scholarly journals Coinfection of the intestinal tract with Aeromonas hydrophila, Clostridium difficile and Rotavirus - a case report

Folia Medica ◽  
2021 ◽  
Vol 63 (4) ◽  
pp. 576-581
Author(s):  
Petar Vasilev ◽  
Mariya Ivanovska ◽  
Gergana Lengerova ◽  
Atanaska Petrova ◽  
Eli Hristozova ◽  
...  
Keyword(s):  
Aeromonas Hydrophila ◽  
Favourable Outcome ◽  
Molecular Test ◽  
Good Communication ◽  
Rotavirus A ◽  
Severe Diarrhea ◽  
Clostridioides Difficile ◽  
Stool Cultures ◽  
Positive Results ◽  
Infectious Etiology

Most cases of acute diarrhea in adults are of infectious etiology, likely viral and self-limited. Among those with severe diarrhea, however, bacterial causes are responsible for most cases. Apart from the standard stool cultures, to increase the positive yield a novel multiplex molecular test can be performed simultaneously. The authors present a patient with recurrent diarrhea and detection of Aeromonas hydrophila by culturing and Rotavirus and Clostridioides difficile by multiplex molecular test. They discuss and justify which is the most likely actionable pathogen. Good communication between the physicians and interpretation on the multiple positive results in the context of clinical picture and the test employed were important for a better management and favourable outcome of the patient.

scholarly journals Genotypic detection of some virulence factors among Aeromonas hydrophila Isolated from Diarrhea Cases (Iraq)

2018 ◽  
Vol 9 (SPL1) ◽  
Author(s):  
Ilham A Bunyan ◽  
Israa K Obais
Keyword(s):  
Virulence Factors ◽  
Aeromonas Hydrophila ◽  
Molecular Detection ◽  
Virulence Gene ◽  
Molecular Study ◽  
Protease Gene ◽  
Allelic Ladder ◽  
Specific Pcr ◽  
Molecular Length ◽  
Positive Results

The present study included the detection ofsome virulence factorsof Aeromonas hydrophila under molecular level to clinical isolates were taken from patients suffering from diarrhea during the period from July (2017) to October (2017). Molecular detection of Hemolysin gene (ahh) was done for all isolates. The results showed that all isolates (100%) gave positive results for this virulence gene. the positive results were detected by the presence of (130) bp bands when compared with allelic ladder. The genomic DNA of the samples was extracted and bands were observed by performing agarose gel electrophoresis. When PCR was performed,results clearly indicate that all isolated organisms contained serine protease gene and all the amplified products produced a band at the level of (900 bp) when compared with the allelic ladder. Molecular detection of this gene was carried out by using a specific PCR primer were done by comparison with allelic ladder which gave a (309bp) It was found that (Aerolysin) gene present in (12) (75%) of the positive samples. Lip gene was also detected in A. hydrophila samples and found that all 16 samples (100%) gave positive results to this gene which gave molecular length (382) bp. Molecular study was carried out to show the sequence identity of cytotonic enterotoxins gene in Aeromonas spp. to that in A. hydrophila. Analysis of the A. hydrophila genome revealed a number of a putative virulence factors,including a gene that heat-labile cytotonic enterotoxin (alt). Our study showed that all (16) isolates (100%) gave positive results to this gene,which gave molecular length (442)bp. Molecular detection of cytotonic enterotoxins gene (ast) was done for (16) A. hydrophila isolates and the results showed that all isolates have this gene (100%). The positive results for (ast) virulence were detected by the presence of (331) bp band compared with allelic ladder.

scholarly journals Significance of a polymerase chain reaction method in the detection of Clostridioides difficile

2021 ◽  
Vol 34 (2) ◽  
pp. 141-144
Author(s):  
Jerónimo Jaqueti Aroca ◽  
Laura M. Molina Esteban ◽  
Isabel García-Arata ◽  
Jesús García-Martínez ◽  
Isabel Cano De Torres ◽  
...  
Keyword(s):  
Polymerase Chain Reaction ◽  
Rapid Test ◽  
Polymerase Chain Reaction Method ◽  
Nucleic Acid Amplification ◽  
Confirmatory Test ◽  
Chain Reaction ◽  
Clostridioides Difficile ◽  
Toxigenic Culture ◽  
Polymerase Chain ◽  
Positive Results

