Neumonía por Bordetella bronchiseptica en paciente con antecedente de linfoma pulmonar / Bordetella bronchiseptica pneumonia in a patient with a history of pulmonary lymphoma

Resumen Bordetella bronchiseptica es un cocobacilo Gram negativo patógeno de animales que, con poca frecuencia causa infecciones en seres humanos. La mayoría de casos registrados en la literatura están asociados con pacientes que presentan algún tipo de inmunosupresión. Este reporte de caso se refiere a una paciente femenina de 67 años con antecedentes de linfoma pulmonar, que recibió quimioterapia y radioterapia 16 años atrás, fue ingresada al Servicio de Medicina Interna del Hospital Tomás Casas Casajús con un diagnóstico de neumonía bacteriana, tras descartarse infección por Covid19. Unos días después, se aisló una B. brochiseptica de una muestra de esputo y con el reporte de la prueba sensibilidad a los antibióticos, se modificó la terapia de antibióticos que originalmente se había indicado, lo que se conlleva a una mejoría en el estado físico de la paciente. Sin embargo, debido a una aparente infección nosocomial la paciente se contagió de SARS- CO2 y falleció debido a las complicaciones causadas por el Covid19.

Abstract Bordetella bronchiseptica is an animal pathogenic Gram negative coccobacillus that infrequently causes human infections. Most of the cases recorded in the literature are associated with patients with some type of immunosuppression. In this case, a 67-year- old female patient with a history of pulmonary lymphoma, who received chemotherapy and radiotherapy 16 years ago, is admitted to the Internal Medicine Service of the Tomás Casas Casajús Hospital, with a diagnosis of bacterial pneumonia, after ruling out Covid19 infection. A few days later, a B. brochiseptica is isolated from a sputum sample and with the report of the antibiotic sensitivity test, the antibiotic therapy that had originally been indicated is modified, which is reflected in an improvement in the physical state of the patient. However, due to an apparent nosocomial infection, the patient becomes infected with SARS-CO2 and dies due to complications caused by Covid19.

Pneumonia caused by Bordetella bronchiseptica in two HIV-positive patients / Pneumonia causada por Bordetella bronchiseptica em dois pacientes HIV-positivos

ABSTRACT: CONTEXT AND OBJECTIVE: Bordetella bronchiseptica (BB) is a Gram-negative coccobacillus responsible for respiratory diseases in dogs, cats and rabbits. Reports on its development in humans are rare. However, in immunosuppressed patients, especially in those with the immunodeficiency virus (HIV), BB can cause severe pulmonary infections. We report on two cases of pneumonia caused by BB in HIV-positive male patients in a university hospital. CASE REPORT: The first case comprised a 43-year-old patient who was admitted presenting chronic leg pain and coughing, with suspected pneumonia. BB was isolated from sputum culture and was successfully treated with trimethoprim/sulfamethoxazole in association with levofloxacin. The second case comprised a 49-year-old patient who was admitted presenting fever, nausea, sweating and a dry cough, also with suspected pneumonia. BB was isolated from sputum culture, tracheal secretions and bronchoalveolar lavage. The disease was treated with ciprofloxacin but the patient died. CONCLUSION: BB should be included in the etiology of pneumonia in immunodeficient HIV patients. As far as we know, these two were the first cases of pneumonia due to BB to occur in this university hospital.

