phenylephrine-hydrochloride and Bacterial-Infections

Topics: Bacterial Infections; Chronic Disease; Humans; Nose; Rhinitis; Sinusitis

Our health is highly determined by the diverse microbial community living within our body and upon our skin. Balance among the members of the commensal microbiota is essential for the preservation of health. New generation sequencing is a rapid, sensitive method for determining the whole microbiome without prior hypothesis and also gives information on the resistance and virulence status. Application of this method can help to identify the pathogens contributing to different diseases, and also the protective bacteria inhibiting their growth. Detecting the changes of the microbiome helps to identify new therapeutic targets and establish targeted antibiotic therapy. Broad-spectrum antibiotics also act against the beneficial members of the microbial flora, which may lead to the development of recurrent or chronic disease. Ear, nose and throat infections are the most common infective diseases in humans and the leading cause for antibiotic prescription worldwide. In recent years, many studies using molecular biology methods were performed examining the microbiome of healthy humans and in otorhinolaryngologic diseases. In the present work, the authors review the changes of the microbiological communities in the healthy state and in various pathologic states in the anatomic regions of the ear, nose and throat. Orv Hetil. 2019; 160(39): 1533-1541.. Absztrakt: Egészségünket a szervezetünkben és a bőrünkön élő sokszínű mikrobaközösség jelentősen meghatározza. A normálflóra tagjai közötti egyensúly elengedhetetlen az egészség fenntartásában. Az újgenerációs szekvenálás gyors, szenzitív módszer, amely a mikrobiom egészének vizsgálatára alkalmas előzetes hipotézis nélkül, és információt ad a rezisztenciáról és a virulenciáról is. Ennek a módszernek a segítségével lehetővé vált betegségekben a patogén baktériumok, illetve az ezek szaporodását gátló, úgynevezett protektív baktériumok azonosítása. A mikrobiom változásainak feltérképezése segít új terápiás célpontok meghatározásában és az antibiotikumok célzott kiválasztásában. Széles spektrumú antibiotikum használatakor a normálflóra hasznos tagjai is kipusztulnak, ami visszatérő vagy krónikussá váló fertőzések kialakulásához vezet. A fül-orr-gégészeti infekciók a leggyakoribb fertőző betegségek az emberi szervezetben és az antibiotikum alkalmazásának vezető okai világszerte. Az egészséges emberben, illetve a fül-orr-gégészeti betegségekben előforduló baktérium-összetétellel kapcsolatban számos molekuláris biológiai vizsgálat történt az utóbbi években. A szerzők ismertetik az egyes fül-orr-gégészeti anatómiai régiók normálflórájának tagjait, és különböző patológiás állapotokban a baktérium-összetétel változásait is összefoglalják. Orv Hetil. 2019; 160(39): 1533–1541.

Topics: Anti-Bacterial Agents; Bacteria; Bacterial Infections; Ear; Humans; Microbiota; Nose; Otolaryngology; Otorhinolaryngologic Diseases; Pharynx; Sequence Analysis, DNA

To address 3 questions: What are the origins of bacteria causing surgical site infections (SSIs)? Is there evidence that the offending bacteria are present at the incision site when surgery begins? What are the estimates of the proportion of SSIs that can be prevented with perioperative control of the microbiome?. Review of the literature, examining recognized sources of bacteria causing surgical site infections.. Specifically, I examined the impact of improved control of the microbiome of the skin and nares on reducing SSIs. The initial effort was to examine the reduction of SSIs linked solely to preoperative skin preparation regimens and to either topical nasal antibiotics or pre- and postoperative nasal antiseptic regimens. To corroborate the concept of the importance of the microbiome, a review of studies showing the relationship of SSIs and marker organisms (eg, Propionobacterium acnes) present at the incision sites was performed. The relationships of SSIs to the microbiome of the skin and nares were summarized.. Depending on key assumptions, ∼70%-95% of all SSIs arise from the microbiome of the patients' skin or nares. Data from the studies of marker organisms suggest that the infecting bacteria are present at the incision site at the time of surgery.. Almost all SSIs arise from the patient's microbiome. The occurrence of SSIs can be viewed as a perioperative failure to control the microbiome.

Topics: Bacterial Infections; Cross Infection; Humans; Microbiota; Nose; Propionibacterium acnes; Skin; Surgical Wound Infection; United States

Topics: Adolescent; Anti-Bacterial Agents; Anti-Inflammatory Agents; Bacterial Infections; Child; Child, Preschool; Diagnosis, Differential; Histamine H1 Antagonists; Humans; Mucociliary Clearance; Nasal Decongestants; Nasal Mucosa; Nasopharyngeal Diseases; Nose; Paranasal Sinuses; Sinusitis

Serious complications of cosmetic rhinoplasty are extremely rare. However, awareness of their existence is essential so that the surgeon can minimize the potential hazards of the procedure. This demands a careful preoperative examination, a meticulous intraoperative technique, and a careful postoperative monitoring of the patient. The complications of rhinoplasty have been classified into infectious, traumatic, hemorrhagic, systemic, and miscellaneous groups. The pertinent literature is reviewed, as well as cases of inclusion cyst formation, disturbance of eye closure, local activation of systemic disease, and fatalities from intracranial injury with brain laceration and pneumocephalus.

Topics: Adolescent; Adult; Aged; Anesthesia; Arteriovenous Fistula; Bacterial Infections; Endocarditis; Female; Gastrointestinal Hemorrhage; Hemorrhage; Humans; Intraoperative Care; Male; Middle Aged; Nose; Pneumocephalus; Postoperative Care; Radiography; Rhinoplasty

Topics: Antigens; Bacterial Infections; Bronchi; Cilia; Cough; Environmental Pollutants; Environmental Pollution; Genes; Histocompatibility; Humans; Immunity, Cellular; Immunoglobulin E; Lung; Lymphatic System; Lymphocytes; Mucus; Neutralization Tests; Nose; Pulmonary Alveoli; Reflex; Respiratory Tract Diseases; Respiratory Tract Infections; Sensory Receptor Cells; Sneezing; Virus Diseases

Bovine infectious keratoconjunctivitis, which is caused by Moraxella bovis, occurs perennially in all cattle-raising areas. Disease may occur any time during the year but manifests itself often during summer when disease-enhancing factors such as ultraviolet radiation and fly population are increased. Although some recent research findings indicate that cattle can be immunized against the disease, many problems have to be overcome before the cattle industry can benefit from such immunization. Some pressing problems relate to lack of cross-protection between vaccines of different strains of M bovis, resistant or resilient carrier states, and how these factors affect vaccination regimens undertaken. Though cattle vaccinated with 1 strain are somewhat protected against subsequent challange by the same strain, protection against heterologous strains has not been demonstrated. In most herds, cattle harbor M bovis, and these carriers may serve as a source of infection.

Topics: Animals; Bacterial Infections; Carrier State; Cattle; Cattle Diseases; Conjunctiva; Diptera; Houseflies; Insect Vectors; Keratoconjunctivitis; Moraxella; Nose; Seasons; Vaccination

Topics: Air Microbiology; Antisepsis; Bacteria; Bacterial Infections; Blood Bactericidal Activity; Cross Infection; Equipment and Supplies, Hospital; Humans; Length of Stay; Mouth; Nose; Skin; Surgical Wound Infection; Urinary Catheterization; Urinary Tract Infections; Urology

Topics: Acid-Base Equilibrium; Agglutinins; Animals; Antibody Formation; Bacterial Infections; Blood Bactericidal Activity; Blood Glucose; Body Weight; Diabetes Complications; Diabetes Mellitus; Erythrasma; Glucose Tolerance Test; Humans; Ketones; Leprosy; Leukocytosis; Nose; Phagocytosis; Rats; Skin; Skin Diseases, Infectious; Staphylococcal Infections; Urinary Tract Infections

Sinus puncture and aspiration is an invasive procedure that hinders patient enrollment in studies of acute bacterial maxillary sinusitis (ABMS). Pain and minor bleeding also limit its potential diagnostic utility in clinical practice. Cultures obtained by rigid nasal endoscopy were compared with those from sinus puncture and aspiration in 53 patients with ABMS; 46 patients were assessable. Considering recovery of Haemophilus influenzae, Moraxella catarrhalis, or Streptococcus pneumoniae from puncture and aspiration as the gold standard, endoscopy cultures demonstrated a sensitivity of 85.7% (95% confidence interval, 56.2-97.5), specificity of 90.6% (73.8-97.5), positive predictive value of 80% (51.4-94.7), negative predictive value of 93.5% (77.2-98.9), and accuracy of 89.1% (75.6-95.9). Ten adverse events related to puncture and aspiration occurred in 5 (9.6%) of 52 patients; there were no endoscopy-related adverse events. In our study, the largest to date, endoscopic sampling compared favorably with puncture and aspiration for identifying H. influenzae, M. catarrhalis, and S. pneumoniae in ABMS and produced less morbidity.

