Prevalence and antimicrobial susceptibility of Streptococcus equi isolated from horses in Santa Catarina state, Southern Brazil.

The objective of this study was to determine the prevalence of Streptococcus equi (S. equi subsp equi and S. equi subsp zooepidemicus) in the state of Santa Catarina and evaluate the antimicrobial susceptibility of the isolates. For this, 420 nasal swab samples were collected from randomly selected horses. Isolation and phenotypic characterization of the bacteria were performed by sowing on 5% sheep blood agar, followed by analysis of morphotinctorial characteristics and biochemical analysis. To differentiate the main beta-hemolytic Streptococcus in horses, the fermentation profiles of the sugar's lactose, maltose, sorbitol, and trehalose were used, which were confirmed at the subspecies level by the PCR technique. The antimicrobial susceptibility panel was defined by the disk diffusion method, testing 13 antimicrobials from ten different classes, all regularly used in equine medical clinics, followed by the calculation of the multiple antimicrobial resistance index. Ten strains of S. equi were isolated, with a prevalence of 2.38% (10/420). Of the total positive samples, 3% (3/10) were confirmed as belonging to S. equi subsp equi and 70% (7/10) were confirmed as belonging to S. zooepidemicus. Multidrug resistance was observed in 60% (6/10) of isolates. The antimicrobial with the greatest resistance was clindamycin with 70% (7/10), followed by beta-lactams, with 40% (4/10) resistance to penicillin and 30% (3/10) to ceftiofur. The isolates were 100% (10/10) sensitive to gentamicin, chloramphenicol, levofloxacin, and vancomycin. This was the first study carried out in the state, and based on these data, it can be said that Santa Catarina has a low prevalence of S. equi and the presence of multi-resistant strains of S. equi was confirmed in the equine herd in Santa Catarina.

Shedding reduction and immunity modulation in piglets with an inactivated Mycoplasma hyopneumoniae vaccine encapsulated in nanostructured SBA-15 silica.

Mycoplasma (M.) hyopneumoniae is a primary etiological agent of porcine enzootic pneumonia (PEP), a disease that causes significant economic losses to pig farming worldwide. Current commercial M. hyopneumoniae vaccines induce partial protection, decline in preventing transmission of this pathogen or inducing complete immunity, evidencing the need for improving vaccines against PEP. In our study, we aimed to test the effectiveness of the SBA-15 ordered mesoporous silica nanostructured particles as an immune adjuvant of a vaccine composed of M. hyopneumoniae strain 232 proteins encapsulated in SBA-15 and administered by intramuscular route in piglets to evaluate the immune responses and immune-protection against challenge. Forty-eight 24-day-old M. hyopneumoniae-free piglets were divided into four experimental groups with different protocols, encompassing a commercial vaccine against M. hyopneumoniae, SBA-15 vaccine, SBA-15 adjuvant without antigens and a non-immunized group. All piglets were challenged with the virulent strain 232 of M. hyopneumoniae. Piglets that received the SBA-15 and commercial vaccine presented marked immune responses characterized by anti-M. hyopneumoniae IgA and IgG antibodies in serum, anti-M. hyopneumoniae IgA antibodies in nasal mucosa and showed an upregulation of IL-17 and IL-4 cytokines and downregulation of IFN-γ in lungs 35 days post-infection. Piglets immunized with SBA-15 vaccine presented a reduction of bacterial shedding compared to piglets immunized with a commercial bacterin. In addition, piglets from SBA-15 adjuvant suspension group presented increased IL-17 gene expression in the lungs without involvement of Th1 and Th2 responses after challenge. These results indicated that SBA-15 vaccine induced both humoral and cell-mediated responses in the upper respiratory tract and lungs, first site of replication and provided protection against M. hyopneumoniae infection with a homologous strain with reduction of lung lesions and bacterial shedding. Finally, these results enhance the potential use of new technologies such as nanostructured particles applied in vaccines for the pig farming industry.

Shedding reduction and immunity modulation in piglets with an inactivated Mycoplasma hyopneumoniae vaccine encapsulated in nanostructured SBA-15 silica

Mycoplasma (M.) hyopneumoniae is a primary etiological agent of porcine enzootic pneumonia (PEP), a disease that causes significant economic losses to pig farming worldwide. Current commercial M. hyopneumoniae vaccines induce partial protection, decline in preventing transmission of this pathogen or inducing complete immunity, evidencing the need for improving vaccines against PEP. In our study, we aimed to test the effectiveness of the SBA-15 ordered mesoporous silica nanostructured particles as an immune adjuvant of a vaccine composed of M. hyopneumoniae strain 232 proteins encapsulated in SBA-15 and administered by intramuscular route in piglets to evaluate the immune responses and immune-protection against challenge. Forty-eight 24-day-old M. hyopneumoniae-free piglets were divided into four experimental groups with different protocols, encompassing a commercial vaccine against M. hyopneumoniae, SBA-15 vaccine, SBA-15 adjuvant without antigens and a non-immunized group. All piglets were challenged with the virulent strain 232 of M. hyopneumoniae. Piglets that received the SBA-15 and commercial vaccine presented marked immune responses characterized by anti-M. hyopneumoniae IgA and IgG antibodies in serum, anti-M. hyopneumoniae IgA antibodies in nasal mucosa and showed an upregulation of IL-17 and IL-4 cytokines and downregulation of IFN-γ in lungs 35 days post-infection. Piglets immunized with SBA-15 vaccine presented a reduction of bacterial shedding compared to piglets immunized with a commercial bacterin. In addition, piglets from SBA-15 adjuvant suspension group presented increased IL-17 gene expression in the lungs without involvement of Th1 and Th2 responses after challenge. These results indicated that SBA-15 vaccine induced both humoral and cell-mediated responses in the upper respiratory tract and lungs, first site of replication and provided protection against M. hyopneumoniae infection with a homologous strain with reduction of lung lesions and bacterial shedding. Finally, these results enhance the potential use of new technologies such as nanostructured particles applied in vaccines for the pig farming industry.

