[Detection of Borrelia burgdorferi DNA by gene amplification in the muscle of a patient with fibromyalgia].
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Publications and source records attributed to H Monteil.
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The pore-forming activity of leukocidin (PVL) secreted by Staphylococcus aureus has been investigated on human white cells by flow cytometry techniques. This two-component toxin induced morphological modifications of neutrophils and monocytes as detected by forward light scattering measurements, but was inactive on lymphocytes. These modifications were the consequence of pore formation through the cell membrane leading to its permeabilization. In the absence of calcium, PVL formed pores large enough to allow ethidium ions to penetrate the cells and become fluorescent by intercalating nucleic acids. In the presence of calcium, the pores were too small for ethidium entry but allowed an influx of calcium as shown by the increase in fluorescence of Fluo-3 loaded in the cells. This increase in intracellular calcium concentration induced the activation of neutrophils by PVL as shown by the liberation of their granule content measured by a decrease in side light scattering. Furthermore, ethidium fluorescence was used to discriminate the cells sensitive to PVL, and the analysis of differentiated HL-60 cells and cells obtained from a case of chronic myeloid leukemia led to the conclusion that myeloid cells become sensitive to PVL during differentiation to the metamyelocyte stage.
Hybridization of an oligodeoxyribonucleotide (oligo) probe, designed from a repeated sequence ('oligo rep') at the C terminus of the Clostridium difficile (Cd) cytotoxin (Cyt), revealed that homologies exist between the Cd cyt gene and the genomes of several other clostridia, including Clostridium sordellii (Cs), suggesting a common ancestral cyt amongst the Clostridium genus. This Cd 'oligo rep' probe was used to clone the Cs (strain 6018) cyt. The sequenced (7095 bp) region encodes 2364 amino acids (aa) and corresponds to a protein of 270,614 Da. Cs Cyt has 76% identity with the Cd Cyt and 47% identity with the Cd enterotoxin (Ent). The latter third of the protein consists of repeated units, similar to those found for Cd Cyt. A highly conserved hydrophobic domain can be delineated. Few structural differences are evident between Cd and Cs Cyt to explain their different cellular and sub-cellular effects. A small open reading frame (ORF) encoding a protein of 16,484 Da is located 210 bp downstream from cyt. No homology was evident with any known sequence. The first 30 aa of this ORF may correspond to a signal peptide.
Levels of genomic DNA relatedness were determined using a S1 nuclease procedure for reference bacteria identified as biotypes of Corynebacterium diphtheriae, biovars of Corynebacterium pseudotuberculosis, and 'Corynebacterium ulcerans'. These results showed that the three species are separate taxa at the genomospecies level whereas biotypes and biovars are closely related genomically within each species. Phylogenetic analyses of small-subunit rDNA sequences revealed that 'Corynebacterium ulcerans' forms a tight cluster with Corynebacterium pseudotuberculosis within the robust branch that groups all Corynebacterium sequenced to date. Therefore, we propose that the species incertae sedis 'C. ulcerans' should be conclusively recognized as a distinct species within the genus Corynebacterium with strain CCUG 2708 = NCTC 7910 as type strain. This species is characterized by urease production and fermentation of glycogen.
The 16S rRNA genes (rDNA) of 50 strains belonging to 26 different coryneform bacterial species and genomospecies and of the type strain of Rhodococcus equi were enzymatically amplified. Amplified rDNA restriction analysis (ARDRA) with the enzymes AluI, CfoI and RsaI was carried out. The combination of the ARDRA patterns obtained after restriction with these three different enzymes enabled the differentiation between the following species: Corynebacterium accolens (number of strains = 2), C. afermentans subsp. afermentans (2), C. afermentans subsp. lipophilum (2), C. amycolatum (3), CDC coryneform group ANF-1-like (1), CDC coryneform group ANF-3-like (1), C. cystitidis (1), C. diphtheriae (4), C. jeikeium (3), C. macginleyi (2), C. minutissimum (1), C. pilosum (1), C. pseudotuberculosis (2), C. renale (2), C. striatum (2), C. urealyticum (3), C. xerosis (1), CDC coryneform groups B-1 (2), B-3 (2), F-1, genomospecies 1 and 2 (6), G, genomospecies 1 (1) and G, genomospecies 2 (2). The following strains or species could not be differentiated from each other: C. pseudodiphtheriticum (2) from C. propinquum (former CDC coryneform group ANF-3) (2), CDC coryneform group F-1, genomospecies 1 (4) from genomospecies 2 (2) and C. jeikeium genomospecies A (1) from genomospecies C (2). ARDRA may represent a possible alternative for identification of coryneforms, since this technique enabled the identification of most coryneforms tested and since DNA extraction (i.e. cell lysis by boiling), amplification, restriction and electrophoresis can be carried out within 8 hours. This might allow quick identification of C. diphtheriae and other possible pathogens of the genus Corynebacterium.
