Mixed Bacterial Flora Research Articles

The influence of the vaginal ecosystem on vaginitis, bacterial vaginosis, and sexually transmitted diseases: an epidemiological study and literature review.

This study aimed to demonstrate the correlation between altered balance of the vaginal ecosystem and increased risk of vaginitis, bacterial vaginosis, and sexually transmitted diseases and the association between specific alterations found in fresh bacterioscopic examinations (FBE) and the risk of certain infections. A retrospective, monocentric study was conducted from January 2013 to December 2023. Patients who underwent FBE and vaginal swabs following reported symptoms or suspected syndromic pictures of vulvovaginal infections were included. Two thousand one hundred ten patients were included and divided into a control group (n = 811, 38.4%) and a pathological group (n = 1299 patients, 61.6%), based on the presence of alterations at the FBE. In the pathological group, 1185 women (91% of positive FBE) had vaginal infections detected through vaginal swabs. The presence of lactobacilli and typical inflammatory cells was detected in 111 (8%) women with pathological FBE and correlated with higher rates of positive swabs for common germs (n = 104, 94%), often leading to co-infections (n = 30, 29%). Conversely, Döderlein's cytolysis (n = 56, 4.3% of positive FBE) indicated a predominance of positive human papillomavirus (HPV) swabs (n = 33, 59%). The presence of fungal elements (n = 208, 16% of positive FBE) suggested a higher prevalence of co-infections (n = 62, 30%). Similarly, mixed bacterial flora (n = 470, 36% of positive FBE) and Trichomonas vaginalis (n = 11, 0.8% of positive FBE) correlated with positive swabs for other pathogens, except for Mycoplasma (n = 0). Bacterial vaginosis (n = 443, 34% of positive FBE) was linked to co-infections (n = 142, 32%) and HPV (n = 123, 28%). The importance of conducting FBE in patients with vulvovaginal symptoms is emphasized. This approach aids in determining the need for further diagnostic tests like vaginal swabs, guided by microscopic findings. A strong correlation emerges between the presence of specific alterations in the FBE and an increased prevalence of certain infections.

PATHOGENETIC SIGNIFICANCE OF THE CHARACTER OF WOMAN’S UROGENITAL INFECTION IN THE DEVELOPMENT OF ADENOMYOSIS

Adenomyosis is one of the important problems of modern gynecology, which leads to impaired reproductive function, reduced work capacity and quality of life of women. The prevalence of endometriosis in the female population ranges from 20-55% in patients of reproductive age. An important role in the occurrence and development of adenomyosis is played by genetic predisposition, hormonal changes and the influence of immunological factors. Of great interest is a new concept regarding the significant role of bacterial contamination of the genital tract in patients with adenomyosis. The study of the influence of microorganisms on the mechanisms of activation of the inflammatory reaction associated with the progression of endometrioid lesions is relevant and requires the search for new approaches to diagnosis and treatment of the disease.
 The purpose of the work is to study the influence of the woman’s urogenital infection in the development of adenomyosis.
 Materials and methods. 85 patients with 1st and 2nd degree adenomyosis and 30 healthy fertile women were examined. The average age of the examined was 27.3±1.6 years. A comprehensive clinical examination, ultrasound, colposcopic, hysteroscopic studies were conducted. Microbial flora analysis included bacterioscopic, bacteriological research methods with determination of sensitivity to antibiotics, and PCR method. The concentration of cytokines in the culture medium (supernatant) was determined by the enzyme immunoassay. Statistical data processing was performed using the Statsoft Statistica v6.0 and Microsoft Excel 97 software packages.
 Results. In the structure of gynecological diseases, 95.6% of patients with adenomyosis had inflammatory diseases of female genital organs, chronic herpes and cytomegalovirus infection was found in almost 93%. In women with adenomyosis, the II-III stage of vaginal cleanliness prevails with an “intermediate” type of biocenosis, which is characterized by a reduced content of lactobacilli, the presence of various types of morphotypes of gram-positive and gram-negative rods and cocci, and dysbiosis (49.4%), when a mixed bacterial flora prevails microflora, a high percentage of the combination of adenomyosis with chronic inflammatory diseases of the pelvic organs justifies the need to use antimicrobial therapy in this category of patients. When studying the cytokine profile of the cervical contents and endometrium, an increase in the concentration of the main proinflammatory cytokines IL-1β, IL-6, TNFα and a factor with chemotoxic properties IL-8 was found. The obtained data indicate that the development of adenomyosis is facilitated by a previous immuneinflammatory reaction, which is accompanied by a violation of the local cytokine balance.
 Conclusions. Microbiological examination of patients with adenomyosis revealed a violation of the microbial landscape of the reproductive tract in most of the examined. The obtained data indicate a high percentage of the combination of adenomyosis with chronic inflammatory diseases of the pelvic reproductive organs. Previous adenomyosis is an immunoinflammatory reaction, accompanied by a violation of the local cytokine balance. Increased cytokine activity and the presence of infectious agents are associated with the spread of adenomyosis.

