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15321 - What's all this got to do with patients What...

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University of California,San Francisco 1 Department of Anesthesia and Perioperative Care What’s all this got to do with patients? What evidence is there that the type III secretion system and toxins are involved in disease? What evidence is there regarding the difference between colonizing strains and strains that cause infections?
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University of California,San Francisco 2 Department of Anesthesia and Perioperative Care
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University of California,San Francisco 3 Department of Anesthesia and Perioperative Care Gross autopsy: Necrotic lung
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University of California,San Francisco 4 Department of Anesthesia and Perioperative Care Analysis of P.aeruginosa strains from critically ill patients P.aeruginosa strains from patients produced either ExoU or ExoS, but not both All of the deaths in ICU patients infected with P.aeruginosa were associated with a strain secreting type III toxins; strains secreting type III toxins were also associated with pneumonia, bacteremia and sepsis J Infect Disease 183:1767, 2001
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University of California,San Francisco 5 Department of Anesthesia and Perioperative Care Prevalence of type III genes in P.aeruginosa strains Evaluated 100 strains from urine, blood, wound and lungs All isolates have genes for type III apparatus but toxin genes vary among isolates 72% isolates have exoS and 28% have exoU genes--no strains had both CF strains did not have exoU gene Microbiology 2001;147:2659
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University of California,San Francisco 6 Department of Anesthesia and Perioperative Care Virulence Factors in VAP 35 VAP isolates; performed pulse-field gel electrophoresis (non-clonal) 19/35 died (54%) 9/35 recovered from VAP; 6/35 relapsed 27/35 (77%) + for type III secretion 10/35 (29%) + for ExoU--90% severe disease vs 38%of patients with non-type III isolates Isolates either had exoS gene or exoU gene Crit Care Med 2002;30:521
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University of California,San Francisco 7 Department of Anesthesia and Perioperative Care P.aeruginosa strains from blood 92 unique strains divided into 4 groups Profiles of TTSS protein secretion on SDS- PAGE and kinetics of cytotoxicity #1-28% isolates--rapidly (1h) cytotoxic (ExoU and ExoT) #2-52% slower cytotoxic (ExoS & ExoT) #3-15% some cell death 3~4h ; no TTSS #4- 4% no cytotoxicity & no TTSS J Infectious Disease 2003;188:512
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University of California,San Francisco 8 Department of Anesthesia and Perioperative Care O serotypes-Utilized to characterize P. aeruginosa
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