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1.
Sci Rep ; 10(1): 16258, 2020 10 01.
Article in English | MEDLINE | ID: mdl-33004862

ABSTRACT

Uropathogenic Escherichia coli (UPEC) are common pathogens in urinary tract infections (UTIs), which show resistance to antibiotics. Therefore, there is a need for a vaccine to reduce susceptibility to the infection. In the present study, bioinformatics approaches were employed to predict the best B and T-cell epitopes of UPEC virulence proteins to develop a multiepitope vaccine candidate against UPEC. Then, the efficacy of the candidate was studied with and without Freund adjuvant. Using bioinformatics methods, 3 epitope-rich domains of IutA and FimH antigens were selected to construct the fusion. Molecular docking and Molecular dynamics (MD) simulation were employed to investigate in silico interaction between designed vaccine and Toll-like receptor 4 (TLR4). Our results showed that the levels of IgG and IgA antibodies were improved in the serum and mucosal samples of the vaccinated mice, and the IgG responses were maintained for at least 6 months. The fusion protein was also able to enhance the level of cytokines IFN.γ (Th1), IL.4 (Th2), and IL.17. In challenge experiments, all vaccine combinations showed high potency in the protection of the urinary tract even after 6 months post first injection. The present study indicates that the designed candidate is able to evoke strong protective responses which warrant further studies.


Subject(s)
Escherichia coli Infections/prevention & control , Escherichia coli Vaccines/therapeutic use , Urinary Tract Infections/prevention & control , Uropathogenic Escherichia coli/immunology , Animals , Computer Simulation , Cytokines/metabolism , Epitopes/immunology , Escherichia coli Infections/immunology , Escherichia coli Vaccines/immunology , Immunoglobulin G/immunology , Mice , Mice, Inbred BALB C , Molecular Docking Simulation , Toll-Like Receptor 4/metabolism , Urinary Tract Infections/immunology
2.
J Dairy Sci ; 103(7): 6692-6697, 2020 Jul.
Article in English | MEDLINE | ID: mdl-32331898

ABSTRACT

The objective of the present study was to evaluate the efficacy of a J-5 Escherichia coli vaccine in a mild to moderate inflammatory challenge model using primiparous dairy cows for inoculation only. We hypothesized a clinical difference between placebo and J-5 E. coli vaccinated animals with the mild to moderate inflammatory challenge model. In case the null hypothesis could not be confirmed, the alternate hypothesis was no clinical difference between both treatment groups. Therefore, 23 primiparous cows in mo 7 of pregnancy were randomly assigned to 1 of 2 treatment groups: J-5 E. coli vaccine (n = 12) or placebo (n = 11). Animals were vaccinated 3 times at 56 (±7) and 28 (±7) d before expected calving date and within 14 d postcalving (DIM 5 ± 3). All cows were challenged by infusion with E. coli P4:O32 into 2 left mammary quarters between 14 and 28 d postparturition, at least 10 d after the 3rd vaccination, immediately after the morning milking. Clinical observations and blood and milk samples were collected at several time points from 7 d pre-challenge until 13 d post-challenge. Primiparous cows responded mild to moderately to intramammary E. coli challenge with little clinical difference between treatment groups. Rectal temperature increased earlier in the vaccinated animals, which also eliminated bacteria faster during the early hours after intramammary E. coli challenge. At post-infusion hour 9, the bacterial population was significantly lower in the infected quarters of the vaccinated animals. Blood leukocyte number was only numerically higher in the vaccinated animals, in combination with a numerically higher percentage of late immature polymorphonuclear leukocytes (band cells) in circulation. Even in the nonvaccinated animals, the E. coli challenge in the primiparous cows elicited only a mild to moderate response. The absence of a pronounced clinical difference between vaccinated and nonvaccinated animals was therefore not surprising.


Subject(s)
Escherichia coli Infections/veterinary , Escherichia coli Vaccines/therapeutic use , Mastitis, Bovine/prevention & control , Animals , Cattle , Escherichia coli/immunology , Escherichia coli Infections/prevention & control , Escherichia coli Vaccines/administration & dosage , Female , Leukocyte Count , Mastitis, Bovine/microbiology , Milk/microbiology , Neutrophils/immunology , Parity , Pregnancy , Vaccination/veterinary
3.
Acta Biochim Pol ; 66(2): 129-138, 2019 May 28.
Article in English | MEDLINE | ID: mdl-31136644

ABSTRACT

Urinary tract infections (UTIs) are the most widespread and annoying infections affecting millions of people every year annually. The biggest problems of urinary diseases are recurrences, increasing resistance of uropathogens to commonly used antibiotics, as well as the high health care costs of afflicted persons. Uropathogenic Escherichia coli strains (UPECs) are the most dominant etiologic agents of community-acquired infections of this type. During UTI pathogenesis, UPECs utilize various virulence factors, especially mono- and polyadhesive appendages of the chaperone-usher secretion pathway (CUP) required for adhesion, invasion and biofilm formation. Commonly used antibiotics for UTI treatment are usually effective, but their long-term utility may affect gut microbiota of the treated individuals and cause selection of drug resistant uropathogenic variants. Due to increasing resistance of UPEC strains to antibiotics via the evolution of specific defense mechanisms, there is a need to develop alternative methods and therapeutic strategies to fight UTIs (vaccines, receptor analogues, pilicides and curlicides, bacterial interference or phagotherapy). Such therapeutic approaches usually target processes enabling uropathogens to survive within the urinary tract and cause recurrent infections.


