High relative abundance of firmicutes and increased TNF-α levels correlate with obesity in children / Obesidad infantil y su correlación con la alta abundancia relativa de firmicutes y el aumento de los niveles de TNF-α

Abstract: Objective: To investigate the correlation among pro- or anti-inflammatory cytokines and the two main gut microbiota phyla in obese children. Materials and methods: Anthropometric data were obtained from 890 children under 14 years old to determine the degree of obesity. Serum cytokine concentration was measured by ELISA. Relative abundance of gut microbiota in feces was evaluated by quantitative Real-Time PCR assays. Results: Anthropometric and biochemical parameters were statistically higher in overweight /obese children than in lean ones. Increased TNF-α levels were found in obese children that also have a high relative abundance of Firmicutes. Conclusions: Obese children have a high relative abundance of Firmicutes that correlates with increased levels of TNF-α. This is the first study that shows a relation between Firmicute abundance and TNF-α serum concentration in obese children.

Resumen: Objetivo: Investigar la correlación entre las citocinas proinflamatorias o antiinflamatorias y los dos principales filos de la microbiota intestinal en niños obesos. Material y métodos: Se obtuvieron mediciones antropométricas de 890 niños de 6 a 14 años; posteriormente se clasificaron en normopeso y sobrepeso/obeso. Las concentraciones séricas fueron medidas por el método de ELISA. La abundancia relativa de la microbiota intestinal en heces se evaluó por PCR tiempo real. Resultados: Los parámetros bioquímicos y antropométricos fueron estadísticamente más altos en niños con sobrepeso / obesidad que en niños delgados. Se encontraron niveles más altos de FNT-α en niños obesos que también tenían una abundancia relativa alta de Firmicutes. Conclusiones: Los niños obesos tienen una alta abundancia relativa de Firmicutes, la cual se correlaciona con un incremento de los niveles de FNT-α. Este es el primer estudio que evalúa la reacción entre la abundancia de Firmicutes y la concentración sérica de FNT-α en niños obesos.

Primary Aortoenteric Fistula to the Sigmoid Colon in Association with Intra-abdominal Abscess / 대한소화기학회지

Primary aortoenteric fistula (PAEF) is a rare but catastrophic cause of massive gastrointestinal bleeding. Diagnosis of PAEF is difficult to make and is frequently delayed without strong clinical suspicion. Timely surgical intervention is essential for patient's survival. We report on a case of an 86-year-old woman with no history of abdominal surgery, who presented with abdominal pain. Initially, computed tomography scan showed an intra-abdominal abscess, located anterior to the aortic bifurcation. However, she was discharged without treatment because of spontaneous improvement on a follow-up computed tomography scan, which showed a newly developed right common iliac artery aneurysm. One week later, she was readmitted due to recurrent abdominal pain. On the second day of admission, sudden onset of gastrointestinal bleeding occurred for the first time. After several endoscopic examinations, an aortoenteric fistula bleeding site was found in the sigmoid colon, and aortography showed progression of a right common iliac artery aneurysm. We finally concluded that intra-abdominal abscess induced an infected aortic aneurysm and enteric fistula to the sigmoid colon. This case demonstrated an extremely rare type of PAEF to the sigmoid colon caused by an infected abdominal aortic aneurysm, which has rarely been reported.

Evaluation of fecal microorganisms of children with cleft palate before and after palatoplasty

