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1.
Int J Artif Organs ; 42(12): 765-769, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31277560

RESUMO

OBJECTIVE: CytoSorb® hemadsorption is an adjunctive therapy in order to reduce elevated cytokine levels of interleukin-6, interleukin-1, and tumor necrosis factor alpha. Here we present a successful administration of CytoSorb® hemadsorption in an immunocompromised pediatric patient with collapsing glomerulopathy, acute respiratory distress syndrome, and sepsis. DATA SOURCES: Clinical observations of one patient. STUDY SELECTION: Case report. DATA EXTRACTION: Data sources are clinical observation during patient management and patient's medical records if needed. The patient's consent was obtained prior to the study. DATA SYNTHESIS: A 17-year-old male with diarrhea was admitted to the hospital and was later found to have elevated creatinine levels and proteinuria. The renal biopsy was consistent with collapsing glomerulopathy and treatment with multi immunosuppressive agents including corticosteroids, mycophenolate mofetil, and rituximab coupled with several courses of hemodialysis and plasmapheresis were administered. During the hospital stay, Stenotrophomonas maltophilia bacteremia from the blood and the catheter cultures were identified. No clinical response was achieved, and patient developed severe sepsis despite antibiotics, intravenous immunoglobulin, and supportive management including albumin, platelet and erythrocyte concentrations, and fresh frozen plasma. CytoSorb® hemadsorption was then added to the ongoing treatment for three consecutive days. Subsequent to CytoSorb® hemadsorption, immediate laboratory and clinical response were observed. CONCLUSION: This is the successful clinical report of an immunocompromised teenager with collapsing nephropathy, sepsis, and multi-organ dysfunction syndrome treated with a combination of renal replacement therapy and CytoSorb® hemadsorption. The usage of CytoSorb® hemadsorption represents a novel approach to improve survival of the patients with multiple organ dysfunction and sepsis.


Assuntos
Antibacterianos/administração & dosagem , Infecções por Bactérias Gram-Negativas , Hemoperfusão/métodos , Insuficiência de Múltiplos Órgãos/terapia , Insuficiência Renal , Sepse , Stenotrophomonas maltophilia/isolamento & purificação , Adolescente , Infecções por Bactérias Gram-Negativas/microbiologia , Infecções por Bactérias Gram-Negativas/fisiopatologia , Infecções por Bactérias Gram-Negativas/terapia , Humanos , Hospedeiro Imunocomprometido , Imunossupressores/administração & dosagem , Imunossupressores/efeitos adversos , Masculino , Insuficiência de Múltiplos Órgãos/diagnóstico , Insuficiência de Múltiplos Órgãos/etiologia , Diálise Renal/métodos , Insuficiência Renal/diagnóstico , Insuficiência Renal/etiologia , Insuficiência Renal/fisiopatologia , Insuficiência Renal/terapia , Sepse/microbiologia , Sepse/fisiopatologia , Sepse/terapia , Resultado do Tratamento
2.
Microb Pathog ; 132: 261-265, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-31078710

RESUMO

Aeromonosis is a fish disease that leads to haemorrhagic septicaemia and high mortality. The detection of early behavioural changes associated to this disease could be helpful in anticipating the initiation of treatment, increasing the probability of success. The influence of this disease on the hypothalamic-pituitary-interrenal (HPI) axis and on the brain expression of heat shock proteins (HSP) is little known. Therefore, the aim of this study was to evaluate the effect of Aeromonas hydrophila infection on individual behaviour and brain expression of genes related to stress (slc6a2, hsp90, hspa12a, hsd20b, hsd11b2, crh) in silver catfish (Rhamdia quelen). Thirty fish were divided into healthy and infected groups. The fish of the infected group were inoculated intramuscularly with 50 µL of bacterial suspension (6.4 × 108 CFU/mL), while control animals received 50 µL of saline. On day five post-infection, animals were submitted to the novel tank test, euthanized, and the brain was collected for molecular analysis. Infected fish swam more in the unknown aquarium and presented an increase in brain expression of genes related to HSP (hspa12a) and the route of cortisol synthesis (crh) when compared to uninfected fish. Therefore, this disease causes hyperlocomotion related to stress.


Assuntos
Aeromonas hydrophila/patogenicidade , Peixes-Gato/microbiologia , Doenças dos Peixes/microbiologia , Doenças dos Peixes/fisiopatologia , Infecções por Bactérias Gram-Negativas/microbiologia , Infecções por Bactérias Gram-Negativas/fisiopatologia , Infecções por Bactérias Gram-Negativas/veterinária , 11-beta-Hidroxiesteroide Desidrogenase Tipo 2/genética , Animais , Comportamento Animal , Encéfalo/metabolismo , Peixes-Gato/genética , Modelos Animais de Doenças , Feminino , Expressão Gênica , Proteínas de Choque Térmico HSP90/genética , Proteínas de Choque Térmico/genética , Locomoção , Masculino , Proteínas da Membrana Plasmática de Transporte de Norepinefrina/genética
3.
ACS Infect Dis ; 5(4): 493-505, 2019 04 12.
Artigo em Inglês | MEDLINE | ID: mdl-30857388

RESUMO

With the success of the Human Genome Project, large-scale systemic projects became a reality that enabled rapid development of the systems biology field. Systems biology approaches to host-pathogen interactions have been instrumental in the discovery of some specifics of Gram-negative bacterial recognition, host signal transduction, and immune tolerance. However, further research, particularly using multi-omics approaches, is essential to untangle the genetic, immunologic, (post)transcriptional, (post)translational, and metabolic mechanisms underlying progression from infection to clearance of microbes. The key to understanding host-pathogen interactions lies in acquiring, analyzing, and modeling multimodal data obtained through integrative multi-omics experiments. In this article, we will discuss how multi-omics analyses are adding to our understanding of the molecular basis of host-pathogen interactions and systemic maladaptive immune response of the host to microbes and microbial products.


