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1.
Medicine (Baltimore) ; 99(28): e21113, 2020 Jul 10.
Artigo em Inglês | MEDLINE | ID: mdl-32664134

RESUMO

RATIONALE: Emphysematous osteomyelitis is a rare disease caused by gas-forming bacteria. But only 45 cases have been reported in the literature since then. PATIENT CONCERNS: A 72-year-old female presented to our hospital with severe lower back pain that aggravated 4 days ago. DIAGNOSES: Computed tomography (CT) revealed intraosseous mottled air in the T12 and L1 vertebral bodies and epidural space. The enhanced T1 and T2 magnetic resonance imaging scans showed heterogeneous signal intensity of vertebral bodies, suggestive of emphysematous osteomyelitis. INTERVENTIONS: Surgery was performed to identify culture strains and to remove emphysematous lesions of the vertebral body using extensive transpedicular irrigation. OUTCOMES: Escherichia coli (E coli) was identified in the surgical specimen, and intravenous antibiotic therapy was continued with cefotaxime. The patient had a significant decrease in lower back pain after the surgery and the final CT scan before discharge revealed significantly decreased air at T12 and L1 vertebral bodies and no air density in the epidural space. LESSONS: We present a patient diagnosed with emphysematous osteomyelitis in vertebral bodies caused by E coli and successfully treated with surgical intervention.


Assuntos
Enfisema/diagnóstico , Infecções por Escherichia coli/diagnóstico , Vértebras Lombares , Osteomielite/diagnóstico , Doenças da Coluna Vertebral/diagnóstico , Vértebras Torácicas , Idoso , Enfisema/etiologia , Escherichia coli/isolamento & purificação , Infecções por Escherichia coli/complicações , Infecções por Escherichia coli/microbiologia , Feminino , Humanos , Imagem por Ressonância Magnética , Osteomielite/complicações , Doenças Raras , Doenças da Coluna Vertebral/complicações , Tomografia Computadorizada por Raios X
2.
PLoS Negl Trop Dis ; 14(6): e0008375, 2020 06.
Artigo em Inglês | MEDLINE | ID: mdl-32603324

RESUMO

BACKGROUND: Acute gastroenteritis (AGE) is a major cause of morbidity and mortality in children aged less than 5 years in low- and middle-income countries where limited access to potable water, poor sanitation, deficient hygiene, and food product contamination are prevalent. Research on the changing etiology of AGE and associated risk factors in Latin America, including Colombia, is essential to understand the epidemiology of these infections. The primary objectives of this study were to describe etiology of moderate to severe AGE in children less than 5 years of age from Bucaramanga, Colombia, a middle-income country in Latin American, and to identify the presence of emerging E. coli pathotypes. METHODOLOGY/PRINCIPAL FINDINGS: This was a prospective, matched for age, case-control study to assess the etiology of moderate to severe AGE in children less than 5 years of age in Bucaramanga, Colombia, South America. We tested for 24 pathogens using locally available diagnostic testing, including stool culture, polymerase chain reaction, microscopy and enzyme-linked immunoassay. Adjusted attributable fractions were calculated to assess the association between AGE and each pathogen in this study population. The study included 861 participants, 431 cases and 430 controls. Enteric pathogens were detected in 71% of cases and in 54% of controls (p = <0.001). Co-infection was identified in 28% of cases and in 14% of controls (p = <0.001). The adjusted attributable fraction showed that Norovirus GII explained 14% (95% CI: 10-18%) of AGE, followed by rotavirus 9.3% (6.4-12%), adenovirus 3% (1-4%), astrovirus 2.9% (0.6-5%), enterotoxigenic Escherichia coli (ETEC) 2.4% (0.4-4%), Cryptosporidium sp. 2% (0.5-4%), Campylobacter sp. 2% (0.2-4%), and Salmonella sp.1.9% (0.3 to 3.5%). Except for Cryptosporidium, all parasite infections were not associated with AGE. Three emergent diarrheagenic E. coli pathotypes were identified in cases (0.7%), including an enteroaggregative/enterotoxigenic E.coli (EAEC/ETEC), an enteroaggregative/enteropathogenic E.coli (EAEC/EPEC), and an emergent enteroinvasive E. coli with a rare O96:H19. No deaths were reported among cases or controls. CONCLUSIONS/SIGNIFICANCE: Norovirus and rotavirus explained the major proportion of moderate to severe AGE in this study. Higher proportion of infection in cases, in the form of single infections or co-infections, showed association with AGE. Three novel E. coli pathotypes were identified among cases in this geographic region.


Assuntos
Gastroenterite/epidemiologia , Gastroenterite/etiologia , Gastroenterite/microbiologia , Gastroenterite/virologia , Adenoviridae , Infecções por Adenoviridae/complicações , Infecções por Adenoviridae/epidemiologia , Infecções por Astroviridae/complicações , Infecções por Astroviridae/epidemiologia , Infecções por Caliciviridae/complicações , Infecções por Caliciviridae/epidemiologia , Campylobacter , Infecções por Campylobacter/complicações , Infecções por Campylobacter/epidemiologia , Estudos de Casos e Controles , Pré-Escolar , Coinfecção/microbiologia , Coinfecção/virologia , Colômbia/epidemiologia , Criptosporidiose/complicações , Criptosporidiose/epidemiologia , Cryptosporidium , Diarreia/epidemiologia , Diarreia/etiologia , Diarreia/microbiologia , Diarreia/virologia , Escherichia coli Enterotoxigênica , Infecções por Escherichia coli/complicações , Infecções por Escherichia coli/epidemiologia , Feminino , Humanos , Lactente , Recém-Nascido , Masculino , Norovirus , Reação em Cadeia da Polimerase , Rotavirus , Infecções por Rotavirus/complicações , Infecções por Rotavirus/epidemiologia , Salmonella , Infecções por Salmonella/complicações , Infecções por Salmonella/epidemiologia
3.
Artigo em Inglês | MEDLINE | ID: mdl-32708640

