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1.
Clin Infect Dis ; 78(3): 663-666, 2024 03 20.
Artículo en Inglés | MEDLINE | ID: mdl-38330299

RESUMEN

In this retrospective/prospective study, we assessed the role of fundoscopy in 711 episodes with suspected infective endocarditis (IE); 238 (33%) had IE. Ocular embolic events (retinal emboli or chorioretinitis/endophthalmitis) and Roth spots were found in 37 (5%) and 34 (5%) episodes, respectively, but had no impact on IE diagnosis.


Asunto(s)
Embolia , Endocarditis Bacteriana , Endocarditis , Humanos , Estudios de Cohortes , Estudios Retrospectivos , Estudios Prospectivos , Endocarditis/diagnóstico , Endocarditis Bacteriana/diagnóstico por imagen
2.
Pulm Pharmacol Ther ; 60: 101885, 2020 02.
Artículo en Inglés | MEDLINE | ID: mdl-31891761

RESUMEN

Plasma drug concentrations, spectrum of antibacterial activity and minimum inhibitory concentration (MIC) had been widely considered as markers of the efficacy of antibiotics. Nonetheless, in several cases, antibiotics characterized by all these features were ineffective for the treatment of respiratory tract infections. A typical paradigm represented the case of patients with bronchiectasis who do not always benefit from antibiotics and thus experiencing increased sputum production, worse quality of life, more rapid forced expiratory volume in the first second (FEV1) decline, more frequent exacerbations and increased mortality rates, especially those with Pseudomonas aeruginosa (P. aeruginosa) chronic infection. Subsequently, penetrance of antibiotics in the epithelial lining fluid has gradually emerged as another key factor for the outcome of antibiotic treatment. Given that a plethora of antibiotics presented with poor or intermediate penetrance in the epithelial lining fluid, inhaled antibiotics targeting directly the site of infection emerged as a new option for patients with respiratory disorders including patients with bronchiectasis. This review article intends to summarize the current state of knowledge for the penetrance of antibiotics in the epithelial lining fluid and present results from clinical trials of inhaled antibiotics in patients with bronchiectasis of etiology other than cystic fibrosis.


Asunto(s)
Antibacterianos/administración & dosificación , Bronquiectasia/complicaciones , Infecciones del Sistema Respiratorio/tratamiento farmacológico , Administración por Inhalación , Ensayos Clínicos como Asunto , Humanos , Pulmón/efectos de los fármacos , Penetrancia , Infecciones por Pseudomonas/tratamiento farmacológico
3.
Rev Med Suisse ; 16(710): 1916-1919, 2020 Oct 14.
Artículo en Francés | MEDLINE | ID: mdl-33058577

RESUMEN

Probiotics are a big food and pharmaceutical industry today. The most widely used probiotics are Lactobacillus spp, Bifidobacterium spp, strains of Enterococcus spp, Streptococcus spp and yeasts such as Saccharomyces pp. Among the best-known indications are Clostridioides difficile colitis and diarrhea due to antibiotics, but probiotics are also proposed as adjuvants for atopic syndromes, autoimmune diseases, prevention and treatment of obesity, diabetes and cystic fibrosis, where dysbiosis play an important role. However, their use remains debated due to a lack of powerful data proving their effectiveness and their often-overlooked side effects.


Les probiotiques constituent de nos jours une grande industrie alimentaire et pharmaceutique. Les plus utilisés sont des Lactobacillus spp, les Bifidobacterium spp., des souches d'Enterococcus spp., de Streptococcus spp. et des levures comme les Saccharomyces spp. La colite à Clostridioides difficile et les diarrhées dues aux antibiotiques sont des indications reconnues, mais les probiotiques sont aussi proposés comme adjuvants pour des syndromes atopiques, des maladies autoimmunes, la prévention et le traitement de l'obésité, du diabète et de la mucoviscidose, où la dysbiose joue un rôle important. Néanmoins, leur utilisation reste débattue en raison du manque de données puissantes prouvant leur efficacité et d'effets indésirables sous-estimés et mal étudiés.