Subject(s)
Bacterial Adhesion/drug effects , Escherichia coli Infections/therapy , Phage Therapy , Urinary Tract Infections/microbiology , Urinary Tract Infections/therapy , Uropathogenic Escherichia coli/pathogenicity , Vaccination , Anti-Bacterial Agents/adverse effects , Anti-Bacterial Agents/therapeutic use , Bacteriophages , Drug Resistance, Bacterial , Escherichia coli Vaccines/therapeutic use , Female , Humans , Male , Mannosides/therapeutic use , Uropathogenic Escherichia coli/virology , Virulence Factors
4.
Urol Int ; 102(4): 449-455, 2019.
Article in English | MEDLINE | ID: mdl-30917371

ABSTRACT

OBJECTIVE: To investigate the long-term prophylactic effect of a vaccine on lower urinary tract infections (UTI) of bacterial and the impact of the intensity of the symptoms on the quality of life (QoL). METHODS: Adult female could be enrolled in this study if they had acute UTI at the enrolment visit and bacterial microbiological count of ≥103 CFU/mL of Escherichia coli. RESULTS: A total of 21 patients were included. Fifteen days after the administration of a vaccine for 3 months, the number of infections dropped almost to zero. Significant differences were observed in the QoL score (p < 0.05). The safety profile was good. CONCLUSIONS: In patients diagnosed with recurrent UTI and treated for 3 months with the vaccine the number of UTI episodes fell very quickly (15 days), and patients remained free of episodes and improved their QoL significantly for 1 year. These results suggest that bacterial vaccines are a possible effective alternative in the prevention of recurrent UTI.


Subject(s)
Escherichia coli Infections/prevention & control , Escherichia coli Vaccines/therapeutic use , Urinary Tract Infections/prevention & control , Adolescent , Adult , Anti-Bacterial Agents/pharmacology , Escherichia coli , Female , Humans , Middle Aged , Patient Safety , Prospective Studies , Quality of Life , Recurrence , Spain , Urinary Tract Infections/microbiology , Young Adult
5.
Eur Urol Focus ; 5(1): 39-41, 2019 01.
Article in English | MEDLINE | ID: mdl-30093359

ABSTRACT

Urinary tract infections (UTIs) are among the most common bacterial infections. Its management has become increasingly challenging due to antimicrobial resistance. The four mainstays to tackle this crisis rely on the development of new antibiotic agents, the introduction of preventive and alternative antimicrobial strategies, the concept of antimicrobial stewardship, and effective hygiene measures. One of the most effective approaches to prevent UTIs is the design of a potent vaccine. OM-89 is a lyophilised preparation of membrane proteins from 18 different uropathogenic Escherichia coli strains. The safety and efficacy of this immunoactive agent is well documented; therefore, it is recommended for the prophylaxis of UTI according to the current European Association of Urology guidelines on urological infections. In terms of a true vaccine designed to target specifically pathogenic bacteria, no substance is currently available. ExPEC4V, a novel tetravalent bioconjugate vaccine against extraintestinal pathogenic E. coli, was evaluated for safety, immunogenicity, and clinical efficacy in a randomised, single-blinded, placebo-controlled phase 1b trial. The vaccine was well tolerated and elicited a robust antibody response in patients suffering from recurrent UTIs. Although the first clinical data suggested a reduced incidence of UTIs after vaccination, especially for higher bacterial loads, further randomised controlled trials are necessary to determine its true clinical benefit.


Subject(s)
Escherichia coli Infections/prevention & control , Escherichia coli Vaccines/therapeutic use , Urinary Tract Infections/microbiology , Uropathogenic Escherichia coli/drug effects , Antigens, Bacterial/pharmacology , Antigens, Bacterial/therapeutic use , Bacterial Load/drug effects , Clinical Trials, Phase I as Topic , Drug Resistance, Multiple, Bacterial , Escherichia coli Vaccines/pharmacology , Humans , Randomized Controlled Trials as Topic , Urinary Tract Infections/prevention & control , Uropathogenic Escherichia coli/pathogenicity
6.
Curr Top Microbiol Immunol ; 416: 213-242, 2018.
Article in English | MEDLINE | ID: mdl-30062594

ABSTRACT

Escherichia coli has a complex and versatile nature and continuously evolves from non-virulent isolates to highly pathogenic strains causing severe diseases and outbreaks. Broadly protective vaccines against pathogenic E. coli are not available and the rising in both, multi-drug resistant and hypervirulent isolates, raise concern for healthcare and require continuous efforts in epidemiologic surveillance and disease monitoring. The evolving knowledge on E. coli pathogenesis mechanisms and on the mediated immune response following infection or vaccination, together with advances in the "omics" technologies, is opening new perspectives toward the design and development of effective and innovative E. coli vaccines.


