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1.
Fish Shellfish Immunol ; 118: 169-179, 2021 Nov.
Article in English | MEDLINE | ID: mdl-34487829

ABSTRACT

Understanding of pathogenicity and immunity is crucial in producing disease-resistant cultured mollusk varieties. This study aimed to isolate pathogenic Vibrio alginolyticus from naturally infected Perna viridis, and to determine histopathological and immunological changes after challenge test with the same bacteria. Biochemical tests and 16S rDNA identified the pathogen as V. alginolyticus (99%). Antibiotic susceptibility test showed ampicillin resistance of the pathogen. Pathogenicity assay was conducted by immersing P. viridis in 1.5 × 106 CFU mL-1V. alginolyticus for 60 min and observed for 5 days. Clinical signs, histopathological and immunological alterations were observed and monitored. Infected groups showed 60% mortality and decreased immunity factors, including total hemocyte count and lysozymes activity. Histopathological examination revealed pathological lesions in the hepatopancreas at 24 h post-challenge and hemocyte proliferation as part of a severe inflammatory reaction. Karyomegaly in the hepatopancreas tissue, concomitant with necrosis demolition of tubules cells, was also observed. V. alginolyticus was determined to be pathogenic to P. viridis, causing mortality as a result of multiple organ lesions and dysfunction in digestive gland and immune organs. This study demonstrated the role of histopathological and immunological parameters as potential biomarkers in assessing vibriosis caused by Vibrio species in green mussel, P. viridis.


Subject(s)
Perna , Vibrio Infections , Animals , Hemocytes , Perna/microbiology , Seafood , Vibrio Infections/veterinary , Vibrio alginolyticus
2.
Food Microbiol ; 99: 103829, 2021 Oct.
Article in English | MEDLINE | ID: mdl-34119114

ABSTRACT

The endogenous microflora of mussels, filter feeders, can include pathogens with resulting food safety concerns. The aim was to develop a cook-then-ferment technology to extend shelf life and safety of a ready-to-eat mussels. Only after cooking to destroy the mussel's endogenous microflora could an edible product be made as determined by pH decline after fermentation and the fate of common pathogens. Perna canaliculus was bought live at retail on many dates. Fermentation was with commercial lactic cultures incubated under vacuum at 30 °C for four days. Using one culture containing Pediococcus pentosaceus and Staphylococcus carnosus as a model, pH typically declined to 4.5 to 4.7, and common pathogens, Staphylococcus aureus, Salmonella and Vibrio parahaemolyticus were absent or reduced to acceptable levels. The fate of Listeria monocytogenes was studied with five cultures. These were variably effective at inhibition with one clear success, Chr Hansen's T-SC-150 containing a specific strain of Lactobacillus sakei, and flavour-generating Staphylococcus carnosus. This culture's efficacy was confirmed with sterile extracts of LAB challenging L. monocytogenes in vitro. This culture was also the most rapid fermenter by pH fall. Cook-then-ferment technology may be applied to other novel foods to minimise a disruptive endogenous microflora.


Subject(s)
Food Handling/methods , Lactobacillales/metabolism , Perna/microbiology , Shellfish/microbiology , Animals , Cooking , Fast Foods/microbiology , Fermentation , Latilactobacillus sakei/metabolism , Listeria monocytogenes/growth & development , Perna/chemistry , Shellfish/analysis , Staphylococcus aureus/growth & development
3.
Mar Pollut Bull ; 153: 110976, 2020 Apr.
Article in English | MEDLINE | ID: mdl-32275531

ABSTRACT

The Pestalotiopsis sp. genus comprises filamentous fungi whose species present both pathogenic and clinical-industrial importance. The cultivation and production of bivalve molluscs in regions of Rio de Janeiro is lucrative both artisanally and industrially, as the climate, geography and water quality favor the practice of this activity throughout the year at reduced costs, making the region competitive in the national market. The aim of this study was to isolate and identify filamentous fungi associated with the internal tissue anatomy of bivalve molluscs (Perna perna) from mariculture farms. Samples collected from BEMAR marine farms were dissected and transferred to 1% hypochlorite, washed in sterile distilled water and sown on Petri dishes containing potato dextrose agar (BDA). After four days, a white colony, displaying vigorous mycelium, cotton-like with abundant sporulation and black conidia masses was isolated. Observations concerning vegetative and reproductive structures were performed by microcultures stained with Amann's Lactophenol andCotton Blue. Micromorphology analyses indicated spindle and septated conidia, with two to three apical filiform appendages and a short basal pedicel. The result indicates that bivalve mollusks may be bioindicators for the presence of Pestalotiopsis sp; associated with water transport, possibly due to diluted sediments in the medium. No infectious processes or lesions in the processed material were observed. This is, to the best of our knowledge, the first report of Pestalotiopsis sp; in Perna perna mytilids.


