Case report of Curtobacterium isolated from a catheter tip sample misidentified as Cronobacter.

The Curtobacterium genus is a member of the family Microbacteriaceae, and Curtobacterium species are recognized as plant pathogens. The aim of this study was to investigate a dubious result of species identification for an infection located on a catheter tip of a patient with Covid-19. A strain isolated from a catheter tip sample, identified by VITEK® 2 as Cronobacter spp., was submitted to polyphasic analysis: Matrix-Assisted Laser Desorption Ionization-Time of Flight Mass Spectrometry (MALDI-TOF MS) using VITEK® MS, real-time polymerase chain reaction targeting dnaG gene, and 16S rRNA full gene Sanger sequencing analysis for confirmation. The strain presented negative result using qPCR and could not identified by MALDI-TOF MS. 16S rRNA full gene Sanger sequencing analysis identified the strain as Curtobacterium spp. The Gram-variable characteristic (Gram-negative instead of Gram-positive) of the isolated strain was the responsible for the misidentification by VITEK® 2 and VITEK® MS did not identify the strain. 16S rRNA full gene sequencing analysis identified the strain as Curtobacterium genus, but other complementary techniques are necessary to identify at species level.

Treatment of keloids and hypertrophic scars. Position statement of the Brazilian expert group GREMCIQ.

Keloids (K) and hypertrophic scars (HS) are abnormal responses to wound healing that occur as the result of dermal inflammation. Despite the advances on their treatment, many patients still suffer from the negative effects of excessive scarring; its approach is impaired by the lack of objective data on different treatments and the large genetic variability among patients and the difficulties in producing multicentre studies. Their incidence among the Brazilian population is high, as the result of an admixture of Amerindians, Europeans and Africans ancestral roots. With the aim of producing multicentre studies on K and HS, a panel of senior Brazilian dermatologists focused on their treatment was invited to contribute with the K and HS Treatment Brazilian Guidelines. In the first part of this study, different treatment modalities for keloids and HS are fully reviewed by the panel. The second part of the study presents a consensus recommendation of treatment for different types of lesions. More than a literature review, this article aims to show the pitfalls and pearls of each therapeutic option, as well as a therapeutic approach by the Panel of Experts on keloids and Scars on a highly mixed population, providing simple guidelines.

Incidence and antimicrobial resistance of enteropathogens isolated from an integrated aquaculture system.

AIMS: To evaluate an integrated aquaculture system, microbiological analyses of water used in this system were carried out and the incidence and antimicrobial resistance of enteropathogens were determined in the related ecosystem. METHODS AND RESULTS: Microbiological analysis was undertaken for Salmonella sp., Shigella sp., Vibrio sp. and Aeromonas sp. The disc-diffusion method was performed according to the Clinical and Laboratory Standards Institute. Water samples tested had 32.9% of faecal coliform rates (≤1600 per 100 ml) in accordance with WHO for pisciculture in wastewater. Salmonella spp. were detected in 14.5% of the samples. From a total of 33 strains, 15.1% were resistant to one or two antimicrobial drugs tested and multidrug resistance was not observed. Aeromonas spp. were identified in 91.6% of the samples. From a total of 416 strains, resistance to one antimicrobial class was observed in 66.3% and multidrug resistance in 37.7%. CONCLUSIONS: This system reflects the community profile, drawing attention to the circulation of pathogens, because the genes coding for resistance to classical antibiotics and broad spectrum are a public health problem. SIGNIFICANCE AND IMPACT OF THE STUDY: The reuse of water resources requires continuous monitoring as the system is subject to treatment failure, which can result in the spread of bacterial pathogens.

The effect of the canal-filled area on the bacterial leakage of oval-shaped canals.

