Disbiosis bacteriana y su efecto en enfermedades bucales: una revisión bibliográfica / Bacterial dysbiosis and its effect on oral diseases: a review bibliographic

Objetivo: actualizar la información sobre la disbiosis bacteriana oral y su efecto en enfermedades bucales. Material y métodos: se realizó una revisión bibliográfica detallada, donde la búsqueda de artículos comenzó desde el 2014 con trabajos de investigación relacionados con el tema. Se aplicaron palabras clave para facilitar y delimitar el tema. En los resultados obtenidos se observa información específica de disbiosis bacteriana y los problemas y enfermedades que causan en la cavidad bucal. Conclusión: la cavidad oral es un ecosistema muy complejo e interactivo donde se desarrollan variedades de hábitats que establecen relaciones entre los microorganismos en los distintos medios bucales. Por lo general, el cuerpo humano vive en simbiosis con dichas bacterias, esta relación hospedador-huésped es producto de años de evolución y convivencia para poder tolerar a dichas especies y por medio de años de investigación, determinar a los agentes patógenos y a los simbióticos, lo que permitirá en un futuro tener enfoques terapéuticos y científicos, para así solucionar, mejorar y evitar problemas relacionados con la salud (AU)

Objective: this review aimed to update the information on oral bacterial dysbiosis and its effect on oral diseases. Material and methods: a detailed literature review was performed, where the search for articles began in 2014 with research papers related to the topic. Keywords were applied to facilitate and delimit the topic. The results obtained show specific information on bacterial dysbiosis and the problems and diseases they cause in the oral cavity. Conclusion: the oral cavity is a very complex and interactive ecosystem where a variety of habitats develop and establish relationships between microorganisms in different oral environments. Generally, the human body lives in symbiosis with these bacteria, this host-guest relationship is the product of years of evolution and coexistence to be able to tolerate these species and through years of research to determine the pathogens and symbiotics, which will allow in the future to have therapeutic and scientific approaches, to solve, improve and avoid health-related problems (AU)

Study of Normal Flora in the Pharynx of Healthy Children.

To improve our current understanding of normal flora in children, we investigated bacterial isolates from the pharynx and nasopharynx of 173 and 233 healthy children, respectively. The bacterial isolation rates were compared among three age groups: infants (<1 year), toddlers (1-5 years), and school-aged children (6-15 years). Gram-positive cocci were the predominant bacteria in the pharynx (Streptococcus mitis/oralis, 87.3%; Streptococcus salivarius, 54.3%; Rothia mucilaginosa, 41.6%; Staphylococcus aureus, 39.3%). Among infants, S. salivarius and Neisseria subflava, which are related to the development of teeth, were significantly lower than in the other age groups (P <0.0001, S. salivarius; P <0.01, N. subflava). With the exception of Corynebacterium pseudodiphtheriticum (44.2%, gram-positive rods), gram-negative rods largely predominated the nasopharynx (Moraxella catarrhalis, 32.1%; Moraxella nonliquefaciens, 28.3%). Among toddlers, M. catarrhalis and Streptococcus pneumoniae, which are the most common pathogens in acute otitis media, were significantly higher than in the infant group (P <0.05). Among the bacterial species implicated in pediatric respiratory infections, Streptococcus pyogenes was isolated in 3.5% of the pharyngeal samples. S. pneumoniae and Haemophilus influenzae were isolated in 22.3% and 17.2% of the nasopharyngeal samples, respectively. In conclusion, the normal flora of the respiratory tract differs not only by the sampling site but also by the age group.

Antimicrobial-resistant pathogens associated with adult healthcare-associated infections: Summary of data reported to the National Healthcare Safety Network, 2015-2017.

OBJECTIVE: Describe common pathogens and antimicrobial resistance patterns for healthcare-associated infections (HAIs) that occurred during 2015-2017 and were reported to the Centers for Disease Control and Prevention's (CDC's) National Healthcare Safety Network (NHSN). METHODS: Data from central line-associated bloodstream infections (CLABSIs), catheter-associated urinary tract infections (CAUTIs), ventilator-associated events (VAEs), and surgical site infections (SSIs) were reported from acute-care hospitals, long-term acute-care hospitals, and inpatient rehabilitation facilities. This analysis included device-associated HAIs reported from adult location types, and SSIs among patients ≥18 years old. Percentages of pathogens with nonsusceptibility (%NS) to selected antimicrobials were calculated for each HAI type, location type, surgical category, and surgical wound closure technique. RESULTS: Overall, 5,626 facilities performed adult HAI surveillance during this period, most of which were general acute-care hospitals with <200 beds. Escherichia coli (18%), Staphylococcus aureus (12%), and Klebsiella spp (9%) were the 3 most frequently reported pathogens. Pathogens varied by HAI and location type, with oncology units having a distinct pathogen distribution compared to other settings. The %NS for most pathogens was significantly higher among device-associated HAIs than SSIs. In addition, pathogens from long-term acute-care hospitals had a significantly higher %NS than those from general hospital wards. CONCLUSIONS: This report provides an updated national summary of pathogen distributions and antimicrobial resistance among select HAIs and pathogens, stratified by several factors. These data underscore the importance of tracking antimicrobial resistance, particularly in vulnerable populations such as long-term acute-care hospitals and intensive care units.