Subject(s)
Escherichia coli Infections/prevention & control , Escherichia coli Infections/therapy , Escherichia coli Vaccines/immunology , Escherichia coli Vaccines/therapeutic use , Escherichia coli/immunology , Escherichia coli/pathogenicity , Escherichia coli Infections/immunology , Escherichia coli Infections/microbiology , Humans , Vaccination
7.
Vaccine ; 36(27): 3949-3959, 2018 06 22.
Article in English | MEDLINE | ID: mdl-29807709

ABSTRACT

Escherichia coli O157:H7 is a zoonotic pathogen of global importance and the serotype of Shiga toxin-producing E.coli (STEC) most frequently associated with Hemolytic Uremic Syndrome (HUS) in humans. The main STEC reservoir is cattle. Vaccination of calves with the carboxy-terminal fraction of Intimin γ (IntC280) and EspB can reduce E.coli O157:H7 fecal shedding after experimental challenge. Shiga toxin (Stx) exerts local immunosuppressive effects in the bovine intestine and Stx2B fused to Brucella lumazine synthase (BLS-Stx2B) induces Stx2-neutralizing antibodies. To determine if an immune response against Stx could improve a vaccine's effect on fecal shedding, groups of calves were immunized with EspB + IntC280, with EspB + IntC280 + BLS-Stx2B, or kept as controls. At 24 days post vaccination calves were challenged with E.coli O157:H7. Shedding of E.coli O157:H7 was assessed in recto-anal mucosal swabs by direct plating and enrichment followed by immunomagnetic separation and multiplex PCR. Calves were euthanized 15 days after the challenge and intestinal segments were obtained to assess mucosal antibodies. Vaccination induced a significant increase of IntC280 and EspB specific antibodies in serum and intestinal mucosa in both vaccinated groups. Antibodies against Stx2B were detected in serum and intestinal mucosa of animals vaccinated with 3 antigens. Sera and intestinal homogenates were able to neutralize Stx2 verocytotoxicity compared to the control and the 2-antigens vaccinated group. Both vaccines reduced E.coli O157:H7 shedding compared to the control group. The addition of Stx2B to the vaccine formulation did not result in a superior level of protection compared to the one conferred by IntC280 and EspB alone. It remains to be determined if the inclusion of Stx2B in the vaccine alters E.coli O157:H7 shedding patterns in the long term and after recurrent low dose exposure as occurring in cattle herds.


Subject(s)
Adhesins, Bacterial/immunology , Bacterial Outer Membrane Proteins/immunology , Escherichia coli Infections/veterinary , Escherichia coli O157/immunology , Escherichia coli Proteins/immunology , Escherichia coli Vaccines/administration & dosage , Hemolytic-Uremic Syndrome/prevention & control , Shiga Toxin 2/immunology , Zoonoses/prevention & control , Adhesins, Bacterial/genetics , Animals , Antibodies, Bacterial/blood , Antibodies, Neutralizing/blood , Bacterial Outer Membrane Proteins/genetics , Bacterial Shedding , Cattle , Escherichia coli Infections/prevention & control , Escherichia coli Proteins/genetics , Escherichia coli Vaccines/immunology , Escherichia coli Vaccines/therapeutic use , Feces/microbiology , Humans , Immunity, Humoral/immunology , Intestinal Mucosa/immunology , Male , Shiga Toxin 2/genetics , Vaccination/veterinary , Vaccines, Synthetic/administration & dosage , Vaccines, Synthetic/immunology , Vaccines, Synthetic/therapeutic use
8.
PLoS One ; 13(3): e0194888, 2018.
Article in English | MEDLINE | ID: mdl-29566080

ABSTRACT

Avian Colibacillosis is among the major causes of economic loss in the poultry industry worldwide, with a more vivid impact on developing countries. The involvement of several bacteria has made it challenging to develop effective vaccines for this disease, particularly because it is notoriously difficult to make a vaccine that contains all the contributing pathogenic bacteria. Here, we report the design and fabrication of a bacterial ghost (BG) of E. coli O78:K80, which is among the major bacterial serotypes responsible for this disease. The generated ghost is then exploited as a homologous vaccine against Avian Colibacillosis. We demonstrate that hole formation in the cell wall of E. coli O78:K80 can happen properly in optical densities as high as 0.8 compared to the 0.3-0.4 standard for bacteria like E. coli TOP10. This is especially advantageous for mass production of this ghost which is a vital factor in development of any BG-based vaccine. Compared to E. coli TOP10, we faced a great challenge in transforming the wild type bacteria with the E-lysis plasmid which was probably due to higher thickness of the cell wall in O78:K80. This, however, was addressed by treating the cell wall with a different combination of ions.The vaccine was administered to Ross 308 broiler chickens via injection as well as through their respiratory system at a dose of 1010 BGs, repeated 3 times at weekly intervals. Chickens were then challenged with the wild type O78:K80 at a dose of 1011 bacteria together with Infectious Bronchitis H120 vaccine (as immunosuppressant) one week after the last immunization. Air sac lesions were significantly reduced in BG vaccinated groups in comparison with the control group. The levels of IFNγ, IgA and IgY were measured in the serum of immunized chickens as an indication of immune response and were compared with those of the chickens vaccinated with killed bacteria. The results show that O78:K80 BG can be used as an efficient homologous vaccine against Colibacillosis disease in poultry. We expect our findings can serve as the starting point for designing more sophisticated vaccines that contain all three major pathogenic bacteria involved in avian Colibacillosis.


