Anti-OmpA antibodies as potential inhibitors of Acinetobacter baumannii biofilm formation, adherence to, and proliferation in A549 human alveolar epithelial cells.

Outer membrane protein A (OmpA) is a critical virulence factor in Acinetobacter baumannii, influencing adhesion, biofilm formation, host immune response, and host cell apoptosis. We investigated the invasion of A549 alveolar epithelial cells by A. baumannii and examined how anti-OmpA antibodies impact these interactions. OmpA was expressed and purified, inducing anti-OmpA antibodies in BALB/c mice. The potential toxicity of OmpA was evaluated in mice by analyzing histology from six organs. A549 cells were exposed to A. baumannii strains 19606 and a clinical isolate. Using cell culture and light microscopy, we scrutinized the effects of anti-OmpA sera on serum resistance, adherence, internalization, and proliferation of A. baumannii in A549 cells. The viability of A549 cells was assessed upon exposure to live A. baumannii and anti-OmpA sera. OmpA-induced antibody demonstrated potent bactericidal effects on both strains of A. baumannii. Both strains formed biofilms, which were reduced by anti-OmpA serum, along with decreased bacterial adherence, internalization, and proliferation in A549 cells. Anti-OmpA serum improved the survival of A549 cells post-infection. Pre-treatment with cytochalasin D hindered bacterial internalization, highlighting the role of actin polymerization in invasion. Microscopic examination revealed varied interactions encompassing adherence, apoptosis, membrane alterations, vacuolization, and damage. A549 cells treated with anti-OmpA serum exhibited improved structures and reduced damage. The findings indicate that A. baumannii can adhere to and proliferate within epithelial cells with OmpA playing a pivotal role in these interactions, and the complex nature of these interactions shapes the intricate course of A. baumannii infection in host cells.

A two-protein cocktail elicits a protective immune response against Acinetobacter baumannii in a murine infection model.

PURPOSE: Due to its high drug resistance, Acinetobacter baumannii is a priority for new therapeutic measures like vaccines. In this study, the protectivity of a combination cocktail of Omp34 and BauA as a vaccine against A. baumannii was studied in a murine sepsis model. METHODS: The antibody titers were raised to Omp34 and BauA in BALB/c mice and assessed by indirect ELISA. The immunized mice were challenged with A. baumannii ATCC 19606. The bacterial loads in the liver, spleen, and lungs were also determined. RESULTS: A significant increase in survival of the immunized mice was noted. In active immunity, the survival rates in mice receiving Omp34 and BauA alone or in combination were 100%. A significant decrease in the bacterial load was observed in the spleens, livers, and lungs of vaccinated mice. Anti-BauA and anti-Omp34 sera crossly detected Omp34 and BauA respectively. The decrease in bacterial load in body organs of mice vaccinated with a combination of the two proteins was significantly higher than those of the single proteins in both actively and passively immunized mice. In passive immunity, the survival rate of mice receiving specific sera raised to the combination of these proteins was 85.7%. CONCLUSION: Higher protection by a combination of Omp34 and BauA than Omp34 or BauA could be attributed to targeting simultaneously both surface antigens indicating the synergistic effect of Omp34 and BauA as suitable vaccine candidates in the prevention or treatment of A. baumannii infections.

Combination of BauA and OmpA elicit immunoprotection against Acinetobacter baumannii in a murine sepsis model.

