The role of laparoscopic biopsies in lumbar spondylodiscitis.

The infection of an intervertebral disk is a serious condition. The diagnosis often is elusive and difficult to make. It is imperative to have appropriate microbiologic specimens before the initiation of treatment. We report the case of a 51-year-old woman with lumbar spondylodiscitis caused by infection after the placement of an epidural catheter for postoperative analgesia. A spinal magnetic resonance imaging (MRI) scan confirmed the diagnosis, but computed tomography (CT)-guided fine-needle biopsy did not yield adequate material for a microbiologic diagnosis. Laparoscopic biopsies of the involved disk provided good specimens and a diagnosis of Propionibacterium acnes infection. We believe that this minimally invasive procedure should be performed when CT-guided fine-needle biopsy fails to yield a microbiologic diagnosis in spondylodiscitis.

Bacterial colonization and infection of electrophysiological cardiac devices detected with sonication and swab culture.

BACKGROUND: Electrophysiological cardiac devices are increasingly used. The frequency of subclinical infection is unknown. We investigated all explanted devices using sonication, a method for detection of microbial biofilms on foreign bodies. METHODS AND RESULTS: Consecutive patients in whom cardiac pacemakers and implantable cardioverter/defibrillators were removed at our institution between October 2007 and December 2008 were prospectively included. Devices (generator and/or leads) were aseptically removed and sonicated, and the resulting sonication fluid was cultured. In parallel, conventional swabs of the generator pouch were performed. A total of 121 removed devices (68 pacemakers, 53 implantable cardioverter/defibrillators) were included. The reasons for removal were insufficient battery charge (n=102), device upgrading (n=9), device dysfunction (n=4), or infection (n=6). In 115 episodes (95%) without clinical evidence of infection, 44 (38%) grew bacteria in sonication fluid, including Propionibacterium acnes (n=27), coagulase-negative staphylococci (n=11), Gram-positive anaerobe cocci (n=3), Gram-positive anaerobe rods (n=1), Gram-negative rods (n=1), and mixed bacteria (n=1). In 21 of 44 sonication-positive episodes, bacterial counts were significant (>or=10 colony-forming units/mL of sonication fluid). In 26 sterilized controls, sonication cultures remained negative in 25 cases (96%). In 112 cases without clinical infection, conventional swab cultures were performed: 30 cultures (27%) were positive, and 18 (60%) were concordant with sonication fluid cultures. Six devices and leads were removed because of infection, growing Staphylococcus aureus, Streptococcus mitis, and coagulase-negative staphylococci in 6 sonication fluid cultures and 4 conventional swab cultures. CONCLUSIONS: Bacteria can colonize cardiac electrophysiological devices without clinical signs of infection.

Bacterial biofilms and capsular contracture in patients with breast implants.

BACKGROUND: It has been hypothesized that bacterial biofilms on breast implants may cause chronic inflammation leading to capsular contracture. The association between bacterial biofilms of removed implants and capsular contracture was investigated. METHODS: Breast implants explanted between 2006 and 2010 at five participating centres for plastic and reconstructive surgery were investigated by sonication. Bacterial cultures derived from sonication were correlated with patient, surgical and implant characteristics, and the degree of capsular contracture. RESULTS: The study included 121 breast implants from 84 patients, of which 119 originated from women and two from men undergoing gender reassignment. Some 50 breast prostheses were implanted for reconstruction, 48 for aesthetic reasons and 23 implants were used as temporary expander devices. The median indwelling time was 4·0 (range 0·1-32) years for permanent implants and 3 (range 1-6) months for temporary devices. Excluding nine implants with clinical signs of infection, sonication cultures were positive in 40 (45 per cent) of 89 permanent implants and in 12 (52 per cent) of 23 temporary devices. Analysis of permanent implants showed that a positive bacterial culture after sonication correlated with the degree of capsular contracture: Baker I, two of 11 implants; Baker II, two of ten; Baker III, nine of 23; and Baker IV, 27 of 45 (P < 0·001). The most frequent organisms were Propionibacterium acnes (25 implants) and coagulase-negative staphylococci (21). CONCLUSION: Sonication cultures correlated with the degree of capsular contracture, indicating the potential causative role of bacterial biofilms in the pathogenesis of capsular contracture. Registration number: NCT01138891 (http://www.clinicaltrials.gov).

