Bacteriophage therapy- a refurbished age-old potential strategy to treat antibiotic and multidrug resistant bacterial infections in future.

The worldwide prevalence of antimicrobial resistance coupled with the unavailability of newer antibiotics, has brought the sharp focus back among the scientific community, towards the discovery of novel alternative therapeutics to tackle the menace. Consequently, in the current post-antibiotic era, 'Bacteriophage Therapy' has emerged as one of the most promising option to address this problem. Bacteriophages, actually discovered long back, has shown greater potential to kill various bacterial pathogens, including the resistant clinical ones. Some of the other advantages for the use of bacteriophage therapy to treat infectious diseases include, wider availability of these microorganisms in nature, host-specific action, absence of any significant side-effects in humans and most often also exhibiting a broader anti-bacterial potential. In the recent times, the potential of phage therapy has been demonstrated in various treatments, clinical trials and infection models across the globe, where even antibiotics have completely failed. To address the global threat of AMR, WHO and UN have jointly illustrated "One Health" approach, recently extending the context to bacteriophage therapy. Many pharmaceutical companies have also recently started employing bacteriophages for developing different kinds of formulations for catering to medical and other industries. It has even shown great effect as combinatorial therapy along with antibiotics, to treat or manage various critical antibiotic resistant clinical infections. This continuously expanding potential of the bacteriophages holds great promise in the future, in the fight against the rising threat of AMR globally.

Implications of lytic phage infections inducing persistence.

Phage therapy holds much promise as an alternative to antibiotics for fighting infection. However, this approach is no panacea as recent results show that a small fraction of cells survives lytic phage infection due to both dormancy (i.e. formation of persister cells) and resistance (genetic change). In this brief review, we summarize evidence suggesting phages induce the persister state. Therefore, it is predicted that phage cocktails should be combined with antipersister compounds to eradicate bacterial infections.

Myriad applications of bacteriophages beyond phage therapy.

Bacteriophages are the most abundant biological entity on the planet, having pivotal roles in bacterial ecology, animal and plant health, and in the biogeochemical cycles. Although, in principle, phages are simple entities that replicate at the expense of their bacterial hosts, due the importance of bacteria in all aspects of nature, they have the potential to influence and modify diverse processes, either in subtle or profound ways. Traditionally, the main application of bacteriophages is phage therapy, which is their utilization to combat and help to clear bacterial infections, from enteric diseases, to skin infections, chronic infections, sepsis, etc. Nevertheless, phages can also be potentially used for several other tasks, including food preservation, disinfection of surfaces, treatment of several dysbioses, and modulation of microbiomes. Phages may also be used as tools for the treatment of non-bacterial infections and pest control in agriculture; moreover, they can be used to decrease bacterial virulence and antibiotic resistance and even to combat global warming. In this review manuscript we discuss these possible applications and promote their implementation.

Pericarditis purulenta por mycobacterium tuberculosis y streptococcus pneumoniae: revisión del tema, a propósito de un caso / Purulent pericarditis due to mycobacterium tuberculosis and streptococcus pneumoniae: case report and review

La pericarditis purulenta es una patología poco frecuente pero que conlleva alta mortalidad. En la era pre antibióticos, se observaba en pacientes con neumonía complicada y las cocáceas gram positivas eran los gérmenes frecuentemente involucrados. Por otro lado, la pericarditis tuberculosa representa el 1% del total de casos de tuberculosis, aunque es frecuente zonas endémicas, principalmente asociada a la infección por el virus de la inmunodeficiencia humana (VIH). Presentamos el caso de un paciente de 19 años, en situación calle, infectado con VIH, con diagnóstico de pericarditis purulenta, donde se demostró la co-infección de Mycobacterium tuberculosis y Streptecoccus pneumoniae en el pericardio. La pericarditis purulenta polimicrobiana es poco frecuente y la co-infección por los gérmenes mencionados es anecdótica. A pesar del tratamiento antimicrobiano, el aseo quirúrgico, los esteroides y la fibrinolisis intrapericárdica, esta patología tiene un pronóstico ominoso, en parte, debido a la condición basal de los enfermos que la padecen.

