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Objective: To evaluate the serotype distribution and antibiotic resistance in pneumococcal infections in adults and to provide a perspective regarding serotype coverage of both current and future pneumococcal vaccines. Patients and methods: This passive surveillance study was conducted with the Streptococcus pneumoniae strains isolated from the specimens of patients with pneumonia (materials isolated from bronchoalveolar lavage), bacteraemia, meningitis, pleuritis and peritonitis between 2015 and 2018. Serogrouping and serotyping were performed by latex particle agglutination and by conventional Quellung reaction using commercial type-specific antisera, respectively. The strains were analysed for penicillin, cefotaxime, erythromycin and moxifloxacin susceptibilities by E-test. Results: In the whole study group (410 samples from adults aged ≥18 years), the most frequent serotypes were 3 (14.1%), 19 F (12%) and 1 (9.3%). The vaccine coverage for PCV13, PCV15, PCV20 and PPV23 was 63.9%, 66.6%, 74.1% and 75.9%, respectively, in all isolates. Penicillin non-susceptibility in invasive pneumococcal disease (IPD) was 70.8% and 57.1% in the patients aged

Hepatitis would be related to non-hepatotropic virus. A 6-year-old boy was presented with acute hepatitis finding. He had specific rashes for scarlet fever. His liver was enlarged and liver enzyme was elevated. Other reasons of acute viral hepatitis were excluded. Liver enzymes were normalized after appropriate antibotherapy. We aimed to remind unusual presentation of scarlet fever and uncommon reasons of acute hepatitis. © 2021 University of the West Indies. All rights reserved.

Copper (Cu) is an essential element, however it's excess into the environment causes detrimental effect on plant and risks for public health. Four Cu and drought tolerant 1-aminocyclopropane-1-carboxylate (ACC) deaminase producing rhizobacteria were isolated from the roots of Trifolium repens L. growing on Cu smelter contaminated soils, characterized and identified based on 16S rRNA gene sequencing. A consortium of high ACC deaminase (53.74 μM α-ketobutyrate mg−1 protein h−1) producing bacteria Pseudomonas sp. strain TR15a + siderophore producing Bacillus aerophilus strain TR15c significantly (p < 0.05) produced better results for multiple-metal tolerance including Cu (1750 mg kg−1), antibiotic resistance (ampicillin, kanamycin, chloramphenicol, penicillin, tetracycline, and streptomycin) and plant growth promoting attributes (phosphate solubilization: 315 mg L−1, indole-3-acetic acid (IAA) production: 8 mg L−1, ammonia and hydrogen cyanide production) as compared to individual isolates. Pot scale experiment (enriched with 100 mg Cu kg−1) showed inoculation of Helianthus annuus seeds with consortium of TR15a + TR15c had significantly (p < 0.05) improved seed germination by 32%, total dry biomass by 64%, root Cu by 47% and shoot Cu by 75% as compared to uninoculated control whereas 0.2−7 fold higher results were observed for above stated parameters as compared to four individual isolates studied. The result suggests consortium of ACC deaminase producing Pseudomonas sp. TR15a and siderophore producing B. aerophilus TR15c could play a vital role in enhanced Cu uptake and improvement of biomass and may provide a better alternative for decontamination of Cu contaminated natural ecosystem than individual isolates. © 2021 Elsevier Ltd. The authors acknowledge the work support by RFBR, Russia (Project No. 19-516-45006) and DST, India (INT/ RUS / RFBR /363) and the Ministry of Science and Higher Education of the Russian Federation (agreement No. 02.A03.21.0006). We also thank Prof. Katarzyna Turnau and Rafal Wazny, Department of Bioremediation, Malopolska Center of Biotechnology, University of Jagiellonian, Krakow for giving assistance in identification of isolated rhizobacteria.

Indexado en Scopus Self-medication impacts both negatively and positively the health of people, which has become evident during the COVID-19 pandemic. The study aimed to assess the prevalence of self-medicated drugs used for respiratory symptoms, as COVID-19 preventive, for its symptoms or once tested positive. To determine the perception of symptom relief and demographic variables that promote self-medication in Peru. We performed a cross-sectional, analytical, multicenter study in 3792 study respondents on the use, the reason for use, and perception of relief after the use of six drugs during the quarantine period. An online questionnaire was developed, pretested and submitted to the general public. Multivariable logistic regression was used to ascertain factors that influence an individual's desire to self-medicate, associations were considered significant at p < 0.05 and using region (coast, mountain and jungle) as cluster group. The majority of respondents self-medicated with acetaminophen for respiratory symptoms and mainly because they had a cold or flu. It was observed that all the surveyed drugs (acetaminophen, ibuprofen, azithromycin, penicillin, antiretrovirals and hydroxychloroquine) were consumed for various symptoms including: fever, fatigue, cough, sneezing, muscle pain, nasal congestion, sore throat, headache and breathing difficulty. Over 90% of respondents perceived relief of at least one symptom. Multivariable logistic regression showed that older people have a higher frequency of antiretroviral self-medication, respondents who currently have a job had a higher frequency of penicillin self-medication, and that respondents from the Andes consumed less acetaminophen, while the ones from the rainforest consumed it more. There were significant percentages of self-medication, including drugs without sufficient scientific evidence. Age, region where one lived and job status were variables associated with self-medication frequency. Continuous awareness and sensitization about the risks of self-medication are warranted. info:eu-repo/semantics/publishedVersion Revisión por pares

The vast majority of the microscopy methods currently available to study biological samples require staining prior to imaging. Nevertheless, the ability to reveal specific cell structures or organelles in a label-free manner remains desirable in different contexts. Polarization microscopy has long been considered as an interesting alternative to fluorescence-based methods in order to gain specificity on the imaged biological samples. In this work, we show how an original polarization imaging technique, implementing micro-wave photonics and referred to as orthogonality-breaking (OB) microscopy, can provide informative polarization images from a single scan of the cell sample in a fast and sensitive way. For OB imaging, the sample is probed with a laser setup simultaneously generating two orthogonal polarizations shifted in frequency by a few tens of MHz. If the imaged samples display some polarimetric properties, the orthogonality between the two polarizations is broken, leading to a beatnote interference signal that can be detected with a fast detector. The comparison of the images of various cell lines at different cell-cycle stages obtained by OB polarization microscopy and fluorescence confocal images shows that an endogenous polarimetric contrast arizes on compacted chromosomes during cell division. This technique paves the way to label-free real-time polarization imaging of mitotic chromosomes with further potential applications in histology and cancer diagnosis.