Objectives. Clostridioides difficile (CD) is the most common cause of nosocomial diarrhea. Detection of CD toxin in patients’ faecal samples is the traditional rapid method for the diagnosis of CD infection. Various testing algorithms have been proposed: an initial screening test using a rapid test, and a confirmatory test (cytotoxicity neutralization assay, toxigenic culture, nucleic acid amplification test) for discordant results. The aim of this study was to evaluate the effectiveness of a two-step algorithm using an immunochromatographic test followed of a polymerase chain reaction (PCR). Material and methods. The specimens have been tested according to the following schedule: 1) Step one: All samples were tested for detection of glutamate dehydrogenase antigen (GDH) and toxin A/B using the C. diff QUIK CHEK Complete test. All GDH and toxins positive results were considered CD positives; 2) Step two: When the results were discrepant (only GDH+ or toxins+), the samples were confirmed using the PCR test BD MAX Cdiff. All PCR positive results were considered CD positives. Results. A total of 2,138 specimens were initially tested. 139 were positive for GDH and toxins. 160 discrepant results (148 GDH+ and 12 toxins+) were tested by PCR, 117 were positive (107/148 GDH+ and 10/12 toxins+). Conclusions. The implementation of a PCR method showed an increase de 117 positive results (73.1% of discrepant). Considering the sensitivity of C.diff QUIK CHEK (instructions of manufacturer), the GDH discrepant results may be false negatives, y the samples PCR and toxins positives may be real positives results.

scholarly journals Correlation between prevalence of selected enteropathogens and diarrhea in children: a case-control study in China

2021 ◽  
Author(s):  
Zheng Huang ◽  
Zixiang He ◽  
Zhongqiu Wei ◽  
Wei Wang ◽  
Zhenpeng Li ◽  
...  
Keyword(s):  
Real Time ◽  
Clinical Significance ◽  
Detection Methods ◽  
Nucleic Acid Detection ◽  
Rotavirus A ◽  
Reverse Transcription Pcr ◽  
Polymerase Chain ◽  
Norovirus Gii ◽  
Positive Results ◽  
Control Study

Abstract Background The application of nucleic acid detection methods improves the ability of laboratories to detect diarrheal pathogens, but it also poses new challenges for the interpretation of the results. It is often difficult to attribute a diarrhea episode to the detected pathogens. Here we investigated the prevalence of 19 enteropathogens among diarrheal and non-diarrheal children and provided support for understanding the clinical significance of the pathogens. Methods A total of 710 fecal samples were collected from children under 5 years old in two different regions of China from May 2017 to March 2018, comprising 383 mild to moderate diarrheal cases and 327 non-diarrheal controls. The enteropathogens were detected using real-time polymerase chain reaction (PCR) or real-time reverse transcription PCR (RT-PCR). Results Enteropathogens were detected in 68.9% of the cases and 41.3% of the controls. Rotavirus A (adjusted OR [aOR], 9.91; 95% CI, 4.99–19.67), norovirus GI and GII (aOR, 3.82; 95% CI, 2.12–6.89), and Campylobacter jejuni (aOR, 20.12; 95% CI, 2.57–157.38) were significantly associated with diarrhea (p < 0.05). Adenovirus, norovirus GII, rotavirus A, and enteroaggregative Escherichia coli (pCVD432) gave lower cycle threshold (Ct) values in the cases than in the controls (p < 0.05). Rotavirus A and norovirus GII were associated with diarrhea when the Ct value were ≤ 30 and ≤ 25, respectively. Conclusions The types and loads of enteropathogens are likely to influence the interpretation of the clinical significance of positive results.

Plakoglobin and HMGB1 mediate intestinal epithelial cell apoptosis induced by Clostridioides difficile TcdB

2021 ◽  
Author(s):  
Yingxue Li ◽  
Wei Xu ◽  
Yutian Ren ◽  
Hung-Chi Cheung ◽  
Panpan Huang ◽  
...  
Keyword(s):  
Cell Death ◽  
Epithelial Cell ◽  
Cell Apoptosis ◽  
Cultured Cells ◽  
High Mobility ◽  
Host Factors ◽  
Loop Model ◽  
Severe Diarrhea ◽  
Clostridioides Difficile ◽  
Epithelial Cell Apoptosis

Clostridioides difficile infection (CDI) is the leading cause of antibiotic-associated intestinal disease, resulting in severe diarrhea and fatal pseudomembranous colitis. TcdB, one of the essential virulence factors secreted by this bacterium, induces host cell apoptosis through a poorly understood mechanism. Here, we performed an RNAi screen customized to Caco-2 cells, a cell line model of the intestinal epithelium, to discover host factors involved in TcdB-induced apoptosis. We identified plakoglobin, also known as junction plakoglobin (JUP) or γ-catenin, a member of the catenin family, as a novel host factor, and a previously known cell death-related chromatin factor, high mobility group box 1 (HMGB1). Disruption of those host factors by RNAi and CRISPR resulted in resistance of cells to TcdB-mediated and mitochondria-dependent apoptosis. JUP was redistributed from adherens junctions to the mitochondria and colocalized with Bcl-XL after stimulation by TcdB, suggesting a role of JUP in cell death signaling through mitochondria. Treatment with glycyrrhizin, an HMGB1 inhibitor, resulted in significantly increased resistance to TcdB-induced epithelial damage in cultured cells and a mouse ligated colon loop model. These findings demonstrate the critical roles of JUP and HMGB1 in TcdB-induced epithelial cell apoptosis.

