Microbial Flora In Patients Research Articles

Metagenomic Analysis of Biliary Microbial Flora in Patients with Gallbladder Cancer or Gallstones-Associated Chronic Cholecystitis

Biliary dysbiosis is associated with gallbladder cancer (GBC). We aimed to look for biliary bacteria specifically detected in GBC patients. We used 16S rRNA-based metagenomic analysis to elucidate biliary microbiota in 30 GBC and 30 gallstones-associated chronic cholecystitis patients. Relative abundance of five genera, Streptococcus, Enterococcus, Halomonas, Escherichia and Caulobacter was significantly associated with GBC. Of 15-species, 7 were detected significantly higher in GBC, Streptococcus anginosus, Streptococcus constellatus, Streptococcus intermedius, Actinomyces bowdenii, Actinomyces israelii, Actinomyces gerencseriae, and Escherichia fergusonii were biosafety level-2 infectious bacteria; other 8 species were biosafety level-1 bacteria. These bacterial species may be involved in pathogenesis of GBC.

Microbial Diversity and Abundance in Pulmonary Tissue of Patients with Early-Stage Lung Cancer

Background: The composition of lung tissue microorganisms in patients with different tissue types of lung cancer has not yet been determined. Previous studies have shown changes in the composition of pulmonary microbial flora in patients with lung cancer. Objectives: This study aimed to investigate the differences and correlations in the microbial flora of pulmonary tissue among different histological types of lung cancer. Methods: Samples of tumor and normal lung tissue from 29 patients with early-stage lung cancer were collected. The samples were sequenced using Illumina HiSeq high throughput sequencing technology for 16S rDNA in the V4 region of the bacteria. Also, their microbiological characteristics were detected, and bioinformatics analysis was performed. Results: The results of microbial abundance analysis in the lung tissue of patients with lung cancer showed that the bacterial colony composition of the two tissues was similar, with Proteobacteria, Firmicutes, Anomalococcus, Bacteroides, and Actinobacteria predominating. Analysis of microbial diversity found no difference in α diversity and β diversity between normal lung tissue and tumor tissue. When analyzing patients with adenocarcinoma, the abundance of Micrococcales and Blastomonas was significantly higher in tumor tissue than in normal lung tissue. Conclusions: The composition of microbial flora in different parts of lung tissue of early-stage lung cancer patients is consistent, but the dominant flora varies among different histological types of lung cancer.

Microbial community structure of different tongue fur types in patients with chronic gastritis.

To explore the correlation between tongue and oral microbiota, we studied the microbial community structure of different tongue coating types in patients with chronic gastritis. 16S rDNA gene sequencing and bioinformatics analysis were used to study the dynamic changes and correlation of microbial flora in patients with chronic gastritis, healthy people, and patients with different tongue fur. In addition, it was also discussed between the severity of gastritis and the microflora of tongue fur. The microbial diversity of tongue fur in patients with chronic gastritis was significantly different from healthy controls. There were significant changes in bacterial communities' diversity and relative abundance between extra tongue fur in patients but not in healthy people. Oral bacteria with relative abundance > 1% and < 0.05 among different tongue fur flora were dominant bacteria, including 12 phyla such as and , and 256 genera such as and . The changes in oral flora in patients with chronic gastritis were related to tongue fur. Therefore, the significant microbiota might enlighten further study on the correlation between tongue inspection and oral microbiota in patients with chronic gastritis.

Type of microbial flora in patients with bone and joint infections: Our experience at a tertiary care center of Eastern India

Introduction: Bone and joint infections are very common in eastern India. Due to the lack of authentic data on the type of bacteriology in our region, this study was planned. Materials and Methods: After ethical clearance, retrospective data of 2 years from 2019 to 2021 were collected. Out of 115 patients, 77 patients were included in the study whereas 38 were excluded due to nonbacterial infections and incomplete data. Results: The average age of patients was 21.14 years. Pediatric patients were 58.66%. The common clinical condition was chronic osteomyelitis, followed by septic arthritis. The most common bone affected was femur, followed by tibia. The most common organism noted was methicillin-resistant Staphylococcus aureus (MRSA) and coagulase-negative Staphylococcus aureus (CNSA). Gram-negative infections were also noted. Conclusions: Eastern India has a high incidence of bone and joint infection. MRSA followed by CNSA is the most common isolate affecting large bones such as femur and tibia.

