Evaluation of a medium (STGG) for transport and optimal recovery of Streptococcus pneumoniae from nasopharyngeal secretions collected during field studies.

Field studies of Streptococcus pneumoniae (pneumococci) nasopharyngeal (NP) colonization are hampered by the need to directly plate specimens in order to ensure isolate viability. A medium containing skim milk, tryptone, glucose, and glycerin (STGG) has been used to transport and store NP material, but its ability to preserve pneumococci has not been evaluated. Our objective was to qualitatively and semiquantitatively evaluate the ability of STGG to preserve pneumococci in NP secretions. Entwined duplicate calcium alginate NP swab samples were obtained from children. One swab was plated directly onto a gentamicin blood agar plate; the other was placed in STGG. Growth from the directly plated specimen was compared with growth from an STGG aliquot immediately cultured or stored at -70 degrees C for 9 weeks, -20 degrees C for 9 weeks, or 4 degrees C for 5 days. Of 186 specimens, 96 (52%) were positive for pneumococci from the direct plating; 94 (98%) of these were positive from the fresh STGG specimen. Pneumococci were recovered from all 38 positive specimens frozen at -70 degrees C, all 18 positive specimens frozen at -20 degrees C, and 18 of 20 positive specimens stored at 4 degrees C. Recovery of pneumococci after storage of NP material in STGG medium at -70 degrees C is at least as good as that from direct plating. Storage at -20 degrees C is also acceptable. Storage at 4 degrees C for 5 days is not ideal.

Detection of enzootic babesiosis in baboons (Papio cynocephalus) and phylogenetic evidence supporting synonymy of the genera Entopolypoides and Babesia.

Blood smear evaluation of two baboons (Papio cynocephalus) experiencing acute hemolytic crises following experimental stem cell transplantation revealed numerous intraerythrocytic organisms typical of the genus Babesia. Both animals had received whole-blood transfusions from two baboon donors, one of which was subsequently found to display rare trophozoites of Entopolypoides macaci. An investigation was then undertaken to determine the prevalence of hematozoa in baboons held in our primate colony and to determine the relationship, if any, between the involved species. Analysis of thick and thin blood films from 65 healthy baboons (23 originating from our breeding facility, 26 originating from an out-of-state breeding facility, and 16 imported from Africa) for hematozoa revealed rare E. macaci parasites in 31%, with respective prevalences of 39, 35, and 12%. Phylogenetic analysis of nuclear small-subunit rRNA gene sequences amplified from peripheral blood of a baboon chronically infected with E. macaci demonstrated this parasite to be most closely related to Babesia microti (97.9% sequence similarity); sera from infected animals did not react in indirect fluorescent-antibody tests with Babesia microti antigen, however, suggesting that they represent different species. These results support an emerging view that the genus Entopolypoides Mayer 1933 is synonymous with that of the genus Babesia Starcovici 1893 and that the morphological variation noted among intracellular forms is a function of alteration in host immune status. The presence of an underrecognized, but highly enzootic, Babesia sp. in baboons may result in substantial, unanticipated impact on research programs. The similarity of this parasite to the known human pathogen B. microti may also pose risks to humans undergoing xenotransplantation, mandating effective screening of donor animals.

Genetic evidence for host specificity in the adhesin-encoding genes hxaA of Helicobacter acinonyx, hnaA of H. nemestrinae and hpaA of H. pylori.