Subject(s)
Chickens , Escherichia coli Infections/therapy , Escherichia coli Vaccines/therapeutic use , Escherichia coli/immunology , Poultry Diseases/therapy , Animals , Animals, Domestic , Antigens, Bacterial/immunology , Bacterial Vaccines/therapeutic use , Chickens/immunology , Escherichia coli/pathogenicity , Escherichia coli Infections/immunology , Escherichia coli Infections/veterinary , Poultry Diseases/immunology , Serogroup , Vaccines, Attenuated/therapeutic use
9.
J Vet Med Sci ; 79(7): 1215-1219, 2017 Jul 19.
Article in English | MEDLINE | ID: mdl-28603216

ABSTRACT

Colibacillosis is one of an economically significant disease in the poultry industry, especially for meat breed chickens. Recently it has become a serious problem for layer especially when the birds start laying and also at the later stage of laying. In Japan, the productivity of field laying hens improved when the Δcrp avian colibacillosis live vaccine ("Gall N tect CBL") was used. The survival rate and egg laying rate increased during almost all of the laying period when compared with the control group. The improvement in productivity was clearly demonstrated by comparing the number of eggs laid per day. The use of an avian colibacillosis live vaccine proved to be cost-effective in laying hens.


Subject(s)
Escherichia coli Infections/veterinary , Escherichia coli Vaccines/therapeutic use , Poultry Diseases/prevention & control , Animals , Chickens/microbiology , Escherichia coli Infections/prevention & control , Female , Japan , Oviposition , Poultry Diseases/microbiology , Vaccines, Attenuated/therapeutic use
10.
Lancet Infect Dis ; 17(5): 528-537, 2017 05.
Article in English | MEDLINE | ID: mdl-28238601

ABSTRACT

BACKGROUND: Escherichia coli infections are increasing worldwide in community and hospital settings. The E coli O-antigen is a promising vaccine target. We aimed to assess the safety and immunogenicity of a bioconjugate vaccine containing the O-antigens of four E coli serotypes (ExPEC4V). METHODS: In this multicentre phase 1b, first-in-human, single-blind, placebo-controlled trial, we randomly assigned (1:1) healthy adult women with a history of recurrent urinary tract infection (UTI) to receive a single injection of either intramuscular ExPEC4V or placebo. The primary outcome was the incidence of adverse events among vaccine and placebo recipients throughout the study. Secondary outcomes included immunogenicity and antibody functionality, and the incidence of UTIs caused by E coli vaccine serotypes in each group. This study is registered with ClinicalTrials.gov, number NCT02289794. FINDINGS: Between Jan 20, 2014, and Aug 27, 2014, 93 women received target-dose ExPEC4V and 95 received placebo. The vaccine was well tolerated: no vaccine-related serious adverse events occurred. Overall, 56 (60%) target-dose vaccines and 47 (49%) placebo recipients experienced at least one adverse event that was possibly, probably, or certainly related to injection. Vaccination induced significant IgG responses for all serotypes: at day 30 compared with baseline, O1A titres were 4·6 times higher, O2 titres were 9·4 times higher, O6A titres were 4·9 times higher, and O25B titres were 5·9 times higher (overall p<0·0001). Immune responses persisted at 270 days but were lower than those at 30 days. Opsonophagocytic killing activity showed antibody functionality. No reduction in the incidence of UTIs with 103 or more colony-forming units per mL of vaccine-serotype E coli was noted in the vaccine compared with the placebo group (0·149 mean episodes vs 0·146 mean episodes; p=0·522). In post-hoc exploratory analyses of UTIs with higher bacterial counts (≥105 colony-forming units per mL), the number of vaccine serotype UTIs did not differ significantly between groups (0·046 mean episodes in the vaccine group vs 0·110 mean episodes in the placebo group; p=0·074). However, significantly fewer UTIs caused by E coli of any serotype were noted in the vaccine group compared with the placebo group (0·207 mean episodes vs 0·463 mean episodes; p=0·002). INTERPRETATION: This tetravalent E coli bioconjugate vaccine candidate was well tolerated and elicited functional antibody responses against all vaccine serotypes. Phase 2 studies have been initiated to confirm these findings. FUNDING: GlycoVaxyn, Janssen Vaccines.


Subject(s)
Escherichia coli Vaccines/administration & dosage , Extraintestinal Pathogenic Escherichia coli/isolation & purification , Urinary Tract Infections/prevention & control , Adult , Aged , Escherichia coli Vaccines/therapeutic use , Female , Humans , Immunogenicity, Vaccine , Middle Aged , Single-Blind Method , Treatment Outcome , Vaccination/methods
11.
J Dairy Sci ; 99(11): 9014-9026, 2016 Nov.
Article in English | MEDLINE | ID: mdl-27638260

