Occurrence of bacteraemia following oral and maxillofacial surgical procedures in Port Harcourt, Nigeria

Study Design: A prospective study of 130 patients attending the Government Dental and Maxillofacial Hospital (now Maxillofacial unit, Rivers State University Teaching Hospital), Port Harcourt, between August 2018 and September 2019. Objective: To examine the factors that affect the occurrence of a bacteremia associated with oral and maxillofacial surgical procedures, and the types of bacteria causing this bacteremia, and establish the need or otherwise for prophylactic antibiotics in, ‘at risk’ patients. Methods: 130 healthy adult patients requiring various oral and maxillofacial surgical procedures under local anesthesia using 2% lidocaine with 1: 100,000 adrenaline, were screened bacteriologically to determine the occurrence of a bacteremia. 5 milliliters of venous blood was collected from the antecubital vein of each patient preoperatively and within 3 minutes postoperatively. The samples collected were cultured and bacteriological identification done and analyzed. Results: Bacteremia was found in 43 (33.1%) of 130 patients postoperatively. In patients undergoing extractions, bacteremia occurred more frequently when teeth were extracted due to inflammatory dental diseases. There was no statistical correlation between the occurrence of a bacteremia and the number of teeth extracted (p>0.05). Of the 70 isolates obtained postoperatively, 5 (6.4%) were aerobes, 51 (65.4%) were facultative anaerobes (including microaerophiles) and 14 (17.9%) were anaerobes. Among the facultative anaerobes (including microaerophiles), the most frequently isolated bacteria generawere species of Staphylococcus (25.7%), Streptococcus spp. (17.1%) and Streptococcus viridans (15.7%) and among the anaerobes, Bacteriodes spp. (8.6%) were the most frequently isolated. All the isolates were sensitive to azithromycin, amikacin, imipenemand meropenem. However, 3 (30%) of the isolates were resistant to amoxicillin, which is a commonly used drug for antimicrobial prophylaxis. Conclusion: This study shows the occurrence of bacteremia in Nigerians following various oral and maxillofacial surgical procedures and that the observed bacteremia was not dependent on the patient’s age or gender. This study emphasizes the need for antibiotic prophylaxis in those patients who are at risk of developing complications from bacteremia. Amoxicillin as this study shows will not be an effective antibiotic prophylactic agent in a majority of patients. The author therefore recommends the use of azithromycin as an alternative prophylactic agent in those patients. Keywords: Bacteremia; bacteria isolates; antimicrobial prophylaxis; Port Harcourt, Nigeria.

Features of the vaginal microbiota in recurrent urinary tract infections in childhood

BACKGROUND. Currently, there is a stable deterioration in the somatic health of preschool-age girls, which creates a real threat to the realization of reproductive function in the future. The state of vaginal microbiocenosis in preschool girls suffering from recurrent urinary tract infections (UTIs) remains a little-studied problem.THE AIM: to assess the state of the vaginal biotope in preschool girls suffering from recurrent UTIs.PATIENTS AND METHODS. 92 girls aged 3-6 years were examined, of which: group 1 (n=32) - patients with recurrent UTI; group 2 (n=30) - patients with rare UTI; group 3 (n=30) - girls of 1,2 health groups. Vaginal microbiocenosis was assessed by quantitative PCR using the «Femoflor-17 test system». Statistical analysis was performed using the application program "Statistica 6.0 for Windows".RESULTS. Facultative anaerobes predominate in the vaginal microbiocenosis of patients with UTI, the absolute content of which is significantly higher in patients with the recurrent course (p <0.05). The relative number of facultative anaerobes is significantly higher in patients with rare UTIs (p<0.05). In patients with recurrent UTI, the absolute and relative content of obligate anaerobes is lower than in patients with rare UTI and girls from the control group. The index of total bacterial mass in patients with UTI, compared with girls of the control group, is significantly higher (p<0.05). In patients with UTI, an increase in the colonies of the Enterobacteriacea family and a decrease in obligate anaerobes were determined in comparison with similar indicators of girls in the control group.CONCLUSION. The presence of recurrent UTI in preschool girls is a risk factor for the development of the severe vaginal dysbiotic condition. Rare UTIs can also be a risk of developing vaginal dysbiosis. Real-time multi-dimensional PCR provides quantitative and qualitative characteristics of the conditionally pathogenic flora of the vaginal biotope.

