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Andrup L, Krogfelt KA, Stephansen L, Hansen KS, Graversen BK, Wolkoff P, Madsen AM. Reduction of acute respiratory infections in day-care by non-pharmaceutical interventions: a narrative review. Front Public Health 2024; 12:1332078. [PMID: 38420031 PMCID: PMC10899481 DOI: 10.3389/fpubh.2024.1332078] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2023] [Accepted: 02/02/2024] [Indexed: 03/02/2024] Open
Abstract
Objective Children who start in day-care have 2-4 times as many respiratory infections compared to children who are cared for at home, and day-care staff are among the employees with the highest absenteeism. The extensive new knowledge that has been generated in the COVID-19 era should be used in the prevention measures we prioritize. The purpose of this narrative review is to answer the questions: Which respiratory viruses are the most significant in day-care centers and similar indoor environments? What do we know about the transmission route of these viruses? What evidence is there for the effectiveness of different non-pharmaceutical prevention measures? Design Literature searches with different terms related to respiratory infections in humans, mitigation strategies, viral transmission mechanisms, and with special focus on day-care, kindergarten or child nurseries, were conducted in PubMed database and Web of Science. Searches with each of the main viruses in combination with transmission, infectivity, and infectious spread were conducted separately supplemented through the references of articles that were retrieved. Results Five viruses were found to be responsible for ≈95% of respiratory infections: rhinovirus, (RV), influenza virus (IV), respiratory syncytial virus (RSV), coronavirus (CoV), and adenovirus (AdV). Novel research, emerged during the COVID-19 pandemic, suggests that most respiratory viruses are primarily transmitted in an airborne manner carried by aerosols (microdroplets). Conclusion Since airborne transmission is dominant for the most common respiratory viruses, the most important preventive measures consist of better indoor air quality that reduces viral concentrations and viability by appropriate ventilation strategies. Furthermore, control of the relative humidity and temperature, which ensures optimal respiratory functionality and, together with low resident density (or mask use) and increased time outdoors, can reduce the occurrence of respiratory infections.
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Affiliation(s)
- Lars Andrup
- The National Research Centre for the Working Environment, Copenhagen, Denmark
| | - Karen A Krogfelt
- Department of Science and Environment, Molecular and Medical Biology, PandemiX Center, Roskilde University, Roskilde, Denmark
| | - Lene Stephansen
- Gladsaxe Municipality, Social and Health Department, Gladsaxe, Denmark
| | | | | | - Peder Wolkoff
- The National Research Centre for the Working Environment, Copenhagen, Denmark
| | - Anne Mette Madsen
- The National Research Centre for the Working Environment, Copenhagen, Denmark
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Doranga S, Krogfelt KA, Cohen PS, Conway T. Nutrition of Escherichia coli within the intestinal microbiome. EcoSal Plus 2024:eesp00062023. [PMID: 38417452 DOI: 10.1128/ecosalplus.esp-0006-2023] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Accepted: 11/03/2023] [Indexed: 03/01/2024]
Abstract
In this chapter, we update our 2004 review of "The Life of Commensal Escherichia coli in the Mammalian Intestine" (https://doi.org/10.1128/ecosalplus.8.3.1.2), with a change of title that reflects the current focus on "Nutrition of E. coli within the Intestinal Microbiome." The earlier part of the previous two decades saw incremental improvements in understanding the carbon and energy sources that E. coli and Salmonella use to support intestinal colonization. Along with these investigations of electron donors came a better understanding of the electron acceptors that support the respiration of these facultative anaerobes in the gastrointestinal tract. Hundreds of recent papers add to what was known about the nutrition of commensal and pathogenic enteric bacteria. The fact that each biotype or pathotype grows on a different subset of the available nutrients suggested a mechanism for succession of commensal colonizers and invasion by enteric pathogens. Competition for nutrients in the intestine has also come to be recognized as one basis for colonization resistance, in which colonized strain(s) prevent colonization by a challenger. In the past decade, detailed investigations of fiber- and mucin-degrading anaerobes added greatly to our understanding of how complex polysaccharides support the hundreds of intestinal microbiome species. It is now clear that facultative anaerobes, which usually cannot degrade complex polysaccharides, live in symbiosis with the anaerobic degraders. This concept led to the "restaurant hypothesis," which emphasizes that facultative bacteria, such as E. coli, colonize the intestine as members of mixed biofilms and obtain the sugars they need for growth locally through cross-feeding from polysaccharide-degrading anaerobes. Each restaurant represents an intestinal niche. Competition for those niches determines whether or not invaders are able to overcome colonization resistance and become established. Topics centered on the nutritional basis of intestinal colonization and gastrointestinal health are explored here in detail.
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Affiliation(s)
- Sudhir Doranga
- Department of Microbiology and Molecular Genetics, Oklahoma State University, Stillwater, Oklahoma, USA
| | - Karen A Krogfelt
- Department of Science and Environment, Pandemix Center Roskilde University, Roskilde, Denmark
| | - Paul S Cohen
- Department of Cell and Molecular Biology, University of Rhode Island, Kingston, Rhode Island, USA
| | - Tyrrell Conway
- Department of Microbiology and Molecular Genetics, Oklahoma State University, Stillwater, Oklahoma, USA
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Dion MB, Shah SA, Deng L, Thorsen J, Stokholm J, Krogfelt KA, Schjørring S, Horvath P, Allard A, Nielsen DS, Petit MA, Moineau S. Escherichia coli CRISPR arrays from early life fecal samples preferentially target prophages. ISME J 2024; 18:wrae005. [PMID: 38366192 PMCID: PMC10910852 DOI: 10.1093/ismejo/wrae005] [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] [Subscribe] [Scholar Register] [Received: 12/26/2023] [Revised: 01/09/2024] [Accepted: 01/10/2024] [Indexed: 02/18/2024]
Abstract
CRISPR-Cas systems are defense mechanisms against phages and other nucleic acids that invade bacteria and archaea. In Escherichia coli, it is generally accepted that CRISPR-Cas systems are inactive in laboratory conditions due to a transcriptional repressor. In natural isolates, it has been shown that CRISPR arrays remain stable over the years and that most spacer targets (protospacers) remain unknown. Here, we re-examine CRISPR arrays in natural E. coli isolates and investigate viral and bacterial genomes for spacer targets using a bioinformatics approach coupled to a unique biological dataset. We first sequenced the CRISPR1 array of 1769 E. coli isolates from the fecal samples of 639 children obtained during their first year of life. We built a network with edges between isolates that reflect the number of shared spacers. The isolates grouped into 34 modules. A search for matching spacers in bacterial genomes showed that E. coli spacers almost exclusively target prophages. While we found instances of self-targeting spacers, those involving a prophage and a spacer within the same bacterial genome were rare. The extensive search for matching spacers also expanded the library of known E. coli protospacers to 60%. Altogether, these results favor the concept that E. coli's CRISPR-Cas is an antiprophage system and highlight the importance of reconsidering the criteria use to deem CRISPR-Cas systems active.
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Affiliation(s)
- Moïra B Dion
- Département de biochimie, de microbiologie, et de bio-informatique, Faculté des sciences et de génie, Université Laval, Québec, QC G1V 0A6, Canada
- Groupe de recherche en écologie buccale, Faculté de médecine dentaire, Université Laval, Québec, QC G1V 0A6, Canada
| | - Shiraz A Shah
- Copenhagen Prospective Studies on Asthma in Childhood, Herlev and Gentofte Hospital, University of Copenhagen, Ledreborg Alle 34, 2820 Gentofte, Denmark
| | - Ling Deng
- Food Science, University of Copenhagen, Rolighedsvej 26, 1958 Frederiksberg, Denmark
| | - Jonathan Thorsen
- Copenhagen Prospective Studies on Asthma in Childhood, Herlev and Gentofte Hospital, University of Copenhagen, Ledreborg Alle 34, 2820 Gentofte, Denmark
- Novo Nordisk Foundation Center for Basic Metabolic Research, Faculty of Health and Medical Sciences, University of Copenhagen, Blegdamsvej 3B, 2200 Copenhagen, Denmark
| | - Jakob Stokholm
- Copenhagen Prospective Studies on Asthma in Childhood, Herlev and Gentofte Hospital, University of Copenhagen, Ledreborg Alle 34, 2820 Gentofte, Denmark
- Food Science, University of Copenhagen, Rolighedsvej 26, 1958 Frederiksberg, Denmark
| | - Karen A Krogfelt
- Department of Bacteria, Parasites and Fungi, Statens Serum Institut, Artillerivej 5, 2300S Copenhagen, Denmark
- Department of Science and Environment, Roskilde University, Universitetsvej 1, 4000 Roskilde, Denmark
| | - Susanne Schjørring
- Department of Bacteria, Parasites and Fungi, Statens Serum Institut, Artillerivej 5, 2300S Copenhagen, Denmark
| | - Philippe Horvath
- IFF Danisco, Health & Biosciences, Dangé-Saint-Romain 86220, France
| | - Antoine Allard
- Département de physique, de génie physique et d’optique, Université Laval, Québec, QC G1V 0A6, Canada
- Centre interdisciplinaire en modélisation mathématique, Université Laval, Québec, QC G1V 0A6, Canada
| | - Dennis S Nielsen
- Food Science, University of Copenhagen, Rolighedsvej 26, 1958 Frederiksberg, Denmark
| | - Marie-Agnès Petit
- Université Paris-Saclay, INRAE, AgroParisTech, Institut Micalis, Jouy-en-Josas 78350, France
| | - Sylvain Moineau
- Département de biochimie, de microbiologie, et de bio-informatique, Faculté des sciences et de génie, Université Laval, Québec, QC G1V 0A6, Canada
- Groupe de recherche en écologie buccale, Faculté de médecine dentaire, Université Laval, Québec, QC G1V 0A6, Canada
- Félix d’Hérelle Reference Center for Bacterial Viruses, Faculté de médecine dentaire, Université Laval, Québec, QC G1V 0A6, Canada
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Andrup L, Krogfelt KA, Hansen KS, Madsen AM. Transmission route of rhinovirus - the causative agent for common cold. A systematic review. Am J Infect Control 2023; 51:938-957. [PMID: 36535318 DOI: 10.1016/j.ajic.2022.12.005] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2022] [Revised: 12/09/2022] [Accepted: 12/09/2022] [Indexed: 12/23/2022]
Abstract
BACKGROUND Human rhinoviruses (RVs) are the most common cause of acute respiratory tract illness and upper respiratory tract infections, traditionally defined as 'common colds'. Experimental transmission of RV has been studied for more than 50 years. However, there are divergent results as to whether hands and fomites or aerosols constitute the dominant route of transmission in natural settings. METHODS We have systematically reviewed the literature according to the PRISMA 2020 statement. Searches were run in PubMed and Web of Science until August 2022. Inclusion criteria were original studies of relevance for revealing the route of transmission of rhinovirus in humans. RESULTS The search yielded 663 results, and 25 studies met the inclusion criteria and were selected for this review. These articles addressing RV transmission routes were assigned to 1 of 3 groups: (1) indirect transmission by fomites and hands, (2) direct transmission via large aerosols (droplets) or small aerosols, or (3) transmission either direct via large aerosols (droplets) or small aerosols and fomite or hands. CONCLUSIONS We found low evidence, that transmission via hands and fomite followed by self-inoculation is the dominant transmission route in real-life indoor settings. We found moderate evidence, that airborne transmission either via large aerosols or small aerosols is the major transmission route of rhinovirus transmission in real-life indoor settings. This suggests that the major transmission route of RVs in many indoor settings is through the air (airborne transmission).
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Affiliation(s)
- Lars Andrup
- The National Research Centre for the Working Environment, Copenhagen, Denmark.
| | - Karen A Krogfelt
- Department of Science and Environment, Molecular and Medical Biology, PandemiX Center Roskilde University, Roskilde, Denmark
| | | | - Anne Mette Madsen
- The National Research Centre for the Working Environment, Copenhagen, Denmark
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5
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Munkstrup C, Krogfelt KA, Greisen G, Juhl SM. Feeding tube practices and the colonisation of the preterm stomach in the first week of life. Dan Med J 2022; 69:A06210494. [PMID: 35959833] [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] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
INTRODUCTION We aimed to determine if changing nasogastric feeding tubes more often would impact colonisation of the upper gastrointestinal tract of the premature infant. METHODS We included 22 neonates born less-than 32 weeks gestation within 48 hours after birth. The neonates were randomised to have their feeding tubes changed on day seven or daily during the first week of life. We determined the bacterial concentration by the culture method in maternal milk samples, gastric aspirates and feeding tube flushes. Bacteria were identified by matrix-assisted laser desorption/ionization time-of-flight (MALDI-TOF). The primary outcome was the concentration of bacteria in the gastric aspirate from a freshly placed nasogastric tube on day seven of life. RESULTS Data from only 11 neonates were eligible for primary outcome analysis. We found no difference in bacterial concentration between the two groups with a mean colony-forming unit count per ml aspirate of 4.62 log10 (standard deviation (SD): ± 3.43) in the intervention group and 2.76 log10 (SD: ± 3.13) in the control group. Data from 19 neonates were eligible for analysis of secondary outcome measures. We found no statistically significant differences in the composition of the bacterial load between the two groups. Infants with a lower gastric pH had lower gastric bacterial counts. CONCLUSION Changing the feeding tube daily rather than weekly in the first week of life did not result in reduced bacterial concentration in gastric aspirates. The bacterial load from the feeding tubes was low suggesting that contamination of feeding tubes did not affect early colonisation of the upper gastrointestinal tract. FUNDING none. TRIAL REGISTRATION ClinicalTrials identification number NCT02830503.
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Affiliation(s)
| | - Karen A Krogfelt
- Department of Bacteria, Parasites and Fungi, Statens Serum Institut
- Department of Science and Environment, Molecular and Medical Biology, Roskilde University, Denmark
| | - Gorm Greisen
- Department of Neonatology, Copenhagen University Hospital - Rigshospitalet
| | - Sandra M Juhl
- Department of Neonatology, Copenhagen University Hospital - Rigshospitalet
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Vavougios GD, Zarogiannis SG, Hadjigeorgiou G, Krogfelt KA, Gourgoulianis KI. SARS-CoV-2 and type I interferon signaling in brain endothelial cells: Blurring the lines between friend or foe. Stem Cell Reports 2022; 17:1012-1013. [PMID: 35545022 PMCID: PMC9087889 DOI: 10.1016/j.stemcr.2022.04.011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Affiliation(s)
- George D Vavougios
- Department of Neurology, Faculty of Medicine, University of Cyprus, 75 Kallipoleos Street, 1678, Lefkosia, Cyprus; Department of Respiratory Medicine, Faculty of Medicine, University of Thessaly, Biopolis, 41500, Larissa, Greece.
| | - Sotirios G Zarogiannis
- Department of Physiology, Faculty of Medicine, School of Health Sciences, University of Thessaly, Biopolis, 41500, Larissa, Greece
| | - Georgios Hadjigeorgiou
- Department of Neurology, Faculty of Medicine, University of Cyprus, 75 Kallipoleos Street, 1678, Lefkosia, Cyprus
| | - Karen A Krogfelt
- Department of Molecular and Medical Biology, Centre for Mathematical Modeling - Human Health and Disease, PandemiX Center, Universitetsvej 1, 28A.1, 4000 Roskilde, Denmark
| | - Konstantinos I Gourgoulianis
- Department of Respiratory Medicine, Faculty of Medicine, University of Thessaly, Biopolis, 41500, Larissa, Greece
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7
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Vavougios GD, Mavridis T, Artemiadis A, Krogfelt KA, Hadjigeorgiou G. Trained immunity in viral infections, Alzheimer's disease and multiple sclerosis: A convergence in type I interferon signalling and IFNβ-1a. Biochim Biophys Acta Mol Basis Dis 2022; 1868:166430. [DOI: 10.1016/j.bbadis.2022.166430] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Revised: 05/02/2022] [Accepted: 05/02/2022] [Indexed: 12/14/2022]
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Nasrin S, Hegerle N, Sen S, Nkeze J, Sen S, Permala-Booth J, Choi M, Sinclair J, Tapia MD, Johnson JK, Sow SO, Thaden JT, Fowler VG, Krogfelt KA, Brauner A, Protonotariou E, Christaki E, Shindo Y, Kwa AL, Shakoor S, Singh-Moodley A, Perovic O, Jacobs J, Lunguya O, Simon R, Cross AS, Tennant SM. Distribution of serotypes and antibiotic resistance of invasive Pseudomonas aeruginosa in a multi-country collection. BMC Microbiol 2022; 22:13. [PMID: 34991476 PMCID: PMC8732956 DOI: 10.1186/s12866-021-02427-4] [Citation(s) in RCA: 21] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2021] [Accepted: 12/06/2021] [Indexed: 12/22/2022] Open
Abstract
Background Pseudomonas aeruginosa is an opportunistic pathogen that causes a wide range of acute and chronic infections and is frequently associated with healthcare-associated infections. Because of its ability to rapidly acquire resistance to antibiotics, P. aeruginosa infections are difficult to treat. Alternative strategies, such as a vaccine, are needed to prevent infections. We collected a total of 413 P. aeruginosa isolates from the blood and cerebrospinal fluid of patients from 10 countries located on 4 continents during 2005–2017 and characterized these isolates to inform vaccine development efforts. We determined the diversity and distribution of O antigen and flagellin types and antibiotic susceptibility of the invasive P. aeruginosa. We used an antibody-based agglutination assay and PCR for O antigen typing and PCR for flagellin typing. We determined antibiotic susceptibility using the Kirby-Bauer disk diffusion method. Results Of the 413 isolates, 314 (95%) were typed by an antibody-based agglutination assay or PCR (n = 99). Among the 20 serotypes of P. aeruginosa, the most common serotypes were O1, O2, O3, O4, O5, O6, O8, O9, O10 and O11; a vaccine that targets these 10 serotypes would confer protection against more than 80% of invasive P. aeruginosa infections. The most common flagellin type among 386 isolates was FlaB (41%). Resistance to aztreonam (56%) was most common, followed by levofloxacin (42%). We also found that 22% of strains were non-susceptible to meropenem and piperacillin-tazobactam. Ninety-nine (27%) of our collected isolates were resistant to multiple antibiotics. Isolates with FlaA2 flagellin were more commonly multidrug resistant (p = 0.04). Conclusions Vaccines targeting common O antigens and two flagellin antigens, FlaB and FlaA2, would offer an excellent strategy to prevent P. aeruginosa invasive infections. Supplementary Information The online version contains supplementary material available at 10.1186/s12866-021-02427-4.
