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1.
Appl Environ Microbiol ; 89(2): e0124422, 2023 02 28.
Article in English | MEDLINE | ID: mdl-36744930

ABSTRACT

Ail confers serum resistance in humans and is a critical virulence factor of Y. pestis, the causative agent of plague. Here, the contribution of Ail for Y. pestis survival in the flea vector was examined. Rat or human but not mouse sera were bactericidal against a Y. pestis Δail mutant at 28°C in vitro. Complement components deposited rapidly on the Y. pestis surface as measured by immunofluorescent microscopy. Ail reduced the amount of active C3b on the Y. pestis surface. Human sera retained bactericidal activity against a Y. pestis Δail mutant in the presence of mouse sera. However, in the flea vector, the serum protective properties of Ail were not required. Flea colonization studies using murine sera and Y. pestis KIM6+ wild type, a Δail mutant, and the Δail/ail+ control showed no differences in bacterial prevalence or numbers during the early stage of flea colonization. Similarly, flea studies with human blood showed Ail was not required for serum resistance. Finally, a variant of Ail (AilF100V E108_S109insS) from a human serum-sensitive Y. pestis subsp. microtus bv. Caucasica 1146 conferred resistance to human complement when expressed in the Y. pestis KIM6+ Δail mutant. This indicated that Ail activity was somehow blocked, most likely by lipooligosaccharide, in this serum sensitive strain. IMPORTANCE This work contributes to our understanding of how highly virulent Y. pestis evolved from its innocuous enteric predecessor. Among identified virulence factors is the attachment invasion locus protein, Ail, that is required to protect Y. pestis from serum complement in all mammals tested except mice. Murine sera is not bactericidal. In this study, we asked, is bactericidal sera from humans active in Y. pestis colonized fleas? We found it was not. The importance of this observation is that it identifies a protective niche for the growth of serum sensitive and nonsensitive Y. pestis strains.


Subject(s)
Plague , Siphonaptera , Yersinia pestis , Animals , Humans , Mice , Rats , Anti-Bacterial Agents/metabolism , Bacterial Outer Membrane Proteins/metabolism , Mammals , Plague/microbiology , Siphonaptera/metabolism , Siphonaptera/microbiology , Virulence Factors/genetics , Virulence Factors/metabolism , Yersinia pestis/genetics , Yersinia pestis/metabolism , Complement C3b/metabolism , Complement C3b/pharmacology
2.
J Infect Dis ; 214(suppl 3): S258-S262, 2016 10 15.
Article in English | MEDLINE | ID: mdl-27587631

ABSTRACT

During the Ebola virus outbreak of 2013-2016, the Viral Special Pathogens Branch field laboratory in Sierra Leone tested approximately 26 000 specimens between August 2014 and October 2015. Analysis of the B2M endogenous control Ct values showed its utility in monitoring specimen quality, comparing results with different specimen types, and interpretation of results. For live patients, blood is the most sensitive specimen type and oral swabs have little diagnostic utility. However, swabs are highly sensitive for diagnostic testing of corpses.


Subject(s)
Disease Outbreaks , Ebolavirus/isolation & purification , Hemorrhagic Fever, Ebola/diagnosis , RNA, Viral/analysis , Reverse Transcriptase Polymerase Chain Reaction/methods , Clinical Laboratory Services , Ebolavirus/genetics , Hemorrhagic Fever, Ebola/epidemiology , Hemorrhagic Fever, Ebola/virology , Humans , Laboratories , Real-Time Polymerase Chain Reaction/methods , Sensitivity and Specificity , Sierra Leone/epidemiology
3.
Emerg Infect Dis ; 22(2): 217-23, 2016 Feb.
Article in English | MEDLINE | ID: mdl-26812579

ABSTRACT

To determine whether 2 readily available indicators predicted survival among patients with Ebola virus disease in Sierra Leone, we evaluated information for 216 of the 227 patients in Bo District during a 4-month period. The indicators were time from symptom onset to healthcare facility admission and quantitative real-time reverse transcription PCR cycle threshold (Ct), a surrogate for viral load, in first Ebola virus-positive blood sample tested. Of these patients, 151 were alive when detected and had reported healthcare facility admission dates and Ct values available. Time from symptom onset to healthcare facility admission was not associated with survival, but viral load in the first Ebola virus-positive blood sample was inversely associated with survival: 52 (87%) of 60 patients with a Ct of >24 survived and 20 (22%) of 91 with a Ct of <24 survived. Ct values may be useful for clinicians making treatment decisions or managing patient or family expectations.