Endocarditis infecciosa por bacilos gram negativos no HACEK. Experiencia en un centro de alta complejidad de la República Argentina (1998-2016) / Infective endocarditis due to non-HACEK gram-negative bacilli in a Level III cardiovascular center in Argentina (1998-2016)

Los bacilos gram negativos (BGN) que no pertenecen al grupo HACEK son una causa infrecuente de endocarditis infecciosa. Los aspectos epidemiológicos, diagnósticos y pronósticos de esta entidad son poco conocidos y la experiencia aún es limitada. Nuestros objetivos fueron analizar las características clínicas y microbiológicas de las endocarditis infecciosas (EI) por BGN no HACEK diagnosticadas en un centro de alta complejidad de Argentina en el período 1998-2016 y conocer su evolución hospitalaria, a fin de compararlas con las EI debidas a otros microorganismos.

Non-HACEK Gram-negative bacilli are a rare cause of infective endocarditis. Epidemiological, diagnostic and prognostic aspects of this entity are little known, and there is limited experience. The aim of this study was to analyze the clinical, microbiological and in-hospital outcomes of non-HACEK Gram negative bacilli endocarditis and to compare them with those due to other microorganisms.

Roseithermus sacchariphilus gen. nov., sp. nov. and proposal of Salisaetaceae fam. nov., representing new family in the order Rhodothermales.

A novel bacterium with cells that were pinkish-cream-coloured, aerobic, rod-shaped, 0.62-1.00 µm wide and 2.3-3.3 µm long, designated as strain MEBiC09517T, was isolated from Buksung-Po, a small port in Incheon, Republic of Korea. Strain MEBiC09517T had low 16S rRNA gene sequence similarity to validly reported strains; among them, Rubrivirgaprofundi SAORIC-476T displayed highest sequence similarity (89.9 %). Nevertheless, the novel strain shared a phylogenetic line with members of the genus Rhodothermus, not the genus Rubrivirga. Optimum growth conditions of strain MEBiC09517T were at 50-55 °C, pH 7 and in 2.0-4.0 % salt concentration. Strain MEBiC09517T was found to be an obligate marine bacterium that requires KCl, MgCl2 and CaCl2 as well as NaCl for growth. A phosphatidylethanolamine, a diphosphatidylglycerol, three glycolipids and four unidentified lipids were the strain's predominant polar lipid components. The fatty acid of the cell wall mainly consisted of carbons with 16 or 18 chain lengths such as C16 : 0, C18 : 0, C18 : 1 and summed feature 3 (C16 : 1ω6c and/or C16 : 1ω7c). The predominant menaquinone was MK-7. The DNA G+C content is 68.65 mol%. Strain MEBiC09517T differs from genera of the order Rhodothermales in terms of fatty acid composition, growth conditions, and range of carbon source utilization. Based on phylogenetic analysis using the strain's 16S rRNA gene sequence and results of physiological tests, strain MEBiC09517T (KCCM=43267T, JCM=32374T) is proposed as Roseithermus sacchariphilus gen. nov., sp. nov. Additionally, the novel family Salisaetaceae fam. nov. based on phylogenetic analysis and physiological characteristics is suggested.

Capsulimonas corticalis gen. nov., sp. nov., an aerobic capsulated bacterium, of a novel bacterial order, Capsulimonadales ord. nov., of the class Armatimonadia of the phylum Armatimonadetes.

