铜绿假单胞菌感染豚鼠后生物被膜形成的研究

目的 建立体内铜绿假单胞菌生物被膜模型，研究体内细菌生物被膜的组织学及细菌学特征。方法 通过吸入法使铜绿假单胞菌以气雾剂的形式吸入豚鼠肺内并生长定植，分别观察不同时期肺组织内细菌生物被膜的特征。结果 定植在肺内的铜绿假单胞菌以肉芽肿结节的形式存在，外周包绕类上皮细胞和成纤维细胞。结节内细菌被被膜基质所包绕并彼此连结，中间镶嵌宿主炎性细胞。接种后3周，肺内仍可见结节并培养出铜绿假单胞菌。结论 用吸入法可建立较稳定的铜绿假单胞菌肺感染生物被膜，其以肉芽肿结节的形式存在，宿主的反应细胞参与了生物被膜的形成。     

铜绿假单胞菌耐药性在生物被膜形成过程中的变化

目的 研究铜绿假单胞菌遗传性耐药(gyrA基因突变和MexAB-OprM主动外排)在生物被膜形成过程中对药物抗性的作用。方法 通过PCR技术鉴定gyrA基因突变株和MexB-OprM主动外排株，利用三亲杂交的方法将绿色荧光蛋白(GFP)基因转到铜绿假单胞菌药物敏感株中，测定gyrA基因突变株、MexAB-OprM主动外排株以及带有绿色荧光蛋白的铜绿假单胞菌在特氟隆上产生生物被膜耐药的规律。结果 筛选出gyrA基因突变株和MexAB-OprM主动外排株。通过三亲杂交成功构建了带有pGFPuv质粒的铜绿假单胞菌。将突变株和敏感株培养在最低杀菌浓度(MBC)的环丙沙星溶液中形成生物被膜使菌株的存活率均在50％以上。结论 比较遗传性耐药和生物被膜耐药的作用表明gyrA基因突变和主动外排在生物被膜耐药形成前期发挥主要作用，当生物被膜完全形成之后，铜绿假单胞菌的耐药性有可能是由生物被膜介导的。     

铜绿假单胞菌生物被膜形成过程中多糖合成相关基因表达的研究

目的 了解铜绿假单胞菌(Pseudomonas aerugirtosa,Pa)生物被膜形成过程中多糖生物合成相关基因在生物被膜形成中的表达,探讨其在生物被膜形成中的调控作用.方法 分别收集非黏液型铜绿假单胞菌PAO1的浮游菌及生物被膜菌,用实时荧光定量RT-PCR的方法对基因的表达进行相对定量分析.结果 多糖合成相关基因pslA、algD.pelA的mRNA在生物被膜菌中的相对表达量均高于浮游菌.结论 .pslA、algD,pelA的表达与铜绿假单胞菌生物被膜形成密切相关,在生物被膜形成中具有重要作用.     

铜绿假单胞菌生物被膜形成过程中多糖合成相关基因表达的研究

目的 了解铜绿假单胞菌(Pseudomonas aerugirtosa,Pa)生物被膜形成过程中多糖生物合成相关基因在生物被膜形成中的表达,探讨其在生物被膜形成中的调控作用.方法 分别收集非黏液型铜绿假单胞菌PAO1的浮游菌及生物被膜菌,用实时荧光定量RT-PCR的方法对基因的表达进行相对定量分析.结果 多糖合成相关基因pslA、algD.pelA的mRNA在生物被膜菌中的相对表达量均高于浮游菌.结论 .pslA、algD,pelA的表达与铜绿假单胞菌生物被膜形成密切相关,在生物被膜形成中具有重要作用.     

铜绿假单胞菌生物被膜形成过程中多糖合成相关基因表达的研究

目的 了解铜绿假单胞菌(Pseudomonas aerugirtosa,Pa)生物被膜形成过程中多糖生物合成相关基因在生物被膜形成中的表达,探讨其在生物被膜形成中的调控作用.方法 分别收集非黏液型铜绿假单胞菌PAO1的浮游菌及生物被膜菌,用实时荧光定量RT-PCR的方法对基因的表达进行相对定量分析.结果 多糖合成相关基因pslA、algD.pelA的mRNA在生物被膜菌中的相对表达量均高于浮游菌.结论 .pslA、algD,pelA的表达与铜绿假单胞菌生物被膜形成密切相关,在生物被膜形成中具有重要作用.     

