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Eisenreich W, Rudel T, Heesemann J, Goebel W. Link Between Antibiotic Persistence and Antibiotic Resistance in Bacterial Pathogens. Front Cell Infect Microbiol 2022; 12:900848. [PMID: 35928205 PMCID: PMC9343593 DOI: 10.3389/fcimb.2022.900848] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2022] [Accepted: 06/21/2022] [Indexed: 12/15/2022] Open
Abstract
Both, antibiotic persistence and antibiotic resistance characterize phenotypes of survival in which a bacterial cell becomes insensitive to one (or even) more antibiotic(s). However, the molecular basis for these two antibiotic-tolerant phenotypes is fundamentally different. Whereas antibiotic resistance is genetically determined and hence represents a rather stable phenotype, antibiotic persistence marks a transient physiological state triggered by various stress-inducing conditions that switches back to the original antibiotic sensitive state once the environmental situation improves. The molecular basics of antibiotic resistance are in principle well understood. This is not the case for antibiotic persistence. Under all culture conditions, there is a stochastically formed, subpopulation of persister cells in bacterial populations, the size of which depends on the culture conditions. The proportion of persisters in a bacterial population increases under different stress conditions, including treatment with bactericidal antibiotics (BCAs). Various models have been proposed to explain the formation of persistence in bacteria. We recently hypothesized that all physiological culture conditions leading to persistence converge in the inability of the bacteria to re-initiate a new round of DNA replication caused by an insufficient level of the initiator complex ATP-DnaA and hence by the lack of formation of a functional orisome. Here, we extend this hypothesis by proposing that in this persistence state the bacteria become more susceptible to mutation-based antibiotic resistance provided they are equipped with error-prone DNA repair functions. This is - in our opinion - in particular the case when such bacterial populations are exposed to BCAs.
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Affiliation(s)
- Wolfgang Eisenreich
- Bavarian NMR Center – Structural Membrane Biochemistry, Department of Chemistry, Technische Universität München, Garching, Germany
- *Correspondence: Wolfgang Eisenreich,
| | - Thomas Rudel
- Chair of Microbiology, Biocenter, University of Würzburg, Würzburg, Germany
| | - Jürgen Heesemann
- Max von Pettenkofer-Institute, Ludwig Maximilian University of Munich, München, Germany
| | - Werner Goebel
- Max von Pettenkofer-Institute, Ludwig Maximilian University of Munich, München, Germany
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2
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First Report of Bacillary Angiomatosis by Bartonella elizabethae in an HIV-Positive Patient. Am J Dermatopathol 2020; 41:750-753. [PMID: 31094718 DOI: 10.1097/dad.0000000000001439] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
We present the case of an HIV-positive patient who developed polymorphous lesions in which the evidence in the skin biopsy corresponds to the diagnosis of bacillary angiomatosis, and further tests proved the pathological agent involved in this case is not the usual Bartonella species, B. henselae and B. quintana, but B. elizabethae. As far as we know, this is the first case of bacillary angiomatosis secondary to this etiological agent.
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Abstract
Carrion's disease (CD) is a neglected biphasic vector-borne illness related to Bartonella bacilliformis. It is found in the Andean valleys and is transmitted mainly by members of the Lutzomyia genus but also by blood transfusions and from mother to child. The acute phase, Oroya fever, presents severe anemia and fever. The lethality is high in the absence of adequate treatment, despite the organism being susceptible to most antibiotics. Partial immunity is developed after infection by B. bacilliformis, resulting in high numbers of asymptomatic carriers. Following infection there is the chronic phase, Peruvian warts, involving abnormal proliferation of the endothelial cells. Despite potentially being eradicable, CD has been expanded due to human migration and geographical expansion of the vector. Moreover, in vitro studies have demonstrated the risk of the development of antimicrobial resistance. These findings, together with the description of new Bartonella species producing CD-like infections, the presence of undescribed potential vectors in new areas, the lack of adequate diagnostic tools and knowledge of the immunology and bacterial pathogenesis of CD, and poor international visibility, have led to the risk of increasing the potential expansion of resistant strains which will challenge current treatment schemes as well as the possible appearance of CD in areas where it is not endemic.
