Methicillin-resistance among Turkish isolates of Staphylococcus aureus strains from nosocomial and community infections and their resistance patterns using various antimicrobial agents

The purposes of this study were to determine the prevalence of Turkish isolates of methicillin-resistant Staphylococcus aureus (MRSA) in nosocomial and community infections and their antibiotic resistant patterns. The oxacillin disk diffusion method for the detection of methicillin resistance and the Kirby-Bauer disk diffusion for antibiotic susceptibility tests were used. A total 383 S. aureus strains were identified from different patients. The prevalence of methicillin resistance among S. aureus strains was 31·3% (). The proportions of MRSA isolated from nosocomial and community infections were 26·4% () and 35·4% (), respectively. The resistance rates of MRSA to other antibiotics were as follows: 71% resistant to erythromycin, 54% to clindamycin, 52% to gentamicin, 44·5% to trimethoprim-sulfamethoxazole and 36% to ciprofloxacin. No strain resistant to vancomycin was recorded in this study.     

Epidemiological significance of cutaneous, pharyngeal, and digestive tract colonization by multiresistant Acinetobacter baumannii in ICU patients

The aim of this prospective study was to assess the relative epidemiological role of digestive tract colonization by Acinetobacter baumannii, in comparison with other body site colonizations, in patients admitted to intensive care units (ICUs). From January to May 1995, axillary, pharyngeal and rectal swabs were taken together within the first 48 h of admission, and then weekly during ICU stay. Seventy-three patients were included, 48 of them (66%) had axillary, pharyngeal, or rectal colonization with A. baumannii, nine (19%) of these 48 during the first 48 h and the remaining 28 (77%) during the first week. Twenty-one (29%) had clinical samples positive for A. baumannii and axillary, pharyngeal, or rectal colonization. In 15 of these 21 (71%), colonization on body sites occurred prior to isolation from clinical samples (mean seven days, range 1–20). Throughout admission, rates of detection of A. baumannii were 75% () for axillary or pharyngeal swabs and 77% () for rectal swabs. Combination of two body site swabs yielded culture positive rates of 90% () for axillary-pharyngeal or axillary-rectal sites, and 96% () for pharyngeal-rectal. Two epidemic clones were defined by antibiotype and pulsed-field gel electrophoresis (PFGE) of SmaI DNA digests in 43 isolates from 11 patients. We conclude that body sites of patients were a major reservoir for A. baumannii infections in the outbreak. This finding casts doubt on the value of selective decontamination of the digestive tract as an additional infection control measure in this kind of outbreak. The weekly performance of pharyngeal and rectal swabs appears to detect A. baumannii colonization early among ICU patients and enables barrier methods to be applied rapidly.     

Early onset pneumonia in neurosurgical intensive care unit patients

To investigate early onset pneumonia in a neurosurgical intensive care unit, we studied a cohort of patients over a 13-month period and compared neurotrauma (T) with non-neurotrauma (NT) patients. Data were abstracted from the infection surveillance database. Five hundred and sixty-five adults were hospitalized in the neurosurgical intensive care unit. 57·9% had trauma and 129 patients developed 152 episodes of pneumonia. Incidence rates, restricted to the 129 first episodes of pneumonia, were 20·1 versus patient days and 34·2 versus ventilation days, in the T and NT groups respectively. In both groups, the distribution of risk stratified by hospital days was bimodal, being highest during the first three days. However, the risk was higher for T patients (at day 3, ventilation days versus ventilation days). The daily risk peaked again at days 5 and 6, and thereafter remained low. Pneumonia occurring within the first three days, or early onset pneumonia (EOP), was associated with trauma (P = 0·036) and, in the NT group only, with a Glasgow coma scale score lower than 9 (P = 0·062). EOF was caused by Staphylococcus aureus (33%), Haemophilus spp. (23%), other Gram-positive cocci (22%), and other Gram-negative bacilli (GNB) (19%); whereas after the third day GNB other than Haemophilus spp. accounted for 45·4% of isolates (P = 0·11). This large series confirms the high incidence of EOP in neurosurgical intensive care units, particularly among trauma patients, in relation to risk factors different from those seen in other intensive care patients. Further studies are needed to elaborate specific preventive measures during early care.     

