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Protection against atypical furunculosis in Atlantic halibut, Hippoglossus hippoglossus (L.); comparison of a commercial furunculosis vaccine and an autogenous vaccine.

Atlantic halibut, Hippoglossus hippoglossus (L.), was shown to be sensitive to infection by three different isolates of Aeromonas salmonicida ssp. achromogenes in pre-challenge tests using intraperitoneal (i.p.) and intramuscular (i.m.) injections as well as bath challenges. A commercial furunculosis vaccine, Alphaject 1200, and an autogenous vaccine, AAS, based on the challenge strain, induced immune protection as shown in challenge tests 8 weeks post-immunization. The survival rate of vaccinated fish after i.p. challenge was 100%, whereas mortality of control fish was 61%. Employing i.m. challenge, relative percentage survival induced by the furunculosis vaccine and the AAS vaccine was 47 and 44, respectively. Mortality of i.m. injected controls was 68%. Vaccinated fish behaved normally following vaccination but the weight gain was significantly reduced in vaccinated fish 8 weeks post-vaccination compared with control fish receiving phosphate-buffered saline. At the same time, intra-abdominal adhesions were observed in fish injected with either of the two vaccines or adjuvant alone. Antibody response against A. salmonicida ssp. achromogenes was detected in sera from fish receiving either vaccine.

Aeromonas↗

Impaired neutrophil functions in the pathogenesis of an outbreak of recurrent furunculosis caused by methicillin-resistant Staphylococcus aureus among mentally retarded adults.

Staphylococcus aureus is an important cause of skin infections. We recently described an outbreak of recurrent furunculosis involving methicillin-resistant S. aureus among mentally retarded adults. We sought to determine the role of impaired neutrophil functions in its pathogenesis. Blood neutrophil functions were determined during both the outbreak (1997) and a disease-free period (2000). Chemotaxis was measured by migration toward formyl-methionyl-leucyl-phenylalanine (FMLP), specifically and randomly; phagocytosis of opsonized zymosan (OZ) was assessed by microscopy; superoxide production was determined by cytochrome c reduction in unstimulated neutrophils and after stimulation with 50 ng/ml phorbol myristate acetate, 1 mg/ml OZ or 5 x 10(-7)M FMLP. Functions were compared between recurrent furunculosis (n=10) and non-recurrent furunculosis patients (n=13). During 2000, functions were normal among the 23 subjects, except for specific/nonspecific chemotaxis (mean 68%+/-26 and 69%+/-28). During infection, recurrent furunculosis patients had a significantly increased basal superoxide production as compared to disease-free period (10.5+/-4.7 vs. 4.9+/-1.9 nmol O(-)(2)/10(6) cells/min, p=0.003). During the disease-free period, recurrent furunculosis patients had lower basal superoxide production (4.9+/-1.9 vs. 7.7+/-3.5, p=0.067) and impaired specific chemotaxis (57%+/-28 vs. 76%+/-21, p<0.05) as compared to non-recurrent furunculosis patients. Only specific chemotaxis was an independent risk factor for recurrent furunculosis. Mentally retarded adults have impaired chemotaxis, with recurrent furunculosis cases having an even greater impairment. Abnormal specific chemotaxis is an independent risk factor for recurrent furunculosis. Impaired neutrophil functions thus have a role in the pathogenesis of outbreaks of recurrent furunculosis.

Adult↗

Association between anal furunculosis and colitis in the dog: preliminary observations.