Characterization of the upper respiratory tract microbiota in Chilean asthmatic children reveals compositional, functional, and structural differences.

Around 155 million people worldwide suffer from asthma. In Chile, the prevalence of this disease in children is around 15% and has a high impact in the health system. Studies suggest that asthma is caused by multiple factors, including host genetics, antibiotic use, and the development of the airway microbiota. Here, we used 16S rRNA high-throughput sequencing to characterize the nasal and oral mucosae of 63 asthmatic and 89 healthy children (152 samples) from Santiago, Chile. We found that the nasal mucosa was dominated by a high abundance of Moraxella, Dolosigranulum, Haemophilus, Corynebacterium, Streptococcus, and Staphylococcus. In turn, the oral mucosa was characterized by a high abundance of Streptococcus, Haemophilus, Gemella, Veillonella, Neisseria, and Porphyromonas. Our results showed significantly (P < 0.001) lower alpha diversity and an over-abundance of Streptococcus (P < 0.01) in nasal samples from asthmatics compared to samples from healthy subjects. Community structure, as revealed by co-occurrence networks, showed different microbial interactions in asthmatic and healthy subjects, particularly in the nasal microbiota. The networks revealed keystone genera in each body site, including Prevotella, Leptotrichia, and Porphyromonas in the nasal microbiota, and Streptococcus, Granulicatella, and Veillonella in the oral microbiota. We also detected 51 functional pathways differentially abundant on the nasal mucosa of asthmatic subjects, although only 13 pathways were overrepresented in the asthmatic subjects (P < 0.05). We did not find any significant differences in microbial taxonomic (composition and structure) and functional diversity between the oral mucosa of asthmatic and healthy subjects. This study explores for the first time the relationships between the upper respiratory airways bacteriome and asthma in Chile. It demonstrates that the nasal cavity of children from Santiago harbors unique bacterial communities and identifies potential taxonomic and functional biomarkers of pediatric asthma.

Microbiota Profile of the Nasal Cavity According to Lifestyles in Healthy Adults in Santiago, Chile.

BACKGROUND: The respiratory microbiome is dynamic, varying between anatomical niches, and it is affected by various host and environmental factors, one of which is lifestyle. Few studies have characterized the upper respiratory tract microbiome profile according to lifestyle. We explored the association between lifestyles and microbiota profiles in the upper respiratory tract of healthy adults. METHODS: We analyzed nasal samples from 110 healthy adults who were living in Santiago, Chile, using 16S ribosomal RNA gene-sequencing methods. Volunteers completed a structured questionnaire about lifestyle. RESULTS: The composition and abundance of taxonomic groups varied across lifestyle attributes. Additionally, multivariate models suggested that alpha diversity varied in the function of physical activity, nutritional status, smoking, and the interaction between nutritional status and smoking, although the significant impact of those variables varied between women and men. Although physical activity and nutritional status were significantly associated with all indexes of alpha diversity among women, the diversity of microbiota among men was associated with smoking and the interaction between nutritional status and smoking. CONCLUSIONS: The alpha diversity of nasal microbiota is associated with lifestyle attributes, but these associations depend on sex and nutritional status. Our results suggest that future studies of the airway microbiome may provide a better resolution if data are stratified for differences in sex and nutritional status.

Culturable Microbial Population From the Upper Respiratory Tract of 1,010 Clinically Healthy Horses in Southern Brazil.

Microbiological diagnosis of equine respiratory infections is essential for disease management. However, reliable diagnosis can be a challenge due to colonization of the upper respiratory tract (URT) by a diverse microbial population, and because there is a lack of studies with samples from healthy animals. Aiming to guide adequate URT culture, this work reports culturable microbial population from the URT of 1,010 apparently healthy horses from 341 farms in Southern Brazil and identifies the putative presence of pathogenic microorganisms. Nasal swabs were cultured in 5% blood agar, and the isolates were phenotypically identified to genus level. A diverse respiratory microbial population was found, mostly composed of Gram-positive bacteria, including Staphylococcus spp., Bacillus spp., Streptococcus spp. and Corynebacterium spp. The microbiological profile from the nasal cavity of 911 horses was described, with the five most common profiles being: (1) Staphylococcus sp. + Gram-negative bacilli (12.67%), (2) Staphylococcus sp. in pure culture (12.47%), (3) Staphylococcus sp. + Bacillus sp. (10.10%), (4) Gram-negative bacilli in pure culture (6.93%), and (5) Staphylococcus sp. + Bacillus sp. + Gram-negative bacilli (6.73%). Streptococcus equi equi and Rhodococcus equi were detected in 34 horses (3.37%), demonstrating the presence of pathogenic bacteria along with commensal microorganisms in apparently healthy animals. The disclosed data may guide and facilitate microbiological diagnosis of URT infection in horses. The significant presence of Gram-negative bacilli was evidenced, as well as the occurrence of relevant pathogens, such as S. equi equi and R. equi, thus helping to improve diagnosis and antimicrobial therapy.

The Respiratory Commensal Bacterium Dolosigranulum pigrum 040417 Improves the Innate Immune Response to Streptococcus pneumoniae.