Asunto(s)
Probióticos/efectos adversos , Probióticos/uso terapéutico , Antibacterianos/efectos adversos , Diarrea/microbiología , Diarrea/terapia , Disbiosis/microbiología , Disbiosis/terapia , Humanos
4.
Crit Rev Food Sci Nutr ; 59(4): 537-545, 2019.
Artículo en Inglés | MEDLINE | ID: mdl-28910544

RESUMEN

In most developed countries, ageing of the population started more than a century ago and it seems to be emerged in a wide range of developing countries as well. Moreover, research into ageing has moved forward in extremely rapidly rhythms nowadays, and the scientific area is of great interest, as implications for nearly all sectors of society, including work, social, economic features, in addition to nutrition and health issues which are involved. The fragile elder population is affected and experienced more frequently infections than the younger population. Infections in elderly patients are of major medical importance because of hormonal changes, increased production of pro-inflammatory cytokines and chemokines, abnormalities of the telomeres which could cause a dysfunction of the immune system called immunosenescence and malnutrition.


Asunto(s)
Envejecimiento/fisiología , Infecciones/microbiología , Microbiota/fisiología , Inmunidad Adaptativa/fisiología , Anciano , Autoinmunidad , Quimioterapia , Hormonas/fisiología , Humanos , Inmunidad Innata/fisiología , Inmunosenescencia/fisiología , Infecciones/inmunología , Inflamación , Probióticos , Telómero/fisiología
5.
Rev Med Suisse ; 14(622): 1786-1789, 2018 Oct 10.
Artículo en Francés | MEDLINE | ID: mdl-30307137

RESUMEN

Crimean-Congo hemorrhagic fever is transmitted by Hyalomma spp ticks or exposure to blood of infected persons or animals. It is present in European regions that are frequently visited by people living in Switzerland. It is suspected in case of fever with hemorrhagic signs and confirmed by PCR or serology. Because of its severity and potential for nosocomial transmission, it should be included of the differential diagnosis of fever in returning travelers in order to rapidly implement the adequate measures : hospitalisation with isolation precautions and treatment with ribavirin. In the absence of an effective vaccine, prevention consists of barriers precautions and postexposure prophylaxis with ribavirin in case of exposure to infected blood.


La fièvre hémorragique de Crimée-Congo est transmise par les tiques Hyalomma spp ou par contact avec le sang de personnes ou d'animaux infectés. Elle est endémique dans des régions d'Europe fréquemment visitées par des personnes vivant en Suisse. Le diagnostic repose sur la clinique d'un état fébrile et de manifestations hémorragiques. Il est confirmé par PCR ou sérologie. Sa gravité et son potentiel de transmission nosocomiale en font une infection à inclure dans le diagnostic différentiel de fièvre au retour de voyage afin de rapidement prendre les mesures qui s'imposent : hospitalisation en isolement adéquat et traitement précoce par ribavirine. En l'absence de vaccin efficace, sa prévention repose sur l'application de mesures de barrières et l'administration prophylactique de ribavirine en cas d'accident exposant au sang d'un malade.


Asunto(s)
Virus de la Fiebre Hemorrágica de Crimea-Congo , Fiebre Hemorrágica de Crimea , Animales , Antivirales/uso terapéutico , Europa (Continente)/epidemiología , Fiebre Hemorrágica de Crimea/diagnóstico , Fiebre Hemorrágica de Crimea/tratamiento farmacológico , Fiebre Hemorrágica de Crimea/epidemiología , Humanos , Ribavirina/uso terapéutico , Suiza
6.
Microb Ecol Health Dis ; 26: 26543, 2015.
Artículo en Inglés | MEDLINE | ID: mdl-25952773