ABSTRACT

The objective of this study was to evaluate the efficacy of intramammary immunization with UV-killed Escherichia coli ECC-Z on prevention of intramammary colonization after a challenge with a dose of the homologous E. coli ECC-Z live bacteria. A total of 10 cows were included in a study to evaluate the efficacy of intramammary immunization. All 10 cows received an intramammary immunization of 100 cfu of UV-killed E. coli ECC-Z bacteria into one hind quarter at the time of dry off. Approximately 2wk before the anticipated calving date, both hind quarters of all cows were challenged with 100 cfu of live E. coli ECC-Z bacteria. Five of the cows were vaccinated parenterally with a commercial J5 bacterin, and 5 cows served as controls with no parenteral vaccination. The cows were then followed over time and infection risk, clinical scores, somatic cell count, and milk production were observed over time. The results of these 10 cows showed partial protection of intramammary immunization on the outcome of a subsequent homologous intramammary challenge. Immunization resulted in a lower probability of infection, a lower bacteria count, lower somatic cell counts and milk conductivity, a lower clinical mastitis score, and increased milk production compared with unimmunized control quarters. Once the analysis was corrected for immunization, parenteral J5 vaccination had no significant effect on any of the measured parameters. These results provide the first evidence that intramammary immunization may improve the outcome of an intramammary E. coli infection in late gestation and onset of mastitis immediately following parturition. Unlike systemic vaccination, which generally does not reduce the intramammary infection risk, the intramammary immunization did show a 5-times reduced odds of an established intramammary infection after challenge. Cytokine profiles indicated a local return of proinflammatory response after challenge as the data showed a more pronounced increase in in IFN-γ with a subsequent negative feedback due to a spike in the level of IL-10 in immunized quarters relative to nonimmunized quarters. Although these results are preliminary and obtained on only 10 cows, the results provide insight into the biological benefits of triggering mucosal immunity in the mammary gland.


Subject(s)
Escherichia coli Infections/veterinary , Escherichia coli Vaccines/therapeutic use , Mastitis, Bovine/prevention & control , Vaccination/veterinary , Animals , Animals, Newborn , Antibodies, Bacterial/blood , Cattle , Cell Count/veterinary , Escherichia coli/immunology , Escherichia coli Infections/prevention & control , Escherichia coli Vaccines/administration & dosage , Female , Interferon-gamma/blood , Interleukin-10/blood , Mammary Glands, Animal/immunology , Mammary Glands, Animal/microbiology , Mastitis, Bovine/microbiology
12.
Vaccine ; 34(27): 3132-3140, 2016 06 08.
Article in English | MEDLINE | ID: mdl-27133878

ABSTRACT

UNLABELLED: We have evaluated the capacity of an oral multivalent enterotoxigenic Escherichia coli (ETEC) vaccine (MEV) to induce mucosal immunological memory. MEV consists of four inactivated E. coli strains over-expressing the major colonization factors (CFs) CFA/I, CS3, CS5 and CS6 and the LTB-related toxoid LCTBA. Memory responses were analyzed by comparing the magnitudes and kinetics of intestine-derived antibody-secreting cell responses to a single dose of MEV in three groups of adult Swedish volunteers (n=16-19 subjects per group) in a Phase I trial: non-immunized controls (I) and subjects who in a previous Phase I trial 13-23 months earlier had received two biweekly doses of MEV (II) or MEV+double mutant LT (dmLT) adjuvant (III). Responses against CFs and LTB were analyzed in antibodies in lymphocyte secretions (ALS) of blood mononuclear cells collected before (day 0) and 4/5 and 7 days after immunization. Specific circulating memory B cells present at the time of the single dose vaccination were also studied to determine if such cells may reflect mucosal memory. Considerably higher and significantly more frequent IgA ALS responses against all CFs and LTB were induced by the single vaccine dose in the previously immunized than in non-immunized volunteers. Furthermore, peak IgA ALS responses against all antigens were observed on days 4/5 in most of the previously immunized subjects whereas only a few previously non-vaccinated individuals responded before day 7. Priming with adjuvant did not influence memory responses. Circulating vaccine specific IgA memory B cells were not detected, whereas anti-toxin IgG memory B cells were identified 13-23 months after priming vaccination. We conclude that MEV induces functional mucosal immunological memory which remains at least 1-2 years. Furthermore, our results support that analysis of antibody-secreting cell responses after booster vaccination may be a useful approach to evaluate longstanding mucosal immunological memory in humans. CLINICAL TRIALS REGISTRATION: ISRCTN27096290.


Subject(s)
Escherichia coli Infections/prevention & control , Escherichia coli Vaccines/therapeutic use , Immunity, Mucosal , Immunologic Memory , Adjuvants, Immunologic/administration & dosage , Adult , Antibodies, Bacterial/blood , Antibody-Producing Cells/immunology , B-Lymphocytes/immunology , Enterotoxigenic Escherichia coli , Female , Humans , Immunoglobulin A/blood , Male , Sweden , Vaccines, Inactivated/therapeutic use , Young Adult
13.
PLoS One ; 11(3): e0149358, 2016.
Article in English | MEDLINE | ID: mdl-26938983

ABSTRACT

BACKGROUND: Experimental human challenge models have played a major role in enhancing our understanding of infectious diseases. Primary outcomes have typically utilized overly simplistic outcomes that fail to entirely account for complex illness syndromes. We sought to characterize clinical outcomes associated with experimental infection with enterotoxigenic Escherichia coli (ETEC) and to develop a disease score. METHODS: Data were obtained from prior controlled human ETEC infection studies. Correlation and univariate regression across sign and symptom severity was performed. A multiple correspondence analysis was conducted. A 3-parameter disease score with construct validity was developed in an iterative fashion, compared to standard outcome definitions and applied to prior vaccine challenge trials. RESULTS: Data on 264 subjects receiving seven ETEC strains at doses from 1x105 to 1x1010 cfu were used to construct a standardized dataset. The strongest observed correlation was between vomiting and nausea (r = 0.65); however, stool output was poorly correlated with subjective activity-impacting outcomes. Multiple correspondence analyses showed covariability in multiple signs and symptoms, with severity being the strongest factor corresponding across outcomes. The developed disease score performed well compared to standard outcome definitions and differentiated disease in vaccinated and unvaccinated subjects. CONCLUSION: Frequency and volumetric definitions of diarrhea severity poorly characterize ETEC disease. These data support a disease severity score accounting for stool output and other clinical signs and symptoms. Such a score could serve as the basis for better field trial outcomes and gives an additional outcome measure to help select future vaccines that warrant expanded testing in pivotal pre-licensure trials.


