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Campler MR, Hashish A, Ghanem M, El-Gazzar MM, Arruda AG. Space-Time Patterns of Poultry Pathogens in the USA: A Case Study of Ornithobacterium rhinotracheale and Pasteurella multocida in Turkey Populations. Pathogens 2023; 12:1004. [PMID: 37623964 PMCID: PMC10460037 DOI: 10.3390/pathogens12081004] [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: 05/31/2023] [Revised: 07/27/2023] [Accepted: 07/28/2023] [Indexed: 08/26/2023] Open
Abstract
Respiratory infections caused by Ornithobacterium rhinotrachealis (ORT) and Pasteurella multocida (PM) bacteria are significant threats to the poultry industry by causing economic losses and welfare issues. Due to characterization difficulties and underutilization of epidemiological tools, description of the spatio-temporal spread of these diseases in the field is limited. The objectives of this retrospective observational cross-sectional study were to (a) investigate the existence of space-time clusters (hotspots); and (b) investigate the association between genetic similarity and spatial proximity for both pathogens using molecular typing and a recently developed Core-Genome Multilocus Sequencing Typing (cgMLST) scheme. ORT (n = 103) and PM (n = 69) isolates from confirmed disease outbreaks from one commercial company between 2013 and 2021 were obtained from a veterinary diagnostic laboratory, characterized using a cgMLST scheme and visualized using a minimum spanning tree. Spatio-temporal cluster analysis using SaTScanTM and a Spearman's rank correlation were performed to investigate clustering and any association between allelic diversity and geospatial distance. The cgMLST sequencing revealed three allelic clusters for ORT and thirteen clusters for PM. The spatio-temporal analysis revealed two significant clusters for PM, one with a 259.3 km cluster containing six cases between May and July 2018 and a 9 km cluster containing five cases between February 2019 and February 2021. No spatio-temporal clusters were found for ORT. A weak negative correlation between allelic diversity and geospatial distance was observed for ORT (r = -0.04, p < 0.01) and a weak positive correlation was observed for PM (r = 0.11, p < 0.01). This study revealed regional spatio-temporal clusters for PM in commercial turkey sites between 2018 and 2021 and provided additional insight into bacterial strain subgroups and the geographical spread of ORT and PM over time.
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Affiliation(s)
- Magnus R. Campler
- Department of Veterinary Preventive Medicine, College of Veterinary Medicine, The Ohio State University, Columbus, OH 43210, USA;
| | - Amro Hashish
- Department of Veterinary Diagnostic and Production Animal Medicine, College of Veterinary Medicine, Iowa State University, Ames, IA 50011, USA; (A.H.); (M.M.E.-G.)
| | - Mostafa Ghanem
- Department of Veterinary Medicine, College of Veterinary Medicine, University of Maryland, College Park, MD 20740, USA;
| | - Mohamed M. El-Gazzar
- Department of Veterinary Diagnostic and Production Animal Medicine, College of Veterinary Medicine, Iowa State University, Ames, IA 50011, USA; (A.H.); (M.M.E.-G.)
