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da Silveira BP, Cohen ND, Lawhon SD, Watson RO, Bordin AI. Protective immune response against Rhodococcus equi: An innate immunity-focused review. Equine Vet J 2024. [PMID: 39258739 DOI: 10.1111/evj.14214] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2024] [Accepted: 07/30/2024] [Indexed: 09/12/2024]
Abstract
Rhodococcus equi causes pyogranulomatous pneumonia in foals and immunocompromised people. Despite decades of research efforts, no vaccine is available against this common cause of disease and death in foals. The purpose of this narrative review is to summarise the current understanding of interactions between R. equi and the host innate immune system, to describe features of the immune response that are associated with resistance or susceptibility to R. equi infection, and help guide strategies for developing novel approaches for preventing R. equi infections. Virulence of R. equi in foals has been attributed to the virulence associated protein A which allows intracellular survival in macrophages by preventing acidification of R. equi-containing vacuole. Additionally, foal susceptibility to R. equi infection is associated with immaturity and naivety of innate and adaptive immune systems, while adult horses with fully functional immune system are resistant to pneumonia. Specific interaction between R. equi and innate immune cells can result in bacterial survival or death; learning how to manipulate these responses to control infection is critical to prevent pneumonia in foals. Administration of live vaccines and stimulation of innate immune responses appears to improve foals' immune response and has the potential to overcome the challenges of foal active vaccination and elicit protection against pneumonia.
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Affiliation(s)
- Bibiana Petri da Silveira
- Equine Infectious Disease Laboratory, Department of Large Animal Clinical Sciences, Texas A&M University, School of Veterinary Medicine & Biomedical Sciences, College Station, Texas, USA
| | - Noah D Cohen
- Equine Infectious Disease Laboratory, Department of Large Animal Clinical Sciences, Texas A&M University, School of Veterinary Medicine & Biomedical Sciences, College Station, Texas, USA
| | - Sara D Lawhon
- Department of Veterinary Pathobiology, Texas A&M University, School of Veterinary Medicine & Biomedical Sciences, College Station, Texas, USA
| | - Robert O Watson
- Department of Microbial Pathogenesis & Immunology, Texas A&M University, School of Medicine, College Station, Texas, USA
| | - Angela I Bordin
- Equine Infectious Disease Laboratory, Department of Large Animal Clinical Sciences, Texas A&M University, School of Veterinary Medicine & Biomedical Sciences, College Station, Texas, USA
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Xiao Y, Sheng ZM, Williams SL, Taubenberger JK. Two complete 1918 influenza A/H1N1 pandemic virus genomes characterized by next-generation sequencing using RNA isolated from formalin-fixed, paraffin-embedded autopsy lung tissue samples along with evidence of secondary bacterial co-infection. mBio 2024; 15:e0321823. [PMID: 38349163 PMCID: PMC10936189 DOI: 10.1128/mbio.03218-23] [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: 11/28/2023] [Accepted: 01/22/2024] [Indexed: 03/14/2024] Open
Abstract
The 1918 influenza pandemic was the most devastating respiratory pandemic in modern human history, with 50-100 million deaths worldwide. Here, we characterized the complete genomes of influenza A virus (IAV) from two fatal cases during the fall wave of 1918 influenza A (H1N1) pandemic in the United States, one from Walter Reed Army Hospital in Washington, DC, and the other from Camp Jackson, SC. The two complete IAV genomes were obtained by combining Illumina deep sequencing data from both total RNA and influenza viral genome-enriched libraries along with Sanger sequencing data from PCR across the sequencing gaps. This study confirms the previously reported 1918 IAV genomes and increases the total number of available complete or near-complete influenza viral genomes of the 1918 pandemic from four to six. Sequence comparisons among them confirm that the genomes of the 1918 pandemic virus were highly conserved during the main wave of the pandemic with geographic separation in North America and Europe. Metagenomic analyses revealed bacterial co-infections in both cases. Interestingly, in the Washington, DC, case, evidence is presented of the first reported Rhodococcus-influenza virus co-infection. IMPORTANCE This study applied modern molecular biotechnology and high-throughput sequencing to formalin-fixed, paraffin-embedded autopsy lung samples from two fatal cases during the fall wave of the 1918 influenza A (H1N1) pandemic in the United States. Complete influenza genomes were obtained from both cases, which increases the total number of available complete or near-complete influenza genomes of the 1918 pandemic virus from four to six. Sequence analysis confirms that the 1918 pandemic virus was highly conserved during the main wave of the pandemic with geographic separation in North America and Europe. Metagenomic analyses revealed bacterial co-infections in both cases, including the first reported evidence of Rhodococcus-influenza co-infection. Overall, this study offers a detailed view at the molecular level of the very limited samples from the most devastating influenza pandemic in modern human history.
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Affiliation(s)
- Yongli Xiao
- Viral Pathogenesis and Evolution Section, Laboratory of Infectious Diseases, Division of Intramural Research, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland, USA
| | - Zong-Mei Sheng
- Viral Pathogenesis and Evolution Section, Laboratory of Infectious Diseases, Division of Intramural Research, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland, USA
| | - Stephanie L. Williams
- Viral Pathogenesis and Evolution Section, Laboratory of Infectious Diseases, Division of Intramural Research, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland, USA
- Sir William Dunn School of Pathology, University of Oxford, Oxford, United Kingdom
| | - Jeffery K. Taubenberger
- Viral Pathogenesis and Evolution Section, Laboratory of Infectious Diseases, Division of Intramural Research, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland, USA
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Franco-Álvarez M, Fernández-Castro I, Fernández Cambeiro MF, Beceiro Abad C, Otero Antón E, Rodríguez López S, Calvo Barbeito MD, Novo-Veleiro I. 'The Year of Living Dangerously': Successful Rhodococcus Equi Therapy in an Immunosuppressed Patient with Minimal Toxicity by One Year of Continuous Intravenous Vancomycin Therapy Combined with Oral Levofloxacin And Rifampicin. Eur J Case Rep Intern Med 2024; 11:004249. [PMID: 38352814 PMCID: PMC10860908 DOI: 10.12890/2024_004249] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2023] [Accepted: 12/20/2023] [Indexed: 02/16/2024] Open
Abstract
Background Rhodococcus equi is a Gram-positive microorganism that causes infections, particularly in immunocompromised patients. Treatment duration can be prolonged. While vancomycin is an effective drug in this scenario, its use may lead to renal damage. Studies have shown that continuous vancomycin infusion appears to be a safe strategy in terms of adverse effects compared to bolus administration. Case description We present the case of a 71-year-old female liver transplant recipient. After being diagnosed with a mediastinal infection caused by Rhodococcus equi with poor response to initial therapy, she required 12 months of continuous intravenous domiciliary infusion of vancomycin combined with oral levofloxacin and rifampicin. There was no drug-related complication throughout the follow-up. Conclusions The use of continuous vancomycin infusion has emerged as a safer, more efficient, and cost-effective alternative to intermittent administration. We want to emphasise the uniqueness of this case, where despite the unprecedented treatment duration, no adverse effects occurred. LEARNING POINTS Vancomycin therapy based on continuous infusion represents a safer and cheaper strategy than classic intermittent administration.The use of continuous infusion facilitates the management of complex infections with outpatient antimicrobial therapy.
