ABSTRACT
Abstract Objective Research and identification of Cutibacterium acnes (C. acnes) and other microorganisms in deeptissue samples collected in clean shoulder surgeries of patients who did not undergo any previous invasive joint procedure and who had no clinical history of infection. Methods We analyzed the results of cultures of intraoperative deep tissue samples from 84 patients submitted to primary clean shoulder surgery. Tubes containing culture medium were used for storage and transport of anaerobic agents, prolonged incubation time, and mass spectrometer for diagnosis of bacterial agents. Results Bacteria growth was evidenced in 34 patients (40.4%) of the 84 included in the study. Of these, 23 had growth of C. acnes in at least one sample of deep tissue collected, corresponding to 27.3% of the total patients. The second most common agent was Staphylococcus epidermidis, present in 7.2% of the total individuals included. We showed a higher relationship between sample positivity and males, a lower mean age, absence of diabetes mellitus, ASA I score, and antibiotic prophylaxis in anesthetic induction with cefuroxime. Conclusions A high percentage of isolates of different bacteria was found in shoulder tissue samples of patients undergoing clean and primary surgeries, who had no history of previous infection. Identification of C. acnes was high (27.6%), and Staphylococcus epidermidis was the second most frequent agent (7.2%).
Resumo Objetivo Pesquisa e identificação de Cutibacterium acnes (C. acnes) e de outros microrganismos em amostras de tecidos profundos coletados em cirurgias limpas de ombro em pacientes que não foram submetidos a nenhum procedimento invasivo articular prévio e que não possuíam antecedentes clínicos de infecção. Métodos Foram analisados os resultados das culturas de amostras de tecidos profundos intraoperatórias de 84 pacientes submetidos à cirurgia limpa primária do ombro. Foram utilizados tubos contendo meio de cultivo para armazenamento e transporte de agentes anaeróbicos, tempo prolongado de incubação e espectrômetro de massa para diagnósticos de agentes bacterianos. Resultados Foi evidenciado o crescimento de bactérias em 34 pacientes (40,4%) dos 84 incluídos no estudo. Desses, 23 apresentavam crescimento de C. acnes em pelo menos uma amostra de tecido profundo coletada, correspondendo a 27,3% do total de pacientes. O segundo agente mais encontrado foi o Staphylococcus epidermidis, presente em 7,2% do total de indivíduos incluídos. Evidenciamos maior relação da positividade de amostras com o gênero masculino, uma média de idade inferior, a ausência de diabetes mellitus, o escore ASA I e a profilaxia antibiótica na indução anestésica com cefuroxima. Conclusões Verificou-se um elevado percentual de isolados de diferentes bactérias em amostras de tecidos de ombros de pacientes submetidos a cirurgias limpas e primárias e sem histórico de infecção anterior. A identificação de C. acnes foi elevada (27,6%) e o Staphylococcus epidermidis foi o segundo agente mais frequente (7,2%).
Subject(s)
Humans , Shoulder/physiopathology , Staphylococcus epidermidis , Gram-Positive Bacterial InfectionsABSTRACT
Abstract Objective The present study aimed to identify bacterial agents in shoulder surgery specimens from patients with no history of previous shoulder infection or surgery. Methods Tendon, bursa, and bone specimens were collected during surgery, stored in sterile dry bottles, and sent to a hospital-associated laboratory for culture growth analysis in media for aerobic and anaerobic agents. Findings from 141 samples from 47 shoulders were analyzed. Results The cultures were negative in 46 cases (97.8%) and in 140 samples (99.2%). The culture was positive in a single patient, with growth of Staphylococcus hominis from one of three specimens collected. Conclusions The rates of bacterial growth were not consistent with the international literature, indicating the low effectiveness of laboratory methods used in Brazil.
Resumo Objetivo Identificar agentes bacterianos em amostras de cirurgias do ombro de pacientes sem histórico de infecção e de cirurgias prévias no ombro. Métodos Amostras de tendão, bursa e osso foram coletadas no intraoperatório, armazenadas em frascos estéreis a seco e enviadas para análise de crescimento de cultura em meios para agentes aeróbios e anaeróbios no laboratório credenciado ao hospital. Foram analisados os resultados de 141 amostras de 47 ombros. Resultados Obtivemos resultados de culturas negativas em 46 casos (97,8%) e em 140 amostras (99,2%). Apenas um paciente apresentou resultado positivo, com crescimento bacteriano do Staphylococcus hominis em uma das três amostras coletadas. Conclusões Não evidenciamos taxas de crescimento bacteriano condizentes com a literatura internacional, alertando para a baixa eficácia dos métodos laboratoriais utilizados no nosso país.
