Utilizing a Post-discharge Telephone Call in Outpatient Parenteral Antimicrobial Therapy (OPAT): Findings from a Quality Improvement Project

Science.gov (United States)

Felder, Kimberly; Vaz, Louise; Barnes, Penelope; Varley, Cara

2017-01-01

Abstract Background Transitions of care from hospitals to outpatient settings, especially for patients requiring outpatient parenteral antimicrobial therapy (OPAT) are complex. OPAT complications, such as adverse antimicrobial reactions, vascular access problems, and hospital readmissions are common. Data from transitions of care literature suggest that post-discharge telephone calls (TCs) may significantly decrease re-hospitalization but no studies have assessed the utility of post-discharge TCs as an OPAT program quality improvement process. Methods Adult OPAT patients discharged from our hospital between April 1, 2015 and May 31, 2016 were queried for post-discharge concerns. TCs to patients or their caregivers were administered by trained medical assistants within the Department of Infectious Diseases using a standardized script and documented in the electronic medical record (EMR). Feasibility was assessed using call completion rate. The type and frequency of reported issues were analyzed by retrospective chart review. Results 636 of 689 eligible adult OPAT patients or their caregivers received a TC with responses to scripted questions documented in the EMR (92% completion rate). 302 patients (47%) reported 319 issues, including 293 (92%) relevant to OPAT. Antimicrobial issues included diarrhea/stool changes (58; 9%); nausea/vomiting (27; 4%); and missed antimicrobial doses (22; 3%). Vascular access issues included line patency concerns (21; 3%); vascular access dressing problems (17; 2.6%) and arm pain/swelling (6; 1%). OPAT vendor issues included delays in lab or line care services (23; 4%) and OPAT orders reported as lost/not received (21; 3%). Other ID-related issues included fevers/chills/sweats (27; 4%), wound concerns (16; 2.5%), and pain (15; 2.5%). Conclusion Adding a post-discharge TC to an OPAT program was feasible and resulted in frequent and early identification of significant OPAT patient and caregiver concerns. Findings suggest potential high

Barriers to and enablers of implementing antimicrobial stewardship programs in veterinary practices.

Science.gov (United States)

Hardefeldt, Laura Y; Gilkerson, J R; Billman-Jacobe, H; Stevenson, M A; Thursky, K; Bailey, K E; Browning, G F

2018-03-23

Antimicrobial stewardship (AMS) programs are yet to be widely implemented in veterinary practice and medical programs are unlikely to be directly applicable to veterinary settings. To gain an in-depth understanding of the factors that influence effective AMS in veterinary practices in Australia. A concurrent explanatory mixed methods design was used. The quantitative phase of the study consisted of an online questionnaire to assess veterinarians' attitudes to antimicrobial resistance (AMR) and antimicrobial use in animals, and the extent to which AMS currently is implemented (knowingly or unknowingly). The qualitative phase used semi-structured interviews to gain an understanding of the barriers to and enablers of AMS in veterinary practices. Data were collected and entered into NVivo v.11, openly coded and analyzed according to mixed methods data analysis principles. Companion animal, equine, and bovine veterinarians participated in the study. Veterinary practices rarely had antimicrobial prescribing policies. The key barriers were a lack of AMS governance structures, client expectations and competition between practices, cost of microbiological testing, and lack of access to education, training and AMS resources. The enablers were concern for the role of veterinary antimicrobial use in development of AMR in humans, a sense of pride in the service provided, and preparedness to change prescribing practices. Our study can guide development and establishment of AMS programs in veterinary practices by defining the major issues that influence the prescribing behavior of veterinarians. © 2018 The Authors. Journal of Veterinary Internal Medicine published by Wiley Periodicals, Inc. on behalf of the American College of Veterinary Internal Medicine.

The antimicrobial resistance monitoring and research (ARMoR) program: the US Department of Defense response to escalating antimicrobial resistance.

Science.gov (United States)

Lesho, Emil P; Waterman, Paige E; Chukwuma, Uzo; McAuliffe, Kathryn; Neumann, Charlotte; Julius, Michael D; Crouch, Helen; Chandrasekera, Ruvani; English, Judith F; Clifford, Robert J; Kester, Kent E

2014-08-01

Responding to escalating antimicrobial resistance (AMR), the US Department of Defense implemented an enterprise-wide collaboration, the Antimicrobial Resistance Monitoring and Research Program, to aid in infection prevention and control. It consists of a network of epidemiologists, bioinformaticists, microbiology researchers, policy makers, hospital-based infection preventionists, and healthcare providers who collaborate to collect relevant AMR data, conduct centralized molecular characterization, and use AMR characterization feedback to implement appropriate infection prevention and control measures and influence policy. A particularly concerning type of AMR, carbapenem-resistant Enterobacteriaceae, significantly declined after the program was launched. Similarly, there have been no further reports or outbreaks of another concerning type of AMR, colistin resistance in Acinetobacter, in the Department of Defense since the program was initiated. However, bacteria containing AMR-encoding genes are increasing. To update program stakeholders and other healthcare systems facing such challenges, we describe the processes and impact of the program. Published by Oxford University Press on behalf of the Infectious Diseases Society of America 2014. This work is written by (a) US Government employee(s) and is in the public domain in the US.

A World Wide Web-based antimicrobial stewardship program improves efficiency, communication, and user satisfaction and reduces cost in a tertiary care pediatric medical center.

Science.gov (United States)

Agwu, Allison L; Lee, Carlton K K; Jain, Sanjay K; Murray, Kara L; Topolski, Jason; Miller, Robert E; Townsend, Timothy; Lehmann, Christoph U

2008-09-15

Antimicrobial stewardship programs aim to reduce inappropriate hospital antimicrobial use. At the Johns Hopkins Children's Medical and Surgical Center (Baltimore, MD), we implemented a World Wide Web-based antimicrobial restriction program to address problems with the existing restriction program. A user survey identified opportunities for improvement of an existing antimicrobial restriction program and resulted in subsequent design, implementation, and evaluation of a World Wide Web-based antimicrobial restriction program at a 175-bed, tertiary care pediatric teaching hospital. The program provided automated clinical decision support, facilitated approval, and enhanced real-time communication among prescribers, pharmacists, and pediatric infectious diseases fellows. Approval status, duration, and rationale; missing request notifications; and expiring approvals were stored in a database that is accessible via a secure Intranet site. Before and after implementation of the program, user satisfaction, reports of missed and/or delayed doses, antimicrobial dispensing times, and cost were evaluated. After implementation of the program, there was a $370,069 reduction in projected annual cost associated with restricted antimicrobial use and an 11.6% reduction in the number of dispensed doses. User satisfaction increased from 22% to 68% and from 13% to 69% among prescribers and pharmacists, respectively. There were 21% and 32% reductions in the number of prescriber reports of missed and delayed doses, respectively, and there was a 37% reduction in the number of pharmacist reports of delayed approvals; measured dispensing times were unchanged (P = .24). In addition, 40% fewer restricted antimicrobial-related phone calls were noted by the pharmacy. The World Wide Web-based antimicrobial approval program led to improved communication, more-efficient antimicrobial administration, increased user satisfaction, and significant cost savings. Integrated tools, such as this World

Japanese utilities' plutonium utilization program

International Nuclear Information System (INIS)

Matsuo, Yuichiro.

1996-01-01

Japan's 10 utility companies are working and will continue to work towards establishing a fully closed nuclear fuel cycle. The key goals of which are: (1) reprocessing spent fuel; (2) recycling recovered uranium and plutonium; and (3) commercializing fast breeder technology by around the year 2030. This course of action by the Japanese electric power industry is in full accordance with Japan's national policy outlined in the government's report ''The Long-Term Program for Research, Development, and Nuclear Energy,'' which was published in June 1994. The Japanese civilian nuclear program is a long-term program that looks into the 21st century and beyond. It is quite true that sustaining the recycling option for energy security and the global environment demands a large investment. For it to be accepted by the public, safety must be the highest priority and will be pursued at a great cost if necessary. In its history, Japan has learned that as technology advances, costs will come down. The Japanese utility industry will continue investment in technology without compromising safety until the recycling option becomes more competitive with other options. This effort will be equally applied to the development of the commercial FBRs. The Japanese utility industry is confident that Japan's stable policy and strong objective to develop competitive and peaceful technology will contribute to the global economy and the environment without increasing the threat of plutonium proliferation

Antimicrobial resistance

DEFF Research Database (Denmark)

Llor, Carl; Bjerrum, Lars

2014-01-01

Antimicrobial resistance is a global public health challenge, which has accelerated by the overuse of antibiotics worldwide. Increased antimicrobial resistance is the cause of severe infections, complications, longer hospital stays and increased mortality. Overprescribing of antibiotics......-the-counter sale of antibiotics, the use of antimicrobial stewardship programmes, the active participation of clinicians in audits, the utilization of valid rapid point-of-care tests, the promotion of delayed antibiotic prescribing strategies, the enhancement of communication skills with patients with the aid...

Implementation of an antimicrobial stewardship program on the medical-surgical service of a 100-bed community hospital

Directory of Open Access Journals (Sweden)

Storey Donald F

2012-10-01

Full Text Available Abstract Background Antimicrobial stewardship has been promoted as a key strategy for coping with the problems of antimicrobial resistance and Clostridium difficile. Despite the current call for stewardship in community hospitals, including smaller community hospitals, practical examples of stewardship programs are scarce in the reported literature. The purpose of the current report is to describe the implementation of an antimicrobial stewardship program on the medical-surgical service of a 100-bed community hospital employing a core strategy of post-prescriptive audit with intervention and feedback. Methods For one hour twice weekly, an infectious diseases physician and a clinical pharmacist audited medical records of inpatients receiving systemic antimicrobial therapy and made non-binding, written recommendations that were subsequently scored for implementation. Defined daily doses (DDDs; World Health Organization Center for Drug Statistics Methodology and acquisition costs per admission and per patient-day were calculated monthly for all administered antimicrobial agents. Results The antimicrobial stewardship team (AST made one or more recommendations for 313 of 367 audits during a 16-month intervention period (September 2009 – December 2010. Physicians implemented recommendation(s from each of 234 (75% audits, including from 85 of 115 for which discontinuation of all antimicrobial therapy was recommended. In comparison to an 8-month baseline period (January 2009 – August 2009, there was a 22% decrease in defined daily doses per 100 admissions (P = .006 and a 16% reduction per 1000 patient-days (P = .013. There was a 32% reduction in antimicrobial acquisition cost per admission (P = .013 and a 25% acquisition cost reduction per patient-day (P = .022. Conclusions An effective antimicrobial stewardship program was implemented with limited resources on the medical-surgical service of a 100-bed community hospital.

Utility green pricing programs: a statistical analysis of program effectiveness

International Nuclear Information System (INIS)

Ryan, W.; Scott, O.; Lori, B.; Blair, S.

2005-01-01

Utility green pricing programs represent one way in which consumers can voluntarily support the development of renewable energy. The design features and effectiveness of these programs varies considerably. Based on a survey of utility program managers in the United States, this article provides insight into which program features might help maximize both customer participation in green pricing programs and the amount of renewable energy purchased by customers in those programs. We find that program length has a substantial impact on customer participation and purchases; to achieve higher levels of success, utilities will need to remain committed to their product offering for some time. Our findings also suggest that utilities should consider higher renewable energy purchase thresholds for residential customers in order to maximize renewable energy sales. Smaller utilities are found to be more successful than larger utilities, and we find some evidence that providing private benefits to nonresidential participants can enhance success. Interestingly, we find little evidence that the cost of the green pricing product greatly impacts customer participation and renewable energy sales, at least over the narrow range of premiums embedded in our data set, and for the initial set of green power purchasers. (author)

Trends in Utility Green Pricing Programs (2004)

Energy Technology Data Exchange (ETDEWEB)

Bird, L.; Brown, E.

2005-10-01

In the early 1990s, only a handful of utilities offered their customers a choice of purchasing electricity generated from renewable energy sources. Today, nearly 600 utilities in regulated electricity markets--or almost 20% of all utilities nationally--provide their customers a "green power" option. Because some utilities offer programs in conjunction with cooperative associations or other publicly owned power entities, the number of distinct programs totals about 125. Through these programs, more than 40 million customers spanning 34 states have the ability to purchase renewable energy to meet some portion or all of their electricity needs--or make contributions to support the development of renewable energy resources. Typically, customers pay a premium above standard electricity rates for this service. This report presents year-end 2004 data on utility green pricing programs, and examines trends in consumer response and program implementation over time. The data in this report, which were obtained via a questionnaire distributed to utility green pricing program managers, can be used by utilities as benchmarks by which to gauge the success of their green power programs.

Trends in Utility Green Pricing Programs (2003)

Energy Technology Data Exchange (ETDEWEB)

Bird, L.; Cardinal, K.

2004-09-01

Utilities first began offering consumers a choice of purchasing electricity generated from renewable energy sources in the early 1990s. Since then, the number of U.S. utilities offering green pricing programs has steadily grown. Today, more than 500 utilities in regulated electricity markets--or about 16% of all utilities nationally--offer their customers green power options. Because some of these utilities offer programs in conjunction with cooperative associations or other public power entities, the number of distinct programs is slightly more than 100. Through these programs, more than 33 million customers spanning 34 states have the ability to purchase renewable energy to meet some portion or all of their electricity needs, or make contributions to support the development of renewable energy resources. Typically, customers must pay a premium above standard electricity rates for this service. This report presents year-end 2003 data on utility green pricing programs, and examines trends in consumer response and program implementation over time. The data provided in this report can be used by utilities as benchmarks by which to gauge the success of their green power programs.

Trends in Utility Green Pricing Programs (2005)

Energy Technology Data Exchange (ETDEWEB)

Bird, L.; Brown, E.

2006-10-01

This report presents year-end 2005 data on utility green pricing programs, and examines trends in consumer response and program implementation over time. The data in this report, which were obtained via a questionnaire distributed to utility green pricing program managers, can be used by utilities to benchmark the success of their green power programs.

[A program for optimizing the use of antimicrobials (PROA): experience in a regional hospital].

Science.gov (United States)

Ugalde-Espiñeira, J; Bilbao-Aguirregomezcorta, J; Sanjuan-López, A Z; Floristán-Imízcoz, C; Elorduy-Otazua, L; Viciola-García, M

2016-08-01

Programs for optimizing the use of antibiotics (PROA) or antimicrobial stewardship programs are multidisciplinary programs developed in response to the increase of antibiotic resistant bacteria, the objective of which are to improve clinical results, to minimize adverse events and to reduce costs associated with the use of antimicrobials. The implementation of a PROA program in a 128-bed general hospital and the results obtained at 6 months are here reported. An intervention quasi-experimental study with historical control group was designed with the objective of assessing the impact of a PROA program with a non-restrictive intervention model to help prescription, with a direct and bidirectional intervention. The basis of the program is an optimization audit of the use of antimicrobials with not imposed personalized recommendations and the use of information technologies applied to this setting. The impact on the pharmaceutical consumption and costs, cost per process, mean hospital stay, percentage of readmissions to the hospital are described. A total of 307 audits were performed. In 65.8% of cases, treatment was discontinued between the 7th and the 10th day. The main reasons of treatment discontinuation were completeness of treatment (43.6%) and lack of indication (14.7%). The reduction of pharmaceutical expenditure was 8.59% (P = 0.049) and 5.61% of the consumption in DDD/100 stays (P=0.180). The costs by processes in general surgery showed a 3.14% decrease (p=0.000). The results obtained support the efficiency of these programs in small size hospitals with limited resources.

The cost-benefit of federal investment in preventing Clostridium difficile infections through the use of a multifaceted infection control and antimicrobial stewardship program.

Science.gov (United States)

Slayton, Rachel B; Scott, R Douglas; Baggs, James; Lessa, Fernanda C; McDonald, L Clifford; Jernigan, John A

2015-06-01

To determine the potential epidemiologic and economic value of the implementation of a multifaceted Clostridium difficile infection (CDI) control program at US acute care hospitals Markov model with a 5-year time horizon Patients whose data were used in our simulations were limited to hospitalized Medicare beneficiaries ≥65 years old. CDI is an important public health problem with substantial associated morbidity, mortality, and cost. Multifaceted national prevention efforts in the United Kingdom, including antimicrobial stewardship, patient isolation, hand hygiene, environmental cleaning and disinfection, and audit, resulted in a 59% reduction in CDI cases reported from 2008 to 2012. Our analysis was conducted from the federal perspective. The intervention we modeled included the following components: antimicrobial stewardship utilizing the Antimicrobial Use and Resistance module of the National Healthcare Safety Network (NHSN), use of contact precautions, and enhanced environmental cleaning. We parameterized our model using data from CDC surveillance systems, the AHRQ Healthcare Cost and Utilization Project, and literature reviews. To address uncertainty in our parameter estimates, we conducted sensitivity analyses for intervention effectiveness and cost, expenditures by other federal partners, and discount rate. Each simulation represented a cohort of 1,000 hospitalized patients over 1,000 trials. RESULTS In our base case scenario with 50% intervention effectiveness, we estimated that 509,000 CDI cases and 82,000 CDI-attributable deaths would be prevented over a 5-year time horizon. Nationally, the cost savings across all hospitalizations would be $2.5 billion (95% credible interval: $1.2 billion to $4.0 billion). The potential benefits of a multifaceted national CDI prevention program are sizeable from the federal perspective.

Trends in Utility Green Pricing Programs (2005)

Energy Technology Data Exchange (ETDEWEB)

Bird, Lori [National Renewable Energy Lab. (NREL), Golden, CO (United States); Brown, Elizabeth [National Renewable Energy Lab. (NREL), Golden, CO (United States)

2006-10-01

In the early 1990s, only a handful of utilities offered their customers a choice of purchasing electricity generated from renewable energy sources. Today, more than 600 utilities—or about 20% of all utilities nationally—provide their customers a “green power” option. Because some utilities offer programs in conjunction with cooperative associations or other publicly owned power entities, the number of distinct programs totals more than 130. Through these programs, more than 50 million customers have the ability to purchase renewable energy to meet some portion or all of their electricity needs—or make contributions to support the development of renewable energy resources. Typically, customers pay a premium above standard electricity rates for this service. This report presents year-end 2005 data on utility green pricing programs, and examines trends in consumer response and program implementation over time. The data in this report, which were obtained via a questionnaire distributed to utility green pricing program managers, can be used by utilities to benchmark the success of their green power programs.

Trends in Utility Green Pricing Programs (2006)

Energy Technology Data Exchange (ETDEWEB)

Bird, L.; Kaiser, M.

2007-10-01

In the early 1990s, only a handful of utilities offered their customers a choice of purchasing electricity generated from renewable energy sources. Today, more than 750 utilities--or about 25% of all utilities nationally--provide their customers a "green power" option. Through these programs, more than 70 million customers have the ability to purchase renewable energy to meet some portion or all of their electricity needs--or make contributions to support the development of renewable energy resources. Typically, customers pay a premium above standard electricity rates for this service. This report presents year-end 2006 data on utility green pricing programs, and examines trends in consumer response and program implementation over time. The data in this report, which were obtained via a questionnaire distributed to utility green pricing program managers, can be used by utilities to benchmark the success of their green power programs.

Antimicrobial stewardship in a Gastroenterology Department: Impact on antimicrobial consumption, antimicrobial resistance and clinical outcome.

Science.gov (United States)

Bedini, Andrea; De Maria, Nicola; Del Buono, Mariagrazia; Bianchini, Marcello; Mancini, Mauro; Binda, Cecilia; Brasacchio, Andrea; Orlando, Gabriella; Franceschini, Erica; Meschiari, Marianna; Sartini, Alessandro; Zona, Stefano; Paioli, Serena; Villa, Erica; Gyssens, Inge C; Mussini, Cristina

2016-10-01

A major cause of the increase in antimicrobial resistance is the inappropriate use of antimicrobials. To evaluate the impact on antimicrobial consumption and clinical outcome of an antimicrobial stewardship program in an Italian Gastroenterology Department. Between October 2014 and September 2015 (period B), a specialist in infectious diseases (ID) controlled all antimicrobial prescriptions and decided about the therapy in agreement with gastroenterologists. The defined daily doses of antimicrobials (DDDs), incidence of MDR-infections, mean length of stay and overall in-hospital mortality rate were compared with those of the same period in the previous 12-months (period A). During period B, the ID specialist performed 304 consultations: antimicrobials were continued in 44.4% of the cases, discontinued in 13.8%, not recommended in 12.1%, de-escalated 9.9%, escalated in 7.9%, and started in 4.0%. Comparing the 2 periods, we observed a decreased of antibiotics consumption (from 109.81 to 78.45 DDDs/100 patient-days, p=0.0005), antifungals (from 41.28 to 24.75 DDDs/100pd, p=0.0004), carbapenems (from 15.99 to 6.80 DDDsx100pd, p=0.0032), quinolones (from 35.79 to 17.82 DDDsx100pd, p=0.0079). No differences were observed in incidence of MDR-infections, length of hospital stay (LOS), and mortality rate. ASP program had a positive impact on reducing the consumption of antimicrobials, without an increase in LOS and mortality. Copyright © 2016 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.

A Review of Quality Measures for Assessing the Impact of Antimicrobial Stewardship Programs in Hospitals

Directory of Open Access Journals (Sweden)

Mary Richard Akpan

2016-01-01

Full Text Available The growing problem of antimicrobial resistance (AMR has led to calls for antimicrobial stewardship programs (ASP to control antibiotic use in healthcare settings. Key strategies include prospective audit with feedback and intervention, and formulary restriction and preauthorization. Education, guidelines, clinical pathways, de-escalation, and intravenous to oral conversion are also part of some programs. Impact and quality of ASP can be assessed using process or outcome measures. Outcome measures are categorized as microbiological, patient or financial outcomes. The objective of this review was to provide an overview of quality measures for assessing ASP and the reported impact of ASP in peer-reviewed studies, focusing particularly on patient outcomes. A literature search of papers published in English between 1990 and June 2015 was conducted in five databases using a combination of search terms. Primary studies of any design were included. A total of 63 studies were included in this review. Four studies defined quality metrics for evaluating ASP. Twenty-one studies assessed the impact of ASP on antimicrobial utilization and cost, 25 studies evaluated impact on resistance patterns and/or rate of Clostridium difficile infection (CDI. Thirteen studies assessed impact on patient outcomes including mortality, length of stay (LOS and readmission rates. Six of these 13 studies reported non-significant difference in mortality between pre- and post-ASP intervention, and five reported reductions in mortality rate. On LOS, six studies reported shorter LOS post intervention; a significant reduction was reported in one of these studies. Of note, this latter study reported significantly (p < 0.001 higher unplanned readmissions related to infections post-ASP. Patient outcomes need to be a key component of ASP evaluation. The choice of metrics is influenced by data and resource availability. Controlling for confounders must be considered in the design of

ONTOLOGY-DRIVEN TOOL FOR UTILIZING PROGRAMMING STYLES

Directory of Open Access Journals (Sweden)

Nikolay Sidorov

2017-07-01

Full Text Available Activities of a programmer will be more effective and the software will be more understandable when within the process of software development, programming styles (standards are used, providing clarity of software texts. Purpose: In this research, we present the tool for the realization of new ontology-based methodology automated reasoning techniques for utilizing programming styles. In particular, we focus on representing programming styles in the form of formal ontologies, and study how description logic reasoner can assist programmers in utilizing programming standards. Our research hypothesis is as follows: ontological representation of programming styles can provide additional benefits over existing approaches in utilizing programmer of programming standards. Our research goal is to develop a tool to support the ontology-based utilizing programming styles. Methods: ontological representation of programming styles; object-oriented programming; ontology-driven utilizing of programming styles. Results: the architecture was obtained and the tool was developed in the Java language, which provide tool support of ontology-driven programming styles application method. On the example of naming of the Java programming language standard, features of implementation and application of the tool are provided. Discussion: application of programming styles in coding of program; lack of automated tools for the processes of programming standards application; tool based on new method of ontology-driven application of programming styles; an example of the implementation of tool architecture for naming rules of the Java language standard.

Trends in Utility Green Pricing Programs (2006)

Energy Technology Data Exchange (ETDEWEB)

Bird, Lori [National Renewable Energy Lab. (NREL), Golden, CO (United States); Kaiser, Marshall [National Renewable Energy Lab. (NREL), Golden, CO (United States)

2007-10-01

In the early 1990s, only a handful of utilities offered their customers a choice of purchasing electricity generated from renewable energy sources. Today, more than 750 utilities—or about 25% of all utilities nationally—provide their customers a “green power” option. Through these programs, more than 70 million customers have the ability to purchase renewable energy to meet some portion or all of their electricity needs—or make contributions to support the development of renewable energy resources. Typically, customers pay a premium above standard electricity rates for this service. This report presents year-end 2006 data on utility green pricing programs, and examines trends in consumer response and program implementation over time. The data in this report, which were obtained via a questionnaire distributed to utility green pricing program managers, can be used by utilities to benchmark the success of their green power programs.

Participatory eHealth development to support nurses in antimicrobial stewardship

NARCIS (Netherlands)

Wentzel, Jobke; van Velsen, Lex; van Limburg, Maarten; de Jong, Nienke; Karreman, Joyce; Hendrix, Ron; van Gemert-Pi, Julia Elisabeth Wilhelmina Cornelia

2014-01-01

Background: Antimicrobial resistance poses a threat to patient safety worldwide. To stop antimicrobial resistance, Antimicrobial Stewardship Programs (ASPs; programs for optimizing antimicrobial use), need to be implemented. Within these programs, nurses are important actors, as they put

Participatory eHealth development to support nurses in antimicrobial stewardship

NARCIS (Netherlands)

Wentzel, M.J.; van Velsen, Lex Stefan; van Limburg, A.H.M.; Beerlage-de Jong, Nienke; Karreman, Joyce; Hendrix, Ron; van Gemert-Pijnen, Julia E.W.C.

2014-01-01

Background Antimicrobial resistance poses a threat to patient safety worldwide. To stop antimicrobial resistance, Antimicrobial Stewardship Programs (ASPs; programs for optimizing antimicrobial use), need to be implemented. Within these programs, nurses are important actors, as they put

Antimicrobial stewardship: Strategies for a global response

Directory of Open Access Journals (Sweden)

Jenny Grunwald

2014-01-01

Full Text Available The increasing antimicrobial resistance worldwide, combined with dwindling antimicrobial armamentarium, has resulted in a critical threat to the public health and safety of patients. To combat this hazard, antimicrobial stewardship programs (ASPs have emerged. Antimicrobial stewardship programs prevent or slow the emergence of antimicrobial resistance by coordinated interventions designed to optimize antimicrobial use to achieve the best clinical outcomes and limiting selective pressures that drive the emergence of resistance. This also reduces excessive costs attributable to suboptimal antimicrobial use. Even though an ideal effective ASP should incorporate more than one element simultaneously, it also requires a multidisciplinary team, which should include an infectious diseases physician, a clinical pharmacist with infectious diseases training, infection control professionals, hospital epidemiologist, a clinical microbiologist and an information specialist. However, for antimicrobial stewardship (AMS programs to be successful, they must address the specific needs of individual institutions, must be built on available resources, the limitations and advantages of each institution, and the available staffing and technological infrastructure.

Cost-effectiveness analysis of implementing an antimicrobial stewardship program in critical care units.

Science.gov (United States)

Ruiz-Ramos, Jesus; Frasquet, Juan; Romá, Eva; Poveda-Andres, Jose Luis; Salavert-Leti, Miguel; Castellanos, Alvaro; Ramirez, Paula

2017-06-01

To evaluate the cost-effectiveness of antimicrobial stewardship (AS) program implementation focused on critical care units based on assumptions for the Spanish setting. A decision model comparing costs and outcomes of sepsis, community-acquired pneumonia, and nosocomial infections (including catheter-related bacteremia, urinary tract infection, and ventilator-associated pneumonia) in critical care units with or without an AS was designed. Model variables and costs, along with their distributions, were obtained from the literature. The study was performed from the Spanish National Health System (NHS) perspective, including only direct costs. The Incremental Cost-Effectiveness Ratio (ICER) was analysed regarding the ability of the program to reduce multi-drug resistant bacteria. Uncertainty in ICERs was evaluated with probabilistic sensitivity analyses. In the short-term, implementing an AS reduces the consumption of antimicrobials with a net benefit of €71,738. In the long-term, the maintenance of the program involves an additional cost to the system of €107,569. Cost per avoided resistance was €7,342, and cost-per-life-years gained (LYG) was €9,788. Results from the probabilistic sensitivity analysis showed that there was a more than 90% likelihood that an AS would be cost-effective at a level of €8,000 per LYG. Wide variability of economic results obtained from the implementation of this type of AS program and short information on their impact on patient evolution and any resistance avoided. Implementing an AS focusing on critical care patients is a long-term cost-effective tool. Implementation costs are amortized by reducing antimicrobial consumption to prevent infection by multidrug-resistant pathogens.

Review of US utility demand-side bidding programs

International Nuclear Information System (INIS)

Goldman, C.A.; Kito, M.S.

1995-01-01

In this study, we review utility experiences with demand-side management (DSM) bidding programs. Since 1987, about 35 US utilities have signed long-term contracts with developers of DSM resources (ie energy service companies and customers) to provide a quantity of demand and energy savings at specified prices. Total resource costs range between 5.4 and 8 cents/kWh for DSM bidding programs where complete information on program costs is available. Almost all DSM bidding programs have been cost-effective compared with the utility's own supply-side alternatives, although there is substantial disagreement regarding the value of these programs compared with the utility's own DSM programs. In most bidding programs, payments to bidders account for between 70 and 90% of total program costs. Variation in winning bid prices is influenced primarily by DSM bid ceiling prices, differences in the mix of measures and markets targeted by developers, and the degree of performance risk borne by the DSM developer. Bids targeting residential customers averaged 6.2 cents/kWh compared with about 5.0 cents/kWh for commercial/industrial bids. We also compared the costs of acquiring lighting savings in DSM bidding contracts with a sample of 20 utility sponsored commercial/industrial lighting programs. We found that, on average total resource costs were slightly higher in bidding programs (6.1 vs 5.6 cents/kWh), although ratepayers bear significantly less performance risk in bidding programs compared with traditional utility-sponsored DSM programs. (author)

Electric-utility DSM programs in a competitive market

Energy Technology Data Exchange (ETDEWEB)

Hirst, E.

1994-04-01

During the past few years, the costs and effects of utility demand-side management (DSM) programs have grown sharply. In 1989, US electric utilities spent 0.5% of revenues on such programs and cut total electricity consumption by 0.6%. By 1992, these numbers had increased to 1.3% and 1.2%, respectively. Utility projections, as of early 1993, of DSM expenditures and energy savings for 1997 were 1.7% and 2.5%, respectively. Whether this projected growth comes to pass may depend on current debates about deregulation of, and increased competition in, the electric-utility industry. This report examines the factors likely to affect utility DSM programs in a more competitive environment. The electric-utility industry faces two forces that may conflict with each other. One is the pressure to open up both wholesale and retail markets for competition. The net effect of such competition, especially at the retail level, would have much greater emphasis on electricity prices and less emphasis on energy services. Such an outcome would force a sharp reduction in the scale of DSM programs that are funded by customers in general. The second force is increased concern about environmental quality and global warming. Because utilities are major contributors to US carbon dioxide emissions, the Administration`s Climate Change Action Plan calls on utilities to reduce such emissions. DSM programs are one key way to do that and, in the process, to cut customer electric bills and improve economic productivity. This report discusses the forms of competition and how they might affect DSM programs. It examines the important roles that state regulatory commissions could play to affect retail competition and utility DSM programs. The report also considers the effects of DSM programs on retail electricity prices.

Handbook of evaluation of utility DSM programs

Energy Technology Data Exchange (ETDEWEB)

Hirst, E.; Reed, J. [eds.; Bronfman, B.; Fitzpatrick, G.; Hicks, E.; Hirst, E.; Hoffman, M.; Keating, K.; Michaels, H.; Nadel, S.; Peters, J.; Reed, J.; Saxonis, W.; Schoen, A.; Violette, D.

1991-12-01

Program evaluation has become a central issue in the world of utility integrated resource planning. The DSM programs that utilities were operating to meet federal requirements or to improve customer relations are now becoming big business. DSM is being considered an important resource in a utility`s portfolio of options. In the last five years, the amount of money that utilities have invested in DSM has grown exponentially in most regulatory jurisdictions. Market analysts are now talking about DSM being a $30 billion industry by the end of the decade. If the large volume of DSM-program investments was not enough to highlight the importance of evaluation, then the introduction of regulatory incentives has really focused the spotlight. This handbook was developed through a process that involved many of those people who represent the diverse constituencies of DSM-program evaluation. We have come to recognize the many technical disciplines that must be employed to evaluate DSM programs. An analysis might start out based on the principles of utility load research to find out what happened, but a combination of engineering and statistical methods must be used to ``triangulate`` an estimate of what would have happened without the program. The difference, of course, is that elusive but prized result of evaluation: what happened as the direct result of the DSM program. Technical performance of DSM measures is not the sole determinant of the answer, either. We also recognize the importance of such behavioral attributes of DSM as persistence and free ridership. Finally, DSM evaluation is meaningless without attention to planning an approach, communicating results to relevant decision-makers, and focusing as much on the process as the impacts of the program. These topics are all covered in this handbook.

Point prevalence survey of antimicrobial utilization in a Canadian tertiary-care teaching hospital

Directory of Open Access Journals (Sweden)

Colin Lee

2015-06-01

Conclusion: This prospective point prevalence survey provided important baseline information on antimicrobial use within a large tertiary care teaching hospital and identified potential targets for future antimicrobial stewardship initiatives. A multi-center point prevalence survey should be considered to identify patterns of antimicrobial use in Canada and to establish the first steps toward international antimicrobial surveillance.

Behavioral approach to appropriate antimicrobial prescribing in hospitals: the Dutch Unique Method for Antimicrobial Stewardship (DUMAS) participatory intervention study.

NARCIS (Netherlands)

Sikkens, J.J.; Agtmael, M.A. van; Peters, E.J.G.; Lettinga, K.D.; Kuip, M. van der; Vandenbroucke-Grauls, C.M.J.E.; Wagner, C.; Kramer, M.H.H.

2017-01-01

Importance: Inappropriate antimicrobial prescribing leads to antimicrobial resistance and suboptimal clinical outcomes. Changing antimicrobial prescribing is a complex behavioral process that is not often taken into account in antimicrobial stewardship programs. Objective: To examine whether an

Beyond Widgets -- Systems Incentive Programs for Utilities

Energy Technology Data Exchange (ETDEWEB)

Regnier, Cindy [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Mathew, Paul [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Robinson, Alastair [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Schwartz, Peter [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Walter, Travis [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States)

2017-08-15

Utility incentive programs remain one of the most significant means of deploying commercialized, but underutilized building technologies to scale. However, these programs have been largely limited to component-based products (e.g., lamps, RTUs). While some utilities do provide ‘custom’ incentive programs with whole building and system level technical assistance, these programs require deeper levels of analysis, resulting in higher program costs. This results in custom programs being restricted to utilities with greater resources, and are typically applied mainly to large or energy-intensive facilities, leaving much of the market without cost effective access and incentives for these solutions. In addition, with increasingly stringent energy codes, cost effective component-based solutions that achieve significant savings are dwindling. Building systems (e.g., integrated façade, HVAC and/or lighting solutions) can deliver higher savings that translate into large sector-wide savings if deployed at the scale of these programs. However, systems application poses a number of challenges – baseline energy use must be defined and measured; the metrics for energy and performance must be defined and tested against; in addition, system savings must be validated under well understood conditions. This paper presents a sample of findings of a project to develop validated utility incentive program packages for three specific integrated building systems, in collaboration with Xcel Energy (CO, MN), ComEd, and a consortium of California Public Owned Utilities (CA POUs) (Northern California Power Agency(NCPA) and the Southern California Public Power Authority(SCPPA)). Furthermore, these program packages consist of system specifications, system performance, M&V protocols, streamlined assessment methods, market assessment and implementation guidance.

Antimicrobial stewardship in long term care facilities: what is effective?

OpenAIRE

Nicolle, Lindsay E

2014-01-01

Intense antimicrobial use in long term care facilities promotes the emergence and persistence of antimicrobial resistant organisms and leads to adverse effects such as C. difficile colitis. Guidelines recommend development of antimicrobial stewardship programs for these facilities to promote optimal antimicrobial use. However, the effectiveness of these programs or the contribution of any specific program component is not known. For this review, publications describing evaluation of antimicro...

Retrospective Evaluation of Pharmacist Interventions on Use of Antimicrobials Using a Clinical Surveillance Software in a Small Community Hospital

Directory of Open Access Journals (Sweden)

Samuel R. Huber

2016-10-01

Full Text Available The Infectious Diseases Society of America and the Society for Healthcare Epidemiology of America “Guidelines for Developing an Institutional Program to Enhance Antimicrobial Stewardship” recommend the use of computer-based surveillance programs for efficient and thorough identification of potential interventions as part of an antimicrobial stewardship program (ASP. This retrospective study examined the benefit of utilizing a clinical surveillance software program to help guide antimicrobial therapy in an inpatient setting, in a small community hospital, without a formal ASP. The electronic health record (EHR was used to retrieve documentations for the following types of antibiotic interventions: culture surveillance, duplicate therapy, duration of therapy and renal dose adjustments. The numbers of interventions made during the three-month periods before and after implementation of the clinical surveillance software were compared. Antibiotic related interventions aggregated to 144 and 270 in the pre- and post-implementation time frame, respectively (p < 0.0001. The total number of antibiotic interventions overall and interventions in three of the four sub-categories increased significantly from the pre-implementation to post-implementation period. Clinical surveillance software is a valuable tool to assist pharmacists in evaluating antimicrobial therapy.

Antimicrobial stewardship: attempting to preserve a strategic resource

Directory of Open Access Journals (Sweden)

Trevor Van Schooneveld, Md

2011-07-01

Full Text Available Antimicrobials hold a unique place in our drug armamentarium. Unfortunately the increase in resistance among both gram-positive and gram-negative pathogens coupled with a lack of new antimicrobial agents is threatening our ability to treat infections. Antimicrobial use is the driving force behind this rise in resistance and much of this use is suboptimal. Antimicrobial stewardship programs (ASP have been advocated as a strategy to improve antimicrobial use. The goals of ASP are to improve patient outcomes while minimizing toxicity and selection for resistant strains by assisting in the selection of the correct agent, right dose, and best duration. Two major strategies for ASP exist: restriction/pre-authorization that controls use at the time of ordering and audit and feedback that reviews ordered antimicrobials and makes suggestions for improvement. Both strategies have some limitations, but have been effective at achieving stewardship goals. Other supplemental strategies such as education, clinical prediction rules, biomarkers, clinical decision support software, and institutional guidelines have been effective at improving antimicrobial use. The most effective antimicrobial stewardship programs have employed multiple strategies to impact antimicrobial use. Using these strategies stewardship programs have been able to decrease antimicrobial use, the spread of resistant pathogens, the incidence of C. difficile infection, pharmacy costs, and improved patient outcomes.

Antimicrobial stewardship in long term care facilities: what is effective?

Science.gov (United States)

Nicolle, Lindsay E

2014-02-12

Intense antimicrobial use in long term care facilities promotes the emergence and persistence of antimicrobial resistant organisms and leads to adverse effects such as C. difficile colitis. Guidelines recommend development of antimicrobial stewardship programs for these facilities to promote optimal antimicrobial use. However, the effectiveness of these programs or the contribution of any specific program component is not known. For this review, publications describing evaluation of antimicrobial stewardship programs for long term care facilities were identified through a systematic literature search. Interventions included education, guidelines development, feedback to practitioners, and infectious disease consultation. The studies reviewed varied in types of facilities, interventions used, implementation, and evaluation. Comprehensive programs addressing all infections were reported to have improved antimicrobial use for at least some outcomes. Targeted programs for treatment of pneumonia were minimally effective, and only for indicators of uncertain relevance for stewardship. Programs focusing on specific aspects of treatment of urinary infection - limiting treatment of asymptomatic bacteriuria or prophylaxis of urinary infection - were reported to be effective. There were no reports of cost-effectiveness, and the sustainability of most of the programs is unclear. There is a need for further evaluation to characterize effective antimicrobial stewardship for long term care facilities.

Antimicrobial susceptibilities of Proteus mirabilis: a longitudinal nationwide study from the Taiwan surveillance of antimicrobial resistance (TSAR) program.

Science.gov (United States)

Wang, Jann-Tay; Chen, Pei-Chen; Chang, Shan-Chwen; Shiau, Yih-Ru; Wang, Hui-Ying; Lai, Jui-Fen; Huang, I-Wen; Tan, Mei-Chen; Lauderdale, Tsai-Ling Yang

2014-09-05

Longitudinal nationwide data on antimicrobial susceptibility in Proteus mirabilis from different sources are rare. The effects of the revised Clinical and Laboratory Standards Institute (CLSI) β-lactam breakpoints on susceptibility rates and on detecting extended-spectrum β-lactamase (ESBL) and AmpC β-lactamase-producers in this species are also seldom evaluated. The present study analyzed data from the Taiwan Surveillance of Antimicrobial Resistance program to address these issues. Isolates were collected biennially between 2002 and 2012 from 25 to 28 hospitals in Taiwan. Minimum inhibitory concentrations (MIC) were determined by reference broth microdilution method. All isolates with aztreonam, ceftazidime, or cefotaxime MIC ≥ 2 mg/L were checked for the presence of ESBL by CLSI confirmatory test and subjected to ESBL and AmpC β-lactamases gene detection by PCR. Univariate and multivariate analyses were performed. Between 2002 and 2012, a total of 1157 P. mirabilis were studied. Susceptibility to cefotaxime, ceftazidime, and ciprofloxacin decreased significantly during the past decade, from 92.6% to 81.7%, 100% to 95.2%, and 80.1% to 53.8%, respectively (P mirabilis from Taiwan in the past decade. The prevalence of ESBL remained stable but AmpC β-lactamase-producing P. mirabilis increased significantly. Cefotaxime was a better surrogate than ceftazidime for predicting the presence of these β-lactamases. Continuous surveillance on antimicrobial resistance and associated resistance mechanisms in P. mirabilis is warranted.

Impact of an Antimicrobial Stewardship Program on Antibiotic Use at a Nonfreestanding Children's Hospital.

Science.gov (United States)

Turner, R Brigg; Valcarlos, Elena; Loeffler, Ann M; Gilbert, Michael; Chan, Dominic

2017-09-01

Pediatric stewardship programs have been successful at reducing unnecessary antibiotic use. Data from nonfreestanding children's hospitals are currently limited. This study is an analysis of antibiotic use after implementation of an antimicrobial stewardship program at a community nonfreestanding children's hospital. In April 2013, an antimicrobial stewardship program that consisted of physician-group engagement and pharmacist prospective auditing and feedback was initiated. We compared antibiotic use in the preintervention period (April 2012 to March 2013) with that in the postintervention period (April 2013 to March 2015) in all units except the neonatal intensive care unit and the emergency department. In addition, drug-acquisition costs, antibiotic-specific use, death, length of stay, and case-mix index were examined. Antibiotic use decreased by 16.8% (95% confidence interval, 18.0% to -9.2%; P antibiotic use without an overt negative impact on overall clinical outcomes. The results of this study suggest that nonfreestanding children's hospitals can achieve substantial reductions in antibiotic use despite limited resources. © The Author 2016. Published by Oxford University Press on behalf of the Pediatric Infectious Diseases Society. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.

How externalities impact an evaluation of strategies to prevent antimicrobial resistance in health care organizations

Directory of Open Access Journals (Sweden)

Jenine R. Leal

2017-06-01

Full Text Available Abstract Background The rates of antimicrobial-resistant organisms (ARO continue to increase for both hospitalized and community patients. Few resources have been allocated to reduce the spread of resistance on global, national and local levels, in part because the broader economic impact of antimicrobial resistance (i.e. the externality is not fully considered when determining how much to invest to prevent AROs, including strategies to contain antimicrobial resistance, such as antimicrobial stewardship programs. To determine how best to measure and incorporate the impact of externalities associated with the antimicrobial resistance when making resource allocation decisions aimed to reduce antimicrobial resistance within healthcare facilities, we reviewed the literature to identify publications which 1 described the externalities of antimicrobial resistance, 2 described approaches to quantifying the externalities associated with antimicrobial resistance or 3 described macro-level policy options to consider the impact of externalities. Medline was reviewed to identify published studies up to September 2016. Main body An externality is a cost or a benefit associated with one person’s activity that impacts others who did not choose to incur that cost or benefit. We did not identify a well-accepted method of accurately quantifying the externality associated with antimicrobial resistance. We did identify three main methods that have gained popularity to try to take into account the externalities of antimicrobial resistance, including regulation, charges or taxes on the use of antimicrobials, and the right to trade permits or licenses for antimicrobial use. To our knowledge, regulating use of antimicrobials is the only strategy currently being used by health care systems to reduce antimicrobial use, and thereby reduce AROs. To justify expenditures on programs that reduce AROs (i.e. to formally incorporate the impact of the negative externality of

Federal Energy Efficiency through Utility Partnerships: Federal Energy Management Program (FEMP) Program Overview Fact Sheet

International Nuclear Information System (INIS)

Beattie, D.; Wolfson, M.

2001-01-01

This Utility Program Overview describes how the Federal Energy Management Program (FEMP) utility program assists Federal energy managers. The document identifies both a utility financing mechanism and FEMP technical assistance available to support agencies' implementation of energy and water efficiency methods and renewable energy projects

Renewable Energy Price-Stability Benefits in Utility Green Power Programs

Energy Technology Data Exchange (ETDEWEB)

Bird, L. A.; Cory, K. S.; Swezey, B. G.

2008-08-01

This paper examines utility experiences when offering the fixed-price benefits of renewable energy in green pricing programs, including the methods utilized and the impact on program participation. It focuses primarily on utility green pricing programs in states that have not undergone electric industry restructuring.

EPRI Guide to Managing Nuclear Utility Protective Clothing Programs

International Nuclear Information System (INIS)

Kelly, J.J.; Kelly, D.M.

1993-10-01

The Electric Power Research Institute (EPRI) commissioned a radioactive waste related project (RP2414-34) in 1989 to produce a guide for developing and managing nuclear plant protective clothing programs. Every nuclear facility must coordinate some type of protective clothing program for its radiation workers to ensure proper and safe protection for the wearer and to maintain control over the spread of contamination. Yet, every nuclear facility has developed its own unique program for managing such clothing. Accordingly, a need existed for a reference guide to assist with standardizing protective clothing programs and in controlling the potentially escalating economics of such programs. The initial Guide to Managing Nuclear Utility Protective Clothing Programs, NP-7309, was published in May 1991. Since that time, a number of utilities have reviewed and/or used the report to enhance their protective clothing programs. Some of these utilities requested that a computer program be developed to assist utilities in evaluating the economics of protective clothing programs consistent with the guidance in NP-7309. The PCEVAL computer code responds to that industry need. This report, the PCEVAL User's Manual, provides detailed instruction on use of the software

U.S. utilities' experiences with the implementation of energy efficiency programs

Science.gov (United States)

Goss, Courtney

In the U.S., many electric utility companies are offering demand-side management (DSM) programs to their customers as ways to save money and energy. However, it is challenging to compare these programs between utility companies throughout the U.S. because of the variability of state energy policies. For example, some states in the U.S. have deregulated electricity markets and others do not. In addition, utility companies within a state differ depending on ownership and size. This study examines 12 utilities' experiences with DSM programs and compares the programs' annual energy savings results that the selected utilities reported to the Energy Information Administration (EIA). The 2009 EIA data suggests that DSM program effectiveness is not significantly affected by electricity market deregulation or utility ownership. However, DSM programs seem to generally be more effective when administered by utilities located in states with energy savings requirements and DSM program mandates.

OPTIMIZING ANTIMICROBIAL PHARMACODYNAMICS: A GUIDE FOR YOUR STEWARDSHIP PROGRAM

Directory of Open Access Journals (Sweden)

Joseph L. Kuti, PharmD

2016-09-01

Full Text Available Pharmacodynamic concepts should be applied to optimize antibiotic dosing regimens, particularly in the face of some multidrug resistant bacterial infections. Although the pharmacodynamics of most antibiotic classes used in the hospital setting are well described, guidance on how to select regimens and implement them into an antimicrobial stewardship program in one's institution are more limited. The role of the antibiotic MIC is paramount in understanding which regimens might benefit from implementation as a protocol or use in individual patients. This review article outlines the pharmacodynamics of aminoglycosides, beta-lactams, fluoroquinolones, tigecycline, vancomycin, and polymyxins with the goal of providing a basis for strategy to select an optimized antibiotic regimen in your hospital setting.

Effect of a Health Care System Respiratory Fluoroquinolone Restriction Program To Alter Utilization and Impact Rates of Clostridium difficile Infection.

Science.gov (United States)

Shea, Katherine M; Hobbs, Athena L V; Jaso, Theresa C; Bissett, Jack D; Cruz, Christopher M; Douglass, Elizabeth T; Garey, Kevin W

2017-06-01

Fluoroquinolones are one of the most commonly prescribed antibiotic classes in the United States despite their association with adverse consequences, including Clostridium difficile infection (CDI). We sought to evaluate the impact of a health care system antimicrobial stewardship-initiated respiratory fluoroquinolone restriction program on utilization, appropriateness of quinolone-based therapy based on institutional guidelines, and CDI rates. After implementation, respiratory fluoroquinolone utilization decreased from a monthly mean and standard deviation (SD) of 41.0 (SD = 4.4) days of therapy (DOT) per 1,000 patient days (PD) preintervention to 21.5 (SD = 6.4) DOT/1,000 PD and 4.8 (SD = 3.6) DOT/1,000 PD posteducation and postrestriction, respectively. Using segmented regression analysis, both education (14.5 DOT/1,000 PD per month decrease; P = 0.023) and restriction (24.5 DOT/1,000 PD per month decrease; P cost of moxifloxacin, the formulary respiratory fluoroquinolone, was observed postrestriction compared to preintervention within the health care system ($123,882 versus $12,273; P = 0.002). Implementation of a stewardship-initiated respiratory fluoroquinolone restriction program can increase appropriate use while reducing overall utilization, acquisition cost, and CDI rates within a health care system. Copyright © 2017 American Society for Microbiology.

Antimicrobial use surveillance in broiler chicken flocks in Canada, 2013-2015.

Science.gov (United States)

Agunos, Agnes; Léger, David F; Carson, Carolee A; Gow, Sheryl P; Bosman, Angelina; Irwin, Rebecca J; Reid-Smith, Richard J

2017-01-01

There is a paucity of data on the reason for and the quantity of antimicrobials used in broiler chickens in Canada. To address this, the Canadian Integrated Program for Antimicrobial Resistance Surveillance (CIPARS) implemented surveillance of antimicrobial use (AMU) and antimicrobial resistance (AMR) in broiler chicken flocks in 2013. Shortly after this (2014), the poultry industry banned the preventive use of ceftiofur in broiler chickens. The objectives of this analysis were to describe antimicrobial use (AMU) in Canadian broiler chickens between 2013 and 2015 (n = 378 flocks), compare these results to other animal species in Canada, to highlight the utility of farm surveillance data to evaluate the impact of a policy change, and to explore how different antimicrobial use metrics might affect data interpretation and communication. The surveillance data indicated that the poultry industry policy resulted in lower antimicrobial use and resistance, and they successfully captured information on when, where, why, and how much antimicrobials were being used. The majority of antimicrobials were administered via the feed (95%). The relative frequency of antimicrobial classes used in broiler chickens differed from those used in swine or in food animal production in general. Coccidiostats were the most frequently used antimicrobial classes (53% of total kg). Excluding coccidiostats, the top three most frequently used antimicrobial classes were bacitracin (53% of flocks), virginiamycin (25%) and avilamycin (21%), mainly used for the prevention of necrotic enteritis. Depending on the AMU metric utilized, the relative rankings of the top antimicrobials changed; hence the choice of the AMU metric is an important consideration for any AMU reporting. When using milligrams/Population Correction Unit (mg/PCU) the top three antimicrobial classes used were bacitracins (76 mg/PCU), trimethoprim-sulfonamides (24 mg/PCU), and penicillins (15 mg/PCU), whereas when using a number of

Antimicrobial use surveillance in broiler chicken flocks in Canada, 2013-2015.

Directory of Open Access Journals (Sweden)

Agnes Agunos

Full Text Available There is a paucity of data on the reason for and the quantity of antimicrobials used in broiler chickens in Canada. To address this, the Canadian Integrated Program for Antimicrobial Resistance Surveillance (CIPARS implemented surveillance of antimicrobial use (AMU and antimicrobial resistance (AMR in broiler chicken flocks in 2013. Shortly after this (2014, the poultry industry banned the preventive use of ceftiofur in broiler chickens. The objectives of this analysis were to describe antimicrobial use (AMU in Canadian broiler chickens between 2013 and 2015 (n = 378 flocks, compare these results to other animal species in Canada, to highlight the utility of farm surveillance data to evaluate the impact of a policy change, and to explore how different antimicrobial use metrics might affect data interpretation and communication. The surveillance data indicated that the poultry industry policy resulted in lower antimicrobial use and resistance, and they successfully captured information on when, where, why, and how much antimicrobials were being used. The majority of antimicrobials were administered via the feed (95%. The relative frequency of antimicrobial classes used in broiler chickens differed from those used in swine or in food animal production in general. Coccidiostats were the most frequently used antimicrobial classes (53% of total kg. Excluding coccidiostats, the top three most frequently used antimicrobial classes were bacitracin (53% of flocks, virginiamycin (25% and avilamycin (21%, mainly used for the prevention of necrotic enteritis. Depending on the AMU metric utilized, the relative rankings of the top antimicrobials changed; hence the choice of the AMU metric is an important consideration for any AMU reporting. When using milligrams/Population Correction Unit (mg/PCU the top three antimicrobial classes used were bacitracins (76 mg/PCU, trimethoprim-sulfonamides (24 mg/PCU, and penicillins (15 mg/PCU, whereas when using a number

75 FR 16111 - Antimicrobial Pesticide Products; Registration Applications

Science.gov (United States)

2010-03-31

... ENVIRONMENTAL PROTECTION AGENCY [EPA-HQ-OPP-2009-0935; FRL-8807-1] Antimicrobial Pesticide... . List of Subjects Environmental protection, Antimicrobial pesticides and pest. Dated: March 15, 2010. Joan Harrigan Farrelly, Director, Antimicrobial Division, Office of Pesticide Programs. [FR Doc. 2010...

