Epidemiology and species distribution of anaerobic Gram-negative cocci: a 10-year retrospective survey (2008-2017)

Introduction: The group of anaerobic Gram-negative cocci (AGNC) includes the genera Veillonella, Megasphaera, Anaeroglobus, Negativicoccus and Acidaminococcus. These bacteria are an integral part of the microbiome of humans but may be causative agents in various infectious processes. The available data on the epidemiology and significance of AGNCs is scarce. Aims: To assess and compare the prevalence of different species of AGNCs among inpatients and outpatients at the Albert Szent-Györgyi Clinical Center retrospectively, during a 10-year study period. Methods: Isolates containing AGNC were identified retrospectively by reviewing the online microbiology records of the Institute of Clinical Microbiology. Results: The median age of affected patients overall was 52 years (range: 1–90 years), with a male dominance. 59.79% of samples originated from inpatients. 572 individual AGNCs isolates were recovered from clinical samples, most of the isolated GNACs were Veillonella spp. (95.28%), Megasphaera and Acidaminococcus species accounted for a minority of isolates (2.79% and 1.93%, respectively), while Anaeroglobus and Negativicoccus species were not isolated. In the second half of the study period (2013-2017), 91.31% of isolates were identified on the species level (p<0.001) using MALDI-TOF MS. Conclusion: The current study represents a long-term surveillance study on the isolation frequency and trends among anaerobic Gram-negative cocci (AGNCs), isolated in the Southern Great Plain of Hungary, highlighting the beneficial effect of MALDI-TOF MS on the diagnostic efficacy of the laboratorie

A Szülői Konfliktusok Észlelését Mérő Skála hazai alkalmazásával szerzett tapasztalatok = Psychometric evaluation of the Hungarian version of the Children’s Perception of Interparental Conflict Scale

Elméleti háttér: A Szülői Konfliktusok Észlelését Mérő Skála (Children’s Perception of Interparental Conflict Scale; CPIC) egy széles körben használt kérdőív, amely a szülői konfliktusok gyermekek által észlelt természetét és a gyermekeknek e konfliktusokra adott reakcióit vizsgálja. Cél: A kutatás célja a CPIC magyar nyelvre adaptálása és pszichometriai elemzése volt. Módszer: Keresztmetszeti, kérdőíves vizsgálatunkban 127 szülő-gyermek pár vett részt. A gyermekek (átlagéletkor = 10,8 év; szórás = 1,05 év; terjedelem: 9—12 év) az alábbi kérdőíveket töltötték ki: CPIC, Vonásszorongás Skála, Gyermek Depresszió Kérdőív. A szülőkkel a Rövidített Házastársi Stressz Skálát vettük fel. Eredmények: A konfirmatív faktoranalízis nem támasztotta alá a CPIC elméleti, nyolcfaktoros faktorstruktúráját (χ2(1052) = 1355,0, p90: 0,040—0,055, p = 0,698). A Trianguláció alskála három tételének törlésével az illeszkedés elfogadhatóvá vált (χ2(917) = 1113,4, p90: 0,032—0,049, p = 0,960). A négyfaktoros alternatív elméleti modell szignifikánsan rosszabbul illeszkedett az adatokra, mint a nyolcfaktoros modell (Δχ2 = 66,5, Δdf = 22, p<0,001). A kérdőív alskáláinak belső megbízhatósága a Trianguláció alskála (Cronbach-alfa: 0,40) kivételével elfogadható (Cronbach-alfa: 0,63—0,81). A mérőeszköz konstruktumvaliditását támogatja, hogy az alskálák zöme a várakozásnak megfelelő irányú és erősségű lineáris kapcsolatot mutat a depresszióval, a vonásszorongással, valamint a szülő által észlelt házastársi stresszel. Következtetések: Az alacsony mintaelemszám ellenére összességében elmondhatjuk, hogy a CPIC magyar változatának pszichometriai mutatói megfelelőek. Javasoljuk a mérőeszköz hazai kutatásba történő bevezetését és további vizsgálatát. | Background: The Children’s Perception of Interparental Conflict Scale is a widely used measure for assessing perceived interparental conflicts and children’s subsequent adjustment. Aim: The aims of this study were to prepare the Hungarian adaptation and evaluate the psychometric properties of the Hungarian version of Children’s Perception of Interparental Conflict Scale. Method: 143 child-parent pairs participated in this cross-sectional questionnaire study. Children between the ages of 9—12 years (mean of age 10.8 years, SD = 1.05 years, range: 9—12 years) completed the CPIC, anxiety (STAI-C) and depression (CDI) scales, whereas the parent’s battery of tests contained the short version of the Marital Stress Scale (MSS). Results: The results of the confirmatory factor analysis did not support the theoretical eight-factor structure of the CPIC (χ2 = 1355.0, DF = 1052, p90: .040—.055, p = .698). The model fit indices became acceptable after the deletion of three items of the Triangulation subscale: (χ2(917) = 1113.4, p90: .032—.049, p = .960). The four-factor alternative theoretical model showed significantly worse fit than the eight-factor model (Δχ2 = 66.5, Δdf = 22, p<.001). The internal consistency of the CPIC was acceptable (Cronbach-alpha: .63—.81) except the Triangulation subscale (Cronbach-alpha: .40). Construct validity was supported by the expected association in the case of six subscales with depression, anxiety and the self-reported marital stress. Conclusions: Although the number of participants in the present study was suboptimal, the Hungarian version of the Children’s Perception of Interparental Conflict Scale seemed to have adequate psychometric properties. We recommend the introduction of this scale to the Hungarian research and its further investigation

