Effect of Chemo-radiotherapy on Salivary Flora of Oral Cancer Patients

Management of cancers of oral cancers has remained a major challenge in India and globally. Radiotherapy and chemotherapy are mostly employed for treatment which inflicts changes in oral mucosa and makes it vulnerable for bacterial colonization and eventual infections. This study aims at evaluating the changes in oropharyngeal flora (bacteria and yeast) in oral cancer patients treated by a combination of chemo-radiotherapy with the control groups comprising of non-cancerous patients living in the same environment. This prospective evaluation included Seventy seven patients with oral squamous cell carcinomas in the study group. Whereas the control group comprised of twenty five non-cancerous patients. Saliva samples were collected from patients with oral carcinomas and those of the control group for bacteriological examination, and were transported within 2 hours to the laboratory and immediately inoculated and incubated. The oral microflora samples collected were evaluated for the presence of bacteria in saliva in both study and control group of patients. We evaluated the change in salivary oral flora during chemo-radiotherapy treatment. A statistically significant increase in growth of normal as well as abnormal oral flora was observed post-radiation. Escherichia coli showed a significant decrease in post-RT and also near to significant in control. Various changes in salivary oral flora were observed during the course of chemo-radiotherapy in study and controls groups. This shows that there are some sensitive spots in the oral cavity where the occurrence of oral cancer is more.

Is there a real need for sputum culture for community-acquired pneumonia diagnostics? Results from a retrospective study in Russia

ObjectivesThe mortality rate associated with community-acquired pneumonia is still considered high as it occupies a leading position among all infectious diseases. The primary purpose of this study is to evaluate the implementation of the respiratory bacterial culture sampling in the clinical practice of the Russian Federation’s therapeutic departments and its impact on inpatient care.MethodsThe study included 1,344 patients with community-acquired pneumonia. The analysis of the obtained data was performed using the statistical software package SPSS 23.0 (IBM SPSS Statistics). The description of quantitative indicators was carried out with an indication of the median (25; 75 percentile). Qualitative with an indication of the absolute and relative frequencies n (%).ResultsIt was noted that a third of the sample did not pass through the first stage (bacterioscopy). We noticed the predominance of oropharyngeal flora in the results. The sputum collection was carried out on average 3 (1; 5) days after the start of hospitalization, while antibiotic therapy was prescribed to all patients on the first day, the results of the bacteriological study were ready on average 6 (4; 8th) calendar days after hospitalization, while in 20 (1.5%) cases, the patient was already discharged. Due to the inefficiency of the starting regimen, antimicrobial agents have changed in 84 (6.3%) patients and averaged 5.5 (4.0; 10.0) days from the start of hospitalization.ConclusionsThe violation of the technique and the time of sputum collection resulted in a reduction in the method’s value.

Draft Genome Sequence of a Haemophilus parainfluenzae Strain Isolated from a Patient with Chronic Obstructive Pulmonary Disease

Haemophilus parainfluenzae is considered part of the normal oropharyngeal flora but is known to occasionally cause infections. It is closely related to Haemophilus influenzae. Here, we report the genome sequence of H. parainfluenzae COPD-014-E1 O, which was cultured from the sputum of a patient with chronic obstructive pulmonary disease.

Porphyromonas asaccharolytica as a Rare Causative Agent for Lemierre’s Syndrome

Lemierre’s syndrome is a rare disease associated with significant morbidity and mortality. It begins with an oropharyngeal infection, which spreads locally to involve the internal jugular vein causing thrombophlebitis, followed by distant spread and metastatic infections. Affected individuals are commonly young adults. Causative organisms are usually oropharyngeal flora, most commonly being the anaerobe Fusobacterium necrophorum. Porphyromonas asaccharolytica is a rare etiological agent with only three cases being reported in the literature. This case report describes a previously healthy 22-year-old man who initially presented with acute tonsillitis and was later found to have left internal jugular vein thrombophlebitis along with bilateral septic emboli to the lungs. The patient was treated with a five-week course of ampicillin-sulbactam and metronidazole. Subsequent imaging also showed progression of internal jugular vein thrombus, for which warfarin was given for three months for anticoagulation.

