The patient's daily activities in acute psychiatric care

The patient's daily activities in acute psychiatric care
This study is part of a research project entitled:'Towards patient-focused nursing on an acute psychiatric ward'. The aim of the project is to describe the changes taking place in nursing activities during a research project. This paper is a qualitative analysis of the patient's daily activities in acute psychiatric care. The data were collected by observing, selectively, seven patients for 61 h. The constant comparative method was used in data analysis. On the basis of the data analysis, the categories listed below were identified.
1 The core category of the patient's daily activities was'being a patient'.
2 Being a patient mainly consisted of being alone without meaningful activities.
3 Participating in the daily routines of the ward consisted of being alone while being together with others.
4 Being together was initiated by either the patient or the nurse. The aim of being together was to satisfy the acute basic needs of the patients.
5 Being together on the initiative of the nurse meant participating in the daily routines of the ward.
Because the data were collected by observation, no insight into the patients'desires, expectations and thoughts could be presented. The findings challenged the nursing staff to develop a more therapeutic daily routine in acute psychiatric care. It was also of importance to change the patients'meaningless existence into a meaningful participation in the daily activities on the ward.     

Antimicrobial susceptibility of 136 Escherichia coli isolates from cases of neonatal meningitis and relationship with virulence

The susceptibility of 136 Escherichia coli isolates from cases of neonatal meningitis to amoxycillin, ceftriaxone, nalidixic acid, ciprofloxacin and gentamicin was determined in relation to the carriage of virulence factors and phylogenetic group. Only amoxycillin and nalidixic acid resistance was observed (40% and 3%, respectively). Nalidixic acid resistance alone was associated with non-virulent phylogenetic group A (50% vs. 6% of susceptible isolates; p 0.03). No difference in virulence was observed between two representative nalidixic acid-susceptible virulent group B2 isolates and their nalidixic acid-resistant derivatives in a rat model of neonatal meningitis, suggesting that nalidixic acid resistance does not affect the virulence of E. coli strains causing meningitis.     

Surveillance of resistance in bacteria causing community-acquired respiratory tract infections

Bacterial resistance to antibiotics in community-acquired respiratory tract infections is a serious problem and is increasing in prevalence world-wide at an alarming rate. Streptococcus pneumoniae , one of the main organisms implicated in respiratory tract infections, has developed multiple resistance mechanisms to combat the effects of most commonly used classes of antibiotics, particularly the β -lactams (penicillin, aminopenicillins and cephalosporins) and macrolides. Furthermore, multidrug-resistant strains of S. pneumoniae have spread to all regions of the world, often via resistant genetic clones. A similar spread of resistance has been reported for other major respiratory tract pathogens, including Haemophilus influenzae , Moraxella catarrhalis and Streptococcus pyogenes . To develop and support resistance control strategies it is imperative to obtain accurate data on the prevalence, geographic distribution and antibiotic susceptibility of respiratory tract pathogens and how this relates to antibiotic prescribing patterns. In recent years, significant progress has been made in developing longitudinal national and international surveillance programs to monitor antibiotic resistance, such that the prevalence of resistance and underlying trends over time are now well documented for most parts of Europe, and many parts of Asia and the Americas. However, resistance surveillance data from parts of the developing world (regions of Central America, Africa, Asia and Central/Eastern Europe) remain poor. The quantity and quality of surveillance data is very heterogeneous; thus there is a clear need to standardize or validate the data collection, analysis and interpretative criteria used across studies. If disseminated effectively these data can be used to guide empiric antibiotic therapy, and to support—and monitor the impact of—interventions on antibiotic resistance.     

Loss-of-function mutations in caspase recruitment domain-containing protein 14 (CARD14) are associated with a severe variant of atopic dermatitis

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Antimicrobial susceptibility patterns of Staphylococcus aureus in Poland obtained by the National Quality Assurance Programme

As part of the Polish external quality assurance scheme, clinical laboratories were asked to send five consecutive isolates of Staphylococcus aureus and the corresponding susceptibility results to the national Centre of Quality Control in Microbiology. Of 1376 isolates submitted as S. aureus from 276 medical centres, 13 (< 1%) had been misidentified by local laboratories. Of 181 (13.5%) methicillin-resistant S. aureus (MRSA) isolates, most were identified correctly (c. 98% of laboratories). Although all MRSA isolates were fully susceptible to vancomycin, teicoplanin and linezolid, they were usually multiresistant; almost 23% were resistant to seven antimicrobial agents. Most (> 90%) MSSA isolates were susceptible to the tested antibiotics, except penicillin (21% susceptible) and tetracycline (62.4% susceptible). In addition to evaluating the proficiency of testing by local laboratories, the study yielded valuable information regarding the susceptibility patterns of S. aureus isolates in Poland.     

