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      Leptospira Is an Environmental Bacterium That Grows in Waterlogged Soil

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          ABSTRACT

          Leptospirosis is a zoonotic disease caused by infection with pathogenic leptospires. Consistent with recent studies by other groups, leptospires were isolated from 89 out of 110 (80.9%) soil or water samples from varied locations in the Philippines in our surveillance study, indicating that leptospires might have a life cycle that does not involve animal hosts. However, despite previous work, it has not been confirmed whether leptospires multiply in the soil environment under various experimental conditions. Given the fact that the case number of leptospirosis is increased after flood, we hypothesized that waterlogged soil, which mimics the postflooding environment, could be a suitable condition for growing leptospires. To verify this hypothesis, pathogenic and saprophytic leptospires were seeded in the bottles containing 2.5 times as much water as soil, and bacterial counts in the bottles were measured over time. Pathogenic and saprophytic leptospires were found to increase their number in waterlogged soil but not in water or soil alone. In addition, leptospires were reisolated from soil in closed tubes for as long as 379 days. These results indicate that leptospires are in a resting state in the soil and are able to proliferate with increased water content in the environment. This notion is strongly supported by observations that the case number of leptospirosis is significantly higher in rainy seasons and increased after flood. Therefore, we reached the following conclusion: environmental soil is a potential reservoir of leptospires.

          IMPORTANCE Since research on Leptospira has focused on pathogenic leptospires, which are supposed to multiply only in animal hosts, the life cycle of saprophytic leptospires has long been a mystery. This study demonstrates that both pathogenic and saprophytic leptospires multiply in the waterlogged soil, which mimics the postflooding environment. The present results potentially explain why leptospirosis frequently occurs after floods. Therefore, environmental soil is a potential reservoir of leptospires and leptospirosis is considered an environment-borne as well as a zoonotic disease. This is a significant report to reveal that leptospires multiply under environmental conditions, and this finding leads us to reconsider the ecology of leptospires.

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          Leptospirosis: a zoonotic disease of global importance

          In the past decade, leptospirosis has emerged as a globally important infectious disease. It occurs in urban environments of industrialised and developing countries, as well as in rural regions worldwide. Mortality remains significant, related both to delays in diagnosis due to lack of infrastructure and adequate clinical suspicion, and to other poorly understood reasons that may include inherent pathogenicity of some leptospiral strains or genetically determined host immunopathological responses. Pulmonary haemorrhage is recognised increasingly as a major, often lethal, manifestation of leptospirosis, the pathogenesis of which remains unclear. The completion of the genome sequence of Leptospira interrogans serovar lai, and other continuing leptospiral genome sequencing projects, promise to guide future work on the disease. Mainstays of treatment are still tetracyclines and beta-lactam/cephalosporins. No vaccine is available. Prevention is largely dependent on sanitation measures that may be difficult to implement, especially in developing countries.
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            Global Morbidity and Mortality of Leptospirosis: A Systematic Review

            Background Leptospirosis, a spirochaetal zoonosis, occurs in diverse epidemiological settings and affects vulnerable populations, such as rural subsistence farmers and urban slum dwellers. Although leptospirosis is a life-threatening disease and recognized as an important cause of pulmonary haemorrhage syndrome, the lack of global estimates for morbidity and mortality has contributed to its neglected disease status. Methodology/Principal Findings We conducted a systematic review of published morbidity and mortality studies and databases to extract information on disease incidence and case fatality ratios. Linear regression and Monte Carlo modelling were used to obtain age and gender-adjusted estimates of disease morbidity for countries and Global Burden of Disease (GBD) and WHO regions. We estimated mortality using models that incorporated age and gender-adjusted disease morbidity and case fatality ratios. The review identified 80 studies on disease incidence from 34 countries that met quality criteria. In certain regions, such as Africa, few quality assured studies were identified. The regression model, which incorporated country-specific variables of population structure, life expectancy at birth, distance from the equator, tropical island, and urbanization, accounted for a significant proportion (R2 = 0.60) of the variation in observed disease incidence. We estimate that there were annually 1.03 million cases (95% CI 434,000–1,750,000) and 58,900 deaths (95% CI 23,800–95,900) due to leptospirosis worldwide. A large proportion of cases (48%, 95% CI 40–61%) and deaths (42%, 95% CI 34–53%) were estimated to occur in adult males with age of 20–49 years. Highest estimates of disease morbidity and mortality were observed in GBD regions of South and Southeast Asia, Oceania, Caribbean, Andean, Central, and Tropical Latin America, and East Sub-Saharan Africa. Conclusions/Significance Leptospirosis is among the leading zoonotic causes of morbidity worldwide and accounts for numbers of deaths, which approach or exceed those for other causes of haemorrhagic fever. Highest morbidity and mortality were estimated to occur in resource-poor countries, which include regions where the burden of leptospirosis has been underappreciated.
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              Leptospirosis

