The prevailing O serogroups among the serologically differentiated clinical Proteus spp. strains in central Poland.

In the years 2006-2011, 617 Proteus spp. strains isolated mostly from urine and wounds or other clinical sources were collected in Lódz, Poland, to determine the offensive O serotypes frequently occurring among patients. P. mirabilis exhibited the most intensive swarming growth and was dominating species (86.9%), followed by P. genomospecies, P. vulgaris, and P. penneri. Ninety four per cent strains were recognized as S (smooth) forms. Serological studies (involving ELISA-enzyme-linked immunosorbent assay and Western blotting using native and adsorbed rabbit antisera) enabled classification of 80% S isolates into respective Proteus O serogroups among the 83 ones, described so far. The remaining strains seemed to be serologically unique. Despite the observed big serological variety of Proteus spp. isolates, we found the O78 serogroup recently described in Poland as dominating and identified other widespread serotypes: O3, O6, O10, O11, O27, O28, and O30 reported earlier as predominating also in other countries; O77 and O79 detected lately in Poland; O16, O18, O20, and O50. No unique structural feature of the prevalent O serotypes has been indicated. However, the prevalence of some O serogroups indicates that particular serotypes may be in some ways beneficial to the strains producing these kinds of O antigen.

Primary and Secondary Bacteremia Caused by Proteus spp.: Epidemiology, Strains Susceptibility and Biofilm Formation.

Proteus spp. is an etiological factor of urinary tract and bloodstream infections. The aim of this study was the retrospective analysis of susceptibility of Proteus spp. strains isolated from bloodstream infections (BSIs) as well as similarity evaluation of the strains isolated from different clinical samples. Proteus spp. strains were isolated in 2009-2017 from hospital patients. Identification was based on the colony's morphology and biochemical or MALDI-TOF MS analyzes. The antibiotic susceptibility test was done using the diffusion method. Biofilm formation was evaluated with microplate method using TTC. Bacteremia caused by Proteus spp. was found in 97 patients, mainly secondary to urinary tract infection. Most of the strains were susceptible to piperacillin with tazobactam (95.9%) and amikacin (86.7%). Elderly patients have a higher risk of mortality after BSIs caused by Proteus spp. A detailed analysis was made for randomly chosen 26 strains isolated from 11 patients with Proteus mirabilis bacteremia. Using PFGE, we found that 10 (90.9%) isolates, collected from different clinical specimens of the same patient, were genetically identical.Proteus spp. is an etiological factor of urinary tract and bloodstream infections. The aim of this study was the retrospective analysis of susceptibility of Proteus spp. strains isolated from bloodstream infections (BSIs) as well as similarity evaluation of the strains isolated from different clinical samples. Proteus spp. strains were isolated in 2009­2017 from hospital patients. Identification was based on the colony's morphology and biochemical or MALDI-TOF MS analyzes. The antibiotic susceptibility test was done using the diffusion method. Biofilm formation was evaluated with microplate method using TTC. Bacteremia caused by Proteus spp. was found in 97 patients, mainly secondary to urinary tract infection. Most of the strains were susceptible to piperacillin with tazobactam (95.9%) and amikacin (86.7%). Elderly patients have a higher risk of mortality after BSIs caused by Proteus spp. A detailed analysis was made for randomly chosen 26 strains isolated from 11 patients with Proteus mirabilis bacteremia. Using PFGE, we found that 10 (90.9%) isolates, collected from different clinical specimens of the same patient, were genetically identical.

Increased serum procalcitonin levels in pregnant patients with asymptomatic bacteriuria.

BACKGROUND: Among the pregnancy urinary tract infections, asymptomatic bacteriuria (ASB) is the most common one. Untreated ASB can progress to pyelonephritis in 30-50% of the patients and can also result in prematurity in 27% of the pregnancy so it needs immediate diagnosis and treatment. In this study, we wanted to evaluate procalcitonin levels, compared to other inflammatory in pregnant women with ASB. METHODS: The study was designed between the period of January 2012 and February 2013 at Sakarya University School of Medicine, Department of Gynecology and Obstetrics. The study population included 30 pregnant patients with asymptomatic bacteriuria and 39 healthy pregnant controls. RESULTS: Mean age was 28 (SD, 5.5) of the study population; mean maternal weight was 70 (SD, 8) kilogram. There were no statically significant differences between the groups according to the routine biochemical parameters, but gestational age was significantly lower in the ASB group compared to the controls (20.4 vs 28.6, respectively; p < 0.001). Serum procalcitonin levels were negative in all of the controls. In ASB group, 9 (30%) patients had procalcitonin levels greater than >0.05 ng/ml and 21(70%) patients had negative procalcitonin levels (Chi-squrae, p < 0.001). The sensitivity and specificity of procalcitonin assay for ASB was calculated as 30% and 100%, respectively. The positive predictive value was 100% and the negative predictive value was 65%. The most frequent microorganisms in the urine culture were Escherichia coli (26 patients, 87%), Proteus mirabilis (3 patients, 10%) and Klebsiella (1 patient, 3%) in the ASB group. We experienced four (44%) recurrences among nine positive procalcitonin in ASB patients after completion of treatment of the first ASB diagnosis. DISCUSSION: Procalcitonin levels were significantly higher in ASB group than the control group and serum procalcitonin levels were higher in pregnant women with recurrent ASB. This finding is an important result revealed that high procalcitonin level can predict the further urinary tract infection risk. Finally, serum procalcitonin levels were normal in healthy pregnant women while other inflammatory markers such as WBC, ESR and CRP levels were higher.

