996 resultados para Staphylococci coagulase-negativa


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Numerosas investigaciones han encontrado una relación entre las habilidades de solución de problemas y el ajuste psicológico, llegando algunas a proponer que estas habilidades, cuando son eficaces, constituyen un factor de protección frente a las situaciones difíciles o traumáticas de la vida, mientras que cuando son ineficaces constituyen un factor de riesgo para la ansiedad, la depresión, la ira y otros síntomas psicológicos (Nezu, Nezu y D’Zurilla, 2013). Otros estudios han señalado, sin embargo, que, en contra de la predicción general de los modelos de habilidades de solución de problemas propuestos por D’Zurilla y Goldfried (1971) y D’Zurilla, Nezu y Maydeu-Olivares (2002, 2004, 2014), no todos los componentes de estas habilidades tendrían el mismo peso a la hora de explicar el ajuste psicológico o el desarrollo de síntomas psicológicos. Estos estudios han afirmado, de hecho, que el aspecto motivacional –la orientación hacia el problema y, más particularmente, la orientación negativa hacia el problema– sería el más importante y explicaría gran proporción de los resultados encontrados en la investigación...

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BACKGROUND Respiratory tract infections and subsequent airway inflammation occur early in the life of infants with cystic fibrosis. However, detailed information about the microbial composition of the respiratory tract in infants with this disorder is scarce. We aimed to undertake longitudinal in-depth characterisation of the upper respiratory tract microbiota in infants with cystic fibrosis during the first year of life. METHODS We did this prospective cohort study at seven cystic fibrosis centres in Switzerland. Between Feb 1, 2011, and May 31, 2014, we enrolled 30 infants with a diagnosis of cystic fibrosis. Microbiota characterisation was done with 16S rRNA gene pyrosequencing and oligotyping of nasal swabs collected every 2 weeks from the infants with cystic fibrosis. We compared these data with data for an age-matched cohort of 47 healthy infants. We additionally investigated the effect of antibiotic treatment on the microbiota of infants with cystic fibrosis. Statistical methods included regression analyses with a multivariable multilevel linear model with random effects to correct for clustering on the individual level. FINDINGS We analysed 461 nasal swabs taken from the infants with cystic fibrosis; the cohort of healthy infants comprised 872 samples. The microbiota of infants with cystic fibrosis differed compositionally from that of healthy infants (p=0·001). This difference was also found in exclusively antibiotic-naive samples (p=0·001). The disordering was mainly, but not solely, due to an overall increase in the mean relative abundance of Staphylococcaceae in infants with cystic fibrosis compared with healthy infants (multivariable linear regression model stratified by age and adjusted for season; second month: coefficient 16·2 [95% CI 0·6-31·9]; p=0·04; third month: 17·9 [3·3-32·5]; p=0·02; fourth month: 21·1 [7·8-34·3]; p=0·002). Oligotyping analysis enabled differentiation between Staphylococcus aureus and coagulase-negative Staphylococci. Whereas the analysis showed a decrease in S aureus at and after antibiotic treatment, coagulase-negative Staphylococci increased. INTERPRETATION Our study describes compositional differences in the microbiota of infants with cystic fibrosis compared with healthy controls, and disordering of the microbiota on antibiotic administration. Besides S aureus, coagulase-negative Staphylococci also contributed to the disordering identified in these infants. These findings are clinically important in view of the crucial role that bacterial pathogens have in the disease progression of cystic fibrosis in early life. Our findings could be used to inform future studies of the effect of antibiotic treatment on the microbiota in infants with cystic fibrosis, and could assist in the prevention of early disease progression in infants with this disorder. FUNDING Swiss National Science Foundation, Fondation Botnar, the Swiss Society for Cystic Fibrosis, and the Swiss Lung Association Bern.

