Role of Proteus mirabilis flagella in biofilm formation / Papel de los flagelos de Proteus mirabilis en la formación de biofilms

Abstract Proteus mirabilis (P. mirabilis) is a common etiological agent of urinary tract infec-tions, particularly those associated with catheterization. P. mirabilis efficiently forms biofilms on different surfaces and shows a multicellular behavior called 'swarming', mediated by flagella. To date, the role of flagella in P. mirabilis biofilm formation has been under debate. In this study, we assessed the role of P. mirabilis flagella in biofilm formation using an isogenic allelic replacement mutant unable to express flagellin. Different approaches were used, such as the evaluation of cell surface hydrophobicity, bacterial motility and migration across catheter sections, measurements of biofilm biomass and biofilm dynamics by immunofluorescence and confocal microscopy in static and flow models. Our findings indicate that P. mirabilis flagella play a role in biofilm formation, although their lack does not completely avoid biofilm genera-tion. Our data suggest that impairment of flagellar function can contribute to biofilm prevention in the context of strategies focused on particular bacterial targets.

Resumen Proteus mirabilis (P mirabilis) es un agente etiológico común de infecciones del tracto urinario, en particular de aquellas asociadas con cateterización. P. mirabilis forma biofilms eficientemente en diferentes superficies y muestra un comportamiento multicelular llamado swarming, mediado por flagelos. Hasta el momento, el papel de los flagelos en la formación de biofilms de P. mirabilis ha estado en discusión. En este estudio, se evaluó el papel de los flagelos de P. mirabilis en la formación de biofilms, utilizando una mutante isogénica generada por reemplazo alélico, incapaz de expresar flagelina. Se utilizaron diferentes enfoques, como la evaluación de la hidrofobicidad de la superficie celular, de la movilidad y la migración bacteriana sobre secciones de catéteres y medidas de biomasa y de la dinámica del biofilm mediante inmunofluorescencia y microscopia confocal, tanto en modelos estáticos como de flujo. Nuestros hallazgos indican que los flagelos de P. mirabilis desempeñan un papel en la formación de biofilms, aunque su falta no suprime por completo su generación. Asimismo, evidencian que la interferencia de la función flagelar puede contribuir a evitar la formación de biofilms en el contexto de estrategias centradas en blancos bacterianos particulares.

A Core Genome Multilocus Sequence Typing Scheme for Proteus mirabilis / 生物医学与环境科学（英文）

OBJECTIVE@#A core genome multilocus sequence typing (cgMLST) scheme to genotype and identify potential risk clonal groups (CGs) in Proteus mirabilis.@*METHODS@#In this work, we propose a publicly available cgMLST scheme for P. mirabilis using chewBBACA. In total 72 complete P. mirabilis genomes, representing the diversity of this species, were used to set up a cgMLST scheme targeting 1,842 genes, 635 unfinished (contig, chromosome, and scaffold) genomes were used for its validation.@*RESULTS@#We identified a total of 205 CGs from 695 P. mirabilis strains with regional distribution characteristics. Of these, 159 unique CGs were distributed in 16 countries. CG20 and CG3 carried large numbers of shared and unique antibiotic resistance genes. Nine virulence genes ( papC, papD, papE, papF, papG, papH, papI, papJ, and papK) related to the P fimbrial operon that cause severe urinary tract infections were only found in CG20. These CGs require attention due to potential risks.@*CONCLUSION@#This research innovatively performs high-resolution molecular typing of P. mirabilis using whole-genome sequencing technology combined with a bioinformatics pipeline (chewBBACA). We found that the CGs of P. mirabilis showed regional distribution differences. We expect that our research will contribute to the establishment of cgMLST for P. mirabilis.

Construction and biological characterization of a Proteus mirabilis strain with modABC gene deletion / 南方医科大学学报

