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Jia L, Arick MA, Hsu CY, Peterson DG, Evans JD, Robinson K, Sukumaran AT, Ramachandran R, Adhikari P, Zhang L. High-throughput Oxford Nanopore sequencing-based approach for the multilocus sequence typing analysis of large-scale avian Escherichia coli study in Mississippi. Poult Sci 2024; 103:104067. [PMID: 39067129 PMCID: PMC11338106 DOI: 10.1016/j.psj.2024.104067] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2024] [Revised: 06/28/2024] [Accepted: 07/02/2024] [Indexed: 07/30/2024] Open
Abstract
Avian pathogenic Escherichia coli (APEC) cause avian colibacillosis and accurately distinguishing infectious isolates is critical for controlling its transmission. Multilocus sequence typing (MLST) is an accurate and efficient strain identification method for epidemiological surveillance. This research aimed to develop a fast and high-throughput workflow that simultaneously sequences the Achtman typing scheme's 7 housekeeping genes of multiple E. coli isolates using the Oxford Nanopore Technologies (ONT) platform for large-scale APEC study. E. coli strains were isolated from poultry farms, the housekeeping genes were amplified, and amplicons were sequenced on an R9.4 MinION flow cell using the Nanopore GridION sequencer (ONT, Oxford, UK) following the initial workflow (ONT-MLST). Moreover, the workflow was revised by introducing large-scale DNA extraction and multiplex PCR into the ONT-MLST workflow and applied to 242 new isolates, 18 isolates from the previous workflow, and 5 ATCC reference strains using Flongle flow cell on the Nanopore MinION Mk1C sequencer (ONT, Oxford, UK). Finally, the sequence type (ST) results of the 308 isolates collected from infected chickens and poultry farm environments were reported and analyzed. Data indicated that E. coli belonging to ST159, ST8578, and ST355 have the potential to infect multiple organs in broiler. In addition, zoonotic STs, ST69, ST10, ST38, and ST131, were detected from poultry farms. With the advantages of the high throughput of ONT, this study provides a rapid workflow for large-scale E. coli typing and identified frequently isolated sequence types related to APEC infection in poultry.
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Affiliation(s)
- Linan Jia
- Department of Poultry Science, Mississippi State University, Mississippi, MS 39762, USA
| | - Mark A Arick
- Institute for Genomics, Biocomputing and Biotechnology, Mississippi State University, Mississippi, MS 39762, USA
| | - Chuan-Yu Hsu
- Institute for Genomics, Biocomputing and Biotechnology, Mississippi State University, Mississippi, MS 39762, USA
| | - Daniel G Peterson
- Institute for Genomics, Biocomputing and Biotechnology, Mississippi State University, Mississippi, MS 39762, USA
| | - Jeffrey D Evans
- USDA, Agriculture Research Service, Poultry Research Unit, Mississippi, MS 39762, USA
| | - Kelsy Robinson
- USDA, Agriculture Research Service, Poultry Research Unit, Mississippi, MS 39762, USA
| | | | | | - Pratima Adhikari
- Department of Poultry Science, Mississippi State University, Mississippi, MS 39762, USA
| | - Li Zhang
- Department of Poultry Science, Mississippi State University, Mississippi, MS 39762, USA.
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Zhang S, Zhang N, Han J, Sun Z, Jiang H, Huang W, Kong D, Li Q, Ren Y, Zhao S, Jiang Y, Liu P. Dynamic immune status analysis of peripheral blood mononuclear cells in patients with Klebsiella pneumoniae bloodstream infection sepsis using single-cell RNA sequencing. Front Immunol 2024; 15:1380211. [PMID: 38898888 PMCID: PMC11185935 DOI: 10.3389/fimmu.2024.1380211] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2024] [Accepted: 04/16/2024] [Indexed: 06/21/2024] Open
Abstract
Background Klebsiella pneumoniae is a common Gram-negative bacterium. Blood infection caused by K. pneumoniae is one of the most common causes of human sepsis, which seriously threatens the life of patients. The immune status of peripheral blood mononuclear cells (PBMCs) based on single-cell RNA sequencing (scRNA-seq) in acute stage and recovery stage of sepsis caused by K. pneumoniae bloodstream infection has not been studied. Methods A total of 13 subjects were included in this study, 3 healthy controls, 7 patients with K. pneumoniae bloodstream infection in the acute stage (4 patients died), and 3 patients in the recovery stage. Peripheral blood of all patients was collected and PBMCs were isolated for scRNA-seq analysis. We studied the changes of PBMCs components, signaling pathways, differential genes, and cytokines in acute and recovery stages. Results During K. pneumoniae acute infection we observed a decrease in the proportion of T cells, most probably due to apoptosis and the function of T cell subtypes was disorder. The proportion of monocytes increased in acute stage. Although genes related to their phagocytosis function were upregulated, their antigen presentation capacity-associated genes were downregulated. The expression of IL-1β, IL-18, IFNGR1 and IFNGR2 genes was also increased in monocytes. The proportion of DCs was depleted during the acute stage and did not recover during sepsis recovery. DCs antigen presentation was weakened during the acute stage but recovered fast during the recovery stage. pDCs response to MCP-1 chemokine was weakened, they recovered it quickly during the recovery stage. B cells showed apoptosis both in the acute stage and recovery stage. Their response to complement was weakened, but their antigen presentation function was enhanced. The proportion of NK cells stable during all disease's stages, and the expression of IFN-γ gene was upregulated. Conclusion The proportion of PBMCs and their immune functions undergo variations throughout the course of the disease, spanning from the acute stage to recovery. These findings provide new insights into the mechanism of PBMCs immune function during K. pneumoniae bloodstream infection sepsis and recovery and sets the basis for further understanding and treatment.
