Antibacterial and Antibiofilm Activity of Carvacrol against Oral Pathogenic Bacteria.

Faced with the current situation of high rates of microbial resistance, together with the scarcity of new antibiotics, it is necessary to search for and identify new antimicrobials, preferably natural, to alleviate this situation. The aim of this work was to evaluate the antibacterial activity of carvacrol (CAR), a phenolic compound of essential oils, against pathogenic microorganisms causing oral infections, such as Streptococcus mutans and S. sanguinis, never evaluated before. The minimum inhibitory and the minimum bactericidal concentration were 93.4 µg/mL and 373.6 µg/mL, respectively, for the two strains. The growth kinetics under different concentrations of CAR, as well as the bactericidal power were determined. The subinhibitory concentrations delayed and decreased bacterial growth. Its efficacy on mature biofilms was also tested. Finally, the possible hemolytic effect of CAR, not observable at the bactericidal concentrations under study, was evaluated. Findings obtained point to CAR as an excellent alternative agent to safely prevent periodontal diseases. In addition, it is important to highlight the use of an experimental methodology that includes dual-species biofilm and subinhibitory concentration models to determine optimal CAR treatment concentrations. Thus, CAR could be used preventively in mouthwashes or biomaterials, or in treatments to avoid existing antibiotic resistance.

Modification of physico-chemical surface properties and growth of Staphylococcus aureus under hyperglycemia and ketoacidosis conditions.

Diabetes is a widely spread disease affecting the quality of life of millions of people around the world and is associated to a higher risk of developing infections in different parts of the body. The reasons why diabetes enhances infection episodes are not entirely clear; in this study our aim was to explore the changes that one of the most frequently pathogenic bacteria undergoes when exposed to hyperglycemia and ketoacidosis conditions. Physical surface properties such as hydrophobicity and surface electrical charge are related to bacterial growth behavior and the ability of Staphylococcus aureus to form biofilms. The addition of glucose made bacteria more negatively charged and with moderate-intermediate hydrophobicity. Ketone bodies increased hydrophobicity to approximately 75% and pathological concentrations hindered some of the bacterial surface charge by decreasing the negative zeta potential of cells. When both components were present, the bacterial physical surface changes were more similar to those observed in ketone bodies, suggesting a preferential adsorption of ketone bodies over glucose because of the more favorable solubility of glucose in water. Glucose diabetic concentrations gave the highest number of bacteria in the stationary phase of growth and provoked an increase in the biofilm slime index of around 400% in relation to the control state. Also, this situation is related with an increase of bacterial coverage. The combination of a high concentration of glucose and ketone bodies, which corresponds to a poorly controlled diabetic situation, appears associated with an early infection phase; increased hydrophobic attractive force and reduced electrostatic repulsion between cells results in better packing of cells within the biofilm and more efficient retention to the host surface. Knowledge of bacterial response in high amount of glucose and ketoacidosis environments can serve as a basis for designing strategies to prevent bacterial adhesion, biofilm formation and, consequently, the development of infections.

Antimicrobial activity of a novel Spanish propolis against planktonic and sessile oral Streptococcus spp.

Increased bacterial resistance to traditional antimicrobial agents has prompted the use of natural products with antimicrobial properties such as propolis, extensively employed since ancient times. However, the chemical composition of propolis extracts is extremely complex and has been shown to vary depending on the region and season of collection, due to variations in the flora from which the pharmacological substances are obtained, being therefore essential for their antimicrobial activity to be checked before use. For this purpose, we evaluate the in vitro antimicrobial and anti-biofilm activity of a new and promising Spanish ethanolic extract of propolis (SEEP) on Streptococcus mutans and Streptococcus sanguinis, responsible, as dominant 'pioneer' species, for dental plaque. Results reveal that S. sanguinis is more sensitive to SEEP, slowing and retarding its growth considerably with lower concentrations than those needed to produce the same effect in S. mutans. SEEP presents concentration- and time-dependent killing activity and, furthermore, some of the subinhibitory concentrations employed increased biofilm formation even when bacterial growth decreased. Mono and dual-species biofilms were also inhibited by SEEP. Findings obtained clearly show the relevance of using biofilm and subinhibitory concentration models to determine optimal treatment concentrations.

