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Most papers on kidney stones arising from infection concentrate on the mineral struvite. In this contribution, we would like to call attention to other mineral phases such as highly carbonated calcium phosphate apatite, ammonium urate, and whitlockite, by presenting clinical and chemical data. We start with epidemiological data which emphasize the increase in the prevalence of kidney stones related to infection. Then we present a statistical analysis of more than 85,000 stones which have been analysed at the Laboratoire des Lithiases of Assistance Publique-Hôpitaux de Paris which gives insights regarding the link between urinary tract infection and struvite, carbonated calcium phosphate apatite (carbapatite), and also surprisingly whitlockite. Some information regarding the pathogenesis of kidney stones linked to infection, the nature of the bacteria which have been identified, and the approach to precisely analyse infrared spectra to identify struvite, carbapatite, and whitlockite, conclude this first part. To complete this clinical description, we describe the crystallographic structure and the chemistry of three relevant compounds namely carbonated calcium phosphate, struvite, and whitlockite. To conclude this second part, the dependence of crystallite morphology of struvite on pH and on the presence, or absence, of bacteria, is described. Based on clinical and chemical data, it is becoming clear that struvite is not the only mineral intimately related to renal infectious processes, but that whitlockite and carbapatite with a high carbonation rate are strongly associated with urinary tract infection as well.

Research has been conducted on the agent of cholera Vibrio cholerae. The identification of the nhaA gene in V. cholerae O1 wild-type epidemic strain has been carried out.

Research has been conducted on Vibrio cholerae. The efect of NhaA, NhaB, and NhaD Na (super)+ /H (super)+ antiporters in V. cholerae survival in saline environment has been in vestigated, and the results are reported.

To the Editor: In tong-term care facilities, most endemic infections affect respiratory and urinary tracts, as well as skin and soft tissues (1-3). Infection and colonization by antimicrobial-resistant organisms, in [...]

Uropathogenic E scherichia coli ( UPEC) colonizing kidneys is the main cause of acute pyelonephritis. TLR5 that senses flagellin was shown to be highly expressed in the bladder and to participate in host defence against flagellated UPEC, although its role in kidneys still remains elusive. Here we show that TLR5 is expressed in renal medullary collecting duct ( MCD) cells, which represent a preferential site of UPEC adhesion. Flagellin, like lipopolysaccharide, stimulated the production of the chemoattractant chemokines CXCL1 and CXCL2, and subsequent migration capacity of neutrophils in cultured wild-type ( WT) and Tlr4−/− MCDs, but not in Tlr5−/− MCDs. UPEC can translocate across intact MCD layers without altering tight junctions. Strikingly, the invasion capacity and transcellular translocation of the UPEC strain HT7 were significantly lower in Tlr5−/− than in WT MCDs. The non-motile HT7Δ fliC mutant lacking flagellin also exhibited much lower translocation capacities than the HT7 isolates. Finally, Tlr5−/− kidneys exhibited less infiltrating neutrophils than WT kidneys one day after the transurethral inoculation of HT7, and greater delayed renal bacterial loads in the day 4 post-infected Tlr5−/− kidneys. Overall, these findings indicate that the epithelial TLR5 participates to renal antibacterial defence, but paradoxically favours the translocation of UPEC across intact MCD cell layers. [ABSTRACT FROM AUTHOR]

Vibrio cholerae, the causative agent of cholera, is a normal inhabitant of aquatic environments, where it survives in a wide range of conditions of pH and salinity. In this work, we investigated the role of three Na[sup +]/H[sup +] antiporters on the survival of V. cholerae in a saline environment. We have previously cloned the Vc-nhaA gene encoding the V. cholerae homolog of Escherichia coli. Here we identified two additional antiporter genes, designated Vc-nhaB and Vc-nhaD, encoding two putative proteins of 530 and 477 residues, respectively, highly homologous to the respective antiporters of Vibrio species and E. coli. We showed that both Vc-NhaA and Vc-NhaB confer Na[sup +] resistance and that Vc-NhaA displays an antiport activity in E. coli, which is similar in magnitude, kinetic parameters, and pH regulation to that of E. coli NhaA. To determine the roles of the Na[sup +]/H[sup +] antiporters in V. cholerae, we constructed nhaA, nhaB, and nhaD mutants (single, double, and triple mutants). In contrast to E. coli, the inactivation of the three putative antiporter genes (Vc-nhaABD) in V. cholerae did not alter the bacterial exponential growth in the presence of high Na[sup +] concentrations and had only a slight effect in the stationary phase. In contrast, a pronounced and similar Li[sup +]-sensitive phenotype was found with all mutants lacking Vc-nhaA during the exponential phase of growth and also with the triple mutant in the stationary phase of growth. By using 2-n-nonyl-4-hydroxyquinoline N-oxide, a specific inhibitor of the electron-transport-linked Na[sup +] pump NADH-quinone oxidoreductase (NQR), we determined that in the absence of NQR activity, the Vc-NhaA Na[sup +]/H[sup +] antiporter activity becomes essential for the resistance of V. cholerae to Na[sup +] at alkaline pH. Since the ion pump NQR is Na[sup +] specific, we suggest that its activity masks the Na[sup +]/H[sup +] but not the Li[sup +]/H[sup +] antiporter activities. Our results... [ABSTRACT FROM AUTHOR]

Identifies the nhaA gene from a wild-type epidemic strain of Vibrio cholerae. Survival of V. cholerae in various environmental conditions; Influence of hydrogen-ion concentration and salinity on growth of V. cholerae; Characterization of nhaA as a sodium and hydrogen antiporter; Involvement of gene in survival and persistence of free-living bacteria.

