Levels of pro- and anti-inflammatory cytokines in cystic fibrosis patients with or without gingivitis.

BACKGROUND: Inflammatory periodontal diseases are caused by interaction between gram negative, anaerobic bacteria and host response. Persistent infection of Pseudomonas aeruginosa in cystic fibrosis (CF) patients also cause increased pro-inflammatory response and the imbalance of pro- and anti-inflammatory response in brochoalveolar lavage fluid which leads to destruction of lungs. The aim of this study is to evaluate periodontal status of CF patients, to measure level of cytokines and biochemical molecules in gingival crevicular fluid (GCF), and to detect presence of P. aeruginosa in dental plaque samples. MATERIALS AND METHODS: GCF samples were collected from 41 CF patients and 39 healthy (non-CF) subjects. Interleukin (IL)-1ß, IL-17, IL-10, human neutrophil elastase (HNE), cystic fibrosis transmembrane regulator (CFTR) protein, and human ß-defensin-1 (HBD1) in GCF were evaluated by ELISA method. Dental plaque samples were collected from 18 CF patients with history of P. aeruginosa colonization and 15 non-CF subjects. Presence of P. aeruginosa was evaluated by using conventional culture methods and molecular methods. RESULTS: Levels of IL-1ß, HNE, and HBD1 in CF patients were significantly higher than non-CF subjects. However, IL-10 level was significantly lower in CF patients. Increased pro-inflammatory (IL-1ß) and decreased anti-inflammatory (IL-10) cytokine levels were observed in GCF samples from CF patients, irrespective of their periodontal status. P. aeruginosa were detected in four samples of 18 CF patients, and all were negative in non-CF group. CONCLUSIONS: As a result of this study, CF coexists increasing pro-inflammatory and decreasing anti-inflammatory response locally. Due to increasing pro-inflammation, CF patients should be followed-up more often than non-CF children.

In-vitro activity of fosfomycin against Escherichia coli and Klebsiella pneumoniae bloodstream isolates and frequency of OXA-48, NDM, KPC, VIM, IMP types of carbapenemases in the carbapenem-resistant groups.

The aim of this study was to determine the in-vitro activity of fosfomycin against Escherichia coli (E. coli) and Klebsiella pneumoniae (K. pneumoniae) isolates and the frequency of OXA-48, NDM, KPC, VIM, IMP types of carbapenemases in the carbapenem-resistant (CR) groups. A total of 346 isolates (126 E. coli and 220 K. pneumoniae) from nosocomial bloodstream infections were included. Carbapenem and fosfomycin susceptibility were tested by Etest (bioMerieux, France) and agar dilution methods, respectively and evaluated in accordance with EUCAST criteria. The presence of OXA-48, NDM, KPC, VIM, IMP types of carbapenemases were conducted by using PCR method. Of the total 346 isolates, 185 (41 E. coli, 144 K. pneumoniae) were CR. Fosfomycin susceptibility of E. coli was higher than 95% and was not statistically significant between the CR and carbapenem-susceptible (CS) groups. Fosfomycin susceptibility of CS and CR K. pneumoniae was 90.7% and 69.4%, respectively, and statistically significantly lower in CR group. Of the total 185 CR isolates, 163 (32 E. coli, 131 K. pneumoniae) were producing carbapenemases. OXA-48 was the prominent carbapenemase type produced by E. coli (96.8%) and K. pneumoniae (70.9%). The frequency of NDM and KPC types produced by K. pneumoniae was 20.6% and 15.2%, respectively. Fosfomycin has substantial in-vitro activity against nosocomial CS and CR E. coli and CS K. pneumoniae bloodstream isolates. However, due to the risk of emerging resistance with fosfomycin monotherapy, combination therapy should be considered to obtain the possible additive or synergistic activity. Emerging fosfomycin resistance of CR K. pneumoniae isolates is alarming and OXA-48 is still the prominent carbapenemase type in Turkey.

A new look at the etiology of interstitial cystitis/bladder pain syndrome: extraordinary cultivations.

PURPOSE: So far, studies have not clearly identified infectious agents as an etiological factor for interstitial cystitis (IC). Specific microbiological diagnosis for detecting the pathogen with higher sensitivity in IC may decrease the treatment costs and increase psychosocial health of the patients. METHODS: A prospective clinical study was performed in 26 IC patients and 20 controls between April and September 2017. All participants were asked to give mid-stream urine sample for routine urine cultures. Followed by the negative results, symptomatic 26 patients were evaluated for L-form pathogen existence by extraordinary cultivation methods. Biopsy samples were taken from 19 patients with ulcerative lesions in the bladder while collecting sterile urine samples from all 26 patients. PG broth, 5% sheep blood agar, EMB, Sabouraud's dextrose, LEM, and GYPA were used. Followed by the 1st day inoculations, all inoculated PG broths were subcultured into the same solid media at the 2nd and 10th days in case of any growth after incubation of 24 h under 35-37 °C. The "O'Leary Sant Symptom and Problem Index" score forms were used to evaluate response to the appropriate treatment for those patients with documented pathogens. RESULTS: Bacterial isolations were yielded from samples of 13 IC patients in PG broth. Eight (61.5%) P. aeruginosa, 2 (15.4%) K. pneumoniae, 2 (15.4%) C. mucifaciens, and 1 (7.7%) E. faecalis were isolated. Antibiotic susceptibility tests were performed. Somehow, the median symptom index and problem scores of those 13 IC patients were lower after the appropriate antibiotic treatment (p < 0.05). CONCLUSIONS: Extraordinary mediums with longer incubation periods may reveal a causative pathogen in the etiology of IC. Future culture techniques may have some value, because still some of IC/BPS patients are describing symptomatic relief by a group of antibiotics.