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| 2. |
- Ejrnaes, K, et al.
(författare)
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Characteristics of Escherichia coli causing persistence or relapse of urinary tract infections Phylogenetic groups, virulence factors and biofilm formation
- 2011
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Ingår i: VIRULENCE. - 2150-5594. ; 2:6, s. 528-537
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Tidskriftsartikel (refereegranskat)abstract
- Abstract: Recurrent urinary tract infections (RUTIs) pose a major problem but little is known about characteristics of Escherichia coli associated with RUTI. This study includes E. coli from 155 women with community-acquired lower urinary tract infections (UTIs) randomized to one of three dosing regiments of pivmecillinam and aimed to identify associations between the presence of 29 virulence factor genes (VFGs), phylogenetic groups and biofilm formation and the course of infection during follow-up visits at 8-10 and 35-49 d post-inclusion, respectively. E. coli causing persistence or relapse were more often of phylogenetic group B2 and had a significantly higher aggregate VFG score than E. coli that were not detectable at follow-up. Specifically, these E. coli causing persistence or relapse were characterized by a higher prevalence of hemolysis and 12 VFGs (sfa/focDE, papAH, agn43, chuA, fyuA, iroN, kpsM II, kpsM II K2, cnf1, hlyD, malX and usp). KpsM II K2 and agn43a(CFT073) were independently associated with persistence or relapse. No specific combination of presence/absence of VFGs could serve as a marker to predict RUTI. Stratifying for VFGs, seven days of pivmecillinam treatment reduced the prevalence of persistence or relapse of UTI compared with three days. In vitro biofilm formation was not higher among E. coli causing persistence or relapse. The presence of agn43a(CFT073) or agn43b(CFT073) was associated with biofilm forming capacity. In conclusion, our results show potential targets for prevention and treatment of persistence/relapse of UTI and potential markers for selecting treatment lengths and warrant studies of these and new VFGs.
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| 4. |
- Emgård, Per, et al.
(författare)
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External otitis caused by infection with Pseudomonas aeruginosa or Candida albicans cured by use of a topical group III steroid, without any antibiotics
- 2005
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Ingår i: Acta Oto-Laryngologica. - : Informa UK Limited. - 0001-6489 .- 1651-2251. ; 125:4, s. 346-352
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Tidskriftsartikel (refereegranskat)abstract
- CONCLUSIONS: Irrespective of the microbial agent, group III steroid solution cured external otitis efficiently in a rat model. The addition of antibiotic components to steroid solutions for the treatment of external otitis is of questionable validity. OBJECTIVE: External otitis, caused by infection with either Pseudomonas aeruginosa or Candida albicans, was established in a rat model and the treatment efficacy of a group III steroid solution was studied. MATERIAL AND METHODS: Three treatments were studied: (i) a group III steroid solution; (ii) a group I steroid combined with two antibiotic components; and (iii) a saline solution. A scoring scale was used to evaluate the characteristics of the ear canal skin. Bacteriological and fungal samples were collected for culturing and ear canal skin biopsies were taken for structural analyses. RESULTS: It was possible to cause P. aeruginosa and C. albicans infections in an animal model. In the P. aeruginosa-infected animals, only the group III steroid treatment cured all the animals. In the C. albicans-infected animals, group III steroid treatment resolved external otitis faster than the other treatment modalities.
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| 7. |
- Monsen, Tor J., et al.
