1
|
Vietri NJ, Tobery SA, Chabot DJ, Ingavale S, Somerville BC, Miller JA, Schellhase CW, Twenhafel NA, Fetterer DP, Cote CK, Klimko CP, Boyer AE, Woolfitt AR, Barr JR, Wright ME, Friedlander AM. Clindamycin Protects Nonhuman Primates Against Inhalational Anthrax But Does Not Enhance Reduction of Circulating Toxin Levels When Combined With Ciprofloxacin. J Infect Dis 2021; 223:319-325. [PMID: 32697310 DOI: 10.1093/infdis/jiaa365] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2020] [Accepted: 06/19/2020] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND Inhalational anthrax is rare and clinical experience limited. Expert guidelines recommend treatment with combination antibiotics including protein synthesis-inhibitors to decrease toxin production and increase survival, although evidence is lacking. METHODS Rhesus macaques exposed to an aerosol of Bacillus anthracis spores were treated with ciprofloxacin, clindamycin, or ciprofloxacin + clindamycin after becoming bacteremic. Circulating anthrax lethal factor and protective antigen were quantitated pretreatment and 1.5 and 12 hours after beginning antibiotics. RESULTS In the clindamycin group, 8 of 11 (73%) survived demonstrating its efficacy for the first time in inhalational anthrax, compared to 9 of 9 (100%) with ciprofloxacin, and 8 of 11 (73%) with ciprofloxacin + clindamycin. These differences were not statistically significant. There were no significant differences between groups in lethal factor or protective antigen levels from pretreatment to 12 hours after starting antibiotics. Animals that died after clindamycin had a greater incidence of meningitis compared to those given ciprofloxacin or ciprofloxacin + clindamycin, but numbers of animals were very low and no definitive conclusion could be reached. CONCLUSION Treatment of inhalational anthrax with clindamycin was as effective as ciprofloxacin in the nonhuman primate. Addition of clindamycin to ciprofloxacin did not enhance reduction of circulating toxin levels.
Collapse
Affiliation(s)
- Nicholas J Vietri
- Division of Bacteriology, United States Army Medical Research Institute of Infectious Diseases, Frederick, Maryland, USA
| | - Steven A Tobery
- Division of Bacteriology, United States Army Medical Research Institute of Infectious Diseases, Frederick, Maryland, USA
| | - Donald J Chabot
- Division of Bacteriology, United States Army Medical Research Institute of Infectious Diseases, Frederick, Maryland, USA
| | - Susham Ingavale
- Division of Bacteriology, United States Army Medical Research Institute of Infectious Diseases, Frederick, Maryland, USA
| | - Brandon C Somerville
- Division of Bacteriology, United States Army Medical Research Institute of Infectious Diseases, Frederick, Maryland, USA
| | - Jeremy A Miller
- Division of Bacteriology, United States Army Medical Research Institute of Infectious Diseases, Frederick, Maryland, USA
| | - Chris W Schellhase
- Division of Pathology, United States Army Medical Research Institute of Infectious Diseases, Frederick, Maryland, USA
| | - Nancy A Twenhafel
- Division of Pathology, United States Army Medical Research Institute of Infectious Diseases, Frederick, Maryland, USA
| | - David P Fetterer
- Division of Biostatistics, United States Army Medical Research Institute of Infectious Diseases, Frederick, Maryland, USA
| | - Christopher K Cote
- Division of Bacteriology, United States Army Medical Research Institute of Infectious Diseases, Frederick, Maryland, USA
| | - Christopher P Klimko
- Division of Bacteriology, United States Army Medical Research Institute of Infectious Diseases, Frederick, Maryland, USA
| | - Anne E Boyer
- National Center for Environmental Health, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Adrian R Woolfitt
- National Center for Environmental Health, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - John R Barr
- National Center for Environmental Health, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Mary E Wright
- Division of Clinical Research, National Institute of Allergy and Infectious Diseases, Bethesda, Maryland, USA
| | - Arthur M Friedlander
- Headquarters, United States Army Medical Research Institute of Infectious Diseases, Frederick, Maryland, USA.,Department of Medicine, Uniformed Services University of the Health Sciences, Bethesda, Maryland, USA
| |
Collapse
|
2
|
Pillai SP, Prentice KW, Ramage JG, DePalma L, Sarwar J, Parameswaran N, Bell M, Plummer A, Santos A, Singh A, Pillai CA, Thirunavvukarasu N, Manickam G, Avila JR, Sharma SK, Hoffmaster A, Anderson K, Morse SA, Venkateswaran KV, Hodge DR. Rapid Presumptive Identification of Bacillus anthracis Isolates Using the Tetracore RedLine Alert™ Test. Health Secur 2020; 17:334-343. [PMID: 31433282 DOI: 10.1089/hs.2019.0038] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
Abstract
A comprehensive laboratory evaluation of the Tetracore RedLine Alert test, a lateral flow immunoassay (LFA) for the rapid presumptive identification of Bacillus anthracis, was conducted at 2 different test sites. The study evaluated the sensitivity of this assay using 16 diverse strains of B. anthracis grown on sheep blood agar (SBA) plates. In addition, 83 clinically relevant microorganisms were tested to assess the specificity of the RedLine Alert test. The results indicated that the RedLine Alert test for the presumptive identification of B. anthracis is highly robust, specific, and sensitive. RedLine Alert is a rapid test that has applicability for use in a clinical setting for ruling-in or ruling-out nonhemolytic colonies of Bacillus spp. grown on SBA medium as presumptive isolates of B. anthracis.