This study isolated and quantified intestinal bacteria of children with cleft palate before and after palatoplasty. A prospective study was conducted from May 2007 to September 2008 on 18 children with cleft palate, aged one to four years, of both genders, attending a tertiary cleft center in Brazil for palatoplasty, to analyze the effect of surgical palate repair on the concentration of anaerobes Bacteroides sp, Bifidobacterium sp and microaerophiles Lactobacillus sp in feces of infants with cleft palate before and 24 hours after treatment with cefazolin for palatoplasty. There was significant reduction of Lactobacillus sp (p < 0.002), Bacteroides sp (p < 0.001) and Bifidobacterium sp (p = 0.021) after palatoplasty, revealing that surgery and utilization of cefazolin significantly influenced the fecal microbiota comparing collections before and after surgery. However, due to study limitations, it was not possible to conclude that other isolated factors, such as surgical stress, anesthetics and other medications used in palatoplasty might have a significant influence on the microbiota. Considering the important participation of the intestinal microbiota on both local and systemic metabolic and immunological activities of the host, professionals should be attentive to the possible influence of these changes in patients submitted to cleft repair.

Detection of odoriferous subgingival and tongue microbiota in diabetic and nondiabetic patients with oral malodor using polymerase chain reaction.

Background: Halitosis has been correlated with the concentration of volatile sulfur compounds (VSCs) produced in the oral cavity by metabolic activity of bacteria colonizing the periodontal pockets and the dorsum of the tongue. It has been assumed that there is a relationship between periodontal disease and diabetes mellitus. Objectives: The aim of the study was to assess the malodor using the organoleptic method and tanita device; to quantify odoriferous microorganisms of subgingival plaque and tongue coating, such as P. gingivalis (Pg), T. forsythia (Tf), and F. nucleatum (Fn) using polymerase chain reaction (PCR) in nondiabetic and diabetic chronic periodontitis patients. Patients and Methods: Thirty chronic periodontitis patients (with and without diabetes) with 5-7 mm pocket depth, radiographic evidence of bone loss, and presence of oral malodor participated in this study. Subjective assessment of mouth air was done organoleptically and by using a portable sulfide monitor. Tongue coating was also assessed. Results: The scores of plaque index, gingival index, gingival bleeding index, VSC levels, and tongue coating between the nondiabetic and diabetic patients were not significant (P>0.5). In nondiabetic patients, Fn was found to be significantly (P<0.5) more in tongue samples, whereas Pg and Tf have not shown significant values (P>0.5). In diabetic patients, Fn and Tf have shown significant (P<0.5) an increase in subgingival and tongue samples, respectively, whereas Pg has not shown significant difference between subgingival and tongue samples. Interpretation and Conclusion: The results confirm that there is no difference in clinical parameters between nondiabetic and diabetic periodontitis patients, but the odoriferous microbial profiles in tongue samples of diabetic patients were found to be high. However, there is a weak positive correlation between VSC levels, clinical parameters, and odoriferous microbial profiles.

Antimicrobial resistance and prevalence of resistance genes in intestinal Bacteroidales strains

OBJECTIVE: This study examined the antimicrobial resistance profile and the prevalence of resistance genes in Bacteroides spp. and Parabacteroides distasonis strains isolated from children's intestinal microbiota. METHODS: The susceptibility of these bacteria to 10 antimicrobials was determined using an agar dilution method. β-lactamase activity was assessed by hydrolysis of the chromogenic cephalosporin of 114 Bacteriodales strains isolated from the fecal samples of 39 children, and the presence of resistance genes was tested using a PCR assay. RESULTS: All strains were susceptible to imipenem and metronidazole. The following resistance rates were observed: amoxicillin (93 percent), amoxicillin/clavulanic acid (47.3 percent), ampicillin (96.4 percent), cephalexin (99 percent), cefoxitin (23 percent), penicillin (99 percent), clindamycin (34.2 percent) and tetracycline (53.5 percent). P-lactamase production was verified in 92 percent of the evaluated strains. The presence of the cfiA, cepA, ermF, tetQ and nim genes was observed in 62.3 percent, 76.3 percent, 27 percent, 79.8 percent and 7.8 percent of the strains, respectively. CONCLUSIONS: Our results indicate an increase in the resistance to several antibiotics in intestinal Bacteroides spp. and Parabacteroides distasonis and demonstrate that these microorganisms harbor antimicrobial resistance genes that may be transferred to other susceptible intestinal strains.

