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Forstner P, Laireiter CM, Friedl S, Steinmetz I, Dichtl K. Bacitracin agar vs. oleandomycin disk supplemented chocolate agar for the recovery of Haemophilus influenzae in diagnostic samples: A prospective comparison. Diagn Microbiol Infect Dis 2024; 109:116203. [PMID: 38422664 DOI: 10.1016/j.diagmicrobio.2024.116203] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2023] [Revised: 01/30/2024] [Accepted: 01/30/2024] [Indexed: 03/02/2024]
Abstract
Haemophilus influenzae is an important pathogen able to cause various forms of respiratory and invasive disease. To provide high sensitivity for detection, culture media must inhibit growth of residential flora from the respiratory tract. This study aimed to identify and compare the diagnostic and economic advantages of using bacitracin containing selective agar (SEL) or oleandomycin disk supplemented chocolate agar (CHOC). Growth and semi-quantitative abundance of H. influenzae and growth suppression of residential flora was prospectively assessed in a 28-week period. H. influenzae was identified in 164 (5 %) of all included samples: CHOC and SEL, CHOC only, and SEL only were positive in 95, 24, and 45 cases. Diagnostic superiority of SEL was primarily attributable to the results of throat swabs. However, on average, € 200 had to be spent for the detection of each additional isolate that was recovered only because of additional incubation on SEL.
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Affiliation(s)
- Patrick Forstner
- Diagnostic and Research Institute of Hygiene, Microbiology and Environmental Medicine, Medical University of Graz, Graz, Austria
| | - Christina Maria Laireiter
- Diagnostic and Research Institute of Hygiene, Microbiology and Environmental Medicine, Medical University of Graz, Graz, Austria
| | - Simone Friedl
- Diagnostic and Research Institute of Hygiene, Microbiology and Environmental Medicine, Medical University of Graz, Graz, Austria
| | - Ivo Steinmetz
- Diagnostic and Research Institute of Hygiene, Microbiology and Environmental Medicine, Medical University of Graz, Graz, Austria
| | - Karl Dichtl
- Diagnostic and Research Institute of Hygiene, Microbiology and Environmental Medicine, Medical University of Graz, Graz, Austria.
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2
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Desoutter A, Deshayes T, Vorimore F, Klotoe B, Durand B, Colot J, Wagner-Lichtenegger G, Steinmetz I, Tuanyok A, Laroucau K. Isolation of Burkholderia pseudomallei from a goat in New Caledonia: implications for animal and human health monitoring and serological tool comparison. BMC Vet Res 2024; 20:114. [PMID: 38521903 PMCID: PMC10960402 DOI: 10.1186/s12917-024-03957-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2023] [Accepted: 02/27/2024] [Indexed: 03/25/2024] Open
Abstract
BACKGROUND Melioidosis is a serious bacterial infection caused by Burkholderia pseudomallei, a gram-negative bacterium commonly found in soil and water. It can affect both humans and animals, and is endemic in regions such as Southeast Asia and Northern Australia. In recent years, there have been reports of an emergence of human melioidosis in other areas, including New Caledonia. RESULTS During standard laboratory analysis in New Caledonia in 2021, a strain of B. pseudomallei was isolated from a goat. The strain was characterized using both MLST and WGS techniques and was found to cluster with previously described local human strains from the area. In parallel, several serological tests (CFT, ELISA, Luminex (Hcp1, GroEL, BPSS1840), arrays assay and a latex agglutination test) were performed on animals from the farm where the goat originated, and/or from three other neighboring farms. Using two commercial ELISA kits, seropositive animals were found only on the farm where the infected goat originated and tests based on recombinant proteins confirmed the usefulness of the Hcp1 protein for the diagnosis of melioidosis in animals. CONCLUSIONS Despite the regular reports of human cases, this is the first confirmed case of melioidosis in an animal in New Caledonia. These results confirm the presence of the bacterium in the region and highlight the importance of vigilance for both animal and human health. It is critical that all health partners, including breeders, veterinarians, and biologists, work together to monitor and prevent the spread of the disease.
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Affiliation(s)
- Anais Desoutter
- LNC (Laboratory of New Caledonia), Animal Health Department, Paita, New Caledonia
| | - Thomas Deshayes
- Anses, Animal Health Laboratory, Bacterial Zoonosis Unit, Maisons-Alfort, France
| | - Fabien Vorimore
- Anses, Animal Health Laboratory, Bacterial Zoonosis Unit, Maisons-Alfort, France
- Anses, Identypath, Maisons-Alfort, France
| | - Bernice Klotoe
- Anses, Animal Health Laboratory, Bacterial Zoonosis Unit, Maisons-Alfort, France
| | - Benoit Durand
- Anses, Animal Health Laboratory, Epidemiological Unit, Maisons-Alfort, France
| | - Julien Colot
- Territorial Hospital Center Gaston-Bourret, Medical Biology Laboratory, Noumea, New Caledonia
| | - Gabriel Wagner-Lichtenegger
- Diagnostic and Research Institute of Hygiene, Microbiology and Environmental Medicine, Medical University of Graz, Graz, Austria
| | - Ivo Steinmetz
- Diagnostic and Research Institute of Hygiene, Microbiology and Environmental Medicine, Medical University of Graz, Graz, Austria
| | - Apichai Tuanyok
- Department of Infectious Diseases and Immunology, College of Veterinary Medicine, and Emerging Pathogens Institute, University of Florida, Gainesville, FL, 32608, USA
| | - Karine Laroucau
- Anses, Animal Health Laboratory, Bacterial Zoonosis Unit, Maisons-Alfort, France.
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Pham TS, König E, Bui TT, Vu TNA, Nguyen TN, Do CV, Lichtenegger S, Bui NHL, Trinh HT, Steinmetz I, Trinh TT. Newly detected paediatric melioidosis cases in a single referral children's hospital in Ho Chi Minh City indicate the probable underrecognition of melioidosis in South Vietnam. Trans R Soc Trop Med Hyg 2024; 118:190-198. [PMID: 38000070 DOI: 10.1093/trstmh/trad080] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2023] [Revised: 08/24/2023] [Accepted: 11/01/2023] [Indexed: 11/26/2023] Open
Abstract
BACKGROUND The epidemiology of melioidosis in Vietnam, a disease caused by the soil bacterium Burkholderia pseudomallei, remains unclear. This study aimed to detect paediatric melioidosis in South Vietnam and describe clinical features and the geographic distribution. METHODS We introduced a simple laboratory algorithm for detecting B. pseudomallei from clinical samples at Children's Hospital 2 in Ho Chi Minh City in July 2015. A retrospective observational study of children <16 y of age with culture-confirmed melioidosis between July 2015 and August 2019 was undertaken. RESULTS Thirty-five paediatric cases of melioidosis were detected, with cases originating from 13 of 32 provinces and cities in South Vietnam. The number of paediatric melioidosis cases detected from a certain region correlated with the overall number of inpatients originating from the respective geographic area. Suppurative parotitis (n=15 [42.8%]) was the most common clinical presentation, followed by lung infection (n=10 [28.6%]) and septicaemia (n=7 [20%]). Fourteen (40%) children had disseminated disease, including all cases of lung infection, four cases with central nervous system symptoms and four (11.4%) deaths. CONCLUSIONS The patients' origin indicates a wide distribution of melioidosis in South Vietnam. It seems probable that cases not only in children, but also in adults, remain grossly undiagnosed. Further awareness raising and laboratory capacity strengthening are needed in this part of the country.
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Affiliation(s)
| | - Elisabeth König
- Diagnostic and Research Institute of Hygiene, Microbiology and Environmental Medicine, Medical University of Graz, Graz, Austria
| | | | - Thi Ngoc Anh Vu
- VNU Institute of Microbiology and Biotechnology, Vietnam National University, Hanoi, Vietnam
| | - Tran Nam Nguyen
- Children's Hospital 2, Ho Chi Minh City, Vietnam
- City Children's Hospital, Ho Chi Minh City, Vietnam
| | - Chau Viet Do
- Children's Hospital 2, Ho Chi Minh City, Vietnam
| | - Sabine Lichtenegger
- Diagnostic and Research Institute of Hygiene, Microbiology and Environmental Medicine, Medical University of Graz, Graz, Austria
| | - Nguyen Hai Linh Bui
- VNU Institute of Microbiology and Biotechnology, Vietnam National University, Hanoi, Vietnam
| | | | - Ivo Steinmetz
- Diagnostic and Research Institute of Hygiene, Microbiology and Environmental Medicine, Medical University of Graz, Graz, Austria
| | - Thanh Trung Trinh
- VNU Institute of Microbiology and Biotechnology, Vietnam National University, Hanoi, Vietnam
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4
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Wagner GE, Stanjek TFP, Albrecht D, Lipp M, Dunachie SJ, Föderl-Höbenreich E, Riedel K, Kohler A, Steinmetz I, Kohler C. Deciphering the human antibody response against Burkholderia pseudomallei during melioidosis using a comprehensive immunoproteome approach. Front Immunol 2023; 14:1294113. [PMID: 38146371 PMCID: PMC10749318 DOI: 10.3389/fimmu.2023.1294113] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2023] [Accepted: 11/22/2023] [Indexed: 12/27/2023] Open
Abstract
Introduction The environmental bacterium Burkholderia pseudomallei causes the often fatal and massively underreported infectious disease melioidosis. Antigens inducing protective immunity in experimental models have recently been identified and serodiagnostic tools have been improved. However, further elucidation of the antigenic repertoire of B. pseudomallei during human infection for diagnostic and vaccine purposes is required. The adaptation of B. pseudomallei to very different habitats is reflected by a huge genome and a selective transcriptional response to a variety of conditions. We, therefore, hypothesized that exposure of B. pseudomallei to culture conditions mimicking habitats encountered in the human host might unravel novel antigens that are recognized by melioidosis patients. Methods and results In this study, B. pseudomallei was exposed to various stress and growth conditions, including anaerobiosis, acid stress, oxidative stress, iron starvation and osmotic stress. Immunogenic proteins were identified by probing two-dimensional Western blots of B. pseudomallei intracellular and extracellular protein extracts with sera from melioidosis patients and controls and subsequent MALDI-TOF MS. Among B. pseudomallei specific immunogenic signals, 90 % (55/61) of extracellular immunogenic proteins were identified by acid, osmotic or oxidative stress. A total of 84 % (44/52) of intracellular antigens originated from the stationary growth phase, acidic, oxidative and anaerobic conditions. The majority of the extracellular and intracellular protein antigens were identified in only one of the various stress conditions. Sixty-three immunoreactive proteins and an additional 38 candidates from a literature screening were heterologously expressed and subjected to dot blot analysis using melioidosis sera and controls. Our experiments confirmed melioidosis-specific signals in 58 of our immunoproteome candidates. These include 15 antigens with average signal ratios (melioidosis:controls) greater than 10 and another 26 with average ratios greater than 5, including new promising serodiagnostic candidates with a very high signal-to-noise ratio. Conclusion Our study shows that a comprehensive B. pseudomallei immunoproteomics approach, using conditions which are likely to be encountered during infection, can identify novel antibody targets previously unrecognized in human melioidosis.
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Affiliation(s)
- Gabriel E. Wagner
- Diagnostic and Research Institute of Hygiene, Microbiology and Environmental Medicine, Medical University of Graz, Graz, Austria
| | | | - Dirk Albrecht
- Institute of Microbiology, Department of Microbial Physiology and Molecular Biology, University of Greifswald, Greifswald, Germany
| | - Michaela Lipp
- Diagnostic and Research Institute of Hygiene, Microbiology and Environmental Medicine, Medical University of Graz, Graz, Austria
| | - Susanna J. Dunachie
- Nuffield Department of Medicine (NDM) Centre for Global Health Research, Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom
- National Institute for Health and Care Research (NIHR) Oxford Biomedical Centre, Oxford University Hospitals National Health Service (NHS) Foundation Trust, Oxford, United Kingdom
- Mahidol-Oxford Tropical Medicine Research Unit, Mahidol University, Bangkok, Thailand
| | - Esther Föderl-Höbenreich
- Diagnostic and Research Institute of Hygiene, Microbiology and Environmental Medicine, Medical University of Graz, Graz, Austria
- Diagnostic & Research Institute of Pathology, Medical University Graz, Graz, Austria
| | - Katharina Riedel
- Institute of Microbiology, Department of Microbial Physiology and Molecular Biology, University of Greifswald, Greifswald, Germany
| | - Anne Kohler
- Friedrich Loeffler Institute of Medical Microbiology, University Medicine, Greifswald, Germany
| | - Ivo Steinmetz
- Diagnostic and Research Institute of Hygiene, Microbiology and Environmental Medicine, Medical University of Graz, Graz, Austria
- Friedrich Loeffler Institute of Medical Microbiology, University Medicine, Greifswald, Germany
| | - Christian Kohler
- Friedrich Loeffler Institute of Medical Microbiology, University Medicine, Greifswald, Germany
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Dichtl K, Klugherz I, Greimel H, Luxner J, Köberl J, Friedl S, Steinmetz I, Leitner E. A head-to-head comparison of three MALDI-TOF mass spectrometry systems with 16S rRNA gene sequencing. J Clin Microbiol 2023; 61:e0191322. [PMID: 37732759 PMCID: PMC10595064 DOI: 10.1128/jcm.01913-22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2023] [Accepted: 07/17/2023] [Indexed: 09/22/2023] Open
Abstract
Matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF MS) has revolutionized diagnostics in culture-based microbiology. Commonly used MALDI-TOF MS systems in clinical microbiology laboratories are MALDI Biotyper (Bruker Daltonics) and Vitek MS (bioMérieux), but recently the new EXS2600 (Zybio) has been launched. This study aimed to evaluate the performance of the three devices by comparing the results to 16S rRNA gene sequencing. A set of 356 previously collected difficult-to-identify bacteria was tested in parallel with the three systems. Only the direct smear method and simple formic acid extraction were applied. Valid results were achieved for 98.6%, 94.4%, and 93.3% of all isolates by MALDI Biotyper, EXS2600, and Vitek MS, respectively. Of all valid results, agreement with sequencing data was achieved in 98.9%, 98.5%, and 99.7% by MALDI Biotyper, EXS2600, and Vitek MS, respectively. Considering only the isolates with valid measurements at the single-species level, misidentification rates were 0%, 2.6%, and 1.1% for MALDI Biotyper, EXS2600, and Vitek MS, respectively. Apart from minor performance differences, our data demonstrate that the three systems provide comparable results and are suitable for use in medical diagnostic laboratories.
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Affiliation(s)
- Karl Dichtl
- Diagnostic and Research Institute of Hygiene, Microbiology and Environmental Medicine, Medical University of Graz , Graz, Austria
| | - Isabel Klugherz
- Diagnostic and Research Institute of Hygiene, Microbiology and Environmental Medicine, Medical University of Graz , Graz, Austria
| | - Hanna Greimel
- Diagnostic and Research Institute of Hygiene, Microbiology and Environmental Medicine, Medical University of Graz , Graz, Austria
| | - Josefa Luxner
- Diagnostic and Research Institute of Hygiene, Microbiology and Environmental Medicine, Medical University of Graz , Graz, Austria
| | - Julian Köberl
- Diagnostic and Research Institute of Hygiene, Microbiology and Environmental Medicine, Medical University of Graz , Graz, Austria
| | - Simone Friedl
- Diagnostic and Research Institute of Hygiene, Microbiology and Environmental Medicine, Medical University of Graz , Graz, Austria
| | - Ivo Steinmetz
- Diagnostic and Research Institute of Hygiene, Microbiology and Environmental Medicine, Medical University of Graz , Graz, Austria
| | - Eva Leitner
- Diagnostic and Research Institute of Hygiene, Microbiology and Environmental Medicine, Medical University of Graz , Graz, Austria
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6
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Assig K, Lichtenegger S, Bui LNH, Mosbacher B, Vu ATN, Erhart D, Trinh TT, Steinmetz I. Rational design of an acidic erythritol (ACER) medium for the enhanced isolation of the environmental pathogen Burkholderia pseudomallei from soil samples. Front Microbiol 2023; 14:1213818. [PMID: 37469425 PMCID: PMC10353019 DOI: 10.3389/fmicb.2023.1213818] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2023] [Accepted: 06/07/2023] [Indexed: 07/21/2023] Open
Abstract
The soil bacterium Burkholderia pseudomallei causes melioidosis, a potentially fatal and greatly underdiagnosed tropical disease. Detection of B. pseudomallei in the environment is important to trace the source of infections, define risk areas for melioidosis and increase the clinical awareness. Although B. pseudomallei polymerase chain reaction (PCR)-based environmental detection provides important information, the culture of the pathogen remains essential but is still a methodological challenge. B. pseudomallei can catabolize erythritol, a metabolic pathway, which is otherwise rarely encountered among bacteria. We recently demonstrated that replacing threonine with erythritol as a single carbon source in the pH-neutral threonine-basal salt solution (TBSS-C50) historically used improved the isolation of B. pseudomallei from rice paddy soils. However, further culture medium parameters for an optimized recovery of B. pseudomallei strains from soils are still ill-defined. We, therefore, aimed to design a new erythritol-based medium by systematically optimizing parameters such as pH, buffer capacity, salt and nutrient composition. A key finding of our study is the enhanced erythritol-based growth of B. pseudomallei under acidic medium conditions. Our experiments with B. pseudomallei strains from different geographical origin led to the development of a phosphate-buffered acidic erythritol (ACER) medium with a pH of 6.3, higher erythritol concentration of 1.2%, supplemented vitamins and nitrate. This highly selective medium composition shortened the lag phase of B. pseudomallei cultures and greatly increased growth densities compared to TBSS-C50 and TBSS-C50-based erythritol medium. The ACER medium led to the highest enrichments of B. pseudomallei as determined from culture supernatants by quantitative PCR in a comparative validation with soil samples from the central part of Vietnam. Consequently, the median recovery of B. pseudomallei colony forming units on Ashdown's agar from ACER subcultures was 5.4 times higher compared to TBSS-C50-based erythritol medium (p = 0.005) and 30.7 times higher than TBSS-C50 (p < 0.001). In conclusion, our newly developed ACER medium significantly improves the isolation of viable B. pseudomallei from soils and, thereby, has the potential to reduce the rate of false-negative environmental cultures in melioidosis risk areas.
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Affiliation(s)
- Karoline Assig
- Diagnostic and Research Institute of Hygiene, Microbiology and Environmental Medicine, Medical University Graz, Graz, Austria
| | - Sabine Lichtenegger
- Diagnostic and Research Institute of Hygiene, Microbiology and Environmental Medicine, Medical University Graz, Graz, Austria
| | - Linh N. H. Bui
- Institute of Microbiology and Biotechnology, Vietnam National University, Hanoi, Vietnam
| | - Bettina Mosbacher
- Diagnostic and Research Institute of Hygiene, Microbiology and Environmental Medicine, Medical University Graz, Graz, Austria
| | - Anh T. N. Vu
- Institute of Microbiology and Biotechnology, Vietnam National University, Hanoi, Vietnam
| | - Daniel Erhart
- Diagnostic and Research Institute of Hygiene, Microbiology and Environmental Medicine, Medical University Graz, Graz, Austria
| | - Trung T. Trinh
- Institute of Microbiology and Biotechnology, Vietnam National University, Hanoi, Vietnam
| | - Ivo Steinmetz
- Diagnostic and Research Institute of Hygiene, Microbiology and Environmental Medicine, Medical University Graz, Graz, Austria
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7
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Wagner GE, Dabernig-Heinz J, Lipp M, Cabal A, Simantzik J, Kohl M, Scheiber M, Lichtenegger S, Ehricht R, Leitner E, Ruppitsch W, Steinmetz I. Real-Time Nanopore Q20+ Sequencing Enables Extremely Fast and Accurate Core Genome MLST Typing and Democratizes Access to High-Resolution Bacterial Pathogen Surveillance. J Clin Microbiol 2023; 61:e0163122. [PMID: 36988494 PMCID: PMC10117118 DOI: 10.1128/jcm.01631-22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2022] [Accepted: 02/17/2023] [Indexed: 03/30/2023] Open
Abstract
Next-generation whole-genome sequencing is essential for high-resolution surveillance of bacterial pathogens, for example, during outbreak investigations or for source tracking and escape variant analysis. However, current global sequencing and bioinformatic bottlenecks and a long time to result with standard technologies demand new approaches. In this study, we investigated whether novel nanopore Q20+ long-read chemistry enables standardized and easily accessible high-resolution typing combined with core genome multilocus sequence typing (cgMLST). We set high requirements for discriminatory power by using the slowly evolving bacterium Bordetella pertussis as a model pathogen. Our results show that the increased raw read accuracy enables the description of epidemiological scenarios and phylogenetic linkages at the level of gold-standard short reads. The same was true for our variant analysis of vaccine antigens, resistance genes, and virulence factors, demonstrating that nanopore sequencing is a legitimate competitor in the area of next-generation sequencing (NGS)-based high-resolution bacterial typing. Furthermore, we evaluated the parameters for the fastest possible analysis of the data. By combining the optimized processing pipeline with real-time basecalling, we established a workflow that allows for highly accurate and extremely fast high-resolution typing of bacterial pathogens while sequencing is still in progress. Along with advantages such as low costs and portability, the approach suggested here might democratize modern bacterial typing, enabling more efficient infection control globally.
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Affiliation(s)
- Gabriel E. Wagner
- Diagnostic and Research Institute of Hygiene, Microbiology and Environmental Medicine, Medical University of Graz, Graz, Austria
| | - Johanna Dabernig-Heinz
- Diagnostic and Research Institute of Hygiene, Microbiology and Environmental Medicine, Medical University of Graz, Graz, Austria
| | - Michaela Lipp
- Diagnostic and Research Institute of Hygiene, Microbiology and Environmental Medicine, Medical University of Graz, Graz, Austria
| | - Adriana Cabal
- Austrian Agency for Health and Food Safety, Vienna, Austria
| | - Jonathan Simantzik
- Medical and Life Sciences Faculty, Furtwangen University, Villingen-Schwenningen, Germany
| | - Matthias Kohl
- Medical and Life Sciences Faculty, Furtwangen University, Villingen-Schwenningen, Germany
| | - Martina Scheiber
- Diagnostic and Research Institute of Hygiene, Microbiology and Environmental Medicine, Medical University of Graz, Graz, Austria
| | - Sabine Lichtenegger
- Diagnostic and Research Institute of Hygiene, Microbiology and Environmental Medicine, Medical University of Graz, Graz, Austria
| | - Ralf Ehricht
- InfectoGnostics Research Campus, Centre for Applied Research, Jena, Germany
- Leibniz-Institute of Photonic Technology (Leibniz-IPHT), Jena, Germany
- Friedrich Schiller University Jena, Institute of Physical Chemistry, Jena, Germany
| | - Eva Leitner
- Diagnostic and Research Institute of Hygiene, Microbiology and Environmental Medicine, Medical University of Graz, Graz, Austria
| | | | - Ivo Steinmetz
- Diagnostic and Research Institute of Hygiene, Microbiology and Environmental Medicine, Medical University of Graz, Graz, Austria
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8
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König E, Iser J, Zechner-Sammer T, Friedl H, Krause R, Valentin T, Leitner E, Steinmetz I, Zollner-Schwetz I. Establishing breakpoints for amoxicillin/clavulanate and ampicillin/sulbactam for rapid antimicrobial susceptibility testing directly from positive blood culture bottles. J Med Microbiol 2023; 72. [PMID: 36951904 DOI: 10.1099/jmm.0.001672] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/24/2023] Open
Abstract
Introduction. In 2018, EUCAST released guidelines on rapid antimicrobial susceptibility testing (RAST) directly from positive blood culture bottles for selected bacterial species and antimicrobial agents, but not for the commonly used agents amoxicillin/clavulanate (AMC) and ampicillin/sulbactam (SAM).Hypothesis/Gap statement. This work addresses the Enterobacterales RAST capability gap for betalactam/betalactamase inhibitor combinations.Aim. We aimed to determine RAST breakpoints for AMC and SAM for Escherichia coli and Klebsiella pneumoniae after 4 and 6 h of incubation directly from positive blood cultures.Methodology. Blood culture bottles were spiked with clinical isolates of E. coli (n=89) and K. pneumoniae (n=81). RAST was performed according to EUCAST guidelines and zones were read after 4 and 6 h. Breakpoints were defined to avoid very major errors.Results. The proportion of readable zone diameters after 4 h of incubation were 90.8 % in E. coli and 85.8 % in K. pneumoniae isolates. After 6 h of incubation all zone diameters could be read. The proposed breakpoints for E. coli after 6 h of incubation were ≥16 mm S (susceptible), 14-15 mm ATU (area of technical uncertainty) and <14 mm R (resistant) for AMC; ≥15 mm S, 12-14 mm ATU and <12 mm R for SAM; for K. pneumoniae these were ≥16 mm S, 14-15 mm ATU and <14 mm R for AMC; ≥13 mm S, 12 mm ATU, <12 mm R for SAM. Applying our newly set breakpoints, major errors were infrequent (2.6 %).Conclusion. We propose novel AMC and SAM breakpoints for RAST directly from positive blood cultures for reading after 4 and 6 h of incubation.
