Electronic measurement apparatus movable in a cased borehole and compensating for casing resistance differences

DOEpatents

Vail, W.B. III.

1991-12-24

Methods of operation are described for an apparatus having at least two pairs of voltage measurement electrodes vertically disposed in a cased well to measure the resistivity of adjacent geological formations from inside the cased well. During stationary measurements with the apparatus at a fixed vertical depth within the cased well, the invention herein discloses methods of operation which include a measurement step and subsequent first and second compensation steps respectively resulting in improved accuracy of measurement. The invention also discloses multiple frequency methods of operation resulting in improved accuracy of measurement while the apparatus is simultaneously moved vertically in the cased well. The multiple frequency methods of operation disclose a first A.C. current having a first frequency that is conducted from the casing into formation and a second A.C. current having a second frequency that is conducted along the casing. The multiple frequency methods of operation simultaneously provide the measurement step and two compensation steps necessary to acquire accurate results while the apparatus is moved vertically in the cased well. 6 figures.

Electronic measurement apparatus movable in a cased borehole and compensating for casing resistance differences

DOEpatents

Vail, III, William B.

1991-01-01

Methods of operation of an apparatus having at least two pairs of voltage measurement electrodes vertically disposed in a cased well to measure the resistivity of adjacent geological formations from inside the cased well. During stationary measurements with the apparatus at a fixed vertical depth within the cased well, the invention herein discloses methods of operation which include a measurement step and subsequent first and second compensation steps respectively resulting in improved accuracy of measurement. The invention also discloses multiple frequency methods of operation resulting in improved accuracy of measurement while the apparatus is simultaneously moved vertically in the cased well. The multiple frequency methods of operation disclose a first A.C. current having a first frequency that is conducted from the casing into formation and a second A.C. current having a second frequency that is conducted along the casing. The multiple frequency methods of operation simultaneously provide the measurement step and two compensation steps necessary to acquire accurate results while the apparatus is moved vertically in the cased well.

Methods of operation of apparatus measuring formation resistivity from within a cased well having one measurement and two compensation steps

DOEpatents

Vail, III, William B.

1993-01-01

Methods of operation of an apparatus having at least two pairs of voltage measurement electrodes vertically disposed in a cased well to measure the resistivity of adjacent geological formations from inside the cased well. During stationary measurements with the apparatus at a fixed vertical depth within the cased well, the invention herein discloses methods of operation which include a measurement step and subsequent first and second compensation steps respectively resulting in improved accuracy of measurement. First and second order errors of measurement are identified, and the measurement step and two compensation steps provide methods to substantially eliminate their influence on the results. A multiple frequency apparatus adapted to movement within the well is described which simultaneously provide the measurement and two compensation steps.

Identifying multidrug resistant tuberculosis transmission hotspots using routinely collected data12

PubMed Central

Manjourides, Justin; Lin, Hsien-Ho; Shin, Sonya; Jeffery, Caroline; Contreras, Carmen; Cruz, Janeth Santa; Jave, Oswaldo; Yagui, Martin; Asencios, Luis; Pagano, Marcello; Cohen, Ted

2012-01-01

SUMMARY In most countries with large drug resistant tuberculosis epidemics, only those cases that are at highest risk of having MDRTB receive a drug sensitivity test (DST) at the time of diagnosis. Because of this prioritized testing, identification of MDRTB transmission hotspots in communities where TB cases do not receive DST is challenging, as any observed aggregation of MDRTB may reflect systematic differences in how testing is distributed in communities. We introduce a new disease mapping method, which estimates this missing information through probability–weighted locations, to identify geographic areas of increased risk of MDRTB transmission. We apply this method to routinely collected data from two districts in Lima, Peru over three consecutive years. This method identifies an area in the eastern part of Lima where previously untreated cases have increased risk of MDRTB. This may indicate an area of increased transmission of drug resistant disease, a finding that may otherwise have been missed by routine analysis of programmatic data. The risk of MDR among retreatment cases is also highest in these probable transmission hotspots, though a high level of MDR among retreatment cases is present throughout the study area. Identifying potential multidrug resistant tuberculosis (MDRTB) transmission hotspots may allow for targeted investigation and deployment of resources. PMID:22401962

Treating methamphetamine-induced resistant psychosis with clozapine.

PubMed

Seddigh, Ruohollah; Keshavarz-Akhlaghi, Amir-Abbas; Shariati, Behnam

2014-01-01

Background. Methamphetamine-induced psychosis (MIP) in Iran has turned into a serious issue in terms of health and treatment, lacking any obvious treatment methods for its resistant cases. Aims of Case Report. In the present study, a number of two cases of treatment of MIP with clozapine, which were resistant to the treatment with other antipsychotics, have been reported. Both cases completely responded to the treatment in only 2 weeks and no signs of psychosis relapse were seen in an 8-9 follow-up. Conclusion. Because of its particular pharmacologic features, clozapine may be effective in treating MIP.

Chloroquine-resistant falciparum malaria in Madagascar and Kenya.

PubMed

Aronsson, B; Bengtsson, E; Björkman, A; Pehrson, P O; Rombo, L; Wahlgren, M

1981-08-01

3 African cases of chloroquine-resistent (RI) P. falciparum malaria, proved by recrudescences after administration of recommended doses and adequate serum levels of chloroquine, are described. The 3 patients, Swedish women aged 43, 27, and 41, had never visited areas where chloroquine-resistent P. falciparum is known to exist. 2 patients had taken regular prophylaxis with chloroquine, while the 3rd had interrupted chloroquine use with temporary use of pyrimethamine. All 3 were treated with chloroquine and had serum levels well above those considered necessary for cure of malaria due to sensitive strains of P. falciparum. All had recrudescences, ranging from 13 to 41 days after the previous chloroquine treatment. Reinfection was not possible for any of the patients and none took other drugs during the study period. In 2 cases the Rieckmann in vitro test for resistence failed. In 1 case from Madagascar the in vitro method described by Nguyen-Dinh and Trager produced results indicating resistence and in another case from Madagascar the results indicated probable resistence, but the procedure failed in the case from Kenya. The 2 cases mark the 1st time resistence has been reported from Madagascar. In vivo tests in all cases and in vitro results in 2 cases, together with the adequate serum levels of chloroquine, confirm that malaria due to chloroquine-resistent P. falciparum is being transmitted in some parts of Africa.

Prevalence of resistance to second-line tuberculosis drug among multidrug-resistant tuberculosis patients in Viet Nam, 2011

PubMed Central

Tran, Huong Thi Giang; Bui, Quyen Thi Tu

2016-01-01

Introduction Extensively drug-resistant tuberculosis (XDR-TB) represents an emerging public health problem worldwide. According to the World Health Organization, an estimated 9.7% of multidrug-resistant TB (MDR-TB) cases are defined as XDR-TB globally. The objective of this study was to determine the prevalence of drug resistance to second-line TB drugs among MDR-TB cases detected in the Fourth National Anti-Tuberculosis Drug Resistance Survey in Viet Nam. Methods Eighty clusters of TB cases were selected using a probability-proportion-to-size approach. To identify MDR-TB cases, drug susceptibility testing (DST) was performed for the four major first-line TB drugs. DST of second-line drugs (ofloxacin, amikacin, kanamycin, capreomycin) was performed on isolates from MDR-TB cases to identify pre-XDR and XDR cases. Results A total of 1629 smear-positive TB cases were eligible for culture and DST. Of those, DST results for first-line drugs were available for 1312 cases, and 91 (6.9%) had MDR-TB. Second-line DST results were available for 84 of these cases. Of those, 15 cases (17.9%) had ofloxacin resistance and 6.0% were resistant to kanamycin and capreomycin. Five MDR-TB cases (6.0%) met the criteria of XDR-TB. Conclusion This survey provides the first estimates of the proportion of XDR-TB among MDR-TB cases in Viet Nam and provides important information for local policies regarding second-line DST. Local policies and programmes that are geared towards TB prevention, early diagnosis and treatment with effective regimens are of high importance. PMID:27508089

“Big data” and Gram-negative Resistance: A Multiple Logistic Regression Model Using EMR Data to Predict Carbapenem Resistance in Patients with Klebsiella pneumoniae Bloodstream Infection

PubMed Central

Sullivan, Timothy; Aberg, Judith

2017-01-01

Abstract Background The timely identification of carbapenem resistance is essential in the management of patients with Klebsiella pneumoniae bloodstream infection (BSI). An algorithm using electronic medical record (EMR) data to quickly predict resistance could potentially help guide therapy until more definitive resistance testing results are available. Methods All cases of K. pneumoniae BSI at Mount Sinai Hospital from September 2012 through September 2016 were identified. Cases of persistent BSI or recurrent BSI within 2 weeks were included only once. Patients with recurrent BSI after more than 2 weeks of negative blood cultures were considered distinct cases and included more than once. Carbapenem resistance was defined as an imipenem minimum inhibitory concentration of ≥2 μg/ml. Extensive EMR data for each patient were compiled into a relational database using SQLite. Possible risk factors for carbapenem resistance were queried from the database and analyzed via univariate methods. Significant factors were then entered into a multiple logistic regression model in a forward stepwise approach using SPSS. Results A total of 613 cases of K. pneumoniae BSI were identified in 540 unique patients. The overall incidence of imipenem resistance was 10% (61 cases). Significant markers of resistance included in the final model were (1) prior colonization with imipenem-resistant Klebsiella pneumoniae; (2) hospital unit (defined as high-risk unit, low-risk unit, and emergency department); (3) total inpatient days in the previous 5 years; (4) total days of oral or parenteral antibiotics in the past 2 years; and (5) age >60 years old (Figure 1). The model generated a receiver operating characteristic curve with an area under the curve of 0.75 (Figure 2). At a cut point of 0.083, the model correctly predicted 72% of imipenem-resistant cases while incorrectly labeling 32% of susceptible cases as resistant (Sn = 72%, Sp = 63%, Figure 3). Conclusion A multiple logistic regression model using EMR data can generate immediate, clinically useful predictions of carbapenem resistance in patients with K. pneumoniae BSI. Larger data sets are needed to improve and validate these findings. Figure 1. Algorithm variables Figure 2. Receiver operating characteristic curve Figure 3. Classification table Disclosures All authors: No reported disclosures.

Comparison of Xpert MTB/RIF Assay and GenoType MTBDRplus DNA Probes for Detection of Mutations Associated with Rifampicin Resistance in Mycobacterium tuberculosis.

PubMed

Rahman, Arfatur; Sahrin, Mahfuza; Afrin, Sadia; Earley, Keith; Ahmed, Shahriar; Rahman, S M Mazidur; Banu, Sayera

2016-01-01

GeneXpert MTB/RIF (Xpert) and Genotype MTBDRplus (DRplus) are two World Health Organization (WHO) endorsed probe based molecular drug susceptibility testing (DST) methods for rapid diagnosis of drug resistant tuberculosis. Both methods target the same 81 bp Rifampicin Resistance Determining Region (RRDR) of bacterial RNA polymerase β subunit (rpoB) for detection of Rifampicin (RIF) resistance associated mutations using DNA probes. So there is a correspondence of the probes of each other and expected similarity of probe binding. We analyzed 92 sputum specimens by Xpert, DRplus and LJ proportion method (LJ-DST). We compared molecular DSTs with gold standard LJ-DST. We wanted to see the agreement level of two molecular methods for detection of RIF resistance associated mutations. The 81bp RRDR region of rpoB gene of discrepant cases between the two molecular methods was sequenced by Sanger sequencing. The agreement of Xpert and DRplus with LJ-DST for detection of RIF susceptibility was found to be 93.5% and 92.4%, respectively. We also found 92.4% overall agreement of two molecular methods for the detection of RIF susceptibility. A total of 84 out of 92 samples (91.3%) had agreement on the molecular locus of RRDR mutation by DRplus and Xpert. Sanger sequencing of 81bp RRDR revealed that Xpert probes detected seven of eight discrepant cases correctly and DRplus was erroneous in all the eight cases. Although the overall concordance with LJ-DST was similar for both Xpert and DRplus assay, Xpert demonstrated more accuracy in the detection of RIF susceptibility for discrepant isolates compared with DRplus. This observation would be helpful for the improvement of probe based detection of drug resistance associated mutations especially rpoB mutation in M. tuberculosis.

30 CFR 75.701-1 - Approved methods of grounding of equipment receiving power from ungrounded alternating current...

Code of Federal Regulations, 2014 CFR

2014-07-01

... casing having low resistance to earth; (c) A solid connection to metal waterlines having low resistance to earth; (d) A solid connection to a grounding conductor extending to a low resistance ground field... earth. ...

30 CFR 75.701-1 - Approved methods of grounding of equipment receiving power from ungrounded alternating current...

Code of Federal Regulations, 2012 CFR

2012-07-01

... casing having low resistance to earth; (c) A solid connection to metal waterlines having low resistance to earth; (d) A solid connection to a grounding conductor extending to a low resistance ground field... earth. ...

30 CFR 75.701-1 - Approved methods of grounding of equipment receiving power from ungrounded alternating current...

Code of Federal Regulations, 2013 CFR

2013-07-01

... casing having low resistance to earth; (c) A solid connection to metal waterlines having low resistance to earth; (d) A solid connection to a grounding conductor extending to a low resistance ground field... earth. ...

Optimization of Archeological Anomalies using GIS method for Magnetic and Resistivity Study at Sungai Batu, Lembah Bujang, Kedah (Malaysia)

NASA Astrophysics Data System (ADS)

Yusoh, R.; Saad, R.; Saidin, M.; Anda, S. T.; Muhammad, S. B.; Ashraf, M. I. M.; Hazreek, Z. A. M.

2018-04-01

Magnetic and resistivity method has become a reliable option in archeological exploration. The use of both method has become popular these day. However, both method gives different type of sensing in detecting anomalies and direct interpret from the anomalies will result large coverage area for excavation. Therefore, to overcome this issue, both anomalies can be extracted using ArcGIS software to reduce excavated coverage area. The case study located at Sungai Batu, Lembah Bujang near SB2ZZ lot expected buried clay brick monument which will be a perfect case to apply this technique. Magnetic and resistivity method was implemented at the study area where the anomalies coverage area for magnetic and resistivity is 531.5 m2 and 636 m2 respectively which total area of both anomalies was 764 m2. By applying combine technique, the anomalies area reduce to 403.7 m2 which reduce the suspected anomalies by 47.16 %. The unsuspected clay brick monument area was increase from 15.86% to 55.54% which improve the cost and labor work for excavation.

Usefulness of detection of clarithromycin-resistant Helicobacter pylori from fecal specimens for young adults treated with eradication therapy.

PubMed

Osaki, Takako; Mabe, Katsuhiro; Zaman, Cynthia; Yonezawa, Hideo; Okuda, Masumi; Amagai, Kenji; Fujieda, Shinji; Goto, Mitsuhide; Shibata, Wataru; Kato, Mototsugu; Kamiya, Shigeru

2017-10-01

To prevent Helicobacter pylori infection in the younger generation, it is necessary to investigate the prevalence of antibiotic-resistant H. pylori. The aim of this study was to evaluate the method of PCR-based sequencing to detect clarithromycin (CAM) resistance-associated mutations using fecal samples as a noninvasive method. DNA extracted from fecal specimens and isolates from gastric biopsy specimens were collected from patients with H. pylori infection. Antibiotic resistance to CAM was analyzed by molecular and culture methods. The detection rates of CAM resistance-associated mutations (A2142C or A2143G) were compared before and after eradication therapy. With CAM resistance of H. pylori evaluated by antibiotic susceptibility test as a gold standard, the sensitivity and the specificity of gene mutation detection from fecal DNA were 80% and 84.8%, respectively. In contrast, using DNA of isolated strains, the sensitivity and the specificity were 80% and 100%. Of the seven cases in which eradication was unsuccessful by triple therapy including CAM, CAM-resistant H. pylori, and resistance-associated mutations were detected in three cases, CAM-resistant H. pylori without the mutation was detected in two patients, and resistance-associated mutation was only detected in one patient. PCR-based sequencing to detect CAM resistance-associated mutations using isolates or fecal samples was useful for finding antibiotic-resistant H. pylori infection. Although the specificity of the detection from fecal samples compared with antibiotic susceptibility testing was lower than that from isolates, this fecal detection method is suitable especially for asymptomatic subjects including children. Further improvement is needed before clinical application. © 2017 John Wiley & Sons Ltd.

[Monitoring of Mycobacterium tuberculosis infections in Iaşi County in 2009].

PubMed

Luncă, Cătălina; Enache, Ecaterina; Olaru, Simona Peter; Diculencu, Daniela; Iancu, Luminiţa Smaranda

2011-01-01

Tuberculosis is a major public health problem worldwide. Our study aimed to investigate epidemiological and demographic characteristics of tuberculosis infection and resistance to antituberculous drugs in Iasi County in 2009. We have analysed the epidemiological parameters for 687 patients with pulmonary tuberculosis, new cases confirmed by microscopy and cultivation on Lowenstein Jensen. First and second-line antituberculous susceptibility testing was done for 130 strains, using agar proportion method and absolute-concentration method. The number of new cases of tuberculosis was higher in rural areas and in males 41-50 years old (sex ratio=2.22). The proportion of positive cases in microscopy was 81.51%. Drug resistance was as follows: 16 isolates (12.3%) to isoniazid, 5 (3.84%) to rifampin, 2 (1.53%) to ethambutol, 2 (1.53%) to streptomycin and 4 (3.07%) were multidrug-resistant. In this study we found high resistance rates to isoniazid, streptomycin and ethambutol. This requires increasing efficiency of tuberculosis diagnosis and susceptibility testing.

Prevalence of drug-resistant tuberculosis in Nigeria: A systematic review and meta-analysis.

PubMed

Onyedum, Cajetan C; Alobu, Isaac; Ukwaja, Kingsley Nnanna

2017-01-01

Drug-resistant tuberculosis (TB) undermines control efforts and its burden is poorly understood in resource-limited settings. We performed a systematic review and meta-analysis to provide an up-to-date summary of the extent of drug-resistant TB in Nigeria. We searched PubMed, Scopus, Embase, HINARI, AJOL, the Cochrane library, Web of Science, and Google Scholar for reports published before January 31 2017, that included any resistance, mono-resistance or multidrug resistance to anti-TB drugs in Nigeria. Summary estimates were calculated using random effects models. We identified 34 anti-TB drug resistance surveys with 8002 adult TB patients consisting of 2982 new and 5020 previously-treated cases. The prevalence rate of any drug resistance among new TB cases was 32.0% (95% CI 24.0-40.0%; 734/2892) and among previously-treated cases, the rate was 53.0% (95% CI 35.0-71.0%; 1467/5020). Furthermore, multidrug resistance among new and previously-treated cases was 6.0% (95% CI 4.0-8.0%;161/2502)and 32.0% (95%CI 20.0-44.0; 357/949), respectively. There was significant heterogeneity between the studies (p<0.001, I2 tests). The prevalence of drug-resistant TB varied according to methods of drug susceptibility testing and geographic region of Nigeria. The burden of drug-resistant TB in Nigeria is high. We recommend that a national anti-TB drug resistance survey be carried out, and strategies for case detection and programmatic management of drug-resistant TB in Nigeria need to be strengthened.

Prevalence of and Risk Factors for Multidrug-Resistant Acinetobacter baumannii Colonization Among High-Risk Nursing Home Residents

PubMed Central

Mody, Lona; Gibson, Kristen E.; Horcher, Amanda; Prenovost, Katherine; McNamara, Sara E.; Foxman, Betsy; Kaye, Keith S.; Bradley, Suzanne

2015-01-01

OBJECTIVE To characterize the epidemiology of multidrug-resistant (MDR) Acinetobacter baumannii colonization in high-risk nursing home (NH) residents. DESIGN Nested case-control study within a multicenter prospective intervention trial. SETTING Four NHs in Southeast Michigan. PARTICIPANTS Case patients and control subjects were NH residents with an indwelling device (urinary catheter and/or feeding tube) selected from the control arm of the Targeted Infection Prevention study. Cases were residents colonized with MDR (resistant to ≥3 classes of antibiotics) A. baumannii; controls were never colonized with MDR A. baumannii. METHODS For active surveillance cultures, specimens from the nares, oropharynx, groin, perianal area, wounds, and device insertion site(s) were collected upon study enrollment, day 14, and monthly thereafter. A. baumannii strains and their susceptibilities were identified using standard microbiologic methods. RESULTS Of 168 NH residents, 25 (15%) were colonized with MDR A. baumannii. Compared with the 143 controls, cases were more functionally disabled (Physical Self-Maintenance Score >24; odds ratio, 5.1 [95% CI, 1.8–14.9]; P < .004), colonized with Proteus mirabilis (5.8 [1.9–17.9]; P < .003), and diabetic (3.4 [1.2–9.9]; P < .03). Most cases (22 [88%]) were colonized with multiple antibiotic-resistant organisms and 16 (64%) exhibited co-colonization with at least one other resistant gram-negative bacteria. CONCLUSION Functional disability, P. mirabilis colonization, and diabetes mellitus are important risk factors for colonization with MDR A. baumannii in high-risk NH residents. A. baumannii exhibits widespread antibiotic resistance and a preference to colonize with other antibiotic-resistant organisms, meriting enhanced attention and improved infection control practices in these residents. PMID:26072936

Investigation of the antibiotic resistance and biofilm-forming ability of Staphylococcus aureus from subclinical bovine mastitis cases.

PubMed

Aslantaş, Özkan; Demir, Cemil

2016-11-01

A total of 112 Staphylococcus aureus isolates obtained from subclinical bovine mastitis cases were examined for antibiotic susceptibility and biofilm-forming ability as well as genes responsible for antibiotic resistance, biofilm-forming ability, and adhesin. Antimicrobial susceptibility of the isolates were determined by disk diffusion method. Biofilm forming ability of the isolates were investigated by Congo red agar method, standard tube method, and microplate method. The genes responsible for antibiotic resistance, biofilm-forming ability, and adhesion were examined by PCR. Five isolates (4.5%) were identified as methicillin-resistant Staph. aureus by antibiotic susceptibility testing and confirmed by mecA detection. The resistance rates to penicillin, ampicillin, tetracycline, erythromycin, trimethoprim-sulfamethoxazole, enrofloxacin, and amoxicillin-clavulanic acid were 45.5, 39.3, 33, 26.8, 5.4, 0.9, and 0.9%, respectively. All isolates were susceptible against vancomycin and gentamicin. The blaZ (100%), tetK (67.6%), and ermA (70%) genes were the most common antibiotic-resistance genes. Using Congo red agar, microplate, and standard tube methods, 70.5, 67, and 62.5% of the isolates were found to be biofilm producers, respectively. The percentage rate of icaA, icaD, and bap genes in Staph. aureus isolates were 86.6, 86.6, and 13.4%, respectively. The adhesion molecules fnbA, can, and clfA were detected in 87 (77.7%), 98 (87.5%), and 75 (70%) isolates, respectively. The results indicated that Staph. aureus from sublinical bovine mastitis cases were mainly resistant to β-lactams and, to a lesser extent, to tetracycline and erythromycin. Also, biofilm- and adhesion-related genes, which are increasingly accepted as an important virulence factor in the pathogenesis of Staph. aureus infections, were detected at a high rate. Copyright © 2016 American Dairy Science Association. Published by Elsevier Inc. All rights reserved.

Assessing Local Risk of Rifampicin-Resistant Tuberculosis in KwaZulu-Natal, South Africa Using Lot Quality Assurance Sampling

PubMed Central

Heidebrecht, Christine L.; Podewils, Laura J.; Pym, Alexander; Mthiyane, Thuli; Cohen, Ted

2016-01-01

Background KwaZulu-Natal (KZN) has the highest burden of notified multidrug-resistant tuberculosis (MDR TB) and extensively drug-resistant (XDR) TB cases in South Africa. A better understanding of spatial heterogeneity in the risk of drug-resistance may help to prioritize local responses. Methods Between July 2012 and June 2013, we conducted a two-way Lot Quality Assurance Sampling (LQAS) study to classify the burden of rifampicin (RIF)-resistant TB among incident TB cases notified within the catchment areas of seven laboratories in two northern and one southern district of KZN. Decision rules for classification of areas as having either a high- or low-risk of RIF resistant TB (based on proportion of RIF resistance among all TB cases) were based on consultation with local policy makers. Results We classified five areas as high-risk and two as low-risk. High-risk areas were identified in both Southern and Northern districts, with the greatest proportion of RIF resistance observed in the northernmost area, the Manguzi community situated on the Mozambique border. Conclusion Our study revealed heterogeneity in the risk of RIF resistant disease among incident TB cases in KZN. This study demonstrates the potential for LQAS to detect geographic heterogeneity in areas where access to drug susceptibility testing is limited. PMID:27050561

Exploration of buried carbonate aquifers by the inverse and forward modelling of the Controlled Source Audio-Magnetotelluric data

NASA Astrophysics Data System (ADS)

Šumanovac, Franjo; Orešković, Jasna

2018-06-01

On the selected cases, Gotalovec in the area of Pannonian basin and Baška in the Dinaridic karst area, that are representing a common hydrogeological model in both regions of Croatia, CSAMT data together with data of other geophysical methods (electrical resistivity tomography, electrical sounding and seismic reflection) enabled the definition of a reliable prognostic geological model. The model consists of carbonate aquifer which underlies an impermeable thick package of clastic deposits. There are great variations of the dolomitic aquifer depths in the Gotalovec area due to strong tectonic activity, while in the Baška area depth changes are caused by the layer folding. The CSAMT method provides the most complete data on lithological and structural relationships in cases of hydrogeological targets deeper than 100 m. Based on the presented models we can conclude that the CSAMT method can provide greater exploration depth than electrical resistivity tomography (ERT) and can be considered as a fundamental geophysical method for exploration of buried carbonate aquifers, deeper than 100 m. But, the CSAMT research may demonstrate its advantages only in the case of very dense layout of CSAMT stations (25-50 m), due to the greater sensitivity to noise in relation to resistivity methods. Interpretation of CSAMT data is more complex in relation to resistivity methods, and a forward modelling method sometimes gives better results than an inversion due to possibility of the use of additional data acquired by other geophysical methods (ERT, electrical sounding and seismic reflection). At greater depths, the resolution of all electrical methods including the CSAMT method is significantly reduced, and seismic reflection can be very useful to resolve deeper lithological interfaces.

Prevalence of Anti-Tuberculosis Drug Resistance in Foreign-Born Tuberculosis Cases in the U.S. and in Their Countries of Origin

PubMed Central

Taylor, Allison B.; Kurbatova, Ekaterina V.; Cegielski, J. Peter

2012-01-01

Background Foreign-born individuals comprise >50% of tuberculosis (TB) cases in the U.S. Since anti-TB drug resistance is more common in most other countries, when evaluating a foreign-born individual for TB, one must consider the risk of drug resistance. Naturally, clinicians query The Global Project on Anti-tuberculosis Drug Resistance Surveillance (Global DRS) which provides population-based data on the prevalence of anti-TB drug resistance in 127 countries starting in 1994. However, foreign-born persons in the U.S. are a biased sample of the population of their countries of origin, and Global DRS data may not accurately predict their risk of drug resistance. Since implementing drug resistance surveillance in 1993, the U.S. National TB Surveillance System (NTSS) has accumulated systematic data on over 130,000 foreign-born TB cases from more than 200 countries and territories. Our objective was to determine whether the prevalence of drug resistance among foreign-born TB cases correlates better with data from the Global DRS or with data on foreign-born TB cases in the NTSS. Methods and Findings We compared the prevalence of resistance to isoniazid and rifampin among foreign-born TB cases in the U.S., 2007–2009, with US NTSS data from 1993 to 2006 and with Global DRS data from 1994–2007 visually with scatterplots and statistically with correlation and linear regression analyses. Among foreign-born TB cases in the U.S., 2007–2009, the prevalence of isoniazid resistance and multidrug resistance (MDR, i.e. resistance to isoniazid and rifampin), correlated much better with 1993–2006 US surveillance data (isoniazid: r = 0.95, P<.001, MDR: r = 0.75, P<.001) than with Global DRS data, 1994–2007 (isoniazid: r = 0.55, P = .001; MDR: r = 0.50, P<.001). Conclusion Since 1993, the US NTSS has accumulated sufficient data on foreign-born TB cases to estimate the risk of drug resistance among such individuals better than data from the Global DRS. PMID:23145161

Resistance of Trichomonas vaginalis to Metronidazole: Report of the First Three Cases from Finland and Optimization of In Vitro Susceptibility Testing under Various Oxygen Concentrations

PubMed Central

Meri, Taru; Jokiranta, T. Sakari; Suhonen, Lauri; Meri, Seppo

2000-01-01

Trichomonas vaginalis is a globally common sexually transmitted human parasite. Many strains of T. vaginalis from around the world have been described to be resistant to the current drug of choice, metronidazole. However, only a few cases of metronidazole resistance have been reported from Europe. The resistant strains cause prolonged infections which are difficult to treat. T. vaginalis infection also increases the risk for human immunodeficiency virus transmission. We present a practical method for determining the resistance of T. vaginalis to 5-nitroimidazoles. The suggested method was developed by determining the MICs and minimal lethal concentrations (MLCs) of metronidazole and ornidazole for T. vaginalis under various aerobic and anaerobic conditions. Using this assay we have found the first three metronidazole-resistant strains from Finland, although the origin of at least one of the strains seems to be Russia. Analysis of the patient-derived and previously characterized isolates showed that metronidazole-resistant strains were also resistant to ornidazole, and MLCs for all strains tested correlated well with the MICs. The suggested MICs of metronidazole for differentiation of sensitive and resistant isolates are >75 μg/ml in an aerobic 24-h assay and >15 μg/ml in an anaerobic 48-h assay. PMID:10655382

Development, Characterization, and Resultant Properties of a Carbon, Boron, and Chromium Ternary Diffusion System

NASA Astrophysics Data System (ADS)

Domec, Brennan S.

In today's industry, engineering materials are continuously pushed to the limits. Often, the application only demands high-specification properties in a narrowly-defined region of the material, such as the outermost surface. This, in combination with the economic benefits, makes case hardening an attractive solution to meet industry demands. While case hardening has been in use for decades, applications demanding high hardness, deep case depth, and high corrosion resistance are often under-served by this process. Instead, new solutions are required. The goal of this study is to develop and characterize a new borochromizing process applied to a pre-carburized AISI 8620 alloy steel. The process was successfully developed using a combination of computational simulations, calculations, and experimental testing. Process kinetics were studied by fitting case depth measurement data to Fick's Second Law of Diffusion and an Arrhenius equation. Results indicate that the kinetics of the co-diffusion method are unaffected by the addition of chromium to the powder pack. The results also show that significant structural degradation of the case occurs when chromizing is applied sequentially to an existing boronized case. The amount of degradation is proportional to the chromizing parameters. Microstructural evolution was studied using metallographic methods, simulation and computational calculations, and analytical techniques. While the co-diffusion process failed to enrich the substrate with chromium, significant enrichment is obtained with the sequential diffusion process. The amount of enrichment is directly proportional to the chromizing parameters with higher parameters resulting in more enrichment. The case consists of M7C3 and M23C6 carbides nearest the surface, minor amounts of CrB, and a balance of M2B. Corrosion resistance was measured with salt spray and electrochemical methods. These methods confirm the benefit of surface enrichment by chromium in the sequential diffusion method with corrosion resistance increasing directly with chromium concentration. The results also confirm the deleterious effect of surface-breaking case defects and the need to reduce or eliminate them. The best combination of microstructural integrity, mean surface hardness, effective case depth, and corrosion resistance is obtained in samples sequentially boronized and chromized at 870°C for 6hrs. Additional work is required to further optimize process parameters and case properties.

Two-Point Resistance of a Non-Regular Cylindrical Network with a Zero Resistor Axis and Two Arbitrary Boundaries

NASA Astrophysics Data System (ADS)

Tan, Zhi-Zhong

2017-03-01

We study a problem of two-point resistance in a non-regular m × n cylindrical network with a zero resistor axis and two arbitrary boundaries by means of the Recursion-Transform method. This is a new problem never solved before, the Green’s function technique and the Laplacian matrix approach are invalid in this case. A disordered network with arbitrary boundaries is a basic model in many physical systems or real world systems, however looking for the exact calculation of the resistance of a binary resistor network is important but difficult in the case of the arbitrary boundaries, the boundary is like a wall or trap which affects the behavior of finite network. In this paper we obtain a general resistance formula of a non-regular m × n cylindrical network, which is composed of a single summation. Further, the current distribution is given explicitly as a byproduct of the method. As applications, several interesting results are derived by making special cases from the general formula. Supported by the Natural Science Foundation of Jiangsu Province under Grant No. BK20161278

Application of Monte Carlo Method for Evaluation of Uncertainties of ITS-90 by Standard Platinum Resistance Thermometer

NASA Astrophysics Data System (ADS)

Palenčár, Rudolf; Sopkuliak, Peter; Palenčár, Jakub; Ďuriš, Stanislav; Suroviak, Emil; Halaj, Martin

2017-06-01

Evaluation of uncertainties of the temperature measurement by standard platinum resistance thermometer calibrated at the defining fixed points according to ITS-90 is a problem that can be solved in different ways. The paper presents a procedure based on the propagation of distributions using the Monte Carlo method. The procedure employs generation of pseudo-random numbers for the input variables of resistances at the defining fixed points, supposing the multivariate Gaussian distribution for input quantities. This allows taking into account the correlations among resistances at the defining fixed points. Assumption of Gaussian probability density function is acceptable, with respect to the several sources of uncertainties of resistances. In the case of uncorrelated resistances at the defining fixed points, the method is applicable to any probability density function. Validation of the law of propagation of uncertainty using the Monte Carlo method is presented on the example of specific data for 25 Ω standard platinum resistance thermometer in the temperature range from 0 to 660 °C. Using this example, we demonstrate suitability of the method by validation of its results.

Change of point mutations in Helicobacter pylori rRNA associated with clarithromycin resistance in Italy.

PubMed

De Francesco, Vincenzo; Zullo, Angelo; Giorgio, Floriana; Saracino, Ilaria; Zaccaro, Cristina; Hassan, Cesare; Ierardi, Enzo; Di Leo, Alfredo; Fiorini, Giulia; Castelli, Valentina; Lo Re, Giovanna; Vaira, Dino

2014-03-01

Primary clarithromycin resistance is the main factor affecting the efficacy of Helicobacter pylori therapy. This study aimed: (i) to assess the concordance between phenotypic (culture) and genotypic (real-time PCR) tests in resistant strains; (ii) to search, in the case of disagreement between the methods, for point mutations other than those reported as the most frequent in Europe; and (iii) to compare the MICs associated with the single point mutations. In order to perform real-time PCR, we retrieved biopsies from patients in whom H. pylori infection was successful diagnosed by bacterial culture and clarithromycin resistance was assessed using the Etest. Only patients who had never been previously treated, and with H. pylori strains that were either resistant exclusively to clarithromycin or without any resistance, were included. Biopsies from 82 infected patients were analysed, including 42 strains that were clarithromycin resistant and 40 that were clarithromycin susceptible on culture. On genotypic analysis, at least one of the three most frequently reported point mutations (A2142C, A2142G and A2143G) was detected in only 23 cases (54.8%), with a concordance between the two methods of 0.67. Novel point mutations (A2115G, G2141A and A2144T) were detected in a further 14 out of 19 discordant cases, increasing the resistance detection rate of PCR to 88% (P<0.001; odds ratio 6.1, 95% confidence interval 2-18.6) and the concordance to 0.81. No significant differences in MIC values among different point mutations were observed. This study suggests that: (i) the prevalence of the usually reported point mutations may be decreasing, with a concomitant emergence of new mutations; (ii) PCR-based methods should search for at least six point mutations to achieve good accuracy in detecting clarithromycin resistance; and (iii) none of the tested point mutations is associated with significantly higher MIC values than the others.

Genetic diversity among pandemic 2009 influenza viruses isolated from a transmission chain

PubMed Central

2013-01-01

Background Influenza viruses such as swine-origin influenza A(H1N1) virus (A(H1N1)pdm09) generate genetic diversity due to the high error rate of their RNA polymerase, often resulting in mixed genotype populations (intra-host variants) within a single infection. This variation helps influenza to rapidly respond to selection pressures, such as those imposed by the immunological host response and antiviral therapy. We have applied deep sequencing to characterize influenza intra-host variation in a transmission chain consisting of three cases due to oseltamivir-sensitive viruses, and one derived oseltamivir-resistant case. Methods Following detection of the A(H1N1)pdm09 infections, we deep-sequenced the complete NA gene from two of the oseltamivir-sensitive virus-infected cases, and all eight gene segments of the viruses causing the remaining two cases. Results No evidence for the resistance-causing mutation (resulting in NA H275Y substitution) was observed in the oseltamivir-sensitive cases. Furthermore, deep sequencing revealed a subpopulation of oseltamivir-sensitive viruses in the case carrying resistant viruses. We detected higher levels of intra-host variation in the case carrying oseltamivir-resistant viruses than in those infected with oseltamivir-sensitive viruses. Conclusions Oseltamivir-resistance was only detected after prophylaxis with oseltamivir, suggesting that the mutation was selected for as a result of antiviral intervention. The persisting oseltamivir-sensitive virus population in the case carrying resistant viruses suggests either that a small proportion survive the treatment, or that the oseltamivir-sensitive virus rapidly re-establishes itself in the virus population after the bottleneck. Moreover, the increased intra-host variation in the oseltamivir-resistant case is consistent with the hypothesis that the population diversity of a RNA virus can increase rapidly following a population bottleneck. PMID:23587185

Impact of Air Entraining Method on the Resistance of Concrete to Internal Cracking

NASA Astrophysics Data System (ADS)

Wawrzeńczyk, Jerzy; Molendowska, Agnieszka

2017-10-01

This paper presents the test results of air entrained concrete mixtures made at a constant W/C ratio of 0.44. Three different air entraining agents were used: polymer microspheres, glass microspheres and a conventional air entraining admixture. The aim of this study was to compare the effectiveness of the air entraining methods. Concrete mixture tests were performed for consistency (slump test), density and, in the case of AEA series, air content by pressure method. Hardened concrete tests were performed for compressive strength, water absorption, resistance to chloride ingress, and freeze-thaw durability - resistance to internal cracking tests were conducted in accordance with PN-88/B-06250 on cube specimens and with the modified ASTM C666 A test method on beam specimens; porosity characteristics (A, A300, \\bar L) were determined to PN-EN 480-11:1998. No significant mass and length changes were recorded for the concrete air entrained with the conventional methods or with polymer microspheres. The results indicate that polymer microspheres are a very good alternative to traditional air entraining methods for concrete, providing effective air entrainment and protection from freezing and thawing. The glass microsphere-based concretes showed insufficient freeze-thaw resistance. The test results indicate that both the conventional methods (AEA) and the air entrainment by polymer microspheres are effective air entraining methods. It has to be noted that in the case of the use of polymer microspheres, a comparable value of \\bar L and a very good freeze-thaw resistance can be achieved at a noticeably lower air and micropore contents and at lower strength loss.

[Drug resistance profile of Mycobacterium tuberculosis in the state of Mato Grosso do Sul, Brazil, 2000-2006].

PubMed

Marques, Marli; Cunha, Eunice Atsuko Totumi; Ruffino-Netto, Antonio; Andrade, Sonia Maria de Oliveira

2010-01-01

To determine the drug resistance profile of Mycobacterium tuberculosis in the state of Mato Grosso do Sul, Brazil, between 2000 and 2006. Descriptive study of reported tuberculosis cases in the Brazilian Case Registry Database. We included only those cases in which M. tuberculosis culture was positive and sensitivity to drugs (rifampicin, isoniazid, streptomycin and ethambutol) was tested. Löwenstein-Jensen and Ogawa-Kudoh solid media were used for cultures, as was an automated liquid medium system. Sensitivity tests were based on the proportion method. Among the 783 cases evaluated, males predominated (69.7%), as did patients in the 20-49 year age bracket (70%), a diagnosis of pulmonary tuberculosis (94.4%) and positive HIV serology (8.6%); 645 (82.4%) were new cases, and 138 (17.6%) had previously been treated. Resistance to at least one drug was found in 143 cases (18.3%). The primary resistance (PR) rate was, respectively, 8.1%, 1.6%, 2.8% and 12.4%, for monoresistance, multidrug resistance (MDR), other patterns of resistance and resistance to at least one drug, whereas the acquired resistance (AR) rate was 14.5%, 20.3%, 10.9% and 45.7%, respectively, and the combined resistance (CR) rate was 9.2%, 4.9%, 4.2% and 18.3%, respectively. In PR, streptomycin was the most common drug, whereas isoniazid was the most common in AR and CR (7.2% and 3.7%, respectively). These high levels of resistance undermine the efforts for tuberculosis control in Mato Grosso do Sul. Acquired MDR was 12.7 times more common than was primary MDR, demonstrating that the previous use of drug therapy is an indicator of resistance. These levels reflect the poor quality of the health care provided to these patients, showing the importance of using the directly observed treatment, short course strategy, as well as the need to perform cultures and sensitivity tests for the early diagnosis of drug resistance.

Electrical Resistivity of Wire Arc Sprayed Zn and Cu Coatings for In-Mold-Metal-Spraying

NASA Astrophysics Data System (ADS)

Bobzin, K.; Öte, M.; Knoch, M. A.; Liao, X.; Hopmann, Ch; Ochotta, P.

2018-06-01

Electrical functionalities can be integrated into plastic parts by integrating thermally sprayed metal coatings into the non-conductive base material. Thermally sprayed conducting tracks for power and signal transmission are one example. In this case, the electrical resistance or resistivity of the coatings should be investigated. Therefore, the electrical resistivity of wire arc sprayed Zn and Cu coatings has been investigated. In case of Zn coatings, spray distance, gas pressure and wire diameter could be identified as significant influencing parameters on the electrical resistivity. In contrast, process gas, gas pressure and voltage do have a significant influence on the electrical resistivity of Cu coatings. Through the use of the In-Mold-Metal-Spraying method (IMMS), thermal degradation can be avoided by transferring thermally sprayed coating from a mold insert onto the plastic part. Therefore, the influence of the transfer process on the electrical resistance of the coatings has also been investigated.

Importation of chloroquine-resistant Plasmodium falciparum by Guatemalan peacekeepers returning from the Democratic Republic of the Congo

PubMed Central

2013-01-01

Background Malaria elimination is being pursued in five of seven Central American countries. Military personnel returning from peacekeeping missions in sub-Saharan Africa could import chloroquine-resistant Plasmodium falciparum, posing a threat to elimination and to the continued efficacy of first-line chloroquine (CQ) treatment in these countries. This report describes the importation of P. falciparum from among 150 Guatemalan army special forces and support staff who spent ten months on a United Nations’ peacekeeping mission in the Democratic Republic of the Congo (DRC) in 2010. Methods Investigators reviewed patients’ medical charts and interviewed members of the contingent to identify malaria cases and risk factors for malaria acquisition. Clinical specimens were tested for malaria; isolated parasites were characterized molecularly for CQ resistance. Results Investigators identified 12 cases (8%) of laboratory-confirmed P. falciparum infection within the contingent; one case was from a soldier infected with a CQ-resistant pfcrt genotype resulting in his death. None of the contingent used an insecticide-treated bed net (ITN) or completely adhered to malaria chemoprophylaxis while in the DRC. Conclusion This report highlights the need to promote use of malaria prevention measures, in particular ITNs and chemoprophylaxis, among peacekeepers stationed in malaria-endemic areas. Countries attempting to eliminate malaria should consider appropriate methods to screen peacekeepers returning from endemic areas for malaria infections. Cases of malaria in travellers, immigrants and soldiers returning to Central America from countries with CQ-resistant malaria should be assumed to be carry resistant parasites and receive appropriate anti-malarial therapy to prevent severe disease and death. PMID:24060234

Rapid molecular diagnostics for multi-drug resistant tuberculosis in India.

PubMed

Ramachandran, Rajeswari; Muniyandi, M

2018-03-01

Rapid molecular diagnostic methods help in the detection of TB and Rifampicin resistance. These methods detect TB early, are accurate and play a crucial role in reducing the burden of drug resistant tuberculosis. Areas covered: This review analyses rapid molecular diagnostic tools used in the diagnosis of MDR-TB in India, such as the Line Probe Assay and GeneXpert. We have discussed the burden of MDR-TB and the impact of recent diagnostic tools on case detection and treatment outcomes. This review also discusses the costs involved in establishing these new techniques in India. Expert commentary: Molecular methods have considerable advantages for the programmatic management of drug resistant TB. These include speed, standardization of testing, potentially high throughput and reduced laboratory biosafety requirements. There is a desperate need for India to adopt modern, rapid, molecular tools with point-of-care tests being currently evaluated. New molecular diagnostic tests appear to be cost effective and also help in detecting missing cases. There is enough evidence to support the scaling up of these new tools in India.

Determining resistivity of a formation adjacent to a borehole having casing with an apparatus having all current conducting electrodes within the cased well

DOEpatents

Vail, III, William Banning

2001-01-01

Methods of operation of different types of multiple electrode apparatus vertically disposed in a cased well to measure information useful to determine the resistivity of adjacent geological formations from within the cased well are described. The multiple electrode apparatus has a plurality of spaced apart voltage measurement electrodes that electrically engage a portion of the interior of the cased well. During measurements of information useful to determine formation resistivity, current is conducted between a first current conducting electrode in electrical contact with the interior of the cased well to a second current conducting electrode that is also in electrical contact with the interior of the cased well. The first and second current conducting electrodes are separated by a distance sufficient so that at least a portion of the current conducted between the first and second current conducting electrodes is conducted through the geological formation of interest.

Antibiotic resistance patterns and occurrence of mecA gene in Staphylococcus intermedius strains of canine origin.

PubMed

Kizerwetter-Swida, M; Chrobak, D; Rzewuska, M; Binek, M

2009-01-01

We have evaluated 102 Staphylococcus intermedius isolates of canine origin for susceptibility to antimicrobial primary agents, i.e. penicillin, amoxicillin, amoxicillin with clavulanic acid, cefuroxime, trimethoprim/sulfonamides, neomycin, streptomycin, gentamicin, norfloxacin, tetracycline, vancomycin, erythromycin and secondary agents, i.e., chloramphenicol, ciprofloxacin, lincomycin, teicoplanin, rifampicin, imipenem, mupirocin. Antimicrobial sensitivity was examined using the disk diffusion method and performed according to NCCLS quidelines. Methicillin resistance was detected using the disk diffusion method with oxacillin, and the occurrence of mecA gene was detected by PCR. Resistance to streptomycin, penicillin, amoxicillin, neomycin, followed by tetracycline was predominant. From 14 mecA-positive strains, 12 were multidrug-resitant, and the remaining two showed atypical susceptibility. One strain resistant to oxacillin in the disc diffusion method was mecA-negative, suggesting a different mechanism of resistance. Our results indicate that the emergence of S. intermedius resistance to methicillin may be underestimated. In case of clinical multidrug-resitant S. intermedius isolates, resistance to methicillin should be considered.

Lithography With Metallo-Organic Resists

NASA Astrophysics Data System (ADS)

Pastor, A. C.; Pastor, R. C.; Braunstein, M.; Tangonan, G. L.

1981-02-01

Photolithography with metallo-organic resists is a relatively new addition to photo-engraving technology, and involves the chemical incorporation of inorganic constituents into photopolymerizable organic compounds, so that the photoresist functions not merely as a masking material, as in conventional photolithography, but also as the mass transference vehicle itself. The deposition of thin structured films of metal oxides with this method has been accomplished, the metal-doped resist in each case being the metal acrylate in acrylic acid, except in those cases where the metal acrylate was insoluble. Polymerization was effected with uv irradiation. The criteria for depositing other classes of inorganic compounds are outlined.

Constructing Ecological Networks Based on Habitat Quality Assessment: A Case Study of Changzhou, China

NASA Astrophysics Data System (ADS)

Gao, Yu; Ma, Lei; Liu, Jiaxun; Zhuang, Zhuzhou; Huang, Qiuhao; Li, Manchun

2017-04-01

Fragmentation and reduced continuity of habitat patches threaten the environment and biodiversity. Recently, ecological networks are increasingly attracting the attention of researchers as they provide fundamental frameworks for environmental protection. This study suggests a set of procedures to construct an ecological network. First, we proposed a method to construct a landscape resistance surface based on the assessment of habitat quality. Second, to analyze the effect of the resistance surface on corridor simulations, we used three methods to construct resistance surfaces: (1) the method proposed in this paper, (2) the entropy coefficient method, and (3) the expert scoring method. Then, we integrated habitat patches and resistance surfaces to identify potential corridors using graph theory. These procedures were tested in Changzhou, China. Comparing the outputs of using different resistance surfaces demonstrated that: (1) different landscape resistance surfaces contribute to how corridors are identified, but only slightly affect the assessment of the importance of habitat patches and potential corridors; (2) the resistance surface, which is constructed based on habitat quality, is more applicable to corridor simulations; and (3) the assessment of the importance of habitat patches is fundamental for ecological network optimization in the conservation of critical habitat patches and corridors.

Constructing Ecological Networks Based on Habitat Quality Assessment: A Case Study of Changzhou, China

PubMed Central

Gao, Yu; Ma, Lei; Liu, Jiaxun; Zhuang, Zhuzhou; Huang, Qiuhao; Li, Manchun

2017-01-01

Fragmentation and reduced continuity of habitat patches threaten the environment and biodiversity. Recently, ecological networks are increasingly attracting the attention of researchers as they provide fundamental frameworks for environmental protection. This study suggests a set of procedures to construct an ecological network. First, we proposed a method to construct a landscape resistance surface based on the assessment of habitat quality. Second, to analyze the effect of the resistance surface on corridor simulations, we used three methods to construct resistance surfaces: (1) the method proposed in this paper, (2) the entropy coefficient method, and (3) the expert scoring method. Then, we integrated habitat patches and resistance surfaces to identify potential corridors using graph theory. These procedures were tested in Changzhou, China. Comparing the outputs of using different resistance surfaces demonstrated that: (1) different landscape resistance surfaces contribute to how corridors are identified, but only slightly affect the assessment of the importance of habitat patches and potential corridors; (2) the resistance surface, which is constructed based on habitat quality, is more applicable to corridor simulations; and (3) the assessment of the importance of habitat patches is fundamental for ecological network optimization in the conservation of critical habitat patches and corridors. PMID:28393879

Research on a New Method of Estimating the Potential Depth of Slope Failure Using the Airborne Electromagnetic Survey

NASA Astrophysics Data System (ADS)

Seto, Shuji; Takahara, Teruyoshi; Kinoshita, Atsuhiko; Mizuno, Hideaki; Kawato, Katsushi; Okumura, Minoru; Kageura, Ryouta

2017-04-01

In Japan, at Ontake volcano in 1984 and Kurikoma volcano in 2008, parts of the volcanoes collapsed and large-scale sediment-related disasters occurred. These disasters were unrelated to volcanic eruption directly. We conducted the case studies by using the airborne electromagnetic surveys to investigate the slopes likely to induce landslides on such volcanoes. The airborne electromagnetic surveys are the effective exploration tool when we investigate in extreme environments that person can't enter and it's necessary to investigate with wide range by a short time. The surveys were conducted by using a helicopter carrying the survey instruments; this method of non-contact investigation acquires resistivity data by the electromagnetic induction. In Japan, the surveys were conducted of 15 active volcanoes where volcanic disasters could have serious social implications. These cases focused on the seeking for the possible slopes that landslides would occur. However, the depth of the slope failure was not evaluated. Therefore in the study, we proposed a new method to determine the potential depth of slope failure. First, we categorized the three characteristics as the cap rock type, the extended collapse type, and the landslide type on the basis of collapsed cases and paid attention to the slope of the cap rock type and also defined the collapse range based on the topography and geological properties. Second, we analyzed resistivity structure about collapsed cases with the differential filter and made clear that collapse occurred in the depth which resistivity suddenly changes. In other volcanoes, we could estimate failure depth by extracting the part which resistivity suddenly changes. In the study, we use the three volcanoes as the main cases, Hokkaido Komagatake, Asama Volcano, and Ontake volcano.

Multidrug Resistance among New Tuberculosis Cases: Detecting Local Variation through Lot Quality-Assurance Sampling

PubMed Central

Lynn Hedt, Bethany; van Leth, Frank; Zignol, Matteo; Cobelens, Frank; van Gemert, Wayne; Viet Nhung, Nguyen; Lyepshina, Svitlana; Egwaga, Saidi; Cohen, Ted

2012-01-01

Background Current methodology for multidrug-resistant TB (MDR TB) surveys endorsed by the World Health Organization provides estimates of MDR TB prevalence among new cases at the national level. On the aggregate, local variation in the burden of MDR TB may be masked. This paper investigates the utility of applying lot quality-assurance sampling to identify geographic heterogeneity in the proportion of new cases with multidrug resistance. Methods We simulated the performance of lot quality-assurance sampling by applying these classification-based approaches to data collected in the most recent TB drug-resistance surveys in Ukraine, Vietnam, and Tanzania. We explored three classification systems—two-way static, three-way static, and three-way truncated sequential sampling—at two sets of thresholds: low MDR TB = 2%, high MDR TB = 10%, and low MDR TB = 5%, high MDR TB = 20%. Results The lot quality-assurance sampling systems identified local variability in the prevalence of multidrug resistance in both high-resistance (Ukraine) and low-resistance settings (Vietnam). In Tanzania, prevalence was uniformly low, and the lot quality-assurance sampling approach did not reveal variability. The three-way classification systems provide additional information, but sample sizes may not be obtainable in some settings. New rapid drug-sensitivity testing methods may allow truncated sequential sampling designs and early stopping within static designs, producing even greater efficiency gains. Conclusions Lot quality-assurance sampling study designs may offer an efficient approach for collecting critical information on local variability in the burden of multidrug-resistant TB. Before this methodology is adopted, programs must determine appropriate classification thresholds, the most useful classification system, and appropriate weighting if unbiased national estimates are also desired. PMID:22249242

Mycobacterium tuberculosis resistance to antituberculosis drugs in Mozambique*, **

PubMed Central

Pires, Germano Manuel; Folgosa, Elena; Nquobile, Ndlovu; Gitta, Sheba; Cadir, Nureisha

2014-01-01

OBJECTIVE: To determine the drug resistance profile of Mycobacterium tuberculosis in Mozambique. METHODS: We analyzed secondary data from the National Tuberculosis Referral Laboratory, in the city of Maputo, Mozambique, and from the Beira Regional Tuberculosis Referral Laboratory, in the city of Beira, Mozambique. The data were based on culture-positive samples submitted to first-line drug susceptibility testing (DST) between January and December of 2011. We attempted to determine whether the frequency of DST positivity was associated with patient type or provenance. RESULTS: During the study period, 641 strains were isolated in culture and submitted to DST. We found that 374 (58.3%) were resistant to at least one antituberculosis drug and 280 (43.7%) were resistant to multiple antituberculosis drugs. Of the 280 multidrug-resistant tuberculosis cases, 184 (65.7%) were in previously treated patients, most of whom were from southern Mozambique. Two (0.71%) of the cases of multidrug-resistant tuberculosis were confirmed to be cases of extensively drug-resistant tuberculosis. Multidrug-resistant tuberculosis was most common in males, particularly those in the 21-40 year age bracket. CONCLUSIONS: M. tuberculosis resistance to antituberculosis drugs is high in Mozambique, especially in previously treated patients. The frequency of M. tuberculosis strains that were resistant to isoniazid, rifampin, and streptomycin in combination was found to be high, particularly in samples from previously treated patients. PMID:24831398

Interpretation of magnetotelluric resistivity and phase soundings over horizontal layers

DOE Office of Scientific and Technical Information (OSTI.GOV)

Patella, D.

1976-02-01

The present paper deals with a new inverse method for quantitatively interpreting magnetotelluric apparent resistivity and phase-lag sounding curves over horizontally stratified earth sections. The recurrent character of the general formula relating the wave impedance of an (n-l)-layered medium to that of an n-layered medium suggests the use of the method of reduction to a lower boundary plane, as originally termed by Koefoed in the case of dc resistivity soundings. The layering parameters are so directly derived by a simple iterative procedure. The method is applicable for any number of layers but only when both apparent resistivity and phase-lag soundingmore » curves are jointly available. Moreover no sophisticated algorithm is required: a simple desk electronic calculator together with a sheet of two-layer apparent resistivity and phase-lag master curves are sufficient to reproduce earth sections which, in the range of equivalence, are all consistent with field data.« less

REPLY: Reply to 'Comment on "Electron-phonon scattering in Sn-doped In2O3 FET nanowires probed by temperature-dependent measurements"'

NASA Astrophysics Data System (ADS)

Berengue, Olivia M.; Chiquito, Adenilson J.; Pozzi, Livia P.; Lanfredi, Alexandre J. C.; Leite, Edson R.

2009-11-01

In this reply we discuss the use of two and four-probe methods in the resistivity measurements of ITO nanowires. We pointed out that the results obtained by using two or four probe methods are indistinguishable in our case. Additionally we present the correct values for resistivity and consequently for the density of electrons.

[Epidemiology of resistance to antituberculosis drugs in Mycobacterium tuberculosis complex strains isolated from adenopathies in Djibouti. Prospective study carried out in 1999].

PubMed

Koeck, J L; Bernatas, J J; Gerome, P; Fabre, M; Houmed, A; Herve, V; Teyssou, R

2002-01-01

Tuberculosis is a major cause of death in the Republic of Djibouti. Tuberculous lymphadenitis represents about 25% of the clinical forms of tuberculosis in this country. Between January 1999 and April 1999, 196 lymph node specimens were consecutively collected from 153 patients living in Djibouti. Testing of susceptibility to the major anti-tuberculosis drugs was performed by the proportion method. Growth of Mycobacterium tuberculosis complex strains was obtained from specimens of 85 patients including 9 with prior treatment. Strains were identified as Mycobacterium tuberculosis in 78 cases, Mycobacterium canetti in 3, Mycobacterium africanum in 3, and Mycobacterium bovis in 1. Prevalence of HIV infection was 15%. Assessment of primary resistance demonstrated that the overall resistance rate, i.e., resistance to 1 or more drugs, was 18 (21.2%). Results showed resistance to isoniazid (H) in 6 cases (7.1%), rifampicin (R) in 3 (3.5%), ethambutol (E) in 1 (1.2%), streptomycin (S) in 13 (15.3%) and pyrazinamide (Z) in 1 (1.2%). Multidrug resistance (MDR) was found in 2 cases (2.4%). Assessment of acquired resistance demonstrated resistance to H in 4 cases (44%), R in 2 (22%), S in 2 (22%), E in 0, Z in 0 and MDR in 1 (11%). These findings were not significantly different from data obtained from sputum samples analysed between 1997 and 2000 or from those described in a study conducted in 1985.

