Physiological Flora Research Articles

Effects of Sublingual Colostrum Application on Oral and Intestinal Flora of Extremely Low Birth Weight Infants.

The aim of this study is to analyze the effects of colostrum application on the establishment of normal flora in the intestinal tracts and oral cavities of extremely low birth weight infants (ELBWI). A prospective cohort study design was adopted following the STROBE guidelines (Supplementary File 1). Colostrum was administered immediately after obtaining maternal breast milk using a special sterile cotton swab. There were no specific treatments for infants who did not receive colostrum. This experiment was completed on day 5 post-birth and the patients were divided into the colostrum and control groups, corresponding to whether or not colostrum was administered. Throat swabs and stool samples were collected on days 1 and 5 post-birth. Using the conventional bacteria cultivation technique, the detection rate of bacteria in 98 cases of meconium at birth was 15.31%. On day 5, the detection rates of Staphylococcus in the colostrum and control groups were 36.54% and 34.78%, with no significant difference between them (P = 0.856), and that of Enterococcus was 26.92% and 13.04%, respectively, with no statistically significant difference (P = 0.089). Likewise, at birth, the detection rate of bacteria in 98 cases of throat swabs was 27.55%. On day 5, the detection rate of Streptococcus in the colostrum and control groups was 78.85% and 50.00%, respectively, recording a statistically significant difference this time (P = 0.003). Colostrum application had limited effects on intestinal flora colonization but contributes to physiological oral flora colonization.

The Content of Bacterial Cells Depends on the Type of Bacteria

Bacteria are the most numerous group of organisms. Most of these unicellular organisms are necessary for maintaining the life of other macroorganisms on Earth. These bacteria were essential in biological evolution, and today they are the basis of every food chain in nature. They are present in soil and water. Other bacteria are members of the physiological flora of humans and animals (they live on the skin, in the oral and nasal mucosa, intestines, lower part of the female reproductive system), perform desirable chemical processes and are used in various economic activities. Of the 1,500 described species of bacteria, only about a hundred species are human pathogens.

Bacteraemia caused by Lactobacillus casei in a patient after cardiac surgery. A case report

BackgroundBacteria of the Lactobacillus family are a part of the physiological flora of the oral cavity, gastrointestinal tract, and urinary tract. We have used them in the food industry as probiotics and supplements. In some settings, rod-shaped lactic acid bacteria may become pathogenic. It may occur in immunocompromised or heart disease patients after cardiac surgery, patients with disturbed intestinal wall permeability, or those treated with broad-spectrum antibiotics.Case presentationWe present rare bacteraemia induced by the probiotic bacterium Lactobacillus casei in a 63-year-old patient after the attempted removal of ICD electrodes, complicated by acute regurgitation of the tricuspid valve. The patient underwent urgent cardiac surgery, the electrode elements were removed, and the tricuspid valve was replaced with a biological prosthesis. After surgery, the patient required intensive, multidisciplinary treatment with mechanical ventilation, continuous renal replacement therapy, broad-spectrum empirical antibiotic therapy, parenteral nutrition, and blood product transfusion because of multiple organ failure. On the 14th day of hospitalisation, the clinical symptoms of septic shock were observed. The microbiological investigation was performed, and Lactobacillus casei was cultured from a dialysis catheter sample. Dedicated antimicrobials were administered, and the patient was discharged home in good overall condition.ConclusionsThe present case shows that the promoted use of probiotics must be cautiously administered to patients in severe conditions, especially when accompanied by reduced immune system efficiency symptoms.

