Caracterización epidemiológica de los casos humanos de ántrax en Perú, 2015 - 2019

Introducción. La epidemiología del ántrax en Perú es poco conocida. Su alto potencial epidémico y epizoótico podría amenazar la salud pública, especialmente desde sus regiones endémicas. Objetivo. Caracterizar los casos de ántrax humano en Perú del 2015 al 2019. Métodos. Se realizó un estudio transversal retrospectivo, a partir de los datos del Sistema Nacional de Vigilancia Epidemiológica e investigaciones de brotes en Perú del 2015 al 2019. Resultados. 71 casos de ántrax humano fueron registrados, 34 % (n = 24) confirmados y66 % (n = 47) probables. Los más afectados fueron varones (55 %) y el grupo etario de 30 a 59 años (45 %). Los casos estuvieron distribuidos principalmente en la costa norte del país. La forma cutánea autolimitada en miembros superiores fue la presentación clínica más frecuente. El 94 % (n = 67) de los casos tuvieron contacto con ganado vacuno infectado. Conclusión. Los casos de ántrax humano en Perú fueron en su mayoría de la forma cutánea, que se presentaron por brotes focalizados en áreas con antecedentes de trasmisión zoonótica. Este reporte pretende aportar al conocimiento epidemiológico de esta enfermedad y servir como insumo en la implementación de medidas de prevención y control.

Introduction. The epidemiology of anthrax in Peru is poorly understood. Its high epidemic and epizootic potential could threaten public health, especially in its endemic regions. Objective. To characterize cases of human anthrax in Peru from 2015 to 2019. Methods. A retrospective cross-sectional study was carried out; based on data from the National Epidemiological Surveillance System and investigations of anthrax outbreaks from 2015 to 2019 in Peru. Results. 71 cases of human anthrax were registered, 34 % (n = 24)confirmed and 66 % (n = 47) probable. The most affected were males (55 %) and the age group from 30to 59 years (45 %), distributed mainly on the north coast of the country. The self-limited cutaneous form was the most frequent clinical presentation. 94% (n = 67) of the cases had contact with infected cattle. Conclusions. The cases of human anthrax in Peru appear as focalized outbreaks in areas with a history of zoonotic transmission. This report aims to contribute to the epidemiological knowledge of this disease and serve as input in the implementation of prevention and control measures.

Sporadic human cutaneous anthrax outbreak in Shaanxi Province, China: report of two cases from 2018

ABSTRACT China's compulsory annual livestock anthrax vaccination policy has remarkably reduced but not completely eradicated human anthrax infections. Herein we describe a sporadic human cutaneous anthrax outbreak involving two cases in 2018 in Shaanxi Province, both involving herdsman who dealt with unvaccinated and potentially sick cattle. Both patients showed Bacillus anthracis-positive blister smear and blood culture. Treatment with penicillin was followed by uneventful recovery for both. The prompt performance of the prophylactic measures successfully interrupted the further transmission of this sporadic human cutaneous anthrax outbreak.

Detection of Bacillus anthracis and Bacillus anthracis-like spores in soil from state of Rio de Janeiro, Brazil

BACKGROUND Bacillus anthracis is the aetiologic agent of anthrax, a re-emerging, septicaemic, haemorrhagic and lethal disease that affects humans, domestic ruminants and wildlife. Plasmids pXO1 and pXO2 are attributes that confer pathogenicity to B. anthracis strains. This bacterium was used as biological weapon in the World Wars and in the biological attack in the United States of America at 2001. B. anthracis is classified as a Tier 1 bioterrorism agent by the Centers for Diseases Control and Prevention. Anthrax is recognised as a re-emerging disease. Several studies concerning the dynamics of B. anthracis cycle in soil revealed that nonpathogenic B. anthracis strains due to lack of pXO2 plasmid are commonly found in some types of soil. OBJECTIVES This study aimed isolation and identification of B. anthracis spores in soil samples of the state of Rio de Janeiro, Brazil. METHODS Phenotypic and genotypic approaches were used to identify isolates including MALDI-TOF/MS, motility test, susceptibility to gamma phage and penicillin, survey for pag and cap genes as surrogates of pXO1 and pXO2 plasmids, respectively, and sequencing of 16SrRNA-encoding gene. Physicochemical analysis of the soil samples were carried out to describe soil characteristics. FINDINGS We observed the presence of one B. anthracis pXO1+ and pXO2- isolated from clay loam soil; one B. anthracis-like strain pXO1+ and pXO2-isolated from loamy sand; and 10 Bacillus spp. strains sensitive to phage-gamma that need better characterisation to define which their species were recovered from loamy sand. MAIN CONCLUSIONS This work showed promising results and it was the first study to report results from an active surveillance for B. anthracis in Brazil.

