DOCSLIB.ORG

Elizabeth Gyamfi

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
Elizabeth Gyamfi University of Ghana http://ugspace.ug.edu.gh GENOTYPING AND TREATMENT OF SECONDARY BACTERIAL INFECTIONS AMONG BURULI ULCER PATIENTS IN THE AMANSIE CENTRAL DISTRICT OF GHANA BY ELIZABETH GYAMFI (10442509) THIS THESIS IS SUBMITTED TO THE UNIVERSITY OF GHANA, LEGON IN PARTIAL FULFILMENT OF THE REQUIREMENTS FOR THE AWARD OF A MASTER OF PHILOSOPHY DEGREE IN MEDICAL BIOCHEMISTRY JULY, 2015 University of Ghana http://ugspace.ug.edu.gh DECLARATION I ELIZABETH GYAMFI, do hereby declare that with the exception of references to other people’s work, which have been duly acknowledged, this thesis is the outcome of my own research conducted at the Department of Medical Biochemistry, University of Ghana Medical School, College of Health Sciences and the Department of Cell, Molecular Biology and Biochemistry, University of Ghana, College of Basic and Applied Science under the supervision of Dr. Lydia Mosi and Dr. Bartholomew Dzudzor. Neither all nor parts of this project have been presented for another degree elsewhere. ……………………………………………. Date: ………………………. ELIZABETH GYAMFI (Student) ……………………………………………. Date: ………………………… DR. LYDIA MOSI (Supervisor) ………………………………………….. Date: ……………………….. DR. BATHOLOMEW DZUDZOR (Supervisor) i University of Ghana http://ugspace.ug.edu.gh ABSTRACT Background Buruli ulcer (BU) is a skin disease caused by Mycobacterium ulcerans. BU is the third most common mycobacterial disease after tuberculosis and leprosy, but in Ghana and Cote d’ Ivoire, it is the second. M. ulcerans produces mycolactone, an immunosuppressant macrolide toxin which makes the infection painless. However, some patients have complained of painful lesions and delay healing. Painful ulcers and delay healing experienced by some patients may be due to secondary bacterial infections. Main Objective: To identify secondary microbial infections of BU patients, their genetic diversity as well as determine the levels of antibiotics resistance of these microorganisms. Methodology: The study was conducted at Biochemistry, Cell and Molecular Biology, University of Ghana. Subjects were recruited from Amansie Central District, Ashanti Region. Swabs of 51 BU patients were taken and immediately frozen for transport into the laboratory. Microscopy was performed using Ziehl-Neelsen and Gram staining techniques. The samples were also cultured on Luria Bertani, MacConkey, Mannitol, BPA and Sabouraud dextrose agar to identify bacteria and fungi. Antibiotic susceptibility tests were performed on selected bacteria species. DNA was extracted from the samples, after which Polymerase Chain Reaction (PCR) was performed using universal (16S rRNA), MSHA/PA (16S rRNA for mycobacterial) and IS2404 (insertion sequence specific to mycolactone producers) primers to find the different strains of organisms. Finally sequencing was performed on the DNA amplicons that were randomly selected to identify the kinds of microorganisms causing secondary infection. ii University of Ghana http://ugspace.ug.edu.gh Results: All the samples were positive for bacteria. However 49 and 40 positives were obtained from PCR products using the primers MSHA/PA, and IS2404 respectively, thus 40 BU patients were identified out of the total 51 patient samples. Majority of the bacteria identified after sequencing with universal primers for bacteria were Staphylococcus spp (aureus including MRSA, saprophyticus, and lentus), Alcaligene spp (aquatilis and faecalis), Pseudomonas spp (aeruginosa, stutzeri and koreensis) and bacilli cereus group of bacteria. Interestingly, 60% of the sequencing result for mycobacteria detected the presence of Corynebacterium spp (aurimucosum, diphtheria and striatum). Other bacteria identified were Brevibacterium iodinum and Rhodococcus erythropolis. Majority of these bacteria live in muddy areas and dirty water. The selected bacteria were less susceptible to rifampicin, clarithromycin and amikacin. Conclusion: Other bacteria beside M. ulcerans colonize and proliferate on BU lesions. The selected bacteria were less susceptible to clarithromycin and amikacin and rifampicin. The pains and healing delay experienced by some BU patients could be the result of these bacteria colonizing and proliferating on the ulcer or lesions. iii University of Ghana http://ugspace.ug.edu.gh DEDICATION This research work is foremost dedicated to the Almighty God for His undeserved kindness that has been showered upon me throughout my academic life. My profound appreciation goes to my mother for her love, care, support and encouragement over the years. iv University of Ghana http://ugspace.ug.edu.gh ACKNOWLEDGEMENT I am most grateful to the Almighty God for his wisdom, guidance and protection throughout my academic years. I want to thank my