Assuntos
Bactérias Gram-Negativas/fisiologia , Infecções por Bactérias Gram-Negativas/microbiologia , Interações Hospedeiro-Patógeno , Biologia de Sistemas/métodos , Animais , Genômica , Bactérias Gram-Negativas/genética , Infecções por Bactérias Gram-Negativas/genética , Infecções por Bactérias Gram-Negativas/imunologia , Infecções por Bactérias Gram-Negativas/fisiopatologia , Humanos , Proteômica
5.
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
6.
Pediatr Pulmonol ; 53(7): E21-E23, 2018 07.
Artigo em Inglês | MEDLINE | ID: mdl-29790674

RESUMO

PRESENTATION: Patient is a 6-year-old male with CF, MRSA colonization, and pancreatic insufficiency that presented with worsening ppFEV1 and systemic symptoms despite multiple interventions. BAL grew NTM, Stenotrophomonas maltophilia, and Inquilinus limosus, a rare organism found in patients with CF. COURSE: I. limosus treatment was deferred. Despite treatment of other pathogens, symptoms worsened. I. limosus was targeted with meropenem, amikacin, and ciprofloxacin along with clindamycin for MRSA colonization. Within weeks, symptoms had resolved with ppFEV1 improvement. DISCUSSION: This case discusses the importance of a rare organism in the CF population. Targeting I. limosus was key to recovery, revealing its potential pathogenicity.


Assuntos
Fibrose Cística/microbiologia , Rhodospirillaceae/patogenicidade , Amicacina/uso terapêutico , Antibacterianos/uso terapêutico , Criança , Ciprofloxacino/uso terapêutico , Clindamicina/uso terapêutico , Fibrose Cística/tratamento farmacológico , Fibrose Cística/fisiopatologia , Infecções por Bactérias Gram-Negativas/tratamento farmacológico , Infecções por Bactérias Gram-Negativas/microbiologia , Infecções por Bactérias Gram-Negativas/fisiopatologia , Humanos , Masculino , Meropeném/uso terapêutico , Staphylococcus aureus Resistente à Meticilina/efeitos dos fármacos , Rhodospirillaceae/efeitos dos fármacos , Stenotrophomonas maltophilia/efeitos dos fármacos , Virulência
7.
J Med Microbiol ; 67(7): 952-956, 2018 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-29787364

RESUMO

PURPOSE: Cystic fibrosis (CF) patients are susceptible to infection with Achromobacter spp., although its clinical significance remains controversial. The aim of this study was to investigate the clinical impact of infection with Achromobacter spp. in CF patients. METHODS: CF outpatients with multiple sputum cultures and follow-up lung function tests were assigned to the case group (infected with Achromobacter spp.) or the control group (never infected with Achromobacter spp.) according to the isolation of Achromobacter spp. The Achromobacter spp. group included two subgroups, taking into consideration whether the isolation of Achromobacter spp. was intermittent or chronic. Baseline lung function tests and longitudinal behaviour were examined in relation to Achromobacter spp. status. RESULTS: A total of 190 CF patients were treated from January 2003 to December 2015 in the CF unit and 21 (11 %) had at least one positive culture for Achromobacter spp. Of these, 11/21 (52.4 %) patients were chronically infected with Achromobacter spp. An analysis of changes during follow-up showed the annual rate of FEV1 decline: -2.3±1.6 % in the Achromobacter spp. group compared to -1.1±0.9 % (P=0.02) in the control group. The chronically infected group also had a significantly greater decline in FEV1 compared to the control group (-2.9±1.9 vs -1.1±0.9; P=0.04). The mean number of annual pulmonary exacerbations during the study period was significantly higher in the case group (1.9±0.9 vs 1.1±0.8; P=0.03). CONCLUSIONS: The Achromobacter spp. status in CF shows a trend towards more severe airflow obstruction and an association with accelerated decline in lung function parameters.


