摘要
Resumen Objetivo: describir las características epidemiológicas, clínicas y microbiológicas de los pacientes que cursan con miocarditis por Enterobacterias. Métodos: se realizó una revisión sistemática de la literatura, en la que se incluyeron Pubmed, Ovid, Scopus, SciELO y LILACS sin exclusión por tipo de idioma. La población objetivo de estudio fueron los pacientes con diagnóstico de infección bacteriana por bacilo gram negativo mediante cultivo, técnicas moleculares o histopatología, y quienes presentaban biopsia de miocardio o, en su defecto, resonancia magnética cardiaca con hallazgos sugestivos de miocarditis. Resultados: se encontraron 742 artículos, de los cuales se incluyeron 24; en estos se reportaron 27 pacientes. La edad promedio fue de 31 años. El 81% de los pacientes eran de sexo masculino. El síntoma principal fue diarrea (80%), seguido de fiebre (53%) y dolor torácico (38%). El 37% de los pacientes fallecieron. El hallazgo más común en el electrocardiograma fue la elevación del segmento ST (36,7%). En quienes se realizó ecocardiograma se encontraron anormalidades en 50% de los casos, siendo más frecuente la disminución en la fracción de eyección. El microorganismo más común fue el Campylobacter jejuni, seguido por Salmonela sp. Conclusiones: la miocarditis causada por enterobacterias es más frecuente en pacientes adultos jóvenes de sexo masculino. Los síntomas gastrointestinales suelen estar presentes al momento de la presentación clínica. El diagnóstico requiere de alta sospecha clínica teniendo en cuenta que las anormalidades eléctricas y en ecocardiograma no se encuentran en todos los pacientes.
Abstract Objective: To describe the epidemiological, clinical, and microbiological characteristics of patients with myocarditis due to Enterobacteria. Methods: A systematic review was carried out on the literature, which included Pubmed, Ovid, Scopus, SciELO, and LILACS, with no exclusions due to language. The target population of the study were patients with a diagnosis of bacterial infection due to gram negative bacillus by means of a culture, or using molecular or histopathology technique. They also had to have had a myocardial biopsy or, if not, a cardiac magnetic resonance scan with findings suggestive of myocarditis. Results: Out of a total of 742 articles found, 24 of these, in which 27 patients were described, were included. The mean age was 31 years, and 81% were male. The main symptom was diarrhoea (80%), followed by fever (53%), and chest pain (38%). More than one-third (37%) of the patients died. The most common finding on the electrocardiogram (ECG) was elevation of the ST segment (36.7%). Abnormalities were found in 50% of the cases, on whom a cardiac ultrasound was performed, with a decrease in the ejection fraction being the most common. The most common microorganism was Campylobacter jejuni, followed by Salmonella spp. Conclusions: Myocarditis caused by enterobacteria is most common in young male patients. The gastrointestinal symptoms are usually present from the clinical onset. The diagnosis requires a high clinical suspicion, taking into account that the abnormalities in the ECG and cardiac ultrasound are not found in all patients.
Subject(s)
Humans , Male , Adult , Salmonella , Shigella , Enterobacteriaceae , Myocarditis , Vibrio , Yersinia , Campylobacter , Clostridium摘要
PURPOSE: The roles of gut microbiota on the natural course of atopic dermatitis (AD) are not yet fully understood. We investigated whether the composition and function of gut microbiota and short-chain fatty acids (SCFAs) at 6 months of age could affect the natural course of AD up to 24 months in early childhood.METHODS: Fecal samples from 132 infants were analyzed using pyrosequencing, including 84 healthy controls, 22 transient AD and 26 persistent AD subjects from the Cohort for Childhood Origin of Asthma and Allergic Diseases (COCOA) birth cohort. The functional profile of the gut microbiome was analyzed by whole-metagenome sequencing. SCFAs were measured using gas chromatography-mass spectrometry.RESULTS: Low levels of Streptococcus and high amounts of Akkermansia were evident in transient AD cases, and low Clostridium, Akkermansia and high Streptococcus were found in children with persistent AD. The relative abundance of Streptococcus positively correlated with scoring of AD (SCORAD) score, whereas that of Clostridium negatively correlated with SCORAD score. The persistent AD group showed decreased gut microbial functional genes related to oxidative phosphorylation compared with healthy controls. Butyrate and valerate levels were lower in transient AD infants compared with healthy and persistent AD infants.CONCLUSIONS: Compositions, functions and metabolites of the early gut microbiome are related to natural courses of AD in infants.
