Pulmonary opsonins in Klebsiella pneumoniae pneumonia in rats

Bacterial isolation from internal organs of rats (Rattus rattus) captured in Baghdad city of Iraq

Aim

Rats are accused in disseminating many zoonotic diseases. This study aimed to isolate and identify bacteria from internal organs of rats captured in Baghdad City, Iraq.

Materials and Methods

A total of 120 black rats (R. rattus) were trapped from different areas in Baghdad city. Rats were kept in individual plastic cages for 3 h before euthanizing. Deep pharyngeal swab, intestinal content, urine, and pieces of the liver and spleen, lung, kidney, and brain were obtained aseptically. The specimens were inoculated into peptone water and incubated at 37°C for 24 h for enrichment. A loopful of each specimen was then subcultured onto MacConkey Agar, Blood Agar, and Mannitol Salt Agar. CHROMagar O157 H7 and CHROMagar Listeria were used to detect Escherichia coli 157:7 and Listeria spp., respectively. Biochemical tests on analytical profile index, microscopic examination, and commercial kit for latex agglutination test for serotyping E. coli O157:H7 were used.

Results

Mixed bacterial isolates were recorded as 116, 52, 36, 28, 18, 6, and 4 from intestinal contents, deep pharyngeal, liver and spleen, urine, lung, brain, and kidney, respectively. Microorganisms included E. coli, Staphylococcus aureus, Streptococcus spp., Bacillus spp., Pseudomonas aeruginosa, Citrobacter freundii, Proteus vulgaris, E. coli O157:H7, Enterobacter cloacae, Listeria spp., Klebsiella spp., Ochrobactrum anthropi, Aeromonas spp., Brucella spp., Pseudomonas fluorescens, Escherichia fergusonii, Micrococcus spp., Morganella spp., Proteus mirabilis, Pseudomonas luteola, and Streptobacillus spp. The highest bacterial prevalence (88; 73.33%) was recorded for E. coli, where 68 isolates were identified from the intestinal contents. Of these, four isolates were E. coli O157:H7.

Conclusion

Rats are important carriers and transmitters of a number of pathogens and can disseminate these microorganisms to humans and animals.

Differing complement-mediated opsonic activity of rabbit interstitial fluids from autologous serum

Lack of appropriate methods for withdrawing extravascular or interstitial fluid from an animal host has limited in vitro study on the role of complement in the local defence of the extravascular space. In the present study, we obtained fluids from membrane diffusion chambers (porosity 0.22 micron) implanted into the kidneys, peritoneal cavity and soft tissues in rabbits. The complement-mediated opsonic activity (CMOA) of these fluids for Staphylococcus aureus ATCC 502A and Escherichia coli 01 was then compared to that of autologous sera. Soft tissue and renal interstitial fluids were as opsonic for E. coli as autologous sera but were however, poor opsonins for S. aureus. The peritoneal fluid was marginally effective in opsonization of both bacterial strains. While chelation of the fluids with MgEGTA (to block the classical pathway) did not diminish CMOA for E. coli, it reduced the CMOA for S. aureus by half. Conversely, heat-inactivation of the fluids and serum eliminated the opsonic activity for E. coli but only decreased the opsonic activity for S. aureus by half. Following a 24 h in vivo growth of E. coli in the implanted chambers, the CMOA was drastically reduced. Concomitant to the reduction in functional complement in the fluids, E. coli recovered from the chambers were found coated, though not maximally, with C3b as evidenced by studies with fluorescent antibody. The differences in opsonic content of extravascular fluids observed here might explain why certain sites of the body may be more vulnerable to attack by some bacterial species which are not effectively opsonized and therefore phagocytized.

Opsonic activity of the alternative complement pathway in infected human intra-abdominal fluid

The complement-mediated opsonic activity (CMOA) in intra-abdominal exudates collected during laparotomy from peritonitis patients was examined by an in vitro phagocytic bactericidal assay. It was found that infected intra-abdominal exudates barely promoted detectable killing of Escherichia coli 01 by polymorphonuclear leukocytes. Only the minority of bacteria recovered by differential centrifugation from the infected exudates had C3 on their surfaces. Such bacteria were not optimally opsonized in vivo, whereas they became fully coated with C3 during a brief incubation in vitro in normal human serum. The low level of CMOA in the peritoneal fluid paralleled a depletion of complement in the peripheral blood. Thus, in cases complicated by sepsis with gram-negative bacteria, the CMOA in the blood was extremely low. These data suggest that the high susceptibility of the peritoneum to infection by gut flora, despite the normal phagocytic response, may be partly explained by the low local level of functional complement which is inadequate for optimal opsonization of the bacteria.