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Affiliation(s)
- Miguel Franco-Álvarez
- Internal Medicine Department, University Clinical Hospital, Santiago de Compostela, Spain
| | - Iván Fernández-Castro
- Internal Medicine Department, University Clinical Hospital, Santiago de Compostela, Spain
| | | | - Carmen Beceiro Abad
- Home Hospitalisation Unit, University Clinical Hospital, Santiago de Compostela, Spain
| | - Esteban Otero Antón
- Internal Medicine Department, University Clinical Hospital, Santiago de Compostela, Spain
| | | | | | - Ignacio Novo-Veleiro
- Home Hospitalisation Unit, University Clinical Hospital, Santiago de Compostela, Spain
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Liang GF, Chao S, Sun Z, Zhu KJ, Chen Q, Jia L, Niu YL. Pleural empyema with endobronchial mass due to Rhodococcus equi infection after renal transplantation: A case report and review of literature. World J Clin Cases 2024; 12:224-231. [PMID: 38292625 PMCID: PMC10824171 DOI: 10.12998/wjcc.v12.i1.224] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/05/2023] [Revised: 11/30/2023] [Accepted: 12/20/2023] [Indexed: 01/02/2024] Open
Abstract
BACKGROUND Kidney transplantation is the best option for patients with end-stage renal disease. However, the need for lifelong immunosuppression results in renal transplant recipients being susceptible to various infections. Rhodococcus equi (R. equi) is a rare opportunistic pathogen in humans, and there are limited reports of infection with R. equi in post-renal transplant recipients and no uniform standard of treatment. This article reports on the diagnosis and treatment of a renal transplant recipient infected with R. equi 21 mo postoperatively and summarizes the characteristics of infection with R. equi after renal transplantation, along with a detailed review of the literature. CASE SUMMARY Here, we present the case of a 25-year-old man who was infected with R. equi 21 mo after renal transplantation. Although the clinical features at the time of presentation were not specific, chest computed tomography (CT) showed a large volume of pus in the right thoracic cavity and right middle lung atelectasis, and fiberoptic bronchoscopy showed an endobronchial mass in the right middle and lower lobe orifices. Bacterial culture and metagenomic next-generation sequencing sequencing of the pus were suggestive of R. equi infection. The immunosuppressive drugs were immediately suspended and intravenous vancomycin and azithromycin were administered, along with adequate drainage of the abscess. The endobronchial mass was then resected. After the patient's clinical symptoms and chest CT presentation resolved, he was switched to intravenous ciprofloxacin and azithromycin, followed by oral ciprofloxacin and azithromycin. The patient was re-hospitalized 2 wk after discharge for recurrence of R. equi infection. He recovered after another round of adequate abscess drainage and intravenous ciprofloxacin and azithromycin. CONCLUSION Infection with R. equi in renal transplant recipients is rare and complex, and the clinical presentation lacks specificity. Elaborate antibiotic therapy is required, and adequate abscess drainage and surgical excision are necessary. Given the recurrent nature of R. equi, patients need to be followed-up closely.
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Affiliation(s)
- Guo-Fu Liang
- Department of Organ Transplantation, School of Clinical Medicine, Guizhou Medical University, Guiyang 550025, Guizhou Province, China
| | - Sheng Chao
- Department of Organ Transplantation, The Affiliated Hospital of Guizhou Medical University, Guiyang 550000, Guizhou Province, China
| | - Zhou Sun
- Department of Organ Transplantation, School of Clinical Medicine, Guizhou Medical University, Guiyang 550025, Guizhou Province, China
| | - Ke-Jing Zhu
- Department of Organ Transplantation, The Affiliated Hospital of Guizhou Medical University, Guiyang 550000, Guizhou Province, China
| | - Qian Chen
- Department of Organ Transplantation, The Affiliated Hospital of Guizhou Medical University, Guiyang 550000, Guizhou Province, China
| | - Lei Jia
- Department of Organ Transplantation, The Affiliated Hospital of Guizhou Medical University, Guiyang 550000, Guizhou Province, China
| | - Yu-Lin Niu
- Department of Organ Transplantation, The Affiliated Hospital of Guizhou Medical University, Guiyang 550000, Guizhou Province, China
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Alkhalifa W, Ali BA, AlDandan H, Aljehani H, Alwazzeh M, Diab A. Rhodococcus equi bacteremia with necrotizing pneumonia and brain abscess in a newly diagnosed HIV patient in Saudi Arabia: A case report and review of literature. Heliyon 2023; 9:e21953. [PMID: 38034617 PMCID: PMC10682116 DOI: 10.1016/j.heliyon.2023.e21953] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2023] [Revised: 10/20/2023] [Accepted: 11/01/2023] [Indexed: 12/02/2023] Open
Abstract
Rhodococcus equi is a Gram-positive coccobacillus that falls within the category of aerobic actinomycetes. The Rhodococcus genus belongs to the nocardioform bacteria group. This microorganism has been found in various settings, including natural environments, animals, and particularly in individuals with compromised immune systems, such as those living with HIV. Notably, there is an increasing number of reports concerning R. equi infections in transplant recipients and even individuals with a normally functioning immune system. Traditionally, R. equi has been primarily associated with pulmonary infections, but there is a growing body of evidence documenting its involvement in extrapulmonary infections. In this report, we present a case involving a newly diagnosed HIV patient who experienced R. equi -induced necrotizing pneumonia, bacteremia, and a brain abscess in newly diagnosed HIV patient. It is important to note that a direct Gram stain may potentially lead to misclassification of such microorganisms as contaminants. Microbiologists should therefore prioritize the careful examination of colony morphology, biochemical reactions, and consider the limitations of automated machine databases. Furthermore, they should correlate their identification findings with clinical data to ensure optimal patient care and management, especially in the context of an immunocompromised state.
