Opportunistic Organisms Research Articles

Comparing methods to estimate incremental inpatient costs and length of stay due to methicillin-resistant Staphylococcus aureus in Alberta, Canada

BackgroundMethicillin-resistant Staphylococcus aureus (MRSA) is an opportunistic bacterial organism resistant to first line antibiotics. Acquisition of MRSA is often classified as either healthcare-associated or community-acquired. It has been shown that both healthcare-associated and community-acquired infections contribute to the spread of MRSA within healthcare facilities. The objective of this study was to estimate the incremental inpatient cost and length of stay for individuals colonized or infected with MRSA. Common analytical methods were compared to ensure the quality of the estimate generated. This study was performed at Alberta Ministry of Health (Edmonton, Alberta), with access to clinical MRSA data collected at two Edmonton hospitals, and ministerial administrative data holdings.MethodsA retrospective cohort study of patients with MRSA was identified using a provincial infection prevention and control database. A coarsened exact matching algorithm, and two regression models (semilogarithmic ordinary least squares model and log linked generalized linear model) were evaluated. A MRSA-free cohort from the same facilities and care units was identified for the matched method; all records were used for the regression models. Records span from January 1, 2011 to December 31, 2015, for individuals 18 or older at discharge.ResultsOf the models evaluated, the generalized linear model was found to perform the best. Based on this model, the incremental inpatient costs associated with hospital-acquired cases were the most costly at $31,686 (14,169 – 60,158) and $47,016 (23,125 – 86,332) for colonization and infection, respectively. Community-acquired MRSA cases also represent a significant burden, with incremental inpatient costs of $7397 (2924 – 13,180) and $14,847 (8445 – 23,207) for colonization and infection, respectively. All costs are adjusted to 2016 Canadian dollars. Incremental length of stay followed a similar pattern, where hospital-acquired infections had the longest incremental stays of 35.2 (16.3–69.5) days and community-acquired colonization had the shortest incremental stays of 3.0 (0.6–6.3) days.ConclusionsMRSA, and in particular, hospital-acquired MRSA, places a significant but preventable cost burden on the Alberta healthcare system. Estimates of cost and length of stay varied by the method of analysis and source of infection, highlighting the importance of selecting the most appropriate method.

Identification of Gram negative non-fermentative bacteria: How hard can it be?

IntroductionThe prevalence of bacteremia caused by Gram negative non-fermentative (GNNF) bacteria has been increasing globally over the past decade. Many studies have investigated their epidemiology but focus on the common GNNF including Pseudomonas aeruginosa and Acinetobacter baumannii. Knowledge of the uncommon GNNF bacteremias is very limited. This study explores invasive bloodstream infection GNNF isolates that were initially unidentified after testing with standard microbiological techniques. All isolations were made during laboratory-based surveillance activities in two rural provinces of Thailand between 2006 and 2014.MethodsA subset of GNNF clinical isolates (204/947), not identified by standard manual biochemical methodologies were run on the BD Phoenix automated identification and susceptibility testing system. If an organism was not identified (12/204) DNA was extracted for whole genome sequencing (WGS) on a MiSeq platform and data analysis performed using 3 web-based platforms: Taxonomer, CGE KmerFinder and One Codex.ResultsThe BD Phoenix automated identification system recognized 92% (187/204) of the GNNF isolates, and because of their taxonomic complexity and high phenotypic similarity 37% (69/187) were only identified to the genus level. Five isolates grew too slowly for identification. Antimicrobial sensitivity (AST) data was not obtained for 93/187 (50%) identified isolates either because of their slow growth or their taxa were not in the AST database associated with the instrument. WGS identified the 12 remaining unknowns, four to genus level only.ConclusionThe GNNF bacteria are of increasing concern in the clinical setting, and our inability to identify these organisms and determine their AST profiles will impede treatment. Databases for automated identification systems and sequencing annotation need to be improved so that opportunistic organisms are better covered.

Interaction of Photoprotective and Acclimation Mechanisms in Ulva rigida (Chlorophyta) in Response to Diurnal Changes in Solar Radiation in Southern Chile.