Assuntos
Achromobacter/fisiologia , Fibrose Cística/fisiopatologia , Infecções por Bactérias Gram-Negativas/fisiopatologia , Pulmão/fisiopatologia , Infecções Respiratórias/fisiopatologia , Achromobacter/genética , Achromobacter/isolamento & purificação , Adolescente , Adulto , Fibrose Cística/microbiologia , Feminino , Infecções por Bactérias Gram-Negativas/microbiologia , Humanos , Pulmão/microbiologia , Masculino , Pessoa de Meia-Idade , Infecções Respiratórias/microbiologia , Adulto Jovem
8.
BMC Pulm Med ; 18(1): 92, 2018 May 29.
Artigo em Inglês | MEDLINE | ID: mdl-29843675

RESUMO

BACKGROUND: Plague is a life-threatening disease caused by the bacterium, Yersinia pestis. Madagascar is the leading country for human plague cases worldwide. Human plague is a serious disease, particularly in its septicaemic and pneumonic forms. We report a case of pneumonic plague co-infected by a MDR-Stenotrophomonas maltophilia. CASE PRESENTATION: A 24 year-old man originated from Soavinandriana, a plague focus, felt uneasy and developed high fever with chills. He started treatment by himself, by private medical care and by a traditional healer for nine days moving several times from place to place. His condition had deteriorated when he presented to a district hospital with a syndrome of dyspnea, bronchial rale and altered state of consciousness. Two days later, plague diagnosis, performed as a last resort, revealed a positive F1 antigen on rapid diagnostic test. Additional tests (pla PCR and plague serology) evidenced a Y. pestis infection. However, streptomycin treatment did not achieve a complete recovery as the course of disease was complicated by the presence of MDR-S. maltophilia in his lung. This opportunistic infection could have been favored by an immunosuppression due to Y. pestis pulmonary infection and probably been acquired during his stay at a District Hospital. He was treated with a combination of ciprofloxacin and gentamycin and recovered fully. CONCLUSIONS: Pneumonic plague infection may promote another virulent or avirulent bacterial infection particularly when it is not initially suspected. However, coinfection is rarely described and its occurrence frequency is unknown. In middle or low resources areas, which is the case of most plague endemic countries, control and prevention of infections in health facilities is not optimal. Co-infection with an opportunistic pathogen agent, such as S. maltophilia, is a risk which must not be disregarded as demonstrated by this case report. When deciding of a national control strategy, it should be taken into account in the choice of the first line treatment.


Assuntos
Ciprofloxacino/administração & dosagem , Infecção Hospitalar , Gentamicinas/administração & dosagem , Peste , Stenotrophomonas maltophilia , Estreptomicina/administração & dosagem , Yersinia pestis , Antibacterianos , Coinfecção , Infecção Hospitalar/tratamento farmacológico , Infecção Hospitalar/microbiologia , Infecção Hospitalar/fisiopatologia , Farmacorresistência Bacteriana Múltipla , Infecções por Bactérias Gram-Negativas/tratamento farmacológico , Infecções por Bactérias Gram-Negativas/microbiologia , Infecções por Bactérias Gram-Negativas/fisiopatologia , Humanos , Masculino , Peste/diagnóstico , Peste/tratamento farmacológico , Peste/fisiopatologia , Stenotrophomonas maltophilia/efeitos dos fármacos , Stenotrophomonas maltophilia/isolamento & purificação , Stenotrophomonas maltophilia/patogenicidade , Resultado do Tratamento , Yersinia pestis/efeitos dos fármacos , Yersinia pestis/isolamento & purificação , Adulto Jovem
9.
Pediatr Pulmonol ; 53(4): 426-430, 2018 04.
Artigo em Inglês | MEDLINE | ID: mdl-29314745

RESUMO

BACKGROUND: While the prevalence of Stenotrophomonas maltophilia lung infection in cystic fibrosis (CF) patients has increased in the last decades, its pathogenicity remains controversial. The aim of this study was to investigate the effects of S. maltophilia initial infection on the progression of lung disease in CF children. METHODS: This case-control retrospective study took place in a pediatric CF center. A total of 23 cases defined by at least one sputum culture positive for S. maltophilia, were matched for age, sex, and CFTR mutations to 23 never infected CF controls. The clinical data were collected for 2 years before and after S. maltophilia initial infection and comprised lung function analyses, rates of exacerbations and of antibiotic courses. RESULTS: Compared with controls, cases had lower lung function (P = 0.05), more frequent pulmonary exacerbations (P = 0.01), hospitalizations (P = 0.02), and intravenous antibiotic courses (P = 0.04) before S. maltophilia acquisition. In the year following S. maltophilia initial infection, lung function decline was similar in cases and controls but cases remained more severe, with more frequent pulmonary exacerbations (P = 0.01), hospitalizations (P = 0.02) and intravenous antibiotic courses (P = 0.02). CONCLUSIONS: S. maltophilia seems to be a marker of CF lung disease severity and international recommendations to reduce lung infection by this pathogen should rapidly emerge.


Assuntos
Fibrose Cística , Infecções por Bactérias Gram-Negativas , Infecções Respiratórias , Stenotrophomonas maltophilia , Adolescente , Antibacterianos/uso terapêutico , Estudos de Casos e Controles , Criança , Pré-Escolar , Fibrose Cística/tratamento farmacológico , Fibrose Cística/epidemiologia , Fibrose Cística/fisiopatologia , Progressão da Doença , Feminino , Infecções por Bactérias Gram-Negativas/tratamento farmacológico , Infecções por Bactérias Gram-Negativas/epidemiologia , Infecções por Bactérias Gram-Negativas/fisiopatologia , Humanos , Masculino , Prevalência , Testes de Função Respiratória , Infecções Respiratórias/tratamento farmacológico , Infecções Respiratórias/epidemiologia , Infecções Respiratórias/fisiopatologia , Estudos Retrospectivos , Índice de Gravidade de Doença
10.
Hum Reprod ; 33(1): 3-10, 2018 01 01.
Artigo em Inglês | MEDLINE | ID: mdl-29145645

