Pathogenic properties of Yersinia enterocolitica

Yersinia enterocolitica: Mode of Transmission, Molecular Insights of Virulence, and Pathogenesis of Infection

Although Yersinia enterocolitica is usually transmitted through contaminated food and untreated water, occasional transmission such as human-to-human, animal-to-human and blood transfusion associated transmission have also identified in human disease. Of the six Y. enterocolitica biotypes, the virulence of the pathogenic biotypes, namely, 1B and 2-5 is attributed to the presence of a highly conserved 70-kb virulence plasmid, termed pYV/pCD and certain chromosomal genes. Some biotype 1A strains, despite lacking virulence plasmid (pYV) and traditional chromosomal virulence genes, are isolated frequently from humans with gastrointestinal diseases similar to that produced by isolates belonging known pathogenic biotypes. Y. enterocolitica pathogenic biotypes have evolved two major properties: the ability to penetrate the intestinal wall, which is thought to be controlled by plasmid genes, and the production of heat-stable enterotoxin, which is controlled by chromosomal genes.

Analysis of the presence of ail, ystA and ystB genes in Yersinia enterocolitica strains isolated from aborting sows and aborted fetuses

Forty-five Yersinia enterocolitica strains isolated from aborted fetuses and placentas and from vaginal and rectal swabs of aborting sows were subjected to serotyping, biochemical typing and polymerase chain reaction multiplex analyses to detect the presence of the ail, yst A and ystB genes. The isolates were recovered from the internal organs (tonsil, lung, liver, spleen, kidney, mesentheric lymph nodes, small intestine and rectal intestine) of 18 (18.6%) of 97 aborted fetuses examined, two (8%) of 25 aborted placentas and 27 (15.8%) of 172 examined aborting sows. Serotyping of Y. enterocolitica revealed that only six (13.3%) of the examined isolates belonged to serotype O:3, with a considerable number of isolates (31.1%) having serotype O:5, while biochemical studies showed that as many as 40 of the 45 strains belonged to biotype 1A. As expected, the Y. enterocolitica strains of bioserotype 4/O:3 contained ail and ystA genes, while strains of biotype 1A contained only the ystB gene.

Comparison of siderophore production and utilization in pathogenic and environmental isolates of Yersinia enterocolitica

Yersinia enterocolitica strains of serotypes lethal to mice have been reported previously to produce an endogenous siderophore. In this study, an ethyl acetate-extractable siderophore was characterized and given the name yersiniophore. Yersiniophore was produced by 16 of 16 human isolates of serotypes O:4, O:4,32, O:8, O:21, and one nonhuman isolate of serotype O:21. It was not produced by isolates of serotype O:3, O:5, or O:9. One strain of Yersinia pseudotuberculosis produced yersiniophore, but strains of Yersinia kristensenii, Yersinia frederiksenii, and Yersinia intermedia did not produce or utilize yersiniophore. Food and water isolates of Y. enterocolitica produced a water-soluble siderophore but not yersiniophore. Sixty-two strains of Y. enterocolitica including 42 isolates from human infections, 2 animal isolates, and 18 water and food isolates were examined for utilization of yersiniophore, the water-soluble siderophore, and ferrioxamine. Yersiniophore promoted growth rate, iron binding, and uptake in 17 of 62 strains, all of which produced yersiniophore. Ten of 17 food and water isolates and one human isolate were capable of utilizing the water-soluble siderophore. Utilization studies suggest that at least one additional water-soluble siderophore may be produced. Ferrioxamine promoted the growth of 60 of 62 strains examined; however, only the 17 strains which produced yersiniophore actively accumulated [59Fe]ferrioxamine. Yersiniophore production and utilization may be important in clinical infections since all human strains belonging to serotype O:8 produced yersinophore. The water-soluble siderophore was not detected in human isolates.

