Kolonisation oder Infektion bei Früh- und Neugeborenen

Incidence of sepsis

Out of 650,000 newborn infants per year in Germany approximately 7,000 (1.1?%) of term born infants suffer from neonatal sepsis. Approximately 1.3?% of neonates belong to the group of very low birth weight (VLBW) infants with a birth weight <?1,500 g who have a 10-fold higher risk of sepsis compared to term infants.

Discussion

The complex interplay of intrinsic factors (e.g. adaptation of fetal and maternal immune systems, functional immaturity, small anatomical size and loss of protective measures) and exogenous influences (e.g. intensive care measures) is decisive for the vulnerability of preterm and term infants. This review article focuses on these pathophysiological aspects.     

Color stability of composites: effect of immersion media

Coloring in drinks decreases the color stability of composite restorations, reducing their longevity. The purpose of this in vitro study was to evaluate the effect of immersion media on color stability of seven different composite resins (Solidex - Shofu, Resilab-Wilcos, Signum - Heraeus, Epricord - Tokuyama, Adoro - Ivoclar Vivadent, Admira - Voco and Sinfony - 3MESPE). Seven resin-based composite specimens were prepared using a cylindrical teflon mold 2 mm thick and 10 mm in diameter Fifteen specimens of each resin were light-cured according to manufacturers' instructions and randomized into 3 groups (n= 5) according to immersion media: coffee, cola beverage and water A digital spectrophotometer Easy Shade (VITA) was used to evaluate the color changes at baseline and 7 days after immersion in each solution. Specimens were stored in the different staining media for 24 h/day during one week. The color differences were analyzed by two-way ANOVA and Tukey 's test (p< 0.05). Color change was observed after one week of immersion and there were statistical differences in staining, composite and interaction factors. The least staining was observed in Admira (deltaE= 3.934+/-0.814) and Resilab (deltaE= 3.993+/-0.735), followed by Adoro (deltaE= 4.044+/-1.001), Epri-cord (deltaE= 4.049+/-1.234), Signum (deltaE= 4.260+/-1.785), Solidex (deltaE=5,122+/-0.534) and Sinfony (deltaE=5.126+/-0.838). All of the composites tested except Adoro were susceptible to staining by substances present in coffee and cola, when stored in beverage for seven days. The lowest deltaE means were obtained with Admira.     

Dimensional alterations and solubility of new endodontic sealers

This study evaluated the dimensional alterations and the solubility of two experimental endodontic sealers based on Copaifera multijuga oil-resin (Biosealer) and castor oil bean cement (Poliquil), maintained in different storage solutions. Twenty specimens (3 mm diameter and 2 mm height) of each sealer were assigned to 2 groups (n=10) according to the storage solution: simulated tissue fluid (STF) or distilled water (DW). The specimens were stored in these solutions during 90 days, being removed every 30 days for weighting. The solutions were renewed every 15 days. The results were subjected to statistical analysis by Dunn's and Mann-Whitney tests (a=0.05). The solubility of Poliquil was higher in STF (38.4 ± 36.0) than in DW (28.4 ± 15.0), while Biosealer showed higher solubility in DW (34.61 ± 6.0) than in STF (18.59 ± 8.0). The storage solution influenced the behavior of sealers in relation to the weight variation (p=0.0001). Poliquil presented higher variation of weight independent of the solution (p=0.239). Biosealer also presented higher variation of weight regardless of the solution (p=0.0001). The solubility of Biosealer was different from that of Poliquil, but both sealers showed low solubility in STF. Under the tested conditions, neither of the materials were according to the ADA'S specification.     

Efficacy of mupirocin in methicillin-resistant Staphylococcus aureus burn wound infection.

