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1.
PLoS One ; 15(8): e0238479, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32866217

RESUMO

The performances of the ImmuView Streptococcus pneumoniae (Sp) and Legionella pneumophila (Lp) urinary antigen test were compared to that of the BinaxNOW Sp and Lp assays, using frozen urine from 166 patients with Legionnaires' disease (LD) and 59 patients with pneumococcal pneumonia. Thirty Sp-positive or contrived cerebrospinal fluids (CSF) were also tested. Test specimens were collected and tested at different sites, with each site testing unique specimens by technologists blinded to expected results. No significant differences in test concordances were detected for the ImmuView and BinaxNOW assays for the Sp or Lp targets for urine from patients with pneumococcal pneumonia or LD when performance from both sites were combined. At one of two test sites the ImmuView Lp assay was more sensitive than the BinaxNOW assay, with no correlation between test performance and Lp serogroup 1 monoclonal type. Urines from six of seven patients with LD caused by Legionella spp. bacteria other than Lp serogroup 1 were negative in both assays. Both tests had equivalent performance for Sp-positive CSF. The clinical sensitivities for pneumococcal pneumonia were 88.1 and 94.4% for the ImmuView and Binax assays, and 87.6 and 84.2% for the Lp assays, respectively. Test specificities for pneumococcal pneumonia were 96.2 and 97.0% for the ImmuView and Binax assays, and 99.6 and 99.1% for the Lp assays. Both assays were highly specific for Sp in pediatric urines from children with nasopharyngeal colonization by the bacterium. ImmuView and BinaxNOW assay performance was equivalent in these studies.


Assuntos
Antígenos de Bactérias/metabolismo , Antígenos de Bactérias/urina , Bioensaio/métodos , Líquido Cefalorraquidiano/microbiologia , Legionella pneumophila/isolamento & purificação , Streptococcus pneumoniae/isolamento & purificação , Urina/microbiologia , Adolescente , Adulto , Criança , Pré-Escolar , Feminino , Humanos , Testes Imunológicos/métodos , Lactente , Doença dos Legionários/metabolismo , Doença dos Legionários/microbiologia , Doença dos Legionários/urina , Masculino , Meningite/metabolismo , Meningite/microbiologia , Meningite/urina , Pneumonia Pneumocócica/metabolismo , Pneumonia Pneumocócica/microbiologia , Pneumonia Pneumocócica/urina , Sensibilidade e Especificidade , Sorogrupo , Adulto Jovem
2.
PLoS One ; 15(7): e0236007, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32668449

RESUMO

Leptospirosis is a re-emerging zoonotic disease of high medical importance that affects humans worldwide. Humans or animals acquire an infection with pathogenic leptospires either by direct contact with infected animals or by indirect contact to contaminated environment. Survival of Leptospira spp. in the environment after having been shed via animal urine is thus a key factor to estimate the risk of infection, but not much is known about the tenacity of pathogenic leptospires. Here, the survival time of both a laboratory strain and a field strain of L. kirschneri serovar Grippotyphosa in animal urine and their tenacity while drying was investigated and compared at different temperatures (15°C-37°C). Leptospira spp. are also often found in rivers and ponds. As the infection risk for humans and animals also depends on the spreading and survival of Leptospira spp. in these environments, the survival of L. kirschneri serovar Grippotyphosa was investigated using a 50-meter-long hose system simulating a water stream. Both strains did not survive in undiluted cattle or dog urine. Comparing different temperatures and dilution media, the laboratory strain survived the longest in diluted cattle urine with a slightly alkaline pH value (3 days), whilst the field strain survived in diluted dog urine with a slightly acid pH value up to a maximum of 24 h. Both strains did not survive drying on a solid surface. In a water stream, leptospires were able to move faster or slower than the average velocity of the water due to their intrinsic mobility but were not able to survive the mechanical damage caused by running water in the hose system. From our results we conclude, that once excreted via animal urine, the leptospires immediately need moisture or a water body to survive and stay infectious.


