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1.
Einstein (Sao Paulo) ; 18: eRC5063, 2020.
Artigo em Inglês, Português | MEDLINE | ID: mdl-31553357

RESUMO

A 65-year-old male with a history of urinary tract trauma requiring cystotomy and chronic bladder catheterization, presenting with chronic and uninvestigated changes in the color of the urine bag system, with no urine color change, and positive urine culture for Proteus mirabilis . These characteristics refer to the purple urine bag syndrome, a not weel-known condition, with a benign course in most cases, and associated with urinary tract infection in patients with chronic bladder catheterization. Although it is characterized by marked changes, it is underdiagnosed by healthcare professionals.


Assuntos
Infecções Relacionadas a Cateter/microbiologia , Coletores de Urina/efeitos adversos , Infecções Urinárias/microbiologia , Idoso , Infecções Relacionadas a Cateter/patologia , Humanos , Masculino , Proteus mirabilis/isolamento & purificação , Fatores de Risco , Síndrome , Infecções Urinárias/patologia , Urina/microbiologia
2.
J Med Microbiol ; 68(10): 1471-1478, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31418671

RESUMO

Purpose. To identify potential biomarkers and/or therapeutic targets for bladder cancer we characterized and analysed the composition of the urinary microbiota from bladder cancer and non-cancer patients.Methodology. In this study, we collected urine samples from 29 bladder cancer patients and 26 non-cancer patients. To avoid contamination and the impact of antibiotics, urine specimens were collected in a clean manner prior to antibiotic administration. Using the amplicon-based next-generation sequencing approach, the potential determinant bacteria were estimated in a between-group comparison. The results illustrated the differences in microbiota abundance among cancer and non-cancer patients and the overall number of cases carrying these bacteria.Results. We found that the urine samples contained a conserved microbiota with four phyla (Firmicutes, Actinobacteria, Proteobacteria and Bacteroidetes), which accounted for 94.4 % of bacteria in all cases. Comparing the microbiota between the bladder cancer and control group, five genera of bacteria (Streptococcus, Bifidobacterium, Lactobacillus, Veillonella and Actinomyces) existed in all samples, but with significant intergroup differences (P<0.05). The bladder cancer patients presented with a higher abundance of Actinomyces, while the other strains were enriched in the control group. A higher abundance of Actinomyces europaeus was also observed in the bladder cancer group compared to the control group.Conclusion. The samples collected from the bladder cancer patients displayed a significantly different pattern relative to those from the control group. The higher abundance of A. europaeus observed in bladder cancer patient samples also suggests that the strain may be indicative of bladder cancer. The urinary microbiota may be a potential biomarker and therapeutic target for bladder cancer.


Assuntos
Bactérias/isolamento & purificação , Microbiota , Neoplasias da Bexiga Urinária/microbiologia , Bexiga Urinária/microbiologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Bactérias/classificação , Bactérias/genética , Biomarcadores/análise , Estudos de Casos e Controles , Humanos , Masculino , Pessoa de Meia-Idade , Urina/microbiologia
3.
BMC Infect Dis ; 19(1): 531, 2019 Jun 17.
Artigo em Inglês | MEDLINE | ID: mdl-31208347

RESUMO

BACKGROUND: Clinical microbiology laboratories are asked to process large numbers of urine specimens for culture, but only 20-40% of them are positive. Therefore, a rapid, reliable screening method is necessary to speed up the reporting of a negative result. In this study, we evaluated the iQ200/iChem workstation, which is a combination of digital imaging software and a strip reader to predict negative urine culture. METHOD: A total of 1942 urine specimens were processed through both culture and iQ200/ iChem workstation. We analyzed the performance using two definition of positive urine culture; one or two potential uropathogens at a concentration of ≥105 CFU/ml and ≥ 104 CFU/ml. We assessed combinations of parameters (ASP; all small particles, WBC; leukocyte, BACT; bcteria, LE; leukocyte esterase) applying various cut-offs which can achieve the negative predictive value (NPV) ≥97% and culture reduction rate ≥ 50%. RESULTS: The culture positive rate was 12.8 and 18.4% applying the criteria of ≥105 CFU/ml and ≥ 104 CFU/ml, respectively. The area under the curve (AUC) of each parameter for ≥105 CFU/ml / ≥104 CFU/ml bacteriuria was 795 /0.719 for WBC, 0.722 / 0.701 for ASP and 0.740 /0.704 for bacteria. Therefore, we investigated the combination of the parameters. With the fixed parameter of BACT≥1/HPF and positive LE, the combinations of WBC ≥ 4/HPF and ASP ≥8500/µl or WBC ≥ 6/HPF and ASP≥5500/µl showed good performance for detecting ≥105 CFU/ml uropathogen. The ranges of sensitivity, specificity, negative predictive value and culture reduction rate were 91.5-92.3%, 49.8-52.6%, 97.7-97.9% and 50.4-53.0%, respectively. However, none of the combined setting yielded acceptable range of NPV for detecting ≥104 CFU/ml uropathogen (NPV 92.9-94.9%). Enterococcus spp. was the most common uropathogen causing the false negative results (55.7%), and also the main pathogen among the positive culture of 104-5 CFU/ml bacteriuria (45%). CONCLUSIONS: iQ200/iChem workstation was excellent in detection of ≥105 CFU/ml uropathogen, but unsatisfactory in detection of 104-5 CFU/ml uropathogen and Enterococcus spp. It can be useful for screening of urine specimens to reduce bacterial culture. However, notice from clinician will be necessary for specimens from the patients with high risk for UTI, such as pregnant woman, infant, elderly or immune compromised patients.