Topics: Acute Disease; Adult; Aged; Bacteria; Bacterial Infections; Endoscopy; Female; Humans; Male; Maxillary Sinus; Maxillary Sinusitis; Middle Aged; Nose; Predictive Value of Tests; Punctures; Sensitivity and Specificity

Catheter-related infections remain a significant cause of method failure in chronic peritoneal dialysis (PD) therapy. Given the increasing antibiotic resistance, such nonpharmacological strategies as local silver devices attract more interest. To establish whether a silver ring device (designed by Grosse-Siestrup in 1992) mounted onto the PD catheter and placed at the exit site at skin level is effective in preventing exit-site and other catheter-related infections, a prospective 12-month, multicenter, controlled study stratified by diabetes status was conducted. The study subjects were assessed by an extensive structured inventory, including a broad spectrum of control variables, such as age, body mass index (BMI), Staphylococcus aureus carrier status, catheter features, mode and quality of PD therapy, comorbidity, and psychosocial rehabilitation. Ten experienced German outpatient dialysis centers (seven adult, three pediatric) participated in the trial. All eligible patients (n=195) from the study area without catheter-related infections during the ascertainment period were included (incidental subjects undergoing PD therapy for at least 3 months). The main outcome measures were the occurrence of first exit-site infections (primary study end point), sinus tract/tunnel infection, and peritonitis. Ninety-seven patients were assigned to the silver ring and 98 patients to the control group. Baseline characteristics of age, sex, proportion of pediatric and incidental patients, S aureus carrier status, and other variables were similar in both groups. The incidence of infections in the silver ring group versus the control group was as follows: 23 of 97 versus 16 of 98 patients had exit-site infections, 12 of 97 versus 12 of 98 patients had sinus tract/tunnel infections, 16 of 97 versus 18 of 98 patients had peritonitis, respectively. Kaplan-Meier analysis for the probability of an infection-free interval showed no statistical difference (log-rank test) between the two groups. Displacement of the silver ring contributed to study termination in 6% of the study group patients, including two patients with catheter loss. Univariate analysis and multiple logistic regression identified younger age (<50 years), low serum albumin level (<35 g/L), number of previously placed PD catheters, short cuff-exit distance (<2 cm), and S aureus nasal carriage as risk factors for the development of exit-site infections. In conclusion, our study does not show any benefit of the sil

Topics: Adult; Age Factors; Analysis of Variance; Anti-Bacterial Agents; Bacterial Infections; Body Mass Index; Catheters, Indwelling; Child; Cutaneous Fistula; Diabetic Nephropathies; Equipment Design; Female; Humans; Incidence; Logistic Models; Male; Middle Aged; Nose; Peritoneal Dialysis; Peritonitis; Prospective Studies; Risk Factors; Serum Albumin; Silver; Staphylococcus aureus; Treatment Outcome

ESI remain a major problem in patients undergoing peritoneal dialysis and are frequently the reason for catheter removal. The treatment is often costly and not effective and the need for routine prophylactics has to be clarified. In this study 38 peritoneal dialysis patients (15 F & 23 M, age: 18-73) were analysed prospectively for ESI and TI in respect to skin (exit site and inguinal area) and nostrils colonisation. There were 14 diabetics and 24 non-diabetics. All had standard double-cuff Tenckhoff catheter and none presented with ESI prior to the study. No treatment was applied on the basis of positive culture only. In 27 patients swab were repeated after 6-11 months. Eight episodes of ESI and three TI were recorded. Following pathogens were cultured: S.aureus in 4 Klebsiella pneumoniae in 2, Corynebacterium sp. in 1, negative in 1 and with TI S.aureus in 3. Positive nasal cultures (S.aureus, Klebs.pn.) were observed in 5 patients subsequently developing ESI (p < 0.01) and in 2 with TI. In 2 cases exit site was also colonized by pathogens responsible for ESI (p = NS). Inguinal area was colonized by various pathogens in 7 patients, but only one of these developed ESI (p = NS) and no one TI. There was no difference between diabetic and non-diabetics neither in the frequency of ESI, TI nor in nasal carriage of pathogens. In the majority of patients nostrils and inguinal area were colonized by S.epidermidis. When the second culture was analyzed it appeared that significantly more patients had exit site colonized by S.epidermidis (2 and 11 patients in 2 consecutive cultures respectively (p < 0.01). In conclusion, it appears that nasal carriers of pathogens like S.aureus and Klebsiella pneumoniae are more prone to ESI. Inguinal area and exit site colonization does not seem to precede ESI or TI. We would suggest that nasal carriage status should be routinely identified in all patients entering peritoneal dialysis programme and the carriers properly treated.

Topics: Adult; Aged; Bacteria; Bacterial Infections; Catheters, Indwelling; Disease Reservoirs; Disease Transmission, Infectious; Female; Humans; Male; Middle Aged; Nose; Peritoneal Dialysis; Peritonitis; Prospective Studies; Skin

The role of gastric microbial colonization in nosocomial infections and endotoxemia was investigated prospectively in 40 neurosurgical patients requiring mechanical ventilation for greater than 48 h. Each was studied up to 7 d. Swabs from the nose and oropharynx were cultured at admission, and aspirates from the stomach and trachea were cultured daily until enteral alimentation was started. Patients were evaluated every second day for endotoxemia and coagulation activation. Of 153 gastric aspirates, 66.7% contained microorganisms at a mean quantity of 10(7) cfu/ml. Nosocomial pneumonia occurred in 15 patients, septicemia in 5, and meningitis in 1. The stomach was the evident source of infection in only 1 patient with pneumonia. Of 140 plasma samples, 12 (8.6%) from 10 patients showed detectable endotoxin levels, but there was no association between endotoxemia or coagulation activation and the presence of microorganisms in the stomach. The stomach was not an important source for nosocomial infections or endotoxemia, even in patients with high gastric pH.

Topics: Adult; Bacteria; Bacterial Infections; Candida; Cross Infection; Female; Humans; Male; Neurosurgery; Nose; Oropharynx; Prospective Studies; Respiration, Artificial; Stomach; Toxemia; Trachea

In a prospective randomized study different regimens for skin and umbilical disinfection in newborn infants were tested: daily whole body soap wash (control group), daily whole body soap wash and umbilical cleansing with (i) benzine solution, or (ii) 0.05% chlorhexidine, and daily whole body wash and umbilical cleansing with a 4% chlorhexidine detergent solution (Hibiscrub). Bacterial cultures were taken from the nose and umbilical area at discharge. Clinical infections were registered in the nursery, and after discharge until 6 weeks of age. Cultures were taken from infected areas. In the control group a high colonization rate was found for S. aureus (91%), E. coli (39%), and group B streptococci (GBS) (20%). The colonization rates were influenced by the Hibiscrub regimen (colonization rate for S. aureus 59%, E. coli 23%, and GBS 10%), but not by the other regimens. Infections (pemphigus, paronychia, conjunctivitis, umbilical infection) occurred in 12.9% of the infants, of whom 65% got infection after discharge from the nursery. 96% of the infections were caused by S. aureus, and 87% caused by strains colonizing the infants in the nursery. None of the tested regimens reduced the rate of infections during the first 6 weeks of life.

Topics: Alkanes; Bacterial Infections; Chlorhexidine; Clinical Trials as Topic; Cross Infection; Disinfectants; Humans; Infant, Newborn; Nose; Prospective Studies; Random Allocation; Skin; Soaps; Umbilicus

The ability to accurately distinguish bacterial from viral infection would help clinicians better target antimicrobial therapy during suspected lower respiratory tract infections (LRTI). Although technological developments make it feasible to rapidly generate patient-specific microbiota profiles, evidence is required to show the clinical value of using microbiota data for infection diagnosis. In this study, we investigated whether adding nasal cavity microbiota profiles to readily available clinical information could improve machine learning classifiers to distinguish bacterial from viral infection in patients with LRTI.. Various multi-parametric Random Forests classifiers were evaluated on the clinical and microbiota data of 293 LRTI patients for their prediction accuracies to differentiate bacterial from viral infection. The most predictive variable was C-reactive protein (CRP). We observed a marginal prediction improvement when 7 most prevalent nasal microbiota genera were added to the CRP model. In contrast, adding three clinical variables, absolute neutrophil count, consolidation on X-ray, and age group to the CRP model significantly improved the prediction. The best model correctly predicted 85% of the 'bacterial' patients and 82% of the 'viral' patients using 13 clinical and 3 nasal cavity microbiota genera (Staphylococcus, Moraxella, and Streptococcus).. We developed high-accuracy multi-parametric machine learning classifiers to differentiate bacterial from viral infections in LRTI patients of various ages. We demonstrated the predictive value of four easy-to-collect clinical variables which facilitate personalized and accurate clinical decision-making. We observed that nasal cavity microbiota correlate with the clinical variables and thus may not add significant value to diagnostic algorithms that aim to differentiate bacterial from viral infections.

