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Ye Z, He J, Ji H, Xu H, Zhang Y, Zhou K, Liu H. Case report: isolated prevotella intermedia causing intracranial infection detected using metagenomic next generation sequencing. BMC Neurol 2023; 23:383. [PMID: 37872501 PMCID: PMC10591364 DOI: 10.1186/s12883-023-03374-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2023] [Accepted: 09/08/2023] [Indexed: 10/25/2023] Open
Abstract
BACKGROUND Isolated Prevotella intermedia, a rare gram-negative, rod-shaped, anaerobic bacterium, is rarely detected in clinical practice. It has been associated with infections of the oral cavity and female genital tract, but has never been detected in cerebrospinal fluid (CSF) of patients in China. Accurate detection of causative pathogens is still an arduous task owing to the difficult conditions of anaerobic bacterial culture. Isolated Prevotella intermedia can be detected by metagenomic next generation sequencing (mNGS) of the CSF. Correct diagnosis and antibiotic treatment can help patients avoid life-threatening events. CASE PRESENTATION Herein, we describe the case of a 64-year-old Chinese woman who presented with typical features of meningoencephalitis. Routine CSF culture failed to identify the causative pathogen. Isolated Prevotella intermedia was detected by mNGS, and the patient was treated with antibacterial agents including ceftriaxone, vancomycin, moxifloxacin, meropenem, metronidazole, and linezolid. The patient underwent surgical treatment for abscess of left frontal parietal lobe, which was observed on magnetic resonance imaging (MRI) and was suspected to be caused by Prevotella intermedia. It was further confirmed that it was a secondary infection from the oral cavity, and the possible etiology might have been dental surgery. Treatment was rendered to the patient based on metagenomic test result, and her condition improved after two months. CONCLUSIONS This case highlights the role of mNGS in accurate diagnosis of patients with central nervous system infection. In particular, mNGS can be used to identify rare pathogens and confirm the diagnosis in patients with unknown etiology.
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Affiliation(s)
- Zhinan Ye
- Department of Neurology, Municipal Hospital Affiliated to the Medical School of Taizhou University, Taizhou, Zhejiang Province, China
| | - Jinfeng He
- Department of Neurology, Municipal Hospital Affiliated to the Medical School of Taizhou University, Taizhou, Zhejiang Province, China
| | - Hailong Ji
- Department of Neurosurgery, Municipal Hospital Affiliated to the Medical School of Taizhou University, No. 381 of East Zhongshan Road, Jiaojiang District, 318000, Taizhou, Zhejiang Province, China
| | - Hao Xu
- Department of Neurology, Municipal Hospital Affiliated to the Medical School of Taizhou University, Taizhou, Zhejiang Province, China
| | - Yaping Zhang
- Department of Neurology, Municipal Hospital Affiliated to the Medical School of Taizhou University, Taizhou, Zhejiang Province, China
| | - Kaiyu Zhou
- Department of Neurosurgery, Municipal Hospital Affiliated to the Medical School of Taizhou University, No. 381 of East Zhongshan Road, Jiaojiang District, 318000, Taizhou, Zhejiang Province, China.
| | - Hongwei Liu
- Department of Neurology, Taiyuan Central Hospital, Shanxi Medical University, No.5, Three lanes East Road, Taiyuan, 030000, Shanxi Province, China.
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Vâţă A, Irimie-Băluţă E, Roşu FM, Onofrei IM, Loghin II, Perţea M, Avădanei AN, Miron M, Rădulescu L, Eşanu I, Luca CM. Polymicrobial Bacterial Meningitis in a Patient with Chronic Suppurative Otitis Media: Case Report and Literature Review. MEDICINA (KAUNAS, LITHUANIA) 2023; 59:1428. [PMID: 37629718 PMCID: PMC10456347 DOI: 10.3390/medicina59081428] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/07/2023] [Revised: 08/02/2023] [Accepted: 08/03/2023] [Indexed: 08/27/2023]
Abstract
Polymicrobial meningitis is a rare entity in the adult population, especially in the antibiotic era. However, disorders such as chronic suppurative otitis media (CSOM) or even poor oral hygiene are considered risk factors for the development of such cerebral infection. We report a case of polymicrobial meningitis associated with oto-mastoiditis in a 64-year-old female patient known to have CSOM. The patient presented atypical symptoms for community-acquired meningitis, showing subacute evolution of headache, without fever or neck stiffness. The aerobe microorganisms Streptococcus anginosus and Corynebacterium spp., sensitive to beta-lactamines, and the anaerobe Prevotella spp., resistant to penicillin and metronidazole, were isolated from CSF specimens, while Proteus mirabilis and Enterococcus faecalis were identified from the ear drainage. The diversity of pathogens identified in our case led us to the hypothesis of two different sources of meningitis: otogenic and/or odontogenic. Favorable evolution was obtained after a multi-disciplinary approach, combining surgery and broad-spectrum antibiotics. In addition, we performed a literature review that highlights the low incidence of polymicrobial mixed aerobe-anaerobe meningitis.