Previously, we demonstrated that the nasal administration of Dolosigranulum pigrum 040417 differentially modulated the respiratory innate immune response triggered by the activation of Toll-like receptor 2 in infant mice. In this work, we aimed to evaluate the beneficial effects of D. pigrum 040417 in the context of Streptococcus pneumoniae infection and characterize the role of alveolar macrophages (AMs) in the immunomodulatory properties of this respiratory commensal bacterium. The nasal administration of D. pigrum 040417 to infant mice significantly increased their resistance to pneumococcal infection, differentially modulated respiratory cytokines production, and reduced lung injuries. These effects were associated to the ability of the 040417 strain to modulate AMs function. Depletion of AMs significantly reduced the capacity of the 040417 strain to improve both the reduction of pathogen loads and the protection against lung tissue damage. We also demonstrated that the immunomodulatory properties of D. pigrum are strain-specific, as D. pigrum 030918 was not able to modulate respiratory immunity or to increase the resistance of mice to an S. pneumoniae infection. These findings enhanced our knowledge regarding the immunological mechanisms involved in modulation of respiratory immunity induced by beneficial respiratory commensal bacteria and suggested that particular strains could be used as next-generation probiotics.

Investigation of Feline calicivirus infection in cats with upper respiratory tract disease in Diyarbakir, Turkey / Investigação de infecção por calicivírus felino em gatos com doença do trato respiratório superior na região de Diyarbakir, Turquia

Feline calicivirus is among the most common pathogenic microorganisms in upper respiratory tract disease (URTD) and oral lesions of cats. It leads to stomatitis, oral ulceration, ocular and nasal discharge, conjunctivitis, fever, lameness, anorexia, hypersalivation, pneumonia, respiratory distress, coughing, and depression in infected cats. This study aimed to determine the role of Feline calicivirus (FCV) in cats with the upper respiratory tract disease in the Diyarbakir region, Turkey, to provide treatment for infected cats and contribute to the disease prophylaxis. The study material consisted of 10 cats (control group) considered to be healthy according to the clinical examination and 20 cats with URTD that were not vaccinated against Feline calicivirus infection of different breeds, ages, and genders brought to Dicle University Veterinary Faculty Prof. Dr. Servet SEKIN Polyclinic with URTD. After routine clinical examinations of the animals, oral and conjunctival swabs and blood samples were taken. Hematological and biochemical analyzes of blood samples were performed. Swab samples were analyzed by the polymerase chain reaction (PCR) method for the diagnosis of the agent. Oral lesions, hypersalivation, ocular and nasal discharge, coughing, and breathing difficulties were seen in clinical examinations of cats with URTD. Feline calicivirus was detected in only one cat's conjunctival swab sample in PCR analyses. As a result, we found that Feline calicivirus infection was present in cats with URTD in the Diyarbakir region, and 5% positivity was found in cats with clinical symptoms according to PCR analysis.(AU)

O calicivírus felino está entre os microrganismos patogênicos mais comuns nas doenças do trato respiratório superior de gatos, determinando estomatites, ulcerações orais, descarga ocular e nasal, conjuntivite, febre, manqueira, anorexia, hipersalivação, pneumonia, distúrbios respiratórios, tosse e depressão. O presente trabalho foi delineado para determinar o papel do calicivírus felino (CVF) em gatos com doenças do trato respiratório superior na região de Diyarbakir, Turquia. Com o objetivo de orientar a prescrição do tratamento para os gatos infectados e contribuir com a profilaxia da doença. O material de estudo consistiu em 10 gatos saudáveis sem qualquer problema de saúde e 20 gatos acometidos por doenças do trato respiratório superior que não haviam sido vacinados contra a infecção pelo calicivírus felino. Os animais de diferentes raças, idades e gêneros foram encaminhados para a Universidade de Dicle, na Faculdade de Veterinária, na policlínica Professor Dr. Servet Sekin. Após o exame clínico de rotina dos animais, foram colhidos swabs orais e da conjuntiva e amostras de sangue. Análises hematológicas e bioquímicas das amostras de sangue foram realizadas e os swabs foram analisados pelo método da reação em cadeia pela polimerase (PCR) para diagnóstico do agente. Nos gatos infectados foram constatadas: lesões orais, hipersalivação, descargas oculares e nasais, tosse e dificuldade respiratória. O calicivírus felino foi detectado pela técnica de PCR no swab conjuntival de apenas um gato. A conclusão obtida foi que a infecção pelo calicivírus felino foi detectada pela técnica de PCR na região de Diyarbakir, Turquia, em gatos com doença do trato respiratório superior com a frequência de 5%.(AU)

Erratum: Investigation of Feline calicivirus infection in cats with upper respiratory tract disease in Diyarbakir, Turkey / Errata: Investigação de infecção por calicivírus felino em gatos com doença do trato respiratório superior na região de Diyarbakir, Turquia

Feline calicivirus is among the most common pathogenic microorganisms in upper respiratory tract disease (URTD) and oral lesions of cats. It leads to stomatitis, oral ulceration, ocular and nasal discharge, conjunctivitis, fever, lameness, anorexia, hypersalivation, pneumonia, respiratory distress, coughing, and depression in infected cats. This study aimed to determine the role of Feline calicivirus (FCV) in cats with the upper respiratory tract disease in the Diyarbakir region, Turkey, to provide treatment for infected cats and contribute to the disease prophylaxis. The study material consisted of 10 cats (control group) considered to be healthy according to the clinical examination and 20 cats with URTD that were not vaccinated against Feline calicivirus infection of different breeds, ages, and genders brought to Dicle University Veterinary Faculty Prof. Dr. Servet SEKIN Polyclinic with URTD. After routine clinical examinations of the animals, oral and conjunctival swabs and blood samples were taken. Hematological and biochemical analyzes of blood samples were performed. Swab samples were analyzed by the polymerase chain reaction (PCR) method for the diagnosis of the agent. Oral lesions, hypersalivation, ocular and nasal discharge, coughing, and breathing difficulties were seen in clinical examinations of cats with URTD. Feline calicivirus was detected in only one cat's conj

