Brachyspira Explained

Brachyspira is a genus of bacteria classified within the phylum Spirochaetota.[1] [2] [3]

Brachyspira species include pathogens in pigs, birds, dogs, and humans.

B. pilosicoli colonizes millions of humans worldwide, leading to human intestinal spirochaetosis, a chronic, intermittent watery diarrhea vastly underdiagnosed [4] because of the lack of a simple diagnostic tool for clinicians. Multiplex qPCRs are promising diagnostic tools, as Brachyspira do not grow on conventional media.[5] B. pilosicoli also cause avian spirochetosis:[1] birds might be considered as the natural reservoir.

B. hyodysenteriae leads to diarrheal disease in growing pigs worldwide, causing the so-called swine dysentery, typhlocolitis or porcine intestinal spirochaetosis, which contributes to major "production losses" in agrobusiness.

Some species like B. innocens or B. intermedia seem to be less virulent.

Phylogeny

The currently accepted taxonomy is based on the List of Prokaryotic names with Standing in Nomenclature (LPSN)[6] and National Center for Biotechnology Information (NCBI).[7]

Species incertae sedis:

Pathogenesis of human intestinal spirochetosis (HIS)

Brachyspira bacteria have evolved a parasitic lifestyle through genomic reduction (~2.5 to 3.3 Mb) [15] compared to other gram negative bacteria (~5 Mb).

Humans become infected through dirty water ingestion, possibly by swimming in waters containing the bacteria or by direct oral exposure to contaminated feces (outdoor tribes, raw egg eaters, slum inhabitants with no sanitation, MSM).

Genome homologies between Borellia, Treponema and Brachyspira imply that Brachyspira is expected to:

Once attached apically to the enterocyte, hidden to the natural and acquired immunity by the mucous layer and occupying a niche that other bacteria cannot use, Brachyspira most likely expresses at its apex porins https://www.ncbi.nlm.nih.gov/pubmed/8955283 allowing it to import from the colonocyte's cytoplasm the amino acids and nucleic acids necessary to replicate.

It has also been demonstrated that Brachyspira creates an environment which is favorable to its locomotion by upregulating mucin expression:[21] it creates its own niche.

Clinical manifestations in human medicine

Publications now tend to point out that Brachyspira colonization should not be considered harmless commensalism:

Antibiotic treatment and resistances in human medicine

Treatment with 10 days co-amoxicilline 1g bid + metronidazole 500 tid seems to have very good results on abdominal symptoms.[27] It is advised to administer Saccharomyces boulardii once a day during this course of antibiotherapy.[28]

Doxycycline resistance has been documented and should be avoided.

Antibiotic treatment and resistance in veterinary medicine

Veterinary antibiotics used to treat pigs with dysentery due to Brachyspira species include the lincosamide lincomycin, the ionophore salinomycin, the quinoxaline carbadox, the pleuromodulins tiamulin and valnemulin, as well as the aminoglycoside gentamicin, an important antibiotic used in humans.

Brachyspira resistance to the above antibiotics has been increasingly reported. While no Clinical and Laboratory Standards Institute (CLSI) antimicrobial breakpoints for Brachyspira have been established, resistance to the pleuromodulins tiamulin and valnemulin is considered at MIC ≥ 2 μg/ml.[29] Resistance to pleuromodulins is important, because they are antibiotics of "last resort"; as of 2001, they were the only antibiotics with sufficient minimum inhibitory concentration (MIC) values left to treat swine dysentery in Sweden, per the National Veterinary Institute in Uppsala.[30]

Antibiotic resistance varies by geographic region and is not developing as rapidly in U.S. isolates as has been seen in isolates from other countries.[31] Tiamulin resistance was first described in 1996 in Hungary,[32] and subsequently reported from other countries in Europe and Asia,.[33] [34] [35] [36] [37] [38] In Spain, 7.4% of Brachyspira isolates were reported to be venamulin-resistant and 17.6% were tiamulin-resistant in 2009.[39] In Sweden, 10-15% of B. pilosicoli isolates between 2002 and 2010 were resistant to tiamulin (MICs >4 μg/ml), and a gradual increase in tiamulin MICs was seen in B. hyodysenteriae between 1990 and 2003, which has since plateaued.[40]

Decreased susceptibility to lincomycin, but not to tiamulin was found among Polish isolates.[41]

In the US, resistance of Brachyspira species collected 2008–2010 was common only against lincomycin (80% had MIC of 32 or 64), MIC's were moderately high against gentamicin, while resistance to valnemulin(4.7%) and tiamulin (3.2% of isolates) was yet uncommon, as reported in the only U.S. study to date, from Iowa.