Infective endocarditis with negative blood cultures in patient with end-stage renal disease treated with peritoneal dialysis

Infective endocarditis (IE) is an inflammatory disease involving a proliferative-destructive processes, usually of streptococcal or staphylococcal etiology. It may also be caused by the physiological flora of the oral cavity, mainly gram-negative bacteria from the HACEK group. IE typically develops in damaged areas of the endocardium. Bacterial vegetations are found in majority on valves but they may be as well visualised in blood vessels, ventricles, on mechanical valves, electrodes and intracardiac catheters. Risk factors for endocarditis concern the growing population of adults with congenital heart disease and patients with frequent healthcare contact for other comorbidities, also patients who are immunocompromised, treated with hemodialysis or use intravenous drugs. The diagnosis of IE is made by the use of transthoracic or transesophageal echocardiography, also other imaging techniques are used. Blood cultures also should be taken. However, it was estimated that approximately 10% of patients have cultures and serologic tests negative for IE. In our study we present a case of a 51-year-old man with end-stage renal disease treated with peritoneal dialysis for 3 weeks prior to hospital admission with an acute infection of unknown origin. Infective endocarditis was suspected based on echocardiography examination. In this case PET-CT (positron emission tomography/computed tomography) was performed for verification. Its result as well as sterile blood cultures did not fully confirm the diagnosis of IE. Despite the access to highly specialized diagnostic methods and broad spectrum antibiotics the diagnosis and treatment were not easy. This story of patient’s disease can be the confirmation that IE is heterogeneous in etiology, clinical manifestations, and course.

Retrospective Data Analysis on Local Infections after Insertion of Breast Implants

Introduction: Breast implant infections are feared complications in aesthetic as well as in reconstructive breast surgery. They are associated with high costs for the healthcare system and suffering for the patients. Adequate infection prevention starts with an understanding of the causative pathogens. Therefore, the objective of this study was to analyze possible differences in the microbial spectrum of implant infections after breast augmentation and after breast reconstruction. Materials and Methods: For the period from January 2001 to December 2019, patients who received medical care from the Department of Plastic and Reconstructive Surgery of the Vienna General Hospital, due to a breast implant infection, were retrospectively analyzed. All data was collected using the documentation system of the Vienna General Hospital. A total of 28 patients were included. Results: In total 28 breast implant infections occurred: 15 after reconstruction and 13 after augmentation. A smear test was obtained in 25 patients. 17 cultures showed bacterial growth. A total of 22 germs, including 11 different bacteria, were detected. The three most common pathogens were Staphylococcus aureus n=4 (24%), Pseudomonas aeruginosa n=4 (24%) and Staphylococcus epidermidis n=4 (24%). Staphylococcus aureus was detected more frequently in the augmentation group than in the reconstruction group (33.3% vs. 12.5%, p>0.312). The incidence of gram-negative bacilli was greater under the augmentations than under the reconstructions (50% vs. 30%, p>0.342). Anaerobic bacteria, on the other hand, were found less frequently in augmentation patients (33.3% vs. 62.5%, p>0.229). There was a slight difference in bacteria that occur in the physiological skin flora (66.7% vs. 50%, p>0.486). Conclusion: Differences in the pathogens of implant infections in reconstruction patients and augmentation patients could be shown. However, these results showed no statistical significance. Nevertheless, these findings could help to adapt strategies for prevention and treatment of implant infections in future patients.

Microbiological Aspects of Pharmaceutical Manufacturing of Adipose-Derived Stem Cell-Based Medicinal Products.

Subcutaneous adipose tissue is an excellent source of mesenchymal stem cells (ADSCs), which can be used in cell therapies as an active substance in advanced therapy medicinal products (ATMPs). Because of the short shelf-life of ATMPs and the time needed to obtain the results of microbiological analysis, the final product is often administered to the patient before sterility is confirmed. Because the tissue used for cell isolation is not sterilized to maintain cell viability, controlling and ensuring microbiological purity at all stages of production is crucial. This study presents the results of monitoring the contamination incidence during ADSC-based ATMP manufacturing over two years. It was found that more than 40% of lipoaspirates were contaminated with thirteen different microorganisms, which were identified as being physiological flora from human skin. Such contamination was successfully eliminated from the final ATMPs through the implementation of additional microbiological monitoring and decontamination steps at various stages of production. Environmental monitoring revealed incidental bacterial or fungal growth, which did not result in any product contamination and was reduced thanks to an effective quality assurance system. To conclude, the tissue used for ADSC-based ATMP manufacturing should be considered contaminated; therefore, good manufacturing practices specific to this type of product must be elaborated and implemented by the manufacturer and the clinic in order to obtain a sterile product.

