Infection Of Intestinal Tract Research Articles

Oropharyngeal microbial ecosystem perturbations influence the risk for acute respiratory infections in common variable immunodeficiency.

The respiratory tract microbiome is essential for human health and well-being and is determined by genetic, lifestyle, and environmental factors. Patients with Common Variable Immunodeficiency (CVID) suffer from respiratory and intestinal tract infections, leading to chronic diseases and increased mortality rates. While CVID patients' gut microbiota have been analyzed, data on the respiratory microbiome ecosystem are limited. This study aims to analyze the bacterial composition of the oropharynx of adults with CVID and its link with clinical and immunological features and risk for respiratory acute infections. Oropharyngeal samples from 72 CVID adults and 26 controls were collected in a 12-month prospective study. The samples were analyzed by metagenomic bacterial 16S ribosomal RNA sequencing and processed using the Quantitative Insights Into Microbial Ecology (QIME) pipeline. Differentially abundant species were identified and used to build a dysbiosis index. A machine learning model trained on microbial abundance data was used to test the power of microbiome alterations to distinguish between healthy individuals and CVID patients. Compared to controls, the oropharyngeal microbiome of CVID patients showed lower alpha- and beta-diversity, with a relatively increased abundance of the order Lactobacillales, including the family Streptococcaceae. Intra-CVID analysis identified age >45 years, COPD, lack of IgA, and low residual IgM as associated with a reduced alpha diversity. Expansion of Haemophilus and Streptococcus genera was observed in patients with undetectable IgA and COPD, independent from recent antibiotic use. Patients receiving azithromycin as antibiotic prophylaxis had a higher dysbiosis score. Expansion of Haemophilus and Anoxybacillus was associated with acute respiratory infections within six months. CVID patients showed a perturbed oropharynx microbiota enriched with potentially pathogenic bacteria and decreased protective species. Low residual levels of IgA/IgM, chronic lung damage, anti antibiotic prophylaxis contributed to respiratory dysbiosis.

Bacillus cereus Sensu Lato Accelerate Cellular Bioenergetic Metabolism of Human Colorectal Adenocarcinoma Caco-2 Cell Line.

How foodborne enterotoxigenic Bacillus cereus rewires energy metabolism during intestinal tract infection is still not understood. In this study, we used the Seahorse XFe technology to simultaneously analyze oxygen consumption and acidification rates to estimate bioenergetic changes in the intestinal Caco-2 cell line after exposure to the B. cereus sensu lato (s.l.) enterotoxin-producing pathotypes, American Type Culture Collection (ATCC) 14579 (836), NVH0391-98 (828), and NVH0075/95 (825). Infection of Caco-2 led to a more energetic phenotype due to increased flux through oxidative phosphorylation and glycolysis. Strain 836 caused the most pronounced effects toward the specific energy phenotype, followed by strains 828 and 825. However, the metabolic potential of Caco-2 cells was most strongly induced by the 828 strain. Furthermore, infected cells manifested an increased adenosine triphosphate (ATP) production rate. Strain 828 caused the highest glycolytic and mitochondrial ATP production rates, followed by the 836 and 825 B. cereus s.l. strains. The glycolytic stress assay showed that strains 828 and 826 slightly increased compensatory glycolysis, providing a better understanding of the pathogenicity of this versatile pathogen. The results of this study underline that extracellular flux measurement can be used to accurately estimate bioenergetic perturbations of Caco-2 cells as a consequence of infection. Our findings enhance our understanding of how intestinal cells adjust their metabolism during infection with B. cereus s.l.