Molecular confirmation of the circulating Bacillus anthracis during outbreak of anthrax in different villages of Simdega District, Jharkhand

Aims and Objectives: Molecular confirmation of the circulating Bacillus anthracis during outbreak of anthrax in different villages of Simdega district, Jharkhand, India. Materials and Methods: Blood samples with swabs from skin lesions (eschar) were collected from the suspected cases of Anthrax from October 2014 to June 2016 from Simdega district, Jharkhand. All the swabs were inoculated on polymyxin lysozyme EDTA thallous acetate media, nutrient agar media as well as 5% sheep blood agar media. Gamma-phage lysis was done. DNA extraction was done using a QIAamp DNA Mini Kit (QIAGEN, Valencia, CA, USA) and subjected to polymerase chain reaction (PCR) using anthrax-specific primers. Results: On Gram and acid fast staining, purple rods and pink-coloured anthrax spores were detected. Capsular and M'Fadyean staining was done. Gamma-phage lysed B. anthracis culture. Of 39 suspected cases, 8 were culture and PCR positive and showed gamma-phage lysis. 3 deaths were reported. Discussion and Conclusion: The conventional and real-time PCR methods are suitable for both the clinical and the epidemiological practice.

Evaluation of in vitro antimicrobial susceptibility of Bacillus anthracis strains isolated during anthrax outbreaks in Italy from 1984 to 2017

Anthrax, caused by Bacillus anthracis, is a non-contagious infectious disease that affects a wide range of animal species (primarily ruminants) including humans. Due to the often-fatal outcome in humans, quick administration of definitely effective antimicrobials is crucial either as prophylaxis or as a clinical case therapy. In this study, 110 B. anthracis strains, temporally, geographically, and genetically different, isolated during anthrax outbreaks in Italy from 1984 to 2017, were screened using a broth microdilution method to determine their susceptibility to 16 clinically relevant antimicrobial agents. The strains were isolated from various matrices (human, animal, and environmental samples) and were representative of thirty distinct genotypes previously identified by 15-loci multiple-locus variable-number of tandem repeats analysis. The antimicrobials tested were gentamicin, ceftriaxone, streptomycin, penicillin G, clindamycin, chloramphenicol, vancomycin, linezolid, cefotaxime, tetracycline, erythromycin, rifampin, amoxicillin, ciprofloxacin, doxycycline, and trimethoprim. All isolates were susceptible to most of the tested antimicrobials, with the exception of trimethoprim for which all of them showed high minimal inhibitory concentration values. An intermediate level of susceptibility was recorded for ceftriaxone and cefotaxime. Although the Centers for Disease Control and Prevention recommend the use of doxycycline, ciprofloxacin, penicillin G, and amoxicillin for treatment of human cases and for post-exposure prophylaxis to anthrax spores, this study shows a high degree of in vitro susceptibility of B. anthracis to many other antimicrobials, suggesting the possibility of an alternative choice for prophylaxis and therapy.

Construction of sigF deletion mutant of Bacillus anthracis and its effect on formation of spores / 军事医学

Objective To construct sigF deletion mutant of Bacillus anthracis and the complementary strain of sigF deletion mutant in order to analyze the effect of losing sigF on formation of spores.Methods The spectinomycinadenyltransferase gene(spc) was inserted to replace sigF of B.anthracis by homologous recombination.A plasmid which contained sigF and sigF promotor was constructed and then transferred to the mutant to get a complementary strain of sigF deletion mutant.The characters of the mutant were analyzed by measuring growth curves, the ability of carbohydrate metabolism was compared, and spore formation was observed under a microscope.Results The sigF deletion strain A16D2△sigF was constructed from A16D2,which had a similar growth rate to the wild type A16D2 in logarithmic phase, but was not significantly different from the initial strain in the ability to use carbohydrates,although unable to form spores.The strain was found to maintain the state of asymmetric division by microfluidics experiment.Conclusion It is showed by this study that sigF is the essential gene of B.anthracis for spore formation, but not essential for vegetative growth.

