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1.
Cell Host Microbe ; 29(11): 1649-1662.e7, 2021 11 10.
Artigo em Inglês | MEDLINE | ID: mdl-34637779

RESUMO

Saccharibacteria (TM7) are obligate epibionts living on the surface of their host bacteria and are strongly correlated with dysbiotic microbiomes during periodontitis and other inflammatory diseases, suggesting they are putative pathogens. However, due to the recalcitrance of TM7 cultivation, causal research to investigate their role in inflammatory diseases is lacking. Here, we isolated multiple TM7 species on their host bacteria from periodontitis patients. These TM7 species reduce inflammation and consequential bone loss by modulating host bacterial pathogenicity in a mouse ligature-induced periodontitis model. Two host bacterial functions involved in collagen binding and utilization of eukaryotic sialic acid are required for inducing bone loss and are altered by TM7 association. This TM7-mediated downregulation of host bacterial pathogenicity is shown for multiple TM7/host bacteria pairs, suggesting that, in contrast to their suspected pathogenic role, TM7 could protect mammalian hosts from inflammatory damage induced by their host bacteria.


Assuntos
Actinobacteria/patogenicidade , Perda do Osso Alveolar/microbiologia , Fenômenos Fisiológicos Bacterianos , Gengivite/microbiologia , Periodontite/microbiologia , Simbiose , Actinobacteria/genética , Actinobacteria/isolamento & purificação , Actinobacteria/fisiologia , Actinomyces/genética , Actinomyces/isolamento & purificação , Actinomyces/patogenicidade , Actinomyces/fisiologia , Perda do Osso Alveolar/prevenção & controle , Animais , Bactérias/classificação , Bactérias/isolamento & purificação , Bactérias/patogenicidade , Infecções Bacterianas/microbiologia , Infecções Bacterianas/prevenção & controle , Colágeno/metabolismo , Placa Dentária/microbiologia , Regulação para Baixo , Genes Bacterianos , Gengivite/prevenção & controle , Humanos , Masculino , Camundongos , Camundongos Endogâmicos BALB C , Camundongos Endogâmicos C57BL , Microbiota , Ácido N-Acetilneuramínico/metabolismo , Periodontite/prevenção & controle , Propionibacteriaceae/genética , Propionibacteriaceae/isolamento & purificação , Propionibacteriaceae/patogenicidade , Propionibacteriaceae/fisiologia , Virulência
3.
Artigo em Inglês | MEDLINE | ID: mdl-34252022

RESUMO

Six novel strains (ZJ34T, ZJ561, ZJ750T, ZJ1629, zg-993T and zg-987) isolated from faeces and respiratory tracts of Marmota himalayana from the Qinghai-Tibet Plateau of PR China were characterized comprehensively. The results of analyses of the 16S rRNA gene and genome sequences indicated that the six strains represent three novel species of the genus Actinomyces, and are closely related to Actinomyces urogenitalis DSM 15434T (16S rRNA gene sequences similarities, 94.9-98.7 %), Actinomyces weissii CCUG 61299T (95.6-96.6 %), Actinomyces bovis CCTCC AB2010168T (95.7 %) and Actinomyces bowdenii DSM 15435T (95.2-96.4 %), with values of digital DNA-DNA hybridization less than 30.1 % when compared with their closest relatives but higher than 70 % within each pair of novel strains (ZJ34T/ZJ561, ZJ750T/ZJ1629 and zg-993T/zg-987). All the novel strains had C18 : 1 ω9c and C16 : 0 as the two most abundant major fatty acids. MK-9(H4) or MK-8(H4) was the sole or predominant respiratory quinone of strains ZJ34T, ZJ750T and zg-993T and their polar lipid profiles differed, but all had diphosphatidylglycerol, phosphatidylglycerol, phosphatidylinositol, and phosphatidyl inositol mannoside as major components. ZJ750T shared identical peptidoglycan amino acid profile with ZJ34T (alanine, glutamic acid, lysine and ornithine) and the same whole-cell sugar composition with zg-993T (glucose, rhamnose and ribose). Strain zg-993T contained alanine, aspartic acid, glutamic acid, glycine and lysine in the peptidoglycan, and the only sugar in ZJ34T was ribose. The DNA G+C contents of the novel strains were within the range of 65.8-70.1 mol%. On the basis of the results from the aforementioned analyses, the six novel strains were classified as representing three novel species of genus Actinomyces, for which the names Actinomyces faecalis sp. nov. [type strain ZJ34T (=GDMCC 1.1952T=JCM 34355T)], Actinomyces respiraculi sp. nov. [type strain ZJ750T (=GDMCC 1.1950T=JCM 34356T)] and Actinomyces trachealis sp. nov. [type strain zg-993T (=GDMCC 1.1956T=JCM 34357T)] were proposed, respectively.


