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1.
Invest Ophthalmol Vis Sci ; 62(14): 14, 2021 11 01.
Artigo em Inglês | MEDLINE | ID: mdl-34784411

RESUMO

Purpose: The purpose of this study was to explore the C-X-C chemokines CXCL2 and CXCL10 as potential anti-inflammatory targets for Bacillus endophthalmitis. Methods: Bacillus endophthalmitis was induced in C57BL/6J, CXCL2-/-, and CXCL10-/- mice. At specific times postinfection, eyes were analyzed for Bacillus, retinal function, and inflammation. The efficacies of intravitreal anti-CXCL2 and anti-CXCL10 with or without gatifloxacin in B. cereus endophthalmitis were also assessed using the same techniques. Results: Despite similar Bacillus growth in eyes of C57BL/6J, CXCL2-/-, and CXCL10-/- mice, retinal function retention was greater in eyes of CXCL2-/- and CXCL10-/- mice compared to that of C57BL/6J mice. Neutrophil migration into eyes of CXCL2-/- and CXCL10-/- mice was reduced to a greater degree compared to that of eyes of C57BL/6J mice. Infected CXCL2-/- and CXCL10-/- mouse eyes had significantly less inflammation compared to that of C57BL/6J eyes. Retinal structures in infected eyes of CXCL2-/- mice were preserved for a longer time than in CXCL10-/- eyes. Compared to untreated eyes, there was less inflammation and significant retention of retinal function in eyes treated with anti-CXCL2 and anti-CXCL10 with or without gatifloxacin. Conclusions: For Bacillus endophthalmitis, the absence of CXCL2 or CXCL10 in mice resulted in retained retinal function and less inflammation. The absence of CXCL2 led to a better clinical outcome than the absence of CXCL10. The use of anti-CXCL2 and anti-CXCL10 limited inflammation during B. cereus endophthalmitis. These results highlight the utility of CXCL2 and CXCL10 as potential targets for anti-inflammatory therapy that can be tested in conjunction with antibiotics for improving treating Bacillus endophthalmitis.


Assuntos
Bacillus cereus/crescimento & desenvolvimento , Quimiocina CXCL10/fisiologia , Quimiocina CXCL2/fisiologia , Endoftalmite/fisiopatologia , Infecções Oculares Bacterianas/fisiopatologia , Infecções por Bactérias Gram-Positivas/fisiopatologia , Inflamação/fisiopatologia , Animais , Antibacterianos/uso terapêutico , Anticorpos Monoclonais/farmacologia , Bacillus cereus/isolamento & purificação , Quimiocinas CXC/fisiologia , Contagem de Colônia Microbiana , Modelos Animais de Doenças , Eletrorretinografia , Endoftalmite/tratamento farmacológico , Endoftalmite/microbiologia , Infecções Oculares Bacterianas/tratamento farmacológico , Infecções Oculares Bacterianas/microbiologia , Feminino , Infecções por Bactérias Gram-Positivas/tratamento farmacológico , Infecções por Bactérias Gram-Positivas/microbiologia , Inflamação/tratamento farmacológico , Inflamação/microbiologia , Masculino , Camundongos , Camundongos Endogâmicos C57BL , Neutrófilos/imunologia , Retina/fisiopatologia
2.
JAMA Netw Open ; 4(2): e2036518, 2021 02 01.
Artigo em Inglês | MEDLINE | ID: mdl-33538825

RESUMO

Importance: Infection in neonates remains a substantial problem. Advances for this population are hindered by the absence of a consensus definition for sepsis. In adults, the Sequential Organ Failure Assessment (SOFA) operationalizes mortality risk with infection and defines sepsis. The generalizability of the neonatal SOFA (nSOFA) for neonatal late-onset infection-related mortality remains unknown. Objective: To determine the generalizability of the nSOFA for neonatal late-onset infection-related mortality across multiple sites. Design, Setting, and Participants: A multicenter retrospective cohort study was conducted at 7 academic neonatal intensive care units between January 1, 2010, and December 31, 2019. Participants included 653 preterm (<33 weeks) very low-birth-weight infants. Exposures: Late-onset (>72 hours of life) infection including bacteremia, fungemia, or surgical peritonitis. Main Outcomes and Measures: The primary outcome was late-onset infection episode mortality. The nSOFA scores from survivors and nonsurvivors with confirmed late-onset infection were compared at 9 time points (T) preceding and following event onset. Results: In the 653 infants who met inclusion criteria, median gestational age was 25.5 weeks (interquartile range, 24-27 weeks) and median birth weight was 780 g (interquartile range, 638-960 g). A total of 366 infants (56%) were male. Late-onset infection episode mortality occurred in 97 infants (15%). Area under the receiver operating characteristic curves for mortality in the total cohort ranged across study centers from 0.71 to 0.95 (T0 hours), 0.77 to 0.96 (T6 hours), and 0.78 to 0.96 (T12 hours), with utility noted at all centers and in aggregate. Using the maximum nSOFA score at T0 or T6, the area under the receiver operating characteristic curve for mortality was 0.88 (95% CI, 0.84-0.91). Analyses stratified by sex or Gram-stain identification of pathogen class or restricted to infants born at less than 25 weeks' completed gestation did not reduce the association of the nSOFA score with infection-related mortality. Conclusions and Relevance: The nSOFA score was associated with late-onset infection mortality in preterm infants at the time of evaluation both in aggregate and in each center. These findings suggest that the nSOFA may serve as the foundation for a consensus definition of sepsis in this population.