ASSESSING KNOWLEDGE, ATTITUDES, AND PRACTICES OF HEALTHCARE PROFESSIONALS REGARDING HOSPITAL ACQUIRED INFECTION IN TERTIARY CARE TEACHING HOSPITAL AT EASTERN NEPAL: CROSS-SECTIONAL STUDY

Hospital-acquired infections (HAIs) are a common problem and represent significant challenges to the effective delivery of healthcare services faced by hospitals in all countries around the world. Healthcare workers (HCWs) are an important part of the healthcare team that plays a unique role in the control of HAIs. Compliance on the part of healthcare workers (HCWs) with standard precautions has been recognized as being an efficient means to prevent and control HAIs. Objective: The present study was conducted with objective of understanding the level of Knowledge, attitude and practice (KAP) regarding Hospital-acquired infections (HAIs) among health care workers in the Eastern region of Nepal. Method:This descriptive cross-sectional study was conducted among healthcare workers posted in different wards of hospitals of BPKIHS. A self administered questionnaire containing different set of questions regarding knowledge, attitude and practice on HAI were used for data collection. Simple random sampling method was employed. Statistical package for social sciences (SPSS) was used to analyze the data and presented in frequency tables and graph. Results: Regarding knowledge of the participants: Among the total participants in the study, 97% of the participants had good knowledge regarding Hospital acquired infections (HAIs) but only 72% of the participants had received formal training regarding hand hygiene. 97 % participants agreed on the fact that hand hygiene act should be performed before and after direct patient contact. Highest proportions of the participants (97%) were aware of the fact that washing hands with antiseptic decreases the risk of transmission of hospital acquired pathogens. Large proportion of the respondents ( 95%) were aware of the fact that Gloves should be worn if blood or body fluid exposure is anticipated and still considered that gloves provided complete protection against acquiring/ transmitting infections. Hand hygiene (89%) and Personal protective equipment 68%) were common preventive measures of transmission of hospital acquired infection. The common sources of acquiring infections was uniform (59%) whereas commonly hospital acquired infection (HAIs) were reproductive tract infection (86%) and gastro -intestinal tract (GIT) infection (76%) and most susceptible group to hospital acquired infections (HAIs) were OT assistants (74%), Lab technicians(69%) etc. Regarding attitude of the participants, 91% of the participants felt that they would be less likely to transmit infection to the patient if they performed hand-hygiene. Regarding various hindrances in adoption of hand hygiene, few of the respondents (48%) identified that hand hygiene agents were not readily available in our current settings. 31% of the health care workers reported that they often forgot to perform hand hygiene.42% of health care workers found that Gloves are always available when they wanted. 25% of health workers believed that there was very low risk of acquiring infections from my patients.79 % participants thought that all patients are potentially contagious while 88% transmission of hospital acquired infections occurred through unsterilized use of needles and sharp objects. Regarding practice of the participants , majority of respondents (more than 90%) performed hand hygiene before patient contact, after patient contact and caring for wound.95% of the participants practiced hand hygiene after removal of gloves. Majority of the participants (97%) washed their hands after handling every patient. 74% participants practiced of using reusable instruments while 86% respondents practiced of using pre-sterilized instruments. 82 % of the participants exposed to patients blood. Conclusion: All health workers had good knowledge regarding Hospital-acquired infections (HAIs) that was reflected in their attitude and practice on hand hygiene for the prevention of HAIs. However there is the need of regular training and performance feedback regarding hand hygiene and the hospital environment should be hand-hygiene friendly with easily accessible to sinks and other facilities. Improving sustainable supplies like personal protective equipment, water supply and hand washing facilities at patient care site is vital to reduce nosocomial infection. Therefore health workers should strictly follow hospital acquired infection prevention guidelines to reduce infections.

Role of aggregate-forming pilus (AFP) in adherence and colonization of both intestinal and urinary tracts

