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1.
Adv Exp Med Biol ; 1204: 141-167, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32152946

RESUMO

Galectins are differentially expressed in a variety of cell types, including immune cells, and characterized by the affinity for ß-galactoside-containing glycans. There are fifteen galectin members in mammals. Galectins are primarily located intracellularly, but can be secreted outside the cells. They exhibit pivotal roles during microbial infection, such as pathogen recognition and innate and adaptive immunity, and this review aims to discuss the functions of endogenous galectins during infection by four main types of microbes (bacteria, fungi, viruses, and parasites). Extracellular galectins are known to exert a bacteriostatic effect on some bacteria via association with bacterial glycans, whereas cytosolic galectins are recognized to control antibacterial autophagy by binding to luminal host glycans of ruptured endo-lysosomes. With regard to fungal infections, most studies deal with galectin-3. Galectin-3 modulates fungal burdens, the adaptive immune responses, and mortality in fungi-infected mice, which has been shown to be associated with its ability to manipulate fungicidal functions in neutrophils and cytokine expression in dendritic cells. Some viral infections, such as human immunodeficiency virus (HIV) and influenza virus infections, can be regulated by galectin-1 and -3, and they affect various aspects of viral infections, including viral binding, replication, budding, transmission, and infection-associated inflammation. Functions of galectins during a number of different parasitic infections have been identified in studies using galectin-knockout mice. Different parasitic infections have consistently demonstrated a role of galectins in tuning T helper immune responses in infected hosts.


Assuntos
Galectinas/imunologia , Infecções/imunologia , Animais , Humanos , Infecções/microbiologia , Infecções/parasitologia , Infecções/virologia , Polissacarídeos/química , Polissacarídeos/imunologia
2.
Nat Rev Neurol ; 16(4): 193-197, 2020 04.
Artigo em Inglês | MEDLINE | ID: mdl-32152461

RESUMO

The idea that infectious agents in the brain have a role in the pathogenesis of Alzheimer disease (AD) was proposed nearly 30 years ago. However, this theory failed to gain substantial traction and was largely disregarded by the AD research community for many years. Several recent discoveries have reignited interest in the infectious theory of AD, culminating in a debate on the topic at the Alzheimer's Association International Conference (AAIC) in July 2019. In this Viewpoint article, experts who participated in the AAIC debate weigh up the evidence for and against the infectious theory of AD and suggest avenues for future research and drug development.


Assuntos
Doença de Alzheimer/microbiologia , Encéfalo/microbiologia , Infecções/microbiologia , Doença de Alzheimer/etiologia , Doença de Alzheimer/genética , Apolipoproteína E4/genética , Borrelia burgdorferi , Chlamydophila pneumoniae , Herpesvirus Humano 1 , Herpesvirus Humano 6 , Herpesvirus Humano 7 , Humanos , Infecções/complicações , Porphyromonas gingivalis
4.
Zhonghua Yu Fang Yi Xue Za Zhi ; 54(2): 187-191, 2020 Feb 06.
Artigo em Chinês | MEDLINE | ID: mdl-32074708

RESUMO

Objective: To investigate the drug resistance pattern and drug resistance genotypes of Salmonella. spp isolated from fecal specimens and anal swabs of diarrhea cases in Anhui Province. Methods: The 149 strains of Salmonella.spp isolated from feces and anal swabs of diarrhea cases in Anhui Province from April to October 2017 were selected. The serotypes of Salmonella.spp were identified by slide agglutination. The susceptibility of all strains to 14 antibiotics were determined by micro-broth dilution method. Sixty of the cephalosporin-resistant antibiotics were selected. The ß-lactamase encoding genes bla(TEM), bla(SHV), bla(OXA-1), bla(OXA-2), bla(PER), bla(CMY), bla(CTX-M), and colistin resistance genes mcr-1 and mcr-2 were performed using the multi-PCR method. Results: Of the 149 diarrhea cases, the median (P(25), P(75)) of the age was 5.0 (1.1, 38.5). The 92 of them were male and 54.4% were children. Of the 149 strains of Salmonella.spp, 105 strains had different degrees of resistance to 13 antibiotics other than imipenem. The resistance rate of ampicillin was 55.0% (82/149), which was the highest. 53.0% strains (79 strains) were multidrug resistant, main of which were Salmonella typhimurium and Salmonella enteritidis. A total of 53 resistance patterns were detected, and 10 strains were resistant to ampicillin-ampicillin/sulbactam-tetracycline-chloramphenicol-cefazolin-trimethoprim/sulfamethoxazole, which was the most common resistance pattern. Among the 60 cephalosporin resistant strains, 45 strains carried bla(TEM-1), 6 of which also carried bla(CTX-M-14) and 3 of which also carried bla(CTX-M-65). All the 32 strains carried only bla(TEM-1) show resistance to ampicillin and 31 of them show resistance to cefazolin. There were 2 strains showing negative results of gene detection. mcr-1 was detected in a multidrug resistant strain. Conclusion: The resistance of Salmonella.spp to ampicillin shows a serious situation in this region, and there were a number of multidrug resistant strains. The bla(TEM-1) was the major drug resistance gene detected in this research. Detection of the mcr-1 suggests the emergence of surveillance to colistin resistance of Salmonella.spp in this area.