An aerobic bacterial strain designated AX-7T was isolated from the trunk surface of a Japanese beech (Fagus crenata). Cells of strain AX-7T were Gram-stain-negative, non-spore-forming, non-motile rods (1.0-1.2 µm in width and 1.2-3.0 µm in length) with peritrichous fimbriae. Cells were capsulated, and a number of them were surrounded by a thick slime layer. During growth, large aggregates formed, and the culture medium became viscous probably owing to exopolysaccharide release from the slime layer. The temperature range for growth was 10-37 °C, with an optimum at 30 °C. The pH range for growth was 5.0-7.0, with an optimum at pH 6.0. Strain AX-7T used various sugars, including polysaccharides, and yeast extract as growth substrates. Strain AX-7T contained menaquinones MK-9 and MK-10 as the respiratory quinones, and C16 : 1ω5c, C16 : 1ω11c, C16 : 0 and C14 : 0 as the major cellular fatty acids. Four unidentified phospholipids and 11 unidentified polar lipids constituted the polar lipids. The DNA G+C content was 61.0 mol%. The cell-wall peptidoglycan contained ll-diaminopimelic acid. Phylogenetic analysis based on 16S rRNA gene sequences revealed that strain AX-7T belonged to the class Armatimonadia, its closest relative being Armatimonas rosea YO-36T, with sequence similarity of 88.1%. Based on data from this polyphasic study, we propose that strain AX-7T represents a new genus of a novel species within the novel order Capsulimonadales ord. nov. of the class Armatimonadia, for which the name Capsulimonas corticalis gen. nov., sp. nov. is proposed. The type strain of C. corticalis is AX-7T (=DSM 105890T=NBRC 113044T).

Trinickia diaoshuihuensis sp. nov., a plant growth promoting bacterium isolated from soil.

A novel Gram-stain-negative, aerobic, rod-shaped plant growth promoting bacterium, NEAU-SY24T, was isolated from soil in Diaoshuihu, Heilongjiang, China. The isolate grew at temperatures 10-40 °C (optimum, 30 °C), pH 5-8 (optimum, pH 6) and in the presence of up to 1 % (w/v) NaCl, although NaCl was not required for growth. Phylogenetic analysis based on the 16S rRNA gene sequence indicated that strain NEAU-SY24T belonged to the genus Trinickia and was closely related to Trinickia dabaoshanensis NRRL B-59553T (99.16 % similarity) and Trinickia soli DSM 18235T (99.11 %). The average nucleotide identity values between NEAU-SY24T and its most closely related species were 79.30-87.09 %. The in silico DNA-DNA hybridization values between NEAU-SY24T and T. dabaoshanensis NRRL B-59553T and T. soli DSM 18235T were 29.30 and 24.00 %, respectively, again indicating they belong to different taxa. The genomic DNA G+C content was 63.3 mol%. The major cellular fatty acids were C17 : 0cyclo, C18 : 1ω7c, C16 : 0, summed feature 2 (comprising C14 : 0 3-OH and/or C16 : 1iso I) and C16 : 0 3-OH. The predominant respiratory quinone was Q-8 and the whole-cell sugars contained ribose, glucose and galactose. The polar lipids consisted of diphosphatidylglycerol, phosphatidylglycerol, phosphatidylethanolamine, hydroxyphosphatidylethanolamine and two unidentified aminolipids. On the basis of morphological, physiological, biochemical and chemotaxonomic analysis, strain NEAU-SY24T was classified as a novel species in the genus Trinickia, for which the name Trinickiadiaoshuihuensis sp. nov. is proposed. The type strain is NEAU-SY24T (=DSM 106065T=CCTCC AA 2018003T).

Leclercia adecarboxylata, a rare cause of soft tissue infections in immunocompromised patients, case report and review of the literature / Leclercia adecarboxylata, una causa rara de infección de tejidos blandos en pacientes inmunocomprometidos, reporte de caso y revisión de la literatura

Leclercia adecarboxylata is a member of the Enterobacteriaceae family that has been isolated from several environmental and animal specimens, however it rarely causes diseases in human beings. It has natural resistance to several antibiotics, and has shown the ability to harbor and produce enzymes capable of hydrolyzing most of the antibiotics used in daily clinical practice, making its treatment a challenge when a strain with such characteristics causes disease. Here we report the first known case of infection by Leclercia adecarboxylata after a trauma with plant material, in a 69-year-old male patient, with poorly controlled Diabetes Mellitus type 2.

Leclercia adecarboxylata es un miembro de la familia Enterobacteriaceae que ha sido aislada tanto de muestras de animales como medioambientales, sin embargo raramente produce enfermedad en seres humanos. Tiene resistencia natural a varios antibióticos y se ha encontrado que tiene enzimas capaces de hidrolizar la mayoría de los antibióticos utilizados en la práctica clínica, lo cual hace un verdadero tratar una infección por este microorganismo en humanos. Aquí reportamos el primer caso de infección por Leclercia adecarboxylata luego de un trauma con material vegetal, en un paciente de 69 años y con una diabetes tipo 2, mal controlada.