Effect of acute Yersinia enterocolitica infection on in vivo and in vitro small intestinal solute and fluid absorption in the rabbit

The impact of acute Yersinia enterocolitica infection on jejunal and ileal solute and water transport was examined. New Zealand White rabbits (500-600 g) were infected with Y. enterocolitica and compared with unmanipulated controls and pair-fed controls. Transport studies were performed 6 days after infection on jejunum and ileum by an in vivo single-pass perfusion technique and in vitro under short-circuited conditions in Ussing chambers. When studied in vivo, Y. enterocolitica infection resulted in decreased water and electrolyte absorption in the jejunum under basal conditions and in both jejunum and ileum in the presence of glucose. Glucose absorption was also decreased in jejunum and ileum. When studied in vitro, net basal Na+ and Cl- transport was not altered in jejunal or ileal epithelium from infected animals. Glucose-stimulated Na+ absorption was decreased in ileal epithelium, and absorption of 3-O-methyl-D-glucose was decreased in both jejunum and ileum. Secretory capacity of Cl-, as assessed by isobutylmethyl xanthine stimulation, was unimpaired in both jejunum and ileum. Decreased food intake alone, in the pair-fed animals, had little effect on intestinal transport. The results indicate that malabsorption, rather than active intestinal secretion, is the major small intestinal transport defect in acute Y. enterocolitica infection. Furthermore, the abnormalities can be directly attributed to injury induced by the organism itself, rather than malnutrition.

Yersiniaspecies infection of lambs and cull cows at an abattoir

The rectal contents of 330 cull cows and 66 lambs were sampled over the 1984-1985 killing season at a New Zealand freezing works for the presence of Yersinia species. Samples from the cows revealed one isolation of Y. pseudotuberculosis and one isolation of Y. intermedia. Samples from the lambs gave thirteen isolates of Y. enterocolitica, three of Y. inter-media, two of Y. pseudotuberculosis and one of Y. frederiksenii. Two of the isolates of Y. enterocolitica were shown to be serotype 0:3. Although no parallel studies were carried out on young cattle or adult sheep, these findings are consistent with the hypothesis that Yersinia infection primarily involves young animals. Thus there exists the potential for transmission of the above species of Yersinia from young animals to man which needs further detailed study.

Characteristics of Yersinia intermedia-like bacteria isolated from patients with diarrhea in Nigeria

Five Yersinia strains, biochemically mimicking Yersinia intermedia, were isolated from patients with acute diarrheal diseases seen at the University of Lagos (Nigeria) Teaching Hospital between October 1979 and September 1982. The five isolates utilized citrate as their source of carbon and fermented sucrose, L-rhamnose, and alpha-methyl-D-glucoside, but unlike any other Y. intermedia biogroup, they failed to ferment D-melibiose or D-raffinose. They all belonged to serogroup O:52,53. Four autoagglutinated and were calcium dependent for growth at 37 degrees C. Three caused conjunctivitis in the guinea pig eye model, but none possessed the 42-megadalton virulence plasmid. Four of the isolates caused diarrhea in orally infected mice and rabbits but were nonlethal for these animals. These results suggest that these isolates represent yet another Yersinia species with disease-producing capabilities in humans.

Serotype-related HEp-2 cell interaction of Yersinia enterocolitica

The ability of human clinical isolates of Yersinia enterocolitica to interact with HEp-2 cells was found to vary considerably between the serotypes O:3, O:8, and O:9. Although all three serotypes adhered initially to the cell surface, regardless of incubation temperature of the bacterial inoculum or presence of the 40- to 48-megadalton virulence plasmid, the ability to localize intracellularly was not uniformly expressed. By using a combined light optical method based on differential interference contrast and UV incident light microscopy, we found that in serotype O:3, resistance to internalization was dependent upon prior growth at 37 degrees C and carriage of the virulence plasmid; in serotype O:9, this property was plasmid dependent but not temperature dependent; in serotype O:8, it was constitutive. The ability of serotype O:3 to resist internalization was correlated with the expression of plasmid-associated fibrillae on the bacterial surface. No relationship between fibrillation and HEp-2 cell interaction was apparent for serotype O:8 or O:9. Serotypes O:8 and O:9, unlike the O:3 strains studied, associated with HEp-2 cells in greater number after cultivation at 22 degrees C than after cultivation at 37 degrees C. We failed to establish a correlation between the expression of surface fibrillae and the ability to evoke guinea pig conjunctivitis.