The use of pleuromodulins in U.S. food animals is not separately reported in the U.S. Food and Drug Administration's annual Animal Drug User Fee Act (ADUFA) report, "Antimicrobials Sold or Distributed for Use in Food-Producing Animals".[42] However, the amount of 190 tonnes of lincosamides used is substantial per ADUFA; antibiotics used in the U.S. in food animals in 2011 was: Ionophores 4,123,259 kg, aminoglycosides 214,895 kg, and Lincosamides 190,101 kg.

Microbiologic identification

Brachyspira are capable of hemolysis, the degree of which has been used to characterize them, with B. hyodysenteriae showing strong beta hemolysis while B. pilosicoli, B. intermedia, B. murdochii, and B. innocens have been described as weakly hemolytic.[43] However, in a recent study from Iowa State University, all (10/10) B. intermedia isolates, 91% (9/11) of Brachyspira spp. isolates, and 20% (2/6) of B. pilosicoli isolates from farms in North Carolina (36), Iowa (23), Minnesota (9), Nebraska (3), Michigan (2), Illinois (2), Missouri (1), North Dakota (1), South Dakota (1), and Ohio (1), demonstrated strong beta-hemolysis.

Recently quantitative PCR seems to be a more sensitive way to identify Brachyspira, which is globally a very fastidious bacterium to grow.

Change in ecology

In the U.S.A. Brachyspira-associated pig disease and isolation of Brachyspira species from swine with diarrheal disease largely disappeared from swine herds in the late 1990s and early 2000s, but returned in the mid-2000s for unknown reasons.

A 2011 study of isolates from Midwestern swine herds described major changes in Brachyspira spp frequency and hemolysis, i.e. pathogenicity: the majority of isolated Brachyspira species were previously considered minimally pathogenic or commensal, like Brachyspira murdochi (27%)or novel/unclassifiable Brachyspira species (25%), while only 40.5% of 79 isolates from diseased pigs could be confirmed as the classic pathogens B. hyodysenteriae or Brachyspira pilosicoli by PCR.[44] Brachyspira species previously capable of weak hemolysis only, like B. intermedia and B. pilosicoli were found to produce strong hemolysis. They were also frequently identified from diseased swine which suggests they are emerging pathogens.

A compelling explanation for this change in epidemiology and ecology is selection by the increasing use of antibiotics in pigs (e.g. as growth promoters), since B. murdochii and unclassifiable Brachyspira spp. are less susceptible to antimicrobials than the previously established Brachyspira pathogens.