RESUMO

Shiga toxin-producing Escherichia coli (STEC) infections result in a significant public health impact because of the severity of the disease that, in young children especially, can lead to hemolytic-uremic syndrome (HUS). A rise in the number of HUS cases was observed in the Apulia region of Italy from 2013 to 2017, and so, in 2018, a symptom-based surveillance system for children with bloody diarrhea (BD) was initiated in order to detect and manage STEC infections. The objective of the study was to describe the epidemiology of STEC infections in children from June 2018 to August 2019. Children <15 years old with BD were hospitalized and tested for STEC. Real-time PCR for virulence genes (stx1, stx2, eae) and serogroup identification tests were performed on stool samples/rectal swabs of cases. STEC infection was detected in 87 (10.6%) BD cases. The median age of STEC cases was 2.7 years, and 60 (68.9%) were <4. Of these 87 cases, 12 (13.8%) came from households with diarrhea. The reporting rate was 14.2/100,000, with the highest incidence in cases from the province of Bari (24.2/100,000). Serogroups O26 and O111 were both detected in 22/87 (25.3%) cases. Co-infections occurred in 12.6% of cases (11/87). Twenty-nine STEC were positive for stx1, stx2, and eae. Five cases (5.7%) caused by O26 (n = 2), O111 (n = 2), and O45 (n = 1) developed into HUS. A risk-oriented approach based on the testing of children with BD during the summer may represent a potentially beneficial option to improve the sensitivity of STEC surveillance, not only in Italy but also in the context of Europe as a whole.


Assuntos
Infecções por Escherichia coli , Escherichia coli Shiga Toxigênica , Adolescente , Criança , Pré-Escolar , Diarreia/epidemiologia , Diarreia/etiologia , Infecções por Escherichia coli/complicações , Infecções por Escherichia coli/epidemiologia , Proteínas de Escherichia coli , Fezes , Humanos , Itália/epidemiologia , Escherichia coli Shiga Toxigênica/genética
4.
PLoS One ; 15(6): e0235294, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32598400

RESUMO

Drosophila melanogaster's blood cells (hemocytes) play essential roles in wound healing and are involved in clearing microbial infections. Here, we report the transcriptional changes of larval plasmatocytes after clean injury or infection with the Gram-negative bacterium Escherichia coli or the Gram-positive bacterium Staphylococcus aureus compared to hemocytes recovered from unchallenged larvae via RNA-Sequencing. This study reveals 676 differentially expressed genes (DEGs) in hemocytes from clean injury samples compared to unchallenged samples, and 235 and 184 DEGs in E. coli and S. aureus samples respectively compared to clean injury samples. The clean injury samples showed enriched DEGs for immunity, clotting, cytoskeleton, cell migration, hemocyte differentiation, and indicated a metabolic reprogramming to aerobic glycolysis, a well-defined metabolic adaptation observed in mammalian macrophages. Microbial infections trigger significant transcription of immune genes, with significant differences between the E. coli and S. aureus samples suggesting that hemocytes have the ability to engage various programs upon infection. Collectively, our data bring new insights on Drosophila hemocyte function and open the route to post-genomic functional analysis of the cellular immune response.


Assuntos
Proteínas de Drosophila/genética , Drosophila melanogaster/genética , Infecções por Escherichia coli/complicações , Hemócitos/metabolismo , Sepse/genética , Infecções Estafilocócicas/complicações , Infecção dos Ferimentos/genética , Animais , Drosophila melanogaster/crescimento & desenvolvimento , Drosophila melanogaster/microbiologia , Escherichia coli/isolamento & purificação , Infecções por Escherichia coli/microbiologia , Feminino , Hemócitos/microbiologia , Incidência , Larva/genética , Larva/microbiologia , Masculino , RNA-Seq/métodos , Sepse/epidemiologia , Sepse/microbiologia , Infecções Estafilocócicas/microbiologia , Staphylococcus aureus/isolamento & purificação , Infecção dos Ferimentos/epidemiologia , Infecção dos Ferimentos/microbiologia
5.
BMC Infect Dis ; 20(1): 342, 2020 May 13.
Artigo em Inglês | MEDLINE | ID: mdl-32404129

RESUMO

BACKGROUND: Purulent pericarditis is an infectious disease, frequently caused by gram-positive bacteria, that is rarely observed in healthy individuals, and is often associated with predisposing conditions. CASE PRESENTATION: Here, we present the case of an Escherichia coli post-surgical localized purulent pericarditis complicated by transient constrictive pericarditis and its diagnostic and therapeutic management. CONCLUSIONS: Our case report focuses on the importance of imaging-guided treatment of purulent pericardial diseases, in particular on the emerging role of 18 F-labelled 2-fluoro-2-deoxy-D-glucose Positron Emission Tomography/Computed Tomography in pericardial diseases and on the management of transient constrictive pericarditis, often seen after thoracic surgery.


