Prevalence of Cryptosporidium species and subtypes in paediatric oncology and non-oncology patients with diarrhoea in Jordan

Cryptosporidiosis is a protozoan parasitic disease which affects human and animals worldwide. In adult immunocompetent individuals, cryptosporidiosis usually results in acute and self-limited diarrhoea; however, it can cause life threatening diarrhoea in children and immunocompromised individuals. In the present study, we compared the prevalence of Cryptosporidium species and gp60 subtypes amongst paediatric oncology patients with diarrhoea (n = 160) from King Hussein Medical Centre for Cancer in Jordan, and non-oncology paediatric patients with diarrhoea (n = 137) from Al-Mafraq paediatric hospital. Microscopy results using modified acid fast staining identified a significantly (p ≤ 0.05) higher prevalence of Cryptosporidium in paediatric oncology patients with diarrhoea (14.4% - 23/160), compared to non-oncology paediatric patients with diarrhoea only (5.1% - 7/137). With the exception of one sample, all microscopy-positive samples (n = 29) and an additional 3/30 microscopy-negative controls were typed to species and subtype level at the 18S and gp60 loci, respectively. All Cryptosporidium positives were typed as C. parvum. Of the 22 typed Cryptosporidium positives from the paediatric oncology patients, 21 were subtyped as IIaA17G2R1 and one as IIaA16G2R1 C. parvum subtypes. The 7 typed positives from the paediatric patients from Al-Mafraq hospital were subtyped as IIaA17G2R1 (n = 5) and IIaA16G2R1 (n = 2). The 3 additional positives from the 30 microscopy negative control samples were subtyped as IIaA17G2R1. The high prevalence of the IIaA17G2R1 subtype, particularly amongst oncology patients, suggests that an outbreak of cryptosporidiosis may have been occurring in oncology patients during the collection period (April to December, 2016). New therapies for cryptosporidiosis in immunocompromised patients are urgently required.     

Inter- and intra-subtype variation of Blastocystis subtypes isolated from diarrheic and non-diarrheic patients in Iran

Blastocystis is a common intestinal parasitic protist infecting birds and mammals. Blastocystis comprises at least 17 subtypes (ST), of which ST1–ST9 have been detected in humans. Significant correlation between certain subtypes and pathogenicity remains to be established. Nevertheless, some studies suggest a potential linkage between subtypes (inter- and intra-subtype variation) and clinical manifestations. The aim of this study was to identify intra-subtype genetic variation of subtypes of Blastocystis in stools samples submitted by diarrheic and non-diarrheic patients. A 550-bp fragment of the nuclear small subunit ribosomal rRNA gene was amplified from 58 culture-positive samples isolated from diarrheic and non-diarrheic Iranian patients. PCR products were sequenced and sequences subjected to phylogenetic analysis. Intra-and inter-subtype variation was calculated. Based on comparison with reference sequences in GenBank, ST1, ST2 and ST3 were found in 18 (31.03%), 21 (36.22%), and 19 (32.75%) of the samples, respectively. Diarrheic stools were observed in eight (44.44%), 10 (47.61%), and nine (47.36%) patients with ST1, ST2, and ST3, respectively. No statistically significant correlation was found between subtypes and diarrhea (P = 1.000). Multiple sequence alignment exhibited a within-subtype similarity of 98.76%, 97.17%, and 99.78% in ST1, ST2, and ST3, respectively. Highest similarity was seen among ST3 isolates, while lowest similarity was seen among ST2 isolates. Phylogenetic analysis did not suggest any correlation between diarrhea and intra-subtype variation. Inter- and intra-subtype variation in SSU rRNA gene appears not to reflect differences in the clinical outcome of Blastocystis carriage.     

