bacterial adherence

细菌粘附
  • 文章类型: Journal Article
    ormaechei肠杆菌,阴沟肠杆菌复合体中的一个物种,是医疗保健相关感染的相关代理。此外,它已经获得了相关性,因为分离株已经显示出抵抗几种抗生素的能力,尤其是碳青霉烯类。然而,关于Hormaechei大肠杆菌的定植和毒力机制的知识没有像大肠杆菌或肺炎克雷伯菌等其他肠杆菌科细菌一样进步。这里,我们描述了3型菌毛的存在和作用,一个陪护者组装的Fimbria,首先在克雷伯菌属中描述。,并在肠杆菌科的其他代表中检测到。检查了8个智利阴沟肠杆菌分离株,其中,发现了四个E.hormaechei分离株产生3型菌毛。这些分离株被鉴定为E.hormaechei亚种。霍夫曼尼,已知的五个亚种之一。变种E.hormaechei亚种。缺乏mrkA基因的hoffmannii菌株,编码主要结构亚基,对塑料表面和Caco-2细胞的粘附能力显着降低,与野生型菌株相比。在诱导型启动子控制下补充mrkA基因的突变菌株中未观察到粘附能力降低的这种表型。因此,这些数据表明,3型菌毛在E.hormaechei亚种的粘附能力中起作用。霍夫曼尼.NCBIRefSeqAssembly数据库中包含的E.hormaechei基因组的筛选表明,3型菌毛的整体存在并不常见(5.94-7.37%),尽管在五个E.hormaechei亚种的代表中检测到编码该结构的基因。对完整基因组的探索表明,在大多数情况下,mrkABCDF基因座,编码3型纤毛,位于质粒中。此外,目前在医疗保健相关感染中发现的序列类型被发现含有编码3型菌毛的基因,主要是ST145、ST78、ST118、ST168、ST66、ST93和ST171。因此,尽管3型菌毛在物种中并不普遍,这可能是E.hormaechei代表子集适合度的决定因素。
    Enterobacter hormaechei, one of the species within the Enterobacter cloacae complex, is a relevant agent of healthcare-associated infections. In addition, it has gained relevance because isolates have shown the capacity to resist several antibiotics, particularly carbapenems. However, knowledge regarding colonization and virulence mechanisms of E. hormaechei has not progressed to the same extent as other Enterobacteriaceae species as Escherichia coli or Klebsiella pneumoniae. Here, we describe the presence and role of the type 3 fimbria, a chaperone-usher assembled fimbria, which was first described in Klebsiella spp., and which has been detected in other representatives of the Enterobacteriaceae family. Eight Chilean E. cloacae isolates were examined, and among them, four E. hormaechei isolates were found to produce the type 3 fimbria. These isolates were identified as E. hormaechei subsp. hoffmannii, one of the five subspecies known. A mutant E. hormaechei subsp. hoffmannii strain lacking the mrkA gene, encoding the major structural subunit, displayed a significantly reduced adherence capacity to a plastic surface and to Caco-2 cells, compared to the wild-type strain. This phenotype of reduced adherence capacity was not observed in the mutant strains complemented with the mrkA gene under the control of an inducible promoter. Therefore, these data suggest a role of the type 3 fimbria in the adherence capacity of E. hormaechei subsp. hoffmannii. A screening in E. hormaechei genomes contained in the NCBI RefSeq Assembly database indicated that the overall presence of the type 3 fimbria is uncommon (5.94-7.37%), although genes encoding the structure were detected in representatives of the five E. hormaechei subspecies. Exploration of complete genomes indicates that, in most of the cases, the mrkABCDF locus, encoding the type 3 fimbria, is located in plasmids. Furthermore, sequence types currently found in healthcare-associated infections were found to harbor genes encoding the type 3 fimbria, mainly ST145, ST78, ST118, ST168, ST66, ST93, and ST171. Thus, although the type 3 fimbria is not widespread among the species, it might be a determinant of fitness for a subset of E. hormaechei representatives.
