolates from this outbreak to evaluate higher resolution markers for disease epizootiology. RESULTS Phylogenetic analysis revealed that the B. abortus outbreak in Northern Ireland was caused by two distinct pathogen lineages. One contained isolates consistent with the 1997-2012 outbreak being linked to a previous endemic infection thought eradicated. The dominant second lineage exhibited little genetic diversity throughout the recrudescent outbreak, with limited population sub-structure evident. This finding was inconsistent with prior MLVA molecular characterizations that suggested the presence of seven clonal complexes. Spatio-temporal modeling revealed a significant association of pairwise SNP differences between isolates and geographic distances. However, effect sizes were very small due to reduced pathogen diversity. CONCLUSIONS Genome sequence data suggested that hyper-variability in some MLVA loci contributed to an overestimate of pathogen diversity in the most recent outbreak. The low diversity observed in our genomic dataset made it inappropriate to apply phylodynamic methods to these data. We conclude that maintaining data repositories of genome sequence data will be invaluable for source attribution/epizootiological inference should recrudescence ever re-occur. However genomic epizootiological methods may have limited utility in some settings, such as when applied to recrudescent/re-emergent infections of slowly-evolving bacterial pathogens.
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Affiliation(s)
- Adrian R Allen
- Agri Food and Biosciences Institute (AFBI), AFBI Stormont, Bacteriology Branch, Stoney Road, Belfast, United Kingdom..
| | - Georgina Milne
- Agri Food and Biosciences Institute (AFBI), AFBI Stormont, Bacteriology Branch, Stoney Road, Belfast, United Kingdom
| | - Kevin Drees
- University of New Hampshire, Department of Molecular, Cellular and Biomedical Sciences, Rudman Hall, 46 College Road, Durham, NH, USA
| | - Eleanor Presho
- Agri Food and Biosciences Institute (AFBI), AFBI Stormont, Bacteriology Branch, Stoney Road, Belfast, United Kingdom
| | - Jordon Graham
- Agri Food and Biosciences Institute (AFBI), AFBI Stormont, Bacteriology Branch, Stoney Road, Belfast, United Kingdom
| | - Paul McAdam
- Fios Genomics, Nine Edinburgh Bioquarter, 9 Little France Road, Edinburgh, United Kingdom
| | - Kerri Jones
- Agri Food and Biosciences Institute (AFBI), AFBI Stormont, Bacteriology Branch, Stoney Road, Belfast, United Kingdom
| | - Lorraine Wright
- Agri Food and Biosciences Institute (AFBI), AFBI Stormont, Bacteriology Branch, Stoney Road, Belfast, United Kingdom
| | - Robin Skuce
- Agri Food and Biosciences Institute (AFBI), AFBI Stormont, Bacteriology Branch, Stoney Road, Belfast, United Kingdom
| | - Adrian M Whatmore
- Department of Bacteriology, Animal and Plant Health Agency (APHA), New Haw, Addlestone, Surrey, United Kingdom
| | - Judith Graham
- Department of Agriculture, Environment and Rural Affairs, Veterinary Service, Belfast, Northern Ireland, United Kingdom
| | - Jeffrey T Foster
- University of New Hampshire, Department of Molecular, Cellular and Biomedical Sciences, Rudman Hall, 46 College Road, Durham, NH, USA
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Abstract
The clinical presentation of brucellosis in humans is variable and unspecific, and thus, laboratory corroboration of the diagnosis is essential for the patient's proper treatment. The diagnosis of brucellar infections can be made by culture, serological tests, and nucleic acid amplification assays. Modern automated blood culture systems enable detection of acute cases of brucellosis within the routine 5- to 7-day incubation protocol employed in clinical microbiology laboratories, although a longer incubation and performance of blind subcultures may be needed for protracted cases. Serological tests, though they lack specificity and provide results that may be difficult to interpret in individuals repeatedly exposed to Brucella organisms, nevertheless remain a diagnostic cornerstone in resource-poor countries. Nucleic acid amplification assays combine exquisite sensitivity, specificity, and safety and enable rapid diagnosis of the disease. However, long-term persistence of positive molecular test results in patients that have apparently fully recovered is common and has unclear clinical significance and therapeutic implications. Therefore, as long as there are no sufficiently validated commercial tests or studies that demonstrate an adequate interlaboratory reproducibility of the different homemade PCR assays, cultures and serological methods will remain the primary tools for the diagnosis and posttherapeutic follow-up of human brucellosis.