Detection of antibiotic resistance genes in samples from acute and chronic endodontic infections and after treatment.

PubMed

Rôças, Isabela N; Siqueira, José F

2013-09-01

The purpose of this study was twofold: survey samples from acute and chronic endodontic infections for the presence of genes encoding resistance to beta-lactams, tetracycline and erythromycin, and evaluate the ability of treatment to eliminate these genes from root canals. DNA extracts from samples of abscess aspirates (n=25) and root canals of teeth with asymptomatic apical periodontitis (n=24) were used as template for direct detection of the genes blaTEM, cfxA, tetM, tetQ, tetW, and ermC using real-time polymerase chain reaction (PCR). Bacterial presence was determined using PCR with universal bacterial primers. Root canals of the asymptomatic cases were also sampled and evaluated after chemomechanical procedures using NiTi instruments with 2.5% NaOCl irrigation. All abscess and initial root canal samples were positive for bacteria. At least one of the target resistance genes was found in 36% of the abscess samples and 67% of the asymptomatic cases. The most prevalent genes in abscesses were blaTEM (24%) and ermC (24%), while tetM (42%) and tetW (29%) prevailed in asymptomatic cases. The blaTEM gene was significantly associated with acute cases (p=0.02). Conversely, tetM was significantly more prevalent in asymptomatic cases (p=0.008). Treatment eliminated resistance genes from most cases. Acute and chronic endodontic infections harboured resistance genes for 3 classes of widely used antibiotics. In most cases, treatment was effective in eliminating these genes, but there were a few cases in which they persisted. The implications of persistence are unknown. Direct detection of resistance genes in abscesses may be a potential method for rapid diagnosis and establishment of proactive antimicrobial therapy. Copyright © 2013 Elsevier Ltd. All rights reserved.

Measuring resistivity changes from within a first cased well to monitor fluids injected into oil bearing geological formations from a second cased well while passing electrical current between the two cased wells

DOEpatents

Vail, III, William B.

1993-01-01

A.C. current is conducted through geological formations separating two cased wells in an oil field undergoing enhanced oil recovery operations such as water flooding operations. Methods and apparatus are disclosed to measure the current leakage conducted into a geological formation from within a first cased well that is responsive to fluids injected into formation from a second cased well during the enhanced oil production activities. The current leakage and apparent resistivity measured within the first cased well are responsive to fluids injected into formation from the second cased well provided the distance of separation between the two cased wells is less than, or on the order of, a Characteristic Length appropriate for the problem.

Measuring resistivity changes from within a first cased well to monitor fluids injected into oil bearing geological formations from a second cased well while passing electrical current between the two cased wells

DOEpatents

Vail, W.B. III.

1993-02-16

A.C. current is conducted through geological formations separating two cased wells in an oil field undergoing enhanced oil recovery operations such as water flooding operations. Methods and apparatus are disclosed to measure the current leakage conducted into a geological formation from within a first cased well that is responsive to fluids injected into formation from a second cased well during the enhanced oil production activities. The current leakage and apparent resistivity measured within the first cased well are responsive to fluids injected into formation from the second cased well provided the distance of separation between the two cased wells is less than, or on the order of, a Characteristic Length appropriate for the problem.

The use of whole-genome sequencing in cluster investigation of a multidrug-resistant tuberculosis outbreak.

PubMed

Lalor, Maeve K; Casali, Nicola; Walker, Timothy M; Anderson, Laura F; Davidson, Jennifer A; Ratna, Natasha; Mullarkey, Cathy; Gent, Mike; Foster, Kirsty; Brown, Tim; Magee, John; Barrett, Anne; Crook, Derrick W; Drobniewski, Francis; Thomas, H Lucy; Abubakar, Ibrahim

2018-06-01

We used whole-genome sequencing (WGS) to delineate transmission networks and investigate the benefits of WGS during cluster investigation.We included clustered cases of multidrug-resistant (MDR) tuberculosis (TB)/extensively drug-resistant (XDR) TB linked by mycobacterial interspersed repetitive unit variable tandem repeat (MIRU-VNTR) strain typing or epidemiological information in the national cluster B1006, notified between 2007 and 2013 in the UK. We excluded from further investigation cases whose isolates differed by greater than 12 single nucleotide polymorphisms (SNPs). Data relating to patients' social networks were collected.27 cases were investigated and 22 had WGS, eight of which (36%) were excluded as their isolates differed by more than 12 SNPs to other cases. 18 cases were ruled into the transmission network based on genomic and epidemiological information. Evidence of transmission was inconclusive in seven out of 18 cases (39%) in the transmission network following WGS and epidemiological investigation.This investigation of a drug-resistant TB cluster illustrates the opportunities and limitations of WGS in understanding transmission in a setting with a high proportion of migrant cases. The use of WGS should be combined with classical epidemiological methods. However, not every cluster will be solvable, regardless of the quality of genomic data. Copyright ©ERS 2018.

[Biliary calculi resistant to dissolution with bile acids: their heterogeneous composition and diversity of treatment response].

PubMed

Ruíz de Aguiar, A; Medina, J A; Garrido, G; Villacorta, J; Berenguer, J

1992-05-01

We have studied thirteen biliary stones resistant to biliary acids, using technical methods of stereomicroscopy, scanning electronic microscopy and EDX analyses. We have investigated changes on surface. Three biliary stones did not change and were considered resistant. Seven biliary stones appear partially dissolved and we observed many irregularities on surface and/or concentric dips in relation with cholesterol dissolution. In six cases, biliary pigment alternates with cholesterol. In three cases we observed a calcium carbonate coat on surface. One case included organic fibers. One biliary stone showed cholesterol with spherical bodies of calcium carbonate and pigment. It was a relapsed case of combined treatment. Three stones are composed of small black portions of polymerized calcium bilirubinate, rich in copper and iron. Our results demonstrate that biliary stones previously selected for treatment are a heterogeneous group. Because of this fact we get variable and unpredictable results.

30 CFR 75.700-1 - Approved methods of grounding.

Code of Federal Regulations, 2012 CFR

2012-07-01

... a borehole casing having low resistance to earth; (b) A solid connection to metal waterlines having low resistance to earth; (c) A solid connection to a grounding conductor, other than the neutral... ensures that there is no difference in potential between such metallic enclosures and the earth. ...

30 CFR 75.700-1 - Approved methods of grounding.

Code of Federal Regulations, 2014 CFR

2014-07-01

... a borehole casing having low resistance to earth; (b) A solid connection to metal waterlines having low resistance to earth; (c) A solid connection to a grounding conductor, other than the neutral... ensures that there is no difference in potential between such metallic enclosures and the earth. ...

Forced vibrations of a two-layered shell in the case of viscous resistance

NASA Astrophysics Data System (ADS)

Aghalovyan, L. A.; Ghulghazaryan, L. G.

2018-04-01

Forced vibrations of a two-layered orthotropic shell are studied in the case of viscous resistance in the lower layer of the shell. Two versions of spatial boundary conditions on the upper surface of the shell are posed, and the displacement vector is given on the lower surface. An asymptotic method is used to solve the corresponding dynamic equations and relations of the three-dimensional problem of elasticity. The amplitudes of the forced vibrations are determined, and the resonance conditions are established.

Improving resistivity survey resolution at sites with limited spatial extent using buried electrode arrays

NASA Astrophysics Data System (ADS)

Kiflu, H.; Kruse, S.; Loke, M. H.; Wilkinson, P. B.; Harro, D.

2016-12-01

Electrical resistivity tomography (ERT) surveys are widely used in geological, environmental and engineering studies. However, the effectiveness of surface ERT surveys is limited by decreasing resolution with depth and near the ends of the survey line. Increasing the array length will increase depth of investigation, but may not be possible at urban sites where access is limited. One novel method of addressing these limitations while maintaining lateral coverage is to install an array of deep electrodes. Referred to here as the Multi-Electrode Resistivity Implant Technique (MERIT), self-driving pointed electrodes are implanted at depth below each surface electrode in an array, using direct-push technology. Optimal sequences of readings have been identified with the "Compare R" method of Wilkinson. Numerical, laboratory, and field case studies are applied to examine the effectiveness of the MERIT method, particularly for use in covered karst terrain. In the field case studies, resistivity images are compared against subsurface structure defined from borings, GPR surveys, and knowledge of prior land use. In karst terrain where limestone has a clay overburden, traditional surface resistivity methods suffer from lack of current penetration through the shallow clay layer. In these settings, the MERIT method is found to improve resolution of features between the surface and buried array, as well as increasing depth of penetration and enhancing imaging capabilities at the array ends. The method functions similar to a cross-borehole array between horizontal boreholes, and suffers from limitations common to borehole arrays. Inversion artifacts are common at depths close to the buried array, and because some readings involve high geometric factors, inversions are more susceptible to noise than traditional surface arrays. Results are improved by using errors from reciprocal measurements to weight the data during the inversion.

Cutaneous Squamous Cell Carcinoma in Lupus Vulgaris Caused by Drug Resistant Mycobacterium Tuberculosis

PubMed Central

Kumaran, Muthu S.; Narang, Tarun; Jitendriya, Madhukara; Tirumale, Rajalakshmi; Manjunath, Suraj; Savio, Jayanthi

2017-01-01

Tuberculosis (TB) is still a major public health problem in the world, with many factors contributing to this burden, including poor living conditions, overcrowding, poverty, malnutrition, illiteracy, and rapid spread of human immunodeficiency virus infection. Cutaneous tuberculosis is a less common form of extrapulmonary tuberculosis, and in this paucibacillary form the diagnosis depends on histopathology, tuberculin positivity, and response to treatment. The diagnosis is even more difficult in cases with drug resistant Mycobacterium tuberculosis due to lack of awareness and lack of facilities to diagnose drug resistant tuberculosis. In this article, we describe an unusual case of multidrug resistant lupus vulgaris (LV), in a 34-year-old male who responded to anti-tubercular treatment (ATT) initially, but developed recurrent disease which failed to respond to standard four-drug ATT; subsequently, tissue culture showed growth of multidrug resistant M. tuberculosis. Subsequently, he also developed cutaneous squamous cell carcinoma. This article aims to exemplify a grave complication that can occur in long-standing case of LV, the limitations faced by clinicians in developing countries where tuberculosis is endemic, and classical methods of proving drug resistance are generally unavailable or fail. PMID:28761842

[Clinical characteristics of whooping cough in neonates and antimicrobial resistance of the pathogenic bacteria].

PubMed

Luo, Jie; Wang, Hui-Xin; Yuan, Lin; Gu, Song; Jiang, Min; Ding, Yi-Jun; Guo, Dan; Yao, Kai-Hu; Wang, Ya-Juan

2014-10-01

To study the clinical characteristics of whooping cough in neonates and the antimicrobial resistance of the bacterial isolates. Clinical information of 7 neonates with whooping cough confirmed by bacterial culture was collected. The antimirobial resistance of the isolates was tested using E-test and disk diffusion methods. The children′s mothers or other family members had cough for more than 10 days in 6 neonates, in which four neonates contacted with 3 or more family members with cough. All the neonates had rhinobyon and slight cough at the beginning of the disease. Five cases presented typical spasmodic cough after 4-7 days of the onset. Five cases displayed cyanosis, four cases occurred apnea, three cases suffered breath holding, and only two cases had fever. Nares flaring and three depression signs were found in the physical examination. No bacteriostatic ring around the erythromycin disks were found for five bacterial isolates. The minimal inhibitory concentration (MIC) for erythromycin, azithromycin, clarithromycin and clindamycin were all >256 mg/L against the five isolates. Whooping cough should be considered for neonates with respiratory symptoms and a history of close contact with respiratory infection patients. Macrolide-resistant Bordetella pertussis is common in children with whooping cough.

Empirical Mode Decomposition and k-Nearest Embedding Vectors for Timely Analyses of Antibiotic Resistance Trends

PubMed Central

Teodoro, Douglas; Lovis, Christian

2013-01-01

Background Antibiotic resistance is a major worldwide public health concern. In clinical settings, timely antibiotic resistance information is key for care providers as it allows appropriate targeted treatment or improved empirical treatment when the specific results of the patient are not yet available. Objective To improve antibiotic resistance trend analysis algorithms by building a novel, fully data-driven forecasting method from the combination of trend extraction and machine learning models for enhanced biosurveillance systems. Methods We investigate a robust model for extraction and forecasting of antibiotic resistance trends using a decade of microbiology data. Our method consists of breaking down the resistance time series into independent oscillatory components via the empirical mode decomposition technique. The resulting waveforms describing intrinsic resistance trends serve as the input for the forecasting algorithm. The algorithm applies the delay coordinate embedding theorem together with the k-nearest neighbor framework to project mappings from past events into the future dimension and estimate the resistance levels. Results The algorithms that decompose the resistance time series and filter out high frequency components showed statistically significant performance improvements in comparison with a benchmark random walk model. We present further qualitative use-cases of antibiotic resistance trend extraction, where empirical mode decomposition was applied to highlight the specificities of the resistance trends. Conclusion The decomposition of the raw signal was found not only to yield valuable insight into the resistance evolution, but also to produce novel models of resistance forecasters with boosted prediction performance, which could be utilized as a complementary method in the analysis of antibiotic resistance trends. PMID:23637796

Multidrug-resistant tuberculosis.

PubMed

Zager, Ellen M; McNerney, Ruth

2008-01-25

With almost 9 million new cases each year, tuberculosis remains one of the most feared diseases on the planet. Led by the STOP-TB Partnership and WHO, recent efforts to combat the disease have made considerable progress in a number of countries. However, the emergence of mutated strains of Mycobacterium tuberculosis that are resistant to the major anti-tuberculosis drugs poses a deadly threat to control efforts. Multidrug-resistant tuberculosis (MDR-TB) has been reported in all regions of the world. More recently, extensively drug resistant-tuberculosis (XDR-TB) that is also resistant to second line drugs has emerged in a number of countries. To ensure that adequate resources are allocated to prevent the emergence and spread of drug resistance it is important to understand the scale of the problem. In this article we propose that current methods of describing the epidemiology of drug resistant tuberculosis are not adequate for this purpose and argue for the inclusion of population based statistics in global surveillance data. Whereas the prevalence of tuberculosis is presented as the proportion of individuals within a defined population having disease, the prevalence of drug resistant tuberculosis is usually presented as the proportion of tuberculosis cases exhibiting resistance to anti-tuberculosis drugs. Global surveillance activities have identified countries in Eastern Europe, the former Soviet Union and regions of China as having a high proportion of MDR-TB cases and international commentary has focused primarily on the urgent need to improve control in these settings. Other regions, such as sub-Saharan Africa have been observed as having a low proportion of drug resistant cases. However, if one considers the incidence of new tuberculosis cases with drug resistant disease in terms of the population then countries of sub-Saharan Africa have amongst the highest rates of transmitted MDR-TB in the world. We propose that inclusion of population based statistics in global surveillance data is necessary to better inform debate on the control of drug resistant tuberculosis. Re-appraisal of global MDR-TB data to include population based statistics suggests that the problem of drug resistant tuberculosis in sub-Saharan Africa is more critical than previously perceived.

Rapid Detection of Mycobacterium tuberculosis and Rifampin Resistance by Use of On-Demand, Near-Patient Technology▿ † ‡

PubMed Central

Helb, Danica; Jones, Martin; Story, Elizabeth; Boehme, Catharina; Wallace, Ellen; Ho, Ken; Kop, JoAnn; Owens, Michelle R.; Rodgers, Richard; Banada, Padmapriya; Safi, Hassan; Blakemore, Robert; Lan, N. T. Ngoc; Jones-López, Edward C.; Levi, Michael; Burday, Michele; Ayakaka, Irene; Mugerwa, Roy D.; McMillan, Bill; Winn-Deen, Emily; Christel, Lee; Dailey, Peter; Perkins, Mark D.; Persing, David H.; Alland, David

2010-01-01

Current nucleic acid amplification methods to detect Mycobacterium tuberculosis are complex, labor-intensive, and technically challenging. We developed and performed the first analysis of the Cepheid Gene Xpert System's MTB/RIF assay, an integrated hands-free sputum-processing and real-time PCR system with rapid on-demand, near-patient technology, to simultaneously detect M. tuberculosis and rifampin resistance. Analytic tests of M. tuberculosis DNA demonstrated a limit of detection (LOD) of 4.5 genomes per reaction. Studies using sputum spiked with known numbers of M. tuberculosis CFU predicted a clinical LOD of 131 CFU/ml. Killing studies showed that the assay's buffer decreased M. tuberculosis viability by at least 8 logs, substantially reducing biohazards. Tests of 23 different commonly occurring rifampin resistance mutations demonstrated that all 23 (100%) would be identified as rifampin resistant. An analysis of 20 nontuberculosis mycobacteria species confirmed high assay specificity. A small clinical validation study of 107 clinical sputum samples from suspected tuberculosis cases in Vietnam detected 29/29 (100%) smear-positive culture-positive cases and 33/39 (84.6%) or 38/53 (71.7%) smear-negative culture-positive cases, as determined by growth on solid medium or on both solid and liquid media, respectively. M. tuberculosis was not detected in 25/25 (100%) of the culture-negative samples. A study of 64 smear-positive culture-positive sputa from retreatment tuberculosis cases in Uganda detected 63/64 (98.4%) culture-positive cases and 9/9 (100%) cases of rifampin resistance. Rifampin resistance was excluded in 54/55 (98.2%) susceptible cases. Specificity rose to 100% after correcting for a conventional susceptibility test error. In conclusion, this highly sensitive and simple-to-use system can detect M. tuberculosis directly from sputum in less than 2 h. PMID:19864480

Assess drug resistance pattern and genetic profile of Mycobacterium tuberculosis clinical isolates by molecular typing methods using direct repeats and IS6110 in pulmonary tuberculosis cases

PubMed Central

Kalo, Deepika; Kant, Surya; Srivastava, Kanchan; Sharma, Ajay K

2017-01-01

Background: Tuberculosis (TB), a highly contagious disease that sees no gender, age, or race is mainly a disease of lungs. According to World Health Organization, a TB patient can be completely cured with 6–9 months of anti-TB treatment under directly observed treatment short course. Objectives: The aim of this study was to check the mono, multi- and triple-drug resistance to first line drugs (FLDs) among TB patients and to access their genetic profile using DR 3074, DR 0270, DR 0642, DR 2068, and DR 4110 using molecular techniques. Material and Methods: To gain a better understanding of drug resistant TB, we characterized 121 clinical isolates recovered from 159 drug resistant pulmonary tuberculosis patients by IS6110 genotyping. MTB isolates recovered from HIV- negative, and smear positive cases of both genders, age varied from 18 to 70 years with drug resistant-TB that was refractory to chemotherapy given for > 12 months. Of a total of 159 sputum smear positive patients sum number of male and female patients was 121 (76.10%) and 38 (23.89%), respectively. Among these patients, number of literate and illiterate patients were 123 (77.3%) and 36 (22.6%). 25 (15.7%) patients had farming as their occupation, 80 (50.3%) had nonagricultural occupation and 54 (33.9%) women were housewives. Results: Mono drug resistant, multi-drug resistant, and totally drug resistant (TDR) cases of TB were calculated as 113.83%, 125.1%, and 67.9%. Isoniazid showed the highest percentage of resistance among the patients. Conclusion: Any noncompliance to TB medications, lack of knowledge, and poor management in health centers, etc., results in the emergence of deadly direct repeat forms of TB, which are further complicated and complex to treat. PMID:28360464

Prevalence and Risk factors for Drug Resistance among Hospitalized TB Patients in Georgia

PubMed Central

Vashakidze, L; Salakaia, A.; Shubladze, N.; Cynamon, M.; Barbakadze, K.; Kikvidze, M.; Papitashvili, L.; Nonikashvili, M.; Solomonia, N.; Bejanishvili, N.; Khurtsilava, I.

2010-01-01

SUMMARY Background Tuberculosis control in Georgia follows the WHO recommended DOTS strategy and has reached Global TB Control targets in treatment of sensitive TB, but the management of drug resistant forms of TB still represents a serious problem. A country-wide Drug Resistance Survey (DRS) found that the prevalence of MDR-TB was 6.8% in new and 27.4% in previously treated TB cases. Objective To determine prevalence and risk factors for drug resistance among TB patients in order to improve DR-TB case management and control. Methods Extensive social, clinical and bacteriological data were collected from hospitalized patients (National Centre for Tuberculosis and Lung Diseases, Georgia, 2005–2007). Results Out of 605 patients DR-TB was found in 491 (81.2%) cases, MDR-TB was observed in 261(43.1%) [51 (23%) out of 222 New cases and 210 (55%) out of 383 Previously treated cases], mono-DR-TB in 130 (21.5%), poly-DR-TB in 67 (11.1%) and XDR-TB in 33 (5.5%) cases. Study showed that female gender, living in densely populated capital, family TB contact and previous TB treatment are associated with risk for having MDR-TB. Conclusions Findings confirm the necessity of improvement of infection control measures and availability of standardized treatment for DR-TB patients. PMID:19723406

Reconstructing former urban environments by combining geophysical electrical methods and geotechnical investigations—an example from Chania, Greece

NASA Astrophysics Data System (ADS)

Soupios, P. M.; Loupasakis, C.; Vallianatos, F.

2008-06-01

Nowadays, geophysical prospecting is implemented in order to resolve a diversity of geological, hydrogeological, environmental and geotechnical problems. Although plenty of applications and a lot of research have been conducted in the countryside, only a few cases have been reported in the literature concerning urban areas, mainly due to high levels of noise present that aggravate most of the geophysical methods or due to spatial limitations that hinder normal method implementation. Among all geophysical methods, electrical resistivity tomography has proven to be a rapid technique and the most robust with regard to urban noise. This work presents a case study in the urban area of Chania (Crete Island, Greece), where electrical resistivity tomography (ERT) has been applied for the detection and identification of possible buried ancient ruins or other man-made structures, prior to the construction of a building. The results of the detailed geophysical survey indicated eight areas of interest providing resistivity anomalies. Those anomalies were analysed and interpreted combining the resistivity readings with the geotechnical borehole data and the historical bibliographic reports—referring to the 1940s (Xalkiadakis 1997 Industrial Archaeology in Chania Territory pp 51-62). The collected ERT-data were processed by applying advanced algorithms in order to obtain a 3D-model of the study area that depicts the interesting subsurface structures more clearly and accurately.

Perinatal acquisition of drug-resistant HIV-1 infection: mechanisms and long-term outcome

PubMed Central

Delaugerre, Constance; Chaix, Marie-Laure; Blanche, Stephane; Warszawski, Josiane; Cornet, Dorine; Dollfus, Catherine; Schneider, Veronique; Burgard, Marianne; Faye, Albert; Mandelbrot, Laurent; Tubiana, Roland; Rouzioux, Christine

2009-01-01

Background Primary-HIV-1-infection in newborns that occurs under antiretroviral prophylaxis that is a high risk of drug-resistance acquisition. We examine the frequency and the mechanisms of resistance acquisition at the time of infection in newborns. Patients and Methods We studied HIV-1-infected infants born between 01 January 1997 and 31 December 2004 and enrolled in the ANRS-EPF cohort. HIV-1-RNA and HIV-1-DNA samples obtained perinatally from the newborn and mother were subjected to population-based and clonal analyses of drug resistance. If positive, serial samples were obtained from the child for resistance testing. Results Ninety-two HIV-1-infected infants were born during the study period. Samples were obtained from 32 mother-child pairs and from another 28 newborns. Drug resistance was detected in 12 newborns (20%): drug resistance to nucleoside reverse transcriptase inhibitors was seen in 10 cases, non-nucleoside reverse transcriptase inhibitors in two cases, and protease inhibitors in one case. For 9 children, the detection of the same resistance mutations in mothers' samples (6 among 10 available) and in newborn lymphocytes (6/8) suggests that the newborn was initially infected by a drug-resistant strain. Resistance variants were either transmitted from mother-to-child or selected during subsequent temporal exposure under suboptimal perinatal prophylaxis. Follow-up studies of the infants showed that the resistance pattern remained stable over time, regardless of antiretroviral therapy, suggesting the early cellular archiving of resistant viruses. The absence of resistance in the mother of the other three children (3/10) and neonatal lymphocytes (2/8) suggests that the newborns were infected by a wild-type strain without long-term persistence of resistance when suboptimal prophylaxis was stopped. Conclusion This study confirms the importance of early resistance genotyping of HIV-1-infected newborns. In most cases (75%), drug resistance was archived in the cellular reservoir and persisted during infancy, with or without antiretroviral treatment. This finding stresses the need for effective antiretroviral treatment of pregnant women. PMID:19765313

The laparoscopic ovarian electrocautery versus gonadotropin therapy in infertile women with clomiphene citrate-resistant polycystic ovary syndrome; a randomized controlled trial.

PubMed

Mehrabian, Ferdous; Eessaei, Fatemeh

2012-03-01

This study aimed to compare two methods of treatment of infertility with gonadotropin with laparoscopic ovarian electrocauterization in patients with clomiphene citrate-resistant polycystic ovary syndrome (PCOS). A number of 104 nulipara patients with polycystic ovary syndrome, who were resistant to clomiphene citrate were randomly assigned to two groups. One group received gonadotropin; after the bleeding withdrawal and from the third day of the cycle, the injection of human menopausal gonadotropin (HMG) was started with 10 mg medroxy progesterone. The patients were followed with serial trans-vaginal sonographies. When the diameter of follicles reached to 18 mm, human chorionic gonadotropin (HCG) was prescribed. The other group was treated with laparoscopic ovarian electrocauterization under general anesthesia. If after 3 cycles, the anovulation was established with progesterone measurement, the clomiphene citrate was prescribed. Gonadotropin was administered, if the lack of ovulation persisted. No significant difference was documented between the two groups in terms of the obesity indexes, duration of infertility, age, sonographic and laboratory findings. In the gonadotropin group, 37 cases (71%) of pregnancy occurred. The rate of pregnancy was the same in the other group consisting of 18 cases treated by electrocautery, 9 cases with cautery + clomiphene, and 10 cases with clomiphene + cautery + gonadotropin. In the group treated with gonadotropin, there were 1 triple and 4 twins pregnancies. In the group treated with ovarian electrocautery, one twin pregnancy was observed. In the group treated with gonadotropin, 2 cases of ovarian hyperstimulation syndrome, 1 case of ectopic pregnancy and 6 cases of miscarriage occurred; the corresponding figure in the ovarian electrocautery group consisted of 5 cases of miscarriage. Our findings suggest that ovarian electrocauterization is an appropriate method with good efficacy and low complication rate for infertility treatment of women with clomiphene citrate-resistant polycystic ovary syndrome.

Resist process optimization for further defect reduction

NASA Astrophysics Data System (ADS)

Tanaka, Keiichi; Iseki, Tomohiro; Marumoto, Hiroshi; Takayanagi, Koji; Yoshida, Yuichi; Uemura, Ryouichi; Yoshihara, Kosuke

2012-03-01

Defect reduction has become one of the most important technical challenges in device mass-production. Knowing that resist processing on a clean track strongly impacts defect formation in many cases, we have been trying to improve the track process to enhance customer yield. For example, residual type defect and pattern collapse are strongly related to process parameters in developer, and we have reported new develop and rinse methods in the previous papers. Also, we have reported the optimization method of filtration condition to reduce bridge type defects, which are mainly caused by foreign substances such as gels in resist. Even though we have contributed resist caused defect reduction in past studies, defect reduction requirements continue to be very important. In this paper, we will introduce further process improvements in terms of resist defect reduction, including the latest experimental data.

Characterization of Multidrug Resistant E. faecalis Strains from Pigs of Local Origin by ADSRRS-Fingerprinting and MALDI -TOF MS; Evaluation of the Compatibility of Methods Employed for Multidrug Resistance Analysis

PubMed Central

Nowakiewicz, Aneta; Ziółkowska, Grażyna; Zięba, Przemysław; Gnat, Sebastian; Trościańczyk, Aleksandra; Adaszek, Łukasz

2017-01-01

The aim of this study was to characterize multidrug resistant E. faecalis strains from pigs of local origin and to analyse the relationship between resistance and genotypic and proteomic profiles by amplification of DNA fragments surrounding rare restriction sites (ADSRRS-fingerprinting) and matrix-assisted laser desorption ionization time-of-flight mass spectrometry (MALDI -TOF MS). From the total pool of Enterococcus spp. isolated from 90 pigs, we selected 36 multidrug resistant E. faecalis strains, which represented three different phenotypic resistance profiles. Phenotypic resistance to tetracycline, macrolides, phenicols, and lincomycin and high-level resistance to aminoglycosides were confirmed by the occurrence of at least one corresponding resistance gene in each strain. Based on the analysis of the genotypic and phenotypic resistance of the strains tested, five distinct resistance profiles were generated. As a complement of this analysis, profiles of virulence genes were determined and these profiles corresponded to the phenotypic resistance profiles. The demonstration of resistance to a wide panel of antimicrobials by the strains tested in this study indicates the need of typing to determine the spread of resistance also at the local level. It seems that in the case of E. faecalis, type and scope of resistance strongly determines the genotypic pattern obtained with the ADSRRS-fingerprinting method. The ADSRRS-fingerprinting analysis showed consistency of the genetic profiles with the resistance profiles, while analysis of data with the use of the MALDI- TOF MS method did not demonstrate direct reproduction of the clustering pattern obtained with this method. Our observations were confirmed by statistical analysis (Simpson’s index of diversity, Rand and Wallace coefficients). Even though the MALDI -TOF MS method showed slightly higher discrimination power than ADSRRS-fingerprinting, only the latter method allowed reproduction of the clustering pattern of isolates based on phenotypic resistance and analysis of resistance and virulence genes (Wallace coefficient 1.0). This feature seems to be the most useful for epidemiological purposes and short-term analysis. PMID:28135327

Accurate calculation of multispar cantilever and semicantilever wings with parallel webs under direct and indirect loading

NASA Technical Reports Server (NTRS)

Sanger, Eugen

1932-01-01

In the present report the computation is actually carried through for the case of parallel spars of equal resistance in bending without direct loading, including plotting of the influence lines; for other cases the method of calculation is explained. The development of large size airplanes can be speeded up by accurate methods of calculation such as this.

[Multicenter transversal study of tuberculosis and drug resistance in Madrid (October 1993-April 1994)].

PubMed

1996-01-13

The aim of this study was to know the demographic profile of the new cases of tuberculosis (TB) and evaluate the current status of resistance to antituberculous drugs in Madrid, Spain. A transversal study was carried out in 8 hospitals (6 general hospitals) during 6 months. The clinical data of patients over 14 years old who presented a positive culture for Mycobacterium tuberculosis were collected in a protocolized method; the study on sensitivity to 5 drugs was independently and centrally performed (proportions method). 467 patients (339 from general hospitals), were included. In respect to the latter patients, 71% were under the age of 45 years and 36% presented coinfection with the human immunodeficiency virus (HIV). A sensitivity study was performed in 419 strains. Forty strains showed resistance to one or more of the antituberculous drugs; 13 were from the same center (CIC) in which a nosocomial outbreak of multiresistent TB had been detected among HIV infected patients. Resistence to more than one drug was observed in 29 cases (6.9%) and to rifampicine (RIF) and isoniacide (INH) in 24 patients (5.7%). On excluding the patients from the CIC these values were 16 (4.1%) and 13 (3.3%), respectively. Ninety-two percent of the strains with resistence to RIF + INH were from HIV positive patients. The rate of primary resistence to iNH in the patients with TB without HIV infection was 2.7%. This rate was 9.3% in those with HIV infection, and was 5.7% on excluding CIC cases. In patients with HIV infection most of the strains with primary resistence to INH also presented primary resistance to RIF. More than one third of the patients with TB diagnosed in the general hospitals in Madrid, presented coinfection with HIV. In this population, the initial treatment for TB should probably begin with 4 drugs while awaiting the obliged sensitivity study.

Simple Molecular Methods for Early Detection of Chloroquine Drug Resistance in Plasmodium vivax and Plasmodium falciparum

PubMed Central

Singh, Raksha; Urhehar, Anant Dattatraya

2016-01-01

Introduction Malaria is a human disease of which causes high morbidity and mortality. In Plasmodium falciparum malaria, the resistance to antimalarial drugs, especially chloroquine (CQ) is one of the paramount factors contributing to the global increase in morbidity and mortality, due to malaria. Hence, there is a need for detection of chloroquine drug resistance genes i.e., pfcrt-o (Plasmodium falciparum chloroquine resistance transporter-o) and pfmdr-1 (Plasmodium falciparum multidrug resistance-1) of P. falciparum and pvcrt-o (Plasmodium vivax chloroquine resistance transporter-o) and pvmdr-1 (Plasmodium vivax multidrug resistance-1) of P. vivax by using molecular methods to prevent mortality in malarial cases. Aim To standardize chloroquine drug sensitivity testing by molecular method so as to provide reports of chloroquine within 6-8 hours to physicians for better treatment. Materials and Methods This study was conducted over a period of one year from January to December 2014. A Total of 300 blood samples were collected from malaria suspected patient attending MGM Hospital, Kamothe, Navi Mumbai, India. Out of 300 blood samples, 44 were malaria positive as assessed by Thick and Thin blood smear stained, by Leishman’s method and examination with light microscope. Chloroquine drug sensitivity testing was performed using WHO III plate method (micro test). Nested PCR was done for detection of pfcrt-o and pfmdr-1 for P. falciparum and pvcrt-o, pvmdr-1 genes for P. vivax. Results Total 44 samples were included in this study, out of which 22 samples confirmed for Plasmodium falciparum and 22 samples confirmed for Plasmodium vivax. Out of 22 P. falciparum 15 (68.18%) samples were chloroquine resistant. P. vivax showed chloroquine resistance to 5 samples (22.73%) by method similar to WHO III plate method (micro test) and nested PCR. Conclusion Drug resistance testing by molecular methods is useful for early detection of antimalarial drug resistance. pfmdr-1 along with pfcrt-o can be used as biomarker for chloroquine drug resistance in P. falciparum and pvmdr-1 along with pvcrt-o for P. vivax. PMID:27630842

Drug resistance of Mycobacterium tuberculosis in Malawi: a cross-sectional survey

PubMed Central

Abouyannis, Michael; Dacombe, Russell; Dambe, Isaias; Mpunga, James; Faragher, Brian; Gausi, Francis; Ndhlovu, Henry; Kachiza, Chifundo; Suarez, Pedro; Mundy, Catherine; Banda, Hastings T; Nyasulu, Ishmael

2014-01-01

Abstract Objective To document the prevalence of multidrug resistance among people newly diagnosed with – and those retreated for – tuberculosis in Malawi. Methods We conducted a nationally representative survey of people with sputum-smear-positive tuberculosis between 2010 and 2011. For all consenting participants, we collected demographic and clinical data, two sputum samples and tested for human immunodeficiency virus (HIV).The samples underwent resistance testing at the Central Reference Laboratory in Lilongwe, Malawi. All Mycobacterium tuberculosis isolates found to be multidrug-resistant were retested for resistance to first-line drugs – and tested for resistance to second-line drugs – at a Supranational Tuberculosis Reference Laboratory in South Africa. Findings Overall, M. tuberculosis was isolated from 1777 (83.8%) of the 2120 smear-positive tuberculosis patients. Multidrug resistance was identified in five (0.4%) of 1196 isolates from new cases and 28 (4.8%) of 581 isolates from people undergoing retreatment. Of the 31 isolates from retreatment cases who had previously failed treatment, nine (29.0%) showed multidrug resistance. Although resistance to second-line drugs was found, no cases of extensive drug-resistant tuberculosis were detected. HIV testing of people from whom M. tuberculosis isolates were obtained showed that 577 (48.2%) of people newly diagnosed and 386 (66.4%) of people undergoing retreatment were positive. Conclusion The prevalence of multidrug resistance among people with smear-positive tuberculosis was low for sub-Saharan Africa – probably reflecting the strength of Malawi’s tuberculosis control programme. The relatively high prevalence of such resistance observed among those with previous treatment failure may highlight a need for a change in the national policy for retreating this subgroup of people with tuberculosis. PMID:25378741

Delineating Potential Karst Water-Bearing Structures based on Resistivity Anomalies and Microtremor Analyses-A Case Study in Yunnan Province, China

NASA Astrophysics Data System (ADS)

Gan, F.; Su, C.; Liu, W.; Zhao, W.

2016-12-01

Heterogeneity, anisotropy and rugged landforms become challenges for geophysicists to locate drilling site by water-bearing structure profiling in Karst region. If only one geophysical method is used to achieve this objective, low resistivity anomalies deduced to be water-rich zones could actually be zones rich in marl and shale. In this study, integrated geophysical methods were used to locate a favorable drilling position for the provision of karst water to Juede village, which had been experiencing severe water shortages over a prolonged period. According to site conditions and hydrogeological data, appropriate geophysical profiles were conducted, approximately perpendicular to the direction of groundwater flow. In general, significant changes in resistivity occur between water-filled caves/ fractures and competent rocks. Thus, electrical and electromagnetic methods have been widely applied to search for karst groundwater indirectly. First, electrical resistivity tomography was carried out to discern shallow resistivity distributions within the profile where the low resistivity anomalies were of most interest. Second, one short profile of audio-frequency magnetotelluric survey was used to ascertain the vertical and horizontal extent of these low resistivity anomalies. Third, the microtremor H/V spectral ratio method was applied to identify potential water-bearing structures from low resistivity anomalies and to differentiate these from the interference of marl and shale with low resistivity. Finally, anomalous depths were estimated by interpreting Schlumberger sounding data to determine an optimal drilling site. The study shows that karst hydrogeology and geophysical methods can be effectively integrated for the purposes of karst groundwater exploration.

Tuberculosis in Sudan: a study of Mycobacterium tuberculosis strain genotype and susceptibility to anti-tuberculosis drugs

PubMed Central

2011-01-01

Background Sudan is a large country with a diverse population and history of civil conflict. Poverty levels are high with a gross national income per capita of less than two thousand dollars. The country has a high burden of tuberculosis (TB) with an estimated 50,000 incident cases during 2009, when the estimated prevalence was 209 cases per 100,000 of the population. Few studies have been undertaken on TB in Sudan and the prevalence of drug resistant disease is not known. Methods In this study Mycobacterium tuberculosis isolates from 235 patients attending three treatment centers in Sudan were screened for susceptibility to isoniazid, rifampicin, ethambutol and streptomycin by the proportion method on Lowenstein Jensen media. 232 isolates were also genotyped by spoligotyping. Demographic details of patients were recorded using a structured questionnaire. Statistical analyses were conducted to examine the associations between drug resistance with risk ratios computed for a set of risk factors (gender, age, case status - new or relapse, geographic origin of the patient, spoligotype, number of people per room, marital status and type of housing). Results Multi drug-resistant tuberculosis (MDR-TB), being resistance to at least rifampicin and isoniazid, was found in 5% (95% CI: 2,8) of new cases and 24% (95% CI: 14,34) of previously treated patients. Drug resistance was associated with previous treatment with risk ratios of 3.51 (95% CI: 2.69-4.60; p < 0.001) for resistance to any drug and 5.23 (95% CI: 2.30-11.90; p < 0.001) for MDR-TB. Resistance was also associated with the geographic region of origin of the patient, being most frequently observed in patients from the Northern region and least in the Eastern region with risk ratios of 7.43 (95%CI:3.42,16.18; p: < 0.001) and 14.09 (95%CI:1.80,110.53; p:0.026) for resistance to any drug and MDR-TB. The major genotype observed was of the Central Asia spoligotype family (CAS1_Delhi), representing 49% of the 232 isolates examined. Conclusions We conclude that emergence of drug resistant tuberculosis has the potential to be a serious public health problem in Sudan and that strengthened tuberculosis control and improved monitoring of therapy is needed. Further surveillance is required to fully ascertain the extent of the problem. PMID:21846389

Reduction of movement resistance force of pipeline in horizontal curved well at stage of designing underground passage

NASA Astrophysics Data System (ADS)

Toropov, V. S.; Toropov, S. Yu

2018-05-01

A method has been developed to reduce the resistance to movement of a pipeline in a horizontal curved well in the construction of underground passages using trenchless technologies. The method can be applied at the design stage. The idea of the proposed method consists in approximating the trajectory of the designed trenchless passage to the equilibrium profile. It has been proved that in order to reduce the resistance to movement of the pipeline arising from contact with the borehole wall, the profile of its initial and final sections must correspond, depending on the initial conditions, to the parabola or hyperbolic cosine equation. Analytical dependences are obtained which allow supplementing the methods of calculation of traction effort in trenchless construction for the case when the profile of the well is given by an arbitrary function.

Use of Xpert MTB/RIF in Decentralized Public Health Settings and Its Effect on Pulmonary TB and DR-TB Case Finding in India

PubMed Central

Sachdeva, Kuldeep Singh; Raizada, Neeraj; Sreenivas, Achuthan; van't Hoog, Anna H.; van den Hof, Susan; Dewan, Puneet K.; Thakur, Rahul; Gupta, R. S.; Kulsange, Shubhangi; Vadera, Bhavin; Babre, Ameet; Gray, Christen; Parmar, Malik; Ghedia, Mayank; Ramachandran, Ranjani; Alavadi, Umesh; Arinaminpathy, Nimalan; Denkinger, Claudia; Boehme, Catharina; Paramasivan, C. N.

2015-01-01

Background Xpert MTB/RIF, the first automated molecular test for tuberculosis, is transforming the diagnostic landscape in high-burden settings. This study assessed the impact of up-front Xpert MTB/RIF testing on detection of pulmonary tuberculosis (PTB) and rifampicin-resistant PTB (DR-TB) cases in India. Methods This demonstration study was implemented in 18 sub-district level TB programme units (TUs) in India in diverse geographic and demographic settings covering a population of 8.8 million. A baseline phase in 14 TUs captured programmatic baseline data, and an intervention phase in 18 TUs had Xpert MTB/RIF offered to all presumptive TB patients. We estimated changes in detection of TB and DR-TB, the former using binomial regression models to adjust for clustering and covariates. Results In the 14 study TUs, which participated in both phases, 10,675 and 70,556 presumptive TB patients were enrolled in the baseline and intervention phase, respectively, and 1,532 (14.4%) and 14,299 (20.3%) bacteriologically confirmed PTB cases were detected. The implementation of Xpert MTB/RIF was associated with increases in both notification rates of bacteriologically confirmed TB cases (adjusted incidence rate ratio [aIRR] 1.39; CI 1.18-1.64), and proportion of bacteriological confirmed TB cases among presumptive TB cases (adjusted risk ratio (aRR) 1.33; CI 1.6-1.52). Compared with the baseline strategy of selective drug-susceptibility testing only for PTB cases at high risk of drug-resistant TB, Xpert MTB/RIF implementation increased rifampicin resistant TB case detection by over fivefold. Among, 2765 rifampicin resistance cases detected, 1055 were retested with conventional drug susceptibility testing (DST). Positive predictive value (PPV) of rifampicin resistance detected by Xpert MTB/RIF was 94.7% (CI 91.3-98.1), in comparison to conventional DST. Conclusion Introduction of Xpert MTB/RIF as initial diagnostic test for TB in public health facilities significantly increased case-notification rates of all bacteriologically confirmed TB by 39% and rifampicin-resistant TB case notification by fivefold. PMID:25996389

Scleritis Caused by In Vitro Linezolid-Resistant Nocardia asteroides

PubMed Central

Tuli, Sonal

2014-01-01

Purpose. To describe a case of postoperative scleritis caused by a novel strain of Nocardia resistant to linezolid and trimethoprim-sulfamethoxazole (TMP-SMX). Methods. Case report of a patient with microbiologically proven scleritis due to Nocardia asteroides. Results. The patient presented with pain, redness, and nodules on the sclera three months following pterygium excision with mitomycin C and amniotic membrane placement. As no response was noted with empiric treatment for bacterial scleritis, debridement was performed. The cytopathology report showed gram positive filamentous bacteria. A presumptive diagnosis of Nocardia scleritis was made and therapy was initiated based on a literature review on treatments for Nocardia infections. Cultures returned growing Nocardia asteroides. Antibiotic sensitivity testing revealed resistance to linezolid and TMP-SMX which are the traditional drugs of choice for Nocardia. The patient was treated with amikacin and imipenem as well as extensive debridement with pedicle grafts. The patient's scleritis resolved with a good visual outcome. Conclusions. Cultures should be obtained in all cases of necrotizing scleritis in patients with a recent history of conjunctival surgery to rule out unusual organisms such as Nocardia. Although literature states that resistance to linezolid and TMP-SMX is rare in Nocardia, sensitivity testing can be useful in unresponsive cases. PMID:25400961

Scleritis Caused by In Vitro Linezolid-Resistant Nocardia asteroides.

PubMed

Gonzalez, Andres; Fakhar, Kaihan; Gubernick, David; Tuli, Sonal

2014-01-01

Purpose. To describe a case of postoperative scleritis caused by a novel strain of Nocardia resistant to linezolid and trimethoprim-sulfamethoxazole (TMP-SMX). Methods. Case report of a patient with microbiologically proven scleritis due to Nocardia asteroides. Results. The patient presented with pain, redness, and nodules on the sclera three months following pterygium excision with mitomycin C and amniotic membrane placement. As no response was noted with empiric treatment for bacterial scleritis, debridement was performed. The cytopathology report showed gram positive filamentous bacteria. A presumptive diagnosis of Nocardia scleritis was made and therapy was initiated based on a literature review on treatments for Nocardia infections. Cultures returned growing Nocardia asteroides. Antibiotic sensitivity testing revealed resistance to linezolid and TMP-SMX which are the traditional drugs of choice for Nocardia. The patient was treated with amikacin and imipenem as well as extensive debridement with pedicle grafts. The patient's scleritis resolved with a good visual outcome. Conclusions. Cultures should be obtained in all cases of necrotizing scleritis in patients with a recent history of conjunctival surgery to rule out unusual organisms such as Nocardia. Although literature states that resistance to linezolid and TMP-SMX is rare in Nocardia, sensitivity testing can be useful in unresponsive cases.

From Multidrug- to Extensively Drug-Resistant Tuberculosis: Upward Trends as Seen from a 15-Year Nationwide Study

PubMed Central

Stoffels, Karolien; Allix-Béguec, Caroline; Groenen, Guido; Wanlin, Maryse; Berkvens, Dirk; Mathys, Vanessa; Supply, Philip; Fauville-Dufaux, Maryse

2013-01-01

Background Emergence of extensively drug-resistant tuberculosis (XDR-TB) represents an enormous challenge to Public Health globally. Methods Progression towards XDR-TB was investigated in Belgium, a country with a typically low TB incidence, by analyzing the magnitude, characteristics, and treatment success of multidrug-resistant tuberculosis (MDR-TB) through a population-based study from 1994 to 2008. Results Among the 174 MDR-TB patients, 81% were foreign-born, 48% of these being asylum seekers. Although the number of MDR-TB patients remained stable through the study period at around 15 new cases annually, frequencies of resistance of the patients’ first MDR-TB isolate to second-line drugs increased, as well as the total number of antibiotics it was resistant to (p<0.001). XDR-TB cases were detected from 2002 onwards. For 24 patients, additional resistance to several second-line drugs was acquired during treatment. Molecular-guided investigations indicated little to no contribution of in-country clonal spread or exogenous re-infection. The increase of pre-XDR and XDR cases could be attributed to rising proportions of patients from Asia and Central and Eastern Europe (p<0.001) and an increase in the isolation of Beijing strains in these groups (p<0.001). Despite augmented resistance, the treatment success rate improved from 63.0% to 75.8% (p = 0.080) after implementation in 2005 of improved surveillance measures and therapeutic access. Conclusions Increasing severity in drug resistance patterns leading to more XDR- and “panresistant” TB cases in a country with a low TB incidence like Belgium represents a strong alert on worsening situations in other world regions and requires intense public health measures. PMID:23671662

Antimicrobial Susceptibility/Resistance of Streptococcus Pneumoniae

PubMed Central

Karcic, Emina; Aljicevic, Mufida; Bektas, Sabaheta; Karcic, Bekir

2015-01-01

Introduction: Pneumococcal infections are a major cause of morbidity and mortality worldwide, whose treatment is threatened with an increase in the number of strains resistant to antibiotic therapy. Goal: The main goal of this research was to investigate the presence of antimicrobial susceptibility/resistance of S. pneumoniae. Material and methods: Taken are swabs of the nose and nasopharynx, eye and ear. In vitro tests that were made in order to study the antimicrobial resistance of pneumococci are: disk diffusion method and E-test. Results: The resistance to inhibitors of cell wall synthesis was recorded at 39.17%, protein synthesis inhibitors 19.67%, folate antagonists 47.78% and quinolone in 1.11%. S. pneumoniae has shown drug resistance to erythromycin in 45%, clindamycin in 45%, chloramphenicol–0.56%, rifampicin–6.11%, tetracycline–4.67%, penicillin-G in 4.44%, oxacillin in 73.89%, ciprofloxacin in 1.11% and trimethoprim-sulfamethoxazole in 5.34% of cases. Conclusion: The highest resistance pneumococcus showed to erythromycin, clindamycin and trimethoprim-sulfamethoxazole and these should be avoided in the treatment. The least resistance pneumococcus showed to tetracycline, rifampicin, chloramphenicol, penicillin-G and ciprofloxacin. PMID:26236165

Method for applying photographic resists to otherwise incompatible substrates

NASA Technical Reports Server (NTRS)

Fuhr, W. (Inventor)

1981-01-01

A method for applying photographic resists to otherwise incompatible substrates, such as a baking enamel paint surface, is described wherein the uncured enamel paint surface is coated with a non-curing lacquer which is, in turn, coated with a partially cured lacquer. The non-curing lacquer adheres to the enamel and a photo resist material satisfactorily adheres to the partially cured lacquer. Once normal photo etching techniques are employed the lacquer coats can be easily removed from the enamel leaving the photo etched image. In the case of edge lighted instrument panels, a coat of uncured enamel is placed over the cured enamel followed by the lacquer coats and the photo resists which is exposed and developed. Once the etched uncured enamel is cured, the lacquer coats are removed leaving an etched panel.

Drug resistance of Mycobacterium tuberculosis isolates from tuberculosis lymphadenitis patients in Ethiopia

PubMed Central

Biadglegne, Fantahun; Tessema, Belay; Sack, Ulrich; Rodloff, Arne C.

2014-01-01

Background & objectives: The emergence of drug resistance tuberculosis (TB) is a significant challenge for TB control and prevention programmes, and the major problem is multidrug resistant tuberculosis (MDR-TB). The present study was carried out to determine the frequency of drug resistant Mycobacterium tuberculosis isolates among newly and retreated TB lymphadenitis patients and risk factors for acquiring this infection. Methods: Two hundred twenty five M. tuberculosis isolates from TB lymphadenitis patients who were diagnosed as new and retreated tuberculosis cases between April 2012 and May 2012 were included in this study. Isolates were tested for susceptibility to isoniazed (INH), rifampicin (RMP), streptomycin (SM), ethambutol (EMB) and pyrazinamide (PZA) using the BacT/AlerT 3D system protocol. Results: Among 225 isolates, 15 (6.7%) were resistant to at least one first line anti-TB drug. Three (1.3%) were MDR-TB. Resistance to INH, RMP, SM, and EMB was found in 8 (3.6%), 4 (1.8%), 10 (4.4%), and 4 (1.8%) isolates, respectively. Of the 212 new TB lymphadenitis cases three (1.4%) were MDR-TB. A rifampicin resistant M. tuberculosis isolate was diagnosed from smear and culture negative newly treated cases. All isolates were susceptible to PZA. Matted cervical lymph nodes were the prominent sites involved. Newly treated TB lymphadenitis patients had a greater risk for presenting resistance to anti-TB drugs (P=0.046). Interpretation & conclusions: Our study showed that TB lymphadenitis patients harboured drug resistant TB and MDR-TB, although at a low rate. Resistance was not associated with age, sex, patients’ education and contact history. Further research is required to determine transmission dynamics of drug resistant strains. PMID:25222786

Prototype Development and Redesign: A Case Study

DTIC Science & Technology

1990-03-01

deal with difficult problems of leadership , strategy and management." [Ref. 10:p. 1] Admiral Turner feels that using the case study method "will help...placement officer was a Lieutenant Commander or Commander. Often times they came from leadership positions of executive officer equivalence. They were...ting power. Personnel within the computer organizatin who are used to manual methods and potential users of the system are resisting the change and

Epidemiology and Antimicrobial Resistance of International Travel-Associated Campylobacter Infections in the United States, 2005–2011

PubMed Central

Palmer, Amanda; Wymore, Katie; Clogher, Paula; Oosmanally, Nadine; Robinson, Trisha; Lathrop, Sarah; Karr, Jillian; Hatch, Julie; Dunn, John; Ryan, Patricia; Blythe, David

2014-01-01

Objectives. The objective of this study was to determine the role international travel plays in US Campylobacter epidemiology and antimicrobial resistance. Methods. In this study, epidemiological and antimicrobial resistance data, encompassing the years 2005 to 2011, from 10 sites participating in the Foodborne Diseases Active Surveillance Network were linked. The 10 sites are represented by 7 states that conducted surveillance on a statewide level, and 3 states which conducted county-level surveillance. Cases of Campylobacter among persons with history of international travel in the week prior to illness were compared with cases among individuals with no international travel. Results. Approximately 18% of Campylobacter infections were estimated to be associated with international travel, and 60% of international travel-associated infections had a quinolone-resistant Campylobacter isolate. Conclusions. We confirm that international travel plays a significant role in campylobacteriosis diagnosed in the United States. Recognizing this is important to both medical management decisions and understanding burden and attribution estimates of US campylobacteriosis and antibiotic-resistant campylobacteriosis. PMID:24832415

A Novel aadA Aminoglycoside Resistance Gene in Bovine and Porcine Pathogens.

PubMed

Cameron, Andrew; Klima, Cassidy L; Ha, Reuben; Gruninger, Robert J; Zaheer, Rahat; McAllister, Tim A

2018-01-01

A novel variant of the AAD(3″) class of aminoglycoside-modifying enzymes was discovered in fatal bovine respiratory disease-associated pathogens Pasteurella multocida and Histophilus somni . The aadA31 gene encodes a spectinomycin/streptomycin adenylyltransferase and was located in a variant of the integrative and conjugative element ICE Mh1 , a mobile genetic element transmissible among members of the family Pasteurellaceae . The gene was also detected in Mannheimia haemolytica from a case of porcine pneumonia and in Moraxella bovoculi from a case of keratoconjunctivitis. IMPORTANCE Aminoglycosides are important antimicrobials used worldwide for prophylaxis and/or therapy in multiple production animal species. The emergence of new resistance genes jeopardizes current pathogen detection and treatment methods. The risk of resistance gene transfer to other animal and human pathogens is elevated when resistance genes are carried by mobile genetic elements. This study identified a new variant of a spectinomycin/streptomycin resistance gene harbored in a self-transmissible mobile element. The gene was also present in four different bovine pathogen species.

A Novel aadA Aminoglycoside Resistance Gene in Bovine and Porcine Pathogens

PubMed Central

Cameron, Andrew; Klima, Cassidy L.; Ha, Reuben; Gruninger, Robert J.; Zaheer, Rahat

2018-01-01

ABSTRACT A novel variant of the AAD(3″) class of aminoglycoside-modifying enzymes was discovered in fatal bovine respiratory disease-associated pathogens Pasteurella multocida and Histophilus somni. The aadA31 gene encodes a spectinomycin/streptomycin adenylyltransferase and was located in a variant of the integrative and conjugative element ICEMh1, a mobile genetic element transmissible among members of the family Pasteurellaceae. The gene was also detected in Mannheimia haemolytica from a case of porcine pneumonia and in Moraxella bovoculi from a case of keratoconjunctivitis. IMPORTANCE Aminoglycosides are important antimicrobials used worldwide for prophylaxis and/or therapy in multiple production animal species. The emergence of new resistance genes jeopardizes current pathogen detection and treatment methods. The risk of resistance gene transfer to other animal and human pathogens is elevated when resistance genes are carried by mobile genetic elements. This study identified a new variant of a spectinomycin/streptomycin resistance gene harbored in a self-transmissible mobile element. The gene was also present in four different bovine pathogen species. PMID:29507894

Slope failures evaluation and landslides investigation using 2-D resistivity method

NASA Astrophysics Data System (ADS)

Nordiana, M. M.; Azwin, I. N.; Nawawi, M. N. M.; Khalil, A. E.

2018-06-01

Slope failure is a complex phenomenon that may caused to landslides. Buildings and infrastructure such as transportation facilities and pipelines located within the boundaries of a landslide can be damaged or destroyed. Slope failure classification and various factors contributing to the instability using 2-D resistivity survey conducted in Selangor, Malaysia are described. Six 2-D resistivity survey lines with 5 m minimum electrode spacing using Pole-dipole array were performed. The data were processed using Res2Dinv and surfer10 software to evaluate the subsurface characteristics. The 2-D resistivity results show that the subsurface consist of two main zones. The first zone was alluvium or highly weathered with resistivity value of 100-1000 Ω m and depth of >30 m. This zone consists of saturated area with resistivity value of 1-100 Ω m and boulders with resistivity value of 1200-7000 Ω m. The second zone with resistivity value of >7000 Ω m was interpreted as granitic bedrock. The study area was characterized by saturated zones, highly weathered zone, highly contain of sand and boulders that will trigger slope failure in the survey area. This will cause to low strength of soil, debris flow and movement of earth. On the basis of the case examples described, 2-D resistivity method is categorized into desirable and useful method in determination of slope failure and future assessments.

