Reference Susceptibility Testing and Genomic Surveillance of Clostridioides difficile, United States, 2012-17

alexandrossfakianakis shared this article with you from Inoreader Reference Susceptibility Testing and Genomic Surveillance of Clostridioides difficile, United States, 2012-17 via Clinical Infectious Diseases Advance Access Abstract Background Antimicrobial susceptibility testing (AST) is not routinely performed for Clostridioides difficile and data evaluating minimum inhibitory concentrations (MICs) are limited. We performed AST and whole genome sequencing (WGS) for 593 C. difficile isolates collected between 2012-2017 through the Centers for Disease Control and Prevention's Emerging Infections Program. M ethods MICs to six antimicrobial agents (ceftriaxone, clindamycin, meropenem, metronidazole, moxifloxacin, and vancomycin) were determined using the reference agar dilution method according to Clinical and Laboratory Standards Institute guidelines. WGS was performed on all isolates to detect the presence of genes or mutations previously associated with resistance. Results Among all isolates, 98.5% displayed a vancomycin MIC ≤ 2 μg/mL and 97.3% displayed a metronidazole MIC ≤ 2 μg/mL. Ribotype 027 (RT027) isolates displayed higher vancomycin MICs (MIC50: 2 μg/mL; MIC90: 2 μg/mL) than non-RT027 isolates (MIC50: 0.5 μg/mL; MIC90: 1 μg/mL) (P < 0.01). No vanA/B genes were detected. RT027 isolates also showed higher MICs to clindamycin and moxifloxacin and were more likely to harbor associated resistance genes or mutations. Conclusions Elevated MICs to antib iotics used for treatment of C. difficile infection were rare and there was no increase in MICs over time. The lack of vanA/B genes or mutations consistently associated with elevated vancomycin MICs suggests there are multifactorial mechanisms of resistance. Ongoing surveillance of C. difficile using reference AST and WGS to monitor MIC trends and the presence of antibiotic resistance mechanisms is essential. View on Web

Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Nosocomial malaria transmissions resolved by genomic analyses – a retrospective case report study in France (2007-2021)

alexandrossfakianakis shared this article with you from Inoreader Nosocomial malaria transmissions resolved by genomic analyses – a retrospective case report study in France (2007-2021) via Clinical Infectious Diseases Advance Access Abstract Background Exposure of blood to malaria parasites can lead to infection even in the absence of the anopheles mosquito vector. During a stay in a healthcare facility, accidental inoculation of the skin with blood from a malaria patient might occur, referred to as nosocomial malaria transmission. Methods Between 2007 and 2021, we identified six autochthonous malaria cases that occurred in six different French hospitals, originating from nosocomial transmi ssion and imported malaria patients being the infection source. Four cases were observed during the COVID-19 pandemic. The genetic relatedness between source and nosocomial infections was evaluated by genome-wide short tandem repeats (STRs) and single-nucleotide polymorphisms (SNPs). Results None of the patients with autochthonous malaria had travel history to an endemic area nor had been transfused. For each case, both the source and recipient patients stayed a few hours in the same ward. After diagnosis, autochthonous cases were treated with antimalarials and all recovered except one. Genetically, each pair of matched source/nosocomial parasite infections showed less than 1% of different genome-wide STRs, and less than 6.9% (<1.5% for monoclonal infections) of different SNPs. Similar levels of genetic differences were obtained for parasite DNA samples that were independently sequenced twice as references of identical infections. Parasite phylogenomic results were consi stent with travel information reported by the source patients. Conclusions Our study demonstrates that genomics analyses may resolve nosocomial malaria transmissions, despite the uncertainty regarding the modes of contamination. Nosocomial transmission of potentially life-threatening parasites should be taken into consideration in settings or occasions where compliance with universal precautions is not rigorous. View on Web

Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Gut Microbiota May Mediate the Impact of Chronic Apical Periodontitis on Atherosclerosis in Apolipoprotein E‐deficient Mice

alexandrossfakianakis shared this article with you from Inoreader Gut Microbiota May Mediate the Impact of Chronic Apical Periodontitis on Atherosclerosis in Apolipoprotein E‐deficient Mice via International Endodontic Journal Abstract Aim There are growing evidences linking chronic apical periodontitis (CAP) to atherosclerosis. Gut microbiota is found to be involved in the development of atherosclerosis. Recent studies have shown that CAP could change the diversity and composition of the gut microbiota. It was therefore, we hypothesized that gut microbiota and its metabolites could mediate the impact of CAP on atherosclerosis. Methodology Twenty-four 5-week-old lipoprotein E knockout (apoE-/-) mice were randomly divided into four groups: the CAP group, Con group, Co-CAP (cohoused with CAP), and Co-Con (cohoused with Con) group. In the CAP group, sterile cotton wool containing P. gingivalis was placed into the exposed pulp chamber, followed by coronal resin-based composite restoration of the bilateral maxillary first and second molars. In the Con group, a sham operation was performed. Biweekly, mice in the CAP group were anesthetized to check the sealing of coronal access. Meanwhile, the animals in the Con group were anesthetized. The cohousing approach was used to introduce gut microbiota from the CAP and Con groups into the Co-CAP and Co-Con groups, respectively. Alterations in the abundance and diversity of the gut microbiota were detected using 16S rRNA sequencing, Oil red O staining was used to demonstrate the extent of lesions, and serum levels of trimethylamine N-oxide (TMAO), and immunohist ochemistry of flavin-containing monooxygenase 3 (FMO3) in liver were used to assess TMAO-related metabolic alterations. Results Alterations of alpha and beta diversity were shown both in the CAP and the Co-CAP groups. Moreover, the percentage of atherosclerotic lesion area increased in the CAP and Co-CAP groups (p<.05). Linear discriminant analysis effect size (LEfSe) at the family level found the increases of Lachnospiraceae and Ruminococcaceae (P<.05), which were positively correlated with serum TMAO levels (P<.05). In the redundancy analysis technique (RDA), serum levels of TMAO were positively associated with the atherosclerotic lesions. Co-occurrence analysis revealed that the relative abundances of Lachnospiraceae and Porphyromonadacae were positively correlated with both the percentage of lesion area and TMAO level (P<.05) Conclusion Thus, within the limitations of this study, the data suggest that the gut microbiota can mediate the effects of CAP on atherosclerosis. View on Web

Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Automated Detection of Smiles as Discrete Episodes

alexandrossfakianakis shared this article with you from Inoreader Automated Detection of Smiles as Discrete Episodes via Journal of Oral Rehabilitation Abstract Background Patients seeking restorative and orthodontic treatment expect an improvement in their smiles and oral health-related quality of life. Nonetheless, the qualitative and quantitative characteristics of dynamic smiles are yet to be understood. Objective To develop, validate, and introduce open-access software for automated analysis of smiles in terms of their frequency, genuineness, duration, and intensity. Materials and Methods A software script was developed using the Facial Action Coding System (FACS) and artificial intelligence to assess activations of (1) cheek raiser, a marker of smile genuineness; (2) lip corner puller, a marker of smile intensity; and (3) perioral lip muscles, a marker of lips apart. Thirty study participants were asked to view a series of amusing videos. A full-face video was recorded using a webcam. The onset and cessation of smile episodes were identified by two examiners trained with FACS coding. A Receiver Operating Characteristic (ROC) curve was then used to assess detection accuracy and optimise thresholding. The videos of participants were then analysed off-line to automatedly assess the features of smiles. Results The area under the ROC curve for smile detection was 0.94, with a sensitivity of 82.9% and a specificity of 89.7%. The software correctly identified 90.0% of smile episodes. While watching the amusing videos, study participants smiled 1.6 (±0.8) times per minute. Conclusions Features of smiles such as frequency, duration, genuineness, and intensity can be automatedly assessed with an acceptable level of accuracy. The software can be used to investigate the impact of oral conditions and their rehabilitation on smiles. View on Web

Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Effect of Ceftriaxone on Intestinal Transit Time

alexandrossfakianakis shared this article with you from Inoreader Effect of Ceftriaxone on Intestinal Transit Time via Fundamental & Clinical Pharmacology Abstract Background Ceftriaxone reduces gallbladder and ileal contractility. Many studies have shown that ceftriaxone causes biliary sludge and pseudolithiasis. However, its effect on intestinal transit time has not been investigated. This study aimed to investigate the effect of ceftriaxone on intestinal transit time. Material and Method Sixteen rats were examined in two groups: The study group (GroupA, n=8) was administered 100mg/kg ceftriaxone intramuscularly for 7 days. The control group (GroupB, n=8) was administered intramuscular distilled water for 7 days. On the 7th day, amixture of 2 cc barium and saline was given orally to both groups. Barium transit was evaluated using serial digital X-ray images. Results The stomach was full and transition into the small intestine loop was observed in all rats at 45 min in both groups. At the 2nd hour, colonic transition was observed in two rats in group A (2/8, 25%) and in seven in group B (7/8, 87.5%). At the 4th hour, five (62.5%) rats in group A had transverse colonic transition, and all rats in group B (8/8, 100%) had transverse and/or left colonic transition. At the 6th hour, no rat in group A had rectal transition, and all rats in group B (8/8, 100%) had complete passage of colonic contrast material. Conclusion Ceftriaxone significantly prolongs the small intestine transit time, large intestine transit time, and total intestinal transit times. View on Web

Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Hybrid mandibular Bologna midline distractor in combination with surgically assisted rapid maxillary expansion for transverse facial expansion: clinical and cephalometric results

alexandrossfakianakis shared this article with you from Inoreader Hybrid mandibular Bologna midline distractor  in combination with surgically assisted rapid maxillary expansion for transverse facial expansion: clinical and cephalometric results via International Journal of Oral and Maxillofacial Surgery via MedWorm.com Transverse maxillomandibular hypoplasia can be treated with surgically assisted rapid maxillary expansion (SARME) in association with mandibular symphyseal distraction (MSD). This paper introduces a hybrid mandibular Bologna midline distractor (BMD); the effectiveness of the distractor in combination with SARME for the treatment of transverse skeletal deficiency was evaluated. This two-centre study included 10 patients with a transverse arch width deficit>7  mm and dental crowding, in both the maxilla and mandible, treated with SARME and MSD. (Source: International Journal of Oral and Maxillofacial Surgery) View on Web

Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Effectiveness of pulpotomy compared with root canal treatment in managing non‐traumatic pulpitis associated with spontaneous pain: A systematic review and meta‐analysis

alexandrossfakianakis shared this article with you from Inoreader Effectiveness of pulpotomy compared with root canal treatment in managing non‐traumatic pulpitis associated with spontaneous pain: A systematic review and meta‐analysis via International Endodontic Journal Abstract Abstract Background Pulpitis characterized by spontaneous pain can result in debilitating pain. Dogma has existed to offer only have two treatment options, namely, root canal treatment (RCT) or extraction although, pulpotomy has always remained a potential treatment modality. Objective This review aimed to answer the following research question: "Does pulpotomy (partial or full)(I) result in better patient and clinical reported outcomes (O), compared to RCT (C) in permanent teeth with pulpitis characterized by spontaneous pain (P) evaluated at various time intervals? (T). Methods Two authors independently performed study selection, data extraction and risk of bias assessment. The literature search was conducted in the following electronic databases: Clarivate Analytics' Web of Science, Scopus, PubMed, and Cochrane Central Register of Controlled Trials. English language clinical trials comparing the patient and clinical reported outcomes between RCT and pulpotomy were included. The meta-analysis was performed on a fixed-effect model and the quality of evidence assessed by the Grading of Recommendations, Assessment, Development and Evaluations (GRADE) approach. Results Two randomised clinical trials, were included. Among two trials, one has published four reports at different time points involving same cohorts. The meta-analysis revealed no difference in postoperative pain (Day 7) between RCT and pulpotomy (OR= 0.99,95% CI 0.63 – 1.55,I2=0%) and quality of evidence was graded as "High". Clinical success was high at year 1, 98% for both interventions, however decreased over time to 78.1% (pulpotomy) and 75.3% (RCT) at 5 years. Discussion Pulpotomy is a definitive treatment modality that is as effective as RCT . This could have a significant impact on treatment of such patients affording the advantages of retaining a vital pulp and preventing the need for RCT. Conclusion This review could only include two trials, hence there is insufficient evidence to draw robust conclusions. The clinical data accumulated so far suggests no difference in pain between RCT and pulpotomy at day 7 postoperatively and a single randomised control trial suggests that the clinical success rate for both treatment modalities is similar long term. There is a need for more well-designed trials by different research groups to develop a stronger evidence base in this area. View on Web

Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.