O calicivirus felino está entre os microrganismos patogênicos mais comuns nas doençcas do trato respiratório superior de gatos, determinando estomatites, ulcerações orais, descarga ocular e nasal, conjuntivite, febre, manqueira, anorexia, hipersalivação, peneumoria, distúrbios respiratórios, tosse e depressão.  O presente trabalho foi delineado paras determinar o papel do calicivirus felino (CVF) em gatos com doenças do trato respiratório superior na região de Diyarbakir, Turquia.para orientar a precrição do tratamento para os gatos infectados e contribuir para a profilaxia da doença. O material de estudo consistiu em 10 gatos saudáveis sem qualquer problema de saúde e 20 gatos acometidos por doenças do trato respiratório superior que não haviam sido vacinados contra a infecção pelo calicivirus felino, de diferentes raças, idades e gêneros encaminhados para a Universidade de Dicle, Faculdade de Veterinária, policlínica do Prof. Dr. Servet SEKIN,. Após o exame clínico de rotina dos animais foram colhidos swabes orais e da conjuntiva e amostras de sangue. Foram realizadas as análises hematológias e bioquímicas das amostras de sangue e os swabs foram analisados pelo método da reação em cadeia pela polimerase (PCR) para diagnóstico do agente. Nos gatos infectados foram constatadas: lesões orais, hipersalivação, discargas oculares e nasais, tosse e dificuldade respiratória.

Investigation of Feline calicivirus infection in cats with upper respiratory tract disease in Diyarbakir, Turkey / Investigação de infecção por calicivírus felino em gatos com doença do trato respiratório superior na região de Diyarbakir, Turquia

Feline calicivirus is among the most common pathogenic microorganisms in upper respiratory tract disease (URTD) and oral lesions of cats. It leads to stomatitis, oral ulceration, ocular and nasal discharge, conjunctivitis, fever, lameness, anorexia, hypersalivation, pneumonia, respiratory distress, coughing, and depression in infected cats. This study aimed to determine the role of Feline calicivirus (FCV) in cats with the upper respiratory tract disease in the Diyarbakir region, Turkey, to provide treatment for infected cats and contribute to the disease prophylaxis. The study material consisted of 10 cats (control group) considered to be healthy according to the clinical examination and 20 cats with URTD that were not vaccinated against Feline calicivirus infection of different breeds, ages, and genders brought to Dicle University Veterinary Faculty Prof. Dr. Servet SEKIN Polyclinic with URTD. After routine clinical examinations of the animals, oral and conjunctival swabs and blood samples were taken. Hematological and biochemical analyzes of blood samples were performed. Swab samples were analyzed by the polymerase chain reaction (PCR) method for the diagnosis of the agent. Oral lesions, hypersalivation, ocular and nasal discharge, coughing, and breathing difficulties were seen in clinical examinations of cats with URTD. Feline calicivirus was detected in only one cat's conjunctival swab sample in PCR analyses. As a result, we found that Feline calicivirus infection was present in cats with URTD in the Diyarbakir region, and 5% positivity was found in cats with clinical symptoms according to PCR analysis.(AU)

O calicivírus felino está entre os microrganismos patogênicos mais comuns nas doenças do trato respiratório superior de gatos, determinando estomatites, ulcerações orais, descarga ocular e nasal, conjuntivite, febre, manqueira, anorexia, hipersalivação, pneumonia, distúrbios respiratórios, tosse e depressão. O presente trabalho foi delineado para determinar o papel do calicivírus felino (CVF) em gatos com doenças do trato respiratório superior na região de Diyarbakir, Turquia. Com o objetivo de orientar a prescrição do tratamento para os gatos infectados e contribuir com a profilaxia da doença. O material de estudo consistiu em 10 gatos saudáveis sem qualquer problema de saúde e 20 gatos acometidos por doenças do trato respiratório superior que não haviam sido vacinados contra a infecção pelo calicivírus felino. Os animais de diferentes raças, idades e gêneros foram encaminhados para a Universidade de Dicle, na Faculdade de Veterinária, na policlínica Professor Dr. Servet Sekin. Após o exame clínico de rotina dos animais, foram colhidos swabs orais e da conjuntiva e amostras de sangue. Análises hematológicas e bioquímicas das amostras de sangue foram realizadas e os swabs foram analisados pelo método da reação em cadeia pela polimerase (PCR) para diagnóstico do agente. Nos gatos infectados foram constatadas: lesões orais, hipersalivação, descargas oculares e nasais, tosse e dificuldade respiratória. O calicivírus felino foi detectado pela técnica de PCR no swab conjuntival de apenas um gato. A conclusão obtida foi que a infecção pelo calicivírus felino foi detectada pela técnica de PCR na região de Diyarbakir, Turquia, em gatos com doença do trato respiratório superior com a frequência de 5%.(AU)

Enhancing innate immunity against virus in times of COVID-19: Trying to untangle facts from fictions.