Potential Mechanisms of Transmission of Tick-Borne Viruses at the Virus-Tick Interface.

Ticks (Acari; Ixodidae) are the second most important vector for transmission of pathogens to humans, livestock, and wildlife. Ticks as vectors for viruses have been reported many times over the last 100 years. Tick-borne viruses (TBVs) belong to two orders (Bunyavirales and Mononegavirales) containing nine families (Bunyaviridae, Rhabdoviridae, Asfarviridae, Orthomyxovirida, Reoviridae, Flaviviridae, Phenuviridae, Nyamiviridae, and Nairoviridae). Among these TBVs, some are very pathogenic, causing huge mortality, and hence, deserve to be covered under the umbrella of one health. About 38 viral species are being transmitted by <10% of the tick species of the families Ixodidae and Argasidae. All TBVs are RNA viruses except for the African swine fever virus from the family Asfarviridae. Tick-borne viral diseases have also been classified as an emerging threat to public health and animals, especially in resource-poor communities of the developing world. Tick-host interaction plays an important role in the successful transmission of pathogens. The ticks' salivary glands are the main cellular machinery involved in the uptake, settlement, and multiplication of viruses, which are required for successful transmission into the final host. Furthermore, tick saliva also participates as an augmenting tool during the physiological process of transmission. Tick saliva is an important key element in the successful transmission of pathogens and contains different antimicrobial proteins, e.g., defensin, serine, proteases, and cement protein, which are key players in tick-virus interaction. While tick-virus interaction is a crucial factor in the propagation of tick-borne viral diseases, other factors (physiological, immunological, and gut flora) are also involved. Some immunological factors, e.g., toll-like receptors, scavenger receptors, Janus-kinase (JAK-STAT) pathway, and immunodeficiency (IMD) pathway are involved in tick-virus interaction by helping in virus assembly and acting to increase transmission. Ticks also harbor some endogenous viruses as internal microbial faunas, which also play a significant role in tick-virus interaction. Studies focusing on tick saliva and its role in pathogen transmission, tick feeding, and control of ticks using functional genomics all point toward solutions to this emerging threat. Information regarding tick-virus interaction is somewhat lacking; however, this information is necessary for a complete understanding of transmission TBVs and their persistence in nature. This review encompasses insight into the ecology and vectorial capacity of tick vectors, as well as our current understanding of the predisposing, enabling, precipitating, and reinforcing factors that influence TBV epidemics. The review explores the cellular, biochemical, and immunological tools which ensure and augment successful evading of the ticks' defense systems and transmission of the viruses to the final hosts at the virus-vector interface. The role of functional genomics, proteomics, and metabolomics in profiling tick-virus interaction is also discussed. This review is an initial attempt to comprehensively elaborate on the epidemiological determinants of TBVs with a focus on intra-vector physiological processes involved in the successful execution of the docking, uptake, settlement, replication, and transmission processes of arboviruses. This adds valuable data to the existing bank of knowledge for global stakeholders, policymakers, and the scientific community working to devise appropriate strategies to control ticks and TBVs.

Antibiotic therapy of postoperative bronchopneumonia in patients after lung resections - single-site experience.

