Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 188
Filtrar
1.
BMC Microbiol ; 20(1): 22, 2020 Jan 29.
Artigo em Inglês | MEDLINE | ID: mdl-31996131

RESUMO

BACKGROUND: Staphylococcus aureus is a human pathogen that is a common cause of nosocomial infections and infections on indwelling medical devices, mainly due to its ability to shift between the planktonic and the biofilm/sessile lifestyle. Biofilm infections present a serious problem in human medicine as they often lead to bacterial persistence and thus to chronic infections. The immune responses elicited by biofilms have been described as specific and ineffective. In the few experiments performed in vivo, the importance of neutrophils and macrophages as a first line of defence against biofilm infections was clearly established. However, the bilateral interactions between biofilms and myeloid cells remain poorly studied and analysis of the dynamic processes at the cellular level in tissues inoculated with biofilm bacteria is still an unexplored field. It is urgent, therefore, to develop biologically sound experimental approaches in vivo designed to extract specific immune signatures from the planktonic and biofilm forms of bacteria. RESULTS: We propose an in vivo transgenic mouse model, used in conjunction with intravital confocal microscopy to study the dynamics of host inflammatory responses to bacteria. Culture conditions were created to prepare calibrated inocula of fluorescent planktonic and biofilm forms of bacteria. A confocal imaging acquisition and analysis protocol was then drawn up to study the recruitment of innate immune cells in the skin of LysM-EGFP transgenic mice. Using the mouse ear pinna model, we showed that inflammatory responses to S. aureus can be quantified over time and that the dynamics of innate immune cells after injection of either the planktonic or biofilm form can be characterized. First results showed that the ability of phagocytic cells to infiltrate the injection site and their motility is not the same in planktonic and biofilm forms of bacteria despite the cells being considerably recruited in both cases. CONCLUSION: We developed a mouse model of infection to compare the dynamics of the inflammatory responses to planktonic and biofilm bacteria at the tissue and cellular levels. The mouse ear pinna model is a powerful imaging system to analyse the mechanisms of biofilm tolerance to immune attacks.


Assuntos
Orelha/microbiologia , Interações entre Hospedeiro e Microrganismos/imunologia , Otite/imunologia , Pele , Infecções Cutâneas Estafilocócicas/imunologia , Staphylococcus aureus , Animais , Biofilmes , Modelos Animais de Doenças , Feminino , Masculino , Camundongos , Camundongos Transgênicos , Otite/microbiologia , Pele/imunologia , Pele/microbiologia , Staphylococcus aureus/patogenicidade , Staphylococcus aureus/fisiologia
4.
Vet Dermatol ; 30(3): 218-e67, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-30895679

RESUMO

BACKGROUND: Pseudomonas spp. are commonly isolated from dogs with clinical otitis and have been shown to produce biofilm. There is a paucity of studies demonstrating biofilm growth in veterinary medicine. HYPOTHESIS/OBJECTIVES: To compare biofilm production of Pseudomonas spp. isolated from dogs with otitis using three different enrichment broths at two different time points. Speciation was performed. ANIMALS: One hundred isolates from 98 dogs with clinical otitis were assessed for biofilm production. METHODS AND MATERIALS: One hundred isolates were assessed for biofilm production using a microtitre plate assay. Biofilm production in Luria-Bertani Broth (LBB), Mueller-Hinton Broth (MHB) and Tryptic Soy Broth (TSB) were assessed after 18 and 24 h of incubation. RESULTS: At 18 h, biofilm production was demonstrated in 87% of LBB, 91% of TSB and 93% of MHB grown isolates. By 24 h, this was 92% of LBB, 96% of TSB and 99% of MHB isolates. Biofilm production was significantly increased after 24 h incubation compared to 18 h. A significant difference was noted in biofilm production between LBB and MHB (P = 0.0349), but not between LBB and TSB (P = 0.3727) or MHB and TSB (P = 0.3687) at 24 h incubation. Two isolates were speciated as P. fluorescens and 98 as P. aeruginosa. CONCLUSION AND CLINICAL IMPORTANCE: Not all enrichment broths were equivalent to one another and 24 h incubation was superior to 18 h. Biofilm production was high in this population of Pseudomonas spp. isolates.