| | - Andréia G. Arruda
- Department of Veterinary Preventive Medicine, College of Veterinary Medicine, The Ohio State University, Columbus, OH 43210, USA;
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Hess C, Maegdefrau M, Grafl B, Hess M. Ornithobacterium rhinotracheale Isolated from Turkeys over a 20-Year Period Harbor Similar Antimicrobial Susceptibility Profiles and Multidrug Resistance. Avian Dis 2022; 66:1-7. [PMID: 36214406 DOI: 10.1637/aviandiseases-d-22-00015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2022] [Accepted: 06/29/2022] [Indexed: 12/14/2022]
Abstract
Infections with Ornithobacterium rhinotracheale are causing respiratory diseases that require antibiotic treatment in poultry worldwide. In the field, this agent is known to often be resistant to many antimicrobials, complicating therapeutic interventions. Therefore, there is a clear need to monitor trends in resistance development. In the present study, antibiotic resistance profiles of 64 O. rhinotracheale strains isolated from diseased turkeys from 2002 to 2021 were investigated against 19 antimicrobial substances by the microdilution method. Susceptibility toward chloramphenicol, carbapenem, and sulfamethozaxole combination was found for all strains. Most isolates were also susceptible to penicillins (98%-100%), with the exception of oxacillin, cephalosporins (84%-100%), tetracycline (89%), and tylosin (88%). In the case of quinolones, 89% of isolates showed intermediate resistance to enrofloxacin, whereas 90% showed full resistance to nalidixic acid. Full resistance to the tested aminoglycosides and colistin was revealed for all strains. Eighteen different AMR profiles were elucidated; more than half of the isolates (53%) shared the same AMR profile. Similar susceptibility profiles of O. rhinotracheale isolates were found on the different farms, proving some stability over the years. All isolates were classified as multidrug resistant. Multiple outbreaks within a flock or in successive flocks within a farm comprised 46 O. rhinotracheale isolates. Here, occasional changes in susceptibility for some antimicrobial substances were observed. In general, most of the changes occurred in quinolones, followed by tetracycline switching mainly from intermediate resistance to full resistance and vice versa. The present surveillance provides actual data on effective antibiotic treatments in case of disease outbreaks and contributes to the One Health concept acknowledging the important link between animal and human health.
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Affiliation(s)
- C Hess
- Clinic for Poultry and Fish Medicine, Department for Farm Animals and Veterinary Public Health, University of Veterinary Medicine, Veterinaerplatz 1, 1210 Vienna, Austria,
| | - M Maegdefrau
- Clinic for Poultry and Fish Medicine, Department for Farm Animals and Veterinary Public Health, University of Veterinary Medicine, Veterinaerplatz 1, 1210 Vienna, Austria
| | - B Grafl
- Clinic for Poultry and Fish Medicine, Department for Farm Animals and Veterinary Public Health, University of Veterinary Medicine, Veterinaerplatz 1, 1210 Vienna, Austria
| | - M Hess
- Clinic for Poultry and Fish Medicine, Department for Farm Animals and Veterinary Public Health, University of Veterinary Medicine, Veterinaerplatz 1, 1210 Vienna, Austria
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Occurrence of Ornithobacterium rhinotracheale in Polish turkey flocks. J Vet Res 2022; 66:77-84. [PMID: 35582491 PMCID: PMC8959689 DOI: 10.2478/jvetres-2022-0014] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2021] [Accepted: 03/03/2022] [Indexed: 11/20/2022] Open
Abstract
Abstract
Introduction
Ornithobacterium rhinotracheale (ORT) causes significant economic losses to the poultry industry around the world. The bacterium often affects poultry as part of multiple infections causing very serious clinical signs that are usually not limited only to the respiratory system. This study’s main objective was the retrospective detection and identification of ORT in turkey flocks.
Material and Methods
ORT identification was performed in 6,225 samples taken from 133 different flocks between 2015 and 2020. Molecular methods were used, specifically real-time PCR and traditional PCR. We focused on partial 16S rRNA gene sequences of isolates, which were compared with sequences obtained from GenBank. The reaction products were analysed phylogenetically. Molecular methods indicating secondary infections was carried out, and the bacterial composition of the upper respiratory tract was 16S metasequenced for selected flocks to identify any other pathogens.
Results
The presence of ORT was detected in 30.83% of samples by real-time PCR and 28.57% by PCR. Phylogenetic analysis of the PCR products from the turkeys samples showed that their sequences resolved into two main genetic groups. Tests for the occurrence of secondary infections showed the presence of Mycoplasma gallisepticum and M. synoviae in some samples but the total absence of Bordetella avium. The upper respiratory tract in turkeys was dominated by two major phyla Firmicutes and Proteobacteria. At the genus level, the genera Ornithobacterium, Mycoplasma, Gallibacterium, Avibacterium, and Escherichia-Shigella were found which may include pathogenic bacteria that can cause clinical symptoms.
