Case report: two human Streptococcus suis infections in Borneo, Sabah, Malaysia

Rajahram, Giri Shan; Hameed, Ahneez Abdul; Menon, Jayaram; William, Timothy; Tambyah, Paul Anantharajah; Yeo, Tsin Wen

doi:10.1186/s12879-017-2294-z

Cited by 18 publications

(21 citation statements)

References 11 publications

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“…Of note, a total of 240 human cases with 53 deaths were recorded in China during two large outbreaks of S. suis 2 infection, which occurred in 1998 and 2005 [16,17]. In recent years, sporadic human cases of S. suis infection have been frequently reported worldwide [18][19][20][21][22], indicating that S. suis is a persistent threat to public health.…”

Section: Introductionmentioning

confidence: 99%

PmtA functions as a ferrous iron and cobalt efflux pump in Streptococcus suis

Zheng

Jia

Gao

et al. 2019

Emerging Microbes & Infections

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Transition metals are nutrients essential for life. However, an excess of metals can be toxic to cells, and host-imposed metal toxicity is an important mechanism for controlling bacterial infection. Accordingly, bacteria have evolved metal efflux systems to maintain metal homeostasis. Here, we established that PmtA functions as a ferrous iron [Fe(II)] and cobalt [Co(II)] efflux pump in Streptococcus suis, an emerging zoonotic pathogen responsible for severe infections in both humans and pigs. pmtA expression is induced by Fe(II), Co(II), and nickel [Ni(II)], whereas PmtA protects S. suis against Fe(II) and ferric iron [Fe(III)]-induced bactericidal effect, as well as Co(II) and zinc [Zn(II)]-induced bacteriostatic effect. In the presence of elevated concentrations of Fe(II) and Co(II), ΔpmtA accumulates high levels of intracellular iron and cobalt, respectively. ΔpmtA is also more sensitive to streptonigrin, a Fe(II)-activated antibiotic. Furthermore, growth defects of ΔpmtA under Fe(II) or Co(II) excess conditions can be alleviated by manganese [Mn(II)] supplementation. Finally, PmtA plays a role in tolerance to H 2 O 2-induced oxidative stress, yet is not involved in the virulence of S. suis in mice. Together, these data demonstrate that S. suis PmtA acts as a Fe(II) and Co(II) efflux pump, and contributes to oxidative stress resistance.

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Section: Introductionmentioning

confidence: 99%

PmtA functions as a ferrous iron and cobalt efflux pump in Streptococcus suis

Zheng

Jia

Gao

et al. 2019

Emerging Microbes & Infections

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“…Sabah state, positioned on the northern tip of Borneo, reports the highest incidence of the sylvatic malaria parasite Plasmodium knowlesi , with transmission risk linked to deforestation (16, 17). The emergence of other zoonotic pathogens has also been documented in Sabah (18, 19), including Zika virus in 2015 (20). Given the marked environmental change occurring in Sabah, and the increase in dengue cases noted in recent years (12, 14), it is essential from a public health perspective to understand current transmission patterns and their drivers.…”

Section: Introductionmentioning

confidence: 99%

Spatial and epidemiologic features of dengue in Sabah, Malaysia

Murphy

Rajahram

Jilip

et al. 2019

Preprint

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3435 In South East Asia, dengue epidemics have increased in size and geographical distribution in 36 recent years. Most studies investigating dengue transmission and control have had an urban 37 focus, while less consideration is currently given to rural settings, or where urban and rural 38 areas overlap. We examined the spatiotemporal distribution and epidemiological 39 characteristics of reported dengue cases in the predominantly rural state of Sabah, in 40 Malaysian Borneo -an area where sylvatic and urban circulation of pathogens are known to 41 intersect. We found that annual dengue incidence rates were spatially variable over the 7-42 year study period from 2010-2016 (state-wide mean annual incidence of 21 cases/100,000 43 people; range 5-42/100,000), but were highest in rural localities in the western districts of 44 the state (Kuala Penyu, Nabawan, Tenom and Kota Marudu). The eastern districts exhibited 45 lower overall dengue rates; however, we noted a concentration of severe (haemorrhagic) 46 dengue cases (44%) in Sandakan and Tawau districts. Dengue incidence was slightly higher 47 for males than females, and was significantly higher for both genders aged between 10 and 48 29 years (24/100,000; p=0.029). The largest ever recorded outbreaks occurred during 2015-49 2016, with the vector Aedes albopictus found to be most prevalent in both urban and rural 50 households (House Index of 64%), compared with Ae. Aegypti (15%). These findings suggest 51 that dengue outbreaks in Sabah are driven by the sporadic expansion of dengue virus in both 52 urban and rural settings. This may require tailoring of preventative strategies to suit 53 different transmission ecologies across Sabah. Further studies to better understand the 54 drivers of dengue in Sabah may aid dengue control efforts in Malaysia, and more broadly in 55 South East Asia.3 56 Author summary 57 58 In order to combat the rising regional incidence of dengue in South East Asia, the drivers of 59 transmission must be better characterised across different environmental settings. We 60 conducted the first retrospective analysis of dengue epidemiology in the predominantly rural 61 state of Sabah, Malaysia, where both urban and sylvatic transmission cycles exist. Human 62 notification data over a 7-year period were reviewed and spatiotemporal and demographic 63 risk factors identified. We found: 64 1. Urban habitats and population density are not the only determinants mediating the 65 spread of epidemic dengue in Sabah. Case from both urban and rural localities 66 contributed equally to dengue outbreaks. 67 2. Human demographic risk factors included being aged between 10 and 29 years, and 68 being male. 69 3. High incidence areas for dengue do not predict the occurrence of severe dengue. Severe 70 dengue was largely localised to lower incidence districts in the east of the state. 71 4. The sole presence of Aedes albopictus in and around the majority of urban and rural 72 case households suggests that this vector may play a major role in facilitating outbr...