Assuntos
Biofilmes/crescimento & desenvolvimento , Meios de Cultura/química , Otite/microbiologia , Pseudomonas/crescimento & desenvolvimento , Animais , Caseínas/química , Cães , Testes de Sensibilidade Microbiana , Hidrolisados de Proteína/química
5.
J Clin Microbiol ; 57(4)2019 04.
Artigo em Inglês | MEDLINE | ID: mdl-30760535

RESUMO

The emerging yeast Candida auris can be highly drug resistant, causing invasive infections, and large outbreaks. C. auris went from an unknown pathogen a decade ago to being reported in over thirty countries on six continents. C. auris consists of four discrete clades, based on where the first isolates of the clade were reported, South Asian (clade I), East Asian (clade II), African (clade III), and South American (clade IV). These clades have unique genetic and biochemical characteristics that are important to understand and inform the global response to C. auris Clade II has been underrepresented in the literature despite being the first one discovered. In this issue of the Journal of Clinical Microbiology, Y. J. Kwon et al. (J Clin Microbiol 57:e01624-18, 2019, https://doi.org/10.1128/JCM.01624-18) describe the largest collection of clinical isolates from Clade II, which is also the longest-running span of clinical cases, 20 years, from any single region to date. Clade II appears to have a propensity for the ear that is uncharacteristic of the other clades, which typically cause invasive infections and large-scale outbreaks. This study provides new information on an understudied lineage of C. auris and has important implications for future surveillance.


Assuntos
Candida/classificação , Candida/fisiologia , Candidíase/microbiologia , Antifúngicos/farmacologia , Candida/efeitos dos fármacos , Candidíase/epidemiologia , Farmacorresistência Fúngica Múltipla , Humanos , Testes de Sensibilidade Microbiana , Otite/epidemiologia , Otite/microbiologia
6.
Auris Nasus Larynx ; 46(2): 294-301, 2019 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-30098846

RESUMO

OBJECTIVE: Ear, nose and throat infections are among the most common reasons for absence from work. They are usually caused by various bacteria like Haemophilus influenzae, Staphylococcus aureus, Streptococcus pneumoniae and Streptococcus pyogenes. Cold atmospheric plasma (CAP) can effectively eliminate even multi-resistant bacteria and has no cytotoxic or mutagenic effects on the mucosa when applied for less than 60s. Aim of the study was to evaluate the effects of CAP on common ENT bacteria and on the mucosa of the upper aerodigestive tract. METHODS: The bactericidal effects of CAP against the bacteria most commonly causing ENT infections were investigated using the colony-forming units assay (CFU) on a Müller-Hinton agar plate after applying CAP for 30, 60, 90 and 120s. To evaluate the interaction of CAP with mucosal cells, 3D mini organ cultures were treated for up to 180s, after which cell viability and necrosis induction were evaluated. RESULTS: Treatment with CAP for 60s or longer induced at least a 3-log10 reduction in the bacterial load (> 99.9%). Treatment times shorter than 60s had only slight cytotoxic effects on cell viability and necrosis whereas treatment times above 60s showed a fast increase of cytotoxic side effects. CONCLUSION: CAP exhibited strong bactericidal effects on the most common ENT pathogens. Treatment times of up to 60s showed only minimal adverse reactions in healthy mucosa. CAP could be a promising new therapeutic modality for ENT infections.


Assuntos
Haemophilus influenzae/efeitos dos fármacos , Otite/microbiologia , Gases em Plasma/farmacologia , Mucosa Respiratória/efeitos dos fármacos , Infecções Respiratórias/microbiologia , Staphylococcus aureus/efeitos dos fármacos , Streptococcus pneumoniae/efeitos dos fármacos , Streptococcus pyogenes/efeitos dos fármacos , Adulto , Sobrevivência Celular/efeitos dos fármacos , Contagem de Colônia Microbiana , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Necrose , Técnicas de Cultura de Órgãos , Orofaringe , Faringite/microbiologia , Mucosa Respiratória/patologia , Rinite/microbiologia , Adulto Jovem
7.
Med Mycol ; 57(2): 196-203, 2019 Feb 01.
Artigo em Inglês | MEDLINE | ID: mdl-29534201

RESUMO

Combination therapy has become popular in clinical practice, but limited data on the effects of combinations of antifungal agents is still available for most fungal pathogens. We studied the in vitro response of 30 genetically diverse clinical strains of the basidiomycetous lipophilic yeast Malassezia pachydermatis obtained from cases of canine otitis to several amphotericin B (AMB)-azole combinations. Broth microdilution checkerboard tests revealed that AMB antagonized the effects of itraconazole (ITC) and voriconazole (VRC) in 50% and 6.7% of the strains, respectively, but did not interact with fluconazole or posaconazole (fractional inhibitory concentration index (FICI) values were <4 in all cases). Subsequent Etest-based assays performed for a subset of strains did not confirm the antagonism between AMB and ITC or AMB and VRC. In summary, the results of this study suggest that antagonistic combination effects between AMB and azoles might occur when tested against M. pachydermatis. Nevertheless, as observed for other fungi, different in vitro analyses yielded contrasting results, and the response to AMB-azole combinations was compound- and strain-dependant.


