Neisseria meningitidis Serogroup W Meningitis Epidemic in Togo, 2016

BACKGROUND

During 2014, 4 regions in Togo within the African meningitis belt implemented vaccination campaigns with meningococcal serogroup A conjugate vaccine (MACV). From January to July 2016, Togo experienced its first major Neisseria meningitidis serogroup W (NmW) outbreak. We describe the epidemiology, response, and management of the outbreak.

METHODS

Suspected, probable, and confirmed cases were identified using World Health Organization case definitions. Through case-based surveillance, epidemiologic and laboratory data were collected for each case. Cerebrospinal fluid specimens were analyzed by polymerase chain reaction, culture, or latex agglutination. Vaccination campaigns were conducted in affected districts.

RESULTS

From January 11 to July 5, 2016, 1995 suspected meningitis cases were reported, with 128 deaths. Among them, 479 (24.0%) were confirmed by laboratory testing, and 94 (4.7%) and 1422 (71.3%) remained as probable and suspected cases, respectively. Seven epidemic districts had cumulative attack rates greater than 100 per 100 000 population. Of the confirmed cases, 91.5% were NmW; 39 of 40 available NmW isolates were sequence type-11/clonal complex-11.

CONCLUSIONS

This outbreak demonstrates that, although high coverage with MACV has reduced serogroup A outbreaks, large meningococcal meningitis outbreaks due to other serogroups may continue to occur; effective multivalent meningococcal conjugate vaccines could improve meningococcal disease prevention within meningitis belt populations.

Fatal leptospirosis in free-ranging Eurasian beavers (Castor fiber L.), Switzerland

Leptospirosis was first diagnosed in free-ranging Eurasian beavers (Castor fiber L.) in Switzerland in 2010. Pathologic, serologic, molecular and epidemiologic analyses were carried out on 13 animals submitted for necropsy from 2010 through 2014. Typical lesions included alveolar haemorrhages in the lungs, tubular degeneration and interstitial nephritis in the kidneys. Microscopic agglutination test results were positive for serogroups Icterohaemorrhagiae, Australis, Autumnalis and Sejroe. Molecular analysis identified four distinct profiles belonging to serovar Icterohaemorrhagiae or Copenhageni. The severity and features of the lesions were consistent with a fatal disease associated with leptospires similarly to what has been reported in other animals and humans. The spatiotemporal occurrence of leptospirosis in beavers suggested an upstream spread of the bacteria and coincided with an increased incidence of leptospirosis in dogs and a case cluster in humans. However, an epidemiologic link among beaver cases and among species was not supported neither by the serologic nor molecular data.

Epidemiological investigation of a human leptospirosis case reported in a suburban area near Marseille

Leptospirosis has been re-emerging in both developed and developing countries, including in Europe, where the phenomenon has notably been associated with urban transmission. In this work, we describe an epidemiological investigation that demonstrated a case of human infection due to peri-urban transmission of Leptospira interrogans serovar icterohaemorrhagiae in southeastern France.

[Serological study of leptospirosis in equids, camelids and bovids from Djibouti]

Sera obtained from 31 domestic and feral animals in Djibouti were assayed for leptospiral antibodies using the microscopic agglutination test. Antibodies were detected in 26 samples (84%), corresponding to 116 positive reactions. The most common antigen serogroups were Icterohaemorrhagiae and Australis. The highest titre was recorded for serovar Munchen (1:1280) in sera from Somalian wild asses and goats. This study shows a broad dispersion and high prevalence of the different Leptospira serogroups tested. High biodiversity has been previously reported in tropical countries and is thought to be linked to the wide range of reservoir mammals. Additional study will be needed to identify the reservoirs of the different serogroups in this part of Africa.