Lead exposure in indigenous communities of the Amazon basin, Peru

Since 2006, three studies have reported elevated levels of lead (Pb) among the indigenous population of the Corrientes river, in the Amazon basin of Peru. Due to the large evidence of environmental pollution related to oil exploitation in the area, this activity has been suggested as the source of exposure. This study aimed to evaluate Pb levels in the population and environment of two communities exposed and one community non-exposed to the oil exploitation activity. Blood lead levels (BLL) were determined by the instrument Leadcare. A comparison with the graphite furnace atomic absorption technique was performed in order to validate the Leadcare results. Environmental samples were analyzed by inductively coupled plasma atomic emission spectroscopy. Among 361 capillary samples, the mean BLL was 9.4 μg/dl. Mean BLL of the communities exposed (n = 171, ) and non-exposed (n = 190, ) to the oil activity were not significantly different. Pb levels in environmental samples were below the maximum permissible levels. The sources of exposure could not be identified. Elevated levels of Pb in the oil-non-exposed community pointed out at other sources not yet clarified.     

Folate and vitamin B12 status is associated with insulin resistance and metabolic syndrome in morbid obesity

1. Download high-res image (244KB)
2. Download full-size image

     

A survey of the incidence and care of postoperative wound infections in the community

The incidence of postoperative wound infection after clean surgery in the four weeks following early discharge from hospital and its effect on community medical services have been studied prospectively. The wound infection rate as assessed by patients who responded to a postoperative questionnaire was 9%; half of the wound problems presented after discharge. Postoperative wound infection increased the time spent by general practitioners per patient twofold, and that of practice/district nurses ≥fivefold.     

Non-alcoholic fatty liver disease and its treatment with n-3 polyunsaturated fatty acids

1. Download high-res image (191KB)
2. Download full-size image

     

Stress response and potential biomarkers in spinach (Spinacia oleracea L.) seedlings exposed to soil lead

Oxidative stress and biochemical responses of spinach seedlings to soil Pb stress were investigated by pot experiments. The seedlings were exposed to 0-500 mg kg⁻¹ extraneous Pb. After 30 days of germination, production of O₂⁻, HSP 70, HSP 60, superoxide dismutase (SOD) activities, carbonyl groups and lipid peroxidation was significantly induced by soil Pb. After 50 days, HSP 70 and HSP 60 decreased, and HSP 60 was significantly inhibited at 500 mg kg⁻¹. The results indicated that Pb probably induced oxidative stress and proteotoxicity to the seedlings through O₂⁻ accumulation, and that SOD, HSP 70 and HSP 60 were important defense mechanisms to alleviate the oxidative stress. It is found that O₂⁻, HSP 70 and HSP 60 were the most sensitive parameters and had the potential to act as biomarkers for early warning of soil Pb contamination. Concentrations of soil Pb, exposing time and combination of multiple parameters should be also taken into consideration when assessing soil Pb pollution by these biomarkers.     

Establishment of steady-state metabolism of ethanol in perfused rat liver: the quantitative analysis using kinetic mechanism-based rate equations of alcohol dehydrogenase