Assuntos
Anfotericina B/farmacologia , Antifúngicos/farmacologia , Azóis/farmacologia , Dermatomicoses/veterinária , Doenças do Cão/microbiologia , Malassezia/efeitos dos fármacos , Malassezia/isolamento & purificação , Animais , Dermatomicoses/microbiologia , Cães , Malassezia/classificação , Testes de Sensibilidade Microbiana , Viabilidade Microbiana/efeitos dos fármacos , Otite/microbiologia , Otite/veterinária , Especificidade da Espécie
8.
J Laryngol Otol ; 132(9): 842-845, 2018 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-30187838

RESUMO

BACKGROUND: Unilateral total facial palsy is a debilitating condition that can affect an individual's physical, social and emotional wellbeing. When this occurs bilaterally, the severity of impact is extreme, with significant cosmetic disfigurement and functional morbidity. A variety of facial reanimation techniques have been used for unilateral facial weakness of varying House-Brackmann grades, and these are also applicable in bilateral cases. In bilateral cases, it is difficult to gauge successful improvement in comparison to the contralateral side, which also is afflicted.Case reportThis paper presents our experience with a bilateral facial paralysis patient who had a complex otological history. The patient, who presented with bilateral debilitating grade VI facial palsy, achieved a good result from bilateral facial reanimation with sequential hypoglossal-facial anastomosis. This is considered a reasonable option in cases of bilateral facial paralysis.


Assuntos
Anastomose Cirúrgica/métodos , Aspergilose/microbiologia , Paralisia de Bell/cirurgia , Orelha Média/microbiologia , Nervo Hipoglosso/cirurgia , Mastoidectomia/efeitos adversos , Otite/microbiologia , Aspergilose/complicações , Aspergilose/tratamento farmacológico , Aspergillus fumigatus/isolamento & purificação , Paralisia de Bell/classificação , Paralisia de Bell/etiologia , Paralisia de Bell/reabilitação , Orelha Média/patologia , Humanos , Nervo Hipoglosso/fisiopatologia , Doença Iatrogênica , Masculino , Pessoa de Meia-Idade , Procedimentos Neurocirúrgicos/métodos , Otite/complicações , Otite/tratamento farmacológico , Modalidades de Fisioterapia/efeitos adversos , Complicações Pós-Operatórias/patologia , Qualidade de Vida , Recuperação de Função Fisiológica/fisiologia , Resultado do Tratamento
9.
Pesqui. vet. bras ; 38(8): 1597-1607, Aug. 2018. tab, graf
Artigo em Inglês | LILACS, VETINDEX | ID: biblio-976469

