RESUMO
INTRODUCTION: Alterations in microbiota composition have been implicated in a variety of human diseases. Patients with adenomyosis present immune dysregulation leading to a persistent chronic inflammatory response. In this context, the hypothesis that alterations in the microbiota may be involved in the pathogenesis of adenomyosis, by affecting the epigenetic, immunologic, and biochemical functions of the host, has recently been postulated. The aim of the present study was to compare the microbiota composition in the vagina, endometrium, and gut of individuals with and without adenomyosis. MATERIAL AND METHODS: Cross-sectional study including 38 adenomyosis patients and 46 controls, performed between September 2021 and October 2022 in a university hospital-based research center. The diagnosis of adenomyosis was based on sonographic criteria. Fecal, vaginal, and endometrial samples were collected. Study of the microbiota using 16S rRNA gene sequencing. RESULTS: Patients with adenomyosis exhibited a significant reduction in the gut microbial alpha diversity compared with healthy controls (Chao1 p = 0.012, Fisher p = 0.005, Observed species p = 0.005). Beta-diversity analysis showed significant differences in the compositions of both gut and vaginal microbiota between adenomyosis patients and the control group (Adonis p-value = 0.001; R2 = 0.03 and Adonis p-value = 0.034; R2 = 0.04 respectively). Specific bacterial taxa were found to be either overrepresented (Rhodospirillales, Ruminococcus gauvreauii group, Ruminococcaceae, and Actinomyces) or underrepresented in the gut and endometrial microbiota of adenomyosis patients compared with controls. Distinct microbiota profiles were identified among patients with internal and external adenomyosis phenotypes. CONCLUSIONS: The study revealed reduced gut microbiota diversity in adenomyosis patients, accompanied by distinct compositions in gut and vaginal microbiota compared with controls. Overrepresented or underrepresented bacterial taxa were noted in the gut and endometrial microbiota of adenomyosis patients, with variations in microbiota profiles among those with internal and external adenomyosis phenotypes. These findings suggest a potential association between microbiota and adenomyosis, indicating the need for further research to comprehensively understand the implications of these differences.
Assuntos
Adenomiose , Endométrio , Microbioma Gastrointestinal , Vagina , Humanos , Feminino , Adenomiose/microbiologia , Estudos Transversais , Adulto , Vagina/microbiologia , Endométrio/microbiologia , Pessoa de Meia-Idade , Estudos de Casos e Controles , RNA Ribossômico 16S/genéticaRESUMO
Introduction: We examined the gut microbiota of travellers returning from tropical areas with and without traveller's diarrhoea (TD) and its association with faecal lipocalin-2 (LCN2) levels. Methods: Participants were recruited at the Hospital Clinic of Barcelona, Spain, and a single stool sample was collected from each individual to perform the diagnostic of the etiological agent causing gastrointestinal symptoms as well as to measure levels of faecal LCN2 as a biomarker of gut inflammation. We also characterised the composition of the gut microbiota by sequencing the region V3-V4 from the 16S rRNA gene, and assessed its relation with the clinical presentation of TD and LCN2 levels using a combination of conventional statistical tests and unsupervised machine learning approaches. Results: Among 61 participants, 45 had TD, with 40% having identifiable etiological agents. Surprisingly, LCN2 levels were similar across groups, suggesting gut inflammation occurs without clinical TD symptoms. Differential abundance (DA) testing highlighted a microbial profile tied to high LCN2 levels, marked by increased Proteobacteria and Escherichia-Shigella, and decreased Firmicutes, notably Oscillospiraceae. UMAP analysis confirmed this profile's association, revealing distinct clusters based on LCN2 levels. The study underscores the discriminatory power of UMAP in capturing meaningful microbial patterns related to clinical variables. No relevant differences in the gut microbiota composition were found between travellers with or without TD. Discussion: The findings suggest a correlation between gut microbiome and LCN2 levels during travel, emphasising the need for further research to discern the nature of this relationship.