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Affiliation(s)
- Andrei Vâţă
- Department of Infectious Diseases, “Grigore T. Popa” University of Medicine and Pharmacy of Iasi, 16 Universitatii Street, 700115 Iasi, Romania; (A.V.); (E.I.-B.); (I.M.O.); (C.M.L.)
- Clinic of Infectious Diseases, “Sf. Parascheva” Clinical Hospital of Infectious Diseases, 700116 Iasi, Romania;
| | - Erika Irimie-Băluţă
- Department of Infectious Diseases, “Grigore T. Popa” University of Medicine and Pharmacy of Iasi, 16 Universitatii Street, 700115 Iasi, Romania; (A.V.); (E.I.-B.); (I.M.O.); (C.M.L.)
| | - Florin Manuel Roşu
- Clinic of Infectious Diseases, “Sf. Parascheva” Clinical Hospital of Infectious Diseases, 700116 Iasi, Romania;
- Department of Dento-Alveolar Surgery, Anesthesia, Sedation, and Medical-Surgical Emergencies, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iasi, Romania
| | - Ioana Maria Onofrei
- Department of Infectious Diseases, “Grigore T. Popa” University of Medicine and Pharmacy of Iasi, 16 Universitatii Street, 700115 Iasi, Romania; (A.V.); (E.I.-B.); (I.M.O.); (C.M.L.)
- Clinic of Infectious Diseases, “Sf. Parascheva” Clinical Hospital of Infectious Diseases, 700116 Iasi, Romania;
| | - Isabela Ioana Loghin
- Department of Infectious Diseases, “Grigore T. Popa” University of Medicine and Pharmacy of Iasi, 16 Universitatii Street, 700115 Iasi, Romania; (A.V.); (E.I.-B.); (I.M.O.); (C.M.L.)
- Clinic of Infectious Diseases, “Sf. Parascheva” Clinical Hospital of Infectious Diseases, 700116 Iasi, Romania;
| | - Mihaela Perţea
- Department of Surgery 1, Faculty of Medicine, “Grigore T. Popa” University of Medicine and Pharmacy of Iasi, 16 Universitatii Street, 700115 Iasi, Romania;
| | | | - Mihnea Miron
- Intensive Care Department, “Sf. Spiridon” Emergency Hospital, 700115 Iasi, Romania;
| | - Luminiţa Rădulescu
- ENT Surgery Department, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iasi, Romania;
| | - Irina Eşanu
- Department of Internal Medicine, “Grigore T. Popa” University of Medicine and Pharmacy of Iasi, 16 Universitatii Street, 700115 Iasi, Romania;
| | - Cătălina Mihaela Luca
- Department of Infectious Diseases, “Grigore T. Popa” University of Medicine and Pharmacy of Iasi, 16 Universitatii Street, 700115 Iasi, Romania; (A.V.); (E.I.-B.); (I.M.O.); (C.M.L.)