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Affiliation(s)
- Elisabeth König
- Diagnostic & Research Institute of Hygiene, Microbiology and Environmental Medicine, Medical University of Graz, Neue Stiftingtalstraße 6, 8010 Graz, Austria
- Division of Infectious Diseases, Department of Internal Medicine, Medical University of Graz, Auenbruggerplatz 15, 8036 Graz, Austria
| | - Juliane Iser
- Division of Infectious Diseases, Department of Internal Medicine, Medical University of Graz, Auenbruggerplatz 15, 8036 Graz, Austria
| | - Tanja Zechner-Sammer
- Division of Infectious Diseases, Department of Internal Medicine, Medical University of Graz, Auenbruggerplatz 15, 8036 Graz, Austria
| | - Herwig Friedl
- Institute of Statistics, Graz University of Technology, Kopernikusgasse 24, 8010 Graz, Austria
| | - Robert Krause
- Division of Infectious Diseases, Department of Internal Medicine, Medical University of Graz, Auenbruggerplatz 15, 8036 Graz, Austria
| | - Thomas Valentin
- Division of Infectious Diseases, Department of Internal Medicine, Medical University of Graz, Auenbruggerplatz 15, 8036 Graz, Austria
| | - Eva Leitner
- Diagnostic & Research Institute of Hygiene, Microbiology and Environmental Medicine, Medical University of Graz, Neue Stiftingtalstraße 6, 8010 Graz, Austria
| | - Ivo Steinmetz
- Diagnostic & Research Institute of Hygiene, Microbiology and Environmental Medicine, Medical University of Graz, Neue Stiftingtalstraße 6, 8010 Graz, Austria
| | - Ines Zollner-Schwetz
- Division of Infectious Diseases, Department of Internal Medicine, Medical University of Graz, Auenbruggerplatz 15, 8036 Graz, Austria
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9
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Hodl I, Sallegger C, Forstner P, Sareban N, Moritz M, Dreo B, Schulz E, Lackner A, Kleinhappl B, Hatzl S, Moazedi-Fürst F, Seifert-Held T, Heschl B, Khalil M, Enzinger C, Greinix H, Stradner MH, Steinmetz I, Schlenke P, Fessler J. Altered cellular immune response to vaccination against SARS-CoV-2 in patients suffering from autoimmunity with B-cell depleting therapy. Microbes Infect 2023; 25:105103. [PMID: 36681177 PMCID: PMC9850844 DOI: 10.1016/j.micinf.2023.105103] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2022] [Revised: 01/11/2023] [Accepted: 01/12/2023] [Indexed: 01/20/2023]
Abstract
B-cell depleting therapies result in diminished humoral immunity following vaccination against COVID-19, but our understanding on the impact on cellular immune responses is limited. Here, we performed a detailed analysis of cellular immunity following mRNA vaccination in patients receiving B-cell depleting therapy using ELISpot assay and flow cytometry. Anti-SARS-CoV-2 spike receptor-binding domain antibody assays were performed to elucidate B-cell responses. To complement our cellular analysis, we performed immunophenotyping for T- and B-cell subsets. We show that SARS-CoV-2 vaccination using mRNA vaccines elicits cellular T-cell responses in patients under B-cell depleting therapy. Some facets of this immune response including TNFα production of CD4+ T-cells and granzyme B production of CD8+ T-cells, however, are distinctly diminished in these patients. Consequently, it appears that the finely coordinated process of T-cell activation with a uniform involvement of CD4+ and CD8+ T-cells as seen in HCs is disturbed in autoimmune patients. In addition, we observed that immune cell composition does impact cellular immunity as well as sustainability of anti-spike antibody titers. Our data suggest disturbed cellular immunity following mRNA vaccination in patients treated with B-cell depleting therapy. Immune cell composition may be an important determinant for vaccination efficacy.
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Affiliation(s)
- Isabel Hodl
- Division of Rheumatology and Immunology, Department of Internal Medicine, Medical University of Graz, Graz, Austria
| | - Clarissa Sallegger
- Division of Rheumatology and Immunology, Department of Internal Medicine, Medical University of Graz, Graz, Austria
| | - Patrick Forstner
- Institute of Hygiene, Microbiology and Environmental Medicine, Medical University of Graz, Graz, Austria
| | - Nazanin Sareban
- Department of Blood Group Serology and Transfusion Medicine, Medical University of Graz, Graz, Austria
| | - Martina Moritz
- Department of Blood Group Serology and Transfusion Medicine, Medical University of Graz, Graz, Austria
| | - Barbara Dreo
- Division of Rheumatology and Immunology, Department of Internal Medicine, Medical University of Graz, Graz, Austria
| | - Eduard Schulz
- Division of Hematology, Department of Internal Medicine, Medical University of Graz, Graz, Austria,Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, Maryland, United States
| | - Angelika Lackner
- Division of Rheumatology and Immunology, Department of Internal Medicine, Medical University of Graz, Graz, Austria
| | - Barbara Kleinhappl
- Institute of Hygiene, Microbiology and Environmental Medicine, Medical University of Graz, Graz, Austria
| | - Stefan Hatzl
- Division of Hematology, Department of Internal Medicine, Medical University of Graz, Graz, Austria
| | - Florentine Moazedi-Fürst
- Division of Rheumatology and Immunology, Department of Internal Medicine, Medical University of Graz, Graz, Austria
| | | | - Bettina Heschl
- Department of Neurology, Medical University of Graz, Graz, Austria
| | - Michael Khalil
- Department of Neurology, Medical University of Graz, Graz, Austria
| | | | - Hildegard Greinix
- Division of Hematology, Department of Internal Medicine, Medical University of Graz, Graz, Austria
| | - Martin H. Stradner
- Division of Rheumatology and Immunology, Department of Internal Medicine, Medical University of Graz, Graz, Austria,Corresponding author. Division of Rheumatology and Immunology Department of Internal Medicine Medical University of Graz Auenbruggerplatz 15, 8036 Graz, Austria. Tel.: +43/316/385-81794; fax: +43/316/385-17813
| | - Ivo Steinmetz
- Institute of Hygiene, Microbiology and Environmental Medicine, Medical University of Graz, Graz, Austria
| | - Peter Schlenke
- Department of Blood Group Serology and Transfusion Medicine, Medical University of Graz, Graz, Austria
| | - Johannes Fessler
- Division of Immunology, Medical University of Graz, Graz, Austria
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10
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Sourij C, Aziz F, Kojzar H, Obermayer AM, Sternad C, Müller A, Tripolt NJ, Pferschy PN, Aberer F, Schlenke P, Kleinhappl B, Stradner M, Sareban N, Moritz M, Dominguez‐Villar M, Oliver N, Steinmetz I, Sourij H. Severe acute respiratory syndrome coronavirus 2 spike antibody level decline is more pronounced after the second vaccination, but response to the third vaccination is similar in people with type 1 and type 2 diabetes compared with healthy controls: The prospective COVAC-DM cohort study. Diabetes Obes Metab 2023; 25:314-318. [PMID: 36057945 PMCID: PMC9538806 DOI: 10.1111/dom.14855] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/17/2022] [Revised: 08/16/2022] [Accepted: 08/29/2022] [Indexed: 12/14/2022]
Affiliation(s)
- Caren Sourij
- Division of CardiologyMedical University of GrazGrazAustria
- Interdisciplinary Metabolic Medicine Trials UnitMedical University of GrazGrazAustria
| | - Faisal Aziz
- Interdisciplinary Metabolic Medicine Trials UnitMedical University of GrazGrazAustria
- Division of Endocrinology and DiabetologyMedical University of GrazGrazAustria
| | - Harald Kojzar
- Interdisciplinary Metabolic Medicine Trials UnitMedical University of GrazGrazAustria
- Division of Endocrinology and DiabetologyMedical University of GrazGrazAustria
| | - Anna M. Obermayer
- Interdisciplinary Metabolic Medicine Trials UnitMedical University of GrazGrazAustria
- Division of Endocrinology and DiabetologyMedical University of GrazGrazAustria
| | - Christoph Sternad
- Interdisciplinary Metabolic Medicine Trials UnitMedical University of GrazGrazAustria
- Division of Endocrinology and DiabetologyMedical University of GrazGrazAustria
| | - Alexander Müller
- Interdisciplinary Metabolic Medicine Trials UnitMedical University of GrazGrazAustria
- Division of Endocrinology and DiabetologyMedical University of GrazGrazAustria
| | - Norbert J. Tripolt
- Interdisciplinary Metabolic Medicine Trials UnitMedical University of GrazGrazAustria
- Division of Endocrinology and DiabetologyMedical University of GrazGrazAustria
| | - Peter N. Pferschy
- Interdisciplinary Metabolic Medicine Trials UnitMedical University of GrazGrazAustria
- Division of Endocrinology and DiabetologyMedical University of GrazGrazAustria
- Centre for Biomarker Research in Medicine (CBmed)GrazAustria
| | - Felix Aberer
- Interdisciplinary Metabolic Medicine Trials UnitMedical University of GrazGrazAustria
- Division of Endocrinology and DiabetologyMedical University of GrazGrazAustria
| | - Peter Schlenke
- Department of Blood Group Serology and Transfusion MedicineMedical University of GrazGrazAustria
| | - Barbara Kleinhappl
- Institute of Hygiene, Microbiology and Environmental MedicineMedical University of GrazGrazAustria
| | - Martin Stradner
- Division of Rheumatology and ImmunologyMedical University of GrazGrazAustria
| | - Nazanin Sareban
- Department of Blood Group Serology and Transfusion MedicineMedical University of GrazGrazAustria
| | - Martina Moritz
- Department of Blood Group Serology and Transfusion MedicineMedical University of GrazGrazAustria
| | | | - Nick Oliver
- Department of Metabolism, Digestion and ReproductionImperial CollegeLondonUK
| | - Ivo Steinmetz
- Institute of Hygiene, Microbiology and Environmental MedicineMedical University of GrazGrazAustria
| | - Harald Sourij
- Interdisciplinary Metabolic Medicine Trials UnitMedical University of GrazGrazAustria
- Division of Endocrinology and DiabetologyMedical University of GrazGrazAustria
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11
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Matzhold EM, Körmöczi GF, Banfi C, Schönbacher M, Drexler-Helmberg C, Steinmetz I, Berghold A, Schlenke P, Wagner GE, Stoisser A, Kleinhappl B, Mayr WR, Wagner T. Lower Levels of ABO Anti-A and Anti-B of IgM, IgG and IgA Isotypes in the Serum but Not the Saliva of COVID-19 Convalescents. J Clin Med 2022; 11:jcm11154513. [PMID: 35956128 PMCID: PMC9369710 DOI: 10.3390/jcm11154513] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Revised: 07/25/2022] [Accepted: 08/01/2022] [Indexed: 12/04/2022] Open
Abstract
Individuals with ABO type O, naturally possessing anti-A and anti-B antibodies in their serum, are underrepresented among patients infected with SARS-CoV-2 compared with healthy controls. The ABO antibodies might play a role in the viral transmission. Therefore, we aimed to quantify anti-A/anti-B, including their subclasses IgM, IgG and IgA, in the serum and saliva of Caucasians (n = 187) after mild COVID-19 to compare them with individuals who had never been infected with SARS-CoV-2. Two samples were collected within two months after the diagnosis (median days: 44) and two months later. ABO antibodies were determined by flow cytometry. Additionally, total IgA in saliva and antibodies specific to SARS-CoV-2 were tested by ELISA. COVID-19 convalescents had significantly lower levels of anti-A/anti-B IgM, IgG and IgA in their serum than control subjects (p < 0.001). Interestingly, no significant differences were observed in saliva. ABO antibody levels remained stable over the period considered. No relation of ABO to the level of SARS-CoV-2-specific antibodies was observed. Total IgA was lower in convalescents than in controls (p = 0.038). Whereas ABO antibodies in the saliva may not contribute to the pathogenesis of COVID-19, individual pre-existing high serum concentrations of anti-A/anti-B may have a protective effect against SARS-CoV-2 infection.
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Affiliation(s)
- Eva M. Matzhold
- Department of Blood Group Serology and Transfusion Medicine, Medical University of Graz, 8036 Graz, Austria; (C.D.-H.); (P.S.); (A.S.); (T.W.)
- Correspondence: ; Tel.: +43-316-385-81438
| | - Günther F. Körmöczi
- Department of Blood Group Serology and Transfusion Medicine, Medical University of Vienna, 1090 Vienna, Austria; (G.F.K.); (M.S.); (W.R.M.)
| | - Chiara Banfi
- Institute for Medical Informatics, Statistics and Documentation, Medical University of Graz, 8036 Graz, Austria; (C.B.); (A.B.)
| | - Marlies Schönbacher
- Department of Blood Group Serology and Transfusion Medicine, Medical University of Vienna, 1090 Vienna, Austria; (G.F.K.); (M.S.); (W.R.M.)
| | - Camilla Drexler-Helmberg
- Department of Blood Group Serology and Transfusion Medicine, Medical University of Graz, 8036 Graz, Austria; (C.D.-H.); (P.S.); (A.S.); (T.W.)
| | - Ivo Steinmetz
- Diagnostic & Research Institute of Hygiene, Microbiology and Environmental Medicine, Diagnostic and Research Center for Molecular Biomedicine, Medical University of Graz, 8010 Graz, Austria; (I.S.); (G.E.W.); (B.K.)
| | - Andrea Berghold
- Institute for Medical Informatics, Statistics and Documentation, Medical University of Graz, 8036 Graz, Austria; (C.B.); (A.B.)
| | - Peter Schlenke
- Department of Blood Group Serology and Transfusion Medicine, Medical University of Graz, 8036 Graz, Austria; (C.D.-H.); (P.S.); (A.S.); (T.W.)
| | - Gabriel E. Wagner
- Diagnostic & Research Institute of Hygiene, Microbiology and Environmental Medicine, Diagnostic and Research Center for Molecular Biomedicine, Medical University of Graz, 8010 Graz, Austria; (I.S.); (G.E.W.); (B.K.)
| | - Anja Stoisser
- Department of Blood Group Serology and Transfusion Medicine, Medical University of Graz, 8036 Graz, Austria; (C.D.-H.); (P.S.); (A.S.); (T.W.)
| | - Barbara Kleinhappl
- Diagnostic & Research Institute of Hygiene, Microbiology and Environmental Medicine, Diagnostic and Research Center for Molecular Biomedicine, Medical University of Graz, 8010 Graz, Austria; (I.S.); (G.E.W.); (B.K.)
| | - Wolfgang R. Mayr
- Department of Blood Group Serology and Transfusion Medicine, Medical University of Vienna, 1090 Vienna, Austria; (G.F.K.); (M.S.); (W.R.M.)
| | - Thomas Wagner
- Department of Blood Group Serology and Transfusion Medicine, Medical University of Graz, 8036 Graz, Austria; (C.D.-H.); (P.S.); (A.S.); (T.W.)
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12
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Shaw T, Assig K, Tellapragada C, Wagner GE, Choudhary M, Göhler A, Eshwara VK, Steinmetz I, Mukhopadhyay C. Environmental Factors Associated With Soil Prevalence of the Melioidosis Pathogen Burkholderia pseudomallei: A Longitudinal Seasonal Study From South West India. Front Microbiol 2022; 13:902996. [PMID: 35847064 PMCID: PMC9283100 DOI: 10.3389/fmicb.2022.902996] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2022] [Accepted: 06/07/2022] [Indexed: 11/13/2022] Open
Abstract
Melioidosis is a seasonal infectious disease in tropical and subtropical areas caused by the soil bacterium Burkholderia pseudomallei. In many parts of the world, including South West India, most cases of human infections are reported during times of heavy rainfall, but the underlying causes of this phenomenon are not fully understood. India is among the countries with the highest predicted melioidosis burden globally, but there is very little information on the environmental distribution of B. pseudomallei and its determining factors. The present study aimed (i) to investigate the prevalence of B. pseudomallei in soil in South West India, (ii) determine geochemical factors associated with B. pseudomallei presence and (iii) look for potential seasonal patterns of B. pseudomallei soil abundance. Environmental samplings were performed in two regions during the monsoon and post-monsoon season and summer from July 2016 to November 2018. We applied direct quantitative real time PCR (qPCR) together with culture protocols to overcome the insufficient sensitivity of solely culture-based B. pseudomallei detection from soil. A total of 1,704 soil samples from 20 different agricultural sites were screened for the presence of B. pseudomallei. Direct qPCR detected B. pseudomallei in all 20 sites and in 30.2% (517/1,704) of all soil samples, whereas only two samples from two sites were culture-positive. B. pseudomallei DNA-positive samples were negatively associated with the concentration of iron, manganese and nitrogen in a binomial logistic regression model. The highest number of B. pseudomallei-positive samples (42.6%, p < 0.0001) and the highest B. pseudomallei loads in positive samples [median 4.45 × 103 genome equivalents (GE)/g, p < 0.0001] were observed during the monsoon season and eventually declined to 18.9% and a median of 1.47 × 103 GE/g in summer. In conclusion, our study from South West India shows a wide environmental distribution of B. pseudomallei, but also considerable differences in the abundance between sites and within single sites. Our results support the hypothesis that nutrient-depleted habitats promote the presence of B. pseudomallei. Most importantly, the highest B. pseudomallei abundance in soil is seen during the rainy season, when melioidosis cases occur.
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Affiliation(s)
- Tushar Shaw
- Department of Microbiology, Kasturba Medical College, Manipal Academy of Higher Education, Manipal, India
- Faculty of Life and Allied Health Sciences, Ramaiah University of Applied Sciences, Bengaluru, India
| | - Karoline Assig
- Diagnostic and Research Institute of Hygiene, Microbiology and Environmental Medicine, Medical University of Graz, Graz, Austria
- Friedrich Loeffler Institute of Medical Microbiology, University Medicine Greifswald, Greifswald, Germany
| | - Chaitanya Tellapragada
- Department of Microbiology, Kasturba Medical College, Manipal Academy of Higher Education, Manipal, India
- Division of Clinical Microbiology, Department of Laboratory Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Gabriel E. Wagner
- Diagnostic and Research Institute of Hygiene, Microbiology and Environmental Medicine, Medical University of Graz, Graz, Austria
| | - Madhu Choudhary
- ICAR-Central Soil Salinity Research Institute (CSSRI), Karnal, India
| | - André Göhler
- German Federal Institute for Risk Assessment, Berlin, Germany
| | - Vandana Kalwaje Eshwara
- Department of Microbiology, Kasturba Medical College, Manipal Academy of Higher Education, Manipal, India
- Centre for Antimicrobial Resistance and Education, Manipal Academy of Higher Education, Manipal, India
| | - Ivo Steinmetz
- Diagnostic and Research Institute of Hygiene, Microbiology and Environmental Medicine, Medical University of Graz, Graz, Austria
- Friedrich Loeffler Institute of Medical Microbiology, University Medicine Greifswald, Greifswald, Germany
- *Correspondence: Ivo Steinmetz,
| | - Chiranjay Mukhopadhyay
- Department of Microbiology, Kasturba Medical College, Manipal Academy of Higher Education, Manipal, India
- Centre for Emerging and Tropical Diseases, Manipal Academy of Higher Education, Manipal, India
- Chiranjay Mukhopadhyay,
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13
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Sourij C, Tripolt NJ, Aziz F, Aberer F, Forstner P, Obermayer AM, Kojzar H, Kleinhappl B, Pferschy PN, Mader JK, Cvirn G, Goswami N, Wachsmuth N, Eckstein ML, Müller A, Abbas F, Lenz J, Steinberger M, Knoll L, Krause R, Stradner M, Schlenke P, Sareban N, Prietl B, Kaser S, Moser O, Steinmetz I, Sourij H. Humoral immune response to COVID-19 vaccination in diabetes is age-dependent but independent of type of diabetes and glycaemic control: The prospective COVAC-DM cohort study. Diabetes Obes Metab 2022; 24:849-858. [PMID: 34984802 PMCID: PMC9303917 DOI: 10.1111/dom.14643] [Citation(s) in RCA: 43] [Impact Index Per Article: 21.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/29/2021] [Revised: 12/11/2021] [Accepted: 01/01/2022] [Indexed: 01/08/2023]
Abstract
AIMS To investigate the seroconversion following first and second COVID-19 vaccination in people with type 1 and type 2 diabetes in relation to glycaemic control prior to vaccination and to analyse the response in comparison to individuals without diabetes. MATERIALS AND METHODS This prospective, multicentre cohort study analysed people with type 1 and type 2 diabetes and a glycated haemoglobin level ≤58 mmol/mol (7.5%) or >58 mmol/mol (7.5%), respectively, and healthy controls. Roche's Elecsys anti-SARS-CoV-2 S immunoassay targeting the receptor-binding domain was used to quantify anti-spike protein antibodies 7 to 14 days after the first and 14 to 21 days after the second vaccination. RESULTS A total of 86 healthy controls were enrolled in the study, as well as 161 participants with diabetes, of whom 150 (75 with type 1 diabetes and 75 with type 2 diabetes) were eligible for the analysis. After the first vaccination, only 52.7% of participants in the type 1 diabetes group and 48.0% of those in the type 2 diabetes group showed antibody levels above the cut-off for positivity. Antibody levels after the second vaccination were similar in participants with type 1 diabetes, participants with type 2 diabetes and healthy controls after adjusting for age, sex and multiple testing (P > 0.05). Age (r = -0.45, P < 0.001) and glomerular filtration rate (r = 0.28, P = 0.001) were significantly associated with antibody response. CONCLUSIONS Anti-SARS-CoV-2 S receptor-binding domain antibody levels after the second vaccination were comparable in healthy controls and in participants with type 1 and type 2 diabetes, irrespective of glycaemic control. Age and renal function correlated significantly with the extent of antibody levels.
