Challenges in the Diagnosis and Management of Bacterial Lung Infections in Solid Organ Recipients: A Narrative Review

Respiratory infections pose a significant threat to the success of solid organ transplantation, and the diagnosis and management of these infections are challenging. The current narrative review addressed some of these challenges, based on evidence from the literature published in the last 20 years. Specifically, we focused our attention on (i) the obstacles to an etiologic diagnosis of respiratory infections among solid organ transplant recipients, (ii) the management of bacterial respiratory infections in an era characterized by increased antimicrobial resistance, and (iii) the development of antimicrobial stewardship programs dedicated to solid organ transplant recipient

PEMANFAATAN LIDAH BUAYA (Aloe vera) SEBAGAI ANTI MIKROBA DAN ANTI DIABETES MELLITUS

Aloe vera (Aloe vera) is a multifunctional plant which easily found in various yards. Processed AV leaves are used as food, medicine and cosmetics, but in-depth and comprehensive studies of their bioactivity are still limited. The writing of this article is based on the study of literature in various books, the results of research published on line and off line. Aloe vera has long been used as a wound drug and a drug for diabetes mellitus. The use of Aloe vera as a wound medicine is related to its ability to inhibit the growth of microbes (bacteria and fungi). Research shows that AV extracts inhibit the growth of Streptococcus mutans, Aggregatibacter actinomycetemcomitans, Porphyromonas gingivalis, Bacteroides fragilis, Mycobacterium smegmatis, Staphylococcu aureus, Enterococcus faecalis, Micrococcus luteus Bacillus sphericaus, Cholesterolus, Cholesterolus, Cholesterolus. The use of Aloe vera as a diabetes mellitus drug is related to its ability to improve the function of the pancreas in producing insulin.

Isolation, Identification and Characterization of Staphylococcus Aureus from Raw Milk in Different Places of Savar, Bangladesh

Milk and its derivates are considered vehicles of Staphylococcucs aureus infection in human. S.aureus commonly found on the skin and hair as well as in the noses and throats of people and animals. The bacteria are present in up to 25 percent of healthy people and are even more common among those with skin, eye, nose, or throat infection. S. aureus can cause food poisoning when a food handler contaminates food and then the food is not properly stored. Other sources of food contamination include the equipment and surfaces on which food is prepared .These bacteria multiply quickly at room temperature to produce a toxin that causes illness. S.aureus is killed by cooking and pasteurization. Present study was carried out from  June 2017 to November 2018 .The aim this investigation was to isolate Staphylococcus aureus from  raw cow milk obtained from different parts of Savar, Ashulia, Dhamrai area distract of Dhaka,  Bangladesh. A total of 45 milk samples were collected. Milk samples were subjected to bacteriological and biochemical tests. All the characterized isolates were    subjected to determine antibiotic susceptibility pattern by disc diffusion method testing such as and using bacteriological and biochemical schemes, 31 out of 45 sample (69%) isolates were identified as S .aureus from 45 samples. All  the isolates showed growth  on MSA and MHA agar. According  to antibiogram results  of  antibiotic  sensitivity of S.aureus,  percentages of sensitivity was observed against different group of antibiotics as follows:     chloramphenicol (93%, Gentamycin(93%), Vancomycin (89%), Streptomycin(89%)  Ciprofloxacin(64%),Tetracycillin(71%), Oxcillin (57%) Sulfamethoxazole (50%), All of the   isolates  were  found  to  be     resistant  against  Penicillin (100%) and Azithromycin 100%) . Isolated S.aureus showed  the resistance  pattern to  broad spectrum antibiotic. Some people who have tendency to drink without cooking milk and raw milk products, there is high risk of S. aureus infection in human health

Cerebrovascular complications and infective endocarditis. impact of available evidence on clinical outcome

