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The Role of Streptococcal and Staphylococcal Exotoxins and Proteases in Human Necrotizing Soft Tissue Infections
toxins Review The Role of Streptococcal and Staphylococcal Exotoxins and Proteases in Human Necrotizing Soft Tissue Infections Patience Shumba 1, Srikanth Mairpady Shambat 2 and Nikolai Siemens 1,* 1 Center for Functional Genomics of Microbes, Department of Molecular Genetics and Infection Biology, University of Greifswald, D-17489 Greifswald, Germany; [email protected] 2 Division of Infectious Diseases and Hospital Epidemiology, University Hospital Zurich, University of Zurich, CH-8091 Zurich, Switzerland; [email protected] * Correspondence: [email protected]; Tel.: +49-3834-420-5711 Received: 20 May 2019; Accepted: 10 June 2019; Published: 11 June 2019 Abstract: Necrotizing soft tissue infections (NSTIs) are critical clinical conditions characterized by extensive necrosis of any layer of the soft tissue and systemic toxicity. Group A streptococci (GAS) and Staphylococcus aureus are two major pathogens associated with monomicrobial NSTIs. In the tissue environment, both Gram-positive bacteria secrete a variety of molecules, including pore-forming exotoxins, superantigens, and proteases with cytolytic and immunomodulatory functions. The present review summarizes the current knowledge about streptococcal and staphylococcal toxins in NSTIs with a special focus on their contribution to disease progression, tissue pathology, and immune evasion strategies. Keywords: Streptococcus pyogenes; group A streptococcus; Staphylococcus aureus; skin infections; necrotizing soft tissue infections; pore-forming toxins; superantigens; immunomodulatory proteases; immune responses Key Contribution: Group A streptococcal and Staphylococcus aureus toxins manipulate host physiological and immunological responses to promote disease severity and progression. 1. Introduction Necrotizing soft tissue infections (NSTIs) are rare and represent a more severe rapidly progressing form of soft tissue infections that account for significant morbidity and mortality [1]. -
Legionnaires' Disease
epi TRENDS A Monthly Bulletin on Epidemiology and Public Health Practice in Washington Legionnaires’ disease Vol. 22 No. 11 Legionellosis is a bacterial respiratory infection which can result in severe pneumonia and death. Most cases are sporadic but legionellosis is an important public health issue because outbreaks can occur in hotels, communities, healthcare facilities, and other settings. Legionellosis Legionellosis was first recognized in 1976 when an outbreak affected 11.17 more than 200 people and caused more than 30 deaths, mainly among attendees of a Legionnaires’ convention being held at a Philadelphia hotel. Legionellosis is caused by numerous different Legionella species and serogroups but most epiTRENDS P.O. Box 47812 recognized infections are due to Olympia, WA 98504-7812 L. pneumophila serogroup 1. The extent to which this is due to John Wiesman, DrPH, MPH testing bias is unclear since only Secretary of Health L. pneumophila serogroup 1 is Kathy Lofy, MD identified via commonly used State Health Officer urine antigen tests; other species Scott Lindquist, MD, MPH Legionella pneumophila multiplying and serogroups must be identified in a human lung cell State Epidemiologist, through PCR or culture, tests Communicable Disease www.cdc.gov which are less commonly ordered. Jerrod Davis, P.E. Assistant Secretary The disease involves two clinically distinct syndromes: Pontiac fever, Disease Control and Health Statistics a self-limited flu-like illness without pneumonia; and Legionnaires’ disease, a potentially fatal pneumonia with initial symptoms of fever, Sherryl Terletter Managing Editor cough, myalgias, malaise, and sometimes diarrhea progressing to symptoms of pneumonia which can be severe. Health conditions that Marcia J. -
Drug-Resistant Streptococcus Pneumoniae and Methicillin