Species of the genus Ulva (Chlorophyta) are regarded as opportunistic organisms, which efficiently adjust their metabolism to the prevailing environmental conditions. In this study, changes in chlorophyll-a fluorescence-based photoinhibition of photosynthesis, electron transport rates, photosynthetic pigments, lipid peroxidation, total phenolic compounds, and antioxidant metabolism were investigated during a diurnal cycle of natural solar radiation in summer (for 12h) under two treatments: photosynthetically active radiation (PAR: 400-700nm) and PAR+ ultraviolet (UV) radiation (280-700nm). In the presence of PAR alone, Ulva rigida showed dynamic photoinhibition, and photosynthetic parameters and pigment concentrations decreased with the intensification of the radiation. On the other hand, under PAR+UV conditions a substantial decline up to 43% was detected and an incomplete fluorescence recovery, also, P-I curve values remained low in relation to the initial condition. The phenolic compounds increased their concentration only in UV radiation treatments without showing a correlation with the antioxidant activity. The enzimatic activity of superoxide dismutase (SOD) and ascorbate peroxidase (APX) increased over 2-fold respect at initial values during the onset of light intensity. In contrast, catalase (CAT) increased its activity rapidly in response to the radiation stress to reach maxima at 10a.m. and decreasing during solar. The present study suggests that U.rigida is capable of acclimating to natural radiation stress relies on a concerted action of various physiological mechanisms that act at different times of the day and under different levels of environmental stress.

Alerting prevalence of MBLs producing Pseudomonas aeruginosa isolates

MBL (Metallo-β-lactamases) producing Pseudomonas aeruginosa isolates are the most common opportunistic organisms with multidrug resistance (MDR) in hospital infections. The aim of this study was to determine the frequency of MBL producing isolates, antibiotic resistance pattern, and detection of the related genes using PCR technique. In this descriptive cross-sectional study, 150 clinical samples were collected from different wards (Internal, Surgical, and ICU) of Baqiyatallah Hospital during 2017, and isolates were identified by biochemical, and microbiology tests. Antibiotic susceptibility testing was performed using the Kirby-Bauer disk diffusion method. To detect β-lactamases, Double Disc Synergy Test (DDST) and Metallo-β-lactamase detection test were used. And genes associated with β-lactamases and Metallo-β-lactamases were detected by PCR technique. Data were analyzed by SPSS software through Chi-square statistical test. Of 150 clinical specimens 75 P. aeruginosa isolates recovered, and 68.6% of those were MBLs producers. The highest resistance belonged to Ciprofloxacin (94.66%), followed by Amikacin (93.44%), and no resistance was observed to Polymyxin B. The highest prevalence of genes in P. aeruginosa isolates was reported for vim (100%) and aac6 (95.71%). Results of this study showed that the prevalence of MBLs in patients hospitalized in Baqiyatallah Hospital, Tehran (Iran) was high, which causes resistance to a wide range of antibiotics. Also, due to the lack of resistance to Polymyxin B, this antibiotic is a suitable drug choice for treatment of life threating infections produced by P. aeruginosa in the studied wards, although the toxic effect of it should be considered.

A Rare Case of Candida Pericarditis Associated with Esophagopericardial Fistula

Patient: Male, 43Final Diagnosis: Candida albicans pericarditisSymptoms: Chest painMedication: —Clinical Procedure: —Specialty: CardiologyObjective:Rare diseaseBackground:Candida albicans is the principal human fungal opportunistic organism commonly detected in the gastrointestinal and genitourinary systems. Five species of candida (Glabrata, Tropicalis, Albicans, Parapsilosis, and Kruzei) are responsible for most cases of invasive candidiasis or candidemia, which is a growing public health concern due to the increasing complexity of patients, leading to a high fatality rate.Case Report:We report an extremely rare case of candida pericarditis due to esophagopericardial fistula in a young, heavy, alcoholic adult diagnosed by culture of the drained pericardial fluid, which showed a growth of Candida albicans.Conclusions:We highlight the first case of candida pericarditis in immunocompetent adult successfully treated by pericardiocentesis and oral fluconazole.