Topics: Bacterial Infections; C-Reactive Protein; Humans; Microbiota; Nose; Respiratory Tract Infections; Virus Diseases

The microorganisms at the workplace contribute towards a large portion of the biodiversity a person encounters in his or her life. Health care professionals are often at risk due to their frontline nature of work. Competition and cooperation between nasal bacterial communities of individuals working in a health care setting have been shown to mediate pathogenic microbes. Therefore, we investigated the nasal bacterial community of 47 healthy individuals working in a clinical research laboratory in Kuwait. The taxonomic profiling and core microbiome analysis identified three pre-dominant genera as Corynebacterium (15.0%), Staphylococcus (10.3%) and, Moraxella (10.0%). All the bacterial genera exhibited seasonal variations in summer, winter, autumn and spring. SparCC correlation network analysis revealed positive and negative correlations among the classified genera. A rich set of 16 genera (q < 0.05) were significantly differentially abundant (LEfSe) across the four seasons. The highest species counts, richness and evenness (P < 0.005) were recorded in autumn. Community structure profiling indicated that the entire bacterial population followed a seasonal distribution (R2-0.371; P < 0.001). Other demographic factors such as age, gender and, ethnicity contributed minimally towards community clustering in a closed indoor laboratory setting. Intra-personal diversity also witnessed rich species variety (maximum 6.8 folds). Seasonal changes in the indoor working place in conjunction with the outdoor atmosphere seems to be important for the variations in the nasal bacterial communities of professionals working in a health care setting.

Topics: Adult; Bacteria; Bacterial Infections; Clinical Laboratory Services; Corynebacterium; Corynebacterium Infections; Female; Health Personnel; Humans; Kuwait; Male; Microbiota; Middle Aged; Moraxella; Moraxellaceae Infections; Nose; Seasons; Staphylococcal Infections; Staphylococcus; Young Adult

Research conducted on severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pathogenesis and coronavirus disease 2019 (COVID-19) generally focuses on the systemic host response, especially that generated by severely ill patients, with few studies investigating the impact of acute SARS-CoV-2 at the site of infection. We show that the nasal microbiome of SARS-CoV-2-positive patients (CoV

Topics: Adult; Aged; Aged, 80 and over; Bacteria; Bacterial Infections; Coinfection; COVID-19; Cross-Sectional Studies; DNA, Bacterial; Female; Humans; Immunity, Innate; Inflammation; Male; Microbiota; Middle Aged; Nose; Pseudomonas aeruginosa; Pseudomonas Infections; RNA-Seq; RNA, Ribosomal, 16S; RNA, Viral; Transcriptome; Viral Load; Young Adult

Multidrug-resistant organisms (MDRO) are considered an emerging threat worldwide. Data covering the clinical impact of MDRO colonization in patients with solid malignancies, however, is widely missing. We sought to determine the impact of MDRO colonization in patients who have been diagnosed with Non-small cell lung cancer (NSCLC) who are at known high-risk for invasive infections.. Patients who were screened for MDRO colonization within a 90-day period after NSCLC diagnosis of all stages were included in this single-center retrospective study.. Two hundred and ninety-five patients were included of whom 24 patients (8.1%) were screened positive for MDRO colonization (MDROpos) at first diagnosis. Enterobacterales were by far the most frequent MDRO detected with a proportion of 79.2% (19/24). MDRO colonization was present across all disease stages and more present in patients with concomitant diabetes mellitus. Median overall survival was significantly inferior in the MDROpos study group with a median OS of 7.8 months (95% CI, 0.0-19.9 months) compared to a median OS of 23.9 months (95% CI, 17.6-30.1 months) in the MDROneg group in univariate (p = 0.036) and multivariate analysis (P = 0.02). Exploratory analyses suggest a higher rate of non-cancer-related-mortality in MDROpos patients compared to MDROneg patients (p = 0.002) with an increased rate of fatal infections in MDROpos patients (p = 0.0002).. MDRO colonization is an independent risk factor for inferior OS in patients diagnosed with NSCLC due to a higher rate of fatal infections. Empirical antibiotic treatment approaches should cover formerly detected MDR commensals in cases of (suspected) invasive infections.

Topics: Adult; Aged; Aged, 80 and over; Bacteria; Bacterial Infections; Carcinoma, Non-Small-Cell Lung; Cause of Death; Comorbidity; Drug Resistance, Multiple, Bacterial; Female; Humans; Length of Stay; Lung Neoplasms; Male; Middle Aged; Nose; Patient Admission; Pharynx; Rectum; Retrospective Studies; Risk Factors

Acute bacterial sinusitis is a frequent complication of viral upper respiratory infection (URI). We describe the clinical and virologic features of URIs that remain uncomplicated and those that precede an episode of sinusitis. We hypothesize that certain viruses are more likely to lead to acute sinusitis, and we compare viruses identified at the time of diagnosis of sinusitis with those identified early in the URI.. Children aged 48-96 months were followed longitudinally for 1 year. Nasal samples were obtained at surveillance visits, on Day 3-4 of the URI, and on Day 10, when sinusitis was diagnosed. Molecular diagnostic testing was performed on nasal washes for common respiratory viruses and pathogenic bacteria. A standardized score was used to quantify symptom severity.. We evaluated 519 URIs, and 37 illnesses in 31 patients met the criteria for sinusitis. Respiratory syncytial virus was detected more frequently in URI visits that led to sinusitis, compared to in uncomplicated URIs (10.8% vs 3.4%; P = .05). New viruses were detected in 29% of sinusitis episodes, and their pattern was different than those patterns observed at surveillance. The median number of URIs per subject per year was 1 (range 0-9) in uncomplicated URI subjects and 3 (range 1-9) in sinusitis subjects (P < .001).. Children who developed sinusitis experienced more frequent URIs, compared to children whose URIs remained uncomplicated. When nasal samples were obtained on the day of diagnosis of acute sinusitis, nearly 30% of children had a new virus identified, suggesting that some children deemed to have sinusitis were experiencing sequential viral infections.

Topics: Acute Disease; Bacteria; Bacterial Infections; Child; Child, Preschool; Female; Humans; Longitudinal Studies; Male; Nose; Respiratory Tract Infections; Sinusitis; Virus Diseases; Viruses

Nasal microbial communities may have crucial implications for human health, including for residents of healthcare institutes (HCIs). Factors that determine the diversity of nasal microbiota in HCIs remain unclear. Herein, we used 16S rRNA amplicon sequencing to investigate the relationship between nasal and surface microbiota in three HCIs. Participants were classified into a hospitalised or nonhospitalised group based on their most recent date of hospitalisation. A total of 88 nasal samples and 83 surface samples were analysed. Dysgonomonas and Corynebacterium were the most abundant taxa in the surface and nasal samples, respectively. Significant differences were discovered in microbiota diversity among HCIs when comparing the surface and nasal samples. Fifteen taxa were identified as present in all the surface and nasal samples. SourceTracker analysis revealed that the ventilation conditions of environment might be associated with the proportion of shared microbial communities between nasal and surface. Additionally, as compared with the nonhospitalised group, the hospitalised group had a higher proportion of surface microbiota in their nasal samples, which might lead to a higher risk of human-related microorganisms or pathogens colonising the nasal cavity. The data suggest that nasal bacterial diversity could be influenced by both health status and living environment. Our results therefore highlight the importance of the indoor environment for HCI residents.

Topics: Air Microbiology; Air Pollution, Indoor; Bacteria; Bacterial Infections; Hospitalization; Hospitals; Humans; Microbiota; Nasal Cavity; Nose; RNA, Ribosomal, 16S

Chronic rhinosinusitis with nasal polyp (CRSwNP) patients are often characterized by asthma comorbidity and a type-2 inflammation of the sinonasal mucosa. The mucosal microbiota has been suggested to be implicated in the persistence of inflammation, but associations have not been well defined. To compare the bacterial communities of healthy subjects with CRSwNP patients, we collected nasal swabs from 17 healthy subjects, 21 CRSwNP patients without asthma (CRSwNP-A), and 20 CRSwNP patients with co-morbid asthma (CRSwNP+A). We analysed the microbiota using high-throughput sequencing of the bacterial 16S rRNA. Bacterial communities were different between the three groups. Haemophilus influenzae was significantly enriched in CRSwNP patients, Propionibacterium acnes in the healthy group; Staphylococcus aureus was abundant in the CRSwNP-A group, even though present in 57% of patients. Escherichia coli was found in high amounts in CRSwNP+A patients. Nasal tissues of CRSwNP+A patients expressed significantly higher concentrations of IgE, SE-IgE, and IL-5 compared to those of CRSwNP-A patients. Co-cultivation demonstrated that P. acnes growth was inhibited by H. influenzae, E. coli and S. aureus. The nasal microbiota of healthy subjects are different from those of CRSwNP-A and CRSwNP+A patients. However, the most abundant species in healthy status could not inhibit those in CRSwNP disease.

Topics: Adult; Asthma; Bacteria; Bacterial Infections; Case-Control Studies; Chronic Disease; Dysbiosis; Female; Humans; Inflammation; Male; Middle Aged; Nasal Polyps; Nose; Rhinitis; Sinusitis

Data concerning intensive care unit (ICU)-acquired bacterial colonization and infections are scarce from low and middle-income countries (LMICs). ICU patients in these settings are at high risk of becoming colonized and infected with antimicrobial-resistant organisms (AROs). We conducted a prospective observational study at the Ho Chi Minh City Hospital for Tropical Diseases, Vietnam from November 2014 to January 2016 to assess the ICU-acquired colonization and infections, focusing on the five major pathogens in our setting: Staphylococcus aureus (S. aureus), Escherichia coli (E. coli), Klebsiella spp., Pseudomonas spp. and Acinetobacter spp., among adult patients with more than 48 hours of ICU stay. We found that 61.3% (223/364) of ICU patients became colonized with AROs: 44.2% (161/364) with rectal ESBL-producing E. coli and Klebsiella spp.; 30.8% (40/130) with endotracheal carbapenemase-producing Acinetobacter spp.; and 14.3% (52/364) with nasal methicillin-resistant S. aureus. The incidence rate of ICU patients becoming colonized with AROs was 9.8 (223/2,276) per 100 patient days. Significant risk factor for AROs colonization was the Charlson Comorbidity Index score. The proportion of ICU patients with HAIs was 23.4% (85/364), and the incidence rate of ICU patients contracting HAIs was 2.3 (85/3,701) per 100 patient days. The vascular catheterization (central venous, arterial and hemofiltration catheter) was significantly associated with hospital-acquired bloodstream infection. Of the 77 patients who developed ICU-acquired infections with one of the five specified bacteria, 44 (57.1%) had prior colonization with the same organism. Vietnamese ICU patients have a high colonization rate with AROs and a high risk of subsequent infections. Future research should focus on monitoring colonization and the development of preventive measures that may halt spread of AROs in ICU settings.

Topics: Adult; Bacterial Infections; Catheter-Related Infections; Catheterization; Cross Infection; Drug Resistance, Bacterial; Female; Humans; Intensive Care Units; Male; Nose; Prospective Studies; Rectum; Trachea; Vietnam

Multidrug-resistant organisms (MDRO) and in particular multidrug-resistant Gram-negative organisms (MRGN) are an increasing problem in hospital care. However, data on the current prevalence of MDRO in long-term care facilities (LTCFs) are rare. To assess carriage rates of MDRO in LTCF residents in the German Rhine-Main region, we performed a point prevalence survey in 2013. Swabs from nose, throat and perineum were analysed for meticillin-resistant Staphylococcus aureus (MRSA), perianal swabs were analysed for extended-spectrum beta-lactamase (ESBL)-producing organisms, MRGN and vancomycin-resistant enterococci (VRE). In 26 LTCFs, 690 residents were enrolled for analysis of MRSA colonisation and 455 for analysis of rectal carriage of ESBL/MRGN and VRE. Prevalences for MRSA, ESBL/MRGN and VRE were 6.5%, 17.8%, and 0.4%, respectively. MRSA carriage was significantly associated with MRSA history, the presence of urinary catheters, percutaneous endoscopic gastrostomy tubes and previous antibiotic therapy, whereas ESBL/MRGN carriage was exclusively associated with urinary catheters. In conclusion, this study revealed no increase in MRSA prevalence in LTCFs since 2007. In contrast, the rate of ESBL/MRGN carriage in German LTCFs was remarkably high. In nearly all positive residents, MDRO carriage had not been known before, indicating a lack of screening efforts and/or a lack of information on hospital discharge.

Topics: Anti-Bacterial Agents; Bacteria; Bacterial Infections; beta-Lactamases; Cross Infection; Drug Resistance, Multiple, Bacterial; Female; Germany; Health Facilities; Humans; Long-Term Care; Male; Methicillin-Resistant Staphylococcus aureus; Nose; Oropharynx; Prevalence; Rectum; Risk Factors; Vancomycin Resistance; Vancomycin-Resistant Enterococci

Intensive chemotherapy for pediatric acute myeloid leukemia incurs the risk of infectious complications, but the benefits of antibiotic prophylaxis remain unclear.. In the current study, among 103 children treated on the AML02 protocol between October 2002 and October 2008 at St. Jude Children's Research Hospital, the authors retrospectively assessed the effect of antibiotic prophylaxis on the frequency of febrile neutropenia, clinically or microbiologically confirmed infections (including bacteremia), and antibiotic resistance, as well as on the results of nasal and rectal surveillance cultures. Initially, patients received no prophylaxis or oral cephalosporin (group A). The protocol was then amended to administer intravenous cefepime alone or intravenous vancomycin plus either oral cephalosporin, oral ciprofloxacin, or intravenous cefepime (group B).. There were 334 infectious episodes. Patients in group A had a significantly greater frequency of documented infections and bacteremia (both P < .0001) (including gram-positive and gram-negative bacteremia; P = .0003 and .001, respectively) compared with patients in group B, especially viridans streptococcal bacteremia (P = .001). The incidence of febrile neutropenia without documented infection was not found to be different between the 2 groups. Five cases of bacteremia with vancomycin-resistant enterococci (VRE) occurred in group B (vs none in group A), without related mortality. Two of these cases were preceded by positive VRE rectal surveillance cultures.. Outpatient intravenous antibiotic prophylaxis is feasible in children with acute myeloid leukemia and reduces the frequency of documented infection but not of febrile neutropenia. Despite the emergence of VRE bacteremia, the benefits favor antibiotic prophylaxis. Creative approaches to shorten the duration of prophylaxis and thereby minimize resistance should be explored.

Topics: Administration, Oral; Adolescent; Anti-Bacterial Agents; Antibiotic Prophylaxis; Bacteremia; Bacterial Infections; Candidiasis; Cefepime; Cephalosporins; Chemotherapy-Induced Febrile Neutropenia; Child; Child, Preschool; Ciprofloxacin; Consolidation Chemotherapy; Drug Therapy, Combination; Feasibility Studies; Female; Humans; Incidence; Induction Chemotherapy; Infant; Infusions, Intravenous; Leukemia, Myeloid, Acute; Male; Neoplasm Staging; Nose; Outpatients; Rectum; Retrospective Studies; Treatment Outcome; Vancomycin; Young Adult

A longitudinal analysis was carried out of the colonization by four potential respiratory pathogens - Streptococcus pneumoniae, Haemophilus influenzae, Moraxella catarrhalis and Staphylococcus aureus - in 165 healthy children (aged 3-7 years) attending three kindergartens and 417 healthy children (aged 7-10 years) attending an elementary school in Seoul, Korea, by four consecutive examinations over 1 year. The prevalence of nasal carriers of one or more of four bacteria was found to be higher in younger children (≤7 years) (mean 68.6%) than that in older children (mean 46.8%). The mean rates of nasal carriage of Strep. pneumoniae, H. influenzae, M. catarrhalis and Staph. aureus were 16.8, 18.9, 20.2 and 18.2%, respectively. Colonization by Strep. pneumoniae, H. influenzae and M. catarrhalis was higher in pre-school children (28.6, 32.4 and 35.0%, respectively) than in school children (12.2, 13.6 and 14.3%, respectively). Carriage trends differed with age, with Strep. pneumoniae, H. influenzae and M. catarrhalis colonization decreasing with age but Staph. aureus colonization increasing. Positive associations of co-occurrence between Strep. pneumoniae, H. influenzae and M. catarrhalis were evident, with a significant negative association evident between Staph. aureus and the other three bacteria. A better understanding of the colonization and interaction of potential respiratory pathogens may be important for predicting changes in bacterial ecology and for designing control strategies that target bacterial colonization in upper respiratory tract infections.

Topics: Bacteria; Bacterial Infections; Carrier State; Child; Child Day Care Centers; Child, Preschool; Female; Humans; Longitudinal Studies; Nose; Prevalence; Republic of Korea; Schools

To determine prevalence, incidence and risk factors of colonization by extended-spectrum β-lactamase-producing Enterobacteriacae (ESBLE), methicillin-resistant Staphylococcus aureus (MRSA), and vancomycin-resistant Enterococcus (VRE) in aged subjects admitted to an acute geriatric unit at a teaching hospital.. During 12 months, 337 patients were screened by nasal, oropharyngeal, groin, axillary and rectal swabs upon admission and at discharge.. The prevalence of ESBLE, MRSA and VRE carriage upon admission was 11.6%, 7.5% and 0.6%, respectively. The incidence density of ESBLE and MRSA carriage was respectively of 1.77 and 2.40 new cases for 1000 patient-days. No cases of VRE acquisition were found. Risk factors for ESBLE colonization on admission were: multiple contacts with the hospital within the previous year, chronic catheter use and a high level of dependency. For MRSA, risk factors were: chronic wounds, anti-acid use and a high level of dependency.. This study shows a high prevalence of asymptomatic colonization of ESBL-producing Escherichia coli in patients admitted to an acute geriatric ward, as high as MRSA carriage. A low functional status is a common risk factor both for ESBLE and for MRSA colonization and it highlights the need to reinforce infection control measures.