Objective: Streptococcus pneumoniae is the most frequent bacterial pathogen isolated in subjects with Community-acquired pneumonia (CAP) worldwide. Limited data are available regarding the current global burden and risk factors associated with drug-resistant Streptococcus pneumoniae (DRSP) in CAP subjects. We assessed the multinational prevalence and risk factors for DRSP-CAP in a multinational point-prevalence study. Design: The prevalence of DRSP-CAP was assessed by identification of DRSP in blood or respiratory samples among adults hospitalized with CAP in 54 countries. Prevalence and risk factors were compared among subjects that had microbiological testing and antibiotic susceptibility data. Multivariate logistic regressions were used to identify risk factors independently associated with DRSP-CAP. Results: 3,193 subjects were included in the study. The global prevalence of DRSP-CAP was 1.3% and continental prevalence rates were 7.0% in Africa, 1.2% in Asia, and 1.0% in South America, Europe, and North America, respectively. Macrolide resistance was most frequently identified in subjects with DRSP-CAP (0.6%) followed by penicillin resistance (0.5%). Subjects in Africa were more likely to have DRSP-CAP (OR: 7.6; 95% CI: 3.34-15.35, p < 0.001) when compared to centres representing other continents. Conclusions: This multinational point-prevalence study found a low global prevalence of DRSP-CAP that may impact guideline development and antimicrobial policies. Published by Elsevier Ltd on behalf of The British Infection Association.

Background: Pneumococcal conjugate vaccines have reduced the incidence of invasive pneumococcal disease, caused by vaccine serotypes, but non-vaccine-serotypes remain a concern. We used whole genome sequencing to study pneumococcal serotype, antibiotic resistance and invasiveness, in the context of genetic background. Methods: Our dataset of 13,454 genomes, combined with four published genomic datasets, represented Africa (40%), Asia (25%), Europe (19%), North America (12%), and South America (5%). These 20,027 pneumococcal genomes were clustered into lineages using PopPUNK, and named Global Pneumococcal Sequence Clusters (GPSCs). From our dataset, we additionally derived serotype and sequence type, and predicted antibiotic sensitivity. We then measured invasiveness using odds ratios, relating prevalence in disease to carriage. Findings: The combined collections (n=20,027) were clustered into 621 GPSCs. Thirty-five GPSCs observed in our dataset were represented by >100 isolates, and subsequently classed as dominant-GPSCs. In 22/35 (63%) of dominant-GPSCs both non-vaccine serotypes and vaccine serotypes were observed pre-PCV. Penicillin and multidrug resistance were higher (p

Organic fertilizers became a better alternative to chemical fertilizers in modern agricultural practices however, contamination of copper (Cu) from organic fertilizer is still a major concern for the globe. Plant growth promoting (PGP) microorganisms showed their efficiency to combat with this problem and thus Cu tolerant PGP endophytes from roots of Odontarrhena obovata (Alyssum obovatum) growing on Cu smelter contaminated serpentine soil were explored in present study. Out of twenty-four isolates, Pseudomonas lurida strain EOO26 identified by 16s rRNA gene sequencing was selected to check its efficacy for Cu-remediation. The strain EOO26 showed multi-metal tolerance, drought resistance and exhibited PGP attributes such as 1-aminocyclopropane-1-carboxylic acid (ACC) deaminase, siderophore and ammonia production. Significant production of indole-3-acetic acid and phosphate-solubilization under different Cu concentration (0–100 mg L−1) at varying pH (5.0–8.0) suggests potentiality of this strain to work effectively under wide range of abiotic stress conditions. Plant growth experiment (pH 6.8 ± 0.3) in copper spiked soil suggested a significant increase in length and dry weight of root and shoot of sunflower (Helianthus annuus) after inoculation with strain EOO26. Plants inoculated with strain EOO26 resulted in increase in Cu uptake by 8.6-fold for roots and 1.9-fold for leaves than uninoculated plants. The total plant uptake in inoculated Cu treatment was 2.6-fold higher than uninoculated one, which is much higher than the previously reported Cu accumulating plants. The excellent adaptation abilities and promising metal removal efficiency strongly indicate superiority of strain EOO26 for phytoremediation of Cu-contamination and may work effectively for Cu removal from contaminated soils. © 2020 Elsevier Ltd Science and Engineering Research Board, SERB; Department of Science and Technology, Government of West Bengal, DST: INT/ RUS / RFBR /363; Ministry of Science and Higher Education of the Russian Federation The authors acknowledge the work support by RFBR , Russia (Project No. 19-516-45006) and DST , India (INT/ RUS / RFBR /363) and the Ministry of Science and Higher Education of the Russian Federation (Agreement No. 02.A03.21.0006). L.B.B thankful to the Science and Engineering Research Board (SERB), India for providing National Post-Doctoral Fellowship (Grant No. PDF/2017/001074 ).

Background: Irritable bowel syndrome (IBS) is a common gastrointestinal disorder associated with altered gastrointestinal microflora and increased nociception to colonic distension. This visceral hypersensitivity can be reversed in our rat maternal separation model by fungicides. Menthacarin® is a proprietary combination of essential oils from Mentha x piperita L. and Carum carvi. Because these oils exhibit antifungal and antibacterial properties, we investigated whether Menthacarin® can reverse existing visceral hypersensitivity in maternally separated rats. Methods: In non-handled and maternally separated rats, we used the visceromotor responses to colorectal distension as measure for visceral sensitivity. We evaluated this response before and 24 hours after water-avoidance stress and after 7 days treatment with Menthacarin® or control. The pre- and post-treatment mycobiome and microbiome were characterized by sequencing of fungal internal transcribed spacer 1 (ITS-1) and bacterial 16s rDNA regions. In vitro antifungal and antimicrobial properties of Menthacarin® were studied with radial diffusion assay. Key Results: Menthacarin® inhibited in vitro growth of yeast and bacteria. Water-avoidance caused visceral hypersensitivity in maternally separated rats, and this was reversed by treatment. Multivariate analyses of ITS-1 and 16S high throughput data showed that maternal separation, induced changes in the myco- and microbiome. Menthacarin® treatment of non-handled and maternally separated rats shifted the mycobiomes to more similar compositions. Conclusions & Inferences: The development of visceral hypersensitivity in maternally separated rats and the Menthacarin®-mediated reversal of hypersensitivity is associated with changes in the mycobiome. Therefore, Menthacarin® may be a safe and effective treatment option that should be tested for IBS. © 2018 The Authors. Neurogastroenterology & Motility Published by John Wiley & Sons Ltd. Chemicals / CAS: decanoic acid, 334-48-5, 3398-75-2; fluconazole, 86386-73-4; octanoic acid, 124-07-2, 1984-06-1, 74-81-7; peppermint oil, 8006-90-4; streptomycin, 57-92-1