INTRODUCTION: In light of the current COVID-19 pandemic, during which the world is confronted with a new, highly contagious virus that suppresses innate immunity as one of its initial virulence mechanisms, thus escaping from first-line human defense mechanisms, enhancing innate immunity seems a good preventive strategy. METHODS: Without the intention to write an official systematic review, but more to give an overview of possible strategies, in this review article we discuss several interventions that might stimulate innate immunity and thus our defense against (viral) respiratory tract infections. Some of these interventions can also stimulate the adaptive T- and B-cell responses, but our main focus is on the innate part of immunity. We divide the reviewed interventions into: 1) lifestyle related (exercise, >7 h sleep, forest walking, meditation/mindfulness, vitamin supplementation); 2) Non-specific immune stimulants (letting fever advance, bacterial vaccines, probiotics, dialyzable leukocyte extract, pidotimod), and 3) specific vaccines with heterologous effect (BCG vaccine, mumps-measles-rubeola vaccine, etc). RESULTS: For each of these interventions we briefly comment on their definition, possible mechanisms and evidence of clinical efficacy or lack of it, especially focusing on respiratory tract infections, viral infections, and eventually a reduced mortality in severe respiratory infections in the intensive care unit. At the end, a summary table demonstrates the best trials supporting (or not) clinical evidence. CONCLUSION: Several interventions have some degree of evidence for enhancing the innate immune response and thus conveying possible benefit, but specific trials in COVID-19 should be conducted to support solid recommendations.

Sinonasal neoplasms in 49 dogs: clinical, macroscopic, and histopathological aspects / Neoplasmas nasossinusais em 49 cães: aspectos clínicos, macroscópicos e histopatológicos

This study aimed to quantify nasosinusal neoplasms diagnosed in dogs in 20 years (2000-2019) and characterize the main clinical, macroscopic, and histological aspects of these neoplasms. The sex, breed, age, skull conformation, the main clinical signs, and the anatomopathological characteristics (distribution, macroscopy, and histology) were computed. During this period, 49 dogs were affected by neoplasms in these regions, totaling 50 neoplasms (one dog had two neoplasms of different locations and histogenetic origins). Similar amounts of mixed-breed dogs (25/49) and purebred dogs (24/49) were affected, these distributed in 16 breeds. Among purebreds, it was noted that dogs with mesocephalic cranial conformation (12/24) were the most affected, followed by dolichocephalic (10/24) and brachycephalic (2/24). There were 22 cases in males and 27 in females, making a proportion of 1:1.23. There was an age variation from 11 months to 16 years old. The epithelial neoplasms have occurred in older dogs compared to those of other histogenic origins (mesenchymal and other origins/round cells). The main clinical signs were similar between the histogenetic categories, related to the involvement of the upper respiratory tract, sometimes accompanied by nervous signs (when there was brain invasion of nasal neoplasms or vice versa). The possible origin site was mostly in the nasal cavity concerning the paranasal sinuses (and other locations). Invasions occurred in different tissues adjacent to the nasal cavity and paranasal sinuses, resulting in cranial and facial deformities (21/49). The frequency was 48% of epithelial neoplasms, 32% of mesenchymal neoplasms, and 10% of neoplasms with other origins and round cells. The neoplasms most frequently observed, in decreasing order of frequency, were: adenocarcinoma (9/50), squamous cell carcinoma (9/50), transmissible venereal tumor (5/50), osteosarcoma (5/50), chondrosarcoma (4/50), and undifferentiated sarcoma (4/50). Through this study, it was possible to establish the frequency of these neoplasms in 20 years and their clinical, macroscopic, and histological characteristics.(AU)

Este estudo teve como objetivo quantificar os neoplasmas nasossinusais diagnosticados em cães em 20 anos (2000-2019) e caracterizar os principais aspectos clínicos, macroscópicos e histológicos desses neoplasmas. Foram computados sexo, raça, idade, conformação do crânio, principais sinais clínicos e características anatomopatológicas (distribuição, macroscopia e histologia). Nesse período, 49 cães foram acometidos por neoplasmas nessas regiões, totalizando 50 neoplasmas (um cão tinha dois neoplasmas de localização e origens histogenéticas distintas). Foram acometidas quantidades semelhantes de cães sem raça definida (25/49) e de cães com raça definida (24/49), estes distribuídos em 16 raças. Entre os cães com raça definida, notou-se que os cães com conformação craniana mesocefálica (12/24) foram os mais acometidos, seguidos pelos dolicocefálicos (10/24) e braquicefálicos (2/24). Foram observados 22 casos em machos e 27 em fêmeas, perfazendo a relação de 1:1,23. Ocorreu uma variação de idade de 11 meses a 16 anos; tendo os neoplasmas epiteliais ocorrido em cães mais velhos quando comparado aos de outras origens histogênicas (mesenquimais e outras origens/células redondas). Os principais sinais clínicos foram semelhantes entre as categorias histogenéticas, sendo relacionados ao comprometimento do trato respiratório superior, por vezes acompanhados de sinais nervosos (quando houve invasão encefálica de neoplasmas nasais ou vice-versa). O possível local de origem em sua maioria foi na cavidade nasal em relação aos seios nasais (e de outras localizações). Ocorreram invasões para diferentes tecidos adjacentes à cavidade nasal e seios paranasais, tendo como consequência deformidades cranianas e faciais (21/49). A frequência foi de 48% de neoplasmas epiteliais, 32% de neoplasmas mesenquimais e 10% de neoplasmas com outras origens e de células redondas. Os neoplasmas mais frequentemente observados, em ordem decrescente de frequência, foram: adenocarcinoma (9/50), carcinoma de células escamosas (9/50), tumor venéreo transmissível (5/50), osteossarcoma (5/50), condrossarcoma (4/50) e sarcoma indiferenciado (4/50). Com isso, pode-se estabelecer a frequência desses neoplasmas em 20 anos, bem como suas características clínicas, macroscópicas e histológicas.(AU)

