The action of OXA-24/40 and OXA-58 β-lactamase-like enzymes represents the main mechanism underlying resistance to carbapenems in Spain in the last decade. AbkA/AbkB proteins in the toxin/antitoxin system may be involved in the successful dissemination of plasmids carrying the bla(OXA-24/40)-like gene, and probably also the bla(OXA-58)-like gene, thus contributing to the plasmid stability.
Background: Presence of biofilm (BF) chronic otitis media (COM) has been demonstrated in experimental studies of chinchillas and also of tympanostomy tubes in children with refractory otorrhea postimpanostomy. To investigate the presence of BF in the middle ear (ME) of children with COM to which tympanostomy tubes were to be placed Methods & Materials: We studied 19 children with OME who were treated with tympanostomy tubes. During the surgical procedure, the material of the middle ear was aspirated, extended on glass devices (GD) and immediately placed in a culture medium for the study of BF. The adenoids were sent to the laboratory where cuts were made to make imprints, and then proceeded similarly to the otical material. GD were incubated at 36 • C for 24 hours. Subsequently an aliquot of each broth, where the devices were incubated, was taken, inoculated into two chocolate agar plates and incubated for 24 hours (planktonic bacteria evaluation). The GD were studied according to the usual technique for BF.coincidence.Results: Mixed BF were obtained in 16 ME samples and in 18 AD samples (100%). The predominant microorganisms (MOs) were viridans group Streptococcus, Streptococcus pneumoniae, Haemophilus influenzae, Neisseria spp and coagulase negative Staphylococcus.Total concordance of BF from ME with BF from AD was observed in 4 of the studied cases, partial in 9 cases and in the 3 remaining cases of simultaneous study there was no coincidence.Conclusion: Acute infections of the middle ear are usually monomicrobial in their etiology (Haemophilus influenzae, Streptococcus pneumoniae or Staphylococcus aureus). Our observations of mixed BF in COM would indicate an ascent from the oropharyngeal microbiota. Its presence possibly facilitates the permanence of the habitual pathogens by forming coaggregates and giving rise to the mixed BF. The nature of the BF and the formation of exuberant exopolymer difficults the arrival of antimicrobials to the interior, allowing the persistence of the MOs and the recurrence of episodes of otitis when MOs are released from the BF.
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