Assuntos
Abscesso/complicações , Estenose da Valva Aórtica/cirurgia , Infecções por Escherichia coli/complicações , Escherichia coli/isolamento & purificação , Pericardite Constritiva/diagnóstico por imagem , Pericardite Constritiva/microbiologia , Infecções Relacionadas à Prótese/complicações , Abscesso/tratamento farmacológico , Antibacterianos/uso terapêutico , Colchicina/uso terapêutico , Infecções por Escherichia coli/tratamento farmacológico , Infecções por Escherichia coli/microbiologia , Fluordesoxiglucose F18 , Seguimentos , Supressores da Gota/uso terapêutico , Humanos , Masculino , Pessoa de Meia-Idade , Pericardite Constritiva/tratamento farmacológico , Tomografia Computadorizada com Tomografia por Emissão de Pósitrons , Infecções Relacionadas à Prótese/microbiologia , Resultado do Tratamento
6.
Artigo em Inglês | MEDLINE | ID: mdl-32366011

RESUMO

(1) Background: In response to the notification made by an elementary school authority that reported a number of elementary school children being absent in three schools as a result of gastroenteritis symptoms on 4 July 2018, in Gyeongsangbuk-Do Province, South Korea, an epidemic investigation was carried out to determine the extent, cause, and source of the outbreak in order to prevent secondary cases and make recommendations to prevent future recurrences. (2) Methods: In this epidemiologic study, a total of 106 human subjects (school children, staff members, and cooks) who had consumed the possibly contaminated foodstuffs were enrolled retrospectively. Human specimens from clinically defined cases, food and drinks, supply and storage of them, and environmental and sanitary conditions were also assessed by observation, laboratory tests, and survey questionnaires-where and whatever applicable. The attack rate and positive rate for human specimens were first presented followed by the calculation of the relative risk ratio (RR) with 95% CI (confidence intervals) in order to identify the exposure and outcome relationships. (3) Results: The attack rate was 12.26% (13/106) for those who had ingested the food items at the three schools and the positive rate of enteropathogenic Escherichia coli (EPEC) was 15.38% (2/13). The relative risk (RR) of developing food poisoning of those who consumed the cucumber chili with ssamjang and seasoned cucumber and chives were 4.55 (95% CI 1.05-19.54) and 9.20 (95% CI 1.24-68.22), respectively. In addition, within the human specimens as well as the water and environmental samples different strains of diarrhoeagenic enteropathogenic Escherichia coli (EPEC) were detected. (4) Conclusions: Provision of safe and wholesome water access to all elementary schools by concerned authorities, especially during the likely seasons of water source contamination, as well as health education promotion about foodborne outbreaks to all school stakeholders is therefore recommended.


Assuntos
Diarreia , Surtos de Doenças , Escherichia coli Enteropatogênica , Infecções por Escherichia coli , Infecções , Criança , Diarreia/epidemiologia , Diarreia/microbiologia , Infecções por Escherichia coli/complicações , Infecções por Escherichia coli/epidemiologia , Humanos , República da Coreia/epidemiologia , Estudos Retrospectivos , Água
7.
Rev. cuba. med. trop ; 72(1): e429, ene.-abr. 2020. tab, graf
Artigo em Espanhol | LILACS, CUMED | ID: biblio-1126702

RESUMO

Introducción: En los países en vías de desarrollo las enfermedades diarreicas agudas son causa frecuente de morbilidad y mortalidad. Entre las primeras causas se encuentra Escherichia coli diarrogénicos, que afecta a pacientes en edades extremas de la vida y con inmunodeficiencias. Objetivo: Identificar los patotipos de Escherichia coli diarrogénicos que más inciden y los fenotipos de resistencia antimicrobiana expresados por el patotipo predominante. Métodos: Se estudiaron 184 aislamientos procedentes de 15 centros provinciales de Higiene, Epidemiología y Microbiología de Cuba e Isla de la Juventud. La investigación se realizó desde julio de 2012 hasta febrero de 2014. La identificación de género, especie y patotipos fue realizada por métodos de diagnóstico convencional y molecular. La determinación de la susceptibilidad antimicrobiana se realizó por el método de Bauer y Kirby, y las normas del Clinical and Laboratory Institute Standards de 2013. Resultados: Se identificaron 108 (58 por ciento) Escherichia coli diarrogénicos. Los patotipos confirmados fueron: en la PCR múltiple 1, 5 (6 por ciento) de Escherichia coli enteropatogénico, 4 (4 por ciento) de enterotoxigénico y 0 (0 por ciento) de enterohemorrágico. La PCR múltiple 2 reveló 72 (82 por ciento) Escherichia coli enteroagregativo, que resultó el predominante en el estudio. La PCR 3 (simple) detectó 7 (8 por ciento) de enteroinvasivo. El 100 por ciento del patotipo predominante mostró resistencia, al menos a un antimicrobiano de los probados, un solo patron de resistencia a dos antimicrobianos, y nueve patrones de multirresistencia. Conclusiones: El estudio demuestra la importancia del uso de pruebas moleculares rápidas para la confirmación de los patotipos de E. coli diarrogénicos, los que provocan deshidratación ligera, complicaciones graves y la muerte. Se logra identificar los cuatro patotipos más frecuentes y E. coli enteroagregativo, el de mayor incidencia en la población estudiada. El patotipo predominante mostró altos porcentaje de resistencia antimicrobiana a betalactámicos y buena sensibilidad antimicrobiana a los aminoglucósidos y cefalosporinas de tercera generación. La investigación aporta conocimientos, no revelados en estudios anteriores con aislados cubanos, lo que es considerado de alto valor para los clínicos, pediatras y epidemiólogos del país(AU)


