Immunoprophylaxis and immunotherapy of experimental Pseudomonas aeruginosa sepsis

The protective activity of pyoimmunogen II, lot 9, was studied on P. aeruginosa experimental sepsis used as a model. In experiments on rats the preparation was shown to be nontoxic according to the results of the determination of acute and chronic toxicity. The preparation under test produced a high protective effect in experiments on animals infected with various P. aeruginosa strains, irrespective of their virulence and immunotype. Anti-P. aeruginosa plasma, obtained by plasmapheresis from donors immunized with pyoimmunogen II, showed a curative effect when injected into experimental animals in a dose of 0.02 ml/g body weight at early stages of the infection.     

Experimental vaccinal prophylaxis of Pseudomonas aeruginosa burn sepsis

After the injection of P. aeruginosa live culture under the burned skin of mice sepsis develops within the first 24 hours, finally leading to the death of the animals. The microorganisms can be isolated from the blood, liver, kidneys and mesenterial lymph nodes till day 3 and from the spleen till day 5. After the intraperitoneal injection of P. aeruginosa live culture into mice, sepsis also develops within 24 hours, and the culture can be isolated from the blood and parenchymatous organs till day 3. The LD50 of the culture is equal to 5.1 X 10(6) microbial cells when introduced intraperitoneally and to 30 microbial cells in experimental burn sepsis. Experimental burn sepsis clearly demonstrates the effectiveness of Pseudomonas acellular protein vaccine: its index of effectiveness exceeds 3,000.     

ICU患者铜绿假单胞菌获得性肺炎耐药研究

目的监测重症监护病房（ICU）铜绿假单胞菌（Pseudomonas aeruginosa,PA）的感染状况及耐药变迁,指导临床合理使用抗菌药物。方法对2003年至2007年间,我院ICU收治的患者下呼吸道分泌物进行培养及体外耐药试验。结果铜绿假单胞菌是ICU下呼吸道感染的主导致病菌且感染率呈逐年上升的趋势（46．3％-81．0％）,细菌对三代头孢、亚胺培南及氨基糖苷类药物的耐药性也呈逐年上升的趋势,并呈现多重耐药的特性。结论铜绿假单胞菌是ICU院内下呼吸道感染的常见病原菌,其多重耐药性及应引起高度重视。     

Effect of Carbenicillin on Pseudomonas aeruginosa

The activity of carbenicillin against 200 strains of Pseudomonas aeruginosa was measured by a quantitative agar dilution method. Minimal inhibitory concentrations (M.I.C.''s) for five graded inocula were measured in terms of complete inhibition (CI) and reduced growth (RG). The M.I.C. decreased progressively as inocula were reduced, median values for the 200 strains ranging from 100 to 37.5 μg. per ml. by the CI criterion, and from 75 to 25 μg. per ml. by the RG definition. Ratios of M.I.C. obtained for large and small inocula were usually small. Identical M.I.C.''s by both CI and RG criteria were most often obtained when the inoculum for the RG criterion was 1 or 2 logs higher than that for complete inhibition.Population analysis of 15 strains of Ps. aeruginosa showed that one specific drug concentration usually caused a sharp drop in proportion of viable cells, ranging from 3 to 5 logs. None of the populations were completely non-viable even at 150 μg. per ml. There was evidence that the viability of different-sized populations was reduced disproportionately by carbenicillin.Carbenicillin 300 μg. per ml. exerted appreciable bactericidal effect against nine of 15 strains of Ps. aeruginosa after a 24-hour contact period; after only six hours the bactericidal effect was very small.Quantitative sensitivity measurements for carbenicillin should include M.I.C. values for both CI and RG criteria, using a range of inocula for testing. Such M.I.C. values may well be useful in monitoring carbenicillin therapy of tissue infections.     

Chronic pneumonia with Pseudomonas aeruginosa and impaired alveolar fluid clearance

Background

While the functional consequences of acute pulmonary infections are widely documented, few studies focused on chronic pneumonia. We evaluated the consequences of chronic Pseudomonas lung infection on alveolar function.

Methods

P. aeruginosa, included in agar beads, was instilled intratracheally in Sprague Dawley rats. Analysis was performed from day 2 to 21, a control group received only sterile agar beads. Alveolar-capillary barrier permeability, lung liquid clearance (LLC) and distal alveolar fluid clearance (DAFC) were measured using a vascular (¹³¹I-Albumin) and an alveolar tracer (¹²⁵I-Albumin).