Assuntos
Doenças do Cão/epidemiologia , Leptospira/crescimento & desenvolvimento , Leptospira/isolamento & purificação , Leptospirose/veterinária , Urina/microbiologia , Poluentes da Água/análise , Zoonoses/epidemiologia , Animais , Bovinos , Doenças do Cão/microbiologia , Cães , Feminino , Leptospirose/microbiologia , Doenças Transmitidas pela Água/epidemiologia , Doenças Transmitidas pela Água/microbiologia , Zoonoses/microbiologia
4.
PLoS One ; 15(6): e0228234, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32589639

RESUMO

A major issue in the surveillance of antimicrobial resistance (AMR) is "de-duplication" or removal of repeated isolates, for which there exist multiple methods. The World Health Organization (WHO) Global Antimicrobial Resistance Surveillance System (GLASS) requires de-duplication by selecting only the first isolate of a given bacterial species per patient per surveillance period per specimen type per age group, gender, and infection origin stratification. However, no study on the comparative application of this method has been reported. The objective of this study was to evaluate differences in data tabulation between the WHO GLASS and the Japan Nosocomial Infections Surveillance (JANIS) system, which counts both patients and isolates after removing repeated isolates of the same bacterial species isolated from a patient within 30 days, regardless of specimen type, but distinguishing isolates with change of antimicrobial resistance phenotype. All bacterial data, consisting of approximately 8 million samples from 1795 Japanese hospitals in 2017 were exported from the JANIS database, and were tabulated using either the de-duplication algorithm of GLASS, or JANIS. We compared the tabulated results of the total number of patients whose blood and urine cultures were taken and of the percentage of resistant isolates of Escherichia coli for each priority antibiotic. The number of patients per specimen type tabulated by the JANIS method was always smaller than that of GLASS. There was a small (< 3%) difference in the percentage of resistance of E. coli for any antibiotic between the two methods in both out- and inpatient settings and blood and urine isolates. The two tabulation methods did not show considerable differences in terms of the tabulated percentages of resistance for E. coli. We further discuss how the use of GLASS tabulations to create a public software and website that could help to facilitate the understanding of and treatment against AMR.


Assuntos
Infecção Hospitalar/epidemiologia , Farmacorresistência Bacteriana , Organização Mundial da Saúde , Adolescente , Adulto , Sangue/microbiologia , Infecção Hospitalar/microbiologia , Escherichia coli/efeitos dos fármacos , Escherichia coli/isolamento & purificação , Escherichia coli/fisiologia , Feminino , Humanos , Japão/epidemiologia , Masculino , Pessoa de Meia-Idade , Urina/microbiologia , Adulto Jovem
5.
Int J Infect Dis ; 98: 227-229, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-32592907

RESUMO

Sodium-glucose co-transporter 2 (SGLT2) inhibitors exhibit impressive cardio-renal benefits in patients with a high cardiovascular risk. Genital yeast infections are important side effects of this class of drugs. We report a case of Candida glabrata sepsis secondary to a Candida infection of the urostomy of a patient on SGLT2 inhibitor therapy. In urostomy patients, one should critically evaluate the risk of mycotic infections against the cardiovascular and glycaemic benefits of SGLT2 inhibition. Urostomy patients without a high cardiovascular risk should not be treated with SGLT2 inhibitors.


Assuntos
Hipoglicemiantes/efeitos adversos , Sepse/etiologia , Inibidores do Transportador 2 de Sódio-Glicose/efeitos adversos , Idoso , Candida/efeitos dos fármacos , Candida/crescimento & desenvolvimento , Diabetes Mellitus Tipo 2/complicações , Diabetes Mellitus Tipo 2/tratamento farmacológico , Humanos , Hipoglicemiantes/uso terapêutico , Masculino , Sepse/microbiologia , Inibidores do Transportador 2 de Sódio-Glicose/uso terapêutico , Urina/microbiologia
6.
J Vis Exp ; (160)2020 06 13.
Artigo em Inglês | MEDLINE | ID: mdl-32597873

RESUMO

Transition of bacteria to the L-form state is thought to play a possible role in immune evasion and bacterial persistence during treatment with cell wall-targeting antibiotics. However, isolation and handling of L-form bacteria is challenging, mainly due to their high sensitivity to changes in osmolarity. Here, we describe detailed protocols for the preparation of L-form medium, isolation of L-forms from urine using a filtration method, detection of L-forms in urine samples by phase contrast microscopy and induction of L-forms in vitro. The exact requirements for survival and growth of L-forms may vary from strain to strain. Therefore, the methods presented here are intended to act as basic guidelines for establishing L-form protocols within individual laboratories, rather than as precise instructions. The filtration method can lead to a reduction in the number of L-forms in a sample and should not be used for quantification. However, it is the only method used so far for effective separation of cell wall-deficient variants from their walled counterparts and for identification of bacterial strains, which are capable of L-form switching in patients with urinary tract infections. The filtration method has the potential to be adapted for the isolation of L-forms from patients with other categories of bacterial infections and from environmental samples.