AIM: To compare the sealing ability and the canal-filled area (gutta-percha + sealer) of three current filling techniques in oval-shaped canals. METHODOLOGY: A total of 50 oval-shaped root canals were prepared and root filled as follows: G1: lateral condensation (n = 10), G2: System B (n = 10) and G3: Thermafil system (n = 10). All teeth were mounted in a two-chamber apparatus and the coronal access was exposed to human saliva. The appearance of turbidity in the BHI broth over a 15-week period was observed. A cross section of each tooth was made 5 mm from the apex and the samples were prepared for microscopic analysis. Digital image measurements of the cross-sectional area and the area filled by gutta-percha and sealer were performed. Log-rank and Fisher's exact tests were used to analyse the leakage data. Student's t-test was used to analyse the filled-area data. RESULTS: Overall, 30% of the specimens of G1 and G2 and 20% of G3 demonstrated leakage after 15 weeks and no significant difference was found amongst the groups (P > 0.05). The percentage of canal-filled area was 68, 70 and 78%, respectively (P > 0.05). The correlation analysis revealed no significant relation between the pattern of bacterial leakage and canal-filled area (P = 0.128). CONCLUSIONS: No significant difference in apical sealing and canal-filled area in oval-shaped canals was seen between the three filling techniques. No significant correlation was found between the quality of the apical seal and the filled-area of the root canal space.

Co-site digital optical microscopy and image analysis: an approach to evaluate the process of dentine demineralization.

AIM: To introduce and explore the potential of digital optical co-site microscopy and image analysis for the observation of changes in dentine surfaces during demineralization. The effect of ethylenediamine tetraacetic acid (EDTA) was evaluated quantitatively and longitudinally. METHODOLOGY: Three maxillary human molars were sectioned transversely at the cemento-enamel junction, and the crowns discarded. Subsequently, discs approximately 3 mm thick were cut in the cervical third of the root and a standardized smear layer produced. Co-site image sequences of the dentine surface subjected to 17% EDTA were obtained over the experimental period (15, 30, 60, 180 and 300 s). Sixteen images were obtained in each dentine sample for each experimental time, thus, a total of 48 image fields were obtained. For each field, an image analysis routine automatically discriminated open dentine tubules and measured their number, area fraction and minimum diameter, thus allowing the quantification of the demineralization process. The Student t-test was used to analyse the data. RESULTS: The number of open tubules remained essentially constant during the demineralization process. The area fraction increased from 9% to 32%. Tubule minimum diameter increased from 1.5 to 3.0 microm. The changes over time for the area fraction and minimum diameter were significant for comparison between all experimental times (P<0.05). CONCLUSIONS: The methodology developed for longitudinal observation of dentinal surfaces was fast, robust and reproducible. It could be easily extended to other chelating substances, thus contributing to the understanding of the demineralization process and in establishing an optimal time-effect relationship in the clinical application.

In situ atomic force microscopy and image analysis of dentine submitted to acid etching.

The effect of acid etching on root dentine was analyzed with Atomic Force Microscopy using a liquid cell that allowed image acquisition while the sample was kept in contact with the etching solution. The time evolution of the etching process was evaluated both qualitatively and quantitatively. Image sequences against etching time were obtained showing a clear trend of surface cleaning and opening of dentine tubules. Image analysis methods were employed to quantify the changes on the dentine surface, through the detection and morphological measurement of dentine tubules over time. The measurements indicated an overall increase in the diameter of the tubules against time, with a saturation value between 3.5 and 5.5 microm reached after approximately 300 seconds.

Microbiologic profile of intra-abdominal infections at Belo Horizonte, Brazil.

Intra-abdominal infections (IAIs) represent one of the most common clinical problems in hospital practice, especially in surgical areas and centers of intensive care. The treatment of IAIs generally involves the draining of abscesses and empirical antimicrobial therapy. In this study, among 150 patients suffering from IAI, 106 (70.7%) yielded samples that presented microbial growth. Polyinfection was detected in 51.9% of the cases and varied from 2 to 9 distinct microbes per specimen. The overall mean number of micro-organisms isolated per patient was 2.17. Aerobic bacteria (as strict aerobes and facultative anaerobes), strict anaerobic bacteria, and fungi of the genus Candida represented 93.4%, 30.2%, and 13.2% of the cases positive for micro-organisms, respectively. The most common aerobic bacteria were those of the genera Staphylococcus, Escherichia, Proteus, and Streptococcus. Despite the frequent prior use (52%) with antimicrobials of recognized action against strict anaerobes, these micro-organisms constituted 30.9% of the total isolates, and the most frequently found were of the Bacteroides fragilis group and Prevotella species. The high prevalence of anaerobes in the specimens obtained from IAI demonstrates the need to give greater importance to these micro-organisms by making available material and human resources to carry out culture of the anaerobes as part of routine hospital procedures.