The incidence of Proteus mirabilis infection increases in patients on treatment but does not trigger disease activity.

The aim of this study is to determine whether treatment increases the levels of anti-Proteus antibodies (APA) in patients with rheumatoid arthritis (RA). The blood samples of 32 patients suffering from RA who were recruited in our previous study and continued to participate in our follow-up study were collected after 1 year. Their first and follow-up samples were analysed for the presence of IgG isotype and total immunoglobulins (IgG+IgA+IgM) against Proteus mirabalis (PM) using enzyme-linked immunosorbent assay with two kinds of antigen preparations: whole bacteria and sodium dodecyl sulphate (SDS) lysed bacterial extract. All patients were treated with methotrexate and hydroxychloroquine with adequate dose of non-steroidal anti-inflammatory drug. After 1 year, 11 patients were in clinical remission [erythrocyte sedimentation rate (ESR) less than 30 mm/h and C-reactive protein (CRP) less than or equal to 10 mg/l], while the rest of the 21 were in the state of active disease. Correlation and Student's t test were used for statistical analysis. APA titres were significantly elevated in patients after 1 year of therapy. However, the rise was not different between patients who were in clinical remission and those in the state of active disease. APA titre increases in the treatment of RA, and the probable mechanisms are discussed.

ELISA for bovine interleukin-1 receptor antagonist and its application to mastitic sera and whey.

A sandwich ELISA for the bovine IL-1 receptor antagonist (bIL-1ra) was developed using recombinant (r) bIL-1ra produced by Escherichia coli, anti-rbIL-1ra rabbit IgG, its biotinylated one and avidin-peroxidase. This ELISA system enabled detection of rbIL-1ra at a concentration of more than 2 ng/ml. This ELISA was applied to quantitation of bIL-1ra in sera and whey of mastitic and healthy cows. The results indicate that although IL-1ra levels in healthy and mastitic sera and whey were comparable, serum IL-1ra/IL-1beta ratio of euthanized cows was significantly lower than that of the recovered.

Pattern of gram negative rods bacteraemia in diabetic patients in Ibadan, Nigeria.

In a study of 100 patients in Ibadan between July and December 1995 to evaluate bacteraemia due to gram-negative bacilli, 64% were culture positive, 44 (68.8%) of these yielded gram-negative rods. The isolates were Klebsiella species (43.2%), Escherichia coli (27.3%), Pseudomonas aeruginosa (13.6%), Proteus species (11.4%) and Bacteroides melaninogenious (4.15%) by standard bacteriological methods. Antimicrobial sensitivity results suggested ofloxacin or ceftriaxone with metronidazole as empirical antibiotic therapy.

The effect of the bacterial product, succinic acid, on neutrophil bactericidal activity.

We investigated the effect of succinic acid on neutrophil bactericidal activity in a model of intra-abdominal abscess induced in mice by the peritoneal inoculation of 5 x 10(6) cfu ml-1 E. coli and 5 x 10(8) cfu ml-1 B. fragilis plus 1 mg of bran as faecal fibre analogue. The mean pH of the induced abscesses at week 1 was 6.7, higher than the pH associated with succinic acid inhibitory activity. We therefore determined the effect of succinic acid (0-100 mM) at pH 6.7 on the bactericidal activity of mouse bone marrow-derived neutrophils. Phagocytic killing of Proteus mirabilis by neutrophils was significantly inhibited by 30-100 mM succinic acid at pH 6.7 but there was no significant effect of succinic acid on engulfment of bacteria at this pH. However, significant inhibition of intracellular killing (assayed by adding succinic acid to suspensions of neutrophils which had engulfed bacteria in low serum concentrations but in the absence of succinic acid) was noted at 70 and 100 mM. These results indicate that succinic acid inhibits neutrophil bactericidal activity at a physiological pH, principally through inhibition of intracellular killing mechanisms and therefore contributing to bacterial persistence in this model of abscess formation.