Assuntos
Urinálise/instrumentação , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Bacteriúria/diagnóstico , Hidrolases de Éster Carboxílico/análise , Criança , Pré-Escolar , Enterococcus/isolamento & purificação , Feminino , Humanos , Processamento de Imagem Assistida por Computador , Lactente , Recém-Nascido , Leucócitos , Masculino , Programas de Rastreamento , Pessoa de Meia-Idade , Sensibilidade e Especificidade , Software , Urinálise/métodos , Infecções Urinárias/microbiologia , Urina/microbiologia , Adulto Jovem
4.
Zhonghua Wei Zhong Bing Ji Jiu Yi Xue ; 31(5): 629-632, 2019 May.
Artigo em Chinês | MEDLINE | ID: mdl-31198153

RESUMO

OBJECTIVE: To investigate the detection and distribution of hospitalized specimens from a tertiary hospital over 5 years. METHODS: Specimens of sputum, urine, blood, secretions and puncture fluid were collected from patients admitted to the Harrison International Peace Hospital from November 2013 to November 2018. The origin of specimens, the distribution of departments and the distribution of pathogenic bacteria isolated were analyzed retrospectively. RESULTS: A total of 61 286 specimens were sent for examination during the 5 years. The top 5 specimens were sputum culture (n = 18 302, 29.9%), sputum smear (n = 11 253, 18.4%), blood culture (n = 9 713, 15.8%), urine culture (n = 6 448, 10.5%) and secretion culture (n = 6 133, 10.0%), accounting for 84.6% (51 849/61 286). Sputum specimens accounted for 48.2% (29 555/61 286) with the largest proportion. The number of specimens from medical wards was much higher than that from surgical wards (specimens: 25 468 vs. 10 521), respiratory medicine, department of critical care medicine and emergency intensive care unit (EICU) were important sources of pathogenic specimens in the hospital, accounting for 29.8% (18 243/61 286) in total. The average positive rate of all specimens was 23.5% (14 424/61 286). The positive rates of sputum culture and urine culture were 29.7% (5 428/18 302) and 35.4% (2 281/6 448), respectively, while the positive rate of blood culture was only 6.6% (643/9 713). Escherichia coli was the most common pathogen in all specimens except for sputum culture and fecal culture. Escherichia coli [40.6% (926/2 281)], Klebsiella pneumoniae [9.2% (210/2 281)], Pseudomonas aeruginosa [8.2% (188/2 281)], Enterococcus faecalis (group D) [6.6% (151/2 281)] and Candida albicans [3.2% (73/2 281)] were the most common pathogens in urine culture. Klebsiella pneumoniae [24.1% (1 309/5 428)], Acinetobacter baumannii [21.3% (1 154/5 428)], Pseudomonas aeruginosa [15.1% (818/5 428)], Escherichia coli [6.5% (351/5 428)] and Maltose oligotrophomonas maltose [5.8% (316/5 428)] were the most common pathogens in sputum culture. Escherichia coli [36.5% (235/643)], Klebsiella pneumoniae [10.9% (70/643)], Pseudomonas aeruginosa [4.8% (31/643)], Staphylococcus epidermidis [3.4% (22/643)] and Staphylococcus humanis [3.3% (21/643)] were the most common pathogens in blood culture. CONCLUSIONS: Specimens sent for examination by inpatients are mainly from internal medicine wards, mainly from sputum, blood and urine, and the detected pathogens are mainly Gram-negative bacteria.


Assuntos
Manejo de Espécimes/estatística & dados numéricos , Centros de Atenção Terciária , Sangue/microbiologia , Bactérias Gram-Negativas/isolamento & purificação , Hospitalização , Humanos , Medicina Interna/estatística & dados numéricos , Estudos Retrospectivos , Escarro/microbiologia , Urina/microbiologia
5.
Talanta ; 201: 245-252, 2019 Aug 15.
Artigo em Inglês | MEDLINE | ID: mdl-31122419

