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Jerome Wakefield criticizes my biostatistical analysis of the pathological—as statistically subnormal biological part-functional ability relative to species, sex, and age—for its lack of a harm clause. He first charges me with ignoring two general distinctions: biological versus medical pathology, and disease of a part versus disease of a whole organism. He then offers 10 counterexamples that, he says, are harmless dysfunctions but not medical disorders. Wakefield ends by arguing that we need a harm clause to explain American psychiatry's 1973 decision to declassify homosexuality. I reply, first, that his two distinctions are philosophic fantasies alien to medical usage, invented only to save his own harmful-dysfunction analysis (HDA) from a host of obvious counterexamples. In any case, they do not coincide with the harmless/harmful distinction. In reality, medicine admits countless chronic diseases that are, contrary to Wakefield, subclinical for most of their course, as well as many kinds of typically harmless skin pathology. As for his 10 counterexamples, no medical source he cites describes them as he does. I argue that none of his examples contradicts the biostatistical analysis: all either are not part-dysfunctions (situs inversus, incompetent sperm, normal-flora infection) or are indeed classified as medical disorders (donated kidney, Typhoid Mary's carrier status, latent tuberculosis or HIV, cherry angiomas). And if Wakefield's HDA fits psychiatry, the fact that it does not fit medicine casts doubt on psychiatry's status as a medical specialty. [ABSTRACT FROM AUTHOR]

The use of medicinal plants has increased tremendously and that has led to the scientific interest for testing this plant for toxicity and antimicrobial activity. The manuscript used a comprehensive literature search from databases such as PubMed, Google Scholar, and ScienceDirect to identify relevant studies published within the last five years (2018-2023) and selectively those beyond that provide the necessary background to the article. The literature analysis found a huge scientific progress made and a lot of plants have been tested for safe use and antimicrobial resistance using the different microorganisms. Nonetheless, the article also highlights the possible hormonal effect or microbiota imbalance which could be attributed to these medical plants being used without proper guidance among our population. Age wise on patients, any prolonged use of these medicinal plants may have devastating effects as such this article advocates for a thorough understanding of the normal flora when communities are treated at home by traditional healers. [ABSTRACT FROM AUTHOR]

Microbiota are present everywhere in human existence and have an impact on every facet of it. Many species can be found within the human mouth. The human oral cavity is home to a variety of habitats. The combination and cooperation of the modified oral microbes protect the human body from the intrusion of external stimuli. On the other hand, systemic and oral illnesses are linked to an imbalance in the microbial flora. The human microbial community is significantly influenced by oral microbiomes. The use of recently noticed molecular tools has significantly improved our understanding of the makeup and roles of the oral microbiome in both wellness and sickness. Research on oral microbiomes and their relationships to microbiomes in different body locations and health conditions is essential to understanding our bodies and understanding how to improve human health. The purpose of this review is to go over the most recent information that explains the possible mechanisms underlying the relationships between oral and overall systemic health. The theory is that the influence of oral diseases on overall health may be partially explained by the oral microbiota. We will discuss the basic principles, the primary techniques in microbiology for describing oral organisms, and the most important information pointing to a biologically tenable connection between systemic illnesses and the oral microbiota. [ABSTRACT FROM AUTHOR]

Background: Escherichia coli belongs to the Enterobacteriaceae family and is found in the digestive systems of humans and various animals as normal flora. Objective: This study aims to identify the optimal conditions necessary for the synthesis of hemolysin by E. coli isolated from a variety of clinical contexts. Methods: A total of 120 specimens were collected from different clinical sources in Baghdad Hospitals. Screening for hemolysin production was done by plate and Spectrophotometric methods. Furthermore, many conditions for producing hemolysin from clinical E. coli isolates were investigated including temperature, pH, incubation time, inoculum size, culture medium, and aeration. Results: Six isolates of E. coli exhibited hemolysin production. Optimal conditions for hemolysin production were determined: the temperature was 37 °C with an optical density of 0.931, the pH was 7 with an optical density of 0.976, the incubation period was 24 hours with an optical density of 0.885, 1% inoculum resulting in an optical density of 0.558, brain heart infusion as the best medium with an optical density of 1.697, and a shaker method showing superior results (optical density of 1.235) compared to static aeration (optical density of 0.988). Conclusions: This study identified the optimal conditions necessary for the synthesis of hemolysin by E. coli. By understanding these optimal conditions, researchers may be better equipped to develop strategies for managing and controlling the spread of these pathogenic bacteria.