ABSTRACT Hybrid-pathogenic Escherichia coli represent an important group of strains associated with intestinal and extraintestinal infections. Recently, we described strain UPEC-46, a uropathogenic/enteroaggregative E. coli (UPEC/EAEC) strain presenting the aggregative adherence (AA) pattern on bladder and colorectal epithelial cells mediated by aggregate-forming pili (AFP). However, the role of AFP and other uninvestigated putative fimbriae operons in UPEC-46 pathogenesis remains unclear. Thus, this study evaluated the involvement of AFP and other adhesins in uropathogenicity and intestinal colonization using different in vitro and in vivo models. The strain UPEC-46 was able to adhere and invade intestinal and urinary cell lines. A library of transposon mutants also identified the involvement of type I fimbriae (TIF) in the adherence to HeLa cells, in addition to colorectal and bladder cell lines. The streptomycin-treated mouse in vivo model also showed an increased number of bacterial counts in the colon in the presence of AFP and TIF. In the mouse model of ascending urinary tract infection (UTI), AFP was more associated with kidney colonization, while TIF appears to mediate bladder colonization. Results observed in in vivo experiments were also confirmed by electron microscopy (EM) analyses. In summary, the in vitro and in vivo analyses show a synergistic role of AFP and TIF in the adherence and colonization of intestinal and urinary epithelia. Therefore, we propose that hybrid E. coli strains carrying AFP and TIF could potentially cause intestinal and urinary tract infections in the same patient.

Babies, Bugs, and Barriers: Dietary Modulation of Intestinal Barrier Function in Early Life.

The intestinal barrier is essential in early life to prevent infection, inflammation, and food allergies. It consists of microbiota, a mucus layer, an epithelial layer, and the immune system. Microbial metabolites, the mucus, antimicrobial peptides, and secretory immunoglobulin A (sIgA) protect the intestinal mucosa against infection. The complex interplay between these functionalities of the intestinal barrier is crucial in early life by supporting homeostasis, development of the intestinal immune system, and long-term gut health. Exclusive breastfeeding is highly recommended during the first 6 months. When breastfeeding is not possible, milk-based infant formulas are a safe alternative. Breast milk contains many bioactive components that help to establish the intestinal microbiota and influence the development of the intestinal epithelium and the immune system. Importantly, breastfeeding lowers the risk for intestinal and respiratory tract infections. Here we review all aspects of intestinal barrier function and the nutritional components that impact its functionality in early life, such asmicronutrients, bioactive milk proteins, milk lipids, and human milk oligosaccharides. These components are present in breast milk and can be added to milk-based infant formulas to support gut health and immunity.

Phenolic Compounds and Antimicrobial Activity of Olive (Olea europaea L.) Leaves

Background: Olive leaves are of great interest, especially in traditional medicine. The polyphenols contained in olive leaves play an important role in this respect, as they have anti-carcinogenic, anti-inflammatory and anti-microbial properties. Olive leaves share phenolic compounds with other plants, but they also contain phenolic compounds belonging to the Oleaceae family. Methods: We report the determination of phenolic compounds in olive leaves by HPLC and the evaluation of their in vitro activity against several microorganisms that may be causal agents of human intestinal and respiratory tract infections, Staphylococcus aureus, Bacillus cereus, Escherichia coli, Pseudomonas aeruginosa, Klebsiella pneumonia, Enterobacter cloacae, Proteus mirabilis and Salmonella typhimurium. Result: The results reveal that the olive leaves may constitute a good source of antimicrobial agents. The high performance liquid chromatography (HPLC) analysis showed the presence of five phenolic compounds: oleuropein, ascorbic acid, rutin, catechinand verbascoside and for the first time ascorbic acid. At low concentrations, olive leaf extracts showed an unusual antibacterial action, which suggests their great potential as nutraceuticals, particularly as a source of phenolic compounds.