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Healthy replacement heifers are one of the foundations of a healthy dairy herd. Farm management andrearing systems in Switzerland provide a wide variety of factors that could potentially be associated withintramammary infections (IMI) in early lactating dairy heifers. In this study, IMI with minor mastitispathogens such as coagulase-negative staphylococci (CNS), contagious pathogens, and environmentalmajor pathogens were identified. Fifty-four dairy farms were enrolled in the study. A questionnaire wasused to collect herd level data on housing, management and welfare of young stock during farm isitsand interviews with the farmers. Cow-level data such as breed, age at first calving, udder condition andswelling, and calving ease were also recorded. Data was also collected about young stock that spent aperiod of at least 3 months on an external rearing farm or on a seasonal alpine farm. At the quarterlevel, teat conditions such as teat lesions, teat dysfunction, presence of a papilloma and teat lengthwere recorded. Within 24 h after parturition, samples of colostral milk from 1564 quarters (391 heifers)were collected aseptically for bacterial culture. Positive bacteriological culture results were found in 49%of quarter samples. Potential risk factors for IMI were identified at the quarter, animal and herd levelusing multivariable and multilevel logistic regression analysis. At the herd level tie-stalls, and at cow-level the breed category “Brown cattle” were risk factors for IMI caused by contagious major pathogenssuch as Staphylococcus aureus (S. aureus). At the quarter-level, teat swelling and teat lesions were highlyassociated with IMI caused by environmental major pathogens. At the herd level heifer rearing at externalfarms was associated with less IMI caused by major environmental pathogens. Keeping pregnant heifersin a separate group was negatively associated with IMI caused by CNS. The odds of IMI with coagulase-negative staphylococci increased if weaning age was less than 4 months and if concentrates were fed tocalves younger than 2 weeks. This study identified herd, cow- and quarter-level risk factors that may beimportant for IMI prevention in the future.

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In the present study the use and experience of using social media was examined in men and women in order to evaluate a possible relationship to gender. Particular emphasis was placed upon negative emotions. A questionnaire was constructed and submitted via Facebook by an online survey. There were 61 women and 50 men who completed the questionnaire. It was found that women and men used social media similarly with regard to frequency and the kind of social media they approached. Both genders used social media on a daily basis and both had profiles on the most popular social network sites as Facebook, Instagram, YouTube and Snapchat. The main purpose for using social media was to maintain already established friend relationships and to take part of other peoples content. A majority of the women but not the men used blogs, whereas a majority of the men but not the women used Twitter more frequently. The study also indicated a sex difference concerning the contents they took part of in the social media. More women took part of content that was related to a female stereotypic image whereas more men took part of content that was related to a male stereotypic image. There was no gender difference concerning contents such as fashion, entertainment, humour, news or politics. In the women there was a significant relationship between the use of social media and negative emotions. However, in the men, such a relationship was not found. The results indicate that more women tend to experience negative emotions when active on social media. More women experienced life as meaningless and boring, as well as stress after consuming contents in social media. They also did compare their life with others on social media leaving them with negative feelings. Such relationships could not be found in the men. In conclusion the present study indicated that for many aspects the use of social media is similar in women and men. However there seems to be a difference with regard to the experience of negative emotions in relation to the use of social media in women but not in men. 

