Molecular Characterization of Clinical Isolates of Aeromonas Species from Malaysia

Background: Aeromonas species are common inhabitants of aquatic environments giving rise to infections in both fish and humans. Identification of aeromonads to the species level is problematic and complex due to their phenotypic and genotypic heterogeneity. Methodology/Principal Findings: Aeromonas hydrophila or Aeromonas sp were genetically re-identified using a combination of previously published methods targeting GCAT, 16S rDNA and rpoD genes. Characterization based on the genus specific GCAT-PCR showed that 94 (96%) of the 98 strains belonged to the genus Aeromonas. Considering the patterns obtained for the 94 isolates with the 16S rDNA-RFLP identification method, 3 clusters were recognised, i.e. A. caviae (61%), A. hydrophila (17%) and an unknown group (22%) with atypical RFLP restriction patterns. However, the phylogenetic tree constructed with the obtained rpoD sequences showed that 47 strains (50%) clustered with the sequence of the type strain of A. aquariorum, 18 (19%) with A. caviae, 16 (17%) with A. hydrophila, 12 (13%) with A. veronii and one strain (1%) with the type strain of A. trota. PCR investigation revealed the presence of 10 virulence genes in the 94 isolates as: lip (91%), exu (87%), ela (86%), alt (79%), ser (77%), fla (74%), aer (72%), act (43%), aexT (24%) and ast (23%). Conclusions/Significance: This study emphasizes the importance of using more than one method for the correct identification of Aeromonas strains. The sequences of the rpoD gene enabled the unambiguous identication of the 9

Prevalence of autoantibody patterns in a group of patients with early scleroderma

Background.: Scleroderma is traditionally classified into two forms with different clinical expression: localized and diffused. An early variant has been described that is distinguished in three different “subsets” characterized by the constant presence of Raynaud phenomenon associated or not with anatomic alterations in the microcirculation detectable by nailfold videocapillaroscopy and/or the presence of autoantibodies (anti centromere or anti topoisomerase I): subset (1): autoantibodies plus microcirculation alterations; subset (2): autoantibodies, in the absence of microcirculation alterations; subset (3): microcirculation alterations, in the absence of autoantibodies. Methods.: Our study was conducted on a group of 89 subjects with a positive history for Raynaud’s phenomenon enrolled at the Interdisciplinary Interdepartmental Reference Center for Early Diagnosis of Scleroderma Ulcers (CRIIS) of “Sandro Pertini” hospital in Rome, with the aim of defining the subset to which they belonged basing on the positivity to nailfold videocapillaroscopy and/or the presence of specific autoantibody markers. Results and conclusions.: We identified: 25 patients with anti-CENP B antibodies, two of which were also positive for anti-SSA antibodies; 7 with anti-Topoisomerase I antibodies, of which one was also positive for anti-SS-A and another for both anti-Ro60 and anti-snRNP. These patients were classified as subset 1 or 2. Three patients were positive for anti-PM/Scl-100 antibodies in addition to other autoantibody markers: one resulted also positive for anti-snRNP, the others for both anti-SS-A and anti-Ro52

Cutaneous Granulomatosis: a Comprehensive Review

Cutaneous granulomatosis is a heterogeneous group of diseases, characterized by a skin inflammatory reaction triggered by a wide variety of stimuli, including infections, foreign bodies, malignancy, metabolites, and chemicals. From a pathogenic point of view, they are divided into non-infectious and infectious granulomas. Pathophysiological mechanisms are still poorly understood. Non-infectious granulomatous skin diseases include granuloma annulare, necrobiosis lipoidica, rheumatic nodules, foreign body granulomas, cutaneous sarcoidosis, and interstitial granulomatous dermatitis. Necrobiosis lipoidica is more frequent in diabetic patients. Infectious granulomas of the skin are caused by mycobacteria, in particular Mycobacterium tuberculosis or atypical mycobacteria; parasites, such as Leishmania; or fungi. Pathogenic mechanisms of M. tuberculosis-related granuloma are discussed. From a clinical point of view, it is useful to divide cutaneous granulomatosis into localized and more disseminated forms, although this distinction can be sometimes artificial. Three types of localized granulomatous lesions can be distinguished: palisaded granulomas (granuloma annulare, necrobiosis lipoidica, and rheumatoid nodules), foreign body granulomas, and infectious granulomas, which are generally associated with localized infections. Disseminated cutaneous granulomas can be divided into infectious, in particular tuberculosis, and non-infectious forms, among which sarcoidosis and interstitial granulomatous dermatitis. From a histological point of view, the common denominator is the presence of a granulomatous inflammatory infiltrate in the dermis and/or hypodermis; this infiltrate is mainly composed of macrophages grouped into nodules having a nodular, palisaded or interstitial architecture. Finally, we propose which diagnostic procedure should be performed when facing a patient with a suspected cutaneous granulomatosis