The microflora of ulzerous zone mucosa in patients with duodenal ulcer

Bacteriological study of the biopsies taken from gastric and duodenal mucosa of 10 healthy volunteers and 74 patients with duodenal ulcer, was carried out. In the gastroduodenal zone of healthy subjects microorganisms of 6 genera (Streptococcus, Candida, Staphylococcus, Bacillus, Helicobacter and Lactobacillus) were detected. H. pylori was isolated in 20% of cases only in biopsy specimens taken from the antral section of the stomach of healthy as monoculture or in combination with C. albicans. In patients with duodenal ulcer activation of opportunistic microflora was observed in the periulcerous zone. More often H. pylori occurred in associations with fungi of the genus Candida, streptococci, staphylococci, enterobacteria, Pseudomonas and other microorganisms (of more than 30 genera). Quantitatively the dominating microorganisms (3.8-5.7 lg CFU/g) were H. pylori, fungi of the genus Candida, bacteria of the genera Streptococcus, Peptostreptococcus, Bacteroides, Gemella, Prevotella, Veillonella, Peptococcus, Bacillus, different species of opportunistic enterobacteria, as well as bacteria of the genera Staphylococcus, Micrococcus, Corynebacterium, Neisseria, Pseudomonas, etc. Opportunistic bacteria detected in the ulcerous zone, as a rule, expressed hemolytic, lecithinase, RNAase, caseinolytic, catalase and urease activity. Sonicated filtrates of such cultures produced a cytotoxic effect on cells HEp-2. Ulcer is an infected wound that needs sanitation.     

The Relationship Between Visceral Adiposity and the Risk of Erosive Esophagitis in Severely Obese Chinese Patients

A higher prevalence of erosive esophagitis is found in obese than in nonobese patients; however, it remains unclear why some obese patients develop this disease, whereas others do not. Accordingly, we elucidated the risk factors associated with erosive esophagitis in severely obese Chinese patients. Between June 2007 and January 2009, a total of 260 Chinese patients with morbid obesity referred for bariatric surgery were enrolled in this cross‐sectional study. All patients received preoperative endoscopy for evaluation of the presence and severity of erosive esophagitis. Demographic variables, anthropometric measurements, and metabolic factors were included in a logistic regression model to identify the factors predictive of erosive esophagitis. The prevalence of erosive esophagitis was 32.3%. Multiple logistic regression showed that increased waist circumference (odds ratio (OR) = 1.03, 95% confidence interval (CI) = 1.01–1.04), increased insulin resistance (OR = 1.57, 95% CI = 1.06–2.31), and presence of reflux symptoms (OR = 2.40, 95% CI = 1.22–4.74) were independent risk factors associated with erosive esophagitis. In conclusion, among Chinese patients with morbid obesity, increased waist circumference and insulin resistance were risk factors for erosive esophagitis, which highlights the critical role of visceral adiposity in the pathogenesis of erosive esophagitis.     

幽门螺杆菌与糜烂性食管炎的相关性研究

目的：探讨幽门螺杆菌与糜烂性食管炎的相关性。方法：回顾性分析2010年1月-2012年10月期间的胃镜患者,根据胃窦活检、快速尿素酶试验等检测幽门螺杆菌感染所诊断出的105例糜烂性食管炎,观察幽门螺杆菌阴阳性的发生率和病变程度,选择中度糜烂性食管炎分别予以质子泵抑制剂和质子泵抑制剂加抗生素治疗,观察其疗效情况。结果：HP阴性组在重度EE上较HP阳性组多,而轻、中度刚好相反（P〈0．05）;治疗1组和治疗2、3组在总有效率上比较有明显差异性（P〈0．05）,而治疗2组和治疗3组的总有效率则无差异性（P〉0．05）,但是治疗2组的显效率明显高于治疗3组,在显效率上比较有明显差异性（P〈0．05）。结论：HP感染不是造成糜烂性食管炎的病因,Hp感染能减轻糜烂性食管炎粘膜损伤程度并增强抑酸剂的疗效。     