Introduction: Acute diarrheal disease is a frequent cause of morbidity and mortality in developing countries. One of the leading causes is diarrheagenic Escherichia coli, which affects patients at extreme ages and with immunodeficiencies. Objective: Identify the most active pathotypes of diarrheagenic Escherichia coli and the antimicrobial resistance phenotypes expressed by the prevailing pathotype. Methods: A study was conducted from July 2012 to February 2014 of 184 isolates obtained from 15 provincial Hygiene, Epidemiology and Microbiology Centers in Cuba and the Isle of Youth. Identification of the genus, species and pathotypes was based on conventional and molecular diagnostic methods. Determination of antimicrobial susceptibility was performed by the Bauer-Kirby method in compliance with guidelines from the Clinical and Laboratory Standards Institute of 2013. Results: A total 108 (58 percent) diarrheagenic Escherichia coli were identified. The following pathotypes were confirmed: Multiplex PCR 1 revealed 5 (6 percent) enteropathogenic, 4 (4 percent) enterotoxigenic and 0 (0 percent ) enterohemorrhagic Escherichia coli. Multiplex PCR 2 found 72 (82 percent) enteroaggregative Escherichia coli, which was the prevailing type in the study. PCR 3 (simple) detected 7 (8 percent) enteroinvasive Escherichia coli. 100 percent of the prevailing pathotype displayed resistance to at least one of the antimicrobials tested, a single resistance pattern to two antimicrobials, and nine multiresistance patterns. Conclusions: The study showed the importance of the use of rapid molecular tests to confirm diarrheagenic E. coli pathotypes, which cause mild dehydration, serious complications and death. Identification could be done of the four most common pathotypes and enteroaggregative E. coli, the one with the highest incidence in the study population. The prevailing pathotype displayed high percentages of antimicrobial resistance to beta-lactams and good antimicrobial sensitivity to third-generation cephalosporins and aminoglycosides. The study contributed knowledge not revealed by previous research about Cuban isolates. Such information is considered to be highly valuable for clinicians, pediatricians and epidemiologists in the country(AU)


Assuntos
Humanos , Masculino , Feminino , Resistência Microbiana a Medicamentos/genética , Escherichia coli/isolamento & purificação , Escherichia coli/patogenicidade , Infecções por Escherichia coli/complicações
8.
Ann Rheum Dis ; 79(5): 605-611, 2020 05.
Artigo em Inglês | MEDLINE | ID: mdl-32179576

RESUMO

OBJECTIVES: Using a prospective research design, we evaluated the association between acquisition of diarrhoeagenic Escherichia coli (DEC) and development of reactive arthritis (ReA) and other reactive musculoskeletal (MSK) symptoms among international travellers. METHODS: A total of 526 study participants were asked to provide pretravel and post-travel stool samples and fill in questionnaires (pretravel, post-travel and 3-week follow-up). A multiplex quantitative PCR assay was deployed to detect five DEC comprising enteroaggregative E. coli, enteropathogenic E. coli, enterotoxigenic E. coli, enterohaemorrhagic E. coli and enteroinvasive E. coli and Salmonella, Shigella, Campylobacter, Yersinia, and Vibrio cholerae. Multivariate analysis was employed to identify factors predisposing to MSK symptoms. New post-travel MSK symptoms reported by participants with DEC were assessed by phone interviews and, if needed, clinically confirmed. RESULTS: From among the total of 224 volunteers who returned all questionnaires and stool specimens, 38 (17.0%) reported MSK symptoms. Multivariate analysis revealed that acquisition of DEC was associated with MSK symptoms (OR 3.9; 95% CI 1.2 to 13.3). Of the 151 with only-DEC, four (2.6%) had ReA, two (1.3%) reactive tendinitis and three (2.0%) reactive arthralgia. ReA was mostly mild, and all patients with ReA were negative for human leucocyte antigen B27. Antibiotic treatment of travellers' diarrhoea did not prevent development of MSK symptoms. CONCLUSION: A total of 17% of volunteers reported post-travel MSK symptoms. DEC acquisition was associated with an increased risk of developing them, yet the ReA incidence remained low and the clinical picture mild. Antibiotic treatment did not protect against development of MSK symptoms.


Assuntos
Antibacterianos/uso terapêutico , Artrite Reativa/epidemiologia , Diarreia/complicações , Infecções por Escherichia coli/complicações , Doenças Musculoesqueléticas/epidemiologia , Doença Relacionada a Viagens , Centros Médicos Acadêmicos , Artrite Reativa/etiologia , Artrite Reativa/fisiopatologia , Estudos de Coortes , Diarreia/diagnóstico , Diarreia/microbiologia , Escherichia coli/patogenicidade , Infecções por Escherichia coli/diagnóstico , Feminino , Finlândia , Humanos , Incidência , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Reação em Cadeia da Polimerase Multiplex/métodos , Análise Multivariada , Doenças Musculoesqueléticas/etiologia , Doenças Musculoesqueléticas/fisiopatologia , Prognóstico , Estudos Prospectivos , Medição de Risco , Índice de Gravidade de Doença
9.
Am J Pathol ; 190(4): 830-843, 2020 04.
Artigo em Inglês | MEDLINE | ID: mdl-32035059

