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Hussain H, Fadel A, Garcia E, Hernandez RJ, Saadoon ZF, Naseer L, Casmartino E, Hamad M, Schnepp T, Sarfraz R, Angly S, Jayakumar AR. Clostridial Myonecrosis: A Comprehensive Review of Toxin Pathophysiology and Management Strategies. Microorganisms 2024; 12:1464. [PMID: 39065232 PMCID: PMC11278868 DOI: 10.3390/microorganisms12071464] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2024] [Revised: 07/13/2024] [Accepted: 07/17/2024] [Indexed: 07/28/2024] Open
Abstract
Clostridial myonecrosis, commonly known as gas gangrene (GG), is a rapidly progressing and potentially fatal bacterial infection that primarily affects muscle and soft tissue. In the United States, the incidence of GG is roughly 1000 cases per year, while, in developing countries, the incidence is higher. This condition is most often caused by Clostridium perfringens, a Gram-positive, spore-forming anaerobic bacterium widely distributed in the environment, although other Clostridium species have also been reported to cause GG. The CP genome contains over 200 transport-related genes, including ABC transporters, which facilitate the uptake of sugars, amino acids, nucleotides, and ions from the host environment. There are two main subtypes of GG: traumatic GG, resulting from injuries that introduce Clostridium spores into deep tissue, where anaerobic conditions allow for bacterial growth and toxin production, and spontaneous GG, which is rarer and often occurs in immunocompromised patients. Clostridium species produce various toxins (e.g., alpha, theta, beta) that induce specific downstream signaling changes in cellular pathways, causing apoptosis or severe, fatal immunological conditions. For example, the Clostridium perfringens alpha toxin (CPA) targets the host cell's plasma membrane, hydrolyzing sphingomyelin and phosphatidylcholine, which triggers necrosis and apoptosis. The clinical manifestations of clostridial myonecrosis vary. Some patients experience the sudden onset of severe pain, swelling, and muscle tenderness, with the infection progressing rapidly to widespread tissue necrosis, systemic toxicity, and, if untreated, death. Other patients present with discharge, pain, and features of cellulitis. The diagnosis of GG primarily involves clinical evaluation, imaging studies such as X-rays, computer tomography (CT) scans, and culture. The treatment of GG involves surgical exploration, broad-spectrum antibiotics, antitoxin, and hyperbaric oxygen therapy, which is considered an adjunctive treatment to inhibit anaerobic bacterial growth and enhance the antibiotic efficacy. Early recognition and prompt, comprehensive treatment are critical to improving the outcomes for patients affected by this severe and life-threatening condition.
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Affiliation(s)
- Hussain Hussain
- Department of Internal Medicine, Kendall Hospital-HCA Florida Healthcare, Miami, FL 33136, USA;
- Department of Internal Medicine and Infectious Disease, Larkin Community Hospital, Miami, FL 33143, USA; (E.G.); (Z.F.S.); (L.N.); (E.C.); (M.H.); (T.S.); (R.S.); (S.A.)
| | - Aya Fadel
- Department of Internal Medicine, Ocean University Medical Center—Hackensack Meridian Health, Brick, NJ 08724, USA;
| | - Efrain Garcia
- Department of Internal Medicine and Infectious Disease, Larkin Community Hospital, Miami, FL 33143, USA; (E.G.); (Z.F.S.); (L.N.); (E.C.); (M.H.); (T.S.); (R.S.); (S.A.)
| | - Robert J. Hernandez
- Department of Internal Medicine, Kendall Hospital-HCA Florida Healthcare, Miami, FL 33136, USA;
- Department of Internal Medicine and Infectious Disease, Larkin Community Hospital, Miami, FL 33143, USA; (E.G.); (Z.F.S.); (L.N.); (E.C.); (M.H.); (T.S.); (R.S.); (S.A.)
| | - Zahraa F. Saadoon
- Department of Internal Medicine and Infectious Disease, Larkin Community Hospital, Miami, FL 33143, USA; (E.G.); (Z.F.S.); (L.N.); (E.C.); (M.H.); (T.S.); (R.S.); (S.A.)