- Clinic of Infectious Diseases, “Sf. Parascheva” Clinical Hospital of Infectious Diseases, 700116 Iasi, Romania;
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Kottrashetti VS, Bhat KG, Kugaji MS, Naik SS, Tanakanti P. Simultaneous detection and evaluation of Prevotella intermedia, Prevotella nigrescens, Prevotella loescheii, and Prevotella melaninogenica in subgingival plaque samples of chronic periodontitis and healthy individuals through multiplex polymerase chain reaction. J Indian Soc Periodontol 2023; 27:283-289. [PMID: 37346862 PMCID: PMC10281318 DOI: 10.4103/jisp.jisp_154_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2022] [Revised: 10/25/2022] [Accepted: 11/27/2022] [Indexed: 06/23/2023] Open
Abstract
Background Prevotella is a Gram-negative anaerobic bacilli. The phenotypic characteristics of the various species of Prevotella are similar, which often makes it difficult in routine differentiation and identification of all the species. Aim The purpose of the study was to detect and compare presence of Prevotella intermedia, Prevotella nigrescens, Prevotella melaninogenica, and Prevotella loescheii in subgingival plaque samples of chronic periodontitis and healthy individuals. Materials and Methods Two hundred and thirty-six subjects were considered consisting of chronic periodontitis (128) and healthy (108) individuals. Subgingival plaque sample was collected in reduced transport fluid and analyzed. DNA extraction and polymerase chain reaction (PCR) were performed for genus Prevotella followed by positive samples were considered for the detection of selected species through multiplex PCR using specific primers. Results Out of 236 samples, 94.1% were positive for genus Prevotella. Out of 222 cases P. nigrescens showed the highest number of cases positive (59.5%) followed by P. melaninogenica (57.2%), P. intermedia (55.4%), and P. loescheii (40.1%). Species were analyzed individually between chronic periodontitis and healthy, P. intermedia, P. nigrescens, and P. loescheii showed greater positivity in healthy compared to chronic periodontitis. Positivity for P. melaninogenica was high in chronic periodontitis compared to healthy. Conclusion The number of positive cases for species, when correlated with clinical parameters showed an increase in mean score for all clinical parameters assessed, suggesting the presence of variation in the prevalence of Prevotella species and geographic variation do exist in oral microflora. Findings suggest that they can be normal commensals and opportunistic.
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Affiliation(s)
- Vijaylakshmi S Kottrashetti
- Department of Oral Pathology and Microbiology, Maratha Mandal’s Nathajirao G. Halgekar Institute of Dental Sciences and Research Centre, Belagavi, Karnataka, India
| | - Kishore G Bhat
- Central Research Laboratory, Maratha Mandal’s Nathajirao G. Halgekar Institute of Dental Sciences and Research Centre, Belagavi, Karnataka, India
| | - Manohar S Kugaji
- Central Research Laboratory, Maratha Mandal’s Nathajirao G. Halgekar Institute of Dental Sciences and Research Centre, Belagavi, Karnataka, India
| | - Sachita Shrikant Naik
- Department of Periodontology, Maratha Mandal’s Nathajirao G. Halgekar Institute of Dental Sciences and Research Centre, Belagavi, Karnataka, India
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Castillo Y, Delgadillo NA, Neuta Y, Hernández A, Acevedo T, Cárdenas E, Montaño A, Lafaurie GI, Castillo DM. Antibiotic Susceptibility and Resistance Genes in Oral Clinical Isolates of Prevotella intermedia, Prevotella nigrescens, and Prevotella melaninogenica. Antibiotics (Basel) 2022; 11:antibiotics11070888. [PMID: 35884141 PMCID: PMC9312306 DOI: 10.3390/antibiotics11070888] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Revised: 06/22/2022] [Accepted: 06/24/2022] [Indexed: 11/16/2022] Open
Abstract
The Prevotella genus is a normal constituent of the oral microbiota, and is commonly isolated from mechanically treated polymicrobial infections. However, antibiotic treatment is necessary for some patients. This study compared the antibiotic susceptibility and the presence of resistance genes in clinical oral isolates of P. intermedia, P. nigrescens, and P. melaninogenica. Antibiotic susceptibility was assessed using the agar dilution method. PCR confirmed the species and resistance gene frequency in the Prevotella species. The frequencies of species P. intermedia, P. nigrescens, and P. melaninogenica were 30.2%, 45.7%, and 24.1%, respectively. No isolates of P. intermedia were resistant to amoxicillin/clavulanic acid, tetracycline, or clindamycin. P. nigrescens and P. melaninogenica were resistant to amoxicillin/clavulanic acid and tetracycline at frequencies of 40% and 20%, respectively. P. intermedia was resistant to metronidazole at a frequency of 30%, P. nigrescens at 20%, and P. melaninogenica at 40%. P. nigrescens and P. melaninogenica were resistant to 50% and 10% clindamycin, respectively. The gene most frequently detected was tetQ, at 43.3%, followed by tetM at 36.6%, blaTEM at 26.6%, ermF at 20%, cfxA, cfxA2, and nimAB at 16.6%, and nimAEFI at 3.3%. P. nigrescens was the species with the highest resistance to antibiotics such as amoxicillin/clavulanic acid, amoxicillin, and clindamycin, in addition to being the species with the largest number of genes compared to P. intermedia and P. melaninogenica.