Stool preparation under anaerobic conditions contributes to retention of obligate anaerobes: potential improvement for fecal microbiota transplantation

Background Fecal microbiota transplantation (FMT) in patients with ulcerative colitis has shown variable efficacy depending on the protocol used. A previous randomized controlled trial reported that anaerobic preparation of donor stool contributes to improved efficacy. Despite the suggestion that viable obligate anaerobes would be decreased through aerobic handling, there have been only a limited number of reports on how these aerobic or anaerobic procedures affect the composition of viable microbiota in the fecal slurries used for FMT. Methods We adopted 16S and 23S rRNA-targeted reverse transcription-quantitative polymerase chain reaction to quantify viable bacteria in fecal slurries. This study utilized specific primers designed to detect obligate anaerobes (including Clostridium coccoides group, C. leptum subgroup, Bacteroides fragilis group, Bifidobacterium, Atopobium cluster, and Prevotella) and facultative anaerobes (including total lactobacilli, Enterobacteriaceae, Enterococcus, Streptococcus, and Staphylococcus). We then calculated the ratio change (RC) between before and after mixing, and compared the resulting values between anaerobic-prep and aerobic-prep in samples fixed immediately after blending (RCAn0 vs. RCAe0) and in samples maintained (under anaerobic or aerobic conditions) for 1 h after blending (RCAn1 vs. RCAe1). Results For most obligate anaerobes, the median RC tended to be less than 1, indicating that the number of obligate anaerobes was decreased by the blending procedure. However, in samples maintained for 1 h after blending, anaerobic-prep counteracted the decrease otherwise seen for the C. coccoides group and B. fragilis groups (P < 0.01 for both). The C. leptum subgroup also tended to show higher RC by anaerobic-prep than by aerobic-prep, although this effect was not statistically significant. Among facultative anaerobes, Enterobacteriaceae, Enterococcus, and Staphylococcus showed median RC values of more than 1, indicating that these organisms survived and even grew after mixing. Moreover, oxygen exposure had no significant influence on the survival of the facultative anaerobes. Conclusions The conditions under which the blending procedure was performed affected the proportion of live anaerobes in fecal slurries. The obligate anaerobes tended to be decreased by blending processes, but anaerobic-prep significantly mitigated this effect. Anaerobic-prep may improve the efficacy of FMT by permitting the efficient transfer of obligate anaerobes to patients with ulcerative colitis.

Microbiota of semen samples with normozoospermia: analysis of real-time PCR data

The analysis of semen microbiota is difficult due to the lack of established criteria for interpretation of microbiological tests. The aim of the study was to determine the stable clusters of semen microbiota analyzed by real-time PCR in samples with normozoospermia. Semen samples of 227 men with normal spermiograms were included in the study. The quantity of total bacterial DNA and at least one group of microorganisms was more than 103 GE/ml in 107 (41.7%) samples. Four stable microbiota clusters with the prevalence of a specific microorganism group were distinguished in these samples: obligate anaerobes (OA) cluster (proportion in the centroid — 81.1%); Lactobacillus spp. cluster (proportion in the centroid — 64.3%); gram-positive facultative anaerobes (GPFA) cluster (proportion in the centroid — 92.5%); Enterobacteriaceae/Enterococcoccus (EE) cluster (proportion in the centroid — 80.8%). The clusters were ranked by frequency of occurrence: OA cluster was the most prevalent (43 (40.2%) of 107), second-most frequent were GPFA-cluster (27 (25.2%)) and Lactobacillus-cluster (22 (20.6%)). EE-dominated cluster was found in 15 (14.0%) cases.