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The potential source of CVC colonisation was assessed. Isolates of coagulase-negative staphylococci (CoNS) recovered from the skin and CVC components of 3 cardiothoracic surgery patients were characterised by pulsed-field gel electrophoresis (PFGE). The genetic heterogeneity of CoNS isolated from the skin was demonstrated and specific genotypes implicated in catheter colonisation. In addition, phenotypic and genotypic typing techniques were assessed for their ability to characterise strains of CoNS recovered from 33 patients who developed catheter-related bloodstream infection (CR-BSI) on a bone marrow transplant (BMT) unit and Siaphylococcus aureus recovered from 6 cardiothoracic surgery patients with surgical site infection (SSI) following median sternotomy. This epidemiological investigation revealed that common strains of CoNS and 51 aureus where not associated with infection in patients with CR-BSI or sternal SSI during the study period. Furthermore, there was no correlation between phenotypic and genotypic characterisation results. The variable expression of phenotypic traits within strains of staphylococci was evident whilst PFGE and randomly amplified polymorphic DNA (RAPD) were highly discriminatory for the molecular characterisation of S. aureus and CoNS. This was highlighted in 8 stem cell transplant (SCT) patients whereby it was demonstrated that routine identification and characterisation of CoNS by phenotypic techniques may not be adequate for the diagnosis of CR-BSI by current guidelines. The potential of the lipid S ELISA to facilitate the diagnosis of CR-BSI in 38 haematology/SCT patients and sternal SSI in 57 cardiothoracic surgery patients was also assessed. The ELISA proved to be a sensitive test for the rapid serodiagnosis of infection due to staphylococci in immunocompetent patients. The acridine orange leucocyte cytospin test (AOLC) was also evaluated for the rapid diagnosis of CR-BSI in 16 haematology/SCT patients with Hickman CVC in situ. Although the sensitivity of the test was low, it may provide a useful adjunct to conventional methods for the in situ sampling of catheters to predict and diagnose CR-BSI, preventing the unnecessary removal of CVC.

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Gram-positive microorganisms, specifically coagulase-negative staphylococci are the most common species recovered from clinical culture specimens of patients with end-stage renal disease. The propensity of coagulase-negative staphylococci (CNS) to cause infection in this patient group has been widely debated. However, it is still unclear how this usually avirulent commensal microorganism produces infection that contributes to high rates of morbidity and mortality in patients with end-stage renal disease. The aim of this thesis was to investigate the rate, geographical distribution, molecular and phenotypic mechanisms of Gram-positive microorganisms associated with infection in renal dialysis patients. In addition, it sought to assess the value of early serological diagnosis of dialysis catheter-associated infection and the effect of antimicrobial treatment regimens on the faecal carriage of enteric microorganisms. In this study, the incidence of haemodialysis catheter-associated infection was established with the Meditrend audit tool. This tool was used to assess the infection outcomes of catheter insertion and management procedures until the catheter was explanted. Introduction of a catheter management protocol decreased the incidence of catheter-related infection. Staphylococcal species recovered from episodes of haemodialysis catheter-associated infection and continuous ambulatory peritoneal dialysis (CAPD)-associated peritonitis were genotyped by determination of macrorestriction profiles with pulsed-field gel electrophoresis. This highlighted horizontal transfer of microorganisms between different patients and the environment. The phenotypic characteristics of these strains were also investigated to determine characteristics that could be used as markers for dialysis catheter-associated infection. The expression of elastase, lipase and esterase by CNS was significantly associated with infection. A rapid enzyme-linked immunosorbent assay incorporating a novel staphylococcal antigen (lipid S) was used to evaluate the early detection of anti-staphylococcal immunoglobulin gamma in patient sera. The comparison of culture positive and culture negative patients demonstrated a steady state of immune activation in both groups. However anti-lipid S serum antibody titres > 1000 were found to be a predictor of infection. The effect on faecal carriage of vancomycin resistant enterococci (VRE) and Clostridium difficile toxins in patients treated with CAPD when empiric cephalosporin therapy was substituted for piperacillin/tazobactam was investigated. The introduction of piperacillin/tazobactam demonstrated a decrease in the faecal carriage of VRE.