Neutropenic versus regular diet for acute leukaemia induction chemotherapy: randomised controlled trial

ObjectivesRestriction of raw fruits and vegetables (neutropenic diet) is advised for patients receiving treatment for acute leukaemia in low-income and middle-income countries (LMICs) to reduce infections despite evidence to the...

Study of Conjunctival Microbial Flora in Patients of Intensive Care Unit.

PurposeThe objective of the study was to evaluate the type of conjunctival microbial flora in intensive care unit patients and their antimicrobial sensitivity pattern.MethodsA total of 272 samples (conjunctival swabs) were taken from patients in various intensive care units and sent for culture and sensitivity. An ocular examination was done to look for lagophthalmos, conjunctival discharge, exposure keratitis, and corneal perforation.ResultsMajority (82.1%) of the samples showed at least one microbial isolate while 29 (10.7%) samples showed multiple microbial growth. The most common microbes were coagulase negative Staphylococcus spp. (41.5% of isolates), diphtheroids (11.0% of isolates), and Staphylococcus aureus (9.6% of isolates) which are the usual commensals of the ocular surface. Of the other microbes isolated, Pseudomonas aeruginosa (4.0%) was the most common. Eighty-four percent isolates of coagulase negative Staphylococcus sp., 81.8% isolates of diphtheroids and 100% isolates of Staphylococcus aureus were penicillin resistant. All isolates of Enterococcus fecalis were sensitive only to vancomycin. Two hundred and twenty eyes (80.9%) had varying degrees of lagophthalmos. Nineteen (7.0%) had severe corneal exposure changes leading to infectious corneal ulcer and perforation in all of them.ConclusionsThe isolates in patients of intensive care units were no different from the normal conjunctival flora though few pathogenic organisms such as Pseudomonas aeruginosa and Acinetobacter sp. were also isolated. Most of the isolates were penicillin resistant. This knowledge will help take appropriate prophylactic measures to contain ocular infections in the intensive care units.

Oral Bacteriotherapy in Patients With COVID-19: A Retrospective Cohort Study.

Background: Mounting evidence suggests SARS-CoV-2 may impact on host microbiota and gut inflammation, infecting intestinal epithelial cells. This possible link and its implications can be investigated by observing the effects of modulation of the microbial flora in patients with COVID-19. The aim of this study was to compare the rate of mortality, the need of ICU hospitalization and the length of hospitalization in patients with severe COVID-19 pneumonia who received the best available therapy (BAT) vs. patients treated with BAT and supplemented with oral bacteriotherapy.Methods: This retrospective, observational cohort study included 200 adults with severe COVID-19 pneumonia. All patients received therapeutic regimens including low molecular weight heparin plus one or more between hydroxychloroquine, azithromycin, antivirals, and Tocilizumab. Oral bacteriotherapy was used as complementary treatment.Results: Out of the 200 patients, 112 received BAT without oral bacteriotherapy, and 88 BAT with oral bacteriotherapy. Crude mortality was 22%. Eleven percent died in the group of patients treated with BAT plus oral bacteriotherapy vs. 30% subjects in the group of patients managed only with BAT (p < 0.001). By multivariate analysis, the age >65 years, CRP >41.8 mg/L, Platelets <150.000 mmc, and cardiovascular events were associated with the increased risk of mortality. Oral bacteriotherapy was an independent variable associated with a reduced risk for death. Despite large prospective trials are needed, this study highlights a possible role for oral bacteriotherapy in the management of patients hospitalized for COVID-19 pneumonia.

