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Yeoh S, Estrada-Rivadeneyra D, Jackson H, Keren I, Galassini R, Cooray S, Shah P, Agyeman P, Basmaci R, Carrol E, Emonts M, Fink C, Kuijpers T, Martinon-Torres F, Mommert-Tripon M, Paulus S, Pokorn M, Rojo P, Romani L, Schlapbach L, Schweintzger N, Shen CF, Tsolia M, Usuf E, van der Flier M, Vermont C, von Both U, Yeung S, Zavadska D, Coin L, Cunnington A, Herberg J, Levin M, Kaforou M, Hamilton S. Plasma Protein Biomarkers Distinguish Multisystem Inflammatory Syndrome in Children From Other Pediatric Infectious and Inflammatory Diseases. Pediatr Infect Dis J 2024; 43:444-453. [PMID: 38359342 PMCID: PMC11003410 DOI: 10.1097/inf.0000000000004267] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/19/2023] [Indexed: 02/17/2024]
Abstract
BACKGROUND Multisystem inflammatory syndrome in children (MIS-C) is a rare but serious hyperinflammatory complication following infection with severe acute respiratory syndrome coronavirus 2. The mechanisms underpinning the pathophysiology of MIS-C are poorly understood. Moreover, clinically distinguishing MIS-C from other childhood infectious and inflammatory conditions, such as Kawasaki disease or severe bacterial and viral infections, is challenging due to overlapping clinical and laboratory features. We aimed to determine a set of plasma protein biomarkers that could discriminate MIS-C from those other diseases. METHODS Seven candidate protein biomarkers for MIS-C were selected based on literature and from whole blood RNA sequencing data from patients with MIS-C and other diseases. Plasma concentrations of ARG1, CCL20, CD163, CORIN, CXCL9, PCSK9 and ADAMTS2 were quantified in MIS-C (n = 22), Kawasaki disease (n = 23), definite bacterial (n = 28) and viral (n = 27) disease and healthy controls (n = 8). Logistic regression models were used to determine the discriminatory ability of individual proteins and protein combinations to identify MIS-C and association with severity of illness. RESULTS Plasma levels of CD163, CXCL9 and PCSK9 were significantly elevated in MIS-C with a combined area under the receiver operating characteristic curve of 85.7% (95% confidence interval: 76.6%-94.8%) for discriminating MIS-C from other childhood diseases. Lower ARG1 and CORIN plasma levels were significantly associated with severe MIS-C cases requiring inotropes, pediatric intensive care unit admission or with shock. CONCLUSION Our findings demonstrate the feasibility of a host protein biomarker signature for MIS-C and may provide new insight into its pathophysiology.
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Affiliation(s)
- Sophya Yeoh
- From the Department of Infectious Disease, Faculty of Medicine
| | - Diego Estrada-Rivadeneyra
- From the Department of Infectious Disease, Faculty of Medicine
- Centre for Paediatrics and Child Health, Imperial College London, London, United Kingdom
| | - Heather Jackson
- From the Department of Infectious Disease, Faculty of Medicine
- Centre for Paediatrics and Child Health, Imperial College London, London, United Kingdom
| | - Ilana Keren
- From the Department of Infectious Disease, Faculty of Medicine
| | | | - Samantha Cooray
- From the Department of Infectious Disease, Faculty of Medicine
- Centre for Paediatrics and Child Health, Imperial College London, London, United Kingdom
| | - Priyen Shah
- From the Department of Infectious Disease, Faculty of Medicine
- Centre for Paediatrics and Child Health, Imperial College London, London, United Kingdom
| | - Philipp Agyeman
- Department of Pediatrics, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Romain Basmaci
- Service de Pédiatrie-Urgences, AP-HP, Hôpital Louis-Mourier, Colombes, France
- Infection, Antimicrobials, Modelling, Evolution, Université Paris Cité, Inserm, IAME, Paris, France
| | - Enitan Carrol
- Department of Clinical Infection Microbiology and Immunology, University of Liverpool Institute of Infection, Veterinary and Ecological Sciences, Liverpool, United Kingdom
| | - Marieke Emonts
- Translational and Clinical Research Institute, Newcastle University
- Paediatric Infectious Diseases and Immunology Department, Newcastle upon Tyne Hospitals Foundation Trust, Great North Children’s Hospital
- NIHR Newcastle Biomedical Research Centre, Newcastle upon Tyne Hospitals NHS Trust and Newcastle University, Newcastle upon Tyne, United Kingdom
