Bacillus anthracis infection

Pezard C, Berche P, Mock M (1991) Contribution of individual toxin components to virulence of Bacillus anthracis. Infect Immun 59 3472-3477... 

Brossier, F., Weber-Levy, M., Mock, M., Shard, J.C. (2000). Protective antigen-mediated antibody response against a heterologous protein produced in vivo by Bacillus anthracis. Infect. Immun. 68 5731-4. 

Ivins, B.I., Ezzell, J.W., Jr., Jemski, J., Hedlund, K.W., Ristroph, J.D., Leppla, S.H. (1986). Immunization studies with attenuated strains of Bacillus anthracis. Infect. Immun. 52 454-8. 

Bartkus JM, Leppla SH. Transcriptional regulation of the protective antigen gene of Bacillus anthracis. Infect Immun. 1989 57 2295-2300. 

Mikesell P, Ivins BE, Ristroph JD, Dreier TM. Evidence for plasmid-mediated toxin production in Bacillus anthracis. Infect Immun. 1983 39 371-376. 

Hoffmaster AR, Koehler TM. 1997. The anthrax toxin activator geneatxA is associated with COj enhanced nontoxin gene expression in Bacillus anthracis. Infection and Immunity 65 3091-3099. 

Janes, B.K. and Stibitz, S. (2006) Routine markerless gene replacement in Bacillus anthracis. Infect. Immun., 74 (3), 1949-1953. 

Hsu, L. C. "A NOD2-NALP1 complex mediates caspase-l-dependent IL-la secretion in response to Bacillus anthracis infection and muramyl dipeptide." Proc. Natl Acad. Sci. USA 105 7803-7808. 

Hahn, B.L., Sharma, S., Sohnle, P.G., 2005. Analysis of epidermal entry in experimental cutaneous Bacillus anthracis infections in mice. J. Lab. Clin. Med. 146,95-102. 

Chloroquine (Aralen) is also used in die treatment of extraintestinal amebiasis (see section on Amebicides). Doxycycline is also used to treat infections caused by Neisseria gonorrhoeae, Treponema pallidum, Listeria monocytogenes, Clostridium, and Bacillus anthracis when penicillin is contraindicated. Quinine also may be used for die prevention and treatment of nocturnal leg cramps. 

Many diseases, including anthrax, are most effectively treated before actual manifestation of the symptoms is observed. Presently a presumptive identification of Bacillus anthracis can be made in about 3 hours however, if a full laboratory response network (LRN) confirmation procedure is utilized, the theoretical time increases substantially to approximately 48 hours. During the recent anthrax cases 72 to 96 hours were common to complete the entire LRN protocol. In the meantime antibiotics were administered as a precaution based on the presumptive results to individuals thought to be exposed to B. anthracis spores or with anthrax symptoms. The mass administering of antibiotics from a cost standpoint, as well as from medical prudence to prevent the rise of antibiotic-resistant strains, is not the optimal answer to the anthrax infection problem. Therefore it is important that early tests be rapid and reliable with a minimum number of false positive and false negative results. 

Kubler-Kielb J, Liu TY, Mocca C et al (2006) Additional conjugation methods and immunogenicity of Bacillus anthracis poly-y-D-glutamic acid-protein conjugates. Infect Immun 74 4744 1749... 

The anthrax bioterrorist attacks that followed the events of September 11th 2001 resulted in a renewed interest BadUus anthracis, the causative agent of this disease. Research has focused on the development of better vaccines than the one currently available. It has been estimated that the aerosolized release of 100 kg of anthrax spores upwind of Washington DC would cause mortalities of 130,000-3,000,000 [63]. Nonetheless, wild-type Bacillus anthracis is susceptible to conventional antibiotics, including penicillin, oxyfloxacin and ciprofloxacin. The problem lies not with the bacterial infection itself, but with three proteins released by the bacteria - protective antigen (PA, 83 kDa), lethal factor (LF, 90 kDa) and edema factor (EF, 89 kDa) -known as anthrax toxins [63]. 