Subject(s)
Child , Humans , Infant , Asthma , Butyrates , Clostridium , Cohort Studies , Dermatitis, Atopic , Fatty Acids, Volatile , Gas Chromatography-Mass Spectrometry , Gastrointestinal Microbiome , Metabolomics , Metagenome , Oxidative Phosphorylation , Parturition , Streptococcus摘要
ABSTRACT We report the clinical case of an infant with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection with gastrointestinal signs and symptoms, predominantly vomiting. The patient also had colic, poor feeding, mild diarrhea and mild rhinorrhea without fever. The child had evidence of altered coagulation, increased interleukin 10, moderate dehydration and she was admitted to the pediatric intensive care unit. Simultaneously, the patient was diagnosed as Clostridioides difficile infection, which possibly may have facilitated the persistence of SARS-CoV-2 in feces, for more than 27 days, even after the nasopharyngeal test turned negative. This coinfection might exacerbate the gastrointestinal signs and symptoms and increased the possibility of fecal-oral transmission of SARS-CoV-2 and Clostridioides . The patient was breastfed and received complementary infant formula, hydrated with intravenous fluid, and was discharged without complications, 4 days after admission.
RESUMO Relatamos o caso clínico de uma lactente com infecção por coronavírus da síndrome respiratória aguda grave 2 (SARS-CoV-2) com sinais e sintomas gastrintestinais - predominantemente vômitos. A paciente apresentou, adicionalmente, cólica, dificuldade para mamar, evacuações amolecidas e rinorreia leve, sem febre. Houve evidências de alterações da coagulação, aumento de interleucina 10 e desidratação moderada, que justificaram internação na unidade de terapia intensiva. Simultaneamente, a paciente foi diagnosticada com infecção por Clostridioides difficile , que pode ter facilitado a persistência do SARS-CoV-2 nas fezes por mais de 27 dias, mesmo após negativação do teste nasofaríngeo. Essa coinfecção pode ter exacerbado os sinais e sintomas gastrintestinais e aumentado a possibilidade da transmissão do SARS-CoV-2 e Clostridioides . A paciente foi mantida em aleitamento materno e complemento com fórmula infantil, recebeu hidratação intravenosa e teve alta hospitalar, sem complicações, após 4 dias de internação.
Subject(s)
Humans , Female , Infant , Coinfection/epidemiology , COVID-19 , Clostridium , Clostridioides , SARS-CoV-2摘要
Clostridia inhabiting in jiupei and pit mud plays key roles in the formation of flavour during the fermentation process of Luzhou-flavour baijiu. However, the differences of Clostridial communities between jiupei and pit mud remains unclear. Here, the species assembly, succession, and metabolic capacity of Clostridial communities between jiupei and pit mud were analysed by high-throughput sequencing and pure culture approaches. The ratio of Clostridial biomass to bacterial biomass in the pit mud was relatively stable (71.5%-91.2%) throughout the fermentation process. However, it varied widely in jiupei (0.9%-36.5%). The dominant Clostridial bacteria in jiupei were Clostridium (19.9%), Sedimentibacter (8.8%), and Hydrogenispora (7.2%), while Hydrogenispora (57.2%), Sedimentibacter (5.4%), and Caproiciproducens (4.9%) dominated in the Clostridial communities in pit mud. The structures of Clostridial community in pit mud and jiupei were significantly different (P=0.001) throughout fermentation. Isolated Clostridial strains showed different metabolic capacities of volatile fatty acids in pure culture. Spatial and temporal heterogeneity of Clostridial communities existed in the baijiu fermentation pit, which was closely related to the main flavour components of Luzhou-flavour baijiu.
Subject(s)
Alcoholic Beverages , Microbiology , Bacteria , Classification , Metabolism , Clostridium , Physiology , Fatty Acids, Volatile , Metabolism , Fermentation , Food Microbiology摘要
Introduction: Common variable immunodeficiency (CVID) is the main symptomatic primary immunodeficiency and is associated with complex immune disorders. Gut microbiota interacts closely with the immune system, and intestinal dysbiosis is related to multiple diseases. Objective: To describe for the first time the composition of gut microbiota in Mexican patients with CVID. Methods: Fecal samples from five patients with CVID were collected and massive sequencing of the V3-V4 region of 16S rRNA gene was carried out using illumina technology. Results: Bacterial relative abundance was observed at all taxonomic levels. Firmicutes, Actinobacteria and Verrucomicrobia were the predominant phyla. The Clostridia class and the Clostridial order were the most common in their respective taxon; the Ruminococcaceae family predominated. A total of 166 genera were reported, with the most abundant being Faecalibacterium. Five species were identified, but only Bifidobacterium longum was present in all patients. Conclusions: Unlike healthy subjects' gut microbiota, where Firmicutes and Bacteroidetes predominate, the microbiota of the patients with CVID considered in this study was abundant in Firmicutes, Actinobacteria and Verrucomicrobia. The low presence of Bacteroidetes and high abundance of Firmicutes might indicate the existence of intestinal dysbiosis in these patients.