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Affiliation(s)
- Yormaris Castillo
- Unidad de Investigación Básica Oral-UIBO, Vicerrectoría de Investigaciones, Facultad de Odontología, Universidad El Bosque, 110121 Bogotá, Colombia
| | - Nathaly Andrea Delgadillo
- Unidad de Investigación Básica Oral-UIBO, Vicerrectoría de Investigaciones, Facultad de Odontología, Universidad El Bosque, 110121 Bogotá, Colombia
| | - Yineth Neuta
- Unidad de Investigación Básica Oral-UIBO, Vicerrectoría de Investigaciones, Facultad de Odontología, Universidad El Bosque, 110121 Bogotá, Colombia
| | - Andrés Hernández
- Facultad de Odontología, Universidad El Bosque, 110121 Bogotá, Colombia
| | - Tania Acevedo
- Facultad de Odontología, Universidad El Bosque, 110121 Bogotá, Colombia
| | - Edwin Cárdenas
- Facultad de Odontología, Universidad El Bosque, 110121 Bogotá, Colombia
| | - Andrea Montaño
- Facultad de Odontología, Universidad El Bosque, 110121 Bogotá, Colombia
| | - Gloria Inés Lafaurie
- Unidad de Investigación Básica Oral-UIBO, Vicerrectoría de Investigaciones, Facultad de Odontología, Universidad El Bosque, 110121 Bogotá, Colombia
| | - Diana Marcela Castillo
- Unidad de Investigación Básica Oral-UIBO, Vicerrectoría de Investigaciones, Facultad de Odontología, Universidad El Bosque, 110121 Bogotá, Colombia
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Könönen E, Fteita D, Gursoy UK, Gursoy M. Prevotella species as oral residents and infectious agents with potential impact on systemic conditions. J Oral Microbiol 2022; 14:2079814. [PMID: 36393976 PMCID: PMC9662046 DOI: 10.1080/20002297.2022.2079814] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2022] [Revised: 04/25/2022] [Accepted: 05/13/2022] [Indexed: 10/18/2022] Open
Abstract
Oral Prevotella are known as anaerobic commensals on oral mucosae and in dental plaques from early life onwards, including pigmented P. melaninogenica, P. nigrescens, and P. pallens and non-pigmented Prevotella species. Many Prevotella species contribute to oral inflammatory processes, being frequent findings in dysbiotic biofilms of periodontal diseases (P. intermedia, P. nigrescens), cariotic lesions (P. denticola, Alloprevotella (formerly Prevotella) tannerae), endodontic infections (P. baroniae, P. oris, P. multisaccharivorax), and other clinically relevant oral conditions. Over the years, several novel species have been recovered from the oral cavity without knowledge of their clinical relevance. Within this wide genus, virulence properties and other characteristics like biofilm formation seemingly vary in a species- and strain-dependent manner, as shown for the P. intermedia group organisms (P. aurantiaca, P. intermedia, P. nigrescens, and P. pallens). Oral Prevotella species are identified in various non-oral infections and chronic pathological conditions. Here, we have updated the knowledge of the genus Prevotella and the role of Prevotella species as residents and infectious agents of the oral cavity, as well as their detection in non-oral infections, but also gathered information on their potential link to cancers of the head and neck, and other systemic disorders.
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Affiliation(s)
- Eija Könönen
- Institute of Dentistry, University of Turku, Turku, Finland
| | - Dareen Fteita
- Institute of Dentistry, University of Turku, Turku, Finland
| | - Ulvi K. Gursoy
- Institute of Dentistry, University of Turku, Turku, Finland
| | - Mervi Gursoy
- Institute of Dentistry, University of Turku, Turku, Finland
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Tett A, Pasolli E, Masetti G, Ercolini D, Segata N. Prevotella diversity, niches and interactions with the human host. Nat Rev Microbiol 2021; 19:585-599. [PMID: 34050328 PMCID: PMC11290707 DOI: 10.1038/s41579-021-00559-y] [Citation(s) in RCA: 267] [Impact Index Per Article: 89.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/09/2021] [Indexed: 02/06/2023]
Abstract
The genus Prevotella includes more than 50 characterized species that occur in varied natural habitats, although most Prevotella spp. are associated with humans. In the human microbiome, Prevotella spp. are highly abundant in various body sites, where they are key players in the balance between health and disease. Host factors related to diet, lifestyle and geography are fundamental in affecting the diversity and prevalence of Prevotella species and strains in the human microbiome. These factors, along with the ecological relationship of Prevotella with other members of the microbiome, likely determine the extent of the contribution of Prevotella to human metabolism and health. Here we review the diversity, prevalence and potential connection of Prevotella spp. in the human host, highlighting how genomic methods and analysis have improved and should further help in framing their ecological role. We also provide suggestions for future research to improve understanding of the possible functions of Prevotella spp. and the effects of the Western lifestyle and diet on the host-Prevotella symbiotic relationship in the context of maintaining human health.
