Am. J. Trop. Med. Hyg., 79(6), 2008, pp. 881-886
Copyright © 2008 by The American Society of Tropical Medicine and Hygiene
Identification of Aerobic Gut Bacteria from the Kala Azar Vector, Phlebotomus argentipes: A Platform for Potential Paratransgenic Manipulation of Sand Flies
Heidi Hillesland
,
Amber Read
,
Bobban Subhadra,
Ivy Hurwitz,
Robin McKelvey,
Kashinath Ghosh,
Pradeep Das, AND
Ravi Durvasula*
Department of Internal Medicine, University of New Mexico, Albuquerque, New Mexico; Walter Reed Army Institute of Research, Silver Spring, Maryland; Rajendra Memorial Research Institute of Medical Sciences, Patna, India
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ABSTRACT
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Visceral leishmaniasis is an understudied parasitic disease responsible for significant global morbidity and mortality. We are presently investigating a method of disease prevention termed paratransgenesis. In this approach, symbiotic or commensal bacteria are transformed to produce anti-Leishmania molecules. The transformed bacteria are delivered back to sand flies to inactivate the parasite within the vector itself. In this study, we identified 28 distinct gut microorganisms from Phlebotomus argentipes trapped from four visceral leishmaniasis–endemic sites in India. A significant percent of Staphylococcus spp., environmental bacteria, and Enterobacteriaceae were identified. Two non-pathogenic organisms, Bacillus megaterium and Brevibacterium linens, were also isolated. Both organisms are also used extensively in industry. Our results indicate that B. megaterium and B. linens are possible candidates for use in a model of paratransgenesis to prevent transmission of Leishmania.
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INTRODUCTION
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Leishmaniasis is a global health concern with an estimated 12 million people infected and 367 million at risk. This disease is caused by the protozoan kinetoplastid flagellate Leishmania donovani in India, L. infantum in Europe, and L. chagasi in South America. Natural transmission occurs through the bite of an infected sand fly of the genus Phlebotomus (Old World) or Lutzomyia (New World). Visceral leishmaniasis, also known as kala azar, is perhaps one of the most devastating forms of leishmaniasis. Two hundred fifty thousand cases are reported in India annually and, of those, 90% are from the state of Bihar. The leading vector for kala azar is the sand fly P. argentipes.
Despite the demonstrated public health importance, relatively little work has been directed at disrupting the transmission of Leishmania parasites by the insect vector. DDT spraying associated with the National Malaria Control Program in India in the 1960s was very successful in reducing sand fly populations, and cases of kala azar were nearly eliminated.1 However, recent studies show that certain populations are gaining insecticide resistance,2–4 resulting in growing concern about the efficacy, cost, and environmental toxicity of insecticide use. In many parts of India, return of peri-domestic populations of sand flies has been observed within 1 year of insecticide spraying.5 Recent surveys in Patna, India, further showed rates of DDT resistance among P. argentipes ranging from 60% to 100% (Das P and others, unpublished data). Difficulties in sustaining insecticide campaigns over a number of decades, the attendant risks of toxicity, the evolution of vector resistance, and the lack of effective vaccines to protect against kala azar necessitate the development of alternative methods to block transmission of L. donovani.
Our group has been developing a novel paratransgenic strategy to control vectorial transmission of certain infectious agents. In this strategy, commensal or symbiotic bacteria found at mucosal sites of transmission are isolated and genetically altered to elaborate molecules that kill the infectious agents. Transgenic bacteria are delivered back to insect vectors to block pathogen transmission. Our laboratory initially developed this "Trojan Horse" approach to combat transmission of the Chagas disease parasite, Trypanosoma cruzi, by a triatomine vector. In the Chagas disease vector, Rhodnius prolixus, the symbiotic bacterium, Rhodococcus rhodnii, was transformed to produce the anti-trypanosomal peptide cecropin A at levels capable of eliminating T. cruzi carriage by the bug.6 Subsequently, a paratransgenic system was developed to express a functional antibody in the triatomine bug.7 We have since applied this approach to commensal bacteria of the human respiratory tree8 and sharpshooter vectors of Pierces disease.9
For the paratransgenic approach to be successful in the sand fly, the identification of suitable extracellular commensal microorganisms within the vector is critical. Although relatively sparse, some literature exists on the gut microbiology of field-caught sand flies. Dillon and others10 evaluated gut microbes from P. papatasi caught in Egypt. Microbes isolated from these studies included E. coli, species of Pseudomonas, Enterobacter, Acinetobacter, Erwinia, and Propionibacterium in addition to unspeciated gram-negative cocci, gram-positive cocci, and gram-positive rods. Rajendran and Modi11 evaluated microorganisms from field-caught P. argentipes and Sergentomyia spp. from cattle sheds in India and from laboratory-reared P. papatasi. They reported isolation of E. coli, Bacillus spp., Staphylococcal spp., Micrococcus tetragenes, and yeast. Although these studies established presence of bacteria in the digestive tract of sand flies, they consistently yielded a variety of pathogenic bacterial species.