supervisor; Dr. Lydia Mosi for her guidance and financial assistance throughout the project. I am very grateful for all the workshops she helped me to attend. I am also grateful to my co-supervisor, Dr. Bartholomew Dzudzor of the Department of Medical Biochemistry (U.G.M.S) for the trouble he took to frequently find out how the work was progressing. I appreciate the corrections and advice. I render an appreciation to Charles Narh and Charles Quaye for the wonderful skills they taught me during the field work. Your criticism and corrections kept me on my toes. My profound gratitude goes to the staffs and students of Molecular Biology Laboratory at the Department of Biochemistry, Cell and Molecular Biology (U.G) especially Mr. Jacob Kwaku Donkor, Adiza Abass, David Abana, Godwin Williams Ametsi, Senyo Gideon Amevinya and Georgia Naa K. Ghartey (Department of Animal Biology) for assisting me whenever help was needed. A big thank you also goes to the staff of the Department of Medical Biochemistry (U.G.M.S) especially, Dr. Nii Ayite Aryee for helping me in the completion of my thesis. Finally, I am grateful to my family and friends especially my mother, Grace Gyamfi, my sister, Esther Gyamfi and Ofori Adomako Ampaw and my colleagues Bismark Bimah, Hayford Narh and Elisha Kwaku Denkyirah for their advice and emotional support. v University of Ghana http://ugspace.ug.edu.gh TABLE OF CONTENT DECLARATION ................................................................................................................. i ABSTRACT ........................................................................................................................ ii DEDICATION ................................................................................................................... iv ACKNOWLEDGEMENT .................................................................................................. v TABLE OF CONTENT ..................................................................................................... vi LIST OF FIGURES ........................................................................................................... ix LIST OF TABLES ............................................................................................................. xi LIST OF ABBREVIATIONS ........................................................................................... xii CHAPTER ONE ................................................................................................................. 1 1.0 INTRODUCTION ..................................................................................................... 1 1.1 Background ............................................................................................................... 1 1.2. Justification/Relevance............................................................................................. 3 1.3. Hypothesis ................................................................................................................ 4 1.4. Aim ........................................................................................................................... 4 1.5. Objectives ................................................................................................................. 4 CHAPTER TWO ................................................................................................................ 5 2.0. LITERATURE REVIEW ......................................................................................... 5 2.1. Buruli Ulcer .............................................................................................................. 5 2.1.1. Mycolactone ...................................................................................................... 6 2.1.2. Epidemiology..................................................................................................... 7 2.2. Ecology and Transmission of the Disease.............................................................. 10 2.3. Clinical Presentation of Buruli ulcer ...................................................................... 11 2.4. Diagnosis ................................................................................................................ 14 2.5. Treatment of Buruli Ulcer ...................................................................................... 15 2.6. Suggested treatment other than antibiotics............................................................. 17 2.7. Immunology of the Disease.................................................................................... 18 2.8. Genetic Variation ................................................................................................... 19 2.8.1. Genetic Variation in Mycobacterium ulcerans ...............................................