铜绿假单胞菌生物被膜形成过程中多糖合成相关基因表达的研究

目的 了解铜绿假单胞菌(Pseudomonas aerugirtosa,Pa)生物被膜形成过程中多糖生物合成相关基因在生物被膜形成中的表达,探讨其在生物被膜形成中的调控作用.方法 分别收集非黏液型铜绿假单胞菌PAO1的浮游菌及生物被膜菌,用实时荧光定量RT-PCR的方法对基因的表达进行相对定量分析.结果 多糖合成相关基因pslA、algD.pelA的mRNA在生物被膜菌中的相对表达量均高于浮游菌.结论 .pslA、algD,pelA的表达与铜绿假单胞菌生物被膜形成密切相关,在生物被膜形成中具有重要作用.     

铜绿假单胞菌生物被膜形成过程中多糖合成相关基因表达的研究

目的 了解铜绿假单胞菌(Pseudomonas aerugirtosa,Pa)生物被膜形成过程中多糖生物合成相关基因在生物被膜形成中的表达,探讨其在生物被膜形成中的调控作用.方法 分别收集非黏液型铜绿假单胞菌PAO1的浮游菌及生物被膜菌,用实时荧光定量RT-PCR的方法对基因的表达进行相对定量分析.结果 多糖合成相关基因pslA、algD.pelA的mRNA在生物被膜菌中的相对表达量均高于浮游菌.结论 .pslA、algD,pelA的表达与铜绿假单胞菌生物被膜形成密切相关,在生物被膜形成中具有重要作用.     

铜绿假单胞菌生物被膜形成过程中多糖合成相关基因表达的研究

目的 了解铜绿假单胞菌(Pseudomonas aerugirtosa,Pa)生物被膜形成过程中多糖生物合成相关基因在生物被膜形成中的表达,探讨其在生物被膜形成中的调控作用.方法 分别收集非黏液型铜绿假单胞菌PAO1的浮游菌及生物被膜菌,用实时荧光定量RT-PCR的方法对基因的表达进行相对定量分析.结果 多糖合成相关基因pslA、algD.pelA的mRNA在生物被膜菌中的相对表达量均高于浮游菌.结论 .pslA、algD,pelA的表达与铜绿假单胞菌生物被膜形成密切相关,在生物被膜形成中具有重要作用.     

铜绿假单胞菌生物被膜形成过程中多糖合成相关基因表达的研究

目的 了解铜绿假单胞菌(Pseudomonas aerugirtosa,Pa)生物被膜形成过程中多糖生物合成相关基因在生物被膜形成中的表达,探讨其在生物被膜形成中的调控作用.方法 分别收集非黏液型铜绿假单胞菌PAO1的浮游菌及生物被膜菌,用实时荧光定量RT-PCR的方法对基因的表达进行相对定量分析.结果 多糖合成相关基因pslA、algD.pelA的mRNA在生物被膜菌中的相对表达量均高于浮游菌.结论 .pslA、algD,pelA的表达与铜绿假单胞菌生物被膜形成密切相关,在生物被膜形成中具有重要作用.     

铜绿假单胞菌生物被膜形成过程中多糖合成相关基因表达的研究

目的 了解铜绿假单胞菌(Pseudomonas aerugirtosa,Pa)生物被膜形成过程中多糖生物合成相关基因在生物被膜形成中的表达,探讨其在生物被膜形成中的调控作用.方法 分别收集非黏液型铜绿假单胞菌PAO1的浮游菌及生物被膜菌,用实时荧光定量RT-PCR的方法对基因的表达进行相对定量分析.结果 多糖合成相关基因pslA、algD.pelA的mRNA在生物被膜菌中的相对表达量均高于浮游菌.结论 .pslA、algD,pelA的表达与铜绿假单胞菌生物被膜形成密切相关,在生物被膜形成中具有重要作用.     

Endothelial cells and renal epithelial cells do not express the Wegener''s autoantigen, proteinase 3.

