Die operative Therapie pyogener Wirbelsäulenerkrankungen in der Klinik und Poliklinik für Neurochirurgie des Universitätsklinikums Jena in dem Zeitraum von 2000 - 2007: eine retrospektive Untersuchung zu Symptomen, Ursachen, Therapie und Verlauf bei 75 Patienten

Bakteriell entzündliche Infektionen im Bereich der Wirbelsäule bzw. des Spinalkanals stellen sehr seltene, aber aufgrund ihrer unspezifischen Symptomatik und daher oft verspäteten Diagnose und der damit verbundenen Gefahr bleibender neurologischer Schäden, chronischer Schmerzen und septischer Verläufe nicht minder ernsthafte und zum Teil lebensbedrohliche Erkrankungen dar. In dieser retrospektiven Arbeit wurden 53 Patienten mit einer Spondylodiszitis und 22 Patienten mit einem rein intraspinalen Empyem, die in dem Zeitraum von 2000–2007 in der Klinik für Neurochirurgie der Friedrich-Schiller-Universität operativ versorgt wurden, im Hinblick auf die präoperative klinische Symptomatik, die Diagnostik, die operative und antibiotische Therapie, den Verlauf und letztendlich das klinische Outcome untersucht. In 54,7% d.F. wurde der Erreger Staph. aureus als häufigster Keim nachgewiesen, an dem sich im Zweifelsfall die kalkulierte Antibiose ausrichten muß. 91% der Patienten zeigten präoperativ zum Teil erhebliche Rückenschmerzen und 63% wiesen bereits neurologische Defizite auf. Davon 37% ein inkomplettes und immerhin 9,3% ein komplettes Querschnittsyndrom. In Abhängigkeit des betroffenen Wirbelsäulenabschnittes und des Instabilitätsausmaßes der Wirbelsäule wurden bei den Spondylodiszitis-Patienten verschiedene Stabilisierungen, die allgemein kontrovers in der Literatur diskutiert werden, durchgeführt. Alle Empyem-Patienten erhielten eine reine Dekompression. Unter dem durchgeführten Therapiekonzept trat kein Rezidiv auf. Trotz einer Verbesserung der neurologischen Defizite bei insgesamt 61,2% der initial betroffenen Patienten blieben bei 61,7% dieser Patienten Residuen (40,5% davon Frankel Grad A-C) zurück. Die Mortalitätsrate betrug 6,7%. Die Ergebnisse dieser Arbeit verdeutlichen in Übereinstimmung mit der aktuellen Literatur die Wichtigkeit einer frühzeitigen Diagnosestellung bei dann guter Behandelbarkeit zur Vermeidung ernsthafter Komplikationen und Konsequenzen

A Systematic Review of Serum Biomarkers Anti-Cyclic Citrullinated Peptide and Rheumatoid Factor as Tests for Rheumatoid Arthritis

This systematic review assesses the current status of anti-cyclic citrullinated peptide (anti-CCP) and rheumatoid factor (RF) tests in the diagnosis and prognosis of rheumatoid arthritis (RA). We reviewed publications on tests and biomarkers for early diagnosis of RA from English-language MEDLINE-indexed journals and non-MEDLINE-indexed sources. 85 publications were identified and reviewed, including 68 studies from MEDLINE and 17 non-MEDLINE sources. Anti-CCP2 assays provide improved sensitivity over anti-CCP assays and RF, but anti-CCP2 and RF assays in combination demonstrate a positive predictive value (PPV) nearing 100%, greater than the PPV of either of the tests alone. The combination also appears to be able to distinguish between patients whose disease course is expected to be more severe and both tests are incorporated in the 2010 ACR Rheumatoid Arthritis Classification Criteria. While the clinical value of anti-CCP tests has been established, differences in cut-off values, sensitivities and specificities exist between first-, second- and third-generation tests and harmonization efforts are under way. Anti-CCP and RF are clinically valuable biomarkers for the diagnosis and prognosis of RA patients. The combination of the two biomarkers in conjunction with other clinical measures is an important tool for the diagnosis and management of RA patients

Complete genome sequence and lifestyle of black-pigmented Corynebacterium aurimucosum ATCC 700975 (formerly C. nigricans CN-1) isolated from a vaginal swab of a woman with spontaneous abortion

Trost E, Götker S, Schneider J, et al. Complete genome sequence and lifestyle of black-pigmented Corynebacterium aurimucosum ATCC 700975 (formerly C. nigricans CN-1) isolated from a vaginal swab of a woman with spontaneous abortion. BMC Genomics. 2010;11(1): 91.Background Corynebacterium aurimucosum is a slightly yellowish, non-lipophilic, facultative anaerobic member of the genus Corynebacterium and predominantly isolated from human clinical specimens. Unusual black-pigmented variants of C. aurimucosum (originally named as C. nigricans) continue to be recovered from the female urogenital tract and they are associated with complications during pregnancy. C. aurimucosum ATCC 700975 (C. nigricans CN-1) was originally isolated from a vaginal swab of a 34-year-old woman who experienced a spontaneous abortion during month six of pregnancy. For a better understanding of the physiology and lifestyle of this potential urogenital pathogen, the complete genome sequence of C. aurimucosum ATCC 700975 was determined. Results Sequencing and assembly of the C. aurimucosum ATCC 700975 genome yielded a circular chromosome of 2,790,189 bp in size and the 29,037-bp plasmid pET44827. Specific gene sets associated with the central metabolism of C. aurimucosum apparently provide enhanced metabolic flexibility and adaptability in aerobic, anaerobic and low-pH environments, including gene clusters for the uptake and degradation of aromatic amines, L-histidine and L-tartrate as well as a gene region for the formation of selenocysteine and its incorporation into formate dehydrogenase. Plasmid pET44827 codes for a non-ribosomal peptide synthetase that plays the pivotal role in the synthesis of the characteristic black pigment of C. aurimucosum ATCC 700975. Conclusions The data obtained by the genome project suggest that C. aurimucosum could be both a resident of the human gut and possibly a pathogen in the female genital tract causing complications during pregnancy. Since hitherto all black-pigmented C. aurimucosum strains have been recovered from female genital source, biosynthesis of the pigment is apparently required for colonization by protecting the bacterial cells against the high hydrogen peroxide concentration in the vaginal environment. The location of the corresponding genes on plasmid pET44827 explains why black-pigmented (formerly C. nigricans) and non-pigmented C. aurimucosum strains were isolated from clinical specimens