Clinical epidemiology and natural history of gastroesophageal reflux disease

In the MUSE classification of gastroesophageal reflux disease (GERD), esophagitis is assessed by the presence of metaplasia, ulcer, stricture, or erosion, each being graded as absent, mild or severe. Daily reflux symptoms affect about 4 to 7 percent of the population; erosive esophagitis occurs in about 2 percent; the prevalence rate of Barrett's metaplasia is 0.4 percent; and esophageal adenocarcinoma leads to two deaths per million living population. In persons with GERD symptoms, about 20 percent are found to have erosive esophagitis, while ulcers or strictures are found in less than 5 percent of all patients with erosive esophagitis. No clear-cut temporal progression exists between successive grades of disease severity, as the most severe grade of GERD is reached at the onset of the disease. Mild forms of GERD tend to be more common in women than men, while severe GERD characterized by erosive esophagitis, esophageal ulcer, stricture or Barrett's metaplasia are far more common in men than women. All forms of GERD affect Caucasians more often than African Americans or Native Americans. The prevalence of GERD is high among developed countries in North America and Europe and relatively low in developing countries in Africa and Asia. During the past three decades, hospital discharges and mortality rates of gastric cancer, gastric ulcer and duodenal ulcer have declined, while those of esophageal adenocarcinoma and GERD have markedly risen. These opposing time trends suggest that corpus gastritis secondary to Helicobacter pylori infection protects against GERD. This hypothesis is consistent with the geographic and ethnic distributions of GERD. Case-control studies also indicate that cases with erosive esophagitis are less likely to harbor active or chronic corpus gastritis than controls without esophagitis.     

Distribution of microorganisms lysing Pseudomonas aeruginosa and Staphylococcus aureus in the system of sewage waters

The regularities of lytic microorganisms distribution in domestic sewage have been studied. A reproduction of mesophilic gram-negative bacteria producing lytic substances against Pseudomonas aeruginosa and Staphylococcus aureus has been shown to take place at mechanical cleaning stages. In the primary sediment trap the number and the relative content of microorganisms lysing P. aeruginosa at mean temperature and the number of microorganisms lysing S. aureus are maximum. The number of gram-positive sporogenous bacteria lysing P. aeruginosa under conditions close to thermophilic does not change considerably till the secondary sediment trap and remains comparatively high. Certain stages of purification can be regarded as a source of microorganisms producing lytic substances.     

Role of persisting opportunistic bacteria in the pathogenesis of the gastric and duodenum ulcer

Dynamic study of the bacterial microflora of 122 patients with gastric and duodenal ulcer was carried out. Microflora examination of the bioptic samples of mucosa, obtained from the ulcerous zone of the patients, revealed that an open ulcer is like an infected wound needing sanitation. In the focus of lesion microorganisms of 32 genera and species, including Helicobacter pylori, fungi of the genus Candida, representatives of the genera Streptococcus, Staphylococcus, Corynebacterium, Bacteroides, etc., were detected. Opportunistic microorganisms were isolated in associations (up to 8 different cultures), possessing cytotoxic, hemolytic, antilysozyme, lecithinase, caseinolytic and RNAase activities. To inhibit the microflora, chitosan was used; 82-85% of the cultures of different bacteria under study proved to be sensitive to it. The inclusion of chitosan into the complex therapy suppressed the persistence of H. pylori, ensured the sanitation of mucosa affected by opportunistic bacteria and accelerated ulcers cicatrization.     

Biofilm interactions between distinct bacterial genera isolated from drinking water

In the environment, multiple microorganisms coexist as communities, competing for resources and often associated as biofilms. In this study, single- and dual-species biofilm formation by, and specific activities of, six heterotrophic intergeneric bacteria were determined using 96-well polystyrene plates over a 72-h period. These bacteria were isolated from drinking water and identified by partial 16S rRNA gene sequencing. A series of planktonic studies was also performed, assessing the bacterial growth rate, motility, and production of quorum-sensing inhibitors (QSI). This constituted an attempt to identify key attributes allowing bacteria to effectively interact and coexist in a drinking-water environment. We observed that in both pure and dual cultures, all of the isolates formed stable biofilms within 72 h, with specific metabolic activity decreasing, in most cases, with an increase in biofilm mass. The largest single- and dual-biofilm amounts were found for Methylobacterium sp. and the combination of Methylobacterium sp. and Mycobacterium mucogenicum, respectively. Evidences of microbial interactions in dual-biofilm formation, associated with appreciable biomass variation in comparison with single biofilms, were found for the following cases: synergy/cooperation between Sphingomonas capsulata and Burkholderia cepacia, S. capsulata and Staphylococcus sp., and B. cepacia and Acinetobacter calcoaceticus and antagonism between S. capsulata and M. mucogenicum, S. capsulata and A. calcoaceticus, and M. mucogenicum and Staphylococcus sp. A neutral interaction was found for Methylobacterium sp.-M. mucogenicum, S. capsulata-Staphylococcus sp., M. mucogenicum-A. calcoaceticus, and Methylobacterium sp.-A. calcoaceticus biofilms, since the resultant dual biofilms had a mass and specific metabolic activity similar to the average for each single biofilm. B. cepacia had the highest growth rate and motility and produced QSI. Other bacteria producing QSI were Methylobacterium sp., S. capsulata, and Staphylococcus sp. However, only for S. capsulata-M. mucogenicum, S. capsulata-A. calcoaceticus, and M. mucogenicum-Staphylococcus sp., dual-biofilm formation seems to be regulated by the QSI produced by S. capsulata and Staphylococcus sp. and by the increased growth rate of S. capsulata. The parameters assessed by planktonic studies did not allow prediction and generalization of the exact mechanism regulating dual-species biofilm formation between the drinking-water bacteria.     