Infectious complications after lung surgery are the most important factor that affects mortality and morbidity, prolongs hospital stays and increases financial costs. According to various sources, 30-day mortality after lung resections reaches 123%. Infectious complications account for 2075% of overall mortality. The infections most often present as postoperative pneumonia (POP), and their treatment is based on empirical and targeted antibiotic therapy. Any time lag in initiating effective antibiotic therapy significantly increases morbidity and mortality. Postoperative pneumonia is defined according to current guidelines of the American Thoracic Society of 2016 as nosocomial or ventilator pneumonia in patients after surgery. Evaluation of risk factors, infectious agents, morbidity and mortality in patients after lung resections at a single site in the period from 1 January 2018 to 31 December 2019. Of our group of 190 patients, 21 (11.1%) patients had POP which was severe in 6 (33% with POP) patients, and 11 patients with POP required artificial oxygenation for saturation below 92%. Two patients with POP had to be intubated for respiratory failure, and 3 patients required noradrenaline circulatory support. One patient with severe POP died of multiorgan failure after developing refractory sepsis. Early identification of lung infection and early initiation of POP therapy are critical points for reducing morbidity and mortality after lung resections. Advanced antibiotic regimens for POP stratify the risk of mortality and infection with multidrug-resistant bacterial strains. However, the regimes require modification according to the epidemiological situation at the site with individualization of the specific procedure. Other research tasks include identification of valid markers of the initial stages of infection, and targeting of antibiotic therapy according to risk stratification and the relationship with physiological flora.

Nasal carriage of Staphylococcus aureus in children with grass pollen-induced allergic rhinitis and the effect of polyvalent mechanical bacterial lysate immunostimulation on carriage status: A randomized controlled trial.

ABSTRACTBackgroundNumerous studies indicate that Staphylococcus aureus (S. aureus) colonizing the nasal cavity plays a role in the pathogenesis of allergic rhinitis (AR). This bacterium is able to produce a variety of toxins with superantigenic properties that can exacerbate allergic inflammation.ObjectiveThe objective of the study was to evaluate the ability of polyvalent mechanical bacterial lysate (PMBL) to eliminate S. aureus nasal carriage in children with grass pollen‐induced AR.MethodsThis randomized, double‐blind, placebo‐controlled study included 80 children aged 5–17 years with seasonal AR (SAR). At the randomization visit and after 12 weeks of the study, a swab was taken from the region of the middle nasal meatus. Standard microbiology culture and identification techniques were used to analyze the swab contents.ResultsNasal colonization by S. aureus was confirmed in 29 children (42%), with Moraxella catarrhalis in three participants (4.4%). Physiological flora was detected in 37 children. No statistically significant differences were observed between the two measurement points in both the PMBL and placebo groups with respect to the number of patients whose nasal swab cultures showed a growth of S. aureus (p = 1). Both groups also showed no significant changes in the mean number of S. aureus colonies in nasal swab cultures taken at baseline and after 12 weeks of the study (PMBL group p = .41; placebo group p = .16).ConclusionAlmost every second child with SAR is S. aureus nasal carrier. Sublingual administration of PMBL in children with grass pollen‐induced AR did not affect S. aureus nasal colonization. Therefore, PMBL should not be used for the eradication of S. aureus from the nasal cavity.

Decontamination of disposable respirators for reuse in a pandemic employing in-situ-generated peracetic acid

BackgroundDuring shortages of filtering face pieces (FFP) in a pandemic, it is necessary to implement a method for safe reuse or extended use. Our aim was to develop a simple, inexpensive and ecological method for decontamination of disposable FFPs that preserves filtration efficiency and material integrity. Material and methodsContamination of FFPs (3M Aura 9320+) with SARS-CoV-2 (1.15 × 104 PFUs), Enterococcus faecium (>106 CFUs), and physiological nasopharyngeal flora was performed prior to decontamination by submersion in a solution of 6 % acetic acid and 6 % hydrogen peroxide (6%AA/6%HP solution) over 30 minutes. Material integrity was assessed by testing the filtering efficiency, loss of fit and employing electron microscopy. Results and DiscussionDecontamination with the 6%AA/6%HP solution resulted in the complete elimination of SARS-CoV-2, E. faecium and physiological nasopharyngeal flora. Material characterization post-treatment showed neither critical material degradation, loss of fit or reduction of filtration efficiency. Electron microscopy revealed no damage to the fibers, and the rubber bands’ elasticity was not affected by the decontamination procedure. No concerning residuals of the decontamination procedure were found. ConclusionThe simple application and widespread availability of 6%AA/6%HP solution for decontaminating disposable FFPs make this solution globally viable, including developing and third world countries.

