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Staphylococcus aureus has acquired resistance to antibiotics since their first use. The S. aureus protein NorA, an efflux pump belonging to the major facilitator superfamily (MFS), contributes to resistance to fluoroquinolones (e.g., ciprofloxacin), biocides, dyes, quaternary ammonium compounds, and antiseptics. Different compounds have been identified as potential efflux pump inhibitors (EPIs) of NorA that result in increased intracellular concentration of antibiotics, restoring their antibacterial activity and cell susceptibility. However, none of the currently known EPIs have been approved for clinical use, probably due to their toxicity profiles. In the present study, we screened approved drugs for possible efflux pump inhibition. By screening a compound library of approximately 1200 different drugs, we identified nilotinib, a tyrosine kinase inhibitor, as showing the best efflux pump inhibitory activity, with a fractional inhibitory concentration index of 0.1875, indicating synergism with ciprofloxacin, and a minimum effective concentration as low as 0.195 μM. Moreover, at 0.39 μM, nilotinib, in combination with 8 μg/mL of ciprofloxacin, led to a significant reduction in biofilm formation and preformed mature biofilms. This is the first description of an approved drug that can be used as an efflux pump inhibitor and to reduce biofilms formation at clinically achievable concentrations.
Infektionen des Zentralnervensystems (ZNS) können durch unterschiedliche Erreger verursacht werden, wobei Viren das Hauptpotential bilden. Bei der Abklärung der Ätiologie von Infektionen des ZNS nimmt die Labordiagnostik eine zentrale Rolle ein. Die Kenntnis des ätiologischen Agents ist von hoher prognostischer und therapeutischer Relevanz und für die Optimierung des Patientenmanagements bedeutend. Es wurden molekularbiologische Methoden zur Identifizierung und Charakterisierung ZNS-assoziierter Viren etabliert und zur Gewinnung aktueller Prävalenzdaten eingesetzt. Enteroviren (EV) waren mit 21,8% das häufigste Pathogen, gefolgt von Adenoviren. HSV und VZV spielten nur eine untergeordnete Rolle. Eine Bedeutung von West Nil-Virus bei ZNS-Infektionen in der Region Vorpommern konnte ausgeschlossen werden. Die genotypische Charakterisierung zirkulierender Stämme zeigte für EV Cluster mit hoher Homologie zur Gruppe der Coxsackie B-Viren. Weiterhin wurden Vertreter von Coxsackievirus A und von Echovirus identifiziert. Isolierte EV-Stämme wiesen gegenüber Pleconaril eine hohe Empfindlichkeit auf. Ein unerwartet hoher Anteil wurde für Adenoviren gefunden. Die identifizierten Serotypen waren ADV-2, ADV-5 und ADV-41. Untersuchungen zum Proteinprofil EV-infizierter Zellen zeigten signifikante Veränderungen in der Expression für Proteine des Zytoskeletts, für Bestandteile von metabolischen Prozessen und für Proteine, die in Signal- und Transportprozesse sowie die Stress-Abwehr involviert sind und bieten Ansätze für die Entwicklung neuer therapeutischer Strategien.
Fruktoselysin-spezifische Rezeptoren auf Zellmembranen von Monozyten und Makrophagen binden Amadori-modifizierte Proteine. Die Ligandenbindung führt zu Endozytose und Degradation der gebundenen Proteine sowie zur Produktion proinflammatorischer Zytokine. HL-60 und THP-l sind Vorläuferzellen reifer Monozyten, welche ebenfalls Fruktoselysin-Rezeptoren exprimieren. Affinitätschromatographisch wurden zwei Proteinfraktionen mit molekularen Massen von 100 und 200 kDa isoliert und als Homologe zu Nukleolin und der schweren Kette zellulären Myosins identifiziert. Die membrangebundenen Proteine sind im Gegensatz zu den nukleären bzw. zytosolischen Formen glykosyliert. Entsprechende Rezeptorproteine wurden bereits auf Zellmembranen der monozytären Zelllinien MonoMac 6 und U937 nachgewiesen. Somit werden Fruktoselysin-spezifische Bindungsproteine bereits auf Vorläuferzellen reifer Monozyten exprimiert.