Assuntos
Farmacorresistência Bacteriana/genética , Infecções/microbiologia , Salmonella/efeitos dos fármacos , Salmonella/genética , Adolescente , Adulto , Antibacterianos/farmacologia , Criança , Pré-Escolar , China , Feminino , Humanos , Lactente , Infecções/tratamento farmacológico , Masculino , Salmonella/isolamento & purificação , Adulto Jovem
5.
BMC Infect Dis ; 20(1): 102, 2020 Feb 03.
Artigo em Inglês | MEDLINE | ID: mdl-32013908

RESUMO

BACKGROUND: Minimising antimicrobial overuse is needed to limit antimicrobial resistance. There is little evidence on how often microbiological testing informs antimicrobial de-escalation (e.g. stopping, shortening duration, switching to narrower spectrum or intravenous to oral switch) at 48-72 h "review and revise". We performed a patient level analysis of diagnostic microbiology and antimicrobial prescribing to determine the impact of microbiology results on antimicrobial review outcomes. METHODS: Antimicrobial prescribing data were collected for hospitalised adults from across Brighton and Sussex University Hospitals NHS Trust using routine monthly audits of prescribing practice from July 2016 to April 2017. Microbiology testing data for cultures of blood, urine, sputum and cerebrospinal fluid (CSF) were gathered from the hospital pathology database and linked to prescriptions with matching patient identification codes. Antimicrobial prescriptions were grouped into "prescription episodes" (PEs), defined as one or more antimicrobials prescribed to the same patient for the same indication. Medical records were reviewed for all PEs with positive microbiology and a randomised sample of those with negative results to assess the impact of the microbiology result on the antimicrobial prescription(s). RESULTS: After excluding topical and prophylactic prescriptions, data were available for 382 inpatient antimicrobial prescriptions grouped into 276 prescription episodes. 162/276 (59%) had contemporaneous microbiology sent. After filtering likely contaminants, 33/276 (12%) returned relevant positive results, of which 20/33 (61%) had antimicrobials changed from empiric therapy as a result with 6/33 (18%) prompting de-escalation. Positive blood and CSF tended to have greater impact than urine or sputum cultures. 124/276 (45%) PEs returned only negative microbiology, and this was documented in the medical notes less often (9/40, 23%) than positive results (28/33, 85%). Out of 40 reviewed PEs with negative microbiology, we identified just one (~ 3%) in which antimicrobials were unambiguously de-escalated following the negative result. CONCLUSIONS: The majority of diagnostic microbiology tests sent to inform clinical management yielded negative results. However, negative microbiology contributed little to clinical decision making about antimicrobial de-escalation, perhaps reflecting a lack of trust in negative results by treating clinicians. Improving the negative predictive value of currently available diagnostic microbiology could help hospital prescribers in de-escalating antimicrobial therapy.