Isolation of Biofilm Producing Bacteria from Stool Samples and Their Antibiogram

Aim: Bacterial biofilm formation is a menacing attribute that has been linked to a rise in antibiotic resistance. The aim of this study was to isolate biofilm-producing bacteria from stool samples and their antibiogram. Study Design: The study involved laboratory research, statistical analysis and interpretation of the data. Place and Duration of Study: The research was carried out in three (3) hospital facilities. They are University of Port Harcourt Teaching Hospital (UPTH), Meridian Hospital D/line branch (MRD1), and Meridian Hospital Ikoku branch (MDR2). Specimens were gathered within three (3) months, and analyses were performed. Methodology: 45 stool specimens were collected from the three (3) hospitals. The specimens were correctly labelled with the sampling date and time. Standard microbiological procedures were performed on the collected specimens, including plate counts, identification, biofilm screening, sensitivity testing, extended spectrum beta lactamase phenotypic screening, and molecular characterization of the isolates. Results: The total heterotrophic bacterial counts ranged from 6.2 to 8.2 x107 cfu/g, total coliform counts ranged from 3.2 to 4.1 x106 cfu/g and faecal coliform counts ranged from 1.3 to 1.4 x105 cfu/g. There was no significant difference at (p≤0.05) in the total heterotrophic bacterial counts, total and faecal coliform counts between the hospitals sampled. A total of Thirty-two (32) bacterial isolates were identified in stool specimens, with 20 (62.5%) of them being biofilm producers. Staphylococcus 30%, 35% Escherichia coli, 25% Enterococcus and 10% Bacillus species were detected among biofilm bacteria. Biofilm isolates showed a variety of susceptibility patterns and antibiotic resistance was found in biofilm bacteria. Most bacterial intestinal tract infections from patients and hospitals investigated can be treated with ofloxacin, Gentamycin, Imipenem, and Nitrofurantoin. TET A and CTX-M genes, were reported in Bacillus subtilis and Escherichia coli biofilm bacteria as possible genes that could confer antibiotic resistance.The existence of the icaD and papC genes in Bacillus subtilis and Escherichia coli has been discovered to be probable determinants that impart biofilm forming abilities, according to genomic studies. Conclusion: The existence of biofilm-producing bacteria in patients’ stools, as well as their antibiotic resistance, was observed in this study. Ceftazidime (third generation cephalosporin) resistance was found in both biofilm and non-biofilm bacteria. This research reveals that ofloxacin, Gentamycin, Imipenem, and Nitrofurantoin are the drugs of choice for bacterial intestinal tract infections caused by Escherichia coli, Staphylococcus, Enterococcus, and Bacillus species. As a result, proper infection control techniques and therapeutic recommendations for proven infections should be swiftly implemented.

DETERMINATION OF GENOTYPIC PROFILES OF ESCHERICIA COLI STRAINS BY PFGE MOLECULAR METHOD

From the family Enterobacteriaceae is Escherichia coli ( E. Coli) is a pathogenic bacterium that is becoming increasingly important, especially in hospitals, common social areas. Thanks to the broad-spectrum beta-lactams (ESBL) they produce, they are usually multi-resistant and are common in intestinal and urinary tract infections. It is of great importance to reduce cross-contamination from public areas and to examine and reveal the genotype structure of the bacteria in question, i.e. to reach fingerprints, subtype sequences of strains. 50 E. Coli strains selected in the study were typified by Pulse field gel electrophoresis.

Escherichia coli Colonization of Intestinal Epithelial Layers In Vitro in the Presence of Encapsulated Bifidobacterium breve for Its Protection against Gastrointestinal Fluids and Antibiotics.

Encapsulation of probiotic bacteria can enhance their functionality when used in combination with antibiotics for treating intestinal tract infections. The interaction strength of encapsulating shells, however, varies among the encapsulation methods and impacts encapsulation. Here, we compared the protection offered by encapsulating shells with different interaction strengths toward probiotic Bifidobacterium breve against simulated gastric fluid and tetracycline, including protamine-assisted SiO2 nanoparticle yolk–shell packing (weak interaction across a void), alginate gelation (intermediate interaction due to hydrogen binding), and ZIF-8 mineralization (strong interaction due to coordinate covalent binding). The presence of encapsulating shells was demonstrated using X-ray-photoelectron spectroscopy, particulate microelectrophoresis, and dynamic light scattering. Strong interaction upon ZIF-8 encapsulation caused demonstrable cell wall damage to B. breve and slightly reduced bacterial viability, delaying the growth of encapsulated bacteria. Cell wall damage and reduced viability did not occur upon encapsulation with weakly interacting yolk–shells. Only alginate-hydrogel-based shells yielded protection against simulated gastric acid and tetracycline. Accordingly, only alginate-hydrogel-encapsulated B. breve operated synergistically with tetracycline in killing tetracycline-resistant Escherichia coli adhering to intestinal epithelial layers and maintained surface coverage of transwell membranes by epithelial cell layers and their barrier integrity. This synergy between alginate-hydrogel-encapsulated B. breve and an antibiotic warrants further studies for treating antibiotic-resistant E. coli infections in the gastrointestinal tract.