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The coagulase-negative staphylococci are the most frequent cause of sepsis associated with indwelling intravascular catheters. Current microbiological investigations to support the diagnosis of catheter-related sepsis (CRS) include the culture of blood and catheter tips, however positive results may reflect specimen contamination, or colonisation of the catheter rather than true sepsis. Previous serological approaches to assist in the diagnosis of CRS based on cellular staphylococcal antigens have been of limited value. In this current study, the serodiagnostic potential of an exocellular antigen produced by 7 strains of coagulase-negative staphylococci cultured in brain heart infusion broth was investigated. Antigenic material isolated by gel permeation from liquid culture was characterised by immunological techniques and chemical analysis. Characterisation of the exocellular antigen revealed a novel glycerophosphoglycolipid, termed lipid S. which shared antigenic determinants with lipoteichoic acid, but differed by comprising a glycerophosphate chain length of only 6 units. In addition, lipid S was immunologically distinct from diphosphatidyl glycerol, a constituent cell membrane phospho lipid. An indirect enzyme linked immunosorbent assay (ELISA) based on lipid S was subsequently developed and used to determine serum antibody levels (IgM and IgG) in 67 patients with CRS due to staphylococci, and 67 patients with a central venous catheter (CVC) in situ who exhibited no evidence of sepsis. The sensitivity and specificity of the lipid S IgG ELISA was 75% and 90% respectively whilst the IgM assay had sensitivity and specificity of 52% and 85%. The addition of GullSORereagent to the EL1SA procedure to remove competing serum IgG and rheumatoid factor did not significantly improve the performance of the IgM assay. The serological response in serial serum samples of 13 patients with CRS due to staphylococci was investigated. Elevated levels of antibody were detected at an early stage of infection, prior to the isolation of microorganisms by standard culture methods, and before the clinical presentation of sepsis in 3 patients. The lipid S ELISA was later optimised and a rapid 4-hour assay developed for the serodiagnosis of CRS. Serum IgG levels were determined in 40 patients with CRS due to staphylococci and 40 patients with a CVC in situ who exhibited no evidence of sepsis. The sensitivity and specificity of the rapid IgG assay was 70% and 100% respectively. Elevated serum antibody levels in patients with endocarditis, prosthetic joint infection and pyogenic spondylodiscitis due to Gram-positive cocci were also detected with the lipid S ELISA suggesting that the assay may facilitate the diagnosis of these infections. Unexpected increased levels of anti-lipid S IgG in 31% of control patients with sciatica suggested a possible microbial aetiology of this condition. Further investigation of some of these patients by culture of microdiscectomy tissue removed at operation, revealed the presence of low-virulent microorganisms in 37% of patients of which Propionibacterium aeries accounted for 85% of the positive culture isolates. The results suggested a previously unrecognised association between P. acnes and sciatica, which may have implications for the future management of the condition.

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DUE TO COPYRIGHT RESTRICTIONS ONLY AVAILABLE FOR CONSULTATION AT ASTON UNIVERSITY LIBRARY AND INFORMATION SERVICES WITH PRIOR ARRANGEMENT

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Objectives: To determine the sensitivity and specificity of a novel ELISA for the serodiagnosis of surgical site infection (SSI) due to staphylococci following median sternotomy. Methods: Twelve patients with a superficial sternal SSI and 19 with a deep sternal SSI due to Staphylococcus aureus were compared with 37 control patients who also underwent median sternotomy for cardiac surgery but exhibited no microbiological or clinical symptoms of infection. A further five patients with sternal SSI due to coagulase-negative (CoNS) staphylococci were studied. An ELISA incorporating a recently recognised exocellular short chain form of lipoteichoic acid (lipid S) recovered from CoNS, was used to determine serum levels of anti-lipid S IgG in all patient groups. Results: Serum anti-lipid S IgG titres of patients with sternal SSI due to S. aureus were significantly higher than the control patients (P<0.0001). In addition, patients with deep sternal SSI had significantly higher serum anti-lipid S IgG titres than patients with superficial sternal SSI (P=0.03). Serum anti-lipid S IgG titres of patients with sternal SSI due to CoNS were significantly higher than the control patients (P=0.001). Conclusion: The lipid S ELISA may facilitate the diagnosis of sternal SSI due to S. aureus and could also be of value with infection due to CoNS. © 2005 Published by Elsevier Ltd. on behalf of The Bristish Infection Society.