NEWS & NOTES Conference Summary pneumoniae can vary among popula- conference sessions was that statically tions and is influenced by local pre- sound methods of data collection that Drug-resistant scribing practices and the prevalence capture valid, meaningful, and useful of resistant clones. Conference pre- data and meet the financial restric- Streptococcus senters discussed the role of surveil- tions of state budgets are indicated. pneumoniae and lance in raising awareness of the Active, population-based surveil- Methicillin- resistance problem and in monitoring lance for collecting relevant isolates is the effectiveness of prevention and considered the standard criterion. resistant control programs. National- and state- Unfortunately, this type of surveil- Staphylococcus level epidemiologists discussed the lance is labor-intensive and costly, aureus benefits of including state-level sur- making it an impractical choice for 1 veillance data with appropriate antibi- many states. The challenges of isolate Surveillance otic use programs designed to address collection, packaging and transport, The Centers for Disease Control the antibiotic prescribing practices of data collection, and analysis may and Prevention (CDC) convened a clinicians. The potential for local sur- place an unacceptable workload on conference on March 12–13, 2003, in veillance to provide information on laboratory and epidemiology person- Atlanta, Georgia, to discuss improv- the impact of a new pneumococcal nel. ing state-based surveillance of drug- vaccine for children was also exam- Epidemiologists from several state resistant Streptococcus pneumoniae ined; the vaccine has been shown to health departments that have elected (DRSP) and methicillin-resistant reduce infections caused by resistance to implement enhanced antimicrobial Staphylococcus aureus (MRSA). -
Pneumonia: Prevention and Care at Home
FACT SHEET FOR PATIENTS AND FAMILIES Pneumonia: Prevention and Care at Home What is it? On an x-ray, pneumonia usually shows up as Pneumonia is an infection of the lungs. The infection white areas in the affected part of your lung(s). causes the small air sacs in your lungs (called alveoli) to swell and fill up with fluid or pus. This makes it harder for you to breathe, and usually causes coughing and other symptoms that sap your energy and appetite. How common and serious is it? Pneumonia is fairly common in the United States, affecting about 4 million people a year. Although for many people infection can be mild, about 1 out of every 5 people with pneumonia needs to be in the heart hospital. Pneumonia is most serious in these people: • Young children (ages 2 years and younger) • Older adults (ages 65 and older) • People with chronic illnesses such as diabetes What are the symptoms? and heart disease Pneumonia symptoms range in severity, and often • People with lung diseases such as asthma, mimic the symptoms of a bad cold or the flu: cystic fibrosis, or emphysema • Fatigue (feeling tired and weak) • People with weakened immune systems • Cough, without or without mucus • Smokers and heavy drinkers • Fever over 100ºF or 37.8ºC If you’ve been diagnosed with pneumonia, you should • Chills, sweats, or body aches take it seriously and follow your doctor’s advice. If your • Shortness of breath doctor decides you need to be in the hospital, you will receive more information on what to expect with • Chest pain or pain with breathing hospital care. -
Scarlet Fever Fact Sheet
Scarlet Fever Fact Sheet Scarlet fever is a rash illness caused by a bacterium called Group A Streptococcus (GAS) The disease most commonly occurs with GAS pharyngitis (“strep throat”) [See also Strep Throat fact sheet]. Scarlet fever can occur at any age, but it is most frequent among school-aged children. Symptoms usually start 1 to 5 days after exposure and include: . Sandpaper-like rash, most often on the neck, chest, elbows, and on inner surfaces of the thighs . High fever . Sore throat . Red tongue . Tender and swollen neck glands . Sometimes nausea and vomiting Scarlet fever is usually spread from person to person by direct contact The strep bacterium is found in the nose and/or throat of persons with strep throat, and can be spread to the next person through the air with sneezing or coughing. People with scarlet fever can spread the disease to others until 24 hours after treatment. Treatment of scarlet fever is important Persons with scarlet fever can be treated with antibiotics. Treatment is important to prevent serious complications such as rheumatic fever and kidney disease. Infected children should be excluded from child care or school until 24 hours after starting treatment. Scarlet fever and strep throat can be prevented . Cover the mouth when coughing or sneezing. Wash hands after wiping or blowing nose, coughing, and sneezing. Wash hands before preparing food. See your doctor if you or your child have symptoms of scarlet fever. Maryland Department of Health Infectious Disease Epidemiology and Outbreak Response Bureau Prevention and Health Promotion Administration Web: http://health.maryland.gov February 2013 . -