DNA relatedness experiments were performed with 38 clinical isolates and 13 reference strains of coryneform taxa exhibiting a lipid requirement for optimal growth. Forty-five of these strains split into five genomic groups at the species level, whereas six other strains remained unclustered. Genomospecies II fits Corynebacterium accolens, but the other genomospecies were not genetically related to any of the defined Corynebacterium species. Phylogenetic analyses of genes coding for small-subunit rRNA sequences revealed that two genomospecies (I and III) and C. accolens form a tight cluster within the robust branch that groups all Corynebacterium species presently sequenced. Reference strains of biotypes C-1, C-2, and C-3 of "Corynebacterium pseudogenitalium" were found to fall into genomospecies I, as well as "Corynebacterium tuberculostearicum," Centers for Disease Control and Prevention (CDC) coryneform group G-1, and CDC coryneform group G-2 reference strains. Biochemical tests allowed differentiation between genomospecies except between genomospecies IV and V and between six unclustered strains and genomospecies I. We propose a new classification for these lipid-requiring diphtheroids within the genus Corynebacterium with the delineation of some CDC coryneform group G-1 strains (genomospecies III) as a new species for which the name Corynebacterium macginleyi is proposed. The type strain is strain JCL-2 (CIP 104099), isolated from a human corneal ulcer.
A new Corynebacterium species, Corynebacterium argentoratense was isolated from the throats of four human patients. It is characterized by the presence of chemotype IV, a cell wall, corynomycolic acids, and a G+C content ranging from 60 to 61 mol%. Strains belonging to this species exhibit high levels of DNA relatedness as determined by DNA-DNA hybridization experiments (S1 nuclease procedure) but no close DNA relatedness with related Corynebacterium species. Phylogenies based on comparative analyses of nearly complete small-subunit rDNA sequences confirmed the inclusion of this new species within the genus Corynebacterium and grouped it in a cluster with C. diphtheriae, C. ulcerans, C. pseudotuberculosis, and C. kutscheri. PCR experiments revealed an absence of the gene coding for diphtheria toxin. This new species can be identified by its mycolic acid pattern, fermentation of sugars, and enzymatic activities. Strain IBS B10697 (CIP 104296) is the type strain of C. argentoratense.
We determined almost complete small-subunit ribosomal DNA sequences of 50 reference strains belonging to the genera Corynebacterium, Rhodococcus, and Gordona and compared these sequences with previously published sequences. Three phylogenetic methods (the neighbor-joining, maximum-likelihood, and maximum-parsimony methods), as well as a bootstrap analysis, were used to assess the robustness of each topology which we obtained. The results of comparative phylogenetic analyses confirmed that the genera Corynebacterium, Dietzia, Gordona, Mycobacterium, Nocardia, Tsukamurella, and Turicella form a monophyletic taxon within the phylum containing the high-G+C-content gram-positive bacteria. The genus Corynebacterium appeared to be a monophyletic unit whose members could be divided into four major clusters. The validity of the genus Turicella is doubtful since members of this genus clearly belong to the genus Corynebacterium. The variability of chemotaxonomic characteristics within the genus Corynebacterium suggests that small-subunit ribosomal DNA sequence analysis is probably the most straightforward method for confirming that a bacterium belongs to this genus.
DNA hybridisation of 309 consecutive Staphylococcus aureus clinical isolates with oligonucleotide probes specific for genes encoding Panton-Valentine leucocidin (luk-PV) and gamma-haemolysin (hlg) revealed that 99% of randomly selected strains carried the hlg locus whereas only 2% harboured the luk-PV as well as the hlg loci. Only 1% of the strains did not possess either gene. In a clinical prospective study of independent S. aureus strains, 58 Panton-Valentine leucocidin (PVL)-producing isolates were shown to be responsible for primary skin infections, mainly furuncles (86%). Phage susceptibility patterns and pulsed field gel electrophoresis (PFGE) profiles of DNA were shown to be polymorphic epidemiological markers of PVL-producing strains. In eight patients with recurrent furuncles, the PVL-producing strains isolated either from furuncles or from the anterior nares were considered to be identical in each based upon phage sensitivity profiles or PFGE patterns.
