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The cellular fatty acid compositions of 29 strains of Yersinia pestis representing the global diversity of this species have been analyzed by gas-liquid chromatography to investigate the extent of fatty acid polymorphism in this microorganism. After culture standardization, all Y. pestis strains studied displayed some major fatty acids, namely, the 12:0, 14:0, 3-OH-14:0, 16:0, 16:1ω9cis, 17:0-cyc, and 18:1ω9trans compounds. The fatty acid composition of the various isolates studied was extremely homogeneous (average Bousfield’s coefficient, 0.94) and the subtle variations observed did not correlate with epidemiological and genetic characteristics of the strains. Y. pestis major fatty acid compounds were analogous to those found in other Yersinia species. However, when the ratios for the 12:0/16:0 and 14:0/16:0 fatty acids were plotted together, the genus Yersinia could be separated into three clusters corresponding to (i) nonpathogenic strains and species of Yersinia, (ii) pathogenic Yersinia enterocolitica isolates, and (iii) Yersinia pseudotuberculosis and Y. pestis strains. The grouping of the two latter species into the same cluster was also demonstrated by their high Bousfield’s coefficients (average, 0.89). Therefore, our results indicate that the fatty acid composition of Y. pestis is highly homogeneous and very close to that of Y. pseudotuberculosis.
Plague, one of the most devastating infectious diseases in human history, will not be soon eradicated despite the major advances made in the knowledge of its causative agent (Yersinia pestis), its reservoir (wild rodents), its vector (fleas), and the advent of antibiotic therapy (35). This gram-negative bacillus was initially classified in the genus Pasteurella before being taxonomically reclassified in the genus Yersinia, a member of the family Enterobacteriaceae. The genus Yersinia includes eleven species (6), three of which are human and animal pathogens: Y. pestis, Yersinia pseudotuberculosis, and Yersinia enterocolitica.
Despite the wide variety of animal hosts and insect vectors and the capacity to survive in the environment (29), Y. pestis forms a phenotypically highly homogeneous species which contains only one serotype, one phage type, and three biotypes (varieties). Based on historical records and on the persistence of ancient plague foci, Devignat (15) suggested that each biotype of Y. pestis was responsible for a different pandemic: biotype Antiqua (glycerol positive, nitrate positive) for the first pandemic, biotype Medievalis (glycerol positive, nitrate negative) for the second pandemic, and biotype Orientalis (glycerol negative, nitrate positive) for the third pandemic. Recent results obtained with different molecular typing methods such as rRNA gene restriction pattern analysis (ribotyping) (18) and pulsed-field gel electrophoresis (27) argued for Devignat’s hypothesis. A relationship was established between biotypes and ribotypes (18). Moreover, several ribotypes were distinguished within each biotype, indicating a higher genotypic than phenotypic diversity in this species.
Determination of fatty acid composition by gas chromatography (GC) has been shown to be a simple method of identification and classification of different bacterial species (1) and could represent a useful alternative for further investigating the phenotypic diversity of Y. pestis. GC was previously used to study some strains of this species (2, 21), but this technique was applied to a small number of isolates, most often from the same geographical origin and/or biotype. It was thus not possible from the results of these works to evaluate the extent of fatty acid diversity in Y. pestis.
In the present study, after standardization of the different parameters of the technique, the fatty acid composition of 29 strains of Y. pestis isolated at different times from various geographical areas and having different biotypes and ribotypes were analyzed. We demonstrate a high homogeneity of the fatty acid composition of this species. We also show that the subtle differences observed in fatty acid patterns among Y. pestis strains do not correlate with their biotypes, ribotypes, and epidemiological characteristics. Finally, we demonstrate that based on the analysis of the fatty acid composition of various isolates, the genus Yersinia can be separated into three distinct clusters.
High Homogeneity of the Yersinia pestis Fatty Acid Composition
Alexandre Leclercq,1,* Annie Guiyoule,2 Mohamed El Lioui,1 Elisabeth Carniel,2 and Jacques Decallonne1
To quantitatively summarize the available epidemiological evidence on the survival rate of out-of-hospital cardiac arrest (OHCA) patients who received cardiopulmonary resuscitation (CPR).