Genetically manipulated virulence of Yersinia enterocolitica

Mobilizable virulence plasmids of Yersinia enterocolitica of serotypes O:3 and O:9 were constructed by cointegration of a mobilizable vector into the virulence plasmids. The obtained cointegrates were mobilized into plasmidless Y. enterocolitica strains of serotypes O:3, O:5, O:8, and O:9. The transfer experiments revealed the existence of two different subgroups of plasmid-associated traits. (i) Animal virulence functions (mouse lethality and conjuctivitis provocation) were only transferable to plasmid-cured derivatives of virulent parent strains (serotypes O:3, O:8, and O:9), but they were not transferable to Y. enterocolitica antigen reference strains (serotypes O:3 and O:8) or to a plasmidless clinical isolate of serotype O:5. A further striking result was that a serotype O:8 strain regained the mouse lethality trait after receipt of a plasmid from a strain not lethal to mice. These results demonstrate that plasmid-mediated animal virulence functions are not uniformly expressed within Y. enterocolitica. (ii) The second subgroup of plasmid-mediated traits (calcium dependency, surface agglutinogens, HEp-2 cell adherence, and protein release) were transferable to all Y. enterocolitica recipient strains tested (serotypes O:3, O:5, O:8, and O:9 of different origin). For the first time HEp-2 cell adherence and temperature-induced release of five major protein species are described as transferable traits.

Invasiveness of Salmonella typhimurium in HEp-2 cell cultures preinfected with Coxsackie B 1 virus

The influence of infection of HEp-2 cells with Coxsackie B 1 virus on the invasiveness of Salmonella typhimurium has been studied. The bacterial invasiveness was significantly increased in the cell cultures incubated with virus before bacterial inoculation. This effect was a function of time after introduction of virus into the cell cultures and the concentration of virus. The increase in bacterial invasiveness was observed before production of infectious virus particles and before development of cytopathogenic effect was evident. Two strains of non-invasive Escherichia coli did not show invasiveness after the virus treatment of the cells. The results indicate a specific mechanism for the interaction.

Cytotoxicity and calcium-dependent antigen of Yersinia

The relationship between invasiveness and calcium dependency was examined in various strains of Yersinia enterocolitica and Y. pseudotuberculosis by using established cell lines. Infection with calcium-dependent bacteria resulted in the formation of microvilli and the adherence of bacteria on the cell surface, and the adherent bacteria were ingested 1.5 hr after infection. Morphological changes in the cells became visible 2 to 3 hr after infection, and intracellular multiplication of the ingested bacteria was noted. When the cells were incubated with bacteria at 37 C for 1.5 hr and then at 25 C, however, the morphological changes in the infected cells were not observed. No isogenic strains that had lost calcium dependency for growth at 37 C were able to elicit the morphological changes in the cells, though they possessed the ability to adhere to and penetrate the cells. The antigen(s) supposedly related to cytotoxicity of the calcium-dependent Yersinia was sought by using antibodies prepared against calcium-dependent bacteria and then absorbed with calcium-independent bacteria and with calcium-independent bacterial cytosol. Double diffusion tests between the antisera and bacterial cytosol extracts revealed the presence of an antigen which was a cytoplasmic substance common to all calcium-dependent but not calcium-independent strains of Y. enterocolitica and Y. pseudotuberculosis.

Pathogenicity of 42-44 Mdal plasmid positive and negative Yersinia pseudotuberculosis I and Yersinia enterocolitica 0:8 and 0:9 studied in the guinea pig eye model (Serény test)

When virulence plasmid (42-44 Mdal) positive and negative Yersinia pseudotuberculosis I and Yersinia enterocolitica 0:8 and 0:9 were tested in the guinea pig eye model the following order of pathogenicity was observed: Plasmid-positive Y. pseudotuberculosis I (death of the animal) greater than plasmid-negative Y. pseudotuberculosis I approximately equal to plasmid-positive Y. enterocolitica 0:8 (severe conjunctivitis) greater than plasmid-positive Y. enterocolitica 0:9 (mild conjunctivitis) greater than plasmid-negative Y. enterocolitica 0:8 and 0:9 (no effect).

