Genetic analysis of exopolysaccharide acetilation product by Burkholderia cepacia

Bacteria belonging to the Burkholderia cepacia complex are mainly isolated from the sputum of cystic fibrosis patients and frequently show a mucoid phenotype.Most of them produce an exopolysaccharide called cepacian, whose repeating unit consists of a branched heptasaccharide carrying from one to three acetyl esters. Two genetic loci, bceI and bceII, consisting of 11 and 9 genes respectively, are involved in cepacian biosynthesis.Three genes located in the bceII locus, named bceOSU, code for different acyltransferases. As the presence of acetyl groups influences the viscosity of cepacian, we compared three strains (two clinical isolates named BTS2 and BTS7, and the reference strain Burkholderia sp. 383) exhibiting differences both in the acetylation pattern and at the genomic level, for the presence of insertion sequences adjacent to bceU

Colonization of the tip of a thoracic catheter by Enterococcus faecalis resistant to vancomycin and linezolid

We report the isolation ofEnterococcus faecalisresistant to vancomycin and linezolid from the tip of a thoracic drainage catheter in an elderly patient. He was treated with vancomycin for a pleural empyema due to a meticillin-resistantStaphylococcus aureusbut never received linezolid. A surveillance rectal swab yielded both linezolid-susceptible and -resistant strains, and the two isolates were not genotypically related. Careful monitoring for linezolid-resistance is critical to avoid potential therapy failure and transmission of resistantE. faecalis

pKBuS13, a KPC-2-Encoding Plasmid from Klebsiella pneumoniae Sequence Type 833, Carrying Tn4401b Inserted into an Xer Site-Specific Recombination Locus

Here, we report the first detection of a Klebsiella pneumoniae carbapenemase 2 (KPC-2)-producing Klebsiella pneumoniae strain belonging to sequence type 833 (ST833), collected in an Italian hospital from a patient coming from South America. Its bla KPC determinant was carried by a ColE1 plasmid, pKBuS13, that showed the Tn4401b::bla KPC-2 transposon inserted into the regulatory region of an Xer site-specific recombination locus. This interfered with the correct resolution of plasmid multimers into monomers, lowering plasmid stability and leading to overestimation of the number of plasmids harbored by a single host cell. Sequencing of the fragments adjacent to Tn4401b detected a region that did not have significant matches in databases other than the genome of a carbapenem-resistant Escherichia coli strain collected during the same year at a hospital in Boston. This is interesting in an epidemiologic context, as it suggests that despite the absence of tra genes and the instability under nonselective conditions, the circulation of pKBuS13 or of analogous plasmids might be wider than reported

Congenital myopathies: Clinical phenotypes and new diagnostic tools

Congenital myopathies are a group of genetic muscle disorders characterized clinically by hypotonia and weakness, usually from birth, and a static or slowly progressive clinical course. Historically, congenital myopathies have been classified on the basis of major morphological features seen on muscle biopsy. However, different genes have now been identified as associated with the various phenotypic and histological expressions of these disorders, and in recent years, because of their unexpectedly wide genetic and clinical heterogeneity, next-generation sequencing has increasingly been used for their diagnosis. We reviewed clinical and genetic forms of congenital myopathy and defined possible strategies to improve cost-effectiveness in histological and imaging diagnosis

Characterization of integrons in Burkholderia cepacia clinical isolates

Burkholderia cepacia is an opportunistic pathogen able to colonize the airways of Cystic Fibrosis (CF) patients, frequently developing chronic infections. In 20% of cases these infections cause severe and poorly controlled pathological situations because of the intrinsic antibiotic resistance expressed by the microorganism. CF patients are often subjected to antibiotic therapy: this facilitates the acquisition of antibiotic resistance determinants by the infecting bacteria. Integrons are mobile genetic elements that are widespread in bacterial populations and favor the acquisition of gene cassettes coding for these determinants.The presence of class 1 integrons was investigated by PCR with primers specific for the 5’ and 3’ ends in Burkholderia isolates recovered from patients in treatment at the CF center of Friuli Venezia Giulia. The same integron, carrying an uncommon allelic form (Ib) of the aacA4 gene in its cassette array and conferring resistance to some aminoglycosides, was found in two independent isolates (different RAPD profiles) infecting two different patients. In both isolates the integron was carried by plasmids and was still present 3 and 6 years later the first finding. Despite the exchange of integrons between bacterial pathogens is fully described, these items were not frequently found in Burkholderia isolates. Although the clinical relevance of the integron we identified is low (a single gene cassette encoding a widespread resistance),we feel concerned that these genetic elements begin to circulate in this bacterial species, as this could make more and more troublesome the treatment of infections notoriously difficult to eradicate

Study of class I integron in a Burkholderia cepacia complex strain isolated from blood colture

The Burkholderia cepacia complex (Bcc) consists of several species that cause lung infections in patients with cystic fibrosis but are also capable to colonize immunocompromised patients. Once established, the infection is usually difficult to eradicate, as Bcc is intrinsically resistant to many antibiotics. Besides, the acquisition of additional resistance determinants by horizontal gene transfer makes very difficult the therapeutic approach to these infections. Among horizontally acquired DNAs, integrons have been frequently reported in many Gramnegative bacteria that affect human health, but they have not been found frequently in Burkholderia isolates until now. In the present work we report on a Bcc isolate, recovered from the blood of an immunocompromised patient, that carries a 2.3 kb class I integron already described in a Salmonella enterica isolate eight years ago, coding for aacA4, aadA1 and catB2 in its cassette array

The biofilm produced by Burkholderia cepacia complex: molecular aspects and relationship with exopolysaccharides

Introduction. In cystic fibrosis patients, Burkholderia cepacia complex (Bcc) can cause serious pulmonary chronic infections thanks in part to the ability to form biofilm, matrix rich in exopolysaccharides. In Bcc grown in the planktonic state, the main exopolysaccharide is cepacian while in biofilm its presence is controversial. Methods and Results. Two clinical isolates, named BTS7 and BTS2, were studied. BTS7 produces abundant cepacian but not much biofilm (quantified by colorimetric method).At least two of the genes involved in cepacian biosynthesis are not necessary for biofilm production as two BTS7 derivatives, bceB and bceQ knocked out by transposon mutagenesis, produce biofilm levels comparable to the wild-type. BTS2 sinthesyzes cepacian only if cultured on a specific medium. It has been colonizing a patient for almost ten years, showing a significant reduction of biofilm production during this period. This reduction did not appear together with the lack of factors required for the initial adhesion to the surface, or to differences in some of the Bcc genes involved in biofilm formation. Moreover, sequencing of its bce locus revealed a bceX gene, absent in BTS7, coding for a trascriptional regulator. Its product may negatively regulate the production of cepacian but not the one of other polysaccharides, promoting the formation of biofilm. Conclusions. Cepacian seems to be marginal in the production of biofilm.The reduced ability to produce biofilm of BTS2 suggests possible gene mutations occurred over time. Using custom arrays we will compare the gene expression of the BTS2 isolates, to identify the genes responsible for the observed phenotypic changes