Subject(s)
Humans , Adult , Common Variable Immunodeficiency/microbiology , Gastrointestinal Microbiome/immunology , Bacteria/classification , RNA, Ribosomal, 16S/genetics , Actinobacteria/isolation & purification , Clostridium/isolation & purification , Bacteroidetes/isolation & purification , Ruminococcus/isolation & purification , Feces/microbiology , Verrucomicrobia/isolation & purification , Dysbiosis/immunology , Dysbiosis/microbiology , Firmicutes/isolation & purification , Clostridiales/isolation & purification , Faecalibacterium/isolation & purification , Bifidobacterium longum/isolation & purification , Mexico摘要
Clostridial diseases are important causes of livestock losses in the southern Rio Grande do Sul. Since 1978 annual surveys conducted at the "Laboratório Regional de Diagnóstico" of the "Universidade Federal de Pelotas" (LRD-UFPel) have shown that clostridial diseases represent 10.40% of the bacterial diseases diagnosed in cattle and 1.65% of all diseases diagnosis in cattle over a 40-year period. The purpose of this study is to review the clinical, epidemiological and pathological aspects of the clostridial diseases diagnosed in cattle from January 1978 to December 2018 at the LRD-UFPel in the hopes that it will constitute a useful guide for field veterinary practitioners and interested farmers. We assessed and review the necropsy protocols of 6,736 cattle; these necropsies were performed either by LRD-UFPel faculty or by field veterinary practitioners; 111 outbreaks (1.65%) were diagnosed as clostridial disease, distributed as follows: 35 outbreaks of tetanus, 34 of blackleg, 23 of bacillary hemoglobinuria, 11 of malignant edema (gas gangrene), and eight of botulism. Approximately 904, from a total of 42,480 cattle at risk, died in these outbreaks.(AU)
Clostridioses são doenças produzidas por alguma das espécies do gênero Clostridium e são importantes causas de perdas pecuárias no sul do Rio Grande do Sul. Pesquisas anuais realizadas no Laboratório Regional de Diagnóstico da Faculdade de Veterinária da Universidade Federal de Pelotas (LRD-UFPel) desde 1978 demonstraram que as clostridioses representaram 11,1% das doenças bacterianas diagnosticadas em bovinos e 1,65% de todos os diagnósticos de doenças em bovinos ao longo de 40 anos. O objetivo deste estudo é revisar os aspectos clínicos, epidemiológicos e patológicos das clostridioses diagnosticadas de janeiro de 1978 a dezembro de 2018, pelo LRD/UFPel com a intenção de que esse trabalho possa servir de guia útil para os veterinários de campo e fazendeiros interessados. Foram avaliados e revisados os protocolos de necropsia de 6.736 bovinos; essas necropsias foram realizadas pelo pessoal do LRD/UFPel ou por veterinários de campo. Cento e quatro (1,16%) casos foram diagnosticados como clostridioses, distribuídos da seguinte forma: 35 surtos de tétano, 34 de carbúnculo sintomático, 23 de hemoglobinúria bacilar, 11 de edema maligno (gangrena gasosa) e oito de botulismo. Aproximadamente 904, de um total de 42.480 bovinos sob-risco, morreram nesses surtos.(AU)
Subject(s)
Animals , Cattle , Botulism/veterinary , Carbuncle/veterinary , Clostridium/isolation & purification , Clostridium Infections/veterinary , Clostridium Infections/epidemiology , Gas Gangrene/veterinary , Hemoglobinuria/veterinary , Brazil/epidemiology摘要
Avaliou-se a ação antimicrobiana da combinação dos óleos essenciais de canela, pimenta chinesa, limão Taiti e cardamomo e de suas nanoemulsões no controle de Clostridium sporogenes e sua influência sobre a oxidação lipídica em mortadela. A Concentração Mínima Bactericida (CMB) de cada óleo foi determinada pelo método de macrodiluição. As CMB encontradas foram: 0,10% óleo essencial de pimenta chinesa e canela e 1,00% óleo essencial de cardamomo e limão Taiti. A nanoemulsão elaborada apresentou redução significativa no número de células vegetativas de C. sporogenes na mortadela, além de ser o tratamento mais eficiente no controle da oxidação lipídica. Os resultados obtidos comprovam a ação antimicrobiana dos óleos testados, sugerindo sua possível utilização como conservantes naturais em produtos alimentícios.
