Aggregative adherent strains of Corynebacterium pseudodiphtheriticum enter and survive within HEp-2 epithelial cells

Corynebacterium pseudodiphtheriticum is a well-known human pathogen that mainly causes respiratory disease and is associated with high mortality in compromised hosts. Little is known about the virulence factors and pathogenesis of C. pseudodiphtheriticum. In this study, cultured human epithelial (HEp-2) cells were used to analyse the adherence pattern, internalisation and intracellular survival of the ATCC 10700 type strain and two additional clinical isolates. These microorganisms exhibited an aggregative adherence-like pattern to HEp-2 cells characterised by clumps of bacteria with a "stacked-brick" appearance. The differences in the ability of these microorganisms to invade and survive within HEp-2 cells and replicate in the extracellular environment up to 24 h post infection were evaluated. The fluorescent actin staining test demonstrated that actin polymerisation is involved in the internalisation of the C. pseudodiphtheriticum strains. The depolymerisation of microfilaments by cytochalasin E significantly reduced the internalisation of C. pseudodiphtheriticum by HEp-2 cells. Bacterial internalisation and cytoskeletal rearrangement seemed to be partially triggered by the activation of tyrosine kinase activity. Although C. pseudodiphtheriticum strains did not demonstrate an ability to replicate intracellularly, HEp-2 cells were unable to fully clear the pathogen within 24 h. These characteristics may explain how some C. pseudodiphtheriticum strains cause severe infection in human patients.

Potential pathogenic role of aggregative- adhering Corynebacterium diphtheriae of different clonal groups in endocarditis

Invasive diseases caused by Corynebacterium diphtheriae have been described increasingly. Several reports indicate the destructive feature of endocarditis attributable to nontoxigenic strains. However, few reports have dealt with the pathogenicity of invasive strains. The present investigation demonstrates a phenotypic trait that may be used to identify potentially invasive strains. The study also draws attention to clinical and microbiological aspects observed in 5 cases of endocarditis due to C. diphtheriae that occurred outside Europe. Four cases occurred in female school-age children (7-14 years) treated at different hospitals in Rio de Janeiro, Brazil. All patients developed other complications including septicemia, renal failure and/or arthritis. Surgical treatment was performed on 2 patients for valve replacement. Lethality was observed in 40% of the cases. Microorganisms isolated from 5 blood samples and identified as C. diphtheriae subsp mitis (N = 4) and C. diphtheriae subsp gravis (N = 1) displayed an aggregative adherence pattern to HEp-2 cells and identical one-dimensional SDS-PAGE protein profiles. Aggregative-adhering invasive strains of C. diphtheriae showed 5 distinct RAPD profiles. Despite the clonal diversity, all 5 C. diphtheriae invasive isolates seemed to display special bacterial adhesive properties that may favor blood-barrier disruption and systemic dissemination of bacteria. In conclusion, blood isolates from patients with endocarditis exhibited a unique adhering pattern, suggesting a pathogenic role of aggregative-adhering C. diphtheriae of different clones in endocarditis. Accordingly, the aggregative-adherence pattern may be used as an indication of some invasive potential of C. diphtheriae strains.

High prevalence of aggregative adherent Escherichia coli strains in the mucosa-associated microbiota of patients with inflammatory bowel diseases

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Influence of environmental factors in the adherence of an atypical enteropathogenic Escherichia coli strain to epithelial cells

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Detecção e caracterização de patotipos diarreiogênicos de Escherichia coli por métodos fenotípicos e genotípicos em indivíduos de todas as idades atendidos nas unidades de saúde de Vitória-ES

