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Prevalence of Erysipelothrix rhusiopathiae in tonsils of domestic pigs and wild boars in Sweden.

Erysipelothrix rhusiopathiae (ER) causes erysipelas in multiple animal species and may persist in the environment or be carried asymptomatically. It is estimated that 30-50% of apparently healthy or convalescent pigs harbour ER in their tonsils and other lymphoid tissues. This study aimed to determine the prevalence of ER in the tonsils of healthy Swedish fattening pigs and wild boars. Tonsils were collected from 200 fattening pigs at slaughter from ten abattoirs across Sweden in 2017, with one pig per herd sampled. Wild boars (n = 180) were sampled during hunting, primarily in Östergötland County, in 2018. Cultures were performed using selective media and isolates were confirmed as ER by MALDI-TOF MS. ER was recovered from 6/200 pig tonsils (3.0%), all originating from three abattoirs in southern Sweden. ER was isolated from 76/167 (45.5%) of wild boar tonsils. Whole-genome sequencing revealed a high genetic diversity among the isolates with no dominant clones. Overall, these results indicate that Swedish pig husbandry, characterized by indoor rearing of fattening pigs, age-segregated rearing, sow vaccination, enhanced biosecurity, and restricted straw access largely prevents tonsillar colonization by ER aligning with the low occurrence of clinically diagnosed erysipelas in such herds. For wild boars, the high isolation rate suggests that wild boar could act as a reservoir and potential source of infection for domestic pigs. The potential zoonotic risk should also be considered.

Animals↗

Effect of attenuated Erysipelothrix rhusiopathiae vaccine in pigs infected with porcine reproductive respiratory syndrome virus.

Twenty 2nd specific pathogen-free pigs were divided into 4 groups: Group A were infected with porcine reproductive and respiratory syndrome (PRRS) virus at 6 weeks of age and treated with available swine erysipelas and swine fever combined vaccine (vaccinated) at 7 weeks of age; Group B were vaccinated at 7 weeks of age and infected with PRRS virus at 8 weeks of age; Group C were vaccinated at 7 weeks of age: Group D were neither vaccinated nor infected with PRRS virus. All pigs were challenged to Erysipelothrix rhusiopathiae C42 strain at 10 weeks of age. No clinical signs appeared after vaccination of group A and B pigs, thus confirming that the safety of the vaccine was not influenced by infection with PRRS virus. None of the pigs in Groups A and C developed erysipelas after challenge exposure to E. rhusiopathiae. In contrast, fever and/or urticaria appeared transiently in all pigs of Group B after challenge exposure. At the time of challenge exposure to E. rhusiopathiae, the PRRS virus titer was high in sera of Group B, but was low in those from Group A. However, vaccination of pigs with attenuated E. rhusiopathiae was effective in dual infection with PRRS virus and E. rhusiopathiae, because the clinical signs were milder and the E. rhusiopathiae strain was less recovered from these pigs compared to pigs of group D.

Animals↗

Detection of Erysipelothrix rhusiopathiae in clinical and environmental samples.