Assuntos
Bactérias/isolamento & purificação , Filtração/métodos , Formas L/isolamento & purificação , Urina/microbiologia , Bactérias/citologia , Parede Celular/metabolismo , Humanos , Formas L/citologia
7.
Ann Biol Clin (Paris) ; 78(2): 139-146, 2020 Apr 01.
Artigo em Inglês | MEDLINE | ID: mdl-32319942

RESUMO

The pre-analytical step of the cytobacteriological examination of urine (CBEU) is one of the most critical in microbiology. The objectives of our study were to determine the rate of urinary contamination and to analyze the factors that would facilitate this in order to propose solutions to this problem. METHOD: This is a 26-month descriptive study including all CBEU requests to our laboratory. Urine was treated in accordance with the recommendations of the medical microbiology recommendations. Urine was considered contaminated in the case of polymorphic culture with at least three different types of germs with a count from 103 CFU/mL. RESULTS: We collected 16,412 CBEU requests. Urine was contaminated in 4,830 cases (29.43%). Of the contaminated urine, 39.23% (n=1,895) was from emergency departments, 79.44% (n=3,837) was collected in the middle of the stream, 69.83% (n=3,373) was from a female patient and 16.34% (n=789) was from children under the age of 5. DISCUSSION AND CONCLUSION: To reduce urine contamination, quality instructions describing sampling procedures should be available and samples in the middle of the stream and through the collection adhesive bags should be replaced by sus-pubic puncture samples in children, whenever the profit/risk ratio of this method is favourable.


Assuntos
Urinálise/normas , Infecções Urinárias/diagnóstico , Coleta de Urina/normas , Urina/microbiologia , Adolescente , Adulto , Fatores Etários , Idoso , Idoso de 80 Anos ou mais , Criança , Pré-Escolar , Reações Falso-Positivas , Feminino , Hospitais Universitários , Humanos , Lactente , Recém-Nascido , Masculino , Técnicas Microbiológicas/métodos , Técnicas Microbiológicas/normas , Pessoa de Meia-Idade , Marrocos/epidemiologia , Fase Pré-Analítica/normas , Fase Pré-Analítica/estatística & dados numéricos , Estudos Retrospectivos , Fatores Sexuais , Urinálise/métodos , Urinálise/estatística & dados numéricos , Infecções Urinárias/epidemiologia , Infecções Urinárias/microbiologia , Coleta de Urina/métodos , Coleta de Urina/estatística & dados numéricos , Adulto Jovem
8.
Int J Infect Dis ; 95: 15-21, 2020 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-32194240

RESUMO

OBJECTIVES: Effective methods for diagnosing urogenital tuberculosis (UGTB) are important for its clinical management. Therefore, we undertook a systematic review to assess the performance of the urine-based Xpert MTB/RIF assay for UGTB. METHODS: PubMed, Embase, Web of Science, the Cochrane library, and Scopus were systematically searched up to July 30, 2019. A hierarchical summary receiver operating characteristic (HSROC) was applied to calculate the pooled sensitivity, specificity, positive likelihood ratio (PLR), negative likelihood ratio (NLR), and odds ratio (OR) for the diagnostic accuracy of the Xpert test. RESULTS: Our search identified 858 unique articles from which 69 studies were selected for full-text revision, with 12 studies meeting the inclusion criteria. Eleven studies comprising 1202 samples compared Xpert with mycobacterial culture, while 924 samples from eight studies compared it with a composite reference standard (CRS). The values for pooled sensitivity, specificity, PLR, NLR, and OR were 0.89, 0.95, 20.1, 0.18, and 159.53, respectively, when compared with the mycobacterial culture. Likewise, when compared with a CRS, the respective pooled sensitivity, specificity, PLR, NLR, and OR values were 0.55, 0.99, 40.67, 0.43, and 166.17, thereby suggesting a high level of accuracy for diagnosing UGTB. A meta-regression and sub-group analysis of TB-burden countries, study design, decontamination, concentration, and reference standard could not explain the heterogeneity (p > 0.05) in the diagnostic efficiency. CONCLUSIONS: Our results suggested that Xpert is a promising diagnostic tool for the diagnosis of UGTB via urine specimen.


