Malignant external otitis: The shifting treatment paradigm.

IMPORTANCE: Malignant external otitis (MEO) is an aggressive infection occurring in immunocompromised hosts. Increasing antimicrobial resistance is making the disease more difficult to treat. OBJECTIVE: Determine if there has been a shift in the microbiology and outcomes of MEO. DESIGN: A retrospective case series at a tertiary care institution. SETTING: Inpatient and outpatient tertiary care hospital. PARTICIPANTS: 12 cases of recent MEO were reviewed. MAIN OUTCOMES AND MEASURES: The primary outcome was progression of disease. Secondary outcomes were drug resistance and complications of MEO. RESULTS: Only 4 patients were cured of MEO. Four patients expired during the study period and at least one of these deaths was a direct result of the MEO. 7 patients developed Cranial nerve palsies, and 3 patients developed abscesses. CONCLUSIONS: Select cases of MEO now require multi-drug and long-term parenteral antibiotic therapy with extended hospital stays.

Use of Entomopathogenic Nematodes and Thyme Oil to Suppress Plant-Parasitic Nematodes on English Boxwood.

A 2-year experiment was conducted to test suppression of plant-parasitic nematodes on English boxwood using entomopathogenic nematodes and 3.5% thyme oil formulated as Promax. Treatments were Steinernema riobrave formulated as BioVector and S. feltiae formulated as Nemasys, both applied at a rate of 2.5 billion infective juveniles/ha, thyme oil at rate of 9.3 liters/ha, and nontreated control. In the 2001 season, treatment with S. feltiae reduced (P ≤ 0.05) the population growth of Tylenchorhynchus sp. 7 days after treatment and Hoplolaimus sp. 30 and 60 days after treatment. Treatment with S. riobrave reduced (P ≤ 0.05) the population growth of all plant-parasitic nematode species at all sampling dates, with the exception of Mesocriconema sp. 30 days after treatment and Tylenchorhynchus sp. and Rotylenchus buxophilus 60 days after treatment. Treatment with thyme oil reduced (P ≤ 0.05) the population growth of all plant-parasitic nematode genera at all sampling dates except Tylenchorhynchus sp. and R. buxophilus 60 days after treatment. In the 2002 season, treatment with S. feltiae had no effect on nematode population growth. Treatment with S. riobrave reduced (P ≤ 0.05) the population growth of R. buxophilus 7 days after treatment, and all plant-parasitic nematodes 30 and 60 days after treatment except Hoplolaimus sp. 30 days after treatment and Mesocriconema sp. 60 days after treatment. Treatment with thyme oil reduced (P ≤ 0.05) the population growth at all sampling dates of plant-parasitic nematodes except Mesocriconema sp. 60 days after treatment.

Use of entomopathogenic nematodes to suppress Meloidogyne incognita on greenhouse tomatoes.

Tomato seedlings in a growth chamber were inoculated with 150 Meloidogyne incognita eggs and 25 infective juveniles (IJ)/cm² of Steinernema feltiae, S. riobrave, or Heterorhabditis bacteriophora. With the exception of seedling roots treated with H. bacteriophora, all seedlings treated with entomopathogenic nematodes had fewer M. incognita juveniles inside roots and produced fewer eggs than the control seedlings. Tomato plants in the greenhouse were infested with 4,000 M. incognita eggs and treated 2 weeks before, 1 week before, at the same time, 1 week after, or 2 weeks after with 25 or 125 IJ/cm² of S. feltiae, S. riobrave, or H. bacteriophora. Plants with pre- and post-infestation applications of S. feltiae or S. riobrave suppressed M. incognita. Plants treated with H. bacteriophora 1 week before and at the time of infestation suppressed M. incognita. Increasing the rate of H. bacteriophora and S. feltiae from 25 to 125 IJ/cm² improved M. incognita suppression.

Impact of the host cadaver on survival and infectivity of entomopathogenic nematodes (Rhabditida: Steinernematidae and Heterorhabditidae) under desiccating conditions.

Entomopathogenic nematode species of Steinernema carpocapsae, Steinernema riobrave, or Heterorhabditis bacteriophora were used to compare survival and infectivity among infective juveniles (IJs) emerging in water from hosts in White traps (treatment a), emerging in sand from hosts placed in sand (treatment c), and emerging from hosts placed on a mesh suspended over sand (treatment m). Nematode survival and infectivity was recorded in sand at three-day intervals during 21 days of storage in desiccators at 75% relative humidity and 25 degrees C. Infectivity was measured by exposing 5 Galleria mellonella for 16 h to IJs. Treatment did not affect percent survival of H. bacteriophora IJs. Percent survival of S. riobrave and S. carpocapsae IJs was lowest in treatment a. Across all treatments, by 10 days after the beginning of the experiments, IJ survival declined to 93, 43, and 28% of levels on day 1 for H. bacteriophora, S. riobrave, and S. carpocapsae, respectively. For the three treatments, infection rate over time was described by a negative exponential function for S. riobrave and S. carpocapsae and by a sigmoid function for H. bacteriophora.