Purulent pericarditis is a rare disease with a high mortality rate. In the pre-antibiotic era it was observed as a complication in patients with pneumonia. Gram-positive coccaceae were the most commonly implicated bacteria. Tuberculous pericarditis represents 1% of all tuberculosis (TBC) cases, although it is common in endemic areas, associated with human immunodeficiency virus (HIV) infection. We present the case of a 19-year-old homeless, admitted with HIV and malnutrition, diagnosed with purulent pericarditis. Mycobacterium tuberculosis and Streptococcus pneumoniae were found as a cause of purulent pericarditis. Polymicrobial purulent pericarditis is a rare condition and co-infection with the bacteria previously mentioned is merely anecdotal. Despite antimicrobial treatment, surgical management, steroids, and intrapericardial fibrinolysis, this pathology has an ominous prognosis, due in part to the pre-existing condition of these patients.

Present status and future directions: Microbiology of endodontic infections.

Apical periodontitis has a microbial aetiology and is one of the most common inflammatory diseases that affect humans. Fungi, archaea and viruses have been found in association with apical periodontitis, but bacteria are by far the most prevalent and dominant microorganisms in endodontic infections. Bacterial infection of the root canal system only occurs when the pulp is necrotic or was removed for previous treatment. In some specific cases, including acute and chronic abscesses, the bacterial infection may reach the periradicular tissues. Intracanal bacteria are usually observed as sessile multispecies communities (biofilms) attached to the dentinal root canal walls. Infection in the main root canal lumen can spread to other areas of the root canal system. Although more than 500 bacterial species have been detected in endodontic infections, a selected group of 20 to 30 species are most frequently detected and may be considered as the core microbiome. There is a high interindividual variability in the endodontic microbiome in terms of species composition and relative abundance. Obligate anaerobic species are more abundant in the intraradicular bacterial communities of teeth with primary apical periodontitis, while both anaerobes and facultatives dominate the communities in post-treatment apical periodontitis. Bacterial interactions play an essential role in determining the overall virulence of the community, which has been regarded as the unit of pathogenicity of apical periodontitis. This article reviews the microbiologic aspects of endodontic infections and provides perspectives for future research and directions in the field.

Phage therapy as strategy to face post-antibiotic era: a guide to beginners and experts.

Interest in the therapeutic use of bacteriophages (phages) has emerged in recent years, driven mainly by the antimicrobial resistance crisis. This review aimed to summarize some important studies addressing the use of phages as a therapeutic alternative for multiresistant bacterial infections. To this end, a literature search was conducted to address the efficacy and versatility of phage therapy, the advantages and disadvantages of its use, and potential limitations for the application of phage therapy that need to be overcome, especially in Western countries. Thus, this review highlights that phage therapy may be a promising route in the treatment of infections caused by multidrug-resistant pathogens and that a combined approach has the potential to prolong the life of the current available antimicrobials. In addition, standardized clinical trials using monoclonal or polyclonal phages, alone or in combination with antimicrobials, are crucial to determine the real potential of these treatments in clinical practice.

Six-year study on peripheral venous catheter-associated BSI rates in 262 ICUs in eight countries of South-East Asia: International Nosocomial Infection Control Consortium findings.

BACKGROUND: Short-term peripheral venous catheter-associated bloodstream infection rates have not been systematically studied in Asian countries, and data on peripheral venous catheter-associated bloodstream infections incidence by number of short-term peripheral venous catheter days are not available. METHODS: Prospective, surveillance study on peripheral venous catheter-associated bloodstream infections conducted from 1 September 2013 to 31 May 2019 in 262 intensive care units, members of the International Nosocomial Infection Control Consortium, from 78 hospitals in 32 cities of 8 countries in the South-East Asia Region: China, India, Malaysia, Mongolia, Nepal, Philippines, Thailand, and Vietnam. For this research, we applied definition and criteria of the CDC NHSN, methodology of the INICC, and software named INICC Surveillance Online System. RESULTS: We followed 83,295 intensive care unit patients for 369,371 bed-days and 376,492 peripheral venous catheter-days. We identified 999 peripheral venous catheter-associated bloodstream infections, amounting to a rate of 2.65/1000 peripheral venous catheter-days. Mortality in patients with peripheral venous catheter but without peripheral venous catheter-associated bloodstream infections was 4.53% and 12.21% in patients with peripheral venous catheter-associated bloodstream infections. The mean length of stay in patients with peripheral venous catheter but without peripheral venous catheter-associated bloodstream infections was 4.40 days and 7.11 days in patients with peripheral venous catheter and peripheral venous catheter-associated bloodstream infections. The microorganism profile showed 67.1% were Gram-negative bacteria: Escherichia coli (22.9%), Klebsiella spp (10.7%), Pseudomonas aeruginosa (5.3%), Enterobacter spp. (4.5%), and others (23.7%). The predominant Gram-positive bacteria were Staphylococcus aureus (11.4%). CONCLUSIONS: Infection prevention programs must be implemented to reduce the incidence of peripheral venous catheter-associated bloodstream infections.

