Recurrent Bacteremia Caused by a “Flexispira”-Like Organism in a Patient with X-Linked (Bruton’s) Agammaglobulinemia

Helicobacter spp., except for Helicobacter cinaedi, have only rarely been reported in cases of septicemia. A patient with X-linked (Bruton's) agammaglobulinemia was found to have persistent sepsis with a Helicobacter-like organism despite multiple courses of antibiotics. His periods of sepsis were associated with leg swelling thought to be consistent with cellulitis. The organism was fastidious and required a microaerophilic environment containing H(2) for growth. Optimal growth was observed at 35 to 37 degrees C on sheep blood, CDC anaerobe, and Bordet-Gengou agars. Serial subcultures every 4 to 5 days were required to maintain viability. The organism was strongly urease positive and showed highest relatedness to Helicobacter-like organisms with the vernacular name "Flexispira rappini" by 16S rRNA gene sequence analysis. Genomic DNA hybridization studies, however, found 24 to 37% relatedness to "F. rappini" and even less to other Helicobacter spp. Although the organism phenotypically resembles "Flexispira" and Helicobacter, it is thought to represent a new taxon. The patient's infection was eventually cleared with a prolonged (5-month) course of intravenous imipenem and gentamicin.     

"Campylobacter cinaedi" bacteremia: case report and laboratory findings

"Campylobacter cinaedi" was isolated from the blood of a 29-year-old homosexual man with previously diagnosed acquired immune deficiency syndrome. Subculturing of the organism was achieved with the use of 7% lysed horse blood and 10% sheep blood agars at 37 degrees C in a microaerophilic atmosphere. Problems associated with the culturing of this organism are reviewed.     

The influence of the triterpenoid from the weeping birch (Betula Pendula) on the changed reactivity of an organism exposed to action of the dust-radiating factor

The obtained data testify about immunmodulating properties of the given medicine. Influence of "Be phytomedicine on organism, which undergoes dust-radiation factor leads to positive dynamics in humoral and cellular parts of immunity, also to increasing immunological reactivity of an organism.     

Feasibility of Novel Atomic-Molecular Resuscitation Tools

Complex multifactor diseases are characterized by enhanced formation of toxic free radicals. The developed apparatuses based on electron paramagnetic resonance or nuclear magnetic resonance electrodialysis are therapeutic tools playing the role of atomic-molecular "artificial kidney" excreting anion and cation radicals from the organism. These tools can be used in medicine in combination with drug therapy to protect cells from toxic action of free radicals produced during metabolic neutralizing deactivation of exogenous toxic substances invading the organism.     

Damage to cell DNA in the bone marrow and testes of mice with experimental trichinosis

Metabolites of Trichinella spiralis produced genotoxic and cytotoxic effects on somatic and generative cells of the host organism. They increased the number of single-chain breaks, alkaline-labile sites in nuclear DNA, and count of apoptotic cells in the bone marrow and testes of infected mice. These effects depended on the stage of parasite development in the host organism and became more pronounced with increasing invasion intensity.Translated from Byulleten Eksperimentalnoi Biologii i Meditsiny, Vol. 138, No. 9, pp. 320–323, September, 2004     

Apoptosis and necrosis: interrelation of the phenomena

Cell death types in the multicellular organism may be divided into two groups: (1) natural cell death--programmed, or apoptotic cell death, which involves the activity of regulatory factors including genetic mechanisms, and (2) occasional (pathologic) death, encompassing numerous types of death that result from the severe cell injuries, caused by damaging factors and which are incompatible with cell life. It is suggested that the term "necrosis" should be applied to describe the process of cell destruction and fragmentation within the living organism, following any type of its death. For the cells, that have died by the mechanism of apoptosis, the period of necrosis is usually short and seems to correspond to the duration of apoptotic body existence. In some cases, specific apoptotic bodies may persist for a longer intervals, performing important functions in the organism (epidermal cornified scales, platelets etc.).     