Subject(s)
Diarrhea/physiopathology , Enterotoxigenic Escherichia coli/pathogenicity , Escherichia coli Infections/physiopathology , Escherichia coli Vaccines/therapeutic use , Adult , Diarrhea/microbiology , Escherichia coli Infections/microbiology , Female , Fever/microbiology , Fever/physiopathology , Headache/microbiology , Headache/physiopathology , Humans , Male , Nausea/microbiology , Nausea/physiopathology , Severity of Illness Index , Vomiting/microbiology , Vomiting/physiopathology
14.
Vaccine ; 34(26): 2880-2886, 2016 06 03.
Article in English | MEDLINE | ID: mdl-26988259

ABSTRACT

Enterotoxigenic Escherichia coli (ETEC) is one of the most common bacterial causes of diarrhea-associated morbidity and mortality, particularly among infants and young children in developing countries. Still, the true impact on child and traveler health is likely underestimated. There are currently no licensed vaccines for ETEC, but studies indicate high public health impact, cost-effectiveness, and feasibility of immune protection through vaccination. ETEC vaccine development remains a World Health Organization priority. Traditionally, ETEC vaccine development efforts have focused on inducing antitoxin and anticolonization antigen immunity, as studies indicate that antibodies against both antigen types can contribute to protection and thus have potential for vaccines. Leading cellular vaccine candidates are ETVAX (a mixture of four inactivated strains) and ACE527 (a mixture of three live attenuated strains), both of which have been found to be safe and immunogenic in Phase 1/2 trials. ETVAX is the furthest along in development with descending-age studies already underway in Bangladesh. Other ETEC vaccine candidates based on protein subunits, toxoids (both LT and ST), or novel, more broadly conserved ETEC antigens are also under development. Of these, a protein adhesin-based subunit approach is the most advanced. Impact and economic models suggest favorable vaccine cost-effectiveness, which may help expand market interest in ETEC vaccines. Combination vaccine formulations may help improve the economic case for development and use, and better point-of-care diagnostics will help to raise awareness of the true health burden of ETEC and highlight the potential public health benefit of ETEC vaccine introduction. Better diagnostics and vaccine demand forecasting will also improve vaccine development financing and support accelerated uptake once a licensed vaccine becomes available.


Subject(s)
Enterotoxigenic Escherichia coli , Escherichia coli Infections/prevention & control , Escherichia coli Vaccines/therapeutic use , Biomedical Research/trends , Clinical Trials as Topic , Diarrhea/microbiology , Diarrhea/prevention & control , Escherichia coli Infections/epidemiology , Humans , Vaccines, Subunit/therapeutic use
15.
Epidemiol Infect ; 143(11): 2355-66, 2015 Aug.
Article in English | MEDLINE | ID: mdl-25427776

ABSTRACT

Structural equation modelling and survey data were used to test determinants' influence on farmers' intentions towards Escherichia coli O157 on-farm control. Results suggest that farmers more likely to show willingness to spend money/time or vaccinate to control Escherichia coli O157 are those: who think farmers are most responsible for control; whose income depends more on opening farms to the public; with stronger disease control attitudes; affected by outbreaks; with better knowledge and more informed; with stronger perceptions of biosecurity measures' practicality; using a health plan; who think farmers are the main beneficiaries of control; and whose farms are dairy rather than beef. The findings might suggest that farmers may implement on-farm controls for E. coli O157 if they identify a clear hazard and if there is greater knowledge of the safety and efficacy of the proposed controls.


Subject(s)
Animal Husbandry , Attitude , Cattle Diseases/prevention & control , Escherichia coli Infections/veterinary , Escherichia coli O157 , Infection Control/methods , Intention , Adult , Aged , Animals , Cattle , Cattle Diseases/transmission , Escherichia coli Infections/prevention & control , Escherichia coli Infections/transmission , Escherichia coli Vaccines/therapeutic use , Female , Humans , Infection Control/economics , Male , Middle Aged , Perception , Surveys and Questionnaires
16.
Toxins (Basel) ; 6(6): 1799-812, 2014 Jun 10.
Article in English | MEDLINE | ID: mdl-24918359

ABSTRACT

Enterotoxigenic Escherichia coli (ETEC) are a leading cause of diarrheal illness in developing countries. Despite the discovery of these pathogens as a cause of cholera-like diarrhea over 40 years ago, and decades of vaccine development effort, there remains no broadly protective ETEC vaccine. The discovery of new virulence proteins and an improved appreciation of the complexity of the molecular events required for effective toxin delivery may provide additional avenues to pursue in development of an effective vaccine to prevent severe diarrhea caused by these important pathogens.


