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1.
Nature ; 613(7945): 721-728, 2023 01.
Article in English | MEDLINE | ID: mdl-36450355

ABSTRACT

The microbial cell wall is essential for maintenance of cell shape and resistance to external stressors1. The primary structural component of the cell wall is peptidoglycan, a glycopolymer with peptide crosslinks located outside of the cell membrane1. Peptidoglycan biosynthesis and structure are responsive to shifting environmental conditions such as pH and salinity2-6, but the mechanisms underlying such adaptations are incompletely understood. Precursors of peptidoglycan and other cell surface glycopolymers are synthesized in the cytoplasm and then delivered across the cell membrane bound to the recyclable lipid carrier undecaprenyl phosphate7 (C55-P, also known as UndP). Here we identify the DUF368-containing and DedA transmembrane protein families as candidate C55-P translocases, filling a critical gap in knowledge of the proteins required for the biogenesis of microbial cell surface polymers. Gram-negative and Gram-positive bacteria lacking their cognate DUF368-containing protein exhibited alkaline-dependent cell wall and viability defects, along with increased cell surface C55-P levels. pH-dependent synthetic genetic interactions between DUF368-containing proteins and DedA family members suggest that C55-P transporter usage is dynamic and modulated by environmental inputs. C55-P transporter activity was required by the cholera pathogen for growth and cell shape maintenance in the intestine. We propose that conditional transporter reliance provides resilience in lipid carrier recycling, bolstering microbial fitness both inside and outside the host.


Subject(s)
Bacterial Proteins , Carrier Proteins , Genetic Fitness , Gram-Negative Bacteria , Gram-Positive Bacteria , Polyisoprenyl Phosphates , Bacterial Proteins/metabolism , Carrier Proteins/metabolism , Cell Membrane/metabolism , Cell Wall/chemistry , Cell Wall/metabolism , Lipids/analysis , Peptidoglycan/metabolism , Polyisoprenyl Phosphates/metabolism , Gram-Negative Bacteria/chemistry , Gram-Negative Bacteria/cytology , Gram-Negative Bacteria/metabolism , Gram-Positive Bacteria/chemistry , Gram-Positive Bacteria/cytology , Gram-Positive Bacteria/metabolism , Microbial Viability
2.
PLoS Pathog ; 19(7): e1011536, 2023 07.
Article in English | MEDLINE | ID: mdl-37486930

ABSTRACT

Central metabolic pathways control virulence and antibiotic resistance, and constitute potential targets for antibacterial drugs. In Staphylococcus aureus the role of the pentose phosphate pathway (PPP) remains largely unexplored. Mutation of the 6-phosphogluconolactonase gene pgl, which encodes the only non-essential enzyme in the oxidative phase of the PPP, significantly increased MRSA resistance to ß-lactam antibiotics, particularly in chemically defined media with physiologically-relevant concentrations of glucose, and reduced oxacillin (OX)-induced lysis. Expression of the methicillin-resistance penicillin binding protein 2a and peptidoglycan architecture were unaffected. Carbon tracing and metabolomics revealed extensive metabolic reprogramming in the pgl mutant including increased flux to glycolysis, the TCA cycle, and several cell envelope precursors, which was consistent with increased ß-lactam resistance. Morphologically, pgl mutant cells were smaller than wild-type with a thicker cell wall and ruffled surface when grown in OX. The pgl mutation reduced resistance to Congo Red, sulfamethoxazole and oxidative stress, and increased resistance to targocil, fosfomycin and vancomycin. Levels of lipoteichoic acids (LTAs) were significantly reduced in pgl, which may limit cell lysis, while the surface charge of pgl cells was significantly more positive. A vraG mutation in pgl reversed the increased OX resistance phenotype, and partially restored wild-type surface charge, but not LTA levels. Mutations in vraF or graRS from the VraFG/GraRS complex that regulates DltABCD-mediated d-alanylation of teichoic acids (which in turn controls ß-lactam resistance and surface charge), also restored wild-type OX susceptibility. Collectively these data show that reduced levels of LTAs and OX-induced lysis combined with a VraFG/GraRS-dependent increase in cell surface positive charge are accompanied by significantly increased OX resistance in an MRSA pgl mutant.


