Streptococcus agalactiae (GBS) PNA FISH -tekniikan soveltuminen B-ryhmän streptokokin tunnistukseen

B-ryhmän beetahemolyyttinen streptokokki (GBS = Group B Streptococcus, Streptococcus agalactiae)aiheuttaa vakavia infektioita yleensä astasyntyneillä. Tartunta saadaan yleensä synnytyskanavasta ja riskitekijöinä ovat muun muassa keskosuus, ennenaikainen lapsivedenmeno ja äidin runsas Bstreptokokkikolonisaatio emättimessä. Bakteerin tunnistukseen käytetään tällä hetkellä viljelytekniikkaa, jonka tulos saadaan vasta 24-48 tunnin kuluttua. Opinnäytetyöni tarkoituksena on tutkia uutta ja nopeampaa tunnistusmenetelmää: GBS PNA FISH - tekniikkaa (Peptide Nucleic Acid Fluorescence in Situ Hybridization). Tarkoituksena on tutkia tekniikan spesifiteettiä ja sensitiviteettiä. Tekniikan spesifiteettiä tutkitaan B-ryhmän beetahemolyyttisellä streptokokilla sekä kuudella muulla emättimen normaaliflooraan kuuluvalla bakteerilajilla. Yhteensä bakteerikantoja on tutkimuksessa mukana 48 kappaletta. Tämän lisäksi tutkitaan myös tekniikan sensitiviteettiä, jota tutkitaan bakteereista tehdyn laimennossarjan avulla. Sensitiviteetti tutkitaan bakteeriseoksesta, jonne on B-ryhmän beetahemolyyttisen streptokokin lisäksi lisätty muita emättimen normaaliflooran bakteereita. Lisäksi sensitiviteetti tutkitaan pelkällä B-ryhmän beetahemolyyttisellä streptokokilla käyttäen sekä normaalia että bakteerin rikastusmenetelmää. Testeistä saadut tulokset tulkitaan fluoresenssimikroskoopin avulla. GBS PNA FISH -tekniikan spesifiteetti todettiin erittäin hyväksi. Tekniikka tunnisti kaikki B-ryhmän beetahemolyyttiset streptokokit positiivisiksi ja kaikki muut lajit antoivat negatiivisen tuloksen. B-streptokokin positiivisuus oli erotettavissa mikroskopoitaessa vahvana fluoresointina, kun taas muut lajit eivät fluoresoineet lainkaan. GBS PNA FISH -tekniikan sensitiivisyyden tulokset eivät kuitenkaan täyttäneet odotuksia. Ainoastaan bakteerin rikastusmenetelmällä saadut tulokset olivat loistavia, mutta bakteeriseoksella ja pelkällä B-ryhmän beetahemolyyttisellä streptokokilla saadut tulokset olivat lähes olemattomia. Rikastusmenetelmän kaikki laimennokset fluoresoivat positiivisina, kun taas muissa tapauksissa vain vahvin liuos antoi jonkinlaista positiivista fluoresointia. GBS PNA FISH -tekniikan spesifiteetti todettiin hyväksi. Tekniikan sensitiviteetti ei kuitenkaan vastaa käyttötarkoitusta ja todellisessa tilanteessa tekniikka ei pystyisi tunnistamaan sille spesifistä bakteeria muiden bakteerien joukosta.

Inactive endosialidase-based detection of bacterial and oncofetal polysialic acid

Polysialic acid is a carbohydrate polymer which consist of N-acetylneuraminic acid units joined by alpha2,8-linkages. It is developmentally regulated and has an important role during normal neuronal development. In adults, it participates in complex neurological processes, such as memory, neural plasticity, tumor cell growth and metastasis. Polysialic acid also constitutes the capsule of some meningitis and sepsis-causing bacteria, such as Escherichia coli K1, group B meningococci, Mannheimia haemolytica A2 and Moraxella nonliquefaciens. Polysialic acid is poorly immunogenic; therefore high affinity antibodies against it are difficult to prepare, thus specific and fast detection methods are needed. Endosialidase is an enzyme derived from the E. coli K1 bacteriophage, which specifically recognizes and degrades polysialic acid. In this study, a novel detection method for polysialic acid was developed based on a fusion protein of inactive endosialidase and the green fluorescent protein. It utilizes the ability of the mutant, inactive endosialidase to bind but not cleave polysialic acid. Sequencing of the endosialidase gene revealed that amino acid substitutions near the active site of the enzyme differentiate the active and inactive forms of the enzyme. The fusion protein was applied for the detection of polysialic acid in bacteria and neuroblastoma. The results indicate that the fusion protein is a fast, sensitive and specific reagent for the detection of polysialic acid. The use of an inactive enzyme as a specific molecular tool for the detection of its substrate represents an approach which could potentially find wide applicability in the specific detection of diverse macromolecules.