[Dermatophytic pseudomycetoma: report of a case caused by Trichophyton tonsurans]. / Pseudomicetoma dermatofítico: relato de um caso devido a Trichophyton tonsurans.

A case of dermatophytic pseudomycetoma, in a patient with a history of recurrent lesions in the scalp, for over two years, is reported. Histopathological examination of the affected tissues revealed the mycelial aggregates or pseudogranules characteristic of the disease. Cultures of fresh tissues samples detected a fungus identified as Trichophyton tonsurans. Additional examinations failed to demonstrate lesions of tinea capitis, a probable source of the deep infection. Dermatophytic pseudomycetoma is an extremely rare form of dermatophytosis, and the rarity of such cases is the motive for the present communication.

Pseudomicetoma dermatofítico: relato de um caso devido a Trichophyton tonsurans / Dermatophytic pseudomycetoma: report of a case caused by Trichophyton tonsurans

A case of dermatophytic pseudomycetoma, in a patient with a history of recurrent lesions in the scalp, for over two years, is reported. Histopathological examination of the affected tissues revealed the mycelial aggregates or pseudogranules characteristic of the disease. Cultures of fresh tissues samples detected a fungus identified as Trichophyton tonsurans. Additional examinations failed to demonstrate lesions of tinea capitis, a probable source of the deep infection. Dermatophytic pseudomycetoma is an extremely rare form of dermatophytosis, and the rarity of such cases is the motive for the present communication.

É descrito um caso de pseudomicetoma dermatofítico, recidivante, em paciente com lesões no couro cabeludo. O exame histopatológico de uma das lesões mostrou, nos tecidos, os agregados micelianos ou pseudogrânulos, característicos da enfermidade. Dos tecidos frescos de outras lesões foi isolado o dermatófito Trichophyton tonsurans. Exames micológicos adicionais falharam em demonstrar a existência de tinea capitis, possível fonte do pseudomicetoma. A raridade dessa forma de dermatofitose profunda justifica a presente publicação.

Atividade antiinflamatória, antiúlcera gástrica e toxicidade subcrônica do extrato etanólico de própolis / Anti-inflammatory activity, gastric antiulcer and subchronic toxicity of the ethanol extract of propolis

Avaliou-se a atividade antiinflamatória do extrato etanólico de própolis - EEP, . sobre o edema desencadeado por carragenina, dextrana e histamina. O EEP apresentou dose eficaz (DE50) de 650 mg/kg (v.o), inibindo significativamente o processo inflamatório desencadeado pela carragenina, mas não inibiu o produzido por dextrana. O EEP antagonizou ainda o efeito edematogênico produzido por histamina. Nas úlceras produzidas por estresse, o EPP inibiu de forma significativa a geração dos diversos tipos classificados. Em todos os parâmetros analisados no estudo da toxicidade em fase de tratamento subcrônico , (hematológicos, bioquímicos e histopatológicos), o grupo tratado com o EEP não apresentou diferença significativa em relação ao grupo controle. Desta forma, sugere-se que na dose de 650 mg/kg (dose eficaz) não existe a presença de efeitos tóxicos que possam comprometer a utilização deste extrato.

The antlinflammatory activity of Ethanolic Extract of Propolis - EEP was evaluated on edema induced by carrageenan, dextran and hystamine. The inflammatory process induced by carrageenan was significantly reduced by the treatment with EEP (650 mg/kg, p.o), while it did not interfere in the response induced by dextran. The EEP antagonized the edematous effect produced by hystamine. The EEP promoted a significant inhibition in the generation of the ulcers induced by stress (p < 0.05). The hematological, biochemical and histopathological parameters presented no differences between treated and control groups. Therefore it can be concluded that the effective dose of 650 mg/kg of the EEP has no toxic effect which may compromise the use of this extract.

