Molecular Diagnosis of Severe Angiostrongylus cantonensis-Induced Eosinophilic Meningitis: A Case Report Emphasizing the Need for Accurate Detection Methods.

BACKGROUND Angiostrongylus cantonensis, also known as the rat lungworm, is the most common parasitic cause of human eosinophilic meningitis. A. cantonensis infection is an emergent disease causing permanent neurological injury or even death when not diagnosed and treated promptly. Usually, human infection occurs through ingestion of food contaminated by intermediated hosts or the third stage larvae of A. cantonensis. Indicators for diagnosis include clinical signs of meningitis; contact history, such as that from eating raw or improperly cooked intermediated hosts or contaminated vegetables; and cerebrospinal fluid (CSF) eosinophilia. However, diagnosis is now primarily defined through polymerase chain reaction (PCR) assay of CSF or serum. CASE REPORT A 66-year-old homeless man with unclear exposure history presented with fever and conscious change. The initial hemogram showed eosinophilia without neutrophilic leukocytosis. Non-contrast computed tomography (CT) and magnetic resonance imaging (MRI) of the head revealed no evidence of stroke. A lumbar puncture was performed and showed eosinophilic meningitis. The patient was ultimately diagnosed through PCR and sequencing for A. cantonensis infection, and dexamethasone treatment was started immediately. Although his general condition improved after dexamethasone treatment, his mental status did not improve completely. CONCLUSIONS Our report highlights the importance of applying molecular techniques in diagnosis of angiostrongylosis, especially in individuals who have unknown contact history.

Acinetobacter baylyi as a pathogen for opportunistic infection.

There are no previous reports of human infection due to Acinetobacter baylyi. In this study, we report on six patients with bacteremia due to A. baylyi, based on analysis of the 16S-23S rRNA intergenic spacer and the 16S rRNA gene. All six patients had multiple underlying diseases. The infection was nosocomially acquired in five patients. The six clinical isolates had similar ribopatterns, suggesting a clonal relationship. Compared to the reference strain, the clinical isolates were more resistant to antimicrobial agents, especially beta-lactam antibiotics. In three of the isolates, they may have undetermined plasmid mediated class C type beta-lactamases because of the positive results in a double-disk synergy test using 3-aminophenylboronic acid. Two of the clinical isolates retained a level of natural transformability similar to that of the reference strain. None of the patients died, although only three of them received appropriate antimicrobial therapy. This study demonstrates that A. baylyi is a potential human pathogen that can cause nosocomial infection in immunocompromised patients.

Acquisition of a plasmid-borne blaOXA-58 gene with an upstream IS1008 insertion conferring a high level of carbapenem resistance to Acinetobacter baumannii.

The oxacillinase gene was reported to confer limited resistance to carbapenem in Acinetobacter baumannii. In this study, we have demonstrated that an A. baumannii clinical isolate harboring a plasmid, pTVICU53, has 11,037 bp encoding 13 open reading frames. A bla(OXA-58) gene with an upstream insertion of truncated ISAba3 (DeltaISAba3) and IS1008 was found in this plasmid. DeltaISAba3and IS1008 provided two independent promoters for the transcription control of the bla(OXA-58) gene. The transformation of pTVICU53 or a shuttle vector bearing IS1008-DeltaISAba3-bla(OXA-58) to different A. baumannii recipients can increase their MICs of carbapenem 64- to 256-fold. The deletion of promoters provided by IS1008 resulted in dramatic decreases in bla(OXA-58) transcription and a 32- to 64-fold reduction in the carbapenem MIC. These findings highlight that A. baumannii might develop carbapenem resistance with a single transformation step, taking up a plasmid containing a genetic construct with a potentially high level of transcription of the bla(OXA-58) gene.

Description of the transcriptomes of immune response-activated hemocytes from the mosquito vectors Aedes aegypti and Armigeres subalbatus.

Mosquito-borne diseases, including dengue, malaria, and lymphatic filariasis, exact a devastating toll on global health and economics, killing or debilitating millions every year (54). Mosquito innate immune responses are at the forefront of concerted research efforts aimed at defining potential target genes that could be manipulated to engineer pathogen resistance in vector populations. We aimed to describe the pivotal role that circulating blood cells (called hemocytes) play in immunity by generating a total of 11,952 Aedes aegypti and 12,790 Armigeres subalbatus expressed sequence tag (EST) sequences from immune response-activated hemocyte libraries. These ESTs collapsed into 2,686 and 2,107 EST clusters, respectively. The clusters were used to adapt the web-based interface for annotating bacterial genomes called A Systematic Annotation Package for Community Analysis of Genomes (ASAP) for analysis of ESTs. Each cluster was categorically characterized and annotated in ASAP based on sequence similarity to five sequence databases. The sequence data and annotations can be viewed in ASAP at https://asap.ahabs.wisc.edu/annotation/php/ASAP1.htm. The data presented here represent the results of the first high-throughput in vivo analysis of the transcriptome of immunocytes from an invertebrate. Among the sequences are those for numerous immunity-related genes, many of which parallel those employed in vertebrate innate immunity, that have never been described for these mosquitoes. The sequences and annotations presented in this paper have been submitted to GenBank under accession numbers AY 431103 to AY 433788 (Aedes aegypti) and AY 439334 to AY 441440 (Armigeres subalbatus).