Association Between Carriage of Streptococcus Pneumoniae and Staphylococcus Aureus in Children
BRIEF REPORT Association Between Carriage of Streptococcus pneumoniae and Staphylococcus aureus in Children Gili Regev-Yochay, MD Context Widespread pneumococcal conjugate vaccination may bring about epidemio- Ron Dagan, MD logic changes in upper respiratory tract flora of children. Of particular significance may Meir Raz, MD be an interaction between Streptococcus pneumoniae and Staphylococcus aureus, in view of the recent emergence of community-acquired methicillin-resistant S aureus. Yehuda Carmeli, MD, MPH Objective To examine the prevalence and risk factors of carriage of S pneumoniae Bracha Shainberg, PhD and S aureus in the prevaccination era in young children. Estela Derazne, MSc Design, Setting, and Patients Cross-sectional surveillance study of nasopharyn- geal carriage of S pneumoniae and nasal carriage of S aureus by 790 children aged 40 Galia Rahav, MD months or younger seen at primary care clinics in central Israel during February 2002. Ethan Rubinstein, MD Main Outcome Measures Carriage rates of S pneumoniae (by serotype) and S aureus; risk factors associated with carriage of each pathogen. TREPTOCOCCUS PNEUMONIAE AND Results Among 790 children screened, 43% carried S pneumoniae and 10% car- Staphylococcus aureus are com- ried S aureus. Staphylococcus aureus carriage among S pneumoniae carriers was 6.5% mon inhabitants of the upper vs 12.9% in S pneumoniae noncarriers. Streptococcus pneumoniae carriage among respiratory tract in children and S aureus carriers was 27.5% vs 44.8% in S aureus noncarriers. Only 2.8% carried both Sare responsible for common infec- pathogens concomitantly vs 4.3% expected dual carriage (P=.03). Risk factors for tions. Carriage of S aureus and S pneu- S pneumoniae carriage (attending day care, having young siblings, and age older than moniae can result in bacterial spread and 3 months) were negatively associated with S aureus carriage. -
Universidade Do Algarve Investigation of Listeria Monocytogenes And
Universidade do Algarve Investigation of Listeria monocytogenes and Streptococcus pneumoniae mutants in in vivo models of infection Ana Raquel Chaves Mendes de Alves Porfírio Dissertação para a obtenção do Grau de Mestrado em Engenharia Biológica Tese orientada pelo Prof. Dr. Peter W. Andrew e coorientada pela Prof. Dr. Maria Leonor Faleiro 2015 I Investigation of Streptococcus pneumoniae and Listeria monocytogenes mutants in in vivo models of infection Declaro ser a autora deste trabalho, que é original e inédito. Autores e trabalhos consultados estão devidamente citados no texto e constam na listagem de referências incluída. Copyright © 2015, por Ana Raquel Chaves Mendes de Alves Porfírio A Universidade do Algarve tem o direito, perpétuo e sem limites geográficos, de arquivar e publicitar este trabalho através de exemplares impressos reproduzidos em papel ou de forma digital, ou por qualquer outro meio conhecido ou que venha a ser inventado, de o divulgar através de repositórios científicos e de admitir a sua copia e distribuição com objetivos educacionais ou de investigação, não comerciais, desde que seja dado crédito ao autor e editor. II “I was taight that the way of progress was neither swift nor easy” – Marie Curie III Acknowledgements First of all I would like to thank the University of Algarve and the University of Leicester for providing me with the amazing opportunity of doing my dissertation project abroad. I wish to particularly express my deepest gratitude to my supervisors Prof. Peter Andrew and Prof. Maria Leonor Faleiro for their continuous guidance and support throughout this project. Their useful insight and feedback was thoroughly appreciated. -
Obliterative Bronchiolitis, Cryptogenic Organising Pneumonitis and Bronchiolitis Obliterans Organizing Pneumonia: Three Names for Two Different Conditions