Treatment of anal furunculosis in dogs is often unsatisfactory and may be associated with significant recurrence and complications. This may be compounded by the simultaneous presence of colitis in affected animals. Clinical signs associated with colitis and anal furunculosis may be similar, including faecal tenesmus, dyschezia and haematochezia. To examine the incidence of concurrent anal furunculosis and colitis, colonic biopsies were collected from 18 dogs referred for treatment of anal furunculosis. Nine dogs (50 per cent) had a histopathological diagnosis of colitis. Clinical signs more indicative of colitis than anal furunculosis (increased frequency of defecation, mucus in faeces and diarrhoea) were not observed more frequently in dogs with confirmed colitis compared with those with furunculosis alone. Therefore, while an association between colitis and anal furunculosis may exist, clinical signs alone cannot be used as an indicator of the presence of colitis in cases of anal furunculosis. The authors recommend that colonic biopsies should be undertaken in all dogs presented with anal furunculosis. Whether specific treatment of colitis in dogs with histopathological evidence of colitis improves the outcome of treatment for anal furunculosis awaits further study.

Animals↗

Effects of host density on furunculosis epidemics determined by the simple SIR model.

To determine the transmission dynamics of furunculosis, Chinook salmon, Oncorhynchus tshawytscha held at various densities were challenged with a single infectious fish. Data from the in vivo experiments were compared to predicted values from a susceptible--infected--removed (SIR) model. Seven different densities were tested including 9.13, 4.56, 0.72, 0.36, 0.19, 0.06 and 0.03 fish/L and each produced different transmission coefficients (beta) of 0.01, 0.019, 0.0051, 0.0076, 0.0001, 0.0005 and 0.00, respectively. Furunculosis related mortality rates decreased as density of the host decreased. Mortality rates at the highest fish densities where disease specific mortality (DSM) was observed were 0.42, 0.44, 0.18 and 0.02 infected animals per day. The natural mortality rate also followed a similar pattern with 0.005, 0.005, 0.001, 0.005, 0.0001, 0.000 and 0.000 surviving animals per day. The results indicated that the transmission coefficient and the DSM of furunculosis was dependent on host density. It is possible that fish behavioral changes at the lower densities caused the reproductive rate of disease to be persistent even at very low densities. In summary, the simple SIR model suggested that low mortality does not always mean low prevalence of furunculosis in a given population. This is the first study evaluating host density as a risk factor for fish diseases using experimental furunculosis data.

Animal Husbandry↗

Association of furunculosis and familial deficiency of mannose-binding lectin.

BACKGROUND: Polymorphisms in the mannose-binding lectin gene reduce serum mannose-binding lectin levels and are associated with enhanced risk of infection. In a family with recurrent staphylococcal disease presenting as furunculosis or carbuncles, an association with mannose-binding lectin deficiency was investigated. MATERIALS AND METHODS: Levels of functional mannose-binding lectin were estimated and the genotypes of the mannose-binding lectin gene were analysed on blood samples, collected from the members of one particular family with a high prevalence of furunculosis. RESULTS: Functional mannose-binding lectin levels in sera of 13 of the 28 members of one family showed deficiency. Furunculosis or carbuncles appeared to be present in nine of the 28 family members, seven of which showing the pBly allele and mannose-binding lectin deficiency. Four young family members of the second generation were pBly positive and mannose-binding lectin deficient, but had not shown furunculosis yet. CONCLUSION: Members of a particular family suffering from furunculosis differ from their 'healthy' relatives as to mannose-binding lectin genotypes, indicating the relevance of normal mannose-binding lectin levels in the defence against staphylococcal disease.

Adolescent↗

Neutrophil chemotaxis in patients with Staphylococcus aureus furunculosis.

Neutrophil chemotaxis was evaluated in patients with staphylococcal furunculosis using a modified Boyden chamber assay. Neutrophil chemotactic response to Staphylococcus aureus-derived chemotactic factor was compared with response to Escherichia coli-derived chemotactic factor and zymosan-activated serum. Twenty-one patients with active furunculosis were compared with 29 patients with a history of furunculosis but no recent infection and with 29 healthy control subjects. Chemotactic response to the staphylococcal chemotactic factor was significantly higher in patients with active furunculosis (mean 61.6) than in patients with a history of furunculosis (mean 36.4) or controls (mean 31.4), P less than 0.001. Neutrophils from patients with active staphylococcal infections also had higher chemotactic activity toward E. coli chemotactic factor, but not significantly so (P = 0.09). Chemotactic response to zymosan-activated serum and background neutrophil motility was comparable among the three groups. The increased neutrophil chemotactic response of patients with active infection to bacterial factors, but not zymosan-activated serum, may represent a specific neutrophil response to products of infecting organisms. The differential response of the patients' neutrophils to these attractants supports evidence for the presence of separate categories of chemotaxin receptor on the surface of neutrophils.