Subject(s)
Fungi/isolation & purification , Perna/microbiology , Animals , Aquaculture , Brazil , Food Contamination , Fungi/metabolism , Humans , Mytilidae/microbiology
4.
Mar Pollut Bull ; 142: 533-536, 2019 May.
Article in English | MEDLINE | ID: mdl-31232334

ABSTRACT

We report the occurrence and genomic features of multidrug-resistant vancomycin-resistant Enterococcus faecium vanA belonging to a novel sequence type (designated ST1336), carrying a Tn1546-like element, in marine brown mussels (Perna perna) from anthropogenically affected coastal waters of the Atlantic coast of Brazil, highlighting a potential source of dissemination for related ecosystems, with additional consequences for seafood safety and quality.


Subject(s)
Enterococcus faecium/drug effects , Enterococcus faecium/isolation & purification , Perna/microbiology , Vancomycin Resistance/genetics , Animals , Bacterial Proteins/genetics , Brazil , Carbon-Oxygen Ligases/genetics , DNA Transposable Elements , Ecosystem , Enterococcus faecium/genetics , Humans , Microbial Sensitivity Tests
5.
Metabolomics ; 15(7): 97, 2019 06 22.
Article in English | MEDLINE | ID: mdl-31230148

ABSTRACT

INTRODUCTION: Itaconic acid (ITA) has recently been identified as an antimicrobial metabolite in mammalian immune cells. The presence of ITA was also reported in different tissues of marine molluscs, indicating its role as an endogenous metabolite of molluscs. In addition, the accumulation of ITA has been observed in different tissues of mussels following pathogen challenges. However, the concentration of ITA in mussel tissues and the possible role of this metabolite in the molluscan innate immune system remain unknown. OBJECTIVES: This study aims to quantitatively measure ITA levels in different tissues of marine mussels following an experimental challenge with Vibrio sp. DO1 isolate, and to identify the antimicrobial role of ITA in the innate immune system through the measurement of metabolic and immune alterations in tissues following the challenge. METHODS: In this study, adult Perna canaliculus mussels were experimentally challenged with a pathogenic Vibrio sp. DO1 isolate. The metabolite profiles of five different tissues, including mantle, gill, muscle, hepatopancreas and haemolymph were obtained, and levels of ITA in each tissue were characterized using a gas chromatography-mass spectrometry (GC-MS) metabolomics approach. Flow cytometry was also employed to measure cell health parameters, including oxidative stress via reactive oxygen species (ROS) production, apoptosis via changes in mitochondrial membrane potential (MMP) and haemocyte viability. RESULTS: The ITA levels in mantle, gill, muscle and hepatopancreas tissues at 18-h post infection (hpi) with Vibrio sp. were 40.31, 41.71, 11.61 and 41.66 ng mg-1, respectively. In haemolymph, the level of ITA was significantly increased from 95.25 ng ml-1 at 6 hpi to 174.36 ng ml-1 at 18 hpi and 572.12 ng ml-1 at 60 hpi. In line with the accumulation of ITA, we observed increased levels of metabolites within the tricarboxylic acid (TCA) cycle, anti-inflammatory metabolites and alterations of other metabolites associated with immune responses of the host. The flow cytometry analyses revealed increases in ROS production, apoptotic cells and decreases in cell viability. CONCLUSIONS: We reported on the production of ITA in different tissues of P. canaliculus mussels challenged with a marine pathogen which confirmed ITA as an antimicrobial metabolite. The findings revealed insights into the biosynthesis of ITA and suggests its role in antimicrobial and anti-inflammatory activities in the innate immune system. This study also provided insights into the innate immune system of bivalves and highlighted the potential use of ITA as a biomarker for shellfish health assessment in aquaculture.


