35 results on '"Raphael, Brian H"'
Search Results
2. Locally Acquired Mosquito-Transmitted (Autochthonous) Plasmodium falciparum Malaria -- National Capital Region, Maryland, August 2023.
- Author
-
Duwell, Monique, DeVita, Timothy, Jenny Chen, Myers, Robert A., Mace, Kimberly, Ridpath, Alison D., Odongo, Wycliffe, Raphael, Brian H., Lenhart, Audrey, Tongren, Jon Eric, Stanley, Stephen, and Blythe, David
- Subjects
MALARIA ,PLASMODIUM falciparum ,MALARIA diagnosis ,MEDICAL history taking - Abstract
The article describes the case of locally acquired mosquito-transmitted Plasmodium falciparum Malaria in a patient in Maryland in August 2023. It discusses the patient's medical history, results of the patient's laboratory tests, the diagnosis of Plasmodium falciparum, treatment given to the patient and the implementation of active case finding to identify other malaria cases in Maryland following the confirmation of malaria in the patient.
- Published
- 2023
- Full Text
- View/download PDF
3. Surveillance for Disseminated Gonococcal Infections, Active Bacterial Core Surveillance (ABCs)—United States, 2015–2019.
- Author
-
Weston, Emily J, Heidenga, Brooke L, Farley, Monica M, Tunali, Amy, D'Angelo, Melissa Tobin, Moore, Ashley, Workowski, Kimberly, Raphael, Brian H, Weinstock, Hillard, and Torrone, Elizabeth
- Subjects
PUBLIC health surveillance ,GONORRHEA ,RETROSPECTIVE studies ,NEISSERIA infections ,DATA analysis software ,LONGITUDINAL method ,MICROBIAL sensitivity tests - Abstract
Background Disseminated gonococcal infections (DGIs) are thought to be uncommon; surveillance is limited, and case reports are analyzed retrospectively or in case clusters. We describe the population-level burden of culture-confirmed DGIs through the Active Bacterial Core surveillance (ABCs) system. Methods During 2015–2016, retrospective surveillance was conducted among residents in 2 ABCs areas and prospectively in 3 ABCs areas during 2017–2019. A DGI case was defined as isolation of Neisseria gonorrhoeae from a normally sterile site. A case report form was completed for each case and antimicrobial susceptibility testing (AST) was performed on available isolates. Results During 2015–2019, 77 DGI cases were identified (a rate of 0.13 cases per 100 000 population) and accounted for 0.06% of all reported gonorrhea cases in the 3 surveillance areas. Most DGI cases were male (64%), non-Hispanic Black (68%), and ranged from 16 to 67 years of age; blood (55%) and joint (40%) were the most common sterile sites. Among 29 isolates with AST results during 2017–2019, all were susceptible to ceftriaxone. Conclusions DGI is an infrequent complication of N gonorrhoeae ; because it can quickly develop antimicrobial resistance, continued DGI surveillance, including monitoring trends in antimicrobial susceptibility, could help inform DGI treatment recommendations. [ABSTRACT FROM AUTHOR]
- Published
- 2022
- Full Text
- View/download PDF
4. Phylogenomic Comparison of Neisseria gonorrhoeae Causing Disseminated Gonococcal Infections and Uncomplicated Gonorrhea in Georgia, United States.
- Author
-
Cartee, John C, Joseph, Sandeep J, Weston, Emily, Pham, Cau D, Thomas, Jesse C, Schlanger, Karen, Cyr, Sancta B St, Farley, Monica M, Moore, Ashley E, Tunali, Amy K, Cloud, Charletta, and Raphael, Brian H
- Subjects
NEISSERIA gonorrhoeae ,GONORRHEA ,NEISSERIA ,WHOLE genome sequencing ,GENETIC variation ,GENETIC markers ,DRUG resistance in microorganisms - Abstract
Disseminated gonococcal infection (DGI) is a rare complication caused by the systemic dissemination of Neisseria gonorrhoeae to normally sterile anatomical sites. Little is known about the genetic diversity of DGI gonococcal strains and how they relate to other gonococcal strains causing uncomplicated mucosal infections. We used whole genome sequencing to characterize DGI isolates (n = 30) collected from a surveillance system in Georgia, United States, during 2017–2020 to understand phylogenetic clustering among DGI as well as uncomplicated uro- and extragenital gonococcal infection (UGI) isolates (n = 110) collected in Fulton County, Georgia, during 2017–2019. We also investigated the presence or absence of genetic markers related to antimicrobial resistance (AMR) as well as surveyed the genomes for putative virulence genetic factors associated with normal human-serum (NHS) resistance that might facilitate DGI. We found that DGI strains demonstrated significant genetic variability similar to the population structure of isolates causing UGI, with sporadic incidences of geographically clustered DGI strains. DGI isolates contained various AMR markers and genetic mechanisms associated with NHS resistance. DGI isolates had a higher frequency of the porB1A allele compared with UGI (67% vs 9%, P < .0001); however, no single NHS resistance marker was found in all DGI isolates. Continued DGI surveillance with genome-based characterization of DGI isolates is necessary to better understand specific factors that promote systemic dissemination. [ABSTRACT FROM AUTHOR]
- Published
- 2022
- Full Text
- View/download PDF
5. Chlamydia trachomatis Variants Escaping Detection in the Aptima Combo 2 Assay in the United States.
- Author
-
Katz, Samantha S., Danavall, Damien C., Morris, Monica R., Herrod, Bridgett P., Dale, Suzanne E., Nye, Melinda B., Kersh, Ellen N., Kirkcaldy, Robert D., and Raphael, Brian H.
- Published
- 2022
- Full Text
- View/download PDF
6. Characterization of a Neisseria gonorrhoeae Ciprofloxacin panel for an antimicrobial resistant Isolate Bank.
- Author
-
Liu, Hsi, Tang, Kevin, Pham, Cau D., Schmerer, Matthew, Kersh, Ellen N., and Raphael, Brian H.