Introduction: The environmental bacterium Burkholderia pseudomallei causes the often fatal and massively underreported infectious disease melioidosis. Antigens inducing protective immunity in experimental models have recently been identified and serodiagnostic tools have been improved. However, further elucidation of the antigenic repertoire of B. pseudomallei during human infection for diagnostic and vaccine purposes is required. The adaptation of B. pseudomallei to very different habitats is reflected by a huge genome and a selective transcriptional response to a variety of conditions. We, therefore, hypothesized that exposure of B. pseudomallei to culture conditions mimicking habitats encountered in the human host might unravel novel antigens that are recognized by melioidosis patients.
Methods and results: In this study, B. pseudomallei was exposed to various stress and growth conditions, including anaerobiosis, acid stress, oxidative stress, iron starvation and osmotic stress. Immunogenic proteins were identified by probing two-dimensional Western blots of B. pseudomallei intracellular and extracellular protein extracts with sera from melioidosis patients and controls and subsequent MALDI-TOF MS. Among B. pseudomallei specific immunogenic signals, 90 % (55/61) of extracellular immunogenic proteins were identified by acid, osmotic or oxidative stress. A total of 84 % (44/52) of intracellular antigens originated from the stationary growth phase, acidic, oxidative and anaerobic conditions. The majority of the extracellular and intracellular protein antigens were identified in only one of the various stress conditions. Sixty-three immunoreactive proteins and an additional 38 candidates from a literature screening were heterologously expressed and subjected to dot blot analysis using melioidosis sera and controls. Our experiments confirmed melioidosis-specific signals in 58 of our immunoproteome candidates. These include 15 antigens with average signal ratios (melioidosis:controls) greater than 10 and another 26 with average ratios greater than 5, including new promising serodiagnostic candidates with a very high signal-to-noise ratio.
Conclusion: Our study shows that a comprehensive B. pseudomallei immunoproteomics approach, using conditions which are likely to be encountered during infection, can identify novel antibody targets previously unrecognized in human melioidosis.
Analysis of volatile organic compounds (VOCs) is a novel approach to accelerate bacterial culture diagnostics of Mycobacterium avium subsp. paratuberculosis (MAP). In the present study, cultures of fecal and tissue samples from MAP-infected and non-suspect dairy cattle and goats were explored to elucidate the effects of sample matrix and of animal species on VOC emissions during bacterial cultivation and to identify early markers for bacterial growth. The samples were processed following standard laboratory procedures, culture tubes were incubated for different time periods. Headspace volume of the tubes was sampled by needle trap-micro-extraction, and analyzed by gas chromatography-mass spectrometry. Analysis of MAP-specific VOC emissions considered potential characteristic VOC patterns. To address variation of the patterns, a flexible and robust machine learning workflow was set up, based on random forest classifiers, and comprising three steps: variable selection, parameter optimization, and classification. Only a few substances originated either from a certain matrix or could be assigned to one animal species. These additional emissions were not considered informative by the variable selection procedure. Classification accuracy of MAP-positive and negative cultures of bovine feces was 0.98 and of caprine feces 0.88, respectively. Six compounds indicating MAP presence were selected in all four settings (cattle vs. goat, feces vs. tissue): 2-Methyl-1-propanol, 2-methyl-1-butanol, 3-methyl-1-butanol, heptanal, isoprene, and 2-heptanone. Classification accuracies for MAP growth-scores ranged from 0.82 for goat tissue to 0.89 for cattle feces. Misclassification occurred predominantly between related scores. Seventeen compounds indicating MAP growth were selected in all four settings, including the 6 compounds indicating MAP presence. The concentration levels of 2,3,5-trimethylfuran, 2-pentylfuran, 1-propanol, and 1-hexanol were indicative for MAP cultures before visible growth was apparent. Thus, very accurate classification of the VOC samples was achieved and the potential of VOC analysis to detect bacterial growth before colonies become visible was confirmed. These results indicate that diagnosis of paratuberculosis can be optimized by monitoring VOC emissions of bacterial cultures. Further validation studies are needed to increase the robustness of indicative VOC patterns for early MAP growth as a pre-requisite for the development of VOC-based diagnostic analysis systems.