Assuntos
Bacteriemia/mortalidade , Fungemia/mortalidade , Infecções por Bactérias Gram-Negativas/mortalidade , Infecções por Bactérias Gram-Positivas/mortalidade , Sepse Neonatal/mortalidade , Escores de Disfunção Orgânica , Peritonite/mortalidade , Bacteriemia/microbiologia , Bacteriemia/fisiopatologia , Infecções Relacionadas a Cateter/microbiologia , Infecções Relacionadas a Cateter/mortalidade , Infecções Relacionadas a Cateter/fisiopatologia , Feminino , Fungemia/microbiologia , Fungemia/fisiopatologia , Idade Gestacional , Infecções por Bactérias Gram-Negativas/microbiologia , Infecções por Bactérias Gram-Negativas/fisiopatologia , Infecções por Bactérias Gram-Positivas/microbiologia , Infecções por Bactérias Gram-Positivas/fisiopatologia , Mortalidade Hospitalar , Humanos , Recém-Nascido de Peso Extremamente Baixo ao Nascer , Lactente Extremamente Prematuro , Recém-Nascido , Recém-Nascido Prematuro , Recém-Nascido de muito Baixo Peso , Unidades de Terapia Intensiva Neonatal , Perfuração Intestinal , Masculino , Sepse Neonatal/fisiopatologia , Peritonite/microbiologia , Peritonite/fisiopatologia , Prognóstico , Medição de Risco
3.
Anaerobe ; 69: 102343, 2021 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-33582302

RESUMO

The present study aimed to determine the utility of detection of co-infection of Gardnerella vaginalis and Atopobium vaginae using qualitative PCR for diagnosing bacterial vaginosis (BV). Vaginal samples (n = 385) categorized as positive (n = 108) or negative (n = 208) for bacterial vaginosis based on the Nugent scoring system, were analyzed for the presence of G. vaginalis and A. vaginae by conventional PCR. We compared the sensitivity, specificity, positive predictive value, negative predictive value and odds ratio for the detection of each bacterium alone with the combination of the two bacteria for diagnosing BV. The detection of co-infection of the two bacteria demonstrated a sensitivity of 96%, a specificity of 82.9%, a positive predictive value of 68.5%, a negative predictive value of 98.2% with an odds ratio of 116 (CI -32 - 409). In our study, we found a high sensitivity, specificity, negative predictive value and odds ratio for the detection of co-infection of A. vaginae and G. vaginalis for the diagnosis of BV.


Assuntos
Actinobacteria/isolamento & purificação , Actinobacteria/patogenicidade , Coinfecção/diagnóstico , Gardnerella vaginalis/isolamento & purificação , Infecções por Bactérias Gram-Positivas/diagnóstico , Reação em Cadeia da Polimerase/métodos , Vaginose Bacteriana/diagnóstico , Adolescente , Adulto , Técnicas Bacteriológicas , Feminino , Infecções por Bactérias Gram-Positivas/fisiopatologia , Humanos , Sensibilidade e Especificidade , Vaginose Bacteriana/fisiopatologia , Adulto Jovem
4.
Toxins (Basel) ; 13(2)2021 01 28.
Artigo em Inglês | MEDLINE | ID: mdl-33525722

RESUMO

Bacillus cereus is a ubiquitous soil bacterium responsible for two types of food-associated gastrointestinal diseases. While the emetic type, a food intoxication, manifests in nausea and vomiting, food infections with enteropathogenic strains cause diarrhea and abdominal pain. Causative toxins are the cyclic dodecadepsipeptide cereulide, and the proteinaceous enterotoxins hemolysin BL (Hbl), nonhemolytic enterotoxin (Nhe) and cytotoxin K (CytK), respectively. This review covers the current knowledge on distribution and genetic organization of the toxin genes, as well as mechanisms of enterotoxin gene regulation and toxin secretion. In this context, the exceptionally high variability of toxin production between single strains is highlighted. In addition, the mode of action of the pore-forming enterotoxins and their effect on target cells is described in detail. The main focus of this review are the two tripartite enterotoxin complexes Hbl and Nhe, but the latest findings on cereulide and CytK are also presented, as well as methods for toxin detection, and the contribution of further putative virulence factors to the diarrheal disease.


Assuntos
Bacillus cereus/metabolismo , Proteínas de Bactérias/metabolismo , Diarreia/microbiologia , Enterotoxinas/metabolismo , Doenças Transmitidas por Alimentos/microbiologia , Infecções por Bactérias Gram-Positivas/microbiologia , Proteínas Hemolisinas/metabolismo , Vômito/microbiologia , Animais , Bacillus cereus/genética , Bacillus cereus/patogenicidade , Proteínas de Bactérias/genética , Depsipeptídeos/genética , Depsipeptídeos/metabolismo , Diarreia/diagnóstico , Diarreia/fisiopatologia , Enterotoxinas/genética , Doenças Transmitidas por Alimentos/diagnóstico , Doenças Transmitidas por Alimentos/fisiopatologia , Regulação Bacteriana da Expressão Gênica , Infecções por Bactérias Gram-Positivas/diagnóstico , Infecções por Bactérias Gram-Positivas/fisiopatologia , Proteínas Hemolisinas/genética , Interações Hospedeiro-Patógeno , Humanos , Virulência , Vômito/diagnóstico , Vômito/fisiopatologia
5.
Clin Neurol Neurosurg ; 202: 106507, 2021 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-33493883