RESUMEN

BACKGROUND: Nowadays, there has been an increased interest in essential oils from various plant origins as potential antimicrobial, antioxidant, and antiproliferative agents. This trend can be mainly attributed to the rising number and severity of food poisoning outbreaks worldwide along with the recent negative consumer perception against artificial food additives and the demand for novel functional foods with possible health benefits. Origanum dictamnus (dittany) is an aromatic, tender perennial plant that only grows wild on the mountainsides and gorges of the island of Crete in Greece. OBJECTIVE: The aim of the present study was to investigate the antimicrobial, antioxidant, and antiproliferative properties of O. dictamnus essential oil and its main components and assess its commercial potential in the food industry. DESIGN: O. dictamnus essential oil was initially analyzed by gas chromatography-mass spectrometry (GC-MS) to determine semi-quantitative chemical composition of the essential oils. Subsequently, the antimicrobial properties were assayed and the minimum inhibitory and non-inhibitory concentration values were determined. The antioxidant activity and cytotoxic action against the hepatoma adenocarcinoma cell line HepG2 of the essential oil and its main components were further evaluated by the 2,2-diphenyl-1-picrylhydrazyl (DPPH) assay and by the sulforhodamine B (SRB) assay, respectively. RESULTS: The main constituents of O. dictamnus essential oil identified by GC-MS analysis were carvacrol (52.2%), γ-terpinene (8.4%), p-cymene (6.1%), linalool (1.4%), and caryophyllene (1.3%). O. dictamnus essential oil and its main components were effective against Staphylococcus aureus, Staphylococcus epidermidis, Escherichia coli, Listeria monocytogenes, Salmonella Enteritidis, Salmonella typhimurium, Saccharomyces cerevisiae, and Aspergillus niger. In addition, the estimated IC50 value for the DPPH radical scavenging activity for O. dictamnus essential oil was 0.045±0.0042% (v/v) and was mainly attributed to carvacrol. The EC50 value for the essential oil in the 72h SRB assay in HepG2 cells was estimated to be 0.0069±0.00014% (v/v). Among the individual constituents tested, carvacrol was the most bioactive compound and accounted for the observed antiproliferative activity of the essential oil. CONCLUSIONS: The results revealed that O. dictamnus essential oil is a noteworthy growth inhibitor against the microbes studied. It also possesses significant antioxidant activity and demonstrated excellent cytotoxicity against HepG2 cells. Taken together, O. dictamnus essential oil may represent an effective and inexpensive source of potent natural antimicrobial agents with health-promoting properties, which may be incorporated in food systems.

7.
Microb Ecol Health Dis ; 26: 23289, 2015.
Artículo en Inglés | MEDLINE | ID: mdl-25881620

RESUMEN

BACKGROUND: Oregano (Origanum vulgare), sage (Salvia officinalis), and thyme (Thymus vulgaris) are aromatic plants with ornamental, culinary, and phytotherapeutic use all over the world. In Europe, they are traditionally used in the southern countries, particularly in the Mediterranean region. The antimicrobial activities of the essential oils (EOs) derived from those plants have captured the attention of scientists as they could be used as alternatives to the increasing resistance of traditional antibiotics against pathogen infections. Therefore, significant interest in the cultivation of various aromatic and medicinal plants is recorded during the last years. However, to gain a proper and marketable chemotype various factors during the cultivation should be considered as the geographical morphology, climatic, and farming conditions. In this frame, we have studied the antimicrobial efficiency of the EOs from oregano, sage, and thyme cultivated under different conditions in a region of NE Greece in comparison to the data available in literature. METHODS: Plants were purchased from a certified supplier, planted, and cultivated in an experimental field under different conditions and harvested after 9 months. EOs were extracted by using a Clevenger apparatus and tested for their antibacterial properties (Minimum inhibitory concentration - MIC) against clinical isolates of multidrug resistant Escherichia coli (n=27), Klebsiella oxytoca (n=7), and Klebsiella pneumoniae (n=16) strains by using the broth microdilution assay. RESULTS: Our results showed that the most sensitive organism was K. oxytoca with a mean value of MIC of 0.9 µg/mL for oregano EOs and 8.1 µg/mL for thyme. The second most sensitive strain was K. pneumoniae with mean MIC values of 9.5 µg/mL for thyme and 73.5 µg/mL for oregano EOs. E. coli strains were among the most resistant to EOs antimicrobial action as the observed MICs were 24.8-28.6 µg/mL for thyme and above 125 µg/mL for thyme and sage. Most efficient were the EOs from thyme followed by those of oregano. CONCLUSIONS: With MIC values above 150 µg/mL, sage EOs did not show any antibacterial efficiency against the majority of the strains. However, no significant differences were observed concerning the antimicrobial action of all EOs originating from irrigated versus non-irrigated cultivated aromatic plants.