Subject(s)
Methicillin-Resistant Staphylococcus aureus , Methicillin-Resistant Staphylococcus aureus/genetics , Methicillin-Resistant Staphylococcus aureus/metabolism , Pentose Phosphate Pathway/genetics , Anti-Bacterial Agents/pharmacology , Anti-Bacterial Agents/metabolism , Oxacillin/pharmacology , Cell Wall/metabolism , Monobactams/metabolism , beta-Lactam Resistance/genetics , Bacterial Proteins/genetics , Bacterial Proteins/metabolism , Microbial Sensitivity Tests
3.
Anaerobe ; 84: 102803, 2023 Dec.
Article in English | MEDLINE | ID: mdl-37984560

ABSTRACT

Infections from anaerobic microorganisms result from breached mucosal barriers, posing a significant mortality risk. A retrospective study at Hospital Universitario La Paz (Madrid) from 2010 to 2022 analyzed 491 (6.17 %) anaerobic bacteremia cases out of 7956 significant bacteremia cases among 171,833 blood culture requests. Bacteroides fragilis was the most frequently isolated species (28.3 %), followed by Clostridium perfringens (13.6 %). B. fragilis showed good susceptibility to amoxicillin/ clavulanic acid (86 %), piperacillin/tazobactam (86 %), and metronidazole (87.7 %). In general, non-fragilis Bacteroides species showed low susceptibility to penicillin (7 %), amoxicillin (17.5 %), and clindamycin (64.9 %). Of our 13 non-perfringens Clostridium isolates, four exhibited resistance to penicillin and four showed resistance to clindamycin. Lactobacillus species were highly susceptible to antibiotics tested. Prevotella spp. showed low susceptibility to penicillin (20 %), amoxicillin (20 %), and clindamycin (40 %). The study contributes valuable data for monitoring and improving anaerobic bacteremia treatment.


Subject(s)
Bacteremia , Bacteria, Anaerobic , Humans , Clindamycin , Retrospective Studies , Tertiary Care Centers , Microbial Sensitivity Tests , Anti-Bacterial Agents/pharmacology , Bacteremia/drug therapy , Bacteremia/microbiology , Piperacillin, Tazobactam Drug Combination , Bacteroides fragilis , Amoxicillin , Amoxicillin-Potassium Clavulanate Combination , Clostridium perfringens
4.
Int J Mol Sci ; 23(3)2022 Jan 27.
Article in English | MEDLINE | ID: mdl-35163408

ABSTRACT

The greenhouse gas nitrous oxide (N2O) has strong potential to drive climate change. Soils are a major source of N2O, with microbial nitrification and denitrification being the primary processes involved in such emissions. The soybean endosymbiont Bradyrhizobium diazoefficiens is a model microorganism to study denitrification, a process that depends on a set of reductases, encoded by the napEDABC, nirK, norCBQD, and nosRZDYFLX genes, which sequentially reduce nitrate (NO3-) to nitrite (NO2-), nitric oxide (NO), N2O, and dinitrogen (N2). In this bacterium, the regulatory network and environmental cues governing the expression of denitrification genes rely on the FixK2 and NnrR transcriptional regulators. To understand the role of FixK2 and NnrR proteins in N2O turnover, we monitored real-time kinetics of NO3-, NO2-, NO, N2O, N2, and oxygen (O2) in a fixK2 and nnrR mutant using a robotized incubation system. We confirmed that FixK2 and NnrR are regulatory determinants essential for NO3- respiration and N2O reduction. Furthermore, we demonstrated that N2O reduction by B. diazoefficiens is independent of canonical inducers of denitrification, such as the nitrogen oxide NO3-, and it is negatively affected by acidic and alkaline conditions. These findings advance the understanding of how specific environmental conditions and two single regulators modulate N2O turnover in B. diazoefficiens.


Subject(s)
Bradyrhizobium/metabolism , Glycine max/microbiology , Greenhouse Gases/metabolism , Nitrous Oxide/metabolism , Symbiosis
5.
Antimicrob Agents Chemother ; 65(8): e0245820, 2021 07 16.
Article in English | MEDLINE | ID: mdl-33972255

ABSTRACT

We present a proof-of-concept study on the use of MALDI Biotyper to detect and monitor the levels of voriconazole in human serum. A simple extraction-concentration method and a MALDI Biotyper protocol were developed, and a parent ion of voriconazole (1 H+) could be detected and quantified with good reproducibility. Our results point to a new application of MALDI Biotyper for therapeutic drug monitoring.