RESUMO

INTRODUCTION: Polymerase chain reaction (PCR)-based testing of cerebrospinal fluid (CSF) samples has greatly facilitated the diagnosis of central nervous system (CNS) infections. However, the clinical significance of Epstein-Barr virus (EBV) DNA in CSF of individuals with suspected CNS infection remains unclear. We wanted to gain a better understanding of EBV as an infectious agent in immunocompetent patients with CNS disorders. METHODS: We identified cases of EBV-associated CNS infections and reviewed their clinical and laboratory characteristics. The study population was drawn from patients with EBV PCR positivity in CSF who visited Pusan National University Hospital between 2010 and 2019. RESULTS: Of the 780 CSF samples examined during the 10-year study period, 42 (5.4 %) were positive for EBV DNA; 9 of the patients (21.4 %) were diagnosed with non-CNS infectious diseases, such as optic neuritis, Guillain-Barré syndrome, and idiopathic intracranial hypotension, and the other 33 cases were classified as CNS infections (22 as encephalitis and 11 as meningitis). Intensive care unit admission (13/33 patients, 39.3 %) and presence of severe neurological sequelae at discharge (8/33 patients, 24.2 %) were relatively frequent. In 10 patients (30.3 %), the following pathogens were detected in CSF in addition to EBV: varicella-zoster virus (n = 3), cytomegalovirus (n = 2), herpes simplex virus 1 (n = 1), herpes simplex virus 2 (n = 1), Streptococcus pneumomiae (n = 2), and Enterococcus faecalis (n = 1). The EBV-only group (n = 23) and the co-infection group (n = 10) did not differ in age, gender, laboratory data, results of brain imaging studies, clinical manifestations, or prognosis; however, the co-infected patients had higher CSF protein levels. CONCLUSION: EBV DNA in CSF is occasionally found in the immunocompetent population; the virus was commonly associated with encephalitis and poor prognosis, and frequently found together with other microbes in CSF.


Assuntos
DNA Viral/líquido cefalorraquidiano , Infecções por Vírus Epstein-Barr/fisiopatologia , Herpesvirus Humano 4/genética , Imunocompetência , Encefalite Infecciosa/fisiopatologia , Meningite/fisiopatologia , Adulto , Idoso , Coinfecção , Infecções por Citomegalovirus/líquido cefalorraquidiano , Infecções por Citomegalovirus/complicações , Infecções por Citomegalovirus/fisiopatologia , Encefalite por Herpes Simples/líquido cefalorraquidiano , Encefalite por Herpes Simples/complicações , Encefalite por Herpes Simples/fisiopatologia , Encefalite Viral/líquido cefalorraquidiano , Encefalite Viral/complicações , Encefalite Viral/fisiopatologia , Enterococcus faecalis , Infecções por Vírus Epstein-Barr/líquido cefalorraquidiano , Infecções por Vírus Epstein-Barr/complicações , Feminino , Infecções por Bactérias Gram-Positivas/líquido cefalorraquidiano , Infecções por Bactérias Gram-Positivas/complicações , Infecções por Bactérias Gram-Positivas/fisiopatologia , Síndrome de Guillain-Barré/líquido cefalorraquidiano , Síndrome de Guillain-Barré/complicações , Síndrome de Guillain-Barré/fisiopatologia , Humanos , Encefalite Infecciosa/líquido cefalorraquidiano , Encefalite Infecciosa/complicações , Encefalite Infecciosa/microbiologia , Unidades de Terapia Intensiva , Hipotensão Intracraniana/líquido cefalorraquidiano , Hipotensão Intracraniana/complicações , Hipotensão Intracraniana/fisiopatologia , Masculino , Meningite/líquido cefalorraquidiano , Meningite/complicações , Meningite/microbiologia , Meningite Pneumocócica/líquido cefalorraquidiano , Meningite Pneumocócica/complicações , Meningite Pneumocócica/fisiopatologia , Meningite Viral/líquido cefalorraquidiano , Meningite Viral/complicações , Meningite Viral/fisiopatologia , Pessoa de Meia-Idade , Neurite Óptica/líquido cefalorraquidiano , Neurite Óptica/complicações , Neurite Óptica/fisiopatologia , Infecções Estreptocócicas/líquido cefalorraquidiano , Infecções Estreptocócicas/complicações , Infecções Estreptocócicas/fisiopatologia , Streptococcus pneumoniae , Infecção pelo Vírus da Varicela-Zoster/líquido cefalorraquidiano , Infecção pelo Vírus da Varicela-Zoster/complicações
6.
Microb Drug Resist ; 27(4): 536-545, 2021 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-32799629

RESUMO

Enterococci are ubiquitous, facultative, anaerobic Gram-positive bacteria that mainly reside, as part of the normal microbiota, in the gastrointestinal tracts of several animal species, including humans. These bacteria have the capability to turn from a normal gut commensal organism to an invasive pathogen in patients debilitated by prolonged hospitalization, concurrent illnesses, and/or exposed to broad-spectrum antibiotics. The majority of vancomycin-resistant enterococcus (VRE) infections are linked to the vanA genotype; however, outbreaks caused by vanB-type VREs have been increasingly reported, representing a new challenge for effective antimicrobial treatment. Teicoplanin, daptomycin, fosfomycin, and linezolid are useful antimicrobials for infections due to vanB enterococci. In addition, new drugs have been developed (e.g., dalbavancin, telavancin, and tedizolid), new molecules will soon be available (e.g., eravacycline, omadacycline, and oritavancin), and new treatment strategies are progressively being used in clinical practice (e.g., combination therapies and bacteriophages). The aim of this article is to discuss the pathogenesis of infections due to enterococci harboring the vanB operon (vanBVRE) and their therapeutic, state-of-the-art, and future treatment options and provide a comprehensive and easy to use review for clinical purposes.


