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Karen A Krogfelt


kak@ssi.dk

Journal articles

2009
Stahlhut, Chattopadhyay, Struve, Weissman, Aprikian, Libby, Fang, Krogfelt, Sokurenko (2009)  Population variability of the FimH type 1 fimbrial adhesin in Klebsiella pneumoniae.   J Bacteriol Jan  
Abstract: FimH is an adhesive subunit of type 1 fimbriae expressed by different enterobacterial species. The enteric bacterium Klebsiella pneumoniae is an environmental organism that is also a frequent cause of sepsis, urinary tract infection (UTI) and liver abscess. Type 1 fimbriae have been shown to be critical for the ability of K. pneumoniae to cause UTI in a murine model. We show here that the K. pneumoniae fimH gene is found in 90% of strains from various environmental and clinical sources. The fimH alleles exhibit relatively low nucleotide and structural diversity, but are prone to frequent horizontal transfer events between different bacterial clones. Addition of the fimH locus to Multiple Locus Sequence Typing significantly improved resolution of the clonal structure of pathogenic strains, including the K1-encapsulated liver isolates. In addition, the K. pneumoniae FimH protein is targeted by adaptive point mutations, though not to the same extent as FimH from uropathogenic E. coli or TonB from the same K. pneumoniae strains. Such adaptive mutations include a single amino acid deletion from the signal peptide that might affect the length of the fimbrial rod by affecting FimH translocation into the periplasm. Another FimH mutation (S62A) occurred in the course of endemic circulation of a nosocomial uropathogenic clone of K. pneumoniae. This mutation is identical to one found in a highly virulent uropathogenic strain of E. coli, suggesting that the FimH mutations are pathoadaptive in nature. Considering the abundance of type 1 fimbriae in Enterobacteriaceae, our present finding suggest that fimH genes are subject to adaptive microevolution substantiates the importance of type 1 fimbriae-mediated adhesion in K. pneumoniae.
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Kantsø, Svendsen, Jørgensen, Krogfelt (2009)  Evaluation of serological tests for the diagnosis of rickettsiosis in Denmark.   J Microbiol Methods Jan  
Abstract: Two commercially available immunofluorescence assays (IFA) were compared using historical sera evaluated for rickettsial antibodies by the Weil-Felix test. An IFA test produced by Focus Diagnostics prepared with Rickettsia rickettsii and R. typhi antigens was compared with a custom made kit from Fuller Laboratories with R. rickettsii, R. typhi, R. conorii and R. helvetica as antigens. The serum panel used for the comparison included Weil-Felix-positive and -negative samples. Cross-reactions were analyzed using serum samples from patients with clinical symptoms similar to those of rickettsiosis. When analyzing the data using the manufacturers' cut-off values, 41% of samples from presumably healthy blood donors were found positive for spotted fever group Rickettsia antibodies. This does not correlate to the general picture of rickettsiosis in Denmark. Furthermore, sera with Coxiella burnetii antibodies were found to be cross-reacting in both tests. When applying cut-off values calculated on the 95% percentile on data from blood donor serum samples, there was no significant difference between the two kits. Moreover, when using the newly established cut-off, cross-reactions were eliminated.
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Claus Bo Svendsen, Karen A Krogfelt, Per Moestrup Jensen (2009)  Detection of Rickettsia spp. in Danish ticks (Acari: Ixodes ricinus) using real-time PCR.   Scand J Infect Dis 41: 1. 70-72  
Abstract: We examined 192 Ixodes ricinus tick nymphs from Denmark for the presence of Rickettsia spp. We used a species-specific real-time PCR; 13.0% of the ticks were positive for rickettsial DNA. Only DNA from Rickettsia helvetica was found in the ticks.
