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1.
Rev. Odontol. Araçatuba (Impr.) ; 41(2): 9-14, maio-ago.2020. ilus
Artigo em Português | LILACS, BBO - Odontologia | ID: biblio-1102388

RESUMO

Infecções maxilo-faciais graves são caracterizadas pela disseminação do processo infeccioso aos tecidos adjacentes e espaços fasciais da região de cabeça, pescoço e tórax. Sua principal origem é odontogênica, geralmente resultante de infecção periapical e doença periodontal. Podem variar de infecções bem localizadas de baixa severidade, até infecções graves, com potencial de disseminação para espaços fasciais da cabeça e pescoço, podendo causar o comprometimento de estruturas vitais, septicemia e morte. Essas infecções podem atingir diversos espaços, dentre eles o espaço mastigatório, composto pelos espaços fasciais: submassetérico, pterigomandibular, temporal profundo e temporal superficial. Esses quatro compartimentos do espaço mastigatório, comportamse clinicamente como espaços separados, pois, na maioria dos casos, somente um compartimento torna-se infectado, entretanto, infecções severas ou duradouras podem envolver todos os quatro compartimentos. O objetivo do presente estudo é apresentar o manejo clínico e cirúrgico de infecção odontogênica disseminada para o espaço temporal superficial. Paciente de 51 anos de idade, do sexo feminino, com histórico de infecção odontogênica disseminada para o espaço temporal superficial, tendo como fator etiológico resto radicular da unidade 13. Procedeu-se drenagem ambulatorial do conteúdo associada à antibioticoterapia. Após o período de 07 dias, houve remissão da condição. Apesar de incomum, infecções odontogênicas originadas de dentes anteriores, podem se disseminar para os espaços mastigatórios. Independente de sua origem deve ser tratada de forma imediata, drenando o espaço comprometido, identificando a causa e eliminando-a, e associando o uso de antibióticos como coadjuvante(AU)


Severe maxillofacial infections are characterized by the spread of the infectious process to adjacent tissues and fascial spaces of the head, neck and chest region. Its main origin is odontogenic, usually resulting from periapical infection and periodontal disease. It can range from well-localized infections of low severity to severe infections with potential for dissemination to spread through the facial planes of the head and neck, which can lead to compromised airways, resulting in septicemia and death. These infections can reach several spaces, among them the masticatory space, composed of fascial spaces: subassayeric, pterygomandibular, deep temporal and superficial temporal. These four compartments of the masticatory space behave clinically as separate spaces, since in most cases only one compartment becomes infected, however, severe or long-lasting infections may involve all four compartments. The goal of the present study is to present the clinical management of disseminated odontogenic infection for superficial temporal space. A 51-year-old female patient with a history of odontogenic infection, disseminated to the superficial temporal space, having as the etiological factor the root rest of unit 13. Outpatient drainage of contents and antibiotic therapy-associated was performed. After the period of 07 days, there was remission of the condition. Although uncommon, odontogenic infections originating from anterior teeth may spread to masticatory spaces. Regardless of its origin, it must be treated immediately, draining the compromised space, identifying the cause and eliminating it, and associating the use of antibiotics as a coadjuvante(AU)


Assuntos
Humanos , Feminino , Pessoa de Meia-Idade , Cirurgia Bucal , Infecções Bacterianas , Doenças Periodontais
2.
Surg Clin North Am ; 100(4): 757-776, 2020 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-32681875

RESUMO

This review of the literature concerning bacteria, antibiotics and tissue repair shows there are extensive data supporting microbial interference with wound healing once bacterial burden exceeds 104 CFU per unit of measure, The mechanism of bacterial interference lies largely in prolonging the inflammatory phase of tissue repair. Reducing the microbial bioburden allows tissue repair to continue. Systemic and topical antimicrobials appear critical to reducing the bioburden and facilitating repair. The current controversy over the use of antimicrobials in patients with chronically infected wounds, in particular, revolves around the definition of infection. The reliance on classic clinical signs of inflammation to support antimicrobial use in these patients is tenuous due to the lack of correlation of these signs with the microbial burden known to impair tissue repair.