The paratransgenic approach would deploy commensal sand fly bacteria that are non-pathogenic to humans or animals. Such non-pathogenic bacteria would be transformed to deliver peptides with anti-leishmanial activity. One potential strategy for delivery of the transformed microbes is at sand fly breeding sites. These sites in India have been characterized previously and are found in association with cattle sheds that are often in close proximity to human dwellings.12
Here we report a microbiologic analysis of the gut flora of P. argentipes from four kala azar–endemic regions of Bihar state in India. We have identified several non-pathogenic commensal bacteria that could have potential use for paratransgenic manipulation of P. argentipes. Two of these, Bacillus megaterium and Brevibacterium linens, are extensively used in commercial applications in Bihar and could serve as delivery vehicles to block vectorial transmission of L. donovani.
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MATERIALS AND METHODS
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Sand fly collection.
Sand flies were collected from four different regions within the state of Bihar, India. The geographic locations of the sampling areas were Gaya (24.79 N, 85.01 E), Gulmehiya (25.37 N, 85.13 E), Bahapur (24.53 N, 85.07 E), and Mahnar (25.66 N, 85.44 E). CDC light traps were placed in cowsheds between the hours of 4:00 AM and 9:00 AM during the month of October. In each case, samples were located immediately adjacent to human dwellings. Sand flies were narcotized, removed from the traps, and sorted by species. Only P. argentipes were examined in this work. Insects from each locality were pooled in separate tubes and stored at –70°C until further use.
Isolation of commensal microbes.
Aerobic gut bacteria were isolated from each sand fly by one of the following two methods. In initial experiments, the gut from each sand fly was microdissected from the insect and homogenized in 100 µL of 0.1% peptone. A portion of this homogenate was plated onto brain heart infusion (BHI) plates. In subsequent experiments, each sand fly was surface sterilized for 30 seconds in ethanol, rinsed thoroughly in phosphated-buffer saline (PBS) and transferred to a 1.5-mL microcentrifuge tube. The insect was homogenized in 30 µL of BHI. An aliquot of this homogenate was plated onto BHI plates. BHI was chosen as a nonselective medium to promote growth of a diversity of microbes including nutritionally fastidious bacteria. Plates from both isolation methods were incubated at 28°C for up to 2 weeks. To assess microbial growth the total number of total colony-forming units (CFUs) was determined. The number of phenotypically different colonies was counted to determine the diversity of microbes in each sand fly. In a subset of samples, the number of phenotypically similar colonies was counted to assess the relative abundance of each microbial species per sand fly. Pure cultures for each microbe were obtained from these primary plates. All of the isolates were differentiated by gram staining and morphological shape.
Identification of microbes.
Genomic DNA was isolated from each of the pure cultures. 16S rDNA PCR amplifications were performed from these samples using the forward primer 5'-AGAGTTTGATGGCTCAG-3' and the reverse primer 5'-TACGGCTACCTTGTTACGACTT-3'. Thermal cycling reactions consisted of an initial denaturation (95°C, 2 minutes) followed by 35 cycles of denaturation (95°C, 15 seconds), annealing (65°C, 30 seconds), and extension (72°C, 60 seconds), with a single final extension (72°C, 2 minutes). To control for the presence of contaminating nucleic acids, water samples with no template DNA were run in parallel. The amplicons were purified from gels and sequenced using the BigDye Terminator V2.0 Ready Reaction Cycle Sequencing Kit (Applied Biosystems, Foster City, CA) using the PCR primers as described above as well as an internal sequence primer, 5'-GTGCCAGCCGCCGCGG-3'. Ambiguities were re-sequenced, and at least 98% percent of the complete double-stranded sequences were obtained. Sequences were aligned using the Sequencer 4.8 software (Gene Codes). Completely aligned sequences were compared with the BLAST database. Isolates were identified when their 16S rDNA sequences shared
97% homology with completed 16S rDNA sequences found in the GenBank database.