Serological and molecular ecology of Listeria monocytogenes isolates collected from 13 French pork meat salting–curing plants and their products

The purpose of this study was dual: 1. to evaluate the serotype distribution of 1028 Listeria monocytogenes isolates collected in 13 French salting factories and their products and 2. to identify sources of L. monocytogenes contamination in these factories and trace the routes of spread by PFGE (Pulsed-Field Gel Electrophoresis) typing. Serotypes 1/2a, 1/2b, 1/2c, 4b and 4e occurred. Pulsotype diversity was high among strains collected in plants and products. Furthermore, strains showing similar pulsotypes occurred on the same surfaces after an interval of at least two weeks and in unrelated factories. Forty five strains were genetically closely related to a 4b serotype L. monocytogenes strain isolated from a human clinical case of listeriosis. Our results highlighted the fact that L. monocytogenes is introduced into meat processing plants through raw meat. To overcome such contamination, suppliers of raw material should adhere to specific microbiological control measures. In addition, more attention should be focused on the appropriateness and compliance with procedures of cleaning and disinfection.

Serological and molecular comparison of Mannheimia haemolytica and Pasteurella trehalosi strains isolated from wild and domestic ruminants in the French Alps

Over a period of 17 years, 84 bacterial isolates identified as Mannheimia haemolytica or M. glucosida, and 52 isolates identified as Pasteurella trehalosi were detected in the lungs of domestic and wild ruminants in the French Alps. The isolates were serotyped according to their surface capsular antigens, and those sharing common antigens were further characterized by pulsed field gel electrophoresis. The results showed that the bacterial isolates included in the study clustered according to the host species from which they were isolated. These findings indicate that the transmission of serotypes of M. haemolytica, M. glucosida or P. trehalosi from an animal host in which they are common to another species sharing the same geographical space may be a rare epidemiological event.

Discrimination of Staphylococcus aureus strains from different species of Staphylococcus using Fourier transform infrared (FTIR) spectroscopy

Staphylococcus aureus is a widespread opportunistic pathogen that can cause food-borne illness and is sometimes associated with raw milk and raw milk cheese products. The traditional taxonomic procedures for classification of staphylococcal species are time consuming and often several tests are required. FTIR spectroscopy offers a rapid method for the discrimination and identification of S. aureus strains isolated from raw milk and raw milk cheeses. FTIR spectroscopy was used to discriminate S. aureus from other species of Staphylococcus. This was achieved by using a model composed of 39 species and subspecies of Staphylococcus. The model was validated using a set of spectra of strains isolated from raw milk and different varieties of French raw milk cheese. S. aureus was successfully discriminated from the other species of Staphylococcus and all the strains of S. aureus isolated from raw milk and different varieties of French raw milk cheese were also successfully identified as such. These results demonstrated that FTIR spectroscopy is a rapid (results obtained within 24 h starting from a pure strain or a single colony) and robust method for the identification of S. aureus isolates of dairy origin and food-borne origin in general.

Pulsed-field gel electrophoresis profiles of aeromonads isolated from healthy and diseased Helix aspersa from French snail farms

The XbaI digestion patterns of chromosomal DNA of 42 aeromonads isolated from French breeding snails during a new epizootic disease, which rapidly progressed to death during the summer of 1994, were analyzed by pulsed-field gel electrophoresis. Biochemical identification to species level was also performed. Interestingly, we found that 76% of the aeromonads isolated from diseased snails clustered into a unique pulsotype (P1) whatever their geographic origin, and were assessed to belong to Aeromonas hydrophila. Other strains belonged to Aeromonas caviae or remained unspecified. Our results provide retrospective supplementary epidemiological evidence for implication of A. hydrophila strains in the snail summer disease.

Rat bite fever caused by Streptobacillus moniliformis in a child: human infection and rat carriage diagnosed by PCR

A child owning pet rats developed an eruptive fever with blisters, polyarthritis, and spectacular desquamation of the hands. Streptobacillus moniliformis was identified after culture of the child's blister fluid and was detected in rat samples by molecular methods. Such detection in the pet of a human victim of rat bite fever has not been reported previously.