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Affiliation(s)
- Caren Sourij
- Division of CardiologyMedical University of GrazGrazAustria
| | - Norbert J. Tripolt
- Interdisciplinary Metabolic Medicine Trials Unit, Division of Endocrinology and DiabetologyMedical University of GrazGrazAustria
| | - Faisal Aziz
- Interdisciplinary Metabolic Medicine Trials Unit, Division of Endocrinology and DiabetologyMedical University of GrazGrazAustria
| | - Felix Aberer
- Interdisciplinary Metabolic Medicine Trials Unit, Division of Endocrinology and DiabetologyMedical University of GrazGrazAustria
- Diagnostic and Research Institute of Hygiene, Microbiology and Environmental MedicineMedical University of GrazGrazAustria
| | | | - Anna M. Obermayer
- Interdisciplinary Metabolic Medicine Trials Unit, Division of Endocrinology and DiabetologyMedical University of GrazGrazAustria
| | - Harald Kojzar
- Interdisciplinary Metabolic Medicine Trials Unit, Division of Endocrinology and DiabetologyMedical University of GrazGrazAustria
| | | | - Peter N. Pferschy
- Interdisciplinary Metabolic Medicine Trials Unit, Division of Endocrinology and DiabetologyMedical University of GrazGrazAustria
- Division of Endocrinology and DiabetologyMedical University of GrazGrazAustria
| | - Julia K. Mader
- Division of Physiological ChemistryMedical University of GrazGrazAustria
| | - Gerhard Cvirn
- Division of Physiology, Otto Loewi Research CenterMedical University of GrazGrazAustria
| | - Nandu Goswami
- Division of Exercise Physiology and MetabolismInstitute of Sport ScienceBayreuthGermany
| | - Nadine Wachsmuth
- Diagnostic and Research Institute of Hygiene, Microbiology and Environmental MedicineMedical University of GrazGrazAustria
| | - Max L. Eckstein
- Diagnostic and Research Institute of Hygiene, Microbiology and Environmental MedicineMedical University of GrazGrazAustria
| | - Alexander Müller
- Interdisciplinary Metabolic Medicine Trials Unit, Division of Endocrinology and DiabetologyMedical University of GrazGrazAustria
| | - Farah Abbas
- Interdisciplinary Metabolic Medicine Trials Unit, Division of Endocrinology and DiabetologyMedical University of GrazGrazAustria
| | - Jacqueline Lenz
- Interdisciplinary Metabolic Medicine Trials Unit, Division of Endocrinology and DiabetologyMedical University of GrazGrazAustria
| | - Michaela Steinberger
- Interdisciplinary Metabolic Medicine Trials Unit, Division of Endocrinology and DiabetologyMedical University of GrazGrazAustria
| | - Lisa Knoll
- Interdisciplinary Metabolic Medicine Trials Unit, Division of Endocrinology and DiabetologyMedical University of GrazGrazAustria
| | - Robert Krause
- Division for Infectious DiseasesMedical University of GrazGrazAustria
| | - Martin Stradner
- Division of Rheumatology and ImmunologyMedical University of GrazGrazAustria
| | - Peter Schlenke
- Department of Blood Group Serology and Transfusion MedicineMedical University of GrazGrazAustria
| | - Nazanin Sareban
- Department of Blood Group Serology and Transfusion MedicineMedical University of GrazGrazAustria
| | - Barbara Prietl
- Division of Endocrinology and DiabetologyMedical University of GrazGrazAustria
| | - Susanne Kaser
- Department for Internal Medicine IMedical University of InnsbruckInnsbruckAustria
| | - Othmar Moser
- Interdisciplinary Metabolic Medicine Trials Unit, Division of Endocrinology and DiabetologyMedical University of GrazGrazAustria
- Diagnostic and Research Institute of Hygiene, Microbiology and Environmental MedicineMedical University of GrazGrazAustria
| | - Ivo Steinmetz
- Center for Biomarker Research in Medicine (CBmed)GrazAustria
| | - Harald Sourij
- Interdisciplinary Metabolic Medicine Trials Unit, Division of Endocrinology and DiabetologyMedical University of GrazGrazAustria
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14
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Birnie E, James A, Peters F, Olajumoke M, Traore T, Bertherat E, Trinh TT, Naidoo D, Steinmetz I, Wiersinga WJ, Oladele R, Akanmu AS. Melioidosis in Africa: Time to Raise Awareness and Build Capacity for Its Detection, Diagnosis, and Treatment. Am J Trop Med Hyg 2022; 106:394-397. [PMID: 35008053 PMCID: PMC8832903 DOI: 10.4269/ajtmh.21-0673] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2021] [Accepted: 10/22/2021] [Indexed: 02/03/2023] Open
Abstract
Melioidosis is a tropical infectious disease caused by the soil-dwelling bacterium Burkholderia pseudomallei with a mortality of up to 50% in low resource settings. Only a few cases have been reported from African countries. However, studies on the global burden of melioidosis showed that Africa holds a significant unrecognized disease burden, with Nigeria being at the top of the list. The first World Health Organization African Melioidosis Workshop was organized in Lagos, Nigeria, with representatives of health authorities, microbiology laboratories, and clinical centers from across the continent. Dedicated hands-on training was given on laboratory diagnostics of B. pseudomallei. This report summarises the meeting objectives, including raising awareness of melioidosis and building capacity for the detection, diagnosis, biosafety, treatment, and prevention across Africa. Further, collaboration with regional and international experts provided a platform for sharing ideas on best practices.
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Affiliation(s)
- Emma Birnie
- Division of Infectious Diseases, Department of Medicine and Center for Experimental Molecular Medicine (CEMM), Amsterdam University Medical Centers, AMC, Amsterdam, The Netherlands;,Address correspondence to Emma Birnie, Division of Infectious Diseases, Department of Medicine and Center for Experimental Molecular Medicine (CEMM), Amsterdam University Medical Centers, AMC, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands. E-mail:
| | - Ayorinde James
- Department of Biochemistry, Nigerian Institute of Medical Research, Lagos, Nigeria
| | - Folake Peters
- Department of Medical Microbiology and Parasitology, Lagos University Teaching Hospital, Lagos, Nigeria
| | - Makinwa Olajumoke
- Department of Medical Microbiology and Parasitology, Lagos University Teaching Hospital, Lagos, Nigeria
| | - Tieble Traore
- World Health Organization, Regional Office for Africa, Dhakar-Hub, Senegal
| | - Eric Bertherat
- Department of Infectious Hazard Management, Health Emergency Programme, World Health Organization, Geneva, Switzerland
| | - Trung T. Trinh
- VNU Institute of Microbiology and Biotechnology, Vietnam National University, Hanoi, Vietnam
| | | | - Ivo Steinmetz
- Institute of Hygiene, Microbiology and Environmental Medicine, Medical University of Graz, Austria
| | - W. Joost Wiersinga
- Division of Infectious Diseases, Department of Medicine and Center for Experimental Molecular Medicine (CEMM), Amsterdam University Medical Centers, AMC, Amsterdam, The Netherlands
| | - Rita Oladele
- Department of Medical Microbiology and Parasitology, Lagos University Teaching Hospital, Lagos, Nigeria
| | - Alani S. Akanmu
- Department of Hematology and Blood Transfusion, Lagos University Teaching Hospital, Lagos, Nigeria
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15
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Niedrist T, Drexler C, Torreiter PP, Matejka J, Strahlhofer-Augsten M, Kral S, Riegler S, Gülly C, Zurl C, Kriegl L, Krause R, Berghold A, Steinmetz I, Schlenke P, Herrmann M. Longitudinal comparison of automated SARS-CoV-2 serology assays in assessing virus neutralization capacity in COVID-19 convalescent sera. Arch Pathol Lab Med 2022; 146:538-546. [PMID: 35085385 DOI: 10.5858/arpa.2021-0604-sa] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/24/2022] [Indexed: 11/06/2022]
Abstract
CONTEXT.– Serological tests on automated immunology analyzers are increasingly used to monitor the acquired immunity against SARS-CoV-2. The heterogeneity of assays raises concerns about their diagnostic performance and comparability. OBJECTIVE.– To test sera from formerly infected individuals for SARS-Cov-2 antibodies utilizing six automated serology assays and a pseudoneutralization test (PNT). DESIGN.– Six SARS-CoV-2 serology assays were utilized to assess 954 samples collected during a 12 months period from 315 COVID-19 convalescents. The tests determined either antibodies against the viral nucleocapsid (anti-NC) or spike protein (anti-S). Two assays did not distinguish between antibody classes whereas the others selectively measured immunoglubulins G (IgG) antibodies. PNT was used to detect the presence of neutralizing antibodies. RESULTS.– Comparison of qualitative results showed only slight to moderate concordance between the assays (Cohen's kappa < 0.57). Significant correlations (P < .001) were observed between the antibody titers from all quantitative assays. However, titer changes were not detected equally. A total anti-S assay measured an increase in 128 out of 172 cases (74%) of a suitable subset, whereas all IgG anti-S tests reported decreases in at least 118 (69%). Regarding the PNT results, diagnostic sensitivities ≥89% were achieved with PPVs ≥93%. In contrast, specificity changed substantially over time varying from 20 to 100%. CONCLUSIONS.– Comparability of serological SARS-CoV-2 antibody tests is rather poor. Due to different diagnostic specificities, the tested assays were not equally capable of capturing changes in antibody titers. However, with thoroughly validated cut-offs, IgG-selective anti-S assays are a reliable surrogate test for SARS-CoV-2 neutralizing antibodies in former COVID-19 patients.
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Affiliation(s)
- Tobias Niedrist
- Clinical Institute of Medical and Chemical Laboratory Diagnostics (Niedrist, Herrmann), Medical University of Graz, Graz, Austria
| | - Camilla Drexler
- Department of Blood Group Serology and Transfusion Medicine (Drexler, Torreiter, Schlenke), Medical University of Graz, Graz, Austria
| | - Patrick Paul Torreiter
- Department of Blood Group Serology and Transfusion Medicine (Drexler, Torreiter, Schlenke), Medical University of Graz, Graz, Austria
| | - Julia Matejka
- Biobank Graz (Matejka, Strahlhofer-Augsten, Kral, Riegler, Gülly), Medical University of Graz, Graz, Austria
| | - Manuela Strahlhofer-Augsten
- Biobank Graz (Matejka, Strahlhofer-Augsten, Kral, Riegler, Gülly), Medical University of Graz, Graz, Austria
| | - Sabrina Kral
- Biobank Graz (Matejka, Strahlhofer-Augsten, Kral, Riegler, Gülly), Medical University of Graz, Graz, Austria
| | - Skaiste Riegler
- Biobank Graz (Matejka, Strahlhofer-Augsten, Kral, Riegler, Gülly), Medical University of Graz, Graz, Austria
| | - Christian Gülly
- Biobank Graz (Matejka, Strahlhofer-Augsten, Kral, Riegler, Gülly), Medical University of Graz, Graz, Austria.,Center for Medical Research (Gülly), Medical University of Graz, Graz, Austria
| | - Christoph Zurl
- Division of Infectious Diseases in the Department of Internal Medicine (Zurl, Kriegl, Krause), Medical University of Graz, Graz, Austria.,Division of General Paediatrics in the Department of Paediatrics and Adolescents Medicine (Zurl), Medical University of Graz, Graz, Austria
| | - Lisa Kriegl
- Division of Infectious Diseases in the Department of Internal Medicine (Zurl, Kriegl, Krause), Medical University of Graz, Graz, Austria
| | - Robert Krause
- Division of Infectious Diseases in the Department of Internal Medicine (Zurl, Kriegl, Krause), Medical University of Graz, Graz, Austria.,BioTechMed Graz, Graz, Austria (Krause)
| | - Andrea Berghold
- Institute for Medical Informatics, Statistics and Documentation (Berghold), Medical University of Graz, Graz, Austria
| | - Ivo Steinmetz
- Diagnostic and Research Institute of Hygiene, Microbiology and Environmental Medicine (Steinmetz), Medical University of Graz, Graz, Austria
| | - Peter Schlenke
- Department of Blood Group Serology and Transfusion Medicine (Drexler, Torreiter, Schlenke), Medical University of Graz, Graz, Austria
| | - Markus Herrmann
- Clinical Institute of Medical and Chemical Laboratory Diagnostics (Niedrist, Herrmann), Medical University of Graz, Graz, Austria
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16
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Schulz E, Hodl I, Forstner P, Hatzl S, Sareban N, Moritz M, Fessler J, Dreo B, Uhl B, Url C, Grisold AJ, Khalil M, Kleinhappl B, Enzinger C, Stradner MH, Greinix HT, Schlenke P, Steinmetz I. CD19+IgD+CD27- Naïve B Cells as Predictors of Humoral Response to COVID 19 mRNA Vaccination in Immunocompromised Patients. Front Immunol 2021; 12:803742. [PMID: 34950155 PMCID: PMC8688243 DOI: 10.3389/fimmu.2021.803742] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2021] [Accepted: 11/19/2021] [Indexed: 01/04/2023] Open
Abstract
Immunocompromised patients are considered high-risk and prioritized for vaccination against COVID-19. We aimed to analyze B-cell subsets in these patients to identify potential predictors of humoral vaccination response. Patients (n=120) suffering from hematologic malignancies or other causes of immunodeficiency and healthy controls (n=79) received a full vaccination series with an mRNA vaccine. B-cell subsets were analyzed prior to vaccination. Two independent anti-SARS-CoV-2 immunoassays targeting the receptor-binding domain (RBD) or trimeric S protein (TSP) were performed three to four weeks after the second vaccination. Seroconversion occurred in 100% of healthy controls, in contrast to 67% (RBD) and 82% (TSP) of immunocompromised patients, while only 32% (RBD) and 22% (TSP) achieved antibody levels comparable to those of healthy controls. The number of circulating CD19+IgD+CD27- naïve B cells was strongly associated with antibody levels (ρ=0.761, P<0.001) and the only independent predictor for achieving antibody levels comparable to healthy controls (OR 1.07 per 10-µL increase, 95%CI 1.02-1.12, P=0.009). Receiver operating characteristic analysis identified a cut-off at ≥61 naïve B cells per µl to discriminate between patients with and without an optimal antibody response. Consequently, measuring of naïve B cells in immunocompromised hematologic patients could be useful in predicting their humoral vaccination response.
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Affiliation(s)
- Eduard Schulz
- Division of Hematology, Department of Internal Medicine, Medical University of Graz, Graz, Austria
| | - Isabel Hodl
- Division of Rheumatology and Immunology, Department of Internal Medicine, Medical University of Graz, Graz, Austria
| | - Patrick Forstner
- Institute of Hygiene, Microbiology and Environmental Medicine, Medical University of Graz, Graz, Austria
| | - Stefan Hatzl
- Division of Hematology, Department of Internal Medicine, Medical University of Graz, Graz, Austria
| | - Nazanin Sareban
- Department of Blood Group Serology and Transfusion Medicine, Medical University of Graz, Graz, Austria
| | - Martina Moritz
- Department of Blood Group Serology and Transfusion Medicine, Medical University of Graz, Graz, Austria
| | - Johannes Fessler
- Institute of Immunology and Pathophysiology, Medical University of Graz, Graz, Austria
| | - Barbara Dreo
- Division of Rheumatology and Immunology, Department of Internal Medicine, Medical University of Graz, Graz, Austria
| | - Barbara Uhl
- Division of Hematology, Department of Internal Medicine, Medical University of Graz, Graz, Austria
| | - Claudia Url
- Department of Blood Group Serology and Transfusion Medicine, Medical University of Graz, Graz, Austria
| | - Andrea J. Grisold
- Institute of Hygiene, Microbiology and Environmental Medicine, Medical University of Graz, Graz, Austria
| | - Michael Khalil
- Department of Neurology, Medical University of Graz, Graz, Austria
| | - Barbara Kleinhappl
- Institute of Hygiene, Microbiology and Environmental Medicine, Medical University of Graz, Graz, Austria
| | | | - Martin H. Stradner
- Division of Rheumatology and Immunology, Department of Internal Medicine, Medical University of Graz, Graz, Austria
| | - Hildegard T. Greinix
- Division of Hematology, Department of Internal Medicine, Medical University of Graz, Graz, Austria
| | - Peter Schlenke
- Department of Blood Group Serology and Transfusion Medicine, Medical University of Graz, Graz, Austria
| | - Ivo Steinmetz
- Institute of Hygiene, Microbiology and Environmental Medicine, Medical University of Graz, Graz, Austria
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17
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Matzhold EM, Berghold A, Bemelmans MKB, Banfi C, Stelzl E, Kessler HH, Steinmetz I, Krause R, Wurzer H, Schlenke P, Wagner T. Lewis and ABO histo-blood types and the secretor status of patients hospitalized with COVID-19 implicate a role for ABO antibodies in susceptibility to infection with SARS-CoV-2. Transfusion 2021; 61:2736-2745. [PMID: 34151460 PMCID: PMC8447157 DOI: 10.1111/trf.16567] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2020] [Revised: 05/11/2021] [Accepted: 06/13/2021] [Indexed: 12/17/2022]
Abstract
BACKGROUND Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) targets the respiratory and gastric epithelium, causing coronavirus disease 2019 (COVID-19). Tissue antigen expression variations influence host susceptibility to many infections. This study aimed to investigate the closely linked Lewis (FUT3) and ABO histo-blood types, including secretor (FUT2) status, to infections with SARS-CoV-2 and the corresponding severity of COVID-19. STUDY DESIGN AND METHODS Patients (Caucasians, n = 338) were genotyped for ABO, FUT3, and FUT2, and compared to a reference population of blood donors (n = 250,298). The association between blood types and severity of COVID-19 was addressed by dividing patients into four categories: hospitalized individuals in general wards, patients admitted to the intensive care unit with and without intubation, and deceased patients. Comorbidities were considered in subsequent analyses. RESULTS Patients with blood type Lewis (a-b-) or O were significantly less likely to be hospitalized (odds ratio [OR] 0.669, confidence interval [CI] 0.446-0.971, OR 0.710, CI 0.556-0.900, respectively), while type AB was significantly more prevalent in the patient cohort (OR 1.519, CI 1.014-2.203). The proportions of secretors/nonsecretors, and Lewis a+ or Lewis b+ types were consistent between patients and controls. The analyzed blood groups were not associated with the clinical outcome as defined. DISCUSSION Blood types Lewis (a-b-) and O were found to be protective factors, whereas the group AB is suggested to be a risk factor for COVID-19. The antigens investigated may not be prognostic for disease severity, but a role for ABO isoagglutinins in SARS-CoV-2 infections is strongly suggested.
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Affiliation(s)
- Eva Maria Matzhold
- Department of Blood Group Serology and Transfusion MedicineMedical University of GrazGrazAustria
| | - Andrea Berghold
- Institute for Medical Informatics, Statistics and DocumentationMedical University of GrazGrazAustria
| | - Maria Karin Berta Bemelmans
- Department of Blood Group Serology and Transfusion MedicineMedical University of GrazGrazAustria
- FH Campus WienUniversity of Applied SciencesViennaAustria
| | - Chiara Banfi
- Institute for Medical Informatics, Statistics and DocumentationMedical University of GrazGrazAustria
| | - Evelyn Stelzl
- Diagnostic and Research Institute of Hygiene, Microbiology and Environmental Medicine, Research Unit Molecular Diagnostics, Diagnostic and Research Center for Molecular BiomedicineMedical University of GrazGrazAustria
| | - Harald Hans Kessler
- Diagnostic and Research Institute of Hygiene, Microbiology and Environmental Medicine, Research Unit Molecular Diagnostics, Diagnostic and Research Center for Molecular BiomedicineMedical University of GrazGrazAustria
| | - Ivo Steinmetz
- Diagnostic and Research Institute of Hygiene, Microbiology and Environmental Medicine, Research Unit Molecular Diagnostics, Diagnostic and Research Center for Molecular BiomedicineMedical University of GrazGrazAustria
| | - Robert Krause
- Section of Infectious Diseases and Tropical Medicine, Department of Internal MedicineMedical University of GrazGrazAustria
| | - Herbert Wurzer
- Department of Internal MedicineLandeskrankenhaus Graz IIGrazAustria
| | - Peter Schlenke
- Department of Blood Group Serology and Transfusion MedicineMedical University of GrazGrazAustria
| | - Thomas Wagner
- Department of Blood Group Serology and Transfusion MedicineMedical University of GrazGrazAustria
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18
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Kral S, Banfi C, Niedrist T, Sareban N, Guelly C, Kriegl L, Schiffmann S, Zurl C, Herrmann M, Steinmetz I, Schlenke P, Berghold A, Krause R. Long-lasting immune response to a mild course of PCR-confirmed SARS-CoV-2 infection: A cohort study. J Infect 2021; 83:607-635. [PMID: 34433071 PMCID: PMC8380195 DOI: 10.1016/j.jinf.2021.08.030] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2021] [Accepted: 08/18/2021] [Indexed: 01/10/2023]
Affiliation(s)
- Sabrina Kral
- Biobank Graz, Medical University of Graz, Graz, Austria.
| | - Chiara Banfi
- Institute for Medical Informatics, Statistics and Documentation, Medical University Graz, Graz, Austria
| | - Tobias Niedrist
- Clinical Institute of Medical and Chemical Laboratory Diagnostics, Medical University of Graz, Graz, Austria
| | - Nazanin Sareban
- Department of Blood Group Serology and Transfusion Medicine, Medical University of Graz, Graz, Austria
| | - Christian Guelly
- Biobank Graz, Medical University of Graz, Graz, Austria; Center for Medical Research, Medical University of Graz, Graz, Austria
| | - Lisa Kriegl
- Division of Infectious Diseases, Department of Internal Medicine, Medical University of Graz, Graz, Austria
| | - Stefanie Schiffmann
- Department of Blood Group Serology and Transfusion Medicine, Medical University of Graz, Graz, Austria
| | - Christoph Zurl
- Division of Infectious Diseases, Department of Internal Medicine, Medical University of Graz, Graz, Austria; Division of General Paediatrics, Department of Paediatrics and Adolescent Medicine, Medical University of Graz, Graz, Austria; BioTechMed-Graz, Graz, Austria
| | - Markus Herrmann
- Clinical Institute of Medical and Chemical Laboratory Diagnostics, Medical University of Graz, Graz, Austria
| | - Ivo Steinmetz
- Diagnostic and Research Institute of Hygiene, Microbiology and Environmental Medicine, Medical University of Graz, Graz, Austria
| | - Peter Schlenke
- Department of Blood Group Serology and Transfusion Medicine, Medical University of Graz, Graz, Austria
| | - Andrea Berghold
- Institute for Medical Informatics, Statistics and Documentation, Medical University Graz, Graz, Austria
| | - Robert Krause
- Division of Infectious Diseases, Department of Internal Medicine, Medical University of Graz, Graz, Austria; BioTechMed-Graz, Graz, Austria
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19
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Willeit P, Bernar B, Zurl C, Al-Rawi M, Berghold A, Bernhard D, Borena W, Doppler C, Kerbl R, Köhler A, Krause R, Lamprecht B, Pröll J, Schmidt H, Steinmetz I, Stelzl E, Stoiber H, von Laer D, Zuber J, Müller T, Strenger V, Wagner M. Sensitivity and specificity of the antigen-based anterior nasal self-testing programme for detecting SARS-CoV-2 infection in schools, Austria, March 2021. Euro Surveill 2021; 26:2100797. [PMID: 34448449 PMCID: PMC8393891 DOI: 10.2807/1560-7917.es.2021.26.34.2100797] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2021] [Accepted: 08/25/2021] [Indexed: 11/20/2022] Open
Abstract
This study evaluates the performance of the antigen-based anterior nasal screening programme implemented in all Austrian schools to detect SARS-CoV-2 infections. We combined nationwide antigen-based screening data obtained in March 2021 from 5,370 schools (Grade 1-8) with an RT-qPCR-based prospective cohort study comprising a representative sample of 244 schools. Considering a range of assumptions, only a subset of infected individuals are detected with the programme (low to moderate sensitivity) and non-infected individuals mainly tested negative (very high specificity).
