Bacterial cyanogenesis occurs in the cystic fibrosis lung.

The cystic fibrosis (CF) lung environment is poorly defined, but data suggest that bacteria may encounter reduced oxygen tensions and possibly an anaerobic environment. Pseudomonas aeruginosa produces the potent toxin cyanide under strictly microaerobic conditions. Evidence of bacterial cyanogenesis in the CF lung was investigated in the present study by measuring sputum cyanide concentrations. Sputum cyanide was measured in seven stable CF patients, as well as before and after intravenous antibiotic therapy during a hospital admission in a further eight patients experiencing acute exacerbations. All patients were chronically infected with P. aeruginosa. Comparative sputum data were obtained from nine CF patients with no documented P. aeruginosa infection and 10 healthy, nonsmoking normal controls. High levels of cyanide were detected in all the P. aeruginosa-infected stable CF patients (median (range) 0.56 (0.37-2.81) microg.mL(-1)), and in seven out of eight acute sputum samples (0.73 (0-1.43) microg.mL(-1)). In contrast, cyanide was not detectable in sputum from eight out of nine CF patients without P. aeruginosa infection or in any of the normal controls. Intravenous antibiotic treatment significantly reduced sputum cyanide levels (median 0.73 to median 0.0 microg.mL(-1)). The cyanide detected indicates that the cystic fibrosis lung provides a predominantly microaerobic environment for Pseudomonas aeruginosa. Cyanide is likely to be a potentially important virulence factor in Pseudomonas aeruginosa-infected cystic fibrosis patients.

Increased airway iron as a potential factor in the persistence of Pseudomonas aeruginosa infection in cystic fibrosis.

Iron availability is critical to many bacteria and increased iron has been described in airway secretions in cystic fibrosis (CF). The main aim of the present study was to assess the relationship between iron in CF sputum and the quantitative bacterial burden. Iron, ferritin and total cell counts (TCC) were assessed in sputum samples obtained from 15 clinically stable CF patients chronically infected with Pseudomonas aeruginosa. Sputum samples were also obtained at the commencement of episodes of acute exacerbation in 10 subjects and analyses were repeated in six of these exacerbation cases after i.v. antibiotic treatment. The relationship between iron indices and the presence of P. aeruginosa, as well as total anaerobic bacterial load, was determined. Sputum was also obtained from 10 CF patients with no evidence of infection with P. aeruginosa and 11 normal healthy controls. Sputum iron, ferritin and TCC were significantly elevated in all CF patients, even in those not infected with P. aeruginosa, compared with healthy controls. There was a strong positive relationship between sputum iron and P. aeruginosa in clinically stable patients, but not in samples obtained during an acute exacerbation. There was no relationship between sputum iron and anaerobic bacterial load. Antibiotic treatment significantly reduced sputum TCC and anaerobic bacterial load, but not iron, ferritin or the presence of P. aeruginosa during an exacerbation. In conclusion, the present study suggests that increased airway iron may be important to Pseudomonas aeruginosa persistence in cystic fibrosis.

Rattus norvegicus: not a model for Aeromonas-associated gastroenteritis in man.

The lack of a suitable animal model of Aeromonas-associated diarrhoea has hampered investigations into Aeromonas pathogenic mechanisms. Hence, a published report that clindamycin-pretreated rats developed signs and symptoms of enteritis following intragastric inoculation of an Aeromonas strain required further investigation. Although we could demonstrate long-term colonisation (>12 days) and histological damage in this animal model with Pseudomonas aeruginosa isolated from patients with chronic diarrhoea, this was not seen with Aeromonas spp. Six Aeromonas strains, selected for their potential virulence and colonising abilities and including the strain from the original report, were either not recovered from stools or were recovered for no longer than 2 days post inoculation. Intestinal histology remained normal. Destruction of bacteria in vivo appeared to be due to immune mechanisms as inoculum strains were not 'suicidal' or unduly sensitive to low pH or clindamycin. This study was, therefore, unable to validate the clindamycin-treated rat model as a useful one for investigating the enteropathogenicity of Aeromonas species. Possible reasons for the discrepancy between our study and the original report are discussed.

Investigation of the role of type IV Aeromonas pilus (Tap) in the pathogenesis of Aeromonas gastrointestinal infection.

