Bacteriological Examination Research Articles

Involvement of healthcare staff in hospital hygiene during emergency hemodialysis.

Healthcare-associated infections are still a worrying health problem that complicates patient care and increases morbidity and mortality. The incidence of infections in hemodialysis patients is still high and they constitute the second cause of hospitalization and death in this category. The study's objective was to evaluate nursing and medical staff's involvement in hospital hygiene. This is an observational study that took place within the hemodialysis unit of a Moroccan university hospital from March 2021 to June 2021. A surface swabbing technique for bacteriological examination was also carried out. The study revealed some shortcomings regarding hand hygiene which was respected by the nurses in only 17.5% of sessions and in 42.2% by the doctors. Other shortcomings in asepsis measures, were also noted such as the non-change of gloves after skin preparation (1.03%) and before manual compression. The serological status of patients concerning HBV, HVC, and HIV was also not always known (31.1%). The bacteriological samples from the surfaces also showed colonization of the medical devices and the ultrasound scanner used for the ultrasound-guided introduction of the central catheters. The results of the study showed some deviations concerning the recommendations; however, they are comparable to other studies conducted internationally, especially in terms of hand hygiene. Our study results highlight some shortcomings adherence to hygiene measures like inconsistent disinfection of medical devices and dialysis stations, as well as insufficient hand hygiene practices among some staff members. However, we observed an improvement in practices following the implementation of awareness-raising sessions. To maintain improved hygiene practices and prevent infections, it is crucial to provide ongoing training for staff, ensure adequate resources, and regularly monitor compliance with hygiene standards.

Nucleotide sequence variants, gene expression and serum profile of immune and antioxidant markers associated with bacterial diarrhea susceptibility in Barki lambs

BackgroundDespite the fact that diarrhea is more accurately described as a clinical symptom than a disease. Diarrhea is one of the most important issues in ovine medicine, particularly in lambs, and because of high morbidity and mortality rate, sluggish growth performance, and veterinary costs, it is believed to be a major source of economic loss. Salmonella and enterotoxigenic Escherichia coli are the most common and commercially significant agents responsible for diarrhea.ObjectiveThe objective of this study was to monitor the nucleotide sequence variations, gene expression, serum inflammatory and oxidative stress biomarkers in diarrheic lambs. Another aim was to identify different pathotypes and virulence genes of Salmonella and E. coli causing diarrhea.MethodologyBlood samples were taken from 50 Barki who were diarrheal and 50 who appeared to be healthy, and then divided in 3 portions, with EDTA added to the first part for CBC, DNA and RNA extraction. The second sample received 5000 I.U. of heparin calcium, and a clean plain tube was used for the third component. The second and third sections were centrifuged to extract serum and plasma until the biochemical and immunological analysis was completed. Fecal samples were collected for bacteriological examination, and the bacteria were identified by PCR analysis. PCR-DNA sequencing was conducted for immune (SELL, JAK2, SLC11A1, IL10, FEZF1, NCF4, LITAF, SBD2, NFKB, TNF-α, IL1B, IL6, LGALS, and CATH1), antioxidant (SOD1, CAT, GPX1, GST, Nrf2, Keap1, HMOX1, and NQO1), and GIT health (CALB1, GT, and MUC2) genes in healthy and diarrheic lambs.ResultsVirulent genetic markers of pathogenic characteristics of E. coli (astA, Vt2e (Stx2e), CFA/I, groES and luxS) and Salmonella (invA, SopB, bcfC and avrA) were detected in all diarrheic lambs. PCR-DNA sequencing of immune, antioxidant and intestinal health genes found eleven single nucleotide polymorphisms (SNPs) linked to either diarrhea resistance or susceptibility in Barki lambs. Transcript levels of immune, antioxidant, and GIT health (CALB1, GT, and MUC2) genes varied between healthy and diarrheic lambs. Nucleotide sequence variation of the genes under inquiry between reference sequences in GenBank and those of the animals under investigation verified all identified SNPs. Significant (P = 0.001) erythrocytosis, neutrophilic leukocytosis, with lymphocytopenia were observed in diarrheic lambs. Significant (P = 0.001) increases in serum IL-1α, IL-1β, IL-6, TNF-α (90.5 ± 1.7, 101.8 ± 1.7, 72.3 ± 6.6, 71.26 ± 4.89 Pg/ml, respectively), serum Fb, Cp, Hp, SAA (230.7 ± 12.4 mg/dl, 6.5 ± 0.07 mg/dl, 2.5 ± 0.09 g/dl, 7.4 ± 0.4 mg/L, respectively), free radicals (MDA, NO), cortisol (6.91 ± 0.18 μg/dl) and growth hormone, with significant (P = 0.001) decreases in serum IL-10 (81.71 ± 1.05 Pg/ml), antioxidants (CAT, GPx), insulin, triiodothyronine (T3) and thyroxine (T4) in diarrheic lambs.ConclusionsThe study's findings provided credence to the theory that marker-assisted selection (MAS) could be used to predict and prevent diarrhea in Barki sheep by selecting lambs based on SNPs in genes linked to inflammation, antioxidants, and intestinal health. In order to establish an efficient management protocol and determine the most susceptible risk period for disease occurrence, gene expression profiles of the genes under investigation, pro-inflammatory cytokines and acute phase proteins may also be utilized as proxy biomarkers for lamb enteritis.