| | - Lamia Naseer
- Department of Internal Medicine and Infectious Disease, Larkin Community Hospital, Miami, FL 33143, USA; (E.G.); (Z.F.S.); (L.N.); (E.C.); (M.H.); (T.S.); (R.S.); (S.A.)
| | - Ekaterina Casmartino
- Department of Internal Medicine and Infectious Disease, Larkin Community Hospital, Miami, FL 33143, USA; (E.G.); (Z.F.S.); (L.N.); (E.C.); (M.H.); (T.S.); (R.S.); (S.A.)
| | - Mohammad Hamad
- Department of Internal Medicine and Infectious Disease, Larkin Community Hospital, Miami, FL 33143, USA; (E.G.); (Z.F.S.); (L.N.); (E.C.); (M.H.); (T.S.); (R.S.); (S.A.)
| | - Taylor Schnepp
- Department of Internal Medicine and Infectious Disease, Larkin Community Hospital, Miami, FL 33143, USA; (E.G.); (Z.F.S.); (L.N.); (E.C.); (M.H.); (T.S.); (R.S.); (S.A.)
| | - Rehan Sarfraz
- Department of Internal Medicine and Infectious Disease, Larkin Community Hospital, Miami, FL 33143, USA; (E.G.); (Z.F.S.); (L.N.); (E.C.); (M.H.); (T.S.); (R.S.); (S.A.)
| | - Sohair Angly
- Department of Internal Medicine and Infectious Disease, Larkin Community Hospital, Miami, FL 33143, USA; (E.G.); (Z.F.S.); (L.N.); (E.C.); (M.H.); (T.S.); (R.S.); (S.A.)
| | - Arumugam R. Jayakumar
- Department of Obstetrics, Gynecology and Reproductive Sciences, University of Miami Miller School of Medicine, Miami, FL 33136, USA
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Debnath SK, Debnath M, Srivastava R. Opportunistic etiological agents causing lung infections: emerging need to transform lung-targeted delivery. Heliyon 2022; 8:e12620. [PMID: 36619445 PMCID: PMC9816992 DOI: 10.1016/j.heliyon.2022.e12620] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2022] [Revised: 09/03/2022] [Accepted: 12/16/2022] [Indexed: 12/27/2022] Open
Abstract
Lung diseases continue to draw considerable attention from biomedical and public health care agencies. The lung with the largest epithelial surface area is continuously exposed to the external environment during exchanging gas. Therefore, the chances of respiratory disorders and lung infections are overgrowing. This review has covered promising and opportunistic etiologic agents responsible for lung infections. These pathogens infect the lungs either directly or indirectly. However, it is difficult to intervene in lung diseases using available oral or parenteral antimicrobial formulations. Many pieces of research have been done in the last two decades to improve inhalable antimicrobial formulations. However, very few have been approved for human use. This review article discusses the approved inhalable antimicrobial agents (AMAs) and identifies why pulmonary delivery is explored. Additionally, the basic anatomy of the respiratory system linked with barriers to AMA delivery has been discussed here. This review opens several new scopes for researchers to work on pulmonary medicines for specific diseases and bring more respiratory medication to market.
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Oliveira AR, de Castro MF, Pimentel SP, de Carvalho TP, Santana CH, Santos DDO, Tinoco HP, Coelho CM, Pessanha AT, da Paixão TA, Santos RL. Streptococcus pasteurianus-induced valvular endocarditis and sepsis in a puerperal emperor tamarin (Saguinus imperator). J Med Primatol 2022; 51:388-391. [PMID: 35451506 DOI: 10.1111/jmp.12587] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2022] [Revised: 03/27/2022] [Accepted: 04/06/2022] [Indexed: 11/29/2022]
Abstract
Streptococcus pasteurianus is associated with endocarditis and sepsis in humans. A puerperal emperor tamarin died, and necropsy showed a bacterial endocarditis with sepsis. DNA sequencing from the paraffinized heart tissue was compatible with S. pasteurianus. S. pasteurianus could be an important agent associated with sepsis in tamarins.