Collapse
Affiliation(s)
- Segaran P Pillai
- Segaran P. Pillai, PhD, is Director, Office of Laboratory Science and Safety, FDA Office of the Commissioner, Department of Health and Human Services, Silver Spring, MD
| | - Kristin W Prentice
- Kristin W. Prentice, MS, is an Associate, and Lindsay DePalma, MS, is a Staff Life Scientist; both at Booz Allen Hamilton, Rockville, MD
| | - Jason G Ramage
- Jason G. Ramage, MS, MBA, PMP, is Assistant Vice Chancellor for Research and Innovation and Director of Research Compliance, University of Arkansas, Fayetteville, AR
| | - Lindsay DePalma
- Kristin W. Prentice, MS, is an Associate, and Lindsay DePalma, MS, is a Staff Life Scientist; both at Booz Allen Hamilton, Rockville, MD
| | - Jawad Sarwar
- Jawad Sarwar, MS, is a Senior Research Scientist, and Nishanth Parameswaran is a Research Scientist; both at Omni Array Biotechnology, Rockville, MD
| | - Nishanth Parameswaran
- Jawad Sarwar, MS, is a Senior Research Scientist, and Nishanth Parameswaran is a Research Scientist; both at Omni Array Biotechnology, Rockville, MD
| | - Melissa Bell
- Melissa Bell, MS, is a Microbiologist, and Alex Hoffmaster, PhD, is Chief, Bacterial Special Pathogens Branch; both in the National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, GA
| | - Andrea Plummer
- Andrea Plummer and Alan Santos are Microbiologists, and Kodumudi Venkat Venkateswaran, PhD, is Chief Scientist; all at Tetracore, Inc., Rockville, MD
| | - Alan Santos
- Andrea Plummer and Alan Santos are Microbiologists, and Kodumudi Venkat Venkateswaran, PhD, is Chief Scientist; all at Tetracore, Inc., Rockville, MD
| | - Ajay Singh
- Ajay Singh, PhD, is a Research Scientist, Laulima Government Solutions, Contractor Support to USAMRICD Neurobiological Toxicology Branch, Analytical Toxicology Division, Aberdeen Proving Ground, MD
| | - Christine A Pillai
- Christine A. Pillai, Nagarajan Thirunavvukarasu, PhD, and Gowri Manickam, PhD, are ORISE Fellow Research Scientists, and Shashi K. Sharma, PhD, is a Research Microbiologist; all with the FDA Center for Food Safety and Applied Nutrition, Molecular Methods Development Branch, Division of Microbiology, Office of Regulatory Science, College Park, MD
| | - Nagarajan Thirunavvukarasu
- Christine A. Pillai, Nagarajan Thirunavvukarasu, PhD, and Gowri Manickam, PhD, are ORISE Fellow Research Scientists, and Shashi K. Sharma, PhD, is a Research Microbiologist; all with the FDA Center for Food Safety and Applied Nutrition, Molecular Methods Development Branch, Division of Microbiology, Office of Regulatory Science, College Park, MD
| | - Gowri Manickam
- Christine A. Pillai, Nagarajan Thirunavvukarasu, PhD, and Gowri Manickam, PhD, are ORISE Fellow Research Scientists, and Shashi K. Sharma, PhD, is a Research Microbiologist; all with the FDA Center for Food Safety and Applied Nutrition, Molecular Methods Development Branch, Division of Microbiology, Office of Regulatory Science, College Park, MD
| | - Julie R Avila
- Julie R. Avila, MS, is a Scientific Associate, Biosciences and Biotechnology Division, Lawrence Livermore National Laboratory, Livermore, CA
| | - Shashi K Sharma
- Christine A. Pillai, Nagarajan Thirunavvukarasu, PhD, and Gowri Manickam, PhD, are ORISE Fellow Research Scientists, and Shashi K. Sharma, PhD, is a Research Microbiologist; all with the FDA Center for Food Safety and Applied Nutrition, Molecular Methods Development Branch, Division of Microbiology, Office of Regulatory Science, College Park, MD
| | - Alex Hoffmaster
- Melissa Bell, MS, is a Microbiologist, and Alex Hoffmaster, PhD, is Chief, Bacterial Special Pathogens Branch; both in the National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, GA
| | - Kevin Anderson
- Kevin Anderson, PhD, and David R. Hodge, PhD, are Program Managers, Science and Technology Directorate, US Department of Homeland Security, Washington, DC
| | - Stephen A Morse
- Stephen A. Morse, MSPH, PhD, is a Senior Advisor, CDC Division of Select Agents and Toxins, and is currently with IHRC, Inc., Atlanta, GA
| | - Kodumudi Venkat Venkateswaran
- Andrea Plummer and Alan Santos are Microbiologists, and Kodumudi Venkat Venkateswaran, PhD, is Chief Scientist; all at Tetracore, Inc., Rockville, MD
| | - David R Hodge