Background: Irritable bowel syndrome (IBS) is a common gastrointestinal disorder associated with altered gastrointestinal microflora and increased nociception to colonic distension. This visceral hypersensitivity can be reversed in our rat maternal separation model by fungicides. Menthacarin® is a proprietary combination of essential oils from Mentha x piperita L. and Carum carvi. Because these oils exhibit antifungal and antibacterial properties, we investigated whether Menthacarin® can reverse existing visceral hypersensitivity in maternally separated rats. Methods: In non-handled and maternally separated rats, we used the visceromotor responses to colorectal distension as measure for visceral sensitivity. We evaluated this response before and 24 hours after water-avoidance stress and after 7 days treatment with Menthacarin® or control. The pre- and post-treatment mycobiome and microbiome were characterized by sequencing of fungal internal transcribed spacer 1 (ITS-1) and bacterial 16s rDNA regions. In vitro antifungal and antimicrobial properties of Menthacarin® were studied with radial diffusion assay. Key Results: Menthacarin® inhibited in vitro growth of yeast and bacteria. Water-avoidance caused visceral hypersensitivity in maternally separated rats, and this was reversed by treatment. Multivariate analyses of ITS-1 and 16S high throughput data showed that maternal separation, induced changes in the myco- and microbiome. Menthacarin® treatment of non-handled and maternally separated rats shifted the mycobiomes to more similar compositions. Conclusions & Inferences: The development of visceral hypersensitivity in maternally separated rats and the Menthacarin®-mediated reversal of hypersensitivity is associated with changes in the mycobiome. Therefore, Menthacarin® may be a safe and effective treatment option that should be tested for IBS. © 2018 The Authors. Neurogastroenterology & Motility Published by John Wiley & Sons Ltd. Chemicals / CAS: decanoic acid, 334-48-5, 3398-75-2; fluconazole, 86386-73-4; octanoic acid, 124-07-2, 1984-06-1, 74-81-7; peppermint oil, 8006-90-4; streptomycin, 57-92-1

PurposeTo describe the prescription of antibiotics before, during and after pregnancy, and the trends over a 16-year period in the Netherlands, and to determine whether they were prescribed according to national guidelines.MethodsThe IADB (http://iadb.nl) contains prescriptions dispensed by community pharmacies in the Netherlands. We extracted information on 18873 pregnancies for 14969 women between 1994 and 2009, focusing on antibiotics dispensed in the four trimesters before conception to two trimesters after birth (nine trimesters in total). We calculated trends in prescription rates during pregnancy and over time, and also compared the prescription of antibiotics in the Netherlands with safety category based on the Australian Drug Evaluation Committee.ResultsDuring pregnancy 20.8% of the women were prescribed at least one antibiotic. The beta-lactam antibacterials/penicillins' group and the specific antibiotic amoxicillin were most commonly prescribed in the nine trimesters covered. The prescription rate of the other antibacterials' group during pregnancy increased over the years, in contrast to that of the sulphonamides/trimethoprim' group, which decreased. In total, 2.0% of pregnancies were exposed to a potentially harmful' antibiotic and 0.8% to a harmful' antibiotic. Compared with the period before conception, safe' antibiotics were prescribed more often during pregnancy than the other groups.ConclusionsOne in five women was prescribed at least one antibiotic during pregnancy in the Netherlands, which is comparable with rates in other European countries. Our results suggest that antibiotics appear to be prescribed to pregnant women generally in accordance with national recommendations. Copyright (c) 2013 John Wiley & Sons, Ltd.

In the present research, the 20 lactobacilli isolated from children feces aged 4-15 years old were investigated for their capabilities to survive at pH 2.0, 2.5, 3.0 and in the presence of 0.25, 0.50 and 0.75% bile salts, their effect on the growth of pathogens, in addition to their sensitivity against 13 selected antibiotics. All the lactobacilli strains were able to survive in low pH and bile salt conditions at pH 2.0 and 0.25% bile salt for 2 h. Moreover, all lactobacilli strains exhibited inhibitory activity against Escherichia coli ATCC 11229, Pseudomonas aeruginosa ATCC 27853 and Staphylococcus aureus ATCC 29213. In addition, all lactobacilli strains indicated resistance to teicoplanin, vancomycin, and bacitracin. The amount of exopolysaccharide (EPS) produced by the strains was 70 and 290 mg/L. The capabilities to autoaggregation and coaggregate with E. coli ATCC 11229 of the strains were also evaluated. High EPS-producing strains indicated significant autoaggregation and coaggregation capability with test bacteria (p < 0.01). The maximum cholesterol removal (76.5%) was observed by strain Lactobacillus pentosus T3, producing a high amount of exopolysaccharide, in 0.3%oxgall concentration (p < 0.05). Our results demonstrate that the capability to EPS production, acid-bile tolerance, antimicrobial activity, antibiotic resistance, aggregation and cholesterol removal of lactobacilli could be utilized for preliminary screening in order to identify potentially probiotic bacteria suitable for human. (C) 2013 Elsevier Ltd. All rights reserved.

