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Background The purpose of this study was to evaluate prospectively the presence and impact of the gastric carcinogen Helicobacter pylori (H. pylori) in the upper aerodigestive tract. Previous studies suggested it could represent a risk factor for head and neck squamous cell carcinoma (HNSCC). Methods Serology, rapid urease test, and quantitative polymerase chain reaction (qPCR) for H. pylori were performed in patients with head and neck cancer (N = 56) and cancer-free controls (N = 90). Comparison between groups was done using logistic regression analysis. Results Rates of positive serology and rapid urease test did not differ between the 2 groups in logistic regression analysis (p = .677 and p = .633, respectively). Birth in a developing country and age above 50 years old were predictors of positive serology (p

Study Type - Therapy (case series) Level of Evidence 4 What's known on the subject? and What does the study add? Several studies describe a reduction of symptomatic urinary tract infections in patients with neurogenic detrusor overactivity after intradetrusor injections of botulinum neurotoxin A (BoNT/A). It was, however, unclear if a direct antibacterial effect of BoNT/A plays a role in this clinical observation. This is the first study to investigate a potential antibacterial effect of two frequently used BoNT/A formulations (i.e. Botox® and Dysport®), providing evidence that BoNT/A does not exert an antibacterial effect on lower urinary tract pathogens. OBJECTIVE: • To determine a potential direct antimicrobial effect of botulinum neurotoxin type A (BoNT/A). MATERIALS AND METHODS: • A prospective study was carried out using onabotulinumtoxin A (Botox®) and abobotulinumtoxin A (Dypsort®) in agar diffusion and broth microdilution assays with various clinical urinary tract isolates (Escherichia coli, Klebsiella pneumoniae, Enterobacter cloacae, Pseudomonas aeruginosa, Acinetobacter baumannii, Citrobacter freundii, Klebsiella oxytoca and Bacillus subtilis). • Inhibition zones (mm) of bacteria around a disc containing 20 µL saline with 4 IU of Botox® were measured in the agar diffusion assay. • Minimal inhibitory concentrations (MICs, IU/mL) of both toxins for all bacteria were determined in the broth microdilution assay after overnight incubation at 35 °C. RESULTS: • There was no inhibition zone in the agar diffusion assays with any bacterial strain. • The microdilution test using Botox® and Dysport® showed bacterial growth in all dilutions, i.e. MICs > 20 and >100 IU/mL for Botox® and Dysport®, respectively. CONCLUSIONS: • BoNT/A has no direct antimicrobial effect. • The reduced frequency of symptomatic urinary tract infections (sUTIs) in patients with neurogenic detrusor overactivity (NDO) after BoNT/A intradetrusor injections seems to be caused by different indirect mechanisms, which are still not completely understood.

This chapter covers bacterial genera which are taxonomically diverse and belong to the families Cardiobacteriaceae, Flavobacteriaceae, Fusobacteriaceae, Neisseriaceae, Pasteurellaceae, and Porphyromonadaceae, but common traits justify their discussion as a group. It discusses only species that can be isolated from humans. The Pasteurellaceae consist of several genera, of which four are known to contain human pathogens: Actinobacillus, Aggregatibacter, Haemophilus, and Pasteurella. Phenotypic identification of fastidious gram-negative rods presents several challenges. Triple sugar iron or Kligler's agar may not support the growth of fastidious genera (e.g., Eikenella). Detection of antibodies directed against any of the bacteria discussed in the chapter has been tried on a small scale only and does not seem to offer much value. With specimens normally colonized with aerobic and anaerobic bacteria, as well as with specimens from wounds, e.g., bite wounds, the significance of the bacteria discussed in the chapter depends on their predominance and the absence of other potentially pathogenic bacteria. If these conditions are met, identification to the species level is needed for adequate interpretation and reporting as infectious agents and for susceptibility testing. If none of these conditions is present, a repeat culture and close cooperation between the microbiology laboratory and the physician are necessary for interpretation, for identification to the species or genus level, and for susceptibility testing.