Objectives: Escherichia coli producing CTX-M-type extended-spectrum beta-lactamases (ESBLs) are spreading worldwide. The aim of this work was to investigate the addiction systems carried by the replicons involved in the emergence and spread of ESBLs in relation to ESBL and replicon types., Methods: A collection of 125 TEM, SHV and CTX-M ESBL-producing E. coli isolates and their 125 transconjugants or transformants was analysed. Five plasmid protein antitoxin-regulated systems and three plasmid antisense RNA-regulated systems were sought by PCR., Results: Two hundred and ninety-eight plasmid addiction systems were detected in the parental strains (mean 2.38, range 0-6 per strain) and 86 were detected in the recipient strains (mean 0.69, range 0-5 per strain). PemKI, CcdAB, Hok-Sok and VagCD were the most frequently represented systems in both recipient and parental strains. The parental SHV and CTX-M ESBL-producing strains had more addiction systems than the TEM ESBL producers. In the recipient strains, the frequency of addiction systems was significantly higher in IncF plasmids. Among the IncF replicons carrying CTX-M-type enzymes, the frequency of addiction systems was significantly higher in IncF plasmids carrying CTX-M-15 (mean 3.5) or CTX-M-9 (mean 4) than in those carrying CTX-M-14 (mean 0.6)., Conclusions: In E. coli producing CTX-M-15 or CTX-M-9 ESBLs, plasmids bearing the bla(CTX-M) gene have multiple addiction systems that could contribute to their maintenance in host strains.

Syphilis has been a public health problem for centuries. Syphilis and HIV form a dangerous combination: syphilis significantly increases the risk of contracting HIV infection, and HIV can alter the natural course of syphilis. Despite a better understanding of the interaction between these two diseases, many controversies persist. The incidence of syphilis has increased among HIV-infected patients both in Europe and in the USA, and especially in the homosexual/bisexual transmission group. We discuss the interaction between HIV/AIDS and syphilis in a review of the most recent literature, focusing particularly on the diagnosis, treatment, and follow-up of HIV-infected patients with syphilis. Early diagnosis of syphilis in HIV-infected patients requires awareness among both patients and clinicians. Early treatment of syphilis is crucial as it reduces the risk of transmission.

Objectives: To investigate the correlation between in vitro activity and in vivo efficacy of broad-spectrum beta-lactams for treating experimental infections due to Escherichia coli expressing two types of plasmid-mediated AmpC-type beta-lactamases, LAT-1 and FOX-1., Methods: Susceptibility testing and time-kill curves were determined for piperacillin/tazobactam, ceftazidime, cefepime and imipenem. A mouse model of peritonitis was developed to determine 50% effective doses (ED(50)s) of beta-lactams against E. coli clinical strains producing recombinant plasmids pLAT-1 and pFOX-1., Results: MIC and MBC values correlated with the ED(50)s for ceftazidime, cefepime and imipenem. Among the beta-lactams tested, both cefepime and imipenem were effective for treating peritonitis caused by E. coli strains harbouring pLAT-1 or pFOX-1, whereas ceftazidime was effective only against E. coli (pLAT-1). Piperacillin/tazobactam was not effective for treating infections with either of these two strains., Conclusions: Piperacillin/tazobactam was not efficacious for treating infections due to E. coli producing plasmid-mediated AmpC-type beta-lactamases, whereas cefepime and imipenem were efficacious.

Sixty-two isolates of Enterobacteriaceae (35 Escherichia coli and 27 Klebsiella pneumoniae isolates) producing CTX-M-type beta-lactamases were collected between March 2000 and June 2003 in different wards of Charles Nicolle Hospital in Tunis (Tunisia). Sequencing identified the bla(CTX-M-15) determinant in 55 isolates and bla(CTX-M-16) in 7 isolates. The CTX-M-15-producing strains were isolated in several wards and consisted mainly of two successive clonal groups of E. coli and a major clonal group of K. pneumoniae. The second clonal group of E. coli belonged to phylogenetic group B2 and harbored more virulence factors than the first clonal group. Among the 22 transconjugants or electroporants obtained with selected E. coli and K. pneumoniae CTX-M-15-producing strains, a predominant plasmid restriction pattern was obtained with 17 isolates. The four CTX-M-16-producing strains of E. coli yielded the same pulsed-field gel electrophoresis (PFGE) pattern, while the three CTX-M-16-producing strains of K. pneumoniae yielded two different PFGE patterns. All of the CTX-M-16-producing isolates were recovered in the pediatric ward and had the same plasmid restriction pattern.

From whole-cell DNA of an enterobacterial Erwinia persicina reference strain that displayed a penicillinase-related antibiotic-resistant phenotype, a beta-lactamase gene was cloned and expressed in Escherichia coli. It encoded a clavulanic-acid-inhibited Ambler class A beta-lactamase, ERP-1, with a pI value of 8.1 and a relative molecular mass of ca. 28 kDa. ERP-1 shared 45 to 50% amino acid identity with the most closely related enzymes, the chromosomally encoded enzymes from Citrobacter koseri, Kluyvera ascorbata, Kluyvera cryocrescens, Klebsiella oxytoca, Proteus vulgaris, Proteus penneri, Rahnella aquatilis, Serratia fonticola, Yersinia enterocolitica, and the plasmid-mediated enzymes CTX-M-8 and CTX-M-9. The substrate profile of the noninducible ERP-1 was similar to that of these beta-lactamases. ERP-1 is the first extended-spectrum beta-lactamase from an enterobacterial species that is plant associated and plant pathogenic.