Silver Nanoparticles Produced by Laser Ablation and Re-Irradiation Are Effective Preventing Peri-Implantitis Multispecies Biofilm Formation

Implant-associated infection due to biofilm formation is a growing problem. Given that silver nanoparticles (Ag-NPs) have shown antibacterial effects, our goal is to study their effect against multispecies biofilm involved in the development of peri-implantitis. To this purpose, Ag-NPs were synthesized by laser ablation in de-ionized water using two different lasers, leading to the production of colloidal suspensions. Subsequently, part of each suspension was subjected to irradiation one and three times with the same laser source with which it was obtained. Ag-NPs were immobilized on the surface of titanium discs and the resultant materials were compared with unmodified titanium coupons. Nanoparticles were physico-chemically analysed to determine their shape, crystallinity, chemical composition, and mean diameter. The materials were incubated for 90 min or 48 h, to evaluate bacterial adhesion or biofilm formation respectively with Staphylococcus aureus or oral mixed bacterial flora composed of Streptococcus oralis, Actinomyces naeslundii, Veionella dispar, and Porphyromonas gingivalis. Ag-NPs help prevent the formation of biofilms both by S. aureus and by mixed oral bacterial flora. Nanoparticles re-irradiated three times showed the biggest antimicrobial effects. Modifying dental implants in this way could prevent the development of peri-implantitis.

Synchronous cervical necrotizing fasciitis and pharyngocutaneous fistula: A case report

Introduction and importanceNecrotizing fasciitis is a fulminant infection that spreads along the fascial planes. It is a rare entity with potentially fatal outcomes. The head and neck involvement is infrequent, with primary source either odontogenic or pharyngeal infection by single or mixed bacterial flora. To our knowledge, synchronous cervical necrotizing fasciitis (CNF) and pharyngocutaneous fistula is rarely reported in pieces of literature.Case presentationWe present a 38-years-old female patient who presented with CNF and pharyngocutaneous fistula. Diabetes mellitus was accidentally discovered during the investigation. The patient was successfully treated with broad-spectrum antibiotics, serial surgical debridement sessions, wound irrigation, and multiple muscular and myocutaneous skin flaps.Clinical discussionRapid diagnosis, radical surgical debridement of all necrotic tissue, intravenous broad-spectrum antibiotics, and close monitoring of patients with CNF are crucial to avoid critical complications and better patient survival. Due to the poor healing process in the neck area, the pharyngocutaneous fistula should be repaired with good musculocutaneous flaps such as the pectoralis major myocutaneous flap. Meticulous suturing of the flap to the mucosa, reinforcement of the repair with muscle, and suturing of the skin without tension are essential to obtaining a successful outcome.ConclusionSynchronous CNF and pharyngocutaneous fistula are rare events. Initial diagnosis and serial surgical debridement, along with aggressive broad-spectrum antibiotics and adequate resuscitation with great attention to the poor healing process in the diabetic patients' neck area, are critical for a beneficial result. In our case, the reconstruction was performed successfully using multiple muscular and skin flaps.

