RESUMO
Due to the recent recovery of brown bear populations in Central Europe, information about their ascarid parasite, Baylisascaris transfuga is necessary as the parasite represents a part of natural ecological networks. B. transfuga can lead to larva migrans syndrome in accidental hosts, but its zoonotic potential has not been confirmed. The resent study compares development of larva migrans in infected mice inoculated with two infectious doses (ID 200 and ID 2000) of B. transfuga embryonated eggs, and the clinical manifestation to evaluate the pathogenicity of the larvae. Histopathology revealed that the liver was the most severely infected organ. The moderately infected organs included lung, brain, skeletal muscles and jejunum and the less infected ones were the eyes, heart, kidneys and spleen. The high pathogenicity of B. transfuga to mice was reflected in high mortality (33,3%) after infection, with mortality increasing with higher infectious dose. The results extend the knowledge of the interaction of B. transfuga and its aberrant hosts and contribute to the understanding of the epidemiology and transmission of this bears roundworm.
Assuntos
Infecções por Ascaridida , Ascaridoidea , Larva Migrans , Infecções por Nematoides , Ursidae , Animais , Infecções por Ascaridida/veterinária , Larva , CamundongosRESUMO
Hedgehogs (Mammalia: Erinaceidae) are omnivorous nocturnal animals typically living in anthropogenic areas. They may be suitable as sentinels for a wide range of zoonotic infections. Only a few studies have investigated hedgehogs (and then as representative wildlife species) to establish their role in the life cycle of such tissue parasites with zoonotic potential as Toxoplasma gondii or Trichinella spp. Working with frozen hedgehog cadavers, we tested for these parasites using T. gondii DNA-specific magnetic capture isolation plus polymerase chain reaction and Trichinella spp. digestion assay. All of 50 examined hedgehogs were negative for Trichinella spp. larvae in their muscles, but brain tissue from 5 out of 26 Erinaceus europaeus (19.2%) and 4 out of 24 E. roumanicus (16.6%) tested positive for T. gondii DNA. Frequency of T. gondii for both hedgehog species was equal, as was distribution between males and females and across age categories. Although a few studies have suggested the possibility of Trichinella spp. infection in hedgehogs, the zero prevalence in the tested hedgehogs is not surprising in view of the generally low prevalence of Trichinella spp. in Central Europe. Our results show that hedgehogs are susceptible to infection by T. gondii and can be used as indicator wildlife animal species in anthropogenic ecosystems.
Assuntos
Ouriços/parasitologia , Toxoplasma/isolamento & purificação , Toxoplasmose Animal/epidemiologia , Trichinella/isolamento & purificação , Triquinelose/epidemiologia , Triquinelose/veterinária , Animais , Animais Selvagens/parasitologia , República Tcheca , DNA de Protozoário/genética , Europa (Continente)/epidemiologia , Feminino , Larva/genética , Masculino , Reação em Cadeia da Polimerase , Toxoplasma/genética , Toxoplasmose Animal/parasitologia , Trichinella/classificação , Trichinella/genética , Triquinelose/parasitologia , ZoonosesRESUMO
This study reports a new case of Candidatus Neoehrlichia sp. (FU98) infection in a fox from the Czech Republic, and provides confirmatory evidence on the occurrence of this newly identified sequence type. However, further studies are needed to investigate the distribution, host range and possible vector(s) for this bacterium, as well as its impact on animals and humans.