Assuntos
Antibacterianos/uso terapêutico , Infecções Bacterianas/tratamento farmacológico , Cicatrização/fisiologia , Infecção dos Ferimentos/tratamento farmacológico , Infecções Bacterianas/fisiopatologia , Carga Bacteriana/fisiologia , Biofilmes , Hipóxia Celular/fisiologia , Humanos , Neutrófilos/fisiologia , Infecção dos Ferimentos/fisiopatologia
4.
JAMA ; 324(1): 47-56, 2020 07 07.
Artigo em Inglês | MEDLINE | ID: mdl-32633801

RESUMO

Importance: Probiotics are frequently used by residents in care homes (residential homes or nursing homes that provide residents with 24-hour support for personal care or nursing care), although the evidence on whether probiotics prevent infections and reduce antibiotic use in these settings is limited. Objective: To determine whether a daily oral probiotic combination of Lactobacillus rhamnosus GG and Bifidobacterium animalis subsp lactis BB-12 compared with placebo reduces antibiotic administration in care home residents. Design, Setting, and Participants: Placebo-controlled randomized clinical trial of 310 care home residents, aged 65 years and older, recruited from 23 care homes in the United Kingdom between December 2016 and May 2018, with last follow-up on October 31, 2018. Interventions: Study participants were randomized to receive a daily capsule containing a probiotic combination of Lactobacillus rhamnosus GG and Bifidobacterium animalis subsp lactis BB-12 (total cell count per capsule, 1.3 × 1010 to 1.6 × 1010) (n = 155), or daily matched placebo (n = 155), for up to 1 year. Main Outcomes and Measures: The primary outcome was cumulative antibiotic administration days for all-cause infections measured from randomization for up to 1 year. Results: Among 310 randomized care home residents (mean age, 85.3 years; 66.8% women), 195 (62.9%) remained alive and completed the trial. Participant diary data (daily data including study product use, antibiotic administration, and signs of infection) were available for 98.7% randomized to the probiotic group and 97.4% randomized to placebo. Care home residents randomized to the probiotic group had a mean of 12.9 cumulative systemic antibiotic administration days (95% CI, 0 to 18.05), and residents randomized to placebo had a mean of 12.0 days (95% CI, 0 to 16.95) (absolute difference, 0.9 days [95% CI, -3.25 to 5.05]; adjusted incidence rate ratio, 1.13 [95% CI, 0.79 to 1.63]; P = .50). A total of 120 care home residents experienced 283 adverse events (150 adverse events in the probiotic group and 133 in the placebo group). Hospitalizations accounted for 94 of the events in probiotic group and 78 events in the placebo group, and deaths accounted for 33 of the events in the probiotic group and 32 of the events in the placebo group. Conclusions and Relevance: Among care home residents in the United Kingdom, a daily dose of a probiotic combination of Lactobacillus rhamnosus GG and Bifidobacterium animalis subsp lactis BB-12 did not significantly reduce antibiotic administration for all-cause infections. These findings do not support the use of probiotics in this setting. Trial Registration: ISRCTN Identifier:16392920.


Assuntos
Antibacterianos/uso terapêutico , Infecções Bacterianas/tratamento farmacológico , Bifidobacterium animalis , Uso de Medicamentos/estatística & dados numéricos , Lactobacillus rhamnosus , Probióticos/uso terapêutico , Idoso , Idoso de 80 Anos ou mais , Moradias Assistidas , Infecções Bacterianas/prevenção & controle , Bifidobacterium animalis/isolamento & purificação , Método Duplo-Cego , Fezes/microbiologia , Feminino , Humanos , Lactobacillus rhamnosus/isolamento & purificação , Masculino , Casas de Saúde , Reino Unido
7.
Front Immunol ; 11: 1221, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32574271

RESUMO

Lactoferrin is a nutrient classically found in mammalian milk. It binds iron and is transferred via a variety of receptors into and between cells, serum, bile, and cerebrospinal fluid. It has important immunological properties, and is both antibacterial and antiviral. In particular, there is evidence that it can bind to at least some of the receptors used by coronaviruses and thereby block their entry. Of importance are Heparan Sulfate Proteoglycans (HSPGs) and the host receptor angiotensin-converting enzyme 2 (ACE2), as based on other activities lactoferrin might prevent severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) from attaching to the host cells. Lactoferrin (and more specifically enteric-coated LF because of increased bioavailability) may consequently be of preventive and therapeutic value during the present COVID-19 pandemic.