RESUMO CONTEXTO E OBJETIVO: Bordetella bronchiseptica (BB) é um cocobacilo Gram-negativo responsável por causar doenças no trato respiratório de cães, gatos e coelhos. São raros os relatos do desenvolvimento desse microrganismo em seres humanos. Porém, em pacientes imunodeprimidos, especialmente nos portadores do vírus da imunodeficiência humana (HIV), a BB pode causar infecções pulmonares graves. Nós relatamos dois casos de pneumonia por BB em pacientes do sexo masculino, HIV-positivos em um hospital universitário. RELATO DE CASO: No primeiro caso, o paciente de 43 anos foi internado apresentando dor crônica nos membros inferiores e tosse com suspeita de pneumonia. Na cultura de escarro, foi isolado BB, e a infecção foi tratada com sucesso com a associação de sulfametoxazol/trimetroprima e levofloxacino. No segundo caso, o paciente de 49 anos foi internado apresentando febre, náuseas, sudorese e tosse seca, também com suspeita de pneumonia. Das culturas de escarro, secreção traqueal e lavado bronco-alveolar, foi isolado BB, infecção tratada com ciprofloxacino: porém, o paciente foi a óbito. CONCLUSÃO: BB deve ser incluído na etiologia de pneumonia em pacientes imunocomprometidos com HIV. Pelo que é de nosso conhecimento, estes dois relatos foram os primeiros casos de pneumonia por BB que ocorreram neste hospital universitário.

Persistent Bordetella petrii Infection Related to Bone Fractures

No abstract available.

Bacteriemia recurrente por Bordetella bronchiseptica en un paciente con trasplante de medula ósea / Bordetella bronchiseptica recurrent bacteraemia in a patient with bone marrow transplantation

Se reporta un caso de bacteriemia recurrente por Bordetella bronchiseptica en un paciente inmunocomprometido con antecedentes de trasplante alogénico de medula ósea por síndrome mielodisplásico, quien ingresó al hospital por síndrome febril. Bordetella bronchiseptica es un agente patógeno veterinario poco común en humanos que afecta principalmente a pacientes inmunocomprometidos y es causa poco frecuente de bacteriemia.

We report a case of recurrent bacteraemia caused by Bordetella bronchiseptica in an immunocompromised patient with a history of allogenic bone marrow transplantation for myelodysplastic syndrome, who was admitted to hospital with febrile syndrome. Bordetella bronchiseptica is an uncommon human pathogen which mainly affects immunocompromised patients, being a rare cause of bacteraemia.

Clinical, laboratorial and radiographic predictors of Bordetella pertussis infection / Preditores clínicos, laboratoriais e radiográficos para infecção por Bordetella pertussis

OBJECTIVE: To identify clinical, laboratorial and radiographic predictors for Bordetella pertussis infection. METHODS: This was a retrospective study, which analyzed medical records of all patients submitted to a molecular dignosis (qPCR) for B. pertussis from September 2011 to January 2013. Clinical and laboratorial data were reviewed, including information about age, sex, signs/symptoms, length of hospitalization, blood cell counts, imaging findings, coinfection with other respiratory pathogens and clinical outcome. RESULTS: 222 cases were revised. Of these, 72.5% had proven pertussis, and 60.9% were under 1 year old. In patients aging up to six months, independent predictors for B. pertussis infection were (OR 8.0, CI 95% 1.8-36.3; p=0.007) and lymphocyte count >104/µL (OR 10.0, CI 95% 1.8-54.5; p=0.008). No independent predictors of B. pertussis infection could be determined for patients older than six months. Co-infection was found in 21.4% of patients, of which 72.7% were up to six months of age. Adenovirus was the most common agent (40.9%). In these patients, we were not able to identify any clinical features to detect patients presenting with a respiratory co-infection, even though longer hospital stay was observed in patients with co-infections (12 vs. 6 days; p=0.009). CONCLUSIONS: Cyanosis and lymphocytosis are independent predictors for pertussis in children up to 6 months old...