Encephalomyelitis and serositis caused by Chlamydia pecorum in buffalo calves from Brazil.

Chlamydia pecorum causes subclinical infections in cattle, but sporadic, bovine encephalomyelitis cases have been reported in calves and documented in two instances in European buffalo. An outbreak of Chlamydia pecorum-induced encephalomyelitis and serositis occurred in 3-month-old buffalo calves from Brazil. Initially presenting with pelvic limb incoordination, the calves progressed to lateral recumbency, depression, and death. Necropsies of two calves revealed encephalomyelomalacia, fibrin deposition on the external surface of the pericardium (case 1) and pleural and pericardial fibrosis (case 2). Microscopically, a multifocal to coalescing, necrotizing, neutrophilic and lymphocytic meningoencephalomyelitis with fibrinoid vasculitis and thrombosis was present. Anti-Chlamydia antibody labeling was demonstrated by immunohistochemistry. Bacteriological examination yielded no pathogenic bacteria in the brain or lungs. Chlamydia pecorum was confirmed by PCR. This work describes the gross, histopathological, microbiological, and molecular findings in two cases from an outbreak of Chlamydia pecorum-induced disease in buffalo calves.

Influence of dental status on postoperative complications in major visceral surgical and organ transplantation procedures—the bellydent retrospective observational study

PurposeThe significance of dental status and oral hygiene on a range of medical conditions is well-recognised. However, the correlation between periodontitis, oral bacterial dysbiosis and visceral surgical outcomes is less well established. To this end, we study sought to determine the influence of dental health and oral hygiene on the rates of postoperative complications following major visceral and transplant surgery in an exploratory, single-center, retrospective, non-interventional study.MethodsOur retrospective non-interventional study was conducted at the Department of General, Visceral, and Transplant Surgery, University Hospital Heidelberg, Germany. Patients operated on between January 2018 and December 2019 were retrospectively enrolled in the study based on inclusion (minimum age of 18 years, surgery at our Department, intensive care / IMC treatment after major surgery, availability of patient-specific preoperative dental status assessment, documentation of postoperative complications) and exclusion criteria (minor patients or legally incapacitated patients, lack of intensive care or intermediate care (IMC) monitoring, incomplete documentation of preoperative dental status, intestinal surgery with potential intraoperative contamination of the site by intestinal microbes, pre-existing preoperative infection, absence of data regarding the primary endpoints of the study). The primary study endpoint was the incidence of postoperative complications. Secondary study endpoints were: 30-day mortality, length of hospital stay, duration of intensive care stay, Incidence of infectious complications, the microbial spectrum of infectious complication. A bacteriology examination was added whenever possible (if and only if the examination was safe for the patient)for infectious complications.ResultsThe final patient cohort consisted of 417 patients. While dental status did not show an influence (p = 0.73) on postoperative complications, BMI (p = 0.035), age (p = 0.049) and quick (p = 0.033) were shown to be significant prognostic factors. There was significant association between oral health and the rate of infectious complications for all surgical procedures (p = 0.034), excluding transplant surgery. However, this did not result in increased 30-day mortality rates, prolonged intensive care unit treatment or an increase in the length of hospital stay (LOS) for the cohort as a whole. In contrast there was a significant correlation between the presence of oral pathogens and postoperative complications for a group as a whole (p < 0.001) and the visceral surgery subgroup (p < 0.001). Whilst this was not the case in the cohort who underwent transplant surgery, there was a correlation between oral health and LOS in this subgroup (p = 0.040). Bacterial swabs supports the link between poor oral health and infectious morbidity.ConclusionsDental status was a significant predictor of postoperative infectious complications in this visceral surgery cohort. This study highlights the importance preoperative dental assessment and treatment prior to major surgery, particularly in the case of elective surgical procedures. Further research is required to determine the effect of oral health on surgical outcomes in order to inform future practice.Trial registrationTrial registered under the ethics-number S-082/2022 (Ethic Committee of the University Heidelberg).