Curva epidemiológica de Bordetella pertussis en el Ecuador referente a los años 1999 al 2014 / Bordetella pertussis epidemiological curve in Ecuador referring to the years 1999 to 2014

Bordetella pertussises un cocobacilo Gram negativo aerobio estricto agente causal de la enfermedad infectocontagiosa conocida como tosferina que afecta predominantemente a lactantes, produciendo un alto índice de mortalidad. Mediante la elaboración de una curva epidemiológica del número de casos de la patología por Bordetella pertussis en un periodo epidémico dispuesto según etapas del tiempo, se evidenciará la evolución de los brotes en el Ecuador como aporte a la epidemiología nacional. Como objetivo específico se determina la frecuencia de aparición de B. pertussis, mediante el aislamiento de la cepa se procede a describir el comportamiento epidemiológico según la frecuencia de aparicióncomparando los datos epidemiológicos obtenidos en Ecuador con datos en el mundo, para poder destacar la importancia de implementar nuevas técnicas de laboratorio para el diagnóstico de la tosferina. El método aplicado en la investigación es descriptivo de cohorte transversal, siendo analizada la curva epidemiológica con los datos obtenidos de los aislamientos durante los años 1999 al 2014; como resultados del comportamiento epidemiológico de la Bordetella pertussisen el Ecuador se pueden visualizar picos en las gráficas que indican el inicio y el final de un brote, esto ocurre cada 3 a 5 años con la presencia de 0, 1 a 2 casos esporádicos entre cada una, tal como lo describen los reportes epidemiológicos de la OMS.Los resultados obtenidos en el estudio revelan la categoría en cuanto los recursos humanos, educación y comunicación, sus dimensiones, procedimientos clínicos, técnicos para la vigilancia de enfermedades transmisibles, las técnicas de cultivo, serología, y la unidad de análisis de las muestras clínicas recibidas de las diferentes zonas del Ecua

Bordetellapertussis is a strict aerobic Gram negative coccobacillus, causative agent of the infectious disease known as pertussis, which predominantly affects infants, producing a high mortality rate. By means of the elaboration of an epidemiological curve of the number of cases of the pathology by Bordetella Pertussis in an epidemic period arranged according to time stages, the evolution of the outbreaks in Ecuador as a contribution to the National Epidemiology will be evidenced.As a specific objective, the frequency of appearance of B. pertussis is determined by means of the isolation of the strain, we proceed to describe the epidemiological behavior according to the frequency of appearance, comparing the epidemiological data obtained in Ecuador with data obtainedin the world, in order to highlight the importance of implementing new laboratory techniques for the diagnosis of whooping cough.The method applied in the research is descriptive of a transversal cohort, the epidemiological curve being analyzed with the data obtained from the isolations during the years 1999 to 2014, as results of the epidemiological behavior of the Bordetella pertussis in Ecuador can be seen peaks in the graphs that indicate the beginning and end of an outbreak, this occurs every 3 to 5 years with the presence of 0, 1 to 2 sporadic cases between each, as described in the WHO epidemiological reports.The results obtained in the study reveal the category in terms of human resources, education and communication, its dimensions, clinical, technical procedures for the surveillance of communicable diseases, culture techniques, serology, and the unit of analysis of the clinical samples received of the different zones of Ecuador.

In vitro detection of common rhinosinusitis bacteria by the eNose utilising differential mobility spectrometry.

Acute rhinosinusitis (ARS) is a sudden, symptomatic inflammation of the nasal and paranasal mucosa. It is usually caused by respiratory virus infection, but bacteria complicate for a small number of ARS patients. The differential diagnostics between viral and bacterial pathogens is difficult and currently no rapid methodology exists, so antibiotics are overprescribed. The electronic nose (eNose) has shown the ability to detect diseases from gas mixtures. Differential mobility spectrometry (DMS) is a next-generation device that can separate ions based on their different mobility in high and low electric fields. Five common rhinosinusitis bacteria (Streptococcus pneumoniae, Haemophilus influenzae, Moraxella catarrhalis, Staphylococcus aureus, and Pseudomonas aeruginosa) were analysed in vitro with DMS. Classification was done using linear discriminant analysis (LDA) and k-nearest neighbour (KNN). The results were validated using leave-one-out cross-validation and separate train and test sets. With the latter, 77% of the bacteria were classified correctly with LDA. The comparative figure with KNN was 79%. In one train-test set, P. aeruginosa was excluded and the four most common ARS bacteria were analysed with LDA and KNN; the correct classification rate was 83 and 85%, respectively. DMS has shown its potential in detecting rhinosinusitis bacteria in vitro. The applicability of DMS needs to be studied with rhinosinusitis patients.