Topics: Aged; Aged, 80 and over; Anti-Bacterial Agents; Axilla; Bacteria; Bacterial Infections; Carrier State; Cross Infection; Drug Resistance, Multiple, Bacterial; Female; Groin; Hospitals; Humans; Incidence; Male; Nose; Oropharynx; Prevalence; Prospective Studies; Rectum; Risk Factors

The epidemiology of new acquisition of antibiotic-resistant organisms (AROs) in community-based skilled nursing facilities (SNFs) is not well studied. To define the incidence, persistence of, and time to new colonization with methicillin-resistant Staphylococcus aureus (MRSA), vancomycin-resistant enterococci (VRE), and ceftazidime-resistant (CAZ(r)) and ciprofloxacin-resistant (CIP(r)) Gram-negative bacteria (GNB) in SNFs, SNF residents were enrolled and specimens from the nares, oropharynx, groin, perianal area, and wounds were prospectively cultured monthly. Standard microbiological tests were used to identify MRSA, VRE, and CAZ(r) and CIP(r) GNB. Residents with at least 3 months of follow-up were included in the analysis. Colonized residents were categorized as having either preexisting or new acquisition. The time to colonization for new acquisition of AROs was calculated. Eighty-two residents met the eligibility criteria. New acquisition of AROs was common. For example, of the 59 residents colonized with CIP(r) GNB, 28 (47%) were colonized with CIP(r) GNB at the start of the study (96% persistent and 4% intermittent), and 31 (53%) acquired CIP(r) GNB at the facility (61% persistent). The time to new acquisition was shortest for CIP(r) GNB, at a mean of 75.5 days; the time to new acquisition for MRSA was 126.6 days (P = 0.007 versus CIP(r) GNB), that for CAZ(r) was 176.0 days (P = 0.0001 versus CIP(r) GNB), and that for VRE was 186.0 days (P = 0.0004 versus CIP(r) GNB). Functional status was significantly associated with new acquisition of AROs (odds ratio [OR], 1.24; P = 0.01). New acquisition of AROs, in particular CIP(r) GNB and MRSA, is common in SNFs. CIP(r) GNB are acquired rapidly. Additional longitudinal studies to investigate risk factors for ARO acquisition are required.

Topics: Aged; Aged, 80 and over; Anti-Bacterial Agents; Bacterial Infections; Drug Resistance, Bacterial; Enterococcus; Female; Gram-Negative Bacteria; Groin; Humans; Incidence; Male; Methicillin-Resistant Staphylococcus aureus; Nose; Oropharynx; Perineum; Prospective Studies; Skilled Nursing Facilities; Time Factors; Wounds and Injuries

To determine the occurrence of colonization and subsequent infection with multidrug-resistant organisms (MDROs) among patients in the neonatal intensive care unit and to assess the yield of surveillance cultures.. Cultures of nose, throat and stool were obtained from 196 neonates admitted to the Neonatal Intensive Care Unit (NICU) at the Clinical Center of the University of Sarajevo in the six-month period upon admission and once a week if the length of stay was more than seven days. At the same time clinical relevant samples (blood, urine, CSF, wounds swabs, tracheal aspirates) were examined for presence of MDROs. Identification and antibiotic sensitivity pattern of organisms were determined according to the CLSI.. A total of 126 (64.3%) patients were identified as colonized and 50 (25.5%) as infected with MDROs. 44.4% (56) of patients were colonized on admission. Fecal carriage was most common with extended-spectrum beta lactamase (ESBL)-producing Klebsiella pneumonia, and nose/throat with Acinetobacter baumannii. The patients become colonized more often during the first week of hospitalization (31.7%; p less .001). The infection is more observed in patients who had previously been colonized than those who had not (78% vs. 22%; p less 0.05). The most common infection was the blood infection (bacteremia). The median length of stay in neonates with an infection was 3.5 weeks and without infection 1 week (p less than 0.001).. An infection was more frequently observed in patients who had been previously colonized than those who had not. Microbial surveillance is necessary to detect colonized neonates when multidrug-resistant organisms become epidemic.

Topics: Bacterial Infections; Cross Infection; Drug Resistance, Multiple, Bacterial; Feces; Female; Humans; Infant, Newborn; Intensive Care Units, Neonatal; Male; Nose; Pharynx

Pathogenic organisms are thought to be widely distributed among food handlers. This study was designed to assess the prevalence of carriers of some pathogenic bacteria and intestinal parasites among food handlers in the city of Omdurman, Sudan.. A total of 518 nasal swabs and stool specimens were collected. Nasal swabs were cultured on bacteriological culture media. Stool specimens were examined microscopically for intestinal parasites.. Of the total subjects examined, 30.1% were found to be carriers of pathogenic organisms. The pathogens isolated and identified were the bacteria Staphylococcus aureus, Salmonella typhi, and Shigella boydii, and the intestinal parasites, Giardia lamblia and Entamoeba histolytica/dispar. Bacteria and intestinal parasites were most prevalent among storekeepers (41%), followed by restaurant workers (24.4%), bakers (24.4%), butchers (5.1%), milk distributors (2.6%), and fruits/vegetables sellers (2.6%). S. aureus, the most abundant pathogen, was most prevalent in storekeepers (44.6%), followed by restaurant workers (25%), bakers (17.9%), butchers (5.4%), milk distributors (3.6%), and fruit/vegetable sellers (3.6%).. The findings from this study indicate a key role for food handlers in the spread and transmission of food communicable diseases and reveal the need for protective measures.

Topics: Adolescent; Adult; Animals; Bacteria; Bacterial Infections; Carrier State; Feces; Female; Food Handling; Humans; Male; Middle Aged; Nose; Occupational Health Services; Parasites; Parasitic Diseases; Prevalence; Sudan; Young Adult

Fifty HCWs in ICUs of Internal medicine, Chest, Neonatology and Burn were included in prospective cohort study. Collection of nasal, hand and rectal swabs, proper biochemical identification, culture media and antibiotic sensitivity tests were used to detect Methicillin-resistant Staphylococcus aureus (MRSA); vancomycin-resistant Enterococci (VRE) & extended spectrum beta-lactamase producing gram -ve bacilli (ESBLs). S. aureus was isolated from 34% of HCWs; 28% were nasal carriers, 4% were hand carriers and 2% had S. aureus at both sites. Nasal and hand carriage rates of MRSA were 20% & 4% respectively, with an overall rate of 22%. Gram -ve bacilli were isolated from 8% of HCWs hand swabs & showed Citrobacter koseri, Escherichia coli, Klebsiella pneumoniae and Pseudomonas aeruginosa. Hand carriage rate of ESBLs was 2%. Hand contamination with gram -ve bacilli and S. aureus was in 14% of HCWs. VRE carriage rate was 9.5%. ESBLs carriage rate in rectal swabs was 21.43%. K. pneumoniae was the most common ESBLs producing isolate (33.3%), followed by E. coli (18.75%). In combined disc method, aztreonam was the most sensitive (90%) in detecting ESBLs. Burn ICU had highest % of MRSA & ESBLs carriage. Neonatal ICU showed highest % of VRE carriage. An insignificant association was between infection control training or antimicrobial intake and carriage of antimicrobial resistant bacteria.

Topics: Adolescent; Adult; Anti-Bacterial Agents; Bacterial Infections; Carrier State; Cohort Studies; Drug Resistance, Bacterial; Egypt; Female; Health Personnel; Humans; Intensive Care Units; Male; Middle Aged; Nose; Young Adult

To study the relationship between nasal anatomic abnormalities and the bacteria infection status of maxillary sinus.. The anatomic abnormalities of 115 cases of maxillary sinuses were detected with the CT images and confirmed with chronic infection, which were divided into two groups: high anatomic abnormality group and low anatomic abnormality group. The sinusal contents were sent to bacteria culture, compare the bacteria infection rate and the distribution of bacteria between the two groups.. The bacteria positive rate of the high anatomic abnormality group and low anatomic abnormality group was 90.32% and 56.60% (P < 0.01) respectively. The contribution of gram-positive bacteria and gram-negative bacteria are 47.76% and 52.24% in high anatomic abnormality group, 62.16% and 37.84% in low anatomic abnormality group.. Nasal anatomic abnormalities can improve the bacteria infectious rate of maxillary sinuses. High anatomic abnormality may more induces gram-negative bacteria infections,while low anatomic abnormality may more induces gram-positive bacteria infections.