RESUMO

In this study, the coupling of magnetic enrichment of bacteria from real samples with rapid surface enhanced Raman spectroscopy (SERS) detection was reported. The selective isolation and enrichment for the model bacteria Escherichia coli (E. coli) was performed using E. coli (primary) antibody bound-magnetic gold (Fe3O4@Au) nanoparticles. Following isolation and enrichment, the rennet enzyme was used to cleave of casein modified Fe3O4/Au-PEI nanoparticles from primary antibody-bound bacteria to prevent the nanoparticle aggregation and provide the movement of bacteria on nitrocellulose membrane. In the first part of the study, optimization studies were carried out namely; the amounts of gold nanoparticles (AuNPs), polyethyleneimine coated magnetic gold (Fe3O4/Au-PEI) nanoparticles, casein and rennet enzyme. The SERS signals of DTNB (5,5'-Dithiobis(2-nitrobenzoic acid)) molecule were collected on the test line and a calibration curve was plotted by using signal intensities. The correlation between the concentration of E. coli and SERS signal was found to be linear within the range of 101-107 cfu/mL (R2 = 0.984, LOD = 0.52 cfu/mL and LOQ = 1.57 cfu/mL). The selectivity of the paper-based lateral flow immunoassay (LFIA) was examined with Bacillus subtilis (B. subtilis), Micrococcus luteus (M. luteus), Salmonella enteritidis (S. enteritidis) which did not produce any significant response compared with E. coli measurement. Finally, the developed paper-based LFIA was tested with urine and milk samples. The obtained SERS results were compared with a plate counting method results which were in a good accordance. The developed method was found as rapid and sensitive to E. coli with a total analysis time of less than 60 min.


Assuntos
Bactérias/isolamento & purificação , Técnicas de Tipagem Bacteriana/métodos , Nanopartículas de Magnetita/química , Leite/microbiologia , Papel , Urina/microbiologia , Animais , Anticorpos/imunologia , Bacillus subtilis/isolamento & purificação , Caseínas/imunologia , Quimosina/química , Escherichia coli/isolamento & purificação , Ouro/química , Limite de Detecção , Micrococcus luteus/isolamento & purificação , Salmonella enteritidis/isolamento & purificação
6.
Dis Markers ; 2019: 5853486, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30944667

RESUMO

Background: Bacterium and leucocyte counts in urine can be measured by urine flow cytometry (UFC). They are used to predict significant bacterial growth in urine culture and to diagnose infections of the urinary tract. However, little information is available on appropriate UFC cut-off values for bacterium and leucocyte counts in specific clinical presentations. Objective: To develop, validate, and evaluate adapted cut-off values that result in a high negative predictive value for significant bacterial growth in urine culture in common clinical presentation subgroups. Methods: This is a single center, retrospective, observational study with data from patients of the emergency department of Bern University Hospital, Switzerland, with suspected infections of the urinary tract. The patients presented with different symptoms, and urine culture and urine flow cytometry were performed. For different clinical presentations, the patients were grouped by (i) age (>65 years), (ii) sex, (iii) clinical symptoms (e.g., fever or dysuria), and (iv) comorbidities such as diabetes and immunosuppression. For each group, cut-off values were developed, validated, and analyzed using different strategies, i.e., linear discriminant analysis (LDA) and Youden's index, and were compared with known cut-offs and cut-offs optimized for sensitivity. Results: 613 patients were included in the study. Significant bacterial growth in urine culture depended on clinical presentation and ranged from 32.3% in male patients to 61.5% in patients with urinary frequency. In all clinical presentations, the predictive accuracy of UFC leucocyte and UFC bacterium counts was good for significant bacterial growth in urine culture (AUC ≥ 0.88). The adapted LDA95 equations did not exhibit consistently high sensitivity. However, the in-house cut-offs (test positive if UFC leucocytes > 17/µL or UFC bacteria > 125/µL) were highly sensitive (>90%). In female, younger, and dysuric patients, even higher cut-offs for UFC leucocytes (169/µL, 169/µL, and 205/µL) exhibited high sensitivity. Specificity was insufficient (<0.9) for all tested cut-offs. Conclusions: For various clinical presentations, significant bacterial growth in urine culture can be excluded if flow cytometry measurements give a bacterial count of ≤125/µL or a leucocyte count of ≤17/µL. In female patients, dysuric patients, and patients younger than ≤65 years, the leucocyte cut-off can be increased to 170/µL.


Assuntos
Citometria de Fluxo/normas , Infecções Urinárias/urina , Urina/microbiologia , Idoso , Carga Bacteriana , Feminino , Citometria de Fluxo/métodos , Humanos , Contagem de Leucócitos , Masculino , Pessoa de Meia-Idade , Infecções Urinárias/microbiologia , Infecções Urinárias/patologia , Urina/citologia
7.
Mycoses ; 62(7): 554-561, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-31025417

RESUMO

Candidaemia is the most common clinical presentation of invasive candidiasis and is a major cause of morbidity and mortality. Candiduria is a predictor for candidaemia; however, patient characteristics that are associated with concurrent candidaemia in the setting of candiduria are unclear. Identifying these characteristics could aid in the early detection of systemic disease. We performed a retrospective cohort analysis of hospitalised patients with candiduria at our institution over a 13-year period. Our evaluation of patient characteristics included demographics, comorbidities, medications, procedures, devices, vital signs and laboratory values. We developed a multivariable logistic model to identify factors associated with candidaemia in patients with candiduria. We identified 4240 patients with candiduria, 263 (6.2%) of whom had candidaemia. Predictors for increased risk of candidaemia with candiduria included hospitalisations > 12 days, central venous catheter, parenteral nutrition, haematological and gynaecological malignancy, and receipt of ß-lactam/ß-lactamase inhibitors. Vital signs and laboratory values associated with candidaemia included elevated heart rate, temperature and creatinine, along with neutropenia and neutrophilia. Factors that demonstrated a decreased risk of candidaemia included diabetes mellitus, gastrostomy and urinary catheter with antibiotic use. The c-statistic was 0.741 (95% CI, 0.710-0.772). We identified a set of clinical characteristics that can predict the presence of candidaemia with candiduria.