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RESULTS
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In this analysis, 109 P. argentipes were examined (Table 1
). Although 103 of these insects were collected from four kala azar–endemic regions in the state of Bihar, India, the other six sand flies were collected from laboratory colonies.
The total number of CFUs per sand fly ranged from 0 to < 20. As shown in Table 2
, the majority of the sand flies examined harbored microorganisms (59%). A significant number, however, did not harbor any organisms (41%). Among sand flies that harbored bacteria, polymicrobial cultures (38%) were more common than monocultures (21%). In one case, six different microbes were isolated from a single sand fly.
In cases of polymicrobial colonization, the relative abundance of each microbe was examined in 48 of the sand flies. This analysis is shown in Table 3
. Our results show that when present with other organisms, Staphylococcus spp., Escherichia coli, and Enterobacter spp. were generally found in greatest abundance. Bacillus spp. and Brevibacterium linens were usually found in least abundance.
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TABLE 3 Relative abundance of microbes isolated from a sample of sand flies when polymicrobial colonization was present
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We isolated > 100 different microbial colonies from the sand flies. These isolates were subsequently identified by 16S rDNA sequencing. A total of 28 distinct microorganisms were identified from the gut of P. argentipes. Microorganisms from each collection site are tabulated in Table 4
. Some overlap can clearly be seen between microbes isolated from the four different sites. Gram-negative Enterobacteriaceae such as E. cloacae and E. coli were isolated from sand flies collected from all four sampling sites, as were a number of soil organisms. Pathogenic staphylococci were isolated from three of four sites. Importantly, however, several non-pathogenic organisms, namely B. megaterium, B. linens, and related species, were also isolated from all four sites. It is also interesting to note that all the sand flies collected from the site in Bahapur harbored the same microbes, and seven of nine sand flies from the site in Mahnar carried Brevibacterium casei, suggesting a strong correlation between sand fly–microbial association and the environment in which they reside.
Table 5
classifies all the isolated bacteria into groups that are known to be pathogenic and non-pathogenic to humans. It is critical that a non-pathogenic organism be chosen for our proposed application of paratransgenesis.
Table 6
shows further regional differences and similarities. Enterobacteriaceae tended to be more prevalent in Gaya and Bahapur, whereas Bacillus megaterium was isolated most commonly from sand flies collected in Gulmehiya. Sand flies from Gaya had the most B. linens, whereas sand flies from Bahapur more commonly harbored other species of Brevibacterium. Table 6
looks specifically at B. linens and B. megaterium because of their lack of pathogenicity and potential application in future paratransgenesis work.
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DISCUSSION
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This study is the most comprehensive evaluation of the microbiology of P. argentipes to date. Our results showed that P. argentipes isolated from kala azar–endemic regions in Bihar harbor a variety of gut bacteria. The diversity of microbes would strongly suggest that the sand fly–microbial association reflects the environment in which these sand flies reside. For example, a number of the isolates identified in our work and by others showed that Enterobacteriaceae are prevalent in P. argentipes. Kesari and others12 identified sand fly breeding sites by cowsheds. Adult sand flies are also known to rest on the walls in the dark corners of cowsheds. It is therefore highly likely that these sand flies acquire Enterobacteriaceae from cow feces. There were a large number of soil and environmental bacteria isolated in this study, such as species of Acinetobacter, Gordonia, Microbacterium, Micrococcus, Stenotrophomonas, and Bacillus. The isolates showed regional variation. This suggests that the local soil and water environment plays an important role in colonization of the sand flies with regional bacteria encountered at breeding sites or during sugar meals.
Previous studies of sand fly gut microbiology yielded similar profiles of bacteria. Dillon and others10 showed that Enterobacteriaceae such as species of Enterobacter were isolated in greatest abundance from P. papatasi. We also found a significant percentage of Enterobacteriaceae (13%), although Staphylococcus spp. were found in greatest abundance (21%). It has been reported previously that species of Enterobacter are the most common bacteria isolated from the gut of insects.13 E. coli, Bacillus spp., Micrococcus spp., and coagulase-negative Staphylococcus spp. were previously reported by Rajendran and Modi.11 These organisms were also isolated in our study.