OBJECTIVE@#To construct a modABC gene knockout strain of Proteus mirabilis and explore the effect of modABC gene deletion on biological characteristics of Proteus mirabilis.@*METHODS@#Fusion PCR was used to obtain the fusion gene of modABC and the kanamycin-resistant gene Kn, which was ligated with the suicide vector pCVD442 and transduced into Proteus mirabilis. The modABC gene knockout strain of Proteus mirabilis was obtained after homologous recombination with the suicide vector. PCR and Sanger sequencing were used to identify genomic deletion of modABC gene in the genetically modified strain. The concentration of molybdate in the wild-type and gene knockout strains was determined using inductively coupled plasma mass spectrometry (ICP-MS), and their survival ability in LB medium was compared under both aerobic and anaerobic conditions.@*RESULTS@#PCR and sanger sequencing confirmed genomic deletion of modABC gene in the obtained Proteus mirabilis strain. The concentration of intracellular molybdenum in the modABC gene knockout strain was 1.22 mg/kg, significantly lower than that in the wild-type strain (1.46 mg/kg, P < 0.001). Under the aerobic condition, the modABC gene knockout strain grown in LB medium showed no significant changes in survival ability compared with the wild-type strain, but its proliferation rate decreased significantly under the anaerobic condition and also when cultured in nitrate-containing LB medium under anaerobic condition.@*CONCLUSION@#Homologous recombination with the suicide vector can be used for modABC gene knockout in Proteus mirabilis. modABC gene participates in molybdate uptake and is associated with anaerobic growth of Proteus mirabilis in the presence of nitrate.

Progress in Diagnosis and Treatment of Proteus Syndrome / 罕见病研究

Proteus syndrome is a rare congenital hamartomatous syndrome characterized by the asymmetric and disproportionate overgrowth of limbs, emergence of connective tissue nevi, epidermal nevi, ysregulated adipose tissue, and vascular malformations. The Proteus syndrome is caused by mosaicism of somatic activating mutation in the AKT1 gene which locates at chromosome 14q32.3. This syndrome is extremely rare, making it difficult to diagnose. The most commonly used diagnostic criteria are too complicated to be used in clinical practice. Surgery can partially alleviate the clinical symptoms of overgrowth, but it can't inhibit the progression of the disease. This article summarizes the diagnostic criteria, treatment principles, and perioperative managements for Proteus syndrome in the world. The article proposes the highly suspected morphological manifestations of Proteus syndrome was based on clinical experiences of the author.The article emphasizes using genetic detection of pathological tissue as the gold standard for diagnosis, and suggests targeted therapy as the optimal treatment for Proteus syndrome.

Serum Procalcitonin Guide in a Case of Proteus mirabilis Prosthetic Joint Infection

@#Infection is a dreaded complication in patients who have underwent arthroplasty and often very challenging to treat. It accounts for lesser than 1% of arthroplasty cases and although low in occurrence, requires appropriate investigations and management to successfully treat the condition. This case demonstrates a case of a rare microorganism with unusual antibiotic susceptibility causing a prosthetic joint infection and the use of serum procalcitonin level as guide in management of the patient.

MBL PRODUCING P.PENNERI - A MAJOR THREAT TO THE HOSPITAL

Introduction: Proteus spp. has been the signi?cant cause of wound infections as they commonly colonize the wound. Simultaneously multiple drug resistance mechanisms also pose a therapeutic challenge. P.penneri is commonly misidenti?ed as P.mirabilis which is multidrug resistant. The current study was Aim and objectives: conducted to determine the prevalence of MBLs in P.penneri among wound infections at a tertiary care hospital from Western Maharashtra. Specimens collected from wounds of OPD and IPD patients were examined by standard Material and Methods: bacteriological methods. All Proteus isolates were subjected to Antimicrobial susceptibility and MBL production test as per CLSI guidelines. Total 1826 wound samples were screened over the period of May 2017 to July 2018. Overall Results: prevalence of Proteus spp. was 7.12%, P.mirabilis being the commonest. Among all isolates 53.68% and 37.04% of P.mirabilis and P.vulgaris were ESBL producers, respectively. The rate for MBL production was 11.58% and 0% for P.mirabilis and P.vulgaris, respectively. On the contrary 75% of P.penneri isolates were ESBL producers and 12.5% were MBL producers. Discussion and conclusion: Emergence of ESBL and MBL producers is of special concern as Proteus spp. is intrinsically resistant to tigecycline and colistin. Identi?cation of P.penneri from clinical specimens is necessary, due to its multidrug resistance which makes clinical treatment extremely dif?cult. This will limit its control and eradication especially from wound infections as they are common colonizers. Therefore isolation of such beta lactamases producing P.penneri shall be considered as an alarming sign to control the spread of this superbug.

