ABSTRACT
Abstract Antimicrobial resistance is a global public health problem. Root canal microbiota associated with apical periodontitis represents a well-known reservoir of antimicrobial resistance genes (ARGs). However, the effect of type 2 diabetes mellitus (T2DM) in this reservoir is unknown. This study aimed to establish if root canal microbiota associated with apical periodontitis in T2DM patients is an augmented reservoir by identifying the prevalence of nine common ARGs and comparing it with the prevalence in nondiabetic patients. Methodology This cross-sectional study included two groups: A T2DM group conformed of 20 patients with at least ten years of living with T2DM and a control group of 30 nondiabetic participants. Premolar or molar teeth with pulp necrosis and apical periodontitis were included. A sample was collected from each root canal before endodontic treatment. DNA was extracted, and ARGs were identified by polymerase chain reaction. Results tetW and tetM genes were the most frequent (93.3 and 91.6%, respectively), while ermA was the least frequent (8.3%) in the total population. The distribution of the ARGs was similar in both groups, but a significant difference (p<0.005) was present in ermB, ermC, cfxA, and tetQ genes, being more frequent in the T2DM group. A total of eighty percent of the T2DM patients presented a minimum of four ARGs, while 76.6% of the control group presented a maximum of three. Conclusions Root canal microbiota associated with apical periodontitis in T2DM patients carries more ARGs. Therefore, this pathological niche could be considered an augmented reservoir.
ABSTRACT
Abstract: Background: Chagas disease is an endemic illness in the Americas and therefore constitutes a public health problem. An estimated 8 million people are infected and over 20 million live in areas at risk. In Mexico, the problem is under reported and no epidemiological data by the different States indicating true prevalence for this infection is available. During the chronic phase, 30% of infected patients may develop chagasic cardiomyopathy (CCM), characterized by different types of alterations of cardiac function. Objective: To describe cardiac abnormalities in Trypanosoma cruzi seropositive subjects in the endemic areas. Material and methods: This is a descriptive cross-sectional study with non-random sampling. In our project the endemic area was considered for Trypanosoma cruzi using the Epi Info statistical program (Stat Calc) to calculate the number of subjects to study by means of a sample of 1 033 subjects aged 2-90 years. Prior informed consent or parental consent, implementation of a survey, a 5 mL of blood sample free from anticoagulant was taken from the cubital vein to detect anti-Trypanosoma cruzi by ELISA, recombinant ELISA, hemagglutination indirect (HAI), indirect immunofluorescence (IFI) and Western blot (using the enzyme superoxide dismutase iron as antigen). Those subjects who were positive in two or more tests were chosen for electrocardiogram (EKG) and an echocardiogram (ECO) with portable devices. Results: Of the 1 033 participants, 84 between 6 and 88 years tested positive for Trypanosoma cruzi. In the analysis of data with echocardiograms and electrocardiograms, 47 subjects over 26 years (56%), presented right bundle branch block or left bundle block (RBBB/LBBB), changes in the diameters of the right ventricle or left ejection fraction accounting of 70%. In subjects under 26 years there were electrocardiographic changes (RBBB/LBBB). Conclusion: 8.13% were seropositive for Trypanosoma cruzi with ventricular conduction system and morphological alterations.
Resumen: Antecedentes: La enfermedad de Chagas es una patología endémica en las Américas, donde representa un problema de salud pública. Se estima que aproximadamente 8 millones de personas están infectadas y 20 millones viven en áreas de riesgo de infectarse. En México el problema está subestimado y se carece de datos epidemiológicos por estado del país que indiquen una prevalencia real de este padecimiento. Durante la fase crónica, el 30% de los pacientes infectados pueden desarrollar miocardiopatía chagásica (MCC), que se caracteriza por presentar diferentes alteraciones de la función cardiaca. Objetivo: Describir las alteraciones cardiacas en sujetos seropositivos para Trypanosoma cruzi de áreas endémicas. Material y métodos: Es un estudio con diseño transversal descriptivo, con muestra no probabilística. En nuestro proyecto, se consideró una zona endémica a Trypanosoma cruzi, mediante el programa estadístico Epi Info (Stat Calc), para estimar el número de sujetos a estudiar, obteniéndose una muestra de 1 033 sujetos de edades entre 2 a 90 años. Previo consentimiento informado, y aplicación de una encuesta, se puncionó la vena cubital, obteniéndose una muestra sanguínea de 5 mL, sin anticoagulante, para buscar anticuerpos anti-Trypanosoma cruzi mediante, ELISA, ELISA recombinante, hemaglutinación indirecta (HAI), inmunofluorescencia indirecta (IFI) y Western-Blot (usando la enzima superóxido dismutasa de hierro como antígeno). Los sujetos reactivos a dos o más pruebas fueron seleccionados para la realización de un electrocardiograma (EKG) y un ecocardiograma (ECO) con equipos portátiles Resultados: De los 1 033 participantes, 84 entre 6 a 88 años resultaron positivos para Trypanosoma cruzi. En el análisis de los hallazgos ecocardiográficos y electrocardiográficos en los 47 sujetos mayores de 26 años (56%) presentaron bloqueo de rama derecha o izquierda del haz de His (BRDHH/BRIHH). Conclusión: El 8.13% fueron seropositivos para Trypanosoma cruzi con cambios morfológicos ventriculares y del sistema de conducción del haz de His.