Erysipelothrix rhusiopathiae is pathogenic for both animals and humans, causing erysipelas in swine and erysipeloid in humans. In swine, disease may be either acute or chronic, resulting in the development of arthritis and endocarditis. In Japan, erysipelas remains an animal hygiene problem causing great economic loss as infected swine are disused. Human infection closely resembles that seen in swine, with both acute and chronic forms also. The most common presentation is erysipeloid, a localized cutaneous infection. In Western Australia, an erysipeloid-like infection referred to as "crayfish poisoning" occurs in lobster fishermen and handlers. A second type of presentation is a generalized cutaneous form involving lesions that progress from the initial site of infection or appear in remote areas. The third and most serious form of disease is a septicemia that is almost always linked to endocarditis. The mortality rate in Erysipelothrix endocarditis is still high (38%) and can be explained by the use of vancomycin (to which Erysipelothrix spp. are inherently resistant) as empirical therapy. Therefore, it is critical to have an early diagnosis of E. rhusiopathiae infection.Unfortunately, several problems exist with the diagnosis of E. rhusiopathiae infections by conventional cultural procedures, and these infections are often incorrectly diagnosed. First, because of their very small colony size and slow growth rates, it is difficult to isolate E. rhusiopathiae from heavily contaminated specimens. Various selective media have been described to improve the isolation of E. rhusiopathiae from contaminated specimens; however, not all contaminants are inhibited. The development of two polymerase chain reaction (PCR) methods has created an opportunity to greatly improve the efficiency with which these organisms are detected and identified. Makino et al. designed a PCR method that amplifies a 407-bp DNA fragment derived from the 16S rRNA coding sequence. The primers in this method are specific for the genus Erysipelothrix and do not differentiate between the species. A second set of primers designed by Shimoji et al. amplifies a 937-bp DNA fragment which is derived from a sequence associated with virulence of E. rhusiopathiae. These primers are specific for E. rhusiopathiae only. Shimoji et al. also utilized a selective enrichment medium based on tryptic soy broth containing ethidium bromide and sodium azide.

Air Microbiology↗

Trace element alterations in infectious diseases.

Trace elements like copper, zinc, iron and selenium have a significant influence on the function of the immune system. We studied plasma levels of trace elements in 53 patients with acute bacterial and viral infections. In bacterial infections (septicaemia, pneumonia, erysipelas and meningitis) the plasma concentrations of selenium, iron and zinc were decreased. Plasma copper was unchanged in patients with erysipelas, but increased in other types of bacterial infections. Although the patients with viral infections showed similar shifts of the trace elements as were observed in patients with bacterial infections, the changes were not as pronounced. A plasma selenium value below 0.8 mumol/l was found in only 6% of the patients with viral infections in contrast to 63% of the patients with septicaemia or 57% of the patients with pneumonia. Furthermore, in viral infections 60% of the zinc values were below the mean level of 12.8 mumol/l observed in healthy controls as compared with 90% of the values in patients with sepsis or 92% of the values in patients with pneumonia. The onset of change in trace elements occurred within a few days and persisted for several weeks. These changes seem to be non-specific and are independent of the agent causing infection. The different types of infections were followed by changes in most of the plasma proteins which are known to be associated with an inflammatory reaction. The changes in plasma proteins were most pronounced in patients with sepsis and pneumonia. Patients with sepsis having a high degree of inflammation did not show a positive correlation between the severity of the disease--as judged by plasma proteins--and the alterations of trace elements.

Bacterial Infections↗

Group G streptococcal infections on a dermatological ward.

Groups A, B, C and G streptococci were cultured from 63 consecutive in-patients recruited between November 1987 and April 1988 and monitored until the end of July 1988. Chronic leg ulcers were present in 34 patients. Group G was found in 34 patients, 25 of whom had pyoderma and 3 had sepsis. Six of the patients had no signs of clinical infection, and treatment with antibiotics was therefore withheld. Recurrent phlegmon or erysipelas developed in 2 of 28 patients with clinical Group G infections. Erysipelas developed some 1-7 months later in 3 of the 6 patients who were not initially treated. No significant difference in severity or additional medical conditions was found between the patients with either Group G or Group A streptococci. In comparison, data on all streptococcal cultures at the Department indicated that Group G was isolated 2.6 times as often as Group A streptococci for the in-patients, compared with 1.1 for all patients seen. It is concluded that Group G streptococcal skin infections must be regarded with the same clinical vigilance as Group A infections.

Adult↗

[Studies of the toxic components of Erysipelothrix rhusiopathiae. 2. Communication: Detailed characterization of an extracted endotoxin (author's transl)].