Subject(s)
Anti-Infective Agents/analysis , Antioxidants/administration & dosage , Clostridium/drug effects , Food Preservatives/administration & dosage , Food Microbiology , Meat Products/microbiology , Oils, Volatile/administration & dosage摘要
A forma mais comum de inibir a produção de toxina botulínica em produtos cárneos cozidos é pela adição de sais de nitrito, o que pode gerar substâncias carcinogênicas (nitrosaminas), sendo desejável sua substituição. Os óleos essenciais vêm se destacando como agentes antimicrobianos, sendo interessante seu uso como conservante. O objetivo desse trabalho foi avaliar a ação sinergística de óleos essenciais sobre endósporos de Clostridium sporogenes, utilizado como modelo de pesquisa para C. botulinum. As concentrações mínimas esporicidas (CME) dos óleos de alecrim, tomilho, cravo, manjericão, ho wood e alho foram de 3% e de 0,375% para pimenta e canela. Os óleos de orégano e noz moscada não apresentaram ação esporicida nas concentrações testadas. Entre as combinações, as melhores foram de pimenta chinesa (0,1306%), alho (1,1%) e manjericão (1,1%) e pimenta chinesa (0,1306%), alho (1,1%) e tomilho branco (1,1%). Os resultados sugerem o sinergismo entre os óleos, sendo promissor seu uso em alimentos.
Subject(s)
Anti-Infective Agents , Clostridium/drug effects , Food Preservatives , Oils, Volatile/administration & dosage , Clostridium botulinum/drug effects , Drug Synergism摘要
BACKGROUND/AIMS: Optimal management of inflammatory bowel disease (IBD) with concomitant Clostridium difficile infection (CDI) is controversial, especially when CDI diagnosis is made by polymerase chain reaction (PCR) testing, which may reflect colonization without infection. METHODS: We performed a multicenter review of all inpatients with IBD and PCR diagnosed CDI. Outcomes included length of stay, 30- and 90-day readmission, colectomy during admission and within 3 months, intensive care unit (ICU) admission, CDI relapse and death for patients who received corticosteroid (CS) after CDI diagnosis versus those that did not. Propensity-adjusted regression analysis of outcomes based on CS usage was performed. RESULTS: We identified 177 IBD patients with CDI, 112 ulcerative colitis and 65 Crohn's disease. For IBD overall, CS after CDI diagnosis was associated with prolonged hospitalization (5.5 days: 95% confidence interval [CI], 1.5–9.6 days; P=0.008), higher colectomy rate within 3 months (odds ratio [OR], 5.5; 95% CI, 1.1–28.2; P=0.042) and more frequent ICU admissions (OR, 7.8; 95% CI, 1.5–41.6; P=0.017) versus no CS. CS use post-CDI diagnosis in UC patients was associated with prolonged hospitalization (6.2 days: 95% CI, 0.4– 12.0 days; P=0.036) and more frequent ICU admissions (OR, 7.4; 95% CI, 1.1–48.7; P=0.036). CONCLUSIONS: CS use among IBD inpatients with CDI diagnosed by PCR is associated with poorer outcomes and would seem to reinforce the importance of C. difficile toxin assay to help distinguish colonization from infection. This adverse effect appears more prominent among those with UC.
Subject(s)
Humans , Adrenal Cortex Hormones , Clostridioides difficile , Clostridium , Colectomy , Colitis, Ulcerative , Colon , Crohn Disease , Diagnosis , Hospitalization , Inflammatory Bowel Diseases , Inpatients , Intensive Care Units , Length of Stay , Polymerase Chain Reaction , Recurrence摘要
PURPOSE: The bowel frequency of patients who had undergone rectal resection might be difficult to distinguish from the diarrhea of Clostridium difficile infection (CDI). The change of bowel movement following rectal surgery has been a challenge for the diagnosis of CDI and scarce studies discussed this diagnostic difficulty.METHODS: From January 2004 to January 2018, a total of 8,327 patients in a single tertiary colorectal cancer center was evaluated for CDI, and their medical records were ret rospectively reviewed. Bowel frequency and treatment outcomes were compared between the rectal resection group (RG) and colectomy group (CG). Diagnostic time was defined as the time interval between first diarrhea (more than three times a day) and pathologic confirmation date of CDI.RESULTS: CDI incidence was 2.3% (17/752) vs. 0.41% (31/7,575) between RG and CG (P<0.001). RG had frequent bowel movements than CG (RG: 13.56±6.16/day vs. CG: 8.39±6.23/day; P=0.010), but the interval between the time of symptom and the time of CDI diagnosis was longer in the RG than in CG (RG: 1.38±3.34 days vs. CG: 0.39±1.16 days). A total of three mortalities has been occurred (RG: 2 vs. CG: 1), and the reasons were delayed diagnosis and omitted treatment.CONCLUSION: Patients experienced significant bowel frequency after rectal surgery than after colectomy, and the delayed diagnosis was associated with mortality. Active surveillance for CDI should be performed for the patients who underwent rectal surgery to prevent morbidity and mortality from delayed diagnosis of CDI, but sophisticated guideline also should be evaluated to reduce over-examinations.