Subject(s)
Drug Monitoring , Humans , Reproducibility of Results , Spectrometry, Mass, Matrix-Assisted Laser Desorption-Ionization , Voriconazole
6.
Med Mycol ; 59(4): 350-354, 2021 Apr 06.
Article in English | MEDLINE | ID: mdl-32634233

ABSTRACT

The aim of this work was to study the epidemiology of candidemia in our hospital in order to determine whether the T2MR system might be a useful tool for early diagnosis of candidemia in selected units. We perform a retrospective review of all candidemia episodes registered in the last 12 years in selected units of our hospital in adult and pediatric patients. Candida species and antifungal susceptibility patterns were registered. A total of 686 isolates were registered, of which 625 were infections due to the five most common species of Candida. C. albicans (45.6%) and C. parapsilosis (33.1%) were the predominant species found in our institution. In adults these species were closely followed by C. glabrata (12-21%) in all units. While in pediatric medical and intensive care units (PICU), these species were followed by other uncommon yeasts. Resistance rates to triazoles were low in C. albicans and C. parapsilosis. In C. glabrata and C. tropicalis the resistance rates to fluconazole ranged from 10.86 to 6.67%. Resistance rates for echinocandins were very low and all strains were susceptible to amphotericin B. T2Candida® might be useful to guide antifungal targeted treatment and discontinuation of antifungal empirical treatment in those units where the five most common Candida species represent more than the ninety percent of the isolates. The selection of medical and surgical units should be based on local epidemiology and antifungal susceptibility patterns. Incidence should be taken into account in order to make clinical decisions based on negative results. LAY ABSTRACT: T2Candida® might be useful selectively in clinical units according to their local epidemiology, antifungal resistance patterns, and incidence of candidemia. It optimizes the clinical value of positive results supporting decisions about targeted therapies or discontinuations based on negative results.


Subject(s)
Antifungal Agents/pharmacology , Candida/drug effects , Candidemia/diagnosis , Candidemia/epidemiology , Clinical Laboratory Techniques/methods , Drug Resistance, Fungal , Tertiary Care Centers/statistics & numerical data , Adult , Antifungal Agents/classification , Candida/classification , Candidemia/microbiology , Child , Clinical Laboratory Techniques/instrumentation , Health Plan Implementation , Hospital Units/statistics & numerical data , Humans , Incidence , Microbial Sensitivity Tests , Retrospective Studies , Spain/epidemiology
7.
Eur J Pediatr ; 180(8): 2563-2569, 2021 Aug.
Article in English | MEDLINE | ID: mdl-34002301

ABSTRACT

The aim of this study was to investigate the effect of tobacco smoke exposure among severely pediatric ICU patients. A prospective epidemiological observational study was conducted among children with bronchiolitis younger than 2 years of age admitted to the Pediatric Intensive Care Unit of Children's University Hospital La Paz during the October 2017 to March 2018 outbreak. On admission, parents were asked whether they smoked. In children who required invasive mechanical ventilation, endotracheal aspirate was collected at the time of intubation. A total of 102 patients with bronchiolitis were studied. Among these, 14 (47%) of 30 infants whose parents smoked required invasive mechanical ventilation vs. 14 (19%) of 72 whose parents were nonsmokers (p = 0.007). Among patients on invasive mechanical ventilation, 10 (71%) of 14 infants with secondhand smoke exposure presented pulmonary bacterial superinfection vs. 3 (21%) of 14 in the unexposed (p = 0.012).Conclusion: Secondhand smoke exposure is an additional high risk for pulmonary bacterial superinfection and invasive mechanical ventilation in infants with severe acute bronchiolitis What is known: •Environmental tobacco smoke exposure is known to be an important risk factor for childhood lower respiratory tract infections. •Tobacco smoke makes structural changes in the respiratory tract and reduces the immune response. What in new: •Secondhand smoke exposure showed to be associated with the increased need and duration of invasive mechanical ventilation, and pediatric intensive care length of stay. •Tobacco smoke exposure is an additional risk factor for the presence of bacteria in the endotracheal aspirate.