The endotoxins of different Erysipelothrix rhusiopathiae strains were examined in various biological systems, since in earlier investigations (Leimbeck and Böhm, 1975) the lethal effect for 10 day old chick embryos had been found to be highly dependent upon the virulence of the strains. The lethal effect for mice and rats was found to be much less. The toxin of the strain T28 proved to be highly pyrogenic for rabbits and inducing acute shock-effects in swine SCHULZ et al. (1961) already suggested that a shock-like pathogenesis existed in the swine erysipelas infection. Furthermore the endotoxic nature was confirmed by the typical course of temperature after i.v. application of the toxin, the ability to cause the Sanarelli-Schwartzman-reaction (both in rabbits), the protection against toxicity by cortisones, and heat stability. An erysipelas antiserum did not neutralize the toxin. It was found to have low antigenic and apparantly no immunogenic properties and an allergic skin-reaction in experimentally infected swine could not be induced. The toxins of various strains were tested by the macrophagemigration-inhibition test. In respect to a preliminary classification the toxin could be identified as a complexed water-soluble and heat-stable glucoproteid with an estimated molecular weight of 31.700. The polysaccharides were found to be the presumable carriers of toxicity.

Animals↗

Common bacterial skin infections.

Family physicians frequently treat bacterial skin infections in the office and in the hospital. Common skin infections include cellulitis, erysipelas, impetigo, folliculitis, and furuncles and carbuncles. Cellulitis is an infection of the dermis and subcutaneous tissue that has poorly demarcated borders and is usually caused by Streptococcus or Staphylococcus species. Erysipelas is a superficial form of cellulitis with sharply demarcated borders and is caused almost exclusively by Streptococcus. Impetigo is also caused by Streptococcus or Staphylococcus and can lead to lifting of the stratum corneum resulting in the commonly seen bullous effect. Folliculitis is an inflammation of the hair follicles. When the infection is bacterial rather than mechanical in nature, it is most commonly caused by Staphylococcus. If the infection of the follicle is deeper and involves more follicles, it moves into the furuncle and carbuncle stages and usually requires incision and drainage. All of these infections are typically diagnosed by clinical presentation and treated empirically. If antibiotics are required, one that is active against gram-positive organisms such as penicillinase-resistant penicillins, cephalosporins, macrolides, or fluoroquinolones should be chosen. Children, patients who have diabetes, or patients who have immunodeficiencies are more susceptible to gram-negative infections and may require treatment with a second- or third-generation cephalosporin.

Cellulitis↗

[Survey on the activity of hospital departments of dermatology in France].

INTRODUCTION: The Collège des Enseignants de Dermatologie de France initiated a study to assess the activity of the departments of dermatology in French hospitals. We report the results of this survey. MATERIAL AND METHODS: The study was conducted during a randomly selected week in the year 2000. An anonymous questionnaire was sent to all the departments of dermatology in the hospitals in France and was completed for each patient leaving the hospital during that week. The data collected were: the type of establishment, admission method, hospitalization method, type of pathology, motive for hospitalization, length of hospitalization and type of treatment used. RESULTS: The response rate was of 96 p. 100 for the University hospital centers and 80 p. 100 for the non-university hospitals. The number of patients treated per year was of 65 628 for the University hospitals and of 16,000 for the others. Ninety percent of the hospitalizations corresponded to direct admissions. The pathologies at the origin of the majority of yearly hospitalizations were, for the University hospitals: melanoma, leg ulcers, highly specialized dermatoses and systemic diseases and for the other hospitals: leg ulcers, HIV infection, highly specialized dermatoses and erysipela. The pathologies requiring the greatest number of hospitalization days were melanoma, leg ulcers, erysipela and highly specialized dermatoses. DISCUSSION: This study shows that the activity in the departments of dermatology is centered on pathologies that are clearly severe in terms of Public Health (oncology, infectious diseases and angiology). It also shows the efforts made for the management of patients in out-patient settings.

Delivery of Health Care↗

[Haemorrhagic cellulitis: three cases].

