Profile of patients hospitalized with odontogenic infections in a public hospital in Belo Horizonte, Brazil

Objectives: We aimed to evaluate the profile of hospitalized patients presenting with odontogenic infections requiring intensive care and to identify predictive factors of worsening of the disease. Study Design: In this retrospective study, 119 consecutive medical records were assessed for data regarding odontogenic infections. The variables examined were age, gender, etiology, time from onset of infection to hospital admission, hospital stay, complications during hospitalization, and anatomical sites affected. Results: Most patients were female (64.7%) and the mean age of our study group was 28.3 years. Average length of hospital stay was 7.3 ± 6.3 days and the mean time from onset of infection to hospitalization was 6.9 days. Lower teeth corresponded to the initially affected site in the great majority (72.3%) of the cases and the mandibular third molar was the most commonly first infected tooth (31.9%). Post-surgical infection was involved in 21.8% of the cases. Systemic conditions were reported for 18.5% of the patients, mainly hypertension, but they were not determinant for admission. The main reasons for hospitalization were dyslalia, dysphagia, and dyspnea, either as single or associated signs (96.6%). Antimicrobial therapy was administered alone or combined with surgical drainage to 64 (53.8%) and 53 (44.5%) patients, respectively. Conclusions: Overall data generated by this investigation on the profile of severe odontogenic infection patients in our region are similar to those reported by other researchers. Conversely we found a higher prevalence of the disease among women in disagreement with previously published results. Such a kind of study may improve our knowledge relative to the disease and also reveal the regional scenario regarding severe odontogenic infections. Consequently it may contribute to the designing of strategies that may lead to a more efficient oral health care system what ultimately would culminate with the prevention of more severe outcomes from the disease

Cocos gram-positivos anaeróbios estritos da cavidade oral e do trato intestinal de primatas Calitriquídeos (Callithrix jacchus e Callithrix penicillata) mantidos em cativeiro.

The present work describes the recovery and identification of anaerobic Gram positive cocci of the oral cavity and fecal specimens of Marmosets bred in captivity in the Central Bioterium of the ICB/UFMG. Fecal and oral specimens were collected from 8 animals, cultivated in blood agar medium with neomycine and Thioglicolate supplemented broth. The isolated strains were identified according to microscopic appearance, colonial morphology, respiratory characteristics and biochemical tests. Anaerobic Gram positive cocci were recovered from oral and fecal specimens of marmosets; a greater recovery was obtained from the oral cavity. Streptococcus intermedius, Streptococcus parvulus, Peptostreptococcus prevotii and Streptococcus sp. were isolated from fecal specimens. Within the fecal specimens, Peptostreptococcus sp., Peptostreptococcus productus and Streptococcus parvulus were isolated. Those findings represent an original contribution to the knowledge of the marmosets’ oral intestinal microflora, especially to the Comparative Microbiology, by considering that that group is among the most frequent anaerobic microbes related to human infections.Este trabalho descreve a recuperação e a identificação de cocos gram-positivos anaeróbios estritos da cavidade oral e em espécimes fecais de sagüis Calitriquídeos, mantidos em cativeiro no Centro de Bioterismo do Instituto de Ciências Biológicas/UFMG. Foram coletados espécimes fecais e orais de oito animais, cultivados em ágar sangue com neomicina e em caldo tioglicolato suplementado. As cepas isoladas foram identificadas segundo as suas características morfocoloniais, morfotintoriais, respiratórias e testes bioquímicos. Foram recuperados cocos gram-positivos anaeróbios em espécimes orais e fecais, observando-se maior recuperação na cavidade oral. De espécimes orais foram isolados Streptococcus intermedius, Peptostreptococcus prevotii, Streptococcus parvulus, e Streptococcus sp. aerotolerante. Nos espécimes fecais, foram isolados Peptostreptococcus sp., Peptostreptococcus productus e Streptococcus parvulus. Os resultados obtidos representam contribuição original para o conhecimento da microbiota oral e intestinal de Calitriquídeos, tendo significado para a Microbiologia comparada, por estar o grupo microbiano em estudo entre os anaeróbios mais freqüentes em infecções humanas