Hygiene measures in antenatal care

HintergrundDie Infektionsprävention in der Schwangerenbetreuung hat eine herausragende Bedeutung, zum einen mit Blick auf die Erreger konnataler Infektionen, zum anderen durch die Assoziation von mütterlichen Infekten mit vorzeitiger Entbindung.FragestellungWelche Maßnahmen sind zur effektiven Vermeidung geburtshilflich relevanter bakterieller und viraler Erkrankungen zu empfehlen?Material und MethodeLiteraturrecherche zu Maßnahmen der Prophylaxe der Übertragung von Erregern konnataler Infektionen sowie maternaler Infektionen im geburtshilflichen Kontext.ErgebnisseDie physiologische Vaginalflora der schwangeren Frau ist ein fundamentaler Faktor der natürlichen Infektionsprävention. Ihre Störung – auch durch antimikrobielle Therapien – hat einen nachgewiesenen Einfluss auf den Schwangerschaftsverlauf (vorzeitiger Blasensprung, Frühgeburt). Sie führt aber auch zu einem gestörten intestinalen Mikrobiom beim Neugeborenen, was Langzeitfolgen für dessen neurologische, respiratorische, metabolische und immunologische Entwicklung hat und die Mortalität erhöht. Der Fokus sollte daher auf der Prävention – und nicht der Therapie – von Infektionserkrankungen in der Schwangerschaft liegen. Dazu sind in der Schwangerenbetreuung eine detaillierte Anamnese, eine Kontrolle und Aktualisierung des Impfstatus und ggf. eine Abklärung des Infektionsstatus durch gezielte serologische Tests erforderlich. Dann kann der Gynäkologe individuell zu Präventionsmaßnahmen beraten. Der Artikel gibt gezielte Empfehlungen zu ausgewählten geburtshilflich relevanten Infektionen.SchlussfolgerungenDie Fokussierung auf Hygienemaßnahmen zur Infektionsvermeidung in der Geburtshilfe kann die Gesundheit von Mutter und Kind verbessern.

Effects of different types and doses of whey protein on the physiological and intestinal flora in D-galactose induced aging mice

The elderly usually suffer from many diseases. Improving the quality of life of the elderly is an urgent social issue. In this present study, D-galactose treated aging mice models were used to reveal the effects of different animal sources and different doses of whey protein (WP) on the immune indexes organs and intestinal flora. A total of 9 groups were set up, including normal control (NC), negative control (NS), positive control (Vc), low-, medium- and high-doses of cow WP intervention groups (CL, CM and CH for short, correspondingly) and low-, medium- and high-doses of goat WP intervention groups (GL, GM and GH for short, correspondingly). The body weight gain, thymus/body weight ratio, superoxide dismutase (SOD) activity, malondialdehyde (MDA) content, spleen immunoglobulins G (IgG), spleen interleukin-2 (IL-2) and spleen interleukin-2 (IL-6) were measured. Then, the intestinal contents were collected, and 16s genes of intestinal bacteria were sequenced to reveal the changes in bacterial flora structure. WP intervention significantly increased the weight gain, thymus/body ratio and SOD activity, but decrease the content of MDA. WP intervention increased some immune indicators. All the WP treated aging mice showed similar values of physiological indexes to that of the Vc group, even better. The relative abundance of Lactobacillus and Stenotrophomonas was increased and decreased, respectively, by both cow and goat WP. Lactobacillus may be involved in regulating the functional repair of organisms. In contrast, Stenotrophomonas might play a negative role in the immune and antioxidant capacity of the body. Combining physiological indicators and intestinal flora structure, low-concentration WP for cow and goat might be optimal for aging models.

Guideline: Vulvovaginal candidosis (AWMF 015/072, level S2k).