Comparative efficacy of new combined drugs against complicated otodectic mange in small domestic animals

The purpose of the research is to evaluate the comparative efficacy of two veterinary drugs («Inspector ear drops» and «Rolf Club 3D ear drops») to treat dogs and cats for otodectic mange complicated by otitis media of bacterial etiology.Materials and methods. A total of 36 animals participated in the studies. The studies were carried out at the VNIIP – FSC VIEV. The diagnosis was confirmed comprehensively from epidemiological data, clinical signs and laboratory tests. Microscopy of scrapings taken from the inner surface of the ears was performed to detect Otodectes cynotis. Bacteriological and mycological examination of ear canal discharge was conducted according to established procedures. Ear canal otoscopic examination was performed using a veterinary otoscope. For therapeutic purposes, the experimental animals were treated with «Inspector ear drops» and «Rolf Club 3D ear drops» as per instructions for use.Results and discussion. The initial comprehensive clinical examination diagnosed otodectic mange in all animals as complicated by acute otitis media of bacterial etiology. On treatment day 8, the animals showed a positive effect of the studied drugs; clinical signs of the disease reduced significantly. In a repeated clinical examination on day 11, most animals showed clinical recovery that was confirmed by negative bacteriological and mycological studies. Acarological studies showed no mites on days 8 and 14-15. However, the course of treatment was extended to 14 days for two dogs, after which their complete clinical recovery was observed. After the end of the study, the animals from the control group were treated with «Rolf Club 3D ear drops». Thus, an assessment of the results revealed that the drugs for veterinary use, «Inspector ear drops» and «Rolf Club 3D ear drops» showed an identical therapeutic effect in dogs and cats against otodectic mange complicated by acute bacterial otitis media.

Is it a potential pneumonia pathogen in Pseudomonas putida group? First isolation and identification of Pseudomonas plecoglossicida in clinic and a comparison of pathogenicity with Pseudomonasputida

PurposePseudomonas plecoglossicida belongs to the Pseudomonas putida group and is a common aquatic pathogen that induces visceral lesions in fish. However, it has never been previously isolated from human specimen and associated with human infections. In the study, we first investigated the pathogenicity of Pseudomonas plecoglossicida strain “SXY” isolated from a child with infectious pneumonia. MethodsUsing 16S rRNA sequencing, matrix-assisted laser desorption/ionization time-of-flight mass spectrometry analysis, and unique biochemical phenotypes, we isolated and identified Pseudomonas plecoglossicida in clinical practice, a highly suspicious pneumonia-related pathogen based on bacteriological examinations and clinical manifestations. Its pathogenicity was assessed and compared with that of Pseudomonas putida clinical strain “ECL” (a recognized pathogen in the Pseudomonas putida group) by a series of in vitro pathogenicity tests (including the growth capacity assay at 37 °C, the lung leukocyte-killing and inflammatory factor release assay, and the whole blood-killing, serum-killing and complement sensitivity assay). ResultsAll tests demonstrated its ability to cause colonization, infection, and inflammation in the lungs. However, the pathogenicity and risk of bloodstream infection of Pseudomonas plecoglossicida strain “SXY” were limited and weaker than those of Pseudomonas putida strain “ECL”. Notably, Pseudomonas plecoglossicida could be incorrectly identified as Pseudomonas putida, based on the biochemical identification of VITEK-2, potentially leading to a high rate of missing infections. ConclusionsPseudomonas plecoglossicida is a potential and neglected pneumonia pathogen.

Suppurative Cervicomediastinitis From the Perspective of the Head and Neck Surgeon in a Tertiary Treatment Unit.