8.
Front Oncol ; 14: 1434795, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-39165685

RESUMEN

This case study presents the diagnostic and therapeutic course of a 72-year-old male patient with a history of high-grade urothelial carcinoma with papillary features. The report outlines the patient's initial presentation, the intervention strategies employed, including transurethral resection and intravesical Bacillus Calmette-Guérin (BCG) therapy, the subsequent complications and clinical decisions following the intense symptoms post-treatment. The study highlights the challenges in managing bladder cancer in elderly patients, considering the tumor's characteristics, treatment responses, and the patient's quality of life.

9.
J Pers Med ; 14(5)2024 May 11.
Artículo en Inglés | MEDLINE | ID: mdl-38793089

RESUMEN

Inflammatory Bowel Disease (IBD), encompassing Crohn's disease (CD) and ulcerative colitis (UC), is a chronic and relapsing inflammatory condition of the intestine that significantly impairs quality of life and imposes a heavy burden on healthcare systems globally. While the exact etiology of IBD is unclear, it is influenced by genetic, environmental, immunological, and microbial factors. Recent advances highlight the gut microbiome's pivotal role in IBD pathogenesis. The microbial dysbiosis characteristic of IBD, marked by a decline in beneficial bacteria and an increase in pathogenic microbes, suggests a profound connection between microbial imbalance and disease mechanisms. This review explores diagnostic approaches to IBD that integrate clinical assessment with advanced microbiological analyses, highlighting the potential of microbiome profiling as a non-invasive diagnostic tool. In addition, it evaluates conventional and emerging treatments and discusses microbiome-targeted intervention prospects, such as probiotics, symbiotics, and faecal microbiota transplantation. The necessity for future research to establish their efficacy and safety is emphasised.

10.
Front Nutr ; 11: 1383040, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-38818135

RESUMEN

The nutritional habits regulate the gut microbiota and increase risk of an autoimmune disease. Western diet is rich in sugars, meat, and poly-unsaturated fatty acids, which lead to dysbiosis of intestinal microbiota, disruption of gut epithelial barrier and chronic mucosal inflammation. In contrast, the Mediterranean Diet (MedDiet) is abundant in ω3 fatty acids, fruits, and vegetables, possessing anti-inflammatory properties that contribute to the restoration of gut eubiosis. Numerous studies have extensively examined the impact of MedDiet and its components on both health and various disease states. Additionally, specific investigations have explored the correlation between MedDiet, microbiota, and the risk of autoimmune diseases. Furthermore, the MedDiet has been linked to a reduced risk of cardiovascular diseases, playing a pivotal role in lowering mortality rates among individuals with autoimmune diseases and comorbidities. The aim of the present review is to specifically highlight current knowledge regarding possible interactions of MedDiet with the patterns of intestinal microbiota focusing on autoimmunity and a blueprint through dietary modulations for the prevention and management of disease's activity and progression.