- Subjects
NEISSERIA gonorrhoeae ,CIPROFLOXACIN ,WHOLE genome sequencing ,MICROBIAL sensitivity tests ,DRUG resistance in bacteria - Abstract
Objectives: Neisseria gonorrhoeae (gonococcus) infection is one of the most commonly reported nationally notifiable conditions in the United States. Gonococcus has developed antimicrobial resistance to each previously used antibiotic for gonorrhea therapy. However, some isolates may be still susceptible to no longer recommended, yet still effective antibiotics. This in turn suggests that targeted therapy could slow resistance development to currently recommended empirical treatments. We curated a gonococcal Ciprofloxacin Antibiotic Resistance Isolate Bank panel (Cipro-panel) as a tool for validating or developing new tests to determine ciprofloxacin susceptibility. Method: The Cipro-panel was selected using whole genome sequencing, bioinformatic tools, and antimicrobial susceptibility testing (AST) data. Isolates were further selected based on nucleotide variations in gyrA and parC genes. Results: We selected 14 unique N. gonorrhoeae isolates from the 2006–2012 Gonococcal Isolate Surveillance Project (GISP) collection. They represented a wide range of antimicrobial susceptibility to ciprofloxacin and commonly observed nucleotide variations of gyrA and parC genes. This Cipro-panel consists of 5 isolates with resistant phenotypes (MIC > = 1 μg/mL), 8 isolates with susceptible phenotypes (MIC < = 0.06 μg/mL), and 1 isolate falling in the Clinical and Laboratory Standards Institute defined intermediate range. Among the gyrA variations we observed a total of 18 SNPs. Four positions had nonsynonymous changes (nucleotide positions 272, 284, 1093, and 1783). The first two positions (272 and 284) have been linked previously with resistance to ciprofloxacin (i.e. amino acid positions 91 and 95). For the parC gene, we observed a total of 21 possible SNPs. Eight of those SNPs resulted in non-synonymous amino acid changes. One location (amino acid 87) has been previously reported to be associated with ciprofloxacin resistance. Conclusions: This Cipro-Panel is useful for researchers interested in developing clinical tests related to ciprofloxacin. It could also provide additional choices for validation, quality assurance purposes and improve antibiotic usage. [ABSTRACT FROM AUTHOR]
- Published
- 2022
- Full Text
- View/download PDF
7. Global Emergence and Dissemination of Neisseria gonorrhoeae ST-9363 Isolates with Reduced Susceptibility to Azithromycin.
- Author
-
Joseph, Sandeep J, Thomas, Jesse C, Schmerer, Matthew W, Cartee, John C, Cyr, Sancta St, Schlanger, Karen, Kersh, Ellen N, Raphael, Brian H, Gernert, Kim M, and Group, Antimicrobial Resistant Neisseria gonorrhoeae Working
- Subjects
NEISSERIA gonorrhoeae ,AZITHROMYCIN - Abstract
Neisseria gonorrhoeae multilocus sequence type (ST) 9363 core-genogroup isolates have been associated with reduced azithromycin susceptibility (AZM
rs ) and show evidence of clonal expansion in the United States. Here, we analyze a global collection of ST-9363 core-genogroup genomes to shed light on the emergence and dissemination of this strain. The global population structure of ST-9363 core-genogroup falls into three lineages: Basal, European, and North American; with 32 clades within all lineages. Although, ST-9363 core-genogroup is inferred to have originated from Asia in the mid-19th century; we estimate the three modern lineages emerged from Europe in the late 1970s to early 1980s. The European lineage appears to have emerged and expanded from around 1986 to 1998, spreading into North America and Oceania in the mid-2000s with multiple introductions, along with multiple secondary reintroductions into Europe. Our results suggest two separate acquisition events of mosaic mtrR and mtrR promoter alleles: first during 2009–2011 and again during the 2012–2013 time, facilitating the clonal expansion of this core-genogroup with AZMrs in the United States. By tracking phylodynamic evolutionary trajectories of clades that share distinct demography as well as population-based genomic statistics, we demonstrate how recombination and selective pressures in the mtrCDE efflux operon granted a fitness advantage to establish ST-9363 as a successful gonococcal lineage in the United States and elsewhere. Although it is difficult to pinpoint the exact timing and emergence of this young core-genogroup, it remains critically important to continue monitoring it, as it could acquire additional resistance markers. [ABSTRACT FROM AUTHOR]- Published
- 2022
- Full Text
- View/download PDF
8. Implementation and Evaluation of Gradient Strip Antimicrobial Susceptibility Testing in US Public Health Laboratories to Respond to Resistant Gonorrhea.
- Author
-
Raphael, Brian H., Pham, Cau D., Sharpe, Samera, Mauk, Kerry, Harvey, Alesia, Khubbar, Manjeet, Triplett, Laura, Soge, Olusegun O., Denny, Michael, Palavecino, Elizabeth L., Finney, Rose, Olsen, Aaron, Carlson, Jonathan, St. Cyr, Sancta B., Schlanger, Karen, Kersh, Ellen N., and Strengthening the US Response to Resistant Gonorrhea Working Group
- Published
- 2021
- Full Text
- View/download PDF
9. Exploring and Comparing the Structure of Sexual Networks Affected by Neisseria gonorrhoeae Using Sexual Partner Services Investigation and Genomic Data.
- Author
-
Town, Katy, Learner, Emily R., Chivukula, Vasanta L., Mauk, Kerry, Reimche, Jennifer L., Schmerer, Matthew W., Black, Jamie, Pathela, Preeti, Bhattacharyya, Sanjib, Kerani, Roxanne P., Gieseker, Karen E., Fukuda, Acasia, Sankaran, Madeline, McNeil, Candice J., Spicknall, Ian H., Raphael, Brian H., St Cyr, Sancta B., Bernstein, Kyle, Kersh, Ellen N., and Kirkcaldy, Robert D.
- Published
- 2021
- Full Text
- View/download PDF
10. High Plasmid Gene Protein 3 (Pgp3) Chlamydia trachomatis Seropositivity, Pelvic Inflammatory Disease, and Infertility Among Women, National Health and Nutrition Examination Survey, United States, 2013–2016.