Adaptation of Amoeba Plate Test To Recover Legionella Strains from Clinical Samples

ABSTRACT The isolation of Legionella from respiratory samples is the gold standard for diagnosis of Legionnaires' disease (LD) and enables epidemiological studies and outbreak investigations. The purpose of this work was to adapt and to evaluate the performance of an amoebic coculture procedure (the amoeba plate test [APT]) for the recovery of Legionella strains from respiratory samples, in comparison with axenic culture and liquid-based amoebic coculture (LAC). Axenic culture, LAC, and APT were prospectively performed with 133 respiratory samples from patients with LD. The sensitivities and times to results for the three techniques were compared. Using the three techniques, Legionella strains were isolated in 46.6% ( n = 62) of the 133 respiratory samples. The sensitivity of axenic culture was 42.9% ( n = 57), that of LAC was 30.1% ( n = 40), and that of APT was 36.1% ( n = 48). Seven samples were positive by axenic culture only; for those samples, there were <10 colonies in total. Five samples, all sputum samples, were positive by an amoebic procedure only (5/5 samples by APT and 2/5 samples by LAC); all had overgrowth by oropharyngeal flora with axenic culture. The combination of axenic culture with APT yielded a maximal isolation rate (i.e., 46.6%). Overall, the APT significantly reduced the median time for Legionella identification to 4 days, compared with 7 days for LAC ( P < 0.0001). The results of this study support the substitution of LAC by APT, which could be implemented as a second-line technique for culture-negative samples and samples with microbial overgrowth, especially sputum samples. The findings provide a logical basis for further studies in both clinical and environmental settings.

Pyothorax in cats and dogs

Pyothorax, or thoracic empyema, is an infection of the pleural space, characterized by the accumulation of purulent exudate. It is a life-threatening emergency in dogs as well as in cats, with a guarded prognosis. Dyspnea and/or tachypnea, anorexia and lethargy are the most typical clinical signs. Diagnosis is usually straightforward, based on the clinical symptoms combined with pleural fluid analysis, including cytology and bacterial culture. Most commonly, oropharyngeal flora is isolated in the pleural fluid. Treatment can be medical or surgical, but needs to be immediate and aggressive. In this article, an overview of the various causes of both feline and canine pyothorax with its similarities and differences is provided. Epidemiology, symptoms, diagnosis, treatment and prognosis are discussed.

Native Mitral Valve Endocarditis Caused byNeisseria elongatasubsp.nitroreducensin a Patient with Marfan Syndrome: First Case in Italy and Review of the Literature

Neisseria elongata(NE) is an aerobic Gram-negative organism that constitutes part of the commensal human normal oropharyngeal flora. Although previously considered not to be pathogenic, it has been recognized as an occasional cause of significant infections in humans. We report here the first case in Italy of infective endocarditis of a native prolapsing mitral valve in a patient with Marfan syndrome, caused by NE subspeciesnitroreducenswhich has been rarely isolated from clinical specimens. The culprit organism has been confirmed by mass spectrometry directly from the positive blood culture, as previously reported. The amplified gene has been deposited in GenBank under accession number KT591873. In spite of the reported aggressive nature of NE, clinical remission was promptly obtained, there being no requirement for surgery.

PasteurellaSpecies Peritoneal Dialysis-Associated Peritonitis: Household Pets as a Risk Factor

BACKGROUND: Pasteurellaspecies are Gram-negative coccobacilli that are a part of the normal oropharyngeal flora of numerous domestic animals. They have been recognized as a rare but significant cause of peritonitis in patients undergoing peritoneal dialysis (PD). A consensus about management strategies for PD-associated peritonitis caused byPasteurellaspecies currently does not exist.METHODS: The microbiological database serving the Manitoba Renal Program was searched from 1997 to 2013 for cases ofPasteurellaspecies PD-associated peritonitis, and charts were reviewed. PubMed was searched for case reports and data were abstracted.RESULTS: Seven new local cases and 30 previously reported cases were analyzed. This infection is clinically similar to other forms of PD peritonitis, with household pet exposure appearing to be the strongest risk factor. Cats are the most commonly implicated pet. Direct contact between the pet and the equipment was commonly reported (25 of 37 patients) but was not necessary for infection to develop. The mean duration of treatment was 15 days. Complication rates were low, with only 11% of patients requiring PD catheter removal. There was no mortality reported.CONCLUSION:Pasteurellaspecies are a rare cause of PD-associated peritonitis that can be successfully treated with a two-week course of intraperitoneal antibiotics with a high likelihood of catheter salvage.