OBJETIVO: Identificar preditores clínicos, laboratoriais e radiológicos da infecção por Bordetella pertussis. MÉTODOS: Trabalho retrospectivo, com análise de prontuários clínicos de todos os indivíduos submetidos ao diagnóstico molecular (qPCR) para B. pertussis de setembro de 2011 à janeiro de 2013. Foram revistos dados clínicos e laboratoriais, incluindo informações sobre idade, sexo, sinais/sintomas, tempo de hospitalização, contagens de células sanguíneas, exames de imagem, co-infecção com outros patógenos respiratórios, e evolução clínica. RESULTADOS: 222 casos foram revistos, do quais 72,5% tinham coqueluche confirmada, sendo 60,9% menores de um ano de idade. Foram observados preditores independentes para B. pertussis em pacientes com menos de seis meses de idade. Nesses casos, os preditores identificados foram cianose (OR 8,0; CI 95% 1,8-36,3; p=0,007) e contagem de linfócitos >104/µL (OR 10,0, CI 95% 1,8-54,5; p=0,008). Preditores de coqueluche não puderam ser determinados para crianças maiores de 6 meses de idade. Coinfecção foi encontrada em 21,4% dos pacientes, dos quais 72,7% tinham até seis meses de idade, sendo que o adenovírus foi o agente mais comum (40,9%). Nesses indivíduos, não foram observadas características clíncias capazes de distinguir pacientes com co-infecção, porém foi verificado um maior tempo de internação hospitalar nos pacientes com mais de um agente infeccioso detectado (12 vs. 6 dias; p=0,009). CONCLUSÕES: Cianose e linfocitose são preditores independentes para coqueluche em crianças com até seis meses de idade...

Rapid and sensitive detection of Bordetella bronchiseptica by loop-mediated isothermal amplification (LAMP)

Bordetella bronchiseptica causes acute and chronic respiratory infections in diverse animal species and occasionally in humans. In this study, we described the establishment of a simple, sensitive and cost-efficient loop-mediated isothermal amplification (LAMP) assay for the detection of B. bronchiseptica. A set of primers towards a 235 bp region within the flagellum gene of B. bronchiseptica was designed with online software.. The specificity of the LAMP assay was examined by using 6 porcine pathogens and 100 nasal swabs collected from healthy pigs and suspect infected pigs. The results indicated that positive reactions were confirmed for all B. bronchiseptica and no cross-reactivity was observed from other non-B. bronchiseptica. In sensitivity evaluations, the technique successfully detected a serial dilutions of extracted B. bronchiseptica DNA with a detection limit of 9 copies, which was 10 times more sensitive than that of PCR. Compared with conventional PCR, the higher sensitivity of LAMP method and no need for the complex instrumentation make this LAMP assay a promising alternative for the diagnosis of B. bronchiseptica in rural areas and developing countries where there lacks of complex laboratory services.

Endocarditis por Bordetella holmesii en un paciente asplénico / [Bordetella holmesii endocarditis in an asplenic patient].

The case of a 52-year-old female patient with a history of critical aortic stenosis, hypothyroidism and splenectomy as treatment for her Hodgkin’s lymphoma is herein presented. In April 2011, the patient was admitted to the cardiology service due to global heart failure, fever and poor response to diuretic and vasodilator therapy. A transesophageal echocardiogram showed images compatible with vegetations in the aortic, pulmonary, and mitral valves. A diagnosis of infective endocarditis was made. Growth of gram-negative coccobacilli was observed in two blood culture sets. The microorganism was finally identified as Bordetella holmesii. The patient was treated with ceftriaxone 1 g every 12 hours for 28 days with favorable outcome.

Desarrollo y validación de una PCR múltiple para el diagnóstico de Bordetella spp / Development and validation of a multiplex PCR for diagnosis of Bordetella spp / Desenvolvimento e validação de uma PCR múltipla para o diagnóstico de Bordetella spp

El objetivo del trabajo consistió en diseñar y validar una PCR en formato convencional que permita confirmar la presencia o ausencia de Bordetella pertussis y detectar otras especies del género, como Bordetella parapertussis y Bordetella bronchiseptica, que pudieran estar involucradas en el cuadro clínico de coqueluche. A tal fin se diseñó una reacción en cadena de la polimerasa (PCR) múltiple que amplifica una secuencia del promotor del gen de Toxina Pertussis y otra del gen de la Toxina Adenilato Ciclasa-Hemolisina. Se validó la metodología siguiendo esquemas publicados anteriormente. Se optimizaron las condiciones de la PCR. Se validó la metodología obteniéndose un límite de detección para ambas secuencias de 0,5 bacterias por reacción. Se validó, además, la especificidad y robustez de la técnica. Se presenta una nueva herramienta diagnóstica optimizada y validada, que permite detectar la presencia de las especies de Bordetella más frecuentemente involucradas en el cuadro clínico de coqueluche. Su uso combinado con alguna de las PCR habituales en diagnóstico, como la PCR IS481, permite aumentar la sensibilidad del diagnóstico de esta en­fermedad, la especificidad del mismo discriminando los resultados falsos positivos/negativos y aumentar el conocimiento sobre los agentes etiológicos implicados en esta patología.

