Isoniazid resistance of exponentially growing Mycobacterium smegmatis biofilm culture

Biofilm growth of Mycobacterium smegmatis was found to be unaffected at an isoniazid concentration that inhibited growth of planktonic bacilli (i.e. at isoniazid minimum inhibitory concentration=10 microg ml(-1)). Significant growth (50% of drug-free control) of biofilms was observed at up to 40 microg ml(-1) and the MIC for biofilm growth showed an increase to up to 80 microg ml(-1) isoniazid. Thus, the biofilm growth modus appears to be a strategy for replicating bacilli to evade the onslaught of antibacterials.     

Genetic diversity and models of viral evolution for the hepatitis C virus

In this review we discuss the application of theoretical frameworks to the interpretation of viral gene sequence data, with particular reference to the hepatitis C virus (HCV). The increasing availability of such data means that it is now possible (and necessary) to proceed from simple qualitative models of viral evolution, to more quantitative frameworks based on statistical inference, notably population genetics and molecular phylogenetics. We argue that these approaches are invaluable tools to the virologist and are essential for understanding the dynamics of viral infection and the outcome of therapeutic strategies. We use several recent HCV data-sets to illustrate the methods.     

Diaminodiphenylsulfone resistance of Mycobacterium leprae due to mutations in the dihydropteroate synthase gene

The nucleotide sequence analysis of the dihydropteroate synthase (DHPS) gene of six diaminodiphenylsulfone-resistant Mycobacterium leprae strains revealed that the mutation was limited at highly conserved amino acid residues 53 or 55. Though the mutation at amino acid residue 55 or its homologous site has been reported in other bacteria, the mutation at residue 53 is the first case in bacteria. This is the first paper which links the mutations in DHPS and sulfonamide resistance in M. leprae. This finding is medically and socially relevant, since leprosy is still a big problem in certain regions.     

Evolution of linkage disequilibrium of the founders in exponentially growing populations

Evolution of linkage disequilibrium of the founders in exponentially growing populations was studied using a time-inhomogeneous It? process model. The model is an extension of the diffusion approximation of the Wright-Fisher model. As a measure of linkage disequilibrium, the squared standard linkage deviation, which is defined by a ratio of the moments, was considered. A system of ordinary differential equations that these moments obey was obtained. This system can be solved numerically. By simulations, it was shown that the squared standard linkage deviation gives a good approximation of the expectation of the squared correlation coefficient of gamete frequencies. In addition, a perturbative solution was obtained when the growth rate is not large. By using the perturbation, an asymptotic formula for the squared standard linkage deviation after a large number of generations was obtained. According to the formula, the squared standard linkage deviation tends to be 1/(4Nc), where N is the current size of the population and c is the recombination fraction between two loci. It is dependent on neither the initial effective size, the growth rate, nor the mutation rate. In exponentially growing populations, linkage disequilibrium will be asymptotically the same as that in a constant size population, the effective size of which is the current effective size.     

Modeling within-host HIV-1 dynamics and the evolution of drug resistance: trade-offs between viral enzyme function and drug susceptibility

There are many biological steps between viral infection of CD4(+) T cells and the production of HIV-1 virions. Here we incorporate an eclipse phase, representing the stage in which infected T cells have not started to produce new virus, into a simple HIV-1 model. Model calculations suggest that the quicker infected T cells progress from the eclipse stage to the productively infected stage, the more likely that a viral strain will persist. Long-term treatment effectiveness of antiretroviral drugs is often hindered by the frequent emergence of drug resistant virus during therapy. We link drug resistance to both the rate of progression of the eclipse phase and the rate of viral production of the resistant strain, and explore how the resistant strain could evolve to maximize its within-host viral fitness. We obtained the optimal progression rate and the optimal viral production rate, which maximize the fitness of a drug resistant strain in the presence of drugs. We show that the window of opportunity for invasion of drug resistant strains is widened for a higher level of drug efficacy provided that the treatment is not potent enough to eradicate both the sensitive and resistant virus.     

