Az atherosclerosis és Chlamydia pneumoniae fertőzések összefüggésének genetikai háttere = The genetic background of the interactions between atherosclerosis and Chlamydia pneumoniae infections

Atherosclerotikus plakkokban gyakran a Chlamydophila pneumoniae (C. pneumoniae) DNS és human cytomegalovirus (HCMV) DNS közös jelenléte mutatható ki. A kettősen fertőzött monocytákban az atherosclerosisban szerepet játszó gének expressziója jön létre. A HCMV-vel (Oslo törzs) fertőzött dendritikus sejtekben (DC) a virus nem szaporodik, de a HCMV-vel fertőzött fibroblast sejtek által termelt faktorok a DC érését indítják el. A DC fertőzése C. pneumoniae-val elindítja a DC érését, de a fertőző baktériumok szaporodasát nem. Bizonyos chlamydiális transzkriptok kifejezőséde megtörténik, de a baktérium osztódásásban szerepet jatszó ftsK gén mRNA expressziója nem. Akut nem-cardioembóliás eredetű stroke betegek és kontroll egyének vérének vizsgálata szerint a CD14 és IL-8 promoter polimorfizmusok nem jatszanak szerepet a stroke kialakulásában. A stroke betegekben szignifikánsan magasabb a HCMV-IgG és HSV-1 IgA ellenanyag szint. Percutan transluminalis angioplasztikai beavatkozás után a C. pneumoniae DNS és HCMV DNS kimutathatósága fokozott, a hisztamin, CRP, és IL-6 szintek emelkedettek. Egér modellen az egyszeri vagy ismételt C. pneumoniae fertőzés bakteriális perzisztenciát eredményez. | Chlamydophila pneumoniae (C. pneumoniae) is often present in combination with human cytomegalovirus (HCMV) in atherosclerotic carotid lesions. The doubly-infected monocytes are potent expressors of proatherosclerotic genes. The HCMV (strain Oslo) does not replicate in infected dendritic cells (DC), however HCMV conditioning medium harvested from human fibroblast cells induce the expression of maturation markers on the DC. Full replication of C. pneumoniae in DC is not observed, but C. pneumoniae infection induce the maturation and functional activation of DC. Some chlamydial genes are expressed, but the expression of the division-related ftsK gen is limited. By analyzing blood samples of patients with acute noncardioembolic ischemic stroke and control individuals, the IL-8 or CD14 promoter polymorphisms are not related with the development of the disease. Serum levels of HCMV-IgG and HSV-1 IgA are higher in the patients than in the controls. Reactivation of C. pneumoniae and HCMV and increased levels of histamine, CRP and IL-6 followoing percutan transluminal angioplasty are observed. A single or repeated inoculation of mice with C. pneumoniae result in bacterial persistence in a few mice

Global phylogeny of Treponema pallidum lineages reveals recent expansion and spread of contemporary syphilis.

Funder: Queensland GovernmentSyphilis, which is caused by the sexually transmitted bacterium Treponema pallidum subsp. pallidum, has an estimated 6.3 million cases worldwide per annum. In the past ten years, the incidence of syphilis has increased by more than 150% in some high-income countries, but the evolution and epidemiology of the epidemic are poorly understood. To characterize the global population structure of T. pallidum, we assembled a geographically and temporally diverse collection of 726 genomes from 626 clinical and 100 laboratory samples collected in 23 countries. We applied phylogenetic analyses and clustering, and found that the global syphilis population comprises just two deeply branching lineages, Nichols and SS14. Both lineages are currently circulating in 12 of the 23 countries sampled. We subdivided T. p. pallidum into 17 distinct sublineages to provide further phylodynamic resolution. Importantly, two Nichols sublineages have expanded clonally across 9 countries contemporaneously with SS14. Moreover, pairwise genome analyses revealed examples of isolates collected within the last 20 years from 14 different countries that had genetically identical core genomes, which might indicate frequent exchange through international transmission. It is striking that most samples collected before 1983 are phylogenetically distinct from more recently isolated sublineages. Using Bayesian temporal analysis, we detected a population bottleneck occurring during the late 1990s, followed by rapid population expansion in the 2000s that was driven by the dominant T. pallidum sublineages circulating today. This expansion may be linked to changing epidemiology, immune evasion or fitness under antimicrobial selection pressure, since many of the contemporary syphilis lineages we have characterized are resistant to macrolides