The objective of this study was to determine the prevalence and molecular typing of methicillin-susceptible Staphylococcus aureus (MSSA) and methicillin-resistant S. aureus (MRSA) in food-producing animals and retail meat in Fargo, North Dakota. A two-step enrichment followed by culture methods were used to isolate S. aureus from 167 nasal swabs from animals, 145 samples of retail raw meat, and 46 samples of deli meat. Positive isolates were subjected to multiplex polymerase chain reaction in order to identify the genes 16S rRNA, mecA, and Panton-Valentine Leukocidin. Pulsed-field gel electrophoresis and multilocus sequence typing were used for molecular typing of S. aureus strains. Antimicrobial susceptibility testing was carried out using the broth microdilution method. The overall prevalence of S. aureus was 37.2% (n = 133), with 34.7% (n = 58) of the animals positive for the organism, and the highest prevalence observed in pigs (50.0%) and sheep (40.6%) (p < 0.05); 47.6% (n = 69) of raw meat samples were positive, with the highest prevalence in chicken (67.6%) and pork (49.3%) (p < 0.05); and 13.0% (n = 6) of deli meat was positive. Five pork samples (7.0%) were positive for MRSA, of which three were ST398 and two were ST5. All exhibited penicillin resistance and four were multidrug resistant (MDR). The Panton-Valentine Leukocidin gene was not detected in any sample by multiplex polymerase chain reaction. The most common clones in sheep were ST398 and ST133, in pigs and pork both ST398 and ST9, and in chicken ST5. Most susceptible S. aureus strains were ST5 isolated from chicken. The MDR isolates were found in pigs, pork, and sheep. The presence of MRSA, MDR, and the subtype ST398 in the meat production chain and the genetic similarity between strains of porcine origin (meat and animals) suggest the possible contamination of meat during slaughtering and its potential transmission to humans. College of Agriculture, Food Systems and Natural Resources College, North Dakota State University College of Veterinary Medicine, Iowa State University

Actinomycosis is a chronic granulomatous infection that commonly occurs in the cervicofacial region. Although Actinomcyes is an element of the normal oral flora, infections of the facial skin are very rare because of the entirely endogenous habitation of the organism. The authors report a case of facial actinomycosis, which mimicked a cutaneous tumor both clinically and surgically in a 44-year-old woman with chronic renal failure and Hepatitis C viral infection. The majority of cases can be treated with long-term antibiotics. However, a treatment-resistant abscess, a fistula, or postsurgical excision of the mass formation that are infected can be treated with antibiotics as soon as possible, and recurrence of infection is prevented. The treatment should consist of conservative surgery to obtain a firm histological diagnosis and to drain any collections.

Objective: To provide an update to "Surviving Sepsis Campaign Guidelines for Management of Sepsis and Septic Shock: 2012." Design: A consensus committee of 55 international experts representing 25 international organizations was convened. Nominal groups were assembled at key international meetings (for those committee members attending the conference). A formal conflict-of-interest (COI) policy was developed at the onset of the process and enforced throughout. A stand-alone meeting was held for all panel members in December 2015. Teleconferences and electronic-based discussion among subgroups and among the entire committee served as an integral part of the development. Methods: The panel consisted of five sections: hemodynamics infection adjunctive therapies metabolic and ventilation. Population, intervention, comparison, and outcomes (PICO) questions were reviewed and updated as needed, and evidence profiles were generated. Each subgroup generated a list of questions, searched for best available evidence, and then followed the principles of the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) system to assess the quality of evidence from high to very low, and to formulate recommendations as strong or weak, or best practice statement when applicable. Results: The Surviving Sepsis Guideline panel provided 93 statements on early management and resuscitation of patients with sepsis or septic shock. Overall, 32 were strong recommendations, 39 were weak recommendations, and 18 were best-practice statements. No recommendation was provided for four questions. Conclusions: Substantial agreement exists among a large cohort of international experts regarding many strong recommendations for the best care of patients with sepsis. Although a significant number of aspects of care have relatively weak support, evidence-based recommendations regarding the acute management of sepsis and septic shock are the foundation of improved outcomes for these critically ill patients with high mortality. © 2016 by the Society of Critical Care Medicine and Wolters Kluwer Health, Inc. All Rights Reserved.

WOS: 000382446000075, Enterococci, which have useful biotechnological applications, produce bacteriocins, including those that exert anti-Listerial activity. The present study aimed to determine the antibiotic susceptibility patterns and antimicrobial activity of Enterococcus faecium strains isolated from human breast milk. The strains were identified using carbohydrate fermentation tests and ribotyping. Subsequently, the antibacterial activity of the isolates was investigated, and the quantities of lactic acid and hydrogen peroxide produced, and the proteolytic activity of E. faecium, were determined. In addition, biofilm formation by E. faecium strains was assessed. E. faecium strains exhibited antimicrobial activity against food-borne and clinical bacterial isolates. Furthermore, following 24 h incubation, the tested strains exhibited resistance to a pH range of 2.0-9.5 and tolerance of bile acid, lysozyme activity and phenol. Supernatants of the E. faecium TM13, TM15, TM17 and TM18 strains were shown to be effective against Listeria monocytogenes, and were also resistant to heat. Further studies are required in order to determine whether certain strains of E. faecium may be used for the development of novel antibacterial agents., Anadolu University Council of Research Project Fund [41020], The present study was supported by the Anadolu University Council of Research Project Fund (grant no. 41020).

Gökmen, Mukadderat (Balikesir Author), Methicillin-Resistant Staphylococcus aureus is an important pathogen that causes severe infections in humans and animals. The aim of this study was to determine the prevalence and the antimicrobial profile of methicillin-resistant S. aureus (MRSA) in cow bulk tank milk and dairy products in the region of Balikesir in Turkey. Of 175 milk and dairy products' samples, 26 were found to be positive for coagulase-positive staphylococci and 3 (2 samples from cow bulk tank milk and 1 sample from tulum cheese) were MRSA phenotypically being resistant against both oxacillin and cefoxitin. Among these, 17 were confirmed as S. aureus by the detection of nuc gene and one as MRSA carrying the mecA gene. All MRSA isolates were found to be also resistant against ampicillin, penicillin and sulfamethoxazole-trimethoprim. Consequently, even though the prevalence of MRSA in cow bulk tank milk and dairy products was relatively low (1.70%), it may pose serious risks in terms of food safety and public health. In order to prevent the prevalence of MRSA in dairy products, hygienic measures, especially in terms of personal hygiene and disinfection of equipment in all stages of dairy production, should be taken, and HACCP and GMP regulations should be implemented.

