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Urinary tract infection and enterococcus endocarditis

Kamelia M Osman, Mohamed N Ali, Ismail Radwan, Fatma ElHofy, Ahmed H Abed, Ahmed Orabi, Nehal M Fawzy
Although normally regarded harmless commensals, enterococci may cause a range of different infections in humans, including urinary tract infections, sepsis, and endocarditis. The acquisition of vancomycin resistance by enterococci (VRE) has seriously affected the treatment and infection control of these organisms. VRE are frequently resistant to all antibiotics that are effective treatment for vancomycin-susceptible enterococci, which leaves clinicians treating VRE infections with limited therapeutic options...
2016: Frontiers in Microbiology
Maria Camila Montealegre, Kavindra V Singh, Sudha R Somarajan, Puja Yadav, Chungyu Chang, Robert Spencer, Jouko Sillanpää, Hung Ton-That, Barbara E Murray
Enterococcus faecium is an important cause of hospital-associated infections, including urinary tract infections (UTIs), bacteremia, and infective endocarditis. Pili have been shown to play a role in the pathogenesis of Gram-positive bacteria, including E. faecium We previously demonstrated that a nonpiliated ΔempABC::cat derivative of E. faecium TX82 was attenuated in biofilm formation and in a UTI model. Here, we studied the contributions of the individual pilus subunits EmpA, EmpB, and EmpC to pilus architecture, biofilm formation, adherence to extracellular matrix (ECM) proteins, and infection...
May 2016: Infection and Immunity
Kavindra V Singh, Sabina Leanti La Rosa, Sudha R Somarajan, Jung Hyeob Roh, Barbara E Murray
EfbA is a PavA-like fibronectin adhesin of Enterococcus faecalis previously shown to be important in experimental urinary tract infection. Here, we expressed and purified the E. faecalis OG1RF EfbA and confirmed that this protein binds with high affinity to immobilized fibronectin, collagen I, and collagen V. We constructed an efbA deletion mutant and demonstrated that its virulence was significantly attenuated (P < 0.0006) versus the wild type in a mixed inoculum rat endocarditis model. Furthermore, efbA deletion resulted in diminished ability to bind fibronectin (P < 0...
December 2015: Infection and Immunity
Tristan O'Driscoll, Christopher W Crank
Since its discovery in England and France in 1986, vancomycin-resistant Enterococcus has increasingly become a major nosocomial pathogen worldwide. Enterococci are prolific colonizers, with tremendous genome plasticity and a propensity for persistence in hospital environments, allowing for increased transmission and the dissemination of resistance elements. Infections typically present in immunosuppressed patients who have received multiple courses of antibiotics in the past. Virulence is variable, and typical clinical manifestations include bacteremia, endocarditis, intra-abdominal and pelvic infections, urinary tract infections, skin and skin structure infections, and, rarely, central nervous system infections...
2015: Infection and Drug Resistance
Diane Sunira Daniel, Sui Mae Lee, Gary A Dykes, Sadequr Rahman
Enterococci rank as one of the leading causes of nosocomial infections, such as urinary tract infections, surgical wound infections, and endocarditis, in humans. These infections can be hard to treat because of the rising incidence of antibiotic resistance. Enterococci inhabiting nonhuman reservoirs appear to play a critical role in the acquisition and dissemination of antibiotic resistance determinants. The spread of antibiotic resistance has become a major concern in both human and veterinary medicine, especially in Southeast Asia, where many developing countries have poor legislation and regulations to control the supply and excessive use of antimicrobials...
September 2015: Applied and Environmental Microbiology
Kristi L Frank, Paschalis Vergidis, Cassandra L Brinkman, Kerryl E Greenwood Quaintance, Aaron M T Barnes, Jayawant N Mandrekar, Patrick M Schlievert, Gary M Dunny, Robin Patel
Enterococcus faecalis can cause healthcare-associated biofilm infections, including those of orthopedic devices. Treatment of enterococcal prosthetic joint infection is difficult, in part, due to biofilm-associated antimicrobial resistance. We previously showed that the E. faecalis OG1RF genes ahrC and eep are in vitro biofilm determinants and virulence factors in animal models of endocarditis and catheter-associated urinary tract infection. In this study, we evaluated the role of these genes in a rat acute foreign body osteomyelitis model and in in vitro biofilm-associated antimicrobial resistance...
2015: PloS One
Magnus Øverlie Arntzen, Ingrid Lea Karlskås, Morten Skaugen, Vincent G H Eijsink, Geir Mathiesen
Enterococcus faecalis is a robust bacterium, which is able to survive in and adapt to hostile environments such as the urinary tract and bladder. In this label-free quantitative proteomic study based on MaxQuant LFQ algorithms, we identified 127 proteins present in the secretome of the clinical vancomycin-resistant isolate E. faecalis V583 and we compared proteins secreted in the initial phase of cultivation in urine with the secretome during cultivation in standard laboratory medium, 2xYT. Of the 54 identified proteins predicted to be secreted, six were exclusively found after cultivation in urine including the virulence factor EfaA ("endocarditis specific antigen") and its homologue EF0577 ("adhesion lipoprotein")...