A diarreia é a segunda causa de mortalidade em <5 anos e é responsável pela diminuição da produtividade na população economicamente ativa. Dentre os agentes infecciosos envolvidos, seis patotipos diarreiogênicos de Escherichia coli (DEC) merecem destaque: E. coli enteropatogênica (EPEC), E.coli enteroinvasora (EIEC), E. coli enterotoxigênica (ETEC), E. coli enteroemorrágica ou produtora de toxina de Shiga (EHEC/STEC), E. coli enteroagregativa (EAEC) e E. coli de aderência difusa (DAEC). O objetivo deste estudo foi determinar a frequência dos patotipos de DEC e caracterizar fenotípica e genotipicamente EAEC, DAEC, aEPEC e E. coli chain-like adhesion (CLA) isolados de fezes indivíduos de todas as idades atendidos nas Unidades de Saúde do município de Vitória, ES, entre janeiro de 2008 e junho de 2011. Os isolados de E. coli foram submetidos à: (i) PCR para detecção dos genes eae, bfpA, aat, lt, st, ipaH, stx1 e stx2; (ii) hibridização de colônia com as sondas eae, aat e daaC; (iii) adesão em cultura de células HEp-2 para evidenciar padrão de aderência agregativa (AA), difusa (DA) e chain-like adhesion (CLA). PCR para detecção de genes de virulência foi realizado em isolados de EAEC, CLA, DAEC e aEPEC. Isolados de EAEC e CLA, foram submetidos a testes de formação de biofilme e de película. Foram obtidos 328 espécimes fecais e E. coli foi isolada de 85,7%. Os seguintes patotipos foram identificados: EAEC (18,3%), DAEC (11%), aEPEC (2,6%), ETEC (0,7%). CLA foi identificada em 4,9% e EIEC, tEPEC e STEC não foram detectados. Dos 60 isolados de EAEC (AA) (25% aat+ por PCR e 35% por hibridização), fímbrias de aderência agregativa foram evidenciadas em baixa frequência (aggA- 1,7%, aafA- 0%, agg3A- 11,7%, hdA- 8,3%). EAEC típica correspondeu a 31,7% dos isolados de EAEC (aggR+), e foram significantes nestas a formação de biofilme, escore 3+ de produção de película e presença dos genes aat, agg3A, hdA, aap, sat, pet, set1A e iucA. Todos os isolados CLA apresentaram o gene pet, 87,5%, foram aggR-, formaram película e nenhum produziu biofilme. Dentre dos 42 isolados de DAEC (DA), a sonda daaC detectou 52,4%. PCR evidenciou adesinas afa/Dr (daaD e afa) em 59,5% e adesina AIDA-I não foi encontrada, sugerindo que outras adesinas estejam envolvidas na adesão da DAEC. Isolados de DAEC afa/Dr + foram estatisticamente mais isolados de <5 anos. Em aEPEC, os genes da ilha de patogenicidade OI-122 pesquisados, nleE, efa1/lifA e paa foram evidenciados em 30% dos isolados, todos provenientes de <5 anos. Características de virulência de tEAEC e DAEC Afa/Dr sugerem que sejam subpopulações relacionadas com diarreia. CLA não parece ser variante de EAEC.

Fimbriae- and flagella-mediated association with and invasion of cultured epithelial cells by Salmonella enteritidis

Salmonella enteritidis expresses flagella and several finely regulated fimbriae, including SEF14, SEF17 and SEF21 (type 1). A panel of mutants was prepared in three strains of S. enteritidis to elucidate the role of these surface appendages in the association with and invasion of cultured epithelial cells. In all assays, the naturally occurring regulatory-defective strain 27655R associated with tissue culture cells significantly more than wild-type progenitor strains LA5 and S1400/94. Compared with wild-type strains, SEF14 mutants had no effect on association and invasion, whereas SEF17, SEF21 and aflagellate mutants showed significant reductions in both processes. Histological examination suggested a role for SEF17 in localized, aggregative adherence, which could be specifically blocked by anti-SEF17 sera and purified SEF17 fimbriae. SEF21-mediated association was neutralized by mannose and a specific monoclonal antibody, although to observe enhanced association it was necessary for the bacteria to be in fimbriate phase prior to infection. Additionally, aflagellate mutants associated and invaded less than motile bacteria. This study demonstrated the potential for multifactorial association and invasion of epithelial cells which involved SEF17 and SEF21 fimbriae, and flagella-mediated motility.