Antifungal and anti-biofilm activity of a new Spanish extract of propolis against Candida glabrata.

BACKGROUND: Resistance to traditional antifungal agents is a considerable health problem nowadays, aggravated by infectious processes related to biofilm formation, usually on implantable devices. Therefore, it is necessary to identify new antimicrobial molecules, such as natural products, to develop new therapeutic strategies to prevent and eradicate these infections. One promising product is propolis, a natural resin produced by honeybees with substances from various botanical sources, beeswax and salivary enzymes. The aim of this work was to study the effect of a new Spanish ethanolic extract of propolis (SEEP) on growth, cell surface hydrophobicity, adherence and biofilm formation of Candida glabrata, a yeast capable of achieving high levels of resistance to available anti-fungal agents. METHODS: The antifungal activity of SEEP was evaluated in the planktonic cells of 12 clinical isolates of C. glabrata. The minimum inhibitory concentration (MIC) of propolis was determined by quantifying visible growth inhibition by serial plate dilutions. The minimum fungicide concentration (MFC) was evaluated as the lowest concentration of propolis that produced a 95% decrease in cfu/mL, and is presented as MFC50 and MFC90, which corresponds to the minimum concentrations at which 50 and 90% of the C. glabrata isolates were inhibited, respectively. Influence on cell surface hydrophobicity (CSH) was determined by the method of microbial adhesion to hydrocarbons (MATH). The propolis effect on adhesion and biofilm formation was determined in microtiter plates by measurement of optical density (OD) and metabolic activity (XTT-assay) in the presence of sub-MIC concentrations of SEEP. RESULTS: SEEP had antifungal capacity against C. glabrata isolates, with a MIC50 of 0.2% (v/v) and an MFC50 of 0.4%, even in azole-resistant strains. SEEP did not have a clear effect on surface hydrophobicity and adhesion, but an inhibitory effect on biofilm formation was observed at subinhibitory concentrations (0.1 and 0.05%) with a significant decrease in biofilm metabolism. CONCLUSIONS: The novel Spanish ethanolic extract of propolis shows antifungal activity against C. glabrata, and decreases biofilm formation. These results suggest its possible use in the control of fungal infections associated with biofilms.

A physico-chemical study of the interaction of ethanolic extracts of propolis with bacterial cells.

In the present study, an effort has been made to understand the interaction mode of propolis, a natural substance produced by honey bees, with gram-positive and gram-negative bacterial cells by measuring alterations in cell surface physico-chemical properties following the incubation of the cells with different sub-inhibitory concentrations of this antimicrobial agent. Electrophoretic mobility and surface hydrophobicity measurements revealed for the first time that propolis induced substantial changes in the volumetric charge density, electrophoretic softness and degree of hydrophobicity characterizing the outermost surface layer of cells. These changes, which appear to be dose-dependent, seem to be consistent with the increasing accumulation and penetration of the propolis antimicrobial components through the cells extracellular layer. Moreover, electron microscopy observation and the determination of the cell constituents' release demonstrated that propolis at sub-bactericidal concentrations already provoked (at least localized) cell wall damage and/or perturbations. These findings thus suggest that the initial mechanism of action of propolis is most likely structural, resulting from sufficient interaction between the different propolis components and bacterial cell wall structures.

Chemical Profile and Antibacterial Activity of a Novel Spanish Propolis with New Polyphenols also Found in Olive Oil and High Amounts of Flavonoids.