Improved diagnosis of periprosthetic joint infection by multiplex PCR of sonication fluid from removed implants.

The microbiological diagnosis of periprosthetic joint infection (PJI) is crucial for successful antimicrobial treatment. Cultures have limited sensitivity, especially in patients receiving antibiotics. We evaluated the value of multiplex PCR for detection of microbial DNA in sonication fluid from removed orthopedic prostheses. Cases of PJI in which the prosthesis (or part of it) was removed were prospectively included. The removed implant was sonicated, and the resulting sonication fluid was cultured and subjected to multiplex PCR. Of 37 PJI cases (17 hip prostheses, 14 knee prostheses, 4 shoulder prostheses, 1 elbow prosthesis, and 1 ankle prosthesis), pathogens were identified in periprosthetic tissue in 24 (65%) cases, in sonication fluid in 23 (62%) cases, and by multiplex PCR in 29 (78%) cases. The pathogen was detected in 5 cases in sonication fluid only (Propionibacterium acnes in all cases; none of these patients had previously received antibiotics) and in 11 cases by multiplex PCR only (all of these patients had previously received antibiotics). After exclusion of 8 cases caused by P. acnes or Corynebacterium species, which cannot be detected due to the absence of specific primers in the PCR kit, sonication cultures were positive in 17 cases and multiplex PCR sonication cultures were positive in 29 cases (59% versus 100%, respectively; P < 0.01). Among 19 cases (51%) receiving antibiotics, multiplex PCR was positive in all 19 (100%), whereas sonication cultures grew the organism in 8 (42%) (P < 0.01). Multiplex PCR of sonication fluid is a promising test for diagnosis of PJI, particularly in patients who previously received antibiotics. With modified primer sets, multiplex PCR has the potential for further improvement of the diagnosis of PJI.

The role of laparoscopic biopsies in lumbar spondylodiscitis.

Infection of an intervertebral disk is a serious condition. Diagnosis often is elusive and difficult. It is imperative to obtain appropriate microbiological specimens before initiation of treatment. The authors describe a 51-year-old woman with lumbar spondylodiscitis that was because of infection after the placement of an epidural catheter for postoperative analgesia. A spinal magnetic resonance imaging confirmed the diagnosis, but computed tomography-guided fine needle biopsy did not provide adequate material for a microbiologic diagnosis. Laparoscopic biopsies of the involved disk provided good specimens and a diagnosis of Propionibacterium acnes infection. The authors believe that this minimally invasive procedure should be performed when computed tomography-guided fine needle biopsy does not provide a microbiologic diagnosis in spondylodiscitis.

Retention of short chain fatty acids under drying and storage conditions

Cheese whey permeate was used as a substrate for the fermentation of Propionibacterium freudenreichi PS1 for the production of short chain fatty acids, components of the bio-aroma of Swiss cheese. The liquid bio-aroma was encapsulated by spray drying under different conditions of air inlet temperature and feed rate. A study was carried out on the stability of the bio-aroma during storage in laminated packages at 30 °C for 96 days using the product showing the greatest retention of acetic and propionic acids. The results showed that the best drying conditions were an air entrance temperature of 180 °C and a feed rate of 24 g/min resulting in particles with a smooth surface and few invaginations and micro-fissures. However, 72% of the acetic acid and 80% of the propionic acid were lost during storage showing that the wall material used was inadequate to guarantee product stability.