Utility Green Pricing Programs: Design, Implementation, and Consumer Response

Energy Technology Data Exchange (ETDEWEB)

Bird, L.; Swezey, B.; Aabakken, J.

2004-02-01

The term green pricing refers to programs offered by utilities in traditionally regulated electricity markets, which allow customers to support the development of renewable energy sources by paying a small premium on their electric bills. Since the introduction of the concept in the United States, the number of unique utility green pricing programs has expanded from just a few programs in 1993 to more than 90 in 2002. About 10% of U.S. utilities offered a green pricing option to about 26 million consumers by the end of 2002. This report provides: (1) aggregate industry data on consumer response to utility programs, which indicate the collective impact of green pricing on renewable energy development nationally; and (2) market data that can be used by utilities as a benchmark for gauging the relative success of their green pricing programs. Specifically, the paper presents current data and trends in consumer response to green pricing, as measured by renewable energy sales, participants, participation rates, and new renewable energy capacity supported. It presents data on various aspects of program design and implementation, such as product pricing, ownership of supplies, retention rates, marketing costs, the effectiveness of marketing techniques, and methods of enrolling and providing value to customers.

The effects of utility DSM programs on electricity costs and prices

Energy Technology Data Exchange (ETDEWEB)

Hirst, E.

1991-11-01

More and more US utilities are running more and larger demand-side management (DSM) programs. Assessing the cost-effectiveness of these programs raises difficult questions for utilities and their regulators. Should these programs aim to minimize the total cost of providing electric-energy services or should they minimize the price of electricity? This study offers quantitative estimates on the tradeoffs between total costs and electricity prices. This study uses a dynamic model to assess the effects of energy-efficiency programs on utility revenues, total resource costs, electricity prices, and electricity consumption for the period 1990 to 2010. These DSM programs are assessed under alternative scenarios. In these cases, fossil-fuel prices, load growth, the amount of excess capacity the utility has in 1990, planned retirements of power plants, the financial treatment of DSM programs, and the costs of energy- efficient programs vary. These analyses are conducted for three utilities: a ``base`` that is typical of US utilities; a ``surplus`` utility that has excess capacity, few planned retirements, and slow growth in fossil-fuel prices and incomes; and a ``deficit`` utility that has little excess capacity, many planned retirements, and rapid growth in fossil-fuel prices and incomes. 28 refs.

The Establishment of the Colombian Integrated Program for Antimicrobial Resistance Surveillance (COIPARS): A Pilot Project on Poultry Farms, Slaughterhouses and Retail Market.

Science.gov (United States)

Donado-Godoy, P; Castellanos, R; León, M; Arevalo, A; Clavijo, V; Bernal, J; León, D; Tafur, M A; Byrne, B A; Smith, W A; Perez-Gutierrez, E

2015-04-01

The development of antimicrobial resistance among bacteria (AMR) is currently one of the world's most pressing public health problems. The use of antimicrobial agents in humans and animals has resulted in AMR which has narrowed the potential use of antibiotics for the treatment of infections in humans. To monitor AMR and to develop control measures, some countries, such as the USA, Canada and Denmark, have established national integrated surveillance systems (FDA, , CIPARS, 2007, DANMAP,2002). The components of these programs monitor changes in susceptibility/resistance to antimicrobial agents of selected zoonotic pathogens and commensal organisms recovered from animals, retail meats and humans. The rapid development of Colombia's animal production industry has raised food safety issues including the emergence of antibiotic resistance. The Colombian Integrated Surveillance Program for Antimicrobial Resistance (COIPARS) was established as a pilot project to monitor AMR on poultry farms, slaughter houses and retail markets. © 2015 Blackwell Verlag GmbH.

Macromolecular agents with antimicrobial potentialities: A drive to combat antimicrobial resistance.

Science.gov (United States)

Bilal, Muhammad; Rasheed, Tahir; Iqbal, Hafiz M N; Hu, Hongbo; Wang, Wei; Zhang, Xuehong

2017-10-01

In recent years, the antimicrobial resistance (AMR) or multidrug resistance (MDR) has become a serious health concern and major challenging issue, worldwide. After decades of negligence, the AMR has now captured global attention. The increasing number of antibiotic-resistant strains has threatened the achievements of science and medicine since it inactivates conventional antimicrobial therapeutics. Scientists are trying to respond to AMR/MDR threat by exploring innovative platforms and new therapeutic strategies to tackle infections from these resistant strains and bypass treatment limitations related to these pathologies. The present review focuses on the utilization of bio-inspired novel constructs and their potential applications as novel antimicrobial agents. The first part of the review describes plant-based biological macromolecules containing an immense variety of secondary metabolites, which could be potentially used as alternative strategies to combat antimicrobial resistance. The second part discusses the potential of metal-based macromolecules as effective antimicrobial platforms for preventing infections from resistant strains. The third part comprehensively elucidates how nanoparticles, in particular, metal-integrated nanoparticles can overcome this AMR or MDR issue. Towards the end, information is given with critical concluding remarks, gaps, and finally envisioned with future considerations. Copyright © 2017 Elsevier B.V. All rights reserved.

Utility battery storage systems. Program report for FY95

Energy Technology Data Exchange (ETDEWEB)

Butler, P.C.

1996-03-01

Sandia National Laboratories, New Mexico, conducts the Utility Battery Storage Systems Program, which is sponsored by the U.S. Department of Energy`s Office of Utility Technologies. The goal of this program is to assist industry in developing cost-effective battery systems as a utility resource option by 2000. Sandia is responsible for the engineering analyses, contracted development, and testing of rechargeable batteries and systems for utility energy storage applications. This report details the technical achievements realized during fiscal year 1995.

Utility Green-Pricing Programs: What Defines Success? (Topical Issues Brief)

Energy Technology Data Exchange (ETDEWEB)

Swezey, B.; Bird, L.

2001-09-13

''Green pricing'' is an optional service through which customers can support a greater level of investment by their electric utility in renewable energy technologies. Electric utilities in 29 states are now implementing green-pricing programs. This report examines important elements of green-pricing programs, including the different types of programs offered, the premiums charged, customer response, and additional factors that experience indicates are key to the development of successful programs. The best-performing programs tend to share a number of common attributes related to product design, value creation, product pricing, and program implementation. The report ends with a list of ''best practices'' for utilities to follow when developing and implementing programs.

Improving utility conservation programs: outcomes, interventions, and evaluations

Energy Technology Data Exchange (ETDEWEB)

Condelli, L; Archer, D; Aronson, E; Curbow, B; McLeod, B; Pettigrew, T F; White, L T; Yates, S

1984-06-01

Four major California utility companies have active energy conservation programs mandated by the State's Public Utilities Commission (CPUC). These companies evaluate their programs and send reports of the evaluations to the CPUC. A review of 213 of these reports revealed a marketing research approach toward promoting conservation. Advertising and informational campaigns characterize most programs, and attitudes and self-reported behavior were the major outcome measures. This approach is shown to be ineffective. Suggestions for improvement include: (1) the use of actual energy consumption as the primary outcome measure in evaluating conservation programs; (2) the abandonment of conventional advertising, and the use of it only for the promotion of ''hard'' interventions; (3) increased use of social diffusion methods to disseminate information; (4) the design of more effective educational material by incorporating cognitive social psychological principles; and (5) the utilization of ''hard'' interventions that have a direct, verifiable link to conservation.

Longitudinal evaluation of a World Wide Web-based antimicrobial stewardship program: assessing factors associated with approval patterns and trends over time.

Science.gov (United States)

Venugopal, Vidya; Lehmann, Christoph U; Diener-West, Marie; Agwu, Allison L

2014-02-01

The Johns Hopkins Children's Medical and Surgery Center developed a Web-based Antimicrobial Stewardship Program (ASP) in 2005. The present study aimed to assess longitudinal antimicrobial request and approval patterns for this ASP. We analyzed a total of 16,229 antimicrobial requests for 3,542 patients between June 1, 2005, and June 30, 2009. Antimicrobial approval was the outcome of interest. We assessed gaming by studying trends in automatically approved requests. Nonparametric tests for trend were performed to detect changes in approval patterns. Multiple logistic regression was used to identify factors associated with approval. The vast majority (91.3%) of antimicrobial requests were approved, with an increase of 6.1% over time (P Web-based ASP allows management of a large number of antimicrobial requests, without apparent gaming. Observed differences in approval patterns based on patient, requestor, and antimicrobial factors may inform the development of ASPs and evaluation of provider education and training. Copyright © 2014 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Mosby, Inc. All rights reserved.

MOCUP, MCNP/ORIGEN Coupling Utility Programs

International Nuclear Information System (INIS)

SEIDL, Marcus

2003-01-01

1 - Description of program or function: MOCUP is a series of utility and data manipulation programs to solve time and space-dependent coupled neutronics/isotopics problems. 2 - Methods: The neutronics calculation is performed by the Los Alamos National Laboratory code system, version 4a or later (CCC-200 or CCC-660),and the depletion and isotopics calculation is performed by CCC-371/ORIGEN2.1 developed at Oak Ridge National Laboratory. MCNP and ORIGEN2.1 are NOT included in this package. MOCUP consists of three utility programs (mcnpPRO, origenPRO, compPRO) to, respectively, search the MCNP output and tally files for relevant cell and tally parameters, prepare ORIGEN2.1 input files and execute the ORIGEN2.1 runs, and search ORIGEN2.1 punch files for relevant isotope concentrations and produce new MCNP input files. A graphical user interface is provided for execution convenience. 3 - Restrictions on the complexity of the problem: At present, no mechanism exists for automatic serial execution of the program modules. The user must interface with the GUI to run each of the modules

The effects of utility DSM programs on electricity costs and prices

Energy Technology Data Exchange (ETDEWEB)

Hirst, E.

1991-11-01

More and more US utilities are running more and larger demand-side management (DSM) programs. Assessing the cost-effectiveness of these programs raises difficult questions for utilities and their regulators. Should these programs aim to minimize the total cost of providing electric-energy services or should they minimize the price of electricity This study offers quantitative estimates on the tradeoffs between total costs and electricity prices. This study uses a dynamic model to assess the effects of energy-efficiency programs on utility revenues, total resource costs, electricity prices, and electricity consumption for the period 1990 to 2010. These DSM programs are assessed under alternative scenarios. In these cases, fossil-fuel prices, load growth, the amount of excess capacity the utility has in 1990, planned retirements of power plants, the financial treatment of DSM programs, and the costs of energy- efficient programs vary. These analyses are conducted for three utilities: a base'' that is typical of US utilities; a surplus'' utility that has excess capacity, few planned retirements, and slow growth in fossil-fuel prices and incomes; and a deficit'' utility that has little excess capacity, many planned retirements, and rapid growth in fossil-fuel prices and incomes. 28 refs.

Deep Learning Improves Antimicrobial Peptide Recognition.

Science.gov (United States)

Veltri, Daniel; Kamath, Uday; Shehu, Amarda

2018-03-24

Bacterial resistance to antibiotics is a growing concern. Antimicrobial peptides (AMPs), natural components of innate immunity, are popular targets for developing new drugs. Machine learning methods are now commonly adopted by wet-laboratory researchers to screen for promising candidates. In this work we utilize deep learning to recognize antimicrobial activity. We propose a neural network model with convolutional and recurrent layers that leverage primary sequence composition. Results show that the proposed model outperforms state-of-the-art classification models on a comprehensive data set. By utilizing the embedding weights, we also present a reduced-alphabet representation and show that reasonable AMP recognition can be maintained using nine amino-acid types. Models and data sets are made freely available through the Antimicrobial Peptide Scanner vr.2 web server at: www.ampscanner.com. amarda@gmu.edu for general inquiries and dan.veltri@gmail.com for web server information. Supplementary data are available at Bioinformatics online.

Potential Negative Effects of Antimicrobial Allergy Labelling on Patient Care: A Systematic Review.

Science.gov (United States)

Wu, Julie Hui-Chih; Langford, Bradley J; Schwartz, Kevin L; Zvonar, Rosemary; Raybardhan, Sumit; Leung, Valerie; Garber, Gary

2018-01-01

Antimicrobial allergy labels, either self-reported or placed in a patient's medical record, are common, but in many cases they are not associated with a true immunoglobulin E-mediated allergic response. To assess the impact of antimicrobial allergy labels on antimicrobial prescribing, resource utilization, and clinical outcomes. The MEDLINE, Embase, CINAHL, and Scopus electronic databases were searched for the period 1990 to January 2016. Controlled studies with the objective of assessing antimicrobial prescribing, resource utilization, and/or clinical outcomes associated with antimicrobial allergy labels were included. The search identified 560 unique citations, of which 7 articles met the inclusion criteria. One additional article identified by an expert in the field was also included. Four of the identified papers were limited to penicillin or other β-lactam allergies. Six studies noted differences in antibiotic selection between patients with allergy labels and those without such labels. Broader-spectrum or second-line agents (e.g., vancomycin, clindamycin, and fluoroquinolones) were more commonly prescribed for patients with penicillin allergy labels. Antibiotic therapy costs were significantly higher for patients with allergy labels than for those without. The impact of allergy labels on clinical outcomes was mixed. One study indicated a longer length of hospital stay, 2 studies reported higher readmission rates, and 1 study reported a higher rate of antibiotic-resistant organisms for patients with allergy labels. Most of the available literature is limited to penicillin or β-lactam allergy. The growing body of knowledge supports the concept that β-lactam allergy labels are not benign and that labelling in the absence of a true allergy has a negative effect on patient care. Allergy labelling appears to be associated with suboptimal antibiotic selection, greater treatment costs, prolonged length of stay, greater readmission rates, and higher prevalence of

Controversies in Antimicrobial Stewardship: Focus on New Rapid Diagnostic Technologies and Antimicrobials

Directory of Open Access Journals (Sweden)

Eric Wenzler

2016-01-01

Full Text Available Antimicrobial stewardship programs (ASPs are challenged with ensuring appropriate antimicrobial use while minimizing expenditures. ASPs have consistently demonstrated improved patient outcomes and significant cost reductions but are continually required to justify the costs of their existence and interventions due to the silo mentality often adopted by hospital administrators. As new technologies and antimicrobials emerge, ASPs are in a constant tug-of-war between providing optimal clinical outcomes and ensuring cost containment. Additionally, robust data on cost-effectiveness of new rapid diagnostic technologies and antimicrobials with subsequent ASP interventions to provide justification are lacking. As the implementation of an ASP will soon be mandatory for acute care hospitals in the United States, ASPs must find ways to justify novel interventions to align themselves with healthcare administrators. This review provides a framework for the justification of implementing a rapid diagnostic test or adding a new antimicrobial to formulary with ASP intervention, reviews approaches to demonstrating cost-effectiveness, and proposes methods for which ASPs may reduce healthcare expenditures via alternative tactics.

Utility Green-Pricing Programs: What Defines Success? (Topical Issues Brief); TOPICAL

International Nuclear Information System (INIS)

Swezey, B.; Bird, L.

2001-01-01

''Green pricing'' is an optional service through which customers can support a greater level of investment by their electric utility in renewable energy technologies. Electric utilities in 29 states are now implementing green-pricing programs. This report examines important elements of green-pricing programs, including the different types of programs offered, the premiums charged, customer response, and additional factors that experience indicates are key to the development of successful programs. The best-performing programs tend to share a number of common attributes related to product design, value creation, product pricing, and program implementation. The report ends with a list of ''best practices'' for utilities to follow when developing and implementing programs

Antimicrobial stewardship in small animal veterinary practice

DEFF Research Database (Denmark)

Guardabassi, Luca; Prescott, John F

2015-01-01

Despite the increasing recognition of the critical role for antimicrobial stewardship in preventing the spread of multidrug-resistant bacteria, examples of effective antimicrobial stewardship programs are rare in small animal veterinary practice. This article highlights the basic requirements...

Utility battery storage systems program report for FY 94

Energy Technology Data Exchange (ETDEWEB)

Butler, P.C.

1995-03-01

Sandia National Laboratories, New Mexico, conducts the Utility Battery Storage Systems Program, which is sponsored by the US Department of Energy`s Office of Energy Management. The goal of this program is to assist industry in developing cost-effective battery systems as a utility resource option by 2000. Sandia is responsible for the engineering analyses, contracted development, and testing of rechargeable batteries and systems for utility energy storage applications. This report details the technical achievements realized during fiscal year 1994.

Cyclodextrins: A Weapon in the Fight Against Antimicrobial Resistance

Science.gov (United States)

Wong, Chew Ee; Dolzhenko, Anton V.; Lee, Sui Mae; Young, David James

Antimicrobial resistance poses one of the most serious global challenges of our age. Cyclodextrins (CDs) are widely utilized excipients in formulations because of their solubilizing properties, low toxicity, and low inflammatory response. This review summarizes recent investigations of antimicrobial agents involving CDs and CD-based antimicrobial materials. CDs have been employed for antimicrobial applications either through formation of inclusion complexes or by chemical modification of their hydroxyl groups to tailor pharmaceutically active compounds. Applications of these CD inclusion complexes include drug delivery, antimicrobial coatings on materials (e.g., biomedical devices and implants) and antimicrobial dressings that help to prevent wound infections. There are relatively limited studies of chemically modified CDs with antimicrobial activity. The mechanism of action of antimicrobial CD inclusion complexes and derivatives needs further elucidation, but activity of CDs and their derivatives is often associated with their interaction with bacterial cell membranes.

Antimicrobial stewardship activities: a survey of Queensland hospitals.

Science.gov (United States)

Avent, Minyon L; Hall, Lisa; Davis, Louise; Allen, Michelle; Roberts, Jason A; Unwin, Sean; McIntosh, Kylie A; Thursky, Karin; Buising, Kirsty; Paterson, David L

2014-11-01

In 2011, the Australian Commission on Safety and Quality in Health Care (ACSQHC) recommended that all hospitals in Australia must have an Antimicrobial Stewardship (AMS) program by 2013. Nevertheless, little is known about current AMS activities. This study aimed to determine the AMS activities currently undertaken, and to identify gaps, barriers to implementation and opportunities for improvement in Queensland hospitals. The AMS activities of 26 facilities from 15 hospital and health services in Queensland were surveyed during June 2012 to address strategies for effective AMS: implementing clinical guidelines, formulary restriction, reviewing antimicrobial prescribing, auditing antimicrobial use and selective reporting of susceptibility results. The response rate was 62%. Nineteen percent had an AMS team (a dedicated multidisciplinary team consisting of a medically trained staff member and a pharmacist). All facilities had access to an electronic version of Therapeutic Guidelines: Antibiotic, with a further 50% developing local guidelines for antimicrobials. One-third of facilities had additional restrictions. Eighty-eight percent had advice for restricted antimicrobials from in-house infectious disease physicians or clinical microbiologists. Antimicrobials were monitored with feedback given to prescribers at point of care by 76% of facilities. Deficiencies reported as barriers to establishing AMS programs included: pharmacy resources, financial support by hospital management, and training and education in antimicrobial use. Several areas for improvement were identified: reviewing antimicrobial prescribing with feedback to the prescriber, auditing, and training and education in antimicrobial use. There also appears to be a lack of resources to support AMS programs in some facilities. WHAT IS KNOWN ABOUT THE TOPIC?: The ACSQHC has recommended that all hospitals implement an AMS program by 2013 as a requirement of Standard 3 (Preventing and Controlling Healthcare

Characteristics of Pediatric Antimicrobial Stewardship Programs: Current Status of the Sharing Antimicrobial Reports for Pediatric Stewardship (SHARPS) Collaborative.

Science.gov (United States)

McPherson, Christopher; Lee, Brian R; Terrill, Cindy; Hersh, Adam L; Gerber, Jeffrey S; Kronman, Matthew P; Newland, Jason G

2018-01-25

In response to the growing epidemic of antibiotic-resistant bacterial infections, antimicrobial stewardship programs (ASP) have been rapidly implemented in the United States (US). This study examines the prevalence of the Centers for Disease Control and Prevention's (CDC) seven core elements of a successful ASP within a large subset of US Children's Hospitals. In 2016, a survey was conducted of 52 pediatric hospitals assessing the presence of the seven core elements: leadership commitment, accountability, drug expertise, action, tracking, reporting, and education. Forty-nine hospitals (94%) had established ASPs and 41 hospitals (79%) included all seven core elements. Physician accountability (87%) and a dedicated ASP pharmacist or drug expert (88%) were present in the vast majority of hospitals. However, substantial variability existed in the financial support allotted to these positions. This variability did not predict program actions, tracking, reporting, and education. When compared with previous surveys, these results document a dramatic increase in the prevalence and resources of pediatric stewardship programs, although continued expansion is warranted. Further research is required to understand the feasibility of various core stewardship activities and the impact on patient outcomes in the setting of finite resources.

Characteristics of Pediatric Antimicrobial Stewardship Programs: Current Status of the Sharing Antimicrobial Reports for Pediatric Stewardship (SHARPS Collaborative

Directory of Open Access Journals (Sweden)

Christopher McPherson

2018-01-01

Full Text Available In response to the growing epidemic of antibiotic-resistant bacterial infections, antimicrobial stewardship programs (ASP have been rapidly implemented in the United States (US. This study examines the prevalence of the Centers for Disease Control and Prevention’s (CDC seven core elements of a successful ASP within a large subset of US Children’s Hospitals. In 2016, a survey was conducted of 52 pediatric hospitals assessing the presence of the seven core elements: leadership commitment, accountability, drug expertise, action, tracking, reporting, and education. Forty-nine hospitals (94% had established ASPs and 41 hospitals (79% included all seven core elements. Physician accountability (87% and a dedicated ASP pharmacist or drug expert (88% were present in the vast majority of hospitals. However, substantial variability existed in the financial support allotted to these positions. This variability did not predict program actions, tracking, reporting, and education. When compared with previous surveys, these results document a dramatic increase in the prevalence and resources of pediatric stewardship programs, although continued expansion is warranted. Further research is required to understand the feasibility of various core stewardship activities and the impact on patient outcomes in the setting of finite resources.

Renewable Energy Price-Stability Benefits in Utility Green Power Programs. 36 pp

Energy Technology Data Exchange (ETDEWEB)

Bird, Lori A. [National Renewable Energy Lab. (NREL), Golden, CO (United States); Cory, Karlynn S. [National Renewable Energy Lab. (NREL), Golden, CO (United States); Swezey, Blair G. [Applied Materials, Santa Clara, CA (United States)

2008-08-01

This paper examines utility experiences when offering the fixed-price benefits of renewable energy in green pricing programs, including the methods utilized and the impact on program participation. It focuses primarily on utility green pricing programs in states that have not undergone electric industry restructuring.

Assessment of net lost revenue adjustment mechanisms for utility DSM programs

Energy Technology Data Exchange (ETDEWEB)

Baxter, L.W.

1995-01-01

Utility shareholders can lose money on demand-side management (DSM) investments between rate cases. Several industry analysts argue that the revenues lost from utility DSM programs are an important financial disincentive to utility DSM investment. A key utility regulatory reform undertaken since 1989 allows utilities to recover the lost revenues incurred through successful operation of DSM programs. Explicitly defined net lost revenue adjustment (NLRA) mechanisms are states` preferred approach to lost revenue recovery from DSM programs. This report examines the experiences states and utilities are having with the NLRA approach. The report has three objectives. First, we determine whether NLRA is a feasible and successful approach to removing the lost-revenue disincentive to utility operation of DSM programs. Second, we identify the conditions linked to successful implementation of NLRA mechanisms in different states and assess whether NLRA has changed utility investment behavior. Third, we suggest improvements to NLRA mechanisms. We first identify states with NLRA mechanisms where utilities are recovering lost revenues from DSM programs. We interview staff at regulatory agencies in all these states and utility staff in four states. These interviews focus on the status of NLRA, implementation issues, DSM measurement issues, and NLRA results. We also analyze regulatory agency orders on NLRA, as well as associated testimony, reports, and utility lost revenue recovery filings. Finally, we use qualitative and quantitative indicators to assess NLRA`s effectiveness. Contrary to the concerns raised by some industry analysts, our results indicate NLRA is a feasible approach to the lost-revenue disincentive.

Mapping educational opportunities for healthcare workers on antimicrobial resistance and stewardship around the world.

Science.gov (United States)

Rogers Van Katwyk, Susan; Jones, Sara L; Hoffman, Steven J

2018-02-05

Antimicrobial resistance is an important global issue facing society. Healthcare workers need to be engaged in solving this problem, as advocates for rational antimicrobial use, stewards of sustainable effectiveness, and educators of their patients. To fulfill this role, healthcare workers need access to training and educational resources on antimicrobial resistance. To better understand the resources available to healthcare workers, we undertook a global environmental scan of educational programs and resources targeting healthcare workers on the topic of antimicrobial resistance and antimicrobial stewardship. Programs were identified through contact with key experts, web searching, and academic literature searching. We summarized programs in tabular form, including participating organizations, region, and intended audience. We developed a coding system to classify programs by program type and participating organization type, assigning multiple codes as necessary and creating summary charts for program types, organization types, and intended audience to illustrate the breadth of available resources. We identified 94 educational initiatives related to antimicrobial resistance and antimicrobial stewardship, which represent a diverse array of programs including courses, workshops, conferences, guidelines, public outreach materials, and online-resource websites. These resources were developed by a combination of government bodies, professional societies, universities, non-profit and community organizations, hospitals and healthcare centers, and insurance companies and industry. Most programs either targeted healthcare workers collectively or specifically targeted physicians. A smaller number of programs were aimed at other healthcare worker groups including pharmacists, nurses, midwives, and healthcare students. Our environmental scan shows that there are many organizations working to develop and share educational resources for healthcare workers on antimicrobial

The utilization and valuation of the program CONTIN

International Nuclear Information System (INIS)

Yu Weizhong; Sun Yizhan

2000-01-01

The updated analysis program CONTIN(PALS2) based on the Laplace inversion of positron annihilation spectra has been studied comprehensively. The principle and utilization of the program have been explained exhaustively. Three auxiliary programs have been made to help the transportation of data and adjustment of the data's pattern. Four experiments have been made, the results computed by program CONTIN(PALS2) have been analyzed, and compared with those by POSIREONFIT program

Hyaluronan- and heparin-reduced silver nanoparticles with antimicrobial properties

Science.gov (United States)

Kemp, Melissa M; Kumar, Ashavani; Clement, Dylan; Ajayan, Pulickel; Mousa, Shaker

2009-01-01

Aims Silver nanoparticles exhibit unique antibacterial properties that make these ideal candidates for biological and medical applications. We utilized a clean method involving a single synthetic step to prepare silver nanoparticles that exhibit antimicrobial activity. Materials & methods These nanoparticles were prepared by reducing silver nitrate with diaminopyridinylated heparin (DAPHP) and hyaluronan (HA) polysaccharides and tested for their efficacy in inhibiting microbial growth. Results & discussion The resulting silver nanoparticles exhibit potent antimicrobial activity against Staphylococcus aureus and modest activity against Escherichia coli. Silver–HA showed greater antimicrobial activity than silver–DAPHP, while silver–glucose nanoparticles exhibited very weak antimicrobial activity. Neither HA nor DAPHP showed activity against S. aureus or E. coli. Conclusion These results suggest that DAPHP and HA silver nanoparticles have potential in antimicrobial therapeutic applications. PMID:19505245

Utilization program of HANARO under IMF situation in Korea

International Nuclear Information System (INIS)

Choi, Chang Oong; Kuk, Il Hiun; Chae, Sung Ki; Sohn, Jae Min

1999-01-01

Some of utilization facilities in HANARO are still being installed and among them CNS and FTL are yet in the design stage. This kind of situation in HANARO was mainly caused by the shortage of total budget of the reactor project during the period of reactor construction (1985 ∼ 1994). Installation of remaining utilization facilities to be equipped after HANARO construction had to rely on the resources of the long-term nuclear R and D program. The program commenced in 1992 with the 10-year implementation plan. It stipulates to be revised every 5 years in order to reflect changing national and international nuclear circumstances. The original nuclear R and D program (1992 ∼ 2001) set up in 1992 was amended in 1997 to establish nuclear policy infrastructure and to strengthen technological self-reliance in nuclear power. In this amended long-term nuclear R and D program (1997 ∼ 2006), full scope of utilization facility in HANARO was accommodated. However, economical difficulty befell to Korea from the end of 1997 and every social structure in Korea had to be reshaped with top priority of productivity base. Every industrial sector was desperately striving to cope with the financial difficulty by utilizing maximum production efficiency and by minimizing other functions or activities, which are not directly related to production activity. Even though nationwide endeavor strenuously to get over the economical difficulty, the government had to be supported from IMF (International Monetary Fund). Under the IMF situation in Korea, the nuclear R and D program must be adjusted due to cut-down of research fund from the government. Consequently utilization facility of HANARO is to be evaluated based on the users' program and their requirements. According to the evaluation results from the users' conditions, among the HANARO utilization facilities the first priority is pointed to be RI production facility, the second is to be neutron scattering facility, the third to be fuel

Building Maintenance and Utilities Management. Florida Vocational Program Guide.

Science.gov (United States)

University of South Florida, Tampa. Dept. of Adult and Vocational Education.

This program guide identifies primary concerns in the organization, operation, and evaluation of a building maintenance and utilities management program. It is designed for local school district and community college administrators, instructors, program advisory committees, and regional coordinating councils. The guide begins with the Dictionary…

Effects of utility demand-side management programs on uncertainty

International Nuclear Information System (INIS)

Hirst, E.

1994-01-01

Electric utilities face a variety of uncertainties that complicate their long-term resource planning. These uncertainties include future economic and load growths, fuel prices, environmental and economic regulations, performance of existing power plants, cost and availability of purchased power, and the costs and performance of new demand and supply resources. As utilities increasingly turn to demand-side management (DSM) programs to provide resources, it becomes more important to analyze the interactions between these programs and the uncertainties facing utilities. This paper uses a dynamic planning model to quantify the uncertainty effects of supply-only vs DSM + supply resource portfolios. The analysis considers four sets of uncertainties: economic growth, fuel prices, the costs to build new power plants, and the costs to operate DSM programs. The two types of portfolios are tested against these four sets of uncertainties for the period 1990 to 2010. Sensitivity, scenario, and worst-case analysis methods are used. The sensitivity analyses show that the DSM + supply resource portfolio is less sensitive to unanticipated changes in economic growth, fuel prices, and power-plant construction costs than is the supply-only portfolio. The supply-only resource mix is better only with respect to uncertainties about the costs of DSM programs. The base-case analysis shows that including DSM programs in the utility's resource portfolio reduces the net present value of revenue requirements (NPV-RR) by 490 million dollars. The scenario-analysis results show an additional 30 million dollars (6%) in benefits associated with reduction in these uncertainties. In the worst-case analysis, the DSM + supply portfolio again reduces the cost penalty associated with guessing wrong for both cases, when the utility plans for high needs and learns it has low needs and vice versa. 20 refs

Animation of Antimicrobial Resistance

Medline Plus

Full Text Available ... NARMS 2015 NARMS Integrated Report Data Meetings and Publications Resources Judicious Use of Antimicrobials Page Last Updated: ... Emergency Preparedness International Programs News & Events Training & Continuing Education Inspections & Compliance Federal, State & Local Officials Consumers Health ...

Demonstrating a small utility approach to demand-side program implementation

International Nuclear Information System (INIS)

1991-01-01

The US DOE awarded a grant to the Burlington Electric Department (B.E.D.) to test a demand-side management (DSM) demonstration program designed to quickly save a significant amount of power with little disruption to the utility's customers or its normal operations. B.E.D. is a small municipal utility located in northern Vermont, with a lengthy history of successful DSM involvement. In our grant application, we proposed to develop a replicable program and approach to DSM that might be useful to other small utilities and to write a report to enable such replication. We believe that this DSM program and/or individual program components are replicable. This report is designed to allow other utilities interested in DSM to replicate this program or specific program design features to meet their DSM goals. We also wanted to use the opportunity of this grant to test the waters of residential heating fuel-switching. We hoped to test the application of one fuel-switching technology, and to benefit from the lessons learned in developing a full-scale DSM program for this end- use. To this end the pilot effort has been very successful. In the pilot pressure we installed direct-vent gas fired space heaters sized as supplemental heating units in 44 residences heated solely by electric resistance heat. We installed the gas space heating units at no cost to the owners or residents. We surveyed participating customers. The results of those surveys are included in this report and preliminary estimates of winter peak capacity load reductions are also noted in this report

Demonstrating a small utility approach to demand-side program implementation

Energy Technology Data Exchange (ETDEWEB)

1991-10-01

The US DOE awarded a grant to the Burlington Electric Department (B.E.D.) to test a demand-side management (DSM) demonstration program designed to quickly save a significant amount of power with little disruption to the utility's customers or its normal operations. B.E.D. is a small municipal utility located in northern Vermont, with a lengthy history of successful DSM involvement. In our grant application, we proposed to develop a replicable program and approach to DSM that might be useful to other small utilities and to write a report to enable such replication. We believe that this DSM program and/or individual program components are replicable. This report is designed to allow other utilities interested in DSM to replicate this program or specific program design features to meet their DSM goals. We also wanted to use the opportunity of this grant to test the waters of residential heating fuel-switching. We hoped to test the application of one fuel-switching technology, and to benefit from the lessons learned in developing a full-scale DSM program for this end- use. To this end the pilot effort has been very successful. In the pilot pressure we installed direct-vent gas fired space heaters sized as supplemental heating units in 44 residences heated solely by electric resistance heat. We installed the gas space heating units at no cost to the owners or residents. We surveyed participating customers. The results of those surveys are included in this report and preliminary estimates of winter peak capacity load reductions are also noted in this report.

Promoting high efficiency residential HVAC equipment: Lessons learned from leading utility programs

Energy Technology Data Exchange (ETDEWEB)

Neme, C.; Peters, J.; Rouleau, D.

1998-07-01

The Consortium for Energy Efficiency recently sponsored a study of leading electric utility efforts to promote high efficiency residential HVAC equipment. Given growing concerns from some utilities about the level of expenditures associated with rebate programs, special emphasis was placed on assessing the success of financing and other non-rebate options for promoting efficiency. Emphasis was also placed on review of efforts--rebate or otherwise--to push the market to very high levels of efficiency (i.e., SEER 13). This paper presents the results of the study. It includes discussion of key lessons from the utility programs analyzed. It also examines program participation rates and other potential indicators of market impacts. One notable conclusion is that several utility programs have pushed market shares for SEER 12 equipment to about 50% (the national average is less than 20%). At least one utility program has achieved a 50% market share for SEER 13 equipment (the national average is less than 3%). In general, financing does not appear to have as broad an appeal as consumer rebates. However, one unique utility program which combines the other of customer financing with modest incentives to contractors--in the form of frequent seller points that can be redeemed for advertising, technician training, travel and other merchandise--offers some promise that high participation rates can be achieved without customer rebates.

Interactions between Energy Efficiency Programs funded under the Recovery Act and Utility Customer-Funded Energy Efficiency Programs

Energy Technology Data Exchange (ETDEWEB)

Goldman, Charles A.; Stuart, Elizabeth; Hoffman, Ian; Fuller, Merrian C.; Billingsley, Megan A.

2011-02-25

Since the spring of 2009, billions of federal dollars have been allocated to state and local governments as grants for energy efficiency and renewable energy projects and programs. The scale of this American Reinvestment and Recovery Act (ARRA) funding, focused on 'shovel-ready' projects to create and retain jobs, is unprecedented. Thousands of newly funded players - cities, counties, states, and tribes - and thousands of programs and projects are entering the existing landscape of energy efficiency programs for the first time or expanding their reach. The nation's experience base with energy efficiency is growing enormously, fed by federal dollars and driven by broader objectives than saving energy alone. State and local officials made countless choices in developing portfolios of ARRA-funded energy efficiency programs and deciding how their programs would relate to existing efficiency programs funded by utility customers. Those choices are worth examining as bellwethers of a future world where there may be multiple program administrators and funding sources in many states. What are the opportunities and challenges of this new environment? What short- and long-term impacts will this large, infusion of funds have on utility customer-funded programs; for example, on infrastructure for delivering energy efficiency services or on customer willingness to invest in energy efficiency? To what extent has the attribution of energy savings been a critical issue, especially where administrators of utility customer-funded energy efficiency programs have performance or shareholder incentives? Do the new ARRA-funded energy efficiency programs provide insights on roles or activities that are particularly well-suited to state and local program administrators vs. administrators or implementers of utility customer-funded programs? The answers could have important implications for the future of U.S. energy efficiency. This report focuses on a selected set of ARRA

Evaluation of an antimicrobial resistance monitoring program for campylobacter in poultry by simulation

DEFF Research Database (Denmark)

Regula, G.; Wong, Danilo Lo Fo; Ledergerber, U.

2005-01-01

An ideal national resistance monitoring program should deliver a precise estimate of the resistance situation for a given combination of bacteria and antimicrobial at a low cost. To achieve this, decisions need to be made on the number of samples to be collected at each of different possible...... sampling points. Existing methods of sample size calculation can not be used to solve this problem, because sampling decisions do not only depend on the prevalence of resistance and sensitivity and specificity of resistance testing, but also on the prevalence of the bacteria, and test characteristics...... of isolation of these bacteria. Our aim was to develop a stochastic simulation model that optimized a national resistance monitoring program, taking multi-stage sampling, imperfect sensitivity and specificity of diagnostic tests, and cost-effectiveness considerations into account. The process of resistance...

Treatment Modalities and Antimicrobial Stewardship Initiatives in the Management of Intra-Abdominal Infections

Directory of Open Access Journals (Sweden)

Charles Hoffmann

2016-02-01

Full Text Available Antimicrobial stewardship programs (ASPs focus on improving the utilization of broad spectrum antibiotics to decrease the incidence of multidrug-resistant Gram positive and Gram negative pathogens. Hospital admission for both medical and surgical intra-abdominal infections (IAIs commonly results in the empiric use of broad spectrum antibiotics such as fluoroquinolones, beta-lactam beta-lactamase inhibitors, and carbapenems that can select for resistant organisms. This review will discuss the management of uncomplicated and complicated IAIs as well as highlight stewardship initiatives focusing on the proper use of broad spectrum antibiotics.

Ground-source heat pump case studies and utility programs

Energy Technology Data Exchange (ETDEWEB)

Lienau, P.J.; Boyd, T.L.; Rogers, R.L.

1995-04-01

Ground-source heat pump systems are one of the promising new energy technologies that has shown rapid increase in usage over the past ten years in the United States. These systems offer substantial benefits to consumers and utilities in energy (kWh) and demand (kW) savings. The purpose of this study was to determine what existing monitored data was available mainly from electric utilities on heat pump performance, energy savings and demand reduction for residential, school and commercial building applications. In order to verify the performance, information was collected for 253 case studies from mainly utilities throughout the United States. The case studies were compiled into a database. The database was organized into general information, system information, ground system information, system performance, and additional information. Information was developed on the status of demand-side management of ground-source heat pump programs for about 60 electric utility and rural electric cooperatives on marketing, incentive programs, barriers to market penetration, number units installed in service area, and benefits.

Handbook of evaluation of utility DSM programs. [Demand-Side Management (DSM)

Energy Technology Data Exchange (ETDEWEB)

Hirst, E.; Reed, J. (eds.); Bronfman, B.; Fitzpatrick, G.; Hicks, E.; Hirst, E.; Hoffman, M.; Keating, K.; Michaels, H.; Nadel, S.; Peters, J.; Reed, J.; Saxonis, W.; Schoen, A.; Violette, D.

1991-12-01

Program evaluation has become a central issue in the world of utility integrated resource planning. The DSM programs that utilities were operating to meet federal requirements or to improve customer relations are now becoming big business. DSM is being considered an important resource in a utility's portfolio of options. In the last five years, the amount of money that utilities have invested in DSM has grown exponentially in most regulatory jurisdictions. Market analysts are now talking about DSM being a $30 billion industry by the end of the decade. If the large volume of DSM-program investments was not enough to highlight the importance of evaluation, then the introduction of regulatory incentives has really focused the spotlight. This handbook was developed through a process that involved many of those people who represent the diverse constituencies of DSM-program evaluation. We have come to recognize the many technical disciplines that must be employed to evaluate DSM programs. An analysis might start out based on the principles of utility load research to find out what happened, but a combination of engineering and statistical methods must be used to triangulate'' an estimate of what would have happened without the program. The difference, of course, is that elusive but prized result of evaluation: what happened as the direct result of the DSM program. Technical performance of DSM measures is not the sole determinant of the answer, either. We also recognize the importance of such behavioral attributes of DSM as persistence and free ridership. Finally, DSM evaluation is meaningless without attention to planning an approach, communicating results to relevant decision-makers, and focusing as much on the process as the impacts of the program. These topics are all covered in this handbook.

Investigation of antimicrobial use at a tertiary care hospital in Southern Punjab, Pakistan using WHO methodology.

Science.gov (United States)

Atif, Muhammad; Azeem, Muhammad; Saqib, Anum; Scahill, Shane

2017-01-01

Globally, between 20 to 50% of antimicrobial consumption is inappropriate, causing significant impact on the quality of care, cost of therapy and incidence of adverse drug reactions. The purpose of this study was to investigate the prescribing patterns and utilization of antimicrobials in ten selected wards at Bahawal Victoria Hospital (BVH), Bahawalpur, Punjab, Pakistan. A descriptive cross-sectional study was designed using the World Health Organization (WHO) indicators for antimicrobial use. Standard data collection forms were used in ten wards and the Pharmacy Department at BVH. Antimicrobial utilization patterns in terms of frequency and percentage were also determined. Systematic random sampling techniques were used to collect data from 1,000 prescription records out of 21,115 prescriptions written for the six months January to June 2016. For the hospital indicators, a formulary list or essential medicines list (FL/EML) was available, but standard treatment guidelines (STGs) for infectious diseases was not. The average number of days that key antimicrobials were out of stock was 3.3 days per month. The expenditure on antimicrobials as a percentage of the total medicines costs was 12.2%. For the prescribing indicators, the percentage of hospitalizations with antimicrobial(s) prescribed was 82.3%, and the average number of antimicrobials per hospitalization was 1.4 (SD = 0.6). The average duration of antimicrobial treatment per hospitalization was 5.4 days (SD = 3.2). The average cost of antimicrobials prescribed per hospitalization was USD 5.4 (SD = 6.7). None of the patients who were prescribed antimicrobials, received AM according to the STGs (pneumonia and cesarean section cases). Among the patient-care and supplemental indicators, the average duration of hospital stay of patients who received antimicrobials was 6.4 (SD = 4.3) days. The drug sensitivity testing was almost non-existent, with only 0.24% prescription records having drug

Electric Utility Transmission and Distribution Line Engineering Program

Energy Technology Data Exchange (ETDEWEB)

Peter McKenny

2010-08-31

Economic development in the United States depends on a reliable and affordable power supply. The nation will need well educated engineers to design a modern, safe, secure, and reliable power grid for our future needs. An anticipated shortage of qualified engineers has caused considerable concern in many professional circles, and various steps are being taken nationwide to alleviate the potential shortage and ensure the North American power system's reliability, and our world-wide economic competitiveness. To help provide a well-educated and trained workforce which can sustain and modernize the nation's power grid, Gonzaga University's School of Engineering and Applied Science has established a five-course (15-credit hour) Certificate Program in Transmission and Distribution (T&D) Engineering. The program has been specifically designed to provide working utility engineering professionals with on-line access to advanced engineering courses which cover modern design practice with an industry-focused theoretical foundation. A total of twelve courses have been developed to-date and students may select any five in their area of interest for the T&D Certificate. As each course is developed and taught by a team of experienced engineers (from public and private utilities, consultants, and industry suppliers), students are provided a unique opportunity to interact directly with different industry experts over the eight weeks of each course. Course material incorporates advanced aspects of civil, electrical, and mechanical engineering disciplines that apply to power system design and are appropriate for graduate engineers. As such, target students for the certificate program include: (1) recent graduates with a Bachelor of Science Degree in an engineering field (civil, mechanical, electrical, etc.); (2) senior engineers moving from other fields to the utility industry (i.e. paper industry to utility engineering or project management positions); and (3) regular

Antimicrobial Stewardship in Acute Care Centres: A Survey of 68 Hospitals in Quebec

Directory of Open Access Journals (Sweden)

Vincent Nault

2008-01-01

Full Text Available BACKGROUND: Antimicrobial stewardship programs (ASPs and quantitative monitoring of antimicrobial use are required to ensure that antimicrobials are used appropriately in the acute care setting, and have the potential to reduce costs and limit the spread of antimicrobial-resistant organisms and Clostridium difficile. Currently, it is not known what proportion of Quebec hospitals have an ASP and/or monitor antimicrobial use.

Guide for monitoring effectiveness of utility Reliability Centered Maintenance (RCM) programs

International Nuclear Information System (INIS)

Midgett, W.D.; Wilson, J.F.; Krochmal, D.F.; Owsenek, L.W.

1991-02-01

Reliability centered maintenance (RCM) programs help utilities optimize preventive maintenance efforts while improving plant safety and economy through increased dependability of plant components. The project team developed this guide and accompanying methodology based on status updates from the Ginna and San Onofre demonstration projects. These updates addressed areas ranging from system selection to the effectiveness of RCM program implementation. In addition, the team incorporated information from a 12-utility survey soliciting opinions on the need for a methodology to monitor RCM cost-effectiveness. An analysis of the 12-utility survey showed that no techniques had been developed to measure RCM program cost-effectiveness. Thus, this guide addresses two key areas: Pros and cons of various monitoring techniques available to assess the overall effectiveness of RCM and a methodology for specifically evaluating the cost-effectiveness of RCM programs. 1 fig

Utility Green Tariff Programs: Considerations for Federal Agencies

Energy Technology Data Exchange (ETDEWEB)

Heeter, Jenny

2017-05-08

This FEMP First Thursday presentation will explain the concept of a utility green tariff, how it differs from a green pricing program, and what questions federal agencies should have about participating.

National Antimicrobial Resistance Monitoring System: Two Decades of Advancing Public Health Through Integrated Surveillance of Antimicrobial Resistance.

Science.gov (United States)

Karp, Beth E; Tate, Heather; Plumblee, Jodie R; Dessai, Uday; Whichard, Jean M; Thacker, Eileen L; Hale, Kis Robertson; Wilson, Wanda; Friedman, Cindy R; Griffin, Patricia M; McDermott, Patrick F

2017-10-01

Drug-resistant bacterial infections pose a serious and growing public health threat globally. In this review, we describe the role of the National Antimicrobial Resistance Monitoring System (NARMS) in providing data that help address the resistance problem and show how such a program can have broad positive impacts on public health. NARMS was formed two decades ago to help assess the consequences to human health arising from the use of antimicrobial drugs in food animal production in the United States. A collaboration among the Centers for Disease Control and Prevention, the U.S. Food and Drug Administration, the United States Department of Agriculture, and state and local health departments, NARMS uses an integrated "One Health" approach to monitor antimicrobial resistance in enteric bacteria from humans, retail meat, and food animals. NARMS has adapted to changing needs and threats by expanding surveillance catchment areas, examining new isolate sources, adding bacteria, adjusting sampling schemes, and modifying antimicrobial agents tested. NARMS data are not only essential for ensuring that antimicrobial drugs approved for food animals are used in ways that are safe for human health but they also help address broader food safety priorities. NARMS surveillance, applied research studies, and outbreak isolate testing provide data on the emergence of drug-resistant enteric bacteria; genetic mechanisms underlying resistance; movement of bacterial populations among humans, food, and food animals; and sources and outcomes of resistant and susceptible infections. These data can be used to guide and evaluate the impact of science-based policies, regulatory actions, antimicrobial stewardship initiatives, and other public health efforts aimed at preserving drug effectiveness, improving patient outcomes, and preventing infections. Many improvements have been made to NARMS over time and the program will continue to adapt to address emerging resistance threats, changes in

Targeting utility customers to improve energy savings from conservation and efficiency programs

International Nuclear Information System (INIS)

Taylor, Nicholas W.; Jones, Pierce H.; Kipp, M. Jennison

2014-01-01

Highlights: • Improving DSM program impacts by targeting high energy users. • DSM energy savings potential hinges on pre-participation performance. • Targeting can benefit different utilities and energy efficiency programs. • Overall performance can be improved by up to 250% via targeting strategies. - Abstract: Electric utilities, government agencies, and private interests in the US have committed and continue to invest substantial resources – including billions of dollars of financial capital – in the pursuit of energy efficiency and conservation through demand-side management (DSM) programs. While most of these programs are deemed to be cost effective, and therefore in the public interest, opportunities exist to improve cost effectiveness by targeting programs to those customers with the greatest potential for energy savings. This article details an analysis of three DSM programs offered by three Florida municipal electric utilities to explore such opportunities. First, we estimate programs’ energy savings impacts; second, we measure and compare energy savings across subgroups of program participants as determined by their pre-intervention energy performance, and third, we explore potential changes in program impacts that might be realized by targeting specific customers for participation in the DSM programs. All three programs resulted in statistically significant average (per-participant) energy savings, yet average savings varied widely, with the customers who performed best (i.e., most efficient) before the intervention saving the least energy and those who performed worst (i.e., least efficient) before the intervention saving the most. Assessment of alternative program participation scenarios with varying levels of customer targeting suggests that program impacts could be increased by as much as 80% for a professional energy audit program, just over 100% for a high-efficiency heat pump upgrade program, and nearly 250% for an attic insulation

Antibiotic stewardship programs and the internist’s role

Directory of Open Access Journals (Sweden)

Massimo Giusti

2016-12-01

Full Text Available Antimicrobial resistance (AMR is a worldwide issue, but with significant epidemiological diversity in different countries. A recently observed phenomenon is represented by the diffusion of AMR, initially confined to intensive-care units, to medical wards. This was predictable, since patients hospitalized in medical units are made up of more than 70% of elderly people (over 75 years of age in 1 case out of 2. They are fragile patients, with significant comorbidity (over a half with at least 3 diseases, weakened immune systems, and consequently a higher risk of infection. Given such a scenario, it becomes therefore both necessary and urgent to adopt a multifaceted approach of antimicrobial stewardship programs in order to prevent, detect and control the emergence of antimicrobial resistant organisms. The ideal antimicrobial program is led by an infectious diseases (ID physician and clinical pharmacist with ID training, together with a list of other important staff: clinical microbiologist, information systems specialist, infection control professional, and hospital epidemiologist. In real life, not all the Italian hospitals have got an ID physician and therefore the best canditates for antimicrobial management practices are internists if provided with a specific expertise in ID and antibiotic therapy. Adhering to the principles of optimal antimicrobial therapy in their clinical practice, the internist is able to improve the care and help to reduce the resistance of a patient at his bedside. At the same time, he can achieve other key goals reducing the length of stay and reducing the cost and utilization of health care resources.

Antimicrobial resistance challenged with metal-based antimicrobial macromolecules.

Science.gov (United States)

Abd-El-Aziz, Alaa S; Agatemor, Christian; Etkin, Nola

2017-02-01

Antimicrobial resistance threatens the achievements of science and medicine, as it deactivates conventional antimicrobial therapeutics. Scientists respond to the threat by developing new antimicrobial platforms to prevent and treat infections from these resistant strains. Metal-based antimicrobial macromolecules are emerging as an alternative to conventional platforms because they combine multiple mechanisms of action into one platform due to the distinctive properties of metals. For example, metals interact with intracellular proteins and enzymes, and catalyse various intracellular processes. The macromolecular architecture offers a means to enhance antimicrobial activity since several antimicrobial moieties can be conjugated to the scaffold. Further, these macromolecules can be fabricated into antimicrobial materials for contact-killing medical implants, fabrics, and devices. As volatilization or leaching out of the antimicrobial moieties from the macromolecular scaffold is reduced, these medical implants, fabrics, and devices can retain their antimicrobial activity over an extended period. Recent advances demonstrate the potential of metal-based antimicrobial macromolecules as effective platforms that prevent and treat infections from resistant strains. In this review these advances are thoroughly discussed within the context of examples of metal-based antimicrobial macromolecules, their mechanisms of action and biocompatibility. Copyright © 2016 Elsevier Ltd. All rights reserved.

Utility residential new construction programs: Going beyond the code. A report from the Database on Energy Efficiency Programs (DEEP) Project

Energy Technology Data Exchange (ETDEWEB)

Vine, E.

1995-08-01

Based on an evaluation of 10 residential new construction programs, primarily sponsored by investor-owned utilities in the United States, we find that many of these programs are in dire straits and are in danger of being discontinued because current inclusion of only direct program effects leads to the conclusion that they are not cost-effective. We believe that the cost-effectiveness of residential new construction programs can be improved by: (1) promoting technologies and advanced building design practices that significantly exceed state and federal standards; (2) reducing program marketing costs and developing more effective marketing strategies; (3) recognizing the role of these programs in increasing compliance with existing state building codes; and (4) allowing utilities to obtain an ``energy-savings credit`` from utility regulators for program spillover (market transformation) impacts. Utilities can also leverage their resources in seizing these opportunities by forming strong and trusting partnerships with the building community and with local and state government.

The cost and performance of utility commercial lighting programs. A report from the Database on Energy Efficiency Programs (DEEP) project

Energy Technology Data Exchange (ETDEWEB)

Eto, J.; Vine, E.; Shown, L.; Sonnenblick, R.; Payne, C. [Lawrence Berkeley Lab., CA (United States). Energy and Environment Div.

1994-05-01

The objective of the Database on Energy Efficiency Programs (DEEP) is to document the measured cost and performance of utility-sponsored, energy-efficiency, demand-side management (DSM) programs. Consistent documentation of DSM programs is a challenging goal because of problems with data consistency, evaluation methodologies, and data reporting formats that continue to limit the usefulness and comparability of individual program results. This first DEEP report investigates the results of 20 recent commercial lighting DSM programs. The report, unlike previous reports of its kind, compares the DSM definitions and methodologies that each utility uses to compute costs and energy savings and then makes adjustments to standardize reported program results. All 20 programs were judged cost-effective when compared to avoided costs in their local areas. At an average cost of 3.9{cents}/kWh, however, utility-sponsored energy efficiency programs are not ``too cheap to meter.`` While it is generally agreed upon that utilities must take active measures to minimize the costs and rate impacts of DSM programs, the authors believe that these activities will be facilitated by industry adoption of standard definitions and reporting formats, so that the best program designs can be readily identified and adopted.

A cost analysis of introducing an infectious disease specialist-guided antimicrobial stewardship in an area with relatively low prevalence of antimicrobial resistance.

