Ameliorative Effects of Larazotide Acetate on Intestinal Permeability and Bacterial Translocation in Acute Pancreatitis Model in Rats.

BACKGROUND: Intestinal barrier dysfunction in acute pancreatitis (AP) may progress to systemic inflammatory response syndrome (SIRS) and multi-organ failures by causing bacterial translocation. Larazotide acetate (LA) is a molecule that acts as a tight junction (TJ) regulator by blocking zonulin (Zo) receptors in the intestine. AIMS: In our study, we aimed to investigate the effects of LA on intestinal barrier dysfunction and bacterial translocation in the AP model in rats. METHODS: Thirty-two male Sprague-Dawley rats were divided into 4 groups; control, larazotide (LAR), AP, and AP + LAR. The AP model was created by administering 250 mg/100 g bm L-Arginine intraperitoneally 2 times with an hour interval. AP + LAR group received prophylactic 0.01 mg/mL LA orally for 7 days before the first dose of L-Arginine. For intestinal permeability analysis, fluorescein isothiocyanate-dextran (FITC-Dextran) was applied to rats by gavage. The positivity of any of the liver, small intestine mesentery, and spleen cultures were defined as bacterial translocation. Histopathologically damage and zonulin immunoreactivity in the intestine were investigated. RESULTS: Compared to the control group, the intestinal damage scores, anti-Zo-1 immunoreactivity H-Score, serum FITC-Dextran levels and bacterial translocation frequency (100% versus 0%) in the AP group were significantly higher (all p < 0.01). Intestinal damage scores, anti-Zo-1 immunoreactivity H-score, serum FITC-Dextran levels, and bacterial translocation frequency (50% versus 100%) were significantly lower in the AP + LAR group compared to the AP group (all p < 0.01). CONCLUSIONS: Our findings show that LA reduces the increased intestinal permeability and intestinal damage by its effect on Zo in the AP model in rats, and decreases the frequency of bacterial translocation as a result of these positive effects.

Evaluation of the effects of mono or combined use of topical antiglaucomatous drops on conjunctival flora and antibiotic susceptibility.

PURPOSE: To evaluate the effects of mono or combined use of topical antiglaucomatous drops (AGD) on conjunctival flora and antibiotic susceptibility. METHODS: The study group consisting of 84 glaucoma patients using AGDs and 32 healthy controls were evaluated. Groups were formed according to the use of 1, 2 and 3 AGDs. A swab was taken from the conjunctival sac from each patient and cultures were made. Patients with conjunctival hyperemia were classified according to their appearance. RESULTS: The mean age was 58.61 ± 14.55 years. Conjunctival culture positivity was 84.37%, 89.28% and 90.6% according to the use of 1, 2, and 3 AGDs, respectively, and it was 93.75% in the control group. Staphylococcus hominis (S. hominis) was statistically significantly higher in all glaucoma patients compared to healthy volunteers (p = .030). S. hominis was significantly higher especially in those using 2 (42.85%) and 3 (50%) AGDs, compared to those who received mono treatment (31.25%). Candida spp. was also significantly higher in glaucoma patients (p = .039). In patients with conjunctival hyperemia in glaucoma patients, the most common two bacteria were S. hominis (55.5%) and Staphylococcus epidermidis (S. epidermidis) (33%), respectively. In the relationship between isolated bacterial species and conjunctival hyperemia grades, Bacillus spp. (p = .013) was statistically significant.In glaucoma patients, norfloxacin and erythromycin resistance were found to be statistically significantly higher compared to the control group (p = .01). CONCLUSION: Considering the statistically significant increase in isolates in all glaucoma patients, we suggest that more care should be taken in terms of infection in surgical procedures planned for glaucoma patients.