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The diagnosis of prosthetic joint infection and its differentiation from aseptic loosening remains problematic. The definitive laboratory diagnostic test is the recovery of identical infectious agents from multiple intraoperative tissue samples; however, interpretation of positive cultures is often complex as infection is frequently associated with low numbers of commensal microorganisms, in particular the coagulase-negative staphylococci (CNS). In this investigation, the value of serum procalcitonin (PCT), interleukin-6 (IL-6) and soluble intercellular adhesion molecule-1 (sICAM-1) as predictors of infection in revision hip replacement surgery is assessed. Furthermore, the diagnostic value of serum IgG to short-chain exocellular lipoteichoic acid (sce-LTA) is assessed in patients with infection due to CNS. Presurgical levels of conventional serum markers of infection including C-reactive protein (CRP), erythrocyte sedimentation rate (ESR) and white blood cell count (WBC) is also established. Forty-six patients undergoing revision hip surgery were recruited with a presumptive clinical diagnosis of either septic (16 patients) or aseptic loosening (30 patients). The diagnosis was confirmed microbiologically and levels of serum markers were determined. Serum levels of IL-6 and sICAM-1 were significantly raised in patients with septic loosening (P=0.001 and P=0.0002, respectively). Serum IgG to sce-LTA was elevated in three out of four patients with infection due to CNS. In contrast, PCT was not found to be of value in differentiating septic and aseptic loosening. Furthermore, CRP, ESR and WBC were significantly higher (P=0.0001, P=0.0001 and P=0.003, respectively) in patients with septic loosening. Serum levels of IL-6, sICAM-1 and IgG to sce-LTA may provide additional information to facilitate the diagnosis of prosthetic joint infection.

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Diabetes mellitus is a major chronic disease that continues to increase significantly. One of the most important and costly complications of diabetes are foot infections that may be colonized by pathogenic and antimicrobial resistant bacteria, harboring several virulence factors, that could impair its successful treatment. Staphylococcus aureus is one of the most prevalent isolate in diabetic foot infections, together with aerobes and anaerobes.

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Jerked beef, an industrial meat product obtained from beef with the addition of sodium chloride and curing salts and subjected to a maturing and drying process is a typical Brazilian product which has been gradually discovered by the consumer. The replacement of synthetic antioxidants by natural substances with antioxidant potential due to possible side effects discovered by lab tests, consumer health, is being implemented by the meat industry. This study aimed to evaluate the lipid oxidation of jerked beef throughout the storage period by replacing the sodium nitrite by natural extracts of propolis and Yerba Mate. For jerked beef processing brisket was used as raw material processed in 6 different formulations: formulation 1 (control - in nature), formulation 2 (sodium nitrite - NO), formulation 3 (Yerba Mate - EM), formulation 4 (propolis extract - PRO), formulation 5 (sodium nitrite + Yerba Mate - MS + NO), formulation 6 (propolis extract + sodium nitrite - PRO + NO). The raw material was subjected to wet salting, dry salting (tombos), drying at 25°C, packaging and storage in BOD 25°C. Samples of each formulation were taken every 7 days for analysis of lipid oxidation by the TBARS method. In all formulations, were carried out analysis of chemical composition at time zero and sixty days of storage. The water activity analysis and color (L *, a *, b *) was monitored at time zero, thirty and sixty days of storage. The Salmonella spp count, Coliform bacteria, Termotolerant coliforms and coagulase positive staphylococci were taken at time zero and sixty days. The activity of natural antioxidants evaluated shows the decline of lipid oxidation up to 2.5 times compared with the product in natura and presented values with no significant differences between treatments NO and EM, confirming the potential in minimize lipid oxidation of Jerked beef throughout the 60 days of storage. The results also showed that yerba mate has a higher antioxidant capacity compared to the propolis except the PRO + NO formulation. When associated with yerba mate with sodium nitrate, TBARS values become close to values obtained only for the control samples with the addition of sodium nitrite. The proximal composition of the formulations remained within the standards required in the IN nº22/2000 for jerked beef. Samples that differ significantly at 5% are directly related to the established type of formulation. The count of microorganisms was within the standards of the DRC nº12/2001 required for matured meat products. The intensity of the red (a*) decreased with storage time and increase the intensity of yellow (b*) indicates a darkening of the product despite L* also have been increased. These results suggest that yerba mate is a good alternative to meat industry in reducing healing addition salts when associated with another antioxidant.