Science.gov (United States)

Lanbeck, Peter; Ragnarson Tennvall, Gunnel; Resman, Fredrik

2016-07-27

Antimicrobial stewardship programs have been widely introduced in hospitals as a response to increasing antimicrobial resistance. Although such programs are commonly used, the long-term effects on antimicrobial resistance as well as societal economics are uncertain. We performed a cost analysis of an antimicrobial stewardship program introduced in Malmö, Sweden in 20 weeks 2013 compared with a corresponding control period in 2012. All direct costs and opportunity costs related to the stewardship intervention were calculated for both periods. Costs during the stewardship period were directly compared to costs in the control period and extrapolated to a yearly cost. Two main analyses were performed, one including only comparable direct costs (analysis one) and one including comparable direct and opportunity costs (analysis two). An extra analysis including all comparable direct costs including costs related to length of hospital stay (analysis three) was performed, but deemed as unrepresentative. According to analysis one, the cost per year was SEK 161 990 and in analysis two the cost per year was SEK 5 113. Since the two cohorts were skewed in terms of size and of infection severity as a consequence of the program, and since short-term patient outcomes have been demonstrated to be unchanged by the intervention, the costs pertaining to patient outcomes were not included in the analysis, and we suggest that analysis two provides the most correct cost calculation. In this analysis, the main cost drivers were the physician time and nursing time. A sensitivity analysis of analysis two suggested relatively modest variation under changing assumptions. The total yearly cost of introducing an infectious disease specialist-guided, audit-based antimicrobial stewardship in a department of internal medicine, including direct costs and opportunity costs, was calculated to be as low as SEK 5 113.

An approach for evaluating utility-financed energy conservation programs. The economic welfare model

Energy Technology Data Exchange (ETDEWEB)

Costello, K W; Galen, P S

1985-09-01

The main objective of this paper is to illustrate how the economic welfare model may be used to measure the economic efficiency effects of utility-financed energy conservation programs. The economic welfare model is the theoretical structure that was used in this paper to develop a cost/benefit test. This test defines the net benefit of a conservation program as the change in the sum of consumer and producer surplus. The authors advocate the operation of the proposed cost/benefit model as a screening tool to eliminate from more detailed review those programs where the expected net benefits are less than zero. The paper presents estimates of the net benefit derived from different specified cost/benefit models for four illustrative pilot programs. These models are representative of those which have been applied or are under review by utilities and public utility commissions. From the numerical results, it is shown that net benefit is greatly affected by the assumptions made about the nature of welfare gains to program participants. The main conclusion that emerges from the numerical results is that the selection of a cost/benefit model is a crucial element in evaluating utility-financed energy conservation programs. The paper also briefly addresses some of the major unresolved issues in utility-financed energy conservation programs. 2 figs., 3 tabs., 10 refs. (A.V.)

The past, present, and future of U.S. utility demand-side management programs

International Nuclear Information System (INIS)

Eto, J.

1996-12-01

Demand-side management or DSM refers to active efforts by electric and gas utilities to modify customers' energy use patterns. The experience in the US shows that utilities, when provided with appropriate incentives, can provide a powerful stimulus to energy efficiency in the private sector. This paper describes the range and history of DSM programs offered by US electric utilities, with a focus on the political, economic, and regulatory events that have shaped their evolution. It also describes the changes these programs are undergoing as a result of US electricity industry restructuring. DSM programs began modestly in the 1970s in response to growing concerns about dependence on foreign sources of oil and environmental consequences of electricity generation, especially nuclear power. The foundation for the unique US partnership between government and utility interests can be traced first to the private-ownership structure of the vertically integrated electricity industry and second to the monopoly franchise granted by state regulators. Electricity industry restructuring calls into question both of these basic conditions, and thus the future of utility DSM programs for the public interest. Future policies guiding ratepayer-funded energy-efficiency DSM programs will need to pay close attention to the specific market objectives of the programs and to the balance between public and private interests

The past, present, and future of U.S. utility demand-side management programs

Energy Technology Data Exchange (ETDEWEB)

Eto, J. [Lawrence Berkeley National Lab., CA (United States). Environmental Energy Technologies Div.

1996-12-01

Demand-side management or DSM refers to active efforts by electric and gas utilities to modify customers` energy use patterns. The experience in the US shows that utilities, when provided with appropriate incentives, can provide a powerful stimulus to energy efficiency in the private sector. This paper describes the range and history of DSM programs offered by US electric utilities, with a focus on the political, economic, and regulatory events that have shaped their evolution. It also describes the changes these programs are undergoing as a result of US electricity industry restructuring. DSM programs began modestly in the 1970s in response to growing concerns about dependence on foreign sources of oil and environmental consequences of electricity generation, especially nuclear power. The foundation for the unique US partnership between government and utility interests can be traced first to the private-ownership structure of the vertically integrated electricity industry and second to the monopoly franchise granted by state regulators. Electricity industry restructuring calls into question both of these basic conditions, and thus the future of utility DSM programs for the public interest. Future policies guiding ratepayer-funded energy-efficiency DSM programs will need to pay close attention to the specific market objectives of the programs and to the balance between public and private interests.

Current activities handbook: formerly utilized sites remedial action program

International Nuclear Information System (INIS)

1981-01-01

This volume is one of a series produced under contract with the DOE, by Politech Corporation to develop a legislative and regulatory data base to assist the FUSRAP management in addressing the institutional and socioeconomic issues involved in carrying out the Formerly Utilized Sites Remedial Action Program. This Information Handbook series contains information about all relevant government agencies at the Federal and state levels, the pertinent programs they administer, each affected state legislature, and current Federal and state legislative and regulatory initiatives. This volume is a compilation of information about the activities each of the thirteen state legislatures potentially affected by the Formerly Utilized Sites Remedial Action Program. It contains a description of the state legislative procedural rules and a schedule of each legislative session; a summary of pending relevant legislation; the name and telephone number of legislative and state agency contacts; and the full text of all bills identified

Current activities handbook: formerly utilized sites remedial action program

Energy Technology Data Exchange (ETDEWEB)

None

1981-02-27

This volume is one of a series produced under contract with the DOE, by Politech Corporation to develop a legislative and regulatory data base to assist the FUSRAP management in addressing the institutional and socioeconomic issues involved in carrying out the Formerly Utilized Sites Remedial Action Program. This Information Handbook series contains information about all relevant government agencies at the Federal and state levels, the pertinent programs they administer, each affected state legislature, and current Federal and state legislative and regulatory initiatives. This volume is a compilation of information about the activities each of the thirteen state legislatures potentially affected by the Formerly Utilized Sites Remedial Action Program. It contains a description of the state legislative procedural rules and a schedule of each legislative session; a summary of pending relevant legislation; the name and telephone number of legislative and state agency contacts; and the full text of all bills identified.

Antimicrobial Drugs in Fighting against Antimicrobial Resistance

OpenAIRE

Cheng, Guyue; Dai, Menghong; Ahmed, Saeed; Hao, Haihong; Wang, Xu; Yuan, Zonghui

2016-01-01

The outbreak of antimicrobial resistance, together with the lack of newly developed antimicrobial drugs, represents an alarming signal for both human and animal healthcare worldwide. Selection of rational dosage regimens for traditional antimicrobial drugs based on pharmacokinetic/pharmacodynamic principles as well as development of novel antimicrobials targeting new bacterial targets or resistance mechanisms are key approaches in tackling AMR. In addition to the cellular level resistance (i....

Synthesis, characteristics and antimicrobial activity of ZnO nanoparticles

Science.gov (United States)

Janaki, A. Chinnammal; Sailatha, E.; Gunasekaran, S.

2015-06-01

The utilization of various plant resources for the bio synthesis of metallic nano particles is called green technology and it does not utilize any harmful protocols. Present study focuses on the green synthesis of ZnO nano particles by Zinc Carbonate and utilizing the bio-components of powder extract of dry ginger rhizome (Zingiber officinale). The ZnO nano crystallites of average size range of 23-26 nm have been synthesized by rapid, simple and eco friendly method. Zinc oxide nano particles were characterized by using X-ray diffraction (XRD), Scanning Electron Microscope (SEM), Energy Dispersive X-ray spectroscopy (EDX). FTIR spectra confirmed the adsorption of surfactant molecules at the surface of ZnO nanoparticles and the presence of ZnO bonding. Antimicrobial activity of ZnO nano particles was done by well diffusion method against pathogenic organisms like Klebsiella pneumonia, Staphylococcus aureus and Candida albicans and Penicillium notatum. It is observed that the ZnO synthesized in the process has the efficient antimicrobial activity.

Implementation of a Mobile Clinical Decision Support Application to Augment Local Antimicrobial Stewardship.

Science.gov (United States)

Hoff, Brian M; Ford, Diana C; Ince, Dilek; Ernst, Erika J; Livorsi, Daniel J; Heintz, Brett H; Masse, Vincent; Brownlee, Michael J; Ford, Bradley A

2018-01-01

Medical applications for mobile devices allow clinicians to leverage microbiological data and standardized guidelines to treat patients with infectious diseases. We report the implementation of a mobile clinical decision support (CDS) application to augment local antimicrobial stewardship. We detail the implementation of our mobile CDS application over 20 months. Application utilization data were collected and evaluated using descriptive statistics to quantify the impact of our implementation. Project initiation focused on engaging key stakeholders, developing a business case, and selecting a mobile platform. The preimplementation phase included content development, creation of a pathway for content approval within the hospital committee structure, engaging clinical leaders, and formatting the first version of the guide. Implementation involved a media campaign, staff education, and integration within the electronic medical record and hospital mobile devices. The postimplementation phase required ongoing quality improvement, revision of outdated content, and repeated staff education. The evaluation phase included a guide utilization analysis, reporting to hospital leadership, and sustainability and innovation planning. The mobile application was downloaded 3056 times and accessed 9259 times during the study period. The companion web viewer was accessed 8214 times. Successful implementation of a customizable mobile CDS tool enabled our team to expand beyond microbiological data to clinical diagnosis, treatment, and antimicrobial stewardship, broadening our influence on antimicrobial prescribing and incorporating utilization data to inspire new quality and safety initiatives. Further studies are needed to assess the impact on antimicrobial utilization, infection control measures, and patient care outcomes.

Advances in pharmacovigilance initiatives surrounding antimicrobial resistance-Indian perspective.

Science.gov (United States)

Bairy, Laxminarayana Kurady; Nayak, Veena; A, Avinash; Kunder, Sushil Kiran

2016-08-01

In recent years the development of antimicrobial resistance has been accelerating, the discovery of new antimicrobial agents has slowed substantially in past decades. This review mainly focuses on the problem of antimicrobial resistance(AMR); the various contributor mechanisms, consequences and future of AMR. The review also highlights the irrational use of antimicrobials, improving their usage and problems associated with pharmacovigilance of antimicrobial resistance. Pharmacovigilance in the form of surveillance of antibiotic use is being done in 90% of the countries worldwide through the WHONET program developed by WHO. However, the data comes from a limited area of the globe. Data from every part of the world is required, so that there is geographical representation of every region. A major hurdle in quantifying the extent of antimicrobial resistance is the fact that there are several known microbes, that may turn out to be resistant to one or more of the several known antimicrobial agents. The global action plan initiated by WHO, if implemented successfully will definitely reduce AMR and will help in evaluating treatment interventions.

A scoping study on energy-efficiency market transformation by California Utility DSM Programs

Energy Technology Data Exchange (ETDEWEB)

Eto, J.; Prahl, R.; Schlegel, J.

1996-07-01

Market transformation has emerged as a central policy objective for future publicly-funded energy-efficiency programs in California. California Public Utilities Commission (CPUC) Decision 95-12-063 calls for public funding to shift to activities designed to transform the energy-efficiency market. The CPUC envisions that funding {open_quotes}would only be needed for specific and limited periods of time to cause the market to be transformed{close_quotes}. At the same time, the CPUC also acknowledges that {open_quotes}there are many definitions of market transformation{close_quotes} ... and does {open_quotes}not attempt to refine those definitions today{close_quotes}. We argue that a definition of market transformation is essential. The literature is now replete with definitions, and an operational definition is needed for the CPUC to decide on which programs should be supported with public funds. The CPUC decision initially indicated a preference for programs that do not provide financial assistance 4-efficiency programs that rely on financial assistance to customers. However, energy customers have traditionally accounted for a substantial portion of California utility`s DSM programs, so the CPUC`s direction to use ratepayer funds to support programs that will transform the market raises critical questions about how to analyze what has happened in order to plan effectively for the future: Which utility energy-efficiency programs, including those that provide financial assistance to customers, have had market transforming effects? To what extent do current regulatory rules and practices encourage or discourage utilities from running programs that are designed to transform the market? Should the rules and programs be modified, and, if so, how, to promote market transformation?

Occurrence of antimicrobial resistance among bacterial pathogens

OpenAIRE

Hendriksen, Rene S.; Mevius, Dik J.; Schroeter, Andreas; Teale, Christopher; Jouy, Eric; Butaye, Patrick; Franco, Alessia; Utinane, Andra; Amado, Alice; Moreno, Miguel; Greko, Christina; Stärk, Katharina D.C.; Berghold, Christian; Myllyniemi, Anna-Liisa; Hoszowski, Andrzej

2008-01-01

Background: The project "Antibiotic resistance in bacteria of animal origin – II" (ARBAO-II) was funded by the European Union (FAIR5-QLK2-2002-01146) for the period 2003–05. The aim of this project was to establish a program for the continuous monitoring of antimicrobial susceptibility of pathogenic and indicator bacteria from food animals using validated and harmonised methodologies. In this report the first data on the occurrence of antimicrobial resistance among bacteria cau...

Advances in rapid identification and susceptibility testing of bacteria in the clinical microbiology laboratory: implications for patient care and antimicrobial stewardship programs

Directory of Open Access Journals (Sweden)

Florian P. Maurer

2017-03-01

Full Text Available Early availability of information on bacterial pathogens and their antimicrobial susceptibility is of key importance for the management of infectious diseases patients. Currently, using traditional approaches, it usually takes at least 48 hours for identification and susceptibility testing of bacterial pathogens. Therefore, the slowness of diagnostic procedures drives prolongation of empiric, potentially inappropriate, antibacterial therapies. Over the last couple of years, the improvement of available techniques (e.g. for susceptibility testing, DNA amplification assays, and introduction of novel technologies (e.g. MALDI-TOF has fundamentally changed approaches towards pathogen identification and characterization. Importantly, these techniques offer increased diagnostic resolution while at the same time shorten the time-to-result, and are thus of obvious importance for antimicrobial stewardship. In this review, we will discuss recent advances in medical microbiology with special emphasis on the impact of novel techniques on antimicrobial stewardship programs.

Antimicrobials and therapeutic decision making: an historical perspective.

Science.gov (United States)

Quintiliani, R; Nightingale, C H

1991-01-01

In an effort to remedy inappropriate and excessive use of antimicrobials and to control costs, most hospitals have developed some type of antimicrobial management program. At Hartford Hospital, our most effective approaches have been those that reduce the chances for physician error, decrease the burden on ancillary services, and encourage short hospital stays. These include automatic correction of dose and dosing intervals of antimicrobials and, if possible, their conversion by pharmacy to cost-effective alternative agents; daily review of patients who are taking the drugs by an antimicrobial team; and replacement of parenteral with oral agents as soon as possible. Physician acceptance of these approaches will require significant changes in traditional prescribing styles and willingness to allow pharmacists to implement the recommendations of therapeutic and medical staff committees.

Variation in Outpatient Oral Antimicrobial Use Patterns among Canadian Provinces, 2000 to 2010

Directory of Open Access Journals (Sweden)

Shiona K Glass-Kaastra

2014-01-01

Full Text Available BACKGROUND: The volume and patterns of antimicrobial drug use are key variables to consider when developing guidelines for prescribing, and programs to address stewardship and combat the increasing prevalence of antimicrobial resistant pathogens. Because drug programs are regulated at the provincial level, there is an expectation that antibiotic use may vary among provinces.

76 FR 30904 - Rural Utilities Service Telecommunications Loan and Loan Guarantee Program

Science.gov (United States)

2011-05-27

..., this new approach will give our customers increased flexibility to find and deploy technology that... DEPARTMENT OF AGRICULTURE Rural Utilities Service Rural Utilities Service Telecommunications Loan and Loan Guarantee Program AGENCY: Rural Utilities Service, USDA. ACTION: Notice of elimination of the...

[Selection of indicators for continuous monitoring of the impact of programs optimizing antimicrobial use in Primary Care].

Science.gov (United States)

Fernández-Urrusuno, Rocío; Flores-Dorado, Macarena; Moreno-Campoy, Eva; Montero-Balosa, M Carmen

2015-05-01

To determine core indicators for monitoring quality prescribing in Primary Care based on the evidence, and to assess the feasibility of these indicators for monitoring the use of antibiotics. A literature review was carried out on quality indicators for antimicrobial prescribing through an electronic search limited to the period 2001-2012. It was completed with an "ad hoc" search on the websites of public national and international health services. Finally, indicators were chosen by consensus by a multidisciplinary group of professionals dedicated to managing infections from several areas. The feasibility and applicability of these indicators was verified through the reporting and use of data in the prescription database. Twenty two indicators were found. The consensus group selected 16 indicators. Eleven of them measure the specific antimicrobial selection, and 5 are consumption rates. The indicators were successfully applied to the prescription database, being able to make comparisons between different geographical areas and to observe trends in prescriptions. The definition of a basic set of indicators to monitor antibiotic use adapted to local conditions is required. The results of these indicators can be used for feedback to professionals and for evaluating the impact of programs aimed at improving antimicrobial use. Copyright © 2014 Elsevier España, S.L.U. y Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. All rights reserved.

Lessons Learned from Surveillance of Antimicrobial Susceptibilities of Pseudomonas aeruginosa at a Large Academic Medical Center

Directory of Open Access Journals (Sweden)

Brett H. Heintz

2010-04-01

Full Text Available This research report assessed the differences in resistance rates and antimicrobial usage-versus-susceptibility relationships of Pseudomonas aeruginosa found in various hospital patient care areas. A simplified case control study was also performed to identify patient-specific risk factors associated with cefepime-resistant P. aeruginosa isolates. Last, we determined the consequence of combining mucoid and non-mucoid derived antimicrobial susceptibilities of P. aeruginosa into hospital antibiograms. Overall, susceptibility rates remained lower in the intensive care units (ICUs compared to the non-ICU patient care areas, except for cefepime over the last time period. Cefepime utilization and antimicrobial-resistance rates among P. aeruginosa isolates had a significant relationship. Decreased meropenem exposure was associated with lower resistance rates relative to cefepime. Risk factors independently associated with cefepime-resistant P. aeruginosa were structural lung disease, ICU admission, recent third generation cephalosporin use, frequent hospital admission and non-urine isolates. Large and statistically significant differences were observed between non-mucoid and combined percent susceptibility data for aminoglycosides. To control antimicrobial resistance and optimize initial empiric antimicrobial therapy, antimicrobial susceptibility and utilization patterns in specific patient care areas should be monitored and risk factors for antimicrobial resistance should be assessed. Mucoid strains of P. aeruginosa should not be included into antimicrobial susceptibility data as this may underestimate activity of most antipseudomonal agents.

Impact of Large Scale Energy Efficiency Programs On Consumer Tariffs and Utility Finances in India

Energy Technology Data Exchange (ETDEWEB)

Abhyankar, Nikit; Phadke, Amol

2011-01-20

Large-scale EE programs would modestly increase tariffs but reduce consumers' electricity bills significantly. However, the primary benefit of EE programs is a significant reduction in power shortages, which might make these programs politically acceptable even if tariffs increase. To increase political support, utilities could pursue programs that would result in minimal tariff increases. This can be achieved in four ways: (a) focus only on low-cost programs (such as replacing electric water heaters with gas water heaters); (b) sell power conserved through the EE program to the market at a price higher than the cost of peak power purchase; (c) focus on programs where a partial utility subsidy of incremental capital cost might work and (d) increase the number of participant consumers by offering a basket of EE programs to fit all consumer subcategories and tariff tiers. Large scale EE programs can result in consistently negative cash flows and significantly erode the utility's overall profitability. In case the utility is facing shortages, the cash flow is very sensitive to the marginal tariff of the unmet demand. This will have an important bearing on the choice of EE programs in Indian states where low-paying rural and agricultural consumers form the majority of the unmet demand. These findings clearly call for a flexible, sustainable solution to the cash-flow management issue. One option is to include a mechanism like FAC in the utility incentive mechanism. Another sustainable solution might be to have the net program cost and revenue loss built into utility's revenue requirement and thus into consumer tariffs up front. However, the latter approach requires institutionalization of EE as a resource. The utility incentive mechanisms would be able to address the utility disincentive of forgone long-run return but have a minor impact on consumer benefits. Fundamentally, providing incentives for EE programs to make them comparable to supply

phytochemical and antimicrobial properties of solanum macranthum ...

African Journals Online (AJOL)

MR J.O. OLAYEMI

reducing sugars and anthraquinones. The in vitro antimicrobial activity was done using agar well diffusion technique. Six clinical strains of human pathogenic microorganisms, comprising two Gram positive, two Gram negative bacteria and two fungi were utilized in the studies. The various plant extracts varied in their high ...

Prevalence and antimicrobial resistance among Escherichia coli and Salmonella in Ontario smallholder chicken flocks.

Science.gov (United States)

Lebert, L; Martz, S-L; Janecko, N; Deckert, A E; Agunos, A; Reid, A; Rubin, J E; Reid-Smith, R J; McEwen, S A

2018-02-01

Surveillance is an important component of an overall strategy to address antimicrobial resistant bacteria in food animals and the food chain. The poultry market has many points of entry into the Canadian food chain, and some production practices are underrepresented in terms of surveillance. For example, pathogen carriage and antimicrobial resistance surveillance data are limited in smallholder chicken flocks raised for slaughter at provincially inspected abattoirs. In Canada, antimicrobial resistance in Escherichia coli and Salmonella isolated from commercial broiler chicken flocks, slaughtered at federally inspected abattoirs, is monitored by the Canadian Integrated Program for Antimicrobial Resistance Surveillance (CIPARS). The objective of this study was to establish baseline information of antimicrobial resistance presence in E. coli and Salmonella isolated from smallholder flocks in Ontario, utilizing CIPARS collection and isolation methodologies, and to compare findings with CIPARS federally inspected abattoir data from Ontario, Canada. Five chickens per flock were sampled from 205 smallholder flocks. Of 1,025 samples, the E. coli prevalence was 99% (1,022/1,025), and 47% (483/1,022) of positive E. coli isolates were resistant to one or more of the 14 antimicrobials. Furthermore, as compared to results reported for the CIPARS commercial flocks, E. coli isolates from smallholder flocks had significantly lower resistance prevalence to six of 14 individual antimicrobials. Recovery of E. coli did not differ between federally inspected and provincially inspected flocks. Salmonella prevalence at the bird level in smallholder flocks was 0.3% (3/1,025), significantly lower (p ≪ 0.0001, 95% CI 0.080%-0.86%) than federally inspected commercial flocks. The overall differences found between the commercial and smallholder flocks may be explained by differences in poultry husbandry practices and hatchery sources. © 2017 Her Majesty the Queen in Right of Canada

Using program impact pathways to understand and improve program delivery, utilization, and potential for impact of Helen Keller International's homestead food production program in Cambodia.

Science.gov (United States)

Olney, Deanna K; Vicheka, Sao; Kro, Meng; Chakriya, Chhom; Kroeun, Hou; Hoing, Ly Sok; Talukder, Aminzzaman; Quinn, Victoria; Iannotti, Lora; Becker, Elisabeth; Roopnaraine, Terry

2013-06-01

Evidence of the impact of homestead food production programs on nutrition outcomes such as anemia and growth is scant. In the absence of information on program impact pathways, it is difficult to understand why these programs, which have been successful in increasing intake of micronutrient-rich foods, have had such limited documented impact on nutrition outcomes. To conduct a process evaluation of Helen Keller International's (HKI's) homestead food production program in Cambodia to assess whether the program was operating as planned (in terms of design, delivery, and utilization) and to identify ways in which the program might need to be strengthened in order to increase its potential for impact. A program theory framework, which laid out the primary components along the hypothesized program impact pathways, was developed in collaboration with HKI and used to design the research. Semistructured interviews and focus group discussions with program beneficiaries (n = 36 and 12, respectively), nonbeneficiaries (n = 12), and program implementers (n = 17 and 2, respectively) and observations of key program delivery points, including health and nutrition training sessions (n = 6), village model farms (n = 6), and household gardens of beneficiaries (n = 36) and nonbeneficiaries (n = 12), were conducted to assess the delivery and utilization of the primary program components along the impact pathways. The majority of program components were being delivered and utilized as planned. However, challenges with some of the key components posited to improve outcomes such as anemia and growth were noted. Among these were a gap in the expected pathway from poultry production to increased intake of eggs and poultry meat, and some weaknesses in the delivery of the health and nutrition training sessions and related improvements in knowledge among the village health volunteers and beneficiaries. Although the program has been successful in delivering the majority of the program

Cost-Utility Analysis of a Cardiac Telerehabilitation Program

DEFF Research Database (Denmark)

Kidholm, Kristian; Rasmussen, Maja Kjær; Andreasen, Jan Jesper

2016-01-01

Background: Cardiac rehabilitation can reduce mortality of patients with cardiovascular disease, but a frequently low participation rate in rehabilitation programs has been found globally. The objective of the Teledialog study was to assess the cost-utility (CU) of a cardiac telerehabilitation (CTR...... was higher in the intervention group, but the difference was not statistically significant. The incremental CU ratio was more than (sic)400,000 per QALY gained. Conclusions: Even though the rehabilitation activities increased, the program does not appear to be cost-effective. The intervention itself...

Utility DSM Programs from 1989 Through 1998: Continuation or Cross-Roads?

Energy Technology Data Exchange (ETDEWEB)

Hadley, S.

1995-01-01

Over the past five years, the Energy Information Administration (EIA) has been collecting data annually from US electric utilities on their demand-side management (DSM) programs, both current and projected. The latest data cover activities for 1993 and projections for 1994 and 1998. In 1993, 991 utilities operated DSM programs. That year, they spent $2.8 billion, a 13% increase over 1992 expenditures. These and earlier DSM programs saved 44,000 GWh of energy and reduced potential peak demand by 40,000 MW, 30% and 22% increases over the 1992 values, respectively. While some people predict the demise of electric-utility DSM programs, the data do not paint so bleak a picture. In most parts of the country, DSM programs grew in 1993 and utilities (as of Spring 1994) projected continued growth through 1998. Expenditures grew from 1.3% of revenues in 1992 to 1.5% in 1993, and are expected to grow 2.5% per year faster than inflation, which is equivalent to revenue growth. Thus, DSM spending is expected to stay constant at 1.5% of revenues through 1998. Because of the cumulative effect of DSM programs, energy savings are expected to grow from 1.2% of sales in 1992 to 1.6% in 1993 and 3.0% in 1998. Potential-peak reductions are expected to increase from 5.9% of peak demand in 1992 to 6.8% in 1993 and 8.9% in 1998. However, the growth in spending is not as rapid as the 8% annual real growth projected a year earlier. Actual expenditures in 1993 were 6.5% lower than projected early that year. Energy savings, on the other hand, were the same as projected earlier. Potential peak reductions were actually 9% higher than previously projected.

Initiatives in training program evaluation outside the nuclear utility industry

International Nuclear Information System (INIS)

Allen, C.J.

1987-01-01

Training literature is reviewed, and program evaluative practices outside the nuclear utility industry are reported. The findings indicate some innovations in philosophy and practice and program evaluation, although not necessarily in the context of evaluation as a route to assessing the impact of training. Program evaluation is described in the context of the impact of training, suggesting continued efforts to accept a multivariate concept of individual and organizational performance

Developing Surgical Antimicrobial Prophylaxis Interventions Using Theoretical Domains Framework

OpenAIRE

Bonnar, Paul E; Senthinathan, Arrani; Nakamachi, Yoshiko; Backstein, David J; Steinberg, Marilyn; Morris, Andrew M

2017-01-01

Abstract Background Surgical site infections are common causes of healthcare-associated infections. Using surgical antimicrobial prophylaxis (SAP) is a complex process that can reduce these rates if performed correctly. While antimicrobial stewardship programs have developed guidelines for SAP, there has been less focus on understanding and modifying the behavioral and contextual factors required to optimize prophylaxis use. We performed chart reviews and workflow analyses to develop interven...

Basic research program for innovated coal utilization in Japan. BRAIN-C program; Sekitan riyo kiban gijutsu kaihatsu. BRAIN-C program

Energy Technology Data Exchange (ETDEWEB)

Harada, M [Center for Coal Utilization, Japan, Tokyo (Japan)

1996-09-01

This paper introduces the circumstances and purpose of establishing the Basic Research Associate for Innovated Coal Utilization (BRAIN-C) Program started in October 1995, and the summary of the results therefrom in fiscal 1995. Although development of coal utilization technologies has been implemented over a number of years, there are many problems still requiring solutions. Early realization has been urged on diversification of coal utilization, acceleration of technological development and diversification of coal types. In order to achieve these goals, the necessity was recognized afresh on not only the hardwares, but also on basic technologies in terms of software which can identify properties of coals, systematize different reactions, and estimate reactions, fluidity and heat transmission of coals. Therefore, receiving a subsidy from the Agency of Natural Resources and Energy of the Ministry of International Trade and Industry, a research and development program to be implemented jointly by industries, administrative agencies and academic societies had been started with a five-year plan for the time being. With the activities for the program such as collecting 50 to 100 types of coals and supplying them to researchers, the program had been accelerated in fiscal 1995 on a large number of themes and results therefrom, including fundamental properties and thermo-chemical reactions. 2 figs., 4 tabs.

User Guide and Documentation for Five MODFLOW Ground-Water Modeling Utility Programs

Science.gov (United States)

Banta, Edward R.; Paschke, Suzanne S.; Litke, David W.

2008-01-01

This report documents five utility programs designed for use in conjunction with ground-water flow models developed with the U.S. Geological Survey's MODFLOW ground-water modeling program. One program extracts calculated flow values from one model for use as input to another model. The other four programs extract model input or output arrays from one model and make them available in a form that can be used to generate an ArcGIS raster data set. The resulting raster data sets may be useful for visual display of the data or for further geographic data processing. The utility program GRID2GRIDFLOW reads a MODFLOW binary output file of cell-by-cell flow terms for one (source) model grid and converts the flow values to input flow values for a different (target) model grid. The spatial and temporal discretization of the two models may differ. The four other utilities extract selected 2-dimensional data arrays in MODFLOW input and output files and write them to text files that can be imported into an ArcGIS geographic information system raster format. These four utilities require that the model cells be square and aligned with the projected coordinate system in which the model grid is defined. The four raster-conversion utilities are * CBC2RASTER, which extracts selected stress-package flow data from a MODFLOW binary output file of cell-by-cell flows; * DIS2RASTER, which extracts cell-elevation data from a MODFLOW Discretization file; * MFBIN2RASTER, which extracts array data from a MODFLOW binary output file of head or drawdown; and * MULT2RASTER, which extracts array data from a MODFLOW Multiplier file.

Trends in Drug Resistance of Acinetobacter baumannii over a 10-year Period: Nationwide Data from the China Surveillance of Antimicrobial Resistance Program.

Science.gov (United States)

Gao, Lei; Lyu, Yuan; Li, Yun

2017-03-20

Acinetobacter baumannii has emerged as an important pathogen causing a variety of infections. Using data from the China Surveillance of Antimicrobial Resistance Program conducted biennially, we investigated the secular changes in the resistance of 2917 isolates of A. baumannii from 2004 to 2014 to differ antimicrobial agents. Pathogen samples were collected from 17 to 20 hospitals located in the eastern, central, and western regions of China. Minimum inhibitory concentrations (MICs) were determined by a 2-fold agar dilution method, and antimicrobial susceptibility was established using the 2014 Clinical Laboratory Standards Institute-approved breakpoints. Isolates not susceptible to all the tested aminoglycosides, fluoroquinolones, β-lactams, β-lactam/β-lactam inhibitors and carbapenems were defined as extensively drug resistant. The rates of nonsusceptibility to common antimicrobial agents remained high (>65%) over the years with some fluctuations to certain agents. The prevalence of imipenem-resistant A. baumannii (IRAB) increased from 13.3% in 2004 to 70.5% in 2014 and that of extensively drug-resistant A. baumannii (XDRAB) increased from 11.1% in 2004 to 60.4% in 2014. The activity of tigecycline was stable with MIC90 ≤4 mg/L against A. baumannii from 2009 to 2014. Susceptibility to colistin remained high (97.0%) from 2009 to 2014. The prevalence of XDRAB increased in all the three surveillance regions over the years and was significantly higher in Intensive Care Unit (ICU) wards than non-ICU wards. This longitudinal multicenter surveillance program revealed the nationwide emergence of A. baumannii in China and showed a significant increase in prevalence from 2004 to 2014. High levels of bacterial resistance were detected among samples collected from clinical settings in China, with IRAB and XDRAB being especially prevalent. This study will help to guide empirical therapy and identify at-risk groups requiring more intense interventional infection control

Role of the hospitalist in antimicrobial stewardship: a review of work completed and description of a multisite collaborative.

Science.gov (United States)

Rohde, Jeffrey M; Jacobsen, Diane; Rosenberg, David J

2013-06-01

Historically, antimicrobial stewardship programs have been led by infectious-disease physicians and pharmacists. With the growing presence of hospitalists in health and hospital systems, combined with their focus on quality improvement and patient safety, this emerging medical specialty has the potential to fill essential roles in antimicrobial stewardship programs. The goal of this article was to present the reasons hospitalists are ideally positioned to fill antimicrobial-stewardship roles, a narrative review of previously reported hospitalist-led antibiotic-stewardship projects, and a description of an ongoing multisite collaborative by the Institute for Healthcare Improvement (IHI) and the Centers for Disease Control and Prevention (CDC). A review of the published literature was performed, including an extensive review of the abstracts submitted to the Society of Hospital Medicine annual meetings. A number of examples of hospitalists developing and leading antimicrobial-stewardship programs are described. The details of a current multisite IHI/CDC hospitalist-focused initiative are discussed in detail. Hospitalists are actively involved with, and even lead, a variety of antimicrobial-stewardship programs in several different hospital systems. A large, multisite collaborative focused on hospitalist-led antimicrobial stewardship is currently in progress. Copyright © 2013 Elsevier HS Journals, Inc. All rights reserved.

Formerly Utilized Sites Remedial Action Program environmental compliance assessment checklists

Energy Technology Data Exchange (ETDEWEB)

Levine, M.B.; Sigmon, C.F.

1989-09-29

The purpose of the Environmental Compliance Assessment Program is to assess the compliance of Formerly Utilized Site Remedial Action Program (FUSRAP) sites with applicable environmental regulations and Department of Energy (DOE) Orders. The mission is to identify, assess, and decontaminate sites utilized during the 1940s, 1950s, and 1960s to process and store uranium and thorium ores in support of the Manhattan Engineer District and the Atomic Energy Commission. To conduct the FUSRAP environmental compliance assessment, checklists were developed that outline audit procedures to determine the compliance status of the site. The checklists are divided in four groups to correspond to these regulatory areas: Hazardous Waste Management, PCB Management, Air Emissions, and Water Discharges.

Formerly Utilized Sites Remedial Action Program environmental compliance assessment checklists

International Nuclear Information System (INIS)

Levine, M.B.; Sigmon, C.F.

1989-01-01

The purpose of the Environmental Compliance Assessment Program is to assess the compliance of Formerly Utilized Site Remedial Action Program (FUSRAP) sites with applicable environmental regulations and Department of Energy (DOE) Orders. The mission is to identify, assess, and decontaminate sites utilized during the 1940s, 1950s, and 1960s to process and store uranium and thorium ores in support of the Manhattan Engineer District and the Atomic Energy Commission. To conduct the FUSRAP environmental compliance assessment, checklists were developed that outline audit procedures to determine the compliance status of the site. The checklists are divided in four groups to correspond to these regulatory areas: Hazardous Waste Management, PCB Management, Air Emissions, and Water Discharges

Antimicrobial Stewardship: A Cross-Sectional Survey Assessing the Perceptions and Practices of Community Pharmacists in Ethiopia

Directory of Open Access Journals (Sweden)

Daniel Asfaw Erku

2016-01-01

Full Text Available Background. Community pharmacists are key healthcare professionals for antimicrobial stewardship programs owing to their role in dispensing of antimicrobials. The aim of the present study was to assess the perception and practices of community pharmacists towards antimicrobial stewardship (AMS in Ethiopia. Methods. A cross-sectional survey was conducted by selecting pharmacy sites through stratified simple random sampling technique. Descriptive and inferential statistics were used to analyze the data. Results. Majority of respondents strongly agreed or agreed that AMS program is vital for the improvement of patient care. Almost all of respondents agreed that pharmacists can play a prominent role in AMS and infection prevention (93.2%, median = 5; IQR = 2–5. However, only 26.5% of respondents strongly agreed or agreed that AMS should be practiced at community pharmacy level (median = 4, IQR = 1–3 and more than half of community pharmacists (59.9% often/always dispense antimicrobial without a prescription. Conclusion. The present study revealed positive perceptions and practices of community pharmacists towards antimicrobial stewardship. Yet, some weak areas like integration of AMS program in community pharmacies, the significance of interprofessional involvement, and dispensing of antimicrobials without a valid prescription still need improvement.

The antimicrobial resistance crisis: causes, consequences, and management.

Science.gov (United States)

Michael, Carolyn Anne; Dominey-Howes, Dale; Labbate, Maurizio

2014-01-01

The antimicrobial resistance (AMR) crisis is the increasing global incidence of infectious diseases affecting the human population, which are untreatable with any known antimicrobial agent. This crisis will have a devastating cost on human society as both debilitating and lethal diseases increase in frequency and scope. Three major factors determine this crisis: (1) the increasing frequency of AMR phenotypes among microbes is an evolutionary response to the widespread use of antimicrobials; (2) the large and globally connected human population allows pathogens in any environment access to all of humanity; and (3) the extensive and often unnecessary use of antimicrobials by humanity provides the strong selective pressure that is driving the evolutionary response in the microbial world. Of these factors, the size of the human population is least amenable to rapid change. In contrast, the remaining two factors may be affected, so offering a means of managing the crisis: the rate at which AMR, as well as virulence factors evolve in microbial world may be slowed by reducing the applied selective pressure. This may be accomplished by radically reducing the global use of current and prospective antimicrobials. Current management measures to legislate the use of antimicrobials and to educate the healthcare world in the issues, while useful, have not comprehensively addressed the problem of achieving an overall reduction in the human use of antimicrobials. We propose that in addition to current measures and increased research into new antimicrobials and diagnostics, a comprehensive education program will be required to change the public paradigm of antimicrobial usage from that of a first line treatment to that of a last resort when all other therapeutic options have failed.

The Program Administrator Cost of Saved Energy for Utility Customer-Funded Energy Efficiency Programs

Energy Technology Data Exchange (ETDEWEB)

Billingsley, Megan A.; Hoffman, Ian M.; Stuart, Elizabeth; Schiller, Steven R.; Goldman, Charles A.; LaCommare, Kristina

2014-03-19

End-use energy efficiency is increasingly being relied upon as a resource for meeting electricity and natural gas utility system needs within the United States. There is a direct connection between the maturation of energy efficiency as a resource and the need for consistent, high-quality data and reporting of efficiency program costs and impacts. To support this effort, LBNL initiated the Cost of Saved Energy Project (CSE Project) and created a Demand-Side Management (DSM) Program Impacts Database to provide a resource for policy makers, regulators, and the efficiency industry as a whole. This study is the first technical report of the LBNL CSE Project and provides an overview of the project scope, approach, and initial findings, including: • Providing a proof of concept that the program-level cost and savings data can be collected, organized, and analyzed in a systematic fashion; • Presenting initial program, sector, and portfolio level results for the program administrator CSE for a recent time period (2009-2011); and • Encouraging state and regional entities to establish common reporting definitions and formats that would make the collection and comparison of CSE data more reliable. The LBNL DSM Program Impacts Database includes the program results reported to state regulators by more than 100 program administrators in 31 states, primarily for the years 2009–2011. In total, we have compiled cost and energy savings data on more than 1,700 programs over one or more program-years for a total of more than 4,000 program-years’ worth of data, providing a rich dataset for analyses. We use the information to report costs-per-unit of electricity and natural gas savings for utility customer-funded, end-use energy efficiency programs. The program administrator CSE values are presented at national, state, and regional levels by market sector (e.g., commercial, industrial, residential) and by program type (e.g., residential whole home programs, commercial new

NASA technology utilization program: The small business market

Science.gov (United States)

Vannoy, J. K.; Garcia-Otero, F.; Johnson, F. D.; Staskin, E.

1980-01-01

Technology transfer programs were studied to determine how they might be more useful to the small business community. The status, needs, and technology use patterns of small firms are reported. Small business problems and failures are considered. Innovation, capitalization, R and D, and market share problems are discussed. Pocket, captive, and new markets are summarized. Small manufacturers and technology acquisition are discussed, covering external and internal sources, and NASA technology. Small business and the technology utilization program are discussed, covering publications and industrial applications centers. Observations and recommendations include small business market development and contracting, and NASA management technology.

Engineering Non-Wetting Antimicrobial Fabrics

Science.gov (United States)

van den Berg, Desmond

This research presents novel techniques and a review of commercially available fabrics for their antimicrobial potential. Based on previous research into the advantages of superhydrophobic self-cleaning surfaces against bacterial contamination, insights into what can make a superhydrophobic fabric inherently antimicrobial were analyzed. Through comparing the characterization results of scanning electron microscopy (SEM) and optical profilometry to microbiology experiments, hypotheses into the relationship between the contact area of a bacterial solution and the extent of contamination is developed. Contact scenario experiments, involving the use of fluorescence microscopy and calculating colony forming units, proved that the contamination potential of any fabric is due to the wetting state exhibited by the fabric, as well as the extent of surface texturing. Transmission experiments, utilizing a novel technique of stamping a contaminated fabric, outlined the importance of retention of solutions or bacteria during interactions within the hospital environment on the extent of contamination.

The effect of Employee Assistance Programs use on healthcare utilization.

OpenAIRE

Zarkin, G A; Bray, J W; Qi, J

2000-01-01

OBJECTIVE: To estimate the effect of Employee Assistance Program (EAP) use on healthcare utilization as measured by health claims. DATA SOURCES: A unique data set that combines individual-level information on EAP utilization, demographic information, and health insurance claims from 1991 to 1995 for all employees of a large midwestern employer. STUDY DESIGN: Using "fixed-effect" econometric models that control for unobserved differences between individuals' propensities to use healthcare reso...

A summary index for antimicrobial resistance in food animals in the Netherlands.

NARCIS (Netherlands)

Havelaar, Arie H; Graveland, Haitske; van de Kassteele, Jan; Zomer, Tizza P; Veldman, Kees; Bouwknegt, Martijn

2017-01-01

The Dutch government has set targets for reduction of antimicrobial usage in food animals, stipulating a 50% reduction in usage (on a weight basis) in 2013 as compared to 2009 and a 70% decrease in 2015. A monitoring program has been instituted to evaluate the impact on antimicrobial resistance

The UMR reactor outreach program for expanded educational utilization

International Nuclear Information System (INIS)

Freeman, D.; Bolon, A.

1992-01-01

In recent years, the University of Missouri-Rolla Reactor (UMRR) facility has been under intense financial scrutiny by the university administration; primarily due to ever-tightening budgets and declines in nuclear engineering (NE) enrollment. In response to criticisms of low utilization, the reactor staff has developed and implemented a dynamic outreach program designed to significantly increase the educational role of the facility on campus. The outreach program is based on the principle that the potential to provide service to the UMR community is far in excess of the present level of service. The program is designed to identify and inform potential users of how their courses or programs can be augmented through use of the reactor facility. The net effect of the outreach program is greater campus communication and awareness of the unique capabilities as applied to each discipline. A natural product of the outreach program should be increased research

Antimicrobials Treatment

Science.gov (United States)

Drosinos, Eleftherios H.; Skandamis, Panagiotis N.; Mataragas, Marios

The use of antimicrobials is a common practice for preservation of foods. Incorporation, in a food recipe, of chemical antimicrobials towards inhibition of spoilage and pathogenic micro-organisms results in the compositional modification of food. This treatment is nowadays undesirable for the consumer, who likes natural products. Scientific community reflecting consumers demand for natural antimicrobials has made efforts to investigate the possibility to use natural antimicrobials such us bacteriocins and essential oils of plant origin to inhibit microbial growth.

Declines in Outpatient Antimicrobial Use in Canada (1995–2010)

Science.gov (United States)

Finley, Rita; Glass-Kaastra, Shiona K.; Hutchinson, Jim; Patrick, David M.; Weiss, Karl; Conly, John

2013-01-01

Background With rising reports of antimicrobial resistance in outpatient communities, surveillance of antimicrobial use is imperative for supporting stewardship programs. The primary objective of this article is to assess the levels of antimicrobial use in Canada over time. Methods Canadian antimicrobial use data from 1995 to 2010 were acquired and assessed by four metrics: population-adjusted prescriptions, Defined Daily Doses, spending on antimicrobials (inflation-adjusted), and average Defined Daily Doses per prescription. Linear mixed models were built to assess significant differences among years and antimicrobial groups, and to account for repeated measurements over time. Measures were also compared to published reports from European countries. Results Temporal trends in antimicrobial use in Canada vary by metric and antimicrobial grouping. Overall reductions were seen for inflation-adjusted spending, population-adjusted prescription rates and Defined Daily Doses, and increases were observed for the average number of Defined Daily Doses per prescription. The population-adjusted prescription and Defined Daily Doses values for 2009 were comparable to those reported by many European countries, while the average Defined Daily Dose per prescription for Canada ranked high. A significant reduction in the use of broad spectrum penicillins occurred between 1995 and 2004, coupled with increases in macrolide and quinolone use, suggesting that replacement of antimicrobial drugs may occur as new products arrive on the market. Conclusions There have been modest decreases of antimicrobial use in Canada over the past 15 years. However, continued surveillance of antimicrobial use coupled with data detailing antimicrobial resistance within bacterial pathogens affecting human populations is critical for targeting interventions and maintaining the effectiveness of these products for future generations. PMID:24146863

Impact of large-scale energy efficiency programs on utility finances and consumer tariffs in India

International Nuclear Information System (INIS)

Abhyankar, Nikit; Phadke, Amol

2012-01-01

The objective of this paper is to analyze the effect on utility finances and consumer tariffs of implementing utility-funded demand-side energy efficiency (EE) programs in India. We use the state of Delhi as a case study. We estimate that by 2015, the electric utilities in Delhi can potentially save nearly 14% of total sales. We examine the impacts on utility finances and consumer tariffs by developing scenarios that account for variations in the following factors: (a) incentive mechanisms for mitigating the financial risk of utilities, (b) whether utilities fund the EE programs only partially, (c) whether utilities sell the conserved electricity into spot markets and (d) the level of power shortages utilities are facing. We find that average consumer tariff would increase by 2.2% although consumers participating in EE programs benefit from reduction in their electricity consumption. While utility incentive mechanisms can mitigate utilities’ risk of losing long-run returns, they cannot address the risk of consistently negative cash flow. In case of power shortages, the cash flow risk is amplified (reaching up to 57% of utilities annual returns) and is very sensitive to marginal tariffs of consumers facing power shortages. We conclude by proposing solutions to mitigate utility risks. - Highlights: ► We model implementation of energy efficiency (EE) programs in Delhi, India. ► We examine the impact on utility finances and consumer tariffs from 2012 to 2015. ► We find that average consumer tariffs increase but participating consumers benefit. ► Existing regulatory mechanisms cannot address utilities’ risk of negative cash flow. ► Frequent true-ups or ex-ante revenue adjustment is required to address such risk.

Investigating the Utilization of Research Evidence in the 4-H Youth Development Program

Directory of Open Access Journals (Sweden)

Lynette H. Bikos

2011-06-01

Full Text Available This study investigated the acquisition, interpretation, and utilization of research evidence in the 4-H Youth Development Program from the frame of Social Cognitive Theory. Utilizing Consensual Qualitative Research, we interviewed twenty 4-H faculty, staff, and volunteers from seven states. Results indicated four domains, which covered participants’ definitions of research utilization, their experiences utilizing research, the process of acquiring and distributing research, and barriers and facilitators to research utilization. Participants described research use primarily in terms of improving 4-H programs. They discussed their level of confidence (i.e. self-efficacy in finding and applying research evidence and their beliefs about the outcomes of research utilization (i.e. outcomes expectancy. Participants mentioned such barriers as not knowing where to look for research, lack of time, lack of funding, and difficulty applying research findings to their work. The facilitators included support from other 4-H colleagues and availability of 4-H specific conferences, publications, and curriculum databases.

Correlation between antimicrobial consumption and antimicrobial resistance of Pseudomonas aeruginosa in a hospital setting: a 10-year study.

Science.gov (United States)

Mladenovic-Antic, S; Kocic, B; Velickovic-Radovanovic, R; Dinic, M; Petrovic, J; Randjelovic, G; Mitic, R

2016-10-01

Antimicrobial resistance is one of the greatest threats to human health. One of the most important factors leading to the emergence of resistant bacteria is overuse of antibiotics. The purpose of this study was to investigate the correlation between antimicrobial usage and bacterial resistance of Pseudomonas aeruginosa (P. aeruginosa) over a 10-year period in the Clinical Center Niš, one of the biggest tertiary care hospitals in Serbia. We focused on possible relationships between the consumption of carbapenems and beta-lactam antibiotics and the rates of resistance of P. aeruginosa to carbapenems. We recorded utilization of antibiotics expressed as defined daily doses per 100 bed days (DBD). Bacterial resistance was reported as the percentage of resistant isolates (percentage of all resistant and intermediate resistant strains) among all tested isolates. A significant increasing trend in resistance was seen in imipenem (P resistance to amikacin (P resistance to imipenem in P. aeruginosa shows significance (P resistance to meropenem showed a trend towards significance (P > 0·05, Pearson r = 0·607). We found a very good correlation between the use of all beta-lactam and P. aeruginosa resistance to carbapenems (P antimicrobial resistance to carbapenems, significant correlations between the consumption of antibiotics, especially carbapenems and beta-lactams, and rates of antimicrobial resistance of P. aeruginosa to imipenem and meropenem. © 2016 John Wiley & Sons Ltd.

An assessment of antimicrobial consumption in food producing animals in Kenya

DEFF Research Database (Denmark)

Mitema, E.S.; Kikuvi, G.M.; Wegener, Henrik Caspar

2001-01-01

Antimicrobial agents are useful for control of bacterial infections in food animals and man. Their prudent use in these animals is important to control any possible development and transfer of resistance between animals and man. The objective of this study was to generate quantitative information...... to evaluate antimicrobial usage patterns by animal species, route of administration, antimicrobial class and type of use from 1995 to 1999 in Kenya. Theses data are essential for risk analysis and planning and can be helpful in interpreting resistance surveillance data, and evaluating the effectiveness...... of prudent use efforts and antimicrobial resistance mitigation strategies. Data on quantities of active substance classes were collected from the official records of the Pharmacy and Poisons Board of the Ministry of Health and analysed in MS Excel 2000 program. The mean antimicrobial consumption for the 5...

Patterns of Antimicrobial Prescribing in a Tertiary Care Hospital in Oman

Directory of Open Access Journals (Sweden)

Abdulrahman Al-Yamani

2016-01-01

Full Text Available Objectives: Antimicrobial stewardship programs have been designed to measure and improve the use of antimicrobials to achieve optimal clinical outcomes and reduce bacterial resistance. The aim of this study was to review patterns of antimicrobial prescribing for hospitalized patients in the acute care setting and assess the appropriateness of antimicrobial use among prescribers in a tertiary care hospital in Oman. Methods: We conducted a retrospective audit of the appropriateness of antimicrobial prescribing in patients admitted to acute care settings in a tertiary care hospital in Oman over a four-week period (1 November to 28 November 2012. The data of all discharged patients were retrieved from the department databases. Patient records and prescriptions were reviewed by an infectious disease consultant. The rationality of antimicrobial use was evaluated, analyzed, and judged based on local standard guidelines and the experience of the evaluating consultant. Results: There were 178 patients discharged from acute medical teams over the study period. Sixty-four percent of the patients received a total of 287 antimicrobial agents during admission. The average number of antimicrobials prescribed per patient in those prescribed antimicrobials was 2.5±1.1. The most commonly prescribed antimicrobial agent was piperacillin/tazobactam. Most patients had infections from gram-negative organisms, and high rates of extended spectrum beta-lactamase producing organisms were observed. Cultures were obtained before antimicrobial initiation in 25% of patients. Variability in antimicrobial selection for common infections was observed. Conclusions: National guidelines for the management of common infections are needed to minimize the overuse and misuse of antimicrobial agents in tertiary care hospitals. A large surveillance study on antimicrobial prescribing appropriateness in different hospital settings is warranted.

Outpatient parenteral antimicrobial therapy for orthopedic infections – a successful public healthcare experience in Brazil

Directory of Open Access Journals (Sweden)

Priscila Rosalba Oliveira

2016-05-01

Full Text Available Treatment of orthopedic infections usually requires prolonged antimicrobial therapy, ranging from 14 days up to 6 months. Nowadays, rising levels of antimicrobial resistance demands parenteral therapy for many patients. Outpatient parenteral antimicrobial therapy (OPAT is a modality that allows treatment out of hospital in these situations. In Brazil, where a public universal healthcare system allows full coverage for all citizens, implantation and dissemination of OPAT programs would be beneficial for patients and for the system, because it would allow a better allocation of health resources. The Instituto de Ortopedia e Traumatologia do Hospital das Clínicas da Faculdade de Medicina da USP (IOT started, in July 2013, a partnership with municipal health authorities in Sao Paulo, Brazil, in order to initiate an OPAT program in which patients discharged from that hospital would be able to continue antimicrobial therapy at primary care facilities. When necessary, patients could also receive their therapy at the day-hospital located at IOT. Primary care nursing and physician staff were trained about antimicrobial infusion and peripherally inserted central catheter manipulation. An OPAT specific antimicrobial protocol was designed and a special reference and counter-reference organized. As a result, 450 primary healthcare professionals were trained. In the first year of this program, 116 patients were discharged for OPAT. Chronic and acute osteomyelitis were most frequent diagnosis. Teicoplanin, ertapenem and tigecycline were the most used drugs. Duration of treatment varied from 10 to 180 days (average 101, median 42. Total sum of days in OPAT regimen was 11,698. Only 3 patients presented adverse effects. Partnership between services of different levels of complexity allowed implantation of a safe and effective public healthcare OPAT program for treatment of orthopedic infections. This program can serve as a model for developing similar strategies

Animation of Antimicrobial Resistance

Medline Plus

Full Text Available ... Animal & Veterinary Safety & Health Antimicrobial Resistance Animation of Antimicrobial Resistance Share Tweet Linkedin Pin it More sharing options ... of Animation of Antimicrobial Resistance More in Antimicrobial ... Antimicrobial Resistance Monitoring System About NARMS 2015 NARMS Integrated ...