Antibacterial Properties of Young and Mature Mango Leaves (Mangifera indica) Extract on Some Clinical Isolates

Aim: This study was carried out to investigate the antibacterial properties and efficacy of mango (Mangifera indica) leaf extracts on some clinical isolates as test rganisms. Study Design: The study employed statistical analysis of the data and interpretationPlace and Duration of Study: Young and mature mango leaves were collected from the Botanical Garden, Kenule Beeson Saro-Wiwa Polytechnic, Bori, Nigeria, and taken to the laboratory for analyses. Methodology: The samples were dried in an oven at 80oC for 3 days. Thereafter, 50 g of each ground mango leaf (young and mature leaves) were soaked separately in 500 ml of water, ethanol (95% v/v), and acetic acid (99.9% v/v) respectively for another 3 days. The soaked materials were filtered through Whatman No. 1 filter paper into sterile beakers and evaporated to dryness in a water bath at 80oC. The dried extracts obtained were reconstituted with water at concentrations of 100, 75, 50, and 25 mg/ml. Test organisms, Escherichia coli, Staphylococcus aureus, Salmonella typhi, Proteus mirabilis, Bacillus cereus, and Pseudomonas aeruginosa were obtained after proper laboratory screening of isolates from the diagnostic laboratory of the Rivers State University Teaching Hospital, Port Harcourt, Nigeria, for confirmation of identity and storage in universal bottles in a refrigerator. Sensitivity tests were carried out with the agar well diffusion method against the test organisms, using tetracycline as the standard control drug, with cultures incubated accordingly. The measured zones of inhibition were compared with the controls and interpreted as resistant, intermediate, or susceptible to mango extracts in accordance with the interpretive guidelines published by the National Committee for Clinical Laboratory Standards (NCCLS). Assay for minimum inhibitory concentration (MIC) and minimum bactericidal concentration (MBC) was also carried out. Results: Results obtained showed that acetic acid young leaf extract at 100mg/ml produced 50 % susceptibility and 50 % intermediate response of test bacterial species. Generally, at 100 mg/ml, acetic acid young leaf extracts yielded 50% susceptibility and 50% intermediate response among both Gram-positive and Gram-negative bacteria. Ethanolic extracts gave 100% intermediate sensitivity of Gram-negative species and 50% each of resistant and intermediate response in Gram-positive forms. Aqueous extracts also produced no susceptibility among the test organisms as there was 100% resistance. Extracts of mature mango leaves of all solvents and at all concentrations used yielded no susceptibility response among the test bacterial species on the NCCLS scale. Minimum inhibitory and bactericidal concentrations were found to range from 25 mg/ml to 50 mg/ml. Additionally, it was observed that the sensitivity of organisms to mango extracts increased with concentration.Conclusion: In conclusion, acetic acid has a better extracting potential than ethanol and water as a solvent for the extraction of mango parts. More so, young mango leaves extracted with acetic acid possess higher broad-spectrum antibacterial properties than the mature mango leaves extracted from the same plant. It is therefore recommended that young mango leaves, extracted with acetic acid, be used for the treatment of microbial infections at concentrations not below 50 mg/ml.

A food poisoning incident suspected to be caused by proteus in a city of Dehong Prefecture，Yunnan Province / 上海预防医学

Objective To Investigate the cause of a food poisoning incident in a city in Dehong Prefecture， determine the scope of the incident， and to formulate effective prevention and control measures. Methods Field epidemiology and case-control study methods were used to formulate case definition； carry out case search； find suspicious food combined with clinical manifestations， dining history and other information； and collect samples from the suspicious food， cases and environment for laboratory testing. Results A total of 160 cases were found and the incidence rate was 26.02% （160/615）. The main clinical manifestations were diarrhea， leukocytosis， vomiting， nausea and abdominal pain. The average incubation period was 10.89±5.09 h， with 2 h as the shortest and 28 h as the longest. The epidemiological curve suggested the point source exposure mode. The results of case-control study showed that eating roast pork with green shoots was an independent risk factor （OR=13.09， 95%CI： 3.26‒52.54）.16 samples were tested by the local CDC laboratory. Proteus mirabilis was detected in two the anal swabs of two patients He and Chen. Both proteus pani and proteus mirabilis were detected in anal swab of patient Zhou and Proteus pani was detected in roast meat. There was no detection of pathogenic bacteria in other samples. Conclusion Based on the field epidemiological investigation and laboratory test results， we conclude that the food poisoning incident is caused by suspected proteus bacteria. We suggest that the market supervision department should strengthen the supervision of local food hygiene； clarify the sampling rights， responsibilities and technical procedures when medical institutions treat patients with foodborne diseases； ensure finding the causes in time； and take effective prevention and control measures to avoid similar food poisoning events.