BACKGROUND: The bacterium Capnocytophaga canimorsus is a relatively newly recognized gram-negative, facultative, slow-growing bacillus that forms part of the normal oral flora of dogs and cats. Considering the pathogenicity of this bacterium in humans, determining its prevalence is very important for public health as well as the health of dog owners. OBJECTIVES: This study aims to investigate the prevalence of Capnocytophaga canimorsus in the normal oral flora of healthy dogs. METHODS: After taking samples from the saliva of 32 healthy dogs without oral, dental or digestive diseases at different ages, breeds, and sexes, they were placed in a test tube containing 10 mL of sterile peptone water with sterile plastic brushes, and immediately sent to the bacteriology laboratory under sterile conditions. The samples were cultured on a chocolate agar medium containing 5 % defibrinated sheep blood. Then, all the samples were kept in a greenhouse for 48 hours at a temperature of 37 °C and under anaerobic conditions. Using a loop, the grown pink colonies were isolated and to confirm the identification of the isolates, polymerase chain reaction (PCR) test was used in three main steps: Gene extraction, PCR reaction, and electrophoresis. RESULTS: Out of 32 saliva samples, four positive cases of Capnocytophaga canimorsus bacteria were identified by PCR diagnostic method. CONCLUSIONS: Given that Capnocytophaga canimorsus bacterium is present in the oral flora of healthy dogs, dog owners should have sufficient and favorable knowledge about this bacterium and related diseases. The PCR method can be used to detect this bacterium. [ABSTRACT FROM AUTHOR]

• Bentonite clay Protects Intestinal Normal Flora and Alleviates Pseudomembranous Colitis following antibiotic usage. • Bentonite clay Adsorbs Residual Antibiotics in the gut, without affecting concentration of the antibiotics in the blood. • Bentonite clay possesses antibacterial properties against pathogens and reduces the concentration of bacterial toxins in the intestine. • Bentonite clay reduces the germination of Clostridium's spores by absorbing bile salts and inhibits bacterial proteases by absorbing zinc. • Bentonite clay improves pseudomembranous colitis through immunomodulation and wound healing. As the most commonly used drugs, antibiotics have several adverse effects. When intravenous broad-spectrum antibiotics are administered for infections outside the gut, they are also released into the gut, upsetting the natural balance of flora and potentially causing opportunistic infections there. Pseudomembranous colitis induced by the excessive growth of Clostridioides difficile following antibiotic administration and disruption of the normal gut flora is a main consequence of antibiotic therapy. Unfortunately, effective strategies to mitigate the damage caused by antibiotics to the microbiota remain elusive, with limited information available on the subject. Several studies have examined the effects of enzymatic inactivation of specific antibiotics, but non-enzymatic inactivation of antibiotics has been explored to a lesser extent, resulting in the introduction of only a restricted number of products. We believe that bentonite clay, an underutilized substance that exhibits promising features for counteracting the unfavorable effects of antibiotics has a high potential to circumvent the side effects of antibiotics. It is a cost-effective and safe and has garnered significant attention in the medical history, predominantly for its superior adsorption properties. Given the diverse characteristics of bentonite clay, capacity to protect the natural flora, antibacterial and anti-inflammatory traits, and its contribution to wound healing, it is plausible to assume that bentonite clay exhibits significant potential in mitigating the detrimental consequences of antibiotic on the natural gut microbiota and following pseudomembranous colitis. Further research is necessary to unravel the full extent of its therapeutic effects in combating this condition. [ABSTRACT FROM AUTHOR]

Purpose:Metallo β-lactamases (MβL) production is a worldwide problem, particularly in gram-negative bacteria. As scanty data is available on the prevalence of MBL, the present study is being undertaken to determine the prevalence, antibacterial sensitivity patterns, and molecular characterization of MβL associated resistant genes in gram-negative bacteria isolated from ocular infections.Material and MethodsAt a tertiary eye care center in south India, 359 gram-negative pathogens, 200 isolates from eye infections, and 159 isolates from normal flora of the eye were studied. A gold standard microbiology method was used to identify the isolates. An antibiotic double disc synergy test and a combination disc test were used to detect MβL production. Multiplex PCR was used to investigate the molecular characteristics of the MβL encoding genes blaVIM, blaIMP, and blaNDM.ResultsOf the 359 gram-negative bacterial pathogens, Pseudomonas aeruginosa 108 (30.1%) and Enterobacter agglomerans 46 (12.8%) were commonly isolated. High prevalence of P. aeruginosa 81% (17 strains) was detected as an MβL producer and it shows 100% resistance to 2nd and 3rd generation cephalosporins and meropenem. Multiplex PCR detected only the blaVIM gene in 56 (28%) of various eye infections and 27 (17%) of normal flora of the gram-negative bacteria (GNB). The blaVIM gene is detected predominantly in 51.8% of keratitis and 21.4% of postoperative endophthalmitis. High prevalence of the gene was detected in P. aeruginosa 42.9% (24 of 56) and Alcaligens denitrificans 10.7% (6 of 56) from eye infections. Whereas, in the control group, P. aeruginosa and E. coli each had 14.8% (4 of 27) that were shown positive.ConclusionThe emerging MβLs mediated resistance among P. aeruginosa is a challenging task for ophthalmologists, especially in patients with endophthalmitis and bacterial keratitis. This local knowledge will aid in advising appropriate antibiotic use and avoiding unnecessary antibiotic prescriptions, which are highly warranted.

