Aerobic midgut microbiota of sand fly vectors of zoonotic visceral leishmaniasis from northern Iran, a step toward finding potential paratransgenic candidates

Background

Leishmaniasis is caused by Leishmania parasites and is transmitted to humans through the bite of infected sand flies. Development of Leishmania to infective metacyclic promastigotes occurs within the sand fly gut where the gut microbiota influences development of the parasite. Paratransgenesis is a new control method in which symbiotic bacteria are isolated, transformed and reintroduced into the gut through their diet to express anti-parasitic molecules. In the present study, the midgut microbiota of three sand fly species from a steppe and a mountainous region of northern Iran, where zoonotic visceral leishmaniasis (ZVL) is endemic, was investigated.

Methods

Briefly, adult female sand flies was collected during summer 2015 and, after dissection, the bacterial composition of the guts were analyzed using a culture-dependent method. Bacterial DNA from purified colonies was extracted to amplify the 16S rRNA gene which was then sequenced.

Results

Three ZVL sand fly vectors including Phlebotomus major, P. kandelakii and P. halepensis were found in the highlighted regions. In total, 39 distinct aerobic bacterial species were found in the sand fly midguts. The sand fly microbiota was dominated by Proteobacteria (56.4%) and Firmicutes (43.6%). Bacterial richness was significantly higher in the steppe region than in the mountainous region (32 vs 7 species). Phlebotomus kandelakii, the most important ZVL vector in the study area, had the highest bacterial richness among the three species. Bacillus subtilis and Pantoea agglomerans were isolated from the guts of the sand flies; these are already used for the paratransgenesis of sand flies and mosquitoes, respectively.

Conclusions

The existence of B. subtilis and P. agglomerans in the ZVL vectors and other sand fly species studied so far suggests that these two bacterial species are potential candidates for paratransgenic approach to prevent ZVL transmission. Further research needs to test the possible relationship between the gut microbiome richness and the vector competence of the ZVL vectors.

Frequency of Mutations in Quinolone Resistance-Determining Regions and Plasmid-Mediated Quinolone Resistance in Shigella Isolates Recovered from Pediatric Patients in Tehran, Iran: An Overlooked Problem

Fluoroquinolone (FQ) resistance in clinical isolates of Shigella species has been increasing reported in recent years. This study was carried out to find the mutations within the quinolone resistance-determining regions (QRDRs) and the prevalence of plasmid-mediated quinolone resistance (PMQR) determinants among the clinical isolates of Shigella sp. in Tehran, Iran. A total of 50 Shigella isolates were collected from five teaching therapeutic centers in Tehran, Iran and analyzed for antibiotic susceptibility over a period of 20 months from July 2015 to January 2017. The PCR and direct nucleotide sequencing were used for genetic alterations in the QRDRs. The PMQR genes were detected using PCR. The results revealed four types of mutations in the QRDR of gyrA: 20 (40%) had a S83L mutation, 1 (2%) had a S83A mutation, 2 (4%) had a D87G mutation, and 1 (2%) isolate had a D87Y mutation. Mutations were also found at codon N57D, D200N, and E210K in three isolates. Seven hospitalized children had qnrS determinants, and one isolates had the mutation S83A, while two isolates had double mutations at S83L and/or D87G (Ser83Leu and Asp-87Gly). The PMQR gene-positive isolates had the single replacement of serine with leucine. In hospitalized children, two isolates had two types of PMQR determinants (qnrS and qnrA) and (qnrS and qnrB) at once. The results of this study indicate that the emergence of strains with mutations in the QRDR regions and the capture of PMQR determinants in strains may lead to failure in therapy with FQ and the widespread emergence of strains with high-level FQ resistance.

Profiling of Virulence-associated Factors in Shigella Species Isolated from Acute Pediatric Diarrheal Samples in Tehran, Iran

OBJECTIVES

The genus Shigella comprises the most infectious and diarrheagenic bacteria causing severe diseases, mostly in children under five years of age. This study aimed to detect nine virulence genes (ipaBCD, VirA, sen, set1A, set1B, ial, ipaH, stx, and sat) in Shigella species (spp.) using multiplex polymerase chain reaction (MPCR) and to determine the relation of Shigella spp. from pediatric diarrheal samples with hospitalization and bloody diarrhea in Tehran, Iran.

