Clonal relationship, virulence genes, and antimicrobial resistance of Morganella morganii isolated from community-acquired infections and hospitalized patients: a neglected opportunistic pathogen.

Morganella morganii is a bacterium belonging to the normal intestinal microbiota and the environment; however, in immunocompromised individuals, this bacterium can become an opportunistic pathogen, causing a series of diseases, both in hospitals and in the community, being urinary tract infections more prevalent. Therefore, the objective of this study was to evaluate the prevalence, virulence profile, and resistance to antimicrobials and the clonal relationship of isolates of urinary tract infections (UTI) caused by M. morganii, both in the hospital environment and in the community of the municipality of Londrina-PR, in southern Brazil, in order to better understand the mechanisms for the establishment of the disease caused by this bacterium. Our study showed that M. morganii presents a variety of virulence factors in the studied isolates. Hospital strains showed a higher prevalence for the virulence genes zapA, iutA, and fimH, while community strains showed a higher prevalence for the ireA and iutA genes. Hospital isolates showed greater resistance compared to community isolates, as well as a higher prevalence of multidrug-resistant (MDR) and extended-spectrum beta lactamase (ESBL)-producing isolates. Several M. morganii isolates from both sources showed high genetic similarity. The most prevalent plasmid incompatibility groups detected were FIB and I1, regardless of the isolation source. Thus, M. morganii isolates can accumulate virulence factors and antimicrobial resistance, making them a neglected opportunistic pathogen.

Water quality monitoring in southern Brazil and the assessment of risk factors related to contamination by coliforms and Escherichia coli.

The potability of water, including underground sources, is constantly affected by human activities. To assess water quality and water security in rural and urban areas of southern Brazil, a quantitative, retrospective analysis of water samples collected monthly by the Brazilian health authorities (19,687 samples from 2013 to 2021) was performed. In rural areas, 5,979 water samples (77.54%) were found to be contaminated by coliform bacteria and 3,431 (44.50%) by Escherichia coli. In addition, 1,616 (20.95%) of the contaminated samples were significantly correlated with rainfall amount. In urban areas, 1,268 (10.95%) of the samples contained coliform bacteria and 293 (2.53%) of these samples contained E. coli, with the factor of rainfall associated with 1,081 samples (9.33%) with bacterial contamination. In terms of physicochemical parameters, turbidity exceeded the national standard (5 uT) in 448 (2.32%) samples and fluoride fell below the required level (0.8 mg/L) in 106 samples (0.54%). The presence of free residual chlorine (0.2-2.0 mg/L) was verified in 846 samples (14.38%) in rural areas and in 10,825 samples (56.13%) in urban areas. These results suggest a strong association between rainfall factors and physicochemical alterations, as well as the risk of greater microbial contamination of water for human consumption.

Prevalence of Antimicrobial Resistance and Clonal Relationship in ESBL/AmpC-Producing Proteus mirabilis Isolated from Meat Products and Community-Acquired Urinary Tract Infection (UTI-CA) in Southern Brazil.

The present study aimed to evaluate the prevalence of antimicrobial resistance and clonal relationships in Proteus mirabilis isolated from chicken meat, beef, pork, and community-acquired urinary tract infections (UTI-CA). Chicken meat isolates showed the highest multidrug resistance (MDR), followed by those from pork and UTI-CA, whereas beef had relatively few MDR strains. All sources had strains that carried blaCTX-M-65, whereas blaCTX-M-2 and blaCMY-2 were only detected in chicken meat and UTI-CA isolates. This indicates that chicken meat should be considered an important risk factor for the spread of P. mirabilis carrying ESBL and AmpC. Furthermore, ESBL/AmpC producing strains were resistant to a greater number of antimicrobials and possessed more resistance genes than non-producing strains. In addition, the antimicrobial resistance genes qnrD, aac(6')-Ib-cr, sul1, sul2, fosA3, cmlA, and floR were also found. Molecular typing showed a genetic similarity between chicken meat and UTI-CA isolates, including some strains with 100% similarity, indicating that chicken can be a source of P. mirabilis causing UTI-CA. It was concluded that meat, especially chicken meat, can be an important source of dissemination of multidrug-resistant P. mirabilis in the community.

