Biological terrorism

[A multi-resistant bacterium before the era of antibiotics: the agent of melioidosis]

Melioidosis is an infectious, tropical and emerging disease, due to a bacterium of the hydrotelluric environment, Burkholderia pseudomallei, which is considered as a potential biological weapon because of its exceptional resistance and virulence capacities. Its worldwide spread, outside the original endemic foci of Southeast Asia and Australia, is favoured by global warming and the diabetes mellitus pandemic, which is the main predisposing factor.In humans, melioidosis is an opportunistic infection, following professional (rice farmers, soldiers) or accidental contamination, by inhalation or inoculation. B. pseudomallei is a facultative intracellular bacterium that can overcome host immune defences, induce acute, subacute, or chronic invasive infection, or remain latent for years. The acute infection is polymorphic, bacteraemic in more than 50% of cases, frequently complicated by shock, and revealed by visceral abscesses, most often pulmonary. It is fatal in 20 to 50% of cases, the prognosis depending on the delay before the establishment of effective first-line antibiotic therapy, using ceftazidime or carbapenems, and therefore on the speed of bacteriological diagnosis.B. pseudomallei is a saprophytic bacterium, resident of the rhizosphere where it has developed and accumulated capacities to overcome environmental stresses and competition with organisms living in such ecosystem. These adaptation mechanisms are also the virulence factors that make melioidosis serious, in particular the efflux pumps that are the main support for its multi-resistance to antibiotics.

Bioterrorism education effect on knowledge and attitudes of nurses

Context:

The most important way against bioterrorism is reinforcement of knowledge of health and medical team to diagnose and rapid reaction during these events.

Aims:

To assess the effect of bioterrorism education on knowledge and attitudes of nurses.

Settings and Design:

the setting of study was one of the infectious disease wards, emergency rooms or internal wards of the hospitals under supervision of Mazandaran University of Medical Sciences.

Materials and Methods:

In this pre-experimental study, 65 nurses who had all inclusion criteria are selected by accessible sampling method. Data on nurses knowledge and attitudes toward bioterrorism were collected using a self-administered questionnaire before and after two two-h sessions education. After a month of education, the units responded to questionnaire again.

Statistical Analysis Used:

A descriptive statistics Wilcoxon tests and Spearman correlation coefficient were used.

Results:

Before education, the majority of units (96.9%) had low knowledge about bioterrorism (0-33.3% score of 100%),whereas after education, the majority of them (100%) had good knowledge(well done) (66.7-100% score of 100%). And majority of units (96.9%) before education had indifferent attitude toward bioterrorism (33.4-66.6% score of 100%), whereas a majority of them (98.5%) after education had positive attitude (66.7-100% score of 100%).

Conclusions:

The education has a positive effect on nurses’ knowledge and attitudes and it can be a guideline for administrators of the Ministry of Health and medicine for planning to achieve the goals of preventive and defense against bioterrorism.

Rapid and reliable detection of bacterial endospores in environmental samples by diagnostic electron microscopy combined with X-ray microanalysis

Diagnostic negative staining electron microscopy is a front-line method for the rapid investigation of environmental and clinical samples in emergency situations caused by bioterrorism or outbreaks of an infectious disease. Spores of anthrax are one of the diagnostic targets in case of bioterrorism, because they have been used as a bio-weapon in the past and their production and transmission are rather simple. With negative staining electron microscopy bacterial spores can be identified based on their morphology at the single cell level. However, because of their particular density, no internal structures are visible which sometimes makes it difficult to distinguish spores from particles with a similar size and shape that are frequently present in environmental samples. Spores contain a high concentration of calcium ions besides other elements, which may allow a proper discrimination of spores from other suspicious particles. To investigate this hypothesis, negative staining electron microscopy, using either transmission or scanning electron microscopes, was combined with energy dispersive X-ray microanalysis, which reveals the element content of individual nanoparticles. A peak pattern consisting of calcium, sulphur and phosphorus was found as a typical signature within the X-ray spectrum of spores in various Clostridium and Bacillus species, including all strains of anthrax (Bacillus anthracis) tested. Moreover, spores could be reliably identified by this combined approach in environmental samples, like household products, soil or various presumed bioterrorist samples. In summary, the use of X-ray spectroscopy, either directly in the transmission electron microscope, or in a correlative approach by using scanning electron microscopy, improves the emergency diagnostics of suspicious environmental samples.

Thoracic radiologic manifestations of melioidosis

Melioidosis (Burkholderia pseudomallei) is a gram-negative bacterial infection that is highly endemic in Southeast Asia and Oceania. Pulmonary disease is the most common form of involvement. The clinical-radiologic thoracic manifestations of melioidosis can be classified as acute, subacute, subclinical, and chronic forms. Radiographic findings include nodular, alveolar, or mixed infiltration/consolidation with or without cavities. Pleural effusion, pneumothorax, and pericardial involvement can be seen. Melioidosis can easily be confused with other infections, especially tuberculosis. Suspicion of this disease in the proper clinical radiologic setting is important for early diagnosis and treatment. In this article, we provide a broad clinical overview of melioidosis, review the radiologic thoracic manifestations of melioidosis with appropriate clinical correlation, as well as compare and contrast the imaging findings of thoracic melioidosis with other similar pulmonary infections.