Evaluation of Aerobic Conjunctival Flora in Patients with Demodex Blepharitis

Objective: Demodex species are frequently found in blepharitis cases. This study aimed to compare the conjunctival flora of eyes with Demodex-positive blepharitis and Demodex-negative blepharitis with healthy individuals. Methods: Eyelash epilation was performed to detect Demodex from 44 eyes of 44 patients with chronic blepharitis and 44 eyes of 44 healthy controls and examined under a microscope. A conjunctival swab was taken from the same eye and inoculated on eosin methylene blue agar, Sabouraud dextrose agar, chocolate agar, and 5% sheep blood agar. Aerobic conjunctival flora was evaluated among Demodex-positive blepharitis, Demodex-negative blepharitis and healthy eyes. Results: Demodex spp. was detected in 3 (6.8%) of 44 healthy controls and 24 (54.5%) of 44 patients with blepharitis. The most frequently isolated bacteria in healthy controls were coagulase-negative Staphylococci (CNS) spp. (n=32, 72.7%), Streptococcus spp. (n=16, 36.4%), Corynebacterium spp. (n=13, 29.5%). The most frequently isolated bacteria in Demodex-positive blepharitis were CNS spp. (n=14, 58.3%), Staphylococcus aureus (n=11, 45.8%), Corynebacterium spp. (n=7, 29.2%). In Demodex-negative blepharitis, CNS (n=10, 50.0%), S. aureus (n=10, 50.0%), Corynebacterium spp. (n=5, 25.0%) were most commonly isolated. S. aureus growth was significantly increased in the Demodex negative and positive blepharitis groups compared with the healthy group (p=0.001 and p=0.002, respectively). Although CNS spp. growth decreased in both groups with Demodex-negative and positive blepharitis compared with the healthy group; the decrease was significant only in those with Demodex-negative blepharitis (p=0.045). In terms of other bacterial growth, there was no significant difference between healthy eyes and Demodex positive and negative eyes with blepharitis. Conclusion: We found that Demodex blepharitis has no significant effect on conjunctival flora. Blepharitis itself may be the main factor in changes in the conjunctival flora.

The Impact of COVID-19 on Conjunctival Flora.

Purpose: This study aims to evaluate the effect of coronavirus disease 2019 (COVID-19) on conjunctival flora in patients hospitalized with COVID-19.Methods: This prospective, controlled study was conducted between June 2020 and December 2020. The study group consisted of 45 confirmed COVID-19 patients and 43 control subjects. The collected samples were inoculated into the Thioglycollate broth media without delay. The samples with growth were then passed on eosin methylene blue agar, sabouraud dextrose agar, chocolate agar, and 5% sheep blood agar solid media.Results: The mean age of the COVID-19 patients was 64.24 ± 15.4 years, and the control subjects were 59.72 ± 11.4 years. The culture positivity of conjunctiva samples in COVID-19 patients (95.6%) was statistically significantly higher than control subjects (76.7%) (p = .024). Coagulase-negative staphylococcus and Staphylococcus aureus' positivity was significantly higher in COVID-19 patients than control subjects (p < .05).Conclusion: Patients with COVID-19 demonstrate significantly higher culture positivity on conjunctival flora than the control subjects.

Investigation of SARS-CoV-2 RNA in milk produced by women with COVID-19 and follow-up of their infants: A preliminary study.

OBJECTIVES: Studies have shown that severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is primarily transmitted from person to person via airborne droplets. It is unclear whether it can be shed into human milk and transmitted to a child via breastfeeding. We investigated the presence of SARS-CoV-2 RNA in human milk samples of 15 mothers with coronavirus disease 19 (COVID-19) and in the throat swab samples of their infants. METHODS: This is a prospective observational study in which breast milk samples were collected from 15 mothers with COVID-19. The presence of SARS-CoV-2 RNA in the whole human milk samples of the patients was investigated using RT-qPCR. All of the infants underwent a clinical follow-up during their 14-day isolation and their throat swab samples were tested for SARS-CoV-2 RNA. RESULTS: Of 15 mothers with COVID-19, SARS-CoV-2 RNA was detected in milk samples from 4 mothers. The throat swab samples from these mothers' infants were found to be positive for SARS-CoV-2 RNA. Three of the four mothers were breastfeeding. In addition, during the 14-day isolation, all but three of the mothers breastfed their infants. Of the 12 breastfed infants, while the test for SARS-CoV-2 RNA in throat swab samples was negative in 6 of the infants, the other 6 infants, who had mild COVID-19 symptoms, tested positive for SARS-CoV-2 RNA. Clinical outcomes of all mothers and infants were uneventful. CONCLUSION: To our knowledge, this is the first case series with the largest number of cases with SARS-CoV-2 RNA positivity in human milk samples of mothers with COVID-19. However, we believe that the benefits of breastfeeding may outweigh the risk of SARS-CoV-2 infection in infants.

Comparison of the simultaneous conjunctiva and oropharynx-nasopharynx swab results in patients applying to the SARS-CoV-2 outpatient clinic for the first time.