Subject(s)
Enterotoxigenic Escherichia coli/immunology , Enterotoxins/antagonists & inhibitors , Escherichia coli Vaccines/therapeutic use , Animals , Antibodies, Neutralizing/therapeutic use , Biological Transport , Dysentery/immunology , Dysentery/microbiology , Dysentery/prevention & control , Enterotoxigenic Escherichia coli/physiology , Enterotoxins/metabolism , Escherichia coli Infections/immunology , Escherichia coli Infections/microbiology , Escherichia coli Infections/prevention & control , Escherichia coli Proteins/antagonists & inhibitors , Escherichia coli Proteins/metabolism , Host-Pathogen Interactions , Humans , Virulence Factors/antagonists & inhibitors , Virulence Factors/metabolism
17.
J Dairy Sci ; 96(8): 5053-63, 2013 Aug.
Article in English | MEDLINE | ID: mdl-23726420

ABSTRACT

The objective of the study was to evaluate the efficacy of an alternative vaccination regimen of a J-5 bacterin against intramammary Escherichia coli challenge in nonlactating late-gestation dairy cows. The parameters analyzed to assess the effect of vaccination were milk yield, milk conductivity, somatic cell count, J-5-specific serum IgG titers, and clinical signs. Twenty multiparous Holstein cows from the Cornell teaching and research dairy herd were paired by days in milk and were randomly selected to receive either the alternative off-label regimen of commercial J-5 bacterin or act as nonvaccinated controls. Cows received a first dose of bacterin 15 d before dry off, a second dose with the same product at the day of dry off, and the third dose 2 wk after dry off. The cows in both groups were challenged 10 d before the expected calving date. Serum IgG (total, IgG1 and IgG2) levels were higher in vaccinates compared with control cows. Eighty-five percent of challenged quarters became infected between both groups of animals. Eight of the 10 vaccinated and 9 of the 10 control cows showed signs of clinical mastitis postfreshening. A non-severe clinical mastitis was observed 24 to 48 h postparturition, characterized by flakes or clots in milk and mild swelling or pain. Off-label vaccination did reduce the clinical severity of clinical mastitis in the vaccinated group of cows as evidenced by reduced California mastitis test score, fewer flakes and lower overall clinical mastitis score. No significant differences between vaccinated and control groups were detected for rectal temperature. In conclusion, the alternative off-label vaccination scheme used in our study and evaluated in a novel E. coli challenge model did not prevent new intramammary infections but reduced clinical severity of experimentally induced E. coli mastitis.


Subject(s)
Escherichia coli Infections/veterinary , Escherichia coli Vaccines/administration & dosage , Mastitis, Bovine/prevention & control , Animals , Cattle , Cell Count/veterinary , Escherichia coli Infections/prevention & control , Escherichia coli Vaccines/therapeutic use , Female , Immunoglobulin G/blood , Mammary Glands, Animal/microbiology , Milk/cytology , Pregnancy
18.
Foodborne Pathog Dis ; 10(8): 678-83, 2013 Aug.
Article in English | MEDLINE | ID: mdl-23692077

ABSTRACT

Preharvest control of Escherichia coli O157:H7 (STEC O157) may prevent human illness by reducing the presence of STEC O157 throughout the beef production chain. Immunization of cattle with a type III secreted protein vaccine inhibits colonization of cattle with STEC O157 and reduces the probability of fecal shedding and hide contamination. Our objectives were to perform a meta-analysis to estimate efficacy of a three-dose regimen of TTSP vaccine at reducing the presence of STEC O157 in the feces of feedlot cattle and to test factors that might modify vaccine efficacy. Pen-level data (n=184 pens, 1462 cattle) from four randomized controlled vaccine trials conducted from 2002 to 2008 at the University of Nebraska-Lincoln were analyzed. Factors explaining a culture-positive fecal sample were tested in generalized estimating equations logistic regression and log-binomial models. An autoregressive correlation structure was defined to account for clustering of repeated test-periods within block. Clustering or potential confounding by study was accounted for by treating study as a fixed effect. STEC O157 was detected from 661 of 5451 postvaccination fecal samples. The probability to detect STEC O157 postvaccination was 8.4% and 15.8% in vaccinated and unvaccinated cattle, respectively. Interactions between vaccination and (1) study; (2) prevalence of control pens within each time-place cluster; and (3) days from vaccination were not significant or fit poorly with observed data. Adjusting for study, cattle in pens receiving three doses of vaccine were less likely to shed STEC O157 (odds ratio=0.46, p<0.0001). Model-adjusted vaccine efficacy was 48% (95% confidence interval: 0.37-0.57). We concluded that a three-dose regimen type III secreted protein vaccine was efficacious at reducing the probability of detecting STEC O157 in the feces of cattle and that vaccine efficacy was not modified by study or level of prevalence observed in control pens.


