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1.
Diabet Med ; 34(3): 305-315, 2017 03.
Artigo em Inglês | MEDLINE | ID: mdl-28029181

RESUMO

Diabetes-related foot disease remains a common problem. For wounds, classic teaching recommends the treatment of any infection, offloading the wound and ensuring a good blood supply, as well as ensuring that the other modifiable risk factors are addressed and optimized. There remain, however, several questions about these and other aspects of the care of diabetes-related foot disease. Some of these questions are addressed in the present report; in particular, the impact of newer technologies in the identification of any organisms present in a wound, as well as the use of novel approaches to treat infections. The use of new remote sensing technology to identify people at risk of developing foot ulceration is also considered, in an attempt to allow early intervention and prevention of foot ulcers. The psychological impact of foot disease is often overlooked, but with an increasing number of publications on the subject, the cause-and-effect role that psychology plays in foot disease, such as ulcers and Charcot neuroarthropathy, is considered. Finally, because of heterogeneity in diabetic foot studies, comparing results is difficult. A recently published document focusing on ensuring a standardized way of reporting foot disease trials is discussed.


Assuntos
Pé Diabético/prevenção & controle , Pé Diabético/terapia , Medicina Baseada em Evidências , Saúde Global , Infecção dos Ferimentos/terapia , Pesquisa Biomédica/métodos , Pesquisa Biomédica/tendências , Terapia Combinada , Congressos como Assunto , Pé Diabético/etiologia , Pé Diabético/microbiologia , Medicina Baseada em Evidências/tendências , Humanos , Reino Unido , Infecção dos Ferimentos/etiologia , Infecção dos Ferimentos/microbiologia , Infecção dos Ferimentos/prevenção & controle
2.
Appl Environ Microbiol ; 79(20): 6236-43, 2013 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-23913427

RESUMO

Clostridium difficile is the leading cause of antibiotic-associated diarrheal disease in health care settings across the world. Despite its pathogenic capacity, it can be carried asymptomatically and has been found in terrestrial and marine ecosystems outside hospital environments. Little is known about these environmental strains, and few studies have been conducted on estuarine systems. Although prophage abundance and diversity are known to occur within clinical strains, prophage carriage within environmental strains of C. difficile has not previously been explored. In this study, we isolated C. difficile from sites sampled in two consecutive years in an English estuarine system. Isolates were characterized by PCR ribotype, antibiotic resistance, and motility. The prevalence and diversity of prophages were detected by transmission electron microscopy (TEM) and a phage-specific PCR assay. We show that a dynamic and diverse population of C. difficile exists within these sediments and that it includes isolates of ribotypes which are associated with severe clinical infections and those which are more frequently isolated from outside the hospital environment. Prophage carriage was found to be high (75%), demonstrating that phages play a role in the biology of these strains.


Assuntos
Clostridioides difficile/classificação , Clostridioides difficile/virologia , Prófagos/classificação , Prófagos/ultraestrutura , Microbiologia da Água , Clostridioides difficile/genética , Clostridioides difficile/isolamento & purificação , Locomoção , Microscopia Eletrônica de Transmissão , Tipagem Molecular , Ribotipagem , Reino Unido , Vírion/ultraestrutura
3.
J Hosp Infect ; 84(2): 181-3, 2013 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-23643391

RESUMO

Spores of Clostridium difficile were deposited on to a stainless steel surface and subsequently exposed to a chlorine-releasing disinfectant (dichloroisocyanurate). Recovery of the spores was carried out using RODAC plates containing a variety of selective and non-selective agars. The non-selective agar media yielded higher recoveries of both control and chlorine-stressed spores. Our results show that the antibiotics used in selective media imposed an additional stress on both disinfectant-treated and untreated spores resulting in considerably reduced recoveries. This could lead to a serious underestimate of the extent of environmental contamination by this organism.


Assuntos
Técnicas Bacteriológicas/métodos , Clostridioides difficile/isolamento & purificação , Meios de Cultura/química , Microbiologia Ambiental , Hospitais , Clostridioides difficile/efeitos dos fármacos , Desinfetantes/farmacologia , Humanos , Esporos Bacterianos/efeitos dos fármacos , Esporos Bacterianos/isolamento & purificação , Triazinas/farmacologia
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