Glucagon-like peptide 1 (GLP-1) is a hormone released from enteroendocrine L cells. Although first described as a glucoregulatory incretin hormone, GLP-1 also suppresses inflammation and promotes mucosal integrity. Here, we demonstrate that plasma GLP-1 levels are rapidly increased by lipopolysaccharide (LPS) administration in mice via a Toll-like receptor 4 (TLR4)-dependent mechanism. Experimental manipulation of gut barrier integrity after dextran sodium sulfate treatment, or via ischemia/reperfusion experiments in mice, triggered a rapid rise in circulating GLP-1. This phenomenon was detected prior to measurable changes in inflammatory status and plasma cytokine and LPS levels. In human subjects, LPS administration also induced GLP-1 secretion. Furthermore, GLP-1 levels were rapidly increased following the induction of ischemia in the human intestine. These findings expand traditional concepts of enteroendocrine L cell biology to encompass the sensing of inflammatory stimuli and compromised mucosal integrity, linking glucagon-like peptide secretion to gut inflammation.

The incidence of nontuberculous mycobacteria (NTM) pulmonary diseases in HIVnegative patients was studied prospectively from January 1, 2001 to December 31, 2003 by 32 sentinel sites distributed throughout France.In total, 262 patients who yielded NTM isolates from respiratory clinical specimens, met the bacteriological, radiological and clinical criteria established by the American Thoracic Society for NTM respiratory disease. Among the 262 NTM isolates, 234 were slow-growing mycobacteria (125 Mycobacterium avium-intracellulare complex (MAC), 66 M. xenopi, 34 M. kansasii) and 28 were rapidly growing mycobacteria (25 M. abscessus complex). In the Paris area, M. xenopi was the most frequently isolated species, followed by MAC.Most patients (.50%), except those with M. kansasii, had underlying predisposing factors such as pre-existing pulmonary disease or immune deficiency. Asthenia, weight loss, chronic cough and dyspnoea were the most common clinical symptoms. The classical radiological appearance of NTM infections was indistinguishable from that observed in patients with pulmonary tuberculosis.In summary, the incidence of nontuberculous mycobacteria pulmonary infections in HIVnegative patients was estimated at 0.74, 0.73 and 0.72 cases per 100,000 inhabitants in

Commercial chemiluminescent DNA probes (Accuprobe; Gen-Probe, San Diego, Calif.) for the identification ofMycobacterium tuberculosis (MTB) complex, M. avium complex (MAC), M. gordonae, and M. kansasii were evaluated with 134 clinical isolates. These included 36 MTB complex, 40 MAC, 27 M. gordonae, 9 M. kansasii, and 22 Mycobacterium spp. The specificity was 100% for the four probes. The sensitivity was 100o for the MTB complex and M. gordonae probes and 95.2% for the MAC probe. Five of the nine M. kansasii isolates tested were not detected with the probe.

Although plasma phospholipid transfer protein (PLTP) has been mainly studied in the context of atherosclerosis, it shares homology with proteins involved in innate immunity. Here, we produced active recombinant human PLTP (rhPLTP) in the milk of new lines of transgenic rabbits. We successfully used rhPLTP as an exogenous therapeutic protein to treat endotoxemia and sepsis. In mouse models with injections of purified lipopolysaccharides or with polymicrobial infection, we demonstrated that rhPLTP prevented bacterial growth and detoxified LPS. In further support of the antimicrobial effect of PLTP, PLTP-knocked out mice were found to be less able than wild-type mice to fight against sepsis. To our knowledge, the production of rhPLTP to counter infection and to reduce endotoxemia and its harmful consequences is reported here for the first time. This paves the way for a novel strategy to satisfy long-felt, but unmet needs to prevent and treat sepsis.

Molecular biology has made a great impact on the diagnosis of mycobacterial infection, considerably reducing the delay of reporting results to clinicians (14). AccuProbe (Gen-Probe Inc./bioMérieux) was the first molecular test developed and commercialized for the rapid identification of mycobacteria from culture-positive specimens (21). Detection of 16S rRNA by a chemiluminescent species-specific probe allowed the identification of mycobacterial isolates belonging to the Mycobacterium tuberculosis complex, the Mycobacterium avium complex (MAC/MAIS) (including species-specific probes for M. avium and Mycobacterium intracellulare), Mycobacterium kansasii (29), and Mycobacterium gordonae. However, the need for rapid identification of more mycobacterial species in parallel has resulted in the development of several in-house PCRbased assays, consisting of the amplification of several conserved genes followed by the characterization of the amplicons ensured by restriction enzyme analysis or sequencing (4-6, 9, 15-17, 22-24, 28). The 16S rRNA sequence is often considered as a gold standard for bacterial identification but has demonstrated lower variability with several examples of species difficult to separate within the genus Mycobacterium (31). The 65-kDa heat shock protein gene is highly conserved in mycobacteria, with several polymorphic regions allowing its use for identification purposes. PCR restriction pattern analysis (PRA) of an hsp65 441-bp sequence has been developed, leading to catalogues of hsp65 PRA patterns (28). The digestion product separated by agarose gel electrophoresis appears as bands whose patterns are usually species specific. In addition to the hsp65 gene, the 16S-23S rRNA internal transcribed spacer (ITS) region has been shown to be more discriminative than the 16S rRNA itself (6, 9, 10). A detailed understanding of ITS data was developed for the heterogeneous MAIS group, allowing the separation and classification of species belonging to this group as sequevars, and for other mycobacteria, including the M. tuberculosis complex (11), leading to the development of a line probe assay (INNO-LiPA-MYCOBACTERIA). This assay has been the first commercial DNA probe test able to identify the most frequently isolated mycobacterial species in parallel (18,19,27,30). After amplification of the ITS, the biotinylated amplified DNA product is hybridized with 14 specific oligonucleotide probes immobilized as parallel lines on membrane strips. These include probes for the identification of strains belonging to the M. tuberculosis complex, M. kansasii (groups I, II, and III), Mycobacterium xenopi, M. gordonae, Mycobacterium chelonae (groups I, II, and III), and MAC

