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1.
J Med Microbiol ; 69(6): 850-853, 2020 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-32430095

RESUMO

Atopic dermatitis (AD) is a chronic skin disease that affects up to 20 % of the paediatric population worldwide. Staphylococcus aureus colonizes anterior nares and can be transmitted in the home environment, aggravating AD. This study aimed to detect S. aureus from nares of AD patients and their family contacts, as well as to evaluate the antimicrobial resistance, virulence and clonality of these isolates. Among the 48 family groups investigated, 30 groups were selected, as both the child and his/her respective contact had methicillin-sensitive S. aureus (MSSA) (24 cases; 54 MSSA isolates) or methicillin-resistant S. aureus (MRSA) isolates (6 cases; 13 MRSA isolates). All MRSA isolates carried SCCmec IV. S. aureus carrying PVL genes were detected in 60 % of patients. Pulsed-field gel electrophoresis (PFGE) analysis was performed for 31 isolates from 15 family groups: all 6 with MRSA and 9 with MSSA isolates. Similar genotypic profiles between isolates from patients and their family contacts were noted in 10 (66.6 %) family groups, 5 (83.3 %) of the MRSA family groups and 5 (55.5 %) of the MSSA family groups, indicating that the pathogen was transmitted through family contacts.


Assuntos
Dermatite Atópica/microbiologia , Mucosa Nasal/microbiologia , Staphylococcus aureus/genética , Adolescente , Criança , Pré-Escolar , Eletroforese em Gel de Campo Pulsado , Humanos , Lactente , Recém-Nascido , Staphylococcus aureus Resistente à Meticilina/genética , Staphylococcus aureus/efeitos dos fármacos
2.
APMIS ; 128(6): 451-462, 2020 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-32358920

RESUMO

Bacteria and viruses were analysed in the upper respiratory tract of symptomatic pig farmers and their domestic pigs. Eighty six human nasal and 495 (50 pools) porcine snout swabs were collected in Schleswig-Holstein, Germany. Staphylococcus (S.) aureus (62.8%, 54/86), human rhino- and coronaviruses (HRV, 29.1%, 25/86; HCoV, 16.3%, 14/86) were frequently detected in humans, while Haemophilus parasuis (90.0%, 45/50), Mycoplasma hyorhinis (78.6%, 11/14), Enterovirus G (EV-G, 56.0%, 28/50) and S. aureus (36.0%, 18/50), respectively, were highly prevalent in pigs. The detection of S. aureus in human follow-up samples indicates a carrier status. The methicillin-resistant phenotype (MRSA) was identified in 33.3% (18/54) of nasal swabs and in one of 18 (5.6%) pooled snout swabs that were tested positive for S. aureus. Strains were indicative of the livestock-associated clonal complex CC398, with t011 being the most common staphylococcal protein A type. Enterobacterales and non-fermenters were frequently isolated from swabs. Their detection in follow-up samples suggests a carrier status. All were classified as being non-multiresistant. There was no example for cross-species transmission of viruses. In contrast, transmission of S. aureus through occupational contact to pigs seems possible. The study contributes to the 'One Health' approach.


Assuntos
Infecções Respiratórias/microbiologia , Infecções Respiratórias/virologia , Infecções Estafilocócicas/veterinária , Sus scrofa/microbiologia , Sus scrofa/virologia , Doenças dos Suínos/epidemiologia , Animais , Portador Sadio , Humanos , Gado , Staphylococcus aureus Resistente à Meticilina/genética , Testes de Sensibilidade Microbiana , Mucosa Nasal/microbiologia , Mucosa Nasal/virologia , Doenças Profissionais/microbiologia , Prevalência , Infecções Respiratórias/epidemiologia , Infecções Estafilocócicas/epidemiologia , Infecções Estafilocócicas/transmissão , Suínos , Doenças dos Suínos/microbiologia , Doenças dos Suínos/transmissão , Doenças dos Suínos/virologia , Viroses/epidemiologia , Viroses/transmissão , Viroses/veterinária
3.
BMC Infect Dis ; 20(1): 254, 2020 Mar 30.
Artigo em Inglês | MEDLINE | ID: mdl-32228480

RESUMO

BACKGROUND: To evaluate nasal carriage, antibiotic susceptibility and molecular characteristics of methicillin-resistant Staphylococcus aureus (MRSA), as well as the risk factors of MRSA colonization, in human immunodeficiency virus (HIV)-infected patients in northern Taiwan. METHODS: From September 2014 to November 2015, HIV-infected patients seeking outpatient care at four hospitals were eligible for this study. A nasal specimen was obtained from each subject for the detection of S. aureus and a questionnaire was completed by each subject. MRSA isolates once identified were characterized. RESULTS: Of 553 patients surveyed, methicillin-susceptible S. aureus (MSSA) was detected in 119 subjects (21.5%) and MRSA in 19 subjects (3.4%). Female gender, injection drug use, smoking, hepatitis C virus carrier, cancer and antibiotic use within 1 year were positively associated with MRSA colonization. By multivariate analysis, only cancer (adjust odds ratio (aOR) 7.78, [95% confidence interval (CI), 1.909-31.731]) and antibiotic use within 1 year (aOR 3.89, [95% CI, 1.219-12.433]) were significantly associated with MRSA colonization. Ten isolates were characterized as sequence type (ST) 59/staphylococcal chromosome cassette (SCC) IV or VT, endemic community strains in Taiwan, four isolates as ST 8/SCCmec IV (USA 300) and one isolate as ST 239/SCCmec IIIA, a hospital strain. All the community-associated MRSA isolates were susceptible to trimethoprim-sulfamethoxazole (TMP-SMX). CONCLUSIONS: Nasal MRSA carriage in HIV-infected patients seeking outpatient care was low (3.4%) in northern Taiwan. Most of the colonizing isolates were genetically endemic community strains and exhibited high susceptibility to TMP-SMX and fluoroquinolones. Cancer and antibiotic use within 1 year were associated with MRSA colonization.