Assuntos
Antibacterianos/uso terapêutico , Infecções por Bactérias Gram-Positivas/genética , Infecções por Bactérias Gram-Positivas/fisiopatologia , Enterococos Resistentes à Vancomicina/efeitos dos fármacos , Enterococos Resistentes à Vancomicina/genética , Antibacterianos/administração & dosagem , Antibacterianos/efeitos adversos , Genes Bacterianos , Humanos , Testes de Sensibilidade Microbiana
7.
J Surg Res ; 260: 82-87, 2021 04.
Artigo em Inglês | MEDLINE | ID: mdl-33326932

RESUMO

BACKGROUND: Bloodstream infections (BSIs) secondary to intraabdominal infections (IAIs) are common in the intensive care unit (ICU). The Surgical Infection Society guidelines recommend treatment duration after achieving source control in patients with secondary bacteremia; however, literature supporting this recommendation is limited. The purpose of this study was to compare outcomes in patients who received shorter versus extended duration of antibiotics for bacteremia secondary to IAI. MATERIALS AND METHODS: A retrospective cohort analysis was conducted in adult surgical ICU patients (n = 42) with BSIs and source control procedure(s) for IAI. The primary outcome was recurrent IAI. Secondary outcomes included surgical site infections (SSIs), Clostridium difficile infections (CDIs), secondary fungal infections, and in-hospital mortality. RESULTS: Forty-two patients met inclusion criteria and were divided into groups according to antimicrobial duration; 12 patients received <7 d, and 30 patients received >7 d of antibiotics. There were no differences in baseline characteristics between the two cohorts except for the presence of sepsis [4/12 (33.3%) versus 27/30 (90.0%); P = 0.001]. Thirty-one percent (13/42) of all organisms isolated from blood cultures were gram-negative bacteria, 12/42 (28.6%) were MDROs, and 2/42 (4.8%) patients experienced a culture mismatch in which cultured bacteria were not susceptible to empiric antibiotic therapy. Rates of recurrent IAI were similar between the two cohorts [1/12 (8.3%) versus 4/30 (13.3%), P = 0.554]. CONCLUSIONS: Among surgical ICU patients with BSI secondary to IAI, cessation of antibiotic therapy within 7 d of source control was not associated with an increased incidence of recurrent IAI.


Assuntos
Antibacterianos/administração & dosagem , Bacteriemia/tratamento farmacológico , Infecções por Bactérias Gram-Negativas/tratamento farmacológico , Infecções por Bactérias Gram-Positivas/tratamento farmacológico , Infecções Intra-Abdominais/tratamento farmacológico , Complicações Pós-Operatórias/tratamento farmacológico , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Antibacterianos/uso terapêutico , Bacteriemia/etiologia , Esquema de Medicação , Feminino , Infecções por Bactérias Gram-Negativas/etiologia , Infecções por Bactérias Gram-Negativas/fisiopatologia , Infecções por Bactérias Gram-Positivas/etiologia , Infecções por Bactérias Gram-Positivas/fisiopatologia , Humanos , Infecções Intra-Abdominais/etiologia , Infecções Intra-Abdominais/fisiopatologia , Masculino , Pessoa de Meia-Idade , Complicações Pós-Operatórias/etiologia , Complicações Pós-Operatórias/fisiopatologia , Recidiva , Estudos Retrospectivos , Resultado do Tratamento , Adulto Jovem
8.
Tex Heart Inst J ; 47(1): 35-37, 2020 02.
Artigo em Inglês | MEDLINE | ID: mdl-32148451

RESUMO

Abiotrophia defectiva, a nutritionally deficient streptococcus, is a rare cause of infective endocarditis. It has been associated with hemophagocytic syndrome. We present the first case of A. defectiva infective endocarditis that led to antineutrophil cytoplasmic antibody-associated glomerulonephritis. The patient was a 55-year-old man whose endocarditis affected the mitral and aortic valves. His course was complicated by atrial fibrillation, stroke, and glomerulonephritis. He was successfully treated with antibiotics and dual valve replacement.


Assuntos
Abiotrophia/isolamento & purificação , Anticorpos Anticitoplasma de Neutrófilos/imunologia , Valva Aórtica/microbiologia , Endocardite Bacteriana/microbiologia , Glomerulonefrite/microbiologia , Infecções por Bactérias Gram-Positivas/microbiologia , Valva Mitral/microbiologia , Abiotrophia/efeitos dos fármacos , Antibacterianos/uso terapêutico , Valva Aórtica/diagnóstico por imagem , Valva Aórtica/fisiopatologia , Valva Aórtica/cirurgia , Endocardite Bacteriana/diagnóstico por imagem , Endocardite Bacteriana/fisiopatologia , Endocardite Bacteriana/terapia , Glomerulonefrite/diagnóstico , Glomerulonefrite/tratamento farmacológico , Glomerulonefrite/imunologia , Infecções por Bactérias Gram-Positivas/diagnóstico , Infecções por Bactérias Gram-Positivas/fisiopatologia , Infecções por Bactérias Gram-Positivas/terapia , Implante de Prótese de Valva Cardíaca , Humanos , Masculino , Pessoa de Meia-Idade , Valva Mitral/diagnóstico por imagem , Valva Mitral/fisiopatologia , Valva Mitral/cirurgia , Resultado do Tratamento
9.
Zhejiang Da Xue Xue Bao Yi Xue Ban ; 49(6): 732-742, 2020 Dec 25.
Artigo em Chinês | MEDLINE | ID: mdl-33448176

RESUMO

OBJECTIVE: To investigate the functional pathways enriched and differentially expressed genes (DEGs) in peripheral blood mononuclear cells (PBMCs) of patients with gram-positive and gram-negative sepsis. METHODS: Dataset GSE9960 obtained from NCBI GEO database containing PBMC samples from 16 non-infectious systematic inflammatory response syndrome (SIRS) patients, 17 gram-positive septic patients and 18 gram-negative septic patients were included in the study. Functional pathway annotations were conducted by gene set enrichment analysis and weighted gene co-expression network analysis. DEGs were filtered and master DEGs were then validated in PBMCs of gram-positive septic, gram-negative septic and non-infectious SIRS patients. RESULTS: The enriched gene sets in gram-positive sepsis and gram-negative sepsis were significantly different. The results indicated the opposite co-expression networks in SIRS and gram-negative sepsis, and the entirely different co-expression networks in gram-positive and gram-negative sepsis. Furthermore, we validated that TYMS was up-regulated in gram-positive sepsis (P<0.05), CD3D was down-regulated in gram-negative sepsis (P<0.01), while IRAK3 was up-regulated in gram-negative sepsis (P<0.05). CONCLUSIONS: The results indicate that there are differences in the mechanism and pathogenesis of gram-positive and gram-negative sepsis, which may provide potential markers for sepsis diagnosis and empirical antimicrobial therapy.