Assuntos
Proteoglicanas de Heparan Sulfato/metabolismo , Lactoferrina/fisiologia , Lactoferrina/uso terapêutico , Peptidil Dipeptidase A/metabolismo , Receptores Virais/metabolismo , Animais , Antibacterianos/uso terapêutico , Infecções Bacterianas/prevenção & controle , Suplementos Nutricionais , Humanos , Lactoferrina/metabolismo , Receptores de Superfície Celular/metabolismo , Viroses/prevenção & controle
8.
J Endod ; 46(8): 1105-1112, 2020 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-32497654

RESUMO

INTRODUCTION: Because active bacteria present a higher abundance of ribosomal RNA (rRNA) than DNA (rRNA gene), the rRNA/DNA ratio of next-generation sequencing (NGS) data was measured to search for active bacteria in endodontic infections. METHODS: Paired complementary DNA and DNA samples from 5 root canals of teeth with apical periodontitis were subjected to polymerase chain reaction with bar-coded primers amplifying the 16S rRNA gene hypervariable regions V4-V5. High-throughput sequencing was performed using MiSeq (Illumina, San Deigo, CA), and data were analyzed using Quantitative Insights Into Microbial Ecology and Human Oral Microbiome Database. Statistical analysis was performed for relative abundance of bacteria in the DNA- and rRNA-based NGS data using the Mann-Whitney test, whereas differences in the diversity and richness indexes were assessed using a nonparametric 2-sample t test (P < .05). For bacterial taxa detected in both approaches, the rRNA/DNA ratios were calculated by dividing the average abundance of individual species in the respective analysis. RESULTS: Although no significant difference was found in the indexes of bacterial richness and diversity, the relative abundance of bacterial members varied in both analyses. Comparing rRNA with DNA data, there was a significant decrease in the relative abundance of Firmicutes (P < .05). The bacterial taxa Bacteroidales [G-2] bacterium HMT 274, Porphyromonas endodontalis, Tannerella forsythia, Alloprevotella tannerae, Prevotella intermedia, Pseudoramibacter alactolyticus, Olsenella sp. HMT 809, Olsenella sp. HMT 939, Olsenella uli, and Fusobacterium nucleatum subsp. animalis were both dominant (DNA ≥ 1%) and active (rRNA/DNA ≥ 1). CONCLUSIONS: The integrated DNA- and rRNA-based NGS strategy was particularly important to disclose the activity of as-yet-uncultivated or difficult-to-culture bacteria in endodontic infections.


Assuntos
Infecções Bacterianas , Sequenciamento de Nucleotídeos em Larga Escala , Actinobacteria , Bactérias , Clostridiales , DNA Bacteriano , Humanos , RNA Ribossômico 16S
10.
N Engl J Med ; 382(25): 2397-2410, 2020 06 18.
Artigo em Inglês | MEDLINE | ID: mdl-32558469

RESUMO

BACKGROUND: In regions with high burdens of tuberculosis and human immunodeficiency virus (HIV), many HIV-infected adults begin antiretroviral therapy (ART) when they are already severely immunocompromised. Mortality after ART initiation is high in these patients, and tuberculosis and invasive bacterial diseases are common causes of death. METHODS: We conducted a 48-week trial of empirical treatment for tuberculosis as compared with treatment guided by testing in HIV-infected adults who had not previously received ART and had CD4+ T-cell counts below 100 cells per cubic millimeter. Patients recruited in Ivory Coast, Uganda, Cambodia, and Vietnam were randomly assigned in a 1:1 ratio to undergo screening (Xpert MTB/RIF test, urinary lipoarabinomannan test, and chest radiography) to determine whether treatment for tuberculosis should be started or to receive systematic empirical treatment with rifampin, isoniazid, ethambutol, and pyrazinamide daily for 2 months, followed by rifampin and isoniazid daily for 4 months. The primary end point was a composite of death from any cause or invasive bacterial disease within 24 weeks (primary analysis) or within 48 weeks after randomization. RESULTS: A total of 522 patients in the systematic-treatment group and 525 in the guided-treatment group were included in the analyses. At week 24, the rate of death from any cause or invasive bacterial disease (calculated as the number of first events per 100 patient-years) was 19.4 with systematic treatment and 20.3 with guided treatment (adjusted hazard ratio, 0.95; 95% confidence interval [CI], 0.63 to 1.44). At week 48, the corresponding rates were 12.8 and 13.3 (adjusted hazard ratio, 0.97 [95% CI, 0.67 to 1.40]). At week 24, the probability of tuberculosis was lower with systematic treatment than with guided treatment (3.0% vs. 17.9%; adjusted hazard ratio, 0.15; 95% CI, 0.09 to 0.26), but the probability of grade 3 or 4 drug-related adverse events was higher with systematic treatment (17.4% vs. 7.2%; adjusted hazard ratio 2.57; 95% CI, 1.75 to 3.78). Serious adverse events were more common with systematic treatment. CONCLUSIONS: Among severely immunosuppressed adults with HIV infection who had not previously received ART, systematic treatment for tuberculosis was not superior to test-guided treatment in reducing the rate of death or invasive bacterial disease over 24 or 48 weeks and was associated with more grade 3 or 4 adverse events. (Funded by the Agence Nationale de Recherches sur le Sida et les Hépatites Virales; STATIS ANRS 12290 ClinicalTrials.gov number, NCT02057796.).