Topics: Adult; Aged; Aged, 80 and over; Bacterial Infections; Chronic Disease; Humans; Middle Aged; Nose; Sinusitis; Young Adult

Topics: Aged; Aged, 80 and over; Bacterial Infections; Carrier State; Cross-Sectional Studies; Female; Humans; Long-Term Care; Male; Nose; Pressure Ulcer; Prevalence; Urine

An outbreak of infectious keratoconjunctivitis (IKC) occurred in semidomesticated reindeer (Rangifer tarandus tarandus) in Troms County, Norway, in February 2009. Twenty-eight animals with clinical symptoms and 12 apparently healthy animals were investigated. They ranged in age from calves of the year to 4-year-old animals (mean, 1.9 years; standard deviation, +/-0.9). The seroprevalence of antibodies against cervid herpesvirus 2 (CvHV2) was 86% in animals with IKC and 42% in unaffected animals. For the 28 clinically affected animals, CvHV2 was detected by PCR in swabs obtained from the eye (82%), nose (64%), and vagina (24%), and CvHV2 was isolated from eye swabs from 8 animals. Virus was not isolated from clinically unaffected animals but was detected by PCR in eye swab samples from five of them. The viral activity, assessed by the ability to cause a cytopathic effect in cell culture, increased with the severity of clinical symptoms, but in severe clinical cases, virus was absent and secondary bacterial infections were dominant. Moraxella sp. isolates were obtained from seven animals, and those from two animals were identified as Moraxella bovoculi. Staphylococcus aureus, Streptococcus sp., and Arcanobacterium pyogenes were also isolated. It is concluded that CvHV2, which is endemic in reindeer, can cause IKC, probably most commonly as a primary infection of calves. This can be a very painful and devastating disease of economic importance for reindeer herders. This is the first report of CvHV2 as the primary agent of IKC in reindeer. This is also the first isolation of this virus in reindeer under natural herding conditions.

Topics: Animals; Antibodies, Viral; Arcanobacterium; Bacterial Infections; Comorbidity; Disease Outbreaks; DNA, Viral; Eye; Female; Herpesviridae; Herpesviridae Infections; Keratoconjunctivitis, Infectious; Male; Molecular Sequence Data; Moraxella; Norway; Nose; Polymerase Chain Reaction; Reindeer; Sequence Analysis, DNA; Staphylococcus aureus; Streptococcus; Vagina

To study the relationship between pathogenic bacteria in the nasal middle meatus and acute bacterial respiratory infection in children.. Three hundred and twenty eight children with respiratory infection (mean age 8 years) were included into the prospective cohort study. The mucosal fluid specimens from the nasal middle meatus were collected under an endoscope for bacterial culture. The patients with bacterial culture positive were defined as the Exposed group and those with bacterial culture negative as the Non-exposed group. The grouping of the patients was blinded to the patients, patients' parents and physicians. Both groups received anti-virus and symptomatic treatments, without antibiotic administration. Five days later, the patients were evaluated as to whether they had bacterial infection based on the leucocyte count and CRP results.. Of the 328 patients, 168 had a positive nasal bacterial culture. The incidence of bacterial respiratory infection in the Exposed group [51.2% (86/168)] was significantly higher than in the Non-exposed group [13.1% (21/160)] (P < 0.01). The relative risk of bacterial respiratory infection occurrence in patients with nasal bacterial culture positive was 3.9002.. The children with respiratory infection who had potential pathogenic bacteria in the nasal middle meatus were more prone to develop bacterial respiratory infection.

Topics: Acute Disease; Bacterial Infections; Child; Cohort Studies; Female; Humans; Male; Nose; Prospective Studies; Respiratory Tract Infections

Bacteriological examination of 70 nesting green turtles (Chelonia mydas) from Tortuguero National Park, Costa Rica was performed to investigate nasal and cloacal aerobic bacteria. A total of 325 bacterial isolates were obtained, including 10 Gram-negative and three Gram-positive genera. Two hundred thirty-nine were Gram-negative and 86 were Gram-positive isolates. Klebsiella pneumoniae was the most common microbe identified in turtle samples: 27/70 (38.5%) in cloacal, and 33/70 (47.1%) in nasal samples. The Enterobacteriaceae family, including Enterobacter agglomerans, E. cloacae, Escherichia coli, Klebsiella oxytoca, K. pneumoniae, and Serratia marcescens, was the largest Gram-negative group of bacteria recovered and comprised 127 of 239 (53.1%) of the Gram-negative isolates. Staphylococcus species was the largest Gram-positive bacteria group, including S. aureus, S. cromogenes, S. epidermis, and S. intermedius, and made up 63 of 86 (73.2%) of the Gram-positive isolates recovered. The results of this study demonstrate that the aerobic bacterial flora of nesting green turtles at Tortuguero National Park is composed of a very wide spectrum of bacteria, including several potential pathogens.

Topics: Animals; Bacteria, Aerobic; Bacterial Infections; Cloaca; Costa Rica; Female; Nesting Behavior; Nose; Turtles

Upper respiratory tract consists resident and transient bacterial microflora, which in appropriate condition can cause infection. Bacteriological study was performed among 201 patients with upper respiratory tract infections treated in ambulatory. From nasal and pharyngeal swabs Staphylococcus aureus, Haemophilus influenzae, Streptococcus pneumoniae, Moraxella catarrhalis, and Streptococci group A, B, C, G were isolated. Antibiotic susceptibility testing of isolated strains was performed using CLSI criteria. All isolated strains of streptococci were susceptible to penicillin; some of them demonstrated resistance to macrolides and lincosamides. Few isolated strains of H. influenzae demonstrated resistance to penicillin and cotrimoxazole. Azitromycin resistant strains were not detected. All isolated strains of M. catarrhalis were beta-lactamase positive and demonstrated resistance to penicillin. Strains of methicillin sensitive S. aureus (MSSA) were isolated most frequently from pharyngeal swabs (35.4%) and S. pneumoniae (33.3)--from nasal swabs.

Topics: Adult; Anti-Bacterial Agents; Bacterial Infections; Child; Drug Resistance, Multiple, Bacterial; Haemophilus influenzae; Humans; Microbial Sensitivity Tests; Moraxella catarrhalis; Nose; Pharynx; Poland; Respiratory Tract Infections; Staphylococcus aureus; Streptococcus pneumoniae

Because of the increased risk of infection with the associated diagnostic and therapeutic problems in bone marrow transplantation (BMT) patients, the usefulness of surveillance cultures (SC) at the BMT department of the National Institute of Haematology, Blood Transfusion, Transplantation and Immunology, Budapest, was reviewed. Between January 1992 and May 1995, 26 BMT operations were performed; 13 patients had 23 febrile espisodes. In 12 of these episodes infection was clinically documented; however, SC of these patients yielded bacteria identical with those in the blood culture in only two episodes (1 and 6 days before their blood cultures became positive, respectively). Out of a total of 1187 samples from these patients, potentially pathogenic bacteria were isolated from 145 SC and 43 blood cultures (drawn on 31 different days). Suppression of the gastrointestinal flora could be achieved by the department's decontamination regimen; however, overgrowth by gram-positive organisms (mainly coagulase-negative staphylococci) occurred in the intestine and at other body sites. On the basis of these results, SC are of limited value in predicting infection or identifying the causative organisms of fever. On the other hand, SC are useful in confirming the efficiency of suppression of the body flora by antimicrobial agents. Specific treatment was based on suitably sampled materials, and close contact between physicians, infectious disease specialists and microbiologists was essential.

Topics: Antibiotic Prophylaxis; Bacteria; Bacterial Infections; Blood; Bone Marrow Transplantation; Candida; Digestive System; Feces; Female; Hospital Units; Humans; Infection Control; Male; Nose; Penis; Pharynx; Predictive Value of Tests; Skin; Sputum; Urine; Vagina

In this paper the bacterial flora of respiratory tract diseases of children and adults was described. Significant differences in the frequency of isolation of various species of bacteria in connection with the age and the clinical form of disease were observed. Haemophilus influenzae was isolated from the accessory sinuses of the nose of children with significantly higher frequency than from adults. This microorganism occurred as the only etiological agent in more than 50% of cases.

Topics: Adult; Age Factors; Bacteria; Bacterial Infections; Child; Haemophilus influenzae; Humans; Nose; Respiratory Tract Infections

We have studied the effectiveness of surgical face masks in reducing bacterial contamination of a surface, produced by dispersal of organisms from the upper airway. Twenty-five volunteers were asked to speak at blood agar plates positioned in close proximity to the mouth, initially whilst not wearing a face mask and then wearing a surgical face mask over the mouth and nose. A fresh face mask almost completely abolished bacterial contamination of agar plates 30 cm from the mouth. After 15 min there was an increase in the level of contamination which was statistically insignificant.