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Affiliation(s)
- Cláudia Gomes
- Institute for Global Health, Barcelona Centre for International Health Research, Hospital Clínic, Universitat de Barcelona, Barcelona, Spain
| | - Joaquim Ruiz
- Institute for Global Health, Barcelona Centre for International Health Research, Hospital Clínic, Universitat de Barcelona, Barcelona, Spain
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Gomes C, Martínez-Puchol S, Ruiz-Roldán L, Pons MJ, Del Valle Mendoza J, Ruiz J. Development and characterisation of highly antibiotic resistant Bartonella bacilliformis mutants. Sci Rep 2016; 6:33584. [PMID: 27667026 PMCID: PMC5035977 DOI: 10.1038/srep33584] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2016] [Accepted: 08/31/2016] [Indexed: 01/31/2023] Open
Abstract
The objective was to develop and characterise in vitro Bartonella bacilliformis antibiotic resistant mutants. Three B. bacilliformis strains were plated 35 or 40 times with azithromycin, chloramphenicol, ciprofloxacin or rifampicin discs. Resistance-stability was assessed performing 5 serial passages without antibiotic pressure. MICs were determined with/without Phe-Arg-β-Napthylamide and artesunate. Target alterations were screened in the 23S rRNA, rplD, rplV, gyrA, gyrB, parC, parE and rpoB genes. Chloramphenicol and ciprofloxacin resistance were the most difficult and easiest (>37.3 and 10.6 passages) to be selected, respectively. All mutants but one selected with chloramphenicol achieved high resistance levels. All rifampicin, one azithromycin and one ciprofloxacin mutants did not totally revert when cultured without antibiotic pressure. Azithromycin resistance was related to L4 substitutions Gln-66 → Lys or Gly-70 → Arg; L4 deletion Δ62–65 (Lys-Met-Tyr-Lys) or L22 insertion 83::Val-Ser-Glu-Ala-His-Val-Gly-Lys-Ser; in two chloramphenicol-resistant mutants the 23S rRNA mutation G2372A was detected. GyrA Ala-91 → Val and Asp-95 → Gly and GyrB Glu474 → Lys were detected in ciprofloxacin-resistant mutants. RpoB substitutions Gln-527 → Arg, His-540 → Tyr and Ser-545 → Phe plus Ser-588 → Tyr were detected in rifampicin-resistant mutants. In 5 mutants the effect of efflux pumps on resistance was observed. Antibiotic resistance was mainly related to target mutations and overexpression of efflux pumps, which might underlie microbiological failures during treatments.
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Affiliation(s)
- Cláudia Gomes
- ISGlobal, Barcelona Ctr. Int. Health Res. (CRESIB), Hospital Clínic - Universitat de Barcelona, Barcelona, Spain
| | - Sandra Martínez-Puchol
- ISGlobal, Barcelona Ctr. Int. Health Res. (CRESIB), Hospital Clínic - Universitat de Barcelona, Barcelona, Spain
| | - Lidia Ruiz-Roldán
- ISGlobal, Barcelona Ctr. Int. Health Res. (CRESIB), Hospital Clínic - Universitat de Barcelona, Barcelona, Spain
| | - Maria J Pons
- School of Medicine, Research Center and Innovation of the Health Sciences Faculty, Universidad Peruana de Ciencias Aplicadas (UPC), Lima, Peru
| | - Juana Del Valle Mendoza
- School of Medicine, Research Center and Innovation of the Health Sciences Faculty, Universidad Peruana de Ciencias Aplicadas (UPC), Lima, Peru.,Instituto de Investigación Nutricional, Lima, Peru
| | - Joaquim Ruiz
- ISGlobal, Barcelona Ctr. Int. Health Res. (CRESIB), Hospital Clínic - Universitat de Barcelona, Barcelona, Spain
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5
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Garnier C, Martin-Blondel G, Debuisson C, Dubois D, Debard A, Cuzin L, Massip P, Delobel P, Marchou B. Intra-nodal injection of gentamicin for the treatment of suppurated cat scratch disease's lymphadenitis. Infection 2015; 44:23-7. [PMID: 26001741 DOI: 10.1007/s15010-015-0797-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2015] [Accepted: 05/13/2015] [Indexed: 10/23/2022]
Abstract
PURPOSE Cat scratch disease (CSD)'s lymphadenitis may have a protracted course with painful suppuration necessitating several needle aspirations or surgical drainage. The objective of this study was to evaluate the benefit of an intra-nodal injection of gentamicin add-on oral azithromycin treatment on the outcome of suppurated CSD's lymphadenitis. METHODS We performed a retrospective monocentric study including 51 consecutive patients diagnosed between Jan 2009 and Mar 2014 with suppurated CSD who had a positive PCR for Bartonella henselae DNA in pus collected from lymph node by needle aspiration, and who were treated with azithromycin. RESULTS Among them, 26/51 patients (51%) received oral azithromycin only, of whom 8 patients (31%) were cured and 18 patients (69%) had complications, while 25/51 patients (49%) received an intra-nodal injection of gentamicin add-on oral azithromycin, of whom 16 patients (64 %) were cured and 9 patients (36%) had complications. In univariate analysis, the combined treatment was the only variable related to cure without complications (64 versus 31%, p = 0.01), but this difference did not remain statistically significant in multivariate analysis (OR = 3.84, 95% CI: 0.95-15.56, p = 0.06). CONCLUSIONS Intra-nodal injection of gentamicin add-on oral azithromycin treatment might improve the outcome of patients with suppurated CSD's lymphadenitis, deserving further randomized studies.