Assuntos
Actinomyces/classificação , Marmota/microbiologia , Filogenia , Actinomyces/isolamento & purificação , Animais , Técnicas de Tipagem Bacteriana , Composição de Bases , DNA Bacteriano/genética , Ácidos Graxos/química , Hibridização de Ácido Nucleico , Fosfolipídeos/química , RNA Ribossômico 16S/genética , Análise de Sequência de DNA , Tibet
4.
Sci Rep ; 11(1): 10745, 2021 05 24.
Artigo em Inglês | MEDLINE | ID: mdl-34031507

RESUMO

Recent advancements in DNA-based approaches have led to the identification of uncommon and rare bacterial pathogens. In this study, by utilizing a DNA-based approach, a total of 1043 clinical specimens were processed for the identification of actinobacteria targeting the 16S rRNA and gyrB genes. Drug susceptibility testing was also conducted using micro-broth dilution and PCR. Two isolates of Nocardia flavorosea and Rhodococcus erythropolis were reported for the first time in Iran. Also, Nocardiopsis dassonvillei, Streptomyces olivaceus, and Streptomyces griseus were reported for the first time in Asia. Infections caused by Nocardia caishijiensis and Prauserella muralis have also been reported in this study. The first Asian case of pulmonary infection caused by Nocardia ignorata and the first global case of brain abscess caused by Nocardia ninae and Nocardia neocaledoniensis have been reported in this study. Overall 30 isolates belonging to 6 genera (Nocardia, Streptomyces, Rodoccoccus, Nocardiopsis, Rothia, and Prauserella) were detected in 30 patients. All 30 isolates were susceptible to amikacin and linezolid. Three isolates including Nocardia otitidiscaviarum (n = 2) and Nocardia flavorosea (n = 1) were resistant to trimethoprim-sulfamethoxazole which were the first trimethoprim-sulfamethoxazole resistant clinical actinomycetes in Iran. Isolation of rare species of actinomycetes particularly Nocardia spp. requires urgent action before they spread clinically particularly among immunocompromised patients.


Assuntos
Actinomyces/classificação , Infecções Bacterianas/diagnóstico , Farmacorresistência Bacteriana , Hospedeiro Imunocomprometido , Análise de Sequência de DNA/métodos , Combinação Trimetoprima e Sulfametoxazol/farmacologia , Actinomyces/efeitos dos fármacos , Actinomyces/genética , Actinomyces/isolamento & purificação , Adulto , Idoso , Estudos de Casos e Controles , Estudos Transversais , DNA Girase , DNA Bacteriano/genética , DNA Ribossômico/genética , Feminino , Humanos , Irã (Geográfico) , Masculino , Testes de Sensibilidade Microbiana , Pessoa de Meia-Idade , RNA Ribossômico 16S/genética
5.
Pan Afr Med J ; 38: 106, 2021.
Artigo em Francês | MEDLINE | ID: mdl-33912276