Efficacy of selamectin administered topically in the treatment of feline otoacariosis

The efficacy of a novel avermectin, selamectin (Stronghold, Pfizer), was evaluated against naturally acquired aural infestations of Otodectes cynotis. Selamectin was administered topically in a single spot to the skin of each animal's back at the base of the neck in front of the scapulae at a minimum dosage of 6mgkg(-1). Thirty cats of a cattery of 120 animals with an endemic infestation were treated on days 0 and 30. Including untreated control cats was therefore not possible because of animal welfare consideration. Clinical examination and visualization of mites by otoscopic examination of the external ear canal and microscopic examination of aural debris/exudate were performed twice weekly from days 0 to 30. On day 0 (and day 28 if the ears canals were erythematous), a swab was taken from each canal and sent to bacteriology and mycology units for detection and identification of bacteria (Staphylococcus mainly) and yeast (Malassezia pachydermatis only). Selamectin was safe, parasites were killed before day 3 and eliminated before day 17. Selamectin was 100% effective against natural aural infestations, even if erythema (26-33% of cats) and scratch reflex (23-40% of cats) persisted for 2 weeks after the cats tested negative for mites.

Diagnosis of canine parvovirus by rapid immunomigration on a membrane

Rapid immunomigration on a membrane was applied to the diagnosis of canine parvovirus (CPV) in 128 samples of faeces containing four strains of parvovirus (two CPV-2a strains, including one vaccine strain, and two CPV-2b strains). The results were compared with the results of haemagglutination and ELISA sandwich techniques. The new test was quick and easy to use, and made it possible to identify both the CPV-2a and CPV-2b strains. Its detection thresholds per gram of faeces corresponded to specific haemagglutination titres of between 320 and 640 and a virus titre of between 10(4) and 10(5) CCID50 (dose required to infect 50 per cent of cell cultures).

Bacterial flora in foals with upper respiratory tract infections in Poland

Bacteria isolated from nasal cavity of 80 foals with upper respiratory tract infection, as well as from 20 healthy foals, were examined. Within the group of sick animals, from 18 (22.5%) bacteria with recognized pathogenicity were isolated. Coagulase-negative staphylococci and Acinetobacter sp. were the dominant species identified (100 and 45%, respectively). No bacteria species with recognized pathogenicity were isolated from the group of healthy animals. Three cases of death within the group of sick foals were investigated. Rhodococcus equi in two cases and Klebsiella pneumoniae pneumoniae together with Escherichia coli were isolated post-mortem from lung abscesses.

Ribotyping and rapid identification of Staphylococcus xylosus by 16-23S spacer amplification

Ninety-five strains of Staphylococcus xylosus isolated from goat milk, French sausage or mice were analyzed together with 35 Staphylococcus type strains by 16-23S spacer amplification and ribotyping. The results obtained by PCR amplification of the 16-23S spacer region permitted the distinction of each type strain and additionally generated a DNA banding pattern characteristic for 93 of the 95 Staphylococcus xylosus strains. Ribotyping proved to be an efficient epidemiological tool for Staphylococcus xylosus species as it clustered the 95 strains into 23 distinct types.

Identification by 16S rDNA fragment amplification and determination of genetic diversity by random amplified polymorphic DNA analysis of Pasteurella pneumotropica isolated from laboratory rodents

Pasteurella pneumotropica is an opportunistic bacterium frequently isolated from colonies of various laboratory rodents. Identification of this species, including its differentiation into two distinct biotypes (Jawetz and Heyl), is usually based on the use of conventional bacteriologic methods. In this study, a 16S rDNA fragment amplification procedure was developed for use as an alternative method for identification and differentiation of P. pneumotropica. Polymerase chain reaction (PCR) products were two distinctive fragments of 937 and 564 bp specific for biotypes Jawetz and Heyl, respectively. Specificity of PCR products could be achieved by EcoRI cleavage, leading to 596 plus 341-bp and 346 plus 218-bp fragments for each of the amplification products. Use of this procedure confirmed identification of 34 field isolates and allowed definitive identification of some strains that could not have been done by use of bacteriologic examinations. Field isolates subjected to random amplified polymorphic DNA (RAPD) analysis had high genetic diversity among biotype Jawetz strains in contrast to biotype Heyl strains. In conclusion, RAPD could represent an additional means for identification of ambiguous strains of biotype Heyl and a valuable epidemiologic tool for identification of biotype Jawetz strains of P. pneumotropica.