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Affiliation(s)
- Adrian Tett
- Centre for Microbiology and Environmental Systems Science, University of Vienna, Vienna, Austria
| | - Edoardo Pasolli
- Department of Agricultural Sciences, University of Naples Federico II, Portici, Italy
- Task Force on Microbiome Studies, University of Naples Federico II, Naples, Italy
| | | | - Danilo Ercolini
- Department of Agricultural Sciences, University of Naples Federico II, Portici, Italy.
- Task Force on Microbiome Studies, University of Naples Federico II, Naples, Italy.
| | - Nicola Segata
- Department CIBIO, University of Trento, Trento, Italy.
- European Institute of Oncology IRCCS, Milan, Italy.
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Prevotella melaninogenica, a Sentinel Species of Antibiotic Resistance in Cystic Fibrosis Respiratory Niche? Microorganisms 2021; 9:microorganisms9061275. [PMID: 34208093 PMCID: PMC8230849 DOI: 10.3390/microorganisms9061275] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2021] [Revised: 06/06/2021] [Accepted: 06/08/2021] [Indexed: 12/31/2022] Open
Abstract
The importance and abundance of strict anaerobic bacteria in the respiratory microbiota of people with cystic fibrosis (PWCF) is now established through studies based on high-throughput sequencing or extended-culture methods. In CF respiratory niche, one of the most prevalent anaerobic genera is Prevotella, and particularly the species Prevotella melaninogenica. The objective of this study was to evaluate the antibiotic susceptibility of this anaerobic species. Fifty isolates of P. melaninogenica cultured from sputum of 50 PWCF have been included. Antibiotic susceptibility testing was performed using the agar diffusion method. All isolates were susceptible to the following antibiotics: amoxicillin/clavulanic acid, piperacillin/tazobactam, imipenem and metronidazole. A total of 96% of the isolates (48/50) were resistant to amoxicillin (indicating beta-lactamase production), 34% to clindamycin (17/50) and 24% to moxifloxacin (12/50). Moreover, 10% (5/50) were multidrug-resistant. A significant and positive correlation was found between clindamycin resistance and chronic azithromycin administration. This preliminary study on a predominant species of the lung “anaerobiome” shows high percentages of resistance, potentially exacerbated by the initiation of long-term antibiotic therapy in PWCF. The anaerobic resistome characterization, focusing on species rather than genera, is needed in the future to better prevent the emergence of resistance within lung microbiota.
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Oral Antibiotic for Empirical Management of Acute Dentoalveolar Infections-A Systematic Review. Antibiotics (Basel) 2021; 10:antibiotics10030240. [PMID: 33670844 PMCID: PMC7997333 DOI: 10.3390/antibiotics10030240] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2021] [Revised: 02/22/2021] [Accepted: 02/23/2021] [Indexed: 12/21/2022] Open
Abstract
Concerns regarding increasing antibiotic resistance raise the question of the most appropriate oral antibiotic for empirical therapy in dentistry. The aim of this systematic review was to investigate the antibiotic choices and regimens used to manage acute dentoalveolar infections and their clinical outcomes. A systematic review was undertaken across three databases. Two authors independently screened and quality-assessed the included studies and extracted the antibiotic regimens used and the clinical outcomes. Searches identified 2994 studies, and after screening and quality assessment, 8 studies were included. In addition to incision and drainage, the antibiotics used to manage dentoalveolar infections included amoxicillin, amoxicillin/clavulanic acid, cefalexin, clindamycin, erythromycin, metronidazole, moxifloxacin, ornidazole and phenoxymethylpenicillin. Regimens varied in dose, frequency and duration. The vast majority of regimens showed clinical success. One study showed that patients who did not receive any antibiotics had the same clinical outcomes as patients who received broad-spectrum antibiotics. The ideal choice, regimen and spectrum of empirical oral antibiotics as adjunctive management of acute dentoalveolar infections are unclear. Given that all regimens showed clinical success, broad-spectrum antibiotics as first-line empirical therapy are unnecessary. Narrow-spectrum agents appear to be as effective in an otherwise healthy individual. This review highlights the effectiveness of dental treatment to address the source of infection as being the primary factor in the successful management of dentoalveolar abscesses. Furthermore, the role of antibiotics is questioned in primary space odontogenic infections, if drainage can be established.