RESUMO

STUDY QUESTION: What is the impact of Waddlia chondrophila, an emerging Chlamydia-related bacterium associated with miscarriage, on human spermatozoa? SUMMARY ANSWER: W. chondrophila had a negative impact on human spermatozoa (decrease in viability and mitochondrial membrane potential) and was not entirely removed from infected samples by density gradient centrifugation. WHAT IS KNOWN ALREADY: Bacterial infection or colonization might have a deleterious effect on male fertility. Waddlia chondrophila was previously associated with miscarriage, but its impact on male reproductive function has never been studied. STUDY DESIGN SIZE, DURATION: An in vitro model of human spermatozoa infection was used to assess the effects of W. chondrophila infection. Controls included Chlamydia trachomatis serovar D and latex beads with similar size to bacteria. PARTICIPANTS/MATERIALS, SETTING, METHODS: Purified motile spermatozoa were infected with W. chondrophila (multiplicity of infection of 1). Immunohistochemistry combined with confocal microscopy was used to evaluate how bacteria interact with spermatozoa. The impact on physiology was assessed by monitoring cell viability, mitochondrial membrane potential and DNA fragmentation. MAIN RESULTS AND THE ROLE OF CHANCE: Using super-resolution confocal microscopy, bacteria were localized on spermatozoa surface, as well as inside the cytoplasm. Compared to controls, W. chondrophila caused a 20% increase in mortality over 72 h of incubation (P < 0.05). Moreover, higher bacterial loads significantly reduced mitochondrial membrane potential. Bacteria present on spermatozoa surface were able to further infect a cell-monolayer, indicating that sperm might vector bacteria during sexual intercourse. LIMITATIONS REASONS FOR CAUTION: The main limitation of the study is the use of an in vitro model of infection, which might be too simplistic compared to an actual infection. An animal model of infection should be developed to better evaluate the in vivo impact of W. chondrophila. WIDER IMPLICATIONS OF THE FINDINGS: Intracellular bacteria, including C. trachomatis, Mycoplasma spp. and Ureaplasma spp., are associated with male infertility. Waddlia chondrophila might represent yet another member of this group, highlighting the need for more rigorous microbiological analysis during investigations for male infertility. STUDY FUNDING/COMPETING INTEREST(S): This work has been funded by the Department of Obstetrics and Gynecology, Lausanne University Hospital, Switzerland, and by the Swiss National Science Foundation (Grant nos. 310030-156169/1, 320030-169853/1 and 320030-169853/2 attributed to D.B.). D.B. is also supported by the 'Fondation Leenaards' through the 'Bourse pour la relève académique', by the 'Fondation Divesa' and by the 'Loterie Romande'. No conflicts of interest to declare.


Assuntos
Chlamydiales/patogenicidade , Espermatozoides/microbiologia , Espermatozoides/fisiologia , Chlamydia trachomatis/patogenicidade , Infecções por Bactérias Gram-Negativas/complicações , Infecções por Bactérias Gram-Negativas/microbiologia , Infecções por Bactérias Gram-Negativas/fisiopatologia , Interações Hospedeiro-Patógeno/fisiologia , Humanos , Técnicas In Vitro , Infertilidade Masculina/etiologia , Infertilidade Masculina/microbiologia , Infertilidade Masculina/fisiopatologia , Masculino , Potencial da Membrana Mitocondrial , Microscopia Confocal , Modelos Biológicos
11.
Blood Purif ; 44(4): 314-326, 2017.
Artigo em Inglês | MEDLINE | ID: mdl-29161706

RESUMO

Gram-negative sepsis is a major cause of morbidity and mortality in critical ill patients. Recent findings in molecular biology and in signaling pathways have enhanced our understanding of its pathogenesis and opened up opportunities of innovative therapeutic approaches. Endotoxin plays a pivotal role in the pathogenesis of multi-organ dysfunction in the setting of gram-negative sepsis. Indeed, heart and kidney impairments seem to be induced by the release of circulating pro-inflammatory and pro-apoptotic mediators triggered by endotoxin interaction with immune cells. These molecules are responsible for cellular apoptosis, autophagy, cell cycle arrest, and microRNAs activation. Therefore, the early identification of sepsis-associated acute kidney injury and heart dysfunction may improve the patient clinical outcome. In this report, we will consider the role of endotoxin in the pathogenesis of sepsis, its effects on both cardiac and renal functions, and the interactions between these 2 systems in the setting of cardiorenal syndromes (CRS), particularly in CRS type 5. Finally, we will discuss the possible role of extracorporeal therapies in reducing endotoxin levels.