Assuntos
Infecções por Bactérias Gram-Negativas , Infecções por Bactérias Gram-Positivas , Leucócitos Mononucleares , Sepse , Biomarcadores/análise , Perfilação da Expressão Gênica , Infecções por Bactérias Gram-Negativas/fisiopatologia , Infecções por Bactérias Gram-Positivas/fisiopatologia , Humanos , Leucócitos Mononucleares/microbiologia , Leucócitos Mononucleares/patologia , Sepse/fisiopatologia
11.
Artigo em Chinês | WPRIM (Pacífico Ocidental) | ID: wpr-879935

RESUMO

OBJECTIVE@#To investigate the functional pathways enriched and differentially expressed genes (DEGs) in peripheral blood mononuclear cells (PBMCs) of patients with gram-positive and gram-negative sepsis.@*METHODS@#Dataset GSE9960 obtained from NCBI GEO database containing PBMC samples from 16 non-infectious systematic inflammatory response syndrome (SIRS) patients, 17 gram-positive septic patients and 18 gram-negative septic patients were included in the study. Functional pathway annotations were conducted by gene set enrichment analysis and weighted gene co-expression network analysis. DEGs were filtered and master DEGs were then validated in PBMCs of gram-positive septic, gram-negative septic and non-infectious SIRS patients.@*RESULTS@#The enriched gene sets in gram-positive sepsis and gram-negative sepsis were significantly different. The results indicated the opposite co-expression networks in SIRS and gram-negative sepsis, and the entirely different co-expression networks in gram-positive and gram-negative sepsis. Furthermore, we validated that @*CONCLUSIONS@#The results indicate that there are differences in the mechanism and pathogenesis of gram-positive and gram-negative sepsis, which may provide potential markers for sepsis diagnosis and empirical antimicrobial therapy.


Assuntos
Humanos , Biomarcadores/análise , Perfilação da Expressão Gênica , Infecções por Bactérias Gram-Negativas/fisiopatologia , Infecções por Bactérias Gram-Positivas/fisiopatologia , Leucócitos Mononucleares/patologia , Sepse/fisiopatologia
12.
Acta Clin Belg ; 74(6): 435-438, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31658898

RESUMO

Case report: We present a case of a 66-year-old female diagnosed with R. gnavus bacteremia associated with fecal peritonits secondary to small-bowel herniation and perforation. Identification  as R. gnavus was delayed because of absence of this species in the MALDI-TOF MS database (Vitek MS, bioMérieux). Identification was provided by 16S rRNA gene sequencing. Review: R. gnavus, a Gram-positive, strictly anaerobic bacterium, is a member of the human gut microbiota. Dysbiosis in the gut microbiota, with increased amounts of R. gnavus, has been described in inflammatory bowel disease. R. gnavus has only been reported occasionally as the cause of infections. Hence the potential pathogenicity is not yet fully recognized, and data regarding the antimicrobial susceptibility profile are rare. Identification of anaerobic bacteria such as R. gnavus is greatly accelerated  as a result of the introduction of MALDI-TOF MS. However, as illustrated in this case report, an extensive and up-to-date MALDI-TOF MS database is necessary for providing an accurate identification.


Assuntos
Antibacterianos/administração & dosagem , Bacteriemia , Infecções por Bactérias Gram-Positivas , Perfuração Intestinal , Intestino Delgado/microbiologia , Técnicas Microbiológicas , Peritonite , Ruminococcus , Idoso , Antibacterianos/classificação , Bacteriemia/etiologia , Bacteriemia/microbiologia , Bacteriemia/terapia , Diagnóstico Tardio , Feminino , Microbioma Gastrointestinal , Infecções por Bactérias Gram-Positivas/diagnóstico , Infecções por Bactérias Gram-Positivas/etiologia , Infecções por Bactérias Gram-Positivas/fisiopatologia , Infecções por Bactérias Gram-Positivas/terapia , Hérnia Abdominal/complicações , Hérnia Abdominal/diagnóstico por imagem , Humanos , Perfuração Intestinal/diagnóstico , Perfuração Intestinal/etiologia , Perfuração Intestinal/cirurgia , Laparoscopia/métodos , Técnicas Microbiológicas/métodos , Técnicas Microbiológicas/normas , Peritonite/diagnóstico , Peritonite/etiologia , Peritonite/fisiopatologia , Peritonite/terapia , Ruminococcus/isolamento & purificação , Ruminococcus/patogenicidade , Resultado do Tratamento
13.
Food Funct ; 10(10): 6267-6275, 2019 Oct 16.
Artigo em Inglês | MEDLINE | ID: mdl-31584060

