Inquilinus limosus isolated from a patient with chronic cystic fibrosis. First report in Mexico and evidence that co-infection with Pseudomonas aeruginosa promotes the accelerated and increased formation of extracellular neutrophil traps.

Cystic fibrosis is characterized by abnormal mucous secretions in the lungs that favor the proliferation of colonizing bacteria, with Pseudomonas aeruginosa and Staphylococcus aureus being the most isolated, however, other less known species could also have an impact on the health of the patient. Here we demonstrate the isolation and antibiotic resistance profiles of Inquilinus limosus, a rarely reported multidrug resistant bacterium, and compare them to a co-infectant strain of Pseudomonas aeruginosa. Likewise, we found that co-infection with both bacteria promotes increased formation of neutrophil extracellular traps, which can have an impact on the disease severity and make treatment difficult.

Pseudomonas aeruginosa isolates from cystic fibrosis patients induce neutrophil extracellular traps with different morphologies that could correlate with their disease severity.

Cystic fibrosis (CF) is a disease characterized by bacterial chronic infection of the respiratory tract and inflammation, which leads to a progressive decrease in lung function. Pseudomonas aeruginosa is commonly isolated from the sputum of patients and their presence is associated with a predominant airway inflammation with neutrophils, causing chronic colonization and higher mortality rates. Neutrophil extracellular traps (NETs) have been observed in response against Pseudomonas, however, these cannot eliminate the pathogen from the respiratory tract, so one possibility is that the bacteria could promote their production to use them as a scaffold to colonize the lungs and as a nutrient source, however, their overproduction could also lead to increased damage to the lungs. In this work, we evaluated NETs formation by Pseudomonas clinical isolates obtained from CF patients and found that these induced NETs formation with globular or spread morphologies, of note, we found that there is a trend by which the spread forms were induced mainly by isolates obtained from patients with severe disease, whereas, the globular morphologies were observed for isolates obtained from patients with mild/moderate disease. Finally, we screened for bacterial molecules implicated in NETs formation and found that Exotoxin S, pyocin S2 and pyoverdine could participate in the process.

[Syndrome of vertebral destruction: understanding to practice]. / Síndrome de destrucción vertebral: del entendimiento a la práctica.

The term «vertebral destruction syndrome¼ comprises pathologies causing structural changes in the spine, mainly in the vertebral body, producing mechanical deformity and neurological involvement. The pathologies found in this definition may be infectious, metabolic or tumoral. Vertebral osteomyelitis is a disease that occurs mainly in adults > 50 years; we speak of spondylodiscitis when the condition affects the disc and vertebral body. The most important organism in vertebral osteomyelitis is Staphylococcus aureus, seen in over 50% of cases. Tumors of the spine can start from local or adjacent spinal injuries or distant ones, and spread through the blood or lymphatic system. Metastases account for about 97% of all tumors of the spine. Primary tumors that most commonly spread to the spine are lung, prostate, breast and kidney. Metabolic bone diseases are a group of disorders that occur as a result of changes in the calcium metabolism. The spine contains large amounts of metabolically active cancellous bone, which must withstand axial loads during stance. Osteoporosis is a metabolic disease that most commonly affects the spine; it is characterized by low bone mass. The diagnosis of these entities is important for the treatment and prognosis of the patient. The term «vertebral destruction syndrome¼ proposes a notarized scheme aimed at improving the patients prognosis and his/her prompt treatment.

El término «síndrome de destrucción vertebral¼ engloba patologías que causan alteraciones estructurales en la columna en particular, en el cuerpo vertebral, produciendo deformidad con afectación neurológica y/o mecánica. Dentro de las patologías que se encuentran en esta definición están la infecciosa, tumoral y metabólica. La osteomielitis vertebral es una enfermedad que se da sobre todo en adultos > 50 años; se habla de espondilodiscitis cuando hay afección del disco y cuerpo vertebral. El más importante organismo en la osteomielitis vertebral es el Staphylococcus aureus, visto en más de 50% de los casos. Los tumores de la columna vertebral pueden iniciar desde lesiones locales o adyacentes a la columna o a distancia, diseminados por vía hematógena o linfática; las lesiones por metástasis abarcan cerca de 97% de todos los tumores de la columna. Los tumores primarios que con mayor frecuencia se diseminan a columna vertebral son pulmonar, de próstata, mama y riñón. Las enfermedades metabólicas óseas son un grupo de desórdenes que ocurren como resultado de cambios en el metabolismo del calcio. La columna vertebral contiene grandes cantidades de hueso esponjoso metabólicamente activo que debe resistir cargas axiales durante la postura. La osteoporosis es la enfermedad metabólica que con más frecuencia afecta la columna vertebral; se caracteriza por disminución en la masa ósea. El diagnóstico de estas entidades es importante para el tratamiento y pronóstico del paciente; el término «síndrome de destrucción vertebral¼ propone un esquema protocolizado encaminado a mejorar el pronóstico del paciente, así como su pronto tratamiento.