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Nadia Boisen, Fernando Ruiz-Perez, Flemming Scheutz, Karen A Krogfelt, James P Nataro (2009)  Short report: high prevalence of serine protease autotransporter cytotoxins among strains of enteroaggregative Escherichia coli.   Am J Trop Med Hyg 80: 2. 294-301 Feb  
Abstract: Enteroaggregative Escherichia coli (EAEC) pathogenesis is thought to comprise intestinal colonization followed by the release of enterotoxins and cytotoxins. Here, we use a polymerase chain reaction (PCR) to determine the prevalence of 10 genes encoding serine protease autotransporter toxins (SPATEs) in a collection of clinical EAEC isolates. Eighty-six percent of EAEC strains harbored genes encoding one or more class I cytotoxic SPATE proteins (Pet, Sat, EspP, or SigA). Two Class II, non-cytotoxic, SPATE genes were found among EAEC strains: pic and sepA, each originally described in Shigella flexneri 2a. Using a multiplex PCR for five SPATE genes (pet, sat, sigA, pic, and sepA), we found that most of the Shigella isolates also harbored more than one SPATE, whereas members of most other E. coli pathotypes rarely harbored a cytotoxic SPATE gene. SPATEs may be relevant to the pathogenesis of both EAEC and Shigella spp.
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2008
Joanna Lampkowska, Louise Feld, Aine Monaghan, Niamh Toomey, Susanne Schjørring, Bodil Jacobsen, Hilko van der Voet, Sigrid Rita Andersen, Declan Bolton, Henk Aarts, Karen A Krogfelt, Andrea Wilcks, Jacek Bardowski (2008)  A standardized conjugation protocol to asses antibiotic resistance transfer between lactococcal species.   Int J Food Microbiol 127: 1-2. 172-175 Sep  
Abstract: Optimal conditions and a standardized method for conjugation between two model lactococcal strains, Lactococcus lactis SH4174 (pAMbeta1-containing, erythromycin resistant donor) and L. lactis Bu2-60 (plasmid-free, erythromycin sensitive recipient), were developed and tested in a inter-laboratory experiments involving five laboratories from different countries. The ultimate goal of the study was to assess the microbial potential of antibiotic resistance transfer among Lactic Acid Bacteria (LAB). The influence of culture age (various OD values) and ratios of donor and recipient cultures as well as filter, solid and liquid mating techniques, were examined in order to optimize the conjugation protocol. In the result of these studies, we concluded that the donor-to-recipient ratio appear to be important; the most efficient technique for conjugation was filter mating and the optimal conditions for gene transfer were observed when late logarithmic cultures of both donor and recipient were used. Comparison of conjugal transfer frequencies between five partner laboratories showed that results are sufficiently intra-laboratory repeatable and inter-laboratory comparable. This is the first study of this kind, in which a standardized protocol of conjugal mating for testing antibiotic resistance dissemination among LAB was established and validated.
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Derrick E Fouts, Heather L Tyler, Robert T DeBoy, Sean Daugherty, Qinghu Ren, Jonathan H Badger, Anthony S Durkin, Heather Huot, Susmita Shrivastava, Sagar Kothari, Robert J Dodson, Yasmin Mohamoud, Hoda Khouri, Luiz F W Roesch, Karen A Krogfelt, Carsten Struve, Eric W Triplett, Barbara A Methé (2008)  Complete genome sequence of the N2-fixing broad host range endophyte Klebsiella pneumoniae 342 and virulence predictions verified in mice.   PLoS Genet 4: 7. 07  
Abstract: We report here the sequencing and analysis of the genome of the nitrogen-fixing endophyte, Klebsiella pneumoniae 342. Although K. pneumoniae 342 is a member of the enteric bacteria, it serves as a model for studies of endophytic, plant-bacterial associations due to its efficient colonization of plant tissues (including maize and wheat, two of the most important crops in the world), while maintaining a mutualistic relationship that encompasses supplying organic nitrogen to the host plant. Genomic analysis examined K. pneumoniae 342 for the presence of previously identified genes from other bacteria involved in colonization of, or growth in, plants. From this set, approximately one-third were identified in K. pneumoniae 342, suggesting additional factors most likely contribute to its endophytic lifestyle. Comparative genome analyses were used to provide new insights into this question. Results included the identification of metabolic pathways and other features devoted to processing plant-derived cellulosic and aromatic compounds, and a robust complement of transport genes (15.4%), one of the highest percentages in bacterial genomes sequenced. Although virulence and antibiotic resistance genes were predicted, experiments conducted using mouse models showed pathogenicity to be attenuated in this strain. Comparative genomic analyses with the presumed human pathogen K. pneumoniae MGH78578 revealed that MGH78578 apparently cannot fix nitrogen, and the distribution of genes essential to surface attachment, secretion, transport, and regulation and signaling varied between each genome, which may indicate critical divergences between the strains that influence their preferred host ranges and lifestyles (endophytic plant associations for K. pneumoniae 342 and presumably human pathogenesis for MGH78578). Little genome information is available concerning endophytic bacteria. The K. pneumoniae 342 genome will drive new research into this less-understood, but important category of bacterial-plant host relationships, which could ultimately enhance growth and nutrition of important agricultural crops and development of plant-derived products and biofuels.