Infective endocarditis (IE) is a life-threatening disease. Its epidemiological profile has substantially changed in recent years although 1-year mortality is still high. Despite advances in medical therapy and surgical technique, there is still uncertainty on the best management and on the timing of surgical intervention. The objective of this review is to produce further insight intothe short- and long-term outcomes of patients with IE, with a focus on those presenting cerebrovascular complications

Secular trends of antimicrobial resistance of blood isolates in a newly founded Greek hospital

BACKGROUND: Antimicrobial resistance is one of the most challenging issues in modern medicine. METHODS: We evaluated the secular trends of the relative frequency of blood isolates and of the pattern of their in vitro antimicrobial susceptibility in our hospital during the last four and a half years. RESULTS: Overall, the data regarding the relative frequency of blood isolates in our newly founded hospital do not differ significantly from those of hospitals that are functioning for a much longer period of time. A noteworthy emerging problem is the increasing antimicrobial resistance of Gram-negative bacteria, mainly Acinetobacter baumannii and Klebsiella pneumoniae to various classes of antibiotics. Acinetobacter baumannii isolates showed an increase of resistance to amikacin (p = 0.019), ciprofloxacin (p = 0.001), imipenem (p < 0.001), and piperacillin/tazobactam (p = 0.01) between the first and second period of the study. CONCLUSION: An alarming increase of the antimicrobial resistance of Acinetobacter baumannii isolates has been noted during our study

Effect of Formulation Variables on the Microencapsulation of Cassava Seed Oil and Evaluation of the Antimicrobial Properties of its Cream Formulations

Cassava seed oil obtained from Manihot esculenta Crantz possesses antimicrobial and anti-oxidant properties and can be incorporated in topical pharmaceutical formulations for treatment of wounds, skin infections and irritations. This work determined the effects of formulation variables on the properties of cassava seed oil microcapsules and the antimicrobial properties of its cream formulations. Cassava seed oil was formulated into alginate microcapsules using calcium chloride and aluminum sulphate as cross-linkers at varying oil: alginate ratios, cross-linker concentrations, and curing times. The surface morphologies, particle sizes, encapsulation efficiencies (EE) and FT-IR spectra of the microcapsules were determined. Selected microcapsules were formulated into creams and the antimicrobial activities of the cream formulations were determined against Acinetobacter baumannii NCTC 7363, Serratia marcescens ATCC 8155, Staphylococcus aureus ATCC 29213, Citrobacter freundii ATCC 8090, Escherichia coli ATCC 25925, Salmonella typhimurium 14028, Pseudomonas aeruginosa 27853 and Staphylococcus aureus ATCC 6571 by agar diffusion. Microcapsules crosslinked with calcium chloride were smaller with smoother surfaces, while those with aluminum sulphate were large, irregularly shaped with rough surfaces. The EE of microcapsules crosslinked with aluminum sulphate were higher than those with calcium chloride. The EE (23.6 – 66.7%) increased with increase in alginate:oil ratio, concentration of cross-linkers and curing times. The oily cream retained its antimicrobial property against many of the microorganisms, showing highest inhibitory activities against Pseudomonas aeruginosa 27853 and Acinetobacter baumannii NCTC 7363. Creams incorporating Cassava seed oil microcapsules with antimicrobial and antioxidant properties were produced using a simple microencapsulation process with biodegradable and renewable materials

