WorldWideScience

Sample records for resistant communities accounted

  1. A Narrative Account of a Teacher Community

    Science.gov (United States)

    Moate, Josephine

    2014-01-01

    This narrative account draws on dialogic approaches to education to critically reflect on teachers' expressed pedagogic thinking in community. The context for the study is a teacher community in Central Finland comprising teachers from pre-primary to upper secondary contexts. The shared interest of the community is in the foreign-language…

  2. Accountability in Community Colleges Using Stakeholder Theory

    Science.gov (United States)

    Pitcher, Paula R.

    2012-01-01

    The purpose of the present study is to analyze stakeholder theory and its applicability to community college accountability. Community colleges have been using strategic planning as a management approach that includes the process of strategic action, and many organizations claim that they collaborate with their stakeholders during this process.…

  3. Autonomy and Accountability in Schools Serving Disadvantaged Communities

    Science.gov (United States)

    Klein, Esther Dominique

    2017-01-01

    Purpose: Increased school autonomy and accountability have been a common denominator of national reforms in otherwise heterogeneous governance systems in Europe and the USA. The paper argues that because schools serving disadvantaged communities (SSDCs) often have lower average performance, they are more often sanctioned or under closer scrutiny,…

  4. Seeking Accountability: Multi-Service Accountability Agreements (MSAAs in Ontario’s Community Support Sector

    Directory of Open Access Journals (Sweden)

    Carolyn Steele Gray

    2014-02-01

    Full Text Available Multi-Service Accountability Agreements (MSAAs have been put in place to hold Community Sector Service (CSS agencies to account for services receiving public funding in Ontario. The MSAA seeks to support financial and performance accountability, requiring CSS agencies to report on their performance quarterly. The MSAA is an expenditure policy tool that has undergone several iterations, each informed by negotiations between the Ontario Ministry of Health and Long-Term Care (MOHLTC, the province’s regional authorities—known as Local Health Integration Networks (LHINs—and organizations/associations representing CSS agency interests. This approach to accountability is consistent with a broader focus on the government role as ‘steering’ service delivery rather than ‘rowing.’ The MSAA offers a standardized, politically acceptable approach to accountability. However, the MSAA relies heavily on performance indicators that may not adequately reflect quality care. The MSAA exemplifies the tension between the need for strong standardized accountability requirements for publicly-funded health service providers and the need for services that meet the needs of their communities.

  5. Community Resilience and Resistance in Regulated Rivers.

    Science.gov (United States)

    Noel, L.; Culp, J. M.

    2005-05-01

    Across diverse ecosystems, environmental factors such as nutrient loading have been shown to induce changes in state and reduce ecosystem resilience. Riverine communities are under increasing pressures from nutrient loading and fragmentation and it is unknown how these pressures will affect community resistance and resilience. This study focuses on determining 1) if nutrient loading and regulation change the resilience and resistance of rivers to further disturbances (floods); and 2) how particular community features create resilience and resistance. Along nutrient and algal biomass gradients in regulated and unregulated reaches of the Saint John River, Canada, community resilience (system capacity to return to its original state post disturbance) is examined both temporally and spatially. Resistance (ability to resist change) is measured by the nutrient concentration at which a change in ecological state occurs. State includes both community structure (species abundance and diversity of benthic algae and invertebrates) and community function (photosynthesis to respiration ratio). To determine how community features create resilience, trophic decoupling and food web connectance are examined along nutrient and physical disturbance gradients by comparing food webs constructed from stable isotope and biomass information. Because decreased resilience is linked with state shifts, strategies for sustainable ecosystem management should focus on maintaining resilience.

  6. The electric commons: A qualitative study of community accountability

    International Nuclear Information System (INIS)

    Melville, Emilia; Christie, Ian; Burningham, Kate; Way, Celia; Hampshire, Phil

    2017-01-01

    This study explores how energy might be conceptualised as a commons, a resource owned and managed by a community with a system of rules for production and consumption. It tests one aspect of Elinor Ostrom's design principles for successful management of common pool resources: that there should be community accountability for individual consumption behaviour. This is explored through interviews with participants in a community demand response (DR) trial in an urban neighbourhood in the UK. Domestic DR can make a contribution to balancing electricity supply and demand. This relies on smart meters, which raise vertical (individual to large organisation) privacy concerns. Community and local approaches could motivate greater levels of DR than price signals alone. We found that acting as part of a community is motivating, a conclusion which supports local and community based roll out of smart meters. Mutually supportive, voluntary, and anonymous sharing of information was welcomed. However, mutual monitoring was seen as an invasion of horizontal (peer to peer) privacy. We conclude that the research agenda, which asks whether local commons-based governance of electricity systems could provide social and environmental benefits, is worth pursuing further. This needs a shift in regulatory barriers and ‘governance-system neutral’ innovation funding. - Highlights: • Commons framings can offer a new perspective on community based demand response. • Community accountability of users raises concerns about horizontal (within community) privacy. • Horizontal privacy is important to individuals, and should be protected. • Supportive sharing of information is welcomed. • Energy policy should enable institutional innovation including local commons based approaches.

  7. Mechanisms accounting for fluoroquinolone resistance in Escherichia coli clinical isolates.

    Science.gov (United States)

    Morgan-Linnell, Sonia K; Becnel Boyd, Lauren; Steffen, David; Zechiedrich, Lynn

    2009-01-01

    Fluoroquinolone MICs are increased through the acquisition of chromosomal mutations in the genes encoding gyrase (gyrA and gyrB) and topoisomerase IV (parC and parE), increased levels of the multidrug efflux pump AcrAB, and the plasmid-borne genes aac(6')-Ib-cr and the qnr variants in Escherichia coli. In the accompanying report, we found that ciprofloxacin, gatifloxacin, levofloxacin, and norfloxacin MICs for fluoroquinolone-resistant E. coli clinical isolates were very high and widely varied (L. Becnel Boyd, M. J. Maynard, S. K. Morgan-Linnell, L. B. Horton, R. Sucgang, R. J. Hamill, J. Rojo Jimenez, J. Versalovic, D. Steffen, and L. Zechiedrich, Antimicrob. Agents Chemother. 53:229-234, 2009). Here, we sequenced gyrA, gyrB, parC, and parE; screened for aac(6')-Ib-cr and qnrA; and quantified AcrA levels in E. coli isolates for which patient sex, age, location, and site of infection were known. We found that (i) all fluoroquinolone-resistant isolates had gyrA mutations; (ii) approximately 85% of gyrA mutants also had parC mutations; (iii) the ciprofloxacin and norfloxacin MICs for isolates harboring aac(6')-Ib-cr ( approximately 23%) were significantly higher, but the gatifloxacin and levofloxacin MICs were not; (iv) no isolate had qnrA; and (v) approximately 33% of the fluoroquinolone-resistant isolates had increased AcrA levels. Increased AcrA correlated with nonsusceptibility to the fluoroquinolones but did not correlate with nonsusceptibility to any other antimicrobial agents reported from hospital antibiograms. Known mechanisms accounted for the fluoroquinolone MICs of 50 to 70% of the isolates; the remaining included isolates for which the MICs were up to 1,500-fold higher than expected. Thus, additional, unknown fluoroquinolone resistance mechanisms must be present in some clinical isolates.

  8. Mechanisms Accounting for Fluoroquinolone Resistance in Escherichia coli Clinical Isolates▿

    Science.gov (United States)

    Morgan-Linnell, Sonia K.; Becnel Boyd, Lauren; Steffen, David; Zechiedrich, Lynn

    2009-01-01

    Fluoroquinolone MICs are increased through the acquisition of chromosomal mutations in the genes encoding gyrase (gyrA and gyrB) and topoisomerase IV (parC and parE), increased levels of the multidrug efflux pump AcrAB, and the plasmid-borne genes aac(6′)-Ib-cr and the qnr variants in Escherichia coli. In the accompanying report, we found that ciprofloxacin, gatifloxacin, levofloxacin, and norfloxacin MICs for fluoroquinolone-resistant E. coli clinical isolates were very high and widely varied (L. Becnel Boyd, M. J. Maynard, S. K. Morgan-Linnell, L. B. Horton, R. Sucgang, R. J. Hamill, J. Rojo Jimenez, J. Versalovic, D. Steffen, and L. Zechiedrich, Antimicrob. Agents Chemother. 53:229-234, 2009). Here, we sequenced gyrA, gyrB, parC, and parE; screened for aac(6′)-Ib-cr and qnrA; and quantified AcrA levels in E. coli isolates for which patient sex, age, location, and site of infection were known. We found that (i) all fluoroquinolone-resistant isolates had gyrA mutations; (ii) ∼85% of gyrA mutants also had parC mutations; (iii) the ciprofloxacin and norfloxacin MICs for isolates harboring aac(6′)-Ib-cr (∼23%) were significantly higher, but the gatifloxacin and levofloxacin MICs were not; (iv) no isolate had qnrA; and (v) ∼33% of the fluoroquinolone-resistant isolates had increased AcrA levels. Increased AcrA correlated with nonsusceptibility to the fluoroquinolones but did not correlate with nonsusceptibility to any other antimicrobial agents reported from hospital antibiograms. Known mechanisms accounted for the fluoroquinolone MICs of 50 to 70% of the isolates; the remaining included isolates for which the MICs were up to 1,500-fold higher than expected. Thus, additional, unknown fluoroquinolone resistance mechanisms must be present in some clinical isolates. PMID:18838592

  9. Fundamentals of microbial community resistance and resilience

    Directory of Open Access Journals (Sweden)

    Ashley eShade

    2012-12-01

    Full Text Available Microbial communities are at the heart of all ecosystems, and yet microbial community behavior in disturbed environments remains difficult to measure and predict. Understanding the drivers of microbial community stability, including resistance (insensitivity to disturbance and resilience (the rate of recovery after disturbance is important for predicting community response to disturbance. Here, we provide an overview of the concepts of stability that are relevant for microbial communities. First, we highlight insights from ecology that are useful for defining and measuring stability. To determine whether general disturbance responses exist for microbial communities, we next examine representative studies from the literature that investigated community responses to press (long-term and pulse (short-term disturbances in a variety of habitats. Then we discuss the biological features of individual microorganisms, of microbial populations, and of microbial communities that may govern overall community stability. We conclude with thoughts about the unique insights that systems perspectives - informed by meta-omics data- may provide about microbial community stability.

  10. Accounting for Incomplete Species Detection in Fish Community Monitoring

    Energy Technology Data Exchange (ETDEWEB)

    McManamay, Ryan A [ORNL; Orth, Dr. Donald J [Virginia Polytechnic Institute and State University; Jager, Yetta [ORNL

    2013-01-01

    Riverine fish assemblages are heterogeneous and very difficult to characterize with a one-size-fits-all approach to sampling. Furthermore, detecting changes in fish assemblages over time requires accounting for variation in sampling designs. We present a modeling approach that permits heterogeneous sampling by accounting for site and sampling covariates (including method) in a model-based framework for estimation (versus a sampling-based framework). We snorkeled during three surveys and electrofished during a single survey in suite of delineated habitats stratified by reach types. We developed single-species occupancy models to determine covariates influencing patch occupancy and species detection probabilities whereas community occupancy models estimated species richness in light of incomplete detections. For most species, information-theoretic criteria showed higher support for models that included patch size and reach as covariates of occupancy. In addition, models including patch size and sampling method as covariates of detection probabilities also had higher support. Detection probability estimates for snorkeling surveys were higher for larger non-benthic species whereas electrofishing was more effective at detecting smaller benthic species. The number of sites and sampling occasions required to accurately estimate occupancy varied among fish species. For rare benthic species, our results suggested that higher number of occasions, and especially the addition of electrofishing, may be required to improve detection probabilities and obtain accurate occupancy estimates. Community models suggested that richness was 41% higher than the number of species actually observed and the addition of an electrofishing survey increased estimated richness by 13%. These results can be useful to future fish assemblage monitoring efforts by informing sampling designs, such as site selection (e.g. stratifying based on patch size) and determining effort required (e.g. number of

  11. Accounting for youth audiences' resistances to HIV and AIDS ...

    African Journals Online (AJOL)

    Results from the study show that HIV and AIDS messages in Tsha Tsha face substantial resistances from situated youth viewers whose social contexts of consumption, shared identities, quotidian experiences and subjectivities, provide critical lines along which the E-E text is often resisted and inflected. These findings do ...

  12. Ohmic resistance affects microbial community and ...

    Science.gov (United States)

    Multi-anode microbial electrochemical cells (MXCs) are considered as one of the most promising configurations for scale-up of MXCs, but fundamental understanding of anode kinetics governing current density is limited in the MXCs. In this study we first assessed microbial community and electrochemical kinetic parameters for biofilms on individual anodes in a multi-anode MXC to better comprehend anode fundamentals. Microbial community analysis using 16S rRNA illumine sequencing showed that Geobactor genus, one of the most kinetically efficient anode-respiring bacteria (ARB), was abundant (87%) only on the biofilm anode closest to a reference electrode in which current density was the highest among four anodes. In comparison, Geobacter populations were less than 11% for other three anodes more distant from the reference electrode, generating small current density. Half-saturation anode potential (EKA) was the lowest at -0.251 to -0.242 V (vs. standard hydrogen electrode) for the closest anode, while EKA was as high as -0.134 V for the farthest anode. Our study clearly proves that ohmic resistance changes anode potential which mainly causes different biofilm communities on individual anodes and consequently influences anode kinetics. This study explored the use of multiple anodes in microelectrochemical cells and the microbial community on these anodes, as a function of the efficiency in producing hydrogen peroxide.

  13. Analysis of the Factors Affecting Resistance to Changes in Management Accounting Systems

    OpenAIRE

    Rodrigo Angonese; Carlos Eduardo Facin Lavarda

    2014-01-01

    Despite changes in the environment and management accounting practices, studies indicate that management accounting systems do not change or change at a much slower rate than expected. The stability of the management accounting systems used by companies may relate to resistance to changing these systems. This study analyzes the factors that contribute to resistance to implementing an integrated management system from the perspective of institutional theory, grounded in the old institutional e...

  14. Accounting for youth audiences' resistances to HIV and AIDS ...

    African Journals Online (AJOL)

    Blessing Makwambeni

    2018-03-06

    Mar 6, 2018 ... Very few studies have sought to investigate and understand why a substantial number of targeted audiences resist the preferred readings that are encoded into E-E interventions on HIV and AIDS. Using cultural studies as its conceptual framework and reception analysis as its methodology, this study.

  15. Accounting Community of Practice Pedagogy: A Course Management Invention for Developing Personal Competencies in Accounting Education

    Science.gov (United States)

    Stephenson, Sandria S.

    2017-01-01

    This paper reports the findings of an exploratory qualitative study using the implementation of Wenger's [(1998). "Communities of practice: Learning, meaning, and identity." Cambridge, MA: Cambridge University Press; Wenger, E. (2000). Communities of practice and social learning systems. "Organization," 7(2), 225-246] Theory of…

  16. Promoting Greater Community Benefit and Accountability in Large ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    They will use the findings as a barometer to assess whether processes governing large-scale land acquisitions are legitimate and accountable. They will also conduct interviews with public officials, investors, and other stakeholders. The research will target two regions in Kenya. Siaya County has granted a 25-year lease to ...

  17. An Accounting System for Solid Waste Management in Small Communities.

    Science.gov (United States)

    Zausner, Eric R.

    This pamphlet provides a guide to the type and quantity of information to be collected for effective solid waste management in small communities. It is directed at municipal or private personnel involved in the operation and ownership of management facilities. Sample activity reports are included for reference. (CS)

  18. Is the Learning Community of Economics and Accounting Effective? Empirical Assessment of Class Achievements

    Science.gov (United States)

    Stumph, Carolyn Fabian; Kim, Myeong Hwan; Han, Yongseung; Minke, Susan

    2017-01-01

    Learning communities are increasingly used at colleges and universities, as one of the goals of a learning community is to increase interaction among students and teach them how to apply knowledge. The goal of this research is to assess the learning community of the economics and accounting students in their class performance measured by class…

  19. The social accountability of doctors: a relationship based framework for understanding emergent community concepts of caring.

    Science.gov (United States)

    Green-Thompson, Lionel P; McInerney, Patricia; Woollard, Bob

    2017-04-12

    Social accountability is defined as the responsibility of institutions to respond to the health priorities of a community. There is an international movement towards the education of health professionals who are accountable to communities. There is little evidence of how communities experience or articulate this accountability. In this grounded theory study eight community based focus group discussions were conducted in rural and urban South Africa to explore community members' perceptions of the social accountability of doctors. The discussions were conducted across one urban and two rural provinces. Group discussions were recorded and transcribed verbatim. Initial coding was done and three main themes emerged following data analysis: the consultation as a place of love and respect (participants have an expectation of care yet are often engaged with disregard); relationships of people and systems (participants reflect on their health priorities and the links with the social determinants of health) and Ubuntu as engagement of the community (reflected in their expectation of Ubuntu based relationships as well as part of the education system). These themes were related through a framework which integrates three levels of relationship: a central community of reciprocal relationships with the doctor-patient relationship as core; a level in which the systems of health and education interact and together with social determinants of health mediate the insertion of communities into a broader discourse. An ubuntu framing in which the tensions between vulnerability and power interact and reflect rights and responsibility. The space between these concepts is important for social accountability. Social accountability has been a concept better articulated by academics and centralized agencies. Communities bring a richer dimension to social accountability through their understanding of being human and caring. This study also creates the connection between ubuntu and social

  20. Accountability

    Science.gov (United States)

    Fielding, Michael; Inglis, Fred

    2017-01-01

    This contribution republishes extracts from two important articles published around 2000 concerning the punitive accountability system suffered by English primary and secondary schools. The first concerns the inspection agency Ofsted, and the second managerialism. Though they do not directly address assessment, they are highly relevant to this…

  1. Rural Embedded Assistants for Community Health (REACH) network: first-person accounts in a community-university partnership.

    Science.gov (United States)

    Brown, Louis D; Alter, Theodore R; Brown, Leigh Gordon; Corbin, Marilyn A; Flaherty-Craig, Claire; McPhail, Lindsay G; Nevel, Pauline; Shoop, Kimbra; Sterner, Glenn; Terndrup, Thomas E; Weaver, M Ellen

    2013-03-01

    Community research and action projects undertaken by community-university partnerships can lead to contextually appropriate and sustainable community improvements in rural and urban localities. However, effective implementation is challenging and prone to failure when poorly executed. The current paper seeks to inform rural community-university partnership practice through consideration of first-person accounts from five stakeholders in the Rural Embedded Assistants for Community Health (REACH) Network. The REACH Network is a unique community-university partnership aimed at improving rural health services by identifying, implementing, and evaluating innovative health interventions delivered by local caregivers. The first-person accounts provide an insider's perspective on the nature of collaboration. The unique perspectives identify three critical challenges facing the REACH Network: trust, coordination, and sustainability. Through consideration of the challenges, we identified several strategies for success. We hope readers can learn their own lessons when considering the details of our partnership's efforts to improve the delivery infrastructure for rural healthcare.

  2. Hospital-community interactions foster coexistence between methicillin-resistant strains of Staphylococcus aureus.

    Directory of Open Access Journals (Sweden)

    Roger Kouyos

    2013-02-01

    Full Text Available Methicillin-resistant Staphylococcus aureus (MRSA is an important cause of morbidity and mortality in both hospitals and the community. Traditionally, MRSA was mainly hospital-associated (HA-MRSA, but in the past decade community-associated strains (CA-MRSA have spread widely. CA-MRSA strains seem to have significantly lower biological costs of resistance, and hence it has been speculated that they may replace HA-MRSA strains in the hospital. Such a replacement could potentially have major consequences for public health, as there are differences in the resistance spectra of the two strains as well as possible differences in their clinical effects. Here we assess the impact of competition between HA- and CA-MRSA using epidemiological models which integrate realistic data on drug-usage frequencies, resistance profiles, contact, and age structures. By explicitly accounting for the differing antibiotic usage frequencies in the hospital and the community, we find that coexistence between the strains is a possible outcome, as selection favors CA-MRSA in the community, because of its lower cost of resistance, while it favors HA-MRSA in the hospital, because of its broader resistance spectrum. Incorporating realistic degrees of age- and treatment-structure into the model significantly increases the parameter ranges over which coexistence is possible. Thus, our results indicate that the large heterogeneities existing in human populations make coexistence between hospital- and community-associated strains of MRSA a likely outcome.

  3. Hospital-Community Interactions Foster Coexistence between Methicillin-Resistant Strains of Staphylococcus aureus

    Science.gov (United States)

    Kouyos, Roger; Klein, Eili; Grenfell, Bryan

    2013-01-01

    Methicillin-resistant Staphylococcus aureus (MRSA) is an important cause of morbidity and mortality in both hospitals and the community. Traditionally, MRSA was mainly hospital-associated (HA-MRSA), but in the past decade community-associated strains (CA-MRSA) have spread widely. CA-MRSA strains seem to have significantly lower biological costs of resistance, and hence it has been speculated that they may replace HA-MRSA strains in the hospital. Such a replacement could potentially have major consequences for public health, as there are differences in the resistance spectra of the two strains as well as possible differences in their clinical effects. Here we assess the impact of competition between HA- and CA-MRSA using epidemiological models which integrate realistic data on drug-usage frequencies, resistance profiles, contact, and age structures. By explicitly accounting for the differing antibiotic usage frequencies in the hospital and the community, we find that coexistence between the strains is a possible outcome, as selection favors CA-MRSA in the community, because of its lower cost of resistance, while it favors HA-MRSA in the hospital, because of its broader resistance spectrum. Incorporating realistic degrees of age- and treatment-structure into the model significantly increases the parameter ranges over which coexistence is possible. Thus, our results indicate that the large heterogeneities existing in human populations make coexistence between hospital- and community-associated strains of MRSA a likely outcome. PMID:23468619

  4. Community factors in the development of antibiotic resistance.

    Science.gov (United States)

    Larson, Elaine

    2007-01-01

    The global impact of antibiotic resistance is potentially devastating, threatening to set back progress against certain infectious diseases to the pre-antibiotic era. Although most antibiotic-resistant bacteria originally emerged in hospitals, drug-resistant strains are becoming more common in the community. Factors that facilitate the development of resistance within the community can be categorized as behavioral or environmental/policy. Behavioral factors include inappropriate use of antibiotics and ineffective infection control and hygiene practices. Environmental/policy factors include the continued use of antibiotics in agriculture and the lack of new drug development. A multifaceted approach that includes behavioral strategies in the community and the political will to make difficult regulatory decisions will help to minimize the problem of antimicrobial resistance globally.

  5. How Patronage Politics Undermines Parental Participation and Accountability: Community-Managed Schools in Honduras and Guatemala

    Science.gov (United States)

    Altschuler, Daniel

    2013-01-01

    This article shows how patronage politics affects a popular international education model: community-managed schools (CMS). Focusing on Honduras's CMS initiative, PROHECO (Programa Hondureno de Educacion Comunitaria), I demonstrate how patronage can undermine CMS accountability. Whereas supporters argue that CMS increases accountability, partisan…

  6. Performance Accountability and the Community College: Using Institutional Performance to Determine Faculty Salaries

    Science.gov (United States)

    Smith, Douglas A.; Tran, Henry

    2016-01-01

    Performance accountability systems are increasingly utilized by state legislatures to hold community colleges more accountable for student outcomes and responsible spending through the linking of state funding to specific outputs. Through these actions, it is reasonable expect an emphasis on institutional performance to permeate into a community…

  7. Collective resistance in microbial communities by intracellular antibiotic deactivation

    NARCIS (Netherlands)

    Sorg, Robin A; Lin, Leo; van Doorn, G Sander; Sorg, Moritz; Olson, Joshua; Nizet, Victor; Veening, Jan-Willem

    2016-01-01

    The structure and composition of bacterial communities can compromise antibiotic efficacy. For example, the secretion of β-lactamase by individual bacteria provides passive resistance for all residents within a polymicrobial environment. Here, we uncover that collective resistance can also develop

  8. Prevalence of community-associated methicillin–resistant ...

    African Journals Online (AJOL)

    Background: Community-associated methicillin-resistant Staphylococcus aureus is increasingly reported. This study investigated its prevalence in urine of healthy women and resistance pattern to other antibiotics. Methods: Urine samples collected from healthy women volunteers in Federal Capital Territory were cultured ...

  9. Analysis of the Factors Affecting Resistance to Changes in Management Accounting Systems

    Directory of Open Access Journals (Sweden)

    Rodrigo Angonese

    2014-12-01

    Full Text Available Despite changes in the environment and management accounting practices, studies indicate that management accounting systems do not change or change at a much slower rate than expected. The stability of the management accounting systems used by companies may relate to resistance to changing these systems. This study analyzes the factors that contribute to resistance to implementing an integrated management system from the perspective of institutional theory, grounded in the old institutional economics. Methodologically, this study provides a qualitative assessment of the problem and a descriptive analysis of the resistance factors through a case-study approach. The data were collected using semi-structured interviews and analyzed through content analysis. Two companies were selected for this study due to their differing characteristics. The following seven factors were analyzed for resistance to implementing integrated management systems: institutional power, ontological insecurity, trust, inertia, lack of knowledge, acceptance of routines and decoupling. However, there was no evidence to characterize hierarchical power. The research findings indicate that changing management accounting systems, through the implementation of an integrated management system, faces internal resistance in these organizations. Each factor varies in intensity but is permanently present in these companies, such as ontological insecurity, trust, inertia, lack of knowledge, acceptance of routines and decoupling. These factors are awakened when the change process begins and, if they gather enough force, can stop the change.

  10. Antibiotic resistance profile in community-associated ...

    African Journals Online (AJOL)

    Isolation, identification and susceptibility pattern of the isolates was determined. The methicillin resistant strains were confirmed by the polymerase chain reaction (PCR) detection of the mecA gene. The entire tests were done according to standard protocols. Forty S. aureus strains were identified and were observed to be ...

  11. Antibiotic misuse in the community--a contributor to resistance?

    LENUS (Irish Health Repository)

    Carey, B

    2012-02-03

    The problem of antibiotic resistance is associated with the indiscriminate usage of antibiotics. Efforts have been directed at encouraging the rational use of these drugs to reduce the volume of antibiotic consumption and decrease resistance rates. There is evidence to suggest that the misuse of antibiotics by patients may also contribute to the problem. We describe a survey of a random selection of patients attending a General Practitioners\\' surgery over a six week period in an effort to estimate the level of non-compliance to antibiotic therapy in the community. The results suggest that there may be a significant level of antibiotic misuse prevalent in the local community. We discuss these results and present evidence in the literature suggesting how antibiotic misuse may affect resistance in the community. The factors affecting patient compliance to therapy are outlined along with suggested measures to improve compliance among patients.

  12. Linking microbial community structure and function to characterize antibiotic resistant bacteria and antibiotic resistant genes from cattle feces

    Science.gov (United States)

    There is widespread interest in monitoring the development of antibiotic resistant bacteria and antibiotic resistance genes in agriculturally impacted environments, however little is known about the relationships between bacterial community structure, and antibiotic resistance gene profiles. Cattl...

  13. Structure of the Scientific Community Modelling the Evolution of Resistance

    OpenAIRE

    2007-01-01

    Faced with the recurrent evolution of resistance to pesticides and drugs, the scientific community has developed theoretical models aimed at identifying the main factors of this evolution and predicting the efficiency of resistance management strategies. The evolutionary forces considered by these models are generally similar for viruses, bacteria, fungi, plants or arthropods facing drugs or pesticides, so interaction between scientists working on different biological organisms would be expec...

  14. Community as Resistance: Reconceptualizing Historical Instances of Community within Latin@ Education

    Science.gov (United States)

    Rothrock, Racheal M.

    2017-01-01

    The term "community" is drawn upon within critical educational literature that seeks to address inequity experienced by students of color in schools, yet little explicit discussion of its meaning and history is presented. In this article, I offer one way of thinking about community. I propose that it has existed as resistance within the…

  15. Experimental DC extraction of the thermal resistance of bipolar transistors taking into account the Early effect

    Science.gov (United States)

    d'Alessandro, Vincenzo

    2017-01-01

    This paper presents three methods to experimentally extract the thermal resistance of bipolar transistors taking into account the Early effect. The approaches are improved variants of recently-proposed techniques relying on common-base DC measurements. The accuracy is numerically verified by making use of a compact model calibrated on I-V characteristics of state-of-the-art SOG BJTs and SiGe:C HBTs.

  16. Greenhouse Gas Emission Accounting and Management of Low-Carbon Community

    Directory of Open Access Journals (Sweden)

    Dan Song

    2012-01-01

    Full Text Available As the major source of greenhouse gas (GHG emission, cities have been under tremendous pressure of energy conservation and emission reduction for decades. Community is the main unit of urban housing, public facilities, transportation, and other properties of city's land use. The construction of low-carbon community is an important pathway to realize carbon emission mitigation in the context of rapid urbanization. Therefore, an efficient carbon accounting framework should be proposed for CO2 emissions mitigation at a subcity level. Based on life-cycle analysis (LCA, a three-tier accounting framework for the carbon emissions of the community is put forward, including emissions from direct fossil fuel combustion, purchased energy (electricity, heat, and water, and supply chain emissions embodied in the consumption of goods. By compiling a detailed CO2 emission inventory, the magnitude of carbon emissions and the mitigation potential in a typical high-quality community in Beijing are quantified within the accounting framework proposed. Results show that emissions from supply chain emissions embodied in the consumption of goods cannot be ignored. Specific suggestions are also provided for the urban decision makers to achieve the optimal resource allocation and further promotion of low-carbon communities.

  17. Greenhouse gas emission accounting and management of low-carbon community.

    Science.gov (United States)

    Song, Dan; Su, Meirong; Yang, Jin; Chen, Bin

    2012-01-01

    As the major source of greenhouse gas (GHG) emission, cities have been under tremendous pressure of energy conservation and emission reduction for decades. Community is the main unit of urban housing, public facilities, transportation, and other properties of city's land use. The construction of low-carbon community is an important pathway to realize carbon emission mitigation in the context of rapid urbanization. Therefore, an efficient carbon accounting framework should be proposed for CO₂ emissions mitigation at a subcity level. Based on life-cycle analysis (LCA), a three-tier accounting framework for the carbon emissions of the community is put forward, including emissions from direct fossil fuel combustion, purchased energy (electricity, heat, and water), and supply chain emissions embodied in the consumption of goods. By compiling a detailed CO₂ emission inventory, the magnitude of carbon emissions and the mitigation potential in a typical high-quality community in Beijing are quantified within the accounting framework proposed. Results show that emissions from supply chain emissions embodied in the consumption of goods cannot be ignored. Specific suggestions are also provided for the urban decision makers to achieve the optimal resource allocation and further promotion of low-carbon communities.

  18. Ciprofloxacin : Use and resistance in Community, Nursing Home and Hospital

    NARCIS (Netherlands)

    van Hees, B.C.

    2011-01-01

    The aim of the studies described in this thesis was to analyze some aspects of ciprofloxacin use and clinical and (molecular) epidemiology of ciprofloxacin resistance in different settings, both within hospitals (chapter 3,4 and 6), community and nursing homes (chapter 2 and 5). With its broad

  19. Restorative justice for sexual violence: repairing victims, building community, and holding offenders accountable.

    Science.gov (United States)

    Koss, Mary P; Bachar, Karen J; Hopkins, C Quince

    2003-06-01

    Problems in criminal justice system response to date and acquaintance rape, and the nonpenetration sexual offenses are identified: (1) these crimes are often markers of a career of sexual offense, yet they are widely viewed as minor; (2) perpetrators of these crimes are now held accountable in ways that reduce their future threat of sex offending; and (3) current criminal justice response to these crimes disappoints and traumatizes victims and families. In response to these identified problems, we are implementing and evaluating RESTORE, an innovative victim-driven, community-based restorative justice program. Restorative justice views crime as harm for which the person responsible must be held accountable in meaningful ways. RESTORE uses a community conference to involve the victim, offender, and both parties' family and friends in a face-to-face dialogue directed at identifying the harm, and developing a plan for repair, rehabilitation, and reintegration into the community.

  20. Accounting for youth audiences’ resistances to HIV and AIDS messages in the television drama Tsha Tsha in South Africa

    Science.gov (United States)

    Makwambeni, Blessing; Salawu, Abiodun

    2018-01-01

    Abstract Theoretical debates and literature on E-E efforts in Africa have largely focussed on understanding how and why interventions on HIV and AIDS are effective in influencing behaviour change among target communities. Very few studies have sought to investigate and understand why a substantial number of targeted audiences resist the preferred readings that are encoded into E-E interventions on HIV and AIDS. Using cultural studies as its conceptual framework and reception analysis as its methodology, this study investigated and accounted for the oppositional readings that subaltern black South African youths negotiate from Tsha Tsha, an E-E television drama on HIV and AIDS in South Africa. Results from the study show that HIV and AIDS messages in Tsha Tsha face substantial resistances from situated youth viewers whose social contexts of consumption, shared identities, quotidian experiences and subjectivities, provide critical lines along which the E-E text is often resisted and inflected. These findings do not only hold several implications for E-E practice and research, they further reflect the utility of articulating cultural studies and reception analysis into a more nuanced theoretical and methodological framework for evaluating the ‘impact’ of E-E interventions on HIV and AIDS. PMID:29508641

  1. Accounting for youth audiences' resistances to HIV and AIDS messages in the television drama Tsha Tsha in South Africa.

    Science.gov (United States)

    Makwambeni, Blessing; Salawu, Abiodun

    2018-12-01

    Theoretical debates and literature on E-E efforts in Africa have largely focussed on understanding how and why interventions on HIV and AIDS are effective in influencing behaviour change among target communities. Very few studies have sought to investigate and understand why a substantial number of targeted audiences resist the preferred readings that are encoded into E-E interventions on HIV and AIDS. Using cultural studies as its conceptual framework and reception analysis as its methodology, this study investigated and accounted for the oppositional readings that subaltern black South African youths negotiate from Tsha Tsha, an E-E television drama on HIV and AIDS in South Africa. Results from the study show that HIV and AIDS messages in Tsha Tsha face substantial resistances from situated youth viewers whose social contexts of consumption, shared identities, quotidian experiences and subjectivities, provide critical lines along which the E-E text is often resisted and inflected. These findings do not only hold several implications for E-E practice and research, they further reflect the utility of articulating cultural studies and reception analysis into a more nuanced theoretical and methodological framework for evaluating the 'impact' of E-E interventions on HIV and AIDS.

  2. Structure of the scientific community modelling the evolution of resistance.

    Science.gov (United States)

    2007-12-05

    Faced with the recurrent evolution of resistance to pesticides and drugs, the scientific community has developed theoretical models aimed at identifying the main factors of this evolution and predicting the efficiency of resistance management strategies. The evolutionary forces considered by these models are generally similar for viruses, bacteria, fungi, plants or arthropods facing drugs or pesticides, so interaction between scientists working on different biological organisms would be expected. We tested this by analysing co-authorship and co-citation networks using a database of 187 articles published from 1977 to 2006 concerning models of resistance evolution to all major classes of pesticides and drugs. These analyses identified two main groups. One group, led by ecologists or agronomists, is interested in agricultural crop or stock pests and diseases. It mainly uses a population genetics approach to model the evolution of resistance to insecticidal proteins, insecticides, herbicides, antihelminthic drugs and miticides. By contrast, the other group, led by medical scientists, is interested in human parasites and mostly uses epidemiological models to study the evolution of resistance to antibiotic and antiviral drugs. Our analyses suggested that there is also a small scientific group focusing on resistance to antimalaria drugs, and which is only poorly connected with the two larger groups. The analysis of cited references indicates that each of the two large communities publishes its research in a different set of literature and has its own keystone references: citations with a large impact in one group are almost never cited by the other. We fear the lack of exchange between the two communities might slow progress concerning resistance evolution which is currently a major issue for society.

  3. Community-Associated Methicillin-Resistant Staphylococcus aureus in the Pediatric Population.

    Science.gov (United States)

    Nemerovski, Carrie W; Klein, Kristin C

    2008-10-01

    To review the epidemiology and prevalence of community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA), define the differences between community-acquired and hospital-acquired strains, highlight the advantages and disadvantages of antibiotics commonly used to treat infections caused by this pathogen, and identify strategies to limit the spread of this organism and prevent future outbreaks. Literature was accessed through MEDLINE using the search terms community-acquired methicillin-resistant Staphylococcus aureus, community-associated methicillin-resistant Staphylococcus aureus, CA-MRSA, pediatrics, and children. Articles evaluated were published in the English language and limited to human studies. References of literature identified by initial search techniques were reviewed for additional relevant articles. Community-associated methicillin-resistant Staphylococcus aureus has become a prominent pathogen in pediatric patients in the last ten years. Its increasing prevalence has been reported throughout the United States, and it is the cause of over one half of all skin and soft tissue infections seen in many hospitals and emergency departments. The risk factors for infection with this pathogen differ from those associated with hospital-acquired strains. Mild to moderate infections can generally be treated with oral antibiotics, while more serious infections may require parenteral therapy. Sulfamethoxazole/trimethoprim and clindamycin are the preferred oral agents due to their efficacy, tolerability, well established side effect profiles, and cost. Vancomycin is the standard of care for parenteral therapy, although clindamycin is an acceptable parenteral alternative. More costly agents such as linezolid, daptomycin, and quinupristin/dalfopristin should be reserved for patients with severe infections, multiple allergies, or in strains with unusual resistance patterns. The best way to prevent and control outbreaks is to maintain standard infection

  4. Online Stigma Resistance in the Pro-Ana Community.

    Science.gov (United States)

    Yeshua-Katz, Daphna

    2015-10-01

    Media scholars often use concepts from Goffman's dramaturgical approach to study online communities of stigmatized individuals as "backstages," spaces where members take refuge from social disapproval. In this study, I extend this view through an examination of in-depth interviews with bloggers from the "pro-ana" community, an online community for people with eating disorders. To explore how this community uses an online environment that is both anonymous and public, I fuse Goffman's ideas about identity performance and stigma with more recent theories about boundary maintenance. In-depth interviews with "pro-ana" bloggers reveal that to protect this virtual group and resist stigmas associated both with their illness and with their online presence, they construct their own norms and rules in the online realm, and discipline and eject members deemed to be out-group. © The Author(s) 2015.

  5. Mechanisms of Invasion Resistance of Aquatic Plant Communities

    Science.gov (United States)

    Petruzzella, Antonella; Manschot, Johan; van Leeuwen, Casper H. A.; Grutters, Bart M. C.; Bakker, Elisabeth S.

    2018-01-01

    Invasive plant species are among the major threats to freshwater biodiversity. Few experimental studies have investigated whether native plant diversity can provide biotic resistance to invaders in freshwater ecosystems. At small spatial scales, invasion resistance may increase with plant species richness due to a better use of available resources, leaving less available for a potential invader (Complementarity effect) and/or the greater probability to have a highly competitive (or productive) native species in the community (Selection effect). In submerged aquatic plant communities, we tested the following hypotheses: (1) invader establishment success is greatest in the absence of a native plant community; (2) lower in plant communities with greater native species richness, due to complementary and/or selection effects; and (3) invader establishment success would be lowest in rooted plant communities, based on the limiting similarity theory as the invader is a rooted submerged species. In a greenhouse experiment, we established mesocosms planted with 0 (bare sediment), 1, 2, and 4 submerged plant species native to NW Europe and subjected these to the South African invader Lagarosiphon major (Ridl.) Moss. We used two rooted (Myriophyllum spicatum L., Potamogeton perfoliatus L.) and two non-rooted native species (Ceratophyllum demersum L., Utricularia vulgaris L.) representing two distinct functional groups considering their nutrient acquisition strategy which follows from their growth form, with, respectively, the sediment and water column as their main nutrient source. We found that the presence of native vegetation overall decreased the establishment success of an alien aquatic plant species. The strength of this observed biotic resistance increased with increasing species richness of the native community. Mainly due to a selection effect, the native biomass of mixed communities overyielded, and this further lowered the establishment success of the invader in our

  6. Methicillin-resistant Staphylococcus aureus in Papua New Guinea: a community nasal colonization prevalence study.

    Science.gov (United States)

    Laman, Moses; Greenhill, Andrew; Coombs, Geoffrey W; Robinson, Owen; Pearson, Julie; Davis, Timothy M E; Manning, Laurens

    2017-08-01

    There are few epidemiological data available to inform a national response to community-acquired methicillin-resistant Staphylococcus aureus (MRSA) in Papua New Guinea (PNG). We performed a cross-sectional survey to determine the pattern of MRSA nasal colonization and the diversity of circulating MRSA clones among adults and adolescents in Madang Province, PNG. S. aureus nasal colonization was confirmed in 44 (17.1%) of 257 participants. Four (9.1%) isolates were methicillin resistant. Resistance to other antimicrobial agents was uncommon. Detailed molecular typing of three MRSA isolates demonstrated multiple MRSA clones in this community, of which two carried the Panton-Valentin leukocidin-associated virulence genes. MRSA is likely to account for a clinically important proportion of staphylococcal disease in PNG. There are multiple MRSA clones in PNG. Ongoing surveillance of community and invasive isolates is a critical component of an effective response to the challenge of community-acquired MRSA in this and many other resource-limited contexts. © The Author 2017. Published by Oxford University Press on behalf of Royal Society of Tropical Medicine and Hygiene. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  7. Positive implications from socially accountable, community-engaged medical education across two Philippines regions.

    Science.gov (United States)

    Woolley, Torres; Cristobal, Fortunato; Siega-Sur, Jusie; Ross, Simone; Neusy, Andre-Jacques; Halili, Servando; Reeve, Carole

    2018-02-01

    Hundreds of millions of people worldwide lack access to quality health services, largely because of geographic and socioeconomic maldistribution of qualified practitioners. This study describes differences between the practice locations of Philippines medical graduates from two 'socially accountable, community-engaged' health professional education (SAHPE) schools and the practice locations of graduates from two 'conventionally trained' medical schools located in the same respective geographic regions. Licensed medical graduates were currently practising in the Philippines and had been practising for at least 6 months. Graduates were from two Philippines SAHPE schools (Ateneo de Zamboanga University-School of Medicine (ADZU-SOM) on the Zamboanga Peninsula (n=212) and the University of the Philippines Manila-School of Health Sciences (SHS-Palo) in Eastern Visayas (n=71), and from two 'conventional' medical schools Methods: Current graduate practice locations in municipalities or cities were linked with their respective population size and socioeconomic income class, and geocoded using Geographical Information System software onto a geospatial map of the Philippines. Bivariate analysis compared the population size and socioeconomic class of communities where the SAHPE medical graduates practised to communities where 'conventional' medical school graduates practised. Thirty-one percent of ADZU-SOM medical graduates practised in communities <100 000 population versus 7% of graduates from the conventional school in the Zamboanga region (p<0.001), while 61% of SHS-Palo medical graduates practised in communities <100 000 population versus 12% of graduates from the conventional school in the Visayas region (p<0.001). Twenty-seven percent of ADZU-SOM graduates practised in lower income category communities (categories 2-6) versus 8% of graduates from the conventional school in the same region (p<0.001), while 49% of SHS-Palo graduates practised in lower income category

  8. Risk of resistance related to antibiotic use before admission in patients with community-acquired bacteraemia

    DEFF Research Database (Denmark)

    Pedersen, Gitte; Schønheyder, Henrik Carl; Steffensen, Flemming Hald

    1999-01-01

    %), Streptococcus pneumoniae (23%) Staphylococcus aureus (10%). Of the 575 isolates of E. coli, 425 (74%), 432 (75%) and 518 (90%) were susceptible to ampicillin, sulphonamides and trimethoprim, respectively. Previous antibiotic prescriptions were strongly associated with resistance to ampicillin, sulphonamides...... and trimethoprim in E. coli. The association was less pronounced for S. aureus and enteric rods other than E. coli. Antibiotic prescriptions within the last 3 months predicted antibiotic resistance, and this should be taken into account when selecting empirical antibiotic therapy of severe community...... admission and to 37% during the 6 months. The most frequently prescribed antibiotics within 30 days were ampicillin (28%), penicillin G (27%), sulphonamides and/or trimethoprim (16%) and macrolides (14%). The most frequent blood isolates were Escherichia coli (33%), other Enterobacteriaceae 8...

  9. Community-Associated Methicillin-Resistant Staphylococcus aureus Case Studies

    Science.gov (United States)

    Sowash, Madeleine G.; Uhlemann, Anne-Catrin

    2014-01-01

    Over the past decade, the emergence of community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA) has changed the landscape of S. aureus infections around the globe. Initially recognized for its ability to cause disease in young and healthy individuals without healthcare exposures as well as for its distinct genotype and phenotype, this original description no longer fully encompasses the diversity of CA-MRSA as it continues to expand its niche. Using four case studies, we highlight a wide range of the clinical presentations and challenges of CA-MRSA. Based on these cases we further explore the globally polygenetic background of CA-MRSA with a special emphasis on generally less characterized populations. PMID:24085688

  10. PROBLEMS OF QUANTIFICATION AND ACCOUNTING FAUNAL DIVERSITY OF EARTHWORMS IN FOREST COMMUNITIES

    Directory of Open Access Journals (Sweden)

    A.P. Geraskina

    2016-06-01

    Full Text Available The problem of quantifying earthworms is that the size of most part of the soil population is calculated per unit volume and the number of earthworms per unit area. This makes incomparable the results both of quantitative indicators of earthworm population in different soils and the number of worms and other soil invertebrates. This article presents a new approach to the faunistic and quantitative account of earthworms in forest communities. The significance of dead wood in the study of earthworm population is shown in the article. The article also presents the technique of quantitative evaluation of Lumbricidae that live in the soil and in the dead wood per unit volume – 1 m3. Examples of the number of earthworms per unit volume – 1 dm3, provided the actual habitat of earthworms is only in the upper 10-cm layer of soil or per unit volume 100 dm3 – in the case of a low number of earthworms, are considered in the article. In the dark coniferous forests of the Pechora-Ilych and Teberdinsky reserves the most favorable habitats of Lumbricidae were identified, communities with their highest species richness and abundance were identified.

  11. Community-associated methicillin-resistant Staphylococcus aureus causing orbital cellulitis in Australian children.

    Science.gov (United States)

    Vaska, Vikram L; Grimwood, Keith; Gole, Glen A; Nimmo, Graeme R; Paterson, David L; Nissen, Michael D

    2011-11-01

    Community-associated methicillin-resistant Staphylococcus aureus has only emerged recently as a cause of serious ocular infections in several different countries. At a tertiary pediatric hospital in Brisbane, Australia, community-associated methicillin-resistant S. aureus orbital cellulitis was first noted in 2009. Since then, it has caused 4 of 9 such infections.

  12. Community-Acquired Methicillin-Resistant "Staphylococcus aureus": Considerations for School Nurses

    Science.gov (United States)

    Alex, Aniltta; Letizia, MariJo

    2007-01-01

    Methicillin-resistant "Staphylococcus aureus" (MRSA) is a disease-causing organism that has been present in hospital settings since the 1960s. However, a genetically distinct strain of MRSA, called community-acquired methicillin-resistant "Staphylococcus aureus" (CA-MRSA), has emerged in recent years in community settings among healthy…

  13. Plant community resistance to invasion by Bromus species: The roles of community attributes, Bromus interactions with plant communities, and Bromus traits [Chapter 10

    Science.gov (United States)

    Jeanne C. Chambers; Matthew J. Germino; Jayne Belnap; Cynthia S. Brown; Eugene W. Schupp; Samuel B. St. Clair

    2016-01-01

    The factors that determine plant community resistance to exotic annual Bromus species (Bromus hereafter) are diverse and context specific. They are influenced by the environmental characteristics and attributes of the community, the traits of Bromus species, and the direct and indirect interactions of Bromus with the plant community. Environmental factors, in...

  14. Accounting the mechanical resistance of testing device for straight-flow branch pipe in the transverse direction

    Science.gov (United States)

    Sitnikov, D. V.; Klishin, S. V.; Zubarev, A. V.; Shvarts, A. A.

    2017-06-01

    The flexible inserts as a rubber-cord branch pipe are used to reduce the vibrations distributed from units of a hydraulic system through the pipelines. The device with completely rigid elements is used for the experimental determination of the stiffness characteristics of the branch pipes that determine their anti-vibration properties. In the paper the study of the mechanical resistances of an experimental device construction is carried out by method of the harmonic analysis in a frequency range of 1 Hz to 1000 Hz. Then these mechanical resistances are compared with the mechanical resistance of the branch pipe with diameter 100 mm obtained experimentally. It is found as a result it is necessary to take into account the value of the device mechanical resistance when the stiffness characteristics of the rubber-cord branch pipes with diameter 100 mm in the transverse direction at frequencies above 735 Hz are determined experimentally.

  15. Genomic Epidemiology of USA300 Methicillin-Resistant Staphylococcus aureus in an Urban Community.

    Science.gov (United States)

    Popovich, Kyle J; Snitkin, Evan; Green, Stefan J; Aroutcheva, Alla; Hayden, Mary K; Hota, Bala; Weinstein, Robert A

    2016-01-01

    In a community, it is unknown what factors account for transmission of methicillin-resistant Staphylococcus aureus (MRSA). We integrated whole genome sequencing (WGS) and epidemiologic data to identify factors associated with MRSA transmission networks in an urban community. WGS was performed on colonizing USA300 MRSA isolates from 74 individuals within 72 hours of admission to a public hospital in Chicago, IL. Single nucleotide variants (SNVs) were used to reconstruct the phylogeny of sequenced isolates, and epidemiologic data was overlaid to identify factors associated with transmission networks. The maximum within-patient SNV difference for an individual with multisite colonization was 41 SNVs, with no systematic divergence among body sites. We observed a minimum of 7 SNVs and maximum of 153 SNVs between isolates from different individuals. We identified 4 pairs of individuals whose isolates were within 40 SNVs of each other. Putting our isolates in the context of previously sequenced USA300 isolates from other communities, we identified a 13-member group and two 4-member groups that represent samples from putative local transmission networks. Individuals in these groups were more likely to be African American, to be human immunodeficiency virus-infected, to reside in high detainee release areas, and to be current users of illicit drugs. Using WGS, we observed potential transmission networks in an urban community and that certain epidemiologic factors were associated with inclusion in these networks. Future work with contact tracing and advanced molecular diagnostics may allow for identification of MRSA "epicenters" in the community where interventions can be targeted. © The Author 2015. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail journals.permissions@oup.com.

  16. 'Repeat' prescriptions and antibiotic resistance: findings from Australian community pharmacy.

    Science.gov (United States)

    Fredericks, Ian; Hollingworth, Samantha; Pudmenzky, Alex; Rossato, Laurence; Kairuz, Therése

    2017-02-01

    Australians are among the highest users of antibiotics in the developed world. The primary aim was to determine the 'age' of antibiotic prescriptions at the time of dispensing as a possible contributor to antibiotic misuse and ultimately, resistance. The secondary aim was to test customised software to permit extraction and de-identification of dispensing records for analysis. Data were extracted and de-identified from computerised dispensing systems in three community pharmacies in Brisbane, Australia, according to a strict ethical protocol. All prescription records dispensed between 1 January 2010 and 31 December 2012 were merged to form a complete dataset of 1 158 871 de-identified dispensing records which were analysed using Microsoft Excel ® . A retrospective drug utilisation study was conducted on a subset of 100 573 antibiotic records. In a substudy conducted at a single pharmacy site, all antibiotic records dispensed over a 4-month (winter) period were examined to determine the age of prescriptions. Nearly one in ten antibiotics (9.0%) was dispensed from prescriptions that were more than a month old, and over one in five (22.1%) were dispensed from a repeat prescription. Health system factors may contribute to inappropriate antibiotic use in Australia, including availability and validity of repeat antibiotic prescriptions. Government health departments, prescribers, pharmacists, other health professionals and consumers have to share the responsibility of ensuring that antibiotics are used appropriately. © 2016 Royal Pharmaceutical Society.

  17. Risk factors for drug-resistant pathogens in community-acquired and healthcare-associated pneumonia.

    Science.gov (United States)

    Shindo, Yuichiro; Ito, Ryota; Kobayashi, Daisuke; Ando, Masahiko; Ichikawa, Motoshi; Shiraki, Akira; Goto, Yasuhiro; Fukui, Yasutaka; Iwaki, Mai; Okumura, Junya; Yamaguchi, Ikuo; Yagi, Tetsuya; Tanikawa, Yoshimasa; Sugino, Yasuteru; Shindoh, Joe; Ogasawara, Tomohiko; Nomura, Fumio; Saka, Hideo; Yamamoto, Masashi; Taniguchi, Hiroyuki; Suzuki, Ryujiro; Saito, Hiroshi; Kawamura, Takashi; Hasegawa, Yoshinori

    2013-10-15

    Identification of patients with drug-resistant pathogens at initial diagnosis is essential for treatment of pneumonia. To elucidate clinical features of community-acquired pneumonia (CAP) and healthcare-associated pneumonia (HCAP), and to clarify risk factors for drug-resistant pathogens in patients with CAP and HCAP. A prospective observational study was conducted in hospitalized patients with pneumonia at 10 institutions in Japan. Pathogens identified as not susceptible to ceftriaxone, ampicillin-sulbactam, macrolides, and respiratory fluoroquinolones were defined as CAP drug-resistant pathogens (CAP-DRPs). In total, 1,413 patients (887 CAP and 526 HCAP) were analyzed. CAP-DRPs were more frequently found in patients with HCAP (26.6%) than in patients with CAP (8.6%). Independent risk factors for CAP-DRPs were almost identical in patients with CAP and HCAP. These included prior hospitalization (adjusted odds ratio [AOR], 2.06; 95% confidence interval [CI], 1.23-3.43), immunosuppression (AOR, 2.31; 95% CI, 1.05-5.11), previous antibiotic use (AOR, 2.45; 95% CI, 1.51-3.98), use of gastric acid-suppressive agents (AOR, 2.22; 95% CI, 1.39-3.57), tube feeding (AOR, 2.43; 95% CI, 1.18-5.00), and nonambulatory status (AOR, 2.45; 95% CI, 1.40-4.30) in the combined patients with CAP and HCAP. The area under the receiver operating characteristic curve for counting the number of risk factors was 0.79 (95% CI, 0.74-0.84). The clinical profile of HCAP was different from that of CAP. However, physicians can predict drug resistance in patients with either CAP or HCAP by taking account of the cumulative number of the risk factors. Clinical trial registered with https://upload.umin.ac.jp/cgi-open-bin/ctr/ctr.cgi?function=brows&action=brows&type=summary&recptno=R000004001&language=E ; number UMIN000003306.

  18. Antibiotic resistance in community-acquired urinary tract infections

    African Journals Online (AJOL)

    the treatment of other infections would inevitably lead to the development of resistance. S Afr Med J 1994; 84: 600-602. Antibiotic resistance is a major problem in developing countries.' There are many reasons for this, including antibiotic use in animal feeds, inappropriate prescribing and poor sanitation. Resistance rates in ...

  19. Developing an Empirical Account of a Community of Practice: Characterizing the Essential Tensions

    Science.gov (United States)

    Barab, Sasha A.; Barnett, Michael; Squire, Kurt

    2002-01-01

    This article examines the potential of a learning-as-a-part-of-a-community approach, focusing on the participatory process of learning in a community-based, teacher education program; a Community of Teachers (CoT). CoT is a preparation program for preservice teachers working toward secondary teacher certification in which they join an on-going…

  20. Bacterial Communities and Antibiotic Resistance Communities in a Full-Scale Hospital Wastewater Treatment Plant by High-Throughput Pyrosequencing

    Directory of Open Access Journals (Sweden)

    Youngho Ahn

    2016-12-01

    Full Text Available The community of whole microbes and antibiotic resistance bacteria (ARB in hospital wastewater treatment plants (WWTP receiving domestic wastewater (DWW and hospital wastewater (HWW was investigated. Samples from an influent of a secondary clarifier, at each treatment train, were characterized for the whole microbial community and ARB on the antibiotic resistance database, based on high-throughput pyrosequencing. The pyrosequencing analysis revealed that the abundance of Bacteroidetes in the DWW sample was higher (~1.6 times than in the HWW sample, whereas the abundance of Proteobacteria in the HWW sample was greater than in the DWW sample. At the top twenty of the genus level, distinct genera were observed—Saprospiraceae in the DWW and Zoogloea in the HWW. Apart from the top twenty genera, minor genera showed various antibiotic resistance types based on the antibiotic resistance gene database.

  1. Point mutations in human guanylate kinase account for acquired resistance to anticancer nucleotide analogue PMEG

    Czech Academy of Sciences Publication Activity Database

    Mertlíková-Kaiserová, Helena; Rumlová, Michaela; Tloušťová, Eva; Procházková, Eliška; Holý, Antonín; Votruba, Ivan

    2011-01-01

    Roč. 82, č. 2 (2011), s. 131-138 ISSN 0006-2952 R&D Projects: GA MŠk 1M0508 Institutional research plan: CEZ:AV0Z40550506 Keywords : resistance * acyclic nucleoside phosphonates * PMEG * PMEDAP Subject RIV: CE - Biochemistry Impact factor: 4.705, year: 2011

  2. Prevalence of community-associated multi-resistant Staphylococcus ...

    African Journals Online (AJOL)

    Antimicrobial resistance has become a great public health problem worldwide and multi-drugvresistance Staphylococcus aureus has been widely reported. This study determined the pattern of resistance to ten commonly used antibiotics. Urine samples collected from healthy women volunteers in the Abuja were cultured ...

  3. Effects of Metals on Antibiotic Resistance and Conjugal Plasmid Transfer in Soil Bacterial Communities

    DEFF Research Database (Denmark)

    Song, Jianxiao

    Antibiotic resistance currently represents one of the biggest challenges for human health and in recent years the environmental dimension of antibiotic resistance has been increasingly recognized. The soil environment serves as an important reservoir of antibiotic resistance determinants....... In addition to direct selection of antibiotic resistance by antibiotics, metals may co-select for antibiotic resistance via different mechanisms causing environmental selection of antibiotic resistance in metal contaminated soils. Horizontal gene transfer of mobile genetic elements (MGEs) like plasmids...... is generally considered one of the most important co-selection mechanisms as multiple resistance genes can be located on the same MGE. This PhD thesis focused on the impact of metals (Cu and Zn) on the development of antibiotic resistance in bacterial communities in soils exposed to different degrees...

  4. Exploring Culturally Specific Drug Resistance Strategies of Hawaiian Youth in Rural Communities

    Science.gov (United States)

    Okamoto, Scott K.; Po'a-Kekuawela, Ka'ohinani; Chin, Coralee I. H.; Nebre, La Risa H.; Helm, Susana

    2010-01-01

    This qualitative study examined the drug resistance strategies of Hawaiian youth residing in rural communities in Hawai'i. Forty seven youth participated in 14 focus groups which focused on the social and environmental context of drug use for these youth. The findings indicated that there were 47 references to resistance strategies used in drug…

  5. Methicillin-resistant Staphylococcus aureus in community-acquired pyoderma in children in South India

    Directory of Open Access Journals (Sweden)

    Umashankar Nagaraju

    2017-01-01

    Conclusion: MRSA in community-acquired pyoderma in children was 6.5% and nasal colonization with S. aureus was 59.7% in our study. High resistance to commonly used antimicrobials in methicillin-sensitive S. aureus was also observed. Judicious use of antimicrobials is essential to control the emergence and spread of antimicrobial resistance.

  6. An account of the plant communities of Tussen die Riviere Game Farm, Orange Free State

    Directory of Open Access Journals (Sweden)

    M. J.A. Werger

    1973-07-01

    Full Text Available As part of the IBP survey of conservation sites, the vegetation of Tussen die Riviere Game Farm,Orange Free State, was surveyed and analysed according to the Braun-Blanquet phytosociological method. A classification of the plant communities occurring there is given. A way by which a hierarchical classification of plant communities in South Africa community is physiognomically classified according of this system are discussed briefly.could be constructed, is suggested. Each plant to Fosberg's (1967 system. Two disadvantages of this system are discussed briefly.

  7. A Preliminary Account of the Dune Communities at Pennington Park, Mtunzini, Natal

    Directory of Open Access Journals (Sweden)

    E. J. Moll

    1972-11-01

    Full Text Available A general description of Pennington Park is given, and some of the more important environmental factors affecting the plant communities are discussed. The structure, distribution and ecology of the various dune communities, from pioneers to Dune Forest, is given. The importance of Pennington Park as a conservation area is discussed in the light of the paucity of comparable sites and the human pressure on this type of environment.

  8. Clinical characteristics and outcomes of community-acquired methicillin-resistant Staphylococcus aureus septic arthritis

    Directory of Open Access Journals (Sweden)

    Sian Yik Lim

    2017-01-01

    Full Text Available Objective: We investigated the clinical characteristics, treatment patterns and outcomes of community-acquired methicillin resistant Staphylococcus aureus (CA-MRSA septic arthritis. Methods: This was a retrospective chart review of CA-MRSA septic arthritis in a tertiary care hospital from 2000-2013. We compared CA-MRSA septic arthritis cases with HA-MRSA septic arthritis cases to identify important differences between the two groups. Results: We identified 11 cases of CA-MRSA septic arthritis and 34 cases of hospital-acquired methicillin-resistant SA (HA-MRSA septic arthritis. Community-acquired methicillin-resistant Staphylococcus aureus caused 25% of the MRSA septic arthritis cases. Community-acquired methicillin-resistant Staphylococcus aureus septic arthritis occurred in younger patients with fewer comorbidities or risk factors. There was no difference in initial presentation between CA-MRSA and HA-MRSA. Community-acquired methicillin-resistant Staphylococcus aureus patients were less likely to be treated with appropriate antibiotics initially. Community-acquired methicillin-resistant Staphylococcus aureus septic arthritis was associated with increased morbidity with a high percentage of patients developing poor joint outcomes or osteomyelitis complications.  Community-acquired methicillin-resistant Staphylococcus aureus septic arthritis was also associated with increased utilization of health care resources due to long hospital stays, high readmissions rates, and increased requirements for rehabilitation facility placement and home health support. There was no difference in mortality, poor joint outcome, readmissions, and osteomyelitis complications between CA-MRSA septic arthritis and HA-MRSA septic arthritis. Conclusions: Community-acquired methicillin-resistant Staphylococcus aureus septic arthritis is associated with increased morbidity and health care resource utilization. Increased awareness into CA-MRSA as a cause of septic

  9. Summer Freezing Resistance: A Critical Filter for Plant Community Assemblies in Mediterranean High Mountains.

    Science.gov (United States)

    Pescador, David S; Sierra-Almeida, Ángela; Torres, Pablo J; Escudero, Adrián

    2016-01-01

    Assessing freezing community response and whether freezing resistance is related to other functional traits is essential for understanding alpine community assemblages, particularly in Mediterranean environments where plants are exposed to freezing temperatures and summer droughts. Thus, we characterized the leaf freezing resistance of 42 plant species in 38 plots at Sierra de Guadarrama (Spain) by measuring their ice nucleation temperature, freezing point (FP), and low-temperature damage (LT50), as well as determining their freezing resistance mechanisms (i.e., tolerance or avoidance). The community response to freezing was estimated for each plot as community weighted means (CWMs) and functional diversity (FD), and we assessed their relative importance with altitude. We established the relationships between freezing resistance, growth forms, and four key plant functional traits (i.e., plant height, specific leaf area, leaf dry matter content (LDMC), and seed mass). There was a wide range of freezing resistance responses and more than in other alpine habitats. At the community level, the CWMs of FP and LT50 responded negatively to altitude, whereas the FD of both traits increased with altitude. The proportion of freezing-tolerant species also increased with altitude. The ranges of FP and LT50 varied among growth forms, and only leaf dry matter content was negatively correlated with freezing-resistance traits. Summer freezing events represent important abiotic filters for assemblies of Mediterranean high mountain communities, as suggested by the CWMs. However, a concomitant summer drought constraint may also explain the high freezing resistance of species that thrive in these areas and the lower FD of freezing resistance traits at lower altitudes. Leaves with high dry matter contents may maintain turgor at lower water potential and enhance drought tolerance in parallel to freezing resistance. This adaptation to drought seems to be a general prerequisite for plants

  10. Community Resistance to Planned Housing for the Elderly: Ageism or General Antipathy to Group Housing?

    Science.gov (United States)

    Mangum, Wiley P.

    1988-01-01

    Compared community resistance to elderly housing and to other group housing through survey of two suburban communities. Found all group housing was objectionable; least objectionable were one-story apartments, shared housing, and multi-story apartments for elderly, in that order. Antipathy to group housing was far more important predictor of…

  11. Community-associated methicillin resistant Staphylococcus aureus in south Florida hospital and recreational environments

    Science.gov (United States)

    Strains of methicillin resistant Staphylococcus aureus (MRSA), a frequent human pathogen, may also be found in the flora of healthy persons and in the environments that they frequent. Strains of MRSA circulating in the community classified as USA 300 are now found not only in the community but also...

  12. Developing Community Reinforcement and Family Training (CRAFT) for Parents of Treatment-Resistant Adolescents

    Science.gov (United States)

    Kirby, Kimberly C.; Versek, Brian; Kerwin, MaryLouise E.; Meyers, Kathleen; Benishek, Lois A.; Bresani, Elena; Washio, Yukiko; Arria, Amelia; Meyers, Robert J.

    2015-01-01

    We describe a project focused on training parents to facilitate their treatment-resistant adolescent's treatment entry and to manage their child after entry into community-based treatment. Controlled studies show that Community Reinforcement and Family Training (CRAFT) is a unilateral treatment that fosters treatment entry of adults; however,…

  13. Unraveling the dynamics of community-associated methicillin-resistant Staphylococcus aureus

    NARCIS (Netherlands)

    Bootsma, M.C.; Bonten, M.J.M.

    2013-01-01

    Since the first description of the community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA) strain USA300 [1] in the 1990s, this pathogen has emerged worldwide [2]. Within a decade, USA300 has become the most prevalent cause of community-acquired S. aureus infections in many

  14. [Antibiotic resistance of Escherichia coli from community-acquired urinary tract infections. What antimicrobial to use?].

    Science.gov (United States)

    Guajardo-Lara, Claudia Elena; González-Martínez, Pedro Mario; Ayala-Gaytán, Juan Jacobo

    2009-01-01

    Determine antibiotic resistance of community-acquired uropathogen Escherichia coli and infer therapeutic options. E. coli strains isolated from urine during a one-year period were studied. Identification and susceptibility tests were performed. A total of 652 isolates were included from patients in two institutions, a healthcare clinic 303 (46.5%) and a hospital 349 ( 53.5%). The antimicrobials with higher resistance rates were ampicillin 67.2%, trimethoprim-sulfametoxazole 59.2%, cefazolin 35.6% and ciprofloxacin 24.7%. Resistance to trimethoprim-sulfamethoxazole and ciprofloxacin used for empiric treatment in community urinary infections is high, and there are few available treatment options.

  15. Drug resistance in community-acquired respiratory tract infections: role for an emerging antibacterial

    Directory of Open Access Journals (Sweden)

    Lorenzo Aguilar

    2010-06-01

    Full Text Available Lorenzo Aguilar1, María-José Giménez1, José Barberán21Microbiology Department, School of Medicine, University Complutense, Madrid; 2Infectious Diseases Department, Hospital Central de la Defensa Gomez Ulla, Madrid, SpainAbstract: The nasopharynx is the ecological niche where evolution towards resistance occurs in respiratory tract isolates. Dynamics of different bacterial populations in antibiotic-free multibacterial niches are the baseline that antibiotic treatments can alter by shifting the competitive balance in favor of resistant populations. For this reason, antibiotic resistance is increasingly being considered to be an ecological problem. Traditionally, resistance has implied the need for development of new antibiotics for which basic efficacy and safety data are required prior to licensing. Antibiotic development is mainly focused on demonstrating clinical efficacy and setting susceptibility breakpoints for efficacy prediction. However, additional information on pharmacodynamic data predicting absence of selection of resistance and of resistant subpopulations, and specific surveillance on resistance to core antibiotics (to detect emerging resistances and its link with antibiotic consumption in the community are valuable data in defining the role of a new antibiotic, not only from the perspective of its therapeutic potential but also from the ecologic perspective (countering resistances to core antibiotics in the community. The documented information on cefditoren gleaned from published studies in recent years is an example of the role for an emerging oral antibacterial facing current antibiotic resistance in community-acquired respiratory tract infections.Keywords: respiratory tract infection, antibiotic resistance, cefditoren, community

  16. [Clinical features and antimicrobial resistance of community-acquired pneumonia caused by Klebsiella pneumoniae in infants].

    Science.gov (United States)

    He, Li-Yun; Wang, Ying-Jian; Li, Ji-Mei

    2012-11-01

    To study the clinical features and antimicrobial resistance of community-acquired pneumonia caused by Klebsiella pneumoniae in infants. The clinical data of 65 infants with community-acquired pneumonia caused by Klebsiella pneumoniae between 2007 and 2011 were retrospectively studied. Of the 65 infants, 37 cases (57%) were aged ≤3 months, 17 cases (26%) over 4 months, 7 cases (11%) over 7 months and 4 cases (6%) between 13 and 24 months. There were no significant differences in clinical manifestations and chest X-ray features between the infants with community-acquired pneumonia caused by Klebsiella pneumoniae and those with other bacterial pneumonia. Forty strains (62%) of ESBLs-producing Klebsiella pneumoniae were detected. Klebsiella pneumoniae was 100% sensitive to imipenem, meropenem and amikacin but resistant to penicillins and cephalosporins. The resistance rates of ESBLs-producing strains to penicillins, cephalosporins, amoxicillin/clavulanic acid, ampicillin/sulbactam, compound sulfamethoxazole, gentamycin, ciprofloxacin and aztreonam were significantly higher than for non-ESBLs-producing strains. ESBLs-producing strains also showed multiple-drug resistance. Community-acquired pneumonia caused by Klebsiella pneumoniae is common in infants aged ≤3 months. ESBLs-producing strains are prevalent in community-acquired pneumonia caused by Klebsiella pneumoniae and demonstrate both high rates of drug resistance and multiple-drug resistance.

  17. Plant community resistance to invasion by Bromus species – the roles of community attributes, Bromus Interactions with plant communities, and Bromus traits

    Science.gov (United States)

    Chambers, Jeanne; Germino, Matthew; Belnap, Jayne; Brown, Cynthia; Schupp, Eugene W.; St. Clair, Samuel B

    2016-01-01

    The factors that determine plant community resistance to exotic annual Bromus species (Bromushereafter) are diverse and context specific. They are influenced by the environmental characteristics and attributes of the community, the traits of Bromus species, and the direct and indirect interactions of Bromus with the plant community. Environmental factors, in particular ambient and soil temperatures, have significant effects on the ability of Bromus to establish and spread. Seasonality of precipitation relative to temperature influences plant community resistance toBromus through effects on soil water storage, timing of water and nutrient availability, and dominant plant life forms. Differences among plant communities in how well soil resource use by the plant community matches resource supply rates can influence the magnitude of resource fluctuations due to either climate or disturbance and thus the opportunities for invasion. The spatial and temporal patterns of resource availability and acquisition of growth resources by Bromus versus native species strongly influence resistance to invasion. Traits of Bromus that confer a “priority advantage” for resource use in many communities include early-season germination and high growth and reproductive rates. Resistance to Bromus can be overwhelmed by high propagule supply, low innate seed dormancy, and large, if short-lived, seed banks. Biological crusts can inhibit germination and establishment of invasive annual plants, including several annual Bromus species, but are effective only in the absence of disturbance. Herbivores can have negative direct effects on Bromus, but positive indirect effects through decreases in competitors. Management strategies can be improved through increased understanding of community resistance to exotic annual Bromus species.

  18. Creation of a community violence exposure scale: accounting for what, who, where, and how often.

    Science.gov (United States)

    Suglia, Shakira Franco; Ryan, Louise; Wright, Rosalind J

    2008-10-01

    Previous research has used the Rasch model, a method for obtaining a continuous scale from dichotomous survey items measuring a single latent construct, to create a scale of community violence exposure. The authors build upon previous work and describe the application of a Rasch model using the continuation ratio model to create an exposure to community violence (ETV) scale including event circumstance information previously shown to modify the impact of experienced events. They compare the Rasch ETV scale to a simpler sum ETV score, and estimate the effect of ETV on child posttraumatic stress symptoms. Incorporating detailed event circumstance information that is grounded in traumatic stress theory may reduce measurement error in the assessment of children's community violence exposure.

  19. Accessing the Classroom Discourse Community through Accountable Talk: English Learners' Voices

    Science.gov (United States)

    Ardasheva, Yuliya; Howell, Penny B.; Vidrio Magaña, Margarita

    2016-01-01

    This case study draws on Gee's (1989) "D/discourse theory" to investigate English learners' (ELs') perspectives regarding Accountable Talk (AT)--a structured, discourse-intensive instructional approach--after a yearlong implementation in three content-based (mathematics) middle school classrooms. Interviews with 21 ELs (3 Advanced…

  20. Knowledge Contribution in Virtual Communities: Accounting for Multiple Dimensions of Social Presence through Social Identity

    Science.gov (United States)

    Shen, Kathy Ning; Yu, Angela Yan; Khalifa, Mohamed

    2010-01-01

    Integrating social presence theory and social identity theory, this study brings system design and social influence aspects together to explain their joint effects on knowledge contribution in virtual communities (VCs). Different from most prior information systems (IS) research that adopts a uni-dimensional approach and restricts social presence…

  1. Measuring the Accountability of CTE Programs: Factors that Influence Postcollege Earnings among Community College Students

    Science.gov (United States)

    Maguire, Kenneth J.; Starobin, Soko S.; Laanan, Frankie Santos; Friedel, Janice N.

    2012-01-01

    In this study specific factors were examined to determine their ability to influence fifth-year earnings of community college students in the Manufacturing/Science, Technology, Engineering and Math (STEM) career cluster and the Arts/Audiovisual/Technology/ Communication career cluster. State and national data sets from Iowa's Management…

  2. A Situated Account of Teacher Agency and Learning: Critical Reflections on Professional Learning Communities

    Science.gov (United States)

    Riveros, Augusto; Newton, Paul; Burgess, David

    2012-01-01

    We propose a practice-based focus for professional learning communities in schools. We start with a brief historical review of the approaches that have deemed peer collaboration as crucial for school improvement and explore how teachers' practices have been characterised in past reform initiatives. Second, we highlight the importance of "teacher…

  3. High Prevalence and Resistance Patterns of Community-Associated Methicillin-Resistant Staphylococcus Aureus in the Pomoravlje Region, Serbia.

    Science.gov (United States)

    Lepsanovic, Zorica; Jeremic, Ljiljana Petrovic; Lazic, Srdjan; Cirkovic, Ivana

    2016-03-01

    With a view to estimating the prevalence and resistance patterns of CA-MRSA in one region of Serbia, we performed an analysis of MRSA isolates from healthy people and hospitalised patients. The detection of CA-MRSA was carried out by SCCmec typing. In MRSA isolates from hospitalised patients SCCmec types IV and V were found in 76% of the strains. Similar percentage (80%) of CA-MRSA genotypes was present in healthy people. SCCmec type V harbouring MRSA was the most successful clone. Higher prevalence of type V in hospitalised patients to that in healthy people (70% vs 54%) may indicate nosocomial transmissions in at least some hospital units. All MRSA strains from hospitalised patients were resistant to one or more non-β-lactam antibiotics while 52% were multi-resistant. In isolates from healthy people, 16% were sensitive to all non-β-lactam antibiotics and 40% were multi-resistant. Similar percentage of multi-resistant CA- and HA-genotypes occurred in a particular environment (53% vs 50% in hospitalised patients, and 37.5% vs 37.5% in healthy people) indicating selective pressure of antibiotics as a leading force conferring antibiotic resistance. High prevalence of CA-MRSA and high resistance rate both in hospitals and the community suggest that this pathogen has been present in the Pomoravlje Region, central Serbia for years.

