Sherlock Holmes and Dr. Watson Reflecting on Recent Trouble in Microbe-Land

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BREAKING NEWS – EARLY PRESS RELEASE
APP News – April 1st   2016


Sherlock Holmes:  Well, I am excited about taking on the case of yet another frightening new microbe…
Dr. Watson:  Yes, it is a particularly virulent bug, no treatment seems to be effective.

SH:  What else is new!  It is becoming rather uninteresting for a sleuth like me to hear only about MDR bugs. The community of newscaster ID’alogues is always prone to hyperbole these days, it seems to me. Is it another Ebola or Zika or Nipah or Hendra virus? Or just an MRSA with resistance to daptomycin?
Dr. W:  You are making light of the worst nightmare we can think of. No, this is a new bacillus, pan-resistant, popping up all over the US and soon to spread over our entire beloved colony.  Many states have already reported significant outbreaks with multiple casualties.US Trump - map

SH:  What do we know so far? Just the facts, please!  Let’s start with basics:  Is it Gram-positive or -negative?  Does it have a name yet?
Dr. W:  Actually, neither. Early reports called it Gram-positive BLUE but now it has been shown as clearly Gram-negative RED on coloring with the standard Republican stain. The organism is called Trumpella dollar-verdensis, formerly linked to the Pseudomonas group of pathogens but now given its own genus and species name because of its distinct 16S IRS status. You could call it Gram-variable, it clearly has a distinctive surface structure.

SH:  What were you able to learn about its origin?
Dr. W:  Glad you asked – while much is still obscure, we have some data in this regard. The pundits believe that it originated here in the US, perhaps in NY State, or around Atlantic City in NJ. However, there is also some support for the notion that it may be related to a Kenyan isolate identified close to Obama’s birthplace. Hence the birthers believe…

SH:  Objection!  Conjecture again! Just the mere facts, my dear friend…we will be able to draw our own conclusions more swiftly, if we can avoid the fluff of hearsay. Tell me about the virulence traits known so far…
Dr. W:  It is a heavily piliated organism, with a tuft of blonde hair from an apical location, a surely identifying feature. It propagates easily and does not require any of the usual growth enhancers that money can buy. It is an aerobic / microaerophilic life form, totally independent of partisan oxygen support that so many saprophytes rely on to flourish. We found that it is much attracted to light sources, especially the spectrum emitted by cameras and studio lamps.

Trumpella dollar-verdensis is a pathogen with blond apical fimbrial growth (combed to one side) with a typical $-shaped growth on agar. It produces a rather unique oscillating green pigment called dollar-verdin

SH:  So, depriving it of the lime light would likely reduce its virulence potential?
Dr. W:  This was tried but failed when it became known that it has other means to thrive in the various media, be it C-NN Wolf-Mueller, FOXy Kelly-Hinton, Middelbrook ABC or the Twitter agar. Forgot to mention the following: the rascal affects the Latino population predominantly, in which it produces a powerful GI reaction, like Turista.

SH:  By my recollection, there is usually an antidote – often long forgotten or relegated to obscurity – which we can rely on for an exceptional invader like this…How about Clintonamycin, an old stalwart that may be able to control the Trumpella…or maybe Bernisandricin, a very old and almost forgotten antagonist?
Dr. W:  Well, Clintonamycin is not going to work – quite predictably, it will only cause a lot of diarrhea. And too little is known about Bernisandricin just yet.  McKainamycin is not useful, and neither is Romneymitticin, the former being too static and the latter too narrow-spectrum.

SH: <Ugh, sigh..c’mon…c’est terrible!  Hmmm…argh!>
Dr. W: There was hope for a while that exposure to Td. cruzii, a parasite in its own right, may be able to limit Trumpellosis. However, this is by no means certain. Both are pathogens, for sure, but Td. cruzii has already been proven ineffective against Trumpella in many test situations and environments. To many experts, Td. cruzii treatment is like giving malaria to treat syphilis.  Do you remember the Nobel prize winner Wagner-Jauregg and his malaria experiments?

SH:  Don’t stray away from our topic – I am just beginning to understand the dilemma. This Td. cruzii is yet another newcomer to the field?
Dr. W:  Yes, considered a non-pathogen, until recently. It is mainly known for a certain Texas-swagger-like motility in liquid media. However, this one is unequivocally Gram-negative and stains a dark Reagan RED even when exposed to only BLUE dye – remarkable!

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T. dollar-verdensis. The colonies often form an S-shaped arrangement reminiscent of a $ sign. Note: The green color shift is only detectable under UV light, just like on banknotes.

SH:  You have not told us much about the clinico-pathologic presentation of the Trumpella – is there something distinctive?
Dr. W:  It is an aggressive invader, penetrating tissues that you thought would be impregnable. It knows no anatomic barriers, demographics of age or gender. It is attacking both on Main Street as on Wall Street. We are at a loss to explain this pervasiveness which defies all reason and has no historic parallels.
Trumpella is not kept in check by immunity. Indeed, despite vigorous development of antibodies, these seem to be neither protective nor neutralizing. Some have felt that they may drive a paradoxical growth of Trumpella.

SH:  Last not least, there is still cellular immunity as I remember from my readings of Metchnikov. We can always count on our built-in defenses in the absence of antibiotics, right?
Dr. W:  Unfortunately, Trumpella survives the attacks of macrophages from any party, and natural killer cells from any lobby. Amazingly, the organism has been able to penetrate the BBB, crossing into the CNS where it causes encephalitis and altered mentation. It has a strange euphoric effect on those infected, as it attacks predominantly the frontal lobes, the seat of emotions and anger control. This explains the irrational exuberance and unbridled agitation in its poor victims.

SH: Glad to see that this is easily distinguished on MRI from Herpes encephalitis. I still don’t believe there would be no remedy. What is the CDC’s reaction and what do they advise?
Dr. W:  They have promptly responded and issued reasonable guidelines. Right now, they recommend isolation for anyone with a fever and mental confusion; culture of a green-staining pathogen that grows in a $ (dollar) shape on agar with surrounding viridans hemolysis is a sure diagnostic criterium for T. dollar-verdensis and what is now referred to as T$$$ disease.

SH:  This is excellent advice which we should heed. Every effort has to be made to avoid a pandemic. We were able to contain pest and cholera in the old days; we should be able to handle this outbreak as well. Isolation to the rescue, when all else fails!
Dr. W: In this case, T. dollar-verdensis will be contained to the US, for sure. A wall is being built as we speak (see map) although genetics indicate that the host range of this organism may be confined to the 50 states that make up the US. But you can never be too careful!

SH: You are right – this is no time for complacency!  I will send a message to Scotland Yard at once with a full description of this threat to our national security. We need new antibiotics against Trumpellas and other marauders.  I’d call the initiative “New drugs for bad bugs”, or ND4BB. Got it?

ND4BB


 

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