Microbiological Environment Research Articles

Evaluation of Three Helicobacter pylori Eradication Protocols in a Digestive Endoscopy Center in Dakar

Introduction: The treatment of Helicobacter pylori (H. pylori) requires the combination of antibiotic therapy with an antisecretory agent. Due to increasing antibiotic resistance, which varies from one geographical region to another, several eradication protocols exist. Objective: The objective is evaluate and compare the efficacy of three treatment regimens for H. pylori infection: 1) Arm A: Omeprazole + Amoxicillin + Clarithromycin for 10 days; 2) Arm B: Omeprazole + Amoxicillin + Metronidazole for 10 days; 3) Arm C: Sequential treatment = Omeprazole + Amoxicillin for 5 days then Omeprazole + Clarithromycin + Metronidazole for 5 days. Patients and Method: This was a prospective randomised study conducted from February 2016 to July 2016 and from April 2017 to September 2017 in the digestive endoscopy center of the gastroenterology and hepatology department of the University Hospital Center Aristide Le Dantec. Our study population consisted of all patients aged 18 years or older referred for upper GI endoscopy. We included all patients whose indication for the examination was epigastralgia and/or dyspepsia and whose rapid urease test was positive. Patients were randomized to the different treatment arms. A 13C-urea breath test was performed at least 4 weeks after stopping antibiotics and 2 weeks after stopping proton pump inhibitor (PPI). Results: We included 120 patients. There were 95 women and 25 men. The mean age was 40 years. Epigastralgia and dyspepsia were present in 90% and 59% of cases, respectively. Upper GI endoscopy showed peptic ulcer in 19.2% and gastroduodenal erosions in 42.5%. The distribution of patients in the different treatment arms was as follows: 40 patients in arm A, 39 patients in arm B and 41 patients in arm C. Treatment was effective in 71.7% of cases in all arms mixed up. Arms A, B and C were effective in 92.5%, 28.2% and 92.7% of cases respectively. The efficacy of arms A and C was like and greater than that of arm B. Conclusion: The therapeutic strategy for H. pylori must consider the local microbiological and ecological environment. Clarithromycin triple therapy and sequential treatment represent effective protocols in our patients.

Systematic Review and Meta-analysis of the Change in Pharyngeal Bacterial Cultures After Pediatric Tonsillectomy.

To review all available biomedical literature to assess published data regarding the effect of pediatric tonsillectomy on the culture results of potentially pathogenic respiratory pharyngeal bacteria before and after surgery. Biomedical literature databases (PubMed, Embase, Web of Science) from January 1970 to December 2019. A systematic review of the literature was performed with the assistance of a medical librarian. Inclusion criteria consisted of pediatric patients and extractable data regarding respiratory bacteria culture data before and after tonsillectomy. Meta-analysis with random effects modeling was used on a limited basis. Only 5 studies met the inclusion criteria. The grand mean age was 5.9 years; the sample size range was 31 to 134; and the range of follow-up was 1 to 12 months. Group A beta hemolytic Streptococcus was generally the least commonly cultured pathogenic bacteria on preoperative cultures. Qualitative culture data generally showed an overall decrease in potentially pathogenic bacteria and some increase in nonpathologic respiratory flora after tonsillectomy. Meta-analysis showed significant reductions in postoperative culture rates for group A beta hemolytic Streptococcus (positive post- vs preoperative culture: risk ratio [RR], 0.144; 95% CI, 0-0.342), Haemophilus influenzae (RR, 0.437; 95% CI, 0.266-0.608), and Streptococcus pneumoniae (RR, 0.268; 95% CI, 0-0.567) and mixed results for Moraxella catarrhalis (0.736; 95% CI, 0.446-1.03) but no significant reduction for Staphylococcus aureus (RR, 0.774; 95% CI, 0.157-1.39). The majority of published evidence shows that pediatric tonsillectomy appears to reduce the quantity of most cultured potentially pathogenic respiratory bacteria in the pharynx after surgery. The implications and possible benefits of this favorable change in the microbiologic environment after surgery require further study.