Non Tuberculosis Mycobacterium, E. coli and E. faecalis from Biofilm in Drinking Water Distribution Systems from Selected Sites of Addis Ababa

Background:The decline in microbial quality of drinking water may be attributed to many factors among which the presence of biofilm within the distribution system is the major cause of contamination. Drinking water distribution systems provide an oligotrophic environment, for post-treatment recovery and regrowth of microorganisms including the opportunistic Nontuberculosis Mycobacterium (NTM).Objective:The aim was to look for opportunistic non tuberculosis mycobacterium and indicator organisms of fecal contamination from biofilm in drinking water distribution pipeline from selected sites of Addis Ababa.Materials and Methods:A total of 40 biofilm samples were collected from two sub-cities of Addis Ababa. Biofilm samples were taken from the inner surfaces of the get valve and water meter. For the detection ofE. coliandE. faecalis,diluted biofilm samples were filtered, then it was incubated on respective culture media. For non-tuberculosis mycobacterium, the homogenized biofilm sediment was processed using the standard SD bio line method, whereby, The processed sediment was inoculated to appropriate solid and liquid culture media. The DNA extraction was conducted by chemical lysis followed by PCR amplification, from the grown colonies on LJ media (Löwenstein–Jensen). The identification of Mycobacterium species was performed by reverse hybridization using a membrane strip and an enzymatic color reaction.Results:From the total biofilm samples, 14 out of 40 (35%) were positive for mycobacteria species.M. gordoneawas the most prevalent specie of Mycobacterium, whereby 8/14 (57.1%) of the isolates were from this species followed byM. fortuitum1/14 (7.14%). About (35.7%) 5/14 of the genus Mycobaterium were unidentified species. Indicator organisms of fecal contamination (E. coliandE. faecalis)were found in 3/40(7.5%) and 6/40(15%) respectively. There was no statistically significant association between nontuberculosis mycobacterium and the indicator organisms atpvalue of 0.01.Conclusion:The study has highlighted that the occurrence of NTM in drinking water distribution in a significant proportion.M. gordonaewas found to be the most dominant species of nontuberculosis mycobacterium found in the distribution line biofilm samples.

The ROLE OF HERBAL ANTIFUNGAL AGENTS FOR THE MANAGEMENT OF FUNGAL DISEASES: A SYSTEMATIC REVIEW

Nowadays, fungal infection of skin is one of the most common dermatological problems worldwide. It has been investigated that 40 million people suffer from fungal infections. Superficial and subcutaneous fungal infections affect the skin, keratinous tissues, and mucous membranes. The dermatophytic infections, superficial candidiasis of the mouth, skin, or genital tract and infections due to Malassezia, such as pityriasis versicolor and Malassezia folliculitis are the main afflicting conditions. Systemic fungal infections may be caused by either an opportunistic organism that infects an at-risk host or may be associated with a more invasive organism or may be endemic to a specific geographical area. The most frequently encountered pathogens are Candida albicans and Aspergillus spp. but other fungi such as non-albicans Candida spp. are increasingly important in causing systemic fungal infections. There are numerous antifungal agents used clinically to treat fungal infections, i.e., azoles, allylamines, echinocandins, griseofulvin, and flucytosine. The course to modern treatment has not been without its problems and complications, particularly the drug resistances. Phytochemistry of various plant species has indicated that the phytochemicals could be a better source of medicine as compared to synthetically produced drugs. Natural medicines from a plant origin are still used as therapeutic agents, especially for treating bacterial, fungal, viral, protozoal, helminthic infections, etc. This review focuses on the use of plant constituents to prevent fungal infections caused by various pathogens. Hence, it will be proved beneficial for the drug industries.

Determination of antibiotic resistance and minimum inhibitory concentration of meropenem and imipenem growth in Klebsiella strains isolated from urinary tract infection in Shahrekord educational hospitals

