BackgroundHigh grade HPV infections and persistence are the strongest risk factors for cervical cancer. Nevertheless other genital microorganisms may be involved in the progression of HPV associated lesions.MethodsCervical samples were collected to search for human Papillomavirus (HPV), bacteria and yeast infections in gynaecologic outpatients. HPV typing was carried out by PCR and sequencing on cervical brush specimens. Chlamydia trachomatis was identified by strand displacement amplification (SDA) and the other microorganisms were detected by conventional methods.ResultsIn this cross-sectional study on 857 enrolled outpatients, statistical analyses revealed a significant association of HPV with C. trachomatis and Ureaplasma urealyticum (at high density) detection, whereas no correlation was found between HPV infection and bacterial vaginosis, Streptococcus agalactiae, yeasts, Trichomonas vaginalis and U. urealyticum. Mycoplasma hominis was isolated only in a few cases both in HPV positive and negative women and no patient was infected with Neisseria gonorrhoeae.ConclusionAlthough bacterial vaginosis was not significantly associated with HPV, it was more common among the HPV positive women. A significant association between HPV and C. trachomatis was found and interestingly also with U. urealyticum but only at a high colonization rate. These data suggest that it may be important to screen for the simultaneous presence of different microorganisms which may have synergistic pathological effects.

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Brevundimonas vesicularis is a non-fermenting gram-negative bacillus, aerobic and motile. This microrganism is ubiquitous in the environment and has rarely been implicated in human infections. We present the second case of cutaneous infection caused by B. vesicularis in an immunocompetent patient.Brevundimonas vesicularis is an aerobic nonsporulating and non-fermenting gram-negative bacillus (1) that is ubiquitous in the environment (2-6).Two species originally described as Pseudomonas diminuta and Pseudomonas vesicularis were re-classified by Segers et al. into a new genus Brevundimonas with Brevundimonas diminuta as the type species of the genus (7). Brevundimonas vesicularis represent a separate line in the usubclass of Proteobacteria, rarely encountered in human infection. It was first described under the name of Corynebacterium vesiculare by Busing et al. (8) and Busing and Freytag (9) who isolated it from a medicinal leech (Hirsuda medicinalis). In 1994 Segers et al. re-classified two species originally described as Pseudomonas diminuta and Pseudomonas vesicularis into a new genus Brevundimonas with Brevundimonas diminuta as the type species of the genus (7). This organism has been very rarely implicated in human infections. We present the second case of cutaneous infection caused by B. vesicularis in an immunocompetent patient. MATERIALS AND METHODSIn February 2007 a 71-year-old caucasian man was referred to our Department of Dermatology, because of a rapidly enlarging skin plaque on his right forearm which had appeared 2 weeks previously and had already been treated with topical (mupirocin 2 g/lOO g cream) and systemic antibiotic (proxetil cefpodoxime 200 mg x 2 die for 7 days) without any improvement.On physical examination, an irregular rectangular erythematous plaque with superficial bright red erosions, micro-pustules and crusting on the surface, measuring approximately 13 x 4 em, was present on the dorsal aspect of his right forearm. The lesion was painful.The patient lived in a rural area and was usually exposed to farm animals. He reported that some days before the onset of the skin lesion he had a trauma on his right forearm whilst handling fodder. Past medical history was unremarkable. The physical examination was normal. Laboratory tests were normal except for

We describe a 79-year-old female with a chronic venous ulceration infected by Staphylococcus aureus and Enterococcus faecalis and not responsive to conventional treatments. The patient was treated with Methyl-Aminolaevulinate Photodynamic Therapy (MAL-PDT). After four weeks the cutaneous swabs become negative and we observed a significant clinical improvement. Therefore we suppose that MALPDT could represent a valid therapeutic option in the treatment of infected chronic ulcers.

Bromhidrosis is a clinical disorder characterized by excessive or abnormal foul axillary odour due to the interaction of apocrine glands with micro-organisms which causes a serious personal and social handicap for affected people. We present the case of a 50-year-old caucasian female with bromhidrosis. The patient referred that this symptom had begun two months previously. Her past treatments included antibacterial soap, topical antibacterial agents and perfumes, but none of these relieved the patient of the odour. A cultural examination of axillary smear was carried out and it revealed the presence of ciproftoxacin sensible Sphingomonas paucimobilis. Therefore the patient was treated with ciproftoxacin and after 1 week the infection resolved completely.Bromhidrosis is a common but unpleasant disease faced by many populations, particularly in Asia, due to the interaction of apocrine glands with microorganisms. Axillary bacteria degrade the apocrine sweat and malodorous smell develops within a few hours. The major odour components are short-chain fatty acids and ammonia (1). However, the definite etiology ofbromhidrosis has not yet been generalized. To our knowledge, this is the first report of axillary bromhidrosis caused by Sphingomonas paucimobilis. MATERIALS AND METHODSA 50-year-old caucasian female was referred to our Department in May 2008, because of a disagreeable odour due to axillary bromhidrosis. Past medical history was unremarkable; the dermatological examination showed no abnormalities and there were no superficial axillary lymphadenopathy; laboratory tests were normal. The patient referred that this symptom had begun two months previously. Her past treatments had included antibacterial soap, topical antibacterial agents, and perfumes, but none of these relieved the patient of the odour. An axillary smear was performed and processed according to standard microbiologic techniques in the Microbiology laboratory of "Umberto I" Hospital in Rome. In particular, the specimen was cultured on Sabouraud agar for yeasts and on routinely selective and elective culture media for bacteria and it was incubated in ambient air at 37°C for 24-48 hours. Macroscopic observation of the microbial colony, Gram staining, the motility assay and catalase tests were performed