Bacteriological findings and antimicrobial resistance in odontogenic and non-odontogenic chronic maxillary sinusitis.

The main objectives of this study were to estimate the frequency of chronic maxillary sinusitis of dental origin, and to evaluate the microbiology of odontogenic and non-odontogenic chronic maxillary sinusitis. Aspirates from 59 patients with chronic maxillary sinusitis (47 non-odontogenic, 12 odontogenic), collected during a 3-year period, were microbiologically processed for aerobic and anaerobic bacteria. Moreover, antimicrobial susceptibility was evaluated in the isolated bacteria. In this study, 20 % of chronic maxillary sinusitis cases were associated with a dental origin, and sinus lift procedures were the main aetiological factor. Our microbiological findings showed that all specimens from chronic maxillary sinusitis were polymicrobial. Sixty aerobes and 75 anaerobes were recovered from the 47 cases of non-odontogenic sinusitis (2.9 bacteria per specimen); 15 aerobes and 25 anaerobes were isolated from the 12 patients with odontogenic sinusitis (3.3 bacteria per specimen). The predominant aerobes were Staphylococcus aureus (27) and Streptococcus pneumoniae (16), while the more frequent anaerobes were Peptostreptococcus species (31) and Prevotella species (30). Haemophilus influenzae and Moraxella catarrhalis were absent in sinusitis associated with a dental origin. Overall, 22 % of Staphylococcus aureus isolates were oxacillin-resistant, and 75 % of Streptococcus pneumoniae isolates were penicillin-resistant and/or erythromycin-resistant; 21 % of anaerobic Gram-positive bacteria were penicillin-resistant, and 44 % of anaerobic Gram-negative bacteria were ß-lactamase-positive. Vancomycin and quinopristin-dalfopristin had the highest in vitro activity against Staphylococcus aureus and Streptococcus species, respectively; amoxicillin-clavulanate and cefotaxime showed the highest in vitro activity against aerobic Gram-negative bacteria; and moxifloxacin, metronidazole and clindamycin were the most active against anaerobic bacteria.

Streptococcus pyogenes emm types and subtypes of isolates from paediatric asymptomatic carriers and children with pharyngitis.

This study determined emm subtypes of Streptococcus pyogenes strains isolated from asymptomatic carriers and children with pharyngitis. All strains were previously investigated for fibronectin-binding genes (prtF1 and prtF2) and antimicrobial susceptibility. The most significant differences between the two groups, which share only 5 of the 14 detected emmsubtypes, concern the presence of the two more common emmsubtypes, 12.0 (50.0% vs. 3.1%, for asymptomatic carriers and children with pharyngitis, respectively) and 1.0 (28.1% vs. 0%, for children with pharyngitis and asymptomatic carriers, respectively).

Acute otitis media: From diagnosis to prevention. Summary of the Italian guideline.

Acute otitis media (AOM) is the most common disease occurring in infants and children and has major medical, social and economic effects. If we consider the Italian pediatric population and the incidence rates in different age ranges it can be calculated that almost one million cases of AOM are diagnosed in Italy every year. Various attempts have been made internationally to clarify the most appropriate ways in which AOM should be managed. In Italy, this has been done at local or regional level but there have so far been no national initiatives. The objective of this guideline is to provide recommendations to pediatricians, general practitioners and otolaryngologists involved in the clinical management of acute otitis media in healthy children aged 2 months to 12 years. After a systematic review and grading of evidences from the literature, the document was drafted by a multidisciplinary panel with identified key clinical questions related to diagnosis, treatment of the acute episode, management of complications and prevention.

Identification and antibiotic susceptibility of bacterial isolates from probiotic products available in Italy.

This study was carried out to assay the bacterial viability and the probable contamination of a range of probiotic products available in Italy and to test the susceptibility of the isolates. Eleven dried food supplements and five fermented functional foods were examined using different isolation media under standardized cultivation conditions. The identification was made by conventional phenotypic characteristics and biochemical tests. Among isolates from the probiotic products antibiotic susceptibility was detected using the E-test (ABBiodisk). Our results demonstrate that nine food supplements and two fermented foods claimed species which could not be isolated, whereas potential pathogens (i.e. Micromonas micros) were isolated. Lactobacilli displayed species-dependent antibiotic resistance. Atypical resistance occurred for penicillin in Lactobacillus acidophilus and Lactobacillus bulgaricus and for erythromycin in Lactobacillus lactis and Lactobacillus salivarius. A broad range of MICs was observed for cephalosporins and fluroquinolones. Aminoglycosides had poor activity against Lactobacillus isolates. Two of the four isolates of Bifidobacterium exhibited high resistance to trimethroprim/sulfametoxazole and to fluoroquinolones. Our results suggest that some probiotic products claim species that cannot always be isolated, and are sometimes contaminated by potential pathogens. Moreover, the probable transferable erythromycin or penicillin resistance among the lactobacilli isolated should be taken into account.

Protection against murine endotoxemia by treatment with Ruta chalepensis L., a plant with anti-inflammatory properties.

The anti-inflammatory effect of the extract of Ruta Chalepensis L. (Rutaceae) on the course of lethal endotoxemia in BALB/c mice was studied. When administered by gavage as 1 g/kg per day starting 14 or 7 days prior to injection of 0.75 mg endotoxin (LPS: lipopolysaccharide), the extract markedly reduced lethality (32.5% in both experiments versus approximately 85% of the control mice). A delay in lethality, but not cumulative lethality, was observed when prophylaxis was given 24 and 1 h prior to LPS challenge. The effect was associated with reduced LPS-induced blood levels of nitrite, an indicator of nitric oxide production. In contrast, the blood levels of tumour necrosis factor, interleukin 6 and interleukin 10 did not differ significantly from those of controls given LPS alone. These data show that Ruta Chalepensis L. possesses powerful immunopharmacological properties that make it capable of counteracting the lethal effects of high doses of LPS in vivo.