Load more

Recommended publications
  • ID 2 | Issue No: 4.1 | Issue Date: 29.10.14 | Page: 1 of 24 © Crown Copyright 2014 Identification of Corynebacterium Species
    UK Standards for Microbiology Investigations Identification of Corynebacterium species Issued by the Standards Unit, Microbiology Services, PHE Bacteriology – Identification | ID 2 | Issue no: 4.1 | Issue date: 29.10.14 | Page: 1 of 24 © Crown copyright 2014 Identification of Corynebacterium species Acknowledgments UK Standards for Microbiology Investigations (SMIs) are developed under the auspices of Public Health England (PHE) working in partnership with the National Health Service (NHS), Public Health Wales and with the professional organisations whose logos are displayed below and listed on the website https://www.gov.uk/uk- standards-for-microbiology-investigations-smi-quality-and-consistency-in-clinical- laboratories. SMIs are developed, reviewed and revised by various working groups which are overseen by a steering committee (see https://www.gov.uk/government/groups/standards-for-microbiology-investigations- steering-committee). The contributions of many individuals in clinical, specialist and reference laboratories who have provided information and comments during the development of this document are acknowledged. We are grateful to the Medical Editors for editing the medical content. For further information please contact us at: Standards Unit Microbiology Services Public Health England 61 Colindale Avenue London NW9 5EQ E-mail: [email protected] Website: https://www.gov.uk/uk-standards-for-microbiology-investigations-smi-quality- and-consistency-in-clinical-laboratories UK Standards for Microbiology Investigations are produced in association with: Logos correct at time of publishing. Bacteriology – Identification | ID 2 | Issue no: 4.1 | Issue date: 29.10.14 | Page: 2 of 24 UK Standards for Microbiology Investigations | Issued by the Standards Unit, Public Health England Identification of Corynebacterium species Contents ACKNOWLEDGMENTS .........................................................................................................
    [Show full text]
  • The Influence of Social Conditions Upon Diphtheria, Measles, Tuberculosis and Whooping Cough in Early Childhood in London
    VOLUME 42, No. 5 OCTOBER 1942 THE INFLUENCE OF SOCIAL CONDITIONS UPON DIPHTHERIA, MEASLES, TUBERCULOSIS AND WHOOPING COUGH IN EARLY CHILDHOOD IN LONDON BY G. PAYLING WRIGHT AND HELEN PAYLING WRIGHT, From the Department of Pathology-, Guy's Hospital Medical School (With 1 Figure in the Text) Before the war diphtheria, measles, tuberculosis and whooping cough were the most important of the better-defined causes of death amongst young children in the London area. The large numbers of deaths registered from these four diseases in the age group 0-4 years in the Metropolitan Boroughs alone between 1931 and 1938, together with the deaths recorded under bronchitis and pneumonia, are set out in Table 1. These records Table 1. Deaths from diphtheria, measles, tuberculosis (all forms), whooping cough, bron- chitis and pneumonia amongst children, 0-4 years, in the Metropolitan Boroughs from 1931 to 1938 Whooping Year Diphtheria Measles Tuberculosis cough Bronchitis Pneumonia 1931 148 109 184 301 195 1394 1932 169 760 207 337 164 1009 1933 163 88 150 313 101 833 1934 232 783 136 ' 277 167 1192 1935 125 17 108 161 119 726 1936 113 539 122 267 147 918 1937 107 21 100 237 122 827 1938 90 217 118 101 109 719 for diphtheria, measles, tuberculosis and whooping cough fail, however, to show all the deaths that should properly be ascribed to these specific diseases. For the most part, the figures represent the deaths occurring during their more acute stages, and necessarily omit some of the many instances in which these infections, after giving rise to chronic disabilities, terminate fatally from some less well-specified cause.
    [Show full text]
  • NGS-Based Phylogeny of Diphtheria-Related Pathogenicity Factors in Different Corynebacterium Spp
    Dangel et al. BMC Microbiology (2019) 19:28 https://doi.org/10.1186/s12866-019-1402-1 RESEARCHARTICLE Open Access NGS-based phylogeny of diphtheria-related pathogenicity factors in different Corynebacterium spp. implies species- specific virulence transmission Alexandra Dangel1* , Anja Berger1,2*, Regina Konrad1 and Andreas Sing1,2 Abstract Background: Diphtheria toxin (DT) is produced by toxigenic strains of the human pathogen Corynebacterium diphtheriae as well as zoonotic C. ulcerans and C. pseudotuberculosis. Toxigenic strains may cause severe respiratory diphtheria, myocarditis, neurological damage or cutaneous diphtheria. The DT encoding tox gene is located in a mobile genomic region and tox variability between C. diphtheriae and C. ulcerans has been postulated based on sequences of a few isolates. In contrast, species-specific sequence analysis of the diphtheria toxin repressor gene (dtxR), occurring both in toxigenic and non-toxigenic Corynebacterium species, has not been done yet. We used whole genome sequencing data from 91 toxigenic and 46 non-toxigenic isolates of different pathogenic Corynebacterium species of animal or human origin to elucidate differences in extracted DT, DtxR and tox-surrounding genetic elements by a phylogenetic analysis in a large sample set. Results: Sequences of both DT and DtxR, extracted from whole genome sequencing data, could be classified in four distinct, nearly species-specific clades, corresponding to C. diphtheriae, C. pseudotuberculosis, C. ulcerans and atypical C. ulcerans from a non-toxigenic toxin gene-bearing wildlife cluster. Average amino acid similarities were above 99% for DT and DtxR within the four groups, but lower between them. For DT, subgroups below species level could be identified, correlating with different tox-comprising mobile genetic elements.