Results

The increase in permeability and LLC peaked on the second day, to return to baseline on the fifth. DAFC increased independently of TNF-α or endogenous catecholamine production. Despite the persistence of the pathogen within the alveoli, DAFC returned to baseline on the 5^th day. Stimulation with terbutaline failed to increase DAFC. Eradication of the pathogen with ceftazidime did not restore DAFC response.

Conclusions

From these results, we observe an adequate initial alveolar response to increased permeability with an increase of DAFC. However, DAFC increase does not persist after the 5^th day and remains unresponsive to stimulation. This impairment of DAFC may partly explain the higher susceptibility of chronically infected patients to subsequent lung injury.     

铜绿假单胞茵肺炎治疗和预后的临床研究

目的探讨感染铜绿假单胞菌肺炎患者的治疗和预后。方法选取2011年1月至2013年2月浙江大学医学院附属第一医院住院的铜绿假单胞菌肺炎患者,共211例作为研究对象。根据药敏试验结果,把铜绿假单胞菌株分为非多重耐药、多重耐药菌株,分别探讨非多重耐药、多重耐药铜绿假单胞菌所致肺炎的治疗和预后。结果非多重耐药、多重耐药铜绿假单胞菌肺炎治疗有效率分别为91.0% （144/155 ）,35. 7% （20/56 ）,差异有统计学意义（P 〈 0. 05）,死亡率分别为2. 6% （4/155）、32. 1%（ 18/56）,差异有统计学意义（P 〈0.05）。抗菌药单药或联合治疗方案对非多重耐药铜绿假单胞菌肺炎的临床有效率差异无统计学意义（P〉0.05）,联合治疗方案能缩短非多重耐药铜绿假单胞菌肺炎的平均住院天数（P〈0. 05）;抗菌药单药或联合治疗方案对多重耐药铜绿假单胞菌肺炎的临床有效率、平均住院天数差异无统计学意义（P 〉0.05）。结论非多重耐药铜绿假单胞菌肺炎治疗疗效好,死亡率低,联合治疗方案可缩短非多重耐药铜绿假单胞菌肺炎的平均住院天数。多重耐药铜绿假单胞菌肺炎治疗疗效差,死亡率高。     

Estrogen aggravates inflammation in Pseudomonas aeruginosa pneumonia in cystic fibrosis mice

Background

Among patients with cystic fibrosis (CF), females have worse pulmonary function and survival than males, primarily due to chronic lung inflammation and infection with Pseudomonas aeruginosa (P. aeruginosa). A role for gender hormones in the causation of the CF "gender gap" has been proposed. The female gender hormone 17β-estradiol (E2) plays a complex immunomodulatory role in humans and in animal models of disease, suppressing inflammation in some situations while enhancing it in others. Helper T-cells were long thought to belong exclusively to either T helper type 1 (Th1) or type 2 (Th2) lineages. However, a distinct lineage named Th17 is now recognized that is induced by interleukin (IL)-23 to produce IL-17 and other pro-inflammatory Th17 effector molecules. Recent evidence suggests a central role for the IL-23/IL-17 pathway in the pathogenesis of CF lung inflammation. We used a mouse model to test the hypothesis that E2 aggravates the CF lung inflammation that occurs in response to airway infection with P. aeruginosa by a Th17-mediated mechanism.

Results

Exogenous E2 caused adult male CF mice with pneumonia due to a mucoid CF clinical isolate, the P. aeruginosa strain PA508 (PA508), to develop more severe manifestations of inflammation in both lung tissue and in bronchial alveolar lavage (BAL) fluid, with increased total white blood cell counts and differential and absolute cell counts of polymorphonuclear leukocytes (neutrophils). Inflammatory infiltrates and mucin production were increased on histology. Increased lung tissue mRNA levels for IL-23 and IL-17 were accompanied by elevated protein levels of Th17-associated pro-inflammatory mediators in BAL fluid. The burden of PA508 bacteria was increased in lung tissue homogenate and in BAL fluid, and there was a virtual elimination in lung tissue of mRNA for lactoferrin, an antimicrobial peptide active against P. aeruginosa in vitro.

Conclusions

Our data show that E2 increases the severity of PA508 pneumonia in adult CF male mice, and suggest two potential mechanisms: enhancement of Th17-regulated inflammation and suppression of innate antibacterial defences. Although this animal model does not recapitulate all aspects of human CF lung disease, our present findings argue for further investigation of the effects of E2 on inflammation and infection with P. aeruginosa in the CF lung.     

