Assuntos
Leishmania mexicana , Infecções por Pseudomonas , Pseudomonas aeruginosa , Superinfecção , Humanos , Pseudomonas aeruginosa/isolamento & purificação , Pseudomonas aeruginosa/genética , Superinfecção/microbiologia , Infecções por Pseudomonas/microbiologia , Infecções por Pseudomonas/diagnóstico , Leishmania mexicana/genética , Leishmania mexicana/isolamento & purificação , Leishmaniose Cutânea/diagnóstico , Leishmaniose Cutânea/parasitologia , Leishmaniose Cutânea/microbiologia , Masculino , Doenças Transmissíveis Importadas/microbiologia , Doenças Transmissíveis Importadas/parasitologia , Doenças Transmissíveis Importadas/diagnóstico , Antibacterianos/uso terapêutico , Antibacterianos/farmacologiaRESUMO
Influenza-associated bacterial superinfections have devastating impacts on the lung and can result in increased risk of mortality. New strains of influenza circulate throughout the population yearly, promoting the establishment of immune memory. Nearly all individuals have some degree of influenza memory before adulthood. Due to this, we sought to understand the role of immune memory during bacterial superinfections. An influenza heterotypic immunity model was established using influenza A/Puerto Rico/8/34 and influenza A/X31. We report in this article that influenza-experienced mice are more resistant to secondary bacterial infection with methicillin-resistant Staphylococcus aureus as determined by wasting, bacterial burden, pulmonary inflammation, and lung leak, despite significant ongoing lung remodeling. Multidimensional flow cytometry and lung transcriptomics revealed significant alterations in the lung environment in influenza-experienced mice compared with naive animals. These include changes in the lung monocyte and T cell compartments, characterized by increased expansion of influenza tetramer-specific CD8+ T cells. The protection that was seen in the memory-experienced mouse model is associated with the reduction in inflammatory mechanisms, making the lung less susceptible to damage and subsequent bacterial colonization. These findings provide insight into how influenza heterotypic immunity reshapes the lung environment and the immune response to a rechallenge event, which is highly relevant to the context of human infection.
Assuntos
Infecções Bacterianas , Coinfecção , Influenza Humana , Staphylococcus aureus Resistente à Meticilina , Infecções por Orthomyxoviridae , Superinfecção , Adulto , Animais , Linfócitos T CD8-Positivos , Humanos , Pulmão , Camundongos , Camundongos Endogâmicos C57BL , Superinfecção/microbiologiaRESUMO
Periodontitis pathogenesis involves activation of host immune responses triggered by microbial dysbiosis. Therefore, controlling periodontal pathogens in-vivo is a main goal of periodontal therapy. New antimicrobials might help to control periodontal infection and improve treatment outcomes at "the dark times" of increasing antibiotic resistance. Here, we determined the biological activity of collinin and isocollinin against 8 bacterial strains. Antimicrobial activity of collinin and isocollinin, chlorhexidine digluconate (CHX) and sodium hypochlorite (NaClO) was evaluated against clinically relevant periodontal bacteria, like Aggregatibacter actinomycetemcomitans, Porphyromonas gingivalis, Fusobacterium nucleatum, Prevotella intermedia, Dialister pneumosintes strains and superinfectants like Escherichia coli, Staphylococcusaureus, and Pseudomonasaeruginosa strains. A broth microdilution test was carried out to determine the minimum inhibitory concentration of collinin and isocollinin against those strains, and bacterial viability was determined by resazurin assay at diverse concentration and exposure times. P. gingivalis was the most susceptible strain to collinin and isocollinin (MIC 2.1 µg/mL and 4.2 µg/mL respectively). Other periodontal pathogens showed MICs <17 µg/mL for collinin and MICs between 20 and 42 µg/mL for isocollinin, whereas CHX and NaClO showed MICs of 62 and 326 µg/mL, respectively. Collinin and isocollinin also exhibited antimicrobial activity against superinfectant bacteria (MIC < 21 and < 42 µg/mL, respectively). Overall, collinin and isocollinin showed a remarkable antibacterial activity against relevant periodontal and superinfective bacteria, especially against P. gingivalis (MIC 2.1 µg/mL and 4.2 µg/mL respectively) and the highly virulent P. aeruginosa (MIC 5.2 and 20.8 µg/mL, respectively).
Assuntos
Cumarínicos/farmacologia , Periodontite/microbiologia , Superinfecção/microbiologia , Cumarínicos/química , Relação Dose-Resposta a Droga , Humanos , Técnicas In Vitro , Testes de Sensibilidade Microbiana , Periodontite/tratamento farmacológicoRESUMO
Strongyloides stercoralis (SS) hyperinfection is a well-documented condition. However, SS eggs in stool samples are not commonly observed during routine analysis. Here, we report a case on SS hyperinfection where both larvae and eggs were observed in the stool sample of an immunossupressed liver allograft transplanted patient.