Susceptibilidade a antimicrobianos de cocos Gram-positivos anaeróbios estritos isolados em primatas Calitriquídeos (Callithrix penicillata e Callithrix jacchus)

The purpose of this study was to evaluate the susceptibility profile to antimicrobial drugs of the anaerobic Gram-positive cocci from the oral cavity and fecal specimens of marmosets (Callithrix penicillata and Callithrix jacchus) maintained in captivity. The samples isolated from fecal specimens were found to be sensitive to penicillin G, cephalothin, cefotaxime, ampicillin and chloramphenicol as well as they showed resistance to clindamycin, cefoxitin, erythromycin, tetracycline, imipenem and metronidazole. The isolated oral samples were sensitive to penicillin G, cephalotin, cefoxitin, cefotaxime and chloramphenicol, but resistant to clindamycin, ampicillin, metronidazole, erythromycin, tetracycline and imipenem. The susceptibility profile to antimicrobial drugs of intestinal and oral Gram positive cocci of C. penicillata and C. jacchus showed the existence of multi-resistance in some strains, up to 5 drugs.O objetivo do presente trabalho foi identificar o perfil de susceptibilidade a drogas antimicrobianas de cocos Grampositivos anaeróbios estritos isolados da cavidade oral e em espécimes fecais de sagüis Calitriquídeos (C. penicillata e C. jacchus) mantidos em cativeiro. As cepas isoladas de espécimes fecais foram sensíveis a penicilina G, cefalotina, cefotaxima, ampicilina e cloranfenicol e resistentes a clindamicina, cefoxitina, eritromicina, tetraciclina, imipenem e metronidazol. Os isolados orais apresentaram sensibilidade a penicilina G, cefalotina, cefoxitina, cefotaxima e cloranfenicol e resistência a clindamicina, ampicilina, metronidazol, eritromicina, tetraciclina e imipenem. O perfil de susceptibilidade a antimicrobianos de cocos Gram-positivos anaeróbios estritos intestinais e orais isolados em Calitriquídeos mostrou a ocorrência de multirresistência, em algumas cepas, até a cinco drogas

Strongyloides venezuelensis: efeito de antimicrobiano e imunossupressor no curso da infecção em camundongos da linhagem AKR/J

Groups of AKR/J strain of mice infected by Strongyloides venezuelensis and treated with Ceftazidima, Dexametasona or with both drugs concomitantly had been killed on 3rd, 7th and 12th day after infection and their lungs and intestines were processed for histological studies. In lungs of all infected groups, it was verified an inflammatory infiltrated (neutrophils and mononuclear cells) in the third day after the infection. In 7th and 12th day after the infection, the inflammatory reaction becomes reduced in control and antimicrobial treated groups, but not in immunosuppressed animals (with or without antimicrobial treatment). Analysis of the duodenal mucosa confirmed the presence of parasites in all groups of animals. On the 7th day after infection it was observed significant alterations in the small intestine of control (infected) and infected and treated with antimicrobial groups with presence of inflammatory foci, constituted by mononuclear and eosinophils in mucosa, associate to a large amount of parasites, mainly in the region of the epithelium and sub epithelium. Two others groups (infected and immunosuppressed mice with or without antimicrobial), did not present inflammatory process. Goblet cells were less evident in mucosa suggesting a reduction in mucous production. In the 12th day of the infection, the treated with antimicrobial and control groups presented a reduced number of parasites and a discrete inflammatory reaction in the small intestine while the immunosuppressed groups showed more parasites in duodenum. The permanence of the infection by S. venezuelensis in immunosuppressed animals was prolonged in relation to other groups, remaining until the 49th day after infection. The results indicate that the interference of treatments in the population of intestinal microbiota favours the parasitism by Strongyloides venezuelensis.Camundongos da linhagem AKR/J infectados pelo Strongyloides venezuelensis e tratados com Ceftazidima, Dexametasona ou com ambas as drogas foram sacrificados no terceiro, sétimo e décimo segundo dia após infecção. Pulmões e intestino delgado foram processados para histologia. Verificaram-se, nos pulmões dos quatro grupos infectados, infiltrados inflamatórios (neutrófilos e mononucleares) no terceiro dia após a infecção. No sétimo e décimo segundo dia após a infecção, o processo inflamatório se torna reduzido nos animais controle e tratados com antimicrobiano, mas não nos animais imunossuprimidos (com ou sem tratamento com antimicrobiano). A análise da mucosa duodenal confirmou a presença de parasitos em todos os grupos de animais. No 7º dia após a infecção, foram observadas alterações significativas no duodeno dos grupos controle (infectados) e dos infectados e tratados com antimicrobiano, com presença de infiltrado inflamatório, constituído de mononucleares e eosinófilos na mucosa, associada a uma maior quantidade de parasitos, principalmente na região do epitélio e sub-epitélio. Os outros dois grupos (camundongos infectados e imunossuprimidos com ou sem antimicrobiano), não apresentaram processo inflamatório. A mucosa apresentou células caliciformes menos evidentes, sugerindo uma redução de produção de muco. No décimo segundo dia da infecção, os grupos não tratados e tratados apenas com antimicrobiano apresentaram um número reduzido de parasitos e um discreto processo inflamatório no duodeno, enquanto os grupos tratados com imunossupressor (com ou sem antimicrobiano) mostraram presença de um maior número do parasito no duodeno. A permanência da infecção do S. venezuelensis foi mais prolongada nos animais imunossuprimidos em relação aos demais grupos, permanecendo até o 490dia após infecção. Os resultados indicam que a interferência dos tratamentos no equilíbrio da microbiota intestinal favoreceu o parasitismo pelo S. venezuelensis