METHODS

Shigella spp. were isolated and identified using standard microbiological and serological methods. The virulence genes were detected using MPCR.

RESULTS

Seventy-five Shigella spp. (40 S. sonnei, 33 S. flexneri, 1 S. dysenteriae, and 1 S. boydii) were isolated in this study. The prevalence of ial, sen, sat, set1A, and set1B was 74.7%, 45.4%, 28%, 24%, and 24%, respectively. All S. flexneri isolates, while no S. sonnei, S. dysenteriae, or S. boydii isolates, contained sat, set1A, and set1B. All isolates were positive for ipaH, ipaBCD, and virA, while one (1.4%) of the isolates contained stx. The highest prevalence of virulence determinants was found in S. flexneri serotype IIa. Nineteen (57.6%) of 33 S. flexneri isolates were positive for ipaBCD, ipaH, virA, ial, and sat. The sen determinants were found to be statistically significantly associated with hospitalization and bloody diarrhea (p = 0.001).

CONCLUSION

This study revealed a high prevalence of enterotoxin genes in S. flexneri, especially in serotype 2a, and has presented relations between a few clinical features of shigellosis and numerous virulence determinants of clinical isolates of Shigella spp.

Aerobic Bacterial Community of American Cockroach Periplaneta americana,a Step toward Finding Suitable Paratransgenesis Candidates

BACKGROUND

Cockroaches mechanically spread pathogenic agents, however, little is known about their gut microbiota. Identification of midgut microbial community helps targeting novel biological control strategies such as paratransgenesis. Here the bacterial microbiota of Periplaneta americana midgut, were identified and evaluated for finding proper paratransgenesis candidate.

METHODS

Midgut of specimens were dissected and cultivated in different media. The bacterial isolates were then identified using the phenotypic and 16S-rRNA sequencing methods.

RESULTS

The analytical profile index (API) kit showed presence of 11 bacterial species including: Escherichia coli, Shigella flexineri, Citrobacter freundii, E. vulneris, Enterobacter cloacae, Yersinia pseudotuberculosis, Y. intermedia, Leclericia adecarboxylata, Klebsiella oxytoca, K. planticola, and Rahnella aquatilis in the cockroach midguts. The first three species are potentially symbiotic whereas others are transient. The conventional plating method revealed presence of only four isolates of Salmonella, E. coli, and Proteus which in three cases mismatched with API and 16S-rRNA genotyping. The API correctly identified the four isolates as Shigella flexneri, Citrobacter freundii, and E. coli (n= 2). 16S-rRNA sequence analysis confirmed the API results; however the C. freundii sequence was identical with C. murliniae indicating lack of genetic variation in the gene between these two closely related species.

CONCLUSION

A low number of potentially symbiotic bacteria were found in the American cockroach midguts. Among them Enterobacter cloacae is a potential candidate for paratransgenesis approach whereas other bacteria are pathogens and are not useful for the approach. Data analysis showed that identification levels increase from the conventional to API and to genotyping respectively.

Aerobic bacterial flora of biotic and abiotic compartments of a hyperendemic Zoonotic Cutaneous Leishmaniasis (ZCL) focus

Background

Identification of the microflora of the sand fly gut and the environmental distribution of these bacteria are important components for paratransgenic control of Leishmania transmission by sand flies.

Methods

Biotic and abiotic bacterial communities of four compartments of a hyper-endemic focus of Zoonotic Cutaneous Leishmaniasis (ZCL) were investigated using 16S ribosomal DNA sequencing and phylogenetic tree construction. These compartments include Phlebotomus papatasi’s gut, skin and intestinal tract of great gerbil Rhombomys opimus, the gerbil nest supplies, and plant food sources of the vectors and reservoirs.