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Affiliation(s)
- Shengwei Zhang
- State Key Laboratory of Pathogen and Biosecurity, Beijing Institute of Microbiology and Epidemiology, Academy of Military Medical Sciences, Beijing, China
- Department of Clinical Laboratory, Dongfang Hospital, Beijing University of Chinese Medicine, Beijing, China
| | - Nan Zhang
- College of Mathematics, Jilin University, Changchun, China
| | - Jing Han
- Department of Clinical Laboratory, Dongfang Hospital, Beijing University of Chinese Medicine, Beijing, China
| | - Zeyu Sun
- State Key Laboratory of Pathogen and Biosecurity, Beijing Institute of Microbiology and Epidemiology, Academy of Military Medical Sciences, Beijing, China
| | - Hua Jiang
- State Key Laboratory of Pathogen and Biosecurity, Beijing Institute of Microbiology and Epidemiology, Academy of Military Medical Sciences, Beijing, China
| | - Wenhua Huang
- State Key Laboratory of Pathogen and Biosecurity, Beijing Institute of Microbiology and Epidemiology, Academy of Military Medical Sciences, Beijing, China
| | - Decong Kong
- State Key Laboratory of Pathogen and Biosecurity, Beijing Institute of Microbiology and Epidemiology, Academy of Military Medical Sciences, Beijing, China
| | - Qian Li
- State Key Laboratory of Pathogen and Biosecurity, Beijing Institute of Microbiology and Epidemiology, Academy of Military Medical Sciences, Beijing, China
| | - Yuhao Ren
- State Key Laboratory of Pathogen and Biosecurity, Beijing Institute of Microbiology and Epidemiology, Academy of Military Medical Sciences, Beijing, China
| | - Shishun Zhao
- College of Mathematics, Jilin University, Changchun, China
| | - Yongqiang Jiang
- State Key Laboratory of Pathogen and Biosecurity, Beijing Institute of Microbiology and Epidemiology, Academy of Military Medical Sciences, Beijing, China
| | - Peng Liu
- State Key Laboratory of Pathogen and Biosecurity, Beijing Institute of Microbiology and Epidemiology, Academy of Military Medical Sciences, Beijing, China
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Fukushima S, Hagiya H, Honda H, Ishida T, Shoji R, Hasegawa K, Otsuka F. Calcium polystyrene sulfonate-induced rectal ulcer causing E. coli native-valve infective endocarditis. Clin J Gastroenterol 2024; 17:472-476. [PMID: 38528197 PMCID: PMC11127893 DOI: 10.1007/s12328-024-01949-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/06/2024] [Accepted: 03/07/2024] [Indexed: 03/27/2024]
Abstract
Escherichia coli-associated native-valve infective endocarditis is a rare disease that affects elderly patients with underlying risk factors such as diabetes mellitus, malignancy, and renal failure. Long-term use of calcium polystyrene sulfonate is a potential risk factor for gastrointestinal mucosal damage or even colorectal ulcers. Herein, we describe a fatal case of a 66-year-old Japanese man with diabetes mellitus and renal failure who was prescribed calcium polystyrene sulfonate (CPS) for 11 years and developed a CPS-induced rectal ulcer, leading to E. coli native-valve infective endocarditis. The patient was admitted to our hospital due to acute-onset impaired consciousness. As a result of the systemic investigation, he was diagnosed with E. coli bacteremia accompanied by multiple cerebral infarctions and an acute hemorrhagic rectal ulcer. Transesophageal echocardiography revealed a 20-mm vegetative structure on the mitral valve, resulting in a final diagnosis of E. coli-associated infective endocarditis. After rectal resection, mitral valve replacement surgery was performed; however, the patient died shortly after surgery. Pathological findings of the resected rectum showed deposition of a basophilic crystalline material suggesting the presence of CPS. Our case highlights the potential risk of colorectal ulcers in a long-term CPS user, which can trigger bacterial translocation and endocarditis as fatal complications.
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Affiliation(s)
- Shinnosuke Fukushima
- Department of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, 2-5-1 Shikata-Cho, Kitaku, Okayama, 700-8558, Japan
| | - Hideharu Hagiya
- Department of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, 2-5-1 Shikata-Cho, Kitaku, Okayama, 700-8558, Japan.