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Affiliation(s)
- Wala Alkhalifa
- Department of Microbiology, King Fahd Hospital of the University, Imam Abdulrahman Bin Faisal University, Al Khobar, Saudi Arabia
| | - Batool Abu Ali
- Department of Internal Medicine, King Fahad Hospital, Al Hofuf, Infectious Disease Division, Al Hofuf, Saudi Arabia
| | - Hassan AlDandan
- Department of Intensive Care Unit, King Fahd Hospital of the University, Imam Abdulrahman Bin Faisal University, Al Khobar, Saudi Arabia
| | - Hosam Aljehani
- Department of Intensive Care Unit, King Fahd Hospital of the University, Imam Abdulrahman Bin Faisal University, Al Khobar, Saudi Arabia
| | - Marwan Alwazzeh
- Department of Internal Medicine, King Fahd Hospital of the University, Imam Abdulrahman Bin Faisal University, Al Khobar, Saudi Arabia
| | - Asim Diab
- Department of Microbiology, King Fahd Hospital of the University, Imam Abdulrahman Bin Faisal University, Al Khobar, Saudi Arabia
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Di Carlo P, Pipitò L, Orlando E, Bellavia S, Boncori G, Sarno C, Rodolico V, Fasciana T, Sergi C, Cascio A. Intestinal Lesions Due to Rhodococcus equi in a Patient With Advanced Retroviral Disease and Pulmonary Infection: A Case of Colonic Malakoplakia. Cureus 2023; 15:e42248. [PMID: 37605704 PMCID: PMC10440044 DOI: 10.7759/cureus.42248] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/21/2023] [Indexed: 08/23/2023] Open
Abstract
In humans, Rhodococcus equi (R. equi) is a zoonotic infection usually involving immunocompromised subjects, only rarely affecting immunocompetent subjects. Herein, we describe an R. equi infection in a 50-year-old Russian man with acquired immune deficiency syndrome (AIDS) who presented with pulmonary cavitary lesions and clinical manifestation of colonic malakoplakia. A colonoscopy examination showed ulceration and mucosal erosion, and the histological findings confirmed the colonic malakoplakia. The patient recovered from pulmonary and gastrointestinal disease after four weeks of antibiotic treatment with intravenous ciprofloxacin and oral azithromycin and also underwent subsequent long-term oral antibiotic treatment to achieve clinical and immune restoration after antiretroviral therapy. Infectious disease pathology subspecialties should always consider R. equi chronic infection as a cause of malakoplakia in patients with AIDS. As only a few cases of colonic malakoplakia associated with R. equi are reported in the literature, these cases are important to describe, especially for clinical and treatment management.
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Affiliation(s)
- Paola Di Carlo
- Department of Infectious and Tropical Diseases, Azienda Ospedaliera Universitaria Policlinico (AOUP) "Paolo Giaccone", Palermo, ITA
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties, "G. D'Alessandro", University of Palermo, Palermo, ITA
| | - Luca Pipitò
- Department of Infectious and Tropical Diseases, Azienda Ospedaliera Universitaria Policlinico (AOUP) "Paolo Giaccone", Palermo, ITA
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties, "G. D'Alessandro", University of Palermo, Palermo, ITA
| | - Elisabetta Orlando
- Department of Pathology, Azienda Ospedaliero Universitaria "Paolo Giaccone", Palermo, ITA
| | - Sandro Bellavia
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties, "G. D'Alessandro", University of Palermo, Palermo, ITA
- Department of Pathology, Azienda Ospedaliero Universitaria "Paolo Giaccone", Palermo, ITA
| | - Giovanni Boncori
- Department of Infectious and Tropical Diseases, Azienda Ospedaliera Universitaria Policlinico (AOUP) "Paolo Giaccone", Palermo, ITA
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties,, "G. D'Alessandro", University of Palermo, Palermo, ITA
| | - Caterina Sarno
- Department of Radiological Sciences, Azienda Ospedaliero Universitaria "Paolo Giaccone", Palermo, ITA
| | - Vito Rodolico
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties, "G. D'Alessandro", University of Palermo, Palermo, ITA
- Department of Pathology, Azienda Ospedaliero Universitaria "Paolo Giaccone", Palermo, ITA
| | - Teresa Fasciana
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties, "G. D'Alessandro", University of Palermo, Palermo, ITA
- Department of Microbiology and Virology, Azienda Ospedaliero Universitaria "Paolo Giaccone", Palermo, ITA
| | - Consolato Sergi
- Department of Medicine and Pathology - Laboratory, Children's Hospital of Eastern Ontario, University of Ottawa, Ottawa, CAN
| | - Antonio Cascio
- Department of Infectious and Tropical Diseases, Azienda Ospedaliera Universitaria Policlinico (AOUP) "Paolo Giaccone", Palermo, ITA
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties, "G. D'Alessandro", University of Palermo, Palermo, ITA
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Swanner KKD, Patel R, Nguyen TT, Patel FN, Magadia R, Rifai AO, Davenport M. A Rare Presentation of Rhodococcus Equi Bacteremia as a Result of Right Upper Arm Cellulitis: A Case Report and Literature Review. Cureus 2023; 15:e38295. [PMID: 37255906 PMCID: PMC10226525 DOI: 10.7759/cureus.38295] [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: 04/08/2023] [Accepted: 04/29/2023] [Indexed: 06/01/2023] Open
Abstract
Rhodococcus equi is an emerging opportunistic pathogen in immunocompromised patients. Owing to its resemblance to Mycobacterium, Nocardia, and Corynebacterium, R. equi is frequently misdiagnosed as a contaminant, which can result in treatment delays. A 65-year-old man with a history of end-stage renal disease (ESRD) presented to the emergency room with pain and increased swelling in his right upper extremity. Shortly after he arrived in the emergency room, his condition deteriorated. Intravenous vancomycin was administered after collecting blood cultures. The blood cultures grew Rhodococcus equi, and oral azithromycin and oral rifampin were added for a 14-day course of treatment. The patient recovered without any further complications and was subsequently discharged home. R. equi is a partially acid-fast actinomycete that spreads through contact with grazing animals and contaminated soil. R. equi invades macrophages to survive and causes infection within a host. In this particular case, the patient worked on a farm taking care of goats. He was exposed to the bacteria after falling and sustaining multiple lacerations to the right arm. This case is unique due to the development of bacteremia with R. equi, an uncommon cause of bacteremia that led to cardiopulmonary arrest. The treatment with oral azithromycin combined with oral rifampin and intravenous vancomycin was effective for the complete resolution of the infection.