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Affiliation(s)
- Peter Willeit
- Clinical Epidemiology Team, Department of Neurology, Medical University of Innsbruck, Innsbruck, Austria
- Department of Public Health and Primary Care, University of Cambridge, Cambridge, United Kingdom
| | - Benoît Bernar
- Department of Pediatrics I, Medical University of Innsbruck, Innsbruck, Austria
| | - Christoph Zurl
- Section of Infectious Diseases and Tropical Medicine, Department of Internal Medicine, Medical University of Graz, Graz, Austria
- BioTechMed-Graz, Graz, Austria
- Department of Paediatrics and Adolescent Medicine, Division of General Paediatrics, Medical University of Graz, Graz, Austria
| | - Mariam Al-Rawi
- Vienna Covid-19 Detection Initiative, Vienna, Austria
- Max Perutz Labs, University of Vienna, Vienna, Austria
| | - Andrea Berghold
- Institute for Medical Informatics, Statistics and Documentation, Medical University of Graz, Graz, Austria
| | - David Bernhard
- Center for Medical Research, Faculty of Medicine, Johannes Kepler University Linz, Linz, Austria
- Division of Pathophysiology, Institute of Physiology and Pathophysiology, Johannes Kepler University Linz, Linz, Austria
| | - Wegene Borena
- Institute of Virology, Medical University Innsbruck, Innsbruck, Austria
| | - Christian Doppler
- Center for Medical Research, Faculty of Medicine, Johannes Kepler University Linz, Linz, Austria
- Division of Pathophysiology, Institute of Physiology and Pathophysiology, Johannes Kepler University Linz, Linz, Austria
| | - Reinhold Kerbl
- Department of Paediatrics and Adolescent Medicine, LKH Hochsteiermark, Leoben, Austria
| | - Alwin Köhler
- Vienna Covid-19 Detection Initiative, Vienna, Austria
- Max Perutz Labs, University of Vienna, Vienna, Austria
| | - Robert Krause
- Section of Infectious Diseases and Tropical Medicine, Department of Internal Medicine, Medical University of Graz, Graz, Austria
- BioTechMed-Graz, Graz, Austria
| | - Bernd Lamprecht
- Department of Pulmonology, Kepler-University-Hospital, Faculty of Medicine, Johannes Kepler University Linz, Linz, Austria
| | - Johannes Pröll
- Center for Medical Research, Faculty of Medicine, Johannes Kepler University Linz, Linz, Austria
| | - Hannes Schmidt
- Centre for Microbiology and Environmental Systems Science, Department of Microbiology and Ecosystem Science, University of Vienna, Vienna, Austria
- Vienna Covid-19 Detection Initiative, Vienna, Austria
| | - Ivo Steinmetz
- Diagnostic and Research Institute of Hygiene, Microbiology and Environmental Medicine, Medical University of Graz, Graz, Austria
| | - Evelyn Stelzl
- Diagnostic and Research Institute of Hygiene, Microbiology and Environmental Medicine, Medical University of Graz, Graz, Austria
| | - Heribert Stoiber
- Institute of Virology, Medical University Innsbruck, Innsbruck, Austria
| | - Dorothee von Laer
- Institute of Virology, Medical University Innsbruck, Innsbruck, Austria
| | - Johannes Zuber
- IMP - Research Institute of Molecular Pathology, Vienna, Austria
- Vienna Covid-19 Detection Initiative, Vienna, Austria
| | - Thomas Müller
- Department of Pediatrics I, Medical University of Innsbruck, Innsbruck, Austria
| | - Volker Strenger
- Department of Paediatrics and Adolescent Medicine, Division of Pediatric Pulmonology and Allergology, Medical University Graz, Graz, Austria
| | - Michael Wagner
- Centre for Microbiology and Environmental Systems Science, Department of Microbiology and Ecosystem Science, University of Vienna, Vienna, Austria
- Center for Microbial Communities, Department of Chemistry and Bioscience, Aalborg University, Aalborg, Denmark
- Vienna Covid-19 Detection Initiative, Vienna, Austria
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20
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Phenn J, Pané-Farré J, Meukow N, Klein A, Troitzsch A, Tan P, Fuchs S, Wagner GE, Lichtenegger S, Steinmetz I, Kohler C. RegAB Homolog of Burkholderia pseudomallei is the Master Regulator of Redox Control and involved in Virulence. PLoS Pathog 2021; 17:e1009604. [PMID: 34048488 PMCID: PMC8191878 DOI: 10.1371/journal.ppat.1009604] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2020] [Revised: 06/10/2021] [Accepted: 05/03/2021] [Indexed: 12/23/2022] Open
Abstract
Burkholderia pseudomallei, the etiological agent of melioidosis in humans and animals, often occupies environmental niches and infection sites characterized by limited concentrations of oxygen. Versatile genomic features enable this pathogen to maintain its physiology and virulence under hypoxia, but the crucial regulatory networks employed to switch from oxygen dependent respiration to alternative terminal electron acceptors (TEA) like nitrate, remains poorly understood. Here, we combined a Tn5 transposon mutagenesis screen and an anaerobic growth screen to identify a two-component signal transduction system with homology to RegAB. We show that RegAB is not only essential for anaerobic growth, but also for full virulence in cell lines and a mouse infection model. Further investigations of the RegAB regulon, using a global transcriptomic approach, identified 20 additional regulators under transcriptional control of RegAB, indicating a superordinate role of RegAB in the B. pseudomallei anaerobiosis regulatory network. Of the 20 identified regulators, NarX/L and a FNR homolog were selected for further analyses and a role in adaptation to anaerobic conditions was demonstrated. Growth experiments identified nitrate and intermediates of the denitrification process as the likely signal activateing RegAB, NarX/L, and probably of the downstream regulators Dnr or NsrR homologs. While deletions of individual genes involved in the denitrification process demonstrated their important role in anaerobic fitness, they showed no effect on virulence. This further highlights the central role of RegAB as the master regulator of anaerobic metabolism in B. pseudomallei and that the complete RegAB-mediated response is required to achieve full virulence. In summary, our analysis of the RegAB-dependent modulon and its interconnected regulons revealed a key role for RegAB of B. pseudomallei in the coordination of the response to hypoxic conditions and virulence, in the environment and the host.
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Affiliation(s)
- Julia Phenn
- Friedrich Loeffler Institute of Medical Microbiology, University Medicine Greifswald, Greifswald, Germany
| | - Jan Pané-Farré
- SYNMIKRO Research Center and Department of Chemistry, Philipps-University Marburg, Marburg, Germany
| | - Nikolai Meukow
- Friedrich Loeffler Institute of Medical Microbiology, University Medicine Greifswald, Greifswald, Germany
| | - Annelie Klein
- Friedrich Loeffler Institute of Medical Microbiology, University Medicine Greifswald, Greifswald, Germany
| | - Anne Troitzsch
- Department for Microbial Physiology and Molecular Biology, University Greifswald, Greifswald, Germany
| | - Patrick Tan
- Genome Institute of Singapore, Singapore, Republic of Singapore
- Duke-NUS Medical School Singapore, Singapore, Republic of Singapore
- Cancer Science Institute of Singapore, National University of Singapore, Singapore, Republic of Singapore
| | - Stephan Fuchs
- FG13 Nosocomial Pathogens and Antibiotic Resistances, Robert Koch Institute, Wernigerode, Germany
| | - Gabriel E Wagner
- Institute of Hygiene, Microbiology and Environmental Medicine, Medical University Graz, Graz, Austria
| | - Sabine Lichtenegger
- Institute of Hygiene, Microbiology and Environmental Medicine, Medical University Graz, Graz, Austria
| | - Ivo Steinmetz
- Friedrich Loeffler Institute of Medical Microbiology, University Medicine Greifswald, Greifswald, Germany
- Institute of Hygiene, Microbiology and Environmental Medicine, Medical University Graz, Graz, Austria
| | - Christian Kohler
- Friedrich Loeffler Institute of Medical Microbiology, University Medicine Greifswald, Greifswald, Germany
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21
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Willeit P, Krause R, Lamprecht B, Berghold A, Hanson B, Stelzl E, Stoiber H, Zuber J, Heinen R, Köhler A, Bernhard D, Borena W, Doppler C, von Laer D, Schmidt H, Pröll J, Steinmetz I, Wagner M. Prevalence of RT-qPCR-detected SARS-CoV-2 infection at schools: First results from the Austrian School-SARS-CoV-2 prospective cohort study. Lancet Reg Health Eur 2021; 5:100086. [PMID: 34396360 PMCID: PMC8350968 DOI: 10.1016/j.lanepe.2021.100086] [Citation(s) in RCA: 26] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
BACKGROUND The role of schools in the SARS-CoV-2 pandemic is much debated. We aimed to quantify reliably the prevalence of SARS-CoV-2 infections at schools detected with reverse-transcription quantitative polymerase-chain-reaction (RT-qPCR). METHODS This nationwide prospective cohort study monitors a representative sample of pupils (grade 1-8) and teachers at Austrian schools throughout the school year 2020/2021. We repeatedly test participants for SARS-CoV-2 infection using a gargling solution and RT-qPCR. We herein report on the first two rounds of examinations. We used mixed-effects logistic regression to estimate odds ratios and robust 95% confidence intervals (95% CI). FINDINGS We analysed data on 10,734 participants from 245 schools (9465 pupils, 1269 teachers). Prevalence of SARS-CoV-2 infection increased from 0·39% at round 1 (95% CI 028-0·55%, 28 September-22 October 2020) to 1·39% at round 2 (95% CI 1·04-1·85%, 10-16 November). Odds ratios for SARS-CoV-2 infection were 2·26 (95% CI 1·25-4·12, P = 0·007) in regions with >500 vs. ≤500 inhabitants/km2, 1·67 (95% CI 1·42-1·97, P<0·001) per two-fold higher regional 7-day community incidence, and 2·78 (95% CI 1·73-4·48, P<0·001) in pupils at schools with high/very high vs. low/moderate social deprivation. Associations of regional community incidence and social deprivation persisted in a multivariable adjusted model. Prevalence did not differ by average number of pupils per class nor between age groups, sexes, pupils vs. teachers, or primary (grade 1-4) vs. secondary schools (grade 5-8). INTERPRETATION This monitoring study in Austrian schools revealed SARS-CoV-2 infection in 0·39%-1·39% of participants and identified associations of regional community incidence and social deprivation with higher prevalence. FUNDING BMBWF Austria.
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Affiliation(s)
- Peter Willeit
- Clinical Epidemiology Team, Department of Neurology, Medical University of Innsbruck, Anichstraße 35, 6020 Innsbruck, Austria,Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK,Corresponding author at: Clinical Epidemiology Team, Department of Neurology, Medical University of Innsbruck, Anichstraße 35, 6020 Innsbruck, Austria.
| | - Robert Krause
- Section of Infectious Diseases and Tropical Medicine, Department of Internal Medicine, Medical University of Graz, Graz, Austria and BioTechMed-Graz, Graz, Austria
| | - Bernd Lamprecht
- Department of Pulmonology, Faculty of Medicine, Kepler-University-Hospital, Johannes Kepler University Linz, Linz, Austria
| | - Andrea Berghold
- Institute for Medical Informatics, Statistics and Documentation, Medical University of Graz, Graz, Austria
| | - Buck Hanson
- Centre for Microbiology and Environmental Systems Science, Department of Microbiology and Ecosystem Science, University of Vienna, Althanstrasse 14, 1090 Vienna, Austria,Vienna Covid-19 Detection Initiative, Vienna, Austria
| | - Evelyn Stelzl
- Diagnostic and Research Institute of Hygiene, Microbiology and Environmental Medicine, Medical University of Graz, Graz, Austria
| | - Heribert Stoiber
- Institute of Virology, Medical University Innsbruck, Innsbruck, Austria
| | - Johannes Zuber
- Vienna Covid-19 Detection Initiative, Vienna, Austria,IMP - Research Institute of Molecular Pathology, Vienna, Austria
| | - Robert Heinen
- Vienna Covid-19 Detection Initiative, Vienna, Austria,Gregor Mendel Institute of Molecular Plant Biology, Austrian Academy of Sciences, Vienna, Austria
| | - Alwin Köhler
- Vienna Covid-19 Detection Initiative, Vienna, Austria,Max Perutz Labs, University of Vienna, Vienna, Austria
| | - David Bernhard
- Center for Medical Research, Faculty of Medicine, Johannes Kepler University Linz, Linz, Austria,Division of Pathophysiology, Institute of Physiology and Pathophysiology, Johannes Kepler University Linz, Linz, Austria
| | - Wegene Borena
- Institute of Virology, Medical University Innsbruck, Innsbruck, Austria
| | - Christian Doppler
- Center for Medical Research, Faculty of Medicine, Johannes Kepler University Linz, Linz, Austria,Division of Pathophysiology, Institute of Physiology and Pathophysiology, Johannes Kepler University Linz, Linz, Austria
| | - Dorothee von Laer
- Institute of Virology, Medical University Innsbruck, Innsbruck, Austria
| | - Hannes Schmidt
- Centre for Microbiology and Environmental Systems Science, Department of Microbiology and Ecosystem Science, University of Vienna, Althanstrasse 14, 1090 Vienna, Austria,Vienna Covid-19 Detection Initiative, Vienna, Austria
| | - Johannes Pröll
- Center for Medical Research, Faculty of Medicine, Johannes Kepler University Linz, Linz, Austria
| | - Ivo Steinmetz
- Diagnostic and Research Institute of Hygiene, Microbiology and Environmental Medicine, Medical University of Graz, Graz, Austria
| | - Michael Wagner
- Centre for Microbiology and Environmental Systems Science, Department of Microbiology and Ecosystem Science, University of Vienna, Althanstrasse 14, 1090 Vienna, Austria,Vienna Covid-19 Detection Initiative, Vienna, Austria,Center for Microbial Communities, Department of Chemistry and Bioscience, Aalborg University, Aalborg, Denmark,Corresponding author at: Centre for Microbiology and Environmental Systems Science, Department of Microbiology and Ecosystem Science, University of Vienna, Althanstrasse 14, 1090 Vienna, Austria.
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22
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Guetl K, Moazedi-Fuerst F, Rosskopf K, Brodmann M, Krause R, Eller P, Wilhelmer P, Eisner F, Sareban N, Schlenke P, Kessler HH, Steinmetz I, Redlberger-Fritz M, Stiasny K, Stradner M. SARS-CoV-2 positive virus culture 7 weeks after onset of COVID-19 in an immunocompromised patient suffering from X chromosome-linked agammaglobulinemia. J Infect 2021; 82:414-451. [PMID: 33121954 PMCID: PMC7588793 DOI: 10.1016/j.jinf.2020.10.025] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2020] [Accepted: 10/24/2020] [Indexed: 12/20/2022]
Affiliation(s)
- Katharina Guetl
- Department of Internal Medicine, Medical University of Graz, Auenbruggerplatz 15, 8036 Graz, Austria
| | - Florentine Moazedi-Fuerst
- Division of Rheumatology and Immunology, Department of Internal Medicine, Medical University of Graz, Auenbruggerplatz 15, 8036 Graz, Austria.
| | - Konrad Rosskopf
- Department of Blood Group Serology and Transfusion Medicine, Hospital of the Federal State of Styria and University Hospital Graz, Auenbruggerplatz 48, 8036 Graz, Austria
| | - Marianne Brodmann
- Department of Internal Medicine, Medical University of Graz, Auenbruggerplatz 15, 8036 Graz, Austria
| | - Robert Krause
- Section of Infectious Diseases and Tropical Medicine, Department of Internal Medicine, Medical University of Graz, Auenbruggerplatz 15, 8036 Graz, Austria
| | - Philipp Eller
- Intensive Care Medicine Unit, Department of Internal Medicine, Medical University of Graz, Auenbruggerplatz 15, 8036 Graz, Austria
| | - Patricia Wilhelmer
- Department of Internal Medicine, Southwest State Hospital Graz, Goestingerstrasse 22, 8020 Graz, Austria
| | - Florian Eisner
- Intensive Care Medicine Unit, Department of Internal Medicine, Medical University of Graz, Auenbruggerplatz 15, 8036 Graz, Austria
| | - Nazanin Sareban
- Department of Blood Group Serology and Transfusion Medicine, Hospital of the Federal State of Styria and University Hospital Graz, Auenbruggerplatz 48, 8036 Graz, Austria
| | - Peter Schlenke
- Department of Blood Group Serology and Transfusion Medicine, Medical University of Graz, Auenbruggerplatz 48, 8036 Graz, Austria
| | - Harald H Kessler
- Diagnostic and Research Institute of Hygiene, Microbiology and Environmental Medicine, Medical University of Graz, Neue Stiftingtalstrasse 6, 8036 Graz, Austria
| | - Ivo Steinmetz
- Diagnostic and Research Institute of Hygiene, Microbiology and Environmental Medicine, Medical University of Graz, Neue Stiftingtalstrasse 6, 8036 Graz, Austria
| | - Monika Redlberger-Fritz
- Department of Virology, Medical University of Vienna, Kinderspitalgasse 15, 1090 Vienna, Austria
| | - Karin Stiasny
- Department of Virology, Medical University of Vienna, Kinderspitalgasse 15, 1090 Vienna, Austria
| | - Martin Stradner
- Division of Rheumatology and Immunology, Department of Internal Medicine, Medical University of Graz, Auenbruggerplatz 15, 8036 Graz, Austria
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Rupp J, Dreo B, Gütl K, Fessler J, Moser A, Haditsch B, Schilcher G, Matzkies LM, Steinmetz I, Greinix H, Stradner MH. T Cell Phenotyping in Individuals Hospitalized with COVID-19. J Immunol 2021; 206:1478-1482. [PMID: 33558375 DOI: 10.4049/jimmunol.2001034] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/09/2020] [Accepted: 01/12/2021] [Indexed: 01/03/2023]
Abstract
Coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection has become pandemic. Cytokine release syndrome occurring in a minority of SARS-CoV-2 infections is associated with severe disease and high mortality. We profiled the composition, activation, and proliferation of T cells in 20 patients with severe or critical COVID-19 and 40 matched healthy controls by flow cytometry. Unsupervised hierarchical cluster analysis based on 18 T cell subsets resulted in separation of healthy controls and COVID-19 patients. Compared to healthy controls, patients suffering from severe and critical COVID-19 had increased frequencies of activated and proliferating CD38+Ki67+ CD4+ and CD8+ T cells, suggesting active antiviral T cell defense. Frequencies of CD38+Ki67+ Th1 and CD4+ cells correlated negatively with plasma IL-6. Thus, our data suggest that patients suffering from COVID-19 have a distinct T cell composition that is potentially modulated by IL-6.
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Affiliation(s)
- Janine Rupp
- Division of Rheumatology and Immunology, Department of Internal Medicine, Medical University of Graz, 8036 Graz, Austria
| | - Barbara Dreo
- Division of Rheumatology and Immunology, Department of Internal Medicine, Medical University of Graz, 8036 Graz, Austria
| | - Katharina Gütl
- Division of Angiology, Department of Internal Medicine, Medical University of Graz, 8036 Graz, Austria
| | - Johannes Fessler
- Division of Rheumatology and Immunology, Department of Internal Medicine, Medical University of Graz, 8036 Graz, Austria
| | - Adrian Moser
- Österreichische Gesundheitskasse, Gesundheitszentrum Graz, 8010 Graz, Austria
| | - Bernd Haditsch
- Österreichische Gesundheitskasse, Gesundheitszentrum Graz, 8010 Graz, Austria
| | - Gernot Schilcher
- Intensive Care Unit, Department of Internal Medicine, Medical University of Graz, 8036 Graz, Austria
| | - Lucie-Marie Matzkies
- Diagnostic and Research Institute of Hygiene, Microbiology and Environmental Medicine, Medical University of Graz, 8036 Graz, Austria; and
| | - Ivo Steinmetz
- Diagnostic and Research Institute of Hygiene, Microbiology and Environmental Medicine, Medical University of Graz, 8036 Graz, Austria; and
| | - Hildegard Greinix
- Division of Hematology, Department of Internal Medicine, Medical University of Graz, 8036 Graz, Austria
| | - Martin H Stradner
- Division of Rheumatology and Immunology, Department of Internal Medicine, Medical University of Graz, 8036 Graz, Austria;
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24
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Tippenhauer CM, Steinmetz I, Heuwieser W, Fricke PM, Lauber MR, Cabrera EM, Borchardt S. Effect of dose and timing of prostaglandin F 2α treatments during a 7-d Ovsynch protocol on progesterone concentration at the end of the protocol and pregnancy outcomes in lactating Holstein cows. Theriogenology 2020; 162:49-58. [PMID: 33444916 DOI: 10.1016/j.theriogenology.2020.12.020] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2020] [Revised: 12/23/2020] [Accepted: 12/23/2020] [Indexed: 11/28/2022]
Abstract
The objective of this study was to evaluate the effect of two prostaglandin F2α (PGF) treatments 24 h apart (500 μg of cloprostenol) and treatment with a double PGF dose on d 7 (1000 μg of cloprostenol) during a 7-d Ovsynch protocol on progesterone (P4) concentration and pregnancy per artificial insemination (P/AI) in lactating Holstein cows. We hypothesized that treatment leads to a decreased P4 concentration at the second GnRH treatment (G2) and an increase in P/AI compared to the traditional 7-d Ovsynch protocol. A secondary hypothesis was that the treatment effect is influenced by the presence of a corpus luteum (CL) at the first GnRH treatment (G1). Two experiments were conducted on 8 commercial dairy farms in Germany. Once a week, cows from both experiments were assigned in a consecutive manner to receive: (1) Ovsynch (control: GnRH; 7 d, PGF; 9 d, GnRH), (2) Ovsynch with a double PGF dose (GDPG: GnRH; 7 d, 2xPGF; 9 d, GnRH), or (3) Ovsynch with a second PGF treatment 24 h later (GPPG: GnRH; 7 d, PGF; 8 d, PGF; 32 h, GnRH). All cows received timed AI (TAI) approximately 16 h after G2. Pregnancy diagnosis was performed by transrectal palpation (38 ± 3 d after TAI, experiment 1) or transrectal ultrasonography (35 ± 7 d after TAI, experiment 2). Whereas farms from experiment 1 used a Presynch-Ovsynch protocol (PGF, 14 d later PGF, 12 d later GnRH, 7 d later PGF, 2 d later GnRH, and 16-18 h later TAI) to facilitate first postpartum TAI, no presynchronization protocol was used on farms from experiment 2. In experiment 1, we enrolled 1581 lactating dairy cows (60 experimental units) from 2 dairy farms. At G2, blood samples were collected from a subsample of cows (n = 491; 16 experimental units) to determine P4 concentration at G2. In experiment 2, we enrolled 1979 lactating dairy cows (252 experimental units) from 6 dairy farms. Transrectal ultrasonography was performed to determine the presence or absence of a CL at G1. In experiment 1, treatment affected P/AI (P = 0.01) and P/AI was greater for GDPG (38.2%) and GPPG (38.9%) than for control cows (29.8%). Both, GDPG and GPPG cows had decreased P4 concentration at G2 compared with control cows (P < 0.01). Whereas both treatments increased the percentage of cows with very low P4 concentration (0.00-0.09 ng/mL) at G2, only the GPPG treatment decreased the percentage of cows with high P4 concentration (≥0.6 ng/mL) at G2 compared to the control group. In experiment 2, P/AI was greater for GPPG (37.4%) than for control cows (31.0%; P = 0.03) and tended to be greater than for GDPG cows (31.8%; P = 0.05). Cows from the GDPG group had similar (P = 0.77) P/AI compared to the control group. Pregnancy per AI did not differ between cows with a CL at G1 and cows without a CL at G1 (34.1% vs. 32.6%; P = 0.50). There was no interaction between treatment and presence of a CL at G1 on P/AI (P = 0.61). Combining data from the 2 experiments but excluding cows from experiment 1 receiving presynchronization before first TAI (n = 2573; 312 experimental units), P/AI was greater for GPPG (40.3%; P < 0.01) than for control (31.8%) and GDPG cows (33.4%). Between GDPG and control cows, P/AI did not differ (P = 0.46). We conclude that overall the addition of a second PGF treatment on d 8 during a 7-d Ovsynch protocol increased P/AI compared to the traditional 7-d Ovsynch including a single PGF dose on d 7 and to a double PGF dose on d 7. Doubling the PGF dose on d 7 in a 7-d Ovsynch protocol did not affect P/AI. Use of a presynchronization protocol, however, seems to influence the effect of a dose frequency modification of PGF treatment in an Ovsynch protocol. Presynchronized cows receiving first postpartum TAI had similarly increased P/AI treated with a double PGF dose compared with treatment with a second PGF dose. Future studies need to elucidate whether the treatment effect is modified by presynchronization of the first postpartum TAI.