| | - Hiroyuki Honda
- Department of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, 2-5-1 Shikata-Cho, Kitaku, Okayama, 700-8558, Japan
| | - Tomoharu Ishida
- Department of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, 2-5-1 Shikata-Cho, Kitaku, Okayama, 700-8558, Japan
| | - Ryohei Shoji
- Department of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, 700-8558, Japan
| | - Kou Hasegawa
- Department of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, 2-5-1 Shikata-Cho, Kitaku, Okayama, 700-8558, Japan
| | - Fumio Otsuka
- Department of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, 2-5-1 Shikata-Cho, Kitaku, Okayama, 700-8558, Japan
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Esfandiary MA, Khosravi AR, Asadi S, Nikaein D, Hassan J, Sharifzadeh A. Antimicrobial and anti-biofilm properties of oleuropein against Escherichia coli and fluconazole-resistant isolates of Candida albicans and Candida glabrata. BMC Microbiol 2024; 24:154. [PMID: 38704559 PMCID: PMC11069153 DOI: 10.1186/s12866-024-03305-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2023] [Accepted: 04/15/2024] [Indexed: 05/06/2024] Open
Abstract
BACKGROUND Side effects associated with antimicrobial drugs, as well as their high cost, have prompted a search for low-cost herbal medicinal substances with fewer side effects. These substances can be used as supplements to medicine or to strengthen their effects. The current study investigated the effect of oleuropein on the inhibition of fungal and bacterial biofilm in-vitro and at the molecular level. MATERIALS AND METHODS In this experimental study, antimicrobial properties were evaluated using microbroth dilution method. The effect of oleuropein on the formation and eradication of biofilm was assessed on 96-well flat bottom microtiter plates and their effects were observed through scanning electron microscopy (SEM). Its effect on key genes (Hwp1, Als3, Epa1, Epa6, LuxS, Pfs) involved in biofilm formation was investigated using the quantitative reverse transcriptase-polymerase chain reaction (RT-qPCR) method. RESULTS The minimum inhibitory concentration (MIC) and minimum fungicidal/bactericidal concentration (MFC/MBC) for oleuropein were found to be 65 mg/ml and 130 mg/ml, respectively. Oleuropein significantly inhibited biofilm formation at MIC/2 (32.5 mg/ml), MIC/4 (16.25 mg/ml), MIC/8 (8.125 mg/ml) and MIC/16 (4.062 mg/ml) (p < 0.0001). The anti-biofilm effect of oleuropein was confirmed by SEM. RT-qPCR indicated significant down regulation of expression genes involved in biofilm formation in Candida albicans (Hwp1, Als3) and Candida glabrata (Epa1, Epa6) as well as Escherichia coli (LuxS, Pfs) genes after culture with a MIC/2 of oleuropein (p < 0.0001). CONCLUSIONS The results indicate that oleuropein has antifungal and antibacterial properties that enable it to inhibit or destroy the formation of fungal and bacterial biofilm.
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Affiliation(s)
- Mohammad Ali Esfandiary
- Department of Microbiology and Immunology, Faculty of Veterinary Medicine, University of Tehran, PO Box: 14155-6453, Tehran, Iran
| | - Ali Reza Khosravi
- Department of Microbiology and Immunology, Faculty of Veterinary Medicine, University of Tehran, PO Box: 14155-6453, Tehran, Iran.
| | - Sepideh Asadi
- Department of Microbiology and Immunology, Faculty of Veterinary Medicine, University of Tehran, PO Box: 14155-6453, Tehran, Iran
| | - Donya Nikaein
- Department of Microbiology and Immunology, Faculty of Veterinary Medicine, University of Tehran, PO Box: 14155-6453, Tehran, Iran
| | - Jalal Hassan
- Department of Comparative Biosciences, Faculty of Veterinary Medicine, University of Tehran, Tehran, Iran
| | - Aghil Sharifzadeh
- Department of Microbiology and Immunology, Faculty of Veterinary Medicine, University of Tehran, PO Box: 14155-6453, Tehran, Iran
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Parsons JB, Sidders AE, Velez AZ, Hanson BM, Angeles-Solano M, Ruffin F, Rowe SE, Arias CA, Fowler VG, Thaden JT, Conlon BP. In-patient evolution of a high-persister Escherichia coli strain with reduced in vivo antibiotic susceptibility. Proc Natl Acad Sci U S A 2024; 121:e2314514121. [PMID: 38190524 PMCID: PMC10801923 DOI: 10.1073/pnas.2314514121] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2023] [Accepted: 12/11/2023] [Indexed: 01/10/2024] Open
Abstract
Gram-negative bacterial bloodstream infections (GNB-BSI) are common and frequently lethal. Despite appropriate antibiotic treatment, relapse of GNB-BSI with the same bacterial strain is common and associated with poor clinical outcomes and high healthcare costs. The role of persister cells, which are sub-populations of bacteria that survive for prolonged periods in the presence of bactericidal antibiotics, in relapse of GNB-BSI is unclear. Using a cohort of patients with relapsed GNB-BSI, we aimed to determine how the pathogen evolves within the patient between the initial and subsequent episodes of GNB-BSI and how these changes impact persistence. Using Escherichia coli clinical bloodstream isolate pairs (initial and relapse isolates) from patients with relapsed GNB-BSI, we found that 4/11 (36%) of the relapse isolates displayed a significant increase in persisters cells relative to the initial bloodstream infection isolate. In the relapsed E. coli strain with the greatest increase in persisters (100-fold relative to initial isolate), we determined that the increase was due to a loss-of-function mutation in the ptsI gene encoding Enzyme I of the phosphoenolpyruvate phosphotransferase system. The ptsI mutant was equally virulent in a murine bacteremia infection model but exhibited 10-fold increased survival to antibiotic treatment. This work addresses the controversy regarding the clinical relevance of persister formation by providing compelling data that not only do high-persister mutations arise during bloodstream infection in humans but also that these mutants display increased survival to antibiotic challenge in vivo.