Assuntos
Infecções Oportunistas Relacionadas com a AIDS/tratamento farmacológico , Antirretrovirais/uso terapêutico , Antituberculosos/uso terapêutico , Infecções por HIV/tratamento farmacológico , Hospedeiro Imunocomprometido , Tuberculose/tratamento farmacológico , Infecções Oportunistas Relacionadas com a AIDS/diagnóstico , Infecções Oportunistas Relacionadas com a AIDS/prevenção & controle , Adulto , Infecções Bacterianas/epidemiologia , Infecções Bacterianas/etiologia , Infecções Bacterianas/prevenção & controle , Contagem de Linfócito CD4 , Feminino , HIV , Infecções por HIV/complicações , Infecções por HIV/mortalidade , Humanos , Masculino , Tuberculose/complicações , Tuberculose/diagnóstico , Tuberculose/mortalidade , Carga Viral
13.
Infez Med ; 28(suppl 1): 29-36, 2020 Jun 01.
Artigo em Inglês | MEDLINE | ID: mdl-32532935

RESUMO

We reviewed studies reporting bacterial and fungal co-infections in patients with COVID-19. The majority were retrospective studies with poor quality data biased with short follow-up and selection of patients. Septic shock was reported in 4% to 33.1% of patients. Seventy-one to 100% of patients received antibacterial treatments. Invasive pulmonary aspergillosis seems to be an increasingly observed complication in critically ill patients with SARS-CoV-2 infection as previously reported in patients hospitalized in ICU with severe influenza. High quality prospective studies are urgently needed to verify the incidence of bacterial and fungal infections and their role on the outcome of COVID-19.


Assuntos
Infecções Bacterianas/epidemiologia , Infecções por Coronavirus/epidemiologia , Micoses/epidemiologia , Pneumonia Viral/epidemiologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Técnicas de Laboratório Clínico , Comorbidade , Infecções por Coronavirus/diagnóstico , Infecção Hospitalar/epidemiologia , Feminino , Humanos , Unidades de Terapia Intensiva , Aspergilose Pulmonar Invasiva/epidemiologia , Masculino , Pessoa de Meia-Idade , Pandemias , Pneumonia Viral/diagnóstico , Estudos Retrospectivos , Choque Séptico/epidemiologia
15.
Rev. SOBECC ; 25(2): 83-89, 30/06/2020.
Artigo em Português | LILACS, BDENF - Enfermagem | ID: biblio-1102114

RESUMO

Objetivo: Avaliar a redução microbiana após antissepsia cirúrgica das mãos dos cirurgiões, realizada com preparação alcoólica, em diferentes tempos. Método: Estudo de prevalência, pragmático, de campo, realizado em hospital terciário do Brasil. Coletaram-se amostras microbiológicas das mãos de 54 cirurgiões após lavagem simples, para determinar a flora microbiana basal e, após a antissepsia cirúrgica alcoólica, para avaliar a redução microbiana imediata. Categorizaram-se os resultados da redução microbiana em redução leve (até 50% de redução da flora bacteriana), moderada (de 51 a 80%) e alta (acima de 80%). A pesquisa foi submetida e aprovada pelo Comitê de Ética e Pesquisa da instituição hospitalar privada, sede do estudo, e da instituição de ensino superior federal. Resultados: Nas técnicas realizadas em menos de 90 segundos, houve 80% de redução severa, 6,7% de redução moderada e 13,3% de redução leve. Nas técnicas desempenhadas em mais de 180 segundos, todas as amostras apresentaram redução de contagem bacteriana, o que não ocorreu em tempos menores de antissepsia. Conclusão: Quando a técnica e o tempo recomendados são seguidos, maior é a redução bacteriana, em comparação aos tempos menores.