Skin is an active immune organ, which protects the human internal organs from biotic and abiotic hazards. Staphylococcus epidermidis is a primary bacterial colonizer of the skin and one of the most abundant microorganisms among the other skin microbiome. Moreover, this bacterial sp. is considered as an active microbiological barrier of the skin and one of its defensive components. On the other side, S. epidermidis is a causative agent of serious infections including wound infections, and bacteremia. The aims of the current minireview were to attract the attention of the scientific community to this perplexing bacterium, and to develop an enhanced understanding about the role of this microorganism in the skin. Furthermore, it is necessary to understand the relationship between the protective mechanisms of this bacterium in the human skin, and to realize the influences that direct this bacterium to turn from a useful commensal to a serious contagion.

A total number of (100) patients with various degrees of acne vulgaris, in addition to 50 individuals without skin infections (ranging from 15 to 25 years) were included in this study. The majority ratio was for male 63 patients, while in female only 37 cases from total patients, with high statistical differences. The majority of patients living in the rural area 46% in comparison to urban (peripheral and central area) 54%. The bacterial species isolated from healthy skin were varied in both Gram-positive and Gram-negative bacteria, where the most common bacteria recorded was Staphylococcus epidermidis (28.57%) followed by other bacteria in total isolated reached to 87 isolates, while no growth showed for 15 cases, while in acne vulgaris patients the total number of isolates reached 179 isolates, Staphylococcus aureus was the most common bacterial species with a percentage of 20.67%, followed by various bacterial types and number of no growth result recorded for 10 cases. With highly statistical differences between healthy and patients and between various bacterial types P<0.05. The common mode of isolation was recorded for isolated three types of bacteria in 12 cases with 36 isolates in percentage 38.7%. The antibiotics susceptibility test was done for various bacterial types isolated from acne vulgaris cases against 11 antibiotics. the highest percentage of sensitivity recorded for cefotaxime, while the most common type of resistance recorded for ampicillin (46 resistant isolates). The results show that the 19 isolates of Pseudomonas auroginosa resist more than 3 antibiotics followed by Staph. aureus and E. coli and Klebsiella (3,2,1 isolates) respectively, while B and A hemolytic streptococci resist 2 antibiotics are 6 and 3 isolates, respectively. [ABSTRACT FROM AUTHOR]

Both pathogenic as well as nonpathogenic species of staphylococci have been reported in poultry, but these studies have not compared staphylococcal flora of both farmed and household broiler chickens. Staphylococci from farmed (n = 51) and household chicken intestines (n = 43) were isolated and tested for resistance to antimicrobials, presence of resistance genes, and inhibitory activity against other bacteria; correlation of resistance phenotype and genotype was also evaluated. At least 12 staphylococcal species were identified; Staphylococcus carnosus subspecies carnosus was the predominant species from both sources. Most farmed chicken staphylococci were resistant to tigecycline (38/51; 74.8%) while the highest level of resistance among the household chicken staphylococci was to clindamycin (31/43; 72.1%). The mecA gene was only detected in staphylococci from household chickens, whereas ermC and tetK or tetM were found in staphylococci from both groups of birds. Multidrug resistance (resistance ≥ 2 antimicrobial classes) was observed in 88% of resistant staphylococci ranging from 2 to 8 classes and up to 10 antimicrobials. Isolates produced inhibitory activity against 7 clinical bacterial strains primarily Enterococcus faecalis (25/88; 28.4%) and Escherichia coli (22/88; 25%). This study demonstrated that the staphylococcal population among farmed and household chickens varies by species and resistance to antimicrobials. These results may reflect the influence of the environment or habitat of each bird type on the intestinal microflora. As resistance in the staphylococci to antimicrobials used to treat human infections was detected, further study is warranted to determine strategies to prevent transfer of these resistant populations to humans via contamination of the poultry meat.

Background: Largest organ of human body, the skin, is colonized by millions of microorganisms, most of which are not only harmless but also beneficial to the host. Human skin microbes depend upon geographical variations, ethnicity and various host factors. Despite several studies on human skin microbiota in various parts of the globe, it has not been studied in Nepalese population. Aims and Objective: To identify skin bacterial normal flora in different ethnic groups residing in different altitude of Nepal. Materials and Methods: We cultured skin swabs of 166 randomly selected volunteers belonging to 10 major ethnic groups from 3 distinct geographical altitudes of Nepal, viz. Bharatpur (415 m from sea level), Kathmandu (1,400 m from sea level) and Lukla (2,860 m from sea level). The isolated organisms were characterized and tested for their susceptibility against different antibiotics. Results: Altogether 231 bacterial isolates were characterized from 166 skin samples. Among them, 140 isolates (60.60 %) were Gram positive and 91 isolates (39.40 %) were Gram negative bacteria. Staphylococcus aureus (35.49%) was the most dominant skin bacterial flora followed by Escherichia coli (22.51%) and Streptococcus spp. (17.75%). Medium altitude Kathmandu exhibited the highest growth (120 isolates) followed by low land Bharatpur (66 isolates) and high land Lukla (51 isolates) which is statistically significant (p value =0.0124). The antibiotic susceptibility testing against 14 antibiotics exhibited the Gram positive isolates were the most sensitive to Imipenem (94.93 %) whereas the least sensitive to Cephalexin (31.36 %) and the Gram negative isolates were the most sensitive to Amikacin (100%) whereas the least sensitive to Amoxycillin (28.57 %). Conclusion: Our data indicates that the skin bacterial normal flora; which is directly exposed to external environment; has significant relationship with altitudes where individuals live. The result desires further study for the adaptability of normal flora found in different altitudes. Some bacterial commensals were found resistant even against new generations of antibiotics as well, and hence can cause life-threatening infections if they happen to cross the skin physical barrier.