Periodontal parameters and BANA test in patents with chronic renal failure undergoing hemodialysis

OBJECTIVES: The aim of this study was to analyze the periodontal parameters of patients with chronic renal failure. MATERIAL AND METHODS: The periodontal status of 16 Brazilian patients aged 29 to 53 (41.7±7.2) years with chronic renal failure (CRF) and another matched group of 14 healthy controls with periodontitis was assessed clinically and microbiologically. Probing pocket depth (PPD), gingival recession (GR), dental plaque index (PLI), gingival index (GI), and dental calculus index (CI) were the clinical parameters recorded for the entire dentition (at least 19 teeth), while the anaerobic periodontopathogen colonization in four sites with the highest PPD was evaluated using the BANA test ("PerioScan"; Oral B). RESULTS: The results for the CRF group and control group, respectively were: PPD: 1.77±0.32 and 2.65±0.53; GR: 0.58±0.56 and 0.51±0.36; PLI: 1.64±0.56 and 1.24±0.67; GI: 0.64±0.42 and 0.93±0.50; CI: 1.17±0.54 and 0.87±0.52. Comparison between groups using the "t" test revealed a significantly increased PPD (p<0.001) in the control group. Comparison of the other clincial parameters by the Mann-Whitney test showed differences only for PLI, which was significantly higher (p<0.05) in the CRF group. Spearman's test applied to each group showed a positive correlation among all clinical parameters, except for GR (p<0.05). None of the groups showed any correlation between GR and GI, while a significant negative correlation between GR and PPD was observed for the CRF group. The percentage of BANA-positive sites was 35.9 percent for the CRF group and 35.7 percent for the control group. The BANA test correlated positively with PPD only in the control group and with GR only in the CRF group. CONCLUSIONS: In spite of a higher PLI and dense anaerobic microbial population even in shallow PPD, patients with CRF exhibited better periodontal conditions than periodontitis patients, which is an evidence of altered response to local irritants.

A quantitative and relative increase in intestinal bacteroides in allergic infants in rural Japan.

Recent studies have suggested that intestinal microbiota play a substantial role in the development of allergic diseases during infancy. We analyzed fecal microbiota in 18 Japanese infants with or without allergy at 6 months and 2 years of age using a cell culture technique. Allergy determination was based on doctor-diagnosed allergic diseases and skin prick tests. There were no differences between 9 allergic and 9 non-allergic infants at 6 months of age in the frequencies or counts of 13 genera and yeast-like organisms. Bifidobacterium was dominant in all infants irrespective of allergy status. At 2 years of age, 8 infants were non-allergic and 10 infants were allergic. Allergic infants at 2 years of age had higher counts of Bacteroides and higher ratios of Bacteroides to Bifidobacterium than non-allergic infants. Despite the small population size used in this study, the results support a significant role of Bacteroides in the pathogenesis of allergy during infancy.

The detection of eight putative periodontal pathogens in adult and rapidly progressive periodontitis patients: an institutional study.

PURPOSE: Periodontal disease is a commonly prevalent problem faced alike by both the developed and third world countries but showing wide variations in prevalence and severity across different geographical areas. The purpose was to identify Actinobacillus actinomycetemcomitans (Aa), Porphyromonas gingivalis (Pg), Prevotella intermedia (Pi), Ekinella corrodens (Ec), Campylobacter rectus (Cr), Bacteroides forsythus (Bf), Treponema denticola (Td) and Fusobacterium nucleatum (Fn) in Indian adult periodontitis and rapidly progressive periodontitis patients. MATERIALS AND METHODS: Paper points were used to collect the sample from 28 sites in both adult periodontitis and rapidly progressive periodontitis (8 healthy/20 diseased sites) patients and DNA analysis done. The categorical data was analysed by Fishers exact test and difference in the clinical parameters was tested by Mann-Whitney test. RESULTS: In healthy sites of adult and rapidly progressive periodontitis patients, Aa, Ec, Bf and Aa, Pg, Pi, Td, Fn were detected respectively. However, when diseased and healthy sites were compared in both adult periodontitis and rapidly progressive periodontitis patients respectively, only Pg( P =0.004), Cr( P =0.04), Fn( P =0.014) and Pg( P =0.002), Cr( P =0.02), Fn( P =0.008) were statistically significant. CONCLUSION: The prevalence of the microorganisms correlate with the clinical parameters like probing depth and bleeding on probing as seen in the Japanese and Western periodontitis patients' population.