Cost Analysis of Emergency Department Criteria for Evaluation of Febrile Infants Ages 29 to 90 Days.

OBJECTIVE: To compare the medical costs associated with risk stratification criteria used to evaluate febrile infants 29-90 days of age. STUDY DESIGN: A cost analysis study was conducted evaluating the Boston, Rochester, Philadelphia, Step-by-Step, and PECARN criteria. The percentage of infants considered low risk and rates of missed infections were obtained from published literature. Emergency department costs were estimated from the Centers for Medicare and Medicaid Services. The Health Care Cost and Utilization Project databases were used to estimate the number of infants ages 29-90 days presenting with fever annually and costs for admissions related to missed infections. A probabilistic Markov model with a Dirichlet prior was used to estimate the transition probability distributions for each outcome, and a gamma distribution was used to model costs. A Markov simulation estimated the distribution of expected annual costs per infant and total annual costs. RESULTS: For low-risk infants, the mean cost per infant for the criteria were Rochester: $1050 (IQR $1004-$1092), Philadelphia: $1416 (IQR, $1365-$1465), Boston: $1460 (IQR, $1411-$1506), Step-by-Step $942 (IQR, $899-$981), and PECARN $1004 (IQR, $956-$1050). An estimated 18 522 febrile 1- to 3-month-old infants present annually and estimated total mean costs for their care by criteria were: Rochester, $127.3 million (IQR, $126.1-$128.5); Philadelphia, $129.9 million (IQR, $128.7-$131.1); Boston, $128.7 million (IQR, $127.5-$129.9); Step-by-Step, $ 126.6 million (IQR, $125.4-$127.8); and PECARN, $125.8 million (IQR, $124.6-$127). CONCLUSIONS: The Rochester, Step-by-step, and PECARN criteria are the least costly when evaluating infants 29-90 days of age with a fever.

Manejo multidisciplinario de rinosinusitis bacteriana aguda posterior a elevación de seno maxilar: reporte de caso rehabilitado a tres años de seguimiento / Multidisciplinary management of acute bacterial rhinosinusitis after maxillary sinus lift: three years follow-up: case report

La cirugía de elevación de seno maxilar se considera como la técnica de aumento óseo más predecible. Sin embargo, no está exenta de complicaciones las cuales deben ser manejadas adecuadamente. Se presenta un caso clínico rehabilitado, con un seguimiento de 3 años, en el cual se realizó un manejo multidisciplinario y resolutivo de complicaciones asociadas a la técnica quirúrgica de elevación de membrana sinusal vía ventana lateral. Frente a una infección postoperatoria, como la presentada en el caso, hay que considerar iniciar un tratamiento antibiótico en el momento adecuado para impedir el agravamiento del cuadro clínico o un cambio de esquema en caso de resistencia antimicrobiana.

Maxillary sinus lift surgery is considered the most predictable bone augmentation technique. However, this procedure is not without complications, which must be handled properly. We present a rehabilitated clinical case, with a 3-year follow-up, in which a multidisciplinary and resolutive management of complications associated with the surgical technique of sinus lift procedure, using lateral window approach, was performed. In case of postoperative infection, such as the one presented in this report, it is necessary to consider starting an antibiotic treatment at the adequate moment to prevent the aggravation of the illness or change the pharmacological treatment in case of antimicrobial resistance.

CCR5 and CCR5Δ32 in bacterial and parasitic infections: Thinking chemokine receptors outside the HIV box.