Subject(s)
Cattle Diseases/prevention & control , Escherichia coli Infections/veterinary , Escherichia coli O157 , Feces/microbiology , Food Contamination/prevention & control , Vaccination/veterinary , Animals , Cattle , Cattle Diseases/microbiology , Colony Count, Microbial/veterinary , Dose-Response Relationship, Drug , Escherichia coli Infections/prevention & control , Escherichia coli Proteins/administration & dosage , Escherichia coli Vaccines/administration & dosage , Escherichia coli Vaccines/therapeutic use , Food Microbiology , Logistic Models , Meat/microbiology , Odds Ratio , Randomized Controlled Trials as Topic
19.
Pesqui. vet. bras ; 33(3): 291-298, Mar. 2013. tab
Article in Portuguese | LILACS | ID: lil-674373

ABSTRACT

Avaliou-se a utilização da vacina Escherichia coli J5, na imunização de vacas leiteiras, para prevenção e controle da mastite causada por E. coli através da análise da prevalência das infecções intramamárias (IMM) no pós-parto, ocorrência e intensidade dos casos clínicos de mastite nos primeiros 100 dias de lactação, influência na contagem de células somáticas (CCS) e produção de leite. O grupo experimental foi composto de 187 animais, divididos em 2 grupos, vacas vacinadas e não vacinadas. As imunizações ocorreram 60 dias antes do parto, 30 dias antes do parto e na primeira semana pós-parto. No dia da secagem e sete dias após o parto foram coletadas amostras para diagnóstico microbiológico dos patógenos causadores de mastite. A ocorrência de casos clínicos foi verificada pelo teste da caneca durante as ordenhas sendo registrados os dados relacionados à intensidade. Amostras foram coletadas mensalmente, a partir do décimo dia de lactação, para avaliação da CCS. A produção de leite foi registrada mensalmente nos primeiros 100 dias de lactação. Verificou-se no grupo vacinado, redução na prevalência de E. coli no pós-parto, na ocorrência de casos clínicos por E.coli nos primeiros 100 dias de lactação bem como na intensidade destes casos clínicos. Não foram observadas diferenças estatísticas significativas na CCS, entretanto vacas vacinadas apresentaram maior produção de leite, comparadas às vacas não vacinadas. A vacinação com E. coli J5 foi eficaz em reduzir a prevalência de infecções intramamárias (IMM) ao parto, ocorrência e intensidade dos casos clínicos e aumento na produção de leite nos primeiros 100 dias de lactação.


We evaluated the use of Escherichia coli J5 vaccine immunization in dairy cows for the prevention and control of mastitis caused by E. coli. Were analyzed the prevalence of postpartum intramammary infections (IMM), occurrence and severity of clinical cases of mastitis in the first 100 days of lactation, influence on somatic cell count (SCC) and milk production. The experimental group consisted of 187 animals that were divided into two groups, vaccinated and unvaccinated cows. Immunizations occurred 60 days before calving, 30 days before calving and the first week postpartum. On the day of drying and seven days after birth, samples were collected for microbiological diagnosis of mastitis pathogens. The occurrence of clinical cases was verified by testing during the milking and data was recorded related to the intensity and duration. Samples were collected monthly starting at day ten of lactation to evaluate the CCS. Milk production was recorded monthly for the first 100 days of lactation. It was found in the vaccinated group reduction in the prevalence of E. coli in the postpartum period, the occurrence of clinical cases of E. coli in the first 100 days of lactation as well the intensity of these clinical cases. There were no statistically significant differences in CCS, however vaccinated cows had higher milk production, compared to unvaccinated cows. Vaccination with E. coli J5 was effective in reducing the prevalence of intramammary infections (IMM) at calving, occurrence and intensity of clinical cases and an increase in milk production in the first 100 days of lactation.


Subject(s)
Animals , Female , Cattle , Hybrid Cells/immunology , Mastitis, Bovine/immunology , Escherichia coli Vaccines/therapeutic use , Immunoglobulins , Lactoferrin
20.
Res Vet Sci ; 94(3): 419-24, 2013 Jun.
Article in English | MEDLINE | ID: mdl-23360687

ABSTRACT

Enteric bacteria with resistance to third and fourth generation cephalosporin antibiotics, especially Escherichia coli bearing the blaCTX-M gene, have been detected in a wide range of food producing animals. However, commercial vaccines for these organisms are not currently available. An autogenous vaccine was prepared from E. coli bearing the blaCTX-M-14 gene and evaluated as a potential control measure to reduce shedding and dissemination of these organisms in cattle. Calves (n=30) received either an autogenous vaccine prepared from E. coli serotype O33 bearing the blaCTX-M-14 gene or a placebo by intramuscular injection on three separate occasions. Two weeks after the final vaccination, all calves were challenged by oral gavage with the O33 CTX-M-14 strain of E. coli (1×10(10) CFU). Faeces, intestinal mucosa and blood samples were taken for enumeration of total and CTX-M-14 E. coli and for assessment of the humoral immune response. The cumulative number of total E. coli excreted at 7 days post-challenge was significantly (p=0.006) lower in the vaccinated group than the placebo group. However, there was no significant difference in the shedding of either CTX-M-14 E. coli or total E. coli between vaccinated and placebo calves throughout the study period. The systemic immune response to E. coli O33 antigen was tested by ELISA and was significantly higher (p<0.001) in vaccinated than placebo calves. However, there was no significant difference in the mucosal immune response. These findings do not support the use of autogenous vaccination for the control of CTX-M-14 E. coli in calves.


Subject(s)
Autovaccines/therapeutic use , Cattle Diseases/prevention & control , Escherichia coli Infections/veterinary , Escherichia coli Vaccines/therapeutic use , Animals , Bacterial Shedding , Cattle , Cattle Diseases/immunology , Cattle Diseases/microbiology , Cephalosporin Resistance/genetics , Escherichia coli/genetics , Escherichia coli Infections/immunology , Escherichia coli Infections/microbiology , Escherichia coli Infections/prevention & control , Feces/microbiology , Plasmids/genetics
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