Assuntos
Infecções por HIV/microbiologia , Staphylococcus aureus Resistente à Meticilina/efeitos dos fármacos , Mucosa Nasal/microbiologia , Infecções Estafilocócicas/epidemiologia , Adulto , Antibacterianos/farmacologia , Feminino , Infecções por HIV/epidemiologia , Humanos , Masculino , Staphylococcus aureus Resistente à Meticilina/isolamento & purificação , Testes de Sensibilidade Microbiana , Pessoa de Meia-Idade , Prevalência , Fatores de Risco , Infecções Estafilocócicas/microbiologia , Abuso de Substâncias por Via Intravenosa/complicações , Taiwan/epidemiologia , Combinação Trimetoprima e Sulfametoxazol/farmacologia
5.
PLoS One ; 15(3): e0229558, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32155176

RESUMO

INTRODUCTION: Pneumococcal colonisation is regarded as a pre-requisite for developing pneumococcal disease. In children previous studies have reported pneumococcal colonisation to be a symptomatic event and described a relationship between symptom severity/frequency and colonisation density. The evidence for this in adults is lacking in the literature. This study uses the experimental human pneumococcal challenge (EHPC) model to explore whether pneumococcal colonisation is a symptomatic event in healthy adults. METHODS: Healthy participants aged 18-50 were recruited and inoculated intra-nasally with either Streptococcus pneumoniae (serotypes 6B, 23F) or saline as a control. Respiratory viral swabs were obtained prior to inoculation. Nasal and non-nasal symptoms were then assessed using a modified Likert score between 1 (no symptoms) to 7 (cannot function). The rate of symptoms reported between the two groups was compared and a correlation analysis performed. RESULTS: Data from 54 participants were analysed. 46 were inoculated with S. pneumoniae (29 with serotype 6B, 17 with serotype 23F) and 8 received saline (control). In total, 14 became experimentally colonised (30.4%), all of which were inoculated with serotype 6B. There was no statistically significant difference in nasal (p = 0.45) or non-nasal symptoms (p = 0.28) between the inoculation group and the control group. In those who were colonised there was no direct correlation between colonisation density and symptom severity. In the 22% (12/52) who were co-colonised, with pneumococcus and respiratory viruses, there was no statistical difference in either nasal or non-nasal symptoms (virus positive p = 0.74 and virus negative p = 1.0). CONCLUSION: Pneumococcal colonisation using the EHPC model is asymptomatic in healthy adults, regardless of pneumococcal density or viral co-colonisation.


Assuntos
Testes de Provocação Nasal/métodos , Infecções Pneumocócicas/fisiopatologia , Streptococcus pneumoniae/imunologia , Adulto , Feminino , Voluntários Saudáveis , Humanos , Masculino , Pessoa de Meia-Idade , Mucosa Nasal/microbiologia , Nariz/microbiologia , Infecções Pneumocócicas/metabolismo , Pneumonia Pneumocócica/metabolismo , Pneumonia Pneumocócica/prevenção & controle , Sorogrupo , Streptococcus pneumoniae/metabolismo , Streptococcus pneumoniae/patogenicidade , Avaliação de Sintomas/métodos
6.
BMC Microbiol ; 20(1): 21, 2020 Jan 28.
Artigo em Inglês | MEDLINE | ID: mdl-31992193

RESUMO

BACKGROUND: Coagulase-negative staphylococci (CoNS) are a group of opportunistic pathogens, which are widely spread in the environment. Animal breeding is an important source of pathogen spreading. However, the concentration and characteristics of CoNS in the bioaerosols of henhouses are unclear. RESULTS: In this study, we showed that CoNS were significantly increased in bioaerosols of henhouses during the first 60 days, and reached 2.0 × 106 CFU/m3, which account for 75.4% of total bacteria. One hundred and two CoNS isolates from bioaerosols and nasal swabs of farmers were further identified, covering seven species. Among these, 41.2% isolates were Staphylococcus sciuri, which was the predominant species, followed by S. equorum, S. saprophyticus, S. haemolyticus, S. xylosus, S. arlettae and S. gallinarum. There were high rates of resistance to oxacillin in CoNS (49.0%), which were defined as Methicillin-Resistant CoNS (MRCoNS), and 36.3% isolates contained resistance gene mecA. Bioaerosol infection models showed that, chickens exposed to aerosolized S. sciuri had significant induction of inflammatory cytokines interleukin (IL)-1ß, IL-6, IL-8 and IL-10 at 5 days post-infection (dpi) in lungs and at 7 dpi in spleens. CONCLUSIONS: We reported a high concentration of CoNS in henhouses, and S. sciuri was the preponderant CoNS species. Antibiotic resistance analysis and bioaerosols infection of CoNS further highlighted its hazards on resistance and immunological challenge. These results suggested that, CoNS in bioaerosols could be one serious factor in the henhouses for not only poultry industry but also public health.