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  • 文章类型: Journal Article
    纤维素纳米晶体(CNCs)是纤维素衍生的纳米材料,可以很容易地获得,例如,来自循环经济产生的蔬菜废物。它们显示出有希望的抗微生物活性并且没有副作用和毒性。这项研究使用体外微生物模型复制口腔环境,研究了CNCs减少微生物粘附和生物膜形成的能力。口腔感兴趣的微生物菌株的微生物粘附,变形链球菌和白色念珠菌,在存在不同CNCs水溶液的情况下,在唾液表膜涂覆的釉质盘的表面上进行评估。使用连续流生物反应器,针对变形链球菌和基于混合菌斑接种物的口腔微观模型测试了相同CNC溶液的抗生物膜活性。结果表明,CNCs对来自最低测试浓度(0.032wt。%,p<0.001)。这种活性对变形链球菌显著高于对白色念珠菌(p<0.01),表明对病原菌株具有选择性的抗粘附活性。同时,有一个最小的,尽管意义重大,抗生物膜活性(0.5和4wt。变形链球菌和口腔微观的%CNC解决方案,分别,p=0.01)。这使得CNCs作为防龋剂特别有趣,鼓励他们在口头领域的使用。
    Cellulose nanocrystals (CNCs) are cellulose-derived nanomaterials that can be easily obtained, e.g., from vegetable waste produced by circular economies. They show promising antimicrobial activity and an absence of side effects and toxicity. This study investigated the ability of CNCs to reduce microbial adherence and biofilm formation using in vitro microbiological models reproducing the oral environment. Microbial adherence by microbial strains of oral interest, Streptococcus mutans and Candida albicans, was evaluated on the surfaces of salivary pellicle-coated enamel disks in the presence of different aqueous solutions of CNCs. The anti-biofilm activity of the same CNC solutions was tested against S. mutans and an oral microcosm model based on mixed plaque inoculum using a continuous-flow bioreactor. Results showed the excellent anti-adherent activity of the CNCs against the tested strains from the lowest concentration tested (0.032 wt. %, p < 0.001). Such activity was significantly higher against S. mutans than against C. albicans (p < 0.01), suggesting a selective anti-adherent activity against pathogenic strains. At the same time, there was a minimal, albeit significant, anti-biofilm activity (0.5 and 4 wt. % CNC solution for S. mutans and oral microcosm, respectively, p = 0.01). This makes CNCs particularly interesting as anticaries agents, encouraging their use in the oral field.
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  • 文章类型: Journal Article
    尿路致病性大肠杆菌(UPEC)是与尿路感染相关的最常见细菌,以高昂的医疗费用和高发病率威胁公共卫生系统。感染的成功建立与其基因组中编码的毒力因子有关,除了抗菌抗性基因,这可能会限制感染的治疗和解决。在这个意义上,传统上,来自Echeveria属的植物提取物被用于治疗各种传染病。然而,人们对这些提取物对细菌的影响及其潜在的作用机制知之甚少。这项研究旨在测序多药耐药UPEC分离株(UTI-U7)并评估多位点序列分型(MLST),毒力因子,抗菌素耐药性概况,基因,血清型,和质粒含量。使用Kirby-Bauer圆盘扩散进行抗菌素敏感性分析。Echeveria的甲醇提取物(ME)的抗菌和抗粘附作用(E.Craigiana,E.Kimnachii,和E.subrigida)对UTI-U7进行了测定。该分离株的特征为O25:H4-B2-ST2279-CH40亚克隆,并具有对氨基糖苷类的抗性决定簇,β-内酰胺,氟喹诺酮/喹诺酮,氨酚,和四环素,这与抗菌素耐药性概况相匹配。鉴定的毒力基因编码粘附因子,铁吸收,保护素/血清抗性,和毒素。鉴定的质粒属于IncF组(IncFIA,IncFIB,和IncFII),还有几个类似预言的元素。经过广泛的基因组分析,证实UTI-U7分离株的致病状态,对Echeveria提取物进行了测试,以确定其抗菌作用;作为提取物,E.subrigida(MIC,5mg/mL)表现出最好的抑制作用。然而,UTI-U7和HeLa细胞之间的粘附不受E.subrigida提取物的ME影响。
    Uropathogenic Escherichia coli (UPEC) is the most common bacterial agent associated with urinary tract infections, threatening public health systems with elevated medical costs and high morbidity rates. The successful establishment of the infection is associated with virulence factors encoded in its genome, in addition to antibacterial resistance genes, which could limit the treatment and resolution of the infection. In this sense, plant extracts from the genus Echeveria have traditionally been used to treat diverse infectious diseases. However, little is known about the effects of these extracts on bacteria and their potential mechanisms of action. This study aims to sequence a multidrug-resistant UPEC isolate (UTI-U7) and assess the multilocus sequence typing (MLST), virulence factors, antimicrobial resistance profile, genes, serotype, and plasmid content. Antimicrobial susceptibility profiling was performed using the Kirby-Bauer disk diffusion. The antibacterial and anti-adherent effects of the methanol extracts (ME) of Echeveria (E. craigiana, E. kimnachii, and E. subrigida) against UTI-U7 were determined. The isolate was characterized as an O25:H4-B2-ST2279-CH40 subclone and had resistant determinants to aminoglycosides, β-lactams, fluoroquinolones/quinolones, amphenicols, and tetracyclines, which matched with the antimicrobial resistance profile. The virulence genes identified encode adherence factors, iron uptake, protectins/serum resistance, and toxins. Identified plasmids belonged to the IncF group (IncFIA, IncFIB, and IncFII), alongside several prophage-like elements. After an extensive genome analysis that confirmed the pathogenic status of UTI-U7 isolate, Echeveria extracts were tested to determine their antibacterial effects; as an extract, E. subrigida (MIC, 5 mg/mL) displayed the best inhibitory effect. However, the adherence between UTI-U7 and HeLa cells was unaffected by the ME of the E. subrigida extract.
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  • 文章类型: Journal Article
    肠道是共生细菌无乳链球菌(B组链球菌或GBS)定植的重要部位,在新生儿和成人中也可以表现为致命的病原体。肠上皮屏障的侵入可能是由属于克隆复合物17(CC17)的GBS引起的新生儿感染发病机理中的关键步骤。我们先前已经证明,原型CC17BM110菌株使用内吞途径通过其侧面侵入极化的肠上皮细胞样细胞。通过分析假定的GBS受体在人肠上皮细胞样Caco-2细胞中的细胞分布,我们在这里发现,α3(α3)和α2(α2)整联蛋白亚基在赤道和鼻旁水平的侧肠上皮细胞表面上沿着极化细胞的垂直轴选择性表达,在对应于GBS入口站点的区域中。在完全分化的Caco-2单层中,α3β1和α2β1整联蛋白不易获得,但在无钙培养基中削弱细胞间连接后,可以暴露于特定抗体。在这些条件下,抗α3β1和抗α2β1抗体显着降低GBS对肠细胞的粘附和侵袭。胞吞后,α3β1和α2β1整联蛋白定位于含有液泡的GBS周围的肌动蛋白重塑区域。一起来看,这些数据表明,GBS可以通过与极化肠细胞侧膜上的α3β1和α2β1整合素结合来侵入肠细胞,导致细胞骨架重塑和细菌内化。阻断整合素可能是防止GBS侵袭肠上皮组织的可行策略。
    The gut represents an important site of colonization of the commensal bacterium Streptococcus agalactiae (group B Streptococcus or GBS), which can also behave as a deadly pathogen in neonates and adults. Invasion of the intestinal epithelial barrier is likely a crucial step in the pathogenesis of neonatal infections caused by GBS belonging to clonal complex 17 (CC17). We have previously shown that the prototypical CC17 BM110 strain invades polarized enterocyte-like cells through their lateral surfaces using an endocytic pathway. By analyzing the cellular distribution of putative GBS receptors in human enterocyte-like Caco-2 cells, we find here that the alpha 3 (α3) and alpha 2 (α2) integrin subunits are selectively expressed on lateral enterocyte surfaces at equatorial and parabasal levels along the vertical axis of polarized cells, in an area corresponding to GBS entry sites. The α3β1 and α2β1 integrins were not readily accessible in fully differentiated Caco-2 monolayers but could be exposed to specific antibodies after weakening of intercellular junctions in calcium-free media. Under these conditions, anti-α3β1 and anti-α2β1 antibodies significantly reduced GBS adhesion to and invasion of enterocytes. After endocytosis, α3β1 and α2β1 integrins localized to areas of actin remodeling around GBS containing vacuoles. Taken together, these data indicate that GBS can invade enterocytes by binding to α3β1 and α2β1 integrins on the lateral membrane of polarized enterocytes, resulting in cytoskeletal remodeling and bacterial internalization. Blocking integrins might represent a viable strategy to prevent GBS invasion of gut epithelial tissues.
