Bacillus cereus Biovar Anthracis Causing Anthrax in Sub-Saharan Africa—Chromosomal Monophyly and Broad Geographic Distribution

Through full genome analyses of four atypical Bacillus cereus isolates, designated B. cereus biovar anthracis, we describe a distinct clade within the B. cereus group that presents with anthrax-like disease, carrying virulence plasmids similar to those of classic Bacillus anthracis. We have isolated members of this clade from different mammals (wild chimpanzees, gorillas, an elephant and goats) in West and Central Africa (Côte d’Ivoire, Cameroon, Central African Republic and Democratic Republic of Congo). The isolates shared several phenotypic features of both B. anthracis and B. cereus, but differed amongst each other in motility and their resistance or sensitivity to penicillin. They all possessed the same mutation in the regulator gene plcR, different from the one found in B. anthracis, and in addition, carry genes which enable them to produce a second capsule composed of hyaluronic acid. Our findings show the existence of a discrete clade of the B. cereus group capable of causing anthrax-like disease, found in areas of high biodiversity, which are possibly also the origin of the worldwide distributed B. anthracis. Establishing the impact of these pathogenic bacteria on threatened wildlife species will require systematic investigation. Furthermore, the consumption of wildlife found dead by the local population and presence in a domestic animal reveal potential sources of exposure to humans

A Case of Acquired Rifampin Resistance in Mycobacterium Bovis Bacillus Calmette-Guérin-induced Cystitis: Necessity for Treatment Guidelines

A case of presumed bacillus Calmette-Guérin (BCG) cystitis in an elderly female patient following direct intravesical BCG instillation treatment for papillary transitional cell carcinoma is reported. The organism cultured from urine samples was eventually identified as a rifampin-resistant Mycobacterium bovis BCG isolate. Because the patient had received rifampin monotherapy during the course of treatment for presumed BCG disease, the clinical picture favoured acquired rifampin resistance. Sequencing of the target gene for rifampin (rpoB) confirmed a known mutation responsible for conferring high levels of resistance to both rifampin and rifabutin (Ser531Tyr). To the authors’ knowledge, this is the first reported case of M bovis BCG disease in a non-HIV patient where the organism had acquired drug resistance to rifampin, and the second reported case of M bovis BCG that had acquired drug resistance. The present case demonstrates the necessity to re-evaluate appropriate guidelines for the effective treatment of BCG disease

Maximum likelihood tree based on core chromosomal SNP data.

<p>A: Full tree. B: Zoom-in focused on the <i>Bacillus cereus</i> biovar anthracis clade. <i>Bacillus anthracis</i> sequences are black, <i>Bacillus cereus</i> and <i>Bacillus thuringiensis</i> red and <i>B</i>. <i>cereus</i> bv anthracis blue. Branch support values were estimated by approximate likelihood ratio tests and are only reported for these internal branches not supported by maximal values. This tree was rooted with TempEst v1.5.</p

Maximum likelihood tree based on core plasmid SNP data.

<p>A: pXO1. B: pXO2. <i>Bacillus anthracis</i> sequences are black, <i>Bacillus cereus</i> red and <i>Bacillus cereus</i> biovar anthracis blue. Branch support values were estimated by approximate likelihood ratio tests and are only reported for these internal branches not supported by maximal values. The trees were rooted with TempEst v1.5.</p

Comparison of selected microbiological and molecular features of <i>Bacillus cereus</i> bv anthracis strains.

<p>Comparison of selected microbiological and molecular features of <i>Bacillus cereus</i> bv anthracis strains.</p