Proteus mirabilis from community-acquired urinary tract infections (UTI-CA) shares genetic similarity and virulence factors with isolates from chicken, beef and pork meat.

Proteus mirabilis is an opportunistic pathogen associated with a variety of infections in humans, especially those in the urinary tract. The isolation of this pathogen in foods of animal origin such as meat is poorly documented and should not be neglected, in view of the zoonotic risk that this can pose to human health. Thus, the objective of this study was to evaluate the prevalence, virulence profile, and similarity between P. mirabilis strains isolated from chicken, beef, and pork meat and those causing community-acquired urinary tract infections (UTI-CA), in order to better understand the role of this bacterium as a zoonotic pathogen. P. mirabilis was isolated from the three types of meat and was found to be more prevalent in chicken. All isolates exhibited several genotypic and phenotypic virulence characteristics, such as adhesion capacity in HEp-2 cell culture, biofilm formation, cytotoxicity in Vero cells and genes that express fimbriae (mrpA, pmfA, ucaA, atfA), hemolysin (hpmA), proteases (zapA and ptA) and siderophore receptor (ireA). UTI-CA strains showed a higher prevalence of ucaA and ireA genes, whereas those from the chicken meat had a higher prevalence of the atfA gene compared with the isolates from the beef and pork meat. It was observed that chicken meat and UTI-CA strains mainly formed very strong biofilms, whereas strains isolated from beef and pork formed more weak and moderate biofilms. Several strains from meat showed close genetic similarity to those from UTI-CA and had the same virulence profiles. Thus, meats may be an important source of the dissemination of P. mirabilis responsible for causing UTIs in the community.

Three-dimensional analysis of dental arch forms in Italian population.

BACKGROUND: The aim of this study was the comparison of male and female upper and lower dental arch form in untreated Italian patients by 3D analysis, to find differences in shape, in transversal and longitudinal diameters between sexes, and to give a representative set of population's dental arch to clinicians in order to provide suitable orthodontic treatment. METHODS: The sample consisted of 3D scans of dental casts deriving from 104 Italian untreated patients (Male = 35, Female = 69) in permanent dentition. An evaluation of the arch form was performed by angular and linear values on every patient using a 3D software (SolidWorks®). A Student's two-tailed t test was used to determine if the differences in measurements between the male and female groups were significant and the level of significance was set at P < 0.05. RESULTS: Statistically significant differences in upper and lower transversal and longitudinal diameters were found. Male arch widths were significantly larger than those of females. Male intercanine, intermolar, and interpremolar diameters were significantly greater than females. Dental arch depth was significantly smaller in the female group. Anterior upper dental arch form was flatter, wider, and less sharp in the female group. CONCLUSIONS: Basing on the anatomical arches differences found between sexes concerning Italian patients, it is suggested to have regard to each patient pre-treatment arch form, width, and depth during orthodontic treatment according to gender.

Comparison between Two Radiological Methods for Assessment of Tooth Root Resorption: An In Vitro Study.

PURPOSE: This study aims to verify the validity of the radiographic image and the most effective radiological techniques for the diagnosis of root resorption to prevent, cure, and reduce it and to verify if radiological images can be helpful in medical and legal situations. METHODS: 19 dental elements without root resorption extracted from several patients were examined: endooral and panoramic radiographs were performed, with traditional and digital methods. Then the root of each tooth was dipped into 3-4 mm of 10% nitric acid for 24 hours to simulate the resorption of the root and later submitted again to radiological examinations and measurements using the same criteria and methods. RESULTS: For teeth with root resorption the real measurements and the values obtained with endooral techniques and digital sensors are almost the same, while image values obtained by panoramic radiographs are more distorted than the real ones. CONCLUSIONS: Panoramic radiographs are not useful for the diagnosis of root resorption. The endooral examination is, in medical and legal fields, the most valid and objective instrument to detect root resorption. Although the literature suggests that CBCT is a reliable tool in detecting root resorption defects, the increased radiation dosage and expense and the limited availability of CBCT in most clinical settings accentuate the outcome of this study.