- Author
-
Anyalechi, Gloria E, Hong, Jaeyoung, Danavall, Damien C, Martin, Diana L, Gwyn, Sarah E, Horner, Patrick J, Raphael, Brian H, Kirkcaldy, Robert D, Kersh, Ellen N, and Bernstein, Kyle T
- Subjects
NUCLEIC acid analysis ,DIAGNOSIS of bacterial diseases ,PELVIC inflammatory disease diagnosis ,BIOMARKERS ,RESEARCH ,SEROPREVALENCE ,CONFIDENCE intervals ,PLASMIDS ,CHLAMYDIACEAE ,INFERTILITY ,SURVEYS ,COMPARATIVE studies ,SEXUALLY transmitted diseases ,QUESTIONNAIRES ,DESCRIPTIVE statistics ,CHLAMYDIA trachomatis ,GENE amplification ,WOMEN'S health ,BLOOD - Abstract
Background Chlamydia trachomatis causes pelvic inflammatory disease (PID) and tubal infertility. Plasmid gene protein 3 antibody (Pgp3Ab) detects prior chlamydial infections. We evaluated for an association of high chlamydial seropositivity with sequelae using a Pgp3Ab multiplex bead array (Pgp3AbMBA). Methods We performed chlamydia Pgp3AbMBA on sera from women 18-39 years old participating in the 2013–2016 National Health and Nutrition Examination Survey (NHANES) with urine chlamydia nucleic acid amplification test results. High chlamydial seropositivity was defined as a median fluorescence intensity (MFI ≥ 50 000; low-positive was MFI > 551–<50 000. Weighted US population high-positive, low-positive, and negative Pgp3Ab chlamydia seroprevalence and 95% confidence intervals (CI) were compared for women with chlamydial infection, self-reported PID, and infertility. Results Of 2339 women aged 18–39 years, 1725 (73.7%) had sera, and 1425 were sexually experienced. Overall, 104 women had high positive Pgp3Ab (5.4% [95% CI 4.0–7.0] of US women); 407 had lowpositive Pgp3Ab (25.1% [95% CI 21.5–29.0]), and 914 had negative Pgp3Ab (69.5% [95% CI 65.5–73.4]). Among women with high Pgp3Ab, infertility prevalence was 2.0 (95% CI 1.1–3.7) times higher than among Pgp3Ab-negative women (19.6% [95% CI 10.5–31.7] versus 9.9% [95% CI 7.7–12.4]). For women with low Pgp3Ab, PID prevalence was 7.9% (95% CI 4.6–12.6) compared to 2.3% (95% CI 1.4–3.6) in negative Pgp3Ab. Conclusions High chlamydial Pgp3Ab seropositivity was associated with infertility although small sample size limited evaluation of an association of high seropositivity with PID. In infertile women, Pgp3Ab may be a marker of prior chlamydial infection. [ABSTRACT FROM AUTHOR]
- Published
- 2021
- Full Text
- View/download PDF
11. Genomic Analysis of the Predominant Strains and Antimicrobial Resistance Determinants Within 1479 Neisseria gonorrhoeae Isolates From the US Gonococcal Isolate Surveillance Project in 2018.
- Author
-
Reimche, Jennifer L., Chivukula, Vasanta L., Schmerer, Matthew W., Joseph, Sandeep J., Pham, Cau D., Schlanger, Karen, St Cyr, Sancta B., Weinstock, Hillard S., Raphael, Brian H., Kersh, Ellen N., and Gernert, Kim M.
- Published
- 2021
- Full Text
- View/download PDF
12. Genomic Analysis of the Predominant Strains and Antimicrobial Resistance Determinants Within 1479 Neisseria gonorrhoeae Isolates From the US Gonococcal Isolate Surveillance Project in 2018.
- Author
-
Reimche, Jennifer L, Chivukula, Vasanta L, Schmerer, Matthew W, Joseph, Sandeep J, Pham, Cau D, Schlanger, Karen, St Cyr, Sancta B, Weinstock, Hillard S, Raphael, Brian H, Kersh, Ellen N, Gernert, Kim M, and Antimicrobial-Resistant Neisseria gonorrhoeae Working Group
- Published
- 2021
- Full Text
- View/download PDF
13. Phylogenomic analysis reveals persistence of gonococcal strains with reduced-susceptibility to extended-spectrum cephalosporins and mosaic penA-34.
- Author
-
Thomas IV, Jesse C., Joseph, Sandeep J., Cartee, John C., Pham, Cau D., Schmerer, Matthew W., Schlanger, Karen, St. Cyr, Sancta B., Kersh, Ellen N., Raphael, Brian H., the Antimicrobial Resistant Neisseria gonorrhoeae Working Group, Dominguez, Cathy, Patel, Ami, Loomis, Jillian, Hun, Sopheay, Ruiz, Ryan, Talosig, Nicole, Hua, Chi, Zhang, Jenny, Oh, Bonnie, and Leavitt, John
- Subjects
NEISSERIA gonorrhoeae ,TREATMENT failure ,CEPHALOSPORINS ,CEFTRIAXONE ,NUCLEOTIDE sequencing ,GONORRHEA ,ALLELES - Abstract
The recent emergence of strains of Neisseria gonorrhoeae associated with treatment failures to ceftriaxone, the foundation of current treatment options, has raised concerns over a future of untreatable gonorrhea. Current global data on gonococcal strains suggest that several lineages, predominately characterized by mosaic penA alleles, are associated with elevated minimum inhibitory concentrations (MICs) to extended spectrum cephalosporins (ESCs). Here we report on whole genome sequences of 813 N. gonorrhoeae isolates collected through the Gonococcal Isolate Surveillance Project in the United States. Phylogenomic analysis revealed that one persisting lineage (Clade A, multi-locus sequence type [MLST] ST1901) with mosaic penA-34 alleles, contained the majority of isolates with elevated MICs to ESCs. We provide evidence that an ancestor to the globally circulating MLST ST1901 clones potentially emerged around the early to mid-20th century (1944, credibility intervals [CI]: 1935–1953), predating the introduction of cephalosporins, but coinciding with the use of penicillin. Such results indicate that drugs with novel mechanisms of action are needed as these strains continue to persist and disseminate globally. Resistance of Neisseria gonorrhoeae to extended spectrum cephalosporins is an increasing concern. Here, the authors conduct whole genome sequencing of isolates from the United States and find that most resistant isolates were associated with a persistent circulating lineage. [ABSTRACT FROM AUTHOR]
- Published
- 2021
- Full Text
- View/download PDF
14. A community-driven resource for genomic epidemiology and antimicrobial resistance prediction of Neisseria gonorrhoeae at Pathogenwatch.