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Abstract
Prevotella genus comprises of obligate anaerobic, gram-negative bacteria that are commensal organisms of oral cavity, gut and vaginal mucosa. Although many Prevotella species have well-established pathogenicity with respect to pulmonary infections, rarely has Prevotella pleuritidis been isolated as a cause of lung abscess. We present a rare case of left lower lobe lung abscess due to P. pleuritidis identified using next-generation sequencing of microbial cell-free DNA testing. A brief review of the literature regarding Prevotella species pulmonary infections, use of next-generation cell-free DNA testing early in the evaluation, antibiotic susceptibility and resistance is also a part of this report.
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Affiliation(s)
- Abuzar Ali Asif
- Internal Medicine, University of Illinois College of Medicine at Peoria, Peoria, Illinois, USA
| | - Moni Roy
- Internal Medicine, University of Illinois College of Medicine at Peoria, Peoria, Illinois, USA .,Internal Medicine, OSF Saint Francis Medical Center, Peoria, Illinois, USA
| | - Sharjeel Ahmad
- Internal Medicine, Section of Infectious Diseases, University of Illinois College of Medicine at Peoria, Peoria, Illinois, USA
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Teoh L, Thompson W, Suda K. Antimicrobial stewardship in dental practice. J Am Dent Assoc 2020; 151:589-595. [PMID: 32718488 DOI: 10.1016/j.esmoop.2020.04.023] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2020] [Revised: 04/05/2020] [Accepted: 04/21/2020] [Indexed: 12/19/2022]
Abstract
BACKGROUND Antibiotic resistance is a global public health problem that is responsible for increased patient morbidity and mortality and financial burden. Dental antibiotic prescribing contributes to approximately 10% of all antibiotic prescriptions, and an estimated 80% of that prescribing is deemed inappropriate. Dental antimicrobial stewardship (AMS) has an important role to play in international efforts to tackle antibiotic resistance. The aim of the authors was to comment on the implementation of AMS strategies in outpatient dental practices. METHODS The authors included previous studies regarding outpatient antibiotic stewardship, longitudinal studies quantifying dispensed dental antibiotic prescription use, and interventional studies aimed at implementing AMS interventions in dentistry. RESULTS Researchers in several studies conducted trials regarding the use of various interventions, mostly comprising a combination of audit, feedback, dissemination of guidelines, and educational components to improve dental prescribing. CONCLUSIONS AND PRACTICAL IMPLICATIONS In regard to the establishment of an AMS strategy, aspects to be considered should include raising awareness about the risks of unnecessary use of antibiotics. Engaging and educating the entire dental team and patients, as well as collaborating with other specialized professionals, are important elements. Context-specific interventions with a methodical and measured approach are ideal.
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Boucher A, Quaranta D, Emonet S, Serratrice J, Coen M. Nonpuerperal breast abscess due to Prevotella bivia. Clin Case Rep 2020; 8:1399-1402. [PMID: 32884762 PMCID: PMC7455417 DOI: 10.1002/ccr3.2824] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2019] [Revised: 02/28/2020] [Accepted: 03/10/2020] [Indexed: 12/12/2022] Open
Abstract
Contrary to puerperal abscess, nonpuerperal breast abscess is often caused by anaerobic bacteria; polymicrobial aerobic-anaerobic infections are also frequent. Empiric first-choice treatment with broad-spectrum antibiotics should be considered.