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Affiliation(s)
| | - Riya Patel
- College of Medicine, Alabama College of Osteopathic Medicine, Dothan, USA
| | - Thuy T Nguyen
- Internal Medicine, Alabama College of Osteopathic Medicine, Dothan, USA
| | - Felicia N Patel
- Internal Medicine, Alabama College of Osteopathic Medicine, Dothan, USA
| | - Raul Magadia
- Department of Infectious Diseases, Regional Medical Center, Anniston, USA
| | - Ahmad O Rifai
- Nephrology, The Virtual Nephrologist, Panama City Beach, USA
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Sanz MG. Rhodococcus equi-What is New This Decade? Vet Clin North Am Equine Pract 2023; 39:1-14. [PMID: 36898784 DOI: 10.1016/j.cveq.2022.11.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/12/2023] Open
Abstract
Foals become infected shortly after birth; most develop subclinical pneumonia and 20% to 30% develop clinical pneumonia that requires treatment. It is now well established that the combination of screening programs based on thoracic ultrasonography and treatment of subclinical foals with antimicrobials has led to the development of resistant Rhodococcus equi strains. Thus, targeted treatment programs are needed. Administration of R equi-specific hyperimmune plasma shortly after birth is beneficial as foals develop less severe pneumonia but does not seem to prevent infection. This article provides a summary of clinically relevant research published during this past decade.
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ARAZ H, BASTUG A, MUMCUOĞLU İ, AKINCİ E, BODUR H. Nadir Bir Etken: Rhodococcus equi, İmmunkompetan Hastalarda Yumuşak Doku Enfeksiyonlarına İlişkin Bir Vaka Sunumu ve Literatür İncelemesi. ANADOLU KLINIĞI TIP BILIMLERI DERGISI 2023. [DOI: 10.21673/anadoluklin.1168458] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/07/2023] Open
Abstract
Rhodococcus equi is a microorganism that was first described in horses and later it had been found out to cause opportunistic infections in immunosuppressed patients. It causes especially pulmonary infections in immunocompromised patients while it rarely causes diseases such as septic arthritis and soft tissue infections. It is important to question epidemiological risk factors for the diagnosis of the disease. Also the clinician-microbiologist relationship is important in the laboratory diagnosis of the microorganism because it is possible to be missed as the part of normal flora or contaminant or to be confused with microorganisms with similar phenotypic features (Nocardia species or rapidly growing mycobacteria). Rarely, it has been reported in immunocompetent patients, as in our case.
MEDLINE, SCOPUS, Google Scholar, and Cochrane searches were performed using keywords Rhodococcus equi and Corynebacterium equi from 1945 to July 2021.
A total of 582 articles were determined. Articles containing these keywords were then scanned for words "humans", “soft tissue infections”, and “cellulite” and a total of 42 articles were listed in the end. A total of 14 case reports of soft tissue infection/cellulitis in immunocompetent patients related R. equi were detected in the literature
In our case, there was a soft tissue infection and R. equi was detected in the abscess culture. Obtaining culture and determining the factor is very important in the treatment of infections. In this report, soft tissue infections caused by R. equi in immunocompetent patients are reviewed.
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Affiliation(s)
| | - Aliye BASTUG
- University of Health Sciences, Gulhane Medical School, Department of Infectious Diseases and Clinical Microbiology, Ankara City Hospital,
| | - İpek MUMCUOĞLU
- Dr.Abdurrahman Yurtaslan Ankara Oncology Training and Research Hospital, Department of Medical Microbiology,
| | - Esragül AKINCİ
- University of Health Sciences, Gulhane Medical School, Department of Infectious Diseases and Clinical Microbiology, Ankara City Hospital,
| | - Hurrem BODUR
- University of Health Sciences, Gulhane Medical School, Department of Infectious Diseases and Clinical Microbiology, Ankara City Hospital,
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10
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Hansen P, Haubenthal T, Reiter C, Kniewel J, Bosse-Plois K, Niemann HH, von Bargen K, Haas A. Differential Effects of Rhodococcus equi Virulence-Associated Proteins on Macrophages and Artificial Lipid Membranes. Microbiol Spectr 2023; 11:e0341722. [PMID: 36786596 PMCID: PMC10100859 DOI: 10.1128/spectrum.03417-22] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2022] [Accepted: 01/06/2023] [Indexed: 02/15/2023] Open
Abstract
Virulence-associated protein A (VapA) of Rhodococcus equi is a pathogenicity factor required for the multiplication of virulent R. equi strains within spacious macrophage vacuoles. The production of VapA is characteristic for R. equi isolates from pneumonic foals. VapB and VapN proteins in R. equi isolates from infected pig (VapB) and cattle (VapN) have amino acid sequences very similar to VapA and consequently have been assumed to be its functional correlates. Using model membrane experiments, phagosome pH acidification analysis, lysosome size measurements, protein partitioning, and degradation assays, we provide support for the view that VapA and VapN promote intracellular multiplication of R. equi by neutralizing the pH of the R. equi-containing vacuole. VapB does not neutralize vacuole pH, is not as membrane active as VapA, and does not support intracellular multiplication. This study also shows that the size of the sometimes enormous R. equi-containing vacuoles or the partitioning of purified Vaps into organic phases are not features that have predictive value for virulence of R. equi, whereas the ability of Vaps to increase phagosome pH is coupled to virulence. IMPORTANCE Rhodococcus equi is a major cause of life-threatening pneumonia in foals and occasionally in immunocompromised persons. Virulence-associated protein A (VapA) promotes R. equi multiplication in lung macrophages, which are the major host cells during foal infection. In this study, we compare cellular, biochemical, and biophysical phenotypes associated with VapA to those of VapB (typically produced by isolates from pigs) or VapN (isolates from cattle). Our data support the hypothesis that only some Vaps support multiplication in macrophages by pH neutralization of the phagosomes that R. equi inhabit.
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Affiliation(s)
- Philipp Hansen
- Institute for Cell Biology, University of Bonn, Bonn, Germany
| | | | - Caroline Reiter
- Institute for Cell Biology, University of Bonn, Bonn, Germany
| | - Jana Kniewel
- Institute for Cell Biology, University of Bonn, Bonn, Germany
| | | | | | | | - Albert Haas
- Institute for Cell Biology, University of Bonn, Bonn, Germany
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Abstract
Pollution with microplastic has become a prime environmental concern. The various ways in which human-made polymers and microorganisms interact are little understood, and this is particularly true for microplastic and pathogenic microorganisms. Previous reports demonstrated that expression of central virulence-associated protein A (VapA) of the pathogenic bacterium Rhodococcus equi is shut off at 30°C, whereas it is strongly expressed at 37°C, a temperature which may serve as an intrahost cue. Here, we show that cultivation at 30°C in disposable plastic tubes increases mRNA levels of vapA 70-fold compared to growth in conventional glass tubes. Strong expression of vapA in plastic tubes does not seem to be caused by a compound leaching from plastic but rather by tube surface properties. Expression stimulation during growth in plastic is regulated by the R. equi transcription regulators VirR and VirS, indicating that plastic-induced vapA expression is (co)regulated through the canonical vapA expression pathway. Our observations have important implications for the future analysis and assessment of environmental microplastic contaminations in that they show that, in principle, contact of pathogens with environmental plastic can increase their virulence. IMPORTANCE Millions of tons small plastic pieces (microplastic) find their way into the environment every year. They pose digestive and toxicity problems to various life forms in soil, freshwater, and seawater. Additionally, microplastic offers an opportunity for microorganisms to attach and to become an important part of a “plastisphere community.” The significance of our study lies in the documentation of a sharp increase in production of a central virulence factor by a bacterial pathogen when the bacterium is in touch with certain makes of plastic. Although this feature may not reflect an increased health risk in case of this particular soilborne pathogen, our data disclose a new facet of how microplastics can endanger life.