Subject(s)
Anti-Infective Agents/analysis , Metabolomics/methods , Perna/metabolism , Succinates/analysis , Vibrio/pathogenicity , Animals , Anti-Infective Agents/metabolism , Anti-Infective Agents/pharmacology , Area Under Curve , Discriminant Analysis , Gas Chromatography-Mass Spectrometry , Gills/drug effects , Gills/metabolism , Hemolymph/drug effects , Hemolymph/metabolism , Immunity, Innate/drug effects , Least-Squares Analysis , Membrane Potential, Mitochondrial/drug effects , Oxidative Stress/drug effects , Perna/microbiology , ROC Curve , Reactive Oxygen Species/metabolism , Succinates/metabolism , Succinates/pharmacology , Vibrio/drug effects , Vibrio/isolation & purification
6.
Pesqui. vet. bras ; 38(8): 1511-1517, Aug. 2018. tab, graf
Article in English | LILACS, VETINDEX | ID: biblio-976487

ABSTRACT

Vibrio species are ubiquitous in aquatic environments, including coastal and marine habitats. Vibrio alginolyticus is an opportunistic pathogen for fish, crustaceans and mussels and their identification by biochemical tests may be impaired due their nutritional requirements. The study used Matrix-Assisted Laser Desorption/Ionization Time-of-Flight Mass Spectrometry (MALDI-TOF MS) to identify 49 Vibrio spp. isolates associated with mussels (Perna perna) from different locations along the Rio de Janeiro coast. The rpoA gene was used as a genus-specific marker of Vibrio spp. and was positive in all 209 isolates. MALDI-TOF MS confirmed 87.8% of V. alginolyticus when compared to the results of the biochemical tests. Four isolates were identified as Shewanella putrefaciens (8.16%) and one was identified as V. parahaemolyticus (2.0%). Just one isolate was not identified by this technique (2.0%). The pyrH sequencing confirmed 75% of the proteomic technique results. MALDI-TOF MS is an excellent option for characterization of bacterial species, as it is efficient, fast and easy to apply. In addition, our study confirms its high specificity and sensitivity in these marine bacteria identification.(AU)


Espécies de Vibrio são ubiquitárias em ambientes aquáticos, incluindo habitats costeiros e marinhos. A espécie Vibrio alginolyticus é oportunista para peixes, crustáceos e moluscos e a sua identificação através de testes bioquímicos pode ter a qualidade prejudicada devido às suas exigências nutricionais. O presente estudo utilizou Espectrometria de Massa por Tempo de Vôo de Ionização/Desorção por Laser Assistida por Matriz (MALDI-TOF MS) para identificar diferentes espécies de Vibrio provenientes de mexilhões (Perna perna) coletados em diferentes locais ao longo da costa do Rio de Janeiro. O gene rpoA foi utilizado como um marcador gênero-específico de Vibrio spp. sendo positivo em todos os 209 isolados. MALDI-TOF MS confirmou 87,75% de V. alginolyticus quando comparados com os resultados dos testes bioquímicos. Quatro isolados foram identificados como Shewanella putrefaciens (8,16%), um como V. parahaemolyticus (2,0%) e apenas um (2,0%) não foi identificado pela técnica proteômica. E o sequenciamento do pyrH confirmou 75% dos resultados da técnica proteomica. MALDI-TOF MS tem sido considerada uma excelente opção para a caracterização bacteriana, por ser eficiente, rápida, de fácil aplicação e este estudo confirmou a sua elevada especificidade e sensibilidade na identificação de bactérias marinhas.(AU)


Subject(s)
Animals , Vibrio alginolyticus/isolation & purification , Vibrio alginolyticus/classification , Perna/microbiology , Perna/pathogenicity
7.
Fish Shellfish Immunol ; 80: 115-123, 2018 Sep.
Article in English | MEDLINE | ID: mdl-29864586