Propolis is a natural product obtained from hives. Its chemical composition varies depending on the flora of its surroundings, but nevertheless, common for all types of propolis, they all exhibit remarkable biological activities. The aim of this study was to investigate the chemical composition and antimicrobial activity of a novel Spanish Ethanolic Extract of Propolis (SEEP). It was found that this new SEEP contains high amounts of polyphenols (205 ± 34 mg GAE/g), with unusually more than half of this of the flavonoid class (127 ± 19 mg QE/g). Moreover, a detailed analysis of its chemical composition revealed the presence of olive oil compounds (Vanillic acid, 1-Acetoxypinoresinol, p-HPEA-EA and 3,4-DHPEA-EDA) never detected before in propolis samples. Additionally, relatively high amounts of ferulic acid and quercetin were distinguished, both known for their important therapeutic benefits. Regarding the antimicrobial properties of SEEP, the minimal inhibitory and bactericidal concentrations (MIC and MBC) against Staphylococcus epidermidis strains were found at the concentrations of 240 and 480 µg/mL, respectively. Importantly, subinhibitory concentrations were also found to significantly decrease bacterial growth. Therefore, the results presented here uncover a new type of propolis rich in flavonoids with promising potential uses in different areas of human health.

The role of magnesium in biomaterials related infections.

Magnesium is currently increasing interest in the field of biomaterials. An extensive bibliography on this material in the last two decades arises from its potential for the development of biodegradable implants. In addition, many researches, motivated by this progress, have analyzed the performance of magnesium in both in vitro and in vivo assays with gram-positive and gram-negative bacteria in a very broad range of conditions. This review explores the extensive literature in recent years on magnesium in biomaterials-related infections, and discusses the mechanisms of the Mg action on bacteria, as well as the competition of Mg2+ and/or synergy with other divalent cations in this subject.

Impact of PLA/Mg films degradation on surface physical properties and biofilm survival.

New biocompatible and bioabsorbable materials are currently being developed for bone regeneration. These serve as scaffolding for controlled drug release and prevent bacterial infections. Films of polylactic acid (PLA) polymers that are Mg-reinforced have demonstrated they have suitable properties and bioactive behavior for promoting the osseointegration process. However little attention has been paid to studying whether the degradation process can alter the adhesive physical properties of the biodegradable film and whether this can modify the biofilm formation capacity of pathogens. Moreover, considering that the concentration of Mg and other corrosion products may not be constant during the degradation process, the question that arises is whether these changes can have negative consequences in terms of the bacterial colonization of surfaces. Bacteria are able to react differently to the same compound, depending on its concentration in the medium and can even become stronger when threatened. In this context, physical surface parameters such as hydrophobicity, surface tension and zeta potential of PLA films reinforced with 10% Mg have been determined before and after degradation, as well as the biofilm formation capacity of Staphylococcus epidermidis. The addition of Mg to the films makes them less hydrophobic and the degradation also reduces the hydrophobicity and increases the negative charge of the surface, especially over long periods of time. Early biofilm formation at 8 h is consistent with the physical properties of the films, where we can observe a reduction in the bacterial biofilm formation. However, after 24 h of incubation, the biofilm formation increases significantly on the PLA/Mg films with respect to PLA control. The explosive release of Mg ions and other corrosion products within the first hours were not enough to prevent a greater biofilm formation after this initial time. Consequently, the Mg addition to the polymer matrix had a bacteriostatic effect but not a bactericidal one. Future works should aim to optimize the design and biofunctionality of these promising bioabsorbable composites for a degradation period suitable for the intended application.

Candida tropicalis biofilm formation and expression levels of the CTRG ALS-like genes in sessile cells.