Microbiotes of the vagina, cervical canal and uterine cavity in chronic endometritis

The objective: to determine the profile of vaginal, cervical and uterine microbiota in chronic endometritis in patients with failed ART attempts in history. Materials and method. A prospective study and clinical laboratory analysis of vaginal microbiocenosis, cervical canal and uterine cavity in women with chronic endometrite in a history on the basis of MC LLC «ISIDA - IVF», in the period from 2020 to 2021 was carried out. The group consisted of 55 women of reproductive age with chronic endometritis and repeated failed ART attempts, and 40 women of reproductive age without fertility impairment who formed the control group. Amount of research – Vaginal Secretion PH, Vaginal Microbial Estimation of Pap Smear Microscopy, Polymerase Chain Reaction Study (PCR), Culture Study of Vaginal Secretions, Study of microflora of the cervical channel and bioptat of endometrium. Results. In women with infertility, against the background of chronic endometritis in history, as a result of bacterial sowing from the uterine cavity, the predominance of mixed bacterial flora, which is represented by various associations of opportunistic and pathogenic micro-organisms, has been detected. Chronic inflammatory endometry is caused by a persistent viral bacterial infection in the uterine cavity, which differs in species composition from the microflora of the lower genital tract. Conclusions. The characteristic feature of the vaginal flora in chronic endometritis is a high level of dissbiotic changes, combined with high values of the notional pathogenic flora. The microbiotopes of the cervical channel and endometrium in the inflammatory processes of endometry are characterized by the predominance of obligatory-anaerobic micro-organisms in the form of associations with viral infection much more than twice as frequently detected in endocervix as compared to endometrium.

P29. Gram negative vs gram positive cultures: A comparison of gram type on washouts & antibiotic duration

P29. Gram negative vs gram positive cultures: A comparison of gram type on washouts & antibiotic duration

Technology for Repairing Osteomyelitic Bone Defects Using Autologous Mesenchymal Stromal Cells on a Collagen Matrix in Experiment.

The aim of the study was to develop a technology for repairing an osteomyelitic bone defect using autologous adipose tissue mesenchymal stromal cells (MSCs) bound to a collagen matrix and to test the efficacy of this technique.Materials and Methods.The study was carried out with 17 rabbits. A bone defect was created using a milling cutter applied to the proximal third of the leg. The wound (8.0×4.0 mm and a depth of 4.0 mm) involved the periosteum, cortical layer, and cancellous substance. Staphylococcus aureus strain was used as an infectious agent.After the development of chronic osteomyelitis, the animals underwent osteonecrectomy. In the study group, autologous MSCs in Collatamp EG collagen carrier were placed into the bone defect. MSCs were obtained from adipose tissue and cultured in the matrix for 5 days. In control, the defect was filled with the collagen matrix without cells.Results.On day 14 upon the initiation of chronic osteomyelitis, bacteriological examination of the discharge from the fistula showed the presence of mixed bacterial flora (Staphylococcus aureus and Escherichia coli) in all operated animals. Results of X-ray, laboratory, and histological tests confirmed the formation of a focus of chronic osteomyelitis.Two months after the treatment (collagen with or without MSCs) began, all animals of the study group showed mature bone tissue regenerated in the affected zone. In the control group, proliferation of osteoblasts on the surface of the bone trabeculae was also observed; however, mature osteoid tissue was more often detected in the study group (35.0 vs 20.0% in control). In the study group (MSCs + collagen matrix), there was a decrease in bone marrow fibrosis (50.0 vs 100.0% in control) and cartilage formation (30.0 and 66.7%, respectively). After full treatment, newly formed bone trabeculae were detected more often (100.0 vs 60.0% in control); they were more mature and filled the defect area more efficiently.Conclusion.Our results indicate that the use of a collagen matrix with autologous MSCs is a promising plastic material for repairing osteomyelitic defects following necrectomy.The MSCs were able to increase the density of the filling material in the bone cavity, significantly accelerate the formation of bone beams around the matrix, and increase the tissue volume around the implant. The presence of MSCs significantly decreased the interference of a connective tissue component with osteogenesis and chondrogenesis.

