Wundheilungsstörung bei einem Pferd – ein Fallbericht

ZusammenfassungEin 4-jähriger Traberwallach wurde aufgrund einer postoperativen Wundheilungsstörung, assoziiert mit antibiotikaresistenten Bakterien, klassisch homöopathisch therapiert, nachdem er auf die antibiotische Therapie mit intravenös verabreichtem Gentamicin und Penicillin, gefolgt von oraler Gabe von Sulfadiazin-Natrium und Trimethoprim nicht ansprach. Die bakteriologische Untersuchung inklusive Antibiogramm ergab oxacillinresistenten Staphylococcus haemolyticus und Actinobacillus equuli. Das Pferd wies eine eitrige Entzündung, ein Ödem und ein Serom auf, die unmittelbar nach der Behandlung abheilten. Das verabreichte homöopathische Arzneimittel, Silicea terra, ist eines von vielen homöopathischen Arzneimitteln, das bei der Behandlung von eitrigen Wundheilungsstörungen, assoziiert mit antibiotikaresistenten Bakterien, wirksam sein kann. Angesichts der weltweiten Bedrohung durch die Antibiotikaresistenz Problematik sind weitere Studien in Kooperation mit homöopathisch arbeitenden Tierärzten vonnöten.

Therapeutic Effect of Darkling Beetle (Zophobas morio) Hemolymph on Skin Thermal Injury in Mice Infected by Staphylococcus haemolyticus

Staphylococci are the most common pathogens isolated from skin infections in livestock or companion animals. Antibiotic therapy is the best treatment for infections, but local or systemic use of antimicrobials increases the risk of bacterial resistance. Insects are rich in antimicrobial peptides, which can reduce bacterial resistance and can be used to treat bacterial infections after skin burns. We propose that the use of the darkling beetle (Z. morio) hemolymph to treat skin infections in mice by Staphylococcus haemolyticus is one of the alternatives. Z. morio hemolymph alleviated the increase in wound area temperature in mice with a skin infection, reduced the bacterial load of the wound, and accelerated the wound healing speed significantly. Pathological sections showed that Z. morio hemolymph can significantly reduce inflammatory cell infiltration, and promote skin tissue repair. Real-time fluorescent quantitative polymerase chain reaction (PCR) revealed that the Z. morio hemolymph can significantly reduce the levels of pro-inflammatory cytokines, including interleukin-1 beta (IL-1β), interleukin-6 (IL-6), tumor necrosis factor-alpha (TNF-α), and chemokine interleukin-8 (IL-8). Our findings suggest that Z. morio antibacterial hemolymph can promote wound contraction, relieve local inflammatory responses and promote wound healing in mice infected with a heat injury, which has a positive therapeutic effect and enormous potential for skin thermal injury.