ABSTRACT

The mussel Perna perna is an intertidal bivalve that is widely distributed, cultivated and consumed in South Africa, Brazil and Venezuela. Among marine resources, bivalve mollusks are one of the most impacted by anthropogenic pollution, as they can accumulate pathogenic bacteria and water pollutants. Hemocytes are molluscan defense cells, and their abundance and functions can be affected in response to contaminants, such as bacterial load. However, no previous study has investigated the immune response of P. perna hemocytes. The aim of this study was to evaluate several immune parameters in P. perna as indicators of fecal pollution in mussel hemolymph and in seawater. We collected mussels and adjacent seawater from beaches with different levels of fecal contamination in Rio de Janeiro state (Brazil): Vermelha Beach (VB); Icaraí Beach (IB); Urca Beach (UB); and Jurujuba Beach (JB). Hemocyte parameters (density, morphology, phagocytic activity and production of Reactive Oxygen Species - ROS) were evaluated using flow cytometry. We quantified Fecal Indicator Bacteria (FIB) in seawater by the multiple tubes technique for each beach and for hemolymph by the spread-plate technique. In agreement with historical evaluation of fecal contamination levels, UB presented the highest FIB abundance in seawater (thermotolerant coliforms, TEC = 1600 NMP 100 mL-1), whereas VB exhibited the lowest (TEC = 17 NMP 100 mL-1). UB mussels had six and eight times higher hemocyte density and phagocytic activity, respectively, than mussels from VB. Mussels from VB and IB presented a significantly lower number of total coliforms in hemolymph and a significantly higher relative internal complexity of hemocytes than those from UB and JB (p ≤ 0.01, PERMANOVA). ROS production by hemocytes was significantly lower in mussels from VB compared to those from JB (p = 0.04, ANOVA). Our results indicate a significant relationship between the level of fecal contamination in aquatic environments and the immune response of mussel hemocytes. Immune-related parameters may therefore be useful as indicators of bivalve health and environmental quality. Our flow cytometric analysis of P. perna hemocytes represents a new approach for studying Perna perna biology and might represent a novel tool for measuring organic pollution and water quality.


Subject(s)
Environmental Monitoring/methods , Feces , Perna/immunology , Water Pollution/analysis , Animals , Brazil , Enterobacteriaceae/isolation & purification , Feces/microbiology , Hemocytes/immunology , Hemocytes/physiology , Hemolymph/microbiology , Perna/microbiology , Phagocytosis , Reactive Oxygen Species/immunology , Respiratory Burst , Seawater , Water Pollutants/analysis
8.
J Water Health ; 15(5): 834-838, 2017 Oct.
Article in English | MEDLINE | ID: mdl-29040086

ABSTRACT

Levels of faecal indicator organisms (FIOs) monitored in surface water and brown mussels collected at 28 production areas in Brazil from August 2012 to October 2013 were used to assess compliance with the bacteriological standards of the shellfish hygiene classification systems used in the European Union (EU) and USA. This classification determines the level of post-harvesting purification needed to reduce the risk of illness in consumers. The results indicate that 36% of production areas would be class A under the EU system and 75% would be 'Approved' under the US system. Mathematical models showed that a 90th percentile of FIO levels in water of 43 MPN (most probable number) 100 mL-1 (standard for 'Approved' areas under the US system) would correspond to an 80th percentile of FIO levels in mussels of 572 MPN 100 g-1. This concentration is more than double that in the class A standard in the EU system. These results have important implications for public health since no post-harvesting purification is required for any of these classification categories. Areas compliant with the US 'Restricted' and EU class B standards, however, provide similar levels of consumer safety.


Subject(s)
Aquaculture/standards , Hygiene/standards , Perna/microbiology , Public Health/standards , Seafood/microbiology , Seafood/standards , Water Microbiology , Animals , Brazil , Environmental Monitoring , European Union , Feces/microbiology , United States
9.
Food Microbiol ; 28(7): 1387-93, 2011 Oct.
Article in English | MEDLINE | ID: mdl-21839390

ABSTRACT

Greenshell™ mussels are New Zealand's largest seafood export species. Some export markets require compliance with 'zero' tolerance legislation for Listeria monocytogenes in 25 g of product. Even though individually quick frozen (IQF) mussel products are labeled 'to be cooked', and are not classified as ready-to-eat, some markets still require them to comply with the strict policy. Three mussel processing plants were assessed for the pattern of L. monocytogenes contamination on raw material, environment, food contact surfaces, and in the final product. Cultures (n = 101) obtained from an industrial Listeria monitoring program from August 2007 to June 2009 were characterized by serotyping and pulsed field gel electrophoresis. Using the crystal violet method, isolates were assessed for their ability to form biofilms. This work confirmed the presence of L. monocytogenes in raw and processed product, and the importance of cross-contamination from external and internal environments. Processing plants had L. monocytogenes pulsotypes that were detected more than once over 6 months. No correlation was found between biofilm-forming ability and persistent isolates. Two pulsotypes (including a persistent one), were previously isolated in human cases of listeriosis in New Zealand, but none of the pulsotypes matched those involved in international outbreaks.