Microbial content recovered from diabetic foot infections: a cross-sectional study in Brazil / Conteúdo microbiano recuperado em infecções de pé diabético: um estudo transversal no Brasil

In Brazil, the prevalence of diabetes mellitus (DM) is 11.9 million cases. Diabetic foot ulcers (DFU) increase morbidity and cause hospital admissions among DM patients. In an attempt to better understand DFU, this cross-sectional study investigated microbial content and their susceptibility to antimicrobials. Secretion from foot ulcers of 30 diabetic patients were obtained in three Brazilian hospitals and submitted to microbiological evaluation. All recovered strains were identified and submitted to antimicrobial susceptibility tests. Genetic diversity was investigated by PCR coupled with denaturing gradient gel electrophoresis (PCR-DGGE). DFU exhibited a polymicrobial profile composed of 72.5% aerobic and 22.3% anaerobic bacteria, and 2.5% fungi species. A total of 91 microorganisms were isolated, and the number of recovered species per patient ranged from 1-9. Peptostreptococcus spp. was the most frequently recovered obligate anaerobic Genus and was resistant mostly to penicillin and clindamycin. A total of 37.5% S. aureus strains were methicillin resistant. E. coli were the most susceptible Gram-negative species and Pseudomonas aeruginosa were the most resistant. The present study demonstrated that almost 34% of microbial species observed on DGGE gels were not cultivable. The recovery of multidrug resistant microorganisms pointed out to the need for more attention when prescribing an empirical therapy and emphasized the relevance of this study

IMPORTÂNCIA DA AVALIAÇÃO CLÍNICA NO DIAGNÓSTICO DE DOENÇA PERIODONTAL EM CÃES DA RAÇA PASTOR ALEMÃO

As doenças periodontais resultam de resposta inflamatória progressiva do hospedeiro ao acúmulo de placa bacteriana, incluindo os metabólitos no dente e nos tecidos gengivais. Assim, avaliou-se, clinicamente, o periodonto de cães da raça Pastor Alemão, levando-se em consideração presença de tártaro, sangramento à sondagem e mobilidade dentária em animais com sítios saudáveis e com doença periodontal. Para isso, utilizaram-se 29 cães,da raça Pastor Alemão, com idade variando de três a seis anos. Clinicamente, 27 (93,10%) cães apresentavam vários sítios com sintomatologia clínica de doença periodontal e somente dois apresentavam sítios saudáveis. Os dentes mais acometidos foram os molares, os pré-molares e os caninos,com sinais clínicos mais intensos nas superfícies dentárias e maior acúmulo de tártaro e placa bacteriana. Os resultados demonstraram a necessidade de se proceder a uma limpeza preventiva dos dentes, para proporcionar maior saúde para os cães.
 PALAVRAS-CHAVE: Periodonto, cães, dente