Subject(s)
Bronchiolitis , Respiratory Syncytial Virus Infections , Bronchiolitis/epidemiology , Bronchiolitis/etiology , Child , Habits , Humans , Infant , Parents , Prospective Studies , Nicotiana
8.
Pediatr Crit Care Med ; 22(2): e109-e114, 2021 02 01.
Article in English | MEDLINE | ID: mdl-33044414

ABSTRACT

OBJECTIVES: Early diagnosis of invasive Candida infections is a challenge for pediatricians, intensivists, and microbiologists. To fill this gap, a new nanodiagnostic method has been developed using manual application of T2 nuclear magnetic resonance to detect Candida species. The aim of this study was to evaluate, prospectively, the usefulness as a tool diagnosis of the T2Candida panel in pediatric patients admitted at the PICU compared with blood culture. DESIGN: This is a prospective, observational, and unicentric study to compare T2Candida results with simultaneous blood cultures for candidemia diagnose. SETTING: This study was carried out in a 1,300-bed tertiary care hospital with a 16-bed medical-surgical PICU. PATIENTS: Sixty-three patients from 0 to 17 years old were enrolled in this study, including those undergoing solid organ transplantation (kidney, liver, pulmonary, multivisceral, intestinal, and heart) and hematopoietic stem cell transplantation. MEASUREMENTS AND MAIN RESULTS: Seven patients were positive by the T2Candida test. Only two of them had the simultaneous positive blood culture. T2Candida yielded more positive results than blood cultures. CONCLUSIONS: T2Candida might be useful for the diagnosis of candidemia in PICUs. The prevalence of candidemia might be underestimated in this pediatric population. The use of this diagnostic tool in these units may help clinicians to start adequate and timely antifungal treatments.


Subject(s)
Candidemia , Adolescent , Candida , Candidemia/diagnosis , Child , Child, Preschool , Humans , Infant , Infant, Newborn , Intensive Care Units, Pediatric , Magnetic Resonance Spectroscopy , Prospective Studies
9.
J Bacteriol ; 202(24)2020 11 19.
Article in English | MEDLINE | ID: mdl-32631948

ABSTRACT

Both fermentative and respiratory processes contribute to bacterial metabolic adaptations to low oxygen tension (hypoxia). In the absence of O2 as a respiratory electron sink, many bacteria utilize alternative electron acceptors, such as nitrate (NO3-). During canonical NO3- respiration, NO3- is reduced in a stepwise manner to N2 by a dedicated set of reductases. Vibrio cholerae, the etiological agent of cholera, requires only a single periplasmic NO3- reductase (NapA) to undergo NO3- respiration, suggesting that the pathogen possesses a noncanonical NO3- respiratory chain. In this study, we used complementary transposon-based screens to identify genetic determinants of general hypoxic growth and NO3- respiration in V. cholerae We found that while the V. cholerae NO3- respiratory chain is primarily composed of homologues of established NO3- respiratory genes, it also includes components previously unlinked to this process, such as the Na+-NADH dehydrogenase Nqr. The ethanol-generating enzyme AdhE was shown to be the principal fermentative branch required during hypoxic growth in V. cholerae Relative to single adhE or napA mutant strains, a V. cholerae strain lacking both genes exhibited severely impaired hypoxic growth in vitro and in vivo Our findings reveal the genetic basis of a specific interaction between disparate energy production pathways that supports pathogen fitness under shifting conditions. Such metabolic specializations in V. cholerae and other pathogens are potential targets for antimicrobial interventions.IMPORTANCE Bacteria reprogram their metabolism in environments with low oxygen levels (hypoxia). Typically, this occurs via regulation of two major, but largely independent, metabolic pathways: fermentation and respiration. In this study, we found that the diarrheal pathogen Vibrio cholerae has a respiratory chain for NO3- that consists largely of components found in other NO3- respiratory systems but also contains several proteins not previously linked to this process. Both AdhE-dependent fermentation and NO3- respiration were required for efficient pathogen growth under both laboratory conditions and in an animal infection model. These observations provide a specific example of fermentative respiratory interactions and identify metabolic vulnerabilities that may be targetable for new antimicrobial agents in V. cholerae and related pathogens.