Assuntos
Anti-Infecciosos/uso terapêutico , Prescrições de Medicamentos/estatística & dados numéricos , Infecções/tratamento farmacológico , Técnicas Microbiológicas/estatística & dados numéricos , Adulto , Líquido Cefalorraquidiano/microbiologia , Prescrições de Medicamentos/normas , Inglaterra , Hospitalização/estatística & dados numéricos , Humanos , Infecções/microbiologia , Pessoa de Meia-Idade , Escarro/microbiologia , Urina/microbiologia
8.
Arch Pathol Lab Med ; 144(1): 99-106, 2020 01.
Artigo em Inglês | MEDLINE | ID: mdl-31219343

RESUMO

CONTEXT.­: Infections are the leading cause of perinatal and infant mortality in low-income and low-resource countries, which have a higher prevalence of infections. Definitive diagnosis of congenital and perinatal infections is largely dependent upon the results of laboratory tests. OBJECTIVE.­: To develop a multiplex nested polymerase chain reaction (PCR) technique for the simultaneous detection of 7 pathogens containing DNA in their genomes in suspected cases of congenital infection. DESIGN.­: Eligible participants were pregnant women with positive immunoglobulin M antibodies raised to one of the pathogens in the prenatal serologic screening, associated or not with fetal ultrasound abnormalities or positive fetal serology. Neonates whose mothers did not attend prenatal care were included when they presented with symptomatology and laboratory parameters suggestive of infection. The detection rate of the multiplex nested PCR was compared with maternal, fetal, and neonatal serology, as well as placental immunohistochemistry and noncommercial amplifications. RESULTS.­: Of 161 suspected cases, the multiplex nested PCR detected 60 (37.3%), whereas the tests available in hospital laboratories detected 13 of 60 (21.7%) of the cases detected by the multiplex nested PCR, demonstrating a 4.6 times higher detection rate for the multiplex nested PCR (Fisher exact test, P < .001). Positive amplifications were to Toxoplasma gondii (32 cases), cytomegalovirus (14 cases), parvovirus B19 (5 cases), and adenovirus (5 cases). In 4 cases, 2 pathogens were simultaneously detected. All types of biological matrices were suitable for amplification. Sequencing of multiplex nested PCR products confirmed the molecular findings. CONCLUSIONS.­: The multiplex nested PCR significantly increased the number of diagnosed congenital infections. Given the scarcity of DNA recovered from amniotic fluid and some neonatal samples, this multiplex nested PCR allows the simultaneous detection of 7 pathogens associated with congenital infections in a reliable, faster, cost-effective, and more sensitive way.


Assuntos
Infecções/congênito , Infecções/diagnóstico , Infecções/microbiologia , Reação em Cadeia da Polimerase Multiplex/métodos , DNA de Protozoário/análise , DNA Viral/análise , Feminino , Humanos , Recém-Nascido , Gravidez
9.
Am J Hosp Palliat Care ; 37(1): 27-33, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31185722

RESUMO

BACKGROUND: Antibiotic use may increase hospital length of stay (LOS) among older patients with advanced cancer who are transitioned to comfort measures. METHODS: We studied a cohort of patients with advanced cancer aged ≥65 years who were transitioned to comfort measures during admission from July 1, 2014, through November 30, 2016. We evaluated the association between antibiotic exposure and LOS using a Poisson regression model adjusted for age, gender, cancer type, comorbidities, infection, and intensive care unit admission. RESULTS: Among 461 patients with advanced cancer, median age was 74 years (range: 65-99), 49.0% (n = 226) were female, and 20.6% (n = 95) had liquid tumors. Overall, 82.9% (n = 382) received ≥1 antibiotic and 64.6% (n = 298) had ≥1 infection diagnosis during hospitalization. Infection diagnoses commonly included sepsis (35%, n = 161/461), pneumonia (25%, n = 117/461), and urinary tract infection (14%, n = 66/461). Among those receiving antibiotics, the most common choices included vancomycin (79%, n = 300/382), cephalosporins (63%, n = 241/382), and penicillins (45%, n = 172/382). In a multivariable Poisson regression model, LOS was 34% longer (count ratio = 1.34, [95% confidence interval: 1.20-1.51]) among those exposed versus unexposed to antibiotics. CONCLUSIONS: Antibiotic use among patients with advanced cancer who are transitioned to comfort measures is associated with longer LOS. These data illustrate the importance of tradeoffs associated with antibiotic use, such as unintended increased LOS, when striving for goal-concordant care near the end of life.