Hemodynamic effects of neuraxial anesthesia in orthopedic surgery

Catedra de anesteziologie și reanimatologie nr.1 „Valeriu Ghereg”, USMF „Nicolae Testemiţanu”, Chişinău, Republica Moldova, Conferința stiințifică „Nicolae Anestiadi – nume etern al chirurgiei basarabene” consacrată centenarului de la nașterea profesorului Nicolae Anestiadi 26 august 2016Introducere. Anestezia combinată spinală epidurală (ACSE) este o metodă de anestezie în ortopedie, ce combină rapiditatea şi siguranţa blocului spinal cu flexibilitatea blocului epidural continuu. Scop. Analiza comparativă a stabilității presiunii arteriale (PA), rezistenţei vasculare sistemice (RVS), volumului bătaie (VB), indicelui bătaie (IB) perioperatoriu, în anestezia spinală (AS), epidurală (AE) și combinată spinală epidurală (ACSE). Materiale și metode. Studiu clinic prospectiv comparativ, bazat pe analiza stabilității PA, RVS, VB, IB perioperatoriu în AS, AE și ACSE a 103 pacienți care au beneficiat de artroplastie de șold şi osteosinteză de femur. Rezultate. Scăderea PA în lotul cu AE postoperatoriu: sistolică cu 9,4% (p<0,05), diastolică cu 5,1% (p<0,01), medie cu 5,6% (p<0,05). RVS în lotul cu AS, a scăzut intraoperatoriu cu 0,5%, și a crescut postoperatoriu cu 22,2% (p<0,05), în lotul cu AE a scăzut cu 7,4% intraoperatoriu și a sporit postoperatoriu cu 29,8%, (p<0,01). VB în lotul cu AS s-a redus postoperatoriu cu 3,3±4,6 ml/bătaie (cu 25,8%) (p<0,01), IB s-a redus cu 1,3±2,3 ml/bătaie/m2 (24,3%) (p<0,01). Pentru lotul cu AE postoperatoriu VB s-a micșorat cu 11,5±3,8 ml/bătaie (cu 23,5%, p<0,01) și IB cu 5,4±1,9 ml/bătaie/m2 (p<0,05). În lotul cu ACSE, variațiile PA, RVS şi funcției sistolice ale cordului la fiecare etapă au fost statistic irelevante. Concluzii. AS și AE manifestă repercusiuni semnificative perioperatoriu asupra PA, RVS şi travaliului cardiac. ACSE a demonstrat cele mai modeste variații hemodinamice la toate etapele de examinare.Introduction. Combined spinal epidural anesthesia (CSEA) is a method of anesthesia in orthopedic surgery, which combines the speed and safety of the spinal block with flexibility of the continuous epidural block. Purpose. Comparative analysis of the perioperative stability of arterial pressure (AP), systemic vascular resistance (SVR), stroke volume (SV), stroke volume index (SVI) during spinal anesthesia (SA), epidural (EA) and combined spinal epidural anesthesia (CSEA).Material and methods. Prospective comparative clinical trial based on perioperatively analysis of PA, SVR, SV, SVI during SA, EA and CSEA of the 103 patients operated with hip arthroplasty and osteosynthesis of the femur. Results. PA decrease postoperatively in the group with EA - systolic by 9.4% (p<0,05), diastolic by 5.1% (p<0,01) and average by 5.6% (p<0,05). SVR in the group with SA, intraoperatively decreased by 0.5% and increased by 22.2% postoperatively (p<0,05), in the group with EA decreased intraoperatively by 7.4% and increased postoperatively by 29 8% (p<0,01). SV decreased postoperatively in the group with SA by 3.3±4.6 mL/beat (25.8%) (p<0,01), SVI decreased by 1.3±2.3 mL/beat/m2 (24.3%) (p<0,01). For the group with EA, SV and SVI decreased postoperative by: 11.5±3.8 ml/beat (23.5% p<0,01) and by 5.4±1.9 mL/beat/m2 (p<0,05). Variations of the PA, SVR and systolic function of the heart at each stage were statistically irrelevant in the group with CSEA. Conclusions. SA and EA revolved significant perioperative impact on PA, SVR and cardiac function. ACSE proved the most modest hemodynamic changes at all stages of examination