Results

Sequence homology analysis using nine available 16S rDNA data bases revealed 40, 24, 15 and 14 aerobic bacterial species from the vector guts, the gerbil bodies, the gerbil nests, and the plants, respectively. The isolated bacteria belong to wide ranges including aerobic to facultative anaerobic, pathogen to commensals, sand fly oviposition inducers, land to air and ocean habitats, animal and human probiotics, and plant growth-promoting rhizobacteria. Matching data analysis suggested that the adult P. papatasi gut bacteria could be acquired from three routes, adult sugar feeding on the plant saps, adult blood feeding on the animal host, and larval feeding from nest supplies. However, our laboratory experiment showed that none of the bacteria of the reservoir skin was transmitted to female sand fly guts via blood feeding. The microflora of sand fly guts were associated with the sand fly environment in which the predominant bacteria were Microbacterium, Pseudomonas, and Staphylococcus in human dwellings, cattle farms, and rodent colonies, respectively. Staphylococcus aureus was the most common bacterium in sand fly guts. Presence of some sand fly ovipoisition inducers such Bacillus spp. and Staphylococcus saprophyticus support association between gut flora and oviposition induction.

Conclusions

Results of this study showed that Bacillus subtilis and Enterobacter cloacae particularly subsp. dissolvens are circulated among the sand fly guts, the plants, and the sand fly larval breeding places and hence are possible candidates for a paratransgenic approach to reduce Leishmania transmission.

Aerobic Microbial Community of Insectary Population of Phlebotomus papatasi

BACKGROUND

Microbes particularly bacteria presenting in the gut of haematophagous insects may have an important role in the epidemiology of human infectious disease.

METHODS

The microbial flora of gut and surrounding environmental of a laboratory strain of Phlebotomus papatasi, the main vector of Zoonotic Cutaneous Leishmaniasis (ZCL) in the old world, was investigated. Biochemical reactions and 16s rDNA sequencing of the isolated bacteria against 24 sugars and amino acids were used for bacteria species identification. Common mycological media used for fungi identification as well.

RESULTS

Most isolates belonged to the Enterobacteriaceae, a large, heterogeneous group of gram-negative rods whose natural habitat is the intestinal tract of humans and animals. Enterobacteriaceae groups included Edwardsiella, Enterobacter, Escherichia, Klebsiella, Kluyvera, Leminorella, Pantoea, Proteus, Providencia, Rahnella, Serratia, Shigella, Tatumella, and Yersinia and non Enterobacteriaceae groups included Bacillus, Staphylococcus and Pseudomonas. The most prevalent isolates were Proteus mirabilis and P. vulgaris. These saprophytic and swarming motile bacteria were isolated from all immature, pupae, and mature fed or unfed male or female sand flies as well as from larval and adult food sources. Five fungi species were also isolated from sand flies, their food sources and colonization materials where Candida sp. was common in all mentioned sources.

CONCLUSION

Midgut microbiota are increasingly seen as an important factor for modulating vector competence in insect vectors so their possible effects of the mirobiota on the biology of P. papatasi and their roles in the sandfly-Leishmania interaction are discussed.

Comparison of five diagnostic methods for Helicobacter pylori

BACKGROUND AND OBJECTIVES

Invasive and non-invasive techniques are used to diagnose H. pylori infection. Some factors influence the choice of a diagnostic test, such as the sensitivity and specificity of the tests, the clinical circumstances and the cost-effectiveness of the testing strategy. The aim of this study was to reveal the relationship between different H. pylori infection diagnosis methods, and clarify the application scope of each diagnosis method.

MATERIALS AND METHODS

patients were included in the study, and specimens including biopsies, blood and stool were taken. Biopsies were evaluated by hematoxylin and eosin, and Giemsa staining. A sequence of 294 bp in the ureC (glmM) gene was amplified. The rapid urease test (RUT) was performed using a non-commercial validated test. Stool samples were analyzed using a polyclonal ELISA stool antigen test. A serological assay for IgG antibodies was performed by a commercial Helicobacter pylori IgG ELISA kit.