JUSTIFICATIVA E OBJETIVOS: Com base nos conhecimentos sobre a ação antiinflamatória e antibacteriana dos anestésicos locais (AL) o estudo teve como objetivo determinar o efeito da lavagem peritoneal com solução de bupivacaína na sobrevida de ratos com peritonite fecal por fezes autógenas. MÉTODO: Foram utilizados 48 ratos da linhagem Wistar, com peso entre 300 g e 330 g (311,45 ± 9,67), submetidos à laparotomia seis horas após a indução de peritonite, distribuídos aleatoriamente em quatro grupos: 1 - Controle, nenhum tratamento (n = 12); 2 - Enxugamento da cavidade abdominal (n = 12); 3 - Lavagem da cavidade abdominal com 3 mL de solução fisiológica a 0,9% e enxugamento (n = 12); 4 - Lavagem da cavidade abdominal com 8 mg.kg-1 (± 0,5 mL) de bupivacaína 0,5%, adicionada a 2,5 mL de solução fisiológica a 0,9% e enxugamento (n = 12). Os animais que faleceram foram necropsiados e o horário do óbito foi anotado. Os animais sobreviventes foram mortos no 11° dia do pós-operatório e realizou-se a necropsia. RESULTADOS: Houve 100% de mortalidade nos animais do Grupo 1, em 52 horas, 100% nos animais do Grupo 2, em 126 horas e 50% nos animais do Grupo 3 em 50 horas. Os animais do Grupo 4 sobreviveram. A sobrevida, no 11º dia de pós-operatório, foi maior nos grupos 3 e 4 com relação aos grupos 1 e 2 (p < 0,001) e maior nos Grupo 4 com relação ao Grupo 3 (p < 0,01). CONCLUSÕES: A lavagem peritoneal com solução de bupivacaína diluída em solução fisiológica foi eficaz para evitar o óbito, por 11 dias, em 100% dos animais com peritonite fecal. BACKGROUND AND OBJECTIVES: Based on the knowledge of the anti-inflammatory and anti-bacterial actions of local anesthetics (LA), the objective of this study was to determine the effects of peritoneal lavage with bupivacaine on survival of mice with fecal peritonitis. METHODS: Forty-eight Wistar mice, weighing between 300 and 330 g (311.45 ± 9.67 g), undergoing laparotomy 6 hours after induction of peritonitis were randomly divided in 4 groups: 1 - Control, without treatment (n = 12); 2 - Drying of the abdominal cavity (n = 12); 3 - Lavage with 3 mL NS and posterior drying of the abdominal cavity (n = 12); and 4 - Lavage with 8 mg.kg-1 (± 0.5 mL) of 0.5% bupivacaine added to 2.5 mL of NS followed by drying out of the abdominal cavity (n = 12). Animals that died underwent necropsy and the time of death was recorded. Surviving animals were killed on the 11th postoperative day and underwent necropsy. RESULTS: Group 1 presented a 100% mortality rate in 52 hours, 100% mortality rate in Group 2 in 126 hours, and Group 3 presented a 50% mortality rate in 50 hours. Animals in Group 4 survived. Survival on the 11th day was greater in groups 3 and 4 than in Groups 1 and 2 (p < 0.001) and greater in Group 4 than in Group 3 (p < 0.01). CONCLUSIONS: Peritoneal lavage with a solution of bupivacaine diluted in NS was effective in preventing death for 11 days in 100% of animals with fecal peritonitis. JUSTIFICATIVA Y OBJETIVOS: Basados en los conocimientos sobre la acción antiinflamatoria y antibacteriana de los anestésicos locales (AL), el estudio tuvo el objetivo de verificar el efecto del lavado peritoneal con solución de bupivacaína en la sobrevida de ratones con peritonitis fecal por heces autógenas. MÉTODO: Se usaron 48 ratones de la raza Wistar, con peso entre 300 g y 330 g (311,45 ± 9,67), sometidos a la laparotomía 6 horas después de la inducción de peritonitis, distribuidos aleatoriamente en 4 grupos: 1 - Control, ningún tratamiento (n = 12); 2 - Secado de la cavidad abdominal (n = 12); 3 - Lavado de la cavidad abdominal con 3 mL de solución fisiológica a 0,9% y secado (n = 12); 4 - Lavado de la cavidad abdominal con 8 mg.kg-1 (± 0,5 mL) de bupivacaína 0,5%, adicionada a 2,5 mL de solución fisiológica a 0,9% y secado (n = 12). Los animales que murieron fueron llevados a necropsia y el horario del óbito se anotó. Los animales sobrevivientes se sacrificaron al 11º día del postoperatorio y se realizó la necropsia. RESULTADOS: Hubo un 100% de mortalidad en los animales del Grupo 1 en 52 horas, 100% en los animales del Grupo 2, en 126 horas y un 50% en los animales del Grupo 3 en 50 horas. Los animales del Grupo 4 sobrevivieron. La sobrevida, al 11° día del postoperatorio, fue mayor en los grupos 3 y 4 con relación a los grupos 1 y 2 (p < 0,001) y mayor en los Grupo 4 con relación al Grupo 3 (p < 0,01). CONCLUSIONES: El lavado peritoneal con solución de bupivacaína diluida en solución fisiológica fue eficaz para evitar el óbito, por 11 días, en un 100% de los animales con peritonitis fecal.

Different clones of methicillin-susceptible (MSSA) and methicillin-resistant (MRSA) Staphylococcus aureus have been found in humans as well as in animals and retail meat. However, more information about the genetic characteristics and similarities between strains is needed. The aim of this study was to identify and characterize Staphylococcus aureus from humans, and to compare their characteristics with isolates of animal origin. A total of 550 nasal swabs were taken from healthy humans, and S. aureus was isolated and identified. Positive S. aureus isolates were subjected to molecular typing and susceptibility testing. In addition, 108 MRSA isolates recovered from clinical patients in the state of North Dakota and 133 S. aureus isolates from animals and meat previously analyzed were included. The nasal carriage of S. aureus in healthy people was 7.6% and, in general, clones were genetically diverse. None of the S. aureus strains obtained from healthy people were mecA-or PVL-positive. A total of 105 (97.2%) MRSA isolates from clinical cases harbored the mecA gene and 11 (10.2%) isolated from blood stream infections harbored the PVL gene. The most common resistance profile among S. aureus from healthy people was penicillin, and from clinical cases were erythromycin-penicillin-ciprofloxacin. The rate of multidrug resistance (MDR) was 70% in humans. Most of the S. aureus harboring mecA and PVL genes were identified as ST5 and ST8, and exhibited MDR. However, S. aureus isolates of animal origin used for comparison exhibited a lower rate of MDR. The most common resistance profiles in isolates of animal origin were penicillin-tetracycline and penicillin-tetracycline-erythromycin, in animals and raw meat, respectively. The ST5 was also found in animals and meat, with ST9 and ST398 being the major clones. The genetic similarity between clones from humans and meat suggests the risk of spread of S. aureus in the food chain. Dean's Office, College of Veterinary Medicine, Iowa State University, Ames, Iowa Dean's Office, College of Agriculture, Food Systems and Natural Resources College, North Dakota State University