It was additionally evident that a high percentage of sand flies did not harbor bacteria. This finding was similar to previous reports,10 suggesting that our sterilization and homogenization technique was adequate. Sand flies do not have known symbiotic bacterial associations. It is therefore not surprising that the sand flies are variably colonized with bacteria. In addition, it is likely that colonization rates under field conditions are greater than reported because bacteria were not cultivated in anaerobic conditions, and certain environmental bacteria will not grow on any media and may not be identified.
We identified a number of bacterial pathogens and potential pathogens in our study. We embarked on this microbiologic survey to identify bacteria that might be used in future work with paratransgenesis in an effort to block vectorial transmission of L. donovani. Although species such as Enterobacter cloacae have been used as shuttle systems to deliver, express, and spread foreign genes in termite colonies,14 it is important that pathogenic bacteria not be used in our work. As part of the paratransgenic approach, it will be necessary to deliver transformed bacteria to the sand flies to allow for sand fly colonization. There is a close association of humans and sand flies in domestic and peri-domestic areas, necessitating the use of non-pathogenic bacteria for future work. Importantly, the extensive nature of this study allowed for identification of a number of non-pathogenic bacteria that could be used as transformants in a paratransgenic approach.
Two bacteria isolated were of particular relevance: B. megaterium and B. linens. Although the association rates of these organisms with the sand flies are low, it should be noted that both organisms are extensively used in biotechnological operations for the production of various compounds and are known to be safe. B. megaterium is marketed as a crude bio-fertilizer and used extensively in many regions of Bihar. Recent studies have shown that B. megaterium has the ability to promote growth and reduce disease in different Indian cultivable plants.15 In addition, both B. linens and B. megaterium have been reported to have a probiotic effect on many animals.16,17 B. linens is one of the main bacteria used in industrial cheese ripening. Some of the sand flies from our collection were from areas with intimate household dairy operations like milk curdling, cheese, and ghee preparation. Methanethiol and isovaleric acid, produced by B. linens, are very strong insect attractants and have been shown to raise the number of mosquitoes and other insects in olfactometer traps by two to three times.18,19 This may be useful in encouraging colonization of sand flies with transformed B. linens in a paratransgenic application.
Transformed B. megaterium and B. linens would be deployed in large concentrations in sand fly breeding sites to selectively colonize the vectors. By increasing the concentration of these bacteria in the soil, we hope to increase the degree of colonization of sand flies despite the low natural rates of colonization seen in our study. Many of the sand flies in the study were colonized with multiple bacteria. Our ongoing studies involve transforming at least two species of bacteria to potentially improve colonization rates of transformants in the sand flies.
Because B. megaterium and B. linens currently play an integral role in agriculture in Bihar, it is conceivable that transformed B. megaterium and B. linens can additionally be spread through a combination of various operations related to agriculture. The marketing of transformed B. megaterium as a bio-fertilizer formula through the proper regulation from Indian health and agricultural departments may be a viable method of spreading transformed bacteria in this endemic region. Furthermore, because most of the sand fly breeding grounds are in close proximity to cattle and dairy operations, another approach could involve release of transformed B. linens as a probiotic for cattle feed. We hope to overcome low percentage rates of colonization and variability of bacterial colonization by using several delivery methods to effectively colonize sand flies with transformed bacteria.
The presence of B. linens and B. megaterium therefore opens a new avenue for vector control of kala azar. Transformation of these species of bacteria to express L. donovani–blocking molecules and the transient expression of these molecules at the critical parasite developmental period in the sand fly vector could potentially serve as an effective platform for paratransgenic control of L. donovani transmission. A large number of anti-leishmania molecules are available, such as histatin 5, racemoside A, monoclonal antibodies, and temporins.20–26 For paratransgenesis, the molecule must be selectively toxic to the amastigotes and promastigotes and pose no environmental threat. Additionally, the molecule must not inhibit growth of the bacteria that express it.
We have recently transformed B. megaterium to express a marker single-chain antibody. Studies are currently underway to track the persistence of this genetically modified microbe through the developmental stages of P. argentipes (unpublished data; data not shown). To date, little is known about transtadial passage of bacteria in sand flies Volf and others27 suggested that there is colonization that persists through the larval stages to the emergent adult sand fly. This would allow for delivery of transformed bacteria in large numbers to the breeding sites to encourage selective colonization of the various developmental stages of the sand fly with resultant colonization of the adult emergent sand fly before ingestion of a blood meal.