Ice as a vehicle for diarrheagenic Escherichia coli

In a recent study of the microbiological quality of commercial ice, 50 Escherichia coli isolates belonging to different serotypes were found. The potential hazard from these isolates was examined by testing their adherence patterns ill HeLa cells and searching for the presence of DNA sequences related to E. coli virulence properties. Twelve potentially diarrheagenic isolates were found and classified as enteroaggregative E. coli (EAEC) based oil their ability to produce aggregative adherence to HeLa cells. The remaining isolates were devoid of the virulence properties searched for. The EAEC isolates belonged to 10 different serotypes, among which O128ab:H35 is often found in diarrheic feces. None of these isolates reacted with a specific EAEC DNA probe or carried any of the known EAEC virulence genes. These data indicate that ice may be all important vehicle for transmission of enteropathogens, especially of the EAEC group. (C) 2003 Elsevier B.V. All rights reserved.

Mucosa-associated but not luminal Escherichia coli is augmented in Crohn's disease and ulcerative colitis

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Pesquisa de fatores de patogenicidade em Escherichia coli Enteroagregativas da microbiota intestinal de pacientes com doença inflamatória intestinal

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Escherichia coli from Crohn’s disease patient displays virulence features of enteroinvasive (EIEC), enterohemorragic (EHEC), and enteroaggregative (EAEC) pathotypes

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

P-220-Escherichia coli displaying virulence features of multiple diarrheogenic pathotypes detected in a Crohn's disease patient

Background: The number of Escherichia coli in the gut of Crohn's disease (CD) patients is higher than that of normal subjects, but the virulence potential of these bacteria is not fully known. Previous studies have shown that these E. coli are closely related to extraintestinal pathogenic categories (ExPEC), are able to invade epithelial cells, and usually do not produce exotoxins. We report here the detection, in a CD patient, of an E. coli which belongs to a classical enteropathogenic (EPEC) serotype and displays virulence markers of enteroinvasive (EIEC), enteroaggregative (EAEC) and enterohemorrhagic (EHEC) pathotypes. Methods: The E. coli strain was isolated, in 2009, by classical bacteriological procedures from a 56 year old woman who underwent ileo-terminal resection 1 year before, due to intestinal obstruction. The bacterial characterization was carried out by in vitro adhesion and invasion assays to cultured epithelial cells and macrophages and screening by PCR to identify virulence genetic markers of diarrheogenic E. coli (DEC) and to detect one of the gene combinations which define the phylogroups of the E. coli reference (EcoR) collection. The strain was also tested for the ability to produce biofilm and shiga cytotoxins and had its whole genome sequenced by Ion Torrent Sequencing Technology. Results: The studied strain, which was detected both in ileum biopsies and the stools of the patient, displayed the aggregative adherence (AA) phenotype to Hep-2 cells and an ability to enter Caco-2 cells 3x as high as that of EIEC reference strain and 89% of that of the prototype AIEC LF82 strain. Although it could invade cultured macrophages, the strain was unable to replicate inside these cells. PCR screening revealed the presence of eae, aggR and stx1. Tests with bacterial culture supernatants in Vero cells demonstrating cytotoxicity suggested the production of Stx1. In addition, the strain revealed to be a strong biofilm producer, belonged to the B2 EcoR phylogroup, to the O126:H27 serogroup and to the multilocus sequencing type (MLST) ST3057. The 2 later features were deduced from the whole genome sequence of the strain. Conclusions: The characterization of this E. coli isolate from a CD patient revealed a combination of virulence markers of distinct DEC pathotypes, namely eae and stx1 of EHEC, AA, aggR and biofilm formation of EAEC, and invasiveness of EIEC. These features along with its serotype and phylogroup identity seem to suggest a potential to be involved in CD, an observation which should be tested with additional studies.