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Affiliation(s)
- Joshua B. Parsons
- Division of Infectious Diseases, Duke University School of Medicine, Durham, NC27710
- Department of Microbiology and Immunology, University of North Carolina, Chapel Hill, NC27559
| | - Ashelyn E. Sidders
- Department of Microbiology and Immunology, University of North Carolina, Chapel Hill, NC27559
| | - Amanda Z. Velez
- Department of Microbiology and Immunology, University of North Carolina, Chapel Hill, NC27559
| | | | - Michelle Angeles-Solano
- Department of Microbiology and Immunology, University of North Carolina, Chapel Hill, NC27559
| | - Felicia Ruffin
- Division of Infectious Diseases, Duke University School of Medicine, Durham, NC27710
| | - Sarah E. Rowe
- Department of Microbiology and Immunology, University of North Carolina, Chapel Hill, NC27559
| | - Cesar A. Arias
- Division of Infectious Diseases, Houston Methodist Hospital and Center for Infectious Diseases, Houston Methodist Research Institute, Houston, TX77030
- Department of Medicine, Weill Cornell Medical College, New York, NY10065
| | - Vance G. Fowler
- Division of Infectious Diseases, Duke University School of Medicine, Durham, NC27710
| | - Joshua T. Thaden
- Division of Infectious Diseases, Duke University School of Medicine, Durham, NC27710
| | - Brian P. Conlon
- Department of Microbiology and Immunology, University of North Carolina, Chapel Hill, NC27559
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Zhou F, Yi G, Liu X, Sheng W, Shu J, Li D, Cai C. A Pair of Compound Heterozygous IARS2 Variants Manifesting West Syndrome and Electrolyte Disorders in a Chinese Patient. Glob Med Genet 2024; 11:25-28. [PMID: 38229969 PMCID: PMC10791488 DOI: 10.1055/s-0043-1778091] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2024] Open
Abstract
Background Aminoacyl-tRNA synthetases (ARSs) are evolutionarily conserved enzymes that ensure the accuracy of the translation process. Isoleucyl-tRNA synthetase 2 ( IARS2 ) gene is a type of ARS that encodes mitochondrial isoleucine-tRNA synthetase. Pathogenic variants in the IARS2 gene are associated with mitochondrial disease which involves several patients presenting broad clinical phenotypes. These clinical phenotypes include West syndrome, Leigh syndrome, and Cataract, growth hormone deficiency, sensory neuropathy, sensorineural hearing loss, and skeletal dysplasia syndrome. Only 29 cases have been reported worldwide. The patient manifested recurrent convulsions, and specific clinical manifestations included electrolyte disorders and recurrent infections. Methods Whole-exome sequencing was performed on the child with West syndrome. Three-dimensional structure reconstruction and thermodynamic stability prediction were performed to further analyze the relationship between variation and phenotype. Conclusion This study further expands the clinical spectrum of IARS2 pathogenic variants. The case summaries help raise clinical awareness of IARS2 -associated disease and reduce misdiagnosis. Result In this report, a 13-month-old girl was diagnosed with West syndrome and Leigh syndrome for 7 months. Compound heterozygous variants in the IARS2 gene (NM_018060.4), c.2450G>A (Arg817His) and copy number variation (NC_000001. 11: g. (220267549_220284289) del), were detected by WES. This study further expands the clinical spectrum of IARS2 pathogenic variants. The case summaries help raise clinical awareness of IARS2-associated disease and reduce misdiagnosis.
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Affiliation(s)
- Feiyu Zhou
- Tianjin Children's Hospital (Tianjin University Children's Hospital), Tianjin, People's Republic of China
- Graduate College of Tianjin Medical University, Tianjin Medical University, Tianjin, People's Republic of China
| | - Gui Yi
- Tianjin Children's Hospital (Tianjin University Children's Hospital), Tianjin, People's Republic of China
- Department of Neurology, Tianjin Children's Hospital (Tianjin University Children's Hospital), Tianjin, People's Republic of China
| | - Xiangyu Liu
- Tianjin Children's Hospital (Tianjin University Children's Hospital), Tianjin, People's Republic of China
- Graduate College of Tianjin Medical University, Tianjin Medical University, Tianjin, People's Republic of China
| | - Wenchao Sheng
- Tianjin Children's Hospital (Tianjin University Children's Hospital), Tianjin, People's Republic of China
- Graduate College of Tianjin Medical University, Tianjin Medical University, Tianjin, People's Republic of China
| | - Jianbo Shu
- Tianjin Children's Hospital (Tianjin University Children's Hospital), Tianjin, People's Republic of China
- Tianjin Pediatric Research Institute, Tianjin Children's Hospital (Tianjin University Children's Hospital), Tianjin, People's Republic of China
- Tianjin Key Laboratory of Birth Defects for Prevention and Treatment, Tianjin Children's Hospital, Tianjin, Peoples' Republic of China
| | - Dong Li
- Tianjin Children's Hospital (Tianjin University Children's Hospital), Tianjin, People's Republic of China
- Department of Neurology, Tianjin Children's Hospital (Tianjin University Children's Hospital), Tianjin, People's Republic of China
| | - Chunquan Cai
- Tianjin Children's Hospital (Tianjin University Children's Hospital), Tianjin, People's Republic of China
- Tianjin Pediatric Research Institute, Tianjin Children's Hospital (Tianjin University Children's Hospital), Tianjin, People's Republic of China
- Tianjin Key Laboratory of Birth Defects for Prevention and Treatment, Tianjin Children's Hospital, Tianjin, Peoples' Republic of China
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Ohta R, Sano C. Bacterial Translocation As the Origin of Gram-Negative Rods Bloodstream Infection Among Older Patients in Rural Hospitals: A Cross-Sectional Study. Cureus 2023; 15:e50706. [PMID: 38234963 PMCID: PMC10792400 DOI: 10.7759/cureus.50706] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/17/2023] [Indexed: 01/19/2024] Open
Abstract
Introduction Bloodstream infections caused by Gram-negative rods are a pressing concern for the aging global population, particularly in rural settings. This study investigates the prevalence and entry pathways of Gram-negative rod bloodstream infections in elderly patients at a rural Japanese hospital, aiming to clarify the frequency and associated factors of straightforward entry and bacterial translocation. Method In this cross-sectional study, we analyzed electronic medical records of patients over 18 years of age with symptomatic Gram-negative rod bloodstream infections at Unnan City Hospital, Japan, from September 2021 to August 2023. We used multivariate logistic regression to assess factors of age, sex, body mass index, care dependency, and comorbidities. Results Among the participants who met the inclusion criteria, significant differences were observed in age, sex, inpatient status, and prevalence of conditions like respiratory diseases and cancer between the straightforward entry and bacterial translocation groups. Escherichia coli was the most common pathogen identified. Conclusion The study emphasizes the need for tailored medical approaches for elderly patients with bloodstream infections, considering their unique health profiles and risks. It highlights the importance of age, inpatient status, and cancer in determining infection risks, pointing to areas for further research to enhance infection management and healthcare outcomes in older populations.