The CCR5 molecule was reported in 1996 as the main HIV-1 co-receptor. In that same year, the CCR5Δ32 genetic variant was described as a strong protective factor against HIV-1 infection. These findings led to extensive research regarding the CCR5, culminating in critical scientific advances, such as the development of CCR5 inhibitors for the treatment of HIV infection. Recently, the research landscape surrounding CCR5 has begun to change. Different research groups have realized that, since CCR5 has such important effects in the chemokine system, it could also affect other different physiological systems. Therefore, the effect of reduced CCR5 expression due to the presence of the CCR5Δ32 variant began to be further studied. Several studies have investigated the role of CCR5 and the impacts of CCR5Δ32 on autoimmune and inflammatory diseases, various types of cancer, and viral diseases. However, the role of CCR5 in diseases caused by bacteria and parasites is still poorly understood. Therefore, the aim of this article is to review the role of CCR5 and the effects of CCR5Δ32 on bacterial (brucellosis, osteomyelitis, pneumonia, tuberculosis and infection by Chlamydia trachomatis) and parasitic infections (toxoplasmosis, leishmaniasis, Chagas disease and schistosomiasis). Basic information about each of these infections was also addressed. The neglected role of CCR5 in fungal disease and emerging studies regarding the action of CCR5 on regulatory T cells are briefly covered in this review. Considering the "renaissance of CCR5 research," this article is useful for updating researchers who develop studies involving CCR5 and CCR5Δ32 in different infectious diseases.

The forgotten tale of Brazilian phage therapy.

The use of bacteriophages to treat bacterial infections (known as phage therapy) is considered a possible solution to the antimicrobial resistance crisis. However, phage therapy is not a new concept. The discovery of phages in the early 20th century was closely tied to clinical practice, and phage therapy quickly spread around the world. The use of phage therapy in South America in the previous century is still shrouded in mystery and has been mentioned only briefly in recent scientific literature. Research on Brazilian reference collections of medical texts showed that Brazil was an important, but so far little-known, player of phage therapy, uncovering interesting priority claims and missing pieces of phage therapy history. Of note, there is the widespread use of phages against bacillary dysentery and staphylococcal infections, with José da Costa Cruz from the Oswaldo Cruz Institute (Rio de Janeiro, Brazil) as Brazil's leading expert and pioneer. This Historical Review about historical phage use in Brazil fills the gaps in our knowledge about the so-called golden years of phage therapy, providing information about successful experiences that can be useful against dangerous pathogens in our time.

Effectiveness of Saccharomyces boulardii and Metronidazole for Small Intestinal Bacterial Overgrowth in Systemic Sclerosis.

BACKGROUND: Small intestinal bacterial overgrowth (SIBO) affects up to 60% of patients with systemic sclerosis (SSc), and it improves with antibiotics. The addition of probiotics could lead to better results. AIMS: To evaluate the efficacy and safety of Saccharomyces boulardii (SB) versus metronidazole (M) versus M + SB for 2 months, to reduce gastrointestinal symptoms and SIBO assessed with hydrogen breath test in SSc. METHODS: An open pilot clinical trial performed in forty patients with SIBO and SSc (ACR-EULAR 2013) who signed informed consent. Three groups were assigned: M, SB, and M + SB, for 2 months. Hydrogen was measured in parts per million with a hydrogen breath test to evaluate SIBO. The National Institutes of Health Patient-Reported Outcomes Measurement Information System (NIH-PROMIS) questionnaire was applied to quantify gastrointestinal symptoms with a raw score of eight symptoms. This study is registered in ClinicalTrials.gov with the following ID: NCT03692299. RESULTS: Baseline characteristics were similar between groups. The average age was 53.2 ± 9.3 years, and the evolution of SSc was 13.5 (1-34) years. After 2 months of treatment, SIBO was eradicated in 55% of the M + SB group: 33% of SB, and 25% of M. The SB and M + SB groups had decreased diarrhea, abdominal pain, and gas/bloating/flatulence, but M remained unchanged. Reductions in expired hydrogen at 45 to 60 min were as follows: M + SB 48% and 44%, M 18% and 20%, and SB 53% and 60% at the first and second months, respectively (p < 0.01). Adverse effects were epigastric burning and constipation in M (53%) and M + SB (36%), and flatulence/diarrhea in SB (22%). CONCLUSIONS: Metronidazole treatment is partially effective in SIBO, but S. boulardii in monotherapy or in combination improves the gastrointestinal outcomes in SSc.