Perceived effectiveness of HPV test as a primary screening modality among US providers

BackgroundThe human papillomavirus (HPV) test, administered alone without the Papanicolaou (Pap) test, was recently recognized as a cervical cancer screening option in the United States by the Society of Gynecologic Oncology and the American Society for Colposcopy and Cervical Pathology, and the Food and Drug Administration has approved an HPV test for primary screening.MethodsSurveys of US internists, family practitioners, nurse practitioners, and obstetrician–gynecologists were conducted in 2009 and 2012 to investigate providers' perceptions of the effectiveness of the HPV test administered alone as a population-based screening modality (2009: N = 1040, 141–494 per provider group; 2012: N = 1039, 155–435 per provider group).ResultsThe majority in each provider group agreed that the HPV test administered alone is an effective screening modality in 2009 (75.3%–86.1%) and 2012 (79.5%–91.8%), and agreement rose significantly during this time period among family practitioners (χ² = 15.26, df = 1, p < 0.001) and nurse practitioners (χ² = 4.53, df = 1, p = 0.033).ConclusionsAgreement that the HPV test administered alone is an effective cervical cancer screening modality was widespread among providers in both 2009 and 2012, however implementation of guidelines for screening with the HPV test may be influenced by many other factors including reimbursement and patient preferences.     

Performance of a PCR assay for the rapid identification of the Klebsiella pneumoniae ST258 epidemic clone in Latin American clinical isolates

The worldwide dissemination of Klebsiella pneumoniae carbapenemase (KPC)-producing Klebsiella pneumoniae ST258 demands a rapid PCR-based typing method to detect unique genes of the ST258 clone. This study evaluates a PCR developed by Adler et al. (2014) for the detection of ST258 in K. pneumoniae clinical isolates centered on the identification of the pilv-I and prp genes. We tested 143 clinical isolates from Argentina (n = 109), Chile (n = 1), Colombia (n = 1), Costa Rica (n = 2), Ecuador (n = 5), El Salvador (n = 2), Nicaragua (n = 5), Panamá (n = 2), Paraguay (n = 2), Perú (n = 3) and Trinidad and Tobago (n = 11) recovered from 2006 to 2015. bla_KPC, pilv-l and prp genes were detected by PCR and sequenced by standard procedures. ST258 and non-ST258 were defined by PFGE and/or MLST. Isolates were grouped according to PFGE patterns: 58 were compatible with ST258 (group 1) and 85 with non-ST258 (group 2). MLST study was done on an arbitrary selection of isolates. The pilv-l gene was present only in ST258 isolates, regardless of the presence of the bla_KPC gene. Results for the prp gene were variable. Its presence did not define ST258. The pilv-I PCR had a sensitivity and specificity of 100%, respectively, for the detection of ST258 in the isolates under investigation. Given our findings, the pilv-I PCR could replace more time and resource consuming methods, allowing for more rapid detection of the circulating high risk K. pneumoniae clone ST258 in Latin American (LA) countries.     

Sexualité au cours de la grossesse : une enquête auprès de femmes enceintes en milieu urbain africain

The aim of this study is to assess the opinions and the practice of pregnant women on sexuality during pregnancy in an african setting. It is a voluntary and anonymous cross sectional survey conducted in September 2004 in an antenatal clinic in Bobo Dioulasso, Burkina Faso. Data collected are analyzed using EPI INFO 2000. A total of 95 pregnant women were interviewed. The profile of the woman who participated in the study is as followed: a mean age of 25 years, having no formal literacy, mainly housewife and Muslim, engaged in a monogamous marriage in 50% of the cases and bearing a pregnancy of 5 months of gestational age. The women's opinions on sexuality during pregnancy are stated as followed: for 92.6% sexual intercourse is possible during pregnancy and that is not related to their instruction level (χ² = 4.4 and p = 0.81). In 85% of the cases, the women say that they have sexual intercourse during the time of the survey and that is related to the fact that they thought that sexual intercourse is possible during pregnancy (χ² = 14.47 and p = 0.005) but not related to the gestational age (χ² = 13.2 and p = 0.67). The majority of the women (60%) say that sexual intercourse has no harmful effect on the baby to be born. The two main reasons given by the women for sexual activity during pregnancy are the pleasure of the couple follow az ed by the pleasure of their partner.ConclusionIn urban setting in Burkina Faso, sexuality is a reality in pregnant women. In-depth surveys may be needed to precise its essential underlying factors.     