Antimicrobial stewardship: a review of prospective audit and feedback systems and an objective evaluation of outcomes.

Science.gov (United States)

Chung, Gladys W; Wu, Jia En; Yeo, Chay Leng; Chan, Douglas; Hsu, Li Yang

2013-02-15

Antimicrobial stewardship is an emerging field currently defined by a series of strategies and interventions aimed toward improving appropriate prescription of antibiotics in humans in all healthcare settings. The ultimate goal is the preservation of current and future antibiotics against the threat of antimicrobial resistance, although improving patient safety and reducing healthcare costs are important concurrent aims. Prospective audit and feedback interventions are probably the most widely practiced of all antimicrobial stewardship strategies. Although labor-intensive, they are more easily accepted by physicians compared with formulary restriction and preauthorization strategies and have a higher potential for educational opportunities. Objective evaluation of antimicrobial stewardship is critical for determining the success of such programs. Nonetheless, there is controversy over which outcomes to measure and there is a pressing need for novel study designs that can objectively assess antimicrobial stewardship interventions despite the limitations inherent in the structure of most such programs.

Line Program Environmental Management Audit: Formerly Utilized Sites Remedial Action Program

International Nuclear Information System (INIS)

1992-05-01

This report documents the results of the Line Program Environmental Management Audit completed for the Formerly Utilized Sites Remedial Action Program (FUSRAP). During this Audit, activities and records were reviewed and personnel interviewed at Oak Ridge, Tennessee. Additionally, since FUSRAP falls under the responsibility of the Office of the Assistant Secretary for Environmental Restoration and Waste Management, selected individuals from this office were interviewed in Washington, DC and Germantown, Maryland. The onsite portion of the FUSRAP Audit was conducted from March 16 through 27, 1992, by the US Department of Energy's Office of Environmental Audit (EH-24) located within the Office of the Assistant Secretary for Environment, Safety and Health (EH-1). The scope of the FUSRAP Line Program Environmental Management Audit was comprehensive and included all areas of environmental management with the exception of the National Environmental Policy Act (NEPA). Since the subject of compliance with and implementation of the requirements of NEPA is the responsibility of the DOE Headquarters Office of NEPA Oversight, management issues pertaining to NEPA were not investigated as part of this Audit

Sustained pediatric antimicrobial stewardship program with consultation to infectious diseases reduced carbapenem resistance and infection-related mortality.

Science.gov (United States)

Horikoshi, Yuho; Suwa, Junichi; Higuchi, Hiroshi; Kaneko, Tetsuji; Furuichi, Mihoko; Aizawa, Yuta; Fukuoka, Kahoru; Okazaki, Kaoru; Ito, Kenta; Shoji, Takayo

2017-11-01

The impact of pediatric antimicrobial stewardship programs (ASP) on antimicrobial resistance (AMR) remains largely unknown. This study aimed to evaluate the AMR for carbapenem of Gram-negative bacilli (GNB) and carbapenem use with infectious diseases consultation after the implementation of an ASP. This quasi-experimental study was conducted at Tokyo Metropolitan Children's Medical Center in Japan. The pre- and post-intervention periods were April 2010 to September 2011 and October 2011 to March 2017, respectively. The pre-intervention phase consisted of consultations with the infectious diseases service alone. The ASP was implemented during the post-intervention phase. The carbapenem resistance rates of GNB were calculated. The correlation between carbapenem resistance rates and carbapenem day of therapy (DOT) was examined. The outcome metrics were compared by average length of hospitalization, all-cause mortality, and infection-related mortality. A positive correlation was observed between the carbapenem resistance rate in Pseudomonas aeruginosa and DOT (0.76, p=0.04). The carbapenem resistance rate in P. aeruginosa (pcarbapenem use and resistance in P. aeruginosa, leading to favorable outcomes in terms of length of hospitalization and infection-related mortality. Copyright © 2017 The Author(s). Published by Elsevier Ltd.. All rights reserved.

Antimicrobial use in Chinese swine and broiler poultry production.

Science.gov (United States)

Krishnasamy, Vikram; Otte, Joachim; Silbergeld, Ellen

2015-01-01

Antimicrobial use for growth promotion in food animal production is now widespread. A major concern is the rise of antimicrobial resistance and the subsequent impact on human health. The antimicrobials of concern are used in concentrated animal feeding operations (CAFOs) which are responsible for almost all meat production including swine and poultry in the US. With global meat consumption rising, the CAFO model has been adopted elsewhere to meet this demand. One such country where this has occurred is China, and evidence suggests 70% of poultry production now occurs outside of traditional small farms. Moreover, China is now the largest aggregate consumer of meat products in the world. With this rapid rise in consumption, the Chinese production model has changed along with the use of antimicrobials in feeds. However, the specific antibiotic use in the Chinese food animal production sector is unclear. Additionally, we are aware of high quantities of antimicrobial use because of reports of high concentrations of antimicrobials in animal waste and surface waters surrounding animal feeding operations. In this report, we estimate the volume of antibiotics used for swine and poultry production as these are the two meat sources with the highest levels of production and consumption in China. We adopt a model developed by Mellon et al. in the US for estimating drug use in feed for poultry and swine production to estimate overall antimicrobial use as well as antimicrobial use by class. We calculate that 38.5 million kg [84.9 million lbs] were used in 2012 in China's production of swine and poultry. By antibiotic class, the highest weights are tetracyclines in swine and coccidiostats in poultry. The volume of antimicrobial use is alarming. Although there are limitations to these data, we hope our report will stimulate further analysis and a sense of urgency in assessing the consequences of such high levels of utilization in terms of antibiotic resistance in the food supply

The Utilization of Ocimum sanctum L. Essential Oil for Antimicrobial Edible Packaging and Its Application for Aloe Vera Dodol

Directory of Open Access Journals (Sweden)

Pramono Putro Utomo

2013-12-01

Full Text Available Aloe vera dodol is a traditional food of West Kalimantan that has short shelf life because of its microbial activity. Antimicrobial edible packaging could be used to maintain the quality of packaged food product actively.The purpose of this study is to prolong the shelf life of food products using antimicrobial edible packaging from durian peel and basil (Ocimum sanctum L. essential oil. The research was conducted through 4 phases,i.e. the extraction of pectin from durian peel, basil essential oil distillation, Aspergillus flavus inhibition assay, and antimicrobial edible coating production incorporated with Ocimum sanctum L. essential oil. The results showed that pectin extracted from durian peel at pH 4.5 could give yield of 5.9% with a clear coat (Colourless.The concentration of Ocimum sanctum L. essential oil by 0.6% could inhibit the growth of Aspergillus flavus and prolong the shelf life when applied as an antimicrobial ingredient in edible coating.

Evaluation of pharmacy generalists performing antimicrobial stewardship services.

Science.gov (United States)

Carreno, Joseph J; Kenney, Rachel M; Bloome, Mary; McDonnell, Jane; Rodriguez, Jennifer; Weinmann, Allison; Kilgore, Paul E; Davis, Susan L

2015-08-01

Improvements in medication use achieved by pharmacy generalists using a care bundle approach to antimicrobial stewardship are reported. A six-month prospective, repeated-treatment, quasi-experimental study involving three month-long intervention periods and three month-long control periods was conducted in the setting of an existing antimicrobial stewardship program at a large hospital. The intervention involved prospective audit and feedback conducted by pharmacy generalists who were trained in an antimicrobial stewardship care bundle approach. During control months, a pharmacy generalist who was not trained in antimicrobial stewardship rounded with the multidisciplinary team and provided standard-of-care pharmacy services. The primary endpoint was compliance with a care bundle of four antimicrobial stewardship metrics: documentation of indication for therapy in the medical record, selection of empirical therapy according to institutional guidelines, documented performance of indicated culture testing, and deescalation of therapy when indicated. Two-hundred eighty-six patients were enrolled in the study: 124 in the intervention group and 162 in the control group. The cumulative rate of full compliance with all care bundle components during the six-month study was significantly greater during intervention months than during control months (68.5% versus 45.7%, p management. Copyright © 2015 by the American Society of Health-System Pharmacists, Inc. All rights reserved.

Spatial scan statistics to assess sampling strategy of antimicrobial resistance monitoring programme

DEFF Research Database (Denmark)

Vieira, Antonio; Houe, Hans; Wegener, Henrik Caspar

2009-01-01

Pie collection and analysis of data on antimicrobial resistance in human and animal Populations are important for establishing a baseline of the occurrence of resistance and for determining trends over time. In animals, targeted monitoring with a stratified sampling plan is normally used. However...... sampled by the Danish Integrated Antimicrobial Resistance Monitoring and Research Programme (DANMAP), by identifying spatial Clusters of samples and detecting areas with significantly high or low sampling rates. These analyses were performed for each year and for the total 5-year study period for all...... by an antimicrobial monitoring program....

Utility of Small Animal Models of Developmental Programming.

Science.gov (United States)

Reynolds, Clare M; Vickers, Mark H

2018-01-01

Any effective strategy to tackle the global obesity and rising noncommunicable disease epidemic requires an in-depth understanding of the mechanisms that underlie these conditions that manifest as a consequence of complex gene-environment interactions. In this context, it is now well established that alterations in the early life environment, including suboptimal nutrition, can result in an increased risk for a range of metabolic, cardiovascular, and behavioral disorders in later life, a process preferentially termed developmental programming. To date, most of the mechanistic knowledge around the processes underpinning development programming has been derived from preclinical research performed mostly, but not exclusively, in laboratory mouse and rat strains. This review will cover the utility of small animal models in developmental programming, the limitations of such models, and potential future directions that are required to fully maximize information derived from preclinical models in order to effectively translate to clinical use.

Perceptions and Practices of Community Pharmacists towards Antimicrobial Stewardship in the State of Selangor, Malaysia

Science.gov (United States)

Khan, Muhammad Umair; Hassali, Mohamed Azmi Ahmad; Ahmad, Akram; Elkalmi, Ramadan Mohamed; Zaidi, Syed Tabish Razi; Dhingra, Sameer

2016-01-01

Background Increasing antimicrobial resistance is one of the pressing concerns globally. Injudicious use of antibiotics is one of the modifiable factors responsible for antimicrobial resistance. Given the widespread use of antimicrobials in community settings, pharmacists have an important role in ensuring appropriate use of antibiotics. The objective of this study was to assess the perception and self-reported practices of community pharmacists towards antimicrobial stewardship. Methods A cross-sectional study was conducted among community pharmacists between March–April, 2015, using a self-administered, pre-tested questionnaire in the State of Selangor, Malaysia. A simple random sampling approach was used to select pharmacy sites. Descriptive and inferential statistical methods were used to analyse the data. Results A total of 188 pharmacists responded to the survey, giving a response rate of 83.5%. The majority of participants (n = 182, 96.8%) believed that antimicrobial stewardship program helps healthcare professionals to improve the quality of patient care. However, more than half of pharmacists were neutral in their opinion about the incorporation of antimicrobial stewardship programs in community pharmacies (n = 102, 54.2%). Though collaboration was often done by pharmacists with other health professionals over the use of antibiotics (n = 104, 55.3%), a significant proportion of participants (n = 102, 54.2%) rarely/occasionally participate in antimicrobial awareness campaigns. Pharmacists having postgraduate qualification were more likely to held positive perceptions of, and were engaged in, antimicrobial stewardship than their non-postgraduate counterpart (p 10 years) held positive perceptions towards antimicrobial stewardship (p<0.05). Conclusion The study highlighted some gaps in the perception and practices of community pharmacist towards antimicrobial stewardship. Development of customized interventions would be critical to bridging these gaps and

Perceptions and Practices of Community Pharmacists towards Antimicrobial Stewardship in the State of Selangor, Malaysia.

Directory of Open Access Journals (Sweden)

Muhammad Umair Khan

Full Text Available Increasing antimicrobial resistance is one of the pressing concerns globally. Injudicious use of antibiotics is one of the modifiable factors responsible for antimicrobial resistance. Given the widespread use of antimicrobials in community settings, pharmacists have an important role in ensuring appropriate use of antibiotics. The objective of this study was to assess the perception and self-reported practices of community pharmacists towards antimicrobial stewardship.A cross-sectional study was conducted among community pharmacists between March-April, 2015, using a self-administered, pre-tested questionnaire in the State of Selangor, Malaysia. A simple random sampling approach was used to select pharmacy sites. Descriptive and inferential statistical methods were used to analyse the data.A total of 188 pharmacists responded to the survey, giving a response rate of 83.5%. The majority of participants (n = 182, 96.8% believed that antimicrobial stewardship program helps healthcare professionals to improve the quality of patient care. However, more than half of pharmacists were neutral in their opinion about the incorporation of antimicrobial stewardship programs in community pharmacies (n = 102, 54.2%. Though collaboration was often done by pharmacists with other health professionals over the use of antibiotics (n = 104, 55.3%, a significant proportion of participants (n = 102, 54.2% rarely/occasionally participate in antimicrobial awareness campaigns. Pharmacists having postgraduate qualification were more likely to held positive perceptions of, and were engaged in, antimicrobial stewardship than their non-postgraduate counterpart (p 10 years held positive perceptions towards antimicrobial stewardship (p<0.05.The study highlighted some gaps in the perception and practices of community pharmacist towards antimicrobial stewardship. Development of customized interventions would be critical to bridging these gaps and improve their perception and

The value of participatory development to support antimicrobial stewardship with a clinical decision support system

NARCIS (Netherlands)

Beerlage-de Jong, Nienke; Wentzel, Jobke; Hendrix, Ron; van Gemert-Pijnen, Lisette

2017-01-01

Background: Current clinical decision support systems (CDSSs) for antimicrobial stewardship programs (ASPs) are guideline- or expert-driven. They are focused on (clinical) content, not on supporting real-time workflow. Thus, CDSSs fail to optimally support prudent antimicrobial prescribing in daily

The value of participatory development to support antimicrobial stewardship with a clinical decision support system

NARCIS (Netherlands)

Beerlage-de Jong, Nienke; Wentzel, M.J.; Hendrix, Ron; van Gemert-Pijnen, Julia E.W.C.

Background Current clinical decision support systems (CDSSs) for antimicrobial stewardship programs (ASPs) are guideline- or expert-driven. They are focused on (clinical) content, not on supporting real-time workflow. Thus, CDSSs fail to optimally support prudent antimicrobial prescribing in daily

Influence of applying different units of measurement on reporting antimicrobial consumption data for pig farms

NARCIS (Netherlands)

F.J. Taverne; J.H. Jacobs; D. Heederik (Dick); J.W. Mouton (Johan); J.A. Wagenaar (Jaap); I.M. van Geijlswijk (Ingeborg M.)

2015-01-01

textabstractBackground: Antimicrobial use in livestock is one of the factors contributing to selection and spread of resistant microorganisms in the environment. National veterinary antimicrobial consumption monitoring programs are therefore in place in a number of countries in the European Union.

Effect of structural animal health planning on antimicrobial use and animal health variables in conventional dairy farming in the Netherlands.

Science.gov (United States)

Speksnijder, David C; Graveland, Haitske; Eijck, Ineke A J M; Schepers, René W M; Heederik, Dick J J; Verheij, Theo J M; Wagenaar, Jaap A

2017-06-01

Widespread veterinary use of antimicrobials might contribute to the increasing burden of antimicrobial resistance. Despite many successful efforts to reduce veterinary antimicrobial use in the Netherlands, antimicrobial use on a substantial number of farms has remained relatively high over the past few years. Farm-specific solutions are required to further lower antimicrobial use on these farms. Reducing the burden of animal diseases at the farm level by means of a structured approach to animal health planning could be promising. This intervention study aimed to evaluate the main effects of an animal health planning program developed by an advisory team consisting of a dairy farmer, his veterinarian, and his feed adviser under the guidance of a professional facilitator. During an initial farm visit, the advisory team developed a farm-specific animal health planning program with support from the facilitator. After 1 yr, the effects of this program on animal health, production parameters, and antimicrobial use were evaluated and compared with control farms that did not have a facilitated animal health planning program. Antimicrobial use on intervention farms was significantly reduced between the start and the end of the study period; however, no significant differences in the rate of reduction between the intervention and control groups could be observed (-19% and -14%, respectively). Reduced antimicrobial use did not result in negative effects on animal health and production parameters during the study period in both groups. On intervention farms, a significant positive relationship was found between the percentage of completed action points at farm level and the percentage reduction in antimicrobial use. The level of compliance with action points and the quality of collaboration between farmer and advisers were positively associated with the accomplishment of corresponding objectives. However, the total number of objectives was negatively associated with the level

Integron, Plasmid and Host Strain Characteristics of Escherichia coli from Humans and Food Included in the Norwegian Antimicrobial Resistance Monitoring Programs.

Science.gov (United States)

Sunde, Marianne; Simonsen, Gunnar Skov; Slettemeås, Jannice Schau; Böckerman, Inger; Norström, Madelaine

2015-01-01

Antimicrobial resistant Escherichia coli (n=331) isolates from humans with bloodstream infections were investigated for the presence of class 1 and class 2 integrons. The integron cassettes arrays were characterized and the findings were compared with data from similar investigations on resistant E. coli from meat and meat products (n=241) produced during the same time period. All isolates were obtained from the Norwegian monitoring programs for antimicrobial resistance in human pathogens and in the veterinary sector. Methods used included PCR, sequencing, conjugation experiments, plasmid replicon typing and subtyping, pulsed-field-gel-electrophoresis and serotyping. Integrons of class 1 and 2 occurred significantly more frequently among human isolates; 45.4% (95% CI: 39.9-50.9) than among isolates from meat; 18% (95% CI: 13.2 -23.3), (pfood source and from a human clinical sample highlights the possible role of meat as a source of resistance elements for pathogenic bacteria.

Influence of applying different units of measurement on reporting antimicrobial consumption data for pig farms

NARCIS (Netherlands)

Taverne, F.J.|info:eu-repo/dai/nl/412350076; Jacobs, J.H.|info:eu-repo/dai/nl/314101144; Heederik, D.J.J.|info:eu-repo/dai/nl/072910542; Mouton, J.W.; Wagenaar, J.A.|info:eu-repo/dai/nl/126613354; van Geijlswijk, I.M.|info:eu-repo/dai/nl/413489477

2015-01-01

Background: Antimicrobial use in livestock is one of the factors contributing to selection and spread of resistant microorganisms in the environment. National veterinary antimicrobial consumption monitoring programs are therefore in place in a number of countries in the European Union. However, due

Influence of applying different units of measurement on reporting antimicrobial consumption data for pig farms

NARCIS (Netherlands)

Taverne, F.J.; Jacobs, J.H.; Heederik, D.J.J.; Mouton, J.W.; Wagenaar, J.A.; Geijlswijk, van I.M.

2015-01-01

Background: Antimicrobial use in livestock is one of the factors contributing to selection and spread of resistant microorganisms in the environment. National veterinary antimicrobial consumption monitoring programs are therefore in place in a number of countries in the European Union. However,

Flame Retardant and Antimicrobial Jute Textile Using Sodium Metasilicate Nonahydrate

Directory of Open Access Journals (Sweden)

Basak S.

2014-06-01

Full Text Available Flame retardant and antimicrobial functionalities were imparted in jute textile using sodium metasilicate nonahydrate (SMSN, commonly known as “water glass”. Sodium metasilicate nonahydrate (SMSN was applied in jute fabric in different concentration by padding method followed by drying. Flame retardancy of the fabric was evaluated by Limiting Oxygen Index (LOI and burning behaviour under vertical flammability tester including the char length. Burning rate was found to decrease by almost 10 times after an application of 2% SMSN compared to the control sample. Thermogravimetry (TG and differential scanning calorimetry (DSC analysis of both the control and treated jute fabrics were utilized to understand the mechanism of developed flame retardance in jute fabric. It was observed that the SMSN treated samples showed excellent antimicrobial property against both gram positive and gram negative bacteria. Antimicrobial properties of both the control and treated jute fabrics were also measured quantitatively.

Alternative Antimicrobial Approach: Nano-Antimicrobial Materials

Directory of Open Access Journals (Sweden)

Nurit Beyth

2015-01-01

Full Text Available Despite numerous existing potent antibiotics and other antimicrobial means, bacterial infections are still a major cause of morbidity and mortality. Moreover, the need to develop additional bactericidal means has significantly increased due to the growing concern regarding multidrug-resistant bacterial strains and biofilm associated infections. Consequently, attention has been especially devoted to new and emerging nanoparticle-based materials in the field of antimicrobial chemotherapy. The present review discusses the activities of nanoparticles as an antimicrobial means, their mode of action, nanoparticle effect on drug-resistant bacteria, and the risks attendant on their use as antibacterial agents. Factors contributing to nanoparticle performance in the clinical setting, their unique properties, and mechanism of action as antibacterial agents are discussed in detail.

Growth and antimicrobial studies of γ-glycine crystal grown using CuSO4

Science.gov (United States)

Vijayalakshmi, V.; Dhanasekaran, P.

2018-05-01

In the current work single crystals of pure and 1M of CuSO4-added glycine were grown by slow evaporation method and its optical and antimicrobial properties were studied. The Polymorph of glycine transforms from a-glycine to γ-glycine due to the incorporation of CuSO4 on glycine was affirmed by the PXRD and FTIR studies. The impact of CuSO4 on the antimicrobial action of the grown samples was deliberate by utilizing the agar diffusion method.

State Clean Energy Policies Analysis: State, Utility, and Municipal Loan Programs

Energy Technology Data Exchange (ETDEWEB)

Lantz, E.

2010-05-01

High initial costs can impede the deployment of clean energy technologies. Financing can reduce these costs. And, state, municipal, and utility-sponsored loan programs have emerged to fill the gap between clean energy technology financing needs and private sector lending. In general, public loan programs are more favorable to clean energy technologies than are those offered by traditional lending institutions; however, public loan programs address only the high up-front costs of clean energy systems, and the technology installed under these loan programs rarely supports clean energy production at levels that have a notable impact on the broader energy sector. This report discusses ways to increase the impact of these loan programs and suggests related policy design considerations.

The Global Alliance for Infections in Surgery: defining a model for antimicrobial stewardship-results from an international cross-sectional survey

NARCIS (Netherlands)

Sartelli, M.; Labricciosa, F.M.; Barbadoro, P.; Pagani, L.; Ansaloni, L.; Brink, A.J.; Carlet, J.; Khanna, A.; Chichom-Mefire, A.; Coccolini, F.; Saverio, S. Di; May, A.K.; Viale, P.; Watkins, R.R.; Scudeller, L.; Abbo, L.M.; Abu-Zidan, F.M.; Adesunkanmi, A.K.; Al-Dahir, S.; Al-Hasan, M.N.; Alis, H.; Alves, C.; Araujo da Silva, A.R.; Augustin, G.; Bala, M.; Barie, P.S.; Beltran, M.A.; Bhangu, A.; Bouchra, B.; Brecher, S.M.; Cainzos, M.A.; Camacho-Ortiz, A.; Catani, M.; Chandy, S.J.; Jusoh, A.C.; Cherry-Bukowiec, J.R.; Chiara, O.; Colak, E.; Cornely, O.A.; Cui, Y.; Demetrashvili, Z.; Simone, B. De; Waele, J.J. De; Dhingra, S.; Marzo, F. Di; Dogjani, A.; Dorj, G.; Dortet, L.; Duane, T.M.; Elmangory, M.M.; Enani, M.A.; Ferrada, P.; Esteban Foianini, J.; Gachabayov, M.; Gandhi, C.; Ghnnam, W.M.; Giamarellou, H.; Gkiokas, G.; Gomi, H.; Goranovic, T.; Griffiths, E.A.; Guerra Gronerth, R.I.; Haidamus Monteiro, J.C.; Hardcastle, T.C.; Hecker, A.; Hodonou, A.M.; Ioannidis, O.; Isik, A.; Iskandar, K.A.; Kafil, H.S.; Kanj, S.S.; Kaplan, L.J.; Kapoor, G.; Karamarkovic, A.R.; Kenig, J.; Kerschaever, I.; Khamis, F.; Khokha, V.; Kiguba, R.; Kim, H.B.; Ko, W.C.; Koike, K.; Kozlovska, I.; Kumar, A.; Lagunes, L.; Latifi, R.; Lee, J.G.; Lee, Y.R.; Leppaniemi, A.; Li, Y.; Liang, S.Y.; Lowman, W.; Machain, G.M.; Maegele, M.; Major, P.; Malama, S.; Manzano-Nunez, R.; Marinis, A.; Casas, I.; Goor, H. van; Zuidema, W.P.; Catena, F.

2017-01-01

BACKGROUND: Antimicrobial Stewardship Programs (ASPs) have been promoted to optimize antimicrobial usage and patient outcomes, and to reduce the emergence of antimicrobial-resistant organisms. However, the best strategies for an ASP are not definitively established and are likely to vary based on

Alternative Antimicrobial Approach: Nano-Antimicrobial Materials

OpenAIRE

Nurit Beyth; Yael Houri-Haddad; Avi Domb; Wahid Khan; Ronen Hazan

2015-01-01

Despite numerous existing potent antibiotics and other antimicrobial means, bacterial infections are still a major cause of morbidity and mortality. Moreover, the need to develop additional bactericidal means has significantly increased due to the growing concern regarding multidrug-resistant bacterial strains and biofilm associated infections. Consequently, attention has been especially devoted to new and emerging nanoparticle-based materials in the field of antimicrobial chemotherapy. The ...

Antimicrobial resistance of zoonotic and commensal bacteria in Europe: The missing link between consumption and resistance in veterinary medicine

DEFF Research Database (Denmark)

Garcia-Migura, Lourdes; Hendriksen, Rene S.; Fraile, Lorenzo

2014-01-01

The emergence of resistance in food animals has been associated to the consumption of antimicrobials in veterinary medicine. Consequently, monitoring programs have been designed to monitor the occurrence of antimicrobial resistant bacteria. This study analyses the amount of antimicrobial agents...... antimicrobial classes. Substantial differences between countries were observed in the amount of antimicrobials used to produce 1kg of meat. Moreover, large variations in proportions of resistant bacteria were reported by the different countries, suggesting differences in veterinary practice. Despite...

Financial Incentives, Workplace Wellness Program Participation, and Utilization of Health Care Services and Spending.

Science.gov (United States)

Fronstin, Paul; Roebuck, M Christopher

2015-08-01

This paper analyzes data from a large employer that enhanced financial incentives to encourage participation in its workplace wellness programs. It examines, first, the effect of financial incentives on wellness program participation, and second, it estimates the impact of wellness program participation on utilization of health care services and spending. The Patient Protection and Affordable Care Act of 2010 (PPACA) allows employers to provide financial incentives of as much as 30 percent of the total cost of coverage when tied to participation in a wellness program. Participation in health risk assessments (HRAs) increased by 50 percentage points among members of unions that bargained in the incentive, and increased 22 percentage points among non-union employees. Participation in the biometric screening program increased 55 percentage points when financial incentives were provided. Biometric screenings led to an average increase of 0.31 annual prescription drug fills, with related spending higher by $56 per member per year. Otherwise, no significant effects of participation in HRAs or biometric screenings on utilization of health care services and spending were found. The largest increase in medication utilization as a result of biometric screening was for statins, which are widely used to treat high cholesterol. This therapeutic class accounted for one-sixth of the overall increase in prescription drug utilization. Second were antidepressants, followed by ACE inhibitors (for hypertension), and thyroid hormones (for hypothyroidism). Biometric screening also led to significantly higher utilization of biologic response modifiers and immunosuppressants. These specialty medications are used to treat autoimmune diseases, such as rheumatoid arthritis and multiple sclerosis, and are relatively expensive compared with non-specialty medications. The added spending associated with the combined increase in fills of 0.02 was $27 per member per year--about one-half of the

Antimicrobial Disk Susceptibility Testing of Leptospira spp. Using Leptospira Vanaporn Wuthiekanun (LVW) Agar.

Science.gov (United States)

Wuthiekanun, Vanaporn; Amornchai, Premjit; Langla, Sayan; White, Nicholas J; Day, Nicholas P J; Limmathurotsakul, Direk; Peacock, Sharon J

2015-08-01

Leptospira Vanaporn Wuthiekanun (LVW) agar was used to develop a disk diffusion assay for Leptospira spp. Ten pathogenic Leptospira isolates were tested, all of which were susceptible to 17 antimicrobial agents (amoxicillin/clavulanic acid, amoxicillin, azithromycin, cefoxitin, ceftazidime, ceftriaxone, chloramphenicol, ciprofloxacin, clindamycin, doripenem, doxycycline, gentamicin, linezolid, nitrofurantoin, penicillin, piperacillin/tazobactam, and tetracycline). All 10 isolates had no zone of growth inhibition for four antimicrobials (fosfomycin, nalidixic acid, rifampicin, and trimethoprim/sulfamethoxazole). Of the ten Leptospira, seven had a growth inhibition zone of ≤ 21 mm for aztreonam, the zone diameter susceptibility break point for Enterobacteriaceae. This assay could find utility as a simple screening method during the epidemiological surveillance of antimicrobial resistance in Leptospira spp. © The American Society of Tropical Medicine and Hygiene.

Making It Count: Understanding the Value of Energy Efficiency Financing Programs Funded by Utility Customers

Energy Technology Data Exchange (ETDEWEB)

Kramer, Chris [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Fadrhonc, Emily Martin [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Goldman, Charles [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Schiller, Steve [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Schwartz, Lisa [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States)

2015-12-01

Utility customer-supported financing programs are receiving increased attention as a strategy for achieving energy saving goals. Rationales for using utility customer funds to support financing initiatives

The efficacy of the direct clinical intervention for infectious diseases by a pediatric infectious disease specialist in the pediatric ward of a tertiary medical facility without a pediatric antimicrobial stewardship program.

Science.gov (United States)

Hoshina, T; Yamamoto, N; Ogawa, M; Nakamoto, T; Kusuhara, K

2017-08-01

Antimicrobial stewardship programs (ASPs) have been introduced in most hospital complexes; however, they are not always useful for pediatric patients. The aim of this study is to investigate the efficacy of direct clinical intervention for infectious diseases by a pediatric infectious disease specialist in a tertiary medical facility without pediatric ASP. This retrospective study included 1,821 patients who were hospitalized in the pediatric ward of a large metropolitan hospital from 2010 to 2015. The clinical course, the use of intravenous antimicrobial agents and the results of a microbiological analysis were compared between the period after the beginning of direct intervention by the specialist (post-intervention period) and the previous period (pre-intervention period). In the post-intervention period, the proportion of the patients who received intravenous antimicrobial agents, the number of antimicrobial agents used for each episode, and the proportion of episodes in which an antimicrobial agent was re-administrated were significantly lower (P = 0.006, P = 0.004, P = 0.036, respectively), and the duration of antimicrobial treatment was significantly shorter (P infectious diseases specialist is useful for the treatment of infectious diseases in the pediatric ward of a tertiary medical facility without a pediatric ASP. The creation of a pediatric ASP is recommended in hospital complexes.

Antimicrobial Resistance

Science.gov (United States)

... least 10 countries (Australia, Austria, Canada, France, Japan, Norway, Slovenia, South Africa, Sweden and the United Kingdom ... plan Global report on surveillance Country situation analysis Policy to combat antimicrobial resistance More on antimicrobial resistance ...

Antimicrobial Resistance

Science.gov (United States)

... can prevent and manage antimicrobial resistance. It is collaborating with partners to strengthen the evidence base and ... on the global action plan. WHO has been leading multiple initiatives to address antimicrobial resistance: World Antibiotic ...

Antimicrobial and biocompatible properties of nanomaterials.

Science.gov (United States)

Ul-Islam, M; Shehzad, A; Khan, S; Khattak, W A; Ullah, M W; Park, J K

2014-01-01

The rapid development of drug-resistant characteristics in pathogenic viral, bacterial, and fungal species and the consequent spread of infectious diseases are currently receiving serious attention. Indeed, there is a pressing demand to explore novel materials and develop new strategies that can address these issues of serious concern. Nanomaterials are currently proving to be the most capable therapeutic agents to cope with such hazards. The exceptional physiochemical properties and impressive antimicrobial capabilities of nanoparticles have provoked their utilization in biomedical fields. Nanomaterials of both organic and inorganic nature have shown the capabilities of disrupting microbial cells through different mechanisms. Along with the direct influence on the microbial cell membrane, DNA and proteins, these nanomaterials produce reactive oxygen species (ROS) that damage cell components and viruses. Currently, a serious hazard associated with these antimicrobial nanomaterials is their toxicity to human and animal cells. Extensive studies have reported the dose, time, and cell-dependent toxicology of various nanomaterials, and some have shown excellent biocompatible properties. Nevertheless, there is still debate regarding the use of nanomaterials for medical applications. Therefore, in this review, the antimicrobial activities of various nanomaterials with details of their acting mechanisms were compiled. The relative toxic and biocompatible behavior of nanomaterials emphasized in this study provides information pertaining to their practical applicability in medical fields.

Program on MOX fuel utilization in light water reactors

International Nuclear Information System (INIS)

Kenda, Hirofumi

2000-01-01

MOX fuel utilization program by the Japanese electric power companies was released in February, 1997. Principal philosophy for MOX fuel design is that MOX fuel shall be compatible with Uranium fuel and behavior of core loaded with MOX fuel shall be similar to that of conventional core. MOX fuel is designed so that geometry and nuclear capability of MOX fuel are equivalent to Uranium fuel. (author)

Antimicrobial susceptibility of Staphylococcus aureus isolated from bovine mastitis in Europe and the United States

DEFF Research Database (Denmark)

De Oliveira, A. P.; Watts, J. L.; Salmon, S. A.

2000-01-01

Minimum inhibitory concentrations were determined for 811 strains of Staphylococcus aureus isolated from cases of bovine mastitis in 11 countries. The countries and number of isolates included Denmark (105), England (92), Finland (95), Germany (103), Iceland (22), Ireland (42), Norway (101), Sweden...... antimicrobial agents tested regardless of country. Given the differences in antimicrobial use in various countries, the widespread adoption of mastitis control programs to prevent infections limits the exposure of S. aureus infected animals to antimicrobial drugs....

Progress report Waste Resources Utilization Program period ending March 31, 1976

International Nuclear Information System (INIS)

1976-06-01

This report describes the work on the Waste Resources Utilization Program for the quarter ending March 31, 1976. The purpose of this program is to develop technologies to utilize a 137 Cs γ source to modify sewage sludge for safe application as a fertilizer or an animal feed supplement. Results are reported from studies in microbiology, virology, and physical-chemical studies. Determinations were made of inactivation rates for Salmonella species, coliforms, and fecal strep in sewage sludge when radiation and thermoradiation were applied while bubbling oxygen through the sludge. Virology studies were continued investigating virucidal characteristics of anaerobically digested sludge. Another area of study was the dewatering of sewage sludge to reduce the drying time of the sewage sludge in the drying beds. A centrifuge was also installed to dewater treated sludge to approximately 30 percent solids

Animation of Antimicrobial Resistance

Medline Plus

Full Text Available ... video) Animation of Antimicrobial Resistance (text version) Arabic Translation of Animation of Antimicrobial Resistance Chinese Translation of Animation of Antimicrobial Resistance French Translation of ...

Phenotypic and genotypic anti-microbial resistance profiles of campylobacters from untreated feedlot cattle and their environment.

Science.gov (United States)

Minihan, D; Whyte, P; O'mahony, M; Cowley, D; O'halloran, F; Corcoran, D; Fanning, S; Collins, J D

2006-05-01

Anti-microbial resistance is an emerging public health issue. Farmed animals may act as reservoirs and potential sources of anti-microbial resistant Campylobacters. The aim of this study was to investigate the anti-microbial resistance profile of cattle and environmental Campylobacter isolates from normal untreated feedlot cattle, the role of the gyrA Thr-86-Ile mutation in ciprofloxacin-resistant Campylobacter jejuni isolates and the involvement of the tripartite CmeABC efflux system for multi-resistant C. jejuni isolates. The phenotypic anti-microbial resistance testing was carried out on 500 Campylobacter isolates (445 cattle isolates and 55 environmental isolates). In general, there was a higher level of anti-microbial resistance for the environmental isolates compared with the animal isolates, 45% of the animal isolates were resistant to one or more of the seven anti-microbials compared with 84% of the environmental isolates. The combined cattle and environmental Campylobacters had 34 (6.8%) isolates resistant to three or more of the seven anti-microbials tested on all isolates and 11 (2.2%) isolates were resistant to the seven anti-microbials. There was a substantial level of ciprofloxacin-resistant Campylobacters in both animal (8.5%) and environmental (21.8%) isolates. The gyrA Thr-86-Ile mutation was only present in five of 22 ciprofloxacin-resistant C. jejuni isolates investigated. No multi-drug-resistant associated mutation was detected in the CmeB or the CmeR regions investigated. In conclusion, our study observed a substantial level of Campylobacter anti-microbial resistance, highlighting the need for an active anti-microbial surveillance program for food animals in Ireland and the importance of the chosen sampling point can have on the findings of such a program.

Progress and problems in the Formerly Utilized Sites Remedial Action Program and Surplus Facilities Management Program

International Nuclear Information System (INIS)

Fiore, J.J.; Turi, G.P.

1988-01-01

The Formerly Utilized Sites Remedial Action Program (FUSRAP) was established in 1974 to identify, evaluate, and as appropriate, conduct remedial actions at sites used in the early years of nuclear energy development by the Manhattan Engineer District and the Atomic Energy Commission (AEC). This program currently has 29 sites and is evaluating 350 other sites for possible inclusion in the program. Another remedial action program in the Department of Energy's (DOE) Division of Facility and Site Decommissioning Projects is the Surplus Facilities Management Program (SFMP). The SFMP involves the safe management, decontamination and disposal of surplus DOE contaminated facilities which were not related to defense activities. There are currently 33 projects at 15 different sites in the program. These two programs have made steady progress over the last 10 or so years in cleaning up sites so that they can be reused or released for unrestricted use. Work has been completed at 8 of the FUSRAP sites and three of the SFMP sites

Antimicrobial resistance of zoonotic and commensal bacteria in Europe: the missing link between consumption and resistance in veterinary medicine.

Science.gov (United States)

Garcia-Migura, Lourdes; Hendriksen, Rene S; Fraile, Lorenzo; Aarestrup, Frank M

2014-05-14

The emergence of resistance in food animals has been associated to the consumption of antimicrobials in veterinary medicine. Consequently, monitoring programs have been designed to monitor the occurrence of antimicrobial resistant bacteria. This study analyses the amount of antimicrobial agents used in nine European countries from 2005 to 2011, and compares by univariate analysis the correlations between consumptions of each of the following antimicrobial classes; tetracycline, penicillins, cephalosporins, quinolones and macrolides. An overview of resistance in zoonotic and commensal bacteria in Europe focusing on Salmonella, Escherichia coli, Campylobacter sp. and Enterococcus sp., during the same period of time based on monitoring programs is also assessed. With the exception of cephalosporins, linear regressions showed strong positive associations between the consumption of the four different antimicrobial classes. Substantial differences between countries were observed in the amount of antimicrobials used to produce 1 kg of meat. Moreover, large variations in proportions of resistant bacteria were reported by the different countries, suggesting differences in veterinary practice. Despite the withdrawn of a specific antimicrobial from "on farm" use, persistence over the years of bacteria resistant to this particular antimicrobial agent, was still observed. There were also differences in trends of resistance associated to specific animal species. In order to correlate the use of antimicrobial agents to the presence of resistance, surveillance of antimicrobial consumption by animal species should be established. Subsequently, intervention strategies could be designed to minimize the occurrence of resistance. Copyright © 2014 Elsevier B.V. All rights reserved.

ACVIM Consensus Statement on Therapeutic Antimicrobial Use in Animals and Antimicrobial Resistance

OpenAIRE

Weese, J.S.; Gigu?re, S.; Guardabassi, L.; Morley, P.S.; Papich, M.; Ricciuto, D.R.; Sykes, J.E.

2015-01-01

The epidemic of antimicrobial resistant infections continues to challenge, compromising animal care, complicating food animal production and posing zoonotic disease risks. While the overall role of therapeutic antimicrobial use in animals in the development AMR in animal and human pathogens is poorly defined, veterinarians must consider the impacts of antimicrobial use in animal and take steps to optimize antimicrobial use, so as to maximize the health benefits to animals while minimizing the...

Novel natural food antimicrobials.

Science.gov (United States)

Juneja, Vijay K; Dwivedi, Hari P; Yan, Xianghe

2012-01-01

Naturally occurring antimicrobial compounds could be applied as food preservatives to protect food quality and extend the shelf life of foods and beverages. These compounds are naturally produced and isolated from various sources, including plants, animals and microorganisms, in which they constitute part of host defense systems. Many naturally occurring compounds, such as nisin, plant essential oils, and natamycin, have been widely studied and are reported to be effective in their potential role as antimicrobial agents against spoilage and pathogenic microorganisms. Although some of these natural antimicrobials are commercially available and applied in food processing, their efficacy, consumer acceptance and regulation are not well defined. This manuscript reviews natural antimicrobial compounds with reference to their applications in food when applied individually or in combination with other hurdles. It also reviews the mechanism of action of selected natural antimicrobials, factors affecting their antimicrobial activities, and future prospects for use of natural antimicrobials in the food industry.

Managing the environmental impacts of utility lighting retrofits programs

International Nuclear Information System (INIS)

Cress, K.

1993-01-01

One of the most popular demand-side management (DSM) programs currently being sponsored by electric utilities is the removal of old fluorescent light ballasts and replacing them with more efficient models. This type of program, however, can produce a substantial waste stream of the old ballasts, many of which contain Polychlorinated Biphenyl(s) (PCBs), a regulated hazardous substance. The proper disposal of spent light ballasts should be an integral component of DSM programs. This paper will discuss the experience that New England Electric System (NEES) 1 has had with disposing of spent light ballasts resulting from the implementation of our Small Commercial ampersand Industrial Program (a direct install lighting program which provides for the installation of energy efficient lighting measures which include fluorescent fixtures, ballasts and lamps, specular reflectors, compact fluorescent systems, high intensity discharge fixtures, and occupancy sensors. This innovative program is one of the largest in the country and has achieved over 6,000 installations). In this paper, we will review why PCBs are classified as hazardous substances and what effect State and Federal regulations have on the transportation and disposal of ballasts that contain PCBs. Second, we will explain our ballast disposal process which includes collecting, processing, storing, shipping and ultimate disposal. Third, we will discuss our experiences with two different methods of disposal - incineration and recycling. And last we will report on program results

Evaluation of Orange and Rockland Utilities, Inc.`s competitive bidding program for demand-side resources. Final report

Energy Technology Data Exchange (ETDEWEB)

Peters, J.S.; Stucky, L.; Seratt, P.; Darden-Butler, D. [Barakat and Chamberlin, Inc., Portland, OR (United States)

1993-02-01

The process evaluation reports on the implementation of Orange and Rockland Utilities demand-side bidding program in New York State during 1991 and 1992. The program is implemented by two energy service companies in Orange and rockland`s New York State service territory. The process evaluation methodology included interviews with utility staff (3), energy service company staff (2), and participating (6) and nonparticipating (7) utility customers. The two energy service companies had enrolled 14 customers in the program by summer 1992. One company had achieved 90% of their 2.75 MW bid and the other had achieved less than 90% of their 6.9 MW bid. Critical factors in success were determination of a reasonable bid amount for the market and marketing to the appropriate customers. Customers most interested in the program included those with limited access to capital and medium-sized firms with poor cash flows, particularly schools and hospitals. The findings also show that due to the incentive structure and associated need for substantial customer contributions, lighting measures dominate all installations. Customers, however, were interested in the potential savings and six of the nonparticipants chose to either install measures on their own or enroll in the utility`s rebate program.

The Global Alliance for Infections in Surgery: defining a model for antimicrobial stewardship-results from an international cross-sectional survey

OpenAIRE

Sartelli, M.; Labricciosa, F.M.; Barbadoro, P.; Pagani, L.; Ansaloni, L.; Brink, A.J.; Carlet, J.; Khanna, A.; Chichom-Mefire, A.; Coccolini, F.; Saverio, S. Di; May, A.K.; Viale, P.; Watkins, R.R.; Scudeller, L.

2017-01-01

BACKGROUND: Antimicrobial Stewardship Programs (ASPs) have been promoted to optimize antimicrobial usage and patient outcomes, and to reduce the emergence of antimicrobial-resistant organisms. However, the best strategies for an ASP are not definitively established and are likely to vary based on local culture, policy, and routine clinical practice, and probably limited resources in middle-income countries. The aim of this study is to evaluate structures and resources of antimicrobial steward...

Oral antimicrobials increase antimicrobial resistance in porcine E. coli--a systematic review.

Science.gov (United States)

Burow, E; Simoneit, C; Tenhagen, B-A; Käsbohrer, A

2014-03-01

Administration of antimicrobials to livestock increases the risk of antimicrobial resistance (AMR) in commensal bacteria. Antimicrobials in pig production are usually administered per pen via feed which implies treatment of sick alongside with healthy animals. The objective of this systematic literature review was to investigate the effect of orally administered antimicrobials on AMR in Escherichia coli of swine. Studies published in peer reviewed journals were retrieved from the international online databases ISI Web of Knowledge, PubMed, Scopus and the national electronic literature data base of Deutsches Institut für Medizinische Dokumentation und Information. The studies were assessed using the eligibility criteria English or German language, access to full paper version, defined treatment and control group (initial value or non-treatment) as well as administration and resistance testing of the same antimicrobial class. In the qualitative synthesis, only studies were included presenting the summary measures odds ratio or prevalence of resistance, the category of the applied antimicrobial and the dosage. An effect of the antimicrobial on AMR in E. coli was evaluated as an "increase", "no effect" or "decrease" if the odds or alternatively the prevalence ratio were >1.0, 1.0 or antimicrobial substance and dosage was missing in 4 and 5 of the 11 finally selected studies. The 36 identified trials were inhomogenous in usage and provision of information on sample size. Oral administration of antimicrobials increases the risk of AMR in E. coli from swine. There is however a lack of studies on the impact of dosage and longitudinal effects of treatment. The published studies have a number of issues concerning their scientific quality. More high quality research is needed to better address and quantifiy the effect of orally administered antimicrobials on AMR in swine. Copyright © 2014 Elsevier B.V. All rights reserved.

Spinoff 2002: Fortieth Anniversary Technology Utilization Program

Science.gov (United States)

2002-01-01

Since its inception 40 years ago, NASA's Technology Transfer Program has led the way for our nation to benefit from cutting-edge aerospace technologies. In addition to contributing to U.S. economic growth, these technologies are improving the quality of life on Earth while finding new ways to protect and preserve it. NASA's research and development efforts have advanced areas in medicine, communications, manufacturing, computer technology, and homeland security. These breakthroughs, translated into commercial products, are enhancing the lives of Americans everywhere. When a congressional mandate led NASA to develop the Scientific and Technical Information (STI) Program, the Agency began a wide dissemination of its research and development results. In doing so, NASA recognized that many of its technologies were transferable to industry for the development of commercial products. As a result, the Technology Utilization Program was born in 1962. The successful program went through several changes over the years, as its philosophy, mission, and goals adapted into the Technology Transfer Program we know today. The program strives to make the latest technologies available to industry as soon as they are developed. Each year, NASA's Spinoff publication showcases new products and services resulting from commercial partnerships between NASA and private industry. In the 2002 issue, the NASA field centers reflect upon the growth that has made these innovations available to the public. The Research and Development section examines past achievements, current successes, and future goals for each of the ten NASA centers. The Commercial Benefits section proudly highlights 51 new spinoff products, including a heart pump for patients needing a heart transplant, as well as an air purifier that destroys anthrax spores. The Technology Transfer and Outreach section describes the outreach achievements and educational successes made possible through the NASA Commercial Technology Network

Utility QA viewpoint: Quality assurance program conforming to 10CFR50, Appendix B and 10CFR71, subpart H

International Nuclear Information System (INIS)

Grodi, D.L.

1987-01-01

The Nuclear Regulatory Commission issued IE Information Notice No. 84-50: ''Clarification of Scope of Quality Assurance Programs for Transport Packages Pursuant to 10CFR50, Appendix B, in June, 1984. The reason for this notice was to eliminate confusion applicable to the quality assurance provisions of Appendix B, 10CFR50 to certain transport packages for which a quality assurance program is required by 10 CFR 71. The purpose of this paper is to provide methodology for establishing, implementing and verifying that all 10CFR71, Subpart H requirements are met with the utility's NRC approved 10CFR50, Appendix B Quality Assurance Program when utilizing a contractor (with a NRC approved Quality Assurance Program for Radioactive Waste Packaging and Transport) providing the radioactive waste solidification, packaging and transport for the utility. Collectively (utility and contractor) the quality assurance programs will meet the applicable regulatory requirements without the necessity of the utility establishing a separate and specific quality assurance program for Packaging and Transport of Radioactive Waste

Substandard/counterfeit antimicrobial drugs.

Science.gov (United States)

Kelesidis, Theodoros; Falagas, Matthew E

2015-04-01

Substandard/counterfeit antimicrobial drugs are a growing global problem. The most common substandard/counterfeit antimicrobials include beta-lactams (among antibiotics) and chloroquine and artemisin derivatives (among antimalarials). The most common type of substandard/counterfeit antimicrobial drugs have a reduced amount of the active drug, and the majority of them are manufactured in Southeast Asia and Africa. Counterfeit antimicrobial drugs may cause increased mortality and morbidity and pose a danger to patients. Here we review the literature with regard to the issue of substandard/counterfeit antimicrobials and describe the prevalence of this problem, the different types of substandard/counterfeit antimicrobial drugs, and the consequences for the individuals and global public health. Local, national, and international initiatives are required to combat this very important public health issue. Copyright © 2015, American Society for Microbiology. All Rights Reserved.

Lessons Learned: A review of utility experience with conservation and load management programs for commercial and industrial customers

Energy Technology Data Exchange (ETDEWEB)

Nadel, S.

1990-10-01

This report examines utility experience with conservation and load management (C LM) programs of commercial and industrial (C I) customers in order to summarize the lessons learned from program experiences to date and what these teach us about how to operate successful programs in the future. This analysis was motivated by a desire to learn about programs which achieve high participation rates and high electricity savings while remaining cost effective. Also, we wanted to review the very latest experiences with innovative program approaches -- approaches that might prove useful to utilities as they scale up their C LM activities. Specific objectives of this phase of the study are threefold: (1) To disseminate information on utility C LM experience to a nationwide audience. (2) To review current New York State utility programs and make suggestions on how these programs can be improved. (3) To collect data for the final phase of the American Council for an Energy-Efficient Economy/New York State Energy Research and Development Authority project, which will examine the savings that are achievable if C LM programs are pushed to the limit'' of current knowledge on how to structure and run cost-effective C LM programs. 19 tabs.

Improving antimicrobial prescribing: implementation of an antimicrobial i.v.-to-oral switch policy.

Science.gov (United States)

McCallum, A D; Sutherland, R K; Mackintosh, C L

2013-01-01

Antimicrobial stewardship programmes reduce the risk of hospital associated infections (HAI) and antimicrobial resistance, and include early intravenous-to-oral switch (IVOS) as a key stewardship measure. We audited the number of patients on intravenous antimicrobials suitable for oral switch, assessed whether prescribing guidelines were followed and reviewed prescribing documentation in three clinical areas in the Western General Hospital, Edinburgh, in late 2012. Following this, the first cycle results and local guidelines were presented at a local level and at the hospital grand rounds, posters with recommendations were distributed, joint infection consult and antimicrobial rounds commenced and an alert antimicrobial policy was introduced before re-auditing in early 2013. We demonstrate suboptimal prescribing of intravenous antimicrobials, with 43.9% (43/98) of patients eligible for IVOS at the time of auditing. Only 56.1% (55/98) followed empiric prescribing recommendations. Documentation of antimicrobial prescribing was poor with stop dates recorded in 14.3%, indication on prescription charts in 18.4% and in the notes in 90.8%. The commonest reason for deferring IVOS was deteriorating clinical condition or severe sepsis. Further work to encourage prudent antimicrobial prescribing and earlier consideration of IVOS is required.

Development of an Evidence-Based Antimicrobial Stewardship Smartphone App in a Tertiary Academic Pediatric and Women’s Health Centre in Canada

OpenAIRE

Slayter, Kathryn; Turple, Jennifer; Comeau, Jeannette L; Top, Karina A; Langley, Joanne M; Mailman, Tim; Halperin, Scott A

2017-01-01

Abstract Background Smart phone use by medical professionals is ubiquitous. In a recent survey, > 90% of health care providers were interested in locally developed antimicrobial stewardship (AMS) and infectious diseases applications (“apps”). We describe the process by which our antimicrobial stewardship program (ASP) developed an app to provide guidance regarding empiric antimicrobial choice, and education about antimicrobials and pathogens, integrating local laboratory data. We also describ...

Therapeutic drug monitoring of antimicrobials

Science.gov (United States)

Roberts, Jason A; Norris, Ross; Paterson, David L; Martin, Jennifer H

2012-01-01

Optimizing the prescription of antimicrobials is required to improve clinical outcome from infections and to reduce the development of antimicrobial resistance. One such method to improve antimicrobial dosing in individual patients is through application of therapeutic drug monitoring (TDM). The aim of this manuscript is to review the place of TDM in the dosing of antimicrobial agents, specifically the importance of pharmacokinetics (PK) and pharmacodynamics (PD) to define the antimicrobial exposures necessary for maximizing killing or inhibition of bacterial growth. In this context, there are robust data for some antimicrobials, including the ratio of a PK parameter (e.g. peak concentration) to the minimal inhibitory concentration of the bacteria associated with maximal antimicrobial effect. Blood sampling of an individual patient can then further define the relevant PK parameter value in that patient and, if necessary, antimicrobial dosing can be adjusted to enable achievement of the target PK/PD ratio. To date, the clinical outcome benefits of a systematic TDM programme for antimicrobials have only been demonstrated for aminoglycosides, although the decreasing susceptibility of bacteria to available antimicrobials and the increasing costs of pharmaceuticals, as well as emerging data on pharmacokinetic variability, suggest that benefits are likely. PMID:21831196

Animation of Antimicrobial Resistance

Medline Plus

Full Text Available ... Veterinary Safety & Health Antimicrobial Resistance Animation of Antimicrobial Resistance Share Tweet Linkedin Pin it More sharing options ... produced a nine-minute animation explaining how antimicrobial resistance both emerges and proliferates among bacteria. Over time, ...