Eur Reaplr J EDITORIAL 1991, 4, 774-775 Obliterative bronchiolitis, cryptogenic organising pneumonitis and bronchiolitis obliterans organizing pneumonia: three names for two different conditions R.M. du Bois, O.M. Geddes Over the last five years, increasing confusion has has been applied to conditions in which airflow obstruc developed over the use of the terms "bronchiolitis tion is prominent and in which response to treatment is obliterans" and "bronchiolitis obliterans organizing poor. pneumonia". The confusion stems largely from the common use of the term "bronchiolitis obliterans" or "obliterative bronchiolitis" in the diagnostic labels applied "Cryptogenic organizing pneumonitis" or "bronchi· to two entities which are quite distinct clinically but which otitis obliterans organizing pneumonia" (BOOP) bear certain resemblances histologically. Cryptogenic organizing pneumonitis was first described by DAVISON et al. [7] in 1983. The clinical syndrome ObUterative bronchiolitis consisted of breathlessness, malaise, fever, high erythrocyte sedimentation rate (ESR), pneumonic In 1977, GEODES et al. [1] reported the case histories shadowing on chest radiograph with a restrictive of six patients whose clinical condition was characterized pulmonary function defect and low gas transfer coeffi by airways obliteration in association with rheumatoid cient. On histological examination of lung biopsy mate· arthritis. The striking clinical features were of rapidly rial, the typical and distinguishing feature was the progressive breathlessness and the fmding on examination presence of connective tissue within the alveoli, alveolar of a high-pitched mid-inspiratory squeak heard over the ducts and, occasionally, in respiratory bronchioles. This lung fields. Chest radiographs showed hyperinflated lungs connective tissue consisted of "loosely woven fibres of but were otherwise normal. -
Chapter 11 – PROKARYOTES: Survey of the Bacteria & Archaea
Chapter 11 – PROKARYOTES: Survey of the Bacteria & Archaea 1. The Bacteria 2. The Archaea Important Metabolic Terms Oxygen tolerance/usage: aerobic – requires or can use oxygen (O2) anaerobic – does not require or cannot tolerate O2 Energy usage: autotroph – uses CO2 as a carbon source • photoautotroph – uses light as an energy source • chemoautotroph – gets energy from inorganic mol. heterotroph – requires an organic carbon source • chemoheterotroph – gets energy & carbon from organic molecules …more Important Terms Facultative vs Obligate: facultative – “able to, but not requiring” e.g. • facultative anaerobes – can survive w/ or w/o O2 obligate – “absolutely requires” e.g. • obligate anaerobes – cannot tolerate O2 • obligate intracellular parasite – can only survive within a host cell The 2 Prokaryotic Domains Overview of the Bacterial Domain We will look at examples from several bacterial phyla grouped largely based on rRNA (ribotyping): Gram+ bacteria • Firmicutes (low G+C), Actinobacteria (high G+C) Proteobacteria (Gram- heterotrophs mainly) Gram- nonproteobacteria (photoautotrophs) Chlamydiae (no peptidoglycan in cell walls) Spirochaetes (coiled due to axial filaments) Bacteroides (mostly anaerobic) 1. The Gram+ Bacteria Gram+ Bacteria The Gram+ bacteria are found in 2 different phyla: Firmicutes • low G+C content (usually less than 50%) • many common pathogens Actinobacteria • high G+C content (greater than 50%) • characterized by branching filaments Firmicutes Characteristics associated with this phylum: • low G+C Gram+ bacteria -
Streptococcus Pneumoniae Technical Sheet
technical sheet Streptococcus pneumoniae Classification On necropsy, a serosanguineous to purulent exudate Alpha-hemolytic, Gram-positive, encapsulated, aerobic is often found in the nasal cavities and the tympanic diplococcus bullae. The lungs can have areas of firm, dark red consolidation. Fibrinopurulent pleuritis, pericarditis, Family and peritonitis are other changes seen on necropsy of animals affected by S. pneumoniae. Histologic Streptococcaceae lesions are consistent with necropsy findings, Affected species and bronchopneumonia of varying severity and fibrinopurulent serositis are often seen. Primarily described as a pathogen of rats and guinea pigs. Mice are susceptible to infection. Agent of human Diagnosis disease and human carriers are a likely source of An S. pneumoniae infection should be suspected if animal infections. Zoonotic infection is possible. encapsulated Gram-positive diplococci are seen on a smear from a lesion. Confirmation of the diagnosis is Frequency via culture of lesions or affected tissues. S. pneumoniae Rare in modern laboratory animal colonies. Prevalence grows best on 5% blood agar and is alpha-hemolytic. in pet and wild populations unknown. The organism is then presumptively identified with an optochin test. PCR assays are also available for Transmission diagnosis. PCR-based screening for S. pneumoniae Transmission is primarily via aerosol or contact with may be conducted on respiratory samples or feces. nasal or lacrimal secretions of an infected animal. S. PCR may also be useful for confirmation of presumptive pneumoniae may be cultured from the nasopharynx and microbiologic identification or confirming the identity of tympanic bullae. bacteria observed in histologic lesions. Clinical Signs and Lesions Interference with Research Inapparent infections and carrier states are common, Animals carrying S. -
