Increased Prevalence of Symptomatic Human Intestinal Spirochetosis in MSM with High-Risk Sexual Behavior in a Cohort of 165 Individuals

Human intestinal spirochetosis (HIS) can cause gastrointestinal symptoms, although asymptomatic infections have been described. Individuals from low-income countries, people living with HIV, and men who have sex with men (MSM) show increased risk. A retrospective review of all patients diagnosed with HIS (n = 165) between January 2013 and October 2020 at a tertiary hospital in Madrid, Spain, was performed to assess risk factors for symptomatic HIS, symptoms, and response to treatment. Most patients were male (n = 156; 94.5%), 86.7% were MSM, and 23.5% practiced chemsex, of whom most were symptomatic (p = 0.039). Most patients (78.4%) reported unprotected oral-anal intercourse. A total of 124 (81.1%) were symptomatic; diarrhea was the most common complaint (68.3%). Multivariable regression showed increased odds of symptoms associated with age under 41 (odds ratio 5.44, 95% CI 1.87-15.88; p = 0.002). Colonoscopy was normal in 153 (92.7%). Furthermore, 66.7% presented previous or concomitant sexually transmitted diseases (STDs). Among the patients, 102 underwent testing for other gastrointestinal pathogens, with positive results in 20 (19.6%). All symptomatic patients without concomitant gastrointestinal infection presenting improvement on follow-up (42 of 53) had received either metronidazole or doxycycline (p = 0.049). HIS should be considered as a cause of chronic diarrhea in MSM with high-risk sexual behavior after other causes have been ruled out; treatment with metronidazole is recommended. Coinfection with other STDs is common.S

Evaluation of bacterial adherence of clinical isolates of Staphylococcus sp. using a competitive model: An in vitro approach to the "race for the surface" theory

Objectives Implant-related infection is one of the most devastating complications in orthopaedic surgery. Many surface and/or material modifications have been developed in order to minimise this problem; however, most of the in vitro studies did not evaluate bacterial adhesion in the presence of eukaryotic cells, as stated by the 'race for the surface' theory. Moreover, the adherence of numerous clinical strains with different initial concentrations has not been studied. Methods We describe a method for the study of bacterial adherence in the presence of preosteoblastic cells. For this purpose we mixed different concentrations of bacterial cells from collection and clinical strains of staphylococci isolated from implant-related infections with preosteoblastic cells, and analysed the minimal concentration of bacteria able to colonise the surface of the material with image analysis. Results Our results show that clinical strains adhere to the material surface at lower concentrations than collection strains. A destructive effect of bacteria on preosteoblastic cells was also detected, especially with higher concentrations of bacteria. Conclusions The method described herein can be used to evaluate the effect of surface modifications on bacterial adherence more accurately than conventional monoculture studies. Clinical strains behave differently than collection strains with respect to bacterial adherence.This work was funded by the following grants from the Spanish MINECO (MAT2013- 48224-C2-2-R and MAT2013-48224-C2-1-R). M. Martínez-Pérez reports funding received from EFORT 2015 congress: travel supported by PFIZER, which is related to this article. J. Esteban and E. Gómez-Barrena report funding received from several companies for travel, expenses and grants, none of which is related to this articl

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

Tolerance and safety of intravenous streptomycin therapy in patients with tuberculosis

Peer Reviewe

The >Race for the Surface> experimentally studied: In vitro assessment of Staphylococcus spp. adhesion and preosteoblastic cells integration to doped Ti-6Al-4V alloys.

Implant-related infection is a devastating complication in orthopedic surgery. Aiming to minimize this problem, many material modifications have been developed. Here we report a study of a surface modification of Ti-6 Al-4 V alloy using a methodology that enables the study of interactions between bacteria and the material in the presence of eukaryotic cells. We mixed different concentrations of collection or clinical strains of staphylococci isolated from implant-related infections with preosteoblastic cells using a previously published methodology, analyzing the minimal concentration of bacteria able to colonize the surface of the material through image analysis. Ti-6 Al-4 V alloy was modified by anodization to obtain two F-doped nanostructured surfaces that have been previously described to have antibacterial properties.Peer Reviewe

In vitro assessment of Staphylococcus epidermidis and Staphylococcus aureus adhesion on TiO 2 nanotubes on Ti-6Al-4V alloy

The aim of this study was to evaluate Staphylococcus sp. adhesion to modified surfaces of titanium alloy (Ti-6Al-4V). Specimens of Ti-6Al-4V alloy 6-4 ELI-grade 23 that meets the requirements of ASTM F136 2002A (AMS 2631B class A1) were anodized in a mixture of sulfuric/hydrofluoric acid at 20 V for 5 and 60 min to form nanoporous (NP) and nanotubular (NT) oxide layers with pore diameter of 20 and 100 nm, respectively. The amount of fluorine incorporated in the oxide films from the electrolyte was 6 and 4 wt %, respectively. Bacterial adherence was studied using laboratory strains and six clinical strains each of Staphylococcus aureus and Staphylococcus epidermidis. Lower adherence of laboratory strains was demonstrated on fluoride nanostructured surfaces in comparison with the fluoride-free surfaces. Significant differences between clinical strains and laboratory strains were also found (p < 0.0001, Kruskal-Wallis test) when NP and NT specimens were compared with chemically polished (CP) surfaces. The results of the tests using multiple clinical strains confirmed a decrease in bacterial adherence on F-containing titanium oxide surfaces, suggesting a potential applicability of this surface, with a confirmed added value of decreasing clinical staphylococci adherence, for medical prosthetic devices. © 2012 Wiley Periodicals, Inc.Peer Reviewe