Assuntos
Antibacterianos/uso terapêutico , Infecções/tratamento farmacológico , Infecções/epidemiologia , Neoplasias/epidemiologia , Neoplasias/patologia , Conforto do Paciente/organização & administração , Fatores Etários , Idoso , Idoso de 80 Anos ou mais , Antibacterianos/administração & dosagem , Comorbidade , Grupos de Populações Continentais , Feminino , Humanos , Infecções/microbiologia , Tempo de Internação , Masculino , Fatores Sexuais , Assistência Terminal/organização & administração , Fatores de Tempo
10.
BMC Infect Dis ; 19(1): 1066, 2019 Dec 19.
Artigo em Inglês | MEDLINE | ID: mdl-31856747

RESUMO

BACKGROUND: Symptomatic and asymptomatic enteric infections in early childhood are associated with negative effects on childhood growth and development, especially in low and middle-income countries, and food may be an important transmission route. Although basic food hygiene practices might reduce exposure to faecal pathogens and resulting infections, there have been few rigorous interventions studies to assess this, and no studies in low income urban settings where risks are plausibly very high. The aim of this study is to evaluate the impact of a novel infant food hygiene intervention on infant enteric infections and diarrhoea in peri-urban settlements of Kisumu, Kenya. METHODS: This is a cluster randomized control trial with 50 clusters, representing the catchment areas of Community Health Volunteers (CHVs), randomly assigned to intervention or control, and a total of 750 infants recruited on a rolling basis at 22 weeks of age and then followed for 15 weeks. The intervention targeted four key caregiver behaviours related to food hygiene: 1) hand washing with soap before infant food preparation and feeding; 2) bringing all infant food to the boil before feeding, including when reheating or reserving; 3) storing all infant food in sealed containers; and, 4) using only specific utensils for infant feeding which are kept separate and clean. RESULTS: The primary outcome of interest is the prevalence of one or more of 23 pre-specified enteric infections, determined using quantitative real-time polymerase chain reaction for enteric pathogen gene targets. In addition, infant food samples were collected at 33 weeks, and faecal indicator bacteria (Enterococcus) isolated and enumerated to assess the impact of the intervention on infant food contamination. CONCLUSION: To our knowledge this is the first randomized controlled trial to assess the effect of an infant food hygiene intervention on enteric infections in a high burden, low income urban setting. Our trial responds to growing evidence that food may be a key pathway for early childhood enteric infection and disease and that basic food hygiene behaviours may be able to mitigate these risks. The Safe Start trial seeks to provide new evidence as to whether a locally appropriate infant food hygiene intervention delivered through the local health extension system can improve the health of young children. TRIAL REGISTRATION: The trial was registered at clinicaltrial.gov on March 16th 2018 before enrolment of any participants (https://clinicaltrials.gov/ct2/show/NCT03468114).


Assuntos
Diarreia/epidemiologia , Diarreia/microbiologia , Enterite/epidemiologia , Enterite/microbiologia , Desinfecção das Mãos/métodos , Infecções/epidemiologia , Pobreza , Cuidadores , Culinária , Diarreia/prevenção & controle , Enterite/prevenção & controle , Enterococcus/isolamento & purificação , Fezes/microbiologia , Feminino , Contaminação de Alimentos/prevenção & controle , Armazenamento de Alimentos , Doenças Transmitidas por Alimentos/microbiologia , Doenças Transmitidas por Alimentos/prevenção & controle , Humanos , Lactente , Controle de Infecções , Infecções/microbiologia , Quênia/epidemiologia , Masculino , Saúde Pública , Sabões , Saúde da População Urbana
11.
J Aquat Anim Health ; 31(4): 354-363, 2019 12.
Artigo em Inglês | MEDLINE | ID: mdl-31765509

RESUMO

The order Saprolegniales (Class Oomycota) is a group of fungus-like eukaryotic microorganisms that have been associated with infections in fish and fish eggs. Infections with microorganisms from this order are clearly evident because they have a cotton wool-like appearance. The aim of this study was to characterize and identify an oomycete that was isolated from the eye of an Orange Blotched Peacock Cichlid Aulonacara sp. A sample of cotton wool-like mycelia was isolated and single-spore isolations were conducted. Molecular characterization and phylogenetic analysis of the ITS1-5.8-ITS2 rDNA region for all isolates were used for species identification. Following molecular identification, one isolate was used to culture and characterize the reproductive structures. Physiological characterization entailed incubating the isolate on potato dextrose agar (PDA) at five different temperatures, ranging from 5°C to 25°C, to monitor growth rates. A multiple sequence alignment showed 100% similarity between all of the single-spore isolates and alignment with other Achlya bisexualis strains. Long, coarse hyphae with zoosporangia and gemmae typical of the order Saprolegniales were observed with an optimal growth rate at 25°C. The oomycete that was isolated from an Orange Blotched Peacock Cichlid was identified as A. bisexualis, the first record of this species in South Africa.