Introduction: Staphylococcus aureus is normal flora that lives in the skin and Escherichia coli is lives in large intestine. This bacteria has an ability to cause infection disease if the host is not in a good condition. Therefore, research on viability of normal flora was conducted. The objective of this research was to determine the effect of temperature on viability of normal flora bacteria. Methods: The research used pre-experimental design, conducted in 2017 in Balai Laboratorium Kesehatan Pengujian dan Kalibrasi NTB. The sample used in the research is the pure isolate of Staphylococcus aureus and Escherichia coli. Treatment in this research was the temperature difference and its effect. The samples were treated in temperature 500oC, 600oC, 700oC and 800oC for 15 minutes. Results: Showed that the growth of normal flora bacteria still occur in 500oC after treatment. Conclusion: It can be concluded that there is effect of temperature on viability. [ABSTRACT FROM AUTHOR]

Introduction: Studies have suggested that in addition to antimicrobials, some non‐antibiotics may alter the gut microbiome. This systematic review sought to determine if there is an association between immunosuppressive agents used in recipients of solid organ transplants (SOT) and alterations in the gut microbiome. Methods: English language PubMed and Scopus searches were conducted to identify relevant articles. Inclusion criteria were defined as pertaining to solid organ transplantation, immunosuppression, and the gut microbiome. Articles were excluded if they contained only genetic microbiota descriptions, narrative reviews of bacteria, or described bacteria as a pathogen for infections. PRISMA reporting was used to guide this literature review. Results: A preliminary search identified 665 articles, of which 75 articles met the inclusion criteria, and 10 articles remained after application of exclusion criteria. Seventy‐one percent of articles discussed calcineurin inhibitors, such as tacrolimus, 38% included mycophenolate mofetil, and 52% included steroids, such as prednisone. Some studies utilized a combination of immunosuppressants or had multiple study arms. Seventy percent of the articles indicated changes in quantities of anaerobic bacteria including Ruminococcaceae, Lachnospiraceae, Firmicutes, Bacteroides, and Clostridiales. Combinations of immunosuppressant agents were associated with an increase in colonization of Escherichia coli and Enterococcus sp. Conclusion: Some immunosuppressants are associated with changes in gut flora, but the impact on clinical outcomes is unknown. Robust clinical trials delineating the direct effect of immunosuppressants on the gut microbiome as well as the impact on clinical outcomes are warranted. [ABSTRACT FROM AUTHOR]

Introduction: Antibacterial products contain active ingredients that are used to prevent bacterial growth and contamination. Previous studies suggest that antibacterial products are no more effective at removing s kin pathogen compared to plain soap. It is essential to collect the data regarding the effectiveness of antibacterial products with the purpose of continuous surveillance in the detection of emerging resistance pattern. Method: In vitro antimicrobial activity of six products were established on four species of bacteria namely Staphylococcus aureus, Streptococcus pyogenes, Escherichia coli, and Pseudomonas aeruginosa that represent the bacterial pathogen commonly found on human skin and the surrounding environment. These pathogens are also implicated as the causative organisms for skin infections. Results: Product that contains triclosan has the highest bactericidal effect as it is effective against a broad spectrum of bacteria. Body washes without any antibacterial agent also exhibit bactericidal activity but at higher concentrations. Gram-positive bacteria showed more sensitivity compared to gram-negative bacteria. Conclusion: Antibacterial and non-antibacterial products have bactericidal effects at different concentration. Different active ingredients showed different antibacterial effects on tested bacteria. Extend usage of antibacterial products pose adverse effects on skin normal flora and can lead to antimicrobial resistance. [ABSTRACT FROM AUTHOR]