Chemotactic Factors↗

[Species composition and antibiotic sensitivity of staphylococci isolated from patients with furunculosis].

Biological properties and sensitivity to modern antibacterial drugs 54 strains of staphylococci isolated under furunculosis have been studied with the aim to optimize this disease treatment. Staphylococcus aureus was revealed with frequency 35.2 +/- 6.50%, S. epidermidis (31.5 +/- 6.32%), S. warneri (16.7 +/- 5.08%), S. hominis (7.4 +/- 3.56%), S. haemolyticus and S. saprophyticus (3.7 +/- 2.57%) as well as S. lentus (1.9 +/- 1.86%) were identified among coagulase-negative staphylococci. Methycillin-resistant staphylococci were isolated from 25.92% of patients with furunculosis. High level of resistance of furunculosis agents to erythromycin, clarythromycine, cephtriaxon, pephloxacyne, tetracycline, doxycycline, levomycetine and phosphomycine has been registered. Basing on the study of isolates antibioticograms, cephasoline is recommended as the selected drug under furunculosis, and tobramycin as the reserve antibiotic. Autovaccine was also made for the patients treatment.

Anti-Bacterial Agents↗

Sphingomyelinase activity of Staphylococcus aureus strains from recurrent furunculosis and other infections.

The sphingomyelinase (beta-hemolysin) production by 180 Staphylococcus aureus strains was determined in a qualitative enzyme impression test (EIT) and all but 4 strains in a quantitative enzyme assay test (EAT) using 14C-sphingomyelin as test substrates. A total of 59 strains (33%) were positive for enzyme production in the EIT. The highest frequency was found in strains isolated from recurrent furunculosis (45%) as compared with strains from chronic osteomyelitis, tropical pyomyositis and healthy nasal carriers (18, 8 and 19%, respectively). High producers of sphingomyelinase in EAT were mostly found among furunculosis strains, phage type 55 and/or 71. The furunculosis strains lysed by phages 3A and/or 3C mostly had a low sphingomyelinase production. In 3 families, high- and low- producing strains of the same phage group were isolated from 2 different members of the same family. The high-producing strains caused more intense skin lesions.

Furunculosis↗

Recurrent staphylococcal furunculosis. Bacteriological findings and epidemiology in 100 cases.

During about 3 years 100 cases of recurrent staphylococcal furunculosis were studied with reference to phage-types of strains from lesions, nares, perineum and groins in relation to possible contamination sources. Phage group II staphylococci were found in 58% of the cases. In about half of the patients the same phage type was found in the nares as in the lesion but in the perineum and/or groins in only 14%. In two thirds of these cases the strains belonged to phage group II. Phage group II strains were isolated mainly from patients after supposed contamination outside hospital, while these strains were not dominating in patients probably infected in hospital. An epidemiological study revealed that recurrent furunculosis mostly has its origin outside hospital. Phage typing of lesion and nares strains is essential for the epidemiological analysis of recurrent furunculosis.

Adolescent↗

Intractable chronic furunculosis: prevention of recurrences with pentoxifylline.