AIMS: Acinetobacter baumannii causes severe nosocomial infections and is a difficult-to-treat pathogen due to the development of multidrug-resistant (MDR) strains. Vaccines and antibody therapy represent alternative promising strategies for the control of infections caused by A. baumannii or its MDR strains. OmpA and BauA have been assigned as protective antigens. However, the efficacy of the combination of these antigens is yet to be investigated. In this study, we targeted two critical antigens of A. baumannii (BauA and OmpA) to enhance immunoprotecting against A. baumannii. METHODS AND RESULTS: The recombinant BauA and OmpA were expressed and purified. The purified proteins were administered to BALB/c mice alone and in combination. Immune sera were assessed against BauA, OmpA and two constructs harboring immunogenic loops of these antigen. The mice were then challenged with a clinical isolate of A. baumannii. Indirect ELISA confirmed significant antibody rise to the antigens. The immunogenic loops were detected in the hybrid construct. The specific sera detected OmpA, BauA and constructs harboring immunogenic loops of these antigen with different affinities. A significant decrease in the bacterial loads was noted in the spleen, liver, and lungs of the immunized mice groups. However, the group received combination of BauA and OmpA showed lower bacterial burden in the spleen and liver. CONCLUSIONS: Combination of BauA and OmpA enhances immunoprotection against A. baumannii infections.

Anti-Omp34 antibodies protect against Acinetobacter baumannii in a murine sepsis model.

Acinetobacter baumannii, an opportunistic extracellular pathogen is one of the major causes of nosocomial infections. Omp34, also known as Omp33-36, is a bacterial porin protein involved in the virulence and fitness of this pathogen by adhesion to the host cell. This antigen nominated as an appropriate candidate for immunization against A. baumannii. In this study, the expression of the recombinant Omp34 (rOmp34) was carried out in E. coli BL21 (DE3). The immunogenicity of the rOmp34 in A. baumannii was studied in a murine sepsis model. Antibody response in mice injected with the recombinant protein was assessed using indirect ELISA. Bactericidal activity of rOmp34-immunized mice sera (1:10 dilution) against A. baumannii ATCC 19606 after 0, 1, 2, 4, and 8 h of incubation at 37 °C was assessed. In addition to survival rate, load of bacteria in liver and spleen of the infected mice were evaluated. A high titer of specific antibody equivalent to optical density of 1.54 ± 0.06 against rOmp34 was elicited in the immunized mice sera. Viability of the A. baumannii incubated 8 h with immunized mice sera was 64%. Homogenized liver and spleen samples of the control mice challenged with A. baumannii were loaded with 8 × 103 and 9 × 103 CFU per gram tissue respectively 48 h post-challenge as against complete clearance of A. baumannii in the immunized group. The protective immunity was achieved by challenging the mice groups with 5 × LD50 of live A. baumannii. Omp34 can be nominated as an immunogen that can bring about protection against Acinetobacter baumannii.

A conserved region of Acinetobacter trimeric autotransporter adhesion, Ata, provokes suppression of Acinetobacter baumannii virulence.

The Acinetobacter trimeric autotransporter adhesin (Ata) is an important virulence factor. The conserved region from the genomic sequence of a 6777bp/2258 amino acid of Acinetobacter baumannii ATCC®19606™ ata was explored. A 263aa of the C-terminal of Ata (rcAta263) was expressed. The effect of rcAta263 on A. baumannii virulence was studied in a murine model. IgG and IgA were elicited and the mice groups challenged with A. baumannii showed significant survival rates from 66 to 100%. The bacterial loads were determined in the spleens, livers, and lungs of both control and test groups. The adhesion rate of A. baumannii to A549 cells in the presence of serum, cytotoxicity, mutagenicity, and biofilm disruption potential of rcAta263 were determined. Intraperitoneally challenged groups showed a significantly reduced bacterial load in the organs of the immunized mice. Intranasal challenge reduced 4 logs of bacterial CFU/g in the test group. The immunized mice sera reduced adherence of A. baumannii to A549 cells to 80%. No cytotoxic or mutagenic effect was detected. Biofilm disruption was significantly increased in the presence of immunized mice sera. Immunization with the conserved region of Ata significantly combats the virulence of A. baumannii which could be considered as a therapeutic strategy to control A. baumannii infections.

An in silico structural and physicochemical characterization of TonB-dependent copper receptor in A. baumannii.