Repurposing of FDA approved drugs and their validation against potential drug targets for Salmonella enterica through molecular dynamics simulation

Salmonella is a widely distributed pathogen causing infection of intestinal tract, typhoid, and paratyphoid fever. Number of drugs was developed against salmonella, but in the last few decades due to the emergence of drug resistant strains, most of these drugs became dormant. As a result Salmonellosis emerges as a trivial cause of human mortality worldwide; therefore, there is an urgent need for unexploited drug targets and drugs to treat Salmonellosis. As development of new drug molecules is very time consuming and costly, drug repurposing is in consideration as a better alternative. With the aim to identify a new drug molecule against the Salmonella through repurposing approach, we utilized 14 well reported druggable targets known to play a vital role in the life cycle of pathogens. These targets were used to screen DrugBank and got 53 FDA approved drugs against them. To find the interaction between considered target proteins and screened drugs, molecular docking was performed. Fourteen docked drug-target complexes with reasonable binding affinities were subjected to Molecular Dynamics Simulation (MDS) at 150 ns, using Amber18. At the end MMPBSA and MMGBSA calculations were performed for all stable complexes and finally, got 3 precise and favourable complexes, i.e. ArcB-Cefpiramide, MrcB-Cefoperazone, and PhoQ-Carindacillin. Rigorous structural and energetic analysis for these complexes validates the potential of drug molecules to act as therapeutic drugs against Salmonella enterica. With this study we hypothesize that the drugs Cefpiramide (DB00430), Cefoperazone (DB01329) and Carindacillin (DB09319) will be the good repurposed-drugs for the treatment of Salmonellosis. Communicated by Ramaswamy H. Sarma

Antimicrobial Evaluation of Plant Parts of Rauwolfia Vomitoria

Aims: This study was aimed at evaluating the antimicrobial activities of fractions of Rauwolfia vomitoria against some isolates including; Salmonella typhi, Escherichia coli, Candida albicans, Aspergillus niger, Microsporon canis, and Trichophyton rubrum.
 Methodology: Primary extraction was done on the dried and pulverized plant samples (leaves, barks, and root) using methanol, after which the crude extracts was fractionated using butanol, ethyl acetate, and n-hexane respectively. The samples were duly labelled according to the plant parts and solvents used. Agar diffusion and dilution methods on Mueller-Hinton agar (MHA) and Sabouraud dextrose agar (SDA) where used to determine the minimum inhibitory concentrations (MIC) and minimum bactericidal and fungicidal concentrations (MBC/MFC) respectively. The percentage inhibition diameter growth (PIDG) of the extracts and fractions were also determined.
 Results: From the results, eleven (11) samples showed inhibitory activity on one or more of the test isolates. Extended spectrum activity was observed with five (5) of the samples, including; RVL ethyl acetate, RVL n-hexane, RVB crude, RVR crude, and RVR ethyl acetate against S. typhi, E. coli, and M. canis. Antifungal activity was observed only against M. canis. The ethyl acetate fraction of the leaves (RVLE) and crude methanol extract of the bark (RVBC) gave the least MIC both against M. canis at a concentration of 25 mg/ml, while the ethyl acetate fraction of the leaves (RVLE) at 12.5 mg/ml also against M. canis gave the least MBC/MFC. Using the inhibition zone diameters (IZD), the obtained PIDG showed apparently that the ethyl acetate fraction of the leaves (RVL ethyl acetate) was the most active against S. typhi (28.57%) and E. coli (20%).
 Conclusion: The study lends support to the traditional use of the plant especially in treating gastro intestinal tract and skin infections.