Use of pyrosequencing to identify streptococci and to detect mutations causing antimicrobial resistance

Rapid identification and resistance determination of pathogens in clinical specimens is vital for accurate treatment and monitoring of infectious diseases. Antimicrobial drug resistance is increasing globally and healthcare settings are facing this cost-intensive and even life-threatening problem. The incidence of resistant pathogens in Finland has remained relatively steady and manageable at least for the time being. DNA sequencing is the gold standard method for genotyping, mutation analysis, and identification of bacteria. Due to significant cost decrease in recent years, this technique is available to many research and clinical laboratories. Pyrosequencing technique, a rapid real-time DNA sequencing method especially suitable for analyzing fairly short stretches of DNA, was used in this study. Due to its robustness and versatility, pyrosequencing was applied in this study for identification of streptococci and detection of certain mutations causing antimicrobial resistance in different bacteria. Certain streptococcal species such as S. pneumoniae and S. pyogenes are significantly important clinical pathogens. S. pneumoniae causes e.g. pneumonia and otitis media and is one of the most important community-acquired pathogens. S. pyogenes, also known as group A streptococcus, causes e.g. angina and erysipelas. In contrast, the socalled alpha-haemolytic streptococci, such as S. mitis and S. oralis, belong to the normal microbiota, which are regarded to be non-pathogenic and are nearly impossible to identify by phenotypic methods. In this thesis, a pyrosequencing method was developed for identification of streptococcal species based on the 16S rRNA sequences. Almost all streptococcal species could be differentiated from one another by the developed method, including S. pneumoniae from its close relatives S. mitis and S. oralis . New resistance genes and their variants are constantly discovered and reported. In this study, new methods for detecting certain mutations causing macrolide resistance or extended spectrum beta-lactamase (ESBL) phenotype were developed. These resistance detection approaches are not only suitable for surveillance of mechanisms causing antimicrobial resistance but also for routine analysis of clinical samples particularly in epidemic settings. In conclusion, pyrosequencing was found to be an accurate, versatile, cost-effective, and rapid DNA sequencing method that is especially suitable for mutation analysis of short DNA fragments and identification of certain bacteria.

Targeting of caries prevention at preschool children, a practice based study

<b>Aim and design:b> To evaluate an oral health program directed to expecting families and their children. The intervention was carried out in one of the four health care areas of the city of Turku. Another area acted as a control. <b>Subjects and methods:b> Children (n = 1217), born between January 1, 1998 and June 30, 1999, in the respective health care areas were screened for mutans streptococci bacteria (MS), and their caretakers were interviewed when the child was 18 months old. MScolonization was used as the child’s risk indicator. Intensified health education and the use of xylitol lozenges targeted at the children at risk were the main elements of the program. Controls and the non-MS-colonized children received routine prevention –examination and education at the ages of three and five years. Altogether 794 subjects were followed for 42 months after receiving consent from their caretakers. Associations of oral-health-related factors with MS colonization and caries increment were studied inside the control group. <b>Results:b> MS colonization associated with the occupation of the caretaker and ethnicity. The program was effective in white-collar families; prevented fraction being 67 %. In blue-collar families no effect was achieved. At the age of five years, caries increment was strongly related to the occupation of the caretaker, MS at 18 months, child’s sugar use, night feeding, use of thirst quencher at the age of 18 months, and father’s reported oral health. <b>Conclusions:b> Programs targeted at MS-colonized children can reduce caries in whitecollar families. A program mainly based on activity at home seems to favor white-collar families, whereas different kind of support is needed for the blue-collar families.

Analysis and validation of space averaged drag model for numerical simulations of gas-solid flows in fluidized beds

This thesis presents an approach for formulating and validating a space averaged drag model for coarse mesh simulations of gas-solid flows in fluidized beds using the two-fluid model. Proper modeling for fluid dynamics is central in understanding any industrial multiphase flow. The gas-solid flows in fluidized beds are heterogeneous and usually simulated with the Eulerian description of phases. Such a description requires the usage of fine meshes and small time steps for the proper prediction of its hydrodynamics. Such constraint on the mesh and time step size results in a large number of control volumes and long computational times which are unaffordable for simulations of large scale fluidized beds. If proper closure models are not included, coarse mesh simulations for fluidized beds do not give reasonable results. The coarse mesh simulation fails to resolve the mesoscale structures and results in uniform solids concentration profiles. For a circulating fluidized bed riser, such predicted profiles result in a higher drag force between the gas and solid phase and also overestimated solids mass flux at the outlet. Thus, there is a need to formulate the closure correlations which can accurately predict the hydrodynamics using coarse meshes. This thesis uses the space averaging modeling approach in the formulation of closure models for coarse mesh simulations of the gas-solid flow in fluidized beds using Geldart group B particles. In the analysis of formulating the closure correlation for space averaged drag model, the main parameters for the modeling were found to be the averaging size, solid volume fraction, and distance from the wall. The closure model for the gas-solid drag force was formulated and validated for coarse mesh simulations of the riser, which showed the verification of this modeling approach. Coarse mesh simulations using the corrected drag model resulted in lowered values of solids mass flux. Such an approach is a promising tool in the formulation of appropriate closure models which can be used in coarse mesh simulations of large scale fluidized beds.