Escherichia coli Population-Based Study in Pediatric Crohn\u2019s Disease

Escherichia coli is assumed to be involved in inflammatory bowel disease (IBD) by many authors. The present Short Report was aimed at analyzing E. coli population isolates from ileal samples collected from 4 CD and 3 non-CD (control group) diagnosed pediatric patients. A total of 539 mu- cosa-associated E. coli strains were characterized by: Random Amplified Polymorphic DNA (RAPD), adhesive and virulence factors, and for their phylogenetic groups. A significant separation be- tween RAPD profiles of the two CD and non-CD cohorts (P < 0.0001), along with a significant reduc- tion of intra-species genomic variability in E. coli populations isolated from CD group (P < 0.0001) was found as assessed by Dice index, indicating a different selective pressure in CD intestinal ha- bitat. A predominance of phylogenetic group A was found in control subjects (P < 0.0001). Results on adhesive and virulence factors evidenced peculiar genes significantly related to CD E. coli pop- ulations (K1, IbeA) (P < 0.0001) and to total DNA from biopsy specimens K1 (P < 0.0001). Results suggest that among E. coli population, particular variants may be favorite in the intestinal habitat of CD pediatric patients. These genotype variants could represent the genetic background that, via evolutionary phenomena driven by a persistent inflammatory state, may evolve in Adherent Inva- sive Escherichia coli (AIEC) like strains found in adult CD patients

Orthopedic Device-Related Infections Due to Emerging Pathogens Diagnosed by a Combination of Microbiological Approaches: Case Series and Literature Review

Orthopedic and trauma device-related infections (ODRI) due to high virulence microorganisms are a devastating complication after orthopedic surgery. Coagulase-negative Staphylococci (CoNS) are mainly involved but commensal bacteria, located in human mucous membranes, are emerging pathogens in ODRI. Currently, bacterial culture is the gold standard for ODRI but the diagnostic process remains time consuming and laborious. We evaluated a combination of microbiological approaches in the diagnosis of emerging pathogens involved in ODRI. We analyzed two synovial fluids, five tissue samples and five surgical wound swabs from two different patients with ODRI, attending the Department of Orthopedic and Trauma Surgery of Mater Domini Teaching Hospital, Catanzaro, Italy. Identification was carried out with a combination of microbiological approaches (culture, mass spectrometry and 16s rRNA gene sequencing). We demonstrated the importance of a combination of microbiological approaches for the diagnosis of emerging pathogens in ODRI, because the low number of cases in the literature makes it very difficult to formulate guidelines for the management of patients

Gut Microbiota Structure and Metabolites, Before and After Treatment in Early Rheumatoid Arthritis Patients: A Pilot Study

Rheumatoid Arthritis (RA) is a chronic systemic autoimmune disease. Modifications of gut microbiota seem to be associated with the disease, but the impact of gut microbiota on therapies’ outcome remains unclear. A role of T cells in RA pathogenesis has been addressed, particularly on the Th17/Treg cells balance. Our study aimed to evaluate in early RA (ERA) patients compared to a control group, fecal gut microbiota composition, short-chain fatty acids concentrations, and the levels of circulating Th17/Treg and their own cytokines, before and after 3 months of standard treatment (Methotrexate (MTX) plus glucocorticoids). Fecal microbiota characterization was carried out on 19 ERA patients and 20 controls matched for sex and age. Significant decreased biodiversity levels, and a partition on the base of the microbiota composition, between the ERA patients at baseline compared to controls, were observed. The co-occurrent analysis of interactions revealed a characteristic clustered structure of the microbial network in controls that is lost in ERA patients where an altered connection between microbes and clinical parameters/metabolites has been reported. Microbial markers such as Acetanaerobacterium elongatum, Cristiansella massiliensis, and Gracilibacter thermotolerans resulted significantly enriched in control group while the species Blautia gnavus emerged to be more abundant in ERA patients. Our results showed an alteration in Th17/Treg balance with higher Th17 levels and lower Treg levels in ERA group respect to control at baseline, those data improved after therapy. Treatment administration and the achievement of a low disease activity/remission appear to exert a positive pressure on the structure of intestinal microbiota with the consequent restoration of biodiversity, of the structure of microbial network, and of the abundance of taxa that became closer to those presented by the subject without the disease. We also found an association between Blautia gnavus and ERA patients characterized by a significant reduction of propionic acid level. Furthermore significant differences highlighted at baseline among controls and ERA patients are no more evident after treatment. These data corroborate the role played by gut microbiota in the disease and suggest that therapy aimed to restore gut microbiota would improve treatment outcome