809. Modified Laboratory Reporting to Prevent Catheter-Associated Urinary Tract Infections (CAUTIs)

BackgroundCatheter-associated urinary tract infections (CAUTIs) are among the most common healthcare-associated infections. Many patients at our institution with a CAUTI do not have signs or symptoms of infection and bacterial growth likely represents asymptomatic bacteriuria (ASB). As a result, we implemented a Modified Lab Workflow (MLW) focused on diagnostic stewardship to improve urine culture (UCx) reporting and prevent misclassification and unnecessary treatment of CAUTIs.MethodsOn Sep. 1, 2019, laboratory reporting of Foley UCx was modified according to the protocol in Figure 1. UCx results were divided into 3 groups: (1) no growth, (2) mixed bacterial flora (≥3 organisms) not consistent with infection or (3) growth of ≤2 organisms with at least 1 organism ≥105 cfu/ml per National Healthcare Safety Network (NSHN) CAUTI definition. Group 3 UCx were resulted with instructions to the clinician (see Figure 1.). When requested, group 3 results were reviewed by Infection Prevention and released with organism identification and antibiotic susceptibility if it met Infectious Diseases Society of America (IDSA) CAUTI criteria. Otherwise they were resulted as: “Bacterial growth indicative of contamination or colonization.”Figure 1. Modified Laboratory Workflow for Reporting Urine Cultures from Foley Catheters ResultsBetween Sep. 1, 2019 to Mar. 1, 2020, a total of 134 UCx from catheterized patients were reviewed. Forty-two (31%) of UCx were from patients with a Foley in-situ ≥48 hours and processed through MLW; 92 UCx were from a Foley in place < 48 hours and excluded from the study. Of the 42 UCx processed via MLW, 16 (38%) were no growth and 7 (17%) had bacterial growth suggestive of contamination. For group 3, 19/42 (45%) had growth of significant bacteria but only 1(5%) met IDSA criteria for reporting. During the study, 6 additional CAUTIs were reported due to incorrect specimen labeling causing Foley urine specimens to subvert MLW.ConclusionDuring our study, we identified 1 CAUTI through apt MLW use. Seven total CAUTIs occurred (SIR=0.66); a majority due to incorrect UCx source labeling, resulting in missed MLW screening. Ten CAUTIs (SIR=0.97) were reported in the preceding 6 months. As part of a comprehensive CAUTI prevention program, a MLW can help reduce classification of ASB as a CAUTI. Education to providers on precise labeling of UCx source is a key component of a successful MLW.Disclosures All Authors: No reported disclosures

Fournier gangrene - a challenge for the surgeon.

Fournier gangrene (FG) is life - threatening condition, defined as the necrotizing fascitis of perineum and can spread to the adjacent areas. It is rare disease and infection is caused by mixed bacterial flora, seldom by fungal infection. Risk factors are: male sex, diabetes, hypertension, malignant neoplasms, alcoholism, immunospression. The analysis of four group patients treateted for Fournier gangrene was made about diagnostic and therapeutic process, assessment of prognosis based on Fournier's Gangrene Severity Index). All patients were males. Average age at the moment of diagnosis was 60 years. All of them had comorbidities resulting with the higher risk of susceptibility to FG. Morbitity was 50%, despite of all of patients had less than 9 points in FGSI. The FG, despite of better diagnostic tools and technological progres remaines the significant clinical issue because of the mortality - 80%. "The golden standard" is surgical excision of necrotic tissues, antibiotics support, equation of fluid, electrolytes and base - acid balance, level of glycemia is very important. The treating results were assessed on the base of FGSI. The significance has the moment of performing the surgical intervention - it is proven, that should be carried out during 24 hours. The hyperbaric oxygen therapy is controversial. Seem to be appropriate if the infection is caused by anaerobic bacteria. Fournier syndrome is significant clinical issue. Its treatment requires early surgical approach with exicision of necrotic tissues, antibiotics support and treatment of hyperbaric oxygen in some cases.

Highly efficient biodegradation of reactive blue 19 under the activation of tea residue by a newly screened mixed bacterial flora DDMY2.