  4. Coding early naturalists' accounts into long-term fish community changes in the Adriatic Sea (1800-2000.

    Directory of Open Access Journals (Sweden)

    Tomaso Fortibuoni

    Full Text Available The understanding of fish communities' changes over the past centuries has important implications for conservation policy and marine resource management. However, reconstructing these changes is difficult because information on marine communities before the second half of the 20(th century is, in most cases, anecdotal and merely qualitative. Therefore, historical qualitative records and modern quantitative data are not directly comparable, and their integration for long-term analyses is not straightforward. We developed a methodology that allows the coding of qualitative information provided by early naturalists into semi-quantitative information through an intercalibration with landing proportions. This approach allowed us to reconstruct and quantitatively analyze a 200-year-long time series of fish community structure indicators in the Northern Adriatic Sea (Mediterranean Sea. Our analysis provides evidence of long-term changes in fish community structure, including the decline of Chondrichthyes, large-sized and late-maturing species. This work highlights the importance of broadening the time-frame through which we look at marine ecosystem changes and provides a methodology to exploit, in a quantitative framework, historical qualitative sources. To the purpose, naturalists' eyewitness accounts proved to be useful for extending the analysis on fish community back in the past, well before the onset of field-based monitoring programs.

  5. Antimicrobial resistance in community and nosocomial Escherichia coli urinary tract isolates, London 2005 – 2006

    Directory of Open Access Journals (Sweden)

    Wareham David W

    2008-06-01

    Full Text Available Abstract Background Escherichia coli is the commonest cause of community and nosocomial urinary tract infection (UTI. Antibiotic treatment is usually empirical relying on susceptibility data from local surveillance studies. We therefore set out to determine levels of resistance to 8 commonly used antimicrobial agents amongst all urinary isolates obtained over a 12 month period. Methods Antimicrobial susceptibility to ampicillin, amoxicillin/clavulanate, cefalexin, ciprofloxacin, gentamicin, nitrofurantoin, trimethoprim and cefpodoxime was determined for 11,865 E. coli urinary isolates obtained from community and hospitalised patients in East London. Results Nitrofurantoin was the most active agent (94% susceptible, followed by gentamicin and cefpodoxime. High rates of resistance to ampicillin (55% and trimethoprim (40%, often in combination were observed in both sets of isolates. Although isolates exhibiting resistance to multiple drug classes were rare, resistance to cefpodoxime, indicative of Extended spectrum β-lactamase production, was observed in 5.7% of community and 21.6% of nosocomial isolates. Conclusion With the exception of nitrofurantoin, resistance to agents commonly used as empirical oral treatments for UTI was extremely high. Levels of resistance to trimethoprim and ampicillin render them unsuitable for empirical use. Continued surveillance and investigation of other oral agents for treatment of UTI in the community is required.

  6. Uterotonic use during childbirth in Uttar Pradesh: accounts from community members and health providers.

    Science.gov (United States)

    Mirzabagi, Ellie; Deepak, Nitya Nand; Koski, Alissa; Tripathi, Vandana

    2013-08-01

    this qualitative study aimed to document provider and community practices regarding uterotonic use during labour and delivery in Uttar Pradesh, India, as well as the knowledge, attitudes, and values that underlie such use. a total of 140 in-depth interviews were conducted between May and July 2011 in Agra and Gorakhpur districts, with clinicians, nurses, recently delivered women, mothers-in-law with at least one grandchild, traditional birth attendants, unlicensed village doctors, and pharmacist assistants at chemical shops. interviews reveal that injectable uterotonic use for the purposes of labour augmentation is widespread in both clinical and community settings. However, use of uterotonics for postpartum haemorrhage prevention and treatment appears to be relatively limited and was rarely discussed by respondents. Key beliefs underlying uterotonic use were identified, including high valuation of labour pain, rapid delivery, and biomedical intervention, particularly administration of medicines. Other factors promoting the use of uterotonics for labour augmentation included lack of knowledge about adverse effects, provider beliefs that prolonged labour poses risks to the baby, community perceptions that modern women are less able to have spontaneous delivery, and financial incentives for uterotonic administration. major challenges to overcome in minimising uterotonic misuse include entrenched use for labour augmentation in both institutional and community deliveries, perceptions of injectable uterotonics as curative agents symbolic of biomedical care, and the widespread availability of these drugs. The findings demonstrate a need for programmes that reduce inappropriate use of uterotonics, promote appropriate use for postpartum haemorrhage prevention and treatment, and ensure adherence to evidence-based guidelines. Copyright © 2012 Elsevier Ltd. All rights reserved.

  7. Community-based palliative care for Bangladeshi patients in east London. Accounts of bereaved carers.

    Science.gov (United States)

    Spruyt, O

    1999-03-01

    The aim of this paper is to describe the palliative care experience of Bangladeshi patients and carers in the Tower Hamlets area in the east of London. Semi-structured interviews were carried out in Sylheti, the Bengali dialect of this community, with bereaved primary carers of 18 patients (10 male, eight female) referred to an east London community palliative care team between 1986 and 1993. It was found that patients were young, with a mean age of males of 55 years (range 34-65) and females of 40 years (range 28-57). Communication difficulties were common. The fluency in English of patients was low, with reliance on family members, especially children, for translation. The diagnosis was known by all patients, but only 56% of carers agreed with disclosure. Team dissatisfaction with communication was recorded in 16 cases. Fourteen patients died in London; however, 13 were buried in Bangladesh. Carers often reported symptoms as poorly controlled. Pain was said to be severe for 14 patients, and pain control said to be poor in 11. Family and friends provided most support during the illness and bereavement. Serious financial difficulties occurred in nine families. General practitioners were involved actively in six cases. In conclusion, there are ethno-specific needs in this particular community, many of which arise from socio-economic factors, recent migration and religious beliefs, and which are highlighted by terminal illness.

  8. Clinical presentation of community-acquired methicillin-resistant Staphylococcus aureus in pregnancy.

    Science.gov (United States)

    Laibl, Vanessa R; Sheffield, Jeanne S; Roberts, Scott; McIntire, Donald D; Trevino, Sylvia; Wendel, George D

    2005-09-01

    The objective of this study was to review the presentation and management of community-acquired methicillin-resistant Staphylococcus aureus (MRSA) in pregnant women. This was a chart review of pregnant patients who were diagnosed with MRSA between January 1, 2000, and July 30, 2004. Data collected included demographic characteristics, clinical presentation, culture results, and pathogen susceptibilities. Patients' pregnancy outcomes were compared with the general obstetric population during the study period. Fifty-seven charts were available for review. There were 2 cases in 2000, 4 in 2001, 11 in 2002, 23 in 2003, and 17 through July of 2004. Comorbid conditions included human immunodeficiency virus and acquired immunodeficiency syndrome (13%), asthma (11%), and diabetes (9%). Diagnostic culture was most commonly obtained in the second trimester (46%); however 18% of cases occurred in the postpartum period. Skin and soft tissue infections accounted for 96% of cases. The most common site for a lesion was the extremities (44%), followed by the buttocks (25%), and breast (mastitis) (23%). Fifty-eight percent of patients had recurrent episodes. Sixty-three percent of patients required inpatient treatment. All MRSA isolates were sensitive to trimethoprim-sulfamethoxazole, vancomycin, and rifampin. Other antibiotics to which the isolates were susceptible included gentamicin (98%) and levofloxacin (84%). In comparison with the general obstetric population, patients with MRSA were more likely to be multiparous and to have had a cesarean delivery. Community-acquired MRSA is an emerging problem in our obstetric population. Most commonly, it presents as a skin or soft tissue infection that involves multiple sites. Recurrent skin abscesses during pregnancy should raise prompt investigation for MRSA. II-3.

  9. Resistance of i-beams in warping torsion with account for the development of plasticdeformations

    Directory of Open Access Journals (Sweden)

    Tusnin Aleksandr Romanovich

    2014-01-01

    Full Text Available Torsion of thin-walled open-section beams due to restrained warping displacements of cross-section is causing additional stresses, which make a significant contribution to the total stress. Due to plastic deformation there are certain reserves of bearing capacity, identification of which is of significant practical interest. The existing normative documents for the design of steel structures in Russia do not include design factor taking into account the development of plastic deformation during warping torsion. The analysis of thin-walled open-section members with plastic deformation will more accurately determine their load-bearing capacity and requires further research. Reserves of the beams bearing capacity due to the development of plastic deformations are revealed when beams are influenced by bending, as well as tension and compression. The existing methodology of determining these reserves and the plastic shape factor in bending was reviewed. This has allowed understanding how it was possible to solve this problem for warping torsion members and outline possible ways of theoretical studies of the bearing capacity in warping torsion. The authors used theoretical approach in determining this factor for the symmetric I-section beam under the action of bimoment and gave recommendations for the design of torsion members including improved value of plastic shape factor.

  10. Antibiotic resistance differentiates Echinacea purpurea endophytic bacterial communities with respect to plant organs.

    Science.gov (United States)

    Mengoni, Alessio; Maida, Isabel; Chiellini, Carolina; Emiliani, Giovanni; Mocali, Stefano; Fabiani, Arturo; Fondi, Marco; Firenzuoli, Fabio; Fani, Renato

    2014-10-01

    Recent findings have shown that antibiotic resistance is widespread in multiple environments and multicellular organisms, as plants, harboring rich and complex bacterial communities, could be hot spot for emergence of antibiotic resistances as a response to bioactive molecules production by members of the same community. Here, we investigated a panel of 137 bacterial isolates present in different organs of the medicinal plant Echinacea purpurea, aiming to evaluate if different plant organs harbor strains with different antibiotic resistance profiles, implying then the presence of different biological interactions in the communities inhabiting different plant organs. Data obtained showed a large antibiotic resistance variability among strains, which was strongly related to the different plant organs (26% of total variance, P antibiotic resistance pattern was present also when a single genus (Pseudomonas), ubiquitous in all organs, was analyzed and no correlation of antibiotic resistance pattern with genomic relatedness among strains was found. In conclusion, we speculate that antibiotic resistance patterns are tightly linked to the type of plant organ under investigation, suggesting the presence of differential forms of biological interaction in stem/leaves, roots and rhizosphere. Copyright © 2014 Institut Pasteur. Published by Elsevier Masson SAS. All rights reserved.

  11. [Staphylococcus aureus methicillin-resistant community acquired neonatal orbital cellulitis].

    Science.gov (United States)

    Pérez, M Guadalupe; Castro, Graciela; Mansilla, Celeste; Kaldzielski, Carina; Salas, Gisela; Rosanova, María Teresa; Berberian, Griselda

    2013-04-01

    Orbital cellulitis typically occurs in older children, but it can occasionally affect infants and neonates. Staphylococcus aureus is the main pathogen isolated. Outcome depends on an adequate initial approach. We report three neonates with orbital cellulitis caused by community-associated MRSA.

  12. Resisting New Concepts: Incorporation of Community-Based ...

    African Journals Online (AJOL)

    This paper is a report on the University of Zimbabwe departments concerned with conservation. The departments were interviewed with the view to finding out whether new concepts regarding a subject matter are readily accepted by the scientific community. In particular, the study sought to understand whether the identified ...

  13. Accounting for Heritage, Cultural and Community Assets – Alternative Metrics from a New Zealand Māori Educational Institution

    Directory of Open Access Journals (Sweden)

    Susan Wild

    2013-03-01

    Full Text Available In the 1980s, with the rise to dominance of governments with neoliberal economic and social agendas, the public sector in major western countries underwent a process of fundamental reforms. A key aspect of the change imposed was the implementation of a market-oriented, cost-efficiency focus towards the management of public sector organisations, described collectively as the New Public Management (NPM model (Kelsey, 1995; Boston et al, 1996; Easton 1996; Barton, 2002, 2005a, 2005b; Carnegie & West, 2005; Ball & Grubnic, 2008; Davis, 2010. This reform process included the imposition of regulatory measures requiring public sector organisations to provide annual financial reports prepared on an accounting basis comparable to those for the private sector, and incorporated an obligation to disclose (at economic values all assets held. For public benefit entities holding heritage, cultural and community assets (HCA, this reporting requirement has been particularly problematic, entailing substantive changes to public accounting policy.This paper critiques the political ideologies and practices of the NPM model, and challenges its assumptions that private sector financial reporting requirements, based on international accounting standards and Generally Accepted Accounting Practice (GAAP, are appropriate for universal application to public benefit and other not-for-profit entities holding HCA. In particular, the paper argues against the NPM assumption that reporting all HCA in economic terms improves accountability in public benefit entities. Instead, the paper proposes an alternative reporting model based on a set of cultural rather than economic values for reporting HCA. It suggests as an exemplar the ‘Wellbeing of Communities’ reporting and accountability framework devised for application by an indigenous New Zealand Māori educational institution, Te Wānanga-o-Raukawa.

  14. The impacts of triclosan on anaerobic community structures, function, and antimicrobial resistance.

    Science.gov (United States)

    McNamara, Patrick J; LaPara, Timothy M; Novak, Paige J

    2014-07-01

    Triclosan is a widespread antimicrobial agent that accumulates in anaerobic digesters used to treat the residual solids generated at municipal wastewater treatment plants; there is very little information, however, about how triclosan impacts microbial communities in anaerobic digesters. We investigated how triclosan impacts the community structure, function and antimicrobial resistance genes in lab-scale anaerobic digesters. Previously exposed (to triclosan) communities were amended with 5, 50, and 500 mg/kg of triclosan, corresponding to the median, 95th percentile, and 4-fold higher than maximum triclosan concentration that has been detected in U.S. biosolids. Triclosan amendment caused all of the Bacteria and Archaea communities to structurally diverge from that of the control cultures (based on ARISA). At the end of the experiment, all triclosan-amended Archaea communities had diverged from the control communities, regardless of the triclosan concentration added. In contrast, over time the Bacteria communities that were amended with lower concentrations of triclosan (5 mg/kg and 50 mg/kg) initially diverged and then reconverged with the control community structure. Methane production at 500 mg/kg was nearly half the methane production in control cultures. At 50 mg/kg, a large variability in methane production was observed, suggesting that 50 mg/kg may be a tipping point where function begins to fail in some communities. When previously unexposed communities were exposed to 500 mg triclosan/kg, function was maintained, but the abundance of a gene encoding for triclosan resistance (mexB) increased. This research suggests that triclosan could inhibit methane production in anaerobic digesters if concentrations were to increase and may also select for resistant Bacteria. In both cases, microbial community composition and exposure history alter the influence of triclosan.

  15. Drug resistance and population structure of M.tuberculosis isolates from prisons and communities in Ethiopia.

    Science.gov (United States)

    Ali, Solomon; Beckert, Patrick; Haileamlak, Abraham; Wieser, Andreas; Pritsch, Michael; Heinrich, Norbert; Löscher, Thomas; Hoelscher, Michael; Niemann, Stefan; Rachow, Andrea

    2016-11-21

    The population structure and drug resistance pattern of Mycobacterium tuberculosis complex (MTBC) isolates in Ethiopian prisons and some communities is still unknown. A comparative cross sectional study was conducted on 126 MTBC strains isolated from prisons and communities in southwestern, southern and eastern Ethiopia. Phenotypic drug susceptibility testing was performed with the MGIT960 system. Combined 24-loci Mycobacterium interspersed repetitive unit-variable number tandem repeat and spacer oligonucleotide typing methods were used to study the MTBC population structure. The obtained data from prisons and communities were compared using statistical tests and regression analysis. A diverse population structure with 11 different lineages and sub-lineages was identified. The predominant strains were the recently described Ethiopia_H37Rv like (27.52%) and Ethiopia_3 (16.51%) with equal lineage distribution between prisons and communities. 28.57% of prison strains and 31.82% of community strains shared the identical genotype with at least one other strain. The multidrug-resistance (MDR) prevalence of the community was 2.27% whereas that of prisons was 9.52%. The highest mono resistance was seen against streptomycin (15.89%). Tuberculosis in communities and prisons is caused by a variety of MTBC lineages with predominance of local Ethiopian lineages. The increasing prevalence of MDR MTBC strains is alarming. These findings suggest the need for new approaches for control of MDR tuberculosis in Ethiopia.

  16. Disaster mitigation action plan: Digital media on improving accountability and community relationships

    Science.gov (United States)

    Adila, I.; Dewi, W. W. A.; Tamitiadini, D.; Syauki, W. R.

    2017-06-01

    This study wants to address on how communication science is applied to Disaster Mitigation Plan. Especially, the implementation of Community Media and Development of Communication Technology that synergize to create a Disaster Mitigation Medium, which is appropriate for typology of Indonesia. Various levels of priorities that include disaster mitigation information, namely, increasing chain system of early warning systems, building evacuation, improving alertness and capacity to face a disaster, as well as minimizing disaster risk factor. Through this concept, mitigation actions plan of Tulungagung Coastal areas is expected to be applied in other regions in Indonesia by BNPB (Badan Nasional Penanggulangan Bencana). Having this strategy to be implemented based on region characteristics, it is expected that risk reduction process can be run optimally. As a result, the strategy is known as Community-Based Disaster Risk Reduction (PRBBK), which means as the organized-efforts by society for pra-, during, and post- disaster by using available resources as much as possible to prevent, reduce, avoid, and recover from the impact of disasters. Therefore, this result can be a Pilot Project for BNBP Indonesia, as a government decisive attitude for the next steps in protecting people residing in the region prone to natural disasters all over Indonesia.

  17. Long-term changes in community assembly, resistance, and resilience following experimental floods.

    Science.gov (United States)

    Robinson, Christopher T

    2012-10-01

    This study examined the long-term changes in community assembly, resistance, and resilience of macroinvertebrates following 10 years of experimental floods in a flow regulated river. Physico-chemistry, macroinvertebrates, and periphyton biomass were monitored before and sequentially after each of 22 floods, and drift/seston was collected during six separate floods over the study period. The floods reduced the density and taxon richness of macroinvertebrates, and a nonmetric dimensional scaling (NMDS) analysis distinguished temporal shifts in community assembly. Resistance (measured as the relative lack of loss in density) tofloods varied among taxa, and the abundance of resistant taxa was related to the temporal changes in community assembly. Community resistance was inversely related to flood magnitude with all larger floods (> 25 m3/s, > 16-fold over baseflow) reducing densities by > 75% regardless of flood year, whereas smaller floods (scour. Drift density was 3-9 times greater and that of seston 3-30 times greater during larger floods than smaller floods. These results demonstrate temporal shifts in macroinvertebrate community assembly toward a pre-dam assemblage following sequential floods in this flow regulated river, thus confirming the ecological role of habitat filtering in organism distribution and abundance. Community resistance and resilience were unrelated to shifts in community assembly, suggesting that they are mostly evolutionary properties of ecosystems as populations adapt to changing environmental (disturbance regimes) and biotic (novel colonists) conditions. As these systems show behaviors similar to dispersal-limited ecosystems, a long-term perspective is required for management actions targeted toward regulated and fragmented rivers.

  18. The increasing importance of community-acquired methicillin-resistant Staphylococcus aureus infections.

    Science.gov (United States)

    Agostino, Jason W; Ferguson, John K; Eastwood, Keith; Kirk, Martyn D

    2017-11-06

    To identify groups at risk of methicillin-resistant Staphylococcus aureus (MRSA) infection, patterns of antimicrobial resistance, and the proportion of patients with MRSA infections but no history of recent hospitalisation. Case series of 39 231 patients with S. aureus isolates from specimens processed by the Hunter New England Local Health District (HNELHD) public pathology provider during 2008-2014. Proportion of MRSA infections among people with S. aureus isolates; antimicrobial susceptibility of MRSA isolates; origin of MRSA infections (community- or health care-associated); demographic factors associated with community-associated MRSA infections. There were 71 736 S. aureus-positive specimens during the study period and MRSA was isolated from 19.3% of first positive specimens. Most patients (56.9%) from whom MRSA was isolated had not been admitted to a public hospital in the past year. Multiple regression identified that patients with community-associated MRSA were more likely to be younger (under 40), Indigenous Australians (odds ratio [OR], 2.6; 95% CI, 2.3-2.8), or a resident of an aged care facility (OR, 4.7; 95% CI, 3.8-5.8). The proportion of MRSA isolates that included the dominant multi-resistant strain (AUS-2/3-like) declined from 29.6% to 3.4% during the study period (P resistant strain decreased, new strategies for controlling infections in the community are needed to reduce the prevalence of non-multi-resistant strains.

  19. Resistance and Resilience of Soil Microbial Communities Exposed to Petroleum-Derived Compounds

    DEFF Research Database (Denmark)

    Modrzynski, Jakub Jan

    Functioning of soil microbial communities is generally considered resilient to disturbance, including chemical stress. Activities of soil microbial communities are often sustained in polluted environments due to exceptional plasticity of microbial communities and functional redundancy. Pollution......-derived compounds (PDCs) is a significant environmental problem on a global scale. Research addressing interactions between microorganisms and PDC pollution is dominated by studies of biodegradation, with less emphasis on microbial ecotoxicology. Soil microbial communities are generally considered highly resilient...... communities. In several scenarios effects of the PDC exposure can be detrimental and sometimes longterm, indicating limited resistance and resilience of microbial communities even though these compounds are biodegradable, volatile and tend to sorb to soil. Considering the widespread environmental PDC...

  20. Metal resistance systems in cultivated bacteria: are they found in complex communities?

    Science.gov (United States)

    Gillan, David C

    2016-04-01

    Metal resistance systems found in complex bacterial communities by shotgun metagenomic approaches were reviewed. For that, 6 recent studies investigating 9 metal-contaminated environments (water or sediments) were selected. Of the 22 possible metal-resistance systems, only 14 were found in complex communities. These widespread and easily detected metal-resistance systems were mainly biogenic sulfide production (dsr genes), resistance mediated in the periplasm (CopK and multicopper oxidases such as PcoA/CopA), efflux proteins (HME-RND systems, P-type ATPases, and the cation diffusion facilitator CzcD) as well as proteins used to treat oxidative damages (e.g., SodA) and down-regulation of transporters. A total of 8 metal-resistance systems were not found in the complex communities investigated. These rare systems include metal resistance by phosphatases, ureases, metallophores, outer membrane vesicles, methylation genes and cytoplasmic metal accumulation systems. In this case rarity may also be explained by a lack of knowledge on the specific genes involved and/or analytical biases. Copyright © 2016 Elsevier Ltd. All rights reserved.

  1. Population Screening Using Sewage Reveals Pan-Resistant Bacteria in Hospital and Community Samples.

    Science.gov (United States)

    Meir-Gruber, Lital; Manor, Yossi; Gefen-Halevi, Shiraz; Hindiyeh, Musa Y; Mileguir, Fernando; Azar, Roberto; Smollan, Gill; Belausov, Natasha; Rahav, Galia; Shamiss, Ari; Mendelson, Ella; Keller, Nathan

    2016-01-01

    The presence of pan-resistant bacteria worldwide possesses a threat to global health. It is difficult to evaluate the extent of carriage of resistant bacteria in the population. Sewage sampling is a possible way to monitor populations. We evaluated the presence of pan-resistant bacteria in Israeli sewage collected from all over Israel, by modifying the pour plate method for heterotrophic plate count technique using commercial selective agar plates. This method enables convenient and fast sewage sampling and detection. We found that sewage in Israel contains multiple pan-resistant bacteria including carbapenemase resistant Enterobacteriacae carrying blaKPC and blaNDM-1, MRSA and VRE. blaKPC carrying Klebsiella pneumonia and Enterobacter cloacae were the most common Enterobacteriacae drug resistant bacteria found in the sewage locations we sampled. Klebsiella pneumonia, Enterobacter spp., Escherichia coli and Citrobacter spp. were the 4 main CRE isolated from Israeli sewage and also from clinical samples in our clinical microbiology laboratory. Hospitals and Community sewage had similar percentage of positive samplings for blaKPC and blaNDM-1. VRE was found to be more abundant in sewage in Israel than MRSA but there were more locations positive for MRSA and VRE bacteria in Hospital sewage than in the Community. Therefore, our upgrade of the pour plate method for heterotrophic plate count technique using commercial selective agar plates can be a useful tool for routine screening and monitoring of the population for pan-resistant bacteria using sewage.

  2. Antimicrobial resistance patterns in community acquired urinary tract infections

    International Nuclear Information System (INIS)

    Gilani, S.Y.H; Ahmad, N.; Shah, S.R.A.

    2016-01-01

    Urinary tract infection (UTI) is the most frequent disease for which patients seek medical care. The antimicrobial agents causing UTI and their sensitivity patterns have remarkably changed throughout the world over the past few years. Hence, the present study was designed to explore the uropathogens and their susceptibility to various molecules in our region. Methods: This descriptive cross sectional study was conducted at Medical C Unit of Ayub Teaching Hospital, Abbottabad from January 2015 to January 2016. Patients with clinical features of UTI were evaluated using Urine R/E and Urine culture and sensitivity. Ten antibiotics were checked for susceptibility. Results were analysed using SPSS 17. Results: A total of 630 patients presented with urinary complaints. Of these, 236 patients had more than 8-10 pus cells on urine R/E. They were further evaluated using culture and sensitivity and positive culture was obtained in 75 patients. Of these 34 (45.3%) were males and 41 (54.7%) were females. E Coli was the predominant isolate being present in 49 (65.3%) patients. This was followed by Klebsiella in 9 (12%) patients. Tazobactam-piperacillin and cefoperazone-sulbactam were the most sensitive drugs having overall sensitivity of 96% and 93.3% respectively. The isolates were highly resistant to Fluoroquinolones 77.3% followed by Penicillins 72% and TMP-SMX 69.3%.Conclusion: Antibiotic sensitivity patterns have enormously changed over the past decade. Newer agents are quite efficacious but their use should be highly judicious to prevent the development of resistance to these molecules. (author)

  3. Accounting for both local aquatic community composition and bioavailability in setting site-specific quality standards for zinc.

    Science.gov (United States)

    Peters, Adam; Simpson, Peter; Moccia, Alessandra

    2014-01-01

    Recent years have seen considerable improvement in water quality standards (QS) for metals by taking account of the effect of local water chemistry conditions on their bioavailability. We describe preliminary efforts to further refine water quality standards, by taking account of the composition of the local ecological community (the ultimate protection objective) in addition to bioavailability. Relevance of QS to the local ecological community is critical as it is important to minimise instances where quality classification using QS does not reconcile with a quality classification based on an assessment of the composition of the local ecology (e.g. using benthic macroinvertebrate quality assessment metrics such as River InVertebrate Prediction and Classification System (RIVPACS)), particularly where ecology is assessed to be at good or better status, whilst chemical quality is determined to be failing relevant standards. The alternative approach outlined here describes a method to derive a site-specific species sensitivity distribution (SSD) based on the ecological community which is expected to be present at the site in the absence of anthropogenic pressures (reference conditions). The method combines a conventional laboratory ecotoxicity dataset normalised for bioavailability with field measurements of the response of benthic macroinvertebrate abundance to chemical exposure. Site-specific QSref are then derived from the 5%ile of this SSD. Using this method, site QSref have been derived for zinc in an area impacted by historic mining activities. Application of QSref can result in greater agreement between chemical and ecological metrics of environmental quality compared with the use of either conventional (QScon) or bioavailability-based QS (QSbio). In addition to zinc, the approach is likely to be applicable to other metals and possibly other types of chemical stressors (e.g. pesticides). However, the methodology for deriving site-specific targets requires

  4. Comparison of clinical prediction models for resistant bacteria in community-onset pneumonia.

    Science.gov (United States)

    Self, Wesley H; Wunderink, Richard G; Williams, Derek J; Barrett, Tyler W; Baughman, Adrienne H; Grijalva, Carlos G

    2015-06-01

    Six recently published algorithms classify pneumonia patients presenting from the community into high- and low-risk groups for resistant bacteria. Our objective was to compare performance of these algorithms for identifying patients infected with bacteria resistant to traditional community-acquired pneumonia antibiotics. This was a retrospective study of consecutive adult patients diagnosed with pneumonia in an emergency department and subsequently hospitalized. Each patient was classified as high or low risk for resistant bacteria according to the following algorithms: original health care-associated pneumonia (HCAP) criteria, Summit criteria, Brito and Niederman strategy, Shorr model, Aliberti model, and Shindo model. The reference for comparison was detection of resistant bacteria, defined as methicillin-resistant Staphylococcus aureus or Gram-negative bacteria resistant to ceftriaxone or levofloxacin. A total of 614 patients were studied, including 36 (5.9%) with resistant bacteria. The HCAP criteria classified 304 (49.5%) patients as high risk, with an area under the receiver operating characteristic curve (AUC) of 0.63 (95% confidence interval [CI] = 0.54 to 0.72), sensitivity of 0.69 (95% CI = 0.52 to 0.83), and specificity of 0.52 (95% CI = 0.48 to 0.56). None of the other algorithms improved both sensitivity and specificity or significantly improved the AUC. Compared to the HCAP criteria, the Shorr and Aliberti models classified more patients as high risk, resulting in higher sensitivity and lower specificity. The Shindo model classified fewer patients as high risk, with lower sensitivity and higher specificity. All algorithms for identification of resistant bacteria included in this study had suboptimal performance to guide antibiotic selection. New strategies for selecting empirical antibiotics for community-onset pneumonia are necessary. © 2015 by the Society for Academic Emergency Medicine.

  5. Socioeconomic Factors Explain Racial Disparities in Invasive Community-Associated Methicillin-Resistant Staphylococcus aureus Disease Rates.

    Science.gov (United States)

    See, Isaac; Wesson, Paul; Gualandi, Nicole; Dumyati, Ghinwa; Harrison, Lee H; Lesher, Lindsey; Nadle, Joelle; Petit, Susan; Reisenauer, Claire; Schaffner, William; Tunali, Amy; Mu, Yi; Ahern, Jennifer

    2017-03-01

    Invasive community-associated methicillin-resistant Staphylococcus aureus (MRSA) incidence in the United States is higher among black persons than white persons. We explored the extent to which socioeconomic factors might explain this racial disparity. A retrospective cohort was based on the Centers for Disease Control and Prevention's Emerging Infections Program surveillance data for invasive community-associated MRSA cases (isolated from a normally sterile site of an outpatient or on hospital admission day ≤3 in a patient without specified major healthcare exposures) from 2009 to 2011 in 33 counties of 9 states. We used generalized estimating equations to determine census tract-level factors associated with differences in MRSA incidence and inverse odds ratio-weighted mediation analysis to determine the proportion of racial disparity mediated by socioeconomic factors. Annual invasive community-associated MRSA incidence was 4.59 per 100000 among whites and 7.60 per 100000 among blacks (rate ratio [RR], 1.66; 95% confidence interval [CI], 1.52-1.80). In the mediation analysis, after accounting for census tract-level measures of federally designated medically underserved areas, education, income, housing value, and rural status, 91% of the original racial disparity was explained; no significant association of black race with community-associated MRSA remained (RR, 1.05; 95% CI, .92-1.20). The racial disparity in invasive community-associated MRSA rates was largely explained by socioeconomic factors. The specific factors that underlie the association between census tract-level socioeconomic measures and MRSA incidence, which may include modifiable social (eg, poverty, crowding) and biological factors (not explored in this analysis), should be elucidated to define strategies for reducing racial disparities in community-associated MRSA rates.

  6. Aetiology and resistance patterns of community-acquired pneumonia in León, Nicaragua

    NARCIS (Netherlands)

    Matute, A J; Brouwer, W P; Hak, E; Delgado, E; Alonso, E; Hoepelman, I M

    2006-01-01

    We conducted a prevalence study to gain greater insight into the aetiology, bacterial resistance and risk factors for community-acquired pneumonia (CAP) in the region of León, Nicaragua. During the period from July 2002 to January 2005, all consecutive patients with signs and symptoms suggestive of

  7. Nosocomial transmission of community-associated methicillin-resistant Staphylococcus aureus in Danish Hospitals

    DEFF Research Database (Denmark)

    Hetem, David J; Westh, Henrik; Boye, Kit

    2012-01-01

    The emergence of community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA) has changed the epidemiology of MRSA infections worldwide. In contrast to hospital-associated MRSA (HA-MRSA), CA-MRSA more frequently affects healthy individuals, both with and without recent healthcare...

  8. Preventing Community-Associated Methicillin-Resistant "Staphylococcus aureus" among Student Athletes

    Science.gov (United States)

    Many, Patricia S.

    2008-01-01

    Methicillin-resistant "Staphylococcus aureus" (MRSA) was once thought to be a bacterium causing infections in only hospitalized patients. However, a new strain of MRSA has emerged among healthy individuals who have not had any recent exposure to a hospital or to medical procedures. This new strain is known as "community-associated…

  9. Antibiotic Discovery: Combatting Bacterial Resistance in Cells and in Biofilm Communities

    Directory of Open Access Journals (Sweden)

    Anahit Penesyan

    2015-03-01

    Full Text Available Bacterial resistance is a rapidly escalating threat to public health as our arsenal of effective antibiotics dwindles. Therefore, there is an urgent need for new antibiotics. Drug discovery has historically focused on bacteria growing in planktonic cultures. Many antibiotics were originally developed to target individual bacterial cells, being assessed in vitro against microorganisms in a planktonic mode of life. However, towards the end of the 20th century it became clear that many bacteria live as complex communities called biofilms in their natural habitat, and this includes habitats within a human host. The biofilm mode of life provides advantages to microorganisms, such as enhanced resistance towards environmental stresses, including antibiotic challenge. The community level resistance provided by biofilms is distinct from resistance mechanisms that operate at a cellular level, and cannot be overlooked in the development of novel strategies to combat infectious diseases. The review compares mechanisms of antibiotic resistance at cellular and community levels in the light of past and present antibiotic discovery efforts. Future perspectives on novel strategies for treatment of biofilm-related infectious diseases are explored.

  10. Classification of Epidemic Community-Acquired Methicillin-Resistant Staphylococcus aureus by Anatomical Site of Isolation

    Directory of Open Access Journals (Sweden)

    Jill C. Roberts

    2014-01-01

    Full Text Available Methicillin-resistant Staphylococcus aureus contributes significantly to cost, morbidity, and mortality due to infectious disease. We surveyed community-associated MRSA isolates to determine which strains were present within anatomical sites of interest. The most likely sources of MRSA among anatomic sites swabbed were wounds followed by the nasal cavity. The USA 300 MRSA strain was most commonly isolated among wound infections while nasal swabs largely yielded USA 100 MRSA. The frequency of isolation of USA 100 amongst community-associated strains is clinically significant as this strain is often correlated with invasive disease, exhibits broad antibiotic resistance, and has been considered to be hospital associated. The potential of USA 100 to cause serious disease and the frequency of its isolation suggest an important reservoir for opportunistic infection. These data demonstrate that MRSA epidemic clones are widespread among the community.

  11. Siderophore cheating and cheating resistance shape competition for iron in soil and freshwater Pseudomonas communities.

    Science.gov (United States)

    Butaitė, Elena; Baumgartner, Michael; Wyder, Stefan; Kümmerli, Rolf

    2017-09-04

    All social organisms experience dilemmas between cooperators performing group-beneficial actions and cheats selfishly exploiting these actions. Although bacteria have become model organisms to study social dilemmas in laboratory systems, we know little about their relevance in natural communities. Here, we show that social interactions mediated by a single shareable compound necessary for growth (the iron-scavenging pyoverdine) have important consequences for competitive dynamics in soil and pond communities of Pseudomonas bacteria. We find that pyoverdine non- and low-producers co-occur in many natural communities. While non-producers have genes coding for multiple pyoverdine receptors and are able to exploit compatible heterologous pyoverdines from other community members, producers differ in the pyoverdine types they secrete, offering protection against exploitation from non-producers with incompatible receptors. Our findings indicate that there is both selection for cheating and cheating resistance, which could drive antagonistic co-evolution and diversification in natural bacterial communities.Lab strains of Pseudomonas are model systems for the evolution of cooperation over public goods (iron-scavenging siderophores). Here, Butaitė et al. add ecological and evolutionary insight into this system by showing that cheating and resistance to cheating both shape competition for iron in natural Pseudomonas communities.

  12. Exposure to dairy manure leads to greater antibiotic resistance and increased mass-specific respiration in soil microbial communities.

    Science.gov (United States)

    Wepking, Carl; Avera, Bethany; Badgley, Brian; Barrett, John E; Franklin, Josh; Knowlton, Katharine F; Ray, Partha P; Smitherman, Crystal; Strickland, Michael S

    2017-03-29

    Intensifying livestock production to meet the demands of a growing global population coincides with increases in both the administration of veterinary antibiotics and manure inputs to soils. These trends have the potential to increase antibiotic resistance in soil microbial communities. The effect of maintaining increased antibiotic resistance on soil microbial communities and the ecosystem processes they regulate is unknown. We compare soil microbial communities from paired reference and dairy manure-exposed sites across the USA. Given that manure exposure has been shown to elicit increased antibiotic resistance in soil microbial communities, we expect that manure-exposed sites will exhibit (i) compositionally different soil microbial communities, with shifts toward taxa known to exhibit resistance; (ii) greater abundance of antibiotic resistance genes; and (iii) corresponding maintenance of antibiotic resistance would lead to decreased microbial efficiency. We found that bacterial and fungal communities differed between reference and manure-exposed sites. Additionally, the β-lactam resistance gene ampC was 5.2-fold greater under manure exposure, potentially due to the use of cephalosporin antibiotics in dairy herds. Finally, ampC abundance was positively correlated with indicators of microbial stress, and microbial mass-specific respiration, which increased 2.1-fold under manure exposure. These findings demonstrate that the maintenance of antibiotic resistance associated with manure inputs alters soil microbial communities and ecosystem function. © 2017 The Author(s).

  13. Exposure to dairy manure leads to greater antibiotic resistance and increased mass-specific respiration in soil microbial communities

    OpenAIRE

    Wepking, C.; Avera, B.; Badgley, B.; Barrett, J. E.; Franklin, J.; Knowlton, K. F.; Ray, Partha P.; Smitherman, C.; Strickland, M. S.

    2017-01-01

    Intensifying livestock production to meet the demands of a growing global population coincides with increases in both the administration of veterinary antibiotics and manure inputs to soils. These trends have the potential to increase antibiotic resistance in soil microbial communities. The effect of maintaining increased antibiotic resistance on soil microbial communities and the ecosystem processes they regulate is unknown. We compare soil microbial communities from paired reference and dai...

  14. European ST80 community-associated methicillin-resistant Staphylococcus aureus orbital cellulitis in a neonate

    Directory of Open Access Journals (Sweden)

    Tsironi Evangelia E

    2012-05-01

    Full Text Available Abstract Background Methicillin-resistant Staphylococcus aureus is a serious cause of morbidity and mortality in hospital environment, but also, lately, in the community. This case report is, to our knowledge, the first detailed description of a community-associated methicillin-resistant S. aureus ST80 orbital cellulitis in a previously healthy neonate. Possible predisposing factors of microbial acquisition and treatment selection are also discussed. Case presentation A 28-day-old Caucasian boy was referred to our hospital with the diagnosis of right orbital cellulitis. His symptoms included right eye proptosis, periocular edema and redness. Empirical therapy of intravenous daptomycin, rifampin and ceftriaxone was initiated. The culture of pus yielded a methicillin-resistant S. aureus isolate and the molecular analysis revealed that it was a Panton-Valentine leukocidine-positive ST80 strain. The combination antimicrobial therapy was continued for 42days and the infection was successfully controlled. Conclusions Clinicians should be aware that young infants, even without any predisposing condition, are susceptible to orbital cellulitis caused by community-associated methicillin-resistant S. aureus. Prompt initiation of the appropriate empirical therapy, according to the local epidemiology, should successfully address the infection, preventing ocular and systemic complications.

  15. The changing face of community-acquired methicillin-resistant Staphylococcus aureus

    Directory of Open Access Journals (Sweden)

    P Kale

    2016-01-01

    Full Text Available Methicillin-resistant Staphylococcus aureus (MRSA is an important cause of infection, both in hospitalised patients with significant healthcare exposure and in patients without healthcare risk factors. Community-acquired methicillin-resistant S. aureus (CA-MRSA are known for their rapid community transmission and propensity to cause aggressive skin and soft tissue infections and community-acquired pneumonia. The distinction between the healthcare-associated (HA-MRSA and CA-MRSA is gradually fading owing to the acquisition of multiple virulence factors and genetic elements. The movement of CA-MRSA strains into the nosocomial setting limits the utility of using clinical risk factors alone to designate community or HA status. Identification of unique genetic characteristics and genotyping are valuable tools for MRSA epidemiological studies. Although the optimum pharmacotherapy for CA-MRSA infections has not been determined, many CA-MRSA strains remain broadly susceptible to several non-β-lactam antibacterial agents. This review aimed at illuminating the characteristic features of CA-MRSA, virulence factors, changing clinical settings and molecular epidemiology, insurgence into the hospital settings and therapy with drug resistance.

  16. Nasopharyngeal bacterial carriage and antimicrobial resistance in underfive children with community acquired pneumonia

    Directory of Open Access Journals (Sweden)

    Cissy B. Kartasasmita

    2001-12-01

    Full Text Available Lung puncture is the best way to determine the etiology of pneumonia since it yields the highest rate of positive cultures. However, this procedure is difficult, especially for a study in the community. According to WHO, isolates to be tested for antimicrobial resistance in the community should be obtained from nasopharyngeal (NP swabs. Previous studies support the use of NP isolates to determine antimicrobial resistance patterns of isolates from children with pneumonia. The aim of our study was to know the bacterial patterns of the nasopharynx in underfive children with community acquired pneumonia and their antimicrobial resistance. The study was carried out in 4 Primary Health Clinics in Majalaya sub-district, Bandung, Indonesia. All underfives with cough or difficult breathing and classified as having non-severe pneumonia (WHO guidelines, were included in the study. Nasopharyngeal swabs (CDC/WHO Manual were obtained by the doctor, the swabs were placed in Amies transport medium and stored in a sterile jar before taken to the laboratory in the same day. All children were treated with co-trimoxazole. During the nine month study, 698 children with clinical signs of non-severe pneumonia were enrolled. About 25% of the nasopharyngeal specimens yielded bacterial isolates; the two most frequently found were S. pneumoniae and S. epidermidis. The antimicrobial resistance test to co-trimoxazole showed 48.2% S. pneumoniae strain had full resistance and 32.7% showed intermediate resistance to co-trimoxazole. This result is almost similar to other studies from Asian countries. It seems that H. influenzae is not a problem in the study area; however, further studies are needed.

  17. Estimating the Transfer Range of Plasmids Encoding Antimicrobial Resistance in a Wastewater Treatment Plant Microbial Community

    DEFF Research Database (Denmark)

    Li, Liguan; Dechesne, Arnaud; He, Zhiming

    2018-01-01

    Wastewater treatment plants (WWTPs) have been suggested as reservoirs and sources of antibiotic resistance genes (ARGs) in the environment. In a WWTP ecosystem, human enteric and environmental bacteria are mixed and exposed to pharmaceutical residues, potentially favoring genetic exchange and thus...... sludge microbial community was challenged in standardized filter matings with one of three multidrug resistance plasmids (pKJK5, pB10, and RP4) harbored by Escherichia coli or Pseudomonas putida. Different donor–plasmid combinations had distinct transfer frequencies, ranging from 3 to 50 conjugation...

  18. Characterization of the bacterioplankton community and its antibiotic resistance genes in the Baltic Sea.

    Science.gov (United States)

    Tiirik, Kertu; Nõlvak, Hiie; Oopkaup, Kristjan; Truu, Marika; Preem, Jens-Konrad; Heinaru, Ain; Truu, Jaak

    2014-01-01

    The residues from human environments often contain antibiotics and antibiotic resistance genes (ARGs) that can contaminate natural environments; the clearest consequence of that is the selection of antibiotic-resistant bacteria. The Baltic Sea is the second largest isolated brackish water reservoir on Earth, serving as a drainage area for people in 14 countries, which differ from one another in antibiotic use and sewage treatment policies. The aim of this study was to characterize the bacterioplankton structure and quantify ARGs (tetA, tetB, tetM, ermB, sul1, blaSHV, and ampC) within the bacterioplankton community of the Baltic Sea. Quantitative polymerase chain reaction was applied to quantify ARGs from four different sampling sites of the Baltic Sea over 2 years, and the bacterial communities were profiled sequencing the V6 region of the 16S rRNA gene on Illumina HiSeq2000. The results revealed that all the resistance genes targeted in the study were detectable from the Baltic Sea bacterioplankton. The percentage of tetA, tetB, tetM, ermB, and sul1 genes in the sea bacterial community varied between 0.0077% and 0.1089%, 0.0003% and 0.0019%, 0.0001% and 0.0105%, 0% and 0.0136%, and 0.0001% and 0.0438%, respectively. The most numerous ARG detected was the tetA gene and this gene also had the highest proportion in the whole microbial community. A strong association between bacterioplankton ARGs' abundance data and community phylogenetic composition was found, implying that the abundance of most of the studied ARGs in the Baltic Sea is determined by fluctuations in its bacterial community structure. © 2013 International Union of Biochemistry and Molecular Biology, Inc.

  19. Peripheral insulin resistance rather than beta cell dysfunction accounts for geographical differences in impaired fasting blood glucose among sub-Saharan African individuals: findings from the RODAM study

    NARCIS (Netherlands)

    Meeks, Karlijn A. C.; Stronks, Karien; Adeyemo, Adebowale; Addo, Juliet; Bahendeka, Silver; Beune, Erik; Owusu-Dabo, Ellis; Danquah, Ina; Galbete, Cecilia; Henneman, Peter; Klipstein-Grobusch, Kerstin; Mockenhaupt, Frank P.; Osei, Kwame; Schulze, Matthias B.; Spranger, Joachim; Smeeth, Liam; Agyemang, Charles

    2017-01-01

    The aim of this study was to assess the extent to which insulin resistance and beta cell dysfunction account for differences in impaired fasting blood glucose (IFBG) levels in sub-Saharan African individuals living in different locations in Europe and Africa. We also aimed to identify determinants

  20. Peripheral insulin resistance rather than beta cell dysfunction accounts for geographical differences in impaired fasting blood glucose among sub-Saharan African individuals : findings from the RODAM study

    NARCIS (Netherlands)

    Meeks, Karlijn A C; Stronks, Karien; Adeyemo, Adebowale; Addo, Juliet; Bahendeka, Silver; Beune, Erik; Owusu-Dabo, Ellis; Danquah, Ina; Galbete, Cecilia; Henneman, Peter; Klipstein-Grobusch, Kerstin; Mockenhaupt, Frank P; Osei, Kwame; Schulze, Matthias B; Spranger, Joachim; Smeeth, Liam; Agyemang, Charles

    2017-01-01

    AIMS/HYPOTHESIS: The aim of this study was to assess the extent to which insulin resistance and beta cell dysfunction account for differences in impaired fasting blood glucose (IFBG) levels in sub-Saharan African individuals living in different locations in Europe and Africa. We also aimed to

  1. Cost effectiveness of amoxicillin for lower respiratory tract infections in primary care : An economic evaluation accounting for the cost of antimicrobial resistance

    NARCIS (Netherlands)

    Oppong, Raymond; Smith, Richard D.; Little, Paul; Verheij, Theo; Butler, Christopher C.; Goossens, Herman; Coenen, Samuel; Moore, Michael; Coast, Joanna

    2016-01-01

    Background Lower respiratory tract infections (LRTIs) are a major disease burden and are often treated with antibiotics. Typically, studies evaluating the use of antibiotics focus on immediate costs of care, and do not account for the wider implications of antimicrobial resistance. Aim This study

  2. Long-term exposure to benzalkonium chloride disinfectants results in change of microbial community structure and increased antimicrobial resistance.

    Science.gov (United States)

    Tandukar, Madan; Oh, Seungdae; Tezel, Ulas; Konstantinidis, Konstantinos T; Pavlostathis, Spyros G

    2013-09-03

    The effect of benzalkonium chlorides (BACs), a widely used class of quaternary ammonium disinfectants, on microbial community structure and antimicrobial resistance was investigated using three aerobic microbial communities: BACs-unexposed (DP, fed a mixture of dextrin/peptone), BACs-exposed (DPB, fed a mixture of dextrin/peptone and BACs), and BACs-enriched (B, fed only BACs). Long-term exposure to BACs reduced community diversity and resulted in the enrichment of BAC-resistant species, predominantly Pseudomonas species. Exposure of the two microbial communities to BACs significantly decreased their susceptibility to BACs as well as three clinically relevant antibiotics (penicillin G, tetracycline, ciprofloxacin). Increased resistance to BACs and penicillin G of the two BACs-exposed communities is predominantly attributed to degradation or transformation of these compounds, whereas resistance to tetracycline and ciprofloxacin is largely due to the activity of efflux pumps. Quantification of several key multidrug resistance genes showed a much higher number of copies of these genes in the DPB and B microbial communities compared to the DP community. Collectively, our findings indicate that exposure of a microbial community to BACs results in increased antibiotic resistance, which has important implications for both human and environmental health.

  3. Can methicillin-resistant Staphylococcus aureus prevalence from dairy cows in India act as potential risk for community-associated infections?: A review

    Science.gov (United States)

    Gopal, Sathish; Divya, Kurunchi C.

    2017-01-01

    Methicillin-resistant Staphylococcus aureus (MRSA) is classified as hospital associated (HA), community associated (CA), livestock associated (LA) and is a global concern. Developing countries, like India, are densely populated country challenging for public hygiene practices. HA-MRSA is comfortably recorded in India, and CA-MRSA is also reported as increasing one. CA-MRSA is serious disease which affects the community as endemic. MRSA is one among major mastitis-causing organisms in India as LA-MRSA. There were reports for transmission of MRSA as community between milk handlers and cow in global perspective. In India reports of MRSA in short among milk handlers and also transmission between animal and human. Hence, proper monitoring of MRSA transmission in India should be elucidated in account among milk handlers and dairy cows to avoid emerging CA-MRSA as outbreak. PMID:28435193

  4. A temporal assessment of nematode community structure and diversity in the rhizosphere of cisgenic Phytophthora infestans-resistant potatoes.

    Science.gov (United States)

    Ortiz, Vilma; Phelan, Sinead; Mullins, Ewen

    2016-12-01

    Nematodes play a key role in soil processes with alterations in the nematode community structure having the potential to considerably influence ecosystem functioning. As a result fluctuations in nematode diversity and/or community structure can be gauged as a 'barometer' of a soil's functional biodiversity. However, a deficit exists in regards to baseline knowledge and on the impact of specific GM crops on soil nematode populations and in particular in regard to the impact of GM potatoes on the diversity of nematode populations in the rhizosphere. The goal of this project was to begin to address this knowledge gap in regards to a GM potato line, cisgenically engineered for resistance to Phytophthora infestans (responsible organism of the Irish potato famine causing late blight disease). For this, a 3 year (2013, 2014, 2015) field experimental study was completed, containing two conventional genotypes (cvs. Desiree and Sarpo Mira) and a cisgenic genotype (cv. Desiree + Rpi-vnt1). Each potato genotype was treated with different disease management strategies (weekly chemical applications and corresponding no spray control). Hence affording the opportunity to investigate the temporal impact of potato genotype, disease management strategy (and their interaction) on the potato rhizosphere nematode community. Nematode structure and diversity were measured through established indices, accounts and taxonomy with factors recording a significant effect limited to the climatic conditions across the three seasons of the study and chemical applications associated with the selected disease management strategy. Based on the metrics studied, the cultivation of the cisgenic potato genotype exerted no significant effect (P > 0.05) on nematode community diversity or structure. The disease management treatments led to a reduction of specific trophic groups (e.g. Predacious c-p = 4), which of interest appeared to be counteracted by a potato genotype with vigorous growth phenotype

  5. Constitutive presence of antibiotic resistance genes within the bacterial community of a large subalpine lake.

    Science.gov (United States)

    Di Cesare, Andrea; Eckert, Ester M; Teruggi, Alessia; Fontaneto, Diego; Bertoni, Roberto; Callieri, Cristiana; Corno, Gianluca

    2015-08-01

    The fate of antibiotic resistance genes (ARGs) in environmental microbial communities is of primary concern as prodromal of a potential transfer to pathogenic bacteria. Although of diverse origin, the persistence of ARGs in aquatic environments is highly influenced by anthropic activities, allowing potential control actions in well-studied environments. However, knowledge of abundance and space-time distribution of ARGs in ecosystems is still scarce. Using quantitative real-time PCR, we investigated the presence and the abundance of twelve ARGs (against tetracyclines, β-lactams, aminoglycosides, quinolones and sulphonamides) at different sampling sites, depths and seasons, in Lake Maggiore, a large subalpine lake, and in the area of its watershed. We then evaluated the correlation between each ARG and a number of ecological parameters in the water column in the deepest part of the lake. Our results suggest the constitutive presence of at least four ARGs within the bacterial community with a high proportion of bacteria potentially resistant to tetracyclines and sulphonamides. The presence of these ARGs was independent of the total bacterial density and temperature. The dynamics of tet(A) and sulII genes were, however, positively correlated with dissolved oxygen and negatively to chlorophyll a, suggesting that the resistant microbes inhabit specific niches. These observations indicate that the lake is a reservoir of antibiotic resistances, highlighting the need of a deeper understanding of the sources of ARGs and the factors allowing their persistence in waters. © 2015 John Wiley & Sons Ltd.

  6. Antibiotics, Antibiotic Resistance Genes, and Bacterial Community Composition in Fresh Water Aquaculture Environment in China.

    Science.gov (United States)

    Xiong, Wenguang; Sun, Yongxue; Zhang, Tong; Ding, Xueyao; Li, Yafei; Wang, Mianzhi; Zeng, Zhenling

    2015-08-01

    Environmental antibiotic resistance has drawn increasing attention due to its great threat to human health. In this study, we investigated concentrations of antibiotics (tetracyclines, sulfonamides and (fluoro)quinolones) and abundances of antibiotic resistance genes (ARGs), including tetracycline resistance genes, sulfonamide resistance genes, and plasmid-mediated quinolone resistance genes, and analyzed bacterial community composition in aquaculture environment in Guangdong, China. The concentrations of sulfametoxydiazine, sulfamethazine, sulfamethoxazole, oxytetracycline, chlorotetracycline, doxycycline, ciprofloxacin, norfloxacin, and enrofloxacin were as high as 446 μg kg(-1) and 98.6 ng L(-1) in sediment and water samples, respectively. The relative abundances (ARG copies/16S ribosomal RNA (rRNA) gene copies) of ARGs (sul1, sul2, sul3, tetM, tetO, tetW, tetS, tetQ, tetX, tetB/P, qepA, oqxA, oqxB, aac(6')-Ib, and qnrS) were as high as 2.8 × 10(-2). The dominant phyla were Proteobacteria, Bacteroidetes, and Firmicutes in sediment samples and Proteobacteria, Actinobacteria and Bacteroidetes in water samples. The genera associated with pathogens were also observed, such as Acinetobacter, Arcobacter, and Clostridium. This study comprehensively investigated antibiotics, ARGs, and bacterial community composition in aquaculture environment in China. The results indicated that fish ponds are reservoirs of ARGs and the presence of potential resistant and pathogen-associated taxonomic groups in fish ponds might imply the potential risk to human health.

  7. Enterobacteriaceae Antibiotic Resistance in Ready-to-Eat Foods Collected from Hospital and Community Canteens: Analysis of Prevalence.

    Science.gov (United States)

    Vincenti, Sara; Raponi, Matteo; Sezzatini, Romina; Giubbini, Gabriele; Laurenti, Patrizia

    2018-03-01

    Foodborne diseases and antibiotic resistance are serious widespread health problems in the contemporary world. In this study, we compared the microbiological quality of ready-to-eat (RTE) foods found in community canteens versus hospital canteens in Rome, Italy, focusing on detection and quantification of Enterobacteriaceae and the antibiotic resistance of these bacteria. Our findings show a remarkable difference in Enterobacteriaceae contamination between RTE foods distributed in community canteens (33.5% of samples) and those distributed in hospital canteens (5.3% of samples). This result highlights greater attention to good manufacturing practices and good hygiene practices by the food operators in hospitals compared with food operators in community canteens. As expected, a higher percentage of cold food samples (70.9%) than of hot food samples (10.8%) were positive for these bacteria. Excluding the intrinsic resistance of each bacterial strain, 92.3% of the isolated strains were resistant to at least one antibiotic, and about half of the isolated strains were classified as multidrug resistant. The prevalence of multidrug-resistant strains was 50% in the community samples and 33.3% in hospital canteens. Our results indicate that approximately 38% of RTE foods provided in community canteens is not compliant with microbiological food safety criteria and could be a special risk for consumers through spread of antibiotic-resistant strains. Hygienic processing and handling of foods is necessary for both hospital and community canteens.

  8. Virulence Strategies of the Dominant USA300 Lineage of Community Associated Methicillin Resistant Staphylococcus aureus (CA-MRSA)

    Science.gov (United States)

    Thurlow, Lance R.; Joshi, Gauri S.; Richardson, Anthony R.

    2014-01-01

    Methicillin-Resistant Staphylococcus aureus (MRSA) poses a serious threat to worldwide health. Historically, MRSA clones have strictly been associated with hospital settings and most hospital-associated MRSA (HA-MRSA) disease resulted from a limited number of virulent clones. Recently, MRSA has spread into the community causing disease in otherwise healthy people with no discernible contact with healthcare environments. These community-associated (CA-MRSA) are phylogenetically distinct from traditional HA-MRSA clones and CA-MRSA strains seem to exhibit hyper virulence and more efficient host:host transmission. Consequently, CA-MRSA clones belonging to the USA300 lineage have become dominant sources of MRSA infections in North America. The rise of this successful USA300 lineage represents an important step in the evolution of emerging pathogens and a great deal of effort has been exerted to understand how these clones evolved. Here we review much of the recent literature aimed at illuminating the source of USA300 success and broadly categorize these findings into three main categories: newly acquired virulence genes, altered expression of common virulence determinants and alterations in protein sequence that increase fitness. We argue that none of these evolutionary events alone account for the success of USA300, but rather their combination may be responsible for the rise and spread of CA-MRSA. PMID:22309135

  9. Cost effectiveness of amoxicillin for lower respiratory tract infections in primary care: an economic evaluation accounting for the cost of antimicrobial resistance.

    Science.gov (United States)

    Oppong, Raymond; Smith, Richard D; Little, Paul; Verheij, Theo; Butler, Christopher C; Goossens, Herman; Coenen, Samuel; Moore, Michael; Coast, Joanna

    2016-09-01

    Lower respiratory tract infections (LRTIs) are a major disease burden and are often treated with antibiotics. Typically, studies evaluating the use of antibiotics focus on immediate costs of care, and do not account for the wider implications of antimicrobial resistance. This study sought to establish whether antibiotics (principally amoxicillin) are cost effective in patients with LRTIs, and to explore the implications of taking into account costs associated with resistance. Multinational randomised double-blinded trial in 2060 patients with acute cough/LRTIs recruited in 12 European countries. A cost-utility analysis from a health system perspective with a time horizon of 28 days was conducted. The primary outcome measure was the quality-adjusted life year (QALY). Hierarchical modelling was used to estimate incremental cost-effectiveness ratios (ICERs). Amoxicillin was associated with an ICER of €8216 (£6540) per QALY gained when the cost of resistance was excluded. If the cost of resistance is greater than €11 (£9) per patient, then amoxicillin treatment is no longer cost effective. Including possible estimates of the cost of resistance resulted in ICERs ranging from €14 730 (£11 949) per QALY gained - when only multidrug resistance costs and health care costs are included - to €727 135 (£589 856) per QALY gained when broader societal costs are also included. Economic evaluation of antibiotic prescribing strategies that do not include the cost of resistance may provide misleading results that could be of questionable use to policymakers. However, further work is required to estimate robust costs of resistance. © British Journal of General Practice 2016.

  10. Tribal communities and coal in Northeast India: The politics of imposing and resisting mining bans

    International Nuclear Information System (INIS)

    McDuie-Ra, Duncan; Kikon, Dolly

    2016-01-01

    Bans on coal mining have been implemented in two tribal majority states in India's north-east frontier; Nagaland and Meghalaya. In Nagaland the state government imposed the ban in an attempt to capture control of coal extraction and trade, while in Meghalaya India's National Green Commission imposed the ban over concern for the environment and labour conditions. In both cases local communities have opposed the bans, and in some areas resumed mining under the authority of tribal councils and powerful civil society actors. In this paper we explore the politics of coal extraction that resulted in these bans and the response of communities and authorities. In doing so we made three main arguments that contribute to understanding of coal and communities in frontier regions where state control is partial and the legacy of armed conflict is powerful. First, in both locations the majority of the coal mining activity has been initiated and managed by members of tribal communities rather than profit-driven outsiders. Second, in contrast to other contexts in India (notably Orissa and Jharkhand) where large state or private enterprises seek to modify the law to enable coal extraction, in Nagaland and Meghalaya it has been communities that resent and challenge state and national laws being applied to their lands. Third, the right to extract coal is connected to the right of tribal communities to determine what happens on their lands. - Highlights: • Tribal communities initiate and manage coal mining in Nagaland and Meghalaya. • Laws banning coal extraction have been challenged and resisted by local communities. • The right to extract coal is tied to protecting tribal land rights. • Tribal autonomy in coal policy is progressive, yet enables capture by local elites. • Where there has been regulation of coal mining it has come from unexpected sources.

  11. Outbreak of Community-Acquired Methicillin-Resistant Staphylococcus aureus Skin Infections Among a Collegiate Football Team

    OpenAIRE

    Romano, Russ; Lu, Doanh; Holtom, Paul

    2006-01-01

    Context: Methicillin-resistant Staphylococcus aureus (MRSA) was once primarily a hospital-acquired organism, but now community-acquired MRSA (CA-MRSA) is causing outbreaks among otherwise healthy sport participants.

  12. Community-Associated Methicillin-Resistant Staphylococcus aureus Necrotizing Pneumonia without Evidence of Antecedent Viral Upper Respiratory Infection

    Directory of Open Access Journals (Sweden)

    Cristina Moran Toro

    2014-01-01

    Full Text Available BACKGROUND: USA300 community-associated (CA methicillin-resistant Staphylococcus aureus (MRSA strains causing necrotizing pneumonia have been reported in association with antecedent viral upper respiratory tract infections (URI.

  13. Global implications of the emergence of community-associated methicillin-resistant Staphylococcus aureus in Indigenous populations.

    Science.gov (United States)

    Tong, Steven Y C; McDonald, Malcolm I; Holt, Deborah C; Currie, Bart J

    2008-06-15

    The emergence of community-associated methicillin-resistant Staphylococcus aureus (MRSA) in Australia may have been facilitated by conditions in socially disadvantaged populations--particularly, remote Australian Aboriginal communities. The appearance of community-associated MRSA was first noticed in Australia during the early 1980s; subsequently, several genetically diverse strains have independently emerged from geographically distinct regions. Molecular and epidemiological studies support the role of genetic transfer of resistance determinants (SCCmecIV) in this process. Conditions in Aboriginal communities--namely, domestic crowding, poor hygiene, and high rates of scabies, pyoderma, and antibiotic use--have facilitated both the clonal expansion and de novo emergence of strains of community-associated MRSA. Combating the worldwide emergence and spread of community-associated MRSA may require novel community-level control strategies targeted at specific groups, such as remote Indigenous populations.

  14. Adiposity and Insulin Resistance in Children from a Rural Community in Mexico.

    Science.gov (United States)

    Barbosa-Cortes, Lourdes; Villasis-Keever, Miguel Angel; Del Prado-Manriquez, Martha; Lopez-Alarcon, Mardia

    2015-04-01

    The study of the incidence of overweight and obesity as well as body composition and insulin resistance in children from rural communities is scarce. The aims of the study were a) to characterize the adiposity and homeostasis model assessment of insulin resistance (HOMA-IR) in school-age children from a rural community and b) to determine factors associated with fat mass and HOMA-IR in this population. A total of 41 school-aged children (15 males and 26 females; 9.9 ± 2.5 years old) from a Mexican rural community was studied. Trained observers had previously assessed the children's nutritional status during the first 6 months of life. Anthropometry, energy intake, physical activity, body composition and biochemical parameters were measured. The overall prevalence of overweight/obesity was 7.3%. The mean energy intake of children was below international recommendations (1,235 ± 400 kcal/day). A higher percentage of fat mass was observed in females (20.3 ± 8.5) than in males (14.1 ± 5.1) (p = 0.006). There were seven children with IR, but we did not observe a correlation between HOMA and BMI percentiles (Pearson's r = 0.09, p = 0.57). In a regression model, gender (females) was the primary factor associated with the percentage of fat mass. The growth velocity during the first 6 months of life was associated with HOMA-IR. There is a low frequency of overweight and obesity in children from rural communities in Mexico. However, these children appear to have increased risk of adiposity and insulin resistance. Copyright © 2015 IMSS. Published by Elsevier Inc. All rights reserved.

  15. Bacterial Communities Differ among Drosophila melanogaster Populations and Affect Host Resistance against Parasitoids.

    Science.gov (United States)

    Chaplinska, Mariia; Gerritsma, Sylvia; Dini-Andreote, Francisco; Falcao Salles, Joana; Wertheim, Bregje

    2016-01-01

    In Drosophila, diet is considered a prominent factor shaping the associated bacterial community. However, the host population background (e.g. genotype, geographical origin and founder effects) is a factor that may also exert a significant influence and is often overlooked. To test for population background effects, we characterized the bacterial communities in larvae of six genetically differentiated and geographically distant D. melanogaster lines collected from natural populations across Europe. The diet for these six lines had been identical for ca. 50 generations, thus any differences in the composition of the microbiome originates from the host populations. We also investigated whether induced shifts in the microbiome-in this case by controlled antibiotic administration-alters the hosts' resistance to parasitism. Our data revealed a clear signature of population background on the diversity and composition of D. melanogaster microbiome that differed across lines, even after hosts had been maintained at the same diet and laboratory conditions for over 4 years. In particular, the number of bacterial OTUs per line ranged from 8 to 39 OTUs. Each line harboured 2 to 28 unique OTUs, and OTUs that were highly abundant in some lines were entirely missing in others. Moreover, we found that the response to antibiotic treatment differed among the lines and significantly altered the host resistance to the parasitoid Asobara tabida in one of the six lines. Wolbachia, a widespread intracellular endosymbiont associated with parasitoid resistance, was lacking in this line, suggesting that other components of the Drosophila microbiome caused a change in host resistance. Collectively, our results revealed that lines that originate from different population backgrounds show significant differences in the established Drosophila microbiome, outpacing the long-term effect of diet. Perturbations on these naturally assembled microbiomes to some degree influenced the hosts' resistance

  16. A genome-wide approach accounting for body mass index identifies genetic variants influencing fasting glycemic traits and insulin resistance

    DEFF Research Database (Denmark)

    Manning, Alisa K; Hivert, Marie-France; Scott, Robert A

    2012-01-01

    Recent genome-wide association studies have described many loci implicated in type 2 diabetes (T2D) pathophysiology and β-cell dysfunction but have contributed little to the understanding of the genetic basis of insulin resistance. We hypothesized that genes implicated in insulin resistance pathw...

  17. Effects of a social accountability approach, CARE's Community Score Card, on reproductive health-related outcomes in Malawi: A cluster-randomized controlled evaluation.

    Directory of Open Access Journals (Sweden)

    Sara Gullo

    Full Text Available Social accountability approaches, which emphasize mutual responsibility and accountability by community members, health care workers, and local health officials for improving health outcomes in the community, are increasingly being employed in low-resource settings. We evaluated the effects of a social accountability approach, CARE's Community Score Card (CSC, on reproductive health outcomes in Ntcheu district, Malawi using a cluster-randomized control design.We matched 10 pairs of communities, randomly assigning one from each pair to intervention and control arms. We conducted two independent cross-sectional surveys of women who had given birth in the last 12 months, at baseline and at two years post-baseline. Using difference-in-difference (DiD and local average treatment effect (LATE estimates, we evaluated the effects on outcomes including modern contraceptive use, antenatal and postnatal care service utilization, and service satisfaction. We also evaluated changes in indicators developed by community members and service providers in the intervention areas.DiD analyses showed significantly greater improvements in the proportion of women receiving a home visit during pregnancy (B = 0.20, P < .01, receiving a postnatal visit (B = 0.06, P = .01, and overall service satisfaction (B = 0.16, P < .001 in intervention compared to control areas. LATE analyses estimated significant effects of the CSC intervention on home visits by health workers (114% higher in intervention compared to control (B = 1.14, P < .001 and current use of modern contraceptives (57% higher (B = 0.57, P < .01. All 13 community- and provider-developed indicators improved, with 6 of them showing significant improvements.By facilitating the relationship between community members, health service providers, and local government officials, the CSC contributed to important improvements in reproductive health-related outcomes. Further, the CSC builds mutual accountability, and ensures

  18. Biodiversity increases functional and compositional resistance, but decreases resilience in phytoplankton communities.

    Science.gov (United States)

    Baert, Jan M; De Laender, Frederik; Sabbe, Koen; Janssen, Colin R

    2016-12-01

    There is now ample evidence that biodiversity stabilizes aggregated ecosystem functions, such as primary production, in changing environments. In primary producer systems, this stabilizing effect is found to be driven by higher functional resistance (i.e., reduced changes in functions by environmental changes) rather than through higher functional resilience (i.e., rapid recovery following environmental changes) in more diverse systems. The stability of aggregated ecosystem functions directly depends on changes in species composition and by consequence their functional contributions to ecosystem functions. Still, it remains only theoretically explored how biodiversity can stabilize ecosystem functions by affecting compositional stability. Here, we demonstrate how biodiversity effects on compositional stability drive biodiversity effects on functional stability in diatom communities. In a microcosm experiment, we exposed 39 communities of five different levels of species richness (1, 2, 4, 6, and 8 species) to three concentrations of a chemical stressor (0, 25, and 250 μg/L atrazine) for four weeks, after which all communities were transferred to atrazine-free medium for three more weeks. Biodiversity simultaneously increased, increasing functional and compositional resistance, but decreased functional and compositional resilience. These results confirm the theoretically proposed link between biodiversity effects on functional and compositional stability in primary producer systems, and provide a mechanistic underpinning for observed biodiversity-stability relationships. Finally, we discuss how higher compositional stability can be expected to become increasingly important in stabilizing ecosystem functions under field conditions when multiple environmental stressors fluctuate simultaneously. © 2016 by the Ecological Society of America.

  19. Community-acquired multidrug-resistant Gram-negative bacterial infective endocarditis.

    Science.gov (United States)

    Naha, Sowjanya; Naha, Kushal; Acharya, Vasudev; Hande, H Manjunath; Vivek, G

    2014-08-05

    We describe two cases of bacterial endocarditis secondary to multidrug-resistant Gram-negative organisms. In both cases, the diagnosis was made in accordance with the modified Duke's criteria and confirmed by histopathological analysis. Furthermore, in both instances there were no identifiable sources of bacteraemia and no history of contact with hospital or other medical services prior to the onset of symptoms. The patients were managed in similar fashion with prolonged broad-spectrum antibiotic therapy and surgical intervention and made complete recoveries. These cases highlight Gram-negative organisms as potential agents for endocarditis, as well as expose the dissemination of such multidrug-resistant bacteria into the community. The application of an integrated medical and surgical approach and therapeutic dilemmas encountered in managing these cases are described. 2014 BMJ Publishing Group Ltd.

  20. A Case of Community-Acquired Pneumonia Caused by Multidrug-Resistant Acinetobacter baumannii in Korea.

    Science.gov (United States)

    Son, Young Woong; Jung, In Young; Ahn, Mi Young; Jeon, Yong Duk; Ann, Hea Won; Ahn, Jin Young; Ku, Nam Su; Han, Sang Hoon; Choi, Jun Young; Song, Young Goo; Kim, June Myung

    2017-12-01

    Acinetobacter baumannii is an aerobic Gram-negative coccobacillus that causes nosocomial pneumonia in patients on mechanical ventilation or previously treated with broad-spectrum antibiotics. Nevertheless, community-acquired pneumonia (CAP) caused by A. baumannii, especially multi-drug resistant (MDR) strains, is rare. We experienced the first case of CAP caused by MDR A. baumannii in Korea in a 78-year-old man. This case shows that MDR A. baumannii can cause CAP in Korea. Copyright © 2017 by The Korean Society of Infectious Diseases and Korean Society for Chemotherapy.

  1. Triclocarban Influences Antibiotic Resistance and Alters Anaerobic Digester Microbial Community Structure.

    Science.gov (United States)

    Carey, Daniel E; Zitomer, Daniel H; Hristova, Krassimira R; Kappell, Anthony D; McNamara, Patrick J

    2016-01-05

    Triclocarban (TCC) is one of the most abundant organic micropollutants detected in biosolids. Lab-scale anaerobic digesters were amended with TCC at concentrations ranging from the background concentration of seed biosolids (30 mg/kg) to toxic concentrations of 850 mg/kg to determine the effect on methane production, relative abundance of antibiotic resistance genes, and microbial community structure. Additionally, the TCC addition rate was varied to determine the impacts of acclimation time. At environmentally relevant TCC concentrations (max detect = 440 mg/kg), digesters maintained function. Digesters receiving 450 mg/kg of TCC maintained function under gradual TCC addition, but volatile fatty acid concentrations increased, pH decreased, and methane production ceased when immediately fed this concentration. The concentrations of the mexB gene (encoding for a multidrug efflux pump) were higher with all concentrations of TCC compared to a control, but higher TCC concentrations did not correlate with increased mexB abundance. The relative abundance of the gene tet(L) was greater in the digesters that no longer produced methane, and no effect on the relative abundance of the class 1 integron integrase encoding gene (intI1) was observed. Illumina sequencing revealed substantial community shifts in digesters that functionally failed from increased levels of TCC. More subtle, yet significant, community shifts were observed in digesters amended with TCC levels that did not inhibit function. This research demonstrates that TCC can select for a multidrug resistance encoding gene in mixed community anaerobic environments, and this selection occurs at concentrations (30 mg/kg) that can be found in full-scale anaerobic digesters (U.S. median concentration = 22 mg/kg, mean = 39 mg/kg).

  2. Bacterial community structure and abundances of antibiotic resistance genes in heavy metals contaminated agricultural soil.

    Science.gov (United States)

    Zhang, Fengli; Zhao, Xiaoxue; Li, Qingbo; Liu, Jia; Ding, Jizhe; Wu, Huiying; Zhao, Zongsheng; Ba, Yue; Cheng, Xuemin; Cui, Liuxin; Li, Hongping; Zhu, Jingyuan

    2018-01-22

    Soil contamination with heavy metals is a worldwide problem especially in China. The interrelation of soil bacterial community structure, antibiotic resistance genes, and heavy metal contamination in soil is still unclear. Here, seven agricultural areas (G1-G7) with heavy metal contamination were sampled with different distances (741 to 2556 m) to the factory. Denaturing gradient gel electrophoresis (DGGE) and Shannon index were used to analyze bacterial community diversity. Real-time fluorescence quantitative PCR was used to detect the relative abundance of ARGs sul1, sul2, tetA, tetM, tetW, one mobile genetic elements (MGE) inti1. Results showed that all samples were polluted by Cadmium (Cd), and some of them were polluted by lead (Pb), mercury (Hg), arsenic (As), copper (Cu), and zinc (Zn). DGGE showed that the most abundant bacterial species were found in G7 with the lightest heavy metal contamination. The results of the principal component analysis and clustering analysis both showed that G7 could not be classified with other samples. The relative abundance of sul1 was correlated with Cu, Zn concentration. Gene sul2 are positively related with total phosphorus, and tetM was associated with organic matter. Total gene abundances and relative abundance of inti1 both correlated with organic matter. Redundancy analysis showed that Zn and sul2 were significantly related with bacterial community structure. Together, our results indicate a complex linkage between soil heavy metal concentration, bacterial community composition, and some global disseminated ARG abundance.

  3. Resistance and resilience of tundra plant communities to disturbance by winter seismic vehicles

    International Nuclear Information System (INIS)

    Felix, N.A.; Raynolds, M.K.; Jorgenson, J.C.; DuBois, K.E.