RESUMO

The molecular mechanisms of prostate inflammation are unclear. We hypothesized that heme oxygenase 1 (HMOX1; HO-1), an enzyme responsible for degradation of heme to carbon monoxide, bilirubin, and iron, is an important regulator of inflammation and epithelial responses in the prostate. Injection of non-uropathogenic Escherichia coli (MG1655 strain) or phosphate-buffered saline into the urethra of mice led to increased numbers of CD45+ leukocytes and mitotic markers (phosphorylated histone H3 and phosphorylated ERK1/2) in the prostate glands. Leukocyte infiltration was elevated in the prostates harvested from mice lacking HO-1 in myeloid compartment. Conversely, exogenous carbon monoxide (250 ppm) increased IL-1ß levels and suppressed cell proliferation in the prostates. Carbon monoxide did not affect the number of infiltrating CD45+ cells in the prostates of E. coli- or phosphate-buffered saline-treated mice. Interestingly, immunomodulatory effects of HO-1 and/or carbon monoxide correlated with early induction of the long-chain acyl-CoA synthetase 1 (ACSL1). ACSL1 levels were elevated in response to E. coli treatment, and macrophage-expressed ACSL1 was in part required for controlling of IL-1ß expression and prostate cancer cell colony growth in soft agar. These results suggest that HO-1 and/or carbon monoxide might play a distinctive role in modulating prostate inflammation, cell proliferation, and IL-1ß levels in part via an ACSL1-mediated pathway.


Assuntos
Infecções por Escherichia coli/complicações , Heme Oxigenase-1/metabolismo , Heme/metabolismo , Inflamação/imunologia , Metabolismo dos Lipídeos/imunologia , Proteínas de Membrana/metabolismo , Próstata/imunologia , Animais , Bilirrubina/metabolismo , Monóxido de Carbono/metabolismo , Proliferação de Células , Coenzima A Ligases/genética , Coenzima A Ligases/metabolismo , Escherichia coli/imunologia , Infecções por Escherichia coli/microbiologia , Heme Oxigenase-1/genética , Inflamação/metabolismo , Inflamação/microbiologia , Inflamação/patologia , Interleucina-1beta/genética , Interleucina-1beta/metabolismo , Macrófagos/imunologia , Macrófagos/metabolismo , Macrófagos/patologia , Masculino , Proteínas de Membrana/genética , Camundongos , Camundongos Endogâmicos C57BL , Próstata/metabolismo , Próstata/microbiologia , Próstata/patologia , Transdução de Sinais
10.
Nervenarzt ; 91(4): 343-348, 2020 Apr.
Artigo em Alemão | MEDLINE | ID: mdl-32086534

RESUMO

Posterior reversible encephalopathy (PRES) is a clinical syndrome characterized by headaches, seizures, cortical blindness, and altered mental status up to coma and by a radiological syndrome defined by edematous alteration on Magnetic Resonance Imaging (MRI)-Scans of the white matter. In the following, we present the case of a 73 years old post-operative patient with PRES in the context of hypertension and endocarditis with E. coli. The initial presentation included a series of seizures, sopor, and cortical blindness. In MRI-Scans a marked cerebral edema could be identified. After successful treatment of underlying conditions, the patient has made a good recovery. However, homonymous hemianopsia towards right due to laminar necrosis in the left occipital lobe remained as a residuum.


Assuntos
Endocardite , Infecções por Escherichia coli , Síndrome da Leucoencefalopatia Posterior , Hipertensão Arterial Pulmonar , Idoso , Endocardite/diagnóstico por imagem , Endocardite/etiologia , Escherichia coli , Infecções por Escherichia coli/complicações , Feminino , Humanos , Imagem por Ressonância Magnética , Síndrome da Leucoencefalopatia Posterior/diagnóstico por imagem , Hipertensão Arterial Pulmonar/etiologia , Resultado do Tratamento
11.
G Ital Cardiol (Rome) ; 21(3): 224-227, 2020 Mar.
Artigo em Italiano | MEDLINE | ID: mdl-32100735

RESUMO

We report a case of acute myocarditis associated with pericarditis in a patient hospitalized for urinary tract infection due to Escherichia coli. To the best of our knowledge, there are no prior descriptions of acute myocarditis associated with pericarditis during Escherichia coli infections in the absence of sepsis. In our patient, myocardial damage has been accurately documented by electrocardiography, echocardiography and magnetic resonance imaging. Inclusion of magnetic resonance imaging allows detection of myocardial inflammatory lesions that otherwise would have remained undiagnosed. The basic mechanisms of myocardial damage during Escherichia coli infection are unclear. Endotoxins might cause inflammatory reactions in the myocardium leading to myocyte damage. After initiation of antibiotic therapy, there was a rapid improvement of contractile function, with concomitant normalization of clinical and biochemical abnormalities. We discussed our findings in the context of the limited information available from the literature.


Assuntos
Infecções por Escherichia coli/complicações , Escherichia coli , Miocardite/etiologia , Pericardite/etiologia , Infecções Urinárias/microbiologia , Antibacterianos/uso terapêutico , Anti-Inflamatórios/uso terapêutico , Infecções por Escherichia coli/tratamento farmacológico , Humanos , Masculino , Pessoa de Meia-Idade , Miocardite/tratamento farmacológico , Pericardite/tratamento farmacológico , Resultado do Tratamento , Infecções Urinárias/tratamento farmacológico
12.
Sci Rep ; 10(1): 175, 2020 01 13.
Artigo em Inglês | MEDLINE | ID: mdl-31932743

RESUMO

Sepsis is typically triggered by an overwhelming systemic inflammatory response to pathogens, and may lead to severe organ dysfunction and/or death. Sepsis consequently has a high mortality rate and a high rate of complications for survivors, despite modern medical advances. Therefore, drug identification and validation for the treatment of sepsis is of the utmost importance. As a selective phosphodiesterase-4 inhibitor, rolipram also exhibits the abilities of inhibiting multiple pro-inflammatory cytokines production in macrophages and toxin-induced inflammation in mice. However, this drug has never been studied as a sepsis treatment method. We found that rolipram significantly improves survival in mice challenged with gram-negative bacterium E. coli, CLP, or E. coli derived lipopolysaccharide. We have also found that rolipram inhibits organ damage, pro-inflammatory cytokine production, and intracellular migration of early-stage inflammatory elements. Our results also show that rolipram increases anti-inflammatory cytokine production. The protective effects of rolipram on septic mice may result from inhibition of the MAP kinase and NF-κB signaling pathways. Rolipram may therefore be a potential novel sepsis treatment, one that would bypass the time-consuming and costly drug-discovery process.