Assuntos
Galinhas/microbiologia , Mucosa Nasal/microbiologia , Staphylococcus/isolamento & purificação , Animais , China , Farmacorresistência Bacteriana , Fazendeiros , Abrigo para Animais , Humanos , Interleucinas/metabolismo , Oxacilina/farmacologia
7.
BMC Infect Dis ; 19(1): 1023, 2019 Dec 02.
Artigo em Inglês | MEDLINE | ID: mdl-31791276

RESUMO

BACKGROUND: Staphylococcus aureus carriage is a known risk factor for staphylococcal disease. However, the carriage rates vary by country, demographic group and profession. This study aimed to determine the S. aureus carriage rate in children in Eastern Uganda, and identify S. aureus lineages that cause infection in Uganda. METHODS: Nasopharyngeal samples from 742 healthy children less than 5 years residing in the Iganga/Mayuge Health and Demographic Surveillance Site in Eastern Uganda were processed for isolation of S. aureus. Antibiotic susceptibility testing based on minimum inhibitory concentrations (MICs) was determined by the BD Phoenix™ system. Genotyping was performed by spa and SCCmec typing. RESULTS: The processed samples yielded 144 S. aureus isolates (one per child) therefore, the S. aureus carriage rate in children was 19.4% (144/742). Thirty one percent (45/144) of the isolates were methicillin resistant (MRSA) yielding a carriage rate of 6.1% (45/742). All isolates were susceptible to rifampicin, vancomycin and linezolid. Moreover, all MRSA were susceptible to vancomycin, linezolid and clindamycin. Compared to methicillin susceptible S. aureus (MSSA) isolates (68.8%, 99/144), MRSA isolates were more resistant to non-beta-lactam antimicrobials -trimethoprim/sulfamethoxazole 73.3% (33/45) vs. 27.3% (27/99) [p < 0.0001]; erythromycin 75.6% (34/45) vs. 24.2% (24/99) [p < 0.0001]; chloramphenicol 60% (27/45) vs. 19.2% (19/99) [p < 0.0001]; gentamicin 55.6% (25/45) vs. 25.3% (25/99) [p = 0.0004]; and ciprofloxacin 35.6% (16/45) vs. 2% (2/99) [p < 0.0001]. Furthermore, 42 MRSA (93.3%) were multidrug resistant (MDR) and one exhibited high-level resistance to mupirocin. Overall, 61 MSSA (61.6%) were MDR, including three mupirocin and clindamycin resistant isolates. Seven spa types were detected among MRSA, of which t037 and t064 were predominant and associated with SCCmec types I and IV, respectively. Fourteen spa types were detected in MSSA which consisted mainly of t645 and t4353. CONCLUSIONS: S. aureus carriage rate in healthy children in Eastern Uganda is high and comparable to rates for hospitalized patients in Kampala. The detection of mupirocin resistance is worrying as it could rapidly increase if mupirocin is administered in a low-income setting. S. aureus strains of spa types t064, t037 (MRSA) and t645, t4353 (MSSA) are prevalent and could be responsible for majority of staphylococcal infections in Uganda.


Assuntos
Antígenos de Bactérias/análise , Portador Sadio/epidemiologia , Farmacorresistência Bacteriana , Nariz/microbiologia , Faringe/microbiologia , Infecções Estafilocócicas/epidemiologia , Staphylococcus aureus/isolamento & purificação , Antibacterianos/farmacologia , Antibacterianos/uso terapêutico , Antígenos de Bactérias/classificação , Antígenos de Bactérias/genética , Portador Sadio/microbiologia , Pré-Escolar , Estudos Transversais , Farmacorresistência Bacteriana/genética , Feminino , Técnicas de Genotipagem/métodos , Humanos , Lactente , Recém-Nascido , Masculino , Staphylococcus aureus Resistente à Meticilina/genética , Staphylococcus aureus Resistente à Meticilina/isolamento & purificação , Testes de Sensibilidade Microbiana , Tipagem Molecular/métodos , Mupirocina/farmacologia , Mupirocina/uso terapêutico , Mucosa Nasal/microbiologia , Vigilância da População/métodos , Infecções Estafilocócicas/tratamento farmacológico , Infecções Estafilocócicas/microbiologia , Staphylococcus aureus/classificação , Staphylococcus aureus/genética , Uganda/epidemiologia
8.
Nat Commun ; 10(1): 5714, 2019 12 16.
Artigo em Inglês | MEDLINE | ID: mdl-31844063

RESUMO

The airway microbiome has an important role in asthma pathophysiology. However, little is known on the relationships between the airway microbiome of asthmatic children, loss of asthma control, and severe exacerbations. Here we report that the microbiota's dynamic patterns and compositions are related to asthma exacerbations. We collected nasal blow samples (n = 319) longitudinally during a clinical trial at 2 time-points within one year: randomization when asthma is under control, and at time of early loss of asthma control (yellow zone (YZ)). We report that participants whose microbiota was dominated by the commensal Corynebacterium + Dolosigranulum cluster at RD experience the lowest rates of YZs (p = 0.005) and have longer time to develop at least 2 episodes of YZ (p = 0.03). The airway microbiota have changed from randomization to YZ. A switch from the Corynebacterium + Dolosigranulum cluster at randomization to the Moraxella- cluster at YZ poses the highest risk of severe asthma exacerbation (p = 0.04). Corynebacterium's relative abundance at YZ is inversely associated with severe exacerbation (p = 0.002).