The worldwide distribution and prevalence of melioidosis, an infectious disease caused by the soil-dwelling Gram-negative bacterium Burkholderia pseudomallei, is unknown. In Vietnam, sporadic cases of melioidosis have been reported for decades, but clinical and epidemiological data for the indigenous population are still scarce. In this study, we reviewed clinical and demographic data of patients with culture-proven melioidosis diagnosed at a single large referral hospital in Hanoi between November 1997 and December 2005. The clinical manifestations of melioidosis with fatal septicaemia as the most common presentation, a high rate of underlying diseases and a peak of cases admitted during the wet season were similar to studies from other endemic areas. The geographical origin of melioidosis patients shows that melioidosis exists in at least 18 northern provinces. The characterization of clinical B. pseudomallei strains by multilocus sequence typing identified 17 different sequence types (STs), ten of which have (as yet) not been found outside Vietnam. Several of these STs presumably were generated through recent evolutionary events in this rapidly diversifying bacterial species, and thus restricted geographic distribution may be a consequence of limited time passed since emergence. In order to define the distribution of the bacterium in the environment, our study also aimed to develop a more sensitive culture method for the detection of B. pseudomallei from soil samples in endemic areas compared to the currently used culture method based on soil dispersion in water. Our newly developed protocol involving soil dispersion in a polyethylene glycol and sodium deoxycholate solution increased the yield of viable B. pseudomallei from soil samples. Comparative testing of soil samples from Northeast Thailand covering a wide range of B. pseudomallei concentrations demonstrated a significantly higher recovery (p < 0.0001) of B. pseudomallei colony forming units by the new method compared to the conventional method. Our data indicate that using the detergents polyethylene glycol and sodium deoxycholate not only results in a higher recovery of viable B. pseudomallei, but also results in a shift in the bacterial species recovered from soil samples. Molecular methods based on direct bacterial nucleic acid extraction from environmental samples and subsequent amplification have the potential to overcome many restrictions of traditional microbiological approaches. Moreover, culture-dependent methods require special expertise in recognizing B. pseudomallei colony morphologies. Thus, a highly sensitive culture-independent DNA-based method that allows direct quantification of B. pseudomallei from soil is needed, particularly in diagnostic laboratories outside endemic areas. We therefore aimed to establish a protocol for B. pseudomallei soil DNA isolation, purification and quantification by qPCR targeting a type three secretion system 1 single copy gene. This assay was validated using 40 soil samples from Northeast Thailand that underwent parallel bacteriological culture. All 26 samples that were B. pseudomallei-positive by direct culture were B. pseudomallei qPCR-positive, with a median of 1.84 x 104 genome equivalents (range 3.65 x 102 to 7.85 x 105) per gram of soil. This was 10.6 fold (geometric mean; range 1.1 to 151.3) higher than the bacterial count as defined by culture. Moreover, the qPCR detected B. pseudomallei in seven samples (median 36.9 genome equivalents per g soil; range 9.4 to 47.3), which were negative on direct culture. These seven positives were reproduced using a nested PCR targeting a second, independent B. pseudomallei-specific sequence. Two samples were direct culture and qPCR negative but nested PCR positive. Five samples were negative by both PCR methods and culture. In conclusion, this is the first report on a series of cases describing clinical and epidemiological features of melioidosis and corresponding Burkholderia pseudomallei strains from northern Vietnam. Moreover, our newly developed culture-based and PCR-based methods provide highly specific and sensitive tools for the quantitative environmental surveillance of B. pseudomallei.