Disseminated Mycobacterium abscessus subsp. massiliense infection in a Good\u2019s syndrome patient negative for human immunodeficiency virus and anti-interferon-\u03b3 autoantibody: a case report

BackgroundGood’s syndrome (GS) is characterized by immunodeficiency, and can lead to severe infection, which is the most significant complication. Although Mycobacterium rarely causes infection in patients with GS, disseminated nontuberculous mycobacterial (NTM) infection frequently occurs in GS patients that are also positive for the human immunodeficiency virus (HIV) or anti-interferon (IFN)-γ autoantibodies. Here, we report a rare case of GS with NTM without HIV or IFN-γ autoantibodies.Case presentationA 57-year-old Japanese male with GS and myasthenia gravis (treated with prednisolone and tacrolimus) was diagnosed with disseminated NTM infection caused by Mycobacterium abscessus subsp. massiliense. He presented with fever and back pain. Blood, lumbar tissue, urine, stool, and sputum cultures tested positive for M. abscessus. Bacteremia, spondylitis, intestinal lumber abscess, and lung infection were confirmed by bacteriological examination and diagnostic imaging; urinary and intestinal tract infections were suspected by bacteriological examination but not confirmed by imaging. Despite multidrug combination therapy, including azithromycin, imipenem/cilastatin, levofloxacin, minocycline, linezolid, and sitafloxacin, the patient ultimately died of the infection. The patient tested negative for HIV and anti-IFN-γ autoantibodies.ConclusionsSince myasthenia gravis symptoms interfere with therapy, patients with GS and their physicians should carefully consider the antibacterial treatment options against disseminated NTM.

A REVIEW ARTICLE ON: ANTIBIOTIC RESISTANCE

Antibiotics are the ‘wonder drugs’ to combat microbes. For decades, various types of antibiotics have not only been used for therapeutic purposes but practiced prophylactically across other industries such as agriculture and animal husbandry. Antibiotic-resistant infections correlate with the level of antibiotic consumption. Non-judicial use of antibiotics is one of the reason for making the microbes resistant. The antibiotic therapy store for emerging hard-to-treat multidrug-resistant bacterial infections is limited, resulting in high morbidity and mortality report. As per the World Health Organization “First worldwide Report on Antibiotic Resistance”, and the U.S. Centers for Disease Control & Prevention (CDC&P) and the spread of “superbugs” - bacteria that have changed in ways that provided antibiotics non effective against them - is a severe and growing threat around the world. Once common treatments for not only everyday intestinal and urinary tract infections but also pneumonia as well as infections in newborn and diseases like gonorrhea are no longer working in people. Thus, in 2013, two million people in the U.S. were affected by antibiotic-resistant bacteria, and 23,000 of them die each year as a result.
 Keywords: Wonder drugs, antibiotic resistance, CDC&P, Superbugs etc.

Detection of Mycobacterium avium subsp. paratuberculosis (MAP) from Subclinical Caprine Paratuberculosis Cases of Odisha

Paratuberculosis is caused by Mycobacterium avium subsp. Paratuberculosis (MAP) and is a chronic, intestinal tract infection in the ruminant sector globally. A total of 122 EDTA mixed blood samples, 121 serum and 16 pooled faecal samples were collected from farms of 4 different districts i.e. Nayagarh, Cuttack, Khordha and Angul and a blind review was conducted at the Animal Health Division, CIRG, Mathura. Microscopic examination of 16 pooled faecal samples revealed +2 reactivity to Acid-Fast Bacilli. All the serum samples were subjected to indirect ELISA. Out of them, 23 (19.01%), 85 (70.25%), shows strongly positive, positive, antibody titre respectively. EDTA blood samples of 23 ELISA-strongly positive were subjected to 413 bp IS900 PCR and 11 (9%) of them were found positive for Mycobacterium avium subsp. Paratuberculosis (MAP). MAP isolates were further subjected to genotyping using 608 bpIS1311 PCR and restriction endonuclease analysis (IS1311 PCR-REA) and 2 (1.64%) of them matched with “Indian Bison Type”. Genotyping of the isolates using IS1311 PCR-REA revealed that goat population of Odisha are primarily infected with “Indian Bison Type” strains.