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Affiliation(s)
- Camille Garnier
- Department of Infectious and Tropical Diseases, Toulouse University Hospital, Place du Docteur Baylac TSA 40031, 31059, Toulouse Cedex 9, France.
| | - Guillaume Martin-Blondel
- Department of Infectious and Tropical Diseases, Toulouse University Hospital, Place du Docteur Baylac TSA 40031, 31059, Toulouse Cedex 9, France. .,INSERM U1043-CNRS UMR 5282, Centre de Physiopathologie Toulouse-Purpan, Toulouse, France. .,Université Toulouse III, 31000, Toulouse, France.
| | - Cécile Debuisson
- Department of Paediatrics, Toulouse University Hospital, Toulouse, France
| | - Damien Dubois
- INSERM U1043-CNRS UMR 5282, Centre de Physiopathologie Toulouse-Purpan, Toulouse, France.,Department of Bacteriology, Toulouse University Hospital, Toulouse, France
| | - Alexa Debard
- Department of Infectious and Tropical Diseases, Toulouse University Hospital, Place du Docteur Baylac TSA 40031, 31059, Toulouse Cedex 9, France
| | - Lise Cuzin
- Department of Infectious and Tropical Diseases, Toulouse University Hospital, Place du Docteur Baylac TSA 40031, 31059, Toulouse Cedex 9, France
| | - Patrice Massip
- Department of Infectious and Tropical Diseases, Toulouse University Hospital, Place du Docteur Baylac TSA 40031, 31059, Toulouse Cedex 9, France.,Université Toulouse III, 31000, Toulouse, France
| | - Pierre Delobel
- Department of Infectious and Tropical Diseases, Toulouse University Hospital, Place du Docteur Baylac TSA 40031, 31059, Toulouse Cedex 9, France.,INSERM U1043-CNRS UMR 5282, Centre de Physiopathologie Toulouse-Purpan, Toulouse, France.,Université Toulouse III, 31000, Toulouse, France
| | - Bruno Marchou
- Department of Infectious and Tropical Diseases, Toulouse University Hospital, Place du Docteur Baylac TSA 40031, 31059, Toulouse Cedex 9, France.,Université Toulouse III, 31000, Toulouse, France
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7
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Biswas S, Rolain JM. Bartonella infection: treatment and drug resistance. Future Microbiol 2011; 5:1719-31. [PMID: 21133691 DOI: 10.2217/fmb.10.133] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Bartonella species, which belong to the α-2 subgroup of Proteobacteria, are fastidious Gram-negative bacteria that are highly adapted to their mammalian host reservoirs. Bartonella species are responsible for different clinical conditions affecting humans, including Carrion's disease, cat scratch disease, trench fever, bacillary angiomatosis, endocarditis and peliosis hepatis. While some of these diseases can resolve spontaneously without treatment, in other cases, the disease is fatal without antibiotic treatment. In this article, we discuss the antibiotic susceptibility patterns of Bartonella species, detected using several methods. We also provide an overview of Bartonella infection in humans and animals and discuss the antibiotic treatment recommendations for the different infections, treatment failure and the molecular mechanism of antibiotic resistance in these bacteria.