Although there is substantial evidence that type IV pili purified from diarrhea-associated Aeromonas species (designated Bfp for bundle-forming pilus) are intestinal colonization factors (S. M. Kirov, L. A. O'Donovan, and K. Sanderson, Infect. Immun. 67:5447-5454, 1999), nothing is known regarding the function of a second family of Aeromonas type IV pili (designated Tap for type IV Aeromonas pilus), identified following the cloning of a pilus biogenesis gene cluster tapABCD. Related pilus gene clusters are widely conserved among gram-negative bacteria, but their significance for virulence has been controversial. To investigate the role of Tap pili in Aeromonas pathogenesis, mutants of Aeromonas strains (a fish isolate of A. hydrophila and a human dysenteric isolate of A. veronii bv. sobria) were prepared by insertional inactivation of the tapA gene which encodes the type IV pilus subunit protein, TapA. Exotoxic activities were unaffected by the mutation in tapA. Inactivation of tapA had no effect on the bacterial adherence of these two isolates to HEp-2 cells. For the A. veronii bv. sobria isolate, adhesion to Henle 407 intestinal cells and to human intestinal tissue was also unaffected. There was no significant effect on the duration of colonization or incidence of diarrhea when the A. veronii bv. sobria strain was tested in the removable intestinal tie adult rabbit diarrhea model or on its ability to colonize infant mice. Evidence was obtained that demonstrated that TapA was expressed by both Aeromonas species and was present on the cell surface, although if assembled into pili this pilus type appears to be an uncommon one under standard bacterial growth conditions. Further studies into factors which may influence Tap expression are required, but the present study suggests that Tap pili may not be as significant as Bfp pili for Aeromonas intestinal colonization.

Functional characterization of type IV pili expressed on diarrhea-associated isolates of Aeromonas species.

Our past work has shown that long, flexible type IV pili (single or in bundles) are the predominant pili expressed on fecal isolates of diarrhea-associated species of Aeromonas (Aeromonas veronii biovar sobria and A. caviae). They represent a family of type IV pili which we have designated Bfp (for bundle-forming pili). Reports from Japan suggest that Bfp are intestinal colonization factors. This study presents compelling evidence to support this conclusion. Aeromonas bacteria and/or Bfp purified from a strain of A. veronii biovar sobria were shown to adhere to epithelial and intestinal cell lines, freshly isolated human enterocytes, and fresh and fixed human and rabbit intestinal tissues, as determined by light and electron microscopy and immunohistochemical detection. Removal of Bfp by mechanical means decreased adhesion to cell lines by up to 80%. Purified Bfp blocked adhesion of the test strain to intestinal cells in a dose-dependent manner. Adhesion was also blocked by the Fab fraction of anti-Bfp immunoglobulin G. Moreover, ultrastructural studies (ruthenium red staining and transmission and scanning electron microscopy) demonstrated for the first time that Aeromonas adhesion to human enterocytes is pilus mediated and suggested that Bfp may also promote colonization by forming bacterium-to-bacterium linkages. Bfp-positive isolates examined for type IV pilus-mediated twitching motility in agar and slide culture assays developed for Pseudomonas aeruginosa did not, however, exhibit this function.

The type IV Aeromonas pilus (Tap) gene cluster is widely conserved in Aeromonas species.

Nothing is known regarding the expression or function of the type IV Aeromonas pilus (Tap), which was recently identified following the cloning of a pilus biogenesis gene cluster (tapABCD). As a first step to determine the possible significance of Tap for Aeromonas virulence, the distribution of the tapA and tapD genes in hybridization group reference strains and clinical (n=42) and environmental (n=29) isolates was determined. Homologues of tapA and tapD were present in all strains tested. Hybridization with the tapA probe enabled us to differentiate between clinical and environmental isolates of A. veronii biovar sobria.

Pseudomonas aeruginosa as a cause of infectious diarrhoea.

Pseudomonas aeruginosa is not generally considered a cause of infectious diarrhoea. However, it was the predominant organism isolated from the faeces of 23 unrelated, hospital outpatients investigated in the course of a year for persistent (> 1 week duration) diarrhoea. To investigate the possible aetiological role of P. aeruginosa, these patient histories were reviewed and a selection of their faecal isolates were investigated in vitro (n > or = 10) and in vivo (n = 2) for virulence. The patients had a mean age of 60 years, were receiving antibiotics and/or had an underlying illness. Extensive microbiological investigations identified no other potential or recognized enteropathogen in the faeces of 20 of these patients. More than 40% of the isolates tested were able to adhere to HEp-2 cells and exhibited twitching motility (type IV pili), properties indicative of their ability to colonize the human intestine. Cytotoxic activity was demonstrated in bacterium-free cell supernatants of over 80% of isolates; supernatants of four isolates tested in infant mice were weakly enterotoxigenic. Two isolates intragastrically inoculated into clindamycin pre-treated rats established persistent infections and induced signs and symptoms of enteritis. Overall these findings suggest that P. aeruginosa can cause diarrhoea particularly in immunodeficient individuals.

