Anaerobe最新文献

Objectives: To analyze the accuracy of diagnostic methodologies for Clostridioides difficile infection (CDI).

Methods: Systematic review was conducted in Medline, Embase, and Lilacs (July 2024). Studies with patients suspected of CDI using any diagnostic method (TC [toxigenic culture], LA [latex agglutination], CCNA [cell cytotoxicity neutralization assay], EIA [enzyme immunoassay], or NAAT [nucleic acid amplification test]) were included. Studies qualities were assessed using QUADAS-2 and QUADAS-C (Quality Assessment of Diagnostic Accuracy Studies - 2 and Comparative Accuracy), and evidence quality using GRADE (Grading of Recommendations Assessment, Development and Evaluation). Meta-analysis (MA) was performed considering central value and 95% confidence interval. This study was registered in PROSPERO (CRD42021234898) and supported by CAPES (Coordenação de Aperfeiçoamento de Pessoal de Nível Superior - Brasil).

Results: 170 studies were included, 79 entered the MA, covering at least 98,786 stool samples. Studies evaluated several methodologies, such as TC; EIA for GDH (glutamate dehydrogenase), GDH and toxin A, GDH and toxin AB, EIA for toxin A or toxin AB; molecular tests like NAAT for toxin A, toxin AB, toxin B and ribotype 027, toxin B/Bi and ribotype 027, toxin A/B/Bi and ribotype 027, toxin B and LA. TC was the most commonly used reference test (93.5%). MA showed variability among methods. Molecular biology methodologies were favored for identifying toxins A and B, with significant accuracy. EIA for GDH was an effective screening method (sensitivity: 91.599% [89.149 - 94.049]).

Conclusion: CDI detection presents challenges without defined gold standard. EIA and NAAT revolutionized diagnostics, offering high accuracy, and faster diagnosis.

Objective: Oral anaerobic bacteria are key contributors to infectious diseases, including endodontic-, periodontal-, peri-implant infections, and oral abscesses. The management of these conditions frequently involves the use of antiseptics. However, the influence of saliva on the antimicrobial efficacy of antiseptics remains insufficiently elucidated. This study assessed the activity of boric acid (BA), chlorhexidine (CHX), ethacridine lactate (ET), hydrogen peroxide (H₂O₂), octenidine (OCT), polyhexanide (PHMB), potassium permanganate (KMnO₄), and povidone-iodine (PVI), against three representative anaerobes: Fusobacterium nucleatum, Porphyromonas gingivalis, Prevotella intermedia, and facultative anaerobe Schaalia odontolytica, in the presence of Schaedler medium or human saliva.

Methods: The minimal inhibitory concentrations (MICs) of antiseptics were determined using the broth microdilution technique. Assays were performed in both Schaedler medium and unstimulated human saliva to compare the antimicrobial effect.

Results: OCT, CHX, PHMB, PVI and H₂O₂ demonstrated strong antimicrobial effects against tested periopathogens, regardless of the medium used. ET and BA showed moderate inhibitory effects, whereas KMnO₄ had weak activity under the experimental conditions. The antiseptics antimicrobial potency was not substantially diminished by the presence of saliva.

Conclusion: OCT, CHX, PHMB, PVI and H₂O₂ retain their antimicrobial efficacy in the salivary environment, underscoring their potential for use in oral hygiene and the management of anaerobic oral infections. Saliva had minimal impact on the antimicrobial efficacy of the antiseptics, with only a slight non-significant reduction for OCT, CHX and PHMB.