Acinetobacter baumannii is an opportunistic multidrug resistant pathogen. TonB-dependent copper receptor is an outer membrane protein and has a role in binding of A. baumannii to host cell via attachment to fibronectin. Moreover, it is highly expressed in biofilm community. In this study the properties of copper receptor were analyzed in silico and its vaccine potential was investigated. TonB-dependent copper and iron receptor domains plus one plug domain at N-terminal were determined by domain analysis. Topology modeling showed 22 ß-strands, 11 loops and 10 periplasmic turns. Interaction of this protein with TonB2 energy transducer was also indicated. Beside the antigenicity, this protein could take part in bacterial virulence. The more preferable 3D structure was selected amongst all 26 predicted structures, refined and used in prediction of ligand binding site and conformational epitope. The results of B and T-cell epitope mapping indicated 8 potential areas in the protein sequence and structure that seems to be able to stimulate both humoral and cellular immune responses. Based on the alignment result, this protein and all selected epitopes are extremely conserved among A. baumannii strains which can be tested as sub unit vaccine by in vivo studies.

In silico design of an immunogen against Acinetobacter baumannii based on a novel model for native structure of Outer membrane protein A.

Outer membrane protein A (OmpA) is the most promising vaccine candidate against one of the most successful nosocomial pathogens, A. baumannii. Despite advantages of the antigen, its cytotoxicity could be considered as a challenge in clinical trials. In order to improve this effective immunogen, rational vaccine design strategies such as structure-based vaccinology should be assessed. However, native structure of OmpA remains controversial. The present study is conducted to address the native structure of OmpA; then, a novel immunogen with lower toxicity and higher antigenicity was designed based on structural vaccinology. Various bioinformatic and immunoinformatic tools were harnessed to perform analyses such as topology, secondary structure, and tertiary structure predictions as well as B-cell epitope predictions. A novel 12-stranded model is suggested for OmpA. K320 and K322 were substituted by Alanine, "NADEEFWN" sequence was replaced by "YKYDFDGVNRGTRGTSEEGTL", Position 1-24 at the N-terminus and the C-terminal sequence "VVQPGQEAAAPAAAQ" were removed. The designed construct has more epitope density and antigenic properties with higher immunogenicity while its cytotoxicity is decreased. Moreover, this single cross-protective antigen could trigger antibodies rendering protection against two important nosocomial pathogens i.e. Pseudomonas aeruginosa and A. baumannii.

In vivo validation of the immunogenicity of recombinant Baumannii Acinetobactin Utilization A protein (rBauA).

Acinetobacter baumannii has become a tremendous challenge to modern healthcare as an antimicrobial resistant. Replication and persistence of A. baumannii within eukaryotes is based on iron acquisition functions including siderophore biosynthesis. Iron transport into the cytosol is mediated by specific membrane receptors which recognize the iron-siderophore complexes. Expression of this acinetobactin mediated Iron uptake system is vital for intracellular growth of A. baumannii. Baumannii acinetobactin utilization (BauA), is an outer membrane protein, acting out the siderophore-ferric complex receptor. This study was aimed at analysis of immunogenicity and specificity of BauA. The genomic bauA was amplified via PCR method and after digestion, bauA was ligated into pET28a. The recombinant gene was expressed in Escherichia coli BL21(DE3) and the product was analyzed by SDS-PAGE and purified by Ni-NTA affinity chromatography method. The recombinant BauA (rBauA) was confirmed by western blot analysis using anti-His antibodies and its immunogenicity was assessed by injecting the rBauA to BALB/c mice. Antibodies produced therein could effectively recognize and bind rBauA. The immunized mice challenged with bacterial doses higher than LD50 survived. The antibodies were highly specific to A. baumannii and its clinical isolates. Passive immunization using serum raised against BauA protected mice from infection. BauA can be nominated as an immunogen against A. baumannii.

Homology modeling of a Camelid antibody fragment against a conserved region of Acinetobacter baumannii biofilm associated protein (Bap).