Population structure of Legionella spp. from environmental samples in Gabon, 2013

Aquatic environments are the most important source for Legionella spp. infections such as Legionnaires’ disease and Pontiac fever. The reservoirs of Legionella spp. are mostly unclear in sub-Saharan Africa. The aim of this study, conducted in 2013, was to identify geographical areas of an increased risk for exposure to Legionella spp., and to describe the population structure of Legionella spp. from different water sources in a cross-sectional study in Gabon. Fresh water samples (n = 200) were cultured on Legionella selective agar; species were confirmed by MALDI-TOF, a Legionella pneumophila specific real-time PCR and 16S RNA gene sequencing. Serogroups were identified by agglutination test. The population structure was assessed by multilocus sequence typing (MLST).Legionella spp. isolates (n = 29) were frequently found in the hospital setting particularly in hot water systems. Open water bodies (i.e. rivers, lakes) were not contaminated with Legionella spp. Isolated L. pneumophila mainly belonged to serogroups 2–14 (n = 19) and MLST sequence type ST1, ST75 (and related STs) and ST1911.In conclusion, hospitalized patients might have an increased risk to become infected with Legionella spp. in the studied areas in Gabon, particularly if they have risk factors such as comorbidities. Both broadly extended (ST1, ST75) and local lineages (ST1911) were present in our setting.     

Objectively measured physical activity,sedentary time and subclinical vascular disease: Cross-sectional study in older British men

Low physical activity (PA) and high levels of sedentary time (ST) are associated with higher cardiovascular disease (CVD) risk among older people. However, their independent contribution and importance of duration of PA and ST bouts remain unclear. We investigated associations between objectively measured PA, ST and non-invasive vascular measures, markers of CVD risk.Cross-sectional study of 1216 men from the British Regional Heart Study, mean age 78.5 years, measured in 2010–2012. Carotid intima thickness (CIMT), distensibility coefficient (DC) and plaque presence were measured using ultrasound; pulse wave velocity (cfPWV) and augmentation index (AIx) using a Vicorder. PA and ST were measured using hip-worn ActiGraph GT3X accelerometers.After adjusting for covariates, each additional 1000 steps per day was associated with a 0.038 m/s lower cfPWV (95% CI = − 0.076, 0.0003), 0.095 10^− 3 kPa^− 1 higher DC (95% CI = 0.006, 0.185), 0.26% lower AIx (95% CI = − 0.40, − 0.12) and a 0.005 mm lower CIMT (95% CI = − 0.008, − 0.001). Moderate and vigorous PA (MVPA) was associated with lower AIx and CIMT, light PA (LPA) with lower cfPWV and CIMT and ST with higher cfPWV, AIx and CIMT and lower DC. LPA and ST were highly correlated (r = − 0.62). The independence of MVPA and ST or MVPA and LPA was inconsistent across vascular measures. Bout lengths for both PA and ST were not associated with vascular measures.In our cross-sectional study of older men, all PA regardless of intensity or bout duration was beneficially associated with vascular measures, as was lower ST. LPA was particularly relevant for cfPWV and CIMT.     

Genetic basis of antimicrobial resistance and clonal dynamics of carbapenem-resistant Acinetobacter baumannii sequence type 191 in a Korean hospital

This study investigated the genetic basis of antimicrobial resistance and the epidemiological characteristics of 125 carbapenem-resistant Acinetobacter baumannii (CRAB) isolates collected from 2011 to 2012 in a Korean hospital. All CRAB isolates showed an extensively drug-resistant phenotype, but were susceptible to tigecycline. The bla_OXA − 23 and armA genes were mainly responsible for resistance to carbapenems and aminoglycosides, respectively. Four colistin-resistant CRAB isolates with different pulsotypes were identified. All four colistin-resistant isolates had a deletion at nucleotide 776 in lpxA, while one also had an insertion at nucleotide 732 in lpxA. All CRAB isolates belonged to three sequence types (STs): ST191 (n = 118), ST208 (n = 6), and ST436 (n = 1), but were classified into 33 arbitrary pulsotypes. Of the CRAB ST191 isolates, two main arbitrary pulsotypes 5 (n = 20) and 18 (n = 17) emerged sequentially, but were not clonally related to CRAB isolates collected from 2009 to 2010 in the same hospital. Furthermore, of the two main pulsotypes identified among CRAB ST191 isolates from 2009 to 2010, one was clonally related to sporadic CRAB ST191 isolates from 2011 to 2012, but the other was not related to any CRAB isolate from 2011 to 2012. In conclusion, this study shows the clonal dynamics of CRAB ST191 isolates in a Korean hospital during the last four years.     