Antimicrobials and resistant bacteria in global fish farming and the possible risk for public health / Antimicrobianos e bactérias resistentes na piscicultura global e o possível risco para a saúde pública

The use of antimicrobials in fish farming is a reflection of the fast aquaculture development worldwide. The intensification of aquaculture to achieve market demands could lead to an increase in infectious diseases by pathogenic bacteria. Consequently, antimicrobials act as controls for emerging infectious diseases, but their use must follow the rules and regulations of the country where the activity is performed. Although the regulations impose limits to the use of antimicrobials in fish farming, many studies show that resistant bacteria are isolated from this system. The selection of resistant bacteria is not limited only to the use of antimicrobials, but also to co-selection of resistance genes or even with cross-resistance processes. Resistant bacteria from fish farming are a serious concern because they can be acquired by humans with handling or food chain, which may represent a public health problem. In the present review, we present an overview of antimicrobials use in aquaculture, the antimicrobial resistance and the impact of antimicrobial and bacterial resistance from a public health perspective.(AU)

O uso de antimicrobianos na piscicultura é um reflexo do rápido desenvolvimento da aquicultura em todo o mundo. A intensificação da aquicultura para suprir as demandas do mercado pode levar ao aumento de doenças infecciosas por bactérias patogênicas. Consequentemente, os antimicrobianos atuam no controle de doenças infecciosas emergentes, mas seu uso deve seguir as regras e regulamentos do país onde a atividade é realizada. Embora os regulamentos imponham limites ao uso de antimicrobianos na piscicultura, muitos estudos mostram que bactérias resistentes são isoladas desse sistema. A seleção de bactérias resistentes não se limita apenas ao uso de antimicrobianos, mas também à cosseleção de genes de resistência ou mesmo por meio do processo de resistência cruzada. As bactérias resistentes da piscicultura são uma preocupação séria, uma vez que tais bactérias podem ser adquiridas pelos seres humanos no manuseio ou na cadeia alimentar, o que pode representar um problema de saúde pública. Nesta revisão, apresentamos uma visão geral do uso de antimicrobianos na aquicultura, a resistência antimicrobiana e o impacto da resistência antimicrobiana e bacteriana do ponto de vista da saúde pública.(AU)

Antimicrobials and resistant bacteria in global fish farming and the possible risk for public health / Antimicrobianos e bactérias resistentes na piscicultura global e o possível risco para a saúde pública

The use of antimicrobials in fish farming is a reflection of the fast aquaculture development worldwide. The intensification of aquaculture to achieve market demands could lead to an increase in infectious diseases by pathogenic bacteria. Consequently, antimicrobials act as controls for emerging infectious diseases, but their use must follow the rules and regulations of the country where the activity is performed. Although the regulations impose limits to the use of antimicrobials in fish farming, many studies show that resistant bacteria are isolated from this system. The selection of resistant bacteria is not limited only to the use of antimicrobials, but also to co-selection of resistance genes or even with cross-resistance processes. Resistant bacteria from fish farming are a serious concern because they can be acquired by humans with handling or food chain, which may represent a public health problem. In the present review, we present an overview of antimicrobials use in aquaculture, the antimicrobial resistance and the impact of antimicrobial and bacterial resistance from a public health perspective.(AU)

O uso de antimicrobianos na piscicultura é um reflexo do rápido desenvolvimento da aquicultura em todo o mundo. A intensificação da aquicultura para suprir as demandas do mercado pode levar ao aumento de doenças infecciosas por bactérias patogênicas. Consequentemente, os antimicrobianos atuam no controle de doenças infecciosas emergentes, mas seu uso deve seguir as regras e regulamentos do país onde a atividade é realizada. Embora os regulamentos imponham limites ao uso de antimicrobianos na piscicultura, muitos estudos mostram que bactérias resistentes são isoladas desse sistema. A seleção de bactérias resistentes não se limita apenas ao uso de antimicrobianos, mas também à cosseleção de genes de resistência ou mesmo por meio do processo de resistência cruzada. As bactérias resistentes da piscicultura são uma preocupação séria, uma vez que tais bactérias podem ser adquiridas pelos seres humanos no manuseio ou na cadeia alimentar, o que pode representar um problema de saúde pública. Nesta revisão, apresentamos uma visão geral do uso de antimicrobianos na aquicultura, a resistência antimicrobiana e o impacto da resistência antimicrobiana e bacteriana do ponto de vista da saúde pública.(AU)

Stingray envenomation in a returning traveller: a complicated disease course.