Assuntos
Técnicas de Amplificação de Ácido Nucleico , Tuberculose Urogenital/diagnóstico , Urina/microbiologia , Farmacorresistência Bacteriana , Humanos , Funções Verossimilhança , Mycobacterium tuberculosis/efeitos dos fármacos , Mycobacterium tuberculosis/isolamento & purificação , Razão de Chances , Curva ROC , Rifampina , Sensibilidade e Especificidade
9.
West Afr J Med ; 37(1): 1-6, 2020.
Artigo em Inglês, Francês | MEDLINE | ID: mdl-32030704

RESUMO

BACKGROUND: Pregnant women with asymptomatic bacteriuria are at increased risk of developing symptomatic urinary tract infections. HIV infection may modify the acquisition of bacteriuria in pregnancy. OBJECTIVE: To identify the determinants of asymptomatic bacteriuria in HIV-positive and HIV-negative pregnant women in Olabisi Onabanjo University Teaching Hospital, Sagamu, Nigeria. METHODS: A cross-sectional study involving 211 HIV-positive pregnant women and 422 HIV-negative pregnant women attending their first antenatal clinic between October 2017 and March 2018. Information on socio-demographic characteristics and risk factors for asymptomatic bacteriuria in study participants was recorded. Microbial culture was carried out on aseptically collected urine samples. RESULTS: Asymptomatic bacteriuria was found in 66(31.3%) and 118(28.0%) in HIV-positive and negative women respectively. Advanced maternal age, gestational age above 20 weeks, low socioeconomic status, history of urinary tract infections in previous pregnancies and low CD4 cell count had statistically significant association with increased prevalence of asymptomatic bacteriuria among HIV positive women. Binary logistic regression analysis showed that low socioeconomic status and history of urinary tract infections in previous pregnancies were strong determinants of asymptomatic bacteriuria among HIV positive women (AOR 4.1, CI 1.9-8.7, P < 0.001; AOR 5.8, CI 2.5-13.6, P < 0.001 respectively). In HIV negative women, gestational age above 20 weeks had statistically significant association with increased prevalence of asymptomatic bacteriuria (AOR= 2.34, CI 1.3-4.1, P= 0.002). CONCLUSION: Low socioeconomic status and previous history of urinary tract infections are determinants of asymptomatic bacteriuria in HIV positive women while gestational age above 20 weeks is a determinant in HIV negative women. These determinants could be used to identify women at high risk of asymptomatic bacteriuria for targeted screening.


Assuntos
Bactérias/isolamento & purificação , Bacteriúria/microbiologia , Bacteriúria/urina , Infecções por HIV/complicações , Soronegatividade para HIV , Complicações Infecciosas na Gravidez/microbiologia , Complicações Infecciosas na Gravidez/urina , Urina/microbiologia , Adulto , Bacteriúria/epidemiologia , Estudos Transversais , Feminino , Infecções por HIV/virologia , Humanos , Nigéria/epidemiologia , Gravidez , Complicações Infecciosas na Gravidez/epidemiologia , Prevalência , Infecções Urinárias/epidemiologia , Infecções Urinárias/microbiologia , Infecções Urinárias/urina
10.
BMC Infect Dis ; 20(1): 102, 2020 Feb 03.
Artigo em Inglês | MEDLINE | ID: mdl-32013908

RESUMO

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


Assuntos
Anti-Infecciosos/uso terapêutico , Prescrições de Medicamentos/estatística & dados numéricos , Infecções/tratamento farmacológico , Técnicas Microbiológicas/estatística & dados numéricos , Adulto , Líquido Cefalorraquidiano/microbiologia , Prescrições de Medicamentos/normas , Inglaterra , Hospitalização/estatística & dados numéricos , Humanos , Infecções/microbiologia , Pessoa de Meia-Idade , Escarro/microbiologia , Urina/microbiologia
11.
Arch Ital Urol Androl ; 91(4): 237-240, 2020 Jan 14.
Artigo em Inglês | MEDLINE | ID: mdl-31937088

RESUMO

OBJECTIVE: We investigated when an indwelling ureteral catheter should be withdrawn for infection and evaluated the importance of urinary cultures in identifying colonized microorganisms and define the bacterial flora encountered in the study. Moreover, this study tried to determine the clinical role of stent culture in clinical practice. MATERIALS AND METHODS: The study was conducted between June 2018 and February 2019. Patients with ureteral stent implantation after endoscopic ureteral stone treatment were divided into two groups and each group consisted of 45 patients. Ureteral catheter was removed 15 and 30 days after ureteral stone treatment in group 1 and 2, respectively, and transferred for microbiological examination. The urine culture was obtained before and after ureteral stent implantation. The groups were compared in terms of demographics, urine and catheter cultures results. Urine analysis and catheter culture results were also compared. RESULTS: Demographic data of patients were similar in both groups. 3 patients in group 1 and 12 patients in group 2 had positive urine culture before catheter retraction; 2 of 45 and 6 of 45 patients had positive catheter culture in group 1 and 2, respectively. Although 2 patients in group 1 and 4 patients in group 2 had urine culture sterile, they had growth in catheter culture. In Group 1, 1 of the microorganisms was E. fecalis and 1 was E. coli. In Group 2, 2 cases were E. fecalis, 3 were E. coli and 1 was MRSE. There was no significant difference between the urine analysis results of the patients before catheter retraction and catheter culture positivity. CONCLUSIONS: Pre-operative urine culture does not exclude catheter colonization, and the prolonged duration of the catheter associated with greater colonization and may be associated urinary tract infection. Ureteral catheter should be removed as early as possible.