Doped TiO2 anodic layers of enhanced antibacterial properties

Ti-6Al-4V joint replacement implants foster uncemented fixation in orthopaedic surgery. However, bacterial colonization competes with host cells and ultimately may produce implant-related difficult-to-treat infections, justifying the efforts to obtain infection-resistant materials. In a previous work, the authors demonstrated the antibacterial properties of anodic fluoride-TiO2 nanostructured layers on Ti-6Al-4V alloy. In this work, the anodizing bath has been modified in order to grow fluoride-TiO2 barrier layers (FBL). A bacterial adherence protocol, run with reference and six different clinical strains of Staphylococcus aureus and Staphylococcus epidermidis, showed a statistically significant decrease in the percentage of covered surface (p<0.0001, Kruskal-Wallis test) for FBL specimens when compared with non fluoride-containing specimens, i.e. chemically polished Ti-6Al-4V and F-free TiO2 barrier layers. The results obtained on the F-barrier layers allowed discrimination between the effects of the presence of fluoride in the layer and the layer nanostructure on bacterial adhesion. © 2013 Elsevier B.V.Peer Reviewe

Changes in microbiota and microbial-derived phenolic metabolites of faeces in mice fed with cranberry and grape seed extracts

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.Proanthocyanidin structure features (i.e, interflavanic bond A- or B-type) seems to influence their biological activity. Among others, A-type proanthocyanidins have proven to inhibit the adhesion of pathogenic bacteria to uroepithelial cells of the urinary tract, a property not found for B-type proanthocyanidins. Scientific evidence indicates that the physiological effects of proanthocyanidins could be due to the metabolites formed in the tissues and, mainly, by the colon microbiota during their passage through the gastrointestinal tract. On the other hand, proanthocyanidins and/or their microbial-derived metabolites could exert a selective effect on inhibition or stimulation on the intestinal microbiota that, in turn, would affect microbial metabolizing capacity. The aim of this study was to explore differences in colonic catabolism between A- and B-type proanthocyanidins, by means of experiments in mice fed with cranberry (rich in type-A proanthocyanidins) and grape seed (rich in type-A proanthocyanidins) extracts. After a 3-week adaptation time, JAXc3H/OuJ female mice (n=30) were divided into three groups and maintained in a specific diet (control, 1% cranberry extract and 1% grape seed extract) for 4 weeks. Faecal samples were collected at 5 different times and analysing for phenolic metabolites by UPLC-ESI-MS/MS and for microbial counting of Lactobacillus, Bifidobacterium, Enterobacteria, Clostridiumgroups and Escherichiacoli species. Results indicated differences in the metabolism of A-type and B-type proanthocyanidins related to changes in some microbial groups.Peer reviewe

Influence of the nanostructure of F-doped TiO<inf>2</inf> films on osteoblast growth and function

© 2014 Wiley Periodicals, Inc. J Biomed Mater Res Part A: 103A: 1985-1990, 2015. © 2014 Wiley Periodicals, Inc. The aim of this study was to evaluate the proliferation and mineralization ability of mouse osteoblastic MC3T3-E1 cells on F-containing TiO2 films with different morphology and nanostructure that previously confirmed antibacterial properties. F-containing TiO2 films were fabricated by anodizing Ti-6Al-4V alloy ELI -grade 23. By using a mixture of H2SO4/HF acid at 20 V for 5 and 60 min, a TiO2 film grows with nanoporous (NP) and nanotubular (NT) features, characterized with a pore diameter of 20 and 100 nm, respectively. Fluoride-TiO2 barrier films (FBL) were produced in 1M NH4H2PO4/0.15M NH4F solution at constant voltage controlled at 20 V for 120 min. The amount of F incorporated in the nanostructured oxide films was 6 at % and of 4 at %, for the NP and NT, respectively, while for the FBL film was 12 at %. MC3T3-E1 cells exhibited different behavior when seeded and grown onto these surfaces. Thus, F-doped TiO2 films with NP structures increased proliferation as well as osteogenic gene expression and the mineralization capacity of these osteoblastic cells. These results confirm that anodizing process is suitable to fabricate multifunctional surfaces on Ti-6Al-4V alloy with improved not only antibacterial but also osteogenic properties useful for bone fixation of prosthetic devicesJuan Manuel Hernández López acknowledges CSIC for funding this work under the grant JAE-pre-2010. Daniel Lozano also acknowledges Comunidad Autónoma de Madrid for his post-doctoral research contract S-2009/MAT/1472. The authors report that they have a patent for the materials regarding their antimicrobial properties PCT/ES2011/070342.Peer Reviewe