Sonication of intramedullary nails: Clinically-related infection and contamination

Background and Aim: Sonication is currently considered the best procedure for microbiological diagnosis of implant-related osteoarticular infection, but studies in nail-related infections are lacking. The study aim was to evaluate implant sonication after intramedullary nail explantation, and relate it to microbiological cultures and clinical outcome. Patients and Methods: A study was performed in two University Hospitals from the same city. Thirty-one patients with implanted nails were prospectively included, whether with clinical infection (8 cases) or without (23 cases). Retrieved nails underwent sonication according a previously published protocol. The clinical and microbiological outcome patient was related to the presence of microorganisms in the retrieved implant. Results: Positive results appeared in 15/31 patients (9 with polymicrobial infections) almost doubling those clinically infected cases. The most commonly isolated organisms were Staphylococcus epidermidis (19.2 %) and Staphylococcus aureus (15.4 %). A significant relationship was found between the presence of positive cultures and previous local superficial infection (p=0.019). The presence of usual pathogens was significantly related to clinical infection (p=0.005) or local superficial infection (p=0.032). All patients with positive cultures showed pain diminution or absence of pain after nail removal (15/15), but this only occurred in 8 (out of 16) patients with negative cultures. Conclusions: In patients with previously diagnosed infection or local superficial infection, study of the hardware is mandatory. In cases where pain or patient discomfort is observed, nail sonication can help diagnose the implant colonization with potential pathogens that might require specific treatment to improve the final outcomePart of this work was funded by grants from the Comunidad de Madrid (S2009/MAT-1472) and from the CONSOLIDER-INGENIO Program (FUNCOAT-CSD2008- 00023). DMM was funded by a grant from the Fundación Conchita Rábago de Jiménez Día

Biofilm development by clinical strains of non-pigmented rapidly growing mycobacteria

AbstractThe relationship between clinical significance of non-pigmented, rapidly growing mycobacteria (NPRGM), in vitro biofilm development and sliding motility was evaluated in this study. One hundred and sixty-eight clinical strains of NPRGM were included. Forty-one of these were clinically significant isolates. Biofilm was formed by 123 strains. Seventy-six biofilm-positive and 25 biofilm-negative strains showed sliding motility. There was a relationship between clinical significance and biofilm development (p <0.000 001), sliding motility (p 0.0037) and species (p <0.000 001). No relationship was found between motility and biofilm development. The ability to develop biofilm is a characteristic that can have importance in the development of infections caused by NPRGM

Cranberry-derived phenolic metabolites and urinary tract infections

Resumen del póster presentado a la 7th International Conference on Polyphenols and Health, celebrada en Tours (Francia) del 27 al 30 de octubre de 2015.The beneficial effects of cranbeny products against urinary tract infections (UTIs) have been attributed, at least partly, to their A-type proanthocyanidin (PAC) content. A-type PACs have shown uropathogenic Escherichia coli (UPEC)-anti-adhesive activity, although they are unlikely to appear in urine at relevant concentrations as they are poorly absorbed. One leading hypothesis is that PAC-derived metabolites present in urine would operate in the phase of UPEC adyherence to uroepithelial cells, preventing bacterial colonization. In addition to this, and as it is becoming evident that the intestine is a reservoir for uropathogenic bacteria, other hypothesis is that. A-type proanthocyanidins specifically decrease the transient intestinal colonisation b UPEC, consequently reducing the risk of UTI incidence. In any case, gut microbiota (and its inter-individual variability) seems to be an important factor to be considered. In this communication, we summarize our results from different approaches aimed to look into the mechanisms that are behind the protedive action of cranberry polyphenols against ITUs: 1)in vitro fermentations of cranbeny polyphenols with colonic microbiota, that were performed to access the microbial-derived metabolic profile of cranbeny polyphenols as well as their effect on gut microbiota survival, 2) an in vivo trial with model mouse intraurethral-inoculated wilh UPEC, that evaluated the effectiveness of cranbeny supplementation in bacterial infection as well as its impact on faecal phenolic metabolism and faecal microbiota, 3) testing the UPEC-antiadhesive capacity of cranbeny phenolic compounds and their metabolites in bladder epithelial cell culíures, and 4) ex vivo studies of UPEC-antiadhesive capacity of mice mines collected after cranbeny supplementation.Ministry of Economy and Competitiveness (MiNECO) (Projects AGL-2010-17499 and AGL2012-40172-C02-01) and the Comunidad Autónoma de Madrid (Project ALIBIRD S2013/ABI-2728), Spain.Peer Reviewe

Comparative effects of A- and B-type proanthocyanidins in the prevention of urinary tract infection in mice