Production of siRNA targeted against TYLCV coat protein transcripts leads to silencing of its expression and resistance to the virus

The coat protein (CP) of Tomato yellow leaf curl virus (TYLCV), encoded by the v1 gene, is the only known component of the viral capsid. In addition, the CP plays a role in the virus transport into the host cell nucleus where viral genes are replicated and transcribed. In this study, we analyzed the effect of small interfering double-stranded RNAs (siRNAs), derived from an intron-hairpin RNA (ihpRNA) construct and targeting the v1 gene product, on CP accumulation. Transient assays involving agroinfiltration of the CP-silencing construct followed by infiltration of a fused GFP-CP (green fluorescent protein-coat protein) gene showed down-regulation of GFP expression in Nicotiana benthamiana. Some of the transgenic tomato plants (cv. Micro-Tom), expressing the siRNA targeted against the TYLCV CP gene, did not show disease symptoms 7 weeks post-inoculation with the virus, while non-transgenic control plants were infected within 2 weeks post inoculation. The present study demonstrates, for the first time, that siRNA targeted against the CP of TYLCV can confer resistance to the virus in transgenic tomato plants, thereby enabling flowering and fruit production.     

The adaptive dynamics of the evolution of host resistance to indirectly transmitted microparasites

We use adaptive dynamics and pairwise invadability plots to examine the evolutionary dynamics of host resistance to microparasitic infection transmitted indirectly via free stages. We investigate trade-offs between pathogen transmission rate and intrinsic growth rate. Adaptive dynamics distinguishes various evolutionary outcomes associated with repellors, attractors or branching points. We find criteria corresponding to these and demonstrate that a major factor deciding the evolutionary outcome is whether trade-offs are acceleratingly or deceleratingly costly. We compare and contrast two models and show how the differences between them lead to different evolutionary outcomes.     

Parasite host range and the evolution of host resistance

Parasite host range plays a pivotal role in the evolution and ecology of hosts and the emergence of infectious disease. Although the factors that promote host range and the epidemiological consequences of variation in host range are relatively well characterized, the effect of parasite host range on host resistance evolution is less well understood. In this study, we tested the impact of parasite host range on host resistance evolution. To do so, we used the host bacterium Pseudomonas fluorescens SBW25 and a diverse suite of coevolved viral parasites (lytic bacteriophage Φ2) with variable host ranges (defined here as the number of host genotypes that can be infected) as our experimental model organisms. Our results show that resistance evolution to coevolved phages occurred at a much lower rate than to ancestral phage (approximately 50% vs. 100%), but the host range of coevolved phages did not influence the likelihood of resistance evolution. We also show that the host range of both single parasites and populations of parasites does not affect the breadth of the resulting resistance range in a naïve host but that hosts that evolve resistance to single parasites are more likely to resist other (genetically) more closely related parasites as a correlated response. These findings have important implications for our understanding of resistance evolution in natural populations of bacteria and viruses and other host–parasite combinations with similar underlying infection genetics, as well as the development of phage therapy.     

多粘菌素耐药性的研究进展

多粘菌素因在多重耐药革兰氏阴性菌上的治疗效果良好,再度被应用于临床,其耐药水平在多种抗菌药中曾一度较低,但目前有研究表明多粘菌素的耐药率有增加趋势。作为抗击多重耐药革兰氏阴性菌的最后一道防线,如何抑制其耐药的发生就显得尤为重要。本文就多粘菌素的耐药性现状、产生机制及防控措施三个方面进行了综述,为指导临床科学合理使用多粘菌素及革兰氏阴性菌耐药菌株传播和蔓延的防控措施提供理论依据。     

Human immunodeficiency virus evolution towards reduced replicative fitness in vivo and the development of AIDS