Gut dysbiosis in Spondyloarthritis: Cause or effect?

Spondyloarthritis (SpA) is a group of chronic, inflammatory rheumatic diseases mainly affecting the axial skeleton. Although the pathogenesis of the disease remains elusive, alterations of intestinal microbial composition have been demonstrated in patients with SpA and associated with intestinal and systemic immune alterations. Substantial data have been published in recent years in ethnically different patient populations, demonstrating in a consolidated way the presence of alterations in the composition of the microbial flora in patients with SpA. It is not currently possible to establish whether these alterations are intrinsically inherent in the disease, for example, the effect of particular genes that confer susceptibility to the disease itself, or are a consequence of a more systemic inflammatory process that also involves the intestine. However, data deriving from animal models and studies on relatives of patients with SpA strongly suggest that these alterations might precede the onset of the disease. In this review, we will try to critically analyze studies on dysbiosis in SpA and animal models of SpA, analyzing their functional consequences and the impact of biotechnological therapies on intestinal bacterial composition.

Ocular Surface Microbial Flora in Patients with Chronic Limbal Stem Cell Deficiency Undergoing Cultivated Oral Mucosal Epithelial Transplantation.

PURPOSE:The purpose of this study is to analyze the ocular surface microbial flora in patients with chronic limbal stem cell deficiency (LSCD) due to Stevens–Johnson Syndrome (SJS) and ocular chemical injury undergoing cultivated oral mucosal epithelial transplantation (COMET).METHODS:Patients of SJS and chemical injury who had bilateral total LSCD planned for COMET were studied. Conjunctival swab was taken before surgery. Parameters evaluated were organism cultured, sensitivity pattern, frequency of positive culture, and clinical impact on management strategy.RESULTS:Thirteen patients were included in which nine were males and four females. All patients had positive conjunctival swab culture. Most common organism isolated was Staphylococcus epidermidis, followed by Staphylococcus aureus and Pseudomonas aeruginosa. The staphylococcal species isolated were sensitive to all the conventional antibiotics while Pseudomonas cultured showed resistance to cefuroxime, ceftriaxone, and ceftazidime. Repeat conjunctival swab sent after a week of topical antibiotic therapy yielded positive culture of the same organism twice in 25% (3/12), thrice in 58.3% (7/12), and four times in 16.6% (2/12) of the patients. One patient had a polymicrobial flora with positive yield of S. aureus (thrice), S. epidermidis (twice), and P. aeruginosa (twice) in consecutive conjunctival swab culture in the absence of clinical infection. Two patients with persistent positive cultures had to undergo repeat oral mucosal harvesting as the transplantation of the cultivated explants had to be deferred.CONCLUSION:Ocular surface in LSCD patients yielded pathogenic organisms on culture. Poor ocular surface with absent tear film could be the contributing factors. It is important to perform the conjunctival swab culture before COMET surgery.

Audit of Microbiological Profile of 95 Serial Cases Presenting with Otorrhea to ENT OPD at Tertiary Care Hospital

ABSTRACT: Otorrhea is a common ENT presentation affecting all the age groups which requires accurate assessment. The etiology of ear discharge is of complex nature, majority being aerobic bacteria, and the rest are anaerobes, fungi and mixed infections. Therefore, the need to determine the cause behind the discharge and to find out the nature and microorganism related to it becomes important. The current study is being conducted to determine the microbial flora in patients presenting with otorrhea and guide towards empirical treatment based on the susceptibility of the safest antimicrobial to the causative organism. The current study is a prospective observational (descriptive) study which involves a preliminary mycobacterial analysis of the ear discharge in a sample of 95 patients presenting with otorrhea. The commonest age group affected in the current study is 20-35 years with males commonly affected. Most common amongst the bacteria are pseudomonas aeruginosa (18.94%) and coagulase negative staphylococcus aureus (14.73%). Mycological profile revealed the predominance of Aspergillus species (9.47%). most common diagnosis was CSOM mucosal (84.21%) followed by CSOM squamous (11.58%). Other less common diagnosis included otomycosis (3.16%) and otitis externa (1.05%).The results of the current study is in concurrence with the other literature available on the microbial flora of otorrhea. However a detailed and in depth prospective study would be more than useful to enrich the knowledge and would enhance the understanding of disease processes which cause acute or chronic otorrhoea, so that appropriate preventive and curative measures can be undertaken.