Incorporation of a Theranostic "Two-Tone" Luminescent Silver Complex into Biocompatible Agar Hydrogel Composite for the Eradication of ESKAPE Pathogens in a Skin and Soft Tissue Infection Model.

Microbial invasion and colonization of the skin and underlying soft tissues are among the most common types of infections, becoming increasingly prevalent in hospital settings. Systemic antibiotic chemotherapies are now extremely limited due to emergence of drug-resistant Gram-positive and multidrug-resistant Gram-negative bacterial strains. Topical administration of antimicrobials provides an effective route for the treatment of skin and soft tissue infections (SSTIs). Therefore, the development of new and effective materials for the delivery of these agents is of paramount importance. Silver is a broad-spectrum antibiotic used for the treatment and prevention of infections since ancient times. However, the high reactivity of silver cation (Ag+) makes its incorporation into delivery materials quite challenging. Herein we report a novel soft agar hydrogel composite for the delivery of Ag+ into infected wound sites. This material incorporates a Ag(I) complex [Ag2(DSX)2(NO3)2] (1; DSX = 5-(dimethylamino)- N, N-bis(pyridin-2-ylmethyl) naphthalene-1-sulfonamide) that exhibits a change in fluorescence upon Ag+ release and qualitatively indicates the end point of silver delivery. The antibacterial efficacy of the material was tested against several bacterial strains in an SSTI model. The complex 1-agar composite proved effective at eradicating the pathogens responsible for the majority of SSTIs. The theranostic (therapeutic/diagnostic) properties coupled with its stability, softness, ease of application, and removal make this material an attractive silver-delivery vehicle for the treatment and prevention of SSTIs.

Gracilimonas amylolytica sp. nov., isolated from deep-sea sediment.

A Gram-stain-negative, aerobic, non-motile and rod-shaped bacterium, designated LA399T, was isolated from deep-sea sediment collected from the Pacific Ocean. Cells of strain LA399T grew in the medium containing 0-10.0 % of NaCl (w/v; optimum 3.0-5.0 %), pH 6.5-8.0 (optimum 7.0) and 20-40 °C (optimum 37 °C). Aesculin, gelatin, starch and Tween 80 were hydrolysed. Strain LA399T was closely related to Gracilimonas halophila WDS2C40T (97.0 % sequence similarity), Gracilimonas mengyeensis YIM J14T (96.4 %), Gracilimonas rosea CL-KR2T (96.4 %) and Gracilimonas tropica DSM 19535T (96.0 %), and exhibited equal or less than 96.0 % sequence similarity to other type strains of species with validly published names. Phylogenetic analyses revealed that strain LA399T clustered with the clade comprising the Gracilimonas species and formed an independent lineage. Strain LA399T contained menaquinone 7 as the sole isoprenoid quinone and iso-C15 : 0, anteiso-C15 : 0, summed feature 3 (C16 : 1ω7c/C16 : 1ω6c) and summed feature 9 (iso-C17 : 1ω9c/10-methyl C16 : 0) as the predominant cellular fatty acids. The major polar lipids were diphosphatidylglycerol, phosphatidylglycerol, phosphatidylethanolamine, one unidentified phospholipid and three unidentified glycolipids. The DNA G+C content was 45.3 mol%. According to the phylogenetic, chemotaxonomic and phenotypic data, it represents a novel species of the genus Gracilimonas, for which the name Gracilimonas amylolytica is proposed. The type strain is LA399T (=CGMCC 1.16248T=KCTC 52885T).

Rhodohalobacter barkolensis sp. nov., isolated from a saline lake and emended description of the genus Rhodohalobacter.

A Gram-stain-negative, non-motile, aerobic, rod-shaped bacterium, designated 15182T, was isolated from a saline lake in China. The novel strain 15182T was able to grow at 10-40 °C (optimum, 37 °C), pH 7.0-8.0 (optimum, 7.5) and with 0.5-4 % NaCl (optimum, 2-3 %, w/v). The phylogenetic analysis based on 16S rRNA gene sequences revealed that strain 15182T was most closely related to the genus Rhodohalobacter by sharing the highest sequence similarity of 97.0 % with Rhodohalobacter halophilus JZ3C29T. Chemotaxonomic analysis showed that the sole respiratory quinone was menaquinone 7, the major fatty acids included C16 : 0 N alcohol and C16 : 1ω11c. The major polar lipids included diphosphatidylglycerol, phosphatidylglycerol, phosphatidylethanolamine, four uncharacterized glycolipids, one uncharacterized phospholipid and two uncharacterized lipids. The genomic DNA G+C content of the strain 15182T was 42.4 mol%. The average nucleotide identity value between 15182T and R. halophilus JZ3C29T was 75.4 %, and the in silico DNA-DNA hybridization value of the two strains was 19.1 %. On the basis of its phenotypic, chemotaxonomic, genotypic and genomic characteristics presented in this study, strain 15182T is suggested to represent a novel species in the genus Rhodohalobacter, for which the name Rhodohalobacter barkolensis sp. nov. is proposed. The type strain is 15182T (=KCTC 62172T=MCCC 1K03442T). An emended description of the genus Rhodohalobacter is also presented.