Occupational exposure to particulate matter from three agricultural crops in California

Agricultural work is a major contributor to California's and the nation's economy and employs a large number of workers. However, agricultural work can have numerous risks, such as exposure to elevated levels of particulate matter (PM) and other airborne pollutants with potential adverse health effects. To determine the magnitude of occupational exposures, PM levels were assessed for 89 workers from three major crops in California; almonds, melons and tomatoes. Personal samples were collected for PM_2.5 and inhalable PM using personal sampling equipment. Geometric mean concentrations from personal exposure for workers in almonds (inhalable PM = 4368 μg/m³, PM_2.5 = 122 μg/m³, N = 5), tomatoes (inhalable PM = 1410 μg/m³, PM_2.5 = 12 μg/m³, N = 33), and melons (inhalable PM = 1118 μg/m³, PM_2.5 = 19 μg/m³, N = 51) showed high PM exposure when working with these three crops. Large exposure differences by crop were more common than by task (i.e. harvesting, packing and weeding) among the three crops studied. This is the largest study of agricultural workers engaged in hand harvesting, a significant employer of farm labor, and relatively high levels of exposure to PM were measured.     

A rare non-synonymous c.102C>G SNP in the IFNB1 gene might be a risk factor for cerebral malaria in Indian populations

Interferon beta1 (IFNB1) is a type I interferon that is mainly known for its antiviral activity, but it also regulates a number of anti-inflammatory and immunomodulatory functions. Studies on mouse models of cerebral malaria have established that IFNB1 regulates severe malaria pathogenesis and increases overall survival against malaria. It down-regulates pro-inflammatory cytokines: TNF, IFNG and ICAM-1, resulting in decreased adherence of Plasmodium falciparum parasitized RBC to capillary wall, entry into the brain and delayed onset of death. Therefore, we hypothesized that variations in IFNB1 gene could regulate malarial pathogenesis. We re-sequenced the complete IFNB1 gene along with 900 bp of 5′ up-stream and 500 bp of 3′-UTR in 437 individuals from malaria endemic regions of the Orissa and Chhattisgarh states of India. The subjects comprised of 173 cases of severe malaria, 101 of mild malaria, and 156 ethnically matched asymptomatic controls. Data were statistically compared between cases and controls for their possible association with P. falciparum malarial outcome. Two single nucleotide polymorphisms (SNPs): a synonymous c.153C>T (rs1051922) and a non-synonymous substitution c.102C>G (rs139262191, p.Ser34Arg) were identified. The genotype and allele distribution of c.153C>T did not differ significantly between the study groups [mild, χ²₂ = 4.10, p-value < 0.13 and severe χ²₂ = 0.06, p-value < 0.97]. Interestingly, the rare non-synonymous SNP (rs139262191) was observed only in malaria patients. The differences between all cases and controls did not reach statistical significance, however, a statistically significant difference was observed between the asymptomatic control group and the cerebral malaria group [OR = 20.32, 95% CI = 1.08–382.63, p-value = 0.044]. Moreover, the genotypes between cerebral malaria positive and negative groups were not significantly different [OR = 5.58, 95% CI = 0.61–50.97, p-value = 0.123]. Our findings suggest that the IFNB1 variant, p.Ser34Arg, might be a risk factor for cerebral malaria in Indian populations.     

Gender differences in the longitudinal associations of depressive symptoms and leisure-time physical activity with cognitive decline in ≥ 57 year-old Taiwanese

ObjectiveThis study investigates the role of gender in the associations of long-term depressive symptoms and leisure-time physical activity (LTPA) with the risk of cognitive decline in elderly Taiwanese.MethodWe analyzed 3679 subjects (age ≥ 57) in the 2003 and 2007 datasets of the Taiwan Longitudinal Survey on Aging, of which data were collected via face-to-face interviews by trained interviewers. We excluded proxy respondents. Multivariable logistic regression analysis examined the associations of long-term depressive symptoms (increased symptoms: CES-D10 scores from < 10 to ≥ 10; decreased symptoms: from ≥ 10 to < 10) and LTPA (frequency, duration, and intensity) with cognitive decline (a decrease of two or more SPMSQ scores).ResultsWomen had significant higher percentages of cognitive impairment, compared to men, at the baseline (5.9 vs. 1.5%; χ² = 51.24, p < 0.001) and end-point (10.8 vs. 5.2%;χ² = 39.5, p < 0.001). Men with long-term depressive symptoms had 5.28 greater odds of cognitive decline (OR = 5.28, 95%CI = 2.84–9.82, p < 0.001) and men with increased depressive symptoms had 2.09 greater odds (2.09, 1.24–3.51, p = 0.006). No such association was observed in women. Men with consistently high LTPA had 65% (0.35, 0.19–0.65, p = 0.001) and women with increased LTPA had 43% (0.57, 0.34–0.93, p = 0.024) reduction in odds of developing cognitive decline.ConclusionWe found gender differences in the longitudinal association between depressive symptoms and cognitive decline. Long-term LTPA may loosen the association between long-term depressive symptoms and cognitive decline. These findings are useful in the identification of vulnerable elderly in the Taiwanese population and public health interventions should focus on assisting their cognitive aging.     

