Staphylococci as uropathogens-frequency of isolation in hospitalized patients and sensitivity to antimicrobial agents

For a period of 24 months (1997-1999) were isolated 266 clinically significant staphylococcal strains, S. aureus, 36 (13.5%) and 230 (86.5%) coagulase negative staphylococci (CNS) from urines of hospitalised patients (over 14 years) with UTI. The most frequently isolated strains from CNS was S. haemolyicus, 110 (47.8) strains, followed by S. saprophyticus 47 (20.4%) strains and S. epidermidis 18 (7.8%). The susceptibility of the isolates to 13 antimicrobial agents was determined by agar dilution method (NCCLS). From the isolated 36 strains S. aureus, 24 were sensitive and 12 were resistant to methicillin. From 230 CNS, 105 strains showed sensitivity and 125 strains resistance to methicillin. All staphylococci were sensitive to vancomycin and most of them (over 95%) to amikacin and rifampin. It was established a considerable difference between the sensitivity of methicillin-sensitive and methicillin-resistant staphylococci. The established resistance accompanied with high rate percentage methicillin resistance requires careful consideration to antimicrobial therapy of staphylococcal urinary tract infections (UTI).     

Adaptive response of a new radioresistant strain of Chlamydomonas reinhardtii and correlation with increased DNA double-strandbreak rejoining

In order to study the relationship between radioresistance and the adaptive response, we aimed to produce a new strain of Chlamydomonas reinhardtii with characteristics of high radioresistance coupled with a protoplast structure typical for the genus, and the cell-wall-less phenotype to facilitate rapid cell lysis in DNA double-strand break (DSB) assays. The adaptive response of the new strain was investigated using clonogenic and DSB assays. Strain H-3 was derived by mating a radioresistant strain (AK-9-9) with the cell-wall-less mutant CW15 strain and selecting for radioresistance by clonogenic assay. The random amplification of polymorphic DNA (RAPD) molecular marker system was used to evaluate genetic polymorphisms between H-3 and other related C. reinhardtii strains. DSB were estimated using constant-field electrophoresis. Of several mutant strains tested, strain H-3 was shown to be most radioresistant on the basis of dose to give a 90% lethality (LD₉₀) rate and dose to give a 99% lethality rate (LD₉₉). In addition to its high radioresistance and thinner cell wall as compared with that of the other parental strain AK-9-9, H-3 also expressed a radiation-induced adaptive response measured by clonal survival when given a priming dose before a test dose. DSB were also rejoined more rapidly in cells exposed to a priming dose 4 h previously. It is concluded from split-dose experiments that the already highly radioresistant strain H-3 is further capable of ‘over recovery’ or adaptation to radiation exposure. Accelerated DSB rejoining in cells given a priming dose may underlie the cellular adaptive response in this organism.     

In vitro investigation of the susceptibility of Acinetobacter baumannii strains isolated from clinical specimens to ampicillin/sulbactam alone and in combination with amikacin

The sensitivity of 52 strains of Acinetobacter baumannii was determined to 13 antimicrobial drugs. All strains tested were multiresistant. Compared with MICs of amikacin and ampicillin/sulbactam alone, there was a significant decrease in MICs for both drugs when the combination was used. The results of the in vitro study of this combination showed a synergistic or partial synergistic effect in 98% of the strains.     

Health workforce attrition in the public sector in Kenya: a look at the reasons

Background  

Kenya, like many other countries in sub-Saharan Africa, has been affected by shortages of health workers in the public sector. Data on the rates and leading reasons for health workers attrition in the public sector are key in developing effective, evidence-based planning and policy on human resources for health.     