scholarly journals Mapping Epitopes of a Novel Peptidoglycan Cross-Linking Enzyme Cwp22 Recognized by Human Sera Obtained from Patients with Clostridioides difficile Infection and Cord Blood

2019 ◽  
Vol 7 (11) ◽  
pp. 565 ◽  
Author(s):  
Razim ◽  
Pacyga ◽  
Martirosian ◽  
Szuba ◽  
Gamian ◽  
...  
Keyword(s):  
Cord Blood ◽  
Umbilical Cord ◽  
Umbilical Cord Blood ◽  
Cross Linking ◽  
Patient Death ◽  
Ongoing Research ◽  
Severe Diarrhea ◽  
Clostridioides Difficile ◽  
Human Sera ◽  
Umbilical Cord Blood Serum

Clostridioides difficile (CD) cause a severe diarrhea which can lead to pseudomembranous colitis and even patient death. CD infection (CDI) is connected mainly with changes in intestinal microbiota as a consequence of antibiotic treatment. The growing resistance to antibiotics, justifies the search for new methods of combating CD. Despite of ongoing research on the immunity against the pathogen, there is still lack of any reliable vaccine. Most recently, Cwp22, that is a cross-linking enzyme involved in the production of CD peptidoglycan, seems to be a promising target to prevent CDI in high-risk patients. In this paper, the Cwp22 protein polypeptide-specific epitopes were mapped in silico and using PEPSCAN procedure. They were recognized not only by antibodies from CDI patients’ but also by umbilical cord blood sera. We identified three epitopes 54EFRVAT59, 201KVNGKM206 and 268WQEKNGKKYY277 of Cwp22 protein. Since Cwp22 protein has key functionality and the described above epitopes are also recognized by umbilical cord blood serum, we postulate that they could have important protective properties. In this paper, we propose Cwp22 protein as a good antigen candidate for CDI preventive vaccine. Our results open the possibility to use 54EFRVAT59, 201KVNGKM206 and 268WQEKNGKKYY277, epitopes as suitable anti-CD vaccine antigens.

scholarly journals Aeromonas hydrophila in acute diarrheal disease: detection of enterotoxin and biotyping of strains

1977 ◽  
Vol 6 (2) ◽  
pp. 96-100
Author(s):  
A Ljungh ◽  
M Popoff ◽  
T Wadstrom
Keyword(s):  
Aeromonas Hydrophila ◽  
Diarrheal Disease ◽  
Test System ◽  
Aeromonas Species ◽  
Biochemical Profile ◽  
Single Test ◽  
Rabbit Skin ◽  
Conventional Test ◽  
Stool Cultures ◽  
Human Stool

Eleven isolates of Aeromonas species from human stool cultures were found to produce enterotoxin activity as determined by assay of culture filtrates in rabbit intestinal loops and rabbit skin and on adrenal Y1 cells. Hemolysin(s) and a cytotoxic protein were found to interfere in all three assay systems but could be inactivated upon heating at 56 degrees C or by specific antihemolysin. Biotyping of each isolate was performed with a conventional test system and with API 50E and APIZYM kit systems (Analytab, Inc.). No single test of the more than 70 biochemical reactions investigated was found to correlate with enterotoxigenicity in the strains of Aeromonas hydrophila examined. All strains were found to belong to ideal phenotypes of A. hydrophila, but each strain possessed its own biochemical profile.

scholarly journals Outbreaks of Typhlocolitis Caused by Hypervirulent Group ST1 Clostridioides difficile in Highly Immunocompromised Strains of Mice

2020 ◽  
Vol 70 (3) ◽  
pp. 277-290
Author(s):  
Kathleen G L Ma ◽  
Kvin Lertpiriyapong ◽  
Alessandra Piersigilli ◽  
Irina Dobtsis ◽  
Juliette R K Wipf ◽  
...  
Keyword(s):  
Clinical Signs ◽  
Genomic Analysis ◽  
Intestinal Content ◽  
Clinical Disease ◽  
Breeding Colony ◽  
Severe Diarrhea ◽  
Clostridioides Difficile ◽  
Naturally Occurring ◽  
Clinical Syndromes ◽  
Immunocompromised Mice