Diseño y validación de un instrumento sobre calidad de la planificación anticipada de decisiones para profesionales

ObjectiveTo develop a questionnaire aimed to measure the quality of the advance care planning process in healthcare professionals and to assess its psychometric quality.MethodInstrumental questionnaire validation study. Scope: primary care centers and outpatients clinics from general hospitals in Ferrol, Ourense, Monforte-Lugo and Health Area V of the Health Service of Asturias. Participants: physicians and nurses. Phases: (1) design of the first version of the questionnaire using the Delphi technique; (2) construction of the second version of 21 items, after judges’ agreement and Kendall's W test; (3) pilot study: internal consistency using Cronbach's alpha and omega coefficient, retest–test by Pearson's correlation coefficient; (4) validation: Barlett's spherity test and Kaiser–Meyer–Olkin measurement, exploratory factor analysis with varimax rotation and study of the dimensions of the questionnaire (number, CCI and correlation), internal consistency using Cronbach's alpha.ResultsPilot study with 28 professionals. Reliability ? = 0.917, α = 0.841, and test–retest correlation coefficient of 0.785 (95% confidence interval: 0.587–0.894; p < 0.001). Validation of the questionnaire (21 items) in 204 professionals. Ítem analysis and exploratory factor analysis (Barlett's test [χ² = 1298,789] and KMO = 0.808; p < 0.001) yielded a five-factor model explaining 64.377% of the total variance, with 18 items grouped into 5 dimensions (information, preferences, behavioral intention, training and communication). Cronbach's alpha of the global questionnaire was 0.841.ConclusionsThe ProPAD-pro questionnaire has showed to be a valid and reliable instrument to assess the quality of the advance care planning process.     

The construct validity of the Restraint Scale among mainland Chinese women

This study aimed to test the construct validity of the newly developed Chinese version of the Revised Restraint Scale (RRS) in two separate female samples from Chinese universities (n₁ = 171; n₂ = 158). The RRS is the most widely used measure of restricted eating for the purpose of achieving or maintaining a desired weight. Results showed that the 10-item Chinese RRS comprised of two subscales of concern dieting (CD) and weight fluctuation (WF), which together accounted for 53.01% of the total variance. Confirmative factor analysis supported this two-factor model as an acceptable model (χ²/df = 1.545, p < 0.001; RMSEA = 0.059, GFI = 0.938, and CFI = 0.935). Cronbach's alpha coefficients were 0.77 for RRS, 0.71 for CD and 0.66 for WF. Significant correlations were shown between RRS and its subscales (r_RRS-CD = 0.894, p < 0.01; r_RRS-WF = 0.850, p < 0.01; r_CD-WF = 0.523, p < 0.01). Moreover, RS significantly correlated with the Three-Factor Eating Questionnaire-R (TFEQ-R), the Dutch Eating Behaviour Questionnaire-R (DEBQ-R), the Fatness Concern (FC) and the body measure index (BMI) (r = 0.548, p < 0.01; r = 0.631, p < 0.01; r = 0.620, p < 0.01; r = 0.351, p < 0.01, respectively). In sum, the RS has stable factor structure, acceptable internal consistency and satisfactory convergent reliability among female Chinese college students. The adapted scale may serve as a useful tool for identifying restrained and unrestrained eaters among Chinese women and may be particularly useful in assessing eating restraint before and after prevention and intervention programs.     

RICH2 is implicated in viraemic control of HIV-1 in black South African individuals

An intronic single nucleotide polymorphism (SNP) in RICH2 (rs2072255; 255ⁱ), in complete linkage disequilibrium (LD) with an exonic SNP (rs2072254; 254^e), has been identified in a genome wide association study to be associated with progression to AIDS in Caucasian individuals. RICH2 links tetherin to the cortical actin network and the RICH2/tetherin interaction has been shown to be important for the downstream activation of NF-κβ and the consequential promotion of proinflammatory responses. We investigated the role of these two SNPs in natural control of HIV-1 in black South Africans including healthy controls (HCs; N = 102) and antiretroviral-naive HIV-1-infected controllers (HICs; N = 52) and progressors (N = 74). HICs were stratified as elite controllers (ECs; N = 11), viraemic controllers (VCs; N = 30), high viral load (VL) long term non-progressors (HVL LTNPs; N = 11) and also according to VL < 400 RNA copies/ml (HICs VL < 400; N = 20) and VL > 400 RNA copies/ml (HICs VL > 400; N = 32). Results showed that in contrast to Caucasians who had very strong LD between these SNPs (r² = 0.97), black populations exhibited low LD (r² = 0.11–0.27), however a 254^e minor allele was always present with a 255ⁱ minor allele but not vice versa. The SNPs did not show significant over- or underrepresentation in any particular group, however the combination of 254^e major allele homozygosity and 255ⁱ heterozygosity (254^eAA/255ⁱGA) was underrepresented in HICs (OR = 3.26; P = 0.04) and VCs (OR = 7.77; P = 0.02) compared to HCs, and in HICs VL > 400 compared to both HCs (P = 0.002) and progressors (P = 0.02). A lower CD4⁺ T-cell count was associated with 254^eAA/255ⁱGA and 255ⁱ (GA + AA) in the total HIV-1-infected group (P = 0.043) and progressors (P = 0.017), respectively. In silico analysis predicted loss of an exonic splice enhancer site with the 254^e-G allele. We postulate that altered splicing of RICH2 will affect levels of RICH2 expression and consequently NF-κβ activation. These findings point to a role for RICH2 and tetherin in viraemic natural control of HIV-1.     

Single nucleotide polymorphisms in Plasmodium falciparum V type H+ pyrophosphatase gene (pfvp2) and their associations with pfcrt and pfmdr1 polymorphisms

BackgroundChloroquine resistance in Plasmodium falciparum malaria has been associated with pfcrt 76T (chloroquine resistance transporter gene) and pfmdr1 86Y (multidrug resistance gene 1) alleles. Pfcrt 76T enables transport of protonated chloroquine out of the parasites digestive vacuole resulting in a loss of hydrogen ions (H⁺). V type H⁺ pyrophosphatase (PfVP2) is thought to pump H⁺ into the digestive vacuole. This study aimed to describe the geographic distribution of single nucleotide polymorphisms in pfvp2 and their possible associations with pfcrt and pfmdr1 polymorphisms.MethodsBlood samples from 384 patients collected (1981–2009) in Honduras (n = 35), Colombia (n = 50), Liberia (n = 50), Guinea Bissau (n = 50), Tanzania (n = 50), Iran (n = 50), Thailand (n = 49) and Vanuatu (n = 50) were analysed. The pfcrt 72–76 haplotype, pfmdr1 copy numbers, pfmdr1 N86Y and pfvp2 V405I, K582R and P711S alleles were identified using PCR based methods.ResultsPfvp2 was amplified in 344 samples. The pfvp2 allele proportions were V405 (97%), 405I (3%), K582 (99%), 582R (1%), P711 (97%) and 711S (3%). The number of patients with any of pfvp2 405I, 582R and/or 711S were as follows: Honduras (2/30), Colombia (0/46), Liberia (7/48), Guinea-Bissau (4/50), Tanzania (3/48), Iran (3/50), Thailand (1/49) and Vanuatu (0/31). The alleles were most common in Liberia (P = 0.01) and Liberia + Guinea-Bissau (P = 0.01). The VKP haplotype was found in 189/194 (97%) and 131/145 (90%) samples harbouring pfcrt 76T and pfcrt K76 respectively (P = 0.007).ConclusionsThe VKP haplotype was dominant. Most pfvp2 405I, 582R and 711S SNPs were seen where CQ resistance was not highly prevalent at the time of blood sampling possibly due to greater genetic variation prior to the bottle neck event of spreading CQ resistance. The association between the pfvp2 VKP haplotype and pfcrt 76T, which may indicate that pfvp2 is involved in CQ resistance, should therefore be interpreted with caution.     