Quantitative and qualitative analyses of bacterial microbiota associated with hatchery of freshwater prawn Macrobrachium rosenbergii (de Man, 1879) were conducted over three larval cycles, along with important water quality parameters. Physicochemical parameters (temperature, DO, salinity, pH and total ammonia) of culture water were within the optimum level required for the hatchery phase of M. rosenbergii. Aerobic plate count (APC) (log10 CFU.mL-1) ranged from 4.2 ± 0.18-8.7 ± 0.01 in rearing water and (log10 CFU.g-1) 3.3 ± 0.12-9.1 ± 1.1 in eggs and larvae. Significant differences in APCs among larval stages were observed. Ten genera and 17 species were identified with the predominance of Gram-negative bacteria constituting 63% of all isolates (n = 706). Acinetobacter baumannii, Acinetobacter lwoffii, Chryseobacterium indologenes, Enterobacter aerogenes, Enterobacter cloacae, Vibrio furnissii, Vibrio cholerae non-01, Plesiomonas shigelloides, Pseudomonas aeruginosa, Pseudomonas pseudoalcaligenes, Bacillus cereus, Staphylococcus haemolyticus, Staphylococcus warneri and Staphylococcus xylosus were predominantly present in culture water. These bacteria likewise dominated in eggs and larvae except for the absence of Ps. aeruginosa, Ps. pseudoalcaligenes, V. cholerae non-01, Staphylococcus epidermidis and Staph. xylosus in eggs, clearly indicating that resident bacteria in water affect the composition of bacteria in eggs and larvae. Some of these are opportunistic pathogens. Thus, control measures to reduce influx of pathogenic microbes in the system by maintaining good water quality and good farm management practices through disinfection of culture facilities, rearing water, Artemia cysts, the practice of good hygiene of personnel, regular water exchange and feed regulation among others and cautionary use of antibiotics can be adopted. [ABSTRACT FROM AUTHOR]

Ducks usually show little or no clinical signs following highly pathogenic avian influenza virus infection. In order to analyze whether the microbiota could contribute to the control of influenza virus replication in ducks, we used a broad-spectrum oral antibiotic treatment to deplete the microbiota before infection with a highly pathogenic H5N9 avian influenza virus. Antibiotic-treated ducks and nontreated control ducks did not show any clinical signs following H5N9 virus infection. We did not detect any significant difference in virus titers neither in the respiratory tract nor in the brain nor spleen. However, we found that antibiotic-treated H5N9 virus-infected ducks had significantly increased intestinal virus excretion at days 3 and 5 postinfection. This was associated with a significantly decreased antiviral immune response in the intestine of antibiotic-treated ducks. Our findings highlight the importance of an intact microbiota for an efficient control of avian influenza virus replication in ducks. [ABSTRACT FROM AUTHOR]

The study aims to check the antimicrobial effect of soft drinks on gut bacteria. A soft drink is a drink that usually contains carbonated water, a sweetener, and a natural or artificial flavouring. The sweetener may be a sugar, high- fructose corn syrup, fruit juice, sugar substitute, or some combination of these. In non-carbonated drinks, preservatives are added to increase the shelf life. The preservative is a substance or a chemical that is added to food or beverages to prevent decomposition due to microbial growth or any other undesirable chemical changes, mainly to prevent bacterial growth. This may affect the bacteria present in the mouth and even in the intestine. Normal flora is a set of microorganisms that live on a host without causing any disease. They become the resident flora of our body. They are called commensals. These bacteria prevent us from being affected by more dangerous bacteria. It is essential to protect our body against the injurious agents. These soft drinks are not at all beneficial to us in any way. The normal flora of our body is very essential to maintain our normal health. Loss of normal flora will lead to colonisation of pathogens in our mouth and intestine. [ABSTRACT FROM AUTHOR]

Several studies have reported that some infections are resulted from distortions of microflora, and hence, it was hypothesized that exploiting the defensive ability of normal flora may represent a promising approach to treat bacterial pathogens. This work seeks to bring attention to bacteriocin-producing bacteria that exist in the outer ear in order to exploit them to treat outer ear infections. Twelve bacterial isolates were collected from the outer ear of healthy individuals and subjected to a screening program in two steps: primary screening using agar plug diffusion assay to test the competitive activities against each other and secondary screening using well diffusion method. Staphylococcus epidermidis A3 showed an activity against different ear isolates with approximately 160 arbitrary unites (AU)/ml of bacteriocin activity. Tryptic soya broth was selected as the best medium to obtain maximum production of bacteriocin which showed a bactericidal action. In addition, 12 clinical isolates of common ear infections pathogens were used to test the activity of both S. epidermidis cells and its bacteriocin. Results revealed that bacteriocin was effective against 7 isolates, whereas S. epidermidis cells had an antagonism capability against 9 pathogens reflecting a competitive behavior. Moreover, interspecies interactions between Staphylococcus epidermidis A3 and clinical ear pathogens were investigated in liquid cultures which generally showed that bacteriocin production was increased in the presence of Streptococcus pyogenes and Staphylococcus aureus. The present study confirms previous findings and contributes an evidence on the possibility of using S. epidermidis and/or its bacteriocin to protect and against outer ear infections. [ABSTRACT FROM AUTHOR]