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Affiliation(s)
- Pablo Yagupsky
- Clinical Microbiology Laboratory, Soroka University Medical Center, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Pilar Morata
- Biochemistry and Molecular Biology Department, Faculty of Medicine, University of Málaga, Málaga, Spain
- IBIMA, Málaga, Spain
| | - Juan D Colmenero
- Infectious Diseases Service, University Regional Hospital, Málaga, Spain
- IBIMA, Málaga, Spain
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Priyanka, Shringi BN, Choudhary OP, Kashyap SK. Cytokines in brucellosis: biological rhythm at the interface of innate and adaptive immunity. BIOL RHYTHM RES 2019. [DOI: 10.1080/09291016.2019.1613794] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Affiliation(s)
- Priyanka
- Department of Veterinary Microbiology and Biotechnology, College of Veterinary and Animal Sciences, Rajasthan University of Veterinary and Animal Sciences, Bikaner, Rajasthan, India
| | - Brij Nandan Shringi
- Department of Veterinary Microbiology and Biotechnology, College of Veterinary and Animal Sciences, Rajasthan University of Veterinary and Animal Sciences, Bikaner, Rajasthan, India
| | - Om Prakash Choudhary
- Department of Veterinary Anatomy and Histology, College of Veterinary Sciences and Animal Husbandry, Central Agricultural University (I), Selesih, Aizawl, Mizoram, India
| | - Sudhir Kumar Kashyap
- Department of Veterinary Microbiology and Biotechnology, College of Veterinary and Animal Sciences, Rajasthan University of Veterinary and Animal Sciences, Bikaner, Rajasthan, India
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Melenotte C, Drancourt M, Gorvel JP, Mège JL, Raoult D. Post-bacterial infection chronic fatigue syndrome is not a latent infection. Med Mal Infect 2019; 49:140-149. [DOI: 10.1016/j.medmal.2019.01.006] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2018] [Accepted: 01/15/2019] [Indexed: 01/20/2023]
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Gutiérrez-Jiménez C, Hysenaj L, Alfaro-Alarcón A, Mora-Cartín R, Arce-Gorvel V, Moreno E, Gorvel JP, Barquero-Calvo E. Persistence of Brucella abortus in the Bone Marrow of Infected Mice. J Immunol Res 2018; 2018:5370414. [PMID: 30622977 PMCID: PMC6304906 DOI: 10.1155/2018/5370414] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2018] [Revised: 08/28/2018] [Accepted: 09/17/2018] [Indexed: 01/10/2023] Open
Abstract
Brucellosis is a zoonotic bacterial infection that may persist for long periods causing relapses in antibiotic-treated patients. The ability of Brucella to develop chronic infections is linked to their capacity to invade and replicate within the mononuclear phagocyte system, including the bone marrow (BM). Persistence of Brucella in the BM has been associated with hematological complications such as neutropenia, thrombocytopenia, anemia, and pancytopenia in human patients. In the mouse model, we observed that the number of Brucella abortus in the BM remained constant for up to 168 days of postinfection. This persistence was associated with histopathological changes, accompanied by augmented numbers of BM myeloid GMP progenitors, PMNs, and CD4+ lymphocytes during the acute phase (eight days) of the infection in the BM. Monocytes, PMNs, and GMP cells were identified as the cells harboring Brucella in the BM. We propose that the BM is an essential niche for the bacterium to establish long-lasting infections and that infected PMNs may serve as vehicles for dispersion of Brucella organisms, following the Trojan horse hypothesis. Monocytes are solid candidates for Brucella reservoirs in the BM.
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Affiliation(s)
- Cristina Gutiérrez-Jiménez
- Programa de Investigación en Enfermedades Tropicales, Escuela de Medicina Veterinaria, Universidad Nacional, Heredia, Costa Rica
| | - Lisiena Hysenaj
- Aix Marseille University, CNRS, INSERM, CIML, Marseille, France
| | - Alejandro Alfaro-Alarcón
- Pathology Department, Escuela de Medicina Veterinaria, Universidad Nacional, Heredia, Costa Rica
| | - Ricardo Mora-Cartín
- Programa de Investigación en Enfermedades Tropicales, Escuela de Medicina Veterinaria, Universidad Nacional, Heredia, Costa Rica
| | | | - Edgardo Moreno
- Programa de Investigación en Enfermedades Tropicales, Escuela de Medicina Veterinaria, Universidad Nacional, Heredia, Costa Rica
| | | | - Elías Barquero-Calvo