Biofouling on the walls of a spent nuclear fuel pool with radioactive ultrapure water

Microbial activity in spent nuclear fuel pools which contain ultrapure and radioactive water has been previously observed. The aim of the present research was to isolate and identify the microorganisms attached to the nuclear pool wall of a Spanish nuclear power plant. Amplification of 16S rDNA fragments from the culturable microorganisms by PCR using universal primers for the domain 'Bacteria', followed by Denaturing Gradient Gel Electrophoresis analysis revealed the presence of six different bacteria. The complete gene for 16S rDNA of each one was sequenced and identified as belonging to three different phylogenetic groups, viz. beta-Proteobacteria, Actinomycetales and the Bacillus/Staphylococcus group. A fungus was also found and identified as Aspergillus fumigatus by sequencing the D2 region of the large subunit rDNA gene. The isolation of these microorganisms in oligotrophic and radioactive conditions is of great interest due to the possibility of their use in bioremediation processes of radionuclide-contaminated environments.     

Development of Barrett's esophagus after 'spontaneous' healing of atrophic corpus gastritis

We report here the case of a 58-year-old asymptomatic male smoker who had a gastroscopy performed in 1990 because of a low serum pepsinogen I level (16 microg/l). The patient had severe atrophic corpus gastritis and elevated Helicobacter pylori antibody titers, but no histologic evidence of the bacteria. Additionally, a hiatal hernia without esophagitis was seen. He was followed up endoscopically because of the atypical changes (indefinite for dysplasia) in addition to atrophic gastritis in some of the gastric biopsy samples. During the follow-up period, H. pylori antibody titers declined to normal levels without eradication therapy, and atrophic gastritis healed. The patient developed first erosive esophagitis, and, 5 years later, a 3-cm-long Barrett's esophagus was detected.     

长沙走马楼东吴竹简蚀斑微生物的研究

竹简为我国古代早期文字记录的一种重要载体。湖南长沙竹简博物馆珍藏了一大批走马楼出土的三国时期东吴竹简,具有极为重要的史料价值。以吴简为材料,从竹简中分离微生物,获得10株细菌纯培养,并对这些分离菌株进行多相分类学鉴定。根据其培养特征、生理生化特性、细胞脂肪酸组份的测定以及部份菌株16S rRNA基因序列分析,将10个菌株划归为4个属。这些菌株可作为进一步探讨竹制品文物的微生物腐蚀提供有价值的材料。     

Antibiotic susceptibility of isolates from blood of patients in intensive care units of emergency medical service

The microbiological tests of 769 blood samples from 220 patients, treated in 4 intensive care units of the N.V. Sklifosovsky Research Institute for Emergency Medical Service within a period from January 2009 to June 2010, were analysed. Etiologically significant microorganisms were detected in 323 samples (42%). 253 isolates were used in the analysis. Grampositive and gramnegative pathogens were detected in 47 and 42% of the cases respectively. Candida and anaerobic organisms were isolated in 8 and 3% of the cases respectively. Staphylococcus aureus and enterococci were isolated in 24 and 15% of the cases respectively. Nonfermenting gramnegative bacteria and enterobacteria were revealed in 25 and 17% of the cases respectively. Differences in the spectrum of the sepsis pathogens depending on the patients contingent were shown. The maximum summary susceptibility of the grampositive cocci was observed with respect to vancomycin and linezolid and that of the gramnegative bacteria was stated with respect to imipenem and meropenem.     