Elevated CO2 mitigates the negative effect of CeO2 and Cr2O3 nanoparticles on soil bacterial communities by alteration of microbial carbon use

The interactive effects of elevated atmospheric CO2 and nanoparticles (NPs) on the structure and function of soil bacterial community remain unknown. Here we compared the impacts of CeO2 (nCeO2) and Cr2O3 (nCr2O3) nanoparticles on the taxonomic compositions and functional attributes of bacterial communities under elevated CO2 (eCO2). The stimulated enzyme activities (dehydrogenase, acid phosphatase and urease), increased microbial biomass carbon (MBC), and higher bacterial alpha-diversity were observed under the combined effects of eCO2 and NPs compared to the single NP treatment, indicating eCO2 could mitigate the adverse effect of NPs on soil microorganisms. NPs and eCO2 are important factors influencing the alpha- and beta-diversity (17% and 18% of variations were explained) as well as functional profile (20% and 26% of variations were explained) of bacterial communities. Rising CO2 level promoted the resilience of NP-resistant bacterial populations, primarily the members of Alphaproteobacteria, Gammaproteobacteria and Bacteroidia, which are also characterized by the fast carbon use capability. Moreover, the significantly (P < 0.05) higher metabolic quotient (qCO2), reduced available carbon and overrepresented carbon metabolism genes at eCO2vs. ambient CO2 (aCO2) indicate the acceleration of available carbon turnover in NP-exposed soils. Correlation analysis revealed that mitigation of NPs toxicity by eCO2 could be attributed to the remarkable decline of bioavailable metals disassociated from NPs and available carbon level, as well as promotion of the rapid carbon-metabolizing microbes. Our study pointed out the positive role of eCO2 in alleviating the adverse effect of NPs on microbiological soil environment, and results can serve as important basis in establishing guidelines for lowering the ecotoxicity of NPs.

ANALYSIS AND PREVENTION OF RISKS IN THE MANUFACTURE OF LABORATORY MICROBIOLOGICAL CULTURE MEDIA BY FMEA METHOD

At all stages of the production of microbiological nutrient media (MNM), the manufacturer, and in particular, the microbiological laboratories that manufacture the media on site, face many operational risks. The presence of such risks, in almost every critical point of production and further operation of the MNM, is due to the presence of common basic requirements for all MNM, which must be taken into account and respected during their development and preparation; as well as the complexity and laboriousness of the very process of manufacturing high-quality differential-diagnostic and other nutrient media, requiring the availability of all the components necessary for preparing these media, equipment, sterile conditions and qualified personnel. In this regard, there is a need to search for effective methods to identify and prevent undesirable situations associated with the production and use of MNM. The aim of this work was to adapt the risk assessment methodology based on the expert method for analyzing the types and consequences of FMEA failures (Failure Mode Effect Analysis) set out in GOST R ISO 31010-2011 for the needs of microbiological laboratories, including those for veterinary and sanitary expertise, producing microbiological nutrient environments and using them. As part of this work, a comparative analysis of risk assessment methods was carried out in order to select the optimal one; adaptation of the QMS principle - risk-oriented thinking and the FMEA method for risk assessment in the implementation of MNM manufacturing processes in a microbiological laboratory (for example, solid agar media); risk assessment protocol forms were developed; calculations of a quantitative assessment of risk levels were carried out in order to determine the need for preventive actions and their implementation in order to minimize the negative consequences of risk in case of its implementation using the developed protocols. The results showed that this technique can be successfully implemented and used in the claimed area.