RESUMO

Cemento-osseous dysplasia is a benign fibro-osseous lesion affecting the alveolar bone. It is classified into three forms: periapical, focal or florid dysplasia. It is often asymptomatic and fortuitously discovered during a routine radiological examination. However, it may become symptomatic after superinfection, after patient's exposure to oral bacterial flora. We here report a case of florid cemento-osseous dysplasia associated with actinomycosis of bone in a 53-year-old Tunisian woman. This superinfection has been rarely reported in the literature; Boolean Searching on PubMed for the keywords "cemento-osseous dysplasia AND actinomyces" displays a single article (Smith et al. 2011). The treatment of actinomycosis infection often requires long-term antibiotic therapy, sometimes associated with surgical debridement, as in the case of this patient who underwent piezosurgery to treat dysplasia and necrotic bone.


Assuntos
Actinomicose/diagnóstico , Displasia Fibrosa Óssea/diagnóstico , Osteomielite/diagnóstico , Piezocirurgia/métodos , Actinomyces/isolamento & purificação , Actinomicose/microbiologia , Actinomicose/cirurgia , Feminino , Displasia Fibrosa Óssea/microbiologia , Displasia Fibrosa Óssea/cirurgia , Humanos , Pessoa de Meia-Idade , Osteomielite/microbiologia , Osteomielite/cirurgia , Radiografia , Superinfecção/diagnóstico , Superinfecção/microbiologia
6.
Tumori ; 107(6): NP77-NP80, 2021 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-33877025

RESUMO

BACKGROUND: Pulmonary actinomycosis is a rare and slowly progressive bacterial infection that is often mistaken for lung cancer. Multiple case reports caution against premature diagnosis of malignancy without proper consideration of potential Actinomyces infection. However, no cases in the English literature have been reported that demonstrate the possible coexistence of Actinomyces and lung cancer. CASE DESCRIPTION: We present two cases of patients with culture-positive Actinomyces who were later found to have concomitant biopsy-proven lung adenocarcinoma. CONCLUSIONS: In the workup of a newly identified lung mass, positive culture for Actinomyces does not rule out an underlying malignancy.


Assuntos
Actinomyces/isolamento & purificação , Actinomicose/diagnóstico , Adenocarcinoma de Pulmão/diagnóstico , Neoplasias Pulmonares/diagnóstico , Actinomicose/complicações , Actinomicose/microbiologia , Adenocarcinoma de Pulmão/complicações , Adenocarcinoma de Pulmão/microbiologia , Adulto , Diagnóstico Diferencial , Feminino , Humanos , Neoplasias Pulmonares/complicações , Neoplasias Pulmonares/microbiologia , Pessoa de Meia-Idade
9.
Microbiologyopen ; 10(1): e1137, 2021 01.
Artigo em Inglês | MEDLINE | ID: mdl-33544453

RESUMO

To survive within complex environmental niches, including the human host, bacteria have evolved intricate interspecies communities driven by competition for limited nutrients, cooperation via complementary metabolic proficiencies, and establishment of homeostatic relationships with the host immune system. The study of such complex, interdependent relationships is often hampered by the challenges of culturing many bacterial strains in research settings and the limited set of tools available for studying the dynamic behavior of multiple bacterial species at the microscale. Here, we utilize a microfluidic-based co-culture system and time-lapse imaging to characterize dynamic interactions between Streptococcus species, Staphylococcus aureus, and Actinomyces species. Co-culture of Streptococcus cristatus or S. salivarius in nanoliter compartments with Actinomyces graevenitzii revealed localized exclusion of Streptococcus and Staphylococcus from media immediately surrounding A. graevenitzii microcolonies. This community structure did not occur with S. mitis or S. oralis strains or in co-cultures containing other Actinomycetaceae species such as S. odontolyticus or A. naeslundii. Moreover, fewer neutrophils were attracted to compartments containing both A. graevenitzii and Staphylococcus aureus than to an equal number of either species alone, suggesting a possible survival benefit together during immune responses.


