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Hoogenkamp MA, Mazurel D, Deutekom-Mulder E, de Soet JJ. The consistent application of hydrogen peroxide controls biofilm growth and removes Vermamoeba vermiformis from multi-kingdom in-vitro dental unit water biofilms. Biofilm 2023; 5:100132. [PMID: 37346320 PMCID: PMC10279787 DOI: 10.1016/j.bioflm.2023.100132] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2023] [Revised: 05/24/2023] [Accepted: 05/24/2023] [Indexed: 06/23/2023] Open
Abstract
The water systems inside a dental unit are known to be contaminated with a multi-kingdom biofilm encompassing bacteria, fungi, viruses and protozoa. Aerosolization of these micro-organisms can potentially create a health hazard for both dental staff and the patient. Very little is known on the efficacy of dental unit disinfection products against amoeba. In this study we have examined the effect of four different treatment regimens, with the hydrogen peroxide (H2O2) containing product Oxygenal, on an in-vitro multi-kingdom dental unit water system (DUWS) biofilm. The treatment efficacy was assessed in time using heterotrophic plate counts, the bacterial 16S rDNA, fungal 18S rDNA gene load and the number of genomic units for Legionella spp. the amoeba Vermamoeba vermiformis. The results indicated that a daily treatment of the DUWS with a low dose H2O2 (0.02% for 5 h), combined with a weekly shock dose (0.25% H2O2, 30 min) is necessary to reduce the heterotrophic plate count of a severely contaminated DUWS (>106 CFU.mL-1) to below 100 CFU.mL-1. A daily treatment with a low dose hydrogen peroxide alone, is sufficient for the statistically significant reduction of the total amount of bacterial 16S rDNA gene, Legionella spp. and Vermamoeba vermiformis load (p < 0.005). Also shown is that even though hydrogen peroxide does not kill the trophozoite nor the cysts of V. vermiformis, it does however result in the detachment of the trophozoite form of this amoeba from the DUWS biofilm and hereby ultimately removing the amoeba from the system.
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Affiliation(s)
- Michel A. Hoogenkamp
- Corresponding author. Gustav Mahlerlaan 3004, 1081 LA, Amsterdam, the Netherlands.
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Perina V, Szaraz D, Harazim H, Urik M, Klabusayova E. Paediatric Deep Neck Infection—The Risk of Needing Intensive Care. CHILDREN 2022; 9:children9070979. [PMID: 35883963 PMCID: PMC9315740 DOI: 10.3390/children9070979] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/27/2022] [Revised: 06/19/2022] [Accepted: 06/28/2022] [Indexed: 11/16/2022]
Abstract
Deep neck infections are potentially dangerous complications of upper respiratory tract or odontogenic infections. The pathophysiology, clinical presentation, and potential spreading depend on the complex anatomy of the neck fascia. These infections can lead to severe pathological conditions, such as mediastinitis, sepsis, and especially airway impairment with difficult management. Because of the risk of life-threatening emergency situations and the possible impacts on the overall health status of affected children, their early recognition is of utmost importance. Torticollis, drooling, and stridor are the most common signs of advancing disease. Children presenting with these symptoms should be admitted to the paediatric intensive care unit for vital function monitoring, where the airway could be readily secured if function is compromised.
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Affiliation(s)
- Vojtech Perina
- Department of Oral and Maxillofacial Surgery, University Hospital Brno, Faculty of Medicine, Masaryk University, Jihlavska 20, 625 00 Brno, Czech Republic; (V.P.); (D.S.)
| | - David Szaraz
- Department of Oral and Maxillofacial Surgery, University Hospital Brno, Faculty of Medicine, Masaryk University, Jihlavska 20, 625 00 Brno, Czech Republic; (V.P.); (D.S.)
| | - Hana Harazim
- Department of Paediatric Anaesthesiology and Intensive Care Medicine, University Hospital Brno, Faculty of Medicine, Masaryk University, Kamenice 5, 625 00 Brno, Czech Republic;
- Department of Simulation Medicine, Faculty of Medicine, Masaryk University, Kamenice 5, 625 00 Brno, Czech Republic
| | - Milan Urik
- Department of Paediatric Otorhinolaryngology, University Hospital Brno, Faculty of Medicine, Masaryk University, Cernopolni 9, 662 63 Brno, Czech Republic;
| | - Eva Klabusayova
- Department of Paediatric Anaesthesiology and Intensive Care Medicine, University Hospital Brno, Faculty of Medicine, Masaryk University, Kamenice 5, 625 00 Brno, Czech Republic;
- Department of Simulation Medicine, Faculty of Medicine, Masaryk University, Kamenice 5, 625 00 Brno, Czech Republic
- Correspondence: ; Tel.: +420-532-234-693
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Al Bulushi Y, Saint-Martin C, Muthukrishnan N, Maleki F, Reinhold C, Forghani R. Radiomics and machine learning for the diagnosis of pediatric cervical non-tuberculous mycobacterial lymphadenitis. Sci Rep 2022; 12:2962. [PMID: 35194075 PMCID: PMC8863781 DOI: 10.1038/s41598-022-06884-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2021] [Accepted: 02/09/2022] [Indexed: 01/01/2023] Open
Abstract
Non-tuberculous mycobacterial (NTM) infection is an emerging infectious entity that often presents as lymphadenitis in the pediatric age group. Current practice involves invasive testing and excisional biopsy to diagnose NTM lymphadenitis. In this study, we performed a retrospective analysis of 249 lymph nodes selected from 143 CT scans of pediatric patients presenting with lymphadenopathy at the Montreal Children’s Hospital between 2005 and 2018. A Random Forest classifier was trained on the ten most discriminative features from a set of 1231 radiomic features. The model classifying nodes as pyogenic, NTM, reactive, or proliferative lymphadenopathy achieved an accuracy of 72%, a precision of 68%, and a recall of 70%. Between NTM and all other causes of lymphadenopathy, the model achieved an area under the curve (AUC) of 89%. Between NTM and pyogenic lymphadenitis, the model achieved an AUC of 90%. Between NTM and the reactive and proliferative lymphadenopathy groups, the model achieved an AUC of 93%. These results indicate that radiomics can achieve a high accuracy for classification of NTM lymphadenitis. Such a non-invasive highly accurate diagnostic approach has the potential to reduce the need for invasive procedures in the pediatric population.