Assuntos
Anti-Inflamatórios/farmacologia , Infecções por Escherichia coli/complicações , Inflamação/tratamento farmacológico , Substâncias Protetoras/farmacologia , Rolipram/farmacologia , Choque Séptico/tratamento farmacológico , Animais , Citocinas/metabolismo , Escherichia coli/fisiologia , Infecções por Escherichia coli/microbiologia , Inflamação/etiologia , Inflamação/patologia , Lipopolissacarídeos/toxicidade , Macrófagos/efeitos dos fármacos , Macrófagos/imunologia , Macrófagos/metabolismo , Masculino , Camundongos , Camundongos Endogâmicos C57BL , NF-kappa B/metabolismo , Inibidores da Fosfodiesterase 4/farmacologia , Choque Séptico/etiologia , Choque Séptico/patologia
13.
Arch Dis Child ; 105(7): 639-647, 2020 07.
Artigo em Inglês | MEDLINE | ID: mdl-31969351

RESUMO

BACKGROUND: Early onset neonatal sepsis (EOS) accounts for a significant portion of neonatal mortality, which accounts for 46% of global under five child mortality. OBJECTIVE: This systematic review studies the bacterial aetiology of EOS in the Middle East, susceptibility patterns to recommended empirical antibiotic therapy and whether this differs between high-income and middle-income countries in the region. METHODS: Articles were collected from Medline, Web of Science, the Cochrane Library and Index Medicus for the Eastern Mediterranean Region. The articles included in our systematic review met the following criteria: published after January 2000, data relevant to the Middle East, data specific for early onset sepsis, no language restriction. Data on aetiology and susceptibility were extracted from prospective and retrospective studies. Risk of bias was assessed using the Newcastle-Ottawa Scale. This study focused on EOS but does include data regarding neonatal late-onset sepsis antibiotic susceptibility. The data regarding coagulase-negative Staphylococcus species were excluded from final analysis, as possible contaminants. The protocol for this systematic review was registered on PROSPERO: CRD42017060662. RESULTS: 33 articles from 10 countries were included in the analysis. There were 2215 cases of culture-positive EOS, excluding coagulase-negative Staphylococcus. In middle-income countries, Klebsiella species (26%), Staphylococcus aureus (17%) and Escherichia coli (16%) were the most common pathogens, in contrast to group B Streptococcus (26%), E. coli (24%) and Klebsiella (9%) in high-income countries. Overall susceptibility to ampicillin/gentamicin and third-generation cephalosporin were 40% and 37%, respectively, in middle-income countries versus 93% and 91%, respectively, in high-income countries. CONCLUSIONS: EOS in middle-income countries was more likely to be due to Gram-negative pathogens and less likely to be susceptible to empirical antibiotic therapy. This has important public health implications regarding neonatal mortality in the Middle East region.


Assuntos
Antibacterianos/farmacologia , Países Desenvolvidos , Países em Desenvolvimento , Sepse/tratamento farmacológico , Sepse/microbiologia , Infecções por Escherichia coli/complicações , Humanos , Recém-Nascido , Infecções por Klebsiella/complicações , Testes de Sensibilidade Microbiana , Oriente Médio , Infecções Estafilocócicas/complicações , Staphylococcus aureus , Infecções Estreptocócicas/complicações , Fatores de Tempo
14.
J Anim Breed Genet ; 137(1): 60-72, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31482656

RESUMO

Enterotoxigenic Escherichia coli (ETEC) is the aetiological agent of postweaning diarrhoea (PWD) in piglets. The SNPs located on the Mucine 4 (MUC4) and Fucosyltransferase 1 (FUT1) genes have been associated with the susceptibility to ETEC F4 and ETEC F18, respectively. The interplay between the MUC4 and FUT1 genotypes to ETEC infection and the use of amoxicillin in modifying the intestinal microbiota during a natural infection by multiresistant ETEC strains have never been investigated. The aim of this study was to evaluate the effects of the MUC4 and FUT1 genotypes and the administration of amoxicillin through different routes on the presence of diarrhoea and the faecal microbiota composition in piglets naturally infected with ETEC. Seventy-one piglets were divided into three groups: two groups differing by amoxicillin administration routes-parenteral (P) or oral (O) and a control group without antibiotics (C). Faecal scores, body weight, presence of ETEC F4 and F18 were investigated 4 days after the arrival in the facility (T0), at the end of the amoxicillin administration (T1) and after the withdrawal period (T2). The faecal bacteria composition was assessed by sequencing the 16S rRNA gene. We described that MUC4 and FUT1 genotypes were associated with the presence of ETEC F4 and ETEC F18. The faecal microbiota was influenced by the MUC4 genotypes at T0. We found the oral administration to be associated with the presence of diarrhoea at T1 and T2. Furthermore, the exposure to amoxicillin resulted in significant alterations of the faecal microbiota. Overall, MUC4 and FUT1 were confirmed as genetic markers for the susceptibility to ETEC infections in pigs. Moreover, our data highlight that group amoxicillin treatment may produce adverse outcomes on pig health in course of multiresistant ETEC infection. Therefore, alternative control measures able to maintain a healthy faecal microbiota in weaners are recommended.