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Affiliation(s)
| | - Chiaki Sano
- Community Medicine, Shimane University Faculty of Medicine, Izumo, JPN
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Ohta R, Sano C. Factors Associated With Blood Culture Contamination in Rural Hospitals in Japan: A Cross-Sectional Study. Cureus 2023; 15:e47987. [PMID: 38034244 PMCID: PMC10685058 DOI: 10.7759/cureus.47987] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/30/2023] [Indexed: 12/02/2023] Open
Abstract
Background Blood culture, a cornerstone diagnostic test, is paramount for identifying bacteremia due to serious infections. However, its accuracy is jeopardized by contamination, often due to inappropriate collection procedures. Resource constraints and a limitation in specialized staff can heighten contamination risks in rural hospitals, underscoring the need to understand the associated demographics and conditions. This study aimed to elucidate the demographics and conditions associated with heightened blood culture contamination risk in rural hospitals to optimize testing practices and improve patient care. Methods A single-center, cross-sectional study was conducted in Unnan City Hospital, Unnan, Japan with participants suspected of having bacteremia. Data from the electronic medical records of 455 patients were analyzed using multivariate logistic regression with contamination as the dependent variable. Results Of the 455 patients who underwent blood culture testing, 321 and 134 tests were negative and positive for contamination, respectively. Older age and blood obtained from arteries were associated with a reduced risk of contamination (odds ratio (OR)=0.97; p=0.012, and OR=0.17; p=0.00069, respectively). Patients with dependencies exhibited an increase in contamination risk (OR=1.81; p=0.044). Patients admitted for infection demonstrated a reduced likelihood of sample contamination (OR=0.44; p=0.0034). The predominant organisms identified varied, with Escherichia coli being more frequent in uncontaminated blood samples and Staphylococcus epidermidis in the contaminated samples. Conclusion This study reveals a complex relationship between patient demographics, clinical practices, and the risk of contamination. Factors such as age, dependency status, and reason for admission were associated with sample contamination. Enhanced procedural stringency, microbial surveillance, and continuous training could mitigate these risks, particularly in resource-constrained settings. Identifying and understanding the factors influencing blood culture contamination can significantly bolster clinical practice in rural settings. While this study provides foundational insights, future research can deepen our understanding, ensuring the refinement of patient care protocols in similar environments.
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Affiliation(s)
| | - Chiaki Sano
- Community Medicine Management, Shimane University Faculty of Medicine, Izumo, JPN
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Li R, Xu H, Tang H, Shen J, Xu Y. The Characteristics of Extended-Spectrum β-Lactamases (ESBLs)-Producing Escherichia coli in Bloodstream Infection. Infect Drug Resist 2023; 16:2043-2060. [PMID: 37056484 PMCID: PMC10086224 DOI: 10.2147/idr.s400170] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2022] [Accepted: 03/16/2023] [Indexed: 04/08/2023] Open
Abstract
Background Bloodstream infection (BSI) is a common type of infection frequently diagnosed in clinics. The emergence and spread of ESBLs-producing Escherichia coli (E. coli) has emerged as one of the biggest challenges in global community health. Methods The production of ESBLs was determined by the composite disk diffusion method. The expression of the various resistance and virulence genes were detected by PCR and sequencing. Multi-locus sequence typing (MLST) and phylogenetic groups were used for the classification. The transfer of resistant plasmids was determined by conjugation assay. The statistical differences were analyzed using Statistical Product and Service Solutions (SPSS) version 23.0. Results A total of 60 strains of ESBLs-producing E. coli were collected. The resistance genes that were identified included bla CTX-M, bla TEM, bla SHV, bla OXA-1 and mcr-1. The most common one was the bla CTX-M including bla CTX-M-27 (n = 16), bla CTX-M-14 (n = 15), bla CTX-M-15 (n = 11), bla CTX-M-55 (n = 14) and bla CTX-M-65 (n = 5). A total of 31 STs were detected, and the most abundant among which was ST131 (n = 16, 26.7%). Most of the E. coli (n = 46, 76.7%) belonged to the groups B2 and D. And some virulence genes were related to the classification of the E. coli. Among them, the detection rates of hek/hra, kpsMII and papGII-III in groups B2 and D were higher than those in groups A and B1. The detection rates of cnf1, iucC and papGII-III in ST131 were higher than those in non-ST131. And the distributions of hek/hra, iroN, iucC, kpsMII and papGII-III were related to the bla CTX-M subtypes. Finally, most bacterial (n = 32, 53.3%) resistance genes could be transferred between the bacteria by plasmids, especially IncFIB. Conclusion ESBLs-producing E. coli in BSI exhibited had high resistance rates and carried a variety of virulence factors (VFs). This is necessary to strengthen the monitoring of ESBLs-producing isolates in the medical environment.