Assuntos
Hospedeiro Imunocomprometido , Transplante de Fígado/efeitos adversos , Strongyloides stercoralis/isolamento & purificação , Estrongiloidíase/diagnóstico , Superinfecção/diagnóstico , Animais , Antiparasitários/uso terapêutico , Carcinoma Hepatocelular/cirurgia , Fezes/parasitologia , Rejeição de Enxerto/imunologia , Rejeição de Enxerto/prevenção & controle , Humanos , Imunossupressores/efeitos adversos , Ivermectina/uso terapêutico , Larva , Cirrose Hepática/cirurgia , Neoplasias Hepáticas/cirurgia , Masculino , Pessoa de Meia-Idade , Óvulo , Estrongiloidíase/tratamento farmacológico , Estrongiloidíase/imunologia , Estrongiloidíase/microbiologia , Superinfecção/tratamento farmacológico , Superinfecção/imunologia , Superinfecção/microbiologia , Resultado do TratamentoRESUMO
Bacterial superinfection is a known complication among patients affected by viral respiratory tract infections. Streptococcus pyogenes, a major bacterial agent involved in acute tonsillopharyngitis, skin and soft tissue infections, was reported as a co-infecting microorganism during the 2009 A H1N1 influenza pandemic. We report a 65-year-old male patient who evolved with multifocal pneumonia and multiple organ failure with a fatal outcome. Influenza A H1N1 was detected by a polymerase chain reaction-based technique from a tracheal aspirate sample. S. pyogenes was identified by a rapid test from a nasopharyngeal sample and isolated afterwards from a positive blood culture.
Assuntos
Vírus da Influenza A Subtipo H1N1/genética , Influenza Humana/complicações , Pneumonia/complicações , Streptococcus pyogenes/isolamento & purificação , Idoso , Coinfecção/microbiologia , Evolução Fatal , Humanos , Influenza Humana/diagnóstico , Masculino , Insuficiência de Múltiplos Órgãos/complicações , Pneumonia/diagnóstico por imagem , Reação em Cadeia da Polimerase , Radiografia , Superinfecção/microbiologiaRESUMO
Bacterial superinfection is a known complication among patients affected by viral respiratory tract infections. Streptococcus pyogenes, a major bacterial agent involved in acute tonsillopharyngitis, skin and soft tissue infections, was reported as a co-infecting microorganism during the 2009 A H1N1 influenza pandemic. We report a 65-year-old male patient who evolved with multifocal pneumonia and multiple organ failure with a fatal outcome. Influenza A H1N1 was detected by a polymerase chain reaction-based technique from a tracheal aspirate sample. S. pyogenes was identified by a rapid test from a nasopharyngeal sample and isolated afterwards from a positive blood culture.
Assuntos
Idoso , Humanos , Masculino , Vírus da Influenza A Subtipo H1N1/genética , Influenza Humana/complicações , Pneumonia/complicações , Streptococcus pyogenes/isolamento & purificação , Coinfecção/microbiologia , Evolução Fatal , Influenza Humana/diagnóstico , Insuficiência de Múltiplos Órgãos/complicações , Pneumonia , Reação em Cadeia da Polimerase , Superinfecção/microbiologiaAssuntos
Erisipela/microbiologia , Linfangioma Cístico/microbiologia , Neoplasias Bucais/microbiologia , Mupirocina/uso terapêutico , Streptococcus pyogenes/isolamento & purificação , Superinfecção/microbiologia , Combinação Amoxicilina e Clavulanato de Potássio/uso terapêutico , Antibacterianos/uso terapêutico , Criança , Diagnóstico Diferencial , Quimioterapia Combinada , Erisipela/diagnóstico , Erisipela/tratamento farmacológico , Feminino , Humanos , Linfangioma Cístico/diagnóstico , Linfangioma Cístico/tratamento farmacológico , Neoplasias Bucais/diagnóstico , Neoplasias Bucais/tratamento farmacológico , Superinfecção/diagnóstico , Superinfecção/tratamento farmacológicoRESUMO
Although the main reservoir of Candida spp. is believed to be the buccal mucosa, these microorganisms can coaggregate with bacteria in subgingival biofilm and adhere to epithelial cells. The treatment of periodontal disease includes scaling and root planning (SRP) associated with proper oral hygiene. However, some patients may have negative responses to different therapeutic procedures, with a continuous loss of insertion, so the use of antimicrobials is needed as an adjuvant to SRP treatment. The use of a broad-spectrum antibiotic, such as tetracycline and metronidazole, as an aid in periodontal treatment has also been a factor for the development of superinfections by resistant bacteria and Candida species, even in patients with HIV. In the dental practice, the most commonly used antifungals are nystatin and fluconazole. However, the introduction of new drugs like the next generation of azoles is essential before the onset of emergent species in periodontal disease. Plants are good options for obtaining a wide variety of drugs. This alternative could benefit a large population that uses plants as a first treatment option. Plants have been used in medicine for a long time and are extensively used in folk medicine, because they represent an economic alternative, are easily accessible and are applicable to various diseases. Herein, we briefly review the literature pertaining the presence of Candida sp. in periodontal pockets, the conventional antifungal resistance and new therapies that include natural antifungal agents are reviewed.