The aim is to comparatively evaluate the results of simultaneous conjunctiva and oropharynx-nasopharynx (ONP) swabs in patients who had presented to the outpatient department with a suspicion of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). An ONP sample was obtained following bilateral conjunctiva swabs in 85 subjects with a contact history or symptoms but unknown SARS-CoV-2 status and with no ocular symptoms or findings. The results were evaluated according to the patient's symptoms and how the swab was taken. The conjunctiva swab was positive in 29 (34.1%) cases and the ONP swab in 20 (23.5%) cases. Both methods produced positive results in 11 (14.1%) cases. The mean cycle threshold (Ct ) value was 30.15 ± 3.41 in symptomatic cases and 33.62 ± 1.76 in asymptomatic cases (p = .008). The mean Ct value was 24.37 ± 3.48 when only the ONP swab was positive and 31.22 ± 1.99 when only the conjunctiva swab was positive. In cases that were positive by both methods, the mean Ct value was 25.21 ± 4.94 for the ONP swab and 30.29 ± 5.05 for the conjunctiva swab. We found higher SARS-CoV-2 detection rates with the conjunctiva swab than the ONP swab in cases with unknown SARS-CoV-2 status in the early period. In addition, the conjunctival viral load seemed to be higher in symptomatic cases than in asymptomatic cases. We, therefore, believe a conjunctiva swab could be an alternative method to detect SARS-CoV-2 at the time of the first presentation to the outpatient department.

The Influence of Corneal Collagen Crosslinking on Conjunctival Flora.

PURPOSE: To investigate the influence of corneal collagen crosslinking (CXL) on conjunctival flora. MATERIALS AND METHODS: Included in this study were 42 patients, all of whom were treated with CXL for progressive keratoconus (KC). Conjunctival swab samples were collected under operating-room conditions immediately before and immediately after the procedure. Samples were quickly immersed in Amies Transport Medium (ATM), transferred to the microbiology laboratory, diluted, and inoculated into three areas each of blood agar, chocolate agar, eosin methylene blue (EMB) agar, and Saboraud-Dextrose agar plates. Inoculated plates were incubated at 35°C for 24-48 h. Preliminary species identification of isolated bacterial colonies was based on catalase and oxidase tests, Gram staining, and colony morphology. Definitive identification of isolates was made with Vitek-II fully automated identification kits. RESULTS: Cultures were positive in 24 (57.1%) preoperative and 10 (23.8%) postoperative samples (p ˂ 0.05). Microorganisms isolated from preoperative conjunctival samples included coagulase-negative Staphylococcus (CNS) spp. in 23 (54.8%) samples, S. aureus in three (7.1%), Moraxella spp. in two (4.8%), Streptococcus spp. in three (7.1%), Corynebacterium spp, in one (2.4%), Micrococcus spp. in one (2.4%), and Candida spp. in one (2.4%). Microorganisms isolated from postoperative conjunctival samples included CNS spp. in nine (21.4%) samples, S. aureus in one (2.4%), Corynebacterium spp. in two (4.8%), and Acinetobacter spp. in one (2.4%). CONCLUSIONS: CXL appears to have a significant impact on conjunctiva flora.

The conjunctival flora in vernal conjunctivitis patients.

We investigated conjunctival flora changes in vernal conjunctivitis (VC) (n = 30) patients compared to the normal eye (n = 30). Growth was observed in 86.6% of the vernal group, and 80% of the control group specimens. We believe that administering prophylactic treatment would be helpful in VC patients who are to have intraocular surgery to prevent postoperative endophthalmitis.

Conjunctival flora in Behçet patients.

BACKGROUND: To determine the difference in conjunctival flora in Behçet patients compared with the normal population. METHODS: This study was carried out on a study group of 50 patients in the inactive period of Behçet's disease and a control group of 50 age- and sex-matched healthy subjects with no systemic or ocular disease. A swab was taken from the lower fornix using a sterile swab and inoculated into bloody eosin methylene blue, chocolate, and Sabouraud dextrose agar media. RESULTS: The mean age was 36.04 (SD 2.16) years for the Behçet group and 35.64 (SD 1.96) years for the control group. Bacterial growth was observed in 92% (n = 46) of the Behçet group and 56% (n = 29) of the control group. The Behçet group results were Staphylococcus aureus in 12 (24%), coagulase negative staphylococci (CNS) in 32 (64%), Moraxella spp in 8 (16%), Streptococcus spp in 8 (16%), Bacillus spp in 4 (8%), Neisseria spp in 4 (8%), Candida spp in 3 (6%), and Haemophilus spp in 1 (2%). In the control group, the results were S. aureus in 2 (4%), CNS in 24 (48%), Moraxella spp in 2 (4%), Streptococcus spp in 1 (2%), Bacillus spp in 3 (6%), Neisseria spp in 3 (6%), and Candida spp in 1 (2%). INTERPRETATION: S. aureus, Moraxella spp, and Streptococcus spp colonization was significantly higher in the conjunctival flora of Behçet patients than in that of the control group. A bacterial etiology may be involved in the pathogenesis of Behçet's disease.