Chronic carriers of hepatitis B surface antigen in an endemic area for shistosomiasis mansoni in Brazil

Data on the association of schistosomiasis and hepatitis B in field-based studies are scarce. Two areas have been selected for this study: i) Queixadinha, endemic for shistosomiasis, with a population of 693 individuals, and ii) Capäo, a control non-endemic area, with 515 inhabitants. Sera of all individuals in both areas were tested for hepatitis B infection, yearly, from 1994 to 1997. In the first area hepatitis B was found in 32.1 per cent of children up to one year old and reached a peak of 68.7 per cent in the age range of 15 to 19 years. In the control area the prevalence of hepatitis B was under 5 per cent up to 19 years of age and the highest prevalence was observed in adults over 45. HBsAg was detected in 9.4 per cent of the individuals living in the endemic area for shistosomiasis and in 1.4 per cent of the controls (OR=4.98; 95 per centCI=3.7-6.7). The index of chronicity of HBsAg was not statistically different in the studied areas (8.1 per cent x 7.3 per cent; OR=1.09; 95 per cent CI=0.42-3.03) nor was it different for people with and without schistosomiasis in Queixadinha (8.7 per cent x 7.0 per cent). We conclude that the Schistosoma mansoni infection has not altered the course of hepatitis B in the studied area.

Chronic carriers of hepatitis B surface antigen in an endemic area for schistosomiasis mansoni in Brazil.

Data on the association of schistosomiasis and hepatitis B in field-based studies are scarce. Two areas have been selected for this study: i) Queixadinha, endemic for schistosomiasis, with a population of 693 individuals, and ii) Capão, a control non-endemic area, with 515 inhabitants. Sera of all individuals in both areas were tested for hepatitis B infection, yearly, from 1994 to 1997. In the first area hepatitis B was found in 32.1% of children up to one year old and reached a peak of 68.7% in the age range of 15 to 19 years. In the control area the prevalence of hepatitis B was under 5% up to 19 years of age and the highest prevalence was observed in adults over 45. HBsAg was detected in 9.4% of the individuals living in the endemic area for schistosomiasis and in 1.4% of the controls (OR = 4.98; 95% CI = 3.7-6.7). The index of chronicity of HBsAg was not statistically different in the studied areas (8.1% x 7.3%; OR = 1.09; 95% CI = 0.42-3.03), nor was it different for people with and without schistosomiasis in Queixadinha (8.7% x 7.0%). We conclude that the Schistosoma mansoni infection has not altered the course of hepatitis B in the studied area.

Open clinical study of the efficacy and safety of terbinafine cream 1% in children with tinea corporis and tinea cruris.

BACKGROUND: Topical application of antifungal agents is considered the treatment of choice for dermatomycoses. Most of the available drugs are fungistatic, requiring long term treatment to prevent relapses. Terbinafine is a synthetic antifungal agent that, because of its fungicidal action, provides high cure rates and low relapse rates after short periods of treatment. METHODS: Ninety-seven children ages 2 to 15 years with a suspected diagnosis of tinea corporis and/or tinea cruris were enrolled in this open trial. After mycologic assessment to confirm diagnosis (culture and direct microscopy) terbinafine 1% cream was applied once daily during 1 week. Clinical and mycologic assessments were made at the baseline visit and on Days 7, 14 and 21. Efficacy assessment was based on 88 children (9 patients excluded by protocol violation). RESULTS: Therapy was considered effective in 92.0% (81 of 88) of patients (complete clinical and mycologic cure or mycologic cure with minimum signs and symptoms or clinical improvement, > or = 50%). Tolerability was assessed in 97 patients on an intention-to-treat basis. Adverse reactions were itching 3% (3 of 97), itching associated with erythema exacerbation 1% (1 of 97) and contact dermatitis 1% (1 of 97). CONCLUSION: Terbinafine 1% cream appears to be an effective and well-tolerated treatment for tinea corporis and tinea cruris in children.