[Uncommon non-fermenting Gram-negative rods as pathogens of lower respiratory tract infection]. / Ritkábban eloforduló, alsó légúti fertozést okozó Gram-negatív nem fermentáló pálcák.

INTRODUCTION: Glucose non-fermenting Gram-negative bacteria are ubiquitous environmental organisms. Most of them are identified as opportunistic, nosocomial pathogens in patients. Uncommon species are identified accurately, mainly due to the introduction of matrix-assisted laser desorption-ionization time of flight mass spectrometry (MALDI-TOF MS) in clinical microbiology practice. Most of these uncommon non-fermenting rods are isolated from lower respiratory tract samples. Their significance in lower respiratory tract infections, such as rules of their testing are not clarified yet. AIM: The aim of this study was to review the clinical microbiological features of these bacteria, especially their roles in lower respiratory tract infections and antibiotic treatment options. METHOD: Lower respiratory tract samples of 3589 patients collected in a four-year period (2013-2016) were analyzed retrospectively at Semmelweis University (Budapest, Hungary). Identification of bacteria was performed by MALDI-TOF MS, the antibiotic susceptibility was tested by disk diffusion method. RESULTS: Stenotrophomonas maltophilia was revealed to be the second, whereas Acinetobacter baumannii the third most common non-fermenting rod in lower respiratory tract samples, behind the most common Pseudomonas aeruginosa. The total number of uncommon non-fermenting Gram-negative isolates was 742. Twenty-three percent of isolates were Achromobacter xylosoxidans. Beside Chryseobacterium, Rhizobium, Delftia, Elizabethkingia, Ralstonia and Ochrobactrum species, and few other uncommon species were identified among our isolates. The accurate identification of this species is obligatory, while most of them show intrinsic resistance to aminoglycosides. Resistance to ceftazidime, cefepime, piperacillin-tazobactam and carbapenems was frequently observed also. CONCLUSIONS: Ciprofloxacin, levofloxacin and trimethoprim-sulfamethoxazole were found to be the most effective antibiotic agents. Orv Hetil. 2018; 159(1): 23-30.

Use of Aerosolized Antibiotics in Gram-Negative Ventilator-Associated Pneumonia in Trauma Patients.

Ventilator-associated pneumonia (VAP) is associated with significant morbidity (ventilator days, ICU days, and cost) and mortality increase in trauma patients. Multidrug-resistant strains of causative VAP pathogens are becoming increasingly common. Aerosolized antibiotics achieve high alveolar concentrations and provide valuable adjuncts in the treatment of VAP. This study examined the impact of aerosolized antibiotics in the treatment of VAP in trauma patients. Patients with either Acinetobacter baumannii or Pseudomonas aeruginosa VAP over 10 years treated with aerosolized antibiotics (cases) were stratified by age, severity of shock, and injury severity. A frequency-matched (by causative pathogen) control group treated without aerosolized antibiotics was used for comparison. Multivariable logistic regression was used to identify predictors for the use of aerosolized antibiotics. One hundred twenty VAP episodes were identified in 100 patients. Microbiologic resolution was achieved in all patients treated with aerosolized antibiotics. There was no difference in mortality (14.5% vs 15.7%, P = 0.87) and no antibiotic-related complications in either group. Multivariable logistic regression identified VAP persistence and relapse as independent predictors for the use of aerosolized antibiotics. Combined with systemic therapy, aerosolized antibiotics broaden the spectrum of therapy. They are valuable adjuncts with minimal risk of antibiotic resistance and/or systemic complications.

Meiothermus luteus sp. nov., a slightly thermophilic bacterium isolated from a hot spring.