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Affiliation(s)
- Shamima Nasrin
- Center for Vaccine Development and Global Health, University of Maryland School of Medicine, 685 W. Baltimore St. - HSF1 Room 480, Baltimore, MD, 21201, USA.,Department of Medicine, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Nicolas Hegerle
- Center for Vaccine Development and Global Health, University of Maryland School of Medicine, 685 W. Baltimore St. - HSF1 Room 480, Baltimore, MD, 21201, USA.,Department of Medicine, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Shaichi Sen
- Center for Vaccine Development and Global Health, University of Maryland School of Medicine, 685 W. Baltimore St. - HSF1 Room 480, Baltimore, MD, 21201, USA.,Department of Medicine, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Joseph Nkeze
- Center for Vaccine Development and Global Health, University of Maryland School of Medicine, 685 W. Baltimore St. - HSF1 Room 480, Baltimore, MD, 21201, USA.,Department of Medicine, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Sunil Sen
- Center for Vaccine Development and Global Health, University of Maryland School of Medicine, 685 W. Baltimore St. - HSF1 Room 480, Baltimore, MD, 21201, USA.,Department of Medicine, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Jasnehta Permala-Booth
- Center for Vaccine Development and Global Health, University of Maryland School of Medicine, 685 W. Baltimore St. - HSF1 Room 480, Baltimore, MD, 21201, USA.,Department of Medicine, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Myeongjin Choi
- Center for Vaccine Development and Global Health, University of Maryland School of Medicine, 685 W. Baltimore St. - HSF1 Room 480, Baltimore, MD, 21201, USA.,Department of Medicine, University of Maryland School of Medicine, Baltimore, MD, USA
| | - James Sinclair
- Center for Vaccine Development and Global Health, University of Maryland School of Medicine, 685 W. Baltimore St. - HSF1 Room 480, Baltimore, MD, 21201, USA.,Department of Medicine, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Milagritos D Tapia
- Center for Vaccine Development and Global Health, University of Maryland School of Medicine, 685 W. Baltimore St. - HSF1 Room 480, Baltimore, MD, 21201, USA.,Department of Pediatrics, University of Maryland School of Medicine, Baltimore, MD, USA
| | - J Kristie Johnson
- Department of Pathology, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Samba O Sow
- Centre pour le Développement des Vaccins, Mali, Bamako, Mali
| | - Joshua T Thaden
- Division of Infectious Diseases, Duke University Medical Center, Durham, NC, USA
| | - Vance G Fowler
- Division of Infectious Diseases and International Health, Department of Medicine, Duke University School of Medicine, Durham, NC, USA.,Duke Clinical Research Institute, Durham, NC, USA
| | - Karen A Krogfelt
- Statens Serum Institut, Copenhagen, Denmark.,Department of Natural Sciences and Environment, Roskilde University, Roskilde, Denmark
| | - Annelie Brauner
- Department of Microbiology, Tumor and Cell Biology, Division of Clinical Microbiology, Karolinska Institutet and Karolinska University Hospital, 17176, Stockholm, Sweden
| | | | - Eirini Christaki
- Department of Medicine, AHEPA University Hospital, Thessaloniki, Greece.,University of Cyprus Medical School, Nicosia, Cyprus
| | - Yuichiro Shindo
- Department of Respiratory Medicine, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Andrea L Kwa
- Department of Pharmacy, Singapore General Hospital, Singapore, Singapore.,Emerging Infectious Diseases, Duke-National University of Singapore Medical School, Singapore, Singapore.,Department of Pharmacy, Faculty of Science, National University of Singapore, Singapore, Singapore
| | - Sadia Shakoor
- Departments of Pathology and Pediatrics, Aga Khan University, Karachi, Pakistan
| | - Ashika Singh-Moodley
- National Institute for Communicable Diseases a Division of the National Health Laboratory Service, and School of Pathology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Olga Perovic
- National Institute for Communicable Diseases a Division of the National Health Laboratory Service, and School of Pathology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Jan Jacobs
- Department of Clinical Sciences, Institute of Tropical Medicine, Antwerp, Belgium.,Department of Microbiology, Immunology and Transplantation, KU Leuven, Leuven, Belgium
| | - Octavie Lunguya
- Department of Clinical Microbiology, National Institute for Biomedical Research, Kinshasa, Democratic Republic of the Congo.,Department of Microbiology, University Hospital of Kinshasa, Kinshasa, Democratic Republic of the Congo
| | - Raphael Simon
- Center for Vaccine Development and Global Health, University of Maryland School of Medicine, 685 W. Baltimore St. - HSF1 Room 480, Baltimore, MD, 21201, USA.,Department of Medicine, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Alan S Cross
- Center for Vaccine Development and Global Health, University of Maryland School of Medicine, 685 W. Baltimore St. - HSF1 Room 480, Baltimore, MD, 21201, USA.,Department of Medicine, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Sharon M Tennant
- Center for Vaccine Development and Global Health, University of Maryland School of Medicine, 685 W. Baltimore St. - HSF1 Room 480, Baltimore, MD, 21201, USA. .,Department of Medicine, University of Maryland School of Medicine, Baltimore, MD, USA.
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Vavougios GD, Zarogiannis S, Barh D, Breza M, Krogfelt KA, Stamoulis G, Gourgoulianis KI. Innate immunity and metal ion trafficking pathway perturbations in idiopathic Parkinson's disease and Tuberculosis: A comparative transcriptomics approach. Brain Disorders 2021. [DOI: 10.1016/j.dscb.2021.100025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
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Eliassen KE, Ocias LF, Krogfelt KA, Wilhelmsson P, Dudman SG, Andreassen Å, Lindbak M, Lindgren PE. Tick-transmitted co-infections among erythema migrans patients in a general practice setting in Norway: a clinical and laboratory follow-up study. BMC Infect Dis 2021; 21:1044. [PMID: 34625049 PMCID: PMC8501555 DOI: 10.1186/s12879-021-06755-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2021] [Accepted: 09/23/2021] [Indexed: 11/14/2022] Open
Abstract
Background Erythema migrans (EM) is the most common manifestation of Lyme borreliosis. Here, we examined EM patients in Norwegian general practice to find the proportion exposed to tick-transmitted microorganisms other than Borrelia, and the impact of co-infection on the clinical manifestations and disease duration. Methods Skin biopsies from 139/188 EM patients were analyzed using PCR for Neoehrlichia mikurensis, Rickettsia spp., Anaplasma phagocytophilum and Babesia spp. Follow-up sera from 135/188 patients were analyzed for spotted fever group (SFG) Rickettsia, A. phagocytophilum and Babesia microti antibodies, and tested with PCR if positive. Day 0 sera from patients with fever (8/188) or EM duration of ≥ 21 days (69/188) were analyzed, using PCR, for A. phagocytophilum, Rickettsia spp., Babesia spp. and N. mikurensis. Day 14 sera were tested for TBEV IgG. Results We detected no microorganisms in the skin biopsies nor in the sera of patients with fever or prolonged EM duration. Serological signs of exposure against SFG Rickettsia and A. phagocytophilum were detected in 11/135 and 8/135, respectively. Three patients exhibited both SFG Rickettsia and A. phagocytophilum antibodies, albeit negative PCR. No antibodies were detected against B. microti. 2/187 had TBEV antibodies without prior immunization. There was no significant increase in clinical symptoms or disease duration in patients with possible co-infection. Conclusions Co-infection with N. mikurensis, A. phagocytophilum, SFG Rickettsia, Babesia spp. and TBEV is uncommon in Norwegian EM patients. Despite detecting antibodies against SFG Rickettsia and A. phagocytophilum in some patients, no clinical implications could be demonstrated.
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Affiliation(s)
- Knut Eirik Eliassen
- Department of Global Public Health and Primary Care, University of Bergen, PO Box 7804, 5020, Bergen, Norway.
| | - Lukas Frans Ocias
- Department of Virus and Microbiological Special Diagnostics, Statens Serum Institut, Artillerivej 5, 2100, Copenhagen, Denmark.,Department of Clinical Microbiology, Karlstad Hospital, Region Värmland, 65230, Karlstad, Sweden
| | - Karen A Krogfelt
- Department of Virus and Microbiological Special Diagnostics, Statens Serum Institut, Artillerivej 5, 2100, Copenhagen, Denmark.,Department of Science and Environment, Roskilde University, Universitetsvej 1, 4000, Roskilde, Denmark
| | - Peter Wilhelmsson
- Division of Inflammation and Infection, Department of Biomedical and Clinical Sciences, Linköping University, 58185, Linköping, Sweden.,Department of Clinical Microbiology, Laboratory Medicine, County Hospital Ryhov, 55185, Jönköping, Sweden
| | - Susanne Gjeruldsen Dudman
- Institute of Clinical Medicine, University of Oslo, 0316, Oslo, Norway.,Department of Microbiology, Oslo University Hospital Rikshospitalet, 0424, Oslo, Norway
| | - Åshild Andreassen
- Department of Virology and Infection Immunology, Norwegian Institute of Public Health, 0213, Oslo, Norway.,Faculty of Technology, Natural Sciences and Maritime Technology-INMH, University of South-Eastern Norway-Campus Bø, 3800, Bø, Norway
| | - Morten Lindbak
- Antibiotic Centre for Primary Care, Department of General Practice, Institute of Health and Society, University of Oslo, 0316, Oslo, Norway
| | - Per-Eric Lindgren
- Division of Inflammation and Infection, Department of Biomedical and Clinical Sciences, Linköping University, 58185, Linköping, Sweden.,Department of Clinical Microbiology, Laboratory Medicine, County Hospital Ryhov, 55185, Jönköping, Sweden
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11
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Haahr R, Tetens MM, Dessau RB, Krogfelt KA, Bodilsen J, Andersen NS, Møller JK, Roed C, Christiansen CB, Ellermann-Eriksen S, Bangsborg JM, Hansen K, Benfield TL, Andersen CØ, Obel N, Lebech AM, Omland LH. Risk of Neurological Disorders in Patients With European Lyme Neuroborreliosis: A Nationwide, Population-Based Cohort Study. Clin Infect Dis 2021; 71:1511-1516. [PMID: 31598647 DOI: 10.1093/cid/ciz997] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2019] [Accepted: 10/04/2019] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Lyme neuroborreliosis (LNB), caused by the tick-borne spirochetes of the Borrelia burgdorferi sensu lato species complex, has been suggested to be associated with a range of neurological disorders. In a nationwide, population-based cohort study, we examined the associations between LNB and dementia, Alzheimer's disease, Parkinson's disease, motor neuron disease, epilepsy, and Guillain-Barré syndrome. METHODS We used national registers to identify all Danish residents diagnosed during 1986-2016 with LNB (n = 2067), created a gender- and age-matched comparison cohort from the general population (n = 20 670), and calculated risk estimates and hazard ratios. RESULTS We observed no long-term increased risks of dementia, Alzheimer's disease, Parkinson's disease, motor neuron diseases, or epilepsy. However, within the first year, 8 (0.4%) of the LNB patients developed epilepsy, compared with 20 (0.1%) of the comparison cohort (difference, 0.3%; 95% confidence interval, .02-.6%). In the LNB group, 11 (0.5%) patients were diagnosed with Guillain-Barré syndrome within the first year after LNB diagnosis, compared with 0 (0.0%) in the comparison cohort. After the first year, the risk of Guillain-Barré was not increased. CONCLUSIONS LNB patients did not have increased long-term risks of dementia, Alzheimer's disease, Parkinson's disease, motor neuron diseases, epilepsy, or Guillain-Barré. Although the absolute risk is low, LNB patients might have an increased short-term risk of epilepsy and Guillain-Barré syndrome.
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Affiliation(s)
- Rasmus Haahr
- Department of Infectious Diseases, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
| | - Malte M Tetens
- Department of Infectious Diseases, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
| | - Ram B Dessau
- Department of Clinical Microbiology, Slagelse Hospital, Slagelse, Denmark
| | - Karen A Krogfelt
- Department of Virus and Microbiological Special Diagnostics, Statens Serum Institut, Copenhagen, Denmark.,Department of Natural Sciences and Environment, Roskilde University, Roskilde, Denmark
| | - Jacob Bodilsen
- Departments of Clinical Microbiology, Aalborg University Hospital, Aalborg, Denmark.,Departments of Infectious Diseases, Aalborg University Hospital, Aalborg, Denmark
| | - Nanna S Andersen
- Clinical Centre for Emerging and Vector-Borne Infections, Odense University Hospital, Odense, Denmark
| | - Jens K Møller
- Department of Clinical Microbiology, Vejle Hospital, Vejle, Denmark
| | - Casper Roed
- Department of Infectious Diseases, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
| | - Claus B Christiansen
- Department of Clinical Microbiology, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
| | | | - Jette M Bangsborg
- Department of Clinical Microbiology, Herlev University Hospital, Copenhagen, Denmark
| | - Klaus Hansen
- Department of Neurology, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
| | - Thomas L Benfield
- Department of Infectious Diseases, Hvidovre University Hospital, Copenhagen, Denmark.,Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Christian Ø Andersen
- Department of Clinical Microbiology, Hvidovre University Hospital, Copenhagen, Denmark
| | - Niels Obel
- Department of Infectious Diseases, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark.,Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Anne-Mette Lebech
- Department of Infectious Diseases, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark.,Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Lars H Omland
- Department of Infectious Diseases, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
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12
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Abstract
Since the outbreak of COVID-19, the world has raced to understand and accurately diagnose infection caused by SARS-CoV-2. Today, hundreds of commercial antibody tests are on the market despite often lacking proper validation and with unsatisfactory sensitivity and/or specificity. In addition, many questions related to the humoral response remain unresolved, although research is carried out at an unprecedented speed. Despite the shortcomings, serological assays have an important part to play in combating the pandemic by aiding in diagnosis and sero-epidemiological studies. However, careful attention must be paid to the application of serology and the interpretation of serological data—especially in low prevalence regions, both at an individual and at a population level. In this article, we argue that serological results are often misinterpreted, and in the eagerness to be first, methodological rigor is often taking a backseat.
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Affiliation(s)
- Sofie Føns
- Roskilde University, Department of Science and Environment, Universitetsvej 1, Roskilde, Denmark
| | - Karen A Krogfelt
- Roskilde University, Department of Science and Environment, Universitetsvej 1, Roskilde, Denmark
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13
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Tetens MM, Haahr R, Dessau RB, Krogfelt KA, Bodilsen J, Andersen NS, Møller JK, Roed C, Christiansen CB, Ellermann-Eriksen S, Bangsborg JM, Hansen K, Andersen CØ, Lebech AM, Obel N, Omland LH. Assessment of the Risk of Psychiatric Disorders, Use of Psychiatric Hospitals, and Receipt of Psychiatric Medication Among Patients With Lyme Neuroborreliosis in Denmark. JAMA Psychiatry 2021; 78:177-186. [PMID: 33026438 PMCID: PMC7542530 DOI: 10.1001/jamapsychiatry.2020.2915] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
IMPORTANCE The association of Lyme neuroborreliosis with the development of psychiatric disease is unknown and remains a subject of debate. OBJECTIVE To investigate the risk of psychiatric disease, the percentage of psychiatric hospital inpatient and outpatient contacts, and the receipt of prescribed psychiatric medications among patients with Lyme neuroborreliosis compared with individuals in a matched comparison cohort. DESIGN, SETTING, AND PARTICIPANTS This nationwide population-based matched cohort study included all residents of Denmark who received a positive result on an intrathecal antibody index test for Borrelia burgdorferi (patient cohort) between January 1, 1995, and December 31, 2015. Patients were matched by age and sex to a comparison cohort of individuals without Lyme neuroborreliosis from the general population of Denmark. Data were analyzed from February 2019 to March 2020. EXPOSURES Diagnosis of Lyme neuroborreliosis, defined as a positive result on an intrathecal antibody index test for B burgdorferi. MAIN OUTCOMES AND MEASURES The 0- to 15-year hazard ratios for the assignment of psychiatric diagnostic codes, the difference in the percentage of psychiatric inpatient and outpatient hospital contacts, and the difference in the percentage of prescribed psychiatric medications received among the patient cohort vs the comparison cohort. RESULTS Among 2897 patients with Lyme neuroborreliosis (1646 men [56.8%]) and 28 970 individuals in the matched comparison cohort (16 460 men [56.8%]), the median age was 45.7 years (interquartile range [IQR], 11.5-62.0 years) for both groups. The risk of a psychiatric disease diagnosis and the percentage of hospital contacts for psychiatric disease were not higher among patients with Lyme neuroborreliosis compared with individuals in the comparison cohort. A higher percentage of patients with Lyme neuroborreliosis compared with individuals in the comparison cohort received anxiolytic (7.2% vs 4.7%; difference, 2.6%; 95% CI, 1.6%-3.5%), hypnotic and sedative (11.0% vs 5.3%; difference, 5.7%; 95% CI, 4.5%-6.8%), and antidepressant (11.4% vs 6.0%; difference, 5.4%; 95% CI, 4.3%-6.6%) medications within the first year after diagnosis, after which the receipt of psychiatric medication returned to the same level as the comparison cohort. CONCLUSIONS AND RELEVANCE In this population-based matched cohort study, patients with Lyme neuroborreliosis did not have an increased risk of developing psychiatric diseases that required hospital care or treatment with prescription medication. The increased receipt of psychiatric medication among patients with Lyme neuroborreliosis within the first year after diagnosis, but not thereafter, suggests that most symptoms associated with the diagnosis subside within a short period.