Assuntos
Asma/diagnóstico , Fluticasona/uso terapêutico , Interações entre Hospedeiro e Microrganismos/imunologia , Microbiota/imunologia , Simbiose/imunologia , Administração por Inalação , Asma/tratamento farmacológico , Asma/imunologia , Asma/microbiologia , Carnobacteriaceae/imunologia , Carnobacteriaceae/isolamento & purificação , Criança , Pré-Escolar , Feminino , Humanos , Masculino , Moraxella/imunologia , Moraxella/isolamento & purificação , Mucosa Nasal/imunologia , Mucosa Nasal/microbiologia , Estudos Prospectivos , Índice de Gravidade de Doença , Staphylococcus/imunologia , Staphylococcus/isolamento & purificação , Streptococcus/imunologia , Streptococcus/isolamento & purificação , Exacerbação dos Sintomas , Resultado do Tratamento
9.
Rev Esp Salud Publica ; 932019 Nov 28.
Artigo em Espanhol | MEDLINE | ID: mdl-31776324

RESUMO

OBJECTIVE: The reduction of unnecessary health interventions determines good care quality. The objective of this work was to evaluate the compliance of the "do not do" recommendations proposed by the Spanish Society of Preventive Medicine, Public Health and Hygiene. METHODS: Prospective, observational, descriptive study of patients admitted to the La Princesa University Hospital between December 2018 and January 2019. The compliance of each recommendation in different patients was analyzed. The quantitative variables are expressed as means and standard deviation and the qualitative values as percentages and confidence interval. RESULTS: In Recommendation 1 (R1: "Do not remove hair systematically"), 231 interventions were studied and the compliance was of 100% (95% CI: 98.27-100). In Recommendation 2 (R2: "Do not maintain antibiotics for more than 48 hours, unless evidence of infection"), 201 interventions were studied and the compliance was of 93.53% (95% CI: 90.09-96.91). In Recommendation 3 (R3: "Do not analyze C. difficile toxin in asymptomatic patients"), 200 determinations were studied and the compliance was of 93.5% (95% CI: 90.08-96.92). In Recommendation 4 (R4: "Do not do routine nasal decolonization"), 167 interventions were recruited and the compliance was of 100% (95% CI: 97.6-100). In Recommendation 5 (R5: "Do not perform routine replacement of peripheral venous catheter every 72-96 hours"), 153 patients were studied in compliance with the recommendation of 98.04% (95% CI: 94.12-99.35). CONCLUSIONS: A 100% compliance was found in Recommendations 1 and 4. There is an opportunity of improvement in the recommendations R2, R3 and R5.


Assuntos
Fidelidade a Diretrizes , Promoção da Saúde/normas , Medicina Preventiva/normas , Saúde Pública/normas , Qualidade da Assistência à Saúde , Idoso , Antibacterianos/uso terapêutico , Cateterismo Periférico , Clostridium difficile , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Mucosa Nasal/microbiologia , Estudos Prospectivos , Indicadores de Qualidade em Assistência à Saúde , Sociedades , Sociedades Médicas , Espanha/epidemiologia
10.
Int J Mol Sci ; 20(22)2019 Nov 11.
Artigo em Inglês | MEDLINE | ID: mdl-31717919

RESUMO

The role of infective agents in autoimmune diseases (ADs) development has been historically investigated, but in the last years has been strongly reconsidered due to the interest in the link between the microbiome and ADs. Together with the gut, the skin microbiome is characterized by the presence of several microorganisms, potentially influencing innate and adaptive immune response. S. aureus is one of the most important components of the skin microbiome that can colonize anterior nares without clinical manifestations. Data from the literature demonstrates a significantly higher prevalence of nasal colonization in ADs patients in comparison with healthy subjects, suggesting a possible role in terms of disease development and phenotypes. Thus, in the present narrative review we focused on the mechanisms by which S. aureus could influence the immune response and on its relationship with ADs, in particular granulomatosis with polyangiitis, rheumatoid arthritis, and systemic lupus erythematosus.


Assuntos
Doenças Autoimunes/microbiologia , Mucosa Nasal/microbiologia , Infecções Estafilocócicas/imunologia , Staphylococcus aureus/patogenicidade , Animais , Doenças Autoimunes/imunologia , Humanos , Mucosa Nasal/imunologia , Fenótipo , Infecções Estafilocócicas/microbiologia , Staphylococcus aureus/imunologia
11.
OMICS ; 23(11): 573-582, 2019 11.
Artigo em Inglês | MEDLINE | ID: mdl-31651219