    1992-01-01

    Effects of winter seismic exploration on arctic tundra were evaluated on the coastal plain of the Arctic National Wildlife Refuge, four to five growing seasons after disturbance. Plant cover, active layer depths, and track depression were measured at plots representing major tundra plant communities and different levels of initial disturbance. Results are compared with the initial effects reported earlier. Little resilience was seen in any vegetation type, with no clearly decreasing trends in community dissimilarity. Active layer depths remained greater on plots in all nonriparian vegetation types, and most plots still had visible trails. Decreases in plant cover persisted on most plots, although a few species showed recovery or increases in cover above predisturbance level. Moist sedge-shrub tundra and dryas terraces had the largest community dissimilarities initially, showing the least resistance to high levels of winter vehicle disturbance. Community dissimilarity continued to increase for five seasons in moist sedge-shrub tundra, with species composition changing to higher sedge cover and lower shrub cover. The resilience amplitude may have been exceeded on four plots which had significant track depression

  4. Community-acquired methicillin-resistant Staphylococcus aureus (CA-MRSA: molecular background, virulence, and relevance for public health

    Directory of Open Access Journals (Sweden)

    MF Bonesso

    2011-01-01

    Full Text Available Staphylococcus aureus and coagulase-negative Staphylococcus (CoNS are frequently found in nosocomial environments as the main pathogen in several infections. In 1961, reports of nosocomial S. aureus resistant to methicillin, the drug of choice against penicillin-resistant strains, required new alternatives and vancomycin started being used to treat infections caused by methicillin-resistant S. aureus (MRSA. Community-acquired methicillin-resistant S. aureus (CA-MRSA was first reported in 1990 affecting patients without risk factors for infection with MRSA of hospital origin. MRSA of community origin harbor the genes responsible for the synthesis of Panton-Valentine leukocidin (PVL, a toxin associated with skin and soft tissue infections and that carries the staphylococcal cassette chromosome mec (SCCmec type IV. CA-MRSA emergence has caused great impact on the worldwide medical community since the presence of this pathogen in patients without risk factors represents a high risk to public health.

  5. Soil microbial communities drive the resistance of ecosystem multifunctionality to global change in drylands across the globe.

    Science.gov (United States)

    Delgado-Baquerizo, Manuel; Eldridge, David J; Ochoa, Victoria; Gozalo, Beatriz; Singh, Brajesh K; Maestre, Fernando T

    2017-10-01

    The relationship between soil microbial communities and the resistance of multiple ecosystem functions linked to C, N and P cycling (multifunctionality resistance) to global change has never been assessed globally in natural ecosystems. We collected soils from 59 dryland ecosystems worldwide to investigate the importance of microbial communities as predictor of multifunctionality resistance to climate change and nitrogen fertilisation. Multifunctionality had a lower resistance to wetting-drying cycles than to warming or N deposition. Multifunctionality resistance was regulated by changes in microbial composition (relative abundance of phylotypes) but not by richness, total abundance of fungi and bacteria or the fungal: bacterial ratio. Our results suggest that positive effects of particular microbial taxa on multifunctionality resistance could potentially be controlled by altering soil pH. Together, our work demonstrates strong links between microbial community composition and multifunctionality resistance in dryland soils from six continents, and provides insights into the importance of microbial community composition for buffering effects of global change in drylands worldwide. © 2017 John Wiley & Sons Ltd/CNRS.

  6. Comparison of antimicrobial resistance phenotypes and resistance genes in Enterococcus faecalis and Enterococcus faecium from humans in the community, broilers and pigs in Denmark

    DEFF Research Database (Denmark)

    Aarestrup, Frank Møller; Agersø, Yvonne; Gerner-Smidt, P.

    2000-01-01

    Enterococcus faecalis and E. faecium isolated from humans in the community (98 and 65 isolates), broilers (126 and 122), and pigs (102 and 88) during 1998 were tested for susceptibility to 12 different antimicrobial agents and for the presence of selected genes encoding resistance using PCR...... and pigs were susceptible to avilamycin, whereas 35% of isolates from broilers were resistant. All E. faecium isolates from humans were susceptible to vancomycin, whereas 10% and 17% of isolates from broilers and pigs, respectively, were resistant. A vancomycin resistant E. faecium isolate was found in one....... faecium isolates of human and animal origin, examined. tet(K) was not observed, whereas tet(L) was detected in 17% of tetracycline resistant E. faecalis isolates and in 16% of the E. faecium isolates. tet(O) was not detected in any of the isolates from pigs, but was observed in 38% of E. faecalis isolates...

  7. An Alternative Hypothesis to the Widely Held View That Renal Excretion of Sodium Accounts for Resistance to Salt-Induced Hypertension

    Science.gov (United States)

    Kurtz, Theodore W.; DiCarlo, Stephen E.; Pravenec, Michal; Schmidlin, Olga; Tanaka, Masae; Morris, R. Curtis

    2016-01-01

    It is widely held that in response to high salt diets, normal individuals are acutely and chronically resistant to salt-induced hypertension because they rapidly excrete salt and retain little of it so that their blood volume, and therefore blood pressure, does not increase. Conversely, it is also widely held that salt-sensitive individuals develop salt-induced hypertension because of an impaired renal capacity to excrete salt that causes greater salt retention and blood volume expansion than that which occurs in normal salt-resistant individuals. Here we review results of both acute and chronic salt-loading studies that have compared salt-induced changes in sodium retention and blood volume between normal subjects (salt-resistant normotensive controls) and salt-sensitive subjects. The results of properly controlled studies strongly support an alternative view: during acute or chronic increases in salt intake, normal salt-resistant subjects undergo substantial salt retention and do not excrete salt more rapidly, retain less sodium, or undergo lesser blood volume expansion than do salt-sensitive subjects. These observations: 1) directly conflict with the widely held view that renal excretion of sodium accounts for resistance to salt-induced hypertension, and 2) have implications for contemporary understanding of how various genetic, immunologic, and other factors determine acute and chronic blood pressure responses to high salt diets. PMID:27546606

  8. An alternative hypothesis to the widely held view that renal excretion of sodium accounts for resistance to salt-induced hypertension.

    Science.gov (United States)

    Kurtz, Theodore W; DiCarlo, Stephen E; Pravenec, Michal; Schmidlin, Olga; Tanaka, Masae; Morris, R Curtis

    2016-11-01

    It is widely held that in response to high salt diets, normal individuals are acutely and chronically resistant to salt-induced hypertension because they rapidly excrete salt and retain little of it so that their blood volume, and therefore blood pressure, does not increase. Conversely, it is also widely held that salt-sensitive individuals develop salt-induced hypertension because of an impaired renal capacity to excrete salt that causes greater salt retention and blood volume expansion than that which occurs in normal salt-resistant individuals. Here we review results of both acute and chronic salt-loading studies that have compared salt-induced changes in sodium retention and blood volume between normal subjects (salt-resistant normotensive control subjects) and salt-sensitive subjects. The results of properly controlled studies strongly support an alternative view: during acute or chronic increases in salt intake, normal salt-resistant subjects undergo substantial salt retention and do not excrete salt more rapidly, retain less sodium, or undergo lesser blood volume expansion than do salt-sensitive subjects. These observations: (i) directly conflict with the widely held view that renal excretion of sodium accounts for resistance to salt-induced hypertension, and (ii) have implications for contemporary understanding of how various genetic, immunologic, and other factors determine acute and chronic blood pressure responses to high salt diets. Copyright © 2016 International Society of Nephrology. Published by Elsevier Inc. All rights reserved.

  9. Community-associated methicillin-resistant Staphylococcus aureus – evolution of the strains or iatrogenic effects?

    Directory of Open Access Journals (Sweden)

    Izabela Błażewicz

    2014-06-01

    Full Text Available Staphylococcus aureus ( S. aureus is a Gram-positive bacterium capable of causing various diseases, from skin infections to life-threatening necrotizing pneumonia, bacteraemia, endocarditis and toxic shock syndrome. Methicillin-resistant Staphylococcus aureus (MRSA is endemic in hospitals worldwide and is a major cause of human morbidity and mortality. Healthcare-associated MRSA (HA-MRSA infections occur in individuals with a compromised immune system and people with prior surgery. Community-associated MRSA (CA-MRSA infections often occur in healthy individuals and are epidemic in some countries, which may suggest that those strains are more virulent and transmissible than HA-MRSA. According to the Center for Disease Control and Prevention, a case of MRSA infection is community acquired when it is diagnosed in an outpatient or within 48 hours of hospitalization if the patient lacks the following traditional risk factors for MRSA infection: receipt of hemodialysis, surgery, residence in a long-term care facility, or hospitalization during the previous year; the presence of an indwelling catheter or a percutaneous device at the time culture samples were obtained. Although progress has been made toward understanding emergence of CA-MRSA, virulence factors and treatment options, our knowledge remains incomplete. The recent occurrence of CA-MRSA in addition to the widespread problem of MRSA in hospitals has underlined the high urgency to find novel treatment options for drug-resistant S. aureus .

  10. Abundances of Clinically Relevant Antibiotic Resistance Genes and Bacterial Community Diversity in the Weihe River, China

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    Xiaojuan Wang

    2018-04-01

    Full Text Available The spread of antibiotic resistance genes in river systems is an emerging environmental issue due to their potential threat to aquatic ecosystems and public health. In this study, we used droplet digital polymerase chain reaction (ddPCR to evaluate pollution with clinically relevant antibiotic resistance genes (ARGs at 13 monitoring sites along the main stream of the Weihe River in China. Six clinically relevant ARGs and a class I integron-integrase (intI1 gene were analyzed using ddPCR, and the bacterial community was evaluated based on the bacterial 16S rRNA V3–V4 regions using MiSeq sequencing. The results indicated Proteobacteria, Actinobacteria, Cyanobacteria, and Bacteroidetes as the dominant phyla in the water samples from the Weihe River. Higher abundances of blaTEM, strB, aadA, and intI1 genes (103 to 105 copies/mL were detected in the surface water samples compared with the relatively low abundances of strA, mecA, and vanA genes (0–1.94 copies/mL. Eight bacterial genera were identified as possible hosts of the intI1 gene and three ARGs (strA, strB, and aadA based on network analysis. The results suggested that the bacterial community structure and horizontal gene transfer were associated with the variations in ARGs.

  11. Prevalence of Methicillin Resistant Staphylococcus aureus in pyogenic community and hospital acquired skin and soft tissues infections

    International Nuclear Information System (INIS)

    Ahmad, M. K.; Asrar, A.

    2014-01-01

    Objective: To determine the percentage and frequency of Methicillin Resistant Staphylococcus aureus in community and hospital-acquired pyogenic skin and soft tissue infections. Methods: The descriptive cross-sectional study was conducted at the Dermatology Department of Combined Military Hospital, Abbottabad, from June 2009 to March 2010, and comprised 144 community-acquired and 54 hospital-acquired skin and soft tissue infections. Pus swabs from the infected lesions one from each individual were sent to laboratory for culture and sensitivity tests. Methicillin resistance was detected by 1 (mu) g oxacillin disk. Organisms were labelled methicillin-resistant once the inhibition zone for oxocillin was less than 10 mm. Data analysis was done by using SPSS 20. Results: Of the 198 patients in the study, 98(49.5%) were males and 100(50.5%) were females, with an overall mean age of 33.7+-14.8144 years. There were 144(72.72%) community-acquired infections and 54(27.27%) had hospital-acquired infections. Community-acquired Methicillin Resistant Staphylococcus aureus numbered 40(27.8%) and hospital-acquired ones numbered 26(48.1%). Conclusion: Prevalence of Methicillin Resistant Staphylococcus aureus in community and hospital-acquired pyogenic skin and soft tissue infections was high. (author)

  12. Community prevalence of methicillin and vancomycin resistant Staphylococcus aureus in and around Bangalore, southern India

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    Rajendra Goud

    2011-06-01

    Full Text Available INTRODUCTION: Staphylococcus aureus is a known colonizer in humans and has been implicated in community acquired soft tissue infections. However emergence of methicillin resistant S. aureus (MRSA has aroused great concern worldwide. This study aimed to determine the prevalence of MRSA in the community of Bangalore, southern India. METHODS: Swabs were collected from anterior nares, forearm, dorsum and palm of the hands of 1,000 healthy individuals residing in and around Bangalore, belonging to different socioeconomic strata and age groups. RESULTS: Analysis verified that 22.5% and 16.6% of the individuals presented Staphylococcus aureus and MRSA, respectively, at any of the three sites. Vancomycin resistance was observed in 1.4% of the S. aureus isolates, which was confirmed by detection of the vanA gene. It was interesting to note that 58.8% of the children in the age group 1-5 years-old presented MRSA, the highest percentage compared to other age groups of 40 (11% years-old and 20-40 (9.9% years-old. Among the population of various socioeconomic strata, maximum MRSA colonization was observed among doctors (22.2%, followed by upper economic class (18.8%, lower economic class (17.7%, apparently healthy hospital in-patients (16.5%, nurses (16% and middle economic class (12.5%. Most of the MRSA isolates were capsular polysaccharide antigen type 8 (57.1%. CONCLUSIONS: There is a need for continuous surveillance and monitoring of the presence of MRSA in the community and a clearer understanding of the dynamics of the spread of MRSA will assist in controlling its dissemination.

  13. Sunlight-exposed biofilm microbial communities are naturally resistant to chernobyl ionizing-radiation levels.

    Science.gov (United States)

    Ragon, Marie; Restoux, Gwendal; Moreira, David; Møller, Anders Pape; López-García, Purificación

    2011-01-01

    The Chernobyl accident represents a long-term experiment on the effects of exposure to ionizing radiation at the ecosystem level. Though studies of these effects on plants and animals are abundant, the study of how Chernobyl radiation levels affect prokaryotic and eukaryotic microbial communities is practically non-existent, except for a few reports on human pathogens or soil microorganisms. Environments enduring extreme desiccation and UV radiation, such as sunlight exposed biofilms could in principle select for organisms highly resistant to ionizing radiation as well. To test this hypothesis, we explored the diversity of microorganisms belonging to the three domains of life by cultivation-independent approaches in biofilms developing on concrete walls or pillars in the Chernobyl area exposed to different levels of radiation, and we compared them with a similar biofilm from a non-irradiated site in Northern Ireland. Actinobacteria, Alphaproteobacteria, Bacteroidetes, Acidobacteria and Deinococcales were the most consistently detected bacterial groups, whereas green algae (Chlorophyta) and ascomycete fungi (Ascomycota) dominated within the eukaryotes. Close relatives to the most radio-resistant organisms known, including Rubrobacter species, Deinococcales and melanized ascomycete fungi were always detected. The diversity of bacteria and eukaryotes found in the most highly irradiated samples was comparable to that of less irradiated Chernobyl sites and Northern Ireland. However, the study of mutation frequencies in non-coding ITS regions versus SSU rRNA genes in members of a same actinobacterial operational taxonomic unit (OTU) present in Chernobyl samples and Northern Ireland showed a positive correlation between increased radiation and mutation rates. Our results show that biofilm microbial communities in the most irradiated samples are comparable to non-irradiated samples in terms of general diversity patterns, despite increased mutation levels at the single

  14. Comparison of antimicrobial resistance phenotypes and resistance genes in Enterococcus faecalis and Enterococcus faecium from humans in the community, broilers and pigs in Denmark

    DEFF Research Database (Denmark)

    Aarestrup, Frank Møller; Agersø, Yvonne; Gerner-Smidt, P.

    2000-01-01

    Enterococcus faecalis and E. faecium isolated from humans in the community (98 and 65 isolates), broilers (126 and 122), and pigs (102 and 88) during 1998 were tested for susceptibility to 12 different antimicrobial agents and for the presence of selected genes encoding resistance using PCR...

  15. Community-associated methicillin-resistant Staphylococcus aureus skin infections in the tropics.

    Science.gov (United States)

    Tong, Steven Y C; Steer, Andrew C; Jenney, Adam W; Carapetis, Jonathan R

    2011-01-01

    Skin and soft tissue infections (SSTI) caused by Staphylococcus aureus are very common, particularly in children, in tropical regions. The proportion of S aureus SSTI caused by community-associated methicillin-resistant S aureus (CA-MRSA) varies according to region, but is up to 25% in some areas. There are diverse CA-MRSA clones, including several that harbor Panton-Valentine leukocidin. Key predisposing factors for staphylococcal infections are scabies infestation, overcrowding, poor hygiene, and inadequate water supplies. In the setting of a community outbreak of staphylococcal SSTI, interventions intended to improve personal and community hygiene are likely to be the most practical, effective, and achievable. Options for oral treatment of clinical infections caused by CA-MRSA include clindamycin and trimethoprim-sulfamethoxazole. Although rapid diagnostics are now available, and 2 vaccines have reached clinical trials, neither of these is likely to be of use in tropical, developing regions in the near future. Crown Copyright © 2011. Published by Elsevier Inc. All rights reserved.

  16. Antimicrobial resistance in pathogens causing urinary tract infections in a rural community of Odisha, India

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    Muktikesh Dash

    2013-01-01

    Full Text Available Background: Antimicrobial resistance of urinary tract pathogens has increased worldwide. Empiric treatment of community-acquired urinary tract infection (CA-UTI is determined by antimicrobial resistance patterns of uropathogens in a population of specific geographical location. Objectives: This study was conducted to determine the prevalence of CA-UTI in rural Odisha, India, and the effect of gender and age on its prevalence as well as etiologic agents and the resistance profile of the bacterial isolates. Materials and Methods: Consecutive clean-catch mid-stream urine samples were collected from 1670 adult patients. The urine samples were processed and microbial isolates were identified by conventional methods. Antimicrobial susceptibility testing was performed on all bacterial isolates by Kirby Bauer′s disc diffusion method. Results: The prevalence of UTI was significantly higher in females compared with males (females 45.2%, males 18.4%, OR = 2.041, 95% CI = 1.64-2.52, P ≤ 0.0001. Young females within the age group of 18-37 years and elderly males (≥68 years showed high prevalence of UTI. Escherichia coli (68.8% was the most prevalent isolate followed by Enterococcus spp. (9.7%. Amikacin and nitrofurantoin were the most active antimicrobial agents which showed low resistance rate of 5.8% and 9.8%, respectively. Conclusion: Our study revealed E. coli as the pre-dominant bacterial pathogen. Nitrofurantoin should be used as empirical therapy for uncomplicated CA-UTIs. In the Indian setting, routine urine cultures may be advisable, since treatment failure is likely to occur with commonly used antimicrobials. Therefore, development of regional surveillance programs is necessary for implementation of national CA-UTI guidelines.

  17. Antibiotic resistance in Haemophilus influenzae decreased, except for beta-lactamase-negative amoxicillin-resistant isolates, in parallel with community antibiotic consumption in Spain from 1997 to 2007.

    Science.gov (United States)

    García-Cobos, Silvia; Campos, José; Cercenado, Emilia; Román, Federico; Lázaro, Edurne; Pérez-Vázquez, María; de Abajo, Francisco; Oteo, Jesús

    2008-08-01

    The susceptibility to 14 antimicrobial agents and the mechanisms of aminopenicillin resistance were studied in 197 clinical isolates of Haemophilus influenzae--109 isolated in 2007 (study group) and 88 isolated in 1997 (control group). Community antibiotic consumption trends were also examined. H. influenzae strains were consecutively isolated from the same geographic area, mostly from respiratory specimens from children and adults. Overall, amoxicillin resistance decreased by 8.4% (from 38.6 to 30.2%). Beta-lactamase production decreased by 15.6% (from 33 to 17.4%, P = 0.01), but amoxicillin resistance without beta-lactamase production increased by 7.1% (from 5.7 to 12.8%). All beta-lactamase-positive isolates were TEM-1, but five different promoter regions were identified, with Pdel being the most prevalent in both years, and Prpt being associated with the highest amoxicillin resistance. A new promoter consisting of a double repeat of 54 bp was detected. Community consumption of most antibiotics decreased, as did the geometric means of their MICs, but amoxicillin-clavulanic acid and azithromycin consumption increased by ca. 60%. For amoxicillin-clavulanic acid, a 14.2% increase in the population with an MIC of 2 to 4 microg/ml (P = 0.02) was observed; for azithromycin, a 21.2% increase in the population with an MIC of 2 to 8 microg/ml (P = 0.0005) was observed. In both periods, the most common gBLNAR (i.e., H. influenzae isolates with mutations in the ftsI gene as previously defined) patterns were IIc and IIb. Community consumption of trimethoprim-sulfamethoxazole decreased by 54%, while resistance decreased from 50 to 34.9% (P = 0.04). Antibiotic resistance in H. influenzae decreased in Spain from 1997 to 2007, but surveillance should be maintained since new forms of resistances may be developing.

  18. Comparison of metals and tetracycline as selective agents for development of tetracycline resistant bacterial communities in agricultural soil

    DEFF Research Database (Denmark)

    Song, Jianxiao; Rensing, Christopher; Holm, Peter Engelund

    2017-01-01

    Environmental selection of antibiotic resistance may be caused by either antibiotic residues or coselecting agents. Using a strictly controlled experimental design, we compared the ability of metals (Cu or Zn) and tetracycline to (co)select for tetracycline resistance in bacterial communities. Soil...... microcosms were established by amending agricultural soil with known levels of Cu, Zn, or tetracycline known to represent commonly used metals and antibiotics for pig farming. Soil bacterial growth dynamics and bacterial community-level tetracycline resistance were determined using the [(3)H......]leucine incorporation technique, whereas soil Cu, Zn, and tetracycline exposure were quantified by a panel of whole-cell bacterial bioreporters. Tetracycline resistance increased significantly in soils containing environmentally relevant levels of Cu (≥365 mg kg(-1)) and Zn (≥264 mg kg(-1)) but not in soil spiked...

  19. Bacterial Etiology and Antibiotic Resistance Profile of Community-Acquired Urinary Tract Infections in a Cameroonian City

    OpenAIRE

    Nzalie, Rolf Nyah-tuku; Gonsu, Hortense Kamga; Koulla-Shiro, Sinata

    2016-01-01

    Introduction. Community-acquired urinary tract infections (CAUTIs) are usually treated empirically. Geographical variations in etiologic agents and their antibiotic sensitivity patterns are common. Knowledge of antibiotic resistance trends is important for improving evidence-based recommendations for empirical treatment of UTIs. Our aim was to determine the major bacterial etiologies of CAUTIs and their antibiotic resistance patterns in a cosmopolitan area of Cameroon for comparison with pres...

  20. Community perceptions of infectious diseases, antibiotic use and antibiotic resistance in context of environmental changes: a study in Odisha, India.

    Science.gov (United States)

    Sahoo, Krushna Chandra; Tamhankar, Ashok J; Johansson, Eva; Stålsby Lundborg, Cecilia

    2014-10-01

    The public health impact of environmental changes and the faceless threat of antibiotic resistance are currently among the top global health challenges. Community understanding of health, diseases and medicines in relation to the changing environment is necessary to mitigate the impact of these changes on health and for prudent use of antibiotics. The objective is to explore community perceptions of infectious diseases, antibiotic use and antibiotic resistance in the context of environmental changes. A qualitative study was conducted among community members with various backgrounds in education, gender, age and occupation of two districts of Odisha, India. Eight focus groups discussions and ten individual interviews were conducted. Data were analysed using content analysis. Two themes emerged: 'Interpretation of infectious diseases and health hazards in the context of environmental changes', and 'Understanding of antibiotic use and its consequences for resistance development and the environment'. The participants perceived that nowadays there is irregularity in the occurrence of seasons, particularly an increase in average temperature, which is influencing health. Participants' perceptions of infectious diseases, antibiotic use and resistance varied according to their social environment. Furthermore, they perceived that improved sanitation, choice of alternative medicine and awareness and education on prudent use of antibiotics are probably some ways to prevent antibiotic resistance. The participants perceived that climate variability is increasing and that this has health consequences for the community. They also hypothesized an interrelationship between the environment, infectious diseases and medicine use, particularly antibiotics. This is helpful for further empirical studies. © 2012 John Wiley & Sons Ltd.

  1. The incidence of methicillin-resistant staphylococcus aureus in community-acquired hand infections.

    Science.gov (United States)

    Wilson, Patrick C; Rinker, Brian

    2009-05-01

    Methicillin-resistant Staphylococcus aureus (MRSA) has become increasingly prevalent in hand infections. Traditionally, the empiric treatment of hand infections has involved beta-lactam antibiotics, which are ineffective against MRSA. Centers for Disease Control recommends empiric coverage of MRSA infections if the local rate of MRSA exceeds 10% to 15%. A retrospective review was performed on all patients admitted for community-acquired soft tissue infections of the hand between 2004 and 2007 at a single institution. The overall incidence of MRSA was 60%. The incidence of MRSA in healthy adults was 64%, healthy pediatric patients was 100%, immunocompromised patients was 45%, and diabetic patients was 20%. The current rates of MRSA would imply that all patients presenting with hand infections should be treated empirically for MRSA. Linezolid is the only oral antibiotic approved by the Food and Drug Administration for treating MRSA, but many studies have reported that trimethoprim-sulfamethoxazole is an effective antibiotic for outpatient treatment of MRSA.

  2. It Takes a Rooted Village: Networked Resistance, Connected Communities, and Adaptive Responses to Forest Tenure Reform in Northern Thailand

    Directory of Open Access Journals (Sweden)

    Kimberly Roberts

    2016-06-01

    Full Text Available Conflicts persist between forest dwelling communities and advocates of forest conservation. In Thailand, a community forestry bill and national park expansion initiatives leave little space for communities. The article analyzes the case of the predominantly ethnic Black Lahu village of Huai Lu Luang in Chiang Rai province that has resisted the threats posed by a community forestry bill and a proposed national park. The villagers reside on a national forest reserve and have no de jure rights to the land. This article argues, however, that through its network rooted in place and connected to an assemblage of civil society, local government, and NGOs, Huai Lu Luang has been able to stall efforts by the Thai government that would detrimentally impact their use of and access to forest resources. Their resistance is best understood not in isolation – as one victimized community resisting threats to their livelihoods – but in connection to place, through dynamic assemblages. A ‘rooted’ networks approach follows the connections and nodes of Huai Lu Luang’s network that influence and aid the village’s attempts to resist forest tenure reform.

  3. Rhizosphere microbial communities from resistant and susceptible watermelon cultivars showed different response to fusarium oxysporum f. sp. niveum inoculation

    International Nuclear Information System (INIS)

    Zhi, W.F.; Can, C.S.; Ling, C.; Hui, X.W.

    2015-01-01

    Fusarium oxysporum f. sp. niveum (FON), a soil-borne pathogen of watermelon (Citrullus lanatus), can cause substantial production losses worldwide. In this study, plate culture and PCR-denaturing gradient gel electrophoresis (DGGE) methods were used to evaluate the effects of inoculation of Fusarium oxysporum f.sp. niveum on rhizosphere microbial communities of different watermelon cultivars to FON. Two methods indicated that the effects of watermelon rhizosphere microbial community of different resistance cultivars to FON were much different. Populations of culturable bacteria and actinomycetes in the rhizosphere of susceptible watermelon cultivar were significantly lower than in the resistant cultivar after inoculation (P<0.05), but the opposite result was observed for fungi. Principal component analysis of bacterial and fungal community structure also showed that the cultivar of FON-inoculated soil treatment were separated from the non-inoculated controls after inoculation, and there was clear discrimination between the susceptible cultivars and the resistant cultivars. Sequence analysis of specific bands from DGGE profiles showed that specific rhizosphere bacterial and fungal groups differed between watermelon cultivars after inoculation . Both methods demonstrated that different resistant watermelon cultivars occupied different rhizosphere microbial communities, and and disease suppression might be correlated with high microbial diversity. F. oxysporum f. sp. Niveum alters the structure and functional diversity of microbial communities associated with watermelon rhizosphere. (author)

  4. [Pathogen distribution and bacterial resistance in children with severe community-acquired pneumonia].

    Science.gov (United States)

    Lu, Yun-Yun; Luo, Rong; Fu, Zhou

    2017-09-01

    To investigate the distribution of pathogens and bacterial resistance in children with severe community-acquired pneumonia (CAP). A total of 522 children with severe CAP who were hospitalized in 2016 were enrolled as study subjects. According to their age, they were divided into infant group (402 infants aged 28 days to 1 year), young children group (73 children aged 1 to 3 years), preschool children group (35 children aged 3 to 6 years), and school-aged children group (12 children aged ≥6 years). According to the onset season, all children were divided into spring group (March to May, 120 children), summer group (June to August, 93 children), autumn group (September to November, 105 children), and winter group (December to February, 204 children). Sputum specimens from the deep airway were collected from all patients. The phoenix-100 automatic bacterial identification system was used for bacterial identification and drug sensitivity test. The direct immunofluorescence assay was used to detect seven common respiratory viruses. The quantitative real-time PCR was used to detect Mycoplasma pneumoniae (MP) and Chlamydia trachomatis (CT). Of all the 522 children with severe CAP, 419 (80.3%) were found to have pathogens, among whom 190 (45.3%) had mixed infection. A total of 681 strains of pathogens were identified, including 371 bacterial strains (54.5%), 259 viral strains (38.0%), 12 fungal strains (1.8%), 15 MP strains (2.2%), and 24 CT strains (3.5%). There were significant differences in the distribution of bacterial, viral, MP, and fungal infections between different age groups (Presistance rates of Streptococcus pneumoniae to erythromycin, tetracycline, and clindamycin reached above 85%, and the drug-resistance rates of Staphylococcus aureus to penicillin, erythromycin, and clindamycin were above 50%; they were all sensitive to vancomycin and linezolid. The drug-resistance rates of Haemophilus influenzae to cefaclor and cefuroxime were above 60%, but it was

  5. Xpf and not the Fanconi anaemia proteins or Rev3 accounts for the extreme resistance to cisplatin in Dictyostelium discoideum.

    Directory of Open Access Journals (Sweden)

    Xiao-Yin Zhang

    2009-09-01

    Full Text Available Organisms like Dictyostelium discoideum, often referred to as DNA damage "extremophiles", can survive exposure to extremely high doses of radiation and DNA crosslinking agents. These agents form highly toxic DNA crosslinks that cause extensive DNA damage. However, little is known about how Dictyostelium and the other "extremophiles" can tolerate and repair such large numbers of DNA crosslinks. Here we describe a comprehensive genetic analysis of crosslink repair in Dictyostelium discoideum. We analyse three gene groups that are crucial for a replication-coupled repair process that removes DNA crosslinks in higher eukarya: The Fanconi anaemia pathway (FA, translesion synthesis (TLS, and nucleotide excision repair. Gene disruption studies unexpectedly reveal that the FA genes and the TLS enzyme Rev3 play minor roles in tolerance to crosslinks in Dictyostelium. However, disruption of the Xpf nuclease subcomponent results in striking hypersensitivity to crosslinks. Genetic interaction studies reveal that although Xpf functions with FA and TLS gene products, most Xpf mediated repair is independent of these two gene groups. These results suggest that Dictyostelium utilises a distinct Xpf nuclease-mediated repair process to remove crosslinked DNA. Other DNA damage-resistant organisms and chemoresistant cancer cells might adopt a similar strategy to develop resistance to DNA crosslinking agents.

  6. A Nosocomial Outbreak of Community-Associated Methicillin-Resistant Staphylococcus aureus among Healthy Newborns and Postpartum Mothers

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    Andrea Saunders

    2007-01-01

    Full Text Available BACKGROUND: Community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA has increasingly been isolated from individuals with no predisposing risk factors; however, such strains have rarely been linked to outbreaks in the hospital setting. The present study describes the investigation of an outbreak of CA-MRSA that occurred in the maternal-newborn unit of a large community teaching hospital in Toronto, Ontario.

  7. Risk factors associated with potentially antibiotic-resistant pathogens in community-acquired pneumonia.

    Science.gov (United States)

    Prina, Elena; Ranzani, Otavio T; Polverino, Eva; Cillóniz, Catia; Ferrer, Miquel; Fernandez, Laia; Puig de la Bellacasa, Jorge; Menéndez, Rosario; Mensa, Josep; Torres, Antoni

    2015-02-01

    To identify pathogens that require different treatments in community-acquired pneumonia (CAP), we propose an acronym, "PES" (Pseudomonas aeruginosa, Enterobacteriaceae extended-spectrum β-lactamase-positive, and methicillin-resistant Staphylococcus aureus). To compare the clinical characteristics and outcomes between patients with CAP caused by PES versus other pathogens, and to identify the risk factors associated with infection caused by PES. We conducted an observational prospective study evaluating only immunocompetent patients with CAP and an established etiological diagnosis. We included patients from nursing homes. We computed a score to identify patients at risk of PES pathogens. Of the 4,549 patients evaluated, we analyzed 1,597 who presented an etiological diagnosis. Pneumonia caused by PES was identified in 94 (6%) patients, with 108 PES pathogens isolated (n = 72 P. aeruginosa, n = 15 Enterobacteriaceae extended-spectrum β-lactamase positive, and n = 21 methicillin-resistant Staphylococcus aureus). These patients were older (P = 0.001), had received prior antibiotic treatment more frequently (P associated with increased risk of 30-day mortality (adjusted odds ratio = 2.51; 95% confidence interval = 1.20-5.25; P = 0.015). The area under the curve for the score we computed was 0.759 (95% confidence interval, 0.713-0.806; P risk factors could help to identify these microbial etiologies.

  8. Community-Acquired Methicillin-Resistant Staphylococcus aureus: The New Face of an Old Foe?

    Science.gov (United States)

    Udo, Edet E.

    2013-01-01

    The burden of infections caused by community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA) is increasing among different patient populations globally. As CA-MRSA has become established in healthcare facilities, the range of infections caused by them has also increased. Molecular characterization of CA-MRSA isolates obtained from different centers has revealed significant diversity in their genetic backgrounds. Although many CA-MRSA strains are still susceptible to non-β-lactam antibiotics, multiresistance to non-β-lactam agents has emerged in some clones, posing substantial problems for empirical and directed therapy of infections caused by these strains. Some CA-MRSA clones have acquired the capacity to spread locally and internationally. CA-MRSA belonging to ST80-MRSA-IV and ST30-MRSA-IV appear to be the dominant clones in the countries of the Gulf Cooperation Council (GCC). The emergence of pandemic CA-MRSA clones not only limits therapeutic options but also presents significant challenges for infection control. Continued monitoring of global epidemiology and emerging drug resistance data is critical for the effective management of these infections. PMID:24051949

  9. Evolution of community- and healthcare-associated methicillin-resistant Staphylococcus aureus☆

    Science.gov (United States)

    Uhlemann, Anne-Catrin; Otto, Michael; Lowy, Franklin D.; DeLeo, Frank R.

    2013-01-01

    Staphylococcus aureus is a prominent cause of human infections globally. The high prevalence of infections is compounded by antibiotic resistance—a significant problem for treatment. Methicillin-resistant S. aureus (MRSA) is endemic in hospitals and healthcare facilities worldwide, and is an increasingly common cause of community-associated bacterial infections in industrialized countries. Although much focus is placed on the role of S. aureus as a human pathogen, it is in fact a human commensal organism that has had a relatively long coexistence with the human host. Many S. aureus infections can be explained by host susceptibility or other predisposing risk factors. On the other hand, the emergence/re-emergence of successful S. aureus clones (referred to as epidemic waves) suggests a rapid bacterial adaption and evolution, which includes the emergence of antibiotic resistance and increased virulence and/or transmissibility. It is within this context that we review our understanding of selected S. aureus epidemic waves, and highlight the use of genome sequencing as a means to better understand the evolution of each lineage. PMID:23648426

  10. Breaking the silence on abortion: the role of adult community abortion education in fostering resistance to norms.

    Science.gov (United States)

    Bloomer, Fiona K; O'Dowd, Kellie; Macleod, Catriona

    2017-07-01

    Meanings of abortion in society are constructed within sociohistorical and gendered spaces and manifested through myriad discourses that impact on the perception and treatment of the issue in that society. In societies with powerful oppressive anti-abortion norms, such as Northern Ireland, little is known as to how these norms are resisted by the adult population. This study uses a Foucauldian feminist approach to show how resistance to religious and patriarchal norms can be fostered through adult community abortion education. This resistance is multi-faceted and bolstered by a lived experience discourse, which does not necessarily involve eschewing religious notions held within society.

  11. Necrotizing community-acquired methicillin-resistant Staphylococcus aureus pneumonia: an emerging problem in correctional facilities.

    Science.gov (United States)

    Kohli, Nita; Kochie, Mary; Harber, Philip

    2011-03-01

    Community-acquired methicillin-resistant Staphylococcus aureus (CA-MRSA) skin infections have been common in prisons for more than a decade. However, CA-MRSA as a cause of pneumonia has been reported infrequently. This infection can present with flu-like symptoms and rapidly progress, possibly leading to death in a matter of days. Two cases of MRSA community-acquired pneumonia (CAP) associated with influenza-like illness in correctional officers employed in two separate prisons within the California prison system are presented. Both individuals were previously healthy, but one died of this disease. MRSA is an uncommon, but now recognized, cause of CAP. These cases are notable for their unique presentation and occurrence in non-health care, occupational settings. Prompt diagnosis and intervention by occupational health nurses and physicians are critical to improving outcomes, especially in high-risk settings such as prisons. These worksites need an effective occupational health program to manage MRSA, with adequate training for both employees and inmates.

  12. CAUSES OF COMMUNITY-ACQUIRED BACTEREMIA AND PATTERNS OF ANTIMICROBIAL RESISTANCE IN VIENTIANE, LAOS

    Science.gov (United States)

    PHETSOUVANH, RATTANAPHONE; PHONGMANY, SIMMALY; SOUKALOUN, DOUANGDAO; RASACHAK, BOUACHANH; SOUKHASEUM, VIMONE; SOUKHASEUM, SEUN; FRICHITHAVONG, KAMTHAVI; KHOUNNORATH, SENGMANIVONG; PENGDEE, BOUNTHOM; PHIASAKHA, KHAMPHONG; CHU, VANG; LUANGXAY, KHONESAVANH; RATTANAVONG, SAYADETH; SISOUK, KONKAM; KEOLOUANGKOT, VALY; MAYXAY, MAYFONG; RAMSAY, ANDREW; BLACKSELL, STUART D.; CAMPBELL, JIM; MARTINEZ-AUSSEL, BERTRAND; HEUANVONGSY, MAYBOUN; BOUNXOUEI, BOUNTHAPAANY; THAMMAVONG, CHANPHENG; SYHAVONG, BOUNKONG; STROBEL, MICHEL; PEACOCK, SHARON J.; WHITE, NICHOLAS J.; NEWTON, PAUL N.

    2008-01-01

    There is no published information on the causes of bacteremia in the Lao PDR (Laos). Between 2000 and 2004, 4512 blood culture pairs were taken from patients admitted to Mahosot Hospital, Vientiane, Laos, with suspected community-acquired bacteremia; 483 (10.7%) cultures grew a clinically significant community-acquired organism, most commonly Salmonella enterica serovar typhi (50.9%), Staphylococcus aureus (19.0%), and Escherichia coli (12.4%). S. aureus bacteremia was common among infants (69.2%), while children 1–5 years had a high frequency of typhoid (44%). Multi–drug-resistant S. Typhi was rare (6%). On multiple logistic regression analysis, typhoid was associated with younger age, longer illness, diarrhea, higher admission temperature, and lower peripheral white blood cell count than non-typhoidal bacteremia. Empirical parenteral ampicillin and gentamicin would have some activity against ∼ 88% of clinically significant isolates at a cost of US $1.4/day, an important exception being B. pseudomallei. Bacteremic infants in this setting require an anti-staphylococcal antibiotic. PMID:17124000

  13. Latina/o Parent Organizing for Educational Justice: An Ethnographic Account of Community Building and Radical Healing

    Science.gov (United States)

    Nygreen, Kysa

    2017-01-01

    This article describes a parent organizing effort with Latina/o immigrant parents in a large, high-poverty, racially and linguistically diverse urban school district. Drawing from ethnographic research and the theoretical framework of "mujerismo," it examines the relational processes of community building and radical healing that…

  14. Resistance of Terrestrial Microbial Communities to Impack of Physical Conditinos of Subsurface Layers of Martian Regolith

    Science.gov (United States)

    Cheptsov, V. S.; Vorobyova, E. A.

    2017-05-01

    Currently, astrobiology is focused on Mars as one of the most perspective objects in the Solar System to search for microbial life. It was assumed that the putative biosphere of Mars could be cryopreserved and had been stored for billions of years in anabiotic state like microbial communities of Arctic and Antarctic permafrost deposits have been preserved till now for millions of years. In this case microbial cells should be not able to repair the damages or these processes have to be significantly depressed, and the main factor causing cell's death should be ionizing radiation. In a series of experiments we simulated the effects of combination of physical factors known as characteristics of the Martian regolith (and close to the space environment) on the natural microbial communities inhabiting xerophytic harsh habitats with extreme temperature conditions: polar permafrost and desert soils. The aim of the study was to examine the cumulative effect of factors (gamma radiation, low temperature, low pressure) to assess the possibility of metabolic reactions, and to find limits of the viability of natural microbial communities after exposure to the given conditions. It was found that microbial biomarkers could be reliably detected in soil samples after radiation dose accumulation up to 1 MGy (not further investigated) in combination with exposure to low temperature and low pressure. Resistance to extremely high doses of radiation in simulated conditions proves that if there was an Earth-like biosphere on the early Mars microorganisms could survive in the surface or subsurface layers of the Martian regolith for more than tens of millions of years after climate change. The study gives also some new grounds for the approval of transfer of viable microorganisms in space.

  15. Sunlight-exposed biofilm microbial communities are naturally resistant to chernobyl ionizing-radiation levels.

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    Marie Ragon

    Full Text Available BACKGROUND: The Chernobyl accident represents a long-term experiment on the effects of exposure to ionizing radiation at the ecosystem level. Though studies of these effects on plants and animals are abundant, the study of how Chernobyl radiation levels affect prokaryotic and eukaryotic microbial communities is practically non-existent, except for a few reports on human pathogens or soil microorganisms. Environments enduring extreme desiccation and UV radiation, such as sunlight exposed biofilms could in principle select for organisms highly resistant to ionizing radiation as well. METHODOLOGY/PRINCIPAL FINDINGS: To test this hypothesis, we explored the diversity of microorganisms belonging to the three domains of life by cultivation-independent approaches in biofilms developing on concrete walls or pillars in the Chernobyl area exposed to different levels of radiation, and we compared them with a similar biofilm from a non-irradiated site in Northern Ireland. Actinobacteria, Alphaproteobacteria, Bacteroidetes, Acidobacteria and Deinococcales were the most consistently detected bacterial groups, whereas green algae (Chlorophyta and ascomycete fungi (Ascomycota dominated within the eukaryotes. Close relatives to the most radio-resistant organisms known, including Rubrobacter species, Deinococcales and melanized ascomycete fungi were always detected. The diversity of bacteria and eukaryotes found in the most highly irradiated samples was comparable to that of less irradiated Chernobyl sites and Northern Ireland. However, the study of mutation frequencies in non-coding ITS regions versus SSU rRNA genes in members of a same actinobacterial operational taxonomic unit (OTU present in Chernobyl samples and Northern Ireland showed a positive correlation between increased radiation and mutation rates. CONCLUSIONS/SIGNIFICANCE: Our results show that biofilm microbial communities in the most irradiated samples are comparable to non-irradiated samples in

  16. An Outbreak of Community Associated Methicillin Resistant Staphylococcus aureus Subtype USA300 at an International School in Singapore.

    Science.gov (United States)

    Grant, Dixon; Koh, Tse Hsien; Tan, Yen Ee; Hsu, Li Yang; Kurup, Asok; Donahue, Shelly K; Mann, Janelle; Fisher, Dale

    2013-11-01

    Community associated methicillin-resistant Staphylococcus aureus (CA-MRSA) subtype USA300 remains relatively well confined within North American shores. Between August and November 2010, a large international school in Singapore recorded 27 skin and soft tissue infections, 8 of which were confirmed USA 300. This study reports the outbreak investigation and the interventions instituted.

  17. Characterization of the population structure, drug resistance mechanisms and plasmids of the community-associated Enterobacter cloacae complex in China

    NARCIS (Netherlands)

    Zhou, Kai; Yu, Wei; Cao, Xiaoli; Shen, Ping; Lu, Haifeng; Luo, Qixia; Rossen, John W. A.; Xiao, Yonghong

    Objectives: To investigate the population structure, drug resistance mechanisms and plasmids of community-associated Enterobacter cloacae complex (CA-ECC) isolates in China. Methods: Sixty-two CA-ECC isolates collected from 31 hospitals across China were typed by hsp60 typing and MLST. ESBL and

  18. Building the Dream: Transformational Resistance, Community-Based Organizations, and the Civic Engagement of Latinos in the New South

    Science.gov (United States)

    Petrone, Eleanor A.

    2016-01-01

    This article examines how a group of Latino youth living in the Southeast experienced, adapted to, and resisted oppressive social structures within their community through their involvement with youth media. Through the content analysis of a teen radio show produced by and for Latino youth, in conjunction with semistructured interviews and…

  19. Pre-exposure to drought increases the resistance of tropical forest soil bacterial communities to extended drought

    Science.gov (United States)

    Nicholas J. Bouskill; Hsiao Chien Lim; Sharon Borglin; Rohit Salve; Tana Wood; Whendee L. Silver; Eoin L. Brodie

    2013-01-01

    Global climate models project a decrease in the magnitude of precipitation in tropical regions. Changes in rainfall patterns have important implications for the moisture content and redox status of tropical soils, yet little is known about how these changes may affect microbial community structure. Specifically, does exposure to prior stress confer increased resistance...

  20. Community-Associated Methicillin-Resistant Staphylococcus aureus in a Pediatric Emergency Department in Newfoundland and Labrador

    Directory of Open Access Journals (Sweden)

    Erin Peebles

    2014-01-01

    Full Text Available BACKGROUND: First-generation cephalosporins and antistaphylococcal penicillins are typically the first choice for treating skin and soft tissue infections (SSTI, but are not effective for infections caused by methicillin-resistant Staphylococcus aureus (MRSA. It is currently unclear what percentage of SSTIs is caused by community-associated MRSA in different regions in Canada.

  1. Detection of Antibiotic Resistance Genes in Source and Drinking Water Samples from a First Nations Community in Canada

    Science.gov (United States)

    Fernando, Dinesh M.; Tun, Hein Min; Poole, Jenna; Patidar, Rakesh; Li, Ru; Mi, Ruidong; Amarawansha, Geethani E. A.; Fernando, W. G. Dilantha; Khafipour, Ehsan; Farenhorst, Annemieke

    2016-01-01

    ABSTRACT Access to safe drinking water is now recognized as a human right by the United Nations. In developed countries like Canada, access to clean water is generally not a matter of concern. However, one in every five First Nations reserves is under a drinking water advisory, often due to unacceptable microbiological quality. In this study, we analyzed source and potable water from a First Nations community for the presence of coliform bacteria as well as various antibiotic resistance genes. Samples, including those from drinking water sources, were found to be positive for various antibiotic resistance genes, namely, ampC, tet(A), mecA, β-lactamase genes (SHV-type, TEM-type, CTX-M-type, OXA-1, and CMY-2-type), and carbapenemase genes (KPC, IMP, VIM, NDM, GES, and OXA-48 genes). Not surprisingly, substantial numbers of total coliforms, including Escherichia coli, were recovered from these samples, and this result was also confirmed using Illumina sequencing of the 16S rRNA gene. These findings deserve further attention, as the presence of coliforms and antibiotic resistance genes potentially puts the health of the community members at risk. IMPORTANCE In this study, we highlight the poor microbiological quality of drinking water in a First Nations community in Canada. We examined the coliform load as well as the presence of antibiotic resistance genes in these samples. This study examined the presence of antibiotic-resistant genes in drinking water samples from a First Nations Community in Canada. We believe that our findings are of considerable significance, since the issue of poor water quality in First Nations communities in Canada is often ignored, and our findings will help shed some light on this important issue. PMID:27235436

  2. Heterogeneity and phylogenetic relationships of community-associated methicillin-sensitive/resistant Staphylococcus aureus isolates in healthy dogs, cats and their owners.

    Science.gov (United States)

    Wan, M T; Fu, S Y; Lo, Y P; Huang, T M; Cheng, M M; Chou, C C

    2012-01-01

    To investigate the distribution of staphylococcal enterotoxin genes (se) and the molecular features of community-associated methicillin-sensitive/resistant Staphylococcus aureus (CA-MSSA/MRSA) isolates in the nostrils of healthy pets and their owners. A total of 114 Staph. aureus isolates were identified from 1563 nasal swab samples, and CA-MRSA accounted for 20·2% (n = 23) of the total identified isolates. CA-MRSA isolates (91·3%, 21/23) harboured higher percentage of se than did CA-MSSA isolates (58·2%, 53/91) (P human bond caused by CA-staphylococci in the commonwealth and the need to take cautions worldwide. © 2011 The Authors. Journal of Applied Microbiology © 2011 The Society for Applied Microbiology.

  3. Mupirocin and Chlorhexidine Resistance in Staphylococcus aureus in Patients with Community-Onset Skin and Soft Tissue Infections

    Science.gov (United States)

    Fritz, Stephanie A.; Hogan, Patrick G.; Camins, Bernard C.; Ainsworth, Ali J.; Patrick, Carol; Martin, Madeline S.; Krauss, Melissa J.; Rodriguez, Marcela

    2013-01-01

    Decolonization measures, including mupirocin and chlorhexidine, are often prescribed to prevent Staphylococcus aureus skin and soft tissue infections (SSTI). The objective of this study was to determine the prevalence of high-level mupirocin and chlorhexidine resistance in S. aureus strains recovered from patients with SSTI before and after mupirocin and chlorhexidine administration and to determine whether carriage of a mupirocin- or chlorhexidine-resistant strain at baseline precluded S. aureus eradication. We recruited 1,089 patients with community-onset SSTI with or without S. aureus colonization. In addition to routine care, 483 patients were enrolled in a decolonization trial: 408 received intranasal mupirocin (with or without antimicrobial baths), and 258 performed chlorhexidine body washes. Patients were followed for up to 12 months with repeat colonization cultures. All S. aureus isolates were tested for high-level mupirocin and chlorhexidine resistance. At baseline, 23/1,089 (2.1%) patients carried a mupirocin-resistant S. aureus strain and 10/1,089 (0.9%) patients carried chlorhexidine-resistant S. aureus. Of 4 patients prescribed mupirocin, who carried a mupirocin-resistant S. aureus strain at baseline, 100% remained colonized at 1 month compared to 44% of the 324 patients without mupirocin resistance at baseline (P = 0.041). Of 2 patients prescribed chlorhexidine, who carried a chlorhexidine-resistant S. aureus strain at baseline, 50% remained colonized at 1 month compared to 48% of the 209 patients without chlorhexidine resistance at baseline (P = 1.0). The overall prevalence of mupirocin and chlorhexidine resistance is low in S. aureus isolates recovered from outpatients, but eradication efforts were less successful in patients carrying a mupirocin-resistant S. aureus strain at baseline. PMID:23147738

  4. Establishing New Community-Based Participatory Research Partnerships using the Community-Based Participatory Research Charrette Model: Lessons from the Cancer Health Accountability for Managing Pain and Symptoms Study.

    Science.gov (United States)

    Samuel, Cleo A; Lightfoot, Alexandra F; Schaal, Jennifer; Yongue, Christina; Black, Kristin; Ellis, Katrina; Robertson, Linda; Smith, Beth; Jones, Nora; Foley, Karen; Kollie, Jemeia; Mayhand, Alicia; Morse, Claire; Guerrab, Fatima; Eng, Eugenia

    2018-01-01

    Community-based participatory research (CBPR) is a collaborative and equitable approach to research inquiry; however, the process of establishing and maintaining CBPR partnerships can be challenging. There is an ongoing need for innovative strategies that foster partnership development and long-term sustainability. In 2010, the University of North Carolina at Chapel Hill developed a CBPR charrette model to facilitate stakeholder engagement in translational research. To describe how the Cancer Health Accountability for Managing Pain and Symptoms (CHAMPS) Study leveraged the CBPR charrette process to develop and strengthen its CBPR partnership and successfully implement research objectives. Fourteen CHAMPS community, academic, and medical partners participated in the CBPR charrette. Two co-facilitators guided the charrette application process and in-person discussion of partnership strengths, needs, and challenges. Community experts (CEs) and academic experts (AEs) with extensive experience in CBPR and health disparities provided technical assistance and recommendations during the in-person charrette. Overall, the CHAMPS partnership benefited significantly from the charrette process. Specifically, the charrette process engendered greater transparency, accountability, and trust among CHAMPS partners by encouraging collective negotiation of project goals and implementation, roles and responsibilities, and compensation and communication structures. The process also allowed for the exploration of newly identified challenges and potential solutions with support from CEs and AEs. Furthermore, the charrette also functioned as a catalyst for capacity building among CHAMPS community, academic, and medical partners. Future studies should compare the impact of the CBPR charrette, relative to other approaches, on partnership development and process evaluation outcomes.

  5. Progressive increase in community-associated methicillin-resistant Staphylococcus aureus in Indigenous populations in northern Australia from 1993 to 2012.

    Science.gov (United States)

    Tong, S Y C; Varrone, L; Chatfield, M D; Beaman, M; Giffard, P M

    2015-05-01

    Hospital-based studies have determined high rates of community-associated methicillin-resistant Staphylococcus aureus (MRSA) in Indigenous populations. However, there is a paucity of community-based data. We obtained 20 years (1993-2012) of data on S. aureus isolates (N = 20 210) collected from community clinics that provide services for Indigenous communities in the Northern Territory, Australia. Methicillin resistance increased from 7% to 24%, resistance to macrolides remained stable at ~25%, and there was a slight increase in resistance to trimethoprim-sulfamethoxazole. The increase in methicillin resistance is concerning for the Indigenous communities represented by this data, but it is also of significance if virulent MRSA clones emerge and spread more widely from such settings.

  6. Community-onset extended-spectrum-β-lactamase-producing Escherichia coli sequence type 131 at two Korean community hospitals: The spread of multidrug-resistant E. coli to the community via healthcare facilities.

    Science.gov (United States)

    Kim, Young Ah; Kim, Jin Ju; Kim, Heejung; Lee, Kyungwon

    2017-01-01

    The recent molecular epidemiology of ESBL-producing Escherichia coli infection in two Korean community hospitals was evaluated in this prospective observational study. We collected non-duplicated E. coli isolates from consecutive, sequentially encountered patients with community-onset episodes between March and April 2016 in two community hospitals in Gyeonggi-do province, Korea. We studied the prevalence, clinical characteristics and molecular epidemiology of E. coli sequence type 131 (ST131) isolated from the community. From a total of 213 E. coli isolates collected from the community, 94 (44.1%) were community-onset healthcare-associated isolates and 119 (55.9%) were community-associated isolates, of which urinary tract infection was the majority. A total of 55 (25.8%) of the 213 E. coli isolates were confirmed to have ESBL genes, which were mainly CTX-M types such as CTX-M-14 and CTX-M-15. There was no difference in the proportion of globally epidemic ST131 clones or that of O25, O16, H30, or H30Rx subclones between community-associated and community-onset healthcare-associated isolates. In this study, considerable ST131 E. coli isolations in the community were observed and about half of them were related to the history of a visit to the healthcare facilities, indicating the spread of multidrug-resistant E. coli to the community via healthcare facilities. Copyright © 2016 The Author(s). Published by Elsevier Ltd.. All rights reserved.

  7. Evaluation of the behaviour change communication and community mobilization activities in Myanmar artemisinin resistance containment zones.

    Science.gov (United States)

    Nyunt, Myat Htut; Aye, Khin Myo; Kyaw, Myat Phone; Wai, Khin Thet; Oo, Tin; Than, Aye; Oo, Htet Wai; Phway, Hnin Phyu; Han, Soe Soe; Htun, Thurein; San, Kyaw Kyaw

    2015-12-23

    Behaviour change communication (BCC) can improve malaria prevention and treatment behaviour. As a one of the activities under Myanmar Artemisinin Resistance Containment (MARC) programme, BCC have been conducting. This study aimed to evaluate the effectiveness of the behaviour change communication and community mobilization activities in MARC zones in Myanmar. A cross sectional descriptive survey was conducted in randomly selected 16 townships in Tier I and II areas of MARC zones by quantitative and qualitative approaches. In 832 households resided by 4664 people, there were 3797 bed nets. Around 54% were untreated while 45.6% were insecticide-treated nets (ITN) and 36.2% were long-lasting insecticide-treated nets (LLINs). Proportion of households with at least one ITN was 625 (75.12%), proportion of households with at least one ITN for every two peoples was 487 (58.53%), and proportion of existing ITNs used in previous night was 1225 (70.65%) respectively. Nearly 23% of households had old nets while 52% had new and unused extra bed nets reflecting the adequacy. Interestingly, 38% could not mention the benefit of the use of ITN/LLINs. Although 88.2% knew the disease "malaria", 11.9% could not be able to mention the symptoms. More than 80% provided correct responses that mosquito bite can cause malaria while only 36.9% could mention the blood test for malaria diagnosis. Only 36.6% received malaria information within previous year but nearly 15% could not recognize it. Mostly, 80% of fever episodes were treated at rural health centers (38.24%) followed by drug shops (17.65%) and private clinics (16.18%) respectively. Efforts should focus on correcting misconceptions about malaria transmission, prevention and universal use of ITN/LLINs. Although BCC activities have been documented, it is still necessary to intensify community mobilization through all accessible multiple channels in MARC areas.

  8. Emergence of Community-Associated Methicillin-Resistant Staphylococcus aureus Associated with Pediatric Infection in Cambodia

    Science.gov (United States)

    Chheng, Kheng; Tarquinio, Sarah; Wuthiekanun, Vanaporn; Sin, Lina; Thaipadungpanit, Janjira; Amornchai, Premjit; Chanpheaktra, Ngoun; Tumapa, Sarinna; Putchhat, Hor; Day, Nicholas P. J.; Peacock, Sharon J.

    2009-01-01

    Background The incidence of community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA) infection is rising in the developed world but appears to be rare in developing countries. One explanation for this difference is that resource poor countries lack the diagnostic microbiology facilities necessary to detect the presence of CA-MRSA carriage and infection. Methodology and Principal Findings We developed diagnostic microbiology capabilities at the Angkor Hospital for Children, Siem Reap, western Cambodia in January 2006 and in the same month identified a child with severe community-acquired impetigo caused by CA-MRSA. A study was undertaken to identify and describe additional cases presenting between January 2006 and December 2007. Bacterial isolates underwent molecular characterization using multilocus sequence typing, staphylococcal cassette chromosome mec (SCCmec) typing, and PCR for the presence of the genes encoding Panton-Valentine Leukocidin (PVL). Seventeen children were identified with CA-MRSA infection, of which 11 had skin and soft tissue infection and 6 had invasive disease. The majority of cases were unrelated in time or place. Molecular characterization identified two independent MRSA clones; fifteen isolates were sequence type (ST) 834, SCCmec type IV, PVL gene-negative, and two isolates were ST 121, SCCmec type V, PVL gene-positive. Conclusions This represents the first ever report of MRSA in Cambodia, spread of which would pose a significant threat to public health. The finding that cases were mostly unrelated in time or place suggests that these were sporadic infections in persons who were CA-MRSA carriers or contacts of carriers, rather than arising in the context of an outbreak. PMID:19675670

  9. Emergence of community-associated methicillin-resistant Staphylococcus aureus associated with pediatric infection in Cambodia.

    Directory of Open Access Journals (Sweden)

    Kheng Chheng

    2009-08-01

    Full Text Available The incidence of community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA infection is rising in the developed world but appears to be rare in developing countries. One explanation for this difference is that resource poor countries lack the diagnostic microbiology facilities necessary to detect the presence of CA-MRSA carriage and infection.We developed diagnostic microbiology capabilities at the Angkor Hospital for Children, Siem Reap, western Cambodia in January 2006 and in the same month identified a child with severe community-acquired impetigo caused by CA-MRSA. A study was undertaken to identify and describe additional cases presenting between January 2006 and December 2007. Bacterial isolates underwent molecular characterization using multilocus sequence typing, staphylococcal cassette chromosome mec (SCCmec typing, and PCR for the presence of the genes encoding Panton-Valentine Leukocidin (PVL. Seventeen children were identified with CA-MRSA infection, of which 11 had skin and soft tissue infection and 6 had invasive disease. The majority of cases were unrelated in time or place. Molecular characterization identified two independent MRSA clones; fifteen isolates were sequence type (ST 834, SCCmec type IV, PVL gene-negative, and two isolates were ST 121, SCCmec type V, PVL gene-positive.This represents the first ever report of MRSA in Cambodia, spread of which would pose a significant threat to public health. The finding that cases were mostly unrelated in time or place suggests that these were sporadic infections in persons who were CA-MRSA carriers or contacts of carriers, rather than arising in the context of an outbreak.

  10. Molecular characteristics of extended-spectrum cephalosporin-resistant Enterobacteriaceae from humans in the community.

    Science.gov (United States)

    van Hoek, Angela H A M; Schouls, Leo; van Santen, Marga G; Florijn, Alice; de Greeff, Sabine C; van Duijkeren, Engeline

    2015-01-01

    To investigate the molecular characteristics of extended-spectrum cephalosporin (ESC)-resistant Enterobacteriaceae collected during a cross-sectional study examining the prevalence and risk factors for faecal carriage of extended-spectrum β-lactamase (ESBL)-producing Enterobacteriaceae in humans living in areas with high or low broiler density. ESC-resistant Enterobacteriaceae were identified by combination disc-diffusion test. ESBL/AmpC/carbapenemase genes were analysed using PCR and sequencing. For E. coli, phylogenetic groups and MLST were determined. Plasmids were characterized by transformation and PCR-based replicon typing. Subtyping of plasmids was done by plasmid multilocus sequence typing. 175 ESC-resistant Enterobacteriaceae were cultured from 165/1,033 individuals. The isolates were Escherichia coli(n=65), Citrobacter freundii (n=52), Enterobacter cloacae (n=38), Morganella morganii (n=5), Enterobacter aerogenes (n=4), Klebsiella pneumoniae (n=3), Hafnia alvei (n=2), Shigella spp. (n=2), Citrobacter amalonaticus (n=1), Escherichia hermannii (n=1), Kluyvera cryocrescens (n=1), and Pantoea agglomerans (n=1). The following ESBL genes were recovered in 55 isolates originating from 49 of 1,033 (4.7 %) persons: blaCTX-M-1 (n=17), blaCTX-M-15 (n=16), blaCTX-M-14 (n=9), blaCTX-M-2 (n=3), blaCTX-M-3 (n=2), blaCTX-M-24 (n=2), blaCTX-M-27 (n=1), blaCTX-M-32 (n=1), blaSHV-12 (n=2), blaSHV-65 (n=1) and blaTEM-52 (n=1). Plasmidic AmpC (pAmpC) genes were discovered in 6 out of 1,033 (0.6 %) persons. One person carried two different E. coli isolates, one with blaCTX-M-1 and the other with blaCMY-2 and therefore the prevalence of persons carrying Enterobacteriaceae harboring ESBL and/or pAmpC genes was 5.2 %. In eight E. coli isolates the AmpC phenotype was caused by mutations in the AmpC promoter region. No carbapenemase genes were identified. A large variety of E. coli genotypes was found, ST131 and ST10 being most common. ESBL/pAmpC genes resembled those from

  11. Molecular characteristics of extended-spectrum cephalosporin-resistant Enterobacteriaceae from humans in the community.

    Directory of Open Access Journals (Sweden)

    Angela H A M van Hoek

    Full Text Available To investigate the molecular characteristics of extended-spectrum cephalosporin (ESC-resistant Enterobacteriaceae collected during a cross-sectional study examining the prevalence and risk factors for faecal carriage of extended-spectrum β-lactamase (ESBL-producing Enterobacteriaceae in humans living in areas with high or low broiler density.ESC-resistant Enterobacteriaceae were identified by combination disc-diffusion test. ESBL/AmpC/carbapenemase genes were analysed using PCR and sequencing. For E. coli, phylogenetic groups and MLST were determined. Plasmids were characterized by transformation and PCR-based replicon typing. Subtyping of plasmids was done by plasmid multilocus sequence typing.175 ESC-resistant Enterobacteriaceae were cultured from 165/1,033 individuals. The isolates were Escherichia coli(n=65, Citrobacter freundii (n=52, Enterobacter cloacae (n=38, Morganella morganii (n=5, Enterobacter aerogenes (n=4, Klebsiella pneumoniae (n=3, Hafnia alvei (n=2, Shigella spp. (n=2, Citrobacter amalonaticus (n=1, Escherichia hermannii (n=1, Kluyvera cryocrescens (n=1, and Pantoea agglomerans (n=1. The following ESBL genes were recovered in 55 isolates originating from 49 of 1,033 (4.7 % persons: blaCTX-M-1 (n=17, blaCTX-M-15 (n=16, blaCTX-M-14 (n=9, blaCTX-M-2 (n=3, blaCTX-M-3 (n=2, blaCTX-M-24 (n=2, blaCTX-M-27 (n=1, blaCTX-M-32 (n=1, blaSHV-12 (n=2, blaSHV-65 (n=1 and blaTEM-52 (n=1. Plasmidic AmpC (pAmpC genes were discovered in 6 out of 1,033 (0.6 % persons. One person carried two different E. coli isolates, one with blaCTX-M-1 and the other with blaCMY-2 and therefore the prevalence of persons carrying Enterobacteriaceae harboring ESBL and/or pAmpC genes was 5.2 %. In eight E. coli isolates the AmpC phenotype was caused by mutations in the AmpC promoter region. No carbapenemase genes were identified. A large variety of E. coli genotypes was found, ST131 and ST10 being most common.ESBL/pAmpC genes resembled those from patients in Dutch

  12. Above- and Belowground Trophic Interactions on Creeping Thistle (Cirsium arvense) in High- and Low-Diversity Plant Communities: Potential for Biotic Resistance?

    NARCIS (Netherlands)

    Bezemer, T.M.; Graça, O.; Rousseau, P.; Van der Putten, W.H.

    2004-01-01

    The capacity of local communities to control introduced plants is called biotic resistance. Biotic resistance has been almost exclusively tested for plant competition and aboveground herbivores and pathogens, while neglecting root herbivores and soil pathogens. Here, we present biotic resistance by

  13. Above- and Belowground Trophic Interactions on Creeping Thistle (Cirsium arvense) in High- and Low-Diversity Plant Communities: Potential for Biotic Resistance?

    NARCIS (Netherlands)

    Bezemer, T.M.; Graça, O.; Rousseau, P.; Putten, van der W.H.

    2004-01-01

    The capacity of local communities to control introduced plants is called biotic resistance. Biotic resistance has been almost exclusively tested for plant competition and above-ground herbivores and pathogens, while neglecting root herbivores and soil pathogens. Here, we present biotic resistance by

  14. Effects of a resistance training program performed with an interocclusal splint for community-dwelling older adults: a randomized controlled trial

    OpenAIRE

    Hirase, Tatsuya; Inokuchi, Shigeru; Matsusaka, Nobuou; Nakahara, Kazumi; Okita, Minoru

    2016-01-01

    [Purpose] To examine whether resistance training for elderly community-dwellers performed with an interocclusal splint resulted in greater lower extremity muscle strength and better balance than resistance training performed without an interocclusal splint. [Subjects and Methods] Eighty-eight elderly persons using Japanese community day centers were randomly divided into two groups: an intervention group (n=45), which performed resistance training with an interocclusal splint; and a control g...

  15. Characterization of copper-resistant bacteria and bacterial communities from copper-polluted agricultural soils of central Chile

    Directory of Open Access Journals (Sweden)

    Altimira Fabiola

    2012-09-01

    Full Text Available Abstract Background Copper mining has led to Cu pollution in agricultural soils. In this report, the effects of Cu pollution on bacterial communities of agricultural soils from Valparaiso region, central Chile, were studied. Denaturing gradient gel electrophoresis (DGGE of the 16S rRNA genes was used for the characterization of bacterial communities from Cu-polluted and non-polluted soils. Cu-resistant bacterial strains were isolated from Cu-polluted soils and characterized. Results DGGE showed a similar high number of bands and banding pattern of the bacterial communities from Cu-polluted and non-polluted soils. The presence of copA genes encoding the multi-copper oxidase that confers Cu-resistance in bacteria was detected by PCR in metagenomic DNA from the three Cu-polluted soils, but not in the non-polluted soil. The number of Cu-tolerant heterotrophic cultivable bacteria was significantly higher in Cu-polluted soils than in the non-polluted soil. Ninety two Cu-resistant bacterial strains were isolated from three Cu-polluted agricultural soils. Five isolated strains showed high resistance to copper (MIC ranged from 3.1 to 4.7 mM and also resistance to other heavy metals. 16S rRNA gene sequence analyses indicate that these isolates belong to the genera Sphingomonas, Stenotrophomonas and Arthrobacter. The Sphingomonas sp. strains O12, A32 and A55 and Stenotrophomonas sp. C21 possess plasmids containing the Cu-resistance copA genes. Arthrobacter sp. O4 possesses the copA gene, but plasmids were not detected in this strain. The amino acid sequences of CopA from Sphingomonas isolates (O12, A32 and A55, Stenotrophomonas strain (C21 and Arthrobacter strain (O4 are closely related to CopA from Sphingomonas, Stenotrophomonas and Arthrobacter strains, respectively. Conclusions This study suggests that bacterial communities of agricultural soils from central Chile exposed to long-term Cu-pollution have been adapted by acquiring Cu genetic determinants

  16. The Culturable Soil Antibiotic Resistome: A Community of Multi-Drug Resistant Bacteria

    OpenAIRE

    Walsh, Fiona; Duffy, Brion

    2013-01-01

    Understanding the soil bacterial resistome is essential to understanding the evolution and development of antibiotic resistance, and its spread between species and biomes. We have identified and characterized multi-drug resistance (MDR) mechanisms in the culturable soil antibiotic resistome and linked the resistance profiles to bacterial species. We isolated 412 antibiotic resistant bacteria from agricultural, urban and pristine soils. All isolates were multi-drug resistant, of which greater ...

  17. Process Accounting

    OpenAIRE

    Gilbertson, Keith

    2002-01-01

    Standard utilities can help you collect and interpret your Linux system's process accounting data. Describes the uses of process accounting, standard process accounting commands, and example code that makes use of process accounting utilities.

  18. Survival and transmission of community-associated methicillin-resistant Staphylococcus aureus from fomites.

    Science.gov (United States)

    Desai, Rishi; Pannaraj, Pia S; Agopian, Jaclyn; Sugar, Catherine A; Liu, George Y; Miller, Loren G

    2011-04-01

    Transmission of community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA) from fomites appears to play an important role in CA-MRSA outbreaks. However, the amount and duration of transmissibility of MRSA have not been quantified. We assessed the survival and transmission of the CA-MRSA strain USA300-0114 from 9 fomites (razors, plastic toys, ceramic, soap, wood, vinyl, towels, bed sheets, and shoulder pads). Fomites were inoculated then briefly pressed onto sterile pigskin at 5 minutes; days 1, 2, 3, 7, and 10; and then weekly for 10 weeks. The experiment was repeated using 2 methicillin-susceptible S aureus (MSSA) and 3 health care-associated (HA) MRSA strains on select fomites. Bacteria could be transmitted to skin from all fomites except soap. Transmissibility decreased over time but more rapidly from porous (eg, towels) than nonporous (eg, vinyl) fomites (P = .0002), with some fomites showing transmissibility for more than 8 weeks after contamination. The CA-MRSA strain was transmissible longer than the HA-MRSA strains (P fomites to skin with contaminated nonporous fomites exhibiting transmissibility many weeks after contamination. Transmissibility of HA-MRSA strains demonstrated attenuated transmissibility compared with CA-MRSA strains. Findings may have implications for CA-MRSA infection prevention. Published by Mosby, Inc.

  19. Effect of different biochars on antibiotic resistance genes and bacterial community during chicken manure composting.

    Science.gov (United States)

    Cui, Erping; Wu, Ying; Zuo, Yiru; Chen, Hong

    2016-03-01

    Rice straw biochar (RSB) and mushroom biochar (MB) were added to lab-scale chicken manure composting to evaluate their effects on the behaviors of antibiotic resistance genes (ARGs) and on total and bio-available heavy metals (Cu, Zn and As). The associated bacterial community was characterized by 16SrRNA high-throughput sequencing. The abundance of pathogenic bacteria was also calculated. At the end of the control composting experiment, the average removal rate of ARGs was 0.86 log units and the removal rate of pathogenic bacteria was 57.1%. MB addition resulted in a higher removal rate than that in the control composting experiment. However, RSB addition yielded opposite results, which may be due to the higher abundance of Erysipelotrichaceae, Lactobacillaceae, Family_XI_Incertae_Sedis (belonging to Firmicutes carrying and disseminating ARGs) and pathogenic bacteria carrying ARGs. Furthermore, the correlations between bio-available heavy metals and ARGs were more obvious than those between total heavy metals and ARGs. Copyright © 2015 Elsevier Ltd. All rights reserved.

  20. "This is My Community": Reproducing and Resisting Boundaries of Exclusion in Contested Public Spaces.

    Science.gov (United States)

    Toolis, Erin E; Hammack, Phillip L

    2015-12-01

    The way that public space is structured has significant implications for identity, social interaction, and participation in society. For those experiencing homelessness, with no or limited private space, survival hinges on the accessibility and livability of public space. However, the increasing privatization of public space in the United States has contributed to the implementation of anti-homeless ordinances in cities, restricting sitting, standing, panhandling, and sleeping in public. This study analyzes data from interviews with housed and unhoused community members, text from a local policy document, and ethnographic observations to explore how boundaries between "insiders" and "outsiders" are drawn in public space and mediated through individual discourse. Our findings suggest that boundaries of exclusion are constructed through dominant narratives that portray the unhoused as a threat to safety and economic vitality, thus justifying the need for regulation and punishment through the criminalization of homelessness. Yet, informants also demonstrate resistance to this narrative by discussing how criminalization of homelessness perpetuates dehumanization, violence, and economic inequality. Policy implications for the regulation of public space are discussed.

  1. Building Communities in Resistance, Metelkova City in the Hands of Axt und Kelle

    Directory of Open Access Journals (Sweden)

    Sandi Abram

    2013-09-01

    Full Text Available The article deals with nomadic journeymen and journeywomen from the German guild Axt und Kelle and with their encounter with Metelkova. At the outset, the historical trajectory of German guilds, the constitution of Axt und Kelle and the custom of tramping artisans (i.e., walz are highlighted. The hypothesis that Axt und Kelle make use of re-appropriated spaces (i.e., squats either as a sporadic proactive clientele or they choose such spaces as their annual summer solidarity work camps is defended on a twofold basis: firstly, squats are considered and constructed as a substitute of the previously guaranteed houses of call (i.e., herberge by the classical guilds. Secondly, the guild intentionally constituted itself as a political subject with the mission of empowering communities in resistance. ACC Metelkova City was chosen as a solidarity work camp twice in the early and mid-00s when many emblematic interiors and exteriors were created. Focusing on the non-instrumentalized (own production of knowledge, exchange of experiences and outwardly oriented distribution, the article views the reciprocal interaction between ACC Metelkova City and Axt und Kelle through Mauss’s theory of the gift.

  2. Emergence of Community-Associated Methicillin-Resistant Staphylococcus aureus Carriage in Children in Cambodia

    Science.gov (United States)

    Nickerson, Emma K.; Wuthiekanun, Vanaporn; Kumar, Varun; Amornchai, Premjit; Wongdeethai, Nattavut; Chheng, Kheng; Chantratita, Narisara; Putchhat, Hor; Thaipadungpanit, Janjira; Day, Nicholas P.; Peacock, Sharon J.