Assuntos
Cateteres de Demora , Stents , Cateteres Urinários , Infecções Urinárias/epidemiologia , Adulto , Idoso , Bactérias/isolamento & purificação , Cateteres de Demora/microbiologia , Remoção de Dispositivo/métodos , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Stents/microbiologia , Fatores de Tempo , Cálculos Ureterais/terapia , Cateteres Urinários/microbiologia , Infecções Urinárias/microbiologia , Urina/microbiologia , Adulto Jovem
12.
Chem Commun (Camb) ; 56(11): 1717-1720, 2020 Feb 06.
Artigo em Inglês | MEDLINE | ID: mdl-31942593

RESUMO

A novel sensor array based on a (+)AuNP/AuNC nanocomposite was constructed for the selective discrimination of 10 types of Gram-negative bacteria (including 3 types of antibiotic-resistant strains) at a low concentration level of OD600 = 0.015. By recognizing the triple optical patterns of Gram-negative bacteria with the assistance of LDA, the sensor array is able to group the bacteria with respect to their species to each other.


Assuntos
Técnicas de Tipagem Bacteriana/métodos , Bactérias Gram-Negativas/isolamento & purificação , Nanopartículas Metálicas/química , Análise por Conglomerados , Análise Discriminante , Ouro/química , Bactérias Gram-Negativas/classificação , Bactérias Gram-Positivas/classificação , Bactérias Gram-Positivas/isolamento & purificação , Humanos , Nanocompostos/química , Espalhamento de Radiação , Espectrometria de Fluorescência , Urina/microbiologia , Vancomicina/química
13.
PLoS Negl Trop Dis ; 14(1): e0007950, 2020 01.
Artigo em Inglês | MEDLINE | ID: mdl-31905198

RESUMO

The goal of this study was to characterize how natural routes of infection affect the kinetics of pathogenic Leptospira dissemination to blood and kidney. C3H/HeJ mice were sublethally infected with L. interrogans serovar Copenhageni FioCruz L1-130 (Leptospira) through exposure of a dermis wound and through oral and nasal mucosa, in comparison to uninfected mice and to mice infected via standard intraperitoneal inoculation. In striking contrast to oral mucosa inoculation, transdermal and nasal mucosa infections led to weight loss, renal colonization and inflammation, as previously observed for conjunctival and intraperitoneal infections. However, the timing at which Leptospira gained access to blood, as well as Leptospira' colonization of the kidney and shedding in urine, differed from intraperitoneal infection. Furthermore, a comparative analysis of transcription of pro-inflammatory mediators in kidney and total immunoglobulin isotyping in serum from infected mice, showed increased innate immune response markers (KC, MIP-2, TNF-α) and lower Th1 associated IFN-γ in kidney, as well as lower Th1 associated IgG2a in mice infected through the nasal mucosa as compared to intraperitoneal infection. We conclude that the route of infection affects the timing at which Leptospira gains access to blood for dissemination, as well as the dynamics of colonization and inflammation of the kidney.


Assuntos
Leptospira interrogans/fisiologia , Leptospirose/microbiologia , Leptospirose/transmissão , Animais , Imunidade Inata , Imunoglobulinas/sangue , Cinética , Leptospira interrogans/imunologia , Leptospirose/imunologia , Camundongos Endogâmicos C3H , Mucosa Bucal , Mucosa Nasal , Nefrite/imunologia , Nefrite/microbiologia , Nefrite/patologia , Pele/lesões , Pele/microbiologia , Urina/microbiologia
14.
Int J Syst Evol Microbiol ; 70(3): 1522-1527, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-31951193

RESUMO

One Gram-stain-positive, non-motile, non-spore-forming, catalase-negative, and coccobacilli-shaped strain, designated c10Ua161MT, was isolated from a urine sample from a reproductive-age healthy woman. Comparative 16S rRNA gene sequence analysis indicated that strain c10Ua161MT belonged to the genus Lactobacillus. Phylogenetic analysis based on pheS and rpoA gene sequences strongly supported a clade encompassing strains c10Ua161MT and eight other strains from public databases, distinct from currently recognized species of the genus Lactobacillus. In silico Average Nucleotide Identity (ANI) and Genome-to-Genome Distance Calculator (GGDC), showed 87.9 and 34.3 % identity to the closest relative Lactobacillus jensenii, respectively. The major fatty acids of strain c10Ua161MT were C18 : 1ω9c (65.0%), C16 : 0 (17.8%), and summed feature 8 (10.2 %; comprising C18 : 1ω7c, and/or C18 : 1ω6c). The DNA G+C content of the strains is 34.2 mol%. On the basis of data presented here, strain c10Ua161MT represents a novel species of the genus Lactobacillus, for which the name Lactobacillus mulieris sp. nov. is proposed. The type strain is c10Ua161MT (=CECT 9755T=DSM 108704T).