Assuntos
Actinomyces/crescimento & desenvolvimento , Antibiose/fisiologia , Biofilmes/crescimento & desenvolvimento , Staphylococcus aureus/crescimento & desenvolvimento , Streptococcus/crescimento & desenvolvimento , Actinomyces/imunologia , Actinomyces/isolamento & purificação , Técnicas de Cocultura , Interações entre Hospedeiro e Microrganismos/imunologia , Humanos , Imunidade Inata/imunologia , Microbiota/imunologia , Microfluídica/métodos , Boca/microbiologia , Neutrófilos/imunologia , Staphylococcus aureus/imunologia , Staphylococcus aureus/isolamento & purificação , Streptococcus/imunologia , Streptococcus/isolamento & purificação
10.
Artigo em Inglês | MEDLINE | ID: mdl-33427607

RESUMO

Isolate 4NS15T was isolated from a neglected arid habitat in Kerman, Iran. The strain showed 16S rRNA gene sequence similarity values of 98.9 % to the type strains of Kibdelosporangium aridum subsp. aridum, Kibdelosporangium phytohabitans and Kibdelosporangium philippinense and 98.6 % to the type strain K. aridum subsp. largum, respectively. Genome-based phylogenetic analysis revealed that isolate 4NS15T is closely related to Kibdelosporangium aridum subsp. aridum DSM 43828T. The digital DNA-DNA hybridization value between the genome sequences of 4NS15T and strain DSM 43828T is 29.8 %. Strain 4NS15T produces long chains of spores without a sporangium-like structure which can be distinguished from other Kibdelosporangium species. Isolate 4NS15T has a genome size of 10.35 Mbp with a G+C content of 68.1 mol%. Whole-cell hydrolysates of isolate 4NS15T are rich in meso-diaminopimelic acid and cell-wall sugars such as arabinose, galactose, glucose and ribose. Major fatty acids (>10 %) are C16 : 0, iso-C16 : 0 and iso-C15 : 0. The phospholipid profile contains diphosphatidylglycerol, phosphatidylethanolamine, phosphatidylhydroxyethanolamine, aminolipid and glycoaminolipid. The predominant menaquinone is MK-9(H4). Based on its phenotypic and genotypic characteristics, isolate 4NS15T (NCCB 100701=CIP 111705=DSM 110728) merits recognition as representing a novel species of the genus Kibdelosporangium, for which the name Kibdelosporangium persicum sp. nov. is proposed.


Assuntos
Actinomyces/classificação , Clima Desértico , Filogenia , Microbiologia do Solo , Actinomyces/isolamento & purificação , Técnicas de Tipagem Bacteriana , Composição de Bases , DNA Bacteriano/genética , Ácidos Graxos/química , Irã (Geográfico) , Hibridização de Ácido Nucleico , Fosfolipídeos/química , RNA Ribossômico 16S/genética , Análise de Sequência de DNA , Vitamina K 2/análogos & derivados , Vitamina K 2/química
11.
Ocul Immunol Inflamm ; 29(7-8): 1403-1409, 2021 Nov 17.
Artigo em Inglês | MEDLINE | ID: mdl-32275172

RESUMO

Purpose: To explore the performance of ultrasound biomicroscopy (UBM) and color Doppler flow imaging (CDFI) in the diagnosis of primary lacrimal canaliculitis.Methods: Subjects with relevant symptoms of canaliculitis were prospectively recruited. UBM and CDFI were performed for presumptive diagnosis. Microbiology and histopathology were performed for definitive diagnosis.Results: A total of 37 cases were recruited, including 25 cases of canaliculitis and 12 cases of non-canaliculitis. Pathogens were isolated in 13 canaliculitis cases, and the leading pathogens were Actinomyces (4 cases) and Streptococcus (4 cases). UBM and CDFI identified 24 canaliculitis cases (sensitivity = 96%) and 11 non-canaliculitis cases (specificity = 92%). The predictive factors for canaliculitis were lumen wall thickness >0.25 mm (P = .019) and intracanalicular concretions (P = .010). Other typical features were enlarged lumen (2.16 ± 0.25 mm) and hot-wheel sign-on CDFI (84%). These image findings were congruent with histopathologic changes.Conclusion: Ultrasonography is a valuable tool to assist the diagnosis of canaliculitis.(Clinical trial registration number: ChiCTR1900025411).


Assuntos
Actinomicose/diagnóstico por imagem , Canaliculite/diagnóstico por imagem , Infecções Oculares Bacterianas/diagnóstico por imagem , Microscopia Acústica , Infecções Estreptocócicas/diagnóstico por imagem , Ultrassonografia Doppler em Cores , Actinomyces/isolamento & purificação , Actinomicose/microbiologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Canaliculite/microbiologia , Criança , Infecções Oculares Bacterianas/microbiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Infecções Estreptocócicas/microbiologia , Streptococcus/isolamento & purificação
12.
Am J Forensic Med Pathol ; 42(2): 191-193, 2021 Jun 01.
Artigo em Inglês | MEDLINE | ID: mdl-33346982

RESUMO

ABSTRACT: A 19-year-old woman in septic shock with recent computed tomography findings of a loculated hepatic abscess was transferred to an intensive care unit where she went into asystolic cardiac arrest. After resuscitation, surgical exploration revealed a purulent pericardial effusion with tamponade and a liver abscess. Microbiological analyses from both sites were negative. Shortly after surgical exploration, she developed multiorgan failure and died. At autopsy, pus was observed both within the pericardial cavity and around the left lobe of the liver. Green "sulfur granules" suggestive of infection with Actinomyces spp. were able to be extruded from the liver during the postmortem examination and cultures returned positive for Actinomyces israelii. This case is a rare example of primary hepatic actinomycosis infection that resulted in the death of a young woman. Nonspecific clinical manifestations may delay diagnosis; however, the finding of "sulfur granules" in areas of abscess formation at autopsy should be taken as an indication of possible underlying Actinomyces infection.


Assuntos
Actinomicose/diagnóstico , Abscesso Hepático/microbiologia , Insuficiência de Múltiplos Órgãos/etiologia , Actinomyces/isolamento & purificação , Tamponamento Cardíaco/etiologia , Evolução Fatal , Feminino , Humanos , Abscesso Hepático/patologia , Derrame Pericárdico/microbiologia , Pneumonia/etiologia , Choque Séptico/microbiologia , Adulto Jovem
13.
Klin Mikrobiol Infekc Lek ; 26(1): 12-17, 2020 Mar.
Artigo em Tcheco | MEDLINE | ID: mdl-33326590

RESUMO

Actinomyces urogenitalis is most commonly associated with the human genitourinary system, often only as the resident flora. Outside the genitourinary tract, A. urogenitalis is isolated rather sporadically. Presented are two brief case reports of human infections outside the genitourinary tract as well as experiences with microbiological identification of this actinomycete. Antibiotic susceptibility testing of actinomycetes is focused especially on their resistance to lincosamides and fluoroquinolones. The etiological relationship with the patients' clinical problems was not investigated. Previously reported cases of infections outside the genitourinary tract are also mentioned in the article. The article may aid in expanding the knowledge of the occurrence, diagnosis and susceptibility of A. urogenitalis to antibiotics, particularly in rarely reported extra-genitourinary infections caused by this species. Accurate species identification in routine laboratory practice is important both for determination of the etiological role of the microorganism and for more precise selection of empirical antibiotic therapy.


Assuntos
Actinomyces/efeitos dos fármacos , Antibacterianos/farmacologia , Infecções por Bactérias Gram-Positivas/microbiologia , Actinomyces/isolamento & purificação , Farmacorresistência Bacteriana , Infecções por Bactérias Gram-Positivas/tratamento farmacológico , Humanos , Testes de Sensibilidade Microbiana
14.
BMJ Case Rep ; 13(12)2020 Dec 13.
Artigo em Inglês | MEDLINE | ID: mdl-33318282

RESUMO

This report presents the case of a mixed infection of Actinomyces israelii and Fusobacterium nucleatum, presenting as an extensive neck mass progressing through tissue planes and causing bony destruction. Despite multiple abscess aspirates, imaging and serological investigations, the causative organisms proved elusive over the course of the patient's long admission, only to be identified postdischarge. The patient was successfully initiated on a prolonged course of intravenous antibiotics and did not suffer from any complications. This report aims to raise awareness of the presentation, pathogenicity and treatment of Actinomyces and Fusobacteria infections, given a notable difficulty in diagnosis.


Assuntos
Abscesso/etiologia , Actinomyces/isolamento & purificação , Coinfecção/diagnóstico , Coinfecção/microbiologia , Fusobacterium nucleatum/isolamento & purificação , Pescoço/patologia , Abscesso/microbiologia , Actinomicose/diagnóstico , Actinomicose/microbiologia , Administração Intravenosa , Idoso , Antibacterianos/administração & dosagem , Coinfecção/tratamento farmacológico , Infecções por Fusobacterium/diagnóstico , Infecções por Fusobacterium/microbiologia , Humanos , Masculino , Tomografia Computadorizada por Raios X
15.
Sci Rep ; 10(1): 16652, 2020 10 06.
Artigo em Inglês | MEDLINE | ID: mdl-33024169

RESUMO

Recently, it was suggested that the nitrite (NO2-) produced from NO3- by oral bacteria might contribute to oral and general health. Therefore, we aimed to clarify the detailed information about the bacterial NO2-production in the oral biofilm. Dental plaque and tongue-coating samples were collected, then the NO2-producing activity was measured. Furthermore, the composition of the NO2--producing bacterial population were identified using the Griess reagent-containing agar overlay method and molecular biological method. NO2--producing activity per mg wet weight varied among individuals but was higher in dental plaque. Additionally, anaerobic bacteria exhibited higher numbers of NO2--producing bacteria, except in the adults' dental plaque. The proportion of NO2--producing bacteria also varied among individuals, but a positive correlation was found between NO2--producing activity and the number of NO2--producing bacteria, especially in dental plaque. Overall, the major NO2--producing bacteria were identified as Actinomyces, Schaalia, Veillonella and Neisseria. Furthermore, Rothia was specifically detected in the tongue coatings of children. These results suggest that dental plaque has higher NO2--producing activity and that this activity depends not on the presence of specific bacteria or the bacterial compositions, but on the number of NO2--producing bacteria, although interindividual differences were detected.


Assuntos
Actinomyces/metabolismo , Actinomycetaceae/metabolismo , Bactérias Anaeróbias/metabolismo , Microbiota , Boca/microbiologia , Nitritos/metabolismo , Actinomyces/isolamento & purificação , Actinomycetaceae/isolamento & purificação , Adolescente , Adulto , Bactérias Anaeróbias/isolamento & purificação , Biofilmes , Criança , Pré-Escolar , Placa Dentária/microbiologia , Feminino , Humanos , Masculino , Micrococcaceae/isolamento & purificação , Micrococcaceae/metabolismo , Neisseria/isolamento & purificação , Neisseria/metabolismo , Veillonella/isolamento & purificação , Veillonella/metabolismo , Adulto Jovem
16.
Int J Infect Dis ; 100: 379-381, 2020 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-32979589

RESUMO

Pulmonary actinomycosis (PA) is an uncommon pulmonary infectious disease that often is misdiagnosed. Metagenomic next-generation sequencing (mNGS) is a highly sensitive and culture-independent new molecular technology for precise infectious disease diagnosis. Here we report a PA case diagnosed by the combination of a radial endobronchial-ultrasonography guide sheath (R-EBUS-GS) and mNGS, along with a brief review of the literature.