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Riny Janssen, Karen A Krogfelt, Shaun A Cawthraw, Wilfrid van Pelt, Jaap A Wagenaar, Robert J Owen (2008)  Host-pathogen interactions in Campylobacter infections: the host perspective.   Clin Microbiol Rev 21: 3. 505-518 Jul  
Abstract: Campylobacter is a major cause of acute bacterial diarrhea in humans worldwide. This study was aimed at summarizing the current understanding of host mechanisms involved in the defense against Campylobacter by evaluating data available from three sources: (i) epidemiological observations, (ii) observations of patients, and (iii) experimental observations including observations of animal models and human volunteer studies. Analysis of available data clearly indicates that an effective immune system is crucial for the host defense against Campylobacter infection. Innate, cell-mediated, and humoral immune responses are induced during Campylobacter infection, but the relative importance of these mechanisms in conferring protective immunity against reinfection is unclear. Frequent exposure to Campylobacter does lead to the induction of short-term protection against disease but most probably not against colonization. Recent progress in the development of more suitable animal models for studying Campylobacter infection has opened up possibilities to study the importance of innate and adaptive immunity during infection and in protection against reinfection. In addition, advances in genomics and proteomics technologies will enable more detailed molecular studies. Such studies combined with better integration of host and pathogen research driven by epidemiological findings may truly advance our understanding of Campylobacter infection in humans.
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Susanne Schjørring, Carsten Struve, Karen A Krogfelt (2008)  Transfer of antimicrobial resistance plasmids from Klebsiella pneumoniae to Escherichia coli in the mouse intestine.   J Antimicrob Chemother 62: 5. 1086-1093 Nov  
Abstract: OBJECTIVES AND METHODS: Klebsiella pneumoniae is a nosocomial pathogen and is considered the most common gram-negative bacterium that exhibits multiple antimicrobial resistances. In this study, the transfer of antimicrobial resistance genes from the clinical multiresistant K. pneumoniae MGH75875 isolate was assessed in vitro and in vivo in an intestinal colonization animal model. The ability to colonize and transfer was tested under different antimicrobial treatments. The frequency of the horizontal gene transfer was also examined in vitro. RESULTS: The clinical isolate of K. pneumoniae colonized the intestine of mice at levels up to 10(9) cfu/g faeces in antimicrobial-treated mice. In mice without antimicrobial treatment, the strain quickly decreased to below the detection limit due to competitive exclusion by the indigenous mouse flora. Onset of antimicrobial treatment gave immediate rise to detectable levels of the strain in the faeces of up to 10(9) cfu/g faeces. The experiment clearly shows that the treatment selects resistant strains and gives advantages to colonize the gastrointestinal tract. Furthermore, high transfer frequency of different plasmids was observed during colonization of the mouse intestine. The bla(SHV) and bla(TEM) genotypes were transferred to both an indigenous recipient in the in vivo setting and to an MG1655 Escherichia coli recipient strain in vitro. CONCLUSIONS: K. pneumoniae is an excellent colonizer of the intestine and is extremely promiscuous with respect to the transferability of its numerous plasmids. Antimicrobial treatment enhances the selection of resistant strains and results in an increase in the resistance gene pool, which ultimately raises the risk of spreading resistance genes.