Candida tropicalis is an emergent pathogen with a high rate of mortality associated with it; however, less is known about its pathogenic capacity. Biofilm formation (BF) has important clinical repercussions, and it begins with adherence to a substrate. The adherence capacity depends principally on the cell surface hydrophobicity (CSH) and, at a later stage, on specific adherence due to adhesins. The ALS family in C. tropicalis, implicated in adhesion and BF, is represented in several CTRG genes. In this study, we determined the biofilm-forming ability, the primary adherence, and the CSH of C. tropicalis, including six isolates from blood and seven from urine cultures. We also compared the expression of four CTRG ALS-like genes (CTRG_01028, CTRG_02293, CTRG_03786, and CTRG_03797) in sessile versus planktonic cells, selected for their possible contribution to BF. All the C. tropicalis strains were biofilm producers, related to its filamentation capacity; all the strains displayed a high adherence ability correlated to the CSH, and all the strains expressed the CTRG genes in both types of growth. Urine isolates present, although not significantly, higher CSH, adherence, and biofilm formation than blood isolates. This study reveals that three CTRG ALS-like genes-except CTRG_03797-were more upregulated in biofilm cells, although with a considerable variation in expression across the strains studied and between the CTRG genes. C. tropicalis present a high biofilm capacity, and the overexpression of several CTRG ALS-like genes in the sessile cells suggests a role by the course of the biofilm formation.

Balancing microbial and mammalian cell functions on calcium ion-modified implant surfaces.

Implant integration is a complex process mediated by the interaction of the implant surface with the surrounding ions, proteins, bacteria, and tissue cells. Although most implants achieve long-term bone-tissue integration, preventing pervasive implant-centered infections demands further advances, particularly in surfaces design. In this work, we analyzed classical microrough implant surfaces (only acid etched, AE; sandblasted then acid etching, SB + AE) and a new calcium-ion-modified implant surface (AE + Ca) in terms of soft- and hard-tissue integration, bacterial adhesion, and biofilm formation. We cultured on the surfaces primary oral cells from gingiva and alveolar bone, and three representative bacterial strains of the oral cavity, emulating oral conditions of natural saliva and blood plasma. With respect to gingiva and bone cells and in the presence of platelets and plasma proteins, AE + Ca surfaces yielded in average 86% higher adhesion, 44% more proliferation, and triggered 246% more synthesis of extracellular matrix biomolecules than AE-unmodified controls. Concomitantly, AE + Ca surfaces regardless of conditioning with saliva and/or blood plasma showed significantly less bacterial adhesion (67% reduction in average) and biofilm formation (40% reduction in average) than unmodified surfaces. These results highlight the importance of a calcium-rich hydrated interface to favor mammalian cell functions over microbial colonization at implant surfaces. © 2017 Wiley Periodicals, Inc. J Biomed Mater Res Part B: Appl Biomater, 106B: 421-432, 2018.

Covalent immobilization of hLf1-11 peptide on a titanium surface reduces bacterial adhesion and biofilm formation.

Bacterial infection represents a major cause of implant failure in dentistry. A common approach to overcoming this issue and treating peri-implant infection consists in the use of antibiotics. However, the rise of multidrug-resistant bacteria poses serious concerns to this strategy. A promising alternative is the use of antimicrobial peptides due to their broad-spectrum activity against bacteria and reduced bacterial resistance responses. The aim of the present study was to determine the in vitro antibacterial activity of the human lactoferrin-derived peptide hLf1-11 anchored to titanium surfaces. To this end, titanium samples were functionalized with the hLf1-11 peptide either by silanization methods or physical adsorption. X-ray photoelectron spectroscopy analyses confirmed the successful covalent attachment of the hLf1-11 peptide onto titanium surfaces. Lactate dehydrogenase assay determined that hLf1-11 peptide did not affect fibroblast viability. An outstanding reduction in the adhesion and early stages of biofilm formation of Streptococcus sanguinis and Lactobacillus salivarius was observed on the biofunctionalized surfaces compared to control non-treated samples. Furthermore, samples coated with the hLf1-11 peptide inhibited the early stages of bacterial growth. Thus, this strategy holds great potential to develop antimicrobial biomaterials for dental applications.

Electrochemical analysis of the UV treated bactericidal Ti6Al4V surfaces.