| | - Colin Fink
- Micropathology Ltd., University of Warwick, Warwick, United Kingdom
| | - Taco Kuijpers
- Department of Pediatric Immunology, Rheumatology, and Infectious Diseases, Emma Children’s Hospital, Amsterdam University Medical Centre
- Sanquin Research, Department of Blood Cell Research, Landsteiner Laboratory, Amsterdam University Medical Centre, Amsterdam, Netherlands
| | - Federico Martinon-Torres
- Translational Paediatrics and Infectious Diseases, Hospital Clínico Universitario, Universidad de Santiago de Compostela
- Genetics, Vaccines and Paediatric Infectious Diseases Research Group (GENVIP), Instituto de Investigación Sanitaria de Santiago, Universidade de Santiago de Compostela (USC), Galicia, Spain
- CIBER Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, Spain
| | | | - Stephane Paulus
- Oxford Vaccine Group, Department of Paediatrics, University of Oxford and the NIHR Oxford Biomedical Research Centre, Oxford, United Kingdom
| | - Marko Pokorn
- Division of Pediatrics, University Medical Centre Ljubljana, Medical Faculty, University of Ljubljana, Ljubljana, Slovenia
| | - Pablo Rojo
- Pediatric Infectious Diseases Unit, Pediatric Department, Hospital Doce de Octubre, Madrid, Spain
| | - Lorenza Romani
- Infectious Disease Unit, Academic Department of Pediatrics, Bambino Gesù Children’s Hospital, IRCCS, Rome, Italy
| | - Luregn Schlapbach
- Department of Intensive Care and Neonatology, Children’s Research Center, University Children`s Hospital, Zurich, Switzerland
- Child Health Research Centre, The University of Queensland, Brisbane, Australia
| | - Nina Schweintzger
- Department of Pediatrics and Adolescent Medicine, Division of General Pediatrics, Medical University of Graz, Graz, Austria
| | - Ching-Fen Shen
- Department of Pediatrics, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Maria Tsolia
- Second Department of Paediatrics, National and Kapodistrian University of Athens (NKUA), School of Medicine, P. and A. Kyriakou Children’s Hospital, Athina, Athens, Greece
| | - Effua Usuf
- Medical Research Council Unit, The Gambia at the London School of Hygiene and Tropical Medicine, Fajara, The Gambia
| | - Michiel van der Flier
- Department of Paediatric Infectious Diseases and Immunology, Wilhelmina Children’s Hospital, University Medical Centre Utrecht, Utrecht, Netherlands
| | - Clementien Vermont
- Department of Paediatric Infectious Diseases and Immunology, Erasmus MC Sophia Children’s Hospital, Rotterdam, Netherlands
| | - Ulrich von Both
- Division of Pediatric Infectious Diseases, Department of Pediatrics, Dr von Hauner Children’s Hospital, University Hospital, LMU Munich, Munich, Germany
| | - Shunmay Yeung
- Clinical Research Department, Faculty of Infectious and Tropical Disease, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Dace Zavadska
- Children’s Clinical University Hospital, Rīga, Latvia
| | - Lachlan Coin
- Department of Microbiology and Immunology, University of Melbourne at The Peter Doherty Institute for Infection and Immunity, Melbourne, Australia
| | - Aubrey Cunnington
- From the Department of Infectious Disease, Faculty of Medicine
- Centre for Paediatrics and Child Health, Imperial College London, London, United Kingdom
| | - Jethro Herberg
- From the Department of Infectious Disease, Faculty of Medicine
- Centre for Paediatrics and Child Health, Imperial College London, London, United Kingdom
| | - Michael Levin
- From the Department of Infectious Disease, Faculty of Medicine
- Centre for Paediatrics and Child Health, Imperial College London, London, United Kingdom
| | - Myrsini Kaforou
- From the Department of Infectious Disease, Faculty of Medicine
- Centre for Paediatrics and Child Health, Imperial College London, London, United Kingdom
| | - Shea Hamilton
- From the Department of Infectious Disease, Faculty of Medicine
- Centre for Paediatrics and Child Health, Imperial College London, London, United Kingdom
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2
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Wang H, Shimizu C, Bainto E, Hamilton S, Jackson HR, Estrada-Rivadeneyra D, Kaforou M, Levin M, Pancheri JM, Dummer KB, Tremoulet AH, Burns JC. Subgroups of children with Kawasaki disease: a data-driven cluster analysis. Lancet Child Adolesc Health 2023; 7:697-707. [PMID: 37598693 PMCID: PMC10756500 DOI: 10.1016/s2352-4642(23)00166-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/27/2023] [Revised: 06/22/2023] [Accepted: 06/22/2023] [Indexed: 08/22/2023]