Evaluation of virulence factor testing and characteristics of pathogenicity in Yersinia enterocolitica

The virulence of 10 strains of Yersinia enterocolitica containing 42- to 44-megadalton plasmids (serogroups O:3; O:4,32; O:8; O:9; O:13,7; and O:21) was compared in mice and guinea pigs. Adult mice were more responsive than guinea pigs to the Sereny-like conjunctivitis test. In tests on suckling mice, all Yersinia strains harboring plasmids were lethal, whereas all strains without plasmids were nonlethal. All strains of serogroups O:4,32; O:8; O:13,7; or O:21 which harbored a plasmid gave positive results in the mouse Sereny, peroral, and intraperitoneal tests. A positive reaction in these tests was correlated with the ability of the strains to elaborate lipase. Because the Sereny, peroral, and intraperitoneal tests measured the same virulence factor(s), the findings in any of these three tests would accurately predict the results of the other two tests. Mice which survived the Sereny and peroral tests were subsequently challenged intraperitoneally with 1,000 mouse lethal doses of the virulent WA (O:8) strain. Those inoculated with plasmid-harboring strains were protected, whereas those inoculated with plasmid-free strains were not.

Temperature-inducible outer membrane protein of Yersinia pseudotuberculosis and Yersinia enterocolitica is associated with the virulence plasmid

A strain of Yersinia pseudotuberculosis which harbors a 63-kilobase plasmid was found to cause a lethal infection in Swiss albino mice. The rate of infection paralleled the ability of the pathogenic organism to attach to a monolayer of HeLa cells. One novel outer membrane protein (protein 1) with a molecular weight of 140,000 was found to be associated with the possession of the 63-kilobase plasmid not at 26 degrees C, and expression was moderately affected by the concentration of calcium in the growth medium. Moreover, it was found that synthesis of protein 1 associated outer membrane protein showing similar properties was also found to be expressed in plasmid-containing strains of Yersinia enterocolitica. The properties of protein 1 indicate that it could be identical to the previously described virulence W antigen.

Infection caused by Yersinia enterocolitica serotype O:21

Yersinia enterocolitica serotype O:21, biotype 3 (Wauters) was isolated from the appendix and stool of a 7-year-old girl. The same organism was later isolated in pure culture from pus from a postoperative wound infection in this patient. She developed a significant serological response (titer of 800). There was thus strong clinical evidence of pathogenicity associated with this rather uncommon human serotype. Laboratory studies in vitro and in vivo pathogenicity showed that the organism was autoagglutinable, Serény test positive, and HeLa cell invasive; when given orally to mice, it produced diarrhea and subsequently death. The results of laboratory studies of virulence correlated closely with the clinical evidence of pathogenicity in this case.

Serum resistance associated with virulence in Yersinia enterocolitica

Yersinia enterocolitica strains that exhibited a calcium requirement for growth and autoagglutination at 37 degrees C were invariably virulent in rabbits, causing diarrhea and a high degree of lethality, and were capable of colonizing the intestinal lumen and establishing foci of infection on the Peyer's patches of mice. Strains that had lost the properties of calcium dependency and autoagglutinability were totally avirulent in rabbits and were quickly eliminated from the intestinal lumen and tissues of mice. Virulent and avirulent strains were shown to be equally invasive to HeLa cells. However, the virulent strains were resistant to the bactericidal action of normal serum, and this serum resistance was lost with the loss of virulence. Furthermore, the serum resistance of virulent strains was expressed, as were other properties, when strains were grown at 37 degrees C, but not at 27 degrees C. These results suggest that a virulence factor associated with serum resistance plays an essential role in the pathogenicity of Y. enterocolitica.