Contemporaneous management in periprosthetic hip infection

Catedra de ortopedie și traumatologie, USMF „Nicolae Testemițanu” Chișinău, Republica Moldova, Conferința stiințifică „Nicolae Anestiadi – nume etern al chirurgiei basarabene” consacrată centenarului de la nașterea profesorului Nicolae Anestiadi 26 august 2016Introducere. Creșterea exponențială a numărului de artroplastii de șold mărește dramatic numărul complicațiilor septice a acestei intervenții. Scop. Analiza evoluției a metodelor de tratament al complicațiilor septice în ATȘ cu coroborând experiența autorilor cu datele literaturii. Materiale şi metode. In perioada anilor 2000-2015 în clinică s-au efectuat 24 intervenții chirurgicale de revizie a endoprotezelor de șold complicate septic. Au fost operaţi 9 bărbaţi şi 15 femei cu vârsta medie de 44 de ani. Timpul scurs de la momentul endoprotezării primare până 1а revizia șoldului infectat а variat de 1а 5 zile până 1а 2 ani si 3 luni postoperator. Cazurile au fost eșalonate conform clasificării Tsukayama. Revizia într-o etapă a fost efectuată în trei cazuri, 21 cazuri în două etape. În 5 cazuri a fost folosită metoda originală cu aplicare a spacerului propusă de către autori. Rezultate. Principalii agenți microbieni diagnosticați a constituit Staphylococcus aureus și Staphylococcus epidermidis, ce corespunde cu datele literaturii. Asanarea procesului septic a fost înregistrat la 21 pacienți. La 2 pacienți procesul septic a fost imposibil de asanat, din ce motiv în aceste cazuri s-au înlăturat componentele protetice (procedeul Girdleston). O pacientă și-a păstrat proteza în prezența unei fistule, administrând cure cu antibiotice. Concluzii. Rezultatele obținute sunt în corelare cu datele literaturii, și confirmă faptul că tactica de tratament în cazul protezelor de șold infectate trebuie individualizat, având la dispoziție o gamă largă de tehnici și implante.Actuality. Increase of the primary hip replacement number led to increase of the septic complications in this type of surgery. Purpose. The analysis of the treatment methods in septic complications after total hip arthroplasty, with correlation between the authors experience and international data. Material and methods. During the years 2000-2014 in our clinic were performed 24 revision surgical procedures of septic complication after the total hip replacements. Of these 9 were males and 15 were females; the mean cohort age was of 44 years. Elapsed time from the primary arthroplasty up to the revision of the infected hip varied from 5 days up to the 2 year and 3 months. Cases were staggered according to Tsukayama classification. Revision in one stage was performed in 3 cases; 21 cases were performed in two stages. Original method of spacer application was used in three cases. Results. The most usual infecting organism found from the study was Staphylococcu aureus and Staphylococcus epidermidis. The erradication of the infection was registered in 21 patients. In two patients septic process was impossible to eradicate, the reason why in these cases prosthetic components were removed and were performed Girdleston procedures. One patient preserved her prosthesis, but she had to use multiple courses of antibiotics. Conclusions. Obtained results are in correlation with the international data and confirm that in cases on infected hip arthroplasty the treatment tactics must be customized

The Human Antibody Response to Staphylococcus Aureus in Colonization and Infection

__Abstract_ __Introduction__: Treatment options for Staphylococcus aureus infections are becoming increasingly limited because of the extensive emergence of antimicrobial resistance among S. aureus isolates. Consequently, novel approaches, including vaccines and immunotherapy, are urgently needed. In order to develop such alternative strategies, a better understanding of the human antibody response to S. aureus exposure, is necessary. __Methods__: The qualitative and quantitative levels of antibodies directed to important S. aureus cell wall-associated proteins, immune-modulating proteins and toxins were measured in healthy individuals, children and patients suffering from diverse S. aureus infections. A flow cytometry technique based on differentially coloured microspheres was used (xMAP® Technology). __Results__: In patients as well as in healthy children and adults, the antistaphylococcal antibody profiles showed extensive inter-individual variability. When groups were compared and significant differences were found, the level of antistaphylococcal antibodies was hi