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Affiliation(s)
- Silpak Biswas
- CNRS-IRD, UMR 6236, Unité de Recherche sur les Maladies Infectieuses et Tropicales Emergentes, Faculté de Médecine et de Pharmacie, Université de la Méditerranée, 27 boulevard Jean-Moulin, Marseille cedex 05, France
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8
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Abstract
Bartonella infection is common among domestic cats, but the role of Bartonella species as feline pathogens requires further study. Most Bartonella species that infect cats are zoonotic. Cats are the mammalian reservoir and vector for Bartonella henselae, an important zoonotic agent. Cat fleas transmit Bartonella among cats, and cats with fleas are an important source of human B henselae infections. New information about Bartonella as feline pathogens has recently been published, and this article summarizes much of that information. Issues surrounding diagnosis and treatment of feline Bartonella infections are described, and prevention of zoonotic transmission of Bartonella is discussed.
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Saisongkorh W, Robert C, La Scola B, Raoult D, Rolain JM. Evidence of transfer by conjugation of type IV secretion system genes between Bartonella species and Rhizobium radiobacter in amoeba. PLoS One 2010; 5:e12666. [PMID: 20856925 PMCID: PMC2938332 DOI: 10.1371/journal.pone.0012666] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2010] [Accepted: 08/15/2010] [Indexed: 11/24/2022] Open
Abstract
Background Bartonella species cospeciate with mammals and live within erythrocytes. Even in these specific niches, it has been recently suggested by bioinformatic analysis of full genome sequences that Lateral Gene Transfer (LGT) may occur but this has never been demonstrated biologically. Here we describe the sequence of the B. rattaustraliani (AUST/NH4T) circular plasmid (pNH4) that encodes the tra cluster of the Type IV secretion system (T4SS) and we eventually provide evidence that Bartonella species may conjugate and exchange this plasmid inside amoeba. Principal Findings The T4SS of pNH4 is critical for intracellular viability of bacterial pathogens, exhibits bioinformatic evidence of LGT among bacteria living in phagocytic protists. For instance, 3 out of 4 T4SS encoding genes from pNH4 appear to be closely related to Rhizobiales, suggesting that gene exchange occurs between intracellular bacteria from mammals (bartonellae) and plants (Rhizobiales). We show that B. rattaustraliani and Rhizobium radiobacter both survived within the amoeba Acanthamoeba polyphaga and can conjugate together. Our findings further support the hypothesis that tra genes might also move into and out of bacterial communities by conjugation, which might be the primary means of genomic evolution for intracellular adaptation by cross-talk of interchangeable genes between Bartonella species and plant pathogens. Conclusions Based on this, we speculate that amoeba favor the transfer of genes as phagocytic protists, which allows for intraphagocytic survival and, as a consequence, promotes the creation of potential pathogenic organisms.
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Affiliation(s)
- Watcharee Saisongkorh
- URMITE, CNRS-IRD UMR 6236, Faculté de Médecine et de Pharmacie, Université de la Méditerranée, Marseille, France
| | - Catherine Robert
- URMITE, CNRS-IRD UMR 6236, Faculté de Médecine et de Pharmacie, Université de la Méditerranée, Marseille, France
| | - Bernard La Scola
- URMITE, CNRS-IRD UMR 6236, Faculté de Médecine et de Pharmacie, Université de la Méditerranée, Marseille, France
| | - Didier Raoult
- URMITE, CNRS-IRD UMR 6236, Faculté de Médecine et de Pharmacie, Université de la Méditerranée, Marseille, France
- * E-mail: (JMR); (DR)
| | - Jean-Marc Rolain
- URMITE, CNRS-IRD UMR 6236, Faculté de Médecine et de Pharmacie, Université de la Méditerranée, Marseille, France
- * E-mail: (JMR); (DR)
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Tsuneoka H, Yanagihara M, Nojima J, Ichihara K. Antimicrobial susceptibility by Etest of Bartonella henselae isolated from cats and human in Japan. J Infect Chemother 2010; 16:446-8. [PMID: 20567991 DOI: 10.1007/s10156-010-0081-5] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2010] [Accepted: 05/25/2010] [Indexed: 11/30/2022]
Abstract
Bartonella henselae, a small fastidious Gram-negative bacillus, is the causative agent of cat-scratch disease (CSD). Because of difficulty in isolating the organism, there has been no report on its antibiotic susceptibility in Japan. We determined the minimal inhibitory concentrations (MICs) of eight antimicrobial agents against 32 isolates of B. henselae (31 from cats and one from a human in Japan) by the Etest method. MICs of all 32 isolates were <0.016 μg/ml for minocycline and ranged from ≤0.016 to 0.064 μg/ml for erythromycin, clarithromycin, azithromycin, ceftriaxone, and amoxicillin. MICs ranges of ciprofloxacin and gentamicin were from 0.064 to 0.25 μg/ml and from 0.5 to 3 μg/ml, respectively. All isolated strains showed high susceptibility to minocycline and macrolides antibiotics, which are currently used in the primary treatment of CSD in Japan. Although in vitro result of B. henselae susceptibility testing may not necessarily correlate with clinical response, these data are relevant in the choice of drugs for CSD treatment.