The aim of the present work was to design and validate a conventional PCR that enables to confirm the presence or absence of Bordetella pertussis and to detect other Bordetella species, such as Bordetella parapertussis metoand B. bronchiseptica, that may be involved in this pathology. To this aim, a multiplex PCR that amplifies a sequence of the promoter of the Pertussis Toxin gene and a sequence of the Adenylate Cyclase Toxin-Hemolysin gene were designed. The PCR was validated following previously published schemes. PCR conditions were optimized. The methodology was validated obtaining a detection limit of 0.5 bacteria per reaction, for both sequences. Specificity and robustness of the technique were also validated. A new optimized and validated tool to detect the presence of the Bordetella species most frequently responsible of pertussis was presented. The combined use with some of the usual PCR, such as IS 481, may increase the sensitivity of the diagnosis of this disease, its specificity discriminating false positive/negative results and increase awareness of the etiologic agents involved in this pathology.

O objetivo do trabalho foi desenhar e validar uma reação em cadeia da polimerase (PCR) em formato convencional que permita confirmar a presença ou ausência de Bordetella pertussis e detectar outras espécies do gênero, como Bordetella parapertussis e Bordetella bronchiseptica, que pudessem estar envolvidas no quadro clínico de coqueluche. Para tal, foi desenhada uma PCR múltipla que amplifica uma sequência do promotor do gene de Toxina Pertussis e outra do gene da Toxina Adenilato Ciclase-Hemolisina. A metodologia foi validada seguindo esquemas publicados anteriormente. Foram otimizadas as condições da PCR. Validou-se a metodologia obtendo-se um limite de detecção para ambas as sequências de 0,5 bactérias por reação. Validou-se também a especificidade e robustez da técnica. Apresenta-se uma nova ferramenta diagnóstica otimizada e validada, que permite detectar a presença das espécies de Bordetella mais frequentemente envolvidas no quadro clínico de coqueluche. Seu uso combinado com alguma das PCR habituais em diagnóstico, como a PCR IS481, permite aumentar a sensibilidade do diagnóstico desta doença, a especificidade do mesmo discriminando os resultados falsos positivos/negativos e aumentar o conhecimento sobre os agentes etiológicos envolvidos nesta patologia.

Infección por Bordetella pertussis / Bordetella pertussis infection

Se describen los aspectos fisiopatológicos, clínicos y epidemiológicos de la coqueluche, infección respiratoria aguda producida por Bordetella pertussis, altamente contagiosa. Se hace mención a los diferentes esquemas de vacunación desde la introducciónde la vacuna, hace más de 40 años, hasta nuestros días, y los brotes ocurridos en la Argentina en diversos períodos. Asimismo, se destaca el recrudecimiento de la enfermedad observado en varios países en los últimos años, en especial en preescolares y más aun en adolescentes y adultos jóvenes.

Relapsing Peritonitis Caused by Bordetella bronchiseptica in Continuous Ambulatory Peritoneal Dialysis Patient: A Case Report

Bordetella (B) bronchiseptica is a common veterinary pathogen, but has rarely been implicated in human infections. Most patients with B. bronchiseptica infections are compromised clinically such as in patients with a malignancy, AIDS, malnutrition, or chronic renal failure. We experienced a case of relapsing peritonitis caused by B. bronchiseptica associated with continuous ambulatory peritoneal dialysis (CAPD). A 56-yr-old male, treated with CAPD due to end stage renal disease (ESRD), was admitted with complaints of abdominal pain and a turbid peritoneal dialysate. The culture of peritoneal dialysate identified B. bronchiseptica. The patient was treated with a combination of intraperitoneal antibiotics. There were two further episodes of relapsing peritonitis, although the organism was sensitive to the used antibiotics. Finally, the indwelling CAPD catheter was removed and the patient was started on hemodialysis. This is the first report of a B. bronchiseptica human infection in the Korean literature.