    [Show full text]
  • Diphtheria. In: Epidemiology and Prevention of Vaccine
    Diphtheria Anna M. Acosta, MD; Pedro L. Moro, MD, MPH; Susan Hariri, PhD; and Tejpratap S.P. Tiwari, MD Diphtheria is an acute, bacterial disease caused by toxin- producing strains of Corynebacterium diphtheriae. The name Diphtheria of the disease is derived from the Greek diphthera, meaning ● Described by Hippocrates in ‘leather hide.’ The disease was described in the 5th century 5th century BCE BCE by Hippocrates, and epidemics were described in the ● Epidemics described in 6th century AD by Aetius. The bacterium was first observed 6th century in diphtheritic membranes by Edwin Klebs in 1883 and cultivated by Friedrich Löffler in 1884. Beginning in the early ● Bacterium first observed in 1900s, prophylaxis was attempted with combinations of toxin 1883 and cultivated in 1884 and antitoxin. Diphtheria toxoid was developed in the early ● Diphtheria toxoid developed 7 1920s but was not widely used until the early 1930s. It was in 1920s incorporated with tetanus toxoid and pertussis vaccine and became routinely used in the 1940s. Corynebacterium diphtheria Corynebacterium diphtheriae ● Aerobic gram-positive bacillus C. diphtheriae is an aerobic, gram-positive bacillus. ● Toxin production occurs Toxin production (toxigenicity) occurs only when the when bacillus is infected bacillus is itself infected (lysogenized) by specific viruses by corynebacteriophages (corynebacteriophages) carrying the genetic information for carrying tox gene the toxin (tox gene). Diphtheria toxin causes the local and systemic manifestations of diphtheria. ● Four biotypes: gravis, intermedius, mitis, and belfanti C. diphtheriae has four biotypes: gravis, intermedius, mitis, ● All isolates should be tested and belfanti. All biotypes can become toxigenic and cause for toxigenicity severe disease.
    [Show full text]
  • Information Sheet Immunization and TB Requirements for Health Career Programs
    Information Sheet Immunization and TB Requirements For Health Career Programs Why is immunization important for students in health career programs? Health care providers are at risk of exposure to, and possible transmission of, preventable diseases. Risk of communicable diseases in the workplace is due to health care providers contact with infected patients or infective material from patients. Maintenance of immunity is therefore an essential part of prevention and infection control. Vaccinating health care providers helps protect their health and prevent disease transmission between patients and providers and among providers and their family and friends outside the workplace. What routine immunizations and screenings are required? The vaccines required are Tetanus, Diphtheria, and Pertussis (Tdap), Measles (Rubeola), Mumps and Rubella (MMR), Varicella, and Influenza. Positive Rubella Titer is required in addition to MMR vaccination. Students must also be tested for TB on an annual basis. Tetanus, Diphtheria and Pertussis (required) Diphtheria is a serious communicable disease, causing death in 5-10 percent of cases with the highest rates among the very young and the elderly. Diphtheria disease is most common and most severe in non-immunized or partially immunized individuals. Protection from vaccine decreases over time unless periodic boosters are given. Tetanus is an acute and often fatal disease. While rare, cases have been reported that are associated with injection drug use, animal bites and wounds contaminated with dirt, feces or saliva. Pertussis (whooping cough) is very contagious and can cause serious illness―especially in infants too young to be fully vaccinated. Pertussis vaccines are recommended for children, teens, and adults, including pregnant women Immunization against tetanus, diphtheria, and pertussis is recommended for all adults in the USA and required for students in health career programs at HACC.