Methicillin-resistant Staphylococcus aureus strains (MRSA) have become increasingly prevalent as nosocomial pathogens, especially in burn wounds. MRSA constituted 38% of all S. aureus isolates in our 25-bed burns unit despite the utilization of a combination of 1% silver sulfadiazine and 0.2% chlorhexidine as topical therapy. Mupirocin, a new antibiotic, has proved in vitro and in vivo to be highly effective in the treatment of MRSA infections. A prospective clinical trial with mupirocin ointment in MRSA burn wound infection was untertaken. Forty-five children with 59 discrete burn wounds and from whom MRSA were isolated were treated with 2% mupirocin ointment under occlusive dressings, applied twice daily for 5 days. The average burned area treated was 8% (range, 2 to 20%) of the total body surface area. The burn wounds were assessed clinically and bacteriologically daily. Mupirocin eliminated MRSA in all 59 wounds treated, with the maximum therapeutic response seen within 4 days. In three wounds, gram-negative organisms persisted after 5 days of topical therapy. Treatment was well tolerated by all children. We recommend that mupirocin in its present polyethylene glycol base should be used only on a selective basis, when current prophylactic topical therapy has failed to control MRSA infection in burns of less than 20% of the total body surface area, and that it should be applied only for a limited period of 5 days. The safety and the efficacy of mupirocin in burns exceeding 20% of the total body surface area need to be established.     

Is non-union of tibial shaft fractures due to nonculturable bacterial pathogens? A clinical investigation using PCR and culture techniques

ABSTRACT: BACKGROUND: Non-union continues to be one of the orthopedist's greatest challenges. Despite effective culture methods, the detection of low-grade infection in patients with non-union following tibial fracture still presents a challenge. We investigated whether "aseptic" tibial non-union can be the result of an unrecognized infection. METHODS: A total of 23 patients with non-union following tibial shaft fractures without clinical signs of infection were investigated. Intraoperative biopsy samples obtained from the non-union site were examined by means of routine culture methods and by polymerase chain reaction (PCR) for the detection of 16 S ribosomal RNA (rRNA). Control subjects included 12 patients with tibial shaft fractures. RESULTS: 23 patients (8 women and 15 men; mean age: 47.4 years) were included into this study. Preoperative C-reactive protein levels (mean: 20.8 mg/l) and WBC counts (mean: 8,359/ul) in the study group were not significantly higher than in the control group. None of the samples of non-union routine cultures yielded microorganism growth. Bacterial isolates were found by conventional culturing methods in only 1 case of an open fracture from the control group. In this case, PCR yielded negative results. 16 S rRNA was detected in tissue specimens from 2 patients (8.7%) with non-union. The analysis of these variable speciesspecific sequences enabled the identification of specific microorganisms (1x Methylobacterium species, 1x Staphylococcus species). Both PCR-positive patients were culture-negative. CONCLUSIONS: The combination of microbiological culture and broad-range PCR seems to substantially add to the number of microbiological diagnoses obtained and may improve the clinican's ability to tailor therapy to the individual patient's needs.     

The NutriChip project - translating technology into nutritional knowledge

Advances in food transformation have dramatically increased the diversity of products on the market and, consequently, exposed consumers to a complex spectrum of bioactive nutrients whose potential risks and benefits have mostly not been confidently demonstrated. Therefore, tools are needed to efficiently screen products for selected physiological properties before they enter the market. NutriChip is an interdisciplinary modular project funded by the Swiss programme Nano-Tera, which groups scientists from several areas of research with the aim of developing analytical strategies that will enable functional screening of foods. The project focuses on postprandial inflammatory stress, which potentially contributes to the development of chronic inflammatory diseases. The first module of the NutriChip project is composed of three in vitro biochemical steps that mimic the digestion process, intestinal absorption, and subsequent modulation of immune cells by the bioavailable nutrients. The second module is a miniaturised form of the first module (gut-on-a-chip) that integrates a microfluidic-based cell co-culture system and super-resolution imaging technologies to provide a physiologically relevant fluid flow environment and allows sensitive real-time analysis of the products screened in vitro. The third module aims at validating the in vitro screening model by assessing the nutritional properties of selected food products in humans. Because of the immunomodulatory properties of milk as well as its amenability to technological transformation, dairy products have been selected as model foods. The NutriChip project reflects the opening of food and nutrition sciences to state-of-the-art technologies, a key step in the translation of transdisciplinary knowledge into nutritional advice.