Sequence analysis of the penA gene, encoding penicillin-binding protein 2 (PBP2), in 30 penicillin-intermediate (PenI) Neisseria meningitidis strains showed altered gene sequences due to the translocation of exogenous DNA blocks derived from commensal neisseriae, which are known to have PBP2 proteins with decreased affinity for the antibiotic. In order to obtain a rapid and reproducible method for predicting the PenI phenotype, a real-time PCR assay was set up with primers and probes designed on the basis of the penA gene. The A→G mutation at codon 566, in the transpeptidase domain of the penA gene (which is present in the whole sample of 30 PenI strains and in all the 41 sequences of PenI meningococci isolated worldwide and has been deposited in the sequence databank), was chosen as a marker of penA translocations. Two hybridization probes were designed to distinguish the wild-type penA gene in penicillin-susceptible (PenS) meningococci from the mutated penA gene at codon 566 in PenI strains. Thermal analysis of probe hybridization revealed a melting temperature difference of at least 6°C between PenI and PenS strains. This real-time PCR protocol characterizes the penicillin phenotype of N. meningitidis in a few hours without DNA sequencing and is useful for rapid screening of the penicillin-intermediate genotype among meningococcal isolates.

Background: Foot infection is the most common cause of non-traumatic amputation in people with diabetes. Most diabetic foot infections (DFIs) require systemic antibiotic therapy and the initial choice is usually empirical. Although there are many antibiotics available, uncertainty exists about which is the best for treating DFIs. Objectives: To determine the effects and safety of systemic antibiotics in the treatment of DFIs compared with other systemic antibiotics, topical foot care or placebo. Search methods: In April 2015 we searched the Cochrane Wounds Group Specialised Register; The Cochrane Central Register of Controlled Trials (CENTRAL; The Cochrane Library); Ovid MEDLINE, Ovid MEDLINE (In-Process & Other Non-Indexed Citations); Ovid EMBASE, and EBSCO CINAHL. We also searched in the Database of Abstracts of Reviews of Effects (DARE; The Cochrane Library), the Health Technology Assessment database (HTA; The Cochrane Library), the National Health Service Economic Evaluation Database (NHS-EED; The Cochrane Library), unpublished literature in OpenSIGLE and ProQuest Dissertations and on-going trials registers. Selection criteria: Randomised controlled trials (RCTs) evaluating the effects of systemic antibiotics (oral or parenteral) in people with a DFI. Primary outcomes were clinical resolution of the infection, time to its resolution, complications and adverse effects. Data collection and analysis: Two review authors independently selected studies, assessed the risk of bias, and extracted data. Risk ratios (RR) were estimated for dichotomous data and, when sufficient numbers of comparable trials were available, trials were pooled in a meta-analysis. Main results: We included 20 trials with 3791 participants. Studies were heterogenous in study design, population, antibiotic regimens, and outcomes. We grouped the sixteen different antibiotic agents studied into six categories: 1) anti-pseudomonal penicillins (three trials); 2) broad-spectrum penicillins (one trial); 3) cephalosporins (two trials); 4) carbapenems (four trials); 5) fluoroquinolones (six trials); 6) other antibiotics (four trials). Only 9 of the 20 trials protected against detection bias with blinded outcome assessment. Only one-third of the trials provided enough information to enable a judgement about whether the randomisation sequence was adequately concealed. Eighteen out of 20 trials received funding from pharmaceutical industry-sponsors. The included studies reported the following findings for clinical resolution of infection: there is evidence from one large trial at low risk of bias that patients receiving ertapenem with or without vancomycin are more likely to have resolution of their foot infection than those receiving tigecycline (RR 0.92, 95% confidence interval (CI) 0.85 to 0.99; 955 participants). It is unclear if there is a difference in rates of clinical resolution of infection between: 1) two alternative anti-pseudomonal penicillins (one trial); 2) an anti-pseudomonal penicillin and a broad-spectrum penicillin (one trial) or a carbapenem (one trial); 3) a broad-spectrum penicillin and a second-generation cephalosporin (one trial); 4) cephalosporins and other beta-lactam antibiotics (two trials); 5) carbapenems and anti-pseudomonal penicillins or broad-spectrum penicillins (four trials); 6) fluoroquinolones and anti-pseudomonal penicillins (four trials) or broad-spectrum penicillins (two trials); 7) daptomycin and vancomycin (one trial); 8) linezolid and a combination of aminopenicillins and beta-lactamase inhibitors (one trial); and 9) clindamycin and cephalexin (one trial). Carbapenems combined with anti-pseudomonal agents produced fewer adverse effects than anti-pseudomonal penicillins (RR 0.27, 95% CI 0.09 to 0.84; 1 trial). An additional trial did not find significant differences in the rate of adverse events between a carbapenem alone and an anti-pseudomonal penicillin, but the rate of diarrhoea was lower for participants treated with a carbapenem (RR 0.58, 95% CI 0.36 to 0.93; 1 trial). Daptomycin produced fewer adverse effects than vancomycin or other semi-synthetic penicillins (RR 0.61, 95%CI 0.39 to 0.94; 1 trial). Linezolid produced more adverse effects than ampicillin-sulbactam (RR 2.66; 95% CI 1.49 to 4.73; 1 trial), as did tigecycline compared to ertapenem with or without vancomycin (RR 1.47, 95% CI 1.34 to 1.60; 1 trial). There was no evidence of a difference in safety for the other comparisons. Authors' conclusions: The evidence for the relative effects of different systemic antibiotics for the treatment of foot infections in diabetes is very heterogeneous and generally at unclear or high risk of bias. Consequently it is not clear if any one systemic antibiotic treatment is better than others in resolving infection or in terms of safety. One non-inferiority trial suggested that ertapenem with or without vancomycin is more effective in achieving clinical resolution of infection than tigecycline. Otherwise the relative effects of different antibiotics are unclear. The quality of the evidence is low due to limitations in the design of the included trials and important differences between them in terms of the diversity of antibiotics assessed, duration of treatments, and time points at which outcomes were assessed. Any further studies in this area should have a blinded assessment of outcomes, use standardised criteria to classify severity of infection, define clear outcome measures, and establish the duration of treatment. © 2015 The Cochrane Collaboration.