Assuntos
Anaplasmataceae/fisiologia , Raposas/microbiologia , Animais , República Tcheca , DNA Bacteriano/sangue , DNA Bacteriano/genética , Raposas/sangue , Análise de Sequência de DNARESUMO
Undercooked lamb and mutton are common sources of Toxoplasma gondii infection for humans. A sequence specific magnetic capture technique in combination with quantitative real-time PCR targeting the 529 bp repeat element of T. gondii was used for estimation of the parasite burdens in various sheep tissues (n = 6) three months after peroral experimental inoculation with 10,000 T. gondii oocysts. Brain was the most frequently affected organ (positive in all 6 sheep) and showed the highest estimated parasite loads (0.5-30,913 parasites/g tissue). Lung samples were positive in three sheep, with load estimates of 36.3 to <1 parasite/g tissue. Heart tissue was positive in three sheep and kidney only in one animal with low parasite loads (<1 parasite/g tissue). Only few skeletal muscle samples in 2 animals showed positive results, with very low parasite burdens, while samples from further internal organs (i.e. liver and spleen) were negative in all animals. This study identified the brain as the most important predilection site and therefore the most appropriate tissue for T. gondii detection.
Assuntos
Estruturas Animais/parasitologia , Toxoplasma/isolamento & purificação , Toxoplasmose Animal/parasitologia , Animais , Magnetismo , Reação em Cadeia da Polimerase em Tempo Real/instrumentação , Reação em Cadeia da Polimerase em Tempo Real/métodos , Ovinos , Toxoplasma/genéticaRESUMO
BACKGROUND: The aims of this study were to describe the basic parameters of adult patients with acute community-onset salmonellosis or campylobacteriosis responsible for more than 90 % of all cases of community-onset diarrhea in the Czech Republic, and, according to the results of this analysis, to update the diagnostic and therapeutic algorithms. MATERIALS AND METHODS: The data were collected retrospectively between January 1, 2011 and December 31, 2013. Patients with systemic signs of infection having at least 2 signs of systemic inflammatory response syndrome (SIRS) or with elevated serum procalcitonin levels (more than 0.5 ng/ml) were classified as being at risk for the invasive form of the disease. The remaining patients were classified as having the simple intestinal form of the disease. Patients with community-onset post-antibiotic diarrhea were excluded. The data were statistically processed. RESULTS: The following clinical factors were statistically significantly correlated with the high-risk form of the disease: duration of illness of less than 3 days before admission and any of the following (some of them are part of the SIRS classification), even after being adjusted for age: body temperature above 38 °C, peripheral blood white cell count (WBC) above 12 × 109/l, neutrophil count above 9 × 109/l and CRP level above 150 mg/l. The risk form of the disease occurred in 60 cases (18.7 %). The mean WBC was 9.4 × 109/l (median, 8.4; range, 1.7-89.0). The WBC within the normal range was seen in 194 cases (60.4 %). The mean CRP level was 92.9 mg/l (median, 77.0; range, 1.0-342.0). An elevated procalcitonin level was seen in 21 patients; the marker was not routinely measured. Positive blood culture results were obtained in 2 persons with salmonellosis; the examination was not routinely performed. There were 34 patients (10.6 %) with documented immune system dysfunction; the risk form of salmonellosis or campylobacteriosis was seen in only 11 of them (3.4 %). A total of 306 patients (95.3 %) were treated with antibiotics; the mean duration of antibiotic therapy was 8.7 days (median, 7; range, 2-31). CONCLUSIONS: Antibiotic treatment in salmonellosis/campylobacteriosis should not be indicated only due to elevated CRP levels but rather after comprehensive evaluation of the duration of symptoms, individual risk factors and dynamic changes in markers of inflammation. Blood culture tests should be carried out more frequently.