2015: PloS One
Y A Hashem, A S Yassin, M A Amin
PURPOSE: Enterococci are responsible for serious diseases such as bacteraemia, endocarditis and urinary tract infections. The ability of enterococci to cause such diseases is due to acquisition of certain virulence factors such as haemolysin, gelatinase and enterococcus surface protein. This study has been conducted to investigate the occurrence of virulence factors and resistance to various antibiotics with emphasis on vancomycin in the Enterococcus spp. MATERIALS AND METHODS: Clinical specimens were collected and isolates were identified by proper microscopic, culture and biochemical tests...
February 2015: Indian Journal of Medical Microbiology
Jung Hyeob Roh, Kavindra V Singh, Sabina Leanti La Rosa, Ana Luisa V Cohen, Barbara E Murray
Expression of ace (adhesin to collagen of Enterococcus faecalis), encoding a virulence factor in endocarditis and urinary tract infection models, has been shown to increase under certain conditions, such as in the presence of serum, bile salts, urine, and collagen and at 46 °C. However, the mechanism of ace/Ace regulation under different conditions is still unknown. In this study, we identified a two-component regulatory system GrvRS as the main regulator of ace expression under these stress conditions. Using Northern hybridization and β-galactosidase assays of an ace promoter-lacZ fusion, we found transcription of ace to be virtually absent in a grvR deletion mutant under the conditions that increase ace expression in wild-type OG1RF and in the complemented strain...
January 2015: Infection and Immunity
Dominique Wobser, Liaqat Ali, Elisabeth Grohmann, Johannes Huebner, Türkan Sakinc
BACKGROUND: Enterococci are the third most common cause of healthcare-associated infections, which include urinary tract infections, bacteremia and endocarditis. Cell-surface structures such as lipoteichoic acid (LTA) have been poorly examined in E. faecalis, especially with respect to urinary tract infections (UTIs). The dlt operon is responsible for the D-alanylation of LTA and includes the gene dltA, which encodes the D-alanyl carrier protein ligase (Dcl). The involvement of LTA in UTI infection by E...
2014: PloS One
Ana L Flores-Mireles, Jerome S Pinkner, Michael G Caparon, Scott J Hultgren
Enterococci bacteria are a frequent cause of catheter-associated urinary tract infections, the most common type of hospital-acquired infection. Treatment has become increasingly challenging because of the emergence of multiantibiotic-resistant enterococcal strains and their ability to form biofilms on catheters. We identified and targeted a critical step in biofilm formation and developed a vaccine that prevents catheter-associated urinary tract infections in mice. In the murine model, formation of catheter-associated biofilms by Enterococcus faecalis depends on EbpA, which is the minor subunit at the tip of a heteropolymeric surface fiber known as the endocarditis- and biofilm-associated pilus (Ebp)...
September 17, 2014: Science Translational Medicine
Paweł Lisiecki
INTRODUCTION: Enterococci belong to the normal bacterial flora of the gastrointensinal tract of humans. Enterococci are regarded as harmless commensal, and are even believed to have probiotic characteristics. However, they can cause variety of infections, including endocarditis, bloodstream infections and urinary tract infections. During the past several decades, enterococci, and particularly Enterococcus faecalis and E. faecium, have been identified as an important cause of nosocomial infections...
2014: Medycyna Doświadczalna i Mikrobiologia
Salvatore Patanè
Heart valve repair or replacement is a serious problem.The focused update on infective endocarditis of American College of Cardiology/American Heart Association 2008 (ACC/AHA guidelines) and Guidelines on the prevention, diagnosis, and treatment of infective endocarditis (new version 2009) of the European Society of Cardiology (ESC guidelines) describe prophylaxis against infective endocarditis as not recommended for urinary tract procedures in the absence of active infection. A statistical association has been recently shown between urological procedures and the development of infective endocarditis...
April 2014: Journal of Cardiovascular Translational Research
De Chang, Yuanfang Zhu, Li An, Jinwen Liu, Longxiang Su, Yinghua Guo, Zhenhong Chen, Yajuan Wang, Li Wang, Junfeng Wang, Tianzhi Li, Xiangqun Fang, Chengxiang Fang, Ruifu Yang, Changting Liu
BACKGROUND: For a long time, Enterococcus faecium was considered a harmless commensal of the mammalian gastrointestinal (GI) tract and was used as a probiotic in fermented foods. In recent decades, E. faecium has been recognised as an opportunistic pathogen that causes diseases such as neonatal meningitis, urinary tract infections, bacteremia, bacterial endocarditis and diverticulitis. E. faecium could be taken into space with astronauts and exposed to the space environment. Thus, it is necessary to observe the phenotypic and molecular changes of E...