(författare)
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Mecillinam resistance and outcome of pivmecillinam treatment in uncomplicated lower urinary tract infection in women
- 2014
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Ingår i: Apmis. - Hoboken : Wiley. - 0903-4641 .- 1600-0463. ; 122:4, s. 317-323
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Tidskriftsartikel (refereegranskat)abstract
- Pivmecillinam (PIV) is a first-line antimicrobial for treatment of lower urinary tract infection in women (LUTIW). Mecillinam, the active substance of PIV, is bactericidal mainly against gram-negative uropathogens, whereas gram-positive species are considered intrinsically resistant. However, successful treatment of LUTIW caused by Staphylococcus saprophyticus has been reported, but more rarely for other gram-positive species. The aim of this study was to compare clinical and bacteriological outcome of PIV vs placebo treatment among uropathogens with special focus on mecillinam-resistant isolates. We analysed data from a prospective, multicentre, placebo-controlled, primary health care, therapy study performed in Sweden in 1995-1998 that included 1143 women with symptoms suggestive of LUTIW. Urine cultures were collected and symptoms registered at inclusion and at follow-up visits. Overall, the efficacy of PIV was superior to that of placebo. Clinical and bacteriological outcomes of PIV treatment were similar for S. saprophyticus, Escherichia coli as for most other uropathogens irrespective of their susceptibility to mecillinam. However, the occurrence of enterococci increased nearly fivefold shortly post PIV treatment, although with mild symptoms and a high spontaneous eradication. As susceptibility to mecillinam in vitro did not predict bacteriological and clinical outcome of PIV treatment, we suggest that the present breakpoints for mecillinam should be revised.
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| 9. |
- Simark-Mattsson, Charlotte, 1955, et al.
(författare)
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Lactobacillus-mediated interference of mutans streptococci in caries-free vs. caries-active subjects.
- 2007
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Ingår i: European journal of oral sciences. - : Wiley. - 0909-8836 .- 1600-0722. ; 115:4, s. 308-14
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Tidskriftsartikel (refereegranskat)abstract
- In order to assess whether naturally occurring oral lactobacilli have probiotic properties, lactobacilli were isolated from saliva and plaque from children and adolescents, with or without caries lesions. The interference capacities of these lactobacilli were investigated against a panel of 13 clinical isolates and reference strains of Streptococcus mutans and Streptococcus sobrinus, as well as against the subject's autologous mutans streptococci, using the agar-overlay technique. Lactobacillus-mediated inhibition differed significantly between the three subject groups (no caries, arrested caries, or active caries), demonstrating increased inhibition in subjects without present or previous caries experience compared to subjects with arrested caries or subjects presenting with frank lesions. Lactobacilli from subjects lacking S. mutans inhibited the growth of the test panel of mutans streptococci significantly better than lactobacilli from subjects who were colonized. Furthermore, subjects without caries experience harbored lactobacilli that more effectively repressed the growth of their autologous mutans streptococci. Twenty-three Lactobacillus spp. completely inhibited the growth of all mutans streptococci tested. Species with maximum interference capacity against mutans streptococci included Lactobacillus paracasei, Lactobacillus plantarum, and Lactobacillus rhamnosus. Naturally occurring oral lactobacilli significantly inhibited the growth of both test strains of mutans streptococci and the subject's autologous mutans streptococci in vitro, and this effect was more pronounced in caries-free subjects.
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| 10. |
- Skovbjerg, Susann, 1973, et al.
(författare)
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High cytokine levels in perforated acute otitis media exudates containing live bacteria
- 2010
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Ingår i: Clinical microbiology and infection. - : Elsevier BV. - 1469-0691 .- 1198-743X. ; 16:9, s. 1382-1388
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Tidskriftsartikel (refereegranskat)abstract
- Acute otitis media (AOM) is an inflammatory response to microbes in the middle ear, sometimes associated with rupture of the tympanic membrane. Human leukocytes produce different patterns of inflammatory mediators in vitro when stimulated with Gram-positive and Gram-negative bacteria, respectively. Here, we investigated the cytokine and prostaglandin E(2) (PGE(2)) responses in middle ear fluids (MEFs) from children with spontaneous perforated AOM and related the levels to the presence of pathogens detected by culture (live) or PCR (live or dead). Furthermore, in vivo cytokine pattern was compared with that induced in leukocytes stimulated by dead bacteria in vitro. MEFs with culturable pathogenic bacteria contained more IL-1beta (median 110 vs <7.5 ng/ml), TNF (6.3 vs <2.5 ng/ml), IL-8 (410 vs 38 ng/ml), and IL-10 (0.48 vs <0.30 ng/ml), than culture negative fluids, irrespective of PCR findings. IL-6 and PGE(2) were equally abundant (69-110 ng/ml) in effusions with live, dead or undetectable bacteria. Cytokine levels were unrelated to bacterial species and to the presence or absence of virus. Similar levels of TNF and IL-6 as found in the MEFs were obtained by in vitro stimulation of leukocytes, while 11x more IL-1beta and 3.5x more IL-8 was produced in vivo, and 22x more IL-10 was produced in vitro. A vigorous production of pro-inflammatory cytokines accompany AOM with membrane rupture regardless of causative agent, but the production seems to cease rapidly once the bacteria are killed and fragmented. IL-6 and PGE(2), however, remain after bacterial disintegration and may play a role in the resolution phase.