A 60-year-old HIV-negative man with known noninsulin-dependent diabetes mellitus and glucose 6-phosphate-dehydrogenase deficiency anemia suffered from chronic recurrent furunculosis since the age of 30. In recent years, his condition had become increasingly severe and the recurrences increasingly frequent. Different measures including continuous therapy with large doses of systemic antibiotics for a period of 6 months failed to prevent the recurrences. Oral treatment with pentoxifylline 400 mg t.i.d. was prescribed, and 2 months later the patient experienced a dramatic and complete remission of his furunculosis. Six months later he was still totally free of lesions while continuing to take the same medication. Pentoxifylline may provide a new and effective approach to the previously difficult and often disappointing problem of the management of patients with chronic recurrent furunculosis.

Chronic Disease↗

An outbreak of mycobacterial furunculosis associated with footbaths at a nail salon.

BACKGROUND: In September 2000, a physician in northern California described four patients with persistent, culture-negative boils on the lower extremities. The patients had received pedicures at the same nail salon. We identified and investigated an outbreak of Mycobacterium fortuitum furunculosis among customers of this nail salon. METHODS: Patients were defined as salon customers with persistent skin infections below the knee. A case-control study was conducted that included the first 48 patients identified, and 56 unaffected friends and family members who had had a pedicure at the same salon served as controls. Selected M. fortuitum isolates, cultured from patients and the salon environment, were compared by pulsed-field gel electrophoresis. RESULTS: We identified 110 customers of the nail salon who had furunculosis. Cultures from 34 were positive for rapidly growing mycobacteria (32 M. fortuitum and 2 unidentified). Most of the affected patients had more than 1 boil (median, 2; range, 1 to 37). All patients and controls had had whirlpool footbaths. Shaving the legs with a razor before pedicure was a risk factor for infection (70 percent of patients vs. 31 percent of controls; adjusted odds ratio, 4.8; 95 percent confidence interval, 2.1 to 11.1). Cultures from all 10 footbaths at the salon yielded M. fortuitum. The M. fortuitum isolates from three footbaths and 14 patients were indistinguishable by electrophoresis. CONCLUSIONS: We identified a large outbreak of rapidly growing mycobacterial infections among persons who had had footbaths and pedicures at one nail salon. Physicians should suspect this cause in patients with persistent furunculosis after exposure to whirlpool footbaths.

Beauty Culture↗

A concurrent increasing of natural antibodies and enhancement of resistance to furunculosis in rainbow trout.

In order to compare the respective roles of specific response and non-specific mechanisms in the enhancement of resistance to furunculosis, 2 groups of rainbow trout (Oncorhynchus mykiss) were immunized with supernatants of Aeromonas salmonicida or Escherichia coli cultures. The fish received 4 weekly intraperitoneal injections (70 micrograms of crude proteins). One control group was injected with phosphate-buffered saline, while another was untreated. Specific agglutinins were produced only in the fish immunized with A salmonicida supernatant. Polyspecific natural antibodies were measured using different antigens in an enzyme immunoassay. A significant rise (up to 3 times the mean titer of untreated controls) was observed in the 3 injected groups (even with PBS), which also displayed significant protection against experimental furunculosis (32 to 42% mortality versus 72% in controls). Thus, although the exact significance of natural antibodies still has to be confirmed, the importance of natural defenses and the difficulty in clearly inducing specific protection against furunculosis are confirmed.

Aeromonas↗

Bestatin treatment for the correction of granulocyte dysfunction in patients with recurrent furunculosis.

Bestatin, a new immunomodulator which is chemically well-defined, was examined for its capacity to enhance the phagocytic activity of neutrophilic granulocytes from patients with furunculosis. The ability of the granulocytes to ingest fluorescein-labelled yeast particles was significantly decreased in 19 patients with recurrent furunculosis (p less than 0.01). Oral administration of 40 mg bestatin to ten patients increased the phagocytic function of their granulocytes significantly (p less than 0.01).

Adult↗

Preliminary report: furunculosis and hypoferraemia.

