Neutralization, by a polyspecific antivenom, of the coagulopathy induced by the venom of Bothrops asper: Assessment by standard coagulation tests and rotational thromboelastometry in a murine model.

Venom-induced consumption coagulopathy and thrombocytopenia are common and potentially severe manifestations of viperid snakebite envenoming since they contribute to local and systemic hemorrhage. Therefore, the assessment of the efficacy of antivenoms to neutralize coagulopathic and thrombocytopenic toxins should be part of the preclinical evaluation of these drugs. To evaluate the efficacy of the polyvalent (Crotalinae) antivenom produced in Costa Rica, in this study we have used a mouse model of coagulopathy and thrombocytopenia induced by the venom of Bothrops asper, based on the bolus intravenous (i.v.) injection of venom. When venom and antivenom were incubated before injection, or when antivenom was administered i.v. immediately after venom injection, venom-induced hemostatic alterations were largely abrogated. We also studied the recovery rate of clotting parameters in conditions where antivenom was administered when mice were coagulopathic. Some parameters recovered more rapidly in antivenom-treated mice than in control envenomed animals, but others showed a spontaneous recovery without antivenom. This is due to a rapid clearance of plasma venom levels in these experimental conditions. This implies that models based on the bolus i.v. injection of venom have limitations for assessing the effect of antivenom in the recovery of clotting alterations once coagulopathy has developed. It is suggested that alternative models should be developed based on a slower systemic absorption of venom. Overall, our findings provide a protocol for the preclinical evaluation of antivenoms and demonstrate that the polyvalent antivenom is effective in neutralizing the toxins of B. asper venom responsible for coagulopathy and thrombocytopenia.

Putative Conjugative Plasmids with tcdB and cdtAB Genes in Clostridioides difficile.

The major toxins of Clostridioides difficile (TcdA, TcdB, CDT) are chromosomally encoded in nearly all known strains. Following up on previous findings, we identified 5 examples of a family of putative conjugative plasmids with tcdB and cdtAB in clinical C. difficile isolates from multilocus sequence typing clades C-I, 2, and 4.

Detection of Gastrointestinal Nematode Populations Resistant to Albendazole and Ivermectin in Sheep.

Gastrointestinal parasite infections represent a major welfare problem in small ruminants reared in extensive systems, which may be exacerbated by anthelmintic resistance. Therefore, we aimed to study the efficacy of albendazole and ivermectin in sheep. Eighty-six animals were selected from commercial farms in the temperate area of the State of Mexico at the age of seven months. These animals were randomly distributed into three groups: Group A, treated with albendazole, Group I, treated with ivermectin and Group C, left untreated. Faecal samples were collected before the anthelmintic was administered and 15 days post-treatment. Both Group A and Group I displayed a significant decrease of faecal egg counts when pre- and post-treatment values were compared (p = 0.003 and p = 0.049, respectively), and a significantly lower faecal egg count when compared with Group C after the treatment (p < 0.05). However, the faecal egg count reduction test showed that gastrointestinal nematodes (GIN) developed anthelmintic resistance to both albendazole and ivermectin. The results of the polymerase chain reaction (PCR) allowed the identification of Cooperia spp., and Trichostrongylus colubriformis. The allele-specific PCR results confirmed that T. colubriformis was resistant to albendazole. In conclusion, this study showed the presence of resistant GIN to albendazole and ivermectin in sheep reared in Mexican temperate zones. Therefore, nematode infections should be systematically monitored in order to implement integrated management strategies to prevent the spread of anthelmintic resistance.

The nematophagous fungus Duddingtonia flagrans reduces the gastrointestinal parasitic nematode larvae population in faeces of orally treated calves maintained under tropical conditions-Dose/response assessment.