Assuntos
Síndrome Cardiorrenal , Endotoxinas/toxicidade , Infecções por Bactérias Gram-Negativas , Coração/fisiopatologia , Rim , Miocárdio , Sepse , Síndrome Cardiorrenal/metabolismo , Síndrome Cardiorrenal/patologia , Síndrome Cardiorrenal/fisiopatologia , Infecções por Bactérias Gram-Negativas/metabolismo , Infecções por Bactérias Gram-Negativas/patologia , Infecções por Bactérias Gram-Negativas/fisiopatologia , Humanos , Rim/metabolismo , Rim/patologia , Rim/fisiopatologia , Miocárdio/metabolismo , Miocárdio/patologia , Sepse/metabolismo , Sepse/patologia , Sepse/fisiopatologia
12.
Nat Commun ; 8(1): 265, 2017 08 16.
Artigo em Inglês | MEDLINE | ID: mdl-28814724

RESUMO

Pathogens and parasites can manipulate their hosts to optimize their own fitness. For instance, bacterial pathogens have been shown to affect their host plants' volatile and non-volatile metabolites, which results in increased attraction of insect vectors to the plant, and, hence, to increased pathogen dispersal. Behavioral manipulation by parasites has also been shown for mice, snails and zebrafish as well as for insects. Here we show that infection by pathogenic bacteria alters the social communication system of Drosophila melanogaster. More specifically, infected flies and their frass emit dramatically increased amounts of fly odors, including the aggregation pheromones methyl laurate, methyl myristate, and methyl palmitate, attracting healthy flies, which in turn become infected and further enhance pathogen dispersal. Thus, olfactory cues for attraction and aggregation are vulnerable to pathogenic manipulation, and we show that the alteration of social pheromones can be beneficial to the microbe while detrimental to the insect host.Behavioral manipulation of host by pathogens has been observed in vertebrates, invertebrates, and plants. Here the authors show that in Drosophila, infection with pathogenic bacteria leads to increased pheromone release, which attracts healthy flies. This process benefits the pathogen since it enhances bacterial dispersal, but is detrimental to the host.


Assuntos
Comunicação Animal , Infecções por Bactérias Gram-Negativas/fisiopatologia , Odorantes , Infecções por Pseudomonas/fisiopatologia , Infecções por Serratia/fisiopatologia , Olfato , Comportamento Social , Acinetobacter , Animais , Sinais (Psicologia) , Drosophila melanogaster , Microbioma Gastrointestinal , Lactobacillus plantarum , Pectobacterium carotovorum , Pseudomonas , Serratia marcescens
13.
Pediatr Pulmonol ; 52(10): 1276-1282, 2017 10.
Artigo em Inglês | MEDLINE | ID: mdl-28815999

RESUMO

OBJECTIVES: To determine whether incident detection of Stenotrophomonas maltophilia (SM) in patients with cystic fibrosis (CF) is associated with accelerated lung function decline and increased hospitalizations and to determine whether this effect is more pronounced in individuals with subsequent chronic infection. METHODS: We performed a longitudinal, retrospective single-center, pre-post study of 88 patients with CF, ages 6-51 years, with first positive respiratory culture for SM between 2008 and 2014. Rate of decline in FEV1 and hospitalization rates prior to and following incident SM infection were analyzed using segmented regression analysis of interrupted time series. RESULTS: Mean (SD) age was 17.4 (9.2) years and the mean (SD) FEV1 % predicted at acquisition was 90.0% (25.2). A total of 44% developed chronic SM infection. In regression analysis adjusted for clinical and demographic factors, there was worsening of the mean annual decline in FEV1 % predicted from -1.79 (95%CI: -2.43, -1.15) pre-acquisition to -2.14 (95%CI: -2.61, -1.67) post-acquisition (P = 0.005). A significant change was observed in those with either subsequent intermittent or chronic infection. The mean annual hospitalization rate increased significantly in the subgroup with chronic infection from 0.46 (95%CI: 0.33, 0.60) to 0.88 (95%CI: 0.68, 1.07) (P = 0.007). CONCLUSIONS: In this single-center cohort, acquisition of SM in CF was associated with an acceleration in lung function decline. Among those with chronic colonization, acquisition was also associated with increased hospitalization rates.


Assuntos
Fibrose Cística/fisiopatologia , Infecções por Bactérias Gram-Negativas/fisiopatologia , Stenotrophomonas maltophilia , Adolescente , Adulto , Criança , Fibrose Cística/complicações , Feminino , Volume Expiratório Forçado , Infecções por Bactérias Gram-Negativas/complicações , Hospitalização/estatística & dados numéricos , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Adulto Jovem
14.
J Fish Biol ; 91(1): 242-259, 2017 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-28516502