In vitro and in vivo T cell responses were determined during the course of bronchopulmonary infection with mucoid Pseudomonas aeruginosa. T cell responses were compared in two inbred mouse strains, namely BALB/c mice, which are resistant to the establishment of chronic bronchopulmonary Ps. aeruginosa infection, and C57Bl/6 mice, which have high numbers of bacteria in the lungs through 14 days post-infection. Unseparated lung cells and lung T cells from BALB/c mice exhibited significantly higher in vitro proliferative responses to both heat-killed Ps. aeruginosa and concanavalin A (Con A) than cells from C57Bl/6 mice through 20 days post-intratracheal infection with 10(4) colony-forming units (CFU) Ps. aeruginosa. Proliferation of unseparated lung cells but not lung T cells from BALB/c mice infected 6 days previously with 10(5) CFU Ps. aeruginosa was suppressed in response to Con A; these cells were unresponsive to specific antigen. Suppression of lymphocyte proliferation in the lungs of C57Bl/6 mice infected with 10(4) CFU Ps. aeruginosa and in BALB/c mice infected with 10(5) CFU was found to be mediated by adherent lung cells via the production of nitric oxide and prostaglandins. Determination of in vivo T cell-mediated responses in infected mice demonstrated that resistant BALB/c mice had high DTH and low Pseudomonas-specific antibody responses, while C57Bl/6 mice had low DTH and high antibody levels, in particular, IgG2b and IgM.     

Intranasal inoculation of mice with Yersinia pseudotuberculosis causes a lethal lung infection that is dependent on Yersinia outer proteins and PhoP

Yersinia pseudotuberculosis infects many mammals and birds including humans, livestock, and wild rodents and can be recovered from the lungs of infected animals. To determine the Y. pseudotuberculosis factors important for growth during lung infection, we developed an intranasal model of infection in mice. Following intranasal inoculation, we monitored both bacterial growth in lungs and dissemination to systemic tissues. Intranasal inoculation with as few as 18 CFU of Y. pseudotuberculosis caused a lethal lung infection in some mice. Over the course of 7 days, wild-type Y. pseudotuberculosis replicated to nearly 1 x 10(8) CFU/g of lung in BALB/c mice, induced histopathology in lungs consistent with pneumonia, but disseminated sporadically to other tissues. In contrast, a Delta yopB deletion strain was attenuated in this model, indicating that translocation of Yersinia outer proteins (Yops) is essential for virulence. Additionally, a Delta yopH null mutant failed to grow to wild-type levels by 4 days postintranasal inoculation, but deletions of any other single effector YOP did not attenuate lung colonization 4 days postinfection. Strains with deletions in yopH and any one of the other known effector yop genes were more attenuated that the Delta yopH strain, indicating a unique role for yopH in lungs. In summary, we have characterized the progression of a lung infection with an enteric Yersinia pathogen and shown that YopB and YopH are important in lung colonization and dissemination. Furthermore, this lung infection model with Y. pseudotuberculosis can be used to test potential therapeutics against Yersinia and other gram-negative infections in lungs.     

In vitro production of biofilm in a flow cell system in a strain of Pseudomonas aeruginosa and Staphylococcus aureus and determination of efficiency of ciprofloxacin against them

BACKGROUND: Microorganisms develop biofilm on various medical devices. The process is particularly relevant in public health since biofilm associated organisms are much more resistant to antibiotics and have a potential to cause infections in patients with indwelling medical devices. MATERIALS AND METHODS: To determine the efficiency of an antibiotic against the biofilm it is inappropriate to use traditional technique of determining Minimum Inhibitory Concentration (MIC) on the free floating laboratory phenotype. Thus we have induced formation of biofilm in two strains (Pseudomonas aeruginosa and Staphylococcus aureus, which showed heavy growth of biofilm in screening by Tube method) in a flow cell system and determined their antibiotic susceptibility against ciprofloxacin by agar dilution method in the range (0.25 mg/ml to 8 mg/ml). The MIC value of ciprofloxacin for the biofilm produced organism was compared with its free form and a standard strain as control on the same plates. OBSERVATIONS: Both the biofilm produced strains showed a higher resistance (MIC > 8 mg/ml) than its free form, which were 2 μg/ml for Pseudomonas aeruginosa and 4 mg/ml for Staphylococcus aureus. Thus biofilm can pose a threat in the patient treatment.     