    2011-01-01

    We previously described the first reported isolation of methicillin-resistant Staphylococcus aureus (MRSA) (a case series of pediatric community-associated MRSA infections) in Cambodia. We define the rate of pediatric MRSA carriage in the same population and characterize the associated bacterial genotypes by using pulsed-field gel electrophoresis and multilocus sequence typing. A prospective cohort study of MRSA carriage conducted over one month at the Angkor Hospital for Children, Siem Reap, Cambodia, identified MRSA carriage in 87 (3.5%) of 2,485 children who came to the outpatient department, and 6 (4.1%) of 145 inpatients, including at least two with cases of nosocomial acquisition. Genotyping of all 93 MRSA isolates resolved 5 genotypes. Most (91%) isolates were assigned to sequence type 834. Only 28 (32%) of 87 MRSA carriers identified in the outpatient department had no history of recent healthcare contact. The study findings have important implications for healthcare in a setting where diagnostic microbiology and access to antimicrobial drugs with efficacy against MRSA are limited. PMID:21292906

  3. Community perceptions of infectious diseases, antibiotic use and antibiotic resistance in context of environmental changes: a study in Odisha, India

    Science.gov (United States)

    Sahoo, Krushna Chandra; Tamhankar, Ashok J.; Johansson, Eva; Stålsby Lundborg, Cecilia

    2012-01-01

    Abstract Background  The public health impact of environmental changes and the faceless threat of antibiotic resistance are currently among the top global health challenges. Community understanding of health, diseases and medicines in relation to the changing environment is necessary to mitigate the impact of these changes on health and for prudent use of antibiotics. Objective  The objective is to explore community perceptions of infectious diseases, antibiotic use and antibiotic resistance in the context of environmental changes. Methods  A qualitative study was conducted among community members with various backgrounds in education, gender, age and occupation of two districts of Odisha, India. Eight focus groups discussions and ten individual interviews were conducted. Data were analysed using content analysis. Results  Two themes emerged: ‘Interpretation of infectious diseases and health hazards in the context of environmental changes’, and ‘Understanding of antibiotic use and its consequences for resistance development and the environment’. The participants perceived that nowadays there is irregularity in the occurrence of seasons, particularly an increase in average temperature, which is influencing health. Participants’ perceptions of infectious diseases, antibiotic use and resistance varied according to their social environment. Furthermore, they perceived that improved sanitation, choice of alternative medicine and awareness and education on prudent use of antibiotics are probably some ways to prevent antibiotic resistance. Conclusions  The participants perceived that climate variability is increasing and that this has health consequences for the community. They also hypothesized an interrelationship between the environment, infectious diseases and medicine use, particularly antibiotics. This is helpful for further empirical studies. PMID:22583645

  4. Evolution of resistance to a multiple-herbivore community: genetic correlations, diffuse coevolution, and constraints on the plant's response to selection.

    Science.gov (United States)

    Wise, Michael J; Rausher, Mark D

    2013-06-01

    Although plants are generally attacked by a community of several species of herbivores, relatively little is known about the strength of natural selection for resistance in multiple-herbivore communities-particularly how the strength of selection differs among herbivores that feed on different plant organs or how strongly genetic correlations in resistance affect the evolutionary responses of the plant. Here, we report on a field study measuring natural selection for resistance in a diverse community of herbivores of Solanum carolinense. Using linear phenotypic-selection analyses, we found that directional selection acted to increase resistance to seven species. Selection was strongest to increase resistance to fruit feeders, followed by flower feeders, then leaf feeders. Selection favored a decrease in resistance to a stem borer. Bootstrapping analyses showed that the plant population contained significant genetic variation for each of 14 measured resistance traits and significant covariances in one-third of the pairwise combinations of resistance traits. These genetic covariances reduced the plant's overall predicted evolutionary response for resistance against the herbivore community by about 60%. Diffuse (co)evolution was widespread in this community, and the diffuse interactions had an overwhelmingly constraining (rather than facilitative) effect on the plant's evolution of resistance. © 2013 The Author(s). Evolution © 2013 The Society for the Study of Evolution.

  5. The culturable soil antibiotic resistome: a community of multi-drug resistant bacteria.

    Directory of Open Access Journals (Sweden)

    Fiona Walsh

    Full Text Available Understanding the soil bacterial resistome is essential to understanding the evolution and development of antibiotic resistance, and its spread between species and biomes. We have identified and characterized multi-drug resistance (MDR mechanisms in the culturable soil antibiotic resistome and linked the resistance profiles to bacterial species. We isolated 412 antibiotic resistant bacteria from agricultural, urban and pristine soils. All isolates were multi-drug resistant, of which greater than 80% were resistant to 16-23 antibiotics, comprising almost all classes of antibiotic. The mobile resistance genes investigated, (ESBL, bla NDM-1, and plasmid mediated quinolone resistance (PMQR resistance genes were not responsible for the respective resistance phenotypes nor were they present in the extracted soil DNA. Efflux was demonstrated to play an important role in MDR and many resistance phenotypes. Clinically relevant Burkholderia species are intrinsically resistant to ciprofloxacin but the soil Burkholderia species were not intrinsically resistant to ciprofloxacin. Using a phenotypic enzyme assay we identified the antibiotic specific inactivation of trimethoprim in 21 bacteria from different soils. The results of this study identified the importance of the efflux mechanism in the soil resistome and variations between the intrinsic resistance profiles of clinical and soil bacteria of the same family.

  6. Belowground Carbon Allocation and Plant-Microbial Interactions Drive Resistance and Resilience of Mountain Grassland Communities to Drought

    Science.gov (United States)

    Karlowsky, S.; Augusti, A.; Ingrisch, J.; Hasibeder, R.; Lavorel, S.; Bahn, M.; Gleixner, G.

    2016-12-01

    Belowground carbon allocation (BCA) and plant-microbial interactions are crucial for the functioning of terrestrial ecosystems. Recent research suggests that extreme events can have severe effects on these processes but it is unknown how land use intensity potentially modifies their responses. We studied the resistance and resilience of mountain grassland communities to prolonged drought and investigated the role of plant C allocation and soil microbial communities in mediating drought resistance and immediate recovery. In a common garden experiment we exposed monoliths from an abandoned grassland and a hay meadow to an early summer drought. Two independent 13C pulse labeling experiments were conducted, the first during peak drought and the second during the recovery phase. The 13C incorporation was analyzed in above- and belowground plant parts and in phospho- and neutral lipid fatty acids of soil microorganisms. In addition, a 15N label was added at the rewetting to determine plant N uptake. We found that C uptake, BCA and C transfer to soil microorganisms were less strongly reduced by drought in the abandoned grassland than in the meadow. Moreover, drought induced an increase of arbuscular mycorrhiza fungi (AMF) marker in the abandoned grassland. Nevertheless, C uptake and related parameters were quickly recovered and N uptake increased in the meadow during recovery. Unexpectedly, AMF and their C uptake were generally reduced during recovery, while bacteria increased and quickly recovered C uptake, particularly in the meadow. Our results showed a negative relation between high resistance and fast recovery. The more resistant abandoned grassland plant communities seemed to invest more C below ground and into interactions with AMF during drought, likely to access water through their hyphal network. Conversely, meadow communities invested more C from recent photosynthesis into bacterial communities during recovery, obviously to gain more nutrients for regrowth

  7. Origin and evolution of European community-acquired methicillin-resistant Staphylococcus aureus.

    Science.gov (United States)

    Stegger, Marc; Wirth, Thierry; Andersen, Paal S; Skov, Robert L; De Grassi, Anna; Simões, Patricia Martins; Tristan, Anne; Petersen, Andreas; Aziz, Maliha; Kiil, Kristoffer; Cirković, Ivana; Udo, Edet E; del Campo, Rosa; Vuopio-Varkila, Jaana; Ahmad, Norazah; Tokajian, Sima; Peters, Georg; Schaumburg, Frieder; Olsson-Liljequist, Barbro; Givskov, Michael; Driebe, Elizabeth E; Vigh, Henrik E; Shittu, Adebayo; Ramdani-Bougessa, Nadjia; Rasigade, Jean-Philippe; Price, Lance B; Vandenesch, Francois; Larsen, Anders R; Laurent, Frederic

    2014-08-26

    Community-acquired methicillin-resistant Staphylococcus aureus (CA-MRSA) was recognized in Europe and worldwide in the late 1990s. Within a decade, several genetically and geographically distinct CA-MRSA lineages carrying the small SCCmec type IV and V genetic elements and the Panton-Valentine leukocidin (PVL) emerged around the world. In Europe, the predominant CA-MRSA strain belongs to clonal complex 80 (CC80) and is resistant to kanamycin/amikacin and fusidic acid. CC80 was first reported in 1993 but was relatively rare until the late 1990s. It has since been identified throughout North Africa, the Middle East, and Europe, with recent sporadic reports in sub-Saharan Africa. While strongly associated with skin and soft tissue infections, it is rarely found among asymptomatic carriers. Methicillin-sensitive S. aureus (MSSA) CC80 strains are extremely rare except in sub-Saharan Africa. In the current study, we applied whole-genome sequencing to a global collection of both MSSA and MRSA CC80 isolates. Phylogenetic analyses strongly suggest that the European epidemic CA-MRSA lineage is derived from a PVL-positive MSSA ancestor from sub-Saharan Africa. Moreover, the tree topology suggests a single acquisition of both the SCCmec element and a plasmid encoding the fusidic acid resistance determinant. Four canonical SNPs distinguish the derived CA-MRSA lineage and include a nonsynonymous mutation in accessory gene regulator C (agrC). These changes were associated with a star-like expansion into Europe, the Middle East, and North Africa in the early 1990s, including multiple cases of cross-continent imports likely driven by human migrations. With increasing levels of CA-MRSA reported from most parts of the Western world, there is a great interest in understanding the origin and factors associated with the emergence of these epidemic lineages. To trace the origin, evolution, and dissemination pattern of the European CA-MRSA clone (CC80), we sequenced a global collection

  8. High Prevalence of Multidrug-Resistant Community-Acquired Methicillin-Resistant Staphylococcus aureus at the Largest Veterinary Teaching Hospital in Costa Rica.

    Science.gov (United States)

    Rojas, Irene; Barquero-Calvo, Elías; van Balen, Joany C; Rojas, Norman; Muñoz-Vargas, Lohendy; Hoet, Armando E

    2017-09-01

    Methicillin-resistant Staphylococcus aureus (MRSA) is a pathogen associated with severe infections in companion animals present in the community, and it is diagnosed in animals admitted to veterinary hospitals. However, reports that describe the circulation of MRSA in animal populations and veterinary settings in Latin America are scarce. Therefore, the objective of this study was to determine the prevalence and investigate the molecular epidemiology of MRSA in the environment of the largest veterinary teaching hospital in Costa Rica. Preselected contact surfaces were sampled twice within a 6-week period. Antimicrobial resistance, SCCmec type, Panton-Valentine leukocidin screening, USA type, and clonality were assessed in all recovered isolates. Overall, MRSA was isolated from 26.5% (27/102) of the surfaces sampled, with doors, desks, and examination tables most frequently contaminated. Molecular analysis demonstrated a variety of surfaces from different sections of the hospital contaminated by three highly related clones/pulsotypes. All, but one of the isolates were characterized as multidrug-resistant SCCmec type IV-USA700, a strain sporadically described in other countries and often classified as community acquired. The detection and frequency of this unique strain in this veterinary setting suggest Costa Rica has a distinctive MRSA ecology when compared with other countries/regions. The high level of environmental contamination highlights the necessity to establish and enforce standard cleaning and disinfection protocols to minimize further spread of this pathogen and reduce the risk of nosocomial and/or occupational transmission of MRSA.

  9. Different impacts of manure and chemical fertilizers on bacterial community structure and antibiotic resistance genes in arable soils.

    Science.gov (United States)

    Liu, Peng; Jia, Shuyu; He, Xiwei; Zhang, Xuxiang; Ye, Lin

    2017-12-01

    Both manure and chemical fertilizers are widely used in modern agriculture. However, the impacts of different fertilizers on bacterial community structure and antibiotic resistance genes (ARGs) in arable soils still remain unclear. In this study, high-throughput sequencing and quantitative PCR were employed to investigate the bacterial community structure, ARGs and mobile genetic elements (MGEs) influenced by the application of different fertilizers, including chemical fertilizers, piggery manure and straw ash. The results showed that the application of fertilizers could significantly change the soil bacterial community and the abundance of Gaiella under phylum Actinobacteria was significantly reduced from 12.9% in unfertilized soil to 4.1%-7.4% in fertilized soil (P cause a transient effect on soil resistome composition and the relative abundance of ARGs increased from 7.37 ppm to 32.10 ppm. The abundance of aminoglycoside, sulfonamide and tetracycline resistance genes greatly increased after manure fertilization and then gradually returned to normal levels with the decay of some intestinal bacteria carrying ARGs. In contrast, the application of chemical fertilizers and straw ash significantly changed the bacterial community structure but exerted little effect on soil resistome. Overall, the results of this study illustrated the different effects of different fertilizers on the soil resistome and revealed that the changes of soil resistome induced by manure application mainly resulted from alteration of bacteria community rather than the horizontal gene transfer. Copyright © 2017 Elsevier Ltd. All rights reserved.

  10. Frequency and antimicrobial resistance patterns of bacteria implicated in community urinary tract infections: a ten-year surveillance study (2000–2009

    Directory of Open Access Journals (Sweden)

    Linhares Inês

    2013-01-01

    Full Text Available Abstract Background Urinary tract infection (UTI is one of the most common infectious diseases at the community level. In order to assess the adequacy of the empirical therapy, the prevalence and the resistance pattern of the main bacteria responsible for UTI in the community (in Aveiro, Portugal was evaluated throughout a ten-year period. Methods In this retrospective study, all urine samples from patients of the District of Aveiro, in ambulatory regime, collected at the Clinical Analysis Laboratory Avelab during the period 2000–2009 were analysed. Samples with more than 105 CFU/mL bacteria were considered positive and, for these samples, the bacteria were identified and the profile of antibiotic susceptibility was characterized. Results From the 155597 samples analysed, 18797 (12.1% were positive for bacterial infection. UTI was more frequent in women (78.5% and its incidence varied with age, affecting more the elderly patients (38.6%. Although E. coli was, as usual, the most common pathogen implicated in UTI, it were observed differences related to the other bacteria more implicated in UTI relatively to previous studies. The bacteria implicated in the UTI varied with the sex of the patient, being P. aeruginosa a more important cause of infection in men than in women. The incidence of the main bacteria changed over the study period (P. aeruginosa, Klebsiella spp and Providencia spp increased and Enterobacter spp decreased. Although E. coli was responsible for more than an half of UTI, its resistance to antibiotics was low when compared with other pathogens implicated in UTI, showing also the lowest percentage of multidrug resistant (MDR isolates (17%. Bacteria isolated from females were less resistant than those isolated from males and this difference increased with the patient age. Conclusions The differences in sex and age must be taken into account at the moment of empirical prescription of antimicrobials. From the recommended

  11. Phenotypic and genotypic profiling of antimicrobial resistance in enteric Escherichia coli communities isolated from finisher pigs in Australia.

    Science.gov (United States)

    Smith, M G; Jordan, D; Gibson, J S; Cobbold, R N; Chapman, T A; Abraham, S; Trott, D J

    2016-10-01

    To assess herd-to-herd variation in antimicrobial resistance phenotypes and associated antimicrobial resistance genes (ARGs) in faecal commensal Escherichia coli communities isolated from Australian slaughter-age pigs. Hydrophobic grid-membrane filtration (HGMF) was used to screen populations of E. coli isolated from faecal samples obtained from pigs prior to or at slaughter. Multiplex PCRs were applied to the pooled DNA extracted from the samples to identify specific ARGs. Pooled faecal samples from 30 finishers, from 72 different Australian pig farms, produced 5003 isolates for screening. HGMF techniques and image analysis were used to confirm E. coli resistance phenotypes to four antimicrobial agents (ampicillin, gentamicin, florfenicol and ceftiofur) using selective agars. Multiplex PCRs were performed on DNA from pooled samples for 35 ARGs associated with seven chemical classes. The prevalence of E. coli isolates showing no resistance to any of the drugs was 50.2% (95% confidence interval (CI) 41.8-58.6%). Ceftiofur resistance was very low (1.8%; CI 0.8-3.9%) and no ARGs associated with 3rd-generation cephalosporin resistance were detected. By contrast, ampicillin (29.4%, CI 22.8-37.0%), florfenicol (24.3%, CI 17.8-32.3%) and gentamicin (CI 17.5%, 10.7-27.2%) resistance prevalence varied greatly between farms and associated ARGs were common. The most common combined resistance phenotype was ampicillin-florfenicol. The use of registered antimicrobials in Australian pigs leads to the enteric commensal populations acquiring associated ARGs. However, despite a high intensity of sampling, ARGs imparting resistance to the critically important 3rd-generation cephalosporins were not detected. © 2016 Australian Veterinary Association.

  12. Association between insulin resistance and low relative appendicular skeletal muscle mass: evidence from a cohort study in community-dwelling older men and women participants.

    Science.gov (United States)

    Alemán-Mateo, Heliodoro; López Teros, Miriam T; Ramírez, Fátima A; Astiazarán-García, Humberto

    2014-07-01

    It has been hypothesized that insulin resistance plays a role in the development of the loss of skeletal muscle; however, no cohort studies on insulin resistance and low relative appendicular skeletal muscle mass (ASM) have been published to date. Thus, we examined whether insulin resistance is associated with low relative ASM after a 4.6-year follow-up period among apparently healthy older men and women participants. This is a combined retrospective-prospective cohort study, which includes 147 community-dwelling older men and women participants. ASM was measured by dual-energy x-ray absorptiometry at baseline and follow-up. Participants with a relative change in ASM below the sex-specific 15th value were classified as the low relative ASM group. Homeostatic model assessment was used to quantify insulin resistance. Logistic regression calculated odds ratios and 95% confidence intervals for development of low relative ASM, adjusted for covariates. The loss of ASM in the low relative ASM and normal groups was -1.8kg and -0.35kg, respectively (p ≤ .05). The low relative ASM group was older and had higher insulin and homeostatic model assessment of insulin resistance values at baseline. The risk of developing low relative ASM at 4.6-year follow-up was 2.9 times higher (95% CI, 1.00-7.8; p = .04) among the participants with homeostatic model assessment of insulin resistance levels more than 2.3. After adjusting for age, the risk increased to 3.9 times higher (95% CI, 1.3-11.5; p = .03). Insulin resistance was associated with low relative ASM at 4.6-year follow-up after accounting for several covariates in a cohort of apparently healthy, well-functioning young older men and women. © The Author 2013. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  13. Peripheral insulin resistance rather than beta cell dysfunction accounts for geographical differences in impaired fasting blood glucose among sub-Saharan African individuals: findings from the RODAM study.

    Science.gov (United States)

    Meeks, Karlijn A C; Stronks, Karien; Adeyemo, Adebowale; Addo, Juliet; Bahendeka, Silver; Beune, Erik; Owusu-Dabo, Ellis; Danquah, Ina; Galbete, Cecilia; Henneman, Peter; Klipstein-Grobusch, Kerstin; Mockenhaupt, Frank P; Osei, Kwame; Schulze, Matthias B; Spranger, Joachim; Smeeth, Liam; Agyemang, Charles

    2017-05-01

    The aim of this study was to assess the extent to which insulin resistance and beta cell dysfunction account for differences in impaired fasting blood glucose (IFBG) levels in sub-Saharan African individuals living in different locations in Europe and Africa. We also aimed to identify determinants associated with insulin resistance and beta cell dysfunction among this population. Data from the cross-sectional multicentre Research on Obesity and Diabetes among African Migrants (RODAM) study were analysed. Participants included Ghanaian individuals without diabetes, aged 18-96 years old, who were residing in Amsterdam (n = 1337), Berlin (n = 502), London (n = 961), urban Ghana (n = 1309) and rural Ghana (n = 970). Glucose and insulin were measured in fasting venous blood samples. Anthropometrics were assessed during a physical examination. Questionnaires were used to assess demographics, physical activity, smoking status, alcohol consumption and energy intake. Insulin resistance and beta cell function were determined using homeostatic modelling (HOMA-IR and HOMA-B, respectively). Logistic regression analysis was used to study the contribution of HOMA-IR and inverse HOMA-B (beta cell dysfunction) to geographical differences in IFBG (fasting glucose 5.6-6.9 mmol/l). Multivariate linear regression analysis was used to identify determinants associated with HOMA-IR and inverse HOMA-B. IFBG was more common in individuals residing in urban Ghana (OR 1.41 [95% CI 1.08, 1.84]), Amsterdam (OR 3.44 [95% CI 2.69, 4.39]) and London (OR 1.58 [95% CI 1.20 2.08), but similar in individuals living in Berlin (OR 1.00 [95% CI 0.70, 1.45]), compared with those in rural Ghana (reference population). The attributable risk of IFBG per 1 SD increase in HOMA-IR was 69.3% and in inverse HOMA-B was 11.1%. After adjustment for HOMA-IR, the odds for IFBG reduced to 0.96 (95% CI 0.72, 1.27), 2.52 (95%CI 1.94, 3.26) and 1.02 (95% CI 0.78, 1.38) for individuals in Urban Ghana

  14. Clinical practice: colonization, fomites, and virulence: rethinking the pathogenesis of community-associated methicillin-resistant Staphylococcus aureus infection.

    Science.gov (United States)

    Miller, Loren G; Diep, Binh An

    2008-03-01

    Community-associated methicillin-resistant Staphylococcus aureus (MRSA) infection is increasingly common worldwide and causes considerable morbidity and mortality. Of concern, community-associated MRSA infections are often recurrent and are highly transmissible to close contacts. The traditional tenet of pathogenesis is that MRSA colonization precedes infection. This has prompted persons involved in efforts to prevent community-associated MRSA infection to incorporate the use of intranasal topical antibiotics for nasal decolonization. However, data from outbreaks of community-associated MRSA infection suggest that skin-skin and skin-fomite contact represent important and common alternative routes of acquisition of the infecting strain. Furthermore, strain characteristics of the most successful community-associated MRSA strain, USA300, may contribute to a distinct pathogenesis. As we develop strategies to prevent community-associated MRSA infection, we must reconsider the pathogenesis of S. aureus. Reliance on models of health care-associated MRSA transmission for prevention of community-associated MRSA infection may result in the development of flawed strategies that attenuate our ability to prevent this serious and potentially deadly infection.

  15. Impact of amoxicillin therapy on resistance selection in patients with community-acquired lower respiratory tract infections

    DEFF Research Database (Denmark)

    Malhotra-Kumar, Surbhi; Van Heirstraeten, Liesbet; Coenen, Samuel

    2016-01-01

    OBJECTIVES: To determine the effect of amoxicillin treatment on resistance selection in patients with community-acquired lower respiratory tract infections in a randomized, placebo-controlled trial. METHODS: Patients were prescribed amoxicillin 1 g, three times daily (n = 52) or placebo (n = 50...... that recommend amoxicillin when an antibiotic is indicated for community-acquired lower respiratory tract infections.......) for 7 days. Oropharyngeal swabs obtained before, within 48 h post-treatment and at 28-35 days were assessed for proportions of amoxicillin-resistant (ARS; amoxicillin MIC ≥2 mg/L) and -non-susceptible (ANS; MIC ≥0.5 mg/L) streptococci. Alterations in amoxicillin MICs and in penicillin...

  16. Clinical and Microbiological Features and Factors Associated with Fluoroquinolone Resistance in Men with Community-Acquired Acute Bacterial Prostatitis.

    Science.gov (United States)

    Park, Min Gu; Cho, Min Chul; Cho, Sung Yong; Lee, Jeong Woo

    2016-01-01

    To investigate the clinical and microbiological features in the patients with community-acquired acute bacterial prostatitis (CA-ABP), as well as factors that affect fluoroquinolone resistance. A retrospective analysis was performed of 209 patients hospitalized for antibiotic treatment of CA-ABP. We investigated patient age, body mass index, underlying diseases, recurrence, prostate-related factors and results of urine culture examination and antibiotic sensitivity tests. Seventeen patients (8.1%) had fluoroquinolone-resistant bacterial colonies. When we divided the subjects into groups according to the fluoroquinolone resistance, the group with resistant bacteria was significantly older, had larger prostates and had greater residual urine volumes. Bacteria were identified in 127 of 209 patients (60.8%), and the most commonly cultured included Escherichia coli (43.5%). The sensitivity of the cultured bacteria to fluoroquinolones was high compared to trimethoprim/sulfamethoxazole and gentamicin, but similar to cefotaxime. The bacteria were more sensitive to amikacin and imipenem than to fluoroquinolone. The multivariate analysis revealed that prostate volume ≥40 ml (p = 0.024) and residual urine volume >100 ml (p = 0.004) were independent predictive factors for fluoroquinolone resistance. Fluoroquinolone monotherapy might be an effective treatment in CA-ABP. However, combination antibiotic therapy is recommended in cases with prostate volume ≥40 ml or residual urine volume >100 ml, because fluoroquinolone resistance can occur. © 2016 S. Karger AG, Basel.

  17. Community-associated methicillin-resistant Staphylococcus aureus infective endocarditis in a tennis player: an emerging pathogen in infectious disease

    OpenAIRE

    Basaran, Ozcan; Basaran, Nesrin Filiz; Kaskari, Derya; Sozen, Hamdi

    2013-01-01

    In the 2000s, the Center for Disease Control and Prevention has defined community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA) disease which is a disease of healthcare unrelated patients. We report here on a 39-year-old female patient who was admitted to our institution without any medical history. She was a tennis player and had been suffering from ankle pain for a month. She was diagnosed with infective endocarditis according to modified Duke criteria. Blood cultures we...

  18. Community-acquired pneumonia caused by methicillin-resistant Staphylococcus aureus in critically-ill patients: systematic review

    OpenAIRE

    Nuria Carballo; Marta de Antonio-Cuscó; Daniel Echeverría-Esnal; Sonia Luque; Esther Salas; Santiago Grau

    2017-01-01

    Introduction: Community-acquired pneumonia (CAP) is associated with high morbidity and mortality rates. Despite methicillin-resistant Staphylococcus aureus (MRSA) having often been associated with nosocomial pneumonia, the condition of some MRSA CAP patients is severe enough to warrant their being admitted to ICU. Objective: The purpose of this study is to conduct a systematic review of the literature on antibiotic treatment of MRSA CAP in critically-ill patients. Material and methods: ...

  19. Chronic exposure to triclosan sustains microbial community shifts and alters antibiotic resistance gene levels in anaerobic digesters.

    Science.gov (United States)

    Carey, Daniel E; Zitomer, Daniel H; Kappell, Anthony D; Choi, Melinda J; Hristova, Krassimira R; McNamara, Patrick J

    2016-08-10

    Triclosan, an antimicrobial chemical found in consumer personal care products, has been shown to stimulate antibiotic resistance in pathogenic bacteria. Although many studies focus on antibiotic resistance pertinent to medical scenarios, resistance developed in natural and engineered environments is less studied and has become an emerging concern for human health. In this study, the impacts of chronic triclosan (TCS) exposure on antibiotic resistance genes (ARGs) and microbial community structure were assessed in lab-scale anaerobic digesters. TCS concentrations from below detection to 2500 mg kg(-1) dry solids were amended into anaerobic digesters over 110 days and acclimated for >3 solid retention time values. Four steady state TCS concentrations were chosen (30-2500 mg kg(-1)). Relative abundance of mexB, a gene coding for a component of a multidrug efflux pump, was significantly higher in all TCS-amended digesters (30 mg kg(-1) or higher) relative to the control. TCS selected for bacteria carrying tet(L) and against those carrying erm(F) at concentrations which inhibited digester function; the pH decrease associated with digester failure was suspected to cause this selection. Little to no impact of TCS was observed on intI1 relative abundance. Microbial communities were also surveyed by high-throughput 16S rRNA gene sequencing. Compared to the control digesters, significant shifts in community structure towards clades containing commensal and pathogenic bacteria were observed in digesters containing TCS. Based on these results, TCS should be included in studies and risk assessments that attempt to elucidate relationships between chemical stressors (e.g. antibiotics), antibiotic resistance genes, and public health.

  20. Copper enhances the activity and salt resistance of mixed methane-oxidizing communities.

    Science.gov (United States)

    van der Ha, David; Hoefman, Sven; Boeckx, Pascal; Verstraete, Willy; Boon, Nico

    2010-08-01

    Effluents of anaerobic digesters are an underestimated source of greenhouse gases, as they are often saturated with methane. A post-treatment with methane-oxidizing bacterial consortia could mitigate diffuse emissions at such sites. Semi-continuously fed stirred reactors were used as model systems to characterize the influence of the key parameters on the activity of these mixed methanotrophic communities. The addition of 140 mg L(-1) NH (4) (+) -N had no significant influence on the activity nor did a temperature increase from 28 degrees C to 35 degrees C. On the other hand, addition of 0.64 mg L(-1) of copper(II) increased the methane removal rate by a factor of 1.5 to 1.7 since the activity of particulate methane monooxygenase was enhanced. The influence of different concentrations of NaCl was also tested, as effluents of anaerobic digesters often contain salt levels up to 10 g NaCl L(-1). At a concentration of 11 g NaCl L(-1), almost no methane-oxidizing activity was observed in the reactors without copper addition. Yet, reactors with copper addition exhibited a sustained activity in the presence of NaCl. A colorimetric test based on naphthalene oxidation showed that soluble methane monooxygenase was inhibited by copper, suggesting that the particulate methane monooxygenase was the active enzyme and thus more salt resistant. The results obtained demonstrate that the treatment of methane-saturated effluents, even those with increased ammonium (up to 140 mg L(-1) NH (4) (+) -N) and salt levels, can be mitigated by implementation of methane-oxidizing microbial consortia.

  1. Contribution of Panton-Valentine leukocidin in community-associated methicillin-resistant Staphylococcus aureus pathogenesis.

    Directory of Open Access Journals (Sweden)

    Binh An Diep

    2008-09-01

    Full Text Available Community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA strains typically carry genes encoding Panton-Valentine leukocidin (PVL. We used wild-type parental and isogenic PVL-deletion (Delta pvl strains of USA300 (LAC and SF8300 and USA400 (MW2 to test whether PVL alters global gene regulatory networks and contributes to pathogenesis of bacteremia, a hallmark feature of invasive staphylococcal disease. Microarray and proteomic analyses revealed that PVL does not alter gene or protein expression, thereby demonstrating that any contribution of PVL to CA-MRSA pathogenesis is not mediated through interference of global gene regulatory networks. Inasmuch as a direct role for PVL in CA-MRSA pathogenesis remains to be determined, we developed a rabbit bacteremia model of CA-MRSA infection to evaluate the effects of PVL. Following experimental infection of rabbits, an animal species whose granulocytes are more sensitive to the effects of PVL compared with the mouse, we found a contribution of PVL to pathogenesis over the time course of bacteremia. At 24 and 48 hours post infection, PVL appears to play a modest, but measurable role in pathogenesis during the early stages of bacteremic seeding of the kidney, the target organ from which bacteria were not cleared. However, the early survival advantage of this USA300 strain conferred by PVL was lost by 72 hours post infection. These data are consistent with the clinical presentation of rapid-onset, fulminant infection that has been associated with PVL-positive CA-MRSA strains. Taken together, our data indicate a modest and transient positive effect of PVL in the acute phase of bacteremia, thereby providing evidence that PVL contributes to CA-MRSA pathogenesis.

  2. Prevalence and invasiveness of community-acquired methicillin-resistant Staphylococcus aureus: A meta-analysis

    Directory of Open Access Journals (Sweden)

    Shipeng Li

    2014-01-01

    Full Text Available Background: Reports suggest that the prevalence of community-acquired methicillin-resistant Staphylococcus aureus (CA-MRSA has increased, and that CA-MRSA is more virulent than healthcare-associated (HA-MRSA. Aims: The aim of this study is to gain a better understanding of the invasiveness and prevalence of CA-MRSA in patients; we systematically reviewed the literature by conducting a meta-analysis. Materials and Methods: We searched the MEDLINE and PUBMED databases from the year these databases were established to January 2013. Results: The pooled CA-MRSA prevalence among 50,737 patients from 33 studies was 39.0% (range, 30.8-47.8%. The pooled CA-MRSA prevalence rates among pediatric and adult patients with MRSA infection were 50.2% (range, 37.5-62.8% and 42.3% (range, 16.4-73.3%, respectively. The pooled CA-MRSA prevalence rates of MRSA-infected patients in Asia, Europe, and North America were 23.1% (range, 12.0-39.8%, 37.4% (range, 21.1-56.4%, and 47.4% (range, 35.8-59.4%, respectively. Using the random effects model, we determined that the pooled odds ratio of invasive infections in CA- and HA-MRSA was 0.30 (95% confidence interval: 0.08-1.10; P = 0.07, test for heterogeneity P < 0.00001. Conclusions: The prevalence of CA-MRSA in MRSA infection varied with area and population. No difference in the ability to cause invasive infections was found between CA- and HA-MRSA. This finding challenges the view that CA-MRSA is more virulent than HA-MRSA.

  3. Self-Medication with Antibiotics, Attitude and Knowledge of Antibiotic Resistance among Community Residents and Undergraduate Students in Northwest Nigeria

    Directory of Open Access Journals (Sweden)

    Olumide Ajibola

    2018-04-01

    Full Text Available This study set out to evaluate self-medicated antibiotics and knowledge of antibiotic resistance among undergraduate students and community members in northern Nigeria. Antibiotic consumption pattern, source of prescription, illnesses commonly treated, attitude towards antibiotics, and knowledge of antibiotic resistance were explored using a structured questionnaire. Responses were analyzed and summarized using descriptive statistics. Of the 1230 respondents from undergraduate students and community members, prescription of antibiotics by a physician was 33% and 57%, respectively, amongst undergraduate students and community members. We tested the respondents’ knowledge of antibiotic resistance (ABR and found that undergraduate students displayed less knowledge that self-medication could lead to ABR (32.6% and 42.2% respectively. Self-medication with antibiotics is highly prevalent in Northwest Nigeria, with most medicines being purchased from un-licensed stores without prescription from a physician. We also observed a significant gap in respondents’ knowledge of ABR. There is an urgent need for public health authorities in Nigeria to enforce existing laws on antibiotics sales and enlighten the people on the dangers of ABR.

  4. Cutaneous community-acquired methicillin-resistant Staphylococcus aureus infection in participants of athletic activities.

    Science.gov (United States)

    Cohen, Philip R

    2005-06-01

    Cutaneous community-acquired methicillin-resistant Staphylococcus aureus (CAMRSA) has been identified in otherwise healthy individuals either with or without methicillin-resistant S. aureus (MRSA)-associated risk factors who participate in athletic activities. The purpose of this study was to describe the clinical features of CAMRSA skin infection that occurred in university student athletes, evaluate the potential mechanisms for the transmission of MRSA infection of the skin in participants of athletic activities, and review the measures for preventing the spread of cutaneous CAMRSA infection in athletes. A retrospective chart review of the student athletes from the University of Houston whose skin lesions were evaluated at the Health Center and grew MRSA was performed. The clinical characteristics and the postulated mechanisms of cutaneous MRSA infection in the athletes were compared with those previously published in reports of CAMRSA skin infection outbreaks in other sports participants. Cutaneous CAMRSA infection occurred in seven student athletes (four women and three men) who were either weight lifters (three students) or members of a varsity sports team: volleyball (two women), basketball (one woman), and football (one man). The MRSA skin infection presented as solitary or multiple, tender, erythematous, fluctuant abscesses with surrounding cellulitis. The lesions were most frequently located in the axillary region (three weight lifters), on the buttocks (two women), or on the thighs (two women). The drainage from all of the skin lesions grew MRSA, which was susceptible to clindamycin, gentamicin, rifampin, trimethoprim/sulfamethoxazole, and vancomycin; five of the isolates were also susceptible to ciprofloxacin and levofloxacin. All of the bacterial strains were resistant to erythromycin, oxacillin, and penicillin. The cutaneous MRSA infections persisted or worsened in the six athletes who were empirically treated for methicillin-sensitive S. aureus at

  5. Evidence of transmission of a Panton-Valentine leukocidin-positive community-acquired methicillin-resistant Staphylococcus aureus clone: a family affair.

    Science.gov (United States)

    Cocchi, P; Taccetti, G; Montagnani, C; Campana, S; Galli, L; Braggion, C; de Martino, M

    2013-12-01

    Community-acquired methicillin-resistant Staphylococcus aureus (CA-MRSA) may represent a serious public health problem, owing to the spread of toxin-producing lineages. The presence of genes encoding for Panton-Valentine leukocidin (PVL) is an important virulence marker, as the clinical sequelae of PVL-positive infections are often described as more severe than those of PVL-negative S. aureus infections. To date, the presence of PVL has not appeared to be common in Italy; we describe the intrafamilial transmission of an epidemic PVL-producing CA-MRSA lineage, Southwest Pacific clone (SWP). Our data suggested that the strain circulated from the father, who was recurrently affected by a soft tissue infection, to the mother, who showed nasal colonization, and to their child, who was hospitalized with symptoms of necrotizing pneumonia. In this case, we found that a recurrent skin infection that is not normally taken into account may represent a serious threat if caused by a PVL-producing strain. Our findings may have considerable implications for strategies for infection control and treatment of methicillin-resistant S. aureus infections. © 2013 The Authors Clinical Microbiology and Infection © 2013 European Society of Clinical Microbiology and Infectious Diseases.

  6. On the energy distribution profile of interface states obtained by taking into account of series resistance in Al/TiO{sub 2}/p-Si (MIS) structures

    Energy Technology Data Exchange (ETDEWEB)

    Pakma, O., E-mail: osman@pakma.co [Department of Physics, Faculty of Sciences and Arts, Batman University, Batman (Turkey); Serin, N.; Serin, T. [Department of Engineering Physics, Faculty of Engineering, Ankara University, 06100 Tandogan, Ankara (Turkey); Altindal, S. [Physics Department, Faculty of Arts and Sciences, Gazi University, Teknikokullar, 06500 Ankara (Turkey)

    2011-02-15

    The energy distribution profile of the interface states (N{sub ss}) of Al/TiO{sub 2}/p-Si (MIS) structures prepared using the sol-gel method was obtained from the forward bias current-voltage (I-V) characteristics by taking into account both the bias dependence of the effective barrier height ({phi}{sub e}) and series resistance (R{sub s}) at room temperature. The main electrical parameters of the MIS structure such as ideality factor (n), zero-bias barrier height ({phi}{sub b0}) and average series resistance values were found to be 1.69, 0.519 eV and 659 {Omega}, respectively. This high value of n was attributed to the presence of an interfacial insulator layer at the Al/p-Si interface and the density of interface states (N{sub ss}) localized at the Si/TiO{sub 2} interface. The values of N{sub ss} localized at the Si/TiO{sub 2} interface were found with and without the R{sub s} at 0.25-E{sub v} in the range between 8.4x10{sup 13} and 4.9x10{sup 13} eV{sup -1} cm{sup -2}. In addition, the frequency dependence of capacitance-voltage (C-V) and conductance-voltage (G/{omega}-V) characteristics of the structures have been investigated by taking into account the effect of N{sub ss} and R{sub s} at room temperature. It can be found out that the measured C and G/{omega} are strongly dependent on bias voltage and frequency. -- Research highlights: {yields}We successfully fabricated Al/TiO{sub 2}/p-Si device with interlayer by a sol-gel method. The facts: (i) that the technology of the fabrication of a Al/TiO{sub 2}/p-Si MIS structure much simpler and economical than that for the Si p-n junction and (b) the main advantages of TiO{sub 2} films are low densities of the surface states when compared to SiO{sub 2}.

  7. Semiautomatic approaches to account for 3-D distortion of the electric field from local, near-surface structures in 3-D resistivity inversions of 3-D regional magnetotelluric data

    Science.gov (United States)

    Rodriguez, Brian D.

    2017-03-31

    This report summarizes the results of three-dimensional (3-D) resistivity inversion simulations that were performed to account for local 3-D distortion of the electric field in the presence of 3-D regional structure, without any a priori information on the actual 3-D distribution of the known subsurface geology. The methodology used a 3-D geologic model to create a 3-D resistivity forward (“known”) model that depicted the subsurface resistivity structure expected for the input geologic configuration. The calculated magnetotelluric response of the modeled resistivity structure was assumed to represent observed magnetotelluric data and was subsequently used as input into a 3-D resistivity inverse model that used an iterative 3-D algorithm to estimate 3-D distortions without any a priori geologic information. A publicly available inversion code, WSINV3DMT, was used for all of the simulated inversions, initially using the default parameters, and subsequently using adjusted inversion parameters. A semiautomatic approach of accounting for the static shift using various selections of the highest frequencies and initial models was also tested. The resulting 3-D resistivity inversion simulation was compared to the “known” model and the results evaluated. The inversion approach that produced the lowest misfit to the various local 3-D distortions was an inversion that employed an initial model volume resistivity that was nearest to the maximum resistivities in the near-surface layer.

  8. Update on the development of virus-resistant papaya: virus-resistant transgenic papaya for people in rural communities of Thailand.

    Science.gov (United States)

    Sakuanrungsirikul, S; Sarindu, N; Prasartsee, V; Chaikiatiyos, S; Siriyan, R; Sriwatanakul, M; Lekananon, P; Kitprasert, C; Boonsong, P; Kosiyachinda, P; Fermin, G; Gonsalves, D

    2005-12-01

    Papaya (Carica papaya L.) is one of the most important and preferred crops in rural communities in Thailand. Papaya ringspot virus (PRSV) is a serious disease of papaya throughout Thailand. Efforts to control the virus by various methods either have not been successful or have not resulted in sustainable control. In 1995, collaborative research by the Department of Agriculture of Thailand and Cornell University to develop transgenic papaya resistant to PRSV was initiated. Two local Thai cultivars were transformed by microprojectile bombardment with the use of a nontranslatable coat protein gene of PRSV from Khon Kaen. Numerous kanamycin-resistantplants were regenerated and were inoculated with the PRSV Khon Kaen isolate for selection of resistant lines. Since 1997, promising RO transgenic lines have been transferred to the research station at Thapra for subsequent screenhouse tests and selection of the most PRSV-resistant lines. In selection set 1, three R3 lines initially derived from Khaknuan papaya showed excellent resistance to PRSV (97% to 100%) and had a yield of fruit 70 times higher than nontransgenic Khaknuan papaya. In selection set 2, one R3 line initially derived from Khakdam papaya showed 100% resistance. Safety assessments of these transgenic papayas have so far found no impact on the surrounding ecology. No natural crossing between transgenic and nonmodified papaya was observed beyond a distance of 10 m from the test plots. Analysis of the nutritional composition found no differences in nutrient levels in comparison with the nonmodified counterparts. Molecular characterization by Southern blotting revealed three copies of the transgene presented; however, no coat protein product was expressed. Data on additional topics, such as the effects offeeding the transgenic papaya to rats and the stability of the gene inserts, are currently being gathered.

  9. A horizontally gene transferred copper resistance locus confers hyper-resistance to antibacterial copper toxicity and enables survival of community acquired methicillin resistant Staphylococcus aureus USA300 in macrophages.

    Science.gov (United States)

    Purves, Joanne; Thomas, Jamie; Riboldi, Gustavo P; Zapotoczna, Marta; Tarrant, Emma; Andrew, Peter W; Londoño, Alejandra; Planet, Paul J; Geoghegan, Joan A; Waldron, Kevin J; Morrissey, Julie A

    2018-03-09

    Excess copper is highly toxic and forms part of the host innate immune system's antibacterial arsenal, accumulating at sites of infection and acting within macrophages to kill engulfed pathogens. We show for the first time that a novel, horizontally gene transferred copper resistance locus (copXL), uniquely associated with the SCCmec elements of the highly virulent, epidemic, community acquired methicillin resistant Staphylococcus aureus (CA-MRSA) USA300, confers copper hyper-resistance. These genes are additional to existing core genome copper resistance mechanisms, and are not found in typical S. aureus lineages, but are increasingly identified in emerging pathogenic isolates. Our data show that CopX, a putative P 1B-3 -ATPase efflux transporter, and CopL, a novel lipoprotein, confer copper hyper-resistance compared to typical S. aureus strains. The copXL genes form an operon that is tightly repressed in low copper environments by the copper regulator CsoR. Significantly, CopX and CopL are important for S. aureus USA300 intracellular survival within macrophages. Therefore, the emergence of new S. aureus clones with the copXL locus has significant implications for public health because these genes confer increased resistance to antibacterial copper toxicity, enhancing bacterial fitness by altering S. aureus interaction with innate immunity. © 2018 The Authors. Environmental Microbiology published by Society for Applied Microbiology and John Wiley & Sons Ltd.

  10. Internet accounting

    NARCIS (Netherlands)

    Pras, Aiko; van Beijnum, Bernhard J.F.; Sprenkels, Ron; Parhonyi, R.

    2001-01-01

    This article provides an introduction to Internet accounting and discusses the status of related work within the IETF and IRTF, as well as certain research projects. Internet accounting is different from accounting in POTS. To understand Internet accounting, it is important to answer questions like

  11. Multidrug and mupirocin resistance in environmental methicillin-resistantStaphylococcus aureus(MRSA) collected from the homes of people diagnosed with a community-onset (CO-) MRSA infection.

    Science.gov (United States)

    Shahbazian, J H; Hahn, P D; Ludwig, S; Ferguson, J; Baron, P; Christ, A; Spicer, K; Tolomeo, P; Torrie, A M; Bilker, W B; Cluzet, V C; Hu, B; Julian, K; Nachamkin, I; Rankin, S C; Morris, D O; Lautenbach, E; Davis, M F

    2017-09-22

    Patients with community-onset methicillin-resistant Staphylococcus aureus (CO-MRSA) infections contribute to MRSA contamination of the home environment, and may be re-exposed to MRSA strains from this reservoir. This study evaluates One Health risk factors that focus on the relationship between humans, animals and the environment for increased prevalence of multiple antimicrobial resistant MRSA in the home environment. During a trial of patients with CO-MRSA infection, MRSA was isolated from the household environment at baseline and three months later, following randomization of patients and household members to mupirocin-based decolonization therapy or education control. Up to two environmental MRSA isolates per visit were tested. MRSA isolates were identified in 68% (65/95) of homes at baseline ( n =104 isolates) and 51% (33/65) of homes three months later ( n =56 isolates). Rates of MDR were 61% at baseline and 55% at the three-month visit. At baseline, 100% (14/14) of MRSA isolates from rural homes were MDR. While antimicrobial use in humans or pets was associated with an increased risk for the isolation of MDR MRSA from the environment, clindamycin use was not associated risk for isolation of MDR MRSA. Two (5%) of 39 homes that were randomized to mupirocin treatment, but none of the control families, had incident low-level mupirocin resistant MRSA isolated at three months. Among patients recently treated for a CO-MRSA infection, MRSA and MDR MRSA were common contaminants in the home environment. This study contributes to evidence that occupant use of antimicrobial drugs--except clindamycin--is associated with MDR MRSA in the home environmental reservoir. Importance: MRSA is a common bacterial agent implicated in skin and soft tissue infections (SSTIs) in both community and healthcare settings. Patients with CO-MRSA infections contribute to MRSA contamination and may be re-exposed to MRSA strains from these reservoirs. People interact with natural and built

  12. Pulmonary infections and community associated methicillin resistant Staphylococcus aureus: a dangerous mix?

    Science.gov (United States)

    Shilo, Natalie; Quach, Caroline

    2011-09-01

    The incidence of complicated pneumonias in children is increasing with a concurrent increase in the incidence of community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA) infections. CA-MRSA is distinct from hospital associated MRSA [HA-MRSA] in regards to its genotype, epidemiology, and clinical course. Unlike HA-MRSA, CA-MRSA often strikes young, previously healthy children. Pneumonias caused by CA-MRSA have a rather distinct presentation. Because of its pore-forming toxins, namely Panton-Valentine leukocidin (PVL) and alpha-hemolysin, extensive necrotizing disease with corresponding hypoxaemia and hypercarbia is common. Other features include multilobar disease, leucopenia, haemoptysis, and high mortality rates. A previous influenza-like illness or skin and soft tissue infection [SSTI] often precede the development of pneumonia due to CA-MRSA. Vancomycin is recommended as first-line empiric therapy for suspected CA-MRSA infections. However, vancomycin is not an ideal agent for the treatment of pneumonia given its poor concentrating ability in alveolar fluid. Linezolid and clindamycin have also been used in the treatment of CA-MRSA pneumonia and ongoing research is looking for alternative antimicrobials. Recent studies have continued to report a lack of correlation between nasal colonization and active infections due to CA-MRSA. Given that the role of nasal colonization in CA-MRSA infection is not clear, the utility of decolonization treatment has been a point of debate. Finally, patients with cystic fibrosis are becoming increasingly colonized with MRSA as opposed to MSSA. There is some accumulating evidence that patients with MRSA show a more rapid deterioration in their degree of obstructive disease as measured by forced expiratory volume in one second (FEV(1)). However, it still is not clear whether MRSA is a marker for worsening disease or whether it actually is a cause of disease progression in cystic fibrosis. More longitudinal data is

  13. The molecular evolution of hospital- and community-associated methicillin-resistant Staphylococcus aureus

    NARCIS (Netherlands)

    Deurenberg, Ruud H; Stobberingh, Ellen E

    Staphylococcus aureus can cause a wide variety of infections, ranging from minor skin infections to post-operative wound infections. Its adaptive power to antibiotics has resulted in the emergence of methicillin-resistant S. aureus (MRSA) in the beginning of the 1960s. Resistance to methicillin and

  14. Methicillin-resistant coagulase-negative staphylococci in the community: high homology of SCCmec IVa between Staphylococcus epidermidis and major clones of methicillin-resistant Staphylococcus aureus.

    Science.gov (United States)

    Barbier, François; Ruppé, Etienne; Hernandez, David; Lebeaux, David; Francois, Patrice; Felix, Benjamin; Desprez, Adeline; Maiga, Aminata; Woerther, Paul-Louis; Gaillard, Kevin; Jeanrot, Cécile; Wolff, Michel; Schrenzel, Jacques; Andremont, Antoine; Ruimy, Raymond

    2010-07-15

    Data on community spread of methicillin-resistant coagulase-negative staphylococci (MR-CoNS) are scarce. We assessed their potential role as a reservoir of staphylococcal cassette chromosome mec (SCCmec) IVa, the leading SCCmec subtype in community-acquired methicillin-resistant Staphylococcus aureus (CA-MRSA). Nasal carriage of MR-CoNS was prospectively investigated in 291 adults at hospital admission. MR-CoNS were characterized by SCCmec typing, long-range polymerase chain reaction (PCR) for SCCmec IV, and multiple-locus variable-number tandem repeat analysis (MLVA) for Staphylococcus epidermidis (MRSE) strains. Three SCCmec IVa elements were fully sequenced. The carriage rate of MR-CoNS was 19.2% (25.9% and 16.5% in patients with and patients without previous exposure to the health care system, respectively; P = .09). MR-CoNS strains (n = 83, including 58 MRSE strains with highly heterogeneous MLVA patterns) carried SCCmec type IVa (n = 9, all MRSE), other SCCmec IV subtypes (n = 9, including 7 MRSE), other SCCmec types (n = 15), and nontypeable SCCmec (n = 50). Long-range PCR indicated structural homology between SCCmec IV in MRSE and that in MRSA. Complete sequences of SCCmec IVa from 3 MRSE strains were highly homologous to those available for CA-MRSA, including major clones USA300 and USA400. MR-CoNS are probably disseminated in the community, notably in subjects without previous exposure to the health care system. MRSE, the most prevalent species, may act as a reservoir of SCCmec IVa for CA-MRSA.

  15. Fate of potential indicator antimicrobial resistance genes (ARGs) and bacterial community diversity in simulated manure-soil microcosms.

    Science.gov (United States)

    Wang, Mianzhi; Liu, Peng; Xiong, Wenguang; Zhou, Qin; Wangxiao, Junyi; Zeng, Zhenling; Sun, Yongxue

    2018-01-01

    The aim of this study was to investigate the fate of nine potential indicator antimicrobial resistance genes (ARGs) (sul1, sul2, tetB, tetM, ermB, ermF, fexA, cfr, intI1) and the diversity of bacterial communities in response to poultry manure applications to arable soil over a 90 day period. Quantitative real time PCR and Illumina high-throughput sequencing of 16S rDNA gene were used to quantify and trace ARG fate. The levels of all genes dramatically decreased over time and intI1, sul1, sul2 and tetM always had the greatest abundance and lowest dissipation rates. This indicated that more effort should be focused on the ARG elimination from manure rather than waiting for subsequent attenuation in the environment. Our sequencing results documented dramatic changes in the microbial community structure and diversity during these experiments. In poultry manure groups, Bacteroidetes and Actinobacteria were the two dominant phyla while Acidobacteria dominated the control groups. Moreover, the relative abundance of genera Corynebacterium, Pseudomonas, Ochrobactrum, Actinomadura and Bacillus, which contained potential opportunistic pathogens, changed over time suggesting that poultry manure not only strongly influenced bacterial community composition, but also selected specific bacterial communities. This study provides a glimpse of ARG fates and bacterial community diversity in soil after the application of poultry manure. Copyright © 2017 Elsevier Inc. All rights reserved.

  16. The community diversity of two Caribbean MPAs invaded by lionfish does not support the biotic resistance hypothesis

    Science.gov (United States)

    Cobián-Rojas, Dorka; Schmitter-Soto, Juan J.; Aguilar Betancourt, Consuelo M.; Aguilar-Perera, Alfonso; Ruiz-Zárate, Miguel Á.; González-Sansón, Gaspar; Chevalier Monteagudo, Pedro P.; Herrera Pavón, Roberto; García Rodríguez, Alain; Corrada Wong, Raúl I.; Cabrera Guerra, Delmis; Salvat Torres, Héctor; Perera Valderrama, Susana

    2018-04-01

    Marine protected areas (MPAs) conserve diversity and abundance of fish communities. According to the biotic resistance hypothesis, communities with higher diversity and abundance should resist invasions better. To test this idea, the presence of lionfish in two Caribbean MPAs was studied: Parque Nacional Guanahacabibes (PNG) in Cuba and Parque Nacional Arrecifes de Xcalak (PNAX) in Mexico. Selection of these MPAs was based on both their different levels of success with enforcement and different abundances of native fish, with a more abundant native fish fauna at PNG. Underwater visual censuses were used to evaluate both the native fish structure and composition and at the same time distribution and abundance of lionfish. The abundance of potential predators on lionfish was also measured to determine possible effects of lionfish on both the abundance and the size of its prey and competitors. Lionfish showed higher abundance and larger size in PNG compared to PNAX, even though its probable competitors and predators were also more abundant and larger in PNG. Prey abundance and size decreased after the invasion. No correlation was detected between potential predators and lionfish, which might indicate natural predation is not substantial. In PNAX, lower abundance of prey, potential competitors and predators can also be attributed to historical overfishing, but this did not provide an advantage to lionfish. Lionfish were less abundant and reached smaller sizes in PNAX compared to PNG. This work confirms the effectiveness of lionfish culling at PNAX, but does not support the biotic resistence hypothesis that native fish might have controlled this invasive species.

  17. Sulfamethoxazole and COD increase abundance of sulfonamide resistance genes and change bacterial community structures within sequencing batch reactors.

    Science.gov (United States)

    Guo, Xueping; Pang, Weihai; Dou, Chunling; Yin, Daqiang

    2017-05-01

    The abundant microbial community in biological treatment processes in wastewater treatment plants (WWTPs) may potentially enhance the horizontal gene transfer of antibiotic resistance genes with the presence of antibiotics. A lab-scale sequencing batch reactor was designed to investigate response of sulfonamide resistance genes (sulI, sulII) and bacterial communities to various concentrations of sulfamethoxazole (SMX) and chemical oxygen demand (COD) of wastewater. The SMX concentrations (0.001 mg/L, 0.1 mg/L and 10 mg/L) decreased with treatment time and higher SMX level was more difficult to remove. The presence of SMX also significantly reduced the removal efficiency of ammonia nitrogen, affecting the normal function of WWTPs. All three concentrations of SMX raised both sulI and sulII genes with higher concentrations exhibiting greater increases. The abundance of sul genes was positive correlated with treatment time and followed the second-order reaction kinetic model. Interestingly, these two genes have rather similar activity. SulI and sulII gene abundance also performed similar response to COD. Simpson index and Shannon-Weiner index did not show changes in the microbial community diversity. However, the 16S rRNA gene cloning and sequencing results showed the bacterial community structures varied during different stages. The results demonstrated that influent antibiotics into WWTPs may facilitate selection of ARGs and affect the wastewater conventional treatment as well as the bacteria community structures. Copyright © 2017 Elsevier Ltd. All rights reserved.

  18. The changing pattern of antimicrobial resistance within 42,033 Escherichia coli isolates from nosocomial, community and urology patient-specific urinary tract infections, Dublin, 1999-2009.

    LENUS (Irish Health Repository)

    Cullen, Ivor M

    2012-04-01

    To investigate the changing pattern of antimicrobial resistance in Escherichia coli urinary tract infection over an eleven year period, and to determine whether E. coli antibiotic resistance rates vary depending on whether the UTI represents a nosocomial, community acquired or urology patient specific infection.

  19. Signatures of cytoplasmic proteins in the exoproteome distinguish community-and hospital-associated methicillin-resistant Staphylococcus aureus USA300 lineages

    NARCIS (Netherlands)

    Mekonnen, Solomon A.; Medina, Laura M. Palma; Glasner, Corinna; Tsompanidou, Eleni; de Jong, Anne; Grasso, Stefano; Schaffer, Marc; Maeder, Ulrike; Larsen, Anders R.; Gumpert, Heidi; Westh, Henrik; Voelker, Uwe; Otto, Andreas; Becher, Doerte; van Dijl, Jan Maarten

    2017-01-01

    Methicillin-resistant Staphylococcus aureus (MRSA) is the common name for a heterogeneous group of highly drug-resistant staphylococci. Two major MRSA classes are distinguished based on epidemiology, namely community-associated (CA) and hospital-associated (HA) MRSA. Notably, the distinction of

  20. High prevalence of methicillin-resistant Staphylococcus aureus clone ST80-IV in hospital and community settings in Algiers.

    Science.gov (United States)

    Antri, K; Rouzic, N; Dauwalder, O; Boubekri, I; Bes, M; Lina, G; Vandenesch, F; Tazir, M; Ramdani-Bouguessa, N; Etienne, J

    2011-04-01

    USA300 is an epidemic community-acquired methicillin-resistant Staphylococcus aureus (C-MRSA) clone in the USA, whereas the European C-MRSA clone ST80-IV has mainly a sporadic diffusion in Europe. The prevalence of European clone ST80-IV in Algeria is poorly documented. We prospectively studied S. aureus infections at Mustapha Bacha hospital in Algiers over a 20-month period. S. aureus nasal colonization was studied during a further 6-month period. The European clone ST80-IV was responsible for more than one-third of both community infections (35.7%) and hospital infections (35.8%). Panton-Valentine leukocidin (PVL)-positive MRSA isolated from hospital inpatients were resistant to multiple antibiotics, including fluoroquinolones in 44.9% of cases. The PVL-positive MRSA nasal carriage rate was high among patients and staff in the dermatology unit (8.7% and 18.5%, respectively), but low (2.7%) among patients attending the outpatient clinic. The European PVL-positive C-MRSA clone ST80-IV is widespread in the Algiers hospital and community settings. © 2010 The Authors. Journal Compilation © 2010 European Society of Clinical Microbiology and Infectious Diseases.

  1. HIV drug resistance mutations in proviral DNA from a community treatment program.

    Directory of Open Access Journals (Sweden)

    Anne Derache

    Full Text Available Drug resistance mutations archived in resting memory CD4+ cells may persist despite suppression of HIV RNA to <50 copies/ml. We sequenced pol gene from proviral DNA among viremic and suppressed patients to identify drug resistance mutations.The Peninsula AIDS Research Cohort study enrolled and followed over 2 years 120 HIV infected patients from San Mateo and San Francisco Counties. HIV-1 pol genotyping by bulk sequencing was performed on 38 DNA and RNA from viremic patients and DNA only among 82 suppressed patients at baseline. Antiretroviral susceptibility was predicted by HIVDB.stanford.edu.Among 120 subjects, 81% were on antiretroviral therapy and had been treated for a median time of 7 years. Thirty-two viremic patients showed concordant RNA and DNA genotypes (84%; the discordant profiles were mainly observed in patients with low-level viremia. Among suppressed patients, 21 had drug resistance mutations in proviral DNA (26% with potential resistance to one, two or three ARV classes in 16, 4 and 1 samples respectively.The high level of genotype concordance between DNA and RNA in viremic patients suggested that DNA genotyping might be used to assess drug resistance in resource-limited settings, and further investigation of extracted DNA from dried blood spots is needed. Drug resistance mutations in proviral DNA in 26% of subjects with less than 50 copies/ml pose a risk for the transmission of drug resistant virus with virologic failure, treatment interruption or decreased adherence.

  2. Nasal carriage of resistant Staphylococcus aureus in a medical student community

    Directory of Open Access Journals (Sweden)

    CAROLINA Y. GUSHIKEN

    2016-01-01

    Full Text Available ABSTRACT Staphylococcus aureus can cause a variety of infections due to its high transmissibility, high pathogenic potential and resistance to multiple drugs, factors that contribute to the relevance of infections in healthcare services. The aim of this study was to document phenotypic and genotypic resistance factors of Staphylococcus aureus strains, isolated from nasal mucosa of medical students. A nasal swab was collected from the nares (nostrils of 222 medical students. After collection, the samples were submitted to isolation and identification procedures. From 204 valid samples, 20.6% (42 samples were positive for S. aureus. For the assessment of phenotypic resistance by disk-diffusion technique, from 42 samples, 95.2% showed resistance to erythromycin, 42.8% to clindamycin, 16.6% to cephoxitin and 9.5% to oxacillin. The D test showed that 26.2% of samples were resistant to macrolides, lincosamides and streptogramin B. A PCR assay allowed for the evaluation of a genotypic resistance profile, in which 16.6% of the samples were positive for the mecA gene, 35.7% positive for the ermC gene or ermA gene and 28.5% were positive for both genes. These results demonstrate that medical students can enter the healthcare service previously colonized by multidrug resistant strains and become potential spreaders in the hospital environment.

  3. Community-based management of multiple drug resistant tuberculosis in a tertiary hospital in Tanzania: a best practice implementation project.

    Science.gov (United States)

    Jelly, Isaya; Peters, Micah D J

    2017-12-01

    The World Health Organization (WHO) has prioritized collaboration with communities in its 2016 "End TB" implementation strategy. Acknowledging the difficulties that some communities face in gaining access to health facilities due to barriers such as stigma, discrimination, healthcare expenditure, transport and income loss, partnering with communities in the roll-out of community-based TB management activities is vital. The aim of this project was to make a contribution to promoting evidence-based practice with regards to the community-based management of multidrug-resistant tuberculosis (MDR-TB) at Kibong'oto National Infectious Disease Hospital, Tanzania, and thereby supporting improvements in patient outcomes and resource utilization. The project utilized the Joanna Briggs Institute Practical Application of Clinical Evidence System (JBI PACES) program to facilitate the collection of pre- and post-audit data. The Getting Research into Practice (GRiP) module was also used to analyze the potential barriers and for designing the final action plan. This project was conducted in three phases over a three-month period at the MDR-TB unit in a referral hospital in Northern Tanzania. The project showed that there were significant improvements in compliance rates in staff education and documentation of patients' suitability and preferences in receiving community-based care for MDR-TB. The compliance rate of criterion 2, which was already 100% at baseline, was slightly lower at follow-up. The project achieved significant improvements in the delivery of evidence-based practice with regards to community-based management of MDR-TB.

  4. Comparative genomics of community-acquired ST59 methicillin-resistant Staphylococcus aureus in Taiwan: novel mobile resistance structures with IS1216V.

    Directory of Open Access Journals (Sweden)

    Wei-Chun Hung

    Full Text Available Methicillin-resistant Staphylococcus aureus (MRSA with ST59/SCCmecV and Panton-Valentine leukocidin gene is a major community-acquired MRSA (CA-MRSA lineage in Taiwan and has been multidrug-resistant since its initial isolation. In this study, we studied the acquisition mechanism of multidrug resistance in an ST59 CA-MRSA strain (PM1 by comparative genomics. PM1's non-β-lactam resistance was encoded by two unique genetic traits. One was a 21,832-bp composite mobile element structure (MES(PM1, which was flanked by direct repeats of enterococcal IS1216V and was inserted into the chromosomal sasK gene; the target sequence (att was 8 bp long and was duplicated at both ends of MES(PM1. MES(PM1 consisted of two regions: the 5'-end side 12.4-kb region carrying Tn551 (with ermB and Tn5405-like (with aph[3']-IIIa and aadE, similar to an Enterococcus faecalis plasmid, and the 3'-end side 6,587-bp region (MES(cat that carries cat and is flanked by inverted repeats of IS1216V. MES(cat possessed att duplication at both ends and additional two copies of IS1216V inside. MES(PM1 represents the first enterococcal IS1216V-mediated composite transposon emerged in MRSA. IS1216V-mediated deletion likely occurred in IS1216V-rich MES(PM1, resulting in distinct resistance patterns in PM1-derivative strains. Another structure was a 6,025-bp tet-carrying element (MES(tet on a 25,961-bp novel mosaic penicillinase plasmid (pPM1; MES(tet was flanked by direct repeats of IS431, but with no target sequence repeats. Moreover, the PM1 genome was deficient in a copy of the restriction and modification genes (hsdM and hsdS, which might have contributed to the acquisition of enterococcal multidrug resistance.

  5. Detection and analysis of methicillin-resistant human-adapted sequence type 398 allows insight into community-associated methicillin-resistant Staphylococcus aureus evolution.

    Science.gov (United States)

    He, Lei; Zheng, Hong-Xiang; Wang, Yanan; Le, Katherine Y; Liu, Qian; Shang, Jun; Dai, Yingxin; Meng, Hongwei; Wang, Xing; Li, Tianming; Gao, Qianqian; Qin, Juanxiu; Lu, Huiying; Otto, Michael; Li, Min

    2018-01-29

    Severe infections with highly virulent community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA) are a global problem. However, the molecular events defining the evolution of CA-MRSA are still poorly understood. MRSA of sequence type (ST) 398 is known to frequently infect livestock, while ST398 isolates infecting humans are commonly methicillin-susceptible or represent MRSA originating from livestock-associated (LA)-MRSA. We used whole genome sequencing of newly detected CA-MRSA ST398 isolates, in comparison to geographically matched LA-MRSA and methicillin-sensitive ST398, to determine their evolutionary history. Furthermore, we used phenotypic analyses including animal infection models to gain insight into the evolution of virulence in these CA-MRSA isolates. Finally, we determined methicillin resistance and expression of the methicillin resistance-conferring gene mecA and its penicillin-binding protein product, PBP2a, in a large series of CA-MRSA strains of divergent STs. We report several cases of severe and fatal infections due to ST398 CA-MRSA. The responsible isolates showed the typical genetic characteristics reported for human-adapted methicillin-sensitive ST398. Whole genome sequencing demonstrated that they evolved from human-adapted, methicillin-susceptible clones on several different occasions. Importantly, the isolates had not undergone consistent genetic alterations or changes in virulence as compared to their methicillin-susceptible predecessors. Finally, we observed dramatically and consistently lower methicillin resistance and expression of the resistance gene mecA, as compared to hospital-associated MRSA strains, in a diverse selection of CA-MRSA strains. Our study presents evidence for the development of highly virulent human-adapted ST398 CA-MRSA isolates from methicillin-susceptible predecessors. Notably, our investigation indicates that, in contrast to widespread notions, the development of CA-MRSA is not necessarily

  6. Community-acquired pneumonia caused by carbapenem-resistant Streptococcus pneumoniae: re-examining its prevention and treatment

    Directory of Open Access Journals (Sweden)

    Doi A

    2014-05-01

    Full Text Available Asako Doi,1,2 Kentaro Iwata,3 Hiroshi Takegawa,4 Kanji Miki,5 Yumi Sono,1,2 Hiroaki Nishioka,2 Jumpei Takeshita,6 Keisuke Tomii,7 Tsunekazu Haruta11Department of Infectious Diseases, 2Department of General Internal Medicine, Kobe City Medical Center General Hospital, 3Division of Infectious Diseases, Kobe University Hospital, Japan; 4Department of Laboratory Medicine, Kobe City Medical Center General Hospital, Japan; 5Hyogo Health Service Association, Hyogo, 6Foundation of Biochemical Research and Innovation, Osaka, 7Department of Pulmonary Medicine, Kobe City Medical Center General Hospital, Hyogo, JapanAbstract: A 73-year-old man with no significant past medical history or any history of health care visits was hospitalized for pneumonia. Sputum culture revealed multidrug-resistant Streptococcus pneumoniae, even to carbapenems. The patient was later treated successfully with levofloxacin. Throat cultures from his two grandchildren revealed S. pneumoniae with the same susceptibility pattern. Analysis for resistant genes revealed gPRSP (pbp1a + pbp2x + pbp2b gene variants in both the patient and his grandchildren, none of whom had received pneumococcal vaccines of any kind. This case illustrates the importance of the emergence of carbapenem-resistant S. pneumoniae. Non-rational use of carbapenems for community-acquired infections may be counterproductive. This case also highlights the importance of pneumococcal vaccinations in children and the elderly.Keywords: carbapenem resistance, Streptococcus pneumoniae, pneumonia

  7. A Community Level Theory of Organizational Resistance to Anti Smoking Regulation

    NARCIS (Netherlands)

    Vermeulen, P.A.M.; Simons, T.; Knoben, J.

    2012-01-01

    This study aims to investigate organizations’ resistance to the introduction of new legislation in an established institutional field, which exhibits an intriguing combination of both high consensus as well as intense contestation. Specifically it focuses on smoking regulations affecting the

  8. Community-associated methicillin-resistant Staphylococcus aureus infective endocarditis in a tennis player: an emerging pathogen in infectious disease

    Directory of Open Access Journals (Sweden)

    Basaran, Ozcan

    2013-09-01

    Full Text Available In the 2000s, the Center for Disease Control and Prevention has defined community-associated methicillin-resistant (CA-MRSA disease which is a disease of healthcare unrelated patients. We report here on a 39-year-old female patient who was admitted to our institution without any medical history. She was a tennis player and had been suffering from ankle pain for a month. She was diagnosed with infective endocarditis according to modified Duke criteria. Blood cultures were taken to BD BACTEC Blood Culture System, gram positive bacteria were isolated and identified as methicillin-resistant with BD Phoenix Automated Microbiology System. She was treated with gentamicin plus linezolid. The patients’ pathogen was thought to be CA-MRSA which is an emerging pathogen in infective endocarditis.

  9. On being the right size: the impact of population size and stochastic effects on the evolution of drug resistance in hospitals and the community.

    Science.gov (United States)

    Kouyos, Roger D; Abel Zur Wiesch, Pia; Bonhoeffer, Sebastian

    2011-04-01

    The evolution of drug resistant bacteria is a severe public health problem, both in hospitals and in the community. Currently, some countries aim at concentrating highly specialized services in large hospitals in order to improve patient outcomes. Emergent resistant strains often originate in health care facilities, but it is unknown to what extent hospital size affects resistance evolution and the resulting spillover of hospital-associated pathogens to the community. We used two published datasets from the US and Ireland to investigate the effects of hospital size and controlled for several confounders such as antimicrobial usage, sampling frequency, mortality, disinfection and length of stay. The proportion of patients acquiring both sensitive and resistant infections in a hospital strongly correlated with hospital size. Moreover, we observe the same pattern for both the percentage of resistant infections and the increase of hospital-acquired infections over time. One interpretation of this pattern is that chance effects in small hospitals impede the spread of drug-resistance. To investigate to what extent the size distribution of hospitals can directly affect the prevalence of antibiotic resistance, we use a stochastic epidemiological model describing the spread of drug resistance in a hospital setting as well as the interaction between one or several hospitals and the community. We show that the level of drug resistance typically increases with population size: In small hospitals chance effects cause large fluctuations in pathogen population size or even extinctions, both of which impede the acquisition and spread of drug resistance. Finally, we show that indirect transmission via environmental reservoirs can reduce the effect of hospital size because the slow turnover in the environment can prevent extinction of resistant strains. This implies that reducing environmental transmission is especially important in small hospitals, because such a reduction not only

  10. Dps promotes survival of nontypeable Haemophilus influenzae in biofilm communities in vitro and resistance to clearance in vivo

    Directory of Open Access Journals (Sweden)

    Bing ePang

    2012-05-01

    Full Text Available Nontypeable Haemophilus influenzae (NTHi is a common airway commensal and opportunistic pathogen that persists within surface-attached biofilm communities. In this study, we tested the hypothesis that bacterial stress-responses are activated within biofilms. Transcripts for several factors associated with bacterial resistance to environmental stress were increased in biofilm cultures as compared to planktonic cultures. Among these, a homolog of the DNA-binding protein from starved cells (dps was chosen for further study. An isogenic NTHi 86-028NP dps mutant was generated and tested for resistance to environmental stress, revealing a significant survival defects in high-iron conditions, which was mediated by oxidative stress and was restored by genetic complementation. As expected, NTHi 86-028NP dps had a general stress-response defect, exhibiting decreased resistance to many types of environmental stress. While no differences were observed in density and structure of NTHi 86-028NP and NTHi 86-028NP dps biofilms, bacterial survival was decreased in NTHi 86-028NP dps biofilms as compared to the parental strain. The role of dps persistence in vivo was tested in animal infection studies. NTHi 86-028NP dps had decreased resistance to clearance after pulmonary infection of elastase-treated mice as compared to NTHi 86-028NP, whereas minimal differences were observed in clearance from mock-treated mice. Similarly, lower numbers of NTHi 86-028NP dps were recovered from middle-ear effusions and bullar homogenates in the chinchilla model for otitis media. Therefore, we conclude that Dps promotes bacterial survival within NTHi biofilm communities both in vitro and in chronic infections in vivo.

  11. Community-acquired carbapenem-resistant Acinetobacter baumannii urinary tract infection just after marriage in a renal transplant recipient.

    Science.gov (United States)

    Solak, Y; Atalay, H; Turkmen, K; Biyik, Z; Genc, N; Yeksan, M

    2011-12-01

    Urinary tract infection (UTI) is common in renal transplant recipients and may worsen allograft and patient survival. Many risk factors such as age, female gender, immunosuppression, comorbidity, deceased-donor kidney transplantation, and uretheral catheterization are involved in development of UTI. Acinetobacter baumannii has rarely been reported as a causative agent for development of UTI. Here, we present an unusual case of a renal transplant recipient who developed community-acquired carbapenem-resistent A. baumannii UTI. © 2011 John Wiley & Sons A/S.

  12. Orbital cellulitis caused by community-associated methicillin-resistant Staphylococcus aureus in a previously healthy neonate.

    Science.gov (United States)

    Lei, Tzu-Hui; Huang, Yhu-Chering; Chu, Yen-Chang; Lee, Chien-Yu; Lien, Reyin

    2013-04-01

    A 30-day-old, previously healthy, near-term neonate presented with fever and swelling of the left eye. Orbital cellulitis of the left eye was diagnosed by computed tomography. Both blood culture and pus that was drained from the orbital abscess were positive for methicillin-resistant Staphylococcus aureus (MRSA), which was found to be a strain indigenous to the local community by a molecular method. Using vancomycin therapy and surgical drainage, the infant recovered uneventfully. Orbital cellulitis in neonates may rapidly progress to abscess formation, even to sepsis, and S. aureus is the most common pathogen. With the increasing prevalence of community-associated MRSA, empiric antibiotics effective against MRSA should be first considered in endemic areas. Copyright © 2012. Published by Elsevier B.V.

  13. Accounting standards

    NARCIS (Netherlands)

    Stellinga, B.; Mügge, D.

    2014-01-01

    The European and global regulation of accounting standards have witnessed remarkable changes over the past twenty years. In the early 1990s, EU accounting practices were fragmented along national lines and US accounting standards were the de facto global standards. Since 2005, all EU listed

  14. Accounting outsourcing

    OpenAIRE

    Klečacká, Tereza

    2009-01-01

    This thesis gives a complex view on accounting outsourcing, deals with the outsourcing process from its beginning (condition of collaboration, making of contract), through collaboration to its possible ending. This work defines outsourcing, indicates the main advatages, disadvatages and arguments for its using. The main object of thesis is mainly practical side of accounting outsourcing and providing of first quality accounting services.

  15. Metagenomic analysis of bacterial community composition and antibiotic resistance genes in a wastewater treatment plant and its receiving surface water.

    Science.gov (United States)

    Tang, Junying; Bu, Yuanqing; Zhang, Xu-Xiang; Huang, Kailong; He, Xiwei; Ye, Lin; Shan, Zhengjun; Ren, Hongqiang

    2016-10-01

    The presence of pathogenic bacteria and the dissemination of antibiotic resistance genes (ARGs) may pose big risks to the rivers that receive the effluent from municipal wastewater treatment plants (WWTPs). In this study, we investigated the changes of bacterial community and ARGs along treatment processes of one WWTP, and examined the effects of the effluent discharge on the bacterial community and ARGs in the receiving river. Pyrosequencing was applied to reveal bacterial community composition including potential bacterial pathogen, and Illumina high-throughput sequencing was used for profiling ARGs. The results showed that the WWTP had good removal efficiency on potential pathogenic bacteria (especially Arcobacter butzleri) and ARGs. Moreover, the bacterial communities of downstream and upstream of the river showed no significant difference. However, the increase in the abundance of potential pathogens and ARGs at effluent outfall was observed, indicating that WWTP effluent might contribute to the dissemination of potential pathogenic bacteria and ARGs in the receiving river. Copyright © 2016 Elsevier Inc. All rights reserved.