Subject(s)
Oxygen/metabolism , Vibrio cholerae/genetics , Vibrio cholerae/metabolism , Animals , Bacterial Proteins/genetics , Bacterial Proteins/metabolism , Cholera/microbiology , Electron Transport , Fermentation , Gene Expression Regulation, Bacterial , Humans , Mice , Nitrates/metabolism , Oxygen/analysis , Vibrio cholerae/growth & development
10.
World J Microbiol Biotechnol ; 35(4): 65, 2019 Apr 02.
Article in English | MEDLINE | ID: mdl-30941578

ABSTRACT

Early detection and identification of pathogens in bloodstream infections (BSI) is important to initiate or adjust antibiotic therapy as soon as possible. The current gold standard for diagnostic of BSI infection is the blood culture, that has a turnaround time of one to few days. Molecular tests performed directly in blood samples have promised faster diagnostics, with response times of a few hours, but their implementation into the clinical routine has been hampered by critical technical and procedural problems. Assay integration into laboratory workflows with random-access loading mode and minimal hands-on time is essential to meet rapid response times. Decreasing assay costs will favor fair clinical evaluations and might increase the applicability of the assays. Control of background contamination with bacterial DNA is one of the most difficult problems and might be avoided with pathogen-specific real-time PCR designs oriented to particular patient groups, or perhaps by quantitative, next-generation sequencing approaches.


Subject(s)
Bacteremia/diagnosis , Molecular Diagnostic Techniques , Costs and Cost Analysis , DNA, Bacterial , Humans , Molecular Diagnostic Techniques/economics , Molecular Diagnostic Techniques/methods , Molecular Diagnostic Techniques/standards , Real-Time Polymerase Chain Reaction/methods , Sensitivity and Specificity , Sepsis/diagnosis , Sepsis/microbiology , Sepsis/virology
11.
Mycoses ; 61(1): 35-39, 2018 Jan.
Article in English | MEDLINE | ID: mdl-28922488

ABSTRACT

Rhodotorula species have traditionally been considered as one of common non-virulent environmental inhabitant. They have emerged as an opportunistic pathogen, particularly in immunocompromised hosts and most infections have been associated with intravenous catheters in these patients. We review the isolates in blood cultures of Rhodotorula mucilaginosa in our Hospital. We describe the demographic and clinical features of the cases and the antifungal susceptibility profiles of the isolates. Selected patients had an isolation of R. mucilaginosa in blood cultures in our tertiary care Hospital. All data were collected retrospectively from clinical records during 5 years. We report 8 isolates in blood, two of them were considered contaminants. Immunosuppression, surgery, previous antibiotic therapy were common clinical features. For all the isolates, minimum inhibitory concentration (MIC) values were high for echinocandins and azoles and low for amphotericin B and 5-flucytosine. One strain showed atypical susceptibility profile. Rhodotorula mucilaginosa may be present on the skin and blood cultures can be contaminated. Fungaemia due to R. mucilaginosa is a rare clinical entity which requires risk factors but clinically relevant because of the multiresistant profile. Rhodotorula mucilaginosa shows high MIC values for azoles and echinocandins, therefore amphotericin B and flucytosine must be administered as antifungal therapy.


Subject(s)
Antifungal Agents/pharmacology , Blood Culture , Fungemia/microbiology , Immunocompromised Host , Rhodotorula/isolation & purification , Aged , Aged, 80 and over , Amphotericin B/pharmacology , Antifungal Agents/therapeutic use , Azoles/pharmacology , Child, Preschool , Echinocandins/pharmacology , Female , Flucytosine/pharmacology , Fungemia/drug therapy , Humans , Infant , Male , Microbial Sensitivity Tests , Middle Aged , Retrospective Studies , Rhodotorula/drug effects , Rhodotorula/growth & development , Spain , Tertiary Care Centers
12.
Nitric Oxide ; 68: 137-149, 2017 Aug 01.
Article in English | MEDLINE | ID: mdl-28167162

ABSTRACT

Expression of the Bradyrhizobium japonicum napEDABC, nirK and norCBQD denitrification genes requires low oxygen (O2) tension and nitrate (NO3-), through a regulatory network comprised of two coordinated cascades, FixLJ-FixK2-NnrR and RegSR-NifA. To precisely understand how these signals are integrated in the FixLJ-FixK2-NnrR circuit, we analyzed ß-Galactosidase activities from napE-lacZ, nirK-lacZ and norC-lacZ fusions, and performed analyses of NapC and NorC levels as well as periplasmic nitrate reductase (Nap) activity, in B. japonicum wildtype and fixK2 and nnrR mutant backgrounds. While microoxic conditions (2% O2 at headspace) were sufficient to induce expression of napEDABC and nirK genes and this control depends on FixK2, norCBQD expression requires, in addition to microoxia, nitric oxide gas (NO) and both FixK2 and NnrR transcription factors. Purified FixK2 protein directly interacted and activated transcription in collaboration with B. japonicum RNA polymerase (RNAP) from the napEDABC and nirK promoters, but not from the norCBQD promoter. Further, recombinant NnrR protein bound exclusively to the norCBQD promoter in an O2-sensitive manner. Our work suggest a disparate regulation of B. japonicum denitrifying genes expression with regard to their dependency to microoxia, nitrogen oxides (NOx), and the regulatory proteins FixK2 and NnrR. In this control, expression of napEDABC and nirK genes requires microoxic conditions and directly depends on FixK2, while expression of norCBQD genes relies on NO, being NnrR the candidate which directly interacts with the norCBQD promoter.