Assuntos
Ciclídeos , Oftalmopatias/veterinária , Doenças dos Peixes/microbiologia , Infecções/veterinária , Saprolegnia/fisiologia , Animais , Oftalmopatias/microbiologia , Infecções/microbiologia , Saprolegnia/classificação , África do Sul
12.
Nature ; 575(7781): 130-136, 2019 11.
Artigo em Inglês | MEDLINE | ID: mdl-31695207

RESUMO

With rapidly changing ecology, urbanization, climate change, increased travel and fragile public health systems, epidemics will become more frequent, more complex and harder to prevent and contain. Here we argue that our concept of epidemics must evolve from crisis response during discrete outbreaks to an integrated cycle of preparation, response and recovery. This is an opportunity to combine knowledge and skills from all over the world-especially at-risk and affected communities. Many disciplines need to be integrated, including not only epidemiology but also social sciences, research and development, diplomacy, logistics and crisis management. This requires a new approach to training tomorrow's leaders in epidemic prevention and response.


Assuntos
Infecções/epidemiologia , Saúde Pública/tendências , Ciência/tendências , Métodos Epidemiológicos , História do Século XIX , História do Século XX , História do Século XXI , Controle de Infecções , Infecções/diagnóstico , Infecções/microbiologia , Infecções/virologia , Saúde Pública/história , Ciência/história
13.
Fish Shellfish Immunol ; 94: 327-335, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31491528

RESUMO

The lamprey is a primitive jawless vertebrate that occupies a critical phylogenetic position, and its larval stage represents the major portion of its life cycle [1]. Lamprey larvae have been proven to be an important model organism for studying numerous biological problems, such as the immune system, due to their unique biological features [2]. In addition, early-stage larvae have never been obtained from the wild [3]; therefore, it is necessary to establish artificial breeding of lampreys in the laboratory. However, during early development, the larvae exhibit susceptibility to saprolegniasis, and the immune responses of lamprey larvae to this infection remain poorly understood. Here, we established a model of fungal infection in lamprey larvae and then used RNA sequencing to investigate the transcript profiles of lamprey larvae and their immune responses to Saprolegnia ferax. Among the profiled molecules, genes involved in pathogen recognition, inflammation, phagocytosis, lysosomal degradation, soluble humoral effectors, and lymphocyte development were significantly upregulated. The results were validated by analysis of several genes by quantitative real-time PCR and whole-mount in situ hybridization. Finally, we performed a Western blot for VLRs in infected and uninfected lampreys. This work not only provides an animal model for studying fungal infection but also suggests a molecular basis for developing defensive strategies to manage Saprolegnia ferax infection.


Assuntos
Imunidade Adaptativa , Doenças dos Peixes/imunologia , Imunidade Inata , Lampreias , Transcriptoma/imunologia , Animais , Doenças dos Peixes/microbiologia , Perfilação da Expressão Gênica/veterinária , Infecções/imunologia , Infecções/microbiologia , Infecções/veterinária , RNA-Seq/veterinária , Saprolegnia/parasitologia
14.
Rev Invest Clin ; 71(4): 275-282, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31448779

RESUMO

Background: Rituximab is a monoclonal antibody that increases the disease-free and overall survival of patients with non-Hodgkin lymphoma (NHL) CD20+. The objective of this study is to describe the prevalence and spectrum of infections in patients with NHL receiving rituximab-containing chemotherapy and the impact on survival. Materials and Methods: From January 2011 to December 2012, all patients diagnosed with NHL who received at least one dose of rituximab were included. Results: During the study period, 265 patients received rituximab; 108 (40.8%) males; the mean age was 60 ± 15 years. There were 177 infections in 85 patients, being the most common febrile neutropenia (n = 38; 21.5%) and mucosal barrier injury-related infections (n = 28; 15.8%). In 88 events (49%), there was a microbiologic diagnosis, being bacterial infection the most frequent (39.6%), but tuberculosis (TB) was developed in 4 cases (1.5%; incidence rate 721/100,000 person-year). During follow-up, 71 patients died (27%); in 35 cases, it was related to infection. There were no differences in follow-up between those who died due to infection versus those who died from another cause (p = 0.188). Multivariate analysis for mortality showed that age >60 years, failure to achieve a complete response, and development of an infectious complication increased the risk of death. Conclusions: It is important to perform a screening test for TB in all patients who will receive rituximab and maintain a constant monitoring to detect an infectious process and begin treatment as soon as possible.