This study provided the most extensive survey of sand fly gut microbes to date. Colonization trends were similar to those previously reported in sand flies. This study additionally allowed for broader identification of microbes including non-pathogenic species. Two bacterial species identified, B. megaterium and B. linens, are ideal targets that could be used toward paratransgenic control of Indian leishmaniasis. Leishmaniasis causes significant mortality and is an understudied disease. Our work is ongoing, and we are hopeful that the data presented here will serve as an effective platform for future efforts to prevent leishmaniasis.
Received May 29, 2008.
Accepted for publication August 27, 2008.
* Address correspondence to Ravi Durvasula, Department of Internal Medicine, University of New Mexico, Albuquerque, NM 87131. E-mail: ravi.durvasula{at}va.gov 
These authors contributed equally to this manuscript. 
Authors addresses: Heidi Hillesland, Amber Read, Bobban Subhadra, Ivy Hurwitz, Robin McKelvey, and Ravi Durvasula, Department of Internal Medicine, University of New Mexico, Albuquerque, NM 87131. Kashinath Ghosh, Walter Reed Army Institute of Research, Silver Spring, MD 20910. Pradeep Das, Rajendra Memorial Research Institute of Medical Sciences, Patna, India 800007.
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REFERENCES
|
- Thakur CP, Kumar K, 1992. Post kala-azar dermal leishmaniasis: a neglected aspect of kala-azar control programmes. Ann Trop Med Parasitol 86: 355–359.[Medline]
- Dhiman RC, Raghavendra K, Kumar V, Kesari S, Kishore K, 2003. Susceptibility status of Phlebotomus argentipes to insecticides in districts Vaishaii and Patna (Bihar). J Commun Dis 35: 49–51.[Medline]
- Kishore K, Kumar V, Kesari S, Bhattacharya SK, Das P, 2004. Susceptibility of Phlebotomus argentipes against DDT in endemic districts of North Bihar, India. J Commun Dis 36: 41–44.[Medline]
- Singh R, Das RK, Sharma SK, 2001. Resistance of sandflies to DDT in kala-azar endemic districts of Bihar, India. Bull World Health Organ 79: 793.[Medline]
- Mukhopadhyay AK, Hati AK, Chakraborty S, Saxena NB, 1996. Effect of DDT on Phlebotomus sandflies in kala-azar endemic foci in West Bengal. J Commun Dis 28: 171–175.[Medline]
- Durvasula RV, Gumbs A, Panackal A, Kruglov O, Aksoy S, Merrifield RB, Richards FF, Beard CB, 1997. Prevention of insect-borne disease: an approach using transgenic symbiotic bacteria. Proc Natl Acad Sci USA 94: 3274–3278.[Abstract/Free Full Text]
- Durvasula RV, Gumbs A, Panackal A, Kruglov O, Taneja J, Kang AS, Cordon-Rosales C, Richards FF, Whitham RG, Beard CB, 1999. Expression of a functional antibody fragment in the gut of Rhodnius prolixus via transgenic bacterial symbiont Rhodococcus rhodnii. Med Vet Entomol 13: 115–119.[Medline]
- Sundaram RK, Hurwitz I, Matthews S, Hoy E, Kurapati S, Crawford C, Sundaram P, Durvasula RV, 2008. Expression of a functional single chain antibody in Corynebacterium pseudo-diphtheriticum. Eur J Clin Microbiol Infect Dis 27: 617–622.[Medline]
- Bextine B, Lauzon C, Potter S, Lampe D, Miller TA, 2004. Delivery of a genetically marked Alcaligenes sp. to the glassy-winged sharpshooter for use in a paratransgenic control strategy. Curr Microbiol 48: 327–331.[Web of Science][Medline]
- Dillion RJ, El Kordy E, Lane RP, 1996. The prevalence of a microbiota in the digestive tract of Phlebotomus papatasi. Ann Trop Med Parasitol 90: 669–673.[Medline]
- Rajendran P, Modi GB, 1982. Bacterial flora of sandfly gut (Diptera: Psychodidae). Indian J Public Health 26: 49–52.[Medline]
- Kesari S, Kishore K, Palit A, Kumar V, Roy MS, Sivakumar S, Kar SK, 2000. An entomological field evaluation of larval biology of sandfly in kala-azar endemic focus of Bihar—exploration of larval control tool. J Commun Dis 32: 284–288.[Medline]
- Tanada Y, Kaya HK, 1993. Insect Pathology. San Diego: Academic Press, 12–51.
