Abstract
BackgroundSimkania negevensis is an obligate intracellular bacterium belonging to the family Simkaniaceae in the Chlamydiales order. It is considered an ubiquitous microorganism and aquatic environments may be involved as a source of infection for humans. It was just isolated in samples from domestic water supplies and from mains water supplies, like spa water or swimming pool water, confirming its ability to resist to the common chlorination treatments. Evidence indicates a possible role of the microorganism in respiratory tract infections, in gastroenteric disorders and in the pathogenesis of cardiovascular disease, furthermore it has hypothesized that it could play a role in lung transplant rejection. Prevalence and possible effects in nephrology are unknown.MethodsWe examined the occurrence of Simkania negevensis in two differents populations, both characterized by a high susceptibility to infectious complications: 105 hemodialysis patients, 105 renal transplant recipients and 105 healthy subjects through the IgG and IgA response to Simkania negevensis in their sera. Serum antibodies to Simkania negevensis were detected by a homemade ELISA performed according to the Kahane’s protocol. Furthermore water samples from hemodialytic circuit were collected, to evaluate Simkania negevensis resistance to usual treatment of disinfection.ResultsOur results were unexpected, showing a higher seroprevalence of antibodies against Simkania negevensis in the hemodialysis patients, compared to renal transplant patients (IgG 22% vs 9% - IgA 9% vs 3%). S. negevensis was isolated in all water samples analyzed.ConclusionsOur study detected for the first time the occurrence of S. negevensis in hemodialysis and in renal transplant patients. Our findings suggest that water used in hemodialysis could be one of the possible sources of S. negevensis infection, without clinical involvement risk for patients.
Highlights
Simkania negevensis is an obligate intracellular bacterium belonging to the family Simkaniaceae in the Chlamydiales order
Simkania negevensis (S. negevensis) is an obligate intracellular bacterium belonging to the family Simkaniaceae in the Chlamydiales order, able to survive and grow as an amoeba resisting microorganism in trophozoites and cysts of Acanthamoeba and other free living protozoa, which probably represent its natural reservoirs
Because of a possible role as new pathogenic agent of lower respiratory tract infection, it was investigated among immunocompromised hosts, and it was demostrated that S. negevensis is most prevalent in lung transplant recipients [15]
Summary
Simkania negevensis is an obligate intracellular bacterium belonging to the family Simkaniaceae in the Chlamydiales order It is considered an ubiquitous microorganism and aquatic environments may be involved as a source of infection for humans. The prevalence and pathogenic potential role of S. negevensis in RT recipients and in HD patients is still unknown In this prospective study we proposed to analyze the S. negevensis occurrence in HD and RT patients, through IgG and IgA response to S. negevensis in blood simple: IgA are antibodies produced by the immune system in the first phase of the infection or during any episodes of reactivation while IgG are “memory” antibodies, which appear later and remain circulating in the blood for all life from the first contact with S. negevensis. This investigation was prompted by previous S. negevensis detection in water sources and by its relatively resistance to chlorination procedures used for routine treatment of drinking water supplies [16] and Spa swimming water [17]: water samples were collected from HD course to evaluate S. negevensis resistance to the purifying treatment commonly performed for HD fluid
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