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Affiliation(s)
- Hidehiro Tsuneoka
- Department of Clinical Laboratory Science, Graduate School of Medicine, Yamaguchi University, 1-1-1 Minami-kogushi, Ube, Yamaguchi 755-8505, Japan.
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Breitschwerdt EB, Maggi RG, Cadenas MB, de Paiva Diniz PPV. A groundhog, a novel Bartonella sequence, and my father's death. Emerg Infect Dis 2010; 15:2080-6. [PMID: 19998749 PMCID: PMC3044516 DOI: 10.3201/eid1512.090206] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Affiliation(s)
- Edward B Breitschwerdt
- College of Veterinary Medicine, North Carolina State University, 4700 Hillsborough St, Research Bldg, Rm 454, Raleigh, NC 27606, USA.
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12
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Breitschwerdt EB, Maggi RG, Chomel BB, Lappin MR. Bartonellosis: an emerging infectious disease of zoonotic importance to animals and human beings. J Vet Emerg Crit Care (San Antonio) 2010; 20:8-30. [DOI: 10.1111/j.1476-4431.2009.00496.x] [Citation(s) in RCA: 224] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Biswas S, Raoult D, Rolain JM. Molecular mechanism of gentamicin resistance in Bartonella henselae. Clin Microbiol Infect 2009; 15 Suppl 2:98-9. [DOI: 10.1111/j.1469-0691.2008.02178.x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Breitschwerdt EB, Maggi RG, Cadenas MB, Diniz PPVDP. A Groundhog, a NovelBartonellaSequence, and My Father’s Death. Emerg Infect Dis 2009. [DOI: 10.3201/eid1512.ad1512] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
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Varanat M, Travis A, Lee W, Maggi R, Bissett S, Linder K, Breitschwerdt E. Recurrent Osteomyelitis in a Cat due to Infection withBartonella vinsoniisubsp.berkhoffiiGenotype II. J Vet Intern Med 2009; 23:1273-7. [DOI: 10.1111/j.1939-1676.2009.0372.x] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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Diniz PPVDP, Wood M, Maggi RG, Sontakke S, Stepnik M, Breitschwerdt EB. Co-isolation of Bartonella henselae and Bartonella vinsonii subsp. berkhoffii from blood, joint and subcutaneous seroma fluids from two naturally infected dogs. Vet Microbiol 2009; 138:368-72. [PMID: 19560291 DOI: 10.1016/j.vetmic.2009.01.038] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2008] [Revised: 01/21/2009] [Accepted: 01/26/2009] [Indexed: 11/24/2022]
Abstract
This report describes the clinical presentation, isolation and treatment of two dogs naturally infected with Bartonella henselae and Bartonella vinsonii subsp. berkhoffii. Chronic and progressive polyarthritis was the primary complaint for dog #1, from which B. henselae and B. vinsonii subsp. berkhoffii were cultured on three independent occasions from blood and joint fluid samples, despite administration of nearly 4 months of non-consecutive antibiotic therapy. A clinically atypical and progressively severe trauma-associated seroma was the primary complaint for dog #2, from which B. henselae and B. vinsonii subsp. berkhoffii were isolated from serum, blood and seroma fluid. Dogs can be co-infected with two Bartonella spp. and infection with these organisms should not be ruled out if specific antibodies are not detected. Specialized culture techniques should be used for isolation and to assess antibiotic efficacy.