Improving the thermal stability of Proteus mirabilis lipase based on multiple computational design strategies / 生物工程学报

Proteus mirabilis lipase (PML) features tolerance to organic solvents and great potential for biodiesel synthesis. However, the thermal stability of the enzyme needs to be improved before it can be used industrially. Various computational design strategies are emerging methods for the modification of enzyme thermal stability. In this paper, the complementary algorithm-based ABACUS, PROSS, and FoldX were employed for positive selection of PML mutations, and their pairwise intersections were further subjected to negative selection by PSSM and GREMLIN to narrow the mutation library. Thereby, 18 potential single-point mutants were screened out. According to experimental verification, 7 mutants had melting temperature (Tm) improved, and the ΔTm of K208G and G206D was the highest, which was 3.75 ℃ and 3.21 ℃, respectively. Five mutants with activity higher than the wild type (WT) were selected for combination by greedy accumulation. Finally, the Tm of the five-point combination mutant M10 increased by 10.63 ℃, and the relative activity was 140% that of the WT. K208G and G206D exhibited certain epistasis during the combination, which made a major contribution to the improvement of the thermal stability of M10. Molecular dynamics simulation indicated that new forces were generated at and around the mutation sites, and the rearrangement of forces near G206D/K208G might stabilize the Ca2+ binding site which played a key role in the stabilization of PML. This study provides an efficient and user-friendly computational design scheme for the thermal stability modification of natural enzymes and lays a foundation for the modification of PML and the expansion of its industrial applications.

Pathogenic bacteria spectrum of infectious stones and experience of preventing stone recurrence / 中华泌尿外科杂志

Objective:To investigate the pathogenic bacteria profiles in preoperative urine bacterial cultures of patients with infected kidney stones and use antibacterial drugs to prevent recurrence.Methods:The data of 79 cases with infected kidney stones admitted to the Second Affiliated Hospital of Zhengzhou University from January 2017 to July 2021 were retrospectively analyzed, among whom 29 (36.7%) were male and 50 (63.3%) were female. The age ranged from 17-75 years, with a median age of 49.0 (40, 55) years. Fifteen cases (19.0%) combined hypertension, 13 cases (16.5%) combined diabetes mellitus, and 3 cases (3.8%) combined with cardiovascular disease. Fifty-one cases (64.6%) were diagnosed with cast infectious stones. All patients underwent surgical lithotripsy, and postoperative review of the urological computerized tomography (CT) revealed no residual stones defined as complete lithotripsy, and postoperative oral medication was continued to control infection and prevent stone recurrence. According to post-hospitalization compliance, patients were divided into high and low compliance groups. The high compliance group consisted of patients who returned to the hospital regularly for routine urinalysis and urine bacterial culture after discharge, followed the doctor's prescription for standardized antibacterial drug therapy, and complied with urease inhibitor therapy for ≥6 months. The low compliance group included patients who did not take sensitive antimicrobial drugs regularly and/or were unable to adhere to the medication even after the reduction of vinblastine due to adverse events such as tremor, palpitations, headache, anemia, or gastrointestinal discomfort. The recurrence of stones at 3, 6 and 12 months of follow-up was compared between the two groups.Results:Of the 79 cases in this group, 56(70.9%) were completely clear of stone after surgery. Thirty-three cases (41.8%) presented positive in preoperative urine bacterial culture, and the most common causative organism was Aspergillus oddus in 17 cases (21.5%), followed by Escherichia coli in 8 cases (10.1%) and Klebsiella pneumoniae in 3 cases (3.8%). Among the 17 positive cases of A. oddis, six were positive for ultra broad spectrum β-lactamases (ESBLs), 6/6 were resistant to ampicillin, cefazolin, and cotrimoxazole, 1/6 were resistant to amikacin, cefoxitin, and ticarcillin/stick acid, and none were resistant to imipenem, polymyxin, or aminotrans (0/6 cases). Of the cases, 11 were negative for ESBLs. Ten out of eleven cases were resistant to ampicillin. Furthermore, 8/11 cases were resistant to cefazolin, levofloxacin, ciprofloxacin, and cotrimoxazole and 1/11 were resistant to cefoxitin, cefaclor, furantoin, amikacin, and minocycline, and 0/11 were resistant to imipenem, ticarcillin/stick acid, aminotrans. ESBLs positive strains were resistant to 78.6% of the tested drugs (cefaclor, cefazolin, ceftazidime, furantoin, norfloxacin, levofloxacin, ciprofloxacin, cefoxitin, amoxicillin/rod acid, ticarcillin/rod acid, ampicillin, ceftriaxone, cefotaxime, cefuroxime, cefepime, gentamicin, cotrimoxazole, tobramycin, amikacin, tetracycline, chloramphenicol, and minocycline) at a lower rate of resistance than ESBLs positive strains. Of the eight positive cases of E. coli, seven were ESBLs positive, 7/7 were resistant to ampicillin, cefazolin, cefotaxime, cefuroxime, and cefepime, 1/7 were resistant to cefoxitin and minocycline, and 0/7 were resistant to imipenem, furantoin, or amikacin. One case was ESBLs negative and was resistant to all antimicrobial drugs except for ampicillin. Stone recurrence rates at 3, 6, and 12 months after discharge were 9.1%(4/44) and 31.4%(11/35), 13.6%(6/44), respectively, in the high compliance group, and 60.0%(21/35), 36.4%(16/44), and 71.4% (25/35), respectively, in the low compliance group. All differences were statistically significant.Conclusion:The most common pathogenic bacteria isolated from urine bacterial cultures of patients with infectious stones were A. chimaera, E. coli, and K. pneumoniae. The resistance rate of ESBLs-positive strains to antimicrobial drugs was significantly higher than that of ESBL-negative strains, and the resistance rate of antimicrobial drugs such as β-lactamase inhibitors, cefoxitin, amikacin, and imipenem was low. Combination therapy with standardized sensitive antimicrobial drugs and urease inhibitors significantly reduced the recurrence rate of stones among patients.