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Żychska M, Witkowski L, Klementowska A, Rzewuska M, Kwiecień E, Stefańska I, Czopowicz M, Szaluś-Jordanow O, Mickiewicz M, Moroz A, Bonecka J, Kaba J. Rhodococcus equi-Occurrence in Goats and Clinical Case Report. Pathogens 2021; 10:pathogens10091141. [PMID: 34578172 PMCID: PMC8472617 DOI: 10.3390/pathogens10091141] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2021] [Revised: 08/31/2021] [Accepted: 09/01/2021] [Indexed: 01/11/2023] Open
Abstract
Background: Rhodococcus equi infection is commonly known in equine medicine to cause frequently fatal rhodococcosis. Infections in other species and people are also reported. Clinical manifestation in goats is relatively similar to horses and humans, but data regarding bacterium prevalence are scarce. Thus, the study aimed to estimate the occurrence of R. equi in goats. Methods: During post mortem examination, submandibular, mediastinal, and mesenteric lymph nodes were collected. Standard methods were used for bacteria isolation and identification. Results: A total of 134 goats were examined, and 272 lymph node samples were collected. R. equi was isolated from four animals. All four isolates carried the choE gene, and one also had traA and pVAPN plasmid genes. Conclusions: To the authors’ best knowledge, this is the first report of R. equi occurrence and genetic diversity in goats. The results may help create a model for treating rhodococcosis in other animal species and assessing the role of meat contamination as a potential source of human infection. This research should be considered a pilot study for further application of the goat as a model of R. equi infection in horses and humans.
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Affiliation(s)
- Monika Żychska
- Division of Veterinary Epidemiology and Economics, Institute of Veterinary Medicine, Warsaw University of Life Sciences-SGGW, 02-776 Warsaw, Poland; (M.Ż.); (A.K.); (M.C.); (M.M.); (A.M.); (J.K.)
| | - Lucjan Witkowski
- Division of Veterinary Epidemiology and Economics, Institute of Veterinary Medicine, Warsaw University of Life Sciences-SGGW, 02-776 Warsaw, Poland; (M.Ż.); (A.K.); (M.C.); (M.M.); (A.M.); (J.K.)
- Correspondence: ; Tel.: +48-22-593-6111
| | - Agnieszka Klementowska
- Division of Veterinary Epidemiology and Economics, Institute of Veterinary Medicine, Warsaw University of Life Sciences-SGGW, 02-776 Warsaw, Poland; (M.Ż.); (A.K.); (M.C.); (M.M.); (A.M.); (J.K.)
| | - Magdalena Rzewuska
- Department of Preclinical Sciences, Institute of Veterinary Medicine, Warsaw University of Life Sciences-SGGW, 02-786 Warsaw, Poland; (M.R.); (E.K.); (I.S.)
| | - Ewelina Kwiecień
- Department of Preclinical Sciences, Institute of Veterinary Medicine, Warsaw University of Life Sciences-SGGW, 02-786 Warsaw, Poland; (M.R.); (E.K.); (I.S.)
| | - Ilona Stefańska
- Department of Preclinical Sciences, Institute of Veterinary Medicine, Warsaw University of Life Sciences-SGGW, 02-786 Warsaw, Poland; (M.R.); (E.K.); (I.S.)
| | - Michał Czopowicz
- Division of Veterinary Epidemiology and Economics, Institute of Veterinary Medicine, Warsaw University of Life Sciences-SGGW, 02-776 Warsaw, Poland; (M.Ż.); (A.K.); (M.C.); (M.M.); (A.M.); (J.K.)
| | - Olga Szaluś-Jordanow
- Department of Small Animal Diseases with Clinic, Institute of Veterinary Medicine, Warsaw University of Life Sciences-SGGW, 02-776 Warsaw, Poland; (O.S.-J.); (J.B.)
| | - Marcin Mickiewicz
- Division of Veterinary Epidemiology and Economics, Institute of Veterinary Medicine, Warsaw University of Life Sciences-SGGW, 02-776 Warsaw, Poland; (M.Ż.); (A.K.); (M.C.); (M.M.); (A.M.); (J.K.)
| | - Agata Moroz
- Division of Veterinary Epidemiology and Economics, Institute of Veterinary Medicine, Warsaw University of Life Sciences-SGGW, 02-776 Warsaw, Poland; (M.Ż.); (A.K.); (M.C.); (M.M.); (A.M.); (J.K.)
| | - Joanna Bonecka
- Department of Small Animal Diseases with Clinic, Institute of Veterinary Medicine, Warsaw University of Life Sciences-SGGW, 02-776 Warsaw, Poland; (O.S.-J.); (J.B.)
| | - Jarosław Kaba
- Division of Veterinary Epidemiology and Economics, Institute of Veterinary Medicine, Warsaw University of Life Sciences-SGGW, 02-776 Warsaw, Poland; (M.Ż.); (A.K.); (M.C.); (M.M.); (A.M.); (J.K.)
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13
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Siavashifar M, Rezaei F, Motallebirad T, Azadi D, Absalan A, Naserramezani Z, Golshani M, Jafarinia M, Ghaffari K. Species diversity and molecular analysis of opportunistic Mycobacterium, Nocardia and Rhodococcus isolated from the hospital environment in a developing country, a potential resources for nosocomial infection. Genes Environ 2021; 43:2. [PMID: 33509299 PMCID: PMC7844956 DOI: 10.1186/s41021-021-00173-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2020] [Accepted: 01/15/2021] [Indexed: 11/10/2022] Open
Abstract
Background Hospital environmental resources have a significant role in cross-transmission of opportunistic pathogens such as actinomycetes species to the patients. Actinomycetes have a remarkable capability to survive in adverse and harsh conditions of hospital environments; therefore, they are a threat to the health of patients. Due to this issue, we aimed to determine the frequency and diversity of actinomycetes species in hospital soil, water and dust by using a combination of conventional and molecular methods including the phenotypic and biochemical tests for preliminary identification and the PCR amplification of the specific region of the 16S rRNA, hsp65 gene and sequence analyses of 16S rRNA for the genus and species identification. Results A total of 50 (35.2%) actinomycetes isolates from 7 genera were isolated from 142 hospital environmental samples. The three most prevalent species were M. setense 10%, R. erythropolis and M. fortuitum 8% followed by N.cyriacigeorgica and M. gordonae 6%, M. chelonae, M. abscessus, M. lentiflavum, M. mucogenicum, N. asteroides, N. farcinica, R. equi and L. shinushuensis 4% and the single isolates of M. conceptionense, M. septicum, N. rhamnosophilia, N. bravicatena, M. flavescens, M. arupense, M. doricum, M. frederiksbergense, S. heliomycini, S. albus, S. albogriseolus, R. facians, D. maris, G. terae and A. globiformis. Conclusions In conclusion we showed that the hospital environment is a potential reservoir for a broad range of actinomycetes species, due to the remarkable survival capability of these microorganisms in adverse hospital environment, carrying a threat to the health of patients.