We report the case of a returning traveller, a woman in her early 20s, who presents with chronic inflammation and infection of her left foot following a stingray strike. Surgery was performed to remove foreign material a remarkable 9 months after the initial injury. The case highlights the importance of the initial assessment and early management of stingray attacks and illustrates the potential need for exploration and debridement of problematic stingray wounds.

Clinical predictors of cystic fibrosis chronic rhinosinusitis severity.

BACKGROUND: Chronic rhinosinusitis (CRS) is a significant manifestation of cystic fibrosis (CF) with wide-ranging symptom and disease severity. The goal of the study was to determine clinical variables that correlate with outcome measures of disease severity. METHODS: A prospective, longitudinal, observational study of 33 adults with symptomatic CRS treated in a CF-focused otolaryngology clinic was performed. Symptom severity, the presence of rhinosinusitis exacerbations, and endoscopic appearance were assessed, and regression analysis was used to determine clinical predictors of disease outcome. RESULTS: Thirty-three adults with CF-CRS were included in the study and followed for a mean of 15 months. Rhinosinusitis exacerbations occurred in 61% of participants during the study, and female sex increased the odds of presenting with an exacerbation visit. Sinus disease exacerbations were associated with an odds ratio of 2.07 for presenting with a pulmonary exacerbation at the next visit. CF-related diabetes was found to be associated with worse symptoms and endoscopic appearance. Infection with Staphylococcus aureus predicted worsening of symptoms, whereas infections with Pseudomonas aeruginosa improved over time. Allergic rhinitis was associated with worse endoscopic appearance, and nasal steroid use was associated with improved endoscopic appearance. CONCLUSION: Sex, CF-related diabetes, sinonasal infection status, allergic rhinitis, and nasal steroid use may all modulate severity of CF-CRS in adults. Sinusitis exacerbation may be a precursor to pulmonary exacerbation.

Plant essential oils against bacteria isolated from fish: an in vitro screening and in vivo efficacy of Lippia origanoides / Óleos essenciais de plantas contra bactérias isoladas de peixes: uma triagem in vitro e eficácia in vivo de Lippia origanoides

The use of natural products, such as essential oils (EOs), is a potential novel approach to treat fish bacterial infections with a lower risk of developing resistance. There has been a number of studies reporting the activity of EOs as those obtained from the species Achyrocline satureioides, Aniba parviflora, Aniba rosaeodora, Anthemis nobilis, Conobea scoparioides, Cupressus sempervirens, Illicium verum, Lippia origanoides, and Melaleuca alternifolia against bacteria. However, there are few studies investigating the effect of these EOs against fish bacteria. Therefore, the aim of this study was to evaluate the in vitro antibacterial activity of EOs against the following fish bacteria, Aeromonas hydrophila, Citrobacter freundii, and Raoultella ornithinolytica. Additionally, the in vivo antibacterial activity of the EO L. origanoides was evaluated against experimentally induced A. hydrophila infection of silver catfish (Rhamdia quelen). The EO of L. origanoides was chosen as it showed the highest in vitro antibacterial activity, with minimum inhibitory concentrations ranging from 0.2 to 0.8 mg mL-1. This EO also presented a therapeutic success of 58.33%, on a 30 day A. hydrophila infection. Therefore, we suggested that the EO of L. origanoides may be a viable alternative as a treatment for A. hydrophila infection.(AU)