Subject(s)
Ebolavirus , Hemorrhagic Fever, Ebola/mortality , Hemorrhagic Fever, Ebola/virology , Adolescent , Adult , Female , Hemorrhagic Fever, Ebola/epidemiology , Hospitalization , Humans , Male , Middle Aged , Mortality , Population Surveillance , Prognosis , Sierra Leone/epidemiology , Young Adult
4.
J Infect Dis ; 212 Suppl 2: S350-8, 2015 Oct 01.
Article in English | MEDLINE | ID: mdl-26232439

ABSTRACT

In August 2014, the Viral Special Pathogens Branch of the US Centers for Disease Control and Prevention established a field laboratory in Sierra Leone in response to the ongoing Ebola virus outbreak. Through March 2015, this laboratory tested >12 000 specimens from throughout Sierra Leone. We describe the organization and procedures of the laboratory located in Bo, Sierra Leone.


Subject(s)
Ebolavirus/isolation & purification , Hemorrhagic Fever, Ebola/diagnosis , Hemorrhagic Fever, Ebola/virology , Centers for Disease Control and Prevention, U.S. , Disease Outbreaks , Epidemics , Humans , Laboratories , Sierra Leone/epidemiology , United States
5.
Cell ; 161(7): 1516-26, 2015 Jun 18.
Article in English | MEDLINE | ID: mdl-26091036

ABSTRACT

The 2013-2015 Ebola virus disease (EVD) epidemic is caused by the Makona variant of Ebola virus (EBOV). Early in the epidemic, genome sequencing provided insights into virus evolution and transmission and offered important information for outbreak response. Here, we analyze sequences from 232 patients sampled over 7 months in Sierra Leone, along with 86 previously released genomes from earlier in the epidemic. We confirm sustained human-to-human transmission within Sierra Leone and find no evidence for import or export of EBOV across national borders after its initial introduction. Using high-depth replicate sequencing, we observe both host-to-host transmission and recurrent emergence of intrahost genetic variants. We trace the increasing impact of purifying selection in suppressing the accumulation of nonsynonymous mutations over time. Finally, we note changes in the mucin-like domain of EBOV glycoprotein that merit further investigation. These findings clarify the movement of EBOV within the region and describe viral evolution during prolonged human-to-human transmission.


Subject(s)
Ebolavirus/genetics , Ebolavirus/isolation & purification , Genome, Viral , Hemorrhagic Fever, Ebola/epidemiology , Hemorrhagic Fever, Ebola/virology , Mutation , Biological Evolution , Disease Outbreaks , Ebolavirus/classification , Hemorrhagic Fever, Ebola/transmission , Humans , Sierra Leone/epidemiology , Specimen Handling
6.
Microbiology (Reading) ; 161(Pt 3): 628-38, 2015 Mar.
Article in English | MEDLINE | ID: mdl-25533446

ABSTRACT

Yersinia pestis, the causative agent of plague, can be transmitted by fleas by two different mechanisms: by early-phase transmission (EPT), which occurs shortly after flea infection, or by blocked fleas following long-term infection. Efficient flea-borne transmission is predicated upon the ability of Y. pestis to be maintained within the flea. Signature-tagged mutagenesis (STM) was used to identify genes required for Y. pestis maintenance in a genuine plague vector, Xenopsylla cheopis. The STM screen identified seven mutants that displayed markedly reduced fitness in fleas after 4 days, the time during which EPT occurs. Two of the mutants contained insertions in genes encoding glucose 1-phosphate uridylyltransferase (galU) and UDP-4-amino-4-deoxy-l-arabinose-oxoglutarate aminotransferase (arnB), which are involved in the modification of lipid A with 4-amino-4-deoxy-l-arabinose (Ara4N) and resistance to cationic antimicrobial peptides (CAMPs). These Y. pestis mutants were more susceptible to the CAMPs cecropin A and polymyxin B, and produced lipid A lacking Ara4N modifications. Surprisingly, an in-frame deletion of arnB retained modest levels of CAMP resistance and Ara4N modification, indicating the presence of compensatory factors. It was determined that WecE, an aminotransferase involved in biosynthesis of enterobacterial common antigen, plays a novel role in Y. pestis Ara4N modification by partially offsetting the loss of arnB. These results indicated that mechanisms of Ara4N modification of lipid A are more complex than previously thought, and these modifications, as well as several factors yet to be elucidated, play an important role in early survival and transmission of Y. pestis in the flea vector.


Subject(s)
Insect Vectors/microbiology , Lipid A/metabolism , Plague/microbiology , Siphonaptera/microbiology , Yersinia pestis/growth & development , Yersinia pestis/metabolism , Animals , Bacterial Proteins/genetics , Bacterial Proteins/metabolism , Humans , Microbial Viability , Plague/transmission , Rats , Rats, Sprague-Dawley , Yersinia pestis/genetics
7.
J Med Entomol ; 51(5): 1079-86, 2014 Sep.
Article in English | MEDLINE | ID: mdl-25276941