  16. Low prevalence of methicillin-resistant Staphylococcus aureus nasal carriage in urban and rural community settings in Bolivia and Peru.

    Science.gov (United States)

    Bartoloni, Alessandro; Pallecchi, Lucia; Fernandez, Connie; Mantella, Antonia; Riccobono, Eleonora; Magnelli, Donata; Mannini, Dario; Strohmeyer, Marianne; Bartalesi, Filippo; Segundo, Higinio; Monasterio, Joaquin; Rodriguez, Hugo; Cabezas, César; Gotuzzo, Eduardo; Rossolini, Gian Maria

    2013-05-01

    To investigate the prevalence of methicillin-resistant Staphylococcus aureus (MRSA) nasal carriage in rural and urban community settings of Bolivia and Peru. MRSA nasal carriage was investigated in 585 individuals living in rural and urban areas of Bolivia and Peru (one urban area, one small rural village, and two native communities, one of which was highly isolated). MRSA isolates were subjected to molecular analysis for the detection of virulence genes, characterization of the staphylococcal cassette chromosome mec (SCCmec), and genotyping (multilocus sequence typing (MLST) and pulsed-field gel electrophoresis (PFGE)). An overall very low prevalence of MRSA nasal carriage was observed (0.5%), with MRSA carriers being detected only in a small rural village of the Bolivian Chaco. The three MRSA isolates showed the characteristics of community-associated MRSA (being susceptible to all non-beta-lactam antibiotics and harboring the SCCmec type IV), were clonally related, and belonged to ST1649. This study provides an insight into the epidemiology of MRSA in community settings of Bolivia and Peru. Reliable, time-saving, and low-cost methods should be implemented to encourage continued surveillance of MRSA dissemination in resource-limited countries. Copyright © 2012 International Society for Infectious Diseases. Published by Elsevier Ltd. All rights reserved.

  17. Antibiotic Resistance Genes and Correlations with Microbial Community and Metal Resistance Genes in Full-Scale Biogas Reactors As Revealed by Metagenomic Analysis.

    Science.gov (United States)

    Luo, Gang; Li, Bing; Li, Li-Guan; Zhang, Tong; Angelidaki, Irini

    2017-04-04

    Digested residues from biogas plants are often used as biofertilizers for agricultural crops cultivation. The antibiotic resistance genes (ARGs) in digested residues pose a high risk to public health due to their potential spread to the disease-causing microorganisms and thus reduce the susceptibility of disease-causing microorganisms to antibiotics in medical treatment. A high-throughput sequencing (HTS)-based metagenomic approach was used in the present study to investigate the variations of ARGs in full-scale biogas reactors and the correlations of ARGs with microbial communities and metal resistance genes (MRGs). The total abundance of ARGs in all the samples varied from 7 × 10 -3 to 1.08 × 10 -1 copy of ARG/copy of 16S-rRNA gene, and the samples obtained from thermophilic biogas reactors had a lower total abundance of ARGs, indicating the superiority of thermophilic anaerobic digestion for ARGs removal. ARGs in all the samples were composed of 175 ARG subtypes; however, only 7 ARG subtypes were shared by all the samples. Principal component analysis and canonical correspondence analysis clustered the samples into three groups (samples from manure-based mesophilic reactors, manure-based thermophilic reactors, and sludge-based mesophilic reactors), and substrate, temperature, and hydraulic retention time (HRT) as well as volatile fatty acids (VFAs) were identified as crucial environmental variables affecting the ARGs compositions. Procrustes analysis revealed microbial community composition was the determinant of ARGs composition in biogas reactors, and there was also a significant correlation between ARGs composition and MRGs composition. Network analysis further revealed the co-occurrence of ARGs with specific microorganisms and MRGs.

  18. Antiseptics: a forgotten weapon in the control of antibiotic resistant bacteria in hospital and community settings?

    Science.gov (United States)

    Payne, D N; Gibson, S A; Lewis, R

    1998-02-01

    The aim of this study was to ascertain the activity of a selection of widely-used antiseptic/disinfectant agents against antibiotic resistant bacteria and strains isolated from patients infected with clinically significant species. Four antiseptic agents (Dettol, Dettol Hospital Concentrate, Savlon and Betadine) were tested against Staphylococcus aureus, Methicillin Resistant S. aureus (MRSA), Enterococcus hirae, Vancomicin Resistant Enterococcus sp (VRE), Escherichia coli and E. coli 0157. The antiseptics were applied at recommended use dilutions and at a half and a quarter of those concentrations in a standard suspension test (EST). Organic material was added to mimic the presence of blood, protein and other such contaminants to be found in the clinical situation. All antiseptics tested were effective against both the antibiotic sensitive and antibiotic resistant strains of S. aureus and E. hirae as well as normal and clinical strains of E. coli at recommended concentrations. All but Betadine were also effective against the antibiotic resistant bacteria at a half and a quarter of normal concentration. The iodine containing antiseptic, however, failed the test against MRSA at a half normal concentration and showed virtually no activity against MRSA at a quarter normal concentration.

  19. Child-responsive Accountability: Lessons from social accountability

    OpenAIRE

    Lena Thu Phuong Nguyen

    2013-01-01

    This paper links the concept and practice of accountability with child rights, by asking: (1) What accountability means when children are the rights holders, and whose role is it to exact that accountability? (2) What are the assumptions underpinning social accountability, and how can they be revised from the child-rights perspective? (3) How do social and political dynamics at community and national levels, often not linked to child rights issues, shape accountability outcomes? The paper is ...

  20. Stepwise impact of urban wastewater treatment on the bacterial community structure, antibiotic contents, and prevalence of antimicrobial resistance.

    Science.gov (United States)

    Wang, Mingyu; Shen, Weitao; Yan, Lei; Wang, Xin-Hua; Xu, Hai

    2017-12-01

    Bacteria, antibiotics, and antibiotic resistance determinants are key biological pollutants in aquatic systems, which may lead to bacterial infections or prevent the cure of bacterial infections. In this study, we investigated how the wastewater treatment processes in wastewater treatment plants (WWTPs) affect these pollutants. We found that the addition of oxygen, polyaluminum chloride (PAC), and polyacrylamide (PAM), as well as ultraviolet (UV) disinfection could significantly alter the bacterial communities in the water samples. An overall shift from Gram-negative bacteria to Gram-positive bacteria was observed throughout the wastewater treatment steps, but the overall bacterial biomass was not reduced in the WWTP samples. The antibiotic contents were reduced by the WWTP, but the size of the reduction and the step when antibiotic degradation occurred differed among antibiotics. Ciprofloxacin, sulfamethoxazole and erythromycin could be removed completely by the WWTP, whereas cephalexin could not. The removal of ciprofloxacin, cephalexin, and erythromycin occurred in the anaerobic digester, whereas the removal of sulfamethoxazole occurred after the addition of PAC and PAM, and UV disinfection. Antimicrobial resistance determinants were highly prevalent in all of the samples analyzed, except for those targeting vancomycin and colistin. However, wastewater treatment was ineffective at removing antimicrobial resistance determinants from wastewater. There were strong correlations between intI1, floR, sul1, and ermB, thereby suggesting the importance of integrons for the spread of these antimicrobial resistance genes. In general, this study comprised a stepwise analysis of the impact of WWTPs on three biological pollutants: bacteria, antibiotics, and antimicrobial resistance determinants, where our results suggest that the design of WWTPs needs to be improved to address the threats due to these pollutants. Copyright © 2017 Elsevier Ltd. All rights reserved.

  1. Antibiotic resistance profile of Pseudomonas aeruginosa isolated from aquaculture and abattoir environments in urban communities

    Directory of Open Access Journals (Sweden)

    Isoken Henrietta Igbinosa

    2017-01-01

    Full Text Available Objective: To characterize multiple antibiotic resistance profile of Pseudomonas aeruginosa from aquaculture and abattoir environments. Methods: Wastewater samples were obtained from the abattoir and aquaculture environments between May 2016 and July 2016 and analysed using standard phenotypic, biochemical and PCR-based methods. Results: The mean pseudomonads count ranged from (4 × 102 ± 1.01 to (2 × 104 ± 0.10 colony-forming unit/mL in the aquaculture environment and (3 × 103 ± 0.00 to (1 × 105 ± 1.00 colony-forming unit/mL in the abattoir environment. A total of 96 isolates of Pseudomonas aeruginosa confirmed by PCR were thereafter selected from both aquaculture and abattoir environments and further characterized for their antimicrobial susceptibility profile by adopting the disc diffusion method. High level of resistance was observed against the aminoglycosides [gentamycin 64/96 (66.67% and kanamycin 52/96 (54.17%], monobactams [aztreonam 76/96 (79.17%], carbapenems [meropenem 52/96 (54.17%], tetracyclines [tetracycline 72/96 (75.00%] and cephems [ceftazidime 72/96 (75.00% and cefuroxime 48/96 (50.00%]. Multiple antibiotic resistant index of the respective isolates ranged from 0.4 to 0.8 while multidrug resistant profile of the isolates revealed that 28 of the respective isolates were resistant to ceftazidime, cefuroxime, gentamycin, kanamycin, aztreonam which belongs to cephems, aminoglycosides and monobactam class of antimicrobials. Conclusions: Findings from the present study therefore underscores the need for effective monitoring of the abattoir and aquaculture environments as they could be the significant source for spreading antibiotic resistant bacteria within the environment.

  2. Antibiotic Resistance in an Indian Rural Community: A 'One-Health' Observational Study on Commensal Coliform from Humans, Animals, and Water.

    Science.gov (United States)

    Purohit, Manju Raj; Chandran, Salesh; Shah, Harshada; Diwan, Vishal; Tamhankar, Ashok J; Stålsby Lundborg, Cecilia

    2017-04-06

    Antibiotic-resistant bacteria are an escalating grim menace to global public health. Our aim is to phenotype and genotype antibiotic-resistant commensal Escherichia coli (E. coli) from humans, animals, and water from the same community with a 'one-health' approach. The samples were collected from a village belonging to demographic surveillance site of Ruxmaniben Deepchand (R.D.) Gardi Medical College Ujjain, Central India. Commensal coliforms from stool samples from children aged 1-3 years and their environment (animals, drinking water from children's households, common source- and waste-water) were studied for antibiotic susceptibility and plasmid-encoded resistance genes. E. coli isolates from human ( n = 127), animal ( n = 21), waste- ( n = 12), source- ( n = 10), and household drinking water ( n = 122) carried 70%, 29%, 41%, 30%, and 30% multi-drug resistance, respectively. Extended spectrum beta-lactamase (ESBL) producers were 57% in human and 23% in environmental isolates. Co-resistance was frequent in penicillin, cephalosporin, and quinolone. Antibiotic-resistance genes bla CTX-M-9 and qnrS were most frequent. Group D-type isolates with resistance genes were mainly from humans and wastewater. Colistin resistance, or the mcr-1 gene, was not detected. The frequency of resistance, co-resistance, and resistant genes are high and similar in coliforms from humans and their environment. This emphasizes the need to mitigate antibiotic resistance with a 'one-health' approach.

  3. Antibiotic Resistance in an Indian Rural Community: A ‘One-Health’ Observational Study on Commensal Coliform from Humans, Animals, and Water

    Science.gov (United States)

    Purohit, Manju Raj; Chandran, Salesh; Shah, Harshada; Diwan, Vishal; Tamhankar, Ashok J.; Stålsby Lundborg, Cecilia

    2017-01-01

    Antibiotic-resistant bacteria are an escalating grim menace to global public health. Our aim is to phenotype and genotype antibiotic-resistant commensal Escherichia coli (E. coli) from humans, animals, and water from the same community with a ‘one-health’ approach. The samples were collected from a village belonging to demographic surveillance site of Ruxmaniben Deepchand (R.D.) Gardi Medical College Ujjain, Central India. Commensal coliforms from stool samples from children aged 1–3 years and their environment (animals, drinking water from children's households, common source- and waste-water) were studied for antibiotic susceptibility and plasmid-encoded resistance genes. E. coli isolates from human (n = 127), animal (n = 21), waste- (n = 12), source- (n = 10), and household drinking water (n = 122) carried 70%, 29%, 41%, 30%, and 30% multi-drug resistance, respectively. Extended spectrum beta-lactamase (ESBL) producers were 57% in human and 23% in environmental isolates. Co-resistance was frequent in penicillin, cephalosporin, and quinolone. Antibiotic-resistance genes blaCTX-M-9 and qnrS were most frequent. Group D-type isolates with resistance genes were mainly from humans and wastewater. Colistin resistance, or the mcr-1 gene, was not detected. The frequency of resistance, co-resistance, and resistant genes are high and similar in coliforms from humans and their environment. This emphasizes the need to mitigate antibiotic resistance with a ‘one-health’ approach. PMID:28383517

  4. ‘Intellectual Acid’:Cultural Resistance, Cultural Citizenship, and Emotional (CounterCommunity in the Freewoman

    Directory of Open Access Journals (Sweden)

    M. Sage Milo

    2017-06-01

    Full Text Available This article explores the Freewoman’s relation to culture, as well as its role as a countercultural periodical — one that resisted hegemonic ideas and styles — and in the creation of an emotional (countercommunity. It follows Raymond Williams’s understanding of culture as having two senses: one is ‘a whole way of life’ — everyday practices — the other arts and other creative endeavours. The Freewoman was cultivating a view of feminism as a way of life that encompassed both these meanings, as its editor, Dora Marsden, encouraged the expression of both traditional and novel perspectives, working to connect everyday life to a vision of a feminist, perhaps utopian, future. My focus here is on three main ideas of culture and community under Williams’s general framework of ‘culture’: cultural resistance and counterculture, cultural citizenship, and emotional countercommunity. These aspects of the Freewoman were central to its feminist politics, and I offer that attention to emotions and emotional communities can enrich our understanding of periodicals and their political workings.

  5. Effects of chlortetracycline and copper on tetracyclines and copper resistance genes and microbial community during swine manure anaerobic digestion.

    Science.gov (United States)

    Wang, Rui; Chen, Meixue; Feng, Feng; Zhang, Junya; Sui, Qianwen; Tong, Juan; Wei, Yuansong; Wei, Dongbin

    2017-08-01

    As antibiotic and heavy metals are over used in the livestock industry, animal manure is a reservoir of antibiotic resistance genes (ARGs). Anaerobic digestion has been reported to have the potential to reduce ARGs. However, few studies investigated whether reduction of ARGs would be affected by different external pressures including antibiotics and heavy metals during anaerobic digestion. The purpose of this study was thus to investigate effects of both chlortetracycline (CTC) and Cu on reduction of ARGs, heavy metal resistance genes (HMRGs) and mobile genetic elements (MGEs) during the swine manure anaerobic digestion. The results showed that the predominant ARGs (tetO, tetW, tetX, tetL) could be effectively reduced (approximately 1.00 log copies/g TS) through mesophilic anaerobic digestion. Microbial community evolution was the main driver. It was interesting that Treponema might indicate the termination of anaerobic digestion and compete with ARGs host bacteria. Addition of CTC, Cu and CTC+Cu affected microbial community change and hindered removal of ARGs, especially, CTC+Cu seriously affected Treponema and ARGs during anaerobic digestion. Copyright © 2017 Elsevier Ltd. All rights reserved.

  6. Methicillin-Resistant Staphylococcus aureus in the Community in Luanda, Angola: Blurred Boundaries with the Hospital Setting.

    Science.gov (United States)

    Conceição, Teresa; Coelho, Céline; Santos Silva, Isabel; de Lencastre, Hermínia; Aires-de-Sousa, Marta

    2016-01-01

    Although the nosocomial prevalence of methicillin-resistant Staphylococcus aureus (MRSA) in Angola is over 60% and one of the highest in Africa, the extent of MRSA in the community is unknown. To fill this gap, we conducted a hospital-based study in which 158 children attending the emergency ward and ambulatory services of a pediatric hospital in Luanda, the capital of Angola, were screened for S. aureus nasal colonization. Overall, 70 (44.3%) individuals were colonized with S. aureus, of which 20 (28.6%) carried MRSA, resulting in a prevalence of 12.7% (20/158) of MRSA in the population screened. Molecular characterization by pulsed-field gel electrophoresis (PFGE), spa typing, multilocus sequence typing, and SCCmec typing distributed the isolates into two major MRSA clones and one dominant methicillin-susceptible S. aureus (MSSA) lineage, corresponding to the main clones circulating in hospitals in Luanda. The MRSA isolates mainly belonged to clones A (PFGE type A, spa type t105, ST5-IVa-65%) and B (PFGE B, t3869, ST88-IVa-30%), while MSSA isolates mainly belonged to clone L (PFGE type L, t861, ST508-42%). S. aureus isolates showed resistance to penicillin (96%), rifampin (87%), and trimethoprim-sulfamethoxazole (21%). In conclusion, the prevalence of MRSA among children in the community in Luanda is high and seems to originate from hospitals, warranting continuous monitoring and implementation of additional infection control measures.

  7. Diversity and community composition of tributyltin-resistant bacteria under different conditions

    International Nuclear Information System (INIS)

    Lee, Y. H.; Park, S.; Park, H.; Choi, Y

    2009-01-01

    Tributyltin (TBT) is an organometallic compound used as anti fouling agent in marine paints. this compound is toxic not only for eukaryotes, but also for bacteria. Based on the literature review, a few researchers have reported evidence for the presence of TBT-resistant bacteria in natural seawater and marine sediment. (Author)

  8. Love and Resistance of Mothers with Intellectual Disability from Ethnocultural Communities in Canada

    Science.gov (United States)

    Pacheco, Laura; McConnell, David

    2017-01-01

    Background: Mothers with intellectual disability are thought to be passive, dependent and in need of protection. This study contributes to a nascent body of research that challenges this schema, revealing how women with intellectual disability who are mothers resist oppression. Methods: Narrative research methods underpinned by intersectionality…

  9. Antibiotic usage and resistance in different regions of the Dutch community

    NARCIS (Netherlands)

    Bruinsma, N; Filius, PMG; De Smet, PAGM; Degener, J; Endtz, P; Van den Bogaard, AE; Stobberingh, EE

    2002-01-01

    Regional differences of antibiotic use and antibiotic resistance in the fecal indicator bacteria Escherichia coli and enterococci were determined in different cities in the south, west, and north of The Netherlands. In 1999, differences in antibiotic consumption were observed between the different

  10. Antibiotic usage and resistance in different regions of the Dutch community.

    NARCIS (Netherlands)

    Bruinsma, N.; Filius, P.M.; Smet, P.A.G.M. de; Degener, J.E.; Endtz, P.; Bogaard, A.E. van den; Stobberingh, E.E.

    2002-01-01

    Regional differences of antibiotic use and antibiotic resistance in the fecal indicator bacteria Escherichia coli and enterococci were determined in different cities in the south, west, and north of The Netherlands. In 1999, differences in antibiotic consumption were observed between the different

  11. Is fasting leptin associated with insulin resistance among nondiabetic individuals? The Miami Community Health Study

    DEFF Research Database (Denmark)

    Donahue, R P; Prineas, R J; Donahue, R D

    1999-01-01

    Whether serum leptin levels are associated with insulin resistance independent of the effects of hyperinsulinemia and adiposity is an important unanswered question. We examined the relationship between the rate of insulin-mediated glucose uptake and serum leptin concentrations among nondiabetic m...

  12. Hospitalization, a risk factor for antibiotic-resistant Escherichia coli in the community?

    NARCIS (Netherlands)

    Bruinsma, N; Filius, PMG; van den Bogaard, AE; Nys, S; Degener, J; Endtz, HP; Stobberingh, EE

    Objective: The impact of hospitalization on the prevalence of resistant Escherichia coli in the intestinal flora of patients admitted to the surgical wards of three Dutch university-affiliated hospitals was analysed prospectively. Methods: Faecal samples were obtained on admission to the hospital,

  13. Is fasting leptin associated with insulin resistance among nondiabetic individuals? The Miami Community Health Study

    DEFF Research Database (Denmark)

    Donahue, R P; Prineas, R J; Donahue, R D

    1999-01-01

    Whether serum leptin levels are associated with insulin resistance independent of the effects of hyperinsulinemia and adiposity is an important unanswered question. We examined the relationship between the rate of insulin-mediated glucose uptake and serum leptin concentrations among nondiabetic men...

  14. Clinical and Molecular Characterization of Community-Onset Urinary Tract Infections Due to Extended-Spectrum Cephalosporin-Resistant Enterobacteriaceae.

    Science.gov (United States)

    Anesi, Judith A; Lautenbach, Ebbing; Nachamkin, Irving; Garrigan, Charles; Bilker, Warren B; Wheeler, Mary; Tolomeo, Pam; Han, Jennifer H

    2016-12-01

    OBJECTIVE To evaluate risk factors for and molecular characteristics of community-onset extended-spectrum cephalosporin-resistant (ESC-R) Enterobacteriaceae (EB) urinary tract infections (UTIs) in a US health system. DESIGN Case-control study. PARTICIPANTS All patients presenting to the emergency department or outpatient practices with EB UTIs from December 21, 2010, through April 22, 2013, were included. Case patients had ESC-R EB UTIs. Control patients had ESC-susceptible EB UTIs and were matched 1:1 on study year. METHODS Risk factors for ESC-R EB UTI were assessed using multivariable conditional logistic regression. A subset of case isolates was evaluated for extended-spectrum beta-lactamases. RESULTS A total of 302 patients with community-onset EB UTI were included, of which 151 were cases. On multivariable analysis, risk factors for ESC-R EB UTI included trimethoprim-sulfamethoxazole use in the prior 6 months (odds ratio, 2.40 [95% CI, 1.22-4.70]; P=.01), older age (1.03 [1.01-1.04]; Pspectrum beta-lactamases among 120 case isolates was 52% CTX-M, 29% TEM, 20% OXA, and 13% SHV. The prevalence of AmpC was 25%. Pulsed-field gel electrophoresis of the CTX-M Escherichia coli isolates showed no distinct clusters. CONCLUSIONS Use of trimethoprim-sulfamethoxazole, older age, diabetes, and presentation to the emergency department were associated with community-onset ESC-R EB UTI. There was a high prevalence of CTX-M among our community isolates. Further studies are needed to determine strategies to limit emergence of these organisms in the community. Infect Control Hosp Epidemiol 2016;1433-1439.

  15. Clonal Diversity, Virulence Potential and Antimicrobial Resistance ofEscherichia coliCausing Community Acquired Urinary Tract Infection in Switzerland.

    Science.gov (United States)

    Nüesch-Inderbinen, Magdalena T; Baschera, Melinda; Zurfluh, Katrin; Hächler, Herbert; Nüesch, Hansjakob; Stephan, Roger

    2017-01-01

    Objectives: The aim of this study was to assess the clonal structure, virulence potential and antibiotic susceptibility of uropathogenic Escherichia coli (UPEC) isolates causing community acquired urinary tract infection (CAUTI) in unselected primary care patients in Switzerland. Methods: We performed multilocus sequence typing, virulence factor determination, and phenotypic and genotypic antimicrobial resistance testing on 44 non-duplicate UPEC isolates. Results: Twenty-seven different sequence types (STs) were identified. Major UPEC clones were represented by 19 (43.2%) of the isolates, including E. coli ST131, ST69 (both 13.6%), ST73 (6.8%), ST10 (4.5%), ST127, ST140, (both 2.3%). Five (11.4%) isolates belonged to ST141. Aggregate virulence factor (VF) scores were highest among isolates belonging to ST127 and ST141. Overall, 50% of the isolates were susceptible to all 12 antimicrobials tested, and all isolates remained susceptible to fosfomycin and nitrofurantoin. Resistance to sulfamethoxazole and ciprofloxacin were found in 31.8, and 15.9% of the isolates, respectively. Plasmid-mediated resistance genes were detected in ST69 and ST131 and included aac(6 ' )-Ib-cr (2.3% of all isolates) bla CTX-M-14 and bla CTX-M-15 (9%), and mph(A) (13.6%). None of the isolates tested positive for mcr-1 or mcr-2 . Conclusions: Our results show that CAUTI in Switzerland is caused by a wide variety of UPEC STs for which fosfomycin remains a good treatment option. We suggest that ST141 is an emerging clone associated with UTI in the community, and warrants closer attention. Moreover, the high rate of E. coli harboring mph(A) from patients without a history of antimicrobial therapy or hospitalization indicates that UPEC is an important reservoir for mph(A) .

  16. Clonal Diversity, Virulence Potential and Antimicrobial Resistance of Escherichia coli Causing Community Acquired Urinary Tract Infection in Switzerland

    Directory of Open Access Journals (Sweden)

    Magdalena T. Nüesch-Inderbinen

    2017-12-01

    Full Text Available Objectives: The aim of this study was to assess the clonal structure, virulence potential and antibiotic susceptibility of uropathogenic Escherichia coli (UPEC isolates causing community acquired urinary tract infection (CAUTI in unselected primary care patients in Switzerland.Methods: We performed multilocus sequence typing, virulence factor determination, and phenotypic and genotypic antimicrobial resistance testing on 44 non-duplicate UPEC isolates.Results: Twenty-seven different sequence types (STs were identified. Major UPEC clones were represented by 19 (43.2% of the isolates, including E. coli ST131, ST69 (both 13.6%, ST73 (6.8%, ST10 (4.5%, ST127, ST140, (both 2.3%. Five (11.4% isolates belonged to ST141.Aggregate virulence factor (VF scores were highest among isolates belonging to ST127 and ST141. Overall, 50% of the isolates were susceptible to all 12 antimicrobials tested, and all isolates remained susceptible to fosfomycin and nitrofurantoin. Resistance to sulfamethoxazole and ciprofloxacin were found in 31.8, and 15.9% of the isolates, respectively. Plasmid-mediated resistance genes were detected in ST69 and ST131 and included aac(6′-Ib-cr (2.3% of all isolates blaCTX−M−14 and blaCTX−M−15 (9%, and mph(A (13.6%. None of the isolates tested positive for mcr-1 or mcr-2.Conclusions: Our results show that CAUTI in Switzerland is caused by a wide variety of UPEC STs for which fosfomycin remains a good treatment option. We suggest that ST141 is an emerging clone associated with UTI in the community, and warrants closer attention. Moreover, the high rate of E. coli harboring mph(A from patients without a history of antimicrobial therapy or hospitalization indicates that UPEC is an important reservoir for mph(A.

  17. COMPARISON OF METHICILLIN RESISTANT STAPHYLOCOCCUS AUREUS IN HEALTHY COMMUNITY HOSPITAL VISITORS[CA-MRSA] AND HOSPITAL STAFF [HA-MRSA

    Directory of Open Access Journals (Sweden)

    Nirmal A Pathare

    2015-10-01

    Full Text Available Background: The prevalence of community associated methicillin resistant Staphylococcus aureus [CA-MRSA] in unknown in Oman. Methods: Nasal and cell phones swabs were collected from hospital visitors and health-care workers on sterile polyester swabs and directly inoculated onto a mannitol salt agar containing oxacillin, allowing growth of methicillin-resistant microorganisms. Antibiotic susceptibility tests were performed using Kirby Bauer’s disc diffusion method on the isolates. A brief survey questionnaire was requested be filled to ascertain the exposure to known risk factors for CA-MRSA carriage. Results: Overall, nasal colonization with CA-MRSA was seen in 34 individuals (18%, 95% confidence interval [CI] =12.5%-23.5%, whereas, CA-MRSA was additionally isolated from the cell phone surface in 12 participants (6.3%, 95% CI =5.6%-6.98%. Nasal colonization prevalence with HA-MRSA was seen in 16 individuals (13.8%, 95% confidence interval [CI] =7.5%-20.06%, whereas, HA-MRSA was additionally isolated from the cell phone surface in 3 participants (2.6%, 95% CI =1.7-4.54.  Antibiotic sensitivity was 100% to linezolid and rifampicin in the CA-MRSA isolates. Antibiotic resistance to vancomycin and clindamycin varied between 9-11 % in the CA-MRSA isolates.  There was no statistically significant correlation between CA-MRSA nasal carriage and the risk factors (P>0.05, Chi-square test. Conclusions: The prevalence of CA-MRSA in the healthy community hospital visitors was 18 % (95% CI, 12.5% to 23.5% as compared to 13.8% [HA-MRSA] in the hospital health-care staff. In spite of a significant prevalence of CA-MRSA, these strains were mostly sensitive. Recommendation the universal techniques of hand washing, personal hygiene and sanitation are thus warranted.

  18. Performance of an electronic health record-based phenotype algorithm to identify community associated methicillin-resistant Staphylococcus aureus cases and controls for genetic association studies

    Directory of Open Access Journals (Sweden)

    Kathryn L. Jackson

    2016-11-01

    Full Text Available Abstract Background Community associated methicillin-resistant Staphylococcus aureus (CA-MRSA is one of the most common causes of skin and soft tissue infections in the United States, and a variety of genetic host factors are suspected to be risk factors for recurrent infection. Based on the CDC definition, we have developed and validated an electronic health record (EHR based CA-MRSA phenotype algorithm utilizing both structured and unstructured data. Methods The algorithm was validated at three eMERGE consortium sites, and positive predictive value, negative predictive value and sensitivity, were calculated. The algorithm was then run and data collected across seven total sites. The resulting data was used in GWAS analysis. Results Across seven sites, the CA-MRSA phenotype algorithm identified a total of 349 cases and 7761 controls among the genotyped European and African American biobank populations. PPV ranged from 68 to 100% for cases and 96 to 100% for controls; sensitivity ranged from 94 to 100% for cases and 75 to 100% for controls. Frequency of cases in the populations varied widely by site. There were no plausible GWAS-significant (p < 5 E −8 findings. Conclusions Differences in EHR data representation and screening patterns across sites may have affected identification of cases and controls and accounted for varying frequencies across sites. Future work identifying these patterns is necessary.

  19. Community.

    Science.gov (United States)

    Grauer, Kit, Ed.

    1995-01-01

    Art in context of community is the theme of this newsletter. The theme is introduced in an editorial "Community-Enlarging the Definition" (Kit Grauer). Related articles include: (1) "The Children's Bridge is not Destroyed: Heart in the Middle of the World" (Emil Robert Tanay); (2) "Making Bridges: The Sock Doll…

  20. Fate of antibiotic resistance genes and their associations with bacterial community in livestock breeding wastewater and its receiving river water.

    Science.gov (United States)

    Jia, Shuyu; Zhang, Xu-Xiang; Miao, Yu; Zhao, Yanting; Ye, Lin; Li, Bing; Zhang, Tong

    2017-11-01

    Large amounts of antibiotics are currently used in livestock breeding, which is the main driving factor contributing to the occurrence, spread and proliferation of antibiotic resistant bacteria (ARB) and antibiotic resistance genes (ARGs) in the environment. In this study, high-throughput sequencing based metagenomic approaches were employed to characterize the tempo-spacial changes of antibiotic resistome, bacterial community and their correlations in pig farming wastewater and its receiving river. A total of 194 ARG subtypes within 14 ARG types were detectable in all the samples, and their total relative abundance increased in the river water after receiving wastewater discharge, while decreased in the downstream river water. Network analysis showed that 25.26% ARGs within the same type or among the different types showed higher incidences of non-random co-occurrence. The wastewater discharge evidently increased bacterial diversity and induced bacterial community shift in the receiving river water. The genera of Treponema, Prevotella, Pseudomonas, Bacteroides, Oscillibacter and Acholeplasma dominated in the wastewater samples and almost disappeared in the receiving river water, but bacterial pathogens Clostridium difficile and Arcobacter butzleri still occurred in the receiving water. Correlation analysis and host analysis consistently showed that the changes in the abundances of several key genera like Prevotella and Treponema were significantly and positively correlated with the antibiotic resistome alteration. Variation partitioning analysis indicated that bacterial community played a more important role in the resistome alteration than mobile genetic elements. This study may help to understand the correlations among antibiotic resistome, microbiota and environmental conditions in the wastewater-receiving river water. Copyright © 2017 Elsevier Ltd. All rights reserved.

  1. Emergence of Community-Genotype Methicillin-Resistant Staphylococcus aureus in Korean Hospitals: Clinical Characteristics of Nosocomial Infections by Community-Genotype Strain

    Science.gov (United States)

    Kim, So Hyun; Baek, Jin Yang; Lee, Nam Yong; Cho, Sun Young; Ha, Young Eun; Kang, Cheol-In; Peck, Kyong Ran; Song, Jae-Hoon

    2017-01-01

    Background As community-genotype methicillin-resistant Staphylococcus aureus (MRSA) strains spread into hospitals, the genotypes of the MRSA strains causing hospital-acquired (HA) infections have become more diverse. We describe clinical characteristics of nosocomial MRSA infections by a community-genotype of sequence type (ST) 72. Materials and Methods A case-control study was designed among patients with HA-MRSA infections. Forty patients with infections caused by ST72-MRSA SCCmec type IV were selected as cases. Cases were matched to the controls with 106 patients infected with ST5/ST239 MRSA, which are representative hospital genotypes in Korea. Results Patients infected with ST72 isolates were younger than those with ST5/ST239 isolates. Female gender predominated among ST72 MRSA group compared to ST5/ST239 MRSA group. Solid tumor was a more frequent underlying disease in MRSA infections by ST72 isolates, whereas underlying renal, lung, heart, and neurologic diseases were more frequently found in those by ST5/ST239 isolates. The most common type of infection was pneumonia in both ST72 and ST5/ST239 groups (45.0% vs. 51.9%), followed by skin and soft tissue infection (SSTI). Female gender and underlying solid tumor were identified to be independent predictors for MRSA infections by ST72 isolates. All-cause mortality rates (20.0% vs. 30.2%) were not different between the groups. Conclusion A community-genotype MRSA, ST72 isolate has emerged as a nosocomial pathogen presenting as hospital-acquired pneumonia and SSTI. Although differences in underlying disorders were found, the distribution of infection type and mortality rate did not differ between the groups. PMID:28608660

  2. Community-onset Escherichia coli infection resistant to expanded-spectrum cephalosporins in low-prevalence countries.

    Science.gov (United States)

    Rogers, Benjamin A; Ingram, Paul R; Runnegar, Naomi; Pitman, Matthew C; Freeman, Joshua T; Athan, Eugene; Havers, Sally M; Sidjabat, Hanna E; Jones, Mark; Gunning, Earleen; De Almeida, Mary; Styles, Kaylene; Paterson, David L

    2014-01-01

    By global standards, the prevalence of community-onset expanded-spectrum-cephalosporin-resistant (ESC-R) Escherichia coli remains low in Australia and New Zealand. Of concern, our countries are in a unique position, with high extramural resistance pressure from close population and trade links to Asia-Pacific neighbors with high ESC-R E. coli rates. We aimed to characterize the risks and dynamics of community-onset ESC-R E. coli infection in our low-prevalence region. A case-control methodology was used. Patients with ESC-R E. coli or ESC-susceptible E. coli isolated from blood or urine were recruited at six geographically dispersed tertiary care hospitals in Australia and New Zealand. Epidemiological data were prospectively collected, and bacteria were retained for analysis. In total, 182 patients (91 cases and 91 controls) were recruited. Multivariate logistic regression identified risk factors for ESC-R among E. coli strains, including birth on the Indian subcontinent (odds ratio [OR]=11.13, 95% confidence interval [95% CI]=2.17 to 56.98, P=0.003), urinary tract infection in the past year (per-infection OR=1.430, 95% CI=1.13 to 1.82, P=0.003), travel to southeast Asia, China, the Indian subcontinent, Africa, and the Middle East (OR=3.089, 95% CI=1.29 to 7.38, P=0.011), prior exposure to trimethoprim with or without sulfamethoxazole and with or without an expanded-spectrum cephalosporin (OR=3.665, 95% CI=1.30 to 10.35, P=0.014), and health care exposure in the previous 6 months (OR=3.16, 95% CI=1.54 to 6.46, P=0.02). Among our ESC-R E. coli strains, the blaCTX-M ESBLs were dominant (83% of ESC-R E. coli strains), and the worldwide pandemic ST-131 clone was frequent (45% of ESC-R E. coli strains). In our low-prevalence setting, ESC-R among community-onset E. coli strains may be associated with both "export" from health care facilities into the community and direct "import" into the community from high-prevalence regions.

  3. Prevalence of antibiotic resistance genes in bacterial communities associated with Cladophora glomerata mats along the nearshore of Lake Ontario.

    Science.gov (United States)

    Ibsen, Michael; Fernando, Dinesh M; Kumar, Ayush; Kirkwood, Andrea E

    2017-05-01

    The alga Cladophora glomerata can erupt in nuisance blooms throughout the lower Great Lakes. Since bacterial abundance increases with the emergence and decay of Cladophora, we investigated the prevalence of antibiotic resistance (ABR) in Cladophora-associated bacterial communities up-gradient and down-gradient from a large sewage treatment plant (STP) on Lake Ontario. Although STPs are well-known sources of ABR, we also expected detectable ABR from up-gradient wetland communities, since they receive surface run-off from urban and agricultural sources. Statistically significant differences in aquatic bacterial abundance and ABR were found between down-gradient beach samples and up-gradient coastal wetland samples (ANOVA, Holm-Sidak test, p bacterial densities overall, including on ampicillin- and vancomycin-treated plates. However, quantitative polymerase chain reaction analysis of the ABR genes ampC, tetA, tetB, and vanA from environmental communities showed a different pattern. Some of the highest ABR gene levels occurred at the 2 coastal wetland sites (vanA). Overall, bacterial ABR profiles from environmental samples were distinguishable between living and decaying Cladophora, inferring that Cladophora may control bacterial ABR depending on its life-cycle stage. Our results also show how spatially and temporally dynamic ABR is in nearshore aquatic bacteria, which warrants further research.

  4. Clinical significance of methicillin-resistant Staphylococcus aureus colonization in residents in community long-term-care facilities in Spain.

    Science.gov (United States)

    Manzur, A; De Gopegui, E Ruiz; Dominguez, M; Mariscal, D; Gavalda, L; Perez, J L; Segura, F; Pujol, M

    2012-03-01

    Methicillin-resistant Staphylococcus aureus (MRSA) is highly prevalent in Spanish hospitals and community long-term-care facilities (LTCFs). This longitudinal study was performed in community LTCFs to determine whether MRSA colonization is associated with MRSA infections and overall mortality. Nasal and decubitus ulcer cultures were performed every 6 months for an 18-month period on 178 MRSA-colonized residents (86 490 patient-days) and 196 non-MRSA carriers (97 470 patient-days). Fourteen residents developed MRSA infections and 10 of these were skin and soft tissue infections. Two patients with respiratory infections required hospitalization. The incidence rate of MRSA infection was 0·12/1000 patient-days in MRSA carriers and 0·05/1000 patient-days in non-carriers (P=0·46). No difference in MRSA infection rate was found according to the duration of MRSA colonization (P=0·69). The mortality rate was 20·8% in colonized residents and 16·8% in non-carriers; four residents with MRSA infection died. Overall mortality was statistically similar in both cohorts. Our results suggest that despite a high prevalence of MRSA colonization in LTCFs, MRSA infections are neither frequent nor severe while colonized residents remain at the facility. The epidemiological impact of an MRSA reservoir is more relevant than the clinical impact of this colonization for an individual resident and supports current recommendations to control MRSA spread in community LTCFs.

  5. Trend and seasonality of community-acquired Escherichia coli antimicrobial resistance and its dynamic relationship with antimicrobial use assessed by ARIMA models.

    Science.gov (United States)

    Asencio Egea, María Ángeles; Huertas Vaquero, María; Carranza González, Rafael; Herráez Carrera, Óscar; Redondo González, Olga; Arias Arias, Ángel

    2017-12-04

    We studied the trend and seasonality of community-acquired Escherichia coli resistance and quantified its correlation with the previous use of certain antibiotics. A time series study of resistant community-acquired E. coli isolates and their association with antibiotic use was conducted in a Primary Health Care Area from 2008 to 2012. A Poisson regression model was constructed to estimate the trend and seasonality of E. coli resistance. A significant increasing trend in mean E. coli resistance to cephalosporins, aminoglycosides and nitrofurantoin was observed. Seasonal resistance to ciprofloxacin and amoxicillin-clavulanic acid was significantly higher in autumn-winter. There was a delay of 7, 10 and 12 months between the use of cotrimoxazole (P<0.038), fosfomycin (P<0.024) and amoxicillin-clavulanic acid (P<0.015), respectively, and the occurrence of E. coli resistance. An average delay of 10 months between the previous use of amoxicillin-clavulanic acid, cotrimoxazole and fosfomycin and the appearance of resistant community-acquired E. coli strains was detected. Copyright © 2017 Elsevier España, S.L.U. and Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. All rights reserved.

  6. Fire and grazing influence site resistance to Bromus tectorum through their effects on shrub, bunchgrass and biocrust communities in the Great Basin (USA)

    Science.gov (United States)

    Condon, Lea A.; Pyke, David A.

    2018-01-01

    Shrubs, bunchgrasses and biological soil crusts (biocrusts) are believed to contribute to site resistance to plant invasions in the presence of cattle grazing. Although fire is a concomitant disturbance with grazing, little is known regarding their combined impacts on invasion resistance. We are the first to date to test the idea that biotic communities mediate the effects of disturbance on site resistance. We assessed cover of Bromus tectorum, shrubs, native bunchgrasses, lichens and mosses in 99 burned and unburned plots located on similar soils where fires occurred between 12 and 23 years before sampling. Structural equation modeling was used to test hypothesized relationships between environmental and disturbance characteristics, the biotic community and resistance to B. tectorum cover. Characteristics of fire and grazing did not directly relate to cover of B. tectorum. Relationships were mediated through shrub, bunchgrass and biocrust communities. Increased site resistance following fire was associated with higher bunchgrass cover and recovery of bunchgrasses and mosses with time since fire. Evidence of grazing was more pronounced on burned sites and was positively correlated with the cover of B. tectorum, indicating an interaction between fire and grazing that decreases site resistance. Lichen cover showed a weak, negative relationship with cover of B. tectorum. Fire reduced near-term site resistance to B. tectorum on actively grazed rangelands. Independent of fire, grazing impacts resulted in reduced site resistance to B. tectorum, suggesting that grazing management that enhances plant and biocrust communities will also enhance site resistance.

  7. Bacterial communities differ among Drosophila melanogaster populations and affect host resistance against parasitoids

    NARCIS (Netherlands)

    Chaplinska, Mariia; Gerritsma, Sylvia; Dini-Andreote, Francisco; Falcao Salles, Joana; Wertheim, Bregje

    2016-01-01

    In Drosophila, diet is considered a prominent factor shaping the associated bacterial community. However, the host population background (e.g. genotype, geographical origin and founder effects) is a factor that may also exert a significant influence and is often overlooked. To test for population

  8. From rainforest to oil palm plantations: Shifts in predator population and prey communities, but resistant interactions

    Directory of Open Access Journals (Sweden)

    Oliver Konopik

    2014-12-01

    Full Text Available Anthropogenic habitat change can dramatically alter biotic communities in tropical landscapes. Species that persist in human dominated landscapes are therefore likely to modify the way they interact. Although human impacts on community composition are relatively well studied, changes in species interactions are less well documented. Here we assess how logging of rainforest and conversion to oil palm plantations affects the populations of the ant-specialist giant river toad (Phrynoidis juxtaspera, and the availability and composition of its ant prey. We measured canopy cover as an estimate for the degree of disturbance and found that toad abundance decreased with increasing disturbance, and that retaining riparian vegetation should therefore help conserve this species. Both abundance and species richness of local ground-foraging ants increased with disturbance, and ant community composition was altered. Despite these changes, composition of ants consumed by toads was only weakly affected by habitat change, with the exception of the invasive yellow crazy ant (Anoplolepis gracilipes, which was positively selected in oil palm plantations. This suggests that predator–prey interactions can be mostly maintained with habitat disturbance despite shifts in the community composition of potential prey, and even that some predators are capable of exploiting new prey sources in novel ecosystems.

  9. Now Is the Moment: The State, Public Education, & Communities of Resistance in Oaxaca & Wisconsin

    Science.gov (United States)

    Hones, Donald

    2012-01-01

    This study draws from narrative research, wherein stories of individuals, groups, and communities are central to the interpretation. Through a process of interpretive interactionism, the author examined the groups and institutions involved in the ongoing conflict between the state and public education in Oaxaca, and then included comparisons and…

  10. Biofilm formation of methicillin-resistant coagulase negative staphylococci (MR-CoNS) isolated from community and hospital environments

    Science.gov (United States)

    Seng, Rathanin; Kitti, Thawatchai; Thummeepak, Rapee; Kongthai, Phattaraporn; Leungtongkam, Udomluk; Wannalerdsakun, Surat

    2017-01-01

    Methicillin-resistant coagulase negative staphylococci (MR-CoNS) are the major cause of infectious diseases because of their potential ability to form biofilm and colonize the community or hospital environments. This study was designed to investigate the biofilm producing ability, and the presence of mecA, icaAD, bap and fnbA genes in MR-CoNS isolates. The MR-CoNS used in this study were isolated from various samples of community environment and five wards of hospital environments, using mannitol salt agar (MSA) supplemented with 4 μg/ml of oxacillin. The specie level of Staphylococcus haemolyticus, Staphylococcus epidermidis, Staphylococcus hominis and Staphylococcus warneri was identified by specific primers of groESL (S. haemolyticus), rdr (S. epidermidis) and nuc (S. hominis and S. warneri). The remainder isolates were identified by tuf gene sequencing. Biofilm production was determined using Congo red agar (CRA) and Microtiter plate (MTP) assay. The mecA and biofilm associated genes (icaAD, fnbA and bap) were detected using PCR method. From the 558 samples from community and hospital environments, 292 MR-CoNS were isolated (41 from community environments, and 251 from hospital environments). S. haemolyticus (41.1%) and S. epidermidis (30.1%) were the predominant species in this study. Biofilm production was detected in 265 (90.7%) isolates by CRA, and 260 (88.6%) isolates were detected by MTP assay. The staphylococci isolates derived from hospital environments were more associated with biofilm production than the community-derived isolates. Overall, the icaAD and bap genes were detected in 74 (29.5%) and 14 (5.6%) of all isolates from hospital environments. When tested by MTP, the icaAD gene from hospital environment isolates was associated with biofilm biomass. No association was found between bap gene and biofilm formation. The MR-CoNS isolates obtained from community environments did not harbor the icaAD and bap genes. Conversely, fnbA gene presented in MR

  11. Biofilm formation of methicillin-resistant coagulase negative staphylococci (MR-CoNS) isolated from community and hospital environments.

    Science.gov (United States)

    Seng, Rathanin; Kitti, Thawatchai; Thummeepak, Rapee; Kongthai, Phattaraporn; Leungtongkam, Udomluk; Wannalerdsakun, Surat; Sitthisak, Sutthirat

    2017-01-01

    Methicillin-resistant coagulase negative staphylococci (MR-CoNS) are the major cause of infectious diseases because of their potential ability to form biofilm and colonize the community or hospital environments. This study was designed to investigate the biofilm producing ability, and the presence of mecA, icaAD, bap and fnbA genes in MR-CoNS isolates. The MR-CoNS used in this study were isolated from various samples of community environment and five wards of hospital environments, using mannitol salt agar (MSA) supplemented with 4 μg/ml of oxacillin. The specie level of Staphylococcus haemolyticus, Staphylococcus epidermidis, Staphylococcus hominis and Staphylococcus warneri was identified by specific primers of groESL (S. haemolyticus), rdr (S. epidermidis) and nuc (S. hominis and S. warneri). The remainder isolates were identified by tuf gene sequencing. Biofilm production was determined using Congo red agar (CRA) and Microtiter plate (MTP) assay. The mecA and biofilm associated genes (icaAD, fnbA and bap) were detected using PCR method. From the 558 samples from community and hospital environments, 292 MR-CoNS were isolated (41 from community environments, and 251 from hospital environments). S. haemolyticus (41.1%) and S. epidermidis (30.1%) were the predominant species in this study. Biofilm production was detected in 265 (90.7%) isolates by CRA, and 260 (88.6%) isolates were detected by MTP assay. The staphylococci isolates derived from hospital environments were more associated with biofilm production than the community-derived isolates. Overall, the icaAD and bap genes were detected in 74 (29.5%) and 14 (5.6%) of all isolates from hospital environments. When tested by MTP, the icaAD gene from hospital environment isolates was associated with biofilm biomass. No association was found between bap gene and biofilm formation. The MR-CoNS isolates obtained from community environments did not harbor the icaAD and bap genes. Conversely, fnbA gene presented in MR

  12. Genes homologous to glycopeptide resistance vanA are widespread in soil microbial communities

    DEFF Research Database (Denmark)

    Guardabassi, L.; Agersø, Yvonne

    2006-01-01

    The occurrence of D-Ala : D-Lac ligase genes homologous to glycopeptide resistance vanA was studied in samples of agricultural (n=9) and garden (n=3) soil by culture-independent methods. Cloning and sequencing of nested degenerate PCR products obtained from soil DNA revealed the occurrence of D......A in enterococci. Such sequences were recovered from all agricultural samples as well as from two garden samples with no history of organic fertilization. The results indicated that soil is a rich and assorted reservoir of genes closely related to those conferring glycopeptide resistance in clinical bacteria.......-Ala : D-Ala ligase genes unrelated to vanA. In order to enhance detection of vanA-homologous genes, a third PCR step was added using primers targeting vanA in soil Paenibacillus. Sequencing of 25 clones obtained by this method allowed recovery of 23 novel sequences having 86-100% identity with van...

  13. Nosocomial Infections in Intensive Care Unit: Pattern of Antibiotic-resistance in Iranian Community.

    Science.gov (United States)

    Esfahani, Bahram Nasr; Basiri, Rozita; Mirhosseini, Seyed Mohammad Mahdy; Moghim, Sharareh; Dolatkhah, Shahaboddin

    2017-01-01

    Bacterial infections are responsible for great number of mortality in Intensive Care Unit (ICU). Knowledge about prevalence of bacterial infections and their antibiotic-resistance pattern would be a great step for their treatment and management. Data about nosocomial infections in ICUs of Alzahra Hospital (referral hospital in Isfahan, center of Iran) were gathered during the years 2007-2010. A questionnaire was fulfilled for any specific patient with nosocomial infection containing demographic data of patient and also characteristics of the infection. Out of all patients, 707 individuals (65.6%) were male and 370 (34.4%) were female. Our data revealed that Pseudomonas aeruginosa (13.9%), Klebsiella (11%), and Escherichia coli (6.4%) were the most prevalent bacterial infections. The most common sites of nosocomial infections in the ICU were respiratory system (399 cases, 37%), urinary system (230 cases, 21.4%), and blood (102 cases, 9.5%). The antibiotic-resistance of each bacteria in ICU ward was assessed and data were categorized in a table. There were less documentary about bacterial cultures in the year 2007 when compared with the next years. We found some differences (such as bacterial prevalence in ICU wards which caused nosocomial infections) in our local prevalence of nosocomial infections and also in their resistance pattern compared to other centers. Knowing about our data will help physicians to administer the most suitable antibiotics for treatment of nosocomial infections in our area.

  14. Extended-spectrum cephalosporin-resistant Escherichia coli in community, specialized outpatient clinic and hospital settings in Switzerland.

    Science.gov (United States)

    Seiffert, Salome N; Hilty, Markus; Kronenberg, Andreas; Droz, Sara; Perreten, Vincent; Endimiani, Andrea

    2013-10-01

    Resistance to extended-spectrum cephalosporins (ESCs) in Escherichia coli can be due to the production of ESBLs, plasmid-mediated AmpCs (pAmpCs) or chromosomal AmpCs (cAmpCs). Information regarding type and prevalence of β-lactamases, clonal relations and plasmids associated with the bla genes for ESC-R E. coli (ESC-R-Ec) detected in Switzerland is lacking. Moreover, data focusing on patients referred to the specialized outpatient clinics (SOCs) are needed. We analysed 611 unique E. coli isolated during September-December 2011. ESC-R-Ec were studied with microarrays, PCR/DNA sequencing for blaESBLs, blapAmpCs, promoter region of blacAmpC, IS elements, plasmid incompatibility group, and also implementing transformation, aIEF, rep-PCR and MLST. The highest resistance rates were observed in the SOCs, whereas those in the hospital and community were lower (e.g. quinolone resistance of 22.6%, 17.2% and 9.0%, respectively; P = 0.003 for SOCs versus community). The prevalence of ESC-R-Ec in the three settings was 5.3% (n = 11), 7.8% (n = 22) and 5.7% (n = 7), respectively. Thirty isolates produced CTX-M ESBLs (14 were CTX-M-15), 5 produced CMY-2 pAmpC and 5 hyper-expressed cAmpCs due to promoter mutations. Fourteen isolates were of sequence type 131 (ST131; 10 with CTX-M-15). blaCTX-M and blaCMY-2 were associated with an intact or truncated ISEcp1 and were mainly carried by IncF, IncFII and IncI1plasmids. ST131 producing CTX-M-15 is the predominant clone. The prevalence of ESC-R-Ec (overall 6.5%) is low, but an unusual relatively high frequency of AmpC producers (25%) was noted. The presence of ESC-R-Ec in the SOCs and their potential ability to be exchanged between hospital and community should be taken into serious consideration.

  15. Effects of progressive resistance training on physical disability among older community-dwelling people with history of hip fracture.

    Science.gov (United States)

    Edgren, Johanna; Rantanen, Taina; Heinonen, Ari; Portegijs, Erja; Alén, Markku; Kiviranta, Ilkka; Kallinen, Mauri; Sipilä, Sarianna

    2012-04-01

    Hip fracture is a common trauma in older people, and often leads to decreased muscle strength and increased physical disability. This randomized controlled trial examined whether three months of progressive resistance training (PRT) can reduce physical disability among older people with a history of hip fracture. A population-based sample of 60-85-year-old community- dwelling persons, with hip fractures sustained on average three years earlier, were enrolled in the study. Of 78 people participating in laboratory assessments, those without contraindications for participation in resistance training were randomly assigned to a training group (TG, n=22) or a control group (CG, n=21). TG took part in resistance training for three months twice a week. Training focused on lower limb muscles. Disability was assessed by a validated questionnaire containing six questions on activities of daily living (ADL) and nine on instrumental activities of daily living (IADL). A sum score was calculated separately for both items. High scores indicated more difficulties. Group differences were analysed with the Mann-Whitney and Chi-square tests. The effects of PRT on disability were tested with the McNemar test and by covariance analysis (ANCOVA). TG and CG were comparable with respect to gender, age, chronic diseases, BMI, time since fracture, self-reported health, and level of physical activity at baseline. The ADL sum score in TG was 1.8 (2.0) at baseline and 1.1 (1.3) after follow-up; in CG values were 1.7 (1.8) and 1.5 (1.8) (ANCOVA p=0.034). IADL sum scores in TG were 3.9 (4.6) at baseline and 2.2 (3.8) after follow-up, and in CG 3.4 (3.6) and 2.4 (2.3) (ANCOVA p=0.529). Progressive resistance training reduced self-reported difficulties in ADL, even several years after fracture. More research is still needed on how to prevent physical disability among community-dwelling older people, especially after hip fracture.

  16. A cross sectional study of animal and human colonization with Methicillin-Resistant Staphylococcus aureus (MRSA) in an Aboriginal community.

    Science.gov (United States)

    Daley, Peter; Bajgai, Janak; Penney, Carla; Williams, Karen; Whitney, Hugh; Golding, George R; Weese, Scott

    2016-07-19

    Methicillin-resistant Staphylococcus aureus (MRSA) infections are common among humans in Aboriginal communities in Canada, for unknown reasons. Cross sectional study of humans and dogs in an Aboriginal community of approximately 1200 persons. Our objectives were to measure community-based prevalence of nasal MRSA colonization among humans, use multivariable logistic regression to analyze risk factors for MRSA colonization, and perform molecular typing of Staphylococci isolated to investigate interspecies transmission. 461 humans were approached for consent and 442 provided complete data. 109/442 (24.7 %, 95 % C.I. = 20.7-28.7 %) of humans were colonized with MRSA. 169/442 (38.2 %) of humans had received antibiotics in the last 12 months. Only number of rooms in the house (OR 0.86, p = 0.023) and recreational dog use (OR 7.7, p = 0.002) were significant risk factors for MRSA colonization. 95/109 (87.1 %) of MRSA strains from humans were of the same spa type (CMRSA10/USA300). 8/157 (5.1 %, 95 % C.I. = 1.7-8.5 %) of dogs were colonized with methicillin-susceptible S. aureus, and no dogs were colonized with MRSA. Human MRSA colonization in this community is very common, and a single clone is predominant, suggesting local transmission. Antibiotic use is also very common. Crowding may partially explain high colonization, but most considered risk factors including animal exposure were not predictive. Very few dogs carried human Staphylococcal strains.

  17. A cross sectional study of animal and human colonization with Methicillin-Resistant Staphylococcus aureus (MRSA in an Aboriginal community

    Directory of Open Access Journals (Sweden)

    Peter Daley

    2016-07-01

    Full Text Available Abstract Background Methicillin-resistant Staphylococcus aureus (MRSA infections are common among humans in Aboriginal communities in Canada, for unknown reasons. Methods Cross sectional study of humans and dogs in an Aboriginal community of approximately 1200 persons. Our objectives were to measure community-based prevalence of nasal MRSA colonization among humans, use multivariable logistic regression to analyze risk factors for MRSA colonization, and perform molecular typing of Staphylococci isolated to investigate interspecies transmission. Results 461 humans were approached for consent and 442 provided complete data. 109/442 (24.7 %, 95 % C.I. = 20.7–28.7 % of humans were colonized with MRSA. 169/442 (38.2 % of humans had received antibiotics in the last 12 months. Only number of rooms in the house (OR 0.86, p = 0.023 and recreational dog use (OR 7.7, p = 0.002 were significant risk factors for MRSA colonization. 95/109 (87.1 % of MRSA strains from humans were of the same spa type (CMRSA10/USA300. 8/157 (5.1 %, 95 % C.I. = 1.7–8.5 % of dogs were colonized with methicillin-susceptible S. aureus, and no dogs were colonized with MRSA. Conclusions Human MRSA colonization in this community is very common, and a single clone is predominant, suggesting local transmission. Antibiotic use is also very common. Crowding may partially explain high colonization, but most considered risk factors including animal exposure were not predictive. Very few dogs carried human Staphylococcal strains.

  18. Molecular characteristics of community-acquired methicillin-resistant Staphylococcus aureus in Hokkaido, northern main island of Japan: identification of sequence types 6 and 59 Panton-Valentine leucocidin-positive community-acquired methicillin-resistant Staphylococcus aureus.

    Science.gov (United States)

    Kawaguchiya, Mitsuyo; Urushibara, Noriko; Kuwahara, Osamu; Ito, Masahiko; Mise, Keiji; Kobayashi, Nobumichi

    2011-06-01

    Prevalence and molecular characteristics of community-acquired methicillin-resistant Staphylococcus aureus (CA-MRSA) were studied in Hokkaido, the main northern island of Japan. Among the 1,015 S. aureus isolates derived from clinical specimens of outpatients collected in 2009, methicillin resistance gene mecA was detected in 189 isolates (18.6%). The most frequent staphylococcal cassette chromosome mec (SCCmec) type in MRSA was II (83.1%), followed by IV (6.9%) and V (3.2%). MRSA with type II-SCCmec showed multiple drug resistance and harbored various toxin and virulence factor genes except for Panton-Valentine leucocidin (PVL) gene. These isolates were mostly classified into sequence type 5 (ST5) (or other STs in CC5) and coagulase genotype II and were thus genetically similar to hospital-acquired MRSA, which have been predominating in Japan (New York/Japan clone). PVL gene was detected in three MRSA strains belonging to ST6 (two strains) and ST59 (one strain), having type IVa- and Vt-SCCmec, respectively, and also in two methicillin-susceptible S. aureus ST121 and ST188. The arcA gene within the arginine catabolic mobile element (ACME) was detected in the two PVL-negative ST5 MRSA strains, which had type IIa- or V-SCCmec. The PVL gene-positive ST6 and ST59 CA-MRSA strains were susceptible to more antimicrobials and had less virulence factor genes than the PVL-negative ST5 MRSA, including the ACME-arcA-positive strains. In the present study, ST6 was identified as a lineage of PVL-positive CA-MRSA, the ACME-arcA was first detected in ST5 MRSA with type V-SCCmec, and ST59 Taiwanese CA-MRSA strain was isolated in Hokkaido for the first time. These findings suggest a potential spread of these emerging CA-MRSA clones in Japan.

  19. Integrated community case management for childhood illnesses: explaining policy resistance in Kenya.

    Science.gov (United States)

    Juma, Pamela A; Owuor, Karen; Bennett, Sara

    2015-12-01

    There has been a re-emphasis recently on community health workers to provide child health care services including integrated community case management for childhood illness (iCCM). This research analysed iCCM policy development in Kenya and in particular the types of decision-making criteria used by Kenyan policy-makers in considering whether to advance iCCM policy. Data were collected through document reviews (n = 41) and semi-structured interviews (n = 19) with key stakeholders in iCCM policy including government officials, development partners, bilateral donors, and civil society organizations. Initial analysis was guided by the policy triangle with further analysis of factors affecting policy decision-making drawing upon a simple framework developed by Grindle and Thomas (Policy makers, policy choices and policy outcomes: the political economy of reform in developing countries. 1989; Policy Sci 22: :213-48.). Policy development for iCCM has been slow in Kenya, compared with other Sub-Saharan African countries. At the time of the study, the Government had just completed the Community Health Training Manual which incorporated iCCM as a module, but this was the only formal expression of iCCM in Kenya. We found technical considerations, notably concerns about community health workers dispensing antibiotics to be a key factor slowing iCCM policy development, but this also overlapped with bureaucratic considerations, such as how the development of community health worker cadres may affect clinicians, as well as initial concerns about how an integrated approach might affect vertically oriented programs. International actors through agreements such as the Millennium Development Goals helped to get child survival onto the national policy agenda and such actors were active promoters of iCCM policy change. However international funders had not committed funding to scale-up iCCM policy, and this probably constrained their influence over iCCM policy debate. Kenyan actors

  20. Characterization of SCCmec and spa types of methicillin-resistant Staphylococcus aureus isolates from health-care and community-acquired infections in Kerman, Iran.

    Science.gov (United States)

    Fasihi, Yaser; Kiaei, Somayeh; Kalantar-Neyestanaki, Davood

    2017-12-01

    Spread of methicillin-resistant Staphylococcus aureus (MRSA) isolates is a worldwide problem. Molecular typing is a useful tool to understand MRSA epidemiology. Herein, we determined vancomycin-resistant, SCCmec and spa types among MRSA isolates recovered from healthcare and community-acquired infections in Kerman, Iran. A total of 170 S. aureus isolates were collected from different patients who were admitted to affiliated hospitals of Kerman University of Medical science. MRSA and vancomycin-resistant S. aureus (VRSA) isolates were detected by phenotypic methods. Polymerase chain reaction (PCR) technique was used for detection of mecA, vanA and vanB genes. Staphylococcal cassette chromosomemec (SCCmec) and spa typing were used for molecular typing of among MRSA isolates. Overall, 53% of isolates were considered as MRSA. Two MRSA isolates were resistant to vancomycin and vanA was detected in only one of VRSA isolates. SCCmec type III belonged to spa types t030 and t459 which they were the dominant spa types among community-associated MRSA (CA-MRSA) and healthcare-acquired MRSA (HA-MRSA) isolates. Our findings showed that the SCCmec type I and III spread from hospital settings to community, although the SCCmec type IV spread from community to healthcare systems. We have also reported VRSA isolates from hospitalized patients, therefore, appropriate policies should be enforced in order to prevent the spread of antibiotic resistance isolates in hospitals settings. Copyright © 2017 Ministry of Health, Saudi Arabia. Published by Elsevier Ltd. All rights reserved.

  1. Tritium accountancy

    International Nuclear Information System (INIS)

    Avenhaus, R.; Spannagel, G.

    1995-01-01

    Conventional accountancy means that for a given material balance area and a given interval of time the tritium balance is established so that at the end of that interval of time the book inventory is compared with the measured inventory. In this way, an optimal effectiveness of accountancy is achieved. However, there are still further objectives of accountancy, namely the timely detection of anomalies as well as the localization of anomalies in a major system. It can be shown that each of these objectives can be optimized only at the expense of the others. Recently, Near-Real-Time Accountancy procedures have been studied; their methodological background as well as their merits will be discussed. (orig.)

  2. Community-acquired necrotizing pneumonia caused by methicillin-resistant Staphylococcus aureus ST30-SCCmecIVc-spat019-PVL positive in San Antonio de Areco, Argentina

    Directory of Open Access Journals (Sweden)

    Silvina Fernández

    2015-03-01

    Full Text Available Community-acquired methicillin-resistant Staphylococcus aureus is the first cause of skin and soft tissue infections, but can also produce severe diseases such as bacteremia, osteomyelitis and necrotizing pneumonia. Some S. aureus lineages have been described in cases of necrotizing pneumonia worldwide, usually in young, previously healthy patients. In this work, we describe a fatal case of necrotizing pneumonia due to community-acquired methicillin-resistant S. aureus clone ST30-SCCmecIVc-spat019-PVL positive in an immunocompetent adult patient.

  3. Novel pandemic influenza A (H1N1) and community-associated methicillin-resistant Staphylococcus aureus pneumonia.

    Science.gov (United States)

    Chung, Doo Ryeon; Huh, Kyungmin

    2015-02-01

    Postinfluenza bacterial pneumonia is a leading cause of influenza-associated death, and Staphylococcus aureus and Streptococcus pneumoniae have been important pathogens that have caused pneumonia since the influenza pandemic in 1919. Emergence of novel influenza A (H1N1) pdm09 and the concomitant global spread of community-associated methicillin-resistant S. aureus (CA-MRSA) have led to increasing prevalence of CA-MRSA pneumonia following influenza infection. Such an epidemiologic change poses a therapeutic challenge due to a high risk of inappropriate empiric antimicrobial therapy and poor clinical outcomes. Early diagnosis and initiation of appropriate antimicrobial therapy for post-influenza bacterial pneumonia have become even more important in the era of CA-MRSA. Therefore, novel molecular diagnostic techniques should be applied to more readily diagnose MRSA pneumonia.

  4. Molecular Characteristic and Virulence Gene Profiles of Community-associated Methicillin-Resistant Staphylococcus aureus Isolates from Pediatric Patients in Shanghai, China

    Directory of Open Access Journals (Sweden)

    Xing Wang

    2016-11-01

    Full Text Available Staphylococcus aureus is a globally important human pathogen, especially among children and immunocompromised patients. The emergence and spread of community-associated methicillin-resistant S. aureus (CA-MRSA has become a serious public health problem worldwide. The aim of this study was to investigate the prevalence, molecular characteristics and virulence profiles of CA-MRSA infections from pediatric patients in a university hospital in Shanghai, China. A total of eighty CA-MRSA isolates were collected from July 2012 to December 2013 in Shanghai Children's Medical Center and analyzed by multilocus sequence typing, staphylococcus chromosomal cassette mec(SCCmec typing, and spa typing. The detection of Panton-Valentine Leukocidin(pvl, superantigenic and exfoliative toxins, and adhesin genes was also performed. Overall, 16 distinct sequence types (STs were identified among the 80 isolates. Among them, ST59 was found to be the most prevalent, followed by ST398 (11.3%, 9/80 and ST88 (8.8%,7/80. SCCmec types IV and V were observed, at 60% and 40% respectively. Thirty spa types were identified, spa t437 (23.8% was the most predominant type. All 80 isolates exhibited carriage of at least 4 virulence genes. Thirty-four (42.5%, 34/80 isolates harbored ≥10 tested virulence genes. Adhesion genes were present in most of the MRSA isolates, including the following: icaA (100%, clfA (100%, sdrC (95%, and sdrE (63.8%. The prevalence of pvl gene was 20%, and multidrug resistance was observed in 36% of all strains. In addition, ST59-MRSA-IV with t437 accounted for 21.3% of occurrences, making it the most prevalent clone. Isolates that were carriers of toxin genes, and hla(100% and hlg(87.5% were the most frequent. In conclusion, simultaneous carriage of multiple virulence genes and genetically considerable diversity were very common among CA-MRSA from pediatric patients in Shanghai. ST59-MRSA-IV with t437 was still the most predominant type. The combination

  5. Accounting assessment

    Directory of Open Access Journals (Sweden)

    Kafka S.М.

    2017-03-01

    Full Text Available The proper evaluation of accounting objects influences essentially upon the reliability of assessing the financial situation of a company. Thus, the problem in accounting estimate is quite relevant. The works of home and foreign scholars on the issues of assessment of accounting objects, regulatory and legal acts of Ukraine controlling the accounting and compiling financial reporting are a methodological basis for the research. The author uses the theoretical methods of cognition (abstraction and generalization, analysis and synthesis, induction and deduction and other methods producing conceptual knowledge for the synthesis of theoretical and methodological principles in the evaluation of assets accounting, liabilities and equity. The tabular presentation and information comparison methods are used for analytical researches. The article considers the modern approaches to the issue of evaluation of accounting objects and financial statements items. The expedience to keep records under historical value is proved and the articles of financial statements are to be presented according to the evaluation on the reporting date. In connection with the evaluation the depreciation of fixed assets is considered as a process of systematic return into circulation of the before advanced funds on the purchase (production, improvement of fixed assets and intangible assets by means of including the amount of wear in production costs. Therefore it is proposed to amortize only the actual costs incurred, i.e. not to depreciate the fixed assets received free of charge and surplus valuation of different kinds.

  6. Gender, Success, and Drop-Out during a Resistance Exercise Program in Community Dwelling Old Adults

    Directory of Open Access Journals (Sweden)

    O. G. Geirsdottir

    2017-01-01

    Full Text Available Background. Resistance exercise training can be effective against sarcopenia. We identified predictors of drop-out and compared physical outcomes between men and women after such training. Methods. Subjects (N=236, 73.7±5.7 years participated in a 12-week resistance exercise program. Outcome variables were measured at baseline and endpoint. Results. Drop-out was 11.9% and not significantly different between genders. Drop-outs were significantly older and had poorer strength and physical function in comparison to completers. Anthropometrics, QoL, and cognitive function were not related to drop-out. According to multivariate analysis, gait speed and physical activity were the strongest predictors of drop-out. After the training, gains in lean mass or appendicular muscle were significantly higher in men than women; however relative gains in appendicular muscle as well as absolute improvements in strength and function were similar in men and women, respectively. Conclusions. Participants who drop out are older, have poorer physical function, and are less physically active. Old women do not drop out more frequently than men and show meaningful improvements in relevant outcomes similar to men after such a training program. The trial is registered at the US National Library of Medicine (NCT01074879.

  7. Abundance of antibiotics, antibiotic resistance genes and bacterial community composition in wastewater effluents from different Romanian hospitals.

    Science.gov (United States)

    Szekeres, Edina; Baricz, Andreea; Chiriac, Cecilia Maria; Farkas, Anca; Opris, Ocsana; Soran, Maria-Loredana; Andrei, Adrian-Stefan; Rudi, Knut; Balcázar, Jose Luis; Dragos, Nicolae; Coman, Cristian

    2017-06-01

    Antimicrobial resistance represents a growing and significant public health threat, which requires a global response to develop effective strategies and mitigate the emergence and spread of this phenomenon in clinical and environmental settings. We investigated, therefore, the occurrence and abundance of several antibiotics and antibiotic resistance genes (ARGs), as well as bacterial community composition in wastewater effluents from different hospitals located in the Cluj County, Romania. Antibiotic concentrations ranged between 3.67 and 53.05 μg L -1 , and the most abundant antibiotic classes were β-lactams, glycopeptides, and trimethoprim. Among the ARGs detected, 14 genes confer resistance to β-lactams, aminoglycosides, chloramphenicol, macrolide-lincosamide-streptogramin B (MLSB) antibiotics, sulfonamides, and tetracyclines. Genes encoding quaternary ammonium resistance and a transposon-related element were also detected. The sulI and qacEΔ1 genes, which confer resistance to sulfonamides and quaternary ammonium, had the highest relative abundance with values ranging from 5.33 × 10 -2 to 1.94 × 10 -1 and 1.94 × 10 -2 to 4.89 × 10 -2 copies/16 rRNA gene copies, respectively. The dominant phyla detected in the hospital wastewater samples were Proteobacteria, Bacteroidetes, Firmicutes, and Actinobacteria. Among selected hospitals, one of them applied an activated sludge and chlorine disinfection process before releasing the effluent to the municipal collector. This conventional wastewater treatment showed moderate removal efficiency of the studied pollutants, with a 55-81% decrease in antibiotic concentrations, 1-3 order of magnitude lower relative abundance of ARGs, but with a slight increase of some potentially pathogenic bacteria. Given this, hospital wastewaters (raw or treated) may contribute to the spread of these emerging pollutants in the receiving environments. To the best of our knowledge, this study quantified for the first time the

  8. Complete genome sequence of community-associated methicillin-resistant Staphylococcus aureus (strain USA400-0051, a prototype of the USA400 clone

    Directory of Open Access Journals (Sweden)

    Marina Farrel Côrtes

    Full Text Available Staphylococcus aureus subsp. aureus, commonly referred as S. aureus, is an important bacterial pathogen frequently involved in hospital- and community-acquired infections in humans, ranging from skin infections to more severe diseases such as pneumonia, bacteraemia, endocarditis, osteomyelitis, and disseminated infections. Here, we report the complete closed genome sequence of a community-acquired methicillin-resistant S. aureus strain, USA400-0051, which is a prototype of the USA400 clone.

  9. Community-acquired necrotizing pneumonia caused by methicillin-resistant Staphylococcus aureus producing Panton–Valentine leukocidin in a Chinese teenager: case report and literature review

    OpenAIRE

    Jie Chen; Yanping Luo; Shu Zhang; Zhixin Liang; Ying Wang; Ying Zhang; Guang Zhou; Yanhong Jia; Liangan Chen; Danyang She

    2014-01-01

    Background: Methicillin-resistant Staphylococcus aureus (MRSA) has now been established as an important community-acquired pathogen. Although necrotizing pneumonia caused by community-acquired MRSA (CA-MRSA) strains producing Panton–Valentine leukocidin (PVL) has been reported with increasing frequency in many countries, it has been reported in only a few children younger than 1 year of age in Mainland China. Methods: We describe a case of life-threatening necrotizing pneumonia due to PVL-...

  10. Are biological communities in naturally unproductive streams resistant to additional anthropogenic stressors?

    Science.gov (United States)

    Annala, M; Mykrä, H; Tolkkinen, M; Kauppila, T; Muotka, T

    Studies on the interactive responses to multiple simultaneously acting stressors have focused on individual or population-level responses in laboratory microcosms, while field-based studies on community-level responses are rare. We examined the influence of a natural (non-anthropogenic acidity) vs. human-induced stress (land drainage) and their interaction on species richness and spatial turnover (β diversity) of stream diatom, bryophyte, and benthic invertebrate communities. Our four stream categories were: circumneutral reference, circumneutral impacted, naturally acidic, and naturally acidic impacted streams. We expected the most sensitive species to be present only in the circumneutral reference streams. Therefore, species richness should be highest in these streams and lowest in the naturally acidic streams additionally stressed by forest drainage. Alternatively, communities in acidic streams may consist of the most tolerant taxa that are unaffected by further stressors, species richness in these streams remaining unaffected by drainage. We also expected spatial turnover to be highest in the circumneutral near-pristine streams and lowest in the drainage-impacted acidic streams. In all three taxonomic groups, α diversity was lower in the naturally acidic than in circumneutral streams. The additional impact of the anthropogenic stress on species richness varied between groups, having no effect on diatoms, antagonistic effect on bryophytes, and additive effect on invertebrates. We also found differences in how each stressor modified β diversity of each taxonomic group. For diatoms, β diversity showed an overall tendency to decrease with increasing stress level, while bryophyte β diversity responded mainly to forest drainage. Benthic invertebrate β diversity did not differ between treatments. Our results suggest that non-additive effects among stressors need special attention to improve the understanding and management of multifactor responses in streams

  11. Community-Associated Methicillin-Resistant Staphylococcus aureus Lacking PVL, as a Cause of Severe Invasive Infection Treated with Linezolid

    Directory of Open Access Journals (Sweden)

    Catarina Gouveia

    2013-01-01

    Full Text Available Community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA is an emerging public health problem worldwide. Severe invasive infections have been described, mostly associated with the presence of Panton-Valentine leukocidin (PVL. In Portugal limited information exists regarding CA-MRSA infections. In this study we describe the case of a previously healthy 12-year-old female, sport athlete, who presented to the hospital with acetabulofemoral septic arthritis, myositis, fasciitis, acetabulum osteomyelitis, and pneumonia. The MRSA isolated from blood and synovial fluid was PVL negative and staphylococcal enterotoxin type P (SEP and type L (SEL positive, with a vancomycin MIC of 1.0 mg/L and resistant to clindamycin and ciprofloxacin. The patient was submitted to multiple surgical drainages and started on vancomycin, rifampicin, and gentamycin. Due to persistence of fever and no microbiological clearance, linezolid was started with improvement. This is one of the few reported cases of severe invasive infection caused by CA-MRSA in Portugal, which was successfully treated with linezolid. In spite of the severity of infection, the MRSA isolate did not produce PVL.