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Affiliation(s)
- Yarab Al Bulushi
- Augmented Intelligence and Precision Health Laboratory (AIPHL), Department of Radiology and the Research Institute of McGill University Health Centre, 5252 Boulevard de Maisonneuve O, Montréal, QC, H4A 3S9, Canada.,Department of Radiology, McGill University Health Centre, 1001 Decarie Blvd, Montreal, QC, H4A 3J1, Canada.,Department of Radiology, Stanford University, Stanford, CA, 94305, USA
| | - Christine Saint-Martin
- Department of Radiology, McGill University Health Centre, 1001 Decarie Blvd, Montreal, QC, H4A 3J1, Canada
| | - Nikesh Muthukrishnan
- Augmented Intelligence and Precision Health Laboratory (AIPHL), Department of Radiology and the Research Institute of McGill University Health Centre, 5252 Boulevard de Maisonneuve O, Montréal, QC, H4A 3S9, Canada
| | - Farhad Maleki
- Augmented Intelligence and Precision Health Laboratory (AIPHL), Department of Radiology and the Research Institute of McGill University Health Centre, 5252 Boulevard de Maisonneuve O, Montréal, QC, H4A 3S9, Canada
| | - Caroline Reinhold
- Augmented Intelligence and Precision Health Laboratory (AIPHL), Department of Radiology and the Research Institute of McGill University Health Centre, 5252 Boulevard de Maisonneuve O, Montréal, QC, H4A 3S9, Canada.,Department of Radiology, McGill University Health Centre, 1001 Decarie Blvd, Montreal, QC, H4A 3J1, Canada
| | - Reza Forghani
- Augmented Intelligence and Precision Health Laboratory (AIPHL), Department of Radiology and the Research Institute of McGill University Health Centre, 5252 Boulevard de Maisonneuve O, Montréal, QC, H4A 3S9, Canada. .,Department of Radiology, McGill University Health Centre, 1001 Decarie Blvd, Montreal, QC, H4A 3J1, Canada. .,Radiomics and Augmented Intelligence Laboratory (RAIL), Department of Radiology and Division of Medical Physics, University of Florida, PO Box 100374, Gainesville, FL, 32610-0374, USA.
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Zhukhovitskaya A, Chang DT, Huoh KC, Pham NS, Singh J, Ahuja GS. Surgical management of atypical mycobacterial cervical lymphadenitis in an outbreak of odontological infection. Int J Pediatr Otorhinolaryngol 2020; 131:109882. [PMID: 31981916 DOI: 10.1016/j.ijporl.2020.109882] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/27/2019] [Revised: 01/12/2020] [Accepted: 01/13/2020] [Indexed: 11/26/2022]
Abstract
INTRODUCTION We report on our experience with surgical management of nosocomial Mycobacterium abscessus cervical lymphadenitis in the setting of an epidemic linked to a dental practice in the community. METHODS This is an observational case series of children who required surgical treatment of cervical lymphadenitis as part of multidisciplinary management of nosocomial M. abscessus infections. We describe the criteria for surgical management of cervical lymphadenitis as well as patient characteristics and outcomes. RESULTS Over 1000 children undergoing pulpectomies and pulpotomies at a local dental practice with a contaminated water source were identified as potentially susceptible to atypical mycobacteria infection, identified as M. abscessus. Between August 2016 and May 2017 108 children underwent inpatient evaluation at our institution by general pediatricians and pediatric infectious disease specialists. 90 children required at least 1 surgical intervention by pediatric otolaryngology and/or oral and maxillofacial surgery (OMFS). Children were evaluated by the Pediatric Otolaryngology service if computer tomography (CT) scan of the neck demonstrated lymph nodes of at least 1.5 cm in shortest dimension or lymph nodes with central hypolucencies suspicious for infection with central necrosis. Pediatric Otolaryngology intervened on 11 patients all of whom required selective cervical lymphadenectomy with or without curettage. These patients ranged in age from 3 to 8 years; 8 were male, 6 had concurrent pulmonary nodules. Two patients underwent curettage in addition to lymphadenectomy. Five patients required at least 2 surgical interventions by Pediatric Otolaryngology. CONCLUSION We found M. abscessus to be an aggressive infection requiring early cervical lymphadenectomy in select patients.
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Affiliation(s)
- A Zhukhovitskaya
- University of California - Irvine, Department of Otolaryngology, Orange, CA, USA; CHOC Children's Hospital, Orange, CA, USA.
| | - D T Chang
- CHOC Children's Hospital, Orange, CA, USA
| | - K C Huoh
- CHOC Children's Hospital, Orange, CA, USA
| | - N S Pham
- CHOC Children's Hospital, Orange, CA, USA
| | - J Singh
- CHOC Children's Hospital, Orange, CA, USA
| | - G S Ahuja
- CHOC Children's Hospital, Orange, CA, USA
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