Background: Largest organ of human body, the skin, is colonized by millions of microorganisms, most of which are not only harmless but also beneficial to the host. Human skin microbes depend upon geographical variations, ethnicity and various host factors. Despite several studies on human skin microbiota in various parts of the globe, it has not been studied in Nepalese population. Aims and Objective: To identify skin bacterial normal flora in different ethnic groups residing in different altitude of Nepal. Materials and Methods: We cultured skin swabs of 166 randomly selected volunteers belonging to 10 major ethnic groups from 3 distinct geographical altitudes of Nepal, viz. Bharatpur (415 m from sea level), Kathmandu (1,400 m from sea level) and Lukla (2,860 m from sea level). The isolated organisms were characterized and tested for their susceptibility against different antibiotics. Results: Altogether 231 bacterial isolates were characterized from 166 skin samples. Among them, 140 isolates (60.60%) were Gram positive and 91 isolates (39.40%) were Gram negative bacteria. Staphylococcus aureus (35.49%) was the most dominant skin bacterial flora followed by Escherichia coli (22.51%) and Streptococcus spp. (17.75%). Medium altitude Kathmandu exhibited the highest growth (120 isolates) followed by low land Bharatpur (66 isolates) and high land Lukla (51 isolates) which is statistically significant (p value =0.0124). The antibiotic susceptibility testing against 14 antibiotics exhibited the Gram positive isolates were the most sensitive to Imipenem (94.93%) whereas the least sensitive to Cephalexin (31.36%) and the Gram negative isolates were the most sensitive to Amikacin (100%) whereas the least sensitive to Amoxycillin (28.57%). Conclusion: Our data indicates that the skin bacterial normal flora; which is directly exposed to external environment; has significant relationship with altitudes where individuals live. The result desires further study for the adaptability of normal flora found in different altitudes. Some bacterial commensals were found resistant even against new generations of antibiotics as well, and hence can cause life-threatening infections if they happen to cross the skin physical barrier. [ABSTRACT FROM AUTHOR]

A diverse range of normal flora populates the human skin and numbers are relatively different between individuals and parts of the skin. Humans and normal flora have formed a symbiotic relationship over a period of time. With numerous disease processes, the interaction between the host and normal flora can be interrupted. Unlike normal wound healing, which is complex and crucial to sustaining the skin’s physical barrier, chronic wounds, especially in diabetes, are wounds that fail to heal in a timely manner. The conditions become favorable for microbes to colonize and establish infections within the skin. These include secretions of various kinds of molecules, substances or even trigger the immune system to attack other cells required for wound healing. Additionally, the healing process can be slowed down by prolonging the inflammatory phase and delaying the wound repair process, which causes further destruction to the tissue. Antibiotics and wound dressings become the targeted therapy to treat chronic wounds. Though healing rates are improved, prolonged usage of these treatments could become ineffective or microbes may become resistant to the treatments. Considering all these factors, more studies are needed to comprehensively elucidate the role of human skin normal flora at the cellular and molecular level in a chronic injury. This article will review wound healing physiology and discuss the role of normal flora in the skin and chronic wounds.

Background: This study was done to determine the level of high level gentamicin resistant (HLGR) and vancomycin resistant enterococci (VRE) in the healthy normal human population living in Tehran, Iran. Methods: A total of 700 fecal samples were isolated from the period of September 2007 to September 2008 and the species were identified by the biochemical tests and PCR. Antibiotic susceptibility test, gentamicin and vancomycin resistant genes and the conjugation tests were performed to evaluate the transferability of the drug resistant genes. The clonality of the isolates was also determined by PFGE. Results: The results showed that the prevalence of HLGR and VRE in the healthy normal population were 16.6% (100) and 1% (6) for HLGR and VRE, respectively. Amongst the HLGR enterococci, the most frequent species were found to be Enterococcus faecalis in 63% of the isolates. This was followed by E. faecium (33%), E. gallinarum (3%) and E. casseliflavus (1%). The frequency of the gentamicin resistant genes were 99 (99%), 91 (91%), 3(3%) and 1(1%) for aac(6')-Ie-aph(2'')-Ia, aph(3')-IIIa, ant(4')Ia and aph(2'')-Id genes, respectively. Among the vancomycin resistant genes, vanA was found in 1% (6) of isolates only. PFGE revealed high heterogeneity among the 63 E. faecalis strains and 33 E. faecium with 31 and 28 different patterns, respectively. The 6 VR E. faecium revealed 6 different patterns. Conclusion: The prevalence and heterogenous populations of HLGR in the normal flora of the humans found here were higher than reports from many countries, may be suggestive of excessive antibiotic usage in Iranian.