  12. Being Met as marked - patients' experiences of being infected with community-acquired methicillin-resistant Staphylococcus aureus (MRSA).

    Science.gov (United States)

    Skyman, Eva; Lindahl, Berit; Bergbom, Ingegerd; Sjöström, Harrieth Thunberg; Åhrén, Christina

    2016-12-01

    It is known that patients who acquired methicillin-resistant Staphylococcus aureus (MRSA) in hospitals suffer and feel as plague. Moreover, the patient interaction with nurses and physicians is described as frightening. Little is known about patient experiences after having acquired CA-MRSA concerning care and everyday life. To reveal and interpret otherwise healthy patients' lived experiences of receiving care and their everyday life after having acquired community MRSA (CA-MRSA). A phenomenological hermeneutic approach guided by Ricouer was conducted. Interviews with twelve patients were transcribed verbatim into a text. The text was analysed in three phases: naive understanding, structural analysis and comprehensive understanding to reveal a possible being in the world. In this study, this referred to what it means to be infected with CA-MRSA. The findings indicate that patients who acquired MRSA experience a changed body image. They suffer from ignorant and frightened behavior from healthcare workers, social contacts, and also of being bullied by colleagues. Despite this, patients assume great responsibility for protecting others. However, knowledgeable staff alleviate suffering and bring peace of mind to the patients. Preventing patient's feelings of being a pest, an outsider living with fear, requires urgent education and understanding about resistant bacteria and how to meet an infected patient. The results describing patients, affected with MRSA, may contribute and touch the readers to better understanding of patient's changed body image and suffering and how to mitigate these feelings. © 2016 Nordic College of Caring Science.

  13. Amoxicillin effects on functional microbial community and spread of antibiotic resistance genes in amoxicillin manufacture wastewater treatment system.

    Science.gov (United States)

    Meng, Lingwei; Li, Xiangkun; Wang, Xinran; Ma, Kaili; Liu, Gaige; Zhang, Jie

    2017-11-01

    This study aimed to reveal how amoxicillin (AMX) affected the microbial community and the spread mechanism of antibiotic resistance genes (ARGs) in the AMX manufacture wastewater treatment system. For this purpose, a 1.47 L expanded granular sludge bed (EGSB) reactor was designed and run for 241days treating artificial AMX manufacture wastewater. 454 pyrosequencing was applied to analyze functional microorganisms in the system. The antibiotic genes OXA- 1 , OXA -2 , OXA -10 , TEM -1 , CTX-M -1 , class I integrons (intI1) and 16S rRNA genes were also examined in sludge samples. The results showed that the genera Ignavibacterium, Phocoenobacter, Spirochaeta, Aminobacterium and Cloacibacillus contributed to the degradation of different organic compounds (such as various sugars and amines). And the relative quantification of each β-lactam resistance gene in the study was changed with the increasing of AMX concentration. Furthermore the vertical gene transfer was the main driver for the spread of ARGs rather than horizontal transfer pathways in the system. Copyright © 2017. Published by Elsevier B.V.

  14. Parallel Epidemics of Community-Associated Methicillin-Resistant Staphylococcus aureus USA300 Infection in North and South America.

    Science.gov (United States)

    Planet, Paul J; Diaz, Lorena; Kolokotronis, Sergios-Orestis; Narechania, Apurva; Reyes, Jinnethe; Xing, Galen; Rincon, Sandra; Smith, Hannah; Panesso, Diana; Ryan, Chanelle; Smith, Dylan P; Guzman, Manuel; Zurita, Jeannete; Sebra, Robert; Deikus, Gintaras; Nolan, Rathel L; Tenover, Fred C; Weinstock, George M; Robinson, D Ashley; Arias, Cesar A

    2015-12-15

    The community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA) epidemic in the United States is attributed to the spread of the USA300 clone. An epidemic of CA-MRSA closely related to USA300 has occurred in northern South America (USA300 Latin-American variant, USA300-LV). Using phylogenomic analysis, we aimed to understand the relationships between these 2 epidemics. We sequenced the genomes of 51 MRSA clinical isolates collected between 1999 and 2012 from the United States, Colombia, Venezuela, and Ecuador. Phylogenetic analysis was used to infer the relationships and times since the divergence of the major clades. Phylogenetic analyses revealed 2 dominant clades that segregated by geographical region, had a putative common ancestor in 1975, and originated in 1989, in North America, and in 1985, in South America. Emergence of these parallel epidemics coincides with the independent acquisition of the arginine catabolic mobile element (ACME) in North American isolates and a novel copper and mercury resistance (COMER) mobile element in South American isolates. Our results reveal the existence of 2 parallel USA300 epidemics that shared a recent common ancestor. The simultaneous rapid dissemination of these 2 epidemic clades suggests the presence of shared, potentially convergent adaptations that enhance fitness and ability to spread. © The Author 2015. Published by Oxford University Press on behalf of the Infectious Diseases Society of America. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.

  15. Temporal changes of antibiotic-resistance genes and bacterial communities in two contrasting soils treated with cattle manure.

    Science.gov (United States)

    Hu, Hang-Wei; Han, Xue-Mei; Shi, Xiu-Zhen; Wang, Jun-Tao; Han, Li-Li; Chen, Deli; He, Ji-Zheng

    2016-02-01

    The emerging environmental spread of antibiotic-resistance genes (ARGs) and their subsequent acquisition by clinically relevant microorganisms is a major threat to public health. Animal manure has been recognized as an important reservoir of ARGs; however, the dissemination of manure-derived ARGs and the impacts of manure application on the soil resistome remain obscure. Here, we conducted a microcosm study to assess the temporal succession of total bacteria and a broad spectrum of ARGs in two contrasting soils following manure application from cattle that had not been treated with antibiotics. High-capacity quantitative PCR detected 52 unique ARGs across all the samples, with β-lactamase as the most dominant ARG type. Several genes of soil indigenous bacteria conferring resistance to β-lactam, which could not be detected in manure, were found to be highly enriched in manure-treated soils, and the level of enrichment was maintained over the entire course of 140 days. The enriched β-lactam resistance genes had significantly positive relationships with the relative abundance of the integrase intI1 gene, suggesting an increasing mobility potential in manure-treated soils. The changes in ARG patterns were accompanied by a significant effect of cattle manure on the total bacterial community compositions. Our study indicates that even in the absence of selective pressure imposed by agricultural use of antibiotics, manure application could still strongly impact the abundance, diversity and mobility potential of a broad spectrum of soil ARGs. Our findings are important for reliable prediction of ARG behaviors in soil environment and development of appropriate strategies to minimize their dissemination. © FEMS 2015. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  16. Population genetics, community of parasites, and resistance to rodenticides in an urban brown rat (Rattus norvegicus) population.

    Science.gov (United States)

    Desvars-Larrive, Amélie; Pascal, Michel; Gasqui, Patrick; Cosson, Jean-François; Benoît, Etienne; Lattard, Virginie; Crespin, Laurent; Lorvelec, Olivier; Pisanu, Benoît; Teynié, Alexandre; Vayssier-Taussat, Muriel; Bonnet, Sarah; Marianneau, Philippe; Lacôte, Sandra; Bourhy, Pascale; Berny, Philippe; Pavio, Nicole; Le Poder, Sophie; Gilot-Fromont, Emmanuelle; Jourdain, Elsa; Hammed, Abdessalem; Fourel, Isabelle; Chikh, Farid; Vourc'h, Gwenaël

    2017-01-01

    Brown rats are one of the most widespread urban species worldwide. Despite the nuisances they induce and their potential role as a zoonotic reservoir, knowledge on urban rat populations remains scarce. The main purpose of this study was to characterize an urban brown rat population from Chanteraines park (Hauts-de-Seine, France), with regards to haematology, population genetics, immunogenic diversity, resistance to anticoagulant rodenticides, and community of parasites. Haematological parameters were measured. Population genetics was investigated using 13 unlinked microsatellite loci. Immunogenic diversity was assessed for Mhc-Drb. Frequency of the Y139F mutation (conferring resistance to rodenticides) and two linked microsatellites were studied, concurrently with the presence of anticoagulant residues in the liver. Combination of microscopy and molecular methods were used to investigate the occurrence of 25 parasites. Statistical approaches were used to explore multiple parasite relationships and model parasite occurrence. Eighty-six rats were caught. The first haematological data for a wild urban R. norvegicus population was reported. Genetic results suggested high genetic diversity and connectivity between Chanteraines rats and surrounding population(s). We found a high prevalence (55.8%) of the mutation Y139F and presence of rodenticide residues in 47.7% of the sampled individuals. The parasite species richness was high (16). Seven potential zoonotic pathogens were identified, together with a surprisingly high diversity of Leptospira species (4). Chanteraines rat population is not closed, allowing gene flow and making eradication programs challenging, particularly because rodenticide resistance is highly prevalent. Parasitological results showed that co-infection is more a rule than an exception. Furthermore, the presence of several potential zoonotic pathogens, of which four Leptospira species, in this urban rat population raised its role in the maintenance

  17. Influences of graphene on microbial community and antibiotic resistance genes in mouse gut as determined by high-throughput sequencing.

    Science.gov (United States)

    Xie, Yongchao; Wu, Bing; Zhang, Xu-Xiang; Yin, Jinbao; Mao, Liang; Hu, Maojie

    2016-02-01

    Graphene is a promising candidate as an antibacterial material owning to its bacterial toxicity. However, little information on influence of graphene on gut microbiota is available. In this study, mice were exposed to graphene for 4 weeks, and high-throughput sequencing was applied to characterize the changes in microbial community and antibiotic resistance genes (ARGs) in mouse gut. The results showed that graphene exposure increased biodiversity of gut microbiota, and changed their community. The 1 μg/d graphene exposure had higher influences on the gut microbiota than 10 μg/d and 100 μg/d graphene exposures, which might be due to higher aggregation of high-level graphene. The influence of graphene on gut microbiota might attribute to that graphene could induce oxidative stress and damage of cell membrane integrity. The results were verified by the increase of ratio of Gram-negative bacteria. Outer membrane of Gram-negative bacteria could reduce the membrane damage induced by graphene and make them more tolerance to graphene. Further, we found that graphene exposure significantly increased the abundance and types of ARGs, indicating a potential health risk of graphene. This study firstly provides new insight to the health effects of graphene on gut microbiota. Copyright © 2015 Elsevier Ltd. All rights reserved.

  18. Oasis desert farming selects environment-specific date palm root endophytic communities and cultivable bacteria that promote resistance to drought

    KAUST Repository

    Cherif, Hanene

    2015-07-21

    Oases are desert-farming agro-ecosystems, where date palm (Phoenix dactyliferaL.) plays a keystone role in offsetting the effects of drought and maintaining a suitable microclimate for agriculture. At present, abundance, diversity and plant growth promotion (PGP) of date palm root-associated bacteria remain unknown. Considering the environmental pressure determined by the water scarcity in the desert environments, we hypothesized that bacteria associated with date palm roots improve plant resistance to drought. Here, the ecology of date palm root endophytes from oases in the Tunisian Sahara was studied with emphasis on their capacity to promote growth under drought. Endophytic communities segregated along a north-south gradient in correlation with geo-climatic parameters. Screening of 120 endophytes indicated that date palm roots select for bacteria with multiple PGP traits. Bacteria rapidly cross-colonized the root tissues of different species of plants, including the original Tunisian date palm cultivar, Saudi Arabian cultivars and Arabidopsis. Selected endophytes significantly increased the biomass of date palms exposed to repeated drought stress periods during a 9-month greenhouse experiment. Overall, results indicate that date palm roots shape endophytic communities that are capable to promote plant growth under drought conditions, thereby contributing an essential ecological service to the entire oasis ecosystem. © 2015 Society for Applied Microbiology and John Wiley & Sons Ltd.

  19. Evolutionary ecology of resistance to herbivory: an investigation of potential genetic constraints in the multiple-herbivore community of Solanum carolinense.

    Science.gov (United States)

    Wise, Michael J

    2007-01-01

    As part of a study of the ecological and evolutionary dynamics of herbivore resistance in Solanum carolinense (horsenettle), potential genetic constraints to the evolution of resistance to 11 of its most common herbivores were investigated. Leaf, flower, fruit, and stem herbivory were measured in a field experiment involving 24 ramets of each of 40 horsenettle genets. The experimental plant population contained significant genetic variation for resistance to all 11 species of herbivore. For only one species was there an indication of a genotype-by-environment interaction in the expression of resistance that might constrain its evolution. Genetic correlations in resistance to different species were common but not universal, with seven negative and 12 positive correlations out of the 55 pairwise species comparisons. Correlations were independent of plant part fed upon. The evolution of the resistance of horsenettle to most of its diverse community of herbivores does not appear to be prevented by a lack of genetic variation or by genotype-by-environment interactions in resistance. Negative genetic correlations in resistance to different herbivores may play a small role in slowing the evolution of resistance, but positive correlations may play at least as large a role in facilitating its evolution.

  20. Survival of epidemic strains of nosocomial- and community-acquired methicillin-resistant Staphylococcus aureus on coins.

    Science.gov (United States)

    Tolba, Ola; Loughrey, Anne; Goldsmith, Colin E; Millar, B Cherie; Rooney, Paul J; Moore, John E

    2007-06-01

    The aim of this study was to examine the survival dynamics of several epidemic nosocomial and community-acquired methicillin-resistant Staphylococcus aureus (MRSA) strains on copper alloy coins. Six different phage types of nosocomial MRSA (Irish 1, Irish 2, EMRSA 15, EMRSA 16, distinct type, and untypeable), as well as community-acquired MRSA, were examined in this study. Two isolates of each type were studied, resulting in a total of 14 organisms being examined. Cells were harvested from overnight cultures of Columbia blood agar (Oxoid) supplemented with 5% (wt/vol) defibrinated blood to make a 0.5 McFarland inoculum standard. An inoculum of each MRSA isolate in 5-microl volume was added to washed, dried, and presterilized 1-penny copper-plated steel coins, equating to log(10) 5 colony-forming units (cfu) and allowed to dry naturally at ambient temperatures in the dark. Recovery experiments were unable to isolate any of the inoculated organisms 4 hours postinoculation. To ascertain whether this was a toxic effect from the copper alloy of the coins or a physical desiccation effect, experiments were repeated on glass and plastic, and similar results were demonstrated. The effect of soil was investigated by repeating the experiment with (60)Co irradiated pus and sterile blood, and we were able to demonstrate the survival of all organisms after at least 2 weeks storage in the dark at ambient temperature, during which the quantitative counts were reduced by approximately 1-log unit and 2-log units for blood and pus, respectively. This study demonstrates that all epidemic nosocomial- and community-acquired MRSA do not survive when no organic protection is offered but survive well when soil (pus and blood) is present, thus offering protection from drying. This study indicates that contaminated coins may serve as potential vehicles for MRSA.

  1. Clinical outcomes and treatment approach for community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA) infections in Israel.

    Science.gov (United States)

    Berla-Kerzhner, E; Biber, A; Parizade, M; Taran, D; Rahav, G; Regev-Yochay, G; Glikman, D

    2017-01-01

    Community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA) infections are increasingly documented worldwide. We recently identified two major CA-MRSA clones in Israel: USA300 and t991. Here, we assessed clinical outcomes by CA-MRSA clones and the physicians' treatment approach to CA-MRSA infections. All community-onset, clinical MRSA isolates detected during 2011-2013 by Maccabi Healthcare Services were collected and characterized phenotypically and genotypically; data were collected retrospectively from electronic medical records. Of 309 patients with MRSA infections, 64 were identified as CA-MRSA (21 %). Of the CA-MRSA infections, 72 % had skin and soft tissue infections (SSTIs), 38 % were Panton-Valentine leukocidin (PVL)+, the major clone being USA300 (n = 13, 54 %). Of PVL- isolates (n = 40, 62 %), t991 was the major clone. Age was the only predictor for PVL+ CA-MRSA infection (p MRSA had higher incidence of SSTI recurrences (1.061 vs. 0.647 events per patient/per year, p MRSA. USA300 was more common among adults, while t991 was more common among children (p = 0.002). The physician's referral to culture results and susceptibility were the only predictors of appropriate antibiotic therapy (p MRSA isolates caused significantly more recurrences of SSTIs and increased the need for drainage compared with PVL- isolates. Physicians' awareness of CA-MRSA as a cause of SSTIs in the community was suboptimal. Culturing of pus-producing SSTIs is crucial for providing adequate antimicrobials and elucidating MRSA epidemiology.

  2. The effects of Tai-Chi in conjunction with thera-band resistance exercise on functional fitness and muscle strength among community-based older people.

    Science.gov (United States)

    Lin, Shu-Fen; Sung, Huei-Chuan; Li, Tzai-Li; Hsieh, Tsung-Cheng; Lan, Hsiao-Chin; Perng, Shoa-Jen; Smith, Graeme D

    2015-05-01

    The aim of this study was to investigate the effects of Tai-Chi in conjunction with thera-band resistance exercise on functional fitness and muscle strength in community-based older people. Tai-Chi is known to improve functional fitness in older people. Tai-Chi is usually performed with free hands without resistance training and usually focuses on training lower limbs. To date, no study has examined the use of Tai-Chi in conjunction with thera-band resistance exercise in this population. Cluster randomised trial design. Older people at six senior day care centres in Taiwan were assigned to thera-band resistance exercise or control group using a cluster randomisation. The thera-band resistance exercise group (n = 48) received sixty minute thera-band resistance exercise twice weekly for a period of 16 weeks. The control group (n = 47) underwent routine activities in the day care centre, receiving no Tai-Chi or resistance exercise. After receiving the thera-band resistance exercise, intervention participants displayed a significant increase in muscle strength of upper and lower extremities. Significant improvements were recorded on most measures of the Senior Fitness Test, with the exception of the chair-stand and back-scratch test. Thera-band resistance exercise has the potential to improve functional fitness and muscle strength in community-based older people. Thera-band resistance exercise potentially offers a safe and appropriate form of physical activity that nursing staff can easily incorporate into the daily routine of older people in day care centres, potentially improving functional performance and muscle strength. © 2015 John Wiley & Sons Ltd.

  3. SOCIAL LEARNING IN POLITICAL CONSTRAST: GOVERNMENTAL RESISTANCE OR DEPENDENCY OF INDIGENOUS COMMUNITIES IN CHIAPAS, MEXICO

    Directory of Open Access Journals (Sweden)

    Daniela Gallardo-Olimón

    2016-01-01

    Full Text Available In recent years there has been a broad conceptual discussion on processes of Social Learning (SL as the driving force of territorial management processes. Similarly, there has been a discussion on the role of the government and its implications on groups of territorial action. However, there are no studies that deal with SL in indigenous communities with the same ethnic roots but with a contrasting relation with the government and its institutionality. The present work takes on this comparison within the framework of cultural control in order to explain the course of their processes of development and territorial management. While one group shows goals towards education and spirituality, the other reveals technical and productive interests. Nevertheless, both processes exhibit a trajectory towards a culture of appropriation and self-management, against internal and external pressures. In this sense, we bring to light different local possibilities that replace the unfullfilness and backwardness of the centralized government.

  4. Frequency of escherichia coli in patients with community acquired urinary tract infection and their resistance pattern against some commonly used anti bacterials

    International Nuclear Information System (INIS)

    Ahmad, W.; Jamshed, F.; Ahmad, W.

    2015-01-01

    Urinary tract infection (UTI) is a very common health problem and Escherichia coli (E coli) are the most common organisms associated with community acquired UTI. Unfortunately these bacteria have developed extensive resistance against most of the commonly used anti-bacterials. The objective of this study was to determine the frequency and resistance pattern of E coli in patients of community acquired UTI in an area in northern part of Pakistan. Methods: Urine specimens were collected from patients who were clinically diagnosed as community acquired UTI. Urine routine examination (Urine RE) was done and samples positive for UTI (Pus cells >10/High Power Field) were included in the study. These samples were inoculated on Eosin Methylene Blue (EMB) agar plates and incubated at 37 degree C for 36 hours. Suspected colonies were then inoculated further on EMB plates for pure cultures of E coli characterized by certain morphological characteristics. IMViC was applied for the confirmation of E coli. In vitro antibiotic susceptibility tests of E coli were performed with standardized commercial susceptibility discs (OXOID). Results: Out of 50 specimens, positive for UTI by urine RE, 20 showed pure growth of E coli on culture (40%). The majority of the isolates (28%; n=14) were from women while only 12% (n=6) were from men. Escherichia coli showed a high rate of resistance towards Ampicillin (90%), Tetracycline (70%), Erythromycin (70%) and Trimethoprim-Sulfamethoxazole (55%). Sparfloxacin showed better results (45%) than ciprofloxacin (50%). Out of 20 E coli isolates, two (10%) were resistant to all the antibacterials except chloramphenicol, eight isolates (40%) showed resistance to six or more than six while 14 (70%) were resistant to four or more than four drugs. Conclusion: Rate of resistance of E coli against commonly used antibacterials was quite high and majority of the strains showed multidrug resistance. (author)

  5. Significant ecological impact on the progression of fluoroquinolone resistance in Escherichia coli with increased community use of moxifloxacin, levofloxacin and amoxicillin/clavulanic acid.

    Science.gov (United States)

    Cuevas, Oscar; Oteo, Jesús; Lázaro, Edurne; Aracil, Belén; de Abajo, Francisco; García-Cobos, Silvia; Ortega, Adriana; Campos, José

    2011-03-01

    To determine trends in ciprofloxacin resistance and co-resistance to other antibiotic classes in blood isolates of Escherichia coli, and to investigate if there is an ecological relationship to the community use of fluoroquinolones and other antibiotics. Forty-two Spanish hospitals of the European Antimicrobial Resistance Surveillance Network collected ciprofloxacin and other antibiotic susceptibility data for non-duplicate consecutive E. coli isolates from patients with bacteraemia between 2001 and 2009. The nationwide ambulatory use of antibiotics between 1997 and 2008 was determined by WHO methods, and the co-evolution of both parameters was further analysed. Of the 28 307 E. coli blood isolates, 27.9% were ciprofloxacin non-susceptible (CIPNS), increasing from 17.6% in 2001 to 32.7% in 2009. A continuous increase was observed between CIPNS and other resistances, including cephalosporin resistance due to the production of extended-spectrum β-lactamases (ESBLs) and non-susceptibility to both amoxicillin/clavulanic acid and tobramycin. Although the total use of antibiotics did not increase, community use of levofloxacin, moxifloxacin and amoxicillin/clavulanic acid increased by 307.2%, 62.6% and 70.1%, respectively. Yearly rates of CIPNS E. coli strongly correlated with the use of levofloxacin, moxifloxacin and amoxicillin/clavulanic acid (r(2 )> 0.80; P resistance to amoxicillin/clavulanic acid, production of ESBLs and resistance to aminoglycosides. Community use of fluoroquinolones (mainly moxifloxacin and levofloxacin) and of amoxicillin/clavulanic acid represents a significant driver in the progression of fluoroquinolone resistance in bacteraemic E. coli.

  6. Impact of amoxicillin therapy on resistance selection in patients with community-acquired lower respiratory tract infections : A randomized, placebo-controlled study

    NARCIS (Netherlands)

    Malhotra-Kumar, Surbhi; Van Heirstraeten, Liesbet; Coenen, Samuel; Lammens, Christine; Adriaenssens, Niels; Kowalczyk, Anna; Godycki-Cwirko, Maciek; Bielicka, Zuzana; Hupkova, Helena; Lannering, Christina; Mölstad, Sigvard; Fernandez-Vandellos, Patricia; Torres, Antoni; Parizel, Maxim; Ieven, Margareta; Butler, Chris C.; Verheij, Theo; Little, Paul; Goossens, Hermanon; Frimodt-Møller, Niels; Bruno, Pascale; Hering, Iris; Lemiengre, Marieke; Loens, Katherine; Malmvall, Bo Eric; Muras, Magdalena; Romano, Nuria Sanchez; Prat, Matteu Serra; Svab, Igor; Swain, Jackie; Tarsia, Paolo; Leus, Frank; Veen, Robert; Worby, Tricia

    2016-01-01

    Objectives: To determine the effect of amoxicillin treatment on resistance selection in patients with community-acquired lower respiratory tract infections in a randomized, placebo-controlled trial. Methods: Patients were prescribed amoxicillin 1 g, three times daily (n = 52) or placebo (n = 50) for

  7. Primary care treatment guidelines for skin infections in Europe: congruence with antimicrobial resistance found in commensal Staphylococcus aureus in the community.

    NARCIS (Netherlands)

    Bijnen, E.M.E. van; Paget, W.J.; Heijer, C.D.J. den; Stobberingh, E.E.; Bruggeman, C.A.; Schellevis, F.G.

    2014-01-01

    Background: Over 90% of antibiotics for human use in Europe are prescribed in primary care. We assessed the congruence between primary care treatment guidelines for skin infections and commensal Staphylococcus aureus (S. aureus) antimicrobial resistance levels in community-dwelling persons. Methods:

  8. Primary care treatment guidelines for skin infections in Europe: congruence with antimicrobial resistance found in commensal Staphylococcus aureus in the community

    NARCIS (Netherlands)

    van Bijnen, E.M.E.; Paget, W.J.; den Heijer, C.D.J.; Stobberingh, E.E.; Bruggeman, C.A.; Schellevis, F.G.

    2014-01-01

    Background: Over 90% of antibiotics for human use in Europe are prescribed in primary care. We assessed the congruence between primary care treatment guidelines for skin infections and commensal Staphylococcus aureus (S. aureus) antimicrobial resistance levels in community-dwelling persons. Methods:

  9. Rise and subsequent decline of community-associated methicillin resistant Staphylococcus aureus ST30-IVc in Copenhagen, Denmark through an effective search and destroy policy

    DEFF Research Database (Denmark)

    Bartels, M D; Kristoffersen, K; Boye, K

    2010-01-01

    The number of patients with community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA) has increased rapidly in Copenhagen, Denmark since 2003. Patients with the typical Panton-Valentine leukocidin-positive CA-MRSA clone ST30-IVc were contacted with the aim of treating MRSA carriers...

  10. Accounts Assistant

    Indian Academy of Sciences (India)

    CHITRA

    (Not more than three months old). Annexure 1. Indian Academy of Sciences. C V Raman Avenue, Bengaluru 560 080. Application for the Post of: Accounts Assistant / Administrative Assistant Trainee / Assistant – Official Language. Implementation Policy / Temporary Copy Editor and Proof Reader / Social Media Manager. 1.

  11. Multidrug-resistant pathogens in hospitalised patients coming from the community with pneumonia: a European perspective.

    Science.gov (United States)

    Aliberti, Stefano; Cilloniz, Catia; Chalmers, James D; Zanaboni, Anna Maria; Cosentini, Roberto; Tarsia, Paolo; Pesci, Alberto; Blasi, Francesco; Torres, Antoni

    2013-11-01

    Probabilistic scores have been recently suggested to identify pneumonia caused by multidrug-resistant (MDR) bacteria. The aim of the study was to validate both Aliberti and Shorr scores in predicting MDR pneumonia, comparing them with healthcare associated pneumonia (HCAP) classification. Two independent European cohorts of consecutive patients hospitalised with pneumonia were prospectively evaluated in Barcelona, Spain (BC) and Edinburgh, UK (EC). Data on admission and during hospitalisation were collected. The predictive value of the three scores was explored for correctly indicating the presence of MDR pneumonia via a receiver-operating characteristic (ROC) curve. A total of 1591 patients in the BC and 1883 patients in the EC were enrolled. The prevalence of patients with MDR pathogen among those with isolated bacteria was 7.6% in the BC and 3.3% in the EC. The most common MDR pathogen found in both cohorts was MRSA, followed by MDR P aeruginosa. A significantly higher prevalence of MDR bacteria was found among patients in the intensive care unit (ICU). The two probabilistic scores, and particularly the Aliberti one, showed an area under the ROC curve higher than the HCAP classification in predicting MDR pneumonia, especially in the ICU. Risk scores able to identify MDR pneumonia could help in developing strategies for antimicrobial stewardship.

  12. Community fecal carriage of broad-spectrum cephalosporin-resistant Escherichia coli in Tunisian children.

    Science.gov (United States)

    Ferjani, Sana; Saidani, Mabrouka; Hamzaoui, Zeineb; Alonso, Carla Andrea; Torres, Carmen; Maamar, Elaa; Slim, Amine Faouzi; Boutiba, Ben Boubaker Ilhem

    2017-02-01

    The spread of extended spectrum β-lactamases (ESBL) and plasmid mediated AmpC β-lactamases (pAmpC) was evaluated in Escherichia coli strains collected from the intestinal microbiota of healthy children in Tunisia. The carriage rate of CTX R E. coli was 6.6% (7 of 105 samples) and one strain/sample was further characterized (7 isolates). These isolates harbored bla CTX-M-1 (n = 4), bla CTX-M-15 (n = 2), and bla CMY-2 gene (n = 1), which were usually located on FIB replicon type and carried class 1 integrons. The acc(6')-Ib-cr variant was identified in one isolate that harbored bla CTX-M-15 . CTX R E. coli isolates were genetically unrelated and belonged to B1 (n = 3/ST155/ST398/ST58), D (n = 2/ST117/ST493), B2 (n = 1/ST127), and A (n = 1/ST746) phylogroups. Strain virulence scores varied from 3 to 12, and frequently harbored the pathogenicity island PAI IV 536 . The intestinal tract of healthy children constitute an important reservoir of ESBL producing E. coli. Thus, improvement of hygiene measures mainly in the school environment and rational use of antibiotics would be of great help in preventing selection and diffusion of resistant strains from intestinal microbiota. Copyright © 2016 Elsevier Inc. All rights reserved.

  13. The recent emergence in hospitals of multidrug-resistant community-associated sequence type 1 and spa type t127 methicillin-resistant Staphylococcus aureus investigated by whole-genome sequencing: Implications for screening.

    Directory of Open Access Journals (Sweden)

    Megan R Earls

    Full Text Available Community-associated spa type t127/t922 methicillin-resistant Staphylococcus aureus (MRSA prevalence increased from 1%-7% in Ireland between 2010-2015. This study tracked the spread of 89 such isolates from June 2013-June 2016. These included 78 healthcare-associated and 11 community associated-MRSA isolates from a prolonged hospital outbreak (H1 (n = 46, 16 other hospitals (n = 28, four other healthcare facilities (n = 4 and community-associated sources (n = 11. Isolates underwent antimicrobial susceptibility testing, DNA microarray profiling and whole-genome sequencing. Minimum spanning trees were generated following core-genome multilocus sequence typing and pairwise single nucleotide variation (SNV analysis was performed. All isolates were sequence type 1 MRSA staphylococcal cassette chromosome mec type IV (ST1-MRSA-IV and 76/89 were multidrug-resistant. Fifty isolates, including 40/46 from H1, were high-level mupirocin-resistant, carrying a conjugative 39 kb iles2-encoding plasmid. Two closely related ST1-MRSA-IV strains (I and II and multiple sporadic strains were identified. Strain I isolates (57/89, including 43/46 H1 and all high-level mupirocin-resistant isolates, exhibited ≤80 SNVs. Two strain I isolates from separate H1 healthcare workers differed from other H1/strain I isolates by 7-47 and 12-53 SNVs, respectively, indicating healthcare worker involvement in this outbreak. Strain II isolates (19/89, including the remaining H1 isolates, exhibited ≤127 SNVs. For each strain, the pairwise SNVs exhibited by healthcare-associated and community-associated isolates indicated recent transmission of ST1-MRSA-IV within and between multiple hospitals, healthcare facilities and communities in Ireland. Given the interchange between healthcare-associated and community-associated isolates in hospitals, the risk factors that inform screening for MRSA require revision.

  14. Antibiotic Resistance in Haemophilus influenzae Decreased, except for β-Lactamase-Negative Amoxicillin-Resistant Isolates, in Parallel with Community Antibiotic Consumption in Spain from 1997 to 2007▿

    Science.gov (United States)

    García-Cobos, Silvia; Campos, José; Cercenado, Emilia; Román, Federico; Lázaro, Edurne; Pérez-Vázquez, María; de Abajo, Francisco; Oteo, Jesús

    2008-01-01

    The susceptibility to 14 antimicrobial agents and the mechanisms of aminopenicillin resistance were studied in 197 clinical isolates of Haemophilus influenzae—109 isolated in 2007 (study group) and 88 isolated in 1997 (control group). Community antibiotic consumption trends were also examined. H. influenzae strains were consecutively isolated from the same geographic area, mostly from respiratory specimens from children and adults. Overall, amoxicillin resistance decreased by 8.4% (from 38.6 to 30.2%). β-Lactamase production decreased by 15.6% (from 33 to 17.4%, P = 0.01), but amoxicillin resistance without β-lactamase production increased by 7.1% (from 5.7 to 12.8%). All β-lactamase-positive isolates were TEM-1, but five different promoter regions were identified, with Pdel being the most prevalent in both years, and Prpt being associated with the highest amoxicillin resistance. A new promoter consisting of a double repeat of 54 bp was detected. Community consumption of most antibiotics decreased, as did the geometric means of their MICs, but amoxicillin-clavulanic acid and azithromycin consumption increased by ca. 60%. For amoxicillin-clavulanic acid, a 14.2% increase in the population with an MIC of 2 to 4 μg/ml (P = 0.02) was observed; for azithromycin, a 21.2% increase in the population with an MIC of 2 to 8 μg/ml (P = 0.0005) was observed. In both periods, the most common gBLNAR (i.e., H. influenzae isolates with mutations in the ftsI gene as previously defined) patterns were IIc and IIb. Community consumption of trimethoprim-sulfamethoxazole decreased by 54%, while resistance decreased from 50 to 34.9% (P = 0.04). Antibiotic resistance in H. influenzae decreased in Spain from 1997 to 2007, but surveillance should be maintained since new forms of resistances may be developing. PMID:18505850

  15. Pressures and Resistance to the Introduction of Skills in Business Administration and Accounting Education in Spain: A New Institutional Theory Analysis

    Science.gov (United States)

    Gonzalez, Jose Maria Gonzalez; Montano, Jose Arquero; Hassall, Trevor

    2009-01-01

    Teachers, students and professionals have confirmed the need to introduce skills into business administration and accounting education in Spain. However, this change has not taken place at any desirable level. This paper uses the New Institutional Sociology (NIS) to analyse the pressures to introduce the policy that consists of the incorporation…

  16. Neonatal sepsis in rural India: timing, microbiology and antibiotic resistance in a population-based prospective study in the community setting.

    Science.gov (United States)

    Panigrahi, P; Chandel, D S; Hansen, N I; Sharma, N; Kandefer, S; Parida, S; Satpathy, R; Pradhan, L; Mohapatra, A; Mohapatra, S S; Misra, P R; Banaji, N; Johnson, J A; Morris, J G; Gewolb, I H; Chaudhry, R

    2017-08-01

    To examine the timing and microbiology of neonatal sepsis in a population-based surveillance in the Indian community setting. All live born infants in 223 villages of Odisha state were followed at home for 60 days. Suspect sepsis cases were referred to study hospitals for further evaluation including blood culture. Of 12 622 births, 842 were admitted with suspected sepsis of whom 95% were 4 to 60 days old. Culture-confirmed incidence of sepsis was 6.7/1000 births with 51% Gram negatives (Klebsiella predominating) and 26% Gram positives (mostly Staphylococcus aureus). A very high level of resistance to penicillin and ampicillin, moderate resistance to cephalosporins and extremely low resistance to Gentamicin and Amikacin was observed. The bacterial burden of sepsis in the Indian community is not high. Judicious choice of empiric antibiotics, antibiotic stewardship and alternate modalities should be considered for the management or prevention of neonatal sepsis in India.

  17. Clinical features and molecular characteristics of childhood community-associated methicillin-resistant Staphylococcus aureus infection in a medical center in northern Taiwan, 2012.

    Science.gov (United States)

    Wang, Hong-Kai; Huang, Chun-Yen; Huang, Yhu-Chering

    2017-07-05

    Since first reported in 2002, the rate of methicillin-resistant Staphylococcus aureus (MRSA) among childhood community-associated (CA) S. aureus infection in Taiwan increased significantly up to 2005. There have been no reports on this issue since then. We prospectively collected clinical S. aureus isolates from the patients aureus isolates were included, and 260 (63.6%) were MRSA. The proportion of MRSA among all S. aureus isolates in 2012 increased significantly (p resistant to erythromycin (81%) and clindamycin (79.3%). Around two-thirds of childhood community-associated S. aureus infections in northern Taiwan were MRSA. Though CC59 is still the prevalent community clone, several new clones emerged in northern Taiwan.

  18. AMERICAN ACCOUNTING

    Directory of Open Access Journals (Sweden)

    Mihaela Onica

    2005-01-01

    Full Text Available The international Accounting Standards already contribute to the generation of better and more easily comparable financial information on an international level, supporting thus a more effective allocationof the investments resources in the world. Under the circumstances, there occurs the necessity of a consistent application of the standards on a global level. The financial statements are part of thefinancial reporting process. A set of complete financial statements usually includes a balance sheet,a profit and loss account, a report of the financial item change (which can be presented in various ways, for example as a status of the treasury flows and of the funds flows and those notes, as well as those explanatory situations and materials which are part of the financial statements.

  19. An alternative hypothesis to the widely held view that renal excretion of sodium accounts for resistance to salt-induced hypertension

    Czech Academy of Sciences Publication Activity Database

    Kurtz, T. W.; DiCarlo, S. E.; Pravenec, Michal; Schmidlin, O.; Tanaka, M.; Morris Jr., R. C.

    2016-01-01

    Roč. 90, č. 5 (2016), s. 965-973 ISSN 0085-2538 Grant - others:AV ČR(CZ) AP1502 Program:Akademická prémie - Praemium Academiae Institutional support: RVO:67985823 Keywords : blood pressure * hypertension * kidney * salt * salt-resistance * salt-sensitivity * sodium * sodium chloride Subject RIV: FA - Cardiovascular Diseases incl. Cardiotharic Surgery Impact factor: 8.395, year: 2016

  20. Fluoroquinolone-Resistant Sequence Type 131 Subgroups O25b and O16 Among Extraintestinal Escherichia coli Isolates from Community-Acquired Urinary Tract Infections.

    Science.gov (United States)

    Hefzy, Enas Mamdouh; Hassuna, Noha Anwar

    2017-03-01

    The multidrug-resistant sequence type 131 (ST131) Escherichia coli is a spreading epidemiological burden particularly among isolates resistant to fluoroquinolones. We aimed to evaluate the commonality of ST131-O25b and ST131-O16 among fluoroquinolone-resistant E. coli isolates causing community-acquired urinary tract infections (UTIs) at Fayoum University Hospital, in Egypt. Ninety-two fluoroquinolone-resistant E. coli isolates were subjected to multiplex PCR for detection of ST131 of either O25b or O16 subgroups. Positive isolates were then assessed for antimicrobial susceptibility and virulence genotyping. Out of 92 fluoroquinolone-resistant E. coli isolates, 56 (60.9%) isolates were O25b/O16 subgroups of ST131, including 44 (78.6%) ST131-O25b and 12 (21.4%) ST131-O16 subgroups. All the O25b/O16 ST131 isolates were sensitive to meropenem, where ST131-O25b isolates were significantly more resistant to extended spectrum cephalosporins compared to S131-O16 strains. All the O25b/O16 ST131 isolates harbored three or more of the virulence factors associated with extraintestinal pathogenic E. coli status. ST131-O16 showed a significantly higher virulence score than ST131-O25b isolates. Our results bring to highlight the emergence of O25b/O16 ST131 isolates between community acquired UTIs among Egyptian patients. This is the first report for the presence of O16 isolates in Egypt, showing a lower predominance than the O25b subgroup. The high prevalence of O25b/O16 ST131 isolates requires strict stewardship on antimicrobial use, notably fluoroquinolones, to control the endemicity of such emerging multidrug-resistant clone in the community.

  1. American Accounting

    OpenAIRE

    Mihaela Cristina Onica

    2005-01-01

    The international Accounting Standards already contribute to the generation of better and more easily comparable financial information on an international level, supporting thus a more effective allocation of the investments resources in the world. Under the circumstances, there occurs the necessity of a consistent application of the standards on a global level. The financial statements are part of the financial reporting process. A set of complete financial statements usually includes a bala...

  2. Molecular characterization of community- & hospital-acquired methicillin-resistant & methicillin-sensitive Staphylococcus aureus isolates in Sikkim.

    Science.gov (United States)

    Bhutia, Kunsang Ongmoo; Singh, Tsk; Adhikari, Luna; Biswas, Shilpie

    2015-09-01

    The two major genotypic markers that distinguish community acquired (CA) from hospital acquired (HA) methicillin resistant Staphylococcus aureus (MRSA) isolates are the architecture of mobile genetic element (SCCmec type) and presence of panton valentine leukocidin (PVL) toxin. This study was conducted to determine the molecular characteristics of CA- and HA- MRSA and methicillin sensitive S. aureus (MSSA) isolates in Sikkim. A total of 150 clinical isolates of S. aureus isolated from various clinical specimens were subjected to duplex (mec-A and pvl gene) and multiplex (SCCmec typing) PCR. Of the 150 isolates, 53 (35.33%) and 66 (44%) were positive for mec-A (MRSA) and pvl genes, respectively. Thirty eight (25.33%) met the definition of CA-MRSA and 15 (10%) of HA-MRSA and the remaining 63 (42%) and 34 (22.66%) as CA- and HA-MSSA, respectively. No significant difference was seen in the distribution of PVL toxin in MRSA and MSSA isolates, but it was significantly (P<0.001) high in overall MRSA isolates than in MSSA. The majority of the MRSA isolates showed a double amplification band of SCCmec type III plus V (54.71%), and only a fewer isolates were amplified by single DNA fragments of type I (1.88%), III (3.77%), IVa (1.88%) and V (11.32%). SCCmec types I, III, IVa, were found only in HA-MRSA isolates, whereas type V in both the CA- and HA-MRSA. AST pattern showed that 18.42 per cent (7/38) and 46.66 per cent (7/15) were multidrug resistant (MDR)-CA-MRSA and MDR-HA-MRSA, respectively. The present results show that SCCmec type V MRSA has been on the rise, and genotypic markers such as pvl gene detection used for the differentiation of these clinically distinct isolates of MRSA may not be reliable.

  3. Community-associated methicillin-resistant Staphylococcus aureus infections in men who have sex with men: A case series.

    Science.gov (United States)

    Sztramko, R; Katz, K; Antoniou, T; Mulvey, Mr; Brunetta, J; Crouzat, F; Kovacs, C; Merkley, B; Tilley, D; Loutfy, Mona R

    2007-07-01

    The purpose of the present study was to describe the clinical characteristics and management of community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA) infections among a cohort of men who have sex with men. A retrospective chart review was conducted of patients with culture-proven MRSA at Maple Leaf Medical Clinic (Toronto, Ontario) between November 2004 and December 2005. Cases were identified by individual physicians and by queries in the clinical management system. A standard data collection form was used to record patient demographics, potential risk factors for MRSA and course of illness. When available, antimicrobial sensitivities were recorded. DNA fingerprinting using pulsed-field gel electrophoresis, and genetic analysis for SCCmec typing and detection of the Panton-Valentine leukocidin cytotoxin were performed on six available isolates. Seventeen patients with MRSA infection were identified, 12 (71%) of whom were HIV-positive. The most common clinical presentation was abscess (35%), followed by furuncle (17%), folliculitis (17%), cellulitis (17%) and sinusitis (12%). The majority of MRSA isolates were resistant to ciprofloxacin (92%) and levofloxacin (77%). All isolates were susceptible to trimethoprim-sulfamethoxazole, rifampin, linezolid, gentamicin and clindamycin, while the majority were susceptible to tetracycline (80%). All six isolates tested were SCCmec type IVa-positive and Panton-Valentine leukocidin-positive, and had fingerprint patterns consistent with the CMRSA-10 (USA300) clone. The present study describes the clinical presentation and management of CA-MRSA infections occurring in Toronto among men who have sex with men. The infections appear to have been caused by CMRSA-10, which has caused the majority of CA-MRSA outbreaks elsewhere.

  4. The (Street) Art of Resistance

    DEFF Research Database (Denmark)

    Awad, Sarah H.; Wagoner, Brady; Glaveanu, Vlad Petre

    2017-01-01

    This chapter focuses on the interrelation between resistance, novelty and social change We will consider resistance as both a social and individual phenomenon, a constructive process that articulates continuity and change and as an act oriented towards an imagined future of different communities....... In this account, resistance is thus a creative act having its own dynamic and, most of all, aesthetic dimension. In fact, it is one such visibly artistic form of resistance that will be considered here, the case of street art as a tool of social protest and revolution in Egypt. Street art is commonly defined...... in sharp contrast with high or fine art because of its collective nature and anonymity, its different kind of aesthetics, and most of all its disruptive, ‘anti-social’ outcomes. With the use of illustrations, we will argue here that street art is prototypical of a creative form of resistance, situated...

  5. Acute haematogenous community-acquired methicillin-resistant Staphylococcus aureus osteomyelitis in an adult: Case report and review of literature

    Directory of Open Access Journals (Sweden)

    Dhanoa Amreeta

    2012-10-01

    Full Text Available Abstract Background Methicillin-resistant Staphylococcus aureus (MRSA has of late emerged as a cause of community-acquired infections among immunocompetent adults without risk factors. Skin and soft tissue infections represent the majority of community-acquired methicillin-resistant Staphylococcus aureus (CA-MRSA clinical presentations, whilst invasive and life-threatening illness like necrotizing pneumonia, necrotizing fasciitis, pyomyositis, osteomyelitis and sepsis syndrome are less common. Although more widely described in the pediatric age group, the occurrence of CA-MRSA osteomyelitis in adults is an uncommonly reported entity. Case presentation We describe an invasive CA-MRSA infection in a 28 year-old previously healthy male, manifesting with bacteraemia, osteomyelitis of femur, pyomyositis and septic arthritis of the knee. Initially a preliminary diagnosis of osteosarcoma was suggested by imaging studies and patient underwent a bone biopsy. MRSA was subsequently isolated from blood cultures taken on day of admission, bone, tissue and pus cultures. Incision and drainage of abscess was performed and patient was treated with vancomycin, with fusidic acid added later. It took 6 months for the inflammatory markers to normalize, warranting 6-months of anti-MRSA therapy. Patient was a fervent deer hunter and we speculate that he acquired this infection from extensive direct contact with deer. Molecular characterization of this isolate showed that it belonged to multilocus sequence type (MLST ST30 and exhibited the staphylococcal chromosome cassette mec (SCCmec type IV, staphylococcus protein A (spa type t019, accessory gene regulator (agr type III and dru type dt10m. This strain harbored Panton-Valentine leukocidin (pvl genes together with 3 other virulent genes; sei (enterotoxin, hlg (hemolysin and fnbA (fibronectin binding protein. Conclusion This case study alerts physicians that beyond the most commonly encountered skin and soft tissue

  6. Induction of the staphylococcal proteolytic cascade by antimicrobial fatty acids in community acquired methicillin resistant Staphylococcus aureus.

    Directory of Open Access Journals (Sweden)

    Benjamin Arsic

    Full Text Available Community acquired methicillin resistant Staphylococcus aureus (CA-MRSA, and the USA300 strain of CA-MRSA in particular, are known for their rapid community transmission, and propensity to cause aggressive skin and soft tissue infections. To assess factors that contribute to these hallmark traits of CA-MRSA, we evaluated how growth of USA300 and production of secreted virulence factors was influenced on exposure to physiologic levels of unsaturated free fatty acids that would be encountered on the skin or anterior nares, which represent the first sites of contact with healthy human hosts. There was a sharp threshold between sub-inhibitory and inhibitory concentrations, such that 100 µM sapienic acid (C16∶1 and linoleic acid (C18∶1 were sufficient to prevent growth after 24 h incubation, while 25 µM allowed unrestricted growth, and 50 µM caused an approximate 10-12 h lag, followed by unimpeded exponential growth. Conversely, saturated palmitic or stearic acids did not affect growth at 100 µM. Although growth was not affected by 25 µM sapienic or linoleic acid, these and other unsaturated C16 and C18 fatty acids, but not their saturated counterparts, promoted robust production of secreted proteases comprising the Staphylococcal proteolytic cascade. This trait was also manifested to varying degrees in other CA-MRSA, and in genetically diverse methicillin susceptible S. aureus strains. Therefore, induction of the Staphylococcal proteolytic cascade by unsaturated fatty acids is another feature that should now be evaluated as a potential contributing factor in the aggressive nature of skin and soft tissue infections caused by USA300, and as a general virulence mechanism of S. aureus.

  7. Characterization of microbial community and antibiotic resistance genes in activated sludge under tetracycline and sulfamethoxazole selection pressure

    International Nuclear Information System (INIS)

    Zhang, Yingying; Geng, Jinju; Ma, Haijun; Ren, Hongqiang; Xu, Ke; Ding, Lili

    2016-01-01

    To investigate the microbial community characteristics, antibiotic resistance genes (ARGs), and bioreactor effluent quality change under tetracycline (TC) and sulfamethoxazole (SMX) selection pressure, sequencing batch reactors (SBRs) were used with environmentally relevant concentration and high-level of TC and SMX concentrations (0, 5 ppb, 50 ppb and 10 ppm). Chemical oxygen demand (COD) and ammonia nitrogen (NH 4 + −N) removals appeared unchanged (p > 0.05) with 5 and 50 ppb, but decreased significantly with 10 ppm (p < 0.05). Extracellular polymeric substances (EPS) concentrations increased significantly with increasing TC or SMX concentrations (p < 0.05). High-throughput 16S rRNA gene sequencing results suggested that Proteobacteria, Actinobacteria and Bacteroidetes were the three most abundant phyla in sludge samples. The Actinobacteria percentages increased with increasing TC or SMX concentration, while Proteobacteria and Bacteroidetes decreased. The microbial diversity achieved its maximum at 5 ppb and decreased with higher concentrations. The total ARGs abundances in sludge increased with addition of TC or SMX, and the higher relative abundances were in the order of sul1 > tetG > sul2 > tetA > intI1 > tetS > tetC. Pearson correlation analysis showed most ARGs (tetA, tetC, tetG, tetK, tetM, sul1) were significantly correlated with intI1 (p < 0.01). - Highlights: • COD and NH 4 + −N removals significantly decrease under 10 ppm TC or SMX. • Activated sludge EPS concentrations increase with increasing TC or SMX concentrations. • TC and SMX affect the microbial community diversity of activated sludge. • Actinobacteria abundances increase with increase of TC or SMX concentration. • ARGs abundance increases with addition of TC or SMX.

  8. Characterization of microbial community and antibiotic resistance genes in activated sludge under tetracycline and sulfamethoxazole selection pressure

    Energy Technology Data Exchange (ETDEWEB)

    Zhang, Yingying; Geng, Jinju, E-mail: jjgeng@nju.edu.cn; Ma, Haijun; Ren, Hongqiang; Xu, Ke; Ding, Lili

    2016-11-15

    To investigate the microbial community characteristics, antibiotic resistance genes (ARGs), and bioreactor effluent quality change under tetracycline (TC) and sulfamethoxazole (SMX) selection pressure, sequencing batch reactors (SBRs) were used with environmentally relevant concentration and high-level of TC and SMX concentrations (0, 5 ppb, 50 ppb and 10 ppm). Chemical oxygen demand (COD) and ammonia nitrogen (NH{sub 4}{sup +}−N) removals appeared unchanged (p > 0.05) with 5 and 50 ppb, but decreased significantly with 10 ppm (p < 0.05). Extracellular polymeric substances (EPS) concentrations increased significantly with increasing TC or SMX concentrations (p < 0.05). High-throughput 16S rRNA gene sequencing results suggested that Proteobacteria, Actinobacteria and Bacteroidetes were the three most abundant phyla in sludge samples. The Actinobacteria percentages increased with increasing TC or SMX concentration, while Proteobacteria and Bacteroidetes decreased. The microbial diversity achieved its maximum at 5 ppb and decreased with higher concentrations. The total ARGs abundances in sludge increased with addition of TC or SMX, and the higher relative abundances were in the order of sul1 > tetG > sul2 > tetA > intI1 > tetS > tetC. Pearson correlation analysis showed most ARGs (tetA, tetC, tetG, tetK, tetM, sul1) were significantly correlated with intI1 (p < 0.01). - Highlights: • COD and NH{sub 4}{sup +}−N removals significantly decrease under 10 ppm TC or SMX. • Activated sludge EPS concentrations increase with increasing TC or SMX concentrations. • TC and SMX affect the microbial community diversity of activated sludge. • Actinobacteria abundances increase with increase of TC or SMX concentration. • ARGs abundance increases with addition of TC or SMX.

  9. Predominance of community-associated sequence type 59 methicillin-resistant Staphylococcus aureus in a paediatric intensive care unit.

    Science.gov (United States)

    Song, Qifa; Wu, Junhua; Ruan, Peisen

    2018-03-01

    To investigate the distribution of molecular types of methicillin-resistant Staphylococcus aureus (MRSA) in a paediatric intensive care unit (PICU) according to their community-associated (CA) and hospital-associated (HA) source of acquisition, and thus assess the degree to which CA-MRSA has been introduced into the PICU. We implemented an MRSA surveillance in a PICU during 2013-2016 and investigated the genetic diversity of the isolates retrospectively using three genetic typing methods, as well as antibiograms and virulence factor profiles.Results/Key findings. From 2684 specimens, we identified 60 MRSA isolates, 43 of which were ST59 CA-MRSA. These 43 ST59 MRSA isolates could be further subtyped into 2 clusters and 7 sporadic isolates by pulsed-field gel electrophoresis, and 3 spa types, which demonstrated the genetic diversity in ST59 MRSA. Phenotypic diversity was also demonstrated among these ST59 MRSA isolates, with 12 virulence factor profiles and 4 antibiograms being identified. Epidemiological information showed that 43 ST59 MRSA isolates were both community-associated (15 isolates) and hospital-associated (28 isolates) and caused colonization and various types of infections in different age groups of children. Our results show that a predominant ST59 CA-MRSA has been introduced into the PICU to a significant extent. This has caused the ST59 HA-MRSA and CA-MRSA in the PICU to be indistinguishable. Our results also demonstrate that when we are interpreting situations where the causative agents of infections focus on very limited pathogenic clones, combined typing methods and epidemiological information are needed to investigate isolates' genetic and phenotypic diversity to distinguish an outbreak from endemic cases.

  10. Dependence and resistance in community mental health care-Negotiations of user participation between staff and users.

    Science.gov (United States)

    Femdal, I; Knutsen, I R

    2017-10-01

    interplay between users and health professionals in community mental health care. Method This qualitative study is based on semi-structured in-depth interviews, involving ten service users and ten professionals in community mental health care in Norway. The analysis is inspired by Willig's model for Foucauldian discourse analysis. Results The study illuminates the dynamic nature of user participation that arises through negotiation between users' and professionals' positions as change enablers, dependents, resisters, persuaders and knowledge holders. Discussion Discourses of user participation allow for different subject positions in mental health care. User participation also involves government and questions of power, as well as ambitions of change and control. Professionals act in different ways to make and keep users active, participating, enterprising and self-governing, and users respond and take part within the same discursive framework. Implications for practice Awareness of subjects' positions in discourses is important to increase reflection on the dynamic interplay in user-professional collaboration. © 2017 John Wiley & Sons Ltd.

  11. Infrastrukturel Accountability

    DEFF Research Database (Denmark)

    Ubbesen, Morten Bonde

    Hvordan redegør man troværdigt for noget så diffust som en hel nations udledning af drivhusgasser? Det undersøger denne afhandling i et etnografisk studie af hvordan Danmarks drivhusgasregnskab udarbejdes, rapporteres og kontrolleres. Studiet trækker på begreber og forståelser fra 'Science & Tech...... & Technology Studies', og bidrager med begrebet 'infrastrukturel accountability' til nye måder at forstå og tænke om det arbejde, hvormed højt specialiserede praksisser dokumenterer og redegør for kvaliteten af deres arbejde....

  12. Community-acquired pneumonia caused by methicillin-resistant Staphylococcus aureus in critically-ill patients: systematic review

    Directory of Open Access Journals (Sweden)

    Nuria Carballo

    2017-03-01

    Full Text Available Introduction: Community-acquired pneumonia (CAP is associated with high morbidity and mortality rates. Despite methicillin-resistant Staphylococcus aureus (MRSA having often been associated with nosocomial pneumonia, the condition of some MRSA CAP patients is severe enough to warrant their being admitted to ICU. Objective: The purpose of this study is to conduct a systematic review of the literature on antibiotic treatment of MRSA CAP in critically-ill patients. Material and methods: An online search was conducted for locating articles on MRSA CAP in critically ill patients. Relevant publications were identified in PUBMED, the BestPractice database, UpToDate database and the Cochrane Library for articles published in English within the December 2001 - April 2016 time frame. Results: A total of 70 articles were found to have been published, 13 (18.8% having been included and 57 (81.4% excluded. Cohort studies were predominant, having totaled 16 in number (20.7% as compared to one sole cross-sectional study (3.5%. Conclusions: The experience in the treatment of MRSA CAP in patients requiring admission to ICU is quite limited. Vancomycin or linezolid seem to be the treatments of choice for MRSA CAP, although there not be any specific recommendation in this regard. It may be useful to use alternative routes, such as administration via aerosolized antibiotics, continuous infusion or in association with other antibiotics.

  13. Radiological findings of community-acquired methicillin-resistant and methicillin-susceptible staphylococcus aureus pediatric pneumonia in Hawaii

    International Nuclear Information System (INIS)

    Erdem, Guliz; Bergert, Lora; Len, Kyra; Melish, Marian; Kon, Kevin; DiMauro, Robert

    2010-01-01

    Community-acquired Staphylococcus aureus (CA-SA) infections are common among pediatric patients in Hawaii. We wanted to characterize the radiological features of methicillin-susceptible (CA-MSSA) and methicillin-resistant (CA-MRSA) staphylococcal pneumonia in Hawaiian children. We retrospectively reviewed medical records and imaging studies of children with SA pneumonia identified from 1996 through 2007. Of 40 children, 26 (65%) had CA-MRSA pneumonia and 14 patients (35%) had CA-MSSA pneumonia. CA-MRSA patients were significantly younger than CA-MSSA patients (65% younger than 1 year vs. 36% older). In a majority (62%) of CA-MRSA patients, the consolidation was unilateral; in most of the CA-MSSA cases (79%), the consolidation was bilateral. Fifty percent of the patients with CA-MRSA and 21% of those with CA-MSSA had pneumatoceles (P = 0.1). CA-MRSA patients more commonly had pleural effusions (85% vs. 64% for CA-MSSA) and pleural thickening (50% vs. 36% for CA-MSSA). This case series describes the radiologic characteristics of CA-MRSA and CA-MSSA pneumonia in children in a highly endemic area. We found that CA-MRSA pneumonias are unilateral in a majority of pediatric pneumonia cases, are more common in children 1 year or younger, and have higher rates of complications in comparison to CA-MSSA patients. (orig.)

  14. Radiological findings of community-acquired methicillin-resistant and methicillin-susceptible staphylococcus aureus pediatric pneumonia in Hawaii

    Energy Technology Data Exchange (ETDEWEB)

    Erdem, Guliz; Bergert, Lora; Len, Kyra; Melish, Marian [University of Hawaii, John A. Burns School of Medicine, Department of Pediatrics, Honolulu, HI (United States); Kon, Kevin; DiMauro, Robert [Kapiolani Medical Center for Women and Children, Department of Radiology, Honolulu, HI (United States)

    2010-11-15

    Community-acquired Staphylococcus aureus (CA-SA) infections are common among pediatric patients in Hawaii. We wanted to characterize the radiological features of methicillin-susceptible (CA-MSSA) and methicillin-resistant (CA-MRSA) staphylococcal pneumonia in Hawaiian children. We retrospectively reviewed medical records and imaging studies of children with SA pneumonia identified from 1996 through 2007. Of 40 children, 26 (65%) had CA-MRSA pneumonia and 14 patients (35%) had CA-MSSA pneumonia. CA-MRSA patients were significantly younger than CA-MSSA patients (65% younger than 1 year vs. 36% older). In a majority (62%) of CA-MRSA patients, the consolidation was unilateral; in most of the CA-MSSA cases (79%), the consolidation was bilateral. Fifty percent of the patients with CA-MRSA and 21% of those with CA-MSSA had pneumatoceles (P = 0.1). CA-MRSA patients more commonly had pleural effusions (85% vs. 64% for CA-MSSA) and pleural thickening (50% vs. 36% for CA-MSSA). This case series describes the radiologic characteristics of CA-MRSA and CA-MSSA pneumonia in children in a highly endemic area. We found that CA-MRSA pneumonias are unilateral in a majority of pediatric pneumonia cases, are more common in children 1 year or younger, and have higher rates of complications in comparison to CA-MSSA patients. (orig.)

  15. An outbreak of community-associated methicilin-resistant Staphylococcus aureus infection in a boarding school in Hong Kong (China

    Directory of Open Access Journals (Sweden)

    Wong Mui-ling

    2014-01-01

    Full Text Available Background: In November 2012, an outbreak of community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA skin and soft tissue infections affecting students at a boarding school in Hong Kong (China was detected. Methods: A case was defined as any student or staff notified with MRSA infection from 25 October 2012 to 5 July 2013 with the clinical isolate being of staphylococcal cassette chromosome mec type IV or V and positive for Panton-Valentine leukocidin gene. We conducted field investigations, advised on control measures and enhanced surveillance for skin and soft tissue infections at the school. Decolonization therapies were offered to all cases and contacts, and carrier screening was conducted. Results: There were five cases; two (40% were hospitalized and three (60% required surgical treatments. Initial screening comprised 240 students and 81 staff members. Overall, four cases (80% plus eight other students (3.3% were carriers, with eight of 12 (66.7% from the same dormitory. All staff members screened negative. After intensified control measures, the number of students screened positive for CA-MRSA decreased from nine to one with no more cases identified in the school. Conclusion: Identification of carriers, decolonization therapy, monitoring of cases and contacts and strengthening of environmental and personal hygiene were control measures that helped contain this CA-MRSA outbreak in a boarding school in Hong Kong (China.

  16. Update on the prevention and control of community-acquired meticillin-resistant Staphylococcus aureus (CA-MRSA).

    Science.gov (United States)

    Skov, Robert; Christiansen, Keryn; Dancer, Stephanie J; Daum, Robert S; Dryden, Matthew; Huang, Yhu-Chering; Lowy, Franklin D

    2012-03-01

    The rapid dissemination of community-acquired meticillin-resistant Staphylococcus aureus (CA-MRSA) since the early 2000s and the appearance of new successful lineages is a matter of concern. The burden of these infections varies widely between different groups of individuals and in different regions of the world. Estimating the total burden of disease is therefore problematic. Skin and soft-tissue infections, often in otherwise healthy young individuals, are the most common clinical manifestation of these infections. The antibiotic susceptibilities of these strains also vary, although they are often more susceptible to 'traditional' antibiotics than related hospital-acquired strains. Preventing the dissemination of these organisms throughout the general population requires a multifaceted approach, including screening and decolonisation, general hygiene and cleaning measures, antibiotic stewardship programmes and, in the future, vaccination. The current evidence on the prevention and control of CA-MRSA is appraised and summarised in this review. Copyright © 2011 Elsevier B.V. and the International Society of Chemotherapy. All rights reserved.

  17. The impact of a freshwater fish farm on the community of tetracycline-resistant bacteria and the structure of tetracycline resistance genes in river water.

    Science.gov (United States)

    Harnisz, Monika; Korzeniewska, Ewa; Gołaś, Iwona

    2015-06-01

    The aim of this study was to assess the impact of a fish farm on the structure of antibiotic resistant bacteria and antibiotic resistance genes in water of Drwęca River. Samples of upstream river waters; post-production waters and treated post-production waters from fish farm; as well as downstream river waters were monitored for tetracycline resistant bacteria, tetracycline resistant genes, basic physico-chemical parameters and tetracyclines concentration. The river waters was characterized by low levels of pollution, which was determined based on water temperature, pH and concentrations of dissolved oxygen and tetracycline antibiotics. Culture-dependent (heterotrophic plate counts, counts of bacteria resistant to oxytetracycline (OTC(R)) and doxycycline (DOX(R)), minimum inhibitory concentrations for oxytetracycline and doxycycline, multidrug resistance of OTC(R) and DOX(R), qualitative composition of OTC(R) and DOX(R), prevalence of tet genes in resistant isolates) and culture-independent surveys (quantity of tet gene copies) revealed no significant differences in the abundance of antibiotic-resistant bacteria and antibiotic resistance genes between the studied samples. The only way in which the fish farm influenced water quality in the Drwęca River was by increasing the diversity of tetracycline-resistance genes. However, it should also be noted that the bacteria of the genera Aeromonas sp. and Acinetobacter sp. were able to transfer 6 out of 13 tested tet genes into Escherichiacoli, which can promote the spread of antibiotic resistance in the environment. Copyright © 2015 Elsevier Ltd. All rights reserved.

  18. Enhanced Student Learning in Accounting Utilising Web-Based Technology, Peer-Review Feedback and Reflective Practices: A Learning Community Approach to Assessment

    Science.gov (United States)

    Taylor, Sue; Ryan, Mary; Pearce, Jon

    2015-01-01

    Higher education is becoming a major driver of economic competitiveness in an increasingly knowledge-driven global economy. Maintaining the competitive edge has seen an increase in public accountability of higher education institutions through the mechanism of ranking universities based on the quality of their teaching and learning outcomes. As a…

  19. New patterns of methicillin-resistant Staphylococcus aureus (MRSA) clones, community-associated MRSA genotypes behave like healthcare-associated MRSA genotypes within hospitals, Argentina.

    Science.gov (United States)

    Egea, Ana L; Gagetti, Paula; Lamberghini, Ricardo; Faccone, Diego; Lucero, Celeste; Vindel, Ana; Tosoroni, Dario; Garnero, Analía; Saka, Hector A; Galas, Marcelo; Bocco, José L; Corso, Alejandra; Sola, Claudia

    2014-11-01

    Methicillin-resistant Staphylococcus aureus (MRSA) burden is increasing worldwide in hospitals [healthcare-associated (HA)-MRSA] and in communities [community-associated (CA)-MRSA]. However, the impact of CA-MRSA within hospitals remains limited, particularly in Latin America. A countrywide representative survey of S. aureus infections was performed in Argentina by analyzing 591 clinical isolates from 66 hospitals in a prospective cross-sectional, multicenter study (Nov-2009). This work involved healthcare-onset infections-(HAHO, >48 hospitalization hours) and community-onset (CO) infections [including both, infections (HACO) in patients with healthcare-associated risk-factors (HRFs) and infections (CACO) in those without HRFs]. MRSA strains were genetically typed as CA-MRSA and HA-MRSA genotypes (CA-MRSAG and HA-MRSAG) by SCCmec- and spa-typing, PFGE, MLST and virulence genes profile by PCR. Considering all isolates, 63% were from CO-infections and 55% were MRSA [39% CA-MRSAG and 16% HA-MRSAG]. A significantly higher MRSA proportion among CO- than HAHO-S. aureus infections was detected (58% vs 49%); mainly in children (62% vs 43%). The CA-MRSAG/HA-MRSAG have accounted for 16%/33% of HAHO-, 39%/13% of HACO- and 60.5%/0% of CACO-infections. Regarding the epidemiological associations identified in multivariate models for patients with healthcare-onset CA-MRSAG infections, CA-MRSAG behave like HA-MRSAG within hospitals but children were the highest risk group for healthcare-onset CA-MRSAG infections. Most CA-MRSAG belonged to two major clones: PFGE-type N-ST30-SCCmecIVc-t019-PVL(+) and PFGE-type I-ST5-IV-SCCmecIVa-t311-PVL(+) (45% each). The ST5-IV-PVL(+)/ST30-IV-PVL(+) clones have caused 31%/33% of all infections, 20%/4% of HAHO-, 43%/23% of HACO- and 35%/60% of CACO- infections, with significant differences by age groups (children/adults) and geographical regions. Importantly, an isolate belonging to USA300-0114-(ST8-SCCmecIVa-spat008-PVL(+)-ACME(+)) was detected

  20. The Real of Community, the Desire for Development and the Performance of Egalitarianism in the Peruvian Andes: A Materialist–Utopian Account

    NARCIS (Netherlands)

    Vries, de P.A.

    2015-01-01

    The paper proposes a materialist–utopian perspective for explaining the persistence of community in the Andes by drawing upon Lacanian theory and the thought of the Peruvian Marxist José Carlos Mariátegui. What characterizes the Andean comunidad are not notions of belonging and identity, but the

  1. Design Accountability

    DEFF Research Database (Denmark)

    Koskinen, Ilpo; Krogh, Peter

    2015-01-01

    . This paper looks at constructive design research which takes the entanglement of theory and practice as its hallmark, and uses it as a test case in exploring how design researchers can work with theory, methodology, and practice without losing their identity as design researchers. The crux of practice based...... design research is that where classical research is interested in singling out a particular aspect and exploring it in depth, design practice is characterized by balancing numerous concerns in a heterogenous and occasionally paradoxical product. It is on this basis the notion of design accountability......When design research builds on design practice, it may contribute to both theory and practice of design in ways richer than research that treats design as a topic. Such research, however, faces several tensions that it has to negotiate successfully in order not to lose its character as research...

  2. "Population structure of drug-susceptible, -resistant and ESBL-producing Escherichia coli from community-acquired urinary tract infections"

    DEFF Research Database (Denmark)

    Hertz, Frederik Boetius; Nielsen, Jesper Boye; Schønning, Kristian

    2016-01-01

    BACKGROUND: Escherichia coli is the most common cause of urinary tract infection (UTI). The pathogenic isolates are becoming increasingly resistant to antibiotics; with a worldwide dissemination of resistant sequence types (ST). We characterized three different uropathogenic E. coli populations...

  3. Assessment of pit latrines in a peri-urban community in KwaZulu-Natal (South Africa) as a source of antibiotic resistant E. coli strains.

    Science.gov (United States)

    Beukes, Lorika S; King, Tracy L B; Schmidt, Stefan

    2017-11-01

    Due to the frequent use of antibiotics and recurring illnesses related to multidrug-resistant (MDR) bacteria in South Africa, we determined if MDR Escherichia coli were present in pit latrine fecal sludge samples obtained from a peri-urban community in KwaZulu-Natal, South Africa. The abundance of E. coli in pit latrine samples was established using a most probable number (MPN) method with species confirmation done using biochemical tests and polymerase chain reaction (PCR). Forty-four randomly selected E. coli pit latrine isolates were further characterized, using the European committee on antimicrobial susceptibility testing (EUCAST) disk diffusion method to establish antibiotic resistance profiles for these E. coli isolates. The resulting MPN values for E. coli ranged from one to 6.2 log 10 MPN per gram of fresh pit latrine fecal sludge. While only 3 out of 44 E. coli pit latrine isolates showed no resistance to any of the 12 tested antibiotics, most isolates were resistant to two or more antibiotics. The majority of isolates showed resistance to at least one of the two tested aminoglycosides, one isolate showed resistance to the carbapenem ertapenem, and although resistance was not detected for tigecycline four pit latrine E. coli isolates showed intermediate resistance to this antibiotic. However, about 14% of the E. coli pit latrine isolates were categorized as MDR, all of which showed resistance to four or more antibiotics. The presence of MDR E. coli strains in pit latrine samples demonstrates that these facilities are potential sources for MDR bacteria. Copyright © 2017 Elsevier GmbH. All rights reserved.

  4. The dissemination of ST80-SCCmec-IV community-associated methicillin resistant Staphylococcus aureus clone in Kuwait hospitals

    Directory of Open Access Journals (Sweden)

    Sarkhoo Eiman

    2010-11-01

    Full Text Available Abstract Background Community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA is a global healthcare problem. The purpose of this study was to characterize CA-MRSA clones and their distribution in Kuwait hospitals. Methods In total, 135 CA-MRSA isolates, carrying the SCCmec IV or V genetic elements, isolated in eight hospitals were characterized using antibiogram, pulsed-field gel electrophoresis, multilocus sequence typing, and carriage of genes for Panton-Valentine Leukocidin (PVL, capsular polysaccharides types (cap 5 and 8, accessory genes regulators (agr, Staphylococcal enterotoxins (SE and toxic shock syndrome toxin 1 (tst. Results They were susceptible to vancomycin, teicoplanin and linezolid but resistant to kanamycin (62%, fusidic acid (42.2%, tetracycline (39.3%, erythromycin and clindamycin (21.5%, gentamicin (5.9%, streptomycin (6.7%, trimethoprim (5.9%, mupirocin (6.6% and cadmium acetate (82.2%. They consisted of 10 pulsotypes with the majority belonging to PFGE type I (51.1%, type II (22.2%, type IV (13.3% and type III (3.7%. They belonged to 10 sequence types (ST comprising ST80 (51.1%, ST30 (22.2%, ST5 (14.1%, ST1 (4.45, ST6 (3.7%, ST88 (1.5%, ST834 (1.5%, ST8 (0.7%, ST46 (0.7% and ST950 (0.7%. Genes for PVL, cap 8, cap 5 and agr III, agr I and agr II were detected in 61.5%, 77.3%, 20.7% and 62.2%, 17% and 8.1% of the isolates respectively. Nine (6.7% isolates contained tst while 103 isolates were positive for SE genes with sei (63.0%, seg (41.5% and sed (29.6% as the common SE genes. Conclusions ST80-SCCmecIV was the most common CA-MRSA clone in Kuwait hospitals presenting new challenges for infection control.

  5. Who possesses drug resistance genes in the aquatic environment?: sulfamethoxazole (SMX) resistance genes among the bacterial community in water environment of Metro-Manila, Philippines

    OpenAIRE

    Suzuki, Satoru; Ogo, Mitsuko; Miller, Todd W.; Shimizu, Akiko; Takada, Hideshige; Siringan, Maria Auxilia T.

    2013-01-01

    Recent evidence has shown that antibiotic resistant bacteria (ARB) and antibiotic resistance genes (ARGs) are ubiquitous in natural environments, including sites considered pristine. To understand the origin of ARGs and their dynamics, we must first define their actual presence in the natural bacterial assemblage. Here we found varying distribution profiles of sul genes in “colony forming bacterial assemblages” and “natural bacterial assemblages.” Our monitoring for antibiotic contamination r...

  6. Prospective Investigation of Nasal Mupirocin, Hexachlorophene Body Wash, and Systemic Antibiotics for Prevention of Recurrent Community-Associated Methicillin-Resistant Staphylococcus aureus Infections

    OpenAIRE

    Miller, Loren G.; Tan, Jennifer; Eells, Samantha J.; Benitez, Esther; Radner, Allen B.

    2012-01-01

    Recurrent community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA) skin infections are an increasingly common problem. However, there are no data on the efficacy of decolonization regimens. We prospectively evaluated 31 patients with recurrent CA-MRSA skin infections who received nasal mupirocin, topical hexachlorophene body wash, and an oral anti-MRSA antibiotic. The mean number of MRSA infections after the intervention decreased significantly from baseline (0.03 versus 0.8...