Subject(s)
Humans , Clostridioides difficile , Clostridium , Colectomy , Colon , Colorectal Neoplasms , Colorectal Surgery , Delayed Diagnosis , Diagnosis , Diarrhea , Incidence , Medical Records , Mortality , Rectum , Treatment Outcome摘要
PURPOSE: We evaluated the impact of collagenase clostridium histolyticum (CCH) on rates of diagnosis, treatment, and corporal rupture in Peyronie's disease (PD). We examined the impact of CCH on cost of PD treatment. MATERIALS AND METHODS: We extracted data on PD diagnosis (ICD-9 607.95 and ICD-10 N48.6), corporal rupture (ICD-9 959.13 and ICD-10 S39.840A), CCH use (J0775), penile injections (CPT 54200), and corporal rupture repair from 2008 to 2016 in men over 40 years old using the Clinformatics® Data Mart Database (3.7 to 4.9 million males). We analyzed for prevalence of PD, rates of PD treatments, cost associated with treatment, and rates of corporal rupture and repair by year. RESULTS: The prevalence of PD was 0.29% in 2013 and did not increase after CCH entered the market in 2014. An average of 2.52% of men with PD received treatment before CCH, compared with 3.75% after (p<0.0001). Penile injection rates increased (1.34% vs. 2.61%, p<0.0001), while rates of surgical treatments decreased between these periods. There was no change in rate of corporal rupture in men with PD before (0.024%) and after (0.024%) CCH. Overall, only 20.0% of corporal ruptures were repaired. After CCH entered practice, a significant increase in cost occurred (p=0.013). CONCLUSIONS: The prevalence of men with PD did not change after CCH. However, more men with PD received treatment due to an increase in penile injections. The cost of treating PD increased after CCH became available. The overall prevalence of corporal rupture did not change after CCH entered the market.
Subject(s)
Humans , Male , Clostridium histolyticum , Clostridium , Diagnosis , Epidemiology , International Classification of Diseases , Microbial Collagenase , Penile Induration , Prevalence , Rupture , United States摘要
BACKGROUND: Clostridium difficile infection (CDI) is a nosocomial condition prevalent in patients with hematological disorders. We aimed to identify the risk factors associated with the development of CDI and assess the mortality rate at 15 and 30 days among hematologic patients admitted to a tertiary care center. METHODS: We conducted a retrospective case-control study from January 2010 to December 2015. Forty-two patients with hematologic malignancy and CDI, and 84 with hematologic disease and without history of CDI were included in the case and control groups, respectively. RESULTS: Univariate analysis revealed that episodes of febrile eutropenia [odds ratio (OR), 5.5; 95% confidence interval (CI), 2.3–12.9; P1 hospitalization (OR, 5.6; 95% CI, 2.5–12.6; P1 hospitalization (OR, 4.3; 95% CI, 1.7–11.0; P=0.002) were independent risk factors. Three (7.1%) and 6 (14.2%) case patients died at 15 and 30 days, respectively. CONCLUSION: The risk factors for developing CDI were exposure to therapeutic antibiotics and previous hospitalization. Hematological patients who developed CDI had higher early mortality rates, suggesting that new approaches for prevention and treatment are needed.
Subject(s)
Humans , Anti-Bacterial Agents , Case-Control Studies , Clostridioides difficile , Clostridium , Hematologic Diseases , Hematologic Neoplasms , Hospitalization , Intensive Care Units , Mortality , Multivariate Analysis , Retrospective Studies , Risk Factors , Tertiary Care Centers摘要
In May 2015, we conducted a voluntary online survey on laboratory diagnostic assays for Clostridium difficile infection (CDI) across clinical microbiology laboratories in Korea. Responses were obtained from 66 laboratories, including 61 hospitals and five commercial laboratories. Among them, nine laboratories reported having not conducted CDI assays. The toxin AB enzyme immunoassay (toxin AB EIA), nucleic acid amplification test (NAAT), and C. difficile culture, alone or in combination with other assays, were used in 51 (89.5%), 37 (64.9%), and 37 (64.9%) of the remaining 57 laboratories, respectively, and 23 (40.4%) of the laboratories performed all three assays. Only one laboratory used the glutamate dehydrogenase assay. Nine laboratories used the toxin AB EIA as a stand-alone assay. The median (range) of examined specimens in one month for the toxin AB EIA, NAAT, and C. difficile culture was 160 (50–2,060), 70 (7–720), and 130 (9–750), respectively. These findings serve as valuable basic data regarding the current status of laboratory diagnosis of CDI in Korea, offering guidance for improved implementation.