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Svendsen, Boye, Struve, Krogfelt (2008)  A novel fluorescent in situ hybridization technique for detection of Rickettsia spp. in archival samples.   J Microbiol Methods Nov  
Abstract: A novel, sensitive and specific method for detecting Rickettsia spp. in archival samples is described. The method involves the use of fluorescently marked oligonucleotide probes for in situ hybridization. Specific hybridization of Rickettsia was found without problems of cross-reactions with bacterial species shown to cross-react serologically.
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Helle Holst, Keld Andresen, Jens Blom, Niels Højlyng, Michael Kemp, Karen Angeliki Krogfelt, Jens Jørgen Christensen (2008)  A Case of Helicobacter cinaedi Bacteraemia in a Previously Healthy Person with Cellulitis.   Open Microbiol J 2: 29-31 04  
Abstract: Helicobacter cinaedi is an infrequent, but well recognized cause of gastroenteritis in immunosuppressed patients. Here we report a case of an extra-intestinal infection in a previous healthy 61-year old heterosexual male. Focus for the infection was most likely cellulitis on the lower right leg. The bacterium was cultured from blood twice within one week. Electron microscopy of the isolate visualized bipolar flagella. Partial DNA sequencing of the 16S rRNA gene and phenotypic characterization of the isolate established the species diagnosis. The patient was treated with rifampicin. After end of treatment blood cultures were negative and the cellulitis had disappeared.
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2006
Peter Schiellerup, Thomas Dyhr, Jean Marc Rolain, Marianne Christensen, Rasmus Damsgaard, Niels Fisker, Niels Frost Andersen, Didier Raoult, Karen A Krogfelt (2006)  No serological evidence for rickettsial diseases among Danish elite orienteerers.   Ann N Y Acad Sci 1078: 150-153 Oct  
Abstract: A series of sudden unexpected cardiac deaths among Swedish elite orienteerers in the 1980s have resulted from the combination of infectious diseases and physical exercise. Studies in the late 1990s have pointed to Chlamydia and Barontella, which both had a high seroprevalence among Swedish elite orienteerers. We conducted a case-control study aimed to elucidate the serologic prevalence of rickettsial diseases among Danish elite orienteerers. Ticks are known as vectors for some rickettsial diseases. None of the orienteerers had a positive antibody titer against any of the tested Rickettsia despite a very high frequency of tick bites in this group.
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2004
Peter Schiellerup, Thomas Dyhr, Jean Marc Rolain, Marianne Christensen, Rasmus Damsgaard, Steen Ethelberg, Niels Fisker, Niels Frost Andersen, Didier Raoult, Karen A Krogfelt (2004)  Low seroprevalence of bartonella species in danish elite orienteers.   Scand J Infect Dis 36: 8. 604-606  
Abstract: In the 1990s, studies were conducted to investigate 16 episodes of sudden unexpected cardiac death (SUCD) among Swedish elite orienteers during the period from 1979 to 1992. A case control study revealed that a significantly higher proportion of Swedish elite orienteers were B. elizabethae seropositive compared to controls. The aim of our study, designed as a case-control study, was to determine whether similarly high rates of B. elizabethae seropositivity were present among Danish elite orienteers. Cases were 43 elite orienteers; controls were 159 blood donors and 63 elite indoor sportsmen. All participants were tested for antibodies against B. henselae, B. quintana and B. elizabethae using immunofluorescent antibody tests. Surprisingly, Bartonella antibodies were only detected in sera from 5 persons: B. henselae from 1 elite orienteer, 1 handball player and 1 blood donor. B. elizabethae antibodies were detected in 1 handball player and 1 basketball player. We found no association between elite orienteers and the prevalence of Bartonella antibody positivity. This is in contrast to the Swedish study, and might be explained by the use of different serological methods in the 2 studies; to determine whether it is a true difference, a new study is needed.
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