ABSTRACT

Plague, a primarily flea-borne disease caused by Yersinia pestis, is characterized by rapidly spreading epizootics separated by periods of quiescence. Little is known about how and where Y. pestis persists between epizootics. It is commonly proposed, however, that Y pestis is maintained during interepizootic periods in enzootic cycles involving flea vectors and relatively resistant host populations. According to this model, while susceptible individuals serve as infectious sources for feeding fleas and subsequently die of infection, resistant hosts survive infection, develop antibodies to the plague bacterium, and continue to provide bloodmeals to infected fleas. For Y. pestis to persist under this scenario, fleas must remain infected after feeding on hosts carrying antibodies to Y. pestis. Studies of other vector-borne pathogens suggest that host immunity may negatively impact pathogen survival in the vector. Here, we report infection rates and bacterial loads for fleas (both Xenopsylla cheopis (Rothschild) and Oropsylla montana (Baker)) that consumed an infectious bloodmeal and subsequently fed on an immunized or age-matched naive mouse. We demonstrate that neither the proportion of infected fleas nor the bacterial loads in infected fleas were significantly lower within 3 d of feeding on immunized versus naive mice. Our findings thus provide support for one assumption underlying the enzootic host model of interepizootic maintenance of Y. pestis.


Subject(s)
Siphonaptera/immunology , Siphonaptera/microbiology , Yersinia pestis/physiology , Animals , Bacterial Load , Blood , Feeding Behavior , Host-Pathogen Interactions , Mice
8.
Microbiology (Reading) ; 160(Pt 11): 2517-2525, 2014 Nov.
Article in English | MEDLINE | ID: mdl-25187626

ABSTRACT

Plague, caused by Yersinia pestis, is characterized by quiescent periods punctuated by rapidly spreading epizootics. The classical 'blocked flea' paradigm, by which a blockage forms in the flea's proventriculus on average 1-2 weeks post-infection (p.i.), forces starving fleas to take multiple blood meals, thus increasing opportunities for transmission. Recently, the importance of early-phase transmission (EPT), which occurs prior to blockage formation, has been emphasized during epizootics. Whilst the physiological and molecular mechanisms of blocked flea transmission are well characterized, the pathogen-vector interactions have not been elucidated for EPT. Within the blocked flea model, Yersinia murine toxin (Ymt) has been shown to be important for facilitating colonization of the midgut within the flea. One proposed mechanism of EPT is the regurgitation of infectious material from the flea midgut during feeding. Such a mechanism would require bacteria to colonize and survive for at least brief periods in the midgut, a process that is mediated by Ymt. Two key bridging vectors of Y. pestis to humans, Oropsylla montana (Siphonaptera: Ceratophyllidae) or Xenopsylla cheopis (Siphonaptera: Pulicidae), were used in our study to test this hypothesis. Fleas were infected with a mutant strain of Y. pestis containing a non-functional ymt that was shown previously to be incapable of colonizing the midgut and were then allowed to feed on SKH-1 mice 3 days p.i. Our results show that Ymt was not required for EPT by either flea species.


Subject(s)
Bacterial Toxins/metabolism , Insect Vectors/microbiology , Plague/transmission , Siphonaptera/microbiology , Xenopsylla/microbiology , Yersinia pestis/metabolism , Animals , Humans , Insect Vectors/physiology , Mice , Plague/microbiology , Rats , Rats, Sprague-Dawley , Siphonaptera/physiology , Virulence , Xenopsylla/physiology , Yersinia pestis/genetics , Yersinia pestis/pathogenicity
9.
Vector Borne Zoonotic Dis ; 13(7): 468-78, 2013 Jul.
Article in English | MEDLINE | ID: mdl-23590319

ABSTRACT

Yersinia pestis, the causative agent of plague, is primarily a rodent-associated, flea-borne zoonosis maintained in sylvatic foci throughout western North America. Transmission to humans is mediated most commonly by the flea vector Oropsylla montana and occurs predominantly in the southwestern United States. With few exceptions, previous studies showed O. montana to be an inefficient vector at transmitting Y. pestis at ambient temperatures, particularly when such fleas were fed on susceptible hosts more than a few days after ingesting an infectious blood meal. We examined whether holding fleas at subambient temperatures affected the transmissibility of Y. pestis by this vector. An infectious blood meal containing a virulent Y. pestis strain (CO96-3188) was given to colony-reared O. montana fleas. Potentially infected fleas were maintained at different temperatures (6°C, 10°C, 15°C, or 23°C). Transmission efficiencies were tested by allowing up to 15 infectious fleas to feed on each of 7 naïve CD-1 mice on days 1-4, 7, 10, 14, 17, and 21 postinfection (p.i.). Mice were monitored for signs of infection for 21 days after exposure to infectious fleas. Fleas held at 6°C, 10°C, and 15°C were able to effectively transmit at every time point p.i. The percentage of transmission to naïve mice by fleas maintained at low temperatures (46.0% at 6°C, 71.4% at 10°C, 66.7% at 15°C) was higher than for fleas maintained at 23°C (25.4%) and indicates that O. montana fleas efficiently transmit Y. pestis at low temperatures. Moreover, pooled percent per flea transmission efficiencies for flea cohorts maintained at temperatures of 10°C and 15°C (8.67% and 7.87%, respectively) showed a statistically significant difference in the pooled percent per flea transmission efficiency from fleas maintained at 23°C (1.94%). This is the first comprehensive study to demonstrate efficient transmission of Y. pestis by O. montana fleas maintained at temperatures as low as 6°C. Our findings further contribute to the understanding of plague ecology in temperate climates by providing support for the hypothesis that Y. pestis is able to overwinter within the flea gut and potentially cause infection during the following transmission season. The findings also might hold implications for explaining the focality of plague in tropical regions.


