A recent article in the New England Journal of Medicine by Shah et al. sought to clarify whether new cases of XDR-TB were the result of acquired resistance or of person-to-person spread (1). ......efforts may include an increased focus on preventing transmission in the community in addition to healthcare settings and expanding access to rapid diagnostic testing and universal drug-susceptibility testing. Because XDR-TB is quickly becoming a global issue, knowledge of the dynamics of transmission is crucial to stem the spread of this challenging disease. Author Contributions: All authors confirmed they have contributed to the intellectual content of this paper and have met the following 3 requirements: (a) significant contributions to the conception and design, acquisition of data, or analysis and interpretation of data; (b) drafting or revising the article for intellectual content; and (c) final approval of the published article.
The Vibrio parahaemolyticus type III effector VopS is implicated in cell rounding and the collapse of the actin cytoskeleton by inhibiting Rho guanosine triphosphatases (GTPases). We found that VopS ...could act to covalently modify a conserved threonine residue on Rho, Rac, and Cdc42 with adenosine 5'-monophosphate (AMP). The resulting AMPylation prevented the interaction of Rho GTPases with downstream effectors, thereby inhibiting actin assembly in the infected cell. Eukaryotic proteins were also directly modified with AMP, potentially expanding the repertoire of posttranslational modifications for molecular signaling.
The veterinary pathogens in the
group (SIG) are increasingly recognized as causes of human infection. Shared features between SIG and
may result in the misidentification of SIG in human clinical ...cultures. This study examined the clinical and microbiological characteristics of isolates recovered at a tertiary-care academic medical center. From 2013 to 2015, 81 SIG isolates were recovered from 62 patients. Patients were commonly ≥50 years old, diabetic, and/or immunocompromised. Documentation of dog exposure in the electronic medical record was not common. Of the 81 SIG isolates, common sites of isolation included 37 (46%) isolates from wound cultures and 17 (21%) isolates from respiratory specimens. Although less common, 10 (12%) bloodstream infections were documented in 7 unique patients. The majority of SIG (65%) isolates were obtained from polymicrobial cultures. In comparison to
isolates from the same time period, significant differences were noted in proportion of SIG isolates that were susceptible to doxycycline (74% versus 97%, respectively;
< 0.001), trimethoprim-sulfamethoxazole (65% versus 97%, respectively;
< 0.001), and ciprofloxacin (78% versus 59%, respectively;
< 0.01). Methicillin resistance (MR) was detected in 12 (15%) of 81 SIG isolates. All MR isolates detected by an oxacillin disk diffusion test would have been misclassified as methicillin susceptible using a cefoxitin disk diffusion test. Thus, SIG is recovered from human clinical specimens, and distinction of SIG from
is critical for the accurate characterization of MR status in these isolates.
The Vibrio parahaemolyticus type III secreted effector VopS contains a fic domain that covalently modifies Rho GTPase threonine with AMP to inhibit downstream signaling events in host cells. The VopS ...fic domain includes a conserved sequence motif (HPFxD/EGNG/KR) that contributes to AMPylation. Fic domains are found in a variety of species, including bacteria, a few archaea, and metazoan eukaryotes.
We show that the AMPylation activity extends to a eukaryotic fic domain in Drosophila melanogaster CG9523, and use sequence and structure based computational methods to identify related domains in doc toxins and the type III effector AvrB. The conserved sequence motif that contributes to AMPylation unites fic with doc. Although AvrB lacks this motif, its structure reveals a similar topology to the fic and doc folds. AvrB binds to a peptide fragment of its host virulence target in a similar manner as fic binds peptide substrate. AvrB also orients a phosphate group from a bound ADP ligand near the peptide-binding site and in a similar position as a bound fic phosphate.
The demonstrated eukaryotic fic domain AMPylation activity suggests that the VopS effector has exploited a novel host posttranslational modification. Fic domain-related structures give insight to the AMPylation active site and to the VopS fic domain interaction with its host GTPase target. These results suggest that fic, doc, and AvrB stem from a common ancestor that has evolved to AMPylate protein substrates.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
New blood culture instrumentation and medium formulations have led to improved time to positivity (TTP) for positive blood cultures. Data regarding the necessity of pediatric blood culture bottles ...with contemporary blood culture systems are sparse. We compared performance of three commercial blood culture systems, evaluating impact of blood volumes in standard and pediatric blood culture media across systems. Simulated blood cultures with packed red blood cells (PRBCs) and three Gram-positive, four Gram-negative, and one anaerobic organism (final concentrations ranging from 0.5 to 19 CFU/ml blood) on the Virtuo, VersaTrek, and Bactec FX instruments were evaluated with FAN Plus, Redox, and Bactec Plus media, respectively. For each medium/instrument/organism combination, 1-, 3-, 5-, and 10-ml blood volumes were evaluated in triplicate. Detection rate was not affected by blood volume. Aerobic organisms that demonstrated variable rates of detection were Kingella kingae, Haemophilus influenzae, and Neisseria meningitidis. Bacteroides fragilis was detected in 83%, 100%, and 100% of Virtuo, VersaTrek, and Bactec anaerobic bottles, respectively. The average TTP of standard medium for aerobic organisms detected on Virtuo was decreased compared to those for VersaTrek (-2.3 h) and Bactec (-4.9 h). Compared to standard medium, detection rate and TTP were unchanged on Virtuo, while TTP was reduced with pediatric medium for 2/8 organisms tested on Bactec and 7/8 organisms on VersaTrek, illustrating the potential benefit of pediatric medium on VersaTrek or Bactec when low blood volumes (<5 ml) are collected. These results demonstrate that TTP is decreased on the Virtuo compared to VersaTrek and Bactec for many microorganisms associated with bloodstream infection (BSI) but may have species-specific limitations.
Rapid diagnostic testing (RDT) can facilitate earlier optimization of the treatment of bloodstream infections, particularly in conjunction with an effective antimicrobial stewardship program (ASP). ...However, the effective implementation and workflow of RDTs are still a matter of debate, particularly in a pediatric setting. In this issue of the
, L. J. Juttukonda, S. Katz, J. Gillon, J. Schmitz, and R. Banerjee (J Clin Microbiol 58:e01400-19, 2020, https://doi.org/10.1128/JCM.01400-19) investigate the impact of a multiplex, molecular RDT on changes to antimicrobial therapy in an academic children's hospital. These data reveal several factors that clinical laboratories should consider prior to the implementation of RDTs for positive blood cultures.
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