BACKGROUND: VHH or the single-domain antibodies (sdAb), are studied for therapeutic applications in cancers, infections and other diseases. In our previous study, we expressed and produced a soluble VHH against a conserved region of Acinetobacter baumannii biofilm associated protein (Bap). The present study was undertaken to predict the 2D and 3D structure of the receptor and ligand as well as residues involved in their interactions. METHODS AND FINDINGS: Apart from ab initio, other rational methods such as homology modeling and threading were invoked to achieve the 3D structures. For homology modeling, BLAST was run on the sequences in order to find the best templates. Pocket detection and identification of functionally and structurally important residues of VHH 3D structure as well as determination of its clefts and ligand binding site were carried out on the structure. ZDOCK docking server predicted all possible binding modes in the translational and rotational space between the selected region of Bap as an antigen and the VHH structure as an antibody. CONCLUSION: We identified the amino acids involved in antigen-VHH interactions. Some functional conserved residues located in the largest cleft that participate in ligand binding site are identified. It seems that these amino acids are involved in antigen-VHH interactions.

Functional Exposed Amino Acids of BauA as Potential Immunogen Against Acinetobacter baumannii.

Multidrug-resistant Acinetobacter baumannii is recognized to be among the most difficult antimicrobial-resistant gram negative bacilli to control and treat. One of the major challenges that the pathogenic bacteria face in their host is the scarcity of freely available iron. To survive under such conditions, bacteria express new proteins on their outer membrane and also secrete iron chelators called siderophores. Antibodies directed against these proteins associated with iron uptake exert a bacteriostatic or bactericidal effect against A. baumanii in vitro, by blocking siderophore mediated iron uptake pathways. Attempts should be made to discover peptides that could mimic protein epitopes and possess the same immunogenicity as the whole protein. Subsequently, theoretical methods for epitope prediction have been developed leading to synthesis of such peptides that are important for development of immunodiagnostic tests and vaccines. The present study was designed to in silico resolving the major obstacles in the control or in prevention of the diseases caused by A. baumannii. We exploited bioinformatic tools to better understand and characterize the Baumannii acinetobactin utilization structure of A. baumannii and select appropriate regions as effective B cell epitopes. In conclusion, amino acids 26-191 of cork domain and 321-635 of part of the barrel domain including L4-L9, were selected as vaccine candidates. These two regions contain functional exposed amino acids with higher score of B cell epitopes properties. Majority of amino acids are hydrophilic, flexible, accessible, and favorable for B cells from secondary structure point of view.

The role of filamentous hemagglutinin adhesin in adherence and biofilm formation in Acinetobacter baumannii ATCC19606(T).

Filamentous hemagglutinin adhesins (FHA) are key factors for bacterial attachment and subsequent cell accumulation on substrates. Here an FHA-like Outer membrane (OM) adhesin of Acinetobacter baumannii ATCC19606(T) was displayed on Escherichia coli. The candidate autotransporter (AT) genes were identified in A. baumannii ATCC19606(T) genome. The exoprotein (FhaB1) and transporter (FhaC1) were produced independently within the same cell (FhaB1C1). The fhaC1 was mutated. In vitro adherence to epithelial cells of the recombinant FhaB1C1 and the mutant strains were compared with A. baumanni ATCC19606(T). A bivalent chimeric protein (K) composed of immunologically important portions of fhaB1 (B) and fhaC1 (C) was constructed. The mice vaccinated with chimeric protein were challenged with A. baumannii ATCC19606(T) and FhaB1C1 producing recombinant E. coli. Mutations in the fhaC1 resulted in the absence of FhaB1 in the OM. Expression of FhaB1C1 enhanced the adherence of recombinant bacteria to A546 bronchial cell line. The results revealed association of FhaB1 with bacterial adhesion and biofilm formation. Immunization with a combination of recombinant B and K proteins proved protective against A. baumanni ATCC19606(T). The findings may be applied in active and passive immunization strategies against A. baumannii.

