Bacteriological Samples Research Articles

Mycotic Necrotizing Fasciitis of the Face: A Case Report and Review of Literature

Necrotizing fasciitis is a rare but potentially serious and fatal infection. It is a dermo-hypodermitis with necrosis of the superficial fascia, typically caused by Streptococcus pyogenes. However, rare cases of fungal necrotizing fasciitis have been reported. We report the case of a 65-year-old type II diabetic patient who developed necrotizing cellulitis of the right hemiface with homolateral orbito-palpebral extension. The initial management was based on drainage of purulent collections with resection of necrotic tissues associated with parenteral antibiotherapy without clinical improvement. Bacteriological sampling revealed the presence of yeast. The mycological examination was positive for Candida albicans resistant to fluconazole. Antifungal treatment with intravenous amphotericin B was initiated with good clinical progression and complete remission after 1 month. The aim of this paper is to highlight the importance of promptly considering this diagnosis and extending the initial assessment of necrotic skin lesions to include mycological examination to detect severe forms of cutaneous candidiasis.

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.

Pyometra alters uterine aquaporins related with lipopolysaccharide concentrations and antioxidant enzyme activities in bitches

Pyometra is a common life-threatening inflammatory disease with a complex etiopathogenesis that develops during the diestrus stage and can be observed in elderly intact bitches. The present study evaluated five aquaporin (AQP1, AQP2, AQP3, AQP5, and AQP9) transcript abundances and immunolocalization in the uterine tissue, and investigated their relationship with uterine tissue and blood lipopolysaccharide (LPS) concentration, superoxide dismutase (SOD) and glutathione peroxidase (GPX) activity, and nitric oxide (NO) production in dogs suffering from pyometra. The study sampled 36 client-owned intact bitches from different breeds, of which 24 cases were diagnosed with pyometra. Twelve of these bitches in the diestrus stage that presented for elective ovariohysterectomy were used as the control group. Blood samples were collected into tubes without anticoagulant for serum progesterone, LPS concentration, and antioxidant activities at the time of diagnosis. Bacteriological and tissue samples from the uteri were collected after the ovariohysterectomy. The tissue samples were used to determine antioxidant activity, and hormone and toxin concentrations. Transcript abundance of uterine AQPs were determined by qPCR, and their presence and localization were determined by by immunohistochemistry. For all pyometra samples, the bacteria isolated from the uterine swabs were Escherichia coli. Compared to the control group, AQP1, AQP2, and AQP5 were downregulated more than 2-fold, whereas AQP9 was upregulated nearly 3-fold and AQP3 was upregulated more than 4-fold in the pyometra affected uteri (P<0.05). Uterine AQP1 was moderately negatively correlated with serum LPS concentration (r=-0.568, P<0.01) and tissue NO production (r=-0.407, P<0.05). AQP5 was positively correlated with serum SOD activity (r=0.485, P<0.05) and negatively correlated with serum LPS concentration (r=-0.512, P<0.05). AQP9 was negatively correlated with tissue SOD and serum GPx activity. This is the first study to identify AQP9 transcript abundance and immunolocalization in canine uterine tissue. Uterine AQP1, AQP2, AQP3, AQP5, and AQP9 transcript abundances were altered in spontaneously developed canine pyometra while AQP transcript abundance was negatively related to serum toxin concentration, NO production, and antioxidant enzyme activity. Further studies should be conducted to determine the role of altered abundances of AQPs transcripts in pyometra pathogenesis.

Efficacy of Glycyrrhizin as an Intracanal Medicament on Bacterial Load Reduction in Primary Infected Root Canals: A Randomized Clinical Trial.

