Saliva culture as a predictive indicator for current blood infections and antimicrobial resistance in the ICU setting.

Antimicrobial resistance is a worldwide health problem and patients in intensive care are more vulnerable, requiring strict control measures and early identification. Currently, clinical culture materials are used to identify the bacterial agent, but saliva culture is not validated, which has great clinical relevance because it participates in several pathophysiological processes. The aim of this study was to validate saliva culture in an intensive care unit environment, determining its diagnostic value for infection. For this purpose, the results of the 39-month surveillance cultures, from the database of a private hospital were evaluated. A total of 323 cultures were paired between saliva, tracheal secretions, blood and urine from patients who were hospitalized for more than 5 days. The search for correlations between the results was performed using the Spearman correlation test. Severity and evolution data were also correlated. It was possible to correlate the presence of Klebsiella spp. between blood culture and saliva culture in 25% of the results (r = 0.01) and the correlation between saliva and tracheal secretion was 33% (r = 0.33447) with p < 0.0001. In conclusion, saliva can be an excellent discriminator of systemic infections, and can be considered a useful culture in clinical practice.

Biofilm formation and cell viability on monolithic zirconia with silver-doped sodalime glass.

The present study evaluated the effect of glass application with and without silver-doped soda-lime glass on roughness, biofilm formation, cell viability and flexural strength of a zirconia. Samples of 3-YTZP (3 mol% yttria stabilized tetragonal zirconia polycrystals) were divided into: polished (P); glaze (G); glass infiltration (INF); 4% silver-doped soda-lime glass (Ag4); glass infiltration + 4% silver-doped soda-lime glass (INF-Ag4); 5% silver-doped soda-lime glass (Ag5); glass infiltration + 5% silver-doped soda-lime glass (INF-Ag5). Samples were submitted to the following analyses: roughness (Ra); free surface energy (FSE); colony-forming units count (log CFU/mL); scanning electron microscopy (SEM); cytotoxicity (MTT assay) and flexural strength. Ag5 had greater roughness and FSE, but less biofilm adherence. In the CFU, silver-doped soda-lime glass groups inhibited the growth of Candida albicans, while the Ag5 inhibited Streptococcus mutans and none of the groups was effective against Streptococcus sanguinis. In the qualitative evaluation, lower number of colonies in the Ag5 grew up, compared to the control groups (P; G and INF) for both C. albicans and S. mutans. Regarding the MTT assay, the Ag4, INF-Ag4 and INF-Ag5 obtained percentage of cell viability greater than 50%. Ag5 showed lower flexural strength when compared to the control groups, while the application of glass infiltration increased the flexural strength by formation of a graded region between zirconia-glass. In conclusion, Ag5 had the greatest antimicrobial effect, Ag4 and INF-Ag4 were the less cytotoxic and the INF was the most resistant to fracture. Therefore, INF-Ag4 conciliates the best performance in terms of antimicrobial and mechanical properties for a 3-YTZP.

Influence of Chronic Alcohol Use on Osteoblastic Differentiation of Bone Marrow Cells, Bone Properties, and Hepatic and Renal Morphology of Rats.

Chronic alcohol exposure can affect the osteoblastic activity and the proliferation and differentiation of cells due to its toxic effect, which can affect negatively bone repair and bone microarchitecture. The aim of this study was to evaluate the effects of chronic use of 20% alcohol on rats regarding osteoblastic differentiation, extrinsic and intrinsic properties of the tibia, and hepatic and renal morphology. Wistar rats were divided into three groups (n = 9) in accordance with a 24-week diet. After euthanasia, kidneys, liver, and tibias were removed for analysis and femurs mesenchymal cells were collected. The results showed that chronic use of 20% alcohol influenced neither the alkaline phosphatase production nor total protein (p > 0.05) in rats, with similar formation of nodules in all groups (p > 0.05). However, significant changes in the liver and kidneys and adverse effects on the mechanical properties of the tibia were observed. According to the results, it can be concluded that the chronic use of alcohol for 24 weeks had no negative influence on the activity and differentiation of osteoblasts, but the mechanical properties of the tibia were impaired and the organs responsible for metabolism and excretion were also affected due to the consumption of alcohol.