Characterisation of a type IV pilus produced by Aeromonas caviae.

A pilus produced by a clinical isolate of Aeromonas caviae (strain CA195) was purified and partially characterised. The Mr of the pilin was estimated to be 23 kDa by SDS-PAGE. Its N-terminal amino-acid sequence showed that it was closely related to 'bundle-forming' type IV pili purified from other Aeromonas spp. associated with gastro-enteritis and considered to be important intestinal colonisation factors. Bundle-forming pili, often with a polar location, were seen on the surface of strain CA195 which was highly adherent to HEp-2 cells. Removal of surface structures by mechanical means decreased adhesion (by > or = 50%) suggesting that these pili played some role in HEp-2 cell binding. This pilus type could prove an important marker for enteropathogenic A. caviae which appear to lack other putative virulence factors.

Aeromonas spp. possess at least two distinct type IV pilus families.

Type IV pili have been purified from strains of most of the Aeromonas species associated with gastroenteritis (A. veronii biovar sobria, A. hydrophila, A. trota and A. caviae). They appear to be a related family (molecular mass of pilin 19 to 23 kDa) with a tendency to bundle-formation. Hence, we have designated them 'bundle-forming pili' (Bfp). A type IV pilus biogenesis gene cluster (tapABCD) recently cloned from a strain of A. hydrophila, however, encoded a 17 kDa pilin which differed significantly in its N-terminal amino acid sequence from the Bfp pilins. This paper describes the cloning of part (tapA and approximately 20% of tapB) of a homologous pilin gene cluster from a Bfp-positive strain of A. veronii biovar sobria, and presents evidence that the entire pilin gene cluster (tapABCD) is present in this strain. The predicted N-terminal amino acid sequence of the pilin encoded by the A. veronii biovar sobria tapA differed markedly from the corresponding sequence of its Bfp pilin, and those of the Bfp purified from other Aeromonas strains and species. Probing with tapA and tapD genes showed that these Bfp-positive Aeromonas strains also possessed the Tap gene cluster. TapA proteins of A. veronii biovar sobria and A. hydrophila shared 53% identity and 63% homology. We conclude that Aeromonas species are potentially able to express at least two distinct families of type IV pili (Bfp and Tap).

Plasmids and Aeromonas virulence.

Most putative virulence determinants of Aeromonas species are chromosomally encoded. However, several recent reports have indicated that some may be carried on or regulated by plasmids. Therefore, we examined the plasmid carriage rate of a total of 140 clinical and environmental Aeromonas isolates. Plasmid carriage was compared with the ability of an isolate to produce toxins and adhere to HEp-2 cells. Overall, plasmid incidence in Aeromonas species was low (23/140, 16%) and independent of the source of the isolate. Plasmids were, however, more common in environmental isolates of A. veronii biovar sobria than in clinical isolates of this species (P < 0.05). We could find no evidence to support the recent literature findings that plasmids may have a role in Aeromonas virulence.

Characterization of a type IV bundle-forming pilus (SFP) from a gastroenteritis-associated strain of Aeromonas veronii biovar sobria.

The colonization mechanisms of enteropathogenic Aeromonas strains are poorly characterized, but recent studies indicate that some filamentous structures are intestinal adhesins. This study describes the purification and characterization of a long, flexible pilus from a gastroenteritis-associated strain of Aeromonas veronii biovar sobria. SDS-PAGE analysis (various conditions) of pili preparations yielded a pilin protein band of approximately 21 kDa. Its N-terminal amino acid sequence was unambiguous and homologous with those of type IV pilins. Immunogold electron microscopy with rabbit antisera produced against this pilin protein (SFP) decorated single pili and rope-like bundles of pili on the bacterial surface. These were seen more frequently on strains grown at 22 degrees C compared with 37 degrees C and in liquid rather than on solid medium. SFP was not detected on any of 104 strains of Aeromonas (different species and sources) from our culture collection, although morphologically similar structures were seen on a number of these strains. This finding and differences among other published amino acid sequences show that Aeromonas type IV pili are antigenically diverse. Bundle-forming type IV 'class B' pili are important in the virulence of other enteropathogenic bacteria. The N-terminal amino acid sequence of the Aeromonas SFP, however, showed closer homology to the type IV 'class A' pilins. Studies are in progress to investigate the role of SFP in Aeromonas virulence.