Human immunodeficiency virus (HIV) infection progresses to AIDS following an asymptomatic period during which the virus is thought to evolve towards increased fitness and pathogenicity. We show mathematically that progression to the strongest HIV-induced pathology requires evolution of the virus towards reduced replicative fitness in vivo. This counter-intuitive outcome can happen if multiple viruses co-infect the same cell frequently, which has been shown to occur in recent experiments. According to our model, in the absence of frequent co-infection, the less fit AIDS-inducing strains might never emerge. The frequency of co-infection can correlate with virus load, which in turn is determined by immune responses. Thus, at the beginning of infection when immunity is strong and virus load is low, co-infection is rare and pathogenic virus variants with reduced replicative fitness go extinct. At later stages of infection when immunity is less efficient and virus load is higher, co-infection occurs more frequently and pathogenic virus variants with reduced replicative fitness can emerge, resulting in T-cell depletion. In support of these notions, recent data indicate that pathogenic simian immunodeficiency virus (SIV) strains occurring late in the infection are less fit in specific in vitro experiments than those isolated at earlier stages. If co-infection is blocked, the model predicts the absence of any disease even if virus loads are high. We hypothesize that non-pathogenic SIV infection within its natural hosts, which is characterized by the absence of disease even in the presence of high virus loads, could be explained by a reduced occurrence of co-infection in this system.     

人体泌尿系微生物感染与耐药及宿主状态分析

目的了解泌尿系感染常见病原细菌和真菌分布、耐药性及宿主相关状态,为理解相关微生物感染影响因素及临床合理用药提供资料和依据。方法对门诊及住院患者中段尿培养分离的179株病原细菌和真菌进行微生物学鉴定和K-B法药敏试验,同时记录门诊和住院的菌株相关的泌尿系感染患者情况。结果泌尿系感染微生物以大肠埃希菌居首位,占62.4%,其次为真菌和肠球菌,各占12.4%、14.0%。药敏结果显示,大肠埃希菌产ESBLs占62.2%;肠杆菌科细菌对亚胺培南、美罗培南的敏感率为100%,其次敏感性较好的为氨基糖苷类阿米卡星、头孢头霉类头孢西丁及第三代头孢类头孢哌酮/舒巴坦、头孢他啶,敏感率均大于80%。革兰阳性球菌万古霉素敏感率为100%,对呋喃妥因敏感率为70.8%。大肠埃希菌感染率与患者的身体状态和行为具有显著的相关性(P<0.01)。结论革兰阴性杆菌是泌尿系感染的主要病原菌,机体免疫状态低下、不洁等生活行为与尿路微生物感染密切相关,但与耐药性不相关。维护机体正常免疫力、注意合适的生活行为,对预防泌尿道病原细菌与真菌的感染十分重要。     

A comparative evaluation of modelling strategies for the effect of treatment and host interactions on the spread of drug resistance

The evolutionary responses of infectious pathogens often have ruinous consequences for the control of disease spread in the population. Drug resistance is a well-documented instance that is generally driven by the selective pressure of drugs on both the replication of the pathogen within hosts and its transmission between hosts. Management of drug resistance therefore requires the development of treatment strategies that can impede the emergence and spread of resistance in the population. This study evaluates various treatment strategies for influenza infection as a case study by comparing the long-term epidemiological outcomes predicted by deterministic and stochastic versions of a homogeneously mixing (mean-field) model and those predicted by a heterogeneous model that incorporates spatial pair-wise correlation. We discuss the importance of three major parameters in our evaluation: the basic reproduction number, the population level of treatment, and the degree of clustering as a key parameter determining the structure of heterogeneous interactions. The results show that, as a common feature in all models, high treatment levels during the early stages of disease outset can result in large resistant outbreaks, with the possibility of a second wave of infection appearing in the pair-approximation model. Our simulations demonstrate that, if the basic reproduction number exceeds a threshold value, the population-wide spread of the resistant pathogen emerges more rapidly in the pair-approximation model with significantly lower treatment levels than in the homogeneous models. We tested an antiviral strategy that delays the onset of aggressive treatment for a certain amount of time after the onset of the outbreak. The findings indicate that the overall disease incidence is reduced as the degree of clustering increases, and a longer delay should be considered for implementing the large-scale treatment.     