Subject(s)
Humans , Male , Female , Adult , Middle Aged , Aged , Aged, 80 and over , Shoulder/surgery , Gram-Positive Bacterial Infections , Anti-Bacterial AgentsABSTRACT
La hipomelanosis macular progresiva es un trastorno adquirido de la pigmentación que aparece con más frecuencia en mujeres, adolescentes y adultas jóvenes. Se caracteriza por máculas hipopigmentadas asintomáticas, mal delimitadas, no descamativas, simétricas y de predominio en región lumbar. El estudio histopatológico evidencia disminución del contenido de melanina en la epidermis afectada, con número y distribución de los melanocitos conservados. En su etiopatogenia interviene el Cutibacterium acnes tipo III, bacteria responsable de la característica fluorescencia rojiza de distribución folicular que se observa con la lámpara de Wood. Por este motivo, los tratamientos propuestos incluyen el uso de tetraciclinas por vía oral y tratamientos tópicos como el peróxido de benzoílo, asociados a fototerapia UVA o UVB de banda angosta. Se presenta una paciente con hipomelanosis macular progresiva del tronco que respondió satisfactoriamente al tratamiento con doxiciclina vía oral
Progressive macular hypomelanosis is an acquired pigmentation disorder that occurs mostly in adolescent and young women. It is characterized by asymptomatic, poorly defined, non-scaly, symmetrical hypopigmented macules localized predominantly in the lumbar area. Histopathology shows a decrease in melanin content with preserved number and distribution of melanocytes in the affected epidermis. Cutibacterium acnes type III appears to be the responsible for the dermatosis and for the characteristic reddish fluorescence of follicular distribution observed with Wood´s lamp. Treatment include oral tetracyclines and topical benzoyl peroxide associated with UVA or narrow band UVB phototherapy. We present a patient with progressive macular hypomelanosis of the trunk with excellent response to treatment with oral doxycycline
Subject(s)
Humans , Female , Adult , Phototherapy , Tetracycline/therapeutic use , Administration, Oral , Hypopigmentation/therapy , Doxycycline/therapeutic use , Diagnosis, Differential , Melanosis/therapyABSTRACT
Resumen: Introducción. El aceite del árbol de té es un aceite esencial reconocido por sus propiedades antimicrobianas. Objetivos. Evaluar la composición, características y efecto antimicrobiano del aceite al 2 % del árbol de té y su concentración inhibitoria mínima (CIM) contra Cutibacterium acnes (Propionibacterium acnes). Materiales y métodos. Se evaluó el quimiotipo en tres lotes diferentes de este aceite mediante cromatografía de gases, así como su actividad antimicrobiana en concentración al 2 % v/v y la CIM contra C. acnes mediante ensayo de difusión en agar (guía M11-A8 CLSI). Resultados. Los lotes evaluados presentaron los quimiotipos ajustados a la norma ISO 4730, lo que indicó la alta calidad del producto. Los lotes contenían de 30 a 40 % de terpinen-4-ol, compuesto que favorece la actividad antimicrobiana, la cual presentó en todos los lotes un efecto dependiente de la concentración contra C. acnes, con una inhibición del crecimiento microbiano en concentración al 2 % v/v en todas las pruebas. La concentración inhibitoria mínima fue de 0,25 % v/v. La actividad antimicrobiana del aceite del árbol de té contra este microorganismo ya ha sido reportada con una concentración inhibitoria mínima entre 0,05 y 1,25 % v/v, rango que cobija la obtenida en este estudio. Conclusiones. Los resultados evidenciaron la gran calidad de este producto y su capacidad como agente antibacteriano contra C. acnes. Se deben hacer estudios con otros aislamientos del microorganismo provenientes de pacientes con acné vulgar para confirmar su actividad general y la de cada uno de sus componentes.
Abstract: Introduction: Tea tree oil is an essential oil recognized for its antimicrobial properties. Objective: To evaluate the composition, features, and antimicrobial effect at 2% v/v, and its minimal inhibitory concentration (MIC) against Cutibacterium acnes (Propionibacterium acnes). Materials and methods: Three different batches of tea tree oil were evaluated. We characterized its chemotype by gas chromatography and its 2% v/v antimicrobial activity against C. acnes by agar diffusion assay (guide M11-A8 CLSI). Results: The three batches of oil had the chemotypes required by the ISO 4730 standard, which indicates that it is a high-quality product. Additionally, they had 30% to 40% of terpinen-4-ol, a compound that favors its antimicrobial activity. Antimicrobial activity against C. acnes for all batches had a concentration-dependent effect with microbial growth inhibitory activity in all assays at 2% v/v. The MIC obtained against C. acnes for all batches was 0.25% v/v. The antimicrobial activity of tea tree oil against this microorganism has been previously reported with a MIC between 0.05% and 1.25% v/v, a range that covers the one obtained in this study. Conclusion: These results show the high quality of the oil and its capacity as an antibacterial agent against C. acnes. New studies should be conducted to confirm its activity and that of its components in isolates of the microorganism from patients with acne vulgaris.
Subject(s)
Propionibacterium acnes , Tea Tree Oil , Microbial Sensitivity Tests , Chromatography, GasABSTRACT
The purpose of this study was to investigate the antimicrobial activity of the ethanol extract of Garcinia mangostana L. (mangosteen) against Cutibacterium acnes (6 strains) and Staphylococcus aureus (6 strains). The antimicrobial activity of the mangosteen extract was evaluated based on its minimal bactericidal concentration. Cytotoxicity of the mangosteen extract against human embryonic kidney 293 (HEK 293) cells was determined using the cell counting method. The data showed that the mangosteen extract was not toxic to HEK 293 cells at a concentration of up to 16 µg/mL and killed 87.0% and 99.9% of C. acnes and S. aureus after 10 minutes and 1 hour of treatment, respectively. These results suggest that ethanol extract of mangosteen can be used as an anti-acne agent.