Assuntos
Lactobacillus/classificação , Filogenia , Urina/microbiologia , Técnicas de Tipagem Bacteriana , Composição de Bases , DNA Bacteriano/genética , Ácidos Graxos/química , Feminino , Genes Bacterianos , Humanos , Lactobacillus/isolamento & purificação , Lactobacillus delbrueckii , Hibridização de Ácido Nucleico , Portugal , RNA Ribossômico 16S/genética , Análise de Sequência de DNA
15.
Am J Obstet Gynecol ; 222(2): 154.e1-154.e10, 2020 02.
Artigo em Inglês | MEDLINE | ID: mdl-31421123

RESUMO

BACKGROUND: Although the vaginal and urinary microbiomes have been increasingly well-characterized in health and disease, few have described the relationship between these neighboring environments. Elucidating this relationship has implications for understanding how manipulation of the vaginal microbiome may affect the urinary microbiome and treatment of common urinary conditions. OBJECTIVE: To describe the relationship between urinary and vaginal microbiomes using 16S rRNA gene sequencing. We hypothesized that the composition of the urinary and vaginal microbiomes would be significantly associated, with similarities in predominant taxa. STUDY DESIGN: This multicenter study collected vaginal swabs and catheterized urine samples from 186 women with mixed urinary incontinence enrolled in a parent study and 84 similarly aged controls. Investigators decided a priori that if vaginal and/or urinary microbiomes differed between continent and incontinent women, the groups would be analyzed separately; if similar, samples from continent and incontinent women would be pooled and analyzed together. A central laboratory sequenced variable regions 1-3 (v1-3) and characterized bacteria to the genus level. Operational taxonomic unit abundance was described for paired vaginal and urine samples. Pearson's correlation characterized the relationship between individual operational taxonomic units of paired samples. Canonical correlation analysis evaluated the association between clinical variables (including mixed urinary incontinence and control status) and vaginal and urinary operational taxonomic units, using the Canonical correlation analysis function in the Vegan package (R version 3.5). Linear discriminant analysis effect size was used to find taxa that discriminated between vaginal and urinary samples. RESULTS: Urinary and vaginal samples were collected from 212 women (mean age 53±11 years) and results from 197 paired samples were available for analysis. As operational taxonomic units in mixed urinary incontinence and control samples were related in canonical correlation analysis and since taxa did not discriminate between mixed urinary incontinence or controls in either vagina or urine, mixed urinary incontinence and control samples were pooled for further analysis. Canonical correlation analysis of vaginal and urinary samples indicated that that 60 of the 100 most abundant operational taxonomic units in the samples largely overlapped. Lactobacillus was the most abundant genus in both urine and vagina (contributing on average 53% to an individual's urine sample and 64% to an individual's vaginal sample) (Pearson correlation r=0.53). Although less abundant than Lactobacillus, other bacteria with high Pearson correlation coefficients also commonly found in vagina and urine included: Gardnerella (r=0.70), Prevotella (r=0.64), and Ureaplasma (r=0.50). Linear discriminant analysis effect size analysis identified Tepidimonas and Flavobacterium as bacteria that distinguished the urinary environment for both mixed urinary incontinence and controls as these bacteria were absent in the vagina (Tepidimonas effect size 2.38, P<.001, Flavobacterium effect size 2.15, P<.001). Although Lactobacillus was the most abundant bacteria in both urine and vagina, it was more abundant in the vagina (linear discriminant analysis effect size effect size 2.72, P<.001). CONCLUSION: Significant associations between vaginal and urinary microbiomes were demonstrated, with Lactobacillus being predominant in both urine and vagina. Abundance of other bacteria also correlated highly between the vagina and urine. This inter-relatedness has implications for studying manipulation of the urogenital microbiome in treating conditions such as urgency urinary incontinence and urinary tract infections.