Pertussis An update for general practice

Although there has been a global decline in the incidence of pertussis in the past four decades; the incidence has increased in developed countries; particularly in preteens; adolescents and adults. These groups provide a major reservoir of the disease for vulnerable unimmunised or incompletely immunised infants. This trend has not yet been documented in South Africa. In young infants; the diagnosis is made on the basis of clinical features. Older age groups do not usually show the typical clinical picture; leading to misdiagnosis and underreporting. The culture of Bordetella pertussis from the posterior nasopharynx remains the gold standard for diagnosis but laboratory diagnosis is complex and unavailable in most settings. Erythromycin; instituted early in the course of illness; remains the treatment of choice although there is now good evidence for the use of other macrolides; particularly in the neonate. Immunisation of young infants remains the best preventative methodagainst the disease. Due to the re-emergence of the disease in older age groups; developed countries are recommending booster vaccines in adolescents

Infecciones respiratorias bajas mixtas por Bordetella Pertussis y virus. Análisis de dos casos clínicos / Concomitant low respiratory infections caused by Bordetella pertussis and virus. Report of two cases

Las infecciones respiratorias bajas en lactantes pueden tener múltiples etiologías, y su investigación plantea dificultades técnicas y económicas. Pueden ser producidas por un único germen, o ser infecciones mixtas, producidas por más de un agente infeccioso en forma concomitante o sucesiva. La infección por Bordetella pertussis ha vuelto a ocupar el interés en las publicaciones científicas. Se destaca su importancia en las infecciones respiratorias en niños pequeños no completamente inmunizados y en adolescentes o adultos con tos persistente. En el presente artículo se presentan dos casos clínicos de infecciones respiratorias mixtas en las que Bordetella pertussis fue la bacteria responsable, asociada a adenovirus en un caso, y a virus respiratorio sincicial en el otro. Ambos se presentaron como infecciones respiratorias graves que requirieron ingreso a unidades de cuidados intensivos y tratamiento con asistencia ventilatoria mecánica. La identificación etiológica de la Bordetella pertussis permite adoptar las medidas adecuadas de tratamiento, aislamiento y profilaxis en los contactos.

Canine distemper virus infection with secondary Bordetella bronchiseptica pneumonia in dogs

Canine distemper virus infection and secondary Bordetella bronchiseptica pneumonia are described in mongrel dogs. Canine distemper was characterised by nonsuppurative demyelinating encephalitis with typical inclusion bodies in astrocytes. B. bronchiseptica was isolated from areas of purulent bronchopneumonia.

Biología molecular de Bordetella pertussis / Molecular biology of Bordetella pertussis

Bordetella pertusis produce una infección localizada del tracto respiratorio; en los tejidos humanos y en los modelos animales de laboratorio tiene una predilección por el epitelio ciliado. Hay un cierto número de antígenos y toxinas los cuales pueden ser importantes en la patogénesis: aglutinógenos, hemaglutinina filmentosa, factor promotor de la linfocitosis (FPL), adenilatociclasa, toxina termolabil, lipopolisacárido y la citotoxina traqueal. La B. pertussis puede producir también una reacción febril causada por la endotoxina, la atenuación de la respuesta inflamatoria del huésped posiblemente por efecto de la adenilatociclasa, la linfocitosis, leucocitosis, los efectos sobre la homeostasis de la glucosa y la neurotoxicidad producidos por el FPL; sin embargo, no existe un modelo razonable para estudiar la inmunidad local de la tosferina. Los avances recientes en el laboratorio, podrían tener una repercusión sobre la producción de la vacuna y su empleo clínico