Assuntos
Candida/isolamento & purificação , Candidemia/diagnóstico , Técnicas de Apoio para a Decisão , Urina/microbiologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos
8.
PLoS Negl Trop Dis ; 13(4): e0007293, 2019 04.
Artigo em Inglês | MEDLINE | ID: mdl-30986214

RESUMO

Non-typhoidal Salmonella (NTS) bacteremia is a significant cause of morbidity and mortality worldwide. It is considered to be an emerging and neglected tropical disease in Africa. We studied this in two tertiary hospitals-Al Farwaniya and Al Amiri-in Kuwait, a subtropical country, from April 2013-May 2016. NTS bacteremia was present in 30 of 53,860 (0.75%) and 31 of 290,36 (1.33%) blood cultures in the two hospitals respectively. In Al Farwaniya hospital, one-third of the patients were from some tropical developing countries of Asia. About 66% of all patients (40/61) had diarrhea, and of these, 65% had the corresponding blood serovar isolated from stool culture. A few patients had Salmonella cultured from urine. Patients were either young or old. Most of the patients had co-morbidities affecting the immune system. Two patients each died in both hospitals. The number of different serovars cultured in each hospital was 13, and most infections were due to S. Enteritidis (all sequence type [ST]) 11) and S. Typhimurium (all ST19) except in a subgroup of expatriate patients from tropical developing countries in Al Farwaniya hospital. About a quarter of the isolates were multidrug-resistant. Most patients were treated with a cephalosporin with or without other antibiotics. S. Enteritidis and S. Typhimurium isolates were typed by pulsed field-gel electrophoresis (PFGE) and a selected number of isolates were whole-genome sequenced. Up to four different clades were present by PFGE in either species. Whole-genome sequenced isolates showed antibiotic-resistance genes that showed phenotypic correlation, and in some cases, phenotypes showed absence of specific genes. Whole-genome sequenced isolates showed presence of genes that contributed to blood-stream infection. Phylogeny by core genome analysis showed a close relationship with S. Typhimurium and S. Enteritidis from other parts of the world. The uniqueness of our study included the finding of a low prevalence of infection, mortality and multidrug-resistance, a relatively high prevalence of gastrointestinal infection in patients, and the characterization of selected isolates of S. Typhimurium and S. Enteritidis serovars by whole-genome sequencing that shed light on phylogeny, virulence and resistance. Similarities with studies from developing countries especially Africa included infection in patients with co-morbidities affecting the immune system, predominance of S. Typhimurium and S. Enteritidis serovars and presence of drug-resistance in isolates.


Assuntos
Bacteriemia/microbiologia , Bacteriemia/patologia , Infecções por Salmonella/microbiologia , Infecções por Salmonella/patologia , Salmonella/classificação , Salmonella/isolamento & purificação , Adulto , Idoso , Idoso de 80 Anos ou mais , Antibacterianos/uso terapêutico , Bacteriemia/epidemiologia , Sangue/microbiologia , Pré-Escolar , Farmacorresistência Bacteriana , Fezes/microbiologia , Feminino , Genótipo , Humanos , Lactente , Kuweit/epidemiologia , Masculino , Pessoa de Meia-Idade , Epidemiologia Molecular , Tipagem Molecular , Prevalência , Infecções por Salmonella/epidemiologia , Sorogrupo , Centros de Atenção Terciária , Urina/microbiologia , Sequenciamento Completo do Genoma , Adulto Jovem
9.
New Microbiol ; 42(2): 121-124, 2019 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-31034080

RESUMO

Because of the high prevalence of CTX-M-15-producing Escherichia coli isolates causing urinary tract infections in Rio de Janeiro, we have investigated bla-CTX-M-15 gene presence, as well as CTX-M-15 production, in 32 E. coli isolates recovered from the urine of outpatients assisted at a public hospital located in the west zone of Rio. Molecular epidemiology was assessed by PFGE and phylo-typing methods. The work highlights the good performance of MALDI-TOF MS as an alternative tool to detect extended-spectrum beta-lactamases among CTX-M-15-producing E. coli isolates.