Sinonasal neoplasms in 49 dogs: clinical, macroscopic, and histopathological aspects / Neoplasmas nasossinusais em 49 cães: aspectos clínicos, macroscópicos e histopatológicos

This study aimed to quantify nasosinusal neoplasms diagnosed in dogs in 20 years (2000-2019) and characterize the main clinical, macroscopic, and histological aspects of these neoplasms. The sex, breed, age, skull conformation, the main clinical signs, and the anatomopathological characteristics (distribution, macroscopy, and histology) were computed. During this period, 49 dogs were affected by neoplasms in these regions, totaling 50 neoplasms (one dog had two neoplasms of different locations and histogenetic origins). Similar amounts of mixed-breed dogs (25/49) and purebred dogs (24/49) were affected, these distributed in 16 breeds. Among purebreds, it was noted that dogs with mesocephalic cranial conformation (12/24) were the most affected, followed by dolichocephalic (10/24) and brachycephalic (2/24). There were 22 cases in males and 27 in females, making a proportion of 1:1.23. There was an age variation from 11 months to 16 years old. The epithelial neoplasms have occurred in older dogs compared to those of other histogenic origins (mesenchymal and other origins/round cells). The main clinical signs were similar between the histogenetic categories, related to the involvement of the upper respiratory tract, sometimes accompanied by nervous signs (when there was brain invasion of nasal neoplasms or vice versa). The possible origin site was mostly in the nasal cavity concerning the paranasal sinuses (and other locations). Invasions occurred in different tissues adjacent to the nasal cavity and paranasal sinuses, resulting in cranial and facial deformities (21/49). The frequency was 48% of epithelial neoplasms, 32% of mesenchymal neoplasms, and 10% of neoplasms with other origins and round cells. The neoplasms most frequently observed, in decreasing order of frequency, were: adenocarcinoma (9/50), squamous cell carcinoma (9/50), transmissible venereal tumor (5/50), osteosarcoma (5/50), chondrosarcoma (4/50), and undifferentiated sarcoma (4/50). Through this study, it was possible to establish the frequency of these neoplasms in 20 years and their clinical, macroscopic, and histological characteristics.(AU)

Este estudo teve como objetivo quantificar os neoplasmas nasossinusais diagnosticados em cães em 20 anos (2000-2019) e caracterizar os principais aspectos clínicos, macroscópicos e histológicos desses neoplasmas. Foram computados sexo, raça, idade, conformação do crânio, principais sinais clínicos e características anatomopatológicas (distribuição, macroscopia e histologia). Nesse período, 49 cães foram acometidos por neoplasmas nessas regiões, totalizando 50 neoplasmas (um cão tinha dois neoplasmas de localização e origens histogenéticas distintas). Foram acometidas quantidades semelhantes de cães sem raça definida (25/49) e de cães com raça definida (24/49), estes distribuídos em 16 raças. Entre os cães com raça definida, notou-se que os cães com conformação craniana mesocefálica (12/24) foram os mais acometidos, seguidos pelos dolicocefálicos (10/24) e braquicefálicos (2/24). Foram observados 22 casos em machos e 27 em fêmeas, perfazendo a relação de 1:1,23. Ocorreu uma variação de idade de 11 meses a 16 anos; tendo os neoplasmas epiteliais ocorrido em cães mais velhos quando comparado aos de outras origens histogênicas (mesenquimais e outras origens/células redondas). Os principais sinais clínicos foram semelhantes entre as categorias histogenéticas, sendo relacionados ao comprometimento do trato respiratório superior, por vezes acompanhados de sinais nervosos (quando houve invasão encefálica de neoplasmas nasais ou vice-versa). O possível local de origem em sua maioria foi na cavidade nasal em relação aos seios nasais (e de outras localizações). Ocorreram invasões para diferentes tecidos adjacentes à cavidade nasal e seios paranasais, tendo como consequência deformidades cranianas e faciais (21/49). A frequência foi de 48% de neoplasmas epiteliais, 32% de neoplasmas mesenquimais e 10% de neoplasmas com outras origens e de células redondas. Os neoplasmas mais frequentemente observados, em ordem decrescente de frequência, foram: adenocarcinoma (9/50), carcinoma de células escamosas (9/50), tumor venéreo transmissível (5/50), osteossarcoma (5/50), condrossarcoma (4/50) e sarcoma indiferenciado (4/50). Com isso, pode-se estabelecer a frequência desses neoplasmas em 20 anos, bem como suas características clínicas, macroscópicas e histológicas.(AU)

Characterization of antibiotic resistance and host-microbiome interactions in the human upper respiratory tract during influenza infection.