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Affiliation(s)
- Rongrong Li
- Department of Clinical Laboratory, The First Affiliated Hospital of Anhui Medical University, Hefei, 230022, People’s Republic of China
- Department of Pathogen Biology and Provincial Laboratories of Pathogen Biology and Zoonoses, Anhui Medical University, Hefei, People’s Republic of China
| | - Huaming Xu
- The First Affiliated Hospital of Anhui University of Traditional Chinese Medicine, Hefei, People’s Republic of China
| | - Hao Tang
- Department of Clinical Laboratory, The Second Affiliated Hospital of Anhui Medical University, Hefei, People’s Republic of China
| | - Jilu Shen
- Department of Clinical Laboratory, The First Affiliated Hospital of Anhui Medical University, Hefei, 230022, People’s Republic of China
- Anhui Public Health Clinical Center, Hefei, People’s Republic of China
| | - Yuanhong Xu
- Department of Clinical Laboratory, The First Affiliated Hospital of Anhui Medical University, Hefei, 230022, People’s Republic of China
- Correspondence: Yuanhong Xu, Department of Clinical Laboratory, The First Affiliated Hospital of Anhui Medical University, Hefei, 230022, People’s Republic of China, Tel +86 13505694447, Email
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Bock A, Hanson BM, Ruffin F, Parsons JB, Park LP, Sharma-Kuinkel B, Mohnasky M, Arias CA, Fowler VG, Thaden JT. Clinical and Molecular Analyses of Recurrent Gram-Negative Bloodstream Infections. Clin Infect Dis 2023; 76:e1285-e1293. [PMID: 35929656 PMCID: PMC10169420 DOI: 10.1093/cid/ciac638] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2022] [Revised: 07/21/2022] [Accepted: 08/01/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND The causes and clinical characteristics of recurrent gram-negative bacterial bloodstream infections (GNB-BSI) are poorly understood. METHODS We used a cohort of patients with GNB-BSI to identify clinical characteristics, microbiology, and risk factors associated with recurrent GNB-BSI. Bacterial genotyping (pulsed-field gel electrophoresis [PFGE] and whole-genome sequencing [WGS]) was used to determine whether episodes were due to relapse or reinfection. Multivariable logistic regression was used to identify risk factors for recurrence. RESULTS Of the 1423 patients with GNB-BSI in this study, 60 (4%) had recurrent GNB-BSI. Non-White race (odds ratio [OR], 2.35; 95% confidence interval [CI], 1.38-4.01; P = .002), admission to a surgical service (OR, 2.18; 95% CI, 1.26-3.75; P = .005), and indwelling cardiac device (OR, 2.73; 95% CI, 1.21-5.58; P = .009) were associated with increased risk for recurrent GNB-BSI. Among the 48 patients with recurrent GNB-BSI whose paired bloodstream isolates underwent genotyping, 63% were due to relapse (30 of 48) and 38% were due to reinfection (18 of 48) based on WGS. Compared with WGS, PFGE correctly differentiated relapse and reinfection in 98% (47 of 48) of cases. Median time to relapse and reinfection was similar (113 days; interquartile range [IQR], 35-222 vs 174 days; IQR, 69-599; P = .13). Presence of a cardiac device was associated with relapse (relapse: 7 of 27, 26%; nonrelapse: 65 of 988, 7%; P = .002). CONCLUSIONS In this study, recurrent GNB-BSI was most commonly due to relapse. PFGE accurately differentiated relapse from reinfection when compared with WGS. Cardiac device was a risk factor for relapse.
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Affiliation(s)
- Andrew Bock
- Duke University School of Medicine, Durham, North Carolina, USA
| | - Blake M Hanson
- Division of Infectious Diseases, Department of Medicine, Houston Methodist Hospital, Houston, Texas, USA.,Center for Antimicrobial Resistance and Microbial Genomics, McGovern Medical School, University of Texas Health Science Center, Houston, Texas, USA.,Division of Infectious Disease, Department of Pediatrics, McGovern Medical School, University of Texas Health Science Center, Houston, Texas, USA
| | - Felicia Ruffin
- Division of Infectious Diseases, Department of Medicine, Duke University School of Medicine, Durham, North Carolina, USA
| | - Joshua B Parsons
- Division of Infectious Diseases, Department of Medicine, Duke University School of Medicine, Durham, North Carolina, USA
| | - Lawrence P Park
- Division of Infectious Diseases, Department of Medicine, Duke University School of Medicine, Durham, North Carolina, USA.,Duke Global Health Institute, Durham, North Carolina, USA
| | - Batu Sharma-Kuinkel
- Division of Infectious Diseases, Department of Medicine, Duke University School of Medicine, Durham, North Carolina, USA
| | - Michael Mohnasky
- University of North Carolina-Chapel Hill School of Medicine, Chapel Hill, North Carolina, USA
| | - Cesar A Arias
- Division of Infectious Diseases, Department of Medicine, Houston Methodist Hospital, Houston, Texas, USA.,Center for Infectious Diseases, Houston Methodist Research Institute, Houston, Texas, USA
| | - Vance G Fowler
- Division of Infectious Diseases, Department of Medicine, Duke University School of Medicine, Durham, North Carolina, USA.,Duke Clinical Research Institute, Durham, North Carolina, USA
| | - Joshua T Thaden
- Division of Infectious Diseases, Department of Medicine, Duke University School of Medicine, Durham, North Carolina, USA
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11
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Guangzhang C, Fangfang F, Siqian D, Xinyi X, Xiaochuan B, Yihan R, Li W. Outer membrane vesicles from Escherichia coli are efficiently internalized by macrophage cells and alter their inflammatory response. Microb Pathog 2023; 175:105965. [PMID: 36592640 DOI: 10.1016/j.micpath.2022.105965] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2022] [Revised: 12/26/2022] [Accepted: 12/29/2022] [Indexed: 12/31/2022]
Abstract
The release of extracellular vesicles (EV) by pathogenic microbes is considered an alternative cell-to-cell transport of macromolecules transport mechanism. In Gram-negative bacteria, EVs may be formed by outer membrane budding, so-called outer membrane vesicles (OMVs). Previous studies have revealed E. coli constitutively release nano-sized OMVs, which can be potent activators of cellular functions without live bacteria. But the immunomodulatory activity of E. coli OMVs is still relatively poorly understood. Here we investigated the morphological characterization and composition of E.Coli OMVs, kinetics of internalization by Raw 264.7 macrophage cells, and their immunomodulatory activity on cells. By transmission electron microscopy and dynamic light scattering, E.Coli OMVs were identified as typical cup-shaped, bilayered membranous structures, mainly distributed between 72.5 and 212.5 nm. We also demonstrated by confocal fluorescence microscopy that exposure of Raw 264.7 cells to E.Coli OMVs resulted in internalization of these nanoparticles and decreased mitochondrial membrane potential. In addition, E. Coli OMVs treatment induced the production of ROS, iNOS, IL-1β, IL-6, IL-10 and up-regulation of CD86 and CD206. Taken together, our results indicated that E.Coli OMVs are immunobiologically active, can directly interact with macrophage and participate in immune responses.