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  • 文章类型: Journal Article
    尽管已经确立了人类乳腺(MG)作为具有自身微生物群的栖息地的概念,MG定植的确切机制仍然难以捉摸,并且充分表征的体外模型将加强对MG微生物群发育的研究。我们旨在建立和表征体外细胞模型,以研究乳腺胫骨定植(MAGIC)模型。我们使用永生化细胞系MCF10A,当在可渗透支持物(Transwell)上培养时,其表达类似于MG导管上皮的强极化表型。我们通过E-cadherin的基因表达分析分析了MAGIC模型的表面特性,紧密连接蛋白,和粘蛋白和扫描电子显微镜。为了证明模型的适用性,我们测试了全人乳(HM)微生物群落的粘附能力,以及直接用原始HM样品攻击时模型的细胞反应。MCF10A在可渗透的支持物上分化并形成紧密的屏障,通过上调CLDN8、MUC1、MUC4和MUC20基因。模型的表面被粘蛋白覆盖,并且在形态上具有至少两种细胞类型和两种类型的微绒毛。MAGIC模型中的细胞经受了热处理的HM样品的挑战,并通过独特的细胞因子反应对不平衡的HM微生物群产生不同的反应。粘附在MAGIC模型上的细菌的微生物谱反映了输入HM样品的微生物谱。经过充分研究的MAGIC模型可用于研究细菌与MG的附着以及生物膜形成和微生物群发育的体外研究。重要性MAGIC模型可能特别适用于研究细菌附着在乳腺导管表面的研究,以及对生物膜形成和人类乳腺(MG)微生物群发育的体外研究。该模型还可用于细菌和MG细胞之间相互作用的免疫学研究。我们获得了关于原人乳(HM)中存在的哪些细菌能够附着于用原始HM直接处理的上皮的开创性信息,以及细菌对MG上皮细胞的影响。MAGIC细胞模型还为MG生理学其他领域的研究提供了新的机会,如生物活性乳成分对MG微生物定植的影响,预防乳腺炎,和益生菌发育的研究。由于居住的MG细菌可能是乳腺癌发展的重要因素,MAGIC体外工具也为癌症研究提供了新的机会.
    Despite the established concept of the human mammary gland (MG) as a habitat with its own microbiota, the exact mechanism of MG colonization is still elusive and a well-characterized in vitro model would reinforce studies of the MG microbiota development. We aimed to establish and characterize an in vitro cell model for studying MAmmary Gland mIcrobial Colonization (MAGIC) model. We used the immortalized cell line MCF10A, which expresses the strong polarized phenotype similar to MG ductal epithelium when cultured on a permeable support (Transwell). We analyzed the surface properties of the MAGIC model by gene expression analysis of E-cadherin, tight junction proteins, and mucins and by scanning electron microscopy. To demonstrate the applicability of the model, we tested the adhesion capability of the whole human milk (HM) microbial community and the cellular response of the model when challenged directly with raw HM samples. MCF10A on permeable supports differentiated and formed a tight barrier, by upregulation of CLDN8, MUC1, MUC4, and MUC20 genes. The surface of the model was covered with mucins and morphologically diverse with at least two cell types and two types of microvilli. Cells in the MAGIC model withstood the challenge with heat-treated HM samples and responded differently to the imbalanced HM microbiota by distinctive cytokine response. The microbial profile of the bacteria adhered on the MAGIC model reflected the microbiological profile of the input HM samples. The well-studied MAGIC model could be useful for studies of bacterial attachment to the MG and for in vitro studies of biofilm formation and microbiota development.IMPORTANCEThe MAGIC model may be particularly useful for studies of bacterial attachment to the surface of the mammary ducts and for in vitro studies of biofilm formation and the development of the human mammary gland (MG) microbiota. The model is also useful for immunological studies of the interaction between bacteria and MG cells. We obtained pioneering information on which of the bacteria present in the raw human milk (HM) were able to attach to the epithelium treated directly with raw HM, as well as on the effects of bacteria on the MG epithelial cells. The MAGIC cell model also offers new opportunities for research in other areas of MG physiology, such as the effects of bioactive milk components on microbial colonization of the MG, mastitis prevention, and studies of probiotic development. Since resident MG bacteria may be an important factor in breast cancer development, the MAGIC in vitro tool also offers new opportunities for cancer research.