- Husseneder C, Grace JK, 2005. Genetically engineered termite gut bacteria (Enterobacter cloacae) deliver and spread foreign genes in termite colonies. Appl Microbiol Biotechnol 68: 360–367.[Medline]
- Chakraborty U, Chakraborty B, Basnet M, 2006. Plant growth promotion and induction of resistance in Camellia sinensis by Bacillus megaterium. J Basic Microbiol 46: 186–195.[Medline]
- Marshall-Jones ZV, Baillon ML, Croft JM, Butterwick RF, 2006. Effects of Lactobacillus acidophilus DSM13241 as a probiotic in healthy adult cats. Am J Vet Res 67: 1005–1012.[Medline]
- Otero MC, Morelli L, Nader-Macias ME, 2006. Probiotic properties of vaginal lactic acid bacteria to prevent metritis in cattle. Lett Appl Microbiol 43: 91–97.[Medline]
- Braks MA, Anderson RA, Knols BG, 1999. Infochemicals in mosquito host selection: human skin microflora and Plasmodium parasites. Parasitol Today 15: 409–413.[Web of Science][Medline]
- Meijerink J, van Loon JJ, 1999. Sensitivities of antennal olfactory neurons of the malaria mosquito, Anopheles gambiae, to carboxylic acids. J Insect Physiol 45: 365–373.[Web of Science][Medline]
- Anjili C, Langat B, Ngumbi P, Mbati PA, Githure J, Tonui WK, 2006. Effects of anti-Leishmania monoclonal antibodies on the development of Leishmania major in Phlebotomus duboscqi (Diptera: Psychodidae). East Afr Med J 83: 72–78.[Medline]
- Castro-Pinto DB, Lima EL, Cunha AS, Genestra M, De Leo RM, Monteiro F, Leon LL, 2007. Leishmania amazonensis trypanothione reductase: evaluation of the effect of glutathione analogs on parasite growth, infectivity and enzyme activity. J Enzyme Inhib Med Chem 22: 71–75.[Medline]
- Dutta A, Ghoshal A, Mandal D, Mondal NB, Banerjee S, Sahu NP, Mandal C, 2007. Racemoside A, an anti-leishmanial, water-soluble, natural steroidal saponin, induces programmed cell death in Leishmania donovani. J Med Microbiol 56: 1196– 1204.[Abstract/Free Full Text]
- Luque-Ortega JR, vant Hof W, Veerman EC, Saugar JM, Rivas L, 2008. Human antimicrobial peptide histatin 5 is a cell-penetrating peptide targeting mitochondrial ATP synthesis in Leishmania. FASEB J 22: 1817–1828.[Abstract/Free Full Text]
- Mangoni ML, Saugar JM, Dellisanti M, Barra D, Simmaco M, Rivas L, 2005. Temporins, small antimicrobial peptides with leishmanicidal activity. J Biol Chem 280: 984–990.[Abstract/Free Full Text]
- Sarkar A, Sen R, Saha P, Ganguly S, Mandal G, Chatterjee M, 2008. An ethanolic extract of leaves of Piper betle (Paan) Linn mediates its antileishmanial activity via apoptosis. Parasitol Res 102: 1249–1255.[Medline]
- Sen R, Bandyopadhyay S, Dutta A, Mandal G, Ganguly S, Saha P, Chatterjee M, 2007. Artemisinin triggers induction of cell-cycle arrest and apoptosis in Leishmania donovani promastigotes. J Med Microbiol 56: 1213–1218.[Abstract/Free Full Text]
- Volf P, Kiewegova A, Nemec A, 2002. Bacterial colonisation in the gut of Phlebotomus duboseqi (Diptera: Psychodidae): transtadial passage and the role of female diet. Folia Parasitol (Praha) 49: 73–77.
- Ozkocaman V, Ozcelik T, Ali R, Ozkalemkas F, Ozkan A, Ozakin C, Akalin H, Ursavas A, Coskun F, Ener B, Tunali A, 2006. Bacillus spp. among hospitalized patients with haematological malignancies: clinical features, epidemics and outcomes. J Hosp Infect 64: 169–176.[Medline]
- Haymore BR, Akers KS, Ferguson TM, 2006. A case of persistent Bacillus pumilis bacteremia associated with cholangitis. J Infect 52: 154–155.