Gastric and non-gastric species of Helicobacter were examined for the presence of the adhesin-encoding gene, hpaA, from the human-associated gastric Helicobacter H. pylori (Hp), and for adhesin subunit protein HpaA. Amplification of a 375-bp internal DNA fragment of hpaA by PCR demonstrated the presence of the gene in Hp and in two closely related gastric Helicobacters, H. nemestrinae (Hn) and H. acinonyx (Hx), but not in the more distantly related H. felis (Hf) and H. mustelae (Hm). The non-gastric Helicobacters, H. canis (Hc), H. muridarum (Hr), H. fennelliae (He) and H. cinaedi (Hi), were all negative for hpaA. An immunoblot assay of water extracts with adhesin-specific antibody confirmed these results. The deduced amino acid (aa) sequences of Hp HpaA and Hn adhesin A (hereafter termed HnaA) are very similar, having identical receptor-binding motifs (rbm); also, the hemagglutination (HA) properties of Hn and Hp cells were indistinguishable. In contrast, the rbm of Hx adhesin A (hereafter termed HxaA), compared to that of Hp, contained a non-conservative aa substitution (Ile to Thr); also, there was variance in five consecutive aa from 10 to 14 residues upstream from the rbm. We conclude that these aa substitutions in HxaA are probably responsible for the difference in receptor recognition of this adhesin, as evidenced by the resistance of Hx HA to inhibition with N-acetylneuraminyl-alpha(2,3)-lactose. These results are consistent with the biological similarity between the natural host(s) of Hp and Hn; i.e., human and non-human primates, and the dissimilarity between these hosts and the feline host, the cheetah.

The phylogenetic position of Helicobacter nemestrinae.

Comparison of the Helicobacter nemestrinae 16S ribosomal DNA with published homologous sequences from members of the genera Helicobacter, Wolinella, and Campylobacter reveals a close relationship between H. nemestrinae, H. pylori, and H. acinonyx. This finding is unexpected since these species differ significantly in their DNA guanine-plus-cytosine contents (24 to 38 mol%).

Helicobacter nemestrinae sp. nov., a spiral bacterium found in the stomach of a pigtailed macaque (Macaca nemestrina)

A new microaerophilic, spirally curved, rod-shaped bacterium was isolated from the gastric mucosa of a pigtailed macaque (Macaca nemestrina). The gram-negative cells of this bacterium are oxidase, catalase, and urease positive and strongly resemble Helicobacter pylori (Campylobacter pylori) cells. Like H. pylori, this organism does not metabolize glucose, does not reduce nitrate or produce indole, does not produce H2S from triple sugar iron agar, does not hydrolyze hippurate or esculin, and does not grow in the presence of 1% glycine, 1.5% salt, or 1% bile. Also like H. pylori, it is resistant to nalidixic acid and susceptible to cephalothin. However, unlike H. pylori, the colorless colonies are flat and have irregular edges. This organism has a unique cellular fatty acid composition, forming a new gas-liquid chromatography group, group K, and a distinctive DNA content (24 mol% guanine plus cytosine). It exhibits less than 10% DNA-DNA homology (as determined by the nylon filter blot method at 65 degrees C) with other members of the genus Helicobacter. Although the levels of DNA relatedness between previously described Helicobacter species and the new organism are low (less than 10%) and the difference in guanine-plus-cytosine content is large (24 versus 36 to 41 mol%), the genus Helicobacter is the only genus in which it is logical to include the organism at this time. We propose that our single strain represents a new species, Helicobacter nemestrinae, and we designate strain T81213-NTB (= ATCC 49396) as the type strain.

Experimental infection of pig-tailed macaques (Macaca nemestrina) with Campylobacter cinaedi and Campylobacter fennelliae.

Campylobacter cinaedi and C. fennelliae have been associated with proctocolitis, bacteremia, and asymptomatic rectal infection, primarily in homosexual men. To more directly assess the pathogenic role of these organisms, we studied their disease-producing potential in 12- to 25-day-old pig-tailed macaques (Macaca nemestrina). Four infant monkeys were challenged with 10(8) to 10(9) C. cinaedi, three were challenged with C. fennelliae, two were challenged with C. jejuni, and one received no microorganisms. Watery or loose stools without associated fever or fecal leukocytes developed 3 to 7 days postinoculation in all of the animals given C. cinaedi, C. fennelliae, and C. jejuni, but not in the control animal. Stool cultures were simultaneously positive and remained so in the animals challenged with C. cinaedi or C. fennelliae for 3 weeks after inoculation despite the resolution of clinical illness. All of the animals challenged with C. cinaedi and C. fennelliae became bacteremic, and three had clinical evidence of septicemia. Histopathologic evaluation of rectal biopsies (five animals) and necropsy (one animal) showed no evidence of mucosal disruption. Specific immunoglobulin M and immunoglobulin G antibody responses occurred in all of the animals challenged with C. cinaedi and C. fennelliae, as determined by enzyme-linked immunosorbent assay and immunoblotting. We conclude that C. cinaedi and C. fennelliae consistently produce a diarrheal illness accompanied by bacteremia and followed by prolonged gastrointestinal colonization in M. nemestrina.