Efficacy comparison of adjuvants in PcrV vaccine against Pseudomonas aeruginosa pneumonia

Vaccination against the type III secretion system of P. aeruginosa is a potential prophylactic strategy for reducing the incidence and improving the poor prognosis of P. aeruginosa pneumonia. In this study, the efficacies of three different adjuvants, Freund's adjuvant (FA), aluminum hydroxide (alum) and CpG oligodeoxynucleotide (ODN), were examined from the viewpoint of inducing PcrV‐specific immunity against virulent P. aeruginosa. Mice that had been immunized intraperitoneally with recombinant PcrV formulated with one of the above adjuvants were challenged intratracheally with a lethal dose of P. aeruginosa. The PcrV–FA immunized group attained a survival rate of 91%, whereas the survival rates of the PcrV–alum and PcrV–CpG groups were 73% and 64%, respectively. In terms of hypothermia recovery after bacterial instillation, PcrV–alum was the most protective, followed by PcrV–FA and PcrV–CpG. The lung edema index was lower in the PcrV–CpG vaccination group than in the other groups. PcrV–alum immunization was associated with the greatest decrease in myeloperoxidase in infected lungs, and also decreased the number of lung bacteria to a similar number as in the PcrV–FA group. There was less neutrophil recruitment in the lungs of mice vaccinated with PcrV–alum or PcrV–CpG than in those of mice vaccinated with PcrV–FA or PcrV alone. Overall, in terms of mouse survival the PcrV–CpG vaccine, which could be a relatively safe next‐generation vaccine, showed a comparable effect to the PcrV–alum vaccine.     

Oral administration of Bifidobacterium longum prevents gut-derived Pseudomonas aeruginosa sepsis in mice

Aims: The aim of the study was to evaluate the efficacy of probiotics on gut‐derived sepsis caused by Pseudomonas aeruginosa in immunocompromised mice. Methods and Results: After oral inoculation of P. aeruginosa, mice were treated with cyclophosphamide to induce leucopenia and translocation of the intestinal P. aeruginosa into blood, thereby producing gut‐derived sepsis. In this model, administration of 1 × 10⁹ CFU of Bifidobacterium longum strain BB536 for 10 days significantly (P < 0·01) increased the survival rate compared with groups of mice administered either with Bifidobacterium breve strain ATCC 15700 or excipients contained in the probiotic bacterial powder. Administration of B. longum significantly decreased viable counts of P. aeruginosa in the liver and blood compared with other groups. Culture of intestinal contents revealed a significantly lower viable count of P. aeruginosa in the jejunum of B. longum‐treated mice compared with other groups of mice. Furthermore, in vitro data demonstrated that B. longum possessed apparently higher adherent activity to Caco‐2 cell monolayers and significantly suppressed the adherence of P. aeruginosa to the monolayers of cells compared with other groups. Conclusion: Oral administration of B. longum protects mice against gut‐derived sepsis caused by P. aeruginosa, and the effect may be due to interference of P. aeruginosa adherence to intestinal epithelial cells. Significance and Impact of this Study: This study demonstrated that oral administration of B. longum BB536 is effective to protect against opportunistic infection with drug‐resistant bacteria such as P. aeruginosa. The results suggest that probiotics may play an important role even in the immunocompromised patients.     

Effect of chromium on growth of Pseudomonas aeruginosa

Tolerance level to trivalent chromium-Cr(salen)(H2O)2+ and hexavalent chromium-K2Cr2O7 was assessed in P. aeruginosa isolated from tannery effluent soil. It could tolerate 80 and 100 ppm in liquid cultures and up to 100 and 200 ppm in plate count agar in the presence of trivalent and hexavalent chromium respectively. Unadapted cells took a longer time to grow than adapted cells in the presence of K2Cr2O7. Chromium influenced the cellular contents, morphology and respiration of P. aeruginosa. The chosen trivalent salt of chromium was more toxic than the hexavalent one.     