Assuntos
Amoxicilina/farmacologia , Diarreia/genética , Infecções por Escherichia coli/complicações , Fezes/microbiologia , Genótipo , Microbiota , Suínos/microbiologia , Amoxicilina/administração & dosagem , Amoxicilina/uso terapêutico , Animais , DNA Bacteriano/genética , Diarreia/complicações , Diarreia/tratamento farmacológico , Diarreia/microbiologia , Escherichia coli Enterotoxigênica/fisiologia , Polimorfismo de Nucleotídeo Único , Suínos/genética , Desmame
15.
J Trop Pediatr ; 66(1): 46-55, 2020 02 01.
Artigo em Inglês | MEDLINE | ID: mdl-31168590

RESUMO

OBJECTIVES: To evaluate the effect of bovine colostrum (BC) on the treatment of children with acute diarrhea attending the outpatient clinic. METHODS: This double-blind randomized controlled trial was conducted on 160 children with diarrhea; 80 cases were randomly treated with BC group and 80 cases randomly received placebo (placebo group). All cases were investigated for bacterial causes of diarrhea (Salmonella spp, Shigella spp, diarrheagenic E. coli (DEC), Campylobacter spp., and Vibrio cholerae) as well as for Rotavirus antigen in stool. RESULTS: After 48 h, the BC group had a significantly lower frequency of vomiting, diarrhea and Vesikari scoring compared with the placebo group (p = 0.000, p = 0.000, p = 0.000, respectively), whether it was due to Rotavirus or E. coli infection. CONCLUSIONS: BC is effective in the treatment of acute diarrhea and can be considered as adjuvant therapy in both viral and bacterial diarrhea to prevent diarrhea-related complications.


Assuntos
Colostro , Diarreia Infantil/terapia , Doença Aguda , Animais , Antígenos Virais/análise , Aleitamento Materno , Bovinos , Pré-Escolar , Diarreia Infantil/microbiologia , Diarreia Infantil/virologia , Método Duplo-Cego , Escherichia coli/isolamento & purificação , Infecções por Escherichia coli/complicações , Fezes/microbiologia , Fezes/virologia , Feminino , Humanos , Lactente , Fórmulas Infantis , Masculino , Rotavirus/isolamento & purificação , Infecções por Rotavirus/complicações
16.
Trop Anim Health Prod ; 52(4): 1599-1607, 2020 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-31828572

RESUMO

This study is aimed to appraise the impact of dietary supplementation with Echinacea purpurea (EP) in broiler chickens infected by pathogenic E. coli. Eighty-one-day-old chicks of both sexes, commercial Hubbard chicks, were divided into 4 groups. The first was kept as normal control, the second was supplemented by EP (5 mg/kg feed) from the first day to the end, where the third was infected orally by 1 ml E. coli O78 at 107 CFU intra-crop at 7 days old, while the last group was supplemented by EP and infected by the E. coli O78 as previously described . E. coli-infected chicks disclosed severe symptoms with mortality 30%. Where, the infected and EP supplemented group showed less clinical symptoms and 15% mortality. EP-supplemented groups showed a significant improvement in their body weight in comparing with infected group. E. coli-infected chickens revealed a significant drop in lymphocytes' number with a significant elevation in monocyte and heterophils with non-significant changes in total leucocyte count when matched with gp. (1), while the fourth group revealed non-significant changes in total leucocyte with a significant drop in heterophils and monocyte and a significant elevation in the lymphocytes matching with the 3rd group. Serum biochemical markers of liver, kidneys, and immunological parameters showed sever adverse alterations associated with E. coli infection. Dietary supplementations with Echinacea purpurea improve the final body weight and immune response of non-infected chicks and have a respectable effect for facing E. coli infection. EP improves hematological and serum biochemical adverse effects occured by E. coli infection. Histopathology of liver, kidneys, intestines, and spleen confirms these alterations.


Assuntos
Galinhas , Suplementos Nutricionais , Echinacea , Infecções por Escherichia coli/veterinária , Ração Animal/análise , Animais , Peso Corporal , Dieta/veterinária , Escherichia coli , Infecções por Escherichia coli/complicações , Feminino , Intestinos/efeitos dos fármacos , Fígado , Masculino , Baço
17.
Pediatr Int ; 62(3): 308-315, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-31742829

RESUMO

Hemolytic - uremic syndrome (HUS) is a severe complication of infection by Shiga toxin (STx)-producing enterohemorrhagic Escherichia coli. Hemolytic - uremic syndrome is defined clinically as a triad of non-immune microangiopathic hemolytic anemia, thrombocytopenia, and acute kidney injuries. Neurologic complications such as acute encephalopathy are also observed. In humans, endothelial cells, proximal tubular epithelial cells, mesangial cells, podocytes, intestinal epithelial cells, and monocytes / macrophages are susceptible to STx-mediated injury. Shiga toxin induces the secretion of inflammatory cytokines and chemokines from susceptible cells, including tumor necrosis factor-α interleukin (IL)-1, IL-6, and IL-8. These cytokines and chemokines contribute to the pathogenesis of HUS and encephalopathy by enhancing STx-induced cytotoxicity and inducing inflammatory cell infiltration. Serum cytokine/chemokine levels are therefore useful as indicators of disease activity and predictors of progression from acute kidney injury to chronic kidney disease. Anti-inflammation therapy combined with apheresis to remove excessive cytokines / chemokines and methylprednisolone pulse therapy to suppress cytokine/chemokine production may be an effective treatment regimen for severe E. coli-associated HUS. However, this regimen requires careful monitoring of potential side effects, such as infections, thrombus formation, and hypertension.