Assuntos
Infecções por Escherichia coli , Epidemiologia Molecular , Escherichia coli Uropatogênica , beta-Lactamases , Brasil/epidemiologia , Eletroforese em Gel de Campo Pulsado , Infecções por Escherichia coli/epidemiologia , Infecções por Escherichia coli/microbiologia , Humanos , Espectrometria de Massas por Ionização e Dessorção a Laser Assistida por Matriz , Infecções Urinárias/epidemiologia , Infecções Urinárias/microbiologia , Urina/microbiologia , Escherichia coli Uropatogênica/química , Escherichia coli Uropatogênica/classificação , Escherichia coli Uropatogênica/enzimologia , Escherichia coli Uropatogênica/genética , beta-Lactamases/genética
10.
Tidsskr Nor Laegeforen ; 139(6)2019 Mar 26.
Artigo em Norueguês | MEDLINE | ID: mdl-30917642

RESUMO

BACKGROUND: Purple urine bag syndrome (PUBS) can occur in cases of bacteriuria with species expressing enzymes capable of converting tryptophan metabolites to red and blue pigments which are excreted in urine, leaving a characteristic purple colour. Risk factors include urinary catheterisation, constipation and chronic kidney disease. Treatment includes catheter replacement, and antibiotics in case of urinary tract infection. CASE PRESENTATION: A man in his 70s with myelodysplastic syndrome, stage 5 chronic kidney disease and chronic indwelling urinary catheterisation due to benign prostatic hyperplasia was admitted for transfusion for symptomatic anaemia. On the second day of hospitalisation, his urine turned purple. There was no sign of transfusion reaction, haemoglobinuria, myoglobinuria or bilirubinuria. Urine cultures were positive for Proteus vulgaris and Enterococcus faecalis, two species associated with PUBS. INTERPRETATION: The constellation was consistent with PUBS. His bacteriuria was considered colonisation not requiring antibiotic treatment. The catheter was replaced and the urine colour returned to normal.


Assuntos
Bacteriúria/microbiologia , Infecções Relacionadas a Cateter/microbiologia , Cateteres Urinários/microbiologia , Infecções Urinárias/microbiologia , Idoso , Bacteriúria/terapia , Infecções Relacionadas a Cateter/terapia , Enterococcus faecalis/isolamento & purificação , Humanos , Masculino , Proteus vulgaris/isolamento & purificação , Infecções Urinárias/terapia , Urina/microbiologia
11.
Braz J Microbiol ; 50(2): 445-448, 2019 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-30796714

RESUMO

This study investigated the serotypes and antimicrobial resistance of Salmonella isolates in urine cultures from 38 hospitalized patients. Nine serotypes were detected, and a large proportion was Typhimurium and Enteritidis. The strains presented resistance to 11 different antibiotics. Thirteen isolates (11 from serotype Typhimurium) exhibited multidrug resistance.


Assuntos
Antibacterianos/farmacologia , Farmacorresistência Bacteriana Múltipla/fisiologia , Infecções por Salmonella/microbiologia , Salmonella enteritidis/efeitos dos fármacos , Salmonella typhimurium/efeitos dos fármacos , Urina/microbiologia , Adolescente , Adulto , Criança , Pré-Escolar , Feminino , Humanos , Lactente , Recém-Nascido , Masculino , Testes de Sensibilidade Microbiana , Pessoa de Meia-Idade , Infecções por Salmonella/urina , Salmonella enteritidis/isolamento & purificação , Salmonella typhimurium/isolamento & purificação , Sorotipagem , Adulto Jovem
12.
Int J Antimicrob Agents ; 53(5): 541-546, 2019 May.
Artigo em Inglês | MEDLINE | ID: mdl-30769198

RESUMO

Candida auris is an emerging pathogen causing candidaemia outbreaks in several countries for which azole, amphotericin B (AmB) and echinocandin resistance has been reported. In this study, the antifungal susceptibilities of 73 Spanish C. auris isolates (56 bloodstream and 17 urine) to eight antifungal agents were determined using three methods. Isolates were identified by internal transcribed spacer (ITS) sequencing, and minimum inhibitory concentrations (MICs) of fluconazole, isavuconazole, itraconazole, posaconazole, voriconazole, anidulafungin, micafungin and AmB were determined by EUCAST methodology and Sensititre® YeastOne® (SYO) (bloodstream isolates) and Liofilchem® MIC Test Strip (all isolates). Agreement between the methods was analysed and the MICs (ours and published data) were categorised using recently proposed epidemiological cut-off values (ECVs). Fluconazole MICs were >64 mg/L, whilst >60% of voriconazole MICs were >1 mg/L by the three methods. Posaconazole was the most active azole (EUCAST geometric mean MIC, 0.053 mg/L), followed by isavuconazole (0.066 mg/L) and itraconazole (0.157 mg/L). Echinocandins MICs were ≤0.5 mg/L by SYO and EUCAST. The overall lowest AmB MICs (≤0.25 mg/L) were obtained by EUCAST. Essential agreement (±2 dilutions) between EUCAST and SYO was >93% for the eight antifungals. For this new C. auris clade, all isolates were resistant to fluconazole, and MICs for anidulafungin, micafungin and AmB were ≤1 mg/L using dilution methods. Voriconazole MICs were method-dependent. The number of non-wild-type (non-WT) isolates depended on the ECV applied; by the 97.5% ECV all isolates were WT except for isavuconazole (1.8% non-WT). Good essential agreement (>93%) was observed between EUCAST and SYO.