16 patients with recurrent staphylococcal furunculosis but without anaemia had significantly lower serum iron concentrations than normal laboratory reference values, 8 controls with single furuncles, or 10 controls with acne conglobata. There were no significant differences in serum glucose or iron binding capacity between the groups studied. Furunculosis resolved after 3-4 weeks' treatment with iron supplements in all but 1 patient. The relation between iron and susceptibility to infection is unclear, but merits further investigation.

Adolescent↗

The role of alpha 2-macroglobulin in furunculosis: a comparison of rainbow trout and brook trout.

1. The molecular basis for the high survival rate of rainbow trout, Oncorhynchus mykiss, infected with furunculosis was investigated. 2. Alpha 2-macroglobulin (alpha 2M), a major serum protease inhibitor, was partially purified from rainbow trout and brook trout, Salvelinus fontinalis, sera; the latter species shows marked disease susceptibility. 3. It is shown that a 10-fold species-based difference in alpha 2M inhibitory activity exists against a furunculosis associated bacterial protease. 4. A possible basis for the observed disparity is discussed. 5. Results suggest that the high mol. wt form of teleost (trout) albumin is a dimer composed of two 85,000 subunits.

Aeromonas↗

Surface-disorganized, attenuated mutants of Aeromonas salmonicida as furunculosis live vaccines.

A slow-growing, aminoglycoside-resistant mutant and a rapidly-growing pseudo-revertant were isolated from Aeromonas salmonicida, the causative agent of salmonid furunculosis. These mutants continued to elicit a variety of classical virulence factors associated with A. salmonicida pathogenesis. They differed morphologically from the wild-type and from one another with respect to A-layer organization, membrane antagonist sensitivity and particularly to aerobic metabolism. Both mutants were drastically altered in the architecture of the 2D crystalline surface array (A-layer), although both were similar to wild-type with respect to cell surface composition. The slow-growing, antibiotic-resistant mutant differed significantly from the wild-type by the apparent loss of virtually all aerobic metabolism; the pseudo-revertant had partially recovered the ability to aerobically metabolize certain carbon sources. Both mutants were avirulent and incapable of tissue persistence. The rapidly-growing, antibiotic-sensitive pseudo-revertant, when administered either intraperitoneally or by immersion, effectively protected salmonid fish from challenge by a heterologous virulent stain suggesting its candidature as a live, attenuated furunculosis vaccine.

Aeromonas↗

Immunostimulatory effects of dimerized lysozyme (KLP-602) on the nonspecific defense mechanisms and protection against furunculosis in salmonids.

Utilization of natural immunostimulants in fish culture offers a wide range of attractive methods for inducing and building protection against diseases. Lysozyme is an enzyme with bacteriolytic properties and is ubiquitous in its distribution among living organisms. This enzyme has antiviral, antibacterial and anti-inflammatory properties. In nature, lysozyme is found as a monomer. Lysozyme dimer is significantly less toxic than its monomer, and its high biological activity has been ascertained in cases of both viral and bacterial infections. In our study, we examined the influence of dimerized lysozyme (KLP-602) on the nonspecific cellular and humoral defense mechanisms and protection against furunculosis in rainbow trout (Oncorhynchus mykiss). We have analyzed the immunomodulatory effects of KLP-602 after experimental infection by Aeromonas salmonicida. Application of dimerized lysozyme (KLP-602) by injection stimulated the cellular and humoral defense mechanisms and provided protection against furunculosis. By contrast, mortality rate was reduced to 45% (one injection) and 25% (three injections) using 10 or 100 microg/kg KLP-602. Mortality in the untreated control group was 85%.

Adjuvants, Immunologic↗

Multiple bilateral orbital abscesses secondary to nasal furunculosis.

Orbital inflammation secondary to sinus inflammation is a well known entity and has been widely reported. However, nasal furunculosis resulting in orbital inflammation is a rare occurrence. We present a case of a 2-year-old boy who developed multiple bilateral orbital abscesses secondary to nasal furunculosis. To our knowledge such a case has not been reported before.

Abscess↗