This research assessed the dose/response to Duddingtonia flagrans chlamydospores (Df-C) administered to calves naturally infected with gastrointestinal nematodes (GINs), and its effect in reducing the infective larvae (L3) population in faeces in a farm in the Mexican tropics. Forty zebu calves, between 6 and 12 months of age, were randomly distributed into four groups of 10 calves. One control and three groups treated with different oral doses of Df-C based on their body weight (BW) were established as follows: group 1 (control); group 2, 0.250 × 106Df-C per kg/BW; group 3, 0.5 × 106Df-C per kg/BW and group 4, 1 × 106Df-C per kg/BW. The fungal doses were administered daily for 10 days. Every group was confined to individual pens, and they received a nutritional regime based on Buffel grass, concentrated supplement and water ad libitum. Every third day, starting one week before treatments, faeces were taken from the rectum of each animal to determine the number of eggs per g of faeces (epg) through the McMaster technique. Four coprocultures of 20 g each from each individual faecal sample were prepared and incubated for 14 days. The efficacy of the treatments was based on the mean of the GIN L3 recovered from coprocultures of the different groups. Data were analysed using a completely randomized design through an ANOVA analysis, followed by a Duncan multiple range test. The efficacy of treatments was expressed as the larval reduction rate. High variation in the epg in the different groups along the experiment was recorded. The reduction in the GIN L3 population was observed from the 4 to 11 day post-treatment in the three assessed doses. Results in group 2 (lowest fungal dose), showed 88.5, 57.6, 55.9 and 30% (58% overall reductions) in the GIN L3 in the faeces of animals 4, 7, 9 and 11 days post-treatment, respectively. In group 3 (medium fungal dose), 95.8, 80.4, 63.4 and 52.7% GIN L3 reductions (73% overall reduction) were recorded, respectively. At the highest Df-C dose used (1 × 106 per kg/BW), the results were 88.9, 78.0, 59.3 and 67.3% (73.5% overall reduction), respectively (p < 0.05). The species of identified nematodes through L3 morphometric and molecular taxonomy were Cooperia spp. and H. contortus. From the three Df-C assessed doses, the medium dose (0.5 × 106Df-C per kg/BW) was sufficient to substantially reduce the GIN L3 in zebu calves maintained under conditions in the Mexican tropics.

Novel Clade C-I Clostridium difficile strains escape diagnostic tests, differ in pathogenicity potential and carry toxins on extrachromosomal elements.

The population structure of Clostridium difficile currently comprises eight major genomic clades. For the highly divergent C-I clade, only two toxigenic strains have been reported, which lack the tcdA and tcdC genes and carry a complete locus for the binary toxin (CDT) next to an atypical TcdB monotoxin pathogenicity locus (PaLoc). As part of a routine surveillance of C. difficile in stool samples from diarrheic human patients, we discovered three isolates that consistently gave negative results in a PCR-based screening for tcdC. Through phenotypic assays, whole-genome sequencing, experiments in cell cultures, and infection biomodels we show that these three isolates (i) escape common laboratory diagnostic procedures, (ii) represent new ribotypes, PFGE-types, and sequence types within the Clade C-I, (iii) carry chromosomal or plasmidal TcdBs that induce classical or variant cytopathic effects (CPE), and (iv) cause different levels of cytotoxicity and hamster mortality rates. These results show that new strains of C. difficile can be detected by more refined techniques and raise questions on the origin, evolution, and distribution of the toxin loci of C. difficile and the mechanisms by which this emerging pathogen causes disease.

Two Groups of Cocirculating, Epidemic Clostridiodes difficile Strains Microdiversify through Different Mechanisms.