BACKGROUND: The abundance and diversity of antibiotic resistance genes (ARGs) in the human respiratory microbiome remain poorly characterized. In the context of influenza virus infection, interactions between the virus, the host, and resident bacteria with pathogenic potential are known to complicate and worsen disease, resulting in coinfection and increased morbidity and mortality of infected individuals. When pathogenic bacteria acquire antibiotic resistance, they are more difficult to treat and of global health concern. Characterization of ARG expression in the upper respiratory tract could help better understand the role antibiotic resistance plays in the pathogenesis of influenza-associated bacterial secondary infection. RESULTS: Thirty-seven individuals participating in the Household Influenza Transmission Study (HITS) in Managua, Nicaragua, were selected for this study. We performed metatranscriptomics and 16S rRNA gene sequencing analyses on nasal and throat swab samples, and host transcriptome profiling on blood samples. Individuals clustered into two groups based on their microbial gene expression profiles, with several microbial pathways enriched with genes differentially expressed between groups. We also analyzed antibiotic resistance gene expression and determined that approximately 25% of the sequence reads that corresponded to antibiotic resistance genes mapped to Streptococcus pneumoniae and Staphylococcus aureus. Following construction of an integrated network of ARG expression with host gene co-expression, we identified several host key regulators involved in the host response to influenza virus and bacterial infections, and host gene pathways associated with specific antibiotic resistance genes. CONCLUSIONS: This study indicates the host response to influenza infection could indirectly affect antibiotic resistance gene expression in the respiratory tract by impacting the microbial community structure and overall microbial gene expression. Interactions between the host systemic responses to influenza infection and antibiotic resistance gene expression highlight the importance of viral-bacterial co-infection in acute respiratory infections like influenza. Video abstract.

Risk Factors for Unnecessary Antibiotic Prescribing for Acute Respiratory Tract Infections in Primary Care.

OBJECTIVE: To determine independent risk factors for inappropriate antibiotic prescribing for acute respiratory tract infections (ARIs) in internal medicine (IM) residency-based primary care offices. PATIENTS AND METHODS: A retrospective study was conducted to measure antibiotic prescribing rates, and multivariable analysis was utilized to identify predictors of inappropriate prescribing among patients presenting to IM residency-based primary care office practices. Patients with an office visit at either of 2 IM residency-based primary care office practices from January 1, 2016, through December 31, 2016, with a primary encounter diagnosis of ARI were included. RESULTS: During the study period, 911 unique patient encounters were included with 518 for conditions for which antibiotics were considered always inappropriate. Antibiotics were not indicated in 85.8% (782 of 911) of encounters. However, antibiotics were prescribed in 28.4% (222 of 782) of these encounters. Inappropriate antibiotic prescribing occurred in 111 of 518 (21.4%) encounters for conditions for which antibiotics are always inappropriate. Using multivariable logistic regression analysis to assess for independent risk factors when adjusted for other potential risk factors for office visits at which antibiotics were not indicated, IM resident-associated visits (odds ratio, 0.25; 95% CI, 0.18-0.36) was the only variable independently associated with lower risk of inappropriate antibiotic prescribing. CONCLUSION: For ARI visits at which antibiotics were not indicated, IM resident comanagement was associated with lower rates of inappropriate prescribing.

Telemedicine for Upper Respiratory Tract Infections During 2018 Epidemiological Outbreak in South America.

Telemedicine is an increasingly used strategy for providing care to patients. The prevention and treatment of Upper Respiratory Tract Infections (URTIs) during outbreaks still require new management approaches. We aimed to describe patients' characteristics and the care process after the creation and implementation of a virtual care program for patients with URTI during the epidemiological outbreak. We studied all consultations that took place between May, 21st, and September, 14th 2018 at Hospital Italiano de Buenos Aires (HIBA). After applying exclusion criteria 218 consultations were left for the analysis. Most patients did not need a referral to a care center for a face-to-face assessment. The consultation rate to the Emergency Department (ED) within 7 days was 11.92% (26/218) with a 95% CI of 7.94-16.99%. This new approach in patient care has a great potential for relieving the overcrowding in EDs, decreasing waiting times and preventing the infection spread in waiting rooms.

Comparison of the nasopharynx microbiome between influenza and non­influenza cases of severe acute respiratory infections: a pilot study

Aims: Influenza A virus (IAV) can cause severe acute respiratory infection (SARI), and disease outcome may be associated with changes in the microbiome of the nasopharynx. This is a pilot study to characterize the microbiome of the nasopharynx in patients hospitalized with SARI, infected and not infected by IAV. Methods and Results: Using target sequencing of the 16S rRNA gene, we assessed the bacterial community of nasopharyngeal aspirate samples and compared the microbiome of patients infected with IAV with the microbiome of patients who were negative for IAV. We observed differences in the relative abundance of Proteobacteria and Firmicutes between SARI patients, with Streptococcus being enriched and Pseudomonas underrepresented in IAV patients compared with patients who were not infected with IAV. Conclusion: Pseudomonas taxon seems to be in high frequency on the nasopharynx of SARI patients with non­IAV infection and might present a negative association with Streptococcus taxon. Microbial profile appears to be different between SARI patients infected or not infected with IAV.

How to avoid the inappropriate use of antibiotics in upper respiratory tract infections? A position statement from an expert panel / Como evitar o uso inadequado de antibióticos nas infecções de vias aéreas superiores? Posição de um painel de especialistas

Abstract Introduction: Bacterial resistance burden has increased in the past years, mainly due to inappropriate antibiotic use. Recently it has become an urgent public health concern due to its impact on the prolongation of hospitalization, an increase of total cost of treatment and mortality associated with infectious disease. Almost half of the antimicrobial prescriptions in outpatient care visits are prescribed for acute upper respiratory infections, especially rhinosinusitis, otitis media, and pharyngotonsillitis. In this context, otorhinolaryngologists play an important role in orienting patients and non-specialists in the utilization of antibiotics rationally and properly in these infections. Objectives: To review the most recent recommendations and guidelines for the use of antibiotics in acute otitis media, acute rhinosinusitis, and pharyngotonsillitis, adapted to our national reality. Methods: A literature review on PubMed database including the medical management in acute otitis media, acute rhinosinusitis, and pharyngotonsillitis, followed by a discussion with a panel of specialists. Results: Antibiotics must be judiciously prescribed in uncomplicated acute upper respiratory tract infections. The severity of clinical presentation and the potential risks for evolution to suppurative and non-suppurative complications must be taken into 'consideration'. Conclusions: Periodic revisions on guidelines and recommendations for treatment of the main acute infections are necessary to orient rationale and appropriate use of antibiotics. Continuous medical education and changes in physicians' and patients' behavior are required to modify the paradigm that all upper respiratory infection needs antibiotic therapy, minimizing the consequences of its inadequate and inappropriate use.