Estimating the fitness cost and benefit of cefixime resistance in Neisseria gonorrhoeae to inform prescription policy: A modelling study

PubMed Central

2017-01-01

Background Gonorrhoea is one of the most common bacterial sexually transmitted infections in England. Over 41,000 cases were recorded in 2015, more than half of which occurred in men who have sex with men (MSM). As the bacterium has developed resistance to each first-line antibiotic in turn, we need an improved understanding of fitness benefits and costs of antibiotic resistance to inform control policy and planning. Cefixime was recommended as a single-dose treatment for gonorrhoea from 2005 to 2010, during which time resistance increased, and subsequently declined. Methods and findings We developed a stochastic compartmental model representing the natural history and transmission of cefixime-sensitive and cefixime-resistant strains of Neisseria gonorrhoeae in MSM in England, which was applied to data on diagnoses and prescriptions between 2008 and 2015. We estimated that asymptomatic carriers play a crucial role in overall transmission dynamics, with 37% (95% credible interval CrI 24%–52%) of infections remaining asymptomatic and untreated, accounting for 89% (95% CrI 82%–93%) of onward transmission. The fitness cost of cefixime resistance in the absence of cefixime usage was estimated to be such that the number of secondary infections caused by resistant strains is only about half as much as for the susceptible strains, which is insufficient to maintain persistence. However, we estimated that treatment of cefixime-resistant strains with cefixime was unsuccessful in 83% (95% CrI 53%–99%) of cases, representing a fitness benefit of resistance. This benefit was large enough to counterbalance the fitness cost when 31% (95% CrI 26%–36%) of cases were treated with cefixime, and when more than 55% (95% CrI 44%–66%) of cases were treated with cefixime, the resistant strain had a net fitness advantage over the susceptible strain. Limitations include sparse data leading to large intervals on key model parameters and necessary assumptions in the modelling of a complex epidemiological process. Conclusions Our study provides, to our knowledge, the first estimates of the fitness cost and benefit associated with resistance of the gonococcus to a clinically relevant antibiotic. Our findings have important implications for antibiotic stewardship and public health policies and, in particular, suggest that a previously abandoned antibiotic could be used again to treat a minority of gonorrhoea cases without raising resistance levels. PMID:29088226

[Application of anaerobic bacteria detection in oral and maxillofacial infection].

PubMed

Bao, Zhen-ying; Lin, Qin; Meng, Yan-hong; He, Chun; Su, Jia-zeng; Peng, Xin

2016-02-18

To investigate the distribution and drug resistance of anaerobic bacteria in the patients with oral and maxillofacial infection. Aerobic and anaerobic bacteria cultures from 61 specimens of pus from the patients with oral and maxillofacial infection in the Department of Oral and Maxillofacial Surgery, Peking University School of Stomatology were identified. The culture type was evaluated by API 20A kit and drug resistance test was performed by Etest method. The clinical data and antibacterial agents for the treatment of the 61 cases were collected, and the final outcomes were recorded. The bacteria cultures were isolated from all the specimens, with aerobic bacteria only in 6 cases (9.8%), anaerobic bacteria only in 7 cases (11.5%), and both aerobic and anaerobic bacteria in 48 cases (78.7%). There were 55 infected cases (90.2%) with anaerobic bacteria, and 81 anaerobic bacteria stains were isolated. The highest bacteria isolation rate of Gram positive anaerobic bacteria could be found in Peptostreptococcus, Bifidobacterium and Pemphigus propionibacterium. No cefoxitin, amoxicillin/carat acid resistant strain was detected in the above three Gram positive anaerobic bacteria. The highest bacteria isolation rate of Gram negative anaerobic bacteria could be detected in Porphyromonas and Prevotella. No metronidazole, cefoxitin, amoxicillin/carat acid resistant strain was found in the two Gram negative anaerobic bacteria. In the study, 48 patients with oral and maxillofacial infection were treated according to the results of drug resistance testing, and the clinical cure rate was 81.3%. Mixed aerobic and anaerobic bacteria cultures are very common in most oral and maxillofacial infection patients. Anaerobic bacteria culture and drug resistance testing play an important role in clinical treatment.

Semi-quantitative MALDI-TOF for antimicrobial susceptibility testing in Staphylococcus aureus.

PubMed

Maxson, Tucker; Taylor-Howell, Cheryl L; Minogue, Timothy D

2017-01-01

Antibiotic resistant bacterial infections are a significant problem in the healthcare setting, in many cases requiring the rapid administration of appropriate and effective antibiotic therapy. Diagnostic assays capable of quickly and accurately determining the pathogen resistance profile are therefore crucial to initiate or modify care. Matrix-assisted laser desorption/ionization time-of-flight (MALDI-TOF) mass spectrometry (MS) is a standard method for species identification in many clinical microbiology laboratories and is well positioned to be applied towards antimicrobial susceptibility testing. One recently reported approach utilizes semi-quantitative MALDI-TOF MS for growth rate analysis to provide a resistance profile independent of resistance mechanism. This method was previously successfully applied to Gram-negative pathogens and mycobacteria; here, we evaluated this method with the Gram-positive pathogen Staphylococcus aureus. Specifically, we used 35 strains of S. aureus and four antibiotics to optimize and test the assay, resulting in an overall accuracy rate of 95%. Application of the optimized assay also successfully determined susceptibility from mock blood cultures, allowing both species identification and resistance determination for all four antibiotics within 3 hours of blood culture positivity.

Evaluation of the BACTEC MGIT 960 SL DST Kit and the GenoType MTBDRsl Test for Detecting Extensively Drug-resistant Tuberculosis Cases

PubMed Central

Tekin, Kemal; Albay, Ali; Simsek, Hulya; Sig, Ali Korhan; Guney, Mustafa

2017-01-01

Objective: The present study aimed to evaluate the performances of the BACTEC MGIT 960 SL DST kit and the GenoType MTBDRsl test for detecting second-line antituberculosis drug resistance in Multidrug-resistant TB (MDR-TB) cases. Materials and Methods: Forty-six MDR-TB strains were studied. Second-line antituberculosis drug resistances were detected using the BACTEC MGIT 960 SL DST kit and the GenoType MTBDRsl test. The Middlebrook 7H10 agar proportion method was used as the reference test. Results: The sensitivity and specificity values for the BACTEC MGIT 960 SL DST kit were both 100% for amikacin, kanamycin, capreomycin (4 µg/mL), and ofloxacin; 100% and 95.3%, respectively, for capreomycin (10 µg/mL); and 85.7% and 100%, respectively, for moxifloxacin (0.5 µg/mL). The sensitivity and specificity values for the GenoType MTBDRsl test to detect fluoroquinolone and aminoglycoside/cyclic peptide resistance were 88.9% and 100%, respectively, for ofloxacin and 85.7% and 94.9%, respectively, for moxifloxacin (0.5 µg/mL). The accuracy of the GenoType MTBDRsl assay for kanamycin, capreomycin, ofloxacin, and moxifloxacin was lower than that of the BACTEC MGIT 960 SL DST. Conclusion: The BACTEC MGIT 960 SL DST kit and the GenoType MTBDRsl were successful in detecting second-line antituberculosis drug resistance. Preliminary results of the GenoType MTBDRsl are very valuable for early treatment decisions, but we still recommend additional BACTEC MGIT 960 SL DST kit usage in the routine evaluation of drug-resistant tuberculosis. PMID:29123441

Identification of resistance of Plasmodium falciparum to artesunate-mefloquine combination in an area along the Thai-Myanmar border: integration of clinico-parasitological response, systemic drug exposure, and in vitro parasite sensitivity

PubMed Central

2013-01-01

Background A markedly high failure rate of three-day artesunate-mefloquine was observed in the area along the Thai-Myanmar border. Methods Identification of Plasmodium falciparum isolates with intrinsic resistance to each component of the artesunate-mefloquine combination was analysed with integrated information on clinico-parasitological response, together with systemic drug exposure (area under blood/plasma concentration-time curves (AUC)) of dihydroartemisinin and mefloquine, and in vitro sensitivity of P. falciparum in a total of 17 out of 29 P. falciparum isolates from patients with acute uncomplicated falciparum malaria. Analysis of the contribution of in vitro parasite sensitivity and systemic drug exposure and relationship with pfmdr1 copy number in the group with sensitive response was performed in 21 of 69 cases. Results Identification of resistance and/or reduced intrinsic parasitocidal activity of artesunate and/or mefloquine without pharmacokinetic or other host-related factors were confirmed in six cases: one with reduced sensitivity to artesunate alone, two with resistance to mefloquine alone, and three with reduced sensitivity to artesunate combined with resistance to mefloquine. Resistance and/or reduced intrinsic parasitocidal activity of mefloquine/artesunate, together with contribution of pharmacokinetic factor of mefloquine and/or artesunate were identified in seven cases: two with resistance to mefloquine alone, and five with resistance to mefloquine combined with reduced sensitivity to artesunate. Pharmacokinetic factor alone contributed to recrudescence in three cases, all of which had inadequate whole blood mefloquine levels (AUC0-7days). Other host-related factors contributed to recrudescence in one case. Amplification of pfmdr1 (increasing of pfmdr1 copy number) is a related molecular marker of artesunate-mefloquine resistance and seems to be a suitable molecular marker to predict occurrence of recrudescence. Conclusions Despite the evidence of a low level of a decline in sensitivity of P. falciparum isolates to artemisinins in areas along the Thai-Myanmar border, artemisinin-based combination therapy (ACT) would be expected to remain the key anti-malarial drug for treatment of multidrug resistance P. falciparum. Continued monitoring and active surveillance of clinical efficacy of ACT, including identification of true artemisinin resistant parasites, is required for appropriate implementation of malaria control policy in this area. PMID:23898808

Characteristics of a Widespread Community Cluster of H275Y Oseltamivir-Resistant A(H1N1)pdm09 Influenza in Australia

PubMed Central

Hurt, A. C.; Hardie, K.; Wilson, N. J.; Deng, Y. M.; Osbourn, M.; Leang, S. K.; Lee, R. T. C.; Iannello, P.; Gehrig, N.; Shaw, R.; Wark, P.; Caldwell, N.; Givney, R. C.; Xue, L.; Maurer-Stroh, S.; Dwyer, D. E.; Wang, B.; Smith, D. W.; Levy, A.; Booy, R.; Dixit, R.; Merritt, T.; Kelso, A.; Dalton, C.; Durrheim, D.; Barr, I. G.

2012-01-01

Background. Oseltamivir resistance in A(H1N1)pdm09 influenza is rare, particularly in untreated community cases. Sustained community transmission has not previously been reported. Methods. Influenza specimens from the Asia–Pacific region were collected through sentinel surveillance, hospital, and general practitioner networks. Clinical and epidemiological information was collected on patients infected with oseltamivir-resistant viruses. Results. Twenty-nine (15%) of 191 A(H1N1)pdm09 viruses collected between May and September 2011 from Hunter New England (HNE), Australia, contained the H275Y neuraminidase substitution responsible for oseltamivir resistance. Only 1 patient had received oseltamivir before specimen collection. The resistant strains were genetically very closely related, suggesting the spread of a single variant. Ninety percent of cases lived within 50 kilometers. Three genetically similar oseltamivir-resistant variants were detected outside of HNE, including 1 strain from Perth, approximately 4000 kilometers away. Computational analysis predicted that neuraminidase substitutions V241I, N369K, and N386S in these viruses may offset the destabilizing effect of the H275Y substitution. Conclusions This cluster represents the first widespread community transmission of H275Y oseltamivir-resistant A(H1N1)pdm09 influenza. These cases and data on potential permissive mutations suggest that currently circulating A(H1N1)pdm09 viruses retain viral fitness in the presence of the H275Y mutation and that widespread emergence of oseltamivir-resistant strains may now be more likely. PMID:22561367

Changing patterns and trends of multidrug-resistant tuberculosis at referral centre in Northern India: a 4-year experience.

PubMed

Maurya, A K; Singh, A K; Kumar, M; Umrao, J; Kant, S; Nag, V L; Kushwaha, R A S; Dhole, T N

2013-01-01

India has a high burden of drug-resistant tuberculosis (TB), although there is little data on multidrug-resistant tuberculosis (MDR-TB). Although MDR-TB has existed for long time in India, very few diagnostic laboratories are well-equipped to test drug sensitivity. The objectives of this study were to determine the prevalence of MDR-TB, first-line drug resistance patterns and its changing trends in northern India in the 4 years. This was a prospective study from July 2007 to December 2010. Microscopy, culture by Bactec460 and p-nitro-α-acetylamino-β-hydroxypropiophenone (NAP) test was performed to isolate and identify Mycobacterium tuberculosis (M. tb) complex (MTBC). Drug sensitivity testing (DST) was performed by 1% proportional method (Bactec460) for four drugs: Rifampicin, isoniazid, ethambutol and streptomycin. Various clinical and demographical profiles were evaluated to analyse risk factors for development of drug resistance. We found the overall prevalence rate of MDR-TB to be 38.8%, increasing from 36.4% in 2007 to 40.8% in 2010. we found that the prevalence of MDR-TB in new and previously treated cases was 29.1% and 43.3% ( P < 0.05; CI 95%). The increasing trend of MDR-TB was more likely in pulmonary TB when compared with extra-pulmonary TB ( P < 0.05; CI 95%). we found a high prevalence (38.8%) of MDR-TB both in new cases (29.1%) and previously treated cases (43.3%).This study strongly highlights the need to make strategies for testing, surveillance, monitoring and management of such drug-resistant cases.

Public Health Response to US Cases of Candida auris, a Globally Emerging, Multidrug-Resistant Yeast, 2013–2017

PubMed Central

Tsay, Sharon; Welsh, Rory M; Adams, Eleanor H; Chow, Nancy A; Gade, Lalitha; Berkow, Elizabeth L; Lutterloh, Emily; Quinn, Monica; Chaturvedi, Sudha; Fernandez, Rafael; Giardina, Rosalie; Greenko, Jane; Southwick, Karen; Kerins, Janna L; Black, Stephanie; Kemble, Sarah K; Barrett, Patricia M; Greeley, Rebecca; Barton, Kerri; Shannon, Dj; Kallen, Alexander; Shugart, Alicia; Litvintseva, Anastasia P; Lockhart, Shawn; Chiller, Tom; Jackson, Brendan R; Vallabhaneni, Snigdha

2017-01-01

Abstract Background Candida auris is an often multidrug-resistant yeast that causes invasive infections and, unlike most Candida species, spreads in healthcare facilities. CDC released a clinical alert in June 2016 requesting reporting of C. auris cases. We investigated cases to contain transmission and inform prevention measures for this novel organism. Methods Clinical cases were defined as C. auris from any clinical specimen from a patient in the United States. Response to cases included implementation of infection control measures, enhanced cleaning and disinfection, and testing of close contacts for C. auris colonisation (isolation from a person’s axilla or groin was defined as a screening case). Microbiology records were reviewed at reporting facilities for missed cases. All isolates were forwarded to CDC for confirmation, antifungal susceptibility testing, and whole-genome sequencing (WGS). Results As of April 13, 2017, 61 clinical cases of C. auris were reported from six states: New York (39), New Jersey (15), Illinois (4), Indiana (1), Maryland (1), and Massachusetts (1). All but two occurred since 2016 (Figure). An additional 32 screening cases were identified among contacts. Median age of clinical case-patients was 70 years (range 21–96); 56% were male. Nearly, all had underlying medical conditions and extensive exposure to healthcare facilities before infection. Most clinical isolates were from blood (38, 62%), followed by urine (8, 13%) and respiratory tract (5, 8%). Among the first 35 isolates, 30 (86%) were resistant to fluconazole, 15 (43%) to amphotericin B, and one (3%) to caspofungin. No isolate was resistant to all three. WGS revealed isolates from each state were highly related and different from other states, suggestive of transmission. Microbiology record reviews did not identify additional cases before 2016. Conclusion C. auris is an emerging pathogen, with similarities to multidrug-resistant bacteria, that has been transmitted in US healthcare settings. CDC and public health partners are committed to prompt and aggressive action through investigation of cases and heightened infection control practices to halt its spread. Disclosures All authors: No reported disclosures.

Electrical resistivity of the liquid phase of vesicular suspensions prepared by different methods

NASA Astrophysics Data System (ADS)

Vitkova, V.; Antonova, K.; Popkirov, G.; Mitov, M. D.; Ermakov, Yu A.; Bivas, I.

2010-11-01

Giant lipid vesicles are obtained mainly by two methods of formation: (i) electroformation and (ii) gentle hydration (spontaneous swelling). Very often the electoformation is carried out in experimental cells consisting of indium-tin oxide (ITO) coated plates as electrodes and various polymer spacers. In the present work, the influence of the ITO coatings and the polymer spacers on the electrical resistivity of the liquid medium of electroformed vesicle suspensions is examined by means of electrochemical impedance spectroscopy (EIS). Our study is intended to point out possible implications of the electroformation method, especially in cases when phenomena, related to electric properties of the vesicle membranes, are investigated.

A population-based study of first and second-line drug-resistant tuberculosis in a high-burden area of the Mexico/United States border.

PubMed

Becerril-Montes, Pola; Said-Fernández, Salvador; Luna-Herrera, Julieta; Caballero-Olín, Guillermo; Enciso-Moreno, José Antonio; Martínez-Rodríguez, Herminia Guadalupe; Padilla-Rivas, Gerardo; Nancy-Garza-Treviño, Elsa; Molina-Salinas, Gloria María

2013-04-01

The resistance of 139 Mycobacterium tuberculosis (MTB) isolates from the city of Monterrey, Northeast Mexico, to first and second-line anti-TB drugs was analysed. A total of 73 isolates were susceptible and 66 were resistant to anti-TB drugs. Monoresistance to streptomycin, isoniazid (INH) and ethambutol was observed in 29 cases. Resistance to INH was found in 52 cases and in 29 cases INH resistance was combined with resistance to two or three drugs. A total of 24 isolates were multidrug-resistant (MDR) resistant to at least INH and rifampicin and 11 MDR cases were resistant to five drugs. The proportion of MDR-TB among new TB cases in our target population was 0.72% (1/139 cases). The proportion of MDR-TB among previously treated cases was 25.18% (35/139 cases). The 13 polyresistant and 24 MDR isolates were assayed against the following seven second-line drugs: amikacin (AMK), kanamycin (KAN), capreomycin (CAP), clofazimine (CLF), ethionamide (ETH), ofloxacin (OFL) and cycloserine (CLS). Resistance to CLF, OFL or CLS was not observed. Resistance was detected to ETH (10.80%) and to AMK (2.70%), KAN (2.70%) and CAP (2.70%). One isolate of MDR with primary resistance was also resistant to three second-line drugs. Monterrey has a high prevalence of MDR-TB among previously treated cases and extensively drug-resistant-MTB strains may soon appear.

A population-based study of first and second-line drug-resistant tuberculosis in a high-burden area of the Mexico/United States border

PubMed Central

Becerril-Montes, Pola; Said-Fernández, Salvador; Luna-Herrera, Julieta; Caballero-Olín, Guillermo; Enciso-Moreno, José Antonio; Martínez-Rodríguez, Herminia Guadalupe; Padilla-Rivas, Gerardo; Nancy-Garza-Treviño, Elsa; Molina-Salinas, Gloria María

2013-01-01

The resistance of 139 Mycobacterium tuberculosis (MTB) isolates from the city of Monterrey, Northeast Mexico, to first and second-line anti-TB drugs was analysed. A total of 73 isolates were susceptible and 66 were resistant to anti-TB drugs. Monoresistance to streptomycin, isoniazid (INH) and ethambutol was observed in 29 cases. Resistance to INH was found in 52 cases and in 29 cases INH resistance was combined with resistance to two or three drugs. A total of 24 isolates were multidrug-resistant (MDR) resistant to at least INH and rifampicin and 11 MDR cases were resistant to five drugs. The proportion of MDR-TB among new TB cases in our target population was 0.72% (1/139 cases). The proportion of MDR-TB among previously treated cases was 25.18% (35/139 cases). The 13 polyresistant and 24 MDR isolates were assayed against the following seven second-line drugs: amikacin (AMK), kanamycin (KAN), capreomycin (CAP), clofazimine (CLF), ethionamide (ETH), ofloxacin (OFL) and cycloserine (CLS). Resistance to CLF, OFL or CLS was not observed. Resistance was detected to ETH (10.80%) and to AMK (2.70%), KAN (2.70%) and CAP (2.70%). One isolate of MDR with primary resistance was also resistant to three second-line drugs. Monterrey has a high prevalence of MDR-TB among previously treated cases and extensively drug-resistant-MTB strains may soon appear. PMID:23579794

High rates of ofloxacin resistance in Mycobacterium tuberculosis among both new and previously treated patients in Tamil Nadu, South India.

PubMed

Selvakumar, N; Kumar, Vanaja; Balaji, S; Prabuseenivasan, S; Radhakrishnan, R; Sekar, Gomathi; Chandrasekaran, V; Kannan, T; Thomas, Aleyamma; Arunagiri, S; Dewan, Puneet; Swaminathan, Soumya

2015-01-01

Periodic drug resistance surveillance provides useful information on trends of drug resistance and effectiveness of tuberculosis (TB) control measures. The present study determines the prevalence of drug resistance among new sputum smear positive (NSP) and previously treated (PT) pulmonary TB patients, diagnosed at public sector designated microscopy centers (DMCs) in the state of Tamil Nadu, India. In this single-stage cluster-sampling prevalence survey, 70 of 700 DMCs were randomly selected using a probability-proportional to size method. A cluster size of 24 for NSP and a varying size of 0 to 99 for PT cases were fixed for each selected DMC. Culture and drug susceptibility testing was done on Lowenstein-Jensen medium using the economic variant of proportion sensitivity test for isoniazid (INH), rifampicin (RMP), ofloxacin (OFX) and kanamycin (KAN). Human Immunodeficiency Virus (HIV) status was collected from patient records. From June 2011 to August 2012, 1524 NSP and 901 PT patients were enrolled. Any RMP resistance and any INH resistance were observed in 2.6% and 15.1%, and in 10.4% and 30% respectively in NSP and PT cases. Among PT patients, multi drug resistant TB (MDR-TB) was highest in the treatment failure (35%) group, followed by relapse (13%) and treatment after default (10%) groups. Extensively drug resistant TB (XDRTB) was seen in 4.3% of MDR-TB cases. Any OFX resistance was seen in 10.4% of NSP, 13.9% of PT and 29% of PT MDR-TB patients. The HIV status of the patient had no impact on drug resistance levels. RMP resistance was present in 2.6% of new and 15.1% of previously treated patients in Tamil Nadu. Rates of OFX resistance were high among NSP and PT patients, especially among those with MDR-TB, a matter of concern for development of new treatment regimens for TB.

High Rates of Ofloxacin Resistance in Mycobacterium tuberculosis among Both New and Previously Treated Patients in Tamil Nadu, South India

PubMed Central

Selvakumar, N.; Kumar, Vanaja; Balaji, S.; Prabuseenivasan, S.; Radhakrishnan, R.; Sekar, Gomathi; Chandrasekaran, V.; Kannan, T.; Thomas, Aleyamma; Arunagiri, S.; Dewan, Puneet; Swaminathan, Soumya

2015-01-01

Periodic drug resistance surveillance provides useful information on trends of drug resistance and effectiveness of tuberculosis (TB) control measures. The present study determines the prevalence of drug resistance among new sputum smear positive (NSP) and previously treated (PT) pulmonary TB patients, diagnosed at public sector designated microscopy centers (DMCs) in the state of Tamil Nadu, India. In this single-stage cluster-sampling prevalence survey, 70 of 700 DMCs were randomly selected using a probability-proportional to size method. A cluster size of 24 for NSP and a varying size of 0 to 99 for PT cases were fixed for each selected DMC. Culture and drug susceptibility testing was done on Lowenstein-Jensen medium using the economic variant of proportion sensitivity test for isoniazid (INH), rifampicin (RMP), ofloxacin (OFX) and kanamycin (KAN). Human Immunodeficiency Virus (HIV) status was collected from patient records. From June 2011 to August 2012, 1524 NSP and 901 PT patients were enrolled. Any RMP resistance and any INH resistance were observed in 2.6% and 15.1%, and in 10.4% and 30% respectively in NSP and PT cases. Among PT patients, multi drug resistant TB (MDR-TB) was highest in the treatment failure (35%) group, followed by relapse (13%) and treatment after default (10%) groups. Extensively drug resistant TB (XDRTB) was seen in 4.3% of MDR-TB cases. Any OFX resistance was seen in 10.4% of NSP, 13.9% of PT and 29% of PT MDR-TB patients. The HIV status of the patient had no impact on drug resistance levels. RMP resistance was present in 2.6% of new and 15.1% of previously treated patients in Tamil Nadu. Rates of OFX resistance were high among NSP and PT patients, especially among those with MDR-TB, a matter of concern for development of new treatment regimens for TB. PMID:25738956

Detection of macrolide resistance genes in culture-negative specimens from Bangladeshi children with invasive pneumococcal diseases.

PubMed

Hasanuzzaman, Md; Malaker, Roly; Islam, Maksuda; Baqui, Abdullah H; Darmstadt, Gary L; Whitney, Cynthia G; Saha, Samir K

2017-03-01

In recent years, an increasing prevalence of macrolide resistance among pneumococci in Bangladesh has been observed. However, the scenario remains incomplete, as few isolates (<1%) are available from pneumonia cases and most pneumococcal meningitis cases (>80%) are culture-negative. This study optimised a triplex PCR method to detect macrolide resistance genes (MRGs) (mefA and ermB) and cpsA from culture-negative pneumococcal cases to predict the prevalence and level of macrolide resistance. The presence of MRGs among pneumococcal strains (n=153) with a wide range of erythromycin MICs (<0.5 to ≥256mg/L) was determined by PCR. Triplex PCR was validated by simultaneous detection of MRG(s) and cpsA in culture-negative clinical specimens and corresponding isolates. The known impact of the presence of specific MRG(s) on MICs of strains was used to predict the MICs of non-culturable strains based on the presence/absence of MRG(s) in the specimens. None of the erythromycin-susceptible isolates possessed any of the MRGs, and all non-susceptible strains had ≥1 MRG. MICs were 2-16mg/L and ≥256mg/L for 93% of strains with mefA and ermB, respectively, whereas 100% of isolates with both genes had MICs≥256mg/L. PCR for body fluids showed 100% concordance with corresponding isolates when tested for MRG(s) in parallel. Erythromycin MICs can be predicted for non-culturable strains with 93-100% precision based on detection of ermB and/or mefA. This method will be useful for establishing comprehensive surveillance for macrolide resistance among pneumococci, specifically in the population with prior antibiotic use. Copyright © 2017. Published by Elsevier Ltd.

What Discourages Students from Engaging with Innovative Instructional Methods: Creating a Barrier Framework

ERIC Educational Resources Information Center

Ellis, Donna E.

2015-01-01

When faculty members choose to implement instructional methods that are learning-centred, this may represent a change for students; and some resist engaging. In this exploratory case study research, 172 students shared what discourages them from being willing to engage with these innovative methods that aim to facilitate their learning.…

[Comparative study on Chinese medical syndrome typing and treatment combined different surgical methods for treating clomiphene-resistant polycystic ovary syndrome].

PubMed

Zeng, Lei; Zeng, Cheng; Tao, Li-Li

2012-11-01

To observe the therapeutic efficacy of Chinese medical syndrome typing and treatment combined cold needle puncture drainage operation or unipolar electrocoagulation drilling technique under laparoscope for treating clomiphene-resistant polycystic ovary syndrome (PCOS). Forty infertility patients with clomiphene-resistant PCOS were assigned to two groups using stratified random sampling method according to age, infertility time, and body mass index, 20 in each group. Patients in Group A were treated with Chinese medical syndrome typing and treatment combined cold needle puncture drainage operation, while those in Group B were treated with Chinese medical syndrome typing and treatment combined unipolar electrocoagulation drilling technique. After operation Chinese herbal treatment was administered to all patients according to syndrome typing. The serum levels of luteinizing hormone (LH), follicle stimulating hormone (FSH), androgen (T), estradiol (E2), and prolactin (PRL) were determined before and after operation. The ovulation was monitored. The pregnancy rate and the pregnancy outcomes were recorded after operation. There was no statistical difference in the 3-month spontaneous ovulation rate or the 1-year pregnancy rate (P > 0.05). The levels of LH, T, and PRL were significantly lower after operation than before operation in the two groups (P < 0.05). The menstruation and ovulation were obviously improved after operation. The total ovulation rate was 95% (19/20) in Group A. Successful pregnancy occurred in 15 cases of Group A. Ovarian hyperstimulation syndrome (OHSS) occurred in 1 case of Group A. The total ovulation rate was 90% (18/20) in Group B. Successful pregnancy occurred in 13 cases of Group B. Hypovaria occurred in 1 case of Group B. Luteinized unruptured follicle (LUFS) occurred in 2 cases of Group A and 1 case of Group B. Chinese medical syndrome typing and treatment combined cold needle puncture drainage operation or unipolar electrocoagulation drilling technique could effectively promote the ovulation. The two methods showed similar therapeutic effects.

Molecular Characteristics of Rifampin- and Isoniazid-Resistant Mycobacterium tuberculosis Strains Isolated in Vietnam

PubMed Central

Van Bac, Nguyen; Son, Nguyen Thai; Lien, Vu Thi Kim; Ha, Chu Hoang; Cuong, Nguyen Huu; Mai, Cung Thi Ngoc; Le, Thanh Hoa

2012-01-01

Molecular characterization of the drug resistance of Mycobacterium tuberculosis strains with different origins can generate information that is useful for developing molecular methods. These methods are widely applicable for rapid detection of drug resistance. A total of 166 rifampin (RIF)- and/or isoniazid (INH)-resistant strains of M. tuberculosis have been isolated from different parts of Vietnam; they were screened for mutations associated with resistance to these drugs by sequence analysis investigating genetic mutations associated with RIF and INH resistance. Seventeen different mutations were identified in 74 RIF-resistant strains, 56 of which (approximately 76%) had mutations in the so-called 81-bp “hot-spot” region of the rpoB gene. The most common point mutations were in codons 531 (37.8%), 526 (23%), and 516 (9.46%) of the rpoB gene. Mutations were not found in three strains (4.05%). In the case of INH resistance, five different mutations in the katG genes of 82 resistant strains were detected, among which the nucleotide substitution at codon 315 (76.83%) is the most common mutation. This study provided the first molecular characterization of INH and RIF resistance of M. tuberculosis strains from Vietnam, and detection of the katG and rpoB mutations of the INH and RIF-resistant strains should be useful for rapid detection of the INH- and RIF-resistant strains by molecular tests. PMID:22170905

Molecular characteristics of rifampin- and isoniazid-resistant mycobacterium tuberculosis strains isolated in Vietnam.

PubMed

Minh, Nghiem Ngoc; Van Bac, Nguyen; Son, Nguyen Thai; Lien, Vu Thi Kim; Ha, Chu Hoang; Cuong, Nguyen Huu; Mai, Cung Thi Ngoc; Le, Thanh Hoa

2012-03-01

Molecular characterization of the drug resistance of Mycobacterium tuberculosis strains with different origins can generate information that is useful for developing molecular methods. These methods are widely applicable for rapid detection of drug resistance. A total of 166 rifampin (RIF)- and/or isoniazid (INH)-resistant strains of M. tuberculosis have been isolated from different parts of Vietnam; they were screened for mutations associated with resistance to these drugs by sequence analysis investigating genetic mutations associated with RIF and INH resistance. Seventeen different mutations were identified in 74 RIF-resistant strains, 56 of which (approximately 76%) had mutations in the so-called 81-bp "hot-spot" region of the rpoB gene. The most common point mutations were in codons 531 (37.8%), 526 (23%), and 516 (9.46%) of the rpoB gene. Mutations were not found in three strains (4.05%). In the case of INH resistance, five different mutations in the katG genes of 82 resistant strains were detected, among which the nucleotide substitution at codon 315 (76.83%) is the most common mutation. This study provided the first molecular characterization of INH and RIF resistance of M. tuberculosis strains from Vietnam, and detection of the katG and rpoB mutations of the INH and RIF-resistant strains should be useful for rapid detection of the INH- and RIF-resistant strains by molecular tests.

Electrical voltages and resistances measured to inspect metallic cased wells and pipelines

DOEpatents

Vail, III, William Banning; Momii, Steven Thomas

2001-01-01

A cased well in the earth is electrically energized with A.C. current. Voltages are measured from three voltage measurement electrodes in electrical contact with the interior of the casing while the casing is electrically energized. In a measurement mode, A.C. current is conducted from a first current carrying electrode within the cased well to a remote second current carrying electrode located on the surface of the earth. In a calibration mode, current is passed from the first current carrying electrode to a third current carrying electrode located vertically at a different position within the cased well, where the three voltage measurement electrodes are located vertically in between the first and third current carrying electrodes. Voltages along the casing and resistances along the casing are measured to determine wall thickness and the location of any casing collars present so as to electrically inspect the casing. Similar methods are employed to energize a pipeline to measure the wall thickness of the pipeline and the location of pipe joints to electrically inspect the pipeline.

Electrical voltages and resistances measured to inspect metallic cased wells and pipelines

DOEpatents

Vail III, William Banning; Momii, Steven Thomas

2003-06-10

A cased well in the earth is electrically energized with A.C. current. Voltages are measured from three voltage measurement electrodes in electrical contact with the interior of the casing while the casing is electrically energized. In a measurement mode, A.C. current is conducted from a first current carrying electrode within the cased well to a remote second current carrying electrode located on the surface of the earth. In a calibration mode, current is passed from the first current carrying electrode to a third current carrying electrode located vertically at a different position within the cased well, where the three voltage measurement electrodes are located vertically in between the first and third current carrying electrodes. Voltages along the casing and resistances along the casing are measured to determine wall thickness and the location of any casing collars present so as to electrically inspect the casing. Similar methods are employed to energize a pipeline to measure the wall thickness of the pipeline and the location of pipe joints to electrically inspect the pipeline.

Landslides Monitoring on Salt Deposits Using Geophysical Methods, Case study - Slanic Prahova, Romania

NASA Astrophysics Data System (ADS)

Ovidiu, Avram; Rusu, Emil; Maftei, Raluca-Mihaela; Ulmeanu, Antonio; Scutelnicu, Ioan; Filipciuc, Constantina; Tudor, Elena

2017-12-01

Electrometry is most frequently applied geophysical method to examine dynamical phenomena related to the massive salt presence due to resistivity contrasts between salt, salt breccia and geological covering formations. On the vertical resistivity sections obtained with VES devices these three compartments are clearly differentiates by high resistivity for the massive salt, very low for salt breccia and variable for geological covering formations. When the land surface is inclined, shallow formations are moving gravitationally on the salt back, producing a landslide. Landslide monitoring involves repeated periodically measurements of geoelectrical profiles into a grid covering the slippery surface, in the same conditions (climate, electrodes position, instrument and measurement parameters). The purpose of monitoring landslides in Slanic Prahova area, was to detect the changes in resistivity distribution profiles to superior part of subsoil measured in 2014 and 2015. Measurement grid include several representative cross sections in susceptibility to landslides point of view. The results are graphically represented by changing the distribution of topography and resistivity differences between the two sets of geophysical measurements.

Antibiotic resistance and molecular characterization of diarrheagenic Escherichia coli and non-typhoidal Salmonella strains isolated from infections in Southwest China.

PubMed

Zhang, Shun-Xian; Zhou, Yong-Ming; Tian, Li-Guang; Chen, Jia-Xu; Tinoco-Torres, Rita; Serrano, Emmanuel; Li, Shi-Zhu; Chen, Shao-Hong; Ai, Lin; Chen, Jun-Hu; Xia, Shang; Lu, Yan; Lv, Shan; Teng, Xue-Jiao; Xu, Wen; Gu, Wen-Peng; Gong, Si-Tang; Zhou, Xiao-Nong; Geng, Lan-Lan; Hu, Wei

2018-05-07

Bacterial diarrhea is one of the most common causes for medical consultations, mortality and morbidity in the world. Diarrheagenic Escherichia coli (DEC) and non-typhoidal Salmonella (NTS) are major intestinal pathogens in developing countries, and the indiscriminate use of antibiotics has greatly contributed to resistant strains. Hence, the aim of the present study is to identify the antimicrobial resistance patterns and the molecular characteristics of DEC and NTS in southwest, China. 1121 diarrheal patients and 319 non-diarrheal subjects across all age groups were recruited from four sentinel hospitals from June 2014 to July 2015 in Kunming City, Yunnan Province. Each stool specimen was collected to detect DEC and NTS with standard microbiological and molecular methods. Antimicrobial resistance testing was performed with the Kirby-Bauer disk diffusion method, and the standards for antimicrobial susceptibility testing complied with the Clinical and Laboratory Standards Institute (CLSI). Molecular characterization of strains was carried out using pulsed-field gel electrophoresis (PFGE). A structured questionnaire was used to record basic epidemiological data (e.g. sex, age, residence, season, etc.). Data were analyzed using Chi-square or Fisher's exact test. DEC was detected in 127 (11.33%) diarrhea cases and 9 (2.82%) non-diarrheal cases (χ 2  = 20.69, P < 0.001, OR = 4.36, 95% CI: 2.19-8.65), and the prevalence of NTS isolated from diarrhea cases was higher than that of non-diarrheal cases across all age groups (n = 42, 3.75%, n = 1, 0.31%, χ 2  = 10.10, P = 0.002, OR = 12.38, 95% CI: 1.70-90.29). The rates of resistance to ten antibiotics of DEC and NTS showed significant differences (χ 2  = 386.77, P < 0.001; χ 2  = 191.16, P < 0.001). The rates of resistance to Amoxicillin and Clavulafiate (AMC), Cephalothin (CEP), Gentamicin (GEN) and Sulfamethoxazole-Trimethoprim (SXT) of DEC isolated from diarrhea cases were higher than those of NTS isolated from diarrhea patients (37.01% vs 14.29%, χ 2  = 7.57, P = 0.006; 29.92% vs 11.90%, χ 2  = 5.40, P = 0.02; 37.01% vs 11.90%, χ 2  = 5.80, P = 0.016; 62.20% vs 26.19%, χ 2  = 16.44, P < 0.001; respectively). Ciprofloxacin (CIP) was the most sensitive antibiotic for DEC and NTS strains isolated from diarrhea cases. Resistance rates of DEC isolates from cases and controls to more than three kinds antimicrobials (multidrug resistance, MDR) showed no significant differences (81.10% vs 88.89%, P = 0.33). Pulsotype patterns of DEC strains were highly diverse; however, the pulsotype pattern of NTS strains was closely related to the serotype. The pattern of S. enteritidis was highly similar, but the S. enterica Typhimurium strain was discrete. Antibiotic resistance of Enterobacteriaceae is of great concern. The societal effects of antibiotic use justify strict monitoring to combat increases in antimicrobial resistance. Molecular epidemiology and systematic epidemiological investigation can provide accurate evidence for tracking the infection source.

Monitoring the fitness of antiviral-resistant influenza strains during an epidemic: A mathematical modeling study

PubMed Central

Leung, Kathy; Lipsitch, Marc; Yuen, Kwok Yung; Wu, Joseph T

2017-01-01

Summary Background Antivirals (e.g. oseltamivir) are important for mitigating influenza epidemics. In 2007, an oseltamivir-resistant seasonal A(H1N1) strain emerged and spread to global fixation within one year. This showed that antiviral-resistant (AVR) strains can be intrinsically more transmissible than their contemporaneous antiviral-sensitive (AVS) counterpart. Surveillance of AVR fitness is therefore essential. Methods We define the fitness of AVR strains as their reproductive number relative to their co-circulating AVS counterparts. We develop a simple method for real-time estimation of AVR fitness from surveillance data. This method requires only information on generation time without other specific details regarding transmission dynamics. We first use simulations to validate this method by showing that it yields unbiased and robust fitness estimates in most epidemic scenarios. We then apply this method to two retrospective case studies and one hypothetical case study. Findings We estimate that (i) the oseltamivir-resistant A(H1N1) strain that emerged in 2007 was 4% (3–5%) more transmissible than its oseltamivir-sensitive predecessor and (ii) the oseltamivir-resistant pandemic A(H1N1) strain that emerged and circulated in Japan during 2013–2014 was 24% (17–30%) less transmissible than its oseltamivir-sensitive counterpart. We show that in the event of large-scale antiviral interventions during a pandemic with co-circulation of AVS and AVR strains, our method can be used to inform optimal use of antivirals by monitoring intrinsic AVR fitness and drug pressure on the AVS strain. Conclusions We have developed a simple method that can be easily integrated into contemporary influenza surveillance systems to provide reliable estimates of AVR fitness in real time. Funding Research Fund for the Control of Infectious Disease (09080792) and a commissioned grant from the Health and Medical Research Fund from the Government of the Hong Kong Special Administrative Region, Harvard Center for Communicable Disease Dynamics from the National Institute of General Medical Sciences (grant no. U54 GM088558), Area of Excellence Scheme of the Hong Kong University Grants Committee (grant no. AoE/M-12/06). PMID:27914853

Combined intrastromal injection of amphotericin B and topical fluconazole in the treatment of resistant cases of keratomycosis: a retrospective study

PubMed Central

Nada, Waled Mahdy; Al Aswad, Mahmoud A; El-Haig, Wael M

2017-01-01

Purpose To evaluate the efficacy of combination therapy of a single intrastromal injection of amphotericin B and topical fluconazole in resistant cases of fungal keratitis, and also topical amphotericin B as monotherapy in terms of the duration of the recovery period and toxic drug effects. Methods This retrospective 2-year study reviewed 68 cases of unilateral fungal keratitis diagnosed by clinical features and positive laboratory culture results. Forty-one cases were resistant and did not respond to monotherapy with an antifungal agent. Thus, they were treated with a single intrastromal injection of amphotericin B in addition to topical fluconazole as combined antifungal therapy, representing group A. Twenty-seven cases were treated with topical amphotericin B as antifungal monotherapy, representing group B. Topical atropine 1% and different antibiotic eye drops were added to the antifungal agents in both groups. Follow-up of patient records was performed monitoring cure rate, duration of recovery period, and toxic drug effects such as pain, burning sensation, and corneal melting. Results The results revealed that group A, treated with combination therapy, showed recovery of 34 cases (82.9%) with a mean duration of 24±6.42 days, significantly different from group B which showed recovery of 16 cases (59.3%) with a mean duration of 39.66±13.6 days. Group A also showed less manifestation of drug toxicity than group B. Conclusion Combined intrastromal injection of amphotericin B and topical fluconazole can provide a good modality in the treatment of resistant cases of fungal keratitis, exhibiting highly potent antifungal effects, shorter recovery period, and reduced corneal toxicity. PMID:28503064

An outbreak of vancomycin-resistant Enterococcus faecium in an acute care pediatric hospital: Lessons from environmental screening and a case-control study

PubMed Central

Drews, Steven J; Richardson, Susan E; Wray, Rick; Freeman, Renee; Goldman, Carol; Streitenberger, Laurie; Stevens, Derek; Goia, Cristina; Kovach, Danuta; Brophy, Jason; Matlow, Anne G

2008-01-01

BACKGROUND The present study describes a vancomycin-resistant enterococci (VRE) outbreak investigation and a case-control study to identify risk factors for VRE acquisition in a tertiary care pediatric hospital. OBJECTIVE To report an outbreak investigation and a case-control study to identify risk factors for VRE colonization or infection in hospitalized children. METHODS Screening for VRE cases was performed by culture or polymerase chain reaction. A case-control study of VRE-colonized patients was undertaken. Environmental screening was performed using standard culture and susceptibility methods, with pulsed-field gel electrophoresis to determine relationships between VRE isolates. Statistical analysis was performed using SAS version 9.0 (SAS Institute Inc, USA). RESULTS Thirty-four VRE-positive cases were identified on 10 wards between February 28, 2005, and May 27, 2005. Pulsed-field gel electrophoresis analysis confirmed a single outbreak strain that was also isolated from a video game found on one affected ward. Multivariate analysis identified cephalosporin use as the major risk factor for VRE colonization. CONCLUSIONS In the present study outbreak, VRE colonization was significantly associated with cephalosporin use. Because shared recreational items and environmental surfaces may be colonized by VRE, they warrant particular attention in housekeeping protocols, particularly in pediatric institutions. PMID:19412380

Methods and apparatus for measurement of electronic properties of geological formations through borehole casing

DOEpatents

Vail, W.B. III.

1991-08-27

Methods and apparatus are provided for measuring electronic properties of geological formations and cement layers adjacent to cased boreholes including resistivities, polarization phenomena and dielectric constants. Current is passed from an electrode in electrical contact with the interior of the borehole casing to an electrode on the surface of the earth. At least three voltage measuring electrodes in electrical contact with the interior of the casing measure the voltage at various points thereon. The voltage differences between discrete pairs of the voltage measuring electrodes provide a measurement of the differential current conducted into the formation in the vicinity of those electrodes. These measurements facilitate calculation of the resistivities of the adjacent geological formations as well as an indication of whether cement is present. Measurements of the differential voltage response to transient currents provide a measurement of the polarization phenomena in formation as well as the capacitance of the casing in contact with the formation which is useful for determining whether oil and gas are present. Lithological characteristics of the formation such as the presence or absence of clay can also be determined. A calibration procedure is provided for minimizing errors induced by variations in the casing. The device also may be placed within the pipe attached to a drill bit while drilling open holes. 48 figures.

Methods and apparatus for measurement of electronic properties of geological formations through borehole casing

DOEpatents

Vail, W.B. III.

1989-11-21

Methods and apparatus are provided for measuring electronic properties of geological formations and cement layers adjacent to cased boreholes including resistivities, polarization phenomena and dielectric constants. Current is passed from an electrode in electrical contact with the interior of the borehole casing to an electrode on the surface of the earth. At least three voltage measuring electrodes in electrical contact with the interior of the casing measure the voltage at various points thereon. The voltage differences between discrete pairs of the voltage measuring electrodes provide a measurement of differential current conducted into formation in the vicinity of those electrodes. These measurements facilitate calculation of the resistivities of the adjacent geological formations as well as an indication of whether cement is present. Measurements of the differential voltage response to transient currents provide a measurement of the polarization phenomena in formation as well as the capacitance of the casing in contact with the formation which is useful for determining whether oil and gas are present. Lithological characteristics of the formation such as the presence or absence of clay can also be determined. A calibration procedure is provided for minimizing errors induced by variations in the casing. The device also may be placed within the pipe attached to a drill bit while drilling open holes. 48 figs.

Methods and apparatus for measurement of electronic properties of geological formations through borehole casing

DOEpatents

Vail, III, William B.

1991-01-01

Methods and apparatus are provided for measuring electronic properties of geological formations and cement layers adjacent to cased boreholes including resistivities, polarization phenomena and dielectric constants. Current is passed from an electrode in electrical contact with the interior of the borehole casing to an electrode on the surface of the earth. At least three voltage measuring electrodes in electrical contact with the interior of the casing measure the voltage at various points thereon. The voltage differences between discrete pairs of the voltage measuring electrodes provide a measurement of the differential current conducted into formation in the vicinity of those electrodes. These measurements facilitate calculation of the resistivities of the adjacent geological formations as well as an indication of whether cement is present. Measurements of the differential voltage response to transient currents provide a measurement of the polarization phenomena in formation as well as the capacitance of the casing in contact with the formation which is useful for determining whether oil and gas present. Lithological characteristics of the formation such as the pressence or absence of clay can also be determined. A calibration procedure is provided for minimizing errors induced by variations in the casing. The device also may be placed within the pipe attached to a drill bit while drilling open holes.

Methods and apparatus for measurement of electronic properties of geological formations through borehole casing

DOEpatents

Vail, III, William B.

1989-01-01

Methods and apparatus are provided for measuring electronic properties of geological formations and cement layers adjacent to cased boreholes including resistivities, polarization phenomena and dielectric constants. Current is passed from an electrode in electrical contact with the interior of the borehole casing to an electrode on the surface of the earth. At least three voltage measuring electrodes in electrical contact with the interior of the casing measure the voltage at various points thereon. The voltage differences between discrete pairs of the voltage measuring electrodes provide a measurement of differential current conducted into formation in the vicinity of those electrodes. These measurements facilitate calculation of the resistivities of the adjacent geological formations as well as an indication of whether cement is present. Measurements of the differential voltage response to transient currents provide a measurement of the polarization phenomena in formation as well as the capacitance of the casing in contact with the formation which is useful for determining whether oil and gas are present. Lithological characteristics of the formation such as the presence or absence of clay can also be determined. A calibration procedure is provided for minimizing errors induced by variations in the casing. The device also may be placed within the pipe attached to a drill bit while drilling open holes.

Clinical, molecular and drug sensitivity pattern of mycobacterial isolates from extra-pulmonary tuberculosis cases in Addis Ababa, Ethiopia.

PubMed

Korma, Workneh; Mihret, Adane; Hussien, Jemal; Anthony, Richard; Lakew, Mekuria; Aseffa, Abraham

2015-10-26

In conjunction with the spread of HIV infection, tuberculosis (TB) remains a major cause of illness and death worldwide. The Ethiopian national report reveals that extra pulmonary tuberculosis is on the rise and that case detection rate is exceeding that of smear positive or negative cases in many parts of the country. Different studies indicated that host and/or pathogen related factors are associated with the rise of extra pulmonary cases. However, the reason for this is not clearly known in our setting. Specimens were taken from clinically suspected extra pulmonary patients and confirmed by cytology, histopathology and culture. Deletion typing and Spoligotyping was utilized to identify the strains. The isolates were then assigned to lineage using conformal Bayesian network (rules model) algorithm and dendrograms were drawn using UPGMA methods. In addition, drug sensitivity test was done using the indirect proportion and 24 well plate methods. Out of the 200 clinically suspected extra pulmonary tuberculosis patients, 106 (53 %) were between 15 and 35 years of age and 167 (83.5 %) were new while 33 (16.5 %) were retreatment cases. The culture yield was 29.5 % (59). Of these only one was M. bovis and 58 were M. tuberculosis strains with 31 different spoligotype patterns grouped into seven clusters. The largest cluster (ST53) comprised 12 (20.3 %) isolates. There was higher clustering of CAS isolates in TBLN than in any other form of extra pulmonary tuberculosis cases. Resistance to rifampicin was higher (22 %) than that for INH, STM and EMB (8.1 %, 5 % and 3 % respectively). Out of the 37 isolates tested for resistance, only 2 isolates were resistant for both STM and INH and no MDR strain was found. There is an ongoing active recent transmission among extra pulmonary tuberculosis in the study areas as shown by the presence of clusters. Although no MDR case was observed, there is a risk of emergence of MDR as noted from the high proportion of resistance to rifampicin. Detailed study at population level is recommended to monitor its trend.

Modeling and inversion Matlab algorithms for resistivity, induced polarization and seismic data

NASA Astrophysics Data System (ADS)

Karaoulis, M.; Revil, A.; Minsley, B. J.; Werkema, D. D.

2011-12-01

M. Karaoulis (1), D.D. Werkema (3), A. Revil (1,2), A., B. Minsley (4), (1) Colorado School of Mines, Dept. of Geophysics, Golden, CO, USA. (2) ISTerre, CNRS, UMR 5559, Université de Savoie, Equipe Volcan, Le Bourget du Lac, France. (3) U.S. EPA, ORD, NERL, ESD, CMB, Las Vegas, Nevada, USA . (4) USGS, Federal Center, Lakewood, 10, 80225-0046, CO. Abstract We propose 2D and 3D forward modeling and inversion package for DC resistivity, time domain induced polarization (IP), frequency-domain IP, and seismic refraction data. For the resistivity and IP case, discretization is based on rectangular cells, where each cell has as unknown resistivity in the case of DC modelling, resistivity and chargeability in the time domain IP modelling, and complex resistivity in the spectral IP modelling. The governing partial-differential equations are solved with the finite element method, which can be applied to both real and complex variables that are solved for. For the seismic case, forward modeling is based on solving the eikonal equation using a second-order fast marching method. The wavepaths are materialized by Fresnel volumes rather than by conventional rays. This approach accounts for complicated velocity models and is advantageous because it considers frequency effects on the velocity resolution. The inversion can accommodate data at a single time step, or as a time-lapse dataset if the geophysical data are gathered for monitoring purposes. The aim of time-lapse inversion is to find the change in the velocities or resistivities of each model cell as a function of time. Different time-lapse algorithms can be applied such as independent inversion, difference inversion, 4D inversion, and 4D active time constraint inversion. The forward algorithms are benchmarked against analytical solutions and inversion results are compared with existing ones. The algorithms are packaged as Matlab codes with a simple Graphical User Interface. Although the code is parallelized for multi-core cpus, it is not as fast as machine code. In the case of large datasets, someone should consider transferring parts of the code to C or Fortran through mex files. This code is available through EPA's website on the following link http://www.epa.gov/esd/cmb/GeophysicsWebsite/index.html Although this work was reviewed by EPA and approved for publication, it may not necessarily reflect official Agency policy.

Mechanisms leading to in vivo ceftolozane/tazobactam resistance development during the treatment of infections caused by MDR Pseudomonas aeruginosa.

PubMed

Fraile-Ribot, Pablo A; Cabot, Gabriel; Mulet, Xavier; Periañez, Leonor; Martín-Pena, M Luisa; Juan, Carlos; Pérez, José L; Oliver, Antonio

2017-11-14

Characterization of the mechanisms driving ceftolozane/tazobactam resistance development in 5 of 47 (10.6%) patients treated for MDR Pseudomonas aeruginosa infections in a Spanish hospital. Five pairs of ceftolozane/tazobactam-susceptible/resistant P. aeruginosa isolates were studied. MICs were determined by broth microdilution, clonal relatedness was assessed by MLST and resistance mechanisms were investigated by phenotypic and genotypic methods, including WGS. ampC variants were cloned to assess their impact on resistance. In all five cases, the same clone was detected for the susceptible/resistant pairs; the widespread ST175 high-risk clone in four of the cases and ST179 in the remaining case. Genomic analysis of the four initial ST175 isolates revealed the characteristic OprD mutation (Q142X) responsible for carbapenem resistance and the AmpR mutation (G154R) responsible for AmpC overexpression and β-lactam resistance. The final isolates had developed ceftolozane/tazobactam and ceftazidime/avibactam resistance, and each additionally showed a mutation in AmpC: E247K in one of the isolates, T96I in two isolates and a deletion of 19 amino acids (G229-E247) in the remaining isolate. The cloned AmpC variants showed greatly increased ceftolozane/tazobactam and ceftazidime/avibactam MICs compared with WT AmpC, but, in contrast, yielded lower MICs of imipenem, cefepime and particularly piperacillin/tazobactam. On the other hand, ceftolozane/tazobactam resistance development in ST179 was shown to be driven by the emergence of the extended-spectrum OXA β-lactamase OXA-14, through the selection of an N146S mutation from OXA-10. Modification of intrinsic (AmpC) and horizontally acquired β-lactamases appears to be the main mechanism leading to ceftolozane/tazobactam resistance in MDR P. aeruginosa. © The Author 2017. Published by Oxford University Press on behalf of the British Society for Antimicrobial Chemotherapy. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

[Tuberculosis and drug-resistance tuberculosis in prisoners. Colombia, 2010-2012].

PubMed

Gómez, Ingrid T; Llerena, Claudia R; Zabaleta, Angie P

2015-01-01

To characterize tuberculosis drug-resistance using anti-tuberculosis drug-sensitivity tests in Colombian prisoners. Descriptive-retrospective analyses were performed on cases of tuberculosis in prisoners. Samples were evaluated by the National Reference Laboratory. Conditions like gender, TB/VIH co-infection and drug-resistance were evaluated. Anti-tuberculosis drug-sensitivity tests were carried out on 72 prisoners. Results showed a distribution of 90.7 % of cases in males and 9.3 % of cases in females. 12 % of cases were TB/VIH co-infections, 94 % of the cases had not received any anti-tuberculosis treatment before, six isolates were drug-resistant corresponding to 8.8 % of total cases, and two cases were multi drug-resistant representing 1.3 % of the cases. Of the drug-resistant cases, 83.3 % were TB/VIH co-infected. Previously treated cases corresponded to 5.6 % of the total cases analyzed. One case with TB/VIH co-infection and rifampicin resistance was observed, representing 1.3 % of the total cases. The government must create a clear policy for prisoners in Colombia, because a high rate of disease in prisoners was observed. In addition, the results showed an association between drug-resistance and TB/VIH co-infection. Overcrowding and low quality of life in penitentiaries could become an important public health problem.

Association of Immune Factors with Drug-Resistant Tuberculosis: A Case-Control Study

PubMed Central

Sun, En-Tao; Xia, Dan; Li, Ben-He; Ma, Jun; Dong, Yuan-Yuan; Ding, Shu-Shu; Chen, Bai-Feng; Wen, Yu-Feng

2017-01-01

Background Presently, studies of factors associated with drug-resistant tuberculosis (TB) focus on patients’ socio-demographic characteristics and living habits, to the exclusion of biochemical indicators, especially immune factors. This study was carried out to determine whether immune factors are associated with drug-resistant TB. Material/Methods A total of 227 drug-resistant pulmonary TB patients and 225 drug-susceptible pulmonary TB patients were enrolled in this study. Information on socio-demographic characteristics and biochemical indicators were obtained through their clinical records. Non-conditional logistic regression was used to analyze the association of these indicators with drug-resistant TB. Results There were significant differences in re-treatment, marital status, alanine aminotransferase (ALT), blood uric acid (BUA), carcino-embryonic antigen (CEA), T-spot, and CD3 and CD4 counts between the 2 groups. In multivariable analysis, re-treatment [Odds Ratio (OR)=5.290, 95% Confidence Interval [CI]=2.652–10.551); CD3 (OR=1.034, 95% CI=1.001–1.068); CD4 (OR=1.035, 95% CI =1.001–1.070) and IgM (OR=1.845, 95% CI=1.153–2.952) were associated with drug-resistant TB. Conclusions These results suggest the need for greater attention to re-treatment cases and immune function when treating drug-resistant TB. PMID:29118314

Electromagnetic detection of deep freshwater lenses in a hyper-arid limestone terrain

NASA Astrophysics Data System (ADS)

Young, Michael E.; Macumber, Phillip G.; Donald Watts, M.; Al-Toqy, Nasser

2004-12-01

In the hyper-arid desert of Central Oman, freshwater lenses are found lying on a regional saline water table. These lenses have developed where recharge from infrequent cyclonic rainfall has collected in shallow depressions on the Tertiary limestones of the Central Plateau and in the catchments of ancient river channels draining the Plateau. Central-loop time-domain electromagnetic (TDEM) sounding was applied as a method of reconnaissance exploration for these lenses at two sites, a shallow depression extending over an area of 60 km 2 and a wadi gorge draining a catchment of 3400 km 2. These results were subsequently tested by drilling. In the case of the shallow depression, drilling intersected a freshwater lens up to 18 m thick at a depth of 92 m. TDEM resistivity-depth inversion showed that the corresponding high resistivity zone included both the lens and overlying unsaturated rocks, and that the depth to the saline interface could be accurately predicted. Where drilling failed to intersect a lens, TDEM inversion resulted in a consistently low resistivity zone in which the water table could not be resolved. By invoking the Archie formula modified for the presence of clays, it is thought that the higher resistivity of the vadose zone observed over the lens may be explained by a reduction in the clay conductivity factor resulting from higher pore-water resistivity. In the case of the wadi gorge, low regional resistivities were also recorded over the limestones on the survey margins, and high resistivity anomalies over the freshwater lens within and extending away from the gorge. Again, TDEM was found to be useful as a reconnaissance method and for mapping the depth to the underlying saline aquifer, but not for predicting the thickness of the overlying freshwater lens.