Clostridiodes difficile strains from the NAPCR1/ST54 and NAP1/ST01 types have caused outbreaks despite of their notable differences in genome diversity. By comparing whole genome sequences of 32 NAPCR1/ST54 isolates and 17 NAP1/ST01 recovered from patients infected with C. difficile we assessed whether mutation, homologous recombination (r) or nonhomologous recombination (NHR) through lateral gene transfer (LGT) have differentially shaped the microdiversification of these strains. The average number of single nucleotide polymorphisms (SNPs) in coding sequences (NAPCR1/ST54 = 24; NAP1/ST01 = 19) and SNP densities (NAPCR1/ST54 = 0.54/kb; NAP1/ST01 = 0.46/kb) in the NAPCR1/ST54 and NAP1/ST01 isolates was comparable. However, the NAP1/ST01 isolates showed 3× higher average dN/dS rates (8.35) that the NAPCR1/ST54 isolates (2.62). Regarding r, whereas 31 of the NAPCR1/ST54 isolates showed 1 recombination block (3,301-8,226 bp), the NAP1/ST01 isolates showed no bases in recombination. As to NHR, the pangenome of the NAPCR1/ST54 isolates was larger (4,802 gene clusters, 26% noncore genes) and more heterogeneous (644 ± 33 gene content changes) than that of the NAP1/ST01 isolates (3,829 gene clusters, ca. 6% noncore genes, 129 ± 37 gene content changes). Nearly 55% of the gene content changes seen among the NAPCR1/ST54 isolates (355 ± 31) were traced back to MGEs with putative genes for antimicrobial resistance and virulence factors that were only detected in single isolates or isolate clusters. Congruently, the LGT/SNP rate calculated for the NAPCR1/ST54 isolates (26.8 ± 2.8) was 4× higher than the one obtained for the NAP1/ST1 isolates (6.8 ± 2.0). We conclude that NHR-LGT has had a greater role in the microdiversification of the NAPCR1/ST54 strains, opposite to the NAP1/ST01 strains, where mutation is known to play a more prominent role.

The Novel Phages phiCD5763 and phiCD2955 Represent Two Groups of Big Plasmidial Siphoviridae Phages of Clostridium difficile.

Until recently, Clostridium difficile phages were limited to Myoviruses and Siphoviruses of medium genome length (32-57 kb). Here we report the finding of phiCD5763, a Siphovirus with a large extrachromosomal circular genome (132.5 kb, 172 ORFs) and a large capsid (205.6 ± 25.6 nm in diameter) infecting MLST Clade 1 strains of C. difficile. Two subgroups of big phage genomes similar to phiCD5763 were identified in 32 NAPCR1/RT012/ST-54 C. difficile isolates from Costa Rica and in whole genome sequences (WGS) of 41 C. difficile isolates of Clades 1, 2, 3, and 4 from Canada, USA, UK, Belgium, Iraq, and China. Through comparative genomics we discovered another putative big phage genome in a non-NAPCR1 isolate from Costa Rica, phiCD2955, which represents other big phage genomes found in 130 WGS of MLST Clade 1 and 2 isolates from Canada, USA, Hungary, France, Austria, and UK. phiCD2955 (131.6 kb, 172 ORFs) is related to a previously reported C. difficile phage genome, phiCD211/phiCDIF1296T. Detailed genome analyses of phiCD5763, phiCD2955, phiCD211/phiCDIF1296T, and seven other putative C. difficile big phage genome sequences of 131-136 kb reconstructed from publicly available WGS revealed a modular gene organization and high levels of sequence heterogeneity at several hotspots, suggesting that these genomes correspond to biological entities undergoing recombination. Compared to other C. difficile phages, these big phages have unique predicted terminase, capsid, portal, neck and tail proteins, receptor binding proteins (RBPs), recombinases, resolvases, primases, helicases, ligases, and hypothetical proteins. Moreover, their predicted gene load suggests a complex regulation of both phage and host functions. Overall, our results indicate that the prevalence of C. difficile big bacteriophages is more widespread than realized and open new avenues of research aiming to decipher how these viral elements influence the biology of this emerging pathogen.

A Clostridium difficile Lineage Endemic to Costa Rican Hospitals Is Multidrug Resistant by Acquisition of Chromosomal Mutations and Novel Mobile Genetic Elements.

The antimicrobial resistance (AMR) rates and levels recorded for Clostridium difficile are on the rise. This study reports the nature, levels, diversity, and genomic context of the antimicrobial resistance of human C. difficile isolates of the NAPCR1/RT012/ST54 genotype, which caused an outbreak in 2009 and is endemic in Costa Rican hospitals. To this end, we determined the susceptibilities of 38 NAPCR1 isolates to 10 antibiotics from seven classes using Etests or macrodilution tests and examined 31 NAPCR1 whole-genome sequences to identify single nucleotide polymorphisms (SNPs) and genes that could explain the resistance phenotypes observed. The NAPCR1 isolates were multidrug resistant (MDR) and commonly exhibited very high resistance levels. By sequencing their genomes, we showed that they possessed resistance-associated SNPs in gyrA and rpoB and carried eight to nine acquired antimicrobial resistance (AMR) genes. Most of these genes were located on known or novel mobile genetic elements shared by isolates recovered at different hospitals and at different time points. Metronidazole and vancomycin remain the first-line treatment options for these isolates. Overall, the NAPCR1 lineage showed an enhanced ability to acquire AMR genes through lateral gene transfer. On the basis of this finding, we recommend further vigilance and the adoption of improved control measures to limit the dissemination of this lineage and the emergence of more C. difficile MDR strains.