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Affiliation(s)
- Malte M. Tetens
- Department of Infectious Diseases, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
| | - Rasmus Haahr
- Department of Infectious Diseases, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
| | - Ram B. Dessau
- Department of Clinical Microbiology, Slagelse Hospital, Slagelse, Denmark
| | - Karen A. Krogfelt
- Department of Virus and Microbiological Special Diagnostics, Statens Serum Institut, Copenhagen, Denmark,Department of Natural Sciences and Environment, Roskilde University, Roskilde, Denmark
| | - Jacob Bodilsen
- Department of Clinical Microbiology, Aalborg University Hospital, Aalborg, Denmark,Department of Infectious Diseases, Aalborg University Hospital, Aalborg, Denmark
| | - Nanna S. Andersen
- Clinical Centre for Emerging and Vector-borne Infections, Odense University Hospital, Odense, Denmark
| | - Jens K. Møller
- Department of Clinical Microbiology, Vejle Hospital, Vejle, Denmark
| | - Casper Roed
- Department of Infectious Diseases, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
| | - Claus B. Christiansen
- Department of Clinical Microbiology, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
| | | | - Jette M. Bangsborg
- Department of Clinical Microbiology, Herlev University Hospital, Copenhagen, Denmark
| | - Klaus Hansen
- Department of Neurology, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
| | - Christian Ø. Andersen
- Department of Clinical Microbiology, Hvidovre University Hospital, Copenhagen, Denmark
| | - Anne-Mette Lebech
- Department of Infectious Diseases, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark,Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Niels Obel
- Department of Infectious Diseases, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark,Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Lars H. Omland
- Department of Infectious Diseases, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
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14
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Ahluwalia TS, Eliasen AU, Sevelsted A, Pedersen CET, Stokholm J, Chawes B, Bork-Jensen J, Grarup N, Pedersen O, Hansen T, Linneberg A, Sharma A, Weiss ST, Evans MD, Jackson DJ, Morin A, Krogfelt KA, Schjørring S, Mortensen PB, Hougaard DM, Bybjerg-Grauholm J, Bækvad-Hansen M, Mors O, Nordentoft M, Børglum AD, Werge T, Agerbo E, Gern JE, Lemanske RF, Ober C, Pedersen AG, Bisgaard H, Bønnelykke K. FUT2-ABO epistasis increases the risk of early childhood asthma and Streptococcus pneumoniae respiratory illnesses. Nat Commun 2020; 11:6398. [PMID: 33328473 PMCID: PMC7744576 DOI: 10.1038/s41467-020-19814-6] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2019] [Accepted: 10/29/2020] [Indexed: 12/17/2022] Open
Abstract
Asthma with severe exacerbation is the most common cause of hospitalization among young children. We aim to increase the understanding of this clinically important disease entity through a genome-wide association study. The discovery analysis comprises 2866 children experiencing severe asthma exacerbation between ages 2 and 6 years, and 65,415 non-asthmatic controls, and we replicate findings in 918 children from the Copenhagen Prospective Studies on Asthma in Childhood (COPSAC) birth cohorts. We identify rs281379 near FUT2/MAMSTR on chromosome 19 as a novel risk locus (OR = 1.18 (95% CI = 1.11-1.25), Pdiscovery = 2.6 × 10-9) as well as a biologically plausible interaction between functional variants in FUT2 and ABO. We further discover and replicate a potential causal mechanism behind this interaction related to S. pneumoniae respiratory illnesses. These results suggest a novel mechanism of early childhood asthma and demonstrates the importance of phenotype-specificity for discovery of asthma genes and epistasis.
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Affiliation(s)
- Tarunveer S Ahluwalia
- COPSAC, Copenhagen Prospective Studies on Asthma in Childhood, Herlev and Gentofte Hospital, University of Copenhagen, Copenhagen, Denmark
- Steno Diabetes Center Copenhagen, Gentofte, Denmark
- Department of Biology, The Bioinformatics Center, University of Copenhagen, Copenhagen, Denmark
| | - Anders U Eliasen
- COPSAC, Copenhagen Prospective Studies on Asthma in Childhood, Herlev and Gentofte Hospital, University of Copenhagen, Copenhagen, Denmark
- Section for Bioinformatics, Department of Health Technology, Technical University of Denmark, Copenhagen, Denmark
| | - Astrid Sevelsted
- COPSAC, Copenhagen Prospective Studies on Asthma in Childhood, Herlev and Gentofte Hospital, University of Copenhagen, Copenhagen, Denmark
| | - Casper-Emil T Pedersen
- COPSAC, Copenhagen Prospective Studies on Asthma in Childhood, Herlev and Gentofte Hospital, University of Copenhagen, Copenhagen, Denmark
| | - Jakob Stokholm
- COPSAC, Copenhagen Prospective Studies on Asthma in Childhood, Herlev and Gentofte Hospital, University of Copenhagen, Copenhagen, Denmark
| | - Bo Chawes
- COPSAC, Copenhagen Prospective Studies on Asthma in Childhood, Herlev and Gentofte Hospital, University of Copenhagen, Copenhagen, Denmark
| | - Jette Bork-Jensen
- Novo Nordisk Foundation Center for Basic Metabolic Research, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Niels Grarup
- Novo Nordisk Foundation Center for Basic Metabolic Research, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Oluf Pedersen
- Novo Nordisk Foundation Center for Basic Metabolic Research, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Torben Hansen
- Novo Nordisk Foundation Center for Basic Metabolic Research, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Allan Linneberg
- Center for Clinical Research and Disease Prevention, Bispebjerg and Frederiksberg Hospital, The Capital Region, Copenhagen, Denmark
- Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Amitabh Sharma
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Scott T Weiss
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Michael D Evans
- Clinical and Translational Science Institute, University of Minnesota, Minneapolis, MN, USA
| | - Daniel J Jackson
- Department of Pediatrics, University of Wisconsin, Madison, WI, USA
| | - Andreanne Morin
- Department of Human Genetics, University of Chicago, Chicago, IL, USA
| | - Karen A Krogfelt
- Department of Bacteria, Parasites and Fungi, Statens Serum Institut, Copenhagen, Denmark
- Department of Science and Environment, Roskilde University, Roskilde, Denmark
| | - Susanne Schjørring
- Department of Bacteria, Parasites and Fungi, Statens Serum Institut, Copenhagen, Denmark
| | - Preben B Mortensen
- iPSYCH, The Lundbeck Foundation Initiative for Integrated Psychiatric Research, Copenhagen, Denmark
- NCRR, The National Center for Register-based research, Business and Social Sciences, Aarhus University, Aarhus C, Denmark
- CIRRAU-Center for Integrated Register-Based Research at Aarhus University, Aarhus C, Denmark
| | - David M Hougaard
- iPSYCH, The Lundbeck Foundation Initiative for Integrated Psychiatric Research, Copenhagen, Denmark
- Department for Congenital Disorders, Statens Serum Institut, Copenhagen, Denmark
- Den Neonatale Screenings Biobank, SSI, Copenhagen, Denmark
| | - Jonas Bybjerg-Grauholm
- iPSYCH, The Lundbeck Foundation Initiative for Integrated Psychiatric Research, Copenhagen, Denmark
- Department for Congenital Disorders, Statens Serum Institut, Copenhagen, Denmark
- Den Neonatale Screenings Biobank, SSI, Copenhagen, Denmark
| | - Marie Bækvad-Hansen
- iPSYCH, The Lundbeck Foundation Initiative for Integrated Psychiatric Research, Copenhagen, Denmark
- Department for Congenital Disorders, Statens Serum Institut, Copenhagen, Denmark
- Den Neonatale Screenings Biobank, SSI, Copenhagen, Denmark
| | - Ole Mors
- iPSYCH, The Lundbeck Foundation Initiative for Integrated Psychiatric Research, Copenhagen, Denmark
- Psychosis Research Unit, Aarhus University Hospital-Psychiatry, Risskov, Denmark
| | - Merete Nordentoft
- iPSYCH, The Lundbeck Foundation Initiative for Integrated Psychiatric Research, Copenhagen, Denmark
- Mental Health Center Copenhagen, Capital Region of Denmark, Copenhagen University Hospital, Copenhagen, Denmark
| | - Anders D Børglum
- iPSYCH, The Lundbeck Foundation Initiative for Integrated Psychiatric Research, Copenhagen, Denmark
- Department of Biomedicine and iSEQ, Center for Integrative Sequencing, Aarhus University, Aarhus C, Denmark
- Center for Genomics and Personalized Medicine, Central Region Denmark, Aarhus C, Denmark
| | - Thomas Werge
- iPSYCH, The Lundbeck Foundation Initiative for Integrated Psychiatric Research, Copenhagen, Denmark
- Mental Health Center Copenhagen, Capital Region of Denmark, Copenhagen University Hospital, Copenhagen, Denmark
- Institute of Biological Psychiatry, Copenhagen Mental Health Services, Copenhagen, Denmark
- Center for GeoGenetics, GLOBE Institute, University of Copenhagen, Copenhagen, Denmark
| | - Esben Agerbo
- iPSYCH, The Lundbeck Foundation Initiative for Integrated Psychiatric Research, Copenhagen, Denmark
- NCRR, The National Center for Register-based research, Business and Social Sciences, Aarhus University, Aarhus C, Denmark
- CIRRAU-Center for Integrated Register-Based Research at Aarhus University, Aarhus C, Denmark
| | - James E Gern
- Department of Pediatrics, University of Wisconsin, Madison, WI, USA
| | | | - Carole Ober
- Department of Human Genetics, University of Chicago, Chicago, IL, USA
| | - Anders G Pedersen
- Section for Bioinformatics, Department of Health Technology, Technical University of Denmark, Copenhagen, Denmark
| | - Hans Bisgaard
- COPSAC, Copenhagen Prospective Studies on Asthma in Childhood, Herlev and Gentofte Hospital, University of Copenhagen, Copenhagen, Denmark
| | - Klaus Bønnelykke
- COPSAC, Copenhagen Prospective Studies on Asthma in Childhood, Herlev and Gentofte Hospital, University of Copenhagen, Copenhagen, Denmark.
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15
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Tetens MM, Haahr R, Dessau RB, Krogfelt KA, Bodilsen J, Andersen NS, Møller JK, Roed C, Christiansen CB, Ellermann-Eriksen S, Bangsborg JM, Hansen K, Benfield TL, Andersen CØ, Obel N, Omland LH, Lebech AM. Changes in Lyme neuroborreliosis incidence in Denmark, 1996 to 2015. Ticks Tick Borne Dis 2020; 11:101549. [PMID: 32993955 DOI: 10.1016/j.ttbdis.2020.101549] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2020] [Revised: 07/31/2020] [Accepted: 08/17/2020] [Indexed: 12/18/2022]
Abstract
Lyme neuroborreliosis (LNB) has recently been added to the list of diseases under the European Union epidemiological surveillance in order to obtain updated information on incidence. The goal of this study was to identify temporal (yearly) variation, high risk geographical regions and risk groups, and seasonal variation for LNB in Denmark. This cohort-study investigated Danish patients (n = 2791) diagnosed with LNB (defined as a positive Borrelia burgdorferi sensu lato (s.l.) intrathecal antibody test) between 1996-2015. We calculated incidence and incidence ratios of LNB by comparing 4-yr groups of calendar-years, area of residency, sex and age, income and education groups, and the number of new LNB cases per month. The incidence of LNB was 2.2 per 100,000 individuals and year in 1996-1999, 2.7 in 2004-2007 and 1.1 per 100,000 individuals in 2012-2015. Yearly variations in LNB incidence were similar for most calendar-year groups. LNB incidence was highest in Eastern Denmark and among males and individuals who were 0-14 yrs old, who had a yearly income of >449,000 DKK, and who had a Master's degree or higher education. The number of LNB cases was highest from July to November (p < 0.001). In conclusion, based on Danish nationwide data of patients with positive B. burgdorferi s.l. intrathecal antibody index (1996-2015) the incidence of LNB was found to increase until 2004-2007 but thereafter to decline. European surveillance studies of Lyme borreliosis should be encouraged to monitor the incidence trend.
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Affiliation(s)
- Malte M Tetens
- Department of Infectious Diseases, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark.
| | - Rasmus Haahr
- Department of Infectious Diseases, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
| | - Ram B Dessau
- Department of Clinical Microbiology, Slagelse Hospital, Slagelse, Denmark
| | - Karen A Krogfelt
- Department of Virus and Microbiological Special Diagnostics, Statens Serum Institut, Denmark; Department of Natural Sciences and Environment, Roskilde University, Denmark
| | - Jacob Bodilsen
- Departments of Clinical Microbiology, Aalborg University Hospital, Aalborg, Denmark; Departments of and Infectious Diseases, Aalborg University Hospital, Aalborg, Denmark
| | - Nanna S Andersen
- Clinical Centre for Emerging and Vector-borne Infections, Odense University Hospital, Odense, Denmark
| | - Jens K Møller
- Department of Clinical Microbiology, Vejle Hospital, Vejle, Denmark
| | - Casper Roed
- Department of Infectious Diseases, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
| | - Claus B Christiansen
- Department of Clinical Microbiology, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
| | | | - Jette M Bangsborg
- Department of Clinical Microbiology, Herlev University Hospital, Copenhagen, Denmark
| | - Klaus Hansen
- Department of Neurology, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
| | - Thomas L Benfield
- Department of Infectious Diseases, Hvidovre University Hospital, Copenhagen, Denmark; Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | | | - Niels Obel
- Department of Infectious Diseases, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark; Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Lars H Omland
- Department of Infectious Diseases, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
| | - Anne-Mette Lebech
- Department of Infectious Diseases, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark; Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
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16
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Vavougios GD, Zarogiannis SG, Krogfelt KA, Stamoulis G, Gourgoulianis KI. Epigenetic regulation of apoptosis via the PARK7 interactome in peripheral blood mononuclear cells donated by tuberculosis patients vs. healthy controls and the response to treatment: A systems biology approach. Tuberculosis (Edinb) 2020; 123:101938. [PMID: 32741527 DOI: 10.1016/j.tube.2020.101938] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2019] [Revised: 03/22/2020] [Accepted: 04/14/2020] [Indexed: 12/22/2022]
Abstract
AIMS The aims of our study were to determine for the first time differentially expressed genes (DEGs) and enriched molecular pathways involving the PARK7 interactome in PBMCs donated from tuberculosis patients. METHODS Data on a previously reconstructed PARK7 interactome (Vavougios et al., 2017) from datasets GDS4966 (Case-Control) and GDS4781 (Treatment Series) were retrieved from the Gene Expression Omnibus (GEO) repository. Gene Enrichment analysis was performed via the STRING algorithm and the GeneTrail2 software. RESULTS 17 and 22 PARK7 interactores were determined as DEGs in the active TB vs HD and Treatment Series subset analyses, correspondingly, associated with significantly enriched pathways (FDR <0.05) involving p53 and PTEN mediated, stress responsive apoptosis regulation pathways. The treatment subset was characterized by the emergence of an additional layer of transcriptional regulation mediated by polycomb proteins among others, as well as TLR-mediated and cytokine survival signaling. Finally, the enrichment of a Parkinson's disease signature including PARK7 interactors was determined by its differential regulation both in the exploratory analyses (FDR = 0.024), as well as the confirmatory analyses (FDR = 1.81e-243). CONCLUSIONS Our in silico analysis revealed for the first time the role of PARK7's interactome in regulating the epigenetics of the PBMC lifecycle and Mtb symbiosis.
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Affiliation(s)
- George D Vavougios
- Department of Neurology, Athens Naval Hospital, Deinokratous 70, 115 21, Athens, Greece; Department of Electrical and Computer Engineering, 37 Glavani - 28th October Street, Deligiorgi Building, 4th floor, 382 21, Volos, Greece.
| | - Sotirios G Zarogiannis
- Department of Pleural Physiology, Faculty of Medicine, University of Thessaly, BIOPOLIS, Mezourlo, 41500, Larisa, Greece
| | - Karen A Krogfelt
- Department of Science and Environment, Molecular and Medical Biology, Roskilde University, Universitetsvej 1, 28A.1, DK-4000, Roskilde, Denmark
| | - George Stamoulis
- Department of Electrical and Computer Engineering, 37 Glavani - 28th October Street, Deligiorgi Building, 4th floor, 382 21, Volos, Greece
| | - Konstantinos I Gourgoulianis
- Department of Respiratory Medicine, Faculty of Medicine, University of Thessaly, BIOPOLIS, Mezourlo, 41110, Larisa, Greece
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17
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Alpízar-Alpízar W, Skindersoe ME, Rasmussen L, Kriegbaum MC, Christensen IJ, Lund IK, Illemann M, Laerum OD, Krogfelt KA, Andersen LP, Ploug M. Helicobacter pylori Colonization Drives Urokinase Receptor (uPAR) Expression in Murine Gastric Epithelium During Early Pathogenesis. Microorganisms 2020; 8:microorganisms8071019. [PMID: 32660136 PMCID: PMC7409347 DOI: 10.3390/microorganisms8071019] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2020] [Revised: 07/04/2020] [Accepted: 07/07/2020] [Indexed: 12/16/2022] Open
Abstract
(1) Background: Persistent Helicobacter pylori infection is the most important risk factor for gastric cancer. The urokinase receptor (uPAR) is upregulated in lesions harboring cancer invasion and inflammation. Circumstantial evidence tends to correlate H. pylori colonization with increased uPAR expression in the human gastric epithelium, but a direct causative link has not yet been established in vivo; (2) Methods: In a mouse model of H. pylori-induced gastritis, we investigated the temporal emergence of uPAR protein expression in the gastric mucosa in response to H. pylori (SS1 strain) infection; (3) Results: We observed intense uPAR immunoreactivity in foveolar epithelial cells of the gastric corpus due to de novo synthesis, compared to non-infected animals. This uPAR induction represents a very early response, but it increases progressively over time as do infiltrating immune cells. Eradication of H. pylori infection by antimicrobial therapy causes a regression of uPAR expression to its physiological baseline levels. Suppression of the inflammatory response by prostaglandin E2 treatment attenuates uPAR expression. Notwithstanding this relationship, H. pylori does induce uPAR expression in vitro in co-cultures with gastric cancer cell lines; (4) Conclusions: We showed that persistent H. pylori colonization is a necessary event for the emergence of a relatively high uPAR protein expression in murine gastric epithelial cells.