Nanoliter Fluid Handling for Microbiology Via Levitated Magnetic Microrobots

Microbiological environments are a clear application area for microscale robotics, but targeted delivery of biochemical cues to particular cells or tissues remains a significant challenge. This challenge is compounded by the sheer number of cells that compose tissues. Multirobot system development has been limited due to challenges in discrete operation of several robots in a confined space. Here, we demonstrate the use of multiple diamagnetically levitated robots for delivering biochemicals dissolved in liquid in amanner compatible with light microscopy. Specifically, we show loading, transport, and diffusive release of fluorescent molecules in hydrogels with microscale precision, as well as induction of synthetically engineered bacterial cells with signaling molecules. This platform holds potential for impact and utility in fields, such as developmental biology, tissue engineering, and synthetic biology.

Potential growth of Listeria monocytogenes in Italian mozzarella cheese as affected by microbiological and chemical-physical environment

In the present study, 33 brands of mozzarella cheese (pasteurized cow milk mozzarella obtained by direct acidification through the addition of food-grade citric acid or obtained by natural acidification through the addition of thermophilic starter cultures, mozzarella for pizza mainly obtained by addition of citric acid, and pasteurized buffalo milk mozzarella obtained by adding microbial rennet) were characterized for the factors potentially influencing the growth of Listeria monocytogenes (microbial populations, moisture, pH, and organic acids). Then, the growth potential of L. monocytogenes in mozzarella was investigated by challenge tests performed at different temperatures. The presence of heterogeneous microflora (lactobacilli, streptococci, Pseudomonas spp., and, for buffalo mozzarella, yeasts) was evidenced. Almost all the product typologies were classified as high-moisture mozzarella cheese because moisture was >52%. Moreover, pH varied from 5.32 to 6.43 depending on the manufacturing methodology applied. Organic acid concentrations too showed great variability depending on the mozzarella production method, with values ranging from less than limit of detection (LOD; 16 mg/kg) to 14,709 mg/kg, less than LOD (216 mg/kg) to 29,195 mg/kg, and less than LOD (47 mg/kg) to 1,725 mg/kg in the water phase of lactic, citric, and acetic acids, respectively. Despite this presence, the concentration of undissociated acids was lower compared with the minimum inhibitory concentrations estimated for L. monocytogenes by other authors. This was confirmed by the results of the challenge tests conducted inoculating the pathogen in mozzarella produced with the addition of citric acid, as the microorganism grew fast at each temperature considered (4, 9, 15, and 20°C). Good hygiene practices should be strictly applied, especially with the aim of avoiding postproduction contamination of mozzarella, as the presence of organic acids and microflora is insufficient to prevent L. monocytogenes growth.

Relationship between early life respiratory infections and childhood asthma

Viral infections in early life, especially respiratory syncytial virus and human rhinovirus, are closely related to childhood asthma.An initial wheezing of the lower respiratory tract infection of human rhinovirus can serve as a marker of asthma predisposition, whereas respiratory syncytial virus bronchiolitis (particularly severe infection) in early life can have a causative role in asthma attacks.The interaction of viral infections with the bacterial microbiological environment of respiratory tract is an important determinant of childhood asthma. Key words: Viral infection; Microbial environment; Asthma; Early life; Children

Microbiological Quality Assessment of Commercially and Laboratory Prepared Orange Juice

Orange juice has become one of the most widely accepted natural beverages due to its invigorating flavours, source of quick energy in the form of natural sugars and its nutrient which support the growth of acid tolerant bacteria, yeasts and moulds. Present investigation was conducted to study the microbiological examination of commercially and freshly prepared orange juices. Freshly prepared orange juices were pasteurised, carbonated, concentrated and chemically treated with a preservative (sodium metabisulphite) and stored under, freezer, refrigeration and ambient temperature for 90 days. The pH ranged from 3.0 to 4.5 for the commercially, fresh and stored samples respectively. The total bacterial load ranged from 1.6x105 to 3.6x106 and the total yeast cell counts ranged from 1.7x104 to 4.8x106 cfu/ml for the commercially, freshly and stored samples. Twenty-two microbial species including 5 bacterial isolates, 6 yeast isolates and 11 isolates of mould were isolated from the orange juices. The bacterial isolates identified from the samples were Bacillus megaterium, Bacillus cereus, Bacillus pantothenticus, Bacillus aeruginosa and Escherichia coli. The fungal isolates were Saccharomyces cerevisiae, Saccharomyces rouxii, Saccharomyces telluris, Blastomyces sp, Aspergillus sp, Mycelia sp, Chrysosporium sp, and Trichoderma sp. Among the bacterial isolates, Bacillus sp was the predominant, while the fungi Saccharomyces sp and Mycelia sp were the predominant fungi and accounted for five out of 11 isolates. The isolates of bacteria, yeasts and moulds appear to be persistent throughout the period of this study and could be used as indicators of microbial quality. A safe microbial load and reduction in contamination of orange juice /fruit juices can be achieved by combination of processing methods such as chemical preservatives with pasteurisation,concentration with carbonation under controlled microbiological environments such as freezer and refrigeration temperatures.