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Affiliation(s)
- Chen Guangzhang
- School of Basic Medicine, Bengbu Medical College, Bengbu, 233030, China
| | - Fan Fangfang
- School of Basic Medicine, Bengbu Medical College, Bengbu, 233030, China
| | - Deng Siqian
- School of Basic Medicine, Bengbu Medical College, Bengbu, 233030, China
| | - Xia Xinyi
- School of Clinical Medicine, Bengbu Medical College, Bengbu, 233030, China
| | - Bian Xiaochuan
- School of Clinical Medicine, Bengbu Medical College, Bengbu, 233030, China
| | - Ren Yihan
- School of Clinical Medicine, Bengbu Medical College, Bengbu, 233030, China
| | - Wei Li
- School of Basic Medicine, Bengbu Medical College, Bengbu, 233030, China; Anhui Key Laboratory of Infection and Immunity at Bengbu Medical College, Bengbu, 233030, China.
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12
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Chen H, Lu Q, An H, Li J, Shen S, Zheng X, Chen W, Wang L, Li J, Du Y, Wang Y, Liu X, Baumann M, Tacke M, Zou L, Wang J. The synergistic activity of SBC3 in combination with Ebselen against Escherichia coli infection. Front Pharmacol 2022; 13:1080281. [PMID: 36588729 PMCID: PMC9797518 DOI: 10.3389/fphar.2022.1080281] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2022] [Accepted: 11/28/2022] [Indexed: 12/23/2022] Open
Abstract
Escherichia coli ranks as the number one clinical isolate in the past years in China according to The China Antimicrobial Surveillance Network (CHINET), and its multidrug-resistant (MDR) pathogenic strains account for over 160 million cases of dysentery and one million deaths per year. Here, our work demonstrates that E. coli is highly sensitive to the synergistic combination of SBC3 [1,3-Dibenzyl-4,5-diphenyl-imidazol-2-ylidene silver (I) acetate] and Ebselen, which shows no synergistic toxicity on mammalian cells. The proposed mechanism for the synergistic antibacterial effect of SBC3 in combination with Ebselen is based on directly inhibiting E. coli thioredoxin reductase and rapidly depleting glutathione, resulting in the increase of reactive oxygen species that cause bacterial cell death. Furthermore, the bactericidal efficacy of SBC3 in combination with Ebselen has been confirmed in mild and acute peritonitis mice. In addition, the five most difficult to treat Gram-negative bacteria (including E. coli, Acinetobacter baumannii, Enterobacter cloacae, Klebsiella pneumoniae, and Pseudomonas aeruginosa) are also highly sensitive to a synergistic combination of SBC3 and Ebselen. Thus, SBC3 in combination with Ebselen has potential as a treatment for clinically important Gram-negative bacterial infections.
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Affiliation(s)
- Hao Chen
- The Second People’s Hospital of China Three Gorges University, Yichang, Hubei, China,The Second People’s Hospital of Yichang, Yichang, Hubei, China
| | - Qianqian Lu
- Hubei Key Laboratory of Tumor Microenvironment and Immunotherapy, College of Basic Medical Sciences, China Three Gorges University, Yichang, Hubei, China,The Institute of Infection and Inflammation, College of Basic Medical Sciences, China Three Gorges University, Yichang, Hubei, China
| | - Haoyue An
- Hubei Key Laboratory of Tumor Microenvironment and Immunotherapy, College of Basic Medical Sciences, China Three Gorges University, Yichang, Hubei, China,The Institute of Infection and Inflammation, College of Basic Medical Sciences, China Three Gorges University, Yichang, Hubei, China
| | - Juntong Li
- Hubei Key Laboratory of Tumor Microenvironment and Immunotherapy, College of Basic Medical Sciences, China Three Gorges University, Yichang, Hubei, China,The Institute of Infection and Inflammation, College of Basic Medical Sciences, China Three Gorges University, Yichang, Hubei, China
| | - Shuchu Shen
- Hubei Key Laboratory of Tumor Microenvironment and Immunotherapy, College of Basic Medical Sciences, China Three Gorges University, Yichang, Hubei, China,The Institute of Infection and Inflammation, College of Basic Medical Sciences, China Three Gorges University, Yichang, Hubei, China
| | - Xi Zheng
- Hubei Key Laboratory of Tumor Microenvironment and Immunotherapy, College of Basic Medical Sciences, China Three Gorges University, Yichang, Hubei, China,The Institute of Infection and Inflammation, College of Basic Medical Sciences, China Three Gorges University, Yichang, Hubei, China
| | - Wei Chen
- Hubei Key Laboratory of Tumor Microenvironment and Immunotherapy, College of Basic Medical Sciences, China Three Gorges University, Yichang, Hubei, China,The Institute of Infection and Inflammation, College of Basic Medical Sciences, China Three Gorges University, Yichang, Hubei, China
| | - Lu Wang
- Hubei Key Laboratory of Tumor Microenvironment and Immunotherapy, College of Basic Medical Sciences, China Three Gorges University, Yichang, Hubei, China,The Institute of Infection and Inflammation, College of Basic Medical Sciences, China Three Gorges University, Yichang, Hubei, China
| | - Jihong Li
- Hubei Key Laboratory of Tumor Microenvironment and Immunotherapy, College of Basic Medical Sciences, China Three Gorges University, Yichang, Hubei, China,The Institute of Infection and Inflammation, College of Basic Medical Sciences, China Three Gorges University, Yichang, Hubei, China