Assuntos
Antifúngicos/farmacologia , Candida/efeitos dos fármacos , Candida/isolamento & purificação , Candidíase/epidemiologia , Surtos de Doenças , Testes de Sensibilidade Microbiana/métodos , Sangue/microbiologia , Candidíase/microbiologia , DNA Espaçador Ribossômico , Humanos , Espanha/epidemiologia , Urina/microbiologia
13.
Eur J Clin Microbiol Infect Dis ; 38(6): 1135-1141, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-30806903

RESUMO

In order to realize the full potential of total laboratory automation (TLA) in the clinical microbiology laboratory, workflows must be optimized to match each laboratory's capabilities, patient population, and staffing model. Using TLA-based digital photography to monitor urine cultures, we sought to improve culture result turn-around-time (TAT) by changing the time at which a culture is first photographed and thus available for analysis/work-up (Pre1) from 18 h (16,391 cultures) to 16 h (53,113 cultures) (with a total of 24-h culture incubation in both time periods); in both time periods, cultures were set up 24/7, and culture work-up occurred during the day shift only. With this change, we observed a significant decrease in time-to-final-result TAT for positive cultures (18 h-Pre1 median: 71.6 h; 16 h-Pre1 median: 61.0 h). This effect was most pronounced for Gram-negative organisms, with a median reduction in time-to-final-result for Escherichia coli cultures (51.8% of positive urine cultures) of 14.2 h (18 h-Pre1 median: 77.3 h; 16 h-Pre1 median: 63.1 h). This reduction in TAT was accompanied by a decrease in sensitivity at the Pre1 time point (18 h-Pre1 91.01%; 16 h-Pre1 88.06%), which we also found to vary by species: there was a reduction in sensitivity at the first culture reading of 1 to 2% for cultures with Gram-negative microorganisms, but for some Gram-positive microorganisms (e.g., Aerococcus urinae and non-aureus Staphylococcus species), there was a reduction in sensitivity at the Pre1 time-point of 3 to 7%. These results can guide workflow decisions for laboratories seeking to implement and/or optimize TLA systems, demonstrating a tradeoff between TAT and the sensitivity of preliminary urine culture results.


Assuntos
Automação Laboratorial , Urina/microbiologia , Fluxo de Trabalho , Bactérias Gram-Negativas/crescimento & desenvolvimento , Bactérias Gram-Negativas/isolamento & purificação , Bactérias Gram-Positivas/crescimento & desenvolvimento , Bactérias Gram-Positivas/isolamento & purificação , Humanos , Sensibilidade e Especificidade , Especificidade da Espécie , Fatores de Tempo
14.
Diagn Microbiol Infect Dis ; 94(2): 113-115, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-30718158

RESUMO

Matrix-assisted laser desorption ionization-time-of-flight (MALDI-TOF) mass spectrometry is commonly used to identify bacteria and yeasts. Studies indicate that MALDI-TOF is relatively indifferent to the medium used for culture. We report on an investigation into high- and low-confidence MALDI-TOF misidentifications of Mycoplasma arginini and Mycoplasma alkalescens from urine specimens plated to CHROMagar™ Orientation medium that appear to be due to the intrinsic mass spectrum of the medium.


Assuntos
Meios de Cultura/química , Erros de Diagnóstico , Infecções por Mycoplasma/diagnóstico , Mycoplasma/isolamento & purificação , Manejo de Espécimes/métodos , Espectrometria de Massas por Ionização e Dessorção a Laser Assistida por Matriz/métodos , Urina/microbiologia , Humanos , Mycoplasma/química , Infecções por Mycoplasma/microbiologia , Infecções Urinárias/diagnóstico , Infecções Urinárias/microbiologia
15.
J Ind Microbiol Biotechnol ; 46(5): 587-599, 2019 May.
Artigo em Inglês | MEDLINE | ID: mdl-30796542

RESUMO

Microbial fuel cell (MFC) technology is currently gaining recognition as one of the most promising bioenergy technologies of the future. One aspect of this technology that has received little attention is the disinfection of effluents and the fate of pathogenic organisms that find their way into the waste stream. In this study, three independent trials were carried out to evaluate the fate of three bioluminescent pathogenic bacteria (Salmonella enterica serovar Typhimurium, Pseudomonas aeruginosa and Staphylococcus aureus) introduced into the anodic chamber of a urine-fed cascade of 9 MFCs with matured, electroactive biofilms. These are common examples of enteric human pathogens, which could contaminate urine or waste streams. The results showed that the average power generation in the closed circuit cascade reached 754 ± 16 µW, with an average pathogen log-fold reduction of 6.24 ± 0.63 compared to 2.01 ± 0.26 for the open circuit cascade for all three pathogens. The results suggest that the bio-electrochemical reactions associated with electricity generation were the primary driving force for the inactivation of the introduced pathogens. These findings show that pathogenic organisms introduced into waste streams could be inactivated by the power-generating process within the MFC cascade system, thereby preventing propagation and thus rendering the effluent safer for possible reuse.