Subject(s)
Flea Infestations/parasitology , Insect Vectors/microbiology , Plague/transmission , Siphonaptera/microbiology , Yersinia pestis/physiology , Animals , Disease Reservoirs , Female , Humans , Male , Mice , Plague/microbiology , Seasons , Specific Pathogen-Free Organisms , Temperature , Yersinia pestis/pathogenicity , Zoonoses
10.
Parasit Vectors ; 4: 191, 2011 Sep 29.
Article in English | MEDLINE | ID: mdl-21958555

ABSTRACT

BACKGROUND: Traditionally, efficient flea-borne transmission of Yersinia pestis, the causative agent of plague, was thought to be dependent on a process referred to as blockage in which biofilm-mediated growth of the bacteria physically blocks the flea gut, leading to the regurgitation of contaminated blood into the host. This process was previously shown to be temperature-regulated, with blockage failing at temperatures approaching 30°C; however, the abilities of fleas to transmit infections at different temperatures had not been adequately assessed. We infected colony-reared fleas of Xenopsylla cheopis with a wild type strain of Y. pestis and maintained them at 10, 23, 27, or 30°C. Naïve mice were exposed to groups of infected fleas beginning on day 7 post-infection (p.i.), and every 3-4 days thereafter until day 14 p.i. for fleas held at 10°C, or 28 days p.i. for fleas held at 23-30°C. Transmission was confirmed using Y. pestis-specific antigen or antibody detection assays on mouse tissues. RESULTS: Although no statistically significant differences in per flea transmission efficiencies were detected between 23 and 30°C, efficiencies were highest for fleas maintained at 23°C and they began to decline at 27 and 30°C by day 21 p.i. These declines coincided with declining median bacterial loads in fleas at 27 and 30°C. Survival and feeding rates of fleas also varied by temperature to suggest fleas at 27 and 30°C would be less likely to sustain transmission than fleas maintained at 23°C. Fleas held at 10°C transmitted Y. pestis infections, although flea survival was significantly reduced compared to that of uninfected fleas at this temperature. Median bacterial loads were significantly higher at 10°C than at the other temperatures. CONCLUSIONS: Our results suggest that temperature does not significantly effect the per flea efficiency of Y. pestis transmission by X. cheopis, but that temperature is likely to influence the dynamics of Y. pestis flea-borne transmission, perhaps by affecting persistence of the bacteria in the flea gut or by influencing flea survival. Whether Y. pestis biofilm production is important for transmission at different temperatures remains unresolved, although our results support the hypothesis that blockage is not necessary for efficient transmission.


Subject(s)
Insect Vectors/physiology , Plague/transmission , Xenopsylla/physiology , Yersinia pestis/physiology , Animals , Female , Flea Infestations/parasitology , Humans , Insect Vectors/microbiology , Male , Mice , Plague/microbiology , Plague/parasitology , Xenopsylla/microbiology
11.
Am J Electroneurodiagnostic Technol ; 51(2): 92-104, 2011 Jun.
Article in English | MEDLINE | ID: mdl-21809746

ABSTRACT

EEG is a safe, inexpensive, mobile test that can be integrated with the neurologic clinical examination and other testing to help physicians move more quickly and accurately to the right branch of the differential diagnostic tree even when the EEG result is not specifically diagnostic itself As technology evolves to allow faster; easier electrode application and remote transmission of EEG data to electroencephalographers; the use of EEG in the emergency room and intensive care units to assist with differential diagnosis is likely to sharply increase. We examine some differential diagnostic scenarios and actual cases where EEG proved useful. Neurologists are trained to think in differential diagnostic terms. As they review EEG tracings, they often ask neurodiagnostic technologists questions pertaining to the patient history or other testing results that help them assimilate the relevant differential diagnostic data. Neurodiagnostic technologists have a unique opportunity to collect useful differential diagnostic information because they spend about 20 minutes talking with the patient as they apply electrodes and they see the EEG results while the patient, family members, or the patient's nurse is still available for questioning. Those technologists who are able to see the bigger picture and think in differential diagnostic terms as they do EEG testing are more likely to include in their patient's history important clinical details that will help the neurologist reach the correct diagnosis of the patient.