Conclusion
The results of the analysis of multiple infection carried out in flocks with respiratory signs are probably associated with outbreaks of ornithobacteriosis in turkey flocks in Poland.
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El-Ghany WAA. An updated comprehensive review on ornithobacteriosis: A worldwide emerging avian respiratory disease. Open Vet J 2021; 11:555-568. [PMID: 35070850 PMCID: PMC8770186 DOI: 10.5455/ovj.2021.v11.i4.5] [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: 04/29/2021] [Accepted: 09/20/2021] [Indexed: 11/03/2022] Open
Abstract
Ornithobacteriosis is an important emerging respiratory disease of domestic and wild birds caused by Ornithobacterium rhinotracheale (ORT) bacterium. The disease has been detected in some countries since 1980, which rapidly spread worldwide later on. Ornithobacteriosis can transmit either horizontally or even vertically. Infection with ORT is mainly characterized by respiratory distress, poor performance, acute death, and a drop in egg production. However, the most characteristic necropsy lesions of dead turkeys and chickens are yoghurt like airsacculitis and pneumonia, usually unilateral. Unfortunately, infection with ORT was misdiagnosed in most of the poultry flocks due to similarity with other respiratory pathogens and the lack of the ideal protocols for diagnosis. Recently, some molecular and serological techniques have been used to detect the infection. Treatment of ORT with antibiotics is very difficult and variable as a result of acquired resistance. Many vaccines have been developed to counteract such infection in broiler, layers, and breeder chicken and turkey flocks. Inactivated, live, and sub-unit vaccines have been used with satisfactory results. Thus, this review paper aimed to address ornithobacteriosis, emphasizing the distribution, transmission, clinical picture, diagnosis, and disease control.
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Affiliation(s)
- Wafaa A Abd El-Ghany
- Poultry Diseases Department, Faculty of Veterinary Medicine, Cairo University, Giza, Egypt
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Ramsubeik S, Stoute S, Shivaprasad H, Mete A, Pitesky M. A retrospective study to identify concomitant pathogens in Mycoplasma gallisepticum positive commercial turkeys and the development of a predictive model of Mycoplasma gallisepticum serologic status in California (2008–2019). J APPL POULTRY RES 2021. [DOI: 10.1016/j.japr.2021.100177] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
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Borysevych BV, Dukhnytskyj VB, Tyshkivska AM, Tyshkivsky MY, Tyshkivska NV. Microscopic changes in the organs of broiler chickens with Ornithobacterium rhinotra-cheale infection. REGULATORY MECHANISMS IN BIOSYSTEMS 2021. [DOI: 10.15421/022105] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Nowadays ornithobacteriosis is widespread among industrial poultry in Ukraine and the world. The disease leads to significant economic losses. The large variation in the serotypes of the bacteria complicates the treatment of the disease. The study of microscopic changes that occur in organs during ornithobacteriosis will help to better understand the pathogenesis of the disease development. Ornithobacteriosis was diagnosed in clinically sick broiler chickens by bacteriological studies using Maldi Tof mass-spectrometry. As a result of the antibiotic sensitivity test, the pathogen was found to be sensitive to doxycycline, tilmicosin, rifampicin, cefazolin, amoxiclav and benzylpenicillin. Histological studies of internal organs – trachea, lungs, heart, kidneys, liver and spleen – were carried out. It was found that with spontaneous ornithobacteriosis of broiler chickens, the most expressive microscopic changes occur in the respiratory organs – the lungs and trachea and are characterized by a decrease in the lumen of the parabronchials due to edema of their walls and infiltration with lymphocytes, the absence of epithelium on the surface of the parabronchials, narrowing of the air capillaries of the parabronchial complexes, hemorrhages in the parenchyma of the parabronchial complexes, vasodilatation of the lung vessels and overflow of their blood vessels with blood cells, edema around the epithelium trachea, destruction of part of the tracheal mucosa epithelial cells, edema of its submucosa, expansion and overflow of blood vessels of the mucous membrane with blood cells. In the spleen there was a uniform diffuse edema of the parenchyma and a decrease in the number of lymphocytes in the lymphoid follicles; in the kidneys – expansion and overflow of the stroma blood vessels, uneven edema of the glomeruli of one part of the renal corpuscles and destruction of the glomeruli of another, granular degeneration of the convoluted and straight tubules of the kidneys; in the liver – edema, hemorrhage, violation of the hepatic lobules’ structure, expansion of the hepatic veins, granular degeneration of hepatocytes or their destruction; in the heart – edema of the myocardial interstitium, muscle fibers’ granular dystrophy, fragmentation of muscle fibers as a result of their rupture. Histological research of ORT infected chickens will lead to a better understanding the mechanism of pathological changes at the microscopic level, which will facilitate the development of more effective methods of treatment and prevention of the disease.