This research investigates in detail the bactericidal effect exhibited by the surface of the biomaterial Ti6Al4V after being subjected to UV-C light. It has been recently hypothesized that small surface currents, occurring as a consequence of the electron-hole pair recombination taking place after the excitation process, are behind the bactericidal properties displayed by this UV-treated material. To corroborate this hypothesis we have used different electrochemical techniques, such as electrochemical impedance spectroscopy (EIS), potentiodynamic polarization plots and Mott-Schottky plots. EIS and Mott-Schottky plots have shown that UV-C treatment causes an initial increase on the surface electrical conduction of this material. In addition, EIS and polarization plots demonstrated that higher corrosion currents occur at the UV treated than at the non-irradiated samples. Despite this increase in the corrosion currents, EIS has also shown that such currents are not likely to affect the good stability of this material oxide film since the irradiated samples completely recovered the control values after being stored in dark conditions for a period not longer than 24h. These results agree with the already-published in vitro transitory behavior of the bactericidal effect, which was shown to be present at initial times after the biomaterial implantation, a crucial moment to avoid a large number of biomaterial associated infections.

La hidrofobicidad de la superficie celular como indicador de otros factores de virulencia en Candida albicans / Cell surface hydrophobicity as an indicator of other virulence factors in Candida albicans

Objetivo. Evaluar factores de virulencia implicados en el proceso de adhesión, como la hidrofobicidad de la superficie celular (HSC), capacidad de adherencia a plástico y a células epiteliales bucales (CEB), así como formación de biocapa, en 17 cepas de Candida albicans aisladas de aspirados bronquiales de pacientes críticos. Método. Se determinó la HSC de las cepas utilizando el método MATH, test de adheresión microbiana a hidrocarburos. El estudio de adherencia al plástico se llevó a cabo en placas de microtitulación según la técnica de Christensen. Se estudió la formación de biocapa sobre placas de microtitulación de poliestireno según el método de Ramage. La adherencia a CEB se valoró cuantificando el porcentaje de levaduras adheridas a células. Resultados. Todas las cepas estudiadas mostraron factores implicados directamente en la adherencia existiendo variabilidad en el grado de expresión de los mismos. Un 52,9% de las cepas presentaron niveles medio-altos de HSC. El 35,3% de las cepas tenían valores altos de adherencia a plástico. Las cepas más hidrofóbicas fueron las más adherentes a plástico, encontrándose un coeficiente de correlación de 0,76. De las 12 cepas productoras de biocapa, 6 de ellas eran altamente productoras. Estas cepas presentaban también altos niveles de HSC y adherencia a plástico con resultados significativos. Todas las cepas estudiadas se adhirieron a CEB dentro de un amplio rango de resultados, desde 45 a 157 lev/100 CEB, sin correlación significativa con el resto de parámetros estudiados, aunque la HSC se mostró como un requisito previo indispensable para la adherencia a células. Conclusión. La HSC es una característica variable en C. albicans y está directamente relacionada con la adherencia a plástico y con la formación de biocapa. La facilidad de valoración de la HSC nos permite su cuantificación y posibilita su utilización como indicador de la presencia de otros determinantes de patogenicidad(AU)

Objective. To evaluate virulence factors involved in the adhesion process, such as cell surface hydrophobicity (CSH), adherence to plastic capacity, adherence capacity to buccal epithelial cells (BEC), and biofilm formation, in 17 strains of C. albicans isolated from bronchial aspirates of critically ill patients. Method. The CSH of the strains of C. albicans was determined using the MATH method, a microbial adhesion to hydrocarbons test. The study of adherence to plastic was performed in microtitre plates in accordance with Christensen's technique. Biofilm formation was studied in polystyrene microtitre plates, according to the method of Ramage. Adherence to BEC was evaluated by quantifying the percentage of adhered yeasts to cells. Results. All the strains studied showed factors directly involved in adhesion, with variability in the degree of expression among them. Medium-high levels of CSH were found in 52.9% of the strains. The percentage of strains with high values in adherence to plastic was 35.3%. The most hydrophobic strains were the most adherent to plastic, with a correlation coefficient of 0.76. Of the 12 biofilm-producing strains, 6 were high producers. These strains had also high levels of CSH and adherence to plastic, with significant results. All the strains studied adhered to BEC, with results ranging widely from 45 to 157 yeasts/100 BEC, with no significant correlation with the rest of the parameters studied, although CSH was seen to be an indispensable prior requisite for adherence to cells. Conclusion. CSH is a variable characteristic in C. albicans and is directly related to adherence to plastic and biofilm formation. Ease in evaluating CSH permits its quantification, and could be used as an indicator of the presence of other determinants of pathogenicity(AU)

[Cell surface hydrophobicity as an indicator of other virulence factors in Candida albicans]. / La hidrofobicidad de la superficie celular como indicador de otros factores de virulencia en Candida albicans.