RESUMO

A polyphenolic-rich fraction (CG50) was obtained from the methanol extract of Coccinia grandis leaves by chromatographic fractionation over a Diaion column using 50% aqueous methanol. LC-ESI-MS/MS analysis of CG50 showed the presence of six flavonoids, namely quercetin-hexoside deoxyhexoside (rutin), quercetin-hexoside deoxyhexoside (quercetin-3-O-neohesperidoside), kaempferol-hexoside deoxyhexoside (kaempferol-3-O-rutinoside), kaempferol-hexoside deoxyhexoside (kaempferol-3-O-neohesperidoside), kaempferol-3-O-glucoside, and kaempferol-hexoside in addition to the presence of two secoiridoids which are oleuropein and ligstroside. CG50 hydrogel showed a pronounced inhibition of the bacterial growth in wounds infected by Bacillus cereus in rats comparable to those treated with hydrogel base only showing 85.08 and 16.50% inhibition for the bacterial growth for the CG50 hydrogel and hydrogel base, respectively. The antimicrobial activity of CG50 hydrogel was close to that of fucidin during all days of treatment. Rats treated with CG50 hydrogel showed remarkable healing ability of the wound compared to other groups and approaching that of fucidin. This was clearly manifested by the clear formation of scars with obvious reduction in the wound size together with the appearance and re-growth of hair. This was further confirmed by the histopathological study of skin tissues as well as by the evaluation of the percentages of collagen fiber deposition. CG50 hydrogel showed 18.71% collagen fiber deposition comparable to the untreated group that showed 6.84% collagen fiber deposition and approaches that of the fucidin group. It was concluded that Coccinia grandis could be used as a natural wound healing agent that further consolidated its traditional use as a wound dressing.


Assuntos
Antibacterianos/administração & dosagem , Cucurbitaceae/química , Infecções por Bactérias Gram-Positivas/tratamento farmacológico , Extratos Vegetais/administração & dosagem , Polifenóis/administração & dosagem , Ferimentos e Lesões/tratamento farmacológico , Animais , Antibacterianos/química , Antibacterianos/metabolismo , Bacillus cereus/efeitos dos fármacos , Bacillus cereus/fisiologia , Cromatografia Líquida de Alta Pressão , Infecções por Bactérias Gram-Positivas/microbiologia , Infecções por Bactérias Gram-Positivas/fisiopatologia , Humanos , Masculino , Extratos Vegetais/química , Folhas de Planta/química , Polifenóis/química , Polifenóis/metabolismo , Ratos , Espectrometria de Massas em Tandem , Cicatrização/efeitos dos fármacos , Ferimentos e Lesões/fisiopatologia
14.
Dermatology ; 235(4): 287-294, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31112983

RESUMO

BACKGROUND: Cutibacterium acnes has been identified as one of the main triggers of acne. However, increasing knowledge of the human skin microbiome raises questions about the role of other skin commensals, such as Staphylococcus epidermidis, in the physiopathology of this skin disease. SUMMARY: This review provides an overview of current knowledge of the potential role of S. epidermidis in the physiopathology of acne. Recent research indicates that acne might be the result of an unbalanced equilibrium between C. acnes and S. epidermidis,according to dedicated interactions. Current treatments act on C. acnesonly. Other treatment options may be considered, such as probiotics derived from S. epidermidis to restore the naturally balanced microbiota or through targeting the regulation of the host's AMP mediators. Key Messages: Research seems to confirm the beneficial role of S. epidermidis in acne by limiting C. acnes over-colonisation and inflammation.


Assuntos
Acne Vulgar/microbiologia , Infecções por Bactérias Gram-Positivas/fisiopatologia , Fenômenos Microbiológicos , Propionibacteriaceae/patogenicidade , Pele/microbiologia , Staphylococcus epidermidis/fisiologia , Acne Vulgar/etiologia , Acne Vulgar/fisiopatologia , Acne Vulgar/terapia , Infecções por Bactérias Gram-Positivas/complicações , Infecções por Bactérias Gram-Positivas/microbiologia , Interações entre Hospedeiro e Microrganismos/fisiologia , Humanos , Interações Microbianas/fisiologia , Microbiota/fisiologia , Propionibacteriaceae/isolamento & purificação , Infecções Estafilocócicas/complicações , Infecções Estafilocócicas/microbiologia , Infecções Estafilocócicas/fisiopatologia , Staphylococcus epidermidis/isolamento & purificação
15.
PLoS One ; 13(10): e0205534, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-30308037

RESUMO

Successful disinfection alongside complete endodontic tissue regeneration and revascularization are the most desired clinical outcomes of regenerative endodontics. Despite reported clinical successes, significant limitations to the current regenerative endodontic procedure (REP) have been elucidated. To improve the current REP, an antibiotics and nitric oxide (NO) releasing biomimetic nanomatrix gel was developed. The study evaluates antibacterial effects of an antibiotics and NO releasing biomimetic nanomatrix gel on multispecies endodontic bacteria. Antibiotics, ciprofloxacin (CF) and metronidazole (MN) were mixed and encapsulated within the NO releasing biomimetic nanomatrix gel. The gel was synthesized and self-assembled from peptide amphiphiles containing various functional groups. Antibacterial effects of the antibiotics and NO releasing biomimetic nanomatrix gel were evaluated using bacterial viability assays involving endodontic microorganisms including clinical samples. Pulp-dentin regeneration was evaluated via animal-model experiments. The antibiotics and NO releasing biomimetic nanomatrix gel demonstrated a concentration dependent antibacterial effect. In addition, NO alone demonstrated a concentration dependent antibacterial effect on endodontic microorganism. An in vivo analysis demonstrated the antibiotics and NO releasing biomimetic nanomatrix gel promoted tooth revascularization with maturation of root canals. An optimal concentration of and NO releasing nanomatrix gel is suggested for its potential as a root treatment material for REP and an appropriate protocol for human trials. Further investigation is required to obtain a larger sample size and decide upon ideal growth factor incorporation.