Background and aims: Klebsiella is an opportunistic organism that is the cause of severe diseases such as pneumonia, septicemia, and urinary tract infections (UTIs). In addition, high antibiotic resistance has challenged the treatment of this bacterium. However, carbapenem antibiotics are considered as the therapeutic agents for selecting the treatment of penicillin- and cephalosporin-resistant gram-negative bacterial infections. The present study aimed to determine the resistance and minimum inhibitory concentration (MIC) of meropenem and imipenem. Methods: A total of 80 Klebsiella spp isolated from UTIs were collected in various educational wards (i.e., urology, obstetrics, and gynecology, as well as the units of infectious diseases, internal medicine, and intensive care) in different hospitals of Shahrekord. The isolates were then identified by using biochemical tests. Further, disc diffusion method was employed to determine the antibiotic resistance. Furthermore, MIC was estimated by the Epsilon-test strip. Moreover, P=Q=0.50, an error of 0.05, and an accuracy of 0.11 were considered for determining the sample size (n=80). Results: Based on the results of disc diffusion method, 24 strains were resistant to meropenem and imipenem. Additionally, the MIC was 24 (30%) by the E-test. In addition, 24 isolates had a MIC of ≥4 μg/mL for meropenem and imipenem and thus were resistant while 18 isolates were found to have a MIC of 1≤ MIC<4 μg/mL and therefore, were considered semi-sensitive (P<0.001). Conclusion: In general, Klebsiella strains were found to be resistant to meropenem and imipenem. Therefore, rapid and accurate identification of these strains and the selection of appropriate antibiotics can help quickly eradicate the infections caused by these bacteria. Accordingly, a waste of time, the consumption of medication, or even an increased resistance are prevented.

CHANGES IN MICROBIAL COMMUNITIES IN PRIMARY SOIL AND GROUND UNDER THE ANTHROPOGENIC INFLUENCE ON THE TERRITORY AROUND ANTARCTIC STATION “MIRNY”

Antarctic station “Mirny” was the first Russian (Soviet) polar station in Antarctica. The anthropogenic impact on the primary ground and soil in the area around of this polar station took place more than 60 years. This is reflected in both the chemical composition of the soil and microbial communities. The article shows multiple increasing of the number of bacteria and microscopic fungi in anthropogenic contaminated soils. Contamination of soil leads to changes of the structure of the microbial community. An increasing proportion of mesophilic bacteria isolates (90%) was shown. The increasing share spores and reduced the proportion of microscopic fungi mycelia were observed. Statistical analysis showed that we have identified almost all of the expected species that live in anthropogenic substrates (42 species), as well as in the control soils (17 species). But we identified only a part of fungal diversity in contaminated soils (32 species). The increase in the number of fungal species in the area of the polar station “Mirny” was proved to be connected with the human activity and introduction of new species. Native species of microscopic fungi were found to be able to colonize new materials previously unavailable to them. They also can be agents of active biodegradation of anthropogenic materials. Among fungal species isolated from anthropogenic contaminated soil and anthropogenic substrates more than 80% can be attributed to opportunistic organisms. Therefore the total number of microorganisms (CFU), the structure of the microbial complexes, the species composition of communities, indicator species, morphology and volume of biomass can be considered as an index of changes in soil microbial complexes and primary soils

Genetic Disorders Affecting Equine Blood Cells and Coagulation Factors: A-State-of-The-Art Review

Genetic diseases that affect blood cells and clotting factors in the horse are uncommon. Unfortunately, the prognosis is reserved, because the treatment in many cases is only symptomatic and when it fails, euthanasia of the patient is the only viable option. The detection of carriers is of pivotal importance in order to prevent the spread of these disorders in the equine population. This manuscript reviews the current state of knowledge of genetic diseases that affect red blood cells, leukocytes, platelets and clotting factors in the horse. The genetic diseases that affect equine red blood cells are defects in the activity of enzymes and cofactors involved in erythrocytes metabolism, such as glucose 6 phosphate dehydrogenase, flavin adenine dinucleotide, glutathione reductase and glutathione. Therefore, their deficiency triggers methemoglobinemia and hemolytic anemia. Genetic disorders affecting granulocytes are rare in horses, but a Pelget-Hüet anomaly has been reported. Primary immunodeficiencies described in horses and arising from defects in the immune system are severe combined immunodeficiency, X-linked agammaglobulinemia and Fell pony immunodeficiency syndrome. Because of the immunodeficiency, foals usually develop fatal infections during the first weeks or months of life, caused for opportunistic organisms. Prognosis of these animals is poor. The most common genetic defect of platelet is Glanzmann thrombasthenia, which results in prolonged bleeding time and hematoma formation. Spontaneous bleeding or impaired hemostasis after trauma or surgery are clinical findings in types 1 and 2 von Willebrand disease. Hemophilia A, resulting from a decreased activity of coagulation factor VIII has also been described in male horses of different breeds, being the most common genetic disorder affecting coagulation factor in the horse. Prekallikrein deficit, although described in some horses, is a rare genetic coagulation factor deficiency.