Microbial interactions represent an understudied facet of human health and disease. In this study, the interactions that occur between Chlamydia trachomatis and the opportunistic fungal pathogen, Candida albicans were investigated. Candida albicans is a common component of the oral and vaginal microbiota responsible for thrush and vaginal yeast infections. Normally, Candida exist in the body as yeast. However, disruptions to the microbiota create conditions that allow expanded growth of Candida, conversion to the hyphal form, and tissue invasion. Previous studies have shown that a myriad of outcomes can occur when Candida albicans interacts with pathogenic bacteria. To determine if C. trachomatis physically interacts with C. albicans, we incubated chlamydial elementary bodies (EB) in medium alone or with C. albicans yeast or hyphal forms for 1 h. Following incubation, the samples were formaldehyde-fixed and processed for immunofluorescence assays using anti-chlamydial MOMP or anti- chlamydial LPS antibodies. Replicate samples were replenished with culture medium and incubated at 35°C for 0–120 h prior to fixation for immunofluorescence analysis or collection for EB infectivity assays. Data from this study indicates that both C. trachomatis serovar E and C. muridarum EB bind to C. albicans yeast and hyphal forms. This interaction was not blocked by pre-incubation of EB with the Candida cell wall components, mannan or β-glucans, suggesting that EB interact with a Candida cell wall protein or other structure. Bound EB remained attached to C. albicans for a minimum of 5 days (120 h). Infectivity assays demonstrated that EB bound to C. albicans are infectious immediately following binding (0h). However, once bound to C. albicans, EB infectivity decreased at a faster rate than EB in medium alone. At 6h post binding, 40% of EB incubated in medium alone remained infectious compared to only 16% of EB bound to C. albicans. Likewise, pre-incubation of EB with laminarin, a soluble preparation of β-glucan, alone or in combination with other fungal cell wall components significantly decreases chlamydial infectivity in HeLa cells. These data indicate that interactions between EB and C. albicans inhibit chlamydial infectivity, possibly by physically blocking EB interactions with host cell receptors.

Skin mediates information from the outer world and provides the first line of defense against pathogens, toxins and hostile environmental conditions. This barrier-function-role is both physical and immunological and it is supported by microbial communities inhabiting the skin. Microorganisms living on the skin and mucous membranes of the oropharynx, upper respiratory tract, conjunctiva, colon and the lower sections of the urogenital tract are called “normal flora“ (physiological, natural, autochthonous, microbiome, microbiota). The skin microbiota contribute to the barrier function by competing with pathogens and, importantly, communicating with immune cells in the skin, to modulate the local and systemic immune responses. The skin microbiota and immune mediators, such as the complement system have a two-way interaction, indicating that commensal microbes should be considered as an essential part of healthy skin. Furthermore, accumulating evidence suggests that the composition of microbiota, especially in the gut but also on the skin, can have major influence on individual health. Age is a major determinant of skin microbial composition. The diversity of microbiota increases during the first years of life, which is associated with a dominance of Lactobaciles (especially genus Streptococcus) on the skin. In puberty there is greater inter-individual variation in diversity than in the younger age groups. At this age the relative abundance of Lactobacilles decreases and is replaced by other groups, namely Actinobacteria and Proteobacteria at the age of 14, the diversity in skin microbiota resembles cloasely that observed for adults. [ABSTRACT FROM AUTHOR]

Microbial interactions represent an understudied facet of human health and disease. In this study, the interactions that occur between Chlamydia trachomatis and the opportunistic fungal pathogen, Candida albicans were investigated. Candida albicans is a common component of the oral and vaginal microbiota responsible for thrush and vaginal yeast infections. Normally, Candida exist in the body as yeast. However, disruptions to the microbiota create conditions that allow expanded growth of Candida , conversion to the hyphal form, and tissue invasion. Previous studies have shown that a myriad of outcomes can occur when Candida albicans interacts with pathogenic bacteria. To determine if C. trachomatis physically interacts with C. albicans , we incubated chlamydial elementary bodies (EB) in medium alone or with C. albicans yeast or hyphal forms for 1 h. Following incubation, the samples were formaldehyde-fixed and processed for immunofluorescence assays using anti-chlamydial MOMP or anti- chlamydial LPS antibodies. Replicate samples were replenished with culture medium and incubated at 35°C for 0–120 h prior to fixation for immunofluorescence analysis or collection for EB infectivity assays. Data from this study indicates that both C. trachomatis serovar E and C. muridarum EB bind to C. albicans yeast and hyphal forms. This interaction was not blocked by pre-incubation of EB with the Candida cell wall components, mannan or β-glucans, suggesting that EB interact with a Candida cell wall protein or other structure. Bound EB remained attached to C. albicans for a minimum of 5 days (120 h). Infectivity assays demonstrated that EB bound to C. albicans are infectious immediately following binding (0h). However, once bound to C. albicans , EB infectivity decreased at a faster rate than EB in medium alone. At 6h post binding, 40% of EB incubated in medium alone remained infectious compared to only 16% of EB bound to C. albicans. Likewise, pre-incubation of EB with laminarin, a soluble preparation of β-glucan, alone or in combination with other fungal cell wall components significantly decreases chlamydial infectivity in HeLa cells. These data indicate that interactions between EB and C. albicans inhibit chlamydial infectivity, possibly by physically blocking EB interactions with host cell receptors. [ABSTRACT FROM AUTHOR]