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Affiliation(s)
- Warner Alpízar-Alpízar
- The Finsen Laboratory, Rigshospitalet, 2100 Copenhagen, Denmark; (M.C.K.); (I.J.C); (I.K.L.); (M.I.); (O.D.L.)
- Biotech Research and Innovation Centre (BRIC), University of Copenhagen, 2100 Copenhagen, Denmark
- Centre for Research on Microscopic Structures (CIEMic) and Department of Biochemistry, University of Costa Rica, 2060 San José, Costa Rica
- Correspondence: (W.A.-A.); (M.P.)
| | - Mette E. Skindersoe
- Department of Bacteria, Parasites and Fungi, Statens Serum Institute, 2300 Copenhagen, Denmark; (M.E.S.); (K.A.K.)
- Bacthera, Kogle Allé 6, 2970 Hoersholm, Denmark
| | - Lone Rasmussen
- Department of Clinical Microbiology, Rigshospitalet, 2100 Copenhagen, Denmark; (L.P.A.); (L.R.)
| | - Mette C. Kriegbaum
- The Finsen Laboratory, Rigshospitalet, 2100 Copenhagen, Denmark; (M.C.K.); (I.J.C); (I.K.L.); (M.I.); (O.D.L.)
- Biotech Research and Innovation Centre (BRIC), University of Copenhagen, 2100 Copenhagen, Denmark
| | - Ib J. Christensen
- The Finsen Laboratory, Rigshospitalet, 2100 Copenhagen, Denmark; (M.C.K.); (I.J.C); (I.K.L.); (M.I.); (O.D.L.)
- Biotech Research and Innovation Centre (BRIC), University of Copenhagen, 2100 Copenhagen, Denmark
- Hvidovre Hospital, University of Copenhagen, 2650 Copenhagen, Denmark
| | - Ida K. Lund
- The Finsen Laboratory, Rigshospitalet, 2100 Copenhagen, Denmark; (M.C.K.); (I.J.C); (I.K.L.); (M.I.); (O.D.L.)
- Biotech Research and Innovation Centre (BRIC), University of Copenhagen, 2100 Copenhagen, Denmark
| | - Martin Illemann
- The Finsen Laboratory, Rigshospitalet, 2100 Copenhagen, Denmark; (M.C.K.); (I.J.C); (I.K.L.); (M.I.); (O.D.L.)
- Biotech Research and Innovation Centre (BRIC), University of Copenhagen, 2100 Copenhagen, Denmark
| | - Ole D. Laerum
- The Finsen Laboratory, Rigshospitalet, 2100 Copenhagen, Denmark; (M.C.K.); (I.J.C); (I.K.L.); (M.I.); (O.D.L.)
- Biotech Research and Innovation Centre (BRIC), University of Copenhagen, 2100 Copenhagen, Denmark
| | - Karen A. Krogfelt
- Department of Bacteria, Parasites and Fungi, Statens Serum Institute, 2300 Copenhagen, Denmark; (M.E.S.); (K.A.K.)
- Department of Science and Environment, Roskilde University, 4000 Roskilde, Denmark
- Department of Virus and microbiological Diagnostics, Statens Serum Institute, 2300 Copenhagen, Denmark
| | - Leif P. Andersen
- Department of Clinical Microbiology, Rigshospitalet, 2100 Copenhagen, Denmark; (L.P.A.); (L.R.)
| | - Michael Ploug
- The Finsen Laboratory, Rigshospitalet, 2100 Copenhagen, Denmark; (M.C.K.); (I.J.C); (I.K.L.); (M.I.); (O.D.L.)
- Biotech Research and Innovation Centre (BRIC), University of Copenhagen, 2100 Copenhagen, Denmark
- Correspondence: (W.A.-A.); (M.P.)
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18
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Schjørring S, Jepsen MT, Sørensen CA, Valentiner-Branth P, Kantsø B, Petersen RF, Skovgaard O, Krogfelt KA. Laboratory Diagnostics of Rickettsia Infections in Denmark 2008-2015. Biology (Basel) 2020; 9:biology9060133. [PMID: 32575502 PMCID: PMC7345066 DOI: 10.3390/biology9060133] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/19/2020] [Revised: 06/10/2020] [Accepted: 06/15/2020] [Indexed: 11/30/2022]
Abstract
Rickettsiosis is a vector-borne disease caused by bacterial species in the genus Rickettsia. Ticks in Scandinavia are reported to be infected with Rickettsia, yet only a few Scandinavian human cases are described, and rickettsiosis is poorly understood. The aim of this study was to determine the prevalence of rickettsiosis in Denmark based on laboratory findings. We found that in the Danish individuals who tested positive for Rickettsia by serology, the majority (86%; 484/561) of the infections belonged to the spotted fever group. In contrast, we could confirm 13 of 41 (32%) PCR-positive individuals by sequencing and identified all of these as R. africae, indicating infections after travel exposure. These 13 samples were collected from wound/skin material. In Denmark, approximately 85 individuals test positive for Rickettsia spp. annually, giving an estimated 26% (561/2147) annual prevalence among those suspected of rickettsiosis after tick bites. However, without clinical data and a history of travel exposure, a true estimation of rickettsiosis acquired endemically by tick bites cannot be made. Therefore, we recommend that both clinical data and specific travel exposure be included in a surveillance system of Rickettsia infections.
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Affiliation(s)
- Susanne Schjørring
- Department of Bacteria, Parasites and Fungi, Statens Serum Institut (SSI), 2300 Copenhagen, Denmark; (S.S.); (M.T.J.); (R.F.P.)
- European Program for Public Health Microbiology Training (EUPHEM), European Centre for Disease Prevention and Control (ECDC), 27180 Solnar, Sweden
| | - Martin Tugwell Jepsen
- Department of Bacteria, Parasites and Fungi, Statens Serum Institut (SSI), 2300 Copenhagen, Denmark; (S.S.); (M.T.J.); (R.F.P.)
- Scandtick Innovation, Project Group, InterReg, 551 11 Jönköping, Sweden;
| | - Camilla Adler Sørensen
- Scandtick Innovation, Project Group, InterReg, 551 11 Jönköping, Sweden;
- Virus and Microbiological Special Diagnostics, Statens Serum Institut (SSI), 2300 Copenhagen, Denmark;
| | - Palle Valentiner-Branth
- Department of Infectious Disease Epidemiology and Prevention, Statens Serum Institut (SSI), 2300 Copenhagen, Denmark;
| | - Bjørn Kantsø
- Virus and Microbiological Special Diagnostics, Statens Serum Institut (SSI), 2300 Copenhagen, Denmark;
| | - Randi Føns Petersen
- Department of Bacteria, Parasites and Fungi, Statens Serum Institut (SSI), 2300 Copenhagen, Denmark; (S.S.); (M.T.J.); (R.F.P.)
- Virus and Microbiological Special Diagnostics, Statens Serum Institut (SSI), 2300 Copenhagen, Denmark;
| | - Ole Skovgaard
- Department of Science and Environment, Roskilde University, 4000 Roskilde, Denmark
- Correspondence: (O.S.); (K.A.K.)
| | - Karen A. Krogfelt
- Department of Bacteria, Parasites and Fungi, Statens Serum Institut (SSI), 2300 Copenhagen, Denmark; (S.S.); (M.T.J.); (R.F.P.)
- Scandtick Innovation, Project Group, InterReg, 551 11 Jönköping, Sweden;
- Virus and Microbiological Special Diagnostics, Statens Serum Institut (SSI), 2300 Copenhagen, Denmark;
- Department of Science and Environment, Roskilde University, 4000 Roskilde, Denmark
- Correspondence: (O.S.); (K.A.K.)
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19
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Abstract
Tick-borne diseases are emerging and re-emerging threats causing public health concerns in Europe and North America. Prevention and control requires understanding of human exposure and behaviour. The aim was to measure exposure to tick bites across Scandinavia, its spatial distribution and the associated risk factors. Methods We sent a web-based survey to a randomly chosen population and analysed answers by Principal Component Analysis and Chi-Square. Individual responses were aggregated at the municipality level to assess the spatial distribution of bites. Results Nearly 60% of adults reported bites at low levels (1-5 bites); however, the majority were not in their resident municipality. We found two spatial profiles: In their home municipalities, people were most often bitten in less, but not the least, urbanized areas. When visiting other municipalities, people were most frequently bitten in peri-urban areas. Running/walking in the forest, gardening, and paddling/rowing were activities most strongly associated with bites. Conclusion Tick bites affect the entire Scandinavian population, with a higher risk in Sweden compared to Denmark and Norway. The frequency of observation of ticks in the environment or on pets might be used as a proxy for the actual risk of exposure to tick bites. Our results indicates that urban-dwelling outdoor enthusiasts and inhabitants of rural areas must be equally targeted for prevention campaigns.
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Affiliation(s)
- Solveig Jore
- Department of Infection Prevention & Preparedness, Norwegian Public Health Institute, Oslo, Norway
| | - Sophie O Vanwambeke
- Georges Lemaître Centre for Earth and Climate Research, Earth & Life Institute, Louvain-la-Neuve, Belgium
| | - Daniel Slunge
- Center for Sustainable Development, GMV, University of Gothenburg, Gothenburg, Sweden
| | - Anders Boman
- Department of Economics, University of Gothenburg, Gothenburg, Sweden
| | - Karen A Krogfelt
- Department of Virus and Microbiological Diagnostics, Statens Serum Institut, Copenhagen, Denmark.,Dept of Science and Environment, Roskilde University, Roskilde, Denmark
| | - Martin Tugwell Jepsen
- Department of Virus and Microbiological Diagnostics, Statens Serum Institut, Copenhagen, Denmark
| | - Line Vold
- Department of Infection Prevention & Preparedness, Norwegian Public Health Institute, Oslo, Norway
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20
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Wilhelmsson P, Lövmar M, Krogfelt KA, Nielsen HV, Forsberg P, Lindgren PE. Clinical/serological outcome in humans bitten by Babesia species positive Ixodes ricinus ticks in Sweden and on the Åland Islands. Ticks Tick Borne Dis 2020; 11:101455. [PMID: 32386909 DOI: 10.1016/j.ttbdis.2020.101455] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2018] [Revised: 04/16/2020] [Accepted: 04/20/2020] [Indexed: 11/25/2022]
Abstract
The risk of contracting babesiosis after a tick bite in Sweden and on the Åland Islands, Finland, is unknown. We investigated clinical and serological outcomes in people bitten by Ixodes ricinus ticks positive for Babesia species. Ticks, blood and questionnaires were obtained from study participants in Sweden and on the Åland Islands. Sixty-five of 2098 (3.1 %) ticks were positive by real-time PCR. Three Babesia species were detected, Babesia microti (n = 33), B. venatorum (n = 27) and B. capreoli (n = 5), the latter species not known to cause human infection. Half (46 %) of the Babesia PCR-positive ticks also contained Borrelia spp. Fifty-three participants bitten by a Babesia PCR-positive tick and a control group bitten by a Babesia PCR-negative tick were tested for B. microti IgG antibodies by IFA. The overall seroprevalence was 4.4 %, but there was no significant difference between the groups. None of the participants seroconverted and no participant with a Babesia PCR-positive tick sought medical care or reported symptoms suggestive of babesiosis. Given the prevalence of Babesia in I. ricinus ticks in southern Sweden and on the Åland Islands, babesiosis should be considered a possible diagnosis in symptomatic residents who seek medical care following tick exposure.
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Affiliation(s)
- P Wilhelmsson
- Division of Inflammation and Infection, Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden; Department of Clinical Microbiology, Region Jönköping County, Jönköping, Sweden.
| | - M Lövmar
- Division of Inflammation and Infection, Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden.
| | - K A Krogfelt
- Department of Bacteria Parasites and Fungi, Statens Serum Institute, Copenhagen, Denmark; Department of Science and Environmental, Roskilde University, Denmark.
| | - H V Nielsen
- Department of Bacteria Parasites and Fungi, Statens Serum Institute, Copenhagen, Denmark.
| | - P Forsberg
- Division of Infectious Diseases, Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden.
| | - P E Lindgren
- Division of Inflammation and Infection, Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden; Department of Clinical Microbiology, Region Jönköping County, Jönköping, Sweden.
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21
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Mathieu A, Dion M, Deng L, Tremblay D, Moncaut E, Shah SA, Stokholm J, Krogfelt KA, Schjørring S, Bisgaard H, Nielsen DS, Moineau S, Petit MA. Virulent coliphages in 1-year-old children fecal samples are fewer, but more infectious than temperate coliphages. Nat Commun 2020; 11:378. [PMID: 31953385 PMCID: PMC6969025 DOI: 10.1038/s41467-019-14042-z] [Citation(s) in RCA: 44] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2019] [Accepted: 12/10/2019] [Indexed: 01/08/2023] Open
Abstract
Bacteriophages constitute an important part of the human gut microbiota, but their impact on this community is largely unknown. Here, we cultivate temperate phages produced by 900 E. coli strains isolated from 648 fecal samples from 1-year-old children and obtain coliphages directly from the viral fraction of the same fecal samples. We find that 63% of strains hosted phages, while 24% of the viromes contain phages targeting E. coli. 150 of these phages, half recovered from strain supernatants, half from virome (73% temperate and 27% virulent) were tested for their host range on 75 E. coli strains isolated from the same cohort. Temperate phages barely infected the gut strains, whereas virulent phages killed up to 68% of them. We conclude that in fecal samples from children, temperate coliphages dominate, while virulent ones have greater infectivity and broader host range, likely playing a role in gut microbiota dynamics. The impact of bacteriophages in the human gut microbiome remains poorly understood. Here, the authors characterize coliphages isolated from a large cohort of 1-year-old infants and show that temperate coliphages dominate, while virulent ones have greater infectivity and broader host range.
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Affiliation(s)
- Aurélie Mathieu
- Université Paris-Saclay, INRAE, AgroParisTech, Micalis Institute, 78350, Jouy-en-Josas, France
| | - Moïra Dion
- Département de biochimie, de microbiologie, et de bio-informatique, Faculté des sciences et de génie, Université Laval, Québec City, QC, G1V 0A6, Canada.,Groupe de recherche en écologie buccale, Faculté de médecine dentaire, Université Laval, Québec City, QC, G1V 0A6, Canada
| | - Ling Deng
- Department of Food Science, University of Copenhagen, Copenhagen, Denmark
| | - Denise Tremblay
- Groupe de recherche en écologie buccale, Faculté de médecine dentaire, Université Laval, Québec City, QC, G1V 0A6, Canada.,Félix d'Hérelle Reference Center for Bacterial Viruses, Faculté de médecine dentaire, Université Laval, Québec City, QC, G1V 0A6, Canada
| | - Elisabeth Moncaut
- Université Paris-Saclay, INRAE, AgroParisTech, Micalis Institute, 78350, Jouy-en-Josas, France
| | - Shiraz A Shah
- Copenhagen Prospective Studies on Asthma in Childhood, Copenhagen University Hospital, Herlev-Gentofte, Ledreborg Allé 34, DK-2820, Gentofte, Denmark
| | - Jakob Stokholm
- Copenhagen Prospective Studies on Asthma in Childhood, Copenhagen University Hospital, Herlev-Gentofte, Ledreborg Allé 34, DK-2820, Gentofte, Denmark
| | - Karen A Krogfelt
- Department of Bacteria, Parasites and Fungi, Statens Serum Institut, Artillerivej5, 2300S, Copenhagen, Denmark
| | - Susanne Schjørring
- Department of Bacteria, Parasites and Fungi, Statens Serum Institut, Artillerivej5, 2300S, Copenhagen, Denmark
| | - Hans Bisgaard
- Copenhagen Prospective Studies on Asthma in Childhood, Copenhagen University Hospital, Herlev-Gentofte, Ledreborg Allé 34, DK-2820, Gentofte, Denmark
| | - Dennis S Nielsen
- Department of Food Science, University of Copenhagen, Copenhagen, Denmark
| | - Sylvain Moineau
- Département de biochimie, de microbiologie, et de bio-informatique, Faculté des sciences et de génie, Université Laval, Québec City, QC, G1V 0A6, Canada.,Groupe de recherche en écologie buccale, Faculté de médecine dentaire, Université Laval, Québec City, QC, G1V 0A6, Canada.,Félix d'Hérelle Reference Center for Bacterial Viruses, Faculté de médecine dentaire, Université Laval, Québec City, QC, G1V 0A6, Canada
| | - Marie-Agnès Petit
- Université Paris-Saclay, INRAE, AgroParisTech, Micalis Institute, 78350, Jouy-en-Josas, France.
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22
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Vester-Andersen MK, Mirsepasi-Lauridsen HC, Prosberg MV, Mortensen CO, Träger C, Skovsen K, Thorkilgaard T, Nøjgaard C, Vind I, Krogfelt KA, Sørensen N, Bendtsen F, Petersen AM. Increased abundance of proteobacteria in aggressive Crohn's disease seven years after diagnosis. Sci Rep 2019; 9:13473. [PMID: 31530835 PMCID: PMC6748953 DOI: 10.1038/s41598-019-49833-3] [Citation(s) in RCA: 79] [Impact Index Per Article: 15.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2019] [Accepted: 08/23/2019] [Indexed: 02/07/2023] Open
Abstract
Intestinal dysbiosis in inflammatory bowel disease (IBD) patients depend on disease activity. We aimed to characterize the microbiota after 7 years of follow-up in an unselected cohort of IBD patients according to disease activity and disease severity. Fifty eight Crohn’s disease (CD) and 82 ulcerative colitis (UC) patients were included. Disease activity was assessed by the Harvey-Bradshaw Index for CD and Simple Clinical Colitis Activity Index for UC. Microbiota diversity was assessed by 16S rDNA MiSeq sequencing. In UC patients with active disease and in CD patients with aggressive disease the richness (number of OTUs, p = 0.018 and p = 0.013, respectively) and diversity (Shannons index, p = 0.017 and p = 0.023, respectively) were significantly decreased. In the active UC group there was a significant decrease in abundance of the phylum Firmicutes (p = 0.018). The same was found in CD patients with aggressive disease (p = 0.05) while the abundance of Proteobacteria phylum showed a significant increase (p = 0.03) in CD patients. We found a change in the microbial abundance in UC patients with active disease and in CD patients with aggressive disease. These results suggest that dysbiosis of the gut in IBD patients is not only related to current activity but also to the course of the disease.