Adverse drug reactions observed in treatment of gastro intestinal and respiratory tract infections: a prospective analysis

Background: The aim of the study was to observe common adverse drug reactions in treatment of gastro intestinal and respiratory tract infections in a tertiary care hospitals.Methods: A prospective observational study was conducted by Departments of Pharmacology for a period of one year from prescriptions and case sheets of medical record section. Adverse drug reaction reporting forms and alert cards were used for reporting.Results: The drugs most commonly used for gastrointestinal tract and respiratory diseases are tablets norflox 400 mg, norflox-tz, taxim 200 mg, IV amikacin and iv amoxicillin (500 mg) and clavulanic acid (125 mg) combination. Systems affected by use of above drugs were skin and gastrointestinal tract. Urticaria on skin, abdominal pain, itching in genital area, ulcer on oral mucosa are the common adverse drug reactions observed.Conclusions: Drugs used for common gastrointestinal tract and respiratory tract infections alert cards should be issued to patients when prescribing and adverse drug reactions should be reported to higher centres. Brand names causing adverse reactions should be monitored regularly and their further usage should be based on signals from other centres. All tertiary care hospitals should have antimicrobial guidelines policy to reduce adverse drug reactions.

1607 The Hidden Parasite

INTRODUCTION: Parasite identification during routine colon cancer screening is unexpected and rather unusual. Schistosoma is a tropical parasite associated to freshwater snails; among which S. mansoni and S. japonicum species have been associated with intestinal tract infection. Although most patients are asymptomatic, identification is crucial to avoid possible complications like chronic intestinal schistosomiasis or hepatosplenic schistosomiasis. CASE DESCRIPTION/METHODS: A 57-year-old Puerto Rican Vietnam veteran with history of schizophrenia and chronic liver disease secondary to Hepatitis C underwent colonoscopy for average-risk colorectal cancer screening. During colonoscopy, a one-centimeter polyp at 15cm was completely removed by hot snare and six additional small sessile polyps in the rectum by cold forceps. Pathology was remarkable for a tubular adenoma, while one of the rectal polyps identified a non-necrotizing granuloma suggestive of schistosoma parasite. Patient had shown no GI symptoms or complaints and was treated with Praziquantel. DISCUSSION: Puerto Rico is an endemic area for schistosoma. Schistosomiasis is a chronic parasitic disease with significant cause of morbidity and mortality. Intestinal polyps and dysplasia can arise due to granulomatous inflammation surrounding eggs deposited in the bowel wall. Gastrointestinal manifestations may result in chronic abdominal pain, poor appetite, and diarrhea for which early identification is necessary for treatment even in the asymptomatic setting.

Comparative study of immune responses elicited by outer membrane vesicles of different Pseudomonas aeruginosa strains

BackgroundPseudomonas aeruginosa (P. aeruginosa) is an opportunistic mucosal human pathogen that naturally releases outer membrane vesicles (OMVs) in different environments, as do other Gram-negative bacteria. The intestinal tract infections caused by P. aeruginosa increase the risk of respiratory infections and mortality of other diseases related to gut infections. Therefore, in this study, we attempted to investigate toll-like receptor (TLR) signaling pathways and immune response profiles of human colon adenocarcinoma (Caco2) cell line exposed to the OMVs of three different P. aeruginosa strains (i.e., antibiotic-susceptible, multi-drug resistant (MDR), and standard lab ATCC 17933). Materials and methodsReal-time quantitative reverse transcription PCR array was carried out to determine mRNA expression in 84 TLRs signaling pathway genes, and the production of specific cytokines was measured by ELISA. ResultsOMVs of different strains could induce unique changes in regulating TLRs signaling pathways, such that there were remarkable differences in pro-inflammatory effects and anti-inflammatory responses among the three strains. ConclusionThe more complete immune responses observed through the MAMPs caused by MDR strain OMVs interactions with Caco2 lead us to the conclusion that the use of MDR or cystic fibrosis strain OMVs for better known the host immune responses seems preferable.

What is the recent trend in the clinical study of liver abcess cases?