Novel mouse model of chronic Pseudomonas aeruginosa lung infection mimicking cystic fibrosis

Pseudomonas aeruginosa causes a chronic infection in the lungs of cystic fibrosis (CF) patients by establishing an alginate-containing biofilm. The infection has been studied in several animal models; however, most of the models required artificial embedding of the bacteria. We present here a new pulmonary mouse model without artificial embedding. The model is based on a stable mucoid CF sputum isolate (NH57388A) with hyperproduction of alginate due to a deletion in mucA and functional N-acylhomoserine lactone (AHL)-based quorum-sensing systems. Chronic lung infection could be established in both CF mice (Cftr(tmlUnc-/-)) and BALB/c mice, as reflected by the detection of a high number of P. aeruginosa organisms in the lung homogenates at 7 days postinfection and alginate biofilms, surrounded by polymorphonuclear leukocytes in the alveoli. In comparison, both an AHL-producing nonmucoid revertant (NH57388C) from the mucoid isolate (NH57388A) and a nonmucoid isolate (NH57388B) deficient in AHL were almost cleared from the lungs of the mice. This model, in which P. aeruginosa is protected against the defense system of the lung by alginate, is similar to the clinical situation. Therefore, the mouse model provides an improved method for evaluating the interaction between mucoid P. aeruginosa, the host, and antibacterial therapy.     

Antibiotic susceptabilities of Pseudomonas aeruginosa isolates derived from patients with cystic fibrosis under aerobic, anaerobic, and biofilm conditions

Recent studies have determined that Pseudomonas aeruginosa can live in a biofilm mode within hypoxic mucus in the airways of patients with cystic fibrosis (CF). P. aeruginosa grown under anaerobic and biofilm conditions may better approximate in vivo growth conditions in the CF airways, and combination antibiotic susceptibility testing of anaerobically and biofilm-grown isolates may be more relevant than traditional susceptibility testing under planktonic aerobic conditions. We tested 16 multidrug-resistant isolates of P. aeruginosa derived from CF patients using multiple combination bactericidal testing to compare the efficacies of double and triple antibiotic combinations against the isolates grown under traditional aerobic planktonic conditions, in planktonic anaerobic conditions, and in biofilm mode. Both anaerobically grown and biofilm-grown bacteria were significantly less susceptible (P < 0.01) to single and combination antibiotics than corresponding aerobic planktonically grown isolates. Furthermore, the antibiotic combinations that were bactericidal under anaerobic conditions were often different from those that were bactericidal against the same organisms grown as biofilms. The most effective combinations under all conditions were colistin (tested at concentrations suitable for nebulization) either alone or in combination with tobramycin (10 microg ml(-1)), followed by meropenem combined with tobramycin or ciprofloxacin. The findings of this study illustrate that antibiotic sensitivities are dependent on culture conditions and highlight the complexities of choosing appropriate combination therapy for multidrug-resistant P. aeruginosa in the CF lung.     

Pseudomonas aerogunosa pneumonia in patients treated at the Hospital for Chest Diseases

Retrospective analysis of pneumonia caused by Pseudomonas aeruginosa was made in 66 patients, treated in hospital. Nosocomial pneumonia was diagnosed in 11 (17%) patients. In 51 patients coexisting lung diseases were present: mainly COPD and bronchiectasis. Strains of Pseudomonas aeruginosa were susceptible mostly to imipenem, meropenem, aztreonam, ticarcillin-clavulanic acid, ceftazidime, ciprofloxacin, amikacin, piperacillin-tazobactam, netilmicin. Duration of treatment in hospital was very long--59% were treated over 30 days. Combined antibacterial therapy was applied in 35 (53%) patients and monotherapy, often with different antibiotics--in 31 (47%) patients. Treatment was successful in 45 (68%) patients. In 9 patients the results of treatment was not successful: mainly because of empyema in 7 pts. Twelve (18%) patients (with coexisting COPD--6 and lung cancer--6) died. We can support current recommendations for treatment of Pseudomonas aeruginosa infection with combination of aminoglycosides or fluoroquinolones plus one of remaining antipseudomonal antibiotics. Treatment failures occurred mainly in patients with severe coexisting diseases and/or empyema.     

Enhancement of Pseudomonas aeruginosa lung clearance after local immunization with a temperature-sensitive mutant.