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Affiliation(s)
- M K Vester-Andersen
- Gastrounit, Hvidovre Hospital, University of Copenhagen, København, Denmark. .,Department of Internal medicine, Zealand University Hospital, Køge, Denmark.
| | | | - M V Prosberg
- Gastrounit, Hvidovre Hospital, University of Copenhagen, København, Denmark
| | - C O Mortensen
- Department of Gastroenterology, Herlev and Gentofte Hospital, University of Copenhagen, København, Denmark
| | - C Träger
- Department of Gastroenterology, Herlev and Gentofte Hospital, University of Copenhagen, København, Denmark
| | - K Skovsen
- Department of Gastroenterology, Herlev and Gentofte Hospital, University of Copenhagen, København, Denmark
| | - T Thorkilgaard
- Department of Gastroenterology, Herlev and Gentofte Hospital, University of Copenhagen, København, Denmark
| | - C Nøjgaard
- Gastrounit, Hvidovre Hospital, University of Copenhagen, København, Denmark
| | - I Vind
- Gastrounit, Hvidovre Hospital, University of Copenhagen, København, Denmark
| | - K A Krogfelt
- Department of Bacteria, Parasites and Fungi, Statens Serum Institut, Copenhagen, Denmark.,Department of Virus and Microbial Diagnostics, Statens Serum Institut, Copenhagen, Denmark
| | - N Sørensen
- Clinical-Microbiomics, Ole Maaløesvej 3, Copenhagen, Denmark
| | - F Bendtsen
- Gastrounit, Hvidovre Hospital, University of Copenhagen, København, Denmark
| | - A M Petersen
- Gastrounit, Hvidovre Hospital, University of Copenhagen, København, Denmark.,Department of Clinical Microbiology, Hvidovre Hospital, University of Copenhagen, København, Denmark
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23
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Gupta S, Mortensen MS, Schjørring S, Trivedi U, Vestergaard G, Stokholm J, Bisgaard H, Krogfelt KA, Sørensen SJ. Amplicon sequencing provides more accurate microbiome information in healthy children compared to culturing. Commun Biol 2019; 2:291. [PMID: 31396571 PMCID: PMC6683184 DOI: 10.1038/s42003-019-0540-1] [Citation(s) in RCA: 64] [Impact Index Per Article: 12.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2019] [Accepted: 07/01/2019] [Indexed: 12/17/2022] Open
Abstract
Next-Generation Sequencing (NGS) of 16S rRNA gene is now one of the most widely used application to investigate the microbiota at any given body site in research. Since NGS is more sensitive than traditional culture methods (TCMs), many studies have argued for them to replace TCMs. However, are we really ready for this transition? Here we compare the diagnostic efficiency of the two methods using a large number of samples (n = 1,748 fecal and n = 1,790 hypopharyngeal), among healthy children at different time points. Here we show that bacteria identified by NGS represented 75.70% of the unique bacterial species cultured in each sample, while TCM only identified 23.86% of the bacterial species found by amplicon sequencing. We discuss the pros and cons of both methods and provide perspective on how NGS can be implemented effectively in clinical settings.
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Affiliation(s)
- Shashank Gupta
- 1Section of Microbiology, Department of Biology, University of Copenhagen, 2100 Copenhagen, Denmark
| | - Martin S Mortensen
- 1Section of Microbiology, Department of Biology, University of Copenhagen, 2100 Copenhagen, Denmark
| | - Susanne Schjørring
- 2Department of Bacterial, Parasites and Fungi, Statens Serum Institut, 2300 Copenhagen S, Denmark
| | - Urvish Trivedi
- 1Section of Microbiology, Department of Biology, University of Copenhagen, 2100 Copenhagen, Denmark
| | - Gisle Vestergaard
- 1Section of Microbiology, Department of Biology, University of Copenhagen, 2100 Copenhagen, Denmark
| | - Jakob Stokholm
- Copenhagen Prospective Studies on Asthma in Childhood, Faculty of Health Sciences, University of Copenhagen, Copenhagen University Hospital Gentofte, Copenhagen, Denmark
| | - Hans Bisgaard
- Copenhagen Prospective Studies on Asthma in Childhood, Faculty of Health Sciences, University of Copenhagen, Copenhagen University Hospital Gentofte, Copenhagen, Denmark
| | - Karen A Krogfelt
- 2Department of Bacterial, Parasites and Fungi, Statens Serum Institut, 2300 Copenhagen S, Denmark
- 4Virus and Microbiological diagnostics, Statens Serum Institut, 2300 Copenhagen S, Denmark
| | - Søren J Sørensen
- 1Section of Microbiology, Department of Biology, University of Copenhagen, 2100 Copenhagen, Denmark
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24
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Kantsø B, Halkjær SI, Østergaard Thomsen O, Belard E, Gottschalck IB, Jørgensen CS, Krogfelt KA, Slotved HC, Ingels H, Petersen AM. Persistence of antibodies to pneumococcal conjugate vaccine compared to polysaccharide vaccine in patients with Crohn's disease - one year follow up. Infect Dis (Lond) 2019; 51:651-658. [PMID: 31290715 DOI: 10.1080/23744235.2019.1638519] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/16/2023] Open
Abstract
Background: Patients suffering from Crohn's disease (CD) are at increased risk of infectious diseases, such as pneumococcal infection. The risk increases with immunotherapy. Pneumococcal infection can be prevented by vaccination. Methods: We conducted a randomized trial of the 23-valent pneumococcal polysaccharide vaccine (PPV23) and the 13-valent pneumococcal conjugated vaccine (PCV13) in groups of CD patients treated with immunosuppressive (IS) drugs in the form of thiopurines (PPV23 n = 28, PCV13 n = 28) alone or in combination with TNF-α antagonists (PPV23 n = 13, PCV13 n = 13) and CD patients not treated with any of these drugs (untreated) (PPV23 n = 30, PCV13 n = 24). In this article, we report the immunogenicity of PPC23 and PCV13 one year after vaccination. Results: No overall differences in vaccine-induced serotype-specific immunoglobulin G (IgG) antibodies or functional antibodies (opsonophagocytic activity (OPA)) were found between the two vaccines. PCV13 induced a higher concentration of IgG antibodies for serotype 9V than PPV23 in untreated patients. In contrast, PPV23 induced higher OPA for serotypes 6B and 19F than PCV13 in IS treated patients. Untreated patients showed generally higher IgG and OPA antibody levels than patients treated with IS and TNF-α antagonists. Conclusions: In conclusion, we found no general differences in the persistence of induced antibodies when comparing PPV23 with PCV13 regardless of treatment and also within treatment groups (IS, IS + TNF-α and untreated). This was demonstrated for both serotype-specific IgG antibodies and as functional antibodies (OPA). Patients treated with thiopurines in combination with TNF-α inhibitors have an impaired immune response against both PPV23 and PCV13, as compared to untreated patients. This study has been registered in the European Clinical Trials Database (EudraCT, record no 2012-002867-86) and ClinicalTrials.gov (record no. NCT01947010).
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Affiliation(s)
- Bjørn Kantsø
- a Department of Virus & Microbiological Special Diagnostics, Statens Serum Institut , Copenhagen , Denmark
| | - Sofie Ingdam Halkjær
- b Department of Gastroenterology, Copenhagen University Hospital Hvidovre , Copenhagen , Denmark
| | - Ole Østergaard Thomsen
- c Department of Gastroenterology, Copenhagen University Hospital Herlev , Copenhagen , Denmark
| | - Erika Belard
- c Department of Gastroenterology, Copenhagen University Hospital Herlev , Copenhagen , Denmark
| | | | - Charlotte Sværke Jørgensen
- a Department of Virus & Microbiological Special Diagnostics, Statens Serum Institut , Copenhagen , Denmark
| | - Karen A Krogfelt
- a Department of Virus & Microbiological Special Diagnostics, Statens Serum Institut , Copenhagen , Denmark.,d Department of Bacteria, Parasites and Fungi, Statens Serum Institut , Copenhagen , Denmark
| | - Hans-Christian Slotved
- d Department of Bacteria, Parasites and Fungi, Statens Serum Institut , Copenhagen , Denmark
| | - Helene Ingels
- d Department of Bacteria, Parasites and Fungi, Statens Serum Institut , Copenhagen , Denmark
| | - Andreas Munk Petersen
- b Department of Gastroenterology, Copenhagen University Hospital Hvidovre , Copenhagen , Denmark.,e Department of Clinical Microbiology, Copenhagen University Hospital Hvidovre , Copenhagen , Denmark
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25
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Kavalari ID, Fuursted K, Krogfelt KA, Slotved HC. Molecular characterization and epidemiology of Streptococcus pneumoniae serotype 24F in Denmark. Sci Rep 2019; 9:5481. [PMID: 30940899 PMCID: PMC6445336 DOI: 10.1038/s41598-019-41983-8] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2018] [Accepted: 03/21/2019] [Indexed: 12/29/2022] Open
Abstract
Since 2012, have we in Denmark observed an increase of invasive pneumococcal infections (IPD) due to Streptococcus pneumoniae serotype 24F. We here present epidemiological data on 24F IPD cases, and characterization of 48 24F clinical isolates based on clonal relationship, antimicrobial resistance (AMR) determinants and virulence factors. IPD surveillance data from (1999-2016) were used to calculate the incidence and age-distribution of serotype 24F IPD and the effect of pneumococcal conjugated vaccines (PCV). Characterization of forty-eight 24F isolates (14.7% of all 24F isolates from the period) was based on whole-genome sequencing analysis (WGS). The IPD cases of serotype 24F showed a significant increase (p < 0.05) for all age groups after the PCV-13 introduction in 2010. The majority of tested 24F isolates consisted of two MLST types, i.e. the ST72 and the ST162. Serotype 24F IPD increased in Denmark after the PCV-13 introduction in parallel with an increase of the ST162 clone. The genotypic penicillin binding protein (PBP) profile agreed with the phenotypical penicillin susceptibility. The virulence genes lytA, ply, piaA, piaB, piaC, rspB and the cpsA/wzg were detected in all 24F isolates, while the pspA and zmpC genes were absent.
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Affiliation(s)
| | - Kurt Fuursted
- Department of Bacteria, Parasites and Fungi, Statens Serum Institut, Copenhagen, Denmark
| | - Karen A Krogfelt
- Department of Bacteria, Parasites and Fungi, Statens Serum Institut, Copenhagen, Denmark
| | - H-C Slotved
- Department of Bacteria, Parasites and Fungi, Statens Serum Institut, Copenhagen, Denmark.
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26
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Hebbelstrup Jensen B, Jokelainen P, Nielsen ACY, Franck KT, Rejkjær Holm D, Schønning K, Petersen AM, Krogfelt KA. Children Attending Day Care Centers are a Year-round Reservoir of Gastrointestinal Viruses. Sci Rep 2019; 9:3286. [PMID: 30824842 PMCID: PMC6397223 DOI: 10.1038/s41598-019-40077-9] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2018] [Accepted: 01/29/2019] [Indexed: 12/22/2022] Open
Abstract
Viral gastroenteritis causes high morbidity worldwide. In this study, stool samples from 179 children aged 0–6 years attending Danish day care centers were investigated for gastrointestinal viruses. Each child was observed for one year with submission of samples and questionnaires every two months. Adenovirus, norovirus, rotavirus, and sapovirus were detected in samples using real-time PCR. A total of 229 (33%) of the 688 samples collected tested positive for at least one virus. At the first sampling point, adenovirus was shed by 6%, norovirus genotype I by 3% and genotype II by 12%, rotavirus A by 9%, and sapovirus by 21% of the 142 children included in the risk factor analyses. Increasing age was identified as a protective factor against testing positive for gastrointestinal virus, whereas nausea during the previous two months was positively associated with testing positive. Odds of shedding adenovirus were 9.6 times higher among children treated with antibiotics within the previous two months than among children who were not. Gastrointestinal viruses were shed year-round and high viral loads were observed in samples from both symptomatic and asymptomatic children, suggesting children in day care as a reservoir and a possible source of spreading of viruses into the community.
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Affiliation(s)
- Betina Hebbelstrup Jensen
- Statens Serum Institut, Department of Bacteria, Parasites and Fungi, Copenhagen, Denmark.,The Research Unit for General Practice and Section of General Practice, Department of Public Health, University of Copenhagen, Copenhagen, Denmark.,Department of Internal Medicine, Amager Hospital, Copenhagen, Denmark
| | - Pikka Jokelainen
- Statens Serum Institut, Department of Bacteria, Parasites and Fungi, Copenhagen, Denmark
| | - Alex Christian Yde Nielsen
- Copenhagen University Hospital, Rigshospitalet, Department of Clinical Microbiology, Copenhagen, Denmark.,Statens Serum Institut, Department of Virus and Microbiology Special Diagnostics, Copenhagen, Denmark
| | - Kristina Træholt Franck
- Statens Serum Institut, Department of Virus and Microbiology Special Diagnostics, Copenhagen, Denmark.,Hvidovre Hospital, Department of Clinical Microbiology, Hvidovre, Denmark
| | - Dorthe Rejkjær Holm
- Statens Serum Institut, Department of Bacteria, Parasites and Fungi, Copenhagen, Denmark
| | - Kristian Schønning
- Hvidovre Hospital, Department of Clinical Microbiology, Hvidovre, Denmark
| | - Andreas M Petersen
- Hvidovre Hospital, Department of Clinical Microbiology, Hvidovre, Denmark.,Hvidovre Hospital, Department of Gastroenterology, Hvidovre, Denmark
| | - Karen A Krogfelt
- Statens Serum Institut, Department of Bacteria, Parasites and Fungi, Copenhagen, Denmark. .,Statens Serum Institut, Department of Virus and Microbiology Special Diagnostics, Copenhagen, Denmark.
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27
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Obel N, Dessau RB, Krogfelt KA, Bodilsen J, Andersen NS, Møller JK, Roed C, Omland LH, Christiansen CB, Ellermann-Eriksen S, Bangsborg JM, Hansen K, Benfield TL, Rothman KJ, Sørensen HT, Andersen CØ, Lebech AM. Long term survival, health, social functioning, and education in patients with European Lyme neuroborreliosis: nationwide population based cohort study. BMJ 2018; 361:k1998. [PMID: 29848547 PMCID: PMC5974636 DOI: 10.1136/bmj.k1998] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
OBJECTIVE To estimate long term survival, health, and educational/social functioning in patients with Lyme neuroborreliosis compared with the general population. DESIGN Nationwide population based cohort study using national registers. SETTING Denmark. PARTICIPANTS All Danish residents diagnosed during 1986-2016 as having Lyme neuroborreliosis (n=2067), defined as a positive Borrelia burgdorferi intrathecal antibody test and a clinical diagnosis of Lyme borreliosis, and a comparison cohort from the general population matched on sex and date of birth (n=20 670). MAIN OUTCOME MEASURES Mortality rate ratios, incidence rate ratios of comorbidities, and differences in educational and social outcomes. RESULTS Mortality among patients with Lyme neuroborreliosis was not higher than in the general population (mortality rate ratio 0.90, 95% confidence interval 0.79 to 1.03). Lyme neuroborreliosis patients had increased risk of haematological (incidence rate ratio 3.07, 2.03 to 4.66) and non-melanoma skin cancers (1.49, 1.18 to 1.88). At diagnosis, Lyme neuroborreliosis patients had slightly higher employment and lower disability pension rates. After five years, patients and comparison cohort members had similar numbers of hospital contacts (difference -0.22, 95% confidence interval -0.45 to 0.02, in-hospital days/year; 0.37, -0.10 to 0.83, outpatient visits/year), employment rates (difference 1.5%, -2.1% to 5.1%), income (difference -1000, -20 000 to 18 000, Danish kroner), days of sick leave (difference -0.3, -3.5 to 3.0, per year), rates of receipt of a disability pension (difference -0.9%, -3.2% to 1.3%), and number of children (difference -0.10, -0.27 to 0.08). More patients were married (difference 4.8%, 2.2% to 7.4%) and had completed high school education (difference 7%, 1% to 12%). CONCLUSION A verified diagnosis of Lyme neuroborreliosis had no substantial effect on long term survival, health, or educational/social functioning. Nevertheless, the diagnosis decreased labour market involvement marginally and was associated with increased risk of haematological and non-melanoma skin cancers.