Ornithosis – aktualitások egy eset kapcsán = Ornithosis – case report and actual questions

A szerzők egy kritikus állapotú, intenzív osztályon ápolt beteg esetének ismertetése kapcsán foglalják össze az ornithosisdiagnosztika jelenlegi lehetőségeit, epidemiológiai, valamint terápiás vonatkozásait. A kórkép egyéb atípusos bakteriális kórképektől való elkülönítése a klinikai tünetek alapján megbízhatóan nem lehetséges, éppen ezért döntő, olykor életmentő jelentőséggel bír a madárkontaktus felderítése. Az anamnesztikus adatokat rögzítő klinikust mindez egyből a helyes diagnózis felé terelheti, ami az adekvát terápia révén gyors gyógyulást eredményezhet. E bejelentendő kórkép feltehetően mindmáig a gyakran félre- vagy későn diagnosztizált infekciók közé tartozik, így az alulreprezentáltnak tekinthető esetszám nem tükrözi a hazai valós epidemiológiai helyzetet. A szerzők célja, hogy felhívják a figyelmet erre a nem is olyan ritka, ám akár halálos kimenetelű megbetegedésre. | Authors describe a severe case of psittacosis requiring intensive care and summarize the potential means, as well as the epidemiological and therapeutical aspects of the diagnosis. Clinical signs of ornithosis do not allow a reliable differentiation from other atypical bacterial infections, thus, exploring the possible exposure to birds in the patient’s history is most important in these cases. Knowledge of bird exposure in the history leads the clinician to the correct diagnosis that may result quick recovery due to the adequate therapy. This notifiable disease may presumably belong to the misdiagnosed or delayed diagnosed infections even today so the underrepresented case-reports do not necessarily reflect the actual epidemiological situation in Hungary. The aim of the authors was to call the attention to this sometimes fatal disease occurring not as rarely as supposed

Distribution of Chlamydia trachomatis genotypes in neonatal conjunctivitis in Hungary

The objective of the present study was to determine the frequency and age distribution of different Chlamydia trachomatis (CT) genotypes causing ophthalmia neonatorum (ON) in Hungary. Using CT specific PCR, we tested 76 conjunctival samples from symptomatic infants up to 3 months old in the National Centre for Epidemiology, Budapest between 2008 and 2016. CT tested positive in 30 of 76 conjunctival samples (39.5 %). The sequencing of the positive samples was successful in every case but one, and resulted in 48 % dominance for genotype E (14/29), followed by 24 % for genotype G (7/29), 10 % for J (3/29), 6.9 % for K and F (2/29), and 3.4 % for H (1/29). CT must still be regarded as a common pathogen causing ON in Hungary. Routine screening and treatment of pregnant women can be recommended to prevent these conditions. Chronic ON cases can be reduced by early diagnosis. Further research is needed to explain the dominance of genotypes E and G

Chronic infections and genetic factors in the development of ischemic stroke

The aim of this study was to examine whether chronic infections and genetic factors of the host play roles in the pathophysiology of acute noncardioembolic ischemic stroke. Blood samples from 59 subjects with ischemic stroke and 52 control patients were investigated by nested PCR for the presence of C. pneumoniae DNA, HCMV DNA and enterovirus RNA, by ELISA for the levels of antibodies to C. pneumoniae, HCMV, HSV, HHV-6, EBV and the inflammatory chemokine IL-8, and by PCR for promoter polymorphism of the IL-8 and CD14 host genes. Associations of stroke with the HCMV IgG and HSV-1 IgA antibody levels were observed. No association of stroke was detected with the presence of C. pneumoniae, HCMV or enterovirus nucleic acids in the peripheral blood, C. pneumoniae IgM, IgG and IgA, the HSV IgG, the EBV IgG, or HHV-6 IgG antibody levels, the pathogen burden, the IL-8 or CD 14 promoter polymorphisms, or with the serum levels of IL-8 in the overall study population. These results are consistent with the hypothesis that certain pathogens are involved in the development of ischemic stroke