Assuntos
Fontes de Energia Bioelétrica/microbiologia , Pseudomonas aeruginosa , Salmonella typhimurium , Staphylococcus aureus , Urina/microbiologia , Adulto , Biofilmes , Reatores Biológicos , Desinfecção , Eletricidade , Eletroquímica , Eletrodos , Humanos , Concentração de Íons de Hidrogênio
16.
Female Pelvic Med Reconstr Surg ; 25(2): e28-e33, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30807432

RESUMO

OBJECTIVES: The expanded quantitative urine culture protocol was used to compare the microbial abundance and diversity of voided urines obtained using a standard urine collection or using the Peezy midstream device versus paired periurethral specimens. METHODS: Sixty-two female participants were assigned to 1 of 3 cohorts. One cohort used a standard clean catch midstream urine protocol that included a castile soap wipe, the second cohort used a Peezy midstream collection device with castile soap wipe and the third used the Peezy device without a castile soap wipe. Each participant watched a video that detailed the collection method. Before using the castile soap wipe, a periurethral swab was obtained to measure periurethral microbial abundance. Demographics and pelvic floor symptoms were assessed by validated questionnaires. Microbes were detected using expanded quantitative urine culture. Diversity within each sample was analyzed using alpha diversity measures. RESULTS: Paired periurethral and urine samples for each woman were analyzed and compared for species abundance, richness, and diversity. Bacterial profiles of Peezy-collected urines differed significantly by multiple diversity indices and had significantly reduced colony-forming units compared to paired periurethral swabs. In contrast, within the standard clean catch cohort, voided urine had higher abundance and richness than paired periurethral swabs. CONCLUSIONS: Compared with standard clean catch method, the Peezy urine collection device with and without the castile soap wipe resulted in urine with lower bacterial abundance that was distinct from the periurethra. Voided urine collected by Peezy may reduce postbladder microbial contribution.


Assuntos
Uretra/microbiologia , Coleta de Urina/instrumentação , Coleta de Urina/métodos , Urina/microbiologia , Adulto , Bactérias/isolamento & purificação , Estudos Transversais , Feminino , Humanos , Microbiota , Pessoa de Meia-Idade , Projetos Piloto , Sabões , Adulto Jovem
17.
J Chemother ; 31(2): 74-80, 2019 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-30784363

RESUMO

This study proposes an algorithm for microbiological diagnosis of urinary tract infections based on screening by luminometry and Gram-stain, followed by identification by matrix-assisted laser desorption ionization time-of-flight mass spectrometry (MALDI-TOF MS). Positive urine samples detected with the luminometry screening Coral UTI ScreenTM system underwent Gram staining and identification of the causative organism was performed by MALDI-TOF Microflex LT mass spectrometer (Bruker Daltonics, Germany). Subsequently, the results were compared with those of conventional culture identification using WIDER MIC/id system (Francisco Soria Melguizo SA, Spain). Considering the conventional approach as the gold standard, the proposed algorithm presented both a high specificity (98.1%) and a positive likelihood ratio of 37.42. The implementation of this algorithm would allow diagnosis of urinary tract infection in less than an hour in 92.4% of positive samples. This combination of techniques would be useful particularly for patients with severe UTI, pyelonephritis or urinary sepsis.


Assuntos
Algoritmos , Bactérias/química , Violeta Genciana/química , Fenazinas/química , Espectrometria de Massas por Ionização e Dessorção a Laser Assistida por Matriz/métodos , Infecções Urinárias/diagnóstico , Infecções Urinárias/microbiologia , Urina/microbiologia , Adulto , Bactérias/classificação , Bactérias/isolamento & purificação , Corantes , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Tipagem Molecular , Estudos Prospectivos , Coloração e Rotulagem
18.
Bioelectrochemistry ; 127: 68-75, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-30735920

RESUMO

The scalability of bioelectrochemical systems is a key parameter for their practical implementation in the real-world. Up until now, only urine-fed self-stratifying microbial fuel cells (SSM-MFCs) have been shown to be scalable in width and length with limited power density losses. For practical reasons, the present work focuses on the scalability of SSM-MFCs in the one dimension that has not yet been investigated, namely height. Three different height conditions were considered (1 cm, 2 cm and 3 cm tall electrodes). The normalised power density of the 2 cm and 3 cm conditions were similar either during the durability test under a hydraulic retention time of ≈39 h (i.e. 15.74 ±â€¯0.99 µW.cm-3) and during the polarisation experiments (i.e. 27.79 ±â€¯0.92 µW.cm-3). Conversely, the 1 cm condition had lower power densities of 11.23 ±â€¯0.07 µW.cm-3 and 17.73 ±â€¯3.94 µW.cm-3 both during the durability test and the polarisation experiment, respectively. These results confirm that SSM-MFCs can be scaled in all 3 dimensions with minimal power density losses, with a minimum height threshold for the electrode comprised between 1 cm and 2 cm.