Detection and measurement of oral malodour in periodontitis patients.

BACKGROUND & OBJECTIVES: Malodour has been correlated with the concentration of volatile sulphur compounds produced in the oral cavity by metabolic activity of bacteria colonizing the periodontal sites and the dorsum of the tongue. The aim of this study was to detect malodour in mouth air organoleptically and using a portable sulphide monitor and to correlate it with the clinical parameters, halitosis linked toxins and BANA, using tongue and subgingival plaque samples. The halitosis grading is also correlated with the microbial colonies of the subgingival plaque sample. METHODS: 20 patients with chronic periodontitis with 5-7 mm pocket depth, radiographic evidence of bone loss and presence of oral malodour participated in this study. Assessment of mouth air was done organoleptically and by using a portable sulphide monitor. The clinical parameter, plaque index (PI), gingival index (GI), gingival bleeding index (BI), were obtained from all the areas. Samples for BANA and to detect halitosis linked toxins were taken from the dorsal surface of the tongue and periodontal pockets ranging 5-7 mm. Halitosis related microbial colonies were identified using anaerobic culturing from the subgingival plaque. RESULTS: The scores of PI, GI, BI and sample that tested positive for halitosis linked toxins and with the halitosis grading were not significant. The presence of tongue coating and the halitosis grading and toxin levels were significant. BANA has shown to be non contributory due to technical problems. Anaerobic culture has shown to identify Streptococcus, Bacteroides, Fusobacterium, Porphyromonas and Prevotella colonies. INTERPRETATION & CONCLUSION: The results confirmed that there was no correlation between the clinical parameters, halitosis linked toxins and halitosis grading. The microbial colonies have shown to correlate with the presence of oral malodour.

Role of non spore forming anaerobes in diarrheal diseases

The study included 40 diarrheic children under 3 years of age [20 acute and 20 chronic cases] and 20 age matched controls. Fecal specimens were collected from each. Isolation and characterization of non spore forming Gram-negative anaerobic rods was carried out by using non selective media [CDC and blood agar] and selective media [KVA and PVA] media, Gram stain, relationship to oxygen, fluorescence and spot tests. Presumptive identification was done by using several biochemical identification systems [presumpto plates, rapid enzyme systems and API 20 A]. Definitive identification was carried out by using gas liquid chromatography and toxin assays on B. fragilis isolates by using tissue culture cell lines [HELF and VERO] and by inoculation [intraperitoneal and intravenous] in 3-week old mice

Bacterias identicadas por el sistema clásico y el sistema API-20E / Bacterias identificated by classic system and API-20E system

Se efectuaron 146 aislamientos bacterianos mediante el uso de hemocultivos. Dichos aislamientos se identificaron usando el método clásico y el sistema API-20E. Con el método clásico identificaron 84 cepas: 34 cepas de Estafilococo coagulasa negativa; 16 cepas de Estafilococo aureus patógeno; 9 cepas de Estreptococo no hemolítico; 13 cepas de Bacteroides; 4 cepas de citrobactter y una cepa de Shiguella flexneri. Con el sistena API-20E se identificaron 62 cepas; 7 cepas de Echerichia coli; 13 cepas de Salmonella tiphy; 22 cepas de Serratia marcescens; 8 cepas de Klebsiella neumoneae; 5 cepas de Enterobacter cloacae; 4 cepas de Acinetobacter calcoacético y 3 cepas de Pseudomona fluorences.