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“…The cases included: meningitis (13 persons), septic disease comprising septic shock, septicemia and septic arthritis (10), endocarditis (1), and peritonitis (1). The occupational origin of the disease was reported in 19 cases from the United Kingdom [80], Germany [66,81], USA [82][83][84], Australia [27], Canada [67], Korea [85], Japan [56,86], Chile [87], Poland [88], Sweden [89], Greece [90], Italy [91], and Malaysia [92], whereas in the remaining 6 cases, from Croatia [93], Argentina [94], Italy [95], Vietnam [96] and Korea [97], no association could be found between the occupation and disease. The patients who contracted S. suis infection at work included: pig farmers (11 persons), truck drivers transporting pigs (2), butchers (2), pet-food processor (1), worker of the restaurant serving raw meat (1), hunter (1), and cattle farmer (1).…”

Section: Relevance To Occupationmentioning

confidence: 99%

Streptococcus suis: a re-emerging pathogen associated with occupational exposure to pigs or pork products. Part I – Epidemiology

Dutkiewicz

Sroka²,

Zając³

et al. 2017

Ann Agric Environ Med.

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Streptococcus suis (ex Elliot 1966, Kilpper-Bälz & Schleifer 1987) is a facultatively anaerobic Gram-positive ovoid or coccal bacterium surrounded by a polysaccharide capsule. Based on the antigenic diversity of the capsule, S. suis strains are classified serologically into 35 serotypes. Streptococcus suis is a commensal of pigs, commonly colonizing their tonsils and nasal cavities, mostly in weaning piglets between 4-10 weeks of age. This species occurs also in cattle and other mammals, in birds and in humans. Some strains, mostly those belonging to serotype 2, are also pathogenic for pigs, as well as for other animals and humans. Meningitis is the primary disease syndrome caused by S. suis, both in pigs and in humans. It is estimated that meningitis accounted for 68.0% of all cases of human disease reported until the end of 2012, followed by septicaemia (including life-threatening condition described as 'streptococcal toxic shock-like syndrome' - STSLS), arthritis, endocarditis, and endophthalmitis. Hearing loss and/or ves tibular dysfunction are the most common sequelae after recovery from meningitis caused by S. suis, occurring in more than 50% of patients. In the last two decades, the number of reported human cases due to S. suis has dramatically increased, mostly due to epidemics recorded in China in 1998 and 2005, and the fulminant increase in morbidity in the countries of south-eastern Asia, mostly Vietnam and Thailand. Out of 1,642 cases of S. suis infections identified between 2002-2013 worldwide in humans, 90.2% occurred in Asia, 8.5% in Europe and 1.3% in other parts of the globe. The human disease has mostly a zoonotic and occupational origin and occurs in pig breeders, abattoir workers, butchers and workers of meat processing facilities, veterinarians and meat inspectors. Bacteria are transmitted to workers by close contact with pigs or pig products, usually through contamination of minor cuts or abrasions on skin of hands and/or arms, or by pig bite. A different epidemiologic situation occurs in the Southeast Asian countries where most people become infected by habitual consumption of raw or undercooked pork, blood and offal products in the form of traditional dishes. Prevention of S. suis infections in pigs includes vaccination, improvement in pig-raising conditions, disinfection and/or fumigation of animal houses, and isolation of sick animals at the outbreak of disease. Prevention of human infections comprises: protection of skin from pig bite or injury with sharp tools by people occupationally exposed to pigs and pig products, prompt disinfection and dressing of wounds and abrasions at work, protection of the respiratory tract by wearing appropriate masks or repirators, consulting a doctor in the case of febrile illness after exposure to pigs or pork meat, avoidance of occupations associated with exposure to pigs and pork by immunocompomised people, avoidance of consumption of raw pork or pig blood, adequate cooking of pork, and health edu...

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Case report: two human Streptococcus suis infections in Borneo, Sabah, Malaysia

Cited by 18 publications

References 11 publications

PmtA functions as a ferrous iron and cobalt efflux pump in Streptococcus suis

PmtA functions as a ferrous iron and cobalt efflux pump in Streptococcus suis

Spatial and epidemiologic features of dengue in Sabah, Malaysia

Streptococcus suis: a re-emerging pathogen associated with occupational exposure to pigs or pork products. Part I – Epidemiology

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