  7. Invasive Community-Acquired Methicillin-Resistant Staphylococcus aureus in a Japanese Girl with Disseminating Multiple Organ Infection: A Case Report and Review of Japanese Pediatric Cases

    OpenAIRE

    Yonezawa, Ryuta; Kuwana, Tsukasa; Kawamura, Kengo; Inamo, Yasuji

    2015-01-01

    Pediatric invasive community-acquired methicillin-resistant Staphylococcus aureus (CA-MRSA) infection is very serious and occasionally fatal. This infectious disease is still a relatively rare and unfamiliar infectious disease in Japan. We report a positive outcome in a 23-month-old Japanese girl with meningitis, osteomyelitis, fasciitis, necrotizing pneumonia, urinary tract infection, and bacteremia due to CA-MRSA treated with linezolid. PCR testing of the CA-MRSA strain was positive for PVL...

  8. Panton-valentine leukocidin enhances the severity of community-associated methicillin-resistant Staphylococcus aureus rabbit osteomyelitis.

    Directory of Open Access Journals (Sweden)

    Anne-Claude Crémieux

    Full Text Available BACKGROUND: Extensive spread of community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA in the United States, and the concomitant increase in severe invasive staphylococcal infections, including osteomyelitis, in healthy children, has led to renewed interest in Panton-Valentine leukocidin (PVL. However, the pathogenetic role of PVL in staphylococcal infections remains controversial, possibly because it depends on the site of infection. METHODOLOGY/PRINCIPAL FINDINGS: We compared the course of experimental rabbit osteomyelitis due to the PVL-positive CA-MRSA strain USA 300 (LAC and its PVL-negative isogenic derivative (LACDeltapvl, using a low and a high inoculum (8x10(5 and 4x10(8 CFU. With the low inoculum, bone infection was less frequent on day 7 (D7 and day 28 (D28 with LACDeltapvl than with LAC (respectively 12/19 and 18/19 animals, p = 0.042. With the high inoculum of both strains, all the animals were infected on D7 and the infection persisted on D28 in almost every case. However, tibial bacterial counts and the serum CRP concentration fell significantly between D7 and D28 with LACDeltapvl but not with LAC. Respectively 67% and 60% of LAC-infected rabbits had bone deformation and muscle/joint involvement on D7, compared to 0% and 7% of LACDeltapvl-infected rabbits (p = 0.001 and p = 0.005 respectively. Between D0 and D28, the anti-PVL antibody titer increased significantly only with the high inoculum of LAC. CONCLUSIONS/SIGNIFICANCE: PVL appears to play a role in the persistence and rapid local extension of rabbit osteomyelitis, in keeping with the greater severity of human bone infections due to PVL-positive S. aureus. The possible therapeutic implications of these findings are discussed.

  9. The effects of loaded and unloaded high-velocity resistance training on functional fitness among community-dwelling older adults.

    Science.gov (United States)

    Glenn, Jordan M; Gray, Michelle; Binns, Ashley

    2015-11-01

    Physical function declines up to 4% per year after the age of 65. High-velocity training is important for maintaining muscular power and ultimately, physical function; however, whether performing high-velocity training without external resistance increases functional fitness among older adults remains unclear. The purpose of this investigation was to evaluate loaded and unloaded high-velocity training on lower body muscular power and functional fitness in older adults. Fifty-seven community-dwelling older adults (n = 16 males, n = 41 females) participated in this study. Inclusion criteria comprised ≥65 years of age, ≥24 on the Mini-mental state examination and no falls within past year. Two groups completed a 20-week high-velocity training intervention. The non-weighted group (UNLOAD, n = 27) performed the protocol without external load while the intervention group (LOAD, n = 30) used external loads via exercise machines. Functional fitness was assessed using the Short Physical Performance Battery (SPPB), Senior Fitness Test (SFT), hand-grip and lower body power measures. Multivariate ANOVA revealed that both groups had significant improvements for average (17.21%) and peak (9.26%) lower body power, along with the SFT arm curl (16.94%), chair stand (20.10%) and 8 ft. up-and-go (15.67%). Improvements were also noticed for SPPB 8 ft. walk (25.21%). However, improvements for all functional fitness measures were independent of training group. Unloaded high-velocity training increased functional fitness and power the same as loaded training. The ability of high-velocity movements to elicit gains in functional fitness without external loads may help health professionals develop fitness programs when time/space is limiting factor. © The Author 2015. Published by Oxford University Press on behalf of the British Geriatrics Society. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  10. Hyperexpression of α-hemolysin explains enhanced virulence of sequence type 93 community-associated methicillin-resistant Staphylococcus aureus.

    Science.gov (United States)

    Chua, Kyra Y L; Monk, Ian R; Lin, Ya-Hsun; Seemann, Torsten; Tuck, Kellie L; Porter, Jessica L; Stepnell, Justin; Coombs, Geoffrey W; Davies, John K; Stinear, Timothy P; Howden, Benjamin P

    2014-02-10

    The community-associated methicillin-resistant S. aureus (CA-MRSA) ST93 clone is becoming dominant in Australia and is clinically highly virulent. In addition, sepsis and skin infection models demonstrate that ST93 CA-MRSA is the most virulent global clone of S. aureus tested to date. While the determinants of virulence have been studied in other clones of CA-MRSA, the basis for hypervirulence in ST93 CA-MRSA has not been defined. Here, using a geographically and temporally dispersed collection of ST93 isolates we demonstrate that the ST93 population hyperexpresses key CA-MRSA exotoxins, in particular α-hemolysin, in comparison to other global clones. Gene deletion and complementation studies, and virulence comparisons in a murine skin infection model, showed unequivocally that increased expression of α-hemolysin is the key staphylococcal virulence determinant for this clone. Genome sequencing and comparative genomics of strains with divergent exotoxin profiles demonstrated that, like other S. aureus clones, the quorum sensing agr system is the master regulator of toxin expression and virulence in ST93 CA-MRSA. However, we also identified a previously uncharacterized AraC/XylS family regulator (AryK) that potentiates toxin expression and virulence in S. aureus. These data demonstrate that hyperexpression of α-hemolysin mediates enhanced virulence in ST93 CA-MRSA, and additional control of exotoxin production, in particular α-hemolysin, mediated by regulatory systems other than agr have the potential to fine-tune virulence in CA-MRSA.

  11. Incidence and risk factors for community-associated methicillin-resistant Staphylococcus aureus in New York City, 2006-2012.

    Science.gov (United States)

    Baker, P; Cohen, B; Liu, J; Larson, E

    2016-04-01

    This study aims to describe changes in incidence and risk factors for community-associated methicillin resistant Staphylococcus aureus (CA-MRSA) infections upon admission to two New York City hospitals from 2006 to 2012. We examined the first hospitalization for adult patients using electronic health record and administrative data and determined the annual incidence/1000 admissions of total S. aureus, total MRSA, and CA-MRSA (within 48 h of admission) in clinical specimens over the study period. Logistic regression was used to identify factors associated with CA-MRSA in 2006 and 2012. In 137 350 admissions, the incidence of S. aureus, MRSA, and CA-MRSA/1000 admissions were 15·6, 7·0, and 3·5, respectively. The total S. aureus and MRSA isolations decreased significantly over the study period (27% and 25%, respectively) while CA-MRSA incidence was unchanged. CA-MRSA increased as a proportion of all MRSA between 2006 (46%) and 2012 (62%), and was most frequently isolated from respiratory (1·5/1000) and blood (0·7/1000) cultures. Logistic regression analysis of factors associated with isolation of CA-MRSA showed that age ⩾65 years [odds ratio (OR) 2·3, 95% confidence interval (CI) 1·2-4·5], male gender (OR 1·8, 95% CI 1·2-2·8) and history of renal failure (OR 2·6, 95% CI 1·6-4·2) were significant predictors of infection in 2006. No predictors were identified in 2012.

  12. Community-acquired pneumonia caused by methicillin-resistant Staphylococcus aureus in critically-ill patients: systematic review.

    Science.gov (United States)

    Carballo, Nuria; De Antonio-Cuscó, Marta; Echeverría-Esnal, Daniel; Luque, Sonia; Salas, Esther; Grau, Santiago

    2017-03-01

    Community-acquired pneumonia (CAP) is associated with high morbidity and mortality rates. Despite methicillin-resistant Staphylococcus aureus (MRSA) having often been associated with nosocomial pneumonia, the condition of some MRSA CAP patients is severe enough to warrant their being admitted to ICU. The purpose of this study is to conduct a systematic review of the literature on antibiotic treatment of MRSA CAP in critically-ill patients. An online search was conducted for locating articles on MRSA CAP in critically ill patients. Relevant publications were identified in PUBMED, the BestPractice database, UpToDate database and the Cochrane Library for articles published in English within the December 2001 - April 2016 time frame. A total of 70 articles were found to have been published, 13 (18.8%) having been included and 57 (81.4%) excluded. Cohort studies were predominant, having totaled 16 in number (20.7%) as compared to one sole cross-sectional study (3.5%). The experience in the treatment of MRSA CAP in patients requiring admission to ICU is quite limited. Vancomycin or linezolid seem to be the treatments of choice for MRSA CAP, although there not be any specific recommendation in this regard. It may be useful to use alternative routes, such as administration via aerosolized antibiotics, continuous infusion or in association with other antibiotics. Copyright AULA MEDICA EDICIONES 2014. Published by AULA MEDICA. All rights reserved.

  13. Community-associated Methicillin-resistant Staphylococcus aureus Bacteremia and Endocarditis among HIV Patients: A cohort study

    Directory of Open Access Journals (Sweden)

    Stine Oscar C

    2011-10-01

    Full Text Available Abstract Background HIV patients are at increased risk of development of infections and infection-associated poor health outcomes. We aimed to 1 assess the prevalence of USA300 community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA among HIV-infected patients with S. aureus bloodstream infections and. 2 determine risk factors for infective endocarditis and in-hospital mortality among patients in this population. Methods All adult HIV-infected patients with documented S. aureus bacteremia admitted to the University of Maryland Medical Center between January 1, 2003 and December 31, 2005 were included. CA-MRSA was defined as a USA300 MRSA isolate with the MBQBLO spa-type motif and positive for both the arginine catabolic mobile element and Panton-Valentin Leukocidin. Risk factors for S. aureus-associated infective endocarditis and mortality were determined using logistic regression to calculate odds ratios (OR and 95% confidence intervals (CI. Potential risk factors included demographic variables, comorbid illnesses, and intravenous drug use. Results Among 131 episodes of S. aureus bacteremia, 85 (66% were MRSA of which 47 (54% were CA-MRSA. Sixty-three patients (48% developed endocarditis and 10 patients (8% died in the hospital on the index admission Patients with CA-MRSA were significantly more likely to develop endocarditis (OR = 2.73, 95% CI = 1.30, 5.71. No other variables including comorbid conditions, current receipt of antiretroviral therapy, pre-culture severity of illness, or CD4 count were significantly associated with endocarditis and none were associated with in-hospital mortality. Conclusions CA-MRSA was significantly associated with an increased incidence of endocarditis in this cohort of HIV patients with MRSA bacteremia. In populations such as these, in which the prevalence of intravenous drug use and probability of endocarditis are both high, efforts must be made for early detection, which may improve

  14. [High prevalence of community- and hospital-acquired infections of methicillin-resistant Staphylococcus aureus containing Panton-Valentine leukocidin gene in Algiers].

    Science.gov (United States)

    Antri, K; Rouzic, N; Boubekri, I; Dauwalder, O; Beloufa, A; Ziane, H; Djennane, F; Neggazi, M; Benhabyles, B; Bes, M; Tazir, M; Etienne, J; Ramdani-Bouguessa, N

    2010-04-01

    To determine the prevalence of community acquired and hospital methicillin-resistant Staphylococcus aureus (S. aureus) infections and the Panton-Valentine leukocidin. Seven hundred S. aureus strains were collected during 21 months period in Mustapha Bacha hospital. Bacterial identification was based on standard methods and susceptibilities were tested by disk diffusion method. Molecular study (toxins, mecA gene and agr alleles) were determined for 221 S. aureus isolates by multiplex PCR. The global MRSA prevalence was 42 %, 35 % in the community and 49 % in hospital setting. The frequency of strains containing PVL genes (PVL+) was 36 %, their molecular profile was: agr3, mecA+, etd, edin, which correspond to the C-MRSA major ST80 clone in Europe and the Maghreb. The H-MRSA-PVL+ were multidrug resistant. Among the MSSA, 13 strains contained the tst gene and five contained the exfoliatine genes ETA and ETB. Our results show a high rate of MRSA-PVL+ in the community and the hospital setting. The H-MRSA-PVL+ were multidrug resistant complicating their antibiotic treatment options. Copyright 2009 Elsevier Masson SAS. All rights reserved.

  15. Drug-resistance in Streptococcus pneumoniae isolates among Spanish middle aged and older adults with community-acquired pneumonia

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    Raga-Luria Xavier

    2009-03-01

    Full Text Available Abstract Background Pneumococcal diseases remain a major cause of morbidity and mortality worldwide. Updated data on drug-resistance from different populations may be important to recognize changes in disease patterns. This study assessed current levels of penicilin resistance among Streptococcus Pneumoniae causing pneumonia in Spanish middle age and older adults. Methods Antimicrobial susceptibility was tested for 104 consecutive isolates of Streptococcus pneumoniae recovered from patients 50 years or older with radiographically confirmed pneumonia in the region of Tarragona (Spain between 2002 and 2007. According to the minimum inhibitory concentration of tested antimicrobials (penicillin, erythromycin, cefotaxime and levofloxacin strains were classified as susceptible or resistant. Antimicrobial resistance was determined for early cases (2002–2004 and contemporary cases (2005–2007. Results Twenty-seven (25.9% were penicillin-resistant strains (19 strains with intermediate resistance and 8 strains with high resistance. Penicillin-resistance was higher in 2002–2004 than in 2005–2007 (39.5% vs 18.2%, p = 0.017. Of 27 penicillin-resistant strains, 10 (37% were resistant to erythromycin, 8 (29.6% to cefotaxime, 2 (7.4% to levofloxacin, and 4 (14.8% were identified as multidrug resistant. Case-fatality rate was higher among those patients who had an infection caused by any penicillin susceptible strain (16.9% than in those with infections due to penicillin-resistant strains. Conclusion Resistance to penicillin among Streptococcus pneumoniae remains high, but such resistance does not result in increased mortality in patients with pneumococcal pneumonia.

  16. Diazotroph-Bacterial Community Structure of Root Nodules Account for Two-Fold Differences in Plant Growth: Consequences for Global Biogeochemical Cycles

    Science.gov (United States)

    Williams, M. A.

    2016-12-01

    The bacterial communities that inhabit and function as mutualists in the nodules of soybean, a major worldwide crop, are a fundamental determinant of plant growth and global nitrogen and carbon cycles. Unfertilized soybean can derive up to 90% of its nitrogen through bacterial-driven diazotrophy. It was the goal of the research in this study to assess whether different bacterial taxa (e.g. Bradyrhizobia spp.) differ in their soybean growth supportive role, which could then feedback to alter global biogeochemical cycling. Using 16S rRNA and NifH genes, nodule bacterial communities were shown to vary across 9 different cultivars of soybean, and that the variation between cultivars were highly correlated to plant yield (97 to 188 bu/Ha) and nitrogen. The relative abundances of gene sequences associated with the closest taxonomic match (NCBI), indicated that several taxa were (r= 0.76) negatively (e.g. Bradyrhizobium sp Ec3.3) or (r= 0.84) positively (e.g. Bradyrhizobium elkanii WSM 2783) correlated with plant yield. Other non-Rhizobiaceae taxa, such as Rhodopseudomonas spp. were also prevalent and correlated with plant yield. Soybeans and other leguminous crops will become increasingly important part of world food production, soil fertility and global biogeochemical cycles with rising population and food demand. The study demonstrates the importance of plant-microbial feedbacks driving plant growth but also ramifications for global cycling of nitrogen and carbon.

  17. Association of Panton Valentine Leukocidin (PVL) genes with methicillin resistant Staphylococcus aureus (MRSA) in Western Nepal: a matter of concern for community infections (a hospital based prospective study)

    DEFF Research Database (Denmark)

    Bhatta, Dharm R.; Cavaco, Lina; Nath, Gopal

    2016-01-01

    specimens and various units (Operation Theater, Intensive Care Units) of the hospital and 139 of these had been confirmed as MRSA by previous study. Multiplex PCR was used to detect mecA and PVL genes. Clinical data as well as antimicrobial susceptibility data was analyzed and compared among PVL positive......Methicillin resistant Staphylococcus aureus (MRSA) is a major human pathogen associated with nosocomial and community infections. Panton Valentine leukocidin (PVL) is considered one of the important virulence factors of S. aureus responsible for destruction of white blood cells, necrosis...... and apoptosis and as a marker of community acquired MRSA. This study was aimed to determine the prevalence of PVL genes among MRSA isolates and to check the reliability of PVL as marker of community acquired MRSA isolates from Western Nepal. A total of 400 strains of S. aureus were collected from clinical...

  18. Accounting for ethnic-cultural and linguistic diversity in neuropsychological assessment of patients with drug-resistant epilepsy: A retrospective study.

    Science.gov (United States)

    Peviani, Valeria; Scarpa, Pina; Toraldo, Alessio; Bottini, Gabriella

    2016-11-01

    Neuropsychological assessment is critical in both diagnosis and prognosis of patients with epilepsy. Beyond electrophysiological and anatomical alterations, other factors including different ethnic-cultural and linguistic backgrounds might affect neuropsychological performance. Only a few studies considered migration and acculturation effects and they typically concerned nonclinical samples. The current study aimed at investigating the influence of ethnic background and time spent in Italy on a full neuropsychological battery administered to both Italian and foreign-born patients and at providing a brief interview for obtaining relevant information on each patient's transcultural and language-related history. Clinical reports from 43 foreign-born patients with drug-resistant epilepsy were collected from the archives of Milan Niguarda Hospital. Epileptogenic zone, age, education, profession, illness duration, seizure frequency, handedness, and gender were considered in selecting 43 Italian controls. Ethnicity (Italian/foreign-born) and years spent in Italy were analyzed as main predictors on 21 neuropsychological scales by means of General(ized) Linear Models. An additional analysis studied two composite scores of overall verbal and nonverbal abilities. Ethnicity significantly affected the following: the verbal overall score, Verbal Fluency, Naming, Token-test, Digit Span, Attentional Matrices, Trail-Making-Test, Line-Orientation-Test, and Raven matrices; no effects were found on the nonverbal overall score, Word Pairs Learning, Episodic Memory, reading accuracy, visual span, Bells test, Rey Figure, and face memory and recognition. No significant effects of years spent in Italy emerged. While years spent in Italy does not predict neuropsychological performance, linguistic background had a strong impact on it. With respect to Italian-speaking patients, those who were foreign-born showed large task-related variability, with an especially low performance on language

  19. Association of Panton Valentine Leukocidin (PVL) genes with methicillin resistant Staphylococcus aureus (MRSA) in Western Nepal: a matter of concern for community infections (a hospital based prospective study).

    Science.gov (United States)

    Bhatta, Dharm R; Cavaco, Lina M; Nath, Gopal; Kumar, Kush; Gaur, Abhishek; Gokhale, Shishir; Bhatta, Dwij R

    2016-05-15

    Methicillin resistant Staphylococcus aureus (MRSA) is a major human pathogen associated with nosocomial and community infections. Panton Valentine leukocidin (PVL) is considered one of the important virulence factors of S. aureus responsible for destruction of white blood cells, necrosis and apoptosis and as a marker of community acquired MRSA. This study was aimed to determine the prevalence of PVL genes among MRSA isolates and to check the reliability of PVL as marker of community acquired MRSA isolates from Western Nepal. A total of 400 strains of S. aureus were collected from clinical specimens and various units (Operation Theater, Intensive Care Units) of the hospital and 139 of these had been confirmed as MRSA by previous study. Multiplex PCR was used to detect mecA and PVL genes. Clinical data as well as antimicrobial susceptibility data was analyzed and compared among PVL positive and negative MRSA isolates. Out of 139 MRSA isolates, 79 (56.8 %) were PVL positive. The majority of the community acquired MRSA (90.4 %) were PVL positive (Positive predictive value: 94.9 % and negative predictive value: 86.6 %), while PVL was detected only in 4 (7.1 %) hospital associated MRSA strains. None of the MRSA isolates from hospital environment was found positive for the PVL genes. The majority of the PVL positive strains (75.5 %) were isolated from pus samples. Antibiotic resistance among PVL negative MRSA isolates was found higher as compared to PVL positive MRSA. Our study showed high prevalence of PVL among community acquired MRSA isolates. Absence of PVL among MRSA isolates from hospital environment indicates its poor association with hospital acquired MRSA and therefore, PVL may be used a marker for community acquired MRSA. This is first study from Nepal, to test PVL among MRSA isolates from hospital environment.

  20. Promoting ADL independence in vulnerable, community-dwelling older adults: a pilot RCT comparing 3-Step Workout for Life versus resistance exercise

    Directory of Open Access Journals (Sweden)

    Liu C

    2017-07-01

    Full Text Available Chiung-ju Liu,1,2 Huiping Xu,3,4 NiCole R Keith,2,4,5 Daniel O Clark2,4,6 1Department of Occupational Therapy, Indiana University School of Health and Rehabilitation Sciences, 2Indiana University Center for Aging Research, 3Department of Biostatistics, Indiana University Richard M. Fairbanks School of Public Health, 4Regenstrief Institute, Inc., 5Department of Kinesiology, Indiana University School of Physical Education and Tourism Management, 6Indiana University School of Medicine, Indianapolis, IN, USA Background: Resistance exercise is effective to increase muscle strength for older adults; however, its effect on the outcome of activities of daily living is often limited. The purpose of this study was to examine whether 3-Step Workout for Life (which combines resistance exercise, functional exercise, and activities of daily living exercise would be more beneficial than resistance exercise alone. Methods: A single-blind randomized controlled trial was conducted. Fifty-two inactive, community-dwelling older adults (mean age =73 years with muscle weakness and difficulty in activities of daily living were randomized to receive 3-Step Workout for Life or resistance exercise only. Participants in the 3-Step Workout for Life Group performed functional movements and selected activities of daily living at home in addition to resistance exercise. Participants in the Resistance Exercise Only Group performed resistance exercise only. Both groups were comparable in exercise intensity (moderate, duration (50–60 minutes each time for 10 weeks, and frequency (three times a week. Assessment of Motor and Process Skills, a standard performance test on activities of daily living, was administered at baseline, postintervention, and 6 months after intervention completion.Results: At postintervention, the 3-Step Workout for Life Group showed improvement on the outcome measure (mean change from baseline =0.29, P=0.02, but the improvement was not greater than

  1. Antibiotic Resistance Genes and Correlations with Microbial Community and Metal Resistance Genes in Full-Scale Biogas Reactors As Revealed by Metagenomic Analysis

    DEFF Research Database (Denmark)

    Luo, Gang; Li, Bing; Li, Li-Guan

    2017-01-01

    resistance genes (MRGs). The total abundance of ARGs in all the samples varied from 7 × 10-3 to 1.08 × 10-1 copy of ARG/copy of 16S-rRNA gene, and the samples obtained from thermophilic biogas reactors had a lower total abundance of ARGs, indicating the superiority of thermophilic anaerobic digestion......Digested residues from biogas plants are often used as biofertilizers for agricultural crops cultivation. The antibiotic resistance genes (ARGs) in digested residues pose a high risk to public health due to their potential spread to the disease-causing microorganisms and thus reduce...

  2. Long-term use of antipsychotics in community-dwelling dementia patients: prevalence and profile accounting for unobservable time bias because of hospitalization.

    Science.gov (United States)

    Boucherie, Quentin; Gentile, Gaëtan; Chalançon, Coralie; Sciortino, Vincent; Blin, Olivier; Micallef, Joëlle; Bonin-Guillaume, Sylvie

    2017-01-01

    The aim of this study was to assess the prevalence of long-term antipsychotic (AP) use in community-dwelling patients with dementia considering hospitalization periods as AP exposure or not. A retrospective study was carried out from 2009 to 2012 on a PACA-Alzheimer cohort (which included 31 963 patients in 2009 and 36 442 in 2012 from 5 million inhabitants). Three groups of patients were identified according to the longest exposure to APs without interruption: nonusers, short-term users (≤3 successive months without discontinuation), and long-term users. Sensitivity analyses on hospitalization periods were carried out. The percentage of patients with at least one AP dispensing was stable over the study period (25.6% in 2009 vs. 26.5% in 2012). In 2012, 27.6% were AP long-term users. This increased to 46.7% when hospitalization periods were counted as AP exposure. In comparison with nonusers, AP users took more benzodiazepines and antidepressants. Short-term users were men [odds ratio (OR)=1.2, 95% confidence interval (CI) (1.1-1.3)] older than 85 years old [OR=1.2, 95% CI (1.1-1.2)]. Long-term users were more exposed to benzodiazepines [OR=1.2, 95% CI (1.1-1.4)]. This study showed that long-term use of AP remained frequent in community-dwelling patients with dementia. It also showed that the prevalence of long-term users almost doubled when hospitalization periods were counted as AP exposure. This underlines the need to consider hospitalization periods when assessing medication exposure in populations with frequent periods of hospitalization.

  3. Bacterial Aetiology and Antibiotic Resistance Pattern of Community-Acquired Urinary Tract Infections in Children in a Tertiary Care Hospital in Bangladesh

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    Lazina Sharmin

    2017-09-01

    Full Text Available Background: Urinary tract infections (UTIs in children are among the most common bacterial infections. Community-acquired urinary tract infections (CAUTI are often treated empirically with broad-spectrum antibiotics. Pattern of aetiologic agents and their antibiotic sensitivity may vary according to geographical and regional location. So, knowledge of antibiotic resistance trends is important for improving evidence-based recommendations for empirical treatment of UTIs. Objectives: To determine the common bacterial aetiologies of CAUTIs and their antibiotic resistance patterns in a tertiary care hospital, Savar. Materials and Methods: This cross-sectional descriptive study was conducted at Enam Medical College Hospital, Savar from May 2016 to April 2017. We collected clean-catch mid-stream urine samples from 257 patients having clinical diagnosis of UTI and submitted to the clinical microbiology laboratory for culture and sensitivity. Results: A total of 120 (46.7% samples were positive for bacterial growth. Escherichia coli (79% was the most common pathogen, followed by Klebsiella spp. (14%. Bacterial isolates showed high prevalence of resistance to multiple antibiotics. Resistance against amoxicillin/clavulanic acid, co-trimoxazole and ciprofloxacin was higher compared to newer quinolones and aminoglycosides. Conclusion: Esch. coli and Klebsiella spp. were the predominant bacterial pathogens. The resistance pattern to commonly prescribed antibiotics was quite high and alarming.

  4. Quantification of the efficiency of treatment of Anopheles gambiae breeding sites with petroleum products by local communities in areas of insecticide resistance in the Republic of Benin

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    Doannio Julien MC MC

    2007-05-01

    Full Text Available Abstract Background The emergence of Anopheles populations capable of withstanding lethal doses of insecticides has weakened the efficacy of most insecticide based strategies of vector control and, has highlighted the need for developing new insecticidal molecules or, improving the efficacy of existing insecticides or abandoning those to which resistance has emerged. The use of petroleum products (PP against mosquito larvae had an immense success during early programmes of malaria control, but these compounds were abandoned and replaced in the 1950s by synthetic insecticides probably because of the high performances given by these new products. In the current context of vector resistance, it is important to elucidate the empirical use of PP by quantifying their efficiencies on resistant strains of Anopheles. Methods Larvae of Anopheles Ladji a local resistant strain were exposed to increasing concentrations of various PP (kerosene, petrol and engine oils for 24 hours and the lethal activities recorded. The highest concentration (HiC having no lethal activity (also referred as the NOEL or no effect level and the lowest concentration (LoC100 yielding 100% mortality were rated for each PP on the Ladji strain. Prior to laboratory analysis, KAP studies were conducted in three traditional communities were insecticide resistance is clearly established to confirm the use of PP against mosquitoes. Results Laboratory analysis of petrol, kerosene and engine oils, clearly established their lethal activities on resistant strains of Anopheles larvae. Contrary to existing references, this research revealed that exposed larvae of Anopheles were mostly killed by direct contact toxicity and not by suffocation as indicated in some earlier reports. Conclusion This research could serve as scientific basis to backup the empirical utilisation of PP on mosquito larvae and to envisage possibilities of using PP in some traditional settings where Anopheles have developed

  5. Does empirical treatment of community-acquired pneumonia with fluoroquinolones delay tuberculosis treatment and result in fluoroquinolone resistance in Mycobacterium tuberculosis? Controversies and solutions.

    Science.gov (United States)

    Shen, Gwan-Han; Tsao, Thomas Chang-Yao; Kao, Shang-Jyh; Lee, Jen-Jyh; Chen, Yen-Hsu; Hsieh, Wei-Chung; Hsu, Gwo-Jong; Hsu, Yen-Tao; Huang, Ching-Tai; Lau, Yeu-Jun; Tsao, Shih-Ming; Hsueh, Po-Ren

    2012-03-01

    The role of fluoroquinolones (FQs) as empirical therapy for community-acquired pneumonia (CAP) remains controversial in countries with high tuberculosis (TB) endemicity owing to the possibility of delayed TB diagnosis and treatment and the emergence of FQ resistance in Mycobacterium tuberculosis. Although the rates of macrolide-resistant Streptococcus pneumoniae and amoxicillin/clavulanic acid-resistant Haemophilus influenzae have risen to alarming levels, the rates of respiratory FQ (RFQ) resistance amongst these isolates remain relatively low. It is reported that ca. 1-7% of CAP cases are re-diagnosed as pulmonary TB in Asian countries. A longer duration (≥ 7 days) of symptoms, a history of night sweats, lack of fever (> 38 °C), infection involving the upper lobe, presence of cavitary infiltrates, opacity in the lower lung without the presence of air, low total white blood cell count and the presence of lymphopenia are predictive of pulmonary TB. Amongst patients with CAP who reside in TB-endemic countries who are suspected of having TB, imaging studies as well as aggressive microbiological investigations need to be performed early on. Previous exposure to a FQ for >10 days in patients with TB is associated with the emergence of FQ-resistant M. tuberculosis isolates. However, rates of M. tuberculosis isolates with FQ resistance are significantly higher amongst multidrug-resistant M. tuberculosis isolates than amongst susceptible isolates. Consequently, in Taiwan and also in other countries with TB endemicity, a short-course (5-day) regimen of a RFQ is still recommended for empirical therapy for CAP patients if the patient is at low risk for TB. Copyright © 2012 Elsevier B.V. and the International Society of Chemotherapy. All rights reserved.

  6. Prevalence and characteristics of Staphylococcus aureus and methicillin-resistant Staphylococcus aureus nasal colonization among a community-based diabetes population in Foshan, China.

    Science.gov (United States)

    Lin, Jialing; Xu, Ping; Peng, Yang; Lin, Dongxin; Ou, Qianting; Zhang, Ting; Bai, Chan; Ye, Xiaohua; Zhou, Junli; Yao, Zhenjiang

    2017-05-01

    Evidence suggests that diabetes might cause an increase in colonization of Staphylococcus aureus (S. aureus) and methicillin-resistant S. aureus (MRSA) in community settings. We carried out a cross-sectional study to determine the prevalence and influencing factors of S. aureus and MRSA nasal colonization among a community-based diabetes population, and to identify the characteristics of the isolated strains. A total of 956 participants from 11 community settings were included in the study. Of the 529 diabetes participants, 46 were colonized with S. aureus and 22 were colonized with MRSA. Of the 427 non-diabetes participants, 25 were colonized with S. aureus and 12 were colonized with MRSA. Men (odds ratio 0.45, 95% confidence interval 0.20-0.99, P = 0.047) were less likely to have S. aureus nasal colonization, and those with well-controlled blood glucose (odds ratio 2.04, 95% confidence interval 1.01-4.13, P = 0.047) among the diabetes population were more likely to have S. aureus nasal colonization. The proportion of multidrug-resistant S. aureus strains in the diabetes population (52.17%) was higher than that in the non-diabetes population (28.00%; χ 2 = 3.848, P = 0.050). The most common clonal complex type and Staphylococcal chromosome cassette mec type of MRSA in diabetes population was clonal complex 5 (40.91%) and type IV (27.27%), respectively. The proportion of Panton-Valentine leukocidin gene in MRSA strains was 17.65%. There was great sequence type diversity in MRSA strains. The prevalence of MRSA in the community-based diabetes population was moderate, and the high proportions of multidrug-resistant S. aureus strains and diverse molecular characteristics in the diabetes population should be noticed. © 2016 The Authors. Journal of Diabetes Investigation published by Asian Association for the Study of Diabetes (AASD) and John Wiley & Sons Australia, Ltd.

  7. Modeling the transmission of community-associated methicillin-resistant Staphylococcus aureus: a dynamic agent-based simulation.

    Science.gov (United States)

    Macal, Charles M; North, Michael J; Collier, Nicholson; Dukic, Vanja M; Wegener, Duane T; David, Michael Z; Daum, Robert S; Schumm, Philip; Evans, James A; Wilder, Jocelyn R; Miller, Loren G; Eells, Samantha J; Lauderdale, Diane S

    2014-05-12

    Methicillin-resistant Staphylococcus aureus (MRSA) has been a deadly pathogen in healthcare settings since the 1960s, but MRSA epidemiology changed since 1990 with new genetically distinct strain types circulating among previously healthy people outside healthcare settings. Community-associated (CA) MRSA strains primarily cause skin and soft tissue infections, but may also cause life-threatening invasive infections. First seen in Australia and the U.S., it is a growing problem around the world. The U.S. has had the most widespread CA-MRSA epidemic, with strain type USA300 causing the great majority of infections. Individuals with either asymptomatic colonization or infection may transmit CA-MRSA to others, largely by skin-to-skin contact. Control measures have focused on hospital transmission. Limited public health education has focused on care for skin infections. We developed a fine-grained agent-based model for Chicago to identify where to target interventions to reduce CA-MRSA transmission. An agent-based model allows us to represent heterogeneity in population behavior, locations and contact patterns that are highly relevant for CA-MRSA transmission and control. Drawing on nationally representative survey data, the model represents variation in sociodemographics, locations, behaviors, and physical contact patterns. Transmission probabilities are based on a comprehensive literature review. Over multiple 10-year runs with one-hour ticks, our model generates temporal and geographic trends in CA-MRSA incidence similar to Chicago from 2001 to 2010. On average, a majority of transmission events occurred in households, and colonized rather than infected agents were the source of the great majority (over 95%) of transmission events. The key findings are that infected people are not the primary source of spread. Rather, the far greater number of colonized individuals must be targeted to reduce transmission. Our findings suggest that current paradigms in MRSA control in

  8. Characterization and comparison of 2 distinct epidemic community-associated methicillin-resistant Staphylococcus aureus clones of ST59 lineage.

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    Chih-Jung Chen

    Full Text Available Sequence type (ST 59 is an epidemic lineage of community-associated (CA methicillin-resistant Staphylococcus aureus (MRSA isolates. Taiwanese CA-MRSA isolates belong to ST59 and can be grouped into 2 distinct clones, a virulent Taiwan clone and a commensal Asian-Pacific clone. The Taiwan clone carries the Panton-Valentine leukocidin (PVL genes and the staphylococcal chromosomal cassette mec (SCCmec VT, and is frequently isolated from patients with severe disease. The Asian-Pacific clone is PVL-negative, carries SCCmec IV, and a frequent colonizer of healthy children. Isolates of both clones were characterized by their ability to adhere to respiratory A549 cells, cytotoxicity to human neutrophils, and nasal colonization of a murine and murine sepsis models. Genome variation was determined by polymerase chain reaction of selected virulence factors and by multi-strain whole genome microarray. Additionally, the expression of selected factors was compared between the 2 clones. The Taiwan clone showed a much higher cytotoxicity to the human neutrophils and caused more severe septic infections with a high mortality rate in the murine model. The clones were indistinguishable in their adhesion to A549 cells and persistence of murine nasal colonization. The microarray data revealed that the Taiwan clone had lost the ø3-prophage that integrates into the β-hemolysin gene and includes staphylokinase- and enterotoxin P-encoding genes, but had retained the genes for human immune evasion, scn and chps. Production of the virulence factors did not differ significantly in the 2 clonal groups, although more α-toxin was expressed in Taiwan clone isolates from pneumonia patients. In conclusion, the Taiwan CA-MRSA clone was distinguished by enhanced virulence in both humans and an animal infection model. The evolutionary acquisition of PVL, the higher expression of α-toxin, and possibly the loss of a large portion of the β-hemolysin-converting prophage likely

  9. The use of the temporal scan statistic to detect methicillin-resistant Staphylococcus aureus clusters in a community hospital.

    Science.gov (United States)

    Faires, Meredith C; Pearl, David L; Ciccotelli, William A; Berke, Olaf; Reid-Smith, Richard J; Weese, J Scott

    2014-07-08

    In healthcare facilities, conventional surveillance techniques using rule-based guidelines may result in under- or over-reporting of methicillin-resistant Staphylococcus aureus (MRSA) outbreaks, as these guidelines are generally unvalidated. The objectives of this study were to investigate the utility of the temporal scan statistic for detecting MRSA clusters, validate clusters using molecular techniques and hospital records, and determine significant differences in the rate of MRSA cases using regression models. Patients admitted to a community hospital between August 2006 and February 2011, and identified with MRSA>48 hours following hospital admission, were included in this study. Between March 2010 and February 2011, MRSA specimens were obtained for spa typing. MRSA clusters were investigated using a retrospective temporal scan statistic. Tests were conducted on a monthly scale and significant clusters were compared to MRSA outbreaks identified by hospital personnel. Associations between the rate of MRSA cases and the variables year, month, and season were investigated using a negative binomial regression model. During the study period, 735 MRSA cases were identified and 167 MRSA isolates were spa typed. Nine different spa types were identified with spa type 2/t002 (88.6%) the most prevalent. The temporal scan statistic identified significant MRSA clusters at the hospital (n=2), service (n=16), and ward (n=10) levels (P ≤ 0.05). Seven clusters were concordant with nine MRSA outbreaks identified by hospital staff. For the remaining clusters, seven events may have been equivalent to true outbreaks and six clusters demonstrated possible transmission events. The regression analysis indicated years 2009-2011, compared to 2006, and months March and April, compared to January, were associated with an increase in the rate of MRSA cases (P ≤ 0.05). The application of the temporal scan statistic identified several MRSA clusters that were not detected by hospital

  10. An 11-year analysis of the prevalent uropathogens and the changing pattern of Escherichia coli antibiotic resistance in 38,530 community urinary tract infections, Dublin 1999-2009.

    Science.gov (United States)

    Cullen, I M; Manecksha, R P; McCullagh, E; Ahmad, S; O'Kelly, F; Flynn, R; McDermott, T E D; Murphy, P; Grainger, R; Fennell, J P; Thornhill, J A

    2013-03-01

    Knowledge of local antimicrobial resistance patterns is essential for evidence-based empirical antibiotic prescribing, and a cutoff point of 20% has been suggested as the level of resistance at which an agent should no longer be used empirically. We sought to identify the changing incidence of causative uropathogens over an 11-year period. We also examined the trends in antibiotic resistance encountered in both the pooled urine samples and those where the causative organism was Escherichia coli. A retrospective analysis of the antimicrobial resistance within the positive community urine isolates over the 11-year period, 1999 to 2009, in a single Dublin teaching hospital was performed. In total 38,530 positive urine samples processed at our laboratory originated in the community of which 23,838 (56.7%) had E. coli as the infecting organism. The prevalence of E. coli has been increasing in recent years in community UTIs with 70.4% of UTIs in the community caused by E.coli in 2009. Ampicillin and trimethoprim were the least-active agents against E. coli with mean 11-year resistance rates of 60.8 and 31.5%, respectively. Significant trends of increasing resistance over the 11-year period were identified for trimethoprim, co-amoxyclav, cefuroxime and gentamicin. Ciprofloxacin remains a reasonable empirical antibiotic choice in this community with an 11-year resistance rate of 10.6%. Higher antibiotic resistance rates were identified in the male population and in children. Resistance rates to commonly prescribed antibiotics are increasing significantly. This data will enable evidence-based empirical prescribing which will ensure more effective treatment and lessen the emergence of resistant uropathogens in the community.

  11. Identification of antibiotic resistant bacteria community and a GeoChip based study of resistome in urban watersheds.

    Science.gov (United States)

    Low, Adrian; Ng, Charmaine; He, Jianzhong

    2016-12-01

    Urban watersheds from point sources are potential reservoirs of antibiotic resistance genes (ARGs). However, few studies have investigated urban watersheds of non-point sources. To understand the type of ARGs and bacteria that might carry such genes, we investigated two non-point source urban watersheds with different land-use profiles. Antibiotic resistance levels of two watersheds (R1, R3) were examined using heterotrophic plate counts (HPC) as a culturing method to obtain counts of bacteria resistant to seven antibiotics belonging to different classes (erythromycin, kanamycin, lincomycin, norfloxacin, sulfanilamide, tetracycline and trimethoprim). From the HPC study, 239 antibiotic resistant bacteria were characterized for resistance to more antibiotics. Furthermore, ARGs and antimicrobial biosynthesis genes were identified using GeoChip version 5.0 to elucidate the resistomes of surface waters in watersheds R1 and R3. The HPC study showed that water samples from R1 had significantly higher counts of bacteria resistant to erythromycin, kanamycin, norfloxacin, sulfanilamide, tetracycline and trimethoprim than those from R3 (Analysis of Similarity (ANOSIM), R = 0.557, p antibiotics tested, lincomycin and trimethoprim resistant bacteria are greater in abundances. The 239 antibiotic resistant isolates represent a subset of resistant bacterial populations, including bacteria not previously known for resistance. Majority of the isolates had resistance to ampicillin, vancomycin, lincomycin and trimethoprim. GeoChip revealed similar ARGs in both watersheds, but with significantly higher intensities for tetX and β-lactamase B genes in R1 than R3. The genes with the highest average normalized intensities in R1 and R3 were tetracycline (tet) and fosfomycin (fosA) resistance genes, respectively. The higher abundance of tetX genes in R1 is congruent with the higher abundance of tetracycline resistant HPC observed in R1 samples. Strong correlations (r ≥ 0.8) of efflux

  12. Increased US emergency department visits for skin and soft tissue infections, and changes in antibiotic choices, during the emergence of community-associated methicillin-resistant Staphylococcus aureus.

    Science.gov (United States)

    Pallin, Daniel J; Egan, Daniel J; Pelletier, Andrea J; Espinola, Janice A; Hooper, David C; Camargo, Carlos A

    2008-03-01

    Test the hypotheses that emergency department (ED) visits for skin and soft tissue infections became more frequent during the emergence of community-associated methicillin-resistant Staphylococcus aureus (MRSA), and that antibiotics typically active against community-associated MRSA were chosen increasingly. From merged National Hospital Ambulatory Medical Care Survey data for 1993-2005, we identified ED visits with diagnosis of cellulitis, abscess, felon, impetigo, hidradenitis, folliculitis, infective mastitis, nonpurulent mastitis, breast abscess, or carbuncle and furuncle. Main outcomes were change over time in rate of ED visits with such a diagnosis and proportion of antibiotic regimens including an agent typically active against community-associated MRSA. We report national estimates derived from sample weights. We tested trends with least squares linear regression. In 1993, infections of interest were diagnosed at 1.2 million visits (95% confidence interval [CI] 0.96 to 1.5 million) versus 3.4 million in 2005 (95% CI 2.8 to 4.1 million; P for trend trend trend skin and soft tissue infections increased markedly from 1993 to 2005, contemporaneously with the emergence of community-associated MRSA. ED clinicians prescribed more antibiotics typically active against community-associated MRSA, especially trimethoprim-sulfamethoxazole. Possible confounders are discussed, such as increasing diabetes or shifts in locus of care.

  13. 'We go to the bush to prove that we are also men': traditional circumcision and masculinity in the accounts of men who have sex with men in township communities in South Africa.

    Science.gov (United States)

    Lynch, Ingrid; Clayton, Matthew

    2017-03-01

    In predominantly isiXhosa-speaking township communities in South Africa, men who have sex with men negotiate their identities and sexual practices alongside heteronormative cultural scripts of what it means to be a man. Such idealised notions of masculinity are predicated on the selective appropriation of cultural practices that preserve (heterosexual) male privilege and power. In this paper, we explore the identity work done by men who have sex with men, with particular reference to male circumcision as a cultural practice widely drawn on to inform and regulate normative masculinity. Through a narrative-discursive analysis of the accounts provided by men who have sex with men from township communities, we highlight how participants' dissident sexualities are constructed as compromising their masculine identities. Participating in cultural practices such as traditional circumcision aligns participants to the idealised forms of masculinity that afford men full citizenship in their communities. Study findings suggest that sexual dissidence is less troubling to participants than deviating from gendered markers of hegemonic masculinity, and point to ways in which marginalised men might have an interest in maintaining the dominant gendered order. We conclude with implications for research and programmatic work with gay, bisexual and other men who have sex with men.

  14. Sepse por Staphylococus aureus resistente à meticilina adquirida na comunidade no sul do Brasil Sepsis due to community-acquired methicillin-resistant Staphylococcus aureus in southern Brazil

    Directory of Open Access Journals (Sweden)

    Luciane Cristina Gelatti

    2009-08-01

    Full Text Available Staphylococcus aureus resistente à meticilina foi inicialmente descrito como um típico microrganismo adquirido em infecções nosocomiais. No entanto, nos últimos anos Staphylococcus aureus resistente à meticilina adquirido na comunidade é causa de infecções de pele e tecidos moles, mas infecções graves como pneumonia e sepse podem ocorrer. Este relato descreve um caso de sepse em criança, complicado com pneumonia secundária a lesão em partes moles por Staphylococcus aureus resistente à meticilina adquirido na comunidade no Sul do Brasil. O paciente foi atendido em Unidade de Emergência com história de ferimento provocado por trauma em membro inferior que evoluiu para celulite, pneumonia e sepse.Methicillin-resistant Staphylococcus aureus was initially described as a typical microorganism acquired in nosocomial infections. However, over recent years, community-acquired methicillin-resistant Staphylococcus aureus has been a cause of skin and soft-tissue infections. Serious infections such as pneumonia and sepsis can also occur. This report describes a case of sepsis in a child that was complicated by pneumonia secondary to soft tissue lesions that were due to community-acquired methicillin-resistant Staphylococcus aureus in southern Brazil. The patient was attended at the Emergency Unit with a history of injury caused by lower-limb trauma that evolved to cellulitis, pneumonia and sepsis.

  15. Accounting for Time-varying Confounding in the Relation between Obesity and Coronary Heart Disease: Analysis with G-estimation, the Atherosclerosis Risk in Communities (ARIC) study.

    Science.gov (United States)

    Shakiba, Maryam; Mansournia, Mohammad Ali; Salari, Arsalan; Soori, Hamid; Mansournia, Nasrin; Kaufman, Jay S

    2017-11-16

    In longitudinal studies, standard analysis may yield biased estimates of exposure effect in the presence of time-varying confounders that are also intermediate variables. We aimed to quantify the relationship between obesity and coronary heart disease (CHD) by appropriately adjusting for time-varying confounders. This study performed on a subset of the Atherosclerosis Risk in Communities Study (1987-2010). General obesity defined as body mass index ≥30 kg/m2, abdominal obesity (AOB) defined as waist circumference ≥102 cm in men and ≥88 cm in women, and waist to hip ratio categorized at ≥0.9 in men and ≥0.85 in women. The effect of obesity on CHD was estimated by G-estimation and compared with accelerated failure time models using three specifications. The first model adjusted for baseline covariates excluding metabolic mediators of obesity showed increased risk of CHD for all measures of obesity. Further adjustment for metabolic mediators in the second model and time-varying variables in the third model showed negligible hazard ratios. The hazard ratios estimated by G-estimation were 1.15 (95%CI: 0.83-1.47) for General obesity, 1.65 (95%CI: 1.35-1.92) and 1.38 (95%CI: 1.13-1.99) for AOB based on waist circumference and waist to hip ratio, respectively, suggesting that AOB increased the risk of CHD. The G-estimated hazard ratio of both measures was further from the null than standard models. © The Author(s) 2017. Published by Oxford University Press on behalf of the Johns Hopkins Bloomberg School of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  16. Nutrients, heavy metals and microbial communities co-driven distribution of antibiotic resistance genes in adjacent environment of mariculture.

    Science.gov (United States)

    Zhao, Zelong; Wang, Jing; Han, Ying; Chen, Jingwen; Liu, Guangfei; Lu, Hong; Yan, Bin; Chen, Shiaoshing

    2017-01-01

    With the rapid development of aquaculture, the large amounts of pollutants were discharged into the aquatic environment, where the detected antibiotic resistance genes (ARGs) have drawn increasing attention due to their potential threats to ecological environment and human health. Thus, the impact of mariculture on ARGs was assessed and the underlying mechanism of their propagation was explained. Sediments from eight sampling sites were collected along a mariculture drainage ditch, and the sediment in Yellow River Delta National Park was used as a non-mariculture control. Microbial ARGs qPCR array and illumina sequencing of 16S rRNA gene were applied to examine the changing patterns of ARGs and bacterial communities. Results showed that 18 ARGs (3 fluoroquinolone, 1 aminoglycoside, 3 macrolide-lincosamide-streptogramin B, 2 tetracycline, and 9 beta-lactam resistance genes) were influenced by mariculture, and ARGs abundance and diversity were significantly increased in mariculture sediments (p bacterial community structure and composition was also observed. The abundance of most of ARGs were significantly decreased in the estuary samples, implying that seawater had a significant dilution effect on the ARGs emission from the mariculture sites. Partial redundancy analysis showed that nutrients, heavy metals, and bacteria communities might directly and indirectly contribute to ARGs propagation, suggesting that the profile and dissemination of ARGs were driven by the combined effects of multiple factors in mariculture-impacted sites. Copyright © 2016 Elsevier Ltd. All rights reserved.

  17. Effects of graphene oxide on the performance, microbial community dynamics and antibiotic resistance genes reduction during anaerobic digestion of swine manure.

    Science.gov (United States)

    Zhang, Junya; Wang, Ziyue; Wang, Yawei; Zhong, Hui; Sui, Qianwen; Zhang, Changping; Wei, Yuansong

    2017-12-01

    The role of graphene oxide (GO) on anaerobic digestion (AD) of swine manure concerning the performance, microbial community and antibiotic resistance genes (ARGs) reduction was investigated. Results showed that methane production was reduced by 13.1%, 10.6%, 2.7% and 17.1% at GO concentration of 5mg/L, 50mg/L, 100mg/L and 500mg/L, respectively, but propionate degradation was enhanced along with GO addition. Both bacterial and archaeal community changed little after GO addition. AD could well reduce ARGs abundance, but it was deteriorated at the GO concentration of 50mg/L and 100mg/L and enhanced at 500mg/L, while no obvious changes at 5mg/L. Network and SEM analysis indicated that changes of each ARG was closely associated with variation of microbial community composition, environmental variables contributed most to the dynamics of ARGs indirectly, GO influenced the ARGs dynamics negatively and (heavy metal resistance genes (MRGs)) influenced the most directly. Copyright © 2017 Elsevier Ltd. All rights reserved.

  18. Effects of oxytetracycline on archaeal community, and tetracycline resistance genes in anaerobic co-digestion of pig manure and wheat straw.

    Science.gov (United States)

    Wang, Xiaojuan; Pan, Hongjia; Gu, Jie; Qian, Xun; Gao, Hua; Qin, Qingjun

    2016-12-01

    In this study, the effects of different concentrations of oxytetracycline (OTC) on biogas production, archaeal community structure, and the levels of tetracycline resistance genes (TRGs) were investigated in the anaerobic co-digestion products of pig manure and wheat straw. PCR denaturing gradient gel electrophoresis analysis and real-time quantitative polymerase chain reaction (RT-qPCR) (PCR) were used to detect the archaeal community structure and the levels of four TRGs: tet(M), tet(Q), tet(W), and tet(C). The results showed that anaerobic co-digestion with OTC at concentrations of 60, 100, and 140 mg/kg (dry weight of pig manure) reduced the cumulative biogas production levels by 9.9%, 10.4%, and 14.1%, respectively, compared with that produced by the control, which lacked the antibiotic. The addition of OTC substantially modified the structure of the archaeal community. Two orders were identified by phylogenetic analysis, that is, Pseudomonadales and Methanomicrobiales, and the methanogen present during anaerobic co-digestion with OTC may have been resistant to OTC. The abundances of tet(Q) and tet(W) genes increased as the OTC concentration increased, whereas the abundances of tet(M) and tet(C) genes decreased as the OTC concentration increased.

  19. Antimicrobial resistance in bacterial pathogens among hospitalized children with community acquired lower respiratory tract infections in Dongguan, China (2011-2016).

    Science.gov (United States)

    He, Xiaoguang; Xie, Mingyu; Li, Siping; Ye, Junqin; Peng, Qi; Ma, Qiang; Lu, Xiaomei; Zhong, Baimao

    2017-09-11

    Bacterial pathogens are a major cause of childhood community acquired lower respiratory tract infections (CA-LRTIs), and few data described the impact of antimicrobial resistance on children with CA-LRTIs. This study aims to investigate the antimicrobial resistance in common bacterial agents among hospitalized children with CA-LRTIs between 2011 and 2016 in Dongguan, China. Sputum samples were collected from hospitalized children (0-5 years old) with CA-LRTIs in Dongguan Children's Hospital. Bacterial pathogens were detected using traditional culture methods, and disc diffusion tests were used to determine antibiotic resistance. Among the 2360 samples analyzed, 342 (14.5%) were positive for bacterial infection. The most prevalent pathogen was MSSA (2.3%), followed by MRSA (1.5%), E. coli (1.7%), E. coli ESBLs (1.2%), K. pneumonia ESBLs (1.5%), K. pneumonia (1.4%) and S. pneumonia (1.3%). Of the hospitalized patients with bacteria causing of CA-LRTIs, 90.1% were less than 1-year-old. MSSA and MRSA were more commonly isolated in infants less than 3 months. E. coli, K. pneumonia and K. pneumonia ESBLs were more common bacteria causing CA-LRTIs in infants less than 1 month. Resistance levels to penicillins, fluoroquinolones, macrolides, cephalosporins, carbapenems and vancomycin varied in different bacteria. S. aureus, E coli and K. pneumonia were the common bacterial isolates recovered from chidren with CA-LTRIs during 2011-2015. Age group of under 1 year old was at a high risk of bacterial infections. Many isolates showed antibiotic resistance level was associated with antibiotic usage in clinic. Increasing surveillance of antibiotic resistance is urgently needed and develops better strategies to cure the antibiotic abuse in China.

  20. Nosocomial and Community-Acquired Staphylococcus Aureus Bacterimias from 1980 to 1993: Impact of Intravascular Devices and Methicillin Resistance

    NARCIS (Netherlands)

    J.P. Steinberg; C.C. Clarke; B.O. Hackman

    1996-01-01

    textabstractThe rate of nosocomial bacteremia due to Staphylococcus aureus has increased over the past decade, but trends in community-acquired S. aureus bacteremia are less certain. This hospital-based observational study compares nosocomial and community-acquired S. aureus bacteremias during

  1. Do Behavioral Risk Factors for Prediabetes and Insulin Resistance Differ across the Socioeconomic Gradient? Results from a Community-Based Epidemiologic Survey

    Directory of Open Access Journals (Sweden)

    May H. Yang

    2015-01-01

    Full Text Available To examine whether behavioral risk factors associated with diabetes (diet, BMI, waist circumference, physical activity, and sleep duration are also related to both prediabetes and insulin resistance (IR, we used data from Boston Area Community Health (BACH Survey (2010–2012, n=3155. Logistic and linear regression models were used to test the association of lifestyle factors with prediabetes status, insulin resistance, and prediabetes or insulin resistance. All regression models were stratified by education and income levels (to examine whether risk factors had differential effects across socioeconomic factors and adjusted for age, gender, race/ethnicity, family history of diabetes, and smoking status. We found that large waist circumference was consistently associated with higher levels of insulin resistance (IR and increased odds of prediabetes. While the association between large waist circumference and IR was consistent across all levels of SES (P<0.001, the association between large waist circumference and prediabetes was only statistically significant in the highest socioeconomic strata with odds ratios of 1.68 (95% CI 1.07–2.62 and 1.88 (95% CI 1.22–2.92 for postgraduate degree and income strata, respectively. There was no association between diet, physical activity, sleep duration, and the presence of multiple risk factors and prediabetes or IR within SES strata.

  2. Signatures of cytoplasmic proteins in the exoproteome distinguish community- and hospital-associated methicillin-resistant Staphylococcus aureus USA300 lineages

    DEFF Research Database (Denmark)

    Mekonnen, Solomon A.; Palma Medina, Laura M.; Glasner, Corinna

    2017-01-01

    Methicillin-resistant Staphylococcus aureus (MRSA) is the common name for a heterogeneous group of highly drug-resistant staphylococci. Two major MRSA classes are distinguished based on epidemiology, namely community-associated (CA) and hospital-associated (HA) MRSA. Notably, the distinction of CA......- and HA-MRSA based on molecular traits remains difficult due to the high genomic plasticity of S. aureus. Here we sought to pinpoint global distinguishing features of CA- and HA-MRSA through a comparative genome and proteome analysis of the notorious MRSA lineage USA300. We show for the first time that CA......- and HA-MRSA isolates can be distinguished by 2 distinct extracellular protein abundance clusters that are predictive not only for epidemiologic behavior, but also for their growth and survival within epithelial cells. This ‘exoproteome profiling’ also groups more distantly related HA-MRSA isolates...

  3. High Levels of Antibiotic Resistance Genes and Their Correlations with Bacterial Community and Mobile Genetic Elements in Pharmaceutical Wastewater Treatment Bioreactors.

    Science.gov (United States)

    Tao, Wenda; Zhang, Xu-Xiang; Zhao, Fuzheng; Huang, Kailong; Ma, Haijun; Wang, Zhu; Ye, Lin; Ren, Hongqiang

    2016-01-01

    To understand the diversity and abundance of antibiotic resistance genes (ARGs) in pharmaceutical wastewater treatment bioreactors, the ARGs in sludge from two full-scale pharmaceutical wastewater treatment plants (PWWTPs) were investigated and compared with sludge samples from three sewage treatment plants (STPs) using metagenomic approach. The results showed that the ARG abundances in PWWTP sludge ranged from 54.7 to 585.0 ppm, which were higher than those in STP sludge (27.2 to 86.4 ppm). Moreover, the diversity of ARGs in PWWTP aerobic sludge (153 subtypes) was higher than that in STP aerobic sludge (118 subtypes). In addition, it was found that the profiles of ARGs in PWWTP aerobic sludge were similar to those in STP aerobic sludge but different from those in PWWTP anaerobic sludge, suggesting that dissolve oxygen (DO) could be one of the important factors affecting the profiles of ARGs. In PWWTP aerobic sludge, aminoglycoside, sulfonamide and multidrug resistance genes were frequently detected. While, tetracycline, macrolide-lincosamide-streptogramin and polypeptide resistance genes were abundantly present in PWWTP anaerobic sludge. Furthermore, we investigated the microbial community and the correlation between microbial community and ARGs in PWWTP sludge. And, significant correlations between ARG types and seven bacterial genera were found. In addition, the mobile genetic elements (MGEs) were also examined and correlations between the ARGs and MGEs in PWWTP sludge were observed. Collectively, our results suggested that the microbial community and MGEs, which could be affected by DO, might be the main factors shaping the profiles of ARGs in PWWTP sludge.

  4. Can a Single Session of a Community-Based Group Exercise Program Combining Step Aerobics and Bodyweight Resistance Exercise Acutely Reduce Blood Pressure?

    Directory of Open Access Journals (Sweden)

    Mendes Romeu

    2014-12-01

    Full Text Available This study aimed to analyze the acute effects of a single session of a community-based group exercise program combining step aerobics and bodyweight resistance exercise on blood pressure in healthy young adult women. Twentythree healthy young adult women (aged 31.57 ± 7.87 years participated in two experimental sessions (exercise and control in a crossover study design. Blood pressure was monitored before, immediately after and at 10, 20 and 30 min of recovery. The exercise session consisted of four phases: 1 a warm-up (5 min of dance aerobics; 2 aerobic exercise training (30 min of step aerobics; 3 resistance exercise training (six sets of 12 repetitions of three bodyweight exercises in a circuit mode, 10 min; and 4 a cool-down (5 min of breathing and flexibility exercises; totaling 50 min of duration. Systolic blood pressure after exercise was significantly lower compared to control at the 10th min (-10.83 ± 2.13 vs. -2.6 ± 2.13 mmHg; p = 0.009, 20th min (-11.26 ± 2.13 vs. -3.04 ± 2.13 mmHg; p = 0.009 and 30th min of recovery (-10.87 ± 2.39 vs. -0.48 ± 2.39 mmHg; p = 0.004. A single session of a community-based group exercise program combining step aerobics and bodyweight resistance exercise was effective in inducing significant post-exercise hypotension in healthy young adult women. This type of low-cost exercise interventions may have an important role in the prevention of cardiovascular diseases and in community health promotion.

  5. High Levels of Antibiotic Resistance Genes and Their Correlations with Bacterial Community and Mobile Genetic Elements in Pharmaceutical Wastewater Treatment Bioreactors.

    Directory of Open Access Journals (Sweden)

    Wenda Tao

    Full Text Available To understand the diversity and abundance of antibiotic resistance genes (ARGs in pharmaceutical wastewater treatment bioreactors, the ARGs in sludge from two full-scale pharmaceutical wastewater treatment plants (PWWTPs were investigated and compared with sludge samples from three sewage treatment plants (STPs using metagenomic approach. The results showed that the ARG abundances in PWWTP sludge ranged from 54.7 to 585.0 ppm, which were higher than those in STP sludge (27.2 to 86.4 ppm. Moreover, the diversity of ARGs in PWWTP aerobic sludge (153 subtypes was higher than that in STP aerobic sludge (118 subtypes. In addition, it was found that the profiles of ARGs in PWWTP aerobic sludge were similar to those in STP aerobic sludge but different from those in PWWTP anaerobic sludge, suggesting that dissolve oxygen (DO could be one of the important factors affecting the profiles of ARGs. In PWWTP aerobic sludge, aminoglycoside, sulfonamide and multidrug resistance genes were frequently detected. While, tetracycline, macrolide-lincosamide-streptogramin and polypeptide resistance genes were abundantly present in PWWTP anaerobic sludge. Furthermore, we investigated the microbial community and the correlation between microbial community and ARGs in PWWTP sludge. And, significant correlations between ARG types and seven bacterial genera were found. In addition, the mobile genetic elements (MGEs were also examined and correlations between the ARGs and MGEs in PWWTP sludge were observed. Collectively, our results suggested that the microbial community and MGEs, which could be affected by DO, might be the main factors shaping the profiles of ARGs in PWWTP sludge.

  6. ACCOUNTING AND AUDIT OPERATIONS ON CURRENT ACCOUNT

    Directory of Open Access Journals (Sweden)

    Koblyanska Olena

    2018-03-01

    Full Text Available Introduction. The article is devoted to theoretical, methodical and practical issues of accounting and auditing of operations on the current account. The purpose of the study is to deepen and consolidate the theoretical and practical knowledge of the issues of accounting and auditing of operations on the current account, identify practical problems with the implementation of the methodology and organization of accounting and auditing of operations on the current account and develop recommendations for the elimination of deficiencies and improve the accounting and auditing. Results. The issue of the relevance of proper accounting and audit of transactions on the current account in the bank is considered. The research of typical operations on the current account was carried out with using of the method of their reflection in the account on practical examples. Features of the audit of transactions on the current account are examined, the procedure for its implementation is presented, and types of abuses and violations that occur while performing operations on the current account are identified. The legal regulation of accounting, analysis and control of operations with cash on current accounts is considered. The problem issues related to the organization and conducting of the audit of funds in the accounts of the bank are analyzed, as well as the directions of their solution are determined. The proposals for determining the sequence of actions of the auditor during the check of cash flow on accounts in the bank are provided. Conclusions. The questions about theoretical, methodological and practical issues of accounting and auditing of operations on the current account in the bank. A study of typical operations with cash on the current account was carried out with the use of the method of their reflection in the accounts and the features of the auditing of cash on the account.

  7. Prospective investigation of nasal mupirocin, hexachlorophene body wash, and systemic antibiotics for prevention of recurrent community-associated methicillin-resistant Staphylococcus aureus infections.

    Science.gov (United States)

    Miller, Loren G; Tan, Jennifer; Eells, Samantha J; Benitez, Esther; Radner, Allen B

    2012-02-01

    Recurrent community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA) skin infections are an increasingly common problem. However, there are no data on the efficacy of decolonization regimens. We prospectively evaluated 31 patients with recurrent CA-MRSA skin infections who received nasal mupirocin, topical hexachlorophene body wash, and an oral anti-MRSA antibiotic. The mean number of MRSA infections after the intervention decreased significantly from baseline (0.03 versus 0.84 infections/month, P = <0.0001). This regimen appears promising at preventing recurrent CA-MRSA infections.

  8. Spread of community-acquired meticillin-resistant Staphylococcus aureus skin and soft-tissue infection within a family: implications for antibiotic therapy and prevention.

    LENUS (Irish Health Repository)

    Amir, N H

    2010-04-01

    Outbreaks or clusters of community-acquired meticillin-resistant Staphylococcus aureus (CA-MRSA) within families have been reported. We describe a family cluster of CA-MRSA skin and soft-tissue infection where CA-MRSA was suspected because of recurrent infections which failed to respond to flucloxacillin. While the prevalence of CA-MRSA is low worldwide, CA-MRSA should be considered in certain circumstances depending on clinical presentation and risk assessment. Surveillance cultures of family contacts of patients with MRSA should be considered to help establish the prevalence of CA-MRSA and to inform the optimal choice of empiric antibiotic treatment.

  9. Who possesses drug resistance genes in the aquatic environment?: sulfamethoxazole (SMX) resistance genes among the bacterial community in water environment of Metro-Manila, Philippines.

    Science.gov (United States)

    Suzuki, Satoru; Ogo, Mitsuko; Miller, Todd W; Shimizu, Akiko; Takada, Hideshige; Siringan, Maria Auxilia T

    2013-01-01

    Recent evidence has shown that antibiotic resistant bacteria (ARB) and antibiotic resistance genes (ARGs) are ubiquitous in natural environments, including sites considered pristine. To understand the origin of ARGs and their dynamics, we must first define their actual presence in the natural bacterial assemblage. Here we found varying distribution profiles of sul genes in "colony forming bacterial assemblages" and "natural bacterial assemblages." Our monitoring for antibiotic contamination revealed that sulfamethoxazole (SMX) is a major contaminant in aquatic environments of Metro-Manila, which would have been derived from human and animal use, and subsequently decreased through the process of outflow from source to the sea. The SMX-resistant bacterial rate evaluated by the colony forming unit showed 10 to 86% of the total colony numbers showed higher rates from freshwater sites compared to marine sites. When sul genes were quantified by qPCR, colony-forming bacteria conveyed sul1 and sul2 genes in freshwater and seawater (10(-5)-10(-2) copy/16S) but not sul3. Among the natural bacterial assemblage, all sul1, sul2, and sul3 were detected (10(-5)-10(-3) copy/16S), whereas all sul genes were at an almost non-detectable level in the freshwater assemblage. This study suggests that sul1 and sul2 are main sul genes in culturable bacteria, whereas sul3 is conveyed by non-culturable bacteria in the sea. As a result marine bacteria possess sul1, sul2 and sul3 genes in the marine environment.

  10. Who Possesses Drug Resistance Genes in the Aquatic Environment? : Sulfamethoxazole (SMX Resistance Genes among the Bacterial Community in Water Environment of Metro-Manila, Philippines

    Directory of Open Access Journals (Sweden)

    Satoru eSuzuki

    2013-04-01

    Full Text Available Recent evidence has shown that antibiotic resistant bacteria (ARB and antibiotic resistance genes (ARG are ubiquitous in natural environments, including sites considered pristine. To understand the origin of ARGs and their dynamics, we must first define their actual presence in the natural bacterial assemblage. Here we found varying distribution profiles of sul genes in colony forming bacterial assemblages and natural bacterial assemblages. Our monitoring for antibiotic contamination revealed that sulfamethoxazole (SMX is a major contaminant in aquatic environments of Metro-Manila, which would have been derived from human and animal use, and subsequently decreased through the process of outflow from source to the sea. The SMX-resistant bacterial rate evaluated by the colony forming unit showed 10 to 86 % of the total colony numbers showed higher rates from freshwater sites compared to marine sites. When sul genes were quantified by qPCR, colony-forming bacteria conveyed sul1 and sul2 genes in freshwater and seawater (10-5-10-2 copy/16S but not sul3. Among the natural bacterial assemblage, all sul1, sul2 and sul3 were detected (10-5-10-3 copy/16S, whereas all sul genes were at an almost non-detectable level in the freshwater assemblage. This study suggests that sul1 and sul2 are main sul genes in culturable bacteria, whereas sul3 is conveyed by non-culturable bacteria in the sea. As a result marine bacteria possess sul1, sul2 and sul3 genes in the marine environment.

  11. Integrating Computer Concepts into Principles of Accounting.

    Science.gov (United States)

    Beck, Henry J.; Parrish, Roy James, Jr.

    A package of instructional materials for an undergraduate principles of accounting course at Danville Community College was developed based upon the following assumptions: (1) the principles of accounting student does not need to be able to write computer programs; (2) computerized accounting concepts should be presented in this course; (3)…

  12. 42 CFR 51c.112 - Grantee accountability.

    Science.gov (United States)

    2010-10-01

    ... 42 Public Health 1 2010-10-01 2010-10-01 false Grantee accountability. 51c.112 Section 51c.112 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES GRANTS GRANTS FOR COMMUNITY HEALTH SERVICES General Provisions § 51c.112 Grantee accountability. (a) Accounting for grant award...

  13. 28 CFR 810.2 - Accountability contract.

    Science.gov (United States)

    2010-07-01

    ... 28 Judicial Administration 2 2010-07-01 2010-07-01 false Accountability contract. 810.2 Section... COLUMBIA COMMUNITY SUPERVISION: ADMINISTRATIVE SANCTIONS § 810.2 Accountability contract. (a) Your CSO will... accountability contract with CSOSA. (b) The CSO is responsible for monitoring your compliance with the conditions...

  14. Toward Modeling the Resistance and Resilience of "Below-ground" Fungal Communities: A Mechanistic and Trait-Based Approach.

    Science.gov (United States)

    Falconer, Ruth E; Otten, Wilfred; White, Nia A

    2015-01-01

    The role of fungi in shaping ecosystems is well evidenced and there is growing recognition of their importance among scientists and the general public. Establishing and separating the role of key local (soil chemical, biological, and physical properties) and global (climate, dispersal limitation) drivers in fungal community structure and functioning is currently a source of frustration to mycologists. The quest to determine niche processes and environmental characteristics shaping fungal community structure, known to be important for plant and animal communities, is proving difficult, resulting in the acknowledgment that niche neutral processes (climate, dispersal limitations) may dominate. The search for predictable patterns in fungal community structure may have been restricted as the "appropriate" scales at which to measure community structure and characterize the environment have not been fully determined yet, and the focus on taxonomy makes it difficult to link environmental characteristics to fungal traits. While key determinants of microbial community composition have been uncovered for some functional groups, the differential response of functional groups is largely unknown. Before we can truly understand what drives the development of microbial community structure, an understanding of the autecology of major fungal taxa and how they interact with their immediate environment (from the micro- up to kilometer scale) is urgently needed. Furthermore, key information and empirical data is missing at the microscale due to experimental difficulties in mapping this heterogeneous and opaque environment. We therefore present a framework that would help generate this much-needed empirical data and information at the microscale, together with modeling approaches to link the spatial and temporal scales. The latter is important as we propose that there is much to be gained by linking our understanding of fungal community responses across scales, in order to develop

  15. The epidemiology and transmission of methicillin-resistant Staphylococcus aureus in the community in Singapore: study protocol for a longitudinal household study.

    Science.gov (United States)

    Shankar, Nivedita; Chow, Angela Li Ping; Oon, Jolene; Hsu, Li Yang; Ang, Brenda; Pang, Junxiong; De Sessions, Paola Florez; Periaswamy, Balamurugan; Tambyah, Paul A; Teo, Desmond B; Tam, Clarence C

    2017-10-11

    Methicillin-resistant Staphylococcus aureus (MRSA) is one of the most common multidrug-resistant organisms in healthcare settings worldwide, but little is known about MRSA transmission outside of acute healthcare settings especially in Asia. We describe the methods for a prospective longitudinal study of MRSA prevalence and transmission. MRSA-colonized individuals were identified from MRSA admission screening at two tertiary hospitals and recruited together with their household contacts. Participants submitted self-collected nasal, axilla and groin (NAG) swabs by mail for MRSA culture at baseline and monthly thereafter for 6 months. A comparison group of households of MRSA-negative patients provided swab samples at one time point. In a validation sub-study, separate swabs from each site were collected from randomly selected individuals, to compare MRSA detection rates between swab sites, and between samples collected by participants versus those collected by trained research staff. Information on each participant's demographic information, medical status and medical history, past healthcare facilities usage and contacts, and personal interactions with others were collected using a self-administered questionnaire. Understanding the dynamics of MRSA persistence and transmission in the community is crucial to devising and evaluating successful MRSA control strategies. Close contact with MRSA colonized patients may to be important for MRSA persistence in the community; evidence from this study on the extent of community MRSA could inform the development of household- or community-based interventions to reduce MRSA colonization of close contacts and subsequent re-introduction of MRSA into healthcare settings. Analysis of longitudinal data using whole-genome sequencing will yield further information regarding MRSA transmission within households, with significant implications for MRSA infection control outside acute hospital settings.

  16. ACCOUNTING HARMONIZATION AND HISTORICAL COST ACCOUNTING

    OpenAIRE

    Valentin Gabriel CRISTEA

    2017-01-01

    There is a huge interest in accounting harmonization and historical costs accounting, in what they offer us. In this article, different valuation models are discussed. Although one notices the movement from historical cost accounting to fair value accounting, each one has its advantages.

  17. ACCOUNTING HARMONIZATION AND HISTORICAL COST ACCOUNTING

    Directory of Open Access Journals (Sweden)

    Valentin Gabriel CRISTEA

    2017-05-01

    Full Text Available There is a huge interest in accounting harmonization and historical costs accounting, in what they offer us. In this article, different valuation models are discussed. Although one notices the movement from historical cost accounting to fair value accounting, each one has its advantages.

  18. Social Contingency and Advising Accountability

    Directory of Open Access Journals (Sweden)

    Shinyi Lin

    2016-02-01

    Full Text Available The issue of teaching and learning accountability has been discussed for years. This study focuses specifically on advising accountability of management education to explore how faculty advisors communicate with their student advisees using instant messaging (IM to enhance advising presence primarily based on Tetlock’s social contingency model. The dependent relationships between advisor and advisee are considered a cohort, and their collaboration as a community of practice. Of the 254 graduate students in the college of management, the result reveals that their perception of advising accountability has been casually explained by the antecedents, that is, self-efficacy, advising presence, epistemic engagement, advisor credibility, and their flow experience toward using IM to communicate with their thesis advisors. The research finding validates intervening factors between students’ perception of IM self-efficacy and advising accountability of thesis advisors. The findings, regardless of the limited generalization, provide prescriptive implications that educational practitioners can use to evaluate related issues of advising accountability.

  19. Phylogenetic, virulence and antibiotic resistance characteristics of commensal strain populations of Escherichia coli from community subjects in the Paris area in 2010 and evolution over 30 years.