Subject(s)
Bradyrhizobium/genetics , Genes, Bacterial/genetics , Nitrogen Oxides/metabolism , Oxygen/metabolism , Bradyrhizobium/metabolism , Denitrification/genetics
13.
Enferm Infecc Microbiol Clin ; 34(9): 571-576, 2016 Nov.
Article in English | MEDLINE | ID: mdl-26804792

ABSTRACT

INTRODUCTION: A steroid-immunosuppressed rat model of invasive pulmonary aspergillosis was use to examine the usefulness of galactomannan enzyme immunoassay (GM) and quantitative real time PCR (RT-PCR) in evaluating the association between response and exposure after a high dose of prophylactic posaconazole. METHODS: Two different strains of Aspergillus fumigatus with different in vitro posaconazole susceptibility were used. RESULTS: Serum concentrations demonstrated similar posaconazole exposure for all treated animals. However, response to posaconazole relied on the in vitro susceptibility of the infecting strain. After prophylaxis, galactomannan index and fungal burden only decreased in those animals infected with the most susceptible strain. CONCLUSION: This study demonstrated that both biomarkers may be useful tools for predicting efficacy of antifungal compounds in prophylaxis.


Subject(s)
Antifungal Agents/therapeutic use , Mannans/blood , Pulmonary Aspergillosis/drug therapy , Real-Time Polymerase Chain Reaction/methods , Triazoles/therapeutic use , Animals , Antifungal Agents/blood , Biomarkers/blood , Galactose/analogs & derivatives , Immunoenzyme Techniques , Pulmonary Aspergillosis/blood , Rats , Triazoles/blood
14.
J Med Virol ; 87(5): 845-50, 2015 May.
Article in English | MEDLINE | ID: mdl-25690782

ABSTRACT

Human Cytomegalovirus (CMV) is the most common cause of intrauterine and perinatal infections worldwide. Postnatal CMV transmission has usually no consequences, but in some cases it may produce disease in preterm infants. Literature reports a broad range of breast milk-acquired CMV infections (5.7-58.6%), which depends on the study's design and the treatment of the milk. To evaluate CMV transmission via breast milk, a prospective study using a real-time PCR assay was performed. One hundred and thirty-one mothers (accounting for 160 children) accepted the participation in the study. Urine samples from the infants and breast milk samples from their mothers were collected at 3, 15, 30, 60, and 90 days after delivery. CMV-DNA in breast milk was analysed by quantitative real-time PCR assay Affigene® CMV Trender (Cepheid, Bromma, Sweden). The breast milk samples from 92 mothers (92 of 131, 70.2%) were positive for CMV by PCR. CMV infection was detected in thirteen children by PCR, and four of them (30.7%) had clinical symptoms. There were not significant differences in morbidity between symptomatic and non- symptomatic patients; nonetheless, the average length of hospitalization in symptomatic children was higher than that of non-symptomatic children (P < 0.05). The rtPCR technique is useful for detection of mothers with high viral loads of CMV-DNA in milk, and might be of help to decide whether to freeze the breast milk in preterm children less than 28 weeks.