Assuntos
Actinomyces/genética , Actinomicose/diagnóstico por imagem , Actinomyces/classificação , Actinomyces/isolamento & purificação , Actinomicose/diagnóstico , Actinomicose/microbiologia , Idoso , Broncoscopia , Endossonografia , Genoma Bacteriano , Sequenciamento de Nucleotídeos em Larga Escala , Humanos , Pulmão/diagnóstico por imagem , Pulmão/microbiologia , Pneumopatias/diagnóstico , Pneumopatias/diagnóstico por imagem , Pneumopatias/microbiologia , Masculino , Metagenômica
17.
BMJ Case Rep ; 13(9)2020 Sep 29.
Artigo em Inglês | MEDLINE | ID: mdl-32994271

RESUMO

A 72-year-old man with a history of right reverse shoulder arthroplasty presented with a 1-month history of erythema, pain and drainage from the right shoulder. Arthrocentesis was performed and synovial fluid gram stain revealed gram-positive rods. Clinical diagnosis of prosthetic shoulder joint infection was made. Orthopaedic surgeons performed irrigation and debridement with resection of the right shoulder prothesis and implantation of an antimicrobial spacer. Operative cultures grew Actinomyces neuii The patient was treated with 6 weeks of ceftriaxone with improvement in both clinical symptoms and laboratory values. Actinomyces species remain a rare cause of late prosthetic joint infection (PJI) due to their slow growing and indolent course. While generalised actinomycosis is often treated with 6-12 months of antibiotics, the treatment course of Actinomyces PJI is not well characterised, with some sources suggesting a minimum of 6 weeks of antimicrobial therapy.


Assuntos
Actinomyces/isolamento & purificação , Actinomicose/diagnóstico , Articulação do Ombro/microbiologia , Prótese de Ombro/microbiologia , Idoso , Antibacterianos/uso terapêutico , Ceftriaxona/uso terapêutico , Humanos , Masculino , Infecções Relacionadas à Prótese/diagnóstico
18.
Am J Obstet Gynecol ; 223(5): 727.e1-727.e11, 2020 11.
Artigo em Inglês | MEDLINE | ID: mdl-32791124

RESUMO

BACKGROUND: Previous work has shown that the vaginal microbiome decreases in Lactobacillus predominance and becomes more diverse after menopause. It has also been shown that estrogen therapy restores Lactobacillus dominance in the vagina and that topical estrogen is associated with overactive bladder symptom improvement. We now know that the bladder contains a unique microbiome and that increased bladder microbiome diversity is associated with overactive bladder. However, there is no understanding of how quickly each pelvic floor microbiome responds to estrogen or if those changes are associated with symptom improvement. OBJECTIVE: This study aimed to determine if estrogen treatment of postmenopausal women with overactive bladder decreases urobiome diversity. STUDY DESIGN: We analyzed data from postmenopausal participants in 2 trials (NCT02524769 and NCT02835846) who chose vaginal estrogen as the primary overactive bladder treatment and used 0.5 g of conjugated estrogen (Premarin cream; Pfizer, New York City, NY) twice weekly for 12 weeks. Baseline and 12-week follow-up data included the Overactive Bladder questionnaire, and participants provided urine samples via catheter, vaginal swabs, perineal swabs, and voided urine samples. Microbes were detected by an enhanced culture protocol. Linear mixed models were used to estimate microbiome changes over time. Urinary antimicrobial peptide activity was assessed by a bacterial growth inhibition assay and correlated with relative abundance of members of the urobiome. RESULTS: In this study, 12 weeks of estrogen treatment resulted in decreased microbial diversity within the vagina (Shannon, P=.047; Richness, P=.043) but not in the other niches. A significant increase in Lactobacillus was detected in the bladder (P=.037) but not in the vagina (P=.33), perineum (P=.56), or voided urine (P=.28). The change in Lactobacillus levels in the bladder was associated with modest changes in urgency incontinence symptoms (P=.02). The relative abundance of the genus Corynebacterium correlated positively with urinary antimicrobial peptide activity after estrogen treatment. CONCLUSION: Estrogen therapy may change the microbiome of different pelvic floor niches. The vagina begins to decrease in diversity, and the bladder experiences a significant increase in Lactobacillus levels; the latter is correlated with a modest improvement in the symptom severity subscale of the Overactive Bladder questionnaire.