Assuntos
Diarreia , Fezes , Microbioma Gastrointestinal , Lipocalina-2 , Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Adulto Jovem , Bactérias/classificação , Bactérias/genética , Bactérias/isolamento & purificação , Biomarcadores , Diarreia/microbiologia , Fezes/microbiologia , Fezes/química , Inflamação/microbiologia , Lipocalina-2/metabolismo , RNA Ribossômico 16S/genética , Espanha , ViagemRESUMO
Early detection of disseminating vancomycin-resistant Enterococcus faecium (VREfm) in ICU wards is crucial for outbreak identification and the implementation of prompt infection control measures. Genotypic methods like pulsed-field gel electrophoresis (PFGE) and whole-genome sequencing (WGS) are costly and time-consuming, hindering rapid response due to batch dependency. Fourier-transform infrared spectroscopy (FT-IR) offers the potential for real-time outbreak detection and reliable strain typing. We utilized FT-IR to identify clonal VREfm dissemination and compared its performance to PFGE and WGS. Between February through October 2023, an unusually high number of VREfm were recovered at a tertiary hospital in Barcelona. Isolates were examined for antimicrobial susceptibility, carriage of vanA/vanB genes and clonality was also studied using FT-IR, PFGE, and WGS. Routine FT-IR inspections revealed recurring VREfm clustering during the outbreak's initial weeks. In total, 104 isolates were recovered from 75 patients and from multiple wards. However, only one isolate was recovered from an environmental sample, suggesting the absence of environmental reservoirs. An ST80 vancomycin-resistant (vanA) E. faecium strain was the main strain responsible for the outbreak, although a few additional VREfm strains were also identified, all belonging to CC17. PFGE and cgMLST (WGS) yielded identical clustering results to FT-IR, and WGS confirmed vanA/vanB gene carriage in all VREfm isolates. Infection control measures led to a rapid decline in VREfm isolates, with no isolates detected in November. FT-IR spectroscopy offers rapid turnaround times, sensitivity, and reproducibility, comparable to standard typing methods. It proved as an effective tool for monitoring VREfm dissemination and early outbreak detection.
Assuntos
Infecção Hospitalar , Eletroforese em Gel de Campo Pulsado , Enterococcus faecium , Infecções por Bactérias Gram-Positivas , Enterococos Resistentes à Vancomicina , Sequenciamento Completo do Genoma , Humanos , Enterococcus faecium/genética , Enterococcus faecium/efeitos dos fármacos , Enterococcus faecium/isolamento & purificação , Enterococcus faecium/classificação , Enterococos Resistentes à Vancomicina/genética , Enterococos Resistentes à Vancomicina/isolamento & purificação , Enterococos Resistentes à Vancomicina/efeitos dos fármacos , Enterococos Resistentes à Vancomicina/classificação , Espectroscopia de Infravermelho com Transformada de Fourier/métodos , Infecção Hospitalar/microbiologia , Infecção Hospitalar/epidemiologia , Infecções por Bactérias Gram-Positivas/microbiologia , Infecções por Bactérias Gram-Positivas/epidemiologia , Sequenciamento Completo do Genoma/métodos , Surtos de Doenças , Proteínas de Bactérias/genética , Testes de Sensibilidade Microbiana , Espanha/epidemiologia , Carbono-Oxigênio Ligases/genética , Antibacterianos/farmacologiaRESUMO
Background: Phaeoacremonium parasiticum is considered a rare infectious agent that is part of a heterogeneous group of fungi causing phaeohyphomycosis. This organism is capable of producing subcutaneous infections, eumycetomas, osteomyelitis, arthritis, myositis and also disseminated diseases, such as fungemia and endocarditis. Case report: We describe a case of cutaneous infection by P. parasiticum in a kidney transplant patient. The identification of this microorganism was performed by microbiological and histopathological studies and confirmed with the sequence of the gene encoding β-tubulin and a real time panfungal PCR targeting 18S ribosomal RNA gene. The microorganism was correctly identified by phenotypic and molecular methods. The patient was treated with oral antifungal therapy and a debulking surgery and evolved without any complication. Conclusions: The diagnosis of this infection is difficult and usually affects kidney transplant patients, but the reasons of this association are still unknown
Antecedentes: Phaeoacremonium parasiticum es considerado un agente infeccioso poco común que forma parte de un grupo heterogéneo de hongos causantes de feohifomicosis. Este microorganismo es capaz de producir infección cutánea, eumicetoma, osteomielitis, artritis, miositis e incluso enfermedad diseminada como fungemia y endocarditis. Caso clínico: Se describe un caso de infección cutánea por P. parasiticum en un paciente trasplantado renal. Para la identificación del microorganismo se realizaron pruebas microbiológicas e histopatológicas, y se confirmó la identificación con la secuenciación del gen de la β-tubulina y una PCR a tiempo real para la detección del gen 18S rRNA. El microorganismo fue identificado correctamente por métodos fenotípicos y moleculares. El paciente recibió tratamiento con antifúngicos orales y citorreducción quirúrgica, y evolucionó sin ninguna complicación. Conclusiones: El diagnóstico de esta infección es difícil y se presenta habitualmente en pacientes trasplantados renales. Sin embargo, la asociación de esta infección con este tipo de pacientes no ha sido aún explicada