Prevalence of oral Candida in saliva of uncontrolled and controlled type 2 diabetes mellitus patients – Beyond reasonable doubt?

Aim: The aim of this study was to compare the prevalence of Candida in the saliva of uncontrolled and controlled group of type II diabetic and in nondiabetic individuals. Settings and Design: This was a cross-sectional study. Subjects and Methods: Total study group consists of 75 type 2 diabetic patients, in which 25 patients in Group I were taken as controlled diabetics, 25 patients in Group II were considered as uncontrolled diabetics, and 25 patients were considered as nondiabetics, control group in Group III, respectively. Statistical Analysis Used: Student's t-test, Chi-square test, and one-way ANOVA test were used in this study. Results: In this study, a total of 75 patients were included, of which a total of 30 saliva samples had shown the presence of candidial growth. Out of 25 saliva samples collected from Group I (controlled diabetic patients), 11 samples showed the presence of candidial growth and out of 25 samples collected from Group II (uncontrolled diabetic patients), 19 samples showed the presence of candidial growth. Samples obtained from Group III (nondiabetic patients) were negative for any candidial growth. A significant difference was observed in candidial growth from saliva samples obtained between the various study groups. The uncontrolled diabetic patients group showed a higher candidial colony-forming unit when compared with that of controlled diabetic patients group. Conclusion: The prevalence of Candida in the oral cavity of patients with diabetes is of primary concern for dentists in the early detection of opportunistic infections, such as oral candidiasis, by understanding the predisposing local and systemic factors. The habitat provided by the predisposing disease may, beyond reasonable doubt, reset the microbiological environment to favor the proliferation and colonization of opportunistic microorganisms such as the oral commensal, Candida.

Efficient treatment of chronic endometritis through a novel approach of intrauterine antibiotic infusion: a case series

BackgroundEarly diagnosis and efficient management of Chronic Endometritis (CE) in patients seeking fertility treatment are two components every practitioner wishes to address. With respect to endometrial restoration, antibiotic treatment appears to perform well. However, regarding the improvement of In Vitro Fertilization (IVF) success rates, literature evidence is inconclusive, and consensus on optimal treatment has yet to be reached. This manuscript uniquely brings to literature the first report on effective employment of intrauterine antibiotic infusion to treat CE and contribute to addressing the infertility related to it.Case presentationIn this case series, we present 3 patients reporting numerous previous failed IVF attempts accompanied with diagnosed CE which failed to be properly treated in the past. Following initial assessment in our clinic and verification of CE findings, an oral antibiotic regime was administered based on the infectious agent detected. Re-evaluation concluded slightly improved microbiological environment in the endometrium but persisting inflammation. Antibiotic intrauterine infusion was proposed to the patients as an alternative practice. All our patients achieved a pregnancy shortly following intrauterine treatment with one patient reporting a live birth of twin babies and two patients currently reporting an ongoing pregnancy.ConclusionsThe implications of this case series contribute to medical knowledge and extend to both effective treatment of CE and subsequent management of related infertility. The current line of treatment of CE through oral antibiotic regimes highlights the need for exploring new options and calls for larger studies on the clinical implication of their use. This novel approach enabled natural conception for patients presenting with established Recurrent Implantation Failure (RIF) having undergone numerous futile IVF attempts. The clinical impact from the practitioner’s perspective is considerable allowing for an alternative line of treatment that merits further investigation.