妥布霉素伤用凝胶的体外抗菌作用研究

观察妥布霉素伤用凝胶的体外抗菌活性 ,为临床应用提供试验依据。采用平皿二倍稀释法测定了妥布霉素伤用凝胶对临床分离的 12 0株临床常见的革兰氏阳性及革兰氏阴性菌的体外抗菌作用。以对青霉素敏感的金葡菌、表葡菌、对庆大霉素敏感的大肠杆菌、敏感绿脓杆菌的作用为最强 ,MIC50 均为 0 2 5mg/L。妥布霉素伤用凝胶抗菌谱较广 ,对试验中的革兰氏阳性及革兰氏阴性菌均具有较强的杀灭或抑制作用 ,显示出较好的抗菌活性。     

Staphylococcus epidermidis protease EcpA can be a deleterious component of the skin microbiome in atopic dermatitis

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Human defensins

Antimicrobial peptides are small, cationic, amphiphilic peptides of 12–50 amino acids with microbicidal activity against both bacteria and fungi. The eukaryotic antimicrobial peptides may be divided into four distinct groups according to their structural features: cysteine-free -helices, extended cysteine-free -helices with a predominance of one or two amino acids, loop structures with one intramolecular disulfide bond, and -sheet structures which are stabilised by two or three intramolecular disulfide bonds. Mammalian defensins are part of the last-mentioned group. The mammalian defensins can be subdivided into three main classes according to their structural differences: the -defensins, -defensins and the recently described -defensins. Mammalian -defensins are predominantly found in neutrophils and in small intestinal Paneth cells, whereas mammalian -defensins have been isolated from both leukocytes and epithelial cells. Recently, two novel human -defensins, human beta-defensin-3 (HBD-3), and human beta-defensin-4 (HBD-4) have been discovered. Similar to HBD-1 and HBD-2, HBD-3 has microbicidal activity towards the Gram-negative bacteria (Pseudomonas aeruginosa, Escherichia coli) and the yeasts Candida albicans and Malassezia furfur. In addition, HBD-3 kills Gram-positive bacteria such as Streptococcus pyogenes or Staphylococcus aureus, including multi-resistant S. aureus strains, and even vancomycin-resistant Enterococcus faecium. In contrast to HBD-1 and HBD-2, significant expression of HBD-3 has been demonstrated in non-epithelial tissues, such as leukocytes, heart and skeletal muscle. HBD-4 is expressed in certain epithelia and in neutrophils. Its bactericidal activity against P. aeruginosa is stronger than that of the other known -defensins. Here we present an overview of human antimicrobial peptides with some emphasis on their antifungal properties.J.J. Schneider and A. Unholzer contributed equally to this work     

Inactivation of viruses infecting ectothermic animals by amphibian and piscine antimicrobial peptides

The ability of five purified amphibian antimicrobial peptides (dermaseptin-1, temporin A, magainin I, and II, PGLa), crude peptide fractions isolated from the skin of Rana pipiens and R. catesbeiana, and four antimicrobial peptides (AMPs) from hybrid striped bass (piscidin-1N, -1H, -2, and -3) were examined for their ability to reduce the infectivity of channel catfish virus (CCV) and frog virus 3 (FV3). All compounds, with the exception of magainin I, markedly reduced the infectivity of CCV. In contrast to CCV, FV3 was 2- to 4-fold less sensitive to these agents. Similar to an earlier study employing two other amphibian peptides, the agents used here acted rapidly and over a wide, physiologically relevant, temperature range to reduce virus infectivity. These results extend our previous findings and strongly suggest that various amphibian and piscine AMPs may play important roles in protecting fish and amphibians from pathogenic viruses.     

Evaluation of the WIDER I system for antimicrobial susceptibility testing of clinical isolates of Haemophilus influenzae and Streptococcus pneumoniae

The aim of this study was to evaluate the WIDER I system for susceptibility testing of Haemophilus influenzae and Streptococcus pneumoniae . MICs of 12 antimicrobials against 42 H. influenzae and 58 S. pneumoniae strains were determined using 1W MIC panels and compared with those obtained by microdilution. Overall essential agreements were >99%. Very major errors were not detected. Major errors occurred with ampicillin (1.7% H. influenzae ). Minor errors were 2.3% (amoxicillin–clavulanate, cefuroxime, chloramphenicol), 7.1% (ampicillin) and 16.7% (clarithromycin) for H. influenzae , and 1.7% (chloramphenicol, erythromycin, meropenem), 3.4% (amoxicillin–clavulanate, cefuroxime, tetracycline) and 8.6% (levofloxacin) for S. pneumoniae . The WIDER I system is a reliable method for susceptibility testing of H. influenzae and S. pneumoniae .