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PubMed2004

Isolation of Rhodococcus equi from the feces of indigenous animals and soil from the Lower Zambezi National Park and Lochinvar National Park, Zambia.

Rhodococcus equi is an important pathogen in foals; however, its incidence in African indigenous animals is poorly understood. Fecal samples (92 from nine indigenous species) and 43 soil samples were collected from two Zambian National Parks. The presence of R. equi was investigated and 533 isolates were tested for the presence of 15- to 17-kDa antigens (VapA) and a 20-kDa antigen (VapB) by immunoblotting and PCR. R. equi was isolated (10(2)-10(4) colony forming units/g) from 75% of fecal and 74% of soil samples. Neither antigen was detected; however, about 20% of the isolates contained cryptic plasmids of various sizes. There was no evidence of virulent R. equi, but the avirulent form was widespread in the animals and the soil.

Animals↗
PubMed2003

Effects of iron modulation on growth and viability of Rhodococcus equi and expression of virulence-associated protein A.

OBJECTIVE: To determine the importance of iron for in vitro growth of Rhodococcus equi, define potential iron sources in the environment and mechanisms by which R equi may obtain iron from the environment, and assess expression and immunogenicity of iron-regulated proteins. SAMPLE POPULATION: 10 virulent and 11 avirulent strains of R equi. PROCEDURE: In vitro growth rates and protein patterns of R equi propagated in media with normal, excess, or limited amounts of available iron were compared. Immunoblot analyses that used serum from foals naturally infected with R equi and monoclonal antibody against virulence-associated protein (Vap)A were conducted to determine immunogenicity and identity of expressed proteins. RESULTS: Excess iron did not alter growth of any R equi strains, whereas growth of all strains was significantly decreased in response to limited amounts of available iron. Virulent R equi were able to use iron from ferrated deferoxamine, bovine transferrin, and bovine lactoferrin. Only virulent R equi expressed an iron-regulated, immunogenic, surface-associated protein identified as VapA. CONCLUSIONS AND CLINICAL RELEVANCE: Iron is required for the growth and survival of R equi. Sources of iron for R equi, and mechanisms by which R equi acquire iron in vivo, may represent important virulence factors and novel targets for the development of therapeutic and immunoprophylactic strategies to control R equi infection in foals. Expression of VapA is substantially upregulated when there is a limited amount of available iron.

Bacterial Proteins↗
PubMed1999

Severe otitis and mastoiditis due to Rhodococcus equi in a patient with AIDS. Case report.

We report a case of otitis media associated with pneumonia due to Rhodococcus equi. A 31-year-old patient with AIDS presented with cough and right facial palsy. Imaging revealed right otitis media and severe temporal bone destruction, associated with pneumonia. R. equi was isolated from ear secretions, blood, and sputum. The radiologic findings are described. This unusual pathogen should be included in the differential diagnosis of the immunocompromised patient with aggressive otitis.

AIDS-Related Opportunistic Infections↗
PubMed2006

Molecular typing of VapA-positive Rhodococcus equi isolates from Jeju native horses, Korea.

We recently demonstrated the presence of virulence-associated protein antigen (VapA)-positive Rhodococcus equi in Jeju Island, Korea. These bacteria contained one of two distinct plasmid types, a 90-kb type II plasmid, which has been found in isolates from the native Kiso horses of Japan, and a new variant, a 90-kb type V plasmid. However, the genotypic characters of the VapA-positive R. equi from Jeju native horses and their environments are poorly understood. Ninety-eight isolates from soil samples and 89 isolates from fecal samples were collected from five farms that breed or have bred Jeju native horses, and were tested for the presence of VapA by immunoblotting and PCR. Of the 98 soil isolates and 89 fecal isolates, seven and 13 were VapA-positive R. equi, respectively. In 2003, two Jeju foals died suddenly and were brought to the Faculty of Veterinary Medicine, Cheju National University, for postmortem examination. Pure cultures of R. equi were isolated from the lung lesions of both foals. Of the 16 clinical isolates, 14 were VapA-positive R. equi. Of the 34 VapA-positive clinical and environmental isolates, 16 contained the 90-kb type II plasmid and 18 contained a 90-kb type V plasmid. Pulsed-field gel electrophoresis (PFGE) patterns of the VapA-positive isolates from Jeju horses and Kiso horses, containing the 90-kb type II plasmid, were compared and formed two distinct groups. Furthermore, 18 virulent isolates containing the 90-kb type V plasmid formed two distinct PFGE groups (of 16 and two isolates). These results demonstrate that two virulence plasmid types are widespread in R. equi in Jeju native horses. However, there is little diversity in the PFGE patterns of virulent isolates, suggesting the clonal spread of virulent R. equi. The PFGE pattern of the virulent R. equi isolates from Jeju native horses in Korea is not identical to those of Kiso native horses in Japan.