    [Show full text]
  • (Buruli Ulcer) in Rural Hospital, Southern Benin, 1997–2001 Martine Debacker,* Julia Aguiar,† Christian Steunou,† Claude Zinsou,*† Wayne M
    Mycobacterium ulcerans Disease (Buruli Ulcer) in Rural Hospital, Southern Benin, 1997–2001 Martine Debacker,* Julia Aguiar,† Christian Steunou,† Claude Zinsou,*† Wayne M. Meyers,‡ Augustin Guédénon,§ Janet T. Scott,* Michèle Dramaix,¶ and Françoise Portaels* Data from 1,700 patients living in southern Benin were Even though large numbers of patients have been collected at the Centre Sanitaire et Nutritionnel Gbemoten, reported, the epidemiology of BU remains obscure, even in Zagnanado, Benin, from 1997 through 2001. In the Zou disease-endemic countries. In 1997, a first report was pub- region in 1999, Buruli ulcer (BU) had a higher detection rate lished on 867 BU patients from the Republic of Benin (21.5/100,000) than leprosy (13.4/100,000) and tuberculo- (West Africa) for 1989–1996 (4). Our study covers the sis (20.0/100,000). More than 13% of the patients had osteomyelitis. Delay in seeking treatment declined from 4 ensuing 5 years (1997 to 2001), during which a collabora- months in 1989 to 1 month in 2001, and median hospital- tive project was initiated to improve detection and control ization time decreased from 9 months in 1989 to 1 month of BU. This study describes BU in Benin and presents in 2001. This reduction is attributed, in part, to implement- demographic trends and epidemiologic data from the four ing an international cooperation program, creating a nation- southern regions of Benin (Zou, Oueme, Mono, and al BU program, and making advances in patient care. Atlantique), as seen in a rural hospital in the Zou Region. uruli ulcer (BU), caused by Mycobacterium ulcerans, Patients and Methods Bis the third most common mycobacterial disease in Our observations are based on 1,700 consecutive humans after tuberculosis and leprosy (1).
    [Show full text]
  • Mycobacterium Bovis BCG As a Delivery System for the Dtb Gene Antigen from Diphtheria Toxin
    American Journal of Molecular Biology, 2017, 7, 176-189 http://www.scirp.org/journal/ajmb ISSN Online: 2161-6663 ISSN Print: 2161-6620 Mycobacterium bovis BCG as a Delivery System for the dtb Gene Antigen from Diphtheria Toxin Dilzamar V. Nascimento1,4, Odir A. Dellagostin2, Denise C. S. Matos3, Douglas McIntosh5, Raphael Hirata Jr.1, Geraldo M. B. Pereira1,4, Ana Luíza Mattos-Guaraldi1, Geraldo R. G. Armôa4* 1Faculdade de Ciências Médicas, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, Brazil 2Núcleo de Biotecnologia, Universidade Federal de Pelotas, Campus Universitário, Pelotas, Brazil 3Instituto de Tecnologia em Imunobiológicos, Fundação Oswaldo Cruz, Rio de Janeiro, Brazil 4Instituto Oswaldo Cruz, Fundação Oswaldo Cruz, Rio de Janeiro, Brazil 5Instituto de Veterinária, Universidade Federal Rural do Rio de Janeiro, Seropedica, Rio de Janeiro, Brazil How to cite this paper: Nascimento, D.V., Abstract Dellagostin, O.A., Matos, D.C.S., McIntosh, D., Hirata Jr., R., Pereira, G.M.B., Mat- Diphtheria is a fulminant bacterial disease caused by toxigenic strains of Co- tos-Guaraldi, A.L. and Armôa, G.R.G. rynebacterium diphtheriae whose local and systemic manifestations are due to (2017) Mycobacterium bovis BCG as a the action of the diphtheria toxin (DT). The vaccine which is used to prevent Delivery System for the dtb Gene Antigen from Diphtheria Toxin. American Journal diphtheria worldwide is a toxoid obtained by detoxifying DT. Although asso- of Molecular Biology, 7, 176-189. ciated with high efficacy in the prevention of disease, the current an- https://doi.org/10.4236/ajmb.2017.74014 ti-diphtheria vaccine, one of the components of DTP (diphtheria, tetanus and Received: April 17, 2017 pertussis triple vaccine), may present post vaccination effects such as toxicity Accepted: September 27, 2017 and reactogenicity resulting from the presence of contaminants in the vaccine Published: September 30, 2017 that originated during the process of production and/or detoxification.