Assuntos
Quimiocinas/sangue , Citocinas/sangue , Escherichia coli Êntero-Hemorrágica/isolamento & purificação , Infecções por Escherichia coli/complicações , Síndrome Hemolítico-Urêmica/etiologia , Lesão Renal Aguda/sangue , Lesão Renal Aguda/etiologia , Biomarcadores/sangue , Encefalopatias/sangue , Encefalopatias/etiologia , Infecções por Escherichia coli/sangue , Infecções por Escherichia coli/patologia , Síndrome Hemolítico-Urêmica/sangue , Síndrome Hemolítico-Urêmica/patologia , Humanos , Prognóstico , Índice de Gravidade de Doença , Toxinas Shiga/efeitos adversos
18.
Int Immunopharmacol ; 78: 105798, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31784403

RESUMO

The objective of the present study was to evaluate the effects of low-molecular-weight chitosan (LMWC) on the growth performance, immune responses and intestinal health of weaned pigs challenged by enterotoxigenic Escherichia coli (ETEC). A total of 32 weaned pigs were randomly allocated to four treatments: non-challenged (fed with basal diet), ETEC-challenged (fed with basal diet) and ETEC-challenged plus 50 or 100 mg/kg LMWC supplementation, respectively. After 11 days feeding, the non-challenged pigs were infused with sterilised Luria-Bertani culture, while the remaining pigs were infused with 2.6 × 1011 colony-forming units of ETEC. At 3 days post-challenge, all pigs were administered d-xylose at 0.1 g/kg body weight. One hour later, blood samples were obtained, and the pigs then euthanised to collect intestinal samples. Data showed that only 100 mg/kg LMWC supplementation attenuated (P < 0.05) the average daily gain reduction caused by ETEC. Furthermore, besides the decreased (P < 0.05) serum tumour necrosis factor-α and immunoglobulin (Ig) G concentrations detected in ETEC-challenged pigs supplemented with LMWC at 50 or 100 mg/kg, the higher dose (100 mg/kg) also decreased (P < 0.05) the serum IgM concentration and increased (P < 0.05) the villus height and villus height-to-crypt depth ratio in both the jejunum and ileum, and the sucrase activity in the ileal mucosa. Moreover, LMWC supplementation (50 or 100 mg/kg) in ETEC-challenged pigs elevated (P < 0.05) the mRNA levels of jejunal mucosal peptide transporter 1 and ileal mucosal peptide transporter 1, divalent metal transporter 1 and zinc transporter 1, and decreased (P < 0.05) the ileal and caecal E. coli abundances, while 100 mg/kg LMWC additionally elevated (P < 0.05) the ileal Bacillus abundance, and caecal and colonic Bifidobacterium abundances. These results suggest that LMWC helps alleviate ETEC-induced growth retardation in weaned pigs, which could be associated with the inhibition of the immune responses and improved intestinal health.


Assuntos
Quitosana/uso terapêutico , Suplementos Nutricionais , Escherichia coli Enterotoxigênica , Infecções por Escherichia coli/dietoterapia , Transtornos do Crescimento/dietoterapia , Animais , Quitosana/química , Citocinas/sangue , Infecções por Escherichia coli/sangue , Infecções por Escherichia coli/complicações , Infecções por Escherichia coli/patologia , Transtornos do Crescimento/sangue , Transtornos do Crescimento/etiologia , Transtornos do Crescimento/patologia , Imunoglobulinas/sangue , Intestinos/efeitos dos fármacos , Intestinos/enzimologia , Intestinos/patologia , Lactase/sangue , Peso Molecular , Sacarase/sangue , Suínos , Desmame , alfa-Glucosidases/sangue
20.
Medicine (Baltimore) ; 98(44): e17833, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31689871

RESUMO

RATIONALE: Acute myocarditis complicated with complete atrioventricular block (CAVB) is rare in clinical scenario. We report an uncommon case of myocarditis complicated with permanent CAVB caused by Escherichia coli (E coli) bacteremia. PATIENT CONCERNS: A 77-year-old woman presented at the emergency department with chest pain, dizziness, nausea, and cold sweats of 1-day duration. She had histories of type 2 diabetes mellitus, hyperlipidemia, and chronic kidney disease with regular medical therapy. DIAGNOSIS: Both blood and urine cultures were positive for E coli. Regional inferior wall motion abnormalities on echocardiography, unexplained life-threatening arrhythmias, newly abnormal electrocardiogram, elevated cardiac troponins, and healthy coronary arteries on angiography were consistent with E coli-induced myocarditis. INTERVENTIONS: The patient received implantation of a dual-chamber pacemaker because of irreversible CAVB. OUTCOMES: The patient was discharged on day 8 and remained asymptomatic at 15 months of follow-up, with ST-segment normalization and normal left ventricular function. LESSONS: This extremely rare case of E coli-induced myocarditis masquerading as acute STEMI and with permanent CAVB sequelae, highlights the importance of sensitivity to non-ischemia etiologies of ST-segment elevation and the potential impact of E coli sepsis on the cardiac conduction system.


Assuntos
Bloqueio Atrioventricular/microbiologia , Bacteriemia/complicações , Infecções por Escherichia coli/complicações , Miocardite/microbiologia , Doença Aguda , Idoso , Bloqueio Atrioventricular/terapia , Estimulação Cardíaca Artificial , Feminino , Humanos
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