RESUMO

Microbial communities residing in the nose play important roles in human health and disease. We report marked differences in nasal microbiota between a rural community and an industrial setting located near a major urban city. Nasal samples were collected from 19 healthy male subjects: 9 samples from persons living in a rural village, and 10 samples from ceramic factory workers in a major industrial Egyptian city. The nasal microbiota in the rural sample had higher and distinct diversity compared with industrial samples from workers exposed to pollution daily. Taxonomic analysis of the sequences revealed five major phyla; among these phyla were Actinobacteria, Proteobacteria, Bacteroidetes, and Fusobacteria, revealing significant abundance variation by geographical location. For example, the rural group had a significant increase in representation of Actinobacteria and Bacteroidetes (p = 0.004, p = 0.01, respectively) compared with the industrial group. However, the industrial group showed a significant increase in relative abundance of phylum Proteobacteria (p = 0.02). The most predominant genera for the rural group were Corynebacterium, Staphylococcus, Alloiococcus, and Peptoniphilus. By contrast, the industrial group was dominated by Staphylococcus, Sphingomonas, and Moraxella. Environmental pollution might alter the nasal microbiome leading to an attendant disturbance in the microbiome community structure. The clinical and public health implications of these nasal microbiome variations by rural and industrialized geography warrant further research. This study contributes to our knowledge of the bacterial composition of nasal microbiome in rural and industrialized geographies, and informs public health, respiratory medicine, and occupational health scholarship.


Assuntos
Metagenômica , Microbiota , Mucosa Nasal/microbiologia , Exposição Ocupacional , População Rural , Bactérias/classificação , Bactérias/genética , Biodiversidade , Código de Barras de DNA Taxonômico , Egito , Humanos , Indústrias , Metagenômica/métodos , Vigilância em Saúde Pública , RNA Ribossômico 16S
12.
Ann Clin Microbiol Antimicrob ; 18(1): 25, 2019 Sep 05.
Artigo em Inglês | MEDLINE | ID: mdl-31488199

RESUMO

BACKGROUND: Methicillin-resistant Staphylococcus aureus (MRSA) is one of a medically important Gram-positive bacteria, which can be harboured majorly in the nasal cavity. Risk of consequent infection in a person colonized with S. aureus as well as MRSA upsurges with time and remains insistently increased. Hence, the objective of this meta-analysis was to determine the prevalence of S. aureus and MRSA nasal colonization in Ethiopia at large. METHODS: PubMed, Google Scholar, Embase, Hinari, Sci Hub, Scopus, and the Directory of Open Access Journals were searched and a total of 10 studies have been selected for meta-analysis. Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were used for the literature search strategy, selection of publications, data extraction, and the reporting of results for the review. All statistical analyses were performed using STATA version 11 software via random effects model. The pooled prevalence was presented in forest plots and figure with 95% CI. RESULTS: A total of ten studies with 2495 nasal swab samples were included in this meta-analysis, and the overall pooled estimated prevalence of S. aureus and MRSA nasal colonization in Ethiopia were 30.90% [95% CI 21.81-39.99%], 10.94% [95% CI 8.13-13.75%] respectively. Subgroup analysis was also noted in different regions of Ethiopia, henceforth Oromia region ranked first 21.28% [95% CI 8.22-34.35%], followed by Amhara region 6.78% [95% CI 3.02-10.54%], whereas relatively low magnitude of MRSA colonization was demonstrated from Tigray region 4.82% [95% CI 2.18-7.45%]. CONCLUSION: The analysis showed that the overall prevalence of S. aureus and MRSA nasal colonization in Ethiopia were comparable with the global prevalence. But a huge variation between the regions, so the Ministry of Health of Ethiopia should design appropriate decolonization program that can address the specific regional groups as well as the national population.


Assuntos
Portador Sadio/epidemiologia , Portador Sadio/microbiologia , Staphylococcus aureus Resistente à Meticilina/isolamento & purificação , Mucosa Nasal/microbiologia , Infecções Estafilocócicas/epidemiologia , Infecções Estafilocócicas/microbiologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Criança , Pré-Escolar , Etiópia/epidemiologia , Feminino , Humanos , Lactente , Recém-Nascido , Masculino , Pessoa de Meia-Idade , Prevalência , Adulto Jovem
13.
J Hosp Infect ; 103(4): 461-464, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31513882

RESUMO

This study aimed to evaluate the Danish Board of Health's guidance for treating the carriage of meticillin-resistant Staphylococcus aureus (MRSA), focusing on nose-throat carriage and use of supplementary systemic antibiotics. The results of MRSA eradication treatment among 358 patients were analysed, focusing on those with nose (N=58) or throat (N=183) MRSA colonization. The Danish guidance for MRSA treatment was found to be more successful in patients with nose colonization (66%) compared with throat colonization (41%), despite the fact that the cumulative eradication rates were equal after three treatment cycles (71% vs 73%). This study found that supplementation of colonization treatment with systemic antibiotics does not have a positive effect.


Assuntos
Antibacterianos/administração & dosagem , Portador Sadio/tratamento farmacológico , Staphylococcus aureus Resistente à Meticilina/isolamento & purificação , Mucosa Nasal/microbiologia , Faringe/microbiologia , Infecções Estafilocócicas/tratamento farmacológico , Administração Oral , Administração Tópica , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Portador Sadio/microbiologia , Criança , Pré-Escolar , Dinamarca , Feminino , Guias como Assunto , Humanos , Masculino , Pessoa de Meia-Idade , Infecções Estafilocócicas/microbiologia , Resultado do Tratamento , Adulto Jovem
14.
Ethiop J Health Sci ; 29(4): 487-494, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-31447522