Bacteroides Forsythus: detecçäo molecular e prevalência em pacientes portadores de periodontite / Bacteroides Forsythus: molecular detection and prevalence in periodontitis patients

Foi avaliada a eficácia de uma sonda de DNA genômica marcada com digoxigenina para a detecçäo de B. Forsythus em amostras subgengivais. Além disso, reaçäo de polimerase em cadeia com "primers" arbitrários (AP-PCR), foi empregada com o objetivo de se delinear a diversividade genética de B. Forsythus. A sonda de DNA pode detectar 10(3) células de B. Forsythus e apresentou um forte sinal positivo com 10(4) células. A sonda reagiu com B. Forsythus ATCC 43037T e 44 cepas frescas isoladas da mesma espécie e näo demonstrou reaçäo detectável com 75 cepas de outras 24 espécies da microbiota bucal. Utilizando-se a cultura como referência, a sonda de DNA, através do método dot-blot, demonstrou uma sensibilidade de 88,8 por cento e uma especificidade de 38,4 por cento (exatidäo de 72,5 por cento). Pelo método "colony-blot", foram obtidas sensibilidade de 98,1 por cento e especificidade de 53,8 por cento (exatidäo de 83,7 por cento). B. Forsythus foi detectado em 449 dos 614 pacientes estudados (73,1 por cento). O microrgarnismo demonstrou uma estreita associaçäo com Porphyromonas Gingivalis, sendo ambos presentes em 54,8 por cento e ausentes em 22,2 por cento das 270 amostras estudadas. AP-PCR identificou 24 genotipos de B. Forsythus entre 27 cepas estudadas. Este estudo demonstrou a utilidade de uma genômica de DNA näo-radioativa para a detecçäo direta de B. Forsythus em amostras subgengival. A espécie demonstrou um considerável grau de diversidade genética. A análise de DNA pode ajudar a determinar o papel de B. Forsythus na doença periodontal e seu modo de transmissäo entre indivíduos

Rapid identification of clinically important bacteroides by coagglutination method.

A coagglutination technique using indigenous reagents was applied for the rapid identification of Bacteroides fragilis and the black pigmented bacteroides group, using colony suspensions. All the 58 strains of B. fragilis and 42 strains of black pigmented bacteroides tested could be correctly identified by this method. The specificity of the coagglutination reagent was confirmed by the absence of cross reactivity with the related species of bacteroides, viz., B. distasonis, B. ovatus, B. vulgatus and B. thetaiotaomicron as well as other anaerobic and aerobic bacteria. A panel of four antisera against B. fragilis was required for correct identification of the strains tested, indicating the presence of multiple serotypes. On the other hand, all 42 strains of black pigmented bacteroides tested could be identified, using a single reagent as these strains appeared to have no antigenic type variants.

Meningitis por bacteroides distasonis / Bacteroides distasonis meningitis

Se present ael caso de una paciente de 50 años que durante la internación por un severo cuadro de artritis reumatoidea, desarrolló una bacteriemia por Bacteroides distasonis a partir de una colecistitis no reconocida y cuya expresión final fue una meningitis. La evolución de la paciente no fue favorable por no haber recibido la terapia antibiótica adecuada en forma temprana. El diagnóstico etiológico fue realizado a través del estudio microbiológico del líquido cefalorraquídeo transportado y cultivado en aero y anaerobiosis. Este procedimiento es importante en aquellos pacientes que presentan procesos infecciosos agudos o crónicos pulmonares, intraabdominales o craneofaciales y que además son inmunocomprometidos. En tales casos debe incorporarse al esquema terapéutico inicial un antibiótico efectivo en el tratamiento de los gérmenes anaerobios que pudieran estar involucrados