Genotyping of Brucella melitensis and Brucella abortus strains currently circulating in Xinjiang,China

Brucellosis is a well-known zoonotic disease that can cause severe economic and healthcare losses. Xinjiang, one of the biggest livestock husbandry sectors in China, has gone through increasing incidence of brucellosis in cattle and small ruminants recently. In this paper, 50 B. melitensis strains and 9 B. abortus strains collected from across Xinjiang area (from 2010 to 2015) were genotyped using multiple locus variable-number tandem-repeat (VNTR) analysis (MLVA) and multi-locus sequence typing (MLST). Based on 8 loci (MLVA-8), 50 B. melitensis strains were classified into three genotypes. Genotypes 42 (n = 38, 76%) and 63 (n = 11, 22%) were part of the East Mediterranean group, and one genotype with pattern of 1-5-3-13-2-4-3-2 represents a single-locus variant from genotype 63. MLVA-16 resolved 50 B. melitensis strains into 28 genotypes, of which 15 are unique to Xinjiang and 10 are in common with those in adjacent country Kazakhstan and neighboring provinces of China. Minimum Spanning Tree (MST) analysis implies that B. melitensis strains collected from across Kazakhstan, Xinjiang and China areas may share a common origin. Nine B. abortus strains were sorted into three genotypes by MLVA-8, genotypes 36 (n = 7, 77.8%), 86 (n = 1, 11.1%) and a new genotype with pattern of 4-5-3-13-2-2-3-1. Each B. abortus strain showed distinct MLVA-16 genotypes, suggesting that B. abortus species may possess more genetic diversity than B. melitensis. Using MLST, most B. melitensis strains (n = 49) were identified as sequence type ST8, and most B. abortus strains (n = 8) were recognized as ST2. Two new sequence types, ST37 and ST38, represented by single strain from B. melitensis and B. abortus species respectively, were also detected in this study. These results could facilitate the pathogen surveillance in the forthcoming eradication programs and serve as a guide in source tracking in case of new outbreaks occur.     

Nine year changes in sitting time in young and mid-aged Australian women: Findings from the Australian Longitudinal Study for Women's Health

ObjectiveTo examine changes in sitting time (ST) in women over nine years and to identify associations between life events and these changes.MethodsYoung (born 1973–78, n = 5215) and mid-aged (born 1946–51, n = 6973) women reported life events and ST in four surveys of the Australian Longitudinal Study on Women's Health between 2000 and 2010. Associations between life events and changes in ST between surveys (decreasers ≥ 2 h/day less, increasers ≥ 2 h/day more) were estimated using generalized estimating equations.ResultsAgainst a background of complex changes there was an overall decrease in ST in young women (median change − 0.48 h/day, interquartile range [IQR] = − 2.54, 1.50) and an increase in ST in mid-aged women (median change 0.43 h/day; IQR = − 1.29, 2.0) over nine years. In young women, returning to study and job loss were associated with increased ST, while having a baby, beginning work and decreased income were associated with decreased ST. In mid-aged women, changes at work were associated with increased ST, while retiring and decreased income were associated with decreased ST.ConclusionsST changed over nine years in young and mid-aged Australian women. The life events they experienced, particularly events related to work and family, were associated with these changes.     

The ‘Healthy Dads,Healthy Kids’ community randomized controlled trial: A community-based healthy lifestyle program for fathers and their children