Biofilm Formation by Acinetobacter Spp. in association with Antibiotic Resistance in clinical samples Obtained from Tertiary Care Hospital

Acinetobacter spp., is an opportunistic, gram negative and non-fermenter organism, has occurred as one of the maximum bothersome pathogens for health care organisations worldwide. This organism generally targets the most susceptible hospitalized patients causing pneumonia mainly in patients on mechanical ventilation in ICU, having urinary tract infection, bloodstream infections, skin infections etc. It accounts for about 10% of all nosocomial infections. Its clinical significance over last 15 years has been forced by its amazing capacity to get resistant elements, making it one of the antagonistic organisms in the current antibiotic era. Most of Acinetobacter strains are resistant to all known antibiotics have been reported and they are acting in interaction with this emerging resistance profile, with this ability. Acinetobacter isolatesare able to survive for long periods throughout the hospital environment.Itrecurrently causes infections associated with medical devices, e.g. vascular catheters, cerebrospinal fluid shunts, urinary catheter or an endotracheal tube. Microbial biofilms are considered as virulence factors and is a well-known pathogenic mechanism in such infections. The ability to form biofilms on biotic or abiotic surfaces is a common trait among Acinetobacter strains. Therefore, the present study was undertaken to study antibiotic resistance patterns and association the resistance profile with bio-film production in various clinical isolates of Acinetobacter spp. A total of 35 isolates of Acinetobacter species were obtained for study from various clinical specimens like pus, urine, sputum, blood culture specimens from the patients admitted in hospital. Isolates obtained from different medical specimens were managed and confirmed by conservative microbiological procedures. The isolates of Acinetobacter are identified on the basis of certain biochemical test like catalase positive, oxidase negative, urease negative, nitrate negative, indole negative and non-motility test. A total of 35 isolates were subjected to susceptibility testing by disc diffusion method according to CLSI guidelines for 14 clinically relevant antibiotics. Screening for biofilm production was done quantitatively by micro titre plate assay method. In the present study, 75 % isolates were showing antibiotic resistance and 22.8% isolates produced bio film along with antibiotic resistance. Biofilm formers isolates showed high resistance to imipenem, cephotaxime, ceftazidime, tobramycin, ciprofloxacin as compared to non-biofilm formers. We selected to study the biofilm formation and antibiotic resistance of clinical isolates of Acinetobacter species to understand its ability to persist in the hospital environment to cause outbreaks.

The influence of diet on gastrointestinal Candida spp. colonization and the susceptibility of Candida spp. to antifungal drugs

Candida spp. has been identified as the most common member of human gut microbiota. This yeast-like fungus is recognized as an opportunistic organism due to its potential to cause diseases in all parts of the gastrointestinal tract. The aim of the study was to investigate the relationship between diet and health of the study participants and the presence of gastrointestinal Candida spp. Susceptibility of Candida to antifungal drugs was determined. Material comprised of oral swabs and fecal samples self-collected by the study participants. The participants filled in a nutritional questionnaire. A total of 30 people took part in the study, including 28 women and 2 men. The study was conducted in Wroclaw, Poland. Susceptibility of Candida to antifungal drugs was determined using Bio-Rad’s FUNGITEST™ Kit designed for the susceptibility testing of yeasts to six antifungal drugs. In the group with negative Candida spp. cultures, healthier wheat flour substitutes were consumed significantly more frequently than in the group with positive Candida spp. cultures. Yellow cheeses and quark were eaten significantly more frequently in the group with negative Candida spp. cultures. No antifungal resistance was detected in the study group. The increased consumption of purified wheat flour products was linked to the presence of gastrointestinal Candida spp. A higher consumption of cheese was observed in the group with negative Candida spp. cultures, which may indicate the inhibitory effect of saturated fatty acids on the growth of human Candida spp. Sensitivity of C. albicans to antifungal drugs may increase effectiveness of candidiasis treatment.