Clostridioides difficile is an enteric pathogen that can cause significant clinical disease in both humans and animals. However, clinical disease arises most commonly after treatment with broad-spectrum antibiotics. The organism's ability to cause naturally occurring disease in mice is rare, and little is known about its clinical significance in highly immunocompromised mice. We report on 2 outbreaks of diarrhea associated with C. difficile in mice. In outbreak 1, 182 of approximately 2, 400 NOD.Cg-Prkdcscid Il2rgtm1Wjl/SzJ (NSG) and related strains of mice became clinically ill after cessation of a 14-d course of 0.12% amoxicillin feed to control an increase in clinical signs associated with Corynebacterium bovis infection. Most mice had been engrafted with human tumors; the remainder were experimentally naïve. Affected animals exhibited 1 of 3 clinical syndromes: 1) peracute death; 2) severe diarrhea leading to euthanasia or death; or 3) mild to moderate diarrhea followed by recovery. A given cage could contain both affected and unaffected mice. Outbreak 2 involved a small breeding colony (approximately 50 mice) of NOD. CB17-Prkdcscid/NCrCrl (NOD-scid) mice that had not received antibiotics or experimental manipulations. In both outbreaks, C. difficile was isolated, and toxins A and B were detected in intestinal content or feces. Histopathologic lesions highly suggestive of C. difficile enterotoxemia included fibrinonecrotizing and neutrophilic typhlocolitis with characteristic 'volcano' erosions or pseudomembrane formation. Genomic analysis of 4 isolates (3 from outbreak 1 and 1 from outbreak 2) revealed that these isolates were closely related to a pathogenic human isolate, CD 196. To our knowledge, this report is the first to describe naturally occurring outbreaks of C. difficile-associated typhlocolitis with significant morbidity and mortality in highly immunocompromised strains of mice.

scholarly journals What Are Poop Transplants and How Do They Work?

2021 ◽  
Vol 9 ◽  
Author(s):  
Sushmita Patwardhan ◽  
Christian Diener ◽  
Stephanie Swegle ◽  
Becky Howsmon ◽  
Sean M. Gibbons
Keyword(s):  
Fecal Microbiota Transplantation ◽  
Healthy Person ◽  
Fecal Microbiota ◽  
Antibiotic Resistant ◽  
Severe Diarrhea ◽  
Sick Person ◽  
Clostridioides Difficile ◽  
Healthy State ◽  
The U.S

Microbes are tiny creatures that live in and on our bodies. Many of them, especially those in the gut, help to keep us healthy. Sometimes, when we eat spoiled food or take antibiotics, we wipe out many of these good microbes. Usually, our good microbes recover from these disturbances, but sometimes harmful microbes can take their place and cause disease. Clostridioides difficile is a harmful microbe that causes severe diarrhea. Usually, antibiotics can kill C. difficile and return the gut to a healthy state, but in some cases, this microbe can come back again and again. Some people end up dying from these recurrent, antibiotic-resistant C. difficile infections. Recently, scientists have found that recurrent C. difficile can be cured by transplanting poop from a healthy person into a sick person. This process is called fecal microbiota transplantation (FMT) and it saves thousands of lives in the U.S. each year.

scholarly journals Clostridioides difficile in national food surveillance, Slovenia, 2015 to 2017

2020 ◽  
Vol 25 (16) ◽  
Author(s):  
Valerija Tkalec ◽  
Urska Jamnikar-Ciglenecki ◽  
Maja Rupnik ◽  
Stanka Vadnjal ◽  
Katja Zelenik ◽  
...  
Keyword(s):  
Plant Protection ◽  
Surveillance Programme ◽  
Clostridioides Difficile ◽  
Contaminated Food ◽  
Intestinal Pathogen ◽  
The Republic ◽  
Meat Samples ◽  
Minced Meat ◽  
Positive Results

Background Clostridioides difficile is an important human and animal intestinal pathogen. Because of increasing indications of an association between C. difficile and food, in 2015, the Administration of the Republic of Slovenia for Food Safety, Veterinary Sector and Plant Protection (UVHVVR) included C. difficile in its national food surveillance. Aim We aim to report the results and experience with a nationwide and long-term testing of food for C. difficile as a part of a regular national food surveillance programme. Methods Retail minced meat and meat preparations (beef, pork and poultry) were sampled within a three-year period, 2015 to 2017. Selected raw retail vegetables, leaf salads and root vegetables, and ready-to-eat salads were only sampled during 2016 and 2017. Seafood was only sampled in 2017. Results Altogether, 434 samples were tested, with 12 of 336 (3.6%) meat samples and 6 of 98 (6.1%) raw vegetables contaminated with C. difficile. Twelve of 18 recovered food isolates were toxigenic (toxinotypes 0, III, V, XII). The isolates belonged to 13 different PCR ribotypes, 001 being most common (5 isolates). Several food types with an increased potential of being contaminated with C. difficile were detected by surveillance. Conclusion The three-year C. difficile testing within the national food surveillance revealed a low proportion of C. difficile-contaminated food and high genotype variability. Because the risk of C. difficile infection associated with C. difficile-contaminated food is unknown, no measures were recommended in the case of positive results.

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