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- Assessment of Lactobacillus crispatus´ role in vaginal infections: friend or foe?Publication . Gaspar, C.; Rolo, J.; Vieira, Luís; Donder, G.; Martinez-de-Oliveira, J.; Palmeira-de-Oliveira, A.Lactobacillus spp. are the most prevalent microorganisms in the vaginal milleu. Several probiotic mechanisms have been associated with Lactobacillus, but the most relevant one is lactate production – resulting in a low pH value, typical of the healthy vagina. However, its pathogenic state is still unknown. We aim to elucidate the role of a commensal vaginal microorganism, Lactobacillus crispatus, in vaginal infections. Twenty-four vaginal washes have been collected from women attending a gynaecology consultation of a private clinic. The samples were categorized according with clinical diagnosis at the time of sampling. The distribution of bacterial species, and their prevalence was assessed by Next-Generation Sequencing of the 16S rRNA V4 region. In addition, L- and D-lactate concentration, and LDH enzymatic activity was quantified in all washes by a commercial kit. Detection of Candida spp. was performed by PCR. L. crispatus was dominant (>70%) in 11 out of 24 samples – diagnosed for vaginal atrophy (VA, 3), cytolytic vaginosis (CV, 2) and lactobacillosis (LB, 2). Lactate was increased in CV, LB and VA cases only. The remaining samples, diagnosed for vulvovaginal candidosis in its majority, had lower prevalence of L. crispatus; and lower to moderate lactate metabolite. There was not a direct relationship between LDH enzymatic activity and clinical diagnosis. L. crispatus dominance, associated with increased lactate production, was observed in CV, LB and VA cases. These results indicate that this microorganism might have a role in dysbiosis of the vagina associated with these specific pathologies.
- Simultaneous norovirus outbreak in three Portuguese army bases in the Lisbon region, December 2017Publication . Lopes-João, A.; Mesquita, J.R.; de Sousa, R.; Oleastro, M.; Penha-Gonçalves, C.; Nascimento, M.S.J.Introduction Norovirus outbreaks frequently occur in communities and institutional settings acquiring a particular significance in armed forces where prompt reporting is critical. Here we describe the epidemiological, clinical and laboratorial investigation of a multicentre gastroenteritis outbreak that was detected simultaneously in three Portuguese army units with a common food supplier, Lisbon region, between 5 and 6 December 2017. Methods Questionnaires were distributed to all soldiers stationed in the three affected army units, and stool specimens were collected from soldiers with acute gastrointestinal illness. Stool specimens were tested for common enteropathogenic bacteria by standard methods and screened for a panel of enteric viruses using a multiplex real-time PCR assay. Food samples were also collected for microbiological analysis. Positive stool specimens for norovirus were further genotyped. Results The three simultaneous acute gastroenteritis outbreaks affected a 31 (3.5%) soldiers from a total of 874 stationed at the three units and lasted for 2 days. No secondary cases were reported. Stool specimens (N=11) were negative for all studied enteropathogenic agents but tested positive for norovirus. The recombinant norovirus GII.P16-GII.4 Sydney was identified in all positive samples with 100% identity. Conclusions The results are suggestive of a common source of infection plausibly related to the food supplying chain. Although centralisation of food supplying in the army has economic advantages, it may contribute to the multifocal occurrence of outbreaks. A rapid intervention is key in the mitigation of outbreak consequences and in reducing secondary transmission.