1. The study investigated the port of entry of Helicobacter cinaedi bacteria, which can cause bacteremia in immunocompromised patients. 2. Eighteen strains of H. cinaedi obtained from blood and stool samples from 21 patients were analyzed using pulsed-field gel electrophoresis (PFGE), but multiple genotypes were found, making it difficult to establish the port of entry. 3. While translocation from the gastrointestinal tract remains a possibility, more research is still needed to prove the port of entry, as H. cinaedi bacteremia can also occasionally develop in patients without underlying diseases.

1. • Nombre: Luisa María López Saldarriaga
• Seminario Biología Molecular
• III Semestre
• Medicina-UPB

2. Introduction:
• Helicobacter:
o Is a genus of gram
negative bacteria
o Morphology
o Upper gastrointestinal
tract and liver
o pH
o Susceptible to antibiotics
o Microaerophilic and very
mobile
• Helicobacter
cinaedi:
o Spiral bacterium
o NHPH
o Infectious disease in HIV-
positive patiens
o Underlying diseases

3. • Bacteremia:
o Presence of bacteria in the
blood
o Patterns:
1. Transient
2. Intermittent
3. Persistent
• H.cinaedi
bacteremia:
• H.cinaedi causes
bacteremia
• Multi-focal cellulitis
• Immunocompromised
patients

4. Objetive:
O The objetive of this study was to investigate the port
of entry of this bacterium.

5. Materiales y métodos:
• Selección de pacientes y cepas bacterianas:
o Registros medicos
o Muestras de hemocultivo: Bactec 9240, Bactec FX
o Cultivo microaeróbico
Hospital Toramon Marzo 2009-Mayo
13
(+) Gram negativo- espirales
Botellas aerobicas- (+), no
organismos con Gram
Incubación en medio Ex
modificado Skirrow

6. o PCR 195pb Cebador directo gen gyrB
• Características clínicas de los pacientes:
o Mortalidad
o Enfermedad renal crónica Creatinina sérica mayor a 20mg/dl
o Infecciones nosocomitantes del torrente sanguíneo (N)
Hemocultivo (+) de paciente hospitalizado por 48h o más.
o Infecciones del torrente sanguíneo asociados a la salud (HA)
Hemocultivo (+) momento de ingreso del hospital o si el
paciente cumplia con algunos de estos criterios:
1. Lkl
Cebador indirecto

7. 2. Ljglñfñglñ 2 días en los 90 días previos a la infección
3. Bjgkjgjgjhgjg 90 días previos
o Infecciones del torrente sanguíneo adquiridas en la comunidad
(CA) Hemocultivo (+) momento de ingreso
hospitalario o dentro de las primeras 48h si el paciente no cumplia
con los criterios de la HA

8. • PFGE detectar homología entre las cepas de H.cinaedi
Comparación de ac.nucléicos separación de grandes fragmentos
de DNA reorientación a lo largo del campo eléctrico
Enzima de restricción Spe I Tapones digeridos con 20 unidades
de la enzima de restricción

9. Resultados:
• Selección de pacientes y cepas:
o 71 pacientes diagnosticados
o Tanto las cepas de H.cinaedi obtenidas en sangre y heces de 21
pacientes se almacenaron
o De las 42 cepas analizadas usando PFGE, 18 cepas fueron
evaluables
o 18 cepas se volvieron analizar por PFGE

10. • Características clínicas de los pacientes:

11. • PFGE:

12. Múltiples genotipos

13. Discussion:
AUTHOR POSTULATE DONE OR NO DONE
Gibson; Sutherland; Owen; Zhou;
Oyarzabal
A limitation of this study was the
presence of strains that could not
be evaluated because no band was
detected on PFGE. The reason for
this is unclear, but it has been reported
that a few species of bacteria, including
Campylobacter species, produce
endogenous endonucleases that
can degrade digested DNA into small
fragments that will not appear on
PFGE gels.24,25

Kitamura; Kawamura; Ohkusu;
Minauchi; Takahashi; Sakai; Rimbara;
Mori; Kim
Although
the epidemiology of H. cinaedi infection
is not clear, the number of
case reports has rapidly increased since
2012, which suggests that
it is changing. Some previous reports
have indicated that nosocomial
person-to-
person
transmission of H. cinaedi infection can
occur.11,15,22


14. AUTHOR POSTULATE DONE OR NO DONE
Araoka; Baba; Kimura; Abe; Inagawa;
Yoneyama; Uwamino; Muranaka; Hase;
Otsuka; Hosokawa
However, H. cinaedi bacteremia can also
develop in patients with
no apparent underlying disease, such as
patient no. 3 in our study. It
was not clear why the bacterium
colonized the intestinal tract or what
caused bacterial translocation in that
case. Previous studies have also
reported H. cinaedi bacteremia in
patients with no apparent
immunodeficiency.
10-12

Matsumoto; Goto; Murakami Thus, it is an important causative
bacterium.
This frequency of detection at our
hospital is higher than that
(0.22%) reported in a multicenter study
in Japan in 2007.21


15. Conclusions:
1. It has not been possible to establish the port of entry
of this bacterium into the plasma, although the
translocation route is very viable, only that more
studies are still requiered to prove it.
2. The infections produced by H.cinaedi have been
increasing so it’s necessary to think about mechanisms
to reduce the risks to contract such infections and
decrease the amount of affected population.

16. Mapa: