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2.
JAMA ; 326(4): 324-331, 2021 07 27.
Artigo em Inglês | MEDLINE | ID: mdl-34313686

RESUMO

Importance: Determination of optimal treatment durations for common infectious diseases is an important strategy to preserve antibiotic effectiveness. Objective: To determine whether 7 days of treatment is noninferior to 14 days when using ciprofloxacin or trimethoprim/sulfamethoxazole to treat urinary tract infection (UTI) in afebrile men. Design, Setting, and Participants: Randomized, double-blind, placebo-controlled noninferiority trial of afebrile men with presumed symptomatic UTI treated with ciprofloxacin or trimethoprim/sulfamethoxazole at 2 US Veterans Affairs medical centers (enrollment, April 2014 through December 2019; final follow-up, January 28, 2020). Of 1058 eligible men, 272 were randomized. Interventions: Participants continued the antibiotic prescribed by their treating clinician for 7 days of treatment and were randomized to receive continued antibiotic therapy (n = 136) or placebo (n = 136) for days 8 to 14 of treatment. Main Outcomes and Measures: The prespecified primary outcome was resolution of UTI symptoms by 14 days after completion of active antibiotic treatment. A noninferiority margin of 10% was selected. The as-treated population (participants who took ≥26 of 28 doses and missed no more than 2 consecutive doses) was used for the primary analysis, and a secondary analysis included all patients as randomized, regardless of treatment adherence. Secondary outcomes included recurrence of UTI symptoms and/or adverse events within 28 days of stopping study medication. Results: Among 272 patients (median [interquartile range] age, 69 [62-73] years) who were randomized, 100% completed the trial and 254 (93.4%) were included in the primary as-treated analysis. Symptom resolution occurred in 122/131 (93.1%) participants in the 7-day group vs 111/123 (90.2%) in the 14-day group (difference, 2.9% [1-sided 97.5% CI, -5.2% to ∞]), meeting the noninferiority criterion. In the secondary as-randomized analysis, symptom resolution occurred in 125/136 (91.9%) participants in the 7-day group vs 123/136 (90.4%) in the 14-day group (difference, 1.5% [1-sided 97.5% CI, -5.8% to ∞]) Recurrence of UTI symptoms occurred in 13/131 (9.9%) participants in the 7-day group vs 15/123 (12.9%) in the 14-day group (difference, -3.0% [95% CI, -10.8% to 6.2%]; P = .70). Adverse events occurred in 28/136 (20.6%) participants in the 7-day group vs 33/136 (24.3%) in the 14-day group. Conclusions and Relevance: Among afebrile men with suspected UTI, treatment with ciprofloxacin or trimethoprim/sulfamethoxazole for 7 days was noninferior to 14 days of treatment with regard to resolution of UTI symptoms by 14 days after antibiotic therapy. The findings support the use of a 7-day course of ciprofloxacin or trimethoprim/sulfamethoxazole as an alternative to a 14-day course for treatment of afebrile men with UTI. Trial Registration: ClinicalTrials.gov identifier: NCT01994538.


Assuntos
Antibacterianos/administração & dosagem , Ciprofloxacina/administração & dosagem , Combinação Trimetoprima e Sulfametoxazol/administração & dosagem , Infecções Urinárias/tratamento farmacológico , Idoso , Antibacterianos/efeitos adversos , Ciprofloxacina/efeitos adversos , Método Duplo-Cego , Esquema de Medicação , Duração da Terapia , Humanos , Masculino , Pessoa de Meia-Idade , Combinação Trimetoprima e Sulfametoxazol/efeitos adversos , Infecções Urinárias/microbiologia , Urina/microbiologia
3.
Pan Afr Med J ; 38: 284, 2021.
Artigo em Francês | MEDLINE | ID: mdl-34122711

RESUMO

Purple urine bag syndrome (PUBS) is an uncommon complication of urinary tract infection. It mainly affects elderly patients with constipation, chronic urinary catheter and prolonged bed rest. Several bacteria belonging to two different groups, the group converting indoxyl urinary sulphate into indoxyl and the group alkalizing urine by the production of urease, are associated with it. We here report two cases of young patients aged 30 and 16 years, living in Burkina Faso, with uremic encephalopathy associated with severe infection and cloudy urine with purple urine bag. Unlike cases reported in the literature, our cases occurred two and four days after urinary catheterization and in young patients without constipation. Despite early antibiotic therapy, outcome was unfavorable in one patient.


Assuntos
Cateterismo Urinário/efeitos adversos , Infecções Urinárias/urina , Urina/química , Adolescente , Adulto , Antibacterianos/administração & dosagem , Bactérias/isolamento & purificação , Encefalopatias/complicações , Encefalopatias/microbiologia , Burkina Faso , Cateteres de Demora/efeitos adversos , Feminino , Humanos , Indicã/urina , Síndrome , Uremia/diagnóstico , Infecções Urinárias/complicações , Infecções Urinárias/tratamento farmacológico , Urina/microbiologia
4.
BMC Infect Dis ; 21(1): 531, 2021 Jun 05.
Artigo em Inglês | MEDLINE | ID: mdl-34090359

RESUMO

BACKGROUND: Group B Streptococcus (GBS) is an important cause of invasive infection in neonates and infants. Cerebrospinal fluid (CSF) findings and culture may not show evidence of infection early in GBS meningitis. Next-generation sequencing (NGS) has the potential to detect microbial genetic material in patients with infectious diseases. We report two cases of infantile sepsis of GBS meningitis with negative results for CSF culture tests, but positive results for NGS analysis. CASE PRESENTATION: Patient 1 was a 22-day-old male infant diagnosed with sepsis and meningitis. His CSF findings showed pleocytosis, decreased glucose, and increased protein levels. However, CSF and blood culture results at admission were negative. He received a total of 3 weeks of treatment with ampicillin and cefotaxime, and showed clinical improvement. GBS was detected through NGS analysis of CSF collected at admission. Patient 2 was a 51-day-old male infant with sepsis. CSF findings on admission were normal, and blood and CSF cultures were also negative. Intravenous ampicillin and cefotaxime treatment were initiated. Treatment was de-escalated to ampicillin alone because Enterococcus faecalis was cultured from urine. He was discharged after a total of 1 week of antibiotic treatment. Six days after discharge, he was re-hospitalized for sepsis. Blood and CSF cultures were negative, and E. faecalis was again cultured from urine. He received a total of 3 weeks of ampicillin treatment for enterococcal-induced nephritis and did not relapse thereafter. NGS pathogen searches were retrospectively performed on both blood and CSF collected at the first and second admission. GBS was detected in the CSF collected at the first admission, but no significant pathogen was detected in the other samples. Inadequate treatment for GBS meningitis at the first admission may have caused the recurrence of the disease. CONCLUSION: Infantile sepsis may present bacterial meningitis that is not diagnosed by either culture testing or CSF findings. NGS analysis for CSF may be useful for confirming the diagnosis of bacterial meningitis.


Assuntos
Antibacterianos/uso terapêutico , Meningites Bacterianas/diagnóstico , Meningites Bacterianas/tratamento farmacológico , Infecções Estreptocócicas/diagnóstico , Infecções Estreptocócicas/tratamento farmacológico , Ampicilina/uso terapêutico , Cefotaxima/uso terapêutico , Líquido Cefalorraquidiano/microbiologia , Enterococcus faecalis/efeitos dos fármacos , Enterococcus faecalis/isolamento & purificação , Sequenciamento de Nucleotídeos em Larga Escala , Humanos , Lactente , Recém-Nascido , Masculino , Meningites Bacterianas/microbiologia , Estudos Retrospectivos , Sepse/diagnóstico , Sepse/tratamento farmacológico , Sepse/microbiologia , Streptococcus agalactiae/efeitos dos fármacos , Streptococcus agalactiae/genética , Streptococcus agalactiae/isolamento & purificação , Urina/microbiologia
5.
BMC Infect Dis ; 21(1): 501, 2021 May 29.
Artigo em Inglês | MEDLINE | ID: mdl-34051756

RESUMO

BACKGROUND: Tick-borne pathogens other than Borrelia burgdorferi sensu lato - the causative agent of Lyme borreliosis - are common in Ixodes ricinus ticks. How often these pathogens cause human disease is unknown. In addition, diagnostic tools to identify such diseases are lacking or reserved to research laboratories. To elucidate their prevalence and disease burden, the study 'Ticking on Pandora's Box' has been initiated, a collaborative effort between Amsterdam University Medical Center and the National Institute for Public Health and the Environment. METHODS: The study investigates how often the tick-borne pathogens Anaplasma phagocytophilum, Babesia species, Borrelia miyamotoi, Neoehrlichia mikurensis, spotted fever group Rickettsia species and/or tick-borne encephalitis virus cause an acute febrile illness after tick-bite. We aim to determine the impact and severity of these tick-borne diseases in the Netherlands by measuring their prevalence and describing their clinical picture and course of disease. The study is designed as a prospective case-control study. We aim to include 150 cases - individuals clinically suspected of a tick-borne disease - and 3 matched healthy control groups of 200 persons each. The controls consist respectively of a group of individuals with either a tick-bite without complaints, the general population and of healthy blood donors. During a one-year follow-up we will acquire blood, urine and skin biopsy samples and ticks at baseline, 4 and 12 weeks. Additionally, participants answer modified versions of validated questionnaires to assess self-reported symptoms, among which the SF-36, on a 3 monthly basis. DISCUSSION: This article describes the background and design of the study protocol of 'Ticking on Pandora's Box'. With our study we hope to provide insight into the prevalence, clinical presentation and disease burden of the tick-borne diseases anaplasmosis, babesiosis, B. miyamotoi disease, neoehrlichiosis, rickettsiosis and tick-borne encephalitis and to assist in test development as well as provide recommendations for national guidelines. TRIAL REGISTRATION: NL9258 (retrospectively registered at Netherlands Trial Register, trialregister.nl in in February 2021).


Assuntos
Ixodes/microbiologia , Doenças Transmitidas por Carrapatos/epidemiologia , Doenças Transmitidas por Carrapatos/microbiologia , Adulto , Animais , Sangue/microbiologia , Sangue/virologia , Estudos de Casos e Controles , DNA Bacteriano , Febre/epidemiologia , Febre/microbiologia , Febre/virologia , Seguimentos , Humanos , Pessoa de Meia-Idade , Países Baixos/epidemiologia , Prevalência , Estudos Prospectivos , Reação em Cadeia da Polimerase em Tempo Real , Índice de Gravidade de Doença , Pele/microbiologia , Pele/virologia , Inquéritos e Questionários , Picadas de Carrapatos/epidemiologia , Picadas de Carrapatos/microbiologia , Picadas de Carrapatos/virologia , Urina/microbiologia , Urina/virologia
6.
Toxins (Basel) ; 13(3)2021 03 02.
Artigo em Inglês | MEDLINE | ID: mdl-33801544

RESUMO

The removal of mycotoxins from contaminated feed using lactic acid bacteria (LAB) has been proposed as an inexpensive, safe, and promising mycotoxin decontamination strategy. In this study, viable and heat-inactivated L. acidophilus CIP 76.13T and L. delbrueckii subsp. bulgaricus CIP 101027T cells were investigated for their ability to remove aflatoxin B1 (AFB1), ochratoxin A (OTA), zearalenone (ZEA), and deoxynivalenol (DON) from MRS medium and PBS buffer over a 24 h period at 37 °C. LAB decontamination activity was also assessed in a ZEA-contaminated liquid feed (LF). Residual mycotoxin concentrations were determined by UHPLC-FLD/DAD analysis. In PBS, viable L. acidophilus CIP 76.13T and L. delbrueckii subsp. bulgaricus CIP 101027T cells removed up to 57% and 30% of ZEA and DON, respectively, while AFB1 and OTA reductions were lower than 15%. In MRS, 28% and 33% of ZEA and AFB1 were removed, respectively; OTA and DON reductions were small (≤15%). Regardless of the medium, heat-inactivated cells produced significantly lower mycotoxin reductions than those obtained with viable cells. An adsorption mechanism was suggested to explain the reductions in AFB1 and OTA, while biodegradation could be responsible for the removal of ZEA and DON. Both viable LAB strains reduced ZEA by 23% in contaminated LF after 48 h of incubation. These findings suggest that LAB strains of L. acidophilus CIP 76.13T and L. delbrueckii subsp. bulgaricus CIP 101027T may be applied in the feed industry to reduce mycotoxin contamination.


Assuntos
Ração Animal/microbiologia , Microbiologia de Alimentos , Fungos/metabolismo , Lactobacillus acidophilus/metabolismo , Lactobacillus delbrueckii/metabolismo , Micotoxinas/metabolismo , Adsorção , Animais , Fungos/crescimento & desenvolvimento , Humanos , Inativação Metabólica , Lactobacillus acidophilus/isolamento & purificação , Lactobacillus delbrueckii/isolamento & purificação , Viabilidade Microbiana , Sus scrofa , Urina/microbiologia
8.
Nutrients ; 13(4)2021 Apr 19.
Artigo em Inglês | MEDLINE | ID: mdl-33921829

RESUMO

Lactobacillus plantarum CJLP55 has anti-pathogenic bacterial and anti-inflammatory activities in vitro. We investigated the dietary effect of CJLP55 supplement in patients with acne vulgaris, a prevalent inflammatory skin condition. Subjects ingested CJLP55 or placebo (n = 14 per group) supplements for 12 weeks in this double-blind, placebo-controlled randomized study. Acne lesion count and grade, skin sebum, hydration, pH and surface lipids were assessed. Metagenomic DNA analysis was performed on urine extracellular vesicles (EV), which indirectly reflect systemic bacterial flora. Compared to the placebo supplement, CJLP55 supplement improved acne lesion count and grade, decreased sebum triglycerides (TG), and increased hydration and ceramide 2, the major ceramide species that maintains the epidermal lipid barrier for hydration. In addition, CJLP55 supplement decreased the prevalence of Proteobacteria and increased Firmicutes, which were correlated with decreased TG, the major skin surface lipid of sebum origin. CJLP55 supplement further decreased the Bacteroidetes:Firmicutes ratio, a relevant marker of bacterial dysbiosis. No differences in skin pH, other skin surface lipids or urine bacterial EV phylum were noted between CJLP55 and placebo supplements. Dietary Lactobacillus plantarum CJLP55 was beneficial to clinical state, skin sebum, and hydration and urine bacterial EV phylum flora in patients with acne vulgaris.


Assuntos
Acne Vulgar/microbiologia , Acne Vulgar/terapia , Suplementos Nutricionais , Vesículas Extracelulares/microbiologia , Lactobacillus plantarum , Método Duplo-Cego , Disbiose/microbiologia , Disbiose/terapia , Feminino , Humanos , Concentração de Íons de Hidrogênio , Masculino , Sebo/química , Pele/química , Pele/microbiologia , Resultado do Tratamento , Triglicerídeos/metabolismo , Urina/microbiologia , Adulto Jovem
9.
Orv Hetil ; 162(15): 579-586, 2021 04 02.
Artigo em Húngaro | MEDLINE | ID: mdl-33798103

RESUMO

Összefoglaló. Az immunrendszer nem megfelelo muködése meghatározó szerepet játszik a daganatok kialakulásában, progressziójában és az egyes terápiák hatékonyságában is. A bélrendszer baktériumai a szervezet immunitásán keresztül képesek befolyásolni a szervezet gyógyszeres terápiákra adott válaszreakcióját, kiváltképpen az immunellenorzopont-gátló kezelések hatását. Az újgenerációs nukleinsav-szekvenálási technológiák felhasználásával részletes képet kaphatunk a szervezetben jelen lévo baktériumok minoségi és mennyiségi viszonyairól. A közelmúltban összefüggést igazoltak a vastagbéldaganat, a melanoma, a vesesejtes carcinoma és a nem kissejtes tüdorák esetén alkalmazott immunellenorzopont-gátló terápiák hatékonysága és a bél mikrobiom-összetétele között. Számos olyan baktériumot azonosítottak, melynek jelenlétébol, illetve mennyiségébol következtethetünk az egyes kezelésekkel szembeni egyéni érzékenységre. Ezzel összhangban, az antibiotikumkezelés által okozott dysbiosis növelte az immunellenorzopont-gátló terápia sikertelenségének kockázatát. Ezen eredmények tükrében a jövoben a mikrobiom-összetétel meghatározása is fontos tényezo lehet az immunterápiák hatékonyságának elorejelzésében, illetve egyre inkább bizonyított, hogy a széles spektrumú antibiotikumkezelés a legtöbbször csökkenti a daganatellenes immunterápiák hatékonyságát. Jelenleg folyó klinikai vizsgálatok pedig a mikrobiom-összetétel mesterséges úton történo megváltoztatásának terápiás lehetoségeit tanulmányozzák. Bebizonyosodott, hogy a korábbi állásponttal szemben a vizelet nem steril. DNS-szekvenálás alkalmazásával számos olyan, a vizeletben eloforduló baktériumot sikerült azonosítani, melynek jelenléte hozzájárulhat a húgyhólyagrák kialakulásához és progressziójához, illetve a húgyhólyagban lokálisan alkalmazott BCG-terápia hatékonyságához. Jelen munkában a közelmúlt publikációit feldolgozva összefoglaljuk, mely baktériumok jelenléte hozható összefüggésbe a különbözo daganatok kialakulásával, progressziójával és terápiarezisztenciájával. Orv Hetil. 2020; 162(15): 579-586. Summary. Dysfunction of the immune system plays a crucial role in the development and progression of cancer as well as the effectiveness of antitumor therapies. Gut microbiota, due to their impact on the immune system, are able to influence response to anticancer drug therapies. Next-generation DNA-sequencing technologies enabled a comprehensive quantitative and qualitative exploration of the gut microbiome. An increasing body of evidence indicates the association between the efficacy of immune checkpoint inhibitor therapies and gut microbiome composition in colorectal cancer, malignant melanoma, renal cell carcinoma, and non-small cell lung cancer. Recently, several bacterial strains and species were shown to be associated with treatment efficacies. In accordance, dysbiosis caused by antibiotic treatment was found to increase the risk of failure to immune checkpoint inhibitor therapies. In the light of these results, examination of microbiome composition may become an important factor for the prediction of immunotherapies. Currently ongoing clinical trials are investigating the potential of therapeutic alteration of microbiome composition. Contrary to the previous view, urine has been shown not to be sterile. By using sensitive DNA-sequencing technologies, several urinary bacteria could be identified which may contribute to the development and progression of bladder cancer and may influence the efficacy of intravesical BCG therapy. In the present work, we summarize recent studies that identified the presence of certain bacteria associated with the development, progression, and therapy resistance of various cancers. Orv Hetil. 2020; 162(15): 579-586.


Assuntos
Microbiota , Neoplasias , Microbioma Gastrointestinal/imunologia , Humanos , Microbiota/imunologia , Neoplasias/imunologia , Neoplasias/terapia , Urina/microbiologia
11.
BMC Infect Dis ; 21(1): 303, 2021 Mar 25.
Artigo em Inglês | MEDLINE | ID: mdl-33765944

RESUMO

BACKGROUND: Proper detection of disease-causing organisms is very critical in controlling the course of outbreaks and avoiding large-scale epidemics. Nonetheless, availability of resources to address these gaps have been difficult due to limited funding. This report sought to highlight the importance of in-country partners and non-governmental organizations in improving detection of microbiological organisms in Ghanaian Public Health Laboratories (PHLs). METHODS/CONTEXT: This study was conducted between June, 2018 to August, 2019. U. S CDC engaged the Centre for Health Systems Strengthening (CfHSS) through the Association of Public Health Laboratories to design and implement strategies for strengthening three PHLs in Ghana. An assessment of the three PHLs was done using the WHO/CDS/CSR/ISR/2001.2 assessment tool. Based on findings from the assessments, partner organizations (CfHSS/APHL/CDC) serviced and procured microbiological equipment, laboratory reagents and logistics. CfHSS provided in-house mentoring and consultants to assist with capacity building in detection of epidemic-prone infectious pathogens by performing microbiological cultures and antimicrobial susceptibility tests. RESULTS: A total of 3902 samples were tested: blood (1107), urine (1742), stool (249) and cerebrospinal fluid (CSF) (804). All-inclusive, 593 pathogenic bacteria were isolated from blood cultures (70; 11.8%); urine cultures (356; 60%); stool cultures (19; 3.2%) and from CSF samples (148; 25%). The most predominant pathogens isolated from blood, urine and stool were Staphylococcus aureus (22/70; 31%), Escherichia coli (153/356; 43%) and Vibrio parahaemolyticus (5/19; 26.3%), respectively. In CSF samples, Streptococcus pneumoniae was the most frequent pathogen detected (80/148; 54.1%). New bacterial species such as Pastuerella pneumotropica, Klebsiella oxytoca, Vibrio parahaemolyticus, and Halfnia alvei were also identified with the aid of Analytical Profile Index (API) kits that were introduced as part of this implementation. Streptococcus pneumoniae and Neisseria meningitidis detections in CSF were highest during the hot dry season. Antimicrobial susceptibility test revealed high rate of S. aureus, K. pneumoniae and E. coli resistance to gentamicin (35-55%). In urine, E. coli was highly resistant to ciprofloxacin (39.2%) and ampicillin (34%). CONCLUSION: Detection of epidemic-prone pathogens can be greatly improved if laboratory capacity is strengthened. In-country partner organizations are encouraged to support this move to ensure accurate diagnosis of diseases and correct antimicrobial testing.


Assuntos
Bactérias/isolamento & purificação , Infecções Bacterianas/diagnóstico , Antibacterianos/farmacologia , Bactérias/efeitos dos fármacos , Infecções Bacterianas/microbiologia , Sangue/microbiologia , Líquido Cefalorraquidiano/microbiologia , Farmacorresistência Bacteriana/efeitos dos fármacos , Fezes/microbiologia , Gana , Humanos , Laboratórios , Testes de Sensibilidade Microbiana , Organizações , Estudos Retrospectivos , Estações do Ano , Urina/microbiologia
12.
Sci Rep ; 11(1): 2212, 2021 01 26.
Artigo em Inglês | MEDLINE | ID: mdl-33500504

RESUMO

Recent studies suggest that alterations in the female urinary microbiota is associated to development of bladder disease. However, the normal microbiota composition and variation in healthy women are poorly described. Moreover, the effects of hormonal changes on microbiota during menopause is not well understood. The aim of our study was to investigate the urinary microbiota in healthy pre- and postmenopausal women without urinary tract symptoms. Microbiota composition in catheterized urine samples was mapped using 16S rRNA gene sequencing. In total, 41 premenopausal and 42 postmenopausal women were initially included. Samples with first PCR amplification concentration below level of the negative control were excluded, resulting in 34 premenopausal and 20 postmenopausal women included in data analysis. Urine from postmenopausal women showed significantly higher alpha diversity compared to premenopausal women. Lactobacillus was the most abundant bacteria in both groups, however the relative abundance of Lactobacillus accounted for 77.8% in premenopausal versus 42.0% in postmenopausal women. In conclusion, urine from premenopausal mostly presented with Lactobacillus dominated urotypes, whereas urine from postmenopausal women presented a more diverse urinary microbiota with higher abundance of the genera Gardnerella and Prevotella. The clinical and pathophysiological implications of this difference remain to be elucidated.


Assuntos
Microbiota , Pós-Menopausa/urina , Pré-Menopausa/urina , Urina/microbiologia , Adulto , Bactérias/metabolismo , Feminino , Humanos , Pessoa de Meia-Idade
13.
Ann Clin Microbiol Antimicrob ; 20(1): 2, 2021 Jan 06.
Artigo em Inglês | MEDLINE | ID: mdl-33407528

RESUMO

BACKGROUND: Urinary retention (UR) is a common urinary system disease can be caused by urinary tract obstruction with numerous reasons, however, the role of urine microbes in these disorders is still poorly understood. The aim of this study was to identify the urine microbial features of two common types of obstructive UR, caused by urinary stones or urinary tract tumors, with comparison to healthy controls. METHODS: Urine samples were collected from a cohort of 32 individuals with stone UR, 25 subjects with tumor UR and 25 healthy controls. The urine microbiome of all samples was analyzed using high-throughput 16S rRNA (16S ribosomal RNA) gene sequencing. RESULTS: We observed dramatically increased urine microbial richness and diversity in both obstructive UR groups compared to healthy controls. Despite different origins of UR, bacteria such as Pseudomonas, Acinetobacter and Sphingomonas were enriched, while Lactobacillus, Streptococcus, Gardnerella, Prevotella and Atopobium were decreased in both UR groups in comparison with healthy controls, exhibited an approximate urine microbial community and functional characteristics of two types of obstructive UR. Furthermore, disease classifiers were constructed using specific enriched genera in UR, which can distinguish stone UR or tumor UR patients from healthy controls with an accuracy of 92.29% and 97.96%, respectively. CONCLUSION: We presented comprehensive microbial landscapes of two common types of obstructive urinary retention and demonstrated that urine microbial features of these patients are significantly different from that of healthy people. The urine microbial signatures would shed light on the pathogenesis of these types of urinary retention and might be used as potential classification tools in the future.


Assuntos
Disbiose/diagnóstico , Sequenciamento de Nucleotídeos em Larga Escala/métodos , Microbiota , Cálculos Urinários/microbiologia , Retenção Urinária/microbiologia , Urina/microbiologia , Neoplasias Urológicas/microbiologia , Adulto , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Cálculos Urinários/complicações , Neoplasias Urológicas/complicações , Adulto Jovem
14.
Sci Rep ; 11(1): 578, 2021 01 12.
Artigo em Inglês | MEDLINE | ID: mdl-33436687

RESUMO

Nowadays, increasing extended-spectrum ß-lactamase (ESBL)-producing bacteria have become a global concern because of inducing resistance toward most of the antimicrobial classes and making the treatment difficult. In order to achieve an appropriate treatment option, identification of the prevalent species which generate ESBL as well as their antibiotic susceptibility pattern is essential worldwide. Hence, this study aimed to investigate the prevalence of ESBL-producing bacteria and assess their drug susceptibility in Fardis Town, Iran. A total of 21,604 urine samples collected from patients suspected to have urinary tract infection (UTI) were processed in the current study. The antimicrobial susceptibility of the isolates was tested by the disk diffusion method. The ESBL producing bacteria were determined by Double Disc Synergy Test (DDST) procedure. Bacterial growth was detected in 1408 (6.52%) cases. The most common bacterial strains causing UTI were found E. coli (72.16%), followed by K. pneumoniae (10.3%) and S. agalactiae (5.7%). Overall, 398 (28.26%) were ESBL producer. The highest ESBL production was observed in E. coli, followed by Klebsiella species. ESBL producers revealed a higher level of antibiotic resistance compared with non-ESBLs. In conclusion, ESBL production in uropathogens was relatively high. Carbapenems and Aminoglycosides were confirmed as the most effective treatment options for these bacteria.


Assuntos
Antibacterianos/farmacologia , Escherichia coli/efeitos dos fármacos , Escherichia coli/enzimologia , Klebsiella pneumoniae/efeitos dos fármacos , Klebsiella pneumoniae/enzimologia , Streptococcus agalactiae/efeitos dos fármacos , Streptococcus agalactiae/enzimologia , Urina/microbiologia , beta-Lactamases/metabolismo , Aminoglicosídeos/isolamento & purificação , Aminoglicosídeos/farmacologia , Carbapenêmicos/farmacologia , Estudos Transversais , Farmacorresistência Bacteriana , Escherichia coli/isolamento & purificação , Humanos , Klebsiella pneumoniae/isolamento & purificação , Testes de Sensibilidade Microbiana/métodos , Streptococcus agalactiae/isolamento & purificação
15.
Anal Bioanal Chem ; 413(7): 2007-2020, 2021 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-33507352

RESUMO

Surface-enhanced Raman spectroscopy (SERS) is a vibrational method successfully applied in analytical chemistry, molecular biology and medical diagnostics. In this article, we demonstrate the combination of the negative dielectrophoretic (nDEP) phenomenon and a flexible surface-enhanced Raman platform for quick isolation (3 min), concentration and label-free identification of bacteria. The platform ensures a strong enhancement factor, high stability and reproducibility for the SERS response of analyzed samples. By introducing radial dielectrophoretic forces directed at the SERS platform, we can efficiently execute bacterial cell separation, concentration and deposition onto the SERS-active surface, which simultaneously works as a counter electrode and thus enables such hybrid DEP-SERS device vibration-based detection. Additionally, we show the ability of our DEP-SERS system to perform rapid, cultivation-free, direct detection of bacteria in urine and apple juice samples. The device provides new opportunities for the detection of pathogens.


Assuntos
Bacteriúria/diagnóstico , Eletroforese/métodos , Microbiologia de Alimentos , Sucos de Frutas e Vegetais/análise , Análise Espectral Raman/métodos , Urina/microbiologia , Eletrodos , Desenho de Equipamento , Escherichia coli/metabolismo , Vidro/química , Humanos , Limite de Detecção , Malus , Nanopartículas Metálicas/química , Metais , Microscopia Eletrônica de Varredura , Reprodutibilidade dos Testes , Silício/química , Urinálise
16.
Sci Rep ; 11(1): 259, 2021 01 08.
Artigo em Inglês | MEDLINE | ID: mdl-33420252

RESUMO

Chlamydia trachomatis (CT) increases its plasmid numbers when stressed, as occurs in clinical trachoma samples. Most CT tests target the plasmid to increase the test sensitivity, but some only target the chromosome. We investigated clinical urogenital samples for total plasmid copy numbers to assess its diagnostic value and intra-bacterial plasmid copy numbers to assess its natural variation. Both plasmid and chromosome copies were quantified using qPCR, and the plasmid:chromosome ratio (PCr) calculated in two cohorts: (1) 383 urogenital samples for the total PCR (tPCr), and (2) 42 vaginal swabs, with one half treated with propium-monoazide (PMA) to prevent the quantification of extracellular DNA and the other half untreated to allow for both tPCr and intra-bacterial PCr (iPCr) quantification. Mann-Whitney U tests compared PCr between samples, in relation to age and gender. Cohort 1: tPCr varied greatly (1-677, median 16). Median tPCr was significantly higher in urines than vaginal swabs (32 vs. 11, p < 0.001). Cohort 2: iPCr was more stable than tPCr (range 0.1-3 vs. 1-11). To conclude, tPCr in urogenital samples was much more variable than previously described. Transport time and temperature influences DNA degradation, impacting chromosomal DNA more than plasmids and urine more than vaginal samples. Data supports a plasmid target in CT screening assays to increase clinical sensitivity.


Assuntos
Chlamydia trachomatis/genética , Técnicas de Laboratório Clínico/métodos , Doenças Urogenitais Femininas/microbiologia , Dosagem de Genes , Doenças Urogenitais Masculinas/microbiologia , Tracoma/microbiologia , Cromossomos , Feminino , Doenças Urogenitais Femininas/diagnóstico , Humanos , Masculino , Doenças Urogenitais Masculinas/diagnóstico , Plasmídeos/urina , Tracoma/diagnóstico , Urina/microbiologia , Vagina/microbiologia , Adulto Jovem
17.
Int J Infect Dis ; 102: 40-44, 2021 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-33011278

RESUMO

OBJECTIVES: To implement evidence-based urinalysis (UA) reflex criteria and to evaluate the impact of the intervention on reducing unnecessary antibiotic usage. METHODS: A prospective intervention study was conducted on 4130 urine samples that were subjected to UA during March to May 2020. Results were analyzed in order to evaluate the effectiveness of newly implemented evidence-based criteria in predicting positive urine cultures. The intervention involved implementing evidence-based UA reflex criteria to ensure a high predictive value of the UA reflex parameters. Multivariable logistic regression was utilized to evaluate the effectiveness of these UA parameters in predicting positive urine cultures and to assess the impact of the new UA criteria on antibiotic usage. RESULTS: A total of 4130 patient samples were included in the study; 60.1% (n = 2484) were from female patients and 39.9% (n = 1646) were from male patients. The total number of negative urine reflex samples was 3116, which accounted for 75.4% of the total UA reflex samples. In contrast, 24.6% of the urine reflex samples (n = 1014) returned positive UA results and were reflexed to urine culture. Among the urine samples that were cultured, 9% (n = 91) were negative urine cultures, while 91.0% (n = 923) were positive urine cultures. Chi-square analysis indicated highly statistically significant associations between the combination parameters of (≥5 white blood cells (WBCs) and positive nitrite) and positive urine cultures (Chi-square = 516.428, p < 0.001) and (≥5 WBCs and moderate or large esterase) and positive urine cultures (Chi-square = 503.387, p < 0.001). Additionally, Chi-square analysis indicated a highly statistically significant association between the combination parameters of (≥5 WBCs and ≥1 bacteria) and positive urine cultures (Chi-square = 434.806, p < 0.001). The statistical analysis showed that the implementation of evidence-based UA reflex criteria significantly decreased the number of urine cultures performed and potentially decreased the number of patients inappropriately treated with antibiotics from 45.1% to 9%. CONCLUSIONS: In conclusion, ≥5 WBCs and positive nitrite yielded the highest positive predictive value of 98.00% and showed a highly significant association with positive urine cultures. It was observed that the new UA reflex criteria are highly effective in predicting positive urine cultures, thus potentially resulting in the reduction of unnecessary antibiotic usage.


Assuntos
Anti-Infecciosos/uso terapêutico , Prescrições de Medicamentos/estatística & dados numéricos , Infecções Urinárias/tratamento farmacológico , Resistência a Medicamentos , Prática Clínica Baseada em Evidências , Feminino , Humanos , Modelos Logísticos , Masculino , Análise Multivariada , Valor Preditivo dos Testes , Estudos Prospectivos , Urinálise , Infecções Urinárias/microbiologia , Infecções Urinárias/urina , Urina/microbiologia
18.
Bioelectrochemistry ; 137: 107639, 2021 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-32942188

RESUMO

Human urine can be turned into electricity in bio-electrochemical systems. The acclimation of electro-active bacteria to culture media with increasing urine concentrations has led to raising the obtained current densities, which typically followed a Monod-like evolution profile as a function of urine concentration. However, the acclimation protocol has been so far evaluated using pretreated urine samples (fermented or precipitated), not raw (un-pretreated) urine. We demonstrate that, when un-pretreated urine is used, the microbial adaptation to increasingly concentrated urine leads to a current density profile that does not reach a saturation-like phase, but follows a Han/Levenspiel-type trend (bell-shaped). By diluting un-pretreated urine with a synthetic domestic wastewater (Syntho) up to concentrations matching those of the maximum in the Han/Levenspiel-like current profile (15-20% v/v) it is possible to avoid the drop in the electro-active response, generating anodic current densities as high as 3.6 ± 0.2 A.m-2 (per actual surface area), 35-fold higher than those reached in pure un-pretreated urine.


Assuntos
Fontes de Energia Bioelétrica , Técnicas Eletroquímicas/métodos , Urina , Águas Residuárias , Bactérias/metabolismo , Meios de Cultura , Eletrodos , Fermentação , Humanos , Microbiota , Urina/microbiologia
19.
Rev. Pesqui. (Univ. Fed. Estado Rio J., Online) ; 13: 17-26, jan.-dez. 2021. tab
Artigo em Inglês, Português | LILACS, BDENF - Enfermagem | ID: biblio-1145877

RESUMO

Objetivo: verificar a demanda de hemoculturas, aspirados traqueais e uroculturas realizadas no HU-UNIVASF/ EBSERH e a prevalência dos microrganismos identificados no período de janeiro a junho de 2016. Métodos: estudo retrospectivo documental com abordagem quantitativa. Resultados: o setor de microbiologia realizou 488 hemoculturas, 427 uroculturas e 197 aspirados traqueais. A positividade de hemoculturas mostrou-se entre 10,9 à 25,7%, e o percentual de contaminações variou de 6,8 à 14,0%. Os microrganismos mais prevalência nas hemoculturas foram Staphylococcus epidermidis (23,7%), Staphylococcus aureus (19,3%) e Klebisiella pneumoniae (9,6%). Nas uroculturas foram Klebisiella pneumoniae (23,1%), Candida sp. (13,5%) e Escherichia coli (12,5%). Nos aspirados traqueais foram Acinetobacter baumannii (29,2%), Pseudomonas aeruginosa (26,6%) e Staphylococcus aureus (16,2%). Conclusão: a cultura mais solicitada foi hemocultura. A bactéria mais prevalente nas hemoculturas foi Staphylococcus epidermidis, nos aspirados traqueais Acinetobacter baumannii e nas uroculturas Klebisiella pneumoniae


Objective: the study's purpose has been to verify the demand for blood cultures, tracheal aspirates and urine cultures performed at a University Hospital from the Universidade Federal do Vale do São Francisco (HU-UNIVASF/EBSERH), as well as the predominance of microorganisms identified over the period from January to June 2016. Methods: it is a retrospective documentary study with a quantitative approach. Results: the microbiology sector carried out 488 blood cultures, 427 urine cultures and 197 tracheal aspirates. The positivity of blood cultures was between 10.9 and 25.7%, and the percentage of contaminations ranged from 6.8 to 14.0%. The most prevalent microorganisms in blood cultures were Staphylococcus epidermidis (23.7%), Staphylococcus aureus (19.3%) and Klebsiella pneumoniae (9.6%). In urine cultures were Klebsiella pneumoniae (23.1%), Candida sp. (13.5%) and Escherichia coli (12.5%). In tracheal aspirates were Acinetobacter baumannii (29.2%), Pseudomonas aeruginosa (26.6%) and Staphylococcus aureus (16.2%). Conclusion: the most requested culture was blood culture. The most prevalent bacterium in blood cultures was Staphylococcus epidermidis, in tracheal aspirates was Acinetobacter baumannii, and in urine cultures was Klebsiella pneumoniae


Objetivo: el propósito del trabajo es verificar la demanda de hemocultivos, aspirados traqueales y urocultivos realizados en el Hospital Universitário de la Universidade Federal do Vale do São Francisco (HU-UNIVASF/ EBSERH) y la prevalencia de los microorganismos identificados en el período de enero a junio de 2016. Métodos: este trabajo es un estudio retrospectivo documental con abordaje cuantitativo. Resultados: el sector de microbiología realizó 488 hemocultivos, 427 urocultivos y 197 aspirados traqueales. La positividad de hemocultivos se mostró entre el 10,9 al 25,7%, y el porcentaje de contaminaciones varía de 6,8 a 14,0%. Los microorganismos más prevalentes en los hemocultivos fueron Staphylococcus epidermidis (23,7%), Staphylococcus aureus (19,3%) y Klebsiella pneumoniae (9,6%). En los urocultivos fueron Klebisiella pneumoniae (23,1%), Candida sp. (13,5%) y Escherichia coli (12,5%). En los aspirados traqueales fueron Acinetobacter baumannii (29,2%), Pseudomonas aeruginosa (26,6%) y Staphylococcus aureus (16,2%). Conclusión: la cultura más solicitada fue hemocultivo. La bacteria más prevalente en los hemocultivos fue Staphylococcus epidermidis, en los aspirados traqueales, Acinetobacter baumannii y en los urocultivos, Klebisiella pneumoniae


Assuntos
Urina/microbiologia , Infecção Hospitalar/microbiologia , Infecção Hospitalar/epidemiologia , Técnicas Bacteriológicas/métodos , Hemocultura , Staphylococcus aureus , Staphylococcus epidermidis , Prevalência , Acinetobacter baumannii , Escherichia coli , Hospitais Universitários , Klebsiella pneumoniae
20.
Klin Lab Diagn ; 65(11): 707-711, 2020 Dec 04.
Artigo em Inglês | MEDLINE | ID: mdl-33301661

RESUMO

Studied 74 E. coli strains isolated from stool samples (60) and urine samples (14) of patients examined for clinical indications. Molecular methods included: PCR with electrophoretic detection of genes associated with diarrheal E. coli pathogroup EAgEC (aggR, aaf, aap, aatA, pet, ast, aai) and ExPEC pathogroup UPEC (pap, sfa, afa, kpsMT II, iutA, hlyA, cnf), MLST typing, whole genome sequencing. Strains isolated from stool samples were significantly more likely (88.3%, p > 0.05) to be typical EAgECaggR+ compared to atypical EAgECaggR-. Strains isolated from urine samples, significant differences between typical and atypical EAgEC were not detected (p > 0.05). Genes associated with ExPEC were present in all strains isolated from urine samples and in 45 strains (75%) isolated from stool samples. Coproisolates belonged to 10 serogroups and 13 serovars: O3:H2, O11:H10, O16:H48, O51:H30, O55:H21, O73:H18, O73:H33, O86:H2, O86:H10, O92:H33, O140:H2, O159:H10. Two strains had unique nucleotide sequences of genes encoding O-antigens that were missing from the SerotypeFinder database. 80% of EAgEC isolated from feces and urine was characterized by an enteroaggregative/uropathogenic genotype (EAgEC/UPEC). Most of the strains isolated from urine belonged to the virulent clone of high-risk epidemic spread ST 38 associated with hybrid strains of UPEC / EAgEC.


Assuntos
Infecções por Escherichia coli/microbiologia , Proteínas de Escherichia coli , Escherichia coli/genética , Proteínas de Escherichia coli/genética , Fezes/microbiologia , Variação Genética , Humanos , Tipagem de Sequências Multilocus , Filogenia , Urina/microbiologia , Virulência
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