Assuntos
Estrogênios Conjugados (USP)/uso terapêutico , Estrogênios/uso terapêutico , Lactobacillus/isolamento & purificação , Microbiota , Bexiga Urinária Hiperativa/tratamento farmacológico , Bexiga Urinária/microbiologia , Urina/microbiologia , Actinomyces/isolamento & purificação , Administração Intravaginal , Idoso , Peptídeos Catiônicos Antimicrobianos/urina , Biodiversidade , Cromatografia Líquida de Alta Pressão , Corynebacterium/isolamento & purificação , Feminino , Humanos , Pessoa de Meia-Idade , Pós-Menopausa , Streptococcus/isolamento & purificação , Resultado do Tratamento , Bexiga Urinária Hiperativa/fisiopatologia , Incontinência Urinária de Urgência/fisiopatologia
19.
Medwave ; 20(7): e7986, 2020 Aug 06.
Artigo em Espanhol | MEDLINE | ID: mdl-32804919

RESUMO

INTRODUCTION: Actinomycosis is a rare infectious disease caused by Gram-positive bacteria. The most common species is Actinomyces israelii. Among its forms of presentation, the thoracic is the least frequent. CASE PRESENTATION: We report two patients with thoracic actinomycosis, 8 and 13 years old, from different geographical areas of Peru. The first case had empyema necessitans and the second, lung consolidation and recurrent hemoptysis. Both had a certain degree of difficulty in their diagnosis but responded favorably to antibiotics and surgical treatment. The diagnosis was based on the histopathological study. However, we were not able to ascertain the species of actinomyces. CONCLUSION: Thoracic actinomycosis is rare in children and presents as a parenchymal lesion with possible fistulization to the chest wall. This article is one of the few in the Peruvian literature, constituting a contribution to the knowledge of the disease and its management in pediatrics.


INTRODUCCIÓN: La actinomicosis es una enfermedad infecciosa poco frecuente, ocasionada por una bacteria Gram positiva. La especie más común es Actinomyces israelii. Dentro de sus formas de presentación, la torácica es la menos frecuente. PRESENTACIÓN DE CASOS: Reportamos dos pacientes con actinomicosis torácica de 8 y 13 años de diferentes zonas geográficas de Perú. El primer caso tuvo empiema necessitatis y el segundo, consolidación pulmonar y hemoptisis recurrente. Ambos tuvieron cierto grado de dificultad en su diagnóstico, pero con una buena respuesta al tratamiento antibiótico y quirúrgico. El diagnóstico fue mediante estudio histopatológico. Sin embargo, no se pudo identificar la especie de Actinomyces. CONCLUSIÓN: La actinomicosis torácica es poco frecuente en niños y se presenta como una lesión parenquimal con posible fistulización a la pared torácica. Este es uno de los pocos casos reportados en la literatura peruana, constituyendo una contribución al conocimiento de esta enfermedad y su manejo en pediatría.


Assuntos
Actinomyces/isolamento & purificação , Actinomicose/diagnóstico , Pneumopatias/diagnóstico , Actinomicose/microbiologia , Actinomicose/terapia , Adolescente , Antibacterianos/administração & dosagem , Criança , Feminino , Humanos , Pneumopatias/microbiologia , Pneumopatias/terapia , Masculino , Peru
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