- Author
-
Sánchez-Busó, Leonor, Yeats, Corin A., Taylor, Benjamin, Goater, Richard J., Underwood, Anthony, Abudahab, Khalil, Argimón, Silvia, Ma, Kevin C., Mortimer, Tatum D., Golparian, Daniel, Cole, Michelle J., Grad, Yonatan H., Martin, Irene, Raphael, Brian H., Shafer, William M., Town, Katy, Wi, Teodora, Harris, Simon R., Unemo, Magnus, and Aanensen, David M.
- Subjects
AZITHROMYCIN ,NEISSERIA gonorrhoeae ,GONORRHEA ,DRUG resistance in microorganisms ,PUBLIC health surveillance ,EPIDEMIOLOGY ,MICROBIAL sensitivity tests - Abstract
Background: Antimicrobial-resistant (AMR) Neisseria gonorrhoeae is an urgent threat to public health, as strains resistant to at least one of the two last-line antibiotics used in empiric therapy of gonorrhoea, ceftriaxone and azithromycin, have spread internationally. Whole genome sequencing (WGS) data can be used to identify new AMR clones and transmission networks and inform the development of point-of-care tests for antimicrobial susceptibility, novel antimicrobials and vaccines. Community-driven tools that provide an easy access to and analysis of genomic and epidemiological data is the way forward for public health surveillance. Methods: Here we present a public health-focussed scheme for genomic epidemiology of N. gonorrhoeae at Pathogenwatch (https://pathogen.watch/ngonorrhoeae). An international advisory group of experts in epidemiology, public health, genetics and genomics of N. gonorrhoeae was convened to inform on the utility of current and future analytics in the platform. We implement backwards compatibility with MLST, NG-MAST and NG-STAR typing schemes as well as an exhaustive library of genetic AMR determinants linked to a genotypic prediction of resistance to eight antibiotics. A collection of over 12,000 N. gonorrhoeae genome sequences from public archives has been quality-checked, assembled and made public together with available metadata for contextualization. Results: AMR prediction from genome data revealed specificity values over 99% for azithromycin, ciprofloxacin and ceftriaxone and sensitivity values around 99% for benzylpenicillin and tetracycline. A case study using the Pathogenwatch collection of N. gonorrhoeae public genomes showed the global expansion of an azithromycin-resistant lineage carrying a mosaic mtr over at least the last 10 years, emphasising the power of Pathogenwatch to explore and evaluate genomic epidemiology questions of public health concern. Conclusions: The N. gonorrhoeae scheme in Pathogenwatch provides customised bioinformatic pipelines guided by expert opinion that can be adapted to public health agencies and departments with little expertise in bioinformatics and lower-resourced settings with internet connection but limited computational infrastructure. The advisory group will assess and identify ongoing public health needs in the field of gonorrhoea, particularly regarding gonococcal AMR, in order to further enhance utility with modified or new analytic methods. [ABSTRACT FROM AUTHOR]
- Published
- 2021
- Full Text
- View/download PDF
15. Whole-Genome Enrichment and Sequencing of Chlamydia trachomatis Directly from Patient Clinical Vaginal and Rectal Swabs.
- Author
-
Bowden, Katherine E., Joseph, Sandeep J., Cartee, John C., Ziklo, Noa, Danavall, Damien, Raphael, Brian H., Read, Timothy D., and Dean, Deborah
- Published
- 2021
- Full Text
- View/download PDF
16. 2020 STD Prevention Conference: Disrupting Epidemics and Dismantling Disparities in the Time of COVID-19.
- Author
-
Raphael, Brian H., Haderxhanaj, Laura, and Bowen, Virginia B.
- Published
- 2021
- Full Text
- View/download PDF
17. 2020 STD Prevention Conference: Disrupting Epidemics and Dismantling Disparities in the Time of COVID-19.
- Author
-
Raphael, Brian H, Haderxhanaj, Laura, and Bowen, Virginia B
- Published
- 2021
- Full Text
- View/download PDF
18. Genomic heterogeneity differentiates clinical and environmental subgroups of Legionella pneumophila sequence type 1.
- Author
-
Mercante, Jeffrey W., Caravas, Jason A., Ishaq, Maliha K., Kozak-Muiznieks, Natalia A., Raphael, Brian H., and Winchell, Jonas M.
- Subjects
LEGIONELLA pneumophila ,NUCLEOTIDE sequence ,CLINICAL trials ,MEDICAL microbiology ,BIOLOGICAL evolution - Abstract
Legionella spp. are the cause of a severe bacterial pneumonia known as Legionnaires’ disease (LD). In some cases, current genetic subtyping methods cannot resolve LD outbreaks caused by common, potentially endemic L. pneumophila (Lp) sequence types (ST), which complicates laboratory investigations and environmental source attribution. In the United States (US), ST1 is the most prevalent clinical and environmental Lp sequence type. In order to characterize the ST1 population, we sequenced 289 outbreak and non-outbreak associated clinical and environmental ST1 and ST1-variant Lp strains from the US and, together with international isolate sequences, explored their genetic and geographic diversity. The ST1 population was highly conserved at the nucleotide level; 98% of core nucleotide positions were invariant and environmental isolates unassociated with human disease (n = 99) contained ~65% more nucleotide diversity compared to clinical-sporadic (n = 139) or outbreak-associated (n = 28) ST1 subgroups. The accessory pangenome of environmental isolates was also ~30–60% larger than other subgroups and was enriched for transposition and conjugative transfer-associated elements. Up to ~10% of US ST1 genetic variation could be explained by geographic origin, but considerable genetic conservation existed among strains isolated from geographically distant states and from different decades. These findings provide new insight into the ST1 population structure and establish a foundation for interpreting genetic relationships among ST1 strains; these data may also inform future analyses for improved outbreak investigations. [ABSTRACT FROM AUTHOR]
- Published
- 2018
- Full Text
- View/download PDF
19. Distribution of Legionella and bacterial community composition among regionally diverse US cooling towers.
- Author
-
Llewellyn, Anna C., Lucas, Claressa E., Roberts, Sarah E., Brown, Ellen W., Nayak, Bina S., Raphael, Brian H., and Winchell, Jonas M.
