Chlamydia and gonorrhea are major causes of sexually transmitted infections (STI) in adolescents worldwide. The infections are caused by Chlamydia trachomatis or Neisseria gonorrhoeae, bacteria with clinical manifestations such as urethritis, prostatitis and epididymitis among men, and urethritis, cervicitis and upper genital tract infection (i.e. pelvic inflammatory disease) among women. However, in many cases of genital tract infection, the etiology remains uncertain. In light of this, Mycoplasma genitalium was somewhat accidentally isolated in 1980 after prolonged incubation of urogenital specimens from men with non-gonococcal urethritis. Following the initial isolation in 1980, repeated attempts have been made to recover the extremely fastidious organism from clinical samples by culture techniques, but isolates have been rare and difficult to obtain. With the development of PCR methods in the early 1990s, detection of M. genitalium infection became more feasible. The aim in paper I was to compare three different PCR assays (conventional and real-time 16S rRNA gene PCR as well as real-time Mycoplasma genitalium adhesin protein (MgPa) gene PCR) for detection of M. genitalium. The study also determined the prevalence of M. genitalium. Clinical specimens collected from STI attendees, 381 men and 298 women, were used to determine the prevalence of M. genitalium and 213 of these specimens were used in the PCR comparative study. The prevalence of M. genitalium infection in men and women was 27/381 (7.1 %) and 23/298 (7.7 %) respectively. In the PCR comparative study, M. genitalium DNA were detected in 61/76 (80.3 %) of true-positive specimen by conventional 16S rRNA gene PCR, in 52/76 (68.4 %) by real-time 16S rRNA gene PCR and in 74/76 (97.4 %) by real-time MgPa gene PCR. Hence, real-time MgPa gene PCR is well suited for clinical diagnosis of M. genitalium in urogenital specimens from men and women. The aim in paper II was to determine whether a patients’ endocervical swab specimen can be transported in first void urine (FVU) as combined specimens in detection of Mycoplasma genitalium by real-time PCR. The study also compared two different DNA extraction methods (manual Chelex DNA extraction and automated BioRobot M48 DNA extraction) for observation of possible PCR inhibition. Clinical specimens collected from 329 women attending a STI clinic were used in the study. A total of 100 endocervical swab specimens transported in FVU was used in the PCR inhibition analysis. M. genitalium was detected in 25/329 (7.6 %) women. Endocervical swab specimens transported in FVU demonstrate higher sensitivity compared to both FVU alone and specimens transported in 2-SP medium detecting 24/25 (96 %), 22/25 (88 %) and 17/25 (68 %) of M. genitalium positive women, respectively. Automated BioRobot M48 DNA extraction was shown to be superior to manual Chelex extraction leaving no PCR inhibition and slightly higher DNA yield and/or better sensitivity. The results from these two studies are important knowledge in establishing the future diagnostic level of this STI in our county and also nationally.

Malaria is the most common parasitic disease of humans worldwide. A factor that aggravates the many attempts to control the epidemiologic malaria situation is the spreading of resistance against anti-malarial drugs. In this project the point mutation at position 86 of the Plasmodium. falciparum multidrug resistance gene (pfmdr1), which is thought to contribute to Chloroquine resistance, was analysed in 188 samples from a low transmission area in eastern Sudan, where malaria endemicity is seasonal. The patient group studied had asymptomatic and sub patent parasitemia that persisted during the transmission-free dry season, after being treated with Chloroquine. To differentiate between wild type and mutant genotypes, nested PCR and restriction fragment length polymorphism with the enzyme Apo1 was used. Out of 188 samples 79 (42%) were successfully analysed. Of those, 72% had parasites with mutant genotypes or where mixed infection. No conclusions on the relevance of the pfmdr1 gene in the studied samples are made due to the many remaining gaps. However, eventual sources of error and previous findings in the study area are discussed.