Objective: To evaluate the microbial reduction after surgical hand antisepsis performed with alcohol solution at different application times among surgeons. Method: This is a pragmatic prevalence field study carried out in a Brazilian tertiary hospital. Microbiological samples were collected from the hands of 54 surgeons after simple washing to determine the baseline microbial flora and after surgical antisepsis with an alcohol solution to evaluate the immediate microbial reduction. We categorized the microbial reduction results as mild (up to 50% bacterial flora reduction), moderate (51 to 80%), and high (more than 80%). The research was submitted to and approved by the Research Ethics Committee of the private hospital (study site) and the federal institution of higher education. Results: Techniques performed in less than 90 seconds showed an 80% high reduction, 6.7% moderate reduction, and 13.3% mild reduction. In applications that lasted more than 180 seconds, all samples presented bacterial count reduction, which did not occur in shorter antisepsis times. Conclusion: When the recommended technique and time are followed, the bacterial reduction is greater compared to lower durations.


Objetivo: evaluar la reducción microbiana después de la antisepsia quirúrgica de las manos de los cirujanos, realizada con preparación alcohólica, en diferentes momentos. Método: Estudio pragmático de prevalencia de campo realizado en un hospital terciario de Brasil. Muestras microbiológicas recogidas de las manos de 54 cirujanos después de un simple lavado, para determinar la flora microbiana basal y después de la antisepsia quirúrgica alcohólica, para evaluar la reducción microbiana inmediata. Los resultados de la reducción microbiana se clasificaron como leves (hasta un 50% de reducción en la flora bacteriana), moderados (del 51 al 80%) y altos (más del 80%). La investigación fue presentada y aprobada por el Comité de Ética e Investigación de la institución del hospital privado, sede del estudio y de la institución federal de educación superior. Resultados: en las técnicas realizadas en menos de 90 segundos hubo una reducción severa del 80%; 6,7% de reducción moderada; 13,3% de ligera reducción. En las técnicas realizadas durante 180 segundos, todas las muestras presentaron una reducción en el recuento bacteriano, lo que no ocurrió en tiempos de antisepsia más cortos. Conclusión: Cuando se siguen la técnica y el tiempo recomendados, mayor es la reducción bacteriana, en comparación con los tiempos más cortos.


Assuntos
Humanos , Centros Cirúrgicos , Infecções Bacterianas , Antissepsia , Cirurgiões , Infecções , Anti-Infecciosos Locais
16.
PLoS One ; 15(5): e0230784, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32384113

RESUMO

BACKGROUND: Lactose intolerance is a frequent gastrointestinal disease affecting 47% of the Eastern European population. Small intestinal bacterial overgrowth (SIBO) leads to carbohydrate malabsorption and therefore to false results during lactose breath and tolerance tests. OBJECTIVES: We aimed to assess the prevalence of lactose maldigestion and intolerance in Hungary and to investigate the role of combined diagnostic method and testing for SIBO in reducing false results. METHODS: We retrospectively analyzed data from 264 adult symptomatic patients who underwent 50g lactose breath and tolerance tests in parallel over a one-year period at our center. A ≥20 ppm elevation of H2 or less than 1.1 mmol/l rise of blood glucose was diagnostic for lactose maldigestion. Patients with maldigestion who had symptoms during the test were defined as lactose intolerant. Patients with an early (≤90 min) significant (≥20 ppm) rise of H2 during lactose and/or lactulose breath tests were determined to have SIBO. Patients with slow/rapid oro-cecal transit and inappropriate preparation before the test were excluded. RESULTS: 49.6% of the 264 patients had lactose maldigestion, and 29.5% had lactose intolerance. The most frequent symptom was bloating (22.7%), while 34.8% of the study population and 60% of the symptomatic patients had SIBO. In 9.1% and 9.8% of the patients, the lactose breath and tolerance test alone gave false positive result compared with the combined method. SIBO was present in 75% of the false positives diagnosed with breath test only. CONCLUSIONS: The prevalence of lactose intolerance is lower in Hungary compared to the Eastern European value (29.5% vs 47%), so it is worth performing a population-based prospective analysis in this area. A combination of lactose breath and tolerance tests and the careful monitoring of results (with early H2 rise, lactulose breath test, etc.) can decrease the false cases caused by e.g. SIBO.