- Subjects
LEGIONELLA ,LEGIONNAIRES' disease ,BACTERIAL communities ,INHALATION administration ,AEROSOLS ,COOLING towers - Abstract
Cooling towers (CTs) are a leading source of outbreaks of Legionnaires’ disease (LD), a severe form of pneumonia caused by inhalation of aerosols containing Legionella bacteria. Accordingly, proper maintenance of CTs is vital for the prevention of LD. The aim of this study was to determine the distribution of Legionella in a subset of regionally diverse US CTs and characterize the associated microbial communities. Between July and September of 2016, we obtained aliquots from water samples collected for routine Legionella testing from 196 CTs located in eight of the nine continental US climate regions. After screening for Legionella by PCR, positive samples were cultured and the resulting Legionella isolates were further characterized. Overall, 84% (164) were PCR-positive, including samples from every region studied. Of the PCR-positive samples, Legionella spp were isolated from 47% (78), L. pneumophila was isolated from 32% (53), and L. pneumophila serogroup 1 (Lp1) was isolated from 24% (40). Overall, 144 unique Legionella isolates were identified; 53% (76) of these were Legionella pneumophila. Of the 76 L. pneumophila isolates, 51% (39) were Lp1. Legionella were isolated from CTs in seven of the eight US regions examined. 16S rRNA amplicon sequencing was used to compare the bacterial communities of CT waters with and without detectable Legionella as well as the microbiomes of waters from different climate regions. Interestingly, the microbial communities were homogenous across climate regions. When a subset of seven CTs sampled in April and July were compared, there was no association with changes in corresponding CT microbiomes over time in the samples that became culture-positive for Legionella. Legionella species and Lp1 were detected frequently among the samples examined in this first large-scale study of Legionella in US CTs. Our findings highlight that, under the right conditions, there is the potential for CT-related LD outbreaks to occur throughout the US. [ABSTRACT FROM AUTHOR]
- Published
- 2017
- Full Text
- View/download PDF
20. Legionnaires' Disease Outbreak Caused by Endemic Strain of Legionella pneumophila, New York, New York, USA, 2015.
- Author
-
Lapierre, Pascal, Nazarian, Elizabeth, Yan Zhu, Wroblewski, Danielle, Saylors, Amy, Passaretti, Teresa, Musser, Kimberlee A., Zucker, Howard A., Hughes, Scott, Tran, Anthony, Ying Lin, Kornblum, John, Fitzhenry, Robert, Weiss, Don, Varma, Jay K., Rakeman, Jennifer L., Morrison, Shatavia S., Mercante, Jeffrey W., and Raphael, Brian H.
- Subjects
LEGIONNAIRES' disease ,SOUTH Bronx (New York, N.Y.) ,HOMOGENEITY ,BACTERIAL population ,LUNG diseases - Abstract
During the summer of 2015, New York, New York, USA, had one of the largest and deadliest outbreaks of Legionnaires' disease in the history of the United States. A total of 138 cases and 16 deaths were linked to a single cooling tower in the South Bronx. Analysis of environmental samples and clinical isolates showed that sporadic cases of legionellosis before, during, and after the outbreak could be traced to a slowly evolving, single-ancestor strain. Detection of an ostensibly virulent Legionella strain endemic to the Bronx community suggests potential risk for future cases of legionellosis in the area. The genetic homogeneity of the Legionella population in this area might complicate investigations and interpretations of future outbreaks of Legionnaires' disease. [ABSTRACT FROM AUTHOR]
- Published
- 2017
- Full Text
- View/download PDF
21. Characterization of Legionella Species from Watersheds in British Columbia, Canada.
- Author
-
Peabody, Michael A., Caravas, Jason A., Morrison, Shatavia S., Mercante, Jeffrey W., Prystajecky, Natalie A., Raphael, Brian H., and Brinkman, Fiona S. L.
- Published
- 2017
- Full Text
- View/download PDF
22. Vital Signs: Health Care-Associated Legionnaires' Disease Surveillance Data from 20 States and a Large Metropolitan Area - United States, 2015.
- Author
-
Soda, Elizabeth A., Barskey, Albert E., Shah, Priti P., Schrag, Stephanie, Whitney, Cynthia G., Arduino, Matthew J., Reddy, Sujan C., Kunz, Jasen M., Hunter, Candis M., Raphael, Brian H., and Cooley, Laura A.
- Abstract
Background: Legionnaires' disease, a severe pneumonia, is typically acquired through inhalation of aerosolized water containing Legionella bacteria. Legionella can grow in the complex water systems of buildings, including health care facilities. Effective water management programs could prevent the growth of Legionella in building water systems.Methods: Using national surveillance data, Legionnaires' disease cases were characterized from the 21 jurisdictions (20 U.S. states and one large metropolitan area) that reported exposure information for ≥90% of 2015 Legionella infections. An assessment of whether cases were health care-associated was completed; definite health care association was defined as hospitalization or long-term care facility residence for the entire 10 days preceding symptom onset, and possible association was defined as any exposure to a health care facility for a portion of the 10 days preceding symptom onset. All other Legionnaires' disease cases were considered unrelated to health care.Results: A total of 2,809 confirmed Legionnaires' disease cases were reported from the 21 jurisdictions, including 85 (3%) definite and 468 (17%) possible health care-associated cases. Among the 21 jurisdictions, 16 (76%) reported 1-21 definite health care-associated cases per jurisdiction. Among definite health care-associated cases, the majority (75, 88%) occurred in persons aged ≥60 years, and exposures occurred at 72 facilities (15 hospitals and 57 long-term care facilities). The case fatality rate was 25% for definite and 10% for possible health care-associated Legionnaires' disease.Conclusions and Implications For Public Health Practice: Exposure to Legionella from health care facility water systems can result in Legionnaires' disease. The high case fatality rate of health care-associated Legionnaires' disease highlights the importance of case prevention and response activities, including implementation of effective water management programs and timely case identification. [ABSTRACT FROM AUTHOR]- Published
- 2017
- Full Text
- View/download PDF
23. Genomic Analysis Reveals Novel Diversity among the 1976 Philadelphia Legionnaires’ Disease Outbreak Isolates and Additional ST36 Strains.
- Author
-
Mercante, Jeffrey W., Morrison, Shatavia S., Desai, Heta P., Raphael, Brian H., and Winchell, Jonas M.