Pulsed-field gel electrophoresis is more efficient than ribotyping and random amplified polymorphic DNA analysis in discrimination of Pasteurella haemolytica strains

One hundred thirty-three strains of Pasteurella haemolytica of both biotypes (90 and 43 strains of biotypes A and T, respectively) and almost all the serotypes were subjected to ribotyping, random amplified polymorphic DNA (RAPD) analysis, and pulsed-field gel electrophoresis (PFGE) analysis for epidemiological purposes. A total of 15 patterns recorded as ribotypes HA to HO were found for the P. haemolytica biotype A strains, with ribotypes HA, HC, and HD being encountered most often (66 strains [74%]); and 20 ribotypes, designated HA' to HT', that were clearly distinct from those observed for biotype A strains were observed for strains of biotype T. RAPD analysis generated a total of 44 (designated Rp1 to Rp44) and 15 (designated Rp1' to Rp 15') unique RAPD patterns for biogroup A and biogroup T, respectively. Analysis of the data indicated that a given combined ribotype-RAPD pattern could be observed for biotype A strains of different serotypes, whatever the zoological or geographic origin, whereas this was not the case for biotype T strains. PFGE appeared to be more efficient in strain discrimination since selected strains from various zoological or geographical origins harboring the same ribotype-RAPD group were further separated into unique entities.

Intestinal absorption and permeability in human immunodeficiency virus-infected patients

BACKGROUND

Impaired intestinal function could account for diarrhoea and weight loss, which are common features of advanced human immunodeficiency virus (HIV) infection.

METHODS

We assessed intestinal permeability to lactulose and mannitol and absorption of D-xylose in 96 HIV-infected patients (group I: asymptomatic subjects (CDC-A); group II: symptomatic subjects (CDC-B or C) without body weight loss and/or diarrhoea; group III: 25 acquired immunodeficiency syndrome (AIDS) patients (CDC-C) with severe body weight loss and/or diarrhoea) and 10 healthy subjects as controls.

RESULTS

An incremental decrease in urinary D-xylose recoveries was observed, with all groups statistically different from each other. Impaired intestinal permeability was only found in patients of group III (statistically different from all other groups).

CONCLUSIONS

These findings suggest a loss of intestinal functional absorptive surface as HIV disease progresses. This process may be present at the early stage of infection. Impaired intestinal permeability is observed later in AIDS patients when digestive signs are present, particularly diarrhoea.

Ribotyping of Staphylococcus caprae isolated from goat milk

The usefulness of the API-STAPH system and a method based on ribosomal fingerprinting was evaluated by studying 89 coagulase-negative staphylococci isolated from goat milk. The bacteria were supposed to belong to the species Staphylococcus caprae. The results obtained from the API-STAPH system showed variations in their phenotypic features. DNA cleavage with EcoRI yielded six ribotypes and three distinct patterns were generated when the DNA of the strains was digested with HindIII. Forty-six strains were correctly characterized as S. caprae by the two methods. In addition, 37 isolates having atypical biochemical profiles with the API-STAPH system were confirmed as being S. caprae by the ribotyping. Three strains remained unclassified by both methods. Ribotypes generated by HindIII were found to be the most informative for species determination, whereas the number of bands generated by EcoRI indicated the usefulness of this enzyme in S. caprae typing.