Gastroinvasive Helicobacter infection in an Ocelot (Leopardus pardalis)

Highly invasive Helicobacter-like organisms were found in a 19-year-old female ocelot (Leopardus pardalis) with multiple ulcers in the fundic region of the stomach. The bacteria, resembling Helicobacter heilmannii, were located largely within canaliculi or in the cytosol of parietal cells. Except in the ulcerative lesions, parietal cells were hyperplastic, while chief cells and neck mucous cells were reduced in number. The term "gastroinvasive Helicobacter-like organism" was applied. It seems probable that this organism differs from other Helicobacter organisms in pathogenicity, and possible that its behaviour in vitro would help it to evade antibacterial treatment.     

Capnocytophaga cynodegmi cellulitis, bacteremia, and pneumonitis in a diabetic man

Capnocytophaga cynodegmi (formerly "DF-2 like organism"), a commensal organism of the canine oral cavity, is a capnophilic, gram-negative, facultative bacillus. C. cynodegmi has rarely been encountered in human diseases. We report the first known case of cellulitis, bacteremia, and pneumonitis caused by C. cynodegmi in a diabetic man from central India following a dog bite.     

Recurrent "Flexispira rappini" bacteremia in an adult patient undergoing hemodialysis: case report

A blood culture from a 65-year-old febrile man undergoing hemodialysis revealed, 5 days after inoculation, an unusual gram-negative fusiform rod with darting motility. During another episode of fever 21 days later, this Campylobacter-like organism was again recovered from three blood cultures and subcultured under an H2-enriched microaerobic atmosphere. The organism was catalase negative and oxidase positive and hydrolyzed urea rapidly. Sodium dodecyl sulfate-polyacrylamide gel electrophoresis analysis of whole-cell proteins was indistinguishable from that of "Flexispira rappini" LMG 8738 described by Archer et al. in 1988 (J. R. Archer, S. Romero, A. E. Ritchier, M. E. Hamacher, B. M. Steiner, J. H. Bryner, and R. F. Schell, J. Clin. Microbiol. 26:101-105, 1988). The analysis of the 16S ribosomal DNA sequence revealed a similarity of 99.3% between the two strains. The patient recovered completely after a 4-week course of meropenem therapy. This is the first reported case of a recurrent "F. rappini" bacteremia in an adult patient, which confirms that this organism may be an invasive pathogen in immunocompromised patients, like other newly described Helicobacter species.     

Steady-State Effects of Vitronectin and Fibronectin on the Binding, Uptake, and Degradation of Pneumocystis Carinii by Rat Alveolar Macrophages

Pneumocystis carinii pneumonia remains a serious complication of immunodeficiency. Vitronectin (VN) and fibronectin (FN) accumulate in the lung during P. carinii infection and bind to the organism, thereby enhancing macrophage release of TNF. It is not known whether VN and FN also regulate uptake and degradation of P. carinii by macrophages when present in concentrations similar to those in the lung during pneumonia. To address this, macrophages were cultured with ³⁵S-radiolabeled P. carinii and organism binding, phagocytosis, and degradation determined in media alone (control), or in the presence of VN or FN (100 g/ml each). Soluble VN and FN, in concentrations similar to those in the host, did not significantly affect binding, uptake or degradation of P. carinii by alveolar macrophages. Thus, although VN and FN enhance macrophage activation during P. carinii pneumonia, phagocytosis of the organism is not increased by these host glycoproteins under steady-state conditions.     

The pathogenetic approach to studying the influence of the environmental factors on the population health

The pathogenetic approach to studying the influence of the environmental factors on the population health does not regard the organism as a "black box" and makes it possible not only to evaluate a scope of risk or to substantiate the parameters of the safe impact degree, it also can be used to specify the biological mechanisms of the influence of the above factors. This can be a foundation for the elaboration of actual methods for the medical-and-biological prevention, treatment and rehabilitation. The pathogenetic approach rests on the knowledge of mechanisms of the organism protection from unfavorable impacts. The protection mechanisms of the organism from the extreme conditions of the Far North, from causative agents of infections, from suspended particles and from toxic substances have been analyzed in the article. The pathogenetic trend of study will enable the centers for the sanitary-and-epidemiological supervision to add the methods for individual health protection to their activity related with public health protection.     

Exological relationships of bacteria involved in a simple, mixed anaerobic infection.

