Survey of canine tick-borne diseases in Lábrea, Brazilian Amazon: ‘accidental’ findings of Dirofilaria immitis infection / Pesquisa de agentes transmitidos por carrapatos em cães de Lábrea, Amazonas: achados “acidentais” de Dirofilaria immitis

Blood samples were collected from 99 domestic dogs from the urban and rural areas of the Lábrea municipality, state of Amazonas, Brazil. Canine serum samples were tested by immunofluorescence assay against Rickettsia spp., which revealed that only 3.0% (1/33) and 7.6% (5/66) of the dogs from urban and rural areas, respectively, reacted positively to at least one Rickettsia species. DNA was extracted from canine blood and tested by a battery of PCR assays targeting protozoa of the genera Babesia and Hepatozoon, and bacteria of the genera Rickettsia and Ehrlichia and family Anaplasmataceae. All samples were negative in the PCR assays targeting the genera Babesia, Hepatozoon, Ehrlichia and Rickettsia. For Anaplasmataceae, 3% (1/33) and 39.4% (26/66) of the urban and rural dogs, respectively, yielded amplicons that generated DNA sequences 100% identical to the corresponding sequence of Wolbachia endosymbiont of Dirofilaria immitis. Because of these results, all canine DNA samples were further tested in a PCR assay targeting filarial nematodes, which was positive for 18.2% (6/33) and 57.6% (38/66) urban and rural dogs, respectively. Filarial-PCR products generated DNA sequences 100% identical to D. immitis. While tick-borne infections were rare in Lábrea, D. immitis infection rates were among the highest reported in South America.

Amostras de sangue foram coletadas de 99 cães domésticos de áreas urbana e rural do município de Lábrea, estado do Amazonas. Soros caninos foram testados pela técnica de imunofluorescência indireta contra Rickettsia spp., resultando em apenas 3,0% (1/33) e 7,6% (5/66) de cães soropositivos nas áreas urbana e rural, respectivamente. DNA foi extraído do sangue canino e testado por diferentes protocolos da PCR para detecção de protozoários dos gêneros Babesia e Hepatozoon, e bactérias dos gêneros Rickettsia e Ehrlichia e da família Anaplasmataceae. Todas as amostras foram negativas nos protocolos de PCR para os gêneros Babesia, Hepatozoon, Ehrlichia e Rickettsia. Para Anaplasmataceae, 3% (1/33) e 39,4% (26/66) dos cães de áreas urbana e rural, respectivamente, geraram sequências de DNA 100% idênticas ao endosimbionte Wolbachia de Dirofilaria immitis. Posteriormente, as amostras foram testadas pela PCR para nematódeos filarídeos, resultando em 18,2% (6/33) e 57,6% (38/66) de amostras positivas nas áreas urbana e rural, respectivamente. Os produtos geraram sequências de DNA 100% idênticas a D. immitis. Em contraste com várias outras regiões do Brasil, infecções transmitidas por carrapatos foram raras em Lábrea. Por outro lado, as frequências de infecção por D. immitis estiveram entre as mais altas relatadas na América do Sul.

Endocarditis infecciosa por Aerococcus species: caso clínico y revisión de la literatura / Bacterial endocarditis caused by Aerococcus species: case report and literature review

Introducción: Aeroccus species es una bacteria Gram positiva considerada como un agente inusual de infecciones del tracto urinario y de endocarditis infecciosa. Clásicamente los adultos mayores varones con anomalías genitourinarias crónicas están expuestos a esta infección. Presentación del caso: Hombre de 55 años consulta por un cuadro de dos meses de evolución caracterizado por compromiso del estado general, fiebre continua, diaforesis, dolor torácico sordo lateralizado a izquierda, y baja de peso de 8 kg en un mes, con anorexia. Sin antecedentes mórbidos salvo estenosis uretral crónica con requerimiento de dilataciones transureterales, las cuales realiza con termómetro de mercurio. Paciente ingresa en regulares condiciones generales, quejumbroso. Examen pulmonar con disminución del murmullo pulmonar en la base izquierda más broncofonía. Tacto rectal doloroso a la palpación. Los exámenes complementarios revelan: hemograma con leucocitosis de 13.100/mm3, VHS de 63 mm/h, PCR de 21 mg/dL. En el estudio de fiebre de origen desconocido se realiza ecocardiografía transtorácica la que reveló vegetación en velo coronario izquierdo de 0,9 cm x 1 cm. Los hemocultivos resultan positivos para Aerococcus species sensible a cloranfenicol/ceftriaxona, por lo que se inicia antibioticoterapia con ceftriaxona-gentamicina, mostrando el paciente una notable mejoría clínica, disminuyendo su malestar general y normalizando la temperatura. Discusión: Debido a la difícil interpretación microbiológica de los cultivos, Aerococcus sp es un germen identificado tardíamente, lo cual puede ensombrecer el pronóstico. La antibioticoterapia precoz y la continua monitorización clínica y de laboratorio son las estrategias más útiles en su tratamiento.