In this study, a newly screened mixed bacterial flora DDMY2 had high decolorization capacity for anthraquinone dye reactive blue 19 (RB19) and the decolorization efficiency of 300 mg L−1 RB19 could reach up to 98% within 48 h in the presence of tea residue. Results indicated that RB19 could be efficiently decolorized by flora DDMY2 in wide ranges of pH values (5.0–9.0), temperatures (30–40 °C) and initial dye concentrations (50–500 mg L−1) under the activation of tea residue. Concentration of tea residue had been proved to significantly impact the decolorization performance. UV-vis spectrophotometry, Fourier transform infrared spectrometry and liquid chromatography/time-of-flight/mass spectrometry analysis showed three identified degradation products and the possible degradation pathway of RB19 was speculated. High-throughput sequencing analysis revealed the community structures of bacterial flora before and after domestication by tea residue. Based on the result, it was inferred that unclassified_o_Pseudomonadales, Brevibacillus, Stenotrophomonas and Bordetella activated by tea residue were responsible for the excellent decolorization performance. Results of this research deepen our understanding of the biodegradation process of anthraquinone dyes by bacterial flora and broaden the knowledge of utilizing tea residue as a bioactivator in biological treatment.

Povidon-iodine (betadine) in modern obstetric-gynecological practice

The article describes the pharmacocodynamics of povidone-iodine, the release form under the brand name Betadine, pharmacological benefits, as well as evidence of its effectiveness in preventing infection in the field of surgical intervention. Povidone-iodine is indicated to be a depot of iodine, constantly releasing elemental iodine, which has strong oxidizing properties, and therefore most microorganisms are destroyed in vitro in less than a minute, and the main destructive effect of the drug occurs in the first 15–30 seconds. Povidone-iodine has a wide spectrum of antimicrobial and antiviral action. The data on medications of povidone-iodine in the form of vaginal suppositories, antiseptic solution and ointment under the trade name Betadine are presented. Own data on the effective use of vaginal suppositories in symptomatic vaginal dysbiosis caused by mixed opportunistic bacterial flora (facultative and obligate anaerobes) with the presence of Atopobium vaginae in diagnostically significant amounts are presented. In the presented comparative studies, the advantages of Betadine compared with other antiseptics in the spectrum of microbiological effects, resistance of microorganisms, effects on wound healing, dependence of the effect on the physico-chemical parameters of the environment, side effects, the purpose of application – prevention and/or treatment are shown. The results of recent comparative studies on the treatment of the surgical area with chlohexidine-alcohol and povidone-iodine, according to which povidone-iodine should still be considered acceptable for the preoperative treatment of the caesarean section, are highlighted. It is indicated that the irrigation of the wound cavity with an aqueous solution of povidone-iodine during surgery and before suturing the surgical wound is one of the WHO recommendations for the prevention of infection in the field of surgical intervention. The authors conclude that povidone-iodine, including Betadine, has a broad spectrum of antimicrobial and antiviral activity; high activity in the presence of organic compounds (blood, pus); ability to penetrate through biofilms, necrotic tissue, eschar; low incidence of antiseptic resistance; positive dynamics of wound healing by preventing the spread of inflammation and increasing the ability to heal; well tolerated by patients; low cost; ease of use.

Bacterial flora in chronic sinusitis in children

Chronic rhinosinusitis is one of the main causes of morbidity in the paediatric population. The aetiology of chronic sinusitis (CS) is still investigated. Most cases of chronic sinusitis develop from unresolved acute sinusitis. Acute sinusitis is usually associated with one species of bacteria (most often aerobic), whereas chronic sinusitis is dominated by a mixed bacterial flora including 2-3 bacterial strains. The most common pathogens in chronic sinusitis are S. pneumoniae, H. influenzae, M. catarrhalis, S. aureus, coagulase-negative staphylococci, as well as Gram-negative bacteria, such as Pseudomonas aeruginosa, Proteus spp., Klebsiella spp., Enterobacter spp., Escherichia coli and anaerobic bacteria. Staphylococci predominated in the study group of patients: 36 strains of S. aureus and 31 strains of S. epidermidis were isolated. Typical respiratory pathogens were practically absent, and constituted only a small percentage of all isolated microorganisms. Full diagnosis and treatment of patients with chronic sinusitis should include laryngological, microbiological, allergological, biochemical, and histopathological consultations as well as diagnostic imaging. Isolation of materials with high diagnostic value (aspirates, tissues) is very important. The selection of appropriate antibiotic therapy, in addition to assessing bacterial resistance to antibiotics, may require the determination of virulence traits of cultured strains.

Effectiveness of Hyperbaric Oxygen Therapy for the Management of Chronic Osteomyelitis: A Systematic Review of the Literature.