Abstract
BACKGROUND Although Kawasaki disease is commonly regarded as a single disease entity, variability in clinical manifestations and disease outcome has been recognised. We aimed to use a data-driven approach to identify clinical subgroups. METHODS We analysed clinical data from patients with Kawasaki disease diagnosed at Rady Children's Hospital (San Diego, CA, USA) between Jan 1, 2002, and June 30, 2022. Patients were grouped by hierarchical clustering on principal components with k-means parcellation based on 14 variables, including age at onset, ten laboratory test results, day of illness at the first intravenous immunoglobulin infusion, and normalised echocardiographic measures of coronary artery diameters at diagnosis. We also analysed the seasonality and Kawasaki disease incidence from 2002 to 2019 by subgroup. To explore the biological underpinnings of identified subgroups, we did differential abundance analysis on proteomic data of 6481 proteins from 32 patients with Kawasaki disease and 24 healthy children, using linear regression models that controlled for age and sex. FINDINGS Among 1016 patients with complete data in the final analysis, four subgroups were identified with distinct clinical features: (1) hepatobiliary involvement with elevated alanine transaminase, gamma-glutamyl transferase, and total bilirubin levels, lowest coronary artery aneurysm but highest intravenous immunoglobulin resistance rates (n=157); (2) highest band neutrophil count and Kawasaki disease shock rate (n=231); (3) cervical lymphadenopathy with high markers of inflammation (erythrocyte sedimentation rate, C-reactive protein, white blood cell, and platelet counts) and lowest age-adjusted haemoglobin Z scores (n=315); and (4) young age at onset with highest coronary artery aneurysm but lowest intravenous immunoglobulin resistance rates (n=313). The subgroups had distinct seasonal and incidence trajectories. In addition, the subgroups shared 211 differential abundance proteins while many proteins were unique to a subgroup. INTERPRETATION Our data-driven analysis provides insight into the heterogeneity of Kawasaki disease, and supports the existence of distinct subgroups with important implications for clinical management and research design and interpretation. FUNDING US National Institutes of Health and the Irving and Francine Suknow Foundation.
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Affiliation(s)
- Hao Wang
- Kawasaki Disease Research Center, Department of Pediatrics, University of California San Diego, La Jolla, CA, USA
| | - Chisato Shimizu
- Kawasaki Disease Research Center, Department of Pediatrics, University of California San Diego, La Jolla, CA, USA
| | - Emelia Bainto
- Kawasaki Disease Research Center, Department of Pediatrics, University of California San Diego, La Jolla, CA, USA
| | - Shea Hamilton
- Section of Paediatric Infectious Disease, Department of Infectious Disease, Imperial College London, London, UK
| | - Heather R Jackson
- Section of Paediatric Infectious Disease, Department of Infectious Disease, Imperial College London, London, UK
| | - Diego Estrada-Rivadeneyra
- Section of Paediatric Infectious Disease, Department of Infectious Disease, Imperial College London, London, UK
| | - Myrsini Kaforou
- Section of Paediatric Infectious Disease, Department of Infectious Disease, Imperial College London, London, UK
| | - Michael Levin
- Section of Paediatric Infectious Disease, Department of Infectious Disease, Imperial College London, London, UK
| | - Joan M Pancheri
- Kawasaki Disease Research Center, Department of Pediatrics, University of California San Diego, La Jolla, CA, USA; Rady Children's Hospital-San Diego, San Diego, CA, USA
| | - Kirsten B Dummer
- Kawasaki Disease Research Center, Department of Pediatrics, University of California San Diego, La Jolla, CA, USA; Rady Children's Hospital-San Diego, San Diego, CA, USA
| | - Adriana H Tremoulet
- Kawasaki Disease Research Center, Department of Pediatrics, University of California San Diego, La Jolla, CA, USA; Rady Children's Hospital-San Diego, San Diego, CA, USA
| | - Jane C Burns
- Kawasaki Disease Research Center, Department of Pediatrics, University of California San Diego, La Jolla, CA, USA; Rady Children's Hospital-San Diego, San Diego, CA, USA.