Assuntos
Antibacterianos/administração & dosagem , Antibacterianos/uso terapêutico , Infecções por Campylobacter/tratamento farmacológico , Diarreia/tratamento farmacológico , Infecções por Salmonella/tratamento farmacológico , Adulto , Biomarcadores , Proteína C-Reativa/metabolismo , Infecções por Campylobacter/epidemiologia , República Tcheca/epidemiologia , Diarreia/epidemiologia , Diarreia/etiologia , Feminino , Febre , Humanos , Contagem de Leucócitos , Masculino , Pessoa de Meia-Idade , Neutrófilos , Estudos Retrospectivos , Fatores de Risco , Infecções por Salmonella/epidemiologiaRESUMO
Ingestion of raw or undercooked meat is a potential source of human toxoplasmosis. The aim of this study was to determine the viability of Toxoplasma gondii cysts in vacuum packed (VP) goat meat and in dry fermented sausages (DFS), and evaluate certain physical and chemical parameters, like water activity (aw), pH value, content of salt, dry matter and fat. A portion of muscle tissue from experimentally infected animals was used for production of VP meat with or without addition of 2.5% curing salt, and stored at 4 °C or at -20 °C. Results of bioassay showed that, samples of vacuum packed Toxoplasma positive meat without salt addition were alive after six weeks at 4 °C. Incubation at -20 °C supported the viability after 3 h, but not after 4 h. After 7 days in 2.5% of curing salt, samples of T. gondii VP goat meat were still viable, but not after 14 days at 4 °C. All the DFS samples were not positive for infective cysts which mean that, they do not pose a risk of T. gondii transmission. These data suggest that vacuum packaging increases the survival of T. gondii cysts.
Assuntos
Doenças das Cabras/parasitologia , Produtos da Carne/parasitologia , Carne/parasitologia , Músculo Esquelético/parasitologia , Toxoplasma/crescimento & desenvolvimento , Toxoplasmose Animal/parasitologia , Animais , Qualidade de Produtos para o Consumidor , Embalagem de Alimentos , Cabras , Humanos , Carne/análise , Produtos da Carne/análise , Toxoplasma/genética , Toxoplasma/isolamento & purificação , VácuoRESUMO
Pigs represent an important source of food in many countries, and undercooked pork containing tissue cysts is one of the most common sources of Toxoplasma gondii infection for humans. A magnetic capture method for the isolation of T. gondii DNA and quantitative real-time PCR targeting the 529 bp TOXO repeat element were used to estimate the parasite burden in different tissues of pigs experimentally infected with T. gondii oocysts, and to determine the predilection sites of T. gondii in this host species. The highest concentration of T. gondii DNA was found in brain tissues, equivalent to [median] 553.7 (range 3857.7-121.9) parasites per gram, followed by lungs, heart and dorsal muscles with median values corresponding to 0.3 (range 61.3-0.02); 2.6 (range 7.34-0.37) and 0.6 (range 2.81-0.31) parasites per gram of tissue, respectively. Skeletal muscles from fore and hindlimb, liver and kidney presented very low infection burdens equivalent to [median] ≤0.2 parasites per gram of tissues, and no parasite DNA could be detected in the spleen. This study contributes to understanding the value of different pig tissues as a source of T. gondii infection for humans and shows that the brain, while not being of major importance as human food source, may represent a first-line selection tissue when performing non-serological surveys (e.g. bioassays, histopathological, immunohistochemical or molecular studies) to detect T. gondii infections in pigs.
Assuntos
Encéfalo/parasitologia , Doenças dos Suínos/parasitologia , Toxoplasma/isolamento & purificação , Toxoplasmose Animal/parasitologia , Animais , Encéfalo/patologia , Magnetismo/métodos , Reação em Cadeia da Polimerase em Tempo Real/métodos , Suínos , Doenças dos Suínos/patologia , Toxoplasma/química , Toxoplasma/genética , Toxoplasma/fisiologia , Toxoplasmose Animal/patologiaRESUMO
Campylobacteriosis belongs to the most frequent bacterial gastrointestinal infections worldwide. In the past several years, an increasing trend in the prevalence of campylobacteriosis has been observed in many countries. The rapid spread of antibiotic resistance in Campylobacter spp. also poses a major challenge. The authors review current knowledge on the microbiology of Campylobacter spp., complex pathogenetic as well as pathophysiological mechanisms in the development and course of campylobacteriosis and related complications such as Guillain-Barré syndrome.