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  • 文章类型: Randomized Controlled Trial
    为了评估复方新诺明和N-乙酰半胱氨酸(NAC)的效果,单独和组合,细菌粘附在输尿管支架表面形成的生物膜上。这项前瞻性随机研究是对636例患者进行的,这些患者在泌尿外科手术后接受了双J输尿管支架插入。患者被随机分为四组:A(n=165),支架留置期间无抗生素或粘液溶解剂;B(n=153),支架留置期间口服NAC(12岁以下儿童为200mg/天,成人为600mg/天);C(n=162),支架留置期间口服复方新诺明(2mgTMP/kg/天);和D(n=156),支架留置期间口服NAC和复方新诺明。双J支架(JJ支架)插入两周后,对所有患者进行尿液分析,并在双J支架移除当天对所有患者进行尿液培养.术后2周取支架,并且将距支架的膀胱段3-5厘米大小的支架段送去进行培养。支架培养阳性占63.6%(105/165),43.1%(66/153),37%(60/162),A组19.2%(30/156)的患者,B,C,D,分别。大肠杆菌是所有组中最常见的从支架培养物中分离的生物体。复方新诺明和NAC的组合比单独使用两者更有效地减少输尿管支架表面上的细菌粘附。
    To assess the effect of co-trimoxazole and N-acetylcysteine (NAC), alone and in combination, on bacterial adherence to biofilm formed on ureteral stent surfaces. This prospective randomized study was conducted on 636 patients who underwent double J ureteral stent insertion after variable urological procedures. Patients were randomized into four groups: A (n = 165), no antibiotics or mucolytics during stent indwelling; B (n = 153), oral NAC (200 mg/day for children aged < 12 years old and 600 mg/day for adults) during stent indwelling; C (n = 162), oral co-trimoxazole (2 mg TMP/kg/day) during stent indwelling; and D (n = 156), both oral NAC and co-trimoxazole during stent indwelling. Two weeks following double J stent (JJ stent) insertion, urinalysis was performed on all patients and urine culture was done for all the patients at the day of double J stent removal. The stent was removed 2 weeks postoperatively, and a stent segment sized 3-5 cm from the bladder segment of the stent was sent for culture. Positive stent cultures were found in 63.6% (105/165), 43.1% (66/153), 37% (60/162), and 19.2% (30/156) patients of groups A, B, C, and D, respectively. E. coli was the organism most commonly isolated from the stent culture in all groups. The combination of co-trimoxazole and NAC was more effective in reducing bacterial adherence on ureteral stent surfaces than either alone.
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  • 文章类型: Journal Article
    为了评估和比较二极管激光辅助漂白的效果,用复合材料修复的V类腔上的表面粗糙度和细菌粘附上的超声波缩放和电动刷牙。
    总共一百二十个样本(每个40个样本,BeautifilII和Heytec-N)在标准化的不锈钢模具中制备。将样品进一步细分为四个亚组,即一个对照组(无任何干预)和三个实验组-二极管激光辅助漂白,超声波缩放和电动刷牙,每个10个样本。借助3D光学轮廓仪定量测量表面粗糙度。对于细菌粘附分析,将变异链球菌菌株(ATCC25175)在BHI培养基中培养,并使用菌落形成单位(CFU)计数评估样品中活细菌的存在。然后将获得的结果制表并进行统计分析。
    二极管激光漂白导致表面粗糙度和细菌粘附力的显着增加,Heytec-N表现出最低的平均变化,其次是BeautifilII,最高是BrilliantEverglow组。同样,超声结垢增加了所有三个测试样品的表面粗糙度,两组之间存在显着差异。动力刷牙对测试复合材料的表面粗糙度和细菌粘附没有影响。
    二极管辅助的激光漂白和超声波导致所有测试的复合材料的表面粗糙度和细菌粘附值明显更高。因此,建议在此类程序后对修复体进行精加工和抛光。
    UNASSIGNED: To evaluate and compare the effect of diode laser assisted bleaching, ultrasonic scaling and powered tooth brushing on surface roughness and bacterial adherence on class V cavities restored with composites.
