Lactobacillus crispatus Limits Bladder Uropathogenic E. coli Infection by Triggering a Host Type I Interferon Response.

Many urinary tract infections (UTIs) are recurrent because uropathogens persist within the bladder epithelial cells (BECs) for extended periods between bouts of infection. Because persistent uropathogens are intracellular, they are often refractive to antibiotic treatment. The recent discovery of endogenous Lactobacillus spp. in the bladders of healthy humans raised the question of whether these endogenous bacteria directly or indirectly impact intracellular bacterial burden in the bladder. Here, we report that in contrast to healthy women, female patients experiencing recurrent UTIs have a bladder population of Lactobacilli that is markedly reduced. Exposing infected human BECs to L. crispatus in vitro markedly reduced the intracellular uropathogenic Escherichia coli (UPEC) load. The adherence of Lactobacilli to BECs was found to result in increased type I interferon (IFN) production, which in turn enhanced the expression of cathepsin D within lysosomes harboring UPECs. This lysosomal cathepsin D-mediated UPEC killing was diminished in germ-free mice and type I IFN receptor-deficient mice. Secreted metabolites of L. crispatus seemed to be responsible for the increased expression of type I IFN in human BECs. Intravesicular administration of Lactobacilli into UPEC-infected murine bladders markedly reduced their intracellular bacterial load suggesting that components of the endogenous microflora can have therapeutic effects against UTIs.

Incidence and prevalence of pressure ulcers in hospitals: 10-year cohort study.

OBJECTIVE: Pressure ulcers (PUs) are a serious problem in patients with multiple comorbidities and are associated with a longer duration of hospital stay and higher medical costs. The aetiology and rate of PU occurrence in South Korea remains unclear. Therefore, we aimed to determine the incidence, prevalence, mortality and common comorbidities of hospitalised patients with PUs in the South Korean healthcare system. METHOD: A 10-year cohort study using the healthcare insurance reimbursement claims from the South Korean National Health Insurance System database. Patients diagnosed with a PU on admission to hospital [ICD-10: L89 + procedure code] between January 2002 and December 2016 were included and their comorbidities evaluated. Patients <20 years of age and recurrent PU cases were excluded. RESULTS: Incidence, prevalence, survival rate and risk factors related to survival rate of patients with PUs were determined. The study population in 2006 was 36,195,121 (all patients admitted to hospital that year), which changed yearly because of the inclusion of additional patients who met the study inclusion criteria, and removal of patients who had died during the year. Standardised PU incidence rate decreased from 17.1 in 2006 to 14.9 in 2015 per 10,000 people. Standardised PU prevalence also showed a slightly decreasing trend from 20.2 in 2006 to 18.9 in 2015 per 10,000 people. CONCLUSION: This findings of this 10-year study showed that incidence and prevalence of PUs markedly increased with age after the seventh decade. Incidence of PUs increased in patients with pneumonia, cerebral infarction, sepsis, femoral neck fracture and malignant neoplasm of the bronchus. Patients with femoral neck fracture and cerebral infarction showed a higher rate of survival than those with other high-risk comorbidities.

(CONSORT) Wound closure using Dermabond after excision of hemangioma on the lip.

BACKGROUND: As the lip contains ample blood supply, hemangiomas often occur in this area. When surgical excision is performed, wound closure is important. To prevent infection from saliva and food, watertight wound closure is needed. The purpose of this study is to demonstrate the usefulness of Dermabond for wound closure after hemangioma excision on the lip. METHODS: Between December 2015 and August 2017, 11 patients with lip hemangioma underwent surgical excision. When closing the wound, Dermabond was used for skin closure after subcutaneous sutures. Demographic data and complications were recorded. Scars were evaluated with the Vancouver scar scale (VSS), and the postoperative shape of the lip was assessed on a 10-point satisfaction scale at 1 month and 6 months postoperatively. RESULTS: All cases completely healed without any complications, such as wound dehiscence or infection. There were no recurrences at postoperative 1 month during the follow-up period. The aesthetic results of the scars were also excellent. The average VSS score on postoperative 1 month was 4.2, and it decreased to 2.2 at postoperative 6 months. The average patient satisfaction score at postoperative 1 month was 7.4, and it increased to 9.5 at postoperative 6 months. CONCLUSION: Dermabond is useful for wound closure after hemangioma excision on the lip. It prevents wound contamination, and yields acceptable aesthetic results.