- Subjects
LEGIONNAIRES' disease ,ETIOLOGY of diseases ,CLINICAL trials ,AUTOPOIESIS ,MOLECULAR cloning ,PREVENTION - Abstract
Legionella pneumophila was first recognized as a cause of severe and potentially fatal pneumonia during a large-scale outbreak of Legionnaires’ disease (LD) at a Pennsylvania veterans’ convention in Philadelphia, 1976. The ensuing investigation and recovery of four clinical isolates launched the fields of Legionella epidemiology and scientific research. Only one of the original isolates, “Philadelphia-1”, has been widely distributed or extensively studied. Here we describe the whole-genome sequencing (WGS), complete assembly, and comparative analysis of all Philadelphia LD strains recovered from that investigation, along with L. pneumophila isolates sharing the Philadelphia sequence type (ST36). Analyses revealed that the 1976 outbreak was due to multiple serogroup 1 strains within the same genetic lineage, differentiated by an actively mobilized, self-replicating episome that is shared with L. pneumophila str. Paris, and two large, horizontally-transferred genomic loci, among other polymorphisms. We also found a completely unassociated ST36 strain that displayed remarkable genetic similarity to the historical Philadelphia isolates. This similar strain implies the presence of a potential clonal population, and suggests important implications may exist for considering epidemiological context when interpreting phylogenetic relationships among outbreak-associated isolates. Additional extensive archival research identified the Philadelphia isolate associated with a non-Legionnaire case of “Broad Street pneumonia”, and provided new historical and genetic insights into the 1976 epidemic. This retrospective analysis has underscored the utility of fully-assembled WGS data for Legionella outbreak investigations, highlighting the increased resolution that comes from long-read sequencing and a sequence type-matched genomic data set. [ABSTRACT FROM AUTHOR]
- Published
- 2016
- Full Text
- View/download PDF
24. A Novel Botulinum Neurotoxin, Previously Reported as Serotype H, Has a Hybrid-Like Structure With Regions of Similarity to the Structures of Serotypes A and F and Is Neutralized With Serotype A Antitoxin.
- Author
-
Maslanka, Susan E., Lúquez, Carolina, Dykes, Janet K., Tepp, William H., Pier, Christina L., Pellett, Sabine, Raphael, Brian H., Kalb, Suzanne R., Barr, John R., Rao, Agam, and Johnson, Eric A.
- Subjects
BOTULINUM toxin ,SEROTYPES ,ANTITOXINS ,CLOSTRIDIUM botulinum ,BOTULISM ,LABORATORY mice ,NEURONS ,ANIMAL experimentation ,BIOLOGICAL assay ,MICE ,RESEARCH funding ,PHARMACODYNAMICS - Abstract
Botulism is a potentially fatal paralytic disease caused by the action of botulinum neurotoxin (BoNT) on nerve cells. There are 7 known serotypes (A-G) of BoNT and up to 40 genetic variants. Clostridium botulinum strain IBCA10-7060 was recently reported to produce BoNT serotype B (BoNT/B) and a novel BoNT, designated as BoNT/H. The BoNT gene (bont) sequence of BoNT/H was compared to known bont sequences. Genetic analysis suggested that BoNT/H has a hybrid-like structure containing regions of similarity to the structures of BoNT/A1 and BoNT/F5. This novel BoNT was serologically characterized by the mouse neutralization assay and a neuronal cell-based assay. The toxic effects of this hybrid-like BoNT were completely eliminated by existing serotype A antitoxins, including those contained in multivalent therapeutic antitoxin products that are the mainstay of human botulism treatment. [ABSTRACT FROM AUTHOR]
- Published
- 2016
- Full Text
- View/download PDF
25. Characterizing the fecal microbiota of infants with botulism.
- Author
-
Shirey, T. Brian, Dykes, Janet K., Lúquez, Carolina, Maslanka, Susan E., and Raphael, Brian H.
- Published
- 2015
- Full Text
- View/download PDF
26. Distinguishing highly-related outbreak-associated Clostridium botulinum type A(B) strains.
- Author
-
Raphael, Brian H, Shirey, Timothy B, Lúquez, Carolina, and Maslanka, Susan E
- Abstract
Background: In the United States, most Clostridium botulinum type A strains isolated during laboratory investigations of human botulism demonstrate the presence of an expressed type A botulinum neurotoxin (BoNT/ A) gene and an unexpressed BoNT/B gene. These strains are designated type A(B). The most common pulsed-field gel electrophoresis (PFGE) pattern in the C. botulinum PulseNet database is composed of A(B) strains. The purpose of this study was to evaluate the ability of genome sequencing and multi-loci variable number of tandem repeat analysis (MLVA) to differentiate such strains. Results: The genome sequences of type A(B) strains evaluated in this study are closely related and cluster together compared to other available C. botulinum Group I genomes. In silico multilocus sequence typing (MLST) analysis (7-loci) was unable to differentiate any of the type A(B) strains isolated from seven different outbreak investigations evaluated in this study. A 15-locus MLVA scheme demonstrated an improved ability to differentiate these strains, however, repeat unit variation among the strains was restricted to only two loci. Reference-free single nucleotide polymorphism (SNP) analysis demonstrated the ability to differentiate strains from all of the outbreaks examined and a non-outbreak associated strain. Conclusions: This study confirms that type A(B) strains that share the same PFGE pattern also share closely-related genome sequences. The lack of a complete type A(B) strain representative genome sequence hinders the ability to assemble genomes by reference mapping and analysis of SNPs at pre-identified sites. However, compared to other methods evaluated in this study, a reference-free SNP analysis demonstrated optimal subtyping utility for type A(B) strains using de novo assembled genome sequences. [ABSTRACT FROM AUTHOR]
- Published
- 2014
- Full Text
- View/download PDF
27. Notes from the Field: First Case in the United States of Neisseria gonorrhoeae Harboring Emerging Mosaic penA60 Allele, Conferring Reduced Susceptibility to Cefixime and Ceftriaxone.