Subject(s)
Clinical Laboratory Techniques , Clostridioides difficile , Clostridium , Glutamate Dehydrogenase , Immunoenzyme Techniques , Korea , Nucleic Acid Amplification Techniques摘要
The most common cause of antibiotic-associated diarrhea is Clostridium difficile infection (CDI). Recurrent C. difficile infection (rCDI) often occurs after successful treatment of CDI. Due to the increased incidence and the difficulty in treating rCDI, it is becoming an important clinical issue. Identifying risk factors is helpful for early detection, treatment, and prevention of rCDI. Advanced age, use of antibiotics, gastric acid suppression, and infection with a hypervirulent strain are currently regarded as the major risk factors for rCDI. Several treatment modalities, including vancomycin, fidaxomicin, and fecal microbiota transplant (FMT), are suggested for rCDI treatment. However, there is currently no definitive treatment method with sufficient evidence for rCDI. Recent studies have focused on FMT and have shown positive results for rCDI. Prevention of rCDI by measures such as hand washing and isolation of patients is very important. However, these preventive measures are often overlooked in clinical practice. Here, we review the risk factors, treatment, and prevention of rCDI.
Subject(s)
Humans , Anti-Bacterial Agents , Clostridioides difficile , Clostridium , Diarrhea , Gastric Acid , Hand Disinfection , Incidence , Methods , Microbiota , Recurrence , Risk Factors , Vancomycin摘要
Resumen La epidemiología de las posibles poblaciones en riesgo de sufrir una infección por bacterias anaerobias a nivel nacional es desconocida, se debería de incentivar el conocimiento en los servicios de salud sobre este tipo de infecciones. Las bacterias anaerobias están relacionadas en los medios hospitalarios como causa importante de morbilidad, razón por la cual es conveniente conocer la epidemiologia y prevalecía de especies involucradas. En el Laboratorio de Bacteriología del Hospital San Juan de Dios, durante tres años, se analizaron un total de 1545 pacientes sospechosos de microorganismos anaerobios en medios prerreducidos, mediante un tamizaje se redujeron a un total de 469 posibles muestras, las cuales, fueron enviadas al Laboratorio de Investigación en Bacteriología Anaerobia (LIBA) para su correspondiente identificación. A lo largo de las semanas epidemiológicas de los tres años se encontraron en promedio de 1.77 casos confirmados / semana, con razón de sexo positiva a favor de los masculinos. Se determinó que solo 245 de las muestras enviadas presentaban uno o varios microorganismos anaerobios estrictos representando un 15.85% del total, identificándose 39 especies diferentes, en 306 cepas aisladas. Las mayormente importante fue el género Bacteriodes, provenientes de cavidad abdominal seguido de abscesos y heridas de piel. El presente estudio tiene como objetivo presentar datos que respalden la importancia clínica de la búsqueda de microorganismos anaerobios y que ayuden a los analistas de bacteriología a guiar cuales son los principales microorganismos esperables en muestras clínicas, además de conocer la prevalencia en general.
Abstract The epidemiology of the possible populations at risk of suffering an infection by anaerobic bacteria a national level is unknown, it should be encouraged the knowledge in the health services about this type of infections. Anaerobic bacteria are related in hospital environments as an important cause of morbidity, which is why it is convenient to know the epidemiology and prevalence of species involved. In the Bacteriology Laboratory of the Hospital San Juan de Dios, for three years, a total of 1545 patients suspected of anaerobic microorganisms in prereduced media were analyzed, through a screening was reduced to a total of 469 possible samples, which were sent to the Anaerobic Bacteriology Research Laboratory (LIBA) for its corresponding identification. Throughout the epidemiological weeks of the three years were found on average of 1.77 confirmed cases / week, with a positive sex ratio in favor of men. It was determined that only 245 of the samples sent had one or several strict anaerobic microorganisms representing 15.85% of the total, identifying 39 different species, in 306 isolated strains. The most important was the genus Bacteriodes, coming from the abdominal cavity followed by abscesses and skin wounds. The present study aims to present data that support the clinical importance of the search for anaerobic microorganisms and that help the analysts of bacteriology to guide which are the main expected microorganisms in clinical samples, in addition to knowing the prevalence in general.