Phylogeny of the family Moraxellaceae by 16S rDNA sequence analysis, with special emphasis on differentiation of Moraxella species

Thirty-three strains previously classified into 11 species in the bacterial family Moraxellaceae were subjected to phylogenetic analysis based on 16S rRNA sequences. The family Moraxellaceae formed a distinct clade consisting of four phylogenetic groups as judged from branch lengths, bootstrap values and signature nucleotides. Group I contained the classical moraxellae and strains of the coccal moraxellae, previously known as Branhamella, with 16S rRNA similarity of > or = 95%. A further division of group I into five tentative clusters is discussed. Group II consisted of two strains representing Moraxella atlantae and Moraxella osloensis. These strains were only distantly related to each other (93.4%) and also to the other members of the Moraxellaceae (< or = 93%). Therefore, reasons for reclassification of these species into separate and new genera are discussed. Group III harboured strains of the genus Psychrobacter and strain 752/52 of [Moraxella] phenylpyruvica. This strain of [M.] phenylpyruvica formed an early branch from the group III line of descent. Interestingly, a distant relationship was found between Psychrobacter phenylpyruvicus strain ATCC 23333T (formerly classified as [M.] phenylpyruvica) and [M.] phenylpyruvica strain 752/52, exhibiting less than 96% nucleotide similarity between their 16S rRNA sequences. The establishment of a new genus for [M.] phenylpyruvica strain 752/52 is therefore suggested. Group IV contained only two strains of the genus Acinetobacter. Strategies for the development of diagnostic probes and distinctive sequences for 16S rRNA-based species-specific assays within group I are suggested. Although these findings add to the classificatory placements within the Moraxellaceae, analysis of a more comprehensive selection of strains is still needed to obtain a complete classification system within this family.

Isolation and identification of Salmonella species from chelonians using combined selective media, serotyping and ribotyping

Thirty-two faecal samples from various pet chelonians were bacteriologically examined using various combinations of selective media for Salmonella detection. Strains identified as Salmonella were clustered by rRNA gene restriction pattern (ribotyping) analysis prior to serological typing. The combination of selenite broth and Rambach or Salmonella-Shigella agars gave the maximum rate of Salmonella recovery. Of the 32 samples examined, 13 (40%), were positive for Salmonella. Five serovars were identified, Muenchen, Rubislaw, Newport, Ferruch and a non-motile O:4,5,12, with Salmonella Muenchen the most common. This result indicates that biochemical characterization combined with ribotyping prior to serotyping can contribute to Salmonella detection on a large scale.

Molecular and phenotypic features of aeromonads isolated from snails (Helix aspersa) affected with a new summer disease

Forty-four aeromonads were isolated during the summer of 1994 from snails (Helix aspersa) affected or not by a newly described disease. Snta 1 rRNA gene restriction patterns (ribotyping) and nine selected conventional phenotypic tests were performed to retrospectively determine relationships among these isolates regarding the disease. Results from ribotyping were found highly discriminant in strain differentiation and suggest the possible existence of a group of Aeromonas associated with the disease. Biochemical and molecular characterizations indicated that most of these disease-associated aeromonads could belong to the phenospecies A. hydrophila. Phenospecies of aeromonads from healthy snails were distinct from those isolated from diseased snails and could be identified as A. caviae or remained undetermined. To the authors' knowledge, this is the first report of a probable pathogenic aeromonad found in snails, extending the host-pathogen spectrum of Aeromonas.

Moraxella boevrei sp. nov., a new Moraxella species found in goats

Six Moraxella-like strains that formed a phenotypically homogeneous group were isolated from the nasal flora of healthy goats. Total genomic DNA-DNA hybridization, rRNA gene restriction pattern, DNA base composition, and genetic transformation studies were performed to determine the relationships of these bacteria to species belonging to the genus Moraxella and other fastidious gram-negative species. The new group of isolates was very homogeneous, as shown by rRNA gene restriction fragment length patterns (ribotyping), and these organisms displayed high relative binding ratios (RBRs) to each other in DNA-DNA hybridization experiments (RBRs, > or = 58%) but distinctly lower levels of DNA homology with all other species investigated. However, the RBRs obtained with species of the genus Moraxella were higher than the RBRs obtained with all other gram-negative strains examined. Although the new strains had most of the Moraxella bovis phenotypic characteristics except nitrate reduction, quantitative and qualitative genetic transformation data led to the conclusion that they belong to a distinct new cluster in the genus Moraxella. The results of this study, combined with the general morphological and phenotypic profiles of the new strains, are consistent with the creation of a new Moraxella species, for which the name Moraxella boevrei is proposed. Strain 88365 (= ATCG 700022 = CCUG 35435 = NCTC 12925 = CIP 104716) is the type strain of M. boevrei.