A slightly thermophilic, aerobic bacterium, designated YIM 72257T, was isolated from a sediment sample taken from a hot spring in Tengchong county, Yunnan province, south-west China. The isolate was Gram-stain-negative, non-sporulating and forms non-motile rods, appearing in chains. The isolate grew at 50-65 °C, pH 6.0-9.0 and with 0.5-1 % NaCl (w/v). 16S rRNA gene sequence analysis showed that strain YIM 72257T was most closely related to Meiothermus cateniformans LY1T (95.6 %), Meiothermus ruber DSM 1279T (95.1 %) and Meiothermus taiwanensis WR-30T (94.6 %). The genomic DNA G+C content of strain YIM 72257T was 62.6 mol%. The main cellular fatty acids (>5 %) were anteiso-C15 : 0, anteiso-C17 : 0, iso-C16 : 0, iso-C17 : 0, iso-C15 : 0 and C16 : 0. The polar lipids consisted of an uncharacterized phospholipid and two glycolipids. Based on phenotypic, phylogenetic and chemotaxonomic characteristics, strain YIM 72257T is proposed to be a representative of a novel species of the genus Meiothermus, for which the name Meiothermus luteus sp. nov. is proposed. The type strain is YIM 72257T (=KCTC 52599T=CCTCC AB 2017100T).

Comparación bacteriana de 30 piezas de alta velocidad antes y después de ser utilizadas en la facultad de odontología, Región Veracruz / Bacterial comparison of 30 high speed handpieces before and after being used at the school of dentistry, Veracruz Region

Introducción: en los procedimientos odontológicos se está expuestoa gran cantidad de microorganismos y las intervenciones clínicas provocan un contacto directo o indirecto con éstos, ya sea a través del instrumental, equipo odontológico contaminado con saliva, sangre, exudados, etcétera. Por esta razón debe tomarse en cuenta el tipo de contaminación de las piezas de mano por ser parte del equipo de uso cotidiano para realizar tratamientos odontológicos. Objetivos generales:Determinar la carga bacteriana en las piezas de alta velocidad antes y después de su uso en diferentes clínicas de la Facultad de Odontologíade la UV Región Veracruz. Metodología: Investigación transversal, descriptiva y observacional. Material y métodos: Se seleccionaron al azar 30 piezas de mano de los estudiantes de la Universidad Veracruzana Facultad de Odontología Región Veracruz, a las cuales se tomó una muestra con un hisopo de algodón antes y después de su uso en la práctica dental. Se realizaron cultivos con las muestras obtenidas que se observaron durante tres días seguidos bajo microscopio para comprobar la presencia de colonias bacterianas. Resultados: De las30 piezas antes de ser utilizadas se detectó Bacillus grampositivos en24 por ciento de las muestras; en 20 por ciento Bacillus gramnegativos, en 6 por ciento Streptobacillus gram-positivos; en 20 por ciento Staphylococcus grampositivos; en 3 por ciento Cocobacillus gramnegativos y en 22 por ciento Actinomyces gramnegativos. El restante 2 por ciento no reveló unidades formadoras de colonias (UFC). En un segundo muestreo, 33 por ciento desarrolló Bacillus grampositivos, 10 por cientoBacillus gramnegativos, 20 por ciento adquirió Sthapylococcus grampositivos, 3 por ciento Sthapylococcus gramnegativo y 34 por ciento no reveló UFC. Conclusión:En el primer muestreo se detectaron microorganismos en 98% de laspiezas de mano, mientras que en el segundo muestreo 66% se contaminócon microorganismos y en 34% no se observó contaminación.

Introduction: dental activity is exposed to a lot of microorganisms,and clinical interventions have a direct or indirect contact with them.Whether through the instruments, dental equipment contaminatedwith saliva, blood, etc; so you should take into account the type ofcontamination of handpieces for being the most widely used equipmentfor dental treatment. General Objectives: Determine the bacterialload in high-speed parts before and after being used in diff erentclinical uses in Dentistry School at UV, Veracruz. Methodology:Cross-sectional, descriptive and observational research. Materialand methods: 30 pieces of students from the Universidad VeracruzanaSchool of Dentistry, Veracruz region, which a sample was takenwith a swab to pieces before and after use in dental practice wererandomly selected. Cultures with samples obtained observedduring three days in a row microscope to determine the presenceof bacterial colonies were made. Results: Of the 30 pieces beforebeing used 24% of Bacillus Gram-positive samples were found; 20%Bacillus Gram-negative, Gram-positive Streptobacillus 6%; 20%Gram-positive Staphylococcus, 3% developed Coccobacillus Gramnegativeand 22% Gram negative Actinomyces. The remaining 2%no colony forming units development (UFC). In a second sampling;33% developed Bacillus Gram-positive, Gram-negative Bacillus10%, 20% obtained Sthapylococcus Gram-positive, Gram-negativeSthapylococcus 3% and 34% did not develop colony forming unit(CFU). Conclusion: In the first sampling 98% of the pieces were microorganism growth, while in the second 66% and the presence ofmicroorganisms obtained 34% no development.

The Immune Response in Periodontal Tissues.