First report of bla GES-1 in Proteus mirabilis clinical isolates

Abstract Proteus mirabilis is one of the main pathogens causing urinary tract infections and sepsis. To our knowledge, this is the first report of a P. mirabilis hosting bla GES. The presence of these genes was determined using PCR and sequencing. We identified the presence of bla GES-1 in all three isolates. In addition, we identified the bla KPC-2 and bla NDM-1 genes in the two strains. These data emphasize the importance of monitoring and surveillance of all enterobacteria. The circulation of P. mirabilis strains carrying bla GES-1 constitutes a new scenario of resistance in this species and should be an epidemiological alert for global health.

Síndrome de CLOVES: reporte de un caso y revisión de los diagnósticos diferenciales / CLOVES syndrome: case report and review of differential diagnoses

Resumen Presentamos el caso de una paciente de 27 años con diagnóstico reciente de síndrome de CLOVES (Congenital, Lipomatous, Overgrowth, Vascular malformations, Epidermalnevi and Spinal/Skeletalanomalies and/orScoliosisSyndrome), quien fue diagnosticada previamente con los síndromes Klippel-Trenaunay-Weber y de Proteus. El síndrome de CLOVES es una patología poco frecuente y muchas veces el diagnóstico basado en la clínica suele complicarse por la superposición de signos y síntomas con otras patologías que también cursan con sobrecrecimiento.

Abstract We present the case of a 27-years-old patient with a newly diagnosis of CLOVES syndrome (Congenital, Lipomatous, Overgrowth, Vascular malformations, Epidermal nevi and Spinal/Skeletal anomalies and/or Scoliosis Syndrome). She has previously been diagnosed of Klippel-Trenaunay-Weber (at birth) and Proteus Syndrome (at 7 years). She presents dermatological alterations, syndactyly and overgrowth. CLOVES syndrome is a rare disease and often the clinic-based diagnostic is difficult due to overlapping signs and symptoms with other illnesses that also involve overgrowth.

Purple urine bag syndrome: an unusual clinical presentation

Purple Urine Bag Syndrome (PUBS) is a rare presentation of urinary tract infection caused by certain bacteria that produce sulphatases and phosphatases that bring about metabolism of tryptophan, leading to production of pigments indigo and indirubin that together impart purple colour of urine. It is a benign condition, most often associated with long term urinary catheterization, renal diseases, chronic constipation and female gender. Commonly implicated organisms include Proteus mirabilis, Klebsiella pneumoniae, Providencia stuartii. Diagnosis is made on urinary culture. Treatment includes reassurance and antibiotics for UTI. We present a case of purple urinary bag syndrome in a female patient of carcinoma stomach presenting with gastric outlet obstruction.