RESULTS

According to the predefined criteria, a total of 46 (50.5%) patients tested were positive by at least 2 of the 3 biopsy-based methods. The best sensitivity (95.6%) belonged to histology and RUT. The sensitivities of other tests including PCR, serology and stool antigen test were 93.5%, 91.3% and 73.9%, respectively. RUT showed the best specificity (100%), and the specificities of the other tests, including PCR, stool antigen test, histology and serology, were 95.6%, 86.7%, 77.8% and 55.6%, respectively.

CONCLUSION

In view of the better results obtained for invasive vs non-invasive tests, for a more accurate diagnosis, it is advisable not to solely rely on non-invasive methods of H. Pylori diagnosis.

Frequency of sabA Gene in Helicobacter pylori Strains Isolated From Patients in Tehran, Iran

Background

The importance of sialic acid binding adhesin (sabA) as a new outer membrane protein in gastroduodenal diseases has been recognized. The prevalence rate of sabA gene varies in different geographic areas.

Objectives

The aim of this study was to determine the frequency of sabA gene in Helicobacter pylori (H. pylori) strains isolated from different clinical outcomes in Tehran, Iran.

Patients and Methods

The study included 120 patients with dyspeptic symptoms admitted to the endoscopy suite of gastroenterology section of Firouzgar University Hospital, Tehran, Iran from March to August 2011. Gastric biopsy specimens were evaluated for the presence of H. pylori using standard microbiological method and polymerase chain reaction (PCR) assay. The sabA genopositive was determined by PCR in H. pylori strains.

Results

H. pylori isolates were recovered from 82 patients with duodenal ulcer (DU; n = 17), gastric ulcer (GU; n = 15), gastric cancer (GC; n = 13), and gastritis (G; n = 37). The frequency of sabA gene in H. pylori strains was 100% in gastric cancer, 86.7% in gastric ulcer, and 83.3% in both gastritis and duodenal ulcer.

Conclusions

This is a report on the prevalence of sabA gene in H. pylori isolated from different gastric patients in Iran. The results showed a high prevalence of sabA in our clinical H. pylori isolates.

Assessing the role of the RND efflux pump in metronidazole resistance of Helicobacter pylori by RT-PCR assay

INTRODUCTION

Metronidazole is a significant antibiotic used for eradication of Helicobacter pylori infections and it is of notice that metronidazole-resistant clinical isolates have been found in high rates worldwide. While the RND family of efflux pumps plays a central role in drug resistance among Gram-negative bacteria, this is questionable for H. pylori.

METHODOLOGY

To understand whether TolC homologues of RND pumps contribute to metronidazole resistance in H. pylori isolates, expression of four TolC homologous genes of five resistant clinical isolates exposed to varying concentrations of metronidazole were evaluated by RT-PCR and transcriptional analysis.

RESULTS

The results indicate that excess amounts of metronidazole are able to increase the expression level of these genes at the transcriptional stage.

CONCLUSIONS

Therefore, it may be hypothesized that use of metronidazole in H. pyori infection can induce metronidazole resistance. Furthermore, the RND family of efflux pumps may contribute to metronidazole resistance in clinical isolates of H. pylori.

Novel carotid surgery in an asymptomatic totally occluded common carotid artery

We report the case of a 67 year old English woman with bilateral transient cerebral ischaemic attacks who was managed by unconventional surgery. Duplex ultrasound of the carotid bifurcations indicated complete occlusion of the left common carotid artery with retrograde flow from external to internal carotid artery and an ulcerated plaque at the external carotid artery origin. Following ligation of the external carotid artery origin to exclude the ulcerated plaque, the proximal external carotid artery was re-anastomosed to the internal carotid artery, preserving cephalad flow in the internal carotid artery. This case report provides additional insight into the cause of transient ischaemic attacks and offers an innovative surgical solution which preserves blood flow to the brain. It also emphasises the need for an open minded and innovative approach to vascular surgery.