A single black ulcer in a child with acute lymphocytic leukemia

Abstract Ecthyma gangrenosum is an uncommon dermatological manifestation characterized by round, indurated ulcers with a central necrotic black eschar and surrounding erythema. This report describes the case of a 5-year-old girl, affected by acute lymphocytic leukemia, presenting with a black eschar on her right thigh. Such lesions should always be correctly identified to avoid potentially fatal bacteraemia. Furthermore, because of its similar clinical presentation, cutaneous anthrax must be ruled out.

Expresión y renaturalización del antígeno protector de Bacillus anthracis: un modelo para evaluar el replegado de proteínas antigénicas recombinantes a gran escala / Expression and refolding of the protective antigen of Bacillus anthracis: A model for high-throughput screening of antigenic recombinant protein refolding

Bacillus anthracis protective antigen (PA) is a well known and relevant immunogenic protein that is the basis for both anthrax vaccines and diagnostic methods. Properly folded antigenic PA is necessary for these applications. In this study a high level of PA was obtained in recombinant Escherichia coli. The protein was initially accumulated in inclusion bodies, which facilitated its efficient purification by simple washing steps; however, it could not be recognized by specific antibodies. Refolding conditions were subsequently analyzed in a high-throughput manner that enabled nearly a hundred different conditions to be tested simultaneously. The recovery of the ability of PA to be recognized by antibodies was screened by dot blot using a coefficient that provided a measure of properly refolded protein levels with a high degree of discrimination. The best refolding conditions resulted in a tenfold increase in the intensity of the dot blot compared to the control. The only refolding additive that consistently yielded good results was L-arginine. The statistical analysis identified both cooperative and negative interactions between the different refolding additives. The high-throughput approach described in this study that enabled overproduction, purification and refolding of PA in a simple and straightforward manner, can be potentially useful for the rapid screening of adequate refolding conditions for other overexpressed antigenic proteins.

El antígeno protector de Bacillus anthracis (protective antigen, PA) es una importante proteína inmunogénica, en la que se basan tanto las vacunas contra el ántrax/carbunclo como varios métodos diagnósticos. Para estas aplicaciones es esencial que el PA mantenga sus propiedades antigénicas, para lo cual debe estar correctamente plegado. En este estudio se obtuvieron altos niveles del PA en Escherichia coli recombinante. Inicialmente, la proteína se acumuló desnaturalizada en cuerpos de inclusión, lo que facilitó su eficiente purificación en simples pasos de lavado, pero no fue reconocida por anticuerpos específicos. Se analizaron las condiciones de replegado con un sistema de alto rendimiento, evaluando simultáneamente casi un centenar de condiciones diferentes. La recuperación de la capacidad del PA de ser reconocido por los anticuerpos se evaluó por dot blot utilizando un coeficiente que proporcionó una medida de los niveles de proteína correctamente plegada, con un alto grado de discriminación. Las mejores condiciones de renaturalización permitieron un aumento de diez veces en la intensidad de los dot blots con respecto del control. El único aditivo que produjo buenos resultados de forma constante fue la L-arginina. El análisis estadístico de las interacciones entre los diferentes aditivos de replegado permitió identificar tanto interacciones cooperativas como negativas. El enfoque de alto rendimiento descripto en este trabajo, que permitió la sobreproducción, purificación y plegado del PA de una manera sencilla y directa, puede ser potencialmente útil para el rápido screening de las condiciones adecuadas de replegado cuando se sobreexpresan otras proteínas antigénicas.