Assuntos
Fontes de Energia Bioelétrica , Fontes de Energia Bioelétrica/microbiologia , Reatores Biológicos/microbiologia , Eletricidade , Eletrodos , Desenho de Equipamento , Humanos , Miniaturização , Urina/química , Urina/microbiologia
19.
Eur Urol ; 75(4): 637-646, 2019 04.
Artigo em Inglês | MEDLINE | ID: mdl-30655087

RESUMO

CONTEXT: The recent discovery of the existence of a human genitourinary microbiome has led to the investigation of its role in mediating the pathogenesis of genitourinary malignancies, including bladder, kidney, and prostate cancers. Furthermore, although it is largely recognized that members of the gastrointestinal microbiota are actively involved in drug metabolism, new studies demonstrate additional roles and the potential necessity of the gastrointestinal microbiota in dictating cancer treatment response. OBJECTIVE: To summarize the current evidence of a mechanistic role for the genitourinary and gastrointestinal microbiome in genitourinary cancer initiation and treatment response. EVIDENCE ACQUISITION: We conducted a literature search up to October 2018. Search terms included microbiome, microbiota, urinary microbiome, bladder cancer, urothelial carcinoma, renal cell carcinoma, kidney cancer, testicular cancer, and prostate cancer. EVIDENCE SYNTHESIS: There is preliminary evidence to implicate the members of the genitourinary microbiota as causative factors or cofactors in genitourinary malignancy. Likewise, the current evidence for gastrointestinal microbes in dictating cancer treatment response is mainly correlative; however, we provide examples where therapeutic agents used for the treatment of genitourinary cancers are affected by the human-associated microbiota, or vice versa. Clinical trials, such as fecal microbiota transplant to increase the efficacy of immunotherapy, are currently underway. CONCLUSIONS: The role of the microbiome in genitourinary cancer is an emerging field that merits further studies. Translating microbiome research into clinical action will require incorporation of microbiome surveillance into ongoing and future clinical trials as well as expansion of studies to include metagenomic sequencing and metabolomics. PATIENT SUMMARY: This review covers recent evidence that microbial populations that reside in the genitourinary tract-and were previously not known to exist-may influence the development of genitourinary malignancies including bladder, kidney, and prostate cancers. Furthermore, microbial populations that exist at sites outside of the genitourinary tract, such as those that reside in our gut, may influence cancer development and/or treatment response.


Assuntos
Genitália/microbiologia , Neoplasias Renais/microbiologia , Microbiota , Neoplasias da Próstata/microbiologia , Neoplasias Testiculares/microbiologia , Neoplasias da Bexiga Urinária/microbiologia , Sistema Urinário/microbiologia , Feminino , Genitália/patologia , Interações Hospedeiro-Patógeno , Humanos , Neoplasias Renais/patologia , Neoplasias Renais/terapia , Neoplasias Renais/urina , Masculino , Prognóstico , Neoplasias da Próstata/patologia , Neoplasias da Próstata/terapia , Neoplasias da Próstata/urina , Fatores de Risco , Neoplasias Testiculares/patologia , Neoplasias Testiculares/terapia , Neoplasias Testiculares/urina , Neoplasias da Bexiga Urinária/patologia , Neoplasias da Bexiga Urinária/terapia , Neoplasias da Bexiga Urinária/urina , Sistema Urinário/patologia , Urina/microbiologia
20.
Microb Drug Resist ; 25(3): 386-393, 2019 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-30676258

RESUMO

The worldwide dissemination of multidrug-resistant (MDR) Enterobacteriaceae is a major public health issue. The aim of this study was to investigate the prevalence of MDR Escherichia coli (MDR-EC) isolates, in inpatients/outpatients with urinary tract infections at Sétif University Hospital (Algeria). Bacterial cultures were obtained from 426 of the 3,944 urine samples collected from January 2015 to February 2017. Among these cultures, 215 E. coli isolates were identified by mass spectrometry, and 38 (17.7%) were MDR-EC (disk diffusion method): 36 produced only extended-spectrum ß-lactamases (ESBL), one ESBL and a carbapenemase, and one only a cephalosporinase (double-disk synergy test). Multiplex PCR and sequencing analyses showed that 37 ESBL-producing isolates harbored genes encoding CTX-M enzymes (CTX-M-15 in 33 isolates, 89.19%; and CTX-M-14 group in four isolates, 10.81%). One CTX-M-15-producing isolate co-expressed also an OXA-48-like carbapenemase. Phylogenetic group analysis of the 37 ESBL-producing and 178 non-ESBL-producing isolates indicated that the most common phylogenetic group was B2 (54.05% of ESBL-producing and 48.31% of non-ESBL-producing isolates), followed by A and D for ESBL-, and by B1, A, and F for non-ESBL-producing isolates. This is the first report highlighting the presence of MDR-EC isolates that produce both CTX-M and OXA-48-like enzymes in Sétif, Algeria.


Assuntos
Antibacterianos/uso terapêutico , Farmacorresistência Bacteriana Múltipla/efeitos dos fármacos , Infecções por Escherichia coli/tratamento farmacológico , Infecções por Escherichia coli/epidemiologia , Escherichia coli/efeitos dos fármacos , Escherichia coli/isolamento & purificação , Urina/microbiologia , Adolescente , Adulto , Argélia/epidemiologia , Infecções por Escherichia coli/microbiologia , Feminino , Humanos , Pacientes Internados , Masculino , Testes de Sensibilidade Microbiana/métodos , Pessoa de Meia-Idade , Pacientes Ambulatoriais , Prevalência , Centros de Atenção Terciária , Infecções Urinárias/microbiologia , Adulto Jovem
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