Actinomycetales Infections↗
PubMed1997

Nucleic acid amplification for rapid detection of Rhodococcus equi in equine blood and tracheal wash fluids.

OBJECTIVE: To evaluate the ability of nucleic acid amplification techniques to detect Rhodococcus equi in equine buffy coat, blood, and tracheal wash fluid and to differentiate between virulent and avirulent strains of the bacteria. SAMPLE POPULATION: Blood anticoagulated with EDTA and tracheal wash fluid from healthy horses. PROCEDURE: Logarithmic dilutions of virulent and avirulent strains of R equi were added to equine buffy coat and tracheal wash fluid samples. The DNA was extracted and amplified by polymerase chain reaction (PCR), using primers specific for the 16S ribosomal subunit gene and the virulence plasmid of R equi. RESULTS: PCR with 16S ribosomal subunit primers amplified a 441-bp segment of DNA from virulent and avirulent strains of R equi, but not from samples containing other species of bacteria. The virulence plasmid primers amplified an 875-bp segment of DNA from virulent strains of R equi, but not from avirulent R equi, or from other species of bacteria. Virulent strains of R equi could be identified by PCR and differentiated from avirulent strains within 12 to 24 hours after sample collection, with as few as 10 to 100 organisms present. CONCLUSIONS: PCR can be used to rapidly and accurately identify R equi in equine blood and tracheal wash fluid samples and can differentiate between virulent and avirulent strains of the organism. CLINICAL RELEVANCE: Because PCR can confirm a diagnosis of R equi infection in horses more rapidly and specifically than use of standard culture techniques, extrapolation of this assay to soil and fecal samples could be useful in epidemiologic studies and studies of environmental disinfection or decontamination.

Actinomycetales Infections↗
PubMed1995

Identification of virulent Rhodococcus equi by amplification of gene coding for 15- to 17-kilodalton antigens.

During a survey of the prevalence of virulent Rhodococcus equi at horse-breeding farms by plasmid and protein profiles, cryptic plasmids of various sizes were found in 66 (3.8%) of 1,725 isolates from feces of horses and 129 (5.9%) of 2,200 isolates from soil. Twenty-two isolates, which contained cryptic plasmids of different sizes, were found by plasmid profiles, and their protein profiles and mouse pathogenicities were examined. Of the 22 isolates, 7 were virulent R. equi, contained both virulence and cryptic plasmids, and expressed 15- to 17-kDa antigens. The remaining 15 isolates were avirulent and did not express the antigens: 6 strains contained cryptic plasmids of two different sizes and 9 strains contained cryptic plasmids of various sizes. A PCR assay was developed for the rapid identification of virulence plasmids of R. equi. Oligonucleotide primers, derived from the sequence of a gene coding for the 15- to 17-kDa virulence-associated antigens of R. equi, amplified a 564-bp product from all the tested isolates harboring a virulence plasmid. This PCR product hybridized with virulence plasmid DNA in the Southern hybridization assay. Virulence plasmid-cured derivatives and all of the tested isolates harboring cryptic plasmids only were negative. The PCR is a rapid, sensitive, and specific test for the identification of virulent R. equi from environmental isolates compared with standard techniques, such as plasmid and protein profiles and the mouse pathogenicity test, and is considered to be a useful tool for epidemiological studies.

Animals↗
PubMed1993

Rhodococcus equi.

This article summarizes recent advances in understanding of the epidemiology, pathogenesis, clinical and laboratory diagnosis, immunology, treatment, and control of Rhodococcus equi infections in foals. Our understanding of these aspects currently is sufficient to ensure control of this problem on affected farms and in infected foals. More information, however, is needed on factors predisposing foals to R. equi pneumonia, in particular, the nature of the naturally occurring cellular immunodeficiency in foals of 2 to 4 months of age, which also predisposes them to severe respiratory infection with certain other intracellular pathogens. In addition, the relative importance of R. equi pneumonia in the context of other causes of lower respiratory tract infection of foals needs to be defined.