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Ho A, Orton R, Tayler R, Asamaphan P, Herder V, Davis C, Tong L, Smollett K, Manali M, Allan J, Rawlik K, McDonald SE, Vink E, Pollock L, Gannon L, Evans C, McMenamin J, Roy K, Marsh K, Divala T, Holden MTG, Lockhart M, Yirrell D, Currie S, O'Leary M, Henderson D, Shepherd SJ, Jackson C, Gunson R, MacLean A, McInnes N, Bradley-Stewart A, Battle R, Hollenbach JA, Henderson P, Odam M, Chikowore P, Oosthuyzen W, Chand M, Hamilton MS, Estrada-Rivadeneyra D, Levin M, Avramidis N, Pairo-Castineira E, Vitart V, Wilkie C, Palmarini M, Ray S, Robertson DL, da Silva Filipe A, Willett BJ, Breuer J, Semple MG, Turner D, Baillie JK, Thomson EC. Adeno-associated virus 2 infection in children with non-A-E hepatitis. Nature 2023; 617:555-563. [PMID: 36996873 DOI: 10.1038/s41586-023-05948-2] [Citation(s) in RCA: 41] [Impact Index Per Article: 41.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2022] [Accepted: 03/10/2023] [Indexed: 04/01/2023]
Abstract
An outbreak of acute hepatitis of unknown aetiology in children was reported in Scotland1 in April 2022 and has now been identified in 35 countries2. Several recent studies have suggested an association with human adenovirus with this outbreak, a virus not commonly associated with hepatitis. Here we report a detailed case-control investigation and find an association between adeno-associated virus 2 (AAV2) infection and host genetics in disease susceptibility. Using next-generation sequencing, PCR with reverse transcription, serology and in situ hybridization, we detected recent infection with AAV2 in plasma and liver samples in 26 out of 32 (81%) cases of hepatitis compared with 5 out of 74 (7%) of samples from unaffected individuals. Furthermore, AAV2 was detected within ballooned hepatocytes alongside a prominent T cell infiltrate in liver biopsy samples. In keeping with a CD4+ T-cell-mediated immune pathology, the human leukocyte antigen (HLA) class II HLA-DRB1*04:01 allele was identified in 25 out of 27 cases (93%) compared with a background frequency of 10 out of 64 (16%; P = 5.49 × 10-12). In summary, we report an outbreak of acute paediatric hepatitis associated with AAV2 infection (most likely acquired as a co-infection with human adenovirus that is usually required as a 'helper virus' to support AAV2 replication) and disease susceptibility related to HLA class II status.