11.
Swiss Med Wkly ; 154: 3730, 2024 Mar 26.
Artículo en Inglés | MEDLINE | ID: mdl-38579310

RESUMEN

AIMS OF THE STUDY: Invasive mould infections are life-threatening complications in patients with haematologic cancer and chemotherapy-induced neutropenia. While invasive aspergillosis represents the main cause of invasive mould infections, non-Aspergillus mould infections, such as mucormycosis, are increasingly reported. Consequently, their local epidemiology should be closely monitored. The aim of this study was to investigate the causes of an increased incidence of non-Aspergillus mould infections in the onco-haematology unit of a Swiss tertiary care hospital. METHODS: All cases of proven and probable invasive mould infections were retrospectively identified via a local registry for the period 2007-2021 and their incidence was calculated per 10,000 patient-days per year. The relative proportion of invasive aspergillosis and non-Aspergillus mould infections was assessed. Factors that may affect invasive mould infections' incidence, such as antifungal drug consumption, environmental contamination and changes in diagnostic approaches, were investigated. RESULTS: A significant increase of the incidence of non-Aspergillus mould infections (mainly mucormycosis) was observed from 2017 onwards (Mann and Kendall test p = 0.0053), peaking in 2020 (8.62 episodes per 10,000 patient-days). The incidence of invasive aspergillosis remained stable across the period of observation. The proportion of non-Aspergillus mould infections increased significantly from 2017 (33% vs 16.8% for the periods 2017-2021 and 2007-2016, respectively, p = 0.02). Building projects on the hospital site were identified as possible contributors of this increase in non-Aspergillus mould infections. However, novel diagnostic procedures may have improved their detection. CONCLUSIONS: We report a significant increase in non-Aspergillus mould infections, and mainly in mucormycosis infections, since 2017. There seems to be a multifactorial origin to this increase. Epidemiological trends of invasive mould infections should be carefully monitored in onco-haematology units in order to implement potential corrective measures.


Asunto(s)
Aspergilosis , Hematología , Mucormicosis , Humanos , Mucormicosis/epidemiología , Mucormicosis/diagnóstico , Mucormicosis/microbiología , Estudios Retrospectivos , Incidencia , Antifúngicos/uso terapéutico , Aspergilosis/epidemiología , Aspergilosis/tratamiento farmacológico , Aspergilosis/microbiología
12.
Open Forum Infect Dis ; 11(5): ofae201, 2024 May.
Artículo en Inglés | MEDLINE | ID: mdl-38756760

RESUMEN

Background: Limited data exist on when and how to stop antifungal treatment (AFT) in patients with invasive mold infections (IMIs) who are immunocompromised. Methods: This retrospective multicenter study included adult patients with acute myelogenous leukemia and proven/probable IMI (1 January 2010-31 December 2022) in 3 university hospitals. The primary objective was to describe AFT duration and adaptation. Secondary objectives were to investigate the reasons for AFT adjustments and prolongation. Results: In total 71 patients with 73 IMIs were identified; 51 (71.8%) had an allogeneic hematopoietic cell transplant. Most infections were invasive aspergillosis (IA; 49/71, 69%), followed by mucormycosis (12, 16.9%) and other (12, 16.9%); there were 2 mixed infections. Median treatment duration was 227 days (IQR, 115.5-348.5). There was no difference in AFT duration between patients with IA and non-IA IMI (P = .85) or by center (P = .92). Treatment was longer in patients with an allogeneic hematopoietic cell transplant vs not (P = .004). Sixteen patients (22.5%) had no therapy modifications. In 55 patients (77.5%), a median 2 changes (IQR, 1-3; range, 1-8) were observed. There were 182 reasons leading to 165 changes, associated with clinical efficacy (82/182, 44.5%), toxicity (47, 25.8%), and logistical reasons (22, 12.1%); no reason was documented in 32 changes (18.8%). AFT was continued beyond days 90 and 180 in 59 (83%) and 39 (54.9%) patients, respectively, mostly due to persistence of immunosuppression. Conclusions: AFT in patients with acute myelogenous leukemia and IMI is longer than that recommended by guidelines and is frequently associated with treatment adjustments due to variable reasons. More data and better guidance are required to optimize AFT duration and secondary prophylaxis administration according to immunosuppression.