Assuntos
Microbiota/genética , Sistema Urinário/microbiologia , Urina/microbiologia , Vagina/microbiologia , Adulto , Burkholderiales , Estudos de Casos e Controles , Clostridiales , Análise Discriminante , Escherichia , Feminino , Flavobacterium , Gardnerella , Humanos , Lactobacillus , Modelos Lineares , Pessoa de Meia-Idade , Prevotella , RNA Ribossômico 16S/análise , Streptococcus , Ureaplasma , Incontinência Urinária
16.
J Med Microbiol ; 69(1): 46-48, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31789587

RESUMO

Introduction. The question of whether a single day of incubation is sufficient for urine cultures has been a matter of debate.Aim. The aim of this study was to investigate the potential benefit of prolonged incubation for initially culture-negative urines.Methodology. Eight hundred and twelve urine specimens with no growth after incubation for 20 h were incubated for an additional 20 h to detect slower growing uropathogenic organisms.Results. This study included a considerable number of urine cultures from immunocompromised and/or kidney-transplanted patients. For 99.9 % of the specimens, there was no difference in the interpretation of results.Conclusion. Twenty hours of incubation did not have any negative effect on the detection of uropathogens.


Assuntos
Bactérias/isolamento & purificação , Técnicas Bacteriológicas/métodos , Testes Diagnósticos de Rotina/métodos , Infecções Urinárias/diagnóstico , Urina/microbiologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Criança , Pré-Escolar , Feminino , Humanos , Lactente , Recém-Nascido , Masculino , Pessoa de Meia-Idade , Sensibilidade e Especificidade , Fatores de Tempo , Adulto Jovem
17.
Urology ; 136: 119-126, 2020 02.
Artigo em Inglês | MEDLINE | ID: mdl-31715272

RESUMO

OBJECTIVE: To evaluate whether multiplex PCR-based molecular testing is noninferior to urine culture for detection of bacterial infections in symptomatic patients. METHODS: Retrospective record review of 582 consecutive elderly patients presenting with symptoms of lower urinary tract infection (UTI) was conducted. All patients had traditional urine cultures and PCR molecular testing run in parallel. RESULTS: A total of 582 patients (mean age 77; range 60-95) with symptoms of lower UTI had both urine cultures and diagnostic PCR between March and July 2018. PCR detected uropathogens in 326 patients (56%, 326/582), while urine culture detected pathogens in 217 patients (37%, 217/582). PCR and culture agreed in 74% of cases (431/582): both were positive in 34% of cases (196/582) and both were negative in 40% of cases (235/582). However, PCR and culture disagreed in 26% of cases (151/582): PCR was positive while culture was negative in 22% of cases (130/582), and culture was positive while PCR was negative in 4% of cases (21/582). Polymicrobial infections were reported in 175 patients (30%, 175/582), with PCR reporting 166 and culture reporting 39. Further, polymicrobial infections were identified in 67 patients (12%, 67/582) in which culture results were negative. Agreement between PCR and urine culture for positive cultures was 90%, exceeding the noninferiority threshold of 85% (95% conflict of interest 85.7%-93.6%). CONCLUSION: Multiplex PCR is noninferior to urine culture for detection and identification of bacteria. Further investigation may show that the accuracy and speed of PCR to diagnose UTI can significantly improve patient outcomes.


Assuntos
Infecções Bacterianas/diagnóstico , Infecções Bacterianas/urina , Reação em Cadeia da Polimerase Multiplex , Infecções Urinárias/diagnóstico , Infecções Urinárias/urina , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Urinálise/métodos , Urina/microbiologia
18.
Int J Syst Evol Microbiol ; 70(1): 624-630, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31697226

RESUMO

A novel Vogesella strain, YM-1T, was recovered from human urine in PR China in 2017. Cells of strain YM-1T were Gram-stain-negative, rod-shaped, aerobic, motile, non-spore-forming and poly-ß-hydroxybutyrate-accumulating. The strain contained C16:1ω6c/C 16:1ω7c, C16:0 and C18:0ω7c as major fatty acids; phosphatidylethanolamine, phosphatidylglycerol, diphosphatidylglycerol and an unidentified phospholipid as major polar lipids; and ubiquinone-8 as the predominant respiratory quinone. Comparison of 16S rRNA gene sequences indicated that this strain had highest similarities to Vogesella perlucida DS-28T (98.8 %) and Vogesella mureinivorans 389T (98.1 %). The results of phylogenetic analysis based on the 16S rRNA gene sequences revealed that the novel strain was clustered and well separated with V. perlucida DS-28T and V. mureinivorans 389T within the genus Vogesella. The average nucleotide identity (ANI) and amino acid identity (AAI) analyses showed that this strain was not identified as V. perlucida DS-28T or V. mureinivorans 389T, with values well below the threshold limit for species demarcation (ANI <88.1 %, AAI <88.6 %). Based on the above results, strain YM-1T is proposed to be a novel species of the genus Vogesella with the name Vogesella urethralis sp. nov. (YM-1T=NBRC 113779=CGMCC 1.17135).