RESUMO

Background: Nasal methicillin-resistant Staphylococcus aureus (MRSA) colonization is of public health concern due to increased risk of developing invasive infections and the therapeutic challenges. This concern is more among the vulnerable group. We determined the prevalence and associated risk factors of MRSA nasal carriage among children in a tertiary hospital in Nigeria. Method: We conducted a hospital-based, cross-sectional study among 300 children attending the outpatient clinic of a tertiary hospital recruited through systematic sampling technique. An interviewer-administered, structured questionnaire was used to obtain sociodemographic characteristics and exposure factors. Nasal swabs samples were collected and inoculated on mannitol salt agar and subcultured on nutrient agar to isolate Staphylococcus aureus. We used the conventional Polymerase Chain Reaction (PCR) technique to detect the presence of mecA gene for MRSA. We calculated the prevalence, prevalence odds ratio to determine risk factors for MRSA acquisition at 5% level of significance. Results: The median age was 1.7 years (6 months-16 years). Males accounted for 60.7%, and 75% of the participants were under 5 years. Staphylococcus aureus colonization was found in 36.3% of the participants while 5.3% of the participants had MRSA identified by detecting the mecA gene. History of recent surgery in the last six months was the only independent predictor of nasal MRSA colonization among the participants (aOR=12.5; 95%CI: 2.7-50.0.). Conclusion: The high prevalence of MRSA colonization observed among the children in this study suggests the need to consider screening children with history of previous surgery as infection control and prevention intervention for MRSA.


Assuntos
Staphylococcus aureus Resistente à Meticilina , Mucosa Nasal/microbiologia , Infecções Estafilocócicas/epidemiologia , Centros de Atenção Terciária/estatística & dados numéricos , Adolescente , Portador Sadio/epidemiologia , Portador Sadio/microbiologia , Criança , Pré-Escolar , Feminino , Humanos , Lactente , Masculino , Nigéria/epidemiologia , Prevalência , Fatores de Risco , Infecções Estafilocócicas/etiologia , Infecções Estafilocócicas/microbiologia
15.
Eur J Clin Microbiol Infect Dis ; 38(10): 1811-1819, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31273646

RESUMO

The aim of this study was to investigate the relationship between nasal and rectal Staphylococcus aureus carriage in intensive care unit (ICU) patients and the occurrence of ICU-acquired infections related to S. aureus carriage. Three hundred and ninety-five patients admitted in ICU were screened for S. aureus nasal and rectal carriages and followed to record S. aureus infections during their stay. S. aureus strains were genotyped by arbitrarily primed PCR, spa-typing, microarray and whole genome sequencing. At ICU admission, 112 of 363 (30.9%) patients carried S. aureus including 61 (16.8%) exclusive nasal carriers, 40 (11.0%) combined nasal and rectal carriers and 11 (3.0%) exclusive rectal carriers. The 152 S. aureus isolates from nasal and rectal swabs belonged to 19 clonal complexes (CCs). Patients colonized in both nose and rectum harboured different strains in at least 40% of cases according to arbitrarily primed PCR data. Nasal carriers of CC5 S. aureus had an increased risk of rectal carriage (RR = 1.85, P < .05). S. aureus nasal and rectal carriage was a risk factor of S. aureus ICU-acquired infection (RR = 4.04; 95%CI [1.38-11.76]). Incidence rates of endogenous ICU-acquired infections in exclusive nasal carriers, exclusive rectal carriers and in both nasal and rectal carriers were 0.08 (5/61), 0.09 (1/11) and 0.03 (1/40), respectively (p = 0.47). Rectal swabbing increased the detection of S. aureus carriage and revealed an important diversity of S. aureus strains in ICU patients. Further studies are needed to understand how S. aureus rectal carriage increases the risk of endogenous ICU-acquired infections.


Assuntos
Portador Sadio/epidemiologia , Estado Terminal , Unidades de Terapia Intensiva , Mucosa Nasal/microbiologia , Reto/microbiologia , Infecções Estafilocócicas/epidemiologia , Staphylococcus aureus/isolamento & purificação , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Genótipo , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , Tipagem Molecular , Estudos Prospectivos , Staphylococcus aureus/classificação , Staphylococcus aureus/genética
16.
Nat Commun ; 10(1): 2981, 2019 07 05.
Artigo em Inglês | MEDLINE | ID: mdl-31278315

RESUMO

Streptococcus pneumoniae is the main bacterial pathogen involved in pneumonia. Pneumococcal acquisition and colonization density is probably affected by viral co-infections, the local microbiome composition and mucosal immunity. Here, we report the interactions between live-attenuated influenza vaccine (LAIV), successive pneumococcal challenge, and the healthy adult nasal microbiota and mucosal immunity using an experimental human challenge model. Nasal microbiota profiles at baseline are associated with consecutive pneumococcal carriage outcome (non-carrier, low-dense and high-dense pneumococcal carriage), independent of LAIV co-administration. Corynebacterium/Dolosigranulum-dominated profiles are associated with low-density colonization. Lowest rates of natural viral co-infection at baseline and post-LAIV influenza replication are detected in the low-density carriers. Also, we detected the fewest microbiota perturbations and mucosal cytokine responses in the low-density carriers compared to non-carriers or high-density carriers. These results indicate that the complete respiratory ecosystem affects pneumococcal behaviour following challenge, with low-density carriage representing the most stable ecological state.