13.
Foods ; 13(16)2024 Aug 20.
Artículo en Inglés | MEDLINE | ID: mdl-39200533

RESUMEN

Total Quality Management (TQM) is a holistic approach widely adopted across industries to ensure quality control and management. This document examines TQM practices in the pharmaceutical, food, and nutritional supplement sectors, highlighting their vital role in public health, sustainability, and consumer acceptance. By analyzing the literature and case studies, the article demonstrates how TQM significantly ensures product safety and quality. Real-world examples and empirical evidence showcase the benefits of TQM methodologies, from rigorous quality control to efficient management processes, helping to meet and exceed regulatory standards. The article also underscores TQM's critical role in addressing sustainability challenges, integrating eco-friendly practices, reducing waste, and optimizing resources. Furthermore, TQM fosters consumer trust and loyalty through transparency, continuous improvement, and responsiveness to feedback, building lasting business-customer relationships. In conclusion, this manuscript illuminates TQM's multifaceted impact on the pharmaceutical, food, and nutritional supplement sectors, presenting it as a pivotal framework for safeguarding public health, promoting sustainability, and enhancing consumer acceptance in a dynamic global landscape.

14.
Antibiotics (Basel) ; 12(1)2023 Jan 06.
Artículo en Inglés | MEDLINE | ID: mdl-36671302

RESUMEN

Honey's antibacterial activity has been recently linked to the inhibitory effects of honey microbiota against a range of foodborne and human pathogens. In the current study, the microbial community structure of honey samples exerting pronounced antimicrobial activity was examined. The honey samples were obtained from different geographical locations in Greece and had diverse pollen origin (fir, cotton, fir-oak, and Arbutus unedo honeys). Identification of honey microbiota was performed by high-throughput amplicon sequencing analysis, detecting 335 distinct taxa in the analyzed samples. Regarding ecological indices, the fir and cotton honeys possessed greater diversity than the fir-oak and Arbutus unedo ones. Lactobacillus kunkeei (basionym of Apilactobacillus kun-keei) was the predominant taxon in the fir honey examined. Lactobacillus spp. appeared to be favored in honey from fir-originated pollen and nectar since lactobacilli were more pronounced in fir compared to fir-oak honey. Pseudomonas, Streptococcus, Lysobacter and Meiothermus were the predominant taxa in cotton honey, whereas Lonsdalea, the causing agent of acute oak decline, and Zymobacter, an osmotolerant facultative anaerobic fermenter, were the dominant taxa in fir-oak honey. Moreover, methylotrophic bacteria represented 1.3-3% of the total relative abundance, independently of the geographical and pollen origin, indicating that methylotrophy plays an important role in honeybee ecology and functionality. A total of 14 taxa were identified in all examined honey samples, including bacilli/anoxybacilli, paracocci, lysobacters, pseudomonads, and sphingomonads. It is concluded that microbial constituents of the honey samples examined were native gut microbiota of melliferous bees and microbiota of their flowering plants, including both beneficial bacteria, such as potential probiotic strains, and animal and plant pathogens, e.g., Staphylococcus spp. and Lonsdalea spp. Further experimentation will elucidate aspects of potential application of microbial bioindicators in identifying the authenticity of honey and honeybee-derived products.

15.
Antioxidants (Basel) ; 12(2)2023 Feb 08.
Artículo en Inglés | MEDLINE | ID: mdl-36829972

RESUMEN

Research attention has been drawn to honey's nutritional status and beneficial properties for human health. This study aimed to provide a bibliometric analysis of honey's antioxidant and antimicrobial properties. The research advancements within this field from 2001 to 2022 were addressed using the Scopus database, R, and VOSviewer. Of the 383 results, articles (273) and reviews (81) were the most common document types, while the annual growth rate of published manuscripts reached 17.5%. The most relevant topics about honey's antimicrobial and antioxidant properties were related to the agricultural and biological sciences, biochemistry, and pharmacology. According to a keyword analysis, the most frequent terms in titles, abstracts, and keywords were honey, antimicrobial, antioxidant, bee, propolis, phenolic compounds, wound, antibacterial, anti-inflammatory, and polyphenols. A trend topic analysis showed that the research agenda mainly encompassed antioxidants, pathogens, and anti-infection and chemical agents. In a co-occurrence analysis, antioxidants, anti-infection agents, and chemistry were connected to honey research. The initial research focus of this domain was primarily on honey's anti-inflammatory and antineoplastic activity, wound healing, and antibacterial agents. The research agenda was enriched in the subsequent years by pathogens, propolis, oxidative stress, and flavonoids. It was possible to pinpoint past trends and ongoing developments and provide a valuable insight into the field of honey research.