Topics: Adult; Anesthesia, Spinal; Bacterial Infections; Humans; Masks; Meningitis, Bacterial; Middle Aged; Mouth; Nose; Respiratory System

Febrile intensive care unit (ICU) patients were evaluated prospectively for sinusitis. Of 598 admissions, 26 patients with transnasal cannulas, ICU stays over 48 hours, and occult fevers were identified. These 26 underwent physical examinations and sinus computed tomographic (CT) scans. Maxillary centeses and cultures were done in patients with CT abnormalities. Patients with positive scans had nasal tubes removed and received decongestants. Scans were abnormal in 19 (73%). All patients with major CT changes had positive maxillary taps. Most infections were polymicrobial; enteric bacilli were common. Fever resolved with nonoperative care in 18 (95%) patients; in only 1 patient was fever primarily from sinusitis. Sinus CT scans are often abnormal in ICU patients with occult fevers and transnasal cannulas. Pneumatic otoscopy can serve as a screening tool. Most patients respond to nonoperative management. Remote infections are often present. Although radiographic nosocomial ICU sinusitis is common, it is seldom the sole source of fever or the proximate cause of significant morbidity.

Topics: Bacterial Infections; Endoscopy; Fever; Humans; Intensive Care Units; Intubation, Gastrointestinal; Intubation, Intratracheal; Maxillary Sinusitis; Nose; Otitis Media; Prospective Studies; Punctures; Sinusitis; Tomography, X-Ray Computed

The external nose is a structure that provides prominence to the face. The internal nose is a paired nasal cavity that extends from the face to the pharynx. Turbinates are major structures within the lateral walls of the nose. They perform the major functions of the nose that include respiration, humidification, temperature regulation, and filtration of the inspired air. Conditions that obstruct the nose interfere with its optimal function. These range from acute or chronic infection to enlarged tonsils and adenoid tissue to nasal septal deviation. Surgeons caring for patients with clefts must have familiarity with nasal anatomy and function and conditions that alter them. Correction of these conditions may require medical and/or surgical treatment.

Topics: Adenoids; Bacterial Infections; Child; Cleft Palate; Humans; Hypertrophy; Infant; Nasal Cavity; Nasal Obstruction; Nasal Septum; Nasopharynx; Nose; Palatine Tonsil; Paranasal Sinuses; Pulmonary Ventilation; Respiration; Respiratory Tract Infections; Rhinitis; Smell; Turbinates

We compared a group of 60 insulin-dependent diabetics maintained on CAPD with 60 nondiabetic matched controls to determine if the diabetic patients were at increased risk for catheter-related infections. Although catheter infection rates were 17% higher in the diabetics (1.4/year versus 1.2/year in nondiabetics), time to first catheter infection was not different between the groups (p = 0.6). Rates of peritonitis, peritonitis associated with catheter infection, multiple catheter infection, and catheter removal were also similar among the diabetics and controls. S. aureus caused 52% (42/81) of the catheter infections in the diabetics and 60% (35/58) in the controls. More catheter infections in the nondiabetics versus the diabetics lacked drainage or resulted in sterile cultures (17/75 versus 7/88 respectively, p less than or equal to 0.01), but the significance of this finding is uncertain. In conclusion, we did not find insulin-dependent diabetes mellitus to be a statistically significant risk factor for catheter-related infections.

Topics: Bacterial Infections; Catheterization; Diabetes Mellitus, Type 1; Diabetic Nephropathies; Female; Humans; Male; Middle Aged; Nose; Peritoneal Dialysis, Continuous Ambulatory; Peritonitis; Retrospective Studies; Risk Factors; Staphylococcus aureus

The value of pernasal retropharyngeal swabs in chronic adenoid and tonsillar disease was assessed in a prospective study involving 52 patients. Prior to adenoidectomy (34 patients) or adenotonsillectomy (17 patients), pernasal and tonsillar swabs were taken and the culture compared to the bacteriology profile obtained in the adenoid and tonsil tissue following surgery. The pernasal swab correctly identified 76% of pathogens isolated in the adenoid tissue. In addition, pernasal swabs forecast the presence of pathogens in 64% of core tonsil specimens, compared to an accuracy of 38% when superficial tonsil swabs were compared to the microbes in the deep tonsil. H. influenzae was the predominant organism isolated in all cultures. Our results clearly demonstrate that pernasal swabs give a representative picture of the adenoid bacterial content. Pernasal swabs are also superior to superficial tonsil swabs in indicating the deep tonsillar organisms.

Topics: Adenoidectomy; Adenoids; Bacteria; Bacterial Infections; Bacteriological Techniques; Child; Child, Preschool; Female; Haemophilus Infections; Haemophilus influenzae; Humans; Lymphatic Diseases; Male; Nose; Palatine Tonsil; Prospective Studies; Staphylococcal Infections; Tonsillectomy

In 1986, an outbreak of Moraxella follicular conjunctivitis occurred in girls attending a Navajo boarding school in New Mexico. We diagnosed 19 cases of culture-proven, and 21 of clinical conjunctivitis based on isolation of Moraxella from conjunctival cultures and the occurrence of symptoms significantly associated with positive culture. Sharing eye makeup was significantly associated with Moraxella-positive conjunctivitis (odds ratio [OR] = 7.2, P = .004) and showed a trend toward significance in those with clinical conjunctivitis (OR = 2.9, P = .09). Eyeliner and eye shadow were implicated (OR = 4.1, P less than .05). We cultured samples of 13 students' makeup; one third of the eyeliners were positive for Moraxella. Nasal carriage of Moraxella was found in 35 (44%) of the 79 female boarders and in 20 (21%) of 97 Navajo patients at two nearby clinics. In a prospective evaluation of the effect of patient education and rifampin therapy on the occurrence of conjunctivitis during an 11-month follow-up period, both types of intervention were successful in significantly reducing the rate of conjunctivitis when compared with that in a control group.

Topics: Adolescent; Bacterial Infections; Conjunctiva; Conjunctivitis, Bacterial; Cosmetics; Disease Outbreaks; Female; Humans; Indians, North American; Male; Moraxella; New Mexico; Nose; Patient Education as Topic; Prospective Studies; Rifampin; Risk Factors

We have described a family in which the father and three children appear to have an absence of nasal cilia, resulting in inadequate nasociliary clearance, stasis of nasal secretions, and secondary bacterial contamination. This condition should be considered in chronic rhinitis of obscure etiology.

Topics: Adult; Bacterial Infections; Child; Child, Preschool; Cilia; Female; Humans; Infant; Male; Nasal Mucosa; Nose; Pedigree; Rhinitis; Syndrome

Sinusitis secondary to nasotracheal intubation has not been reported to occur in neurosurgical patients. Over a 1-year period, 11 patients admitted to the Intensive Care/Trauma Unit at St. Paul Ramsey Medical Center developed this entity. The mean age of these patients was 36 +/- 4 years; 7 were trauma victims, 3 had each had a subarachnoid hemorrhage, and 1 had suffered hypertensive hemorrhage. The patients presented with fever of unknown origin (FUO) and evidence of persistent hypermetabolism without an obvious cause. In 8 cases, the diagnosis was not suspected until mucopurulent nasal discharge was noted. Three additional cases were evaluated for suspected sinusitis before the occurrence of discharge. The mean duration of intubation before the diagnosis of sinusitis was 7.8 +/- 1.5 days. The diagnosis was confirmed by sinus films with a Waters view in 7 cases or by computed tomographic scanning in 4 cases and by bacteriological cultures. Two cases involved only the maxillary sinus on the side of intubation; the rest were polysinusites. The organisms involved included gram-positive and gram-negative species; all were polymicrobial with a single organism predominant. Secondary pulmonary involvement was common, and 4 patients revealed a bacteremia consistent with the major sinus organism. One patient developed septic shock. Treatment involved either orotracheal intubation or tracheostomy. This was curative in all cases. It is concluded that neurosurgical patients nasally intubated are at risk for sinusitis, which can have untoward effects such as septicemia or pulmonary infection. A high degree of suspicion will permit early diagnosis and treatment.

Topics: Adult; Anti-Bacterial Agents; Bacterial Infections; Central Nervous System Diseases; Female; Humans; Intubation, Intratracheal; Male; Middle Aged; Nose; Sinusitis

Topics: Bacterial Infections; Bacteriuria; Diabetes Mellitus; Disease Susceptibility; Humans; Larynx; Nose

The abnormal cutaneous flora of hemodialysis (HD) patients might contribute to their frequent septic complications. We compared the effects of 13 wk of Betadine and 13 wk of Hibiclens on the skin flora of HD patients and personnel. Skin cultures were obtained weekly immediately prior to the disinfection, preceding each triweekly HD treatment, and monthly, at 2 and 4 hr postdisinfection. Total bacterial counts from predisinfection cultures were not significantly altered over either 13-wk treatment period. Hibiclens reduced total bacterial counts (p less than 0.01) and eradicated cutaneous staphylococci (p = 0.032) at both 2 and 4 hr postdisinfection significantly more than did Betadine. No reduction of staphylococcal sensitivity to either germicidal agent could be demonstrated. Neither agent was associated with severe adverse reactions and Hibiclens could not be detected in the blood. Hibiclens appears to offer short-term advantages over Betadine in the HD setting because of significantly longer duration of antibacterial activity.