- Programa de Investigación en Enfermedades Tropicales, Escuela de Medicina Veterinaria, Universidad Nacional, Heredia, Costa Rica
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9
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The relationship between caspase-1 related inflammasome expression and serum inflammatory cytokine levels during acute brucellosis. North Clin Istanb 2018; 6:117-123. [PMID: 31297476 PMCID: PMC6593912 DOI: 10.14744/nci.2018.96992] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2018] [Accepted: 06/22/2018] [Indexed: 01/08/2023] Open
Abstract
OBJECTIVE Brucellosis is a zoonotic disease caused by Brucella in domestic and wild animals. It also causes systemic diseases with the involvement of different parts of the human body. An efficient innate immune response is crucial to cure brucellosis with optimum antibiotic treatment. The inflammasomes are innate immune system receptors and sensors that regulate the activation of cysteine-dependent aspartate specific protease-1 (caspase-1) and caspase-1-induced cell death process known as pyroptosis. The aim of the present study was to investigate the expression levels of CASPASE-1 and associated inflammasomes AIM2, NLRP3, and NLRC4 to analyze their relationship with the inflammatory cytokine interleukin (IL)-1β, IL-18, and interferon-gamma (IFN-γ) in peripheral blood samples of patients with acute brucellosis with healthy controls. METHODS Peripheral blood samples were obtained from 20 healthy volunteers and 20 patients with acute brucellosis. RNA and serum samples were isolated to examine the expression levels of AIM2, NLRP3, NLRC4, and CASPASE-1 by real-time polymerase chain reaction, and IL-1β, IL-18, and IFN-γ were measured by enzyme-linked immunosorbent assay. RESULTS In the acute brucellosis group, AIM2 and NLRC4 expressions were significantly higher than in healthy volunteers. A significant increase on caspase-1 expression in patients with acute brucellosis was not observed. Serum IL-18 and IFN-γ levels were significantly higher in patients with acute brucellosis than in healthy controls. CONCLUSION Caspase-1-related inflammasomes are sufficiently activated to induce the secretion of cytokines, such as IFN-γ and IL-18, to induce cellular immune response. Caspase-1 activation level should be investigated at different periods of disease in a group with high number of patients to understand the role of pyroptosis and caspase-1 in brucellosis.
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Mustafa AS, Habibi N, Osman A, Shaheed F, Khan MW. Species identification and molecular typing of human Brucella isolates from Kuwait. PLoS One 2017; 12:e0182111. [PMID: 28800594 PMCID: PMC5553756 DOI: 10.1371/journal.pone.0182111] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2017] [Accepted: 07/12/2017] [Indexed: 11/19/2022] Open
Abstract
Brucellosis is a zoonotic disease of major concern in Kuwait and the Middle East. Human brucellosis can be caused by several Brucella species with varying degree of pathogenesis, and relapses are common after apparently successful therapy. The classical biochemical methods for identification of Brucella are time-consuming, cumbersome, and provide information limited to the species level only. In contrast, molecular methods are rapid and provide differentiation at intra-species level. In this study, four molecular methods [16S rRNA gene sequencing, real-time PCR, enterobacterial repetitive intergenic consensus (ERIC)-PCR and multilocus variable-number tandem-repeat analysis (MLVA)-8, MLVA-11 and MLVA-16 were evaluated for the identification and typing of 75 strains of Brucella isolated in Kuwait. 16S rRNA gene sequencing of all isolates showed 90-99% sequence identity with B. melitensis and real-time PCR with genus- and species- specific primers identified all isolates as B. melitensis. The results of ERIC-PCR suggested the existence of 75 ERIC genotypes of B. melitensis with a discriminatory index of 0.997. Cluster classification of these genotypes divided them into two clusters, A and B, diverging at ~25%. The maximum number of genotypes (n = 51) were found in cluster B5. MLVA-8 analysis identified all isolates as B. melitensis, and MLVA-8, MLVA-11 and MLVA-16 typing divided the isolates into 10, 32 and 71 MLVA types, respectively. Furthermore, the combined minimum spanning tree analysis demonstrated that, compared to MLVA types discovered all over the world, the Kuwaiti isolates were a distinct group of MLVA-11 and MLVA-16 types in the East Mediterranean Region.