RESUMO

Otitis externa is a common complaint in dogs. Bacteria and yeasts are commonly involved and may perpetuate inflammatory reactions inside the ear canal. Otoscopy, cytological examination of secretion and microbiological culture embody forms of diagnosis. Cytology also has great use in accessing treatment evolution. Therapy usually consists of cleaning ear canals and subsequent use of antibiotics or antifungal products. As some of them may cause hypersensitivity and even ototoxicity, searching for new pharmacological bases is currently necessary and justifies this study, which aimed to evaluate in vitro and in vivo efficacy of tea tree essential oil for bacterial and yeast ear infections in dogs. Twenty-eight dogs from a particular shelter in Cuiabá (Mato Grosso, Brazil), presenting clinical signs of otitis externa, were enrolled in this clinical trial. In all of them, clinical and cytological evaluations, as well as culture and susceptibility testing of the affected ears were carried out. From each dog, one ear was treated with 5% tea tree essential oil lotion and the other with standard otic formulation, according to the type of infection (bacterial, yeast or both). In vitro susceptibility testings of all ear cultures, to the same drugs used in treatment, were also carried out. Culture results showed 62.5% bacterial and fungal infection, 33.9% bacterial infection and 3.6% fungal infection, from the 56 ear samples collected. The most common microorganisms isolated were Staphylococcus intermedius, Staphylococcus aureus, Proteus mirabilis and Malassezia pachydermatis. Gram-positive bacteria were susceptible to gentamycin in 60.5% and resistant in 16.3% of the samples. Five percent tea tree essential oil formulation produced a 5mm clear zone of inhibition around the disks in one of the 63 samples evaluated. Pure (100%) tea tree essential oil formulation produced a 10mm clear zone of inhibition around the disks in four of the 63 samples evaluated, a 9mm zone in three samples, an 8mm zone in 16 samples, a 7mm zone in seven samples, a 6mm zone in two samples and there was no clear zone in 31 samples. Inhibition zones were produced by strains of Staphylococcus intermedius, Staphylococcus hyicus, Corynebacterium sp., Proteus mirabilis and Enterobacter sp. tea tree essential oil ear solution significantly induced remission of clinical signs both in bacterial and yeast ear infections. It also reduced as much Malassezia pachydermatis ear infection as the nystatin solution used in this study, while gentamycin solution showed better antibacterial effect. More studies should be conducted to evaluate in vitro diffusion properties of tea tree essential oil. Good antimicrobial spectrum and the absence of adverse reactions confirm the importance of developing a tea tree formulation as an alternative therapy for ear infections in dogs.(AU)


Otite externa é queixa frequente em cães. Bactérias e leveduras estão comumente envolvidas e podem perpetuar as reações inflamatórias dentro do canal auditivo. Dentre as formas de diagnóstico, encontram-se a otoscopia, o exame citológico da secreção e a cultura microbiológica. Citologia também tem grande utilidade no acesso à evolução do tratamento. A terapia consiste de limpeza dos canais auditivos e posterior utilização de antibióticos ou produtos antifúngicos. Como alguns antimicrobianos utilizados no tratamento podem causar hipersensibilidade e até mesmo ototoxicidade, a busca por novas bases farmacológicas justifica a existência deste estudo, que teve como objetivo avaliar in vitro e in vivo a eficiência do óleo de Melaleuca alternifolia em otites bacterianas e fúngicas de cães. Vinte e oito cães, de um abrigo particular, apresentando sinais clínicos de otite externa, foram incluídos neste estudo clínico. Todos passaram por avaliação clínica, citologia e cultura de material das orelhas afetadas. De cada animal, uma orelha foi tratada com óleo de Melaleuca 5% e a outra com formulação ótica padrão, de acordo com a afecção (bacteriana, fúngica ou mista). As culturas também foram submetidas a testes de susceptibilidade in vitro aos mesmos agentes utilizados no tratamento in vivo. Os resultados da cultura mostraram 62,5% de infecção mista (bacteriana e fúngica), 33,9% de infecção bacteriana e 3,6%, de infecção fúngica a partir das 56 orelhas. Os micro-organismos mais isolados foram Staphylococcus intermedius, Staphylococcus aureus, Proteus mirabilis e Malassezia pachydermatis. As bactérias GRAM-positivas foram sensíveis à gentamicina em 60,5% e resistentes em 16,3% das amostras. A formulação com 5% de óleo essencial de Melaleuca produziu uma zona de inibição de 5mm em torno dos discos em uma das 63 amostras avaliadas. A formulação pura (100%) do mesmo produto produziu uma zona de 10mm de inibição em quatro das 63 amostras analisadas, uma zona de 9 mm em três amostras, uma zona de 8mm em 16 amostras, uma zona de 7mm em sete amostras, uma zona de 6mm em duas amostras e não havia nenhuma zona clara em 31 amostras. Zonas de inibição foram produzidas por estirpes de Staphylococcus intermedius, Staphylococcus hyicus, Corynebacterium sp., Proteus mirabilis e Enterobacter sp. Clinicamente, a formulação com o óleo essencial de melaleuca induziu significativamente uma melhora nas manifestações, tanto nas otites bacterianas quanto nas causadas por leveduras, sendo estatisticamente semelhante ao tratamento com nistatina (nas otites por levedura), mas menos eficaz que a solução de gentamicina nas otites bacterianas. Mais estudos devem ser realizados para avaliar as propriedades de difusão in vitro do óleo essencial de melaleuca. O bom espectro antimicrobiano, a boa resposta clínica e a ausência de reações adversas confirmam a possibilidade de desenvolvimento de formulação ótica com o óleo essencial de melaleuca, como uma alternativa para a terapia de infecções do ouvido em cães.(AU)


Assuntos
Otite/microbiologia , Óleos Voláteis/síntese química , Melaleuca/química , Fitoterapia/estatística & dados numéricos
10.
BMJ Case Rep ; 20182018 Apr 21.
Artigo em Inglês | MEDLINE | ID: mdl-29680799

RESUMO

Q fever is a zoonotic disease caused by Coxiella burnetii that usually presents with non-specific or benign constitutional symptoms. Diagnosis is often challenging and, after acute Q fever, 1%-5% of patients can develop chronic disease. We present an 80-year-old male patient who was admitted due to a 3 months history of fever, productive cough, myalgia, weight loss, headache and hearing loss. Chronic Q fever was confirmed by positive antiphase I immunoglobulin G. Frequent locations of chronic infection was discarded, and ear CT revealed a right mastoid infection. He was treated with doxycycline and hydroxychloroquine for 18 months with significant improvement. This is a rare case of chronic Q fever presenting with otomastoiditis that has never been described.


Assuntos
Coxiella burnetii/isolamento & purificação , Mastoidite/patologia , Otite/patologia , Febre Q/diagnóstico , Febre Q/microbiologia , Idoso de 80 Anos ou mais , Antibacterianos/uso terapêutico , Antimaláricos/uso terapêutico , Doxiciclina/administração & dosagem , Doxiciclina/uso terapêutico , Humanos , Hidroxicloroquina/administração & dosagem , Hidroxicloroquina/uso terapêutico , Imunoglobulina G/sangue , Masculino , Mastoidite/diagnóstico por imagem , Mastoidite/tratamento farmacológico , Mastoidite/microbiologia , Otite/diagnóstico por imagem , Otite/tratamento farmacológico , Otite/microbiologia , Febre Q/imunologia , Tomografia Computadorizada por Raios X/métodos , Resultado do Tratamento
12.
Otolaryngol Head Neck Surg ; 158(5): 923-929, 2018 05.
Artigo em Inglês | MEDLINE | ID: mdl-29529928

RESUMO

Objective Despite the rising incidence of methicillin-resistant Staphylococcus aureus (MRSA) otologic infections, choice of treatment remains controversial. Only fluoroquinolone-containing ototopical preparations are approved by the US Food and Drug Administration for middle ear application. Furthermore, American Academy of Otolaryngology-Head and Neck Surgery Foundation guidelines advocate ototopical monotherapy for both tympanostomy tube otorrhea and acute otitis externa. Unfortunately, MRSA may be ciprofloxacin resistant. This causes confusion regarding antibiotic selection, because susceptibility profiles reflect a minimum inhibitory concentration (MIC), referenced against systemic, not ototopical, drug delivery dosing. The goal of this study is to determine the ciprofloxacin MIC for ciprofloxacin-resistant MRSA isolates from otologic infections and compare that value to the expected drug concentration achieved by fluoroquinolone ear drops and determine MRSA genotype for each isolate. Study Design In vitro assay with retrospective medical record review. Setting Tertiary care university hospital. Subjects and Methods Thirty otologically sourced ciprofloxacin-resistant MRSA isolates collected from adult and pediatric patients. MICs were calculated by broth dilution method. Isolates underwent multilocus sequence typing and polymerase chain reaction for arcA and Panton-Valentine leukocidin to establish the genotype. Results MICs ranged from 16 to 1025 µg/mL. There was a relationship between MIC and genotype; of the 7 isolates with an MIC value greater than 512 µg/mL, 6 were sequence type (ST)8. Conclusion These findings support the practice of ototopical monotherapy for patients with uncomplicated ciprofloxacin-resistant MRSA otitis externa. However, they raise concern that ototopical therapy may not be adequate to treat highly resistant strains of MRSA infecting the middle ear space.


Assuntos
Antibacterianos/farmacologia , Ciprofloxacino/farmacologia , Staphylococcus aureus Resistente à Meticilina/efeitos dos fármacos , Otite/microbiologia , Infecções Estafilocócicas/microbiologia , Adolescente , Adulto , Criança , Pré-Escolar , Feminino , Humanos , Lactente , Masculino , Testes de Sensibilidade Microbiana , Estudos Retrospectivos , Adulto Jovem
13.
Vet Microbiol ; 213: 102-107, 2018 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-29291992

RESUMO

The aim of this study was to investigate the prevalence and the implicated mechanisms of resistance against selected veterinary fluoroquinolones (enrofloxacin, marbofloxacin and pradofloxacin) among 101 Pseudomonas aeruginosa (n=75) and Escherichia coli (n=26) isolates collected from dogs suffering from otitis. Resistance ranged from 32.0% to 48.0% with differences not being considered statistically significant among the three agents or between the two bacterial species. However, individual MICs of pradofloxacin, the latest veterinary fluoroquinolone, were significantly lower than those of enrofloxacin, the oldest one, indicating an increased in vitro potency of the former antimicrobial. Pradofloxacin MIC90 was, additionally, the lowest (8µg/ml), in E. coli, or among the lowest (8µg/ml), in P. aeruginosa isolates. Resistance was in most cases associated with topoisomerase substitutions, with patterns GyrA:V73G in P. aeruginosa and GyrA:S83L+D87N/ParC:S58I+A86V in E. coli being reported for the first time in small animal isolates. Only 6.7% and 15.4% of P. aeruginosa and E. coli otitis isolates, respectively, carried plasmid-mediated quinolone resistance (PMQR) genes, which, moreover, contributed minimally to resistance. Efflux pump activity was additionally detected in resistant E. coli isolates, even those lacking topoisomerase substitutions or PMQR genes. The emergence of resistance in the canine otitis isolates seemed to be associated with previous, prolonged systemic fluoroquinolone administration. In any case, antimicrobial susceptibility testing should guide the selection of systemic FQs for the treatment of canine otitis.


Assuntos
Doenças do Cão/epidemiologia , Farmacorresistência Bacteriana , Infecções por Escherichia coli/veterinária , Otite/veterinária , Infecções por Pseudomonas/veterinária , Animais , Antibacterianos/farmacologia , Doenças do Cão/tratamento farmacológico , Doenças do Cão/microbiologia , Cães , Escherichia coli/efeitos dos fármacos , Escherichia coli/isolamento & purificação , Infecções por Escherichia coli/tratamento farmacológico , Infecções por Escherichia coli/epidemiologia , Infecções por Escherichia coli/microbiologia , Fluoroquinolonas/farmacologia , Grécia/epidemiologia , Testes de Sensibilidade Microbiana/veterinária , Otite/tratamento farmacológico , Otite/microbiologia , Prevalência , Infecções por Pseudomonas/tratamento farmacológico , Infecções por Pseudomonas/epidemiologia , Infecções por Pseudomonas/microbiologia , Pseudomonas aeruginosa/efeitos dos fármacos , Pseudomonas aeruginosa/isolamento & purificação
14.
Nutrients ; 9(7)2017 Jun 27.
Artigo em Inglês | MEDLINE | ID: mdl-28654019

RESUMO

Background: Fermented foods have been proposed to prevent common infectious diseases (CIDs) in children attending day care or preschool. OBJECTIVES: To investigate the efficacy of dietary supplementation with cow's skim milk fermented with the probiotic Lactobacillus paracasei CBA L74 in reducing CIDs in children attending day care or preschool. Methods: Multicenter, randomized, double-blind, placebo-controlled trial on healthy children (aged 12-48 months) consuming daily 7 grams of cow's skim milk fermented with L. paracasei CBA L74 (group A), or placebo (maltodextrins group B) attending day care or preschool during the winter season. The main outcome was the proportion of children who experienced ≥1 episode of CID during a 3-month follow-up. Fecal biomarkers of innate (α- and ß-defensins, cathelicidin) and acquired immunity (secretory IgA) were also monitored. Results: A total of 126 children (71 males, 56%) with a mean (SD) age of 33 (9) months completed the study, 66 in group A and 60 in group B. At intention to treat analysis, the proportion of children presenting ≥1 CID was 60% in group A vs. 83% in group B, corresponding to an absolute risk difference (ARD) of -23% (95% CI: -37% to -9%, p < 0.01). At per-protocol-analysis (PPA), the proportion of children presenting ≥1 CID was 18% in group A vs. 40% in group B, corresponding to an absolute risk difference (ARD) of -22% (95% CI: -37% to -6%, p < 0.01). PPA showed that the proportion of children presenting ≥1 acute gastroenteritis (AGE) was significantly lower in group A (18% vs. 40%, p < 0.05). The ARD for the occurrence of ≥1 AGE was -22% (95% CI: -37% to -6%, p < 0.01) in group A. Similar findings were obtained at PPA regarding the proportion of children presenting ≥1 upper respiratory tract infection (URTI), which was significantly lower in group A (51% vs. 74%, p < 0.05), corresponding to an ARD of -23% (95% CI: -40% to -7%, p < 0.01). Significant changes in innate and acquired immunity biomarkers were observed only in subjects in group A. Conclusions: Dietary supplementation with cow's skim milk fermented with L. paracasei CBA L74 is an efficient strategy in preventing CIDs in children.