Actinomycetales Infections↗
PubMed1994

[Pneumonia by Rhodococcus equi in patients with HIV infection].

We present the case of a patient with AIDS who developed abscessified pneumonia by Rhodococcus equi. We publish this case given the rare frequency of presentation of this opportunistic infection in this type of patient and given its good clinical evolution, on the contrary of other cases described so far in the literature. The good evolution of the patient may be due to an early diagnosis, less than one month, and the combined medical therapy with rifampicine and tetracyclines.

AIDS-Related Opportunistic Infections↗
PubMed1998

Maximization of cholesterol oxidase production by Rhodococcus equi no. 23 By using response surface methodology.

Medium optimization for the production of cholesterol oxidase (EC 1. 1.3.6) by Rhodococcus equi no. 23 was investigated by using response surface methodology and a central composite design. Results revealed that cholesterol and yeast extract had positive effects and the interaction between any two of three factors had no significant effect on cholesterol oxidase production. The optimized medium was the basal medium with the addition of 2.30 g/l cholesterol, 8.18 g/l yeast extract and 4.10 ml/l Tween 80. The peak cholesterol oxidase production (0.242 unit/ml) after 60-72 h cultivation was approx. 4-fold that in control medium.

Carbon↗
PubMed2005

Evaluation of a real-time quantitative polymerase chain reaction assay for detection and quantitation of virulent Rhodococcus equi.

OBJECTIVE: To evaluate a real-time quantitative polymerase chain reaction (QPCR) assay in the detection and quantitation of virulent Rhodococcus equi. SAMPLE POPULATION: 1 virulent, 2 intermediately virulent, and 2 avirulent strains of R. equi and 16 isolates of bacteria genetically related to R. equi. PROCEDURE: The QPCR assay was evaluated for detection and quantitation of the virulence-associated gene (vapA) of R. equi in pure culture and in samples of tracheobronchial fluid, which were inoculated with known numbers of virulent R. equi. Results were compared with those derived via quantitative microbial culture and standard polymerase chain reaction methods. RESULTS: The QPCR assay detected the vapA gene in pure culture of R. equi and in tracheobronchial fluid samples that contained as few as 20 CFUs of virulent R. equi/mL and accurately quantitated virulent R. equi to 10(3) CFUs/mL of fluid. The assay was highly specific for detection of the vapA gene of virulent R. equi and was more sensitive than standard polymerase chain reaction for detection of R. equi in tracheobronchial fluid. CONCLUSIONS AND CLINICAL RELEVANCE: The QPCR assay appears to be a rapid and reliable method for detecting and quantitating virulent R. equi. The accuracy of the QPCR assay is comparable to that of quantitative microbial culture. The increased sensitivity of the QPCR method in detection of virulent R. equi should facilitate rapid and accurate diagnosis of R. equi pneumonia in foals.

Actinomycetales Infections↗
PubMed2003

Clearance of virulent but not avirulent Rhodococcus equi from the lungs of adult horses is associated with intracytoplasmic gamma interferon production by CD4+ and CD8+ T lymphocytes.

Rhodococcus equi is a gram-positive bacterium that infects alveolar macrophages and causes rhodococcal pneumonia in horses and humans. The virulence plasmid of R. equi appears to be required for both pathogenicity in the horse and the induction of protective immunity. An understanding of the mechanisms by which virulent R. equi circumvents protective host responses and by which bacteria are ultimately cleared is important for development of an effective vaccine. Six adult horses were challenged with either virulent R. equi or an avirulent, plasmid-cured derivative. By using a flow cytometric method for intracytoplasmic detection of gamma interferon (IFN-gamma) in equine bronchoalveolar lavage fluid (BALF) cells, clearance of the virulent strain was shown to be associated with increased numbers of pulmonary CD4(+) and CD8(+) T lymphocytes producing IFN-gamma. There was no change in IFN-gamma-positive cells in peripheral blood, suggesting that a type 1 recall response at the site of challenge was protective. The plasmid-cured strain of R. equi was cleared in horses without a significant increase in IFN-gamma-producing T lymphocytes in BALF. In contrast to these data, a previous report in foals suggested an immunomodulating role for R. equi virulence plasmid-encoded products in downregulating IFN-gamma expression by equine CD4(+) T lymphocytes. Intracytoplasmic detection of IFN-gamma provides a method to better determine whether modulation of macrophage-activating cytokines by virulent strains occurs uniquely in neonates and contributes to their susceptibility to rhodococcal pneumonia.

Actinomycetales Infections↗
PubMed1992

[Rhodococcus equi in HIV infected patients: 2 new cases].

We reported two HIV infected patients with bacteremia and pneumonia due to Rhodococcus equi. None of them had suffer any opportunistic infection before this episode. Clinical presentation includes respiratory tract symptoms of subacute onset and fever. The X-ray examination in both cases revealed pneumonia and lung abscess in upper lobes as well as lung infiltrates in other lobes. The microorganism was isolated in lung fine needle aspiration, bronchoalveolar lavage and blood cultures in both cases. One patient died and the other was under antibiotic treatment 5 months after discharge. The therapeutic options in this infection must include the use of at least two different antibiotics to which the microorganism is sensitive, and for a prolonged period of time. Surgical treatment should be considered if the evolution is poor.

Actinomycetales Infections↗
PubMed1995

Failure of hyperimmune plasma to prevent pneumonia caused by Rhodococcus equi in foals.

A trial was conducted on a Thoroughbred stud to determine whether or not the administration of anti-Rhodococcus equi hyperimmune plasma would reduce the prevalence of R equi pneumonia (rattles) in foals born in the 1992 horse breeding season. Hyperimmune plasma was administered to 34 foals; another 57 foals were untreated. There was no significant difference in the number of transfused foals developing R equi pneumonia compared with the untreated foals. The time required for recovery from pneumonia between the 2 groups was not significantly different.

Actinomycetales Infections↗
PubMed2002

Gas exchange during intense exercise in Standardbreds with earlier Rhodococcus equi pneumonia.

It is not known if pulmonary function and gas exchange during exercise are altered after pyogranulomatous pneumonia caused by Rhodococcus equi infection in the foal. The aim was to evaluate whether pulmonary gas exchange during high intensity exercise was altered in mature Standardbreds with a history of R. equi pneumonia as foals. In 7 foals, R. equi pneumonia was confirmed and treated. At age 3 years, when these horses were subjected to professional training, an inclined treadmill exercise test including 4 speeds was performed. Samples were collected when a steady state in VO2 was obtained. Red cell volume, heart rate, respiratory rate, and systemic and pulmonary mean arterial pressures were measured and cardiac output calculated. Oxygen and carbon dioxide tensions in arterial and mixed venous blood were analysed. The alveolar ventilation and the alveolar-arterial oxygen tension difference were determined. Pulmonary gas exchange was assessed and the ventilation-perfusion distribution, VA/Q, was estimated by the multiple inert gas elimination technique. Ventilation-perfusion mismatch and shunt were determined and diffusion limitation calculated. The gas exchange in Standardbred trotters previously infected with R. equi and successfully treated was not compromised during intense treadmill exercise compared with reference values for healthy, fit Standardbreds. We conclude that adult Standardbreds trotters with diagnosed R. equi pneumonia as foals, can achieve an adequate gas exchange at a workload close to VO2peak.

Actinomycetales Infections↗
PubMed2003

Emergence of rifampin-resistant Rhodococcus equi with several types of mutations in the rpoB gene among AIDS patients in northern Thailand.

The antimicrobial susceptibilities of 30 Rhodococcus equi isolates obtained from 30 patients between 1993 and 2001 in northern Thailand were investigated. The MICs showed a tendency toward resistance to various antibiotics but sensitivity to imipenem, minocycline, vancomycin, and teicoplanin (MICs, </=0.5 micro g/ml) and relative sensitivity to meropenem, clarithromycin, and ciprofloxacin (MICs, </=2 micro g/ml). Of the 30 isolates, 26 were susceptible (MICs, </=1 micro g/ml), 1 showed low-level resistance (MIC, 8 micro g/ml), and 3 showed high-level resistance (MICs, >/=64 micro g/ml) to rifampin. PCR amplification and DNA sequencing of the rpoB gene and molecular typing by pulsed-field gel electrophoresis (PFGE) were performed for eight R. equi isolates from eight AIDS patients with pneumonia or lung abscess caused by R. equi between 1998 and 2001, including one low- and three high-level rifampin-resistant isolates. As a result, two high-level rifampin-resistant strains with PFGE pattern A had a Ser531Trp (Escherichia coli numbering) mutation, and one high-level rifampin-resistant strain with PFGE pattern B had a His526Tyr mutation, whereas one low-level rifampin-resistant strain with PFGE pattern C had a Ser509Pro mutation. Four rifampin-susceptible strains with PFGE patterns D and E showed an absence of mutation in the rpoB region. Our results indicate the presence of several types of rifampin-resistant R. equi strains among AIDS patients in northern Thailand.

AIDS-Related Opportunistic Infections↗
PubMed1999

Search for an antibody profile of Rhodococcus equi infection in AIDS patients despite the diversity of isolates and patient immune dysfunction.

Diversity of virulence-associated antigens of Rhodococcus equi was detected among thirteen strains isolated from AIDS patients on two continents. One out of four Brazilian isolates presented the virulence-associated antigen of 15- to 17-kDa, and the other three isolates had the 20-kDa virulence-associated antigen. In contrast, only three out of nine Italian isolates were positive for virulence-associated antigens - two for the 15- to 17-kDa antigen and one for the 20-kDa antigen. In four other Italian strains, one or more other low-molecular-weight antigens were identified. Because of R. equi variability and host immune dysfunction, no characteristic antibody profile was detected among patients, although the presence of specific antibodies in serum samples suggested prognostic value: good patient outcome and recovery from pneumonia were correlated with R. equi antibody detection, whereas the lack or disappearance of specific antibodies, mainly those to low-molecular-weight antigens, was correlated with disease progression and patient death. These results confirmed the nonobligatory presence of the well-known virulence-associated antigens for the pathogenicity of R. equi in humans, and also the diversity of R. equi strains isolated from AIDS patients, which may be related to the geographic origin of the isolates or may be a consequence of the route of R. equi transmission in different countries. Some mechanisms underlying the results obtained are discussed, suggesting immune complex formation during the progress of the disease.

AIDS-Related Opportunistic Infections↗
PubMed1991

Protection against naturally acquired Rhodococcus equi pneumonia in foals by administration of hyperimmune plasma.

A 2-year field study was performed to determine the capability of increasing Rhodococcus equi specific antibody in foals via plasma transfusion or mare vaccination, to determine the kinetics of R. equi (ELISA) antibody decay and to assess the protective effects of these procedures in foals on a farm endemic for R. equi. Plasma donors were vaccinated with a killed R. equi bacterin and produced high levels of anti-R. equi antibodies, which were harvested by plasmapheresis. In Experiment 1, 68 foals were given 1 litre of hyperimmune plasma intravenously (i.v.) between 1-60 days of age. Foal plasma R. equi antibody was significantly increased and high levels of R. equi antibody (ELISA) were maintained for 60 days. No R. equi pneumonia developed in any foals receiving plasma. In Experiment 2, 99 pregnant mares were vaccinated with R. equi bacterin at 30, 60 and 90 days before foaling. Group 1 foals (101:85 from R. equi immunized mares) also received plasma transfusions and Group 2 foals (14), from R. equi immunized mares, did not receive plasma transfusions. Pregnant mare immunization increased colostrum R. equi antibody significantly. Eight foals showed failure of transfer of specific R. equi antibody. The incidence of R. equi pneumonia was 2.9% in Group 1 foals and 43% in Group 2 foals. Vaccination of pregnant mares did not provide protection against R. equi pneumonia; however, plasma transfusion with hyperimmune plasma administered prior to R. equi exposure was significantly protective in foals.

Actinomycetales Infections↗
PubMed2000

Characterisation of Rhodococcus equi strains isolated from foals and from immunocompromised human patients.

The cultural, morphological, biochemical, serological characteristics and antibiotic susceptibility of 25 Rhodococcus equi strains isolated from lungs and lung abscesses of pneumonic foals and 5 R. equi strains isolated from immuno-compromised human patients were examined. All R. equi strains showed common cultural, morphological and biochemical characteristics both with conventional tests and on the basis of their enzyme profile. The R. equi strains examined were resistant to penicillins with the exception of ampicillin, to sulphamethazine and several strains also to sulphamethoxazole-trimethoprim. All strains were susceptible to erythromycin and rifampicin. The strains isolated from humans showed somewhat higher rate of antibiotic resistance to penicillin, cefotaxime, kanamycin, streptomycin, lincomycin, and oxytetracycline. The overwhelming majority (96%) of the equine isolates belonged to serotype 1 in Prescott's serotyping system, while the human isolates could not be serotyped.

Animals↗