Subject(s)
Bacteria, Anaerobic/chemistry , Bacteriological Techniques , Clostridium/chemistry , Costa Rica摘要
Background: In view of the current low efficacy of bacterial infection treatment the common trend towards searching for antibiotic systems exhibiting synergistic action is well justified. Among carbapenem analogues a particularly interesting option is provided by combinations of clavulanic acid with meropenem, which have proven to be especially effective. Results: Determination of the minimal inhibitory concentration (MIC) along with the method based on flow cytometry constitutes an important tool in the identification of bacterial sensitivity to active substances. Within this study the inhibitory effect of doripenem, clavulanic acid and the doripenem-clavulanate acid system was analyzed in relation to such bacteria as Salmonella enteritidis, Salmonella typhimurium, Staphylococcus aureus, Klebsiella pneumoniae, Escherichia coli, Pseudomonas aeruginosa, Proteus vulgaris, Clostridium butyricum and Clostridium pasteurianum, Acinetobacter baumannii, Enterobacter aerogenes. The lowest MIC, amounting to 0.03 µg/mL, was observed for the doripenem-clavulanate acid system in the case of E. coli ATCC 25922. In turn, the lowest MIC for doripenem applied alone was recorded for K. pneumoniae ATCC 31488, for which it was 0.1 µg/mL. The strain which proved to be most resistant both to doripenem and the doripenem-clavulanate acid system, was A. baumannii, with MIC of 32 µg/mL (clinical isolate) and 16 µg/mL (reference strain). Cytometric analysis for P. aeruginosa ATCC 27853 and S. aureus ATCC 25923 showed changes in cells following exposure to limiting concentrations of the active substance. Conclusions: Analysis of MIC supplies important information concerning microbial sensitivity to active substances, mainly in terms of limiting concentrations causing mortality or vitality of the tested species, which is essential when selecting appropriate antibiotic therapy.
Subject(s)
Bacteria/drug effects , Clavulanic Acids/pharmacology , Doripenem/pharmacology , Anti-Bacterial Agents/pharmacology , Pseudomonas aeruginosa/drug effects , Salmonella/drug effects , Staphylococcus aureus/drug effects , Microbial Sensitivity Tests , Clostridium/drug effects , Drug Interactions , Flow Cytometry , Klebsiella pneumoniae/drug effects摘要
BACKGROUND/AIMS: Clostridium difficile infection (CDI) has been reported to be a cause of flare-ups in patients with ulcerative colitis (UC). We evaluated the prevalence and clinical outcomes of CDI in patients with UC hospitalized for flare-ups. METHODS: This was a prospective, multicenter study including 7 academic teaching hospitals in Korea. All consecutive patients with UC admitted for disease flare-up were enrolled. We detected the presence of CDI by using enzyme immunoassay, real-time polymerase chain reaction (RT-PCR) for toxin genes, and sigmoidoscopy. RESULTS: Eighty-one consecutive patients with UC were enrolled from January 2014 to December 2015. Among 81 patients, 8 (9.9%) were diagnosed with CDI. Most of the cases were identified by RT-PCR. Enzyme immunoassay was positive in 3 of 8 patients, and only 1 had typical endoscopic findings of pseudomembranous colitis. There were no differences in demographic data, length of hospital stay, or colectomy rate between patients with and without CDI. CONCLUSIONS: CDI was not a rare cause of flare-up in patients with UC in Korea. However, CDI did not appear to affect the course of UC flare-up in Korean patients. RT-PCR was sensitive in detecting CDI and can be considered a diagnostic tool in patients with UC flare-up.
Subject(s)
Humans , Clostridioides difficile , Clostridium Infections , Clostridium , Colectomy , Colitis, Ulcerative , Enterocolitis, Pseudomembranous , Hospitals, Teaching , Immunoenzyme Techniques , Korea , Length of Stay , Polymerase Chain Reaction , Prevalence , Prospective Studies , Real-Time Polymerase Chain Reaction , Sigmoidoscopy , Ulcer摘要
BACKGROUND/AIMS: Tens of trillions of microorganisms constitute the gut microbiota of the human body. The microbiota plays a critical role in maintaining host immunity and metabolism. Analyses of the gut microbial composition in Korea are limited to a few studies consisting of small sample sizes. To investigate the gut microbial community in a large sample of healthy Koreans, we analyzed the 16S ribosomal RNA of 4 representative bacterial genera Lactobacillus, Bifidobacterium, Bacteroides, and Clostridium. METHODS: A total of 378 DNA samples extracted from 164 infants and 214 adults were analyzed using quantitative real-time polymerase chain reaction. RESULTS: Analysis of 16S ribosomal RNA of 4 representative bacterial genera Lactobacillus, Bifidobacterium, Bacteroides, and Clostridium showed that the gut microbiota in infants had higher relative abundances of Bifidobacterium and Lactobacillus than that in adults, which was dominated by Bacteroides and Clostridium. CONCLUSIONS: To the best of our knowledge, this was the first study evaluating the distinct characteristics of the microbial community of Korean infants and adults. The differences between the 2 populations suggest that external factors such as age, diet, and the environment are important contributing factors to the change in gut microbial composition during development.