Antibiotikum rezisztencia alakulása klinikailag releváns aerob és anaerob baktériumok körében; a rezisztencia mechanizmus genetikai hátterének tanulmányozása molekuláris módszerekkel = Evaluation of antibiotic resistant clinical isolates of aerobic and anaerobic bacteria; investigation of the genetic background of resistance by molecular biological methods

Jelen projektünkben fontos antibiotikum rezisztencia mechanizmusok genetikai hátterének molekuláris vizsgálata volt a fő cél klinikailag jelentős aerob és anaerob fajok estén. Az anaerob Bacteroides genus tagjainak cefoxitin, karbapenem és metronidazol rezisztenciáját vizsgáltuk a prevalencia, a genetikai kifejeződés mikéntje és a hordozó genetikai elemek szempontjából. Jelentős számú rezisztens törzs átvizsgálása után bizonyítottuk az inszerciós szekvencia (IS) elemek által történő rezisztencia gén aktiválás mechanizmusát mind már leírt, mind újonnan leírásra kerülő IS elemek azonosításával (IS943, IS944, ISBf6, IS614B és IS614C), valamint az imipenem rezisztencia gén (cfiA) esetén egy újabb IS független aktivációs mechanizmusra utaló megfigyeléseket tettünk. Ezen felül a metronidazol rezisztenciában szerepet játszó, a nimE gént hordozó plazmidot azonosítottunk, tanulmányoztuk a cefoxitin rezisztencia terjedésében szerpet játszó mobilizálható transzpozon, MTn4555, struktúráját különös tekintettel a cefoxitin rezisztencia gén, cfxA, szabályzó régiójára. Megfigyeltük hogy a cfiA és a metronidazol rezisztencia, nimA-E gének kromoszómális lokalizáció esetén asszociációt mutatnak, ami azt is jelentheti, hogy közös elemen helyezkednek el. In vitro kísérleteink tanulsága szerint újabb metronidazol és karbapenem rezisztens Bacteroides törzsek de novo keletkezése ritka esemény, a horizontális tejedés a rezisztens tözsek gyakoriságának valószínű legfőbb oka. Vancomicin rezisztens Enterococcus faecalis és karbapenem rezisztens Pseudomonas aeruginosa tözsek kerültek izolálásra és előzetes jellemzésre. | In this project our main aims were to examine the genetic background of significant antibiotic resistance mechanisms of important aerobic and anaerobic pathogens. We investigated the cefoxitin, carbapenem and metronidazole resistance of Bacteroides strains with regard to their prevalence, genetic expression and the carrying genetic elements. After examination of a great number of strains, we proved the roles of both described and newly described insertion sequence elements (IS943, IS944, ISBf6, IS614B and IS614C) in activation of antibiotic resistance genes of Bacteroides strain, in addition to the implication of a new activation mechanism in the imipenem resistance. We identified a new plasmid molecule carrying the nimE metronidazole resistance genes and investigated the structure of the cefoxitin resistance mobilizable transposon, MTn4555, with special attention to the regulatory region of the cfxA resistance gene. We observed that the cfiA and the metronidazole resistance, nimA-E genes display an association if they are chromosomal implicating their common localization on a distinct genetic element. Our in vitro experiments revealed that the de novo emergence of metronidazole and carbapenem resistant srains could be regarded as a rare event, and the horizontal spread is probably the main reason for their prevalence. We isolated vancomycine-resistant Enterococcus faecalis and carbapenem-resistant Pseudomonas aeruginosa strains, and their preliminary characterization was preformed