<p>This thesis describes recombinant proteins that have been generated by rational and combinatorial protein engineering strategies for use in subunit vaccine delivery and tumor targeting.</p><p>In a first series of studies, recombinant methods for incorporating immunogens into an adjuvant formulation, e.g. immunostimulating complexes (iscoms), were evaluated. Protein immunogens, which are not typically immunogenic in themselves, are normally administered with an adjuvant to improve their immunogenicity. To accomplish iscom incorporation of a <i>Toxoplasma gondii</i> surface antigen through hydrophobic interaction, lipids were added either <i>in vivo</i> via <i>E. coli</i> expression, or <i>in vitro</i> via interaction of an introduced hexahistidyl (His6) peptide and a chelating lipid. The possibility of exploiting the strong interaction between biotin and streptavidin was also explored, in order to couple a<i> Neospora caninum</i> surface antigen to iscom matrix, i.e. iscom particles without any antigen. Subsequent analyses confirmed that the immunogens were successfully incorporated into iscoms by the investigated strategies. In addition, immunization of mice with the recombinant Neospora antigen NcSRS2, associated with iscoms through the biotin-streptavidin interaction, induced specific antibodies to native NcSRS2 and reduced clinical symptoms following challenge infection. The systems described in this thesis might offer convenient and efficient methods for incorporating recombinant immunogens into adjuvant formulations that might be considered for the generation of future recombinant subunit vaccines.</p><p>In a second series of studies, Affibody® (affibody) ligands directed to the extracellular domain of human epidermal growth factor receptor 2 (HER2/neu), which is known to be overexpressed in ∼ 20-30% of breast cancers, were isolated by phage display <i>in vitro</i> selection from a combinatorial protein library based on the 58 amino acid residue staphylococcal protein A-derived Z domain. Biosensor analyses demonstrated that one of the variants from the phage selection, denoted His₆-Z_HER2/neu:4, selectively bound with nanomolar affinity (KD ≈ 50 nM) to the extracellular domain of HER2/neu (HER2-ECD) at a different site than the monoclonal antibody trastuzumab. In order to exploit avidity effects, a bivalent affibody ligand was constructed by head-to-tail dimerization, resulting in a 15.6 kDa affibody ligand, termed His₆-(Z_HER2/neu:4)₂, that was shown to have an improved apparent affinity to HER2-ECD (KD ≈ 3 nM) compared to the monovalent affibody. Moreover, radiolabeled monovalent and bivalent affibody ligands showed specific binding in vitro to native HER2/neu molecules expressed in human cancer cells. Biodistribution studies in mice carrying SKOV-3 xenografted tumors revealed that significant amounts of radioactivity were specifically targeted to the tumors <i>in vivo</i>, and the tumors could easily be visualized with a gamma camera. These results suggest that affibody ligands would be interesting candidates for specific tumor targeting in clinical applications, such as <i>in vivo</i> imaging and radiotherapy.</p>

<p>The study evaluated the Mutant Prevention Concentration (MPC) of Pradofloxacin on three Escherichia coli (E.coli) strains, 2 wildtypes and one first-step gyrA resistant mutant. We also measured the value of AUC (Under the Concentration)/MPC that prevents growth of resistant mutants. It is of importance to reach a concentration above MPC that prevent E.coli from developing resistance against the antibiotic.</p><p>We used an in vitro kinetic model where we added bacteria? and antibiotic. The culture flask was attached to a pump with an adjustable pump-speed. This made it possible to dilute the antibiotics in a satisfying elimination half-life (t1/2= 7 hours) pace. Samples were removed with a syringe at different times in the study. The samples where then cultured on agar- plates to enable counting of the viable colonies after incubation.</p><p>The optimal concentration to completely eradicate both E.coli wildtypes Nu14 and MG1655 with Pradofloxacin was Cmax ≥8 times MPC and AUC/MPC then became73. Additional experiments needs to be done on the resistant mutant LM378 before we can determine the optimal concentration. But results so far indicate that the concentration of Cmax would be about 8-12 timesMPC to completely eradicate that mutant.</p>

Metagenomic sequencing is an increasingly popular way of determining microbial diversity from environmental and clinical samples. By specifically targeting the 16S rRNA gene found in all bacteria, classifications of pathogens can be determined based on the variable and conserved regions found in the gene. Metagenomic sequencing can therefore highlight the vast difference in microbiological diversity between culture-dependent and culture-independent methods. Today, this has expanded into various next-generation sequencing platforms which can provide massively parallel sequencing of the target fragment. One of these platforms is Ion-torrent, which can be utilized for targeting the 16S rRNA gene and with the help of bioinformatics pipelines be able to classify pathogens using the bacteria’s own variable and conserved regions. The overall aim of the present work is to evaluate the clinical use of Ion-torrent 16S ribosomal RNA sequencing for determining pathogenic species from clinical samples, but also to set up a pipeline for clinical practice. Optimal DNA-extraction and quantification methods were determined towards each evaluated sample-type and DNA-eluates were sent for 16S rRNA Sanger and Next-generation sequencing. The result indicated that the next-generation sequencing shows a concordance in results towards the culturing-based method, but also the importance of experimental design and effective quality trimming of the NGS data. The conclusion of the project is that the Ion-torrent pipeline provided by the Public Health Agency of Sweden shows great promise in determining pathogens from clinical samples. However, there is still a lot of validation and standardisations needed for the successful implementation into a clinical setting.