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Affiliation(s)
- Antonia Ho
- Medical Research Council-University of Glasgow Centre for Virus Research, Glasgow, UK
| | - Richard Orton
- Medical Research Council-University of Glasgow Centre for Virus Research, Glasgow, UK
| | - Rachel Tayler
- Department of Paediatrics, Royal Hospital for Children, Glasgow, UK
| | - Patawee Asamaphan
- Medical Research Council-University of Glasgow Centre for Virus Research, Glasgow, UK
| | - Vanessa Herder
- Medical Research Council-University of Glasgow Centre for Virus Research, Glasgow, UK
| | - Chris Davis
- Medical Research Council-University of Glasgow Centre for Virus Research, Glasgow, UK
| | - Lily Tong
- Medical Research Council-University of Glasgow Centre for Virus Research, Glasgow, UK
| | - Katherine Smollett
- Medical Research Council-University of Glasgow Centre for Virus Research, Glasgow, UK
| | - Maria Manali
- Medical Research Council-University of Glasgow Centre for Virus Research, Glasgow, UK
| | - Jay Allan
- Medical Research Council-University of Glasgow Centre for Virus Research, Glasgow, UK
| | - Konrad Rawlik
- Pandemic Science Hub, Centre for Inflammation Research and Roslin Institute, University of Edinburgh, Edinburgh, UK
| | - Sarah E McDonald
- Medical Research Council-University of Glasgow Centre for Virus Research, Glasgow, UK
| | - Elen Vink
- Medical Research Council-University of Glasgow Centre for Virus Research, Glasgow, UK
| | - Louisa Pollock
- Medical Research Council-University of Glasgow Centre for Virus Research, Glasgow, UK
- Department of Paediatrics, Royal Hospital for Children, Glasgow, UK
| | | | - Clair Evans
- Department of Pathology, Queen Elizabeth University Hospital, Glasgow, UK
| | | | | | | | | | | | | | | | | | | | | | | | - Celia Jackson
- West of Scotland Specialist Virology Centre, Glasgow, UK
| | - Rory Gunson
- West of Scotland Specialist Virology Centre, Glasgow, UK
| | | | - Neil McInnes
- West of Scotland Specialist Virology Centre, Glasgow, UK
| | | | - Richard Battle
- Histocompatibility and Immunogenetics (H&I) Laboratory, Scottish National Blood Transfusion Service, Edinburgh Royal Infirmary, Edinburgh, UK
| | - Jill A Hollenbach
- Department of Neurology and Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, CA, USA
| | - Paul Henderson
- Child Life and Health, University of Edinburgh, Edinburgh, UK
| | - Miranda Odam
- Pandemic Science Hub, Centre for Inflammation Research and Roslin Institute, University of Edinburgh, Edinburgh, UK
| | - Primrose Chikowore
- Pandemic Science Hub, Centre for Inflammation Research and Roslin Institute, University of Edinburgh, Edinburgh, UK
| | - Wilna Oosthuyzen
- Pandemic Science Hub, Centre for Inflammation Research and Roslin Institute, University of Edinburgh, Edinburgh, UK
| | | | - Melissa Shea Hamilton
- Section of Paediatric Infectious Disease, Department of Infectious Disease, Imperial College London, London, UK
| | - Diego Estrada-Rivadeneyra
- Section of Paediatric Infectious Disease, Department of Infectious Disease, Imperial College London, London, UK
| | - Michael Levin
- Section of Paediatric Infectious Disease, Department of Infectious Disease, Imperial College London, London, UK
| | - Nikos Avramidis
- Pandemic Science Hub, Centre for Inflammation Research and Roslin Institute, University of Edinburgh, Edinburgh, UK
| | - Erola Pairo-Castineira
- Pandemic Science Hub, Centre for Inflammation Research and Roslin Institute, University of Edinburgh, Edinburgh, UK
| | - Veronique Vitart
- Pandemic Science Hub, Centre for Inflammation Research and Roslin Institute, University of Edinburgh, Edinburgh, UK
- MRC Human Genetics Unit, Institute for Genetics and Cancer, University of Edinburgh, Edinburgh, UK
| | - Craig Wilkie
- School of Mathematics and Statistics, University of Glasgow, Glasgow, UK
| | - Massimo Palmarini
- Medical Research Council-University of Glasgow Centre for Virus Research, Glasgow, UK
| | - Surajit Ray
- School of Mathematics and Statistics, University of Glasgow, Glasgow, UK
| | - David L Robertson
- Medical Research Council-University of Glasgow Centre for Virus Research, Glasgow, UK
| | - Ana da Silva Filipe
- Medical Research Council-University of Glasgow Centre for Virus Research, Glasgow, UK
| | - Brian J Willett
- Medical Research Council-University of Glasgow Centre for Virus Research, Glasgow, UK
| | | | | | - David Turner
- Histocompatibility and Immunogenetics (H&I) Laboratory, Scottish National Blood Transfusion Service, Edinburgh Royal Infirmary, Edinburgh, UK
| | - J Kenneth Baillie
- Pandemic Science Hub, Centre for Inflammation Research and Roslin Institute, University of Edinburgh, Edinburgh, UK
- MRC Human Genetics Unit, Institute for Genetics and Cancer, University of Edinburgh, Edinburgh, UK
| | - Emma C Thomson
- Medical Research Council-University of Glasgow Centre for Virus Research, Glasgow, UK.