- Author
-
Picker, Michael A., Knoblock, Ronald J., Hansen, Holly, Bautista, Ilene, Griego, Rey, Barber, Lora, Bendik, William, Lam, Kit, Adelman, Elizabeth, Qiu-Shultz, Zuwen, Raphae, Brian H., Pham, Cau D., Kersh, Ellen N., Weinstock, Hillard, St. Cyr, Sancta B., and Raphael, Brian H
- Subjects
CEFTRIAXONE ,MEDICAL personnel ,NEISSERIA ,ALLELES ,SEXUALLY transmitted diseases ,NUCLEIC acid amplification techniques ,GONORRHEA diagnosis ,GONORRHEA ,CEFOTAXIME ,DRUG resistance in microorganisms ,PHARMACODYNAMICS - Abstract
The article discusses cases of N. gonorrhoeae with the penA60 allele in the southern Nevada. Topics include that Southern Nevada Health District (SNHD) provided Centers for Disease Control & Prevention with all N. gonorrhoeae NAAT-positive specimens from all clinics; and the importance of surveillance programs like Gonococcal Isolate Surveillance Project (GISP) as effective tools for identification of antimicrobial-resistant pathogens.
- Published
- 2020
- Full Text
- View/download PDF
28. Discovery of a novel enzymatic cleavage site for botulinum neurotoxin F5
- Author
-
Kalb, Suzanne R., Baudys, Jakub, Webb, Robert P., Wright, Patrick, Smith, Theresa J., Smith, Leonard A., Fernández, Rafael, Raphael, Brian H., Maslanka, Susan E., Pirkle, James L., and Barr, John R.
- Subjects
BOTULINUM toxin ,BOTULISM ,NEURAL transmission ,DRUG development ,ACETIC acid ,FORMIC acid ,CINNAMIC acid - Abstract
Abstract: Botulinum neurotoxins (BoNTs) cause botulism by cleaving proteins necessary for nerve transmission. There are seven serotypes of BoNT, A–G, characterized by their response to antisera. Many serotypes are further distinguished into differing subtypes based on amino acid sequence, some of which result in functional differences. Our laboratory previously reported that all tested subtypes within each serotype have the same site of enzymatic activity. Recently, three new subtypes of BoNT/F; /F3, /F4, and /F5, were reported. Here, we report that BoNT/F5 cleaves substrate synaptobrevin-2 in a different location than the other BoNT/F subtypes, between
54 L and55 E. This is the first report of cleavage of synaptobrevin-2 in this location. Structured summary of protein interactions: BoNT/F5 cleaves Synaptobrevin-2 by protease assay (View interaction: 1, 2) BoNT/F1 cleaves Synaptobrevin-2 by protease assay (View interaction: 1, 2) [Copyright &y& Elsevier]- Published
- 2012
- Full Text
- View/download PDF
29. Analysis of a unique Clostridium botulinum strain from the Southern hemisphere producing a novel type E botulinum neurotoxin subtype.
- Author
-
Raphael, Brian H., Lautenschlager, Matthew, Kalb, Suzanne R., de Jong, Laura I. T., Frace, Michael, L£quez, Carolina, Barr, John R., Fern ndez, Rafael A., and Maslanka, Susan E.
- Subjects
CLOSTRIDIUM botulinum ,BOTULINUM toxin ,MASS spectrometry ,GENOMES - Abstract
Background: Clostridium botulinum strains that produce botulinum neurotoxin type E (BoNT/E) are most commonly isolated from botulism cases, marine environments, and animals in regions of high latitude in the Northern hemisphere. A strain of C. botulinum type E (CDC66177) was isolated from soil in Chubut, Argentina. Previous studies showed that the amino acid sequences of BoNT/E produced by various strains differ by < 6% and that the type E neurotoxin gene cluster inserts into the rarA operon. Results: Genetic and mass spectral analysis demonstrated that the BoNT/E produced by CDC66177 is a novel toxin subtype (E9). Toxin gene sequencing indicated that BoNT/E9 differed by nearly 11% at the amino acid level compared to BoNT/E1. Mass spectrometric analysis of BoNT/E9 revealed that its endopeptidase substrate cleavage site was identical to other BoNT/E subtypes. Further analysis of this strain demonstrated that its 16S rRNA sequence clustered with other Group II C. botulinum (producing BoNT types B, E, and F) strains. Genomic DNA isolated from strain CDC66177 hybridized with fewer probes using a Group II C. botulinum subtyping microarray compared to other type E strains examined. Whole genome shotgun sequencing of strain CDC66177 revealed that while the toxin gene cluster inserted into the rarA operon similar to other type E strains, its overall genome content shared greater similarity with a Group II C. botulinum type B strain (17B). Conclusions: These results expand our understanding of the global distribution of C. botulinum type E strains and suggest that the type E toxin gene cluster may be able to insert into C. botulinum strains with a more diverse genetic background than previously recognized. [ABSTRACT FROM AUTHOR]
- Published
- 2012
- Full Text
- View/download PDF
30. Analysis of genomic differences among Clostridium botulinum type A1 strains.
- Author
-
Ping-Ke Fang, Raphael, Brian H., Maslanka, Susan E., Shuowei Cai, and Singh, Bal Ram
- Subjects
CLOSTRIDIUM botulinum ,ANAEROBIC bacteria ,INFECTIOUS disease transmission ,CLOSTRIDIUM diseases ,FOOD poisoning - Abstract
Background: Type A1 Clostridium botulinum strains are a group of Gram-positive, spore-forming anaerobic bacteria that produce a genetically, biochemically, and biophysically indistinguishable 150 kD protein that causes botulism. The genomes of three type A1 C. botulinum strains have been sequenced and show a high degree of synteny. The purpose of this study was to characterize differences among these genomes and compare these differentiating features with two additional unsequenced strains used in previous studies. Results: Several strategies were deployed in this report. First, University of Massachusetts Dartmouth laboratory Hall strain (UMASS strain) neurotoxin gene was amplified by PCR and sequenced; its sequence was aligned with the published ATCC 3502 Sanger Institute Hall strain and Allergan Hall strain neurotoxin gene regions. Sequence alignment showed that there was a synonymous single nucleotide polymorphism (SNP) in the region encoding the heavy chain between Allergan strain and ATCC 3502 and UMASS strains. Second, comparative genomic hybridization (CGH) demonstrated that the UMASS strain and a strain expected to be derived from ATCC 3502 in the Centers for Disease Control and Prevention (CDC) laboratory (ATCC 3502*) differed in gene content compared to the ATCC 3502 genome sequence published by the Sanger Institute. Third, alignment of the three sequenced C. botulinum type A1 strain genomes revealed the presence of four comparable blocks. Strains ATCC 3502 and ATCC 19397 share the same genome organization, while the organization of the blocks in strain Hall were switched. Lastly, PCR was designed to identify UMASS and ATCC 3502* strain genome organizations. The PCR results indicated that UMASS strain belonged to Hall type and ATCC 3502* strain was identical to ATCC 3502 (Sanger Institute) type. Conclusions: Taken together, C. botulinum type A1 strains including Sanger Institute ATCC 3502, ATCC 3502*, ATCC 19397, Hall, Allergan, and UMASS strains demonstrate differences at the level of the neurotoxin gene sequence, in gene content, and in genome arrangement. [ABSTRACT FROM AUTHOR]