Subject(s)
Adult , Humans , Infant , Bacteroides , Bifidobacterium , Clostridium , Diet , DNA , Gastrointestinal Microbiome , Human Body , Korea , Lactobacillus , Metabolism , Microbiota , Real-Time Polymerase Chain Reaction , RNA, Ribosomal, 16S , Sample Size , Transcutaneous Electric Nerve Stimulation摘要
BACKGROUND: Diverse microbiota exist in the lower respiratory tract. Although next generation sequencing (NGS) is the most widely used microbiome analysis technique, it is difficult to implement NGS in clinical microbiology laboratories. Therefore, we evaluated the performance of conventional culture methods together with matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF MS) in identifying microbiota in bronchoalveolar lavage (BAL) fluid. METHODS: BAL fluid samples (n=27) were obtained from patients undergoing diagnostic bronchoscopy for lung mass evaluation. Bacterial and fungal culture was performed with conventional media used in clinical microbiology laboratories. On an average, 20 isolated colonies were picked from each agar plate and identified by MALDI-TOF MS. Microbiome analysis using 16S rRNA NGS was conducted for comparison. RESULTS: Streptococcus spp. and Neisseria spp. were most frequently cultured from the BAL fluid samples. In two samples, Enterobacteriaceae grew predominantly on MacConkey agar. Actinomyces and Veillonella spp. were commonly identified anaerobes; gut bacteria, such as Lactobacillus, Bifidobacterium, and Clostridium, and fungi were also isolated. NGS revealed more diverse bacterial communities than culture, and Prevotella spp. were mainly identified solely by NGS. Some bacteria, such as Staphylococcus spp., Clostridium spp., and Bifidobacterium spp., were identified solely by culture, indicating that culture may be more sensitive for detecting certain bacteria. CONCLUSIONS: Culture and NGS of BAL fluid samples revealed common bacteria with some different microbial communities. Despite some limitations, culture combined with MALDI-TOF MS might play a complementary role in microbiome analysis using 16S rRNA NGS.
Subject(s)
Humans , Actinomyces , Agar , Bacteria , Bifidobacterium , Bronchoalveolar Lavage Fluid , Bronchoalveolar Lavage , Bronchoscopy , Clostridium , Enterobacteriaceae , Fungi , Lactobacillus , Lung , Mass Spectrometry , Microbiota , Neisseria , Prevotella , Respiratory System , Spectrometry, Mass, Matrix-Assisted Laser Desorption-Ionization , Staphylococcus , Streptococcus , Veillonella摘要
PURPOSE: Clostridium difficile colonization and infection are commonly associated with poor outcomes in patients with pediatric inflammatory bowel disease (PIBD). We aimed to investigate the prevalence of C. difficile colonization and infection at the time of diagnosis and to evaluate risk factors associated with the development of C. difficile infection during the course of PIBD treatment. METHODS: We retrospectively enrolled a total of 59 children who were newly diagnosed with PIBD at the tertiary medical center. All patients underwent C. difficile toxin assays and cultures initially and at every follow-up during the disease course. Kaplan-Meier survival analysis and Cox regression test were used for statistical analysis. RESULTS: Initial cultures for C. difficile were positive in 13 (22.0%) of 59 PIBD patients, whereas initial toxin assays were positive in 3 patients (5.1%). During treatment, C. difficile cultures converted to positive in 28 (47.5%) in addition to 13 patients who were initially culture-positive, and C. difficile toxins converted to positive in 13 (22.0%) in addition to 3 originally toxin-positive patients. Antibiotic usage alone was significantly associated with the development of C. difficile colonization (p=0.011), and the length of hospitalization was associated with the development of C. difficile infection (p=0.032). CONCLUSION: C. difficile colonization and infection occur frequently during the disease course of PIBD. Antibiotic usage and longer hospital stay were significant risks factors for the conversion of C. difficile status in PIBD patients undergoing treatment.