Evaluation of iron dextran and mucin for enhancement of the virulence of Yersinia enterocolitica serotype O:3 in mice

The pathogenic role of Yersinia enterocolitica serotypes O:3, O:8, and O:9 in human infections is well documented. Whereas the virulence of the O:8 strains can be readily demonstrated in mice by 50% lethal dose determinations, the O:3 and O:9 strains have no lethal effect on mice by any route of inoculation. A mouse virulence test for the O:3 and O:9 strains is described. Y. enterocolitica strains were first tested for the presence of virulence-associated plasmid characteristics by auto-agglutination and gel electrophoresis procedures before mouse virulence determinations. The 50% lethal dose of the O:3 strains injected intraperitoneally with 2.5% mucin was about 10(7) colony-forming units. However, histological examinations showed that mucin allowed the growth of Y enterocolitica on the surface of the livers and spleens of the mice without internal lesions. The 50% lethal dose of the same O:3 strains injected intraperitoneally with 1 ml of 10% iron dextran in saline was about 10(5) to 10(6) colony-forming units, and the nonlethal infective dose with typical lesion development was 20 to 200 colony-forming units. The infected mice developed symptoms and extensive liver and spleen lesions which differed from those in mice infected intraperitoneally with the virulent O:8 strains. These results showed that the virulence of the O:3 Y. enterocolitica strains can be measured by intraperitoneal injection with iron dextran. This procedure was used to test the virulence of food isolates, plasmidless strains, and the effect of growth temperatures.

Characteristics of Yersinia enterocolitica and related species isolated from human, animal, and environmental sources

During a 4-year period, 4,448 human, animal, and environmental samples collected in New York State were tested for the presence of Yersinia enterocolitica or related species. A total of 339 isolates were identified as Yersinia and characterized according to source, species, biogroup, serogroup, and, in some instances, phage type. Four new biogroups of Y. intermedia were characterized. Of 149 human isolates, 120 (80.5%) were identified as Y. enterocolitica, and 29 were identified as either Y. intermedia (12.1%), Y. frederiksenii (5.4%), or Y. kristensenii (2.0%). Of the other 190 isolates, recovered from animals and the environment, 54 (28.4%) were Y. enterocolitica and 136 were either Y. intermedia (62.6%), Y. frederiksenii (4.7%), Y. kristensenii (3.7%), or an undescribed Yersinia species (0.5%). Two established human pathogenic strains of Y. enterocolitica were recovered: 59 isolates (37 from an outbreak) of "American strain" (serogroup O:8, biogroups Niléhn 2, Wauters 1, and Knapp and Thal 2, phage type Xz) and 11 isolates of "Canadian strain" (serogroup O:3, biogroups Niléhn 4, Wauters 4, and Knapp and Thal 1, phage types IXb). This was the first documented isolation of the Canadian strain in the United States. Isolates of other strains implicated in human disease (serogroups 0:4,33, 0:5, O:6,31, O:7,8, and O:8) were also recovered from both human and nonhuman sources.

Plasmids in Yersinia enterocolitica serotypes O:3 and O:9: correlation with epithelial cell adherence in vitro

Human isolates of Yersinia enterocolitica serotypes O:3 (biotype 4) and O:9 (biotype 3) harbored plasmids sized approximately 47 and 44 megadaltons, respectively. No such plasmids were found in "apathogenic" strains of Y. enterocolitica belonging to biotype 1. There was a positive correlation among the presence of plasmid, autoagglutination, and adherence to and toxicity for HEp-2 cell cultures; all of these properties were lost by culturing at 37 degrees C in the absence of calcium. Strains of Y. enterocolitica O:3 and O:9 cured of the plasmids showed increased invasiveness in the HEp-2 cell culture model, but no invasiveness in guinea pig eye. It is suggested that the plasmids of Y. enterocolitica primarily determine epithelial cell adherence, but may also be associated with other pathogenic properties.

Incorporation of [14C]methionine by Yersinia enterocolitica after invasion of HeLa cells

Invasion of HeLa cells by Yersinia enterocolitica can be measured by the incorporation of [(14)C]methionine in the presence of streptomycin and cycloheximide.

Detection of Yersinia enterocolitica heat-stable enterotoxin by suckling mouse bioassay

A comparison of heat-stable enterotoxins from Escherichia coli and Yersinia enterocolitica by the suckling mouse bioassay showed that whereas E. coli heat-stable enterotoxin evoked a maximum ratio of gut weight to remaining body weight after a 4-h incubation period, the maximum ratio for Y. enterocolitica was achieved at 2 h, decreasing thereafter to values regarded as negative (less than 0.083). This action of Y. enterocolitica heat-stable enterotoxin may give false-negative results for the standard suckling mouse bioassay.