Comparison of Salivary Bacterial Flora in Iranian Patients with Hiatal Hernia and Healthy Subjects

Objective: To evaluate salivary microbial flora of patients with hiatal hernia and compare it with that of healthy subjects. Material and Methods: In this cross-sectional study, 50 patients with hiatal hernia measuring >1 cm and 50 healthy subjects (as the controls) were selected using simple random technique. One mL of salivary sample was taken from each patient, transferred into 50-mL Falcon tubes and immediately carried to the microbiology Laboratory of Tabriz Faculty of Medicine. The salivary samples were cultured on specific Streptococcus viridans ( S. mitis , S. mutans , S. salivarius and S. sanguis ), Enterococcus spp. and Lactobacillus culture media. Then the samples were incubated at 37°C for 7 days, followed by evaluation of the bacterial colonies. Statistical significance was defined at p 0.05). Conclusion: No significant differences in the counts of Lactobacillus spp., Enterococcus spp., Streptococcus viridans and gram-positive and gram-negative bacterial species between healthy controls and subjects with hiatal hernia.

Malabsorption syndrome and microbial flora in patients with stoma

Malabsorption syndrome and microbial flora in patients with stoma

Characterization of microbial flora in patients suspected of having urogenital tuberculosis

In the structure of tuberculosis morbidity, urogenital tuberculosis (UGT) ranks second or third only to pulmonary tuberculosis. Every fourth patient has the stage of cavern formation at first presentation. Seventy five percent of nephrotuberculosis cases co-occur with nonspecific pyelonephritis, which excludes "sterile pyuria". We aimed to determine the microbial spectrum of urine and gonadal appendages in patients with suspected UGT and to investigate the susceptibility of the isolated microorganisms to the main antibacterial drugs. The study investigated the spectrum of pathogenic microflora isolated from patients admitted to the urogenital clinic of the TB Research Institute from January 1, 2012 to September 30, 2016 to rule out UGT. Microorganism species were identified by time-of-flight mass spectrometry using the microbiological analyzer Phoenix 100 (Becton Dickinson, USA). Antibiotic resistance was determined using the Phoenix 100 microbiological analyzer (Becton Dickinson, USA). A total of 3004 bacteriological tests for nonspecific microflora were performed during the analyzed period. In the structure of pathogens, E. coli comprised about half of the cases thus confirming its role as the leading uropathogen. Only piperacillin/tazobactam and nitrofurantoin provided relatively plausible antimicrobial resistance rates, for other antibacterial drugs the rates of susceptible strains progressively decreased and by 2016 dropped to 40% and lower. Our findings cannot be extrapolated to the entire population since patients presenting for differential diagnosis receive multiple courses of treatment with various antibacterial drugs, which led to the selection of resistant strains. The findings emphasize the need for a strict selection of antibiotics for urogenital infection empirical therapy. In the absence of response, the patient should be immediately examined for tuberculosis using molecular and genetic diagnostic techniques.