Animation of Antimicrobial Resistance

Medline Plus

Full Text Available ... how antimicrobial resistance both emerges and proliferates among bacteria. Over time, the use of antimicrobial drugs will result in the development of resistant strains of bacteria, complicating clinician's efforts to select the appropriate antimicrobial ...

Animation of Antimicrobial Resistance

Medline Plus

Full Text Available ... Animal & Veterinary Safety & Health Antimicrobial Resistance Animation of Antimicrobial Resistance Share Tweet Linkedin Pin it More sharing ... CVM) produced a nine-minute animation explaining how antimicrobial resistance both emerges and proliferates among bacteria. Over ...

Rapid Inhibition Profiling in Bacillus subtilis to Identify the Mechanism of Action of New Antimicrobials.

Science.gov (United States)

Lamsa, Anne; Lopez-Garrido, Javier; Quach, Diana; Riley, Eammon P; Pogliano, Joe; Pogliano, Kit

2016-08-19

Increasing antimicrobial resistance has become a major public health crisis. New antimicrobials with novel mechanisms of action (MOA) are desperately needed. We previously developed a method, bacterial cytological profiling (BCP), which utilizes fluorescence microscopy to rapidly identify the MOA of antimicrobial compounds. BCP is based upon our discovery that cells treated with antibiotics affecting different metabolic pathways generate different cytological signatures, providing quantitative information that can be used to determine a compound's MOA. Here, we describe a system, rapid inhibition profiling (RIP), for creating cytological profiles of new antibiotic targets for which there are currently no chemical inhibitors. RIP consists of the fast, inducible degradation of a target protein followed by BCP. We demonstrate that degrading essential proteins in the major metabolic pathways for DNA replication, transcription, fatty acid biosynthesis, and peptidoglycan biogenesis in Bacillus subtilis rapidly produces cytological profiles closely matching that of antimicrobials targeting the same pathways. Additionally, RIP and antibiotics targeting different steps in fatty acid biosynthesis can be differentiated from each other. We utilize RIP and BCP to show that the antibacterial MOA of four nonsteroidal anti-inflammatory antibiotics differs from that proposed based on in vitro data. RIP is a versatile method that will extend our knowledge of phenotypes associated with inactivating essential bacterial enzymes and thereby allow for screening for molecules that inhibit novel essential targets.

Utilities for developing HITAC 10-2 program with U-400 and M-190 systems

International Nuclear Information System (INIS)

Tsuda, Kenzo.

1979-06-01

At the time of developing ''On-line experimental data processing system for JIPP (Japan Institute of Plasma Physics) T-2'', a number of utilities have been developed, which can develop the programs on the HITAC 10-2 side through the PANAFACOM U-400 and the FACOM M-190 computer systems. The HITAC 10-2 is a computer mainly composed of core memories, whose performances of processing speed, peripherals and softwares are considerably different from large and medium size computers. For this reason, it requires tremendous time and labor to develop large scale programs or systems by utilizing only the HITAC 10-2. Accordingly, some utilities have been developed with the U-400 and M-190 systems in order to shorten the developing time and improve the developing efficiency. In the example of above ''On-line experimental data processing system for JIPP T-2'', the time required for one debugging can be reduced to 20 minutes from former 5 to 6 hours. In this report, first, the program development by the HITAC 10-2, and next, the bind processing with U-400 and the cross-assembling with M-190 are described. Then the functions and the method for use of the utilities are explained. (Wakatsuki, Y.)

Comparison of antimicrobial consumption patterns in the Swiss and Danish cattle and swine production (2007-2013)

DEFF Research Database (Denmark)

Carmo, Luis Pedro; Nielsen, Liza Rosenbaum; Alban, Lis

2017-01-01

antimicrobials are reported at sales level without any information on the consumption by different animal species. This hinders a proper comparison of antimicrobial consumption at the species level between countries. However, it is imperative to improve our understanding on antimicrobial usage patterns...... consumption of different antimicrobial classes were also evident. Sulfonamides/trimethoprim and tetracyclines were consumed in a higher proportion in Switzerland than in Denmark, whereas the relative consumption of penicillins was higher in Denmark. The differences observed in veterinary antimicrobial...... consumption are not solely related to animal demographic characteristics in these two countries. Other factors, such as the level of biosecurity and farming practices, veterinarians and farmers’ education, or governmental/industry programs put in place might also partly explain these variations...

Animation of Antimicrobial Resistance

Medline Plus

Full Text Available ... Animal & Veterinary Safety & Health Antimicrobial Resistance Animation of Antimicrobial Resistance Share Tweet Linkedin Pin it More sharing options ... CVM) produced a nine-minute animation explaining how antimicrobial resistance both emerges and proliferates among bacteria. Over time, ...

Frequency of serovars and antimicrobial resistance in Shigella spp. from Brazil

Directory of Open Access Journals (Sweden)

Gisele Peirano

2006-05-01

Full Text Available A total of 296 Shigella spp. were received from State Public Health Laboratories, during the period from 1999 to 2004, by National Reference Laboratory for Cholera and Enteric Diseases (NRLCED - IOC/Fiocruz, Rio de Janeiro, Brazil. The frequency of Shigella spp. was: S. flexneri (52.7%, S. sonnei (44.2%, S. boydii (2.3%, and S. dysenteriae (0.6%. The most frequent S. flexneri serovars were 2a and 1b. The highest incidence rates of Shigella isolation were observed in the Southeast (39% and Northeast (34% regions and the lowest rate in the South (3% of Brazil. Strains were further analyzed for antimicrobial susceptibility by disk diffusion method as part of a surveillance program on antimicrobial resistance. The highest rates of antimicrobial resistance were to trimethoprim-sulfamethozaxole (90%, tetracycline (88%, ampicillin (56%, and chloramphenicol (35%. The patterns of antimicrobial resistance among Shigella isolates pose a major difficulty in the determination of an appropriate drug for shigellosis treatment. Continuous monitoring of antimicrobial susceptibilities of Shigella spp. through a surveillance system is thus essential for effective therapy and control measures against shigellosis.

Hawaii alternative fuels utilization program. Phase 3, final report

Energy Technology Data Exchange (ETDEWEB)

Kinoshita, C.M.; Staackmann, M.

1996-08-01

The Hawaii Alternative Fuels Utilization Program originated as a five-year grant awarded by the US Department of Energy (USDOE) to the Hawaii Natural Energy Institute (HNEI) of the University of Hawaii at Manoa. The overall program included research and demonstration efforts aimed at encouraging and sustaining the use of alternative (i.e., substitutes for gasoline and diesel) ground transportation fuels in Hawaii. Originally, research aimed at overcoming technical impediments to the widespread adoption of alternative fuels was an important facet of this program. Demonstration activities centered on the use of methanol-based fuels in alternative fuel vehicles (AFVs). In the present phase, operations were expanded to include flexible fuel vehicles (FFVs) which can operate on M85 or regular unleaded gasoline or any combination of these two fuels. Additional demonstration work was accomplished in attempting to involve other elements of Hawaii in the promotion and use of alcohol fuels for ground transportation in Hawaii.

Self-assembly of cationic multidomain peptide hydrogels: supramolecular nanostructure and rheological properties dictate antimicrobial activity

Science.gov (United States)

Jiang, Linhai; Xu, Dawei; Sellati, Timothy J.; Dong, He

2015-11-01

Hydrogels are an important class of biomaterials that have been widely utilized for a variety of biomedical/medical applications. The biological performance of hydrogels, particularly those used as wound dressing could be greatly advanced if imbued with inherent antimicrobial activity capable of staving off colonization of the wound site by opportunistic bacterial pathogens. Possessing such antimicrobial properties would also protect the hydrogel itself from being adversely affected by microbial attachment to its surface. We have previously demonstrated the broad-spectrum antimicrobial activity of supramolecular assemblies of cationic multi-domain peptides (MDPs) in solution. Here, we extend the 1-D soluble supramolecular assembly to 3-D hydrogels to investigate the effect of the supramolecular nanostructure and its rheological properties on the antimicrobial activity of self-assembled hydrogels. Among designed MDPs, the bactericidal activity of peptide hydrogels was found to follow an opposite trend to that in solution. Improved antimicrobial activity of self-assembled peptide hydrogels is dictated by the combined effect of supramolecular surface chemistry and storage modulus of the bulk materials, rather than the ability of individual peptides/peptide assemblies to penetrate bacterial cell membrane as observed in solution. The structure-property-activity relationship developed through this study will provide important guidelines for designing biocompatible peptide hydrogels with built-in antimicrobial activity for various biomedical applications.Hydrogels are an important class of biomaterials that have been widely utilized for a variety of biomedical/medical applications. The biological performance of hydrogels, particularly those used as wound dressing could be greatly advanced if imbued with inherent antimicrobial activity capable of staving off colonization of the wound site by opportunistic bacterial pathogens. Possessing such antimicrobial properties would

Purification and MIC analysis of antimicrobial proteins from Cucumis sativus L. seeds.

Science.gov (United States)

Al Akeel, Raid; Mateen, Ayesha; Alharbi, Khalid K; Alyousef, Abdullah A; Al-Mandeel, Hazem M; Syed, Rabbani

2018-04-03

Cucumis sativus L. (cucumber), from the family Cucurbitaceae, is a therapeutic plant with various pharmacological benefits, broadly utilized as a part of complementary medicine (e.g., Unani, Ayurveda, Siddha, and Traditional Chinese). In light of past research discoveries, this plant had been chosen to consider its potential antibacterial action. Extracts were purified by dialysis and ion exchange chromatography strategy and then assayed for antibacterial activity against four standard pathogenic bacterial strains known to cause foodborne infections and spoilage of food and herbal drugs. Antimicrobial peptides were extracted from seeds using a sodium phosphate citrate (pH 7.2) - CTAB cradle (pH 6.0). The highest protein concentration was seen with elute fractions 1 and 3 (370 mg/mL) compared with elute fractions 2 and 4 (340 mg/mL). Among the bacteria utilized, E. coli was clearly the most sensitive out of selected four strains. Our results suggest that Cucumis sativus L seeds extracts have significant potentials as new antimicrobial agents.

A Method of Determination of an Acquisition Program in Order to Maximize the Total Utility Using Linear Programming in Integer Numbers

Directory of Open Access Journals (Sweden)

Alin Cristian Ioan

2010-03-01

Full Text Available This paper solves in a different way the problem of maximization of the total utility using the linear programming in integer numbers. The author uses the diofantic equations (equations in integers numbers and after a decomposing in different cases, he obtains the maximal utility.

Association between selected antimicrobial resistance genes and antimicrobial exposure in Danish pig farms

DEFF Research Database (Denmark)

Birkegård, Anna Camilla; Hisham Beshara Halasa, Tariq; Græsbøll, Kaare

2017-01-01

Bacterial antimicrobial resistance (AMR) in pigs is an important public health concern due to its possible transfer to humans. We aimed at quantifying the relationship between the lifetime exposure of antimicrobials and seven antimicrobial resistance genes in Danish slaughter pig farms. AMR gene...... levels were quantified by qPCR of total-community DNA in faecal samples obtained from 681 batches of slaughter pigs. The lifetime exposure to antimicrobials was estimated at batch level for the piglet, weaner, and finisher periods individually for the sampled batches. We showed that the effect...... of antimicrobial exposure on the levels of AMR genes was complex and unique for each individual gene. Several antimicrobial classes had both negative and positive correlations with the AMR genes. From 10-42% of the variation in AMR gene levels could be explained in the final regression models, indicating...

Antidiarrheal and antimicrobial profiles extracts of the leaves from Trichilia emetica Vahl. (Meliaceae

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Kiessoun Konaté

2015-03-01

Conclusions: The obtained results allow justifying the traditional uses of Trichilia emetica and possess good antidiarrhoeal and antimicrobial activities of EAF from Trichilia emetica. Results of the present study have clearly supported the utilization of Trichilia emetica in Burkina Faso traditional medicine.

Utilization of Healthcare in the Typhoid Fever Surveillance in Africa Program.

Science.gov (United States)

Panzner, Ursula; Pak, Gi Deok; Aaby, Peter; Adu-Sarkodie, Yaw; Ali, Mohammad; Aseffa, Abraham; Baker, Stephen; Bjerregaard-Andersen, Morten; Crump, John A; Deerin, Jessica; Cruz Espinoza, Ligia Maria; Gasmelseed, Nagla; Heriniaina, Jean Noël; Hertz, Julian T; Im, Justin; von Kalckreuth, Vera; Keddy, Karen H; Lankoande, Bruno; Løfberg, Sandra; Meyer, Christian G; Oresto, Michael Munishi; Park, Jin Kyung; Park, Se Eun; Rakotozandrindrainy, Raphaël; Sarpong, Nimako; Soura, Abdramane Bassiahi; Gassama Sow, Amy; Tall, Adama; Teferi, Mekonnen; Worku, Alemayehu; Yeshitela, Biruk; Wierzba, Thomas F; Marks, Florian

2016-03-15

Assessing healthcare utilization is important to identify weaknesses of healthcare systems, to outline action points for preventive measures and interventions, and to more accurately estimate the disease burden in a population. A healthcare utilization survey was developed for the Typhoid Fever Surveillance in Africa Program (TSAP) to adjust incidences of salmonellosis determined through passive, healthcare facility-based surveillance. This cross-sectional survey was conducted at 11 sites in 9 sub-Saharan African countries. Demographic data and healthcare-seeking behavior were assessed at selected households. Overall and age-stratified percentages of each study population that sought healthcare at a TSAP healthcare facility and elsewhere were determined. Overall, 88% (1007/1145) and 81% (1811/2238) of the population in Polesgo and Nioko 2, Burkina Faso, respectively, and 63% (1636/2590) in Butajira, Ethiopia, sought healthcare for fever at any TSAP healthcare facility. A far smaller proportion-namely, 20%-45% of the population in Bissau, Guinea-Bissau (1743/3885), Pikine, Senegal (1473/4659), Wad-Medani, Sudan (861/3169), and Pietermaritzburg, South Africa (667/2819); 18% (483/2622) and 9% (197/2293) in Imerintsiatosika and Isotry, Madagascar, respectively; and 4% (127/3089) in Moshi, Tanzania-sought healthcare at a TSAP healthcare facility. Patients with fever preferred to visit pharmacies in Imerintsiatosika and Isotry, and favored self-management of fever in Moshi. Age-dependent differences in healthcare utilization were also observed within and across sites. Healthcare utilization for fever varied greatly across sites, and revealed that not all studied populations were under optimal surveillance. This demonstrates the importance of assessing healthcare utilization. Survey data were pivotal for the adjustment of the program's estimates of salmonellosis and other conditions associated with fever. © The Author 2016. Published by Oxford University Press for the

Antimicrobial resistance in Danish pigs: A cross sectional study of the association between antimicrobial resistance and geography, exposure to antimicrobials, and trade

DEFF Research Database (Denmark)

Birkegård, Anna Camilla

Antimicrobial resistance is a worldwide problem of paramount importance for both humans and animals. To combat the emergence of antimicrobial resistance, the problem must be targeted in all major reservoirs as it is assumed that a high level of AMR genes in environmental reservoirs can increase...... the risk of human pathogens becoming resistant. Pigs might constitute an important reservoir. Therefore, it is important to manage antimicrobial resistance in pigs. Before effectiveactions can be initiated, it is crucial to know which factors are associated with the levels of antimicrobial resistance...... the collection of information on relevant factors. The aim of this PhD project was to study the relationship between the levels of antimicrobial resistance genes and three factors in Danish pig farms: the geographical location of the farm, the exposure to antimicrobials, and the trade patterns. Data collection...

General principles of antimicrobial therapy.

Science.gov (United States)

Leekha, Surbhi; Terrell, Christine L; Edson, Randall S

2011-02-01

Antimicrobial agents are some of the most widely, and often injudiciously, used therapeutic drugs worldwide. Important considerations when prescribing antimicrobial therapy include obtaining an accurate diagnosis of infection; understanding the difference between empiric and definitive therapy; identifying opportunities to switch to narrow-spectrum, cost-effective oral agents for the shortest duration necessary; understanding drug characteristics that are peculiar to antimicrobial agents (such as pharmacodynamics and efficacy at the site of infection); accounting for host characteristics that influence antimicrobial activity; and in turn, recognizing the adverse effects of antimicrobial agents on the host. It is also important to understand the importance of antimicrobial stewardship, to know when to consult infectious disease specialists for guidance, and to be able to identify situations when antimicrobial therapy is not needed. By following these general principles, all practicing physicians should be able to use antimicrobial agents in a responsible manner that benefits both the individual patient and the community.

Antimicrobial Peptides in 2014

Directory of Open Access Journals (Sweden)

Guangshun Wang

2015-03-01

Full Text Available This article highlights new members, novel mechanisms of action, new functions, and interesting applications of antimicrobial peptides reported in 2014. As of December 2014, over 100 new peptides were registered into the Antimicrobial Peptide Database, increasing the total number of entries to 2493. Unique antimicrobial peptides have been identified from marine bacteria, fungi, and plants. Environmental conditions clearly influence peptide activity or function. Human α-defensin HD-6 is only antimicrobial under reduced conditions. The pH-dependent oligomerization of human cathelicidin LL-37 is linked to double-stranded RNA delivery to endosomes, where the acidic pH triggers the dissociation of the peptide aggregate to release its cargo. Proline-rich peptides, previously known to bind to heat shock proteins, are shown to inhibit protein synthesis. A model antimicrobial peptide is demonstrated to have multiple hits on bacteria, including surface protein delocalization. While cell surface modification to decrease cationic peptide binding is a recognized resistance mechanism for pathogenic bacteria, it is also used as a survival strategy for commensal bacteria. The year 2014 also witnessed continued efforts in exploiting potential applications of antimicrobial peptides. We highlight 3D structure-based design of peptide antimicrobials and vaccines, surface coating, delivery systems, and microbial detection devices involving antimicrobial peptides. The 2014 results also support that combination therapy is preferred over monotherapy in treating biofilms.

A low-cost, hands-on module to characterize antimicrobial compounds using an interdisciplinary, biophysical approach.

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Karishma S Kaushik

2015-01-01

Full Text Available We have developed a hands-on experimental module that combines biology experiments with a physics-based analytical model in order to characterize antimicrobial compounds. To understand antibiotic resistance, participants perform a disc diffusion assay to test the antimicrobial activity of different compounds and then apply a diffusion-based analytical model to gain insights into the behavior of the active antimicrobial component. In our experience, this module was robust, reproducible, and cost-effective, suggesting that it could be implemented in diverse settings such as undergraduate research, STEM (science, technology, engineering, and math camps, school programs, and laboratory training workshops. By providing valuable interdisciplinary research experience in science outreach and education initiatives, this module addresses the paucity of structured training or education programs that integrate diverse scientific fields. Its low-cost requirements make it especially suitable for use in resource-limited settings.

Pharmacist-driven antimicrobial optimization in the emergency department.

Science.gov (United States)

Davis, Lucretia C; Covey, Robin B; Weston, Jaye S; Hu, Bee Bee Y; Laine, Gregory A

2016-03-01

A pharmacist-driven antimicrobial optimization service in the non-trauma emergency department (ED) of an 864-bed non-profit tertiary care teaching hospital was reviewed to assess its value. Local antimicrobial resistance patterns of urine, wound, stool, and blood cultures were also studied to determine whether or not empiric prescribing practices should be modified. A retrospective electronic chart review was performed for ED patients with positive cultures during two different three-month periods. During Period 1, ED nursing management performed positive culture follow-up. During Period 2, ED clinical pharmacists performed this role. The primary objective was to determine the value of the pharmacist-driven antimicrobial optimization service as measured by the number of clinical interventions made when indicated. The secondary objective was to examine resistance patterns of urine and wound isolates in order to determine if empiric prescribing patterns in the ED should be modified. During Period 1, there were 499 patient visits with subsequent positive cultures. Of those, 76 patients (15%) were discharged home. Nursing management intervened on 21 of 42 (50%) positive cultures that required an intervention; in Period 2, there were 473 patient visits with subsequent positive cultures, and 64 (14%) were discharged home. Pharmacists intervened on 24 of 30 (80%) cultures where an intervention was indicated resulting in a 30% increase in interventions for inappropriate therapy (p = 0.01). A review of the secondary objective revealed a 38% fluoroquinolone resistance rate of E. coli, the most frequently isolated urinary organism. Pharmacist-driven antimicrobial stewardship program resulted in a 30% absolute increase in interventions for inappropriate therapy as compared to the nursing-driven model. This stewardship program has further demonstrated the value of ED pharmacists. Pharmacist interventions should help to ensure that infections are resolved through modification of

[Patterns of utilization of external employee assistance program--analysis of employees who have their psychiatrists].

Science.gov (United States)

Ito, H; Fujii, K; Sasaki, Y

1998-01-01

The purpose of this paper is to clarify some patterns of utilization of an external employee assistance program (EAP) we have conducted for other public and private facilities in the Tokyo Kenbikyoin Foundation between April, 1986 and December, 1996. The subjects were 26 men and 12 women in 7 facilities under the following conditions: (1) Employees who have already had their own psychiatrists at the first interview of the external EAP; (2) Facilities utilize the EAP for two or more employees who met the first criterion. As a result, utilization patterns differed depending on medical staff's attitude toward the external EAP. There was a significant difference according to sex. The rate for men was 54% in worksites where medical staff understood this external program (worksite A1) and 93% in worksites where they did not (worksite A2-3, B). As to expectations for the program, there were more consultations for organizational measurements (63%) in worksite A1, while less organizational matters (27%) and more personal complains about their psychiatrists in the worksite A2-3, and B. These results suggest that the involvement of medical staff is the key to utilizing the external EAP effectively.

Free-electron laser research-and-development and utilization program at Tokai, JAERI

International Nuclear Information System (INIS)

Kawarasaki, Yuuki

1992-01-01

The free-electron laser (FEL) research and development (R and D) and utilization program now underway at the Linac Laboratory, Tokai Research Establishment, JAERI, is presented together with the current status of the R and D. Specific feature of this program is at the points that the R and D period will range over a long time, around a decade, tentatively divided into three developmental phases, aiming at the final utilization in a field of nuclear energy industry and the FEL here under R and D is based on a superconducting (SC) linear accelerator (linac) which will in later phases be incorporated with addition of more SC-cavity modules for beam energy increase and with adoption of rather novel accelerator technique: beam recirculation both for further energy increase and for power economy by beam energy recovery. Application scheme is additionally discussed. (author)

GrDHP: a general utility function representation for dual heuristic dynamic programming.

Science.gov (United States)

Ni, Zhen; He, Haibo; Zhao, Dongbin; Xu, Xin; Prokhorov, Danil V

2015-03-01

A general utility function representation is proposed to provide the required derivable and adjustable utility function for the dual heuristic dynamic programming (DHP) design. Goal representation DHP (GrDHP) is presented with a goal network being on top of the traditional DHP design. This goal network provides a general mapping between the system states and the derivatives of the utility function. With this proposed architecture, we can obtain the required derivatives of the utility function directly from the goal network. In addition, instead of a fixed predefined utility function in literature, we conduct an online learning process for the goal network so that the derivatives of the utility function can be adaptively tuned over time. We provide the control performance of both the proposed GrDHP and the traditional DHP approaches under the same environment and parameter settings. The statistical simulation results and the snapshot of the system variables are presented to demonstrate the improved learning and controlling performance. We also apply both approaches to a power system example to further demonstrate the control capabilities of the GrDHP approach.

Antimicrobial use in swine production and its effect on the swine gut microbiota and antimicrobial resistance.

Science.gov (United States)

Holman, Devin B; Chénier, Martin R

2015-11-01

Antimicrobials have been used in swine production at subtherapeutic levels since the early 1950s to increase feed efficiency and promote growth. In North America, a number of antimicrobials are available for use in swine. However, the continuous administration of subtherapeutic, low concentrations of antimicrobials to pigs also provides selective pressure for antimicrobial-resistant bacteria and resistance determinants. For this reason, subtherapeutic antimicrobial use in livestock remains a source of controversy and concern. The swine gut microbiota demonstrates a number of changes in response to antimicrobial administration depending on the dosage, duration of treatment, age of the pigs, and gut location that is sampled. Both culture-independent and -dependent studies have also shown that the swine gut microbiota contains a large number of antimicrobial resistance determinants even in the absence of antimicrobial exposure. Heavy metals, such as zinc and copper, which are often added at relatively high doses to swine feed, may also play a role in maintaining antimicrobial resistance and in the stability of the swine gut microbiota. This review focuses on the use of antimicrobials in swine production, with an emphasis on the North American regulatory context, and their effect on the swine gut microbiota and on antimicrobial resistance determinants in the gut microbiota.

Insecticidal, antimicrobial and antioxidant activities of bulb extracts of Allium sativum.

Science.gov (United States)

Meriga, Balaji; Mopuri, Ramgopal; MuraliKrishna, T

2012-05-01

To evaluate the insecticidal, antimicrobial and antioxidant activities of bulb extracts of Allium sativum (A. sativum). Dried bulbs of A. sativum were extracted with different solvents and evaluated for insecticidal, antimicrobial and antioxidant activities. Aqueous and methanol extracts showed highest insecticidal activity (mortality rate of 81% and 64% respectively) against the larvae of Spodoptera litura (S. litura) at a concentration of 1 000 ppm. With regard to antimicrobial activity, aqueous extract exhibited antibacterial activity against gram positive (Bacillus subtilis, Staphylococcus aureu,) and gram negative (Escherichia coli and Klebsiella pneumonia) strains and antifungal activity against Candida albicans. While methanol extract showed antimicrobial activity against all the tested micro organisms except two (Staphylococcus aureus and Candida albicans), the extracts of hexane, chloroform and ethyl acetate did not show any anti microbial activity. Minimum inhibitory concentration of aqueous and methanol extracts against tested bacterial and fungal strains was 100-150 μg/mL. Antioxidant activity of the bulb extracts was evaluated in terms of inhibition of free radicals by 2, 2'-diphenly-1-picrylhydrazyl. Aqueous and methanol extracts exhibited strong antioxidant activity (80%-90% of the standard). Antioxidant and antimicrobial activity of A. sativum against the tested organisms therefore, provides scientific basis for its utilization in traditional and folk medicine. Also, our results demonstrated the insecticidal efficacy of A. sativum against S. litura, a polyphagous insect. Copyright © 2012 Hainan Medical College. Published by Elsevier B.V. All rights reserved.

Natural Antimicrobials and Oral Microorganisms: A Systematic Review on Herbal Interventions for the Eradication of Multispecies Oral Biofilms

OpenAIRE

Karygianni, Lamprini; Al-Ahmad, Ali; Argyropoulou, Aikaterini; Hellwig, Elmar; Anderson, Annette C.; Skaltsounis, Alexios L.

2016-01-01

Oral diseases such as caries and periodontitis are mainly caused by microbial biofilms. Antibiotic therapy has reached its limits with regard to antimicrobial resistance, and new therapeutic measures utilizing natural phytochemicals are currently a focus of research. Hence, this systematic review provides a critical presentation of the antimicrobial effects of various medicinal herbs against in vitro, ex vivo, and in situ formed multispecies oral biofilms. Searches were performed in three Eng...

Antimicrobial Susceptibility of Enteric Gram Negative Facultative Anaerobe Bacilli in Aerobic versus Anaerobic Conditions

Science.gov (United States)

Amachawadi, Raghavendra G.; Renter, David G.; Volkova, Victoriya V.

2016-01-01

Antimicrobial treatments result in the host’s enteric bacteria being exposed to the antimicrobials. Pharmacodynamic models can describe how this exposure affects the enteric bacteria and their antimicrobial resistance. The models utilize measurements of bacterial antimicrobial susceptibility traditionally obtained in vitro in aerobic conditions. However, in vivo enteric bacteria are exposed to antimicrobials in anaerobic conditions of the lower intestine. Some of enteric bacteria of food animals are potential foodborne pathogens, e.g., Gram-negative bacilli Escherichia coli and Salmonella enterica. These are facultative anaerobes; their physiology and growth rates change in anaerobic conditions. We hypothesized that their antimicrobial susceptibility also changes, and evaluated differences in the susceptibility in aerobic vs. anaerobic conditions of generic E. coli and Salmonella enterica of diverse serovars isolated from cattle feces. Susceptibility of an isolate was evaluated as its minimum inhibitory concentration (MIC) measured by E-Test® following 24 hours of adaptation to the conditions on Mueller-Hinton agar, and on a more complex tryptic soy agar with 5% sheep blood (BAP) media. We considered all major antimicrobial drug classes used in the U.S. to treat cattle: β-lactams (specifically, ampicillin and ceftriaxone E-Test®), aminoglycosides (gentamicin and kanamycin), fluoroquinolones (enrofloxacin), classical macrolides (erythromycin), azalides (azithromycin), sulfanomides (sulfamethoxazole/trimethoprim), and tetracyclines (tetracycline). Statistical analyses were conducted for the isolates (n≥30) interpreted as susceptible to the antimicrobials based on the clinical breakpoint interpretation for human infection. Bacterial susceptibility to every antimicrobial tested was statistically significantly different in anaerobic vs. aerobic conditions on both media, except for no difference in susceptibility to ceftriaxone on BAP agar. A satellite experiment

Antimicrobial Peptides in Reptiles

Science.gov (United States)

van Hoek, Monique L.

2014-01-01

Reptiles are among the oldest known amniotes and are highly diverse in their morphology and ecological niches. These animals have an evolutionarily ancient innate-immune system that is of great interest to scientists trying to identify new and useful antimicrobial peptides. Significant work in the last decade in the fields of biochemistry, proteomics and genomics has begun to reveal the complexity of reptilian antimicrobial peptides. Here, the current knowledge about antimicrobial peptides in reptiles is reviewed, with specific examples in each of the four orders: Testudines (turtles and tortosises), Sphenodontia (tuataras), Squamata (snakes and lizards), and Crocodilia (crocodilans). Examples are presented of the major classes of antimicrobial peptides expressed by reptiles including defensins, cathelicidins, liver-expressed peptides (hepcidin and LEAP-2), lysozyme, crotamine, and others. Some of these peptides have been identified and tested for their antibacterial or antiviral activity; others are only predicted as possible genes from genomic sequencing. Bioinformatic analysis of the reptile genomes is presented, revealing many predicted candidate antimicrobial peptides genes across this diverse class. The study of how these ancient creatures use antimicrobial peptides within their innate immune systems may reveal new understandings of our mammalian innate immune system and may also provide new and powerful antimicrobial peptides as scaffolds for potential therapeutic development. PMID:24918867

2005 to 2014 CT and MRI Utilization Trends in the Context of a Nondenial Prior Authorization Program

Directory of Open Access Journals (Sweden)

Adam C. Powell

2017-10-01

Full Text Available Purpose: Reducing unnecessary testing may benefit patients, as some computed tomography (CT and magnetic resonance imaging (MRI expose patients to contrast, and all CTs expose patients to radiation. This observational study with historical controls assessed shifts in CT and MRI utilization over a 9-year period after a private health insurer’s implementation of a nondenial, consultative prior authorization program. Methods/Materials: Normalized rates of exams per 1000 person-years were plotted over 2005 to 2014 for people with commercial and Medicare Advantage health plans in the San Antonio market, with 2005 utilization set as the baseline. The program was implemented at the start of 2006. Computed tomography and MRI utilization changes were compared with contemporaneous changes in low-tech plain film and ultrasound utilization. Results: Growth in high-tech imaging utilization decelerated or reversed during the period. In 2006, CT utilization dropped to between 76% and 90% of what it had been in 2005, depending on the plan. In 2014, it was between 52% and 88% of its initial level. MRI utilization declined to between 86% and 94% of its initial level in 2006, and then to between 50% and 75% in 2014. Ultrasound utilization was greater in 2014 than in 2005 for some plans. Plain film utilization declined between 2005 and 2014 for all plans. Conclusion: There was an immediate and sustained decline in CT and MRI utilization after the introduction of the program. While many factors may have impacted the long-term trends, the mixed trends in low-tech imaging suggest that a decline in low-tech imaging was not responsible for the decline in CT and MRI utilization.

US utility partnerships

International Nuclear Information System (INIS)

Worthington, B.

1995-01-01

Activities of the United States Energy Association were reviewed, as well as the manner in which its members are benefitting from the Association's programs. The principal cooperative program set up is the Utility Partnership Program, which was described. Through this program the Association is matching US companies, both electric utilities and gas utilities, with counterparts in Eastern Europe or the former Soviet Union. So far, about 25 partnerships were signed, e.g. in the Czech Republic, in Kazakhstan, in Poland, and in Slovakia. It was estimated that the return to the United States from the investments made by the American government in these Utility Partnership Programs has been well over 100-fold

Antimicrobial Stewardship and Urinary Tract Infections

Directory of Open Access Journals (Sweden)

Lilian M. Abbo

2014-05-01

Full Text Available Urinary tract infections are the most common bacterial infections encountered in ambulatory and long-term care settings in the United States. Urine samples are the largest single category of specimens received by most microbiology laboratories and many such cultures are collected from patients who have no or questionable urinary symptoms. Unfortunately, antimicrobials are often prescribed inappropriately in such patients. Antimicrobial use, whether appropriate or inappropriate, is associated with the selection for antimicrobial-resistant organisms colonizing or infecting the urinary tract. Infections caused by antimicrobial-resistant organisms are associated with higher rates of treatment failures, prolonged hospitalizations, increased costs and mortality. Antimicrobial stewardship consists of avoidance of antimicrobials when appropriate and, when antimicrobials are indicated, use of strategies to optimize the selection, dosing, route of administration, duration and timing of antimicrobial therapy to maximize clinical cure while limiting the unintended consequences of antimicrobial use, including toxicity and selection of resistant microorganisms. This article reviews successful antimicrobial stewardship strategies in the diagnosis and treatment of urinary tract infections.

Antimicrobial (Drug) Resistance

Science.gov (United States)

... with facebook share with twitter share with linkedin Antimicrobial (Drug) Resistance Go to Information for Researchers ► Credit: ... and infectious diseases. Why Is the Study of Antimicrobial (Drug) Resistance a Priority for NIAID? Over time, ...

Antimicrobial resistance of mastitis pathogens.

Science.gov (United States)

Oliver, Stephen P; Murinda, Shelton E

2012-07-01

Antibiotics are used extensively in the dairy industry to combat disease and to improve animal performance. Antibiotics such as penicillin, cephalosporin, streptomycin, and tetracycline are used for the treatment and prevention of diseases affecting dairy cows caused by a variety of gram-positive and gram-negative bacteria. Antibiotics are often administrated routinely to entire herds to prevent mastitis during the dry period. An increase in the incidence of disease in a herd generally results in increased use of antimicrobials, which in turn increases the potential for antibiotic residues in milk and the potential for increased bacterial resistance to antimicrobials. Continued use of antibiotics in the treatment and prevention of diseases of dairy cows will continue to be scrutinized. It is clear that strategies employing the prudent use of antimicrobials are needed. This clearly illustrates the importance of effective herd disease prevention and control programs. Based on studies published to date, scientific evidence does not support widespread, emerging resistance among mastitis pathogens to antibacterial drugs even though many of these antibiotics have been used in the dairy industry for treatment and prevention of disease for several decades. However, it is clear that use of antibiotics in dairy cows can contribute to increased antimicrobial resistance. While antimicrobial resistance does occur, we are of the opinion that the advantages of using antibiotics for the treatment of mastitis far outweigh the disadvantages. The clinical consequences of antimicrobial resistance of dairy pathogens affecting humans appear small. Antimicrobial resistance among dairy pathogens, particularly those found in milk, is likely not a human health concern as long as the milk is pasteurized. However, there are an increasing number of people who choose to consume raw milk. Transmission of an antimicrobial-resistant mastitis pathogen and/or foodborne pathogen to humans could occur

42 CFR 423.153 - Drug utilization management, quality assurance, and medication therapy management programs (MTMPs).

Science.gov (United States)

2010-10-01

... PRESCRIPTION DRUG BENEFIT Cost Control and Quality Improvement Requirements § 423.153 Drug utilization... 42 Public Health 3 2010-10-01 2010-10-01 false Drug utilization management, quality assurance, and medication therapy management programs (MTMPs). 423.153 Section 423.153 Public Health CENTERS FOR MEDICARE...

Can a chronic disease management pulmonary rehabilitation program for COPD reduce acute rural hospital utilization?

Science.gov (United States)

Rasekaba, T M; Williams, E; Hsu-Hage, B

2009-01-01

Chronic obstructive pulmonary disease (COPD) imposes a costly burden on healthcare. Pulmonary rehabilitation (PR) is the best practice to better manage COPD to improve patient outcomes and reduce acute hospital care utilization. To evaluate the impact of a once-weekly, eight-week multidisciplinary PR program as an integral part of the COPD chronic disease management (CDM) Program at Kyabram District Health Services. The study compared two cohorts of COPD patients: CDM-PR Cohort (4-8 weeks) and Opt-out Cohort (0-3 weeks) between February 2006 and March 2007. The CDM-PR Program involved multidisciplinary patient education and group exercise training. Nonparametric statistical tests were used to compare acute hospital care utilization 12 months before and after the introduction of CDM-PR. The number of patients involved in the CDM-PR Cohort was 29 (n = 29), and that in the Opt-out Cohort was 24 (n = 24). The CDM-PR Cohort showed significant reductions in cumulative acute hospital care utilization indicators (95% emergency department presentations, 95% inpatient admissions, 99% length of stay; effect sizes = 0.62-0.66, P 0.05). Total costs associated with the hospital care utilization decreased from $130,000 to $7,500 for the CDM-PR Cohort and increased from $77,700 to $101,200 for the Opt-out Cohort. Participation in the CDM-PR for COPD patients can significantly reduce acute hospital care utilization and associated costs in a small rural health service.

Deposition of antimicrobial coatings on microstereolithography-fabricated microneedles

Science.gov (United States)

Gittard, Shaun D.; Miller, Philip R.; Jin, Chunming; Martin, Timothy N.; Boehm, Ryan D.; Chisholm, Bret J.; Stafslien, Shane J.; Daniels, Justin W.; Cilz, Nicholas; Monteiro-Riviere, Nancy A.; Nasir, Adnan; Narayan, Roger J.

2011-06-01

Microneedles are small-scale needle-like projections that may be used for transdermal delivery of pharmacologic agents, including protein-containing and nucleic acid-containing agents. Commercial translation of polymeric microneedles would benefit from the use of facile and cost effective fabrication methods. In this study, visible light dynamic mask microstereolithography, a rapid prototyping technique that utilizes digital light projection for selective polymerization of a liquid resin, was used for fabrication of solid microneedle array structures out of an acrylate-based polymer. Pulsed laser deposition was used to deposit silver and zinc oxide coatings on the surfaces of the visible light dynamic mask microstereolithography-fabricated microneedle array structures. Agar diffusion studies were used to demonstrate the antimicrobial activity of the coated microneedle array structures. This study indicates that light-based technologies, including visible light dynamic mask microstereolithography and pulsed laser deposition, may be used to fabricate microneedles with antimicrobial properties for treatment of local skin infections.

Implementation of the program for conservation and sustainable utilization of forest genetic resources in Republic of Serbia

Directory of Open Access Journals (Sweden)

Šijačić-Nikolić Mirjana

2017-01-01

Full Text Available Program for conservation and sustainable utilization of forest genetic resources has been defined for 2016-2025 period and it is a base for concrete activities in this field. This Program could be divided into several parts that deal with: the legal framework for the conservation and sustainable utilization of forest genetic resources; status of forest genetic resources in Serbia; previous activities on the conservation of forest genetic resources; and objectives, priorities and measures of conservation. The Program should have an impact on the development of the forestry sector through the following activities: conservation and sustainable utilization of the available gene pool; improving forest management in accordance with conservation principles; improving the production of reproductive material of forest trees; make the public awareness of the need for conservation and sustainable utilization of forest genetic resources; fulfillment of international obligations related to this field and the possibility of joining FAO activities related to forest genetic resources - development of the national report as a part of the publication The State of the World's Forest Genetic Resources. Implementation of the Program will depend upon raising the awareness on the importance, conservation and sustainable utilization of forest genetic resources, as a precondition for the forests survival; it will depend of funds that will be allocated for this purpose and enthusiasm of people who deal with these issues.

Antimicrobial polymers.

Science.gov (United States)

Jain, Anjali; Duvvuri, L Sailaja; Farah, Shady; Beyth, Nurit; Domb, Abraham J; Khan, Wahid

2014-12-01

Better health is basic requirement of human being, but the rapid growth of harmful pathogens and their serious health effects pose a significant challenge to modern science. Infections by pathogenic microorganisms are of great concern in many fields such as medical devices, drugs, hospital surfaces/furniture, dental restoration, surgery equipment, health care products, and hygienic applications (e.g., water purification systems, textiles, food packaging and storage, major or domestic appliances etc.) Antimicrobial polymers are the materials having the capability to kill/inhibit the growth of microbes on their surface or surrounding environment. Recently, they gained considerable interest for both academic research and industry and were found to be better than their small molecular counterparts in terms of enhanced efficacy, reduced toxicity, minimized environmental problems, resistance, and prolonged lifetime. Hence, efforts have focused on the development of antimicrobial polymers with all desired characters for optimum activity. In this Review, an overview of different antimicrobial polymers, their mechanism of action, factors affecting antimicrobial activity, and application in various fields are given. Recent advances and the current clinical status of these polymers are also discussed. © 2014 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

Description of the Formerly Utilized Sites Remedial Action Program

International Nuclear Information System (INIS)

1980-09-01

The background and the results to date of the Department of Energy program to identify and evaluate the radiological conditions at sites formerly utilized by the Corps of Engineers' Manhattan Engineer District (MED) and the US Atomic Energy Commission (AEC) are summarized. The sites of concern were federally, privately, and institutionally owned and were used primarily for research, processing, and storage of uranium and thorium ores, concentrates, or residues. Some sites were subsequently released for other purposes without radiological restriction. Surveys have been conducted since 1974 to document radiological conditions at such sites. Based on radiological surveys, sites are identified in this document that require, or are projected to require, remedial action to remove potential restrictions on the use of the property due to the presence of residual low-level radioactive contamination. Specific recommendations for each site will result from more detailed environmental and engineering surveys to be conducted at those sites and, if necessary, an environmental impact assessment or environmental impact statement will be prepared. Section 3.0 describes the current standards and guidelines now being used to conduct remedial actions. Current authority of the US Department of Energy (DOE) to proceed with remedial actions and the new authority required are summarized. A plan to implement the Formerly Utilized Sites Remedial Action Program (FUSRAP) in accordance with the new authority is presented, including the objectives, scope, general approach, and a summary schedule. Key issues affecting schedule and cost are discussed

Description of the Formerly Utilized Sites Remedial Action Program

Energy Technology Data Exchange (ETDEWEB)

1980-09-01

The background and the results to date of the Department of Energy program to identify and evaluate the radiological conditions at sites formerly utilized by the Corps of Engineers' Manhattan Engineer District (MED) and the US Atomic Energy Commission (AEC) are summarized. The sites of concern were federally, privately, and institutionally owned and were used primarily for research, processing, and storage of uranium and thorium ores, concentrates, or residues. Some sites were subsequently released for other purposes without radiological restriction. Surveys have been conducted since 1974 to document radiological conditions at such sites. Based on radiological surveys, sites are identified in this document that require, or are projected to require, remedial action to remove potential restrictions on the use of the property due to the presence of residual low-level radioactive contamination. Specific recommendations for each site will result from more detailed environmental and engineering surveys to be conducted at those sites and, if necessary, an environmental impact assessment or environmental impact statement will be prepared. Section 3.0 describes the current standards and guidelines now being used to conduct remedial actions. Current authority of the US Department of Energy (DOE) to proceed with remedial actions and the new authority required are summarized. A plan to implement the Formerly Utilized Sites Remedial Action Program (FUSRAP) in accordance with the new authority is presented, including the objectives, scope, general approach, and a summary schedule. Key issues affecting schedule and cost are discussed.

The antimicrobial efficacy of commercial dentifrices.

Science.gov (United States)

Haraszthy, Violet I; Zambon, Joseph J; Sreenivasan, Prem K

2010-01-01

This investigation compared the effects of a fluoride dentifrice and toothpastes formulated with antimicrobial ingredients (stannous fluoride and triclosan/copolymer) on oral micro-organisms, including those found in samples taken from the human oral cavity. Microbiological techniques determined the minimum inhibitory concentrations (MICs) of each dentifrice necessary to inhibit the growth of bacterial strains from the healthy oral cavity, as well as those found in dental caries, periodontal disease, and halitosis. Ex vivo studies utilized oral rinse samples and supragingival plaque from adults to determine antimicrobial effects on the entire microbial diversity of these samples, including biofilm-derived micro-organisms. The triclosan/copolymer dentifrice demonstrated the lowest MICs and significantly inhibited Gram-positive and Gram-negative bacteria (including the periodontal pathogens Aggregatibacter actinomycetemcomitans, Eikenella corrodens, and Fusobacterium nucleatum). In the ex vivo tests, the triclosan/copolymer dentifrice demonstrated substantial inhibition in the oral rinse samples over each treatment period (p > 0.0005) as compared to either the fluoride or stannous fluoride dentifrices. Similarly, the triclosan/copolymer dentifrice demonstrated the highest inhibition of micro-organisms in the supragingival plaque biofilm (p fluoride and stannous fluoride dentifrices (p > 0.5).

The use of forests to mitigate global warming - designing programs that work for utilities

International Nuclear Information System (INIS)

Holmes, N.R.

1990-01-01

This paper discusses the use of forests as carbon sinks by utilities to offset carbon dioxide production by fossil-fueled power plants. The topics of the paper include greenhouse gases, greenhouse effect, why trees are carbon sinks, planning a carbon sequestering program based on trees and forests, and descriptions of specific types of programs

Surveillance programs for detection and characterization of emergent pathogens and antimicrobial resistance: results from the Division of Infectious Diseases, UNIFESP.

Science.gov (United States)

Colombo, Arnaldo L; Janini, Mario; Salomão, Reinaldo; Medeiros, Eduardo A S; Wey, Sergio B; Pignatari, Antonio C C

2009-09-01

Several epidemiological changes have occurred in the pattern of nosocomial and community acquired infectious diseases during the past 25 years. Social and demographic changes possibly related to this phenomenon include a rapid population growth, the increase in urban migration and movement across international borders by tourists and immigrants, alterations in the habitats of animals and arthropods that transmit disease, as well as the raise of patients with impaired host defense abilities. Continuous surveillance programs of emergent pathogens and antimicrobial resistance are warranted for detecting in real time new pathogens, as well as to characterize molecular mechanisms of resistance. In order to become more effective, surveillance programs of emergent pathogens should be organized as a multicenter laboratory network connected to the main public and private infection control centers. Microbiological data should be integrated to guide therapy, adapting therapy to local ecology and resistance patterns. This paper presents an overview of data generated by the Division of Infectious Diseases, Federal University of São Paulo, along with its participation in different surveillance programs of nosocomial and community acquired infectious diseases.

Effects of a pain education program in Complementary and Alternative Medicine treatment utilization at a VA medical center.

Science.gov (United States)

Cosio, David; Lin, Erica H

2015-06-01

Past studies have shown that U.S. Veterans are consumers of CAM. However, more than 75% of Veteran non-users report they would utilize these treatment options if made available. Thus, Veterans may not be fully aware of the CAM options currently available to them in the current U.S. VA health care system. The current study tested the hypothesis that Veterans would report an increase in CAM utilization after completing a formal pain education program in a VA medical center. The study used a quasi-experimental, one-group, pre/post-test design. Midwestern, U.S. VA Medical Center. The responses from 103 Veterans who elected to participate in the program and the assessment measures were included in the outcome analyses. "Pain Education School" is a 12-week, educational program that is open to all Veterans and their families. It is a comprehensive program that introduces patients to 23 different disciplines at the VA Medical Center that deal with chronic, non-cancer pain. An adaptation of the Complementary and Alternative Medicine Questionnaire(©), SECTION A: Use of Alternative Health Care Providers. There was a significant difference found in overall utilization of CAM after completing the pain education program. The most utilized CAM modality was the chiropractor; the least utilized were hypnosis and aromatherapy. Not all health care systems or providers may have access to an education-focused, professionally driven program as an amenity. However, lessons can be learned from this study in terms of what pain providers may be able to accomplish in their practice. Published by Elsevier Ltd.

Animation of Antimicrobial Resistance

Science.gov (United States)

... Animal & Veterinary Cosmetics Tobacco Products Animal & Veterinary Home Animal & Veterinary Safety & Health Antimicrobial Resistance Animation of Antimicrobial Resistance Share Tweet Linkedin Pin ...

Patron perception and utilization of an embedded librarian program.

Science.gov (United States)

Blake, Lindsay; Ballance, Darra; Davies, Kathy; Gaines, Julie K; Mears, Kim; Shipman, Peter; Connolly-Brown, Maryska; Burchfield, Vicki

2016-07-01

The study measured the perceived value of an academic library's embedded librarian service model. The study took place at the health sciences campuses of a research institution. A web-based survey was distributed that asked respondents a series of questions about their utilization of and satisfaction with embedded librarians and services. Over 58% of respondents reported being aware of their embedded librarians, and 95% of these were satisfied with provided services. The overall satisfaction with services was encouraging, but awareness of the embedded program was low, suggesting an overall need for marketing of services.

Effect of antimicrobial compounds tylosin and chlortetracycline during batch anaerobic swine manure digestion.

Science.gov (United States)

Stone, James J; Clay, Sharon A; Zhu, Zhenwei; Wong, Kwok L; Porath, Laura R; Spellman, Garth M

2009-10-01

Tylosin and chlortetracycline (CTC) are antimicrobial chemicals that are fed to >45% of the US swine herds at therapeutic and sub-therapeutic dosages to enhance growth rates and treat swine health problems. These compounds are poorly absorbed during digestion so that the bioactive compound or metabolites are excreted. This study investigated the degradation and stabilization of swine manure that contained no additives and compared the observed processes with those of manure containing either tylosin or CTC. The batch anaerobic incubation lasted 216 days. The breakdown of insoluble organic matter through anaerobic hydrolysis reactions was faster for manure containing CTC compared with tylosin or no-antimicrobial treatments. Volatile fatty acid (VFA) accumulation, including acetate, butyrate, and propionate, was greater for CTC-containing manure compared to tylosin and no-antimicrobial treatments. The relative abundance of two aceticlastic methanogens, Methanosaetaceae and Methanosarcinaceae spp., were less for CTC manure than manure with no-antimicrobial treatment. In addition, generation of methane and carbon dioxide was inhibited by 27.8% and 28.4%, respectively, due to the presence of CTC. Tylosin effects on manure degradation were limited, however the relative abundance of Methanosarcinaceae spp. was greater than found in the CTC or no-antimicrobial manures. These data suggest that acetate and other C-1 VFA compounds would be effectively utilized during methanogenesis in the presence of tylosin.

Influence of applying different units of measurement on reporting antimicrobial consumption data for pig farms.

Science.gov (United States)

Taverne, F J; Jacobs, J H; Heederik, Djj; Mouton, J W; Wagenaar, J A; van Geijlswijk, I M

2015-10-06

Antimicrobial use in livestock is one of the factors contributing to selection and spread of resistant microorganisms in the environment. National veterinary antimicrobial consumption monitoring programs are therefore in place in a number of countries in the European Union. However, due to differences in methodology, results on veterinary antimicrobial consumption from these national monitoring programs cannot be compared internationally. International comparison is highly needed to establish regulations on veterinary antimicrobial use and reducing antimicrobial resistance. The aim of this study was to assess differences in the outcomes on veterinary antimicrobial consumption by applying three different sets of nationally established animal defined daily dosages to the same antimicrobial drug delivery dataset of Dutch pigs in 2012. Delivery information for the complete Dutch pig sector for the year 2012 reported to the Netherlands Veterinary Medicines Authority (SDa) was analysed with three differently and nationally established animal defined daily dosages from the Netherlands and Denmark: the Defined Daily Dosage AnimalNL (DDDANL), the Animal Daily DosageDK (ADDDK) and Defined Animal Daily DosageDK (DADDDK). For each applied Dutch product equivalent, Danish products were identified based on authorization for pigs, active substance (including form), administration route, concentration and dosage regimen. Consumption in number of ADDDK/Y was lower than in number of DDDANL/Y for sows/piglets and finisher pigs, with proportions of 83.3 % and 98.3 %. Use in number of DADDDK/Y was even lower, 79.7 % for sows/piglets and 88.1 % for finisher pigs compared to number of DDDANL/Y. At therapeutic group level proportions of number of DADDDK/Y to number of DDDANL/Y were 63.6-150.4 % (sows/piglets) and 55.6-171.0 % (finisher pigs). Proportions were > 100 % for the polymyxines (sows/piglets 150.4 % and finisher pigs 149.9 %) and the macrolides/lincosamides (finisher pigs 171

Antimicrobial activity of Nigerian medicinal plants

Science.gov (United States)

Anyanwu, Madubuike Umunna; Okoye, Rosemary Chinazam

2017-01-01

Antimicrobial resistance (AMR) is currently one of the major threats facing mankind. The emergence and rapid spread of multi- and pan-drug-resistant organisms (such as vancomycin-, methicillin-, extended-spectrum β-lactam-, carbapenem- and colistin-resistant organisms) has put the world in a dilemma. The health and economic burden associated with AMR on a global scale are dreadful. Available antimicrobials have been misused and are almost ineffective with some of these drugs associated with dangerous side effects in some individuals. Development of new, effective, and safe antimicrobials is one of the ways by which AMR burden can be reduced. The rate at which microorganisms develop AMR mechanisms outpaces the rate at which new antimicrobials are being developed. Medicinal plants are potential sources of new antimicrobial molecules. There is renewed interest in antimicrobial activities of phytochemicals. Nigeria boasts of a huge heritage of medicinal plants and there is avalanche of researches that have been undertaken to screen antimicrobial activities of these plants. Scientific compilation of these studies could provide useful information on the antimicrobial properties of the plants. This information can be useful in the development of new antimicrobial drugs. This paper reviews antimicrobial researches that have been undertaken on Nigerian medicinal plants. PMID:28512606

User's guide to SERICPAC: A computer program for calculating electric-utility avoided costs rates

Energy Technology Data Exchange (ETDEWEB)

Wirtshafter, R.; Abrash, M.; Koved, M.; Feldman, S.

1982-05-01

SERICPAC is a computer program developed to calculate average avoided cost rates for decentralized power producers and cogenerators that sell electricity to electric utilities. SERICPAC works in tandem with SERICOST, a program to calculate avoided costs, and determines the appropriate rates for buying and selling of electricity from electric utilities to qualifying facilities (QF) as stipulated under Section 210 of PURA. SERICPAC contains simulation models for eight technologies including wind, hydro, biogas, and cogeneration. The simulations are converted in a diversified utility production which can be either gross production or net production, which accounts for an internal electricity usage by the QF. The program allows for adjustments to the production to be made for scheduled and forced outages. The final output of the model is a technology-specific average annual rate. The report contains a description of the technologies and the simulations as well as complete user's guide to SERICPAC.

Animation of Antimicrobial Resistance

Medline Plus

Full Text Available ... Animal & Veterinary Cosmetics Tobacco Products Animal & Veterinary Home Animal & Veterinary Safety & Health Antimicrobial Resistance Animation of Antimicrobial Resistance Share Tweet Linkedin Pin ...

Antimicrobial compounds in tears.

Science.gov (United States)

McDermott, Alison M

2013-12-01

The tear film coats the cornea and conjunctiva and serves several important functions. It provides lubrication, prevents drying of the ocular surface epithelia, helps provide a smooth surface for refracting light, supplies oxygen and is an important component of the innate defense system of the eye providing protection against a range of potential pathogens. This review describes both classic antimicrobial compounds found in tears such as lysozyme and some more recently identified such as members of the cationic antimicrobial peptide family and surfactant protein-D as well as potential new candidate molecules that may contribute to antimicrobial protection. As is readily evident from the literature review herein, tears, like all mucosal fluids, contain a plethora of molecules with known antimicrobial effects. That all of these are active in vivo is debatable as many are present in low concentrations, may be influenced by other tear components such as the ionic environment, and antimicrobial action may be only one of several activities ascribed to the molecule. However, there are many studies showing synergistic/additive interactions between several of the tear antimicrobials and it is highly likely that cooperativity between molecules is the primary way tears are able to afford significant antimicrobial protection to the ocular surface in vivo. In addition to effects on pathogen growth and survival some tear components prevent epithelial cell invasion and promote the epithelial expression of innate defense molecules. Given the protective role of tears a number of scenarios can be envisaged that may affect the amount and/or activity of tear antimicrobials and hence compromise tear immunity. Two such situations, dry eye disease and contact lens wear, are discussed here. Copyright © 2013 Elsevier Ltd. All rights reserved.

Use and Misuse of Antimicrobial Drugs in Poultry and Livestock: Mechanisms of Antimicrobial Resistance

Directory of Open Access Journals (Sweden)

Toni Poole* and Cynthia Sheffield

2013-07-01

Full Text Available Food safety begins on the farm with management practices that contribute to an abundant, safe, and affordable food supply. To attain this goal antimicrobials have been used in all stages of food animal production in the United States and elsewhere around the world at one time or another. Among food–production animals antimicrobials are used for growth promotion, disease prophylaxis or disease treatment, and are generally administered to the entire flock or herd. Over many decades bacteria have become resistant to multiple antimicrobial classes in a cumulative manner. Bacteria exhibit a number of well characterized mechanisms of resistance to antimicrobials that include: 1 modification of the antimicrobial; 2 alteration of the drug target; 3 decreased access of drug to target; and 4 implementation of an alternative metabolic pathway not affected by the drug. The mechanisms of resistance are complex and depend on the type of bacterium involved (e.g. Gram–positive or Gram–negative and the class of drug. Some bacterial species have accumulated resistance to nearly all antimicrobial classes due to a combination of intrinsic and acquired processes. This has and will continue to lead to clinical failures of antimicrobial treatment in both human and animal medicine.

Animation of Antimicrobial Resistance

Medline Plus

Full Text Available ... More in Antimicrobial Resistance National Antimicrobial Resistance Monitoring System ... If you need help accessing information in different file formats, see Instructions for Downloading ...

Conformational study of melectin and antapin antimicrobial peptides in model membrane environments

Science.gov (United States)

Kocourková, Lucie; Novotná, Pavlína; Čujová, Sabína; Čeřovský, Václav; Urbanová, Marie; Setnička, Vladimír

2017-01-01

Antimicrobial peptides have long been considered as promising compounds against drug-resistant pathogens. In this work, we studied the secondary structure of antimicrobial peptides melectin and antapin using electronic (ECD) and vibrational circular dichroism (VCD) spectroscopies that are sensitive to peptide secondary structures. The results from quantitative ECD spectral evaluation by Dichroweb and CDNN program and from the qualitative evaluation of the VCD spectra were compared. The antimicrobial activity of the selected peptides depends on their ability to adopt an amphipathic α-helical conformation on the surface of the bacterial membrane. Hence, solutions of different zwitterionic and negatively charged liposomes and micelles were used to mimic the eukaryotic and bacterial biological membranes. The results show a significant content of α-helical conformation in the solutions of negatively charged liposomes mimicking the bacterial membrane, thus correlating with the antimicrobial activity of the studied peptides. On the other hand in the solutions of zwitterionic liposomes used as models of the eukaryotic membranes, the fraction of α-helical conformation was lower, which corresponds with their moderate hemolytic activity.

Antimicrobial Drugs in the Home

Centers for Disease Control (CDC) Podcasts

Survey participants in the United Kingdom admitted keeping leftover antimicrobial drugs for future use and taking them without medical advice. Dr. J. Todd Weber, director of CDC's Office of Antimicrobial Resistance, advises against the practice, which can be dangerous and can promote antimicrobial drug resistance.

Patterns Of Antimicrobial Use For Respiratory Tract Infections In Elderly Patients

International Nuclear Information System (INIS)

Taha, H.M.; Rasheedy, D.; Mahmoud, A.H.

2013-01-01

Background: Elderly patients are prone to respiratory tract infections (RTIs) both; acute bronchitis and pneumonia. A large proportion of the antibiotics prescribed are unlikely to provide clinical benefit to patients. There is an increased need to decrease excess antibiotic use in elderly to minimize antibiotic resistance. Objective: To describe patterns of antimicrobial use for respiratory tract infections (RTIs) among elderly Patients and methods: A cross sectional study was conducted on one hundred elderly patients, aged > 60 years, both males and females to describe patterns of antimicrobial use for respiratory tract infections (RTIs) among elderly patients. RTIs, categorized as acute bronchitis, and pneumonia, were studied for appropriateness of antimicrobial use, type of antibiotics used, and factors associated with their use. We rated antibiotic use as appropriate (when an effective drug was used), inappropriate (when a more effective drug was indicated), or unjustified (when use of any antimicrobial was not indicated). Results: Of 100 patients with RTI, overall treatment was appropriate in 79% of episodes, inappropriate in 9%, and unjustified in 12%. For acute bronchitis, treatment was appropriate in 85% and unjustified in 15% of cases. For pneumonia, treatment was appropriate in 55% of episodes. Among the most commonly used antimicrobials, B.Lactam + macrolides their use were unjustified in 41% of cases. There were statistical significant differences in the patterns of antibiotic use when stratified by age, gender, and co- morbid conditions including chronic obstructive pulmonary disease. Conclusion: Antimicrobials are unjustifiably used for 12% of RTIs and 15% of cases of acute bronchitis, thus suggesting a need for programs to improve antibiotic prescribing at hospitals.

Oral administration of antimicrobials increase antimicrobial resistance in E. coli from chicken--a systematic review.

Science.gov (United States)

Simoneit, C; Burow, E; Tenhagen, B-A; Käsbohrer, A

2015-01-01

Antimicrobials play an important role in animal and human health care. It was the aim of this systematic review to assess the effects of oral administration of antimicrobials on the development of antimicrobial resistance (AMR) in Escherichia coli (E. coli) from chickens. Moreover, the effects of the administration of more than one antimicrobial and of different dosages were studied. Literature was searched in November 2012 from the electronic databases ISI Web of Science, PubMed, Scopus and a national literature database (DIMDI) as well as the database ProQuest LLC. The search was updated in March 2014. Original studies describing a treatment (A) and a control group of either non-treatment (C) or initial value (0) and determining AMR in E. coli at different sample points (SP) were included. The literature search resulted in 35 full text articles on the topic, seven (20%) of which contained sufficient information on the administered antimicrobial and the impact of treatment on AMR. Most papers described the use of more than one antimicrobial, several dosages, controls (non-treatment or pre-treatment) and measured AMR at different SPs leading to a total of 227 SPs on the impact of the use of antimicrobials on AMR in chickens. 74% of the SPs (168/227) described a higher AMR-rate in E. coli from treated animals than from controls. After the administration of a single antimicrobial, AMR increased at 72% of the SPs. Administration of more than one antimicrobial increased AMR at 82% of the SPs. Higher dosages were associated with similar or higher AMR rates. The limited number of studies for each antimicrobial agent and the high variability in the resistance effect call for more well designed studies on the impact of oral administration on AMR development and spread. Copyright © 2014 Elsevier B.V. All rights reserved.

Antimicrobial use and antimicrobial susceptibility in Escherichia coli on small- and medium-scale pig farms in north-eastern Thailand

Directory of Open Access Journals (Sweden)

G. Ström

2017-07-01

Full Text Available Abstract Background Intensification of livestock production seen in many low- and middle-income countries is often believed to be associated with increased use of antimicrobials, and may hence contribute to the emergence of antimicrobial resistance. The aim of this study was to map antimicrobial use on small- (n = 25 and medium-scale (n = 27 pig farms in north-eastern Thailand, and to compare antimicrobial susceptibility of commensal Escherichia coli isolated from sows on these farms. Methods Information regarding pig husbandry and antimicrobial treatment regimens was obtained by the use of semi-structured questionnaires. Faecal samples were collected from three healthy sows at each farm, and Escherichia coli was cultured and analysed for antimicrobial susceptibility using the broth microdilution method. Multilevel regression models were used to compare antimicrobial susceptibility between isolates from small- and medium-scale farms. Results All farms included in the study administered antimicrobials to their sows. Small-scale farmers most commonly (64% decided themselves when to give antimicrobials and the majority (60% bought the medicines at the local store or pharmacy, whereas farmers on medium-scale farms always discussed antimicrobial treatment with a veterinarian. Medium-scale farms used a greater diversity of antimicrobials than small-scale farms and did also administer antimicrobials in feed to a higher extent. High levels of antimicrobial resistance to several critically important antimicrobials for human medicine (including ciprofloxacin, streptomycin and ampicillin were found in isolates from both small- and medium-scale farms. Resistance levels were significantly (P < 0.05 higher in isolates from medium-scale farms for several of the antimicrobials tested, as well as the level of multidrug-resistance (P = 0.026. Conclusion The routines regarding access and administration of antimicrobials differed between the small- and

Animation of Antimicrobial Resistance

Medline Plus

Full Text Available ... search Popular ... produced a nine-minute animation explaining how antimicrobial resistance both emerges and proliferates among bacteria. Over time, the use of antimicrobial drugs will ...

A European study on the relationship between antimicrobial use and antimicrobial resistance

NARCIS (Netherlands)

Bronzwaer, SLAM; Cars, O; Buchholz, U; Molstad, S; Goettsch, W; Veldhuijzen, IK; Kool, JL; Sprenger, MJW; Degener, JE

In Europe, antimicrobial resistance has been monitored since 1998 by the European Antimicrobial Resistance Surveillance System (EARSS). We examined the relationship between penicillin nonsusceptibility of invasive isolates of Streptococcus pneumoniae and antibiotic sales. Information was collected

Lessons learned from new construction utility demand side management programs and their implications for implementing building energy codes

Energy Technology Data Exchange (ETDEWEB)

Wise, B.K.; Hughes, K.R.; Danko, S.L.; Gilbride, T.L.

1994-07-01

This report was prepared for the US Department of Energy (DOE) Office of Codes and Standards by the Pacific Northwest Laboratory (PNL) through its Building Energy Standards Program (BESP). The purpose of this task was to identify demand-side management (DSM) strategies for new construction that utilities have adopted or developed to promote energy-efficient design and construction. PNL conducted a survey of utilities and used the information gathered to extrapolate lessons learned and to identify evolving trends in utility new-construction DSM programs. The ultimate goal of the task is to identify opportunities where states might work collaboratively with utilities to promote the adoption, implementation, and enforcement of energy-efficient building energy codes.

Influence of Food Characteristics and Food Additives on the Antimicrobial Effect of Garlic and Oregano Essential Oils.

Science.gov (United States)

García-Díez, Juan; Alheiro, Joana; Pinto, Ana Luisa; Soares, Luciana; Falco, Virgilio; Fraqueza, Maria João; Patarata, Luis

2017-06-10

Utilization of essential oils (EOs) as antimicrobial agents against foodborne disease has gained importance, for their use as natural preservatives. Since potential interactions between EOs and food characteristics may affect their antimicrobial properties, the present work studies the influence of fat, protein, pH, a w and food additives on the antimicrobial effect of oregano and garlic EOs against Salmonella spp. and Listeria monocytogenes. Results showed that protein, pH, a w , presence of beef extract, sodium lactate and nitrates did not influence their antimicrobial effect. In contrast, the presence of pork fat had a negative effect against both EOs associated with their dilution of the lipid content. The addition of food phosphates also exerts a negative effect against EOs probably associated with their emulsification properties as observed with the addition of fat. The results may help the food industry to select more appropriate challenges to guarantee the food safety of foodstuffs.

Antimicrobial Resistance of Faecal Escherichia coli Isolates from Pig Farms with Different Durations of In-feed Antimicrobial Use.

Science.gov (United States)

Gibbons, J F; Boland, F; Egan, J; Fanning, S; Markey, B K; Leonard, F C

2016-05-01

Antimicrobial use and resistance in animal and food production are of concern to public health. The primary aims of this study were to determine the frequency of resistance to 12 antimicrobials in Escherichia coli isolates from 39 pig farms and to identify patterns of antimicrobial use on these farms. Further aims were to determine whether a categorization of farms based on the duration of in-feed antimicrobial use (long-term versus short-term) could predict the occurrence of resistance on these farms and to identify the usage of specific antimicrobial drugs associated with the occurrence of resistance. Escherichia coli were isolated from all production stages on these farms; susceptibility testing was carried out against a panel of antimicrobials. Antimicrobial prescribing data were collected, and farms were categorized as long term or short term based on these. Resistance frequencies and antimicrobial use were tabulated. Logistic regression models of resistance to each antimicrobial were constructed with stage of production, duration of antimicrobial use and the use of 5 antimicrobial classes included as explanatory variables in each model. The greatest frequencies of resistance were observed to tetracycline, trimethoprim/sulphamethoxazole and streptomycin with the highest levels of resistance observed in isolates from first-stage weaned pigs. Differences in the types of antimicrobial drugs used were noted between long-term and short-term use farms. Categorization of farms as long- or short-term use was sufficient to predict the likely occurrence of resistance to 3 antimicrobial classes and could provide an aid in the control of resistance in the food chain. Stage of production was a significant predictor variable in all models of resistance constructed and did not solely reflect antimicrobial use at each stage. Cross-selection and co-selection for resistance was evident in the models constructed, and the use of trimethoprim/sulphonamide drugs in particular was

Patron perception and utilization of an embedded librarian program

Directory of Open Access Journals (Sweden)

Lindsay Blake, MLIS, AHIP

2016-09-01

Full Text Available Objective: The study measured the perceived value of an academic library’s embedded librarian service model. Setting: The study took place at the health sciences campuses of a research institution. Methods: A web-based survey was distributed that asked respondents a series of questions about their utilization of and satisfaction with embedded librarians and services. Results: Over 58% of respondents reported being aware of their embedded librarians, and 95% of these were satisfied with provided services. Conclusions: The overall satisfaction with services was encouraging, but awareness of the embedded program was low, suggesting an overall need for marketing of services.

Antimicrobial effect of Satureja bachtiarica extracts aqueous, ethanol, methanol and glycerin on streptococcus pyogenes, pseudomonas aeruginosa and staphylococcus epidermidis

OpenAIRE

Maryam Heidari Sureshjani; Farideh Tabatabaei Yazdi; Ali Mortazavi; Fakhri Shahidi; Behrooz Alizadeh Behbahani

2013-01-01

The Iranian medicinal plants, such as Satureja bachtiarica have been utilized as traditional medicines by the indigenous people of Chaharmahal va Bakhtiari in Iran. In this study, Satureja bachtiarica were dried in suitable condition (in shadow) after extraction with watery, ethanol 96 %, methanol 96% and 20% glycerin antimicrobial effect of extract were determined by “screening antimicrobial activity” and “disk agar diffusion test” in 10, 20, 30 and 40 mg/ml concentration of the extract agai...

Application of WHONET in the Antimicrobial Resistance Surveillance of Uropathogens: A First User Experience from Nepal.

Science.gov (United States)

Ghosh, A N; Bhatta, D R; Ansari, M T; Tiwari, H K; Mathuria, J P; Gaur, A; Supram, H S; Gokhale, S

2013-05-01

WHONET is a freely downloadable, Windows-based database software which is used for the management and analysis of microbiology data, with a special focus on the analysis of antimicrobial susceptibility test results. Urinary Tract Infections (UTI) are a common medical problem and they are responsible for notable morbidity among young and sexually active women. The major objective of this study was the utilization and application of the WHONET program for the Antimicrobial Resistance (AMR) surveillance of uropathogens. A total of 3209 urine samples were collected from patients who visited Manipal Teaching Hospital with a clinical suspicion of UTI, during December 2010 to July 2011. The isolation and characterization of the isolates were done by conventional methods. Antimicrobial Susceptibility Testing (AST) was performed by Kirby Bauer's disc diffusion method. The data entry and analysis were done by using the WHONET 5.6 software. Out of the 3209 specimens, 497 bacterial isolates were obtained and they were subjected to AST. Escherichia coli (66.2%) was the commonest bacterial isolate, followed by Enterococcus species (9.3%), Staphylococcus aureus (5.0%), and Klebsiella pneumoniae (4.2%). Among the gram-negative enteric bacilli, a high prevalence of resistance was observed against ampicillin and ciprofloxacin. The gram negative nonfermenters exhibited a high degree of resistance to ceftazidime. Staphylococcus species. showed a moderately high resistance to co-trimoxazole. One isolate was Vancomycin Resistant Enterococci (VRE). This study, a first of its kind which was done in Nepal, was carried out by using the WHONET software to monitor, analyze and share the antimicrobial susceptibility data at various levels. This study was also aimed at building a surveillance network in Nepal, with the National Public Health Laboratory, Nepal, acting as a nodal centre. This would help in the formulation of antibiotic policies and in identifying hospital and community outbreaks

Suggested guidelines for using systemic antimicrobials in bacterial skin infections: part?2? antimicrobial choice, treatment regimens and compliance

OpenAIRE

Beco, L.; Guagu?re, E.; M?ndez, C. Lorente; Noli, C.; Nuttall, T.; Vroom, M.

2013-01-01

Systemic antimicrobials are critically important in veterinary healthcare, and resistance is a major concern. Antimicrobial stewardship will be important in maintaining clinical efficacy by reducing the development and spread of antimicrobial resistance. Bacterial skin infections are one of the most common reasons for using systemic antimicrobials in dogs and cats. Appropriate management of these infections is, therefore, crucial in any policy for responsible antimicrobial use. The goals of t...

National disparities in the relationship between antimicrobial resistance and antimicrobial consumption in Europe: an observational study in 29 countries.

Science.gov (United States)

McDonnell, Lucy; Armstrong, David; Ashworth, Mark; Dregan, Alexandru; Malik, Umer; White, Patrick

2017-11-01

Antimicrobial resistance in invasive infections is driven mainly by human antimicrobial consumption. Limited cross-national comparative evidence exists about variation in antimicrobial consumption and effect on resistance. We examined the relationship between national community antimicrobial consumption rates (2013) and national hospital antimicrobial resistance rates (2014) across 29 countries in the European Economic Area (EEA). Consumption rates were obtained from the European Surveillance of Antimicrobial Consumption Network (ESAC-Net). Resistance data were obtained from the European Antimicrobial Resistance Surveillance Network (EARS-Net), based on 196480 invasive isolates in 2014. Data availability and consistency were good. Some countries did not report figures for each strain of resistant bacteria. National antimicrobial consumption rates (2013) varied from ≤ 13 DDD (Estonia, the Netherlands and Sweden) to ≥ 30 DDD (France, Greece and Romania) per 1000 inhabitants per day. National antimicrobial resistance rates (hospital isolates, 15 species) also varied from  37.2% (Bulgaria, Greece, Romania and Slovakia). National antimicrobial consumption rates (2013) showed strong to moderate correlation with national hospital antimicrobial resistance rates (2014) in 19 strains of bacteria (r = 0.84 to r = 0.39). Some countries defied the trend with high consumption and low resistance (France, Belgium and Luxembourg) or low consumption and high resistance (Bulgaria, Hungary and Latvia). We found associations between national community antimicrobial consumption and national hospital antimicrobial resistance across a wide range of bacteria. These associations were not uniform. Different mechanisms may drive resistance in hospital-based invasive infections. Future research on international variations in antimicrobial resistance should consider environmental factors, agricultural use, vaccination policies and prescribing quality. © The Author 2017

Site study plan for utilities and solid waste, Deaf Smith County Site, Texas: Environmental Field Program: Preliminary draft

International Nuclear Information System (INIS)

1987-06-01

This site plan describes utilities and solid waste studies to be conducted during the characterization of the Deaf Smith County, Texas, site for the US Department of Energy's Salt Repository Project. After utilities and solid waste information needs derived from Federal, State, and local statutes and regulations and the project specifications are briefly described, the site study plan describes the study design and rationale, the field data collection procedures and equipment, and data analysis methods and application of results, the data management strategy, the schedule of field activities, the management of the study, and the study's quality assurance program. The field data collection activities are organized into programs to characterize electrical power, natural gas, communication, water, wastewater sludge, nonradiological solid waste, nonradiological hazardous waste, and low-level radiological waste. These programs include details for the collection of project needs, identification of utilities and solid waste disposal contractor capabilities, and verification of the obtained data. Utilities and solid waste field activities will begin approximately at the time of site access. Utilities and solid waste characterization will be completed within the first year of activity. 29 refs., 6 figs., 2 tabs

Usage of antimicrobials and occurrence of antimicrobial resistance among bacteria from mink

DEFF Research Database (Denmark)

Pedersen, Karl; Hammer, Anne Sofie; Sørensen, Charlotte Mark

2009-01-01

, whereas resistance to other antimicrobials was rare. All P aeruginosa were sensitive to gentamicin and colistin and sensitive or intermediate to enrofloxacin. whereas most isolates were resistant to all other antimicrobials. All P. multocida and haemolytic streptococci were sensitive to penicillin...

Isolation and Identification of Phyllospheric Bacteria Possessing Antimicrobial Activity from Astragalus obtusifolius, Prosopis juliflora, Xanthium strumarium and Hippocrepis unisiliqousa.

Science.gov (United States)

Mazinani, Zohreh; Zamani, Marzieh; Sardari, Soroush

2017-01-01

The widespread utilization of antimicrobial compounds has caused emergence of resistant microorganisms in the world. Hence, the research to probe the products with antimicrobial features has led to finding natural habitats and discovering new pharmaceutical products. In this study, an attempt was made to explore the niche of novel habitat to isolate pyllospheric bacteria from the above ground parts (stems and leaves) of Astragalus obtusifolius , Prosopis juliflora , Xanthium strumarium , and Hippocrepis unisiliqousa to evaluate their antimicrobial features. The inhibitory effects of these strains on the growth of two fungi ( Aspergillus niger , Aspergillus fumigatus ), two yeasts ( Saccharomyces cerevisiae , Candida albicans ) and six bacteria ( Escherichia coli , Staphylococcus aureus , Pseudomonas aeruginosa , Bacillus subtilis , Salmonella typhi , Streptococcus pyogenes ) were tested. In total, 113 bacterial strains were isolated. Twenty five bacterial strains (B-1 to B-25) indicated promising antimicrobial (antibacterial and antifungal) activities against aforementioned pathogens. The identification of the bacterial strains was ascertained by morphological, physiological, biochemical tests and two strains with the strongest antimicrobial activities were further characterized based on 16s rRNA sequencing. These two strains were identified as Bacillus amyloliquefaciens . Our results provide evidence that phyllospheric microorganisms are capable of producing some compounds with antimicrobial properties.

Effects of Reducing Antimicrobial Use and Applying a Cleaning and Disinfection Program in Veal Calf Farming: Experiences from an Intervention Study to Control Livestock-Associated MRSA.

Science.gov (United States)

Dorado-García, Alejandro; Graveland, Haitske; Bos, Marian E H; Verstappen, Koen M; Van Cleef, Brigitte A G L; Kluytmans, Jan A J W; Wagenaar, Jaap A; Heederik, Dick J J

2015-01-01

With the ultimate aim of containing the emergence of resistant bacteria, a Dutch policy was set in place in 2010 promoting a reduction of antimicrobial use (AMU) in food-producing animals. In this context, a study evaluated strategies to curb livestock-associated methicillin resistant Staphylococcus aureus (LA-MRSA). Fifty-one veal calf farms were assigned to one of 3 study arms: RAB farms reducing antimicrobials by protocol; RAB-CD farms reducing antimicrobials by protocol and applying a cleaning and disinfection program; and Control farms without interventions. MRSA carriage was tested in week 0 and week 12 of 2 consecutive production cycles in farmers, family members and veal calves. Interventions were validated and a cyclic rise in MRSA-prevalence in animals was shown with a more moderate increase in RAB farms. Prevalence in humans declined parallel over time in the study arms but RAB farms were at the lowest MRSA levels from the beginning of the study. In RAB-CD farms, human and animal prevalence did not differ from Control farms and MRSA air loads were significantly higher than in the other study arms. Mimicking the national trend, an overall AMU decrease (daily dosages per animal per cycle (DDDA/C)) was observed over 4 pre-study and the 2 study cycles; this trend did not have a significant effect on a set of evaluated farm technical parameters. AMU was positively associated with MRSA across study arms (ORs per 10 DDDA/C increase = 1.26 for both humans (p = 0.07) and animals (p = 0.12 in first cycle)). These results suggest that AMU reduction might be a good strategy for curbing MRSA in veal calf farming, however the specific cleaning and disinfecting program in RAB-CD farms was not effective. The drop in MRSA prevalence in people during the study could be attributed to the observed long-term AMU decreasing trend.

Cationic Antimicrobial Polymers and Their Assemblies

Science.gov (United States)

Carmona-Ribeiro, Ana Maria; de Melo Carrasco, Letícia Dias

2013-01-01

Cationic compounds are promising candidates for development of antimicrobial agents. Positive charges attached to surfaces, particles, polymers, peptides or bilayers have been used as antimicrobial agents by themselves or in sophisticated formulations. The main positively charged moieties in these natural or synthetic structures are quaternary ammonium groups, resulting in quaternary ammonium compounds (QACs). The advantage of amphiphilic cationic polymers when compared to small amphiphilic molecules is their enhanced microbicidal activity. Besides, many of these polymeric structures also show low toxicity to human cells; a major requirement for biomedical applications. Determination of the specific elements in polymers, which affect their antimicrobial activity, has been previously difficult due to broad molecular weight distributions and random sequences characteristic of radical polymerization. With the advances in polymerization control, selection of well defined polymers and structures are allowing greater insight into their structure-antimicrobial activity relationship. On the other hand, antimicrobial polymers grafted or self-assembled to inert or non inert vehicles can yield hybrid antimicrobial nanostructures or films, which can act as antimicrobials by themselves or deliver bioactive molecules for a variety of applications, such as wound dressing, photodynamic antimicrobial therapy, food packing and preservation and antifouling applications. PMID:23665898

Cationic Antimicrobial Polymers and Their Assemblies

Directory of Open Access Journals (Sweden)

Ana Maria Carmona-Ribeiro

2013-05-01

Full Text Available Cationic compounds are promising candidates for development of antimicrobial agents. Positive charges attached to surfaces, particles, polymers, peptides or bilayers have been used as antimicrobial agents by themselves or in sophisticated formulations. The main positively charged moieties in these natural or synthetic structures are quaternary ammonium groups, resulting in quaternary ammonium compounds (QACs. The advantage of amphiphilic cationic polymers when compared to small amphiphilic molecules is their enhanced microbicidal activity. Besides, many of these polymeric structures also show low toxicity to human cells; a major requirement for biomedical applications. Determination of the specific elements in polymers, which affect their antimicrobial activity, has been previously difficult due to broad molecular weight distributions and random sequences characteristic of radical polymerization. With the advances in polymerization control, selection of well defined polymers and structures are allowing greater insight into their structure-antimicrobial activity relationship. On the other hand, antimicrobial polymers grafted or self-assembled to inert or non inert vehicles can yield hybrid antimicrobial nanostructures or films, which can act as antimicrobials by themselves or deliver bioactive molecules for a variety of applications, such as wound dressing, photodynamic antimicrobial therapy, food packing and preservation and antifouling applications.

The risk of some veterinary antimicrobial agents on public health associated with antimicrobial resistance and their molecular basis

OpenAIRE

Haihong Hao; Zahid Iqbal; Yulian Wang; Guyue Cheng; Zong-Hui Yuan

2016-01-01

The risk of antimicrobial agents used in food-producing animals on public health associated with antimicrobial resistance continues to be a current topic of discussion as related to animal and human public health. In the present review, resistance monitoring data and risk assessment result of some important antimicrobial agents were cited to elucidate the possible association of antimicrobial use in food animals and antimicrobial resistance in human. From the selected examples, it was obvious...

The use of antimicrobial drugs in agriculture.

Science.gov (United States)

Black, W D

1984-08-01

Antibacterial drugs have been used widely in animal production for treatment and prevention of disease and for growth promotion. Concern has been expressed about possible harm to humans, through the use of drugs, in the following ways: increased microbial drug resistance; drug residues in food; allergic reactions and sensitization to antimicrobials; and drug toxicity. Research has shown that microbial resistance in people can develop from drugs used in animals. Farmers, butchers, etc., have been shown to have an increased incidence of drug-resistant organisms. Resistance to antibiotics can develop in two ways; genetic mutation and natural selection, and through R-factor plasmid transfer. Allergic reactions have been reported following the ingestion of penicillin-containing milk; however, residues in other foods have not caused allergic reactions. Sensitization of humans to antimicrobials through the consumption of drug residues in foods has never been documented. Evidence suggests that the residue levels in food are too low to cause sensitization. Drug toxicity, other than allergic reactions, appears not to result from residues of antimicrobial drugs in food. While it has been studied many times, monitoring programs have failed to find any evidence of a problem. This appears to reflect the low toxicity of these agents and the small amounts obtained in the food, however, it could also reflect failure of the monitoring systems.

Utilization of logistic computer programs in the power plant piping industry

International Nuclear Information System (INIS)

Motzel, E.

1982-01-01

Starting from the general situation of the power plant piping industry, the utilization of computer programs as well as the specific magnitude of complexity connected with the project realisation, the necessity for using logistic computer programs especially in case of nuclear power plants is explained. The logistic term as well as the logistic data are described. At the example of the nuclear power plant KRB II, Gundremmingen, Block B/C the practical use of such programs is shown. The planning, scheduling and supervision is carried out computer-aided by means of network-technique. The material management, prefabrication, installation including management of certificates for welding and testing activities is planned and controlled by computer programs as well. With the piping systems installed a complete erection work documentation is available which also serves as base for the billing versus the client. The budgeted costs are continuously controlled by means of a cost control program. Summing-up the further development in controlling piping contracts computer-supported is described with regard to software, hardware and the organisation structure. Furthermore the concept of a self-supporting field computer is introduced for the first time. (orig.) [de

Genomic and functional techniques to mine the microbiome for novel antimicrobials and antimicrobial resistance genes.

Science.gov (United States)

Adu-Oppong, Boahemaa; Gasparrini, Andrew J; Dantas, Gautam

2017-01-01

Microbial communities contain diverse bacteria that play important roles in every environment. Advances in sequencing and computational methodologies over the past decades have illuminated the phylogenetic and functional diversity of microbial communities from diverse habitats. Among the activities encoded in microbiomes are the abilities to synthesize and resist small molecules, yielding antimicrobial activity. These functions are of particular interest when viewed in light of the public health emergency posed by the increase in clinical antimicrobial resistance and the dwindling antimicrobial discovery and approval pipeline, and given the intimate ecological and evolutionary relationship between antimicrobial biosynthesis and resistance. Here, we review genomic and functional methods that have been developed for accessing the antimicrobial biosynthesis and resistance capacity of microbiomes and highlight outstanding examples of their applications. © 2016 New York Academy of Sciences.

Particulate Respirators Functionalized with Silver Nanoparticles Showed Excellent Real-Time Antimicrobial Effects against Pathogens.

Science.gov (United States)

Zheng, Clark Renjun; Li, Shuai; Ye, Chengsong; Li, Xinyang; Zhang, Chiqian; Yu, Xin

2016-07-05

Particulate respirators designed to filtrate fine particulate matters usually do not possess antimicrobial functions. The current study aimed to functionalize particulate respirators with silver nanoparticles (nanosilver or AgNPs), which have excellent antimicrobial activities, utilizing a straightforward and effective method. We first enhanced the nanosilver-coating ability of nonwoven fabrics from a particulate respirator through surface modification by sodium oleate. The surfactant treatment significantly improved the fabrics' water wet preference where the static water contact angles reduced from 122° to 56°. Both macroscopic agar-plate tests and microscopic scanning electron microscope (SEM) characterization revealed that nanosilver functionalized fabrics could effectively inhibit the growth of two model bacterial strains (i.e., Staphylococcus aureus and Pseudomonas aeruginosa). The coating of silver nanoparticles would not affect the main function of particulate respirators (i.e., filtration of fine air-borne particles). Nanosilver coated particulate respirators with excellent antimicrobial activities can provide real-time protection to people in regions with severe air pollution against air-borne pathogens.

Antimicrobial Treatments and Efficacy

Science.gov (United States)

To limit exposure to indoor biological contamination a risk-management approach which employs various antimicrobial treatments can effectively control contaminants and reduce exposure. Antimicrobial treatment of biological contaminants, especially mold in buildings, it is often n...

Occurrence of antimicrobials and antimicrobial resistance genes in beef cattle storage ponds and swine treatment lagoons

International Nuclear Information System (INIS)

Zhang, Yuping; Zhang, Chiqian; Parker, David B.; Snow, Daniel D.; Zhou, Zhi; Li, Xu

2013-01-01

Livestock manure treatment and storage structures are potential environmental sources of antimicrobials and antimicrobial resistance genes (ARGs). In this study, the occurrence of antimicrobials and ARGs was investigated in the water and the sludge compartments of beef cattle storage ponds and swine lagoons. Analysis was focused on two families of antimicrobials (sulfonamide and tetracycline) and the corresponding ARGs (sul1, sul2, tetO, tetQ and tetX). Results showed that the pseudo-partitioning coefficients of tetracyclines were higher than those of sulfonamides, suggesting different distributions of these two classes of antimicrobials between water and sludge. The ARGs tested were detected in nearly all ponds and lagoons, with the highest relative abundance in sul2 at 6.3 × 10 −1 copies per 16S rRNA gene. A positive correlation was observed between total sul genes and total sulfonamides in water while the correlation was negative in sludge. No significant correlation was found between total tet genes and total tetracyclines in either water or sludge, but significant correlations were observed for certain individual tet genes. Ammonia concentrations strongly correlated with all ARGs except tetX. This study provided quantitative information on the occurrence of antimicrobials and ARGs in the liquid and solid compartments of typical manure treatment and storage structures. - Highlights: • Partitioning of antimicrobials between water and sludge is compound specific. • Antimicrobial resistance genes occurred in both water and sludge. • The ARG abundance varied more substantially in swine lagoons than in cattle ponds. • Correlations between ARGs and antimicrobials are system dependent

Occurrence of antimicrobials and antimicrobial resistance genes in beef cattle storage ponds and swine treatment lagoons

Energy Technology Data Exchange (ETDEWEB)

Zhang, Yuping; Zhang, Chiqian [Department of Civil Engineering, University of Nebraska-Lincoln, Lincoln, NE (United States); Parker, David B. [USDA Meat Animal Research Center, Clay Center, NE (United States); Snow, Daniel D. [Water Sciences Laboratory, University of Nebraska-Lincoln, Lincoln, NE (United States); Zhou, Zhi [Department of Civil and Environmental Engineering, National University of Singapore (Singapore); Li, Xu, E-mail: xuli@unl.edu [Department of Civil Engineering, University of Nebraska-Lincoln, Lincoln, NE (United States)

2013-10-01

Livestock manure treatment and storage structures are potential environmental sources of antimicrobials and antimicrobial resistance genes (ARGs). In this study, the occurrence of antimicrobials and ARGs was investigated in the water and the sludge compartments of beef cattle storage ponds and swine lagoons. Analysis was focused on two families of antimicrobials (sulfonamide and tetracycline) and the corresponding ARGs (sul1, sul2, tetO, tetQ and tetX). Results showed that the pseudo-partitioning coefficients of tetracyclines were higher than those of sulfonamides, suggesting different distributions of these two classes of antimicrobials between water and sludge. The ARGs tested were detected in nearly all ponds and lagoons, with the highest relative abundance in sul2 at 6.3 × 10{sup −1} copies per 16S rRNA gene. A positive correlation was observed between total sul genes and total sulfonamides in water while the correlation was negative in sludge. No significant correlation was found between total tet genes and total tetracyclines in either water or sludge, but significant correlations were observed for certain individual tet genes. Ammonia concentrations strongly correlated with all ARGs except tetX. This study provided quantitative information on the occurrence of antimicrobials and ARGs in the liquid and solid compartments of typical manure treatment and storage structures. - Highlights: • Partitioning of antimicrobials between water and sludge is compound specific. • Antimicrobial resistance genes occurred in both water and sludge. • The ARG abundance varied more substantially in swine lagoons than in cattle ponds. • Correlations between ARGs and antimicrobials are system dependent.

Estimating the cost of saving electricity through U.S. utility customer-funded energy efficiency programs

International Nuclear Information System (INIS)

Hoffman, Ian M.; Goldman, Charles A.; Rybka, Gregory; Leventis, Greg; Schwartz, Lisa; Sanstad, Alan H.; Schiller, Steven

2017-01-01

The program administrator and total cost of saved energy allow comparison of the cost of efficiency across utilities, states, and program types, and can identify potential performance improvements. Comparing program administrator cost with the total cost of saved energy can indicate the degree to which programs leverage investment by participants. Based on reported total costs and savings information for U.S. utility efficiency programs from 2009 to 2013, we estimate the savings-weighted average total cost of saved electricity across 20 states at $0.046 per kilowatt-hour (kW h), comparing favorably with energy supply costs and retail rates. Programs targeted on the residential market averaged $0.030 per kW h compared to $0.053 per kW h for non-residential programs. Lighting programs, with an average total cost of $0.018 per kW h, drove lower savings costs in the residential market. We provide estimates for the most common program types and find that program administrators and participants on average are splitting the costs of efficiency in half. More consistent, standardized and complete reporting on efficiency programs is needed. Differing definitions and quantification of costs, savings and savings lifetimes pose challenges for comparing program results. Reducing these uncertainties could increase confidence in efficiency as a resource among planners and policymakers. - Highlights: • The cost of saved energy allows comparisons among energy resource investments. • Findings from the most expansive collection yet of total energy efficiency program costs. • The weighted average total cost of saved electricity was $0.046 for 20 states in 2009–2013. • Averages in the residential and non-residential sectors were $0.030 and $0.053 per kW h, respectively. • Results strongly indicate need for more consistent, reliable and complete reporting on efficiency programs.

Antimicrobial activities of pomelo (Citrus maxima) seed and pulp ethanolic extract

Science.gov (United States)

Sahlan, Muhamad; Damayanti, Vina; Tristantini, Dewi; Hermansyah, Heri; Wijanarko, Anondho; Olivia, Yuko

2018-02-01

Grapefruit (Citrus paradisi) seed extract is generally used as naturopathic medications, supplements, antiseptic and disinfecting agents and also as preservatives in food and cosmetics products. In vitro studies have demonstrated that grapefruit seed extract has anti bacterial properties against a range of gram-positive and gram-negative organisms. Indonesian grapefruit, known as pomelo (C. maxima), has similar characteristics, contents and is under the same genus (Citrus) as grapefruit; however it has not been completely utilized as a preservative. In this work we analyze the antimicrobial activities of ethanolic extract of Indonesian pomelo (C. maxima) seeds and pulp compared to the grapefruit (C. paradisi) seeds and pulp ethanolic extract. Ethanolic extracts of pomelo and grapefruit seeds and pulp are investigated for activities against Bacillus subtilis, Staphylococcus aureus, Escherichia coli and Candida albicans. The level of antimicrobial effects is established using agar diffusion method. Both of the ethanolic do not show any antimicrobial activities against C. albicans. The ethanolic extract of pomelo seeds and pulp used in this research give positive results with growth inhibition effect on B. subtilis, S. aureus and E. coli. The zones of inhibition ranges from 22 - 30 mm in diameter, which is higher to grapefruit seeds and pulp ethanolic extract (17 - 25 mm). Ethanolic extract of pomelo seeds and pulp has an antimicrobial effect, which makes it a natural preparation for use as an alternative preservative for food and cosmetic.

Change in antimicrobial susceptibility of Mycoplasma gallisepticum field isolates.

Science.gov (United States)

Gharaibeh, Saad; Al-Rashdan, Mohammad

2011-06-02

This study compares the antimicrobial susceptibility over time between two groups of Mycoplasma gallisepticum (MG) isolates from the same geographical area. Minimum inhibitory concentration of 13 antimicrobials was determined against two groups of MG isolates from chickens. Group 1 strains (n=22) were isolated in 2004-2005 while group 2 strains (n=7) were isolated in 2007-2008. Minimum inhibitory concentration 50 for group 1 versus group 2 was 4/4, 0.5/0.5, ≤ 0.031/≥ 64, ≤ 0.031/2, ≤ 0.031/0.125, 1/0.5, 1/1, ≤ 0.031/≤ 0.031, ≤ 0.031/2, ≤ 0.031/2, 1/4, ≤ 0.031/0.062, and 0.062/2 μg/ml against gentamicin, spectinomycin, erythromycin, tilmicosin, tylosin, florfenicol, thiamphenicol, tiamulin, ciprofloxacin, enrofloxacin, chlortetracycline, doxycycline, and oxytetracycline, respectively. There was a statistically significant increase in resistance of group 2 to erythromycin, tilmicosin, tylosin, ciprofloxacin, enrofloxacin, chlortetracycline, doxycycline, and oxytetracycline. This dramatic increase in resistance against 8 antimicrobials belonging to three different families of antimicrobials in a relatively short period of time appears to be rare and of concern. The cause of this increased resistance observed in group 2 of MG isolates was not determined and should be further investigated. Monitoring of MG field strain susceptibility is highly recommended to implement successful treatment and prophylaxis programs in endemic areas. Copyright © 2011 Elsevier B.V. All rights reserved.

Antimicrobial use in long-term-care facilities

NARCIS (Netherlands)

Nicolle, LE; Bentley, DW; Garibaldi, R; Neuhaus, EG; Smith, PW

There is intense antimicrobial use in long-term-care facilities (LTCFs), and studies repeatedly document that much of this use is inappropriate. The current crisis in antimicrobial resistance, which encompasses the LTCF, heightens concerns of antimicrobial use. Attempts to improve antimicrobial use

PHARMACOEPIDEMIOLOGY OF ANTIMICROBIAL AGENTS IN NEONATOLOGY: RESULTS OF THE RETROSPECTIVE CROSS-SECTIONAL STUDY

Directory of Open Access Journals (Sweden)

Alexey S. Kolbin

2016-01-01

Full Text Available Background. Infectious diseases remain the leading causes of morbidity and mortality worldwide. Against the background of ever-increasing resistance of bacteria, it is necessary to develop effective measures aimed at the structure optimization of consumption of antimicrobial agents. Therefore, the pharmacoepidemiological data describing either the consumption of antimicrobial agents or the resistance level to them is required. Objective: Our aim was to assess the antimicrobial load in term and preterm newborns during their stay in the maternity wards and/or in the intensive care units (ICU. Methods. A retrospective cross-sectional study has been carried out. The analysis included data of 419 newborns from 5 medical centers. The study has been carried out as part of a multi-purpose program on antibiotic resistance containment being held in St. Petersburg from 2014. Results. The antimicrobial load on the child's body expressed in days of the antimicrobial therapy was 1,838 per 1,000 patient-days in children staying in the ICU for not more than 16 days, and 1,434 per 1,000 patient-days when staying in the ICU for more than 16 days. The average duration of the antimicrobial therapy is 28 days in the ICU and 5 days out the ICU (department for newborns, physiological departments. The most commonly, the children were treated with ampicillin — 384 (92%, gentamicin — 254 (61%, and fluconazole — 150 (36%. The prevalence of off-label prescriptions was 41% (of 1,557 analyzed prescriptions, unlicensed prescriptions — 10%. Congenital infections were the main reasons for prescription of antimicrobial drugs — 225 (62%. Conclusion. The high anti-bacterial load in newborns has been established. The indicator 'days of antimicrobial therapy' in the ICU is 4 times higher than that in the United States. The prevalence of off-label and unlicensed prescriptions is comparable with foreign data.

Antimicrobial Drugs in the Home

Centers for Disease Control (CDC) Podcasts

2006-10-19

Survey participants in the United Kingdom admitted keeping leftover antimicrobial drugs for future use and taking them without medical advice. Dr. J. Todd Weber, director of CDC's Office of Antimicrobial Resistance, advises against the practice, which can be dangerous and can promote antimicrobial drug resistance.  Created: 10/19/2006 by Emerging Infectious Diseases.   Date Released: 10/26/2006.

Self-stratifying antimicrobial coatings

NARCIS (Netherlands)

Yagci, M.B.

2012-01-01

Today, antimicrobial polymers/coatings are widely used in various areas, such as biomedical devices, pharmaceuticals, hospital buildings, textiles, food processing, and contact lenses, where sanitation is needed. Such wide application facilities have made antimicrobial materials very attractive for

Recent updates of marine antimicrobial peptides.

Science.gov (United States)

Semreen, Mohammad H; El-Gamal, Mohammed I; Abdin, Shifaa; Alkhazraji, Hajar; Kamal, Leena; Hammad, Saba; El-Awady, Faten; Waleed, Dima; Kourbaj, Layal

2018-03-01

Antimicrobial peptides are group of proteins showing broad-spectrum antimicrobial activity that have been known to be powerful agents against a variety of pathogens. This class of compounds contributed to solving the microbial resistance dilemma that limited the use of many potent antimicrobial agents. The marine environment is known to be one of the richest sources for antimicrobial peptides, yet this environment is not fully explored. Hence, the scientific research attention should be directed toward the marine ecosystem as enormous amount of useful discoveries could be brought to the forefront. In the current article, the marine antimicrobial peptides reported from mid 2012 to 2017 have been reviewed.

Recent updates of marine antimicrobial peptides

Directory of Open Access Journals (Sweden)

Mohammad H. Semreen

2018-03-01

Full Text Available Antimicrobial peptides are group of proteins showing broad-spectrum antimicrobial activity that have been known to be powerful agents against a variety of pathogens. This class of compounds contributed to solving the microbial resistance dilemma that limited the use of many potent antimicrobial agents. The marine environment is known to be one of the richest sources for antimicrobial peptides, yet this environment is not fully explored. Hence, the scientific research attention should be directed toward the marine ecosystem as enormous amount of useful discoveries could be brought to the forefront. In the current article, the marine antimicrobial peptides reported from mid 2012 to 2017 have been reviewed.

Animation of Antimicrobial Resistance

Medline Plus

Full Text Available ... Skip to common links HHS U.S. Department of Health and Human Services U.S. Food and Drug Administration ... Tobacco Products Animal & Veterinary Home Animal & Veterinary Safety & Health Antimicrobial Resistance Animation of Antimicrobial Resistance Share Tweet ...

Technical procedures for utilities and solid waste: Environmental Field Program, Deaf Smith County site, Texas: Final draft

International Nuclear Information System (INIS)

1987-08-01

The evaluation of environmental issues and concerns and the addressing of statutory requirements are fundamental parts in the characterization of the site in Deaf Smith County, Texas for the US Department of Energy's Salt Repository Project (SRP). To ensure that the environmental field program comprehensively addresses the issues and requirements of the project, a site study plan (SSP) has been prepared for Utilities and Solid Waste considerations. This technical procedure (TP) has been developed to implement the field program described in the Utilities and Solid Waste Site Study Plan. The purpose and scope of the Utilities and Solid Waste Technical Procedure is to develop and implement a data collection procedure to fulfill the data base needs of the Utilities and Solid Waste SSP. The procedure describes a method of obtaining, assessing and verifying the capabilities of the regional service utilities and disposal contractors. This data base can be used to identify a preferred service source for the engineering contractor. The technical procedure was produced under the guidelines established in Technical Administrative Procedure No. 1.0, Preparation, Review and Approval of Technical Procedures

Antimicrobial Peptides in Biomedical Device Manufacturing

Science.gov (United States)

Riool, Martijn; de Breij, Anna; Drijfhout, Jan W.; Nibbering, Peter H.; Zaat, Sebastian A. J.

2017-08-01

Over the past decades the use of medical devices, such as catheters, artificial heart valves, prosthetic joints and other implants, has grown significantly. Despite continuous improvements in device design, surgical procedures and wound care, biomaterial-associated infections (BAI) are still a major problem in modern medicine. Conventional antibiotic treatment often fails due to the low levels of antibiotic at the site of infection. The presence of biofilms on the biomaterial and/or the multidrug-resistant phenotype of the bacteria further impair the efficacy of antibiotic treatment. Removal of the biomaterial is then the last option to control the infection. Clearly, there is a pressing need for alternative strategies to prevent and treat BAI. Synthetic antimicrobial peptides (AMPs) are considered promising candidates as they are active against a broad spectrum of (antibiotic-resistant) planktonic bacteria and biofilms. Moreover, bacteria are less likely to develop resistance to these rapidly-acting peptides. In this review we highlight the four main strategies, three of which applying AMPs, in biomedical device manufacturing to prevent BAI. The first involves modification of the physicochemical characteristics of the surface of implants. Immobilization of AMPs on surfaces of medical devices with a variety of chemical techniques is essential in the second strategy. The main disadvantage of these two strategies relates to the limited antibacterial effect in the tissue surrounding the implant. This limitation is addressed by the third strategy that releases AMPs from a coating in a controlled fashion. Lastly, AMPs can be integrated in the design and manufacturing of additively manufactured / 3D-printed implants, owing to the physicochemical characteristics of the implant material and the versatile manufacturing technologies compatible with antimicrobials incorporation. These novel technologies utilizing AMPs will contribute to development of novel and safe

Antimicrobial Peptides in Biomedical Device Manufacturing

Directory of Open Access Journals (Sweden)

Martijn Riool

2017-08-01

Full Text Available Over the past decades the use of medical devices, such as catheters, artificial heart valves, prosthetic joints, and other implants, has grown significantly. Despite continuous improvements in device design, surgical procedures, and wound care, biomaterial-associated infections (BAI are still a major problem in modern medicine. Conventional antibiotic treatment often fails due to the low levels of antibiotic at the site of infection. The presence of biofilms on the biomaterial and/or the multidrug-resistant phenotype of the bacteria further impair the efficacy of antibiotic treatment. Removal of the biomaterial is then the last option to control the infection. Clearly, there is a pressing need for alternative strategies to prevent and treat BAI. Synthetic antimicrobial peptides (AMPs are considered promising candidates as they are active against a broad spectrum of (antibiotic-resistant planktonic bacteria and biofilms. Moreover, bacteria are less likely to develop resistance to these rapidly-acting peptides. In this review we highlight the four main strategies, three of which applying AMPs, in biomedical device manufacturing to prevent BAI. The first involves modification of the physicochemical characteristics of the surface of implants. Immobilization of AMPs on surfaces of medical devices with a variety of chemical techniques is essential in the second strategy. The main disadvantage of these two strategies relates to the limited antibacterial effect in the tissue surrounding the implant. This limitation is addressed by the third strategy that releases AMPs from a coating in a controlled fashion. Lastly, AMPs can be integrated in the design and manufacturing of additively manufactured/3D-printed implants, owing to the physicochemical characteristics of the implant material and the versatile manufacturing technologies compatible with antimicrobials incorporation. These novel technologies utilizing AMPs will contribute to development of novel

Radiological guidelines for application to DOE's Formerly Utilized Sites Remedial Action Program

International Nuclear Information System (INIS)

1983-03-01

The US Department of Energy has implemented a program to evaluate and, where necessary, take action to protect the public from contamination at sites that were used in the past to process and/or store radioactive materials for the former US Army Corps of Engineers Manhattan Engineer District or the US Atomic Energy Commission. The program is identified as the Formerly Utilized Sites Remedial Action Program (FUSRAP). This document describes methods considered appropriate for the evaluation of health effects that might possible be caused by radioactive contamination at FUSRAP sites. This assessment methodology is applied to a typical site for the purposeof deriving guidelines for the cleanup of contaminated soil. Additional guidance is provided for planning site-specific remedial action that is consistent with the overall objectives of FUSRAP

Antimicrobial Activities of Three Medicinal Plants and Investigation of Flavonoids of Tripleurospermum disciforme.