Subject(s)
Electroencephalography/methods , Mental Disorders/diagnosis , Acute Disease , Adult , Aged , Aged, 80 and over , Confusion/diagnosis , Diagnosis, Differential , Early Diagnosis , Humans , Male , Memory Disorders/diagnosis , Middle Aged , Seizures/diagnosis
12.
J Med Entomol ; 48(2): 411-7, 2011 Mar.
Article in English | MEDLINE | ID: mdl-21485382

ABSTRACT

Sharp declines in human and animal cases of plague, caused by the bacterium Yersinia pestis (Yersin), have been observed when outbreaks coincide with hot weather. Failure of biofilm production, or blockage, to occur in the flea, as temperatures reach 30 degrees C has been suggested as an explanation for these declines. Recent work demonstrating efficient flea transmission during the first few days after fleas have taken an infectious blood meal, in the absence of blockage (e.g., early-phase transmission), however, has called this hypothesis into question. To explore the potential effects of temperature on early-phase transmission, we infected colony-reared Xenopsylla cheopis (Rothchild) fleas with a wild-type strain of plague bacteria using an artificial feeding system, and held groups of fleas at 10, 23, 27, and 30 degrees C. Naive Swiss Webster mice were exposed to fleas from each of these temperatures on days 1-4 postinfection, and monitored for signs of infection for 21 d. Temperature did not significantly influence the rates of transmission observed for fleas held at 23, 27, and 30 degrees C. Estimated per flea transmission efficiencies for these higher temperatures ranged from 2.32 to 4.96% (95% confidence interval [CI]: 0.96-8.74). In contrast, no transmission was observed in mice challenged by fleas held at 10 degrees C (per flea transmission efficiency estimates, 0-1.68%). These results suggest that declines in human and animal cases during hot weather are not related to changes in the abilities of X. cheopis fleas to transmit Y. pestis infections during the early-phase period. By contrast, transmission may be delayed or inhibited at low temperatures, indicating that epizootic spread of Y. pestis by X. cheopis via early-phase transmission is unlikely during colder periods of the year.


Subject(s)
Plague/transmission , Xenopsylla/microbiology , Yersinia pestis/physiology , Animals , Feeding Behavior/physiology , Mice , Plague/microbiology , Temperature , Xenopsylla/physiology
13.
Infect Immun ; 78(12): 5163-77, 2010 Dec.
Article in English | MEDLINE | ID: mdl-20855510

ABSTRACT

Little is known about Zn homeostasis in Yersinia pestis, the plague bacillus. The Znu ABC transporter is essential for zinc (Zn) uptake and virulence in a number of bacterial pathogens. Bioinformatics analysis identified ZnuABC as the only apparent high-affinity Zn uptake system in Y. pestis. Mutation of znuACB caused a growth defect in Chelex-100-treated PMH2 growth medium, which was alleviated by supplementation with submicromolar concentrations of Zn. Use of transcriptional reporters confirmed that Zur mediated Zn-dependent repression and that it can repress gene expression in response to Zn even in the absence of Znu. Virulence testing in mouse models of bubonic and pneumonic plague found only a modest increase in survival in low-dose infections by the znuACB mutant. Previous studies of cluster 9 (C9) transporters suggested that Yfe, a well-characterized C9 importer for manganese (Mn) and iron in Y. pestis, might function as a second, high-affinity Zn uptake system. Isothermal titration calorimetry revealed that YfeA, the solute-binding protein component of Yfe, binds Mn and Zn with comparably high affinities (dissociation constants of 17.8 ± 4.4 nM and 6.6 ± 1.2 nM, respectively), although the complete Yfe transporter could not compensate for the loss of Znu in in vitro growth studies. Unexpectedly, overexpression of Yfe interfered with the znu mutant's ability to grow in low concentrations of Zn, while excess Zn interfered with the ability of Yfe to import iron at low concentrations; these results suggest that YfeA can bind Zn in the bacterial cell but that Yfe is incompetent for transport of the metal. In addition to Yfe, we have now eliminated MntH, FetMP, Efe, Feo, a substrate-binding protein, and a putative nickel transporter as the unidentified, secondary Zn transporter in Y. pestis. Unlike other bacterial pathogens, Y. pestis does not require Znu for high-level infectivity and virulence; instead, it appears to possess a novel class of transporter, which can satisfy the bacterium's Zn requirements under in vivo metal-limiting conditions. Our studies also underscore the need for bacterial cells to balance binding and transporter specificities within the periplasm in order to maintain transition metal homeostasis.


Subject(s)
ATP-Binding Cassette Transporters/physiology , Plague/microbiology , Yersinia pestis/pathogenicity , Zinc/metabolism , ATP-Binding Cassette Transporters/genetics , Animals , Cloning, Molecular , Gene Expression Regulation, Bacterial/physiology , Mice , Middle East , Mutation , Virulence/genetics , Virulence/physiology , Yersinia pestis/genetics , Yersinia pestis/growth & development , Yersinia pestis/physiology , Zinc/physiology
14.
Microbiology (Reading) ; 156(Pt 7): 2216-2225, 2010 Jul.
Article in English | MEDLINE | ID: mdl-20395271