Assuntos
Antifúngicos/uso terapêutico , Candidíase Bucal/tratamento farmacológico , Doenças Periodontais/microbiologia , Candida/classificação , Candida/efeitos dos fármacos , Farmacorresistência Fúngica , Humanos , Doenças Periodontais/tratamento farmacológico , Bolsa Periodontal/microbiologia , Fitoterapia , Superinfecção/microbiologiaAssuntos
Óleo Mineral/efeitos adversos , Infecções por Mycobacterium não Tuberculosas/diagnóstico , Mycobacterium fortuitum/isolamento & purificação , Pneumonia/induzido quimicamente , Superinfecção/microbiologia , Antibacterianos/uso terapêutico , Terapia Combinada , Constipação Intestinal/complicações , Constipação Intestinal/tratamento farmacológico , Quimioterapia Combinada , Oxigenação por Membrana Extracorpórea/métodos , Seguimentos , Humanos , Lactente , Masculino , Americanos Mexicanos , Óleo Mineral/uso terapêutico , Infecções por Mycobacterium não Tuberculosas/terapia , Pneumonia/fisiopatologia , Pneumonia/terapia , Insuficiência Respiratória/diagnóstico , Insuficiência Respiratória/etiologia , Medição de Risco , Índice de Gravidade de Doença , Superinfecção/diagnóstico , Superinfecção/terapia , Resultado do TratamentoRESUMO
Fungal peritonitis is a rare but serious complication of peritoneal dialysis. The aim of this study was to analyze peritonitis rates, associated factors, clinical course, microbiological aspects, therapeutic regimens, and outcome of patients with fungal peritonitis in the dialysis center of a teaching hospital over the last 25 years. A hundred and eighty three episodes of peritonitis were detected and microbiologically documented in 57 patients. Fungi were identified in eight episodes (4.37%) occurring in seven female patients. The fungal peritonitis rate was 0.06 episodes/patient-year. Gram and Giemsa stains were positive in five out of eight dialysate fluids. The causative microorganisms were: Candida albicans in five episodes, and Candida parapsilosis, Candida glabrata, and Neosartorya hiratsukae in the remaining three. Antibiotics were administered to all but one patient, within 3 months before fungal peritonitis was detected. All patients required hospitalization, and antifungal therapy was administered in all episodes. The Tenckhoff catheter was removed in seven out of eight fungal peritonitis. All patients recovered from the fungal episodes. In the group of patients studied, it is concluded that recent exposure to antibiotics and female sex, were strongly associated with the development of fungal peritonitis by yeasts. The peritonitis caused by the environmental filamentous fungus did not require antibiotic pressure. Direct microscopy of the dialysate pellet was extremely useful for the prompt management of the fungal episode. Fungal peritonitis preceded by multiple episodes of bacterial peritonitis always determined the definitive dropout of the patient from the peritoneal dialysis program. Patients with de novo yeastrelated peritonitis could continue on the program.
La peritonitis fúngica es una complicación infrecuente pero grave de la diálisis peritoneal. Los objetivos de este trabajo fueron el análisis de las tasas de peritonitis, factores asociados, aspectos clínicos y microbiológicos, esquemas terapéuticos y evolución de los pacientes afectados. Se detectaron y documentaron microbiológicamente 183 episodios de peritonitis en 57 pacientes. Se identificaron hongos en ocho episodios (4,37%) en siete pacientes, todos ellos de sexo femenino. La tasa de peritonitis fúngica fue 0,06 episodios/paciente-año. Las coloraciones de Gram y Giemsa revelaron la presencia de microorganismos en cinco de los ocho líquidos de diálisis evaluados. Los microorganismos causales fueron Candida albicans en cinco episodios y Candida parapsilosis, Candida glabrata y Neosartorya hiratsukae en los otros tres. Todos estos pacientes, excepto uno, habían recibido antibióticos en los tres meses previos al episodio de peritonitis fúngica. El catéter de Tenckhoff fue extraído en siete de los ocho episodios. Todos los pacientes evolucionaron favorablemente. Concluimos que en la población estudiada el sexo femenino y la administración reciente de antibióticos estuvieron estrechamente relacionados con el desarrollo de peritonitis fúngicas por levaduras. Sin embargo, la peritonitis causada por el hongo filamentoso ambiental no requirió de la presión antibiótica. La microscopía del sedimento del líquido de diálisis fue útil en el manejo precoz del episodio. La peritonitis fúngica precedida por múltiples episodios de peritonitis bacteriana determinó siempre la exclusión definitiva del paciente del programa de diálisis peritoneal. Los pacientes con peritonitis de novo por levaduras, en cambio, pudieron continuar en él.