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Biomedical subjects

D Raoult

Publications and source records attributed to D Raoult.

At least 451 records · Page 25Linked to original sources
PubMed1992

Chlamydial endocarditis: a report on ten cases.

Over the period 1983-1990, 10 cases of infective native-valve endocarditis as a result of Chlamydia were seen. All patients were men, with a mean age of 42 years, and none had a history of exposure to Chlamydia psittaci. Symptoms, such as weight loss and anorexia, with fever in eight cases, had persisted for at least 2 months before admission. Haemodynamic failure was present in seven patients, and neurological signs in four. The aortic valve was involved in seven cases, the mitral valve in one and both valves in two. Vegetations, often fingerlike, were observed by echocardiography in nine cases. All patients required valve replacement, and three died in the year following diagnosis. Blood cultures were consistently negative in all cases, and no antibiotics had been given before admission. Significant titres of complement fixing anti-chlamydial antibodies were present in six cases, and micro-immunofluorescence using the three chlamydial species showed cross-reacting antibodies in all nine cases studied, with transient IgM positivity in six cases. Histologically, the leaflets were fibrosed and infiltrated by large macrophages containing dark red granules after Machiavello staining. These granules were specifically stained by immunofluorescence using monoclonal antibody to Chlamydia common antigen, but not by that specific for C. pneumoniae. No organisms were seen after Gram staining, and no positive chlamydial immunofluorescence was seen on sections of valves from patients with staphylococcal or streptococcal endocarditis.

Adult↗
PubMed1992

Susceptibility of Rickettsia conorii, R. rickettsii, and Coxiella burnetii to PD 127,391, PD 131,628, pefloxacin, ofloxacin, and ciprofloxacin.

Plaque formation and dye uptake assays were used to measure the MICs of PD 127,391 and PD 131,628 against Rickettsia species. The MICs of PD 127,391 were 0.25 microgram/ml for Rickettsia rickettsii and 0.125 to 0.25 microgram/ml for Rickettsia conorii. The MICs of PD 131,628 were 0.25 to 0.5 microgram/ml for R. rickettsii and 0.5 microgram/ml for R. conorii. As determined by the shell vial technique, 15 strains of Coxiella burnetii were susceptible to PD 127,391 and PD 131,628 (MIC, < or = 1 microgram/ml), while one strain of C. burnetii (MP10) was of intermediate susceptibility.

Anti-Infective Agents↗
PubMed1992

In vitro antibiotic susceptibility of the newly recognized agent of ehrlichiosis in humans, Ehrlichia chaffeensis.

Ehrlichiosis in humans, a rickettsial disease recently discovered in the United States, is generally treated successfully with tetracyclines; however treatment with these agents is usually avoided with children and pregnant women. The in vitro susceptibility of Ehrlichia chaffeensis, the agent of human ehrlichiosis in the United States, was assessed by a quantitative evaluation of infected DH82 cells cultivated in 96-well microtiter plates in the presence of different concentrations of selected antibiotics. Extracellular MICs and MBCs were evaluated after 72 h of exposure to the antibiotics. Doxycycline and rifampin were found to exert rapidly bactericidal effects, with MBCs in the extracellular culture medium of less than 0.5 and 0.125 microgram/ml, respectively. E. chaffeensis was resistant to chloramphenicol, ciprofloxacin, erythromycin, co-trimoxazole, penicillin, and gentamicin, which had MICs greater than 16, 4, 8, 4, 40, and 32 micrograms/ml, respectively. These observations are consistent with the finding that human ehrlichiosis appears to respond to tetracycline therapy, which has been the therapy of first choice. Further clinical investigations are necessary to evaluate the role of rifampin in the treatment of human ehrlichiosis, especially in children.

Anti-Bacterial Agents↗
PubMed1992

von Willebrand factor release and thrombomodulin and tissue factor expression in Rickettsia conorii-infected endothelial cells.