Hyperbaric oxygen has been used as an adjunctive measure in the treatment of chronic osteomyelitis. The aim of this systematic literature review was to analyze the outcome and the complications of hyperbaric oxygen for chronic osteomyelitis. Forty-five of 96 studies reporting the use of hyper-baric oxygen for 460 patients with chronic osteomyelitis met the inclusion criteria and were analyzed qualitatively. All patients previously received antibiotics and surgical debridement. Mixed bacterial flora was detected in most of the studies. Staphylococcus aureus was the isolated pathogen in 12 (60%) of the 20 cohort and in 4 (20%) of the 20 case studies. Adjuvant hyperbaric oxygen was effective in 16 (80%) of the 20 cohort and 19 (95%) of the 20 case studies. Overall, 308 (73.5%) of 419 patients with complete data had a successful outcome and no reported relapse. Available evidence supports a potentially beneficial role of adjunctive hyperbaric oxygen, especially in refractory cases of chronic osteomyelitis. [Orthopedics. 2018; 41(4):193-199.].

Biofilm in voice prosthesis: A prospective cohort study and laboratory tests using sonication and SEM analysis.

The objective of the study was to compare the biofilm growing pattern and its morphological extent on silicone and a teflon-like material using a sonication process and a Scanning Electron Microscope (SEM). A prospective cohort study and a laboratory study. Otolaryngology -Head and Neck surgery Department and the Microbiology Institute. The participants included fifteen laryngectomised patients with phonatory prostheses, which were removed because of device failure, and two different kinds of phonatory prostheses from the laboratory (Provox 2 and ActiValve) that were artificially colonised by Candida albicans. Tracheo-oesophageal puncture (TEP) is currently considered the gold standard for post-laryngectomy voice rehabilitation. "Leakage" represents the most common cause of substitution and is generated by biofilm colonisation of the prosthesis by mixed mycotic and bacterial agents. New biomaterials have been developed that are deemed to be more resistant to the colonisation of micro-organisms and material deformation. The devices showed colonisation by mixed bacterial flora (Staphylococci 13%, Streptococci 9%, and Haemophilus influenzae 5%) and by yeasts (Candida albicans 12%). Moreover, we observed a different distribution of biofilm layers in Provox ActiValve (22.56%) compared to Provox 2 (56.82%) after experimental colonisation by the previously isolated Candida strain. Resident microbiological species from the upper airways unavoidably colonise the polymer surfaces, and no strategies have been effective except for the manipulation of the chemical-physical properties of the device's polymer. Our study confirms that Provox ActiValve, which is made with a fluoroplastic material (teflon-like), is less subject to invitro colonisation by Candida, and thus showed a higher clinical resistance to biofilm and a longer lifespan. The sonication seems to significantly improve the knowledge of bacterial and mycotic flora in biofilm colonisation. The design of a device for the daily cleaning capable to reach and brush the oesophageal flange of the prosthesis preserving the valve mechanism could represent a practical and simple help in this still unsolved problem.

Association of Malassezia pachydermatis with the otitic and the normal ear canal of the dogs

The purpose of this study was to investigate the presence of M. pachydermatis in otitic and healthy ear canals of the dogs and to test the sensitivity of this microorganism to antifungal agents. A total of 180 swabs, 98 from otitic and 82 from clinically healthy dogs, were collected during the years 1998-2000 in Thessaloniki area (Greece). From all the swabs, smears for direct microscopic examination and inoculation on selective media for bacteria and fungi isolation were made. From the 90 M. pachydermatis isolates, 68 (69,38%) were made from infected and 32 (39,02%) from clinically healthy dogs. M. pachydermatiswas the sole isolate in 20 (20,39%) infected and in 12 (14,63%) non infected dogs. In 48 otitic and in 20 clinically healthy dogs, M. pachydermatis was associated with bacteria as Staphylococcus spp., Pseudomonas spp., Proteus spp. and Streptococcus spp. and fungi as Candida spp. ana Aspergillus spp.. S. intermediuswas isolated from 13 infected and 20 non infected animals. A mixed bacterial flora was grown from 6 infected and 22 clinically healthy animals, respectively, while no growth of microorganisms from 11 otitic and 8 healthy dogs was observed. All Malassezia tested strains (46) were found sensitive to ketoconazole, econazole, miconazole and clotrimazole. Nystatin was found effective to 38 isolates and noneffective to 8.