A conserved region from biofilm associated protein as a biomarker for detection of Acinetobacter baumannii.

Acinetobacter baumannii is the leading cause of nosocominal infection within the family Moraxellaceae. Due to multiple antibiotic resistances of the bacteria, the treatment is very difficult, hence specific and economical test for early diagnosis of infection is needed. Development of such a test requires targeting specific cell surface antigens. Bacterial ability of biofilm formation grants major contribution in antimicrobial resistance and other environmental stresses such as nutrient limitation and dehydration. Biofilm associated protein (Bap), a specific cell surface protein, is directly involved in A. baumannii biofilm formation. The goal of this study is diagnosis of A. baumannii infection exploiting specific target from Bap. A selected subunit of Bap was cloned, expressed and purified. Mice were divided into three groups. Group one was immunized with recombinant Bap subunit, mice in group two were infected with A. baumannii (positive control) and mice in groups three served as negative control. Immunization with Bap subunit resulted in high antibody titers. Animals in control group that received same amount of adjuvant and PBS showed no Bap-specific antibodies. Sensitivity and specificity of the antibodies raised were determined by ELISA and Western blotting. Recombinant Bap subunit was tested by ELISA using sera obtained from A. baumannii infected patients and healthy individuals. This conserved and immunodominant region of Bap could serve as an appropriate target for diagnosis A. baumannii infection.

A novel VHH nanobody against the active site (the CA domain) of tumor-associated, carbonic anhydrase isoform IX and its usefulness for cancer diagnosis.

Expression of carbonic anhydrase IX (CAIX) significantly increases under hypoxic conditions in tumor cells. CAIX activity is executed by the catalytic domain (CA) located on the extracellular part of the enzyme. Neutralization of CAIX enzymatic activity reduces malignancy and survival of tumor cells. To inhibit the enzymatic activity, a VHH nanobody was developed against the CA domain of CAIX using phage display technology. Following immunization of a camel with the recombinant CAIX, VHH fragments were isolated by nested PCR on lymphocyte cDNA. Binding affinity of isolated nanobodies was tested by ELISA. A clone (K24) with the highest binding affinity was expressed in a soluble form. Affinity of K24 nanobody was determined to be approx. 2.3 × 10(-5). K24 nanobody recognized the expressed CAIX in the HeLa cell lines with high selectivity and specificity. These findings thus have usefulness for the diagnosis and treatment of cancers.

In silico analysis of Acinetobacter baumannii phospholipase D as a subunit vaccine candidate.

The rate of human health care-associated infections caused by Acinetobacter baumannii has increased significantly in recent years for its remarkable resistance to desiccation and most antibiotics. Phospholipases, capable of destroying a phospholipid substrate, are heterologous group of enzymes which are believed to be the bacterial virulence determinants. There is a need for in silico studies to identify potential vaccine candidates. A. baumannii phospholipase D (PLD) role has been proved in increasing organism's resistance to human serum, destruction of host epithelial cell and pathogenesis in murine model. In this in silico study high potentials of A. baumannii PLD in elicitation of humoral and cellular immunities were elucidated. Thermal stability, long half-life, non-similarity to human and gut flora proteome and non-allergenicity were in a list of A. baumannii PLD positive properties. Potential epitopic sequences were also identified that could be used as peptide vaccines against A. baumannii and various other human bacterial pathogens.

Immune response variations to Salmonella enterica serovar Typhi recombinant porin proteins in mice.