A case of bacterial peritonitis caused by Roseomonas mucosa in a patient undergoing continuous ambulatory peritoneal dialysis.

PubMed

Matsukuma, Yuta; Sugawara, Koji; Shimano, Shota; Yamada, Shunsuke; Tsuruya, Kazuhiko; Kitazono, Takanari; Higashi, Harumichi

2014-11-01

Bacterial peritonitis remains a life-threatening complication of peritoneal dialysis (PD). Roseomonas is a bacterial genus of pink-pigmented, oxidized, gram-negative coccobacilli that was first named in 1993. Importantly, Roseomonas mucosa exhibits antibiotic resistance, with significant resistance to cephalosporin, which is often selected as an empirical antibiotic regimen for peritonitis in PD patients. We herein report the case of a PD patient with bacterial peritonitis caused by Roseomonas mucosa that was fortunately identified using 16S rRNA gene sequencing and successfully treated with ciprofloxacin. Given that Roseomonas demonstrates resistance to a variety of antibiotics. The administration of empiric antibiotic therapy based on the recommendation of the International Society of Peritoneal Dialysis guidelines occasionally fails, leading to the aggravation of bacterial peritonitis. Hence, nephrologists should consider Roseomonas as one of the potential causative organisms of peritonitis, especially when gram-negative bacilli are resistant to cephalosporin and cannot be identified using standard laboratory methods.

Association of leptin and insulin resistance in PCOS: A case-controlled study.

PubMed

Namavar Jahromi, Bahia; Dabaghmanesh, Mohammad Hassan; Parsanezhad, Mohammad Ebrahim; Fatehpoor, Faranak

2017-07-01

Endocrine abnormalities related to polycystic ovary Syndrome (PCOS) are important problems. To compare serum leptin levels between infertile women with and without PCOS. To rank sensitivity of six indirect methods for detection of insulin resistance (IR) and to evaluate the association between leptin and IR in PCOS group. This Case-controlled study performed on 189 infertile women referred to Shiraz Mother and Child Hospital during 2012-2015. Ninety-nine PCOS cases according to Rotterdam criteria were compared to 90 cases without PCOS. Serum leptin, body mass index (BMI), several hormones, and their correlation coefficients with leptin were compared. IR in PCOS women was measured by indirect methods, including fasting blood sugar (FBS), fasting insulin (FI), glucose/insulin, homeostatic model assessment of insulin resistance (HOMA-IR), quantitative insulin sensitivity check index (QUICKI), and MacAuley index. Association between IR and leptin was evaluated. Independent sample t-test and Pearson's test were used. Infertile women with PCOS had higher BMI (26.47±3.62 vs. 24.82±5.18 kg/m 2 ) and serum leptin levels (41.79±187.89 vs. 19.38±12.57 ng/mL). Leptin showed significant association with weight and BMI in both groups (p<0.001) and to age in non-PCOS group. HOMA-IR showed the highest rate of IR followed by FI and QUICKI methods. The mean leptin levels had positive association with IR assessed by HOMA-IR (p<0.001), QUICKI (p<0.001), FI (p=.002), and FBS (p=0.02). BMI and IR have positive association with serum leptin in PCOS infertile women. HOMA-IR followed by FI and QUICKI is the most sensitive test for detection of IR.

A Coupled model for ERT monitoring of contaminated sites

NASA Astrophysics Data System (ADS)

Wang, Yuling; Zhang, Bo; Gong, Shulan; Xu, Ya

2018-02-01

The performance of electrical resistivity tomography (ERT) system is usually investigated using a fixed resistivity distribution model in numerical simulation study. In this paper, a method to construct a time-varying resistivity model by coupling water transport, solute transport and constant current field is proposed for ERT monitoring of contaminated sites. Using the proposed method, a monitoring model is constructed for a contaminated site with a pollution region on the surface and ERT monitoring results at different time is calculated by the finite element method. The results show that ERT monitoring profiles can effectively reflect the increase of the pollution area caused by the diffusion of pollutants, but the extent of the pollution is not exactly the same as the actual situation. The model can be extended to any other case and can be used to scheme design and results analysis for ERT monitoring.

ZK DrugResist 2.0: A TextMiner to extract semantic relations of drug resistance from PubMed.

PubMed

Khalid, Zoya; Sezerman, Osman Ugur

2017-05-01

Extracting useful knowledge from an unstructured textual data is a challenging task for biologists, since biomedical literature is growing exponentially on a daily basis. Building an automated method for such tasks is gaining much attention of researchers. ZK DrugResist is an online tool that automatically extracts mutations and expression changes associated with drug resistance from PubMed. In this study we have extended our tool to include semantic relations extracted from biomedical text covering drug resistance and established a server including both of these features. Our system was tested for three relations, Resistance (R), Intermediate (I) and Susceptible (S) by applying hybrid feature set. From the last few decades the focus has changed to hybrid approaches as it provides better results. In our case this approach combines rule-based methods with machine learning techniques. The results showed 97.67% accuracy with 96% precision, recall and F-measure. The results have outperformed the previously existing relation extraction systems thus can facilitate computational analysis of drug resistance against complex diseases and further can be implemented on other areas of biomedicine. Copyright © 2017 Elsevier Inc. All rights reserved.

Patterns of antimicrobial resistance in Streptococcus suis isolates from pigs with or without streptococcal disease in England between 2009 and 2014.

PubMed

Hernandez-Garcia, Juan; Wang, Jinhong; Restif, Olivier; Holmes, Mark A; Mather, Alison E; Weinert, Lucy A; Wileman, Thomas M; Thomson, Jill R; Langford, Paul R; Wren, Brendan W; Rycroft, Andrew; Maskell, Duncan J; Tucker, Alexander W

2017-08-01

Antimicrobial resistance in Streptococcus suis, a global zoonotic pathogen of pigs, has been mostly studied only in diseased animals using surveys that have not evaluated changes over time. We compared patterns of resistance between S. suis isolates from clinical cases of disease (CC) and non-clinical case (NCC) pigs in England, collected over two discrete periods, 2009-2011 and 2013-2014. Minimum inhibitory concentrations (MIC) of 17 antimicrobials (nine classes) were determined on 405 S. suis isolates categorised by sampling period and disease association to assess changes in resistance over time and association with disease. First, isolates were characterized as resistant or susceptible using published clinical breakpoints. Second, epidemiological cut-offs (ECOFF) were derived from MIC values, and isolates classified as wild type (WT) below the ECOFF and non-wild type (NWT) above the ECOFF. Finally, isolate subsets were analysed for shifts in MIC distribution. NCC isolates were more resistant than CC isolates to cephalosporins, penams, pleuromutilins, potentiated sulphonamides and tetracyclines in both study periods. Resistance levels among CC isolates increased in 2013-2014 relative to 2009-2011 for antimicrobials including aminoglycosides, cephalosporins, fluoroquinolones, pleuromutilins, potentiated sulphonamides and tetracyclines. The prevalence of isolates categorised as NWT for five or more classes of antimicrobials was greater among NCC than CC isolates for both time periods, and increased with time. This study used standardised methods to identify significant shifts in antimicrobial resistance phenotypes of S. suis isolated from pigs in England, not only over time but also between isolates from known clinical cases or disease-free pigs. Copyright © 2017. Published by Elsevier B.V.

Multidrug resistance among new tuberculosis cases: detecting local variation through lot quality-assurance sampling.

PubMed

Hedt, Bethany Lynn; van Leth, Frank; Zignol, Matteo; Cobelens, Frank; van Gemert, Wayne; Nhung, Nguyen Viet; Lyepshina, Svitlana; Egwaga, Saidi; Cohen, Ted

2012-03-01

Current methodology for multidrug-resistant tuberculosis (MDR TB) surveys endorsed by the World Health Organization provides estimates of MDR TB prevalence among new cases at the national level. On the aggregate, local variation in the burden of MDR TB may be masked. This paper investigates the utility of applying lot quality-assurance sampling to identify geographic heterogeneity in the proportion of new cases with multidrug resistance. We simulated the performance of lot quality-assurance sampling by applying these classification-based approaches to data collected in the most recent TB drug-resistance surveys in Ukraine, Vietnam, and Tanzania. We explored 3 classification systems- two-way static, three-way static, and three-way truncated sequential sampling-at 2 sets of thresholds: low MDR TB = 2%, high MDR TB = 10%, and low MDR TB = 5%, high MDR TB = 20%. The lot quality-assurance sampling systems identified local variability in the prevalence of multidrug resistance in both high-resistance (Ukraine) and low-resistance settings (Vietnam). In Tanzania, prevalence was uniformly low, and the lot quality-assurance sampling approach did not reveal variability. The three-way classification systems provide additional information, but sample sizes may not be obtainable in some settings. New rapid drug-sensitivity testing methods may allow truncated sequential sampling designs and early stopping within static designs, producing even greater efficiency gains. Lot quality-assurance sampling study designs may offer an efficient approach for collecting critical information on local variability in the burden of multidrug-resistant TB. Before this methodology is adopted, programs must determine appropriate classification thresholds, the most useful classification system, and appropriate weighting if unbiased national estimates are also desired.

Using well casing as an electrical source to monitor hydraulic fracture fluid injection

DOE Office of Scientific and Technical Information (OSTI.GOV)

Wilt, Michael; Nieuwenhuis, Greg; MacLennan, Kris

2016-03-09

The depth to surface resistivity (DSR) method transmits current from a source located in a cased or openhole well to a distant surface return electrode while electric field measurements are made at the surface over the target of interest. This paper presents both numerical modelling results and measured data from a hydraulic fracturing field test where conductive water was injected into a resistive shale reservoir during a hydraulic fracturing operation. Modelling experiments show that anomalies due to hydraulic fracturing are small but measureable with highly sensitive sensor technology. The field measurements confirm the model results,showing that measured differences in themore » surface fields due to hydraulic fracturing have been detected above the noise floor. Our results show that the DSR method is sensitive to the injection of frac fluids; they are detectable above the noise floor in a commercially active hydraulic fracturing operation, and therefore this method can be used for monitoring fracture fluid movement.« less

Scaling-up the Xpert MTB/RIF assay for the detection of tuberculosis and rifampicin resistance in India: An economic analysis

PubMed Central

Khaparde, Sunil; Nair, Sreenivas Achuthan; Denkinger, Claudia; Sachdeva, Kuldeep Singh; Paramasivan, Chinnambedu Nainarappan; Salhotra, Virender Singh; Vassall, Anna; Hoog, Anja van't

2017-01-01

Background India is considering the scale-up of the Xpert MTB/RIF assay for detection of tuberculosis (TB) and rifampicin resistance. We conducted an economic analysis to estimate the costs of different strategies of Xpert implementation in India. Methods Using a decision analytical model, we compared four diagnostic strategies for TB patients: (i) sputum smear microscopy (SSM) only; (ii) Xpert as a replacement for the rapid diagnostic test currently used for SSM-positive patients at risk of drug resistance (i.e. line probe assay (LPA)); (iii) Upfront Xpert testing for patients at risk of drug resistance; and (iv) Xpert as a replacement for SSM for all patients. Results The total costs associated with diagnosis for 100,000 presumptive TB cases were: (i) US$ 619,042 for SSM-only; (ii) US$ 575,377 in the LPA replacement scenario; (iii) US$ 720,523 in the SSM replacement scenario; and (iv) US$ 1,639,643 in the Xpert-for-all scenario. Total cohort costs, including treatment costs, increased by 46% from the SSM-only to the Xpert-for-all strategy, largely due to the costs associated with second-line treatment of a higher number of rifampicin-resistant patients due to increased drug-resistant TB (DR-TB) case detection. The diagnostic costs for an estimated 7.64 million presumptive TB patients would comprise (i) 19%, (ii) 17%, (iii) 22% and (iv) 50% of the annual TB control budget. Mean total costs, expressed per DR-TB case initiated on treatment, were lowest in the Xpert-for-all scenario (US$ 11,099). Conclusions The Xpert-for-all strategy would result in the greatest increase of TB and DR-TB case detection, but would also have the highest associated costs. The strategy of using Xpert only for patients at risk for DR-TB would be more affordable, but would miss DR-TB cases and the cost per true DR-TB case detected would be higher compared to the Xpert-for-all strategy. As such expanded Xpert strategy would require significant increased TB control budget to ensure that increased case detection is followed by appropriate care. PMID:28880875

The Burden of Drug-Resistant Tuberculosis in Papua New Guinea: Results of a Large Population-Based Survey

PubMed Central

Aia, Paul; Kal, Margaret; Lavu, Evelyn; John, Lucy N.; Johnson, Karen; Coulter, Chris; Ershova, Julia; Tosas, Olga; Zignol, Matteo; Ahmadova, Shalala; Islam, Tauhid

2016-01-01

Background Reliable estimates of the burden of multidrug-resistant tuberculosis (MDR-TB) are crucial for effective control and prevention of tuberculosis (TB). Papua New Guinea (PNG) is a high TB burden country with limited information on the magnitude of the MDR-TB problem. Methods A cross-sectional study was conducted in four PNG provinces: Madang, Morobe, National Capital District and Western Province. Patient sputum samples were tested for rifampicin resistance by the Xpert MTB/RIF assay and those showing the presence of resistance underwent phenotypic susceptibility testing to first- and second-line anti-TB drugs including streptomycin, isoniazid, rifampicin, ethambutol, pyrazinamide, ofloxacin, amikacin, kanamycin and capreomycin. Results Among 1,182 TB patients enrolled in the study, MDR-TB was detected in 20 new (2.7%; 95% confidence intervals [CI] 1.1–4.3%) and 24 previously treated (19.1%; 95%CI: 8.5–29.8%) TB cases. No case of extensively drug-resistant TB (XDR-TB) was detected. Thirty percent (6/20) of new and 33.3% (8/24) of previously treated cases with MDR-TB were detected in a single cluster in Western Province. Conclusion In PNG the proportion of MDR-TB in new cases is slightly lower than the regional average of 4.4% (95%CI: 2.6–6.3%). A large proportion of MDR-TB cases were identified from a single hospital in Western Province, suggesting that the prevalence of MDR-TB across the country is heterogeneous. Future surveys should further explore this finding. The survey also helped strengthening the use of smear microscopy and Xpert MTB/RIF testing as diagnostic tools for TB in the country. PMID:27003160

Genetic polymorphisms in Plasmodium falciparum chloroquine resistance genes, pfcrt and pfmdr1, in North Sulawesi, Indonesia.

PubMed

Reteng, Patrick; Vrisca, Visia; Sukarno, Inka; Djarkoni, Ilham Habib; Kalangi, Jane Angela; Jacobs, George Eduardo; Runtuwene, Lucky Ronald; Eshita, Yuki; Maeda, Ryuichiro; Suzuki, Yutaka; Mongan, Arthur Elia; Warouw, Sarah Maria; Yamagishi, Junya; Tuda, Josef

2017-04-04

Malaria still poses one of the major threats to human health. Development of effective antimalarial drugs has decreased this threat; however, the emergence of drug-resistant Plasmodium falciparum, a cause of Malaria, is disconcerting. The antimalarial drug chloroquine has been effectively used, but resistant parasites have spread worldwide. Interestingly, the withdrawal of the drug reportedly leads to an increased population of susceptible parasites in some cases. We examined the prevalence of genomic polymorphisms in a malaria parasite P. falciparum, associated with resistance to an antimalarial drug chloroquine, after the withdrawal of the drug from Indonesia. Blood samples were collected from 95 malaria patients in North Sulawesi, Indonesia, in 2010. Parasite DNA was extracted and analyzed by polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) for pfcrt and pfmdr1. In parallel, multiplex amplicon sequencing for the same genes was carried out with Illumina MiSeq. Of the 59 cases diagnosed as P. falciparum infection by microscopy, PCR-RFLP analysis clearly identified the genotype 76T in pfcrt in 44 cases. Sequencing analysis validated the identified genotypes in the 44 cases and demonstrated that the haplotype in the surrounding genomic region was exclusively SVMNT. Results of pfmdr1 were successfully obtained for 51 samples, where the genotyping results obtained by the two methods were completely consistent. In pfmdr1, the 86Y mutant genotype was observed in 45 cases (88.2%). Our results suggest that the prevalence of the mutated genotypes remained dominant even 6 years after the withdrawal of chloroquine from this region. Diversified haplotype of the resistance-related locus, potentially involved in fitness costs, unauthorized usage of chloroquine, and/or a short post-withdrawal period may account for the observed high persistence of prevalence.

Rifaximin-resistant Clostridium difficile strains isolated from symptomatic patients.

PubMed

Reigadas, E; Muñoz-Pacheco, P; Vázquez-Cuesta, S; Alcalá, L; Marín, M; Martin, A; Bouza, E

2017-12-01

Rifaximin has been proposed as an alternative treatment for specific cases of Clostridium difficile infection (CDI) and intestinal decontamination. Rifaximin-resistant C. difficile has occasionally been reported. Antibiotic susceptibility testing relies on anaerobic agar dilution (reference method), which is cumbersome and not routinely used. There is no commercial test for detection of resistance to rifaximin. To assess resistance to rifaximin by C. difficile and to evaluate the correlation between the results of the rifampicin E-test and susceptibility to rifaximin. We compared the in vitro susceptibility of clinical CDI isolates to rifaximin over a 6-month period using the agar dilution method with susceptibility to rifampicin using the E-test. All isolates were characterized using PCR-ribotyping. Clinical data were recorded prospectively. We recovered 276 consecutive C. difficile isolates and found that 32.2% of episodes were caused by rifaximin-resistant strains. The MICs for rifaximin ranged from <0.0009-256 mg/L, with a geometric mean (GM) of 0.256 mg/L, an MIC 50/90 of 0.015/>256 mg/L. Rifaximin and rifampicin MICs were comparable, and all strains classed as resistant by agar dilution were correctly classified as resistant by E-test. The most common ribotypes were 001 (37.2%), 078/126 (14.3%), and 014 (12.0%). Ribotype 001 exhibited the highest MICs for rifaximin. Resistance to rifaximin was common; resistance rates were higher in ribotype 001 strains. Susceptibility to rifaximin determined by agar dilution correlated with susceptibility to rifampicin determined using the E-test, including rifaximin-resistant strains. Our results suggest that the rifampicin E-test is a valid method for the prediction of rifaximin-resistant C. difficile. Copyright © 2017 Elsevier Ltd. All rights reserved.

A Bio-Economic Case Study of Canadian Honey Bee (Hymenoptera: Apidae) Colonies: Marker-Assisted Selection (MAS) in Queen Breeding Affects Beekeeper Profits

PubMed Central

Baylis, Kathy; Hoover, Shelley E.; Currie, Rob W.; Melathopoulos, Andony P.; Pernal, Stephen F.; Foster, Leonard J.; Guarna, M. Marta

2017-01-01

Abstract Over the past decade in North America and Europe, winter losses of honey bee (Hymenoptera: Apidae) colonies have increased dramatically. Scientific consensus attributes these losses to multifactorial causes including altered parasite and pathogen profiles, lack of proper nutrition due to agricultural monocultures, exposure to pesticides, management, and weather. One method to reduce colony loss and increase productivity is through selective breeding of queens to produce disease-, pathogen-, and mite-resistant stock. Historically, the only method for identifying desirable traits in honey bees to improve breeding was through observation of bee behavior. A team of Canadian scientists have recently identified markers in bee antennae that correspond to behavioral traits in bees and can be tested for in a laboratory. These scientists have demonstrated that this marker-assisted selection (MAS) can be used to produce hygienic, pathogen-resistant honey bee colonies. Based on this research, we present a beekeeping case study where a beekeeper’s profit function is used to evaluate the economic impact of adopting colonies selected for hygienic behavior using MAS into an apiary. Our results show a net profit gain from an MAS colony of between 2% and 5% when Varroa mites are effectively treated. In the case of ineffective treatment, MAS generates a net profit benefit of between 9% and 96% depending on the Varroa load. When a Varroa mite population has developed some treatment resistance, we show that MAS colonies generate a net profit gain of between 8% and 112% depending on the Varroa load and degree of treatment resistance. PMID:28334400

Diagnosis and Treatment of Drug-Resistant Tuberculosis.

PubMed

Caminero, José A; Cayla, Joan A; García-García, José-María; García-Pérez, Francisco J; Palacios, Juan J; Ruiz-Manzano, Juan

2017-09-01

In the last 2 decades, drug-resistant tuberculosis has become a threat and a challenge to worldwide public health. The diagnosis and treatment of these forms of tuberculosis are much more complex and prognosis clearly worsens as the resistance pattern intensifies. Nevertheless, it is important to remember that with the appropriatesystematic clinical management, most of these patients can be cured. These guidelines itemize the basis for the diagnosis and treatment of all tuberculosis patients, from those infected by strains that are sensitive to all drugs, to those who are extensively drug-resistant. Specific recommendations are given forall cases. The current and future role of new molecular methods for detecting resistance, shorter multi-drug-resistant tuberculosis regimens, and new drugs with activity against Mycobacterium tuberculosis are also addressed. Copyright © 2017 SEPAR. Publicado por Elsevier España, S.L.U. All rights reserved.

Improved 2-D resistivity imaging of features in covered karst terrain with arrays of implanted electrodes

NASA Astrophysics Data System (ADS)

Kiflu, H. G.; Kruse, S. E.; Harro, D.; Loke, M. H.; Wilkinson, P. B.

2013-12-01

Electrical resistivity tomography is commonly used to identify geologic features associated with sinkhole formation. In covered karst terrain, however, it can be difficult to resolve the depth to top of limestone with this method. This is due to the fact that array lengths, and hence depth of resolution, are often limited by residential or commercial lot dimensions in urban environments. Furthermore, the sediments mantling the limestone are often clay-rich and highly conductive. The resistivity method has limited sensitivity to resistive zones beneath conductive zones. This sensitivity can be improved significantly with electrodes implanted at depth in the cover sediments near the top of limestone. An array of deep electrodes is installed with direct push technology in the karst cover. When combined with a surface array in which each surface electrode is underlain by a deep electrode, the array geometry is similar to a borehole array turned on its side. This method, called the Multi-Electrode Resistivity Implant Technique (MERIT), offers the promise of significantly improved resolution of epikarst and cover collapse development zones in the overlying sediment, the limestone or at the sediment-bedrock interface in heterogeneous karst environments. With a non-traditional array design, the question of optimal array geometries arises. Optimizing array geometries is complicated by the fact that many plausible 4-electrode readings will produce negative apparent resistivity values, even in homogeneous terrain. Negative apparent resistivities cannot be used in inversions based on the logarithm of the apparent resistivity. New algorithms for seeking optimal array geometries have been developed by modifying the 'Compare R' method of Wilkinson and Loke. The optimized arrays show significantly improved resolution over basic arrays adapted from traditional 2D surface geometries. Several MERIT case study surveys have been conducted in covered karst in west-central Florida, with 28-electrode arrays with electrodes 2-5 meters apart, and the deep arrays buried at 4-8 meters depth. Ground penetrating radar surveys, SPT borings and coring data provide selected 'ground truthing'. The case studies show that inclusion of the deep electrode array permits karst features such as undulations at the top of limestone and raveling zones within surficial sediments to be imaged. These features are not accessible from surface arrays with equivalent surface footprints. The method also has better resolution at depth at the ends of the lines, where surface arrays are typically plotted with a trapezoidal truncation due to poor resolution at the lower corners of the profile.

[Multidrug-resistant tuberculosis: challenges of a global emergence].

PubMed

Comolet, T

2015-10-01

Drug-resistant tuberculosis, in particular Multi-Drug Resistant (MDR-TB) is an increasing global concern and a major burden for some developing countries, especially the BRICS. It is assumed that every year roughly 350 000 new MDR-TB cases occur in the world, on average in 20.5% of TB patients that have been previously treated but also in 3.5% of persons that have never been on TB treatment before. The global distribution of cases is very heterogeneous and is now better understood thanks to a growing number of specific surveys and routine surveillance systems: incidence is much higher in southern Africa and in all countries formerly part of the USSR. Countries with weak health systems and previously inefficient TB control programs are highly vulnerable to MDR epidemics because program failures do help creating, maintaining and spreading resistances. Global response is slowly rolled out and diagnosis capacities are on the rise (mostly with genotypic methods) but adequate and successful treatment and care is still limited to a minority of global cases. From a public health perspective the MDR-TB growing epidemics will not be controlled merely by the introduction of few new antibiotics because it is also linked to patient's compliance and adequate case management supported by efficient TB program. In depth quality improvement will only be achieved after previous errors are thoroughly analyzed and boldly corrected.

Behavior of drilled shafts with high-strength reinforcement and casing.

DOT National Transportation Integrated Search

2015-09-01

Drilled shafts provide significant geotechnical resistance for support of highway bridges, and are used throughout the States of Oregon : and Washington to meet their structural foundation requirements. Due to changes in construction methods and poor...

Challenges of using electrical resistivity method to locate karst conduits-A field case in the Inner Bluegrass Region, Kentucky

USGS Publications Warehouse

Zhu, J.; Currens, J.C.; Dinger, J.S.

2011-01-01

Conduits serve as major pathways for groundwater flow in karst aquifers. Locating them from the surface, however, is one of the most challenging tasks in karst research. Geophysical methods are often deployed to help locate voids by mapping variations of physical properties of the subsurface. Conduits can cause significant contrasts of some physical properties that can be detected; other subsurface features such as water-bearing fractures often yield similar contrasts, which are difficult to distinguish from the effects of the conduits. This study used electrical resistivity method to search for an unmapped karst conduit that recharges Royal Spring in the Inner Bluegrass karst region, Kentucky, USA. Three types of resistivity techniques (surface 2D survey, quasi-3D survey, and time-lapse survey) were used to map and characterize resistivity anomalies. Some of the major anomalies were selected as drilling targets to verify the existence of the conduits. Drilling near an anomaly identified by an electrical resistivity profile resulted in successful penetration of a major water-filled conduit. The drilling results also suggest that, in this study area, low resistivity anomalies in general are associated with water-bearing features. However, differences in the anomaly signals between the water-filled conduit and other water-bearing features such as water-filled fracture zones were undistinguishable. The electrical resistivity method is useful in conduit detection by providing potential drilling targets. Knowledge of geology and hydrogeology about the site and professional judgment also played important roles in locating the major conduit. ?? 2011 Elsevier B.V.

Geophysical constraints on Rio Grande rift structure and stratigraphy from magnetotelluric models and borehole resistivity logs, northern New Mexico

USGS Publications Warehouse

Rodriguez, Brian D.; Sawyer, David A.; Hudson, Mark R.; Grauch, V.J.S.

2013-01-01

Two- and three-dimensional electrical resistivity models derived from the magnetotelluric method were interpreted to provide more accurate hydrogeologic parameters for the Albuquerque and Española Basins. Analysis and interpretation of the resistivity models are aided by regional borehole resistivity data. Examination of the magnetotelluric response of hypothetical stratigraphic cases using resistivity characterizations from the borehole data elucidates two scenarios where the magnetotelluric method provides the strongest constraints. In the first scenario, the magnetotelluric method constrains the thickness of extensive volcanic cover, the underlying thickness of coarser-grained facies of buried Santa Fe Group sediments, and the depth to Precambrian basement or overlying Pennsylvanian limestones. In the second scenario, in the absence of volcanic cover, the magnetotelluric method constrains the thickness of coarser-grained facies of buried Santa Fe Group sediments and the depth to Precambrian basement or overlying Pennsylvanian limestones. Magnetotelluric surveys provide additional constraints on the relative positions of basement rocks and the thicknesses of Paleozoic, Mesozoic, and Tertiary sedimentary rocks in the region of the Albuquerque and Española Basins. The northern extent of a basement high beneath the Cerros del Rio volcanic field is delineated. Our results also reveal that the largest offset of the Hubbell Spring fault zone is located 5 km west of the exposed scarp. By correlating our resistivity models with surface geology and the deeper stratigraphic horizons using deep well log data, we are able to identify which of the resistivity variations in the upper 2 km belong to the upper Santa Fe Group sediment

Antimicrobial Resistance of Urinary Tract Isolates in Acute Uncomplicated Cystitis among College-Aged Women: Choosing a First-Line Therapy

ERIC Educational Resources Information Center

Hames, Leesa; Rice, Craig E.

2007-01-01

Objective and Participants: The authors of this retrospective case study focused on antimicrobial susceptibility of urinary tract isolates in cases of acute uncomplicated cystitis in college-aged women, aged 18 to 24 years, diagnosed at a major south-central university student health center. Methods: The authors obtained pertinent data from…

Geophysical techniques for low enthalpy geothermal exploration in New Zealand

NASA Astrophysics Data System (ADS)

Soengkono, Supri; Bromley, Chris; Reeves, Robert; Bennie, Stewart; Graham, Duncan

2013-05-01

Shallow warm water resources associated with low enthalpy geothermal systems are often difficult to explore using geophysical techniques, mainly because the warm water creates an insufficient physical change from the host rocks to be easily detectable. In addition, often the system also has a limited or narrow size. However, appropriate use of geophysical techniques can still help the exploration and further investigation of low enthalpy geothermal resources. We present case studies on the use of geophysical techniques for shallow warm water explorations over a variety of settings in New Zealand (mostly in the North Island) with variable degrees of success. A simple and direct method for the exploration of warm water systems is shallow temperature measurements. In some New Zealand examples, measurements of near surface temperatures helped to trace the extent of deeper thermal water. The gravity method was utilised as a structural technique for the exploration of some warm water systems in New Zealand. Our case studies show the technique can be useful in identifying basement depths and tracing fault systems associated with the occurrence of hot springs. Direct current (DC) ground resistivity measurements using a variety of electrode arrays have been the most common method for the exploration of low enthalpy geothermal resources in New Zealand. The technique can be used to detect the extent of shallow warm waters that are more electrically conductive than the surrounding cold groundwater. Ground resistivity investigations using the electromagnetic (EM) techniques of audio magnetotellurics (AMT or shallow MT), controlled source audio magnetotellurics (CSAMT) and transient electromagnetic (TEM) methods have also been used. Highly conductive clays of thermal or sedimentary origin often limit the penetration depth of the resistivity techniques and can create some interpretation difficulties. Interpretation of resistivity anomalies needs to be treated in a site specific manner.

Application of electrical geophysics to the release of water resources, case of Ain Leuh (Morocco)

NASA Astrophysics Data System (ADS)

Zitouni, A.; Boukdir, A.; El Fjiji, H.; Baite, W.; Ekouele Mbaki, V. R.; Ben Said, H.; Echakraoui, Z.; Elissami, A.; El Maslouhi, M. R.

2018-05-01

Being seen needs in increasing waters in our contry for fine domestics, manufactures and agricultural, the prospecting of subterranean waters by geologic and hydrogeologic classic method remains inaplicable in the cases of the regions where one does not arrange drillings or polls (soundings) of gratitude (recongnition) in very sufficient (self-important) number. In that case of figure, the method of prospecting geophysics such as the method of nuclear magnetic resonance (NMR) and the method of the geophysics radar are usually used most usually because they showed, worldwide, results very desive in the projects of prospecting and evaluation of the resources in subterranean waters. In the present work, which concerns only the methodology of the electric resistivity, we treat the adopted methodological approach and the study of the case of application in the tray of Ajdir Ain Leuh.

Weapon involvement in home invasion crimes.

PubMed

Kellermann, A L; Westphal, L; Fischer, L; Harvard, B

1995-06-14

To study the epidemiology of home invasion crimes and determine the frequency with which firearms are used to resist these crimes. Prospective case series. Atlanta, Ga (population 402,877). Between June 1 and August 31, 1994; Atlanta Police Department reports were screened to identify every case of unwanted entry into an occupied, single-family dwelling. Cases of sexual assault and incidents that involved cohabitants were excluded. A total of 198 cases were identified during the study interval. Half (99 cases) involved forced entry into the home. The victim and offender were acquainted in one third of cases. A firearm was carried by one or more offenders in 32 cases (17%). Seven offenders (3.5%) carried knives. In 42% of cases, the offender fled without confronting the victim. Victims who avoided confrontation were more likely to lose property but much less likely to be injured than those who were confronted by the offender. Resistance was attempted in 62 cases (31%), but the odds of injury were not significantly affected by the method of resistance. Forty cases (20%) resulted in one or more victims' being injured, including six (3%) who were shot. No one died. Three victims (1.5%) employed a firearm in self-protection. All three escaped injury, but one lost property. A minority of home invasion crimes result in injury. Measures that increase the difficulty of forced entry or enhance the likelihood of detection could be useful to prevent these crimes. Although firearms are often kept in the home for protection, they are rarely used for this purpose.

Argon laser photocoagulation versus intrastromal voriconazole injection in treatment of mycotic keratitis

PubMed Central

Khater, Mohammad M.; El-Shorbagy, Mohammad S.; Selima, Adel A.

2016-01-01

AIM To compare argon laser photocoagulation and intrastromal injection of voriconazole as adjunctive treatment modalities in cases of resistant mycotic corneal ulcers. METHODS Two groups each of them included 20 cases of resistant mycotic corneal ulcers. Both groups treated with local and systemic specific antimicrobial drugs guided with culture and sensitivity results. In one group argon laser photocoagulation was used as an adjunctive therapy to the specific antifungal drugs and in the other group, intrastromal injection of voriconazole was done besides the specific antifungal drugs. The 40 cases included in the study were proven according to culture and sensitivity to be 28 cases with pure fungal results and 12 cases with mixed (fungal and bacterial). In argon laser group, argon laser irradiation of the corneal ulcer was performed using argon laser 532 nm wavelength (Carl Zeiss LSL 532s AG; Meditec, Inc.) after fluorescein staining. In the other group, voriconazole solution (500 µg/mL) was prepared and injected in the corneal stroma. All cases were followed up for 3mo after healing was achieved. RESULTS Complete healing of the epithelial defect and resolution of stromal infiltration with no adverse effects were achieved in argon laser group in duration ranged from 2-4wk in 90% of cases. In voriconazole group 4 cases needed amniotic membrane graft due to thinning and 16 cases healed in duration ranged from 2-6wk (80% of cases). CONCLUSION Argon laser photocoagulation is superior to intrastromal voriconazole injection in treatment of resistant fungal corneal ulcers. PMID:26949639

Multidrug-resistant tuberculosis outbreak among US-bound Hmong refugees, Thailand, 2005.

PubMed

Oeltmann, John E; Varma, Jay K; Ortega, Luis; Liu, Yecai; O'Rourke, Thomas; Cano, Maria; Harrington, Theresa; Toney, Sean; Jones, Warren; Karuchit, Samart; Diem, Lois; Rienthong, Dhanida; Tappero, Jordan W; Ijaz, Kashef; Maloney, Susan A

2008-11-01

In January 2005, tuberculosis (TB), including multidrug-resistant TB (MDR TB), was reported among Hmong refugees who were living in or had recently immigrated to the United States from a camp in Thailand. We investigated TB and drug resistance, enhanced TB screenings, and expanded treatment capacity in the camp. In February 2005, 272 patients with TB (24 MDR TB) remained in the camp. Among 17 MDR TB patients interviewed, 13 were found to be linked socially. Of 23 MDR TB isolates genotyped, 20 were similar according to 3 molecular typing methods. Before enhanced screening was implemented, 46 TB cases (6 MDR TB) were diagnosed in the United States among 9,455 resettled refugees. After enhanced screening had begun, only 4 TB cases (1 MDR TB), were found among 5,705 resettled refugees. An MDR TB outbreak among US-bound refugees led to importation of disease; enhanced pre-immigration TB screening and treatment decreased subsequent importation.

Low fraction of the 222K PrP variant in the protease-resistant moiety of PrPres in heterozygous scrapie positive goats.

PubMed

Mazza, Maria; Guglielmetti, Chiara; Ingravalle, Francesco; Brusadore, Sonia; Langeveld, Jan P M; Ekateriniadou, Loukia V; Andréoletti, Olivier; Casalone, Cristina; Acutis, Pier Luigi

2017-07-01

The presence of lysine (K) at codon 222 has been associated with resistance to classical scrapie in goats, but few scrapie cases have been identified in 222Q/K animals. To investigate the contribution of the 222K variant to PrPres formation in natural and experimental Q/K scrapie cases, we applied an immunoblotting method based on the use of two different monoclonal antibodies, F99/97.6.1 and SAF84, chosen for their different affinities to 222K and 222Q PrP variants. Our finding that PrPres seems to be formed nearly totally by the 222Q variant provides evidence that the 222K PrP variant confers resistance to conversion to PrPres formation and reinforces the view that this mutation has a protective role against classical scrapie in goats.

Low fraction of the 222K PrP variant in the protease-resistant moiety of PrPres in heterozygous scrapie positive goats

PubMed Central

Guglielmetti, Chiara; Ingravalle, Francesco; Brusadore, Sonia; Langeveld, Jan P. M.; Ekateriniadou, Loukia V.; Andréoletti, Olivier; Casalone, Cristina; Acutis, Pier Luigi

2017-01-01

The presence of lysine (K) at codon 222 has been associated with resistance to classical scrapie in goats, but few scrapie cases have been identified in 222Q/K animals. To investigate the contribution of the 222K variant to PrPres formation in natural and experimental Q/K scrapie cases, we applied an immunoblotting method based on the use of two different monoclonal antibodies, F99/97.6.1 and SAF84, chosen for their different affinities to 222K and 222Q PrP variants. Our finding that PrPres seems to be formed nearly totally by the 222Q variant provides evidence that the 222K PrP variant confers resistance to conversion to PrPres formation and reinforces the view that this mutation has a protective role against classical scrapie in goats. PMID:28691895

Comparative study of resist stabilization techniques for metal etch processing

NASA Astrophysics Data System (ADS)

Becker, Gerry; Ross, Matthew F.; Wong, Selmer S.; Minter, Jason P.; Marlowe, Trey; Livesay, William R.

1999-06-01

This study investigates resist stabilization techniques as they are applied to a metal etch application. The techniques that are compared are conventional deep-UV/thermal stabilization, or UV bake, and electron beam stabilization. The electron beam tool use din this study, an ElectronCure system from AlliedSignal Inc., ELectron Vision Group, utilizes a flood electron source and a non-thermal process. These stabilization techniques are compared with respect to a metal etch process. In this study, two types of resist are considered for stabilization and etch: a g/i-line resist, Shipley SPR-3012, and an advanced i-line, Shipley SPR 955- Cm. For each of these resist the effects of stabilization on resist features are evaluated by post-stabilization SEM analysis. Etch selectivity in all cases is evaluated by using a timed metal etch, and measuring resists remaining relative to total metal thickness etched. Etch selectivity is presented as a function of stabilization condition. Analyses of the effects of the type of stabilization on this method of selectivity measurement are also presented. SEM analysis was also performed on the features after a compete etch process, and is detailed as a function of stabilization condition. Post-etch cleaning is also an important factor impacted by pre-etch resist stabilization. Results of post- etch cleaning are presented for both stabilization methods. SEM inspection is also detailed for the metal features after resist removal processing.

Assessing spatial heterogeneity of MDR-TB in a high burden country

PubMed Central

Jenkins, Helen E.; Plesca, Valeriu; Ciobanu, Anisoara; Crudu, Valeriu; Galusca, Irina; Soltan, Viorel; Serbulenco, Aliona; Zignol, Matteo; Dadu, Andrei; Dara, Masoud; Cohen, Ted

2013-01-01

Multidrug-resistant tuberculosis (MDR-TB) is a major concern in countries of the former Soviet Union. The reported risk of resistance among TB cases in the Republic of Moldova is among the highest in the world. We aimed to produce high-resolution spatial maps of MDR-TB risk and burden in this setting. We analyzed national TB surveillance data collected between 2007 and 2010 in Moldova. High drug susceptibility testing coverage and detailed location data permitted identification of sub-regional areas of higher MDR-TB risk. We investigated whether the distribution of cases with MDR-TB risk factors could explain this observed spatial variation in MDR-TB. 3,447 MDR-TB cases were notified during this period; 24% of new and 62% of previously treated patients had MDR-TB. Nationally, the estimated annual MDR-TB incidence was 54 cases/100,000 persons and >1,000 cases/100,000 persons within penitentiaries. We identified substantial geographic variation in MDR-TB burden and hotspots of MDR-TB. Locations with a higher percentage of previously incarcerated TB cases were at greater risk of being MDR-TB hotspots. Spatial analyses revealed striking geographic heterogeneity of MDR-TB. Methods to identify locations of high MDR-TB risk and burden should allow for better resource allocation and more appropriate targeting of studies to understand local mechanisms driving resistance. PMID:23100496

Meta-analyses of the Association of Sleep Apnea with Insulin Resistance, and the Effects of CPAP on HOMA-IR, Adiponectin, and Visceral Adipose Fat

PubMed Central

Iftikhar, Imran H.; Hoyos, Camilla M.; Phillips, Craig L.; Magalang, Ulysses J.

2015-01-01

Objective: We sought to conduct an updated meta-analysis of randomized controlled trials (RCTs) on the effect of continuous positive airway pressure (CPAP) on insulin resistance, as measured by homeostasis model assessment of insulin resistance (HOMA-IR), visceral abdominal fat (VAF), and adiponectin. Additionally, we performed a separate meta-analysis and meta-regression of studies on the association of insulin resistance and obstructive sleep apnea (OSA). Methods: All included studies were searched from PubMed (from conception to March 15, 2014). Data were pooled across all included RCTs as the mean difference in HOMA-IR and VAF, and as the standardized mean difference in the case of adiponectin analysis. From the included case-control studies, data on the difference of HOMA-IR between cases and controls were pooled across all studies, as the standardized mean difference (SMD). Results: There was a significant difference in HOMA-IR (−0.43 [95% CIs: −0.75 to −0.11], p = 0.008) between CPAP treated and non CPAP treated participants. However, there was no significant difference in VAF or adiponectin; (−47.93 [95% CI: −112.58 to 16.72], p = 0.14) and (−0.06 [95% CI: −0.28 to 0.15], p = 0.56), respectively. Meta-analysis of 16 case-control studies showed a pooled SMD in HOMA-IR of 0.51 (95% CI: 0.28 to 0.75), p ≤ 0.001, between cases and controls. Conclusions: The results of our meta-analyses show that CPAP has a favorable effect on insulin resistance. This effect is not associated with any significant changes in total adiponectin levels or amount of VAF. Our findings also confirm a significant association between OSA and insulin resistance. Citation: Iftikhar IH, Hoyos CM, Phillips CL, Magalang UJ. Meta-analyses of the association of sleep apnea with insulin resistance, and the effects of CPAP on HOMA-IR, adiponectin, and visceral adipose fat. J Clin Sleep Med 2015;11(4):475–485. PMID:25700870

Multidrug Resistant Pseudomonas aeruginosa Causing Prosthetic Valve Endocarditis: A Genetic-Based Chronicle of Evolving Antibiotic Resistance.

PubMed

Domitrovic, T Nicholas; Hujer, Andrea M; Perez, Federico; Marshall, Steven H; Hujer, Kristine M; Woc-Colburn, Laila E; Parta, Mark; Bonomo, Robert A

2016-10-01

Background.  Successful treatment of infections caused by multidrug-resistant (MDR) Pseudomonas aeruginosa is thwarted by the emergence of antibiotic resistance and biofilm formation on prosthetic devices. Our aims were to decipher the molecular basis of resistance in a unique case of prosthetic valve endocarditis (PVE) caused by MDR P. aeruginosa . Methods.  Five sequential MDR P. aeruginosa blood isolates collected during a 7-month period were recovered from a patient suffering from PVE previously exposed to β-lactam antibiotics. Minimum inhibitory concentrations (MICs) of several classes of antibiotics were used to indicate clinical resistance characteristics; relatedness of the isolates was determined using multilocus sequence typing and repetitive sequence-based polymerase chain reaction. Amplification and sequencing of regulatory and resistance genes was performed. Results.  All isolates belonged to ST 298, possessed bla PDC-16 , and were resistant to fluoroquinolones and carbapenems. In the course of therapy, we observed a >2-fold increase in cephalosporin resistance (4 µg/mL to >16 µg/mL). Sequencing of the AmpC regulator, amp R, revealed a D135N point mutation in cephalosporin-resistant isolates. Common carbapenemase genes were not identified. All isolates demonstrated a premature stop codon at amino acid 79 of the outer membrane protein OprD and mutations in the quinolone resistance-determining regions of gyr A and par C. Point mutations in nal C, an efflux pump regulator, were also observed. Conclusions.  In this analysis, we chart the molecular evolution of β-lactam resistance in a case of PVE. We show that mutations in regulatory genes controlling efflux and cephalosporinase production contributed to the MDR phenotype.

Childhood multidrug-resistant tuberculosis in the European Union and European Economic Area: an analysis of tuberculosis surveillance data from 2007 to 2015.

PubMed

Ködmön, Csaba; van den Boom, Martin; Zucs, Phillip; van der Werf, Marieke Johanna

2017-11-01

BackgroundConfirming tuberculosis (TB) in children and obtaining information on drug susceptibility is essential to ensure adequate treatment. We assessed whether there are gaps in diagnosis and treatment of multidrug-resistant (MDR) TB in children in the European Union and European Economic Area (EU/EEA), quantified the burden of MDR TB in children and characterised cases. Methods : We analysed surveillance data from 2007 to 2015 for paediatric cases younger than 15 years. Results : In that period, 26 EU/EEA countries reported 18,826 paediatric TB cases of whom 4,129 (21.9%) were laboratory-confirmed. Drug susceptibility testing results were available for 3,378 (17.9%), representing 81.8% of the confirmed cases. The majority (n = 2,967; 87.8%) had drug-sensitive TB, 249 (7.4%) mono-resistant TB, 64 (1.9%) poly-resistant TB, 90 (2.7%) MDR TB and eight (0.2%) had extensively drug-resistant (XDR) TB. MDR TB was more frequently reported among paediatric cases with foreign background (adjusted odds ratio (aOR) = 1.73; 95% confidence interval (95% CI): 1.12-2.67) or previous TB treatment (aOR: 6.42; 95% CI: 3.24-12.75). Successful treatment outcome was reported for 58 of 74 paediatric MDR TB cases with outcome reported from 2007 to 2013; only the group of 5-9 years-olds was significantly associated with unsuccessful treatment outcome (crude odds ratio (cOR) = 11.45; 95% CI: 1.24-106.04). Conclusions : The burden of MDR TB in children in the EU/EEA appears low, but may be underestimated owing to challenges in laboratory confirmation. Diagnostic improvements are needed for early detection and adequate treatment of MDR TB. Children previously treated for TB or of foreign origin may warrant higher attention.

[Phenotypic and genotypic characterization of resistance to third-generation cephalosporins in Enterobacter spp].

PubMed

Bertona, E; Radice, M; Rodríguez, C H; Barberis, C; Vay, C; Famiglietti, A; Gutkind, G

2005-01-01

Enterobacter spp. are becoming increasingly frequent nosocomial pathogens with multiple resistance mechanism to beta-lactam antibiotics. We carried out the phenotypic and genotypic characterization of beta-lactamases in 27 Enterobacter spp. (25 Enterobacter cloacae y 2 Enterobacter aerogenes), as well as the ability of different extended spectrum-lactamase (ESBL) screening methods. Resistance to third generation cephalosporins was observed in 15/27 (63%) isolates. Twelve resistant isolates produced high level chromosomal encoded AmpC beta-lactamase; 6 of them were also producers of PER-2. Resistance to third generation cephalosporins in the remaining 3 isolates was due to the presence of ESBLs, PER-2 in 2 cases, and CTX-M-2 in the other. Only CTX-M-2 production was detected with all tested cephalosporins using difusion synergy tests, while cefepime improved ESBLs detection in 7/8 PER-2 producers, 4/8 in the inhibitor approximation test and 7/8 with double disk test using cefepime containing disk with and without clavulanic acid. Dilution method, including cephalosporins with and without the inhibitor detected 1/9 ESBLs producers.

Risk factors associated with multidrug-resistant tuberculosis in Espírito Santo, Brazil

PubMed Central

Fregona, Geisa; Cosme, Lorrayne Belique; Moreira, Cláudia Maria Marques; Bussular, José Luis; Dettoni, Valdério do Valle; Dalcolmo, Margareth Pretti; Zandonade, Eliana; Maciel, Ethel Leonor Noia

2017-01-01

ABSTRACT OBJECTIVE To analyze the prevalence and factors associated with multidrug-resistant tuberculosis in Espírito Santo, Brazil. METHODS This is a cross-sectional study of cases of tuberculosis tested for first-line drugs (isoniazid, rifampicin, pyrazinamide, ethambutol, and streptomycin) in Espírito Santo between 2002 and 2012. We have used laboratory data and registration of cases of tuberculosis – from the Sistema Nacional de Agravos de Notificação and Sistema para Tratamentos Especiais de Tuberculose. Individuals have been classified as resistant and non-resistant and compared in relation to the sociodemographic, clinical, and epidemiological variables. Some variables have been included in a logistic regression model to establish the factors associated with resistance. RESULTS In the study period, 1,669 individuals underwent anti-tuberculosis drug susceptibility testing. Of these individuals, 10.6% showed resistance to any anti-tuberculosis drug. The rate of multidrug resistance observed, that is, to rifampicin and isoniazid, has been 5%. After multiple analysis, we have identified as independent factors associated with resistant tuberculosis: history of previous treatment of tuberculosis [recurrence (OR = 7.72; 95%CI 4.24–14.05) and re-entry after abandonment (OR = 3.91; 95%CI 1.81–8.43)], smoking (OR = 3.93; 95%CI 1.98–7.79), and positive culture for Mycobacterium tuberculosis at the time of notification of the case (OR = 3.22; 95%CI 1.15–8.99). CONCLUSIONS The partnership between tuberculosis control programs and health teams working in the network of Primary Health Care needs to be strengthened. This would allow the identification and monitoring of individuals with a history of previous treatment of tuberculosis and smoking. Moreover, the expansion of the offer of the culture of tuberculosis and anti-tuberculosis drug susceptibility testing would provide greater diagnostic capacity for the resistant types in Espírito Santo. PMID:28489185

Nonlinear inversion of resistivity sounding data for 1-D earth models using the Neighbourhood Algorithm

NASA Astrophysics Data System (ADS)

Ojo, A. O.; Xie, Jun; Olorunfemi, M. O.

2018-01-01

To reduce ambiguity related to nonlinearities in the resistivity model-data relationships, an efficient direct-search scheme employing the Neighbourhood Algorithm (NA) was implemented to solve the 1-D resistivity problem. In addition to finding a range of best-fit models which are more likely to be global minimums, this method investigates the entire multi-dimensional model space and provides additional information about the posterior model covariance matrix, marginal probability density function and an ensemble of acceptable models. This provides new insights into how well the model parameters are constrained and make assessing trade-offs between them possible, thus avoiding some common interpretation pitfalls. The efficacy of the newly developed program is tested by inverting both synthetic (noisy and noise-free) data and field data from other authors employing different inversion methods so as to provide a good base for comparative performance. In all cases, the inverted model parameters were in good agreement with the true and recovered model parameters from other methods and remarkably correlate with the available borehole litho-log and known geology for the field dataset. The NA method has proven to be useful whilst a good starting model is not available and the reduced number of unknowns in the 1-D resistivity inverse problem makes it an attractive alternative to the linearized methods. Hence, it is concluded that the newly developed program offers an excellent complementary tool for the global inversion of the layered resistivity structure.

Dealing with uncertainty in landscape genetic resistance models: a case of three co-occurring marsupials.

PubMed

Dudaniec, Rachael Y; Worthington Wilmer, Jessica; Hanson, Jeffrey O; Warren, Matthew; Bell, Sarah; Rhodes, Jonathan R

2016-01-01

Landscape genetics lacks explicit methods for dealing with the uncertainty in landscape resistance estimation, which is particularly problematic when sample sizes of individuals are small. Unless uncertainty can be quantified, valuable but small data sets may be rendered unusable for conservation purposes. We offer a method to quantify uncertainty in landscape resistance estimates using multimodel inference as an improvement over single model-based inference. We illustrate the approach empirically using co-occurring, woodland-preferring Australian marsupials within a common study area: two arboreal gliders (Petaurus breviceps, and Petaurus norfolcensis) and one ground-dwelling antechinus (Antechinus flavipes). First, we use maximum-likelihood and a bootstrap procedure to identify the best-supported isolation-by-resistance model out of 56 models defined by linear and non-linear resistance functions. We then quantify uncertainty in resistance estimates by examining parameter selection probabilities from the bootstrapped data. The selection probabilities provide estimates of uncertainty in the parameters that drive the relationships between landscape features and resistance. We then validate our method for quantifying uncertainty using simulated genetic and landscape data showing that for most parameter combinations it provides sensible estimates of uncertainty. We conclude that small data sets can be informative in landscape genetic analyses provided uncertainty can be explicitly quantified. Being explicit about uncertainty in landscape genetic models will make results more interpretable and useful for conservation decision-making, where dealing with uncertainty is critical. © 2015 John Wiley & Sons Ltd.

Quantification of Organic richness through wireline logs: a case study of Roseneath shale formation, Cooper basin, Australia

NASA Astrophysics Data System (ADS)

Ahmad, Maqsood; Iqbal, Omer; Kadir, Askury Abd

2017-10-01

The late Carboniferous-Middle Triassic, intracratonic Cooper basin in northeastern South Australia and southwestern Queensland is Australia's foremost onshore hydrocarbon producing region. The basin compromises Permian carbonaceous shale like lacustrine Roseneath and Murteree shale formation which is acting as source and reservoir rock. The source rock can be distinguished from non-source intervals by lower density, higher transit time, higher gamma ray values, higher porosity and resistivity with increasing organic content. In current dissertation we have attempted to compare the different empirical approaches based on density relation and Δ LogR method through three overlays of sonic/resistivity, neutron/resistivity and density/resistivity to quantify Total organic content (TOC) of Permian lacustrine Roseneath shale formation using open hole wireline log data (DEN, GR, CNL, LLD) of Encounter 1 well. The TOC calculated from fourteen density relations at depth interval between 3174.5-3369 meters is averaged 0.56% while TOC from sonic/resistivity, neutron/resistivity and density/resistivity yielded an average value of 3.84%, 3.68%, 4.40%. The TOC from average of three overlay method is yielded to 3.98%. According to geochemical report in PIRSA the Roseneath shale formation has TOC from 1 - 5 wt %.There is unpromising correlations observed for calculated TOC from fourteen density relations and measured TOC on samples. The TOC from average value of three overlays using Δ LogR method showed good correlation with measured TOC on samples.

Association between Myeloperoxidase Levels and Risk of Insulin Resistance in Egyptian Obese Women

PubMed Central

Zaki, Moushira; Basha, Walaa; Reyad, Hanaa; Mohamed, Ramy; Hassan, Naglaa; Kholousi, Shams

2018-01-01

BACKGROUND: Myeloperoxidase (MPO) is an enzyme involved in the pathogenesis of several diseases. AIM: The current study aimed to investigate serum MPO levels in obese Egyptian women and assess its relation with insulin resistance (IR) and other biochemical risk parameters. METHODS: The study included 80 obese women and 50 age-and-sex-matched healthy controls. Insulin resistance (IR) was evaluated by the Homeostasis Model Assessment-Insulin Resistance (HOMA-IR). Serum MPO, fasting glucose, insulin and blood lipids and anthropometry were measured. Obese cases were divided into three groups based on MPO tertiles. ROC analysis was performed to obtain the optimal cut-off values of MPO to predicate IR in obese women. RESULTS: The mean serum MPO was significantly higher in obese cases than controls. Cases in the highest MPO tertile had higher HOMA-IR, blood lipids and pressure levels compared with those in the lower tertile. The cutoff point of MPO was > 87.8 (ng/mL) and area under curves was 0.82 (p < 0.01) for diagnosis of IR. MPO levels were higher in obese Egyptian women than healthy controls. CONCLUSION: Elevation of MPO was associated with abnormal metabolic parameters. MPO might be used as an earlier biomarker for IR and metabolic disturbance in obese women. PMID:29731928

2D Inversion of DCR and Time Domain IP data: an example from ore exploration

NASA Astrophysics Data System (ADS)

Adrian, J.; Tezkan, B.

2015-12-01

Ore deposits often appear as disseminated sulfidic materials. Exploring these deposits with the Direct Current Resistivity (DCR) method alone is challenging because the resistivity signatures caused by disseminated material is often hard to detect. The Time-domain Induced Polarization (TDIP) method, on the other hand, is qualified to detect areas with disseminated sulfidic ores due to large electrode polarization effects which result in large chargeability anomalies. By employing both methods we gain information about both, the resistivity and the chargeability distribution of the subsurface.On the poster we present the current state of the development of a 2D smoothness constraint inversion algorithm for DCR and TDIP data. The implemented forward algorithm uses a Finite Element approach with an unstructured mesh. The model parameters resistivity and chargeability are connected by either a simple conductivity pertubation approach or a complex conductivity approach.As a case study, the 2D inversion results of DCR/TDIP and RMT data obtained during a survey on a sulfidic copper ore deposit in Turkey are presented. The presence of an ore deposit is indicated by areas with low resistivity and significantly high chargeability in the inversion models.This work is part of the BMBF/TUEBITAK funded project ``Two-dimensional joint interpretation of Radiomagnetotellurics (RMT), Direct Current Resistivity (DCR) and Induced Polarization (IP) data: an example from ore exploration''.