Resumo Introdução: A resistência bacteriana a antibióticos nos processos infecciosos é um fato crescente nos últimos anos, especialmente devido ao seu uso inapropriado. Ao longo dos anos vem se tornando um grave problema de saúde pública devido ao prolongamento do tempo de internação, elevação dos custos de tratamento e aumento da mortalidade relacionada às doenças infecciosas. Quase a metade das prescrições de antibióticos em unidades de pronto atendimento é destinada ao tratamento de alguma infecção de vias aéreas superiores, especialmente rinossinusites, otite média aguda supurada e faringotonsilites agudas, sendo que uma significativa parcela dessas prescrições é inapropriada. Nesse contexto, os otorrinolaringologistas têm um papel fundamental na orientação de pacientes e colegas não especialistas, para o uso adequado e racional de antibióticos frente a essas situações clínicas. Objetivos: Realizar uma revisão das atuais recomendações de utilização de antibióticos nas otites médias, rinossinusites e faringotonsilites agudas adaptadas à realidade nacional. Método: Revisão na base PubMed das principais recomendações internacionais de tratamentos das infecções de vias aéreas superiores, seguido de discussão com um painel de especialistas. Resultados: Os antibióticos devem ser utilizados de maneira criteriosa nas infecções agudas de vias aéreas superiores não complicadas, a depender da gravidade da apresentação clínica e dos potenciais riscos associados de complicações supurativas e não supurativas. Conclusões: Constantes revisões a respeito do tratamento das principais infecções agudas são necessárias para que sejam tomadas medidas coletivas no uso racional e apropriado de antibióticos. Somente com orientação e transformações no comportamento de médicos e pacientes é que haverá mudanças do paradigma de que toda infecção de vias aéreas superiores deva ser tratada com antibióticos, minimizando por consequência os efeitos de seu uso inadequado.

How to avoid the inappropriate use of antibiotics in upper respiratory tract infections? A position statement from an expert panel.

INTRODUCTION: Bacterial resistance burden has increased in the past years, mainly due to inappropriate antibiotic use. Recently it has become an urgent public health concern due to its impact on the prolongation of hospitalization, an increase of total cost of treatment and mortality associated with infectious disease. Almost half of the antimicrobial prescriptions in outpatient care visits are prescribed for acute upper respiratory infections, especially rhinosinusitis, otitis media, and pharyngotonsillitis. In this context, otorhinolaryngologists play an important role in orienting patients and non-specialists in the utilization of antibiotics rationally and properly in these infections. OBJECTIVES: To review the most recent recommendations and guidelines for the use of antibiotics in acute otitis media, acute rhinosinusitis, and pharyngotonsillitis, adapted to our national reality. METHODS: A literature review on PubMed database including the medical management in acute otitis media, acute rhinosinusitis, and pharyngotonsillitis, followed by a discussion with a panel of specialists. RESULTS: Antibiotics must be judiciously prescribed in uncomplicated acute upper respiratory tract infections. The severity of clinical presentation and the potential risks for evolution to suppurative and non-suppurative complications must be taken into 'consideration'. CONCLUSIONS: Periodic revisions on guidelines and recommendations for treatment of the main acute infections are necessary to orient rationale and appropriate use of antibiotics. Continuous medical education and changes in physicians' and patients' behavior are required to modify the paradigm that all upper respiratory infection needs antibiotic therapy, minimizing the consequences of its inadequate and inappropriate use.

Granulomatosis de wegener: A propósito de un caso infantil / Wegener's granulomatosis: A pediatric case report

La granulomatosis de Wegener es una vasculitis granulomatosa necrotizante, que afecta las vías aéreas y los glomérulos. Ésta y la poliangitis microscópica son enfermedades vasculares, asociadas con anticuerpos anticitoplasma del neutró?lo (ANCA). La granulomatosis de Wegener es una enfermedad rara, de causa aún no de?nida, con incidencia de 0.4 casos por cada 100.000 habitantes. Se reporta el caso de un paciente masculino de 14 años de edad, sin antecedentes médicos de importancia pero con reporte de C3 y C4 normales, ANA positivo y c-ANCA positivos 1:40. La revisión bibliográ?ca pone al día los conocimientos acerca de esta enfermedad, que permiten al clínico tenerla en mente para diagnosticarla con oportunidad.

Wegener's granulomatosis is a necrotizing granulomatous vasculitis, that affects the upper respiratory tract, lower and glomeruli. This and microscopic polyangiitis are vascular diseases associated with neutrophil cytoplasmic antibodies (ANCA). Wegener's granulomatosis is a rare disease, cause not yet de?ned, with an incidence of 0.4 cases per 100.000 inhabitants. We report the case of a male patient of 14 years old, no medical history of importance but with C3 and C4 report normal, positive ANA and positive c-ANCA 1:40. The literature review updates the knowledge about this disease that allows the clinician to diagnose keeps it in mind to try.