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Ghasemipour N, Goudarzi H, Banani M, Asasi K. Comparison of the first Iranian native Ornithobacterium rhinotracheale vaccine with conventional vaccine: A challenge study. Vet World 2020; 13:655-660. [PMID: 32546908 PMCID: PMC7245729 DOI: 10.14202/vetworld.2020.655-660] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2019] [Accepted: 02/10/2020] [Indexed: 12/03/2022] Open
Abstract
Background and Aim: The best strategy to prevent or control an Ornithobacterium rhinotracheale (ORT) infection is vaccination. The present study aimed to compare the efficacy of the first Iranian inactivated ORT vaccine (Razi, Iran), which had been prepared from a native strain, with the Nobilis ORT Inac (Intervet, The Netherlands) through a challenge trial. Materials and Methods: Seventy-two 1-day-old specific pathogen-free White Leghorn chickens were used in this study. The birds were divided randomly into four groups. Following the vaccination and challenge of the birds, the efficacy of the Razi and the Intervet ORT vaccines was evaluated by serological, bacteriological, and molecular methods. Results: The antibody titer in vaccinated groups was determined to be significantly higher than unvaccinated birds. In addition, the difference in postmortem lesion scores between the vaccinated and unvaccinated birds was significant. The differences in the means of the antibody titers and postmortem lesion scores in birds that were vaccinated by the Razi and Intervet ORT vaccines were not significant. Conclusion: Considering the results of this study, it can be concluded that the Iranian native ORT vaccine was comparable to the Intervet vaccine. The Razi ORT vaccine has effectively decreased the duration of the ORT infection and can effectively protect the chickens against an ORT infection.
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Affiliation(s)
- N Ghasemipour
- Department of Clinical Sciences, Poultry Diseases Research Center, Veterinary School of Shiraz University, Shiraz, Iran
| | - H Goudarzi
- Department of Avian Diseases Research and Diagnosis, Razi Vaccine and Serum Research Institute, Agricultural Research, Education and Extension Organization, Karaj, Iran
| | - M Banani
- Department of Avian Diseases Research and Diagnosis, Razi Vaccine and Serum Research Institute, Agricultural Research, Education and Extension Organization, Karaj, Iran
| | - K Asasi
- Department of Clinical Sciences, Poultry Diseases Research Center, Veterinary School of Shiraz University, Shiraz, Iran
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Ornithobacterium rhinotracheale: An Update Review about An Emerging Poultry Pathogen. Vet Sci 2019; 7:vetsci7010003. [PMID: 31892160 PMCID: PMC7157751 DOI: 10.3390/vetsci7010003] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2019] [Revised: 12/05/2019] [Accepted: 12/09/2019] [Indexed: 12/23/2022] Open
Abstract
Respiratory diseases in birds generate sanitary and economic impacts and may be related to the environment and climate. Mycoplasma gallisepticum, Ornithobacterium rhinotracheale (ORT), Pasteurella multocida, Avibacterium paragallinarum, Escherichia coli, Riemerella anatipestifer, and Bordetella avium are among the most important avian respiratory pathogens. ORT is responsible for causing ornitobacteriosis, a disease characterized by clinical signs ranging from mild to severe respiratory conditions, with high mortality rates, mainly affecting turkeys and chickens. The first report of ornitobacteriosis was in 1981 in Germany. Despite its importance, few studies on ORT have been published. In addition, the presence of this pathogen has been neglected in poultry farms, mainly due to the lack of appropriate diagnostic protocols. The lack of correct isolation and diagnostic protocols along with inappropriate use of antimicrobial agents have been contributing to treatment failure. Due to its economic importance to the poultry industry, ornitobacteriosis should be monitored and included in national programs for the prevention and control of avian respiratory diseases. This review aimed to update and discuss important issues related to ORT since this pathogen has great economic and sanitary implications for the chicken production chain.