Mediterranean spotted fever, a tick-borne rickettsiosis caused by Rickettsia conorii, may lead to small-vessel or deep-vein thrombosis. In order to evaluate the role of endothelial cell alteration in this lesion, we infected human endothelial cells derived from umbilical veins with R. conorii. We report the induction of two previously unreported prothrombotic mechanisms in rickettsial disease: (i) a progressive decline in thrombomodulin antigen and (ii) early expression of tissue factor, and, as described for R. rickettsii infection, later release of von Willebrand factor from Weibel-Palade bodies. Thrombomodulin expression in infected endothelial cells, measured by the thrombin-dependent activation of protein C or flow cytometric analysis, decreased steadily between 4 and 24 h after inoculation with rickettsiae. R. conorii infection induced tissue factor expression, measured by clotting assay and flow cytometric analysis, which was detectable 2 h postinoculation, reached its maximum 4 h postinoculation, and progressively decreased thereafter. Infection resulted in a relatively late release of von Willebrand factor antigen into the culture medium. A double-label immunofluorescence assay for the simultaneous evaluation of von Willebrand factor and R. conorii showed that the depletion of cytoplasmic von Willebrand factor stored in Weibel-Palade bodies was due to a direct effect of the intracellular R. conorii. These disturbances of endothelial function observed with R. conorii-infected cells may provide a paradigm for the elucidation of thrombotic pathobiology with Mediterranean spotted fever.

Cells, Cultured↗
PubMed1992

Phagolysosomes of Coxiella burnetii-infected cell lines maintain an acidic pH during persistent infection.

Coxiella burnetii, the agent of Q fever, is an obligate intracellular bacterium that multiples within vacuoles of phagolysosomal origin. Persistently infected cell lines were maintained in continuous culture for months. We studied the pH of the phagolysosomes by using two murine cell lines during early propagation of the bacteria and after establishment of persistent infection. Three strains of C. burnetii were studied because of the purported propensity of each strain to cause acute or chronic disease and to be resistant or susceptible to antibiotics. The pHs were calculated from fluorescence experiments with fluoresceinated dextran as a lysosomal probe. Phagolysosomal vacuoles maintained an acidic pH during a 36-day infection. Minimal variation of the pH occurred over the duration of the experiment with strains that caused either acute or chronic disease. Phagolysosomal pH remained stable for as long as 153 days with the Nine Mile phase II isolate. Thus, neither the course of C. burnetti infection nor the diversity of antibiotic susceptibility of the strains is related to variations in the phagolysosomal pH.

Animals↗
PubMed1992

Determination of genome sizes of Rickettsia spp. within the spotted fever group, using pulsed-field gel electrophoresis.

The chromosome lengths of six spotted fever group Rickettsia species (Rickettsia rickettsii, R. conorii, R. rhipicephali, R. sibirica, R. australis, and R. akari) were estimated by pulsed-field gel electrophoresis. The genome size of R. rickettsii was about 2,100 kb, but the chromosome lengths of the five other species were, surprisingly, much lower and ranged between 1,200 and 1,300 kb.

Base Sequence↗
PubMed1992

Comparison of Western immunoblotting and microimmunofluorescence for diagnosis of Mediterranean spotted fever.

One-hundred serum samples from 41 patients suffering from Mediterranean spotted fever (MSF) were tested by microimmunofluorescence (MIF) and Western blot (WB; immunoblot). Immunoglobulin G (IgG), IgM, and IgA antibody-specific responses to the high-molecular-mass species-specific protein antigens (115 kDa and 135 kDa) of Rickettsia conorii, as well as to cross-reactive lipopolysaccharide (LPS) antigens, were observed. The WB assay detected IgM-type antibodies earlier than did the MIF assay. These antibodies were often directed against nonspecific LPS and may have a questionable positive predictive value. In addition, an IgG reaction to a 60-kDa protein was observed in four cases of malignant forms of MSF but was never observed in cases of mild forms. This reaction could be correlated with a marker of the severity of the development of MSF. From a previous MIF survey of blood donors, 9 negative, 11 IgG-positive, and 6 IgM-positive serum samples were selected for comparison by WB. Sera negative by MIF were also negative by WB. MIF IgG-positive sera showed a specific response to R. conorii in the WB assay, but the six serum samples from this seroepidemiological study positive for IgM by MIF were almost all negative by the WB assay. One was positive for IgM against the LPS but was considered a false positive. The WB is shown to provide a new tool for serodiagnosis.

Antibodies, Bacterial↗
PubMed1992

Antigenic characterization of ehrlichiae: protein immunoblotting of Ehrlichia canis, Ehrlichia sennetsu, and Ehrlichia risticii.

In recent years a febrile illness apparently associated with tick bite in patients in the United States has been attributed to infection by an Ehrlichia species. This implication is based on serologic responses to E. canis, morphologic demonstration of ehrlichiae in clinical materials, and a single isolate distinct from E. canis which was obtained from a human patient by the Centers for Disease Control. Little is known about the antigens of the ehrlichiae. This report expands the breadth of available knowledge concerning the antigenic components and serologic responses to component antigens of E. canis, E. sennetsu, and E. risticii. Protein immunoblotting after sodium dodecyl sulfate-polyacrylamide gel electrophoresis by using density gradient-purified ehrlichiae and homologous antisera demonstrated reproducible and characteristic antigens within each species (for E. sennetsu, 91, 64, 54, 44, 36, 34, 28, 25, and 24 kDa; for E. risticii, 70, 52, 48, 44, 35, 28, 24, 23, and 20 kDa; for E. canis, 110, 64, 52, 42, 33, 28, 24, 23, and 20 kDa). When antisera were reacted with heterologous antigens, cross-reactivity among these species was virtually restricted to the 70-kDa antigen. Furthermore, when serum samples obtained from 10 patients who were convalescing from ehrlichiosis were tested against each antigen, only three serum samples had any reactivities, and these serum samples reacted with only a few of the antigenic bands. These results documented the molecular sizes of electrophoretically separated antigens of the three Ehrlichia species, confirm their serologic relationships, and support the novel nature of the agent(s) of human ehrlichiosis in the United States.

Animals↗
PubMed1992

Comparison of serologic typing, sodium dodecyl sulfate-polyacrylamide gel electrophoresis protein analysis, and genetic restriction fragment length polymorphism analysis for identification of rickettsiae: characterization of two new rickettsial strains.

In 1990, 17 adult Rhipicephalus turanicus ticks were collected in the south of France. Two spotted fever group rickettsiae, Mtu1 and Mtu5, were isolated from the hemolymphs of two of these ticks by the centrifugation shell-vial technique by using HEL cells. These isolates were compared with reference spotted fever group rickettsial serotypes by using three identification methods: microimmunofluorescence serologic typing, sodium dodecyl sulfate-polyacrylamide gel electrophoresis (SDS-PAGE), and polymerase chain reaction followed by restriction endonuclease fragment length polymorphism analysis. The results obtained by all these techniques showed that Mtu1 and Mtu5 are each previously undescribed rickettsial serotypes. A comparison of the three methods used to identify the isolates led us to the conclusion that, in large-scale epidemiological studies, the simplest way to identify isolates in ticks is to first use the polymerase chain reaction-restriction fragment length polymorphism analysis directly on triturated ticks as a screening method to detect interesting rickettsiae, and then attempt to isolate rickettsiae from ticks for identification by microimmunofluorescence and SDS-PAGE, both of which are time-consuming and expensive to carry out.

Animals↗
PubMed1992

Detection of Coxiella burnetti by DNA amplification using polymerase chain reaction.

The polymerase chain reaction (PCR) was used for the detection of Coxiella burnetti, an obligate intracellular bacterium and the etiologic agent of Q fever. A pair of primers derived from the C. burnetii superoxide dismutase gene served to amplify a targeted 257-bp fragment of genomic DNA. These primers were chosen on the basis of GenBank analysis, G + C ratio, and absence of secondary structure. This technique allowed the detection of as few as 10 C. burnetii organisms. C. burnetti was detected in tissue culture and in specimens from patients (heart valves). In all, 8 reference isolates and 22 new isolates of C. burnetii from France were successfully amplified. No amplification products were found when PCR was performed with 25 bacterial species that had been isolated in a clinical laboratory from patients with clinically similar infections. Amplification products of C. burnetii were confirmed by restriction enzyme digestion and dot blot hybridization. The method used here, a combination of PCR and restriction analysis, is a faster and more sensitive assay for C. burnetii than standard culture techniques.

Base Sequence↗
PubMed1992

A cluster of Coxiella burnetii infections associated with exposure to vaccinated goats and their unpasteurized dairy products.

An outbreak of Q fever occurred among patients and staff of a psychiatric institution in southern France. Some of the patients and staff left the institution daily to work on a farm where goats were raised for raw milk and cheese production. The goats had all been vaccinated annually with a commercial vaccine containing phase II Coxiella burnetii antigen. A serologic survey revealed that 40 (66%) of the 61 patients and staff had elevated titers to C. burnetii. Seropositive persons were more likely to report an acute illness (P = 0.001), fever (P = 0.04), weakness (P = 0.04), arthralgia (P = 0.04), and headaches (P = 0.06) in the preceding year than were seronegative persons. Seropositivity rates were significantly higher among persons who worked on the farm and consumed unpasteurized milk products (69% [22 of 32]; P = 0.007), those who only had worked on the farm (75% [9 of 12]; P = 0.009), and those who only had consumed unpasteurized milk products (75% [9 of 12]; P = 0.009), compared with those who had not worked with the goats or consumed unpasteurized milk products (0 of 5). Despite vaccination against Q fever, no antibodies to C. burnetii were detectable in 17 (59%) of 29 goats. All 12 seropositive goats had antibodies to both phase I and phase II antigens, indicating that they were naturally infected, and two of three goats examined were shedding C. burnetii in their milk. Vaccination of this herd did not prevent the outbreak and might have increased shedding of C. burnetii in the dairy products.

Adult↗
PubMed1992

[Current status of knowledge on the epidemiology of rickettsiosis in Africa].

Rickettsioses have been reported all over Africa. Serologic investigations have been driven using non specific methods as Giroud microagglutination and Weil-Felix test which led to numerous false positive. This explains the difficulties encountered in the evaluation of the prevalence of such diseases in Africa. However, three recent studies made in Tunisia, Central Africa and Zimbabwe show that seroprevalence of spotted fever group rickettsiae infections is close to 45% using MIF as reference method. New technics as Western and Line immunoblotting and RFLP PCR should allowed to new studies and revision of epidemiologic data on rickettsioses in Africa.

Africa↗
PubMed1992

Identification of spotted fever group rickettsiae using polymerase chain reaction and restriction-endonuclease length polymorphism analysis.

In order to facilitate the isolation and identification of spotted fever group (SFG) rickettsiae from their tick vectors, we used the centrifugation shell vial technique or traditional isolation procedures and genotypic identification using the restriction fragment length polymorphism analysis of polymerase chain amplified fragments. The presence of Rickettsia conorii both in Rhipicephalus sanguineus ticks collected in southern France, and in Rhipicephalus simus and Haemaphysalis leachi from Zimbabwe was demonstrated. This procedure seems to be of particular interest for studying the epidemiology and ecology of SFG rickettsiae.

Animals↗
PubMed1992

Phenotypic and genotypic heterogeneity of 8 new human Coxiella burnetti isolates.

Eight new strains of Coxiella burnetii were isolated from chronic Q fever patients using centrifugationashell vial technique. Seven patients had endocarditis (including one patient with an immunodeficiency syndrome), and one had a vascular prosthesis infection. Three prototype strains, Nine Mile phase II, Q212 and Priscilla and eight new isolates were cultured in L 929 cells. Heterogeneity of their cytopathic effect was observed. DNAs of the eleven strains have been isolated and purified by standard procedures. Plasmid DNA was separated from chromosomal DNA by a low melting point gel. Electrophoresis in agarose gel showed that seven of the eight new strains had plasmids which were about 40 kb (plasmid V517 was used as size marker). Endonuclease-restriction analysis of the 8 human isolates is currently under investigation.

Cells, Cultured↗
PubMed1992

Study of cross-reaction between Coxiella burnetii and Legionella pneumophila using indirect immunofluorescence assay and immunoblotting.

Patients with Q fever and legionellosis may present identical clinical symptom. Differentiation of these diseases is made by serology, mainly the indirect immunofluorescence assay (IFA). Using IFA the authors tested 154 Q fever positive sera from 55 patients with acute Q fever and 28 patients with chronic Q fever for Legionella pneumophila antibodies and 57 sera from 57 patients with legionellosis for Coxiella burnetii antibodies. Of the 211 sera tested, four sera from different patients had antibodies to both C. burnetii and L. pneumophila. Using cross-adsorption studies and protein immunoblotting, no cross-reaction between C. burnetii and L. pneumophila antibodies could be identified. The moderate antibody titers against L. pneumophila in two Q fever patients and vice versa for one legionellosis patient are consistent with the incidence of seroprevalence in healthy blood donors and were not due to cross-reactivity. One patient was identified with concurrent Q fever and legionellosis.

Antibodies, Bacterial↗
PubMed1992

[Is A29, B12 vasculitis caused by the Q fever agent? (Coxiella burnetii)].

The authors describe the first two cases, to their knowledge, of retinal vasculitis, associated with Q fever. The first case was a chronic infection induced by Coxiella burnetii associated with HLA group A29 and B12; in the second case, the phenotype was B12. The authors tried to determine whether this agent could be the "Birdshot chorioretinopathy" promoting factor. Several epidemiologic findings tend to prove that Q fever is not the only cause. On the other hand, its similarity with rickettsia, the fact that it is found in patients with vasculitis, suggest that it could be one of the initial causal factors.

Adult↗