Science.gov (United States)

Tofighi, Zahra; Molazem, Maryam; Doostdar, Behnaz; Taban, Parisa; Shahverdi, Ahmad Reza; Samadi, Nasrin; Yassa, Narguess

2015-01-01

Rosa damascena, Tripleurospermum disciforme and Securigera securidaca were used as disinfectant agents and for treatment of some disease in folk medicine of Iran. The antimicrobial effects of different fractions of seeds extract of S. securidaca, petals extract of R. damascena and aerial parts extract of T. disciforme were examined against some gram positive, gram negative and fungi by cup plate diffusion method. The petroleum ether and chloroform fractions of S. securidaca showed antibacterial activities against Staphylococcus aureus and Pseudomonas aeruginosa, while its methanol fraction had no antibacterial effects. R. damascena petals extract demonstrated antibacterial activities against Bacillus cereus, Staphylococcus epidermidis, S. aureus and Pseudomonas aeruginosa. T. disciforme aerial parts extract exhibited antimicrobial effects only against S. aureus and S. epidermidis. None of the fractions had any antifungal activities. Therefore, present study confirmed utility of these plants as disinfectant agents. Six flavonoids were isolated from T. disciforme: Luteolin, Quercetin-7-O-glucoside, Kaempferol, Kaempferol-7-O-glucoside, Apigenin and Apigenin-7-O-glucoside. The flavonoids and the antimicrobial activity of T. disciforme are reported for the first time.

Results from utility wind resource assessment programs in Nebraska, Colorado, and Arizona

Energy Technology Data Exchange (ETDEWEB)

Drapeau, C.L. [Global Energy Concepts, Inc., Bothell, WA (United States)

1997-12-31

Global Energy Concepts (GEC) has been retained by utilities in Colorado, Nebraska, and Arizona to site, install, and operate 21 wind monitoring stations as part of the Utility Wind Resource Assessment Program (U*WRAP). Preliminary results indicate wind speed averages at 40 meters (132 ft) of 6.5 - 7.4 m/s (14.5-16.5 mph) in Nebraska and 7.6 - 8.9 m/s (17.0-19.9 mph) in Colorado. The Arizona stations are not yet operational. This paper presents the history and current status of the 21 monitoring stations as well as preliminary data results. Information on wind speeds, wind direction, turbulence intensity, wind shear, frequency distribution, and data recovery rates are provided.

Scottish Antimicrobial Prescribing Group (SAPG): development and impact of the Scottish National Antimicrobial Stewardship Programme.

Science.gov (United States)

Nathwani, Dilip; Sneddon, Jacqueline; Malcolm, William; Wiuff, Camilla; Patton, Andrea; Hurding, Simon; Eastaway, Anne; Seaton, R Andrew; Watson, Emma; Gillies, Elizabeth; Davey, Peter; Bennie, Marion

2011-07-01

In 2008, the Scottish Management of Antimicrobial Resistance Action Plan (ScotMARAP) was published by the Scottish Government. One of the key actions was initiation of the Scottish Antimicrobial Prescribing Group (SAPG), hosted within the Scottish Medicines Consortium, to take forward national implementation of the key recommendations of this action plan. The primary objective of SAPG is to co-ordinate and deliver a national framework or programme of work for antimicrobial stewardship. This programme, led by SAPG, is delivered by NHS National Services Scotland (Health Protection Scotland and Information Services Division), NHS Quality Improvement Scotland, and NHS National Education Scotland as well as NHS board Antimicrobial Management Teams. Between 2008 and 2010, SAPG has achieved a number of early successes, which are the subject of this review: (i) through measures to optimise prescribing in hospital and primary care, combined with infection prevention measures, SAPG has contributed significantly to reducing Clostridium difficile infection rates in Scotland; (ii) there has been engagement of all key stakeholders at local and national levels to ensure an integrated approach to antimicrobial stewardship within the wider healthcare-associated infection agenda; (iii) development and implementation of data management systems to support quality improvement; (iv) development of training materials on antimicrobial stewardship for healthcare professionals; and (v) improving clinical management of infections (e.g. community-acquired pneumonia) through quality improvement methodology. The early successes achieved by SAPG demonstrate that this delivery model is effective and provides the leadership and focus required to implement antimicrobial stewardship to improve antimicrobial prescribing and infection management across NHS Scotland. Copyright © 2011 Elsevier B.V. and the International Society of Chemotherapy. All rights reserved.

Thorium utilization program. Quarterly progress report for the period ending May 31, 1977

Energy Technology Data Exchange (ETDEWEB)

1977-06-01

Results of work performed under the National HTGR Fuel Recycle Program (also known as the Thorium Utilization Program) at General Atomic Company are presented. Results of work on this program prior to June 1974 were included in a quarterly series on the HTGR Base Program. The work reported includes the development of unit processes and equipment for reprocessing of High-Temperature Gas-Cooled Reactor (HTGR) fuel, the design and development of an integrated pilot line to demonstrate the head end of HTGR reprocessing using unirradiated fuel materials, and design work in support of Hot Engineering Tests (HET). Work is also described on trade-off studies concerning the required design of facilities and equipment for the large-scale recycle of HTGR fuels in order to guide the development activities for HTGR fuel recycle.

Advanced Utility Mercury-Sorbent Field-Testing Program

Energy Technology Data Exchange (ETDEWEB)

Ronald Landreth

2007-12-31

This report summarizes the work conducted from September 1, 2003 through December 31, 2007 on the project entitled Advanced Utility Mercury-Sorbent Field-Testing Program. The project covers the testing at the Detroit Edison St. Clair Plant and the Duke Power Cliffside and Buck Stations. The St. Clair Plant used a blend of subbituminous and bituminous coal and controlled the particulate emissions by means of a cold-side ESP. The Duke Power Stations used bituminous coals and controlled their particulate emissions by means of hot-side ESPs. The testing at the Detroit Edison St. Clair Plant demonstrated that mercury sorbents could be used to achieve high mercury removal rates with low injection rates at facilities that burn subbituminous coal. A mercury removal rate of 94% was achieved at an injection rate of 3 lb/MMacf over the thirty day long-term test. Prior to this test, it was believed that the mercury in flue gas of this type would be the most difficult to capture. This is not the case. The testing at the two Duke Power Stations proved that carbon- based mercury sorbents can be used to control the mercury emissions from boilers with hot-side ESPs. It was known that plain PACs did not have any mercury capacity at elevated temperatures but that brominated B-PAC did. The mercury removal rate varies with the operation but it appears that mercury removal rates equal to or greater than 50% are achievable in facilities equipped with hot-side ESPs. As part of the program, both sorbent injection equipment and sorbent production equipment was acquired and operated. This equipment performed very well during this program. In addition, mercury instruments were acquired for this program. These instruments worked well in the flue gas at the St. Clair Plant but not as well in the flue gas at the Duke Power Stations. It is believed that the difference in the amount of oxidized mercury, more at Duke Power, was the difference in instrument performance. Much of the equipment was

A LINEAR PROGRAMMING METHOD TO ENHANCE RESOURCE UTILIZATION CASE OF ETHIOPIAN APPAREL SECTOR

Directory of Open Access Journals (Sweden)

Gezahegn Tesfaye

2016-06-01

Full Text Available The Ethiopian industrial development strategy is characterized by export-led and labor intensive industrialization. The country is emerging as the most important investment destination in its apparel sector. Thought this sector is expected to generate more income from the export market, its export earnings remain trivial mainly due to the inefficient organizational resource utilization. One of the competent techniques that help companies to efficiently improve the use of their resources to increase their profit is linear programming. In apparel manufacturing firms, efficient use of materials such as fabrics and sewing threads and processing time at different stages of production as well as minimization of labor and materials cost are necessary to enhance their profitability. Cutting, sewing, and finishing operations deserve more attention for apparel process optimization. However, the issue of proper resource allocation remains an unsolved problem within the Ethiopian apparel industry. The aim of this research is to devise efficient resource utilization mechanism for Ethiopian apparel sector to improve their resource utilization and profitability, taking one of the garment factories engaged in the export market as a case study. Five types of products the company is currently producing, the amount of resources employed to produce each unit of the products, and the value of profit per unit from the sale of each products have been collected from the case company. The monthly availability of resources utilized and the monthly production volume of the five products have also been collected from the company. The data gathered was mathematically modeled using a linear programming technique, and solved using MS-Excel solver. The findings of the study depicts that all of the organizational resources are severely underutilized. This research proved that the resource utilization of the case company can be improved from 46.41% of the current resource

Animation of Antimicrobial Resistance

Medline Plus

Full Text Available ... Pin it Email Print The Food and Drug Administration's (FDA's) Center for Veterinary Medicine (CVM) produced a nine-minute animation explaining how antimicrobial resistance both emerges and proliferates among bacteria. Over time, the use of antimicrobial drugs will result in ...

Hyperbranched epoxy/MWCNT-CuO-nystatin nanocomposite as a high performance, biocompatible, antimicrobial material

Science.gov (United States)

Barua, Shaswat; Chattopadhyay, Pronobesh; Phukan, Mayur M.; Konwar, Bolin K.; Karak, Niranjan

2014-12-01

Hyperbranched epoxy MWCNT-CuO-nystatin nanocomposite has been presented here as an advanced antimicrobial high performance material. The material showed significant improvement of mechanical properties (tensile strength from 38 to 63 MPa) over the pristine matrix without effecting elongation. MWCNT was modified by a non-ionic surfactant, triton X-100, wherein copper oxide nanoparticles were anchored in situ by a ‘green’ method. Further, sonochemical immobilization of nystatin enhanced the stability of the system. The immobilized nanohybrid system was incorporated into the hyperbranched matrix in 1, 2 and 3 wt%. The resultant system proved its ability to prevent bacterial, fungal and microalgal fouling against the tested strains, Staphylococcus aureus, Candida albicans and Chlorella sp. Additionally, this system is quite compatible with rat heart cells. Furthermore, in vivo assessment showed that this could be utilized as an implantable antimicrobial biomaterial. Thus, the overall study pointed out that the prepared material may have immense utility in marine industry as well as in biomedical domain to address microbial fouling, without inducing any toxicity to higher organisms.

Hyperbranched epoxy/MWCNT-CuO-nystatin nanocomposite as a high performance, biocompatible, antimicrobial material

International Nuclear Information System (INIS)

Barua, Shaswat; Karak, Niranjan; Chattopadhyay, Pronobesh; Phukan, Mayur M; Konwar, Bolin K

2014-01-01

Hyperbranched epoxy MWCNT-CuO-nystatin nanocomposite has been presented here as an advanced antimicrobial high performance material. The material showed significant improvement of mechanical properties (tensile strength from 38 to 63 MPa) over the pristine matrix without effecting elongation. MWCNT was modified by a non-ionic surfactant, triton X-100, wherein copper oxide nanoparticles were anchored in situ by a ‘green’ method. Further, sonochemical immobilization of nystatin enhanced the stability of the system. The immobilized nanohybrid system was incorporated into the hyperbranched matrix in 1, 2 and 3 wt%. The resultant system proved its ability to prevent bacterial, fungal and microalgal fouling against the tested strains, Staphylococcus aureus, Candida albicans and Chlorella sp. Additionally, this system is quite compatible with rat heart cells. Furthermore, in vivo assessment showed that this could be utilized as an implantable antimicrobial biomaterial. Thus, the overall study pointed out that the prepared material may have immense utility in marine industry as well as in biomedical domain to address microbial fouling, without inducing any toxicity to higher organisms. (paper)

Impact of antimicrobial use during beef production on fecal occurrence of antimicrobial resistance

Science.gov (United States)

Objective: To determine the impact of typical antimicrobial use during cattle production on fecal occurrence of antimicrobial resistance by culture, quantitative PCR, and metagenomic sequencing. Experimental Design & Analysis: Feces were recovered from colons of 36 lots of "conventional" (CONV) ca...

Associations of antimicrobial use with antimicrobial resistance in Campylobacter coli from grow-finish pigs in Japan.

Science.gov (United States)

Ozawa, M; Makita, K; Tamura, Y; Asai, T

2012-10-01

To determine associations between antimicrobial use and antimicrobial resistance in Campylobacter coli, 155 isolates were obtained from the feces of apparently healthy grow-finish pigs in Japan. In addition, data on the use of antibiotics collected through the national antimicrobial resistance monitoring system in Japan were used for the analysis. Logistic regression was used to identify risk factors to antimicrobial resistance in C. coli in pigs for the following antimicrobials: ampicillin, dihydrostreptomycin, erythromycin, oxytetracycline, chloramphenicol, and enrofloxacin. The data suggested the involvement of several different mechanisms of resistance selection. The statistical relationships were suggestive of co-selection; use of macrolides was associated with enrofloxacin resistance (OR=2.94; CI(95%): 0.997, 8.68) and use of tetracyclines was associated with chloramphenicol resistance (OR=2.37; CI(95%): 1.08, 5.19). The statistical relationships were suggestive of cross-resistance: use of macrolides was associated with erythromycin resistance (OR=9.36; CI(95%): 2.96, 29.62) and the use of phenicols was associated with chloramphenicol resistance (OR=11.83; CI(95%): 1.41, 99.44). These data showed that the use of antimicrobials in pigs selects for resistance in C. coli within and between classes of antimicrobials. Copyright © 2012 Elsevier B.V. All rights reserved.

Critical Concentration of Lecithin Enhances the Antimicrobial Activity of Eugenol against Escherichia coli

Science.gov (United States)

Zhang, Haoshu; Dudley, Edward G.; Davidson, P. Michael

2017-01-01

ABSTRACT Lecithin is a natural emulsifier used in a wide range of food and nonfood applications to improve physical stability, with no known bioactive effects. In this study, the effect of lecithin on the antimicrobial performance of a constant eugenol concentration was tested against three Escherichia coli strains (C600, 0.1229, and O157:H7 strain ATCC 700728). This is the first study, to our knowledge, focusing on lecithin at concentrations below those commonly used in foods to improve the stability of oil in water emulsions (≤10 mg/100 ml). For all three cultures, significant synergistic antimicrobial effects were observed when E. coli cultures were exposed to a constant eugenol concentration (ranging from 0.043 to 0.050% [wt/wt]) together with critical lecithin concentrations ranging from 0.5 to 1 mg/100 ml. Increasing the concentration of lecithin above 1 mg/100 ml (up to 10 mg/100 ml lecithin) diminished the antibacterial effect to values similar to those with eugenol-only treatments. The formation of aggregates (lecithin concentration was observed using cryo-transmission electron microscopy (cryo-TEM), together with a reduction in light absorbance at 284 nm. At critically low concentrations of lecithin, the formation of nanoscale aggregates is responsible for improving eugenol antimicrobial effects. IMPORTANCE Essential oils (EOs) are effective natural antimicrobials. However, their hydrophobicity and strong aromatic character limit the use of essential oils in food systems. Emulsifiers (e.g., lecithin) increase the stability of EOs in water-based systems but fail to consistently improve antimicrobial effects. We demonstrate that lecithin, within a narrow critical concentration window, can enhance the antimicrobial properties of eugenol. This study highlights the potential bioactivity of lecithin when utilized to effectively control foodborne pathogens. PMID:28213539

Critical Concentration of Lecithin Enhances the Antimicrobial Activity of Eugenol against Escherichia coli.

Science.gov (United States)

Zhang, Haoshu; Dudley, Edward G; Davidson, P Michael; Harte, Federico

2017-04-15

Lecithin is a natural emulsifier used in a wide range of food and nonfood applications to improve physical stability, with no known bioactive effects. In this study, the effect of lecithin on the antimicrobial performance of a constant eugenol concentration was tested against three Escherichia coli strains (C600, 0.1229, and O157:H7 strain ATCC 700728). This is the first study, to our knowledge, focusing on lecithin at concentrations below those commonly used in foods to improve the stability of oil in water emulsions (≤10 mg/100 ml). For all three cultures, significant synergistic antimicrobial effects were observed when E. coli cultures were exposed to a constant eugenol concentration (ranging from 0.043 to 0.050% [wt/wt]) together with critical lecithin concentrations ranging from 0.5 to 1 mg/100 ml. Increasing the concentration of lecithin above 1 mg/100 ml (up to 10 mg/100 ml lecithin) diminished the antibacterial effect to values similar to those with eugenol-only treatments. The formation of aggregates (lecithin concentration was observed using cryo-transmission electron microscopy (cryo-TEM), together with a reduction in light absorbance at 284 nm. At critically low concentrations of lecithin, the formation of nanoscale aggregates is responsible for improving eugenol antimicrobial effects. IMPORTANCE Essential oils (EOs) are effective natural antimicrobials. However, their hydrophobicity and strong aromatic character limit the use of essential oils in food systems. Emulsifiers (e.g., lecithin) increase the stability of EOs in water-based systems but fail to consistently improve antimicrobial effects. We demonstrate that lecithin, within a narrow critical concentration window, can enhance the antimicrobial properties of eugenol. This study highlights the potential bioactivity of lecithin when utilized to effectively control foodborne pathogens. Copyright © 2017 American Society for Microbiology.

Iowa state information handbook: formerly utilized sites remedial action program

Energy Technology Data Exchange (ETDEWEB)

None

1981-02-09

This volume is one of a series produced under contract with the DOE, By Politech Corporation to develop a legislative and regulatory data base to assist the FUSRAP management in addressing the institutional and socioeconomic issues involved in carrying out the Formerly Utilized Sites Remedial Action Program. This Information Handbook series contains information about all relevant government agencies at the Federal and state levels, the pertinent programs they administer, each affected state legislature, and current Federal and state legislative and regulatory initiatives. This volume is a compilation of information about the state of Iowa. It contains: a description of the state executive branch structure; a summary of relevant state statutes and regulations; a description of the structure of the state legislature, identification of the officers and committee chairmen, and a summary of recent relevant legislative action; the full test of relevant statutes and regulations.

California state information handbook: formerly utilized sites remedial action program

Energy Technology Data Exchange (ETDEWEB)

None

1981-02-09

This volume is one of a series produced under contract with the DOE, by Politech Corporation to develop a legislative and regulatory data base to assist the FUSRAP management in addressing the institutional and socioeconomic issues involved in carrying out the Formerly Utilized Sites Remedial Action Program. This Information Handbook series contains information about all relevant government agencies at the Federal and state levels, the pertinent programs they administer, each affected state legislature, and current Federal and state legislative and regulatory initiatives. This volume is a compilation of information about the state of California. It contains: a description of the state executive branch structure; a summary of relevant state statutes and regulations; a description of the structure of the state legislature, identification of the officers and committee chairmen, and a summary of recent relevant legislative action; the full text of relevant statutes and regulations.

Pennsylvania state information handbook: formerly utilized sites remedial action program

Energy Technology Data Exchange (ETDEWEB)

None

1980-12-31

This volume is one of a series produced under contract with the DOE, by Politech Corporation to develop a legislative and regulatory data base to assist the FUSRAP management in addressing the institutional and socioeconomic issues involved in carrying out the Formerly Utilized Sites Remedial Action Program. This Information Handbook series contains information about all relevant government agencies at the Federal and State levels, the pertinent programs they administer, each affected state legislature, and current Federal and state legislative and regulatory initiatives. This volume is a compilation of information about the State of Pennsylvania. It contains a description of the state executive branch structure; a summary of relevant state statutes and regulations; a description of the structure of the state legislature, identification of the officers and committee chairmen, and a summary of recent relevant legislative action; and the full text of relevant statutes and regulations.

Illinois state information handbook: formerly utilized sites remedial action program

International Nuclear Information System (INIS)

1980-01-01

This volume is one of a series produced under contract with the DOE, by Politech Corporation to develop a legislative and regulatory data base to assist the FUSRAP management in addressing the institutional and socioeconomic issues involved in carrying out the Formerly Utilized Sites Remedial Action Program. This Information Handbook series contains information about all relevant government agencies at the Federal and state levels, the pertinent programs they administer, each affected state legislature, and current Federal and state legislative and regulatory initiatives. This volume is a compilation of information about the State of Illinois. It contains a description of the state executive branch structure; a summary of relevant state statutes and regulations; a description of the structure of the state legislature, identification of the officers and committee chairmen, and a summary of recent relevant legislative action; the full text of relevant statutes and regulations

Illinois State information handbook: formerly utilized sites remedial action program

International Nuclear Information System (INIS)

1980-01-01

This volume is one of a series produced under contract with the DOE, by Politech Corporation to develop a legislative and regulatory data base to assist the FUSRAP management in addressing the institutional and socioeconomic issues involved in carrying out the formerly Utilized Sites Remedial Action Program. This Information Handbook series contains information about all relevant government agencies at the Federal and state levels, the pertinent programs they administer, each affected state legislature, and current Federal and state legislative and regulatory initiatives. This volume is a compilation of information about the State of Illinois. It contains: a description of the state executive branch structure; a summary of relevant state statutes and regulations; a description of the structure of the state legislature, identification of the officers and committee chairmen, and a summary of recent relevant legislative action; and the full text of relevant statutes and regulations

Massachusetts state information handbook: formerly utilized sites remedial action program

International Nuclear Information System (INIS)

1981-01-01

This volume is one of a series produced under contract with the DOE, by Politech Corporation to develop a legislative and regulatory data base to assist the FUSRAP management in addressing the institutional and socioeconomic issues involved in carrying out the Formerly Utilized Sites Remedial Action Program. This Information Handbook series contains information about all relevant government agencies at the Federal and state levels, the pertinent programs they administer, each affected state legislature, and current Federal and state legislative and regulatory initiatives. This volume is a compilation of information about the state of Massachusetts. It contains: a description of the state executive branch structure; a summary of relevant state statutes and regulations; a description of the structure of the state legislature, identification of the officers and committee chairmen, and a summary of recent relevant legislative action; the full text of relevant statutes and regulations

Massachusetts state information handbook: formerly utilized sites remedial action program

Energy Technology Data Exchange (ETDEWEB)

None

1981-02-09

This volume is one of a series produced under contract with the DOE, by Politech Corporation to develop a legislative and regulatory data base to assist the FUSRAP management in addressing the institutional and socioeconomic issues involved in carrying out the Formerly Utilized Sites Remedial Action Program. This Information Handbook series contains information about all relevant government agencies at the Federal and state levels, the pertinent programs they administer, each affected state legislature, and current Federal and state legislative and regulatory initiatives. This volume is a compilation of information about the state of Massachusetts. It contains: a description of the state executive branch structure; a summary of relevant state statutes and regulations; a description of the structure of the state legislature, identification of the officers and committee chairmen, and a summary of recent relevant legislative action; the full text of relevant statutes and regulations.

Oregon state information handbook: formerly utilized sites remedial action program

Energy Technology Data Exchange (ETDEWEB)

None

1980-12-31

This volume is one of a series produced under contract with the DOE, by Politech Corporation to develop a legislative and regulatory data base to assist the FUSRAP management in addressing the institutional and socioeconomic issues involved in carrying out the Formerly Utilized Sites Remedial Action Program. This Information Handbook series contains information about all relevant government agencies at the Federal and state levels, the pertinent programs they administer, each affected state legislature, and current Federal and state legislative and regulatory initiatives. This volume is a compilation of information about the State of Oregon. It contains a description of the state executive branch structure; a summary of relevant state statutes and regulations; a description of the structure of the state legislature, identification of the officers and committee chairmen, and a summary of recent relevant legislative action; and the full text of relevant statutes and regulations.

Maryland State information handbook: formerly utilized sites remedial action program

Energy Technology Data Exchange (ETDEWEB)

None

1980-12-31

This volume is one of a series produced under contract with the DOE, by Politech Corporation to develop a legislative and regulatory data base to assist the FUSRAP management in addressing the institutional and socioeconomic issues involved in carrying out the Formerly Utilized Handbook Series Remedial Action Program. This Information Handbook series contains information about all relevant government agencies at the Federal and state levels, the pertinent programs they administer, each affected state legislature, and current Federal and state legislative and regulatory initiatives. This volume is a compilation of information about the State of Maryland. It contains: a description of the state executive branch structure; a summary of relevant state statutes and regulations; a description of the structure of the state legislature, identification of the officers and committee chairmen, and a summary of recent relevant legislative action; and the full text of relevant statutes and regulations.

Pennsylvania state information handbook formerly utilized sites remedial action program

International Nuclear Information System (INIS)

1980-01-01

This volume is one of a series produced under contract with the DOE, by Politech Corporation to develop a legislative and regulatory data base to assist the FUSRAP management in addressing the institutional and socioeconomic issues involved in carrying out the Formerly Utilized Sites Remedial Action Program. This Information Handbook series contains information about all relevant government agencies at the Federal and state levels, the pertinent programs they administer, each affected state legislature, and current Federal and state legislative and regulatory initiatives. This volume is a compilation of information about the State of Pennsylvania. It contains: a description of the state executive branch structure; a summary of relevant state statutes and regulations; a description of the structure of the state legislature, identification of the officers and committee chairmen, and a summary of recent relevant legislative action; and the full text of relevant statutes and regulations

Maryland State information handbook: formerly utilized sites remedial action program

International Nuclear Information System (INIS)

1980-01-01

This volume is one of a series produced under contract with the DOE, by Politech Corporation to develop a legislative and regulatory data base to assist the FUSRAP management in addressing the institutional and socioeconomic issues involved in carrying out the Formerly Utilized Handbook Series Remedial Action Program. This Information Handbook series contains information about all relevant government agencies at the Federal and state levels, the pertinent programs they administer, each affected state legislature, and current Federal and state legislative and regulatory initiatives. This volume is a compilation of information about the State of Maryland. It contains: a description of the state executive branch structure; a summary of relevant state statutes and regulations; a description of the structure of the state legislature, identification of the officers and committee chairmen, and a summary of recent relevant legislative action; and the full text of relevant statutes and regulations

Pennsylvania state information handbook: formerly utilized sites remedial action program

International Nuclear Information System (INIS)

1980-01-01

This volume is one of a series produced under contract with the DOE, by Politech Corporation to develop a legislative and regulatory data base to assist the FUSRAP management in addressing the institutional and socioeconomic issues involved in carrying out the Formerly Utilized Sites Remedial Action Program. This Information Handbook series contains information about all relevant government agencies at the Federal and State levels, the pertinent programs they administer, each affected state legislature, and current Federal and state legislative and regulatory initiatives. This volume is a compilation of information about the State of Pennsylvania. It contains a description of the state executive branch structure; a summary of relevant state statutes and regulations; a description of the structure of the state legislature, identification of the officers and committee chairmen, and a summary of recent relevant legislative action; and the full text of relevant statutes and regulations

Iowa state information handbook: formerly utilized sites remedial action program

International Nuclear Information System (INIS)

1981-01-01

This volume is one of a series produced under contract with the DOE, By Politech Corporation to develop a legislative and regulatory data base to assist the FUSRAP management in addressing the institutional and socioeconomic issues involved in carrying out the Formerly Utilized Sites Remedial Action Program. This Information Handbook series contains information about all relevant government agencies at the Federal and state levels, the pertinent programs they administer, each affected state legislature, and current Federal and state legislative and regulatory initiatives. This volume is a compilation of information about the state of Iowa. It contains: a description of the state executive branch structure; a summary of relevant state statutes and regulations; a description of the structure of the state legislature, identification of the officers and committee chairmen, and a summary of recent relevant legislative action; the full test of relevant statutes and regulations

California state information handbook: formerly utilized sites remedial action program

International Nuclear Information System (INIS)

1981-01-01

This volume is one of a series produced under contract with the DOE, by Politech Corporation to develop a legislative and regulatory data base to assist the FUSRAP management in addressing the institutional and socioeconomic issues involved in carrying out the Formerly Utilized Sites Remedial Action Program. This Information Handbook series contains information about all relevant government agencies at the Federal and state levels, the pertinent programs they administer, each affected state legislature, and current Federal and state legislative and regulatory initiatives. This volume is a compilation of information about the state of California. It contains: a description of the state executive branch structure; a summary of relevant state statutes and regulations; a description of the structure of the state legislature, identification of the officers and committee chairmen, and a summary of recent relevant legislative action; the full text of relevant statutes and regulations

Maryland state information handbook: formerly utilized sites remedial action program

International Nuclear Information System (INIS)

1980-01-01

This volume is one of a series produced under contract with the DOE, by Politech Corporation to develop a legislative and regulatory data base to assist the FUSRAP management in addressing the institutional and socioeconomic issues involved in carrying out the Formerly Utilized Sites Remedial Action Program. This Information Handbook series contains information about all relevant government agencies at the Federal and State levels, the pertinent programs they administer, each affected state legislature, and current Federal and state legislative and regulatory initiatives. This volume is a compilation of information about the State of Maryland. It contains a description of the state executive branch structure; a summary of relevant state statutes and regulations; a description of the structure of the state legislature, identification of the officers and committee chairmen, and a summary of recent relevant legislative action; and the full text of relevant statutes and regulations

Oregon state information handbook: formerly utilized sites remedial action program

International Nuclear Information System (INIS)

1980-01-01

This volume is one of a series produced under contract with the DOE, by Politech Corporation to develop a legislative and regulatory data base to assist the FUSRAP management in addressing the institutional and socioeconomic issues involved in carrying out the Formerly Utilized Sites Remedial Action Program. This Information Handbook series contains information about all relevant government agencies at the Federal and state levels, the pertinent programs they administer, each affected state legislature, and current Federal and state legislative and regulatory initiatives. This volume is a compilation of information about the State of Oregon. It contains a description of the state executive branch structure; a summary of relevant state statutes and regulations; a description of the structure of the state legislature, identification of the officers and committee chairmen, and a summary of recent relevant legislative action; and the full text of relevant statutes and regulations

Oregon state information handbook formerly utilized sites remedial action program

International Nuclear Information System (INIS)

1980-01-01

This volume is one of a series produced under contract with the DOE, by Politech Corporation to develop a legislative and regulatory data base to assist the FUSRAP management in addressing the institutional and socioeconomic issues involved in carrying out the Formerly Utilized Sites Remedial Action Program. This Information Handbook series contains information about all relevant government agencies at the Federal and state levels, the pertinent programs they administater, each affected state legislature, and current Federal and state legislative and regulatory initiatives. This volume is a compilation of information about the State of Oregon. It contains: a description of the state executive branch structure; a summary of relevant state statutes and regulations; a description of the structure of the state legislature, identification of the officers and committee chairmen, and a summary of recent relevant legislative action; and the full text of relevant statutes and regulations

Ohio state information handbook: formerly utilized sites remedial action program

International Nuclear Information System (INIS)

1981-01-01

This volume is one of a series produced under contract with the DOE, by POLITECH CORPORATION to develop a legislative and regulatory data base to assist the FUSRAP management in addressing the institutional and socioeconomic issues involved in carrying out the Formerly Utilized Sites Remedial Action Program. This Information Handbook series contains information about all relevant government agencies at the Federal and state levels, the pertinent programs they administer, each affected state legislature, and current Federal and state legislative and regulatory initiatives. This volume is a compilation of information about the state of Ohio. It contains: a description of the state executive branch structure; a summary of relevant state statutes and regulations; a description of the structure of the state legislature, identification of the officers and committee chairmen, and a summary of recent relevant legislative action; the full test of relevant statutes and regulations

Ohio state information handbook: formerly utilized sites remedial action program

Energy Technology Data Exchange (ETDEWEB)

1981-02-09

This volume is one of a series produced under contract with the DOE, by POLITECH CORPORATION to develop a legislative and regulatory data base to assist the FUSRAP management in addressing the institutional and socioeconomic issues involved in carrying out the Formerly Utilized Sites Remedial Action Program. This Information Handbook series contains information about all relevant government agencies at the Federal and state levels, the pertinent programs they administer, each affected state legislature, and current Federal and state legislative and regulatory initiatives. This volume is a compilation of information about the state of Ohio. It contains: a description of the state executive branch structure; a summary of relevant state statutes and regulations; a description of the structure of the state legislature, identification of the officers and committee chairmen, and a summary of recent relevant legislative action; the full test of relevant statutes and regulations.

Oregon state information handbook formerly utilized sites remedial action program

Energy Technology Data Exchange (ETDEWEB)

None

1980-12-31

This volume is one of a series produced under contract with the DOE, by Politech Corporation to develop a legislative and regulatory data base to assist the FUSRAP management in addressing the institutional and socioeconomic issues involved in carrying out the Formerly Utilized Sites Remedial Action Program. This Information Handbook series contains information about all relevant government agencies at the Federal and state levels, the pertinent programs they administater, each affected state legislature, and current Federal and state legislative and regulatory initiatives. This volume is a compilation of information about the State of Oregon. It contains: a description of the state executive branch structure; a summary of relevant state statutes and regulations; a description of the structure of the state legislature, identification of the officers and committee chairmen, and a summary of recent relevant legislative action; and the full text of relevant statutes and regulations.

Animation of Antimicrobial Resistance

Medline Plus

Full Text Available ... menu Skip to common links HHS U.S. Department of Health and Human Services U.S. Food and Drug Administration ... Tobacco Products Animal & Veterinary Home Animal & Veterinary Safety & Health Antimicrobial Resistance Animation of Antimicrobial Resistance Share Tweet Linkedin Pin it More ...

Correlations between Income inequality and antimicrobial resistance.

Science.gov (United States)

Kirby, Andrew; Herbert, Annie

2013-01-01

The aim of this study is to investigate if correlations exist between income inequality and antimicrobial resistance. This study's hypothesis is that income inequality at the national level is positively correlated with antimicrobial resistance within developed countries. Income inequality data were obtained from the Standardized World Income Inequality Database. Antimicrobial resistance data were obtained from the European antimicrobial Resistance Surveillance Network and outpatient antimicrobial consumption data, measured by Defined daily Doses per 1000 inhabitants per day, from the European Surveillance of antimicrobial Consumption group. Spearman's correlation coefficient (r) defined strengths of correlations of: > 0.8 as strong, > 0.5 as moderate and > 0.2 as weak. Confidence intervals and p values were defined for all r values. Correlations were calculated for the time period 2003-10, for 15 European countries. Income inequality and antimicrobial resistance correlations which were moderate or strong, with 95% confidence intervals > 0, included the following. Enterococcus faecalis resistance to aminopenicillins, vancomycin and high level gentamicin was moderately associated with income inequality (r= ≥0.54 for all three antimicrobials). Escherichia coli resistance to aminoglycosides, aminopenicillins, third generation cephalosporins and fluoroquinolones was moderately-strongly associated with income inequality (r= ≥0.7 for all four antimicrobials). Klebsiella pneumoniae resistance to third generation cephalosporins, aminoglycosides and fluoroquinolones was moderately associated with income inequality (r= ≥0.5 for all three antimicrobials). Staphylococcus aureus methicillin resistance and income inequality were strongly associated (r=0.87). As income inequality increases in European countries so do the rates of antimicrobial resistance for bacteria including E. faecalis, E. coli, K. pneumoniae and S. aureus. Further studies are needed to confirm these

Use of antimicrobial agents in aquaculture.

Science.gov (United States)

Park, Y H; Hwang, S Y; Hong, M K; Kwon, K H

2012-04-01

The aquaculture industry has grown dramatically, and plays an important role in the world's food supply chain. Antimicrobial resistance in bacteria associated with food animals receives much attention, and drug use in aquaculture is also an important issue. There are many differences between aquatic and terrestrial management systems, such as the methods used for administration of drugs. Unique problems are related to the application of drugs in aquatic environments. Residual drugs in fish products can affect people who consume them, and antimicrobials released into aquatic environments can select for resistant bacteria. Moreover, these antimicrobial-resistant bacteria, or their resistance genes, can be transferred to humans. To decrease the risks associated with the use of antimicrobials, various regulations have been developed. In addition, it is necessary to prevent bacterial diseases in aquatic animals by vaccination, to improve culture systems, and to monitor the amount of antimicrobial drugs used and the prevalence of antimicrobial-resistant bacteria.

Editorial of the Special Issue Antimicrobial Polymers

Directory of Open Access Journals (Sweden)

Iolanda Francolini

2013-09-01

Full Text Available The special issue “Antimicrobial Polymers” includes research and review papers concerning the recent advances on preparation of antimicrobial polymers and their relevance to industrial settings and biomedical field. Antimicrobial polymers have recently emerged as promising candidates to fight microbial contamination onto surfaces thanks to their interesting properties. In this special issue, the main strategies pursued for developing antimicrobial polymers, including polymer impregnation with antimicrobial agents or synthesis of polymers bearing antimicrobial moieties, were discussed. The future application of these polymers either in industrial or healthcare settings could result in an extremely positive impact not only at the economic level but also for the improvement of quality of life.

Federal government information handbook formerly utilized sites remedial action program

International Nuclear Information System (INIS)

1980-01-01

This volume is one of a series produced under contract with the DOE, by Politech Corporation to develop a legislative and regulatory data base to assist the FUSRAP management in addressing the institutional and socioeconomic issues involved in carrying out the Formerly Utilized Sites Remedial Action Program. This Information Handbook series contains information about all relevant government agencies at the Federal and state levels, the pertinent programs they administer, each affected state legislature, and current Federal and state legislative and regulatory initiatives. This volume is a compilation of information about the Federal Government. It contains: a summary of the organization and responsibilities of agencies within the executive branch of the Federal government which may be relevant to FUSRAP activities; a brief summary of relevant Federal statutes and regulations; a description of the structure of the US Congress, identification of the officers, relevant committees and committee chairmen; a description of the Federal legislative process; a summary of legislation enacted and considered in the recently-adjourned 96th Congress; a description of the Federal budgetary process; a summary of the Carter Administration's comprehensive radioactive waste management program; and excerpts from the text of relevant Federal statutes and regulations

Federal government information handbook: formerly utilized sites remedial action program

International Nuclear Information System (INIS)

1980-01-01

This volume is one of a series produced under contract with the DOE, by Politech Corporation to develop a legislative and regulatory data base to assist the FUSRAP management in addressing the institutional and socioeconomic issues involved in carrying out the Formerly Utilized Sites Remedial Action Program. This Information Handbook series contains information about all relevant government agencies at the Federal and state levels, the pertinent programs they administer, each affected state legislature, and current Federal and state legislative and regulatory initiatives. This volume is a compilation of information about the Federal Government. It contains a summary of the organization and responsibilities of agencies within the executive branch of the Federal government which may be relevant to FUSRAP activities; a brief summary of relevant Federal statutes and regulations; a description of the structure of the US Congress, identification of the officers, relevant committees and committee chairmen; a description of the Federal legislative process; a summary of legislation enacted and considered in the recently-adjourned 96th Congress; a description of the Federal budgetary process; a summary of the Carter Administration's comprehensive radioactive waste management program; and excerpts from the text of relevant federal statutes and regulations

Federal government information handbook: formerly utilized sites remedial action program

Energy Technology Data Exchange (ETDEWEB)

1980-12-31

This volume is one of a series produced under contract with the DOE, by Politech Corporation to develop a legislative and regulatory data base to assist the FUSRAP management in addressing the institutional and socioeconomic issues involved in carrying out the Formerly Utilized Sites Remedial Action Program. This Information Handbook series contains information about all relevant government agencies at the Federal and state levels, the pertinent programs they administer, each affected state legislature, and current Federal and state legislative and regulatory initiatives. This volume is a compilation of information about the Federal Government. It contains a summary of the organization and responsibilities of agencies within the executive branch of the Federal government which may be relevant to FUSRAP activities; a brief summary of relevant Federal statutes and regulations; a description of the structure of the US Congress, identification of the officers, relevant committees and committee chairmen; a description of the Federal legislative process; a summary of legislation enacted and considered in the recently-adjourned 96th Congress; a description of the Federal budgetary process; a summary of the Carter Administration's comprehensive radioactive waste management program; and excerpts from the text of relevant federal statutes and regulations.

Animation of Antimicrobial Resistance

Medline Plus

Full Text Available ... Skip to common links HHS U.S. Department of Health and Human Services U.S. Food and Drug Administration A to Z Index Follow FDA En Español Search FDA Submit search ... & Health Antimicrobial Resistance Animation of Antimicrobial Resistance Share Tweet ...

On the non-proliferation framework of Japan's peaceful nuclear utilization program

International Nuclear Information System (INIS)

Kano, Takashi

1996-01-01

The Conference of the States Party to the Treaty on the Non-proliferation of Nuclear Weapons (hereinafter referred to as the NPT) convened in New York, from April 17 to May 12, 1995 and decided that the NPT shall continue in force indefinitely, after reviewing the operation and affirming some aspects of the NPT, while emphasizing the ''Decision on Strengthening the Review Process'' for the NPT and the ''Decision on Principles and Objectives for Nuclear Non-proliferation and Disarmament,'' also adopted by the Conference. In parallel, Japan made its basic non-proliferation policy clear in the ''Long-Term Program for Research, Development and Utilization of Nuclear Energy'' which was decided by the Atomic Energy Commission (chaired by Mikio Oomi, then Minister of the Science and Technology Agency of Japan) in June 1994. The Long-Term Program discusses various problems facing post-Cold-War international society and describes Japan's policy for establishing international confidence concerning non-proliferation. This paper summarizes Japan's non-proliferation policy as articulated in the Long-Term Program, and describes some results of an analysis comparing the Long-Term Program with the resolutions on the international non-proliferation frameworks adopted by the NPT conference

Implementation of an antimicrobial stewardship program targeting residents with urinary tract infections in three community long-term care facilities: a quasi-experimental study using time-series analysis.

Science.gov (United States)

Doernberg, Sarah B; Dudas, Victoria; Trivedi, Kavita K

2015-01-01

Asymptomatic bacteriuria in the elderly commonly results in antibiotic administration and, in turn, contributes to antimicrobial resistance, adverse drug events, and increased costs. This is a major problem in the long-term care facility (LTCF) setting, where residents frequently transition to and from the acute-care setting, often transporting drug-resistant organisms across the continuum of care. The goal of this study was to assess the feasibility and efficacy of antimicrobial stewardship programs (ASPs) targeting urinary tract infections (UTIs) at community LTCFs. This was a quasi-experimental study targeting antibiotic prescriptions for UTI using time-series analysis with 6-month retrospective pre-intervention and 6-month intervention period at three community LTCFs. The ASP team (infectious diseases (ID) pharmacist and ID physician) performed weekly prospective audit and feedback of consecutive prescriptions for UTI. Loeb clinical consensus criteria were used to assess appropriateness of antibiotics; recommendations were communicated to the primary treating provider by the ID pharmacist. Resident outcomes were recorded at subsequent visits. Generalized estimating equations using segmented regression were used to evaluate the impact of the ASP intervention on rates of antibiotic prescribing and antibiotic resistance. One-hundred and four antibiotic prescriptions for UTI were evaluated during the intervention, and recommendations were made for change in therapy in 40 (38 %), out of which 10 (25 %) were implemented. Only eight (8 %) residents started on antibiotics for UTI met clinical criteria for antibiotic initiation. An immediate 26 % decrease in antibiotic prescriptions for UTI during the ASP was identified with a 6 % reduction continuing through the intervention period (95 % Confidence Interval ([CI)] for the difference: -8 to -3 %). Similarly, a 25 % immediate decrease in all antibiotic prescriptions was noted after introduction of the ASP with a

High speed graphic program on a personal computer and its utilization in JIPP T-IIU online data-processing system

International Nuclear Information System (INIS)

Taniguchi, Yoshiyuki; Noda, Nobuaki; Sasao, Mamiko; Sato, Masahiro

1986-01-01

A high speed graphic program was developed on a personal computer PC9801. Using this program, one can draw a waveform of successive 16 bit-integer data, such as obtained by analog-to-digital convertor. The program is written by the machine language and has a form of a subroutine program which can be called from main programs under N 88 BASIC. The time for drawing one waveform is 4 ms, which is two orders faster than the time with standard graphic routines of BASIC interpreter. This program is very convenient for the real-time display of plasma-monitoring raw data, such as plasma current, loop voltage, rf power etc. in tokamak experiments. This program has been utilized in JIPP T-IIU experiments and enables to display data of 8 channel ADC within a few seconds before the system transmits the data from CAMAC to the computer center of the institute. The program and its utilization are presented. (author)

Antimicrobial susceptibility and internalization of Salmonella Typhimurium in vacuum-tumbled marinated beef products.

Science.gov (United States)

Pokharel, S; Brooks, J C; Martin, J N; Brashears, M M

2016-12-01

As the incidence of multidrug resistance (MDR) Salmonella enterica serotype Typhimurium is increasing, data regarding the antimicrobial interventions and pathogen internalization in marinated meat products are important. This study evaluated the antimicrobial intervention and internalization of Salm. Typhimurium in marinated beef sirloin steaks. Beef bottom sirloin flaps (IMPS #185A; USDA Select) inoculated (10 8  log 10  CFU ml -1 ) with Salm. Typhimurium were sprayed (lactic acid (4%) and buffered vinegar (2%)) prior to vacuum-tumbled marination (0·35% sodium chloride and 0·45% sodium tripolyphosphate) for 30 min. Pathogen presence after antimicrobial spray, vacuum-tumbled marination, and translocation was determined by direct plating on Xylose Lysine Deoxycholate (XLD) agar with tryptic soy agar (TSA) overlay. The data imply varied internalization and antimicrobial susceptibility pattern of Salm. Typhimurium in marinated meat. Lactic acid (4%) spray (P internalization and potential survival of Salmonella spp. in marinated beef products is a major concern. These results highlight the internalization of pathogens in vacuum-tumbled meat products and emphasize the importance of considering these products as nonintact. Similarly, these data confirm the efficacy and utility of interventions prior to vacuum-tumbled marination. Further research is needed to identify additional strategies to mitigate internalization and translocation of pathogens into vacuum-marinated meat products. © 2016 The Society for Applied Microbiology.

Antimicrobial food packaging: potential and pitfalls

Science.gov (United States)

Malhotra, Bhanu; Keshwani, Anu; Kharkwal, Harsha

2015-01-01

Nowadays food preservation, quality maintenance, and safety are major growing concerns of the food industry. It is evident that over time consumers’ demand for natural and safe food products with stringent regulations to prevent food-borne infectious diseases. Antimicrobial packaging which is thought to be a subset of active packaging and controlled release packaging is one such promising technology which effectively impregnates the antimicrobial into the food packaging film material and subsequently delivers it over the stipulated period of time to kill the pathogenic microorganisms affecting food products thereby increasing the shelf life to severe folds. This paper presents a picture of the recent research on antimicrobial agents that are aimed at enhancing and improving food quality and safety by reduction of pathogen growth and extension of shelf life, in a form of a comprehensive review. Examination of the available antimicrobial packaging technologies is also presented along with their significant impact on food safety. This article entails various antimicrobial agents for commercial applications, as well as the difference between the use of antimicrobials under laboratory scale and real time applications. Development of resistance amongst microorganisms is considered as a future implication of antimicrobials with an aim to come up with actual efficacies in extension of shelf life as well as reduction in bacterial growth through the upcoming and promising use of antimicrobials in food packaging for the forthcoming research down the line. PMID:26136740

Antimicrobial use in Belgian broiler production.

Science.gov (United States)

Persoons, Davy; Dewulf, Jeroen; Smet, Annemieke; Herman, Lieve; Heyndrickx, Marc; Martel, An; Catry, Boudewijn; Butaye, Patrick; Haesebrouck, Freddy

2012-08-01

The use of antimicrobials in production animals has become a worldwide concern in the face of rising resistance levels in commensal, pathogenic and zoonotic bacteria. In the years 2007 and 2008 antimicrobial consumption records were collected during two non consecutive production cycles in 32 randomly selected Belgian broiler farms. Antimicrobials were used in 48 of the 64 monitored production cycles, 7 farms did not use any antimicrobials in both production cycles, 2 farms only administered antimicrobials in one of the two production cycles, the other 23 farms applied antimicrobial treatment in both production cycles. For the quantification of antimicrobial drug use, the treatment incidences (TI) based on the defined daily doses (the dose as it should be applied: DDD) and used daily doses (the actual dose applied: UDD) were calculated. A mean antimicrobial treatment incidence per 1000 animals of 131.8 (standard deviation 126.8) animals treated daily with one DDD and 121.4 (SD 106.7) animals treated daily with one UDD was found. The most frequently used compounds were amoxicillin, tylosin and trimethoprim-sulphonamide with a mean TI(UDD) of 37.9, 34.8, and 21.7, respectively. The ratio of the UDD/DDD gives an estimate on correctness of dosing. Tylosin was underdosed in most of the administrations whereas amoxicillin and trimethoprim-sulphonamide were slightly overdosed in the average flock. Copyright © 2012 Elsevier B.V. All rights reserved.

California Publicly-Owned Utilities (POUs) – LBNL ‘Beyond Widgets’ Project. Task: ambient lighting and occupancy-based plug load control. System Program Manual

Energy Technology Data Exchange (ETDEWEB)

Robinson, Alastair; Mathew, Paul A.; Regnier, Cynthia; Schwartz, Peter; Schakelford, Jordan; Walter, Travis

2017-09-01

This program manual contains detailed technical information for implementing an incentive program for task-ambient lighting and occupancy-based plug load control. This manual was developed by Lawrence Berkeley National Laboratory, in collaboration with the California Publicly-Owned Utilities (CA POUs) as a partner in the ‘Beyond Widgets’ program funded by the U.S. Department of Energy Building Technologies Office. The primary audience for this manual is the program staff of the various CA POUs. It may also be used by other utility incentive programs to help develop similar programs. It is anticipated that the content of this manual be utilized by the CA POU staff for developing related documents such as the Technical Resource Manual and other filings pertaining to the rollout of an energy systems-based rebate incentive program.

Influence of four antimicrobials on methane-producing archaea and sulfate-reducing bacteria in anaerobic granular sludge.

Science.gov (United States)

Du, Jingru; Hu, Yong; Qi, Weikang; Zhang, Yanlong; Jing, Zhaoqian; Norton, Michael; Li, Yu-You

2015-12-01

The influence of Cephalexin (CLX), Tetracycline (TC), Erythromycin (ERY) and Sulfathiazole (ST) on methane-producing archaea (MPA) and sulfate-reducing bacteria (SRB) in anaerobic sludge was investigated using acetate or ethanol as substrate. With antimicrobial concentrations below 400mgL(-1), the relative specific methanogenic activity (SMA) was above 50%, so that the antimicrobials exerted slight effects on archaea. However ERY and ST at 400mgL(-1) caused a 74.5% and 57.6% inhibition to specific sulfidogenic activity (SSA) when the sludge granules were disrupted and ethanol used as substrate. After disruption, microbial tolerance to antimicrobials decreased, but the rate at which MPA utilized acetate and ethanol increased from 0.95gCOD·(gVSS⋅d)(-1) to 1.45gCOD·(gVSS⋅d)(-1) and 0.90gCOD·(gVSS⋅d)(-1) to 1.15gCOD·(gVSS⋅d)(-1) respectively. The ethanol utilization rate for SRB also increased after disruption from 0.35gCOD·(gVSS⋅d)(-1) to 0.46gCOD·(gVSS⋅d)(-1). Removal rates for CLX approaching 20.0% and 25.0% were obtained used acetate and ethanol respectively. The disintegration of granules improved the CLX removal rate to 65% and 78%, but ST was not removed during this process. Copyright © 2014 Elsevier Ltd. All rights reserved.

Animation of Antimicrobial Resistance

Medline Plus

Full Text Available ... More in Antimicrobial Resistance National Antimicrobial Resistance Monitoring System About NARMS 2015 NARMS Integrated Report Data Meetings ... Deutsch | 日本語 | فارسی | English FDA Accessibility Careers FDA Basics FOIA No FEAR ...

Antimicrobial activity predictors benchmarking analysis using shuffled and designed synthetic peptides.

Science.gov (United States)

Porto, William F; Pires, Állan S; Franco, Octavio L

2017-08-07

The antimicrobial activity prediction tools aim to help the novel antimicrobial peptides (AMP) sequences discovery, utilizing machine learning methods. Such approaches have gained increasing importance in the generation of novel synthetic peptides by means of rational design techniques. This study focused on predictive ability of such approaches to determine the antimicrobial sequence activities, which were previously characterized at the protein level by in vitro studies. Using four web servers and one standalone software, we evaluated 78 sequences generated by the so-called linguistic model, being 40 designed and 38 shuffled sequences, with ∼60 and ∼25% of identity to AMPs, respectively. The ab initio molecular modelling of such sequences indicated that the structure does not affect the predictions, as both sets present similar structures. Overall, the systems failed on predicting shuffled versions of designed peptides, as they are identical in AMPs composition, which implies in accuracies below 30%. The prediction accuracy is negatively affected by the low specificity of all systems here evaluated, as they, on the other hand, reached 100% of sensitivity. Our results suggest that complementary approaches with high specificity, not necessarily high accuracy, should be developed to be used together with the current systems, overcoming their limitations. Copyright © 2017 Elsevier Ltd. All rights reserved.

Understanding the determinants of antimicrobial prescribing within hospitals: the role of "prescribing etiquette".

Science.gov (United States)

Charani, E; Castro-Sanchez, E; Sevdalis, N; Kyratsis, Y; Drumright, L; Shah, N; Holmes, A

2013-07-01

There is limited knowledge of the key determinants of antimicrobial prescribing behavior (APB) in hospitals. An understanding of these determinants is required for the successful design, adoption, and implementation of quality improvement interventions in antimicrobial stewardship programs. Qualitative semistructured interviews were conducted with doctors (n = 10), pharmacists (n = 10), and nurses and midwives (n = 19) in 4 hospitals in London. Interviews were conducted until thematic saturation was reached. Thematic analysis was applied to the data to identify the key determinants of antimicrobial prescribing behaviors. The APB of healthcare professionals is governed by a set of cultural rules. Antimicrobial prescribing is performed in an environment where the behavior of clinical leaders or seniors influences practice of junior doctors. Senior doctors consider themselves exempt from following policy and practice within a culture of perceived autonomous decision making that relies more on personal knowledge and experience than formal policy. Prescribers identify with the clinical groups in which they work and adjust their APB according to the prevailing practice within these groups. A culture of "noninterference" in the antimicrobial prescribing practice of peers prevents intervention into prescribing of colleagues. These sets of cultural rules demonstrate the existence of a "prescribing etiquette," which dominates the APB of healthcare professionals. Prescribing etiquette creates an environment in which professional hierarchy and clinical groups act as key determinants of APB. To influence the antimicrobial prescribing of individual healthcare professionals, interventions need to address prescribing etiquette and use clinical leadership within existing clinical groups to influence practice.

National antimicrobial stewardship and fluoroquinolone-resistant Clostridium difficile in China

Directory of Open Access Journals (Sweden)

Xiao M

2017-10-01

Full Text Available Meng Xiao,1,* Jing-Wei Cheng,1,2,* Timothy Kudinha,3 Fanrong Kong,4 Ying-Chun Xu1,21Department of Clinical Laboratory, Peking Union Medical College Hospital, 2Faculty of Clinical Laboratory Diagnostics, Graduate School, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China; 3School of Biomedical Sciences, The Charles Sturt University, Leeds Parade, Orange, 4Centre for Infectious Diseases and Microbiology Laboratory Services, ICPMR–Pathology West, Westmead Hospital, University of Sydney, Westmead, NSW, Australia*These authors contributed equally to this workIn a recent report, Dingle et al showed that national intervention programs aimed at judicious antimicrobial usage, especially restrictions to fluoroquinolones, contributed to a significant decrease in Clostridium difficile infection (CDI in England.1 This is considered an outstanding achievement in combating antimicrobial resistance worldwide.