Topics: Allied Health Personnel; Bacterial Infections; Chlorhexidine; Humans; Nose; Povidone; Povidone-Iodine; Renal Dialysis; Skin; Staphylococcus; Streptococcus; Surface-Active Agents; Time Factors

Nasal swabs from 62 villagers of Kalauna, Goodenough Island were cultured. Streptococcus pneumoniae was isolated from 16 of 25 adults (64%) and 36 of 37 children (97%). Significant regional clustering of prevalent pneumococcal serotypes were seen among families in core hamlets. Five of 20 adults (20%) and 30 of 37 children (81%) grew Haemophilus influenzae all of which were biotypable. A variety of faecal Gram negative bacilli comprising enterobacteria, Alcaligenes species and an aeromonad were isolated from 30 of 62 (48%) swabs.

Topics: Alcaligenes; Bacterial Infections; Carrier State; Enterobacteriaceae Infections; Haemophilus Infections; Haemophilus influenzae; Humans; Nose; Papua New Guinea; Pneumococcal Infections

Topics: Antineoplastic Agents; Bacterial Infections; Ear, Middle; Hemorrhage; Humans; Larynx; Mouth; Mucous Membrane; Neoplasms; Nose; Paralysis; Pharynx; Skin; Virus Diseases

In patients who undergo abdominal aortic operations, cultures have been recommended perioperatively to identify potential sources of graft infection. Bacteriologic monitoring was done in a group of patients receiving antibiotics prophylactically. Of 197 bowel bag cultures, 28 (14.2%) demonsrated small numbers of bacteria, usually Staphylococcus epidermidis, while of 31 aneurysm wall cultures, 7 (22.6%) grew bacteria. Four (6.6%) of 60 urine cultures done preoperatively indicated a significant bacteriuria, necessitating postponement of elective operations. Twenty-eight (46%) of 61 wounds revealed organisms of low pathogenicity, none of which caused overt infection. While the majority of 63 nasal cultures grew bacteria, this result did not influence the management of any patient. Eleven graft infections occurred in 517 abdominal aortic grafts inserted between 1967 and 1977. In three patients, infection was already present at the time of emergency operation while in another three, infections occurred subsequently, due to paraprosthetic-enteric fistulas in two and septicemia secondary to an operation on the genitourinary tract in the third. In the remaining five patients, no cause for infection was identified. Thus, no bowel bag culture and only one aneurysm wall culture was useful. This study has failed to demonstrate the value of routine cultures perioperatively in patients who undergo abdominal aortic operations.

Topics: Anti-Bacterial Agents; Aorta, Abdominal; Aortic Aneurysm; Aortic Rupture; Bacterial Infections; Blood Vessel Prosthesis; Humans; Intestines; Nose; Postoperative Complications; Premedication; Urine

Topics: Bacterial Infections; Child, Preschool; Hemangioma; Humans; Infant; Infant, Newborn; Infant, Newborn, Diseases; Nose; Nose Diseases; Nose Neoplasms

Biological side effects, which are particularly characterized by a change of bacterial flora, appear during chemotherapy, and are dependent on the mode of action of the different substances. While shifts in the germ count of skin flora have no great importance, gram-negative bacilli, especially enterobacteriaceae, multiply in the flora of the nose and throat, particularly after administration of beta-lactam antibiotics. These changes usually revert to normal in a short time after the antibiotic has been discontinued. Considerably more important are the changes in the flora of the large intestine, sensitive species being eliminated and resistant strains, usually R factor carriers, become selected. These organisms then play an important part in hospital cross-infection. This state of affairs can only be controlled by specific selection of chemotherapeutic agents and strict observance of all disinfectant measures.

Topics: Anti-Bacterial Agents; Bacteria; Bacterial Infections; Cross Infection; Digestive System; Disinfection; Drug Resistance, Microbial; Humans; Intestine, Large; Mouth; Nose; R Factors; Skin; Sputum

Topics: Administration, Oral; Bacterial Infections; Drug Contamination; Humans; Infusions, Parenteral; Intubation, Gastrointestinal; Nose

Topics: Age Factors; Anal Canal; Bacterial Infections; Bacteriological Techniques; Ear, External; Escherichia coli; Eye; Humans; Infant, Newborn; Infant, Newborn, Diseases; Klebsiella pneumoniae; Listeria monocytogenes; Meconium; Moraxella; Mouth; Nose; Pharynx; Proteus; Pseudomonas aeruginosa; Skin; Staphylococcus; Stomach; Streptococcus; Umbilicus

Topics: Adolescent; Adult; Air Movements; Amphotericin B; Anti-Bacterial Agents; Antifungal Agents; Bacterial Infections; Bacteriuria; Child; Ear; Feces; Female; Gentamicins; Humans; Male; Middle Aged; Mycoses; Nose; Nystatin; Paromomycin; Patient Isolators; Pharynx; Polymyxins; Skin; Vagina; Vancomycin

Topics: Aged; Arm; Bacterial Infections; Ear Diseases; Ear, External; Escherichia coli Infections; Female; Foot; Foot Diseases; Gangrene; Hand; Humans; Hypotension; Ischemia; Klebsiella Infections; Leg; Male; Middle Aged; Nose; Nose Diseases; Pneumococcal Infections; Pseudomonas Infections; Sepsis; Thrombosis

Topics: Age Factors; Animals; Animals, Newborn; Arthritis; Bacterial Infections; Body Weight; Culture Media; Denmark; Female; Jejunum; Moraxella; Nose; Parity; Pneumonia; Pregnancy; Seasons; Spleen; Swine; Swine Diseases

Topics: Adolescent; Adult; Age Factors; Anti-Bacterial Agents; Australia; Bacterial Infections; Cerebrospinal Fluid; Child; Child, Preschool; Disease Outbreaks; Echovirus Infections; Enterovirus B, Human; Feces; Female; Humans; Infant; Male; Meningitis; Meningitis, Viral; Neutralization Tests; Nose; Pharynx; Rectum; Spinal Puncture

Topics: Bacteria; Bacterial Infections; Child; Child, Preschool; Color; Haemophilus influenzae; Humans; Infant; Nasal Mucosa; Nose; Skin Diseases, Infectious; Staphylococcus; Streptococcus; Streptococcus pneumoniae; Time Factors; Viscosity

Topics: Adult; Anti-Bacterial Agents; Bacteria; Bacterial Infections; Enterobacteriaceae; Eye; Female; Humans; Infant, Newborn; Infant, Newborn, Diseases; Intestines; Milk, Human; Nose; Obstetric Labor Complications; Pharynx; Pregnancy; Pregnancy Complications, Infectious; Rectum; Staphylococcus; Umbilical Veins; Vagina

Topics: Adult; Bacterial Infections; Blepharitis; Child; Conjunctivitis; Humans; Keratoconjunctivitis; Moraxella; Mucous Membrane; Nose; Seasons; Skin

Topics: Acute Disease; Adolescent; Antibodies; Audiometry; Bacteria; Bacterial Infections; Child; Child, Preschool; Drainage; Ear, Middle; Haemophilus influenzae; Humans; Infant; Infant, Newborn; Methods; Nasal Decongestants; Nose; Otitis Media; Penicillins; Rupture, Spontaneous; Streptococcus pneumoniae; Tympanic Membrane

Topics: Adolescent; Adult; Animals; Bacterial Infections; Cell Line; Cells, Cultured; Child; Child, Preschool; Culture Techniques; Cytopathogenic Effect, Viral; Diagnosis, Differential; Female; Haplorhini; HeLa Cells; Humans; Kidney; Lung; Male; Nose; Orthomyxoviridae Infections; Pharynx; Respiratory Syncytial Viruses; Respiratory Tract Infections; Sex Factors; Virus Cultivation; Virus Diseases

Topics: Agglutination Tests; Alcaligenes; Animals; Bacterial Infections; Nasal Mucosa; Nose; Rhinitis, Atrophic; Swine; Swine Diseases; Turbinates

Topics: Air Conditioning; Anti-Bacterial Agents; Bacterial Infections; Cross Infection; Escherichia coli; Haemophilus influenzae; Humans; Influenza, Human; Nose; Pharynx; Pneumonia; Pneumonia, Viral; Pseudomonas aeruginosa; Staphylococcus; Sterilization; Streptococcus pneumoniae; Tetracycline

Topics: Bacterial Infections; Infections; Nose; Penicillin V; Penicillins; Pharyngitis; Pharynx; Rhinitis

Topics: Anti-Bacterial Agents; Antibiotics, Antitubercular; Bacteria; Bacterial Infections; Disease; Humans; Microbial Sensitivity Tests; Nose; Otolaryngology; Pharyngitis; Pharynx; Veterans