Time-kill study and morphological changes of Proteus mirabilis cells exposed to ethyl acetate crude extract of Lasiodiplodia pseudotheobromae IBRL OS-64

@#Aims: To investigate time-kill curve and morphological changes of Proteus mirabilis cells exposed to ethyl acetate crude extract of endophytic fungus, Lasiodiplodia pseudotheobromae IBRL OS-64, isolated from Ocimum sanctum. Methodology and results: Inhibitory effect of the fungal extract against the test bacteria via disc diffusion assay showed a fair antibacterial activity with diameter of inhibition zone was 12.0 ± 0.4 mm. The Minimal Inhibition Concentration (MIC) and Minimal Bactericidal Concentration (MBC) values of the ethyl acetate extract against P. mirabilis was 250 and 500 µg/mL, respectively. The value of MBC which is two-fold higher than MIC value indicated that the fungal extract exerted bactericidal effect on bacterial cells of P. mirabilis. Time-kill curve study revealed that the bactericidal effect of the crude extract towards test bacteria was both dose and time dependent. Scanning electron microscope (SEM) observation revealed that the bacterial cells of P. mirabilis exposed to fungal crude extract resulted in formation of pits, irregular shape of the bacterial cell and ultimately cell death beyond repair. Conclusion, significance and impact of the study: The time-kill curve study, and cell morphological changes suggested the potential of ethyl acetate extract of L. pseudotheobromae IBRL OS-64 against P. mirabilis infection by formation of cavities, irregular bacterial cell that leads to ultimate cell death and the extract may have pharmaceutical potential to be develop as antibacterial agent.

Síndrome de Proteus y síndrome de West en lactante femenina / Proteus Syndrome and West Syndrome in female infant

Introducción: El síndrome de Proteus es un raro síndrome hamartomoso congenito con manifestaciones neuroectodérmicas, de carácter progresivo y grado de severidad variable. Objetivo: Presentar un caso clínico donde se combinan dismorfias faciales, crecimiento excesivo de una hemicara, macrocráneo y manifestaciones neurológicas. Presentación del caso: lactante de 10 meses, femenina, con antecedentes de embarazo de riesgo, hija de madre adolescente, con exposición fetal a tabaco, marihuana y alcohol; nació con macrocefalia, dismorfia facial con hemihipertrofia derecha y nevó hiperpigmentado que comenzó con espasmos infantiles desde el primer mes vida y se diagnosticó síndrome west de etiología estructural con hemimegancefalia derecha. Cumple los criterios clínicos de síndrome de Proteus y tuvo una respuesta favorable con control de los espasmos, mejoría de la hipsarritmia y del desarrollo psicomotor, con tratamiento combinado de hormona adenocorticotrópica y vigabatrina. Conclusiones: el síndrome de Proteus se caracteriza por crecimiento exagerado en varios tejidos (epidérmico, conectivo, óseo, adiposo y endotelial) durante la embriogénesis, por lo que las manifestaciones clínicas suelen ser evidentes desde el nacimiento o en los primeros años de vida, se relaciona con un grupo de casos con malformaciones del sistema nervioso central y síndrome de West(AU)

Introduction: Proteus syndrome is a rare congenital hamartoma syndrome with neuroectodermal manifestations of progressive kind and a degree of variable severity. Objective: To present a clinical case where facial diysmorphias, the excessive growth of a hemicara, a macro-skull, and neurological manifestations are combined. Case presentation: A 10-month-old female infant with a history of risky pregnancy, daughter of a teenage mother, with fetal exposure to tobacco, marijuana and alcohol. She was born with macrocephaly, facial dysmorphia with right hemihypertrophy, hyperpigmented nevus that started with infantile spasms from the first month of life; and West syndrome of structural etiology with right hemimegalencephaly was diagnosed. The patient meets the clinical criteria of Proteus syndrome and she had a favorable response to the combined treatment of adrenocorticotropic hormone and Vigabatrin with control of spasms, improvement of hypsarrhythmia and psychomotor development. Conclusions: Proteus syndrome is characterized by exaggerated growth in various tissues (epidermal, connective, bone, adipose and endothelial) during embryogenesis, so that clinical manifestations are usually evident from birth or in the first years of life. It is related with a group of cases with malformations of the central nervous system and West syndrome(AU)

Optimization and immobilization of urease enzyme isolated from Proteus mirabilis on alginate beads

Urease enzyme was isolated from Proteus mirabilis and immobilized in alginate beads. Various parameters such as optimum pH, optimum temperature, pH stability, thermal stability, reusability, storage stability and substrate concentration were investigated and the findings were compared with free urease enzyme. İmmobilization yield was calculated as 85 %. Optimum temperature was found to be 40°C for free and immobilized urease. Thermal stability of the immobilized urease enzyme was significantly better than the free enzyme. Optimum pH for free and immobilized urease was be 7.0. Immobilized and free urease enzymes protected their stability at pH 7.0 and 8.0 in a similar way. Immobilized enzyme maintained 55% of their initial activity after 12 repeated use of enzyme. It was found that storage stability of immobilized enzyme was better than that of free enzyme. Km and Vmax values from the Lineweaver-Burk plots were calculated.