Relationship between vertical facial patterns and dental arch form in class II malocclusion.

BACKGROUND: The purpose of this study is to evaluate the relationship between dental arch form and the vertical facial pattern determined by the angle between the mandibular plane and the anterior cranial base (Sella-nasion/mandibular plane angle (SN-MP)) in skeletal class II untreated patients. METHODS: A sample of 73 Caucasians patients with untreated skeletal class II in permanent dentition was divided into three groups according to the values of the angle SN-MP. An evaluation of the arch form was performed by angular and linear relation values on each patient. Regression analysis was used to determine the statistical significance of the relationships between SN-MP angle and dental arch form. The differences among the three groups were analyzed for significance using a variance analysis. RESULTS: A decrease of the upper arch transversal diameters in high SN-MP angle patients and an increase in low angle SN-MP ones (P<0.05) were shown. Result analysis showed a change in upper arch shape, with a smaller intercanine width in patients with high SN-MP angle and a greater one in low angle patients. As SN-MP angle increased, the upper arch form tended to be narrower. No statistically significant difference in mandibular arch form among the three groups was found, except the angle value related to incisors position. CONCLUSIONS: The results showed the association between the upper dental arch form and the vertical facial pattern. On the contrary, the lower arch form was not related to the mandibular divergence.

Assessment of mandibular growth and response to functional appliance treatment in prepubertal patients with different auxologic categories.

OBJECTIVE: To assess mandibular growth and response to functional appliance treatment in different Petrovic's auxologic categories and to investigate diagnostic and prognostic usefulness of the Lavergne-Petrovic's flow diagram. MATERIALS AND METHODS: Eighteen patients with class II malocclusion (ANB>/=4 degrees , dental class II) were selected and divided into 4 groups according to the auxologic categories. Category 2 group had 4 patients, category 3 group had 5, category 4 group had 5 and category 5 group had 4. In order to obtain patient's growth curves and detect the correct treatment time, patient's height was measured every 3 months. This method was supported by the cervical vertebral maturation method for the assessment of mandibular growth. Functional appliance and/or class II elastics, during the fixed appliance phase, were used to correct skeletal and dental relationships. Average treatment time was 31 months (Range 28-36 months). CoGn and ANB were detected in pre-treatment and post-treatment radiographs in order to assess mandibular growth. RESULTS: The highest growth was in category 5, the lowest in category 2. Rotational type improvement was generally observed. CONCLUSIONS: In prepubertal class II patients, treatment success not only depends on appliance choice, clinician's ability and correct treatment time, but also on individual growth potential and facial type. Therefore Lavergne-Petrovic's flow diagram could become a great diagnostic and prognostic aid for the orthodontist.

Gabapentin in the treatment of uremic itch: an index case and a pilot evaluation.

BACKGROUND: The prevalence of renal itch in patients on dialysis is approximately 30%, but its treatment is often ineffective. We describe an index case of a hemodialysis (HD) patient suffering from painful diabetic neuropathy (PDN) treated with gabapentin; the first administration of the drug led to the complete remission of the concomitant uremic pruritus. Subsequently, we report the results of a pilot evaluation aimed at testing the effectiveness and safety of low gabapentin doses in HD patients with uremic pruritus. METHODS: Five consecutive HD patients unresponsive to antihistamines received 4-week gabapentin treatment at a starting dose of 100 mg after every thrice-weekly HD, which was subsequently adjusted based on clinical response. Puritus severity was evaluated by means of a visual analogue scale (VAS) before each HD session on days 0, 2, 4, 7, 14, 21, 28 and 35. Safety was assessed using adverse event data. RESULTS: All patients experienced a rapid subjective improvement in pruritus, with the mean VAS score decreasing from 8.4-1.6 after the first drug administration. Three patients required a dose increase to 100 mg four times a week to obtain better itch control. Two patients experienced complete itch remission. CONCLUSION: Although a double-blind placebo-controlled clinical trial should be conducted to better elucidate the efficacy and toxicity of gabapentin in patients with uremic itch, our data suggest that gabapentin could be considered an effective and safe alternative treatment for uremic pruritus.