Infectivity of Bacteroides asaccharolyticus (formerly B. melaninogenicus subsp. asaccharolyticus; see S. M. Finegold and E. M. Barnes, Int. J. Syst. Bacteriol. 27:388--391, 1977) was dependent on the presence of a second organism. An infective consortium consisting of B. asaccharolyticus and Klebsiella pneumoniae was defined. Neither organism was infective alone, but the Klebsiella could be replaced by organisms of a number of different genera. The nature of the infection appeared to be determined by the length of the lag period preceding the initiation of growth of B. asaccharolyticus. A rapid onset of growth led to the severe spreading form of the disease, whereas a slow initiation of growth resulted in the formation of a localized, self-limiting abscess. B. asaccharolyticus depends on the second or "helper" organism to produce a required growth factor which is not present at the inoculation site. The growth factor was shown to be succinate which was able to replace the hemin requirement. The dependency on succinate produced by K. pneumoniae was demonstrated in agar medium, in liquid culture, and in the infectivity assay. Any organism which produced succinate was able to stimulate growth of B. asaccharolyticus on agar medium and could replace K. pneumoniae as a member of the infectious consortium. The need for the second organism could be eliminated by inoculating B. asaccharolyticus together with agar-immobilized succinate or hemin.     

In Vitro Incorporation of Serine into the Staphylococcal Cell Wall

A variant of Staphylococcus aureus 44A HJD was isolated by serial growth in Trypticase soy broth to which 2 M serine had been added (wt/vol). Amino acid analysis of hydrolysates of purified mucopeptides from the variant showed that they contained 1.266 serine and 2.156 glycine residues per glutamic acid residue, compared with 0.174 serine and 3.144 glycine residues per glutamic acid residue in the mucopeptide of the parent strain. In addition to this alteration in the chemical composition of the mucopeptide, the variant lost many of the biochemical and cultural characteristics of the parent organism. The variant was not sensitive to the lytic action of lysostaphin and was non-phage-typable. Moreover, in vitro tests indicated that the organism was coagulase negative, did not produce gelatinase or deoxyribonuclease, and did not hemolyze sheep erythrocytes. Apparently due to the change in the serine content in the cell wall of the parent S. aureus strain, the organism had become "epidermidis-like" in its properties.     

"Candidatus Neoehrlichia mikurensis" infection in a dog from Germany

"Candidatus Neoehrlichia mikurensis" is a new intracellular pathogen associated with human infection and death. "Candidatus Neoehrlichia mikurensis" infection in a chronically neutropenic dog from Germany was confirmed by DNA sequencing. The same organism was previously described from ticks and two sick human beings from Germany.     

Elizabethkingia meningoseptica: Emerging nosocomial pathogen in bedside hemodialysis patients

Elizabethkingia meningoseptica, a ubiquitous gram-negative aerobic bacillus, is an emerging hospital acquired pathogen in patients on dialysis. It has been isolated in the hospital environment in water supplies, disinfectants, and medical devices. We present here an analysis of eight healthcare-acquired infections with this organism in adults. To the best of our our knowledge, this is the first report of infections with this organism in patients on hemodialysis.

Materials and Methods:

Over a 6-month period, eight patients were infected with E. meningoseptica in our hospital. These patients had bacteremia and lower respiratory tract infection. All these patients were on on mechanical ventilation and undergoing bedside hemodialysis in the intensive care unit (ICU). Environmental surveillance was done to detect the possible source.

Results:

These patients had a common denominator of bedside hemodialysis, and use of broad-spectrum antibiotics. E. meningoseptica was isolated from the water and sink of the ICU.

Conclusion:

E. meningoseptica is emerging as a nosocomial pathogen among patients on hemodialysis. Its unusual resistance pattern coupled with inherent resistance to colistin makes this organism difficult to treat unless susceptibility patterns are available. Isolation of this organism in handwash sink and water is a significant finding as they have been reported to survive in chlorinated water. Disinfecting the sinks and using filtered water for hand washing in critical areas may help in preventing infections with this organism.     

Ultrastructure of the agent of Legionnaires' disease in the human lung.