Assuntos
Antineoplásicos Imunológicos/administração & dosagem , Infecções/epidemiologia , Linfoma não Hodgkin/tratamento farmacológico , Rituximab/administração & dosagem , Fatores Etários , Idoso , Infecções Bacterianas/epidemiologia , Intervalo Livre de Doença , Neutropenia Febril/epidemiologia , Feminino , Seguimentos , Humanos , Infecções/microbiologia , Linfoma não Hodgkin/mortalidade , Masculino , Pessoa de Meia-Idade , Prevalência , Estudos Retrospectivos , Taxa de Sobrevida , Tuberculose/epidemiologia
15.
Curr Top Microbiol Immunol ; 424: 107-119, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31463535

RESUMO

Advances in biotechnology in the twenty-first century, fueled in large part by the field of synthetic biology, have greatly accelerated capabilities to manipulate and re-program bacteria, viruses, and other organisms. These genetic engineering capabilities are driving innovation and progress in drug manufacturing, bioremediation, and tissue engineering, as well as biosecurity preparedness. However, biotechnology is largely dual use, holding the potential of misuse for deliberate harm along with positive applications; defenses against those threats need to be anticipated and prepared. This chapter describes the challenges of managing dual-use capabilities enabled by modern biotechnology and synthetic biology and highlights a framework tool developed by a National Academies committee to aid analysis of the security effects of new scientific discoveries and prioritization of concerns. The positive aspects of synthetic biology in preparedness are also detailed, and policy directions are highlighted for taking advantage of the positive aspects of these emerging technologies while minimizing risks.


Assuntos
Biotecnologia , Pesquisa de Uso Dual , Infecções/etiologia , Biologia Sintética , Humanos , Infecções/microbiologia , Infecções/virologia , Gestão de Riscos
16.
Biomed Res Int ; 2019: 6092018, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31467901

RESUMO

Recent data indicates limited awareness and compliance on infection prevention procedures by dental offices and by dental laboratories. Guidelines for infection prevention in dentistry have been published by Centres for Disease Control and Prevention since 2003; the section "IX-Special consideration" includes a subsection concerning the prevention in dental laboratories, but it has not been modernised in later versions to fit the needs of traditional and computer-aided technology. Traditional techniques required disinfecting items (impression, chewing waxes, and appliances) with well-suited products, which are also chosen for limiting impression changes or appliance deterioration. Effective procedures are available with difficulties. Some of these contain irritant or non-eco-friendly disinfectants. The transport of impression, to dental laboratories, is often delayed with limited precautions for limiting cross-infection. Gypsum casts are frequently contaminated mainly by bacteria and their antibiotic-resistant strains and even stored for long periods during dental implant supported restoration and orthodontic therapy, becoming a hidden source of infection. Nowadays, computer-aided design/computer-aided manufacturing technology seems to be an interesting way to promote both business and safety, being more comfortable for patients and more accurate than traditional technology. A further advantage is easier infection prevention since, for the most part, mainly digital impression and casts are not a source of cross-infection and the transport of contaminated items is reduced and limited to try-in stages. Nevertheless, a peculiar feature is that a digital electronic file is of course unalterable, but may be ruined by a computer virus. Additionally, the reconditioning of scanner tips is determinant for the optical characteristics and long term use of the scanner, but information for its reconditioning from producers is often limited. This study focuses on some critical points including (a) insufficient guidelines, (b) choice of proper procedure for scanner reconditioning, and (c) data protection in relation to patient privacy.