[Hemagglutinating properties of Proteus mirabilis strains isolated from clinical specimens]. / Hemaglutynacyjne wlasciwosci paleczek Proteus mirabilis izolowanych z materialu klinicznego.

Haemagglutinating properties of 345 P. mirabilis strains isolated from various clinical samples were determined. Red blood cells of different origin as human group 0, bovine, horse, sheep and rat were used for the study. For the detection of MS and MR/P haemagglutinins the haemagglutination reaction was run with and without D-mannose. On the other hand, for the detection of type MR/K haemagglutinins tanned human and bovine erythrocytes were used. The majority of tested strains (90.14%) was polyhaemagglutinating i.e. showed simultaneously the presence of two or three haemagglutinins. Only three strains of P. mirabilis (0.87%) did not agglutinate any of the erythrocytes used for the study. The majority of strains (95.83-100%) in specific groups of clinical materials showed the presence of MR/K+ while MR/P+ 45.45-93.75% of strains and MS+ 45.83-73.1% of tested strains. Out of P. mirabilis strains isolated from urine, faeces and blood the highest percentage possessed at the same time all three haemagglutinin types (MS+, MR/K+, MR/P+) or pattern MR/K+, MR/P+. Bronchial isolates had usually pattern MR/K+ (31.82%) and strains isolated from skin possessed haemagglutinins of pattern MR/K+, MR/P+ (50%) and MS+, MR/K+, MR/P+ (43.75%). Among strains expressing MR/P+ at 37 degrees C a great differentiation of spectrum activity against tested erythrocytes was seen. Undoubtedly, the majority of MR/P+ strains from specific groups of clinical materials (with the exception of urine) agglutinated sheep and horse erythrocytes with and without D-mannose. The majority of strains isolated from urine agglutinated sheep and bovine erythrocytes.(ABSTRACT TRUNCATED AT 250 WORDS)

Relationships between human blood groups, bacterial pathogens, and urinary tract infections.

Blood groups of 137 patients with acute pyelonephritis and chronic upper tract infection, cystitis, and asymptomatic bacteriuria were compared with those of a normal uninfected control population. In addition, the identified uropathogens were categorized according to the patient's blood group. There was a significant association between the diagnosis of chronic upper tract infection and blood group B as compared with controls (p = less than 0.05, chi 2). Analysis of the bacterial isolates showed that more patients with blood group B had infections with Pseudomonas sp., Klebsiella pneumoniae, and Proteus sp. than was expected; and fewer patients with blood group A had infections with Pseudomonas than predicted (p = less than 0.05, chi 2). There was an increased number of patients in blood group AB with infections caused by Escherichia coli and Klebsiella pneumoniae. These results suggest that an individual's blood group may be a significant factor in the host-response to bacterial invasion and influence the development of infection with certain gram-negative bacilli.

Hyperammonemia in a boy with obstructive ureterocele and proteus infection.

We report on a boy with ureteroceles that obstructed the bladder outlet and ureters, who presented with sepsis and hyperammonemia despite normal liver function. The hyperammonemia was most likely caused by excessive absorption of ammonia produced by Proteus mirabilis in the obstructed urinary tract.

Ammonia encephalopathy secondary to urinary tract infection with Proteus mirabilis.

Hyperammonemia with coma, tachypnea, and respiratory alkalosis developed in a 3-year-old boy with prune"-belly syndrome during a urinary tract infection with Proteus mirabilis. Hyperammonemia is thought to have resulted from the production within the massively dilated urinary tract of excessive amounts of ammonia due to bacterial urease, and its subsequent reabsorption into the systemic circulation. The patient rapidly improved following parenteral antibiotic therapy and continuous catheter drainage of the urinary tract.

Marked suppression of thyroid function in rats with gram-negative septicemia.

Gram-negative septicemia was induced in rats by two daily injections of fecal mixture into the thigh, after which the thyroid function was markedly suppressed for 2 days. Iodine metabolism was studied by organ radioassay and by imaging with a multiwire proportional chamber (MWPC) at various time intervals after intravenous injection of 125I. Plasma T3, T4, and TSH, measured by radioimmunoassays, were suppressed, as were the T3-resin uptakes. Fractional blood supply to the thyroid glands of the infected rats, studied by the 81Rb uptake method, was also found to be markedly reduced. Sections of the thyroid glands showed little structural change during the period of marked thyroid suppression. There was no biochemical evidence of renal failure in the septicemic rats.