The uniqueness of periodontal diseases is caused by several factors. This group of diseases is caused by numerous bacterial species formed in the dental biofilm, and one cannot distinguish the specific pathogen that is responsible for the disease initiation or progress (though Gram-negative anaerobic rods are associated with the advanced form of the disease). The disease is both infectious and inflammatory in its nature, and in the state of health there is always a subclinical level of inflammatory response, caused by the so-called harmless bacteria. Negligence in oral hygiene may result in maturation of the biofilm and trigger host response, manifesting clinically as gingivitis or-later and in susceptible subjects-as periodontitis. The article presents the contemporary knowledge of the inflammatory reaction occurring in tissues surrounding the tooth during periodontal inflammation. The most important mechanisms are described, together with implications for clinicists.

Non-fermentative Gram-negative rods bacteremia in children with cancer: a 14-year single-center experience.

PURPOSE: Data on non-fermentative Gram-negative rods (NFGNR) bacteremia in children with malignancies are limited. The aim of this study was to present clinical picture, antimicrobial susceptibility pattern, risk factors for resistance and outcome in NFGNR bacteremia in children with cancer. METHODS: All episodes of NFGNR bacteremia occurring during 2001-2014 in children with cancer in a tertiary-care hospital were retrospectively analyzed. Pseudomonas and Acinetobacter spp. resistant to three or more antibiotic classes and all Stenotrophomonas maltophilia (SM) were defined as multidrug-resistant bacteria (MDR). RESULTS: A total of 80 children (44 males, 0.8-18 years, median 5 years) developed 107 episodes (116 pathogens) of NFGNR bacteremia; Pseudomonas aeruginosa (PA) (51; 43.9%), Acinetobacter baumannii (AB) (21, 18.1%), SM (18, 15.5%); and others (27, 25.2%). The rate of NFGNR bacteremia in children with certain solid tumors (e.g. sarcoma, 12/134 (9.0%)) was comparable to that of hematological malignancies (52/429 (12.2%). Focal infection and septic shock occurred in 16 (14.9%) and four (3.7%) episodes, respectively. Thirty (25.8%) of 116 NFGNR were MDR. The most significant predictors of bacteremia with MDR PA or AB were severe neutropenia (<100 cells/mm3; OR 7.8, p = 0.002), hospital-acquired (OR 16.9, p < 0.0001) and breakthrough (OR 11.2, p < 0.0001) infection. Infection with MDR bacteria was associated with inappropriate empirical therapy. The 30-day mortality was 3/107 (2.8%), all in neutropenic patients with hematological malignancies. CONCLUSIONS: NFGNR bacteremia can present with nonspecific signs or symptoms. MDR NFGNRs are common and compromise treatment options, but mortality is relatively low. Knowledge of local epidemiology, pattern and risk factors for resistance is important to guide empirical therapy.

Antimicrobial-Resistant Pathogens Associated With Healthcare-Associated Infections: Summary of Data Reported to the National Healthcare Safety Network at the Centers for Disease Control and Prevention, 2011-2014.

OBJECTIVE To describe antimicrobial resistance patterns for healthcare-associated infections (HAIs) that occurred in 2011-2014 and were reported to the Centers for Disease Control and Prevention's National Healthcare Safety Network. METHODS Data from central line-associated bloodstream infections, catheter-associated urinary tract infections, ventilator-associated pneumonias, and surgical site infections were analyzed. These HAIs were reported from acute care hospitals, long-term acute care hospitals, and inpatient rehabilitation facilities. Pooled mean proportions of pathogens that tested resistant (or nonsusceptible) to selected antimicrobials were calculated by year and HAI type. RESULTS Overall, 4,515 hospitals reported that at least 1 HAI occurred in 2011-2014. There were 408,151 pathogens from 365,490 HAIs reported to the National Healthcare Safety Network, most of which were reported from acute care hospitals with greater than 200 beds. Fifteen pathogen groups accounted for 87% of reported pathogens; the most common included Escherichia coli (15%), Staphylococcus aureus (12%), Klebsiella species (8%), and coagulase-negative staphylococci (8%). In general, the proportion of isolates with common resistance phenotypes was higher among device-associated HAIs compared with surgical site infections. Although the percent resistance for most phenotypes was similar to earlier reports, an increase in the magnitude of the resistance percentages among E. coli pathogens was noted, especially related to fluoroquinolone resistance. CONCLUSION This report represents a national summary of antimicrobial resistance among select HAIs and phenotypes. The distribution of frequent pathogens and some resistance patterns appear to have changed from 2009-2010, highlighting the need for continual, careful monitoring of these data across the spectrum of HAI types. Infect Control Hosp Epidemiol 2016;1-14.