See also

Notes and References

  1. Brachyspira pilosicoli-induced avian intestinal spirochaetosis. Caroline I.. Le Roy. Luke J.. Mappley. Roberto M.. La Ragione. Martin J.. Woodward. Sandrine P.. Claus. 5 March 2019. Microbial Ecology in Health and Disease. 26. 28853. 10.3402/mehd.v26.28853. 26679774. 4683989.
  2. See the List of Prokaryotic names with Standing in Nomenclature. Data extracted from Web site: J.P. Euzéby . Spirochaetes . 2011-11-17 . dead . https://web.archive.org/web/20110613224152/http://www.bacterio.cict.fr/classifphyla.html#Negativicutes . 2011-06-13 .
  3. See the NCBI webpage on Spirochaetes Data extracted from Web site: Sayers. NCBI Taxonomy Browser . . 2011-06-05 . etal.
  4. The Spirochete Brachyspira pilosicoli, Enteric Pathogen of Animals and Humans. David J.. Hampson. Clinical Microbiology Reviews. 31. 1. 10.1128/CMR.00087-17. 29187397. 5740978. 2017.
  5. A novel multiplex qPCR targeting 23S rDNA for diagnosis of swine dysentery and porcine intestinal spirochaetosis. Anna. Borgström. Simone. Scherrer. Constanze. Kirchgässner. Sarah. Schmitt. Daniel. Frei. Max M.. Wittenbrink. 7 February 2017. BMC Veterinary Research. 13. 1. 42. 10.1186/s12917-016-0939-6. 28173799. 5297149 . free .
  6. Web site: Brachyspira. J.P. Euzéby. List of Prokaryotic names with Standing in Nomenclature (LPSN). 2016-03-30.
  7. Web site: Brachyspira. Sayers. National Center for Biotechnology Information (NCBI) taxonomy database. 2016-03-30. etal.
  8. Web site: The LTP . 20 November 2023.
  9. Web site: LTP_all tree in newick format. 20 November 2023.
  10. Web site: LTP_08_2023 Release Notes. 20 November 2023.
  11. Web site: GTDB release 08-RS214 . Genome Taxonomy Database. 10 May 2023.
  12. Web site: bac120_r214.sp_label . Genome Taxonomy Database. 10 May 2023.
  13. Web site: Taxon History . Genome Taxonomy Database. 10 May 2023.
  14. Westerman, L. J. . PhD thesis . 2013 . Human Intestinal Spirochaetosis .
  15. 28879525. 2018. Hampson. D. J.. Colonic Spirochetes: What Has Genomics Taught Us?. Current Topics in Microbiology and Immunology. 415. 273–294. Wang. P.. 10.1007/82_2017_48. 978-3-319-89637-3.
  16. Attraction of Brachyspira pilosicoli to mucin. Ram. Naresh. David J.. Hampson. 1 January 2010. Microbiology. 156. Pt 1. 191–197. 10.1099/mic.0.030262-0. 19833772. free.
  17. Web site: Brachyspira swimming in a highly viscous liquid - YouTube . .
  18. Web site: FIG. 1. Transmission electron microscopic view of sectioned rectal.... ResearchGate. 5 March 2019.
  19. Salo. Jemiina. Jaatinen. Annukka. Söderström. Mirva. Viljanen. Matti K.. Hytönen. Jukka. 2015. Decorin binding proteins of Borrelia burgdorferi promote arthritis development and joint specific post-treatment DNA persistence in mice. PLOS ONE. 10. 3. e0121512. 10.1371/journal.pone.0121512. 1932-6203. 4376631. 25816291. 2015PLoSO..1021512S. free.
  20. Middelveen. Marianne J.. Burke. Jennie. Sapi. Eva. Bandoski. Cheryl. Filush. Katherine R.. Wang. Yean. Franco. Agustin. Timmaraju. Arun. Schlinger. Hilary A.. Mayne. Peter J.. Stricker. Raphael B.. 2014. Culture and identification of Borrelia spirochetes in human vaginal and seminal secretions. F1000Research. 3. 309. 10.12688/f1000research.5778.3. 2046-1402. 5482345. 28690828 . free .
  21. Immunohistochemical study of mucins in human intestinal spirochetosis. Sho. Ogata. Ken. Shimizu. Susumu. Tominaga. Kuniaki. Nakanishi. Human Pathology. 62. 126–133. 10.1016/j.humpath.2017.01.013. 28188751. 2017.
  22. Human intestinal spirochetosis--a review. Efstathia. Tsinganou. Jan-Olaf. Gebbers. 7 January 2010. GMS German Medical Science . 8. Doc01. 10.3205/000090. 20200654. 2830567.
  23. Colonic spirochetosis is associated with colonic eosinophilia and irritable bowel syndrome in a general population in Sweden. Marjorie M.. Walker. Nicholas J.. Talley. Linn. Inganäs. Lars. Engstrand. Michael P.. Jones. Henry. Nyhlin. Lars. Agréus. Lars. Kjellstrom. Åke. Öst. Anna. Andreasson. 1 February 2015. Human Pathology. 46. 2. 277–283. 10.1016/j.humpath.2014.10.026. 25540866.
  24. Intestinal spirochaetosis mimicking acute appendicitis with review of the literature. Jason. Gan. Catherine. Bryant. Dhili. Arul. Chetan. Parmar. 4 November 2017. BMJ Case Reports. 2017. bcr–2017–221574. 10.1136/bcr-2017-221574. 29103010. 5747739.