A Case of Severe Human Granulocytic Anaplasmosis in an Immunocompromised Pregnant Patient
Elmer ress Case Report J Med Cases. 2015;6(6):282-284 A Case of Severe Human Granulocytic Anaplasmosis in an Immunocompromised Pregnant Patient Marijo Aguileraa, c, Anne Marie Furusethb, Lauren Giacobbea, Katherine Jacobsa, Kirk Ramina Abstract festations include respiratory or neurologic involvement, acute renal failure, invasive opportunistic infections and a shock- Human granulocytic anaplasmosis (HGA) is a tick-borne disease that like illness [2-4]. Recent delineation of the various species can often result in persistent fevers and other non-specific symptoms associated with ehrlichia infections and an increased under- including myalgias, headache, and malaise. The incidence among en- standing of the epidemiology has augmented our knowledge of demic areas has been increasing, and clinician recognition of disease these tick-borne diseases. However, a detailed understanding symptoms has aided in the correct diagnosis and treatment of patients of HGA infections in both immunocompromised and pregnant who have been exposed. While there have been few cases reported of patients is limited. We report a case of a severe HGA infection HGA disease during pregnancy, all patients have undergone a rela- presenting as an acute exacerbation of Crohn’s disease in a tively mild disease course without complications. HGA may cause pregnant immunocompromised patient. more severe disease in the elderly and immunocompromised. Herein, we report an unusual presentation and severe disease complications of HGA in a pregnant female who was concomitantly immunocompro- Case Report mised due to azathioprine treatment of her Crohn’s disease. Follow- ing successful treatment with rifampin, she subsequently delivered a A 34-year-old primigravida at 17+2 weeks’ gestation presented healthy female infant without any disease sequelae. -
Ehrlichia, and Anaplasma Species in Australian Human-Biting Ticks
RESEARCH ARTICLE Bacterial Profiling Reveals Novel “Ca. Neoehrlichia”, Ehrlichia, and Anaplasma Species in Australian Human-Biting Ticks Alexander W. Gofton1*, Stephen Doggett2, Andrew Ratchford3, Charlotte L. Oskam1, Andrea Paparini1, Una Ryan1, Peter Irwin1* 1 Vector and Water-borne Pathogen Research Group, School of Veterinary and Life Sciences, Murdoch University, Perth, Western Australia, Australia, 2 Department of Medical Entomology, Pathology West and Institute for Clinical Pathology and Medical Research, Westmead Hospital, Westmead, New South Wales, Australia, 3 Emergency Department, Mona Vale Hospital, New South Wales, Australia * [email protected] (AWG); [email protected] (PI) Abstract OPEN ACCESS In Australia, a conclusive aetiology of Lyme disease-like illness in human patients remains Citation: Gofton AW, Doggett S, Ratchford A, Oskam elusive, despite growing numbers of people presenting with symptoms attributed to tick CL, Paparini A, Ryan U, et al. (2015) Bacterial bites. In the present study, we surveyed the microbial communities harboured by human-bit- Profiling Reveals Novel “Ca. Neoehrlichia”, Ehrlichia, ing ticks from across Australia to identify bacteria that may contribute to this syndrome. and Anaplasma Species in Australian Human-Biting Ticks. PLoS ONE 10(12): e0145449. doi:10.1371/ Universal PCR primers were used to amplify the V1-2 hyper-variable region of bacterial journal.pone.0145449 16S rRNA genes in DNA samples from individual Ixodes holocyclus (n = 279), Amblyomma Editor: Bradley S. Schneider, Metabiota, UNITED triguttatum (n = 167), Haemaphysalis bancrofti (n = 7), and H. longicornis (n = 7) ticks. STATES The 16S amplicons were sequenced on the Illumina MiSeq platform and analysed in Received: October 12, 2015 USEARCH, QIIME, and BLAST to assign genus and species-level taxonomies.