Assuntos
Portador Sadio/imunologia , Vacinas contra Influenza/imunologia , Microbiota/imunologia , Mucosa Nasal/microbiologia , Streptococcus pneumoniae/imunologia , Adolescente , Adulto , Coinfecção/imunologia , Coinfecção/microbiologia , Coinfecção/prevenção & controle , Feminino , Voluntários Saudáveis , Humanos , Vacinas contra Influenza/administração & dosagem , Influenza Humana/imunologia , Influenza Humana/prevenção & controle , Influenza Humana/virologia , Masculino , Pessoa de Meia-Idade , Mucosa Nasal/imunologia , Infecções Pneumocócicas/imunologia , Infecções Pneumocócicas/microbiologia , Infecções Pneumocócicas/prevenção & controle , Streptococcus pneumoniae/patogenicidade , Vacinas Atenuadas/administração & dosagem , Vacinas Atenuadas/imunologia , Adulto Jovem
17.
PLoS One ; 14(7): e0219962, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31335912

RESUMO

BACKGROUND: Chronic obstructive pulmonary disease (COPD) is an inflammatory lung disorder associated with lung microbiome dysbiosis. Although the upper airway microbiome is the source of the lung microbiome, the relationships between the oral, nasal, and sputum microbiota are incompletely understood. Our objective was to determine features that differentiate the oral, nasal, and sputum microbiome among subjects with stable COPD. METHODS: We recruited 15 current or former smokers to provide oral and sputum samples on day 1. On day 2, another oral sample and a nasal sample were obtained. Each sample and control underwent DNA extraction, 16S V4 rRNA amplification, 16S V4 sequencing, and qPCR of 16S rRNA. Data were analyzed using dada2 and R. RESULTS: Most (14 of 15) subjects were male with a mean age of 65.2. One subject had no pulmonary obstruction, while 5 had mild COPD, 7 had moderate COPD, and 2 had severe COPD. Three subjects (20%) were current tobacco users and 2 subjects (13%) used inhaled corticosteroids (ICS). Subjects had a mean of 49.1 pack-years of tobacco exposure. Bacterial biomass was associated with anatomic site, but no differences in biomass were observed with age, FEV1 percent predicted (FEV1pp), ICS use, smoking status, or edentulous state. Shannon index was associated with site (lower nasal diversity than oral and sputum diversity, p<0.001), but not age, ICS use, FEV1pp, tobacco use, or edentulous state. ß-diversity was illustrated by principal coordinate analysis using Bray-Curtis dissimilarity and PERMANOVA analyses, showing sample clustering by anatomic site (p = 0.001) with nasal samples forming a cluster separate from the combined oral wash samples and sputum samples. Clustering was also observed with ICS use (p = 0.029) and edentulous state (p = 0.019), while FEV1pp and current tobacco use were not significant. In an amplicon sequencing variant (ASV)-level analysis of oral samples using a linear regression model with Benjamini-Hochberg correction at an FDR<0.10, 10 ASVs were associated with age while no ASVs were associated with FEV1pp or smoking status. Sputum sample analysis demonstrated that 51 ASVs (25 unique genera) were associated with age, 61 ASVs (32 genera) were associated with FEV1pp, and no ASVs were associated with smoking status. In a combined dataset, the frequent exacerbator phenotype, rather than ICS use, was associated with decreased sputum Shannon diversity. CONCLUSIONS: Among the upper airway microbiota of COPD subjects, anatomic site was associated with bacterial biomass, Shannon diversity, and ß-diversity. ICS use and edentulous state were both associated with ß-diversity. Age was associated with taxa relative abundance in oral and sputum samples, while FEV1pp was associated with taxa relative abundance in sputum samples only.


Assuntos
Mucosa Laríngea/microbiologia , Microbiota , Mucosa Nasal/microbiologia , Doença Pulmonar Obstrutiva Crônica/microbiologia , Idoso , Feminino , Humanos , Masculino , Metagenoma , Pessoa de Meia-Idade , Doença Pulmonar Obstrutiva Crônica/epidemiologia , Doença Pulmonar Obstrutiva Crônica/patologia , Fumar/epidemiologia , Escarro/microbiologia
18.
Am J Trop Med Hyg ; 101(3): 716-723, 2019 09.
Artigo em Inglês | MEDLINE | ID: mdl-31287042

RESUMO

This article describes, for the first time, the role of the nasal mucosa (NM) as the initial site for the Histoplasma capsulatum mycelial-to-yeast transition. The results highlight that yeasts may arrive to the cervical lymph nodes (CLN) via phagocytes. Bats and mice were intranasally infected with H. capsulatum mycelial propagules and they were killed 10, 20, and 40 minutes and 1, 2, and 3 hours after infection. The NM and the CLN were monitored for fungal presence. Yeasts compatible with H. capsulatum were detected within the NM and the CLN dendritic cells (DCs) 2-3 hours postinfection, using immunohistochemistry. Histoplasma capsulatum was re-isolated by culturing at 28°C from the CLN of both mammalian hosts 2-3 hours postinfection. Reverse transcription-polymerase chain reaction assays were designed to identify fungal dimorphism, using mycelial-specific (MS8) and yeast-specific (YPS3) gene expression. This strategy supported fast fungal dimorphism in vivo, which began in the NM 1 hour postinfection (a time point when MS8 and YPS3 genes were expressed) and it was completed at 3 hours (a time point when only the YPS3 transcripts were detected) in both bats and mice. The presence of intracellular yeasts in the nasal-associated lymphoid tissue (NALT), in the NM nonassociated with the NALT, and within the interdigitating DCs of the CLN suggests early fungal dissemination via the lymph vessels.