Staphylococcus aureus ATCC 49775 produces three proteins recognized by affinity-purified antibodies against the S component of Panton-Valentine leucocidin (LukS-PV) and two proteins recognized by affinity-purified antibodies against the F component of this toxin (LukF-PV). Purification of these proteins and cloning of the corresponding genes provided evidence for the presence of two loci. The first one, encoding Panton-Valentine leucocidin, consisted of two cotranscribed open reading frames, lukS-PV and lukF-PV, coding the class S and the class F components, respectively. The second one coded for a gamma-hemolysin and consisted of two transcription units, the first one encoding an HlgA-like protein, a class S component, and the second one encoding two cotranscribed open reading frames identical to HlgC and HlgB, class S and class F components, respectively, from gamma-hemolysin from the reference strain Smith 5R. It appears that the Panton-Valentine leucocidin from S. aureus ATCC 49775 (V8 strain) should not be confused with leucocidin from ATCC 27733 (another isolate of V8 strain), which had 95% identity with HlgC and HlgB from gamma-hemolysin. The cosecretion of these five proteins led to six possible synergistic combinations between F and S components. Two of these combinations (LukS-PV-LukF-PV and HlgA-LukF-PV) had dermonecrotic activity on rabbit skin, and all six were leukocytolytic on glass-adsorbed leukocytes. Only three were hemolytic on rabbit erythrocytes, the two gamma-hemolysin combinations and the combination LukF-PV-HlgA.
We studied 12 coryneform isolates having similar biochemical profiles which did not permit their assignment to any recognized taxa. Human semen was the source for seven of these strains, whereas the other strains were isolated from urethra, urine, and blood specimens of adult male patients. These bacteria were found in significant quantities (10(4) to 10(5) CFU/ml) in semen specimens from infertile male patients with the diagnosis of prostatitis. These strains had characteristics of the genus Corynebacterium, such as 60 mol% G + C in the DNA and corynemycolic acids, meso-diaminopimelic acid, arabinose, and galactose in the cell wall. Quantitative DNA-DNA hybridizations (S1 nuclease procedure) and phylogenies based on comparisons of almost-complete small-subunit ribosomal DNA sequences confirmed that these strains constitute a single new species within the genus Corynebacterium. All 12 strains showed similar phenotypic features, i.e., good growth on sheep blood agar in contrast with poor growth on the same medium supplemented with 1% Tween 80, a positive CAMP test in the presence of Staphylococcus aureus, glucose and sucrose fermentation, and the presence of beta-glucuronidase. Some strains reduced nitrate and hydrolyzed urea or esculin. These features allowed us to distinguish these strains from members of any other coryneform taxon, and the proposed name is Corynebacterium seminale with strain IBS B12915 (CIP 104297) as the type strain. The description and delineation of these strains as a new species should be useful for further studies, including evaluations of their prevalence among the normal flora and their clinical implications.
Articular manifestations of Lyme disease may be less common in Europe than in the United States, perhaps because European strains of Borrelia burgdorferi are characterized by greater genetic diversity and different organotropisms as compared with American strains. The diagnosis rests on clinical symptoms. A history of erythema migrans is pathognomonic. Isolated articular manifestations with no history of erythema migrans raise difficult diagnostic problems. Monoarthritis and asymmetric oligoarthritis is the most characteristic pattern; enthesitis can occur, a clinical feature shared with spondylarthropathy. Serologic tests (indirect immunofluorescence, Western blotting) have not been standardized and should be used only to confirm the diagnosis in patients with suggestive clinical manifestations. The interpretation of serologic test results is made difficult by the high seroprevalence rates seen among the general population in endemic areas, where subclinical Borrelia burgdorferi infection probably occurs. Detection of Borrelia burgdorferi DNA using polymerase chain reaction amplification is a potent tool both for diagnosis and for gaining insight into the pathophysiology of Lyme disease. However, difficulties subsist (risk of contamination of the specimens, inhibitory effects). Continued work is needed to determine which targets (chromosomal DNA, plasmidic DNA) and specimens (joint fluid and/or synovial membrane) provide optimal results.
Exposure of McCoy cultured cells to Clostridium difficile cytotoxin B or okadaic acid (OA), a potent phosphatase inhibitor, results in similar morphological changes. Using two-dimensional gel electrophoresis, we have detected a protein of approximately 77 kDa, with a pI of 4.5 (termed pp77) which is hyperphosphorylated in both cases. The level of phosphorylation of pp77 is increased by 293% and 35% after treatment with C. difficile cytotoxin B or OA, respectively. This protein was identified by microsequencing as calnexin, a protein which exhibits the characteristics of an endoplasmic reticulum (ER) chaperone.