OBJECTIVES: Typhoid fever is caused by Salmonella enterica serovar Typhi. OmpC, OmpF and OmpA, the three major outer membrane proteins (OMPs), could serve as vaccine candidates. METHODS: The porins antigenicity was predicted in silico. The OMP genes were amplified, cloned and expressed. Sero-reactivities of the recombinant proteins purified by denaturing method were assayed by ELISA. BALB/c mice were immunized with the recombinant porins followed by bacterial challenge. RESULTS: Bacterial challenge of the animal model brought about antibody triggering efficacy of the antigen in OmpF > OmpC > OmpA order. Experimental findings validated the in silico results. None of the antigens had synergic or antagonistic effects on each other from immune system induction points of view. Despite their high immunogenicity, none of the antigens was protective. However, administration of two or three antigens simultaneously resulted in retardation of lethal effect. Porins, in addition to their specific functions, share common functions. Hence, they can compensate for each other's functions. CONCLUSIONS: The produced antibodies could not eliminate the pathogenicity by blockade of one or some of the antigens. Porin antigens are not suitable vaccine candidates alone or in denatured forms. Native forms of the antigens maybe studied for protective immunogenicity.

Passive immunization with anti-FimA egg yolk antibodies (IgYs) mitigate Acinetobacter baumannii pneumonia in mice.

Acinetobacter baumannii is a formidable pathogen, characterized by high mortality rates and pan-drug-resistant strains. Current commercial antibiotics lack efficacy against drug-resistant variants, necessitating the search for alternative treatments. This study investigates the potential of egg yolk immunoglobulin (IgY) as a cost-effective biomolecule for passive protection against A. baumannii pneumonia. FimA (ABAYE2132), a key virulence factor involved in biofilm development and lung cell adherence, emerges as a promising antigen for triggering protective IgY production. Recombinant FimA was expressed, purified, and used for intramuscular immunization of laying White Leghorn hens. IgY antibodies were subsequently extracted from egg yolks, with their reactivity assessed through indirect ELISA. Neutropenic mice received intranasal administration of IgYs one hour prior to the challenge with a clinical A. baumannii isolate (10 ×LD50). The specific anti-FimA IgYs detected recombinant FimA and provided 100% protection against bacterial infection, while non-specific IgYs prolonged survival for up to 72 h. In contrast, control mice succumbed to infection within 24 h. Analysis of bacterial loads in lungs and spleens after 16 h reveals the following order: control > non-specific IgY > anti-FimA IgY. These findings highlight FimA as a suitable antigen for the development of protective IgYs against A. baumannii.

Enhanced immunoprotection against Acinetobacter baumannii infection: Synergistic effects of Bap and BauA in a murine model.

BACKGROUND: The rise of multi-drug resistant Acinetobacter baumannii poses a grave threat to hospital settings, resulting in increased mortality rates and garnering global attention. The formation of biofilms facilitated by biofilm-associated protein (Bap) and the iron absorption capabilities mediated by Baumannii acinetobactin utilization A (BauA) contribute to the persistence and survival of multidrug-resistant strains. In this study, we aimed to investigate the potential of disrupting the function of BauA and Bap simultaneously as a strategy for controlling A. baumannii. METHODS: Recombinant Bap and BauA were expressed, purified, and subcutaneously administered individually and in combination to BALB/c mice. Subsequently, mice were intraperitoneally challenged with A. baumannii, and the bacterial load and tissue damage in the spleen, lung, and liver were assessed. Serum samples were evaluated to determine antibody titers in surviving mice. RESULTS: Specific IgG antibodies were significantly increased. A combination of the antigens resulted in enhanced titer of specific IgGs in comparison to either BauA or Bap alone. The antibodies remained stable over a seven-month period. The combination of Bap and BauA exhibited superior immunoprotection against A. baumannii infection compared to individual administration, resulting in a further reduction in bacterial load in the liver, spleen, and lungs. The histopathological analysis demonstrated successful protection of the tissues against A. baumannii-induced damage upon administration of the two immunogens. CONCLUSIONS: The combination of Bap and BauA has the potential to target a broader range of A. baumannii strains, including those expressing either Bap or BauA, thereby increasing its efficacy against a diverse array of strains.

Synergistic immunoprotection by Oma87 and Bap against Acinetobacter baumannii sepsis model.