Anthelmintic resistance in gastrointestinal nematodes from grazing beef cattle in Campeche State, Mexico.

Production of beef cattle is one of the most important economic activities in Mexico. However, anthelmintic resistance (AR) has affected animal productivity. The aim of this study was to determine the presence of AR in gastrointestinal nematodes (GIN) of beef cattle in Candelaria Municipality of Campeche State, Mexico. Sixty-five-month-old beef calves were selected for the faecal egg count reduction test (FECRT) and the inhibition of egg hatch (IEH) assay. These parameters were determined using albendazole (benzimidazole, BZ), ivermectin (IVM, Macrocyclic lactone, ML) and levamisole (LEV, imidazothiazole, IMZ). Allele-specific PCR (AS-PCR) confirmed polymorphisms at codon 200 of isotype 1 of the ß-tubulin gene of Haemonchus placei. The results showed 32 % IVM toxicity by FECRT, indicating problems of AR in the GIN population. In contrast, BZ and LEV showed 95 and 100 % toxicity, respectively, against GIN from infected beef calves. The infective larvae (L3) of Cooperia, Haemonchus and Oesophagostomum were identified before anthelmintic treatment, and Cooperia L3 larvae were identified after treatment with IVM. The IEH assays had lethal dose 50 (LD50) of 187 nM to BZ, confirming the ovicidal effect of BZ. In contrast, the LD50 for LEV and IVM were 3.3 and 0.4 mM, respectively. The results obtained by AS-PCR confirmed two DNA fragments of 250 and 550 bp, corresponding to the resistant and susceptible alleles in the H. placei population. The nematode Cooperia showed AR against IVM, while the toxicity effect of BZ against GIN with both FECRT and IEH was confirmed.

Phenotypic and genotypic characterisation of Haemonchus spp. and other gastrointestinal nematodes resistant to benzimidazole in infected calves from the tropical regions of Campeche State, Mexico.

The aim of this study was to identify the presence of anthelmintic resistance to benzimidazole (BZ) in gastrointestinal nematodes (GIN) from naturally infected calves in the tropical regions of Campeche State of Mexico. The faecal egg count reduction test (FECRT) was conducted at 10 livestock farms localised in the Carmen, Candelaria, Champotón, Escárcega and Palizada municipalities of Campeche. The assessed anthelmintic was albendazole. The trial period was between August and November 2012. Infected calves were allocated into two groups, control and treated, on each farm. The number of eggs excreted per g of faeces was estimated by the McMaster technique at 0 and 14 days pre- and post- treatment, respectively. Recovered infective larvae (L3) (pre- and post-treatment) were identified using taxonomic keys and a genomic DNA (gDNA) template from a pool of L3 species prior to BZ treatment. Additionally, BZ-resistance polymorphisms in Haemonchus were determined by Allele Specific PCR (AS-PCR) at codon 200 and by end-point PCR at codons 200, 198 and 167 from isotype 1 of the ß-tubulin gene. Morphological identification revealed Haemonchus, Cooperia, Trichostrongylus, Ostertagia and Oesophagostumum L3 species before BZ treatment, and Haemonchus and Cooperia L3 species after treatment. Additionally, of the GIN populations, three exhibited BZ resistance, and seven were BZ-susceptible by FECRT. Molecular analysis identified mutations in Haemonchus populations on nine farms at codon 200 (TTC to TAC) by AS-PCR, while no changes were observed at 167 (TTC to TAC) or 198 (GAA to GCA) codons in any population. In conclusion, resistance to BZ was determined in Haemonchus and Cooperia nematodes in infected cattle in five tropical regions of Campeche State.