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Affiliation(s)
- Marzieh Siavashifar
- Student Research Comitee, Khomein University of Medical Sciences, Khomein, Iran
| | - Fatemeh Rezaei
- Student Research Comitee, Khomein University of Medical Sciences, Khomein, Iran
| | - Tahereh Motallebirad
- Department of Basic and Laboratory and Sciences, Khomein University of Medical Sciences, Qods street, Khomein, Iran
| | - Davood Azadi
- Department of Basic and Laboratory and Sciences, Khomein University of Medical Sciences, Qods street, Khomein, Iran.
| | - Abdorrahim Absalan
- Department of Basic and Laboratory and Sciences, Khomein University of Medical Sciences, Qods street, Khomein, Iran
| | - Zahra Naserramezani
- Student Research Comitee, Khomein University of Medical Sciences, Khomein, Iran
| | - Mohadeseh Golshani
- Student Research Comitee, Khomein University of Medical Sciences, Khomein, Iran
| | - Morteza Jafarinia
- Department of Immunology, School of Medicine, Isfahan University Of Medical Sciences, Isfahan, Iran
| | - Kazem Ghaffari
- Department of Basic and Laboratory and Sciences, Khomein University of Medical Sciences, Qods street, Khomein, Iran
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14
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Alves A, Silva E, Teixeira T, Figueiredo C, Lameirão A, Vanzeller M, Ribeiro C. Rhodococcus equi infection as inaugural manifestation of idiopathic CD4 + lymphopenia: A rare entity and a therapeutic challenge. Pulmonology 2020; 27:75-77. [PMID: 32622733 DOI: 10.1016/j.pulmoe.2020.06.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2020] [Revised: 05/31/2020] [Accepted: 06/02/2020] [Indexed: 11/16/2022] Open
Abstract
We report a case of disseminated infection by Rhodococcus equi as the inaugural manifestation of idiopathic T-CD4+ lymphopenia. We aim to demonstrate our diagnostic and therapeutic approach and focus on the major dilemmas arising from the lack of scientific evidence regarding best clinical practice of this infection in humans.
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Affiliation(s)
- A Alves
- Pulmonology Department, Centro Hospitalar de Vila Nova de Gaia/Espinho, Rua Conceição Fernandes, 4434-502 Vila Nova de Gaia, Portugal.
| | - E Silva
- Pulmonology Department, Centro Hospitalar de Vila Nova de Gaia/Espinho, Rua Conceição Fernandes, 4434-502 Vila Nova de Gaia, Portugal
| | - T Teixeira
- Infectious Diseases Unit of Internal Medicine Department, Centro Hospitalar de Vila Nova de Gaia/Espinho, Rua Conceição Fernandes, Portugal
| | - C Figueiredo
- Infectious Diseases Unit of Internal Medicine Department, Centro Hospitalar de Vila Nova de Gaia/Espinho, Rua Conceição Fernandes, Portugal
| | - A Lameirão
- Department of Clinical Pathology, Centro Hospitalar de Vila Nova de Gaia/Espinho, Rua Conceição Fernandes, Portugal
| | - M Vanzeller
- Pulmonology Department, Centro Hospitalar de Vila Nova de Gaia/Espinho, Rua Conceição Fernandes, 4434-502 Vila Nova de Gaia, Portugal
| | - C Ribeiro
- Pulmonology Department, Centro Hospitalar de Vila Nova de Gaia/Espinho, Rua Conceição Fernandes, 4434-502 Vila Nova de Gaia, Portugal
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15
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Erol E, Locke S, Saied A, Cruz Penn MJ, Smith J, Fortner J, Carter C. Antimicrobial susceptibility patterns of Rhodococcus equi from necropsied foals with rhodococcosis. Vet Microbiol 2020; 242:108568. [DOI: 10.1016/j.vetmic.2019.108568] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2019] [Revised: 12/10/2019] [Accepted: 12/26/2019] [Indexed: 01/20/2023]
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16
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Abstract
Lung cavitation may be due to infectious or noninfectious pathologic processes. The latter category includes nonmalignant conditions, such as granulomatosis with polyangiitis, and malignant conditions, such as squamous cell carcinoma of the lung. Infectious etiologies that produce lung cavitation usually cause chronic illness, although some, particularly pyogenic bacteria, may produce acute cavitary disease. Tuberculosis is the most common cause of chronic pulmonary infection with cavitation. The goal of this review was to highlight a selection of the better-known infectious agents, other than tuberculosis, that can cause chronic lung disease with cavitation. Emphasis is placed on the following organisms: nontuberculous mycobacteria, Histoplasma, Blastomyces, Coccidioides, Paracoccidioides, Aspergillus, Burkholderia pseudomallei, Paragonimus westermani, and Rhodococcus equi. These organisms generally produce clinical features and radiologic findings that overlap or mimic those of tuberculosis. In a companion article, we have further emphasized aspects of the same conditions that are more pertinent to radiologists.
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17
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Current taxonomy of Rhodococcus species and their role in infections. Eur J Clin Microbiol Infect Dis 2018; 37:2045-2062. [PMID: 30159693 DOI: 10.1007/s10096-018-3364-x] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2018] [Accepted: 08/20/2018] [Indexed: 10/28/2022]
Abstract
Rhodococcus is a genus of obligate aerobic, Gram-positive, partially acid-fast, catalase-positive, non-motile, and none-endospore bacteria. The genus Rhodococcus was first introduced by Zopf. This bacterium can be isolated from various sources of the environment and can grow well in non-selective medium. A large number of phenotypic characterizations are used to compare different species of the genus Rhodococcus, and these tests are not suitable for accurate identification at the genus and species level. Among nucleic acid-based methods, the most powerful target gene for revealing reliable phylogenetic relationships is 16S ribosomal RNA gene (16S rRNA gene) sequence analysis, but this gene is unable to differentiation some of Rhodococcus species. To date, whole genome sequencing analysis has solved taxonomic complexities in this genus. Rhodococcus equi is the major cause of foal pneumonia, and its implication in human health is related to cases in immunocompromised patients. Macrolide family together with rifampicin is one of the most effective antibiotic agents for treatment rhodococcal infections.