Bacillus anthracis como ameaça terrorista / Bacillus anthracis as terrorist threat

Após 2001, a utilização de patógenos reforçou seu emprego como arma de guerra. Este estudo descritivo tem por objetivo discutir estratégias de contingenciamento em ataque por anthrax, auxiliando no reconhecimento precoce e estabelecimento de medidas de contenção. Profissionais de saúde necessitam reconhecer a infecção, pois em atentados, o elemento-chave é médico e não militar. O anthrax por inalação é a forma de atentado mais provável com 100% de mortalidade, caso não haja tratamento imediato. É altamente resistente; tem período de incubação de um a seis dias; seus sintomas iniciais são similares à influenza; só permite diagnóstico em NB3; a vacina é aquela recomendada para ocupações de risco, de disponibilidade restrita; e requer profilaxia antibiótica longa.

As from 2001, the use of biological agents reinforced the possibility of its consolidation as warfare. This descriptive study aims to discuss the contingency strategies for anthrax attack, seeking early recognition and establishment of containment measures. Health professionals need to recognize the infection since the key-element during an attack is medical rather than military one. Anthrax inhalation is the most likely form of attack with 100% mortality rate, if no immediate treatment is provided. The virus is highly resistant; has an incubation period of one to six days; its early symptoms are similar to influenza's; diagnosis is only allowed in NB3; the vaccine is the one recommended for risk occupations, of restricted availability; and requires long antibiotic prophylaxis.

Development & validation of a quantitative anti-protective antigen IgG enzyme linked immunosorbent assay for serodiagnosis of cutaneous anthrax.

Background & objectives: Anthrax caused by Bacillus anthracis is primarily a disease of herbivorous animals, although several mammals are vulnerable to it. ELISA is the most widely accepted serodiagnostic assay for large scale surveillance of cutaneous anthrax. The aims of this study were to develop and evaluate a quantitative ELISA for determination of IgG antibodies against B. anthracis protective antigen (PA) in human cutaneous anthrax cases. Methods: Quantitative ELISA was developed using the recombinant PA for coating and standard reference serum AVR801 for quantification. A total of 116 human test and control serum samples were used in the study. The assay was evaluated for its precision, accuracy and linearity. Results: The minimum detection limit and lower limit of quantification of the assay for anti-PA IgG were 3.2 and 4 μg/ml, respectively. The serum samples collected from the anthrax infected patients were found to have anti-PA IgG concentrations of 5.2 to 166.3 μg/ml. The intra-assay precision per cent CV within an assay and within an operator ranged from 0.99 to 7.4 per cent and 1.7 to 3.9 per cent, respectively. The accuracy of the assay was high with a per cent error of 6.5 - 24.1 per cent. The described assay was found to be linear between the range of 4 to 80 ng/ml (R2=0.9982; slope=0.9186; intercept = 0.1108). Interpretation & conclusions: The results suggested that the developed assay could be a useful tool for quantification of anti-PA IgG response in human after anthrax infection or vaccination.

Antibacterial and antifungal evaluation of some chalcogen bearing ligands, their transition and nontransition metal complexes.

Eight chalcogen bearing compounds, 3-(4-fluorophenyl telluro) propylamine (1), 3-(phenyl telluro)propylammonium acetate salt (2), 3-(phenyl telluro)propylacetamide (3) and α-(phenylseleno) acetic acid (4) (1-4 are ligands), [Ph2Sn(Cl).1](NO3 ) (5), [Ph3Sn.1](BPh4 ) (6), [ZnCl2 .2] (7) and [CdCl2.2] (8) (5-8 are complexes of 1 & 2) were synthesised and screened for antibacterial activity against Gram-positive bacterial strains of Staphylococcus aureus, Bacillus anthracis and the Gramnegative bacteria Escherchia coli. They were also tested for their antifungal activity against Candida tropicalis, Trichophyton rubrum and Asperegillus niger, by using the disk diffusion technique. Inhibition zones demonstrated that compounds 1–3 showed significant activity, due to the presence of N in the form of amine group however Compound 4 bearing an acidic group, shows higher activity against bacterial strains. Compounds 5–8 (having Sn, Zn and Cd in their framework) showed still higher activities, due to increase in the lipophilicity and easier penetration of the compounds into the outer cell wall of the microorganisms, which causes death due to cell membrane rupturing. Compounds 1–8 were most effective against E. coli (bacterial strains), as the cell wall of Gram-negative strains have thin outer lipid membrane, which is made up of lipopolysaccharides. These compounds showed slightly reduced antifungal activity, because the cell wall of fungi is made up of chitin, which is difficult to cross. It could be concluded, from the obtained results that the biological activity of compounds is essentially determined by the number and nature of the organic groups and central metal ion. The presence of NH2, COOH group as well as metal ion like Sn, Zn, Cd in the compounds leads to higher activity.