  25. Human intestinal spirochetosis mimicking ulcerative colitis. Shin. Nishii. Masaaki. Higashiyama. Sho. Ogata. Shunsuke. Komoto. Suguru. Ito. Akinori. Mizoguchi. Hisato. Terada. Hirotaka. Furuhashi. Takeshi. Takajo. Kazuhiko. Shirakabe. Chikako. Watanabe. Kengo. Tomita. Shigeaki. Nagao. Soichiro. Miura. Ryota. Hokari. 4673959. 1 April 2018. Clinical Journal of Gastroenterology. 11. 2. 145–149. 10.1007/s12328-017-0807-3. 29204849.
  26. Brachyspira pilosicoli bloodstream infections: case report and review of the literature. Lilia. Bait-Merabet. Arnaud. Thille. Patrick. Legrand. Christian. Brun-Buisson. Vincent. Cattoir. 25 September 2008. Annals of Clinical Microbiology and Antimicrobials. 7. 19. 10.1186/1476-0711-7-19. 18817558. 2561035 . free .
  27. Intestinal Spirochetosis mimicking inflammatory bowel disease in children. Rossana. Helbling. Maria-Chiara. Osterheld. Bernard. Vaudaux. Katia. Jaton. Andreas. Nydegger. 16 October 2012. BMC Pediatrics. 12. 163. 10.1186/1471-2431-12-163. 23066991. 3480841 . free .
  28. Efficacy and safety of the probiotic Saccharomyces boulardii for the prevention and therapy of gastrointestinal disorders. Theodoros. Kelesidis. Charalabos. Pothoulakis. 1 March 2012. Therapeutic Advances in Gastroenterology. 5. 2. 111–125. 10.1177/1756283X11428502. 22423260. 3296087.
  29. Karlsson M,Fellström C, Johansson KE,Franklin A. Antimicrobial resistance in Brachyspira pilosicoli with special reference to point mutations in the 23S rRNA gene associated with macrolide and lincosamide resistance. Microb Drug Resist 2004. 10:204–208
  30. Karlsson M, Gunnarsson A, Franklin A. Susceptibility to pleuromutilins in Brachyspira (Serpulina) hyodysenteriae. Anim Health Res Rev. 2001 Jun;2(1):59-65.
  31. Clothier KA, Kinyon JM, Frana TS, Naberhaus N, Bower L, Strait EL, Schwartz K.Species characterization and minimum inhibitory concentration patterns of Brachyspira species isolates from swine with clinical disease.J Vet Diagn Invest. 2011 Nov;23(6):1140-5.
  32. Molnàr, L. (1996). Vet. Rec. 138:158-160.
  33. Gresham AC, Hunt BW, Dalziel RW.Treatment of swine dysentery--problems of antibiotic resistance and concurrent salmonellosis. Vet Rec. 1998 Nov 28;143(22):619.
  34. Italy http://www.ivis.org/proceedings/ipvs/2006/TREATMENT/P_31-22.pdf?LA=1
  35. Germany: Rohde J,Kessler M,Baums CG, Amtsberg G.Comparison of methods for antimicrobial susceptibility testing and MIC values for pleuromutilin drugs for Brachyspira hyodysenteriae isolated in Germany. Vet Microbiol 2004. 102:25–32.
  36. Pringle M,Landén A,Franklin A. Tiamulin resistance in porcine Brachyspira pilosicoli isolates. Res Vet Sci 2006. 80:1–4.
  37. Czech Republic: Lobová D, Smola J, Cizek A. Decreased susceptibility to tiamulin and valnemulin among Czech isolates of Brachyspira hyodysenteriae. J Med Microbiol 2004. 53:287–291.
  38. Karlsson M. et al (2002). Proc. 17th IPVS Congr, p.189
  39. Hidalgo A,Carvajal A, García-Feliz C,et al. Antimicrobial susceptibility testing of Spanish field isolates of Brachyspira hyodysenteriae. Res Vet Sci 2009. 87:7–12.
  40. Pringle M, Landén A, Unnerstad HE, Molander B, Bengtsson B. Antimicrobial susceptibility of porcine Brachyspira hyodysenteriae and Brachyspira pilosicoli isolated in Sweden between 1990 and 2010.Acta Vet Scand. 2012 Sep 21;54:54.
  41. Zmudzki J, Szczotka A, Nowak A, Strzelecka H, Grzesiak A, Pejsak Z.Antimicrobial susceptibility of Brachyspira hyodysenteriae isolated from 21 Polish farms.Pol J Vet Sci. 2012;15(2):259-65.
  42. Web site: Antimicrobials Sold or Distributed for Use in Food-Producing Animals. FDA.gov. 5 March 2019.
  43. Komarek V,Maderner A,Spergser J,Weissenböck H. Infections with weakly haemolytic Brachyspira species in pigs with miscellaneous chronic diseases. Vet Microbiol 134: 311–317.
  44. Clothier KA, Kinyon JM, Frana TS, Naberhaus N, Bower L, Strait EL, Schwartz K.Species characterization and minimum inhibitory concentration patterns of Brachyspira species isolates from swine with clinical disease.J Vet Diagn Invest. 2011 Nov;23(6):1140-5.

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