Experimental cryptosporidiosis in a primate model.

Cryptosporidium causes a disease in infant macaques that is clinically, histologically, and microbiologically indistinguishable from that seen in young children. A reproducible experimental model of cryptosporidiosis has been developed in pigtailed macaques (Macaca nemestrina) and used to studied the infectious dose of oocysts and the effect of inoculum size on severity of disease. Inoculation with either 2 x 10(5) or 10 oocysts via nasogastric tube resulted in clinical enteritis and the fecal passage of large numbers of cryptosporidial oocysts in all four primates studied. The size of the inoculum had no apparent effect on the severity or duration of disease. Rechallenge 2 weeks after resolution of the primary infection demonstrated partial acquired immunity. The small inoculum size coupled with the passage of large numbers of oocysts contributes to the highly contagious nature of cryptosporidiosis among captive primates and may be relevant to the epidemiology and control of cryptosporidiosis in humans.

Clinical and parasitologic aspects of cryptosporidiosis in nonhuman primates.

Eighty-one cases of acute cryptosporidiosis were diagnosed among 157 (52%) infant primates, predominantly Macaca nemestrina, housed in the nursery unit of the Washington Regional Primate Research Center. The mean age at onset of oocyst passage was 38 +/- 25 days. The outbreak was confined to the nursery and no cases were detected among juvenile or adult primates housed in other rooms within the colony. All but one animal manifested symptoms of enteric infection, including severe diarrhea and dehydration. Infected animals excreted oocysts for a mean of 36 days (range 7-78 days). No reinfections occurred. Cryptosporidium was the second most common enteric pathogen detected in the population, after Campylobacter jejuni. The risk of infection was related to the length of time the animal was housed in the nursery and to social interaction with other monkeys. These findings are relevant to the understanding of the epidemiology of cryptosporidiosis among human infants and children in environments with close social interactions and minimal learned personal hygiene practices.

Cellular fatty acid composition of Campylobacter pylori from primates and ferrets compared with those of other campylobacters.

The cellular fatty acid profiles of newly described campylobacters were determined on a polar, capillary column. Six isolates of the gastric spiral organism, Campylobacter pylori subsp. mustelae, from ferrets from Australia, England, and the United States were all found to have a similar fatty acid profile which was different from that of C. pylori from humans; C. pylori subsp. mustelae did not have 3-hydroxyoctadecanoic acid (3-OH C18:0) and had much less tetradecanoic acid (C14:0) and much more hexadecanoic acid (C16:0). Inasmuch as Lambert et al. (M.A. Lambert, C.M. Patton, T.J. Barrett, and C.W. Moss, J. Clin. Microbiol. 25:706-713, 1987) have proposed that campylobacters can be grouped by cellular fatty acid composition, we propose this organism should be in a new gas-liquid chromatography (GLC) group, group J. Seven isolates of gastric spiral organisms from macaque monkeys and baboons, including three from Macaca nemestrina, and one isolate from a pig were found to have fatty acid profiles very similar to that of C. pylori; but a second type of organism (type B) from M. nemestrina had a unique profile without 19-carbon cyclopropane fatty acid (C19:0 cyc) but with 3-hydroxy tetradecanoic acid (OH C14:0), which is not present in other gastric spiral bacteria. We propose that this organism (nemestrina type B) should be in a new GLC group, group K. The cellular fatty acid profile of seven isolates of C. jejuni subsp. doylei was found to be similar to that for C. jejuni, but with possibly significant differences in that the former did not have 3-OH C14:0 but did have 3-hydroxyhexadecanoic acid (3-OH C16:0) and had more C14:0 than did C. jejuni. Two strains of urease-positive thermophilic campylobacters were found to have a profile similar to that of "C. cinaedi" and thus should be included with them in GLC group D. We confirm that C. sputorum has a unique cellular fatty acid composition and suggest that it should be in a new group, group H.