Background: Liver abscesses commonly occur secondary to biliary or intestinal tract infections, haematogenous seeding or extension of contiguous infection, and carry a mortality rate of 20-60% even with appropriate medical-surgical management. The aims of the study were to study the current prevelence of etiological factors in cases of liver abscess, to study clinical presentations in cases of liver abscess and study outcomes of the current trend in investigations and outcomes of the modes of treatment in cases of liver abscess.Methods: 50 patients with the diagnosis of liver abscess belonging to various age groups and socio-economic status are included in the study. Written consent and a pre designed proforma was taken from all the patients and to collect relevant data form the patients included in the study.Results: In our study of 50 cases of liver abscess age ranges from 16 to 65, with majority of patients being in young age group (14-34 years). The median age for our study of liver abscess is 31. In our study, there were number of males 41 (82%) greater than females 9 (18%). In our study, right hypochondrium pain 12 cases (24%) was the most common presenting symptom among all liver abscess.Conclusions: Percutaneous aspiration along with medical management yields far better results. Ultrasonography is the most important recommended tool for the initial diagnostic investigation in liver abscess cases with percutaneous aspiration and pigtailing. Hence the prognosis of liver abscess has been improved with different advanced modalities in the management of liver abscess with less or no mortality except in patients with malignant disease.

Potential non-dairy probiotic products – A healthy approach

Abstract The consumer demand has changed from energy providing diet to the diet with balanced nutrient profile along with metabolic, physiological, health and functional benefits. Probiotics, neutraceutical and functional foods belong to such diet category. Probiotics are selective viable micro-organisms administered in adequate amount to confer health benefits beyond inherent general nutrition. These microorganisms have various health promoting functions like prevents intestinal tract infections, improves lactose metabolism, reduces serum cholesterol level, enhance immunity, stimulates calcium absorption, improves protein digestibility, synthesis of vitamins (vitamin B, nicotinic acid and folic acid), and counteracts the effects of food-borne pathogens. For wider distribution and acceptability, probiotic must be low cost, convenient and viable during the processing, storage and consumption. Consumer health consideration from the perspective of cholesterol in probiotic dairy products for the developed countries and economic reasons for the developing countries has diverted research towards non-dairy based probiotics. This has led to development of rapidly emerging cereals, legumes, fruits and vegetables based non-dairy probiotics. These alternative sources are cheaper in cost, possess more phytochemicals and can reduce the risk of cholesterol problems in lactose intolerance people.

Characteristics of Good's Syndrome in China: A Systematic Review.

Background:Good's syndrome (GS) is a rare disease characterized by thymoma, hypogammaglobulinemia, low or absent B-cells, decreased T-cells, an inverted CD4+/CD8+ T-cell ratio and reduced T-cell mitogen proliferative responses. GS is difficult to diagnose preoperatively due to its rarity and lack of typical symptoms, the characteristics of Chinese GS patients are still lacking. This study aimed to systematically review all the clinical, laboratory, and immunologic findings of reported cases of Chinese patients with GS.Methods:We searched for case reports and articles up to January 2017 using PubMed, China National Knowledge Infrastructure, Wangfang database and China Science and Technology Journal Database with the following words in combinations as key words: “thymoma,” “hypogammaglobulinemia,” and “Good's syndrome.” The text words and MeSH terms were entered depending on the databases characteristics. The reference lists from retrieved articles were also screened for additional applicable studies. The authors were restricted to Chinese. There was no language restriction.Results:Forty-seven patients were reported in 27 studies. We found that GS has a nationwide distribution and that most cases (83%) have been described on the mainland of China. The initial clinical presentation is varied, ranging from symptoms related to the thymoma to infections resulting from immunodeficiency. Type AB (50%) is the most common histologic type of thymomas in Chinese GS patients according to the World Health Organization classification of thymomas. With respect to infection, sinopulmonary infection (74%) is the most common type, followed by skin infection (10%) and intestinal tract infection (10%). Diarrhea was presented in 36% of patients, and autoimmune manifestations were presented in 36% of patients.Conclusions:GS is a rare association of thymoma and immunodeficiency with a poor prognosis. Astute clinical acumen and increased awareness of the clinical and immunological profile of GS are needed to increase early diagnosis, that would benefit improved therapeutic effects.