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Godener C, Le Guennec J. Field experiences with the use of
Ornithobacterium rhinotracheale
inactivated autogenous vaccination in prebreeding and breeding turkey flocks in France. VETERINARY RECORD CASE REPORTS 2019. [DOI: 10.1136/vetreccr-2019-000864] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Gornatti-Churria CD, Loukopoulos P, Prescott M, Petruccelli MA, Machuca MA. A combined retrospective, prospective and experimental study of Ornithobacterium rhinotracheale infection in chickens. Avian Pathol 2019; 48:460-469. [PMID: 31106577 DOI: 10.1080/03079457.2019.1620915] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
The aim of this study was to examine the histopathological and immunohistochemical changes caused by natural and experimentally-induced Ornithobacterium rhinotracheale infection in the respiratory system of chickens. To this end, three different studies were carried out. The first was a retrospective study of 82 field cases with respiratory disorders compatible with O. rhinotracheale infection. The bacterium was immunohistochemically detected in the lungs in 48 of 82 field cases, and 50 β-haemolytic (BH) and non-haemolytic (NH) strains were isolated. In the second study, an experimental model of the disease was created using 3-week-old broiler chickens, to identify possible differences of pathogenicity between the BH and NH isolates by the intravenous (IV) and intratracheal (IT) inoculation routes (IR). The group challenged with the NH isolate showed more severe lung lesions than the group challenged with the BH isolate at 7-days postinoculation (p.i.). The 14-day p.i. groups challenged with either the BH or NH isolates by the IT or IV IR had a higher histologic grade of pulmonary and hepatic lesions and a higher total histologic grade of lesions suggesting more severe pathology with longer time of exposure. A direct association between the inoculation routes and the organs affected was shown. Finally, a slaughterhouse study was carried out from October 2014 to May 2015, in which the histologic grade of lesions was significantly higher in immunohistochemically positive for O. rhinotracheale lungs of dead-on-arrival chickens.