- Department of Clinical Research, London School of Hygiene and Tropical Medicine, London, UK.
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Abstract
This poster beautifully illustrates the process and importance of Sanger sequencing. Developed by Diego Estrada-Rivadeneyra, it won one of the three 50th anniversary science communication competition prizes.
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Parker S, Fraczek MG, Wu J, Shamsah S, Manousaki A, Dungrattanalert K, de Almeida RA, Estrada-Rivadeneyra D, Omara W, Delneri D, O'Keefe RT. A resource for functional profiling of noncoding RNA in the yeast Saccharomyces cerevisiae. RNA 2017; 23:1166-1171. [PMID: 28468764 PMCID: PMC5513061 DOI: 10.1261/rna.061564.117] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 03/31/2017] [Accepted: 05/01/2017] [Indexed: 06/07/2023]
Abstract
Eukaryotic genomes are extensively transcribed, generating many different RNAs with no known function. We have constructed 1502 molecular barcoded ncRNA gene deletion strains encompassing 443 ncRNAs in the yeast Saccharomyces cerevisiae as tools for ncRNA functional analysis. This resource includes deletions of small nuclear RNAs (snRNAs), transfer RNAs (tRNAs), small nucleolar RNAs (snoRNAs), and other annotated ncRNAs as well as the more recently identified stable unannotated transcripts (SUTs) and cryptic unstable transcripts (CUTs) whose functions are largely unknown. Specifically, deletions have been constructed for ncRNAs found in the intergenic regions, not overlapping genes or their promoters (i.e., at least 200 bp minimum distance from the closest gene start codon). The deletion strains carry molecular barcodes designed to be complementary with the protein gene deletion collection enabling parallel analysis experiments. These strains will be useful for the numerous genomic and molecular techniques that utilize deletion strains, including genome-wide phenotypic screens under different growth conditions, pooled chemogenomic screens with drugs or chemicals, synthetic genetic array analysis to uncover novel genetic interactions, and synthetic dosage lethality screens to analyze gene dosage. Overall, we created a valuable resource for the RNA community and for future ncRNA research.
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Affiliation(s)
| | | | - Jian Wu
- Division of Molecular and Cellular Function, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester M13 9PT, United Kingdom
| | - Sara Shamsah
- Division of Molecular and Cellular Function, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester M13 9PT, United Kingdom
| | | | | | - Rogerio Alves de Almeida
- Division of Molecular and Cellular Function, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester M13 9PT, United Kingdom
| | - Diego Estrada-Rivadeneyra
- Division of Molecular and Cellular Function, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester M13 9PT, United Kingdom
| | - Walid Omara
- Division of Molecular and Cellular Function, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester M13 9PT, United Kingdom
- Department of Microbiology and Immunology, Faculty of Pharmacy, Minia University, Minya 11432, Egypt
| | | | - Raymond T O'Keefe
- Division of Molecular and Cellular Function, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester M13 9PT, United Kingdom
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Flores-Treviño S, Gutiérrez-Ferman JL, Morfín-Otero R, Rodríguez-Noriega E, Estrada-Rivadeneyra D, Rivas-Morales C, Llaca-Díaz JM, Camacho-Ortíz A, Mendoza-Olazarán S, Garza-González E. Stenotrophomonas maltophilia in Mexico: antimicrobial resistance, biofilm formation and clonal diversity. J Med Microbiol 2014; 63:1524-1530. [PMID: 25165124 DOI: 10.1099/jmm.0.074385-0] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Stenotrophomonas maltophilia is an important multidrug-resistant nosocomial pathogen associated with high mortality. Our aim was to examine antimicrobial susceptibility, biofilm production and clonal relatedness of clinical isolates of S. maltophilia. S. maltophilia isolates were collected between 2006 and 2013 from two tertiary care hospitals in Mexico. Antimicrobial susceptibility was evaluated by the broth microdilution method. PCR was used to determine the presence of β-lactamase genes L1 and L2. Biofilm formation was assessed with crystal violet staining. Clonal relatedness was determined by PFGE. Among the 119 collected S. maltophilia isolates, 73 (61.3%) were from the respiratory tract. Resistance levels exceeded 75% for imipenem, meropenem, ampicillin, aztreonam, gentamicin and tobramycin. Resistance to trimethoprim-sulfamethoxazole was 32.8%. L1 and L2 genes were detected in 77.1% (91/118) and 66.9% (79/118) of isolates, respectively. All S. maltophilia strains were able to produce biofilms. Strains were classified as weak (47.9%, 57/119), moderate (38.7%, 46/119), or strong (13.4%, 16/119) biofilm producers. A total of 89 distinct PFGE types were identified and 21.6% (22/102) of the isolates were distributed in nine clusters. This is the first study in Mexico to reveal characteristics of clinical isolates of S. maltophilia. Clonal diversity data indicate low cross-transmission of S. maltophilia in a hospital setting. The high antibiotic resistance underscores the need for continuous surveillance of S. maltophilia in hospital settings in Mexico.