绿脓杆菌群集生长效应

本文通过群集的绿脓杆菌在高盐、酸性培养基上生长试验,抗金黄色葡萄球菌的拮抗试验及冷休克试验,证明了绿脓杆菌群集生长效应。主要表现为群集的绿脓杆菌可以在含10～20%NaCl 的培养基上生长;pH4环境中也可生长。同样条件下,对照几乎均为阴性。分散成单个细胞分布的绿脓杆菌对冷反应敏感,群集则有抗冷休克作用。实验条件下,密集的金黄色葡萄球菌生长对分散的绿脓杆菌有拮抗作用,群集则可抵抗这种作用而生长。讨论中初步分析了群集生长效应的机理和对细菌种群在自然生境中的稳定作用。     

Effect of permeabilizers on antibiotic sensitivity of Pseudomonas aeruginosa

Agents which had previously been shown to act as permeabilizers against Pseudomonas aeruginosa or other Gram-negative bacteria were tested to determine whether susceptibility to various antibiotics could be increased. In the absence of a permeabilizer, Ps. aeruginosa was resistant to several hydrophobic antibiotics and vancomycin, but not to gentamicin. Tartaric and gluconic acids had weak potentiating activity, whereas ethylenediamine tetraacetic acid and citric acid were more effective permeabilizers. However, sodium polyphosphate enhanced the activity of erythromycin, fucidin, novobiocin, rifampicin and methicillin; vancomycin was unaffected and the activity of gentamicin was reduced considerably.     

Effect of Pseudomonas aeruginosa melanin on antibiotic activity]

The properties of microbial melanines are very diverse. Melanine of P. aeruginosa is little studied. The pigment was isolated from a strain of P. aeruginosa possessing all characteristic properties of the species. Interaction of P. aeruginosa melanine with various antibiotics was determined by the method of serial dilutions in beaf-peptone broth, using Staph. aureus 209 as a test-microbe, which was added to the medium in an amount of 10(6) cells to each tube. It was found that P. aeruginosa melanine differed from DOPA-melanine in a concentration of 1 mg/ml and did not change the activity of penicillin, tetracycline, oleandomycin, kanamycin and gentamicin with respect to Staph. aureus.     

Effect of biocides on Pseudomonas aeruginosa phage F116

Pseudomonas aeruginosa phage F116 is of interest in understanding the virucidal mechanisms of disinfectant action. Phage F116 has been used to test several disinfectants. The bacteriophage was relatively resistant to several biocides commonly used in disinfection processes. Only 0.05% cetylpyridinium chloride, 0.1% peracetic acid and 2% phenol were highly active against the phage.     

Serotypes of Pseudomonas aeruginosa isolated from laboratory rats and mice

Pseudomonas aeruginosa isolates cultured from the feces of laboratory rats and mice were serotyped. The fecal samples originated from primary genetic centers, secondary breeding facilities, and research testing facilities operated under contracts from the National Cancer Institute. Eighty-nine percent or 264 of 297 isolates were of serotypes 1, 4, 6, 10, or 11, and of these, 154 (51.8%) isolates were serotypes 6 or 11. In some instances, Pseudomonas aeruginosa serotypes found in animals at a primary genetic center were also found at secondary breeding facilities which had received breeding stock from the primary genetic center. The same serotypes also were found in animals at research-testing laboratories that had received animals from the secondary breeding facilities.     

Endogenous interferon-gamma impairs bacterial clearance from lungs during Pseudomonas aeruginosa pneumonia

Interferon (IFN-)gamma is thought to play a role in the resistance to various pathogens. To study the role of IFN-gamma in the pathogenesis of Pseudomonas pneumonia, IFN-gamma receptor (R) alpha-subunit-deficient [IFN-gammaR(-/-)] mice and wild type mice were intranasally inoculated with Pseudomonas aeruginosa (10(5) CFU). IFN-gammaR(-/-) mice demonstrated an enhanced clearance of P. aeruginosa from their lungs when compared to normal wild type mice (P < 0.05 at 24 hours after the infection), which was associated with a tendency towards an improved survival. These findings were not accompanied by a more effective activation of several components of the innate immune system known to contribute to host defense against pneumonia, i.e. the lung concentrations of cytokines and chemokines were similar in IFN-gammaR(-/-) and wild type mice, while the influx of neutrophils in bronchoalveolar lavage fluid (BALF) was even higher in wild type mice than in IFN-gammaR(-/-) mice. Remarkably, IFN-gammaR(-/-) mice had higher nitric oxide levels in the BALF at 24 hours after infection (P < 0.05). Endogenous IFN-gamma impairs rather than augments host defense during pneumonia caused by P. aeruginosa.