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Affiliation(s)
- Carlos Daniel Gornatti-Churria
- Cátedra de Patología de Aves y Pilíferos y Laboratorio de Diagnóstico de Enfermedades de las Aves y los Pilíferos, Facultad de Ciencias Veterinarias, Universidad Nacional de La Plata , La Plata , Argentina.,Comité Nacional de Investigaciones Científicas y Técnicas (CONICET-CCT-La Plata) , La Plata , Argentina
| | - Panayiotis Loukopoulos
- Faculty of Veterinary and Agricultural Sciences, Melbourne Veterinary School, University of Melbourne , Werribeee , Australia
| | - Matthew Prescott
- Quantitative Consulting Unit, Charles Sturt University , Wagga Wagga , Australia
| | - Miguel A Petruccelli
- Cátedra de Patología de Aves y Pilíferos y Laboratorio de Diagnóstico de Enfermedades de las Aves y los Pilíferos, Facultad de Ciencias Veterinarias, Universidad Nacional de La Plata , La Plata , Argentina
| | - Mariana A Machuca
- Cátedra de Patología Especial y Laboratorio de Patología Especial Veterinaria, Facultad de Ciencias Veterinarias, Universidad Nacional de La Plata , La Plata , Argentina
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De la Rosa-Ramos MA, Muñoz-Solís K, Palma-Zepeda M, Gutierrez-Castillo AC, López Villegas EO, Guerra-Infante FM, Castro-Escarpulli G. Adherence of Ornithobacterium rhinotracheale to chicken embryo lung cells as a pathogenic mechanism. Avian Pathol 2017; 47:172-178. [PMID: 29016186 DOI: 10.1080/03079457.2017.1390208] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Ornithobacterium rhinotracheale is a bacterium that causes respiratory disease in birds and it has been isolated in countries with a large poultry production, including Mexico. The pathogenicity mechanisms of this bacterium have not been completely elucidated yet. The capacity of the bacterium to adhere to epithelial cells of chicken in vitro has been evidenced, and since this bacterium has been isolated from the lungs and air sacs of several avian species, the aim of this study was to determine if this bacterium can adhere to chicken lung cells. We used five O. rhinotracheale reference serovars (A-E) that were in contact with primary lung cells cultured from a 19-day-old chicken embryo. O. rhinotracheale adherence was evaluated through optical and transmission electron microscopies. The results revealed that O. rhinotracheale is capable of adhering to chicken embryo lung cells within 3 h of incubation with a diffuse adherence pattern. The adherence percentages of the chicken embryo lung cells were 51-96% according to the serovar of the bacterium. Relative adherence was from 4 to 8 bacteria per cell. Transmission electron microscope data revealed intracellular bacteria inside a vacuole in less than 3 h of incubation.
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Affiliation(s)
- Miguel A De la Rosa-Ramos
- a Laboratorio de Microbiología Veterinaria, Departamento de Microbiología de la Escuela Nacional de Ciencias Biológicas (ENCB), Instituto Politécnico Nacional , Mexico City , Mexico.,b Laboratorio de Bacteriología Médica, Departamento de Microbiología de la Escuela Nacional de Ciencias Biológicas (ENCB), Instituto Politécnico Nacional , Mexico City , Mexico
| | - Karina Muñoz-Solís
- a Laboratorio de Microbiología Veterinaria, Departamento de Microbiología de la Escuela Nacional de Ciencias Biológicas (ENCB), Instituto Politécnico Nacional , Mexico City , Mexico
| | - Mario Palma-Zepeda
- c Laboratorio de Virología, Departamento de Microbiología e Inmunología, Facultad de Medicina Veterinaria y Zootecnia (FMVZ) , Universidad Nacional Autónoma de México (UNAM) , Mexico City , Mexico
| | - Adriana C Gutierrez-Castillo
- d Facultad de Medicina Veterinaria y Zootecnia (FMVZ) , Universidad Autónoma del Estado de México (UAEMex) , Toluca , Mexico
| | - Edgar O López Villegas
- e Central de Microscopia, Escuela Nacional de Ciencias Biológicas (ENCB) , Instituto Politécnico Nacional (IPN) , Mexico City , Mexico
| | - Fernando M Guerra-Infante
- a Laboratorio de Microbiología Veterinaria, Departamento de Microbiología de la Escuela Nacional de Ciencias Biológicas (ENCB), Instituto Politécnico Nacional , Mexico City , Mexico.,f Laboratorio de Bioinmunología Molecular del Instituto Nacional de Perinatología (INPerIER) , Mexico City , Mexico
| | - Graciela Castro-Escarpulli
- b Laboratorio de Bacteriología Médica, Departamento de Microbiología de la Escuela Nacional de Ciencias Biológicas (ENCB), Instituto Politécnico Nacional , Mexico City , Mexico
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