Treatment of neuroterrorism

Bioterrorism is defined as the intentional use of biological, chemical, nuclear, or radiological agents to cause disease, death, or environmental damage. Early recognition of a bioterrorist attack is of utmost importance to minimize casualties and initiate appropriate therapy. The range of agents that could potentially be used as weapons is wide, however, only a few of these agents have all the characteristics making them ideal for that purpose. Many of the chemical and biological weapons can cause neurological symptoms and damage the nervous system in varying degrees. Therefore, preparedness among neurologists is important. The main challenge is to be cognizant of the clinical syndromes and to be able to differentiate diseases caused by bioterrorism from naturally occurring disorders. This review provides an overview of the biological and chemical warfare agents, with a focus on neurological manifestation and an approach to treatment from a perspective of neurological critical care.

Phage display of combinatorial peptide libraries: application to antiviral research

Given the growing number of diseases caused by emerging or endemic viruses, original strategies are urgently required: (1) for the identification of new drugs active against new viruses and (2) to deal with viral mutants in which resistance to existing antiviral molecules has been selected. In this context, antiviral peptides constitute a promising area for disease prevention and treatment. The identification and development of these inhibitory peptides require the high-throughput screening of combinatorial libraries. Phage-display is a powerful technique for selecting unique molecules with selective affinity for a specific target from highly diverse combinatorial libraries. In the last 15 years, the use of this technique for antiviral purposes and for the isolation of candidate inhibitory peptides in drug discovery has been explored. We present here a review of the use of phage display in antiviral research and drug discovery, with a discussion of optimized strategies combining the strong screening potential of this technique with complementary rational approaches for identification of the best target. By combining such approaches, it should be possible to maximize the selection of molecules with strong antiviral potential.

Three Yersinia pestis adhesins facilitate Yop delivery to eukaryotic cells and contribute to plague virulence

To establish a successful infection, Yersinia pestis requires the delivery of cytotoxic Yops to host cells. Yops inhibit phagocytosis, block cytokine responses, and induce apoptosis of macrophages. The Y. pestis adhesin Ail facilitates Yop translocation and is required for full virulence in mice. To determine the contributions of other adhesins to Yop delivery, we deleted five known adhesins of Y. pestis. In addition to Ail, plasminogen activator (Pla) and pH 6 antigen (Psa) could mediate Yop translocation to host cells. The contribution of each adhesin to binding and Yop delivery was dependent upon the growth conditions. When cells were pregrown at 28°C and pH 7, the order of importance for adhesins in cell binding and cytotoxicity was Ail > Pla > Psa. Y. pestis grown at 37°C and pH 7 had equal contributions from Ail and Pla but an undetectable role for Psa. At 37°C and pH 6, both Ail and Psa contributed to binding and Yop delivery, while Pla contributed minimally. Pla-mediated Yop translocation was independent of protease activity. Of the three single mutants, the Δail mutant was the most defective in mouse virulence. The expression level of ail was also the highest of the three adhesins in infected mouse tissues. Compared to an ail mutant, additional deletion of psaA (encoding Psa) led to a 130,000-fold increase in the 50% lethal dose for mice relative to that of the KIM5 parental strain. Our results indicate that in addition to Ail, Pla and Psa can serve as environmentally specific adhesins to facilitate Yop secretion, a critical virulence function of Y. pestis.

Variables to be considered when assessing the photocatalytic destruction of bacterial pathogens

The current study sought to assess the importance of three common variables on the outcome of TiO(2) photocatalysis experiments with bacteria. Factors considered were (a) ability of test species to withstand osmotic pressure, (b) incubation period of agar plates used for colony counts following photocatalysis and (c) chemical nature of suspension medium used for bacteria and TiO(2). Staphylococcus aureus, Escherichia coli, Salmonella ser. Typhimurium and Pseudomonas aeruginosa were found to vary greatly in their ability to withstand osmotic pressure, raising the possibility that osmotic lysis may be contributing to loss of viability in some photocatalytic disinfection studies. Agar plate incubation time was also found to influence results, as bacteria treated with UV light only grew more slowly than those treated with a combination of UV and TiO(2.) The chemical nature of the suspension medium used was found to have a particularly pronounced effect upon results. Greatest antibacterial activity was detected when aqueous sodium chloride solution was utilised, with approximately 1 x 10(6) CFU mL(-1)S. aureus being completely killed after 60 min. Moderate activity was observed when distilled water was employed with bacteria being killed after 2h and 30 min, and no antibacterial activity at all was detected when aqueous tryptone solution was used. Interestingly, the antibacterial activity of UV light on its own appeared to be very much reduced in experiments where aqueous sodium chloride was employed instead of distilled water.

Tracking the dynamics of salmonella specific T cell responses

Over the last decade, significant advances have been made in the methodology for studying immune responses in vivo. It is now possible to follow almost every aspect of pathogen-specific immunity using in vivo models that incorporate physiological infectious doses and natural routes of infection. This new ability to study immunity in a relevant physiological context will greatly expand our understanding of the dynamic interplay between host and pathogen. Visualizing the resolution of primary infection and the development of long-term immunological memory should also aid the development of new vaccines and therapeutics for infectious diseases. In this review, we will describe the application of in vivo visualization technology to Salmonella infection, describe our current understanding of Salmonella-specific immunity, and discuss some unanswered questions that remain in this model.

Recent Publications on Medications and Pharmacy

Hospital Pharmacy presents this feature to keep pharmacists abreast of new publications in the medical/pharmacy literature. Articles of interest will be abstracted monthly regarding a broad scope of topics. Suggestions or comments may be addressed to: Jacyntha Sterling, Drug Information Specialist at Saint Francis Hospital, 6161 S Yale Ave., Tulsa, OK 74136 or e-mail: jasterling@saintfrancis.com .