ABSTRACT

Early-phase transmission (EPT) is a recently described model of plague transmission that explains the rapid spread of disease from flea to mammal host during an epizootic. Unlike the traditional blockage-dependent model of plague transmission, EPT can occur when a flea takes its first blood meal after initially becoming infected by feeding on a bacteraemic host. Blockage of the flea gut results from biofilm formation in the proventriculus, mediated by the gene products found in the haemin storage (hms) locus of the Yersinia pestis chromosome. Although biofilms are required for blockage-dependent transmission, the role of biofilms in EPT has yet to be determined. An artificial feeding system was used to feed Xenopsylla cheopis and Oropsylla montana rat blood spiked with the parental Y. pestis strain KIM5(pCD1)+, two different biofilm-deficient mutants (Delta hmsT, Delta hmsR), or a biofilm-overproducer mutant (Delta hmsP). Infected fleas were then allowed to feed on naïve Swiss Webster mice for 1-4 days after infection, and the mice were monitored for signs of infection. We also determined the bacterial loads of each flea that fed upon naïve mice. Biofilm-defective mutants transmitted from X. cheopis and O. montana as efficiently as the parent strain, whereas the EPT efficiency of fleas fed the biofilm-overproducing strain was significantly less than that of fleas fed either the parent or a biofilm-deficient strain. Fleas infected with a biofilm-deficient strain harboured lower bacterial loads 4 days post-infection than fleas infected with the parent strain. Thus, defects in biofilm formation did not prevent flea-borne transmission of Y. pestis in our EPT model, although biofilm overproduction inhibited efficient EPT. Our results also indicate, however, that biofilms may play a role in infection persistence in the flea.


Subject(s)
Biofilms , Plague/transmission , Yersinia pestis/physiology , Animals , Bacterial Proteins/genetics , Bacterial Proteins/metabolism , Humans , Insect Vectors/microbiology , Mice , Plague/microbiology , Rats , Rats, Sprague-Dawley , Siphonaptera/microbiology , Yersinia pestis/genetics
15.
Vector Borne Zoonotic Dis ; 10(1): 85-92, 2010.
Article in English | MEDLINE | ID: mdl-20158336

ABSTRACT

Despite the widespread presence of bubonic plague in sylvatic reservoirs throughout the world, the causative agent (Yersinia pestis) evolved in its present form within the last 20,000 years from enteropathogenic Yersinia pseudotuberculosis. Comparison of the genomes from the two species revealed that Y. pestis possesses only a few unique plasmid-encoded genes that contribute to acute disease, whereas this organism has lost about 13% of the chromosomal genes that remain active in Y. pseudotuberculosis. These losses reflect readily detectable additions, deletions, transpositions, inversions, and acquisition of about 70 insertion sequence (IS) inserts, none of which are likely to promote increased virulence. In contrast, major enzymes of intermediary metabolism, including glucose 6-phosphate dehydrogenase (Zwf ) and aspartase, are present but not catalytically functional due to the presence of missense mutations. The latter are generally not detectable by the technology of bioinformatics and, in the case of Y. pestis, result in radical changes in the metabolic flow of carbon. As an important consequence, plague bacilli exhibit a stringent low-calcium response characterized by conversion of L-glutamate (and metabolically related amino acids) to L-aspartate with secretion of the latter into supernatant fluid at 37 degrees C in culture media containing Na(+) but lacking added Ca(2+). This phenomenon also occurs in vivo and likely adversely affects the bioenergetics of host amino acid pools. Curiously, aspartase is functional in all tested enzootic (pestoides) strains of Y. pestis. These isolates are typically restricted to the ancient plague reservoirs of Central Asia and Africa and are fully virulent in members of the rodent Superfamily Muroidea but avirulent in guinea pigs and man. The implications of these findings for the distribution and ecology of Y. pestis could be significant.


Subject(s)
Aspartate Ammonia-Lyase/metabolism , Calcium/metabolism , Disease Reservoirs/veterinary , Plague/veterinary , Sodium/metabolism , Yersinia pestis/pathogenicity , Aspartic Acid/metabolism , Evolution, Molecular , Plague/microbiology , Virulence/genetics , Virulence/physiology , Yersinia pestis/enzymology , Yersinia pestis/genetics , Yersinia pestis/metabolism , Yersinia pseudotuberculosis/enzymology , Yersinia pseudotuberculosis/genetics , Yersinia pseudotuberculosis/metabolism , Yersinia pseudotuberculosis/pathogenicity , Yersinia pseudotuberculosis Infections/microbiology , Yersinia pseudotuberculosis Infections/veterinary
16.
Epilepsia ; 51(2): 243-50, 2010 Feb.
Article in English | MEDLINE | ID: mdl-19732132

