Persistent
            <i>Legionella</i>
            Infection in a Patient after Bone Marrow Transplantation

Schindel, Christine; Siepmann, U.; Han, S.-R.; Ullmann, Andrew J.; Mayer, E.; Fischer, Thomas J.; Maeurer, Markus

doi:10.1128/jcm.38.11.4294-4295.2000

Cited by 30 publications

(13 citation statements)

References 7 publications

(5 reference statements)

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“…The clinical relevance of microbial persistence has been demonstrated for Burkholderia pseudomallei (125), Escherichia coli (126), Pseudomonas aeruginosa (127), Candida albicans (128), Streptococcus pneumoniae (129), Staphylococcus aureus (126,130), Mycobacterium tuberculosis (131,132), Legionella spp. (133,134), and Salmonella enterica (135). The persistent cells have transient tolerance for antimicrobial agents, and their ability to revert to a sensitive state, in which cells rapidly divide, makes them important in chronic infections (136).…”

Section: Discussionmentioning

confidence: 99%

Generality of Post-Antimicrobial Treatment Persistence of Borrelia burgdorferi Strains N40 and B31 in Genetically Susceptible and Resistant Mouse Strains

2019

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A basic feature of infection caused by Borrelia burgdorferi, the etiological agent of Lyme borreliosis, is that persistent infection is the rule in its many hosts. The ability to persist and evade host immune clearance poses a challenge to effective antimicrobial treatment. A link between therapy failure and the presence of persister cells has started to emerge. There is growing experimental evidence that viable but noncultivable spirochetes persist following treatment with several different antimicrobial agents. The current study utilized the mouse model to evaluate if persistence occurs following antimicrobial treatment in disease-susceptible (C3H/HeJ [C3H]) and disease-resistant (C57BL/6 [B6]) mouse strains infected with B. burgdorferi strains N40 and B31 and to confirm the generality of this phenomenon, as well as to assess the persisters’ clinical relevance. The status of infection was evaluated at 12 and 18 months after treatment. The results demonstrated that persistent spirochetes remain viable for up to 18 months following treatment, as well as being noncultivable. The phenomenon of persistence in disease-susceptible C3H mice is equally evident in disease-resistant B6 mice and not unique to any particular B. burgdorferi strain. The results also demonstrate that, following antimicrobial treatment, both strains of B. burgdorferi, N40 and B31, lose one or more plasmids. The study demonstrated that noncultivable spirochetes can persist in a host following antimicrobial treatment for a long time but did not demonstrate their clinical relevance in a mouse model of chronic infection. The clinical relevance of persistent spirochetes beyond 18 months following antimicrobial treatment requires further studies in other animal models.

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Section: Discussionmentioning

confidence: 99%

Generality of Post-Antimicrobial Treatment Persistence of Borrelia burgdorferi Strains N40 and B31 in Genetically Susceptible and Resistant Mouse Strains

2019

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“…Clinical relevance of microbial persistence has been demonstrated for Burkholderia pseudomallei (100), Escherichia coli (101), Pseudomonas aeruginosa (102), Candida albicans (103), Streptococcus pneumonia (104), Staphylococcus aureus (101, 105), Mycobacterium tuberculosis (106, 107), Legionella spp. (108, 109), and Salmonella enterica (110). The persistent cells have transient tolerance to antimicrobial agents and their ability to revert back to a sensitive state, in which cells rapidly divide make them important in chronic infections.…”

Section: Discussionmentioning

confidence: 99%

The generality of post-antimicrobial treatment persistence of replicatively-attenuatedBorrelia burgdorferiin a mouse model

Hodzic

Escobar

2019

Preprint

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24A basic feature of infection caused by Borrelia burgdorferi, the etiological agent 25 of Lyme borreliosis, is that persistent infection is the rule, not the norm, in its many hosts. 26 The ability to persist and evade host immune clearance poses a challenge to effective 27 antimicrobial treatment. A link between therapy failure and the presence of persister cells 28 has started to emerge. There is growing experimental evidence that viable, but non-29 cultivable spirochetes persist following treatment with several different antimicrobial 30 agents, then resurge after 12 months. The current study utilized the mouse model to 31 evaluate if persistence and resurgence occur following antimicrobial treatment in a 32 disease-susceptible (C3H/HeN) and disease-resistant (C57BL/6) mouse strain infected 33 with B. burgdorferi strains N40 and B31, to confirm the generality of these phenomena. 34 The status of infection was evaluated at 12 and 18-months after treatment. The results 35 demonstrated that persistent spirochetes remain viable for up to 18 months following 36 treatment, but divide slowly, thereby being tolerant to the effects of antimicrobial agents, 37 as well as being non-cultivable. The phenomenon of persistence and resurgence in 38 disease-susceptible C3H mice is equally evident in disease-resistant B6 mice, and not 39 unique to any particular B. burgdorferi strain. The results also demonstrate that following 40 antimicrobial treatment, both strains of B. burgdorferi, N40 and B31, lose one or more 41 small plasmids, resulting in attenuation. The biological relevance of attenuated B. 42 burgdorferi spirochetes is probably inconsequential. The study demonstrated that non-43 cultivable spirochetes can persist in a host following antimicrobial treatment for a long 44 time but did not demonstrate their clinical relevance in a mouse model of chronic 45 infection.

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“…A summary of published cases of cavitary L. pneumophila lung infection is provided in Table 1 4–36 . Cavitation has been associated with L. pneumophila serotypes 1, 3, 4, 5, 6 and 8 as well as other Legionella species: L. micdadei , L. bozemanii , L. dumoffii and L. longbeachae 37,38 .…”

Section: Discussionmentioning

confidence: 99%