Plasmids are small circular DNA molecules within bacterial cells that are separated from the bacterial chromosome and replicate independently. Also, they play a crucial role in the dissemination of antibiotic resistance genes among bacteria through horizontal gene transfer. They can be present in many copies within host cell, which is known as plasmid copy number. Plasmids can regulate their own copy number by different mechanisms. Additionally, the selective pressure can also play a pivotal role in determining plasmid copy number. The presence of antibiotics in the surrounding environment can drive variations of plasmid copy number. In this study, we examined plasmid copy number variations of multidrug resistance plasmids in presence of antibiotics by using EvaGreen® - based multiplexed digital droplet PCR. We could observe that cultures of Klebsiella pneumoniae and Escherichia coli harboring multidrug resistance plasmids grown in presence of sub-MIC concentrations of the antibiotics did not show high variations in plasmid copy numbers. On the other hand, mutants of K. pneumoniae selected for increased antibiotic resistance showed high increases in copy number of a multidrug-resistance plasmid.

Under vissa omständigheter kan bakterier kan ta sig in i blodbanan där de kan orsaka allvarliga infektioner (bakteriemi). Metoden som används för identifiering och resistensbestämning av bakterier i blododlingar kräver minst 16 timmars inkubation. Fram tills en resistensbestämning utförts kan empirisk antibiotikabehandling användas, men med ökande resistensutbredning blir det alltmer osäkert om denna behandling är verksam. Nyligen har en lappdiffusionsmetod för resistensbestämning direkt från blododling validerats, som kan läsas av efter 4, 6 och/eller 8 timmars inkubation. Det finns även publicerade arbeten där flödescytometriassisterad resistensbestämning används, men då krävs att bakterierna finns i tillräckligt hög koncentration, befinner sig i tillväxtfas och finns som renkultur. Syftet med examensarbetet var att optimera hantering av blododlingsflaskor så att bakterier från blododlingsflaskorna kunde isoleras med tillräcklig kvalitet och koncentration för att kunna utföra resistensbestämning med flödescytometri. Upprening av bakterierna utfördes med olika tvättbuffertar och sedan utfördes resistensbestämning med flödescytometri och  referensmetoden buljongspädning. Resultaten från uppreningen visade att sterilt vatten och Tween20 gynnade bakteriernas återhämtningsförmåga mest. Resistensbestämning utfördes med Klebsiella pneumoniae ATCC700603,  K. pneumoniae CCUG56233 och K. pneumoniae ATCC13882, som tvättats med sterilt vatten och Tween20. För CCUG56233 skiljde 1 spädningssteg i koncentrationsskalan mellan metoderna. ATCC-isolaten erhöll likartade MIC-värden (minimum inhibitory concentration) vid alla analyser men där fanns en skillnad på 2 spädningssteg mellan buljongspädning och analys med flödescytometri. Detta kan förklaras av skillnaden i inkubationstid mellan metoderna. Slutsatsen som kan dras är därför att resultaten från de två metoderna vid resistensbestämning är likartade och att sterilt vatten är mest lämpligt att använda vid upprening av bakterier. Fler undersökningar bör dock utföras.

Metropolitan mosquitoes: Understanding urban livestock keeping and vector-borne disease in growing tropical sites – The potential of sustainable control methods and the risks for emergence to Sweden.

No description available.

This report investigates the presence of Nosema in Sweden. Nosema is an intracellular parasite within the order Microsporidia and is considered a global threat. The most recent academic study on the presence of Nosema in Sweden was published in 2013, however in that study no presence of Nosema in the north of Sweden was reported. The aim of this study was to explore the presence of Nosema in Sweden, particularly in the north of Sweden. Samples were gathered from different locations in Sweden, and thereafter analysed (n=74), 54 samples were analysed under microscope. A geographical map was created to establish the range of Nosema on a global perspective. PCR primers and FISH gene probes for molecular identification were evaluated and tested both in SILVA and in an own database created in the bioinformatics software package ‘ARB’. Main findings of the study were that Nosema were detected in two samples in Sweden and that further studies with more sophisticated methods and better sequencing needs to be developed in order to fully investigate the presence of Nosema in the north of Sweden.