ABSTRACT

PURPOSE: Distinguishing nonconvulsive status epilepticus (NCSE) from some nonepileptic encephalopathies is a challenging problem. In many situations, NCSE and nonepileptic encephalopathies are indistinguishable by clinical symptoms and can produce very similar electroencephalography (EEG) patterns. Misdiagnosis or delay to diagnosis of NCSE may increase the rate of morbidity and mortality. METHODS: We developed a fast-differentiating algorithm using quantitative EEG analysis to distinguish NCSE patients from patients with toxic/metabolic encephalopathy (TME). EEG recordings were collected from 11 patients, including 6 with NCSE and 5 with TME. Three nonlinear dynamic measures were used in the proposed algorithm: the maximum short-term Lyapunov exponent (STLmax), phase of attractor (phase/angular frequency), and approximate entropy (ApEn). A further refined metric derived from STLmax and phase of attractor (the mean distance to EEG epoch samples from their centroid in the feature space) was also utilized as a criterion. Paired t tests were carried out to further clarify the separation between the EEG patterns of NCSE and TME. RESULTS: Computational results showed that the performance of the proposed algorithm was sufficient to distinguish NCSE from TME. The results were consistent in all subjects in our study. CONCLUSIONS: The study presents evidence that the maximum short-term Lyapunov exponents (STLmax) and phase of attractors (phase/angular frequency) can be useful in assisting clinical diagnosis of NCSE. Findings presented in this article provide a promising indication that the proposed algorithm may correctly distinguish NCSE from TME. Although the exact mechanism of this association remains unknown, the authors suggest that epileptic activity is highly associated with and can be modeled by dynamic systems.


Subject(s)
Electroencephalography/statistics & numerical data , Status Epilepticus/diagnosis , Adult , Aged , Algorithms , Brain Diseases, Metabolic/diagnosis , Diagnosis, Differential , Diagnostic Errors , Electroencephalography/methods , Entropy , Female , Humans , Male , Nonlinear Dynamics , Pilot Projects , Status Epilepticus/classification
17.
Am J Electroneurodiagnostic Technol ; 49(3): 225-43, 2009 Sep.
Article in English | MEDLINE | ID: mdl-19891415

ABSTRACT

We report four cases of cerebral hemodynamic compromise identified over a five year period. Cerebral hemodynamic compromise is characterized by reversible attacks of regional cerebral ischemia affecting patients with occlusive disease of main arteries supplying blood to the brain. All four of our patients had occlusion of one internal carotid artery (ICA) often associated with high grade stenosis or occlusion of the contralateral internal carotid artery and/or major intracranial arteries. All patients developed likely limb shaking transient ischemic attacks (TIAs) which occur during acute exacerbation of regional cerebral hypoperfusion. These events often trigger EEG testing because of suspicion of seizures. Each patient also had focal delta EEG slowing without evidence of noteworthy structural lesions on imaging scans. A discrepancy or mismatch between these testing results occurred. The patients' focal delta EEG slowing was attributed primarily to resting regional cerebral hypoperfusion. Diagnosis of cerebral hemodynamic compromise may be delayed when limb shaking TIA is misdiagnosed as a seizure disorder or when regional cerebral hypoperfusion is not considered as a potential cause of focal delta EEG slowing in older patients that have normal structural imaging studies. Our cases are discussed in light of the relevant EEG and clinical characteristics that have been described in reports of limb shaking TIA and structural imaging/focal delta EEG slowing mismatches.


Subject(s)
Carotid Stenosis/complications , Carotid Stenosis/diagnosis , Electroencephalography/methods , Ischemic Attack, Transient/complications , Ischemic Attack, Transient/diagnosis , Tremor/diagnosis , Tremor/etiology , Aged , Humans , Male , Middle Aged
18.
Microb Pathog ; 47(5): 243-51, 2009 Nov.
Article in English | MEDLINE | ID: mdl-19716410

ABSTRACT

Type VI secretion systems (T6SSs) have been identified recently in several Gram-negative organisms and have been shown to be associated with virulence in some bacterial pathogens. A T6SS of Yersinia pestis CO92 (locus YPO0499-YPO0516) was deleted followed by investigation of the phenotype of this mutation. We observed that this T6SS locus of Y. pestis was preferentially expressed at 26 degrees C in comparison to 37 degrees C suggesting a possible role in the flea cycle. However, we found that the deletion of T6SS locus YPO0499-YPO0516 in Y. pestis CO92 had no effect on the ability of this strain to infect the oriental rat flea, Xenopsylla cheopis. Nevertheless, this mutant displayed increased intracellular numbers in macrophage-like J774.A1 cells after 20 h post-infection for bacterial cells pre-grown at 26 degrees C indicating that expression of this T6SS locus limited intracellular replication in macrophages. In addition, deletion of the YPO0499-YPO0516 locus reduced the uptake by macrophages of the Y. pestis mutant pre-grown at 37 degrees C, suggesting that this T6SS locus has phagocytosis-promoting activity. Further study of the virulence of the T6SS mutant in murine bubonic and inhalation plague models revealed no attenuation in comparison with the parental CO92 strain.