Approach to Molecular Diagnosis of Chronic Granulomatous Disease (CGD): an Experience from a Large Cohort of 90 Indian Patients.

Chronic granulomatous disease (CGD) is characterized by mutation in any one of the five genes coding NADPH oxidase components that leads to functional abnormality preventing the killing of phagocytosed microbes by affecting the progression of a respiratory burst. CGD patients have an increased susceptibility to infections by opportunistic and pathogenic organisms. Though initial diagnosis of CGD using a nitroblue tetrazolium (NBT) test or dihydrorhodamine (DHR) test is relatively easy, molecular diagnosis is challenging due to involvement of multiple genes, presence of pseudogenes, large deletions, and GC-rich regions, among other factors. The strategies for molecular diagnosis vary depending on the affected gene and the mutation pattern prevalent in the target population. There is a paucity of molecular data related to CGD for Indian population. This report includes data for a large cohort of CGD patients (n = 90) from India, describing the diagnostic approach, mutation spectrum, and novel mutations identified. We have used mosaicism in mothers and the expression pattern of different NADPH components by flow cytometry as a screening tool to identify the underlying affected gene. The techniques like Sanger sequencing, next-generation sequencing (NGS), and Genescan analysis were used for further molecular analysis. Of the total molecularly characterized patients (n = 90), 56% of the patients had a mutation in the NCF1 gene, 30% had mutation in the CYBB gene, and 7% each had mutation in the CYBA and NCF2 genes. Among the patients with NCF1 gene mutation, 82% of the patients had 2-bp deletion (DelGT) mutations in the NCF1 gene. In our cohort, 41 different mutations including 9 novel mutations in the CYBB gene and 2 novel mutations each in the NCF2, CYBA, and NCF1 genes were identified. Substantial number of the patients lack NCF1 gene on both the alleles. This is often missed by advanced molecular techniques like Sanger sequencing and NGS due to the presence of pseudogenes and requires a simple Genescan method for confirmation. Thus, the diagnostic approach may depend on the prevalence of affected genes in respective population. This study identifies potential gene targets with the help of flow cytometric analysis of NADPH oxidase components to design an algorithm for diagnosis of CGD in India. In Indian population, the Genescan method should be preferred as the primary molecular test to rule out NCF1 gene mutations prior to Sanger sequencing and NGS.

Association between Oral Candida and Bacteriome in Children with Severe ECC

Candida albicans is an opportunistic fungal organism frequently detected in the oral cavity of children with severe early childhood caries (S-ECC). Previous studies suggested the cariogenic potential of C. albicans, in vitro and in vivo, and further demonstrated its synergistic interactions with Streptococcus mutans. In combination, the 2 organisms are associated with higher caries severity in a rodent model. However, it remains unknown whether C. albicans influences the composition and diversity of the entire oral bacterial community to promote S-ECC onset. With 16s rRNA amplicon sequencing, this study analyzed the microbiota of saliva and supragingival plaque from 39 children (21 S-ECC and 18 caries-free [CF]) and 33 mothers (17 S-ECC and 16 CF). The results revealed that the presence of oral C. albicans is associated with a highly acidogenic and acid-tolerant bacterial community in S-ECC, with an increased abundance of plaque Streptococcus (particularly S. mutans) and certain Lactobacillus/Scardovia species and salivary/plaque Veillonella and Prevotella, as well as decreased levels of salivary/plaque Actinomyces. Concurrent with this microbial community assembly, the activity of glucosyltransferases (cariogenic virulence factors secreted by S. mutans) in plaque was significantly elevated when C. albicans was present. Moreover, the oral microbial community composition and diversity differed significantly by disease group (CF vs. S-ECC) and sample source (saliva vs. plaque). Children and mothers within the CF and S-ECC groups shared microbiota composition and diversity, suggesting a strong maternal influence on children’s oral microbiota. Altogether, this study underscores the importance of C. albicans in association with the oral bacteriome in the context of S-ECC etiopathogenesis. Further longitudinal studies are warranted to examine how fungal-bacterial interactions modulate the onset and severity of S-ECC, potentially leading to novel anticaries treatments that address fungal contributions.

