Molecular epidemiology of extended-spectrum β-lactamase-producing Klebsiella pneumoniae strains in a university hospital in Tunis,Tunisia, 1999–2005

During a period of 6 years and 5 months (January 1999 to May 2005), 103 extended-spectrum β-lactamase (ESBL)-producing Klebsiella pneumoniae isolates, each from an individual patient or site, were collected at Mongi Slim University Hospital Centre, Tunis, Tunisia. The objectives of our work were the characterization of the bla genes encoding ESBLs, the investigation of clonal diversity of strains, and identification of the transmission modes of the resistance genes. We carried out detection by PCR and sequencing of the bla_SHV, bla_CTX-M and bla_TEM genes, transferability studies, plasmid replicon typing, and analysis by multilocus sequence typing (MLST) on selected isolates. Forty-seven isolates were found to be producers of CTX-M-type ESBLs, of which 43 were CTX-M-15, two CTX-M-14 and two CTX-M-27. Fifty-eight isolates were producers of SHV-12, and three were producers of SHV-2a. More than one ESBL was detected in seven isolates, as five produced both CTX-M-15 and SHV-12, and two produced both CTX-M-27 and SHV-12. By a PCR-based replicon typing method, the plasmids carrying the bla_SHV-2a or bla_CTX-M-15 genes were assigned to IncFII or, more rarely, to IncL/M types. Of 12 plasmids carrying the bla_SHV-12 gene, only one could be typed: it was positive for the H12 replicon. The MLST results showed large genetic background diversity in the SHV-12-producing isolates and dissemination of specific clones of the CTX-M-15-producing isolates within the same ward and among wards, and suggested endemicity with horizontal dissemination of the bla_CTX-M-15 and the bla_SHV-12 genes.     

Heat-Killed Mycobacterium bovis-Bacillus Calmette Guerin-Suppressed Total Serum IgE Response in Ovalbumin-Sensitized Newborn Mice

To determine the impact of bacillus Calmette Guerin (BCG) vaccination on IgE production in ovalbumin (OVA)-sensitized newborn mice, four groups (I, II, III, IV) of BALB/c mice were immunized on the first day of life with live BCG, killed BCG, BCG diluent, and saline, respectively. No injection was applied to mice in group V (control). All mice except group V were sensitized and challenged with OVA in the fourth and sixth weeks, respectively, and serum total IgE levels were determined at 8 weeks, 2 weeks after the second OVA challenge. IgE levels of all groups were significantly higher than the control group except for group II (p = 0.95). Mice in group II showed significantly lower IgE values than group IV and I (p = 0.007 and p = 0.003, respectively). We concluded that heat-killed BCG may downregulate IgE response to OVA in newborn mice.     

The effect of body mass index on functional outcome,pain, and postoperative complications in shoulder arthroplasty after a proximal humerus fracture

BackgroundAlthough shoulder arthroplasty often gives a reliable improvement in shoulder pain and function after proximal humeral fractures (PHFs), one must consider the risk of complications. The purpose of this study was to investigate whether body mass index (BMI) is associated with an increased risk of complications or worse postoperative shoulder function after reverse shoulder arthroplasty (RSA) or hemiarthroplasty (HA) in patients with PHF.MethodsThis study included 233 patients who underwent HA or RSA after PHF in the Ryhov Teaching Hospital between 2006 and 2018. Data collected include age, gender, BMI, preoperative and postoperative Constant score, preoperative and postoperative visual analogue scale (VAS) score during rest and activity, postoperative complications, and patient satisfaction.ResultsAnalysis was made in HA and RSA patients separately. The HA and RSA patients were divided into three groups based on their BMI. Group I consisted of patients with a BMI <25 kg/m², group II consisted of patients with a BMI between 25 and 29.9 kg/m², and group III consisted of patients with a BMI > 30 kg/m². We found no statistically significant difference between BMI groups regarding postoperative Constant score, postoperative VAS score during rest, postoperative VAS score during activity, postoperative complications, and patient satisfaction in neither HA patients nor RSA patients.ConclusionThis study showed that BMI did not affect the risk of postoperative complications or bad functional outcome after treatment of PHF with HA or RSA.     

Antimicrobial susceptibility of Bacillus anthracis in an endemic area

We aimed to test the antimicrobial susceptibility of 28 Bacillus anthracis strains isolated from cutaneous anthrax cases to various antimicrobial agents using the Sceptor automatic system in an anthrax endemic area. All strains tested were susceptible to penicillin (MIC < or = 0.03 microg/ml). Piperacillin-tazobactam and carbapenems showed good activity towards all strains. Trimethoprim-sulfamethoxazole and cefepime had no activity. Strains were also tested with other antimicrobials.     

评价γ干扰素释放试验在结核病诊断中的临界值

背景：土耳其伊斯坦布尔胸部疾病中心。 目的：通过降低结核菌素皮试（TST）、QuantiFERON-TB Gold（QFT）和GT—SPOT．TB（T-SPOT）试验的临界值，可能会提高基于γ干扰素检测试验在诊断结核上的准确性。 设计：对100例未进行过治疗的培养阳性空洞型结核病人及47例健康志愿者进行对照研究，从而评估在不同临界值时，TST、QFT、T—SPOT试验的诊断效力差异。 结果：各试验的敏感性分别为：TST 70％，QFT 78％，T—SPOT 83．5%，特异性分别为TST 35％，OFT 89．4％，T—SPOT 84．8％，QFT和T-SPOT的特异性都明显高于TST（P值都〈0．001），但QFT和T-SPOT特异性相近（P=0．05）。受试者工作特征曲线分析表明，当QFT临界值为0．818 IU／ml时，特异性最高，敏感性没有明显降低，而降低QFT和T-SPOT的临界值时，也提高了试验的敏感性，特异性却明显降低。 结论：降低TST、QFT、T—SPOT的临界值可以增加相应试验的敏感性，但只有QFT的特异性能够保持不变。     

Cholinergic,but not NMDA,receptors in the lateral entorhinal cortex mediate acquisition in trace eyeblink conditioning

Anatomical and electrophysiological studies collectively suggest that the entorhinal cortex consists of several subregions, each of which is involved in the processing of different types of information. Consistent with this idea, we previously reported that the dorsolateral portion of the entorhinal cortex (DLE), but not the caudomedial portion, is necessary for the expression of a memory association between temporally discontiguous stimuli in trace eyeblink conditioning (Morrissey et al. (2012) J Neurosci 32:5356‐5361). The present study examined whether memory acquisition depends on the DLE and what types of local neurotransmitter mechanisms are involved in memory acquisition and expression. Male Long‐Evans rats experienced trace eyeblink conditioning, in which an auditory conditioned stimulus (CS) was paired with a mildly aversive electric shock to the eyelid (US) with a stimulus‐free interval of 500 ms. Immediately before the conditioning, the rats received a microinfusion of neuroreactive substances into the DLE. We found that reversible inactivation of the DLE with GABA_A receptor agonist, muscimol impaired memory acquisition. Furthermore, blockade of local muscarinic acetylcholine receptors (mACh) with scopolamine retarded memory acquisition while blockade of local NMDA receptors with APV had no effect. Memory expression was not impaired by either type of receptor blocker. These results suggest that the DLE is necessary for memory acquisition, and that acquisition depends on the integrity of local mACh receptor‐dependent firing modulation, but not NMDA receptor‐dependent synaptic plasticity. © 2015 Wiley Periodicals, Inc.