We investigated the capacity of the temperature-sensitive mutant strain A/10/25 of Pseudomonas aeruginosa (ts-Psa) to induce enhancement of lung defenses against wild type P. aeruginosa (wt-Psa). Mice of the DBA/2J inbred strain were immunized by aerosolization with a single dose of 2 x 10(5) to 4 x 10(5) CFU of ts-Psa and were challenged 7, 14, and 21 days later with wt-Psa. The uncleared bacteria ratio was determined 4 h after aerosol exposure; significant enhancement in lung clearance of wt-Psa (P less than 0.01) was evident as early as 7 days after immunization and detectable for at least 21 days. Aerosol immunization with Staphylococcus aureus did not enhance lung clearance of wt-Psa; however, slight but significant enhancement in S. aureus clearance was observed in mice immunized 7 days before with ts-Psa. No enhancement of S. aureus clearance was seen in ts-Psa immunized animals after 14 and 21 days. Analysis of the cell composition of lung lavage fluids revealed a transient cell response characterized by rapid increase in the absolute number of polymorphonuclear leukocytes, followed later by an increase in alveolar macrophages. The characteristics of lung lavages returned to base-line values 6 days after aerosol immunization, and a second exposure to a ts-Psa aerosol produced a response of similar magnitude and quality. We conclude that aerosol immunization with a temperature-sensitive mutant of P. aeruginosa enhances specific pulmonary defense mechanisms against the parental pathogen in mice.     

Use of in vivo-generated biofilms from hemodialysis catheters to test the efficacy of a novel antimicrobial catheter lock for biofilm eradication in vitro

This biofilm study was conducted to assess the in vitro activity of tetrasodium EDTA on catheters that had been routinely removed from hemodialysis patients at Leeds Teaching Hospitals Trust due to maturation of fistula. Catheters were screened by culture of through-catheter flush, and isolates were identified by standard methodologies; 20 isolates were found to be biofilm positive. Initial biofilm cell count levels averaged above 10(5) CFU/1-cm catheter section. Bacteria identified in the biofilms were gram-negative (1 isolate), gram-positive (11 isolates), or mixed species (8 isolates). After a 24-h lock, 40 mg of tetrasodium EDTA per ml was effective at eradicating the total biofilm viable count in almost all cases. The efficacy of tetrasodium EDTA as a catheter lock potentially shows that this agent could substantially reduce catheter-related infections and be used to treat patients with limited access.     

Activity of ciprofloxacin and levofloxacin in experimental pneumonia caused by Klebsiella pneumoniae deficient in porins, expressing active efflux and producing QnrA1

The objective of this study was to evaluate the activities of ciprofloxacin and levofloxacin in a murine model of pneumonia caused by Klebsiella pneumoniae C2 (with altered GyrA, deficient in porins and expressing active efflux of quinolones) and the transconjugant C2pMG252 derived from it and expressing the qnrA1 determinant. MICs and MBCs of the two quinolones were determined according to CLSI guidelines. Time-kill curves (at 1× and 4× MIC) were also performed to assess bactericidal activity. An experimental model of pneumonia in mice was evaluated. Groups of 15 mice were infected with either strain and treated with ciprofloxacin (80 mg/kg/day) or levofloxacin (100 mg/kg/day). Control non-treated animals were also evaluated. In the case of strain C2, log₁₀ CFU/g of lung in non-treated animals was 9.16 ± 2.16. This value was reduced to 3.53 ± 1.04 (p <0.001) and 3.38 ± 0.46 (p <0.001) in animals treated with ciprofloxacin or levofloxacin, respectively. Percentages of surviving mice were 26.7% (control group) and 100% (both ciprofloxacin and levofloxacin; p <0.001 vs. controls). Bacterial counts (log₁₀ CFU/g) in lungs of animals infected with strain C2pMG252 were 9.65 ± 2.49 in non-treated animals and 7.74 ± 2.67 and 7.57 ± 3.84 for those treated with ciprofloxacin or levofloxacin, respectively (p >0.05 vs. control group). Of non-treated animals infected with strain C2pMG252, 14.3% survived. Ciprofloxacin and levofloxacin improved the survival in these mice (53.3% for both antimicrobials, p 0.03). In conclusion , the expression of qnrA1 in K. pneumoniae with additional mechanisms of resistance causes decreased efficacy of fluoroquinolones in a pneumonia model in mice.