Cutaneous anthrax is well known, unlike anthrax of the lumbar region, which is not reported elsewhere. We present a case of anthrax of the lumbar region in a 50-year-old man. The infection was characterised by a wide, black eschar and oedema on an erythematous ground. After isolation of the Gram-positive bacilli from the skin lesions, prompt antibiotic treatment (intravenous sulbactam-ampicillin 1.5 g every six hours) was initiated. Following eradication of the bacilli after 14 days of antibiotic treatment, a split-thickness skin graft was applied. A diagnosis of anthrax depends on clinical suspicion. Early diagnosis, antibiotic and surgical treatment can facilitate the treatment and prevent development of complications., NA

WOS: 000340538700017, PubMed ID: 24789652, The aim of this study was to assess the infectious diseases (ID) wards of tertiary hospitals in France and Turkey for technical capacity, infection control, characteristics of patients, infections, infecting organisms, and therapeutic approaches. This cross-sectional study was carried out on a single day on one of the weekdays of June 17-21, 2013. Overall, 36 ID departments from Turkey (n = 21) and France (n = 15) were involved. On the study day, 273 patients were hospitalized in Turkish and 324 patients were followed in French ID departments. The numbers of patients and beds in the hospitals, and presence of an intensive care unit (ICU) room in the ID ward was not different in both France and Turkey. Bed occupancy in the ID ward, single rooms, and negative pressure rooms were significantly higher in France. The presence of a laboratory inside the ID ward was more common in Turkish ID wards. The configuration of infection control committees, and their qualifications and surveillance types were quite similar in both countries. Although differences existed based on epidemiology, the distribution of infections were uniform on both sides. In Turkey, anti-Gram-positive agents, carbapenems, and tigecycline, and in France, cephalosporins, penicillins, aminoglycosides, and metronidazole were more frequently preferred. Enteric Gram-negatives and hepatitis B and C were more frequent in Turkey, while human immunodeficiency virus (HIV) and streptococci were more common in France (p < 0.05 for all significances). Various differences and similarities existed in France and Turkey in the ID wards. However, the current scene is that ID are managed with high standards in both countries.

Kaya, Ertugrul/0000-0003-0081-682X WOS: 000334560800014 PubMed: 24831366 AIM: Epileptic seizures lead to neuronal loss in the hippocampus. Experimental epilepsy can be induced by direct application of various chemicals to cerebral cortex. Nifedipine is an L-type voltage-dependent calcium channel blocker. In spite of several studies that show the seizure-suppressing effects of nifedipine, it has been shown that nifedipine does not suppress but conversely increases epileptic seizures. Similarly, contradictory effects of nifedipine have been reported, such as neuroprotection, failed neuroprotection and neurotoxicity. We therefore aimed to investigate the effect of nifedipine on hippocampal neuronal loss in penicillin induced epileptic rats in this study. MATERIAL and METHODS: The effect of nifedipine on total hippocampal neuron number was estimated by using the optical fractionator method (an unbiased stereological method) in penicillin-G induced epileptic rats. RESULTS:The total number of hippocampal neurons in the control group was 183687 +/- 3184. In the penicillin-induced group, the total neuron number significantly decreased to 146318 +/- 3042 compared to the control group. In the nifedipine group, the neuron number significantly decreased to 128873 +/- 1157 compared to both control and penicillin-induced groups. CONCLUSION: Nifedipine increased neuronal loss and did not suppress epileptic seizures in penicillin-induced epileptic rats. Nifedipine could not protect against hippocampal neuronal loss in penicillin-induced epileptic rats.

PurposeTo describe the prescription of antibiotics before, during and after pregnancy, and the trends over a 16-year period in the Netherlands, and to determine whether they were prescribed according to national guidelines. MethodsThe IADB (http://iadb.nl) contains prescriptions dispensed by community pharmacies in the Netherlands. We extracted information on 18873 pregnancies for 14969 women between 1994 and 2009, focusing on antibiotics dispensed in the four trimesters before conception to two trimesters after birth (nine trimesters in total). We calculated trends in prescription rates during pregnancy and over time, and also compared the prescription of antibiotics in the Netherlands with safety category based on the Australian Drug Evaluation Committee. ResultsDuring pregnancy 20.8% of the women were prescribed at least one antibiotic. The beta-lactam antibacterials/penicillins' group and the specific antibiotic amoxicillin were most commonly prescribed in the nine trimesters covered. The prescription rate of the other antibacterials' group during pregnancy increased over the years, in contrast to that of the sulphonamides/trimethoprim' group, which decreased. In total, 2.0% of pregnancies were exposed to a potentially harmful' antibiotic and 0.8% to a harmful' antibiotic. Compared with the period before conception, safe' antibiotics were prescribed more often during pregnancy than the other groups. ConclusionsOne in five women was prescribed at least one antibiotic during pregnancy in the Netherlands, which is comparable with rates in other European countries. Our results suggest that antibiotics appear to be prescribed to pregnant women generally in accordance with national recommendations. Copyright (c) 2013 John Wiley & Sons, Ltd.

Background: There is widespread concern about possible increases in antibiotic use but comparative data from different European countries on levels of use are lacking. Objectives: This study was designed to measure and understand the variation in antibiotic utilization across seven European health care databases from Denmark, Germany, the Netherlands, Spain and the United Kingdom between 2004 and 2009. Methods: Descriptive analyses were stratified by gender, age and type of antibiotic. Separate analyses were performed to measure the most common underlying indications leading to the prescription of an antibiotic agent. Results: The average yearly period prevalence of antibiotic use between 2004 and 2009 varied from 15 (Netherlands) to 30 (Spain) users per 100 patients, whilst the overall number of prescriptions for antibiotic agents increased. A higher prevalence of antibiotic use by females, the very young (0-9 years) and old (80+) was consistently observed in all databases. The lowest point prevalence was recorded in June and September and ranged from 0.51 (Netherlands) to 1.47 (UK) per 100 patients per day. Twelve (Netherlands) to 49 (Spain) percent of all users were diagnosed with a respiratory tract infection and the most common type of antibiotic drug class in every database were penicillins. Conclusions: Using identical methodology in all 7 EU databases to assess antibiotic use allowed us to compare drug usage patterns across Europe. Our results contribute quantitatively to the overall understanding of the pattern of use of antibiotic agents in different EU countries.