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Affiliation(s)
- C M Tippenhauer
- Clinic for Animal Reproduction, Faculty of Veterinary Medicine, Freie Universitaet Berlin, Koenigsweg 65, 14163, Berlin, Germany
| | - I Steinmetz
- Clinic for Animal Reproduction, Faculty of Veterinary Medicine, Freie Universitaet Berlin, Koenigsweg 65, 14163, Berlin, Germany
| | - W Heuwieser
- Clinic for Animal Reproduction, Faculty of Veterinary Medicine, Freie Universitaet Berlin, Koenigsweg 65, 14163, Berlin, Germany
| | - P M Fricke
- Department of Dairy Science, University of Wisconsin, Madison, 53706, United States
| | - M R Lauber
- Department of Dairy Science, University of Wisconsin, Madison, 53706, United States
| | - E M Cabrera
- Department of Dairy Science, University of Wisconsin, Madison, 53706, United States
| | - S Borchardt
- Clinic for Animal Reproduction, Faculty of Veterinary Medicine, Freie Universitaet Berlin, Koenigsweg 65, 14163, Berlin, Germany.
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25
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Monecke S, König E, Earls MR, Leitner E, Müller E, Wagner GE, Poitz DM, Jatzwauk L, Vremerǎ T, Dorneanu OS, Simbeck A, Ambrosch A, Zollner-Schwetz I, Krause R, Ruppitsch W, Schneider-Brachert W, Coleman DC, Steinmetz I, Ehricht R. An epidemic CC1-MRSA-IV clone yields false-negative test results in molecular MRSA identification assays: a note of caution, Austria, Germany, Ireland, 2020. ACTA ACUST UNITED AC 2020; 25. [PMID: 32613938 PMCID: PMC7331142 DOI: 10.2807/1560-7917.es.2020.25.25.2000929] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
We investigated why a clinical meticillin-resistant Staphylococcus aureus (MRSA) isolate yielded false-negative results with some commercial PCR tests for MRSA detection. We found that an epidemic European CC1-MRSA-IV clone generally exhibits this behaviour. The failure of the assays was attributable to a large insertion in the orfX/SCCmec integration site. To ensure the reliability of molecular MRSA tests, it is vital to monitor emergence of new SCCmec types and junction sites.
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Affiliation(s)
- Stefan Monecke
- These authors contributed equally.,InfectoGnostics Research Campus Jena, Jena, Germany.,Institute for Medical Microbiology and Hygiene, Medical Faculty 'Carl Gustav Carus', Technische Universität Dresden, Dresden, Germany.,Leibniz Institute of Photonic Technology (IPHT), Jena, Germany
| | - Elisabeth König
- Diagnostic and Research Institute for Hygiene, Microbiology and Environmental Medicine, Medical University of Graz, Graz, Austria.,These authors contributed equally
| | - Megan R Earls
- Microbiology Research Unit, Division of Oral Biosciences, Dublin Dental University Hospital, Trinity College, University of Dublin, Dublin, Ireland.,These authors contributed equally
| | - Eva Leitner
- Diagnostic and Research Institute for Hygiene, Microbiology and Environmental Medicine, Medical University of Graz, Graz, Austria
| | - Elke Müller
- InfectoGnostics Research Campus Jena, Jena, Germany.,Leibniz Institute of Photonic Technology (IPHT), Jena, Germany
| | - Gabriel E Wagner
- Diagnostic and Research Institute for Hygiene, Microbiology and Environmental Medicine, Medical University of Graz, Graz, Austria
| | - David M Poitz
- Institute of Clinical Chemistry and Laboratory Medicine, University Hospital 'Carl Gustav Carus', Technische Universität Dresden, Dresden, Germany
| | - Lutz Jatzwauk
- Department of Hospital Infection Control, University Hospital 'Carl Gustav Carus', Technische Universität Dresden, Dresden, Germany
| | - Teodora Vremerǎ
- Microbiology Unit, Department of Preventive and Interdisciplinary Medicine, University of Medicine and Pharmacy 'Grigore T Popa', Iaşi, Romania
| | - Olivia S Dorneanu
- Microbiology Unit, Department of Preventive and Interdisciplinary Medicine, University of Medicine and Pharmacy 'Grigore T Popa', Iaşi, Romania
| | - Alexandra Simbeck
- Department of Infection Control and Infectious Diseases, University Hospital Regensburg, Regensburg, Germany
| | - Andreas Ambrosch
- Institute of Laboratory Medicine, Microbiology and Hygiene, Barmherzige Brüder Hospital, Regensburg, Germany
| | - Ines Zollner-Schwetz
- Section of Infectious Diseases and Tropical Medicine, Department of Internal Medicine, Medical University of Graz, Austria
| | - Robert Krause
- Section of Infectious Diseases and Tropical Medicine, Department of Internal Medicine, Medical University of Graz, Austria
| | - Werner Ruppitsch
- Institute of Medical Microbiology and Hygiene, Austrian Agency for Health and Food Safety, Vienna, Austria
| | - Wulf Schneider-Brachert
- Department of Infection Control and Infectious Diseases, University Hospital Regensburg, Regensburg, Germany
| | - David C Coleman
- Microbiology Research Unit, Division of Oral Biosciences, Dublin Dental University Hospital, Trinity College, University of Dublin, Dublin, Ireland
| | - Ivo Steinmetz
- Diagnostic and Research Institute for Hygiene, Microbiology and Environmental Medicine, Medical University of Graz, Graz, Austria
| | - Ralf Ehricht
- Friedrich- Schiller University; Institute of Physical Chemistry, Jena, Germany.,InfectoGnostics Research Campus Jena, Jena, Germany.,Leibniz Institute of Photonic Technology (IPHT), Jena, Germany
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26
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Lichtenegger S, Stiehler J, Saiger S, Zauner A, Kleinhappl B, Bernecker C, Schlenke P, Wagner GE, Krause K, Gastager M, Steinmetz I. Burkholderia pseudomallei triggers canonical inflammasome activation in a human primary macrophage-based infection model. PLoS Negl Trop Dis 2020; 14:e0008840. [PMID: 33137811 PMCID: PMC7605897 DOI: 10.1371/journal.pntd.0008840] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2020] [Accepted: 10/01/2020] [Indexed: 12/05/2022] Open
Abstract
Most of the current knowledge on Burkholderia pseudomallei-induced inflammasome activation and cell death in macrophages is derived from murine systems. Little is known about the involved bacterial structures and mechanisms in primary human macrophages. This is of particular relevance since murine and human macrophages as well as primary cells and cell lines differ in many aspects of inflammasome activation, including the proteins involved in the recognition of bacterial patterns. In this study, we therefore aimed (i) to establish an in vitro B. pseudomallei infection model with human monocyte-derived primary macrophages from single donors as these cells more closely resemble macrophages in the human host and (ii) to analyze B. pseudomallei-triggered cell death and bacterial elimination in those cells. Our results show that B. pseudomallei-infected primary human macrophages not only release the inflammasome-independent pro-inflammatory cytokines IL-8 and TNF-α, but are also engaged in canonical inflammasome activation as evidenced by caspase-1 and gasdermin D processing. Absence of the B. pseudomallei T3SS-3 needle protein BsaL, a potent activator of the canonical inflammasome, abolished lytic cell death, reduced IL-1β release, and caspase-1 and gasdermin D processing. IFN-γ, known to promote non-canonical inflammasome activation, did not influence pyroptosis induction or IL-1β release from infected primary human macrophages. Nevertheless, it reduced intracellular B. pseudomallei loads, an effect which was partially antagonist by the inhibition of NADPH oxidase. Overall, our data implicate T3SS-3 dependent inflammasome activation and IFN-γ induced immune mechanisms as critical defense mechanisms of human macrophages against B. pseudomallei. In addition, our infection model provides a versatile tool to study human host-pathogen interactions and has the potential to elucidate the role of human individual genetic variations in B. pseudomallei infections. Considering the constantly emerging antibiotic resistance of pathogens, comprehensive analyses of immune response mechanisms against infections are urgently needed to provide the basis for novel therapeutic strategies. Studies based on primary murine cells and cell lines of murine and human origin led to advances in the understanding of immune defense mechanisms against bacterial infections including B. pseudomallei. Nevertheless, results relying on these cell types are not always transferrable to primary human cells due to e.g. pathway alterations. We established and validated a macrophage-based model system derived from human peripheral blood monocytes, which yields high amounts of genetically identical cells more closely resembling cells found in the human host. This model system provides the basis for studying the pathogenesis of B. pseudomallei in primary human macrophages and for developing new human host directed therapies avoiding pitfalls from cell lines. Using our newly established model we demonstrate, that restriction of B. pseudomallei by primary human macrophages is mediated by T3SS-3 dependent canonical inflammasome activation and IFN-γ induced intracellular bacterial restriction.
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Affiliation(s)
- Sabine Lichtenegger
- Diagnostic & Research Institute of Hygiene, Microbiology and Environmental Medicine, Medical University of Graz, Graz, Austria
| | - Julia Stiehler
- Diagnostic & Research Institute of Hygiene, Microbiology and Environmental Medicine, Medical University of Graz, Graz, Austria
| | - Sabine Saiger
- Diagnostic & Research Institute of Hygiene, Microbiology and Environmental Medicine, Medical University of Graz, Graz, Austria
| | - Andrea Zauner
- Diagnostic & Research Institute of Hygiene, Microbiology and Environmental Medicine, Medical University of Graz, Graz, Austria
| | - Barbara Kleinhappl
- Diagnostic & Research Institute of Hygiene, Microbiology and Environmental Medicine, Medical University of Graz, Graz, Austria
| | - Claudia Bernecker
- Department of Blood Group Serology and Transfusion Medicine, Medical University of Graz, Graz, Austria
| | - Peter Schlenke
- Department of Blood Group Serology and Transfusion Medicine, Medical University of Graz, Graz, Austria
| | - Gabriel E. Wagner
- Diagnostic & Research Institute of Hygiene, Microbiology and Environmental Medicine, Medical University of Graz, Graz, Austria
| | - Kathrin Krause
- Friedrich Loeffler Institute of Medical Microbiology, University Medicine Greifswald, Greifswald, Germany, Current address: Max Planck Unit for the Science of Pathogens, Berlin, Germany
| | - Magdalena Gastager
- Diagnostic & Research Institute of Hygiene, Microbiology and Environmental Medicine, Medical University of Graz, Graz, Austria
| | - Ivo Steinmetz
- Diagnostic & Research Institute of Hygiene, Microbiology and Environmental Medicine, Medical University of Graz, Graz, Austria
- * E-mail:
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27
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Leitner E, Schreiner E, Neuhold M, Bozic M, Pux C, Pichler G, Schippinger W, Steinmetz I, Krause R, Zollner-Schwetz I. Low prevalence of Clostridium difficile colonization in patients in long-term care facilities in Graz, Austria: A point-prevalence study. Am J Infect Control 2020; 48:1144-1147. [PMID: 31917013 DOI: 10.1016/j.ajic.2019.12.011] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2019] [Revised: 12/10/2019] [Accepted: 12/10/2019] [Indexed: 12/16/2022]
Abstract
BACKGROUND We aimed to determine the prevalence of asymptomatic colonization by C. difficile in stool of residents in four long-term care facilities (LTCFs) in Graz, Austria and to identify factors associated with colonization. METHODS We conducted a point-prevalence study in March 2018. Stool samples were examined by GDH enzyme immunoassay and when positive a toxin A/B-enzyme immunoassay was carried out. Additionally, all samples were tested by toxin A and B PCR and were plated manually as well as in automated fashion onto selective C. difficile agar. RESULTS In 4/144 (2.8%) residents the GDH assay was positive. Each resident was colonized by a different C. difficile ribotype. C. difficile was not detected in any of the environmental samples. Significantly more colonized residents (60%) had stayed at a hospital in the 3 months previous to the study compared to 10% of non-colonized patients (p=0.01). CONCLUSIONS The prevalence of colonization by toxigenic C. difficile was 2.8% in patients in LTCFs in Graz, Austria.
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Wagner GE, Föderl-Höbenreich E, Assig K, Lipp M, Berner A, Kohler C, Lichtenegger S, Stiehler J, Karoonboonyanan W, Thanapattarapairoj N, Promkong C, Koosakulnirand S, Chaichana P, Ehricht R, Gad AM, Söffing HH, Dunachie SJ, Chantratita N, Steinmetz I. Melioidosis DS rapid test: A standardized serological dipstick assay with increased sensitivity and reliability due to multiplex detection. PLoS Negl Trop Dis 2020; 14:e0008452. [PMID: 32658917 PMCID: PMC7416965 DOI: 10.1371/journal.pntd.0008452] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2020] [Revised: 08/10/2020] [Accepted: 06/04/2020] [Indexed: 11/30/2022] Open
Abstract
Background Melioidosis, caused by Burkholderia pseudomallei, is a severe infectious disease with high mortality rates, but is under-recognized worldwide. In endemic areas, there is a great need for simple, low-cost and rapid diagnostic tools. In a previous study we showed, that a protein multiplex array with 20 B. pseudomallei-specific antigens detects antibodies in melioidosis patients with high sensitivity and specificity. In a subsequent study the high potential of anti-B. pseudomallei antibody detection was confirmed using a rapid Hcp1 single protein-based assay. Our protein array also showed that the antibody profile varies between patients, possibly due to a combination of host factors but also antigen variations in the infecting B. pseudomallei strains. The aim of this study was to develop a rapid test, combining Hcp1 and the best performing antigens BPSL2096, BPSL2697 and BPSS0477 from our previous study, to take advantage of simultaneous antibody detection. Methods and principal findings The 4-plex dipstick was validated with sera from 75 patients on admission plus control groups, achieving 92% sensitivity and 97–100% specificity. We then re-evaluated melioidosis sera with the 4-plex assay that were previously misclassified by the monoplex Hcp1 rapid test. 12 out of 55 (21.8%) false-negative samples were positive in our new dipstick assay. Among those, 4 sera (7.3%) were Hcp1 positive, whereas 8 (14.5%) sera remained Hcp1 negative but gave a positive reaction with our additional antigens. Conclusions Our dipstick rapid test represents an inexpensive, standardized and simple diagnostic tool with an improved serodiagnostic performance due to multiplex detection. Each additional band on the test strip makes a false-positive result more unlikely, contributing to its reliability. Future prospective studies will seek to validate the gain in sensitivity and specificity of our multiplex rapid test approach in different melioidosis patient cohorts. The Gram-negative environmental pathogen Burkholderia pseudomallei, causes the severe disease melioidosis. It is highly endemic in southeast Asia and northern Australia, but recent studies suggest that it is also present in many other parts of the world where it is severely underreported. The latter results from the extremely variable and non-specific clinical manifestations of the disease, lack of clinical recognition, and the global scarcity of good quality laboratories to allow diagnosis from microbiological culture. This is even more unfortunate, as early diagnosis of the disease is indispensable for an effective therapy, since B. pseudomallei is intrinsically resistant to many antibiotics used for empirical treatment in endemic areas. Therefore, the development of new, standardized and sensitive tools is of high importance for both diagnostics and epidemiology. We focused on the development of a dipstick assay, which is based on the detection of serum antibodies against four B. pseudomallei specific protein antigens. Here we present a cost effective, simple and rapid melioidosis assay with improved sensitivity that does not depend on sophisticated laboratory equipment and therefore addresses most of the before mentioned obstacles and is easy to manufacture in large scales.
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Affiliation(s)
- Gabriel E. Wagner
- Institute of Hygiene, Microbiology and Environmental Medicine, Medical University of Graz, Graz, Austria
| | - Esther Föderl-Höbenreich
- Institute of Hygiene, Microbiology and Environmental Medicine, Medical University of Graz, Graz, Austria
| | - Karoline Assig
- Institute of Hygiene, Microbiology and Environmental Medicine, Medical University of Graz, Graz, Austria
| | - Michaela Lipp
- Institute of Hygiene, Microbiology and Environmental Medicine, Medical University of Graz, Graz, Austria
| | - Andreas Berner
- Institute of Hygiene, Microbiology and Environmental Medicine, Medical University of Graz, Graz, Austria
| | - Christian Kohler
- Friedrich Loeffler Institute for Medical Microbiology, Greifswald, Germany
| | - Sabine Lichtenegger
- Institute of Hygiene, Microbiology and Environmental Medicine, Medical University of Graz, Graz, Austria
| | - Julia Stiehler
- Institute of Hygiene, Microbiology and Environmental Medicine, Medical University of Graz, Graz, Austria
| | | | | | - Chidchanok Promkong
- Department of Medical Laboratory, Nakhon Phanom Hospital, Nakhon Phanom, Thailand
| | - Sirikamon Koosakulnirand
- Department of Microbiology and Immunology, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
| | - Panjaporn Chaichana
- Mahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
| | - Ralf Ehricht
- Leibniz Institute of Photonic Technology (IPHT), Jena, Germany
- InfectoGnostics Research Campus, Jena, Germany
- Institute of Physical Chemistry, Friedrich Schiller University Jena, Jena, Germany
| | - Anne-Marie Gad
- Senova Gesellschaft für Biowissenschaft und Technik mbH, Weimar, Germany
| | - Hans H. Söffing
- Senova Gesellschaft für Biowissenschaft und Technik mbH, Weimar, Germany
| | - Susanna J. Dunachie
- Mahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
- Centre for Tropical Medicine and Global Health, University of Oxford, Oxford, United Kingdom
| | - Narisara Chantratita
- Department of Microbiology and Immunology, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
- Mahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
| | - Ivo Steinmetz
- Institute of Hygiene, Microbiology and Environmental Medicine, Medical University of Graz, Graz, Austria
- * E-mail:
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29
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Matzkies LM, Leitner E, Stelzl E, Assig K, Bozic M, Siebenhofer D, Mustafa ME, Steinmetz I, Kessler HH. Lack of sensitivity of an IVD/CE-labelled kit targeting the S gene for detection of SARS-CoV-2. Clin Microbiol Infect 2020; 26:1417.e1-1417.e4. [PMID: 32652240 PMCID: PMC7345380 DOI: 10.1016/j.cmi.2020.06.036] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2020] [Revised: 06/29/2020] [Accepted: 06/30/2020] [Indexed: 01/18/2023]
Abstract
OBJECTIVES New molecular tests for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) are being rapidly launched in response to the coronavirus disease 2019 (COVID-19) pandemic. The aim of this study was to evaluate the analytical and clinical performance of the VIASURE SARS-CoV-2 S gene RT-PCR Kit on the BD Max™ system and to compare results with those obtained with the cobas® SARS-CoV-2 test on the cobas® 6800 system. METHODS For testing the analytical performance, reference material was used. Clinical samples (n = 101) obtained from individuals with symptoms compatible with COVID-19 were studied. Oropharyngeal and nasopharyngeal swabs were collected by using either ESwab™ or UTM™ collection systems. RESULTS When the analytical performance was evaluated, the sample containing the lowest SARS-CoV-2 concentration tested negative with the VIASURE test whereas results obtained with the cobas® test were found to be concordant with the results expected. Six out of the 101 clinical samples (5.9%) showed an inhibition with the VIASURE test. When analysing the remaining 95 clinical samples, 27 were found to be negative with both assays. Of 68 samples that were positive with the cobas® test, the VIASURE test missed 21 (30.9 %) samples. All of those 21 samples had shown Ct values ≥ 31 with the cobas® 6800 system. None of the samples tested positive with the VIASURE test and negative with the cobas® test. CONCLUSIONS The VIASURE test was impaired by a lack of sensitivity and a relatively high number of invalid results. When using the VIASURE test for routine testing, a significant number of COVID-19-positive samples would have been missed.