Staphylococcus pseudintermedius and Staphylococcus schleiferi Subspecies coagulans from Canine Pyoderma Cases in Grenada, West Indies, and Their Susceptibility to Beta-Lactam Drugs

PubMed Central

Gibson, Kathryn; Frankie, Matthew; Matthew, Vanessa; Daniels, Joshua; Martin, Nancy A.; Andrews, Linton; Paterson, Tara; Sharma, Ravindra N.

2014-01-01

Over a 2-year period 66 cases of canine pyoderma in Grenada, West Indies, were examined by aerobic culture in order to ascertain the bacteria involved and their antimicrobial resistance patterns. Of the 116 total bacterial isolates obtained, the majority belonged to Gram-positive species, and the most common organism identified through biochemical and molecular methods was Staphylococcus pseudintermedius. Additionally, identification of a Staphylococcus schleiferi subspecies coagulans isolate was confirmed by molecular methods. All isolates of staphylococci were susceptible to beta-lactam drugs: amoxicillin-clavulanic acid, cefovecin, cefoxitin, cefpodoxime, and cephalothin. They were also susceptible to chloramphenicol and enrofloxacin. Resistance was highest to tetracycline. Methicillin resistance was not detected in any isolate of S. pseudintermedius or in S. schleiferi. Among the Gram-negative bacteria, the most common species was Klebsiella pneumoniae, followed by Acinetobacter baumannii/calcoaceticus. The only drug to which all Gram-negative isolates were susceptible was enrofloxacin. This report is the first to confirm the presence of S. pseudintermedius and S. schleiferi subspecies coagulans, in dogs with pyoderma in Grenada, and the susceptibility of staphylococcal isolates to the majority of beta-lactam drugs used in veterinary practice. PMID:24592351

Case-control study to determine whether river water can spread tetracycline resistance to unexposed impala (Aepyceros melampus) in Kruger National Park (South Africa).

PubMed

Mariano, V; McCrindle, C M E; Cenci-Goga, B; Picard, J A

2009-01-01

A case-control study was performed in the Kruger National Park (KNP), South Africa, to find out whether impala (Aepyceros melampus) were more likely to harbor tetracycline-resistant Escherichia coli (TREC) in their feces when they drank from rivers that contained these bacteria than when they drank from rivers that were uncontaminated with TREC. The following five perennial rivers were selected: the Crocodile, the Letaba, the Olifants, the Sabie, and the Sand. Samples of river water (n = 33) and feces (n = 209), collected at 11 different sites, were cultured for E. coli. The resulting colonies were screened for tetracycline resistance by use of the Lederberg replica plating method (breakpoint, 4 mg/liter). A resistant and/or a susceptible isolate was then selected from each sample and subjected to the CLSI MIC broth microdilution test for tetracyclines. Among the 21 water specimens contaminated by E. coli, 19.05% (n = 4) were found to be resistant by the MIC method (breakpoint, >/=8 mg/liter). This led to the Crocodile, Olifants, and Letaba rivers being classified as TREC positive. Among the 209 impala feces sampled, 191 were positive for the presence of E. coli (91.38%). Within these (n = 191), 9.95% (n = 19) of the isolates were shown to be TREC by the MIC method. It was found that 1.11% (n = 1) of the E. coli isolates cultured from the feces of the control group (n = 90) were TREC, in comparison with 17.82% (n = 18) of those in feces from the exposed group (n = 101). The calculation of the odds ratio showed that impala drinking from TREC-contaminated rivers were 19.3 (2.63 to 141.69) times more likely to be infected with TREC than were unexposed impala. This is a significant finding, indicating that surface water could be a possible source of antimicrobial resistance in naïve animal populations and that impala could act as sentinels for antimicrobial resistance.

Antibody-Mediated Extreme Insulin Resistance: A Report of Three Cases.

PubMed

Kim, Han Na; Fesseha, Betiel; Anzaldi, Laura; Tsao, Allison; Galiatsatos, Panagis; Sidhaye, Aniket

2018-01-01

Type 2 diabetes mellitus is characterized by relative insulin deficiency and insulin resistance. Features suggesting severe insulin resistance include acanthosis nigricans, hyperandrogenism, weight loss, and recurrent hospital admissions for diabetic ketoacidosis. In rare circumstances, hyperglycemia persists despite administration of massive doses of insulin. In these cases, it is important to consider autoimmune etiologies for insulin resistance, such as type B insulin resistance and insulin antibody-mediated extreme insulin resistance, which carry high morbidity and mortality if untreated. Encouragingly, immunomodulatory regimens have recently been published that induce remission at high rates. We describe 3 cases of extreme insulin resistance mediated by anti-insulin receptor autoantibodies or insulin autoantibodies. All cases were effectively treated with an immunomodulatory regimen. Although cases of extreme insulin resistance are rare, it is important to be aware of autoimmune causes, recognize suggestive signs and symptoms, and pursue appropriate diagnostic evaluation. Prompt treatment with immunomodulators is key to restoring euglycemia in patients with autoimmune etiologies of insulin resistance. Copyright © 2018 Elsevier Inc. All rights reserved.

Resistant and sensitive strains of Mycobacterium tuberculosis found in repeated surveys among a South Indian rural population*

PubMed Central

Narain, Raj; Chandrasekhar, P.; Satyanarayanachar, R. A.; Lal, Pyare

1968-01-01

The findings in a highly selected group of patients, such as those attending clinics or sanatoria, cannot be used as the basis for assessing the true prevalence of strains of Mycobacterium tuberculosis with acquired or primary resistance or of sensitive strains in a community. The present report describes the prevalence of such strains as found in 3 successive surveys in a sizeable random sample of villages in a South Indian district. Changes in the status of cases with such strains from an earlier survey to a later one and the status at an earlier round of cases found at a later one are also described. The prevalence of tuberculous infection among household contacts of cases with acquired resistance to isoniazid was significantly higher than that among contacts of cases with primary resistance or of those with sensitive cultures. This is probably due to the longer duration of sputum positivity of the former at the time of diagnosis. But infectivity, as judged by the incidence of new infections among household contacts, was generally less for cases with acquired or primary resistance than for cases with sensitive cultures, though the difference was not statistically significant. A large number of culture-positive cases, especially those with primary resistance, had no radiological evidence of active pulmonary tuberculosis. The prevalence of primary resistance was very high among certain categories of cases, and the differences between cases with primary resistance and those with acquired resistance were many and large. It is suggested that this could be due to some of the primary resistant cultures being those of atypical mycobacteria, despite positivity in the niacin test. There was a significant increase in the number of cases with acquired resistance to isoniazid at the third survey round owing to irregular treatment with that drug after the second round. The prevalence of primary resistance at the 3 rounds was almost the same. PMID:4978410

Ultrasensitive Genotypic Detection of Antiviral Resistance in Hepatitis B Virus Clinical Isolates▿ †

PubMed Central

Fang, Jie; Wichroski, Michael J.; Levine, Steven M.; Baldick, Carl J.; Mazzucco, Charles E.; Walsh, Ann W.; Kienzle, Bernadette K.; Rose, Ronald E.; Pokornowski, Kevin A.; Colonno, Richard J.; Tenney, Daniel J.

2009-01-01

Amino acid substitutions that confer reduced susceptibility to antivirals arise spontaneously through error-prone viral polymerases and are selected as a result of antiviral therapy. Resistance substitutions first emerge in a fraction of the circulating virus population, below the limit of detection by nucleotide sequencing of either the population or limited sets of cloned isolates. These variants can expand under drug pressure to dominate the circulating virus population. To enhance detection of these viruses in clinical samples, we established a highly sensitive quantitative, real-time allele-specific PCR assay for hepatitis B virus (HBV) DNA. Sensitivity was accomplished using a high-fidelity DNA polymerase and oligonucleotide primers containing locked nucleic acid bases. Quantitative measurement of resistant and wild-type variants was accomplished using sequence-matched standards. Detection methodology that was not reliant on hybridization probes, and assay modifications, minimized the effect of patient-specific sequence polymorphisms. The method was validated using samples from patients chronically infected with HBV through parallel sequencing of large numbers of cloned isolates. Viruses with resistance to lamivudine and other l-nucleoside analogs and entecavir, involving 17 different nucleotide substitutions, were reliably detected at levels at or below 0.1% of the total population. The method worked across HBV genotypes. Longitudinal analysis of patient samples showed earlier emergence of resistance on therapy than was seen with sequencing methodologies, including some cases of resistance that existed prior to treatment. In summary, we established and validated an ultrasensitive method for measuring resistant HBV variants in clinical specimens, which enabled earlier, quantitative measurement of resistance to therapy. PMID:19433559

2-D Resistivity Assessment of Subsurface Characterization and its Engineering and Environmental Implications at SiLC

NASA Astrophysics Data System (ADS)

Nordiana, M. M.; Azwin, I. N.; Saad, Rosli; Jia, Teoh Ying; Anderson, A. B.; Tonnizam, Edy; Taqiuddin Zakaria, Muhamad

2017-04-01

The role of geophysics in Environmental Earth Sciences and Engineering is considered. In the developing era, geophysics has mainly contributed in investigation of new constructions such as tunnels, road, dams and high-rise buildings. This study was carried out to assess the foundation depths around a construction site in the Southern Industrial & Logistics Clusters (SiLC), Nusajaya, Johor using 2-D resistivity method. The 2-D resistivity method was carried out with a view to characterize different subsurface geological and to provide the engineering and environmental geophysical characterization of the study area. Measurements of eight 2-D resistivity profile using Pole-dipole array with 2 m minimum electrode spacing was taken with the use of ABEM Terrameter SAS4000 and ES10-64C selector. The results are presented as inversion model resistivity with the outline of the survey line. The inversion model resistivity from L1-L8 obtained is characterized by resistivity range of 1-8000 ohm-m. This range indicates the occurrence of silt, clay, sandy clay and sand whose ranges are; 10-100 ohm-m, 1-100 ohm-m, 100-800 ohm-m and 100-3000 ohm-m respectively. However, there was a boulder with range of >5000 ohm-m and saturated zone (1-20 ohm-m) which may indicate the weak zones of the study area. The 2-D resistivity method is not intended to replace borings, except in specific cases where information gathered would be sufficient to address the intended engineering and environmental purpose.

Identification groundwater aquifer by using geoelectrical method: case study Pondok Pesantren Darussallam, Kradenan, Grobogan

NASA Astrophysics Data System (ADS)

Legowo, B.; Darsono; Putra, A. G.; Kurniawan, M. F. R.

2018-03-01

Geoelectrical is one of the geophysical methods that used to characteristic of rocks for early stage exploration. Geoelectrical using Wenner-Schlumberger configuration has been used to estimate the aquifer at Pondok Pesantren Darussallam. Based on the geological map of Grobogan, Kradenan is consist of Alluvium. There are three lines acquisition which length 500 meters and the space of electrode is 25 meters. The data processed using Res2Dinv and the 2D inversion show that the maximum depth is 78.2 meters. The result of this researh show that there is a aquifer at depth 30 - 50 meters. Based on the values of resistivity, 1 - 10 ohm,m identified as clay, then resistivity 10 - 100 ohm.m is sandstone indicated as aquifer, and resistivity 100 - 1338,9 ohm.m is limestone.

Insulin Dynamics in Young Women with Polycystic Ovary Syndrome and Normal Glucose Tolerance across Categories of Body Mass Index

PubMed Central

Manco, Melania; Castagneto-Gissey, Lidia; Arrighi, Eugenio; Carnicelli, Annamaria; Brufani, Claudia; Luciano, Rosa; Mingrone, Geltrude

2014-01-01

Background Evidence favours insulin resistance and compensatory hyperinsulinemia as the predominant, perhaps primary, defects in polycystic ovary syndrome (PCOS). The aim of the present study was to evaluate insulin metabolism in young women with PCOS but normal glucose tolerance as compared with age, body mass index and insulin resistance-matched controls to answer the question whether women with PCOS hypersecrete insulin in comparison to appropriately insulin resistance-matched controls. Research Design and Methods Sixty-nine cases were divided according to their body mass index (BMI) in normal-weight (N = 29), overweight (N = 24) and obese patients (N = 16). Controls were 479 healthy women (age 16–49 y). Whole body Insulin Sensitivity (WBISI), fasting, and total insulin secretion were estimated following an oral glucose tolerance test (C-peptide deconvolution method). Results Across classes of BMI, PCOS patients had greater insulin resistance than matched controls (p<0.0001 for all the comparisons), but they showed higher fasting and total insulin secretion than their age, BMI and insulin resistance-matched peers (p<0.0001 for all the comparisons). Conclusion Women with PCOS show higher insulin resistance but also larger insulin secretion to maintain normal glucose homeostasis than age-, BMI- and insulin resistance-matched controls. PMID:24705280

Mechanical properties and oxidation and corrosion resistance of reduced-chromium 304 stainless steel alloys

NASA Technical Reports Server (NTRS)

Stephens, J. R.; Barrett, C. A.; Gyorgak, C. A.

1979-01-01

An experimental program was undertaken to identify effective substitutes for part of the Cr in 304 stainless steel as a method of conserving the strategic element Cr. Although special emphasis was placed on tensile properties, oxidation and corrosion resistance were also examined. Results indicate that over the temperature range of -196 C to 540 C the yield stress of experimental austenitic alloys with only 12 percent Cr compare favorably with the 18 percent Cr in 304 stainless steel. Oxidation resistance and in most cases corrosion resistance for the experimental alloys were comparable to the commercial alloy. Effective substitutes for Cr included Al, Mo, Si, Ti, and V, while Ni and Mn contents were increased to maintain an austenitic structure.

The Dynamics of Drug Resistance: A Mathematical Perspective

PubMed Central

Lavi, Orit; Gottesman, Michael M.; Levy, Doron

2012-01-01

Resistance to chemotherapy is a key impediment to successful cancer treatment that has been intensively studied for the last three decades. Several central mechanisms have been identified as contributing to the resistance. In the case of multidrug resistance (MDR), the cell becomes resistant to a variety of structurally and mechanistically unrelated drugs in addition to the drug initially administered. Mathematical models of drug resistance have dealt with many of the known aspects of this field, such as pharmacologic sanctuary and location/diffusion resistance, intrinsic resistance that is therapy independent, therapy-dependent cellular alterations including induced resistance (dose-dependent) and acquired resistance (dose-independent). In addition, there are mathematical models that take into account the kinetic/phase resistance, and models that investigate intra-cellular mechanisms based on specific biological functions (such as ABC transporters, apoptosis and repair mechanisms). This review covers aspects of MDR that have been mathematically studied, and explains how, from a methodological perspective, mathematics can be used to study drug resistance. We discuss quantitative approaches of mathematical analysis, and demonstrate how mathematics can be used in combination with other experimental and clinical tools. We emphasize the potential benefits of integrating analytical and mathematical methods into future clinical and experimental studies of drug resistance. PMID:22387162

Is drug-resistant Mycobacterium leprae a real cause for concern?: First approach to molecular monitoring of multibacillary Colombian patients with and without previous leprosy treatment.

PubMed

Guerrero, Martha Inírida; Colorado, Claudia Lucía; Torres, José Fernando; León, Clara Inés

2014-04-01

There is no information in Colombia on Mycobacterium leprae primary and secondary drug resistance in regards to the WHO-multidrug therapy regime. On the other hand, public health authorities around the world have issued various recommendations, one of which prompts for the immediate organization of resistance surveillance through simple molecular methods. To determine the prevalence of Mycobacterium leprae drug resistance to rifampicin, ofloxacin and dapsone in untreated and previously treated patients at the Centro Dermatológico Federico Lleras Acosta during the 1985-2004 period. We conducted a retrospective study which included multibacillary patient biopsies through elective sampling: 381 of them from new patients and 560 from previously treated patients. Using a microtome, we obtained six slides from each skin biopsy preserved in paraffin, and we extracted M. leprae DNA. We amplified three molecular targets through PCR and obtained the patterns of drug resistance to dapsone, rifampicin and ofloxacin by reverse hybridization. Finally, we collected epidemiological, clinical and demographical data for analyses. From 941 samples under study, 4.14% of them were resistant to one or more drugs, and 5.77 and 3.04% had resistant genotypes in new and previously treated patients, respectively. Total resistance for each drug was 0.43% for dapsone, 3.19% for rifampicin and 1.17% for ofloxacin. We found statistically significant differences for rifampicin and for the total population when comparing the results from untreated versus previously treated patients. Two thirds of the resistant samples were resistant to rifampicin alone or combined. The standard multidrug therapy schemes continue being effective for leprosy cases; however, it is necessary to guarantee adherence and regularity. Surveillance to drug resistance in new and previously treated leprosy cases should be established.

Numerical simulation and fracture identification of dual laterolog in organic shale

NASA Astrophysics Data System (ADS)

Maojin, Tan; Peng, Wang; Qiong, Liu

2012-09-01

Fracture is one of important spaces in shale oil and shale gas reservoirs, and fractures identification and evaluation are an important part in organic shale interpretation. According to the fractured shale gas reservoir, a physical model is set up to study the dual laterolog logging responses. First, based on the principle of dual laterolog, three-dimensional finite element method (FEM) is used to simulate the dual laterolog responses in various formation models with different fractures widths, different fracture numbers, different fractures inclination angle. All the results are extremely important for the fracture identification and evaluation in shale reservoirs. Appointing to different base rock resistivity models, the fracture models are constructed respectively through a number of numerical simulation, and the fracture porosity can be calculated by solving the corresponding formulas. A case study about organic shale formation is analyst and discussed, and the fracture porosity is calculated from dual laterolog. The fracture evaluation results are also be validated right by Full borehole Micro-resistivity Imaging (FMI). So, in case of the absence of borehole resistivity imaging log, the dual laterolog resistivity can be used to estimate the fracture development.

Serum Insulin, Glucose, Indices of Insulin Resistance, and Risk of Lung Cancer.

PubMed

Argirion, Ilona; Weinstein, Stephanie J; Männistö, Satu; Albanes, Demetrius; Mondul, Alison M

2017-10-01

Background: Although insulin may increase the risk of some cancers, few studies have examined fasting serum insulin and lung cancer risk. Methods: We examined serum insulin, glucose, and indices of insulin resistance [insulin:glucose molar ratio and homeostasis model assessment of insulin resistance (HOMA-IR)] and lung cancer risk using a case-cohort study within the Alpha-Tocopherol, Beta-Carotene Cancer Prevention Study of Finnish men. A total of 196 cases and 395 subcohort members were included. Insulin and glucose were measured in fasting serum collected 5 to 12 years before diagnosis. Cox proportional hazards models were utilized to estimate the relative risk of lung cancer. Results: The average time between blood collection and lung cancer was 9.6 years. Fasting serum insulin levels were 8.7% higher in subcohort members than cases. After multivariable adjustment, men in the fourth quartile of insulin had a significantly higher risk of lung cancer than those in the first quartile [HR = 2.10; 95% confidence interval (CI), 1.12-3.94]. A similar relationship was seen with HOMA-IR (HR = 1.83; 95% CI, 0.99-3.38). Risk was not strongly associated with glucose or the insulin:glucose molar ratio ( P trend = 0.55 and P trend = 0.27, respectively). Conclusions: Higher fasting serum insulin concentrations, as well as the presence of insulin resistance, appear to be associated with an elevated risk of lung cancer development. Impact: Although insulin is hypothesized to increase risk of some cancers, insulin and lung cancer remain understudied. Higher insulin levels and insulin resistance were associated with increased lung cancer risk. Although smoking cessation is the best method of lung cancer prevention, other lifestyle changes that affect insulin concentrations and sensitivity may reduce lung cancer risk. Cancer Epidemiol Biomarkers Prev; 26(10); 1519-24. ©2017 AACR . ©2017 American Association for Cancer Research.

Non-typhoidal Salmonella in Calabria, Italy: a laboratory and patient-based survey

PubMed Central

Mascaro, Valentina; Pileggi, Claudia; Crinò, Maria; Proroga, Yolande Therese Rose; Carullo, Maria Rosaria; Graziani, Caterina; Arigoni, Fabio; Turno, Pasquale; Pavia, Maria

2017-01-01

Introduction Although there has been a decrease in the number of cases of salmonellosis in the European Union, it still represents the primary cause of foodborne outbreaks. In Calabria region, data are lacking for the incidence of human non-typhoid salmonellosis as active surveillance has never been carried out. Objective To report the results of a laboratory and patient-based morbidity survey in Calabria to describe the incidence and distribution of Salmonella serovars isolated from humans, with a focus on antimicrobial resistance patterns. Methods Positive cultures from human samples were collected from every laboratory participating in the surveillance, with a minimum set of information about each isolate. A questionnaire was then administered to the patients by telephone interview to assess the potential risk exposures. Salmonella isolates underwent biochemical identification, molecular analysis by PCR and antimicrobial susceptibility testing by the disk-diffusion method. Results During a 2-year period, 105 strains of Salmonella spp were isolated from samples of patients with diarrhoea, with the highest isolation rate for children aged 1–5 years. The standardised rate was 2.7 cases per 1 00 000 population. The most common Salmonella isolates belonged to monophasic variant of S. Typhimurium (S. 4,[5],12:i:-) (33.3%), followed by S. Typhimurium (21.9%). 30.5% of the isolates were susceptible to all microbial agents tested and the most common pan-susceptible serotype was S. Napoli (100%). S. 4,[5],12:i:- was resistant to ampicillin, streptomycin, sulfonamides and tetracyclines in 42.9% cases, while resistance to quinolones was seen in 14.3% of the isolates. Conclusions The results provide evidence that an active surveillance system effectively enhances Salmonella notifications. The high prevalence of antimicrobial resistance, including resistance to quinolones and multiresistance, enforces the need to strengthen strategies of surveillance and monitoring of antimicrobial use. PMID:28893751

Nosocomial infections and antibiotic resistance pattern in open-heart surgery patients at Imam Ali Hospital in Kermanshah, Iran.

PubMed

Heydarpour, Fatemeh; Rahmani, Youssef; Heydarpour, Behzad; Asadmobini, Atefeh

2017-01-01

Background: Patients undergoing open heart surgery have a relatively high risk of acquiring nosocomial infections. The development of antibiotic-resistant infections is associated with prolonged hospital stays and mortalities. Objectives: The present study was conducted to investigate nosocomial infections and the antibiotic resistance pattern in bacteria causing these infections in open heart surgery patients at Imam Ali Hospital in Kermanshah in the west of Iran over a 4-year period from March 2011 to March 2014. Materials and methods: The present cross-sectional study was conducted on 135 cases of nosocomial infection among open heart surgery patients. The demographic characteristics and the risk factors of each case of infection were recorded. The antibiotic susceptibility test was carried out using the Minimum Inhibitory Concentration (MIC) method based on the Clinical and Laboratory Standards Institute (CLSI) protocol. The data collected were then analyzed in SPSS-16. Results: Out of the 6,000 patients who underwent open heart surgery during this 4-year period at the selected hospital, nosocomial infections developed in 135 patients (2.25%), 59.3% of whom were female and 40.7% male. Surgery site infection (SSI), pneumonia (PNEU), urinary tract infection (UTI) and blood stream infection (BSI) affected 52.6%, 37%, 9.6% and 0.8% of the cases, respectively. E.coli , Klebsiella spp. and S. aureus were the most common bacteria causing the nosocomial infections. E. coli was most frequently resistant to imipenem (23.3%) Klebsiella spp. to gentamicin (38.5%) S. aureus to co-trimoxazole (54.2%). Conclusion: SSI had a high prevalence in this study. Further studies should therefore be conducted to examine the risk factors associated with SSI in open heart surgery. Various studies have shown that antibiotic resistance patterns are different in different regions. Finding a definitive treatment therefore requires an antibiogram.

Small-scale electrical resistivity tomography of wet fractured rocks.

PubMed

LaBrecque, Douglas J; Sharpe, Roger; Wood, Thomas; Heath, Gail

2004-01-01

This paper describes a series of experiments that tested the ability of the electrical resistivity tomography (ERT) method to locate correctly wet and dry fractures in a meso-scale model. The goal was to develop a method of monitoring the flow of water through a fractured rock matrix. The model was a four by six array of limestone blocks equipped with 28 stainless steel electrodes. Dry fractures were created by placing pieces of vinyl between one or more blocks. Wet fractures were created by injecting tap water into a joint between blocks. In electrical terms, the dry fractures are resistive and the wet fractures are conductive. The quantities measured by the ERT system are current and voltage around the outside edge of the model. The raw ERT data were translated to resistivity values inside the model using a three-dimensional Occam's inversion routine. This routine was one of the key components of ERT being tested. The model presented several challenges. First, the resistivity of both the blocks and the joints was highly variable. Second, the resistive targets introduced extreme changes the software could not precisely quantify. Third, the abrupt changes inherent in a fracture system were contrary to the smoothly varying changes expected by the Occam's inversion routine. Fourth, the response of the conductive fractures was small compared to the background variability. In general, ERT was able to locate correctly resistive fractures. Problems occurred, however, when the resistive fracture was near the edges of the model or when multiple fractures were close together. In particular, ERT tended to position the fracture closer to the model center than its true location. Conductive fractures yielded much smaller responses than the resistive case. A difference-inversion method was able to correctly locate these targets.

A Bio-Economic Case Study of Canadian Honey Bee (Hymenoptera: Apidae) Colonies: Marker-Assisted Selection (MAS) in Queen Breeding Affects Beekeeper Profits.

PubMed

Bixby, Miriam; Baylis, Kathy; Hoover, Shelley E; Currie, Rob W; Melathopoulos, Andony P; Pernal, Stephen F; Foster, Leonard J; Guarna, M Marta

2017-06-01

Over the past decade in North America and Europe, winter losses of honey bee (Hymenoptera: Apidae) colonies have increased dramatically. Scientific consensus attributes these losses to multifactorial causes including altered parasite and pathogen profiles, lack of proper nutrition due to agricultural monocultures, exposure to pesticides, management, and weather. One method to reduce colony loss and increase productivity is through selective breeding of queens to produce disease-, pathogen-, and mite-resistant stock. Historically, the only method for identifying desirable traits in honey bees to improve breeding was through observation of bee behavior. A team of Canadian scientists have recently identified markers in bee antennae that correspond to behavioral traits in bees and can be tested for in a laboratory. These scientists have demonstrated that this marker-assisted selection (MAS) can be used to produce hygienic, pathogen-resistant honey bee colonies. Based on this research, we present a beekeeping case study where a beekeeper's profit function is used to evaluate the economic impact of adopting colonies selected for hygienic behavior using MAS into an apiary. Our results show a net profit gain from an MAS colony of between 2% and 5% when Varroa mites are effectively treated. In the case of ineffective treatment, MAS generates a net profit benefit of between 9% and 96% depending on the Varroa load. When a Varroa mite population has developed some treatment resistance, we show that MAS colonies generate a net profit gain of between 8% and 112% depending on the Varroa load and degree of treatment resistance. © The Authors 2017. Published by Oxford University Press on behalf of Entomological Society of America.

[Study of the relationship among expression of Survivin and MRP and the drug resistance in human nasopharyngeal carcinoma].

PubMed

Yang, Ning; Zhu, Lepan; Tan, Tan; Hou, Chunyan

2015-02-01

This study aimed to explore the relationship among expression of Survivin and MRP and drug resistance in NPC. Expression of Survivin were detected by immunohistochemistry method in 45 cases of NPC and 24 cases of normal mucous membrane of nasopharynx (NMMN). The relationship between expression of Survivin and pathological factors in NPC were analysized. Expression of Survivin and MRP were detected in 31 patients of NPC with paclitaxel resistance and 20 patients of NPC without paclitaxel resistance. The relation- ship among the expression of Survivin or MRP and paclitaxel resistance in NPC were analysized. The paclitaxel resistance cell line, 5-8F-PTX(+); was established by a step-increased method. The expression of Survivin and MRP were detected by western blot in 5-8F-PTX(+) and 5-8F. The positive were 71. 1% (32/45) in NPC and 8.33% (2/24) in NMMN. And there were significantly differences between them (P < .05). There were relationship among expression of Survivin and differentiation degree, lymph node metastasis, distant metastasis, and clinic stages of NPC. The positive were 75.9% (31/39) in moderately differentiated NPC and 16.7% (1/6) in lowly differentiated NPC, respectively. There were significantly differences between them (P < 0.05). The positive of Survivin were 83.9% (26/31) in NPC patients with paclitaxel resistance and 45.0% (9/20) in NPC patients without Paclitaxel resistance, respectively. There were significantly differences between them (P < 0.05). The positive of MRP were 87.1% (27/31) in NPC patients with paclitaxel resistance and 40.0% (8/20) in NPC patients without paclitaxel resistance, respectively. There were significantly differences between them (P < 0.05). There were positive correlation between the expression of Survivin and MRP in NPC patients with Paclitaxel resistance. The expression of Survivin and MRP were higher in 5-8F-PTX(+) than in 5-8F. The IC50 of paclitaxel, cDDP, 5-FU and Vincristine were significantly higher in 5-8F-PTX(+) than in 5-8F. There were relationship among the expression of Survivin and difference, metastasis and TNM stages of NPC. Survivin may serves as a molecular marker for development and progress in NPC. There were relationship among the high expression of Survivin and MRP and increasing of drug resistance in NPC.

Primary drug resistance in a region with high burden of tuberculosis. A critical problem.

PubMed

Villa-Rosas, Cecilia; Laniado-Laborín, Rafael; Oceguera-Palao, Lorena

2015-01-01

To determine rates of drug resistance in new cases of pulmonary tuberculosis in a region with a high burden of the disease. New case suspects were referred for drug susceptibility testing. 28.9% of new cases were resistant to at least one first line drug; 3.9% had a multidrug-resistant strain, 15.6% a monoresistant strain and 9.4% a polyresistant strain. Our rate of drug resistant tuberculosis in new cases is very high; this has important clinical implications, since even monoresistance can have a negative impact on the outcome of new cases treated empirically with a six month regimen.

Prevalence of resistance to second-line tuberculosis drug among multidrug-resistant tuberculosis patients in Viet Nam, 2011.

PubMed

Nguyen, Hoa Binh; Nguyen, Nhung Viet; Tran, Huong Thi Giang; Nguyen, Hai Viet; Bui, Quyen Thi Tu

2016-01-01

Extensively drug-resistant tuberculosis (XDR-TB) represents an emerging public health problem worldwide. According to the World Health Organization, an estimated 9.7% of multidrug-resistant TB (MDR-TB) cases are defined as XDR-TB globally. The objective of this study was to determine the prevalence of drug resistance to second-line TB drugs among MDR-TB cases detected in the Fourth National Anti-Tuberculosis Drug Resistance Survey in Viet Nam. Eighty clusters of TB cases were selected using a probability-proportion-to-size approach. To identify MDR-TB cases, drug susceptibility testing (DST) was performed for the four major first-line TB drugs. DST of second-line drugs (ofloxacin, amikacin, kanamycin, capreomycin) was performed on isolates from MDR-TB cases to identify pre-XDR and XDR cases. A total of 1629 smear-positive TB cases were eligible for culture and DST. Of those, DST results for first-line drugs were available for 1312 cases, and 91 (6.9%) had MDR-TB. Second-line DST results were available for 84 of these cases. Of those, 15 cases (17.9%) had ofloxacin resistance and 6.0% were resistant to kanamycin and capreomycin. Five MDR-TB cases (6.0%) met the criteria of XDR-TB. This survey provides the first estimates of the proportion of XDR-TB among MDR-TB cases in Viet Nam and provides important information for local policies regarding second-line DST. Local policies and programmes that are geared towards TB prevention, early diagnosis and treatment with effective regimens are of high importance.

Molecular Detection of Antimicrobial Resistance

PubMed Central

Fluit, Ad C.; Visser, Maarten R.; Schmitz, Franz-Josef

2001-01-01

The determination of antimicrobial susceptibility of a clinical isolate, especially with increasing resistance, is often crucial for the optimal antimicrobial therapy of infected patients. Nucleic acid-based assays for the detection of resistance may offer advantages over phenotypic assays. Examples are the detection of the methicillin resistance-encoding mecA gene in staphylococci, rifampin resistance in Mycobacterium tuberculosis, and the spread of resistance determinants across the globe. However, molecular assays for the detection of resistance have a number of limitations. New resistance mechanisms may be missed, and in some cases the number of different genes makes generating an assay too costly to compete with phenotypic assays. In addition, proper quality control for molecular assays poses a problem for many laboratories, and this results in questionable results at best. The development of new molecular techniques, e.g., PCR using molecular beacons and DNA chips, expands the possibilities for monitoring resistance. Although molecular techniques for the detection of antimicrobial resistance clearly are winning a place in routine diagnostics, phenotypic assays are still the method of choice for most resistance determinations. In this review, we describe the applications of molecular techniques for the detection of antimicrobial resistance and the current state of the art. PMID:11585788

[Tuberculosis Laboratory Surveillance Network (TuLSA) study group. The first step for national tuberculosis laboratory surveillance: Ankara, 2011].

PubMed

Sezen, Figen; Albayrak, Nurhan; Özkara, Şeref; Karagöz, Alper; Alp, Alpaslan; Duyar Ağca, Filiz; İnan Süer, Asiye; Müderris, Tuba; Ceyhan, İsmail; Durmaz, Rıza; Ertek, Mustafa

2015-04-01

The most effective method for monitoring country-level drug resistance frequency and to implement the necessary control measures is the establishment of a laboratory-based surveillance system. The aim of this study was to summarize the follow up trend of the drug-resistant tuberculosis (TB) cases, determine the load of resistance and evaluate the capacities of laboratories depending on laboratory quality assurance system for the installation work of National Tuberculosis Laboratory Surveillance Network (TuLSA) which has started in Ankara in 2011. TuLSA studies was carried out under the coordination of National Tuberculosis Reference Laboratory (NRL) with the participation of TB laboratories and dispensaries. Specimens of TB patients, reported from health institutions, were followed in TB laboratories, and the epidemiological information was collected from the dispensaries. One isolate per patient with the drug susceptibility test (DST) results were sent to NRL from TB laboratories and in NRL the isolates were rechecked with the genotypical (MTBDRplus, Hain Lifescience, Germany) and phenotypical (MGIT 960, BD, USA) DST methods. Molecular epidemiological analysis were also performed by spoligotyping and MIRU/VNTR. Second-line DST was applied to the isolates resistant to rifampin. A total of 1276 patients were reported between January 1st to December 31th 2011, and 335 cases were defined as "pulmonary TB from Ankara province". The mean age of those patients was 43.4 ± 20 years, and 67.5% were male. Three hundred seventeen (94.6%) patients were identified as new cases. The average sample number obtained from pulmonary TB cases was 3.26 ± 2.88, and 229 (68.3%) of them was culture positive. DST was applied to all culture positive isolates; 90.4% (207/229) of cases were susceptible to the five drugs tested (ethambutol, isoniazid, pyrazinamide, rifampicin, streptomycin). Eight (3.5%) of the isolates were multidrug-resistant (MDR-TB), while no extensively drug-resistant strains were detected. MDR-TB is likely to occur in 63.3 times more among previously treated cases, and 73.3 times more in legal aliens. The achievement of therapy among pulmonary TB cases was 91.9%. Spoligotyping performed for 221 M.tuberculosis complex isolates, showed that all strains were clustered in nine groups. SIT 41 (105/221; 47.5%) was the most frequent spoligotype detected, and clustering rate based on MIRU-VNTR results were found as 16.3%. All of the clustered strains were sensitive while all of MDR-TB isolates showed specific MIRU-VNTR profiles. In conclusion, TuLSA studies started in Ankara in 2011 and the system is still expanding in the country. Our data obtained with TuLSA have been published as a regional surveillance data in the WHO Global Tuberculosis Report 2011, and as a national surveillance data in Global Tuberculosis Report 2012.

New Classification of Focal Cortical Dysplasia: Application to Practical Diagnosis

PubMed Central

Bae, Yoon-Sung; Kang, Hoon-Chul; Kim, Heung Dong; Kim, Se Hoon

2012-01-01

Background and Purpose: Malformation of cortical development (MCD) is a well-known cause of drug-resistant epilepsy and focal cortical dysplasia (FCD) is the most common neuropathological finding in surgical specimens from drug-resistant epilepsy patients. Palmini’s classification proposed in 2004 is now widely used to categorize FCD. Recently, however, Blumcke et al. recommended a new system for classifying FCD in 2011. Methods: We applied the new classification system in practical diagnosis of a sample of 117 patients who underwent neurosurgical operations due to drug-resistant epilepsy at Severance Hospital in Seoul, Korea. Results: Among 117 cases, a total of 16 cases were shifted to other FCD subtypes under the new classification system. Five cases were reclassified to type IIIa and five cases were categorized as dual pathology. The other six cases were changed within the type I category. Conclusions: The most remarkable changes in the new classification system are the advent of dual pathology and FCD type III. Thus, it will be very important for pathologists and clinicians to discriminate between these new categories. More large-scale research needs to be conducted to elucidate the clinical influence of the alterations within the classification of type I disease. Although the new FCD classification system has several advantages compared to the former, the correlation with clinical characteristics is not yet clear. PMID:24649461

A descriptive study of facial acanthosis nigricans and its association with body mass index, waist circumference and insulin resistance using HOMA2 IR

PubMed Central

Verma, Shyam; Vasani, Resham; Joshi, Rajiv; Phiske, Meghana; Punjabi, Pritesh; Toprani, Tushar

2016-01-01

Introduction: The term facial acanthosis nigricans (FAN) lacks definition of precise clinical and histopathological features. We present a descriptive study of patients with FAN to define pigmentary patterns and estimate the prevalence of obesity and insulin resistance in these cases. Materials and Methods: It is a prospective study that included all patients with classical AN of the neck and/or other areas with facial acanthosis nigricans described as brown-to-black macular pigmentation with blurred ill-defined margins, found on the zygomatic and malar areas. The body mass index (BMI) and waist circumference (WC) of the included patients were used as parameters of obesity. Homeostatic Model of Assessment of Insulin Resistance (HOMA2 IR) was used as a parameter to evaluate insulin resistance. Histopathological features of the 6 skin biopsies that were possible were reviewed. Results: Among the 102 included individuals, the patterns of facial pigmentation seen in addition to the classic pattern involving zygomatic and malar areas were a hyperpigmented band on the forehead in 59.80%, periorbital darkening in 17.64%, perioral darkening in 12.74%, and generalized darkening in 9.8% of cases. 85.29% of the males and 100% of the females were found to be obese. Varying degrees of insulin resistance was noted in 82.34% of the individuals. Six biopsies available for evaluation showed changes such as mild epidermal hyperplasia with prominent basal melanin, however, without the typical papillomatosis seen in AN of the flexures. Conclusion: We document an increased prevalence of obesity and insulin resistance in patients presenting with FAN and its presentations in addition to the classical description. We propose that FAN can be considered a cutaneous marker of insulin resistance and that HOMA2 IR can serve as a parameter of insulin resistance in such cases. PMID:27990384

Virulence Genes and Antibiotic Susceptibilities of Uropathogenic E. coli Strains.

PubMed

Uzun, Cengiz; Oncül, Oral; Gümüş, Defne; Alan, Servet; Dayioğlu, Nurten; Küçüker, Mine Anğ

2015-01-01

The aim of this study is to detect the presence of and possible relation between virulence genes and antibiotic resistance in E. coli strains isolated from patients with acute, uncomplicated urinary tract infections (UTI). 62 E. coli strains isolated from patients with acute, uncomplicated urinary tract infections (50 strains isolated from acute uncomplicated cystitis cases (AUC); 12 strains from acute uncomplicated pyelonephritis cases (AUP)) were screened for virulence genes [pap (pyelonephritis-associated pili), sfa/foc (S and F1C fimbriae), afa (afimbrial adhesins), hly (hemolysin), cnf1 (cytotoxic necrotizing factor), aer (aerobactin), PAI (pathogenicity island marker), iroN (catecholate siderophore receptor), ompT (outer membrane protein T), usp (uropathogenic specific protein)] by PCR and for antimicrobial resistance by disk diffusion method according to CLSI criteria. It was found that 56 strains (90.3%) carried at least one virulence gene. The most common virulence genes were ompT (79%), aer (51.6%), PAI (51.6%) and usp (56.5%). 60% of the strains were resistant to at least one antibiotic. The highest resistance rates were against ampicillin (79%) and co-trimoxazole (41.9%). Fifty percent of the E. coli strains (31 strains) were found to be multiple resistant. Eight (12.9%) out of 62 strains were found to be ESBL positive. Statistically significant relationships were found between the absence of usp and AMP - SXT resistance, iroN and OFX - CIP resistance, PAI and SXT resistance, cnf1 and AMP resistance, and a significant relationship was also found between the presence of the afa and OFX resistance. No difference between E. coli strains isolated from two different clinical presentations was found in terms of virulence genes and antibiotic susceptibility.

Survey of tuberculosis drug resistance among Tibetan refugees in India.

PubMed

Salvo, F; Dorjee, K; Dierberg, K; Cronin, W; Sadutshang, T D; Migliori, G B; Rodrigues, C; Trentini, F; Di Serio, C; Chaisson, R; Cirillo, D M

2014-06-01

Tuberculosis (TB) is a major health problem among Tibetans living in exile in India. Although drug-resistant TB is considered common in clinical practice, precise data are lacking. To determine the proportion of drug-resistant cases among new and previously treated Tibetan TB patients. In a drug resistance survey in five Tibetan settlements in India, culture and drug susceptibility testing (DST) for first-line drugs were performed among all consecutive new and previously treated TB cases from April 2010 to September 2011. DST against kanamycin (KM), ethionamide, para-aminosalicylic acid and ofloxacin (OFX) was performed on multidrug-resistant TB (MDR-TB) isolates. Of 307 patients enrolled in the study, 264 (193 new and 71 previously treated) were culture-positive and had DST available. All patients tested for the human immunodeficiency virus (n = 250) were negative. Among new TB cases, 14.5% had MDR-TB and 5.7% were isoniazid (INH) monoresistant. Among previously treated cases, 31.4% had MDR-TB and 12.7% were INH-monoresistant. Of the MDR-TB isolates, 28.6% of new and 26.1% of previously treated cases were OFX-resistant, while 7.1% of new cases and 8.7% of previously treated cases were KM-resistant. Three patients had extensively drug-resistant TB. MDR-TB is common in new and previously treated Tibetans in India, who also show additional complex resistance patterns. Of particular concern is the high percentage of MDR-TB strains resistant to OFX, KM or both.

Establishment of a nested-ASP-PCR method to determine the clarithromycin resistance of Helicobacter pylori

PubMed Central

Luo, Xiao-Feng; Jiao, Jian-Hua; Zhang, Wen-Yue; Pu, Han-Ming; Qu, Bao-Jin; Yang, Bing-Ya; Hou, Min; Ji, Min-Jun

2016-01-01

AIM: To investigate clarithromycin resistance positions 2142, 2143 and 2144 of the 23SrRNA gene in Helicobacter pylori (H. pylori) by nested-allele specific primer-polymerase chain reaction (nested-ASP-PCR). METHODS: The gastric tissue and saliva samples from 99 patients with positive results of the rapid urease test (RUT) were collected. The nested-ASP-PCR method was carried out with the external primers and inner allele-specific primers corresponding to the reference strain and clinical strains. Thirty gastric tissue and saliva samples were tested to determine the sensitivity of nested-ASP-PCR and ASP-PCR methods. Then, clarithromycin resistance was detected for 99 clinical samples by using different methods, including nested-ASP-PCR, bacterial culture and disk diffusion. RESULTS: The nested-ASP-PCR method was successfully established to test the resistance mutation points 2142, 2143 and 2144 of the 23SrRNA gene of H. pylori. Among 30 samples of gastric tissue and saliva, the H. pylori detection rate of nested-ASP-PCR was 90% and 83.33%, while the detection rate of ASP-PCR was just 63% and 56.67%. Especially in the saliva samples, nested-ASP-PCR showed much higher sensitivity in H. pylori detection and resistance mutation rates than ASP-PCR. In the 99 RUT-positive gastric tissue and saliva samples, the H. pylori-positive detection rate by nested-ASP-PCR was 87 (87.88%) and 67 (67.68%), in which there were 30 wild-type and 57 mutated strains in gastric tissue and 22 wild-type and 45 mutated strains in saliva. Genotype analysis showed that three-points mixed mutations were quite common, but different resistant strains were present in gastric mucosa and saliva. Compared to the high sensitivity shown by nested-ASP-PCR, the positive detection of bacterial culture with gastric tissue samples was 50 cases, in which only 26 drug-resistant strains were found through analyzing minimum inhibitory zone of clarithromycin. CONCLUSION: The nested-ASP-PCR assay showed higher detection sensitivity than ASP-PCR and drug sensitivity testing, which could be performed to evaluate clarithromycin resistance of H. pylori. PMID:27433095

Itraconazole-resistant Candida auris with phospholipase, proteinase and hemolysin activity from a case of vulvovaginitis.

PubMed

Kumar, Dharmendra; Banerjee, Tuhina; Pratap, Chandra Bhan; Tilak, Ragini

2015-04-15

Since the emergence of pathogenic non-albicans Candida species, a number of new isolates have been added to the list. One such unusual species is Candida auris (C. auris), recently isolated and studied in few reports. In this study, a case of vulvovaginitis caused by Candida auris incidentally identified by molecular methods using internal transcribed spacer polymerase chain reaction (ITS PCR) is described. Antifungal susceptibility testing revealed the isolate to be resistant to itraconazole (MIC ≥ 2 µg/ml) and expressed important virulence factors including phospholipase, proteinase and hemolysin activity. The patient was successfully treated with oral fluconazole and did not have any invasive fungemia. Very few cases of this emerging pathogen have been reported. However, its isolation from clinical specimens reveals the significance of non-albicans candida species over C. albicans and the diversity of Candida spp causing infections.

Assessment of electrical resistivity imaging for pre-tunneling geological characterization - A case study of the Qingdao R3 metro line tunnel

NASA Astrophysics Data System (ADS)

Li, Shucai; Xu, Shan; Nie, Lichao; Liu, Bin; Liu, Rentai; Zhang, Qingsong; Zhao, Yan; Liu, Quanwei; Wang, Houtong; Liu, Haidong; Guo, Qin

2018-06-01

Water inrush during tunneling is a significant problem in the underground infrastructure construction. Electrical resistivity imaging (ERI) is a technique that can detect and characterize a water body in an open fracture or fault by exploiting the resistivity contrast that exists between the water body and the surrounding materials. ERI is an efficient method for pre-tunneling geological characterization. In this study, a case study is presented in which tunnel-face and borehole ERI (TBERI) is performed by using the probe hole to detect a water body during tunnel construction. The construction site is a metro line site, situated in the city of Qingdao, China. Unlike the traditional cross-hole observation mode, TBERI only use a single borehole. The installation of injection electrodes inside the probe hole and the installation of measuring electrodes on the tunnel face is proposed as the observation mode. Furthermore, a numerical simulation is carried out before the real field experiment, and the simulation results show that the TBERI is capable of detecting a deeply buried water body. In addition, the water body in the field case is also identified by TBERI. The water body appears as a strongly conductive anomaly relative to the background materials. This study highlights the respective strengths and weaknesses of the TBERI for pre-tunneling geological characterization. This method is a relatively rapid means of investigating the studied area. This study clearly demonstrates the suitability of TBERI in a tunneling scenario.

Gram staining for the treatment of peritonsillar abscess.

PubMed

Takenaka, Yukinori; Takeda, Kazuya; Yoshii, Tadashi; Hashimoto, Michiko; Inohara, Hidenori

2012-01-01

Objective. To examine whether Gram staining can influence the choice of antibiotic for the treatment of peritonsillar abscess. Methods. Between 2005 and 2009, a total of 57 cases of peritonsillar abscess were analyzed with regard to cultured bacteria and Gram staining. Results. Only aerobes were cultured in 16% of cases, and only anaerobes were cultured in 51% of cases. Mixed growth of aerobes and anaerobes was observed in 21% of cases. The cultured bacteria were mainly aerobic Streptococcus, anaerobic Gram-positive cocci, and anaerobic Gram-negative rods. Phagocytosis of bacteria on Gram staining was observed in 9 cases. The bacteria cultured from these cases were aerobic Streptococcus, anaerobic Gram-positive cocci, and anaerobic Gram-negative rods. The sensitivity of Gram staining for the Gram-positive cocci and Gram-negative rods was 90% and 64%, respectively. The specificity of Gram staining for the Gram-positive cocci and Gram-negative rods was 62% and 76%, respectively. Most of the Gram-positive cocci were sensitive to penicillin, but some of anaerobic Gram-negative rods were resistant to penicillin. Conclusion. When Gram staining shows only Gram-positive cocci, penicillin is the treatment of choice. In other cases, antibiotics effective for the penicillin-resistant organisms should be used.

Containment of a country-wide outbreak of carbapenem-resistant Klebsiella pneumoniae in Israeli hospitals via a nationally implemented intervention.

PubMed

Schwaber, Mitchell J; Lev, Boaz; Israeli, Avi; Solter, Ester; Smollan, Gill; Rubinovitch, Bina; Shalit, Itamar; Carmeli, Yehuda

2011-04-01

During 2006, Israeli hospitals faced a clonal outbreak of carbapenem-resistant Klebsiella pneumoniae that was not controlled by local measures. A nationwide intervention was launched to contain the outbreak and to introduce a strategy to control future dissemination of antibiotic-resistant bacteria in hospitals. In March 2007, the Ministry of Health issued guidelines mandating physical separation of hospitalized carriers of carbapenem-resistant Enterobacteriaceae (CRE) and dedicated staffing and appointed a professional task force charged with containment. The task force paid site visits at acute-care hospitals, evaluated infection-control policies and laboratory methods, supervised adherence to the guidelines via daily census reports on carriers and their conditions of isolation, provided daily feedback on performance to hospital directors, and intervened additionally when necessary. The initial intervention period was 1 April 2007-31 May 2008. The primary outcome measure was incidence of clinically diagnosed nosocomial CRE cases. By 31 March 2007, 1275 patients were affected in 27 hospitals (175 cases per 1 million population). Prior to the intervention, the monthly incidence of nosocomial CRE was 55.5 cases per 100,000 patient-days. With the intervention, the continuous increase in the incidence of CRE acquisition was halted, and by May 2008, the number of new monthly cases was reduced to 11.7 cases per 100,000 patient-days (P<.001). There was a direct correlation between compliance with isolation guidelines and success in containment of transmission (P=.02). Compliance neutralized the effect of carrier prevalence on new incidence (P=.03). A centrally coordinated intervention succeeded in containing a nationwide CRE outbreak after local measures failed. The intervention demonstrates the importance of strategic planning and national oversight in combating antimicrobial resistance. © The Author 2011. Published by Oxford University Press on behalf of the Infectious Diseases Society of America. All rights reserved.

Transmission of Multidrug-Resistant and Drug-Susceptible Tuberculosis within Households: A Prospective Cohort Study

PubMed Central

Grandjean, Louis; Gilman, Robert H.; Martin, Laura; Soto, Esther; Castro, Beatriz; Lopez, Sonia; Coronel, Jorge; Castillo, Edith; Alarcon, Valentina; Lopez, Virginia; San Miguel, Angela; Quispe, Neyda; Asencios, Luis; Dye, Christopher; Moore, David A. J.

2015-01-01

Background The “fitness” of an infectious pathogen is defined as the ability of the pathogen to survive, reproduce, be transmitted, and cause disease. The fitness of multidrug-resistant tuberculosis (MDRTB) relative to drug-susceptible tuberculosis is cited as one of the most important determinants of MDRTB spread and epidemic size. To estimate the relative fitness of drug-resistant tuberculosis cases, we compared the incidence of tuberculosis disease among the household contacts of MDRTB index patients to that among the contacts of drug-susceptible index patients. Methods and Findings This 3-y (2010–2013) prospective cohort household follow-up study in South Lima and Callao, Peru, measured the incidence of tuberculosis disease among 1,055 household contacts of 213 MDRTB index cases and 2,362 household contacts of 487 drug-susceptible index cases. A total of 35/1,055 (3.3%) household contacts of 213 MDRTB index cases developed tuberculosis disease, while 114/2,362 (4.8%) household contacts of 487 drug-susceptible index patients developed tuberculosis disease. The total follow-up time for drug-susceptible tuberculosis contacts was 2,620 person-years, while the total follow-up time for MDRTB contacts was 1,425 person-years. Using multivariate Cox regression to adjust for confounding variables including contact HIV status, contact age, socio-economic status, and index case sputum smear grade, the hazard ratio for tuberculosis disease among MDRTB household contacts was found to be half that for drug-susceptible contacts (hazard ratio 0.56, 95% CI 0.34–0.90, p = 0.017). The inference of transmission in this study was limited by the lack of genotyping data for household contacts. Capturing incident disease only among household contacts may also limit the extrapolation of these findings to the community setting. Conclusions The low relative fitness of MDRTB estimated by this study improves the chances of controlling drug-resistant tuberculosis. However, fitter multidrug-resistant strains that emerge over time may make this increasingly difficult. PMID:26103620

Youth, Social Networking, and Resistance: A Case Study on a Multidimensional Approach to Resistance

ERIC Educational Resources Information Center

Scozzaro, David

2011-01-01

This exploratory case study focused on youth and resistance that was aided by the use of technology. The combination of resistance and technology expanded a multidimensional framework and leads to new insight into transformative resistance. This study examined the framework of transformative resistance based on Solorzano and Delgado Bernal's…

Probing resistivity and doping concentration of semiconductors at the nanoscale using scanning microwave microscopy

NASA Astrophysics Data System (ADS)

Brinciotti, Enrico; Gramse, Georg; Hommel, Soeren; Schweinboeck, Thomas; Altes, Andreas; Fenner, Matthias A.; Smoliner, Juergen; Kasper, Manuel; Badino, Giorgio; Tuca, Silviu-Sorin; Kienberger, Ferry

2015-08-01

We present a new method to extract resistivity and doping concentration of semiconductor materials from Scanning Microwave Microscopy (SMM) S11 reflection measurements. Using a three error parameters de-embedding workflow, the S11 raw data are converted into calibrated capacitance and resistance images where no calibration sample is required. The SMM capacitance and resistance values were measured at 18 GHz and ranged from 0 to 100 aF and from 0 to 1 MΩ, respectively. A tip-sample analytical model that includes tip radius, microwave penetration skin depth, and semiconductor depletion layer width has been applied to extract resistivity and doping concentration from the calibrated SMM resistance. The method has been tested on two doped silicon samples and in both cases the resistivity and doping concentration are in quantitative agreement with the data-sheet values over a range of 10-3 Ω cm to 101 Ω cm, and 1014 atoms per cm3 to 1020 atoms per cm3, respectively. The measured dopant density values, with related uncertainties, are [1.1 +/- 0.6] × 1018 atoms per cm3, [2.2 +/- 0.4] × 1017 atoms per cm3, [4.5 +/- 0.2] × 1016 atoms per cm3, [4.5 +/- 1.3] × 1015 atoms per cm3, [4.5 +/- 1.7] × 1014 atoms per cm3. The method does not require sample treatment like cleavage and cross-sectioning, and high contact imaging forces are not necessary, thus it is easily applicable to various semiconductor and materials science investigations.

Geophysical techniques in detection to river embankments - A case study: To locate sites of potential leaks using surface-wave and electrical methods

USGS Publications Warehouse

Chen, C.; Liu, J.; Xu, S.; Xia, J.; ,

2004-01-01

Geophysical technologies are very effective in environmental, engineering and groundwater applications. Parameters of delineating nature of near-surface materials such as compressional-wave velocity, shear-wave velocity can be obtained using shallow seismic methods. Electric methods are primary approaches for investigating groundwater and detecting leakage. Both of methods are applied to detect embankment in hope of obtaining evidences of the strength and moisture inside the body. A technological experiment has done for detecting and discovering the hidden troubles in the embankment of Yangtze River, Songzi, Hubei, China in 2003. Surface-wave and DC multi-channel array resistivity sounding techniques were used to detect hidden trouble inside and under dike like pipe-seeps. This paper discusses the exploration strategy and the effect of geological characteristics. A practical approach of combining seismic and electric resistivity measurements was applied to locate potential pipe-seeps in embankment in the experiment. The method presents a potential leak factor based on the shear-wave velocity and the resistivity of the medium to evaluate anomalies. An anomaly found in a segment of embankment detected was verified, where occurred a pipe-seep during the 98' flooding.

Clonal Expansion and Microevolution of Quinolone-Resistant Salmonella enterica Serotype Typhi in Vietnam from 1996 to 2004▿

PubMed Central

Le, Thi Anh Hong; Fabre, Laëtitia; Roumagnac, Philippe; Grimont, Patrick A. D.; Scavizzi, Maurice R.; Weill, François-Xavier

2007-01-01

Salmonella enterica serotype Typhi clinical isolates (n = 91) resistant to nalidixic acid (Nalr) were collected from sporadic cases and minor outbreaks throughout Vietnam between 1996 and 2004. These isolates were typed and compared by four methods: Vi phage typing, PstI ribotyping, XbaI and SpeI pulsed-field gel electrophoresis (PFGE), and single-nucleotide polymorphism (SNP) analysis. The results indicated that 65% of the isolates were not typeable by Vi phage typing. In contrast, the ribotyping and, with more accuracy, the SNP analysis methods indicated that all Nalr isolates belonged to a single clone (ribotype 3a, haplotype H58) that was found previously and that largely consisted of plasmid-encoded multidrug-resistant serotype Typhi isolates. PFGE demonstrated the occurrence of microevolution within this clone. We identified two major combined PFGE profiles: X1-S1 and X3-S6. X3-S6 predominated between 1996 and 2002 but was replaced by X1-S1 after 2002. Nevertheless, PFGE, with a Simpson's index of 0.78, was not considered an optimal discriminatory method for investigating typhoid fever outbreaks in Vietnam. The rate of quinolone resistance increased and the rate of multidrug resistance decreased during the study period. From 2002 to 2004, 80.6% of the isolates from South Vietnam were resistant only to Nal. The mechanism of Nal resistance in most of the isolates (94%) was a mutation in the quinolone resistance-determining chromosomal region of gyrA that led to the amino acid substitution Ser83Phe. No plasmid-located qnrA, qnrB, or qnrS was detected. PMID:17728470

[Antibiotic resistance pattern of 24, 526 strains of Vibrio cholerae O1 isolated in Mexico from 1991 to 1993].