Microbiological air quality in office buildings equipped with dventilation systems.

Proper hygienic conditions in office buildings are of a high importance for both health and well-being of the employees. The aim of this study was the direct comparison of different ventilation systems on microbiological environments in 15 office buildings. The results showed that both bacterial and fungal concentrations in the naturally ventilated office buildings were between 70 and 1600cfu/m3 , while in the offices equipped with air-conditioning and mechanical ventilation systems, concentrations were lower, that is, between 10 and 530cfu/m3 and 20 and 410cfu/m3 , respectively. The size distribution analysis revealed that microorganisms were present in the air mainly as single cells (1.1-3.3μm) and large aggregates (4.7->7μm). If deposited in the human respiratory tract, they may be responsible for nose and eyes irritations, asthmatic reactions, and allergic inflammations. The most prevalent bacterial species indoors were Gram-positive cocci (mainly from Staphylococcus and Micrococcus/Kocuria genera) and endospore-forming Gram-positive rods (from Bacillus genus). Among the most common fungal species were those from genera Penicillium, Aspergillus, and Cladosporium. Effectively working and regularly maintained mechanical ventilation or air-conditioning systems ensure a better hygienic quality in the office buildings than natural/gravitational ventilation.

Protocolo diagnóstico y tratamiento del paciente febril séptico ingresado en medio hospitalario sin focalidad aparente

IntroductionThe diagnostic criteria of fever of unknown origin are: temperature ≥ 38.3°C measured several times, duration of more than three weeks and in which a diagnosis is not reached despite a study of a week with the hospitalized patient. EpidemiologyMore than 50% of patients with fever admitted to the hospital have an infection. EtiologyMay be of infectious origin (septic) or non-infectious. Clinical manifestationsFever that may be accompanied by hypotension, tissue hypoperfusion, respiratory failure, encephalopathy, oliguria. DiagnosisThe most important considerations are the underlying predisposition of the patient, the possible complications of the hospitalization, the epidemiological situation and the microbiological environment of the hospital. TreatmentInitiate empiric antibiotic treatment with the highest precocity possible. The suspicion of the focus, resistance profile and susceptibility of the pathogens of the hospitalization area will guide the treatment.

Propionibacterium acnes Strains Differentially Regulate the Fate of Th17 Responses in the Skin

Agak etal. demonstrate that different strains of Propionibacterium acnes, a bacterium colonizing pilosebaceous units in healthy skin and acne, have the ability to induce T helper type 17 cells secreting either IFN-γ or IL-10 and exhibiting either pathogenic or protective properties, respectively. This work contributes to growing evidence indicating that the phenotype of T helper type 17 cells is largely dependent on their microbiological environment.

Bacteria-responsive intelligent wound dressing: Simultaneous In situ detection and inhibition of bacterial infection for accelerated wound healing

The evolved resistance of antibiotics exhibited by some dreaded clinical pathogens and formation of biofilms has caused life-threatening problems for patients with burns and other wounds. Here, in order to avoid antibiotic overuse, and thus decreasing the occurrence of antimicrobial-resistant bacteria, a theranostic wound dressing, composed of biocompatible UV-photocrosslinkable methacrylated gelatin (GelMA) encapsulating both antimicrobial and fluorescent vesicles, has been developed. The system can respond to the microbiological environment of the wound via a simple color change and antimicrobials release only when require and this is in essence passive as they do not respond to their local environments and benign bacteria, and only operates when pathogenic bacteria exist. Both in Vitro and in Vivo study demonstrated that the proposed wound dressing was able to kill/inhibit the growth of methicillin-resistant S. aureus and P. aeruginosa, whilst providing a visual warning of infection, due to vesicle bilayer membrane lysed by toxins secreted by the two strains of pathogens but not by a non-pathogenic Escherichia coli species. The strategy of microbiologically responsive wound dressing proposed here could also be used as a general methodology for the design and fabrication of bacterial responsive functional biomaterials that offer opportunities to combat drug-resistant bacterial infections.