16.
Antimicrob Resist Infect Control ; 12(1): 105, 2023 09 19.
Artículo en Inglés | MEDLINE | ID: mdl-37726838

RESUMEN

OBJECTIVE: To compare intravenous (IV) amoxicillin/clavulanic acid (A/CA) to IV cefuroxime plus metronidazole (C + M) for preventing surgical site infections (SSI) in colorectal surgery. BACKGROUND: Given their spectra that include most Enterobacterales and anaerobes, C + M is commonly recommended as prophylaxis of SSI in colorectal surgery. A/CA offers good coverage of Enterobacterales and anaerobes as well, but, in contrast to C + M, it also includes Enterococcus faecalis which is also isolated from patients with SSI and could trigger anastomotic leakage. METHODS: Data from a Swiss SSI surveillance program were used to compare SSI rates after class II (clean contaminated) colorectal surgery between patients who received C + M and those who received A/CA. We employed multivariable logistic regression to adjust for potential confounders, along with propensity score matching to adjust for group imbalance. RESULTS: From 2009 to 2018, 27,922 patients from 127 hospitals were included. SSI was diagnosed in 3132 (11.2%): 278/1835 (15.1%) in those who received A/CA and 2854/26,087 (10.9%) in those who received C + M (p < 0.001). The crude OR for SSI in the A/CA group as compared to C + M was 1.45 [CI 95% 1.21-1.75]. The adjusted OR was 1.49 [1.24-1.78]. This finding persisted in a 1:1 propensity score matched cohort of 1835 patients pairs with an OR of 1.60 [1.28-2.00]. Other factors independently associated with SSI were an ASA score > 2, a longer duration of operation, and a reoperation for a non-infectious complication. Protective factors were female sex, older age, antibiotic prophylaxis received 60 to 30 min before surgery, elective operation, and endoscopic approach. CONCLUSIONS: Despite its activity against enterococci, A/CA was less effective than C + M for preventing SSI, suggesting that it should not be a first choice antibiotic prophylaxis for colorectal surgery.


Asunto(s)
Antiinfecciosos , Cirugía Colorrectal , Gammaproteobacteria , Humanos , Femenino , Masculino , Metronidazol/uso terapéutico , Infección de la Herida Quirúrgica/prevención & control , Cefuroxima/uso terapéutico , Cirugía Colorrectal/efectos adversos , Combinación Amoxicilina-Clavulanato de Potasio/uso terapéutico
17.
Clin Microbiol Infect ; 29(8): 1087.e5-1087.e8, 2023 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-37230250

RESUMEN

OBJECTIVES: To evaluate the role of defervescence within 4 days from antibiotic treatment initiation in ruling out infective endocarditis (IE) among patients suspected of such diagnosis. METHODS: This study was conducted at the Lausanne University Hospital, Switzerland (January 2014 to May 2022). All patients with suspected IE being febrile upon presentation were included. IE was classified according to the modified Duke criteria proposed by the 2015 European Society of Cardiology guidelines, before or after applying the criterion 'resolution of symptoms suggesting IE within 4 days of the introduction of antibiotic therapy' based solely on early defervescence. RESULTS: Among 1022 episodes with suspected IE, 332 (37%) had IE according to Endocarditis-Team evaluation; 248 were classified by clinical Duke criteria as definite and 84 as possible IE. The rate of defervescence within 4 days from antibiotic treatment initiation was similar (p 0.547) among episodes without (606/690; 88%) and those with IE (287/332; 86%); among episodes classified as definite and possible IE by clinical Duke criteria, 211 of 248 (85%) and 76 of 84 (90%), respectively, defervesced within 4 days from antibiotic treatment initiation. By using early defervescence as a rejection criterion, the 76 episodes with final IE diagnosis classified as possible by clinical criteria could be reclassified as rejected. DISCUSSION: The majority of IE episodes defervesced within 4 days from antibiotic treatment initiation; thus, early defervescence should not be used to rule out the diagnosis of IE.