RESUMO

The stress response of turbot Scophthalmus maximus was evaluated in fish maintained 8 days under different water depths, normal (NWD, 30 cm depth, total water volume 40 l) or low (LWD, 5 cm depth, total water volume 10 l), in the additional presence of infection-infestation of two pathogens of this species. This was caused by intraperitoneal injection of sublethal doses of the bacterium Aeromonas salmonicida subsp. salmonicida or the parasite Philasterides dicentrarchi (Ciliophora:Scuticociliatida). The LWD conditions were stressful for fish, causing increased levels of cortisol in plasma, decreased levels of glycogen in liver and nicotinamide adenine dinucleotide phosphate (NADP) and increased activities of G6Pase and GSase. The presence of bacteria or parasites in fish under NWD resulted in increased cortisol levels in plasma whereas in liver, changes were of minor importance including decreased levels of lactate and GSase activity. The simultaneous presence of bacteria and parasites in fish under NWD resulted a sharp increase in the levels of cortisol in plasma and decreased levels of glucose. Decreased levels of glycogen and lactate and activities of GSase and glutathione reductase (GR), as well as increased activities of glucose-6-phosphate dehydrogenase (G6PDH), 6-phosphogluconate dehydrogenase (6PGDH) and levels of nicotinamide adenine dinucleotide phosphate (NADPH) occurred in the same fish in liver. Finally, the presence of pathogens in S. maximus under stressful conditions elicited by LWD resulted in synergistic actions of both type of stressors in cortisol levels. In liver, the presence of bacteria or parasites induced a synergistic action on several variables such as decreased activities of G6Pase and GSase as well as increased levels of NADP and NADPH and increased activities of GPase, G6PDH and 6PGDH.


Assuntos
Aeromonas salmonicida/fisiologia , Doenças dos Peixes/fisiopatologia , Linguados/fisiologia , Oligoimenóforos/fisiologia , Estresse Fisiológico/fisiologia , Aeromonas salmonicida/patogenicidade , Animais , Aquicultura , Glicemia/metabolismo , Infecções por Cilióforos/parasitologia , Infecções por Cilióforos/fisiopatologia , Infecções por Cilióforos/veterinária , Doenças dos Peixes/microbiologia , Doenças dos Peixes/parasitologia , Linguados/microbiologia , Linguados/parasitologia , Glucose-6-Fosfatase/metabolismo , Glicogênio Fosforilase/metabolismo , Glicogênio Sintase/metabolismo , Infecções por Bactérias Gram-Negativas/microbiologia , Infecções por Bactérias Gram-Negativas/fisiopatologia , Infecções por Bactérias Gram-Negativas/veterinária , Hidrocortisona/sangue , Ácido Láctico/sangue , Fígado/química , Fígado/enzimologia , Glicogênio Hepático/metabolismo , NADP/metabolismo , Oligoimenóforos/patogenicidade , Virulência , Água
15.
Fish Shellfish Immunol ; 58: 292-301, 2016 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-27577538

RESUMO

Aeromonas salmonicida, an important pathogenic bacterium which induces furunculosis, is globally causing increased risks in Atlantic salmon (Salmo salar) farming. Although the kidney is the main target organ of A. salmonicida, the metabolic profiling of kidney in response to A. salmonicida in vivo remains unknown. Here, we used 1H nuclear magnetic resonance (NMR) to comprehensively analyze the metabolic changes in the kidney of Atlantic salmon. Through the NOESYPR1D spectrum combined with multi-variate pattern recognition analysis, including principal component analysis (PCA) and orthogonal partial least-squares discriminant analysis (OPLS-DA) models, significant metabolic changes were observed seven and 14 days post-infection and in a control group. Hence, the main objective of this study was to estimate the significant metabolites with resistance to furunculosis and further understand the mechanism of A. salmonicida in Atlantic salmon. Notably, substantial alterations of kidney metabolites were observed, such as with fumarate, alanine, valine, glycine, aspartate, choline, glycerophosphocholine and betaine, and summarized by metabolic pathways including the citrate cycle, glycolysis/gluconeogenesis, tryptophan metabolism, and urea cycle, respectively. Changes were also observed in 3-hydroxybutyrate and phosphocholine which were not involved in these four metabolic pathways. After analyzing the alteration trend of these metabolites, we inferred that A. salmonicida caused absorption inhibition of amino acids and disturbed protein metabolism as well as cell metabolism in favor of its replication. These observations offered novel insights into the mechanisms of infection at a functional level and facilitated further assessment and clarification of fish disease from A. salmonicida exposure.


Assuntos
Furunculose/imunologia , Infecções por Bactérias Gram-Negativas/veterinária , Rim/metabolismo , Metaboloma , Salmo salar , Aeromonas salmonicida/fisiologia , Animais , Furunculose/fisiopatologia , Infecções por Bactérias Gram-Negativas/imunologia , Infecções por Bactérias Gram-Negativas/fisiopatologia , Rim/microbiologia , Imagem por Ressonância Magnética/veterinária
16.
Medicine (Baltimore) ; 95(31): e4375, 2016 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-27495046

RESUMO

Stenotrophomonas maltophilia is a nosocomial pathogen associated with high morbidity and mortality, particularly in immunocompromised or critically ill patients. In this study, we investigated the risk factors for mortality in patients with S. maltophilia bacteremia.Retrospectively, medical records from all patients with S. maltophilia bacteremia between December 2005 and 2014 at Severance Hospital, a 2000-bed tertiary care hospital in Seoul, Korea, were reviewed. Analysis was performed to identify factors associated with 28-day mortality.In total, 142 bacteremia patients were enrolled in this study. The overall 28-day mortality rate was 36.6%. Based on the univariate analysis, hematologic malignancy (P = 0.015), Sepsis-related Organ Failure Assessment (SOFA) score (P < 0.001) and the removal of a central venous catheter (CVC) (P = 0.040) were significantly related to mortality. In the intensive care unit patients, the Acute Physiology and Chronic Health Evaluation II score (P = 0.001) also had significance. Based on the multivariate analysis, the SOFA score (odds ratio [OR] = 1.323; 95% confidence interval [CI]: 1.159, 1.509; P < 0.001) and removal of the CVC (OR = 0.330; 95% CI: 0.109, 0.996; P = 0.049) were independent factors associated with mortality.Our results suggest that removing a CVC may considerably reduce mortality in patients with S. maltophilia bacteremia.