Assuntos
Doenças Transmissíveis/microbiologia , Doenças Transmissíveis/terapia , Produtos Fermentados do Leite , Lactobacillus paracasei , Leite/microbiologia , Animais , Peptídeos Catiônicos Antimicrobianos/metabolismo , Bovinos , Pré-Escolar , Defensinas/metabolismo , Método Duplo-Cego , Fezes/química , Fezes/microbiologia , Feminino , Fermentação , Gastroenterite/microbiologia , Gastroenterite/prevenção & controle , Humanos , Imunoglobulina A/metabolismo , Lactente , Masculino , Otite/microbiologia , Otite/prevenção & controle , Faringite/microbiologia , Faringite/prevenção & controle , Probióticos/administração & dosagem , Rinite/microbiologia , Rinite/prevenção & controle , Tamanho da Amostra , Traqueíte/microbiologia , Traqueíte/prevenção & controle
16.
Eur J Clin Microbiol Infect Dis ; 36(9): 1685-1690, 2017 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-28429163

RESUMO

Empiric initial antibiotic therapy of bacterial infections is based primarily upon the susceptibility of the most common causative pathogens. The purpose of this study was to provide susceptibility data on six bacterial species known to cause ear, nose and throat (ENT) infections. A total of 1066 isolates collected during a nationwide laboratory-based surveillance study were analysed. All Streptococcus pyogenes isolates were penicillin (PEN)-susceptible, indicating that natural penicillins can still be recommended as the first-line treatment for group A streptococcal tonsillopharyngitis. Of the S. pneumoniae isolates, 92.9% were PEN-susceptible and of the Haemophilus influenzae isolates, 89.7% were amoxicillin-susceptible, retaining aminopenicillins as the first-line treatment for acute otitis media (AOM) and acute rhinosinusitis (ARS), in case antibiotic therapy is considered. In contrast, cefuroxime axetil seems less likely to be suitable for the treatment of AOM or ARS, as all Moraxella catarrhalis and >99% of the H. influenzae isolates were categorised as intermediate or resistant. The susceptibility rates of Pseudomonas aeruginosa were 97-100% for the drugs tested, except for the fluoroquinolones (87.6%). Overall, bacterial isolates from outpatients presenting with ENT infections showed low frequencies of resistance in Germany. However, given the emergence of multidrug resistance to standard antibiotics in Escherichia coli and other pathogens, inappropriate use of broad-spectrum antibiotics for the treatment of ENT infections has to be avoided.


Assuntos
Infecções Bacterianas/epidemiologia , Infecções Bacterianas/microbiologia , Otite/epidemiologia , Otite/microbiologia , Faringite/epidemiologia , Faringite/microbiologia , Rinite/epidemiologia , Rinite/microbiologia , Anti-Infecciosos/farmacologia , Serviços de Saúde Comunitária , Alemanha/epidemiologia , Humanos , Testes de Sensibilidade Microbiana
17.
Mycoses ; 60(8): 488-492, 2017 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-28378904

RESUMO

Fungal otomastoiditis is a rare disease, but can be fatal for immunocompromised patients. Recently, there have been increasing cases of otologic infection caused by Candida auris. Candida auris can be easily misdiagnosed for other species and treatment is difficult due to multidrug resistance. Clinician should be aware of this rare pathogen, and it should be treated with appropriate antifungal agent with surgical debridement.