Quantification of the geocarposphere and rhizosphere effect of peanut (Arachis hypogaea L.)

Roots and pods of field-grown peanut (groundnut) (Arachis hypogaea L.) were sampled at the R3, R5, and R7 developmental stages and examined in comparison to root- and pod-free soil for microbial population densities to assess the geocarposphere and rhizosphere effects. G/ S (no. geocarposphere microorganisms/no. soil microorganisms) and R/S (no. rhizosphere microorganisms/no. soil microorganisms) ratios were calculated for total fungi,Asperigillus flavus, spore-forming bacilli, coryneform bacteria, fluorescent pseudomonads, and total bacteria isolated on low- and high-nutrient media. A clear geocarposphere effect was evidenced by increased population densities of bacteria and fungi associated with developing pods compared to soil. G/S and R/S ratios were generally greater than 1.0 for all groups of microorganisms except bacilli. G/S ratios were greater for total bacteria than for total fungi at two of the three sample times, suggesting that bacteria were stimulated more than fungi in the zone around developing pods. In contrast, R/S ratios, were higher for total fungi than for total bacteria at two of three sample times. The preferential association of fungi and bacteria with early developmental stages of the pod indicates that some microorganisms are particularly well adapted for colonization of the peanut geocarposphere. These microorganisms are logical candidates for evaluation as biological control candiates forA. flavus.     

千里光抗菌作用的数量性状分析

应用倍比稀释法检测18份千里光（Senecio scandens Buch-Ham）水煎剂对7种细菌的抗菌效果。最低抑菌浓度（minimal inhibitory concentration,MIC）检测结果表明,千里光对金黄色葡萄球菌的抗菌作用最强,对铜绿假单胞菌的抗菌效果最差。比较不同细菌的MIC值发现,温和气单胞菌共检测出4个不同的MIC值,金黄色葡萄球菌、铜绿假单胞菌、大肠埃希菌、甲型副伤寒杆菌、福氏痢疾杆菌和迟钝爱德华菌的MIC值为5个,迟钝爱德华菌的MIC值最多,表现出6个MIC梯度值。本研究结果提示千里光个体有效抗菌组分的多样性,也意味着千里光抗菌药理学性状为多基因控制的数量性状。     

Intestinal microecology in some systemic connective tissue diseases

In patients with systemic connective tissue diseases were studied. The species structure intestinal microflora was characterized by decrease of dominating status of anaerobic bacteria and increase of role of opportunistic bacteria. The number of Lactobacillus decreased significantly. Bifidobacterium and Bacteroides was also decreased in number while their detection rate did not change. Opportunistic bacteria with hemolytic activity acquired greater significance in the forming of patients' intestinal microbiocenosis. Significant increase of Staphylococcus and opportunistic Enterobacteriaceae detection rate and density of intestine colonization was detected. Colonization of the intestine by S. aureus was revealed. Comparative analysis of the qualitative and quantitative structure of the intestinal microflora in patients with systemic lupus erythematosus and systemic scleriasis revealed similar patterns. However, colonization of the gut by opportunistic intestinal bacteria, Candida and microorganisms with hemolytic activity was more frequently observed in patients with systemic scleriasis.     

Enhanced biofilm-production in pathogens isolated from patients with rare metabolic disorders

Biofilm-producing bacteria were isolated from the urine of 19 patients with very rare metabolic disorders including: hyperlactacidaemia (8 cases), sugar intolerance and gammopathy (1 case), cystinuria (2 cases), Parkinson's disease (1 case), lipidaemia (2 cases), hyperaminoaciduria (1 case) and others (4 cases). A total of 34 strains were collected, Gram-negative and gram-positive microorganisms were equally distributed among the slime-producing bacteria, with a prevalence of Staphylococcus epidermidis (30%) the most frequent microorganism isolated together with Escherichia coli and Proteus mirabilis that accounted for 15% of this group of strains. A quantitative assay of the biofilm production revealed that in Gram-positive pathogens it was three times greater than that observed in bacteria collected from patients not affected by metabolic diseases (p = 0.0001). In Gram-negative strains the biofilm synthesis was 2.2 times higher than those detected in the same bacteria isolated in the absence of metabolic disorders (p = 0.0033). The results observed indicate that biofilm production is enhanced in bacteria isolated from the urine of patients with metabolic disorders. It is suggested that unusual metabolites might facilitate pathogen production of biofilm found in the urine of these patients.     