The relationship between capsular polysaccharide types 5 and 8 and resistance of Staphylococcus aureus to oxacillin was studied with a collection of 406 clinical isolates from six French hospitals. Of 175 type 5 isolates, 84 (48%) were resistant to oxacillin. In contrast, only 8 of 160 type 8 isolates (5%) and 5 of 71 nontypeable isolates (7%) were resistant to oxacillin. Therefore, capsular typing of clinical isolates of S. aureus may facilitate the choice of first-line antibiotic therapy.

Over a 9-month period, 14 strains of Ralstonia pickettii were isolated from various biological samples inoculated in a blood culture medium. Molecular epidemiological investigation confirmed the relatedness of the strains. The source of the contamination proved to be the blood culture bottle caps.Ralstonia pickettii (formerly Pseudomonas picketti and Burkholderia pickettii) is a nonfermenting gram-negative bacillus of relatively low virulence that is often associated with pseudobacteremia or asymptomatic colonization of patients. Contamination of water supplies, skin disinfectants, and saline solutions used either for patient care (1,2,3,5,7,8) or for laboratory diagnosis (4, 9) have previously been incriminated. We report on a new source of contamination caused by R. pickettii in biological samples of patients hospitalized in different units of Antoine Béclère Hospital, Clamart, France.Between March and November 2000, 14 strains of R. pickettii were isolated from various biological samples (five pleural fluid, three ascitic fluid, three pus, and two biopsy samples and one blood sample) inoculated in an enrichment broth (Vital system; BioMérieux, Marcy l'Etoile, France) generally used for blood culture. All samples except the blood sample were inoculated in the microbiology laboratory in both aerobic and anaerobic bottles by removing the caps to open the bottles, a procedure chosen to protect laboratory technicians from the risk of contamination through needle-stick injuries. Growth of R. pickettii was detected in 12 anaerobic bottles and 2 aerobic bottles after 48 to 72 h of incubation in the Vital system at 37°C. All strains were identified by use of the API NE identification system (BioMérieux). Antibiotic susceptibility patterns were determined by the disk diffusion method on MuellerHinton agar (Bio-Rad, Marnes-la-Coquette, France) and were interpreted according to the standards of the Comité de l'Antibiogramme de la Société Française de Microbiologie. The clonalities of the strains were established by random amplified polymorphic DNA (RAPD) analysis, as described previously (6), with primers P3 (5Ј-AGACGTCCAC-3Ј) and P15 (5Ј-AATGGCGCAG-3Ј) (Genset, Paris, France). Briefly, DNA extraction was performed with chloroform and isopropanol after cell lysis with lysozyme and proteinase K. The extracted DNA was amplified in a Trio-Thermoblock system (Biometra). The amplification products were then analyzed by electrophoresis in a 1.5% agarose gel, stained with ethidium bromide, and detected by UV transillumination. For pulsedfield gel electrophoresis (PFGE), DNA embedded in agarose plugs was digested with the SpeI restriction enzyme (4). Separation of the DNA fragments was carried out on a 1.2% agarose gel in a CHEF-DR III system (Bio-Rad). The separated fragments were stained with ethidium bromide and visualized by UV transillumination.An epidemiological investigation was undertaken to elucidate the source of contamination, since isolation of these strains did not correlate with the medical status of any of the sam...

Forty-three percent of the tuberculosis cases reported in France are from the Ile de France region. The incidence of tuberculosis in this region is 33 cases per 100,000 inhabitants, twice the national average. A restriction fragment length polymorphism (RFLP) analysis was performed with clinical isolates of Mycobacterium tuberculosis isolated during 1995 in 10 hospitals in Paris and surrounding areas to detect tuberculosis transmission and define the factors associated with clustering in this population. The molecular markers used were the insertion sequence IS6110 and the direct repeat (DR) sequence. Social, demographic, and clinical data were collected from the patients’ medical files. Ten patients with isolates with a single copy of IS6110 were excluded from further analysis. Twenty-four patients with false-positive cultures due to laboratory contamination (based on RFLP analysis with IS6110 and examination of patient data) were also excluded. The study was then conducted with 272 strains isolated from 272 patients. Further fingerprinting was performed by using the DR element with strains with patterns by RFLP analysis with IS6110that differed by one band only and strains with identical patterns by RFLP analysis with IS6110 and with low numbers of copies of IS6110. The combined use of both markers identified unique patterns for 177 strains and clustered 95 (35.7%) strains in 26 groups, each containing isolates from 2 to 12 patients. The clustering was strongly associated with homelessness and the male sex. It was not associated with age, birth in a foreign country, human immunodeficiency virus positivity, or residence in hostels or prison. Isolates from homeless people were often included in large clusters, and homeless people could be the source of tuberculosis transmission for more than 50% of the clustered patients. These results suggest that homeless people play a key role in the spread of M. tuberculosis in the community and that poor socioeconomic conditions are the main risk factors associated with active tuberculosis transmission.