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Scientists have discovered several biomarkers capable of pinpointing what could be the next superbug-hypervirulent Klebsiella pneumoniae .
The pathogen infects completely healthy people and can cause blindness in one day, brain abscesses and death in a matter of days. In addition, it is also resistant to all antibiotics.
Up to now, there was no precise method for distinguishing the hypervirulent strain from the clbadic strain of K. pneumoniae that occurs most often in the US. Western Hemisphere, is less virulent and generally causes hospital-based infections.
"At the present time, no commercial test makes it possible to distinguish precisely the clbadical and hypervirulent strains. Russo, professor of medicine at the Jacobs School of Medicine and Biomedical Sciences at the University of Buffalo. "This research provides a clear roadmap as to how a company can develop such a test for use in clinical laboratories."
"A bug that is both hypervirulent and difficult to treat is a bad combination."
In addition, a definitive diagnostic test would not only optimize patient care, but would also allow researchers to perform epidemiological surveillance. "Russo says that the hypervirulent strain causes an infection and that it can not be used. it frequently acquires antimicrobial resistance,
Although it is badumed that the pathogen spreads from one person to another through food and water, the mode of transmission is unknown K. pneumoniae can be fatal, says Russo, but the clbadical strain is more likely to infect patients with underlying disease, or who are immunod winning and hospitalized.
In contrast, the hypervirulent strain can infect healthy young people, causing sudden, life-threatening complications ranging from liver or brain abscesses to carnivorous infections. Although it is currently less likely to be resistant to antibiotics, these strains continue to evolve. Traditional strains are more likely to be resistant to antimicrobials.
"What is more and more worrisome is the growing number of reports that describe the hypervirulent strains K. pneumoniae that are resistant to antimicrobials," Russo explains. "A hypervirulent, difficult-to-treat abnormality is a bad combination."
An antimicrobial-resistant hypervirulent strain can develop in two ways, he says: either by acquiring antimicrobial resistance genes or by resisting antimicrobials. "This last mechanism has caused the death of five patients in the intensive care unit of a hospital in Hangzhou, China, which was reported early in the year," says Russo
]. There is no test to detect the hypervirulent strain, it is difficult, if not impossible, to diagnose it correctly, say the researchers.
The so-called string test, currently used in some cases to distinguish between clbadical and hypervirulent strains, is not systematic accurate, according to the research. This is particularly problematic, says Russo, in North America and Europe, where the prevalence of the hypervirulent strain is low.
"Many clinicians do not know the hypervirulent strain," he adds. "And because there is no diagnostic test, the clinical laboratory can not give them a head."
Russo and his coauthors knew that the hypervirulence of K. pneumoniae is mainly due to genes located on a large virulence plasmid, a DNA independent of the chromosome. They hypothesized that some of these genes, including those producing iron acquisition molecules called siderophores, could be good biomarkers. This has turned out to be the case.
They also found that higher concentrations of siderophores predicted hypervirulence. They then validated the biomarkers identified in a mouse infection model.
"The advantage of identifying these genetic biomarkers is that they can be developed in rapid nucleic acid tests, and if they are approved by the Food and Drug Administration. , An accurate method to quickly determine if a patient is suffering from an infection due to the clbadical or hypervirulent strain, "says Russo.
Such a test will not only be beneficial to patients and may save lives , he says, find out more about hypervirulent K. pneumoniae .
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"For example, we do not know the frequency of Hypervirulent infection K. pneumoniae in different parts of the world, "he says. "We know that it infects all ethnic groups, but so far it has been described most often among Asians, especially in the Asian Pacific countries."
"Is this because that hypervirulent K. pneumoniae is more commonly acquired in this part of the world but does not necessarily entail an infection, or because some Asian populations are, for one reason or another, more susceptible to this infection? Now we can begin to study this kind of epidemiological issues. "
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The results appear in the Journal of Clinical Microbiology .
Other co-authors come from the & 90 90 [["""""1965196519651965196519651965196519651965196519651965196519651965UniversityofBuffaloMcGillUniversitytheUniversityofIowatheNationalTaiwanUniversityOxfordUniversitytheRoswellParkCancerInstitutetheUniversityofUniversityofTexasSouthwesternMedicalCenterandtheUniversityofMinnesota
. Department of Veterans Affairs, Oxford University / Public Health England, and Centers for Control and Prevention Diseases Have Funded Work
Source: University of Buffalo
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