This study was done to clinically investigate the efficacy of glycyrrhizin-based intracanal medication (ICM) compared to calcium hydroxide Ca(OH)2 and Ledermix on the bacterial counts inside the root canals of necrotic teeth with chronic periapical periodontitis. Thirty-six patients having single-rooted and single-canaled necrotic teeth with chronic periapical periodontitis were enrolled in this research. Aseptic control measures were taken before clinical steps. Access cavity preparation was done. First bacteriological samples (S1) were collected immediately after access cavity preparation and before cleaning and shaping inside the root canals. Cleaning and shaping were performed on the root canals. Patients were randomly allocated into 3 groups according to the type of intracanal medicament used [Ca(OH)2, Ledermix, Glycyrrhizin]. Second bacteriological samples (S2) were collected after 1 week from placing the ICMs. S1 and S2 were transferred to the lab of microbiology for culturing on blood agar dishes in anaerobic conditions, and the bacteria on the plates were enumerated as colony-forming units (CFUs) by the manual counting method. The anti-bacterial efficacy of the ICM was estimated by the percentage reduction in the bacterial colonies from S1 to S2. All tested ICM documented a significant reduction in the CFUs from S1 to S2 (p < 0.05). Regarding S1, there was no significant difference between the three tested materials (p > 0.05). Regarding S2, Glycyrrhizin and Ledermix showed significantly lower CFUs than Ca(OH)2. There was no significant difference between Glycyrrhizin and Ledermix. Under the conditions of the present study, Glycyrrhizin and Ledermix showed comparable antimicrobial effects that were better than the commonly used Ca(OH)2 ICM. Glycyrrhizin may be a promising ICM. Herbal medicine can be considered as an alternative antimicrobial material for root canal disinfection because it has many benefits, like low toxicity, absence of microbial resistance, and favorable antimicrobial efficacy. This study highlights the clinical efficacy of Glycyrrhizin as a promising ICM. How to cite this article: Eltantawi AR, Abdel-Razik GM, Elhawary YM, et al. Efficacy of Glycyrrhizin as an Intracanal Medicament on Bacterial Load Reduction in Primary Infected Root Canals: A Randomized Clinical Trial. J Contemp Dent Pract 2024;25(6):540-546.

Effectiveness of supplementary antimicrobial procedures in disinfecting lateral canals as evaluated by a novel ex vivo analytical approach

This ex vivo study devised an analytical ex vivo method for infection/disinfection of simulated lateral canals located in the middle and apical segments of the root. The antibacterial effects of supplementary approaches were tested in this model. Extracted mandibular premolars had their main root canals enlarged and then two lateral canals (100 μm in diameter) were created in the root, one in the apical and the other in the middle portion. Micro-computed tomography was used for specimen selection and to confirm the quality of the simulated ramifications. The specimens were contaminated with a mixed bacterial culture from subgingival bacterial biofilm added to pure Enterococcus faecalis strain ATCC 29212 grown overnight, using special strategies to facilitate culture medium penetration within the lateral canals. The following procedures were tested for disinfection: NaOCl/passive ultrasonic irrigation (PUI), NaOCl/XP-endo Finisher, ozonated water/continuous ultrasonic irrigation (CUI), and NaOCl/conventional irrigation with 30-G needles (control). Bacteriological samples were taken from the main canal before (S1) and after (S2) each supplementary protocol, and also from each lateral canal after treatment (S3). DNA extracted from the samples was subjected to quantitative real-time polymerase chain reaction. All S1 main canal samples were positive for bacterial presence. Bacterial counts in the main root canal substantially decreased by 99.2% after PUI, 99.1% after ozone/CUI, 99% after XP-endo Finisher, and 96% in the control group (P < 0.01 for all groups). There were no significant differences between groups (P > 0.05). The same was observed when comparing the effects of the supplementary approaches in the apical and middle lateral canals (P > 0.05). Only a few lateral canals showed no detectable bacteria. The method proposed here proved effective for ex vivo infection/disinfection studies. All supplementary approaches induced a substantial bacterial reduction in the main canal, with no significant differences between them. However, in terms of lateral canal disinfection, none of the tested approaches showed significant effects when compared to the control group.

Treatment of infected humeral shaft nonunion and presumed aseptic nonunion with positive intraoperative cultures: a retrospective single-center study.

The management of infected humeral shaft nonunion (HSN) remains challenging due to the lack of consensus and the potential for occult infection. The aim of this study was to evaluate a surgical strategy based on a two-stage treatment for suspected infection or a one-stage treatment for infection diagnosed retrospectively based on systematic bacteriological sampling. We retrospectively reviewed 16 patients with a median age of 36 years who were treated for septic HSN: 9 patients underwent a two-stage procedure using the induced membrane technique, and 7 patients were treated in a single stage. Revision parameters included achieving bone union, its time frame, and a functional assessment based on joint motion and the Quick-DASH score. At a median follow-up of 47.5 months, 12 out of 16 patients were cured with acquired bone union and no septic recurrence. The median time to bone union was 5.5 months. Smoking and previous surgeries were adverse factors for bone healing. Radiological and functional outcomes were comparable between patients treated in a single stage and those treated in two stages. This study confirms the relevance of one-stage surgery for HSN with occult infection and the value of systematic bacteriological sampling during the revision of humeral diaphyseal osteosynthesis.

Effects of the Irrigation Needle Design on Root Canal Disinfection and Cleaning

IntroductionThis ex vivo study evaluated the disinfecting and cleaning effects of root canal preparation using sodium hypochlorite irrigation with 3 different needle designs. MethodsMesial roots from extracted mandibular molars with Vertucci class II configuration were anatomically matched based on micro-computed tomography (micro-CT) analyses and distributed into 3 groups (n = 18/group). The canals were contaminated with a mixed bacterial culture for 30 days and then subjected to preparation using 2.5% sodium hypochlorite irrigation with open-ended flat needle (3 mm short of the working length - WL), closed-ended side-vented irrigation needle (1 mm short of the WL), or a closed-ended plastic needle with 2 lateral outlets (TruNatomy) (1 mm short of the WL). Bacteriological samples were taken from the canals before (S1) and after preparation (S2). After another micro-CT scan, the roots were sectioned and samples were also taken from the apical canal segment (S3). Bacterial reduction was assessed by quantitative real-time polymerase chain reaction. The amount of accumulated hard tissue debris was evaluated by micro-CT. ResultsA substantial reduction in bacterial counts was observed in all 3 groups when comparing S1 with S2 (99.95%, 98.93%, and 98.90% in the open-ended, closed-ended, and TruNatomy needle groups, respectively) (P < .01). No significant differences were observed between groups for bacterial reduction in the full and apical canal (P > .05). There were no intergroup differences in the amount of accumulated hard tissue debris either (P > .05). The open-ended needle group showed significantly more specimens with quantitative real-time polymerase chain reaction negative results for bacteria in S3 than TruNatomy (P < .05). ConclusionWhen used up to an appropriate insertion depth, the 3 needle types result in similar antibacterial and cleaning performance, provided variables such as needle size and irrigant type, volume and flow rate are controlled. Exclusive analysis of the apical segment, including the isthmus, revealed that the open-ended needle yielded more cases negative for bacteria.

Is SWEEPS better than PUI in reducing intracanal bacteria and inflammation in cases of apical periodontitis?

To evaluate the efficacy of SWEEPS mode of the Er: YAG laser(SL) and passive ultrasonic irrigation(PUI) in the eradication of microorganisms and in the inflammation detection by IL-1β. Thirty patients with chronic apical periodontitis(AP) were allocated into two groups: Group SL–SWEEPS laser activated irrigation(n = 15) and Group PUI–passive ultrasonic irrigation(n = 15). Bacteriological samples were taken before(S1) and after chemomechanical preparation(S2), and then after final irrigation activation(S3). The levels of total bacteria and Streptococci were measured by means of PCR. Blood samples were collected before and 3rd day after treatment. Enzyme-linked immunosorbent assay was used to measure the levels of IL-1β. The bacterial reduction showed no differences between groups after chemo-mechanical treatment and after irrigant activation(p = 0.590). Post-treatment IL-1β levels were lower than pretreatment levels in both groups(p < 0.001). SL or PUI application in addition to chemomechanical preparation has similar effects on total bacterial level and inflammation detected by IL-1β in patients with AP.

IN VIVO STUDY EVALUATES EFFECTIVENESS OF ADDING CIPROFLOXACIN TO CALCIUM HYDROXIDE VERSUS SAUSSUREA COSTUS TO CALCIUM HYDROXIDE MEDICATION AGAINST BACTERIAL BIOFILM IN ROOT CANAL TREATMENT

Background and objectives: Elimination of root canal bacteria is a perquisite for a successful root canal treatment. This research aims to determine the effectiveness of adding ciprofloxacin versus Saussurea costus extract to calcium hydroxide medicament against bacterial biofilm in root canal treatment in vivo study. Materials and methods: In vivo study on 70 single-rooted human teeth at Sana'a University dental clinics used Saussurea costus extract preparation, including washing, drying, crushing, mixing, centrifugation, drying, and homogenization.The intracanal drug concentration was standardized by mixing 1 g of calcium hydroxide powder with 1 ml of ciprofloxacin or 1 ml of Saussurea costus extract in both groups. Three bacteriological samples were taken before root canal treatment, before Medicaments were placed, and 7 days after, and CFU and bacterial isolation were performed using standard methods. Results: An intragroup analysis showed that all drug groups had a significant decrease in the number of intracanal bacterial cells from S1 to S2 and from S2 to S3 (p&lt;0.0001). When comparing quantitative S1 or S2 data, there was no significant difference between the groups; however, at Sample 3, the Saussurea costus extract calcium hydroxide (34.05±21.8) had considerably higher bacterial counts than the calcium hydroxide + Ciprofloxacin group (11.9±29 CFU). The most isolated bacteria in S1 and S2 were Staphylococcus aureus (58.6%, 51.4%), followed by Klebsiella species (27.1%, 18.6%), Escherichia coli (25.7%, 17.1%), Enterococcus faecalis (22.9%, 15.7%) and Pseudomonas aeruginosa (21.4%, 12.9%). Conclusions: The addition of Ciprofloxacin to calcium hydroxide and Saussurea costus- calcium hydroxide provided further antibacterial effectiveness when used as an intracanal medicament in vivo during root canal treatment. Peer Review History: Received 27 March 2024; Revised 5 May 2024; Accepted 28 June; Available online 15 July 2024 Academic Editor: Essam Mohamed Eissa, Beni-Suef University, Egypt, dressamceutics@yahoo.com Average Peer review marks at initial stage: 6.5/10 Average Peer review marks at publication stage: 7.0/10 Reviewers: Dr. Kingsley C Anukam, University of Benin, Nigeria, kanukam@gmail.com Dr. Liliya Logoyda, Horbachevsky Ternopil State Medical University, Ukraine, logojda@tdmu.edu.ua

Effect of Disinfection Protocols on Bacterial Reduction in Mandibular Molars.

Evaluate the bacterial reduction effect of disinfection protocols used in lower molars infected by Enterococcus faecalis. Eighty extracted lower molars were prepared and inoculated with E. faecalis for 2 months. The teeth were then distributed into 2 control groups (n = 4) and 4 experimental groups (n = 18) in function of the disinfection protocol utilized: G1. WaveOne Gold (WOG), passive ultrasonic irrigation (PUI) and Ultracal; G2. WOG, PUI and calcium hydroxide (CH); G3. WOG, XP-Endo Finisher (XPF) and Ultracal; G4. WOG, XPF and CH. Bacteriological samples were collected previously (S1), after preparation (S2), final agitation (S3) and intracanal dressing (S4). Microbial growth was assessed according to culture turbidity and UV spectrophotometry. Statistical analyses used the Friedman test for paired samples and Kruskal-Wallis test for non-paired data (p<0.05). No protocol eliminated E. faecalis effectively. The S2, S3 and S4 samples were statistically different from the S1 samples in G1, G2, G3 and G4 (p<0.05). Statistical differences were observed in bacterial reduction between G1 and G2 and G1 and G3 after the intracanal medicament (S4) (p<0.05). The WOG + PUI + CH disinfection protocol showed higher percentages of bacterial reduction.

Fever of unknown origin revealing testicular nocardiosis: a case report and literature review

BackgroundNocardia is an ubiquitous soil organism. As an opportunistic pathogen, inhalation and skin inoculation are the most common routes of infection. Lungs and skin are the most frequent sites of nocardiosis. Testis is a highly unusual location for nocardiosis.Case presentationWe report the case of an immunocompromised 75-year-old-man admitted for fever of unknown origin. He presented with skin lesions after gardening and was first suspected of Mediterranean spotted fever, but he did not respond to doxycycline. Then, physical examination revealed new left scrotal swelling that was compatible with a diagnosis of epididymo-orchitis. The patient’s condition did not improve despite empirical antibiotic treatment with the onset of necrotic scrotal abscesses requiring surgery. Nocardia brasiliensis yielded from the removed testis culture. High-dose trimethoprim-sulfamethoxazole and ceftriaxone were started. Multiple micro-abscesses were found in the brain and spinal cord on imaging studies. After 6 weeks of dual antibiotic therapy for disseminated nocardiosis, slight regression of the brain abscesses was observed. The patient was discharged after a 6-month course of antibiotics and remained relapse-free at that time of writing these lines. Trimethoprim-sulfamethoxazole alone is meant to be pursued for 6 months thereafter. We undertook a literature review on previously reported cases of genitourinary and urological nocardiosis; to date, only 36 cases have been published with predominately involvement of kidney, prostate and testis.ConclusionsTo the best of our knowledge, this is the first case of Nocardia brasiliensis simultaneously infecting skin, testis, brain and spinal cord in an immunocompromised patient. Knowledge on uncommon forms of nocardiosis remains scarce. This case report highlights the difficulty of diagnosing atypical nocardiosis and the importance of prompt bacteriological sampling in case of empirical antibiotics failure.

The effect of the COVID-19 pandemic on the incidence and resistance of Gram-negative bacilli and antimicrobial consumption in the intensive care units of a referral hospital in Buenos Aires

There was a reported increase in the antimicrobial consumption in hospitals during the COVID-19 pandemic, accompanied by an increase in infections due to multidrug-resistant (MDR) bacteria. This retrospective time series study from intensive care units in Buenos Aires examined changes in antibiotic consumption (defined daily doses/1000 patients/day), the incidence of Gram-negative bacilli (GNB) and the mechanism of resistance. Antibiotics were categorised into group 1 (agents against MDR GNB) and group 2 (agents against non-MDR infections). Bacteriological samples included respiratory samples and blood cultures. Periods were divided into pre-pandemic (July 2019 to March 2020) and pandemic (April 2020 to March 2022). Correlation coefficients (r) were analysed and the Mann-Whitney test was performed to compare both periods. During the study period, GNB incidence, group 1 antibiotic consumption and resistance mechanisms increased, whereas antibiotics decreased in group 2. A significant positive correlation was seen between the consumption of antibiotics in group 1 and the incidence of GNB (r = 0.63; P < 0.001) and resistance (r = 0.52; P = 0.002). Significant differences were found between pre-pandemic and pandemic periods regarding the medians of group 1 consumption (520 [408-570] vs. 753 [495-851] DDD/1000 patients/day; P = 0.029), incidence of GNB (12 [10-13] vs. 43 [25-52.5] cases/month; P < 0.001) and resistance mechanisms (5 [4-8] vs. 17 [10-25] cases/month; P < 0.001), extended-spectrum beta lactamases (2 [1-2] vs. 6 [3-8] cases/month; P < 0.001) and metallo-beta-lactamases (0 [0-0] vs. 6 [1.75-8.5] cases/month; P < 0.001). During the COVID-19 pandemic, the rise in GNB incidence and the amount of resistance mechanisms significantly correlated with the increase in consumption of agents against MDR strains.

Association of Osteoporosis with Antibiotic Resistance among Postmenopausal Women with Open Tibial Fractures

Osteoporosis is common among postmenopausal women and can complicate the healing of open tibial fractures. Antibiotic resistance is a growing concern in treatment. Yet, the connection between osteoporosis and antibiotic resistance remains unclear, needing the investigation for improved patient care. Objective: To explore the association between osteoporosis and antibiotic resistance among postmenopausal female patients with open tibial fractures. Methods: This cross-sectional study was conducted at Department of Orthopedic Surgery, Liaquat University of Medical and Health Sciences, Jamshoro, with sample size of 240 postmenopausal women with open tibial fractures and signs of infection within one week of the fracture. Participants were chosen via non-probability sampling method. Bacteriological samples for culture were obtained from secretions adjacent to the infected tissue. Data analysis was conducted using SPSS version 21.0. Results: The majority of osteoporotic patients experienced Road Traffic Accidents (RTA) (42.5%), followed by falls from height (35.3%), while firearm injuries were less common (22.2%). Staphylococcus aureus was the most common pathogen in both osteoporotic (40%) and non-osteoporotic (39.9%) patients, followed by Escherichia coli, Methicillin-Resistant Staphylococcus Aureus (MRSA), Klebsiella, and Pseudomonas aeruginosa. Antibiotic resistance was predominantly found against S. aureus, MRSA, Klebsiella and E. coli. Co-Trimoxazole exhibited the highest resistance rates across all four bacterial organisms, ranging from 34% to 50%. Conclusions: The study found varying antibiotic resistance patterns across various pathogens, with notable resistance observed MRSA strains. Antibiotic resistance was observed in osteoporotic group, with Co-Trimoxazole showing the highest resistance rates.

The Effect of Intrauterine Administration of Zeolite on the Puerperal Period in Dairy Cows

Background: The development of new protocols has become a priority today in the context of the adverse effects of conventional treatments. Zeolite falls into this category due to its numerous applications reported in the specialized literature. In this study, the main expected objectives were to demonstrate that intrauterine administration of zeolite can contribute to improving the indicators underlying the development of pathologies during the postpartum period. Methods: To determine the dosage and potential toxic effects on the uterine mucosa, we conducted a study on rats, to which we administered different doses on the second day after delivery. Ultrasound measurements of the uterus, collection of bacteriological samples and uterine tissue were performed at 7, 14 and 21 days. The results were satisfactory in terms of tissue effects, with the 20% dosage being the most suitable. Following the completion of the preliminary study, we grouped the animals into two equal groups (n=32). Intrauterine administration of zeolite was performed on the second day after delivery and monitoring of uterine involution was carried out on days 7, 14 and 21 of the puerperium. At 14 days, we collected samples to determine the number of bacteria and uterine tissue. Result: The data obtained indicate that the group receiving intrauterine zeolite (n=16) experienced a decrease in the number of bacteria, significantly faster uterine involution on days 14 and 28, a more favourable uterine score and a significantly shorter service period. However, no significance was established regarding the number of doses of seminal material used.

First Report of Aeromonas schubertii Infection in Striped Snakehead Channa striata (Bloch, 1793) Fingerlings in Malaysia

Striped snakehead fingerlings Channa striata reared in a concrete pond with size 13.5 m3 (3 m ´ 3 m ´ 1.5 m) in a hatchery farm, in Labu, Negeri Sembilan, Malaysia had more than 70% mortality. The pond contained 1500 fingerlings of 5–7 cm in total length (TL). The purpose of this study was to investigate the high mortality event on the farm as part of a veterinary diagnostics service. Clinical signs observed were skin discoloration, lethargy, and anorexia. Necropsy was performed in 10 fish with gross lesions of 1–2 mm and multiple whitish nodules in the abdominal organs and most notably in the liver, and kidney. Following necropsy, bacteriology samples from the kidney and liver were inoculated onto Tryptic Soy Agar (TSA) and Blood Agar (BA). Pure colonies were observed and were Gram-negative with short rod morphology. The full-length 16S rRNA gene was amplified from the pure colonies followed by sequencing using the Nanopore MinION™ (Oxford Nanopore, UK). The isolated strain was identified as Aeromonas schubertii based on the assembled 16S rRNA sequence showing nucleotide identity of 99.73% (top hit) to A. schubertii (GenBank Accession: NR_037014.2) while only a nucleotide identity of 97.55% was observed against Aeromonas hydrophila (GenBank Accession: NR_119190.1-), respectively. Histopathological examination from the liver, kidney, spleen, and intestine revealed granulomatous nephritis, and degeneration of tubular epithelium, with granulomatous hepatitis, splenitis, and enteritis. The prognosis of this case was grave. No treatment was given as the owner had decided to dispose of all current stock. This is the first A. schubertii infection in C. striata described in Malaysia. The findings of the present study may serve as a reference for similar cases in C. striata in the future so rapid diagnosis and treatment can be made if required.

Pathogen-specific patterns of milking traits in automatic milking systems

Early detection of intramammary infection (IMI) can improve animal health and welfare in dairy herds. The implementation of sensors and automatic milking systems (AMS) in dairy production inherently increases the amount of available data and hence also the potential for new approaches to mastitis management. To utilize the full potential of data from AMS and auxiliary sensors, a better understanding of physiological and pathological changes in milking traits associated with different udder pathogens may be imperative. This observational study aimed to investigate pathogen-specific patterns in milking traits recorded in AMS. The milking traits included; online somatic cell count (OCC), electrical conductivity (EC), milk yield (MY), and average milk flow rate (AMF). Data were collected for a study period of 2 years and included 101 492 milkings from 237 lactations in 169 cows from one farm. Measurements of OCC were recorded at cow-level and data on EC, MY, and AMF were obtained at quarter-level. In addition to the data obtained from the AMS, altogether 5756 quarter milk samples (QMS) were collected. Milk samples were obtained monthly for bacteriological culturing. We included findings of 13 known mastitis pathogens to study pathogen-specific patterns in milking traits. These patterns were compared with those in a baseline group consisting of cows that did not have any positive milk culture results throughout the lactation period. Patterns of the milking traits are described for all positive samples both across 305 d in milk (DIM), and in the 15-d period before a positive bacteriological sample. The association between a positive sample and the milking traits (ln(OCC), EC-IQR; the ratio between the quarter with the highest and the quarter with the lowest level of EC, and MY) for the 15 d before the detection of a pathogen was assessed using mixed effects linear regression models. All pathogens were associated with alterations in the level and variability of ln(OCC) relative to lactations with no positive bacteriological samples. A positive sample for Staph. aureus was associated with increased values for MY during the 15 d before a positive diagnosis. It is biologically plausible to interpret changes in OCC and EC-IQR as consequences of an intramammary infection (IMI), while higher MY in bacteriologically-positive cows is most likely linked to the increased risk of infection in high-yielding cows. In this study, the most notable changes in the traits (OCC and EC-IQR) were observed for Staph. aureus and Strep. dysgalactiae, followed by Strep. simulans, Strep. uberis, and Lactococcus lactis. Even if we did not detect significant associations between positive bacteriology and EC-IQR, visual assessment and descriptive statistics indicated that there might be differences suggesting that it could be an informative trait for detecting infection when combined with OCC and possibly other relevant traits using machine learning algorithms.

Epidemiology and risk factors for extension of necrotizing otitis externa.

Necrotizing otitis externa (OEN) is an aggressive and morbid infection of the external acoustic meatus. What are the risk factors for OEN extension? French monocentric retrospective study (2004-2021), including patients with OEN defined by the association of an inflamed EAM, a positive nuclear imaging, the presence of a bacteriological sample and the failure of a well-followed local and/or general antibiotic treatment. OEN was extensive if it was associated with vascular or neurological deficits, if nuclear imaging fixation and/or bone lysis extended beyond the tympanic bone. Our population (n = 39) was male (74%), type 2 diabetic (72%), aged 75.2years and pseudomonas aeruginosa was found in 88% of cases. Complications for 43% of patients were extensive fixation on nuclear imaging, for 21% of them the presence of extensive bone lysis, for 13% the appearance of facial palsy, for 5.3% the presence hypoglossal nerve palsy and for 2.5% the presence of thrombophlebitis or other nerves palsies. 59% of our population had extensive OEN. The diagnosis of the extensive OEN was made 22days later (p = 0.04). The clinical presentation was falsely reassuring due to easier identification of the tympanic membrane (70% vs 46%, p = 0.17) but associated with periauricular oedema (42% vs 0%), bone exposure (16% vs 0%) and a temporomandibular joint pain (41% vs 12%). Delayed treatment of OEN, identification of clinical bone lysis, especially when the tympanic membrane is easily visualized, and the presence of unbalanced diabetes are potential risk factors for extension of OEN.

Antimicrobial efficacy of two commercially available herbal products with and without ultrasonic activation in primary endodontic infections: A randomized clinical trial.

Effective irrigation is crucial for successful endodontic treatment. Traditional irrigants like sodium hypochlorite (NaOCl) have been widely used, but there is a growing interest in exploring natural alternatives for their potential antimicrobial properties. The study aims to compare the antimicrobial efficacy of Neem, Bitter Gourd, and NaOCl, with and without ultrasonic activation in managing primary endodontic infections. Ninety patients were randomly assigned six groups (n = 15) Group 1: NaOCl, Group 2: NaOCl with passive ultrasonic irrigation (PUI), Group 3: Neem juice, Group 4: Neem juice with PUI, Group 5: Bitter gourd juice, and Group 6: Bitter gourd juice with PUI. Bacteriological samples were collected before (S1) and after (S2) shaping, plated on brain heart infusion agar, and colony counting was done after 24 h. Shapiro-Wilk test, one-way ANOVA, post hoc Tukey analysis, and paired t-test. All the groups demonstrated a significant reduction in bacterial count. Groups with PUI (2, 4, 6) demonstrated higher mean bacterial reduction than their counterparts without PUI (1, 3, 5). Neem and Bitter gourd juices, particularly when used with PUI, demonstrated antimicrobial efficacy comparable to NaOCl with PUI.

ASPECTS CLINIQUES ET EVOLUTIFS DU CHOC SEPTIQUE EN REANIMATION DU CHU ANDOHATAPENAKA

Introduction: Septic shock is a major problem in intensive care units because it is responsible for high mortality. We aim to describe septic shocks clinical, bacteriological, therapeutic, and outcome aspects in the Intensive Care Department of Andohatapenaka University Hospital. Methods: This is a 30-month retrospective descriptive study of patients admitted with septic shock to the intensive care unit of CHU Andohatapenaka. The parameters studied were sociodemographic data, clinical parameters, bacteriological parameters, and evolutionary outcomes. Results: The incidence of septic shock was 9.5%. The mean age was 59±15 years. Male predominance was 65.8%, with a sex ratio of 1.9. Hypertension was the main comorbidity (64.3%). Disturbed consciousness was the most common reason for admission (41.5%). Polypnoea was found in 92.7% of patients. Pulmonary infection was predominant in 78.1% of cases. In this study, 34.2% had undergone bacteriological sampling. Kochs bacillus (9.7%) and Gram-negative bacilli (12.2%) predominated among the germs found. All patients received vascular filling, vasopressors, oxygen therapy, and antibiotic treatment. In this study, 39% of patients received mechanical ventilation. The mortality rate was 73.1%. Conclusion: Septic shock is still a real public health problem. It is the leading cause of death in intensive care. A further study will be necessary to determine the predictive factors of septic shock to improve management.

The effect of root canal preparation tapers on planktonic bacteria and biofilm reduction in the apical third: A correlative microtomography and microbiological laboratory study.

To evaluate the influence of different preparation tapers on the reduction in planktonic bacteria and biofilms of Enterococcus faecalis and Candida albicans in the apical third (4 mm) of the mesial roots of mandibular molars, correlating decontamination with canal shape. After microtomography analysis for morphological standardization of the canals, 48 mandibular molar roots, each containing two canals (96 canals), were contaminated with E. faecalis and C. albicans and divided into four groups (n = 11) for canal instrumentation using ProDesign Logic 2 files with different tapers G (.03): # 25.03; G (.04): # 25.04; G (.05): # 25.05; and G (.06): # 25.06 and irrigation with 2.5% sodium hypochlorite. Four roots were examined under a scanning electron microscope (SEM) to qualitatively assess biofilm formation. Eight roots were used as the negative control group (samples were not contaminated). Bacteriological samples were taken exclusively from the apical third of the roots before and after chemical-mechanical preparation and bacterial counts were determined (CFU/mL). The final micro-CT scan was used to quantify the volume variation and unprepared canal area in the apical third. Statistical analysis was performed using the Kruskal-Wallis, Student-Newman-Keuls and Wilcoxon tests for analysis of microbiological data. anova and the Tukey or Games-Howell test were used for analysis of micro-CT data and Spearman's test for correlations (α = 5%). All groups showed a significant reduction in bacteria (p < .05), with no statistically significant difference between groups. There was no significant difference in per cent volume increase between groups. The unprepared area (Δ%) was affected by the file used (p = .026) and was significantly lower for G (.06) compared to G (.03). There was no statistically significant correlation among bacterial reduction, volume and unprepared area (p > .05). The different preparation tapers influenced root canal shaping in the apical third but did not improve decontamination in this region.