Approximately 70‐75% of women will have vulvovaginal candidosis (VVC) at least once in their lifetime. In premenopausal, pregnant, asymptomatic and healthy women and women with acute VVC, Candida albicans is the predominant species. The diagnosis of VVC should be based on clinical symptoms and microscopic detection of pseudohyphae. Symptoms alone do not allow reliable differentiation of the causes of vaginitis. In recurrent or complicated cases, diagnostics should involve fungal culture with species identification. Serological determination of antibody titres has no role in VVC. Before the induction of therapy, VVC should always be medically confirmed. Acute VVC can be treated with local imidazoles, polyenes or ciclopirox olamine, using vaginal tablets, ovules or creams. Triazoles can also be prescribed orally, together with antifungal creams, for the treatment of the vulva. Commonly available antimycotics are generally well tolerated, and the different regimens show similarly good results. Antiseptics are potentially effective but act against the physiological vaginal flora. Neither a woman with asymptomatic colonisation nor an asymptomatic sexual partner should be treated. Women with chronic recurrent Candida albicans vulvovaginitis should undergo dose‐reducing maintenance therapy with oral triazoles. Unnecessary antimycotic therapies should always be avoided, and non‐albicans vaginitis should be treated with alternative antifungal agents. In the last 6 weeks of pregnancy, women should receive antifungal treatment to reduce the risk of vertical transmission, oral thrush and diaper dermatitis of the newborn. Local treatment is preferred during pregnancy.

Rothia aeria and Rothia dentocariosa as biofilm builders in infective endocarditis

BackgroundRothia sp. are Gram-positive bacteria in the class of Actinobacteria that are part of the physiological oral flora. In rare cases, Rothia aeria and Rothia dentocariosa can cause infective endocarditis (IE). The biofilm potential of Rothia in endocarditis is unknown. MethodsSpecimen from two cases of Rothia endocarditis were obtained during cardiac surgery. One of the patients suffered mitral valve IE from Rothia aeria. In the other case, IE of a prosthetic pulmonary valve was caused by Rothia dentocariosa. Fluorescence in situ hybridization (FISH) was used for visualization of microorganisms within heart valve tissues in combination with PCR and sequencing (FISHseq). ResultsThe two heart valve specimens featured mature biofilms of bacteria that were identified by FISHseq as Rothia aeria and Rothia dentocariosa, respectively. FISH showed in situ biofilms of both microorganisms that feature distinct phenotypes for the first time ex vivo. Both of our reported cases were treated successfully by heart valve surgery and antibiotic therapy using beta-lactam antibiotics. ConclusionThe biofilm potential of Rothia sp. must be taken into account. The awareness of Rothia aeria and Rothia dentocariosa as rare but relevant pathogens for infective endocarditis must be raised. Use of biofilm-effective antibiotics in Rothia IE should be discussed.

The Intestinal Flora at Kasai Procedure in Children with Biliary Atresia Appears Not to Affect Postoperative Cholangitis

Evidence supports long-term oral antibiotic prophylaxis to prevent cholangitis after Kasai procedure. Data regarding perioperative intravenous prophylaxis are lacking. Ascending pathogens from the intestine are made responsible for recurrent cholangitis. Therefore, we analyzed the flora in the upper jejunum during the Kasai procedure and their potential impact on postoperative cholangitis. In 26 patients, swabs were taken at the bowel prepared for the Roux-en-Y-loop. Our postoperative protocol includes intravenous third-generation cephalosporins for 2 weeks and rectal steroids starting at day 4. Cholangitis was defined as the postoperative reappearance of acholic stools or increase of serum bilirubin in combination with fevers or increase of inflammatory parameters. In this scenario, Tazocin was administered for another 2 weeks. Swabs remained sterile in nine patients (34.6%). In 17 patients (65.4%), gram-positive and gram-negative pathogens were identified; all belonging to physiological intestinal flora. A total of 96.2% pathogens were covered by the antibiotic prophylaxis. The cholangitis incidence was 55.6% in the sterile cohort, and 23.5% in the gram-positive and gram-negative cohort (p = 0.06). In the cholangitis cohort, no significant differences were detected for the age at Kasai and the pre- and postoperative total bilirubin. We found that our antibiotic regiment covered bacteria in the upper gastrointestinal (GI) tract in the majority of our patients at the time of Kasai. Nonetheless, a significant proportion of patients developed signs of cholangitis. There was no higher rate of cholangitis in patients with resistant bacteria. Thus, our data do not support the hypothesis of extended postoperative intravenous antibiotics to prevent ascending cholangitis.