Introduction Cervical suppurations represent an emergency pathology, with a dramatic evolution in the absence of adequate treatment. It frequently affects young people, hence the medico-legal implications of these cases. The anatomical substrate for the development of these deep cervical suppurations is represented by the cervical fascia and spaces. A distinct and extremely serious sub-chapter within diffuse cervical suppurations is necrotic cervical fasciitis, a polymicrobial infection with the most common oropharyngeal or odontogenic starting point, with rapidly progressive, destructive evolution in the deep fascial planes of the neck. Materials and method We will present a retrospective clinical study carried out on 26 cases diagnosed and treated between September 2013 and September 2018 in the ENT Clinic Department of the Bucharest University Emergency Hospital. Results Our retrospective analysis of a cohort of 26 patients in a tertiary referral center showed that deep cervical suppurations are slightly more common in men than in women. The most affected age groups were 50-59 years, followed by 20-29 years, representing a percentage of 53.84% of all cases. Also, 53.84% of the studied patients with deep cervical suppurations had a precarious and modest status. The most common clinical signs at presentation were malaise, cervical swelling, neck pain, dysphagia, fever, dysphonia, dyspnea, and cervical erythema. More than 60% of suppurations were odontogenic and 23% were caused by a traumatic element. Diabetes mellitus represents a comorbidity in 30.8% of patients, while 42.3% of patients had no personal pathological history, and thus this pathology has a lethal potential also in a patient in full health. In the study group, 46 (15%) had cervicomediastinitis, and 61.53% developed necrotizing fasciitis. One-third (34.61%) of our patients had undergone previous drainage surgery. Bacteriological examinations of the wound were with group C, D, G betahemolytic streptococcus, while 61.53% of the cultures were negative. Most patients required at least two cervicotomies. The average duration of hospitalization was 28.26 days, and the mortality rate was 23.07%; therefore, practically, one out of four cases resulted in death. In the studied group, no direct relationship can be established between the length of hospitalization and the favorable and unfavorable evolution of the patient. We propose a 10-step management protocol for the management of a cervical suppuration. Conclusion The multidisciplinary approach to these suppurations by the head and neck surgeon, the thoracic surgeon, the oromaxillofacial surgeon, anesthetist, imagist, specialist in infectious diseases, pathologist, psychologist, and so on, is the key to success in a patient who presents not only a suppuration in the throat but also a disease with systemic resonance and significant lethal potential.

Analysis of the Synergistic Effect of Antibiotics with Copper Oxide Nanoparticles Against Pseudomonas aeruginosa Isolated from Different Clinical Cases

Synergism between antibiotics and nanoparticles is one of the most important ways to combat antibiotic resistance. Copper nanoparticles were produced using a green, environmentally friendly method of mixing aqueous Ficus Sycomorus leaf extract with copper sulfate. The work aimed to study the synergistic effect of six antibiotics with copper oxide nanoparticles prepared in a green approach against bacteria Pseudomonas aeruginosa isolated from patient. A total of 110 specimens were collected from patients with burn, wound and urine infections. in Samarra General Hospital, Tikrit Teaching Hospital, Tikrit Military Hospital, and Baghdad Medical City of both genders from July to September 2023. A bacteriological examination was conducted to select bacterial pathogens, with a particular focus on Pseudomonas aeruginosa. From a total 110 cases, 50 (45.5%) gave positive cultures for Pseudomonas aeruginosa. CuO-NPs was characterized using different analytical techniques, Scanning Electron Microscope (SEM). showed that the CuO-NPs have a spherical shape, its average size is 29.2 nm. Energy-dispersive X-ray )EDX( results confirmed the presence of copper and oxygen in the composition. The synergistic effect of six antibiotics with CuO-NPs was studied. By evaluating the minimum inhibitory concentration of P. aeruginosa. The results show the highest inhibition against bacterial isolates was due to the synergistic effect of CuO-NPs with Impenem, Ciprofloxacin, Ceftazidime, Polymyxin B, Amikacin, and Cefepime respectively, especially on isolate (15) with zones of inhibition/mm were 19.33 ±0.33, 18.33 ±0.33, 16.33 ±0.33, 15.33 ±0.33, 14.67 ±0.33, and 12.7±0.58, respectively. The results indicated that the synergistic effect gave clear zones of inhibition against all isolates compared with the inhibition effect of nano-copper oxide and antibiotics.

Epidemiological and Bacteriological Profile of Urinary Tract Infections Diagnosed at The Bacteriology Laboratory of the Centre Hospitalier Universitaire De Fann, Dakar from January 1er to December 31 2020

Introduction Urinary tract infections are extremely frequent and caused by bacteria whose treatment is based on the administration of antibiotics. The emergence and spread of acquired resistance mechanisms are limiting the indications for a number of antibiotics. It is in this context that this work is set, the main objective of which is to study the epidemiological and bacteriological profile of urinary tract infections at the CHNU de Fann, Dakar. Methodology: This is a retrospective study covering a one-year period from January 1er to December 31 2020. All patients received at the laboratory for an ECBU request were included. Data collection was based on information sheets and bench registers. The following information was collected : age, sex, germ isolated, antibiotic susceptibility profile. These data were processed using R. Studio software version 3.6.3, 2019. Results : We received 3697 requests for bacteriological examination of urine. The mean age of patients in our series was 48.7 years, with extremes of 15 days and 113 years. The 60 to 80 age group was the most affected. Women were more affected, with a rate of 51.03%, compared with 48.97% for men. A total of 3,697 urine samples were received during the study period, of which 776 were positive after analysis, representing a rate of 21%. 845 bacteria, with enterobacteria predominating (73.14%), followed by Gram-negative non-fermentative bacilli (13.37%) and Gram-positive cocci (13.27%). Escherichia coli was the most prevalent species, with a frequency of 36.09%, followed by Klebsiella pneumoniae (17.99%), Pseudomonas aeruginosa (8.16%), Staphylococcus aureus (6.63%), Enterobacter spp (6.50%), Citrobacter spp (4.02%), Acinetobacter spp (3.73%), Streptococcus spp (3.67%).Enterobacter spp (52.72%), Escherichia coli (47.53%) and Klebsiella pneumoniae (49.34%) showed a high prevalence of ESBL. Staphylococci showed a high rate of resistance to methicillin (55.71%).

The epizootic situation of bovine paratuberculosis in Ukraine for the period 2019–2023

Paratuberculosis (Johne’s disease) is a contagious infectious disease, the etiological agent of which affects various species of mammals, mainly ruminants. The causative agent is the acid-resistant bacterium Mycobacterium avium subsp. paratuberculosis (MAP), which belongs to the family Mycobacteriaceae. The most sensitive to it are domestic ruminants (cattle, sheep, goats etc.), which are the main reservoirs of infection for the various species of animals and humans (the zoonotic potential of the pathogen requires further study). In Ukraine, the main methods for diagnosing paratuberculosis are serological and bacteriological techniques. The authors analyzed the epizootic situation of paratuberculosis among cattle in Ukraine during 2019–2023 by systematizing the data of their own research and official reports of state veterinary laboratories in regions. The results of the investigation are presented without taking into account the temporarily occupied territories of Luhansk and Donetsk oblasts and the Autonomous Republic of Crimea, as well as part of the territory where military operations were conducted. In total, over the five-year period, 41 679 samples were examined serologically in the complement fixation test and 13 405 – bacteriologically, by microscopy and cultivation of biological materials on the nutrient media. During the investigation, specific antibodies to the pathogen were detected in 36 samples (prevalence, about 0.1%; BCI, 0.06–0.12%) from the ten regions. The analysis of the serological studies shows that the disease is sporadic and has a significant downward trend in the number of positive cases (17 positive samples were detected in 2019 and 2020, and only two in 2023). As for bacteriological examination, no positive cases have been registered during the 5-year period. In addition to the scrupulous work of the veterinary medicine service, both the persistent decrease in the cattle population and the ongoing hostilities in Ukraine have a considerable impact on improving the epizootic situation., as the number of serological tests conducted after 2022 has almost halved (especially in the eastern and southern regions), and bacteriological tests have decreased fivefold. The visualization of the data shows that antibodies were mostly detected in animals from the central, eastern, northern, and northwestern regions of the country.

Sensory and Nutritional Evaluation of Fermented and Unfermented Beetroot-ginger- garlic Beverages

The study was carried out to produce beetroot-ginger-garlic drink. The drink was produced with the mixture of beetroot, ginger and garlic at the ratio of 4:2:1 respectively. Two different drinks were produced, one was fermented for 24 hrs while the other unfermented, was soaked in water for 2hrs. The fermented and unfermented drinks were divided into two and poured into four separate 75 cl containers. Sugar (4 g) was added into one fermented and one of unfermented 75 cl containers while no sugar was added to the others. Bacteriological examination, proximate analysis, and micronutrient content were determined. Sensory evaluation was carried out using hedonic rating test. The results obtained were analyzed statistically using degree of freedom. Isolated organisms from the drinks was Lactobacillus sp. which was only isolated from fermented beet root ginger- garlic beverage. Proximate analysis showed very minimal variations in moisture, ash, fiber, protein, fat, and carbohydrate content between fermented and unfermented drinks. Micronutrient content showed significant differences in selenium, calcium, zinc, copper, iron, magnesium, sodium, lead, cadmium, and potassium. Sensory evaluation showed significant differences in taste, mouth feel, flavor, and overall acceptability. The sensory showed that fermented beetroot-ginger-garlic drink with sweetener have highest overall acceptability (5.67±0.58) followed by fermented beetroot-ginger-garlic beverage without sweetener (5.33±0.58) and unfermented beetroot-ginger-garlic beverage without sweetener (2.33±0.58) have the least overall acceptability. Fermented and unfermented beetroot-ginger- garlic drinks have potential nutritional benefits and acceptable sensory properties. This study provides insights into the production and evaluation of functional beverages from beetroot-ginger-garlic and the beverage is better fermented before drinking.

Histopathological and Molecular Identification and Characterization of Pneumonic Pasteurellosis in Sheep and Goats from Outbreaks at AS-Sharika Province, Egypt

Pneumonic Pasteurellosis highly fatal septicemic disease in multi-animal species in bovine, ovine, Poultry and swine. The strain identified from ovine pneumonia were characterized by MLST (Multi-host and RIRDC databases) and virulence-associated gene (VAG) typing and compared with bovine isolates. Recording outbreak of pasteurellosis with high mortality &amp; History of several deaths in different farm and homeowner cases of sheep and goats with severe respiratory illness after shipping them from long distance Elarish and Sinai in period to El-Sharqia province. Most cases that still live are treated with antibiotics after make sensitivity test on sampling from sick cases and most cases recovered and responded to treatments. Histopathological changes of lung tissue from recently dead cases showed the proliferation of pasterulla multicide in the respiratory system. The presence of Pasteurella multocida in swap samples collected from per acute &amp; acute cases of sheep &amp; goats was detected by bacteriological examination and culture.

Erythrasmoid pityriasis versicolor: three case reports and review of the literature

Pityriasis versicolor is characterized clinically by slightly scaly, hyper- or hypopigmented macules usually located on the chest, shoulders, back and arms. Rare cases of atypical locations of pityriasis versicolor have been described, such as groins, penis and perineum. We present three cases of pityriasis versicolor located exclusively on the submammary folds, pubis and inguinal folds (the latter in an 11-year-old girl), respectively. In consideration of both location and clinical presentation of pityriasis versicolor in these three patients, we think that the diagnosis of “erythrasmoid” pityriasis versicolor is acceptable. Differential diagnosis with erythrasma must be taken into consideration. Mycological and bacteriological examinations are therefore necessary in order to make a correct diagnosis and specific therapy.

Brucella spp. in Wildlife of the Lombardy Region, Northern Italy.

Surveillance data collected in the period 2017-20 for Brucella spp. in wildlife of the Lombardy Region in northern Italy were used to describe the exposure of the wildlife species to Brucella spp. in wild boar (Sus scrofa), European brown hare (Lepus europaeus), fallow deer (Dama dama), red deer (Cervus elaphus), and roe deer (Capreolus capreolus). Among the tested species, wild boar (n=6,440) showed the highest percentage of seropositive samples (5.9%). Notably, wild boars of perifluvial area of the Po River showed higher percentages of positivity than those of the pre-Alpine district. In addition, during the hunting season in 2018, 95 organs (uterus or testes, spleen, and submandibular lymph nodes) from wild boar of the perifluvial area of the Po River were collected for bacteriological examination. Brucella suis was isolated in culture from 18.9% of tested lymph nodes. These serological and microbiological results highlight the presence of B. suis in wild boar and suggest the importance of wild boar as a reservoir for B. suis. Comparison of the spatial distribution of Brucella-seropositive wild boars with the location of backyard swine farms revealed a higher chance of contact between the two populations only in the areas where the lower percentage of seropositive samples was observed. Conversely, the high percentage of seropositive samples observed in the Po River area coupled with positive microbiological cultures suggest a greater risk of infection for the humans directly or indirectly involved in wild boar hunting activity. These results may serve as a basis to establish sound wildlife management and to adopt education campaigns aimed at reducing the risk of human infection in people involved in wild boar hunting related activities.

Rare Presentation, Critical Diagnosis: Primary Actinomycosis of the Foot

Actinomycosis, an uncommon granulomatous infection caused by the Actinomyces species, rarely targets as primary involvement the limb and is often linked to traumatic incidents. In this report, we present the case of a 44-year-old female who developed multiple small nodules on her left foot over approximately 12 months. Some nodules exhibited firmness and a violet hue, while others discharged a yellowish fluid. The patient had no significant comorbidities. Despite thorough blood paraclinical assessments, including complete blood count, serological HIV testing, and QuantiFERON-TB Gold testing, no abnormalities were detected. Bacteriological examinations and cultures of the discharge yielded negative results. Dermatoscopic examination revealed ovoid yellowish structures, with confocal microscopy highlighting granulomas. A subsequent skin biopsy confirmed characteristic changes indicative of actinomycosis. Although systemic antibiotic therapy with penicillin derivatives was initially considered, the patient’s documented allergic history to this medication class, verified through allergological testing, prompted the initiation of doxycycline treatment. Notably, significant improvement was observed at the 3-month follow-up. This case underscores the importance of reporting rare instances of actinomycosis due to its diagnostic complexity and management challenges.

Conversion hip arthroplasty in the treatment of adverse effects of proximal femoral fractures

INTRODUCTION. Currently, there are no uniform algorithms for surgical tactics of conversion hip arthroplasty.The OBJECTIVE was to evaluate the mid-term results of conversion hip arthroplasty in patients with adverse effects of proximal femoral fractures.METHODS AND MATERIALS. A retrospective study of the treatment results of 58 patients who underwent conversion hip arthroplasty was conducted. All patients underwent bacteriological examination before and during surgery, blood tests for ESR and CRP. Patients were divided into two groups: Group 1 (low risk of infections) – 29 patients in one stage, group 2 (high risk of infections) – 29 patients with a two-stage technique using a cement spacer. Randomization criteria: positive preoperative culture, elevated CRP (&gt;10 mg/L) and ESR (&gt;30 mm/hour). Efficacy was assessed using the visual analogue pain scale and Oxford Hip Score after 6, 12 and 24 months, as well as the frequency and nature of complications.RESULTS. The average age of patients was 58.7 years. The average follow-up period was 4.5±1.3 years. The average surgery time – 115 minutes in group 1 and 100 minutes in group 2. The average blood loss was 650±123 ml in group 1 and 630±108 ml in group 2. Pain syndrome according to the VAS scale after 6, 12 and 24 months was 2.5–1.2–1.2 points in both groups, respectively (p=0.001). Periprosthetic hip fracture occurred in 7 cases (12 %); dislocation – in 1 case (1.7 %); deep infection – 3 patients (5.1 %); aseptic loosening – in 2 cases (3.4 %). Revision arthroplasty was required in 5 cases (8.6 %).CONCLUSION. The mid-term results of conversion arthroplasty are significantly lower compared to the results of primary arthroplasty. Conversion is associated with a higher number of intraoperative hip fractures and infections. The use of a two-stage conversion technique with temporary installation of a cemented spacer allows to reduce the number of infectious complications after the final arthroplasty by 3 times.

Epidemiology and Antibiotic Resistance of Combat Wound Infection in Surgical Patients

The aim. To analyze the microbiological spectrum of pathogens causing surgical site infections and their antibiotic resistance in surgical patients injured during the military conflict between Ukraine and Russia. Materials and methods. This study was based on 137 bacteriological examinations of biological samples from patients treated in the surgical department of the Kyiv City Oleksandrivska Clinical Hospital in 2022. The samples included 81cultures isolated from postoperative wounds and 56 cultures from the abdominal cavity. Susceptibility to antibacter drugs was determined according to the European Committee on Antimicrobial Susceptibility Testing (EUCAST) standards. Statistical analysis was performed using IBM SPSS Statistics. Results. Among the 137 analyzed samples, the most common pathogens were Klebsiella pneumoniae (22.6%), Enterococcus faecalis (13.1%), Staphylococcus epidermidis (13.1%), Pseudomonas aeruginosa (11.6%), and Escherichia coli (10.2%). In the abdominal cavity samples (n = 56), E. coli was predominant (17.9%), followed by K. pneumoniae (16.1%), E. faecalis (16.1%), S. epidermidis (10.7%), Candida (8.9%), and P. aeruginosa (7.1%). In postoperative wound samples (n = 81), K. pneumoniae was found in 27.2%, P. aeruginosa in 14.8%, S. epidermidis in 14.8%, S. aureus in 12.3%, and E. faecalis in 11.1%. K. pneumoniae showed high resistance to amikacin (86.6%), meropenem (74.2%), piperacillin-tazobactam (82.8%), and ceftriaxone (86.2%). E. faecalis exhibited resistance to imipenem (58.8%), levofloxacin (47.1%), and vancomycin (12.5%). S. epidermidis had resistance to gentamicin (13.3%), meropenem (50%), and oxacillin (35.7%). P. aeruginosa demonstrated resistance to ciprofloxacin (45.6%), meropenem (67.4%), ceftazidime (52.3%), and piperacillin-tazobactam (48.7%). Conclusion. The primary pathogens causing surgical site infections in military surgical patients are K. pneumoniae, E. faecalis, S. epidermidis, P. aeruginosa, and E. coli. The pathogen spectrum varies between abdominal cavity infections and postoperative wound infections. There is a clear trend towards increased detection of antibiotic-resistant pathogens, particularly among military personnel. Colonization with resistant microorganisms increases during medical evacuation through different levels of the evacuation chain.

A clinical case of non-tuberculosis mycobacterial infection of the lungs and larynx

ABSTRACT. An actual clinical case of the diagnosis and course features of non-tuberculosis mycobacterial infection (NTMI) of the lungs and larynx in a patient treated at the Zaporizhzhia Regional Phthisiopulmonology Clinical Treatment and Diagnostic Center is presented. The clinical case demonstrates the difficulty of differential diagnosis of NTMI of the lung caused by scotochromogenic mycobacterium and tuberculosis, since the clinical and radiological manifestations for both diseases are identical, and there are no pathognomonic symptoms of NTMI. NTM affect the respiratory system and mimic the symptoms of tuberculosis, which significantly complicates not only timely differential diagnosis, but also leads to “treatment failure” of tuberculosis, which the patient did not have. After a month of antimycobacterial treatment an ulcerative lesion of the right vocal fold was diagnosed in the patient. Detection of the culture of NTM 1.5 months after its inoculation was the only one method of diagnosis in this case, the diagnosis NTMI of both the lungs and the larynx was made considering those results. The patient did not receive appropriate treatment before receiving the results of the bacteriological examination, which led to the development of negative clinical and radiological dynamics. But, despite the late diagnosis of NTMI, after 6 months of appropriate treatment the patient had a positive clinical and X-ray dynamics with healing of the ulcerative lesion of the right vocal fold. Thus, the presented case shows that despite the late diagnosis of NTMI of the lungs, which was complicated by NTMI of the larynx during antimycobacterial therapy, in the absence of severe concomitant lung diseases in the patient, after 6 months of appropriate treatment of NTMI, it was possible to achieve positive clinical and radiological dynamics with complete healing of the ulcerative lesion of the right vocal fold.

Occurrence of carbapenem-resistant hypervirulent Klebsiella pneumoniae in oysters in Egypt: a significant public health issue

BackgroundThe global dissemination of critical-priority carbapenem-resistant hypervirulent Klebsiella pneumoniae (CR-hvKp) via food sources represents a significant public health concern. Epidemiological data on CR-hvKp in oysters in Egypt is limited. This study aimed to investigate the potential role of oysters sold in Egypt as a source for carbapenem-resistant K. pneumoniae (CRKP), hypervirulent K. pneumoniae (hvKp), and CR-hvKp and assess associated zoonotic risks.MethodsA sample of 330 fresh oysters was randomly purchased from various retail fish markets in Egypt and divided into 33 pools. Bacteriological examination and the identification of Klebsiella pneumoniae were performed. Carbapenem resistance in K. pneumoniae isolates was determined by phenotypic and molecular methods. Additionally, the presence of hypervirulent K. pneumoniae was identified based on virulence gene markers (peg-344, rmpA, rmpA2, iucA, and iroB), followed by a string test. The clustering of CR-hvKp strains was carried out using R with the pheatmap package.ResultsThe overall prevalence of K. pneumoniae was 48.5% (16 out of 33), with 13 isolates displaying carbapenem resistance, one intermediate resistance, and two sensitive. Both carbapenem-resistant K. pneumoniae and carbapenem-intermediate-resistant K. pneumoniae strains exhibited carbapenemase production, predominantly linked to the blaVIM gene (68.8%). HvKp strains were identified at a rate of 62.5% (10/16); notably, peg-344 was the most prevalent gene. Significantly, 10 of the 13 CRKP isolates possessed hypervirulence genes, contributing to the emergence of CR-hvKp. Moreover, cluster analysis revealed the clustering of two CR-hvKp isolates from the same retail fish market.ConclusionThis study provides the first insight into the emergence of CR-hvKp among oysters in Egypt. It underscores the potential role of oysters as a source for disseminating CR-hvKp within aquatic ecosystems, presenting a possible threat to public health.

Necrotizing Soft Tissue Infection Management: a Clinical Case Study

Necrotizing soft tissue infection is a rare (0.4 cases per 100,000 population) but very severe pathology with a mortality rate up to 10%. The paper presents a clinical case of successful management of necrotizing soft tissue infection of the right arm, lateral wall of the chest and abdomen. The dynamics of the wound process was controlled by clinical, bacteriological, X-ray and ultrasound examinations. The cause of necrotizing soft tissue infection in this patient was the associated anaerobic nonclostridial and aerobic flora. Numerous surgical interventions were used to manage the patient; they were aimed at the excision of the necrotic tissue at the start of treatment, plastic surgery of postoperative wounds with local tissues was used at the end of treatment. The progression of the necrotic process was stopped after the third intervention. In addition to surgical treatment, the patient received antibacterial, detoxification, and immunostimulating therapy. Despite numerous staged surgeries with the excision of the necrotic skin, subcutaneous fat and fascia, it was possible to completely restore the patient’s ability to work.