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18
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Alfano G, Ventura P, Fontana F, Marcacci M, Ligabue G, Scarlini S, Franceschini E, Codeluppi M, Guaraldi G, Mussini C, Cappelli G. Rhodococcus equi Pneumonia in Kidney Transplant Recipient Affected by Acute Intermittent Porphyria: A Case Report. Transplant Proc 2018; 51:229-234. [PMID: 30661897 DOI: 10.1016/j.transproceed.2018.02.213] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2017] [Accepted: 02/06/2018] [Indexed: 12/17/2022]
Abstract
Rhodococcus equi is a gram-positive coccobacillus responsible for severe infections in patients with weakened immune systems. R equi generally causes pnumonia that may evolve into fatal systemic infection if left untreated. Here, we present a case of a 67-year-old woman affected by acute intermittent porphyria (AIP) who developed R equi pneumonia 7 months after kidney transplantation. Although clinical features at presentation were nonspecific, lung computed tomography showed right perihilar consolidation with a mass-like appearance causing bronchial obstruction. Appropriate antibiotic including intravenous meropenem and oral azithromycin that was then switched to oral levofloxacin and oral azithromycin along with reduction of immunosuppressive therapy resolved pneumonia without provoking an acute attack of porphyria. AIP limited the choice of antibiotics for the treatment of R equi infection because some potentially porphyrinogenic antibacterial agents were avoided. Based on this experience, azithromycin and meropenem can be safely administered for the treatment of R Equi infection in patients with AIP.
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Affiliation(s)
- G Alfano
- Surgical, Medical and Dental Department of Morphological Sciences, Section of Nephrology, University of Modena and Reggio Emilia, Modena, Italy.
| | - P Ventura
- Center for Porphyrias, Internal Medicine 2 Unit, Department of Medical and Surgical Science for Children and Adults, University of Modena and Reggio Emilia
| | - F Fontana
- Surgical, Medical and Dental Department of Morphological Sciences, Section of Nephrology, University of Modena and Reggio Emilia, Modena, Italy
| | - M Marcacci
- Center for Porphyrias, Internal Medicine 2 Unit, Department of Medical and Surgical Science for Children and Adults, University of Modena and Reggio Emilia
| | - G Ligabue
- Surgical, Medical and Dental Department of Morphological Sciences, Section of Nephrology, University of Modena and Reggio Emilia, Modena, Italy
| | - S Scarlini
- Center for Porphyrias, Internal Medicine 2 Unit, Department of Medical and Surgical Science for Children and Adults, University of Modena and Reggio Emilia
| | - E Franceschini
- Infectious Diseases Clinic University of Modena and Reggio Emilia School of Medicine, Department of Medicine and Medical specialities, AOU Policlinico of Modena, Modena, Italy
| | - M Codeluppi
- Infectious Diseases Clinic University of Modena and Reggio Emilia School of Medicine, Department of Medicine and Medical specialities, AOU Policlinico of Modena, Modena, Italy
| | - G Guaraldi
- Infectious Diseases Clinic University of Modena and Reggio Emilia School of Medicine, Department of Medicine and Medical specialities, AOU Policlinico of Modena, Modena, Italy
| | - C Mussini
- Infectious Diseases Clinic University of Modena and Reggio Emilia School of Medicine, Department of Medicine and Medical specialities, AOU Policlinico of Modena, Modena, Italy
| | - G Cappelli
- Surgical, Medical and Dental Department of Morphological Sciences, Section of Nephrology, University of Modena and Reggio Emilia, Modena, Italy
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19
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Kostric M, Milger K, Krauss-Etschmann S, Engel M, Vestergaard G, Schloter M, Schöler A. Development of a Stable Lung Microbiome in Healthy Neonatal Mice. MICROBIAL ECOLOGY 2018; 75:529-542. [PMID: 28905200 DOI: 10.1007/s00248-017-1068-x] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/26/2017] [Accepted: 09/05/2017] [Indexed: 06/07/2023]
Abstract
The lower respiratory tract has been previously considered sterile in a healthy state, but advances in culture-independent techniques for microbial identification and characterization have revealed that the lung harbors a diverse microbiome. Although research on the lung microbiome is increasing and important questions were already addressed, longitudinal studies aiming to describe developmental stages of the microbial communities from the early neonatal period to adulthood are lacking. Thus, little is known about the early-life development of the lung microbiome and the impact of external factors during these stages. In this study, we applied a barcoding approach based on high-throughput sequencing of 16S ribosomal RNA gene amplicon libraries to determine age-dependent differences in the bacterial fraction of the murine lung microbiome and to assess potential influences of differing "environmental microbiomes" (simulated by the application of used litter material to the cages). We could clearly show that the diversity of the bacterial community harbored in the murine lung increases with age. Interestingly, bacteria belonging to the genera Delftia and Rhodococcus formed an age-independent core microbiome. The addition of the used litter material influenced the lung microbiota of young mice but did not significantly alter the community composition of adult animals. Our findings elucidate the dynamic nature of the early-life lung microbiota and its stabilization with age. Further, this study indicates that even slight environmental changes modulate the bacterial community composition of the lung microbiome in early life, whereas the lung microbes of adults demonstrate higher resilience towards environmental variations.
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Affiliation(s)
- Matea Kostric
- Research Unit Comparative Microbiome Analysis, Helmholtz Zentrum München, Ingolstädter Landstr. 1, 85716, Neuherberg, Germany
| | - Katrin Milger
- Department of Internal Medicine V, University of Munich, Comprehensive Pneumology Center, Member of the German Center for Lung Research (DZL), Munich, Germany
- Institute of Lung Biology and Disease (ILBD), Helmholtz Center Munich, Comprehensive Pneumology Center (CPC-M), Munich, Germany
| | - Susanne Krauss-Etschmann
- Division of Experimental Asthma Research, Research Center Borstel, Leibniz-Center for Medicine and Biosciences, Member of the German Center for Lung Research (DZL), Parkallee 1-40, 23845, Borstel, Germany
- Institute for Experimental Medicine, Christian-Albrechts-Universität zu Kiel, Niemannsweg 11, 24105, Kiel, Germany
| | - Marion Engel
- Research Unit Scientific Computing, Helmholtz Zentrum München, Ingolstädter Landstr. 1, 85716, Neuherberg, Germany
| | - Gisle Vestergaard
- Research Unit Comparative Microbiome Analysis, Helmholtz Zentrum München, Ingolstädter Landstr. 1, 85716, Neuherberg, Germany
| | - Michael Schloter
- Research Unit Comparative Microbiome Analysis, Helmholtz Zentrum München, Ingolstädter Landstr. 1, 85716, Neuherberg, Germany.