A capillary electrophoresis method was developed for the determination of the antibiotic fosfomycin in serum, cerebrospinal fluid and aqueous humor. The technique uses indirect UV detection and the working buffer includes an organic cation to improve fosfomycin mobility. The electrophoretic time of migration is less than 7 min in both fluids. The limit of quantification is 2.5 and 1 microgram/ml in serum and aqueous fluids, respectively (signal-to-noise ratio = 3). The method was validated in serum and water over the concentration range 2.5-200 micrograms/ml. The calibration graph for serum was linear with a correlation coefficient r = 0.999. At a fosfomycin concentration of 2.5 micrograms/ml in serum, the intra- and inter-day precisions (coefficients of variation) were 5 and 5.2%, respectively. The mean recovery in serum was 94.5% (S.D. = 2.4%).
A 33 basepair oligonucleotide probe, designed from the sequence of the Clostridium difficile toxin B gene, was evaluated for its ability to detect toxigenic Clostridium difficile directly in stool samples, without culture or DNA isolation. Two different labelling techniques were investigated: radiolabelling and digoxigenin-labelling. One hundred ninety-six stools were tested, with a good correlation (96%) obtained between the oligonucleotide probe and the gold standard, the cytotoxicity tissue culture assay. The sensitivity and specificity were 83% and 100%, respectively. In parallel, a new commercially available enzyme immunoassay for the detection of Clostridium difficile toxin A in stool specimens was investigated. In 162 samples tested, a sensitivity of 80% and a specificity of 98% were obtained.
The cytotoxins from Clostridium difficile (toxin B) and Clostridium sordellii (toxin L) induce rounding of cultured cells. The cellular effects induced by these two cytotoxins are clearly distinct, suggesting that both toxins use a similar, but not identical mechanism for cell intoxication. We have employed the technique of two-dimensional PAGE for the separation of 32P-labelled cell lysates of McCoy cultured cells to investigate changes in the phosphorylation status of cellular proteins after treatment with toxin B and with toxin L. The two-dimensional electrophoresis patterns suggest the implication of an 80,000 mol. wt cellular protein (named pp80c) in the cytopathic action of the cytotoxin from C. sordellii. This protein shows immunoreactivity with non-muscle caldesmon. Toxin B, however, does not affect the phosphorylation of pp80c, but alters the phosphorylation of another cellular protein, pp77, indicating another mechanism for cell intoxication. In addition, our experiments suggest that the mechanism of action of okadaic acid, a phosphatase inhibitor which causes cell rounding similar to that induced by C. sordellii, and these two cytotoxins are different.
Stool samples (355 from 350 patients) were examined in a new commercial assay, the ToxA test, for the rapid diagnosis of Clostridium difficile-associated diarrhoea. The results were compared with direct assay of cytotoxin in McCoy cell tissue culture, and detection of toxigenic C. difficile by culture and cytotoxin testing of isolates. Discordant results were resolved by consultation of clinical records. Test sensitivities were 84.6% for the ToxA test, 78.5% for the direct cytotoxicity assay and 95.4% for culture. The specificity was 100% for all the tests. The ToxA test is a rapid and reliable alternative for the detection of toxigenic C. difficile where tissue culture facilities are unavailable.
The penetration of piperacillin-tazobactam in eight mechanically ventilated intensive care patients (age, 56.0 +/- 12.2 years, and weight, 76.5 +/- 15.2 kg [means +/- standard deviations]) with bacterial pneumonia was investigated. They were given intravenous doses of piperacillin (4 g) and tazobactam (0.5 g) as 30-min infusions every 6 h. The kinetic study was performed after the fourth dose on day 2 of treatment. Samples of blood and bronchial secretions (BS) were collected before the fourth dosing and 0.5, 1, 2, 4, and 6 h after the end of infusion. Drug concentrations in both sera and BS were measured by high-performance liquid chromatography. Concentrations (in micrograms per milliliter) in serum were 184.80 +/- 63.03 and 40.03 +/- 30.79 for piperacillin and 23.05 +/- 7.53 and 4.86 +/- 4.54 for tazobactam at 0.5 and 6 h, respectively, after the end of infusion. The corresponding concentrations (in micrograms per milliliter) in BS were 29.33 +/- 25.08 and 20.25 +/- 19.11 for piperacillin and 6.86 +/- 4.25 and 4.25 +/- 2.78 for tazobactam. The percentages for the extent of penetration of piperacillin and tazobactam, as defined by the BS/serum area under the curve ratio, were 35.70 and 78.42%, respectively. These data indicate good penetration of both piperacillin and tazobactam into BS. The concentrations of tazobactam in BS are persistent and high enough to exceed the values found to be effective in vitro against the tazobactam-susceptible beta-lactamases produced by the most important pathogens responsible for nosocomial pneumonia.