RESUMO
Patients with solid-organ transplants usually present at the emergency department with nonspecific symptoms. The physician should consider a great variety of syndromes and diseases, given the greater risk that solid-organ transplant patients carry because of immunosuppression and transplant-related conditions. Myocardial infarction caused by cardiac allograft vasculopathy must be always suspected and ruled out, even when initial symptoms do not orientate in that direction. We present a case that conjugates signs that can be present in different pathologies. It shows that fever is not always related to infection or rejection but could also appear in acute cardiac allograft vasculopathy. It emphasizes the need of a multi-disciplinary team led by a heart transplant specialist when dealing with this sort of clinical case.
Assuntos
Doença das Coronárias/etiologia , Dispneia/etiologia , Febre/etiologia , Transplante de Coração/efeitos adversos , Complicações Pós-Operatórias , Cardiomiopatias Diabéticas/cirurgia , Humanos , Terapia de Imunossupressão/efeitos adversos , Masculino , Pessoa de Meia-IdadeRESUMO
Two freshwater isolates (WB4.1-19(T) and WB4.4-101), sharing 99.9â% 16S rRNA gene sequence similarity, were highly related to Aeromonas sobria (99.7â% similarity; 6 bp differences). A phylogenetic tree derived from a multi-locus phylogenetic analysis (MLPA) of the concatenated sequences of five housekeeping genes (gyrB, rpoD, recA, dnaJ and gyrA; 3684 bp) revealed that both strains clustered as an independent phylogenetic line next to members of Aeromonas molluscorum and Aeromonas bivalvium. The DNA-DNA reassociation value between the two new isolates was 89.3â%. Strain WB4.1-19(T) had a DNA-DNA relatedness value of <70â% with the type strains of the other species tested. Phenotypic characterization differentiated the two novel strains from all other type strains of species of the genus Aeromonas. It is concluded that the two new strains represent a novel species of the genus Aeromonas, for which the name Aeromonas rivuli sp. nov. is proposed, with the type strain WB4.1-19(T) (=CECT 7518(T)=DSM 22539(T)=MDC 2511(T)).
Assuntos
Aeromonas/classificação , Técnicas de Tipagem Bacteriana , Água Doce/microbiologia , Aeromonas/isolamento & purificação , DNA Bacteriano/genética , Genes Bacterianos , Dados de Sequência Molecular , Tipagem de Sequências Multilocus , Fenótipo , Filogenia , RNA Ribossômico 16S/genética , Análise de Sequência de DNARESUMO
Strains producing Shiga toxins, encoded by stx1 and stx2 genes, can cause diarrhoea, haemorrhagic colitis and haemolytic uremic syndrome. PCR screening of 80 clinical Aeromonas strains showed that 19 were stx1-positive and only one was positive for both stx1 and stx2. PCR bands were very faint for some strains and negative results were obtained after subculturing. The obtained sequences of Aeromonas stx1 and stx2 genes were highly similar to those of the most virulent stx gene variants of Shiga toxin-producing Escherichia coli. These results may lead to a better understanding of the potential pathogenicity and virulence mechanisms of Aeromonas.
Assuntos
Aeromonas/genética , Infecções por Bactérias Gram-Negativas/microbiologia , Toxina Shiga I/genética , Toxina Shiga II/genética , Aeromonas/isolamento & purificação , Análise por Conglomerados , DNA Bacteriano/química , DNA Bacteriano/genética , Escherichia coli/genética , Humanos , Dados de Sequência Molecular , Filogenia , Reação em Cadeia da Polimerase , Análise de Sequência de DNA , Homologia de Sequência do Ácido NucleicoRESUMO
Four Aeromonas strains (S1.2(T), EO-0505, TC1 and TI 1.1) isolated from moribund fish in Spain showed a restriction fragment length polymorphism (RFLP) pattern related to strains of Aeromonas salmonicida and Aeromonas bestiarum but their specific taxonomic position was unclear. Multilocus sequence analysis (MLSA) of housekeeping genes rpoD, gyrB, recA and dnaJ confirmed the allocation of these isolates to an unknown genetic lineage within the genus Aeromonas with A. salmonicida, A. bestiarum and Aeromonas popoffii as the phylogenetically nearest neighbours. Furthermore, a strain biochemically labelled as Aeromonas hydrophila (AH-3), showing a pattern of A. bestiarum based on 16S rDNA-RFLP, also clustered with the unknown genetic lineage. The genes rpoD and gyrB proved to be the best phylogenetic markers for differentiating these isolates from their neighbouring species. Useful phenotypic features for differentiating the novel species from other known Aeromonas species included their ability to hydrolyze elastin, produce acid from l-arabinose and salicin, and their inability to produce acid from lactose and use l-lactate as a sole carbon source. A polyphasic approach using phenotypic characterization, phylogenetic analysis of the 16S rRNA gene and of four housekeeping genes, as well as DNA-DNA hybridization studies and an analysis of the protein profiles by MALDI-TOF-MS, showed that these strains represented a novel species for which the name Aeromonas piscicola sp. nov. is proposed with isolate S1.2(T) (=CECT 7443(T), =LMG 24783(T)) as the type strain.