Evaluation of novel Saquinavir analogs for resistance mutation compatibility and potential as an HIV-Protease inhibitor drug

A fundamental issue related to therapy of HIV-1 infection is the emergence of viral mutations which severely limits the long term efficiency of the HIV-protease (HIV-PR) inhibitors. Development of new drugs is therefore continuously needed. Chemoinformatics enables to design and discover novel molecules analogous to established drugs using computational tools and databases. Saquinavir, an anti-HIV Protease drug is administered for HIV therapy. In this work chemoinformatics tools were used to design structural analogs of Saquinavir as ligand and molecular dockings at AutoDock were performed to identify potential HIV-PR inhibitors. The analogs S1 and S2 when docked with HIV-PR had binding energies of -4.08 and -3.07 kcal/mol respectively which were similar to that for Saquinavir. The molecular docking studies revealed that the changes at N2 of Saquinavir to obtain newly designed analogs S1 (having N2 benzoyl group at N1) and S2 (having 3-oxo-3phenyl propanyl group at N2) were able to dock with HIV-PR with similar affinity as that of Saquinavir. Docking studies and computationally derived pharmacodynamic and pharmacokinetic properties׳ comparisons at ACD/I-lab establish that analog S2 has more potential to evade the problem of drug resistance mutation against HIV-1 PR subtype-A. S2 can be further developed and tested clinically as a real alternative drug for HIV-1 PR across the clades in future.     

Exploring the role of the immune response in preventing antibiotic resistance

For many bacterial infections, drug resistant mutants are likely present by the time antibiotic treatment starts. Nevertheless, such infections are often successfully cleared. It is commonly assumed that this is due to the combined action of drug and immune response, the latter facilitating clearance of the resistant population. However, most studies of drug resistance emergence during antibiotic treatment focus almost exclusively on the dynamics of bacteria and the drug and neglect the contribution of immune defenses. Here, we develop and analyze several mathematical models that explicitly include an immune response. We consider different types of immune responses and investigate how each impacts the emergence of resistance. We show that an immune response that retains its strength despite a strong drug-induced decline of bacteria numbers considerably reduces the emergence of resistance, narrows the mutant selection window, and mitigates the effects of non-adherence to treatment. Additionally, we show that compared to an immune response that kills bacteria at a constant rate, one that trades reduced killing at high bacterial load for increased killing at low bacterial load is sometimes preferable. We discuss the predictions and hypotheses derived from this study and how they can be tested experimentally.     

Hierarchical Bayesian methods for estimation of parameters in a longitudinal HIV dynamic system

HIV dynamics studies have significantly contributed to the understanding of HIV infection and antiviral treatment strategies. But most studies are limited to short-term viral dynamics due to the difficulty of establishing a relationship of antiviral response with multiple treatment factors such as drug exposure and drug susceptibility during long-term treatment. In this article, a mechanism-based dynamic model is proposed for characterizing long-term viral dynamics with antiretroviral therapy, described by a set of nonlinear differential equations without closed-form solutions. In this model we directly incorporate drug concentration, adherence, and drug susceptibility into a function of treatment efficacy, defined as an inhibition rate of virus replication. We investigate a Bayesian approach under the framework of hierarchical Bayesian (mixed-effects) models for estimating unknown dynamic parameters. In particular, interest focuses on estimating individual dynamic parameters. The proposed methods not only help to alleviate the difficulty in parameter identifiability, but also flexibly deal with sparse and unbalanced longitudinal data from individual subjects. For illustration purposes, we present one simulation example to implement the proposed approach and apply the methodology to a data set from an AIDS clinical trial. The basic concept of the longitudinal HIV dynamic systems and the proposed methodologies are generally applicable to any other biomedical dynamic systems.     

Parasite evolution in response to sex‐based host heterogeneity in resistance and tolerance

Heterogenity between sexes in terms of both the level and the type of immune response to infection is documented in many species, but its role on parasite evolution is only beginning to be explored. We adopt an evolutionary epidemiology approach to study how the ability of a host to respond to infection through active immunity (resistance) or through minimizing deleterious effects of a given parasite load (tolerance) affects the evolution of parasite virulence. Consistently with earlier models, we find that increases in host resistance and tolerance both favour more virulent parasite strains. However, we show that qualitatively different results can be obtained if dimorphism between the sexes occurs through resistance or through tolerance depending on the contact pattern between the sexes. Finally, we find that variations in host sex ratio can amplify the consequences of heterogeneity for parasite evolution. These results are analysed in the light of several examples from the literature to illustrate the prevalence of sexually dimorphic immune responses and the potential for further study of the role of sexual dimorphism on parasite evolution. Such studies are likely to be highly relevant for improving treatment of chronic infections and control of infectious diseases, and understanding the role of sex in immune function.     