Avaliação das actividades antioxidante e antimicrobiana do óleo de café verde em formulações cosméticas

O óleo de café verde (OCV) e formulações cosméticas que contendo 2,5, 5, 10 e 15% de óleo foram avaliados por métodos in vitro quanto às suas atividades antioxidante e antimicrobiana. O OCV e as suas formulações demostraram baixa actividade antioxidante, avaliada pelo método DPPH (42% do OCV foi equivalente a 0,002% de BHT). Não se observou atividade antimicrobiana para o OCV e as suas formulações contra Escherichia coli, Staphylococcus aureus, Staphylococcus epidermidis, Pseudomonas aeruginosa, Bacilus subtilis, Propionibacterium acnes e Candida albicans, utilizando o método de difusão em poço. Embora o OCV seja utilizado há muitos anos em formulações cosméticas, ainda são necessários mais estudos para apoiar adequadamente a utilidade do óleo de café em produtos para cuidado da saúde da pele e em cosméticos.

Insight into the prebiotic concept: lessons from an exploratory, double blind intervention study with inulin-type fructans in obese women

Objective To highlight the contribution of the gut microbiota to the modulation of host metabolism by dietary inulin-type fructans (ITF prebiotics) in obese women. Methods A double blind, placebo controlled, intervention study was performed with 30 obese women treated with ITF prebiotics (inulin/oligofructose 50/50 mix; n=15) or placebo (maltodextrin; n=15) for 3 months (16 g/day). Blood, faeces and urine sampling, oral glucose tolerance test, homeostasis model assessment and impedancemetry were performed before and after treatment. The gut microbial composition in faeces was analysed by phylogenetic microarray and qPCR analysis of 16S rDNA. Plasma and urine metabolic profiles were analysed by 1H-NMR spectroscopy. Results Treatment with ITF prebiotics, but not the placebo, led to an increase in Bifidobacterium and Faecalibacterium prausnitzii; both bacteria negatively correlated with serum lipopolysaccharide levels. ITF prebiotics also decreased Bacteroides intestinalis, Bacteroides vulgatus and Propionibacterium, an effect associated with a slight decrease in fat mass and with plasma lactate and phosphatidylcholine levels. No clear treatment clustering could be detected for gut microbial analysis or plasma and urine metabolomic profile analyses. However, ITF prebiotics led to subtle changes in the gut microbiota that may importantly impact on several key metabolites implicated in obesity and/or diabetes. Conclusions ITF prebiotics selectively changed the gut microbiota composition in obese women, leading to modest changes in host metabolism, as suggested by the correlation between some bacterial species and metabolic endotoxaemia or metabolomic signatures.

Use of denaturing gradient gel electrophoresis to detect Actinobacteria associated with the human faecal microbiota

With the exceptions of the bifidobacteria, propionibacteria and coriobacteria, the Actinobacteria associated with the human gastrointestinal tract have received little attention. This has been due to the seeming absence of these bacteria from most clone libraries. In addition, many of these bacteria have fastidious growth and atmospheric requirements. A recent cultivation-based study has shown that the Actinobacteria of the human gut may be more diverse than previously thought. The aim of this study was to develop a denaturing gradient gel electrophoresis (DGGE) approach for characterizing Actinobacteria present in faecal samples. Amount of DNA added to the Actinobacteria-specific PCR used to generate strong PCR products of equal intenstity from faecal samples of five infants, nine adults and eight elderly adults was anti-correlated with counts of bacteria obtained using fluorescence in situ hybridization probe HGC69A. A nested PCR using Actinobacteria-specific and universal PCR-DGGE primers was used to generate profiles for the Actinobacteria. Cloning of sequences from the DGGE bands confirmed the specificity of the Actinobacteria-specific primers. In addition to members of the genus Bifidobacterium, species belonging to the genera Propionibacterium, Microbacterium, Brevibacterium, Actinomyces and Corynebacterium were found to be part of the faecal microbiota of healthy humans.