Assuntos
Infecções por Campylobacter/microbiologia , Campylobacter/classificação , Infecções por Campylobacter/complicações , Infecções por Campylobacter/patologia , Síndrome de Guillain-Barré , Humanos , PrevalênciaRESUMO
The red fox (Vulpes vulpes) is the most widespread free-living carnivore in the world. Over the years, foxes have been recognized as hosts for a number of tick-borne pathogens. However, their role as reservoirs for zoonotic tick-borne diseases is poorly understood. The aim of our study was to investigate tick-borne pathogens in the red fox population in the Czech Republic. Out of 117 red foxes, 110 (94.02%) individuals tested positive for the presence of at least one pathogen by the combined PCR and sequencing approach. Hepatozoon canis was the most frequently detected pathogen (n = 95; 81.2%), followed by Babesia vulpes (n = 75; 64.1%). Babesia canis was not detected in our study. Four (3.42%) red foxes were positive for Candidatus Neoehrlichia sp., 3 (2.56%) for Anaplasma phagocytophilum, and one red fox (0.85%) tested positive for the presence of Ehrlichia sp. DNA. Overall, DNA of spirochetes from the Borrelia burgdorferi s.l. complex was detected in 8.6% of the foxes and B. miyamotoi in 5.12% of the samples. As a carnivore found in all ecosystems of Central Europe, foxes obviously contribute to transmission of tick-borne pathogens such as A. phagocytophilum, B. burgdorferi s.l., and B. myiamotoi. In addition, foxes apparently harbour a community of pathogens, associated with this host in local ecological context, dominated by H. canis and B. vulpes (possibly also Candidatus Neoehrlichia sp.). These species have the potential to spread to the domestic dog population and should be included in the differential diagnosis of febrile diseases with hematologic abnormalities in dogs.
Assuntos
Raposas , Carrapatos , Cães , Animais , Ecossistema , República Tcheca , Europa (Continente)RESUMO
BACKGROUND: Vector-borne pathogens (VBPs) are a major threat to humans, livestock and companion animals worldwide. The combined effect of climatic, socioeconomic and host composition changes favours the spread of the vectors, together with the expansion of invasive carnivores contributing to the spread of the pathogens. In Europe, the most widespread invasive species of carnivores are raccoons (Procyon lotor) and raccoon dogs (Nyctereutes procyonoides). This study focused on the detection of four major groups of VBPs namely Babesia, Hepatozoon, Anaplasma phagocytophilum and Bartonella in invasive and native carnivores in the Czech Republic, with the emphasis on the role of invasive carnivores in the eco-epidemiology of said VBPs. METHODS: Spleen samples of 84 carnivores of eight species (Canis aureus, Canis lupus, Lynx lynx, P. lotor, Martes foina, Lutra lutra, Mustela erminea and N. procyonoides) were screened by combined nested PCR and sequencing for the above-mentioned VBPs targeting 18S rRNA and cytB in hemoprotozoa, groEL in A. phagocytophilum, and using multilocus genotyping in Bartonella spp. The species determination is supported by phylogenetic analysis inferred by the maximum likelihood method. RESULTS: Out of 84 samples, 44% tested positive for at least one pathogen. Five different species of VBPs were detected in P. lotor, namely Bartonella canis, Hepatozoon canis, Hepatozoon martis, A. phagocytophilum and Bartonella sp. related to Bartonella washoensis. All C. lupus tested positive for H. canis and one for B. canis. Three VBPs (Hepatozoon silvestris, A. phagocytophilum and Bartonella taylorii) were detected in L. lynx for the first time. Babesia vulpes and yet undescribed species of Babesia, not previously detected in Europe, were found in N. procyonoides. CONCLUSIONS: Wild carnivores in the Czech Republic are hosts of several VBPs with potential veterinary and public health risks. Among the studied carnivore species, the invasive raccoon is the most competent host. Raccoons are the only species in our study where all the major groups of studied pathogens were detected. None of the detected pathogen species were previously detected in these carnivores in North America, suggesting that raccoons adapted to local VBPs rather than introduced new ones. Babesia vulpes and one new, probably imported species of Babesia, were found in raccoon dogs.
Assuntos
Babesia , Carnívoros , Lynx , Lontras , Animais , Humanos , Cães Guaxinins , Guaxinins , República Tcheca/epidemiologia , Filogenia , Babesia/genéticaRESUMO
Based on previously published data, the Czech Republic is regarded an endemic country of the onchocercid nematodes Dirofilaria immitis (Leidy, 1856) and Dirofilaria repens Railliet et Henry, 1911. Nevertheless, while cases of D. repens are commonly reported from dogs in South Moravia, no recent records of D. immitis are available. Therefore, the present study was performed to clarify the occurrence of both species of Dirofilaria Railliet et Henry, 1910. Blood samples of 551 dogs sampled during 2015 and 2016 were analysed microscopically for presence of microfilariae and blood sera were examined by IDEXX SNAP® 4Dx® test (IDEXX, USA). DNA from blood of microscopically positive dogs was extracted and PCR protocol amplifying fragment of cytochrome c oxidase I (COI) gene was performed; PCR products were then sequenced. All dogs from the Bohemian part of the Czech Republic were negative. The prevalence of D. repens in the Moravian region was 5.7 % (27/476). BLAST analyses of obtained sequences confirmed the presence of D. repens (99-100% identical to KX265049). All sampled animals showed a negative result for D. immitis antigen in IDEXX SNAP® 4Dx® test. Our study confirmed the previously reported occurrence of D. repens in South Moravia and revealed its spreading from the epicentre to the north and west. PCR with subsequent sequencing together with negative results for D. immitis antigen in IDEXX SNAP® 4Dx® test revealed only D. repens infection. A previously published autochthonous infection of dogs with D. immitis in South Moravia was not confirmed.
Assuntos
Dirofilaria immitis , Dirofilaria repens , Dirofilariose , Doenças do Cão , Animais , República Tcheca/epidemiologia , Dirofilaria immitis/genética , Dirofilaria repens/genética , Dirofilariose/epidemiologia , Doenças do Cão/epidemiologia , CãesRESUMO
BACKGROUND: To describe a set of patients hospitalized at the Clinic of Infectious Diseases of the University Hospital Brno with Clostridium difficile infection (CDI), to interpret clinical and epidemiological data, and to determine the risk factors for the disease and its complications. MATERIAL AND METHODS: A retrospective study of 284 patients with confirmed diagnosis of Clostridium difficile infection hospitalized between 1 January 2007 and 31 December 2010. Epidemiological, clinical and laboratory data were collected from their clinical documentation. RESULTS: Of the 284 patients with a mean age of 73.2 years, 38.0 % were men. Risk factors for developing CDI include the use of antibiotics in the previous 8 weeks (89.1 % of patients), age over 65 years (77.6 %), hospitalization in the previous 4 weeks (65.5 %), and the use of proton pump inhibitors (41.9 %). Recurrence was noted in 89 (31.3 %) cases. Sixty-six (23.2 %) patients required intensive care and 50 (14.6 %) patients died during their hospitalization. Isolates of C. difficile from the stool of 4 patients were sent for ribotyping and identified as ribotype 176. CONCLUSIONS: The CDI rates at the clinic KICH have increased in the recent years. The rise is consistent with the global trends. The study confirmed the disease risk factors reported in the literature. The disease is associated with a high percentage of relapses and complications.
Assuntos
Enterocolite Necrosante/terapia , Hospitalização , Adulto , Idoso , Idoso de 80 Anos ou mais , Antibacterianos/uso terapêutico , Clostridioides difficile , Enterocolite Necrosante/complicações , Enterocolite Necrosante/diagnóstico , Enterocolite Necrosante/microbiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Recidiva , Fatores de RiscoRESUMO
BACKGROUND: The aim was to prove the effectiveness and safety of faecal bacteriotherapy in the treatment of relapsing pseudomembranous colitis due to Clostridium difficile in clinical practice. METHODS: The protocol of faecal bacteriotherapy was adopted from foreign authors (Bakken JS, Aas J, MacConnachie AA). After six months, the success rate was not satisfying and the method was modified so that 40-50 g of stool were administered instead of 20-30 g. RESULTS: A total of 77.8 % of patients included in the study were successfully treated. The study achieved results comparable with foreign literature where the lowest success rate is about 80 %. Neither complications nor death were noticed (0 % mortality rate). CONCLUSIONS: Faecal bacteriotherapy is a safe and simple method capable of curing chronically relapsing forms of pseudomembranous colitis.
Assuntos
Enterocolite Pseudomembranosa/terapia , Fezes/microbiologia , Idoso , Idoso de 80 Anos ou mais , Clostridioides difficile , Enterocolite Pseudomembranosa/microbiologia , Feminino , Humanos , Intubação Gastrointestinal , Masculino , RecidivaRESUMO
PURPOSE: Restored role of the grey wolf in ecological networks of newly recolonized areas can be studied via surveys of parasite communities of this predator. As helminths circulating in multi-host systems, the tapeworms directly reflect wolves' diet, while some species are also important from the One Health perspective. The Czech experienced centuries of wolves' absence, however, now it is situated on the crossroad of recolonising wolves' populations, which is opening questions of their role in ecological networks in this area and thus in sylvatic cycles of heteroxenous parasites. METHODS: Five wolf carcasses from this area were obtained and genetic affinity to a particular population was inspected. Tapeworms isolated from wolves' intestines during necropsies were molecularly identified based on sequences of COI marker. RESULTS: Three wolf haplotypes (w1, w2, w14) correspond with the dominance of haplogroup 1 (w1, w2) within Central European lowland population and haplogroup 2 (w14) within the Carpathian population. Two Taenia spp. were revealed: T. krabbei in Central European population wolves and T. hydatigena in an individual from Carpathian population. CONCLUSIONS: The results serve as a base for future monitoring and studies of the recolonising wolf population and its impact on ecosystems in the studied area to contribute to the hypothesis about differentiation of parasite communities in particular wolf population and higher parasite diversity and richness in established populations in comparison to newly settled ones.
Assuntos
Helmintos , Taenia , Lobos , Animais , Ecossistema , Europa (Continente)RESUMO
Toxoplasma gondii may cause fatal infection in European brown hares (Lepus europaeus). However, the role of this parasite in terms of mortality rate in tularaemia endemic areas, amount of parasites in affected organs and circulating genotypes, is still unknown. In total, 36 hares (killed or found dead) were submitted for pathomorphological examination as a part of the national tularaemia and brucellosis monitoring. Tissue samples (lung, heart, liver, spleen and kidney) were tested by quantitative real-time PCR targeting 529 bp region of T. gondii. Genotyping was performed by a 15 microsatellite markers method in a single multiplex PCR assay. The same tissues of hares were simultaneously used for the bacteriological cultivation. Toxoplasma gondii was detected by qPCR in the tissues of two hares. Spleen and lungs of one infected hare have been found harbouring up to ~7 millions of T. gondii parasites per gram of tissue. Both positive samples were characterized as T. gondii type II, one archetypal clonal type II and the other one a type II variant (W35 = 244). Bacteria Francisella tularensis was proved in pooled samples of three hares but without coinfection with T. gondii; all hares were negative for Brucella suis. Toxoplasma gondii has significant impact on mortality of European brown hares in tularaemia endemic areas and parasite load within the animal tissues may present high risk of human infection.
Assuntos
Lebres , Toxoplasmose Animal , Tularemia , Animais , República Tcheca/epidemiologia , Humanos , Estudos Soroepidemiológicos , Toxoplasmose Animal/epidemiologia , Tularemia/epidemiologia , Tularemia/veterináriaRESUMO
Protists of the genus Cytauxzoon infect a wide variety of wild and domestic felids worldwide. While the American Cytauxzoon felis has been well described, data on the European isolates of Cytauxzoon are still scant. The aim of the current study was to determine the genetic diversity of European Cytauxzoon spp. in wild felids across Europe by analyzing one nuclear and two mitochondrial genes, along with representative complete mitochondrial genomes. Overall, 106 biological samples from wild felids (92 from Felis silvestris and 14 from Lynx lynx) from Germany, Romania, Czech Republic, and Luxembourg were collected and screened for the presence of Cytauxzoon spp. using nested PCR protocols, targeting the highly conserved 18S rDNA, mitochondrial cytochrome b (CytB) and cytochrome c oxidase subunit I (COI) genes. Furthermore, 18 previously confirmed wild felid biological samples from Europe, and comparative material from USA positive for C. felis, were included in the study. In 18S rDNA sequences analyses, Cytauxzoon spp. from felids formed two separate clades of New World and Old World isolates, with a low inner diversity of the European clade. In contrast to 18S rDNA, the phylogenetic analyses of CytB and COI genes affirmatively revealed three highly supported clades, resulting in three defined genotypes. Similar intra- and interspecific variability of CytB and COI genes was observed in the case of different Babesia spp. Considering geography, host species and analyses of three genes, we conclude that the three detected genotypes of Cytauxzoon in European wild felids represent three new species, which we herein describe.
Assuntos
Animais Selvagens/parasitologia , Felidae/parasitologia , Piroplasmida/isolamento & purificação , Infecções Protozoárias em Animais/parasitologia , Animais , DNA de Protozoário/genética , Europa (Continente) , Genoma Mitocondrial , Genoma de Protozoário , Filogenia , Piroplasmida/classificação , Piroplasmida/genética , Infecções Protozoárias em Animais/epidemiologia , RNA Ribossômico 18S/genética , Especificidade da EspécieRESUMO
OBJECTIVE: To determine the effect of Escherichia coli Nissle (Mutaflor, Ardeypharm GmbH, Herdecke, Germany) on the intestinal colonization, level of endotoxin and liver functions in patients with liver cirrhosis. METHODS: Thirty-nine patients with liver cirrhosis diagnosed by means of biopsy and clinical examinations were randomly allocated to treatment with E. coli Nissle or placebo for 42 days. Standard clinical examination, biochemical and hematological examinations, level of endotoxin and microbiological examination of the stool were performed before and after the treatment. RESULTS: In comparing the treatment of E. coli Nissle and placebo, significant improvement of the intestinal colonization (P<0.001) in the E. coli Nissle group was described. We found a trend of significant lowering of the endotoxemia (P=0.07) and improvement of liver functions evaluated by Child-Pugh score (P=0.06). CONCLUSION: E. coli Nissle seems to be effective in the restoration of normal colonic colonization and can probably lower endotoxemia in cirrhotic patients.
Assuntos
Endotoxemia/terapia , Escherichia coli , Cirrose Hepática/terapia , Probióticos/uso terapêutico , Adulto , Idoso , Colo/microbiologia , Método Duplo-Cego , Endotoxemia/complicações , Endotoxinas/sangue , Fezes/microbiologia , Feminino , Humanos , Fígado/fisiopatologia , Cirrose Hepática/complicações , Cirrose Hepática/microbiologia , Cirrose Hepática/fisiopatologia , Masculino , Pessoa de Meia-Idade , Índice de Gravidade de Doença , Resultado do TratamentoRESUMO
The authors present a case report of a patient with sepsis caused by Gram negative rod Capnocytophaga canimorsus resulting from a dog bite. The infection had a course of septic shock progressing into multiorgan failure and serious ischemic damage to the extremities. The etiologic agent was identified utilizing molecular genetic methods and its detailed microbiologic characteristics are provided below. The report also outlines diagnostic and therapeutic options of this otherwise most likely under-diagnosed infection.
Assuntos
Capnocytophaga , Infecções por Bactérias Gram-Negativas/diagnóstico , Sepse/microbiologia , Adulto , Animais , Mordeduras e Picadas/microbiologia , Cães , Infecções por Bactérias Gram-Negativas/terapia , Infecções por Bactérias Gram-Negativas/transmissão , Humanos , Masculino , Sepse/transmissãoRESUMO
BACKGROUND/AIMS: Acute bleeding from esophageal varices due to portal hypertension is a frequent and severe complication of liver cirrhosis. The development of esophageal varices as well as their rupture depends on the level of portal pressure; however, a number of other factors may play a negative role in the rise of bleeding and its prognosis. METHODOLOGY: The report presented has compared a set of 46 patients admitted to hospital for acute bleeding with 48 cirrhotics hospitalized for other reasons. RESULTS: Bleeding patients had significantly higher level of nitrogenous substances (urea 14.1 mmol/L vs. 7.78 mmol/L, p < 0.01, creatinine 129.8 micromol/L vs. 106.04 micromol/L; p = 0.09). The disturbed renal function in itself probably does not increase the risk of bleeding, it may be rather considered a certain prognostic index of the portal hypertension degree. Bleeding patients had a lower level of total protein (60.7 g/L vs. 69.9 g/L; p < 0.01) with only slight insignificant decrease of albumin (26.64 g/L vs. 28.51 g/L). Cirrhotic patients are known to suffer from malnutrition and it is possible that malnutrition shares negatively and directly in the rise of bleeding. CONCLUSIONS: A prognostic index of mortality was a more conspicuous disorder of hepatic function (bilirubin 97.4 micromol/L vs. 57.4 micromol/L; p = 0.1; prolonged prothrombin time 1.99 INR vs. 1.56 INR; p = 0.01) and again the disorder of renal function (creatinine 166.7 micromol/L vs. 114.9 micromol/L; p = 0.09). Therefore, the maintenance of good renal function must be a component of complex therapy given to bleeding patients.
Assuntos
Varizes Esofágicas e Gástricas/etiologia , Varizes Esofágicas e Gástricas/mortalidade , Hemorragia Gastrointestinal/etiologia , Hemorragia Gastrointestinal/mortalidade , Hipertensão Portal/etiologia , Nefropatias/complicações , Cirrose Hepática/complicações , Desnutrição/complicações , Adulto , Idoso , Idoso de 80 Anos ou mais , Bilirrubina/sangue , Varizes Esofágicas e Gástricas/sangue , Feminino , Hemorragia Gastrointestinal/sangue , Hematócrito , Humanos , Hipertensão Portal/sangue , Hipertensão Portal/mortalidade , Nefropatias/sangue , Cirrose Hepática/sangue , Cirrose Hepática/mortalidade , Masculino , Desnutrição/sangue , Pessoa de Meia-Idade , Tempo de Protrombina , Fatores de Risco , Análise de Sobrevida , Ureia/sangueRESUMO
BACKGROUND: Dirofilaria immitis and Dirofilaria repens are mosquito-transmitted zoonotic nematodes, causing heartworm disease and skin lesions, respectively, in carnivores. In Europe, the domestic dog is apparently the main definitive host, but patent infections occur also in other species of carnivores. The rapid spread of the golden jackals (Canis aureus) throughout Europe opens a question of involvement of this species in the sylvatic cycle of pathogens in the colonised territories, including Dirofilaria spp. METHODS: Between January 2014 and May 2015, 54 golden jackals from 18 localities in Romania were examined by full necropsy for the presence of adult filarioid nematodes and blood samples from all animals were screened for the presence of microfilariae of D. immitis, D. repens and Acanthocheilonema reconditum by multiplex PCR DNA amplification. RESULTS: Nematodes morphologically identified as D. immitis were found in 18.52% of the animals, originating from the southern part of Romania. No D. repens or A. reconditum were found at necropsy. The molecular prevalence in blood samples from the same animals was 9.26% for D. immitis and 1.85% for D. repens. All samples were negative by PCR for A. reconditum. CONCLUSION: The relatively high prevalence of Dirofilaria spp. infections in golden jackals from Romania together with the increasing density of the jackal populations highlight their potential role in the transmission of these zoonotic parasites and in the maintenance of natural disease foci.