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Affiliation(s)
- Niels Obel
- Department of Infectious Diseases, Copenhagen University Hospital, Rigshospitalet, DK-2100, Copenhagen, Denmark
| | - Ram B Dessau
- Department of Clinical Microbiology, Slagelse Hospital, Slagelse, Denmark
| | - Karen A Krogfelt
- Bacteria, Parasites and Fungi Department, Statens Serum Institute, Copenhagen, Denmark
| | - Jacob Bodilsen
- Department of Clinical Microbiology and Infectious Diseases, Aalborg University hospital, Aalborg, Denmark
| | - Nanna S Andersen
- Clinical Center for Emerging and Vector-borne Infections, Odense University Hospital, Odense, Denmark
| | - Jens K Møller
- Department of Clinical Microbiology, Vejle Hospital, Vejle, Denmark
| | - Casper Roed
- Department of Infectious Diseases, Copenhagen University Hospital, Rigshospitalet, DK-2100, Copenhagen, Denmark
| | - Lars H Omland
- Department of Infectious Diseases, Copenhagen University Hospital, Rigshospitalet, DK-2100, Copenhagen, Denmark
| | - Claus B Christiansen
- Department of Clinical Microbiology, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
| | | | - Jette M Bangsborg
- Department of Clinical Microbiology, Herlev University Hospital, Copenhagen, Denmark
| | - Klaus Hansen
- Department of Neurology, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
| | - Thomas L Benfield
- Department of Infectious Diseases, Hvidovre University Hospital, Copenhagen, Denmark
| | - Kenneth J Rothman
- Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus, Denmark
- Department of Epidemiology, Boston University, Boston, MA, USA
| | - Henrik T Sørensen
- Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus, Denmark
| | - Christian Ø Andersen
- Department of Clinical Microbiology, Hvidovre University Hospital, Copenhagen, Denmark
| | - Anne-Mette Lebech
- Department of Infectious Diseases, Copenhagen University Hospital, Rigshospitalet, DK-2100, Copenhagen, Denmark
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28
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Vavougios GD, Doskas T, Kormas C, Krogfelt KA, Zarogiannis SG, Stefanis L. Identification of a prospective early motor progression cluster of Parkinson's disease: Data from the PPMI study. J Neurol Sci 2018; 387:103-108. [DOI: 10.1016/j.jns.2018.01.025] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2017] [Revised: 10/25/2017] [Accepted: 01/22/2018] [Indexed: 12/15/2022]
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29
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Yang H, Mirsepasi-Lauridsen HC, Bosman ES, Struve C, Yu H, Wu X, Ma C, Reid G, Li X, Petersen AM, Jacobson K, Krogfelt KA, Vallance B. A10 AN ULCERATIVE COLITIS ESCHERICHIA COLI PATHOBIONT COLONIZES THE INTESTINAL MUCOSA OF SUSCEPTIBLE HOSTS AND PROMOTES COLITIS VIA HEMOLYSIN PRODUCTION. J Can Assoc Gastroenterol 2018. [DOI: 10.1093/jcag/gwy008.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- H Yang
- Pediatrics, BC Children’s Hospital Research Institute, Vancouver, BC, Canada
| | | | - E S Bosman
- Experimental medicine, University of British Columbia, Vancouver, BC, Canada
| | - C Struve
- Statens Serum Institut, Copenhagen, Denmark
| | - H Yu
- Pediatrics, BC Children’s Hospital Research Institute, Vancouver, BC, Canada
| | - X Wu
- Pediatrics, CFRI and University of British Columbia, Vancouver, BC, Canada
| | - C Ma
- Pediatrics, BC Children’s Hospital Research Institute, Vancouver, BC, Canada
| | - G Reid
- Pediatrics, BC Children’s Hospital Research Institute, Vancouver, BC, Canada
| | - X Li
- Cleveland Clinic Lerner Research Institute, Cleveland, OH
| | - A M Petersen
- Hvidovre University Hospital, Copenhagen, Denmark
| | - K Jacobson
- BC Children’s Hospital, Vancouver, BC, Canada
| | | | - B Vallance
- BC Children’s Hospital, Vancouver, BC, Canada
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30
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Clausen ML, Slotved HC, Krogfelt KA, Agner T. Measurements of AMPs in stratum corneum of atopic dermatitis and healthy skin-tape stripping technique. Sci Rep 2018; 8:1666. [PMID: 29374283 PMCID: PMC5786105 DOI: 10.1038/s41598-018-20204-8] [Citation(s) in RCA: 34] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2017] [Accepted: 01/16/2018] [Indexed: 12/16/2022] Open
Abstract
Decreased levels of antimicrobial peptides (AMPs) in atopic dermatitis (AD) have previously been reported and have been linked to the increased susceptibility to skin infections found in AD patients. This study intents to identify AMPs: hBD-2, hBD-3, RNase7, psoriasin and LL-37 in AD patients and healthy controls, and determine concentrations in consecutive depths of the outer most skin layers. Tape stripping was used on lesional and non-lesional skin. From each skin site, 35 consecutive tape strips were collected and pooled in groups of 5. Commercially available ELISA kits were used to determine AMP concentration in stratum corneum samples. hBD-2, hBD-3, RNase7 and psoriasin were identified in stratum corneum samples. hBD-3-level was markedly higher in AD non-lesional skin compared to healthy controls, and a similar trend was observed for RNase7. Most AMPs were distributed evenly through 35 tape strips, implying a homogeneous distribution of antimicrobial defense in the outer most skin layers. The findings indicate that AD patients may not suffer from a general baseline deficiency in AMPs, and that the innate immune defense is present throughout the stratum corneum, both insights of importance for understanding the role of AMPs in AD.
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Affiliation(s)
- Maja-Lisa Clausen
- Department of Dermatology, Bispebjerg University Hospital, Copenhagen, Denmark.
| | - H-C Slotved
- Department of Bacteria, parasites and fungi, Statens Serum Institut, Copenhagen, Denmark
| | - Karen A Krogfelt
- Department of Bacteria, parasites and fungi, Statens Serum Institut, Copenhagen, Denmark
| | - Tove Agner
- Department of Dermatology, Bispebjerg University Hospital, Copenhagen, Denmark
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31
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Jønsson R, Struve C, Jenssen H, Krogfelt KA. The wax moth Galleria mellonella as a novel model system to study Enteroaggregative Escherichia coli pathogenesis. Virulence 2017; 8:1894-1899. [PMID: 27824518 PMCID: PMC5810504 DOI: 10.1080/21505594.2016.1256537] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Affiliation(s)
- Rie Jønsson
- a Department of Science and Environment , Roskilde University , Roskilde , Denmark.,b Department of Microbiology and Infection Control , Statens Serum Institut , Copenhagen , Denmark
| | - Carsten Struve
- b Department of Microbiology and Infection Control , Statens Serum Institut , Copenhagen , Denmark
| | - Håvard Jenssen
- a Department of Science and Environment , Roskilde University , Roskilde , Denmark
| | - Karen A Krogfelt
- b Department of Microbiology and Infection Control , Statens Serum Institut , Copenhagen , Denmark
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32
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Frimodt-Møller J, Charbon G, Krogfelt KA, Løbner-Olesen A. Determination of the Optimal Chromosomal Location(s) for a DNA Element in Escherichia coli Using a Novel Transposon-mediated Approach. J Vis Exp 2017. [PMID: 28930971 DOI: 10.3791/55946] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022] Open
Abstract
The optimal chromosomal position(s) of a given DNA element was/were determined by transposon-mediated random insertion followed by fitness selection. In bacteria, the impact of the genetic context on the function of a genetic element can be difficult to assess. Several mechanisms, including topological effects, transcriptional interference from neighboring genes, and/or replication-associated gene dosage, may affect the function of a given genetic element. Here, we describe a method that permits the random integration of a DNA element into the chromosome of Escherichia coli and select the most favorable locations using a simple growth competition experiment. The method takes advantage of a well-described transposon-based system of random insertion, coupled with a selection of the fittest clone(s) by growth advantage, a procedure that is easily adjustable to experimental needs. The nature of the fittest clone(s) can be determined by whole-genome sequencing on a complex multi-clonal population or by easy gene walking for the rapid identification of selected clones. Here, the non-coding DNA region DARS2, which controls the initiation of chromosome replication in E. coli, was used as an example. The function of DARS2 is known to be affected by replication-associated gene dosage; the closer DARS2 gets to the origin of DNA replication, the more active it becomes. DARS2 was randomly inserted into the chromosome of a DARS2-deleted strain. The resultant clones containing individual insertions were pooled and competed against one another for hundreds of generations. Finally, the fittest clones were characterized and found to contain DARS2 inserted in close proximity to the original DARS2 location.
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Affiliation(s)
- Jakob Frimodt-Møller
- Department of Biology, Section for Functional Genomics and Center for Bacterial Stress Response and Persistence (BASP), University of Copenhagen
| | - Godefroid Charbon
- Department of Biology, Section for Functional Genomics and Center for Bacterial Stress Response and Persistence (BASP), University of Copenhagen
| | - Karen A Krogfelt
- Department of Microbiology and Infection Control, Statens Serum Institut
| | - Anders Løbner-Olesen
- Department of Biology, Section for Functional Genomics and Center for Bacterial Stress Response and Persistence (BASP), University of Copenhagen;
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33
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Hebbelstrup Jensen B, Poulsen A, Hebbelstrup Rye Rasmussen S, Struve C, Engberg JH, Friis-Møller A, Boisen N, Jønsson R, Petersen RF, Petersen AM, Krogfelt KA. Genetic Virulence Profile of Enteroaggregative Escherichia coli Strains Isolated from Danish Children with Either Acute or Persistent Diarrhea. Front Cell Infect Microbiol 2017; 7:230. [PMID: 28611957 PMCID: PMC5447714 DOI: 10.3389/fcimb.2017.00230] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2017] [Accepted: 05/17/2017] [Indexed: 11/13/2022] Open
Abstract
Enteroaggregative Escherichia coli (EAEC) is frequently found in diarrheal stools worldwide. It has been associated with persistent diarrhea, weight loss, and failure to thrive in children living in developing countries. A number of important EAEC virulence genes are identified; however, their roles in acute and persistent diarrhea have not been previously investigated. The aim of this study was to identify specific EAEC virulence genes associated with duration and type of diarrhea in Danish children. We aimed to improve the current diagnostics of EAEC and enable targeting of strains with an expected severe disease course. Questionnaires answered by parents provided information regarding duration of diarrhea and presence of blood or mucus. A total of 295 EAEC strains were collected from children with acute (≤7 days) and persistent diarrhea (≥14 days) and were compared by using multiplex PCR targeting the genes sat, sepA, pic, sigA, pet, astA, aatA, aggR, aaiC, aap, agg3/4C, ORF3, aafA, aggA, agg3A, agg4A, and agg5A. Furthermore, the distribution of EAEC genes in strains collected from cases of bloody, mucoid, and watery diarrhea was investigated. The classification and regression tree analysis (CART) was applied to investigate the relationship between EAEC virulence genes and diarrheal duration and type. Persistent diarrhea was associated with strains lacking the pic gene (p = 0.002) and with the combination of the genes pic, sat, and absence of the aggA gene (p = 0.05). Prolonged diarrhea was associated with the combination of the genes aatA and astA (p = 0.03). Non-mucoid diarrhea was associated with strains lacking the aatA gene (p = 0.004). Acute diarrhea was associated with the genes aggR, aap, and aggA by individual odds ratios. Resistance toward gentamicin and ciprofloxacin was observed in 7.5 and 3% of strains, respectively. Multi-drug resistance was observed in 38% of strains. Genetic host factors have been associated with an increased risk of EAEC-associated disease. Therefore, we investigated a panel of risk factors in two groups of children—EAEC-positive and EAEC-negative—to identify additional factors predisposing to disease. The duration of breastfeeding was positively correlated with the likelihood of belonging to the EAEC-negative group of children.
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Affiliation(s)
| | - Anja Poulsen
- Department of Gastroenterology, Copenhagen University Hospital HvidovreCopenhagen, Denmark
| | | | - Carsten Struve
- Department of Bacteria, Parasites and Fungi, Statens Serum InstitutCopenhagen, Denmark
| | - Jørgen H Engberg
- Department of Clinical Microbiology, Slagelse HospitalSlagelse, Denmark
| | - Alice Friis-Møller
- Department of Clinical Microbiology, Copenhagen University Hospital HvidovreCopenhagen, Denmark
| | - Nadia Boisen
- Department of Bacteria, Parasites and Fungi, Statens Serum InstitutCopenhagen, Denmark
| | - Rie Jønsson
- Department of Bacteria, Parasites and Fungi, Statens Serum InstitutCopenhagen, Denmark
| | - Randi F Petersen
- Department of Bacteria, Parasites and Fungi, Statens Serum InstitutCopenhagen, Denmark
| | - Andreas M Petersen
- Department of Bacteria, Parasites and Fungi, Statens Serum InstitutCopenhagen, Denmark.,Department of Gastroenterology, Copenhagen University Hospital HvidovreCopenhagen, Denmark.,Department of Clinical Microbiology, Copenhagen University Hospital HvidovreCopenhagen, Denmark
| | - Karen A Krogfelt
- Department of Bacteria, Parasites and Fungi, Statens Serum InstitutCopenhagen, Denmark
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34
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Boll EJ, Marti R, Hasman H, Overballe-Petersen S, Stegger M, Ng K, Knøchel S, Krogfelt KA, Hummerjohann J, Struve C. Turn Up the Heat-Food and Clinical Escherichia coli Isolates Feature Two Transferrable Loci of Heat Resistance. Front Microbiol 2017; 8:579. [PMID: 28439262 PMCID: PMC5383660 DOI: 10.3389/fmicb.2017.00579] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2016] [Accepted: 03/21/2017] [Indexed: 11/24/2022] Open
Abstract
Heat treatment is a widely used process to reduce bacterial loads in the food industry or to decontaminate surfaces, e.g., in hospital settings. However, there are situations where lower temperatures must be employed, for instance in case of food production such as raw milk cheese or for decontamination of medical devices such as thermo-labile flexible endoscopes. A recently identified locus of heat resistance (LHR) has been shown to be present in and confer heat resistance to a variety of Enterobacteriaceae, including Escherichia coli isolates from food production settings and clinical ESBL-producing E. coli isolates. Here, we describe the presence of two distinct LHR variants within a particularly heat resistant E. coli raw milk cheese isolate. We demonstrate for the first time in this species the presence of one of these LHRs on a plasmid, designated pFAM21805, also encoding type 3 fimbriae and three bacteriocins and corresponding self-immunity proteins. The plasmid was highly transferable to other E. coli strains, including Shiga-toxin-producing strains, and conferred LHR-dependent heat resistance as well as type 3 fimbriae-dependent biofilm formation capabilities. Selection for and acquisition of this “survival” plasmid by pathogenic organisms, e.g., in food production environments, may pose great concern and emphasizes the need to screen for the presence of LHR genes in isolates.
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Affiliation(s)
- Erik J Boll
- Department of Microbiology and Infection Control, Statens Serum InstitutCopenhagen, Denmark
| | - Roger Marti
- Agroscope, Division of Food Microbial Systems, Microbiological Safety of Foods of Animal Origin GroupBern, Switzerland
| | - Henrik Hasman
- Department of Microbiology and Infection Control, Statens Serum InstitutCopenhagen, Denmark
| | | | - Marc Stegger
- Department of Microbiology and Infection Control, Statens Serum InstitutCopenhagen, Denmark
| | - Kim Ng
- Department of Microbiology and Infection Control, Statens Serum InstitutCopenhagen, Denmark
| | - Susanne Knøchel
- Department of Food Science, University of CopenhagenCopenhagen, Denmark
| | - Karen A Krogfelt
- Department of Microbiology and Infection Control, Statens Serum InstitutCopenhagen, Denmark
| | - Joerg Hummerjohann
- Agroscope, Division of Food Microbial Systems, Microbiological Safety of Foods of Animal Origin GroupBern, Switzerland
| | - Carsten Struve
- Department of Microbiology and Infection Control, Statens Serum InstitutCopenhagen, Denmark
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35
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Jensen HD, Struve C, Christensen SB, Krogfelt KA. Cranberry Juice and Combinations of Its Organic Acids Are Effective against Experimental Urinary Tract Infection. Front Microbiol 2017; 8:542. [PMID: 28421045 PMCID: PMC5378705 DOI: 10.3389/fmicb.2017.00542] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2017] [Accepted: 03/15/2017] [Indexed: 11/13/2022] Open
Abstract
The antibacterial effect of cranberry juice and the organic acids therein on infection by uropathogenic Escherichia coli was studied in an experimental mouse model of urinary tract infection (UTI). Reduced bacterial counts were found in the bladder (P < 0.01) of mice drinking fresh cranberry juice. Commercially available cranberry juice cocktail also significantly reduced (P < 0.01) bacterial populations in the bladder, as did the hydrophilic fraction of cranberry juice (P < 0.05). Quinic, malic, shikimic, and citric acid, the preponderant organic acids in cranberry juice, were tested in combination and individually. The four organic acids also decreased bacterial levels in the bladder when administered together (P < 0.001), and so did the combination of malic plus citric acid (P < 0.01) and malic plus quinic acid (P < 0.05). The other tested combinations of the organic acids, and the acids administered singly, did not have any effect in the UTI model. Apparently, the antibacterial effect of the organic acids from cranberry juice on UTI can be obtained by administering a combination of malic acid and either citric or quinic acid. This study show for the first time that cranberry juice reduce E. coli colonization of the bladder in an experimental mouse model of urinary tract infection and that the organic acids are active agents.
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Affiliation(s)
- Heidi D Jensen
- Department of Bacteria, Parasites and Fungi, Statens Serum InstitutCopenhagen, Denmark.,Natural Products and Peptides, University of CopenhagenCopenhagen, Denmark
| | - Carsten Struve
- Department of Bacteria, Parasites and Fungi, Statens Serum InstitutCopenhagen, Denmark
| | | | - Karen A Krogfelt
- Department of Bacteria, Parasites and Fungi, Statens Serum InstitutCopenhagen, Denmark
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36
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Damm JA, Smith B, Greisen G, Krogfelt KA, Clausen ML, Agner T. The influence of probiotics for preterm neonates on the incidence of atopic dermatitis-results from a historically controlled cohort study. Arch Dermatol Res 2017; 309:259-264. [PMID: 28271213 DOI: 10.1007/s00403-017-1725-4] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2016] [Revised: 02/05/2017] [Accepted: 02/14/2017] [Indexed: 02/06/2023]
Abstract
Probiotic supplementation is a promising preventive strategy for atopic dermatitis (AD). To help clarifying the significance of timing with respect to prevention of AD, we here evaluate the benefit of prophylactic use of probiotic supplementation in neonates younger than 30 weeks of gestation. Preterm children from the Department of Neonatology, Rigshospitalet, Denmark from two different admission periods were included in a historically controlled cohort study. Neonates from January 2007 to February 2010, not treated with and neonates from March 2010 to February 2013 treated with probiotic were enrolled. Main outcome was prevalence of AD, and secondary outcomes were use of topical corticosteroids, and number of skin-related visits to GPs and dermatologists. 527 preterm neonates were included in the study, 249 treated and 278 not treated with probiotics. Response rate for the two cohorts was 76.7 and 77.7% respectively. The prevalence of AD was similar in the two groups (20.9% in the probiotic treated group versus 17.1% in the not treated group, p = 0.33). No significant differences were found between the groups with respect to treatment with topical corticosteroids, or visits at GPs or dermatologist. We found no indication that probiotics may prevent AD when administered to neonates <30 gestation weeks from birth until discharge home. Factors influencing the early maturation of the immune system have been assumed to be of particular importance in atopic dermatitis, and hence, our unique cohorts contribute information on how probiotic supplementation may affect the extremely immature immune systems of preterm infants.