Subject(s)
Macrophages/microbiology , Membrane Transport Proteins/genetics , Mutation , Plague/microbiology , Siphonaptera/microbiology , Yersinia pestis/genetics , Yersinia pestis/pathogenicity , Animals , Cell Line , Disease Models, Animal , Female , Humans , Mice , Sequence Deletion , Survival Analysis , Temperature
19.
PLoS Pathog ; 5(5): e1000459, 2009 May.
Article in English | MEDLINE | ID: mdl-19478886

ABSTRACT

Tularemia is a geographically widespread, severely debilitating, and occasionally lethal disease in humans. It is caused by infection by a gram-negative bacterium, Francisella tularensis. In order to better understand its potency as an etiological agent as well as its potential as a biological weapon, we have completed draft assemblies and report the first complete genomic characterization of five strains belonging to the following different Francisella subspecies (subsp.): the F. tularensis subsp. tularensis FSC033, F. tularensis subsp. holarctica FSC257 and FSC022, and F. tularensis subsp. novicida GA99-3548 and GA99-3549 strains. Here, we report the sequencing of these strains and comparative genomic analysis with recently available public Francisella sequences, including the rare F. tularensis subsp. mediasiatica FSC147 strain isolate from the Central Asian Region. We report evidence for the occurrence of large-scale rearrangement events in strains of the holarctica subspecies, supporting previous proposals that further phylogenetic subdivisions of the Type B clade are likely. We also find a significant enrichment of disrupted or absent ORFs proximal to predicted breakpoints in the FSC022 strain, including a genetic component of the Type I restriction-modification defense system. Many of the pseudogenes identified are also disrupted in the closely related rarely human pathogenic F. tularensis subsp. mediasiatica FSC147 strain, including modulator of drug activity B (mdaB) (FTT0961), which encodes a known NADPH quinone reductase involved in oxidative stress resistance. We have also identified genes exhibiting sequence similarity to effectors of the Type III (T3SS) and components of the Type IV secretion systems (T4SS). One of the genes, msrA2 (FTT1797c), is disrupted in F. tularensis subsp. mediasiatica and has recently been shown to mediate bacterial pathogen survival in host organisms. Our findings suggest that in addition to the duplication of the Francisella Pathogenicity Island, and acquisition of individual loci, adaptation by gene loss in the more recently emerged tularensis, holarctica, and mediasiatica subspecies occurred and was distinct from evolutionary events that differentiated these subspecies, and the novicida subspecies, from a common ancestor. Our findings are applicable to future studies focused on variations in Francisella subspecies pathogenesis, and of broader interest to studies of genomic pathoadaptation in bacteria.


Subject(s)
Comparative Genomic Hybridization , Francisella tularensis/genetics , Francisella tularensis/pathogenicity , Base Sequence , Francisella tularensis/isolation & purification , Genes, Bacterial/genetics , Phylogeny , Recombination, Genetic , Virulence/genetics
20.
Microbiology (Reading) ; 155(Pt 1): 198-209, 2009 Jan.
Article in English | MEDLINE | ID: mdl-19118360

ABSTRACT

It is established that Yersinia pestis, the causative agent of bubonic plague, recently evolved from enteropathogenic Yersinia pseudotuberculosis by undergoing chromosomal degeneration while acquiring two unique plasmids that facilitate tissue invasion (pPCP) and dissemination by fleabite (pMT). Thereafter, plague bacilli spread from central Asia to sylvatic foci throughout the world. These epidemic isolates exhibit a broad host range including man as opposed to enzootic (pestoides) variants that remain in ancient reservoirs where infection is limited to muroid rodents. Cells of Y. pseudotuberculosis are known to express glucose-6-phosphate dehydrogenase (Zwf) and aspartase (AspA); these activities are not detectable in epidemic Y. pestis due to missense mutations (substitution of proline for serine at amino position 155 of Zwf and leucine for valine at position 363 of AspA). In this study, functional Zwf was found in pestoides strains E, F and G but not seven other enzootic isolates; enzymic activity was associated with retention of serine at amino acid position 155. Essentially, full AspA activity occurred in pestoides isolates where valine (pestoides A, B, C and D) or serine (pestoides E, F, G and I) occupied position 363. Reduced activity occurred in strains Angola and A16, which contained phenylalanine at this position. The kcat but not Km of purified AspA from strain Angola was significantly reduced. In this context, aspA of the recently described attenuated enzootic microtus biovar encodes active valine at position 363, further indicating that functional AspA is a biomarker for avirulence of Y. pestis in man.


Subject(s)
Aspartate Ammonia-Lyase/genetics , Aspartate Ammonia-Lyase/metabolism , Rodentia/microbiology , Yersinia pestis/enzymology , Yersinia pestis/pathogenicity , Animals , Disease Outbreaks , Glucosephosphate Dehydrogenase/genetics , Glucosephosphate Dehydrogenase/metabolism , Humans , Plague/epidemiology , Plague/microbiology , Rodent Diseases/microbiology , Virulence , Yersinia Infections/microbiology , Yersinia Infections/veterinary , Yersinia pestis/classification , Yersinia pestis/isolation & purification , Yersinia pseudotuberculosis/enzymology
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