The effect of various oral hygiene products on the microbial flora in patients undergoing orthodontic treatment

Context Orthodontic devices lead to significantly greater plaque accumulation and gingival inflammation resulting in a change of gingival flora from cocci and rods to motile organisms like spirochetes. Aims The aim was to study the effect of various oral hygiene products on the microbial flora in patients undergoing orthodontic treatment. Materials and Methods The microbial composition of 40 patients, divided into four groups of 10 patients each, was evaluated. Group I patients were prescribed nonfluoridated dentifrice which act as the control group, Group II patients were given fluoridated dentifrice while in Group III and Group IV fluoridated mouth rinse and cetylpyridinium chloride mouth rinse, respectively, along with nonfluoridated toothpaste was prescribed. The plaque sample was collected at the start of orthodontic treatment, after 30 days, 60 days and 90 days for all the patients. The microscopic slides were prepared and observed under dark field microscopy at the magnification of ×1000 and microbes were classified as cocci, spirochetes, fusiforms, filaments, and rods. Results After applying analysis of variance and Tukey honest significant difference test, it was observed that after 30 days, only the proportion of filaments was found to be significantly higher in Group I. After 60 days, Group I had significantly lower proportion of cocci and a higher proportion of rods as compared to other groups. After 90 days, Group I had significantly higher count of rods, filaments, fusiforms, and spirochetes as compared to Groups III and IV. Conclusion Less amount of the microbial shift to the pathogenic organisms was seen in the patients in whom mouthwashes along with tooth brushing were prescribed.

Role of altered intestinal microbiota in systemic inflammation and cardiovascular disease in chronic kidney disease.

The normal intestinal microbiota plays a major role in the maintenance of health and disease prevention. In fact, the alteration of the intestinal microbiota has been shown to contribute to the pathogenesis of several pathological conditions, including obesity and insulin resistance, among others. Recent studies have revealed profound alterations of the gut microbial flora in patients and animals with chronic kidney disease (CKD). Alterations in the composition of the microbiome in CKD may contribute to the systemic inflammation and accumulation of gut-derived uremic toxins, which play a central role in the pathogenesis of accelerated cardiovascular disease and numerous other CKD-associated complications. This review is intended to provide a concise description of the potential role of the CKD-associated changes in the gut microbiome and its potential role the pathogenesis of inflammation and uremic toxicity. In addition, the potential efficacy of pre- and pro-biotics in the restoration of the microbiome is briefly described.

Unexplained Nausea and Weight Loss in Two Cases of Longstanding CRPS

Dear Editor, Complex regional pain syndrome (CRPS) is a highly painful, limb-confined condition that arises usually after trauma ⇓. The objective of this letter is to highlight unusual presentations of nausea and rapid, dramatic, but then stabilizing weight loss associated with CRPS, which we observed in two of our patients. These are the only noted cases of this type among 190 cases of Budapest CRPS seen at our center since 2007 when a specialized service for this condition was set up. Other investigators have reported that patients with CRPS report with some regularity gastrointestinal (GI) symptoms including weight changes ⇓. In laboratory studies, we had previously demonstrated abnormal intestinal permeability in some patients ⇓, and other investigators have reported alterations in the GI microbial flora in patients with long-standing disease ⇓. To our knowledge, to date, there have been no case reports describing any association between distressing weight loss and CRPS. We hope that our communication can perhaps give an opening for other clinicians who might have encountered similar cases. The first case is of an 18-year-old female who suffered from relapsing/remitting CRPS involving the right shin and ankle, originally diagnosed by her orthopedic surgeon since she was 8 years old. …

Effects of septoplasty on nasal and oropharyngeal microbial flora

We characterized the changes in oropharyngeal and nasal flora of the patients with a deviated nasal septum before and after septoplasty. Patients who underwent septoplasty for nasal septal deviation were included in this study. Nasal and oropharyngeal cultures were taken with a sterile cotton swab preoperatively and one month after septoplasty. Antimicrobial susceptibility testing was performed using the disc method. Fifty-nine patients with a deviated nasal septum were included in the study: 29 women and 30 men, whose ages ranged from 18 to 40 years. There was no significant difference between the preoperative and postoperative (one month after surgery) isolated bacteria of the nasal and oropharyngeal regions. Septoplasty did not change the nasal and oropharyngel microbial flora in patients who underwent septoplasty for nasal septal deviation. Key words: Septoplasty, nasal microbial flora and oropharyngeal microbial flora.