PubMed

Giono-Cerezo, S; Zárate, A; Gutiérrez, L; Valdespino, J L

1994-01-01

Profile of antimicrobial resistance by Kirby-Bauer method was performed on 24526 Vibrio cholerae O1 strains isolated in México (1991-1993) from fecal swabs in cholera cases and from asymptomatic carriers. Minimal inhibitory concentration (MIC) tests for tetracycline (Te) and doxycycline (D) were done on selected strains. Single antibiotic discs were used at concentrations of: Te, 30 micrograms; D, 30 micrograms; erythromycin (E), 15 micrograms; chloramphenicol (CM), 30 micrograms; ampicillin (AM), 10 micrograms; trimethoprim-sulfamethoxazole (SXT) 1.25 micrograms/23.75 micrograms. Strains whose halos were of a smaller diameter than the intermediate value were considered resistant. It is important to maintain surveillance on antimicrobial susceptibility as epidemiological marker on geographical selected areas in order to detect changes of resistant patterns.

Antimicrobial resistance in Libya: 1970-2011.

PubMed

Ghenghesh, Khalifa Sifaw; Rahouma, Amal; Tawil, Khaled; Zorgani, Abdulaziz; Franka, Ezzedin

2013-03-27

Resistance to antimicrobial agents is a major health problem that affects the whole world. Providing information on the past state of antimicrobial resistance in Libya may assist the health authorities in addressing the problem more effectively in the future. Information was obtained mainly from Highwire Press (including PubMed) search for the period 1970-2011 using the terms 'antibiotic resistance in Libya', 'antimicrobial resistance in Libya', 'tuberculosis in Libya', and 'primary and acquired resistance in Libya' in title and abstract. From 1970 to 2011 little data was available on antimicrobial resistance in Libya due to lack of surveillance and few published studies. Available data shows high resistance rates for Salmonella species in the late 1970s and has remained high to the present day. High prevalence rates (54-68%) of methicillin-resistant Staphylococcus aureus (MRSA) were reported in the last decade among S. aureus from patients with burns and surgical wound infections. No reports were found of vancomycin-resistant S. aureus (VRSA) or vancomycin-intermediate-resistant S. aureus (VISA) using standard methods from Libya up to the end of 2011. Reported rates of primary (i.e. new cases) and acquired (i.e. retreatment cases) multidrug-resistant tuberculosis (MDR-TB) from the eastern region of Libya in 1971 were 16.6 and 33.3% and in 1976 were 8.6 and 14.7%, in western regions in 1984-1986 were 11 and 21.5% and in the whole country in 2011 were estimated at 3.4 and 29%, respectively. The problem of antibiotic resistance is very serious in Libya. The health authorities in particular and society in general should address this problem urgently. Establishing monitoring systems based on the routine testing of antimicrobial sensitivity and education of healthcare workers, pharmacists, and the community on the health risks associated with the problem and benefits of prudent use of antimicrobials are some steps that can be taken to tackle the problem in the future.

Antimicrobial resistance in Libya: 1970–2011

PubMed Central

Ghenghesh, Khalifa Sifaw; Rahouma, Amal; Tawil, Khaled; Zorgani, Abdulaziz; Franka, Ezzedin

2013-01-01

Resistance to antimicrobial agents is a major health problem that affects the whole world. Providing information on the past state of antimicrobial resistance in Libya may assist the health authorities in addressing the problem more effectively in the future. Information was obtained mainly from Highwire Press (including PubMed) search for the period 1970–2011 using the terms ‘antibiotic resistance in Libya’, ‘antimicrobial resistance in Libya’, ‘tuberculosis in Libya’, and ‘primary and acquired resistance in Libya’ in title and abstract. From 1970 to 2011 little data was available on antimicrobial resistance in Libya due to lack of surveillance and few published studies. Available data shows high resistance rates for Salmonella species in the late 1970s and has remained high to the present day. High prevalence rates (54–68%) of methicillin-resistant Staphylococcus aureus (MRSA) were reported in the last decade among S. aureus from patients with burns and surgical wound infections. No reports were found of vancomycin-resistant S. aureus (VRSA) or vancomycin-intermediate-resistant S. aureus (VISA) using standard methods from Libya up to the end of 2011. Reported rates of primary (i.e. new cases) and acquired (i.e. retreatment cases) multidrug-resistant tuberculosis (MDR-TB) from the eastern region of Libya in 1971 were 16.6 and 33.3% and in 1976 were 8.6 and 14.7%, in western regions in 1984–1986 were 11 and 21.5% and in the whole country in 2011 were estimated at 3.4 and 29%, respectively. The problem of antibiotic resistance is very serious in Libya. The health authorities in particular and society in general should address this problem urgently. Establishing monitoring systems based on the routine testing of antimicrobial sensitivity and education of healthcare workers, pharmacists, and the community on the health risks associated with the problem and benefits of prudent use of antimicrobials are some steps that can be taken to tackle the problem in the future. PMID:23537612

Antimicrobial resistance in Libya: 1970-2011.

PubMed

Sifaw Ghenghesh, Khalifa; Rahouma, Amal; Tawil, Khaled; Zorgani, Abdulaziz; Franka, Ezzedin

2013-01-01

Resistance to antimicrobial agents is a major health problem that affects the whole world. Providing information on the past state of antimicrobial resistance in Libya may assist the health authorities in addressing the problem more effectively in the future. Information was obtained mainly from Highwire Press (including PubMed) search for the period 1970-2011 using the terms 'antibiotic resistance in Libya', 'antimicrobial resistance in Libya', 'tuberculosis in Libya', and 'primary and acquired resistance in Libya' in title and abstract. From 1970 to 2011 little data was available on antimicrobial resistance in Libya due to lack of surveillance and few published studies. Available data shows high resistance rates for Salmonella species in the late 1970s and has remained high to the present day. High prevalence rates (54-68%) of methicillin-resistant Staphylococcus aureus (MRSA) were reported in the last decade among S. aureus from patients with burns and surgical wound infections. No reports were found of vancomycin-resistant S. aureus (VRSA) or vancomycin-intermediate-resistant S. aureus (VISA) using standard methods from Libya up to the end of 2011. Reported rates of primary (i.e. new cases) and acquired (i.e. retreatment cases) multidrug-resistant tuberculosis (MDR-TB) from the eastern region of Libya in 1971 were 16.6 and 33.3% and in 1976 were 8.6 and 14.7%, in western regions in 1984-1986 were 11 and 21.5% and in the whole country in 2011 were estimated at 3.4 and 29%, respectively. The problem of antibiotic resistance is very serious in Libya. The health authorities in particular and society in general should address this problem urgently. Establishing monitoring systems based on the routine testing of antimicrobial sensitivity and education of healthcare workers, pharmacists, and the community on the health risks associated with the problem and benefits of prudent use of antimicrobials are some steps that can be taken to tackle the problem in the future.

IN-SITU THERMAL REMEDIATION: MECHANISMS, PRINCIPLES, AND CASE STUDIES

EPA Science Inventory

Since the early 1990's, thermal methods of enhanced oil recovery have been adapted for the remediation of soils and groundwater. Steam injection and electrical resistance heating have proven to be robust and aggressive techniques for the enhanced recovery of volatile and semivol...

Noncontact technique for measuring the electrical resistivity and magnetic susceptibility of electrostatically levitated materials

NASA Astrophysics Data System (ADS)

Rustan, G. E.; Spyrison, N. S.; Kreyssig, A.; Prozorov, R.; Goldman, A. I.

2012-10-01

We describe the development of a new method for measuring the electrical resistivity and magnetic susceptibility of high temperature liquids and solids. The technique combines a tunnel diode oscillator with an electrostatic levitation furnace to perform noncontact measurements on spherical samples 2-3 mm in diameter. The tank circuit of the oscillator is inductively coupled to the sample, and measurements of the oscillator frequency as a function of sample temperature can be translated into changes in the sample's electrical resistivity and magnetic susceptibility. Particular emphasis is given on the need to improve the positional stability of the levitated samples, as well as the need to stabilize the temperature of the measurement coil. To demonstrate the validity of the technique, measurements have been performed on solid spheres of pure zirconium and low-carbon steel. In the case of zirconium, while absolute values of the resistivity were not determined, the temperature dependence of the resistivity was measured over the range of 640-1770 K and found to be in good agreement with literature data. In the case of low-carbon steel, the ferromagnetic-paramagnetic transition was clearly observable and, when combined with thermal data, appears to occur simultaneously with the solid-solid structural transition.

Characterisation of electrical resistance for CMC Materials up to 1200 °C

NASA Astrophysics Data System (ADS)

Stäbler, T.; Böhrk, H.; Voggenreiter, H.

2017-12-01

Damage to thermal protection systems (TPS) during atmospheric re-entry is a severe safety issue, especially when considering re-usability of space transportation systems. There is a need for structural health monitoring systems and non-destructive inspection methods. However, damages are hard to detect. When ceramic matrix composites, in this case carbon fibre reinforced silicon carbide (C/C-SiC), are used as a TPS, the electrical properties of the present semiconductor material can be used for health monitoring, since the resistivity changes with damage, strain and temperature. In this work the electrical resistivity as a function of the material temperature is analysed eliminating effects of thermal electricity and the thermal coefficient of electrical resistance is determined. A sensor network is applied for locally and time resolved monitoring of the 300 mm x 120 mm x 3 mm panel shaped samples. Since the material is used for atmospheric re-entry it needs to be characterised for a wide range of temperatures, in this case as high as 1200 °C. Therefore, experiments in an inductively heated test bench were conducted. Firstly, a reference sample was used with thermocouples for characterising the temperature distribution across the sample surface. Secondly, electrical resistance under heat load was measured, time and spatially resolved. Results will be shown and discussed in terms of resistance dependence on temperature, thermal coefficient of electrical resistance, thermal electricity and electrical path orientation including an analysis on effective conducting cross section. Conversely, the thermal coefficient can also be used to determine the material temperature as a function of electrical resistance.

Methods and apparatus for measurement of the resistivity of geological formations from within cased wells in presence of acoustic and magnetic energy sources

DOEpatents

Vail, W.B. III.

1991-08-27

Methods and apparatus are provided for measuring the acoustically modulated electronic properties of geological formations and cement layers adjacent to cased boreholes. Current is passed from an electrode in electrical contact with the interior of the borehole casing to an electrode on the surface of the earth. Voltage measuring electrodes in electrical contact with the interior of the casing measure the voltage at various points thereon. The voltage differences between discrete pairs of the voltage measuring electrodes provide a measurement of the leakage current conducted into formation in the vicinity of those electrodes. Simultaneously subjecting the casing and formation to an acoustic source acoustically modulates the leakage current measured thereby providing a measure of the acoustically modulated electronic properties of the adjacent formation. Similarly, methods and apparatus are also described which measure the leakage current into formation while simultaneously subjecting the casing to an applied magnetic field which therefore allows measurement of the magnetically modulated electronic properties of the casing and the adjacent formation. 9 figures.

Methods and apparatus for measurement of the resistivity of geological formations from within cased wells in presence of acoustic and magnetic energy sources

DOEpatents

Vail, III, William B.

1991-01-01

Methods and apparatus are provided for measuring the acoustically modulated electronic properties of geological formations and cement layers adjacent to cased boreholes. Current is passed from an electrode in electrical contact with the interior of the borehole casing to an electrode on the surface of the earth. Voltage measuring electrodes in electrical contact with the interior of the casing measure the voltage at various points thereon. The voltage differences between discrete pairs of the voltage measuring electrodes provide a measurement of the leakage current conducted into formation in the vicinity of those electrodes. Simultaneously subjecting the casing and formation to an acoustic source acoustically modulates the leakage current measured thereby providing a measure of the acoustically modulated electronic properties of the adjacent formation. Similarly, methods and apparatus are also described which measure the leakage current into formation while simultaneously subjecting the casing to an applied magnetic field which therefore allows measurement of the magnetically modulated electronic properties of the casing and the adjacent formation.

Drug resistant Skeletal Tuberculosis in a tertiary care centre in South India.

PubMed

Arockiaraj, J; Balaji, G S; Cherian, V M; T S, Jepegnanam; Thomas, B P; Michael, Joy S; Poonnoose, P M

2018-03-01

Drug resistant tuberculosis is alarmingly on the rise especially in developing countries. Skeletal tuberculosis accounts up to 10% of all extra pulmonary tuberculosis. World Health Organisation (WHO) has not formulated guidelines for the management of Multi-drug resistant skeletal tuberculosis. A retrospective analysis of patients treated for musculoskeletal tuberculosis was done, to study drug resistance patterns. The outcome was assessed both clinically and radiologically.898 patients were treated for skeletal tuberculosis during the period of 2006-2013 (96 months). 478 (53.2%) patients were treated for tubercular spondylitis and 420 (46.8%) for extra-spinal skeletal tuberculosis. Ninety two patients (10.2%) had documented resistance to the anti-tubercular drugs. There were 42 mono resistant tuberculosis cases (4.7%), 13 poly resistant cases (1.4%), 33 multi-drug resistant cases (MDR TB) (3.7%) and 4 (0.4%) extremely drug resistant tuberculosis cases (XDR). All the patients were treated medically as per drug susceptibility patterns and protocols. Surgery was performed when indicated in 59 (66%) cases. 85% completed their course of treatment and were successfully healed as per pre-set clinical, biochemical and radiological criteria. The remaining were lost to follow up. One patient died as a result of post op respiratory infection. The prevalence of Multi-drug resistant tuberculosis patients in our centre was 3.7% and that of Extremely drug resistant tuberculosis cases was 0.4%. A Multi-disciplinary approach with drug susceptibility tests, sensitive drugs, and surgery if required is essential. Health education is essential to improve awareness among health care professionals about the danger of drug resistance in tuberculosis.

[Antituberculosis-drug resistance in the border of Brazil with Paraguay and Bolivia].

PubMed

Marques, Marli; Cunha, Eunice Atsuko Totumi; Evangelista, Maria do Socorro Nantua; Basta, Paulo Cesar; Marques, Ana Maria Campos; Croda, Julio; de Andrade, Sonia Maria Oliveira

2017-04-20

To estimate the rate of drug resistance among pulmonary tuberculosis (PTB) cases in the state of Mato Grosso do Sul, Brazil, and specifically in the border areas with Paraguay and Bolivia, as well as to identify associated risk factors. The present cross-sectional, epidemiological study focused on PTB cases recorded between January 2007 and December 2010 in the State Reportable Disease Information System with results of susceptibility tests to rifampicin, isoniazid, ethambutol, and streptomycin. Dependent variables were development of resistance to a single drug or any combination of drugs. Independent variables were being a new or treated case, living in border areas, presence/absence of diabetes, and history of alcoholism. There were 789 TBP cases with susceptibility testing. The following characteristics were associated with resistance: treated case (P = 0.0001), border region (P = 0.0142), alcoholism (P = 0.0451), and diabetes (P = 0.0708). The rates of combined, primary, and acquired resistance for the state were 16.3%, 10.6%, and 39.0%, vs. 22.3%, 19.2%, and 37.5% for the border region. The rates of combined, primary, and acquired multidrug resistance for the state were 1.8%, 0.6%, and 6.3%, vs. 3.1%, 1.2%, and 12.5% for the border region. In the border region, the state should investigate drug resistance in all patients with respiratory symptoms, determine the pattern of resistance in confirmed cases, adopt directly observed treatment for cases of PTB, and develop health actions together with neighboring countries. Across the state, the levels of acquired resistance should be monitored, with investigation of resistance in all treated cases and implementation of directly observed treatment especially among patients with diabetes or alcoholism.

Whole genome sequencing distinguishes between relapse and reinfection in recurrent leprosy cases

PubMed Central

Bührer-Sékula, Samira; Benjak, Andrej; Loiseau, Chloé; Singh, Pushpendra; Pontes, Maria A. A.; Gonçalves, Heitor S.; Hungria, Emerith M.; Busso, Philippe; Piton, Jérémie; Silveira, Maria I. S.; Cruz, Rossilene; Schetinni, Antônio; Costa, Maurício B.; Virmond, Marcos C. L.; Diorio, Suzana M.; Dias-Baptista, Ida M. F.; Rosa, Patricia S.; Matsuoka, Masanori; Penna, Maria L. F.; Cole, Stewart T.; Penna, Gerson O.

2017-01-01

Background Since leprosy is both treated and controlled by multidrug therapy (MDT) it is important to monitor recurrent cases for drug resistance and to distinguish between relapse and reinfection as a means of assessing therapeutic efficacy. All three objectives can be reached with single nucleotide resolution using next generation sequencing and bioinformatics analysis of Mycobacterium leprae DNA present in human skin. Methodology DNA was isolated by means of optimized extraction and enrichment methods from samples from three recurrent cases in leprosy patients participating in an open-label, randomized, controlled clinical trial of uniform MDT in Brazil (U-MDT/CT-BR). Genome-wide sequencing of M. leprae was performed and the resultant sequence assemblies analyzed in silico. Principal findings In all three cases, no mutations responsible for resistance to rifampicin, dapsone and ofloxacin were found, thus eliminating drug resistance as a possible cause of disease recurrence. However, sequence differences were detected between the strains from the first and second disease episodes in all three patients. In one case, clear evidence was obtained for reinfection with an unrelated strain whereas in the other two cases, relapse appeared more probable. Conclusions/Significance This is the first report of using M. leprae whole genome sequencing to reveal that treated and cured leprosy patients who remain in endemic areas can be reinfected by another strain. Next generation sequencing can be applied reliably to M. leprae DNA extracted from biopsies to discriminate between cases of relapse and reinfection, thereby providing a powerful tool for evaluating different outcomes of therapeutic regimens and for following disease transmission. PMID:28617800

First case of New Delhi metallo-β-lactamase in Klebsiella pneumoniae from Ecuador: An update for South America.

PubMed

Romero-Alvarez, Daniel; Reyes, Jorge; Quezada, Viviana; Satán, Carolina; Cevallos, Nelson; Barrera, Sofía; Trueba, Gabriel; Escobar, Luis E; Villacís, José E

2017-12-01

To describe a clinical case of Klebsiella pneumoniae harboring a New Delhi metallo-β-lactamase (NDM) plasmid in Ecuador and to present a map of reports of NDM isolates in South America. The modified Hodge test, carbapenem inactivation method, imipenem-EDTA disk method (synergy), and Rapidec Carba NP test were used to identify antibiotic resistance mechanisms. The presence of resistance genes was explored with a conjugation assay, and molecular confirmation of NDM was performed by PCR and DNA sequencing. Plasmid characterization was conducted by PCR-based replicon typing. A literature review was performed in Google Scholar and PubMed to identify reports from South America. An HIV-infected patient, who had never traveled abroad, developed a bloodstream infection caused by K. pneumoniae ST147 harboring the NDM-1 resistance gene in a plasmid from the IncA/C group. Local circulation of NDM has also been described in other South American countries, in particular in Colombia and Brazil, although published scientific records were not found for other countries. This report presents the first evidence of autochthonous circulation of the NDM-1 resistance gene harbored by an IncA/C plasmid isolated from a K. pneumoniae ST147 in Ecuador. Efforts should be implemented to monitor and characterize the spatial and temporal distribution of NDM in Ecuador and other countries of South America. Copyright © 2017 The Authors. Published by Elsevier Ltd.. All rights reserved.

Genome-wide chemical mutagenesis screens allow unbiased saturation of the cancer genome and identification of drug resistance mutations.

PubMed

Brammeld, Jonathan S; Petljak, Mia; Martincorena, Inigo; Williams, Steven P; Alonso, Luz Garcia; Dalmases, Alba; Bellosillo, Beatriz; Robles-Espinoza, Carla Daniela; Price, Stacey; Barthorpe, Syd; Tarpey, Patrick; Alifrangis, Constantine; Bignell, Graham; Vidal, Joana; Young, Jamie; Stebbings, Lucy; Beal, Kathryn; Stratton, Michael R; Saez-Rodriguez, Julio; Garnett, Mathew; Montagut, Clara; Iorio, Francesco; McDermott, Ultan

2017-04-01

Drug resistance is an almost inevitable consequence of cancer therapy and ultimately proves fatal for the majority of patients. In many cases, this is the consequence of specific gene mutations that have the potential to be targeted to resensitize the tumor. The ability to uniformly saturate the genome with point mutations without chromosome or nucleotide sequence context bias would open the door to identify all putative drug resistance mutations in cancer models. Here, we describe such a method for elucidating drug resistance mechanisms using genome-wide chemical mutagenesis allied to next-generation sequencing. We show that chemically mutagenizing the genome of cancer cells dramatically increases the number of drug-resistant clones and allows the detection of both known and novel drug resistance mutations. We used an efficient computational process that allows for the rapid identification of involved pathways and druggable targets. Such a priori knowledge would greatly empower serial monitoring strategies for drug resistance in the clinic as well as the development of trials for drug-resistant patients. © 2017 Brammeld et al.; Published by Cold Spring Harbor Laboratory Press.

Designing Predictive Diagnose Method for Insulation Resistance Degradation of the Electrical Power Cables from Neutral Insulated Power Networks

NASA Astrophysics Data System (ADS)

Dobra, R.; Pasculescu, D.; Risteiu, M.; Buica, G.; Jevremović, V.

2017-06-01

This paper describe some possibilities to minimize voltages switching-off risks from the mining power networks, in case of insulated resistance faults by using a predictive diagnose method. The cables from the neutral insulated power networks (underground mining) are designed to provide a flexible electrical connection between portable or mobile equipment and a point of supply, including main feeder cable for continuous miners, pump cable, and power supply cable. An electronic protection for insulated resistance of mining power cables can be made using this predictive strategy. The main role of electronic relays for insulation resistance degradation of the electrical power cables, from neutral insulated power networks, is to provide a permanent measurement of the insulated resistance between phases and ground, in order to switch-off voltage when the resistance value is below a standard value. The automat system of protection is able to signalize the failure and the human operator will be early informed about the switch-off power and will have time to take proper measures to fix the failure. This logic for fast and automat switch-off voltage without aprioristic announcement is suitable for the electrical installations, realizing so a protection against fires and explosion. It is presented an algorithm and an anticipative relay for insulated resistance control from three-phase low voltage installations with insulated neutral connection.

Transmission of Extensively Drug-Resistant Tuberculosis in South Africa

PubMed Central

Shah, N. Sarita; Auld, Sara C.; Brust, James C.M.; Mathema, Barun; Ismail, Nazir; Moodley, Pravi; Mlisana, Koleka; Allana, Salim; Campbell, Angela; Mthiyane, Thuli; Morris, Natashia; Mpangase, Primrose; van der Meulen, Hermina; Omar, Shaheed V.; Brown, Tyler S.; Narechania, Apurva; Shaskina, Elena; Kapwata, Thandi; Kreiswirth, Barry; Gandhi, Neel R.

2017-01-01

BACKGROUND Drug-resistant tuberculosis threatens recent gains in the treatment of tuberculosis and human immunodeficiency virus (HIV) infection worldwide. A widespread epidemic of extensively drug-resistant (XDR) tuberculosis is occurring in South Africa, where cases have increased substantially since 2002. The factors driving this rapid increase have not been fully elucidated, but such knowledge is needed to guide public health interventions. METHODS We conducted a prospective study involving 404 participants in KwaZulu-Natal Province, South Africa, with a diagnosis of XDR tuberculosis between 2011 and 2014. Interviews and medical-record reviews were used to elicit information on the participants’ history of tuberculosis and HIV infection, hospitalizations, and social networks. Mycobacterium tuberculosis isolates underwent insertion sequence (IS)6110 restriction-fragment– length polymorphism analysis, targeted gene sequencing, and whole-genome sequencing. We used clinical and genotypic case definitions to calculate the proportion of cases of XDR tuberculosis that were due to inadequate treatment of multidrug-resistant (MDR) tuberculosis (i.e., acquired resistance) versus those that were due to transmission (i.e., transmitted resistance). We used social-network analysis to identify community and hospital locations of transmission. RESULTS Of the 404 participants, 311 (77%) had HIV infection; the median CD4+ count was 340 cells per cubic millimeter (interquartile range, 117 to 431). A total of 280 participants (69%) had never received treatment for MDR tuberculosis. Genotypic analysis in 386 participants revealed that 323 (84%) belonged to 1 of 31 clusters. Clusters ranged from 2 to 14 participants, except for 1 large cluster of 212 participants (55%) with a LAM4/KZN strain. Person-to-person or hospital-based epidemiologic links were identified in 123 of 404 participants (30%). CONCLUSIONS The majority of cases of XDR tuberculosis in KwaZulu-Natal, South Africa, an area with a high tuberculosis burden, were probably due to transmission rather than to inadequate treatment of MDR tuberculosis. These data suggest that control of the epidemic of drug-resistant tuberculosis requires an increased focus on interrupting transmission. (Funded by the National Institute of Allergy and Infectious Diseases and others.) PMID:28099825

Laboratory-Based Surveillance of Extensively Drug-Resistant Tuberculosis in Eastern China.

PubMed

Huang, Yu; Wu, Qingqing; Xu, Shuiyang; Zhong, Jieming; Chen, Songhua; Xu, Jinghang; Zhu, Liping; He, Haibo; Wang, Xiaomeng

2017-03-01

With 25% of the global burden, China has the highest incidence of drug-resistant tuberculosis (TB) in the world. However, surveillance data on extensively drug-resistant TB (XDR-TB) from China are scant. To estimate the prevalence of XDR-TB in Zhejiang, Eastern China, 30 of 90 TB treatment centers in Zhejiang were recruited. Patients with suspected TB who reported to the clinics for diagnosis were requested to undergo a smear sputum test. Positive sputum samples were tested for drug susceptibility. Data on anti-TB drug resistance from 1999 to 2008 were also collected to assess drug resistance trends. A total of 931 cases were recruited for drug susceptibility testing (DST). Among these, 23.6% (95% confidence interval [CI], 18.8-24.4) were resistant to any of the following drugs: isoniazid, rifampin, streptomycin, and ethambutol. Multidrug resistant (MDR) strains were identified in 5.1% of all cases (95% CI, 3.61-6.49). Among MDR-TB cases, 6.4% were XDR (95% CI, 1.7-18.6) and 8.9% (95% CI, 7.0-10.8) of all cases were resistant to either isoniazid or rifampin (but not both). Among MDR-TB cases, 23.4% (95% CI, 12.8-38.4) were resistant to either fluoroquinolones or a second-line anti-TB injectable drug, but not both. From 1999 to 2014, the percentage of MDR cases decreased significantly, from 8.6% to 5.1% (p = 0.00). The Global Fund to Fight TB program showed signs of success in Eastern China. However, drug-resistant TB, MDR-TB, and XDR-TB still pose a challenge for TB control in Eastern China. High-quality directly observed treatment, short-course, and universal DST for TB cases to determine appropriate treatment regimens are urgently needed to prevent acquired drug resistance.

Genomic and metagenomic technologies to explore the antibiotic resistance mobilome.

PubMed

Martínez, José L; Coque, Teresa M; Lanza, Val F; de la Cruz, Fernando; Baquero, Fernando

2017-01-01

Antibiotic resistance is a relevant problem for human health that requires global approaches to establish a deep understanding of the processes of acquisition, stabilization, and spread of resistance among human bacterial pathogens. Since natural (nonclinical) ecosystems are reservoirs of resistance genes, a health-integrated study of the epidemiology of antibiotic resistance requires the exploration of such ecosystems with the aim of determining the role they may play in the selection, evolution, and spread of antibiotic resistance genes, involving the so-called resistance mobilome. High-throughput sequencing techniques allow an unprecedented opportunity to describe the genetic composition of a given microbiome without the need to subculture the organisms present inside. However, bioinformatic methods for analyzing this bulk of data, mainly with respect to binning each resistance gene with the organism hosting it, are still in their infancy. Here, we discuss how current genomic methodologies can serve to analyze the resistance mobilome and its linkage with different bacterial genomes and metagenomes. In addition, we describe the drawbacks of current methodologies for analyzing the resistance mobilome, mainly in cases of complex microbiotas, and discuss the possibility of implementing novel tools to improve our current metagenomic toolbox. © 2016 New York Academy of Sciences.

[Risk factors for multidrug-resistant tuberculosis in the city of Kinshasa in the Democratic Republic of Congo].

PubMed

Misombo-Kalabela, André; Nguefack-Tsague, Georges; Kalla, Ginette Claude Mireille; Ze, Emmanuel Afane; Diangs, Kimpanga; Panda, Tshapenda; Kebela, Ilunga; Fueza, Serge Bisuta; Magazani, Nzanzu; Mbopi-Kéou, François-Xavier

2016-01-01

The aim of this study was to determine the risk factors for multidrug-resistant tuberculosis (TB) in the city of Kinshasa in the Democratic Republic of Congo. This was a case control study. The cases included all TB patients notified as resistant to rifampicin and isoniazid in Kinshasa from January 2012 to June 2013. The controls included TB patients treated during the same period as the cases and declared cured at the end of treatment. For this study, we obtained ethical clearance. The sample consisted of 213 participants, 132 men (62%) and 81 women (38%). The median age was 31 years (16-73 years). Factors associated with significant (p< 0,05) multidrug-resistant tuberculosis were the non-observance of the hours of taking drugs (0R = 111) (80% cases, 4% controls), the failure of treatment (0R = 20 (76% cases, 13% controls); the concept of multidrug-resistant tuberculosis in the family (0R = 6.4) (28% cases, 6% controls); a lack of knowledge of multidrug-resistant tuberculosis (0R = 3.2) (31% cases, 59% controls); a stay in prison (0R = 7.6) (10% cases, 1% controls) and the interruption of treatment (0R = 6.1) (59% cases, 19% controls). The emergence of multidrug-resistant tuberculosis can be avoided by the installation of suitable diagnosis and treatment strategies.

Phenotypic and genotypic antimicrobial susceptibility pattern of Streptococcus spp. isolated from cases of clinical mastitis in dairy cattle in Poland.

PubMed

Kaczorek, E; Małaczewska, J; Wójcik, R; Rękawek, W; Siwicki, A K

2017-08-01

Mastitis of dairy cattle is one of the most frequently diagnosed diseases worldwide. The main etiological agents of mastitis are bacteria of the genus Streptococcus spp., in which several antibiotic resistance mechanisms have been identified. However, detailed studies addressing this problem have not been conducted in northeastern Poland. Therefore, the aim of our study was to analyze, on phenotypic and genotypic levels, the antibiotic resistance pattern of Streptococcus spp. isolated from clinical cases of mastitis from dairy cattle in this region of Poland. The research was conducted using 135 strains of Streptococcus (Streptococcus uberis, n = 53; Streptococcus dysgalactiae, n = 41; Streptococcus agalactiae, n = 27; other streptococci, n = 14). The investigation of the antimicrobial susceptibility to 8 active substances applied in therapy in the analyzed region, as well as a selected bacteriocin (nisin), was performed using the minimum inhibitory concentration method. The presence of selected resistance genes (n = 14) was determined via PCR. We also investigated the correlation between the presence of resistance genes and the antimicrobial susceptibility of the examined strains in vitro. The highest observed resistance of Streptococcus spp. was toward gentamicin, kanamycin, and tetracycline, whereas the highest susceptibility occurred toward penicillin, enrofloxacin, and marbofloxacin. Additionally, the tested bacteriocin showed high efficacy. The presence of 13 analyzed resistance genes was observed in the examined strains [gene mef(A) was not detected]. In most strains, at least one resistance gene, mainly responsible for resistance to tetracyclines [tet(M), tet(K), tet(L)], was observed. However, a relationship between the presence of a given resistance gene and antimicrobial susceptibility on the phenotypic level was not always observed. Copyright © 2017 American Dairy Science Association. Published by Elsevier Inc. All rights reserved.

Neural network modeling and prediction of resistivity structures using VES Schlumberger data over a geothermal area

NASA Astrophysics Data System (ADS)

Singh, Upendra K.; Tiwari, R. K.; Singh, S. B.

2013-03-01

This paper presents the effects of several parameters on the artificial neural networks (ANN) inversion of vertical electrical sounding (VES) data. Sensitivity of ANN parameters was examined on the performance of adaptive backpropagation (ABP) and Levenberg-Marquardt algorithms (LMA) to test the robustness to noisy synthetic as well as field geophysical data and resolving capability of these methods for predicting the subsurface resistivity layers. We trained, tested and validated ANN using the synthetic VES data as input to the networks and layer parameters of the models as network output. ANN learning parameters are varied and corresponding observations are recorded. The sensitivity analysis of synthetic data and real model demonstrate that ANN algorithms applied in VES data inversion should be considered well not only in terms of accuracy but also in terms of high computational efforts. Also the analysis suggests that ANN model with its various controlling parameters are largely data dependent and hence no unique architecture can be designed for VES data analysis. ANN based methods are also applied to the actual VES field data obtained from the tectonically vital geothermal areas of Jammu and Kashmir, India. Analysis suggests that both the ABP and LMA are suitable methods for 1-D VES modeling. But the LMA method provides greater degree of robustness than the ABP in case of 2-D VES modeling. Comparison of the inversion results with known lithology correlates well and also reveals the additional significant feature of reconsolidated breccia of about 7.0 m thickness beneath the overburden in some cases like at sounding point RDC-5. We may therefore conclude that ANN based methods are significantly faster and efficient for detection of complex layered resistivity structures with a relatively greater degree of precision and resolution.

The fourth national anti-tuberculosis drug resistance survey in Viet Nam.

PubMed

Nhung, N V; Hoa, N B; Sy, D N; Hennig, C M; Dean, A S

2015-06-01

Viet Nam's Fourth National Anti-Tuberculosis Drug Resistance Survey was conducted in 2011. To determine the prevalence of resistance to the four main first-line anti-tuberculosis drugs in Viet Nam. Eighty clusters were selected using a probability proportion to size approach. Drug susceptibility testing (DST) against the four main first-line anti-tuberculosis drugs was performed. A total of 1629 smear-positive tuberculosis (TB) patients were eligible for culture. Of these, DST results were available for 1312 patients, including 1105 new TB cases, 195 previously treated TB cases and 12 cases with an unknown treatment history. The proportion of cases with resistance to any drug was 32.7% (95%CI 29.1-36.5) among new cases and 54.2% (95%CI 44.3-63.7) among previously treated cases. The proportion of multidrug-resistant TB (MDR-TB) cases was 4.0% (95%CI 2.5-5.4) in new cases and 23.3 (95%CI 16.7-29.9) in previously treated cases. The fourth drug resistance survey in Viet Nam found that the proportion of MDR-TB among new and previously treated cases was not significantly different from that in the 2005 survey. The National TB Programme should prioritise the detection and treatment of MDR-TB to reduce transmission of MDR-TB in the community.

A critique of assumptions about selecting chemical-resistant gloves: a case for workplace evaluation of glove efficacy.

PubMed

Klingner, Thomas D; Boeniger, Mark F

2002-05-01

Wearing chemical-resistant gloves and clothing is the primary method used to prevent skin exposure to toxic chemicals in the workplace. The process for selecting gloves is usually based on manufacturers' laboratory-generated chemical permeation data. However, such data may not reflect conditions in the workplace where many variables are encountered (e.g., elevated temperature, flexing, pressure, and product variation between suppliers). Thus, the reliance on this selection process is questionable. Variables that may influence the performance of chemical-resistant gloves are identified and discussed. Passive dermal monitoring is recommended to evaluate glove performance under actual-use conditions and can bridge the gap between laboratory data and real-world performance.

On coincident loop transient electromagnetic induction logging

DOE Office of Scientific and Technical Information (OSTI.GOV)

Swidinsky, Andrei; Weiss, Chester J.

Coincident loop transient induction wireline logging is examined as the borehole analog of the well-known land and airborne time-domain electromagnetic (EM) method. The concept of whole-space late-time apparent resistivity is modified from the half-space version commonly used in land and airborne geophysics and applied to the coincident loop voltages produced from various formation, borehole, and invasion models. Given typical tool diameters, off-time measurements with such an instrument must be made on the order of nanoseconds to microseconds — much more rapidly than for surface methods. Departure curves of the apparent resistivity for thin beds, calculated using an algorithm developed tomore » model the transient response of a loop in a multilayered earth, indicate that the depth of investigation scales with the bed thickness. Modeled resistivity logs are comparable in accuracy and resolution with standard frequency-domain focused induction logs. However, if measurement times are longer than a few microseconds, the thicknesses of conductors can be overestimated, whereas resistors are underestimated. Thin-bed resolution characteristics are explained by visualizing snapshots of the EM fields in the formation, where a conductor traps the electric field while two current maxima are produced in the shoulder beds surrounding a resistor. Radial profiling is studied using a concentric cylinder earth model. Results found that true formation resistivity can be determined in the presence of either oil- or water-based mud, although in the latter case, measurements must be taken several orders of magnitude later in time. Lastly, the ability to determine true formation resistivity is governed by the degree that the EM field heals after being distorted by borehole fluid and invasion, a process visualized and particularly evident in the case of conductive water-based mud.« less

On coincident loop transient electromagnetic induction logging

DOE PAGES

Swidinsky, Andrei; Weiss, Chester J.

2017-05-31

Coincident loop transient induction wireline logging is examined as the borehole analog of the well-known land and airborne time-domain electromagnetic (EM) method. The concept of whole-space late-time apparent resistivity is modified from the half-space version commonly used in land and airborne geophysics and applied to the coincident loop voltages produced from various formation, borehole, and invasion models. Given typical tool diameters, off-time measurements with such an instrument must be made on the order of nanoseconds to microseconds — much more rapidly than for surface methods. Departure curves of the apparent resistivity for thin beds, calculated using an algorithm developed tomore » model the transient response of a loop in a multilayered earth, indicate that the depth of investigation scales with the bed thickness. Modeled resistivity logs are comparable in accuracy and resolution with standard frequency-domain focused induction logs. However, if measurement times are longer than a few microseconds, the thicknesses of conductors can be overestimated, whereas resistors are underestimated. Thin-bed resolution characteristics are explained by visualizing snapshots of the EM fields in the formation, where a conductor traps the electric field while two current maxima are produced in the shoulder beds surrounding a resistor. Radial profiling is studied using a concentric cylinder earth model. Results found that true formation resistivity can be determined in the presence of either oil- or water-based mud, although in the latter case, measurements must be taken several orders of magnitude later in time. Lastly, the ability to determine true formation resistivity is governed by the degree that the EM field heals after being distorted by borehole fluid and invasion, a process visualized and particularly evident in the case of conductive water-based mud.« less

An ultrathin wide-band planar metamaterial absorber based on a fractal frequency selective surface and resistive film

NASA Astrophysics Data System (ADS)

Fan, Yue-Nong; Cheng, Yong-Zhi; Nie, Yan; Wang, Xian; Gong, Rong-Zhou

2013-06-01

We propose an ultrathin wide-band metamaterial absorber (MA) based on a Minkowski (MIK) fractal frequency selective surface and resistive film. This absorber consists of a periodic arrangement of dielectric substrates sandwiched with an MIK fractal loop structure electric resonator and a resistive film. The finite element method is used to simulate and analyze the absorption of the MA. Compared with the MA-backed copper film, the designed MA-backed resistive film exhibits an absorption of 90% at a frequency region of 2 GHz-20 GHz. The power loss density distribution of the MA is further illustrated to explain the mechanism of the proposed MA. Simulated absorptions at different incidence cases indicate that this absorber is polarization-insensitive and wide-angled. Finally, further simulated results indicate that the surface resistance of the resistive film and the dielectric constant of the substrate can affect the absorbing property of the MA. This absorber may be used in many military fields.

Resistance Training: Identifying Best Practices?

DTIC Science & Technology

2010-02-18

pretest – posttest research designs. In such cases, the correlation of pretest scores with posttest scores affects the sampling variance that is the ES...magnitude of the pretest – posttest correlation (see Appendix A). Strength was measured more than twice in some studies. When this was the case, ES was...included in this review used a pretest – posttest design. For this reason, methods described by Morris and DeShon (2002) were applied to compute

Using open hole and cased-hole resistivity logs to monitor gas hydrate dissociation during a thermal test in the mallik 5L-38 research well, Mackenzie Delta, Canada

USGS Publications Warehouse

Anderson, B.I.; Collett, T.S.; Lewis, R.E.; Dubourg, I.

2008-01-01

Gas hydrates, which are naturally occurring ice-like combinations of gas and water, have the potential to provide vast amounts of natural gas from the world's oceans and polar regions. However, producing gas economically from hydrates entails major technical challenges. Proposed recovery methods such as dissociating or melting gas hydrates by heating or depressurization are currently being tested. One such test was conducted in northern Canada by the partners in the Mallik 2002 Gas Hydrate Production Research Well Program. This paper describes how resistivity logs were used to determine the size of the annular region of gas hydrate dissociation that occurred around the wellbore during the thermal test in the Mallik 5L-38 well. An open-hole logging suite, run prior to the thermal test, included array induction, array laterolog, nuclear magnetic resonance and 1.1-GHz electromagnetic propagation logs. The reservoir saturation tool was run both before and after the thermal test to monitor formation changes. A cased-hole formation resistivity log was run after the test.Baseline resistivity values in each formation layer (Rt) were established from the deep laterolog data. The resistivity in the region of gas hydrate dissociation near the wellbore (Rxo) was determined from electromagnetic propagation and reservoir saturation tool measurements. The radius of hydrate dissociation as a function of depth was then determined by means of iterative forward modeling of cased-hole formation resistivity tool response. The solution was obtained by varying the modeled dissociation radius until the modeled log overlaid the field log. Pretest gas hydrate production computer simulations had predicted that dissociation would take place at a uniform radius over the 13-ft test interval. However, the post-test resistivity modeling showed that this was not the case. The resistivity-derived dissociation radius was greatest near the outlet of the pipe that circulated hot water in the wellbore, where the highest temperatures were recorded. The radius was smallest near the center of the test interval, where a conglomerate section with low values of porosity and permeability inhibited dissociation. The free gas volume calculated from the resistivity-derived dissociation radii yielded a value within 20 per cent of surface gauge measurements. These results show that the inversion of resistivity measurements holds promise for use in future gas hydrate monitoring. ?? 2008 Society of Petrophysicists and Well Log Analysts. All rights reserved.

A Damage Resistance Comparison Between Candidate Polymer Matrix Composite Feedline Materials

NASA Technical Reports Server (NTRS)

Nettles, A. T

2000-01-01

As part of NASAs focused technology programs for future reusable launch vehicles, a task is underway to study the feasibility of using the polymer matrix composite feedlines instead of metal ones on propulsion systems. This is desirable to reduce weight and manufacturing costs. The task consists of comparing several prototype composite feedlines made by various methods. These methods are electron-beam curing, standard hand lay-up and autoclave cure, solvent assisted resin transfer molding, and thermoplastic tape laying. One of the critical technology drivers for composite components is resistance to foreign objects damage. This paper presents results of an experimental study of the damage resistance of the candidate materials that the prototype feedlines are manufactured from. The materials examined all have a 5-harness weave of IM7 as the fiber constituent (except for the thermoplastic, which is unidirectional tape laid up in a bidirectional configuration). The resin tested were 977-6, PR 520, SE-SA-1, RS-E3 (e-beam curable), Cycom 823 and PEEK. The results showed that the 977-6 and PEEK were the most damage resistant in all tested cases.

Correcting for static shift of magnetotelluric data with airborne electromagnetic measurements: a case study from Rathlin Basin, Northern Ireland

NASA Astrophysics Data System (ADS)

Delhaye, Robert; Rath, Volker; Jones, Alan G.; Muller, Mark R.; Reay, Derek

2017-05-01

Galvanic distortions of magnetotelluric (MT) data, such as the static-shift effect, are a known problem that can lead to incorrect estimation of resistivities and erroneous modelling of geometries with resulting misinterpretation of subsurface electrical resistivity structure. A wide variety of approaches have been proposed to account for these galvanic distortions, some depending on the target area, with varying degrees of success. The natural laboratory for our study is a hydraulically permeable volume of conductive sediment at depth, the internal resistivity structure of which can be used to estimate reservoir viability for geothermal purposes; however, static-shift correction is required in order to ensure robust and precise modelling accuracy.We present here a possible method to employ frequency-domain electromagnetic data in order to correct static-shift effects, illustrated by a case study from Northern Ireland. In our survey area, airborne frequency domain electromagnetic (FDEM) data are regionally available with high spatial density. The spatial distributions of the derived static-shift corrections are analysed and applied to the uncorrected MT data prior to inversion. Two comparative inversion models are derived, one with and one without static-shift corrections, with instructive results. As expected from the one-dimensional analogy of static-shift correction, at shallow model depths, where the structure is controlled by a single local MT site, the correction of static-shift effects leads to vertical scaling of resistivity-thickness products in the model, with the corrected model showing improved correlation to existing borehole wireline resistivity data. In turn, as these vertical scalings are effectively independent of adjacent sites, lateral resistivity distributions are also affected, with up to half a decade of resistivity variation between the models estimated at depths down to 2000 m. Simple estimation of differences in bulk porosity, derived using Archie's Law, between the two models reinforces our conclusion that the suborder of magnitude resistivity contrasts induced by the correction of static shifts correspond to similar contrasts in estimated porosities, and hence, for purposes of reservoir investigation or similar cases requiring accurate absolute resistivity estimates, galvanic distortion correction, especially static-shift correction, is essential.

Method for forming nuclear fuel containers of a composite construction and the product thereof

DOEpatents

Cheng, Bo-Ching; Rosenbaum, Herman S.; Armijo, Joseph S.

1984-01-01

An improved method for producing nuclear fuel containers of a composite construction having components providing therein a barrier system for resisting destructive action by volatile fission products or impurities and also interdiffusion of metal constituents, and the product thereof. The composite nuclear fuel containers of the method comprise a casing of zirconium or alloy thereof with a layer of copper overlying an oxidized surface portion of the zirconium or alloy thereof.

Appraisal of an Array TEM Method in Detecting a Mined-Out Area Beneath a Conductive Layer

NASA Astrophysics Data System (ADS)

Li, Hai; Xue, Guo-qiang; Zhou, Nan-nan; Chen, Wei-ying

2015-10-01

The transient electromagnetic method has been extensively used for the detection of mined-out area in China for the past few years. In the cases that the mined-out area is overlain by a conductive layer, the detection of the target layer is difficult with a traditional loop source TEM method. In order to detect the target layer in this condition, this paper presents a newly developed array TEM method, which uses a grounded wire source. The underground current density distribution and the responses of the grounded wire source TEM configuration are modeled to demonstrate that the target layer is detectable in this condition. The 1D OCCAM inversion routine is applied to the synthetic single station data and common middle point gather. The result reveals that the electric source TEM method is capable of recovering the resistive target layer beneath the conductive overburden. By contrast, the conductive target layer cannot be recovered unless the distance between the target layer and the conductive overburden is large. Compared with inversion result of the single station data, the inversion of common middle point gather can better recover the resistivity of the target layer. Finally, a case study illustrates that the array TEM method is successfully applied in recovering a water-filled mined-out area beneath a conductive overburden.

Prevalence of methicillin-resistant staphylococci in canine pyoderma cases in primary care veterinary practices in Canada: A preliminary study.

PubMed

Joffe, Daniel; Goulding, Fiona; Langelier, Ken; Magyar, Gabor; McCurdy, Les; Milstein, Moe; Nielsen, Kia; Villemaire, Stephanie

2015-10-01

Pyoderma in dogs is most commonly caused by Staphylococcus spp., and significant emergence of methicillin resistance in staphylococcal pyoderma has been reported. This preliminary study of the prevalence of methicillin resistance in canine pyoderma cases in Canadian primary care veterinary practices revealed that methicillin-resistant Staphylococcus spp. were present in 12.1% of 149 staphylococcal positive skin culture cases.

One-dimensional inversion of geo-electrical resistivity sounding data using artificial neural networks—a case study

NASA Astrophysics Data System (ADS)

Singh, U. K.; Tiwari, R. K.; Singh, S. B.

2005-02-01

This paper deals with the application of artificial neural networks (ANN) technique for the study of a case history using 1-D inversion of vertical electrical resistivity sounding (VES) data from the Puga valley, Kashmir, India. The study area is important for its rich geothermal resources as well as from the tectonic point of view as it is located near the collision boundary of the Indo-Asian crustal plates. In order to understand the resistivity structure and layer thicknesses, we used here three-layer feedforward neural networks to model and predict measured VES data. Three algorithms, e.g. back-propagation (BP), adaptive back-propagation (ABP) and Levenberg-Marquardt algorithm (LMA) were applied to the synthetic as well as real VES field data and efficiency of supervised training network are compared. Analyses suggest that LMA is computationally faster and give results, which are comparatively more accurate and consistent than BP and ABP. The results obtained using the ANN inversions are remarkably correlated with the available borehole litho-logs. The feasibility study suggests that ANN methods offer an excellent complementary tool for the direct detection of layered resistivity structure.

High prevalence of multidrug-resistant tuberculosis among patients with rifampicin resistance using GeneXpert Mycobacterium tuberculosis/rifampicin in Ghana.

PubMed

Boakye-Appiah, Justice K; Steinmetz, Alexis R; Pupulampu, Peter; Ofori-Yirenkyi, Stephen; Tetteh, Ishmael; Frimpong, Michael; Oppong, Patrick; Opare-Sem, Ohene; Norman, Betty R; Stienstra, Ymkje; van der Werf, Tjip S; Wansbrough-Jones, Mark; Bonsu, Frank; Obeng-Baah, Joseph; Phillips, Richard O

2016-06-01

Drug-resistant strains of tuberculosis (TB) represent a major threat to global TB control. In low- and middle-income countries, resource constraints make it difficult to identify and monitor cases of resistance using drug susceptibility testing and culture. Molecular assays such as the GeneXpert Mycobacterium tuberculosis/rifampicin may prove to be a cost-effective solution to this problem in these settings. The objective of this study is to evaluate the use of GeneXpert in the diagnosis of pulmonary TB since it was introduced into two tertiary hospitals in Ghana in 2013. A 2-year retrospective audit of clinical cases involving patients who presented with clinically suspected TB or documented TB not improving on standard therapy and had samples sent for GeneXpert testing. GeneXpert identified 169 cases of TB, including 17 cases of rifampicin-resistant TB. Of the seven cases with final culture and drug susceptibility testing results, six demonstrated further drug resistance and five of these were multidrug-resistant TB. These findings call for a scale-up of TB control in Ghana and provide evidence that the expansion of GeneXpert may be an optimal means to improve case finding and guide treatment of drug-resistant TB in this setting. Copyright © 2016. Published by Elsevier Ltd.

Durability of crosslinked polydimethylsyloxanes: the case of composite insulators

NASA Astrophysics Data System (ADS)

Delor-Jestin, Florence; Tomer, Namrata S.; Pal Singh, Raj; Lacoste, Jacques

2008-04-01

Most applications of silicones are linked to their hydrophobic properties and (or) their high resistance to ageing (e.g. thermal ageing and photoageing). However, when placed in extreme environments, these materials can fail as in the case of epoxy/fiber glass composite powerlines insulators, where crosslinked polymethylsyloxanes (PDMSs) are used as the protective envelope (housing) of the insulator. We report on the behavior of both pure/noncrosslinked PDMSs and typical formulations used in industrial insulators, i.e. containing peroxide crosslinked PDMS, alumina trioxide hydrated (ATH) and silica. Special attention is paid on both (i) the sources of potential degradation and (ii) the best analytical methods that can be applied to the study of very complex formulations. (i) Aside from conventional types of ageing such as photo-ageing and thermal, hydrolytic, and service life ageings, treatments with acidic vapors, plasma and ozone possibly generating species from the reaction of a high electric field with air were also performed, which allowed to accelerate electrical and out-door ageings and to obtain differently aged materials. (ii) Aside from conventional analytical methods of polymer degradation such as FTIR/ATR spectroscopy and SEC, TG, hardness measurements, more specific methods like photo/DSC, TG/IR, thermoporosimetry, resistivity and density measurements were also performed to characterize the chemical and physical evolutions of polymer materials. In particular, it was found that treatment with nitric acid vapor has detrimental effects on the properties of both fire retardants (e.g. ATH) and PDMSs, affecting the hardness and resistivity of the formulated material.

Evaluation of the measurement uncertainty when measuring the resistance of solid isolating materials to tracking

NASA Astrophysics Data System (ADS)

Stare, E.; Beges, G.; Drnovsek, J.

2006-07-01

This paper presents the results of research into the measurement of the resistance of solid isolating materials to tracking. Two types of tracking were investigated: the proof tracking index (PTI) and the comparative tracking index (CTI). Evaluation of the measurement uncertainty in a case study was performed using a test method in accordance with the IEC 60112 standard. In the scope of the tests performed here, this particular test method was used to ensure the safety of electrical appliances. According to the EN ISO/IEC 17025 standard (EN ISO/IEC 17025), in the process of conformity assessment, the evaluation of the measurement uncertainty of the test method should be carried out. In the present article, possible influential parameters that are in accordance with the third and fourth editions of the standard IEC 60112 are discussed. The differences, ambiguities or lack of guidance referring to both editions of the standard are described in the article 'Ambiguities in technical standards—case study IEC 60112—measuring the resistance of solid isolating materials to tracking' (submitted for publication). Several hundred measurements were taken in the present experiments in order to form the basis for the results and conclusions presented. A specific problem of the test (according to the IEC 60112 standard) is the great variety of influential physical parameters (mechanical, electrical, chemical, etc) that can affect the results. At the end of the present article therefore, there is a histogram containing information on the contributions to the measurement uncertainty.

Establishment of a nested-ASP-PCR method to determine the clarithromycin resistance of Helicobacter pylori.

PubMed

Luo, Xiao-Feng; Jiao, Jian-Hua; Zhang, Wen-Yue; Pu, Han-Ming; Qu, Bao-Jin; Yang, Bing-Ya; Hou, Min; Ji, Min-Jun

2016-07-07

To investigate clarithromycin resistance positions 2142, 2143 and 2144 of the 23SrRNA gene in Helicobacter pylori (H. pylori) by nested-allele specific primer-polymerase chain reaction (nested-ASP-PCR). The gastric tissue and saliva samples from 99 patients with positive results of the rapid urease test (RUT) were collected. The nested-ASP-PCR method was carried out with the external primers and inner allele-specific primers corresponding to the reference strain and clinical strains. Thirty gastric tissue and saliva samples were tested to determine the sensitivity of nested-ASP-PCR and ASP-PCR methods. Then, clarithromycin resistance was detected for 99 clinical samples by using different methods, including nested-ASP-PCR, bacterial culture and disk diffusion. The nested-ASP-PCR method was successfully established to test the resistance mutation points 2142, 2143 and 2144 of the 23SrRNA gene of H. pylori. Among 30 samples of gastric tissue and saliva, the H. pylori detection rate of nested-ASP-PCR was 90% and 83.33%, while the detection rate of ASP-PCR was just 63% and 56.67%. Especially in the saliva samples, nested-ASP-PCR showed much higher sensitivity in H. pylori detection and resistance mutation rates than ASP-PCR. In the 99 RUT-positive gastric tissue and saliva samples, the H. pylori-positive detection rate by nested-ASP-PCR was 87 (87.88%) and 67 (67.68%), in which there were 30 wild-type and 57 mutated strains in gastric tissue and 22 wild-type and 45 mutated strains in saliva. Genotype analysis showed that three-points mixed mutations were quite common, but different resistant strains were present in gastric mucosa and saliva. Compared to the high sensitivity shown by nested-ASP-PCR, the positive detection of bacterial culture with gastric tissue samples was 50 cases, in which only 26 drug-resistant strains were found through analyzing minimum inhibitory zone of clarithromycin. The nested-ASP-PCR assay showed higher detection sensitivity than ASP-PCR and drug sensitivity testing, which could be performed to evaluate clarithromycin resistance of H. pylori.

Pretreatment HIV Drug Resistance and HIV-1 Subtype C Are Independently Associated With Virologic Failure: Results From the Multinational PEARLS (ACTG A5175) Clinical Trial

PubMed Central

Kantor, Rami; Smeaton, Laura; Vardhanabhuti, Saran; Hudelson, Sarah E.; Wallis, Carol L.; Tripathy, Srikanth; Morgado, Mariza G.; Saravanan, Shanmugham; Balakrishnan, Pachamuthu; Reitsma, Marissa; Hart, Stephen; Mellors, John W.; Halvas, Elias; Grinsztejn, Beatriz; Hosseinipour, Mina C.; Kumwenda, Johnstone; La Rosa, Alberto; Lalloo, Umesh G.; Lama, Javier R.; Rassool, Mohammed; Santos, Breno R.; Supparatpinyo, Khuanchai; Hakim, James; Flanigan, Timothy; Kumarasamy, Nagalingeswaran; Campbell, Thomas B.; Eshleman, Susan H.