The prevalence of cagA and cagE genes in Helicobacter pylori strains isolated from different patient groups by polymerase chain reaction

The aim of this study was to investigate the prevalence of cagA and cagE genes in H. pylori strains isolated from different patient groups with Non-Ulcer Dyspepsia (NUD), Duodenal Ulcer (DU), Gastric Ulcer (GU) and Gastric Cancer (GC). The patients admitted to the gastroenterology unit at Sharyati hospital in Tehran in 2006 were included in this study. Gastric biopsy specimens were obtained from the antrum of the stomach from each patient then cultured for detection of H. pylori. Identification of H. pylori was performed according to the standard bacteriological methods. Genomic DNA was extracted using a commercially available Qia gene kit. PCR was done using primers cagA-F, cagA-R and cagE-F, cagE-R to detect the target genes cagA and cagE, respectively. Amplified products of target genes were confirmed by sequencing. The cagA and cagE were detected among 85 and 86% of H. pylori isolates, respectively. Prevalence of cagA and cagE genes in the patients with NUD, DU, GU and GC were 22 (64.7%), 28 (100%), 18 (90%), 10 (100%) and 25 (73.5%), 27 (96.4%), 19 (95%), 7 (70%), respectively. The current study demonstrated a significant correlation between peptic ulceration and the presence of H. pylori isolates carrying cagE and cagA genes in Iranian patients.

Randomized clinical trial of early versus delayed temporary stoma closure after proctectomy (Br J Surg 2008; 95: 693-698)

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Inhibitory effects of Sage extract on the growth of enteric bacteria

Antibacterial activity of Sage extract at concentrations of 0.1, 0.05, 0.025, 0.0125, 0.00625, 0.003125, 0.00156, 0.0005 and 0.00025 g dL(-1) against Salmonella typhi, Shigella sonnei, S. flexneri, Proteus vulgaris, Staphylococcus aureus, ETEC Escherichia coli and Pseudomonas aeruginosa was evaluated. Susceptibility testing of bacterial strains against 18 antibiotics was also performed for comparison. The results showed that P. aeruginosa and ETEC E. coli were completely resistant to Sage extract even at concentration of 0.1 g dL(-1). Its antibacterial activity (0.1 g dL(-1)) against P. vulgaris, S. flexneri and S. sonnei was the same as nitrofurantoin and ampicilline respectively. Sage extract (0.1 and 0.05 g dL(-1)) exhibited the same effects as ampicilline and streptomycin against S. typhi. Its antibacterial activity (0.1, 0.05 and 0.25 g dL(-1)) against S. aureus was the same as ceftazidim, chloramphenicol, gentamycin, neomycin and nitrofurantoin and was more significant compared to streptomycin and vancomycin. The results suggest Sage can be considered as an alternative herbal in the treatment of infections caused by the above-mentioned bacteria.

Study of bacterial infections among the patients with suspected cutaneous leishmaniasis

The main objective of this study was to evaluate the prevalence of secondary bacterial infections in the patients with cutaneous lesions. The patients admitted to leishmaniasis laboratory of faculty of health, Tehran university of medical sciences from October 2004 to June 2005 were subjected in this study. Clinical samples were analyzed using standard bacteriological and parasitological methods. One hundred seventy three patients were subjected to this study and leishmania was found in 84 (48.5%) cases. According to bacteriological experiments, 47 cases (55.9%) had been also infected by bacterial infections. The most prevalent bacterial isolates included group D Streptococcus (19.1%), Enterococcus spp. (19.1%) and Staphylococcus aureus (12.7%). The findings of current study indicated that the bacterial infections are still an important problem in the patients with cutaneous leishmaniasis and should be considered in treating these patients.

Antibacterial effects of Eucalyptus globulus leaf extract on pathogenic bacteria isolated from specimens of patients with respiratory tract disorders

The antibacterial activity of Eucalyptus globulus leaf extract was determined for 56 isolates of Staphylococcus aureus, 25 isolates of Streptococcus pyogenes, 12 isolates of Streptococcus pneumoniae and seven isolates of Haemophilus influenzae obtained from 200 clinical specimens of patients with respiratory tract disorders. MIC50s for these species were 64, 32, 16 and 16 mg/L, respectively; MIC90s were 128, 64, 32 and 32 mg/L, respectively; and MBCs were 512, 128, 64 and 64 mg/L, respectively. These results suggest that further studies to clarify the possible therapeutic role of E. globulus leaf extract in the treatment of respiratory tract infection are warranted.