Assuntos
Antibacterianos/administração & dosagem , Polpa Dentária/efeitos dos fármacos , Dentina/efeitos dos fármacos , Géis , Óxido Nítrico/administração & dosagem , Regeneração/efeitos dos fármacos , Animais , Biofilmes/efeitos dos fármacos , Materiais Biomiméticos/síntese química , Polpa Dentária/diagnóstico por imagem , Polpa Dentária/patologia , Polpa Dentária/fisiopatologia , Dentina/diagnóstico por imagem , Dentina/patologia , Dentina/fisiopatologia , Cães , Sistemas de Liberação de Medicamentos , Enterococcus faecalis/efeitos dos fármacos , Enterococcus faecalis/fisiologia , Géis/síntese química , Infecções por Bactérias Gram-Positivas/diagnóstico por imagem , Infecções por Bactérias Gram-Positivas/tratamento farmacológico , Infecções por Bactérias Gram-Positivas/patologia , Infecções por Bactérias Gram-Positivas/fisiopatologia , Humanos , Nanoestruturas , Neovascularização Fisiológica/efeitos dos fármacos , Neovascularização Fisiológica/fisiologia , Projetos Piloto , Pulpite/diagnóstico por imagem , Pulpite/tratamento farmacológico , Pulpite/patologia , Pulpite/fisiopatologia , Regeneração/fisiologia , Treponema denticola/efeitos dos fármacos , Treponema denticola/fisiologia
16.
Pediatr Crit Care Med ; 19(9): e486-e494, 2018 09.
Artigo em Inglês | MEDLINE | ID: mdl-30024571

RESUMO

OBJECTIVES: Myocardial dysfunction is well recognized in severe sepsis and septic shock. Echocardiography provides rapid, noninvasive, and bedside evaluation of cardiac function in patients with hemodynamic instability. Mitral annular plane systolic excursion is an M-mode-derived echocardiographic variable used to assess longitudinal left ventricular systolic function. No data are available about the uses of mitral annular plane systolic excursion in children with septic shock. Therefore, we aimed to assess the prognostic significance of mitral annular plane systolic excursion in children with septic shock and to correlate it with the most commonly used measures of left ventricular systolic function and myocardial injury. DESIGN: A prospective cohort study. SETTING: The study carried out at the PICU of Menoufia University Hospital in the period from March 2015 to September 2016. PATIENTS: We serially enrolled 50 children with septic shock. INTERVENTIONS: Complete diagnostic workup was performed for each patient including calculation of Pediatric Risk of Mortality III score. Transthoracic echocardiography was done to obtain mitral annular plane systolic excursion and the left ventricular ejection fraction measurement within 24 hours of inclusion then repeated on third and fifth days. Patients were followed up until hospital discharge or death. The predictive power of mitral annular plane systolic excursion was determined using the receiver operating characteristic curve. MEASUREMENTS AND MAIN RESULTS: Mitral annular plane systolic excursion was significantly lower in nonsurvivors compared with survivors (p < 0.001). Receiver operating characteristic curve analysis showed an area under the curve of 0.892 for mitral annular plane systolic excursion on day 1. The cut-off point was 7.9 mm with 82.76% sensitivity and 80.95% specificity. Furthermore, follow-up of the patient's systolic function showed that mitral annular plane systolic excursion was significantly lower in nonsurvivors compared with survivors on days of follow-up, whereas left ventricular ejection fraction was not significantly different between survivors and nonsurvivors at any day. Mitral annular plane systolic excursion was positively correlated with left ventricular ejection fraction (p = 0.044) and duration of hospital stay (p < 0.001) and negatively correlated with Pediatric Risk of Mortality III score (p < 0.001) and cardiac troponin I level (p < 0.001). CONCLUSIONS: Measurement of mitral annular plane systolic excursion at admission added a prognostic value in septic shock children. Compared with the left ventricular ejection fraction, longitudinal systolic function might be more sensitive in the detection of myocardial dysfunction in critically ill children and should receive more attention.


Assuntos
Ecocardiografia , Infecções por Bactérias Gram-Negativas/mortalidade , Infecções por Bactérias Gram-Positivas/mortalidade , Mortalidade Hospitalar , Valva Mitral/fisiopatologia , Choque Séptico/mortalidade , Disfunção Ventricular Esquerda/diagnóstico por imagem , Criança , Pré-Escolar , Feminino , Seguimentos , Infecções por Bactérias Gram-Negativas/fisiopatologia , Infecções por Bactérias Gram-Positivas/fisiopatologia , Humanos , Lactente , Modelos Lineares , Masculino , Valva Mitral/diagnóstico por imagem , Valor Preditivo dos Testes , Prognóstico , Estudos Prospectivos , Curva ROC , Fatores de Risco , Choque Séptico/fisiopatologia , Sístole , Disfunção Ventricular Esquerda/etiologia , Disfunção Ventricular Esquerda/fisiopatologia
17.
Reprod Biol ; 18(1): 115-121, 2018 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-29449095

RESUMO

The Aim of this study was to evaluate the effects of bacteriospermia on human sperm parameters, nuclear protamines, DNA integrity and ICSI outcome in patients enrolled for ICSI treatment. 84 unselected couples consulting in infertility and obstetrics clinic and enrolled for ICSI treatment were included in this study. The semen specimens were screened bacteriologically; semen and sperm parameters were also evaluated according to WHO guidelines. DNA integrity, protamines concentration and protamine deficiency were estimated by TUNEL assay, AU-PAGE and Chromomycin (CMA3) respectively. The results of this study revealed that 34.52% of studied semen samples were infected with bacteria. The isolated bacteria were identified as Staphylococcus aureus, Staph. epidermidis, Staph. haemolyticus, Escherichia coli, Enterococcus faecalis and Streptococcus agalactiae. Bacteriospermia had a significant (p < .010) negative effect on sperm parameters; concentration, motility, progressive motility and chromatin condensation. Moreover, high DNA fragmentation with low P1 and P2 concentrations were noticed in infected patients in comparison to non-infected patients but non-significant. Also, the fertilization rate decreased significantly (p < .05) with infected patients. IN CONCLUSION: bacteriospermia has significant negative effect on sperm quality and fertilization rate in patients who underwent ICSI treatment.