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Affiliation(s)
- L-M Matzkies
- Diagnostic & Research Institute of Hygiene, Microbiology and Environmental Medicine, Medical University of Graz, Graz, Austria
| | - E Leitner
- Diagnostic & Research Institute of Hygiene, Microbiology and Environmental Medicine, Medical University of Graz, Graz, Austria
| | - E Stelzl
- Diagnostic & Research Institute of Hygiene, Microbiology and Environmental Medicine, Medical University of Graz, Graz, Austria
| | - K Assig
- Diagnostic & Research Institute of Hygiene, Microbiology and Environmental Medicine, Medical University of Graz, Graz, Austria
| | - M Bozic
- Diagnostic & Research Institute of Hygiene, Microbiology and Environmental Medicine, Medical University of Graz, Graz, Austria
| | - D Siebenhofer
- Diagnostic & Research Institute of Hygiene, Microbiology and Environmental Medicine, Medical University of Graz, Graz, Austria
| | - M E Mustafa
- Medical-chemical laboratory Dr Mustafa, Dr Richter OG, Salzburg, Austria
| | - I Steinmetz
- Diagnostic & Research Institute of Hygiene, Microbiology and Environmental Medicine, Medical University of Graz, Graz, Austria.
| | - H H Kessler
- Diagnostic & Research Institute of Hygiene, Microbiology and Environmental Medicine, Medical University of Graz, Graz, Austria
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Normann N, Tietz G, Kühn A, Fuchs C, Balau V, Schulz K, Kolata J, Schuerholz T, Petersmann A, Stentzel S, Steil L, Kuhn SO, Meissner K, Völker U, Nauck M, Steinmetz I, Raafat D, Gründling M, Bröker BM. Pathogen-specific antibody profiles in patients with severe systemic infections. Eur Cell Mater 2020; 39:171-182. [PMID: 32301500 DOI: 10.22203/ecm.v039a11] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023] Open
Abstract
Infections are often caused by pathobionts, endogenous bacteria that belong to the microbiota. Trauma and surgical intervention can allow bacteria to overcome host defences, ultimately leading to sepsis if left untreated. One of the main defence strategies of the immune system is the production of highly specific antibodies. In the present proof-of-concept study, plasma antibodies against 9 major pathogens were measured in sepsis patients, as an example of severe systemic infections. The binding of plasma antibodies to bacterial extracellular proteins was quantified using a semi-automated immunoblot assay. Comparison of the pathogen-specific antibody levels before and after infection showed an increase in plasma IgG in 20 out of 37 tested patients. This host-directed approach extended the results of pathogen-oriented microbiological and PCR diagnostics: a specific antibody response to additional bacteria was frequently observed, indicating unrecognised poly-microbial invasion. This might explain some cases of failed, seemingly targeted antibiotic treatment.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - B M Bröker
- Department of Immunology, University Medicine Greifswald, Greifswald,
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31
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Hajek E, Krebs F, Bent R, Haas K, Bast A, Steinmetz I, Tuettenberg A, Grabbe S, Bros M. BRAF inhibitors stimulate inflammasome activation and interleukin 1 beta production in dendritic cells. Oncotarget 2018; 9:28294-28308. [PMID: 29983861 PMCID: PMC6033361 DOI: 10.18632/oncotarget.25511] [Citation(s) in RCA: 33] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2017] [Accepted: 05/13/2018] [Indexed: 12/21/2022] Open
Abstract
Melanoma is the most dangerous form of skin cancer with a growing incidence over the last decades. Fourty percent of all melanomas harbor a mutation in the signaling adaptor BRAF (V600E) that results in ERK hyperactivity as an oncogenic driver. In these cases, treatment with the BRAFV600E inhibitors Vemurafenib (VEM) or Dabrafenib (DAB) coapplied with the MEK1/2 inhibitors Cobimetinib (COB) or Trametinib (TRA) can result in long-term suppression of tumor growth. Besides direct suppression of ERK activity, these inhibitors have been reported to also modulate tumor immune responses, and exert pro-inflammatory side effects such as fever and rash in some patients. Here we asked for potential effects of BRAFV600E inhibitors on dendritic cells (DC) which are essential for the induction of adaptive anti-tumor responses. Both splenic and bone marrow-derived (BM) mouse dendritic cells (DC) up-regulated costimulator expression (CD80, CD86) in response to DAB but not VEM treatment. Moreover, DAB and to lesser extent VEM enhanced IL-1β (interleukin 1 beta) release by splenic DC, and by LPS-stimulated BMDC. We demonstrate that DAB and VEM activated the NLRC4/Caspase-1 inflammasome. At high concentration, DAB also induced inflammasome activation independent of Caspase-1. TRA and COB elevated MHCII expression on BMDC, and modulated the LPS-induced cytokine pattern. Immunomodulatory activity of DAB and VEM was also observed in human monocyte-derived DC, and DAB induced IL-1β in human primary DC. Altogether, our study shows that BRAFV600E inhibitors upregulate IL-1β release by mouse and human DC which may affect the DC-mediated course of anti-tumor immune responses.
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Affiliation(s)
- Eva Hajek
- Department of Dermatology, University Medical Center of the Johannes Gutenberg University, Mainz, Germany
| | - Franziska Krebs
- Department of Dermatology, University Medical Center of the Johannes Gutenberg University, Mainz, Germany
| | - Rebekka Bent
- Department of Dermatology, University Medical Center of the Johannes Gutenberg University, Mainz, Germany
| | - Katharina Haas
- Department of Dermatology, University Medical Center of the Johannes Gutenberg University, Mainz, Germany
| | - Antje Bast
- Friedrich Loeffler Institute of Medical Microbiology, University Medicine Greifswald, Greifswald, Germany
| | - Ivo Steinmetz
- Friedrich Loeffler Institute of Medical Microbiology, University Medicine Greifswald, Greifswald, Germany
| | - Andrea Tuettenberg
- Department of Dermatology, University Medical Center of the Johannes Gutenberg University, Mainz, Germany
| | - Stephan Grabbe
- Department of Dermatology, University Medical Center of the Johannes Gutenberg University, Mainz, Germany
| | - Matthias Bros
- Department of Dermatology, University Medical Center of the Johannes Gutenberg University, Mainz, Germany
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32
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Steinmetz I, Wagner GE, Kanyala E, Sawadogo M, Soumeya H, Teferi M, Andargie E, Yeshitela B, Yaba Atsé-Achi L, Sanogo M, Bonfoh B, Rakotozandrindrainy R, Pongombo Shongo C, Shongoya Pongombo M, Kasamba Ilunga E, Lichtenegger S, Assig K, May J, Bertherat E, Owusu M, Owusu-Dabo E, Adu-Sarkodie Y. Melioidosis in Africa: Time to Uncover the True Disease Load. Trop Med Infect Dis 2018; 3:E62. [PMID: 30274458 PMCID: PMC6073667 DOI: 10.3390/tropicalmed3020062] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2018] [Revised: 05/31/2018] [Accepted: 06/01/2018] [Indexed: 02/05/2023] Open
Abstract
Melioidosis is an often fatal infectious disease with a protean clinical spectrum, caused by the environmental bacterial pathogen Burkholderia pseudomallei. Although the disease has been reported from some African countries in the past, the present epidemiology of melioidosis in Africa is almost entirely unknown. Therefore, the common view that melioidosis is rare in Africa is not evidence-based. A recent study concludes that large parts of Africa are environmentally suitable for B. pseudomallei. Twenty-four African countries and three countries in the Middle East were predicted to be endemic, but no cases of melioidosis have been reported yet. In this study, we summarize the present fragmentary knowledge on human and animal melioidosis and environmental B. pseudomallei in Africa and the Middle East. We propose that systematic serological studies in man and animals together with environmental investigations on potential B. pseudomallei habitats are needed to identify risk areas for melioidosis. This information can subsequently be used to target raising clinical awareness and the implementation of simple laboratory algorithms for the isolation of B. pseudomallei from clinical specimens. B. pseudomallei was most likely transferred from Asia to the Americas via Africa, which is shown by phylogenetic analyses. More data on the virulence and genomic characteristics of African B. pseudomallei isolates will contribute to a better understanding of the global evolution of the pathogen and will also help to assess potential differences in disease prevalence and outcome.
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Affiliation(s)
- Ivo Steinmetz
- Institute of Hygiene, Microbiology and Environmental Medicine, Medical University of Graz, 8036 Graz, Austria.
- Friedrich Loeffler Institute of Medical Microbiology, University Medicine of Greifswald, KöR, 17475 Greifswald, Germany.
| | - Gabriel E Wagner
- Institute of Hygiene, Microbiology and Environmental Medicine, Medical University of Graz, 8036 Graz, Austria.
| | - Estelle Kanyala
- Departement UFR/Science de la Santé, Université d'Ouagadougou, BP 7021, Ouagadougou, Burkina Faso.
| | - Mamadou Sawadogo
- Departement UFR/Science de la Santé, Université d'Ouagadougou, BP 7021, Ouagadougou, Burkina Faso.
| | - Hema Soumeya
- Centre Muraz, 01 BP 390 Bobo Dioulasso, Burkina Faso.
| | - Mekonnen Teferi
- Armauer Hansen Research Institute, Jimma Road, ALERT Compound, P.O. Box 1005 Addis Ababa, Ethiopia.
| | - Emawayish Andargie
- Armauer Hansen Research Institute, Jimma Road, ALERT Compound, P.O. Box 1005 Addis Ababa, Ethiopia.
| | - Biruk Yeshitela
- Armauer Hansen Research Institute, Jimma Road, ALERT Compound, P.O. Box 1005 Addis Ababa, Ethiopia.
| | - Louise Yaba Atsé-Achi
- Laboratoire Central Vétérinaire de Bingerville, LANADA, P.O. Box 206 Bingerville, Cote D'Ivoire.
- Centre Suisse de Recherches Scientifiques en Côte d'Ivoire (CSRS), 01 BP 1303 Abidjan, Cote D'Ivoire.
| | - Moussa Sanogo
- Laboratoire Central Vétérinaire de Bingerville, LANADA, P.O. Box 206 Bingerville, Cote D'Ivoire.
| | - Bassirou Bonfoh
- Centre Suisse de Recherches Scientifiques en Côte d'Ivoire (CSRS), 01 BP 1303 Abidjan, Cote D'Ivoire.
| | | | - Célestin Pongombo Shongo
- Democratic Republic of the Congo, Université de Lubumbashi, 1825 Lubumbashi, Republic of the Congo.
| | - Mick Shongoya Pongombo
- Democratic Republic of the Congo, Université de Lubumbashi, 1825 Lubumbashi, Republic of the Congo.
| | - Eric Kasamba Ilunga
- Democratic Republic of the Congo, Université de Lubumbashi, 1825 Lubumbashi, Republic of the Congo.
| | - Sabine Lichtenegger
- Institute of Hygiene, Microbiology and Environmental Medicine, Medical University of Graz, 8036 Graz, Austria.
| | - Karoline Assig
- Institute of Hygiene, Microbiology and Environmental Medicine, Medical University of Graz, 8036 Graz, Austria.
- Friedrich Loeffler Institute of Medical Microbiology, University Medicine of Greifswald, KöR, 17475 Greifswald, Germany.
| | - Jürgen May
- Bernhard Nocht Institute for Tropical Medicine, 20359 Hamburg, Germany.
| | - Eric Bertherat
- Department of Infectious Hazard Management, World Health Organization, Geneva 27, Switzerland.
| | - Michael Owusu
- College of Health Sciences, Kwame Nkrumah University of Science and Technology, 00233 Kumasi, Ghana.
| | - Ellis Owusu-Dabo
- College of Health Sciences, Kwame Nkrumah University of Science and Technology, 00233 Kumasi, Ghana.
- Kumasi Centre for Collaborative Research, 00233 Kumasi, Ghana.
| | - Yaw Adu-Sarkodie
- College of Health Sciences, Kwame Nkrumah University of Science and Technology, 00233 Kumasi, Ghana.
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33
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Duong LT, Schwarz S, Gross H, Breitbach K, Hochgräfe F, Mostertz J, Eske-Pogodda K, Wagner GE, Steinmetz I, Kohler C. GvmR - A Novel LysR-Type Transcriptional Regulator Involved in Virulence and Primary and Secondary Metabolism of Burkholderia pseudomallei. Front Microbiol 2018; 9:935. [PMID: 29867844 PMCID: PMC5964159 DOI: 10.3389/fmicb.2018.00935] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2018] [Accepted: 04/23/2018] [Indexed: 01/22/2023] Open
Abstract
Burkholderia pseudomallei is a soil-dwelling bacterium able to survive not only under adverse environmental conditions, but also within various hosts which can lead to the disease melioidosis. The capability of B. pseudomallei to adapt to environmental changes is facilitated by the large number of regulatory proteins encoded by its genome. Among them are more than 60 uncharacterized LysR-type transcriptional regulators (LTTRs). Here we analyzed a B. pseudomallei mutant harboring a transposon in the gene BPSL0117 annotated as a LTTR, which we named gvmR (globally acting virulence and metabolism regulator). The gvmR mutant displayed a growth defect in minimal medium and macrophages in comparison with the wild type. Moreover, disruption of gvmR rendered B. pseudomallei avirulent in mice indicating a critical role of GvmR in infection. These defects of the mutant were rescued by ectopic expression of gvmR. To identify genes whose expression is modulated by GvmR, global transcriptome analysis of the B. pseudomallei wild type and gvmR mutant was performed using whole genome tiling microarrays. Transcript levels of 190 genes were upregulated and 141 genes were downregulated in the gvmR mutant relative to the wild type. Among the most downregulated genes in the gvmR mutant were important virulence factor genes (T3SS3, T6SS1, and T6SS2), which could explain the virulence defect of the gvmR mutant. In addition, expression of genes related to amino acid synthesis, glyoxylate shunt, iron-sulfur cluster assembly, and syrbactin metabolism (secondary metabolite) was decreased in the mutant. On the other hand, inactivation of GvmR increased expression of genes involved in pyruvate metabolism, ATP synthesis, malleobactin, and porin genes. Quantitative real-time PCR verified the differential expression of 27 selected genes. In summary, our data show that GvmR acts as an activating and repressing global regulator that is required to coordinate expression of a diverse set of metabolic and virulence genes essential for the survival in the animal host and under nutrient limitation.
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Affiliation(s)
- Linh Tuan Duong
- Friedrich Loeffler Institute of Medical Microbiology, University Medicine Greifswald, Greifswald, Germany
| | - Sandra Schwarz
- Interfaculty Institute of Microbiology and Infection Medicine Tübingen, University of Tübingen, Tübingen, Germany
| | - Harald Gross
- Department of Pharmaceutical Biology, Pharmaceutical Institute, Eberhard Karls University of Tübingen, Tübingen, Germany.,German Centre for Infection Research, Partner Site Tübingen, Tübingen, Germany
| | - Katrin Breitbach
- Friedrich Loeffler Institute of Medical Microbiology, University Medicine Greifswald, Greifswald, Germany
| | - Falko Hochgräfe
- Competence Center Functional Genomics, Junior Research Group Pathoproteomics, University of Greifswald, Greifswald, Germany
| | - Jörg Mostertz
- Competence Center Functional Genomics, Junior Research Group Pathoproteomics, University of Greifswald, Greifswald, Germany
| | - Kristin Eske-Pogodda
- Friedrich Loeffler Institute of Medical Microbiology, University Medicine Greifswald, Greifswald, Germany
| | - Gabriel E Wagner
- Institute of Hygiene, Microbiology and Environmental Medicine, Medical University of Graz, Graz, Austria
| | - Ivo Steinmetz
- Friedrich Loeffler Institute of Medical Microbiology, University Medicine Greifswald, Greifswald, Germany.,Institute of Hygiene, Microbiology and Environmental Medicine, Medical University of Graz, Graz, Austria
| | - Christian Kohler
- Friedrich Loeffler Institute of Medical Microbiology, University Medicine Greifswald, Greifswald, Germany
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34
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Trinh TT, Nguyen LDN, Nguyen TV, Tran CX, Le AV, Nguyen HV, Assig K, Lichtenegger S, Wagner GE, Do CD, Steinmetz I. Melioidosis in Vietnam: Recently Improved Recognition but still an Uncertain Disease Burden after Almost a Century of Reporting. Trop Med Infect Dis 2018; 3:E39. [PMID: 30274435 PMCID: PMC6073866 DOI: 10.3390/tropicalmed3020039] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2018] [Revised: 03/29/2018] [Accepted: 03/30/2018] [Indexed: 01/09/2023] Open
Abstract
The first cases of human melioidosis were described in Vietnam in the 1920s, almost a century ago. It was in Vietnam in the thirties that the saprophytic nature of B. pseudomallei was first recognized. Although a significant number of French and U.S. soldiers acquired the disease during the Vietnam wars, indigenous cases in the Vietnamese population were only sporadically reported over many decades. After reunification in 1975, only two retrospective studies reported relatively small numbers of indigenous cases from single tertiary care hospitals located in the biggest cities in the South and the North, respectively. Studies from provincial hospitals throughout the country were missing until the Research Network on Melioidosis and Burkholderia pseudomallei (RENOMAB) project started in 2014. From then on seminars, workshops, and national scientific conferences on melioidosis have been conducted to raise awareness among physicians and clinical laboratory staff. This led to the recognition of a significant number of cases in at least 36 hospitals in 26 provinces and cities throughout Vietnam. Although a widespread distribution of melioidosis has now been documented, there are still challenges to understand the true epidemiology of the disease. Establishment of national guidelines for diagnosis, management, and reporting of the disease together with more investigations on animal melioidosis, genomic diversity of B. pseudomallei and its environmental distribution are required.
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Affiliation(s)
- Trung T Trinh
- Institute of Microbiology and Biotechnology, Vietnam National University, Hanoi 100000, Vietnam.
| | - Linh D N Nguyen
- Department of Academic Affairs, Phan Chau Trinh University, Quang Nam 560000, Vietnam.
| | - Trung V Nguyen
- Department of Medical Microbiology, Hanoi Medical University, Hanoi 100000, Vietnam.
- National Hospital for Tropical Diseases, Hanoi 100000, Vietnam.
| | - Chuong X Tran
- Department of Infectious Diseases, Hue University of Medicine and Pharmacy, Hue 530000, Vietnam.
| | - An V Le
- Department of Medical Microbiology, Hue University of Medicine and Pharmacy, Hue 530000, Vietnam.
| | - Hao V Nguyen
- Department of Infectious Diseases, University of Medicine and Pharmacy, Ho Chi Minh 700000, Vietnam.
- Hospital for Tropical Diseases, Ho Chi Minh 700000, Vietnam.
| | - Karoline Assig
- Institute of Hygiene, Microbiology and Environmental Medicine, Medical University of Graz, 8010 Graz, Austria.
| | - Sabine Lichtenegger
- Institute of Hygiene, Microbiology and Environmental Medicine, Medical University of Graz, 8010 Graz, Austria.
| | - Gabriel E Wagner
- Institute of Hygiene, Microbiology and Environmental Medicine, Medical University of Graz, 8010 Graz, Austria.
| | - Cuong D Do
- Department of Infectious Diseases, Bach Mai Hospital, Hanoi 100000, Vietnam.
| | - Ivo Steinmetz
- Institute of Hygiene, Microbiology and Environmental Medicine, Medical University of Graz, 8010 Graz, Austria.
- Friedrich Loeffler Institute of Medical Microbiology, University Medicine Greifswald, 17475 Greifswald, Germany.
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Schmidt IHE, Gildhorn C, Böning MAL, Kulow VA, Steinmetz I, Bast A. Burkholderia pseudomallei modulates host iron homeostasis to facilitate iron availability and intracellular survival. PLoS Negl Trop Dis 2018; 12:e0006096. [PMID: 29329289 PMCID: PMC5785036 DOI: 10.1371/journal.pntd.0006096] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2017] [Revised: 01/25/2018] [Accepted: 11/04/2017] [Indexed: 02/07/2023] Open
Abstract
Background The control over iron homeostasis is critical in host-pathogen-interaction. Iron plays not only multiple roles for bacterial growth and pathogenicity, but also for modulation of innate immune responses. Hepcidin is a key regulator of host iron metabolism triggering degradation of the iron exporter ferroportin. Although iron overload in humans is known to increase susceptibility to Burkholderia pseudomallei, it is unclear how the pathogen competes with the host for the metal during infection. This study aimed to investigate whether B. pseudomallei, the causative agent of melioidosis, modulates iron balance and how regulation of host cell iron content affects intracellular bacterial proliferation. Principal findings Upon infection of primary macrophages with B. pseudomallei, expression of ferroportin was downregulated resulting in higher iron availability within macrophages. Exogenous modification of iron export function by hepcidin or iron supplementation by ferric ammonium citrate led to increased intracellular iron pool stimulating B. pseudomallei growth, whereas the iron chelator deferoxamine reduced bacterial survival. Iron-loaded macrophages exhibited a lower expression of NADPH oxidase, iNOS, lipocalin 2, cytokines and activation of caspase-1. Infection of mice with the pathogen caused a diminished hepatic ferroportin expression, higher iron retention in the liver and lower iron levels in the serum (hypoferremia). In vivo administration of ferric ammonium citrate tended to promote the bacterial growth and inflammatory response, whereas limitation of iron availability significantly ameliorated bacterial clearance, attenuated serum cytokine levels and improved survival of infected mice. Conclusions Our data indicate that modulation of the cellular iron balance is likely to be a strategy of B. pseudomallei to improve iron acquisition and to restrict antibacterial immune effector mechanisms and thereby to promote its intracellular growth. Moreover, we provide evidence that changes in host iron homeostasis can influence susceptibility to melioidosis, and suggest that iron chelating drugs might be an additional therapeutic option. Iron is an essential nutrient for many bacterial pathogens. A sufficient availability is linked to bacterial proliferation and pathogenicity. The host requires iron for cellular functions including innate immune defense mechanisms. Consequently, the control over iron homeostasis plays an important role in the course of infection. Burkholderia pseudomallei is an environmental bacterium ubiquitous in soil and water surfaces causing the disease melioidosis with a wide range of signs and symptoms including localized, pulmonary, or bloodstream infections. Conditions with increased iron stores, such as thalassemia, are considered to increase the risk to acquire melioidosis. Here we show that infection with the pathogen triggers downregulation of the major cellular iron exporter inducing intracellular iron retention and stimulation of bacterial proliferation. Experimental iron overload appears to predispose to infection with B. pseudomallei, whereas iron deficiency confers relative resistance to melioidosis. These effects of changed iron metabolism on the course of infection may be ascribed to modifications in the host immune response and direct effects on bacterial growth, respectively. Thus, the B. pseudomallei-driven alteration of cellular iron traffic leading to increased iron availability can promote its intracellular growth, and treatment with iron chelators together with antibiotics might be an appropriate strategy to control infection.
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Affiliation(s)
- Imke H. E. Schmidt
- Friedrich Loeffler Institute of Medical Microbiology, University Medicine Greifswald, Greifswald, Germany
| | - Claudia Gildhorn
- Friedrich Loeffler Institute of Medical Microbiology, University Medicine Greifswald, Greifswald, Germany
| | - Martha A. L. Böning
- Friedrich Loeffler Institute of Medical Microbiology, University Medicine Greifswald, Greifswald, Germany
| | - Vera A. Kulow
- Friedrich Loeffler Institute of Medical Microbiology, University Medicine Greifswald, Greifswald, Germany
| | - Ivo Steinmetz
- Friedrich Loeffler Institute of Medical Microbiology, University Medicine Greifswald, Greifswald, Germany
- Institute of Hygiene, Microbiology and Environmental Medicine, Medical University of Graz, Graz, Austria
- * E-mail:
| | - Antje Bast
- Friedrich Loeffler Institute of Medical Microbiology, University Medicine Greifswald, Greifswald, Germany
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Trinh TT, Hoang TS, Tran DA, Trinh VT, Göhler A, Nguyen TT, Hoang SN, Krumkamp R, Nguyen LTN, May J, Doan PM, Do CD, Que TA, Steinmetz I. A simple laboratory algorithm for diagnosis of melioidosis in resource-constrained areas: a study from north-central Vietnam. Clin Microbiol Infect 2017; 24:84.e1-84.e4. [PMID: 28780059 DOI: 10.1016/j.cmi.2017.07.029] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2017] [Revised: 06/26/2017] [Accepted: 07/26/2017] [Indexed: 01/25/2023]
Abstract
OBJECTIVES Melioidosis may be endemic in many tropical developing countries, but diagnosis of the disease is currently unreliable in resource-limited areas. We aimed to validate a simple and cheap laboratory algorithm for the identification of Burkholderia pseudomallei from clinical specimens in parts of Vietnam where the disease has not previously been reported. METHODS In June 2015, we conducted training courses at five general hospitals in north-central provinces in order to raise awareness of the disease and to introduce a simple and cheap laboratory identification algorithm for B. pseudomallei including the three-antibiotic disc test. RESULTS Until the end of the year (7 months later), 94 suspected B. pseudomallei strains resistant to gentamicin and colistin but sensitive to amoxicillin/clavulanic acid were detected in clinical specimens from 70 patients. All strains were further confirmed as B. pseudomallei by using a specific TTSS1 real-time PCR assay and recA sequencing analysis. Among positive blood cultures, positive rates with B. pseudomallei ranged from 3.4% (5/147) to 10.2% (32/312) in the various clinics. A total of 82.8% (58/70) patients were bacteraemic, with a mortality of 50% (18/36) among patients with known outcome. No death occurred in nonbacteraemic patients. CONCLUSIONS Our results demonstrate that the introduction of a simple and easy-to-perform laboratory algorithm for the identification of B. pseudomallei from clinical samples, together with clinical awareness raising, can lead to the diagnosis of a significant number of melioidosis cases in resource-limited clinical laboratories which previously did not identify the pathogen.