- ZIEL Institute for Food and Health, Technische Universität München, Weihenstephaner Berg 1, 85354, Freising, Germany.
| | - Anne Schöler
- Research Unit Comparative Microbiome Analysis, Helmholtz Zentrum München, Ingolstädter Landstr. 1, 85716, Neuherberg, Germany
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20
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Bryan LK, Alexander ER, Lawhon SD, Cohen ND. Detection of vapN in Rhodococcus equi isolates cultured from humans. PLoS One 2018; 13:e0190829. [PMID: 29300774 PMCID: PMC5754133 DOI: 10.1371/journal.pone.0190829] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2017] [Accepted: 12/20/2017] [Indexed: 11/18/2022] Open
Abstract
Rhodococcus equi can cause severe infections in people, particularly in immunocompromised individuals. The R. equi virulence plasmids (vap) encoding vapA and vapB are linked to development of infections in domestic animals. Recently, a novel virulence plasmid, vapN, was identified in isolates cultured from cattle, but its prevalence or significance in human R. equi infections has not been extensively studied. To determine the prevalence of vapN in a diverse collection of human-derived isolates from different countries, 65 R. equi isolates collected by various institutions from 1984 to 2002 were screened for the presence of vapN and other virulence plasmids through polymerase chain reaction (PCR) using redesigned primer sets. Of the isolates that carried plasmids, 43% (16/37) were vapN-positive and fewer were vapB or vapA-positive (30 and 16%, respectively). This is the first report of vapN carriage in R. equi isolated from human infections. One isolate (H-30) carried vapN but did not amplify the conjugal plasmid transfer gene traA associated with carriage of vap, which could be explained by sequence variation within the traA gene. Another isolate (H-55) amplified traA, but did not amplify vapA, B, or N (traA+vapABN-) with previously described primer sets or those developed for this study. The H-55 traA sequence had 98% identity to traA sequences in vapA plasmids, which suggests that it may carry a variant of previously characterized virulence plasmids or a novel virulence plasmid. Carriage of vapN in R. equi isolates derived from people is not uncommon and more research is needed to determine its significance in the epidemiology and pathogenesis of human R. equi infections.
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Affiliation(s)
- Laura K. Bryan
- Department of Veterinary Pathobiology, College of Veterinary Medicine & Biomedical Sciences, Texas A&M University, College Station, Texas, United States of America
- * E-mail:
| | - Ellen Ruth Alexander
- Department of Large Animal Clinical Sciences, College of Veterinary Medicine & Biomedical Sciences, Texas A&M University, College Station, Texas, United States of America
| | - Sara D. Lawhon
- Department of Veterinary Pathobiology, College of Veterinary Medicine & Biomedical Sciences, Texas A&M University, College Station, Texas, United States of America
| | - Noah D. Cohen
- Department of Large Animal Clinical Sciences, College of Veterinary Medicine & Biomedical Sciences, Texas A&M University, College Station, Texas, United States of America
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21
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Brock MT, Fedderly GC, Borlee GI, Russell MM, Filipowska LK, Hyatt DR, Ferris RA, Borlee BR. Pseudomonas aeruginosa variants obtained from veterinary clinical samples reveal a role for cyclic di-GMP in biofilm formation and colony morphology. MICROBIOLOGY-SGM 2017; 163:1613-1625. [PMID: 29034850 DOI: 10.1099/mic.0.000541] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Overuse of antibiotics is contributing to an emerging antimicrobial resistance crisis. To better understand how bacteria adapt tolerance and resist antibiotic treatment, Pseudomonas aeruginosa isolates obtained from infection sites sampled from companion animals were collected and evaluated for phenotypic differences. Selected pairs of clonal isolates were obtained from individual infection samples and were assessed for antibiotic susceptibility, cyclic di-GMP levels, biofilm production, motility and genetic-relatedness. A total of 18 samples from equine, feline and canine origin were characterized. A sample from canine otitis media produced a phenotypically heterogeneous pair of P. aeruginosa isolates, 42121A and 42121B, which during growth on culture medium respectively exhibited hyper dye-binding small colony morphology and wild-type phenotypes. Antibiotic susceptibility to gentamicin and ciprofloxacin also differed between this pair of clonal isolates. Sequence analysis of gyrA, a gene known to be involved in ciprofloxacin resistance, indicated that 42121A and 42121B both contained mutations that confer ciprofloxacin resistance, but this did not explain the differences in ciprofloxacin resistance that were observed. Cyclic di-GMP levels also varied between this pair of isolates and were shown to contribute to the observed colony morphology variation and ability to form a biofilm. Our results demonstrate the role of cyclic di-GMP in generating the observed morphological phenotypes that are known to contribute to biofilm-mediated antibiotic tolerance. The generation of phenotypic diversity may go unnoticed during standard diagnostic evaluation, which potentially impacts the therapeutic strategy chosen to treat the corresponding infection and may contribute to the spread of antibiotic resistance.
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Affiliation(s)
- Maria T Brock
- Department of Microbiology, Immunology, and Pathology, Colorado State University, Fort Collins, CO, USA
| | - Galya C Fedderly
- Department of Microbiology, Immunology, and Pathology, Colorado State University, Fort Collins, CO, USA.,Present address: Galya Fedderly, University of Wisconsin-Madison, School of Veterinary Medicine, Madison, WI, USA
| | - Grace I Borlee
- Department of Microbiology, Immunology, and Pathology, Colorado State University, Fort Collins, CO, USA
| | - Michael M Russell
- Department of Microbiology, Immunology, and Pathology, Colorado State University, Fort Collins, CO, USA
| | - Liliana K Filipowska
- Department of Microbiology, Immunology, and Pathology, Colorado State University, Fort Collins, CO, USA
| | - Doreene R Hyatt
- Department of Microbiology, Immunology, and Pathology, Colorado State University, Fort Collins, CO, USA
| | - Ryan A Ferris
- Department of Clinical Sciences, Colorado State University, Fort Collins, CO, USA
| | - Bradley R Borlee
- Department of Microbiology, Immunology, and Pathology, Colorado State University, Fort Collins, CO, USA
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Abstract
ABSTRACT
Pneumonia caused by
Rhodococcus equi
remains an important cause of disease and death in foals. The combination of a macrolide (erythromycin, azithromycin, or clarithromycin) with rifampin has been the recommended treatment for foals with clinical signs of infection caused by
R. equi
since the early 1980s with, until recently, only rare reports of resistance. Resistance to macrolides and rifampin in isolates of
R. equi
cultured from horses is increasing, with isolates resistant to all macrolides and rifampin now being cultured from up to 40% of infected foals at some farms. This text reviews the available data regarding antimicrobial resistance in
R. equi
, with emphasis on the molecular mechanisms of the recent emergence of resistance to macrolides and rifampin in equine isolates of
R. equi
.
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