Subject(s)
Biofilms , Food Handling , Listeria monocytogenes/isolation & purification , Perna/microbiology , Animals , Listeria monocytogenes/classification , Listeria monocytogenes/physiology , New Zealand , Prevalence
10.
Dis Aquat Organ ; 86(1): 15-20, 2009 Sep 07.
Article in English | MEDLINE | ID: mdl-19899345

ABSTRACT

Bacterial diseases remain a large problem in aquaculture hatcheries. The successful design and implementation of protective measures in the hatchery depends on an understanding of the dynamics of the infection process. Developing an in situ experimental protocol for pathogen challenge is therefore of paramount importance. Here, we demonstrated the minimum effective pathogenic dose (MEPD) of Vibrio splendidus (10(5) CFU ml(-1)) and a Vibrio coralliilyticus/neptunius-like isolate, Vibrio sp. DO1 (10(6) CFU ml(-1)), for New Zealand Greenshell mussel (GSM, Perna canaliculus) larvae during hatchery production. In a flow-through water hatchery system, larvae given 1 to 2 h of static water exposure to these pathogen doses showed respective average cumulative mortalities of 58 and 69% on the fourth day following pathogen exposure. After the 1 to 2 h static exposure, larvae were returned to flow-through water. Larvae exposed to a dosage one order of magnitude greater than the MEPD had higher mortalities of 73 and 96% for V. splendidus and Vibrio sp. DO1 respectively. These 4 levels of mortality were significantly greater than those of the non-exposed control larvae which respectively averaged 23 and 35% in experiments involving V. splendidus and Vibrio sp. DO1. Experiments were repeated 4 times to confirm reproducibility. After pathogen exposure, pathogens were detected in the larvae and tank water of treatments with dosages of > or =10(5) CFU ml(-1) (V. splendidus) and 10(6) CFU ml(-1) (Vibrio sp. DO1), but not in treatments with lower pathogen dosages. The challenge protocols are reproducible and provide an opportunity to assess measures for the protection of GSM larvae against infection in the hatchery environment.


Subject(s)
Perna/microbiology , Vibrio/physiology , Animals , Aquaculture , Host-Pathogen Interactions , Larva/microbiology , New Zealand , Seawater/microbiology , Survival Analysis , Time Factors
11.
Mikrobiologiia ; 76(2): 253-62, 2007.
Article in Russian | MEDLINE | ID: mdl-17583223

ABSTRACT

One hundred and four strains of heterotrophic bacteria have been isolated and characterized from two species of bivalve mollusks cultivated in the Gulf of Nha Trang (Vietnam) and from the water of a mariculture farm. The isolates have been identified on the basis of morphological, physiological, biochemical, and chemotaxonomic properties, as well as by the content of G+C bases in DNA. In the microflora of mollusks, Vibrio alginolyticus was predominant; the pathogenic species V. harveyi and V. splendidus were found as well. Staphylococci and bacilli occupied the second place in abundance after vibrios. In addition, coryneforms and enterobacteria, as well as Pseudomonas spp. and Pseudoalteromonas spp., were revealed. The composition of the water microflora was more diverse as compared with the microflora of mollusks. In the water, Bacillus spp., Vibrio spp., and Pseudomonas spp. were predominant. Brevibacterium spp. and other coryneform bacteria, as well as enterobacteria, occurred in significant amounts. In addition, Pseudoalteromonas spp., Marinococcus sp., Halobacillus sp., Shewanella sp., Sulfitobacter sp., and bacteria of the CFB cluster were noticed. The presence of pathogenic and conditionally pathogenic bacterial species in the water and mollusks is probably the reason for the high death rate of cultivated animals at the mariculture farm.


Subject(s)
Bacteria/isolation & purification , Crassostrea/microbiology , Perna/microbiology , Animals , Aquaculture/standards , Bacteria/classification , Bacterial Infections/microbiology , Bacterial Infections/veterinary , Bacterial Physiological Phenomena , Ecosystem , Seawater/microbiology , Species Specificity , Vietnam , Water Microbiology
12.
Rev Soc Bras Med Trop ; 40(1): 56-9, 2007.
Article in Portuguese | MEDLINE | ID: mdl-17486255

ABSTRACT

The marine ecosystem is the natural habitat of bacteria like Vibrio parahaemolyticus, an important pathogen that cause human gastroenteritis associated with seafood consumption. In the present investigation, the presence of V. parahaemolyticus in 86 in natural and precooked mussel samples was evaluated. Vibrio parahaemolyticus was isolated from 11.6% of the in natural and precooked mussels. All strains tested were urease-positive and 28.5% were Kanagawa-positive, which suggests that they have pathogenic potential for humans. There was predominance of the O10:K52 serotype and the emerging O3:K6 strain was identified. These results show the epidemiological relevance of V. parahaemolyticus in cases of human gastroenteritis following mussel consumption without adequately cooking them (100 degrees C/15 min). Moreover, it is important to alert the Brazilian Sanitary Surveillance authorities regarding their presence in the food chain and their public health risks.