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Affiliation(s)
- T T Trinh
- Institute of Microbiology and Biotechnology, Vietnam National University, Hanoi, Viet Nam.
| | - T S Hoang
- Institute of Microbiology and Biotechnology, Vietnam National University, Hanoi, Viet Nam
| | - D A Tran
- General Hospital of Nghe An Province, Viet Nam
| | - V T Trinh
- General Hospital of Ha Tinh Province, Viet Nam
| | - A Göhler
- Friedrich Loeffler Institute for Medical Microbiology, Greifswald, Germany
| | - T T Nguyen
- General Hospital of Quang Binh Province, Viet Nam
| | - S N Hoang
- General Hospital of Quang Tri Province, Viet Nam
| | - R Krumkamp
- Bernhard Nocht Institute for Tropical Medicine, Hamburg, Germany; German Centre for Infection Research (DZIF), Hamburg-Borstel-Lübeck, Germany
| | | | - J May
- Bernhard Nocht Institute for Tropical Medicine, Hamburg, Germany; German Centre for Infection Research (DZIF), Hamburg-Borstel-Lübeck, Germany
| | - P M Doan
- Bach Mai Hospital, Hanoi, Viet Nam
| | - C D Do
- Bach Mai Hospital, Hanoi, Viet Nam
| | - T A Que
- General Hospital of Nghe An Province, Viet Nam
| | - I Steinmetz
- Friedrich Loeffler Institute for Medical Microbiology, Greifswald, Germany; Institute of Hygiene, Microbiology and Environmental Medicine, Medical University of Graz, Graz, Austria
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Borlee GI, Plumley BA, Martin KH, Somprasong N, Mangalea MR, Islam MN, Burtnick MN, Brett PJ, Steinmetz I, AuCoin DP, Belisle JT, Crick DC, Schweizer HP, Borlee BR. Genome-scale analysis of the genes that contribute to Burkholderia pseudomallei biofilm formation identifies a crucial exopolysaccharide biosynthesis gene cluster. PLoS Negl Trop Dis 2017; 11:e0005689. [PMID: 28658258 PMCID: PMC5507470 DOI: 10.1371/journal.pntd.0005689] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2017] [Revised: 07/11/2017] [Accepted: 06/08/2017] [Indexed: 11/19/2022] Open
Abstract
Burkholderia pseudomallei, the causative agent of melioidosis, is an important public health threat due to limited therapeutic options for treatment. Efforts to improve therapeutics for B. pseudomallei infections are dependent on the need to understand the role of B. pseudomallei biofilm formation and its contribution to antibiotic tolerance and persistence as these are bacterial traits that prevent effective therapy. In order to reveal the genes that regulate and/or contribute to B. pseudomallei 1026b biofilm formation, we screened a sequence defined two-allele transposon library and identified 118 transposon insertion mutants that were deficient in biofilm formation. These mutants include transposon insertions in genes predicted to encode flagella, fimbriae, transcriptional regulators, polysaccharides, and hypothetical proteins. Polysaccharides are key constituents of biofilms and B. pseudomallei has the capacity to produce a diversity of polysaccharides, thus there is a critical need to link these biosynthetic genes with the polysaccharides they produce to better understand their biological role during infection. An allelic exchange deletion mutant of the entire B. pseudomallei biofilm-associated exopolysaccharide biosynthetic cluster was decreased in biofilm formation and produced a smooth colony morphology suggestive of the loss of exopolysaccharide production. Conversely, deletion of the previously defined capsule I polysaccharide biosynthesis gene cluster increased biofilm formation. Bioinformatics analyses combined with immunoblot analysis and glycosyl composition studies of the partially purified exopolysaccharide indicate that the biofilm-associated exopolysaccharide is neither cepacian nor the previously described acidic exopolysaccharide. The biofilm-associated exopolysaccharide described here is also specific to the B. pseudomallei complex of bacteria. Since this novel exopolysaccharide biosynthesis cluster is retained in B. mallei, it is predicted to have a role in colonization and infection of the host. These findings will facilitate further advances in understanding the pathogenesis of B. pseudomallei and improve diagnostics and therapeutic treatment strategies. B. pseudomallei, the etiological agent of melioidosis, is an emerging pathogen with limited therapeutic options and no available vaccines. A better understanding of the role of biofilm formation during pathogenesis will aid in melioidosis diagnosis and the development of new therapeutics and vaccines. Melioidosis has both acute and chronic disease manifestations in addition to a highly variable period of latency, which contributes to complications in diagnosis and treatment of the disease. Relapsing melioidosis is correlated with biofilm formation and the role of biofilm growth during chronic human infections has been widely accepted. We utilized a two-allele sequence defined transposon mutant library of B. pseudomallei 1026b to identify genes involved in biofilm formation. This study identified factors that contribute to biofilm formation and included a previously undescribed exopolysaccharide and the genes underlying its biosynthesis. Since antibiotic tolerance in B. pseudomallei has been associated with biofilm formation, the genes identified in this study that contribute to biofilm production are potential targets for therapeutic development. Additionally, the products of these biofilm genes could be used for the development of diagnostics and vaccines.
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Affiliation(s)
- Grace I. Borlee
- Department of Microbiology, Immunology and Pathology, Colorado State University, Fort Collins, Colorado, United States of America
| | - Brooke A. Plumley
- Department of Microbiology, Immunology and Pathology, Colorado State University, Fort Collins, Colorado, United States of America
| | - Kevin H. Martin
- Department of Microbiology, Immunology and Pathology, Colorado State University, Fort Collins, Colorado, United States of America
| | - Nawarat Somprasong
- Department of Molecular Genetics and Microbiology, University of Florida, Gainesville, Florida, United States of America
| | - Mihnea R. Mangalea
- Department of Microbiology, Immunology and Pathology, Colorado State University, Fort Collins, Colorado, United States of America
| | - M. Nurul Islam
- Department of Microbiology, Immunology and Pathology, Colorado State University, Fort Collins, Colorado, United States of America
| | - Mary N. Burtnick
- Department of Microbiology and Immunology, University of South Alabama, Mobile, Alabama, United States of America
| | - Paul J. Brett
- Department of Microbiology and Immunology, University of South Alabama, Mobile, Alabama, United States of America
| | - Ivo Steinmetz
- Institute of Hygiene, Microbiology, and Environmental Medicine, Medical University of Graz, Graz, Austria
| | - David P. AuCoin
- Department of Molecular Microbiology and Immunology, University of Nevada-Reno, School of Medicine Reno, Nevada, United States of America
| | - John T. Belisle
- Department of Microbiology, Immunology and Pathology, Colorado State University, Fort Collins, Colorado, United States of America
| | - Dean C. Crick
- Department of Microbiology, Immunology and Pathology, Colorado State University, Fort Collins, Colorado, United States of America
| | - Herbert P. Schweizer
- Department of Molecular Genetics and Microbiology, University of Florida, Gainesville, Florida, United States of America
| | - Bradley R. Borlee
- Department of Microbiology, Immunology and Pathology, Colorado State University, Fort Collins, Colorado, United States of America
- * E-mail:
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Obasi A, Nwachukwu S, Ugoji E, Kohler C, Göhler A, Balau V, Pfeifer Y, Steinmetz I. Extended-Spectrum β-Lactamase-Producing Klebsiella pneumoniae from Pharmaceutical Wastewaters in South-Western Nigeria. Microb Drug Resist 2017; 23:1013-1018. [PMID: 28375698 DOI: 10.1089/mdr.2016.0269] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
Emergence and spread of Klebsiella pneumoniae isolates producing extended-spectrum β-lactamases (ESBLs) present a major threat to public health. In this study, we characterized β-lactam-resistant K. pneumoniae isolates from six wastewater samples obtained from two pharmaceutical industries located in Lagos and Ogun States, Nigeria. Bacteria were isolated by using MacConkey agar; species identification and antibacterial susceptibility testing were performed by Vitek 2. Etest was used for ESBL phenotype confirmation. The presence of β-lactamase genes was investigated by PCR and sequencing. Bacterial strain typing was done by XbaI-macrorestriction and subsequent pulsed-field gel electrophoresis (PFGE) as well as multilocus sequence typing (MLST). Thirty-five bacterial species were isolated from the six samples; among them, we identified seven K. pneumoniae isolates with resistance to β-lactams and co-resistance to fluoroquinolones, aminoglycosides, and folate pathway inhibitors. The ESBL phenotype was confirmed in six K. pneumoniae isolates that harbored ESBL genes blaCTX-M-15 (n = 5), blaSHV-2 (n = 1), and blaSHV-12 (n = 1). PFGE and MLST analysis revealed five clones belonging to four sequence types (ST11, ST15, ST37, ST101), and clone K. pneumoniae-ST101 was present in the wastewater samples from two different pharmaceutical industries. Additionally performed conjugation assays confirmed the location of β-lactamase genes on conjugative plasmids. This is the first confirmation of K. pneumoniae isolates producing CTX-M-15-ESBL from pharmaceutical wastewaters in Nigeria. The co-resistance observed might be a reflection of the different drugs produced by these industries. Continuous surveillance of the environmental reservoirs of multidrug-resistant bacteria is necessary to prevent their further spread.
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Affiliation(s)
- Avemaria Obasi
- 1 Department of Microbiology, University of Lagos , Lagos, Nigeria
| | | | - Esther Ugoji
- 1 Department of Microbiology, University of Lagos , Lagos, Nigeria
| | - Christian Kohler
- 2 Department of Medical Microbiology, Friedrich Loeffler Institute for Medical Microbiology, University of Greifswald , Greifswald, Germany
| | - André Göhler
- 2 Department of Medical Microbiology, Friedrich Loeffler Institute for Medical Microbiology, University of Greifswald , Greifswald, Germany
| | - Veronica Balau
- 2 Department of Medical Microbiology, Friedrich Loeffler Institute for Medical Microbiology, University of Greifswald , Greifswald, Germany
| | - Yvonne Pfeifer
- 3 FG13 Nosocomial Pathogens and Antibiotic Resistance, Robert Koch Institute , Wernigerode, Germany
| | - Ivo Steinmetz
- 2 Department of Medical Microbiology, Friedrich Loeffler Institute for Medical Microbiology, University of Greifswald , Greifswald, Germany
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Kromrey ML, Göhler A, Friedrich N, Kindermann K, Hadlich S, Puls D, Steinmetz I, Kühn JP. Monitoring of abdominal Staphylococcus aureus infection using magnetic resonance imaging: a murine animal model for hepatic and renal abscesses. Eur J Clin Microbiol Infect Dis 2016; 36:373-378. [PMID: 27778120 DOI: 10.1007/s10096-016-2811-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2016] [Accepted: 10/09/2016] [Indexed: 11/30/2022]
Abstract
To establish a routine workflow for in vivo magnetic resonance imaging (MRI) of mice infected with bacterial biosafety level 2 pathogens and to generate a mouse model for systemic infection with Staphylococcus aureus suitable for monitoring by MRI. A self-contained acrylic glass animal bed complying with biosafety level 2 requirements was constructed. After intravenous infection with 105 colony-forming units (CFU) (n = 3), 106 CFU (n = 11) or 107 CFU (n = 6) of S. aureus strain Newman, female Balb/c mice were whole-body scanned by 7T MRI. Abdominal infections such as abscesses were visualized using a standard T2-weighted scan. Infection monitoring was performed for each animal by measurements at 1, 3, and 7 days after infection. Intravenous pathogen application led to a dose-dependent decrease in survival probability (p = 0.03). In the group with the highest infectious dose the 7-day survival rate was 33 %. An intermediate S. aureus dose showed a survival rate of 80 %, whereas at the lowest infection dose, none of the animals died. All animals with the highest infection dose exhibited hepatic abscesses 4 days after inoculation, 80 % developed renal abscesses on the 3rd day. Mice obtaining the intermediate S. aureus load reached a plateau at day 4 with 72 % liver and 60 % renal abscess probability. No abscesses were observed in other abdominal organs at any time point. The implemented experimental setup provides a suitable and reliable in vivo MRI method to study murine abdominal infection models using BSL-2 pathogen. Systemic Staphylococcus aureus infection leads to a dose-dependent development of hepatic and renal abscesses.
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Affiliation(s)
- M L Kromrey
- Institute of Diagnostic Radiology and Neuroradiology, University Medicine Greifswald, Greifswald, Germany.
| | - A Göhler
- Friedrich Loeffler Institute of Medical Microbiology, University Greifswald, Greifswald, Germany
| | - N Friedrich
- Institute for Clinical Chemistry and Laboratory Medicine, University Medicine Greifswald, Greifswald, Germany.,Research Centre for Prevention and Health, Glostrup University Hospital, Glostrup, Denmark
| | - K Kindermann
- Institute of Diagnostic Radiology and Neuroradiology, University Medicine Greifswald, Greifswald, Germany
| | - S Hadlich
- Institute of Diagnostic Radiology and Neuroradiology, University Medicine Greifswald, Greifswald, Germany
| | - D Puls
- Institute of Diagnostic Radiology and Neuroradiology, University Medicine Greifswald, Greifswald, Germany
| | - I Steinmetz
- Friedrich Loeffler Institute of Medical Microbiology, University Greifswald, Greifswald, Germany
| | - J P Kühn
- Institute of Diagnostic Radiology and Neuroradiology, University Medicine Greifswald, Greifswald, Germany
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Sakellariou C, Gürntke S, Steinmetz I, Kohler C, Pfeifer Y, Gastmeier P, Schwab F, Kola A, Deja M, Leistner R. Sepsis Caused by Extended-Spectrum Beta-Lactamase (ESBL)-Positive K. pneumoniae and E. coli: Comparison of Severity of Sepsis, Delay of Anti-Infective Therapy and ESBL Genotype. PLoS One 2016; 11:e0158039. [PMID: 27442425 PMCID: PMC4956035 DOI: 10.1371/journal.pone.0158039] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2016] [Accepted: 06/09/2016] [Indexed: 12/22/2022] Open
Abstract
Infections with extended-spectrum beta-lactamase-producing Enterobacteriaceae (ESBL-E) are associated with increased mortality. Outcome differences due to various species of ESBL-E or ESBL genotypes are not well investigated. We conducted a cohort study to assess risk factors for mortality in cases of ESBL-E bacteremia (K. pneumoniae or E. coli) and the risk factors for sepsis with organ failure. All consecutive patients of our institution from 2008 to 2011 with bacteremia due to ESBL-E were included. Basic epidemiological data, underlying comorbidities, origin of bacteremia, severity of sepsis and delay of appropriate anti-infective treatment were collected. Isolates were PCR-screened for the presence of ESBL genes and plasmid-mediated AmpC β-lactamases. Cox proportional hazard regression on mortality and multivariable logistic regression on risk factors for sepsis with organ failure was conducted. 219 cases were included in the analysis: 73.1% due to E. coli, 26.9% due to K. pneumoniae. There was no significant difference in hospital mortality (ESBL-E. coli, 23.8% vs. ESBL-K. pneumoniae 27.1%, p = 0.724). However, the risk of sepsis with organ failure was associated in cases of K. pneumoniae bacteremia (OR 4.5, p<0.001) and patients with liver disease (OR 3.4, p = 0.004) or renal disease (OR 6.8, p<0.001). We found significant differences in clinical presentation of ESBL-E bacteremia due to K. pneumoniae compared to E. coli. As K. pneumoniae cases showed a more serious clinical presentation as E. coli cases and were associated with different risk factors, treatment and prevention strategies should be adjusted accordingly.
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Affiliation(s)
- Christian Sakellariou
- Institute of Hygiene and Environmental Medicine, National Reference Center for the Surveillance of Nosocomial Infections, Charité Universitaetsmedizin Berlin, Hindenburgdamm 27, 12203 Berlin, Germany
| | - Stephan Gürntke
- Institute of Hygiene and Environmental Medicine, National Reference Center for the Surveillance of Nosocomial Infections, Charité Universitaetsmedizin Berlin, Hindenburgdamm 27, 12203 Berlin, Germany
| | - Ivo Steinmetz
- Friedrich Loffler Institute of Medical Microbiology, Universitaetsmedizin Greifswald, Martin-Luther-Str.6, 17475, Greifswald, Germany
| | - Christian Kohler
- Friedrich Loffler Institute of Medical Microbiology, Universitaetsmedizin Greifswald, Martin-Luther-Str.6, 17475, Greifswald, Germany
| | - Yvonne Pfeifer
- Robert Koch Institute, FG13 Nosocomial Pathogens and Antibiotic Resistance, 38855, Wernigerode, Germany
| | - Petra Gastmeier
- Institute of Hygiene and Environmental Medicine, National Reference Center for the Surveillance of Nosocomial Infections, Charité Universitaetsmedizin Berlin, Hindenburgdamm 27, 12203 Berlin, Germany
| | - Frank Schwab
- Institute of Hygiene and Environmental Medicine, National Reference Center for the Surveillance of Nosocomial Infections, Charité Universitaetsmedizin Berlin, Hindenburgdamm 27, 12203 Berlin, Germany
| | - Axel Kola
- Institute of Hygiene and Environmental Medicine, National Reference Center for the Surveillance of Nosocomial Infections, Charité Universitaetsmedizin Berlin, Hindenburgdamm 27, 12203 Berlin, Germany
| | - Maria Deja
- Department of Anesthesiology and Intensive Care, Charité Universitaetsmedizin Berlin, Campus Benjamin Franklin, Hindenburgdamm 30, 12203, Berlin, Germany
| | - Rasmus Leistner
- Institute of Hygiene and Environmental Medicine, National Reference Center for the Surveillance of Nosocomial Infections, Charité Universitaetsmedizin Berlin, Hindenburgdamm 27, 12203 Berlin, Germany
- * E-mail:
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Kohler C, Dunachie SJ, Müller E, Kohler A, Jenjaroen K, Teparrukkul P, Baier V, Ehricht R, Steinmetz I. Rapid and Sensitive Multiplex Detection of Burkholderia pseudomallei-Specific Antibodies in Melioidosis Patients Based on a Protein Microarray Approach. PLoS Negl Trop Dis 2016; 10:e0004847. [PMID: 27427979 PMCID: PMC4948818 DOI: 10.1371/journal.pntd.0004847] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2016] [Accepted: 06/22/2016] [Indexed: 12/15/2022] Open
Abstract
Background The environmental bacterium Burkholderia pseudomallei causes the infectious disease melioidosis with a high case-fatality rate in tropical and subtropical regions. Direct pathogen detection can be difficult, and therefore an indirect serological test which might aid early diagnosis is desirable. However, current tests for antibodies against B. pseudomallei, including the reference indirect haemagglutination assay (IHA), lack sensitivity, specificity and standardization. Consequently, serological tests currently do not play a role in the diagnosis of melioidosis in endemic areas. Recently, a number of promising diagnostic antigens have been identified, but a standardized, easy-to-perform clinical laboratory test for sensitive multiplex detection of antibodies against B. pseudomallei is still lacking. Methods and Principal Findings In this study, we developed and validated a protein microarray which can be used in a standard 96-well format. Our array contains 20 recombinant and purified B. pseudomallei proteins, previously identified as serodiagnostic candidates in melioidosis. In total, we analyzed 196 sera and plasmas from melioidosis patients from northeast Thailand and 210 negative controls from melioidosis-endemic and non-endemic regions. Our protein array clearly discriminated between sera from melioidosis patients and controls with a specificity of 97%. Importantly, the array showed a higher sensitivity than did the IHA in melioidosis patients upon admission (cut-off IHA titer ≥1:160: IHA 57.3%, protein array: 86.7%; p = 0.0001). Testing of sera from single patients at 0, 12 and 52 weeks post-admission revealed that protein antigens induce either a short- or long-term antibody response. Conclusions Our protein array provides a standardized, rapid, easy-to-perform test for the detection of B. pseudomallei-specific antibody patterns. Thus, this system has the potential to improve the serodiagnosis of melioidosis in clinical settings. Moreover, our high-throughput assay might be useful for the detection of anti-B. pseudomallei antibodies in epidemiological studies. Further studies are needed to elucidate the clinical and diagnostic significance of the different antibody kinetics observed during melioidosis. Melioidosis is a potentially fatal infectious disease caused by the Gram-negative environmental bacterium Burkholderia pseudomallei. Since the clinical presentations of melioidosis are extremely variable and no specific signs or symptoms exist, early laboratory-based diagnosis is highly desirable to start appropriate antibiotics. Routine methods for culture detection of B. pseudomallei are highly specific but take several days for a result, and depending on the clinical sample and other factors, sensitivity can be low. The standard serology test for melioidosis is an indirect hemagglutination assay (IHA) based on crude B. pseudomallei antigen preparations. Due to the variable prevalence of background seropositivity in endemic areas and the low diagnostic sensitivity of the IHA upon admission, the test is currently not recommended for the diagnosis of melioidosis, but still widely used. Thus, we generated a protein array containing 20 B. pseudomallei antigens previously shown to have serodiagnostic potential. Our array allows highly specific and sensitive antibody recognition in blood sera and plasmas from patients with melioidosis. The standardized microarray device is simple to use and fast, and is thus applicable in a routine diagnostic laboratory. In this study, the multiplex testing of antibodies in melioidosis sera from different time points after admission allowed the detection of short- and long-term antibodies to various antigens. Further studies will examine the potential role of those antibodies to discriminate different stages of the disease. Furthermore, the protein microarray might be useful in studies aimed at elucidating the exposure of humans and animals to B. pseudomallei in different parts of the world.