Assuntos
Núcleo Celular/metabolismo , Fragmentação do DNA , Infertilidade Masculina/etiologia , Protaminas/metabolismo , Infecções do Sistema Genital/fisiopatologia , Injeções de Esperma Intracitoplásmicas , Espermatozoides/metabolismo , Adulto , Núcleo Celular/microbiologia , Núcleo Celular/patologia , Infecções por Escherichia coli/epidemiologia , Infecções por Escherichia coli/microbiologia , Infecções por Escherichia coli/patologia , Infecções por Escherichia coli/fisiopatologia , Características da Família , Feminino , Alemanha/epidemiologia , Infecções por Bactérias Gram-Positivas/epidemiologia , Infecções por Bactérias Gram-Positivas/microbiologia , Infecções por Bactérias Gram-Positivas/patologia , Infecções por Bactérias Gram-Positivas/fisiopatologia , Hospitais Universitários , Humanos , Infertilidade Feminina/terapia , Masculino , Pessoa de Meia-Idade , Gravidez , Taxa de Gravidez , Infecções do Sistema Genital/epidemiologia , Infecções do Sistema Genital/microbiologia , Infecções do Sistema Genital/patologia , Sêmen/microbiologia , Análise do Sêmen , Espermatozoides/microbiologia , Espermatozoides/patologia
18.
Medicine (Baltimore) ; 97(7): e9875, 2018 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-29443752

RESUMO

RATIONALE: Enterococcus gallinarum meningitis (EGM) is rarely found in normal adults and even rarer in children. To our knowledge, EGM in neonate has not been reported previously. PATIENTS CONCERNS: Here we reported the first case of EGM in neonate. Prolonged fever was the only manifestation for the case after admission. DIAGNOSES: Cerebrospinal fluid cultures showed that the isolate was Enterococcus gallinarum and sensitive to linezolid. INTERVENTIONS: Ceftriaxone, beta lactam type, and vancomycin were used respectively, but not effective. OUTCOMES: The temperature went down to normal after linezolid was used and the baby was discharged in good condition in the end. LESSONS: This case indicated that EGM could also occur in neonate and fever could be the only obvious manifestation. Thus, the effective antibiotics and adequate duration are very important and linezolid is a potential good choice, especially for vancomycin-resistant patients.


Assuntos
Infecções por Bactérias Gram-Positivas , Linezolida/administração & dosagem , Meningites Bacterianas , Enterococos Resistentes à Vancomicina , Antibacterianos/administração & dosagem , Infecções por Bactérias Gram-Positivas/tratamento farmacológico , Infecções por Bactérias Gram-Positivas/microbiologia , Infecções por Bactérias Gram-Positivas/fisiopatologia , Humanos , Recém-Nascido , Masculino , Meningites Bacterianas/tratamento farmacológico , Meningites Bacterianas/microbiologia , Meningites Bacterianas/fisiopatologia , Testes de Sensibilidade Microbiana/métodos , Resultado do Tratamento , Enterococos Resistentes à Vancomicina/efeitos dos fármacos , Enterococos Resistentes à Vancomicina/isolamento & purificação
19.
Medicine (Baltimore) ; 96(49): e9000, 2017 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-29245276

RESUMO

Bloodstream infections (BSIs) due to vancomycin-resistant Enterococcus faecium (VREfae) remain a therapeutic challenge. This study aimed to evaluate mortality from BSIs due to VREfae in Central Taiwan.We retrospectively analyzed patients with significant VREfae BSIs in the Changhua Christian Hospital System between January 1, 2010 and December 31, 2014.Of the 152 patients with Enterococcal BSI, 56 patients (36.8%) were admitted to intensive care units (ICUs) at the onset of BSI and 20 (13.2%) patients were associated with polymicrobial bacteremia. VREfae BSI was observed in 36 (23.7%) patients. Van A (100%) is the prevalence genotype, and ST 17 (41.7%) is the predominant ST type among 36 VREfae isolates during the study period. The 30-day mortality rate was 13.2% (20/152). The multivariate logistic regression analysis showed that the onset of VREfae BSI in the ICU (odds ratio [OR] = 4.2, 95% confidence interval [CI] = 1.7-10.0, P = .002) was a significant risk factor for 30-day mortality, whereas an appropriate antimicrobial therapy was a protective factor for 30-day mortality (OR = 0.33, 95% CI = 0.14-0.79, P = .013).Our results underscore the need to assist patients who are admitted to ICUs with VREfae BSIs. We emphasize the use of an appropriate antimicrobial therapy for VREfae BSI with the aim to treat more patients with these infections.


Assuntos
Bacteriemia/microbiologia , Enterococcus faecium , Infecções por Bactérias Gram-Positivas/fisiopatologia , Resistência a Vancomicina , Adulto , Idoso , Idoso de 80 Anos ou mais , Antibacterianos/uso terapêutico , Bacteriemia/tratamento farmacológico , Bacteriemia/epidemiologia , Técnicas Bacteriológicas , Feminino , Genótipo , Infecções por Bactérias Gram-Positivas/tratamento farmacológico , Infecções por Bactérias Gram-Positivas/epidemiologia , Humanos , Masculino , Pessoa de Meia-Idade , Fatores de Risco , Taiwan/epidemiologia , Adulto Jovem
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