Respiratory and Gut Microbiota in Allergy and Asthma

The objective of the study was to assess the potential mechanisms by which the microbiome influences immune responses in allergy and asthma, especially during early childhood and to evaluate the evidence of respiratory and gut microbiota dysbiosis. The development and progression of allergy and asthma may depend on individual susceptibility, allergen exposure, infections, and exposure to indoor and outdoor air pollution. In recent years there has increasingly been an emphasis on the importance of microbiota in the regulation of immune response and the development of atopic diseases, as well as asthma. Commensal microbes are necessary for the induction of a balanced and tolerogenic immune system especially at an early age. An insufficiency of early life exposure to the environmental microbiota necessary for colonization of the gastrointestinal and/or respiratory tracts results in the development of asthma and allergic diseases. On the other hand, disturbed physiological flora in the digestive and respiratory tract also increase the risk for development and progression of asthma and allergy (allergic march). Microbiota in the gut and lungs may influence both the onset and progression of childhood asthma. These microbiota can be modulated by various environmental factors, including the type of delivery, early-life microbial exposures, diet, antibiotics. Conclusion – Intervention regarding airway microbiome, particularly in early life, might be a strategy for prevention or treatment of asthma and allergies. Further investigations are needed to improve our understanding of the role of the microbiome in inflammation, and to clarify the effect of the regulation of lung and gut microbiota and its influence on the prevention or treatment of allergic diseases and asthma.

Analysis of clinical and microbiological results of photodynamic therapy as support in non-surgical treatment of periodontitis – preliminary study

Introduction. Photodynamic therapy is supportive method of non-surgical treatment of periodontitis. The aim of the study was the assessment of photodynamic therapy impact on periodontal disease clinical parameters with a particular emphasis on microbiological aspects during periodontal treatment. Material and methods. The research was conducted on seven healthy patients aged 26- 55 years. All the patients were treated with a non-surgical (SRP) periodontal treatment. Then, the assisted photodynamic therapy was applied in selected pockets. Samples of the material obtained from periodontal pockets before and after the treatment were cultured in a microbiological laboratory. Results. After the introduced therapy the clinical improvement of periodontal disease was observed in the majority (6/7) of patients taking part in the study. There obtained the elimination of inflammation to 85.7% of the patients. Periodontal pocket depths have deteriorated from 0.5 to 3.0 mm in comparison to the pre-treatment values. The overall number of bacteria compared to the pre-treatment value was reduced. In addition, there was noticed a decrease in the number of periopathogens. Control samples showed a vivid dominance of the physiological flora. Conclusions. The non-surgical treatment of periodontitis in combination with the supportive action of photodynamic therapy has promising therapeutic effects by reducing the inflammation and decreasing the depth of periodontal pockets. The change in the ratio of periopathogens to physiological flora may indicate the restoration and maintenance of the state balance in periodontal pockets for patients with periodontitis.

Group B Streptococcal Colonization, Molecular Characteristics, and Epidemiology.