Microbiota saprófita associada à doença periodontal em cães

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Queima e aditivos químicos e bacterianos na ensilagem de cana-de-açúcar

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Estabilidade aeróbia da ração total e de silagens de capim-marandu tratadas com aditivos químicos e bacterianos

Esta pesquisa foi realizada com o objetivo de determinar o efeito da inclusão de aditivo químico e da inoculação de bactérias homo e heterofermentativas sobre a estabilidade aeróbia de silagens de capim-marandu e da ração total. Foram conduzidos três experimentos para avaliação do benzoato de sódio e de dois inoculantes, um contendo Lactobacillus plantarum + Propionibacterium e o segundo Lactobacillus buchneri. Após 60 dias de fermentação, os silos foram abertos e as silagens e a ração total (RT) contendo silagens de capim-marandu foram colocadas em caixas de isopor e transferidas para câmara climática, a 25 ± 1ºC, para determinação das variações de temperatura na ração total e na silagem, das recuperações de MS e das alterações no pH da silagem. O delineamento experimental foi o inteiramente casualizado, em esquema de parcelas subdivididas. Houve perdas de MS e elevação dos teores de pH quando as silagens foram colocadas em condições de aerobiose. A temperatura das silagens e da RT teve discreto aumento durante os seis dias de aeração. O uso de bactérias ou de benzoato de sódio não influenciou a estabilidade aeróbia das silagens.

Associação entre aditivos químicos e bacterianos na ensilagem de cana-de-açúcar

Objetivou-se avaliar a ensilagem de cana-de-açúcar tratada com três aditivos químicos (uréia 1,5%, benzoato de sódio 0,1% e hidróxido de sódio 1%) mais o grupo controle e duas inoculações (Propionibacterium acidipropionici + Lactobacillus plantarum e Lactobacillus buchneri), em um esquema fatorial 4 x 3 com três repetições para cada tratamento. Avaliou-se o valor nutritivo da forragem antes da ensilagem, após a abertura dos silos e após a exposição aeróbia. As associações de P. acidipropionici ou L. buchneri com NaOH, em comparação ao grupo controle, possibilitaram melhor preservação dos teores de MS (32,2 e 33,5 vs 27,4%, respectivamente), FDN ( 53,4; 55,7 vs 75,3%), FDA (39,5; 44,3 vs 48,7%), lignina (6,6; 7,1 vs 8,1%) e CNF (33,8; 31,7 vs 14,9%) e, conseqüentemente, propiciaram os maiores valores de DIVMS (60,3; 63,2 vs 35,1%). Esses valores podem ser atribuídos ao controle das leveduras pelos efeitos da associação dos aditivos. A ensilagem de cana-de-açúcar requer de forma contundente a inclusão de aditivo.

Perdas de silagens de cana-de-açúcar tratadas com aditivos químicos e bacterianos

Objetivou-se avaliar silagens de cana-de-açúcar tratadas com aditivos químicos (uréia 1,5%; benzoato de sódio 0,1%; ou hidróxido de sódio (NaOH) 1% na matéria natural) combinados ou não com inoculantes (Propionibacterium acidipropionici + Lactobacillus plantarum ou Lactobacillus buchneri). Foram avaliadas 12 silagens: uma controle, sem inoculante e sem aditivo químico; três sem inoculante, mas com um dos aditivos; uma com P. acidipropionici + L. plantarum, sem aditivo químico; três com P. acidipropionici + L. plantarum e um dos aditivos; uma com L. buchneri, sem aditivo químico; e três com L. buchneri e um dos aditivos. Os dados foram analisados em esquema fatorial 4 × 3 com três repetições para cada tratamento. Foram determinadas as perdas ocorridas durante o processo fermentativo nas formas de gases e de efluentes e a recuperação da MS. Durante a exposição aeróbia, determinaram-se a recuperação da MS e a estabilidade aeróbia medida pela variação da temperatura. A associação de L. buchneri e NaOH reduziu as perdas por gases e efluentes e elevou a recuperação da MS. No período após abertura, destacou-se a atuação do benzoato de sódio em manter o pH com variação de apenas 0,1 unidade em cinco dias de exposição aeróbia e dos inoculantes L. buchneri e P. acidipropionici + L. plantarum em prolongar o tempo para elevação da temperatura de 34 horas nas silagens controle para 54 e 50 horas, respectivamente. A ensilagem de cana-de-açúcar requer a inclusão de algum aditivo eficiente no controle das perdas quantitativas durante a fermentação e a exposição aeróbia.