- Matsumoto S, Suenaga H, Naito K, Sawazaki M, Hiramatsu T, Agata N, 2000. Management of suspected nosocomial infection: an audit of 19 hospitalized patients with septicemia caused by Bacillus species. Jpn J Infect Dis 53: 196–202.[Medline]
- Oggioni MR, Pozzi G, Valensin PE, Galieni P, Bigazzi C, 1998. Recurrent septicemia in an immunocompromised patient due to probiotic strains of Bacillus subtilis. J Clin Microbiol 36: 325–326.[Free Full Text]
- Richard V, Van der Auwera P, Snoeck R, Daneau D, Meunier F, 1988. Nosocomial bacteremia caused by Bacillus species. Eur J Clin Microbiol Infect Dis 7: 783–785.[Web of Science][Medline]
- Wallet F, Crunelle V, Roussel-Delvallez M, Fruchart A, Saunier P, Courcol RJ, 1996. Bacillus subtilis as a cause of cholangitis in polycystic kidney and liver disease. Am J Gastroenterol 91: 1477–1478.[Medline]
- Brazzola P, Zbinden R, Rudin C, Schaad UB, Heininger U, 2000. Brevibacterium casei sepsis in an 18-year-old female with AIDS. J Clin Microbiol 38: 3513–3514.[Abstract/Free Full Text]
- Cannon JP, Spandoni SL, Pesh-Iman S, Johnson S, 2005. Peri-cardial infection caused by Brevibacterium casei. Clin Microbiol Infect 11: 164–165.[Medline]
- Gruner E, Steigerwalt AG, Hollis DG, Weyant RS, Weaver RE, Moss CW, Daneshvar M, Brown JM, Brenner DJ, 1994. Human infections caused by Brevibacterium casei, formerly CDC groups B-1 and B-3. J Clin Microbiol 32: 1511–1518.[Abstract/Free Full Text]
- Antoniou S, Dimitriadis A, Polydorou F, Malaka E, 1997. Brevi-bacterium iodinum peritonitis associated with acute urticaria in a CAPD patient. Perit Dial Int 17: 614–615.[Free Full Text]
- Brown JM, Frazier RP, Morey RE, Steigerwalt AG, Pellegrini GJ, Daneshvar MI, Hollis DG, McNeil MM, 2005. Phenotypic and genetic characterization of clinical isolates of CDC coryneform group A-3: proposal of a new species of Cellulomonas, Cellulomonas denverensis sp. nov. J Clin Microbiol 43: 1732– 1737.[Abstract/Free Full Text]
- Gil-Sande E, Brun-Otero M, Campo-Cerecedo F, Esteban E, Aguilar L, Garcia-de-Lomas J, 2006. Etiological misidentification by routine biochemical tests of bacteremia caused by Gordonia terrae infection in the course of an episode of acute cholecystitis. J Clin Microbiol 44: 2645–2647.[Abstract/Free Full Text]
- Pham AS, De I, Rolston KV, Tarrand JJ, Han XY, 2003. Catheter-related bacteremia caused by the nocardioform actinomycete Gordonia terrae. Clin Infect Dis 36: 524–527.[Medline]
- Zardawi IM, Jones F, Clark DA, Holland J, 2004. Gordonia terrae-induced suppurative granulomatous mastitis following nipple piercing. Pathology 36: 275–278.[Medline]
- Lau SK, Woo PC, Woo GK, Yuen KY, 2002. Catheter-related Microbacterium bacteremia identified by 16S rRNA gene sequencing. J Clin Microbiol 40: 2681–2685.[Abstract/Free Full Text]
- Alvarez Posadilla M, Linares Torres P, Bailador Andres C, Suarez Alvarez P, Olcoz Goni JL, 2006. Bacteriemia caused by Staphylococcus cohnii associated with acute cholecystitis. Med Interna 23: 51–52.
- Ene N, Serratrice J, Ben Amri A, Jouve JL, Drancourt M, Weiller PJ, 2008. Prolonged inflammatory syndrome revealing asymptomatic Staphylococcus cohnii infection of spinal fixation material. Joint Bone Spine 75: 98–99.
- Yamashita S, Yonemura K, Sugimoto R, Tokunaga M, Uchino M, 2005. Staphylococcus cohnii as a cause of multiple brain abscesses in Weber-Christian disease. J Neurol Sci 238: 97–100.[Medline]