    [Show full text]
  • National Consensus
    National Consensus HIDRADENITIS SUPPURATIVA Published by the Sociedad Argentina de Dermatología [Argentine Society of Dermatology] – Year 1- No. 1 – November 2019 Location of editing: Ciudad Autónoma de Buenos Aires, Argentina 2019 Treatment Guideline ICD 10: L73.2 ICD 11: ED92.0 Synonym: acne inversa Autoinflammatory Disease and Hidradenitis Suppurativa Work Group of the Argentine Society of Dermatology DIRECTOR: Dr. Alberto Lavieri* AUTHORS: Dr. Mario Bittar Dr. Paula Bourren Dr. Jimena Estrada Dr. Sebastián Fagre Dr. Ramón Fernández Bussy (Jr) Dr. Claudio Greco Dr. Alberto Lavieri Dr. Virginia López Gamboa Dr. Mónica Maiolino Dr. Mariano Marini Dr. Mariana Papa Dr. Mario Pelizzari Dr. Ariel Sehtman Dr. María Florencia Vera Morandini Dr. Sabina Zimman* * Director and authors are members of the Autoinflammatory Disease and Hidradenitis Suppurativa Work Group of the Argentine Society of Dermatology A1 Table of Contents 1. Introduction ...................................................................................................................... 1 2. Premises ............................................................................................................................ 2 3. Background on hidradenitis suppurativa ............................................................................ 2 3.a. Definitions .................................................................................................................... 2 3.b. Epidemiology ,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,.
    [Show full text]
  • The Association Between Tuberculosis and Diphtheria
    bioRxiv preprint doi: https://doi.org/10.1101/219584; this version posted November 16, 2017. The copyright holder for this preprint (which was not certified by peer review) is the author/funder. All rights reserved. No reuse allowed without permission. The Association between Tuberculosis and Diphtheria S. COLEMAN Metropolitan State University (retired) 2410 Cromwell Dr Minneapolis MN 55410 USA [email protected] 1 bioRxiv preprint doi: https://doi.org/10.1101/219584; this version posted November 16, 2017. The copyright holder for this preprint (which was not certified by peer review) is the author/funder. All rights reserved. No reuse allowed without permission. The Association between Tuberculosis and Diphtheria Abstract This research investigates the now-forgotten relationship between diphtheria and tuberculosis. Historical medical reports from the 19th century are reviewed followed by a statistical regression analysis of the relationship between the two diseases in the early 20th century. Historical medical records show a consistent association between diphtheria and tuberculosis that can increase the likelihood and severity of either disease in a co- infection. The statistical analysis uses historical weekly public health data on reported cases in five American cities over a period of several years, finding a modest but statistically significant relationship between the two diseases. No current medical theory explains the association between diphtheria and tuberculosis. Alternative explanations are explored with a focus on how the diseases assimilate iron. In a co-infection, the effectiveness of tuberculosis at assimilating extracellular iron can lead to increased production of diphtheria toxin, worsening that disease, which may in turn exacerbate tuberculosis.
    [Show full text]
  • Non-Tuberculous Mycobacterial Lung Disease Due to Multiple “Minor” Risk Factors: an Illustrative Case and a Review of These “Lesser Elements”
    4972 Short Communication Non-tuberculous mycobacterial lung disease due to multiple “minor” risk factors: an illustrative case and a review of these “lesser elements” Patrick Moon1, Elizabeth Guillaumin2, Edward D. Chan3,4,5 1Naval Medical Center, San Diego, CA, USA; 2San Jose, CA, USA; 3Department of Academic Affairs, National Jewish Health, Denver, CO, USA; 4Division of Pulmonary Sciences and Critical Care Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO, USA; 5Rocky Mountain Regional Veterans Affairs Medical Center, Aurora, CO, USA Correspondence to: Edward D. Chan, MD. D509, Neustadt Building, National Jewish Health, 1400 Jackson Street, Denver, CO 80206, USA. Email: [email protected]. Submitted Feb 22, 2020. Accepted for publication Aug 06, 2020. doi: 10.21037/jtd-20-986 View this article at: http://dx.doi.org/10.21037/jtd-20-986 Introduction were made. Pertinent medical and surgical history include Non-tuberculous mycobacterial (NTM) lung disease hypothyroidism and uterine sarcoma, the latter treated with typically occurs in those with structural lung diseases such a total hysterectomy and bilateral salpingo-oophorectomy as pre-existing bronchiectasis and chronic obstructive and adjunctive cis-platinum and ifosfamide 14 years ago. pulmonary disease (COPD, typically emphysema). Gastroesophageal reflux (GER) was also present for many Prototypical causes of bronchiectasis include cystic fibrosis years with the patient preferring to sleep on her left side (CF), alpha-1-antitrypsin (AAT) deficiency, primary ciliary with no head-of-bed elevation. Family history is notable dyskinesia (PCD), Sjogren’s syndrome, and sequela of for father with lung cancer and a maternal grandfather prior tuberculosis or other bacterial pneumonia, as well with pulmonary tuberculosis.