Assuntos
Infecções Bacterianas/diagnóstico , Intestino Delgado/microbiologia , Síndrome do Intestino Irritável/diagnóstico , Intolerância à Lactose/diagnóstico , Adulto , Infecções Bacterianas/epidemiologia , Infecções Bacterianas/microbiologia , Infecções Bacterianas/patologia , Testes Respiratórios , Reações Falso-Positivas , Feminino , Trato Gastrointestinal/microbiologia , Humanos , Hungria/epidemiologia , Hidrogênio , Síndrome do Intestino Irritável/epidemiologia , Síndrome do Intestino Irritável/microbiologia , Síndrome do Intestino Irritável/patologia , Lactose/administração & dosagem , Intolerância à Lactose/epidemiologia , Intolerância à Lactose/microbiologia , Intolerância à Lactose/patologia , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos
17.
Ceska Slov Farm ; 69(1): 17-23, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32460506

RESUMO

Early and appropriate antibiotic therapy remains the key intervention for successful treatment of infection in critically ill patients, particularly in the current era of increasing antibiotic resistance. Optimization of the antimicrobial dosing regimens to achieve therapeutic plasma concentrations and concentrations at the site of infection is crucial for maximizing the therapeutic response and minimizing the risk of organ toxicity and is also an important tool to avoid the resistance emergence. Beta-lactam antibiotics have been considered relatively safe and, as opposed to aminoglycosides, therapeutic drug monitoring as a tool conventionally used primarily to minimize toxicity in drugs with narrow therapeutic window or complex pharmacokinetics, has not been provided routinely yet. However, emerging data suggest that optimal antibiotic exposure may not be achieved with traditional dosing strategies in a significant number of critically ill patients and, on the contrary, concerns about insufficient plasma concentrations leading to microbiological and clinical failure are warranted. The treatment of infections in the intensive care unit (ICU) patients is often challenging because of disease complexity, pathophysiologic alterations they undergo and reduced susceptibility of nosocomial pathogens. Therefore, it is of paramount importance to update current recommendations on dosing of beta-lactam antibiotics in severe infections and therapeutic drug monitoring may be regarded as the only exact method to ensure pharmacodynamics target achievement. Na Homolce Hospital is one of the first medical institutions in the Czech Republic where the practice of routine TDM of beta-lactam antibiotics in ICU-patients has been established. In this paper, we introduce our experience and first case reports.


Assuntos
Antibacterianos/farmacocinética , Infecções Bacterianas/tratamento farmacológico , Unidades de Terapia Intensiva , beta-Lactamas/farmacocinética , Estado Terminal , República Tcheca , Monitoramento de Medicamentos , Humanos
18.
Virus Res ; 285: 198005, 2020 08.
Artigo em Inglês | MEDLINE | ID: mdl-32408156

RESUMO

Accumulating evidence shows that microbial co-infection increases the risk of disease severity in humans. There have been few studies about SARS-CoV-2 co-infection with other pathogens. In this retrospective study, 257 laboratory-confirmed COVID-19 patients in Jiangsu Province were enrolled from January 22 to February 2, 2020. They were re-confirmed by real-time RT-PCR and tested for 39 respiratory pathogens. In total, 24 respiratory pathogens were found among the patients, and 242 (94.2 %) patients were co-infected with one or more pathogens. Bacterial co-infections were dominant in all COVID-19 patients, Streptococcus pneumoniae was the most common, followed by Klebsiella pneumoniae and Haemophilus influenzae. The highest and lowest rates of co-infections were found in patients aged 15-44 and below 15, respectively. Most co-infections occurred within 1-4 days of onset of COVID-19 disease. In addition, the proportion of viral co-infections, fungal co-infections and bacterial-fungal co-infections were the highest severe COVID-19 cases. These results will provide a helpful reference for diagnosis and clinical treatment of COVID-19 patients.