Acinetobacter baumannii is the leading cause of nosocomial infection. A surface protein commonly known as biofilm associate protein (Bap) has been identified in a bloodstream isolate of A. baumannii. Bap of A. baumannii is involved in intercellular adhesion within the mature biofilm. Outer membrane protein Acinetobacter 87 kDa (Oma87) or ß-barrel assembly machinery A (BamA) has been introduced as an immunogenic outer membrane protein via in silico reverse vaccinology. Current research examines the synergistic effect of immunization of mice with both recombinant proteins viz., Oma87 and Bap. Antibodies were raised to the proteins. The mice were challenged with A. baumannii ATCC 19606 and the bacterial burden was enumerated in the mice's livers, spleens, and lungs followed by histological examination. IgG levels significantly increased, and a significant (p < 0.0001) difference was observed between bacterial burdens in the internal organs of the actively and passively immunized groups. Female BALB/c mice weighing 20-25 g, were divided into 4 groups of 14 mice each viz., control, Oma87, Bap, Oma87-Bap groups. The proteins were individually immunogenic, but the combination of both proteins had a synergistic protection property. This is further supported by the histological examination. Based on the results, the combination of Oma87 and Bap may be considered a promising vaccine candidate against A. baumannii .

Clinical efficacy of probiotics in prevention of infectious diseases among hospitalized patients in ICU and non-ICU wards in clinical randomized trials: A systematic review.

Background and Aims: The present study aimed to review probiotics' clinical efficacy in preventing infectious diseases among hospitalized patients in ICU and non-ICU wards. Methods: A search of Medline, EMBASE, The Cochrane Library, Science Direct, Open Grey, and Google Scholar was conducted for eligible publications from 2002 to 2020 following the requirements outlined in the PRISMA guideline. The search strategy was based on the combination of the following terms: "probiotics," "prebiotics," "synbiotics," and "cross-infection." The logical operators "AND" (or the equivalent operator for the databases) and "OR" (e.g., probiotics OR prebiotics OR synbiotics) were used. Results: The results indicated that the probiotic consumption caused a significant reduction in antibiotic-associated diarrhea (AAD) and Clostridioides difficile infection (CDI) in 2/8 randomized clinical trials (RCTs) investigating AAD/CDI. Also, 5/12 clinical trials highlighted the considerable effects of probiotics on the reduction or prevention of ventilator associated pneumoniae (VAP), so the mean prevalence of VAP was lower in the probiotic group than in the placebo group. The total rate of nosocomial infections among preterm infants was nonsignificantly higher in the probiotic group compared to the control group. Conclusion: This systematic review shows that the administration of probiotics has moderate preventive or mitigating effects on the occurrence of VAP in ICU patients, CDI, AAD, and nosocomial infections among children. Consequently, applying antibiotics along with the proper probiotic species can be advantageous.

Precise detection of L. monocytogenes hitting its highly conserved region possessing several specific antibody binding sites.

Listeria monocytogenes, a facultative intracellular fast-growing Gram-positive food-borne pathogen, can infect immunocompromised individuals leading to meningitis, meningoencephalitis and septicaemias. From the pool of virulence factors of the organism, ActA, a membrane protein, has a critical role in the life cycle of L. monocytogenes. High mortality rate of listeriosis necessitates a sensitive and rapid diagnostic test for precise identification of L. monocytogenes. We used bioinformatic tools to locate a specific conserved region of ActA for designing and developing an antibody-antigen based diagnostic test for the detection of L. monocytogenes. A number of databases were looked for ActA related sequences. Sequences were analyzed with several online software to find an appropriate region for our purpose. ActA protein was found specific to Listeria species with no homologs in other organisms. We finally introduced a highly conserved region within ActA sequence that possess several antibody binding sites specific to L. monocytogenes. This protein sequence can serve as an antigen for designing a relatively cheap, sensitive, and specific diagnostic test for detection of L. monocytogenes.