Resumen del póster presentado a la VI International Conference on Polyphenols and Health celebrada en Buenos Aires (Argentina) del 16 al 19 de octubre de 2013.Consumption of cranberry (Vaccinium macrocarpum) is widely recommended forprophylaxis against urinary tract infections (UTI) in women. Among cranberry components, A-type proanthocyanins would be implicated in these preventive effects against UTI. However, proanthocyanidins are poorly absorbed in the small intestine, but subjected to extensive biotransformation in the colon, although studies are almost restricted to B-type proanthocyanidins. Therefore, the hypothesis of this study is that urinary metabolome from of A-type and B-type proanthocyanidins-mainly derived from their colonic catabolism-differ,and only metabolites from the A-type procyanidins have protective effects against UTI. To test this hypothesis, JAXc3H/OuJ female mice previously fed with specific diet (control, 1% cranberry extract and 1% grape seed extract) for 2 weeks, were inoculated with the uropathogenic E. coli (ATCC 53503™) to provoke infection, and maintained 2 weeks more before being sacrificed. Urine samples were collected at different times and subjected to E.coli counting, leukocytary esterase and nitrites analyses, and mieloperoxidase task. Samples of kidney and bladder tissues were also collected for E. coli counting and histopathologic analysis. Additionally, the capacity of the urine samples to inhibit bacterial adherence was tested in the T24 bladder cell line (ATCC HTB4 ™).Peer reviewe

Antibody response in patients admitted to the hospital with suspected SARS-CoV-2 infection: results from a multicenter study across Spain

Aim: To evaluate the serological response against SARS-CoV-2 in a multicenter study representative of the Spanish COVID pandemic. Methods: IgG and IgM + IgA responses were measured on 1466 samples from 1236 Spanish COVID-19 patients admitted to the hospital, two commercial ELISA kits (Vircell SL, Spain) based on the detection of antibodies against the viral spike protein and nucleoprotein, were used. Results: Approximately half of the patients presented antibodies (56.8% were IgM + IgA positive and 43.0% were IgG positive) as soon as 2 days after the first positive PCR result. Serological test positivity increased with time from the PCR test, and 10 days after the first PCR result, 91.5% and 88.0% of the patients presented IgM + IgA and IgG antibodies, respectively. Conclusion: The high values of sensitivity attained in the present study from a relatively early period of time after hospitalization support the use of the evaluated serological assays as supplementary diagnostic tests for the clinical management of COVID-19

Chikungunya virus infections among travellers returning to Spain, 2008 to 2014

Since the first documented autochthonous transmission of chikungunya virus in the Caribbean island of Saint Martin in 2013, the infection has been reported within the Caribbean region as well as North, Central and South America. The risk of autochthonous transmission of chikungunya virus becoming established in Spain may be elevated due to the large numbers of travellers returning to Spain from countries affected by the 2013 epidemic in the Caribbean and South America, as well as the existence of the Aedes albopictus vector in certain parts of Spain. We retrospectively analysed the laboratory diagnostic database of the National Centre for Microbiology, Institute of Health Carlos III (CNM-ISCIII) from 2008 to 2014. During the study period, 264 confirmed cases, of 1,371 suspected cases, were diagnosed at the CNM-ISCIII. In 2014 alone, there were 234 confirmed cases. The highest number of confirmed cases were reported from the Dominican Republic (n = 136), Venezuela (n = 30) and Haiti (n = 11). Six cases were viraemic in areas of Spain where the vector is present. This report highlights the need for integrated active case and vector surveillance in Spain and other parts of Europe where chikungunya virus may be introduced by returning travellers

Occurrence of Corynebacterium striatum as an emerging antibiotic-resistant nosocomial pathogen in a Tunisian hospital

Corynebacterium striatum is a nosocomial opportunistic pathogen increasingly associated with a wide range of human infections and is often resistant to several antibiotics. We investigated the susceptibility of 63 C. striatum isolated at the Farhat-Hached hospital, Sousse (Tunisia), during the period 2011?2014, to a panel of 16 compounds belonging to the main clinically relevant classes of antimicrobial agents. All strains were susceptible to vancomycin, linezolid, and daptomycin. Amikacin and gentamicin also showed good activity (MICs90 = 1 and 2 mg/L, respectively). High rates of resistance to penicillin (82.5%), clindamycin (79.4%), cefotaxime (60.3%), erythromycin (47.6%), ciprofloxacin (36.5%), moxifloxacin (34.9%), and rifampicin (25.4%) were observed. Fifty-nine (93.7%) out of the 63 isolates showed resistance to at least one compound and 31 (49.2%) were multidrug-resistant. Twenty-nine resistance profiles were distinguished among the 59 resistant C. striatum. Most of the strains resistant to fluoroquinolones showed a double mutation leading to an amino acid change in positions 87 and 91 in the quinolone resistance-determining region of the gyrA gene. The 52 strains resistant to penicillin were positive for the gene bla, encoding a class A ?-lactamase. Twenty-two PFGE patterns were identified among the 63 C. striatum, indicating that some clones have spread within the hospital

Tolerance and safety of intravenous streptomycin therapy in patients with tuberculosis

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