OBJECTIVE: To evaluate virulence factors involved in the adhesion process, such as cell surface hydrophobicity (CSH), adherence to plastic capacity, adherence capacity to buccal epithelial cells (BEC), and biofilm formation, in 17 strains of C. albicans isolated from bronchial aspirates of critically ill patients. METHOD: The CSH of the strains of C. albicans was determined using the MATH method, a microbial adhesion to hydrocarbons test. The study of adherence to plastic was performed in microtitre plates in accordance with Christensen's technique. Biofilm formation was studied in polystyrene microtitre plates, according to the method of Ramage. Adherence to BEC was evaluated by quantifying the percentage of adhered yeasts to cells. RESULTS: All the strains studied showed factors directly involved in adhesion, with variability in the degree of expression among them. Medium-high levels of CSH were found in 52.9% of the strains. The percentage of strains with high values in adherence to plastic was 35.3%. The most hydrophobic strains were the most adherent to plastic, with a correlation coefficient of 0.76. Of the 12 biofilm-producing strains, 6 were high producers. These strains had also high levels of CSH and adherence to plastic, with significant results. All the strains studied adhered to BEC, with results ranging widely from 45 to 157 yeasts/100 BEC, with no significant correlation with the rest of the parameters studied, although CSH was seen to be an indispensable prior requisite for adherence to cells. CONCLUSION: CSH is a variable characteristic in C. albicans and is directly related to adherence to plastic and biofilm formation. Ease in evaluating CSH permits its quantification, and could be used as an indicator of the presence of other determinants of pathogenicity.

Bactericidal behaviour of Ti6Al4V surfaces after exposure to UV-C light.

TiO(2)-coated biomaterials that have been excited with UV irradiation have demonstrated biocidal properties in environmental applications, including drinking water decontamination. However, this procedure has not been successfully applied towards the killing of pathogens on medical titanium-based implants, mainly because of practical concerns related to irradiating the inserted biomaterial in situ. Previous researchers assumed that the photocatalysis on the TiO(2) surface during UV application causes the bactericidal effects. However, we show that a residual post-irradiation bactericidal effect exists on the surface of Ti6Al4V, not related with photocatalysis. Using a combination of staining, serial dilutions, and a biofilm assay, we show a significant and time-dependent loss in viability of different bacterial strains of Staphylococcus epidermidis and Staphylococcus aureus on the post-irradiated surface. Although the duration of this antimicrobial effect depends on the strains selected, our experiments suggest that the effect lasts at least 60 min after surface irradiation. The origin of such phenomena is discussed in terms of the physical properties of the irradiated surfaces, which include the emission of energy and changes in surfaces charge occurring during electron-hole recombination processes. The method here proposed for the preparation of antimicrobial titanium surfaces could become especially useful in total implant surgery for which the antimicrobial challenge is mainly during or shortly after surgery.

In vitro biocompatibility and bacterial adhesion of physico-chemically modified Ti6Al4V surface by means of UV irradiation.