              Leptospirosis is a worldwide zoonotic infection with a much greater incidence in tropical regions and has now been identified as one of the emerging infectious diseases. The epidemiology of leptospirosis has been modified by changes in animal husbandry, climate, and human behavior. Resurgent interest in leptospirosis has resulted from large outbreaks that have received significant publicity. The development of simpler, rapid assays for diagnosis has been based largely on the recognition that early initiation of antibiotic therapy is important in acute disease but also on the need for assays which can be used more widely. In this review, the complex taxonomy of leptospires, previously based on serology and recently modified by a genotypic classification, is discussed, and the clinical and epidemiological value of molecular diagnosis and typing is also evaluated.
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                Author and article information

                Contributors
                Role: Editor
                Journal
                Microbiol Spectr
                Microbiol Spectr
                spectrum
                Microbiology Spectrum
                American Society for Microbiology (1752 N St., N.W., Washington, DC )
                2165-0497
                15 March 2022
                Mar-Apr 2022
                15 March 2022
                : 10
                : 2
                : e02157-21
                Affiliations
                [a ] International Institute for Zoonosis Control, Hokkaido Universitygrid.39158.36, , Sapporo, Japan
                [b ] University of Shizuoka, Shizuoka, Japan
                [c ] Department of Medical Microbiology, College of Public Health, University of the Philippines–Manila, Manila, Philippines
                [d ] International Collaboration Unit, International Institute for Zoonosis Control, Hokkaido Universitygrid.39158.36, , Sapporo, Japan
                [e ] Department of Bacteriology, Graduate School of Medical Sciences, Kyushu Universitygrid.177174.3, , Fukuoka, Japan
                [f ] Laboratory of Microbiology and Immunology, Faculty of Pharmaceutical Sciences, Chiba Institute of Science, Chiba, Japan
                [g ] Institute of Pathology, St Luke’s Medical Center, Quezon City, Philippines
                [h ] Department of Microbiology, School of Medicine, University of Occupational and Environmental Health, Kitakyushu, Japan
                [i ] Collaborating Research Center for the Control of Infectious Diseases, Nagasaki University, Nagasaki, Japan
                University of Texas at San Antonio
                Author notes

                The authors declare no conflict of interest.

                Author information
                https://orcid.org/0000-0003-1086-8244
                https://orcid.org/0000-0003-4876-1004
                Article
                02157-21 spectrum.02157-21
                10.1128/spectrum.02157-21
                9045322
                35289672
                2419b7a5-3f63-4449-b8b9-d0bac2fcfa05
                Copyright © 2022 Yanagihara et al.

                This is an open-access article distributed under the terms of the Creative Commons Attribution 4.0 International license.

                History
                : 10 December 2021
                : 24 February 2022
                Page count
                supplementary-material: 1, Figures: 2, Tables: 2, Equations: 0, References: 43, Pages: 9, Words: 6233
                Funding
                Funded by: Japan Agency for Medical Research and Development (AMED), FundRef https://doi.org/10.13039/100009619;
                Award ID: JP19fm0108008
                Award ID: JP21wm0125008
                Award Recipient :
                Funded by: MEXT | JST | Science and Technology Research Partnership for Sustainable Development (SATREPS), FundRef https://doi.org/10.13039/501100009037;
                Award Recipient :
                Funded by: MEXT | Japan Society for the Promotion of Science (JSPS), FundRef https://doi.org/10.13039/501100001691;
                Award ID: 21H02376
                Award Recipient :
                Funded by: MEXT | Japan Society for the Promotion of Science (JSPS), FundRef https://doi.org/10.13039/501100001691;
                Award ID: 18K07135
                Award Recipient :
                Funded by: Ministry of Education, Culture, Sports, Science and Technology (MEXT), FundRef https://doi.org/10.13039/501100001700;
                Award ID: 1801
                Award Recipient :
                Funded by: Ministry of Education, Culture, Sports, Science and Technology (MEXT), FundRef https://doi.org/10.13039/501100001700;
                Award ID: 1801
                Award Recipient :
                Categories
                Research Article
                environmental-microbiology, Environmental Microbiology
                Custom metadata
                March/April 2022

                leptospira,leptospirosis,waterlogged soil,survival in soil

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