Impact of mutual health organizations: evidence from West Africa

Mutual health organizations (MHOs) are voluntary membership organizations providing health insurance services to their members. MHOs aim to increase access to health care by reducing out-of-pocket payments faced by households. We used multiple regression analysis of household survey data from Ghana, Mali and Senegal to investigate the determinants of enrollment in MHOs, and the impact of MHO membership on use of health care services and on out-of-pocket health care expenditures for outpatient care and hospitalization. We found strong evidence that households headed by women are more likely to enroll in MHOs than households headed by men. Education of the household head is positively associated with MHO enrollment. The evidence on the association between household economic status and MHO enrollment indicates that individuals from the richest quintiles are more likely to be enrolled than anyone else. We did not find evidence that individuals from the poorest quintiles tend to be excluded from MHOs. MHO members are more likely to seek formal health care in Ghana and Mali, although this result was not confirmed in Senegal. While our evidence on whether MHO membership is associated with higher probability of hospitalization is inconclusive, we find that MHO membership offers protection against the potentially catastrophic expenditures related to hospitalization. However, MHO membership does not appear to have a significant effect on out-of-pocket expenditures for curative outpatient care.     

Adaptive response of a new radioresistant strain of Chlamydomonas reinhardtii and correlation with increased DNA double-strandbreak rejoining

In order to study the relationship between radioresistance and the adaptive response, we aimed to produce a new strain of Chlamydomonas reinhardtii with characteristics of high radioresistance coupled with a protoplast structure typical for the genus, and the cell-wall-less phenotype to facilitate rapid cell lysis in DNA double-strand break (DSB) assays. The adaptive response of the new strain was investigated using clonogenic and DSB assays. Strain H-3 was derived by mating a radioresistant strain (AK-9-9) with the cell-wall-less mutant CW15 strain and selecting for radioresistance by clonogenic assay. The random amplification of polymorphic DNA (RAPD) molecular marker system was used to evaluate genetic polymorphisms between H-3 and other related C. reinhardtii strains. DSB were estimated using constant-field electrophoresis. Of several mutant strains tested, strain H-3 was shown to be most radioresistant on the basis of dose to give a 90% lethality (LD90) rate and dose to give a 99% lethality rate (LD99). In addition to its high radioresistance and thinner cell wall as compared with that of the other parental strain AK-9-9, H-3 also expressed a radiation-induced adaptive response measured by clonal survival when given a priming dose before a test dose. DSB were also rejoined more rapidly in cells exposed to a priming dose 4 h previously. It is concluded from split-dose experiments that the already highly radioresistant strain H-3 is further capable of 'over recovery' or adaptation to radiation exposure. Accelerated DSB rejoining in cells given a priming dose may underlie the cellular adaptive response in this organism.     

Genetic variability in Daphnia magna and ecotoxicological evaluation

The fresh water crustacean Daphnia magna is widely used as a test organism in aquatic toxicology to assess the adverse effects of individual substances or complex mixtures, e.g. industrial wastewaters. Cultures are held in several European testing laboratories and testing is typically carried out according to internationally standardised protocols. However, despite accounting for many potential confounding factors these guidelines do not currently take into account any specification related to the use of a specific clone. Cultures from seven laboratories were used to assess genetic variability by random-amplified polymorphic DNA polymerase chain reaction. Results pointed out the existence of two main clone clusters Responses in the acute Daphnia immobilisation test showed no direct correlation with genetic clusters resulting from random genetic markers (random-amplified polymorphic DNA) analysis. Considering that genetic differences are the most probable cause for the ecotoxicological test data, further analysis concerning gene expression and genetic stability should be performed.     

A community-based approach to promote household water treatment in Rwanda

Treatment of drinking water at the household level is one of the most effective preventive interventions against diarrhea, a leading cause of illness and death among children in developing countries. A pilot project in two districts in Rwanda aimed to increase use of S?r'Eau, a chlorine solution for drinking water treatment, through a partnership between community-based health insurance schemes and community health workers who promoted and distributed the product. Evaluation of the pilot, drawing on a difference-in-differences design and data from pre- and post-pilot household surveys of 4,780 households, showed that after 18 months of pilot implementation, knowledge and use of the product increased significantly in two pilot districts, but remained unchanged in a control district. The pilot was associated with a 40-42 percentage point increase in ever use, and 8-9 percentage points increase in use of S?r'Eau at time of the survey (self-reported measures). Our data suggest that exposure to inter-personal communication on S?r'Eau and hearing about the product at community meetings and health centers were associated with an increase in use.