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Affiliation(s)
| | | | | | | | | | | | | | - Carlyle Mendes Coelho
- Fundação de Parques Municipais e Zoobotânica de Belo Horizonte, Belo Horizonte, Brazil
| | | | - Tatiane Alves da Paixão
- Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Renato Lima Santos
- Escola de Veterinária, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
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Fitz C, Goodroe A, Wierenga L, Mejia A, Simmons H. Clinical Management of Gastrointestinal Disease in the Common Marmoset (Callithrix jacchus). ILAR J 2021; 61:199-217. [PMID: 33989417 DOI: 10.1093/ilar/ilab012] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2020] [Revised: 11/10/2020] [Accepted: 12/20/2020] [Indexed: 12/17/2022] Open
Abstract
Gastrointestinal disease is a frequently encountered problem among captive common marmoset (Callithrix jacchus) colonies. Management can be challenging due to the number of etiologies responsible for gastrointestinal disease in this species, limitations on diagnostic capabilities, and lack of effective treatments. Understanding commonly described GI diseases in the captive marmoset can provide insight on the impact these diseases have on research studies and aid in the development of appropriate management strategies. A review of commonly encountered GI disease processes as well as routinely implicated causes of GI disease in the common marmoset are provided. Current strategies in clinical management of GI disease in the common marmoset, including approaches to colony health, diagnostic testing, and commonly employed treatments are discussed.
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Affiliation(s)
- Casey Fitz
- Wisconsin National Primate Research Center at the University of Wisconsin-Madison, Madison, Wisconsin, USA
| | - Anna Goodroe
- Texas Biomedical Research Institute and Southwest National Primate Research Center in San Antonio, Texas, USA
| | - Lauren Wierenga
- Wisconsin National Primate Research Center at the University of Wisconsin-Madison, Madison, Wisconsin, USA.,Research Animal Resources and Compliance at the University of Wisconsin-Madison, Madison, Wisconsin, USA
| | - Andres Mejia
- Wisconsin National Primate Research Center at the University of Wisconsin-Madison, Madison, Wisconsin, USA
| | - Heather Simmons
- Wisconsin National Primate Research Center at the University of Wisconsin-Madison, Madison, Wisconsin, USA
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Kovalchuk SN, Babii AV. Draft genome sequence data and comparative analysis of Erysipelothrix Rhusiopathiae vaccine strain VR-2. 3 Biotech 2020; 10:455. [PMID: 33088652 DOI: 10.1007/s13205-020-02451-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2020] [Accepted: 09/21/2020] [Indexed: 11/29/2022] Open
Abstract
Erysipelothrix rhusiopathiae VR-2 is a commercially available live attenuated vaccine strain widely used in Russia, Kazakhstan, and a number of European countries for immunization of pigs against swine erysipelas. The draft genome sequence of E. rhusiopathiae strain VR-2 reported in this paper is 1,704,727 bp in length, has CG content of 36.5%, and contains 1680 genes, including 51 tRNA, 3 rRNA, and 1408 protein-coding genes. Comparative sequence analysis between Fujisawa (serovar 1a), VR-2 and six other serovar N strains of E. rhusiopathiae revealed wide genetic variability of the chromosomal region essential for serovar-specific antigenicity and virulence of E. rhusiopathiae strains. We have performed a BLAST search and found 12 genomic loci potentially specific for the E. rhusiopathiae VR-2 strain. These data could be helpful for developing genetic assays for differentiation of field isolates and this live attenuated vaccine strain, which is especially important for epizootical monitoring of swine erysipelas in countries, where the live vaccine strain E. rhusiopathiae VR-2 is used for pig immunization, as well as for the design of recombinant vaccines against swine erysipelas. The genome of E. rhusiopathiae VR-2 has been submitted in GenBank under accession number RJTK00000000.1.
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Affiliation(s)
- Svetlana N Kovalchuk
- Federal Science Center for Animal Husbandry Named After Academy Member L.K. Ernst, Dubrovitsy 60, Podolsk Municipal District, 142132 Moscow Region Russian Federation
| | - Anna V Babii
- Federal Science Center for Animal Husbandry Named After Academy Member L.K. Ernst, Dubrovitsy 60, Podolsk Municipal District, 142132 Moscow Region Russian Federation
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