We investigated here the potential role of Toll-like receptors (TLR) and the adaptor protein MyD88 in innate immunity responses to Cryptococcus neoformans, a pathogenic encapsulated yeast. Peritoneal macrophages from MyD88 -/-or TLR2 -/-mice released significantly less TNF-a, compared with wild-type controls, after in vitro stimulation with whole yeasts. In contrast, no differences in TNF-a release were noted between macrophages from C3H/HeJ mice, which have a loss of function mutation in TLR4, relative to C3H/HeN controls. When MyD88-or TLR2-deficient mice were infected with low doses of the H99 serotype A strain, all of the control animals, but none of MyD88 -/-and only 38% of the TLR2 -/-animals survived, in association with higher fungal burden in the mutant mice. Both MyD88 -/-and TLR2 -/-animals showed decreased TNF-a, IL12p40 and/or IFN-c expression in various organs during infection. No difference in susceptibility to experimental cryptococcosis was found between C3H/HeJ mice and C3H/HeN controls. In conclusion, our data indicate that TLR2 and MyD88, but not TLR4, critically contribute to anti-cryptococcal defenses through the induction of increased TNF-a, IL-12 and IFN-c expression.

The aims of this study were to evaluate the frequency of Achromobacter xylosoxidans infection in a cohort of cystic fibrosis patients, to investigate antimicrobial sensitivity, to establish possible clonal likeness among strains, and to address the clinical impact of this infection or colonization on the general outcome of these patients. The study was undertaken between January 2004 and December 2008 on 300 patients receiving care at the Regional Cystic Fibrosis Center of the Naples University “Federico II”. Sputum samples were checked for bacterial identification. For DNA fingerprinting, pulsed-field gel electrophoresis (PFGE) was carried out. Fifty-three patients (17.6%) had at least one positive culture for A. xylosoxidans; of these, 6/53 (11.3%) patients were defined as chronically infected and all were co-colonized by Pseudomonas aeruginosa. Of the patients, 18.8% persistently carried multidrug-resistant isolates. Macrorestriction analysis showed the presence of seven major clusters. DNA fingerprinting also showed a genetic relationship among strains isolated from the same patients at different times. The results of DNA fingerprinting indicate evidence of bacterial clonal likeness among the enrolled infected patients. We found no significant differences in the forced expiratory volume in 1 s (FEV1) and body mass index (BMI) when comparing the case group of A. xylosoxidans chronically infected patients with the control group of P. aeruginosa chronically infected patients.

Although photodynamic therapy (PDT), a therapeutic approach that involves a photosensitizer, light and O2, has been principally considered for the treatment of specific types of cancers, other applications exist, including the treatment of infections. Unfortunately, PDT does not always guarantee full success since it exerts lethal effects only in cells that have taken up a sufficient amount of photosensitizer and have been exposed to adequate light doses, conditions that are not always achieved. Based on our previous experience on the combination PDT/chemotherapy, we have explored the possibility of fighting bacteria that commonly crowd infected surfaces by combining PDT with an antibiotic, which normally does not harm the strain at low concentrations. To this purpose, we employed 5-aminolevulinic acid (5-ALA), a pro-drug that, once absorbed by proliferating bacteria, is converted into the natural photosensitizer Protoporphyrin IX (PpIX), followed by Gentamicin. Photoactivation generates reactive oxygen species (ROS) which damage or kill the cell, while Gentamicin, even at low doses, ends the work. Our experiments, in combination, have been highly successful against biofilms produced by several Gram positive bacteria (i.e., Staphylococcus aureus, Staphylococcus epidermidis, etc.). This original approach points to potentially new and wide applications in the therapy of infections of superficial wounds and sores.

Three epidemiologically independent Pseudomonas aeruginosa isolates, representative of the first VIM-1 metallo-␤-lactamase producers detected at three different hospitals in northern Italy, were investigated to determine their genomic relatedness and to compare the structures of the genetic supports for the VIM-1 determinants. The three isolates, all of serotype O11, appeared to be clonally related according to the results of genotyping by macrorestriction analysis of genomic DNA by pulsed-field gel electrophoresis and random amplification of polymorphic DNA. Investigation of the genetic support for the bla VIM-1 determinant revealed that it was carried on identical or almost identical integrons (named In70.2 and In70.3) located within a conserved genomic context. The integrons were structurally related to In70 and In110, two plasmid-borne bla VIM-1 -containing integrons from Achromobacter xylosoxidans and Pseudomonas putida isolates, respectively, from the same geographic area (northern Italy) and were found to be inserted close to the res site of a Tn5051-like transposon, different from any of those described previously, that was apparently carried on the bacterial chromosome. The present findings suggest that the three VIM-1-producing isolates are members of the same clonal complex which have been spreading in hospitals in northern Italy since the late 1990s and point to a common ancestry of their bla VIM-1 -containing integrons.

The existence of a symbiotic relationship between Trichomonas vaginalis and Mycoplasma hominis, which is the first reported example of symbiosis between two obligate human pathogens, has been recently reported by our research group. In this work, we examined the cellular location of M. hominis in respect to T. vaginalis. By using gentamicin protection assays, double immunofluorescence, and confocal microscopy, we obtained strong evidence that M. hominis is located within protozoan cells. 5-Bromodeoxyuridine incorporation assays showed that intracellularly located mycoplasmas actively synthesize DNA. Our results demonstrate that M. hominis has the capability of entering trichomonad cells and of replicating inside the protozoon. These findings suggest that symbiosis might provide the bacteria, during human infection, with the capability to resist to environmental stresses, such as host defense mechanisms and pharmacological therapies.Trichomonas vaginalis is a parasitic protozoon responsible for trichomoniasis, one of the most common sexually transmitted diseases in humans, estimated to affect at least 200 million people worldwide (37). Studies carried out with large groups of women suffering from vaginitis showed that T. vaginalis is clinically associated with Mycoplasma hominis (18, 35), a bacterium that, like the protozoon, resides exclusively in the human genital tract. The association is strictly species specific, since is not observed with Ureaplasma urealyticum, another Mollicutes species that is a much more common inhabitant of the human genital tract. The clinical association between the two pathogens has been recently explained by the demonstration of a symbiotic relationship between T. vaginalis and M. hominis (27). More than 90% of T. vaginalis clinical isolates from our collection proved to be infected by M. hominis independent of their geographic origin. Our recent work has allowed us to shed light on some aspects of the phenomenon (28).The presence of endosymbionts in free-living protozoa is frequently described, but it has been never reported in obligate parasitic protozoa. The first example of symbiosis involving a human pathogen was described for Legionella pneumophila, a bacterial pathogen that is responsible for Legionnaire's disease, and Acanthamoeba sp., a free-living opportunistic amoeba (30). The relationship between T. vaginalis and M. hominis is the only one described so far involving two obligate human pathogens. T. vaginalis is responsible for severe vaginitis accompanied by abdominal pain, itching, and foul-smelling discharge (29) and is mainly asymptomatic in men (20). Moreover, trichomoniasis is associated with an enhanced risk of neoplastic transformation in cervical tissues (38) and increased human immunodeficiency virus seroconversion in women (22,31). The mechanisms by which T. vaginalis exerts its pathogenic effects involve adhesion to host cells (1, 2, 19) and the activity of pH-dependent pore-forming proteins (14, 15) and of cytoskeleton-disrupting proteases (16). M. hominis c...