Assuntos
Adaptação Fisiológica , Quirópteros/microbiologia , Histoplasma/fisiologia , Micélio/fisiologia , Mucosa Nasal/microbiologia , Animais , Células Dendríticas/microbiologia , Feminino , Histoplasma/genética , Linfonodos/microbiologia , Camundongos , Camundongos Endogâmicos C57BL , Micélio/genética , Fagocitose , Infecções Respiratórias/microbiologia
19.
Artigo em Inglês | MEDLINE | ID: mdl-31165051

RESUMO

The nasal mucosa provides first line defense against inhaled pathogens while creating a unique microenvironment for bacterial communities. Studying the impact of microbiota in the nasal cavity has been difficult due to limitations with current models including explant cultures, primary cells, or neoplastic cell lines. Most notably, none have been shown to support reproducible colonization by bacterial communities from human donors. Therefore, to conduct controlled studies of the human nasal ecosystem, we have developed a novel ex vivo mucosal model that supports bacterial colonization of a cultured host mucosa created by immortalized human nasal epithelial cells (NEC). For this model, immortalized NEC established from 5 male and 5 female donors were cultured with an air-interfaced, apical surface on a porous transwell membrane. NEC were grown from nasal turbinate tissues harvested from willed bodies or from discarded tissue collected during sinonasal procedures. Immortalized cells were evaluated through molecular verification of cell type, histological confirmation of tissue differentiation including formation of tight junctions, NEC multilayer viability, metabolism, physiology and imaging of the luminal surface by scanning electron microscopy. Results showed proper differentiation and multilayer formation at seven to 10 days after air interface that was maintained for up to 3 weeks. The optimized mucosal cultures created an environment necessary to sustain colonization by nasal microbiomes (NMBs) that were collected from healthy volunteers, cryogenically preserved and characterized with customized quantitative polymerase chain reaction (qPCR) arrays. Polymicrobial communities of nasal bacteria associated with healthy and inflamed states were consistently reproduced in matured NEC co-cultures by transplant of NMBs from multiple community types. The cultured NMBs were stable after an initial period of bacterial replication and equilibration. This novel ex vivo culture system is the first model that supports controlled cultivation of NMBs, allowing for lab-based causation studies and further experimentation to explore the complexities of host-microbe and microbe-microbe interactions.


Assuntos
Células Epiteliais/microbiologia , Microbiota , Cavidade Nasal/microbiologia , Mucosa Nasal/microbiologia , Bactérias , Linhagem Celular , Células Imobilizadas , Técnicas de Cultura , Ecossistema , Células Epiteliais/imunologia , Feminino , Humanos , Masculino , Interações Microbianas , Cavidade Nasal/imunologia , Mucosa Nasal/imunologia , Texas , Voluntários
20.
J Infect Chemother ; 25(10): 750-757, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31235348

RESUMO

The prevalence of nonencapsulated Streptococcus pneumoniae (NESp) has increased with the introduction of pneumococcal conjugate vaccines in children; however, the bacteriological characteristics of NESp have not been sufficiently clarified. In this study, NESp strains isolated from the nasopharyngeal carriage of children from four nursery schools in Japan were analyzed for molecular type, antibiotic susceptibility, and biofilm productivity. A total of 152 putative S. pneumoniae strains were identified by optochin-susceptibility analysis, of which 21 were not serotypeable by slide agglutination, quellung reaction, or multiplex PCR. Among these 21 strains, three were lytA-negative and, therefore, not S. pneumoniae. The remaining 18 strains were positive for lytA, ply, pspK, and bile solubility and were confirmed as NESp. Therefore, the isolation rate of NESp in the S. pneumoniae strains in this study was 12.0% (18/149). Molecular-typing analyses classified five strains as two existing sequence types (STs; ST7502 and ST7786), and 13 strains formed four novel STs. Horizontal spread was suspected, because strains with the same ST were often isolated from the same nursery school. The NESp isolates were generally susceptible to most antimicrobials, with the exception of macrolides; however, all isolates possessed more than one abnormal penicillin-binding protein gene. Furthermore, NESp strains were more effective than encapsulated counterparts at forming biofilms, which showed obvious differences in morphology. These data indicated that NESp strains should be continuously monitored as emerging respiratory pathogens.


Assuntos
Antibacterianos/farmacologia , Biofilmes/efeitos dos fármacos , Infecções Pneumocócicas/terapia , Vacinas Pneumocócicas/uso terapêutico , Streptococcus pneumoniae/isolamento & purificação , Antibacterianos/uso terapêutico , Farmacorresistência Bacteriana/genética , Humanos , Lactente , Recém-Nascido , Japão/epidemiologia , Testes de Sensibilidade Microbiana , Tipagem Molecular/métodos , Mutação , Mucosa Nasal/microbiologia , Proteínas de Ligação às Penicilinas/genética , Infecções Pneumocócicas/epidemiologia , Infecções Pneumocócicas/microbiologia , Prevalência , Sorotipagem , Streptococcus pneumoniae/genética , Streptococcus pneumoniae/imunologia , Fatores de Virulência/genética
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