Distribution of extended-spectrum beta-lactamase TEM and CTX-M resistance genes among Proteus species Isolated in Sudan

Proteus species are found in the human intestinal tract as part of normal flora. Proteus species are also found in multiple environmental habitats, including long-term care facilities and hospitals, and can cause both community and nosocomial infections. For a long time Proteus was known to be susceptible to beta-lactam antibiotics but nowadays they become resistant. The aim of this study was to detect the Extended-spectrum beta-lactamase (ESBL) TEM and CTX-M genes in 90 Proteus species isolated from urine and wound swabs, obtained from different hospitals in Khartoum state, Sudan, from January to August 2018. Antimicrobial sensitivity was carried out using the following set of antibiotics: amoxiclav, ceftazidime, gentamicin, meropenem, cefotaxime, ciprofloxacin, amoxicillin, ceftriaxone and cotrimoxazole. ESBL producing strains were detected by double disc diffusion synergy test and the resistance genes TEM and CTX-M were detected by Polymerase Chain Reaction (PCR). Antibiotic resistance was found: amoxicillin 40 percent, ceftazidime 25.6 percent, ceftriaxone 23.3 percent, gentamicin 22.2 percent, cotrimoxazole 21.1 percent, and cefotaxime 18.9 percent. Most of the isolates were sensitive to meropenem 92.2 percent and ciprofloxacin 86.7 percent. In double-disk diffusion synergy test, 20 isolates (22.2 percent) were found to be positive for ESBL. The PCR demonstrated that TEM gene was present in 18 isolates (90 percent). It was present alone in 11 isolates (55 percent) and in combination with CTX-M gene in seven isolates (35 percent). The percentage of ESBL producing strains of Proteus was 23.5 percent. This percentage is a bit lower than in previous studies in Sudan. In conclusion; it seems that the CTX-M gene is emerging among Proteus species in SudanAU)

Las especies de Proteus se encuentran en el tracto intestinal humano y forman parte de su flora normal. También se localizan en el medio ambiente y otros hábitats, incluyendo hospitales y diversas instituciones de salud, provocando tanto infecciones en la comunidad como nosocomiales. Durante mucho tiempo, las especies de Proteus fueron susceptibles a los antibióticos betalactámicos, pero actualmente se han tornado resistentes. El propósito de este estudio fue detectar genes de resistencia betalactamasas de espectro extendido (BLEE) TEM y CTX-M, en 90 especies de Proteus aisladas en orina y heridas, provenientes de diversos hospitales del estado de Jartum, Sudán, entre enero y agosto de 2018. La sensibilidad antimicrobiana se determinó con el siguiente juego de antibióticos: amoxiclav, ceftazidima, gentamicina, meropenem, cefotaxima, ciprofloxacina, amoxicilina, ceftriaxona y cotrimoxasol. Las cepas productoras de BLEE se detectaron mediante la técnica de sinergia de doble disco, y los genes de resistencia TEM y CTX-M mediante Reacción en Cadena de la Polimerasa (PCR). Se encontró resistencia antibiótica: amoxicilina 40 por ciento, ceftazidima 25,6 por ciento, ceftriaxona 23,3 por ciento, gentamicina 22,2 por ciento, cotrimoxasol 21,1 por ciento y cefotaxima 18,9 por ciento. La mayor parte de los aislamientos fueron sensibles a meropenem (92,2 por ciento) y ciprofloxacina (86,7 por ciento). Con la técnica de sinergia de doble disco se detectó positividad a BLEE en 20 aislamientos (22,2 por ciento). Mediante PCR se demostró que el gen que codifica TEM estaba presente en 18 aislamientos (90 por ciento); de forma aislada en 11 aislamientos (55 por ciento) y combinado con el gen CTX-M en los otros siete (35 por ciento). El porcentaje de cepas de Proteus productoras de BLEE fue de 23,5 por ciento. Este valor es ligeramente inferior que los detectados en estudios previos en Sudán. En conclusión, hay evidencias de que el gen CTX-M está emergiendo entre las especies de Proteus en Sudán(AU)