Assuntos
Infecções Bacterianas/complicações , Betacoronavirus , Coinfecção , Infecções por Coronavirus/complicações , Micoses/complicações , Pneumonia Viral/complicações , Viroses/complicações , Adolescente , Adulto , Fatores Etários , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Pandemias , Estudos Retrospectivos , Fatores de Tempo , Adulto Jovem
19.
PLoS One ; 15(5): e0232599, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32428000

RESUMO

Ziziphus lotus L. (Lam.) and Z. mauritiana Lam., as a widespread species in Tunisia, are well known for their medicinal and food uses. The aim of the present study was to screen the content of total polyphenols, flavonoids, and condensed tannins together with the radical scavenging capacity and the antimicrobial activity of leaves, fruits and seeds extracts of Z. lotus and Z. mauritiana from different localities. Results showed that leaves extracts presented the highest phenolic compounds content for both species. Furthermore, LC-ESI-MS analysis allowed the identification of 28 bioactive compounds regardless of species and organs, with the predominance of quinic acid and rutin. Leaves extract of Z. mauritiana possessed the highest total antioxidant capacity. The antimicrobial tests showed that leaves extracts of Z. mauritiana and Z. lotus from Oued Esseder exhibited the highest activity against four bacterial strains (Staphylococcus aureus, Listeria monocytogenes, Salmonella typhimurium and Escherichia coli). The main results showed that the studied species of Ziziphus genus are an excellent source of natural bioactive molecules that could be an interesting material for industrial and food purposes.


Assuntos
Antibacterianos/análise , Antioxidantes/análise , Extratos Vegetais/química , Ziziphus/química , Antibacterianos/farmacologia , Antioxidantes/farmacologia , Bactérias/efeitos dos fármacos , Infecções Bacterianas/tratamento farmacológico , Flavonoides/análise , Flavonoides/farmacologia , Humanos , Fenóis/análise , Fenóis/farmacologia , Extratos Vegetais/farmacologia , Folhas de Planta/química , Polifenóis/análise , Polifenóis/farmacologia , Proantocianidinas/análise , Proantocianidinas/farmacologia
20.
Nat Commun ; 11(1): 2211, 2020 05 05.
Artigo em Inglês | MEDLINE | ID: mdl-32371860

RESUMO

Microbial biofilm formation on indwelling medical devices causes persistent infections that cannot be cured with conventional antibiotics. To address this unmet challenge, we engineer tunable active surface topographies with micron-sized pillars that can beat at a programmable frequency and force level in an electromagnetic field. Compared to the flat and static controls, active topographies with the optimized design prevent biofilm formation and remove established biofilms of uropathogenic Escherichia coli (UPEC), Pseudomonas aeruginosa, and Staphylococcus aureus, with up to 3.7 logs of biomass reduction. In addition, the detached biofilm cells are found sensitized to bactericidal antibiotics to the level comparable to exponential-phase planktonic cells. Based on these findings, a prototype catheter is engineered and found to remain clean for at least 30 days under the flow of artificial urine medium, while the control catheters are blocked by UPEC biofilms within 5 days.


Assuntos
Antibacterianos/farmacologia , Biofilmes/crescimento & desenvolvimento , Pseudomonas aeruginosa/fisiologia , Staphylococcus aureus/fisiologia , Escherichia coli Uropatogênica/fisiologia , Infecções Bacterianas/microbiologia , Infecções Bacterianas/prevenção & controle , Biofilmes/efeitos dos fármacos , Biomassa , Campos Eletromagnéticos , Testes de Sensibilidade Microbiana/métodos , Infecções Relacionadas à Prótese/microbiologia , Infecções Relacionadas à Prótese/prevenção & controle , Pseudomonas aeruginosa/efeitos dos fármacos , Pseudomonas aeruginosa/metabolismo , Staphylococcus aureus/efeitos dos fármacos , Staphylococcus aureus/metabolismo , Fatores de Tempo , Escherichia coli Uropatogênica/efeitos dos fármacos , Escherichia coli Uropatogênica/metabolismo
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