Assuntos
Cateterismo Venoso Central/efeitos adversos , Infecções por Bactérias Gram-Negativas/mortalidade , Mortalidade Hospitalar , Stenotrophomonas maltophilia/imunologia , Cateterismo Urinário/efeitos adversos , Adulto , Fatores Etários , Idoso , Causas de Morte , Estudos de Coortes , Infecção Hospitalar/etiologia , Infecção Hospitalar/mortalidade , Bases de Dados Factuais , Feminino , Infecções por Bactérias Gram-Negativas/etiologia , Infecções por Bactérias Gram-Negativas/fisiopatologia , Humanos , Estimativa de Kaplan-Meier , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Análise Multivariada , Estudos Retrospectivos , Medição de Risco , Fatores Sexuais , Análise de Sobrevida
17.
Vet J ; 213: 9-15, 2016 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-27240907

RESUMO

The aim of this study was to evaluate pulmonary dysfunction induced by experimental infection with Parachlamydia acanthamoebae in calves. Intrabronchial inoculation with P. acanthamoebae was performed in 31 calves aged 2-3 months old at two different challenge doses of 10(8) and 10(10) inclusion-forming units (IFU) per animal. Control animals received heat inactivated bacteria. The effects on pulmonary gas exchange were determined by arterial blood gas analysis and haemoximetry during the 7 days post inoculation (DPI). For pulmonary function testing (PFT), impulse oscillometry, capnography, and measurement of O2 uptake were undertaken in spontaneously breathing animals 7 and 3 days before inoculation and were repeated until 10 DPI. In the early phase after challenge (1-3 DPI), mild hypoxaemia occurred, which was accompanied by a significant reduction in both tidal and alveolar volumes (each related to bodyweight, BW). In parallel, expiratory flow rate and specific ventilation (i.e. minute ventilation related to O2 uptake) were significantly increased. Minute and alveolar ventilations (each related to metabolic BW) increased significantly due to higher respiratory rates, lasting until 4 and 5 DPI, respectively. Oxygen uptake was slightly reduced during the first 2 days after challenge, but increased significantly during the recovery phase, from 4 to 8 DPI. No deterioration in respiratory mechanics or acid-base balance was observed. Respiratory infection with 10(10) IFU P. acanthamoebae per calf induced mild respiratory dysfunction, mainly characterised by hypoxaemia. The study's findings do not indicate severe pathophysiological consequences of P. acanthamoebae infection on pulmonary function in the bovine host.


Assuntos
Equilíbrio Ácido-Base , Doenças dos Bovinos/fisiopatologia , Chlamydiales/fisiologia , Infecções por Bactérias Gram-Negativas/veterinária , Respiração , Animais , Bovinos , Doenças dos Bovinos/microbiologia , Modelos Animais de Doenças , Infecções por Bactérias Gram-Negativas/microbiologia , Infecções por Bactérias Gram-Negativas/fisiopatologia , Pulmão/microbiologia , Masculino , Estudos Prospectivos , Troca Gasosa Pulmonar , Ventilação Pulmonar , Testes de Função Respiratória/veterinária , Mecânica Respiratória
18.
Microsurgery ; 36(8): 658-663, 2016 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-26790991

RESUMO

OBJECTIVE: This report evaluates the behavior of anastomosed vessels and transferred flaps after anastomosed site infection in head and neck reconstruction. PATIENTS AND METHODS: Eleven free-flap cases after infection at the vascular pedicle site were included, the patency of which was observed macroscopically after re-exploration and pus drainage. Location was in the tongue (5 cases), oropharynx (3 cases), mouth floor (1 case), mandible (1 case), and hypopharynx (1 case). Transferred flaps originated from rectus abdominis (3 cases), anterolateral thigh (3 cases), radial forearm (3 cases), jejunum (1 case), and latissimus dorsi (1 case). Days for infection found were ranged 3-14 days postoperatively. Causes of infection were the salivary fistula formation in 5 cases, and precise etiology was not defined in the other 6 cases. RESULTS: Disruption of the vascular pedicles occurred with high frequency after infection. Disruption of vein occurred most frequently (5 cases), followed by both artery and vein (2 cases) and artery only (1 case). Of the eight flaps, two flaps failed, but the other six flaps survived despite pedicle disruption, indicating overall survival of nine flaps after pedicle site infection. Five of the nine survived cases were healed with simple washing and ointment application. However, the other four patients, whose cause of infection was a salivary fistula, needed second flap transfer to treat those fistulas. CONCLUSION: Disruption of anastomosed vessels can occur with high frequency after infection, causing subsequent flap loss. Therefore, surgeons need to deal with pedicle site infection to save the flap. © 2015 Wiley Periodicals, Inc. Microsurgery 36:658-663, 2016.


