Cavitary pneumonia in an AIDS patient caused by an unusual Bordetella bronchiseptica variant producing reduced amounts of pertactin and other major antigens
Cavitary pneumonia in an AIDS patient caused by an unusual Bordetella bronchiseptica variant producing reduced amounts of pertactin and other major antigens
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DOI：
10.1128/jcm.40.9.3146-3154.2002
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发表时间：
2002-09-01
影响因子：
9.4
通讯作者：
de Tejada, GM
中科院分区：
文献类型：
--
作者：
Lorenzo-Pajuelo, B;Villanueva, JL;de Tejada, GM
虽然支气管败血波氏杆菌可以感染和定植免疫功能低下的人，其作为肺炎和影响这些患者的其他呼吸过程的主要病原体的作用仍然存在争议。B致空洞性肺炎1例。本文报告了一例艾滋病患者的支气管败血症，并调查了该分离株（命名为814）致病潜力似乎增强的基础。B。支气管败血症是从痰、支气管肺泡灌洗液和通过受保护刷状导管采集的样品中回收的唯一微生物。不像以前的工作报告的参与B。在支气管败血症的肺炎病例中，基于体外抗菌活性选择的抗生素治疗导致感染的清除和肺浸润的消退。尽管分离株814产生的几种主要抗原（包括至少一种Bvg活化因子（perceptin））的量减少，但发现这种缺陷的分子基础与BvgAS无关，因为在分离株814的bvgAS基因座被野生型bvg4S等位基因取代后，缺陷仍持续存在。尽管其突出的表型，分离物814显示出在早期时间点其在免疫活性大鼠的呼吸道定殖的能力中仅存在适度但显著的缺陷。有趣的是，分离株814在这些动物中引发的抗体应答几乎检测不到。我们认为，分离株814在免疫功能低下的患者中可能更具毒性，至少部分是由于其产生少量免疫原性因子的先天能力，这些免疫原性因子可能仅在正常水平下才需要这种病原体与其免疫活性天然宿主的相互作用。
Although Bordetella bronchiseptica can infect and colonize immunocompromised humans, its role as a primary pathogen in pneumonia and other respiratory processes affecting those patients remains controversial. A case of cavitary pneumonia caused by B. bronchiseptica in an AIDS patient is presented, and the basis of the seemingly enhanced pathogenic potential of this isolate (designated 814) is Investigated. B. bronchiseptica was the only microorganism recovered from sputum, bronchoalveolar lavage fluid, and samples taken through the protected brush catheter. Unlike previous work reporting the involvement of B. bronchiseptica in cases of pneumonia, antibiotic treatment selected on the basis of in vitro antibacterial activity resulted in clearance of the infection and resolution of the pulmonary infiltrate. Although isolate 814 produced reduced amounts of several major antigens including at least one Bvg-activated factor (pertactin), the molecular basis of this deficiency was found to be BvgAS independent since the defect persisted after the bvgAS locus of isolate 814 was replaced with a wild-type bvg4S allele. Despite its prominent phenotype, isolate 814 displayed only a modest yet a significant deficiency in its ability to colonize the respiratory tracts of immunocompetent rats at an early time point. Interestingly, the antibody response elicited by isolate 814 in these animals was almost undetectable. We propose that isolate 814 may be more virulent in immunocompromised patients due, at least in part, to its innate ability to produce low amounts of immunogenic factors which may be required at only normal levels for the interaction of this pathogen with its immunocompetent natural hosts.