ANÁLISE DE CULTURA DE TELEFONES MÓVEIS DE PROFISSIONAIS DE ENFERMAGEM DE UMA UNIDADE HOSPITALAR PÚBLICA DE MINAS GERAIS

INTRODUÇÃO: Com a evolução da tecnologia e a disponibilização de telefonia móvel tornou-se cada dia mais comum estes aparelhos fazerem parte da rotina da população e também dos profissionais de saúde inclusive em seus ambientes de trabalho. Apesar dessa tecnologia trazer benefícios, pesquisadores têm associado a presença de patógenos de origem hospitalar em dispositivos de profissionais de saúde, o que torna susceptível a possíveis infecções e o carreamento desses agentes. Como o telefone móvel está em uso rotineiro, sendo visto inclusive em postos de enfermagem, surge à indagação e a necessidade de avaliarmos se há colonização destes aparelhos e quais agentes. OBJETIVO: Verificar se há colonização de telefones móveis dos profissionais de saúde (enfermagem) e se há alguma rotina de higienização dos celulares e se há adesão a higienização de mãos. METODOLOGIA: Foi aplicado um questionário aos profissionais de enfermagem de um hospital geral do interior de Minas Gerais, a amostra constou de 50 servidores, após foi coletado Swab umedecidos em caldo BHI (Brain Heart Infusion) dos telefones celulares deste profissionais. Após os swabs foram inoculados nos meios sólidos Ágar Sangue Colúmbia (Ágar MacConkey (meio seletivo e diferencial para detecção de bacilos entéricos Gram negativos, fermentadores ou não da lactose, em amostras diversas) e Ágar Chocolate (utilizado para o cultivo de microrganismos exigentes, embora cresçam neste meio quase todos os tipos de microrganismos. (meio nutricionalmente rico, não seletivo, geralmente utilizado para o isolamento e cultivo de microrganismos fastidiosos e não fastidiosos de uma variedade de materiais clínicos e não clínicos, possibilitando a verificação da atividade hemolítica das colônias). Foram incubadas em estufa a 35ºC ± 1ºC por 24 a 48 horas e após realizado a leitura do crescimento microbiológico. RESULTADOS: Após a coleta do material e análise das mesmas em laboratório, observado que houve crescimento em 33 amostras (66%), dentre os microorganismos identificados nas culturas temos: Staphylococcus aureus, Staphylococcus epidermides, Staphylococcus spp, Staphylococcus lugdunenis, Staphylococcus haemolyticus, Staphylococcus saprophyticus, Bastonetes gram negativos, Bastontes gram positivos e Candida sp. CONCLUSÃO: Conclui-se que há colonização dos aparelhos celulares, que podem proporcionar a propagação de agentes infecciosos e atuar diretamente na disseminação de microorganismos no ambiente hospitalar.

Successful endovascular coiling of infectious cerebral aneurysm following Staphylococcus haemolyticus endocarditis

Recent reports suggest that Staphylococcus haemolyticus can cause infective endocarditis (IE). However, no data are available regarding infectious intracranial aneurysm (IIA) following S. haemolyticus endocarditis. Endovascular coiling is a challenging approach for the treatment of IIA. We describe the case of a 63-year-old woman who suddenly developed aphasia and dysarthria following an acute cerebral infarction in her left insular and temporal cortex. After a total hysterectomy at the age of 39, the patient had suffered from recurrent bacterial pyomyositis in her legs. At admission, there was no evidence of cerebral aneurysm, as assessed by magnetic resonance angiography, and no vegetation, as assessed by transesophageal echocardiography (TEE), resulting in an incorrect diagnosis. However, subarachnoid hemorrhage and development of cerebral aneurysm in the left middle cerebral artery occurred within 1 week of hospitalization. Continuous positive blood culture results and a second TEE finally revealed that IE was caused by S. haemolyticus. Coil embolization of the IIA was successful on day 26 after symptom onset; after this procedure, the patient began to recover. This case demonstrates that S. haemolyticus-induced endocarditis can cause IIA. Endovascular coiling is a potentially effective approach to treat IIA.

Effect of Sub-inhibitory Dose of Cefotaxime on Multidrug resistant Staphylococcus haemolyticus Isolates

Critical care of neonates involves substantial usage of antibiotics and exposure to multidrug resistant (MDR) nosocomial pathogens. These pathogens are often exposed to sub-MIC doses of antibiotics which might result in a range of physiological effects. Therefore, to understand the outcome of sub-inhibitory dosage of antibiotics on Staphylococcus populations, nasal swab specimens were collected from 34 neonates admitted to the Sick Newborn Care Unit between 2017-2018, a total of 41 non-repetitive isolates were included in this study. Staphylococcus haemolyticus was the prevalent species (58.54%) with high non-susceptibility to cefotaxime (CTX) (79.16%), gentamicin (87.50%), and meropenem (54.17%). Biofilm forming abilities of S. haemolyticus isolates in the presence of sub-optimal CTX (30μg/mL), the predominantly prescribed β-lactam antibiotic, were then determined by crystal violet assays and extracellular DNA (eDNA) quantitation. CTX was found to significantly enhance biofilm production among the non-susceptible isolates (p-valueWilcoxin test- 0.000008) with increase in eDNA levels (p-valueWilcoxin test- 0.000004). Additionally, no changes in non-susceptibility were observed among populations of two MDR isolates, JNM56C1 and JNM60C2 after >500 generations of growth in the absence of antibiotic selection in vitro. These findings demonstrate that sub-MIC concentration of CTX induces biofilm formation and short-term non-exposure to antibiotics does not alter non-susceptibility among S. haemolyticus isolates.