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Affiliation(s)
- Astrid Boucher
- Breast CenterDepartment of Gynaecology and ObstetricsGeneva University HospitalsGenevaSwitzerland
| | - Delphine Quaranta
- Breast CenterDepartment of Gynaecology and ObstetricsGeneva University HospitalsGenevaSwitzerland
| | - Stéphane Emonet
- Service of Infectious DiseasesDepartment of MedicineGeneva University HospitalsGenevaSwitzerland
| | - Jacques Serratrice
- Service of Internal MedicineDepartment of MedicineGeneva University HospitalsGenevaSwitzerland
| | - Matteo Coen
- Service of Internal MedicineDepartment of MedicineGeneva University HospitalsGenevaSwitzerland
- Unit of Development and Research in Medical Education (UDREM)Faculty of MedicineUniversity of GenevaGenevaSwitzerland
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12
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Teoh L, Thompson W, McCullough M. Questioning dual antimicrobial therapy as first line in recent Australian Therapeutic Guidelines. Aust Dent J 2020; 65:302-304. [PMID: 32588465 DOI: 10.1111/adj.12783] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/24/2020] [Indexed: 12/19/2022]
Affiliation(s)
- L Teoh
- Melbourne Dental School, University of Melbourne, Carlton, Victoria, Australia
| | - W Thompson
- University of Manchester, Manchester, UK
| | - M McCullough
- Melbourne Dental School, University of Melbourne, Carlton, Victoria, Australia
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13
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Kates AE, Dalman M, Torner JC, Smith TC. The nasal and oropharyngeal microbiomes of healthy livestock workers. PLoS One 2019; 14:e0212949. [PMID: 30861031 PMCID: PMC6413945 DOI: 10.1371/journal.pone.0212949] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2018] [Accepted: 02/12/2019] [Indexed: 12/26/2022] Open
Abstract
Little information exists on the microbiomes of livestock workers. A cross-sectional, epidemiological study was conducted enrolling 59 participants (26 of which had livestock contact) in Iowa. Participants were enrolled in one of four ways: from an existing prospective cohort study (n = 38), from the Iowa Department of Natural Resources Animal Feeding Operations database (n = 17), through Iowa county fairs (n = 3), and through snowball sampling (n = 1). We collected swabs from the nares and oropharynx of each participant to assess the microbiome via 16s rRNA sequencing. We observed livestock workers to have greater diversity in their microbiomes compared to those with no livestock contact. In the nares, there were 27 operational taxonomic units found to be different between livestock workers and non-livestock workers with the greatest difference seen with Streptococcus and Proteobacteria. In the oropharynx, livestock workers with swine exposure were more likely to carry several pathogenic organisms. The results of this study are the first to characterize the livestock worker nasal and oropharyngeal microbiomes.
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Affiliation(s)
- Ashley E. Kates
- Department of Epidemiology, College of Public Health, University of Iowa, Iowa City, IA, United States of America
| | - Mark Dalman
- Kent State University, College of Public Health, Kent, OH, United States of America
| | - James C. Torner
- Department of Epidemiology, College of Public Health, University of Iowa, Iowa City, IA, United States of America
| | - Tara C. Smith
- Kent State University, College of Public Health, Kent, OH, United States of America
- * E-mail:
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Metronidazole resistance and nim genes in anaerobes: A review. Anaerobe 2019; 55:40-53. [DOI: 10.1016/j.anaerobe.2018.10.004] [Citation(s) in RCA: 35] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2018] [Revised: 10/01/2018] [Accepted: 10/05/2018] [Indexed: 01/06/2023]
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Cobo F, Calatrava E, Rodríguez-Granger J, Sampedro A, Aliaga-Martínez L, Navarro-Marí JM. A rare case of pleural effusion due to Prevotella dentalis. Anaerobe 2018; 54:144-145. [PMID: 30244150 DOI: 10.1016/j.anaerobe.2018.09.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2018] [Revised: 09/15/2018] [Accepted: 09/16/2018] [Indexed: 12/15/2022]
Abstract
Prevotella dentalis is a Gram-negative anaerobic rod involved in various human diseases, especially oral infections. We report a rare case of a pleural effusion due to this microorganism in an elderly patient. An 88-year-old man with chronic respiratory disease presented with a left pleural effusion for more than 1 month. Culture of drained pleural fluid resulted in isolation of P. dentalis. Resistance to penicillin and moxifloxacin was documented. Treatment with drainage and clindamycin was established, but the patient developed cognitive impairment and died after a worsening of his general condition.
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Affiliation(s)
- Fernando Cobo
- Department of Microbiology, University Hospital Virgen de las Nieves, Granada, Spain.
| | - Elizabeth Calatrava
- Department of Microbiology, University Hospital Virgen de las Nieves, Granada, Spain
| | | | - Antonio Sampedro
- Department of Microbiology, University Hospital Virgen de las Nieves, Granada, Spain
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Mo S, Wei L, Chen H, Li R, Li S, Luo G. A chinese case of prevotella intermedia and streptococcus constellatus intracranial mixed infection. Metab Brain Dis 2018; 33:161-166. [PMID: 29094233 PMCID: PMC5769824 DOI: 10.1007/s11011-017-0142-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/11/2017] [Accepted: 10/23/2017] [Indexed: 12/29/2022]
Abstract
Streptococcal Species is increasingly recognized as a potentially preventable emerging infection in human's brain with high prevalence around the world. Streptococcus constellatus is one of the most common pathogens. Meanwhile, anaerobic bacteria are the rare causes for intracranial infection. To date, intracranial mixed infection caused by Prevotella intermedia and Streptococcus constellatus has not been reported. We reported a Chinese case to raise the global awareness of severity of the intracranial mixed infection. Here, we illustrated the epidemiological risk factors, clinical manifestations and outcomes of the patient. For patients who suffer from exacerbated brain infection with fetid cerebrospinal fluid, early repeated imaging is urgently needed and empiric antibiotic therapy should consider anaerobic and aerobic bacteria in these situations.