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Affiliation(s)
- Julie A Damm
- Department of Pediatrics, University of Copenhagen, Herlev Hospital, 2730, Herlev, Denmark.
| | - Birgitte Smith
- Department of Microbiology and Infection Control, Statens Serum Institute, 2300, Copenhagen S, Denmark
| | - Gorm Greisen
- Department of Neonatology, Rigshospitalet, 2100, Copenhagen Ø, Denmark
| | - Karen A Krogfelt
- Department of Microbiology and Infection Control, Statens Serum Institute, 2300, Copenhagen S, Denmark
| | - Maja-Lisa Clausen
- Department of Dermatology, University of Copenhagen, Bispebjerg Hospital, 2400, Copenhagen NV, Denmark
| | - Tove Agner
- Department of Dermatology, University of Copenhagen, Bispebjerg Hospital, 2400, Copenhagen NV, Denmark
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37
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Jønsson R, Struve C, Boll EJ, Boisen N, Joensen KG, Sørensen CA, Jensen BH, Scheutz F, Jenssen H, Krogfelt KA. A Novel pAA Virulence Plasmid Encoding Toxins and Two Distinct Variants of the Fimbriae of Enteroaggregative Escherichia coli. Front Microbiol 2017; 8:263. [PMID: 28275371 PMCID: PMC5320562 DOI: 10.3389/fmicb.2017.00263] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2016] [Accepted: 02/07/2017] [Indexed: 11/29/2022] Open
Abstract
Enteroaggregative Escherichia coli (EAEC) is an increasingly recognized pathogen associated with acute and persistent diarrhea worldwide. While EAEC strains are considered highly heterogeneous, aggregative adherence fimbriae (AAFs) are thought to play a pivotal role in pathogenicity by facilitating adherence to the intestinal mucosa. In this study, we optimized an existing multiplex PCR to target all known AAF variants, which are distinguished by differences in their pilin subunits. We applied the assay on a collection of 162 clinical Danish EAEC strains and interestingly found six, by SNP analysis phylogenetically distinct, strains harboring the major pilin subunits from both AAF/III and AAF/V. Whole-genome and plasmid sequencing revealed that in these six strains the agg3A and agg5A genes were located on a novel pAA plasmid variant. Moreover, the plasmid also encoded several other virulence genes including some not previously found on pAA plasmids. Thus, this plasmid endows the host strains with a remarkably high number of EAEC associated virulence genes hereby likely promoting strain pathogenicity.
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Affiliation(s)
- Rie Jønsson
- Department of Science and Environment, Roskilde UniversityRoskilde, Denmark; Department of Microbiology and Infection Control, Statens Serum InstitutCopenhagen, Denmark
| | - Carsten Struve
- Department of Microbiology and Infection Control, Statens Serum Institut Copenhagen, Denmark
| | - Erik J Boll
- Department of Microbiology and Infection Control, Statens Serum Institut Copenhagen, Denmark
| | - Nadia Boisen
- Department of Microbiology and Infection Control, Statens Serum Institut Copenhagen, Denmark
| | - Katrine G Joensen
- Department of Microbiology and Infection Control, Statens Serum Institut Copenhagen, Denmark
| | - Camilla A Sørensen
- Department of Microbiology and Infection Control, Statens Serum Institut Copenhagen, Denmark
| | - Betina H Jensen
- Department of Microbiology and Infection Control, Statens Serum Institut Copenhagen, Denmark
| | - Flemming Scheutz
- Department of Microbiology and Infection Control, Statens Serum Institut Copenhagen, Denmark
| | - Håvard Jenssen
- Department of Science and Environment, Roskilde University Roskilde, Denmark
| | - Karen A Krogfelt
- Department of Microbiology and Infection Control, Statens Serum Institut Copenhagen, Denmark
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Karikari AB, Obiri-Danso K, Frimpong EH, Krogfelt KA. Antibiotic Resistance in <i>Campylobacter</i> Isolated from Patients with Gastroenteritis in a Teaching Hospital in Ghana. ACTA ACUST UNITED AC 2017. [DOI: 10.4236/ojmm.2017.71001] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Johansen JK, Sehested A, Myrhøj T, Ladefoged K, Krogfelt KA. Helicobacter pylori infection in Greenlandic patients with dyspepsia. Int J Circumpolar Health 2016; 63 Suppl 2:219-20. [PMID: 15736655 DOI: 10.3402/ijch.v63i0.17906] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
OBJECTIVES The aim was to evaluate the incidence of Helicobacter pylori (HP) infection in Greenland, to assess the value of the test "Helicobacter antigen in faeces" as a diagnostic tool and to determine the level of antibiotic resistance. STUDY DESIGN 100 consecutive patients with dyspepsia who visited for endoscopic gastric examination were included. The patients had to be born in Greenland and to be > or = 18 years old. METHODS Samples for HP antibody in blood, HP antigen in faeces, urease test on biopsies were collected from the patients. Gastric biopsies were cultured for HP bacteria, and antibiotic resistance was tested. Patients with positive urease test and/or antigen in faeces and/or positive culture were treated simultaneously with Amoxicillin, Metronidazole and Esomeprazole for 1 week. Patients with duodenal or gastric ulcer were endoscopically re-examined 8 weeks later. Patients with proven HP infection but without ulcer submitted a faeces sample 8 weeks after the eradication. RESULTS 77 patients were considered HP infected, and received treatment. Only 32% of them were eradicated sufficiently. CONCLUSION HP antigen in faeces test is useful as a diagnostic tool and for control of therapy. A change in strategy of HP treatment in Greenland is a must, presumably preceded by an elucidation of microbial sensitivity.
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Jønsson R, Liu B, Struve C, Yang Y, Jørgensen R, Xu Y, Jenssen H, Krogfelt KA, Matthews S. Structural and functional studies of Escherichia coli aggregative adherence fimbriae (AAF/V) reveal a deficiency in extracellular matrix binding. Biochim Biophys Acta Proteins Proteom 2016; 1865:304-311. [PMID: 27939608 PMCID: PMC5289312 DOI: 10.1016/j.bbapap.2016.11.017] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/21/2016] [Revised: 11/14/2016] [Accepted: 11/30/2016] [Indexed: 01/18/2023]
Abstract
Enteroaggregative Escherichia coli (EAEC) is an emerging cause of acute and persistent diarrhea worldwide. The pathogenesis of different EAEC stains is complicated, however, the early essential step begins with attachment of EAEC to intestinal mucosa via aggregative adherence fimbriae (AAFs). Currently, five different variants have been identified, which all share a degree of similarity in the gene organization of their operons and sequences. Here, we report the solution structure of Agg5A from the AAF/V variant. While preserving the major structural features shared by all AAF members, only Agg5A possesses an inserted helix at the beginning of the donor strand, which together with altered surface electrostatics, renders the protein unable to interact with fibronectin. Hence, here we characterize the first AAF variant with a binding mode that varies from previously described AAFs AAF/V expressing strain show no specificity to extracellular matrix (ECM) proteins compared to the uncoated wells. Agg5A share structural similarity to the two previously described AAF subunits AggA and AafA. Fibronectin binding is restored by substitution of a single aspartic acid to lysine.
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Affiliation(s)
- Rie Jønsson
- Institute for Science and Environment, Roskilde University, Roskilde, Denmark; Department of Microbiology and Infection Control, Statens Serum Institut, Copenhagen, Denmark
| | - Bing Liu
- Centre for Structural Biology, Department of Life Sciences, Imperial College London, South Kensington, London, United Kingdom
| | - Carsten Struve
- Department of Microbiology and Infection Control, Statens Serum Institut, Copenhagen, Denmark
| | - Yi Yang
- Centre for Structural Biology, Department of Life Sciences, Imperial College London, South Kensington, London, United Kingdom
| | - René Jørgensen
- Department of Microbiology and Infection Control, Statens Serum Institut, Copenhagen, Denmark
| | - Yingqi Xu
- Centre for Structural Biology, Department of Life Sciences, Imperial College London, South Kensington, London, United Kingdom
| | - Håvard Jenssen
- Institute for Science and Environment, Roskilde University, Roskilde, Denmark
| | - Karen A Krogfelt
- Department of Microbiology and Infection Control, Statens Serum Institut, Copenhagen, Denmark.
| | - Steve Matthews
- Centre for Structural Biology, Department of Life Sciences, Imperial College London, South Kensington, London, United Kingdom.
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Hebbelstrup Jensen B, Stensvold CR, Struve C, Olsen KEP, Scheutz F, Boisen N, Röser D, Andreassen BU, Nielsen HV, Schønning K, Petersen AM, Krogfelt KA. Enteroaggregative Escherichia coli in Daycare-A 1-Year Dynamic Cohort Study. Front Cell Infect Microbiol 2016; 6:75. [PMID: 27468409 PMCID: PMC4942469 DOI: 10.3389/fcimb.2016.00075] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2016] [Accepted: 06/29/2016] [Indexed: 12/24/2022] Open
Abstract
Enteroaggregative Escherichia coli (EAEC) has been associated with persistent diarrhea, reduced growth acceleration, and failure to thrive in children living in developing countries and with childhood diarrhea in general in industrialized countries. The clinical implications of an EAEC carrier-status in children in industrialized countries warrants clarification. To investigate the pathological significance of an EAEC carrier-state in the industrialized countries, we designed a 1-year dynamic cohort study and performed follow-up every second month, where the study participants submitted a stool sample and answered a questionnaire regarding gastrointestinal symptoms and exposures. Exposures included foreign travel, consumption of antibiotics, and contact with a diseased animal. In the capital area of Denmark, a total of 179 children aged 0–6 years were followed in a cohort study, in the period between 2009 and 2013. This is the first investigation of the incidence and pathological significance of EAEC in Danish children attending daycare facilities. Conventional microbiological detection of enteric pathogens was performed at Statens Serum Institute, Copenhagen, Denmark, and at Hvidovre Hospital, Copenhagen, Denmark. Parents completed questionnaires regarding gastrointestinal symptoms. The EAEC strains were further characterized by serotyping, phylogenetic analysis, and susceptibility testing. EAEC was detected in 25 (14%) of the children during the observational period of 1 year. One or more gastrointestinal symptoms were reported from 56% of the EAEC-positive children. Diarrhea was reported in six (24%) of the EAEC positive children, but no cases of weight loss, and general failure to thrive were observed. The EAEC strains detected comprised a large number of different serotypes, confirming the genetic heterogeneity of this pathotype. EAEC was highly prevalent (n = 25, 14%) in Danish children in daycare centers and was accompanied by gastrointestinal symptoms in 56% of the infected children. No serotype or phylogenetic group was specifically linked to children with disease.
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Affiliation(s)
| | - Christen R Stensvold
- Department of Microbiology and Infection Control, Statens Serum Institute Copenhagen, Denmark
| | - Carsten Struve
- Department of Microbiology and Infection Control, Statens Serum Institute Copenhagen, Denmark
| | - Katharina E P Olsen
- Department of Microbiology and Infection Control, Statens Serum Institute Copenhagen, Denmark
| | - Flemming Scheutz
- Department of Microbiology and Infection Control, Statens Serum Institute Copenhagen, Denmark
| | - Nadia Boisen
- Department of Microbiology and Infection Control, Statens Serum Institute Copenhagen, Denmark
| | - Dennis Röser
- Department of Microbiology and Infection Control, Statens Serum InstituteCopenhagen, Denmark; Department of Pediatrics, Copenhagen University Hospital HvidovreCopenhagen, Denmark
| | - Bente U Andreassen
- Department of Pediatrics, H.C. Andersen's Hospital, University of Odense Odense, Denmark
| | - Henrik V Nielsen
- Department of Microbiology and Infection Control, Statens Serum Institute Copenhagen, Denmark
| | - Kristian Schønning
- Department of Clinical Microbiology, Copenhagen University Hospital Hvidovre Copenhagen, Denmark
| | - Andreas M Petersen
- Department of Microbiology and Infection Control, Statens Serum InstituteCopenhagen, Denmark; Department of Clinical Microbiology, Copenhagen University Hospital HvidovreCopenhagen, Denmark; Department of Gastroenterology, Copenhagen University Hospital HvidovreCopenhagen, Denmark
| | - Karen A Krogfelt
- Department of Microbiology and Infection Control, Statens Serum Institute Copenhagen, Denmark
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O'Brien Andersen L, Karim AB, Roager HM, Vigsnæs LK, Krogfelt KA, Licht TR, Stensvold CR. Associations between common intestinal parasites and bacteria in humans as revealed by qPCR. Eur J Clin Microbiol Infect Dis 2016; 35:1427-31. [PMID: 27230509 DOI: 10.1007/s10096-016-2680-2] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2016] [Accepted: 05/13/2016] [Indexed: 02/05/2023]
Abstract
Several studies have shown associations between groups of intestinal bacterial or specific ratios between bacterial groups and various disease traits. Meanwhile, little is known about interactions and associations between eukaryotic and prokaryotic microorganisms in the human gut. In this work, we set out to investigate potential associations between common single-celled parasites such as Blastocystis spp. and Dientamoeba fragilis and intestinal bacteria. Stool DNA from patients with intestinal symptoms were selected based on being Blastocystis spp.-positive (B+)/negative (B-) and D. fragilis-positive (D+)/negative (D-), and split into four groups of 21 samples (B+ D+, B+ D-, B- D+, and B- D-). Quantitative PCR targeting the six bacterial taxa Bacteroides, Prevotella, the butyrate-producing clostridial clusters IV and XIVa, the mucin-degrading Akkermansia muciniphila, and the indigenous group of Bifidobacterium was subsequently performed, and the relative abundance of these bacteria across the four groups was compared. The relative abundance of Bacteroides in B- D- samples was significantly higher compared with B+ D- and B+ D+ samples (P < 0.05 and P < 0.01, respectively), and this association was even more significant when comparing all parasite-positive samples with parasite-negative samples (P < 0.001). Additionally, our data revealed that a low abundance of Prevotella and a higher abundance of Clostridial cluster XIVa was associated with parasite-negative samples (P < 0.05 and P < 0.01, respectively). Our data support the theory that Blastocystis alone or combined with D. fragilis is associated with gut microbiota characterized by low relative abundances of Bacteroides and Clostridial cluster XIVa and high levels of Prevotella.
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Affiliation(s)
- L O'Brien Andersen
- Unit of Mycology and Parasitology, Department of Microbiology and Infection Control, Statens Serum Institut, Artillerivej 5, DK-2300, Copenhagen S, Denmark
| | - A B Karim
- Unit of Mycology and Parasitology, Department of Microbiology and Infection Control, Statens Serum Institut, Artillerivej 5, DK-2300, Copenhagen S, Denmark
| | - H M Roager
- National Food Institute, Technical University of Denmark, Lyngby, Denmark
| | - L K Vigsnæs
- National Food Institute, Technical University of Denmark, Lyngby, Denmark
| | - K A Krogfelt
- Unit of Mycology and Parasitology, Department of Microbiology and Infection Control, Statens Serum Institut, Artillerivej 5, DK-2300, Copenhagen S, Denmark
| | - T R Licht
- National Food Institute, Technical University of Denmark, Lyngby, Denmark
| | - C R Stensvold
- Unit of Mycology and Parasitology, Department of Microbiology and Infection Control, Statens Serum Institut, Artillerivej 5, DK-2300, Copenhagen S, Denmark.
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Stokholm J, Thorsen J, Chawes BL, Schjørring S, Krogfelt KA, Bønnelykke K, Bisgaard H. Cesarean section changes neonatal gut colonization. J Allergy Clin Immunol 2016; 138:881-889.e2. [PMID: 27045582 DOI: 10.1016/j.jaci.2016.01.028] [Citation(s) in RCA: 115] [Impact Index Per Article: 14.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2015] [Revised: 12/18/2015] [Accepted: 01/06/2016] [Indexed: 11/25/2022]
Abstract
BACKGROUND Delivery by means of cesarean section has been associated with increased risk of childhood immune-mediated diseases, suggesting a role of early bacterial colonization patterns for immune maturation. OBJECTIVE We sought to describe the influence of delivery method on gut and airway colonization patterns in the first year of life in the Copenhagen Prospective Studies on Asthma in Childhood2010 (COPSAC2010) birth cohort. METHODS Seven hundred children from the COPSAC2010 birth cohort participated in this analysis. Fecal samples were collected at age 1 week, 1 month, and 1 year, and hypopharyngeal aspirates were collected at age 1 week, 1 month, and 3 months and cultured for bacteria. Detailed information on delivery method, intrapartum antibiotics, and lifestyle factors was obtained by personal interviews. RESULTS Seventy-eight percent of the children were born by means of natural delivery, 12% by means of emergency cesarean section, and 9% by means of elective cesarean section. Birth by means of cesarean section was significantly associated with colonization of the intestinal tract by Citrobacter freundii, Clostridium species, Enterobacter cloacae, Enterococcus faecalis, Klebsiella oxytoca, Klebsiella pneumoniae, and Staphylococcus aureus at age 1 week, whereas colonization by Escherichia coli was associated with natural birth. At age 1 month, these differences were less prominent, and at age 1 year, they were not apparent, which was confirmed by means of multivariate data-driven partial least squares analyses. The initial airway microbiota was unaffected by birth method. CONCLUSION Delivery by means of cesarean section was associated with early colonization patterns of the neonatal gut but not of the airways. The differences normalized within the first year of life. We speculate that microbial derangements, as indicated in our study, can demonstrate a possible link between delivery by means of cesarean section and immune-mediated disease.