We systematically searched the PubMed, Embase, and Web of Science databases, and the references of retrieved articles were manually reviewed to identify studies reporting the outcome of OHCA patients who received CPR. The overall incidence and outcome of OHCA were assessed using a random-effects meta-analysis.
A total of 141 eligible studies were included in this meta-analysis. The pooled incidence of return of spontaneous circulation (ROSC) was 29.7% (95% CI 27.6-31.7%), the rate of survival to hospital admission was 22.0% (95% CI 20.7-23.4%), the rate of survival to hospital discharge was 8.8% (95% CI 8.2-9.4%), the pooled 1-month survival rate was 10.7% (95% CI 9.1-13.3%), and the 1-year survival rate was 7.7% (95% CI 5.8-9.5%). Subgroup analysis showed that survival to hospital discharge was more likely among OHCA patients whose cardiac arrest was witnessed by a bystander or emergency medical services (EMS) (10.5%; 95% CI 9.2-11.7%), who received bystander CPR (11.3%, 95% CI 9.3-13.2%), and who were living in Europe and North America (Europe 11.7%; 95% CI 10.5-13.0%; North America: 7.7%; 95% CI 6.9-8.6%). The survival to discharge (8.6% in 1976-1999 vs. 9.9% in 2010-2019), 1-month survival (8.0% in 2000-2009 vs. 13.3% in 2010-2019), and 1-year survival (8.0% in 2000-2009 vs. 13.3% in 2010-2019) rates of OHCA patients who underwent CPR significantly increased throughout the study period. The Egger’s test did not indicate evidence of publication bias for the outcomes of OHCA patients who underwent CPR.
The global survival rate of OHCA patients who received CPR has increased in the past 40 years. A higher survival rate post-OHCA is more likely among patients who receive bystander CPR and who live in Western countries.
Electronic supplementary material
The online version of this article (10.1186/s13054-020-2773-2) contains supplementary material, which is available to authorized users.
Out-of-hospital cardiac arrest, Resuscitation, Emergency medical services
The global survival rate among adult out-of-hospital cardiac arrest patients who received cardiopulmonary resuscitation: a systematic review and meta-analysis
Shijiao Yan,#1,2 Yong Gan,#3 Nan Jiang,3 Rixing Wang,4 Yunqiang Chen,5,2 Zhiqian Luo,5,2 Qiao Zong,6 Song Chen,7 and Chuanzhu Lvcorresponding author4,5,2
To determine whether the human thymus provides an environment for the maturation of murine T cells, human fetal thymus and liver (hu-thy/liv) were implanted into congenitally athymic NIH-beige-nude-xid (BNX) mice or C.B-17 scid/scid (SCID) mice. 3 mo after implantation, in contrast to the hu-thy/liv implant in SCID mice, which was populated only with human CD4/CD8 single- and double-positive thymocytes, the hu-thy/liv implant in BNX mice contained a chimeric population of human and mouse CD4/CD8 single- and double-positive thymocytes. Immunohistochemical staining of the hu-thy/liv implant in BNX mice indicated that the population of double-positive mouse thymocytes was localized to discrete areas of the human fetal thymus. Quantitative improvements in mouse T cell and immunoglobulin (Ig) G parameters were observed after grafting of the human fetal thymus and liver tissue into BNX mice. In addition, in contrast to the nonimplanted BNX mice, the implanted BNX mice were capable of mounting a keyhole limpet hemocyanin-specific IgG response and their peripheral T cells were responsive to stimulation with mitogens and antibodies directed to the T cell receptor. Furthermore, after in vivo priming, T cells present in lymph nodes of the implanted BNX mice were capable of mounting an antigen-induced in vitro T cell-dependent proliferative response. Thus, concurrent with the continued maturation of human T cells, murine T cells differentiated within the human fetal thymus implanted in the BNX mice and mediated the phenotypic and functional reconstitution of the murine immune system. Mice with a reconstituted immune system that contain a human thymic implant that is infectible with human immunodeficiency virus (HIV) should prove useful in the investigation of T cell maturation in the thymus and in the evaluation of potential HIV vaccines.
The concurrent maturation of mouse and human thymocytes in human fetal thymus implanted in NIH-beige-nude-xid mice is associated with the reconstitution of the murine immune system
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