BACKGROUND: Haemorrhagic erysipelas (cellulitis) is a recently described clinical condition. We report 3 new cases of this rare bacterial dermatosis requiring both antibiotics and systemic corticosteroids for complete resolution. CASE REPORTS: Case 1 was a 75 year-old male patient, with a past history of hypertension and diabetes mellitus. Case 2 was a 69 year-old female patient with a past history of hepatic cirrhosis. Case 3 was a 56 year-old female patient without medical past history, except for obesity. All patients presented with a haemorrhagic and bullous erysipelas of the leg without clinical improvement under parenteral antibiotics. In all cases, adjuvant systemic corticosteroids (prednisone: 0.5 mg/kg/d) for 5-8 days in addition to antibiotics provided dramatic and complete resolution of skin lesions and disappearance of pain and fever. DISCUSSION: Haemorrhagic cellulitis may be misdiagnosed as necrotizing fasciitis because of ecchymotic areas with frequent bullae resulting in haemorrhagic crusts and partial inefficacy of antibiotics given alone. Adjuvant anticoagulant therapy or coagulation abnormalities may have facilitated the clinical condition in 2 of our 3 cases. The efficacy of adjuvant systemic corticosteroids during 5-8 days, in addition to antibiotics is the hallmark of this syndrome.

Aged↗

Epidemiology and prevention of skin and soft tissue infections.

Staphylococcus aureus and Streptococcus pyogenes remain the 2 major organisms responsible for most common skin and soft tissue infections. While methicillin-resistant S aureus (MRSA) typically is considered a hospital-acquired organism, outbreaks of community-acquired MRSA are being reported. Simple interventions can reduce the spread of this infection. Erysipelas is a streptococcal syndrome with high morbidity. The epidemiology has changed, with an increasing number of cases involving the lower extremities. Risk factors for erysipelas can be identified, which allow clinicians to target patients at high risk for recurrent disease. Although staphylococci and streptococci are the predominant cutaneous pathogens, enterococci and gram-negative organisms account for a significant proportion of skin infections.

Humans↗

[Treatment of upper limb lymphedema after radical mastectomy with liposuction technique and pressure therapy].

OBJECTIVE: To study a new method of treatment for upper limb lymphedema after radical mastectomy. METHODS: From Jun. 2001 to Sep. 2003, 11 cases (2 with complication of erysipelas) of upper limb lymphedema being treated with radical mastectomy for more than 2 years were used as model. All the edema of limbs was sucked from hypodermis with liposuction technique and compressed with compression garment. Three months after operation, elasticity stress was conducted every night. RESULTS: The reduction of the edema of upper limbs was remarkable. The average decrease of circumference was 4 cm. No erysipelas was observed. CONCLUSION: The liposuction technique and elasticity stress is a new and effective approach to the treatment of upper limb lymphedema.

Adult↗

[Seven-year clinical experience with the SVL/Beznoska implant for total knee arthroplasty].

PURPOSE OF THE STUDY: The aim of the study was to evaluate our seven-year experience with the anatomic, non-constrained SVL/Beznoska implant for total knee replacement. MATERIAL: A total of 374 cemented total knee replacements, using the SVL/Beznoska implant, were evaluated in 333 patients treated at the First Orthopedic Clinic Charles University in Prague, during a seven-year period. In addition, a patellar replacement was used in five of these patients. Included in the evaluation were also eight non-cemented and hybrid SVL/Beznoska implants used 6 years ago. METHODS: The aim of the study was to evaluate the results in terms of implant function. Therefore, the longevity of implants was assessed by Kaplan-Meier's survival analysis. Another criterion was the flexion achieved. To be able to compare our clinical results involving the SVL/Beznoska implant with other, foreign types of implants, the patients were evaluated on the basis of the New Jersey Orthopaedics Hospital Knee Evaluation System. RESULTS: The Kaplan-Meier's survival score was evaluated. The mean maximum flexion achieved in the patients with SVL implants was 107 degrees . The evaluation by the New Jersey Orthopaedics Hospital Knee Evaluation System showed excellent outcomes in 269 (72 %) patients, good outcomes in 79 (21 %) patients, satisfactory in 19 (5 %) and poor in 7 (2 %) patients. There was no mechanical failure of the implant, such as break of an implant or dislocation of a PE component. Six infected implants and four aseptic loosenings were recorded. Three patients diagnosed with an infected total knee replacement had been treated for rheumatoid arthritis for a long time. One patient was on dialysis for renal insufficiency and one had erysipelas. DISCUSSION: The results of our group with the SVL/Beznoska implant were compared with those obtained from the group of 63 patients who underwent total knee arthroplasty with the LCS implant. In these patients, the mean maximum flexion achieved was 105 degrees , and the criteria of the Knee Evaluation System showed excellent outcomes in 81 %, good in 16 % and satisfactory in 3 % of the patients. No unsatisfactory outcome was recorded. Considering the fact that the LCS implant was used only in younger and active patients, the outcomes achieved with the SVL/Beznoska system can be regarded as very good. Of the six patients with infectious complications, three were treated with immunosuppressive therapy for rheumatoid arthritis, one was on dialysis for renal insufficiency and one experienced a flare-up of erysipelas. CONCLUSIONS: The most important outcome of the evaluation of 374 total knee replacements, using the SVL implant carried out at the First Orthopedic Department of the First Faculty of Medicine, Charles University, was the finding of a perfect function of all components in all patients treated. None of the complications occurring in our group was associated with the use of this implant.

Adult↗

[Changed health problems in a changing pig-farming concern in The Netherlands until 1980].

In 1905 Poels published 'Disease of swine in the Netherlands'. This book dealt predominantly with swine fever, erysipelas, tuberculosis and 'pneumonia'. Between 1920 and 1940 others reported on streptococci, lobular haemmorrhagic pneumonia, bordetellosis, Aujeszky's disease and postweaning diarrhoea. After the second world war, particularly after 1960, the Dutch pig-farming industry developed at a tremendous rate. As a consequence, the health problems changed. Certain diseases became less important: tuberculosis, erysipelas, Leptospira tarrasovi, enteroviruses. Yet other diseases including postweaning diarrhoea, atrophic rhinitis and Aujeszky's disease became problems of increasing importance. At the end of the seventies the knowledge of E. coli toxin types was substantial. On the other hand, information concerning the pathogenesis and pathophysiology was very limited. Bordetella bronchiseptica was still considered to be the most important agent in AR, zootechnical factors being predisposing. However, one was aware of missing links. Aujeszky's disease was obscure until the late fifties. Until 1972 only occasional reports were made. In that year, an epidemic occurred in the Gelderse Vallei. Another epidemic occurred in 1974 in the provinces of Brabant and Limburg. By 1980 proper vaccines were available and Aujeszky's disease was not yet a political problem.

Animals↗

[Trial of the intensity and duration of swine fever immunity in pigs].

Comparative testing of the intensity and the continuity of immunity against swine fever was carried out with pigs producers of serum against edema disease and swine erysipelas, vaccinated with an untreated and a freeze-dried K vaccine. Control infection studies revealed that serum-producing pigs with regard to edema disease, immunized with a freeze-dried and an untreated lapinized K vaccine, could acquire sufficiently stable immunity from the 6th to the 9th month following immunization both in the beginning and at the end of the exploitation period. So far as the intensity and the continuity of immunity of pigs producing serum against erysipelas are concerned the animals were shown to acquire sufficiently stable immunity against swine fever when vaccination was carried out with a freeze-dried K vaccine, while not all of the pigs treated with an untreated K vaccine were protected from swine fever upon control challenging. Therefore, instead of immunization with an untreated K vaccine as many as 400 immunization doses of the freeze-dried K vaccine could be used.