2013: BMC Microbiology
Tsuneaki Kenzaka, Noriko Takamura, Ayako Kumabe, Koichi Takeda
BACKGROUND: Infection by Enterococcus durans (E. durans) is very rare; reported cases are often preceded by therapy or an immunosuppressed state, including infective endocarditis, urinary tract infection, or wound infection. A few reported cases of infective endocarditis exist, with no reports describing involvement of blood access infection. CASE PRESENTATION: The patient is an 83-year-old man who had been undergoing hemodialysis for 8 years due to renal failure caused by diabetic nephropathy...
2013: BMC Infectious Diseases
Hossein Samadi Kafil, Ashraf Mohabati Mobarez, Mehdi Fourozandeh Moghadam
INTRODUCTION: Enterococci rank among leading causes of nosocomial bacteremia, urinary tract infections and community acquired endocarditis. The aim of the present study was to investigate the presence of virulence factors in Enterococci strains isolated from clinical samples in Iranian Educational hospitals. METHODOLOGY: Presence of aggregation substance (asa), extracellular surface protein (esp), Enterococcus faecalis antigen A (efaA), adhesin of collagen from E...
July 2013: Indian Journal of Pathology & Microbiology
Hailyn V Nielsen, Ana L Flores-Mireles, Andrew L Kau, Kimberly A Kline, Jerome S Pinkner, Fabrice Neiers, Staffan Normark, Birgitta Henriques-Normark, Michael G Caparon, Scott J Hultgren
Enterococci commonly cause hospital-acquired infections, such as infective endocarditis and catheter-associated urinary tract infections. In animal models of these infections, a long hairlike extracellular protein fiber known as the endocarditis- and biofilm-associated (Ebp) pilus is an important virulence factor for Enterococcus faecalis. For Ebp and other sortase-assembled pili, the pilus-associated sortases are essential for fiber formation as they create covalent isopeptide bonds between the sortase recognition motif and the pilin-like motif of the pilus subunits...
October 2013: Journal of Bacteriology
Jouko Sillanpää, Chungyu Chang, Kavindra V Singh, Maria Camila Montealegre, Sreedhar R Nallapareddy, Barrett R Harvey, Hung Ton-That, Barbara E Murray
The endocarditis and biofilm-associated pilus (Ebp) operon is a component of the core genome of Enterococcus faecalis that has been shown to be important for biofilm formation, adherence to host fibrinogen, collagen and platelets, and in experimental endocarditis and urinary tract infection models. Here, we created single and double deletion mutants of the pilus subunits and sortases; next, by combining western blotting, immunoelectron microscopy, and using ebpR in trans to increase pilus production, we identified EbpA as the tip pilin and EbpB as anchor at the pilus base, the latter attached to cell wall by the housekeeping sortase, SrtA...
2013: PloS One
Janetta Top, Fernanda L Paganelli, Xinglin Zhang, Willem van Schaik, Helen L Leavis, Miranda van Luit-Asbroek, Tom van der Poll, Masja Leendertse, Marc J M Bonten, Rob J L Willems
Nowadays, Enterococcus faecium is one of the leading nosocomial pathogens worldwide. Strains causing clinical infections or hospital outbreaks are enriched in the enterococcal surface protein (Esp) encoding ICEEfm1 mobile genetic element. Previous studies showed that Esp is involved in biofilm formation, endocarditis and urinary tract infections. In this study, we characterized the role of the putative AraC type of regulator (locus tag EfmE1162_2351), which we renamed ebrB and which is, based on the currently available whole genome sequences, always located upstream of the esp gene, and studied its role in Esp surface exposure during growth...
2013: PloS One
M Pinholt, C Ostergaard, M Arpi, N E Bruun, H C Schønheyder, K O Gradel, M Søgaard, J D Knudsen
Enterococci currently account for approximately 10% of all bacteraemias, reflecting remarkable changes in their epidemiology. However, population-based data of enterococcal bacteraemia are scarce. A population-based cohort study comprised all patients with a first episode of Enterococcus faecalis or Enterococcus faecium bacteraemia in two Danish regions during 2006-2009. We used data collected prospectively during clinical microbiological counselling and hospital registry data. We determined the incidence of mono- and polymicrobial bacteraemia and assessed clinical and microbiological characteristics as predictors of 30-day mortality in monomicrobial bacteraemia by logistic regression analysis...
February 2014: Clinical Microbiology and Infection
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