Bacillus anthracis isolates analysis by multiple-locus variable-numbers of tandem repeats analysis,Liaoning,China / 中国人兽共患病学报

The epidemic characteristics and genotype of Bacillus anthracis strains in Liaoning Province ,China was analyze in this study .Six Bacillus anthracis strains from 2001 to 2011 were studied with multiple‐locus variable‐number tandem repeat analysis (MLVA) .BioNumerics4 .0 software was used to analyze the DNA fingerprint of statistics ,and cluster analysis results were obtained .Clustering analysis found that the 6 strains could be divided into two genotypes .For anthrax outbreaks ,the ge‐netic markers of multiple‐locus variable‐number tandem repeat were highly similar .It's suggested that MLVA is quite useful for investigation of strain relatedness in regions of outbreaks .

Establishment of Bacillus anthracis infection and its mechanism / 军事医学

Anthrax is a fulminating infectious disease .Bacillus anthracis, as the pathogen of anthrax , is a potential ma-terial for biological warfare agents and biological terrors .Immunoprophylaxis and specific theraphies play key roles in cop-ing with anthrax threats.Researches on the mechanism of B.anthracis infection, especially the process of infection , can fa-cilitate the development of novel drugs for anthrax prevention and therapy .Herein, by reviewing research progress , the in-fection process of B.anthracis is introduced and the potential mechanism of anthrax infection is described .Furthermore, the relationship between researches on anthrax infection mechanisms and the development of drugs for anthrax prevention and therapy is also discussed .

Germination of Bacillus anthracis spores:research advances / 军事医学

A spore is another life cycle form of Bacillus anthracis for resisting starvation.When conditions are favorable for growth, the dormant spore will germinate,go through outgrowth, and are ultimately converted back into a growing cell. As the first step back to vegetative growth, germination could be induced by nutrients and a variety of non-nutrient agents. Nutrient germinants trigger cation release and water absorption by binding to receptors in the spore′s inner membrane.Then the spore′s peptidoglycan cortex is hydrolyzed and the spore core rehydrates, which allows the resumption of spore metabo-lism and macromolecular synthesis.This paper reviews the nutrient germinant receptor and cortex lytic enzymes in the spore germination process of B.anthracis.

Genetic diversity of Korean Bacillus anthracis isolates from soil evaluated with a single nucleotide repeat analysis

Bacillus (B.) anthracis, the etiological agent of anthrax, is one of the most genetically monomorphic bacteria species in the world. Due to the very limited genetic diversity of this species, classification of isolates of this bacterium requires methods with high discriminatory power. Single nucleotide repeat (SNR) analysis is a type of variable-number tandem repeat assay that evaluates regions with very high mutation rates. To subtype a collection of 21 isolates that were obtained during a B. anthracis outbreak in Korea, we analyzed four SNR marker loci using nucleotide sequencing analysis. These isolates were obtained from soil samples and the Korean Center for Disease Control and Prevention. The SNR analysis was able to detect 13 subgenotypes, which allowed a detailed evaluation of the Korean isolates. Our study demonstrated that the SNR analysis was able to discriminate between strains with the same multiple-locus variable-number tandem repeat analysis genotypes. In summary, we obtained SNR results for four SNR marker loci of newly acquired strains from Korea. Our findings will be helpful for creating marker systems and help identify markers that could be used for future forensic studies.

