The purpose of this investigation was to explore the epidemiology, clinical history and microbiology of peritonsillar abscess (PTA). A retrospective review of PTA cases treated at the Department of Otolaryngology, Regional Specialist Hospital in Radom, Poland between 1st October 2003 and 30th September 2013 was undertaken. A total of 111 PTA patients were admitted. The study population consisted of 57.7 % males and 42.3 % females, with an average age of 31.0 (range 5–78) years. Smokers comprised 22.0 % of the study group. The seasonal variation of PTA was statistically insignificant (p = 0.45). Recurrent tonsillitis occurred in 35.5 % of patients. In comparison with the rest of the study population, patients with a history of recurrent pharyngotonsillitis had higher incidence of previous PTA episodes [odds ratio (OR) 17.8, 95 % confidence interval (CI) 2.1–148.7, p = 0.001]. Also, they were more frequently treated with antibiotics prior to hospitalisation (OR 4.6, 95 % CI 2.0–10.9, p = 0.0005) and had significantly longer hospital stay (p = 0.03). Bacterial cultures of abscess aspirates were performed in 40.5 % of patients. Monomicrobial growth was detected in 77.8 % of aerobic cultures. Streptococcus pyogenes, growing most frequently in monoculture, was found in 28.9 % of aerobic cultures. PTA patients with and without recurrent pharyngotonsillitis differed with regard to clinical history and course of disease. The percentage of smokers among PTA patients was lower than that described in the literature. Monomicrobial growth predominated in PTA aspirate cultures. S. pyogenes proved to be the most frequent pathogen.
We determined the frequency of isolation of staphylococcal small-colony variants (SCVs) from 31 culture-positive patients undergoing revision of total hip prosthesis for aseptic loosening or presumed prosthetic-joint infection (PJI). We analysed auxotrophy of cultured SCVs, their antimicrobial susceptibility profiles and their biofilm-forming capacity. Eight SCV strains were cultivated from six (19 %) patients. All SCVs were coagulase-negative staphylococci (CNS) with Staphylococcus epidermidis as the predominant species; there was also one Staphylococcus warneri SCV. The SCVs were auxotrophic for haemin, with one strain additionally auxotrophic for menadione. We noted the presence of two phenotypically (differences concerning antimicrobial susceptibility) and genetically distinct SCV strains in one patient, as well as the growth of two genetically related SCVs that differed in terms of their morphology and the type of auxotrophy in another. Seven out of eight SCVs were resistant to meticillin and gentamicin. In addition, antibiotic sensitivity testing revealed three multidrug-resistant SCV-normal-morphology isolate pairs. One S. epidermidis SCV harboured icaADBC genes and was found to be a proficient biofilm producer. This paper highlights the involvement of CNS SCVs in the aetiology of PJIs, including what is believed to be the first report of a S. warneri SCV. These subpopulations must be actively sought in the routine diagnosis of implant-associated infections. Moreover, in view of the phenotypic and genetic diversity of some SCV pairs, particular attention should be paid to the investigation of all types of observed colony morphologies, and isolates should be subjected to antimicrobial susceptibility testing.
Introduction and objective. Cardiovascular diseases are the leading cause of death in Europe and worldwide. One of the most important risk factors for atherosclerosis are lipid metabolism disorders, in particular hipercholesterolaemia. The aim of the study was to determine the correlation between gut microbiota composition and atherosclerosis risk factors, so in order that it might be used as a biomarker for coronary artery disease diagnosis. Material and method. The study involved middle-aged men in eastern Poland with central obesity (n=20), subjects with atherosclerosis (n=15) and those with no cardiovascular diseases (n=5). The gut microbiota composition was determined using tag-encoded 16S rRNA gene using Illuminal MiSeq. Data were analyzed with the use of t-test. Results. Firmicutes (49.26%) and Bacteroidetes (44.46%) were the dominant Phyla in the middle-aged men in eastern Poland. Subjects with improper levels of total cholesterol were enriched in Prevotella (p=0.03) and decreased level of Clostridium (p=0.02). They also showed a falling tendency in Faecalibacterium (p=0.07). An upward trend was observed in Prevotella (p=0.07) in subjects with improper LDL-C values. Conclusions. The study showed that intestinal microbiome is likely to play a role in the pathogenesis of atherosclerosis through its role in lipid metabolism. Bacterial genera of particular importance were Prevotella, Bacteroides, Clostridium, Faecalibacterium. However, further studies involving larger groups of subjects are required to confirm these observations.
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