Fluorometric determination of d-lactate in biological fluids

ObjectiveD-lactic acid in the mammalian body is mainly of microbiological origin and is often located somewhere along the digestive tract. Surgical, extensive re-sectioning of the small bowel may be one of the risk factors for altered balance in the microbiological environment. Higher levels in the body may lead to D-lactate acidosis and neurotoxicity; consequently, the possibility of diagnosis of this condition is important. Several analytical procedures for D-lactate have been introduced, but it is absolutely mandatory to distinguish this metabolite from the much more abundant and naturally occurring stereoisomer L-lactate. If enzymatic analytical methods are used, it is consequently essential to eliminate the response from L-lactate and the ubiquitous enzyme L-lactate dehydrogenase (L-LDH) (and other oxido-reductases) which will interfere with the D-lactate determination heavily. Design and methodsThe present paper introduces an enzymatic-fluorometric method for determination of D-lactate in biological matrices, including blood plasma, serum and urine. Macro molecules, including enzymes, were initially precipitated by ethanol and the supernatant used for analyses. Several plasma samples were analysed with and without standard addition of both L- and D-lactate in order to validate the assay. Results and conclusionsThe procedure effectively eliminates enzyme activities that may interfere with the D-lactate quantification, resulting in the situation that L-lactate in the sample does not interfere with the determination. Intra- and inter-assay precision, accuracy and recovery of the analyte were investigated and everything suggests that this method will be acceptable for analytical as well as descriptive purposes. The analytical procedure is suitable for a semi-automated large scale set-up in the laboratory.

Evaluation of the damaged depths of slag-based mortars in aggressive sulphate conditions

Resistance of cement composites against various chemical processes such as sulphate attack and corrosion is nowadays one of the most desired property. Mechanism largely involved in sulphate corrosion is the ingress of aggressive ions through diffusion. The result of the ingress of aggressive ions is leaching of the elements from the mortar matrix and the deterioration of the composite. In the experiment, the slag-based cement mortars samples were exposed to an aggressive microbiological sulphate environment, represented by the bacteria A. thiooxidans, for the period of 6 months. The paper presents the investigation of damaged depths of cement mortars based on the leaching characteristics of the Ca ions. The damage depths (EDD) of cement composites were much higher (up to 0.2 mm) for samples placed in the biotic environment, which confirms the aggressive action of A. thiooxidans.

Microbial Carbon Substrate Utilization Differences among High- and Average-Yield Soybean Areas

Since soybean (Glycine max L. (Merr.)) yields greater than 6719 kg ha−1 have only recently and infrequently been achieved, little is known about the soil microbiological environment related to high-yield soybean production. Soil microbiological properties are often overlooked when assessing agronomic practices for optimal production. Therefore, a greater understanding is needed regarding how soil biological properties may differ between high- and average-yielding areas within fields. The objectives of this study were to (i) evaluate the effects of region on soil microbial carbon substrate utilization differences between high- (HY) and average-yield (AY) areas and (ii) assess the effect of yield area on selected microbiological property differences. Replicate soil samples were collected from the 0–10 cm depth from yield-contest-entered fields in close proximity that had both a HY and an AY area. Samples were collected immediately prior to or just after soybean harvest in 2014 and 2015 from each of seven geographic regions within Arkansas. Averaged across yield area, community-level carbon substrate utilization and Shannon’s and Simpson’s functional diversity and evenness were greater (p &lt; 0.05) in Region 7 than all other regions. Averaged across regions, Shannon’s functional diversity and evenness were greater (p &lt; 0.05) in HY than in AY areas. Principal component analysis demonstrated that a greater variety of carbon substrates were used in HY than AY areas. These results may help producers understand the soil microbiological environment in their own fields that contribute to or hinder achieving high-yielding soybeans; however, additional parameters may need to be assessed for a more comprehensive understanding of the soil environment that is associated with high-yielding soybean.