More recently, anthrax has been used as a biological weapon in the United States and a total of 22 cases were identified. Six fatalities occurred due to inhalation of the causal agent, Bacillus anthracis. Use of microorganisms for agroterrorism as well as infection of companion animals, and the potential development of genetically engineered agents have made the twenty-first century more vulnerable than past centuries. 

Caution You would have to go to either penicillin G (aqueous) or penicillin G (sodium) for treatment of severe infections caused by sensitive organisms including bacillus anthracis. 

Alternative therapy for the following infections when penicillin is contraindicated Uncomplicated gonorrhea due to Neisseria gonorrhoeae] syphilis due to Treponema pallidum, yaws due to T. pertenue] Listeria monocytogenes] anthrax due to Bacillus anthracis] Vincent s infection due to Fusobacterium fusiforme] actinomycosis due to Actinomyces sp. Clostridium sp. 

Levofloxacin (1), the levo-isomer or the (5)-enantiomer of ofloxacin, received FDA approval in 1996 (Fish, 2003 Hurst et al., 2002 Mascaretti, 2003 Norrby, 1999 North et al., 1998). The initial approval covered community-acquired pneumonia, acute bacterial exacerbation of chronic bronchitis, acute maxillary sinusitis, uncomplicated skin and skin structure infections, acute pyelonephritis, and complicated urinary tract infections (North et al., 1998). Four years later, the levofloxacin indication list grew to include community-acquired pneumonia caused by penicillin-resistant Streptococcus pneumoniae. In addition, in 2002, nosocomial (hospital-acquired) pneumonia caused by methicillin-susceptible Staphylococcus aureus, Pseudomonas aeruginosa, Serratia marcescens, Haemophilus influenzae, Kliebsella pneumoniae, and Escherichia coli was added (Hurst et al., 2002). Finally in 2004, LVX was approved as a post-exposure treatment for individuals exposed to Bacillus anthracis, the microbe that causes anthrax, via inhalation (FDA, 2004). 

Anthrax, a disease caused by infection by Bacillus anthracis via spores, can be transmitted to humans or animals ruminants such as sheep, goats, cattle, and deer are most susceptible. The handling of infected animals or animal products may also lead to human infection. Recently, anthrax has been considered to be a potential candidate for bioterrorism activity. The spores are extremely hardy and may come into contact with humans through a cut or abrasion, through consumption of infected meat, or by inhalation. The Center for Disease Control (CDC) lists anthrax as a category A disease, and the only vaccine that currently exists has a number of drawbacks and health risks. 

The use of Cipro to treat anthrax infection emanated from research carried out in 1990 at Fort Detrick, Maryland (see later). The army was concerned that Saddam Hussein could introduce germ warfare in the Gulf War in the form of anthrax. Sixty monkeys were infected with a strain of Bacillus anthracis by aerosol and were divided into six groups. One group received a vaccine alone another received the vaccine and antibiotics and three groups were treated for 30 days with one of three different classes of antibiotics—penicillin, doxycycline, or Cipro. A control group received saline injections. 

Daptomycin has proven efficacy in a number of in vivo animal models, including soft tissue infections by MRSA, bacteraemia caused by S. aureus or vancomycin-resistant enterococci (VRE), Enterococcus faecalis pyelonephritis, MRSA osteomyelitis, MRSA and Bacillus anthracis pulmonary infections, Gram-positive endocarditis, Clostridium difficile colitis and S. pneumoniae and S. aureus meningitis.9,64 66... 

Bacillus anthracis, a spore-forming bacterium found in soii, transmitted via infected sheep, cattie, goats, or animai products. Can aiso be purified and aerosoiized. 

Bacillus anthracis can remain for extended periods of time in soil. The mechanism responsible for its persistence is unclear. Therefore, persistence may involve multiplication cycles and sporulation. It may involve multiplication of the organism in the soil or bacterial amplification in infected animals prior to soil contamination by the carcass. Spores may germinate simply upon application of water to soil (Hanna and Ireland, 1999 Oncul et al, 2002). 

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