Assuntos
Candida/isolamento & purificação , Candidíase/microbiologia , Mastoidite/microbiologia , Otite/microbiologia , Antifúngicos/farmacologia , Antifúngicos/uso terapêutico , Candida/classificação , Candida/efeitos dos fármacos , Candida/genética , Candidíase/diagnóstico , Candidíase/tratamento farmacológico , Candidíase/cirurgia , Desbridamento , Fluconazol/farmacologia , Fluconazol/uso terapêutico , Humanos , Masculino , Mastoidite/diagnóstico por imagem , Mastoidite/tratamento farmacológico , Mastoidite/cirurgia , Testes de Sensibilidade Microbiana , Pessoa de Meia-Idade , Ventilação da Orelha Média , Otite/diagnóstico por imagem , Otite/tratamento farmacológico , Otite/cirurgia , RNA Ribossômico/genética , Tomografia Computadorizada por Raios X
18.
Vet Dermatol ; 28(1): 118-e25, 2017 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-27426073

RESUMO

BACKGROUND: Pseudomonas aeruginosa is an opportunistic pathogen of the canine ear canal and occupies aquatic habitats in the environment. Nosocomial and zoonotic transmission of P. aeruginosa have been documented, including clonal outbreaks. HYPOTHESIS/OBJECTIVES: The primary objective of this study was to assess various environmental exposures as potential risk factors for canine Pseudomonas otitis. It was hypothesized that isolates derived from infected ears would be clonal to isolates derived from household water sources and the mouths of human and animal companions of the study subjects. ANIMALS: Seventy seven privately owned dogs with otitis were enrolled, along with their human and animal household companions, in a case-control design. METHODS: Data on potential risk factors for Pseudomonas otitis were collected. Oral cavities of all study subjects, their human and animal companions, and household water sources were sampled. Pulsed field gel electrophoresis was used to estimate clonal relatedness of P. aeruginosa isolates. RESULTS: In a multivariate model, visiting a dog park was associated with 77% increased odds of case status (P = 0.048). Strains clonal to the infection isolates were obtained from subjects' mouths (n = 18), companion pets' mouths (n = 5), pet owners' mouths (n = 2), water bowls (n = 7) and water taps (n = 2). Clonally related P. aeruginosa isolates were obtained from dogs that had no clear epidemiological link. CONCLUSIONS AND CLINICAL IMPORTANCE: Genetic homology between otic and environmental isolates is consistent with a waterborne source for some dogs, and cross-contamination with other human and animal members within some households.


Assuntos
Doenças do Cão/microbiologia , Otite/veterinária , Infecções por Pseudomonas/veterinária , Pseudomonas aeruginosa/genética , Animais , Estudos de Casos e Controles , Doenças do Cão/epidemiologia , Cães , Eletroforese em Gel de Campo Pulsado/veterinária , Humanos , Masculino , Otite/epidemiologia , Otite/microbiologia , Estudos Prospectivos , Infecções por Pseudomonas/epidemiologia , Infecções por Pseudomonas/microbiologia , Pseudomonas aeruginosa/isolamento & purificação , Fatores de Risco , Zoonoses/epidemiologia , Zoonoses/microbiologia
20.
Eur J Clin Microbiol Infect Dis ; 35(5): 735-40, 2016 May.
Artigo em Inglês | MEDLINE | ID: mdl-26951264

RESUMO

There is an increased recovery of Fusobacterium necrophorum from cases of otitis media and mastoiditis in the pediatric population. These infections may be highly severe, causing local osteomyelitis, bacteremia, and Lemierre's syndrome. The severity and difficulties in providing optimal treatment for these infections may be especially difficult in this age group due to immunological immaturity and delayed presentation. In this review of literature, we present and analyze the clinical presentation, management, and outcome of otic infections caused by F. necrophorum in infants and young toddlers less than 2 years old. Search in Pubmed was conducted for reported cases in the English literature for the time period of the last 50 years. Twelve well-described cases were retrieved with F. necrophorum otitis and mastoiditis and complications reported in all cases. Treatment included both intravenously with antimicrobial agents (beta lactams plus metronidazole) and mastoidectomy. Lemierre's syndrome and Lemierre's syndrome variants developed in 60 % of the patients. Dissemination of the infection as distal osteomyelitis and septic shock were also reported. The outcome was favorable in all the cases. Otitis and mastoiditis infections in children less then 2 years old are invasive infections, and severe complications can occur.


Assuntos
Infecções por Fusobacterium/microbiologia , Fusobacterium necrophorum/fisiologia , Mastoidite/microbiologia , Otite/microbiologia , Fatores Etários , Pré-Escolar , Infecções por Fusobacterium/complicações , Infecções por Fusobacterium/diagnóstico , Infecções por Fusobacterium/terapia , Humanos , Lactente , Recém-Nascido , Mastoidite/complicações , Mastoidite/diagnóstico , Mastoidite/terapia , Otite/complicações , Otite/diagnóstico , Otite/terapia
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA