Bacteriological Samples Research Articles

Root canals decontamination by coherent photons initiated photoacustic streaming (PIPS) of irrigants: an ex-vivo study

The aim of this ex vivo study was to assess the antibacterial effectiveness of coherent photon initiated photoacoustic streaming (PIPS) of irrigants using an Er:YAG laser equipped with a newly designed, stripped and tapered, tip in extracted teeth with infected root canals. One hundred-forty-eight single-rooted extracted teeth were prepared using a rotary abrasive instrument providing a root channel with a suitable size. The samples were sterilized and all teeth except ten (negative control group) were inoculated with Enterococcus faecalis and incubated in a CO2 chamber at 37°C for 15 days in Eppendorff tubes filled with trypticase soy broth medium changed every 2 days. Infected teeth were then randomly divided into 4 test groups (n=32 for each): pulsed erbium:YAG laser at non-ablative settings for 30 seconds with sterile bi-distilled water (Group A) or 5% sodium hypochlorite (NaOCl) (Group B); without laser activated sterile bi-distilled water irrigation for 30 seconds (Group C) or 5% NaOCl irrigation for 30 seconds (Group D); the positive control group received no treatment in infected teeth (n=10). Colony-forming units (CFUs) were counted from bacteriologic samples taken before (S1) and after treatment (S2). Data were analyzed by Kruskal-Wallis and post hoc Dunn's multiple comparison tests. CFU counts were significantly lower in groups B and D than in group C (P<0.001). Moreover, there was a significant difference between Group A and C (P<0.001). Group B showed the highest CFU reduction, which was significantly greater than that evident in groups A or C (P<0.001). There were no statistically significant differences between group B and D (P>0.05). None of the four groups predictably generated negative samples. Under the conditions of this ex vivo study, statistically significant difference wasn't found in planktonic bacteria reduction between the laser and NaOCl or NaOCl alone groups.

An assessment of boiling as a method of household water treatment in South India.

This article scrutinizes the boiling of water in Tamil Nadu and Puducherry, India. Boiling, as it is commonly practiced, improves water quality, but its full potential is not being realized. Thus, the objective is to refine the method in practice, promote acceptability, and foster the scalability of boiling and household water treatment (HWT) writ large. The study is based on bacteriological samples from 300 households and 80 public standposts, 14 focus group discussions (FGDs), and 74 household interviews. Collectively, the data fashion both an empirical and ethnographic understanding of boiling. The rate and efficacy of boiling, barriers to and caveats of its adoption, and recommendations for augmenting its practice are detailed. While boiling is scientifically proven to eliminate bacteria, data demonstrate that pragmatics inhibit their total destruction. Furthermore, data and the literature indicate that a range of cultural, economic, and ancillary health factors challenge the uptake of boiling. Fieldwork and resultant knowledge arrive at strategies for overcoming these impediments. The article concludes with recommendations for selecting, introducing, and scaling up HWT mechanisms. A place-based approach that can be sustained over the long-term is espoused, and prolonged exposure by the interveners coupled with meaningful participation of the target population is essential.

Epidemiology of burn wound infection in Rabat, Morocco: Three-year review

To determine the bacteriological profile of burn wounds in patients hospitalized in the burn unit of the Military Hospital in Rabat and describe their sensitivity to antibiotics. This prospective study was conducted from July, 2009, through March, 2011, in the hospital bacteriology laboratory, in collaboration with the burn unit. At each admission, a questionnaire was completed to collect the patient's data. Bacteriological samples were collected from burn wounds at admission and every time the bandage was changed. Identification of bacteria was based on their culture, morphological, and biochemical characteristics. Antibiotic susceptibility was determined with the agar diffusion method, in accordance with the recommendations of the French Society of Microbiology. Statistical analysis was performed with SPSS Version 13 (Statistical Package for the Social Sciences) software. The study included 58 burn patients. Their mean age was 38.2 ± 15.5 years; the mortality rate was 13.8%, and the prevalence of infection 43.1%. We identified 126 non-redundant bacterial strains from the 112 samples collected, most often Acinetobacter baumannii, Pseudomonas aeruginosa, Klebsiella pneumoniae, Enterobacter cloacae, and Staphylococcus spp. Heightened vigilance and rigorous application of hygiene rules, together with continuous epidemiological surveillance of burn wound bacteria, are essential to optimize empiric antibiotic therapy.

Campylobacter fetus infections

BackgroundCampylobacter fetus infections usually occur in immunodepressed patients or patients presenting with diabetes mellitus or cancer. They rarely cause diarrhea but frequently cause bacteremia or vascular diseases. The therapeutic management is not well codified and fluoroquinolone resistance is continuously increasing. MethodsWe conducted a retrospective study of C. fetus infections from January 2007 to August 2013 at the Limoges teaching hospital. The infections were defined by at least 1 bacteriological sample positive for C. fetus. ResultsTwenty patients were included (15 men), with an average age of 73 years (43–91). Sixteen presented with cancer, 12 with solid cancer including 9 of the urinary tract, and 9 patients with hematologic diseases. Five patients presented with diabetes mellitus, 9 with isolated bacteremia, 3 with cellulitis, and 3 with septic arthritis. The diagnosis was made by blood cultures for 17 patients. Twenty percent of the isolates were resistant to amoxicillin and 30% to fluoroquinolones. The therapeutic regimens and the treatment duration were quite different. The outcome was unfavorable for 3 patients whose implanted port had not been removed and 1 with subdural hematoma infection. 1 patient died. ConclusionsC. fetus infection occurs in case of underlying diseases, most frequently promoting urinary tract cancer. Fluoroquinolones must not be used without susceptibility testing and catheters should be removed.

Atteintes extra-respiratoires dues à Mycoplasma pneumoniae : à propos d’un cas

Extrapulmonary manifestations of Mycoplasma pneumoniae are sometimes severe and may even be life-threatening. A 10-year-old patient was hospitalized due to a flu-like illness lasting 48 h with impaired general condition, after an extended stay in Africa. There was an inflammatory syndrome associated with hyponatremia, but malaria was negative. A triple antibiotic therapy with ceftriaxone, amikacin, and josamycin was started. The progression was marked by the appearance of hypoxemia pneumoniae associated with extrarespiratory manifestations. He initially presented with acute polyradiculoneuropathy, followed by thrombotic events associated with polyserositis, polyarthritis, a maculopapular rash, and then a hemophagocytic syndrome. Bacteriological samples isolated M. pneumoniae in nasopharyngeal secretions with a positive serology. The appropriate antibiotic therapy associated with corticosteroids and immunoglobulins led to clinical improvement and the patient progressed toward complete recovery. The pathogenesis of M. pneumoniae infection remains largely unknown. However, two main categories have been proposed. The lung injury is caused by the invasion of the respiratory epithelium, whereas the extrarespiratory manifestations are probably due to immunological disorders. The knowledge of extrarespiratory manifestations and their pathomechanisms allows further adjustments to therapeutic management.

The pathogenic role of Blastocystis isolated from patients with irritable bowel syndrome and colitis from Iasi, Romania.

Blastocystis is a common parasite and regarded as one of the etiologic agents of irritable bowel syndrome, colitis and chronic diarrhea. Our study was undertaken in order to identify different subtypes of Blastocystis isolated in patients with irritable bowel syndrome and colitis, as well as with chronic diarrhea and to evaluate their pathogenic potential. Seventy-three subjects (10 asymptomatic infected subjects, 49 subjects harboring Blastocystis or associated with other etiologic agents like bacteria, yeasts, protozoa, helminthes and 14 subjects with unknown etiologic agents) were investigated by in vitro parasitological and bacteriological stool samples followed by PCR subtyping of Blastocystis using STS primers, immunological markers (total serum IgA and IgE antibody levels), Helicobacter pylori antigen rapid test and fecal occult blood test. Also, among 49 subjects, there were 12 subjects harboring Blastocystis as the single etiologic agent. Subtyping proved that only three subtypes of Blastocystis were identified as following: subtype II (66.66%) in single infected subjects, subtype I (16.66%) in mixed infection with subtype II and subtype IV (8.33%) in single infected subjects. Total serum IgA and IgE antibody levels were in normal range. Subtype II was the most frequent subtype followed by subtype I and subtype IV of Blastocystis isolates in patients with irritable bowel syndrome, colitis, and chronic diarrhea as well as in asymptomatic infected group. Our results suggest that the severity of clinical manifestations depend on factors involving the host and possible parasitic density and not necessarily by isolated subtype.

Attitudes, risk of infection and behaviours in the operating room (the ARIBO Project): a prospective, cross-sectional study

IntroductionInappropriate staff behaviours can lead to environmental contamination in the operating room (OR) and subsequent surgical site infection (SSI). This study will focus on the continued assessment of OR staff...

Shock State

Some patients with drug reaction with eosinophilia and systemic symptoms (DRESS) are probably admitted in intensive care unit (ICU), but data concerning their clinical features at admission are scarce. Therefore, in the present study, we used a clinical network of French intensivists to study the clinical features and evolution of DRESS patients hospitalized in ICU. A national, retrospective, multicenter study collected DRESS cases hospitalized in ICU for DRESS from 2000 to end of 2011. All files were analyzed through the RegiSCAR scoring system as "no," "possible," "probable," or "definite" DRESS. Patients were included only if they had a probable or definite DRESS. Demographic, hemodynamic, biological, and infectious data were recorded. Twenty-one patients were included. Hospital mortality was 10 (47%) of 21, and 16 of 21 patients had on admission a shock state necessitating vasopressor agents. Echocardiographic ejection fraction in shock patients was depressed (47% ± 13%). Mechanical ventilation was required in 13 of 21 cases. Hepatic failure was observed in 11 of 21 cases, acute renal failure in 18 of 20 cases, and lactic acidosis in 12 of 20 patients. Initial bacteriology was negative in all patients. Human herpesvirus reactivations were found in five of 15 cases. In conclusion, shock without bacteriological documentation associated with multiple organ failure is the most common presentation of DRESS at admission in ICU and is associated with a higher mortality than previously described.

Mastoïdite aiguë atypique révélant une leucémie de Burkitt chez une enfant de 7 mois

A 7-month-old girl presented with left acute mastoiditis and a white blood cell count of 79,000/mm(3). A surgically obtained bacteriological sample showed Streptococcus pneumoniae. Direct blood examination revealed leukemic blast cells. Histological samples showed leukemic infiltration of the left temporal bone. The final diagnosis was Burkitt's leukemia with left temporal bone leukemic infiltration. The patient received chemotherapy according to the LMB 2001 protocol from the Société française d'oncologie pédiatrique. Clinical, biological, and imaging follow-up 30 months after the end of treatment showed remission with complete recovery in the left temporal bone. Atypical presentation of acute mastoiditis (AM) should prompt investigation into whether there is a rare underlying pathology, such as a hemopathy, histiocytosis, or solid tumor. The first sign of leukemia may be acute middle ear disease. To our knowledge, no other cases of Burkitt's leukemia with temporal bone leukemic infiltration presenting as AM have been reported in a child under 1 year of age.

Pseudomonas aeruginosa burn wound infection in a dedicated paediatric burns unit

Background. Pseudomonas aeruginosa infection is a major cause of morbidity in burns patients. There is a paucity of publications dealing with this infection in the paediatric population. We describe the incidence, microbiology and impact of P. aeruginosa infection in a dedicated paediatric burns unit. Methods. A retrospective review of patients with clinically significant P. aeruginosa infection between April 2007 and January 2010 in the burns unit at Red Cross War Memorial Children’s Hospital in Cape Town, South Africa, was performed. Results. During the 36-month study period, 2 632 patients were admitted. Of 2 791 bacteriology samples sent for microscopy, culture and sensitivity, 406 (14.5%) were positive for P. aeruginosa. Thirty-four patients had clinically significant P. aeruginosa wound infection, giving an incidence of 1.3%. Three patients had loss of Biobrane or allografts, and 23 cases of skin graft loss occurred in 18 patients. An average of 12 dressing days was needed to obtain negative swabs. All isolates were sensitive to chlorhexidine, whereas 92.5% were resistant to povidone-iodine. Piperacillin-tazobactam was the systemic antimicrobial to which there was most resistance (36.1%), and tobramycin had least resistance (3.3%). Conclusions. The incidence of clinically significant burn wound infection is low in our unit, yet the morbidity due to debridement and re-grafting is significant. We observed very high resistance to topical povidone-iodine. Resistance to systemic antimicrobials is lower than that reported from other burns units.

In vivo assessment of caries excavation with a fluorescence camera compared to direct bacteriological sampling and quantitative analysis using flow cytometry

The aim of this study was to assess the performance of the fluorescence camera device VistaCam iX (VC) for the control of caries excavation compared to visual assessment and bacteriological evaluation. Twenty-three patients with 32 dentinal carious lesions were included in the study. The lesions were classified using the International Caries Detection and Assessment System. Fluorescence images were taken at the surface of each lesion using the VC before excavation (stage 1), during (stage 2) and after excavation (stage 3). At each stage, dentine samples were collected. All cavities were closed after excavation using permanent fillings. Bacteria were counted within each dentine sample using flow cytometry. Significant moderate correlation between the fluorescence readings and the bacteria count was found at stage 3 (Spearman correlation coefficient rs = 0.40, p = 0.027). Area under the ROC curve (AUC) was calculated for fluorescence readings and bacteria count using the clinical status at stage 3 as a reference. AUC was 0.954 for the VC readings and 0.797 for bacteria count. Using the median bacteria count at stage 3 as a reference, the AUC for the fluorescence readings was 0.753. The results indicate that the fluorescence camera appears to be a useful supplementary tool in assessing the endpoint of caries excavation with the advantage of enabling data to be digitally visualized and stored. When an experienced dental clinician determined the excavation endpoint, the performance with respect to remaining bacteria count was good.

Pulmonary tuberculosis in its pseudotumoral form; one new case

Pulmonary tuberculosis in its pseudo tumoral form is a rare entity. This pseudo tumor is suggested by a radiological parenchymal lesion or neoplastic-like presence in bronchoscopy of a bud or lung infiltration. The diagnosis is confirmed by bacteriological and/or different histological samples. We report a patient aged 26 with no history conditions, no notion of contagious tuberculosis and without toxic habits, who reports with three months isolated type left chest pain operating in a context of significant weight loss but not encrypted, evening fever and altered general condition. The clinical syndrome is a condensation of apical left and the rest of the examination is unremarkable. The chest radiograph shows an opaque round, dense and homogeneous apical left chest scan objective mass density tissue. Bronchoscopy was performed of a small bud at the apex of the segmental left upper lobe whose biopsy was inconclusive. Transparietal puncture with histological study confirmed the diagnosis of pulmonary tuberculosis. The patient was then put under treatment with antibacillaire. The diagnosis of tuberculosis should be considered in any tumor-like lung, as well as to step up bronchoscopic radiation, especially in an epidemiological context and is suggestive. This will allow early treatment of tuberculosis. The aim of our study is to report the rare and special appearance of pulmonary tuberculosis pseudo-tumoral form in imaging.

Difficulté diagnostique devant une hydrocéphalie aiguë

Tuberculosis disease, in its extra pulmonary form, remains a difficult diagnosis because of its atypical symptoms and evolution. We have observed a case of acute tuberculosis neuromeningitis, without being able to make a definite diagnosis prior to the patient's death because of the negativity of the initial bacteriological samples. We started the most probable appropriate treatment but in vain. This case allows us to challenge diagnostic methods and resulting treatments in emergency cases where tuberculosis is suspected. Moreover, it seems essential to do everything possible to find the bacterium when confronted with a patient with risk factors and clinical and radiological symptoms compatible with tubercular disease, before the disease becomes acute.

Presence of Escherichia coli, Trueperella pyogenes, α-hemolytic streptococci, and coagulase-negative staphylococci and prevalence of subclinical endometritis

Subclinical endometritis (SCE) has a severe negative effect on reproductive performance of dairy cows. Different studies have shown a wide variety of cut points for the polymorphonuclear neutrophilic leukocyte (PMNL) percentage to define SCE and differing sampling times. Possible risk factors for SCE, such as low body condition score, hyperketonemia, and increased haptoglobin concentrations have been demonstrated. The aim of this study was to determine the relationship between bacterial findings in the uterus and PMNL in the early postpartum period and to compare 2 classification schemes for the diagnosis of SCE. Cytological and bacteriological samples from the uterus were taken from 149 cows at 2 consecutive times postpartum [10±1 and 24±1d in milk (DIM)] and additionally, 131 cows were sampled at 21 to 27 DIM. For sample collection, the cytobrush technique was used and vaginal discharge was examined by vaginoscopy. Polymorphonuclear neutrophilic leukocyte cut points were set at 5, 10, and 18%. Cows positive with α-hemolytic streptococci at 10±1 DIM had significant higher PMNL percentages at 21 to 27 DIM and greater median days to pregnancy (193.5d) than cows not infected (123.0d). Cows with Trueperella pyogenes at 10±1 DIM had higher odds (5.2) of having more than 18% PMNL at 21 to 27 DIM compared with cows without infection. Escherichia coli had no effect on the prevalence of SCE regardless of the cut point. Primiparous cows with more than 18% PMNL had greater median days to pregnancy (144.5 d) than cows with less than 5% (80.0d) or cows between 5 and 18% PMNL (68.0d). Cows between 5 and 18% PMNL or 10 and 18% PMNL showed the best reproductive performance. The results demonstrate that an early infection with α-hemolytic streptococci increased the PMNL percentage 2wk later and that 18% PMNL at 21 to 27 DIM was a predictive cut point for primiparous cows to diagnose animals with or without SCE.

Pseudomonas aeruginosa burn wound infection in a dedicated paediatric burns unit

Pseudomonas aeruginosa infection is a major cause of morbidity in burns patients. There is a paucity of publications dealing with this infection in the paediatric population. We describe the incidence, microbiology and impact of P. aeruginosa infection in a dedicated paediatric burns unit. A retrospective review of patients with clinically significant P. aeruginosa infection between April 2007 and January 2010 in the burns unit at Red Cross War Memorial Children's Hospital in Cape Town, South Africa, was performed. During the 36-month study period, 2 632 patients were admitted. Of 2 791 bacteriology samples sent for microscopy, culture and sensitivity, 406 (14.5%) were positive for P. aeruginosa. Thirty-four patients had clinically significant P. aeruginosa wound infection, giving an incidence of 1.3%. Three patients had loss of Biobrane or allografts, and 23 cases of skin graft loss occurred in 18 patients. An average of 12 dressing days was needed to obtain negative swabs. All isolates were sensitive to chlorhexidine, whereas 92.5% were resistant to povidone-iodine. Piperacillin-tazobactam was the systemic antimicrobial to which there was most resistance (36.1%), and tobramycin had least resistance (3.3%). The incidence of clinically significant burn wound infection is low in our unit, yet the morbidity due to debridement and re-grafting is significant. We observed very high resistance to topical povidone-iodine. Resistance to systemic antimicrobials is lower than that reported from other burns units.

Prediction of clinical mastitis outcomes within and between environments using whole-genome markers

The objective of this study was to evaluate genome-enabled predictions of daughter yield deviations for clinical mastitis in Norwegian Red cows within and between environments according to mastitis pathogen status. Genome-based predictions of daughter yield deviations for clinical mastitis for 1,126 bulls within and between 5 environments were performed using Bayesian ridge regression. The environments were defined as herd-5-yr classes with the following prevalence of bacteriological milk samples found positive for contagious mastitis pathogens: <50% (L50), ≥50% (H50), ≤25% (L75), >25% and <75% (M75), and ≥75% (H75). In addition, predictions based on all data across environment groups (the full data set, FD) were calculated to provide a benchmark for comparison. Predictive ability was evaluated using a 10-fold cross validation. A bootstrap procedure was used to obtain 95% confidence intervals for the cross-validation distribution of predictive ability for each data set. Predictive ability ranged from 0.04 for L75 to 0.19 for FD. Similar predictions within and between environments showed no evidence of genotype by environment interaction. The 95% confidence interval for all 5 environmental data sets included zero and ranged from 0.02 to 0.35 for FD. The bootstrap distribution showed large variation within each data set and small variation between data sets. Although we found no evidence of genotype by environment interaction, rank correlations of the single nucleotide polymorphism effects between different environments ranged from 0.15 (L75 – H75) to 0.92 (M75 – FD), indicating that single nucleotide polymorphisms may have a differential contribution to predictive ability in environments with distinct pathogen loads.

THE “NEW SETTLERS”: RESULTS OF A BACTERIOLOGICAL SURVEY DURING THE FIRST 6-MONTHS OPERATION PERIOD OF AN INTERNAL MEDICINE WARD IN A TERTIARY HOSPITAL

During the first six months of operating a new Internal-medicine ward in a tertiary hospital, a prospective survey, tracking both patient and environment bacteriological samples taken, was conducted. The motive behind the study was to establish the pattern in which environmental colonization is transmitted to the hospitalized patients and vice versa, thus defining the nosocomial pathogens that are typical to the ward. That information can be used to guide empirical antibiotic treatment. Patient sampling was done on clinical grounds whereas environmental cultures were systematically acquired from different surfaces around the ward. 6-months’ results analysis suggest that clinically guided culture rates were tightly associated with volume of patients admitted, with no such association demonstrated between volume of cultures taken and rate of positive results, except for urine cultures. Regarding environmental sampling, we demonstrated no benefit in taking empirical, surface samples for common nosocomial pathogens. Our findings could further improve future resources allocation with regard to infection control and clinical bacteriology routines in newly established internal medicine wards.

Exposure of mares to processionary caterpillars (Ochrogaster lunifer) in early pregnancy: An additional dimension to equine amnionitis and fetal loss

Equine amnionitis and fetal loss (EAFL) is an unusual form of abortion in mid- to late-gestation mares, first identified in Australia in 2004. It has been shown that both whole processionary caterpillars (Ochrogaster lunifer) and their shed exoskeletons can induce abortion in mares during midgestation. These abortions exhibited gross pathology and bacteriology results consistent with field cases of EAFL. To determine whether exposure of mares to the shed exoskeletons of processionary caterpillars can induce abortion in the preplacentation (<35 days' gestation) and early placentation (45-60 days) stages of pregnancy. In vivo experimental study. Mares less than 35 days' gestation and between 45 and 60 days' gestation were exposed to a slurry of shed processionary caterpillar exoskeletons by nasogastric intubation. Mares were monitored by clinical examination daily. Transrectal ultrasonography was performed daily (control and treated preplacentation mares, treated early placentation mares) or every second day (control early placentation mares). Uterine swabs were collected from mares that aborted. All live foals underwent a clinical examination. Placentas were examined, with sampling for bacteriology and histopathology if appropriate. Abortions occurred in treated mares in both experiments without signs of impending abortion. One mare aborted in the embryonic stage experiment and 2 in the early placentation experiment. Embryonic and fetal death was detected on transrectal ultrasonography prior to abortion. In the early placentation experiment, one foal was born 5 weeks preterm and was very small, with laxity of the tendons in all limbs. Enteric or environmental bacteria, consistent with EAFL, were isolated from the mares that aborted. Focal mucoid placentitis lesions were present on the placentas of 2 treated mares, one from each experiment. Processionary caterpillar exposure may be associated with EAFL-related embryonic and early fetal loss in mares. Processionary caterpillars may also play a role in the occurrence of focal mucoid placentitis.

GRP-146 Practice Assessment of Antibiotherapy Guidelines For Urinary Infections and Lower Respiratory Tract Infections in Elderly Patients of a Nursing Home

BackgroundThe elderly population keeps growing and a lot are living in nursing homes, where infections are frequent as patients are weak and the risk of transmission is high.PurposeNursing home physicians...

CPC-053 Evaluation of the Management of Diabetic Foot in Rabta National Teaching Hospital

BackgroundFeet lesions are the greatest cause of diabetic consultations in the endocrinology service.Purpose To evaluate the diabetic foot management in a Tunisian hospital in order to improve patients’ quality of...