    Science.gov (United States)

    Massot, Méril; Daubié, Anne-Sophie; Clermont, Olivier; Jauréguy, Françoise; Couffignal, Camille; Dahbi, Ghizlane; Mora, Azucena; Blanco, Jorge; Branger, Catherine; Mentré, France; Eddi, Alain; Picard, Bertrand; Denamur, Erick; The Coliville Group

    2016-04-01

    It is important to study commensal populations of Escherichia coli because they appear to be the reservoir of both extra-intestinal pathogenic E. coli and antibiotic resistant strains of E. coli. We studied 279 dominant faecal strains of E. coli from 243 adults living in the community in the Paris area in 2010. The phylogenetic group and subgroup [sequence type complex (STc)] of the isolates and the presence of 20 virulence genes were determined by PCR assays. The O-types and resistance to 18 antibiotics were assessed phenotypically. The B2 group was the most frequently recovered (34.0 %), followed by the A group (28.7 %), and other groups were more rare. The most prevalent B2 subgroups were II (STc73), IV (STc141), IX (STc95) and I (STc131), with 22.1, 21.1, 16.8 and 13.7 %, respectively, of the B2 group strains. Virulence factors (VFs) were more common in B2 group than other strains. One or more resistances were found in 125 strains (44.8 % of the collection) but only six (2.2 % of the collection) were multiresistant; no extended-spectrum beta-lactamase-producing strain was isolated. The C phylogroup and clonal group A strains were the most resistant. No trade-off between virulence and resistance was evidenced. We compared these strains with collections of strains gathered under the same conditions 30 and 10 years ago. There has been a parallel and linked increase in the frequency of B2 group strains (from 9.4 % in 1980, to 22.7 % in 2000 and 34.0 % in 2010) and of VFs. Antibiotic resistance also increased, from 22.6 % of strains resistant to at least one antibiotic in 1980, to 31.8 % in 2000 and 44.8 % in 2010; resistance to streptomycin, however, remained stable. Commensal human E. coli populations have clearly evolved substantially over time, presumably reflecting changes in human practices, and particularly increasing antibiotic use.

  20. Operating conditions influence microbial community structures, elimination of the antibiotic resistance genes and metabolites during anaerobic digestion of cow manure in the presence of oxytetracycline.

    Science.gov (United States)

    Turker, Gokhan; Akyol, Çağrı; Ince, Orhan; Aydin, Sevcan; Ince, Bahar

    2018-01-01

    The way that antibiotic residues in manure follow is one of the greatest concerns due to its potential negative impacts on microbial communities, the release of metabolites and antibiotic resistant genes (ARGs) into the nature and the loss of energy recovery in anaerobic digestion (AD) systems. This study evaluated the link between different operating conditions, the biodegradation of oxytetracycline (OTC) and the formation of its metabolites and ARGs in anaerobic digesters treating cow manure. Microbial communities and ARGs were determined through the use of quantitative real-time PCR. The biodegradation of OTC and occurrence of metabolites were determined using UV-HPLC and LC/MS/MS respectively. The maximum quantity of resistance genes was also examined at the beginning of AD tests and concentration was in the order of: tetM >tetO. The numbers of ARGs were always higher at high volatile solids (VS) content and high mixing rate. The results of the investigation revealed that relationship between mixing rate and VS content plays a crucial role for elimination of ARGs, OTC and metabolites. This can be attributed to high abundance of microorganisms due to high VS content and their increased contact with elevated mixing rate. An increased interaction between microorganisms triggers the promotion of ARGs. Copyright © 2017 Elsevier Inc. All rights reserved.

  1. Staphylococcal Cassette Chromosome mec (SCCmec Typing of Methicillin-Resistant Staphylococcus aureus Strains Isolated from Community- and Hospital-Acquired Infections

    Directory of Open Access Journals (Sweden)

    Fahimeh Ghanbari

    2017-04-01

    Full Text Available Background Methicillin-resistant Staphylococcus aureus (MRSA is responsible for the growing number of hospital- and community-acquired infections. Objectives In this study, we aimed to determine the prevalence of MRSA, its antimicrobial resistance profile, and molecular typing of strains isolated from different infections in Iran. Methods A total of 100 S. aureus strains were isolated from various clinical specimens from Al-Zahra Hospital of Isfahan, Iran during January-June, 2015. Antimicrobial susceptibility test was performed, using the disk diffusion method. For identifying the MRSA phenotype, oxacillin agar screening was performed. Detection of mecA gene among the isolates was performed via polymerase chain reaction (PCR using specific primers, followed by multiplex PCR for SCCmec typing of MRSA isolates. Results In the present study, 54 (54% isolates were identified as MRSA. Overall, 12 (22.23% and 42 (77.7% isolates were obtained from community- and hospital-acquired infections, respectively. SCCmec typing among MRSA isolates showed that 19 (35.18%, 13 (24.07%, 6 (11.11%, 5 (9.25%, and 3 (5.55% isolates contained SCCmec type III, type I, type IV, type II, and type V, respectively; however, 8 (14.81% isolates were nontypable. Conclusions In the current study, SCCmec type III isolates were the most common among 54 MRSA isolates in a teaching hospital in the center of Iran. This finding might be attributed to antibiotic pressure, facilitating clonal selection.

  2. Characteristics of Community-Associated Methicillin-Resistant Staphylococcus aureus (CA-MRSA Strains Isolated from Skin and Soft-Tissue Infections in Uruguay

    Directory of Open Access Journals (Sweden)

    Lorena Pardo

    2009-01-01

    Full Text Available We analyzed 90 nonduplicates community-associated methicillin-resistant S. aureus (CA-MRSA strains isolated from skin and soft-tissue infections. All strains were mecA positive. Twenty-four of the 90 strains showed inducible macrolide-lincosamide-streptogramin B resistance. All strains produced α-toxin; 96% and 100% of them displayed positive results for lukS-F and cna genes, respectively. Eigthy-five strains expressed capsular polysaccharide serotype 8. Six different pulsotypes were discriminated by pulsed-field gel electrophoresis (PFGE and three predominant groups of CA-MRSA strains (1, 2, and 4 were identified, in agreement with phenotypic and genotypic characteristics. Strains of group 1 (pulsotype A, CP8+, and Panton-Valentine leukocidin (PVL+ were the most frequently recovered and exhibited a PFGE band pattern identical to other CA-MRSA strains previously isolated in Uruguay and Brazil. Three years after the first local CA-MRSA report, these strains are still producing skin and soft-tissue infections demonstrating the stability over time of this community-associated emerging pathogen.

  3. Antibiotic resistance and community analysis of surface and subsurface drainage waters in the South Fork Iowa River watershed

    Science.gov (United States)

    The Midwest is a center for swine production leading to application of swine manure onto lands that have artificial subsurface drainage. Previous reports have indicated elevated levels of antibiotic resistance genes (ARGs) in surface water and groundwater around confined animal feeding operations wh...

  4. Wetland and riparian plant communities at risk of invasion by transgenic-resistant Agrostis stolonifera in Central Oregon

    Science.gov (United States)

    Creeping bentgrass (Agrostis stolonifera) and redtop (A. gigantea) are introduced turfgrasses that are naturalized throughout the northern U.S. Interest in creeping bentgrass has risen following the 2003 escape of a genetically modified (GM), herbicide-resistant cultivar near Mad...

  5. Surveillance of colonization and infection with Staphylococcus aureus susceptible or resistant to methicillin in a community skilled-nursing facility

    NARCIS (Netherlands)

    Y.-L. Lee (Yee-Lean); T. Cesario (Thomas); G.K. Gupta (Geeta); L. Flionis (Leo); C.T. Tran (Chi); M. Decker (Michael); L.D. Thrupp (Lauri)

    1997-01-01

    textabstractBackground: Methicillin-resistant Staphylococcus aureus (MRSA) is an important nosocomial pathogen in acute care hospitals and long-term care facilities. Few studies have been reported in private skilled nursing facilities (SNFs) not experiencing outbreaks of infections caused by MRSA.

  6. Social Responsibility of Accounting

    OpenAIRE

    JINNAI, Yoshiaki

    2011-01-01

    Historical and theoretical inquiries into the function of accounting have provided fruitful insights into social responsibility of accounting, which is, and should be, based on accounts kept through everyday accounting activities. However, at the current stage of capitalist accounting, keeping accounts is often regarded as merely a preparatory process for creating financial statements at the end of an accounting period. Thus, discussions on the social responsibility of accounting tend to conc...

  7. Community-acquired methicillin-resistant Staphylococcus aureus carrying SCCmec type IV and V isolated from healthy children attending public daycares in northeastern Brazil

    Directory of Open Access Journals (Sweden)

    Suzi P. de Carvalho

    2017-07-01

    Full Text Available Nasal colonization with methicillin-resistant Staphylococcus aureus (MRSA have increasingly been reported in healthy communities. This study aimed to assess the rate of S. aureus in general and MRSA in particular from nasal secretion of children in daycare centers in Vitória da Conquista, Brazil. The isolates were identified based on morphology, biochemical tests and by PCR. Detection of virulence genes, biofilm production, and susceptibility test by disk diffusion agar were performed. MRSA isolates were characterized by spa, SCCmec, and multilocus sequence typing (MLST. S. aureus were recovered from 70 (47.3% of 148 children. Among the 11 MRSA strains (15.7%, two SCCmec types (IV and V were detected. MLST identified four STs related to three clonal complexes (CC: 5, 45, and 398. Four spa types were found circulating in this setting. Resistance of S. aureus isolates to ampicillin, erythromycin, ciprofloxacin, clindamycin, and tetracycline was 80%, 32.8%, 7.1%, 7.1% and 4.3%, respectively. One isolate presented intermediate resistance to vancomycin detected by Etest methodology. All strains were biofilm producers. The virulence genes seb, sec, spa, and pvl were detected in some isolates. This study revealed a high rate of children carrying MRSA among healthy attendees in daycare centers in Vitória da Conquista, Brazil.

  8. Impact of amoxicillin therapy on resistance selection in patients with community-acquired lower respiratory tract infections: a randomized, placebo-controlled study.

    Science.gov (United States)

    Malhotra-Kumar, Surbhi; Van Heirstraeten, Liesbet; Coenen, Samuel; Lammens, Christine; Adriaenssens, Niels; Kowalczyk, Anna; Godycki-Cwirko, Maciek; Bielicka, Zuzana; Hupkova, Helena; Lannering, Christina; Mölstad, Sigvard; Fernandez-Vandellos, Patricia; Torres, Antoni; Parizel, Maxim; Ieven, Margareta; Butler, Chris C; Verheij, Theo; Little, Paul; Goossens, Herman

    2016-11-01

    To determine the effect of amoxicillin treatment on resistance selection in patients with community-acquired lower respiratory tract infections in a randomized, placebo-controlled trial. Patients were prescribed amoxicillin 1 g, three times daily (n = 52) or placebo (n = 50) for 7 days. Oropharyngeal swabs obtained before, within 48 h post-treatment and at 28-35 days were assessed for proportions of amoxicillin-resistant (ARS; amoxicillin MIC ≥2 mg/L) and -non-susceptible (ANS; MIC ≥0.5 mg/L) streptococci. Alterations in amoxicillin MICs and in penicillin-binding-proteins were also investigated. ITT and PP analyses were conducted. ARS and ANS proportions increased 11- and 2.5-fold, respectively, within 48 h post-amoxicillin treatment compared with placebo [ARS mean increase (MI) 9.46, 95% CI 5.57-13.35; ANS MI 39.87, 95% CI 30.96-48.78; P  0.1588). ARS/ANS were grouped by pbp mutations. Group 1 strains exhibited significantly lower amoxicillin resistance (mean MIC 2.8 mg/L, 95% CI 2.6-3.1) than group 2 (mean MIC 9.3 mg/L, 95% CI 8.1-10.5; P < 0.0001). Group 2 strains predominated immediately post-treatment (61.07%) and although decreased by days 28-35 (30.71%), proportions remained higher than baseline (18.70%; P = 0.0004). By utilizing oropharyngeal streptococci as model organisms this study provides the first prospective, experimental evidence that resistance selection in patients receiving amoxicillin is modest and short-lived, probably due to 'fitness costs' engendered by high-level resistance-conferring mutations. This evidence further supports European guidelines that recommend amoxicillin when an antibiotic is indicated for community-acquired lower respiratory tract infections. © The Author 2016. Published by Oxford University Press on behalf of the British Society for Antimicrobial Chemotherapy.

  9. Nasal carriage of a single clone of community-acquired methicillin-resistant Staphylococcus aureus among kindergarten attendees in northern Taiwan

    Directory of Open Access Journals (Sweden)

    Lee Shih-Yi

    2007-06-01

    Full Text Available Abstract Background: To evaluate the prevalence and microbiological characterization of community-acquired (CA methicillin-resistant Staphylococcus aureus (MRSA nasal carriage in a kindergarten. Methods: Point prevalence study. Nasal swabs were collected from healthy children younger than 7 years of age who were attending a kindergarten in Taipei, Taiwan. A parent questionnaire regarding MRSA risk factors was administered simultaneously. All CA-MRSA colonization isolates were archived for subsequent antimicrobial susceptibility and molecular typing. Results: Of the 68 children who participated in the study, 17 (25% had S. aureus isolated from nasal swabs. Nine (13.2% of the 68 children had CA-MRSA carriage, and none of them had any identified risk factors. Antimicrobial susceptibility testing revealed all of the 9 CA-MRSA colonization isolates had uniformly high resistance (100% to both clindamycin and erythromycin, the macrolide-lincosamide-streptogramin-constitutive phenotype and the ermB gene. Pulsed-field gel electrophoresis revealed 8 (88.9% of 9 CA-MRSA colonization isolates were genetically related and multilocus sequence typing revealed all isolates had sequence type 59. All of the colonization isolates carried the staphylococcal cassette chromosome mec type IV, but none were positive for the Panton-Valentine leukocidin genes. Conclusion: The results of this study suggest that a single predominant CA-MRSA colonization strain featuring high clindamycin resistance circulated in this kindergarten. Additionally, due to the established transmissibility of colonization isolates, the high prevalence of nasal carriage of CA-MRSA among healthy attendees in kindergartens may indicate the accelerated spread of CA-MRSA in the community.

  10. Accounting Fundamentals for Non-Accountants

    Science.gov (United States)

    The purpose of this module is to provide an introduction and overview of accounting fundamentals for non-accountants. The module also covers important topics such as communication, internal controls, documentation and recordkeeping.

  11. Integrating Ethics in Community Colleges' Accounting Programs.

    Science.gov (United States)

    Clarke, Clifton

    1990-01-01

    Argues that two-year college business programs need to provide moral guidance and leadership to students to help stem the proliferation of fraudulent and questionable financial reporting practices. Reviews amoral and moral unity theories of business ethics. Discusses barriers to ethical instruction in business curricula, and ways to overcome them.…

  12. DO ACCOUNTING PRACTITIONERS USE ACCOUNTING RESEARCH RESULTS?

    OpenAIRE

    ALINA BEATTRICE VLADU

    2015-01-01

    This paper reports the results of a survey designed to explore if accounting practitioners are using as a reference point in their daily activities the opinions of academia. Since accounting research comprises various trends of research the earnings management research field is used as illustrative case. Among our respondents were accounting professional, members of professional bodies as the Chamber of Financial Auditors or Romania and also Body of Expert and Licensed Accountants...

  13. Community- and Healthcare-Associated Methicillin-Resistant Staphylococcus aureus Strains: An Investigation Into Household Transmission, Risk Factors, and Environmental Contamination.

    Science.gov (United States)

    Ng, Wil; Faheem, Amna; McGeer, Allison; Simor, Andrew E; Gelosia, Antonella; Willey, Barbara M; Watt, Christine; Richardson, David C; Wong, Henry; Ostrowska, Krystyna; Vernich, Lee; Muller, Matthew P; Gnanasuntharam, Piraveina; Porter, Vanessa; Katz, Kevin

    2017-01-01

    OBJECTIVE To measure transmission frequencies and risk factors for household acquisition of community-associated and healthcare-associated (HA-) methicillin-resistant Staphylococcus aureus (MRSA). DESIGN Prospective cohort study from October 4, 2008, through December 3, 2012. SETTING Seven acute care hospitals in or near Toronto, Canada. PARTICIPANTS Total of 99 MRSA-colonized or MRSA-infected case patients and 183 household contacts. METHODS Baseline interviews were conducted, and surveillance cultures were collected monthly for 3 months from household members, pets, and 8 prespecified high-use environmental locations. Isolates underwent pulsed-field gel electrophoresis and staphylococcal cassette chromosome mec typing. RESULTS Overall, of 183 household contacts 89 (49%) were MRSA colonized, with 56 (31%) detected at baseline. MRSA transmission from index case to contacts negative at baseline occurred in 27 (40%) of 68 followed-up households. Strains were identical within households. The transmission risk for HA-MRSA was 39% compared with 40% (P=.95) for community-associated MRSA. HA-MRSA index cases were more likely to be older and not practice infection control measures (P=.002-.03). Household acquisition risk factors included requiring assistance and sharing bath towels (P=.001-.03). Environmental contamination was identified in 78 (79%) of 99 households and was more common in HA-MRSA households. CONCLUSION Household transmission of community-associated and HA-MRSA strains was common and the difference in transmission risk was not statistically significant. Infect Control Hosp Epidemiol 2016;1-7.

  14. Adaptive Change Inferred from Genomic Population Analysis of the ST93 Epidemic Clone of Community-Associated Methicillin-Resistant Staphylococcus aureus

    Science.gov (United States)

    Stinear, Timothy P.; Holt, Kathryn E.; Chua, Kyra; Stepnell, Justin; Tuck, Kellie L.; Coombs, Geoffrey; Harrison, Paul Francis; Seemann, Torsten; Howden, Benjamin P.

    2014-01-01

    Community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA) has emerged as a major public health problem around the world. In Australia, ST93-IV[2B] is the dominant CA-MRSA clone and displays significantly greater virulence than other S. aureus. Here, we have examined the evolution of ST93 via genomic analysis of 12 MSSA and 44 MRSA ST93 isolates, collected from around Australia over a 17-year period. Comparative analysis revealed a core genome of 2.6 Mb, sharing greater than 99.7% nucleotide identity. The accessory genome was 0.45 Mb and comprised additional mobile DNA elements, harboring resistance to erythromycin, trimethoprim, and tetracycline. Phylogenetic inference revealed a molecular clock and suggested that a single clone of methicillin susceptible, Panton-Valentine leukocidin (PVL) positive, ST93 S. aureus likely spread from North Western Australia in the early 1970s, acquiring methicillin resistance at least twice in the mid 1990s. We also explored associations between genotype and important MRSA phenotypes including oxacillin MIC and production of exotoxins (α-hemolysin [Hla], δ-hemolysin [Hld], PSMα3, and PVL). High-level expression of Hla is a signature feature of ST93 and reduced expression in eight isolates was readily explained by mutations in the agr locus. However, subtle but significant decreases in Hld were also noted over time that coincided with decreasing oxacillin resistance and were independent of agr mutations. The evolution of ST93 S. aureus is thus associated with a reduction in both exotoxin expression and oxacillin MIC, suggesting MRSA ST93 isolates are under pressure for adaptive change. PMID:24482534

  15. Transmission of community-associated methicillin-resistant Staphylococcus aureus from breast milk in the neonatal intensive care unit.

    Science.gov (United States)

    Gastelum, Dawn Terashita; Dassey, David; Mascola, Laurene; Yasuda, Lori M

    2005-12-01

    Methicillin-resistant Staphylococcus aureus (MRSA) has become increasingly common in neonatal intensive care units and can lead to severe outcomes. Baby C, of a set of quadruplets, died of MRSA sepsis. The surviving siblings were colonized with MRSA. Expressed breast milk was fed to all infants; tested breast milk samples were all MRSA-positive. Pulsed field gel electrophoresis results of isolates from the infants and breast milk were indistinguishable.

  16. Optimizing health care delivery by integrating workplaces, homes, and communities: how occupational and environmental medicine can serve as a vital connecting link between accountable care organizations and the patient-centered medical home.

    Science.gov (United States)

    McLellan, Robert K; Sherman, Bruce; Loeppke, Ronald R; McKenzie, Judith; Mueller, Kathryn L; Yarborough, Charles M; Grundy, Paul; Allen, Harris; Larson, Paul W

    2012-04-01

    In recent years, the health care reform discussion in the United States has focused increasingly on the dual goals of cost-effective delivery and better patient outcomes. A number of new conceptual models for health care have been advanced to achieve these goals, including two that are well along in terms of practical development and implementation-the patient-centered medical home (PCMH) and accountable care organizations (ACOs). At the core of these two emerging concepts is a new emphasis on encouraging physicians, hospitals, and other health care stakeholders to work more closely together to better coordinate patient care through integrated goals and data sharing and to create team-based approaches that give a greater role to patients in health care decision-making. This approach aims to achieve better health outcomes at lower cost. The PCMH model emphasizes the central role of primary care and facilitation of partnerships between patient, physician, family, and other caregivers, and integrates this care along a spectrum that includes hospitals, specialty care, and nursing homes. Accountable care organizations make physicians and hospitals more accountable in the care system, emphasizing organizational integration and efficiencies coupled with outcome-oriented, performance-based medical strategies to improve the health of populations. The ACO model is meant to improve the value of health care services, controlling costs while improving quality as defined by outcomes, safety, and patient experience. This document urges adoption of the PCMH model and ACOs, but argues that in order for these new paradigms to succeed in the long term, all sectors with a stake in health care will need to become better aligned with them-including the employer community, which remains heavily invested in the health outcomes of millions of Americans. At present, ACOs are largely being developed as a part of the Medicare and Medicaid systems, and the PCMH model is still gathering

  17. Safeguards Accountability Network accountability and materials management

    International Nuclear Information System (INIS)

    Carnival, G.J.; Meredith, E.M.

    1985-01-01

    The Safeguards Accountability Network (SAN) is a computerized on-line accountability system for the safeguards accountability control of nuclear materials inventories at Rocky Flats Plant. SAN is a dedicated accountability system utilizing source documents filled out on the shop floor as its base. The system incorporates double entry accounting and is developed around the Material Balance Area (MBA) concept. MBA custodians enter transaction information from source documents prepared by personnel in the process areas directly into the SAN system. This provides a somewhat near-real time perpetual inventory system which has limited interaction with MBA custodians. MBA custodians are permitted to inquire into the system and status items on inventory. They are also responsible for the accuracy of the accountability information used as input to the system for their MBA. Monthly audits by the Nuclear Materials Control group assure the timeliness and accuracy of SAN accountability information

  18. Pyrosequencing the Bemisia tabaci transcriptome reveals a highly diverse bacterial community and a robust system for insecticide resistance.

    Directory of Open Access Journals (Sweden)

    Wen Xie

    Full Text Available BACKGROUND: Bemisia tabaci (Gennadius is a phloem-feeding insect poised to become one of the major insect pests in open field and greenhouse production systems throughout the world. The high level of resistance to insecticides is a main factor that hinders continued use of insecticides for suppression of B. tabaci. Despite its prevalence, little is known about B. tabaci at the genome level. To fill this gap, an invasive B. tabaci B biotype was subjected to pyrosequencing-based transcriptome analysis to identify genes and gene networks putatively involved in various physiological and toxicological processes. METHODOLOGY AND PRINCIPAL FINDINGS: Using Roche 454 pyrosequencing, 857,205 reads containing approximately 340 megabases were obtained from the B. tabaci transcriptome. De novo assembly generated 178,669 unigenes including 30,980 from insects, 17,881 from bacteria, and 129,808 from the nohit. A total of 50,835 (28.45% unigenes showed similarity to the non-redundant database in GenBank with a cut-off E-value of 10-5. Among them, 40,611 unigenes were assigned to one or more GO terms and 6,917 unigenes were assigned to 288 known pathways. De novo metatranscriptome analysis revealed highly diverse bacterial symbionts in B. tabaci, and demonstrated the host-symbiont cooperation in amino acid production. In-depth transcriptome analysis indentified putative molecular markers, and genes potentially involved in insecticide resistance and nutrient digestion. The utility of this transcriptome was validated by a thiamethoxam resistance study, in which annotated cytochrome P450 genes were significantly overexpressed in the resistant B. tabaci in comparison to its susceptible counterparts. CONCLUSIONS: This transcriptome/metatranscriptome analysis sheds light on the molecular understanding of symbiosis and insecticide resistance in an agriculturally important phloem-feeding insect pest, and lays the foundation for future functional genomics research of the

  19. Frequency and antibiotic resistance of bacteria implicated in community urinary tract infections in North Aveiro (2011-2014)

    OpenAIRE

    Costa, Tânia Alexandrina Ribeiro

    2014-01-01

    The urinary tract infection is the second most common infection in community and the most common nosocomial infection worldwide. Specific subpopulations are more likely to have UTI, such as, infants, pregnant women, elderly, diabetics, patients with urologic abnormalities, patients with catheters and immunodeficients. All the samples were collected at Centro Médico da Praça Lda on ambulatory system, located in São João da Madeira municipality, District of Aveiro north (Portugal) from June ...

  20. A fragilidade/resistência da vida humana em comunidades rurais do Pantanal Mato-Grossense (MT, Brasil The human life fragility/resistance in rurals communities of Pantanal (MT, Brazil

    Directory of Open Access Journals (Sweden)

    Marta Gislene Pignatti

    2010-10-01

    Full Text Available A fragilidade/resistência da vida humana tomada no sentido ambíguo/complexo sugere o olhar para a dinâmica da vida de grupos populacionais específicos. O estudo de uma comunidade no entorno da Reserva Particular do Patrimônio Natural do Serviço Social do Comércio (RPPN Sesc Pantanal, Distrito Rural de Joselândia, município de Barão de Melgaço (MT, no período de 2003 a 2005, buscou apreender o modo de vida dessa população, articulando a explicação do processo saúde doença com os aspectos históricos, econômicos e sociais da comunidade em questão e a singularidade das práticas de cura ocorridas no local. Utilizou-se de registros documentais históricos, depoimentos de moradores, inquérito populacional, entrevistas e observações. Verificou-se que houve mudanças nos laços de solidariedade entre os moradores no trabalho e na produção de alimentos. As práticas de cura populares são alternativas utilizadas para abrandar os sintomas e doenças. A fragilidade/resistência desse grupo específico se configura como resistência baseada nas relações de solidariedade e familiares e a fragilidade na dificuldade do acesso ao trabalho, serviços de saúde e equipamentos públicos.The human life fragility/resistance taken in the ambiguous/complexity sense suggests an eye to the dynamics of life of specific groups. The study of the community around the Private Reserve of Natural Patrimony of the Social Service Commerce (RPPN Sesc Pantanal, situated in Joselândia rural district, municipality of Barão de Melgaço - Mato Grosso state - Brasil, 2003 at 2005, used qualitative methods to apprehend the lifestyle of this population, articulating the explanation of the health-ill process with historical, economic and social aspects of the respective community and the singularity of the cure practices that happened on site. It was used historical records, testimonials of residents, population survey, interviews and observations. The

  1. ACCOUNTING TREATMENTS USED FOR ACCOUNTING SERVICES PROVIDERS

    Directory of Open Access Journals (Sweden)

    ŢOGOE GRETI DANIELA

    2014-08-01

    Full Text Available The theme of our research is the ways of keeping accounting entities that are the object of the provision of services in the accounting profession. This paper aims to achieve a parallel between the ways of organizing financial records - accounting provided by freelancers and companies with activity in the financial - accounting. The first step in our scientific research is to establish objectives chosen area of scientific knowledge. Our scientific approach seeks to explain through a thorough and detailed approach as different sides (conceptual and practical looking projections of accounting issues related to regulatory developments and practices in the field. This paper addresses various concepts, accounting treatments, and books and accounting documents used both freelancers in providing accounting services and legal persons authorized accounting profession. In terms of methodology and research perspective, the whole scientific approach combined with quantitative and qualitative research theoretical perspective (descriptive-conceptual with practice perspective (empirical analyzing the main contributions of various authors (Romanian and foreign to knowledge in the field. Following the survey believe that the amendments to the national legislation will support entities providing accounting services, by cutting red tape on Administrative Burdens, and consequently will increase profitability and increase service quality.

  2. Short-term repeatability of insulin resistance indexes in older adults. The Atherosclerosis Risk in Communities Study.

    Science.gov (United States)

    Poon, Anna K; Meyer, Michelle L; Reaven, Gerald; Knowles, Joshua W; Selvin, Elizabeth; Pankow, James S; Couper, David; Loehr, Laura; Heiss, Gerardo

    2018-03-29

    The homeostatic model assessment of insulin resistance (HOMA-IR) and triglyceride to high-density lipoprotein cholesterol ratio (TG/HDL-C) are insulin resistance indexes routinely used in clinical and population-based studies, but their short-term repeatability are not well characterized. To quantify the short-term repeatability of insulin resistances indexes and their analytes, consisting of fasting glucose and insulin for HOMA-IR, and triglyceride and high-density lipoprotein cholesterol (HDL-C) for TG/HDL-C. Prospective cohort study. A total of 102 adults 68 to 88 years old without diabetes attended an initial exam and repeat exam (mean 46 days; range 28 to 102 days). Blood samples were collected, processed, shipped, and assayed following a standardized protocol. Repeatability was quantified using the intraclass correlation coefficient (ICC) and within-person coefficient of variation (CV). Minimum detectable change (MDC95) and minimum detectable difference (MDD95) were quantified. For HOMA-IR, insulin, and fasting glucose, the ICCs were 0.70, 0.68, and 0.70; their respective within-person CVs were 30.4%, 28.8%, and 5.6%. For TG/HDL-C, triglyceride, and HDL-C, the ICCs were 0.80, 0.68, and 0.91; their respective within-person CVs were 23.0%, 20.6%, and 8.2%. The MDC95 for HOMA-IR was 2.3 and for TG/HDL-C was 1.4. The MDD95 for a sample of n=100 for HOMA-IR was 0.8 and for TG/HDL-C was 0.6. Short-term repeatability was fair to good for HOMA-IR and excellent for TG/HDL-C according to suggested benchmarks, reflecting the short-term variability of their analytes. These measurement properties can inform the use of these indexes in clinical and population-based studies.

  3. Community-Associated Methicillin Resistant Staphylococcus aureus Transmission among Households of Infected Cases: a Pooled Analysis of Primary Data from Three Studies across International Settings

    Science.gov (United States)

    Knox, J.; Van Rijen, M.; Uhlemann, A.-C.; Miller, M.; Hafer, C.; Vavagiakis, P.; Shi, Q.; Johnson, P. D. R.; Coombs, G.; Van Den Bergh, M. Kluytmans; Kluytmans, J.; Bennett, C. M.; Lowy, F. D.

    2016-01-01

    SUMMARY Diverse strain types of methicillin resistant Staphylococcus aureus (MRSA) cause infections in community settings worldwide. To examine heterogeneity of spread within households and to identify common risk factors for household transmission across settings, primary data from studies conducted in New York, US, Breda, NL, and Melbourne, AU were pooled. Following MRSA infection of the index patient, household members completed questionnaires and provided nasal swabs. Swabs positive for S. aureus were genotyped by spa-sequencing. Poisson regression with robust error variance was used to estimate prevalence odds ratios for transmission of the clinical isolate to non-index household members. Great diversity of strain types existed across studies. Despite differences between studies, the index patient being colonized with the clinical isolate at the home visit (ptransmission. Targeted decolonization strategies could be used across geographic settings to limit household MRSA transmission. PMID:24763185

  4. Community-associated methicillin-resistant Staphylococcus aureus transmission in households of infected cases: a pooled analysis of primary data from three studies across international settings.

    Science.gov (United States)

    Knox, J; Van Rijen, M; Uhlemann, A-C; Miller, M; Hafer, C; Vavagiakis, P; Shi, Q; Johnson, P D R; Coombs, G; Kluytmans-Van Den Bergh, M; Kluytmans, J; Bennett, C M; Lowy, F D

    2015-01-01

    Diverse strain types of methicillin-resistant Staphylococcus aureus (MRSA) cause infections in community settings worldwide. To examine heterogeneity of spread within households and to identify common risk factors for household transmission across settings, primary data from studies conducted in New York (USA), Breda (The Netherlands), and Melbourne (Australia) were pooled. Following MRSA infection of the index patient, household members completed questionnaires and provided nasal swabs. Swabs positive for S. aureus were genotyped by spa sequencing. Poisson regression with robust error variance was used to estimate prevalence odds ratios for transmission of the clinical isolate to non-index household members. Great diversity of strain types existed across studies. Despite differences between studies, the index patient being colonized with the clinical isolate at the home visit (P transmission. Targeted decolonization strategies could be used across geographical settings to limit household MRSA transmission.

  5. Invasive Community-Acquired Methicillin-Resistant Staphylococcus aureus in a Japanese Girl with Disseminating Multiple Organ Infection: A Case Report and Review of Japanese Pediatric Cases

    Directory of Open Access Journals (Sweden)

    Ryuta Yonezawa

    2015-01-01

    Full Text Available Pediatric invasive community-acquired methicillin-resistant Staphylococcus aureus (CA-MRSA infection is very serious and occasionally fatal. This infectious disease is still a relatively rare and unfamiliar infectious disease in Japan. We report a positive outcome in a 23-month-old Japanese girl with meningitis, osteomyelitis, fasciitis, necrotizing pneumonia, urinary tract infection, and bacteremia due to CA-MRSA treated with linezolid. PCR testing of the CA-MRSA strain was positive for PVL and staphylococcal enterotoxin b and negative for ACME. SCC mec was type IVa. This case underscores the selection of effective combinations of antimicrobial agents for its treatment. We need to be aware of invasive CA-MRSA infection, which rapidly progresses with a serious clinical course, because the incidence of the disease may be increasing in Japan.

  6. Molecular characterization and clonal diversity of meticillin-resistant Staphylococcus aureus isolated from the community in Spain: emergence of clone sequence type 72.

    Science.gov (United States)

    Potel, C; Rey, S; Otero, S; Rubio, J; Álvarez, M

    2016-08-01

    Sequence type 72 meticillin-resistant Staphylococcus aureus (ST72 MRSA) was recently detected in our hospital. Although in Europe this clone is rarely isolated, it is the leading cause of community-associated MRSA infections in Korea, spreading also into hospitals, where it has also emerged as the main MRSA clone recovered from raw meat. We studied MRSA isolated from outpatients in Spain during a nine-year period. More than 70% of the isolates belonged to predominant clones found in hospitals. There was a significant increase in the ST72 prevalence. It appears that boundaries of dominance among MRSA clones have become blurred, demanding continuous surveillance. Copyright © 2016 The Healthcare Infection Society. Published by Elsevier Ltd. All rights reserved.

  7. Invasive Community-Acquired Methicillin-Resistant Staphylococcus aureus in a Japanese Girl with Disseminating Multiple Organ Infection: A Case Report and Review of Japanese Pediatric Cases.

    Science.gov (United States)

    Yonezawa, Ryuta; Kuwana, Tsukasa; Kawamura, Kengo; Inamo, Yasuji

    2015-01-01

    Pediatric invasive community-acquired methicillin-resistant Staphylococcus aureus (CA-MRSA) infection is very serious and occasionally fatal. This infectious disease is still a relatively rare and unfamiliar infectious disease in Japan. We report a positive outcome in a 23-month-old Japanese girl with meningitis, osteomyelitis, fasciitis, necrotizing pneumonia, urinary tract infection, and bacteremia due to CA-MRSA treated with linezolid. PCR testing of the CA-MRSA strain was positive for PVL and staphylococcal enterotoxin b and negative for ACME. SCC mec was type IVa. This case underscores the selection of effective combinations of antimicrobial agents for its treatment. We need to be aware of invasive CA-MRSA infection, which rapidly progresses with a serious clinical course, because the incidence of the disease may be increasing in Japan.

  8. Traditional Market Accounting: Management or Financial Accounting?

    OpenAIRE

    Wiyarni, Wiyarni

    2017-01-01

    The purpose of this study is to explore the area of accounting in traditional market. There are two areas of accounting: management and financial accounting. Some of traditional market traders have prepared financial notes, whereas some of them do not. Their financial notes usually consist of receivables, payables, customer orders, inventories, sales and cost price, and salary expenses. The purpose of these financial notes is usually for decision making. It is very rare for the traditional ma...

  9. Virulence factors, antibiotic resistance phenotypes and O-serogroups of Escherichia coli strains isolated from community-acquired urinary tract infection patients in Mexico.

    Science.gov (United States)

    Paniagua-Contreras, Gloria Luz; Monroy-Pérez, Eric; Rodríguez-Moctezuma, José Raymundo; Domínguez-Trejo, Pablo; Vaca-Paniagua, Felipe; Vaca, Sergio

    2017-08-01

    Uropathogenic Escherichia coli (UPEC) strains isolated from patients with community-acquired urinary tract infections (UTIs) were assessed to determine the prevalence of virulence genes, antibiotic resistance, and the O-serogroup of the strains. Consenting patients with community-acquired UTI were enrolled at Unidad Médica Familiar Number 64 (Instituto Mexicano del Seguro Social, Estado de Mexico, Mexico) and 321 urine samples were collected. Polymerase chain reaction (PCR) was used to assess 24 virulence genes and 14 O-serogroups. The Kirby-Bauer method was used to evaluate the antibiotic susceptibility of the isolated strains to 12 commonly used antibiotics. A total of 194 strains were identified as E. coli using standard biochemical tests, followed by PCR amplification of 16S ribosomal RNA gene. Only 58.2% of the strains belonged to the assessed 14 O-serogroups. The serogroups O25, O15, O8, and O75 were present in 20.6%, 17%, 6.1%, and 4.6% of strains, respectively. The most frequently occurring virulence genes among UPEC strains included kpsMT (92.2% strains), usp (87.1%), irp2 (79.3%), iha (64.9%), fim (61.3%), set (36%), astA (33.5%), pap (24.7%), and papGII (21.1%). In addition, 97% of the strains were multi-drug resistant (coresistance to 3-11 antibiotics). The isolated UPEC strains predominantly belonged to three serogroups (O25, O15, and O8), harboured numerous virulence genes, and are multiresistant to antibiotics. The findings of this study could be used to orient UTI treatment strategies and in epidemiological studies in Mexico. Copyright © 2015. Published by Elsevier B.V.

  10. ABACC's nuclear accounting area

    International Nuclear Information System (INIS)

    Nicolas, Ruben O.

    2001-01-01

    The functions and activities of the Brazilian-Argentine Agency for the Accounting and Control of Nuclear Materials (ABACC) accounting area is outlined together with a detailed description of the nuclear accounting system used by the bilateral organization

  11. Plasmid-mediated AmpC beta-lactamase-producing Escherichia coli causing urinary tract infection in the Auckland community likely to be resistant to commonly prescribed antimicrobials.

    Science.gov (United States)

    Drinkovic, Dragana; Morris, Arthur J; Dyet, Kristin; Bakker, Sarah; Heffernan, Helen

    2015-03-13

    -acquired UTI due to PMACBL-producing E. coli were neither hospitalised nor had any antimicrobial treatment in the previous 6 months. The prevalence of PMACBL-producing E. coli was relatively low in the Auckland community, but has increased in recent years. Typing revealed that the majority of the PMACBL-producing E. coli in the Auckland region were genetically unrelated meaning that a point source or direct person to person transmission are not drivers of local community spread currently. The isolates were more resistant to non-beta-lactam antimicrobials than other non-AmpC, non-ESBL-producing E. coli, leaving few treatment options. The majority of the PMACBL-producing E. coli isolates seemed to be acquired in the community and were most frequently isolated from women with UTI. A large proportion of patients with community-acquired UTI had not been hospitalised nor had any antimicrobial treatment in the previous 6 months.

  12. Impact of Physical Activity on Glycemic Control and Insulin Resistance: A Study of Community-dwelling Diabetic Patients in Eastern China.

    Science.gov (United States)

    Li, Lin; Yin, Xueyao; Yu, Dan; Li, Hong

    2016-01-01

    Objective The aim of this study was to evaluate the relationship of various intensities of physical activity with glycemic control and insulin resistance in eastern China. Methods A population-based, cross-sectional study was conducted in eastern China. The subjects included 604 community-dwelling people. The participants were classified as insufficiently active (IA); sufficiently active (SA) and very active (VA) according to the International Physical Activity Questionnaire (IPAQ). Insulin sensitivity was assessed using the homeostasis model assessment of insulin resistance (HOMA-IR). Related social, biological, lifestyle factors and clinical characteristics were recorded and used as potential confounders. Results The cohort of 604 type 2 diabetes patients were classified according to the activity level: 107 subjects who were classified as IA, 329 met the criteria for SA, and the rest were VA. The proportion of obese patients, smokers, patients with hypertension, and the body weight, body mass index (BMI), waist circumference, hemoglobin A1c protein (HbA1c), and 2-h postprandial blood glucose (2hPG) were significantly lower in the SA and VA groups than in the IA group (pactivity (pactivity. Conclusion Physical activity is a significant factor regarding glycemic control and insulin sensitivity, although SA and walking may be superior to VA for ameliorating insulin sensitivity.

  13. Vancomycin heteroresistant community associated methicillin-resistant Staphylococcus aureus ST72-SCCmecIVa strain colonizing the nostrils of a five-year-old Spanish girl.

    Science.gov (United States)

    Varona-Barquín, Aketza; Iglesias-Losada, Juan José; Ezpeleta, Guillermo; Eraso, Elena; Quindós, Guillermo

    2017-03-01

    During a community methicillin-resistant Staphylococcus aureus (MRSA) nasal colonization study, an MRSA strain with vancomycin hetero-resistance (h-VISA) was isolated from a five year-old girl with tetralogy of Fallot without previous exposure to vancomycin. An extended nasal colonization study was performed on all her close relatives. Only the patient and her sister were colonized by an h-VISA MRSA strain (clone USA 700, ST72, t148, agr 1 and SCCmec IVa). Mupirocin decolonisation was effective in the elder sister. A new nasal decolonisation in the younger girl using fusidic acid was also successful. However, after decolonisation both sisters were colonized by a methicillin-susceptible S. aureus (ST30, t012 and agr 3) previously isolated from their mother's nostrils. As S. aureus have a great capacity to spread among people in close contact, knowledge of a patients' colonization status, tracing contacts, and a correct management are critical issues for the successful containment of multiresistant staphylococci. Copyright © 2016 Elsevier España, S.L.U. and Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. All rights reserved.

  14. [State of infection caused by methicillin-resistant Staphylococcus aureus (MRSA) in Extremadura: susceptibility, clonality and role of community-associated MRSA].

    Science.gov (United States)

    Aguadero, V; González-Velasco, C; Vindel, A; González-Velasco, M; Moreno, J J

    2014-09-01

    The correct surveillance and control of infection caused by methicillin-resistant Staphylococcus aureus (MRSA) needs of update knowledge of its specific properties in each place. Our study aims to describe the current characteristics of infection due to MRSA in Extremadura. During 2010, 309 MRSA were collected from clinical samples in our region. A susceptibility test that included 17 antibiotics tested by AST -588 card Vitek 2 ® and E -test method was performed on all isolates. A sample of 100 strains, selected by stratified random sampling, were genotyped by pulsed field electrophoresis (PFGE). The prevalence of MRSA in Extremadura was 20.2%. Don Benito-Villanueva area showed the most prevalence and a higher incidence. Merida reported the most favourable situation, with a relatively low ratios of prevalence and incidence. The community acquired reached 44 % in the region, showing predominantly in less populated areas (Navalmoral and Coria). The most common multiresistant pattern was tobramycin-levofloxacin-erythromycin (44%), followed tobramycin-erythromycin-clindamycin (20%). No linezolid, daptomycin and tigecycline resistant strains were observed, but 42 % of the MRSA strains showed decreased susceptibility vancomycin (DSV). PFGE analysis reported 27 genotypes, with 3 major genotypes: E8a (25%), E7b (17%) and E7a (12%). The post-hoc statistical analysis did not reveal significant differences in the distribution of genotypes between different areas. However it revealed some trends that should be considered.

  15. Delphi Accounts Receivable Module -

    Data.gov (United States)

    Department of Transportation — Delphi accounts receivable module contains the following data elements, but are not limited to customer information, cash receipts, line of accounting details, bill...

  16. Effects of a community-based progressive resistance training program on muscle performance and physical function in adults with Down syndrome: a randomized controlled trial.

    Science.gov (United States)

    Shields, Nora; Taylor, Nicholas F; Dodd, Karen J

    2008-07-01

    To determine whether progressive resistance training improves muscle strength, muscle endurance, and physical function in adults with Down syndrome. Single-blind randomized controlled trial. General community. Adults (N=20) with Down syndrome (13 men, 7 women; mean age, 26.8+/-7.8 y) were randomly assigned through a concealed allocation block randomized method to either an intervention group (n=9) or a control group (n=11). The intervention was a supervised, group progressive resistance training program, consisting of 6 exercises using weight machines performed twice a week for 10 weeks. Participants completed 2 to 3 sets of between 10 to 12 repetitions of each exercise until they reached fatigue. The control group continued with their usual activities. The outcomes measured by blinded assessors were muscle strength (1-repetition maximum [1-RM]), muscle endurance (number of repetitions at 50% of 1-RM) for chest press and leg press, timed stairs test, and the grocery shelving task. The intervention group showed significant improvement in upper-limb muscle endurance compared with the control group (mean difference in the number of repetitions of the chest press at 50% of 1-RM was 16.7, 95% confidence interval, [CI] 7.1-26.2); and a trend toward an improvement in upper-limb muscle strength (mean difference in chest press 1-RM, 8.6 kg; 95% CI, -1.3 to 18.5 kg) and in upper-limb function (mean difference in grocery shelving task, -20.3s; 95% CI, -45.7 to 5.2s). There were no significant differences between the groups for lower-limb muscle performance or physical function measures. No major adverse events for the intervention were noted. Progressive resistance training is a safe and feasible fitness option that can improve upper-limb muscle endurance in adults with Down syndrome (ACTR identifier ACTRN 012606000515594.).

  17. Effects of superabsorbent polymers on the abundances of antibiotic resistance genes, mobile genetic elements, and the bacterial community during swine manure composting.

    Science.gov (United States)

    Guo, Aiyun; Gu, Jie; Wang, Xiaojuan; Zhang, Ranran; Yin, Yanan; Sun, Wei; Tuo, Xiaxia; Zhang, Li

    2017-11-01

    Superabsorbent polymers (SAPs) are considered suitable amendments for reducing the selection pressure due to heavy metals and the abundances of antibiotic resistance genes (ARGs) during composting. In this study, three SAP (sodium polyacrylate) levels (0, 5, and 15mgkg -1 of compost) were applied and their effects on the abundances of ARGs, mobile genetic elements (MGEs), and the bacterial community were investigated. After composting, the abundances of ARGs and MGEs decreased to different extent, where the removal efficiencies for tetW, dfrA7, ermX, aac(6')-ib-cr and MGEs exceeded 90%. The high SAP concentration significantly reduced the abundances of ARGs and MGEs, and changed the microbial community. Redundancy analysis indicated that the moisture content mainly explained the changes in ARGs and MGEs. Network analysis determined the potential hosts of ARGs and MGEs, and their co-occurrence. The results suggested that applying 15mgkg -1 SAP is appropriate for reducing ARGs in compost. Copyright © 2017. Published by Elsevier Ltd.

  18. Effects of different swine manure to wheat straw ratios on antibiotic resistance genes and the microbial community structure during anaerobic digestion.

    Science.gov (United States)

    Song, Wen; Wang, Xiaojuan; Gu, Jie; Zhang, Sheqi; Yin, Yanan; Li, Yang; Qian, Xun; Sun, Wei

    2017-05-01

    This study explored the effects of different mass ratios of swine manure relative to wheat straw (3:7, 5:5, and 7:3, i.e., control reactors C1, C2, and C3, respectively) on variations in antibiotic resistance genes (ARGs) and the microbial community during anaerobic digestion (AD). The cumulative biogas production volumes were 1711, 3857, and 3226mL in C1, C2, and C3, respectively. After AD, the total relative abundance of ARGs decreased by 4.23 logs in C3, whereas the reductions were only 1.03 and 1.37 logs in C1 and C2, respectively. Network analysis showed that the genera Solibacillus, Enterococcus, Facklamia, Corynebacterium_1, and Acinetobacter were potential hosts of ermB, sul1, and dfrA7. Redundancy analysis showed that the bacterial communities and environmental factors played important roles in the variation in ARGs. Thus, reductions in ARGs should be considered before reusing animal manure treated by AD. Copyright © 2017 Elsevier Ltd. All rights reserved.

  19. Patterns of clozapine and other antipsychotics prescriptions in patients with treatment-resistant schizophrenia in community mental health centers in São Paulo, Brazil

    Directory of Open Access Journals (Sweden)

    Ana Stella de Azevedo Silveira

    2015-12-01

    Full Text Available Abstract Background Despite of its global underuse, clozapine is still the golden standard antipsychotic for patients with treatment-resistant schizophrenia (TRS. Objective To evaluate the patterns of clozapine and other antipsychotic drugs prescription in TRS in community mental health centers in São Paulo, Brazil. Methods A multiple-choice questionnaire was applied to fifteen psychiatrists at five centers inquiring about patients’ clinical condition, adherence to oral treatment and current antipsychotic treatment. History of previous and current antipsychotic treatment was collected through medical chart review. Results Out of 442 schizophrenia patients, 103 (23.3% fulfilled the criteria for TRS. Fifty-eight patients (56.3% were receiving polypharmacy; 30 (29.1% were on atypical antipsychotic monotherapy, 14 (13.6% were on typical antipsychotic monotherapy, 25 (24.3% were taking depot antipsychotic medication and only 22 (21.4% were receiving clozapine. Discussion As well as in other parts of the world, many TRS patients (78.6% receive other drugs instead of clozapine in São Paulo, the best evidence-based medication for patients with TRS. The government should make every effort to provide medical training and the equipment and logistic support to adequately serve those who could benefit from clozapine treatment at the community health centers.

  20. First report in South America of companion animal colonization by the USA1100 clone of community-acquired meticillin-resistant Staphylococcus aureus (ST30) and by the European clone of methicillin-resistant Staphylococcus pseudintermedius (ST71).

    Science.gov (United States)

    Quitoco, Isidório Mebinda Zuco; Ramundo, Mariana Severo; Silva-Carvalho, Maria Cícera; Souza, Raquel Rodrigues; Beltrame, Cristiana Ossaille; de Oliveira, Táya Figueiredo; Araújo, Rodrigo; Del Peloso, Pedro Fernandez; Coelho, Leonardo Rocchetto; Figueiredo, Agnes Marie Sá

    2013-08-27

    Methicillin-resistant staphylococci can colonize and cause diseases in companion animals. Unfortunately, few molecular studies have been carried out in Brazil and other countries with the aim of characterizing these isolates. Consequently, little is known about the potential role of companion animals in transmitting these resistant bacteria to humans. In this work we searched for mecA gene among Staphylococcus isolates obtained from nasal microbiota of 130 healthy dogs and cats attended in a veterinary clinic located in the west region of Rio de Janeiro. The isolates recovered were identified to the species level and characterized using molecular tools. A community-acquired methicillin-resistant Staphylococcus aureus (CA-MRSA) isolate related to USA1100 (Southwest Pacific clone) and susceptible to all non-β-lactams was detected in a cat (1.7%, 1/60). Another coagulase-positive isolate harboring mecA was recovered from a dog (1.4%, 1/70) and identified as Staphylococcus pseudintermedius (MRSP) related to the European clone (ST71). The two isolates of Staphylococcus conhii subsp. urealyticus (1.4%, 1/70 dogs and 1.7%, 1/60 cats), similarly to the MRSP isolate, also presented high-level multiresistance. The majority of the methicillin-resistant coagulase-negative staphylococci recovered were Staphylococcus saprophyticus (5.7%, 4/70 dogs and 6.7%, 4/60 cats) and all clustered into the same PFGE type. This work demonstrates that mecA-harboring Staphylococcus isolates are common members of the nasal microbiota of the healthy companion animals studied (9.2%, 12/130 animals), including some high-level multiresistant isolates of S. pseudintermedius and S. conhii subsp. urealyticus. The detection, for the first time in South America, of USA1100-related CA-MRSA and of ST71 MRSP (European clone), colonizing companion animals, is of concern. Both S. pseudintermedius and S. aureus are important agents of infections for animals. The USA1100 CA-MRSA is a causative of severe and

  1. Exploring the immediate and long-term impact on bacterial communities in soil amended with animal and urban organic waste fertilizers using pyrosequencing and screening for horizontal transfer of antibiotic resistance

    DEFF Research Database (Denmark)

    Riber, Leise; Poulsen, Pernille H. B.; Al-Soud, Waleed A.

    2014-01-01

    these changes, prevalence of antibiotic- and mercury-resistant pseudomonads was investigated. Fertilizer amendment had a transient impact on the resistance profile of the soil community; abundance of resistant isolates decreased with time after fertilizer application, but persistent strains appeared...... time. Seasonal changes seemed to prevail with decreasing bacterial richness in week 9 followed by a significant increase in week 29 (springtime). The Pseudomonas population richness seemed temporarily affected by fertilizer treatments, especially in sludge- and compost-amended soils. To explain...... multiresistant, also in unfertilized soil. Finally, the ability of a P.putida strain to take up resistance genes from indigenous soil bacteria by horizontal gene transfer was present only in week 0, indicating a temporary increase in prevalence of transferable antibiotic resistance genes....

  2. Community-acquired methicillin-resistant Staphylococcus aureus from skin and soft tissue infections (in a sample of Egyptian population: analysis of mec gene and staphylococcal cassette chromosome

    Directory of Open Access Journals (Sweden)

    Nagat Sobhy

    Full Text Available BACKGROUND: Staphylococcus aureus has been recognized as an important pathogen associated with inpatients and community infections. Community-acquired methicillin-resistant S. aureus (CA-MRSA infections commonly present as skin and soft-tissue infections (SSTIs. Treatment often includes incision and drainage with or without adjunctive antibiotics. OBJECTIVES: This study aimed to identify CA-MRSA infections both phenotypically and genotypically, to determine their spectrum of antibiotic resistance, and to establish the best scheme for molecular distinction between hospital-acquired MRSA (HA-MRSA and CA-MRSA by staphylococcal cassette chromosome mec (SCCmec typing and detection of Panton Valentine leukocidin (PVL. MATERIALS: 50 swabs, from skin and soft tissue of infected lesions of outpatients attending the dermatology department of the Medical School, Alexandria University, were collected. Additionally, a nasal swab was taken from every participant. METHODS: Collection of swabs from the infected skin and soft tissues, followed by laboratory testing to phenotypically and genotypically identify MRSA. Also, nasal swabs were taken from every patient to identify MRSA colonization. RESULTS: Staphylococcus aureus strains were identified in 38 (76% of the 50 clinical isolates. 18 (47.37% out of the 38 S. aureus strains were resistant to oxacillin and cefoxitin discs, were penicillin binding protein 2a (PBP2a producers, and were initially diagnosed as MRSA. All of the 18 strains were definitively diagnosed as MRSA by mecA gene detection using real time PCR, while only six (33.33% strains were PVL positive. Using the sets of primers of Zhang et al.: nine (50% out of the 18 CA-MRSA strains were SCCmec type V, and one (5.56% was SCCmec type IVc. Then, using the set of primers by Oliveira et al., two (25% out of the eight untypable MRSA strains were found to be SCCmec type IV, and six (75% remained untypable. CONCLUSIONS: CA-MRSA must be considered when

  3. Effects of manure and mineral fertilization strategies on soil antibiotic resistance gene levels and microbial community in a paddy-upland rotation system.

    Science.gov (United States)

    Lin, Hui; Sun, Wanchun; Zhang, Zulin; Chapman, Stephen J; Freitag, Thomas E; Fu, Jianrong; Zhang, Xin; Ma, Junwei

    2016-04-01

    This work investigated the responses of antibiotic resistance genes (ARGs) and the soil microbial community in a paddy-upland rotation system to mineral fertilizer (NPK) and different application dosages of manure combined with NPK. The occurrence of five tetracycline ARGs (tetA, tetB, tetC, tetG and tetW), two sulfonamide ARGs (sul1 and sul2) and one genetic element (IntI1) was quantified. NPK application showed only slight or no impact on soil ARGs abundances compared with the control without fertilizer. Soil ARGs abundances could be increased by manure-NPK application but was related to manure dosage (2250-9000 kg ha(-1)). Principal component analysis (PCA) showed that the soil ARG profile of the treatment with 9000 kg ha(-1) manure separated clearly from the other treatments; the ARGs that contributed most to the discrimination of this treatment were tetA, tetG, tetW, sul1, sul2 and IntI1. Community level physiological profile (CLPP) analysis showed that increasing manure dosage from 4500 kg ha(-1) to 9000 kg ha(-1) induced a sharp increase in almost all of the detected ARGs but would not change the microbial community at large. However, 9000 kg ha(-1) manure application produced a decline in soil microbial activity. Determination of antibiotics and heavy metals in soils suggested that the observed bloom of soil ARGs might associate closely with the accumulation of copper and zinc in soil. Copyright © 2016 Elsevier Ltd. All rights reserved.

  4. Community-acquired necrotizing pneumonia caused by methicillin-resistant Staphylococcus aureus producing Panton-Valentine leukocidin in a Chinese teenager: case report and literature review.

    Science.gov (United States)

    Chen, Jie; Luo, Yanping; Zhang, Shu; Liang, Zhixin; Wang, Ying; Zhang, Ying; Zhou, Guang; Jia, Yanhong; Chen, Liangan; She, Danyang

    2014-09-01

    Methicillin-resistant Staphylococcus aureus (MRSA) has now been established as an important community-acquired pathogen. Although necrotizing pneumonia caused by community-acquired MRSA (CA-MRSA) strains producing Panton-Valentine leukocidin (PVL) has been reported with increasing frequency in many countries, it has been reported in only a few children younger than 1 year of age in Mainland China. We describe a case of life-threatening necrotizing pneumonia due to PVL-positive CA-MRSA in a 15-year-old previously healthy female who presented with high fever, shivering, a dry cough, and dyspnea. Details of the clinical outcomes, microbiological data, and therapies for this patient were collected and compared with those of cases reported in the literature on CA-MRSA. Computed tomography (CT) findings showed cavitary consolidations in both lungs and bilateral pleural effusion. MRSA strains isolated from the patient's sputum and pleural fluid were susceptible to most non-β-lactam antimicrobial agents except for clindamycin and erythromycin. Both of these isolates tested positive for the mecA gene as well as PVL genes, and were identified as ST59-MRSA-SCCmec type IV-spa type t437. The patient was treated successfully with linezolid, fosfomycin, and teicoplanin. To our knowledge, this is the first report from Mainland China of necrotizing pneumonia due to PVL-positive CA-MRSA among those aged older than 1 year. CA-MRSA necrotizing pneumonia should be considered in the differential diagnosis of severe community-acquired pneumonia, particularly in previously healthy individuals. Copyright © 2014 The Authors. Published by Elsevier Ltd.. All rights reserved.

  5. How "accountable" are accountable care organizations?

    Science.gov (United States)

    Addicott, Rachael; Shortell, Stephen M

    2014-01-01

    The establishment of accountable care organizations (ACOs) in the Affordable Care Act (ACA) was intended to support both cost savings and high-quality care. However, a key challenge will be to ensure that governance and accountability mechanisms are sufficient to support those twin ambitions. This exploratory study considers how recently developed ACOs have established governance structures and accountability mechanisms, particularly focusing on attempts at collaborative accountability and shared governance arrangements. Four case studies of ACOs across the United States were undertaken, with data collected throughout 2012. These involved 34 semistructured interviews with ACO administrative and clinical leaders, observation of nine meetings, and a review of documentary materials from each ACO. We identified very few examples of physicians being held to account as a collective and therefore only limited evidence of collaborative accountability impacting on behavior change. However, ACO leaders do have many mechanisms available to stimulate change across physicians. The challenge is to determine governance structure(s) and accountability mechanisms that facilitate the most effective combination of approaches, measures, incentives, and sanctions to achieve the goals of more accountable care. Accountability structures and processes will need to be tailored to local membership composition, historical evolution, and current stage of development. There are also some common lessons to be drawn. Shared goals and incentives should be reflected through performance criteria. It is important to align measures and thresholds across payers to ensure ACOs are not unnecessarily burdened or compromised by reporting on different and potentially disjointed measures. Finally, emphasis needs to be placed on the importance of credible, transparent data. This exploratory study provides early evidence regarding how ACOs are establishing their governance and accountability arrangements and

  6. Prevalence and molecular characteristics of Staphylococcus aureus, including methicillin resistant strains, isolated from bulk can milk and raw milk products in pastoral communities of South-West Uganda.

    Science.gov (United States)

    Asiimwe, Benon B; Baldan, Rossella; Trovato, Alberto; Cirillo, Daniela M

    2017-06-13

    Staphylococcus aureus strains are now regarded as zoonotic agents. In pastoral settings where human-animal interaction is intimate, multi-drug resistant microorganisms have become an emerging zoonotic issue of public health concern. The study of S. aureus prevalence, antimicrobial resistance and clonal lineages in humans, animals and food in African settings has great relevance, taking into consideration the high diversity of ethnicities, cultures and food habits that determine the lifestyle of the people. Little is known about milk carriage of methicillin resistant S. aureus strains (MRSA) and their virulence factors in Uganda. Here, we present the prevalence of MRSA in bulk can milk and raw milk products in pastoral communities of south-west Uganda. We also present PFGE profiles, spa-types, as well as frequency of enterotoxins genes. S. aureus was identified by the coagulase test, susceptibility testing by the Kirby-Bauer disc diffusion and E-test methods and MRSA by detection of the mecA gene and SCCmec types. The presence of Panton - Valentine Leucocidin (PVL) genes and staphylococcal enterotoxins was determined by PCR, while genotyping was by PFGE and spa typing. S. aureus were isolated from 30/148 (20.3%) milk and 11/91(12%) sour milk samples. mecA gene carriage, hence MRSA, was detected in 23/41 (56.1%) of the isolates, with 21 of the 23 (91.3%) being SCCmec type V; while up to 30/41 (73.2%) of the isolates were resistant to tetracycline. Only five isolates carried the PVL virulence gene, while PFGE typing revealed ten clusters (ranging from two seven isolates each) that comprised 83% of the sample, and only eight isolates with unique pulsotypes. The largest PFGE profile (E) consisted of seven isolates while t7753, t1398, and t2112 were the most common spa-types. Thirty seven of the 41 strains (90.2%) showed at least one of the eight enterotoxin genes tested, with sem 29 (70.7%), sei 25 (61%) and seg 21 (51.2%) being the most frequently observed genes. This

  7. Two distinct clones of methicillin-resistant Staphylococcus aureus (MRSA) with the same USA300 pulsed-field gel electrophoresis profile: a potential pitfall for identification of USA300 community-associated MRSA

    DEFF Research Database (Denmark)

    Larsen, Anders Rhod; Goering, Richard; Stegger, Marc

    2009-01-01

    Analysis of methicillin-resistant Staphylococcus aureus (MRSA) characterized as USA300 by pulsed-field gel electrophoresis identified two distinct clones. One was similar to community-associated USA300 MRSA (ST8-IVa, t008, and Panton-Valentine leukocidin positive). The second (ST8-IVa, t024...

  8. Developing Cameral Accounting

    OpenAIRE

    Monsen, Norvald

    2004-01-01

    -This is the accepted version of the following article: "Developing Cameral Accounting", Beta. Scandinavian Journal of Business Research 2004, 18(2):8-24, which has been published in final form at http://www.idunn.no/beta/2004/02/developing_cameral_accounting. © Universitetsforlaget Cameral accounting has played an important historical role in governmental accounting in many countries, particularly in continental European countries, and arguments for developing cameral accounting have been...

  9. Assessing in financial account

    OpenAIRE

    ZEDEK, Milan

    2008-01-01

    The aim of this thesis is to define possibilities of valuation and their impacts on the function of accounting. Furthermore the comparison of valuation methods within the czech accounting standards with international standards (IAS/IFRS). Valuation is metodical element which has huge influence on use value of information provided by accounting system. It affects the predicative capability of accounting information, mainly the items in accounting document. Monetary expression of company assets...

  10. Identifying motivators and barriers to older community-dwelling people participating in resistance training: A cross-sectional study.

    Science.gov (United States)

    Burton, Elissa; Lewin, Gill; Pettigrew, Simone; Hill, Anne-Marie; Bainbridge, Liz; Farrier, Kaela; Langdon, Trish; Airey, Phil; Hill, Keith D

    2017-08-01

    Participation rates of older people in resistance training (RT) are low despite increasing research showing many health benefits. To increase the number of older people participating in RT it is important to know what would motivate people to become involved, what motivates those who participate to continue, and the factors preventing many older people from commencing participation. To investigate these issues, a questionnaire was mailed to three groups of older people: (1) those receiving home care services, (2) members of a peak non-government seniors' organisation and (3) those participating in a specific gym-based RT programme. In total, 1327 questionnaires were returned (response rate = 42.5%). To feel good physically and mentally were the main reasons motivating participation among all three groups, and falls prevention was identified as an important motivator for the home care respondents. Pain, injury and illness were the main barriers to participating, or continuing to participate. However, medical advice was a factor influencing participation commencement. The results suggest organisations providing RT programmes for older people should tailor the promotion and delivery of programmes to address key motivators and barriers specific to each group to increase the proportion of older people initiating and continuing to engage in RT.

  11. Current scenario of antibiotic resistance and latest strategies to overcome it

    Directory of Open Access Journals (Sweden)

    Mohankumar J Megha

    2014-09-01

    Full Text Available Antibiotic resistance in microorganisms has become a critical health issue these days and has evolved to become a worldwide health threat. Over a decade, the resistance level of bacteria has increased many folds due to various factors, accounting to the added pressure on the environmental resistome. Infections that are resistant to these antibiotics show potentially devastating effects on public health, often affecting developing countries. This review focuses on the present scenario of antibiotic resistance and enlists some of the strategies to combat this global community threat.

  12. Drug resistant tuberculosis in prisons in Azerbaijan: case study

    Science.gov (United States)

    Coninx, R; Pfyffer, G E; Mathieu, C; Savina, D; Debacker, M; Jafarov, F; Jabrailov, I; Ismailov, A; Mirzoev, F; de Haller, R; Portaels, F

    1998-01-01

    Objectives: To document the existence of drug resistance in a tuberculosis treatment programme that adheres strictly to the DOTS principles (directly observed treatment, short course) and to determine the extent of drug resistance in a prison setting in one of the republics of the former Soviet Union. Design: Case study. Setting: Central Penitentiary Hospital in Baku, the referral centre for tuberculosis patients from all prisons in Azerbaijan. Subjects: Prisoners with tuberculosis: 28 selected patients not responding clinically or bacteriologically to the standard treatment (group 1) and 38 consecutive patients at admission to the programme (group 2). Main outcome measures: Drug resistance of Mycobacterium tuberculosis strains grown from sputum. Results: All the non-responding patients (group 1) had strains resistant to at least one drug. 25 (89%) of the non-responding patients and nine (24%) of the consecutive patients had M tuberculosis strains resistant to both rifampicin and isoniazid. A further 17 patients in group 2 had strains resistant to one or more first line drugs. Conclusions: Drug resistant M tuberculosis strains are common in prisons in Azerbaijan. Tuberculosis problems tend to be worse in prisons, but prisoners and former prisoners may have an important role in the transmission of tuberculosis, particularly of drug resistant forms, in the community. National programmes to control tuberculosis will have to take into account and address the problems in prisons to ensure their success. Key messages Tuberculosis is an important problem in prisons in Azerbaijan Multidrug resistant tuberculosis was common and an important cause of non-response to standard treatment National tuberculosis control programmes must include prisons and take account of drug resistance Unless WHO recommended treatment protocols are followed the problem of multidrug resistant tuberculosis may result in untreatable tuberculosis which will spread to the general community PMID

  13. Counting, accounting, and accountability: Helen Verran's relational empiricism.

    Science.gov (United States)

    Kenney, Martha

    2015-10-01

    Helen Verran uses the term 'relational empiricism' to describe situated empirical inquiry that is attentive to the relations that constitute its objects of study, including the investigator's own practices. Relational empiricism draws on and reconfigures Science and Technology Studies' traditional concerns with reflexivity and relationality, casting empirical inquiry as an important and non-innocent world-making practice. Through a reading of Verran's postcolonial projects in Nigeria and Australia, this article develops a concept of empirical and political 'accountability' to complement her relational empiricism. In Science and an African Logic, Verran provides accounts of the relations that materialize her empirical objects. These accounts work to decompose her original objects, generating new objects that are more promising for the specific postcolonial contexts of her work. The process of decomposition is part of remaining accountable for her research methods and accountable to the worlds she is working in and writing about. This is a practice of narrating relations and learning to tell better technoscientific stories. What counts as better, however, is not given, but is always contextual and at stake. In this way, Verran acts not as participant-observer, but as participant-storyteller, telling stories to facilitate epistemic flourishing within and as part of a historically located community of practice. The understanding of accountability that emerges from this discussion is designed as a contribution, both practical and evocative, to the theoretical toolkit of Science and Technology Studies scholars who are interested in thinking concretely about how we can be more accountable to the worlds we study.

  14. In vitro activity of beta-lactam antibiotics to community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA).

    Science.gov (United States)

    Germel, C; Haag, A; Söderquist, B

    2012-04-01

    Community-associated (CA) MRSA often display low MIC values against oxacillin. The in vitro activity of various beta-lactam antibiotics against heterogeneous CA-MRSA (n = 98) isolated in a low endemic area was determined by Etest, and Mueller-Hinton agar (MUHAP) was compared with Mueller-Hinton agar supplemented with 2% NaCl (MUHSP). In general, the CA-MRSA isolates showed higher MIC values for the various beta-lactam antibiotics on MUHSP compared with MUHAP. MIC values for oxacillin ranged from 1 to >256 mg/L on MUHSP. Cephalothin, representing the first generation of cephalosporins, showed MICs from 0.75 to 96 mg/L and the MIC(50) and MIC(90) for cefuroxime, cefotaxime and cefepime, representing the second, third and fourth generations, respectively, were rather high. However, the MIC(50) and MIC(90) for ceftobiprole (fifth generation) were 1.5 and 2 mg/L, respectively, on MUHSP. The MIC(50) and MIC(90) for imipenem were 0.75 and 2 mg/L, respectively, on MUHSP. Only 3/98 (3%) CA-MRSA isolates showed a MIC >4 mg/L. Consequently, low MIC values for imipenem, lower than those of the newly developed fifth generation cephalosporins, were found among CA-MRSA. These findings may be considered for further studies including clinical trials in order to evaluate carbapenems as a potential treatment option for infections caused by CA-MRSA.

  15. New Horizons For Accounting: Social Accounting

    OpenAIRE

    Ertuna, Özer

    2012-01-01

    Currently financial accounting function is going through an accelerated transformation. In this transformation the area of interest of the accounting function is expanding to serve the information needs of a greater number of interest groups’ wider spectrum of interests with financial, economic, social and environmental data related to the performance of companies. This transformation is initiated by the developments in stakeholder, corporate social responsibility, sustainability and environm...

  16. Community-based short-course treatment of pulmonary tuberculosis in a developing nation. Initial report of an eight-month, largely intermittent regimen in a population with a high prevalence of drug resistance.

    Science.gov (United States)

    Manalo, F; Tan, F; Sbarbaro, J A; Iseman, M D

    1990-12-01

    A community-based tuberculosis case-finding and short-course chemotherapy program was conducted in a suburb of Manila and featured 1 month of daily isoniazid (INH), rifampin (RIF), ethambutol (EMB), and pyrazinamide (PZA) followed by 7 months of twice-weekly, high dose, directly observed INH + EMB + PZA. Church-affiliated lay workers obtained 1,990 sputum specimens from subjects who complained of chronic cough or wasting symptoms; 207 of the specimens were positive on Ziehl-Neelsen smears. On culture, 176 yielded a significant growth of M. tuberculosis. Of these 176 patients, 144 were selected to enter the study; 10 were lost because of withdrawal or death and four (2.7%) because of drug toxicity. This left 130 patients who were followed long-term. Remarkably, 80% (104) were initially shedding drug-resistant organisms; 26% (34) were resistant to one drug, 30% (40) were resistant to two drugs, and 24% (30) were resistant to three or more drugs. Responses to therapy corresponded closely to the extent of drug resistance: 80% (48 of 60) of patients with drug-susceptible or single resistance had a favorable outcome; 43% (28 of 65) were resistant to two or three drugs, and 0% (0 of 5) of those were resistant to four or more drugs. Notable findings of this study were the success of a community-based program in conducting prolonged, directly observed treatment, the unexpectedly high prevalence of multiple-drug-resistant organisms in this population, and the inadequacy of INH + PZA + EMB during the continuation phase of therapy in this setting.

  17. Accounting as Myth Maker

    Directory of Open Access Journals (Sweden)

    Kathy Rudkin

    2007-06-01

    Full Text Available Accounting is not only a technical apparatus, but also manifests a societal dimension. Thispaper proposes that accounting is a protean and complex form of myth making, and as suchforms a cohesive tenet in societies. It is argued that there are intrinsic parallels between thetheoretical attributes of myth and accounting practice, and that these mythicalcharacteristics sustain the existence and acceptance of accounting and its consequences insocieties over time. A theoretical exploration of accounting as a form of myth revealsaccounting as pluralistic and culturally sensitive. Such an analysis challenges theoreticalexplanations of accounting that are presented as a “grand narrative” universalunderstanding of accounting. Manifestations of the attributes of myth are described in thecalculus and artefacts of accounting practice to demonstrate how accounting stories andbeliefs are used as a form of myth by individuals to inform and construe their worldpicture.

  18. Dissemination of multiple MRSA clones among community-associated methicillin-resistant Staphylococcus aureus infections from Japanese children with impetigo.

    Science.gov (United States)

    Hisata, Ken; Ito, Teruyo; Matsunaga, Nobuaki; Komatsu, Mitsutaka; Jin, Jingxun; Li, Shanshuang; Watanabe, Shinya; Shimizu, Toshiaki; Hiramatsu, Keiichi

    2011-10-01

    The proportion of MRSA strains that cause skin and soft infections has recently increased. In 3 months we have characterized 17 MRSA strains isolated from children with impetigo at a Japanese hospital. Seventeen MRSA strains belonged to 7 clones defined by clonal complex (CC) in MLST genotype and type of SCCmec, which were rarely identified among healthcare-associated MRSA: CC 91-SCCmecIIb (4 strains); CC91-SCCmecIIn (2 strains); CC91-SCCmecIVa (2 strains); CC91-SCCmecV (4 strains); CC88-SCCmecIVg (3 strains); CC1-SCCmecIVc (1 strain); and CC5-SCCmecIVn (1 strain). Although one strain belonged to CC5, which has been commonly identified in healthcare-associated MRSA, it did not carry type II SCCmec, but carried type IV SCCmec. Fourteen of the 17 strains carried exfoliative toxin a or b gene, and none carried Panton-Valentine leukocidine gene. Furthermore, we determined the entire nucleotide sequences of two type V SCCmec elements carried by strains JCSC5952, a CC91 strain, and TSGH17, a Taiwanese CC59 strain. The structure of SCCmecJCSC5952 was more than 99% homologous in nucleotide identity with those of Taiwanese PVL-positive ST59 MRSA strains TSGH17 and PM1, which were designated as type V (5C2&5). Identification of multiple MRSA clones distinct from those disseminating at the hospital suggests that MRSA strains might be emerging in the community from MSSA strains by acquiring SCCmec elements on various occasions. Carriage of the similar type V(5C2&5) SCCmec element by strains of distinct genetic backgrounds, CC91 and CC59, suggested horizontal transfer of the SCCmec element.

  19. Harmonisation of agricultural accounting

    Directory of Open Access Journals (Sweden)

    Jaroslav Sedláček

    2007-01-01

    Full Text Available This paper deals with the accounting of the biological assets. There are described two approaches: Czech and international. The International Accounting Standards are emulative of more authentic presentment of economic processes in agricultural activities than Czech accounting legislation. From the comparison the both approaches accrued some differences, which can influent the financial statements of enterprises. The causation of main difference appears an application of fair value, which is prescribed for biological assets in international accounting standards. In international accounting standards is preferred principle of fair and true view, while in Czech accounting is preferred prudence principle.

  20. Making Collaborative Innovation Accountable

    DEFF Research Database (Denmark)

    Sørensen, Eva

    The public sector is increasingly expected to be innovative, but the prize for a more innovative public sector might be that it becomes difficult to hold public authorities to account for their actions. The article explores the tensions between innovative and accountable governance, describes the...... the foundation for these tensions in different accountability models, and suggest directions to take in analyzing the accountability of collaborative innovation processes.......The public sector is increasingly expected to be innovative, but the prize for a more innovative public sector might be that it becomes difficult to hold public authorities to account for their actions. The article explores the tensions between innovative and accountable governance, describes...