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Affiliation(s)
- Abu S. Mustafa
- OMICS Research Unit and Research Core Facility, Heath Sciences Centre, Kuwait University, Jabriya, Kuwait
- Department of Microbiology, Faculty of Medicine, Heath Sciences Centre, Kuwait University, Jabriya, Kuwait
- * E-mail:
| | - Nazima Habibi
- OMICS Research Unit and Research Core Facility, Heath Sciences Centre, Kuwait University, Jabriya, Kuwait
| | - Amr Osman
- OMICS Research Unit and Research Core Facility, Heath Sciences Centre, Kuwait University, Jabriya, Kuwait
| | - Faraz Shaheed
- OMICS Research Unit and Research Core Facility, Heath Sciences Centre, Kuwait University, Jabriya, Kuwait
| | - Mohd W. Khan
- OMICS Research Unit and Research Core Facility, Heath Sciences Centre, Kuwait University, Jabriya, Kuwait
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11
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Mailles A, Garin-Bastuji B, Lavigne J, Jay M, Sotto A, Maurin M, Pelloux I, O’Callaghan D, Mick V, Vaillant V, De Valk H. Human brucellosis in France in the 21st century: Results from national surveillance 2004–2013. Med Mal Infect 2016; 46:411-418. [DOI: 10.1016/j.medmal.2016.08.007] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2016] [Accepted: 08/23/2016] [Indexed: 10/20/2022]
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12
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Kiss S, Zsikla V, Frank A, Willi N, Cathomas G. Helicobacter-negative gastritis: polymerase chain reaction for Helicobacter DNA is a valuable tool to elucidate the diagnosis. Aliment Pharmacol Ther 2016; 43:924-932. [PMID: 26890160 DOI: 10.1111/apt.13564] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2015] [Revised: 07/10/2015] [Accepted: 01/30/2016] [Indexed: 02/06/2023]
Abstract
BACKGROUND Helicobacter-negative gastritis has been increasingly reported. Molecular techniques as the polymerase chain reaction (PCR) may detect bacterial DNA in histologically negative gastritis. AIM To evaluate of Helicobacter PCR in gastric biopsies for the daily diagnostics of Helicobacter-negative gastritis. METHODS Over a 5-year period, routine biopsies with chronic gastritis reminiscent of Helicobacter infection, but negative by histology, were tested by using a H. pylori specific PCR. Subsequently, PCR-negative samples were re-evaluated using PCR for other Helicobacter species. RESULTS Of the 9184 gastric biopsies, 339 (3.7%) with histological-negative gastritis and adequate material were forwarded to PCR analysis for H. pylori and 146 (43.1%) revealed a positive result. In 193 H. pylori DNA-negative biopsies, re-analysis using PCR primers for other Helicobacter species, revealed further 23 (11.9%) positive biopsies, including 4 (2.1%) biopsies with H. heilmannii sensu lato. PCR-positive biopsies showed a higher overall inflammatory score, more lymphoid follicles/aggregates and neutrophils (P < 0.05). No Helicobacter DNA was found in control biopsies of 48 patients with neither primer set (P < 0.0001). In 274 patients with an endoscopic description, detection of H. pylori DNA was associated with ulcers and erosions (P < 0.01). Over all, in 339 histologically-negative gastric biopsies, Helicobacter DNA was detected in 169 (49.9%) samples with at least one primer set. CONCLUSION Molecular testing offers a sensitive and specific diagnosis to a selected group of patients, in whom adequate searches for bacteria by conventional histology have resulted in the unsatisfactory diagnosis of H. pylori-negative gastritis.
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Affiliation(s)
- S Kiss
- Institute of Pathology, Kantonsspital Baselland, Liestal, Switzerland
| | - V Zsikla
- Institute of Pathology, Kantonsspital Baselland, Liestal, Switzerland
| | - A Frank
- Institute of Pathology, Kantonsspital Baselland, Liestal, Switzerland
| | - N Willi
- Institute of Pathology, Kantonsspital Baselland, Liestal, Switzerland
| | - G Cathomas
- Institute of Pathology, Kantonsspital Baselland, Liestal, Switzerland
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13
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Abstract
This review considers the role of intracellular bacteria in adverse pregnancy outcomes, such as miscarriage, stillbirths, and preterm labour. The cause of miscarriage, stillbirth and preterm labour often remains unexplained. Intracellular bacteria that grow either poorly or not at all on media used routinely to detect human pathogens could be the aetiological agents of these obstetric conditions. For example, Listeria monocytogenes and Coxiella burnetti are intracellular bacteria that have a predilection for the fetomaternal unit and may induce fatal disease in the mother and/or fetus. Both are important foodborne or zoonotic pathogens in pregnancy. Preventive measures, diagnostic tools and treatment will be reviewed. Moreover, we will also address the importance in adverse pregnancy outcomes of other intracellular bacteria, including Brucella abortus and various members of the order Chlamydiales. Indeed, there is growing evidence that Chlamydia trachomatis, Chlamydia abortus and Chlamydia pneumoniae infections may also result in adverse pregnancy outcomes in humans and/or animals. Moreover, newly discovered Chlamydia-like organisms have recently emerged as new pathogens of both animals and humans. For example, Waddlia chondrophila, a Chlamydia-related bacterium isolated from aborted bovine fetuses, has also been implicated in human miscarriages. Future research should help us to better understand the pathophysiology of adverse pregnancy outcomes caused by intracellular bacteria and to determine the precise mode of transmission of newly identified bacteria, such as Waddlia and Parachlamydia. These emerging pathogens may represent the tip of the iceberg of a large number of as yet unknown intracellular pathogenic agents.
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Affiliation(s)
- D Baud
- Institute of Microbiology, University Hospital Centre and University of Lausanne, Lausanne, Switzerland
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