2015-01-01

Background. Evaluation of pretreatment HIV genotyping is needed globally to guide treatment programs. We examined the association of pretreatment (baseline) drug resistance and subtype with virologic failure in a multinational, randomized clinical trial that evaluated 3 antiretroviral treatment (ART) regimens and included resource-limited setting sites. Methods. Pol genotyping was performed in a nested case-cohort study including 270 randomly sampled participants (subcohort), and 218 additional participants failing ART (case group). Failure was defined as confirmed viral load (VL) >1000 copies/mL. Cox proportional hazards models estimated resistance–failure association. Results. In the representative subcohort (261/270 participants with genotypes; 44% women; median age, 35 years; median CD4 cell count, 151 cells/µL; median VL, 5.0 log10 copies/mL; 58% non-B subtypes), baseline resistance occurred in 4.2%, evenly distributed among treatment arms and subtypes. In the subcohort and case groups combined (466/488 participants with genotypes), used to examine the association between resistance and treatment failure, baseline resistance occurred in 7.1% (9.4% with failure, 4.3% without). Baseline resistance was significantly associated with shorter time to virologic failure (hazard ratio [HR], 2.03; P = .035), and after adjusting for sex, treatment arm, sex–treatment arm interaction, pretreatment CD4 cell count, baseline VL, and subtype, was still independently associated (HR, 2.1; P = .05). Compared with subtype B, subtype C infection was associated with higher failure risk (HR, 1.57; 95% confidence interval [CI], 1.04–2.35), whereas non-B/C subtype infection was associated with longer time to failure (HR, 0.47; 95% CI, .22–.98). Conclusions. In this global clinical trial, pretreatment resistance and HIV-1 subtype were independently associated with virologic failure. Pretreatment genotyping should be considered whenever feasible. Clinical Trials Registration. NCT00084136. PMID:25681380

The detectability of the pretreatment EGFR T790M mutations in lung adenocarcinoma using CAST-PCR and digital PCR

PubMed Central

Tatematsu, Tsutomu; Suzuki, Ayumi; Oda, Risa; Sakane, Tadashi; Kawano, Osamu; Haneda, Hiroshi; Moriyama, Satoru; Sasaki, Hidefumi; Nakanishi, Ryoichi

2017-01-01

Background A gatekeeper T790M mutation is thought to cause resistance to epidermal growth factor receptor tyrosine kinase inhibitor (EGFR-TKI) treatment. The detection of a 2nd mutation is important for planning the next therapy when patients acquire resistance to the first line EGFR-TKI. Methods We used a competitive allele-specific polymerase chain reaction (CAST-PCR) to analyze the incidence and clinical significance of T790M mutations in 153 lung adenocarcinomas with EGFR-activating mutations. To increase the sensitivity and specificity of the detection of T790M mutations, we subjected 20 of the 153 cases to a digital PCR. The genomic DNAs were extracted from frozen, surgically resected tumor tissue specimens. Results The CAST-PCR detected T790M mutations in 45 (29.4%) of the 153 cases. The analytical sensitivity in the detection T790M mutations was 0.13–2.65% (average 0.27%, median 0.20%). In contrast, the digital PCR, detected T790M mutations in 8 (40%) out of 20 cases. Conclusions Our study shows that the pretreatment incidence of T790M mutation was less than that reported in previous studies. In order to clinically use pretreatment EGFR T790M mutation identification method, we should clarify the adequate methods and tissue preserved status. PMID:28932544

Feasibility study of current pulse induced 2-bit/4-state multilevel programming in phase-change memory

NASA Astrophysics Data System (ADS)

Liu, Yan; Fan, Xi; Chen, Houpeng; Wang, Yueqing; Liu, Bo; Song, Zhitang; Feng, Songlin

2017-08-01

In this brief, multilevel data storage for phase-change memory (PCM) has attracted more attention in the memory market to implement high capacity memory system and reduce cost-per-bit. In this work, we present a universal programing method of SET stair-case current pulse in PCM cells, which can exploit the optimum programing scheme to achieve 2-bit/ 4state resistance-level with equal logarithm interval. SET stair-case waveform can be optimized by TCAD real time simulation to realize multilevel data storage efficiently in an arbitrary phase change material. Experimental results from 1 k-bit PCM test-chip have validated the proposed multilevel programing scheme. This multilevel programming scheme has improved the information storage density, robustness of resistance-level, energy efficient and avoiding process complexity.

Meningitis due to ampicillin-and chloramphenicol-resistant Haemophilus influenzae type b in Canada. Case report and review

PubMed Central

Kabani, Amin; Joffe, Ari; Cadrain, Gisele; Jadavji, Taj

1990-01-01

The first report of a case of ampicillin- and chloramphenicol-resistant Haemophilus influenzae type b invasive infection in Canada is described in a four-month-old male with meningitis. He was treated with cefotaxime 200 mg/kg/day divided every 6 h and dexamethasone 0.6 mg/kg/day divided every 6 h, eventually recovering after a complicated course. Follow-up at 21 months showed mild to moderate global developmental delay. While chloramphenicol resistance is rare in North America, a case of meningitis initially unresponsive to ampicillin and chloramphenicol must be considered suspect for resistance. Third generation cephalosporins should be used for resistant cases. PMID:22553448

Evaluation of efficiency of nested multiplex allele-specific PCR assay for detection of multidrug resistant tuberculosis directly from sputum samples.

PubMed

Mistri, S K; Sultana, M; Kamal, S M M; Alam, M M; Irin, F; Nessa, J; Ahsan, C R; Yasmin, M

2016-05-01

For an effective control of tuberculosis, rapid detection of multidrug resistant tuberculosis (MDR-TB) is necessary. Therefore, we developed a modified nested multiplex allele-specific polymerase chain reaction (MAS-PCR) method that enables rapid MDR-TB detection directly from sputum samples. The efficacy of this method was evaluated using 79 sputum samples collected from suspected tuberculosis patients. The performance of nested MAS-PCR method was compared with other MDR-TB detection methods like drug susceptibility testing (DST) and DNA sequencing. As rifampicin (RIF) resistance conforms to MDR-TB in greater than 90% cases, only the presence of RIF-associated mutations in rpoB gene was determined by DNA sequencing and nested MAS-PCR to detect MDR-TB. The concordance between nested MAS-PCR and DNA sequencing results was found to be 96·3%. When compared with DST, the sensitivity and specificity of nested MAS-PCR for RIF-resistance detection were determined to be 92·9 and 100% respectively. For developing- and high-TB burden countries, molecular-based tests have been recommended by the World Health Organization for rapid detection of MDR-TB. The results of this study indicate that, nested MAS-PCR assay might be a practical and relatively cost effective molecular method for rapid detection of MDR-TB from suspected sputum samples in developing countries with resource poor settings. © 2016 The Society for Applied Microbiology.

Helping Parents Cope with Suicide Threats: An Approach Based on Nonviolent Resistance.

PubMed

Omer, Haim; Dolberger, Dan Isaac

2015-09-01

Parent training in nonviolent resistance was adapted to deal with situations of suicide threat by children, adolescents, and young adults. The approach aims at reducing the risk potential and the mutual distress surrounding the threat-interaction. Parent training in nonviolent resistance has been shown to help parents move from helplessness to presence, from isolation to connectedness, from submission to resistance, from escalation to self-control, and from mutual distancing and hostility to care and support. Those emphases can be crucial for the diminution of suicide risk. Parents show good ability to implement the approach and report gains on various areas over and beyond the reduction in suicide threat. A particular advantage is that the method can be used also in cases where the young person threatening suicide is not willing to cooperate. © 2015 Family Process Institute.

The Benefits of Neutering Cats and Dogs: A Conversation

EPA Science Inventory

The castration of a dog or cat can be an emotion laden issue. In many cases it is the best solution for resolving behavior related problems as well as an important method for decreasing pet overpopulation. Sometimes the idea is met with resistance, particularly by some male owner...

Integration of GIS, Electromagnetic and Electrical Methods in the Delimitation of Groundwater Polluted by Effluent Discharge (Salamanca, Spain): A Case Study.

PubMed

Montes, Rubén Vidal; Martínez-Graña, Antonio Miguel; Martínez Catalán, José Ramón; Arribas, Puy Ayarza; Sánchez San Román, Francisco Javier; Zazo, Caridad

2017-11-10

The present work envisages the possible geometry of a contaminated plume of groundwater near hospital facilities by combining GIS (Geographic Information System) and geophysical methods. The rock underlying the soil and thin sedimentary cover of the study area is moderately fractured quartzite, which makes aquifers vulnerable to pollution. The GIS methodology is used to calculate the area that would be affected by the effluent source of residual water, based on algorithms that consider ground surface mapping (slopes, orientations, accumulated costs and cost per distance). Geophysical methods (electromagnetic induction and electric resistivity tomography) use changes in the electrical conductivity or resistivity of the subsurface to determine the geometry of the discharge and the degree of contamination. The model presented would allow a preliminary investigation regarding potential corrective measures.

Integration of GIS, Electromagnetic and Electrical Methods in the Delimitation of Groundwater Polluted by Effluent Discharge (Salamanca, Spain): A Case Study

PubMed Central

Montes, Rubén Vidal; Sánchez San Román, Francisco Javier; Zazo, Caridad

2017-01-01

The present work envisages the possible geometry of a contaminated plume of groundwater near hospital facilities by combining GIS (Geographic Information System) and geophysical methods. The rock underlying the soil and thin sedimentary cover of the study area is moderately fractured quartzite, which makes aquifers vulnerable to pollution. The GIS methodology is used to calculate the area that would be affected by the effluent source of residual water, based on algorithms that consider ground surface mapping (slopes, orientations, accumulated costs and cost per distance). Geophysical methods (electromagnetic induction and electric resistivity tomography) use changes in the electrical conductivity or resistivity of the subsurface to determine the geometry of the discharge and the degree of contamination. The model presented would allow a preliminary investigation regarding potential corrective measures. PMID:29125556

Antianaerobic Antimicrobials: Spectrum and Susceptibility Testing

PubMed Central

Wexler, Hannah M.; Goldstein, Ellie J. C.

2013-01-01

SUMMARY Susceptibility testing of anaerobic bacteria recovered from selected cases can influence the choice of antimicrobial therapy. The Clinical and Laboratory Standards Institute (CLSI) has standardized many laboratory procedures, including anaerobic susceptibility testing (AST), and has published documents for AST. The standardization of testing methods by the CLSI allows comparisons of resistance trends among various laboratories. Susceptibility testing should be performed on organisms recovered from sterile body sites, those that are isolated in pure culture, or those that are clinically important and have variable or unique susceptibility patterns. Organisms that should be considered for individual isolate testing include highly virulent pathogens for which susceptibility cannot be predicted, such as Bacteroides, Prevotella, Fusobacterium, and Clostridium spp.; Bilophila wadsworthia; and Sutterella wadsworthensis. This review describes the current methods for AST in research and reference laboratories. These methods include the use of agar dilution, broth microdilution, Etest, and the spiral gradient endpoint system. The antimicrobials potentially effective against anaerobic bacteria include beta-lactams, combinations of beta-lactams and beta-lactamase inhibitors, metronidazole, chloramphenicol, clindamycin, macrolides, tetracyclines, and fluoroquinolones. The spectrum of efficacy, antimicrobial resistance mechanisms, and resistance patterns against these agents are described. PMID:23824372

Tailings dams stability analysis using numerical modelling of geotechnical and geophysical data

NASA Astrophysics Data System (ADS)

Mihai, S.; Zlagnean, M.; Oancea, I.; Petrescu, A.

2009-04-01

Methods for monitoring seepage and detecting internal erosion are essential for the safety evaluation of embankment dams. Internal erosion is one of the major reasons for embankment dam failures, and there are thousands of large tailings dams and waste-rock dumps in the world that may pe considered as hotspots for environmental impact. In this research the geophysical survey works were performed on Cetatuia 2 tailings dam. Electrical resistivity imaging (ERI) method was able to detect spatially anomalous zones inside the embankment dam. These anomalies are the results of internal erosion phenomena which may progressing inside the dam and is difficult to detect by conventional methods. Data aquired by geophysical survey together with their interpretations were used in the numerical model for slope stability assessment. The final results show us the structural weakness induced by the presence of internal erosion elements especially for seismic loading case. This research methodology may be also available for tailings dam monitoring purposes. Electrical Rezistivity Imaging (ERI) was performed on Cetatuia 2 dam at the Uranium Milling Plant Feldioara, in order to map areas with lateral and vertical changes in resistivity. The electrodes are connected to an automated computer operated switch box that selects the 4 electrodes to be used. A computer controls the switch box and the measuring device, and runs a program that selects the electrodes, makes the measurement, and stores the measurement. For inversion processing procedures was used Res2Din software. The measured resistivity were plotted by the pseudo section contouring method. There are five resistivity pseudosections obtained from the Cetatuia 2 tailings dam during the october 2007 measurements. Four transversal profiles trans1 to trans4 are perpendicular to the berms and the longitudinal one long1 is placed along dam's crest. The high resistivities near the berms surfaces corresponds to unsaturated fill materials and the low resistivities near the crest correspond to water saturated material. The resistivities values greater then 80 ohm.m may be explained by some error obtained for that inversion model. Profiles trans3 and trans4 were measured on perpendicular directions to berm alignment and show two distinct zones. The upward low resistivities zone correspond to water saturated materials especially from the compacted clay dam's core and the downward high resistivities zone belongs to unsaturated fill materials. The boundary between high and low resistivity at the depth of about 5 to 7 meters shows the groundwater level. The continuation of the high resistivity zones towards the end of the profile trans3, which is different from other profiles is probably due to the presence of dry coarse materials in shallow depth correspondingly to sandy clay. The sand fractions from the clay matrix may be affected by internal erosional phenomena, due to seepage currents that overpassed the material critical gradient. In this case the relative high resistivities values were considered as a presumptive erosional pattern. This profile was considered for the slope stability finite element modelling. The profile long1 which is placed along dam's crest is the longest profiles and extends up to nearly 420 m. The boundary between high and low resistivity at the depth of about 4 to 8 meters shows the groundwater across the dam core. The central part of the profile (about meter 200) shows the same relative high resistivities that occurred on transversal profile trans3. Resistivity data was used for building the 3D electrical resistivity model. The water saturated materials have locations very close to dam's crest (resistivity values usually lower then 10 ohm.m) and on both dam's arms. The groundwater levels were confirmed by the piezometric measurements. Electrical Rezistivity Imaging method had the possibility to show the most important disturbant elements that in certain conditions may weak the dam's state of safety. This study considered the SSR (Shear Strength Reduction) technique for slope stability numerical modelling. In the SSR finite element technique, elasto-plastic strength is assumed for dam's materials and shear strengths are progressively reduced until collapse occurs. Numerical modelling was performed on the most critical profile choosed through analysis of geophysical and geotechnical informational volume achieved by insitu or in laboratory tests. Finite element analysis were considered in two situations: first, before geophysical investigations and second considering the whole informational of data achieved. Both situations were analysed in static and pseudo-static conditions. The factor of safety before geophysical investigations is high enough to describe a stable state of stability even for the seismic load. The total displacement distributions were modified by the presence of internal erosional element giving a high state of instability, especially for the pseudo-static case. These analysis using the finite element method prove the importance of structural disturbance elements that may occure inside the dam body produced by internal erosional processes.

[Comparison of two different real-time PCR systems in postmortem diagnosis of tuberculosis in paraffin-embedded tissues].

PubMed

Yağmur, Gülhan; Albayrak, Nurhan; Daş, Taner; Yıldırım, Muzaffer; Ozgün, Ayşe; Büyük, Yalçın

2014-10-01

Tuberculosis (TB) is one of those infections with high morbidity and mortality in all around the world. Hundreds of people died from this disease without diagnosed or due to resistant strains in Turkey. Therefore, it is important to identify postmortem cases who have died from tuberculosis. Molecular methods have been widely used as well as conventional methods in the diagnosis of tuberculosis. The aim of this study was to compare the two different real-time polymerase chain reaction (Rt-PCR) system in the postmortem diagnosis of Mycobacterium tuberculosis infections in paraffin-embedded tissues. A total of 40 paraffin-embedded tissue samples [lung (n= 35), brain (n= 2), heart (n= 2), lymph node (n= 1)] in which histopathologic findings consistent with TB (necrotizing granulomatous inflammation, gelatinous caseous pneumonia, necrotic fibrous nodul) obtained from 37 autopsy cases (31 male, 6 female; age range: 25-85 yrs) were included in the study. Paraffin-embedded tissues were deparafinized with xylene and ethyl alcohol and then DNA isolation was done with QIAsymphony DSP Virus/Pathogen Midi kit in the QIAsymphony device. DNA amplification process was performed by Rt-PCR using the kit Artus® M. tuberculosis RG-PCR in the Rotor-Gene® Q device (Qiagen, Germany). Likewise, after deparafinization process, samples placed in the cartridge and isolation and Rt-PCR was performed by Xpert® MTB/RIF (Cepheid, USA) system, simultaneosly. Seventeen and 20 out of the 40 paraffin-embedded tissues yielded positive results with Qiagen and Xpert system, respectively. M.tuberculosis DNA was found positive in 13 (32.5%) and negative in 16 (40%) of the samples by both of the systems, exhibiting 72.5% (29/40) of concordance. On the other hand, seven (17.5%) samples that were positive with Xpert system yielded negative result with the Qiagen, while four (10%) samples that were positive with Qiagen yielded negative result with the Xpert system. Of the 20 positive cases detected with Xpert MTB/RIF system, 15 were found rifampicin-susceptible, and three were rifampicin-resistant. In two samples in which M. tuberculosis DNA was low positive, rifampicin resistance could not be detected. The identification of M.tuberculosis infections in postmortem cases will contribute epidemiological data in Turkey. In these cases, effective sampling and diagnosing of M.tuberculosis infections by acid-fast stain and culture methods are crucial. However, in cases without microbiological sampling the detection of M.tuberculosis DNA in paraffin-embedded tissues with PCR, although there are differences between PCR systems has diagnostic value. In conclusion, our data indicated that Xpert MTB/RIF system is more favourable to detect M.tuberculosis DNA in paraffin-embedded tissues, with the advantages of determination of rifampicin resistance, and detection of more positive results within a shorter time.

Integrated use of surface geophysical methods for site characterization — A case study in North Kingstown, Rhode Island

USGS Publications Warehouse

Johnson, Carole D.; Lane, John W.; Brandon, William C.; Williams, Christine A.P.; White, Eric A.

2010-01-01

A suite of complementary, non‐invasive surface geophysical methods was used to assess their utility for site characterization in a pilot investigation at a former defense site in North Kingstown, Rhode Island. The methods included frequency‐domain electromagnetics (FDEM), ground‐penetrating radar (GPR), electrical resistivity tomography (ERT), and multi‐channel analysis of surface‐wave (MASW) seismic. The results of each method were compared to each other and to drive‐point data from the site. FDEM was used as a reconnaissance method to assess buried utilities and anthropogenic structures; to identify near‐surface changes in water chemistry related to conductive leachate from road‐salt storage; and to investigate a resistive signature possibly caused by groundwater discharge. Shallow anomalies observed in the GPR and ERT data were caused by near‐surface infrastructure and were consistent with anomalies observed in the FDEM data. Several parabolic reflectors were observed in the upper part of the GPR profiles, and a fairly continuous reflector that was interpreted as bedrock could be traced across the lower part of the profiles. MASW seismic data showed a sharp break in shear wave velocity at depth, which was interpreted as the overburden/bedrock interface. The MASW profile indicates the presence of a trough in the bedrock surface in the same location where the ERT data indicate lateral variations in resistivity. Depths to bedrock interpreted from the ERT, MASW, and GPR profiles were similar and consistent with the depths of refusal identified in the direct‐push wells. The interpretations of data collected using the individual methods yielded non‐unique solutions with considerable uncertainty. Integrated interpretation of the electrical, electromagnetic, and seismic geophysical profiles produced a more consistent and unique estimation of depth to bedrock that is consistent with ground‐truth data at the site. This test case shows that using complementary techniques that measure different properties can be more effective for site characterization than a single‐method investigation.

Composite construction for nuclear fuel containers

DOEpatents

Cheng, Bo-Ching [Fremont, CA; Rosenbaum, Herman S [Fremont, CA; Armijo, Joseph S [Saratoga, CA

1987-01-01

An improved method for producing nuclear fuel containers of a composite construction having components providing therein a barrier system for resisting destructive action by volatile fission products or impurities and also interdiffusion of metal constituents, and the product thereof. The composite nuclear fuel containers of the method comprise a casing of zirconium or alloy thereof with a layer of copper overlying an oxidized surface portion of the zirconium or alloy thereof.

Problems in diagnosis and treatment of tuberculosis infection.

PubMed

Tsara, V; Serasli, E; Christaki, P

2009-01-01

Tuberculosis is still a major health problem in industrialized countries due to specific socioeconomic factors and there is the growing need of new rapid and accurate diagnostic methods, in order to achieve higher sensitivity and specificity compared to traditional methods of microscopic sputum examination and culture. Such methods, recently introduced, are nucleic acid amplification (NAA) tests, used directly on clinical specimens and blood tests (QuantiFERON-TB, T-SPOT.TB test), measuring the IFN-gamma released by stimulated T cells. Furthermore, new drugs for the disease need to be developed, aiming to better treatment results and to prevention of Multiple Drug Resistance (MDR) cases. Critical aspects in the management of drug resistance cases should be the careful choices of drugs combination, the close follow up of the patients alongside with the patients adherence to therapy. The role of national and international tuberculosis programs is invaluable in TB control and therapy, as well as the collaboration of all the health system departments. However, most of the clinical problems that may arise are addressed by the International Standards for Tuberculosis Care-ISTC and these guidelines should be taken into consideration, at least until future research provides more promising diagnostic and therapeutic modalities for control of the disease.

Geothermal Exploration By Using Time Domain IP Method:Balikesir (Gure) And Canakkale (Geyikli) Cases From Turkey

NASA Astrophysics Data System (ADS)

Tezel, O.; Ozcep, F.

2017-12-01

Geothermal energy is heat derived from the earth. It is the thermal energy contained in the rock and fluid (that fills the fractures and pores within the rock) in the earth's crust. These resources are always at a temperature higher than 20°C. Geothermal energy requires no fuel, and is therefore virtually emission free and independent of fluctuations in fuel cost. Since a geothermal power plant doesn't rely on transient sources of energy, unlike, for example, wind turbines or solar panels, its capacity factor can be quite large. Induced polarization (IP) results at geothermal regions show prominent, extended low resistivity zones. Environmental-IP methods can assist in the assessment of the acid generating potential of waste rock and tailings from mine operations. Resistivity can be used to map contamination plumes. Resistivity and chargeability values were determined using the IP method on geothermal resources in Balikesir Güre (Turkey). In this study we found low resistance values and high chargeability values at the geothermal resource. Finally drilling and IP results were correlated to verify our findings. After the positive results of obtained data, a similar study was carried out in Geyikli Area (Canakkale) and a geothermal resource with 450C temperature of 5 lt/sec was explored at a depth of 970 m.

Evaluation of the BACTEC MGIT 960 SL DST Kit and the GenoType MTBDRsl Test for Detecting Extensively Drug-resistant Tuberculosis Cases.

PubMed

Tekin, Kemal; Albay, Ali; Simsek, Hulya; Sig, Ali Korhan; Guney, Mustafa

2017-10-01

The present study aimed to evaluate the performances of the BACTEC MGIT 960 SL DST kit and the GenoType MTBDRsl test for detecting second-line antituberculosis drug resistance in Multidrug-resistant TB (MDR-TB) cases. Forty-six MDR-TB strains were studied. Second-line antituberculosis drug resistances were detected using the BACTEC MGIT 960 SL DST kit and the GenoType MTBDRsl test. The Middlebrook 7H10 agar proportion method was used as the reference test. The sensitivity and specificity values for the BACTEC MGIT 960 SL DST kit were both 100% for amikacin, kanamycin, capreomycin (4 µg/mL), and ofloxacin; 100% and 95.3%, respectively, for capreomycin (10 µg/mL); and 85.7% and 100%, respectively, for moxifloxacin (0.5 µg/mL). The sensitivity and specificity values for the GenoType MTBDRsl test to detect fluoroquinolone and aminoglycoside/cyclic peptide resistance were 88.9% and 100%, respectively, for ofloxacin and 85.7% and 94.9%, respectively, for moxifloxacin (0.5 µg/mL). The accuracy of the GenoType MTBDRsl assay for kanamycin, capreomycin, ofloxacin, and moxifloxacin was lower than that of the BACTEC MGIT 960 SL DST. The BACTEC MGIT 960 SL DST kit and the GenoType MTBDRsl were successful in detecting second-line antituberculosis drug resistance. Preliminary results of the GenoType MTBDRsl are very valuable for early treatment decisions, but we still recommend additional BACTEC MGIT 960 SL DST kit usage in the routine evaluation of drug-resistant tuberculosis.

Association of Serum Ferritin Levels with Metabolic Syndrome and Insulin Resistance.

PubMed

Padwal, Meghana K; Murshid, Mohsin; Nirmale, Prachee; Melinkeri, R R

2015-09-01

The impact of CVDs and Type II DM is increasing over the last decade. It has been estimated that by 2025 their incidence will double. Ferritin is one of the key proteins regulating iron homeostasis and is a widely available clinical biomarker of iron status. Some studies suggest that prevalence of atherosclerosis and insulin resistance increases significantly with increasing serum ferritin. Metabolic syndrome is known to be associated with increased risk of atherosclerosis as well as insulin resistance. The present study was designed to explore the association of serum ferritin levels with metabolic syndrome and insulin resistance. The present study was prospective, cross sectional. The study protocol was approved by IEC. The study group consisted of 90 participants (50 cases of metabolic syndrome and 40 age and sex matched controls). Diagnosis of metabolic syndrome was done as per NCEP ATP III criteria. Estimation of serum Ferritin and Insulin was done by Chemiluminescence Immunoassay (CLIA) while Glucose by Glucose Oxidase and Peroxidase (GOD-POD) method. Insulin Resistance was calculated by HOMA IR score. Data obtained was statistically analysed by using student t-test. We found statistically significant rise in the levels of serum ferritin (p=<0.001), glucose (p=<0.001), insulin (p=<0.001) and HOMA IR score (p=<0.0001) in cases of metabolic syndrome as compared with controls. High serum ferritin levels though within normal range are significantly associated with both metabolic syndrome and insulin resistance.

Flow resistance in open channels with fixed movable bed

USGS Publications Warehouse

Simoes, Francisco J.

2010-01-01

In spite of an increasingly large body of research by many investigators, accurate quantitative prediction of open channel flow resistance remains a challenge. In general, the relations between the elements influencing resistance (turbulence, boundary roughness, and channel shape features, such as discrete obstacles, bars, channel curvature, recirculation areas, secondary circulation, etc.) and mean flow variables are complex and poorly understood. This has resulted in numerous approaches to compute friction using many and diverse variables and equally diverse prescriptions for their use. In this paper, a new resistance law for surface (grain) resistance, the resistance due to the flow viscous effects on the channel boundary roughness elements, is presented for the cases of flow in the transition (5 < Re* <70) and fully rough (Re* ≥ 70) turbulent flow regimes, where Re* is the Reynolds number based on shear velocity and sediment particle mean diameter. It is shown that the new law is sensitive to bed movement without requiring previous knowledge of sediment transport conditions. Comparisons between computation and measurements, as well as comparisons with other well-known existing roughness predictors, are presented to demonstrate its accuracy and range of application. It is shown that the method accurately predicts total friction losses in channels and natural rivers with plane beds, regardless of sediment transport conditions. This work is useful to hydraulic engineers involved with the derivation of depth-discharge relations in open channel flow and with the estimation of sediment transport rates for the case of bedload transport.

Sharp Boundary Inversion of 2D Magnetotelluric Data using Bayesian Method.

NASA Astrophysics Data System (ADS)

Zhou, S.; Huang, Q.

2017-12-01

Normally magnetotelluric(MT) inversion method cannot show the distribution of underground resistivity with clear boundary, even if there are obviously different blocks. Aiming to solve this problem, we develop a Bayesian structure to inverse 2D MT sharp boundary data, using boundary location and inside resistivity as the random variables. Firstly, we use other MT inversion results, like ModEM, to analyze the resistivity distribution roughly. Then, we select the suitable random variables and change its data format to traditional staggered grid parameters, which can be used to do finite difference forward part. Finally, we can shape the posterior probability density(PPD), which contains all the prior information and model-data correlation, by Markov Chain Monte Carlo(MCMC) sampling from prior distribution. The depth, resistivity and their uncertainty can be valued. It also works for sensibility estimation. We applied the method to a synthetic case, which composes two large abnormal blocks in a trivial background. We consider the boundary smooth and the near true model weight constrains that mimic joint inversion or constrained inversion, then we find that the model results a more precise and focused depth distribution. And we also test the inversion without constrains and find that the boundary could also be figured, though not as well. Both inversions have a good valuation of resistivity. The constrained result has a lower root mean square than ModEM inversion result. The data sensibility obtained via PPD shows that the resistivity is the most sensible, center depth comes second and both sides are the worst.

Changing Patterns in Enteric Fever Incidence and Increasing Antibiotic Resistance of Enteric Fever Isolates in the United States, 2008–2012

PubMed Central

Date, Kashmira A.; Newton, Anna E.; Medalla, Felicita; Blackstock, Anna; Richardson, LaTonia; McCullough, Andre; Mintz, Eric D.; Mahon, Barbara E.

2016-01-01

Background Enteric fever in the United States has been primarily associated with travel and with worrisome changes in global patterns of antimicrobial resistance. We present the first comprehensive report of National Typhoid and Paratyphoid Fever Surveillance System (NTPFS) data for a 5-year period (2008–2012). Methods We reviewed data on laboratory-confirmed cases reported to NTPFS, and related antimicrobial susceptibility results of Salmonella Typhi and Paratyphi A isolates sent for testing by participating public health laboratories to the Centers for Disease Control and Prevention’s National Antimicrobial Resistance Monitoring System laboratory. Results During 2008–2012, 2341 enteric fever cases were reported, 80% typhoid and 20% paratyphoid A. The proportion caused by paratyphoid A increased from 16% (2008) to 22% (2012). Foreign travel within 30 days preceding illness onset was reported by 1961 (86%) patients (86% typhoid and 92% paratyphoid A). Travel to southern Asia was common (82% for typhoid, 97% for paratyphoid A). Among 1091 (58%) typhoid and 262 (56%) paratyphoid A isolates tested for antimicrobial susceptibility, the proportion resistant to nalidixic acid (NAL-R) increased from 2008 to 2012 (Typhi, 60% to 68%; Paratyphi A, 91% to 94%). Almost all NAL-R isolates were resistant or showed decreased susceptibility to ciprofloxacin. Resistance to at least ampicillin, chloramphenicol, and trimethoprim-sulfamethoxazole (multidrug resistant [MDR]) was limited to Typhi isolates, primarily acquired in southern Asia (13%). Most MDR isolates were also NAL-R. Conclusions Enteric fever in the United States is primarily associated with travel to southern Asia, and increasing resistance is adding to treatment challenges. A bivalent typhoid and paratyphoid vaccine is needed. PMID:27090993

Role of argon laser as an adjunctive therapy for treatment of resistant infected corneal ulcers

PubMed Central

Khater, Mohammad M; Selima, Adel A; El-Shorbagy, Mohammad S

2014-01-01

Purpose To evaluate the role of argon laser as an adjunctive therapy in ten patients with resistant infected corneal ulcers with or without hypopyon. Methods The study included 20 patients, split into two groups of ten, with resistant infected corneal ulcers with or without hypopyon. One group was considered as the control group and treated with local and systemic specific antimicrobial drugs guided with culture and sensitivity tests. The other group started with the same specific therapy as the control group for 1 week with no obvious improvement and then was further treated with argon laser. The ten patients in the control group included five cases of fungal ulcers, three mixed (fungal and bacterial) ulcers, and two viral ulcers. The ten patients in the other group included three cases of fungal ulcers, three mixed (fungal and viral) ulcers, three viral ulcers, and one bacterial ulcer as proven with microbial culture and sensitivity tests. Eight cases of the control group and seven cases of the other group were associated with hypopyon. Before laser treatment, a drop of benoxinate hydrochloride 0.4% and a single drop of fluorescein sodium 0.25% were instilled. Argon laser irradiation of the affected cornea was performed using an argon 532 nm wavelength (Carl Zeiss LSL 532s AG; Carl Zeiss Meditec AG, Jena, Germany). A spot size of 500 μm, pulse duration of 0.2 seconds, and power of 900 mW were used. All cases were followed up for 3 months after healing was achieved. Results During the first 4 weeks after laser treatment, all patients showed complete healing of the epithelial defect and resolution of stromal infiltration with no adverse effects. In the control group, four cases needed an amniotic membrane graft due to thinning and the other six cases were healed in a duration that ranged from 3 to 7 weeks. Conclusion Argon laser phototherapy is useful as an adjunctive treatment for resistant infected corneal ulcers. More cases are needed to get more reliable results and to confirm our findings. PMID:24920878

Factors related to successful treatment of drug-resistance tuberculosis in H. Adam Malik hospital, Medan, Indonesia

NASA Astrophysics Data System (ADS)

Manurung, M. P. F.; Siagian, P.; Sinaga, B. Y. M.; Mutiara, E.

2018-03-01

The number of drug-resistant TB cases keeps increasing for over the years. Drug-resistant TB is adifficult case because of the treatment, many side effects, more expensive, and less satisfactory results. This study is a retrospective cohort design aimed to determine the factors influencing the success of TB drug resistance treatment at H. Adam Malik Hospital during 2012–2015. The number of confirmed patients with drug-resistant TB was 223 people, 153 male, and 70 female. Two factors have been found to affect the treatment outcomes significantly, age and resistance pattern (P<0.05). Patients aged <50 years old have 2.73 times greater chance of recovery than patients aged ≥50 years old. Based on resistance pattern, patients with rifampicin resistant or poly-resistant would be 6.4 times more likely to recover compared with pre-XDR patients. There was no significant difference in the success rate of treatment among MDR patients compared with rifampicin resistant or poly-resistant cases. Age and resistance pattern has been proved to influence the success of drug-resistant TB treatment.

Cholera Outbreaks in Nigeria Are Associated with Multidrug Resistant Atypical El Tor and Non-O1/Non-O139 Vibrio cholerae

PubMed Central

Marin, Michel A.; Thompson, Cristiane C.; Freitas, Fernanda S.; Fonseca, Erica L.; Aboderin, A. Oladipo; Zailani, Sambo B.; Quartey, Naa Kwarley E.; Okeke, Iruka N.; Vicente, Ana Carolina P.

2013-01-01

Background The current millennium has seen a steep rise in the number, size and case-fatalities of cholera outbreaks in many African countries. Over 40,000 cases of cholera were reported from Nigeria in 2010. Variants of Vibrio cholerae O1 El Tor biotype have emerged but very little is known about strains causing cholera outbreaks in West Africa, which is crucial for the implementation of interventions to control epidemic cholera. Methodology/Principal Findings V. cholerae isolates from outbreaks of acute watery diarrhea in Nigeria from December, 2009 to October, 2010 were identified by standard culture methods. Fifteen O1 and five non-O1/non-O139 strains were analyzed; PCR and sequencing targeted regions associated with virulence, resistance and biotype were performed. We also studied genetic interrelatedness among the strains by multilocus sequence analysis and pulsed-field gel electrophoresis. The antibiotic susceptibility was tested by the disk diffusion method and E-test. We found that multidrug resistant atypical El Tor strains, with reduced susceptibility to ciprofloxacin and chloramphenicol, characterized by the presence of the SXT element, and gyrA Ser83Ile/parC Ser85Leu alleles as well CTX phage and TCP cluster characterized by rstR ElTor, ctxB-7 and tcpA CIRS alleles, respectively, were largely responsible for cholera outbreaks in 2009 and 2010. We also identified and characterized a V. cholerae non-O1/non-O139 lineage from cholera-like diarrhea cases in Nigeria. Conclusions/Significance The recent Nigeria outbreaks have been determined by multidrug resistant atypical El Tor and non-O1/non-O139 V. cholerae strains, and it seems that the typical El Tor, from the beginning of seventh cholera pandemic, is no longer epidemic/endemic in this country. This scenario is similar to the East Africa, Asia and Caribbean countries. The detection of a highly virulent, antimicrobial resistant lineage in Nigeria is worrisome and points to a need for vaccine-based control of the disease. This study has also revealed the putative importance of non-O1/non-O139 V. cholerae in diarrheal disease in Nigeria. PMID:23459673

Human infections due to Staphylococcus pseudintermedius, an emerging zoonosis of canine origin: report of 24 cases.

PubMed

Somayaji, R; Priyantha, M A R; Rubin, J E; Church, D

2016-08-01

Staphylococcus pseudintermedius has been recently identified as a novel species within the genus Staphylococcus, and is commonly associated with infections in dogs. Currently, there are few reports of human infections due to this bacterium. To use a population-based approach to describe the characteristics of human S. pseudintermedius infections in a large Canadian healthcare region. All adult cases aged ≥18 years identified at a large regional laboratory from April 1, 2013 to April 1, 2015 who had at least one positive culture for S. pseudintermedius were retrospectively reviewed. A combination of phenotypic methods, mass spectrometry (i.e., MALDI-TOF), and cpn60 sequencing were used to identify S. pseudintermedius. Chart review was conducted, and cases were analysed descriptively. Twenty-seven isolates of S. pseudintermedius from 24 human cases were included for analysis. 58.3% were male with median age of 61 years (IQR 55-70.5). Most patients [22 (92.1%)] had confirmed contact with dogs at time of infection. S. pseudintermedius was isolated in 18 cases (75.0%) of skin and soft tissue infections (SSTI), and 2 invasive cases (8.3%) including a prosthetic joint and bloodstream infection. The other 4 patients were considered to be colonized (skin - 3; lung - 1). Methicillin resistance was identified in 3 cases with 6 total isolates (22.2%); multi-drug resistance was also demonstrated commonly. S. pseudintermedius is most commonly associated with SSTIs in humans. Transmission probably occurs from a pet dog. Species-level identification of S. pseudintermedius is important due to the high prevalence of antibiotic resistance, particularly to methicillin. Copyright © 2016 Elsevier Inc. All rights reserved.

Estimating the number of human cases of ceftiofur-resistant Salmonella enterica serovar Heidelberg in Québec and Ontario, Canada.

PubMed

Otto, Simon J G; Carson, Carolee A; Finley, Rita L; Thomas, M Kate; Reid-Smith, Richard J; McEwen, Scott A

2014-11-01

A stochastic model was used to estimate the number of human cases of ceftiofur-resistant Salmonella enterica serovar Heidelberg in Québec and Ontario attributable to chicken consumption and excess cases attributable to human prior antimicrobial consumption. The annual mean incidence of S. Heidelberg (Québec/Ontario) decreased from 70/62 cases per 100 000 in 2004 to 29/30 cases per 100 000 in 2007 (Québec)/2008 (Ontario), increasing to 59/45 cases per 100 000 in 2011. The annual mean incidence of ceftiofur-resistant cases from chicken decreased from 8/7 cases per 100 000 in 2004 to 1/1 cases per 100 000 in 2007 (Québec)/2008 (Ontario), increasing to 7/5 cases per 100 000 in 2011. The annual mean total number of excess ceftiofur-resistant cases from chicken attributable to human prior antimicrobial consumption (Québec/Ontario) decreased from 71/123 in 2004 to 6/24 in 2007 (Québec)/2008 (Ontario), but increased to 62/91 in 2011. This model will support future work to determine the increased severity, mortality and healthcare costs for ceftiofur-resistant Salmonella Heidelberg infections. These results provide a basis for the evaluation of future public health interventions to address antimicrobial resistance. © The Author 2014. Published by Oxford University Press on behalf of the Infectious Diseases Society of America. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.

SINGLE BUNCH BEAM BREAKUP - A GENERAL SOLUTION.

DOE Office of Scientific and Technical Information (OSTI.GOV)

WANG,J.M.; MANE,S.R.; TOWNE,N.

2000-06-26

Caporaso, Barletta and Neil (CBN) found in a solution to the problem of the single-bunch beam breakup in a linac[1]. However, their method applies only to the case of a beam traveling in a strongly betatron-focused linac under the influence of the resistive wall impedance. We suggest in this paper a method for dealing with the same problem. Our methods is more general; it applies to the same problem under any impedance, and it applies to a linac with or without external betatron focusing.

Continuing clozapine treatment with lithium in schizophrenic patients with neutropenia or leukopenia: brief review of literature with case reports

PubMed Central

Aydin, Memduha; Ilhan, Bilge Cetin; Calisir, Saliha; Yildirim, Seda; Eren, Ibrahim

2016-01-01

Objective: Clozapine is a second-generation antipsychotic used for treatment-resistant schizophrenia. Despite its effectiveness, clozapine is largely underused due to serious side effects such as leukopenia or neutropenia. We aimed to review whether to continue, discontinue or rechallenge clozapine treatment after such haematological side effects. Methods: We reviewed and summarized the literature on the use of clozapine, how to deal with its side effects, and suitable options in case of any haematological problems. Then, we described several cases successfully treated with clozapine and lithium after development of neutropenia or leukopenia Results: We present three patients with treatment-resistant schizophrenia. While they had demonstrated poor response to multiple antipsychotic trials, clozapine was started. Clozapine induced neutropenia; or leukopenia developed in some cases that was successfully reversed after lithium onset. Increased serious side effects related with coprescription of lithium and clozapine were not observed. Conclusion: Lithium increases neutrophil and total white blood cell count as a side effect that may be useful in patients who develop neutropenia or leukopenia while being treated with clozapine. PMID:26913176

Management Options for Reducing the Release of Antibiotics and Antibiotic Resistance Genes to the Environment

PubMed Central

Pruden, Amy; Amézquita, Alejandro; Collignon, Peter; Brandt, Kristian K.; Graham, David W.; Lazorchak, James M.; Suzuki, Satoru; Silley, Peter; Snape, Jason R.; Topp, Edward; Zhang, Tong; Zhu, Yong-Guan

2013-01-01

Background: There is growing concern worldwide about the role of polluted soil and water environments in the development and dissemination of antibiotic resistance. Objective: Our aim in this study was to identify management options for reducing the spread of antibiotics and antibiotic-resistance determinants via environmental pathways, with the ultimate goal of extending the useful life span of antibiotics. We also examined incentives and disincentives for action. Methods: We focused on management options with respect to limiting agricultural sources; treatment of domestic, hospital, and industrial wastewater; and aquaculture. Discussion: We identified several options, such as nutrient management, runoff control, and infrastructure upgrades. Where appropriate, a cross-section of examples from various regions of the world is provided. The importance of monitoring and validating effectiveness of management strategies is also highlighted. Finally, we describe a case study in Sweden that illustrates the critical role of communication to engage stakeholders and promote action. Conclusions: Environmental releases of antibiotics and antibiotic-resistant bacteria can in many cases be reduced at little or no cost. Some management options are synergistic with existing policies and goals. The anticipated benefit is an extended useful life span for current and future antibiotics. Although risk reductions are often difficult to quantify, the severity of accelerating worldwide morbidity and mortality rates associated with antibiotic resistance strongly indicate the need for action. PMID:23735422

Bloodstream infections in patients with hematological malignancies: which is more fatal – cancer or resistant pathogens?

PubMed Central

Gedik, Habip; Şimşek, Funda; Kantürk, Arzu; Yildirmak, Taner; Arica, Deniz; Aydin, Demet; Demirel, Naciye; Yokuş, Osman

2014-01-01

Background The primary objective of this study was to report the incidence of bloodstream infections (BSIs) and clinically or microbiologically proven bacterial or fungal BSIs during neutropenic episodes in patients with hematological malignancies. Methods In this retrospective observational study, all patients in the hematology department older than 14 years who developed febrile neutropenia during chemotherapy for hematological cancers were evaluated. Patients were included if they had experienced at least one neutropenic episode between November 2010 and November 2012 due to chemotherapy in the hematology ward. Results During 282 febrile episodes in 126 patients, 66 (23%) episodes of bacteremia and 24 (8%) episodes of fungemia were recorded in 48 (38%) and 18 (14%) patients, respectively. Gram-negative bacteria caused 74% (n=49) of all bacteremic episodes. Carbapenem-resistant Gram-negative bacteria (n=6) caused 12% and 9% of Gram-negative bacteremia episodes and all bacteremia episodes, respectively. Carbapenem-resistant Gram-negative bacteria included Acinetobacter baumannii (n=4), Pseudomonas aeruginosa (n=1), and Serratia marcescens (n=1). Culture-proven invasive fungal infection occurred in 24 episodes in 18 cases during the study period, with 15 episodes in ten cases occurring in the first study year and nine episodes in eight cases in the second study year. In 13 of 18 cases (72%) with bloodstream yeast infections, previous azole exposure was recorded. Candida parapsilosis, C. glabrata, and C. albicans isolates were resistant to voriconazole and fluconazole. Conclusion BSIs that occur during febrile neutropenic episodes in hematology patients due to Gram-negative bacteria should be treated initially with non-carbapenem-based antipseudomonal therapy taking into consideration antimicrobial stewardship. Non-azole antifungal drugs, including caspofungin and liposomal amphotericin B, should be preferred as empirical antifungal therapy in the events of possible or probable invasive fungal infections with an absence of pulmonary findings due to increase azole resistance. PMID:25258539

Antibiotic resistance and molecular characterization of shigella isolates recovered from children aged less than 5 years in Manhiça, Southern Mozambique.

PubMed

Vubil, Delfino; Balleste-Delpierre, Clara; Mabunda, Rita; Acácio, Sozinho; Garrine, Marcelino; Nhampossa, Tacilta; Alonso, Pedro; Mandomando, Inacio; Vila, Jordi

2018-06-01

The objective of this study was to assess antibiotic resistance and the molecular epidemiology of shigella isolates from a case-control study of diarrhoea, conducted from 2007 to 2012 in children aged less than 5 years in Manhiça district, southern Mozambique. All isolates were tested for antimicrobial susceptibility using the disc diffusion method. Polymerase chain reaction was used to detect different molecular mechanisms of antibiotic resistance. Serotyping was performed using specific antisera. The clonal relationship of Shigella flexneri and Shigella sonnei was assessed by pulsed-field gel electrophoresis (PFGE). Of the 67 shigella isolates analysed, 59 were diarrhoeal cases and eight were controls. S. flexneri (70.1%; 47/67) was the most common species, followed by S. sonnei (23.9%; 16/67). The most prevalent S. flexneri serotypes were 2a (38.3%; 18/47), 6 (19.2%; 9/47) and 1b (14.9%; 7/47). High rates of antimicrobial resistance were observed for trimethoprim-sulfametoxazole (92.5%; 62/67), tetracycline (68.7%; 46/67), chloramphenicol (53.7%; 36/67) and ampicillin (50.7%; 34/67). Multi-drug resistance (MDR) was present in 55.2% (37/67) of the isolates and was associated with a case fatality rate of 8.1% (3/37). PFGE revealed 22 clones (16 S. flexneri and 6 S. sonnei), among which P1 (31.9%; 15/47), P9 (17%; 8/47) and P2 (10.6%; 5/47) were the most prevalent clones of S. flexneri. In conclusion, S. flexneri was the most prevalent species, with MDR isolates mainly belonging to three specific clones (P1, P9 and P2). The case fatality rate observed among MDR isolates is a matter of concern, indicating the need for appropriate treatment. Copyright © 2018 Elsevier B.V. and International Society of Chemotherapy. All rights reserved.

Nasal carriage of Methicillin- and Mupirocin-resistant S. aureus among health care workers in a tertiary care hospital.

PubMed

Agarwal, Loveleena; Singh, Amit Kumar; Sengupta, Chandrim; Agarwal, Amitabh

2015-01-01

Methicillin-resistant Staphylococcus aureus (MRSA) ranks top among the nosocomial pathogens. Nasal formulation of mupirocin is found to eradicate MRSA from colonized individuals, but the emergence of resistant strains is a matter of concern. Nasal swabs were collected from 200 health care workers (HCWs) who were screened for MRSA. Kirby-Bauer disc diffusion method was used to perform antibiotic susceptibility test. MRSA detection was done using a cefoxitin 30 µg disc and interpreted according to the Clinical and Laboratory Standards Institute guidelines. Determination of mupirocin resistance was performed using Epsilometer test (E-test). About 14% of HCWs showed nasal carriage of MRSA. Nursing orderlies were the predominant carriers. E-test showed four mupirocin resistant isolates. The antibiogram of the MRSA isolates revealed the higher resistance to antibiotics as compared to methicillin-sensitive Staphylococcus aureus. All the MRSA isolates were sensitive to linezolid. HCWs in our hospital showed high nasal carriage rate of MRSA, particularly the nursing orderlies which is statistically significant. It is advisable to detect mupirocin resistance among the isolates obtained from the HCWs so that in case of resistance, alternative treatment should be sought.

Direct Detection by the Xpert MTB/RIF Assay and Characterization of Multi and Poly Drug-Resistant Tuberculosis in Guinea-Bissau, West Africa

PubMed Central

Ponce, Gema; Sanca, Lilica; Mané, Morto; Armada, Ana; Machado, Diana; Vieira, Fina; Gomes, Victor F.; Martins, Elisabete; Colombatti, Raffaella; Riccardi, Fabio; Perdigão, João; Sotero, Joana; Portugal, Isabel; Couto, Isabel; Atouguia, Jorge; Rodrigues, Amabélia; Viveiros, Miguel

2015-01-01

Background This study aimed to evaluate the usefulness of the Xpert MTB/RIF assay for the rapid direct detection of M. tuberculosis complex (MTBC) strains and rifampicin resistance associated mutations in a resource-limited setting such as Guinea-Bissau and its implications in the management of tuberculosis (TB) and drug resistant tuberculosis, complementing the scarce information on resistance and genotypic diversity of MTBC strains in this West African country. Methods and Results This cross-sectional prospective study included 100 consecutive TB patients with positive acid-fast smears at two months of anti-tuberculosis treatment or in a re-treatment situation, between May and December 2012. Resistance to rifampicin was detected using the GeneXpert system and the Xpert MTB/RIF assay. MTBC isolates obtained with the BACTEC MGIT 960 system were tested for susceptibility to first- and second-line anti-tuberculosis drugs. Overall, the prevalence of multidrug-resistant tuberculosis (MDR-TB) was found to be 9 cases. Of these, 67% (6 patients) of confirmed MDR-TB cases had no past history of TB treatment and 33% (3 patients) were previously treated cases. Extensively drug-resistant TB was not found. Molecular typing of the MDR-TB strains revealed recent transmission patterns of imported MDR strains. Conclusions The Xpert MTB/RIF assay was reliable for the detection of rifampicin resistant MTBC strains directly from sputum samples of patients undergoing first-line treatment for two months, being more trustworthy than the simple presence of acid-fast bacilli in the smear. Its implementation is technically simple, does not require specialized laboratory infrastructures and is suitable for resource-limited settings when a regular source of electricity and maintenance is available as well as financial and operation sustainability is guaranteed by the health authorities. A high prevalence of MDR-TB among patients at risk of MDR-TB after two months of first-line treatment was found, in support of the WHO recommendations for its use in the management of this risk group. PMID:26017968

A Huge Morel-Lavallée Lesion Treated Using a Quilting Suture Method: A Case Report and Review of the Literature.

PubMed

Seo, Bommie F; Kang, In Sook; Jeong, Yeon Jin; Moon, Suk Ho

2014-06-01

The Morel-Lavallée lesion is a collection of serous fluid that develops after closed degloving injuries and after surgical procedures particularly in the pelvis and abdomen. It is a persistent seroma and is usually resistant to conservative methods of treatment such as percutaneous drainage and compression. Various methods of curative treatment have been reported in the literature, such as application of fibrin sealant, doxycycline, or alcohol sclerodhesis. We present a case of a huge recurrent Morel-Lavallée lesion in the lower back and buttock region that was treated with quilting sutures, fibrin sealant, and compression, with a review of the literature. © The Author(s) 2014.

Risk factors and outcomes of imipenem-resistant Acinetobacter bloodstream infection in North-eastern Malaysia

PubMed Central

Deris, Zakuan Zainy; Shafei, Mohd Nazri; Harun, Azian

2011-01-01

Objective To determine the risk factors and outcomes of imipenem-resistant Acinetobacter baumannii (IRAB) bloodstream infection (BSI) cases, since there is very little publication on Acinetobacter baumannii infections from Malaysia. Methods A cross sectional study of 41 cases (73.2%) of imipenem-sensitive Acinetobacter baumanii (ISAB) and 15 cases (26.8%) of IRAB was conducted in a teaching hospital which was located at North-Eastern state of Malaysia. Results There was no independent risk factor for IRAB BSI identified but IRAB BSI was significantly associated with longer bacteraemic days [OR 1.23 (95% CI 1.01, 1.50)]. Although prior use of carbepenems and cephalosporin were higher among IRAB than ISAB group, statistically they were not significant. There was no significant difference in term of outcomes between the two groups. Conclusions Although statistically not significant, this analysis compliments previous publication highlighting the importance of appropriate empiric antibiotic usage in hospital especially carbepenems and need further evaluation with bigger subjects. PMID:23569782

ANTIBIOTICS IN MANAGEMENT OF STAPHYLOCOCCAL ENDOCARDITIS—With Special Reference to Increasing Bacterial Resistance

PubMed Central

Levinson, David C.; Griffith, George C.; Pearson, Harold E.

1951-01-01

Eighteen patients with staphylococcal endocarditis were observed at the Los Angeles County Hospital over a 3-year period (1947-49, inclusive). Twelve died. Bacterial sensitivity studies were carried out in 15 of the cases, and there was resistance to penicillin in ten. Aureomycin was effective in two cases of Staphylococcus aureus endocarditis in which there was no response to penicillin therapy. In one case of Staphylococcus aureus endocarditis the organism was resistant to penicillin and developed increasing resistance to aureomycin. PMID:14812349

Microbiology, infection control and infection related outcome in pediatric patients in an oncology center in Eastern India: Experience from Tata Medical Center, Kolkata.

PubMed

Bhattacharyya, Arpita; Krishnan, Shekhar; Saha, Vaskar; Goel, Gaurav; Bhattacharya, Sanjay; Hmar, Lalawmpuia

2014-01-01

Infection is a major determinant in the outcome of patients with cancer. The aim was to know the epidemiology and outcome of patients with cancer in a cancer care center in Eastern India. Retrospective study of pediatric patients in Tata Medical Center, Kolkata, India. Patients (n = 262) between the age group of 0 and 18 years were reviewed for infections and infection-related outcome (January to December 2013). Modified Wald method was used to determine confidence interval of proportions. Gram-negative bacteria were found to be the most common cause of bloodstream infections (BSIs) (56.4%), followed by Gram-positive cocci (34.5%), and Candida species (9.1%). Carbapenem-resistance was noted among 24% of Gram-negative bacilli (GNB), and extended-spectrum beta-lactamase among 64% of GNBs. A single case of Vibrio cholerae septicemia was also noted. No case of vancomycin-resistant Enterococcus was observed, whereas only two cases of methicillin-resistant Staphylococcus aureus bacteremia (1/3 of all Staphylococcus aureus bacteremia) were detected. Escherichia coli, followed by Klebsiella, Pseudomonas, and Acinetobacter were the predominant organisms detected in BSIs. Among Candida spp. BSIs no resistance to caspofungin, amphotericin B, Voriconazole was noted. Candida tropicalis was the most common isolate, and 1 isolate of Candida glabrata showed dose-dependent sensitivity to fluconazole. Three out of 25 patients died of multi-drug resistant Gram-negative bacteria (12%) in 2013. Seventeen patients had radiological evidence of invasive fungal infections (no mortality was noted). Periodic review of infection-related data, as well as infection control practices, is essential to optimize clinical outcome in patients with pediatric malignancies.

Group A beta-hemolytic streptococcal pharyngitis and carriage rate among Egyptian children: a case-control study.

PubMed

Abd El-Ghany, Shereen Mohamed; Abdelmaksoud, Abeer Ahmed; Saber, Sally Mohamed; Abd El Hamid, Dalia Hosni

2015-01-01

Improper prescription of antibiotics for treatment of acute pharyngitis predisposes to emergence of a carrier state and antibiotic-resistant strains of group A streptococci (GAS). We sought to identify the frequency and antimicrobial susceptibility patterns of group A streptococci among Egyptian children with acute pharyngitis compared with asymptomatic children. Case-control study conducted from September 2013 to August 2014 at a pediatric outpatient clinic in Egypt. Throat swabs were collected from children with acute pharyngitis and from asymptomatic children. We evaluated the accuracy of McIsaac scores and the rapid antigen detection test (RADT) for diagnosis of GAS pharyngitis with throat culture as a reference test. Antimicrobial susceptibility testing of GAS isolates was done by the disc diffusion method. Of 142 children with acute pharyngitis (cases) and 300 asymptomatic children (controls) (age range, 4-16 years), GAS pharyngitis was diagnosed in 60/142 children (42.2%); 48/300 (16%) were found to be carriers. All GAS isolates in the case group were sensitive to penicillin; however, an MIC90 (0.12 micro g/mL) for penicillin is high and an alarming sign. The resistance rate to macrolides was 70% with the cMLSB phenotype in 65.1%. The sensitivities and specificities were 78.3% and 73.2% for McIsaac score of >=4 and 81.1% and 93.9% for RADT, respectively. GAS isolates in the control group were 100% sensitive to penicillin, while 12.5% and 37.5% were resistant to macrolides and tetracycline, respectively. An increased MIC90 for GAS isolates to penicillin is an alarming sign. A high frequency of resistance to macrolides was also observed.

[Clinical observation of apatinib mesylate for the treatment of multi-drug resistant advanced breast cancer].

PubMed

Lü, H M; Zhang, M W; Niu, L M; Zeng, H A; Yan, M

2018-04-24

Objective: To assess the clinical efficacy and adverse outcomes of apatinib mesylate for the treatment of multi-drug resistant advanced breast cancer. Methods: A total of 24 patients with multi-drug-resistant advanced breast cancer who underwent apatinib mesylate treatment were retrospectively analyzed at the Diagnosis and Treatment Center for Breast Cancer of Henan Cancer Hospital. Patients were reviewed every 4 weeks after initial treatment and then every 8 weeks after stable disease. Objective response rate (ORR), progression free survival (PFS), overall survival (OS) , toxicity and adverse outcomes of apatinib mesylate treatment were evaluated by imaging examinations. Results: Totally, 24 patients received apatinib mesylate at a dose of 500 mg QD. Out of the 24 patients treated, complete remission (CR) occurred in none of the patients, partial remission (PR) in 10 cases, stable disease (SD) in 10 cases, progressive disease (PD) in 4 cases, and drug with drawal in 2 cases due to adverse outcomes. Treatment with apatinib mesylate resulted in an ORR of 41.7% (10/24), disease control rate (DCR) of 83.3%, PFS of 4.7 months, and OS of 8.0 months. Adverse outcomes included proteinuria, high blood pressure, fatigue, hand-foot skin reaction (HFSR), hyperbilirubinemia, leukopenia, hair/skin pigmentation decreased. Most of the adverse events were tolerable and can be controlled after symptomatic management. Conclusions: Single-agent apatinib mesylate demonstrated the good short-term efficacy for multi-drug resistant advanced breast cancer in patients who previously underwent multiple line treatment failures. Adverse effects were controllable after symptomatic management. Treatment with apatinib mesylate maybe a viable option when other treatment modalities failed.