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| 11. |
- Skovbjerg, Susann, 1973, et al.
(författare)
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High Cytokine Levels in Tonsillitis Secretions Regardless of Presence of Beta-Hemolytic Streptococci
- 2015
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Ingår i: Journal of Interferon and Cytokine Research. - : Mary Ann Liebert Inc. - 1079-9907 .- 1557-7465. ; 35:9, s. 682-689
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Tidskriftsartikel (refereegranskat)abstract
- Acute pharyngotonsillitis denotes tonsillar inflammation caused by bacteria or viruses. Here, we investigated if beta-hemolytic streptococci (beta-HS) tonsillitis would differ in inflammatory mediator response from tonsillitis of other causes. Tonsillar secretions were obtained from 36 acute pharyngotonsillitis patients and 16 controls. Bacteria were cultured quantitatively and 18 different viruses were quantified by real-time polymerase chain reaction. Cytokine and prostaglandin E-2 (PGE(2)) levels were determined by enzyme-linked immunosorbent assays. Almost half of the patients' tonsillar secretions yielded high counts of beta-HS, and most samples contained viruses, irrespective of whether beta-HS were present or not. The Epstein-Barr virus (EBV) was the most common virus (patients 62% and controls 13%). Compared to controls, patients' secretions had higher levels of interleukin (IL)-1 beta, IL-6, IL-8, tumor necrosis factor (TNF), and PGE(2), while few samples contained IL-12, IL-10, or interferon-gamma (IFN-gamma). The presence of beta-HS in tonsillitis secretions could not be distinguished by any of the measured mediators, while the presence of EBV DNA tended to be associated with enhanced levels of IL-1 beta and IL-8. The results suggest a common inflammatory response in acute pharyngotonsillitis, regardless of causative agent. The suggested correlation between intense inflammation and the presence of EBV DNA in tonsillitis secretions may be due to reactivation of the virus and/or the EBV-containing B cells.
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| 12. |
- Skovbjerg, Susann, 1973, et al.
(författare)
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Spray bacteriotherapy decreases middle ear fluid in children with secretory otitis media.
- 2008
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Ingår i: Archives of disease in childhood. - : BMJ. - 1468-2044 .- 0003-9888. ; 94:2, s. 92-8
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: Secretory otitis media (SOM) is characterized by persistent fluid in the middle ear cavity, but the cause is unknown. We investigated clinical, bacteriological and immunological effects of treatment with probiotic bacteria on SOM. DESIGN: In this double blind, pilot/premlininary study, 60 children with long-standing SOM (median 6 months) who were scheduled for insertion of tympanostomy tubes were randomized to nasal spray treatment with Streptococcus sanguinis, Lactobacillus rhamnosus or placebo for 10 days before surgery. Clinical evaluation was made after 10 days of treatment. Middle ear fluid (MEF) was collected during surgery for quantification of cytokines and detection of bacteria by culture and PCR. Nasopharyngeal swabs were obtained before treatment and at surgery. RESULTS: Complete or significant clinical recovery occurred in 7/19 patients treated with S. sanguinis compared to 1/17 patient in the placebo group (p<0.05). In the L. rhamnosus treatment group 3/18 patients were cured or much better (p=0.60 compared with placebo). Spray treatment did not alter the composition of the nasopharyngeal flora, or the cytokine pattern observed in the nasopharynx or MEF, except a higher level of IL-8 in nasopharynx of L. rhamnosus treated children. CONCLUSIONS: This study shows that spray treatment with S. sanguis may be effective against SOM. The mechanism for the effect remains to be investigated.
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