Infektionserkrankungen können im Wirt oxidativen Stress hervorrufen, da dieser zur gezielten Abwehr von Mikroorganismen mithilfe bestimmter Immunzellen erhebliche Mengen an reaktiven Sauerstoff- und Stickstoffspezies produziert. Dabei wird v. a. der Aktivität der NADPH-Oxidase, und weniger der induzierbaren NO-Synthase, eine wichtige Rolle bei der Eliminierung von B. pseudomallei zugeschrieben (Utaisincharoen et al. 2001; Breitbach et al. 2006), was sich wiederum toxisch auf körpereigenes Gewebe auswirken kann. Unter diesen Umständen ist ein gut funktionierendes, antioxidatives Schutzsystem der Zellen von essentieller Bedeutung. In dem Zusammenhang sollte zum einen die antioxidative Funktion des Transkriptionsfaktors Nrf2, und zum anderen die Bedeutung des Glutathion-Redoxsystems bei Infektionen mit dem Gram-negativen, fakultativ intrazellulären Erreger der Melioidose, Burkholderia pseudomallei, geklärt werden. In der vorliegenden Arbeit konnte gezeigt werden, dass die Infektion von Makrophagen und Hepatomzellen mit B. pseudomallei zur nukleären Translokation von Nrf2 und somit dessen Aktivierung beiträgt. Die infektionsbedingte Induktion von Nrf2 auf Genexpressionsebene wurde in Makrophagen, jedoch nicht in Hepatomzellen, festgestellt. Darüber hinaus wurde die Genexpression des Transkriptionsfaktors in den Organen von infizierten C57BL/6-Mäusen unterschiedlich reguliert. Die Anwesenheit von Nrf2 in Nrf2+/+-Makrophagen bzw. die Aktivierung von Nrf2 durch Stimulatoren verbesserten das intrazelluläre Überleben von B. pseudomallei in den Immunzellen, wohingegen in infizierten Hepatomzellen das Replikationsvermögen des Pathogens durch Nrf2 eingeschränkt wurde. In vitro-Infektionsversuche mit anderen Bakterien wiesen zudem auf einen Erreger-spezifischen Einfluss von Nrf2 hin. Des Weiteren war die proinflammatorische Antwort von Makrophagen durch Nrf2 tendenziell, aber nicht signifikant, erhöht. Im pulmonalen in vivo-Infektionsmodell hatte Nrf2 weder einen Einfluss auf das Wachstum von B. pseudomallei in Leber, Lunge und Milz infizierter Tiere, noch auf die Sekretion inflammatorischer Mediatoren im Serum. Die Ergebnisse deuten darauf hin, dass Nrf2 weniger durch die Modulation der proinflammatorischen Immunantwort, als vielmehr durch die Regulation ARE-abhängiger, antioxidativer Proteine unterschiedlich auf die mikrobielle Abwehr in vitro und in vivo einwirkt. Im zweiten Teil der Arbeit sollte daher die Rolle von Glutathion (GSH) und den an seiner Biosynthese bzw. Regeneration beteiligten Enzymen, Glutamatcysteinligase (Gcl) sowie Glutathionreduktase (Gsr), bei der Infektion mit B. pseudomallei untersucht werden. Es konnte nachgewiesen werden, dass die Genexpression der Gcl und Gsr in Abhängigkeit von der infektionsbedingten Nrf2-Induktion durch B. pseudomallei in Makrophagen erhöht war, wohingegen die Enzyme in den Organen infizierter Mäuse unterschiedlich induziert wurden. Die Inhibition der Gcl führte sowohl in Makrophagen als auch in Hepatomzellen zu einer Reduktion des intrazellulären Gesamt-GSH-Gehaltes, was sich jedoch unterschiedlich auf das Wachstumverhalten von B. pseudomallei in den jeweiligen Zellen auswirkte. Die eingeschränkte GSH-Biosynthese verbesserte zum einen die Pathogenkontrolle in den Makrophagen und im Mausmodell, begünstigte jedoch zum anderen die Replikation des Erregers in Hepatomzellen. Die Hemmung der Regeneration von GSH aus GSSG führte ebenfalls zu zelltypabhängigen, kontroversen Ergebnissen. Einerseits wirkten sich die Inhibition der Gsr und der damit verbundene GSH-Mangel positiv auf das Überleben von B. pseudomallei in Makrophagen aus. Andererseits führte die Gsr-Inhibition in Hepatomzellen zu einem Anstieg des intrazellulären GSH-Gehaltes, was sich in reduzierten Keimzahlen äußerte. Wurde GSH direkt mithilfe eines bestimmten Konjugationspartners, der aber auch für seine Nrf2-induzierende Wirkung bekannt ist, depletiert, so wurde das bakterielle Wachstum in beiden Zelltypen und in den Organen von Mäusen begünstigt. Da der GSH-Gehalt in unseren Infektionsmodellen keinen signifikanten Einfluss auf proinflammatorische Mediatoren hatte, ist anzunehmen, dass die wirtsvermittelten Immunmechanismen eine untergeordnete Rolle bei der Pathogenkontrolle spielen. Die Ergebnisse der vorliegenden Arbeit bestätigen die in der Literatur bereits kontrovers beschriebenen Funktionen von Nrf2 und GSH bei mikrobiellen Infektionen. Es ist anzunehmen, dass sowohl der Nrf2-Signalweg als auch die Nrf2-abhängige Regulation des GSH-Stoffwechsels vorwiegend dem Schutz der Wirtszelle dienen, indem sie das durch eine Infektion hervorgerufene, gestörte Gleichgewicht zwischen ROS und Antioxidantien wiederherstellen. Jedoch konnte auch gezeigt werden, dass beide Faktoren unter bestimmten Bedingungen zugunsten des bakteriellen Wachstums genutzt werden können, indem das Pathogen die Schutzmechanismen des Wirtes umgeht.