Animals↗

[A case of skin myiasis caused by Dermatobia hominis].

A case of erysipelas-like symptoms in a 26-year-old female student of medicine having returned from Nicaragua to Germany is reported. On the removal of the scurf covering the supposed entrance of the erysipelas, a larva of Dermatobia hominis, the human bot fly, was extracted from the head skin, and the inflammation completely disappeared within a short period of time.

Adult↗

[Enzootic erysipeloid in pheasants].

Epizootological, clinical, bacteriological and pathomorhological studies on enzooty of erysipelas in a flock of 11 000 pheasants were made. The clinical symptoms of sick pheasants and the pathologoanatomical and patho-histogical changes observed in dead pheasants are described. The pathogen of erysipelas was isolated and differentiated. The disease was reproduced experimentally in 15 pheasants from another fram where no cases of the disease were encountered. The source of infection remained unknown. It was established that, as is the case in other animals and birds, erysepelas in pheasants is characterized clinically and morphologically by the symptoms of septicaemia.

Animals↗

Possible factors influencing the immunoglobulin G concentration in swine colostrum.

The immunoglobulin (Ig) G concentration in swine colostrum was determined by the single radial immunodiffusion method, using 157 samples collected from farm-raised sows in the Yamaguchi Prefecture of Japan during 1976 and 1977. The mean IgG value was 53.03 mg/ml, and the maximum and minimum values were 101.39 mg/ml and 11.74 mg/ml, respectively. The amount of IgG varied greatly among sows. To clarify the possible factors influencing the amount of IgG in colostrum, the following items were surveyed: season, district, breed, age of sows, number of parturitions, udder section from which samples were collected, kind of feed, vaccinations of swine erysipelas live-organism vaccine, hog cholera live-virus vaccine, Japanese encephalitis live-virus vaccine, tramsmissible gastroenteritis liver-virus vaccine, type of farming, and number of sows raised on a farm. Relationships between the amount of IgG in colostrum and each of these 13 items were analyzed. Seemingly, strong correlations with the amounts if IgG in colostrum were found with five items (district, number of parturitions, kind of feed, type of farming, and number of sows). To the contrary, five items (age, udder section, and vaccinations of swine erysipelas live-organism vaccine, hog cholera live-virus vaccine, and Japanese encephalitis live-virus vaccine) had poor correlations. Other items had moderate correlations. The multiple correlation coefficient obtained was 0.5499.

Age Factors↗

Possible factors influencing immunoglobulin A concentration in swine colostrum.

The immunoglobulin (Ig) A concentration in swine colostrum was determined by the single radial immunodiffusion method, using 157 samples collected from the same number of farm-raised sows in the Yamaguchi Prefecture of Japan during 1976 and 1977. The mean IgA value was 12.26 +/- 3.30 mg/ml, and the maximum and minimum values were 28.14 mg/ml and 5.63 mg/ml, respectively. To determine factors influencing the IgA concentration in swine colostrum, the following items were analyzed in the present study: season, district, breed, number of parturitions, udder section from which samples were collected, kind of feed, vaccinations of swine (erysipelas live-organism vaccine, hog cholera live-virus vaccine, Japanese encephalitis live-virus vaccine, and transmissible gastroenteritis live-virus vaccine), type of farming, and number of sows raised on a farm. Relationships between the IgA concentration in swine colostrum and each of these 12 items were analyzed. Of the 12 items, breed and number of parturitions were the most influential on the IgA concentration in colostra of farm-raised sows. Season, district, and vaccination with transmissible gastroenteritis live-virus vaccine were moderately influential. Udder section, kind of feed, vaccinations of swine (erysipelas live-organism vaccine, hog cholera live-virus vaccine, and Japanese encephalitis live-virus vaccine), type of farming, and number of farm-raised sows were slightly influential. The multiple correlation coefficient obtained was 0.5887 (P greater than 0.05).

Animal Feed↗