Invitro antibacterial activity of Cassia fistula Linn methanolic leaf extracts

Background: Cassia fistula Linn is a plant which is widely grown in India and is used for medicinal purposes. The study was carried out with an objective to demonstrate the antimicrobial activity of leaves of Cassia fistula Linn. The aim of the study is to assess antibacterial and antifungal activity of methanolic leaf extract of Cassia fistula Linn against selected clinical isolates.Methods: The antimicrobial activity of methanolic extract of Cassia fistula was evaluated using agar well diffusion method and to zone of inhibition of extract was determined. Clinical isolates of Staphyloccocus aureus, MRSA, Pseudomonas aeruginosa, E. coli and Proteus were screened.Results: The methanolic extracts exhibited antibacterial activity against Staphylococcus aureus. The extract was not active against E. coli, Proteus, MRSA, Pseudomonas aeruginosa. The extract also failed to demonstrate antifungal activity against Candida albicans and Aspergillus niger.Conclusions: The global emergence of multidrug resistant bacterial strains is increasing, limiting the effectiveness of current drugs and treatment failure of infections. A novel approach to the prevention of antibiotic resistance of pathogenic species is the use of new compounds that are not based on existing synthetic antimicrobial agents.

A clinical study of Proteus syndrome caused by a mosaic somatic mutation in AKT1 gene / 中华内科杂志

Objective Proteus syndrome is a rare disease. The aim of the present study was to analyze the clinical characteristics and gene mutations of Proteus syndrome with a case report and relevant literature review. Methods Clinical data of the patient with Proteus syndrome were collected in detail and biochemical measurements and radiological examinations were conducted. Tissues from phalanges with lesions were obtained to extract DNA, and Sanger sequencing of AKT1 gene was carried on. The pathogenic mutation was further tested in peripheral blood samples of the patient, his parents and 250 healthy volunteers. Orthopaedic surgery was performed on the affected limbs of the patient. Results The patient was presented with progressive overgrowth of the right extremity, scoliosis, cerebral connective tissue nevus and lower extremity venous. A heterozygous mutation of AKT1 gene (c. 49G>A) was identified in DNA extracted from the affected bone tissue of the patient, but not be found in genomic DNA of peripheral blood samples from the patient, his parents and 250 healthy volunteers. Movement function of the affected limb improved significantly after the operations. Conclusions The prominent features of Proteus syndrome are overgrowth of one extremity and cerebral connective tissue nevus. A mosaic somatic mutation of AKT1 gene is one of the pathogenic mutations for Proteus syndrome, and orthopedic surgery may be a good way to improve symptoms of the disease.

Isolation and Identification of Chemical Constituents from Rhizomes of Dendropanax proteus / 中国实验方剂学杂志

The chemical constituents from 95% ethanol extract of Dendropanax proteus rhizomes and their anti-inflammatory activities were investigated. These compounds in 95% ethanol extract of D. proteus rhizomes were isolated and purified by silica gel column chromatography, medium-pressure liquid chromatography, preparative liquid chromatography, etc. Their structures were elucidated based on the spectral data and physicochemical properties. All the compounds were tested for their ability to inhibit lipopolysaccharide (LPS) induced nitric oxide production in the murine microglia BV2 cell line. Nine compounds were isolated from the ethyl acetate fraction of 95% ethanol extract of D. proteus rhizomes, and identified as (-)-syringaresinol (1), (+)-(7S,8S)-1',4-dihydroxy-3,3',5'-trimethoxy-7',8,9'-trinor-8,4'-oxyneoligna-7,9-diol (2), erythro-guaiacylglycerol-β-O-4'-coniferyl ether (3), threo-guaiacylglycerol-β-O-4'-coniferyl ether (4), coniferyl alcohol (5), 7-O-ethylguaiacylglycerol (6), vanillin (7), syringaldehyde (8), and excoecanol B (9). Compounds 2 and 4 showed neuritis inhibitory activity against microglial inflammation factor, their half inhibitory concentrations (IC50) were 5.85, 7.29 μmol ·L-1, respectively. Compounds 1-6,8-9 are isolated from this plant for the first time, compounds 2 and 4 exhibit the potent inhibitory activity.