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Affiliation(s)
- Shanying Mo
- Medical Science Laboratory, the Fourth Affiliated Hospital of Guangxi Medical University, Liuzhou, Guangxi, China
| | - Liuhua Wei
- Medical Science Laboratory, the Fourth Affiliated Hospital of Guangxi Medical University, Liuzhou, Guangxi, China
| | - Hongmou Chen
- Department of Neurosurgery, the Fourth Affiliated Hospital of Guangxi Medical University, Liuzhou, Guangxi, China
| | - Rui Li
- MRI Department, the Fourth Affiliated Hospital of Guangxi Medical University, Liuzhou, Guangxi, China
| | - Shuping Li
- Department of Radiology, the Fourth Affiliated Hospital of Guangxi Medical University, Liuzhou, Guangxi, China
| | - Guolan Luo
- Medical Science Laboratory, the Fourth Affiliated Hospital of Guangxi Medical University, Liuzhou, Guangxi, China.
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Infected breast cyst due to Prevotella buccae resistant to metronidazole. Anaerobe 2017; 48:177-178. [PMID: 28866113 DOI: 10.1016/j.anaerobe.2017.08.015] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2017] [Revised: 08/17/2017] [Accepted: 08/28/2017] [Indexed: 11/24/2022]
Abstract
Prevotella buccae is a Gram-negative anaerobic rod involved in some human infections. We report the first case of an infected breast cyst in a non-puerperal women due to this pathogen. A 53-year-old woman presented with pain and a cystic lesion in the right breast. Culture of abscess drainage resulted in isolation of P. buccae. High level of resistance to metronidazole was documented. Treatment with drainage and amoxicillin-clavulanate was established, and improvement of this infection was observed.
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Kim MK, Chuang SK, August M. Antibiotic Resistance in Severe Orofacial Infections. J Oral Maxillofac Surg 2016; 75:962-968. [PMID: 27899019 DOI: 10.1016/j.joms.2016.10.039] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2016] [Revised: 10/27/2016] [Accepted: 10/29/2016] [Indexed: 11/28/2022]
Abstract
PURPOSE This study assessed the antibiotic resistance profile in patients with severe orofacial infections treated at a single institution from 2009 through 2014. Factors contributing to resistance were studied. The resistance profile was compared with that of a cohort of similar patients treated a decade previously to identify changes in antibiotic resistance. In addition, the effect of antibiotic resistance on in-hospital course was studied. MATERIALS AND METHODS This was a 5-year retrospective cohort study. Patients were identified through the oral and maxillofacial surgery data registry. Inclusion criteria were patients treated for orofacial infection requiring hospital admission, surgical drainage, and availability of complete medical, surgical, and microbiological data. Patients with incomplete data or treated as outpatients or nonsurgically were excluded. Sixty patient charts were identified for review. Demographic data; medical, dental, and surgical histories; and hospital course and treatment specifics were obtained for each patient. Linear regression and logistic analyses were used to analyze the data. RESULTS Men composed 60% of the cohort (mean age, 45 yr). Average hospital stay was 5.5 days. Penicillin resistance was found in 32.5% of aerobic isolates and clindamycin resistance was found in 29.3%. Streptococcus viridans and Staphylococcus species showed increased resistance to clindamycin and erythromycin compared with historic controls. Younger patient age, surgical history, and number of cultured aerobes showed a relevant correlation to antibiotic resistance. The need for changes in antibiotics, repeat surgical drainage, and increased serum urea nitrogen levels correlated with longer hospital stay. CONCLUSION A serious increase in clindamycin and erythromycin resistance was found for S viridans and Staphylococcus species. Age, surgical history, and number of cultured aerobes showed a statistically meaningful correlation to antibiotic resistance. Presence of antibiotic resistance failed to show statistically relevant correlations to prolongation of hospital stay. Rather, the need for change in antibiotic regimen, the need for re-drainage, and increased serum urea nitrogen level were associated with longer hospital stay.
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Affiliation(s)
| | | | - Meredith August
- Associate Professor, Massachusetts General Hospital-Harvard School of Dental Medicine, Boston, MA.
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