Klinische Daten und Mikrobiologie bei Patienten mit sekundärer und tertiärer Peritonitis

BACKGROUND: Tertiary peritonitis is defined as a severe recurrent or persistent intra-abdominal infection after adequate surgical source control. Aim of the study was to compare clinical outcome and microbial flora of patients with secondary and tertiary peritonitis. METHODS: A retrospective study was conducted between January 2001 and November 2002. Among 118 patients with severe abdominal infections, 43 patients with a positive microbiology were investigated. The Mannheim Peritonitis Index (MPI) score was recorded at the time of operation. RESULTS: Secondary peritonitis was detected in 20 patients (46.5%) and tertiary peritonitis in 23 patients (53.5%). Mean ICU stay was 18.6 days and mean hospital stay 35.5 days. 100 laparotomies including reoperations were carried out at a follow-up of 38 months. MPI scores in patients with tertiary peritonitis (30.4 ± 8.3) were significantly higher than in patients suffering from the secondary form (24.4 ± 8.0; p < 0.025). Mortality in patients suffering from tertiary peritonitis reached 30.4%. Cardiac co-morbidities (p < 0.035) and fungal infections (p < 0.015) were significantly associated with higher mortality rates. Gram negative and anaerobic isolates in patients with secondary peritonitis were joined or even replaced by fungal and gram positive organisms such as Enterococcus faecalis, faecium and Candida. CONCLUSIONS: In our cohort co-morbidities and microbial isolates were insufficient predictors of tertiary peritonitis and fatal outcome. However, cardiac diseases and fungal organisms correlated with higher mortality. The Mannheim Peritonitis Index can successfully assess and compare patients with different prognoses and therapeutic strategies.

Study of the oral microbial flora in patients with renal disease

The aim of this study is to bacteriologically investigate the oral environment in patients with renal disease and thereby reveal their influence on both caries and periodontal diseases. The authors compared oral microbial flora between patients with renal disease (non-haemodialysis: n = 40, haemodialysis: n = 41) and healthy people (n = 62), and also between haemodialysis patients and non-haemodialysis patients in the disease group. Cariogenic bacteria were identified according to Dentocult System, whereas periodontal bacteria were identified using the polymerase chain reaction method. When comparing between patients with renal disease and healthy people, the detected number of cariogenic bacteria and the detection rates of the periodontal bacteria in the patients with renal disease were significantly higher than in healthy people (P < 0.05). When comparing the patients on haemodialysis with those not receiving it, no significant differences in the detected number of cariogenic bacteria were observed. However, the detection rates of periodontal bacteria were lower in patients on haemodialysis (P < 0.05). The findings suggest that patients with renal disease tend to have a high risk of dental caries and periodontal disease than the control.

Evaluation of the levels of oral Candida in patients with Sjögren's syndrome

Objective. The purpose of this study was to investigate the levels of oral Candida in patients with Sjögren's syndrome. Methods. The Candida count and salivary flow rate of patients with Sjögren's syndrome were compared with those of healthy control subjects. Candida cultures were obtained from oral rinses. The numbers of colony-forming units were determined through use of the Spiral System. Results. The mean Candida count of patients with Sjögren's syndrome was 1672 ± 1455 colony-forming units per mL; the count of healthy control subjects was 0.00 colony-forming units per mL. The mean salivary flow rate of patients with Sjögren's syndrome was significantly lower than that of healthy control subjects (0.16 ± 0.13 mL/min/gland vs 0.55 ± 0.24 mL/min/gland, respectively; p = 0.0001). However, Spearman rank correlation analyses did not reveal a significant correlation between salivary flow rate and Candida count (in colony-forming units per mL) among patients with Sjögren's syndrome. Conclusions. Alteration in the oral microbial flora in patients with Sjögren's syndrome may be enhanced by the reduction in salivary output.