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Affiliation(s)
- Christian Kohler
- Friedrich Loeffler Institut for Medical Microbiology, Greifswald, Germany
| | - Susanna J. Dunachie
- Mahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
- Centre for Tropical Medicine and Global Health, University of Oxford, Oxford, United Kingdom
| | - Elke Müller
- Alere Technologies GmbH, Jena, Germany
- InfectoGnostics Research Campus, Jena, Germany
| | - Anne Kohler
- Friedrich Loeffler Institut for Medical Microbiology, Greifswald, Germany
| | - Kemajittra Jenjaroen
- Mahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
| | | | | | - Ralf Ehricht
- Alere Technologies GmbH, Jena, Germany
- InfectoGnostics Research Campus, Jena, Germany
| | - Ivo Steinmetz
- Friedrich Loeffler Institut for Medical Microbiology, Greifswald, Germany
- Institute of Hygiene, Microbiology and Environmental Medicine, Medical University of Graz, Graz, Austria
- * E-mail:
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Stolt C, Schmidt IHE, Sayfart Y, Steinmetz I, Bast A. Heme Oxygenase-1 and Carbon Monoxide PromoteBurkholderia pseudomalleiInfection. J I 2016; 197:834-46. [DOI: 10.4049/jimmunol.1403104] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/18/2014] [Accepted: 05/26/2016] [Indexed: 12/25/2022]
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Gierok P, Kohler C, Steinmetz I, Lalk M. Burkholderia pseudomallei Colony Morphotypes Show a Synchronized Metabolic Pattern after Acute Infection. PLoS Negl Trop Dis 2016; 10:e0004483. [PMID: 26943908 PMCID: PMC4778764 DOI: 10.1371/journal.pntd.0004483] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2015] [Accepted: 02/02/2016] [Indexed: 11/18/2022] Open
Abstract
Background Burkholderia pseudomallei is a water and soil bacterium and the causative agent of melioidosis. A characteristic feature of this bacterium is the formation of different colony morphologies which can be isolated from environmental samples as well as from clinical samples, but can also be induced in vitro. Previous studies indicate that morphotypes can differ in a number of characteristics such as resistance to oxidative stress, cellular adhesion and intracellular replication. Yet the metabolic features of B. pseudomallei and its different morphotypes have not been examined in detail so far. Therefore, this study aimed to characterize the exometabolome of B. pseudomallei morphotypes and the impact of acute infection on their metabolic characteristics. Methods and Principal Findings We applied nuclear magnetic resonance spectroscopy (1H-NMR) in a metabolic footprint approach to compare nutrition uptake and metabolite secretion of starvation induced morphotypes of the B. pseudomallei strains K96243 and E8. We observed gluconate production and uptake in all morphotype cultures. Our study also revealed that among all morphotypes amino acids could be classified with regard to their fast and slow consumption. In addition to these shared metabolic features, the morphotypes varied highly in amino acid uptake profiles, secretion of branched chain amino acid metabolites and carbon utilization. After intracellular passage in vitro or murine acute infection in vivo, we observed a switch of the various morphotypes towards a single morphotype and a synchronization of nutrient uptake and metabolite secretion. Conclusion To our knowledge, this study provides first insights into the basic metabolism of B. pseudomallei and its colony morphotypes. Furthermore, our data suggest, that acute infection leads to the synchronization of B. pseudomallei colony morphology and metabolism through yet unknown host signals and bacterial mechanisms. Melioidosis is a common disease in Northern Australia and East Asia, with regional mortality rates of up to 40%. Clinical manifestations range from soft tissue infections to severe sepsis. It is caused by the Gram negative saprophytic water and soil bacterium Burkholderia pseudomallei, which forms a variety of colony morphologies on solid agar. Various morphotypes appear after the bacterium is exposed to physiological stress conditions or underwent the process of infection, yet the physiological function is unclear. Metabolism is closely linked to virulence in many pathogens, and since metabolic data are not available so far for this bacterium, we monitored the nutrition uptake and metabolite secretion of B. pseudomallei morphotypes. Interestingly, despite typical genes responsible for gluconate production are missing in the B. pseudomallei genome, we observed high amounts of gluconate in the extracellular space. Furthermore, we were able to investigate metabolic differences among the morphotypes and identified synchronization in morphology and metabolism after infection as an adaptation to the host environment.
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Affiliation(s)
- Philipp Gierok
- Institute of Biochemistry, Ernst-Moritz-Arndt-University, Greifswald, Germany
| | - Christian Kohler
- Friedrich Loeffler Institute of Medical Microbiology, University Medicine Greifswald, Greifswald, Germany
| | - Ivo Steinmetz
- Friedrich Loeffler Institute of Medical Microbiology, University Medicine Greifswald, Greifswald, Germany
| | - Michael Lalk
- Institute of Biochemistry, Ernst-Moritz-Arndt-University, Greifswald, Germany
- * E-mail:
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Hoffmaster AR, AuCoin D, Baccam P, Baggett HC, Baird R, Bhengsri S, Blaney DD, Brett PJ, Brooks TJG, Brown KA, Chantratita N, Cheng AC, Dance DAB, Decuypere S, Defenbaugh D, Gee JE, Houghton R, Jorakate P, Lertmemongkolchai G, Limmathurotsakul D, Merlin TL, Mukhopadhyay C, Norton R, Peacock SJ, Rolim DB, Simpson AJ, Steinmetz I, Stoddard RA, Stokes MM, Sue D, Tuanyok A, Whistler T, Wuthiekanun V, Walke HT. Melioidosis diagnostic workshop, 2013. Emerg Infect Dis 2015; 21. [PMID: 25626057 PMCID: PMC4313648 DOI: 10.3201/eid2102.141045] [Citation(s) in RCA: 80] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Melioidosis is a severe disease that can be difficult to diagnose because of its diverse clinical manifestations and a lack of adequate diagnostic capabilities for suspected cases. There is broad interest in improving detection and diagnosis of this disease not only in melioidosis-endemic regions but also outside these regions because melioidosis may be underreported and poses a potential bioterrorism challenge for public health authorities. Therefore, a workshop of academic, government, and private sector personnel from around the world was convened to discuss the current state of melioidosis diagnostics, diagnostic needs, and future directions.
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Monecke S, Friedrichs A, Pöhlmann C, Hochauf K, Gunzer F, Wiesner D, Sickert W, Steinmetz I, Scholz H, Ehricht R, Schmoock G, Jacobs E. An imported case of melioidosis presenting as pyelonephritis/urosepsis. JMM Case Rep 2015. [DOI: 10.1099/jmmcr.0.000073] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Affiliation(s)
- Stefan Monecke
- Alere Technologies GmbH, Löbstedter Strasse 103-105, D-07749 Jena, Germany
- Institute for Medical Microbiology and Hygiene, Technische Universität Dresden, Fetscherstrasse 74, D-01307 Dresden, Germany
| | - Anette Friedrichs
- Department of Internal Medicine I, University Hospital Schleswig-Holstein, Campus Kiel, Schittenhelmstrasse12, D-24105 Kiel, Germany
| | - Christoph Pöhlmann
- Department of Laboratory Medicine, Robert-Bosch-Hospital, Auerbachstraße 110, D-70376 Stuttgart, Germany
| | - Kristina Hochauf
- Institute for Medical Microbiology and Hygiene, Technische Universität Dresden, Fetscherstrasse 74, D-01307 Dresden, Germany
| | - Florian Gunzer
- Institute for Medical Microbiology and Hygiene, Technische Universität Dresden, Fetscherstrasse 74, D-01307 Dresden, Germany
| | - Diana Wiesner
- Deaconesses' Hospital Dessau, Gropiusallee 3, D-06846 Dessau-Roßlau, Germany
| | | | - Ivo Steinmetz
- Friedrich-Loeffler-Institute for Medical Microbiology, University of Greifswald, Lutherstrasse 6, D-17489 Greifswald, Germany
| | - Holger Scholz
- Bundeswehr Institute of Microbiology, Neuherbergstrasse 11, D-80937 Munich, Germany
- German Center for Infection Research (DZIF), Munich, Germany
| | - Ralf Ehricht
- Alere Technologies GmbH, Löbstedter Strasse 103-105, D-07749 Jena, Germany
| | - Gernot Schmoock
- Friedrich Loeffler Institute, Institute of Bacterial Infections and Zoonoses, Naumburger Strasse 96a, D-07743 Jena, Germany
| | - Enno Jacobs
- Institute for Medical Microbiology and Hygiene, Technische Universität Dresden, Fetscherstrasse 74, D-01307 Dresden, Germany
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Gürntke S, Kohler C, Steinmetz I, Pfeifer Y, Eller C, Gastmeier P, Schwab F, Leistner R. Molecular epidemiology of extended-spectrum beta-lactamase (ESBL)-positive Klebsiella pneumoniae from bloodstream infections and risk factors for mortality. J Infect Chemother 2014; 20:817-9. [PMID: 25224765 DOI: 10.1016/j.jiac.2014.08.012] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2014] [Revised: 07/25/2014] [Accepted: 08/11/2014] [Indexed: 11/17/2022]
Abstract
The prevalence of extended-spectrum beta-lactamase (ESBL)-positive Klebsiella pneumoniae is growing worldwide. Infections with these bacteria are suspected to be related to increased mortality. We aimed to estimate the distribution of ESBL genotypes and to assess the impact on mortality associated with ESBL positivity in cases of bloodstream infection (BSI) due to K. pneumoniae. We performed a cohort study on patients with K. pneumoniae BSI between 2008 and 2011. Presence of ESBL genes was analyzed by PCR and sequencing. Risk factors for mortality were analyzed by Cox-proportional hazard regression. We identified 286 ESBL-negative (81%) and 66 (19%) ESBL-positive cases. 97% (n = 64) of the ESBL-positive isolates were susceptible for meropenem. The most common ESBL genotypes were CTX-M-15 (60%), SHV-5 (27%) and CTX-M-3 (5%). Significant risk factors for mortality were chronic pulmonary disease (HR 1.747) and moderate/severe renal disease (HR 2.572). ESBL positivity was not associated with increased mortality.
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Affiliation(s)
- Stephan Gürntke
- Institute of Hygiene and Environmental Medicine, Charité Universitätsmedizin Berlin, Hindenburgdamm 27, 12203 Berlin, Germany; National Reference Center for the Surveillance of Nosocomial Infections, Charité Universitätsmedizin Berlin, Hindenburgdamm 27, 12203 Berlin, Germany.
| | - Christian Kohler
- Friedrich Löffler Institute of Medical Microbiology, Universitätsmedizin Greifswald, Martin-Luther-Str.6, 17475 Greifswald, Germany.
| | - Ivo Steinmetz
- Friedrich Löffler Institute of Medical Microbiology, Universitätsmedizin Greifswald, Martin-Luther-Str.6, 17475 Greifswald, Germany.
| | - Yvonne Pfeifer
- Robert Koch Institute, FG13 Nosocomial Pathogens and Antibiotic Resistance, 38855 Wernigerode, Germany.
| | - Christoph Eller
- Robert Koch Institute, FG13 Nosocomial Pathogens and Antibiotic Resistance, 38855 Wernigerode, Germany.
| | - Petra Gastmeier
- Institute of Hygiene and Environmental Medicine, Charité Universitätsmedizin Berlin, Hindenburgdamm 27, 12203 Berlin, Germany; National Reference Center for the Surveillance of Nosocomial Infections, Charité Universitätsmedizin Berlin, Hindenburgdamm 27, 12203 Berlin, Germany.
| | - Frank Schwab
- Institute of Hygiene and Environmental Medicine, Charité Universitätsmedizin Berlin, Hindenburgdamm 27, 12203 Berlin, Germany; National Reference Center for the Surveillance of Nosocomial Infections, Charité Universitätsmedizin Berlin, Hindenburgdamm 27, 12203 Berlin, Germany.
| | - Rasmus Leistner
- Institute of Hygiene and Environmental Medicine, Charité Universitätsmedizin Berlin, Hindenburgdamm 27, 12203 Berlin, Germany; National Reference Center for the Surveillance of Nosocomial Infections, Charité Universitätsmedizin Berlin, Hindenburgdamm 27, 12203 Berlin, Germany.
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Göhler A, Hetzer A, Holtfreter B, Geisel MH, Schmidt CO, Steinmetz I, Kocher T. Quantitative molecular detection of putative periodontal pathogens in clinically healthy and periodontally diseased subjects. PLoS One 2014; 9:e99244. [PMID: 25029268 PMCID: PMC4100758 DOI: 10.1371/journal.pone.0099244] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2014] [Accepted: 05/13/2014] [Indexed: 01/11/2023] Open
Abstract
Periodontitis is a multi-microbial oral infection with high prevalence among adults. Putative oral pathogens are commonly found in periodontally diseased individuals. However, these organisms can be also detected in the oral cavity of healthy subjects. This leads to the hypothesis, that alterations in the proportion of these organisms relative to the total amount of oral microorganisms, namely their abundance, rather than their simple presence might be important in the transition from health to disease. Therefore, we developed a quantitative molecular method to determine the abundance of various oral microorganisms and the portion of bacterial and archaeal nucleic acid relative to the total nucleic acid extracted from individual samples. We applied quantitative real-time PCRs targeting single-copy genes of periodontal bacteria and 16S-rRNA genes of Bacteria and Archaea. Testing tongue scrapings of 88 matched pairs of periodontally diseased and healthy subjects revealed a significantly higher abundance of P. gingivalis and a higher total bacterial abundance in diseased subjects. In fully adjusted models the risk of being periodontally diseased was significantly higher in subjects with high P. gingivalis and total bacterial abundance. Interestingly, we found that moderate abundances of A. actinomycetemcomitans were associated with reduced risk for periodontal disease compared to subjects with low abundances, whereas for high abundances, this protective effect leveled off. Moderate archaeal abundances were health associated compared to subjects with low abundances. In conclusion, our methodological approach unraveled associations of the oral flora with periodontal disease, which would have gone undetected if only qualitative data had been determined.
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Affiliation(s)
- André Göhler
- Friedrich Loeffler Institute of Medical Microbiology, Ernst Moritz Arndt University, Greifswald, Germany
| | - Adrian Hetzer
- Friedrich Loeffler Institute of Medical Microbiology, Ernst Moritz Arndt University, Greifswald, Germany
| | - Birte Holtfreter
- Unit of Periodontology, Dental School, University Medicine, Ernst Moritz Arndt University, Greifswald, Germany
| | - Marie Henrike Geisel
- Unit of Periodontology, Dental School, University Medicine, Ernst Moritz Arndt University, Greifswald, Germany
- Institute for Medical Informatics, Biometry and Epidemiology (IMIBE), University Hospital of Essen, University of Duisburg-Essen, Essen, Germany
| | - Carsten Oliver Schmidt
- Section Methods in Community Medicine, Institute for Community Medicine, University Medicine Greifswald, Ernst Moritz Arndt University, Greifswald, Germany
| | - Ivo Steinmetz
- Friedrich Loeffler Institute of Medical Microbiology, Ernst Moritz Arndt University, Greifswald, Germany
- * E-mail: (IM); (TK)
| | - Thomas Kocher
- Unit of Periodontology, Dental School, University Medicine, Ernst Moritz Arndt University, Greifswald, Germany
- * E-mail: (IM); (TK)
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Warnke P, Aepfelbacher M, Fickenscher H, Solbach W, Steinmetz I, Podbielski A. Surveillanceberichte zu Erregern und Antibiotikaresistenzen – eine Empfehlung zur Standardisierung. Dtsch Med Wochenschr 2014; 139:1377-82. [DOI: 10.1055/s-0034-1370124] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Affiliation(s)
- P. Warnke
- Institut für Medizinische Mikrobiologie, Virologie und Hygiene, Universitätsmedizin Rostock
| | - M. Aepfelbacher
- Institut für Medizinische Mikrobiologie, Virologie und Hygiene, Universitätsklinikum Hamburg-Eppendorf
| | - H. Fickenscher
- Institut für Infektionsmedizin, Christian-Albrechts-Universität zu Kiel und Universitätsklinikum Schleswig-Holstein, Campus Kiel
| | - W. Solbach
- Institut für Medizinische Mikrobiologie und Hygiene, Universitätsklinikum Schleswig-Holstein, Campus Lübeck
| | - I. Steinmetz
- Friedrich-Loeffler-Institut für Medizinische Mikrobiologie, Universitätsmedizin Greifswald
| | - A. Podbielski
- Institut für Medizinische Mikrobiologie, Virologie und Hygiene, Universitätsmedizin Rostock
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Depke M, Breitbach K, Dinh Hoang Dang K, Brinkmann L, Salazar MG, Dhople VM, Bast A, Steil L, Schmidt F, Steinmetz I, Völker U. Bone marrow-derived macrophages from BALB/c and C57BL/6 mice fundamentally differ in their respiratory chain complex proteins, lysosomal enzymes and components of antioxidant stress systems. J Proteomics 2014; 103:72-86. [PMID: 24704164 DOI: 10.1016/j.jprot.2014.03.027] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2013] [Revised: 03/05/2014] [Accepted: 03/18/2014] [Indexed: 11/27/2022]
Abstract
UNLABELLED Macrophages are essential components of the innate immune system and crucial for pathogen elimination in early stages of infection. We previously observed that bone marrow-derived macrophages (BMMs) from C57BL/6 mice exhibited increased killing activity against Burkholderia pseudomallei compared to BMMs from BALB/c mice. This effect was particularly pronounced when cells were treated with IFN-γ. To unravel mechanisms that could explain these distinct bactericidal effects, a comparative combined proteome and transcriptome analysis of untreated and IFN-γ treated BALB/c and C57BL/6 BMMs under standardized serum-free conditions was carried out. We found differences in gene expression/protein abundance belonging to cellular oxidative and antioxidative stress systems. Genes/proteins involved in the generation of oxidant molecules and the function of phagosomes (respiratory chain ATPase, lysosomal enzymes, cathepsins) were predominantly higher expressed/more abundant in C57BL/6 BMMs. Components involved in alleviation of oxidative stress (peroxiredoxin, mitochondrial superoxide dismutase) were more abundant in C57BL/6 BMMs as well. Thus, C57BL/6 BMMs seemed to be better equipped with cellular systems that may be advantageous in combating engulfed pathogens. Simultaneously, C57BL/6 BMMs were well protected from oxidative burst. We assume that these variations co-determine differences in resistance between BALB/c and C57BL/6 mice observed in many infection models. BIOLOGICAL SIGNIFICANCE In this study we performed combined transcriptome and proteome analyses on BMMs derived from two inbred mouse strains that are frequently used for studies in the field of host-pathogen interaction research. Strain differences between BALB/c and C57BL/6 BMMs were found to originate mainly from different protein abundance levels rather than from different gene expression. Differences in abundance of respiratory chain complexes and lysosomal proteins as well as differential regulation of components belonging to various antioxidant stress systems help to explain long-known differences between the mouse strains concerning their different susceptibility in several infection models.
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Affiliation(s)
- Maren Depke
- ZIK-FunGene Junior Research Group "Applied Proteomics", Interfaculty Institute for Genetics and Functional Genomics, Department of Functional Genomics, University Medicine Greifswald, Greifswald, Germany; Interfaculty Institute for Genetics and Functional Genomics, Department of Functional Genomics, University Medicine Greifswald, Greifswald, Germany
| | - Katrin Breitbach
- Friedrich Loeffler Institute for Medical Microbiology, University Medicine Greifswald, Greifswald, Germany
| | - Khoa Dinh Hoang Dang
- Interfaculty Institute for Genetics and Functional Genomics, Department of Functional Genomics, University Medicine Greifswald, Greifswald, Germany
| | - Lars Brinkmann
- Interfaculty Institute for Genetics and Functional Genomics, Department of Functional Genomics, University Medicine Greifswald, Greifswald, Germany
| | - Manuela Gesell Salazar
- ZIK-FunGene Junior Research Group "Applied Proteomics", Interfaculty Institute for Genetics and Functional Genomics, Department of Functional Genomics, University Medicine Greifswald, Greifswald, Germany; Interfaculty Institute for Genetics and Functional Genomics, Department of Functional Genomics, University Medicine Greifswald, Greifswald, Germany
| | - Vishnu Mukund Dhople
- Interfaculty Institute for Genetics and Functional Genomics, Department of Functional Genomics, University Medicine Greifswald, Greifswald, Germany
| | - Antje Bast
- Friedrich Loeffler Institute for Medical Microbiology, University Medicine Greifswald, Greifswald, Germany
| | - Leif Steil
- Interfaculty Institute for Genetics and Functional Genomics, Department of Functional Genomics, University Medicine Greifswald, Greifswald, Germany
| | - Frank Schmidt
- ZIK-FunGene Junior Research Group "Applied Proteomics", Interfaculty Institute for Genetics and Functional Genomics, Department of Functional Genomics, University Medicine Greifswald, Greifswald, Germany
| | - Ivo Steinmetz
- Friedrich Loeffler Institute for Medical Microbiology, University Medicine Greifswald, Greifswald, Germany
| | - Uwe Völker
- Interfaculty Institute for Genetics and Functional Genomics, Department of Functional Genomics, University Medicine Greifswald, Greifswald, Germany.
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Leistner R, Sakellariou C, Gürntke S, Kola A, Steinmetz I, Kohler C, Pfeifer Y, Eller C, Gastmeier P, Schwab F. Mortality and molecular epidemiology associated with extended-spectrum β-lactamase production in Escherichia coli from bloodstream infection. Infect Drug Resist 2014; 7:57-62. [PMID: 24648746 PMCID: PMC3958498 DOI: 10.2147/idr.s56984] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Background The rate of infections due to extended-spectrum β-lactamase (ESBL)-producing Escherichia coli is growing worldwide. These infections are suspected to be related to increased mortality. We aimed to estimate the difference in mortality due to bloodstream infections (BSIs) with ESBL-positive and ESBL-negative E. coli isolates and to determine the molecular epidemiology of our ESBL-positive isolates. Materials and methods We performed a cohort study on consecutive patients with E. coli BSI between 2008 and 2010 at the Charité University Hospital. Collected data were ESBL production, basic demographic parameters, and underlying diseases by the Charlson comorbidity index (CCI). The presence of ESBL genes was analyzed by polymerase chain reaction (PCR) and sequencing. Phylogenetic groups of ESBL-positive E. coli were determined by PCR. Risk factors for mortality were analyzed by multivariable regression analysis. Results We identified 115 patients with BSI due to E. coli with ESBL phenotype and 983 due to ESBL-negative E. coli. Fifty-eight percent (n=67) of the ESBL-positive BSIs were hospital-acquired. Among the 99 isolates that were available for PCR screening and sequencing, we found mainly 87 CTX-M producers, with CTX-M-15 (n=55) and CTX-M-1 (n=21) as the most common types. Parameters significantly associated with mortality were age, CCI, and length of stay before and after onset of BSI. Conclusion The most common ESBL genotypes in clinical isolates from E. coli BSIs were CTX-M-15 (58%) and CTX-M-1 (22%). ESBL production in clinical E. coli BSI isolates was not related to increased mortality. However, the common occurrence of hospital-acquired BSI due to ESBL-positive E. coli indicates future challenges for hospitals.
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Affiliation(s)
- Rasmus Leistner
- Institute of Hygiene and Environmental Medicine, National Reference Center for the Surveillance of Nosocomial Infections, Charité Universitätsmedizin Berlin, Berlin, Germany
| | - Christian Sakellariou
- Institute of Hygiene and Environmental Medicine, National Reference Center for the Surveillance of Nosocomial Infections, Charité Universitätsmedizin Berlin, Berlin, Germany
| | - Stephan Gürntke
- Institute of Hygiene and Environmental Medicine, National Reference Center for the Surveillance of Nosocomial Infections, Charité Universitätsmedizin Berlin, Berlin, Germany
| | - Axel Kola
- Institute of Hygiene and Environmental Medicine, National Reference Center for the Surveillance of Nosocomial Infections, Charité Universitätsmedizin Berlin, Berlin, Germany
| | - Ivo Steinmetz
- Friedrich Löffler Institute of Medical Microbiology, Universitätsmedizin Greifswald, Greifswald, Germany
| | - Christian Kohler
- Friedrich Löffler Institute of Medical Microbiology, Universitätsmedizin Greifswald, Greifswald, Germany
| | - Yvonne Pfeifer
- Robert Koch Institute, FG13 Nosocomial Pathogens and Antibiotic Resistance, Wernigerode, Germany
| | - Christoph Eller
- Robert Koch Institute, FG13 Nosocomial Pathogens and Antibiotic Resistance, Wernigerode, Germany
| | - Petra Gastmeier
- Institute of Hygiene and Environmental Medicine, National Reference Center for the Surveillance of Nosocomial Infections, Charité Universitätsmedizin Berlin, Berlin, Germany
| | - Frank Schwab
- Institute of Hygiene and Environmental Medicine, National Reference Center for the Surveillance of Nosocomial Infections, Charité Universitätsmedizin Berlin, Berlin, Germany
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