Assuntos
Humanos , Masculino , Idoso , Ascomicetos/isolamento & purificação , Dermatomicoses/microbiologia , Rim , Feoifomicose/microbiologia , Transplantados , Ascomicetos/genética , Dermatomicoses/terapia , Hospedeiro Imunocomprometido , Feoifomicose/terapia , Fenótipo , RNA Ribossômico 18S/genética , Tubulina (Proteína)/genéticaRESUMO
Stool donors for fecal microbiota transference (FMT) should be rigorously screened to identify any disorder in health status. The success of our screening protocol to identify eligible donors in the last year and a half was evaluated and compared with the published literature.The target population was medical students who responded to 3 public calls to donate stools. Qualified donors brought stool samples to our lab.Out of the 110 students who responded to the call, 26 were enrolled as study donors and delivered at least one stool sample. The main reason for volunteer exclusion was body mass index (BMI) <18.5kg/m2 or >25kg/m2 (n=11) and for the identification of ESBL Escherichia coli in feces (n=3).Our success rate after the screening protocol was considered high. Understanding the incentives to participate is critical to the success of recruitment strategies as FMT is still a little-known practice for general population.(AU)
Se debe seleccionar rigurosamente a los donantes de heces para la transferencia de microbiota fecal (TMF) para identificar cualquier trastorno en la salud. Se evaluó el éxito de nuestro protocolo de selección para identificar donantes idóneos en el último año y medio y se comparó con la literatura publicada.La población objetivo fueron estudiantes de medicina que respondieron a 3 convocatorias públicas para donar heces. Los donantes aptos llevaron muestras de heces a nuestro laboratorio.De los 110 estudiantes que respondieron a la convocatoria, 26 se inscribieron como donantes del estudio y entregaron al menos una muestra de heces. El principal motivo para la exclusión de voluntarios fue un índice de masa corporal (IMC) <18,5 kg/m2 o >25 kg/m2 (n=11) y la identificación de E. coli BLEE en las heces (n=3).Nuestra tasa de éxito tras el protocolo de selección se consideró alta. Comprender los incentivos para participar es fundamental para el éxito de las estrategias de reclutamiento, ya que la TMF sigue siendo una práctica poco conocida para la población en general.(AU)
Assuntos
Humanos , Masculino , Feminino , Transplante de Microbiota Fecal , Estudantes de Medicina , Seleção do Doador , Manejo de Espécimes , Fezes , Índice de Massa Corporal , Doenças Transmissíveis , Microbiologia , Espanha/epidemiologiaRESUMO
OBJETIVO: Analizar la influencia de la resiliencia sobre las distintas dimensiones de la calidad de vida relacionada con la salud en un grupo de adolescentes escolarizados en la ciudad de Cuenca. MÉTODO: Se realizó un estudio descriptivo, transversal, multicéntrico y polietápico en 5 institutos de Educación Secundaria durante el curso académico 2015-1016. Instrumentos: Cuestionario autoadministrado que incluía variables sociodemográficas y las escalas CD-RISC 10 para evaluar resiliencia y KIDSCREEN-52 para medir la calidad de vida relacionada con la salud. RESULTADOS: Se recogieron datos de 844 estudiantes, de los cuales el 54% fueron chicas y la edad media de la muestra fue de 16,36±1,05 años. Se observaron valores superiores de resiliencia en los chicos. Con respecto a la calidad de vida relacionada con la salud, fue menor en las chicas (salvo en la dimensión de aceptación social) y en el grupo de mayor edad. La resiliencia se asoció significativamente con todas las dimensiones del KIDSCREEN-52 y resultó ser un predictor relevante, especialmente en las dimensiones relacionadas con la salud mental y en todas las que miden relaciones sociales. CONCLUSIÓN: Nuestro estudio aporta evidencias sobre la sinergia calidad de vida relacionada con la salud-resiliencia en adolescentes. La resiliencia se asocia con niveles más elevados de calidad de vida en adolescentes y, al ser menor en chicas, puede ser uno de los factores explicativos de su peor calidad de vida relacionada con la salud
OBJECTIVE: To analyze the influence of resilience on the different dimensions of health-related quality of life in a group of adolescents in Cuenca. METHOD: A descriptive, cross-sectional, multicentre and multistage study was carried out in 5 secondary schools during the 2015-2016 school year. Instruments: A self-administered questionnaire, which included sociodemographic characteristics and the CD-RISC 10 scale to assess resilience together with the KIDSCREEN-52 questionnaire to measure health-related quality of life. RESULTS: Data were obtained from 844 students, of whom 54% were girls and the mean age was 16.36±1.05 years. Higher resilience scores were observed in boys. Health-related quality of life was lower in girls (except in the dimension of social acceptance) and in the oldest group. Resilience was significantly associated with all KIDSCREEN-52 dimensions and proved to be a relevant predictor, especially in the dimensions related with mental health and all those that measure social relationships. CONCLUSIONS: Our study provides evidence on the synergy between health-related quality of life and resilience in adolescents. Resilience is associated with higher levels of quality of life in adolescents and as the scores are lower in girls, it could be one of the explanatory factors for their poorer health-related quality of life