The influence of the accessory genome on bacterial pathogen evolution

Bacterial pathogens exhibit significant variation in their genomic content of virulence factors. This reflects the abundance of strategies pathogens evolved to infect host organisms by suppressing host immunity. Molecular arms-races have been a strong driving force for the evolution of pathogenicity, with pathogens often encoding overlapping or redundant functions, such as type III protein secretion effectors and hosts encoding ever more sophisticated immune systems. The pathogens’ frequent exposure to other microbes, either in their host or in the environment, provides opportunities for the acquisition or interchange of mobile genetic elements. These DNA elements accessorise the core genome and can play major roles in shaping genome structure and altering the complement of virulence factors. Here, we review the different mobile genetic elements focusing on the more recent discoveries and highlighting their role in shaping bacterial pathogen evolution

Comparative and Joint Analysis of Two Metagenomic Datasets from a Biogas Fermenter Obtained by 454-Pyrosequencing

Biogas production from renewable resources is attracting increased attention as an alternative energy source due to the limited availability of traditional fossil fuels. Many countries are promoting the use of alternative energy sources for sustainable energy production. In this study, a metagenome from a production-scale biogas fermenter was analysed employing Roche's GS FLX Titanium technology and compared to a previous dataset obtained from the same community DNA sample that was sequenced on the GS FLX platform. Taxonomic profiling based on 16S rRNA-specific sequences and an Environmental Gene Tag (EGT) analysis employing CARMA demonstrated that both approaches benefit from the longer read lengths obtained on the Titanium platform. Results confirmed Clostridia as the most prevalent taxonomic class, whereas species of the order Methanomicrobiales are dominant among methanogenic Archaea. However, the analyses also identified additional taxa that were missed by the previous study, including members of the genera Streptococcus, Acetivibrio, Garciella, Tissierella, and Gelria, which might also play a role in the fermentation process leading to the formation of methane. Taking advantage of the CARMA feature to correlate taxonomic information of sequences with their assigned functions, it appeared that Firmicutes, followed by Bacteroidetes and Proteobacteria, dominate within the functional context of polysaccharide degradation whereas Methanomicrobiales represent the most abundant taxonomic group responsible for methane production. Clostridia is the most important class involved in the reductive CoA pathway (Wood-Ljungdahl pathway) that is characteristic for acetogenesis. Based on binning of 16S rRNA-specific sequences allocated to the dominant genus Methanoculleus, it could be shown that this genus is represented by several different species. Phylogenetic analysis of these sequences placed them in close proximity to the hydrogenotrophic methanogen Methanoculleus bourgensis. While rarefaction analyses still indicate incomplete coverage, examination of the GS FLX Titanium dataset resulted in the identification of additional genera and functional elements, providing a far more complete coverage of the community involved in anaerobic fermentative pathways leading to methane formation

The Clavibacter michiganensis Subspecies: Molecular Investigation of Gram-Positive Bacterial Plant Pathogens

Eichenlaub R, Gartemann K-H. The Clavibacter michiganensis Subspecies: Molecular Investigation of Gram-Positive Bacterial Plant Pathogens. Annu Rev Phytopathol. 2011;49(1):445-464

Specific detection of p-chlorobenzoic acid by Escherichia coli bearing a plasmid-borne fcbA':: lux fusion

Rozen Y, Nejidat A, Gartemann K-H, Belkin S. Specific detection of p-chlorobenzoic acid by Escherichia coli bearing a plasmid-borne fcbA':: lux fusion. CHEMOSPHERE. 1999;38(3):633-641.In this communication we report on a genetically engineered bacterium that reacts by light emission to the presence of 4-chlorobenzoic acid. To construct this strain, DNA fragment (1.7 kb) upstream from the 4-chlorobenzoic acid dehalogenase (fcb) operon of Arthrobacter SU was fused to Vibrio fischeri luxCDABE genes. An Escherichia coli strain transformed with a multi-copy plasmid (pASU) bearing this fusion responded to the presence of 4-chlorobenzoic acid and a few closely related compounds by increased luminescence, exhibiting a high specificity but a relatively low sensitivity. While it could be somewhat, improved by manipulating the experimental pH, sensitivity remained too low for real time applicability. Nevertheless, the principle of using dehalogenase promoters as environmental pollution sensor was demonstrated. (C) 1998 Elsevier Science Ltd. All rights reserved