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Affiliation(s)
- Jakob Stokholm
- COPSAC, Copenhagen Prospective Studies on Asthma in Childhood, Herlev and Gentofte Hospital, University of Copenhagen, Copenhagen, Denmark; Department of Pediatrics, Naestved Hospital, Naestved, Denmark
| | - Jonathan Thorsen
- COPSAC, Copenhagen Prospective Studies on Asthma in Childhood, Herlev and Gentofte Hospital, University of Copenhagen, Copenhagen, Denmark
| | - Bo L Chawes
- COPSAC, Copenhagen Prospective Studies on Asthma in Childhood, Herlev and Gentofte Hospital, University of Copenhagen, Copenhagen, Denmark
| | - Susanne Schjørring
- Department of Microbiology and Infection Control, Statens Serum Institut, Copenhagen, Denmark
| | - Karen A Krogfelt
- Department of Microbiology and Infection Control, Statens Serum Institut, Copenhagen, Denmark
| | - Klaus Bønnelykke
- COPSAC, Copenhagen Prospective Studies on Asthma in Childhood, Herlev and Gentofte Hospital, University of Copenhagen, Copenhagen, Denmark
| | - Hans Bisgaard
- COPSAC, Copenhagen Prospective Studies on Asthma in Childhood, Herlev and Gentofte Hospital, University of Copenhagen, Copenhagen, Denmark.
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Emborg HD, Teunis P, Simonsen J, Krogfelt KA, Jørgensen CS, Takkinen J, Mølbak K. Was the increase in culture-confirmed Campylobacter infections in Denmark during the 1990s a surveillance artefact? ACTA ACUST UNITED AC 2016; 20:30041. [PMID: 26538161 DOI: 10.2807/1560-7917.es.2015.20.41.30041] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2014] [Accepted: 09/21/2015] [Indexed: 11/20/2022]
Abstract
In 1991, 1999 and 2006, randomly selected individuals from the Danish Central Personal Register provided a serum sample. From individuals aged 30 years and above, 500 samples from each year were analysed for Campylobacter IgG, IgA and IgM antibodies using a direct ELISA method. We applied a seroincidence calculator available from the European Centre for Disease Prevention and Control to perform a mathematical back-calculation to estimate the annual Campylobacter seroincidence in the Danish population. The estimated Campylobacter seroincidence did not differ significantly between the 1991, 1999 and 2006 studies although the reported number of culture-confirmed cases of Campylobacter infection increased 2.5 fold from 1993 to 1999 among individuals aged 30 years and above. This suggests that Campylobacter was widely present in the Danish population before the increase in poultry-associated clinical Campylobacter infections observed from 1993 to 2001 among individuals of this age groups.
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Affiliation(s)
- Hanne-Dorthe Emborg
- Department of Infectious Disease Epidemiology, Statens Serum Institut, Copenhagen, Denmark
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Boll EJ, Frimodt-Møller J, Olesen B, Krogfelt KA, Struve C. Heat resistance in extended-spectrum beta-lactamase-producing Escherichia coli may favor environmental survival in a hospital setting. Res Microbiol 2016; 167:345-9. [PMID: 26946311 DOI: 10.1016/j.resmic.2016.02.002] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2015] [Revised: 12/30/2015] [Accepted: 02/03/2016] [Indexed: 11/16/2022]
Abstract
Nosocomial infections caused by extended-spectrum β-lactamase (ESBL)-producing Escherichia coli are a major concern worldwide. There is an urgent need to identify bacterial factors promoting survival and persistence of these organisms in the nosocomial environment. Here, we describe the presence of a gene cluster, containing the Clp ATPase ClpK, within a collection of Danish ESBL-producing E. coli isolates. The cluster conferred thermoprotection upon the isolates, and thus might facilitate survival on medical devices exposed to semi-high temperatures in a hospital setting.
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Affiliation(s)
- Erik J Boll
- Department of Microbiology & Infection Control, Statens Serum Institut, Denmark
| | | | - Bente Olesen
- Department of Clinical Microbiology, Herlev and Gentofte Hospital, University of Copenhagen, Denmark
| | - Karen A Krogfelt
- Department of Microbiology & Infection Control, Statens Serum Institut, Denmark
| | - Carsten Struve
- Department of Microbiology & Infection Control, Statens Serum Institut, Denmark.
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Abstract
The aim of this study was to investigate the amount of protein in stratum corneum in atopic dermatitis (AD) patients and healthy controls, using tape stripping technique. Furthermore, to compare two different methods for protein assessment. Tape stripping was performed in AD patients and healthy controls to collect stratum corneum samples and subsequently analysed with two different methods: Squame Scan, which gives an estimate of total protein (soluble and insoluble) and Micro BCA protein determination kit which measures soluble protein. Significant differences in cumulative protein content between AD lesional, AD non-lesional and healthy control skin was found using the Squame Scan as well as the Micro BCA protein determination kit. AD patients had significantly lower amount of protein, both total protein and soluble protein compared to healthy controls. Furthermore, soluble protein formed 82% of total protein in AD lesional skin, compared to 17-24% for AD non-lesional skin and healthy control. A decreasing amount of total protein with increasing stratum corneum depth was found for all skin types. Significant differences in stratum corneum protein content between AD lesional, AD non-lesional and healthy control skin were revealed, independent of method used.
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Affiliation(s)
- Maja-Lisa Clausen
- Department of Dermatology, Bispebjerg Hospital, University of Copenhagen, Copenhagen, Denmark
| | - H.-C. Slotved
- Department of Microbiology and Infection Control, Statens Serum Institut, Copenhagen, Denmark
| | - Karen A. Krogfelt
- Department of Microbiology and Infection Control, Statens Serum Institut, Copenhagen, Denmark
| | - Tove Agner
- Department of Dermatology, Bispebjerg Hospital, University of Copenhagen, Copenhagen, Denmark
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Skindersoe ME, Krogfelt KA, Blom A, Zhang J, Jiang G, Prestwich GD, Mansell JP. Correction: Dual Action of Lysophosphatidate-Functionalised Titanium: Interactions with Human (MG63) Osteoblasts and Methicillin Resistant Staphylococcus aureus. PLoS One 2016; 11:e0147276. [PMID: 26795373 PMCID: PMC4721640 DOI: 10.1371/journal.pone.0147276] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
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Stokholm J, Chawes BL, Vissing NH, Bjarnadóttir E, Pedersen TM, Vinding RK, Schoos AMM, Wolsk HM, Thorsteinsdóttir S, Hallas HW, Arianto L, Schjørring S, Krogfelt KA, Fischer TK, Pipper CB, Bønnelykke K, Bisgaard H. Azithromycin for episodes with asthma-like symptoms in young children aged 1-3 years: a randomised, double-blind, placebo-controlled trial. Lancet Respir Med 2015; 4:19-26. [PMID: 26704020 PMCID: PMC7164820 DOI: 10.1016/s2213-2600(15)00500-7] [Citation(s) in RCA: 87] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/11/2015] [Revised: 11/18/2015] [Accepted: 11/20/2015] [Indexed: 12/20/2022]
Abstract
Background Bacteria and viruses are equally associated with the risk of acute episodes of asthma-like symptoms in young children, suggesting antibiotics as a potential treatment for such episodes. We aimed to assess the effect of azithromycin on the duration of respiratory episodes in young children with recurrent asthma-like symptoms, hypothesising that it reduces the duration of the symptomatic period. Methods In this randomised, double-blind, placebo-controlled trial, we recruited children aged 1–3 years, who were diagnosed with recurrent asthma-like symptoms from the Copenhagen Prospective Studies on Asthma in Childhood 2010 cohort; a birth cohort consisting of the general Danish population of Zealand, including Copenhagen. Exclusion criteria were macrolide allergy, heart, liver, neurological, and kidney disease, and, before each treatment, one or more clinical signs of pneumonia (respiratory frequency of ≥50 breaths per min; fever of ≥39°C; C-reactive protein concentration of ≥476·20 nmol/L [≥50 mg/L]). Each episode of asthma-like symptoms lasting at least 3 days was randomly allocated to a 3-day course of azithromycin oral solution of 10 mg/kg per day or placebo after thorough examination by a study physician at the Copenhagen Prospective Studies on Asthma research unit. Each episode was randomly allocated independently of previous treatment from a computer-generated list of random numbers in blocks of ten (generated at the Pharmacy of Glostrup). Investigators and children were masked until the youngest child turned 3 years of age and throughout the data validation and analysis phases. The primary outcome was duration of the respiratory episode after treatment, verified by prospective daily diaries and analysed with Poisson regression. Analyses were per protocol (excluding those without a primary outcome measure or who did not receive treatment). This trial is registered with ClinicalTrials.gov, number NCT01233297. Findings Between Nov 17, 2010, and Jan 28, 2014, we randomly allocated 158 asthma-like episodes in 72 children (79 [50%] to azithromycin and 79 [50%] to placebo). The mean duration of the episode after treatment was 3·4 days for children receiving azithromycin compared with 7·7 days for children receiving placebo. Azithromycin caused a significant shortening of the episode of 63·3% (95% CI 56·0–69·3; p<0·0001). The effect size increased with early initiation of treatment, showing a reduction in episode duration of 83% if treatment was initiated before day 6 of the episode compared with 36% if initiated on or after day 6 (p<0·0001). We noted no differences in clinical adverse events between the azithromycin (18 [23%] of 78 episodes included in final analysis) and placebo (24 [30%] of 79) groups (p=0·30), but we did not investigate bacterial resistance patterns after treatment. Interpretation Azithromycin reduced the duration of episodes of asthma-like symptoms in young children, suggesting that this drug could have a role in acute management of exacerbations. Further research is needed to disentangle the inflammatory versus antimicrobial aspects of this relation. Funding Lundbeck Foundation, Danish Ministry of Health, Danish Council for Strategic Research, Capital Region Research Foundation.
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Affiliation(s)
- Jakob Stokholm
- Copenhagen Prospective Studies on Asthma in Childhood, Herlev and Gentofte Hospital, University of Copenhagen, Copenhagen, Denmark; Department of Pediatrics, Naestved Hospital, Naestved, Denmark
| | - Bo L Chawes
- Copenhagen Prospective Studies on Asthma in Childhood, Herlev and Gentofte Hospital, University of Copenhagen, Copenhagen, Denmark
| | - Nadja H Vissing
- Copenhagen Prospective Studies on Asthma in Childhood, Herlev and Gentofte Hospital, University of Copenhagen, Copenhagen, Denmark
| | - Elín Bjarnadóttir
- Copenhagen Prospective Studies on Asthma in Childhood, Herlev and Gentofte Hospital, University of Copenhagen, Copenhagen, Denmark; Department of Pediatrics, Naestved Hospital, Naestved, Denmark
| | - Tine M Pedersen
- Copenhagen Prospective Studies on Asthma in Childhood, Herlev and Gentofte Hospital, University of Copenhagen, Copenhagen, Denmark; Department of Pediatrics, Naestved Hospital, Naestved, Denmark
| | - Rebecca K Vinding
- Copenhagen Prospective Studies on Asthma in Childhood, Herlev and Gentofte Hospital, University of Copenhagen, Copenhagen, Denmark; Department of Pediatrics, Naestved Hospital, Naestved, Denmark
| | - Ann-Marie M Schoos
- Copenhagen Prospective Studies on Asthma in Childhood, Herlev and Gentofte Hospital, University of Copenhagen, Copenhagen, Denmark
| | - Helene M Wolsk
- Copenhagen Prospective Studies on Asthma in Childhood, Herlev and Gentofte Hospital, University of Copenhagen, Copenhagen, Denmark
| | - Sunna Thorsteinsdóttir
- Copenhagen Prospective Studies on Asthma in Childhood, Herlev and Gentofte Hospital, University of Copenhagen, Copenhagen, Denmark
| | - Henrik W Hallas
- Copenhagen Prospective Studies on Asthma in Childhood, Herlev and Gentofte Hospital, University of Copenhagen, Copenhagen, Denmark
| | - Lambang Arianto
- Copenhagen Prospective Studies on Asthma in Childhood, Herlev and Gentofte Hospital, University of Copenhagen, Copenhagen, Denmark
| | - Susanne Schjørring
- Department of Microbiology and Infection Control, Statens Serum Institut, Copenhagen, Denmark
| | - Karen A Krogfelt
- Department of Microbiology and Infection Control, Statens Serum Institut, Copenhagen, Denmark
| | - Thea K Fischer
- Department of Microbiological Diagnostics and Virology, Statens Serum Institut, Copenhagen, Denmark
| | - Christian B Pipper
- Section of Biostatistics, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Klaus Bønnelykke
- Copenhagen Prospective Studies on Asthma in Childhood, Herlev and Gentofte Hospital, University of Copenhagen, Copenhagen, Denmark
| | - Hans Bisgaard
- Copenhagen Prospective Studies on Asthma in Childhood, Herlev and Gentofte Hospital, University of Copenhagen, Copenhagen, Denmark.
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Skindersoe ME, Krogfelt KA, Blom A, Jiang G, Prestwich GD, Mansell JP. Dual Action of Lysophosphatidate-Functionalised Titanium: Interactions with Human (MG63) Osteoblasts and Methicillin Resistant Staphylococcus aureus. PLoS One 2015; 10:e0143509. [PMID: 26605796 PMCID: PMC4659682 DOI: 10.1371/journal.pone.0143509] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2015] [Accepted: 11/05/2015] [Indexed: 11/18/2022] Open
Abstract
Titanium (Ti) is a widely used material for surgical implants; total joint replacements (TJRs), screws and plates for fixing bones and dental implants are forged from Ti. Whilst Ti integrates well into host tissue approximately 10% of TJRs will fail in the lifetime of the patient through a process known as aseptic loosening. These failures necessitate revision arthroplasties which are more complicated and costly than the initial procedure. Finding ways of enhancing early (osseo)integration of TJRs is therefore highly desirable and continues to represent a research priority in current biomaterial design. One way of realising improvements in implant quality is to coat the Ti surface with small biological agents known to support human osteoblast formation and maturation at Ti surfaces. Lysophosphatidic acid (LPA) and certain LPA analogues offer potential solutions as Ti coatings in reducing aseptic loosening. Herein we present evidence for the successful bio-functionalisation of Ti using LPA. This modified Ti surface heightened the maturation of human osteoblasts, as supported by increased expression of alkaline phosphatase. These functionalised surfaces also deterred the attachment and growth of Staphylococcus aureus, a bacterium often associated with implant failures through sepsis. Collectively we provide evidence for the fabrication of a dual-action Ti surface finish, a highly desirable feature towards the development of next-generation implantable devices.
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Affiliation(s)
- Mette Elena Skindersoe
- Department of Systems Biology, Technical University of Denmark, Kgs. Lyngby, Denmark
- Department for Infection and Microbiology Control, Statens Serum Institut, Copenhagen S, Denmark
| | - Karen A. Krogfelt
- Department for Infection and Microbiology Control, Statens Serum Institut, Copenhagen S, Denmark
| | - Ashley Blom
- Musculoskeletal Research Unit, University of Bristol, Southmead Hospital, Bristol, BS10 5NB, United Kingdom
| | - Guowei Jiang
- Department of Medicinal Chemistry, The University of Utah, 419 Wakara Way, Suite 205, Salt Lake City, Utah 84108, United States of America
| | - Glenn D. Prestwich
- Department of Medicinal Chemistry, The University of Utah, 419 Wakara Way, Suite 205, Salt Lake City, Utah 84108, United States of America
| | - Jason Peter Mansell
- Department of Biological, Biomedical & Analytical Sciences, University of the West of England, Frenchay Campus, Bristol, BS16 1QY, United Kingdom
- * E-mail:
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50
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Jensen SR, Mirsepasi-Lauridsen HC, Thysen AH, Brynskov J, Krogfelt KA, Petersen AM, Pedersen AE, Brix S. Distinct inflammatory and cytopathic characteristics of Escherichia coli isolates from inflammatory bowel disease patients. Int J Med Microbiol 2015; 305:925-36. [PMID: 26522075 DOI: 10.1016/j.ijmm.2015.10.002] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2015] [Revised: 09/07/2015] [Accepted: 10/11/2015] [Indexed: 12/26/2022] Open
Abstract
Escherichia coli (E. coli) may be implicated in the pathogenesis of inflammatory bowel disease (IBD), as implied from a higher prevalence of mucosa-associated E. coli in the gut of IBD-affected individuals. However, it is unclear whether different non-diarrheagenic E. coli spp. segregate from each other in their ability to promote intestinal inflammation. Herein we compared the inflammation-inducing properties of non-diarrheagenic LF82, 691-04A, E. coli Nissle 1917 (ECN) and eleven new intestinal isolates from different locations in five IBD patients and one healthy control. Viable E. coli were cultured with human monocyte-derived dendritic cells (moDCs) and monolayers of intestinal epithelial cells (IECs), followed by analysis of secreted cytokines, intracellular levels of reactive oxygen species and cellular death. The IBD-associated E. coli LF82 induced the same dose-dependent inflammatory cytokine profile as ECN and ten of the new E. coli isolates displayed as high level IL-12p70, IL-1β, IL-23 and TNF-α from moDCs irrespective of their site of isolation (ileum/colon/faeces), disease origin (diseased/non-diseased) or known virulence factors. Contrarily, 691-04A and one new IBD E. coli isolate induced a different cellular phenotype with enhanced killing of moDCs and IECs, coupled to elevated IL-18. The cytopathic nature of 691-04A and one other IBD E. coli isolate suggests that colonization with specific non-diarrheagenic E. coli could promote intestinal barrier leakage and profound intestinal inflammation, while LF82, ECN and the remaining non-diarrheagenic E. coli isolates hold notorious pro-inflammatory characteristics that can progress inflammation in case of intestinal barrier leakage.
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Affiliation(s)
- Stina Rikke Jensen
- Center for Biological Sequence Analysis, Department of Systems Biology, Technical University of Denmark, Denmark
| | | | - Anna Hammerich Thysen
- Center for Biological Sequence Analysis, Department of Systems Biology, Technical University of Denmark, Denmark
| | - Jørn Brynskov
- Department of Gastroenterology, Medical Section, Herlev Hospital, University of Copenhagen, Denmark
| | - Karen A Krogfelt
- Department of Microbiology and Infection Control, Statens Serum Institut, Denmark
| | - Andreas Munk Petersen
- Department of Gastroenterology, Medical Section, Hvidovre Hospital, University of Copenhagen, Denmark; Department of Clinical Microbiology, Hvidovre Hospital, University of Copenhagen, Denmark
| | - Anders Elm Pedersen
- Department of Immunology and Microbiology, University of Copenhagen, Denmark
| | - Susanne Brix
- Center for Biological Sequence Analysis, Department of Systems Biology, Technical University of Denmark, Denmark.
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