Assuntos
Desenho Assistido por Computador , Implantes Dentários/efeitos adversos , Infecções/terapia , Implantes Dentários/microbiologia , Materiais para Moldagem Odontológica/efeitos adversos , Técnica de Moldagem Odontológica/efeitos adversos , Odontologia/tendências , Humanos , Infecções/epidemiologia , Infecções/microbiologia
17.
Am J Clin Pathol ; 152(6): 747-756, 2019 11 04.
Artigo em Inglês | MEDLINE | ID: mdl-31334549

RESUMO

OBJECTIVES: Printculture is a method of microbiologic assessment previously described for use in the autopsy setting. We sought to compare printculture of surgical and autopsy pathology specimens to standard microbiology culture using matrix-assisted laser desorption/ionization-time of flight (MALDI-TOF)-based colony identification. METHODS: Printculture was performed on 18 frozen samples with corresponding standard culture results. The results of MALDI-TOF identification of colonies recovered by printculture were compared with standard cultures, and percent concordance was calculated. RESULTS: There was 95.8% concordance to standard culture methods for cases with infections and 100% concordance for cases without infection. The pattern of growth was found to aid in the distinction between contamination and true infection. CONCLUSIONS: Printculture allows the identification of microorganisms from routinely frozen tissues and provides a bridge between microbiology and histomorphology through the identification of associated histologic features of infection. This technique can be successfully integrated into autopsy and surgical pathology workup of potentially infected tissues.


Assuntos
Autopsia/métodos , Infecções/diagnóstico , Técnicas Microbiológicas/métodos , Patologia Cirúrgica/métodos , Secções Congeladas , Humanos , Infecções/microbiologia
18.
Handb Clin Neurol ; 162: 133-153, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31324308

RESUMO

Congenital and perinatal infections represent major causes of permanent disability among children worldwide. Linked together by the acronym TORCH, denoting Toxoplasma gondii, rubella virus, cytomegalovirus, and herpes virus, congenital infections can result from only a modest number of human pathogens that cross the placenta and infect the fetus. Although congenital rubella syndrome has been eliminated in the Americas by immunization, several pathogens discussed in this chapter cannot currently be prevented by vaccines or effectively treated with the available antimicrobial drugs. Due to the immaturity of the immune system, newborn infants are at risk for postnatally acquired infections with certain viruses and several bacteria. This chapter summarizes the epidemiology, pathogenesis, clinical manifestations, diagnosis, treatment, and prevention of selected pathogens that can damage the developing nervous system. As emphasized by the persisting challenges of preventing congenital cytomegalovirus infection and the emergence of severe brain damage associated with congenital Zika syndrome, these pathogens remain important causes of cerebral palsy, epilepsy, and intellectual disability.


Assuntos
Doenças do Recém-Nascido/microbiologia , Infecções/congênito , Adulto , Animais , Feminino , Doenças Fetais/microbiologia , Humanos , Recém-Nascido , Doenças do Recém-Nascido/prevenção & controle , Infecções/microbiologia
20.
Diagn Microbiol Infect Dis ; 95(2): 208-211, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31279585

RESUMO

We sought to evaluate time for bacterial culture and initiation of appropriate therapy for patients, from 2017 (without rapid diagnostic test (RDT) and Antimicrobial Stewardship Program (ASP)) and 2018 (with RDT and ASP). Time to identification (ID) was significantly faster in 2018 (2018 24.9 ±â€¯14.4, 2017 33.8 ±â€¯17 h, P = 0.001). Time to antimicrobial susceptibility test (AST) results was significantly faster for patients in 2018 compared to 2017 (18.2 ±â€¯14 h compared to 28.5 ±â€¯14.9 h, P < 0.001). Length of hospital stay for enrolled patients was significantly shorter in 2018 compared to 2017 (2018 10.7 ±â€¯11.1 days and 2017 15.5 ±â€¯18.1 days, P = 0.05). Length of antimicrobial therapy for enrolled patients was significantly shorter for 2018 (2018 6.7 ±â€¯3.8 d vs. 2017 8.8 ±â€¯7.8 d, P = 0.036). These results demonstrate MALDI-TOF/Vitek 2 leads to an average 21.5 h faster ID and AST results that can be acted upon by ASP for antimicrobial recommendations.


Assuntos
Antibacterianos/uso terapêutico , Gestão de Antimicrobianos , Infecções/diagnóstico , Infecções/tratamento farmacológico , Idoso , Idoso de 80 Anos ou mais , Antibacterianos/farmacologia , Feminino , Hospitalização , Humanos , Infecções/microbiologia , Tempo de Internação , Masculino , Testes de Sensibilidade Microbiana , Pessoa de Meia-Idade , Espectrometria de Massas por Ionização e Dessorção a Laser Assistida por Matriz , Fatores de Tempo , Resultado do Tratamento
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