Complete Genome Sequence of Propionibacterium avidum Strain 44067, Isolated from a Human Skin Abscess

Propionibacterium avidum is an anaerobic Gram-positive bacterium that forms part of the normal human cutaneous microbiota, colonizing moist areas such as the vestibule of the nose, axilla, and perineum. Here we present the complete genome sequence of P. avidum strain 44067, which was isolated from a carbuncle of the trunk

Role of Actinomyces spp. and related organisms in the development of medication-related osteonecrosis of the jaw (MRONJ) : Clinical evidence based on a case series

Medication-related osteonecrosis of the jaw (MRONJ) is an increasingly common consequence of antiresorptive treatment, which often leads to the development of necrotic exposed bone surfaces with inflammatory processes affecting the jawbone. Although the development of MRONJ is often associated with the inflammatory response or infections caused by the colonizing members of the oral microbiota, the exact pathogenesis of MRONJ is still not fully understood. In the present paper, we aimed to provide additional, microbiological culture-supported evidence, supporting the "infection hypothesis" that Actinomyces spp. and related organisms may play an important pathogenic role in the development of MRONJ and the resulting bone necrosis. In our case series, all patients presented with similar underlying conditions and anamnestic data, and have received antiresorptive medications (bisphosphonates or a RANK ligand (RANKL) inhibitor) to prevent the occurrence or progression of bone metastases, secondary to prostate cancer. Nevertheless, a few years into antiresorptive drug therapy, varying stages of MRONJ was identified in the mentioned patients. In all three cases, quantitative microbiological culture of the necrotic bone samples yielded a complex microbiota, dominated by Actinomyces and Schaalia spp. with high colony counts. Additionally, our followed-up case series document the treatment of these patients with a combination of surgical intervention and long-term antibiotic therapy, where favourable clinical responses were seen is all cases. If the "infection hypothesis" is valid, it may have significant consequences in the preventative and therapeutic strategies associated with this disease

STUDIES ON THE EFFECT OF PROPIONIBACTERIUM ACNES ON THE BARRIER PROPERTIES OF HUMAN IN VITRO CULTURED KERATINOCYTES

The human skin is heavily colonized by a specialized microbial community called the microbiome, which plays a complex role in the protection from the attack of external pathogens. This microbial flora can interact with the cells in the healthy skin and play a role in the maintenance of skin homeostasis, but also known to contribute to the pathogenesis of different diseases. Our aim was to analyze whether the Propionibacterium acnes (P. acnes) bacterium, a member of the skin microbiome, or the bacterium induced pro-inflammatory mediator, TNF has any effect on the barrier properties of our epidermis. For that, a confluent monolayer of in vitro cultured human immortalized keratinocytes (HPV-KER cells) were treated with different P.acnes strains and external TNF in different doses, and changes in the barrier properties were analyzed in real time using the xCELLIgence system. We also analyzed the effect of the bacterium on the mRNA expression changes of tight junction proteins claudin 1, 2, 4 (CLDN1, 2, 4), ocludin1 (OCL1) and ZO1 in these cultures using real-time RT-PCR. Our results suggest that the bacterium induced an elevation, followed by a drop of the measured impedance values in the keratinocyte monolayers, possibly due to dynamic alterations of the barrier properties. The extent of these changes depended on the used P. acnes strain and the applied doses. Addition of TNF (1, 5, 10 ng/ml), a cytokine that is a know mediator of the P. acnes-induced innate immune and inflammatory events in keratinocytes also lead to a marked decrease of the measured impedance of the HPV-KER monolayers. Real-time RT-PCR analysis of tight junction genes suggested that CLDN2 and 4 mRNAs were not present in these cells. However, the expression of CLDN1 decreased, whereas ZO1 and OCL1 mRNA levels increased in response to the bacterial treatment. Our results suggest that our microbiome can modulate the barrier properties of the epidermis. It is possibly achieved, in one hand, through the direct regulation of genes playing a key role in the formation of cell-to-cell contacts. On the other hand, secreted factors, such as the TNFα pro-inflammatory mediator, may also have a direct effect and can loosen the epidermal barrier, possibly leading to the easier penetration of keratinocyte- as well as bacterial-derived factors to deeper tissue compartments. These findings strengthen the importance of a balanced interaction among the epidermal cells and our microbiome for the maintenance of healthy skin functions