High frequency induction of RNA-mediated resistance against Cucumber mosaic virus using inverted repeat constructs

The application of RNA-mediated resistance against Cucumber mosaic virus (CMV) by using single transgene constructs generally results in only a small portion of resistant individuals. Inverted repeat constructs encoding self-complementary double-stranded RNA have been demonstrated a potential way to obtain RNA-mediated resistance at high efficiency. To test this observation as a possible method for high frequency induction of CMV resistance, Nicotiana benthamiana plants were transformed with transgenes designed to produce double strand RNA molecules of CMV RNA 2 or coat protein (CP) gene sequences. Seventy-five percent of the tested R₀ plants transformed with an RNA 2-derived inverted repeat construct (1534 nt CMV sequence) showed extreme resistance to CMV, while a lower percentage of resistance (30%) was observed in R₀ lines transformed with a similar construct of a shorter viral RNA 2 sequence (490 nt). The resistance level conferred by CP sequences was also efficient by using a dsRNA construct, reaching a level of 50%. Self-pollinated (S₁) progenies obtained from most resistant R₀ plants all showed resistance levels of 100%, perfectly correlating with the expression of transgenic siRNAs. The results indicate that the use of inverted repeat viral transgenes is a highly efficient approach to obtain CMV resistant transgenic plants. Consequently, only a handful of transgenic plants will have to be generated using such constructs for successful resistance, which enables the implementation of this protocol for crops that are difficult to transform, such as ornamental plants in which CMV is an important pathogen.     

Measurement of the rotational behaviour of virus particles during adsorption to the host cell surface

The rotational diffusion of bacteriophage epsilon 15 was measured before and after virus adsorption to outer membrane vesicles of the host Salmonella anatum. The virus capsid was labeled with eosin isothiocyanate, and the decay of transient dichroism following dye excitation by pulses of plane-polarized light was measured. From the data, the rotational diffusion constant of the unadsorbed virion and its hydrodynamic diameter were estimated and found to be consistent with electron microscopic measurements of the capsid dimensions. Addition of outer membrane vesicles of S. anatum to the virus suspension revealed the immobilization of the virus particles on the membrane surface.     

A multi-generation analysis of the stability of transgenic virus resistance in doubled-haploid tobacco lines

Plants can be genetically engineered for virus resistance by transformation with a viral gene. We transformed tobacco with the tomato spotted wilt virus (TSWV) nucleocapsid gene from the Hawaiian L isolate in order to obtain TSWV resistant breeding lines. Doubled-haploid lines were produced from primary transgenic plants that were selected for resistance to the virus. Several of these lines showed very high levels of resistance and were symptomless after inoculation with the Hawaiian L isolate of TSWV. The accumulation of only low levels of full-length transgene RNA and protein observed in these lines is consistent with an RNA-mediated mechanism of resistance. The lines that were highly resistant to the Hawaiian L isolate of TSWV were also found to be highly resistant to several other isolates of TSWV, while lines that were only moderately resistant to the Hawaiian L isolate were often susceptible to the other isolates. The highly resistant lines were advanced over several generations by self-pollination. Although these lines were fully homozygous, several lines lost resistance in later generations, indicating that the resistance was unstable. Selection for resistance in these unstable lines did not prevent the occurrence of susceptible progeny in subsequent generations. Therefore, testing over several generations is required to determine the stability of resistance when breeding crops with transgenic virus resistance.     

对安贞医院革兰阴性杆菌的耐药趋势调查

目的分析安贞医院感染菌中,居前5位的革兰阴性杆菌的耐药趋势,为临床合理使用抗生素提供必要依据。方法对2000～2002年该院分离的医院感染菌株中,居前5位的革兰阴性杆菌的耐药性,进行回顾性分析。结果革兰阴性杆菌中前5位细菌,对3代头孢菌素的耐药性增高。大多数细菌对亚胺培南和美洛培南敏感。阿米卡星的耐药性有所下降。大肠埃希菌对喹诺酮类抗生素耐药率在85％以上。结论不规范使用抗生素,使细菌的耐药性越来越高,交替使用抗生素可能是降低细菌对抗生素耐药性的有效方法。医院应宏观控制使用抗生素。