On the Role of Enterococci in the Bloodstream: Results of a Single-Center, Retrospective, Observational Study at a German University Hospital.

This study assesses the clinical relevance of vancomycin-susceptible enterococci in bacteremic patients and compares it with bacteremia due to Staphylococcus aureus and Escherichia coli.During a 5-year-study interval, clinical and diagnostic features of patients with enterococcal bacteremia were compared to those of patients with E. coli or S. aureus bacteremia. Each patient was only counted once per hospital stay.During the 5-year study interval, data from 267 patients with enterococcal bacteremia and from 661 patients with bacteremia due to E. coli or S. aureus were evaluated. In spite of a comparable risk of death, patients with enterococci more frequently needed catecholamines and invasive ventilation. Furthermore, enterococci were more frequently associated with a mixed bacterial flora in bloodstream infections. While fatal sepsis due to E. coli and S. aureus was associated with typical shock symptoms, this association was not confirmed for enterococci.Although enterococcal bacteremia is associated with a risk of dying comparable to that with bacteremia due to E. coli and S. aureus, a lower pathogenic potential of enterococci in bloodstream has to be acknowledged. Enterococci in the bloodstream are more likely to be an epiphenomenon of impending death than its major cause.

Microbiological analysis of acute infections of the nail fold on the basis of bait thread test.

IntroductionAn acute infection of the nail fold, called paronychia, is a common clinical problem. The basis for the implementation of the treatment is the result of microbiological examination. Due to the rapid and painful course of infection, usually an empirical antimicrobial treatment prior to obtaining microbiological test results is introduced.AimThe microbial analysis of acute infections of the nail fold.Material and methodsThe study included 32 tests conducted on 31 patients of the Department of Dermatology. Microbiological analysis was performed with the use of the so-called bait thread test.ResultsIn 73% of analyzed cases microbiological examination revealed mixed microbiological flora. Most cultured microorganisms were: Enterococcus faecalis (14%), Staphylococcus aureus (12%), Candida albicans (9%), Enterobacter cloacae (8%), and Klebsiella pneumoniae (7%). Most cultured bacteria belonged to the families or genera of Enterobacteriaceae (36%), other cultured bacteria were staphylococci (26%), enterococci (16%), Candida species (14%), and Gram-negative non-fermenting bacilli (8%).ConclusionsThe acute infection of the nail fold in the vast majority of cases is caused by mixed bacterial flora. A profile of isolated microorganisms suggests that the cause of the infection can be associated with neglect of hygiene. Fluoroquinolone and fusidic acid are recommended as the empirical therapy. Microbiological examination is the basis for the appropriate final treatment.

A study on the relation of the severity of diabetic foot ulcers with the type of bacterial flora isolated from the wounds

Background: The study is to determine the relation between severity of the diabetic foot ulcers and the organisms isolated from the wounds; its implications and prognosis with particular reference to the differences in the final outcome depending upon the type of organism infecting the wound. The study try to correlate the severity of the diabetic foot infection according to Meggit-Wagner classification, the incidence of amputation and the impact on the hospital stay with the difference of bacterial flora isolated from the wounds. This is an observational study done in 53 patients who were admitted in the surgical ward of a large private medical college in Jadavpur, India. It has been found from this study that the incidence and severity of diabetic foot ulcer is more in patients with some particular type of bacteria found in their wounds. A strong correlation is found in patients whose wounds were infected with some particular bacteria had resulted in more severe type of foot ulcers with higher incidence of amputation and concomitant longer hospital stay. Methods: An observational study was done in 53 patients who were admitted in the surgical ward of a teaching hospital in Kolkata, India. The youngest patient was aged 28 years and the oldest patient was 83 years of age. All of them presented with clinically infected foot ulcers. The patients were explained about the study methods in their own language and due consent was taken. A standardized proforma in English, Hindi and the vernacular languages was made for recording the necessary data. The standard X-ray plates were taken into consideration for determination of the involvement of underlying bones. The microbiological studies were done in all patients from the wound swabs of the foot ulcers. The outcome of the diabetic foot ulcer was assessed from the severity of the disease, the presence of the different bacterial flora in their wounds, the incidence of amputation and the duration of hospital stay. Results: The positive wound culture was found in 67.92 of patients, Methicillin resistant Staph. aureus (MRSA) was the commonest isolated organism (44.44%) followed by mixed bacterial flora ( Staph. aureus, Streptococcus epidermidis, Peptococcus, and Bacteroides fragilis ) in 16.98% of patients. ESBL Klebsiella was found in 13.89% of patients, Pseudomonas aeruginosa and Enterococcus feacalis were isolated in 8.33% of patients. 80% of ESBL infected wounds presented with Grade IV ulcers. The incidence of amputation was highest in patients whose wounds were colonized by MRSA and 60% of patients with ESBL Klebsiella infected wounds had hospital stay of more than three weeks. Conclusions: The study observed that the prognosis and outcome of a diabetic foot ulcer vary considerably with the specific type of bacteria colonizing the wound.