Asunto(s)
Endocarditis Bacteriana , Endocarditis , Humanos , Estudios de Cohortes , Endocarditis Bacteriana/diagnóstico , Endocarditis Bacteriana/tratamiento farmacológico , Endocarditis Bacteriana/microbiología , Endocarditis/diagnóstico , Endocarditis/tratamiento farmacológico , Ecocardiografía Transesofágica , Antibacterianos/uso terapéutico
18.
Front Public Health ; 11: 1202216, 2023.
Artículo en Inglés | MEDLINE | ID: mdl-38026326

RESUMEN

The emergence of COVID-19 in Wuhan, China, rapidly escalated into a worldwide public health crisis. Despite numerous clinical treatment endeavors, initial defenses against the virus primarily relied on hygiene practices like mask-wearing, meticulous hand hygiene (using soap or antiseptic solutions), and maintaining social distancing. Even with the subsequent advent of vaccines and the commencement of mass vaccination campaigns, these hygiene measures persistently remain in effect, aiming to curb virus transmission until the achievement of herd immunity. In this scoping review, we delve into the effectiveness of these measures and the diverse transmission pathways, focusing on the intricate interplay within the food network. Furthermore, we explore the virus's pathophysiology, considering its survival on droplets of varying sizes, each endowed with distinct aerodynamic attributes that influence disease dispersion dynamics. While respiratory transmission remains the predominant route, the potential for oral-fecal transmission should not be disregarded, given the protracted presence of viral RNA in patients' feces after the infection period. Addressing concerns about food as a potential viral vector, uncertainties shroud the virus's survivability and potential to contaminate consumers indirectly. Hence, a meticulous and comprehensive hygienic strategy remains paramount in our collective efforts to combat this pandemic.


Asunto(s)
COVID-19 , Higiene de las Manos , Humanos , COVID-19/prevención & control , SARS-CoV-2 , Higiene , Pandemias/prevención & control
19.
Front Cell Infect Microbiol ; 13: 1191126, 2023.
Artículo en Inglés | MEDLINE | ID: mdl-37333847

RESUMEN

Intestinal microorganisms play a crucial role in shaping the host immunity and maintaining homeostasis. Nevertheless, alterations in gut bacterial composition may occur and these alterations have been linked with the pathogenesis of several diseases. In surgical practice, studies revealed that the microbiome of patients undergoing surgery changes and several post-operative complications seem to be associated with the gut microbiota composition. In this review, we aim to provide an overview of gut microbiota (GM) in surgical disease. We refer to several studies which describe alterations of GM in patients undergoing different types of surgery, we focus on the impacts of peri-operative interventions on GM and the role of GM in development of post-operative complications, such as anastomotic leak. The review aims to enhance comprehension regarding the correlation between GM and surgical procedures based in the current knowledge. However, preoperative and postoperative synthesis of GM needs to be further examined in future studies, so that GM-targeted measures could be assessed and the different surgery complications could be reduced.


Asunto(s)
Procedimientos Quirúrgicos del Sistema Digestivo , Microbioma Gastrointestinal , Microbiota , Humanos , Procedimientos Quirúrgicos del Sistema Digestivo/efectos adversos , Fuga Anastomótica/microbiología , Complicaciones Posoperatorias
20.
Microorganisms ; 11(5)2023 Apr 28.
Artículo en Inglés | MEDLINE | ID: mdl-37317131

RESUMEN

Plants have long been thought to contribute to health promotion due to their fiber and phenolic content, as well as their inherent biological potential. The bioactive derivatives of medicinal plants are a valuable resource in the fight against serious diseases all around the world. The present review focuses on the current state of knowledge on the usage and medicinal applications of plant bioactives. Issues concerning the effect of aromatic plant derivatives on human gut microbiota and their antimicrobial and anti-inflammatory potentials are discussed and worth further exploring.

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