    [Show full text]
  • The Effect of Inactivated Mycobacterium Paratuberculosis Vaccine on the Response to a Heterologous Bacterial Challenge in Pigs
    University of Southern Denmark The effect of inactivated mycobacterium paratuberculosis vaccine on the response to a heterologous bacterial challenge in pigs Jensen, Kristoffer Jarlov; Hansen, Mette Sif; Heegaard, Peter Mikael Helweg; Benn, Christine Stabell; Jungersen, Gregers Published in: Frontiers in Immunology DOI: 10.3389/fimmu.2019.01557 Publication date: 2019 Document version: Final published version Document license: CC BY Citation for pulished version (APA): Jensen, K. J., Hansen, M. S., Heegaard, P. M. H., Benn, C. S., & Jungersen, G. (2019). The effect of inactivated mycobacterium paratuberculosis vaccine on the response to a heterologous bacterial challenge in pigs. Frontiers in Immunology, 10(JULY), [1557]. https://doi.org/10.3389/fimmu.2019.01557 Go to publication entry in University of Southern Denmark's Research Portal Terms of use This work is brought to you by the University of Southern Denmark. Unless otherwise specified it has been shared according to the terms for self-archiving. If no other license is stated, these terms apply: • You may download this work for personal use only. • You may not further distribute the material or use it for any profit-making activity or commercial gain • You may freely distribute the URL identifying this open access version If you believe that this document breaches copyright please contact us providing details and we will investigate your claim. Please direct all enquiries to [email protected] Download date: 27. Sep. 2021 ORIGINAL RESEARCH published: 05 July 2019 doi: 10.3389/fimmu.2019.01557
    [Show full text]
  • <I>Mycobacterium Avium</I>
    University of Nebraska - Lincoln DigitalCommons@University of Nebraska - Lincoln Virology Papers Virology, Nebraska Center for 4-2020 Elucidating the Regulon of a Fur-like Protein in Mycobacterium avium subsp. paratuberculosis (MAP) Fernanda Miyagaki Shoyama Michigan State University, [email protected] Taveesak Janetanakit Chulalongkorn University John P. Bannantine National Animal Disease Center, USDA-Agricultural Research Service, [email protected] Raul G. Barletta University of Nebraska-Lincoln, [email protected] Srinand Sreevatsan Michigan State University, [email protected] Follow this and additional works at: https://digitalcommons.unl.edu/virologypub Part of the Biological Phenomena, Cell Phenomena, and Immunity Commons, Cell and Developmental Biology Commons, Genetics and Genomics Commons, Infectious Disease Commons, Medical Immunology Commons, Medical Pathology Commons, and the Virology Commons Shoyama, Fernanda Miyagaki; Janetanakit, Taveesak; Bannantine, John P.; Barletta, Raul G.; and Sreevatsan, Srinand, "Elucidating the Regulon of a Fur-like Protein in Mycobacterium avium subsp. paratuberculosis (MAP)" (2020). Virology Papers. 406. https://digitalcommons.unl.edu/virologypub/406 This Article is brought to you for free and open access by the Virology, Nebraska Center for at DigitalCommons@University of Nebraska - Lincoln. It has been accepted for inclusion in Virology Papers by an authorized administrator of DigitalCommons@University of Nebraska - Lincoln. fmicb-11-00598 April 23, 2020 Time: 14:27 # 1 ORIGINAL RESEARCH
    [Show full text]