UV irradiation leads to a "spontaneous" wettability increase of the Ti6Al4V surface while preserving bulk properties of the alloy that are crucial for its performance as an orthopedic and dental implant. We hypothesized that UV treatment of Ti6Al4V may impair bacterial adhesion without compromising the good response of human bone-forming cells to this alloy. The in vitro biocompatibility of the Ti6Al4V surface, before and after UV irradiation, was analyzed by using human cells related to the osteoblastic phenotype. The adhesion processes of bacterial strains related to clinical orthopedic infections, i.e., Staphylococcus aureus and Staphylococcus epidermidis, were studied theoretically and in vitro, under dynamic and static conditions as well as in the presence or absence of shear forces. While human cell adhesion was not altered by UV irradiation of Ti6Al4V alloy, this treatment reduced not only initial bacterial adhesion rates but also the number of bacteria retained on the surface after the passage of two air-liquid interfaces on the previously adhered bacteria. This study proposes the use of UV treatment prior to implantation protocols as an easy, economic and effective way of reducing bacterial adhesion on the Ti6Al4V surface without compromising its excellent biocompatibility.

Cellular surface hydrophobicity as an additional phenotypic criterion applied to differentiate strains of Candida albicans and Candida dubliniensis.

We have evaluated the cellular surface hydrophobicity (CSH) determination as an additional criterion to differentiate Candida albicans from Candida dubliniensis. Our results show that C. albicans when grown at 37 degrees C in Sabouraud is always hydrophilic, and C. dubliniensis presents high CSH levels.

Serum as a factor influencing adhesion of Enterococcus faecalis to glass and silicone.

The purpose of this work was to analyze the effect of serum on the physicochemical surface properties and adhesion to glass and silicone of Enterococcus faecalis ATCC 29212 at 37 degrees C. As is presented using thermodynamics analysis, serum minimizes the interaction of cells with water, which correlates well with the increase in hydrophobicity and in bacterial adhesion to glass and silicone.

Thermodynamic analysis of growth temperature dependence in the adhesion of Candida parapsilosis to polystyrene.

The purpose of this work was to study the adhesion to polystyrene of two Candida parapsilosis strains, grown at 22 and 37 degrees C, in terms of hydrophobicity, surface charge, and interaction free energy. Growth temperature changed the surface properties of microorganisms, yielding a good correlation between thermodynamic predictions and adhesion behavior.

Patogenicidad de enterococcus spp. características de 169 aislamientos hospitalarios / Enterococcus spp. pathogenicity. Characteristics of 169 hospital isolates

Fundamento: Conocer las características de los aislamientos hospitalarios de Enterococcus spp., analizando la importancia de este microorganismo, así como la resistencia a los antimicrobianos. Pacientes y métodos: Análisis retrospectivo de las historias clínicas de 169 pacientes con aislamiento de Enterococcus spp., seleccionados aleatoriamente en el Hospital Infanta Cristina de Badajoz. Se investigaron la edad, el sexo, las fechas de ingreso y de alta, los síntomas clínicos, los factores de riesgo, el tratamiento antibiótico previo, la evolución clínica y microbiológica, así como el tratamiento recomendado y el tratamiento prescrito. Se identificaron los microorganismos y se llevó a cabo antibiograma con paneles microScan Pos Combo 4I, leídos en un equipo Baxter WalkAway-40. Resultados: La especie más frecuentemente hallada fue Enterococcus faecalis. En 75 casos los aislamientos fueron polimicrobianos. Los enterococos se aislaron principalmente de infecciones urinarias (27 por ciento), infecciones cutáneas (20 por ciento), infecciones intraabdominales (14 por ciento) e infección de herida quirúrgica (14 por ciento). Como factor de riesgo destacó la existencia de catéter periférico. Todas las cepas de E. faecalis fueron sensibles a los glucopéptidos. Dos cepas de Enterococcus faecium no eran sensibles a vancomicina y una de ellas tampoco a teicoplanina. La mortalidad fue del 21-27,5 por ciento. Conclusiones: Enterococcus spp. se aísla con frecuencia en infecciones hospitalarias, pero aproximadamente en la mitad de los casos se encuentra asociado a otras bacterias. Por este motivo, no siempre es posible establecer su contribución patogénica. Las cepas aisladas, excepto dos cepas de E. faecium, son sensibles a vancomicina. Existe relación entre alta resistencia a aminoglucósidos y resistencia a fluoroquinolonas (AU)