Subject(s)
Cytomegalovirus Infections/transmission , Cytomegalovirus/isolation & purification , Infant, Low Birth Weight , Infectious Disease Transmission, Vertical , Milk, Human/virology , Real-Time Polymerase Chain Reaction , Cytomegalovirus Infections/diagnosis , Cytomegalovirus Infections/epidemiology , DNA, Viral/isolation & purification , Female , Humans , Infant , Infant, Newborn , Longitudinal Studies , Male , Mothers , Prospective Studies , Sweden/epidemiology , Urine/virology
15.
Article in English | MEDLINE | ID: mdl-38176845

ABSTRACT

OBJECTIVES: To study the genomic epidemiology of Streptococcus pyogenes causing bloodstream infections (GAS-BSI) in a Spanish tertiary hospital during the United Kingdom invasive S. pyogenes outbreak alert. METHODS: Retrospective epidemiological analysis of GAS-BSI during the January-May 2017-2023 period. WGS was performed using Ion torrent GeneStudio™ S5 system for emm typing and identification of superantigen genes in S. pyogenes isolated during the 2022-2023 UK outbreak alert. RESULTS: During 2023, there were more cases of GAS-BSI compared to the same period of previous year with a non-significant increase in children. Fourteen isolates were sequenced. The emm1 (6/14, 42.9%) and emm12 (2/14, 14.3%) types predominated; 5 of 6 (75%) emm1 isolates were from the M1UK clone. The most detected superantigen genes were speG (12/14, 85.7%), speC (10/14, 71.4%), speJ (7/14, 50%), and speA (5/15, 33.3%). speA and speJ were predominant in M1UK clone. CONCLUSIONS: Our genomic epidemiology in 2023 is similar to the reported data from the UK outbreak alert in the same period and different from previous national S. pyogenes surveillance reports.


Subject(s)
Streptococcal Infections , Streptococcus pyogenes , Child , Humans , Streptococcus pyogenes/genetics , Retrospective Studies , Tertiary Care Centers , Antigens, Bacterial/genetics , Streptococcal Infections/epidemiology , Superantigens/genetics , United Kingdom/epidemiology
16.
Antibiotics (Basel) ; 13(7)2024 Jun 27.
Article in English | MEDLINE | ID: mdl-39061281

ABSTRACT

The prevalence of multidrug-resistant Gram-negative infections, particularly carbapenem-resistant strains, has become a significant global health concern. Ceftazidime-avibactam (CZA) has emerged as a promising treatment option. However, data on its efficacy and safety in children are scarce, necessitating further investigation. We conducted a descriptive case series at a tertiary hospital in Spain from February 2019 to January 2022. Pediatric patients (<16 years) treated with CZA for confirmed or suspected multidrug-resistant Gram-negative infections were included. The clinical and microbiological characteristics, treatment approaches, and outcomes were examined. Eighteen children received CZA treatment. All had complex chronic conditions, with the most frequent underlying main diseases being liver transplantation (n = 8) and biliary atresia (n = 4). The predominant type of infection for which they received CZA was intra-abdominal infection caused or suspected to be caused by OXA-48-producing Klebsiella pneumoniae. CZA was generally well tolerated. Within the first month of starting CZA therapy, two patients died, with one case directly linked to the infection's fatal outcome. Some patients needed repeated courses of therapy due to recurrent infections, yet no resistance development was noted. In summary, the use of CZA showed effectiveness and safety, while the lack of resistance development highlights CZA's potential as a primary treatment option against OXA-48-producing infections.

17.
bioRxiv ; 2024 Jan 16.
Article in English | MEDLINE | ID: mdl-38293037

ABSTRACT

Weak organic acids are commonly found in host niches colonized by bacteria, and they can inhibit bacterial growth as the environment becomes acidic. This inhibition is often attributed to the toxicity resulting from the accumulation of high concentrations of organic anions in the cytosol, which disrupts cellular homeostasis. However, the precise cellular targets that organic anions poison and the mechanisms used to counter organic anion intoxication in bacteria have not been elucidated. Here, we utilize acetic acid, a weak organic acid abundantly found in the gut to investigate its impact on the growth of Staphylococcus aureus. We demonstrate that acetate anions bind to and inhibit d-alanyl-d-alanine ligase (Ddl) activity in S. aureus. Ddl inhibition reduces intracellular d-alanyl-d-alanine (d-Ala-d-Ala) levels, compromising staphylococcal peptidoglycan cross-linking and cell wall integrity. To overcome the effects of acetate-mediated Ddl inhibition, S. aureus maintains a high intracellular d-Ala pool through alanine racemase (Alr1) activity and additionally limits the flux of d-Ala to d-glutamate by controlling d-alanine aminotransferase (Dat) activity. Surprisingly, the modus operandi of acetate intoxication in S. aureus is common to multiple biologically relevant weak organic acids indicating that Ddl is a conserved target of small organic anions. These findings suggest that S. aureus may have evolved to maintain high intracellular d-Ala concentrations, partly to counter organic anion intoxication.