Antigen-43-mediated autoaggregation impairs motility in Escherichia coli

Functional interaction between bacterial surface-displayed autoaggregation proteins such as antigen 43 (Ag43) of Escherichia coli and motility organelles such as flagella has not previously been described. Here, it has been demonstrated for the first time that Ag43-mediated aggregation can inhibit bacterial motility. Ag43 overexpression produces a dominant aggregation phenotype that overrides motility in the presence of low levels of flagella. In contrast, induction of an increased flagellation state prevents Ag43-mediated aggregation. This phenomenon was observed in naturally occurring subpopulations of E coli as phase variants expressing and not expressing Ag43 revealed contrasting motility phenotypes. The effects were shown to be part of a general mechanism because other short adhesins capable of mediating autoaggregation (AIDA-I and TibA) also impaired motility. These novel insights into the function of bacterial autoaggregation proteins suggest that a balance between these two systems, i.e. autoaggregation and flagellation, influences motility.

Localized, diffuse, and aggregative-adhering Escherichia coli from infants with acute diarrhea and matched-controls

Of 126 infants under 2 years, enrolled in a study on the etiology of acute diarrhea in Recife, Brazil, we selected 37 from whom no recognized enteropathogens, except classic enteropathogenic Escherichia coli, were identified. For comparison, we also examined 37 matched-control infants without diarrhea seen at the same hospital setting. This paper had the purpose to determine the prevalence of localized, diffuse, and aggregative-adhering E. coli strains in both groups. Three to five fecal E. coli colonies, of each case and control, were tested individually for adherence to HeLa cells by using the one step 3-h incubation assay. Strains of E. coli showing localized adherence were found significantly more often in patients (37.8%) than in controls (13.5%), p < 0.02, and they were pratically confined to EPEC serovars 055:H-, 0111:H2, and 119:H6. In contrast, E. coli isolates exhibiting the diffuse or aggregative patterns of adherence were restricted to non-EPEC serogroups and were more frequently encountred among controls.

[adherence To Statin Treatment And Associated Factors In Female Users From The Unified Health System (sus)].

To identify the adherence rate of a statin treatment and possible related factors in female users from the Unified Health System. Seventy-one women were evaluated (64.2 ± 11.0 years) regarding the socio-economic level, comorbidities, current medications, level of physical activity, self-report of muscular pain, adherence to the medical prescription, body composition and biochemical profile. The data were analyzed as frequencies, Chi-Squared test, and Mann Whitney test (p<0.05). 15.5% of women did not adhere to the medical prescription for the statin treatment, whose had less comorbidities (p=0.01), consumed less quantities of medications (p=0.00), and tended to be younger (p=0.06). Those patients also presented higher values of lipid profile (CT: p=0.01; LDL-c: p=0.02). Musculoskeletal complains were not associated to the adherence rate to the medication. The associated factors to adherence of dyslipidemic women to statin medical prescription were age, quantity of comorbidities and quantity of current medication.

Beliefs Related To Adherence To Oral Antidiabetic Treatment According To The Theory Of Planned Behavior.

to identify salient behavioral, normative, control and self-efficacy beliefs related to the behavior of adherence to oral antidiabetic agents, using the Theory of Planned Behavior. cross-sectional, exploratory study with 17 diabetic patients in chronic use of oral antidiabetic medication and in outpatient follow-up. Individual interviews were recorded, transcribed and content-analyzed using pre-established categories. behavioral beliefs concerning advantages and disadvantages of adhering to medication emerged, such as the possibility of avoiding complications from diabetes, preventing or delaying the use of insulin, and a perception of side effects. The children of patients and physicians are seen as important social references who influence medication adherence. The factors that facilitate adherence include access to free-of-cost medication and taking medications associated with temporal markers. On the other hand, a complex therapeutic regimen was considered a factor that hinders adherence. Understanding how to use medication and forgetfulness impact the perception of patients regarding their ability to adhere to oral antidiabetic agents. medication adherence is a complex behavior permeated by behavioral, normative, control and self-efficacy beliefs that should be taken into account when assessing determinants of behavior.