Campylobacter pylori isolated from the stomach of the monkey, Macaca nemestrina.

Campylobacter pylori was isolated from the gastric mucosa in 6 of 24 pigtailed macaques (Macaca nemestrina) examined by gastric biopsy and culture; 3 isolates were recovered during gastroendoscopy, and 3 were recovered at necropsy. The isolates were morphologically and biochemically similar to the human type strain NCTC 11638, differing only in colony diameter, pigmentation, and rate of growth. Identity of the isolates was confirmed by whole-genomic DNA-DNA hybridization with the type strain. Colonization of the monkey stomachs was associated with hypochlorhydria and histologic features resembling type B chronic gastritis in humans. Host animals exhibited no morbid clinical effects of colonization, although endoscopy revealed inflammation, erythema, and friable tissue in some animals. The discovery of C. pylori occurring spontaneously in M. nemestrina extends the known range of the hosts of the organism and offers the possibility of a natural or experimental model of the infection in monkeys.

Epidemiology and etiology of diarrhea in colony-born Macaca nemestrina.

The epidemiology of diarrhea in colony-born M. nemestrina was studied in 205 neonates and infants in an Infant Primate Research Laboratory (IPRL), and in 248 neonates, juveniles and adolescents up to 4 years of age at a separate breeding and holding facility (Primate Field Station, PFS). Computerized medical records of individual animals over a 5-year period were analyzed to determine the incidence of diarrhea; age, duration and number of episodes; mortality and etiology. The incidence of diarrhea at the IPRL was highest in infants at less than 1 month of age (18.6 cases per 1000 animal days) and at 1-6 months olds (2.0 cases per 1000 animals days). Many infants had multiple episodes. All episodes were less than 10 days in duration. Mortality was low. At the PFS, the highest incidence occurred in infants at 6-12 months of age (1.36 cases per 1000 animal days). Multiple episodes were less common. Duration was variable. The infectious agents diagnosed at both facilities were Shigella, Campylobacter and Cryptosporidium. No pathogens were identified in many episodes. Shigella was more common at PFS than at the IPRL. Chronic diarrhea occurred in approximately 10% of animals at PFS. Intestinal amyloidosis and retroperitoneal fibromatosis were found in 13 animals with chronic diarrhea. Further studies are needed to determine the pathogenesis of chronic diarrhea, the etiologic significance of Campylobacter, and the causes of diarrhea when no pathogens are isolated.

Rapid dimethyl sulfoxide-modified acid-fast stain of Cryptosporidium oocysts in stool specimens.

A rapid dimethyl sulfoxide modification of an acid-fast technique was applied to direct fecal smears to monitor cryptosporidiosis in nonhuman primates. Brilliantly stained pink oocysts against a pale green background demonstrated well-preserved internal morphology and facilitated rapid, simple, noninvasive diagnosis without fluorescent or phase-contrast microscopy.

Isolation of plasmids encoding tetracycline resistance from Campylobacter jejuni strains isolated from simians.

Fifteen isolates of tetracycline-resistant Campylobacter jejuni were recovered from stool samples of cynomologous monkeys (Macaca fascicularis) housed at the University of Washington Primate Research Center, Seattle. Resistance was associated with carriage of a 38-megadalton plasmid which was transmissible to other strains of C. jejuni but not to Escherichia coli. Seven isolates also contained a 2.6-megadalton plasmid which was phenotypically cryptic.