Colonization of streptomycin-treated mice by Aeromonas species.

Streptomycin-treated adult mice were investigated as a possible model for studying the enteropathogenicity of Aeromonas species. C57BL mice pre-treated with streptomycin (5.0 g/L drinking water, 48 hours) received a single intragastric dose (10(10) bacteria /10.5 mL) of one of six well-characterized, toxin-producing, human diarrhoeal isolates of A. veronii biovar sobria (n = 3) or A. hydrophila (n = 3). Their faeces were examined for Aeromonas for 10 days post-challenge. All strains colonized the antibiotic-treated mice. Colonization did not occur in mice which did not receive streptomycin. Strains of A. hydrophila were recovered in greater numbers than strains of A. veronii biovar sobria, and colonized ( > or = 10(3) cfu/g of faeces) a greater proportion of mice at day 10. Strains of the latter species, however, were more adherent in cell line assays used as models of intestinal adhesion. A. hydrophila strains localized in the large intestine and appeared not to be cell associated. This study, therefore, points to species-related differences in intestinal colonization mechanisms. The streptomycin-treated adult mouse model may prove useful for further investigation of some of these mechanisms. Diarrhoeal symptoms were, however, not produced in this model.

Adhesion of Aeromonas sp. to cell lines used as models for intestinal adhesion.

Adhesion to HEp-2 cells has been shown to correlate with enteropathogenicity for Aeromonas species. Such adhesion is thought to reflect the ability of strains to adhere to human intestinal enterocytes, although HEp-2 cells are not of intestinal origin. In this study strains of Aeromonas veronii biotype sobria isolated from various sources were investigated in parallel assays for their ability to adhere to HEp-2 cells and to an intestinal cell line (Caco-2). Quantitative assays showed identical adhesion values were obtained with both cell lines. Adhesion was best when bacteria were grown at 22 degrees C compared with 37 degrees C and 7 degrees C. Some environmental isolates showed greater adhesion when grown at 7 degrees C than when grown at 37 degrees C. Filamentous structures on these strains are also optimally expressed under the above conditions (reported elsewhere). Mechanical shearing or trypsin treatment to remove surface structures from several adhesive strains grown at 22 degrees C decreased adhesion to cell lines by 50-80% providing further indirect evidence that filamentous adhesins may play a role in cell adhesion for this Aeromonas species.

Electron microscopic examination of factors influencing the expression of filamentous surface structures on clinical and environmental isolates of Aeromonas veronii Biotype sobria.

Strains of Aeromonas veronii biotype sobria isolated from clinical and environmental sources were examined for their expression of surface structures under a variety of culture conditions. When grown on solid media at 37 degrees C, more than 95% of bacteria from the majority of strains isolated from human diarrheal feces and chicken carcasses were non-piliated or expressed only a few pili of long, flexible morphology per cell. Strains isolated from water or other foods were much more likely to express pili. Heavily piliated strains (all sources) possessed pili of several morphological types, including long, flexible pili of varying widths and rigid pili of varying lengths. Expression of Pili was favored by growth at temperatures ca. 20 degrees C and below and growth in liquid medium. Most fecal strains expressed some pili under these conditions. In addition, other surface structures (fibrillar aggregates, fibrillar networks bundle-forming pili) were seen on some strains from most sources. These were also seen most frequently when bacteria were grown in liquid media at temperatures ca. 20 degrees C and below. Pili expression was not dramatically influenced by growth under anaerobic conditions, or in iron-depleted media, or by combinations of the above conditions. The role of the above surface structures in Aeromonas pathogenicity remains to be elucidated.

Distribution of Aeromonas hydrophila hybridization groups and their virulence properties in Australasian clinical and environmental strains.

A total of 182 Aeromonas hydrophila strains isolated from environmental (food and water) and clinical (stool and other sources) samples taken in mainland Australia, Tasmania and New Zealand were assigned to one of three DNA/DNA hybridization groups (HGs) on the basis of biochemical characteristics, and tested with regard to their ability to produce virulence factors. Strains from HG2 were rarely isolated; strains from HG1 were most commonly isolated from clinical sources; and strains from HG3 formed the majority of environmental strains. There was no correlation of HG to geographic source. Strains from HG2 infrequently produced virulence factors. Strains from HG1 were more likely to produce virulence factors if they came from a clinical source. Overall, strains from mainland Australia produced virulence factors more frequently than those from Tasmania or New Zealand. Strains from HG1 may be of more clinical significance than strains from the other two HGs.