Assuntos
Artérias/fisiopatologia , Retalhos de Tecido Biológico/irrigação sanguínea , Neoplasias de Cabeça e Pescoço/cirurgia , Microcirurgia/métodos , Procedimentos Cirúrgicos Reconstrutivos/métodos , Infecção da Ferida Cirúrgica/fisiopatologia , Veias/fisiopatologia , Adulto , Idoso , Anastomose Cirúrgica , Artérias/cirurgia , Feminino , Retalhos de Tecido Biológico/transplante , Sobrevivência de Enxerto , Infecções por Bactérias Gram-Negativas/diagnóstico , Infecções por Bactérias Gram-Negativas/etiologia , Infecções por Bactérias Gram-Negativas/fisiopatologia , Infecções por Bactérias Gram-Positivas/diagnóstico , Infecções por Bactérias Gram-Positivas/etiologia , Infecções por Bactérias Gram-Positivas/fisiopatologia , Humanos , Masculino , Pessoa de Meia-Idade , Reoperação , Infecção da Ferida Cirúrgica/diagnóstico , Infecção da Ferida Cirúrgica/etiologia , Resultado do Tratamento , Veias/cirurgia
19.
J Cyst Fibros ; 15(3): 380-5, 2016 05.
Artigo em Inglês | MEDLINE | ID: mdl-26482717

RESUMO

BACKGROUND: To better understand the relative effects of infection with nontuberculous mycobacteria and Gram negative bacteria on lung function decline in cystic fibrosis, we assessed the impact of each infection in a Danish setting. METHODS: Longitudinal registry study of 432 patients with cystic fibrosis contributing 53,771 lung function measures between 1974 and 2014. We used a mixed effects model with longitudinally structured correlation, while adjusting for clinically important covariates. RESULTS: Infections with a significant impact on rate of decline in %FEV1 were Mycobacterium abscessus complex with -2.22% points per year (95% CI -3.21 to -1.23), Burkholderia cepacia complex -1.95% (95% CI -2.51 to -1.39), Achromobacterxylosoxidans -1.55% (95% CI -2.21 to -0.90), and Pseudomonas aeruginosa -0.95% (95% CI -1.24 to -0.66). Clearing M. abscessus complex was associated with a change to a slower decline, similar in magnitude to the pre-infection slope. CONCLUSIONS: In a national population we have demonstrated the impact on lung function of each chronic CF pathogen. M. abscessus complex was associated with the worst impact on lung function. Eradication of M. abscessus complex may significantly improve lung function.


Assuntos
Fibrose Cística , Bactérias Gram-Negativas , Infecções por Bactérias Gram-Negativas , Pulmão , Infecções por Mycobacterium não Tuberculosas , Micobactérias não Tuberculosas , Adulto , Doença Crônica , Fibrose Cística/diagnóstico , Fibrose Cística/epidemiologia , Fibrose Cística/microbiologia , Fibrose Cística/fisiopatologia , Dinamarca/epidemiologia , Feminino , Bactérias Gram-Negativas/isolamento & purificação , Bactérias Gram-Negativas/patogenicidade , Infecções por Bactérias Gram-Negativas/diagnóstico , Infecções por Bactérias Gram-Negativas/fisiopatologia , Humanos , Estudos Longitudinais , Pulmão/microbiologia , Pulmão/fisiopatologia , Masculino , Infecções por Mycobacterium não Tuberculosas/diagnóstico , Infecções por Mycobacterium não Tuberculosas/fisiopatologia , Micobactérias não Tuberculosas/isolamento & purificação , Micobactérias não Tuberculosas/patogenicidade , Testes de Função Respiratória/métodos , Testes de Função Respiratória/estatística & dados numéricos
20.
BMJ Case Rep ; 20152015 Aug 30.
Artigo em Inglês | MEDLINE | ID: mdl-26323978

RESUMO

Chromobacterium violaceum is a Gram-negative organism found in water and soil. C. violaceum is not usually pathogenic in humans; only approximately 150 human cases have been reported worldwide. C. violaceum bacteraemia progresses rapidly, leading to fatal sepsis on dissemination to multiple organs within a short time. We describe two cases of fatal septicaemia caused by C. violaceum in siblings. Our initial impression was that these cases were associated with an undiagnosed immunodeficiency in the siblings. However, detailed patient histories revealed a potential underlying immunodeficiency in only one patient. These findings prompted us to investigate possible environmental exposure. We identified C. violaceum in filtered water that was sold to the family at a nearby store. This discovery led to a public health alert and closer scrutiny of similar stores by the Ministry of Health.


Assuntos
Chromobacterium/isolamento & purificação , Água Potável/microbiologia , Infecções por Bactérias Gram-Negativas/diagnóstico , Convulsões/etiologia , Sepse/diagnóstico , Irmãos , Criança , Pré-Escolar , Evolução Fatal , Febre/etiologia , Infecções por Bactérias Gram-Negativas/tratamento farmacológico , Infecções por Bactérias Gram-Negativas/microbiologia , Infecções por Bactérias Gram-Negativas/fisiopatologia , Humanos , Masculino , Faringite/etiologia , Convulsões/microbiologia , Sepse/tratamento farmacológico , Sepse/microbiologia , Sepse/fisiopatologia , Fatores de Tempo , Vômito/etiologia
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