This report confirms the gram-negative ultrastructural characteristics of the Legionnaires' disease organism by direct examination of pulmonary tissue from six confirmed cases--two from the original Philadelphia epidemic of 1976 and four from more recent sporadic cases. All microorganisms seen in all six lungs were identical ultrastructurally and were predominantely within intra-alveolar macrophages, as previously observed by light microscopy. They appeared as short, blunt rods that were clearly prokaryotic; i.e., they had diffuse electron-lucent nucleoid areas interspersed among areas of well-defined ribosomes, a pinching nonseptic division, and enclosure within a double envelope consisting of two three-layer "unit" membranes, each approximately 75 A wide. This structure, together with a pinching division, is typical of gram-negative bacteria. The Legionnaires' disease organism multiples both intracellularly and extracellularly in tissue and has no unique ultrastructural features that would aid in its specific identification. These findings are compared with recent reports describing the ultrastructure of what was considered to be the Legionnaires' disease organism in yolk sac and culture medium, and in one human lung.     

First case report of catheter-related bacteremia due to "Mycobacterium lacticola"

This is the first report of infection caused by "Mycobacterium lacticola," a rapidly growing, scotochromogenic mycobacterium that was isolated from the blood of an immunosuppressed child. The organism was identified by sequence analysis of >1,400 bp of the 16S rRNA gene. The clinical relevance of this isolate, coupled with its unique 16S rRNA gene sequence, should prompt further investigation to establish this organism as a valid mycobacterial species.     

Bacteremia and skin/bone infections in two patients with X-linked agammaglobulinemia caused by an unusual organism related to Flexispira/Helicobacter species

Two patients with Bruton's X-linked agammaglobulinemia are described with bacteremia and skin/bone infection due to an organism which by 16S rRNA gene sequence analysis was most closely related to "Flexispira" rappini (and thus designated a Flexispira-like organism, FLO) and more distantly related to the Helicobacter species. The organism required microaerobic conditions and, supplemental H(2) gas for growth and was reliably stained with acridine orange. In common with Helicobacter cinaedi infections, the focus of the FLO infection was in one case in the blood vessels or lymphatics of an extremity and in the other case in the skin and adjacent bone of an extremity. In both cases, prolonged IV antibiotic therapy was necessary to clear the infection. The susceptibility of XLA patients to FLO infection appears to be related to the fact that XLA is associated with severe B cell (humoral) immunodeficiency and thus these patients have difficulty with intravascular or intralymphatic infection. These findings elucidate the nature of FLO infections in humans and point the way to their detection and treatment.     

Metronidazole bioassay with increased sensitivity

The bioassay of metronidazole usingClostridium butyricum incorporated in agar plates detected concentrations higher than 1.0 g/ml. Gentamicin in the sample did not affect the growth of the target organism or the inhibition by metronidazole. Penicillin in the sample could be eliminated by the incorporation of penicillinase in the agar or by using as the target organism a surface inoculum of the penicillin-resistantBacteroides fragilis. Increasing duration and temperature of aerobic prediffusion before allowing the growth of the strictly anaerobicCl. butyricum increased the diameters of inhibition by metronidazole, but did not affect the threshold of detectability. The incorporation of metronidazole in the agar increased the sensitivity of the assay ten- to 100-fold.     

Infiltration of the brain by pathogens causes Alzheimer's disease

Despite very numerous studies on Alzheimer's disease (AD), especially on amyloid plaques and neurofibrillary tangles, little information has been obtained thus on the causes of the disease. Evidence is described here that implicates firstly herpes simplex virus type 1 (HSV1) as a strong risk factor when it is present in brain of carriers of the type 4 allele of the gene for apolipoprotein E (APOE-4). Indirect support comes from studies indicating the role of APOE in several diverse diseases of known pathogen cause. A second putative risk factor is the bacterium, Chlamydia pneumoniae. This pathogen has been identified and localized in AD brain. Current studies aimed at "proof of principle" address the entry of the organism into the CNS, the neuroinflammatory response to the organism, and the role that the organism plays in triggering AD pathology. An infection-based animal model demonstrates that following intranasal inoculation of BALB/c mice with C. pneumoniae, amyloid plaques/deposits consistent with those observed in the AD brain develop, thus implicating this infection in the etiology of AD.