    UNASSIGNED: A total of one hundred and twenty samples (40 samples each of Brilliant Everglow, Beautifil II and Heytec-N) were prepared in standardized stainless steel molds. The samples were further subdivided into four subgroups i.e. one control group (without any intervention) and three experimental groups - diode laser assisted bleaching, ultrasonic scaling and powered tooth brushing consisting of 10 sample each. Surface roughness was measured quantitatively with the help of 3D Optical Profilometer. For bacterial adherence analysis S. mutans strain (ATCC 25175) was cultured in BHI medium and samples were evaluated for the presence of viable bacteria using the Colony Forming Unit (CFU) count. Results obtained were then tabulated and subjected to statistical analysis.
    UNASSIGNED: Diode laser bleaching caused a significant increase in surface roughness and bacterial adherence with lowest mean change exhibited by Heytec-N followed by Beautifil II and highest by Brilliant Everglow group. Similarly, Ultrasonic scaling increased the surface roughness of all the three tested samples with significant difference between the groups. Powered tooth brushing had no effect on the surface roughness and bacterial adherence of the tested composites.
    UNASSIGNED: Diode assisted laser bleaching and ultrasonic caused significantly higher surface roughness and bacterial adherence values for all the tested composites. It may therefore be recommended to do finishing and polishing of restorations after such procedures.
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  • 文章类型: Journal Article
    BACKGROUND: The use of 3D printed material in the dental field is gaining tremendous attention. However, studies related to 3D printed denture resins are scarce and need consideration before their inclusion in routine clinical practice.
    OBJECTIVE: This study aimed to assess the surface roughness (Ra) of 3D printed denture resins following aging and mechanical brushing.
    METHODS: Forty round samples (diameter, 10 mm and thickness, 3 mm) were fabricated from two 3D printed (DentaBASE and Denture 3D+) and one conventional polymethylmethacrylate (PMMA) denture materials. The samples were thermo-cycled, subjected to mechanical brushing, and later immersed in either artificial saliva (AS), coffee, cola, or lemon juice (n= 10) to simulate one and two years of oral use. Surface roughness (Ra) was determined using a non-contact profilometer and scanning electron microscope was used for qualitative analysis. The data was analyzed using SPSS v.20 (α= 0.05).
    RESULTS: Denture 3D+ demonstrated highest mean Ra (1.15 ± 0.28 μm), followed by PMMA (0.99 ± 0.50 μm) and DentaBASE (0.81 ± 24). The difference in mean Ra between the materials was statistically non-significant (P= 0.08). Amongst the different beverages used, the highest Ra was observed for samples immersed in lemon juice (1.06 ± 0.40 μm) followed by cola (1.04 ± 0.46 μm) and coffee (0.98 ± 0.40 μm), respectively. The lowest Ra was observed for samples immersed in AS (0.85 ± 0.24 μm).
    CONCLUSIONS: The surface roughness of 3D printed denture resins was comparable with that of conventional PMMA resins. Denture 3D+ demonstrated the highest mean roughness, followed by PMMA and DentaBASE.
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  • 文章类型: Journal Article
    Infertility has become a common problem in recent decades. The pathogenesis of infertility is variable, but microbiological factors account for a large proportion of it. Dysbiosis of vaginal microbiota is reportedly associated with female infertility, but the influence of normal vaginal microbiota on infertility is unclear. In this review, we summarize the physiological characteristics of the vaginal tract and vaginal microbiota communities. We mainly focus on the bacterial adherence of vaginal Lactobacillus species. Given that the adherent effect plays a crucial role in the colonization of bacteria, we hypothesize that the adherent effect of vaginal Lactobacillus may also influence the fertility of the host. We also analyze the agglutination and immobilization effects of other bacteria, especially Escherichia coli, on ejaculated spermatozoa, and speculate on the possible effects of normal vaginal microbiota on female fertility.
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  • 文章类型: Journal Article
    Haemophilus influenzae is the most common cause of bacterial infection in the lungs of chronic obstructive pulmonary disease (COPD) patients and contributes to episodes of acute exacerbation which are associated with increased hospitalization and mortality. Due to the ability of H. influenzae to adhere to host epithelial cells, initial colonization of the lower airways can progress to a persistent infection and biofilm formation. This is characterized by changes in bacterial behaviour such as reduced cellular metabolism and the production of an obstructive extracellular matrix (ECM). Herein we discuss the multiple mechanisms by which H. influenzae contributes to the pathogenesis of COPD. In particular, mechanisms that facilitate bacterial adherence to host airway epithelial cells, biofilm formation, and microbial persistence through immune system evasion and antibiotic tolerance will be discussed.
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