18.
Antimicrob Agents Chemother ; 57(7): 3437-40, 2013 Jul.
Article in English | MEDLINE | ID: mdl-23650161

ABSTRACT

We describe here a simple, fast, and reliable bioassay method for therapeutic drug monitoring of voriconazole. Fifty-eight clinical and external quality control samples were evaluated with this microbiological assay, and results were compared with those obtained with a previously validated chromatographic method. A good correlation between both assays was observed. This particular microbiological method was demonstrated to be simple and offers enough precision and accuracy to perform voriconazole therapeutic drug monitoring in laboratories without specialized equipment.


Subject(s)
Antifungal Agents/blood , Candida/drug effects , Drug Monitoring/methods , Pyrimidines/blood , Triazoles/blood , Humans , Microbial Sensitivity Tests , Voriconazole
19.
PLoS Pathog ; 7(12): e1002441, 2011 Dec.
Article in English | MEDLINE | ID: mdl-22194688

ABSTRACT

RNA-binding proteins play a central role in post-transcriptional mechanisms that control gene expression. Identification of novel RNA-binding proteins in fungi is essential to unravel post-transcriptional networks and cellular processes that confer identity to the fungal kingdom. Here, we carried out the functional characterisation of the filamentous fungus-specific RNA-binding protein RBP35 required for full virulence and development in the rice blast fungus. RBP35 contains an N-terminal RNA recognition motif (RRM) and six Arg-Gly-Gly tripeptide repeats. Immunoblots identified two RBP35 protein isoforms that show a steady-state nuclear localisation and bind RNA in vitro. RBP35 coimmunoprecipitates in vivo with Cleavage Factor I (CFI) 25 kDa, a highly conserved protein involved in polyA site recognition and cleavage of pre-mRNAs. Several targets of RBP35 have been identified using transcriptomics including 14-3-3 pre-mRNA, an important integrator of environmental signals. In Magnaporthe oryzae, RBP35 is not essential for viability but regulates the length of 3'UTRs of transcripts with developmental and virulence-associated functions. The Δrbp35 mutant is affected in the TOR (target of rapamycin) signaling pathway showing significant changes in nitrogen metabolism and protein secretion. The lack of clear RBP35 orthologues in yeast, plants and animals indicates that RBP35 is a novel auxiliary protein of the polyadenylation machinery of filamentous fungi. Our data demonstrate that RBP35 is the fungal equivalent of metazoan CFI 68 kDa and suggest the existence of 3'end processing mechanisms exclusive to the fungal kingdom.


Subject(s)
Fungal Proteins/genetics , Gene Expression Regulation, Fungal , Magnaporthe/genetics , Polyadenylation , mRNA Cleavage and Polyadenylation Factors/genetics , 3' Untranslated Regions/genetics , Amino Acid Sequence , Fungal Proteins/metabolism , Magnaporthe/growth & development , Magnaporthe/pathogenicity , Molecular Sequence Data , Oryza/microbiology , Plant Diseases/microbiology , RNA Precursors/metabolism , RNA, Messenger/metabolism , Virulence/genetics , mRNA Cleavage and Polyadenylation Factors/metabolism
20.
Enferm Infecc Microbiol Clin ; 31(1): 23-8, 2013 Jan.
Article in English | MEDLINE | ID: mdl-22776376

ABSTRACT

The aim of this study was the development and validation of a fast and simple high performance liquid chromatography method for measuring voriconazole in human serum using ravuconazole as an external standard. The experience of the reference laboratory in therapeutic drug monitoring of voriconazole is also reported. This method is based on the precipitation of proteins in human serum and detection by HPLC/UV. Chromatographic separation is achieved using an isocratic solvent delivery with detection at 255 nm and a run time of 7 min. The assay was validated according to international guidelines and was also applied to the analysis of 141 trough serum samples from patients treated with voriconazole. All validation parameters met the criteria set out in FDA guidelines for bioanalytical methods. A high interpatient and intrapatient variability was observed in clinical samples. This method is accurate enough to perform therapeutic drug monitoring in patients receiving voriconazole treatment.


Subject(s)
Antifungal Agents/blood , Pyrimidines/blood , Triazoles/blood , Chromatography, High Pressure Liquid , Drug Monitoring , Humans , Voriconazole
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