Antimicrobial reduction measures applied in Danish pig herds following the introduction of the “Yellow Card” antimicrobial scheme

DEFF Research Database (Denmark)

Dupont, Nana; Diness, Line Hummelmose; Fertner, Mette Ely

2017-01-01

their annual antimicrobial consumption with ≥10% following the introduction of the Yellow Card Scheme comparing June 1, 2009–May 31, 2010 to June 1, 2010–May 31, 2011. Subsequently, questionnaire surveys of both farmers and veterinarians were carried out, resulting in responses from 179 farmers accounting...... for 202 herds (response ratio: 83%) and 58 veterinarians accounting for 140 herds. Prior to the introduction of the Yellow Card Scheme, 24% of the participating herds had an antimicrobial consumption for one or more age groups which exceeded the Yellow Card Scheme threshold values on antimicrobial......Following introduction of the antimicrobial restrictive “Yellow Card Scheme” in summer 2010, a rapid decrease in the Danish national pig antimicrobial consumption was observed. The aims of this study were to (i) investigate which measures had been implemented to reduce the antimicrobial consumption...

Considering a new domain for antimicrobial stewardship: Topical antibiotics in the open surgical wound.

Science.gov (United States)

Edmiston, Charles E; Leaper, David; Spencer, Maureen; Truitt, Karen; Litz Fauerbach, Loretta; Graham, Denise; Johnson, Helen Boehm

2017-11-01

The global push to combat the problem of antimicrobial resistance has led to the development of antimicrobial stewardship programs (ASPs), which were recently mandated by The Joint Commission and the Centers for Medicare and Medicaid Services. However, the use of topical antibiotics in the open surgical wound is often not monitored by these programs nor is it subject to any evidence-based standardization of care. Survey results indicate that the practice of using topical antibiotics intraoperatively, in both irrigation fluids and powders, is widespread. Given the risks inherent in their use and the lack of evidence supporting it, the practice should be monitored as a core part of ASPs, and alternative agents, such as antiseptics, should be considered. Copyright © 2017 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.

Views of the electric utility industry on the direction and progress of the Department of Energy's Nuclear Waste Program

International Nuclear Information System (INIS)

Mills, L.E.

1986-01-01

The NWPA does provide guidance for a reasonable waste management program and one must work to implement it in an efficient and effective manner. It is well recognized that the lack of stability and predictability has been the bane of many nuclear reactor projects. The electric utilities are not satisfied with the progress of the nuclear waste program even though much has been achieved. DOE must continue in its struggle to seek a better balance between the technical, political and institutional aspects of the program to provide reasonable assurance that it will fulfill its contractual obligation with utilities

Nanostructures for delivery of natural antimicrobials in food.

Science.gov (United States)

Lopes, Nathalie Almeida; Brandelli, Adriano

2017-04-10

Natural antimicrobial compounds are a topic of utmost interest in food science due to the increased demand for safe and high-quality foods with minimal processing. The use of nanostructures is an interesting alternative to protect and delivery antimicrobials in food, also providing controlled release of natural compounds such as bacteriocins and antimicrobial proteins, and also for delivery of plant derived antimicrobials. A diversity of nanostructures are capable of trapping natural antimicrobials maintaining the stability of substances that are frequently sensitive to food processing and storage conditions. This article provides an overview on natural antimicrobials incorporated in nanostructures, showing an effective antimicrobial activity on a diversity of food spoilage and pathogenic microorganisms.

Insights on antimicrobial resistance, biofilms and the use of phytochemicals as new antimicrobial agents.

Science.gov (United States)

Borges, Anabela; Saavedra, Maria J; Simões, Manuel

2015-01-01

Antimicrobial resistance is one of the most serious public health problems. This is of particular concern when bacteria become resistant to various antimicrobial agents simultaneously and when they form biofilms. Consequently, therapeutic options for the treatment of infections have become limited, leading frequently to recurrent infections, treatment failure and increase of morbidity and mortality. Both, persistence and spread of antibiotic resistance, in combination with decreased effectiveness and increased toxicity of current antibiotics have emphasized the urgent need to search alternative sources of antimicrobial substances. Plants are recognized as a source of unexplored chemical structures with high therapeutic potential, including antimicrobial activity against clinically important microorganisms. Additionally, phytochemicals (plant secondary metabolites) present several advantages over synthetic molecules, including green status and different mechanisms of action from antibiotics which could help to overcome the resistance problem. In this study, an overview of the main classes of phytochemicals with antimicrobial properties and their mode of action is presented. A revision about the application of phytochemicals for biofilm prevention and control is also done. Moreover, the use of phytochemicals as scaffolds of new functional molecules to expand the antibiotics pipeline is reviewed.

CHEMICAL COMPOSITION, ANTIMICROBIAL AND ANTIOXYDANT ...

African Journals Online (AJOL)

VOUNDI

2016-04-20

Apr 20, 2016 ... antimicrobial activities of some spices' essential oils on ... antimicrobial effect of their essential oils on some food pathogenic bacteria, namely, Staphylococcus aureus ...... by Origanum compactum essential oil. J. Appl.

Antimicrobial usage and resistance in beef production

OpenAIRE

Cameron, Andrew; McAllister, Tim A.

2016-01-01

Antimicrobials are critical to contemporary high-intensity beef production. Many different antimicrobials are approved for beef cattle, and are used judiciously for animal welfare, and controversially, to promote growth and feed efficiency. Antimicrobial administration provides a powerful selective pressure that acts on the microbial community, selecting for resistance gene determinants and antimicrobial-resistant bacteria resident in the bovine flora. The bovine microbiota includes many harm...

Antimicrobials, stress and mutagenesis.

Directory of Open Access Journals (Sweden)

Alexandro Rodríguez-Rojas

2014-10-01

Full Text Available Cationic antimicrobial peptides are ancient and ubiquitous immune effectors that multicellular organisms use to kill and police microbes whereas antibiotics are mostly employed by microorganisms. As antimicrobial peptides (AMPs mostly target the cell wall, a microbial 'Achilles heel', it has been proposed that bacterial resistance evolution is very unlikely and hence AMPs are ancient 'weapons' of multicellular organisms. Here we provide a new hypothesis to explain the widespread distribution of AMPs amongst multicellular organism. Studying five antimicrobial peptides from vertebrates and insects, we show, using a classic Luria-Delbrück fluctuation assay, that cationic antimicrobial peptides (AMPs do not increase bacterial mutation rates. Moreover, using rtPCR and disc diffusion assays we find that AMPs do not elicit SOS or rpoS bacterial stress pathways. This is in contrast to the main classes of antibiotics that elevate mutagenesis via eliciting the SOS and rpoS pathways. The notion of the 'Achilles heel' has been challenged by experimental selection for AMP-resistance, but our findings offer a new perspective on the evolutionary success of AMPs. Employing AMPs seems advantageous for multicellular organisms, as it does not fuel the adaptation of bacteria to their immune defenses. This has important consequences for our understanding of host-microbe interactions, the evolution of innate immune defenses, and also sheds new light on antimicrobial resistance evolution and the use of AMPs as drugs.

The impact of a conditional cash transfer program on the utilization of non-targeted services: Evidence from Afghanistan.

Science.gov (United States)

Witvorapong, Nopphol; Foshanji, Abo Ismael

2016-03-01

While existing research suggests that health-related conditional cash transfer (CCT) programs have positive impacts on the utilization of CCT-targeted health services, little is known as to whether they also influence the utilization of non-targeted health services-defined as general health services for which program participants are not financially motivated. Based on a sample of 6649 households in a CCT program that took place in May 2009-June 2011 in Afghanistan, we evaluate the impact of the receipt of CCTs on the utilization of non-targeted health services both by women, who were direct beneficiaries of the program, and by members of their households. We estimate the outcomes of interest through four probit models, accounting for potential endogeneity of the CCT receipt and dealing with lack of credible exclusion restrictions in different ways. In comparison with the control group, the receipt of CCTs is found to be associated with an increase in the probability of utilizing non-targeted services among household members across regression models. The results are mixed, with regard to the utilization by women, suggesting that there exist non-economic barriers to health care, unique to women, that are not captured by the data. The results confirm the importance of accounting for direct as well as indirect effects in policy evaluation and suggest that future studies investigate more deeply the role of community health workers in removing non-economic barriers for Afghan women and the possibility of introducing an incentive structure to motivate them to contribute more actively to population health in Afghanistan. Copyright © 2016 Elsevier Ltd. All rights reserved.

An Assessment Model for Energy Efficiency Program Planning in Electric Utilities: Case of the Pacific of Northwest U.S.A

Science.gov (United States)

Iskin, Ibrahim

Energy efficiency stands out with its potential to address a number of challenges that today's electric utilities face, including increasing and changing electricity demand, shrinking operating capacity, and decreasing system reliability and flexibility. Being the least cost and least risky alternative, the share of energy efficiency programs in utilities' energy portfolios has been on the rise since the 1980s, and their increasing importance is expected to continue in the future. Despite holding great promise, the ability to determine and invest in only the most promising program alternatives plays a key role in the successful use of energy efficiency as a utility-wide resource. This issue becomes even more significant considering the availability of a vast number of potential energy efficiency programs, the rapidly changing business environment, and the existence of multiple stakeholders. This dissertation introduces hierarchical decision modeling as the framework for energy efficiency program planning in electric utilities. The model focuses on the assessment of emerging energy efficiency programs and proposes to bridge the gap between technology screening and cost/benefit evaluation practices. This approach is expected to identify emerging technology alternatives which have the highest potential to pass cost/benefit ratio testing procedures and contribute to the effectiveness of decision practices in energy efficiency program planning. The model also incorporates rank order analysis and sensitivity analysis for testing the robustness of results from different stakeholder perspectives and future uncertainties in an attempt to enable more informed decision-making practices. The model was applied to the case of 13 high priority emerging energy efficiency program alternatives identified in the Pacific Northwest, U.S.A. The results of this study reveal that energy savings potential is the most important program management consideration in selecting emerging energy

Antibiotic and Antimicrobial Resistance: Threat Report 2013

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... Form Controls Cancel Submit Search The CDC Antibiotic / Antimicrobial Resistance Note: Javascript is disabled or is not ... please visit this page: About CDC.gov . Antibiotic / Antimicrobial Resistance About Antimicrobial Resistance Biggest Threats Emerging Drug ...

Scoping review to identify potential non-antimicrobial interventions to mitigate antimicrobial resistance in commensal enteric bacteria in North American cattle production systems.

Science.gov (United States)

Murphy, C P; Fajt, V R; Scott, H M; Foster, M J; Wickwire, P; McEwen, S A

2016-01-01

A scoping review was conducted to identify modifiable non-antimicrobial factors to reduce the occurrence of antimicrobial resistance in cattle populations. Searches were developed to retrieve peer-reviewed published studies in animal, human and in vitro microbial populations. Citations were retained when modifiable non-antimicrobial factors or interventions potentially associated with antimicrobial resistance were described. Studies described resistance in five bacterial genera, species or types, and 40 antimicrobials. Modifiable non-antimicrobial factors or interventions ranged widely in type, and the depth of evidence in animal populations was shallow. Specific associations between a factor or intervention with antimicrobial resistance in a population (e.g. associations between organic systems and tetracycline susceptibility in E. coli from cattle) were reported in a maximum of three studies. The identified non-antimicrobial factors or interventions were classified into 16 themes. Most reported associations between the non-antimicrobial modifiable factors or interventions and antimicrobial resistance were not statistically significant (P > 0·05 and a confidence interval including 1), but when significant, the results were not consistent in direction (increase or decrease in antimicrobial resistance) or magnitude. Research is needed to better understand the impacts of promising modifiable factors or interventions on the occurrence of antimicrobial resistance before any recommendations can be offered or adopted.

Phenolic Composition and Antioxidant and Antimicrobial Activities of Extracts Obtained from Crataegus azarolus L. var. aronia (Willd. Batt. Ovaries Calli

Directory of Open Access Journals (Sweden)

Radhia Bahri-Sahloul

2014-01-01

Full Text Available Objective. Plant cell culture is an innovative technology to produce a variety of substances. Numerous plants synthesize among their secondary metabolites phenolic compounds which possess antioxidant and antimicrobial effects. Hawthorn (Crataegus is one of these plants which has long been used in folk medicine and is widely utilized in pharmaceutical preparations mainly in neuro- and cardiosedative actions. Methods and Results. The production of polyphenol by fifty-two-week-old Crataegus azarolus var. aronia calli was studied in relation to growth variation and antioxidant and antimicrobial capacity within a subcultured period. The DPPH and ABTS+ assays were used to characterize the antioxidant actions of the callus cultures. Antimicrobial activity was tested by using disc diffusion and dilution assays for the determination of the minimal inhibitory concentration (MIC and the minimal bactericidal concentration (MBC values of each active extract. High TEACDPPH, TEACABTS, and antimicrobial activity was observed when maximal growth was reached. An optimum of total phenol, proanthocyanidins, flavonoid, (−-epicatechin, procyanidin B2, chlorogenic acid, and hyperoside was produced during this period. Conclusion. Antioxidant and antimicrobial activities were strongly correlated with total phenols and total flavonoids. Crataegus azarolus var. aronia cells culture represents an important alternative source of natural antioxidants and antimicrobials.

Utility oversight of Cask System Development Program

International Nuclear Information System (INIS)

Vincent, J.A.; Jordan, J.M.; Schwartz, M.H.

1993-01-01

This paper will present the electric utility industry's perspective on the status and scope of the DOE's Office of Civilian Radioactive Waste Management's (DOE/OCRWM) transportation cask systems development activities, including the Cask Systems Development Program (CSDP) Initiative I transportation cask projects. This presentation is particularly timely because the CSDP Independent Management Review Group (IMRG), os which one of the authors is a member, completed an objective assessment of OCRWM's transportation cask system development activities and issued its first report in late August 1992. The perspective on these cask systems development activities that will be presented reflects conclusions based on (1) the industry's review of CSDP Preliminary and Draft Final Design Reports for the Initiative I cask projects, (2) the activities of one of the authors as a member of the IMRG, and (3) the positions that the industry has consistently taken on what it believes to be the appropriate scope and pace of the CSDP and its integration with other OCRWM activities. Background information on the OCRWM transportation cask systems development activities and the relevant industry activities will also be provided

The future of utility customer-funded energy efficiency programs in the USA. Projected spending and savings to 2025

Energy Technology Data Exchange (ETDEWEB)

Barbose, G.L.; Goldman, C.A.; Hoffman, I.M.; Billingsley, M. [Ernest Orlando Lawrence Berkeley National Laboratory, One Cyclotron Road, MS 90R4000, Berkeley, CA 94720-8136 (United States)

2013-08-15

We develop projections of future spending on, and savings from, energy efficiency programs funded by electric and gas utility customers in the USA, under three scenarios through 2025. Our analysis, which updates a previous LBNL study, relies on detailed bottom-up modeling of current state energy efficiency policies, regulatory decisions, and demand-side management and utility resource plans. The three scenarios are intended to represent a range of potential outcomes under the current policy environment (i.e., without considering possible major new policy developments). Key findings from the analysis are as follows: (1) By 2025, spending on electric and gas efficiency programs (excluding load management programs) is projected to double from 2010 levels to USD 9.5 billion in the medium case, compared to USD 15.6 billion in the high case and USD 6.5 billion in the low case; (2) Compliance with statewide legislative or regulatory savings or spending targets is the primary driver for the increase in electric program spending through 2025, though a significant share of the increase is also driven by utility DSM planning activity and integrated resource planning; (3) Our analysis suggests that electric efficiency program spending may approach a more even geographic distribution over time in terms of absolute dollars spent, with the Northeastern and Western states declining from over 70 % of total USA spending in 2010 to slightly more than 50 % in 2025, and the South and Midwest splitting the remainder roughly evenly; (4) Under our medium case scenario, annual incremental savings from customer-funded electric energy efficiency programs increase from 18.4 TWh in 2010 in the USA (which is about 0.5 % of electric utility retail sales) to 28.8 TWh in 2025 (0.8 % of retail sales); (5) These savings would offset the majority of load growth in the Energy Information Administration's most recent reference case forecast, given specific assumptions about the extent to which future

Role of Antimicrobial Selective Pressure and Secondary Factors on Antimicrobial Resistance Prevalence in Escherichia coli from Food-Producing Animals in Japan

OpenAIRE

Harada, Kazuki; Asai, Tetsuo

2010-01-01

The use of antimicrobial agents in the veterinary field affects the emergence, prevalence, and dissemination of antimicrobial resistance in bacteria isolated from food-producing animals. To control the emergence, prevalence, and dissemination of antimicrobial resistance, it is necessary to implement appropriate actions based on scientific evidence. In Japan, the Japanese Veterinary Antimicrobial Resistance Monitoring System (JVARM) was established in 1999 to monitor the antimicrobial suscepti...

Structural, physicochemical characterization and antimicrobial ...

Indian Academy of Sciences (India)

Structural, physicochemical characterization and antimicrobial activities of a new Tetraaqua ... Antimicrobial activity of 1 was tested. ... was prepared as good quality yellow single crystals .... at 540 nm. Increase of OD was compared to control.

Effects of Reducing Antimicrobial Use and Applying a Cleaning and Disinfection Program in Veal Calf Farming: Experiences from an Intervention Study to Control Livestock-Associated MRSA.

Directory of Open Access Journals (Sweden)

Alejandro Dorado-García

Full Text Available With the ultimate aim of containing the emergence of resistant bacteria, a Dutch policy was set in place in 2010 promoting a reduction of antimicrobial use (AMU in food-producing animals. In this context, a study evaluated strategies to curb livestock-associated methicillin resistant Staphylococcus aureus (LA-MRSA. Fifty-one veal calf farms were assigned to one of 3 study arms: RAB farms reducing antimicrobials by protocol; RAB-CD farms reducing antimicrobials by protocol and applying a cleaning and disinfection program; and Control farms without interventions. MRSA carriage was tested in week 0 and week 12 of 2 consecutive production cycles in farmers, family members and veal calves. Interventions were validated and a cyclic rise in MRSA-prevalence in animals was shown with a more moderate increase in RAB farms. Prevalence in humans declined parallel over time in the study arms but RAB farms were at the lowest MRSA levels from the beginning of the study. In RAB-CD farms, human and animal prevalence did not differ from Control farms and MRSA air loads were significantly higher than in the other study arms. Mimicking the national trend, an overall AMU decrease (daily dosages per animal per cycle (DDDA/C was observed over 4 pre-study and the 2 study cycles; this trend did not have a significant effect on a set of evaluated farm technical parameters. AMU was positively associated with MRSA across study arms (ORs per 10 DDDA/C increase = 1.26 for both humans (p = 0.07 and animals (p = 0.12 in first cycle. These results suggest that AMU reduction might be a good strategy for curbing MRSA in veal calf farming, however the specific cleaning and disinfecting program in RAB-CD farms was not effective. The drop in MRSA prevalence in people during the study could be attributed to the observed long-term AMU decreasing trend.

Urea uptake enhances barrier function and antimicrobial defense in humans by regulating epidermal gene expression

Science.gov (United States)

Grether-Beck, Susanne; Felsner, Ingo; Brenden, Heidi; Kohne, Zippora; Majora, Marc; Marini, Alessandra; Jaenicke, Thomas; Rodriguez-Martin, Marina; Trullas, Carles; Hupe, Melanie; Elias, Peter M.; Krutmann, Jean

2012-01-01

Urea is an endogenous metabolite, known to enhance stratum corneum hydration. Yet, topical urea anecdotally also improves permeability barrier function, and it appears to exhibit antimicrobial activity. Hence, we hypothesized that urea is not merely a passive metabolite, but a small-molecule regulator of epidermal structure and function. In 21 human volunteers, topical urea improved barrier function in parallel with enhanced antimicrobial peptide (LL-37 and β-defensin-2) expression. Urea both stimulates expression of, and is transported into keratinocytes by two urea transporters, UT-A1 and UT-A2, and by aquaporin 3, 7 and 9. Inhibitors of these urea transporters block the downstream biological effects of urea, which include increased mRNA and protein levels for: (i) transglutaminase-1, involucrin, loricrin and filaggrin; (ii) epidermal lipid synthetic enzymes, and (iii) cathelicidin/LL-37 and β-defensin-2. Finally, we explored the potential clinical utility of urea, showing that topical urea applications normalized both barrier function and antimicrobial peptide expression in a murine model of atopic dermatitis (AD). Together, these results show that urea is a small-molecule regulator of epidermal permeability barrier function and antimicrobial peptide expression after transporter uptake, followed by gene regulatory activity in normal epidermis, with potential therapeutic applications in diseased skin. PMID:22418868

Optimization of the medium composition for production of antimicrobial substances by bacillus subtilis ATCC 6633

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Rončević Zorana Z.

2017-01-01

Full Text Available In the effort to overcome the increase in antimicrobial resistance of different pathogens, natural products from microbial sources appear to be the most favorable alternative to current antibiotics. Production of antimicrobial compounds is highly dependent on the nutritional conditions. Hence, in order to achieve high product yields, selection of the media constituents and optimization of their concentrations are required. In this research, the possibility of antimicrobial substances production using Bacillus subtilis ATCC 6633 was investigated. Also, optimization of the cultivation medium composition in terms of contents of glycerol, sodium nitrite and phosphates was done. Response surface methodology and the method of desirability function were applied for determination of optimal values of the examined factors. The developed model predicts that the maximum inhibition zone diameters for Bacillus cereus ATCC 10876 (33.50 mm and Pseudomonas aeruginosa ATCC 27853 (12.00 mm are achieved when the initial contents of glycerol, sodium nitrite and phosphates were 43.72 g/L, 1.93 g/L and 5.64 g/L, respectively. The results of these experiments suggest that further research should include the utilization of crude glycerol as a carbon source and optimization of composition of such media and cultivation conditions in order to improve production of antimicrobial substances using Bacillus subtilis ATCC 6633.

Utilization of Low-Cost Ellagitannins for Ellagic Acid Production and Antimicrobial Phenolics Enhancing By Aspergillus awamorii and Aspergillus oryzae

International Nuclear Information System (INIS)

El-Bialy, H.A.; Abd EL-Aziz, A.B.

2009-01-01

Three fungal strains, Aspergillus awamorii A 9 , Aspergillus awamorii A 2 3 and Aspergillus oryzae O 2 , were selected out of ten fungal strains for their activeness in converting pomegranate peel ellagitannins into ellagic acid. When pomegranate peel was fermented by Aspergillus awamorii A 9 , the highest yields of ellagic acid (7.93±0.23 mg/g solid substrate) and total soluble phenolics (14.61±0.36 mg/g solid substrate) were produced at 5 and 10 days of incubation, respectively. Also, blue berry pomace, red grape pomace, strawberry pomace were evaluated as low cost ellagitannin sources for ellagic acid and soluble phenolics production. The antimicrobial activity of soluble phenolics extracted from fermented pomegranate peel and strawberry pomace was tested against two food-borne pathogens (Escherichia coli and Salmonella typhimurium). This study also revealed that 3 kGy enhanced the activity of antimicrobial phenolics

Efficacy of triclosan as an antimicrobial hand soap and its potential impact on antimicrobial resistance: a focused review.

Science.gov (United States)

Giuliano, Christopher A; Rybak, Michael J

2015-03-01

Triclosan is a synthetic biocide found in many household products, including antimicrobial hand soap. Levels of triclosan have been found throughout the environment and in human urine, blood, and even breast milk. Increasing levels of exposure to triclosan have led to concerns over the development of resistance to triclosan and cross-resistance to other antimicrobials. We performed a literature search to assess whether the widespread use of triclosan displays a favorable benefit: risk ratio, defined by evaluation of triclosan's efficacy as an antimicrobial hand soap and its potential effect on the development of antimicrobial resistance. Data from laboratory-based studies regarding the efficacy of triclosan are conflicting, although well-designed studies suggest no significant difference in efficacy over nonantimicrobial soap. In addition, when triclosan was introduced in a community setting, no beneficial effects were observed on the reduction of infections over nonantimicrobial soap. Resistance to triclosan and cross-resistance to antimicrobials have been consistently demonstrated in laboratory settings, although overall resistance rates and cross-resistance rates in the community setting are low. Based on the available evidence, the risk of potential antimicrobial resistance outweighs the benefit of widespread triclosan use in antimicrobial soaps. © 2015 Pharmacotherapy Publications, Inc.

Antimicrobial Peptides (AMPs

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Mehrzad Sadredinamin

2016-04-01

Full Text Available Antimicrobial peptides (AMPs are extensive group of molecules that produced by variety tissues of invertebrate, plants, and animal species which play an important role in their immunity response. AMPs have different classifications such as; biosynthetic machines, biological sources, biological functions, molecular properties, covalent bonding patterns, three dimensional structures, and molecular targets.These molecules have multidimensional properties including antimicrobial activity, antiviral activity, antifungal activity, anti-parasite activity, biofilm control, antitumor activity, mitogens activity and linking innate to adaptive immunity that making them promising agents for therapeutic drugs. In spite of this advantage of AMPs, their clinical developments have some limitation for commercial development. But some of AMPs are under clinical trials for the therapeutic purpose such as diabetic foot ulcers, different bacterial infections and tissue damage. In this review, we emphasized on the source, structure, multidimensional properties, limitation and therapeutic applications of various antimicrobial peptides.

The In Vitro Antimicrobial Effects of Lavandula angustifolia Essential Oil in Combination with Conventional Antimicrobial Agents

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de Rapper, Stephanie; Viljoen, Alvaro

2016-01-01

The paper focuses on the in vitro antimicrobial activity of Lavandula angustifolia Mill. (lavender) essential oil in combination with four commercial antimicrobial agents. Stock solutions of chloramphenicol, ciprofloxacin, nystatin, and fusidic acid were tested in combination with L. angustifolia essential oil. The antimicrobial activities of the combinations were investigated against the Gram-positive bacterial strain Staphylococcus aureus (ATCC 6538) and Gram-negative Pseudomonas aeruginosa (ATCC 27858) and Candida albicans (ATCC 10231) was selected to represent the yeasts. The antimicrobial effect was performed using the minimum inhibitory concentration (MIC) microdilution assay. Isobolograms were constructed for varying ratios. The most prominent interaction was noted when L. angustifolia essential oil was combined with chloramphenicol and tested against the pathogen P. aeruginosa (ΣFIC of 0.29). Lavendula angustifolia essential oil was shown in most cases to interact synergistically with conventional antimicrobials when combined in ratios where higher volumes of L. angustifolia essential oil were incorporated into the combination. PMID:27891157

The In Vitro Antimicrobial Effects of Lavandula angustifolia Essential Oil in Combination with Conventional Antimicrobial Agents

Directory of Open Access Journals (Sweden)

Stephanie de Rapper

2016-01-01

Full Text Available The paper focuses on the in vitro antimicrobial activity of Lavandula angustifolia Mill. (lavender essential oil in combination with four commercial antimicrobial agents. Stock solutions of chloramphenicol, ciprofloxacin, nystatin, and fusidic acid were tested in combination with L. angustifolia essential oil. The antimicrobial activities of the combinations were investigated against the Gram-positive bacterial strain Staphylococcus aureus (ATCC 6538 and Gram-negative Pseudomonas aeruginosa (ATCC 27858 and Candida albicans (ATCC 10231 was selected to represent the yeasts. The antimicrobial effect was performed using the minimum inhibitory concentration (MIC microdilution assay. Isobolograms were constructed for varying ratios. The most prominent interaction was noted when L. angustifolia essential oil was combined with chloramphenicol and tested against the pathogen P. aeruginosa (ΣFIC of 0.29. Lavendula angustifolia essential oil was shown in most cases to interact synergistically with conventional antimicrobials when combined in ratios where higher volumes of L. angustifolia essential oil were incorporated into the combination.

The effect of an enhanced employee assistance program (EAP) intervention on EAP utilization.

Science.gov (United States)

Zarkin, G A; Bray, J W; Karuntzos, G T; Demiralp, B

2001-05-01

An enhanced employee assistance program (EAP) intervention was developed that delivers comprehensive EAP outreach services to all employees who may have alcohol-related and other workplace problems; standard EAP materials traditionally targeted at white men were enhanced to include women and minorities. This study evaluates whether the enhanced EAP intervention increased EAP utilization. The enhanced EAP intervention was developed at a large community-based not-for-profit EAP located in Rockford, Illinois. Two primary worksites and 16 other newly contracted worksites received the enhanced EAP intervention and served as intervention sites; the 107 other worksites serviced by the EAP were used as comparison sites. We used time series data from 1991 to 1998 and included repeated measures on each firm's quarterly EAP utilization. The enhanced EAP intervention increased the mean number of women and minority cases per worksite by 58%, white male cases by 45% and total EAP cases by 53%. This study shows that, for a modest cost, the enhanced EAP intervention successfully increased utilization of EAP by all employees, especially utilization by women and minority employees. It also shows that traditional EAP services and outreach materials can be made more appealing to women and minorities without adversely affecting their utilization by white men.

Antimicrobial Stewardship in Inpatient Settings in the Asia Pacific Region: A Systematic Review and Meta-analysis.

Science.gov (United States)

Honda, Hitoshi; Ohmagari, Norio; Tokuda, Yasuharu; Mattar, Caline; Warren, David K

2017-05-15

An antimicrobial stewardship program (ASP) is one of the core elements needed to optimize antimicrobial use. Although collaboration at the national level to address the importance of ASPs and antimicrobial resistance has occurred in the Asia Pacific region, hospital-level ASP implementation in this region has not been comprehensively evaluated. We conducted a systematic review and meta-analysis to assess the efficacy of ASPs in inpatient settings in the Asia Pacific region from January 2005 through March 2016. The impact of ASPs on various outcomes, including patient clinical outcomes, antimicrobial prescription outcomes, microbiological outcomes, and expenditure were assessed. Forty-six studies were included for a systematic review and meta-analysis. The pooled risk ratio for mortality from ASP before-after trials and 2-group comparative studies were 1.03 (95% confidence interval [CI], .88-1.19) and 0.69 (95% CI, .56-.86), respectively. The pooled effect size for change in overall antimicrobial and carbapenem consumption (% difference) was -9.74% (95% CI, -18.93% to -.99%) and -10.56% (95% CI, -19.99% to -3.03%), respectively. Trends toward decreases in the incidence of multidrug-resistant organisms and antimicrobial expenditure (range, 9.7%-58.1% reduction in cost in the intervention period/arm) were also observed. ASPs in inpatient settings in the Asia Pacific region appear to be safe and effective to reduce antimicrobial consumption and improve outcomes. However, given the significant variations in assessing the efficacy of ASPs, high-quality studies using standardized surveillance methodology for antimicrobial consumption and similar metrics for outcome measurement are needed to further promote antimicrobial stewardship in this region. © The Author 2017. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail: journals.permissions@oup.com.

Isolation and characterization of pigmented bacteria showing antimicrobial activity from Malaysian marine environment

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Ahmad, A.

2013-01-01

Full Text Available Aims: Natural products play a prominent role in the discovery of leads for the development of drugs in the treatment ofhuman diseases. Much of nature remains to be explored, especially marine and microbial environments.Methodology and results: Fifty-five pigmented marine bacteria were isolated from sponges, seawater, mangrovesediment, sea cucumber and mussel from different coastal area of Malaysia. The antimicrobial activities of thesebacteria were investigated by disk diffusion method against pathogenic bacteria. Out of 55 isolates, 18 isolates exhibitedantimicrobial activity, which based on morphological characterization, 53% of them were Gram positive and 47% wereGram negative. All active isolates were able to tolerate more than 4% NaCl in the nutrient agar medium that indicatedthey were autochthonous to marine environment and moderate salt tolerant in nature. Molecular identification of isolatesby the strong antimicrobial activities indicates that isolates WPRA3 (JX020764 and SM11-3j belong to genus Serratiaand isolate SDPM1 (JQ083392 belongs to genus Zooshikella.Conclusion, significance and impact of study: The results of present study revealed that the active isolates arepotential producer of antimicrobial secondary metabolites and might be utilized as drug candidate.

Antimicrobial constituents of peel and seeds of camu-camu (Myrciaria dubia).

Science.gov (United States)

Kaneshima, Tai; Myoda, Takao; Toeda, Kazuki; Fujimori, Takane; Nishizawa, Makoto

2017-08-01

Various antimicrobial constituents of camu-camu fruit were isolated. Acylphloroglucinol (compound 1) and rhodomyrtone (compound 2) were isolated from the peel of camu-camu (Myrciaria dubia) fruit, while two other acylphloroglucinols (compounds 3 and 4) were obtained from camu-camu seeds. The structures of the isolated compounds were characterized by spectrophotometric methods. Compounds 1 and 4 were confirmed to be new acylphloroglucinols with different substituents at the C7 or C9 position of 2, and were named myrciarone A and B, respectively. Compound 3 was determined to be isomyrtucommulone B. This is the first report of the isolation of 3 from a natural resource. The antimicrobial activities of compounds 1, 3, and 4 were similar to those of 2, and the minimum inhibitory concentrations were either similar to or lower than that of kanamycin. These results suggest that the peel and seeds of camu-camu fruit could be utilized for therapeutic applications.

Risk assessment of antimicrobial usage in Danish pig production on the human exposure to antimicrobial resistant bacteria from pork

DEFF Research Database (Denmark)

Struve, Tina

to antimicrobials are influenced by the use of antimicrobial agents, and the prudence of antimicrobial use have been emphasized since the Swann report in 1969 recommended that antibiotics used in human medicine should not be used as growth promoters in food-producing animals. In 2007, the World Health Organisation...... the human exposure to cephalosporin resistance from pork purchased in retail shops was assessed using different scenarios for the amount of antimicrobial used in the primary production. Also, farm-related factors affecting the antimicrobial usage were investigated as a part of this thesis. The thesis...... producing E. coli through the purchase of pork chops Objective 3: Identification of management factors in the Danish finishing pig production important for antimicrobial usage In Objective 1, the occurrence (presence/non-presence) of ESC producing E. coli in samples from healthy pigs at slaughter...

Antimicrobial resistance mechanisms among Campylobacter.

Science.gov (United States)

Wieczorek, Kinga; Osek, Jacek

2013-01-01

Campylobacter jejuni and Campylobacter coli are recognized as the most common causative agents of bacterial gastroenteritis in the world. Humans most often become infected by ingesting contaminated food, especially undercooked chicken, but also other sources of bacteria have been described. Campylobacteriosis is normally a self-limiting disease. Antimicrobial treatment is needed only in patients with more severe disease and in those who are immunologically compromised. The most common antimicrobial agents used in the treatment of Campylobacter infections are macrolides, such as erythromycin, and fluoroquinolones, such as ciprofloxacin. Tetracyclines have been suggested as an alternative choice in the treatment of clinical campylobacteriosis but in practice are not often used. However, during the past few decades an increasing number of resistant Campylobacter isolates have developed resistance to fluoroquinolones and other antimicrobials such as macrolides, aminoglycosides, and beta-lactams. Trends in antimicrobial resistance have shown a clear correlation between use of antibiotics in the veterinary medicine and animal production and resistant isolates of Campylobacter in humans. In this review, the patterns of emerging resistance to the antimicrobial agents useful in treatment of the disease are presented and the mechanisms of resistance to these drugs in Campylobacter are discussed.

Variables Influencing the Return on Investment in Management Training Programs: A Utility Analysis of 10 Swiss Cases

Science.gov (United States)

Chochard, Yves; Davoine, Eric

2011-01-01

In this article, we present the utility analysis approach as an alternative and promising approach to measure the return on investment in managerial training programs. This approach, linking economic value with competencies developed by trainees, enables researchers and decision-makers to compare the return on investment from different programs in…

Comparative evaluation of antimicrobials for textile applications.

Science.gov (United States)

Windler, Lena; Height, Murray; Nowack, Bernd

2013-03-01

Many antimicrobial technologies are available for textiles. They may be used in many different textile applications to prevent the growth of microorganisms. Due to the biological activity of the antimicrobial compounds, the assessment of the safety of these substances is an ongoing subject of research and regulatory scrutiny. This review aims to give an overview on the main compounds used today for antimicrobial textile functionalization. Based on an evaluation of scientific publications, market data as well as regulatory documents, the potential effects of antimicrobials on the environment and on human health were considered and also life cycle perspectives were taken into account. The characteristics of each compound were summarized according to technical, environmental and human health criteria. Triclosan, silane quaternary ammonium compounds, zinc pyrithione and silver-based compounds are the main antimicrobials used in textiles. The synthetic organic compounds dominate the antimicrobials market on a weight basis. On the technical side the application rates of the antimicrobials used to functionalize a textile product are an important parameter with treatments requiring lower dosage rates offering clear benefits in terms of less active substance required to achieve the functionality. The durability of the antimicrobial treatment has a strong influence on the potential for release and subsequent environmental effects. In terms of environmental criteria, all compounds were rated similarly in effective removal in wastewater treatment processes. The extent of published information about environmental behavior for each compound varies, limiting the possibility for an in-depth comparison of all textile-relevant parameters across the antimicrobials. Nevertheless the comparative evaluation showed that each antimicrobial technology has specific risks and benefits that should be taken into account in evaluating the suitability of different antimicrobial products. The

Novel Formulations for Antimicrobial Peptides

Directory of Open Access Journals (Sweden)

Ana Maria Carmona-Ribeiro

2014-10-01

Full Text Available Peptides in general hold much promise as a major ingredient in novel supramolecular assemblies. They may become essential in vaccine design, antimicrobial chemotherapy, cancer immunotherapy, food preservation, organs transplants, design of novel materials for dentistry, formulations against diabetes and other important strategical applications. This review discusses how novel formulations may improve the therapeutic index of antimicrobial peptides by protecting their activity and improving their bioavailability. The diversity of novel formulations using lipids, liposomes, nanoparticles, polymers, micelles, etc., within the limits of nanotechnology may also provide novel applications going beyond antimicrobial chemotherapy.

Novel Formulations for Antimicrobial Peptides

Science.gov (United States)

Carmona-Ribeiro, Ana Maria; Carrasco, Letícia Dias de Melo

2014-01-01

Peptides in general hold much promise as a major ingredient in novel supramolecular assemblies. They may become essential in vaccine design, antimicrobial chemotherapy, cancer immunotherapy, food preservation, organs transplants, design of novel materials for dentistry, formulations against diabetes and other important strategical applications. This review discusses how novel formulations may improve the therapeutic index of antimicrobial peptides by protecting their activity and improving their bioavailability. The diversity of novel formulations using lipids, liposomes, nanoparticles, polymers, micelles, etc., within the limits of nanotechnology may also provide novel applications going beyond antimicrobial chemotherapy. PMID:25302615

Antimicrobial stewardship: Limits for implementation

NARCIS (Netherlands)

Sinha, Bhanu

2014-01-01

Antibiotic stewardship programme (ASP) is a multifaceted approach to improve patients' clinical outcomes, prevent the emergence of antimicrobial resistance, and reduce hospital costs by prudent and focused antimicrobial use. Development of local treatment guidelines according to local ecology, rapid

Utilization of carbohydrates by radiation processing

International Nuclear Information System (INIS)

Kume, T.; Nagasawa, N.; Yoshii, F.

2002-01-01

Upgrading and utilization of carbohydrates such as chitosan, sodium alginate, carrageenan, cellulose, pectin have been investigated for recycling these bio-resources and reducing the environmental pollution. These carbohydrates were easily degraded by irradiation and various kinds of biological activities such as anti-microbial activity, promotion of plant growth, suppression of heavy metal stress, phytoalexins induction, etc. were induced. On the other hand, some carbohydrate derivatives, carboxymethylcellulose and carboxymethylstarch, could be crosslinked under certain radiation condition and produce the biodegradable hydrogel for medical and agricultural use

A Cost-Utility Analysis of 5 Strategies for the Management of Acute Otitis Media in Children.

Science.gov (United States)

Shaikh, Nader; Dando, Emily E; Dunleavy, Mark L; Curran, Dorothy L; Martin, Judith M; Hoberman, Alejandro; Smith, Kenneth J

2017-10-01

To assess whether antimicrobial therapy in young children with acute otitis media reduces time to resolution of symptoms, overall symptom burden, and persistence of otoscopic evidence of infection. We used a cost-utility model to evaluate whether immediate antimicrobial treatment seems to be worthwhile, and if so, which antimicrobial agent is most cost effective. We compared the cost per quality-adjusted life-day of 5 treatment regimens in children younger than 2 years of age with acute otitis media: immediate amoxicillin/clavulanate, immediate amoxicillin, immediate cefdinir, watchful waiting, and delayed prescription (DP) for antibiotic. The 5 treatment regimens, listed in order from least effective to most effective were DP, watchful waiting, immediate cefdinir, immediate amoxicillin, and immediate amoxicillin/clavulanate. Listed in order from least costly to most costly, the regimens were DP, immediate amoxicillin, watchful waiting, immediate amoxicillin/clavulanate, and immediate cefdinir. The incremental cost-utility ratio of immediate amoxicillin compared with DP was $101.07 per quality-adjusted life-day gained. The incremental cost-utility ratio of immediate amoxicillin/clavulanate compared with amoxicillin was $2331.28 per quality-adjusted life-day gained. In children younger than 2 years of age with acute otitis media and no recent antibiotic exposure, immediate amoxicillin seems to be the most cost-effective initial treatment. Copyright © 2017 Elsevier Inc. All rights reserved.

Antimicrobial Agents Used in Endodontic Treatment

Directory of Open Access Journals (Sweden)

Marina George Kudiyirickal

2008-01-01

Full Text Available Biomechanical preparation alone does not completely eradicate microorganisms from the root canal, hence the next logical step is to perform root canal procedures in conjunction with antimicrobials. The use of an antimicrobial agent improves the efficacy and prognosis of endodontic treatment. This review enumerates the most widely used antimicrobial agents, their mechanism of action and their potential use in reducing the microbial load.

Antimicrobial polymer films for food packaging

Science.gov (United States)

Concilio, S.; Piotto, S.; Sessa, L.; Iannelli, P.; Porta, A.; Calabrese, E. C.; Galdi, M. R.; Incarnato, L.

2012-07-01

New antimicrobial polymeric systems were realized introducing new antimicrobial azo compounds in PP and LDPE matrices. The polymeric materials containing different percentage of azo compounds were mold-casted and the obtained film were tested in vitro against Gram+ and Gram- bacteria and fungi. These results hold promise for the fabrication of bacteria-resistant polymer films by means of simple melt processing with antimicrobial azo-dyes.

Preventing maritime transport of pathogens: the remarkable antimicrobial properties of silver-supported catalysts for ship ballast water disinfection.

Science.gov (United States)

Theologides, C P; Theofilou, S P; Anayiotos, A; Costa, C N

2017-07-01

Ship ballast water (SBW) antimicrobial treatment is considered as a priority issue for the shipping industry. The present work investigates the possibility of utilizing antimicrobial catalysis as an effective method for the treatment of SBW. Taking into account the well-known antimicrobial properties of ionic silver (Ag + ), five silver-supported catalysts (Ag/γ-Al 2 O 3 ) with various loadings (0.05, 0.1, 0.2, 0.5, and 1 wt%) were prepared and examined for the antimicrobial treatment of SBW. The bactericidal activity of the aforementioned catalysts was investigated towards the inhibition of Escherichia coli (Gram-negative) and Escherichia faecalis (Gram-positive) bacteria. Catalytic experiments were conducted in a three-phase continuous flow stirred tank reactor, used in a semi-batch mode. It was found that using the catalyst with the lowest metal loading, the inhibition of E. coli reached 95.8% after 30 minutes of treatment of an E. coli bacterial solution, while the inhibition obtained for E. faecalis was 76.2% after 60 minutes of treatment of an E. faecalis bacterial solution. Even better results (100% inhibition after 5 min of reaction) were obtained using the catalysts with higher Ag loadings. The results of the present work indicate that the prepared monometallic catalysts exert their antimicrobial activity within a short period of time, revealing, for the first time ever, that the field of antimicrobial heterogeneous catalysis using deposited ionic silver on a solid support may prove decisive for the disinfection of SBW.

[Consensus for antimicrobial susceptibility testing for Enterobacteriaceae. Subcommittee on Antimicrobials, SADEBAC (Argentinian Society of Clinical Bacteriology), Argentinian Association of Microbiology].

Science.gov (United States)

Famiglietti, A; Quinteros, M; Vázquez, M; Marín, M; Nicola, F; Radice, M; Galas, M; Pasterán, F; Bantar, C; Casellas, J M; Kovensky Pupko, J; Couto, E; Goldberg, M; Lopardo, H; Gutkind, G; Soloaga, R

2005-01-01

Taking into account previous recommendations from the National Committee for Clinical Laboratory Standards (NCCLS), the Antimicrobial Committee, Sociedad Argentina de Bacteriología Clínica (SADEBAC), Asociación Argentina de Microbiología (AAM), and the experience from its members and some invited microbiologists, a consensus was obtained for antimicrobial susceptibility testing and interpretation in most frequent enterobacterial species isolated from clinical samples in our region. This document describes the natural antimicrobial resistance of some Enterobacteriaceae family members, including the resistance profiles due to their own chromosomal encoded beta-lactamases. A list of the antimicrobial agents that should be tested, their position on the agar plates, in order to detect the most frequent antimicrobial resistance mechanisms, and considerations on which antimicrobial agents should be reported regarding to the infection site and patient characteristics are included. Also, a description on appropriate phenotypic screening and confirmatory test for detection of prevalent extended spectrum beta-lactamases in our region are presented. Finally, a summary on frequent antimicrobial susceptibility profiles and their probably associated resistance mechanisms, and some infrequent antimicrobial resistance profiles that deserve confirmation are outlined.

Dynamics of a Successful Planned Giving Program Utilizing Shared Leadership at Historically Black Colleges and Universities (HBCUs)

Science.gov (United States)

Baldwin, Robin Lynn Brunty

2013-01-01

The purpose of this study was to evaluate the dynamics of a successful planned giving program utilizing shared leadership at Historically Black Colleges and Universities (HBCUs). This information will assist the leadership in determining if and how a successful planned giving program can be established for HBCUs. It is possible for planned gifts…

The Effect of Persuasion on the Utilization of Program Evaluation Information: A Preliminary Study.

Science.gov (United States)

Eason, Sandra H.; Thompson, Bruce

The utilization of program evaluation may be made more effective by means of the application of contemporary persuasion theory. The Elaboration Likelihood Model--a model of cognitive processing, ability, and motivation--was used in this study to test the persuasive effects of source credibility and involvement on message acceptance of evaluation…

Antimicrobial Usage and Antimicrobial Resistance in Animal Production in Southeast Asia: A Review

Directory of Open Access Journals (Sweden)

Nguyen T. Nhung

2016-11-01

Full Text Available Southeast Asia is an area of great economic dynamism. In recent years, it has experienced a rapid rise in the levels of animal product production and consumption. The region is considered to be a hotspot for infectious diseases and antimicrobial resistance (AMR. We reviewed English-language peer-reviewed publications related to antimicrobial usage (AMU and AMR in animal production, as well as antimicrobial residues in meat and fish from 2000 to 2016, in the region. There is a paucity of data from most countries and for most bacterial pathogens. Most of the published work relates to non-typhoidal Salmonella (NTS, Escherichia coli (E. coli, and Campylobacter spp. (mainly from Vietnam and Thailand, Enterococcus spp. (Malaysia, and methicillin-resistant Staphylococcus aureus (MRSA (Thailand. However, most studies used the disk diffusion method for antimicrobial susceptibility testing; breakpoints were interpreted using Clinical Standard Laboratory Institute (CSLI guidelines. Statistical models integrating data from publications on AMR in NTS and E. coli studies show a higher overall prevalence of AMR in pig isolates, and an increase in levels of AMR over the years. AMU studies (mostly from Vietnam indicate very high usage levels of most types of antimicrobials, including beta-lactams, aminoglycosides, macrolides, and quinolones. This review summarizes information about genetic determinants of resistance, most of which are transferrable (mostly plasmids and integrons. The data in this review provide a benchmark to help focus research and policies on AMU and AMR in the region.

Membrane interactions and antimicrobial effects of inorganic nanoparticles

DEFF Research Database (Denmark)

Malekkhaiat Häffner, Sara; Malmsten, Martin

2017-01-01

Interactions between nanoparticles and biological membranes are attracting increasing attention in current nanomedicine, and play a key role both for nanotoxicology and for utilizing nanomaterials in diagnostics, drug delivery, functional biomaterials, as well as combinations of these, e.g., in t......Interactions between nanoparticles and biological membranes are attracting increasing attention in current nanomedicine, and play a key role both for nanotoxicology and for utilizing nanomaterials in diagnostics, drug delivery, functional biomaterials, as well as combinations of these, e.......g., in theranostics. In addition, there is considerable current interest in the use of nanomaterials as antimicrobial agents, motivated by increasing resistance development against conventional antibiotics. Here, various nanomaterials offer opportunities for triggered functionalites to combat challenging infections....... Although the performance in these diverse applications is governed by a complex interplay between the nanomaterial, the properties of included drugs (if any), and the biological system, nanoparticle-membrane interactions constitute a key initial step and play a key role for the subsequent biological...

ANTIMICROBIALS USED IN ACTIVE PACKAGING FILMS

OpenAIRE

Dıblan, Sevgin; Kaya, Sevim

2017-01-01

Active packaging technology is one of the innovativemethods for preserving of food products, and antimicrobial packaging films is amajor branch and promising application of this technology. In order to controlmicrobial spoilage and also contamination of pathogen onto processed or fresh food,antimicrobial agent(s) is/are incorporated into food packaging structure.Polymer type as a carrier of antimicrobial can be petroleum-based plastic orbiopolymer: because of environmental concerns researcher...

Production of Antimicrobial Agent by Streptomyces violachromogenes

International Nuclear Information System (INIS)

Ahmed, Arwa A.

2007-01-01

The isolation of antibiotics from microorganisms improved the discovery of novel antibiotics, which is relatively easy as compared to chemical synthesis of antimicrobial agents. This study starts from isolation and purification of the antimicrobial producing Sterptomycetes obtained from soil habitat of Yemen. The good antimicrobial producing Sterptomycetes isolate was selected from a batch of Sterptomycetes isolates then identified. This isolate has bioactivity against some G+ve and G-ve bacteria. The antimicrobial agent isolated from Streptomyces violachromogenes (isolate no.YA118) was extracted with ethyl acetate at pH 3. The residue was applied to a silica gel column chromatography and eluted stepwise with many solvent systems. The active fractions were tested with B. subtilis NCTC10400. The purification of the antibiotic has been carried out by thin layer chromatography then the physical and chemical properties were studied to identify the antimicrobial agent. The isolated antimicrobial agent is an antibiotic belonging to the neomycin group. (author)

Paramedical staffs knowledge and attitudes towards antimicrobial resistance in Dire Dawa, Ethiopia: a cross sectional study.

Science.gov (United States)

Tafa, Belay; Endale, Adugna; Bekele, Desalegn

2017-09-19

of paramedical staffs about antimicrobial resistance, it identified areas of misconceptions and specific groups to be targeted for educational interventions regarding antimicrobial resistance. It is, therefore, suggested that a well-planned, organized and structured training programs should be undertaken to improve the appropriate use of antibiotics.

Antimicrobial drug resistance of Escherichia coli isolated from poultry abattoir workers at risk and broilers on antimicrobials

Directory of Open Access Journals (Sweden)

J.W. Oguttu

2008-05-01

Full Text Available Antimicrobial usage in food animals increases the prevalence of antimicrobial drug resistance among their enteric bacteria. It has been suggested that this resistance can in turn be transferred to people working with such animals, e.g. abattoir workers. Antimicrobial drug resistance was investigated for Escherichia coli from broilers raised on feed supplemented with antimicrobials, and the people who carry out evisceration, washing and packing of intestines in a high-throughput poultry abattoir in Gauteng, South Africa. Broiler carcasses were sampled from 6 farms, on each of which broilers are produced in a separate 'grow-out cycle'. Per farm, 100 caeca were randomly collected 5 minutes after slaughter and the contents of each were selectively cultured for E. coli. The minimum inhibitory concentration (MIC of each isolate was determined for the following antimicrobials : doxycycline, trimethoprim, sulphamethoxazole, ampicillin, enrofloxacin, fosfomycin, ceftriaxone and nalidixic acid. The same was determined for the faeces of 29 abattoir workers and 28 persons used as controls. The majority of isolates from broilers were resistant, especially to antimicrobials that were used on the farms in the study. Overall median MICs and the number of resistant isolates from abattoir workers (packers plus eviscerators tended to be higher than for the control group. However, no statistically significant differences were observed when the median MICs of antimicrobials used regularly in poultry and percentage resistance were compared, nor could an association between resistance among the enteric E. coli from packers and those from broilers be demonstrated.

Project selection problem under uncertainty: An application of utility theory and chance constrained programming to a real case

Directory of Open Access Journals (Sweden)

Reza Hosnavi Atashgah

2013-06-01

Full Text Available Selecting from a pool of interdependent projects under certainty, when faced with resource constraints, has been studied well in the literature of project selection problem. After briefly reviewing and discussing popular modeling approaches for dealing with uncertainty, this paper proposes an approach based on chance constrained programming and utility theory for a certain range of problems and under some practical assumptions. Expected Utility Programming, as the proposed modeling approach, will be compared with other well-known methods and its meaningfulness and usefulness will be illustrated via two numerical examples and one real case.

New Mexico state information handbook: formerly utilized sites remedial action program

Energy Technology Data Exchange (ETDEWEB)

None

2014-12-31

This volume is one of a series produced under contract with the DOE, by Politech Corporation to develop a legislative and regulatory data base to assist the FUSRAP management in addressing the institutional and socioeconomic issues involved in carrying out the Formerly Utilized Sites Remedial Action Program. This information Handbook series contains information about all relevant government agencies at the Federal and state levels, the pertinent programs they administer, each affected state legislature, and current Federal and state legislative and regulatory initiatives. This volume is a compilation of information about the State of New Mexico. It contains a description of the state executive branch structure; a summary of relevant state statutes and regulations; a description of the structure of the state legislature, identification of the officers and committee chairmen, and a summary of recent relevant legislative action; and the full text of relevant statutes and regulations.

New York state information handbook formerly utilized sites remedial action program

International Nuclear Information System (INIS)