The use of bacteriophages in eliminating polyresistant strains ofStaphylococcus aureus andStreptococcus agalactiae

Temperate bacteriophages were induced in and released from isolates of Staphylococcus aureus and Streptococcus agalactiae using mitomycin C. Various specific indicator cultures were tested for providing clear plaques after phage infection. Specific lytic mixture of bacteriophages was prepared using the induced, modified and laboratory variants of phages. Under laboratory conditions, the mixture eliminated all isolates from the tested collection of microorganisms. The restriction barrier of some bacterial isolates to bacteriophage infection was overcome either by UV irradiation or in vitro modification of bacteriophage DNA with specific methyltransferases. Conjugative R plasmids, capable of replication in G+ and G- bacteria, were detected and isolated from S. aureus and S. agalactiae antibiotic-resistant strains.     

Esophagitis in a high H. pylori prevalence area: severe disease is rare but concomitant peptic ulcer is frequent

Background

Few data are available on the prevalence of erosive and severe esophagitis in Western countries.

Objective

To retrospectively determine the prevalence and the factors predicting erosive esophagitis and severe esophagitis in a large series of endoscopies in Spain.

Design

Retrospective observational study. A multivariate analysis was performed to determine variables predicting severe esophagitis.

Setting

Databases of 29 Spanish endoscopy units.

Patients

Patients submitted to a diagnostic endoscopy during the year 2005.

Interventions

Retrospective review of the databases.

Main Outcome Measurements

Esophagitis severity (graded according to the Los Angeles classification) and associated endoscopic findings.

Results

Esophagitis was observed in 8.7% of the 93,699 endoscopies reviewed. Severe esophagitis (LA grade C or D) accounted for 22.5% of cases of the disease and was found in 1.9% of all endoscopies. Incidences of esophagitis and those of severe esophagitis were 86.2 and 18.7 cases per 100,000 inhabitants per year respectively. Male sex (OR 1.89) and advanced age (OR 4.2 for patients in the fourth age quartile) were the only variables associated with severe esophagitis. Associated peptic ulcer was present in 8.8% of cases.

Limitations

Retrospective study, no data on individual proton pump inhibitors use.

Conclusions

Severe esophagitis is an infrequent finding in Spain. It occurs predominantly in males and in older individuals. Peptic ulcer disease is frequently associated with erosive esophagitis.     

糖尿病足感染的细菌学调查及耐药性分析

目的 了解临床糖尿病足患者感染的细菌分布及耐药性分析.方法 2009年至2010年,共调查135例糖尿病足患者.结果 检出细菌株数为107株,其中革兰阳性菌44株,占41.1％;革兰阴性菌57株,占53.3％;真菌6株,占5.6％.需氧菌感染80例,检出率59.3％.以金葡菌、链球菌、变形杆菌和大肠埃希菌为主要感染菌.金黄色葡萄球菌的耐药率明显低于其他葡萄球菌.大肠埃希菌治疗以亚胺培南首选,也可选用β-内酰胺类加酶抑制剂.结论 检出革兰阴性菌57株,革兰阳性菌44株,应根据药敏情况合理应用抗菌素.     

Genetic markers of pathogenicity of conditionally pathogenic enterobacteria isolated from children with diarrheal diseases

In the process of examination of 89 children from different age groups with diarrheal disease caused by bacteria from Enterobacteriaceae family 89 microorganisms were isolated including Klebsiella spp. (37 isolates), Citrobacter spp. (9 isolates), Enterobacter spp. (17 isolates), Hafnia alvei (1 isolate), Morganella morganii (11 isolates), Proteus spp. (14 isolates). Presence of genes associated with pathogenicity islands (PAIS): hlyA, hlyB (hemolysin), sfaG (fimbria antigen type S), cnf1 (cytotoxic necrotizing factor 1), estB (heat-stable enterotoxin B)were studied in these cultures by PCR. It was found that 32.6% of examined isolates had fragments of PAIS's genes--hlyA was detected in 9 cases (10.1%), hlyB--in 10 cases (11.2%), sfaG --in 8 cases (9%), cnf1--in 9 cases (10.1%), and estB--in 3 cases (3.4%). Positive correlation between genetic determinants hlyB and cnf1 as well as hlyA and sfaG was found while estB was not associated with other genes. Weak positive correlation between presence of sfaG and resistance to tetracycline and chloramphenicol was detected. Factors coded by revealed determinants of PAIS can play a role in the development of diarrheal syndrome.