Study on the single nucleotide polymorphism in capsule plasmid gene of Bacillus anthracis in the China isolates / 中华流行病学杂志

Objective To study the characteristic of single nucleotide polymorphism (SNP)in capsule plasmid gene of Bacillus anthracis isolated from China.Methods 95 Bacillus anthracis isolates from different sources were selected.23 SNP sites were amplified by PCR method,sequenced and analyzed by clustering analysis.Results 95 Bacillus anthracis isolates were divided into 5 groups by cluster analysis.The identified isolates had the same sequence features in 17 sites and different nucleotide sequence in the other 6 sites of the 23 SNP sites.17.89％ (17/95) of the isolates had homologous locus sequences compared with the reference strain Pnstuer.38.95％ (37/95) of the isolates had the homologous locus sequences compared with the reference strain Ames Ancestor.The remaining strains were different from those completed sequenced strains.3 strains missed length of about 80 bp sequence in the PS-34 loci amplified gene fragment in which the tested SNP loci were included.9 strains were amplified negative at all SNP loci and Bacillus anthracis capsule plasmid genes were missing which was confirmed by capsule plasmid gene-speeific primers.Conclusion Results through analysis showed that single nucleotide genetic stability and specificity for capsule plasmid gene of Bacillus anthracis did exist in the Chinese isolates.The 6 discriminating SNP sites could be used as indicators in genotyping the Bacillus anthracis.

Genetic populations of Bacillus anthracis isolates from Korea

Bacillus (B.) anthracis is the pathogen that causes fatal anthrax. Strain-specific detection of this bacterium using molecular approaches has enhanced our knowledge of microbial population genetics. In the present study, we employed molecular approaches including multiple-locus variable-number tandem repeat analysis (MLVA) and canonical single-nucleotide polymorphism (canSNP) analysis to perform molecular typing of B. anthracis strains isolated in Korea. According to the MLVA, 17 B. anthracis isolates were classified into A3a, A3b, and B1 clusters. The canSNP analyses subdivided the B. anthracis isolates into two of the three previously recognized major lineages (A and B). B. anthracis isolates from Korea were found to belong to four canSNP sub-groups (B.Br.001/2, A.Br.005/006, A.Br.001/002, and A.Br.Ames). The A.Br.001/002 and A.Br.Ames sub-lineages are closely related genotypes frequently found in central Asia and most isolates were. On the other hand, B. anthracis CH isolates were analyzed that belonged to the B.Br.001/002 sub-group which found in southern Africa, Europe and California (USA). B.Br.001/002 genotype is new lineage of B. anthracis in Korea that was not found before. This discovery will be helpful for the creation of marker systems and might be the result of human activity through the development of agriculture and increased international trade in Korea.

Bacillus anthracis: una mirada molecular a un patógeno célebre / Bacillus anthracis: a molecular look at a famous pathogen

Bacillus anthracis es un bacilo gram positivo del grupo Bacillus cereus, que posee un genoma extremadamente monomórfco y comparte gran similitud fsiológica y de estructura genética con B. cereus y Bacillus thuringiensis. En este artículo se describen nuevos métodos moleculares para la identifcación y tipifcación de B. anthracis, basados en repeticiones en tándem de número variable o en diferencias genéticas detectadas por secuenciación, desarrollados en los últimos años. Los aspectos moleculares de los factores de virulencia tradicionales, cápsula, antígeno protector, factor letal y factor edema se describen en profundidad, junto con factores de virulencia recientemente propuestos, como los sideróforos, petrobactina y bacilibactina, la adhesina de la capa S y la lipoproteína MntA. También se detalla la organización molecular de los megaplásmidos pXO1 y pXO2, incluyendo la isla de patogenicidad de pXO1. El esqueleto genético de estos plásmidos se ha encontrado en otras especies relacionadas, probablemente debido a eventos de transferencia lateral. Finalmente, se presentan los dos receptores celulares del antígeno protector, ANTXR1/TEM8 y ANTXR2/CMG2, esenciales en la interacción del patógeno con el hospedador. Los estudios moleculares realizados en los últimos años han permitido aumentar enormemente el conocimiento de los diferentes aspectos de este microorganismo y su relación con el hospedador, pero a la vez han abierto nuevos interrogantes sobre este notorio patógeno.