- Published
- 2011
- Full Text
- View/download PDF
31. Analysis of genomic differences among Clostridium botulinum type A1 strains.
- Author
-
Ping-Ke Fang, Raphael, Brian H., Maslanka, Susan E., Shuowei Cai, and Singh, Bal Ram
- Subjects
CLOSTRIDIUM botulinum ,GENOMES ,NEUROTOXIC agents ,NUCLEOTIDE sequence ,POLYMERASE chain reaction ,GENOMICS - Abstract
Background: Type A1 Clostridium botulinum strains are a group of Gram-positive, spore-forming anaerobic bacteria that produce a genetically, biochemically, and biophysically indistinguishable 150 kD protein that causes botulism. The genomes of three type A1 C. botulinum strains have been sequenced and show a high degree of synteny. The purpose of this study was to characterize differences among these genomes and compare these differentiating features with two additional unsequenced strains used in previous studies. Results: Several strategies were deployed in this report. First, University of Massachusetts Dartmouth laboratory Hall strain (UMASS strain) neurotoxin gene was amplified by PCR and sequenced; its sequence was aligned with the published ATCC 3502 Sanger Institute Hall strain and Allergan Hall strain neurotoxin gene regions. Sequence alignment showed that there was a synonymous single nucleotide polymorphism (SNP) in the region encoding the heavy chain between Allergan strain and ATCC 3502 and UMASS strains. Second, comparative genomic hybridization (CGH) demonstrated that the UMASS strain and a strain expected to be derived from ATCC 3502 in the Centers for Disease Control and Prevention (CDC) laboratory (ATCC 3502*) differed in gene content compared to the ATCC 3502 genome sequence published by the Sanger Institute. Third, alignment of the three sequenced C. botulinum type A1 strain genomes revealed the presence of four comparable blocks. Strains ATCC 3502 and ATCC 19397 share the same genome organization, while the organization of the blocks in strain Hall were switched. Lastly, PCR was designed to identify UMASS and ATCC 3502* strain genome organizations. The PCR results indicated that UMASS strain belonged to Hall type and ATCC 3502* strain was identical to ATCC 3502 (Sanger Institute) type. Conclusions: Taken together, C. botulinum type A1 strains including Sanger Institute ATCC 3502, ATCC 3502*, ATCC 19397, Hall, Allergan, and UMASS strains demonstrate differences at the level of the neurotoxin gene sequence, in gene content, and in genome arrangement. [ABSTRACT FROM AUTHOR]
- Published
- 2010
32. Ongoing Cluster of Highly Related Disseminated Gonococcal Infections -- Southwest Michigan, 2019.
- Author
-
Nettleton, William D., Kent, James B., Macomber, Kathryn, Brandt, Mary-Grace, Jones, Kelly, Ridpath, Alison D., Raphael, Brian H., and Wells, Eden V.
- Abstract
The article offers information on Ongoing Cluster of Highly Related Disseminated Gonococcal Infections. Topics include gonococcal infection is a rare, systemic complication of untreated gonorrhea that occurs after sexual transmission and through hematogenous spread of Neisseria gonorrhoeae to distant body sites; It usually manifests as arthritis, dermatitis, and tenosynovitis. In rare cases, endocarditis, meningitis, myositis, and osteomyelitis can occur.
- Published
- 2020
- Full Text
- View/download PDF
33. Reply: Evidence of Recent Genomic Evolution in Gonococcal Strains With Decreased Susceptibility to Cephalosporins or Azithromycin in the United States, 2014-2016.
- Author
-
Thomas, Jesse C, Kersh, Ellen N, Gernert, Kim M, Shafer, William M, and Raphael, Brian H
- Subjects
AZITHROMYCIN ,CEPHALOSPORINS ,BIOLOGICAL evolution ,EVIDENCE ,GONORRHEA ,NEISSERIA ,PHARMACODYNAMICS - Published
- 2020
- Full Text
- View/download PDF
34. FeoB is not required for ferrous iron uptake in Campylobacter jejuni.
- Author
-
Raphael, Brian H. and Joens, Lynn A.
- Subjects
CAMPYLOBACTER jejuni ,ESCHERICHIA coli ,MAGNESIUM ions ,IRON ,HELICOBACTER pylori ,GENES - Abstract
Copyright of Canadian Journal of Microbiology is the property of Canadian Science Publishing and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
- Published
- 2003
- Full Text
- View/download PDF
35. Cloning and Characterization of a Campylobacter jejuni Iron-Uptake Operon.
- Author
-
Galindo, Mario A., Day, William A., Raphael, Brian H., and Joens, Lynn A.
- Subjects
GENES ,MOLECULAR genetics ,EPITHELIAL cells ,ANTIGENS ,IMMUNITY ,CAMPYLOBACTER jejuni - Abstract
We report that C. jejuni modifies its outer membrane protein (OMP) repertoire when cultivated under iron-limiting conditions such as during incubation with epithelial cells. To identify genes encoding de novo expressed OMPs, a C. jejuni cosmid library was screened with antisera raised against proteins expressed in the presence of epithelial cells. A single clone was identified encoding an 80-kDa antigen. Sequence analysis of subclones identified an operon of three open reading frames (ORFs) encoding proteins that are homologous to the E. coli ferrichrome uptake system encoded by the fhu locus. Under low-iron conditions, C. jejuni expressed the 80-kDa OMP, indicating that its expression is regulated by the presence of iron. Southern blot analysis indicated that six of eleven isolates of C. jejuni harbor a fhuA homolog which, like all other DNA in this region sequenced thus far, is strikingly GC-rich (65%) compared with the C. jejuni genome (35% G+C). [ABSTRACT FROM AUTHOR]
- Published
- 2001
- Full Text
- View/download PDF
Catalog
Discovery Service for Jio Institute Digital Library
For full access to our library's resources, please sign in.