Subject(s)
Food Microbiology , Perna/microbiology , Shellfish/microbiology , Vibrio parahaemolyticus/isolation & purification , Animals , Brazil , Serotyping , Vibrio parahaemolyticus/classification
13.
Rev. Soc. Bras. Med. Trop ; 40(1): 56-59, jan.-fev. 2007. tab
Article in Portuguese | LILACS | ID: lil-449170

ABSTRACT

O ecossistema marinho é o habitat natural de bactérias como Vibrio parahaemolyticus, um importante patógeno causador de gastrenterite humana associada ao consumo de alimentos marinhos. Na presente investigação, foi avaliada a presença de V. parahaemolyticus a partir de 86 amostras de mexilhões in natura e pré-cozidos. Vibrio parahaemolyticus foi isolado a partir de 11,6 por cento dos mexilhões in natura e pré-cozidos avaliados. Todas as cepas avaliadas demonstraram-se urease positivas e 28,5 por cento Kanagawa positivas sugerindo um potencial patogênico para o homem. Houve a predominância do sorotipo O10:K52 e a identificação da cepa emergente O3:K6. Esses resultados apontam para a relevância epidemiológica de V. parahaemolyticus em casos de gastrenterite humana após consumo de mexilhões sem cozimento adequado (100°C/15min). Além disso, é importante alertar as autoridades de Vigilância Sanitária no Brasil quanto a sua presença na cadeia alimentar e seus riscos para a Saúde Pública.


The marine ecosystem is the natural habitat of bacteria like Vibrio parahaemolyticus, an important pathogen that cause human gastroenteritis associated with seafood consumption. In the present investigation, the presence of V. parahaemolyticus in 86 in natura and precooked mussel samples was evaluated. Vibrio parahaemolyticus was isolated from 11.6 percent of the in natura and precooked mussels. All strains tested were urease-positive and 28.5 percent were Kanagawa-positive, which suggests that they have pathogenic potential for humans. There was predominance of the O10:K52 serotype and the emerging O3:K6 strain was identified. These results show the epidemiological relevance of V. parahaemolyticus in cases of human gastroenteritis following mussel consumption without adequately cooking them (100°C/15min). Moreover, it is important to alert the Brazilian Sanitary Surveillance authorities regarding their presence in the food chain and their public health risks.


Subject(s)
Animals , Food Microbiology , Perna/microbiology , Shellfish/microbiology , Vibrio parahaemolyticus/isolation & purification , Brazil , Serotyping , Vibrio parahaemolyticus/classification
14.
West Indian med. j ; 50(suppl. 1): 46-9, Mar. 1-4, 2001. tab
Article in English | MedCarib | ID: med-425

ABSTRACT

Predisposing factors for the diabetic foot include peripheral neuropathy, peripheral vascular disease (PVD), hyperglycaemia and increased duration of diabetes. From the records of patients admitted to the University Hospital of the West Indies with the diabetic foot, we reviewed the results of the microbiology of wound swabs from diabetic foot ulcers. We noted the high prevalence of PVD (66.6 percent), peripheral neuropathy (50 percent), hyperglycaemia (75.6 percent) and increased duration of diabetes (17.5 years). A history of past foot ulcers was common and 87.2 percent had polymicrobial infection. The commonest organisms were gram positive organisms which were usually sensitive to the 2 antibiotic regimes that were commonly used. Euglycaemia, a favourable lipid profile, control of blood pressure, yearly foot examination and institution of measures to prevent foot trauma are important in the prevention of foot ulceration.(Au)


Subject(s)
Humans , Adult , Middle Aged , Aged , Diabetes Mellitus/complications , Diabetic Foot/microbiology , Peripheral Vascular Diseases/microbiology , Diabetic Neuropathies/microbiology , Perna/microbiology , Jamaica/epidemiology
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