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Mogollon-Pasapera E, Otvos L, Giordano A, Cassone M. Bartonella: emerging pathogen or emerging awareness? Int J Infect Dis 2009; 13:3-8. [DOI: 10.1016/j.ijid.2008.04.002] [Citation(s) in RCA: 48] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2007] [Revised: 01/26/2008] [Accepted: 04/14/2008] [Indexed: 11/24/2022] Open
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Biswas S, Raoult D, Rolain JM. A bioinformatic approach to understanding antibiotic resistance in intracellular bacteria through whole genome analysis. Int J Antimicrob Agents 2008; 32:207-20. [PMID: 18619818 DOI: 10.1016/j.ijantimicag.2008.03.017] [Citation(s) in RCA: 48] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2008] [Accepted: 03/19/2008] [Indexed: 12/17/2022]
Abstract
Intracellular bacteria survive within eukaryotic host cells and are difficult to kill with certain antibiotics. As a result, antibiotic resistance in intracellular bacteria is becoming commonplace in healthcare institutions. Owing to the lack of methods available for transforming these bacteria, we evaluated the mechanisms of resistance using molecular methods and in silico genome analysis. The objective of this review was to understand the molecular mechanisms of antibiotic resistance through in silico comparisons of the genomes of obligate and facultative intracellular bacteria. The available data on in vitro mutants reported for intracellular bacteria were also reviewed. These genomic data were analysed to find natural mutations in known target genes involved in antibiotic resistance and to look for the presence or absence of different resistance determinants. Our analysis revealed the presence of tetracycline resistance protein (Tet) in Bartonella quintana, Francisella tularensis and Brucella ovis; moreover, most of the Francisella strains possessed the blaA gene, AmpG protein and metallo-beta-lactamase family protein. The presence or absence of folP (dihydropteroate synthase) and folA (dihydrofolate reductase) genes in the genome could explain natural resistance to co-trimoxazole. Finally, multiple genes encoding different efflux pumps were studied. This in silico approach was an effective method for understanding the mechanisms of antibiotic resistance in intracellular bacteria. The whole genome sequence analysis will help to predict several important phenotypic characteristics, in particular resistance to different antibiotics. In the future, stable mutants should be obtained through transformation methods in order to demonstrate experimentally the determinants of resistance in intracellular bacteria.
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Affiliation(s)
- Silpak Biswas
- URMITE UMR 6236, CNRS IRD, Faculté de Médecine et de Pharmacie, Université de la Méditerranée, 27 Bd Jean Moulin, 13385 Marseille Cedex 05, France
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La Scola B, Elkarkouri K, Li W, Wahab T, Fournous G, Rolain JM, Biswas S, Drancourt M, Robert C, Audic S, Löfdahl S, Raoult D. Rapid comparative genomic analysis for clinical microbiology: the Francisella tularensis paradigm. Genes Dev 2008; 18:742-50. [PMID: 18407970 PMCID: PMC2336804 DOI: 10.1101/gr.071266.107] [Citation(s) in RCA: 39] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2007] [Accepted: 02/27/2008] [Indexed: 11/24/2022]
Abstract
It is critical to avoid delays in detecting strain manipulations, such as the addition/deletion of a gene or modification of genes for increased virulence or antibiotic resistance, using genome analysis during an epidemic outbreak or a bioterrorist attack. Our objective was to evaluate the efficiency of genome analysis in such an emergency context by using contigs produced by pyrosequencing without time-consuming finishing processes and comparing them to available genomes for the same species. For this purpose, we analyzed a clinical isolate of Francisella tularensis subspecies holarctica (strain URFT1), a potential biological weapon, and compared the data obtained with available genomic sequences of other strains. The technique provided 1,800,530 bp of assembled sequences, resulting in 480 contigs. We found by comparative analysis with other strains that all the gaps but one in the genome sequence were caused by repeats. No new genes were found, but a deletion was detected that included three putative genes and part of a fourth gene. The set of 35 candidate LVS virulence attenuation genes was identified, as well as a DNA gyrase mutation associated with quinolone resistance. Selection for variable sequences in URFT1 allowed the design of a strain-specific, highly effective typing system that was applied to 74 strains and six clinical specimens. The analysis presented herein may be completed within approximately 6 wk, a duration compatible with that required by an urgent context. In the bioterrorism context, it allows the rapid detection of strain manipulation, including intentionally added virulence genes and genes that support antibiotic resistance.