- Kevin Anderson, PhD, and David R. Hodge, PhD, are Program Managers, Science and Technology Directorate, US Department of Homeland Security, Washington, DC
| |
Collapse
|
3
|
Sunnetcioglu M, Karadas S, Aslan M, Ceylan MR, Demir H, Oncu MR, Karahocagil MK, Sunnetcioglu A, Aypak C. Serum adenosine deaminase activity in cutaneous anthrax. Med Sci Monit 2014; 20:1151-4. [PMID: 24997584 PMCID: PMC4099211 DOI: 10.12659/msm.890472] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2014] [Accepted: 03/11/2014] [Indexed: 12/03/2022] Open
Abstract
BACKGROUND Adenosine deaminase (ADA) activity has been discovered in several inflammatory conditions; however, there are no data associated with cutaneous anthrax. The aim of this study was to investigate serum ADA activity in patients with cutaneous anthrax. MATERIAL AND METHODS Sixteen patients with cutaneous anthrax and 17 healthy controls were enrolled. We measured ADA activity; peripheral blood leukocyte, lymphocyte, neutrophil, and monocyte counts; erythrocyte sedimentation rate; and C reactive protein levels. RESULTS Serum ADA activity was significantly higher in patients with cutaneous anthrax than in the controls (p<0.001). A positive correlation was observed between ADA activity and lymphocyte counts (r=0.589, p=0.021) in the patient group. CONCLUSIONS This study suggests that serum ADA could be used as a biochemical marker in cutaneous anthrax.
Collapse
Affiliation(s)
- Mahmut Sunnetcioglu
- Department of Infectious Diseases and Clinical Microbiology, Yuzuncu Yil University, Faculty of Medicine, Van, Turkey
| | - Sevdegul Karadas
- Department of Emergency Medicine, Yuzuncu Yil University, Faculty of Medicine, Van, Turkey
| | - Mehmet Aslan
- Department of Infectious Diseases and Clinical Microbiology, Yuzuncu Yil University, Faculty of Medicine, Van, Turkey
- Department of Internal Medicine, Yuzuncu Yil University, Faculty of Medicine, Van, Turkey
| | - Mehmet Resat Ceylan
- Department of Infectious Diseases and Clinical Microbiology, Yuzuncu Yil University, Faculty of Medicine, Van, Turkey
| | - Halit Demir
- Department of Chemistry, Yuzuncu Yil University, Faculty of Science and Art, Van, Turkey
| | - Mehmet Resit Oncu
- Department of Emergency Medicine, Yuzuncu Yil University, Faculty of Medicine, Van, Turkey
| | - Mustafa Kasım Karahocagil
- Department of Infectious Diseases and Clinical Microbiology, Yuzuncu Yil University, Faculty of Medicine, Van, Turkey
| | - Aysel Sunnetcioglu
- Department of Pulmonary Diseases, Yuzuncu Yil University, Faculty of Medicine, Van, Turkey
| | - Cenk Aypak
- Department of Family Medicine, Diskapi Yildirim Beyazit Training and Research Hospital, Ankara, Turkey
| |
Collapse
|
4
|
Boyer AE, Quinn CP, Beesley CA, Gallegos-Candela M, Marston CK, Cronin LX, Lins RC, Stoddard RA, Li H, Schiffer J, Hossain MJ, Chakraborty A, Rahman M, Luby SP, Shieh WJ, Zaki S, Barr JR, Hoffmaster AR. Lethal factor toxemia and anti-protective antigen antibody activity in naturally acquired cutaneous anthrax. J Infect Dis 2011; 204:1321-7. [PMID: 21908727 PMCID: PMC3182309 DOI: 10.1093/infdis/jir543] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Cutaneous anthrax outbreaks occurred in Bangladesh from August to October 2009. As part of the epidemiological response and to confirm anthrax diagnoses, serum samples were collected from suspected case patients with observed cutaneous lesions. Anthrax lethal factor (LF), anti-protective antigen (anti-PA) immunoglobulin G (IgG), and anthrax lethal toxin neutralization activity (TNA) levels were determined in acute and convalescent serum of 26 case patients with suspected cutaneous anthrax from the first and largest of these outbreaks. LF (0.005-1.264 ng/mL) was detected in acute serum from 18 of 26 individuals. Anti-PA IgG and TNA were detected in sera from the same 18 individuals and ranged from 10.0 to 679.5 μg/mL and 27 to 593 units, respectively. Seroconversion to serum anti-PA and TNA was found only in case patients with measurable toxemia. This is the first report of quantitative analysis of serum LF in cutaneous anthrax and the first to associate acute stage toxemia with subsequent antitoxin antibody responses.
Collapse
Affiliation(s)
- Anne E Boyer
- Centers for Disease Control and Prevention, Atlanta, GA 30341, USA.
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|