Commentary on Complications of Immunosuppressive Treatments for Glomerulonephritis.

In this Evidence-Based Nephrology review, Jefferson ([1][1]) summarizes the potential complications and adverse effects of immunosuppressive therapies for GN. Organizing the results of major clinical trials by disease category and type of immunosuppressive therapy, he describes the frequency of

The Cenomanian–Turonian transition in the carbonate platform facies of the Western Saharan Atlas (Rhoundjaïa Formation, Algeria)

Microfacies, fossil macroinvertebrates and microfossil assemblages (foraminifera and ostracods) and δ13C from the Rhoundjaia Formation (Ksour Mountains, Western Saharan Atlas, Algeria) were studied. During the Late Cenomanian–Early Turonian, the Ksour Basin was an isolated platform at mid to outer shelf depths. The neritic conditions were interrupted by pelagic conditions in transgressive intervals. This deepening of the palaeoenvironment is reflected by changes in the foraminiferal assemblages. The composition of benthic and planktic foraminiferal assemblages, characterized by low diversity and abundance of low oxygen tolerant species, reflects a carbonate platform with biotic stress conditions (oxygen and nutrient fluctuations and sea-level changes). Planktic foraminiferal assemblages are dominated by opportunists such as Muricohedbergella and Planoheterohelix, which colonized new ecospace on the shelf during the transgression. The Oceanic Anoxic Event 2 (OAE2) is not represented by organic rich facies but does coincide with the successive proliferation of different opportunist organisms such as microgastropods and small echinoid (hemiasterids) and the heterohelicid shift. The continuous presence of trace fossils (Thalassinoides and Planolites-like) and benthic macroinvertebrates allows us to exclude anoxic conditions during the Whiteinella archaeocretacea Zone. The proliferation of Planoheterohelix indicates the record of eutrophic conditions and the transition from oxygenated to poorly oxygenated waters during stratified open marine settings at the time of maximum flooding. The subsequent increase in thin-shelled bivalves and cytherellid ostracods would confirm the stress conditions at the time of the δ13C isotopic excursion in the upper part of the W. archaeocretacea Zone. The Lower Turonian is represented by a shallowing upward trend in the Ksour Basin. Comparison of the taxonomic composition of the planktic foraminiferal assemblages (phenogram and class diagram) indicates the high degree of relationship of the Ksour Basin with the Northeast Sicily Basin, Central Tunisia Basin and Egypt. This work sheds light on the impact of the OAE2-related environmental perturbation in environments where anoxic conditions were not reached, as well as the response of the fossil assemblages to the biotic crisis.

Uppermost Permian trace fossils along a shelf to slope transect in South China and their implications for oceanic redox evolution and extinction pattern

Abstract Trace fossils are important evidence of benthic activity and proxies of bottom and interstitial water oxygen content, making them a promising tool to understand the oceanic redox evolution and extinction patterns during the end-Permian mass extinction (EPME). Detailed bed-by-bed ichnologic studies were performed at a high-resolution scale from two uppermost Permian sections (Shangsi and Dongpan) in South China, documenting the presence of Chondrites targionii, Chondrites isp., Nereites isp., Planolites isp. A, Planolites isp. B, Palaeophycus isp., Phycosiphon incertum, Thalassinoides isp., and Zoophycos isp. The uppermost Permian strata at the Shangsi section mainly comprise siliceous limestone interbedded with illite-montmorillonite claystone and shale, recording a deep shelf setting. The uppermost Permian strata at the Dongpan section consist of mixed chert, mudstone and claystone, formed in a slope environment. Bioturbation index in uppermost Permian strata is mostly 1–2, but with thin intervals reaching 3–4. Fluctuating bioturbation intensities, ichnofaunal composition (Thalassinoides, Planolites, Zoophycos) and ethologies, as well as the ratio of highly reactive iron to total iron (FeHr/FeT) and the proportion of the highly reactive iron pool in the form of pyrite (Fepy/FeHR) suggest that bottom and interstitial oxygen levels were not permanently anoxic/euxinic, but were interrupted by brief periods of aerobic conditions during the latest Permian. Three bioturbation phases in the EPME are identified. Phase I is characterized by the absence of typical pascichnia ichnotaxa (e.g. Nereites isp.) and relatively large fodinichnia burrow (e.g., Planolites isp. B; Zoophycos isp.). Phase II mainly consists of smaller Planolites isp. A, Thalassinoides isp. and Chondrites isp., recording a transition from softground to firmground. Only occasional smaller Planolites isp. A occur in Phase III without any associated vertical burrows. Ichnodiversity and bioturbation index from Phase I to Phase III show a step by step decline, corresponding to the two-stage extinction patterns. Long-term environmental stress (e.g., oceanic anoxia, volcanic winter, global warming, ocean acidification, hypercapnia) may have played major role in the collapse of the infaunal ecospace and only facies-crossing, highly tolerant, opportunistic organisms may have persisted in otherwise vacant ecological niches in the aftermath of the extinction.