Objective This study presented the demographic, clinical and laboratory data for the patients who presented to our emergency department (ED) with mushroom poisoning. Methods We retrospectively examined the data for adult patients with mushroom poisoning that presented to the ED of Uludag University, Faculty of Medicine between 1 January 2007 and 31 December 2010. Results A total of 53 patients were enrolled in the study. The mean age was 46.58±15.47. 52.8% of the patients were female, while 47.2% were male. These patients were typically admitted in the autumn. The most commonly seen symptoms were gastrointestinal such as nausea and vomiting. The time to symptom onset was 6 hours in 69.8% of the patients. While 73.5% of the patients received gastric lavage, activated charcoal and intravenous fluid therapy, 15.1% received penicillin, N-acetylcysteine and intravenous fluid therapy. For the remaining patients (11.4%) silibinin, dialysis and plasmapheresis were administered. While 35.8% of the patients were hospitalised, 64.2% were discharged from the ED. The median duration of stay in the ED was 6 hours (range: 1-27 hours); the median duration of stay among inpatients was 6 days (range: 1-36 days). Three of the hospitalised patients died, and two underwent hepatic transplantation. Conclusions Mushroom poisoning remains an important issue that is encountered in rural areas during the rainy autumn season in our region. The condition may be fatal, but can be prevented by early and appropriate treatment.

Purpose: To investigate the crude oil yield of eight different varieties of soybean (Glycine max L.) seeds after gamma radiation, and also to evaluate the antimicrobial activity and the chemical composition of G.max-Ataem7. Methods: The seeds were irradiated with doses of 0 (control), 100, 200, 300, 400 and 500 Gy gamma radiation. Irradiation was performed in a cesium (Ce137) source. Extraction of the seeds was done with Soxhlet apparatus using petroleum ether. Antimicrobial activity was determined by the standard disc diffusion method. The chemical composition of the extracts was elucidated using gas chromatographymass spectrometry (GS-MS) Results: The highest crude oil yield was obtained at 300 Gy and and content of 35.09% in Ataem7 seeds. There was a decrease in the total content of chlorophyll in Mutant1 (M1) plants after gamma radiation. However, the level of carotenoid increased in M1 plants. Extracts of the G.max-Ataem7 demonstrated strong antibacterial activity against S. aureus ATCC 25923 and E.coli ATCC 25922. The major components of G.max-Ataem7 were linoliec acid (C18:2n6) and oleic acid (C18:1n9) with a content of 60.31 and 21.64%, respectively. Conclusion: The results show that irradiation of is also can be improved if treated with appropriate doses of irradiation. © Pharmacotherapy Group, Faculty of Pharmacy, University of Benin, Benin City, 300001 Nigeria. All rights reserved.

Background: Infection of burn wounds is a serious problem because it can delay healing, increase scarring and invasive infection may result in the death of the patient. Antibiotic prophylaxis is one of several interventions that may prevent burn wound infection and protect the burned patient from invasive infections. Objectives: To assess the effects of antibiotic prophylaxis on rates of burn wound infection. Search methods: In January 2013 we searched the Wounds Group Specialised Register; The Cochrane Central Register of Controlled Trials (CENTRAL); Ovid MEDLINE; Ovid MEDLINE - In-Process & Other Non-Indexed Citations (2013); Ovid EMBASE; EBSCO CINAHL and reference lists of relevant articles. There were no restrictions with respect to language, date of publication or study setting. Selection criteria: All randomised controlled trials (RCTs) that evaluated the efficacy and safety of antibiotic prophylaxis for the prevention of BWI. Quasi-randomised studies were excluded. Data collection and analysis: Two review authors independently selected studies, assessed the risk of bias, and extracted relevant data. Risk ratio (RR) and mean difference (MD) were estimated for dichotomous data and continuous data, respectively. When sufficient numbers of comparable RCTs were available, trials were pooled in a meta-analysis to estimate the combined effect. Main results: This review includes 36 RCTs (2117 participants); twenty six (72%) evaluated topical antibiotics, seven evaluated systemic antibiotics (four of these administered the antibiotic perioperatively and three administered upon hospital admission or during routine treatment), two evaluated prophylaxis with non absorbable antibiotics, and one evaluated local antibiotics administered via the airway. The 11 trials (645 participants) that evaluated topical prophylaxis with silver sulfadiazine were pooled in a meta analysis. There was a statistically significant increase in burn wound infection associated with silver sulfadiazine compared with dressings/skin substitute (OR = 1.87; 95% CI: 1.09 to 3.19, I2 = 0%). These trials were at high, or unclear, risk of bias. Silver sulfadiazine was also associated with significantly longer length of hospital stay compared with dressings/skin substitute (MD = 2.11 days; 95% CI: 1.93 to 2.28). Systemic antibiotic prophylaxis in non-surgical patients was evaluated in three trials (119 participants) and there was no evidence of an effect on rates of burn wound infection. Systemic antibiotics (trimethoprim-sulfamethoxazole) were associated with a significant reduction in pneumonia (only one trial, 40 participants) (RR = 0.18; 95% CI: 0.05 to 0.72) but not sepsis (two trials 59 participants) (RR = 0.43; 95% CI: 0.12 to 1.61). Perioperative systemic antibiotic prophylaxis had no effect on any of the outcomes of this review. Selective decontamination of the digestive tract with non-absorbable antibiotics had no significant effect on rates of all types of infection (2 trials, 140 participants). Moreover, there was a statistically significant increase in rates of MRSA associated with use of non-absorbable antibiotics plus cefotaxime compared with placebo (RR = 2.22; 95% CI: 1.21 to 4.07). There was no evidence of a difference in mortality or rates of sepsis with local airway antibiotic prophylaxis compared with placebo (only one trial, 30 participants). Authors' conclusions: The conclusions we are able to draw regarding the effects of prophylactic antibiotics in people with burns are limited by the volume and quality of the existing research (largely small numbers of small studies at unclear or high risk of bias for each comparison). The largest volume of evidence suggests that topical silver sulfadiazine is associated with a significant increase in rates of burn wound infection and increased length of hospital stay compared with dressings or skin substitutes; this evidence is at unclear or high risk of bias. Currently the effects of other forms of antibiotic prophylaxis on burn wound infection are unclear. One small study reported a reduction in incidence of pneumonia associated with a specific systematic antibiotic regimen. © 2013 The Cochrane Collaboration.