Neutrophil myeloperoxidase diminishes the toxic effects and mortality induced by lipopolysaccharide.

Neutrophils have crucial antimicrobial functions but are also thought to contribute to tissue injury upon exposure to bacterial products, such as lipopolysaccharide (LPS). To study the role of neutrophils in LPS-induced endotoxemia, we developed a new mouse model, PMNDTR mice, in which injection of diphtheria toxin induces selective neutrophil ablation. Using this model, we found, surprisingly, that neutrophils serve to protect the host from LPS-induced lethal inflammation. This protective role was observed in conventional and germ-free animal facilities, indicating that it does not depend on a particular microbiological environment. Blockade or genetic deletion of myeloperoxidase (MPO), a key neutrophil enzyme, significantly increased mortality after LPS challenge, and adoptive transfer experiments confirmed that neutrophil-derived MPO contributes importantly to protection from endotoxemia. Our findings imply that, in addition to their well-established antimicrobial properties, neutrophils can contribute to optimal host protection by limiting the extent of endotoxin-induced inflammation in an MPO-dependent manner.

Assessment of dairy calves' microbiological environment using 3M™ Petrifilm™ bacteriology plates

Bovine respiratory disease complex is a major disease in dairy calves. Environmental factors such as microbiological air quality have been associated with greater risk of bovine respiratory disease in calves. Routine air sampling for microbiological testing has not been traditionally performed by practitioners, mainly because of the cost associated with air sampling machines. Here we present an alternative, cost-effective air quality assessment technique using 3M™ Petrifilm™ bacteriology plates. This method can determine total aerobic bacteria, coliform, yeast, and mold counts. We found that a 10-min contact time was optimal for assessing calf environments. In the calf pens, median (ranges) bacterial counts were 340 (90 to 840) cfu/plate for aerobic plate counts, 4 (1 to 11) cfu/plate for coliform counts, 4 (1 to 11) cfu/plate for yeast counts, and 42 (1 to 120) cfu/plate for mold counts. Based on our findings, we propose that this approach can be used to monitor air quality in dairy calf barns.

Bacterial load of conditioned pressure ulcers is not a predictor for early flap failure in spinal cord injury.

Pressure ulcers impose a major lifetime medical problem to patients with high-grade spinal cord injury (SCI). For patients with stages 3-4 pressure ulcers, plastic surgery is often the only remaining treatment option. Despite considerable flap failure rates of around 30%, only sparse knowledge exists on predictors for flap failure. Hence, identification of predictors for flap failures is needed. We prospectively enrolled 38 SCI patients with stages 3-4 pressure ulcers scheduled for plastic surgery. Preoperative wound swabs, intraoperative tissue samples and postoperative drainage liquids were microbiologically analyzed. In multivariable logistic regression analyses, bacterial loads of deep tissue cultures of intraoperative samples as well as other clinical variables were analyzed with respect to the prediction of flap failures. The flap failure rate was 27.5%. Bacterial loads of deep tissue cultures were not predictive for flap failure, neither was the colonization with a specific bacterial strain. We observed a considerable fluctuation of microbiological environment from initial swab cultures, intraoperative samples and postoperative drainage fluids. Antibioprophylaxis was sufficient in only 75% of deep tissue cultures and 69% of drainage fluids. Insufficient antibioprophylaxis was associated with a higher flap failure rates (odds ratio 6.3, confidence interval 1.2-41.0). After inpatient wound conditioning, bacterial load analysis of intraoperative wound tissue cultures is ineffective in order to predict flap failure rates in SCI patients with stages 3-4 pressure ulcers after flap surgery. Instead, insufficient antibioprophylaxis might be a factor contributing to flap failure.