Suppurative Thyroiditis due to Nocardia in An Immunocompromised Patient

Objective: Nocardia is an opportunistic organism that usually infects immunocompromised patients. However, suppurative thyroiditis is a rare complication of nocardiosis. Methods: We report a case of Nocardia thyroiditis in an immunosuppressed patient following renal transplant. Results: A 45-year-old man presented with worsening diffuse muscle pain, weakness, and subjective fever. He had a significant history of recent renal transplant with immunosuppression at the time of presentation. Mild swelling was noted in the right submandibular area, and multiple papules were noted on the skin. Although pulmonary exam revealed no abnormalities, computed tomography revealed numerous bilateral small pulmonary nodules and multiple hypodense thyroid nodules. A positron emission tomography scan showed hypermetabolic activity in the mediastinum, lungs, thyroid, and skeletal muscles. During a right-thyroid lobectomy to rule out post-transplant lymphoproliferative disease, purulent discharge from a ruptured cyst was iden...

Facing the arrival of newcomers: an intertidal sea anemone approach (Hexacorallia, Actiniaria)

In this experimental study we explore a dominance-subordination network within a key group of polyphagous opportunistic organisms. This study also includes the possible reconfiguration of this network after the arrival of exotic species of the same ecological guild. Intertidal sea anemone species have been used as an experimental model for this purpose. There are a few documented fight-specialized external morphological structures in actiniarians, including acrorhagii and catch-tentacles, which are also accompanied by a more-or-less differentiated endowment of cnidocysts. Although it is possible to identify an old immigrant in the native dominance-subordination network under study, we also explore the hypothetical arrival of an exotic population of a pantropical sea anemone species, and its effects on the current set of interactions. In this community we detected the presence of the alien species Diadumene lineata (= Haliplanella lineata, = H. luciae) of Pacific origin, which is considered to be a relatively old immigrant in European waters. Exaiptasia pallida (= Aiptasia pallida, among other synonyms), with a worldwide warm-tropical distribution, is here used experimentally as a second invasive alien. A simple Competitive Efficiency index (CEi) is proposed in order to quantify the competitive capacities of these species. The CEi of a given species is based on the percentage of conflicts won, lost, tied, and mutually avoided. Our results demonstrate how alien species can re-organize the hierarchy and dominance-subordination relationships in an established network of interactions, even considering the possible ecological substitution of natives by alien species which are ecologically equivalent (but not identical in their relationships).

Harnessing the Power of Microbiome Assessment Tools as Part of Neuroprotective Nutrition and Lifestyle Medicine Interventions.

An extensive body of evidence documents the importance of the gut microbiome both in health and in a variety of human diseases. Cell and animal studies describing this relationship abound, whilst clinical studies exploring the associations between changes in gut microbiota and the corresponding metabolites with neurodegeneration in the human brain have only begun to emerge more recently. Further, the findings of such studies are often difficult to translate into simple clinical applications that result in measurable health outcomes. The purpose of this paper is to appraise the literature on a select set of faecal biomarkers from a clinician’s perspective. This practical review aims to examine key physiological processes that influence both gastrointestinal, as well as brain health, and to discuss how tools such as the characterisation of commensal bacteria, the identification of potential opportunistic, pathogenic and parasitic organisms and the quantification of gut microbiome biomarkers and metabolites can help inform clinical decisions of nutrition and lifestyle medicine practitioners.