Introduction: Aerococcus species is a Gram-positive bacteria regarded as a rare cause of urinary tract infections and infective endocarditis. Most cases have been described in elderly males with underlying genitourinary tract abnormalities. Case report: 55 years old male complains two-month period of malaise, continuous fever, diaphoresis, left-thoracic dull pain and weight loss of 8 kg in a month, presenting anorexia. With an unremarkable history except for a chronic urethral stricture with needed of periodic transurethral dilation, which where performed using a mercurial thermometer. Patient comes to the emergency room in regular conditions, querulous. Pulmonary examination with diminished left base vesicular breath sound plus bronchovesicular breath sound. Digital rectal examination painfull at palpation. Complementary laboratory test shows: 13.100/mm3 WBC, VHS of 63 mm/h, PCR on 21 mg/dL. In the context of fever of unknown origin it was performed a transthoracic echocardiography, which showed a 0.9 x 1 cm vegetation in left coronary valve. Blood cultures were positive for Aerococcus sp. sensitive to chloramphenicol /ceftriaxone, showing the patient a remarkable clinical improvement, diminishing his malaise and normalizing his temperature. Discussion: Owing to the frequent microbiologic misinterpretation of the cultures, the bacterial identification often is delayed, which could potentially lead to a fatal outcome. Aggressive-fast establishment of antiobiotic therapy and a continuous monitoring of the patient's clinical status and laboratory results are the most effective strategies in treatment.

Airborne microbial contamination of dental units

Occupational risk of dental personnel to microbial airborne contamination has been demonstrated through the increased prevalence of respiratory infections. The American Dental Association has suggested stringent protection for infectious agents present in dental aerosols. Materials and Occupational exposure of dentists to airborne microbial and mycological contamination in various locations of a dental school was monitored by sampling of air in close vicinity of their breathing zone. This sampler drew air at a flow rate of 10 liters/minute and for a 2-hour period and blew it at a high speed through a narrow slit over a solid nutrient agar plate. Immediately after sampling, the plates were placed in an incubator and incubated aerobically for 2 days at 37C. The total bacterial counts in the air of dental surgery rooms and in non-surgery rooms without direct involvements with dental operations were in the range of 120-280 cfu/m3 and 49-128 cfu/m3 respectively. Pathogenic Streptococcus haemolyticus and opportunistic Staphylococcus species were found in some locations of dental surgery rooms. There are no standards for acceptable levels of indoor air contamination with pathogenic microorganisms and since pathogenic Streptococcus haemolyticus and opportunistic Staphylococcus species were found in some areas of the dental school, the need for management of possible risk of infective hazards is recognized

[Evaluation of the effects of chlorhexidine 0.12% mouthwash on mouth pathogen streptococcus and normal microflora]

Mouthwashes like brush and dental floss, can cause reduction in dental plaque and gingivitis. An optimal mouthwash should have antimicrobial properties, low drug resistance, and cause no decrease in normal microflora of the mouth. The purpose of this study was the evaluation of the effects of chlorhexidine 0.12% mouthwash on pathogen streptococcus and normal microflora of the mouth. In this experimental study, based on selected inclusion criteria, 28 subjects, were selected and asked to use 0.12% chlorhexidine mouthwash for 2 weeks, according to the manufacturer instruction. Before and after rinsing with the mouthwash, subjects were requested to wash their mouth with physiologic serum. After washing, 1cc of saliva of each individual was collected in sterile tube and immediately sent to microbiology laboratory. This process was repeated 2 weeks after using mouthwash. The number of pathogen streptococcus and normal microflora colonies of the mouth before and after using chlorhexidine were recorded. For analyzing the data, T and Chi Square Test were used.: Chlorhexidine mouthwash [0.12%] significantly decreased numbers of the pathogen streptococcus and mouth normal microflora [p <0/05] This study showed that, 0.12% chlorhexidine mouthwash, can destroy not only the mouth pathogen streptococci, but also the normal microflora of the mouth. The latter should be considered as its side effect

Penicillin-resistant Aerococcus viridans Bacteremia Associated with Granulocytopenia

Aerococcus viridans, a catalase-negative gram-positive coccus rarely causing bacteremia, was isolated from blood cultures of a 52-yr-old man under the gran-ulocytopenic condition. The isolate showed the typical characteristics of A. viridans, i.e., tetrad arrangements in gram stain, positive pyrrolidonyl aminopeptidase (PYR) and negative leucine aminopeptidase (LAP) reactions, and no growth at 45 degrees C.The isolate was revealed to be highly resistant to penicillin, erythromycin, clindamycin, and ceftriaxone, although most strains of A. viridans isolated from the previously reported patients were susceptible to penicillin and other commonly used antibiotics. Even though A. viridans is rarely associated with human infections, it could be a potential causative agent of bacteremia, especially in immunocompromised patients.

A Case Report of Infective Endocarditis that Caused by Gemella Haemolysans in a Patient with Ventricular Septal Defect

Infective endocarditis is the infectious disease that produces vegetation on endocardium. Acute bacterial endocarditis is most frequently caused by Staphylococcus aureus, occurs on a normal heart valve, and subacute endocarditis usually caused by Streptococcus viridans occurs on damaged valves. Gemella haemolysans are gram-positive cocci that is placed in the family Streptococcaceae. As opportunistic pathogen, Gemella haemolysans are able to cause severe localized and generalized infections and it is known that this organism very rarely causes infective endocarditis. The paucity of reports concerning Gemella haemolysans is probably related to the difficulties associated with their identification. Several laboratory tests to prevent misinterpretation of this organism are now suggested. We have experienced a case of infective endocarditis that is caused by Gemella haemolysans in 37 year old male patient with ventricular septal defect. Gemella haemolysans were detected by blood culture and he was treated with intravenous vancomycin with gentamicin and ceftriaxone, and also underwent cardiac surgery. This is the first case of Gemella haemolysans endocarditis of ventricular septal defect in Korea.