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Affiliation(s)
- Bernard La Scola
- Unité des Rickettsies CNRS UMR 6020, IFR 48, Faculté de Médecine de Marseille, Université de la Méditerranée, 13385 Marseille Cedex 05, France
| | - Khalid Elkarkouri
- Unité des Rickettsies CNRS UMR 6020, IFR 48, Faculté de Médecine de Marseille, Université de la Méditerranée, 13385 Marseille Cedex 05, France
| | - Wenjun Li
- Unité des Rickettsies CNRS UMR 6020, IFR 48, Faculté de Médecine de Marseille, Université de la Méditerranée, 13385 Marseille Cedex 05, France
| | - Tara Wahab
- Swedish Institute for Infectious Disease Control (SMI), Center for Microbiological Preparedness (KCB), 171 82 Solna, Sweden
| | - Ghislain Fournous
- Unité des Rickettsies CNRS UMR 6020, IFR 48, Faculté de Médecine de Marseille, Université de la Méditerranée, 13385 Marseille Cedex 05, France
| | - Jean-Marc Rolain
- Unité des Rickettsies CNRS UMR 6020, IFR 48, Faculté de Médecine de Marseille, Université de la Méditerranée, 13385 Marseille Cedex 05, France
| | - Silpak Biswas
- Unité des Rickettsies CNRS UMR 6020, IFR 48, Faculté de Médecine de Marseille, Université de la Méditerranée, 13385 Marseille Cedex 05, France
| | - Michel Drancourt
- Unité des Rickettsies CNRS UMR 6020, IFR 48, Faculté de Médecine de Marseille, Université de la Méditerranée, 13385 Marseille Cedex 05, France
| | - Catherine Robert
- Unité des Rickettsies CNRS UMR 6020, IFR 48, Faculté de Médecine de Marseille, Université de la Méditerranée, 13385 Marseille Cedex 05, France
| | - Stéphane Audic
- Structural & Genomic Information Laboratory, CNRS UPR-2589, IBSM, Parc Scientifique de Luminy, FR-13288 Marseille Cedex 09, France
| | - Sven Löfdahl
- Swedish Institute for Infectious Disease Control (SMI), Center for Microbiological Preparedness (KCB), 171 82 Solna, Sweden
| | - Didier Raoult
- Unité des Rickettsies CNRS UMR 6020, IFR 48, Faculté de Médecine de Marseille, Université de la Méditerranée, 13385 Marseille Cedex 05, France
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Biswas S, Raoult D, Rolain JM. Molecular mechanisms of resistance to antibiotics in Bartonella bacilliformis. J Antimicrob Chemother 2007; 59:1065-70. [PMID: 17449882 DOI: 10.1093/jac/dkm105] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
OBJECTIVES Bartonella bacilliformis is the aetiological agent of Carrion's disease. Although ciprofloxacin, rifampicin and erythromycin have been successfully used in the treatment of the disease, failures and relapses have been reported. The objective of our study was to select in vitro mutants resistant to antibiotics in order to determine the frequency of mutations and to characterize the mechanism of resistance at the molecular level. METHODS Antibiotic-resistant mutants were selected by serial passages of bacteria on blood agar plates containing antibiotics. Candidate genes involved in resistance were amplified and sequenced and compared in order to look at mutations associated with antibiotic resistance. RESULTS Ciprofloxacin-, rifampicin- and erythromycin-resistant mutants were obtained after five, three and four passages, respectively. Conversely, no mutant was obtained with either gentamicin or doxycycline even after 16 passages. The ciprofloxacin mutant contained an amino acid change at position 87 (Asp --> Asn) in its quinolone resistance-determining region of the DNA gyrase protein, whereas the rifampicin-resistant strain had an amino acid change at position 531 (Ser --> Phe) in the rifampicin resistance-determining region of the rpoB gene. Similarly, the erythromycin-resistant mutant showed an A2058G mutation in the 23S rRNA gene. CONCLUSIONS According with the current knowledge on the treatment of human bartonellosis, we believe that doxycycline in association with gentamicin may be the preferred regimen for the treatment of the acute and eruptive stages of Carrion's disease, but clinical trials are warranted to support our findings.
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Affiliation(s)
- Silpak Biswas
- Unité des Rickettsies, CNRS UMR 6020, IFR 48, Faculté de Médecine et de Pharmacie, Université de la Méditerranée, 27 Bd Jean Moulin, 13385 Marseille Cedex 05, France
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