Bacillus anthracis, a gram-positive rod belonging to the Bacillus cereus group, has an extremely monomorphic genome, and presents high structural and physiological similarity with B. cereus and Bacillus thuringiensis. In this work, the new molecular methods for the identifcation and typing of B. anthracis developed in the last years, based on variable number tandem repeats or on genetic differences detected through sequencing, are described. The molecular aspects of traditional virulence factors: capsule, protective antigen, lethal factor and edema factor are described in depth, together with virulence factors recently proposed, such as the siderophores petrobactin and bacillibactin, the S-layer adhesin and the MntA lipoprotein. It is detailed the molecular organization of megaplasmids pXO1 and pXO2, including the pathogenicity island of pXO1. The genetic skeleton of these plasmids has been observed in related species, and this could be attributed to lateral gene transfer. Finally, the two anthrax toxin protective antigen receptors, ANTXR1/TEM8 and ANTXR2/CMG2, essential for the interaction of the pathogen with the host, are presented. The molecular studies performed in recent years have greatly increased knowledge in different aspects of this microorganism and its relationship with the host, but at the same time they have raised new questions about this noted pathogen.

Ántrax cutáneo: reporte de un caso / Cutaneous anthrax: a case report

Introducción: ántrax o carbunco, es una enfermedad infecciosa causada por bacterias llamadas bacillus anthracis. La infección en los humanos compromete con mayor frecuencia la piel, el tracto gastrointestinal o los pulmones. La infección en humanos ocurre por contacto directo con carne, restos o productos de animales contaminados como: cuero, pelo, lana o huesos, es un contacto generalmente ocupacional. Caso clínico: paciente masculino, de 64 años de edad, raza negra y de profesión obrero agrícola. Durante un periodo de 8 días, previos a su ingreso, presentó fiebre, sin precisar gradación, con escalofríos, decaimiento, cefalea universal pulsátil y pérdida del apetito; notó además aumento local del volumen en la región peri orbitaria derecha con secreción purulenta, acompañándose de adenopatías submaxilares dolorosas y movibles. Con estos elementos se decidió su hospitalización. Al segundo día de estar en sala apareció una lesión costrosa de alrededor de cuatro centímetros de diámetro con un color negruzco, de bordes bien definidos, con halo eritematoso que le impedía la abertura palpebral. Se concluyó que este paciente estuvo en contacto con carnes de ganado vacuno. Conclusiones: se diagnóstico al paciente ántrax cutáneo, se tuvo en cuenta los elementos clínicos epidemiológicos y de laboratorio. Al duodécimo día de tratamiento con penicilina cristalina, se desprendió de forma espontánea la costra, sin dejar secuelas. En este caso no se presentó ninguna complicación clínica. El paciente es egresado con diagnóstico confirmado por el laboratorio, de infección por el bacillus anthracis.

Introduction: anthrax or carbuncle is an infectious disease caused by Bacillus anthracis bacteria. In humans the infection most frequently affects the skin, the gastrointestinal tract or the lungs; it direct contact with parts of infected animals or by consuming their meat, in a occupational contact generally. Clinical case: a 64 years old, masculine, black race patient, agricultural worker as profession. During a period of 8 days, previous to his admission, presented fever, without specifying gradation, with shivers, declining, and pulsatile universal headache and lost of appetite; the patient also noticed local increase of the volume in the right periorbital region with purulent secretion, accompanying by painful and movable submaxilla. With these elements was decided his hospitalization. To the second day of being admitted a crustosus lesion appeared around four centimeters of diameter with a blackish color, of well-defined rims, with erythematous halo impeded him the palpebral opening. It was concluded this patient was in contact with meats of cattle. Conclusions: it was diagnosed him cutaneous anthrax; it was taking into account the epidemiologic, clinical and laboratory elements. To the twelfth day of treatment with crystalline penicillin, the crust came off in a spontaneous way, without any sequelae. In this case any clinical complication was not presented. The patient was discharged with a diagnostic confirmed by the laboratory, of infection by bacillus anthracis.

Progress of research on the proteomics of Bacillus anthracis / 军事医学科学院院刊

Proteomics, which has been widely used in life science, is an emerging discipline following genomics. It can help to explore the pathogenic mechanism and early onset marker of Bacillus anthracis, playing an important part in the prevention, diagnosis and treatment of B.anthracis. In this paper,the application of proteomics in the research of B.anthracis is reviewed.