The Spectrum of Antimicrobial Activity of Cyadox against Pathogens Collected from Pigs, Chicken, and Fish in China

Cyadox has potential use as an antimicrobial agent in animals. However, its pharmacodynamic properties have not been systematically studied yet. In this study, the in vitro antibacterial activities of cyadox were assayed, and the antibacterial efficacy of cyadox against facultative anaerobes was also determined under anaerobic conditions. It was shown that Clostridium perfringens and Pasteurella multocida (MIC = 0.25 and 1 μg/mL) from pigs, Campylobacter jejuni and Pasteurella multocida from poultry, E. coli, Streptococcus spp., and Flavobacterium columnare from fish were highly susceptible to cyadox (MIC= 1 and 8 μg/mL). However, F. columnare has no killing effect for drug tolerance. Under in vitro anaerobic conditions, the antibacterial activity of cyadox against most facultative anaerobes was considerably enhanced Under anaerobic conditions for the facultative anaerobes, susceptible bacteria were P. multocida, Aeromonas spp. (including A. hydrophila, A. veronii, A. jandaei, A. caviae, and A. sobria, excluding A. punctata), E. coli, Salmonella spp. (including S. choleraesui, S. typhimurium, and S. pullorum), Proteus mirabilis, Vibrio fluvialis, Yersinia ruckeri, Erysipelothrix, Acinetobacter baumannii, and Streptococcus agalactiae (MICs were 0.25~8 μg/mL, MBCs were 1–64 μg/mL). Intermediate bacteria were Enterococcus spp. (including E. faecalis and E. faecium), Yersinia enterocolitica, and Streptococcus spp. (MICs mainly were 8~32 μg/mL, MBCs were 16~128 μg/mL). This study firstly showed that cyadox had strong antibacterial activity and had the potential to be used as a single drug in the treatment of bacterial infectious diseases.

Microbiological Analysis of Primary Infected Root Canals with Symptomatic and Asymptomatic Apical Periodontitis of Young Permanent Teeth

SummaryBackground/Aim: Understanding the composition of bacteria in infected root canals is important for ameliorating the treatment strategies that lead to the elimination of pathogens and infection control, but also prevent reinfection. Aim of this study was to investigate microbial composition of primary infected root canals with apical periodontitis of young permanent teeth, originating form school children in Serbia, and its association with clinical symptoms.Material and Methods: To determine the bacterial composition of infected root canals in children, 35 endodontic samples were obtained. The identification of cultured bacteria was performed by MALDI-TOF MS analysis. The presence or absence of clinical symtoms were recorded.Results: Facultative anaerobes were 2,2 times more frequent than obligate anaerobes. The most common facultative anaerobes belonged to following genera, Streptococcus (58 isolates), Actinomyces (10) and Enterococcus (8), while predominant obligate anaerobes, belonged to genera Veillonella (15), Prevotella (9) and Fusobacterium (8). The most common clinical isolates recovered from infected root canals with symptomatic apical periodontitis were Veillonella parvula (10) and Fusobacterium nucleatum (7), while from the asymptomatic ones, they were Streptococcus mitis/Streptococcus oralis (5). Prevalence of Parvimonas micra, Prevotella buccae and Streptococcus constellatus within the root canals might be associated to clinical symptoms.Conclusions: Species of genera Streptococcus and Veillonella were the most common isolates from primary infected root canals with apical periodontitis in Serbian school children. Facultative anaerobes were predominant over obligate anaerobes. The prevalence of obligate anaerobes was much higher in symptomatic compared to asymptomatic root canal infections. No specific bacterial strain might be associated to a single examined clinical symptom (pain, tenderness to percussion or swelling), but majority of the strains are associated to all of the examined three symptoms.