Determination of the Chemical Composition and Antimicrobial Activity of Lavatera thuringiaca L. Medicinal Herb Material Extracted under Subcritical Conditions by the Liquid Carbon Dioxide Method

This article presents the composition of the components of Lavatera thuringiaca L. (Malvaceae Juss. family), which has a certain antibacterial effect. The plant collection was carried out in the Shamalgan gorge of Mountain Range of the Trans-Ili Alatau in the territory of the Karasay district of the Almaty region, in the flowering phase. A CO2 extract of the aboveground part of the medicinal plant Lavatera thuringiaca L. was obtained under subcritical conditions and, for the first time, studied for its component composition and antimicrobial activity. Determination of the chemical composition of the extract was carried out by gas chromatography/mass spectrometry (GC/MS). To identify the obtained mass spectra, we used the Wiley 7th edition and the NIST’02 data library. To determine the antimicrobial and antifungal activity, standard test strains of microorganisms were used: Staphylococcus aureus ATCC 6538-P, Escherichia coli ATCC 8739, Pseudomonas aeruginosa ATCC 9027, Candida albicans ATCC 10231, Streptococcus pneumonia ATCC 660, Klebsiella pneumoniae ATCC 700603, Staphylococcus haemolyticus, and Staphylococcus saprophyticus. In the composition of thick CO2Lavatera thuringiaca L. extract, the content of 31 components was proven: spathulenol 6.97%, pulegone 5 08%, cis-β-farnesene 7.63%, verbenone 1.93%, α-bisabolol oxide B 9.65%, bisabolol oxide A 8.26%, α-bisabolol 1.36%, linolenic acid, ethyl ether 3.15%, phytol 2.49%, herniarin 5.61%, linolenic acid 9.38%, linoleic acid 6.95%, myristic acid 2.33%, and elaidic acid 2.57%. Antimicrobial activity studies have shown that the CO2 extract of Lavatera thuringiaca L. has a pronounced effect against clinically significant microorganisms: Staphylococcus aureus, Escherichia coli, Pseudomonas aeruginosa, Candida albicans, Streptococcus pneumonia, Klebsiella pneumoniae, Staphylococcus haemolyticus, and Staphylococcus saprophyticus. During testing, the method of serial dilutions proved that the extract of Lavatera thuringiaca L. has a bactericidal effect on Staphylococcus aureus at a concentration of 0.83 μg/μl, on Escherichia coli at a concentration of 3.33 μg/μl, on Pseudomonas aeruginosa at a concentration of 0.83 μg/μl, on Streptococcus pneumoniae at a concentration of 1.67 μg/μl, on a clinical isolate of Staphylococcus haemolyticus at a concentration of 26.65 μg/μl, on Staphylococcus saprophyticus at a concentration of 6.67 μg/μl, and against Klebsiella pneumoniae at a concentration of 13.36 μg/μl. The test result showed that the extract also has fungicidal activity against the test culture of Candida albicans at a concentration of 0.21 μg/μl. At tests, the disc diffusion method proved that the extract has antimicrobial activity with high values of the growth suppression zone exceeding 15 mm. The zones of growth retardation of the test strains were 19.33 ± 1.15 for Staphylococcus aureus; 17.33 ± 3.21 for Escherichia coli; 15.67 ± 0.57 for Pseudomonas aeruginosa; 20.0 ± 1.0 for Streptococcus pneumoniae; 16.0 ± 2.64 for Klebsiella pneumoniae; 15.0 ± 1.0 for Staphylococcus saprophyticus, and 22.0 ± 1.73 for Candida albicans. In relation to the clinical isolate of Staphylococcus haemolyticus, the extract has a bacteriostatic effect.