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Affiliation(s)
- Samantha Flores-Treviño
- Servicio de Gastroenterología, Hospital Universitario Dr José Eleuterio González, Universidad Autónoma de Nuevo León, Av. Francisco I. Madero Pte. S/N y Av. Gonzalitos, Col. Mitras Centro, 64460 Monterrey, Nuevo León, Mexico
| | - Jessica Lizzeth Gutiérrez-Ferman
- Laboratorio de Química Analítica, Facultad de Ciencias Biológicas, Universidad Autónoma de Nuevo León, México, Pedro de Alba SN, Col. Ciudad Universitaria, 66450 San Nicolás de los Garza, Nuevo León, Mexico
| | - Rayo Morfín-Otero
- Hospital Civil de Guadalajara, Fray Antonio Alcalde y el Instituto de Patología Infecciosa y Experimental, Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Sierra Mojada 950, Col. Independencia, 44350 Guadalajara, Jalisco, Mexico
| | - Eduardo Rodríguez-Noriega
- Hospital Civil de Guadalajara, Fray Antonio Alcalde y el Instituto de Patología Infecciosa y Experimental, Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Sierra Mojada 950, Col. Independencia, 44350 Guadalajara, Jalisco, Mexico
| | - Diego Estrada-Rivadeneyra
- Hospital Civil de Guadalajara, Fray Antonio Alcalde y el Instituto de Patología Infecciosa y Experimental, Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Sierra Mojada 950, Col. Independencia, 44350 Guadalajara, Jalisco, Mexico
| | - Catalina Rivas-Morales
- Laboratorio de Química Analítica, Facultad de Ciencias Biológicas, Universidad Autónoma de Nuevo León, México, Pedro de Alba SN, Col. Ciudad Universitaria, 66450 San Nicolás de los Garza, Nuevo León, Mexico
| | - Jorge M Llaca-Díaz
- Departamento de Patología Clínica, Hospital Universitario Dr José Eleuterio González, Universidad Autónoma de Nuevo León, Av. Francisco I. Madero Pte. S/N y José E. González, Col. Mitras Centro, CP 64460 Monterrey, Nuevo León, Mexico
| | - Adrián Camacho-Ortíz
- Servicio de Infectología, Hospital Universitario Dr José Eleuterio González, Universidad Autónoma de Nuevo León, Av. Francisco I. Madero Pte. S/N y José E. González, Col. Mitras Centro, CP 64460 Monterrey, Nuevo León, Mexico
| | - Soraya Mendoza-Olazarán
- Servicio de Gastroenterología, Hospital Universitario Dr José Eleuterio González, Universidad Autónoma de Nuevo León, Av. Francisco I. Madero Pte. S/N y Av. Gonzalitos, Col. Mitras Centro, 64460 Monterrey, Nuevo León, Mexico
| | - Elvira Garza-González
- Departamento de Patología Clínica, Hospital Universitario Dr José Eleuterio González, Universidad Autónoma de Nuevo León, Av. Francisco I. Madero Pte. S/N y José E. González, Col. Mitras Centro, CP 64460 Monterrey, Nuevo León, Mexico.,Servicio de Gastroenterología, Hospital Universitario Dr José Eleuterio González, Universidad Autónoma de Nuevo León, Av. Francisco I. Madero Pte. S/N y Av. Gonzalitos, Col. Mitras Centro, 64460 Monterrey, Nuevo León, Mexico
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