Alcohol dehydrogenase (ADH) catalyzes oxidation of ingested ethanol to acetaldehyde, the first step in hepatic metabolism. The purpose of this study was to establish an ex vivo rat liver perfusion system under defined and verified steady states with respect to the metabolites and the metabolic rates, and to quantitatively correlate the observed rates with simulations based on the kinetic mechanism-based rate equations of rat liver ADH. Class I ADH1 was isolated from male Sprague-Dawley rats and characterized by steady-state kinetics in the Krebs-Ringer perfusion buffer with supplements. Nonrecirculating liver perfusion with constant input of ethanol at near physiological hepatic blood flow rate was performed in situ. Ethanol and the related metabolites acetaldehyde, acetate, lactate, and pyruvate in perfusates were determined. Results of the initial velocity, product, and dead-end inhibition studies showed that rat ADH1 conformed to the Theorell-Chance Ordered Bi Bi mechanism. Steady-state metabolism of ethanol in the perfused liver maintained up to 3 h as evidenced by the steady-state levels of ethanol and metabolites in the effluent, and the steady-state ethanol disappearance rates and acetate production rates. The changes of the metabolic rates were qualitatively and in general quantitatively correlated to the results from simulations with the kinetic rate equations of ADH1 under a wide range of ethanol, in the presence of competitive inhibitor 4-methylpyrazole and of uncompetitive inhibitor isobutyramide. Preliminary flux control analysis estimated that apparent in the perfused liver may approximate 0.7 at constant infusion with 1-2 mM ethanol, suggesting that ADH plays a major but not the exclusive role in governing hepatic ethanol metabolism. The reported steady-state rat liver perfusion system may potentially be applicable to other drug or drug-ethanol interaction studies.     

Slime production, adherence and hydrophobicity in coagulase-negative staphylococci causing peritonitis in peritoneal dialysis

Attachment of coagulase-negative staphylococci to plastic surfaces by means of hydrophobic interaction and slime production may be important in producing catheter associated infections. In continuous ambulatory peritoneal dialysis (CAPD), the relationship between these properties and disease is unclear and the effect of dialysate fluid is not considered. For a collection of coagulase-negative staphylococci from CAPD patients, slime production and adherence were measured by colorimetric methods and hydrophobicity was determined by autoaggregation in ammonium sulphate solution. Comparison of 73 nasal isolates with 69 isolates from peritonitis showed no significant differences with respect to three properties, with the exception of a greater adherence of peritoneal isolates in dialysate because of a greater proportion of staphylococcal species other than Staphylococcus epidermidis. Fewer strains showed adherence in dialysate ( 8·5%) than in broth ( 66%) but the proportion of strains producing slime was similar. The milieu of the bacteria rather than the organisms themselves may be of greater importance in the establishment of infection.     

Dietary magnesium intake and risk of incident coronary heart disease in men: A prospective cohort study

We studied 85,975 Japanese subjects by questionnaire at baseline (age 45–65 years, no histories of CVD or cancer) in 1995 and 1998, and were followed until the end of 2009 and 2010 in Cohorts I and II, respectively. Dietary magnesium intake was estimated from a self-administered 138 item food-frequency questionnaire. Confounding variables were used for age, smoking, alcohol, body mass index, history of diabetes, medication of antihypertensive drug and anti-lipidemic drug users, regular exercise, public health centers, foods (vegetables and fish), dietary energy and minerals (salt, calcium, and potassium).

1. Download high-res image (179KB)
2. Download full-size image

     

Dose and accumulative effects of spent lubricating oil on four common mangrove plants in South China

The growth of four mangrove species seedlings, namely Bruguiera gymnorrhiza, Kandelia obovata, Aegiceras corniculatum and Acanthus ilicifolius in sediments contaminated by spent lubricating oil, even at the lowest oil dose (2.5 L m⁻²), showed different degrees of sub-lethal damages. All the seedlings of K. obovata and A. corniculatum were killed at 10 L m⁻² oil, while the lethal oil dose was 15 L m⁻² for A. ilicifolius seedlings. B. gymnorrhiza was the most tolerant species to oil pollution, which could survive under the highest oil dose treatment (15 L m⁻²). Biochemical responses including superoxide radical (O₂⁻) release, superoxide dismutase (SOD) activity and malonyldialdehyde (MDA) content in both leaves and roots of the oil-treated seedlings were increased significantly with oil dose, and presented a positive relationship with leaf and root biomass.     

Potato consumption is prospectively associated with risk of hypertension: An 11.3-year longitudinal cohort study

1. Download : Download high-res image (168KB)
2. Download : Download full-size image