A biosensor platform for rapid detection of E. coli in drinking water

There remains a need for rapid, specific and sensitive assays for the detection of bacterial indicators for water quality monitoring. In this study, a strategy for rapid detection of Escherichia coli in drinking water has been developed. This strategy is based on the use of the substrate 4-methylumbelliferyl-β-d-glucuronide (MUG), which is hydrolyzed rapidly by the action of E. coli β-d-glucuronidase (GUD) enzyme to yield a fluorogenic 4-methylumbelliferone (4-MU) product that can be quantified and related to the number of E. coli cells present in water samples. In this study, the detection time required for the biosensor response ranged between 20 and 120min, depending on the number of bacteria in the sample. This approach does not need extensive sample processing with a rapid detection capability. The specificity of the MUG substrate was examined in both, pure cultures of non-target bacterial genera such as Klebsiella, Salmonella, Enterobacter and Bacillus. Non-target substrates that included 4-methylumbelliferyl-β-d-galactopyranoside (MUGal) and l-leucine β-naphthylamide aminopeptidase (LLβ-N) were also investigated to identify nonspecific patterns of enzymatic activities in E. coli. GUD activity was found to be specific for E. coli and no further enzymatic activity was detected by other species. In addition, fluorescence assays were performed for the detection of E. coli to generate standard curves; and the sensitivity of the GUD enzymatic response was measured and repeatedly determined to be less than 10 E. coli cells in a reaction vial. The applicability of the method was tested by performing multiple fluorescence assays under pure and mixed bacterial flora in environmental samples. The results of this study showed that the fluorescence signals generated in samples using specific substrate molecules can be utilized to develop a bio-sensing platform for the detection of E. coli in drinking water. Furthermore, this system can be applied independently or in conjunction with other methods as a part of an array of biochemical assays in order to reliably detect E. coli in water.

Biodegradation of Resilon Root Canal Filling Material – An In Vitro Study

Aim: The purpose of this study was to compare the biodegradability of Resilon and Gutta percha root canal filling materials, when subjected to a mixed microbial flora of Enterococcus faecalis, Streptococcus mutans and Staphylococcus epidermidis, which are organisms commonly found in failed root canal treatment cases. Materials and Method: 20 Gutta percha and 20 Resilon pellets were taken, examined under Scanning Electron Microscope and then divided into 4 groups of 10 samples each, Group I and Group II being Gutta percha and Resilon pellets respectively in TSB (Trypticase soy broth) medium without the addition of any microorganisms and Group III and Group IV being Gutta percha and Resilon pellets in TSB medium along with mixed bacterial flora. The pellets in each group were then incubated under aerobic, mesophilic conditions (37°c) and retrieved at the end of 4 months. The Resilon and Gutta percha pellets from the four groups were then examined for topographical changes using field emission scanning electron microscope (1500x). Results: The results indicated that the Gutta percha pellets showed significant biodegradation in the form of well-defined surface pitting and erosions while the Resilon pellets showed only minimal surface degradation. Conclusion: Within the limitations of this in-vitro observational simulated field study, it can be concluded that gutta percha undergoes significant biodegradation in the presence of mixed microbial flora while resilon samples showed very minimal degradation. The tested microorganisms, may have enzyme systems capable of degrading Gutta percha, which requires further investigation.