Assuntos
Betaproteobacteria/classificação , Filogenia , Urina/microbiologia , Bactérias Aeróbias/genética , Técnicas de Tipagem Bacteriana , Composição de Bases , Betaproteobacteria/isolamento & purificação , China , DNA Bacteriano/genética , Ácidos Graxos/química , Humanos , Hidroxibutiratos/metabolismo , Hibridização de Ácido Nucleico , Fosfolipídeos/química , Poliésteres/metabolismo , RNA Ribossômico 16S/genética , Análise de Sequência de DNA , Ubiquinona/química
19.
J Med Microbiol ; 69(1): 52-62, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31846419

RESUMO

Introduction. The alarming rise in urinary tract infection (UTI) antimicrobial resistance has resulted from a combination of high prevalence, low specificity and the lack of a rapid, point-of-care (POC) antibiotic susceptibility test (AST), which has led to the overuse/inappropriate use of antibiotics.Aim. This study aimed to evaluate the performance of a rapid POC phenotypic AST device in reporting susceptibility information within 2 h.Methodology. Instrument calibration was performed with model bacteria and fluorescent microbeads to determine the dynamic range and limit of detection for quantifying concentrations of bacteria and demonstrate the ability to rapidly differentiate susceptible and resistant model bacteria. We then evaluated 30 presumptive UTI-positive patient urine samples in a clinical pilot study using a panel of 5 common UTI antibiotics plus a growth control and compared our results to the hospital standard of care AST.Results. Our device was able to robustly detect and quantify bacteria concentrations from 50 to 105 colony-forming units (c.f.u.) ml-1. The high sensitivity of this measurement technique enabled the device to differentiate between susceptible and resistant model bacteria with 100 % specificity over a 2 h growth period. In the clinical pilot study, an overall categorical agreement (CA) of 90.7 % was observed (sensitivity=91.4 %, specificity=88.9 %, n=97) with performance for individual drugs ranging from 85 % CA (ceftazidime) to 100 % (nitrofurantoin).Conclusions. By reducing the typical timeframe for susceptibility testing from 2-3 days to 2 h, our POC phenotypic AST can provide critical information to clinicians prior to the administration of antibiotic therapy.


Assuntos
Antibacterianos/farmacologia , Bactérias/efeitos dos fármacos , Testes de Sensibilidade Microbiana/métodos , Sistemas Automatizados de Assistência Junto ao Leito , Infecções Urinárias/microbiologia , Bactérias/isolamento & purificação , Humanos , Projetos Piloto , Sensibilidade e Especificidade , Fatores de Tempo , Urina/microbiologia
20.
J Sci Med Sport ; 23(1): 63-68, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31558359

RESUMO

OBJECTIVES: The gut microbiome has begun to be characterised in athlete groups, albeit, to date, only across a subset of sports. This study aimed to determine if the gut microbiome and metabolome differed across sports classification groups (SCGs) among elite Irish athletes, many of whom were participating in the 2016 Summer Olympics. METHODS: Faecal and urine samples were collected from 37 international level athletes. Faecal samples were prepared for shotgun metagenomic sequencing and faecal and urine samples underwent metabolomic profiling. RESULTS: Differences were observed in the composition and functional capacity of the gut microbiome of athletes across SCGs. The microbiomes of athletes participating in sports with a high dynamic component were the most distinct compositionally (greater differences in proportions of species), while those of athletes participating in sports with high dynamic and static components were the most functionally distinct (greater differences in functional potential). Additionally, both microbial (faecal) and human (urine) derived metabolites were found to vary between SCGs. In particular cis-aconitate, succinic acid and lactate, in urine samples, and creatinine, in faeces, were found to be significantly different between groups. These differences were evident despite the absence of significant differences in diet, as determined using food frequency questionnaires, which were translated into nutrient intake values using FETA. CONCLUSIONS: Differences in the gut microbiome and metabolome between groups, in the absence of dietary changes, indicates a role for training load or type as a contributory factor. Further exploration of this hypothesis has the potential to benefit athletes, aspiring athletes and the general public.


Assuntos
Atletas , Microbioma Gastrointestinal , Metaboloma , Esportes/classificação , Fezes/microbiologia , Feminino , Humanos , Irlanda , Masculino , Urina/microbiologia
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