Background: This study was done to determine the level of high level gentamicin resistant (HLGR) and vancomycin resistant enterococci (VRE) in the healthy normal human population living in Tehran, Iran. Methods: A total of 700 fecal samples were isolated from the period of September 2007 to September 2008 and the species were identified by the biochemical tests and PCR. Antibiotic susceptibility test, gentamicin and vancomycin resistant genes and the conjugation tests were performed to evaluate the transferability of the drug resistant genes. The clonality of the isolates was also determined by PFGE. Results: The results showed that the prevalence of HLGR and VRE in the healthy normal population were 16.6% (100) and 1% (6) for HLGR and VRE, respectively. Amongst the HLGR enterococci, the most frequent species were found to be Enterococcus faecalis in 63% of the isolates. This was followed by E. faecium (33%), E. gallinarum (3%) and E. casseliflavus (1%). The frequency of the gentamicin resistant genes were 99 (99%), 91 (91%), 3(3%) and 1(1%) for aac(6') -Ieaph( 2'')-Ia, aph(3')-IIIa, ant(4')Ia and aph(2'')-Id genes, respectively. Among the vancomycin resistant genes, vanA was found in 1% (6) of isolates only. PFGE revealed high heterogeneity among the 63 E. faecalis strains and 33 E. faecium with 31 and 28 different patterns, respectively. The 6 VR E. faecium revealed 6 different patterns. Conclusion: The prevalence and heterogenous populations of HLGR in the normal flora of the humans found here were higher than reports from many countries, may be suggestive of excessive antibiotic usage in Iranian. [ABSTRACT FROM AUTHOR]

Investigation of the structure, incidence, and concentration of the microorganisms vegetating on the lacunal mucosa of the palatine tonsils was carried out. Based on the data obtained, the priority pathogenes were determined: Streptococcus (group D) and E. faecalis. Studying the degree of lacunal mucosa sowing with microorganisms enabled elaboration of criteria to assess efficiency of the treatment applied.

Abstract: The genus Malassezia includes a group of lipophilic yeasts that form part of the microbiota of the skin of humans and other vertebrates. Nevertheless, they have been related to several dermatological entities. This research proposed to characterize the morfophysiological Malassezia species isolated on the healthy skin of students at the Baralt High School in the city of Maracaibo, State of Zulia. Samples were taken using the imprint method with adhesive transparent tape on the scalp, pinna, chest and back, inoculated into a modified Dixon Agar medium and incubated at 32°C for 14 days. Identification of the species was carried out following the keys described by Gueho and Cols, the diffusion in tween test proposed by Guillot and collaborators, the catalase test and the utilization of triptophan as the only source of carbon. Out of a total of 100 evaluated students, 81 (81%) were positive for Malassezia and 184 isolations were obtained; 100 (54.30%) were of the masculine sex and 81 (45.6%) were females. The results show a high prevalence of Malassezia furfur (54.3%) followed by Malassezia sympodialis (45.1%) and finally, Malassezia globosa (0.50%). Anatomical locations with the greatest number of isolations were the back (33%) and chest (30.2%). Resumen: El género Malassezia comprende un grupo de levaduras lipofílicas que forman parte de la microbiota de la piel del hombre y otros vertebrados. Sin embargo, se han relacionado con varias entidades dermatológicas. En esta investigación se planteó como objetivo caracterizar las especies de Malassezia aisladas en piel sana de estudiantes del Liceo Baralt de la Ciudad de Maracaibo-Edo. Zulia. Las muestras fueron tomadas, mediante el método de la impronta con cinta adhesiva transparente, de cuero cabelludo, pabellón auricular, pecho y espalda e inoculadas en el medio Dixon Agar modificado e incubadas a 32°C por 14 días. La identificación de las especies se realizó siguiendo las claves descritas por Gueho y Cols. y el test de difusión en tween propuesto por Guillot y Cols, la prueba de la catalasa y la utilización de triptófano como única fuente de carbono. De un total de 100 estudiantes evaluados 81(81%) fueron positivos a Malassezia, se obtuvo 184 aislamientos, 100 (54,30%) para el sexo masculino y 84 (45,6%) para el femenino. Los resultados muestran una alta prevalencia de Malassezia furfur (54,3%) seguida de Malassezia sympodialis (45,1%) y Malassezia globosa (0,50%). Las localizaciones anatómicas con mayor número de aislamientos fueron espalda (33%) y pecho (30,2%).

The purpose of this study was to establish reference ophthalmic findings in the common kestrel ( Falco tinnunculus). Twenty healthy adult kestrels were included in this study. Ophthalmic examinations included slit lamp biomicroscopy, fundus exam, Schirmer tear test, conjunctival bacterial culture and isolation, corneal touch threshold, tonometry, and corneal diameter measurement. Mean tear production was 7.4 ± 3.27 mm/min, and mean intraocular pressure measured via applanation tonometry was 10.5 ± 3.15 mm Hg. In addition, the mean corneal touch threshold was 29.8 ± 20.1 mm, and the mean corneal diameter was 9.8 ± 1.1 mm. Of the 25 conjunctival swabs, 23 (92%) yielded bacterial growth. Most of these bacteria were gram positive (69.6%); the most predominant genus was S taphylococcus. This study presents reference values for ophthalmic examinations in common kestrels. [ABSTRACT FROM AUTHOR]