O uso de produtos naturais, como óleos essenciais (OEs), é uma nova abordagem potencial para o tratamento de infecções bacterianas em peixes com um baixo risco de desenvolvimento de resistência. Existem estudos reportando a atividade de OEs como aqueles obtidos das espécies Achyrocline satureioides, Aniba parviflora, Aniba rosaeodora, Anthemis nobilis, Conobea scoparioides, Cupressus sempervirens, Illicium verum, Lippia origanoides e Melaleuca alternifolia contra bactérias. Porém, existem poucos estudos investigando o efeito desses OEs supracitados contra bactérias isoladas de peixes. Portanto, o objetivo desse estudo foi avaliar a atividade antibacteriana in vitro desses OEs contra bactérias isoladas de peixes (Aeromonas hydrophila, Citrobacter freundii e Raoultella ornithinolytica). Assim como avaliar a atividade antibacteriana in vivo do OE de L. origanoides contra uma infecção por A. hydrophila experimentalmente induzida em jundiá (Rhamdia quelen). O OE de L. origanoides foi escolhido porque apresentou a melhor atividade antibacteriana in vitro, com concentrações inibitórias mínimas variando de 0,2 a 0,8 mg mL-1. Esse OE apresentou sucesso terapêutico de 58,33% no dia 30 pós-infecção. Portanto, sugerimos que o OE de L. origanoides possa ser uma alternativa viável no tratamento da infecção por A. hydrophila em peixes.(AU)

Estudo epidemiológico de pacientes portadores de infecção do complexo bucomaxilofacial tratados no Hospital Universitário de Maringá: estudo retrospectivo ao longo de 8 anos / Epidemiological study of patients with oral maxillofacial infection treated at Universitary Hospital of Maringá: retrospective study about 8 years

Infecções agudas bucomaxilofaciais podem ser condições clínicas graves e de ocorrência comum, caracterizadas pela disseminação do processo infeccioso a tecidos adjacentes e espaços faciais da região de cabeça e pescoço, podendo resultar em várias complicações, até mesmo em óbito, embora seja raro. Objetivo: realizar uma análise epidemiológica de infecções maxilofaciais, relacionando os dados ao tratamento instituído e à sua efetividade, bem como analisar dados referentes a idade, sexo, principais dentes envolvidos e tempo total de internação. Sujeito e método: foram analisados retrospectivamente 240 prontuários de pacientes admitidos no Hospital Universitário de Maringá com infecção odontogênica, atendidos pela equipe de Cirurgia e Traumatologia Bucomaxilofacial no período de janeiro de 2009 a janeiro de 2017. Resultados: a média de idade dos pacientes foi de 38 anos, com 57 mulheres e 54 homens. A média de temperatura de admissão foi 38,5°C. A região mais acometida foi o ramo posterior da mandíbula, tendo uma média de duração de infecção e hospitalização de 6,1 dias. A principal conduta foi drenagem e antibioticoterapia, sendo que cerca de 13 pacientes não precisaram desse tipo de intervenção, e um paciente evoluiu a óbito. Conclusão: com base nestes resultados e na literatura, infecções odontogênicas merecem atenção, pois podem ser fatais e requerem internação rápida e tratamento adequado. Esse, portanto, é um assunto de grande importância para o cirurgião- -dentista, que exerce papel fundamental na prevenção e no tratamento. A resolução precoce ainda é a forma mais adequada para evitar complicações mais graves. (AU)

Acute Oral maxillofacial infections can be serious and relatively common clinical conditions, characterized by the spread of the infectious process to adjacent tissues and facial spaces of the head and neck region, which can result in several complications and lead to even death, although it is rare. Objective: the objective of this study was to perform an epidemiological analysis of maxillofacial infections and relate their data to the treatment instituted and the effectiveness of the same, as well as to analyze data regarding the age, sex, main teeth involved and total time of hospitalization. Subjects and method: in order to carry out study, 240 medical recordswere analyzed retrospectivelyat the University Hospital of Maringá of the patients with odontogenic infection attended by the Oral Maxillofacial Surgeon in the period of January 2009 to January 2017. Results: as a result, mean age was 38 years, with 57 women and 54 men and mean intake temperature was 38.5 °. The most affected region was the posterior branch of the mandible, with a mean duration of infection and hospitalization of 6.1 days. The main conduct was drainage and antibiotic therapy, and about 13 patients did not need this intervention and only 1 died. Conclusion: Based on these results and in literature, attention should be paid to odontogenic infections, which can be fatal and require proper treatment. This is a subject of great importance for the dentist, who plays a key role in prevention and proper treatment, its early resolution is still the most appropriate way to avoid serious complications. (AU)