High Prevalence of Spirochetosis in Cholera Patients, Bangladesh

Nelson, Eric J.; Tanudra, Angela; Chowdhury, A. K. M. Alauddin; Kane, Anne; Qadri, Firdausi; Calderwood, Stephen B.; Coburn, Jenifer; Camilli, Andrew

doi:10.3201/eid1504.081214

Cited by 9 publications

(7 citation statements)

References 16 publications

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“…In contrast to the relative decreases of anaerobes (eg, Prevotella , Bacteroides , Blautia , and Ruminococcus organisms), metronidazole was associated with an increase in taxa associated with active cholera and/or the early phase of recovery from cholera (ie, Enterobacteriaceae; Supplementary Table 2). Ciprofloxacin was associated with a marginal increase in the relative abundance of Brachyspira organisms (Supplementary Table 2); species of this genus have been characterized as pathogens of both humans and livestock [32, 33].…”

Section: Resultsmentioning

confidence: 99%

Identification of Widespread Antibiotic Exposure in Patients With Cholera Correlates With Clinically Relevant Microbiota Changes

Alexandrova

Haque

Rodríguez

et al. 2019

The Journal of Infectious Diseases

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Background A first step to combating antimicrobial resistance in enteric pathogens is to establish an objective assessment of antibiotic exposure. Our goal was to develop and evaluate a liquid chromatography–ion trap mass spectrometry (LC/MS) method to determine antibiotic exposure in patients with cholera. Methods A priority list for targeted LC/MS was generated from medication-vendor surveys in Bangladesh. A study of patients with and those without cholera was conducted to collect and analyze paired urine and stool samples. Results Among 845 patients, 11% (90) were Vibrio cholerae positive; among these 90 patients, analysis of stool specimens revealed ≥1 antibiotic in 86% and ≥2 antibiotics in 52%. Among 44 patients with cholera and paired urine and stool specimens, ≥1 antibiotic was detected in 98% and ≥2 antibiotics were detected in 84%, despite 55% self-reporting medication use. Compared with LC/MS, a low-cost antimicrobial detection bioassay lacked a sufficient negative predictive value (10%; 95% confidence interval, 6%–16%). Detection of guideline-recommended antibiotics in stool specimens did (for azithromycin; P = .040) and did not (for ciprofloxacin) correlate with V. cholerae suppression. A nonrecommended antibiotic (metronidazole) was associated with decreases in anaerobes (ie, Prevotella organisms; P < .001). Conclusion These findings suggest that there may be no true negative control group when attempting to account for antibiotic exposure in settings like those in this study.

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Section: Resultsmentioning

confidence: 99%

Identification of Widespread Antibiotic Exposure in Patients With Cholera Correlates With Clinically Relevant Microbiota Changes

Alexandrova

Haque

Rodríguez

et al. 2019

The Journal of Infectious Diseases

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“…pilosicoli are particularly common in intensively housed pigs and chickens, in which they cause depressed rates of growth and production. Colonization also commonly occurs in human beings living in crowded and unhygienic conditions in developing countries [4-7], as well as amongst homosexual males [8]. Individuals colonized with B .…”

Section: Introductionmentioning

confidence: 99%

The pathogenic intestinal spirochaete Brachyspira pilosicoli forms a diverse recombinant species demonstrating some local clustering of related strains and potential for zoonotic spread

Neo

Phillips

et al. 2013

Gut Pathog

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BackgroundBrachyspira pilosicoli is an anaerobic spirochaete that can colonizes the large intestine of many host species. Infection is particularly problematic in pigs and adult poultry, causing colitis and diarrhea, but it is also known to result in clinical problems in human beings. Despite the economic importance of the spirochaete as an animal pathogen, and its potential as a zoonotic agent, it has not received extensive study.MethodsA multilocus sequence typing (MLST) method based on the scheme used for other Brachyspira species was applied to 131 B. pilosicoli isolates originating from different host species and geographical areas. A variety of phylogenetic trees were constructed and analyzed to help understand the data.ResultsThe isolates were highly diverse, with 127 sequence types and 123 amino acid types being identified. Large numbers (50-112) of alleles were present at each locus, with all loci being highly polymorphic. The results of Shimodaira-Hasegawa tests identified extensive genetic recombination, although the calculated standardized index of association value (0.1568; P <0.0005) suggested the existence of some clonality. Strains from different host species and geographical origins generally were widely distributed throughout the population, although in nine of the ten cases where small clusters of related isolates occurred these were from the same geographical areas or farms/communities, and from the same species of origin. An exception to the latter was a cluster of Australian isolates originating from pigs, chickens and a human being, suggesting the likelihood of relatively recent transmission of members of this clonal group between species.ConclusionsThe strongly recombinant population structure of B. pilosicoli contrasts to the more highly clonal population structures of the related species Brachyspira hyodysenteriae and Brachyspira intermedia, both of which are specialized enteric pathogens of pigs and poultry. The genomic plasticity of B. pilosicoli may help to explain why it has been able to adapt to colonize the large intestines of a wider range of hosts compared to other Brachyspira species. The identification of a clonal group of isolates that had been recovered from different host species, including a human being, suggests that zoonotic transmission by B. pilosicoli may occur in nature. Evidence for local transmission between the same host species also was obtained.

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“…By using appropriate anaerobic culture conditions and/or polymerase chain reaction amplification, these fastidious spirochaetes can be identified in samples from many humans living in crowded or unhygienic conditions in developing countries [ 3 , 4 ]. Recently, the pathogenic potential of B. pilosicoli has been emphasised by its identification in the stools of more than one third of cholera patients in Bangladesh, at densities equal to those of Vibrio cholerae [ 5 ]. Further work is now underway to determine how this spirochaete attaches to colonic enterocytes and induces disease in humans and animals.…”

Section: Introductionmentioning

confidence: 99%

Spirochaetes as intestinal pathogens: Lessons from a Brachyspira genome

Hampson

Ahmed

2009

Gut Pathog

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Anaerobic spirochaetes of the genus Brachyspira have long been known as important gut pathogens of pigs, but increasingly they are recognised as causing disease in birds and other animal species, including human beings. The genome sequence of the major swine pathogen Brachyspira hyodysenteriae was recently published, and this revealed extensive genome optimisation that leads to adaptation to the complex environment of the colon. The genome sequences of other pathogenic and non-pathogenic Brachyspira species are becoming available, and this data will help to reveal how these species have evolved and adapted to varied lifestyles in the large intestines of different species, and why some but not others can induce colitis and diarrhoea.

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High Prevalence of Spirochetosis in Cholera Patients, Bangladesh

Cited by 9 publications

References 16 publications

Identification of Widespread Antibiotic Exposure in Patients With Cholera Correlates With Clinically Relevant Microbiota Changes

Identification of Widespread Antibiotic Exposure in Patients With Cholera Correlates With Clinically Relevant Microbiota Changes

The pathogenic intestinal spirochaete Brachyspira pilosicoli forms a diverse recombinant species demonstrating some local clustering of related strains and potential for zoonotic spread

Spirochaetes as intestinal pathogens: Lessons from a Brachyspira genome

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