| | - Youqin Du
- Hubei Key Laboratory of Tumor Microenvironment and Immunotherapy, College of Basic Medical Sciences, China Three Gorges University, Yichang, Hubei, China,The Institute of Infection and Inflammation, College of Basic Medical Sciences, China Three Gorges University, Yichang, Hubei, China
| | - Yueqing Wang
- Hubei Key Laboratory of Tumor Microenvironment and Immunotherapy, College of Basic Medical Sciences, China Three Gorges University, Yichang, Hubei, China,The Institute of Infection and Inflammation, College of Basic Medical Sciences, China Three Gorges University, Yichang, Hubei, China
| | - Xiaowen Liu
- Hubei Key Laboratory of Tumor Microenvironment and Immunotherapy, College of Basic Medical Sciences, China Three Gorges University, Yichang, Hubei, China,The Institute of Infection and Inflammation, College of Basic Medical Sciences, China Three Gorges University, Yichang, Hubei, China
| | - Marcus Baumann
- The School of Chemistry, University College Dublin, Belfield, Dublin, Ireland
| | - Matthias Tacke
- The School of Chemistry, University College Dublin, Belfield, Dublin, Ireland,*Correspondence: Lili Zou, ; Jun Wang, ; Matthias Tacke,
| | - Lili Zou
- The Second People’s Hospital of China Three Gorges University, Yichang, Hubei, China,The Second People’s Hospital of Yichang, Yichang, Hubei, China,Hubei Key Laboratory of Tumor Microenvironment and Immunotherapy, College of Basic Medical Sciences, China Three Gorges University, Yichang, Hubei, China,The Institute of Infection and Inflammation, College of Basic Medical Sciences, China Three Gorges University, Yichang, Hubei, China,*Correspondence: Lili Zou, ; Jun Wang, ; Matthias Tacke,
| | - Jun Wang
- The People’s Hospital of China Three Gorges University, Yichang, Hubei, China,*Correspondence: Lili Zou, ; Jun Wang, ; Matthias Tacke,
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13
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Hu J, Wang D, Huang X, Yang Y, Lian X, Wang W, Xu X, Liu Y. Effects of TolC on the pathogenicity of porcine extraintestinal pathogenic Escherichia coli. Front Immunol 2022; 13:929740. [PMID: 36059454 PMCID: PMC9433895 DOI: 10.3389/fimmu.2022.929740] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2022] [Accepted: 07/27/2022] [Indexed: 11/25/2022] Open
Abstract
Extraintestinal pathogenic Escherichia coli (ExPEC) is a well-known critical pathogenic zoonosis that causes extraintestinal infections in humans and animals by affecting their immune organs. Recently, research on the outer membrane protein of E. coli, tolerant colicin (TolC), a virulent protein in the formation of the ExPEC efflux pump, has been an attractive subject. However, the pathogenic mechanisms remain unclear. This study aimed to explore the role of TolC in the pathogenesis of the ExPEC strain PPECC42; a complementation strain (Cm-TolC) and an isogenic mutant (ΔTolC) were constructed. Loss of TolC drastically impaired the virulence of ExPEC in an experimental mouse model. ΔTolC showed a substantial decrease in the porcine aortic vascular endothelial cell (PAVEC) adherence, invasion, and pro-inflammatory response, in contrast to that of the wild type, with a reduced survival ratio in both the bacterial load and whole blood in mice. ΔTolC also showed decreased expression of necroptosis signals such as receptor-interacting protein kinase 1, phosphorylated mixed-lineage kinase domain-like protein, and mitochondrial proteins such as phosphoglycerate mutase family member 5. Our data suggest that TolC is closely associated with ExPEC pathogenesis. These results provide scientific grounds for exploring the potential of TolC as an effective drug target for controlling ExPEC infection, screening new inhibitors, and developing new drugs. This will allow for further prevention and control of ExPEC infection.
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Affiliation(s)
- Jin Hu
- Hubei Key Laboratory of Animal Nutrition and Feed Science, Wuhan Polytechnic University, Wuhan, China
| | - Dongfang Wang
- Hubei Key Laboratory of Animal Nutrition and Feed Science, Wuhan Polytechnic University, Wuhan, China
| | - Xingfa Huang
- Hubei Key Laboratory of Animal Nutrition and Feed Science, Wuhan Polytechnic University, Wuhan, China
- Hubei Provincial Key Laboratory for Protection and Application of Special Plants in Wuling Area of China, South-Central University for Nationalities, Wuhan, China
| | - Yang Yang
- Hubei Key Laboratory of Animal Nutrition and Feed Science, Wuhan Polytechnic University, Wuhan, China
| | - Xin Lian
- Hubei Key Laboratory of Animal Nutrition and Feed Science, Wuhan Polytechnic University, Wuhan, China
| | - Wenjun Wang
- Hubei Provincial Key Laboratory for Protection and Application of Special Plants in Wuling Area of China, South-Central University for Nationalities, Wuhan, China
| | - Xiao Xu
- Hubei Key Laboratory of Animal Nutrition and Feed Science, Wuhan Polytechnic University, Wuhan, China
| | - Yulan Liu
- Hubei Key Laboratory of Animal Nutrition and Feed Science, Wuhan Polytechnic University, Wuhan, China
- *Correspondence: Yulan Liu,
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