Streptococcus agalactiae or group B streptococcus (GBS) is a leading cause of serious neonatal infections. GBS is an opportunistic commensal constituting a part of the intestinal and vaginal physiologic flora and maternal colonization is the principal route of GBS transmission. GBS is a pathobiont that converts from the asymptomatic mucosal carriage state to a major bacterial pathogen causing severe invasive infections. At present, as many as 10 serotypes (Ia, Ib, and II–IX) are recognized. The aim of the current review is to shed new light on the latest epidemiological data and clonal distribution of GBS in addition to discussing the most important colonization determinants at a molecular level. The distribution and predominance of certain serotypes is susceptible to variations and can change over time. With the availability of multilocus sequence typing scheme (MLST) data, it became clear that GBS strains of certain clonal complexes possess a higher potential to cause invasive disease, while other harbor mainly colonizing strains. Colonization and persistence in different host niches is dependent on the adherence capacity of GBS to host cells and tissues. Bacterial biofilms represent well-known virulence factors with a vital role in persistence and chronic infections. In addition, GBS colonization, persistence, translocation, and invasion of host barriers are largely dependent on their adherence abilities to host cells and extracellular matrix proteins (ECM). Major adhesins mediating GBS interaction with host cells include the fibrinogen-binding proteins (Fbs), the laminin-binding protein (Lmb), the group B streptococcal C5a peptidase (ScpB), the streptococcal fibronectin binding protein A (SfbA), the GBS immunogenic bacterial adhesin (BibA), and the hypervirulent adhesin (HvgA). These adhesins facilitate persistent and intimate contacts between the bacterial cell and the host, while global virulence regulators play a major role in the transition to invasive infections. This review combines for first time epidemiological data with data on adherence and colonization for GBS. Investigating the epidemiology along with understanding the determinants of mucosal colonization and the development of invasive disease at a molecular level is therefore important for the development of strategies to prevent invasive GBS disease worldwide.

Impact of low-level laser therapy on the dynamics of pressure ulcer-induced changes considering an infectious agent and cathelicidin LL-37 concentration: a preliminary study.

IntroductionLow-level laser therapy is used in managing chronic wounds including pressure ulcers. Less is known about its impact on the healing process if an inhibitive agent e.g. bacterial infection takes place. Modulating non-specific immunity processes might eliminate bacteria if laser therapy is applied.AimTo investigate the impact of low-level laser therapy on pressure ulcer dynamics considering an infectious agent and cathelicidin LL-37 concentration.Material and methodsThe study comprised 6 patients with pressure ulcers ranging from stage II to III in Torrance classification and 12 patients without pressure ulcers. Venous blood sample and decubitus wound swab were taken – in study groups A at baseline and after 2 weeks; in control group B once – at a specific point of time. The swabs served for species identification. Drug susceptibility of isolated pathogens and cathelicidin LL-37 in serum concentration were measured.ResultsIn study group A, the following bacteria predominantly occurred: S. aureus, E. faecalis, P. mirabilis, P. aeruginosa, while in control group B, excluding one MRSA case, S. hominis, S. epidermidis, D. nishinomiyaensis, A. haemolyticus (physiological flora) were present. HLGR resistance mechanisms were detected when analyzing drug susceptibility panels. Study group A findings demonstrated a statistically significant difference between the levels of cathelicidin LL-37 concentration at baseline and at the end.ConclusionsThere is insufficient information to accurately determine the effect of LLLT on pressure ulcer dynamics considering an infectious agent. These effects may occur if innate immunity processes are modulated so that laser therapy might eliminate bacteria indirectly.

Natural antibodies – facts known and unknown

In contrast to adaptive antibodies, natural antibodies are present in a non-immunised organism from birth, and they do not include anti-Gal antibodies and/or anti-Gal natural antibodies, which are developed as a result of the effect of the α-Gal epitope and physiological flora. Natural antibodies are the first line of the organism’s defence before the formation of the immunity created via the stimulation of elements that determine specific and non-specific immunity. This is especially important in the case of infants. Despite the fact that natural antibodies differ in their function from adaptive antibodies, they are polyreactive and they detect autoantigens and new antigenic determinants. Natural antibodies are formed from the subpopulation of B lymphocytes, mainly B1 lymphocytes and B lymphocytes of the marginal zone. This phenomenon is supported by the fact that when the quantity of these cells in the organism decreases, which happens with age, the level of natural antibodies also decreases and the risk of illnesses of old age becomes higher. During ontogenesis, these antibodies participate in many physiological processes, including the “support” of the immune system and homeostasis, the prevention of inflammation, infections and other pathological states, such as autoimmune and cardiovascular diseases, or the process of carcinogenesis. The best known natural antibody is IgM, but the role of IgGs and IgAs is also considered important. Nowadays, many researchers also mention intravenous immunoglobulins, which are used in the treatment of numerous illnesses, and there are discussions on the possibility of increasing their potential if they were based on natural antibodies.