ObjectiveTo evaluate the effectiveness of the ‘Healthy Dads, Healthy Kids (HDHK)’ program when delivered by trained facilitators in community settings.MethodA two-arm randomized controlled trial of 93 overweight/obese fathers (mean [SD] age = 40.3 [5.3] years; BMI = 32.5 [3.8] kg/m²) and their primary school-aged children (n = 132) from the Hunter Region, Australia. In 2010–2011, families were randomized to either: (i) HDHK intervention (n = 48 fathers, n = 72 children) or (ii) wait-list control group. The 7-week intervention included seven sessions and resources (booklets, pedometers). Assessments were held at baseline and 14-weeks with fathers' weight (kg) as the primary outcome. Secondary outcomes for fathers and children included waist, BMI, blood pressure, resting heart rate, physical activity (pedometry), and self-reported dietary intake and sedentary behaviors.ResultsLinear mixed models (intention-to-treat) revealed significant between-group differences for fathers' weight (P < .001, d = 0.24), with HDHK fathers losing more weight (− 3.3 kg; 95%CI, − 4.3, − 2.4) than control fathers (0.1 kg; 95%CI, − 0.9,1.0). Significant treatment effects (P < .05) were also found for fathers' waist (d = 0.41), BMI (d = 0.26), resting heart rate (d = 0.59), energy intake (d = 0.49) and physical activity (d = 0.46) and for children's physical activity (d = 0.50) and adiposity (d = 0.07).DiscussionHDHK significantly improved health outcomes and behaviors in fathers and children, providing evidence for program effectiveness when delivered in a community setting.     

Population deviation of piggery-associated methicillin-resistant Staphylococcus aureus based on mec-associated direct repeat unit analysis

Piggery-associated methicillin-resistant Staphylococcus aureus (MRSA) is a potential zoonotic pathogen. We constructed the population structure and dynamics of staphylococcal chromosome cassette mec (SCCmec) in MRSA ST9 isolates from different geographical areas of Taiwan. A total of 140 MRSA (135 piggery and 5 human clinical) isolates from three populations located in western Taiwan (n = 96 including the 5 clinical isolates), central eastern Taiwan (n = 22), and Penghu Island (n = 22) were collected and characterized by analysis of the mec-associated direct repeat unit (dru). Twenty-eight dru types (with 24 novel) and 15 dru-Clonal Complexes (CCs) were identified. The predominant novel dt12w type (48.6%) was widespread in all populations and may have a superior ability to transmit among populations. The minimum spanning network showed that at least two ancestral dru types (dt11a and dt12w) were identified, and the genetics between different populations could be differentiated. Temporal distributions of clone population dynamics estimated through the Bayesian skyline plot indicated a stable population with a long evolutionary history for MRSA ST9 in Taiwan. Findings indicating that some dru types are shared between piggery-associated and human-clinical MRSA ST9 suggest the occurrence of cross-species horizontal transmission of SCCmec.     

Molecular epidemiology and antibiotic resistance of methicillin-resistant Staphylococcus aureus circulating in the Russian Federation

The aim of this study was to investigate the patterns of antimicrobial resistance and molecular features of methicillin-resistant Staphylococcus aureus (MRSA) isolates in Russia. Isolates recovered from hospital patients (n = 480), healthy medical personnel (n = 25), and healthy carriers (n = 13) were included in the study. Hospital-acquired MRSA (HA-MRSA) demonstrated high resistance to ciprofloxacin, gentamicin, and chloramphenicol (76%–92%), moderate – to tetracycline, erythromycin, clindamycin, and rifampicin (38%–54%), and low – to fusidic acid, co-trimoxazole, mupirocin, and daptomycin (2%–7%). Elevated MIC (2.0 μg/ml) of vancomycin was detected in 26% of isolates. All isolates were susceptible to linezolid and tigecycline. Multilocus sequence typing (MLST) revealed that CC8 isolates (ST8 + ST239) constituted 83.1% of HA-MRSA and that this genetic lineage dominated in all regions from Krasnoyarsk to Saint Petersburg. A local ST239 variant harboring the tst gene (ST239_Kras) was detected in Krasnoyarsk. The other HA-MRSA isolates belonged to clonal complex 5 (CC5) (21 isolates, 12.2%) and CC22 (2, 1.2%). The majority of CC5 isolates were affiliated with sequence type 228 (ST228) and were characterized with decreased susceptibility to ceftaroline (MIC = 2 μg/ml). We also detected, for the first time in Russia, livestock-associated MRSA (LA-MRSA) from clusters CC398 and CC97 in humans. Among the 2053 healthy persons screened for nasal carriage of S. aureus, the bacteria were isolated from 426 (21%); among them, 13 carried isolates identified as community-associated MRSA (CA-MRSA). Eleven of 13 CA-MRSA isolates belonged to ST22 (spa types t223, t3243, and t3689; SCCmec types IVa and IVc, agr type I, tst-positive) and were similar to the EMRSA-15/Middle Eastern variant (Gaza strain).