Moraxella caprae sp. nov., a new member of the classical Moraxellae with very close affinity to Moraxella bovis

Eight phenotypically homogeneous Moraxella-like strains were isolated from the nasal flora of healthy goats. Total genomic DNA-DNA hybridization, DNA base composition determination, and genetic transformation studies were performed to determine the relationships of these bacteria to the classical moraxellae. The eight new isolates exhibited very high levels of genetic affinity to Moraxella bovis, as shown by quantitative and qualitative genetic transformation data, and exhibited high DNA-DNA relative binding ratios to each other (63% or more) but lower levels of DNA homology with all of the other species investigated, including the closely related classical moraxellae. Our results, combined with the general morphologic and phenotypic profiles of these organisms, indicate that they should be classified with the classical moraxellae, and we propose the name Moraxella caprae for them. Strain 8897 (= CCUG 33296 [corrected] = NCTC 12877) is the type strain of M. caprae.

Molecular typing of Actinomyces pyogenes isolates

The molecular characterization of 28 clinical Actinomyces pyogenes strains was attempted. SDS-PAGE protein profiles did not allow to distinguish isolates. Restriction endonuclease analysis of total DNA gave the finest differentiation between strains but the profiles were difficult to read. Ribotypes after DNA digestion by Bst EII or Sma I have a high discriminatory power and are more helpful epidemiological markers. No relationship could be demonstrated between molecular types and clinical sources.

Identification of Moraxella bovis and related species from calves with IBK and goats by qualitative genetic transformation assay

Eight Moraxella bovis strains isolated from bovine pink eye, 16 Moraxella bovis related strains isolated from healthy goats nasal flora, one nonhemolytic Moraxella sp. isolated from bovine conjunctivitis and different collection strains of Moraxella and Branhamella genus were studied through the combined use of qualitative genetic transformation assay and the ability to grow on a moraxella bovis defined medium (medium MB). Crude DNA extracted from the strains studied were used to transform two mutant auxotroph competent strains of Moraxella bovis CIP 103741 and CIP 103743. Non-specific positive transformation was obtained with mutant assay strain CIP 103743 when treated with DNA from caprine or bovine Moraxella strains, collection strains of Moraxella bovis, Moraxella lacunata, Moraxella nonliquefaciens and strains of Branhamella genus, whereas specific transformation was observed with mutant assay CIP 103741 when treated only with DNA from all the Moraxella bovis (collection and clinical isolates) and 14 of the 16 caprine Moraxella bovis related strains. The specificity and the simplicity of the test make it suitable for use in clinical laboratories.

Identification of Moraxella-like bacteria isolated from caprine and ovine nasal flora

Twenty four Moraxella related bacterias were isolated from healthy caprine and ovine nasal swabs and were investigated by classic biochemical tests and by sodium dodecyl sulfate polyacrylamide gel electrophoresis (SDS-PAGE) of whole-cell proteins in comparison with 9 reference strains. Proteolytic and haemolytic strains were investigated by electron microscopy. The biochemical results clustered field isolates in four groups corresponding to Branhamella and Moraxella species. Proteolytic, haemolytic and fimbriated field isolates showed the same morphological structure and biochemical features as Moraxella bovis. SDS-PAGE results indicated that DICE coefficient between a field isolate and the corresponding reference strain can be as 62.5%; 41.7% and 36% respectively for the groups 1, 3 and 4. The group 2 showed a similarity percentage over 75% with the reference strain Moraxella nonliquefaciens. This results indicated that a non proteolytic but haemolytic bacteria, closely related to Moraxella nonliquefaciens was commonly isolated from small ruminants nasal flora. These animals can also be hosts of a subspecies of Moraxella bovis.