Comparative role of complement in pneumococcal and staphylococcal pneumonia

To evaluate the role of complement in pneumococcal and staphylococcal pneumonia, we decomplemented rats with cobra venom factor and inoculated them intratracheally with Staphylococcus aureus or type 25 pneumococci. S. aureus produced a patchy bronchopneumonia in normal Sprague-Dawley or Lewis rats, and decomplementation did not increase the severity of staphylococcal infection in either rat strain as judged by quantitative cultures of the lungs and blood at 6, 24, and 48 h after inoculation. In contrast, decomplementation markedly increased the severity of pneumonia caused by type 25 pneumococci in Sprague-Dawley and Lewis rats. In Sprague-Dawley rats, decomplementation significantly increased the number of bacteria in the lungs at 3, 6, and 24 h of infection. Bacteremia developed early in decomplemented Sprague-Dawley rats, but the higher pulmonary bacterial counts did not appear to be caused by bacteremic seeding of the lungs. Decomplemented Sprague-Dawley rats inoculated intravenously with pneumococci failed to develop the very high levels of bacteria in the lungs that were observed when the rats were inoculated intratracheally. Moreover, decomplemented Lewis rats inoculated intratracheally with pneumococci developed significantly increased numbers of pneumococci in the lungs early in infection (3 and 6 h) when they had no detectable bacteremia. These data indicate that in murine models complement plays a major protective role against type 25 pneumococci in the lung, whereas complement is not important to host defense in staphylococcal pneumonia.

Nonphagocytic clearance of Staphylococcus aureus from murine lungs

Several investigations of host and bacterial factors critical to staphylococcal clearance from lungs suggest that alveolar macrophages may not provide the principal defense against inhaled staphylococci. We evaluated possible contributions of extracellular bactericidal activities in lungs with a standard aerosol challenge model by using methods which allowed recovery of macrophages for in vitro bactericidal assays and recovery of intrapulmonary staphylococci for clearance studies. Macrophages recovered by a gentle lavage technique immediately after aerosol exposure contained 6.0 +/- 2.3 colony-forming units of viable staphylococci per 100 glass-adherent macrophages. These intracellular staphylococci were killed in vitro with a half-life of 10.8 +/- 2.1 h, which is identical to our results with a completely in vitro system for ingestion and killing. However, 99.4 +/- 0.2% and 94.9 +/- 1.5% of the viable cocci recovered in bronchoalveolar lavage at 0.5 and 6.0 h after aerosol exposure were sensitive to lysostaphin, a rapidly bactericidal enzyme with no demonstrable activity against intracellular organisms and therefore, presumably extracellular. Photomicrographs from lavage pellets obtained 0.5, 1.5, 3.0, and 5.5 h after aerosol exposure confirmed the presence of numerous extracellular cocci. These extracellular cocci were eliminated at the same rate as whole lung cocci (half-life = 3.07 and 3.14 h, respectively) and at a much faster rate than intracellular cocci. In summary, we found large numbers of extracellular staphylococci in bronchoalveolar spaces during the first 6 h after aerosol exposure that are inactivated at the same rate as the whole lung bacterial population. Since only a small number of staphylococci are ingested by macrophages and intracellular bactericidal activity appears too slow to explain intrapulmonary killing, we conclude that an as yet unidentified extracellular killing process contributed to staphylococcal clearance.

Early clearance of pneumococci from the lungs of decomplemented rats

Pneumococcal types which exhibited varying degrees of interaction with the complement system in vitro wee aerosolized into normal and decomplemented rats, and the rate of killing of pneumococci was monitored by serial cultures of whole lung homogenates. The clearance of pneumococci from the alveoli did not correlate with the ability of the pneumococci to be opsonized by complement in vitro. Similarly, rats depleted of complement in the serum and the bronchoalveolar lavage fluid maintained their ability to rapidly inactivate aerosolized pneumococci. These results indicate that the early phase of pneumococcal killing in the alveoli does not require complement and suggest that in the nonimmune host, phagocytosis by alveolar macrophages can be achieved without complement-dependent opsonization or, alternatively, that extracellular factors rapidly inactivate inhaled pneumococci.