New Subtypes and Genetic Recombination in HIV Type 1-Infecting Patients with Highly Active Antiretroviral Therapy in Peru (2008–2010)

PubMed Central

Acuña, Maribel; Gazzo, Cecilia; Salinas, Gabriela; Cárdenas, Fanny; Valverde, Ada; Romero, Soledad

2012-01-01

Abstract HIV-1 subtype B is the most frequent strain in Peru. However, there is no available data about the genetic diversity of HIV-infected patients receiving highly active antiretroviral therapy (HAART) here. A group of 267 patients in the Peruvian National Treatment Program with virologic failure were tested for genotypic evidence of HIV drug resistance at the Instituto Nacional de Salud (INS) of Peru between March 2008 and December 2010. Viral RNA was extracted from plasma and the segments of the protease (PR) and reverse transcriptase (RT) genes were amplified by reverse transcriptase polymerase chain reaction (RT-PCR), purified, and fully sequenced. Consensus sequences were submitted to the HIVdb Genotypic Resistance Interpretation Algorithm Database from Stanford University, and then aligned using Clustal X v.2.0 to generate a phylogenetic tree using the maximum likelihood method. Intrasubtype and intersubtype recombination analyses were performed using the SCUEAL program (Subtype Classification by Evolutionary ALgo-rithms). A total of 245 samples (91%) were successfully genotyped. The analysis obtained from the HIVdb program showed 81.5% resistance cases (n=198). The phylogenetic analysis revealed that subtype B was predominant in the population (98.8%), except for new cases of A, C, and H subtypes (n=4). Of these cases, only subtype C was imported. Likewise, recombination analysis revealed nine intersubtype and 20 intrasubtype recombinant cases. This is the first report of the presence of HIV-1 subtypes C and H in Peru. The introduction of new subtypes and circulating recombinants forms can make it difficult to distinguish resistance profiles in patients and consequently affect future treatment strategies against HIV in this country. PMID:22559065

Risk Factors for Carbapenemase-Producing Carbapenem-Resistant Enterobacteriaceae (CP-CRE) Acquisition Among Contacts of Newly Diagnosed CP-CRE Patients.

PubMed

Schwartz-Neiderman, Anat; Braun, Tali; Fallach, Noga; Schwartz, David; Carmeli, Yehuda; Schechner, Vered

2016-10-01

OBJECTIVE Carbapenemase-producing carbapenem-resistant Enterobacteriaceae (CP-CRE) are extremely drug-resistant pathogens. Screening of contacts of newly identified CP-CRE patients is an important step to limit further transmission. We aimed to determine the risk factors for CP-CRE acquisition among patients exposed to a CP-CRE index patient. METHODS A matched case-control study was performed in a tertiary care hospital in Israel. The study population was comprised of patients who underwent rectal screening for CP-CRE following close contact with a newly identified CP-CRE index patient. Cases were defined as positive tests for CP-CRE. For each case patient, 2 matched controls were randomly selected from the pool of contacts who tested negative for CP-CRE following exposure to the same index case. Bivariate and multivariate analyses were conducted using conditional logistic regression. RESULTS In total, 53 positive contacts were identified in 40 unique investigations (896 tests performed on 735 contacts) between October 6, 2008, and June 7, 2012. bla KPC was the only carbapenemase identified. In multivariate analysis, risk factors for CP-CRE acquisition among contacts were (1) contact with an index patient for ≥3 days (odds ratio [OR], 9.8; 95% confidence interval [CI], 2.0-48.9), (2) mechanical ventilation (OR, 4.1; 95% CI, 1.4-11.9), and (3) carriage or infection with another multidrug-resistant organism (MDRO; OR, 2.6; 95% CI, 1.0-7.1). Among patients who received antibiotics, cephalosporins were associated with a lower risk of acquisition. CONCLUSIONS Patient characteristics (ventilation and carriage of another MDRO) as well as duration of contact are risk factors for CP-CRE acquisition among contacts. The role of cephalosporins requires further study. Infect Control Hosp Epidemiol 2016;1-7.

New subtypes and genetic recombination in HIV type 1-infecting patients with highly active antiretroviral therapy in Peru (2008-2010).

PubMed

Yabar, Carlos Augusto; Acuña, Maribel; Gazzo, Cecilia; Salinas, Gabriela; Cárdenas, Fanny; Valverde, Ada; Romero, Soledad

2012-12-01

HIV-1 subtype B is the most frequent strain in Peru. However, there is no available data about the genetic diversity of HIV-infected patients receiving highly active antiretroviral therapy (HAART) here. A group of 267 patients in the Peruvian National Treatment Program with virologic failure were tested for genotypic evidence of HIV drug resistance at the Instituto Nacional de Salud (INS) of Peru between March 2008 and December 2010. Viral RNA was extracted from plasma and the segments of the protease (PR) and reverse transcriptase (RT) genes were amplified by reverse transcriptase polymerase chain reaction (RT-PCR), purified, and fully sequenced. Consensus sequences were submitted to the HIVdb Genotypic Resistance Interpretation Algorithm Database from Stanford University, and then aligned using Clustal X v.2.0 to generate a phylogenetic tree using the maximum likelihood method. Intrasubtype and intersubtype recombination analyses were performed using the SCUEAL program (Subtype Classification by Evolutionary ALgo-rithms). A total of 245 samples (91%) were successfully genotyped. The analysis obtained from the HIVdb program showed 81.5% resistance cases (n=198). The phylogenetic analysis revealed that subtype B was predominant in the population (98.8%), except for new cases of A, C, and H subtypes (n=4). Of these cases, only subtype C was imported. Likewise, recombination analysis revealed nine intersubtype and 20 intrasubtype recombinant cases. This is the first report of the presence of HIV-1 subtypes C and H in Peru. The introduction of new subtypes and circulating recombinants forms can make it difficult to distinguish resistance profiles in patients and consequently affect future treatment strategies against HIV in this country.

[Clinical characteristics and therapeutic effect of drug-resistant tuberculosis in children].

PubMed

Liao, Q; Tan, S; Zhu, Y; Wan, C M; Deng, S Y; Shu, M

2017-02-02

Objective: To explore the clinical characteristics of drug-resistant tuberculosis (TB) in children and to study the effectiveness of second-line anti-TB therapy for children and to examine the incidence of adverse drug reactions. Method: Retrospective research was conducted. The clinical records of children in West China Second Hospital diagnosed as drug-resistant TB from January 2010 to June 2014 were investigated.The clinical characteristics and risk factors were analyzed retrospectively. Treatment effect at discharge was examined as a short-term outcome indicator to evaluate the effectiveness of second-line anti-TB therapy and the incidence of adverse drug reactions. χ(2) test was used. Result: Forty-six patients were diagnosed as drug-resistant TB in 443 children infected with TB, with a 10.4% resistance rate. The 46 children included 26 male and 20 female patients, aged from one month and 28 days to 17 years and 5 months, with the average age (8.4±4.5) years, >7 to 14 years old patients as the biggest part(25 patients, 54.3%). Among the 46 children, 20 patients(43.5%)had close contact with TB patients, of whom 12 patients (60.0%) contacted with family members (including parents, brothers and sisters and grandparents living together) and 8 patients(40.0%) contacted with patients from outside family (such as relatives or neighbors). Moreover, 11 cases (23.9%) were under initial treatment and 35 cases (76.1%) were retreated.From 2010 to 2014, the number of cases of initial and retreated patients had no significant difference(0 and 1, 1 and 13, 4 and 7, 4 and 11, 2 and 3 cases, χ(2)=3.255, P =0.196). Among retreated patients, 31.4% (11/35) had irregular treatment before.Until discharge, the effective rate was 87.0% (40/46), while the incidence rate of adverse drug reaction was 10.9%(5/46). Conclusion: The therapy for drug-resistant TB is effective and the incidence of adverse drug reaction is relatively low.

High Prevalence of Multidrug-Resistant Tuberculosis, Swaziland, 2009–2010

PubMed Central

Dlamini, Themba; Ascorra, Alexandra; Rüsch-Gerdes, Sabine; Tefera, Zerihun Demissie; Calain, Philippe; de la Tour, Roberto; Jochims, Frauke; Richter, Elvira; Bonnet, Maryline

2012-01-01

In Africa, although emergence of multidrug-resistant (MDR) tuberculosis (TB) represents a serious threat in countries severely affected by the HIV epidemic, most countries lack drug-resistant TB data. This finding was particularly true in the Kingdom of Swaziland, which has the world’s highest HIV and TB prevalences. Therefore, we conducted a national survey in 2009–2010 to measure prevalence of drug-resistant TB. Of 988 patients screened, 420 new case-patients and 420 previously treated case-patients met the study criteria. Among culture-positive patients, 15.3% new case-patients and 49.5% previously treated case-patients harbored drug-resistant strains. MDR TB prevalence was 7.7% and 33.8% among new case-patients and previously treated case-patients, respectively. HIV infection and past TB treatment were independently associated with MDR TB. The findings assert the need for wide-scale intervention in resource-limited contexts such as Swaziland, where diagnostic and treatment facilities and health personnel are lacking. PMID:22260950

Clinical and Drug Resistance Characteristics of New Pediatric Tuberculosis Cases in Northern China.

PubMed

Wang, Ting; Dong, Fang; Li, Qin-Jing; Yin, Qing-Qin; Song, Wen-Qi; Mokrousov, Igor; Jiao, Wei-Wei; Shen, A-Dong

2018-05-09

The aim of this study was to evaluate the clinical features and characteristics of drug resistance in newly diagnosed pediatric tuberculosis (TB) patients in northern China. Mycobacterium tuberculosis isolates were collected from September 2010 to October 2016 at the Beijing Children's Hospital. Patients were divided into two groups (resistant to at least one drug and pan-susceptible) according to drug susceptibility testing (DST) results. A total of 132 new cases, mainly from northern China (87.9%), were included in the study. The median age was 1.9 years (1 month-15 years). Resistance to at least one drug was detected in Mycobacterium tuberculosis isolates from 33 (25%) cases. Eight cases of multidrug-resistant TB (MDR-TB) (6.1%) were detected. The two groups did not differ in clinical presentations (disease site, fever >2 weeks, and cough >2 weeks) or in chest imaging (lesion location, lymphadenitis [mediastinal], and pleural effusion). The rate of Mycobacterium tuberculosis drug resistance in new pediatric TB cases was as high as in the new adult patients surveyed in the national drug resistance survey conducted in 2007. No significant difference was observed in clinical features between patients infected with drug-resistant and drug-susceptible strains. Routine DST is important for prescribing effective antituberculosis treatment regimens.

Integrated Method for Purification and Single-Particle Characterization of Lentiviral Vector Systems by Size Exclusion Chromatography and Tunable Resistive Pulse Sensing.

PubMed

Heider, Susanne; Muzard, Julien; Zaruba, Marianne; Metzner, Christoph

2017-07-01

Elements derived from lentiviral particles such as viral vectors or virus-like particles are commonly used for biotechnological and biomedical applications, for example in mammalian protein expression, gene delivery or therapy, and vaccine development. Preparations of high purity are necessary in most cases, especially for clinical applications. For purification, a wide range of methods are available, from density gradient centrifugation to affinity chromatography. In this study we have employed size exclusion columns specifically designed for the easy purification of extracellular vesicles including exosomes. In addition to viral marker protein and total protein analysis, a well-established single-particle characterization technology, termed tunable resistive pulse sensing, was employed to analyze fractions of highest particle load and purity and characterize the preparations by size and surface charge/electrophoretic mobility. With this study, we propose an integrated platform combining size exclusion chromatography and tunable resistive pulse sensing for monitoring production and purification of viral particles.

Prevalence of macrolide and fluoroquinolone resistance-mediating mutations in Mycoplasma genitalium in five cities in Russia and Estonia

PubMed Central

Shipitsyna, Elena; Rumyantseva, Tatiana; Golparian, Daniel; Khayrullina, Guzel; Lagos, Amaya C.; Edelstein, Inna; Joers, Kai; Jensen, Jörgen S.; Savicheva, Alevtina; Rudneva, Natalia; Sukhanova, Larisa; Kozlov, Roman; Guschin, Alexander

2017-01-01

Background and objective Resistance in the sexually transmitted bacterium Mycoplasma genitalium to all recommended therapeutic antimicrobials have rapidly emerged. However, to date, internationally reported resistance surveillance data for M. genitalium strains circulating in Eastern Europe are entirely lacking. The aim of this study was to estimate the prevalence of macrolide and fluoroquinolone resistance-associated mutations in M. genitalium in four cities in Russia and one in Estonia, 2013–2016. Materials and methods Consecutive urogenital samples found positive for M. genitalium during diagnostic testing were retrospectively analyzed for resistance-associated mutations in the 23S rRNA and parC genes using pyrosequencing and conventional Sanger sequencing, respectively. Results In total, 867 M. genitalium positive samples from 2013–2016 were analyzed. Macrolide resistance-associated mutations were detected in 4.6% of the samples from Russia (0.7–6.8% in different cities) and in 10% of the samples from Estonia. The mutations A2059G and A2058G were highly predominating in both Russia and Estonia, accounting together for 90.9% of the cases positive for nucleotide substitutions in the 23S rRNA gene. The rates of possible fluoroquinolone resistance-associated mutations were 6.2% in Russia (2.5–7.6% in different cities) and 5% in Estonia. The mutations S83I and S83N were the most frequent ones in Russia (24.4% each), whereas D87N highly predominated in Estonia (83.3% of all fluoroquinolone resistance-associated mutations). Approximately 1% of the samples in both countries harbored both macrolide and possible fluoroquinolone resistance-associated mutations, with A2058G and S83I being the most frequent combination (37.5%). Conclusions The prevalence of macrolide and fluoroquinolone resistance-associated mutations in M. genitalium was 4.6% and 6.2%, respectively, in Russia, and 10% and 5%, respectively, in Estonia. Despite the relatively low rates of macrolide and fluoroquinolone resistance in these countries, antimicrobial resistance surveillance and testing for resistance-associated mutations in M. genitalium positive cases would be valuable. PMID:28407014

Multi-Drug-Resistant Klebsiella pneumoniae Pancreatitis: A New Challenge in a Serious Surgical Infection

PubMed Central

Tugal, Derin; Lynch, Melanie; Hujer, Andrea M.; Rudin, Susan; Perez, Federico

2015-01-01

Abstract Background: Klebsiella pneumoniae is an important cause of nosocomial infections, but its role in severe acute pancreatitis (SAP) is not well defined. Few cases of K. pneumoniae associated SAP have been reported. Due to the emergence of extended-spectrum beta-lactamases (ESBLs) and carbapenemases, treatment of multidrug-resistant (MDR) K. pneumoniae presents a challenge. Tigecycline and colistin have gained recent attention for their broad-spectrum antimicrobial activity. Methods: We describe a case of SAP due to K. pneumoniae bearing K. pneumoniae carbapenemase (KPC) treated successfully with colistin plus tigecycline and offer a review of similar experiences published in the literature. Results: The case reported herein required surgical drainage of multiple pancreatic abscesses and treatment with tigecycline and colistin. Our comparative analysis revealed a number of unique features associated with SAP due to K. pneumoniae: 1) underlying pancreatic injury, 2) multiple drug resistance determinants and virulence factors that complicate treatment, and 3) surgical debridement as a requirement for cure. Conclusion: As the prevalence of K. pneumoniae bearing KPC continues to increase in the healthcare setting, SAP caused by this MDR pathogen will become more common. Tigecycline plus colistin was a successful antibiotic regimen for the treatment of SAP due to K. pneumoniae bearing KPC. PMID:24850293

Relationship between insulin sensitivity index and cognitive function in diet-induced insulin resistant rats.

PubMed

Chen, Sisi; Xie, Hao; Wu, Jing; Hong, Hao; Jin, Jianwen; Fang, Jinbo; Huang, Ji; Fu, Ying Zhou; Ji, Hui; Li, Yong Qi; Long, Yan; Xia, Yuan Zheng

2009-06-01

Clinical and animal studies have revealed significant cognitive impairment in type II diabetic subjects. However, whether there is a relationship between insulin resistance and cognitive function is poorly understood. In the present study, we used a high fat diet to induce insulin resistance (IR) in rats, insulin sensitivity index (ISI) (= FINS x FPG/22.5) to assess the extent of insulin resistance and the Morris Water Maze Task to judge cognitive function. The relationship between insulin sensitivity index and cognitive function was determined by analysing the correlation between ISI and the time rat spent in targeted quadrant, as well as between ISI and the times the rat swam across the very point where a platform was previously placed, using Pearson's method. Perfect negative correlation between ISI and cognitive function existed when ISI fell within a certain range, which indicates that insulin resistance is associated with cognitive function impairment in some cases where ISI might be an indicator.

Composite construction for nuclear fuel containers

DOEpatents

Cheng, B. C.; Rosenbaum, H. S.; Armijo, J. S.

1987-04-21

Disclosed is an improved method for producing nuclear fuel containers of a composite construction having components providing therein a barrier system for resisting destructive action by volatile fission products or impurities and also interdiffusion of metal constituents, and the product thereof. The composite nuclear fuel containers of the method comprise a casing of zirconium or alloy thereof with a layer of copper overlying an oxidized surface portion of the zirconium or alloy thereof. 1 fig.

Acinetobacter Species Infections among Navy and Marine Corps Beneficiaries: 2012 Annual Report

DTIC Science & Technology

2013-11-18

with a large number of Infections, have the ability to easily acquire resistance determinants , and quickly develop resistance to multiple antibiotics...have the ability to easily acquire resistance determinants , and quickly develop resistance to multiple antibiotics, leaving few, if any, treatment...resistant (XDR) organisms accounted for 1.3% of DON cases. For non-MDR cases in the DON, providers most commonly prescribed trimethoprim /sulfamethoxazole

Development and Use of Personalized Bacteriophage-Based Therapeutic Cocktails To Treat a Patient with a Disseminated Resistant Acinetobacter baumannii Infection.

PubMed

Schooley, Robert T; Biswas, Biswajit; Gill, Jason J; Hernandez-Morales, Adriana; Lancaster, Jacob; Lessor, Lauren; Barr, Jeremy J; Reed, Sharon L; Rohwer, Forest; Benler, Sean; Segall, Anca M; Taplitz, Randy; Smith, Davey M; Kerr, Kim; Kumaraswamy, Monika; Nizet, Victor; Lin, Leo; McCauley, Melanie D; Strathdee, Steffanie A; Benson, Constance A; Pope, Robert K; Leroux, Brian M; Picel, Andrew C; Mateczun, Alfred J; Cilwa, Katherine E; Regeimbal, James M; Estrella, Luis A; Wolfe, David M; Henry, Matthew S; Quinones, Javier; Salka, Scott; Bishop-Lilly, Kimberly A; Young, Ry; Hamilton, Theron

2017-10-01

Widespread antibiotic use in clinical medicine and the livestock industry has contributed to the global spread of multidrug-resistant (MDR) bacterial pathogens, including Acinetobacter baumannii We report on a method used to produce a personalized bacteriophage-based therapeutic treatment for a 68-year-old diabetic patient with necrotizing pancreatitis complicated by an MDR A. baumannii infection. Despite multiple antibiotic courses and efforts at percutaneous drainage of a pancreatic pseudocyst, the patient deteriorated over a 4-month period. In the absence of effective antibiotics, two laboratories identified nine different bacteriophages with lytic activity for an A. baumannii isolate from the patient. Administration of these bacteriophages intravenously and percutaneously into the abscess cavities was associated with reversal of the patient's downward clinical trajectory, clearance of the A. baumannii infection, and a return to health. The outcome of this case suggests that the methods described here for the production of bacteriophage therapeutics could be applied to similar cases and that more concerted efforts to investigate the use of therapeutic bacteriophages for MDR bacterial infections are warranted.

Determination of the dissipation in superconducting Josephson junctions

DOE Office of Scientific and Technical Information (OSTI.GOV)

Mugnai, D., E-mail: d.mugnai@ifac.cnr.it; Ranfagni, A.; Cacciari, I.

2015-02-07

The results relative to macroscopic quantum tunneling rate, out of the metastable state of Josephson junctions, are examined in view of determining the effect of dissipation. We adopt a simple criterion in accordance to which the effect of dissipation can be evaluated by analyzing the shortening of the semiclassical traversal time of the barrier. In almost all the considered cases, especially those with relatively large capacitance values, the relative time shortening turns out to be about 20% and with a corresponding quality factor Q ≃ 5.5. However, beyond the specific cases here considered, still in the regime of moderate dissipation,more » the method is applicable also to different situations with different values of the quality factor. The method allows, within the error limits, for a reliable determination of the load resistance R{sub L}, the less accessible quantity in the framework of the resistively and capacitively shunted junction model, provided that the characteristics of the junction (intrinsic capacitance, critical current, and the ratio of the bias current to the critical one) are known with sufficient accuracy.« less

Development and Use of Personalized Bacteriophage-Based Therapeutic Cocktails To Treat a Patient with a Disseminated Resistant Acinetobacter baumannii Infection

PubMed Central

Biswas, Biswajit; Gill, Jason J.; Hernandez-Morales, Adriana; Lancaster, Jacob; Lessor, Lauren; Barr, Jeremy J.; Reed, Sharon L.; Rohwer, Forest; Benler, Sean; Segall, Anca M.; Taplitz, Randy; Smith, Davey M.; Kerr, Kim; Kumaraswamy, Monika; Nizet, Victor; Lin, Leo; McCauley, Melanie D.; Strathdee, Steffanie A.; Benson, Constance A.; Pope, Robert K.; Leroux, Brian M.; Picel, Andrew C.; Mateczun, Alfred J.; Cilwa, Katherine E.; Regeimbal, James M.; Estrella, Luis A.; Wolfe, David M.; Henry, Matthew S.; Quinones, Javier; Salka, Scott; Bishop-Lilly, Kimberly A.; Young, Ry; Hamilton, Theron

2017-01-01

ABSTRACT Widespread antibiotic use in clinical medicine and the livestock industry has contributed to the global spread of multidrug-resistant (MDR) bacterial pathogens, including Acinetobacter baumannii. We report on a method used to produce a personalized bacteriophage-based therapeutic treatment for a 68-year-old diabetic patient with necrotizing pancreatitis complicated by an MDR A. baumannii infection. Despite multiple antibiotic courses and efforts at percutaneous drainage of a pancreatic pseudocyst, the patient deteriorated over a 4-month period. In the absence of effective antibiotics, two laboratories identified nine different bacteriophages with lytic activity for an A. baumannii isolate from the patient. Administration of these bacteriophages intravenously and percutaneously into the abscess cavities was associated with reversal of the patient's downward clinical trajectory, clearance of the A. baumannii infection, and a return to health. The outcome of this case suggests that the methods described here for the production of bacteriophage therapeutics could be applied to similar cases and that more concerted efforts to investigate the use of therapeutic bacteriophages for MDR bacterial infections are warranted. PMID:28807909

High Corrosion Resistance Offered by Multi-Walled Carbon Nanotubes Directly Grown Over Mild Steel Substrate

NASA Astrophysics Data System (ADS)

Arora, Sweety; Rekha, M. Y.; Gupta, Abhay; Srivastava, Chandan

2018-02-01

The inert and hydrophobic nature of carbon nanotubes (CNTs) makes them a potential material for corrosion protection coatings. In this work, a uniform coating of multi-walled CNTs (MWCNTs) was formed over a mild steel substrate by direct decomposition of a ferrocene-benzene mixture over the substrate which was kept inside a chemical vapor deposition setup at a temperature of 800°C. The MWCNTs formed over the substrate were characterized using x-ray diffraction, Raman spectroscopy and transmission electron microscopy techniques. Corrosion behavior of the bare and MWCNT-coated mild steel substrate was examined through potentiodynamic polarization and electrochemical impedance spectroscopy methods. A significant improvement in the corrosion resistance in terms of the reduction in corrosion current and corrosion rate and increase in polarization resistance was noted in the case of the MWCNT-coated mild steel plate. Corrosion resistance increased due to MWCNT coating.

Tuberculous otitis media -- a diagnostic dilemma.

PubMed

Bhalla, R K; Jones, T M; Rothburn, M M; Swift, A C

2001-08-01

Tuberculous otitis media can provide a diagnostic challenge even to the most astute and experienced clinician. The rarity of the condition and its propensity to masquerade as commoner otological conditions further delays diagnosis and treatment. We present the case of a 22-year-old female who presented with chronic aural discharge, unilateral hearing loss and recurrent hemifacial paralysis. The paper highlights the difficulty in diagnosis and stresses the need for a high index of suspicion in cases resistant to the common methods of treatment.

[Neonatal meningitis caused by atypical Streptococcus pneumoniae: case report and review].

PubMed

Silva B, Verónica; Castillo F, Felipe; O Reilly F, Paula; Araya B, Isabel; Porte T, Lorena; Ulloa F, M Teresa; Varela A, Carmen; Zamorano R, Juanita

2006-12-01

Streptococcus pneumoniae is a rarely recognized cause of neonatal sepsis and/or meningitis, but it is associated with substantial morbidity and mortality. Traditionally, S. pneumoniae is identified in the laboratory by demonstrating susceptibility to optochin. However, the emergence of optochin-resistant organisms makes definite identification difficult when only phenotypic tests are taken as markers. We present the case of a severe early-onset neonatal meningitis due to an atypical strain of S. pneumoniae. Laboratory methods utilized to certify this species diagnosis are discussed.

Surgical aspects of pulmonary tuberculosis: an update.

PubMed

Dewan, Ravindra Kumar; Pezzella, A Thomas

2016-10-01

Tuberculosis remains a major global medical challenge and concern. In the world's population of over 7.4 billion people, 8.6 million are estimated to be infected with Mycobacterium tuberculosis; another 2.2 billion have latent tuberculosis. There is an annual incidence of 16,000 new cases in the USA and 7-8 million new cases worldwide, of which 440,000 are multidrug-resistant or extensively multidrug-resistant, mainly in developing countries or emerging economies. According to the World Health Organization, the incidence of tuberculosis is 133 cases per 100,000 of the population; 3.3% new cases are drug resistant and 20% are already treated cases. Of the drug-resistant cases, 9.7% are extensively drug-resistant. The annual global mortality attributable to tuberculosis is over 1.3 million people. The association with HIV/AIDS in 430,000 people has compounded the global concern and challenge. This review presents the historical indications for surgical treatment of tuberculosis, reviews the current literature and clinical experience, and collates this into increased awareness and contemporary understanding of the indications and need for surgery in primary active tuberculosis, adjuvant surgical therapy for multidrug-resistant tuberculosis, and the complications of chronic tuberculosis sequelae or previous tuberculosis surgery. © The Author(s) 2016.

Guidelines for the Pharmacotherapy of Schizophrenia in Adults

PubMed Central

Addington, Donald; Honer, William; Ismail, Zahinoor; Raedler, Thomas; Teehan, Michael

2017-01-01

Objective: The present guidelines address the pharmacotherapy of schizophrenia in adults across different stages, phases, and symptom domains. Method: Guidelines were developed using the ADAPTE process, which takes advantage of existing guidelines. Six guidelines were identified for adaptation, with recommendations extracted from each. For those specific to the pharmacotherapy of schizophrenia in adults, a working group selected between guidelines and recommendations to create an adapted guideline. Results: Recommendations can be categorized into 6 areas that include 1) first-episode schizophrenia, 2) acute exacerbation, 3) relapse prevention and maintenance treatment, 4) treatment-resistant schizophrenia, 5) clozapine-resistant schizophrenia, and 6) specific symptom domains. For each category, recommendations are made based on the available evidence, which is discussed and linked to other established guidelines. Conclusions: In most cases, evidence-based recommendations are made that can be used to guide current clinical treatment and decision making. Notably, however, there is a paucity of established evidence to guide treatment decision making in the case of clozapine-resistant schizophrenia, a subsample that represents a sizable proportion of those with schizophrenia. PMID:28703015

Prevalence of anthelmintic resistance on Lithuanian sheep farms assessed by in vitro methods.

PubMed

Kupčinskas, Tomas; Stadalienė, Inga; Šarkūnas, Mindaugas; Riškevičienė, Vita; Várady, Marian; Höglund, Johan; Petkevičius, Saulius

2015-12-16

This study examines the prevalence of drug resistance in gastrointestinal nematodes to macrocyclic lactones (ML) and benzimidazoles (BZ) in Lithuanian sheep using sensitive and precise in vitro methods. The survey was conducted from August 2013 to November 2014. Thirty-three farms with sheep previously treated with BZ and ivermectin (IVM) were included in the study. On 12 farms where only BZ were used, egg hatch discrimination dose testing (EHDDT) was conducted to detect anthelmintic resistance (AR) to BZ. On eight farms where only ML were used, micro agar larval development testing (MALDT) was conducted to detect AR to ivermectin (IVM). On the remaining 13 farms, where both classes of drugs were used, EHDDT and MALDT were both applied to detect multidrug resistance to BZ and IVM. BZ-resistant gastrointestinal nematodes were found on all 25 farms with a previous history of BZ use. High levels of resistance (>40 % of hatching) were recorded on 36 % of these farms, and low levels (<20 % of hatching) on 40 % of farms. IVM-resistant populations were found on 13 out of 21 sheep farms using this drug. Of these 13 farms with AR to IVM, low levels of resistance (<30 % development) were recorded on 84.6 % of farms and high levels (>30 % development) on 15.4 % of farms. No resistance to IVM was recorded on 38.1 % of farms. Multi-drug resistance was detected on five farms out of 13 (38.5 %) using both classes of drugs. The present study demonstrates the existence of AR to BZ and ML on Lithuanian sheep farms thus confirming results in a previous in vivo study. Cases of multi-drug resistance were recorded in the present study and require further consideration. An appropriate strategy for anthelmintic treatment, measures to prevent gastrointestinal nematode infection and a better understanding of the management practices associated with resistance may slow down further development of AR.

Influence of Culture Media on the Radiation Resistance of Micrococcus radiodurans

PubMed Central

Krabbenhoft, K. L.; Anderson, A. W.; Elliker, P. R.

1967-01-01

The addition of NZ-case (a tryptic digest of casein) to a growth medium (PC) consisting of tryptone, glucose, and yeast extract caused a significant decrease in γ radiation resistance of Micrococcus radiodurans. The level of radiation resistance was inversely related to the concentration of NZ-case. The ld50 for this organism was approximately 700 krad when grown in tryptone, glucose, yeast extract, and dl-methionine (TGYM) broth, but it was approximately one-half as resistant when grown in a PC medium containing 0.5% NZ-case (PCNZ). The resistance to ultraviolet light was also reduced. Cultures transferred from PCNZ to TGYM media regained the high level of resistance. Images Fig. 2 Fig. 3 PMID:5340165

Insecticide resistance and intracellular proteases.

PubMed

Wilkins, Richard M

2017-12-01

Pesticide resistance is an example of evolution in action with mechanisms of resistance arising from mutations or increased expression of intrinsic genes. Intracellular proteases have a key role in maintaining healthy cells and in responding to stressors such as pesticides. Insecticide-resistant insects have constitutively elevated intracellular protease activity compared to corresponding susceptible strains. This increase was shown for some cases originally through biochemical enzyme studies and subsequently putatively by transcriptomics and proteomics methods. Upregulation and expression of proteases have been characterised in resistant strains of some insect species, including mosquitoes. This increase in proteolysis results in more degradation products (amino acids) of intracellular proteins. These may be utilised in the resistant strain to better protect the cell from stress. There are changes in insect intracellular proteases shortly after insecticide exposure, suggesting a role in stress response. The use of protease and proteasome inhibitors or peptide mimetics as synergists with improved application techniques and through protease gene knockdown using RNA interference (possibly expressed in crop plants) may be potential pest management strategies, in situations where elevated intracellular proteases are relevant. © 2017 Society of Chemical Industry. © 2017 Society of Chemical Industry.

Rhipicephalus (Boophilus) microplus resistant to acaricides and ivermectin in cattle farms of Mexico.

PubMed

Rodríguez-Vivas, Róger Iván; Pérez-Cogollo, Luis Carlos; Rosado-Aguilar, José Alberto; Ojeda-Chi, Melina Maribel; Trinidad-Martinez, Iris; Miller, Robert John; Li, Andrew Yongsheng; de León, Adalberto Pérez; Guerrero, Félix; Klafke, Guilherme

2014-01-01

Ticks and the diseases they transmit cause great economic losses to livestock in tropical countries. Non-chemical control alternatives include the use of resistant cattle breeds, biological control and vaccines. However, the most widely used method is the application of different chemical classes of acaricides and macrocyclic lactones. Populations of the cattle tick, Rhipicephalus (Boophilus) microplus, resistant to organophosphates (OP), synthetic pyrethroids (SP), amitraz and fipronil have been reported in Mexico. Macrocyclic lactones are the most sold antiparasitic drug in the Mexican veterinary market. Ivermectin-resistant populations of R. (B.) microplus have been reported in Brazil, Uruguay and especially in Mexico (Veracruz and Yucatan). Although ivermectin resistance levels in R. (B.) microplus from Mexico were generally low in most cases, some field populations of R. (B.) microplus exhibited high levels of ivermectin resistance. The CHPAT population showed a resistance ratio of 10.23 and 79.6 at lethal concentration of 50% and 99%, respectively. Many field populations of R. (B.) microplus are resistant to multiple classes of antiparasitic drugs, including organophosphates (chlorpyrifos, coumaphos and diazinon), pyrethroids (flumethrin, deltamethrin and cypermethrin), amitraz and ivermectin. This paper reports the current status of the resistance of R. (B.) microplus to acaricides, especially ivermectin, in Mexican cattle.

Impact of Rapid Susceptibility Testing and Antibiotic Selection Strategy on the Emergence and Spread of Antibiotic Resistance in Gonorrhea

PubMed Central

Tuite, Ashleigh R; Gift, Thomas L; Chesson, Harrell W; Hsu, Katherine; Salomon, Joshua A; Grad, Yonatan H

2017-01-01

Abstract Background Increasing antibiotic resistance limits treatment options for gonorrhea. We examined the impact of a hypothetical point-of-care (POC) test reporting antibiotic susceptibility profiles on slowing resistance spread. Methods A mathematical model describing gonorrhea transmission incorporated resistance emergence probabilities and fitness costs associated with resistance based on characteristics of ciprofloxacin (A), azithromycin (B), and ceftriaxone (C). We evaluated time to 1% and 5% prevalence of resistant strains among all isolates with the following: (1) empiric treatment (B and C), and treatment guided by POC tests determining susceptibility to (2) A only and (3) all 3 antibiotics. Results Continued empiric treatment without POC testing was projected to result in >5% of isolates being resistant to both B and C within 15 years. Use of either POC test in 10% of identified cases delayed this by 5 years. The 3 antibiotic POC test delayed the time to reach 1% prevalence of triply-resistant strains by 6 years, whereas the A-only test resulted in no delay. Results were less sensitive to assumptions about fitness costs and test characteristics with increasing test uptake. Conclusions Rapid diagnostics reporting antibiotic susceptibility may extend the usefulness of existing antibiotics for gonorrhea treatment, but ongoing monitoring of resistance patterns will be critical. PMID:28968710

Magnetotelluric Studies for Hydrocarbon and Geothermal Resources: Examples from the Asian Region

NASA Astrophysics Data System (ADS)

Patro, Prasanta K.

2017-09-01

Magnetotellurics (MT) and the other related electrical and electromagnetic methods play a very useful role in resource exploration. This review paper presents the current scenario of application of MT in the exploration for hydrocarbons and geothermal resources in Asia. While seismics is the most preferred method in oil exploration, it is, however, beset with several limitations in the case of sedimentary targets overlain by basalts or evaporate/carbonate rocks where the high-velocity layers overlying the lower velocity layers pose a problem. In such cases, MT plays an important and, in some cases, a crucial role in mapping these potential reservoirs because of significant resistivity contrast generally observed between the basalts and the underlying sedimentary layers. A few case histories are presented that typically illustrate the role of MT in this context. In the case of geothermal exploration, MT is known to be highly effective in deciphering the target areas because of the conductivity structures arising from the presence and circulation of highly conductive fluids in the geothermal target areas. A few examples of MT studies carried out in some of the potential areas of geothermal significance in the Asian region are also discussed. While it is a relatively favorable situation for application of EM and MT methods in the case of exploration of the high-enthalpy region due to the development of well-defined conceptual models, still the low-enthalpy regions need to be understood well, particularly because of more complex structural patterns and the fluid circulation under relatively low-temperature conditions. Currently, a lot of modeling in both geothermal and hydrocarbon exploration is being done using three-dimensional techniques, and it is the right time to go for integration and three-dimensional joint inversion of the geophysical parameters such as resistivity, velocity, density, from MT, electromagnetics (EM), seismics and gravity.

A case study of liquefaction risk analysis based on the thickness and depth of the liquefaction layer using CPT and electric resistivity data in the Hinode area, Itako City, Ibaraki Prefecture, Japan

NASA Astrophysics Data System (ADS)

Jinguuji, Motoharu; Toprak, Selcuk

2017-12-01

The Hinode area of Itako City in Ibaraki Prefecture, Japan, suffered some of the most severe liquefaction damage of any areas in the Great Eastern Japan Earthquake in 2011. This liquefaction damage has been investigated by Itako City, as well as by universities and research institutes in Japan. The National Institute of Advanced Industrial Science and Technology (AIST) has carried out numerous investigations along the Tone River, and in particular, intensive surveys were done in the Hinode area. We have conducted a risk analysis based on the thickness and depth of the liquefaction layer measured using cone penetration testing (CPT) data and electric resistivity data obtained in the Hinode area. The distribution of the risk estimated from CPT at 143 points, and that obtained from analysis of the resistivity survey data, agreed with the distribution of actual damage. We also carried out conventional risk analyses method using the liquefaction resistance factor (FL) and liquefaction potential index (PL) methods with CPT data. The results show high PL values over the entire area, but their distribution did not agree well with actual damage in some parts of the study area. Because the analysis of the thickness and depth of the liquefaction layer, using geophysical prospecting methods, can cover a widespread area, this method will be very useful in investigating liquefaction risk, especially for gas and water pipelines.

Toxic shock syndrome due to community-acquired methicillin-resistant Staphylococcus aureus infection: Two case reports and a literature review in Japan.

PubMed

Sada, Ryuichi; Fukuda, Saori; Ishimaru, Hiroyasu

2017-01-01

Community-acquired methicillin-resistant Staphylococcus aureus has been spreading worldwide, including in Japan. However, few cases of toxic shock syndrome caused by Community-acquired methicillin-resistant Staphylococcus aureus have been reported in Japan. We report 2 cases, in middle-aged women, of toxic shock syndrome due to Community-acquired methicillin-resistant Staphylococcus aureus via a vaginal portal of entry. The first patient had used a tampon and the second patient had vaginitis due to a cleft narrowing associated with vulvar lichen sclerosus. Both patients were admitted to our hospital with septic shock and severe acute kidney injury and subsequently recovered with appropriate antibiotic treatment. In our review of the literature, 8 cases of toxic shock syndrome caused by Community-acquired methicillin-resistant Staphylococcus aureus were reported in Japan. In these 8 cases, the main portals of entry were the skin and respiratory tract; however, the portal of entry of Community-acquired methicillin-resistant Staphylococcus aureus from a vaginal lesion has not been reported in Japan previously.

A Simple Method for Assessment of MDR Bacteria for Over-Expressed Efflux Pumps

PubMed Central

Martins, Marta; McCusker, Matthew P; Viveiros, Miguel; Couto, Isabel; Fanning, Séamus; Pagès, Jean-Marie; Amaral, Leonard

2013-01-01

It is known that bacteria showing a multi-drug resistance phenotype use several mechanisms to overcome the action of antibiotics. As a result, this phenotype can be a result of several mechanisms or a combination of thereof. The main mechanisms of antibiotic resistance are: mutations in target genes (such as DNA gyrase and topoisomerase IV); over-expression of efflux pumps; changes in the cell envelope; down regulation of membrane porins, and modified lipopolysaccharide component of the outer cell membrane (in the case of Gram-negative bacteria). In addition, adaptation to the environment, such as quorum sensing and biofilm formation can also contribute to bacterial persistence. Due to the rapid emergence and spread of bacterial isolates showing resistance to several classes of antibiotics, methods that can rapidly and efficiently identify isolates whose resistance is due to active efflux have been developed. However, there is still a need for faster and more accurate methodologies. Conventional methods that evaluate bacterial efflux pump activity in liquid systems are available. However, these methods usually use common efflux pump substrates, such as ethidium bromide or radioactive antibiotics and therefore, require specialized instrumentation, which is not available in all laboratories. In this review, we will report the results obtained with the Ethidium Bromide-agar Cartwheel method. This is an easy, instrument-free, agar based method that has been modified to afford the simultaneous evaluation of as many as twelve bacterial strains. Due to its simplicity it can be applied to large collections of bacteria to rapidly screen for multi-drug resistant isolates that show an over-expression of their efflux systems. The principle of the method is simple and relies on the ability of the bacteria to expel a fluorescent molecule that is substrate for most efflux pumps, ethidium bromide. In this approach, the higher the concentration of ethidium bromide required to produce fluorescence of the bacterial mass, the greater the efflux capacity of the bacterial cells. We have tested and applied this method to a large number of Gram-positive and Gram-negative bacteria to detect efflux activity among these multi-drug resistant isolates. The presumptive efflux activity detected by the Ethidium Bromide-agar Cartwheel method was subsequently confirmed by the determination of the minimum inhibitory concentration for several antibiotics in the presence and absence of known efflux pump inhibitors. PMID:23589748

Experimental and numerical analysis of interfilament resistances in NbTi strands

NASA Astrophysics Data System (ADS)

Breschi, M.; Massimini, M.; Ribani, P. L.; Spina, T.; Corato, V.

2014-05-01

Superconducting strands are composite wires made of fine superconducting filaments embedded in a metallic matrix. The transverse resistivity among superconducting filaments affects the coupling losses during electromagnetic transients and the electro-thermal behavior of the wire in case of a quench. A direct measurement of the transverse interfilament resistance as a function of temperature in NbTi multi-filamentary wires was performed at the ENEA Frascati Superconductivity Division, Italy by means of a four-probe method. The complexity of these measurements is remarkable, due to the current distribution phenomena that occur among superconducting filaments during these tests. A two-dimensional finite element method model of the wire cross section and a three-dimensional electrical circuit model of the wire sample developed at the University of Bologna are applied here to derive qualitative and quantitative information about the transverse electrical resistance matrix. The experiment is aimed at verifying the qualitative behaviors and trends predicted by the numerical calculations, especially concerning the current redistribution length and consequent length effects of the sample under test. A fine tuning of the model parameters at the filament level allowed us to reproduce the experimental results and get quantitative information about the current distribution phenomena between filaments.

Whole-genome sequencing to determine Neisseria gonorrhoeae transmission: an observational study

PubMed Central

Cole, Kevin; Cole, Michelle J; Cresswell, Fiona; Dean, Gillian; Dave, Jayshree; Thomas, Daniel Rh; Foster, Kirsty; Waldram, Alison; Wilson, Daniel J; Didelot, Xavier; Grad, Yonatan H; Crook, Derrick W; Peto, Tim EA; Walker, A Sarah

2016-01-01

Background New approaches are urgently required to address increasing rates of gonorrhoea and the emergence and global spread of antibiotic-resistant Neisseria gonorrhoeae. Whole genome sequencing (WGS) can be applied to study transmission and track resistance. Methods We performed WGS on 1659 isolates from Brighton, UK, and 217 additional isolates from other UK locations. We included WGS data (n=196) from the USA. Estimated mutation rates, plus diversity observed within patients across anatomical sites and probable transmission pairs, were used to fit a coalescent model to determine the number of single nucleotide polymorphisms (SNPs) expected between sequences related by direct/indirect transmission, depending on the time between samples. Findings We detected extensive local transmission. 281/1061(26%) Brighton cases were indistinguishable (0 SNPs) to ≥1 previous case(s), and 786(74%) had evidence of a sampled direct or indirect Brighton source. There was evidence of sustained transmission of some lineages. We observed multiple related samples across geographic locations. Of 1273 infections in Brighton, 225(18%) were linked to another case from elsewhere in the UK, and 115(9%) to a case from the USA. Four lineages initially identified in Brighton could be linked to 70 USA sequences, including 61 from a lineage carrying the mosaic penA XXXIV associated with reduced cefixime susceptibility. Interpretation We present a WGS-based tool for genomic contact tracing of N. gonorrhoeae and demonstrate local, national and international transmission. WGS can be applied across geographical boundaries to investigate gonorrhoea transmission and to track antimicrobial resistance. Funding Oxford NIHR Health Protection Research Unit and Biomedical Research Centre. PMID:27427203

Lytic phages obscure the cost of antibiotic resistance in Escherichia coli.

PubMed

Tazzyman, Samuel J; Hall, Alex R

2015-03-17

The long-term persistence of antibiotic-resistant bacteria depends on their fitness relative to other genotypes in the absence of drugs. Outside the laboratory, viruses that parasitize bacteria (phages) are ubiquitous, but costs of antibiotic resistance are typically studied in phage-free experimental conditions. We used a mathematical model and experiments with Escherichia coli to show that lytic phages strongly affect the incidence of antibiotic resistance in drug-free conditions. Under phage parasitism, the likelihood that antibiotic-resistant genetic backgrounds spread depends on their initial frequency, mutation rate and intrinsic growth rate relative to drug-susceptible genotypes, because these parameters determine relative rates of phage-resistance evolution on different genetic backgrounds. Moreover, the average cost of antibiotic resistance in terms of intrinsic growth in the antibiotic-free experimental environment was small relative to the benefits of an increased mutation rate in the presence of phages. This is consistent with our theoretical work indicating that, under phage selection, typical costs of antibiotic resistance can be outweighed by realistic increases in mutability if drug resistance and hypermutability are genetically linked, as is frequently observed in clinical isolates. This suggests the long-term distribution of antibiotic resistance depends on the relative rates at which different lineages adapt to other types of selection, which in the case of phage parasitism is probably extremely common, as well as costs of resistance inferred by classical in vitro methods.

Lytic phages obscure the cost of antibiotic resistance in Escherichia coli

PubMed Central

Tazzyman, Samuel J; Hall, Alex R

2015-01-01

The long-term persistence of antibiotic-resistant bacteria depends on their fitness relative to other genotypes in the absence of drugs. Outside the laboratory, viruses that parasitize bacteria (phages) are ubiquitous, but costs of antibiotic resistance are typically studied in phage-free experimental conditions. We used a mathematical model and experiments with Escherichia coli to show that lytic phages strongly affect the incidence of antibiotic resistance in drug-free conditions. Under phage parasitism, the likelihood that antibiotic-resistant genetic backgrounds spread depends on their initial frequency, mutation rate and intrinsic growth rate relative to drug-susceptible genotypes, because these parameters determine relative rates of phage-resistance evolution on different genetic backgrounds. Moreover, the average cost of antibiotic resistance in terms of intrinsic growth in the antibiotic-free experimental environment was small relative to the benefits of an increased mutation rate in the presence of phages. This is consistent with our theoretical work indicating that, under phage selection, typical costs of antibiotic resistance can be outweighed by realistic increases in mutability if drug resistance and hypermutability are genetically linked, as is frequently observed in clinical isolates. This suggests the long-term distribution of antibiotic resistance depends on the relative rates at which different lineages adapt to other types of selection, which in the case of phage parasitism is probably extremely common, as well as costs of resistance inferred by classical in vitro methods. PMID:25268496

Resistance of Pseudomonas aeruginosa isolates to hydrogel contact lens disinfection correlates with cytotoxic activity.

PubMed

Lakkis, C; Fleiszig, S M

2001-04-01

One of the most common pathogens in infection of hydrogel contact lens wearers is Pseudomonas aeruginosa, which can gain access to the eye via contamination of the lens, lens case, and lens care solutions. Only one strain per species is used in current regulatory testing for the marketing of chemical contact lens disinfectants. The aim of this study was to determine whether P. aeruginosa strains vary in their susceptibility to hydrogel contact lens disinfectants. A method for rapidly screening bacterial susceptibility to contact lens disinfectants was developed, based on measurement of the MIC. The susceptibility of 35 P. aeruginosa isolates to two chemical disinfectants was found to vary among strains. MICs ranged from 6.25 to 100% for both disinfectants at 37 degrees C, and a number of strains were not inhibited by a 100% disinfectant concentration in the lens case environment at room temperature (22 degrees C). Resistance to disinfection appeared to be an inherent rather than acquired trait, since some resistant strains had been isolated prior to the introduction of the disinfectants and some susceptible P. aeruginosa strains could not be made more resistant by repeated disinfectant exposure. A number of P. aeruginosa strains which were comparatively more resistant to short-term disinfectant exposure also demonstrated the ability to grow to levels above the initial inoculum in one chemical disinfectant after long-term (24 to 48 h) disinfectant exposure. Resistance was correlated with acute cytotoxic activity toward corneal epithelial cells and with exsA, which encodes a protein that regulates cytotoxicity via a complex type III secretion system. These results suggest that chemical disinfection solutions may select for contamination with cytotoxic strains. Further investigation of the mechanisms and factors responsible for resistance may also lead to strategies for reducing adverse responses to contact lens wear.

Mini epidemic of isoniazide resistant TB in rural TN: a need for supervised preventive therapy.

PubMed

Mehta, Jay; Keith, Rob; Al Hasan, Muhannad; Ryland, Byrd; Roy, Thomas

2009-08-01

With the resurgence of tuberculosis (TB) in the late 1980s, multi-drug-resistant TB (MDR-TB) also became a serious challenge to the TB control programs across the United States (US). While the incidence of TB resumed a downward trend in the mid 1900s, drug-resistant TB continues to be a national and international problem. We reviewed the public health data of drug-resistant TB cases (1996-2002) in Greene County, TN, with a detailed analysis of their contact investigation. Our study included demographic data of age, sex, race, human immunodeficiency virus (HIV) status and other known risk factors for drug-resistant TB. Contact investigation of two patients with isoniazide-resistant active pulmonary TB led to the discovery of two additional cases of active pulmonary tuberculosis, one of them being a 14-month-old child. All four of the patients were U.S. born, had negative HIV tests, and lacked other risk factors for drug-resistant TB. In all four cases, the Mycobacterium tuberculosis isolates were resistant to isoniazide, three were streptomycin resistant, and was ethambutol resistant. A total of 65 close contacts were identified, 11 of whom had a positive purified protein derivative (PPD) skin test indicating latent TB infection. Based on the American Thoracic Society's recommendations, the contacts with a positive PPD were prescribed rifampin for chemo-prevention rather than INH. However, one active case was detected from this infected contact who had failed to comply with chemo-preventive therapy. The second active case was a child who developed active pulmonary TB before chemoprevention could be initiated. Drug culture profile and DNA analysis (RFLP) confirmed the same source for TB transmission. The 11/65 (16.5 percent) infection rate among the contact was comparable to the state average (p < 0.05), but the case rate of 4/65 (6.15 percent) was high. In two out of four active cases, who were family members of the known cases, active infection could have been prevented. High prevalence of drug-resistant TB in rural areas without any known risk factors and failure of prevention are crucial findings of our study. Clinicians practicing in a rural setting should be aware of occasional mini-outbreaks of drug-resistant TB. Supervised therapy for rifampin chemo-prophylaxis and other standard public health measures successfully controlled this mini-epidemic. Awareness of drug resistance in family clusters and an urgent need for prompt chemo-preventive measures are important in implementing successful TB control programs.

Genome-wide study of resistant hypertension identified from electronic health records.

PubMed

Dumitrescu, Logan; Ritchie, Marylyn D; Denny, Joshua C; El Rouby, Nihal M; McDonough, Caitrin W; Bradford, Yuki; Ramirez, Andrea H; Bielinski, Suzette J; Basford, Melissa A; Chai, High Seng; Peissig, Peggy; Carrell, David; Pathak, Jyotishman; Rasmussen, Luke V; Wang, Xiaoming; Pacheco, Jennifer A; Kho, Abel N; Hayes, M Geoffrey; Matsumoto, Martha; Smith, Maureen E; Li, Rongling; Cooper-DeHoff, Rhonda M; Kullo, Iftikhar J; Chute, Christopher G; Chisholm, Rex L; Jarvik, Gail P; Larson, Eric B; Carey, David; McCarty, Catherine A; Williams, Marc S; Roden, Dan M; Bottinger, Erwin; Johnson, Julie A; de Andrade, Mariza; Crawford, Dana C

2017-01-01

Resistant hypertension is defined as high blood pressure that remains above treatment goals in spite of the concurrent use of three antihypertensive agents from different classes. Despite the important health consequences of resistant hypertension, few studies of resistant hypertension have been conducted. To perform a genome-wide association study for resistant hypertension, we defined and identified cases of resistant hypertension and hypertensives with treated, controlled hypertension among >47,500 adults residing in the US linked to electronic health records (EHRs) and genotyped as part of the electronic MEdical Records & GEnomics (eMERGE) Network. Electronic selection logic using billing codes, laboratory values, text queries, and medication records was used to identify resistant hypertension cases and controls at each site, and a total of 3,006 cases of resistant hypertension and 876 controlled hypertensives were identified among eMERGE Phase I and II sites. After imputation and quality control, a total of 2,530,150 SNPs were tested for an association among 2,830 multi-ethnic cases of resistant hypertension and 876 controlled hypertensives. No test of association was genome-wide significant in the full dataset or in the dataset limited to European American cases (n = 1,719) and controls (n = 708). The most significant finding was CLNK rs13144136 at p = 1.00x10-6 (odds ratio = 0.68; 95% CI = 0.58-0.80) in the full dataset with similar results in the European American only dataset. We also examined whether SNPs known to influence blood pressure or hypertension also influenced resistant hypertension. None was significant after correction for multiple testing. These data highlight both the difficulties and the potential utility of EHR-linked genomic data to study clinically-relevant traits such as resistant hypertension.

Novel mutation in the human immunodeficiency virus type 1 reverse transcriptase gene that encodes cross-resistance to 2',3'-dideoxyinosine and 2',3'-dideoxycytidine.

PubMed Central

Gu, Z; Gao, Q; Li, X; Parniak, M A; Wainberg, M A

1992-01-01

We have used the technique of in vitro selection to generate variants of human immunodeficiency virus type 1 (HIV-1) that are resistant to 2',3'-dideoxyinosine (ddI) and cross-resistant to 2',3'-dideoxycytidine (ddC). The complete reverse transcriptase (RT)-coding regions, plus portions of flanking sequences, of viruses possessing a ddI-resistant phenotype were cloned and sequenced by polymerase chain reaction (PCR)-based methods. We observed that several of these viruses possessed mutations at amino acid sites 184 (Met-->Val; ATG-->GTG) and 294 (Pro-->Ser; CCA-->TCA). These mutations were introduced in the pol gene of infectious, cloned HXB2-D DNA by site-directed mutagenesis. Viral replication assays confirmed the importance of site 184 with regard to resistance to ddI. The recombinant viruses thus generated displayed more than fivefold-greater resistance to ddI than parental HXB2-D did. Moreover, more than fivefold-greater resistance to ddC was also documented; however, the recombinant viruses continued to be inhibited by zidovudine (AZT). No resistance to ddI, ddC, or AZT was introduced by inclusion of mutation site 294 in the pol gene of HXB2-D. PCR analysis performed on viral samples obtained from patients receiving long-term ddI therapy confirmed the presence of mutation site 184 in five of seven cases tested. In three of these five positive cases, the wild-type codon was also detected, indicating that mixtures of viral quasispecies were apparently present. Viruses possessing a ddI resistance phenotype were isolated from both subjects whose viruses contained only the mutated rather than wild-type codon at position 184 as well as from a third individual, whose viruses appeared to be mostly of the mutated variety. Images PMID:1279198

Understanding institutional stakeholders’ perspectives on multidrug-resistant bacterial organism at the end of life: a qualitative study

PubMed Central

Heckel, Maria; Herbst, Franziska A; Adelhardt, Thomas; Tiedtke, Johanna M; Sturm, Alexander; Stiel, Stephanie; Ostgathe, Christoph

2017-01-01

Background Information lacks about institutional stakeholders’ perspectives on management approaches of multidrug-resistant bacterial organism in end-of-life situations. The term “institutional stakeholder” includes persons in leading positions with responsibility in hospitals’ multidrug-resistant bacterial organism management. They have great influence on how strategies on multidrug-resistant bacterial organism management approaches in institutions of the public health system are designed. This study targeted institutional stakeholders’ individual perspectives on multidrug-resistant bacterial organism colonization or infection and isolation measures at the end of life. Methods Between March and December 2014, institutional stakeholders of two study centers, a German palliative care unit and a geriatric ward, were queried in semistructured interviews. Interviews were audiotaped, transcribed verbatim, and analyzed qualitatively with the aid of the software MAXQDA for qualitative data analysis using principles of Grounded Theory. In addition, two external stakeholders were interviewed to enrich data. Results Key issues addressed by institutional stakeholders (N=18) were the relevance of multidrug-resistant bacterial organism in palliative and geriatric care, contradictions between hygiene principles and patients’ and family caregivers’ needs and divergence from standards, frame conditions, and reflections on standardization of multidrug-resistant bacterial organism end-of-life care procedures. Results show that institutional stakeholders face a dilemma between their responsibility in protecting third persons and ensuring patients’ quality of life. Until further empirical evidence establishes a clear multidrug-resistant bacterial organism management approach in end-of-life care, stakeholders suggest a case-based approach. Conclusion The institutional stakeholders’ perspectives and their suggestion of a case-based approach advance the development process of a patient-, family-, staff-, and institutional-centered approach of how to deal with multidrug-resistant bacterial organism-positive patients in end-of-life care. Institutional stakeholders play an important role in the implementation of recommendations following this approach. PMID:29042761

Hidden Selection of Bacterial Resistance to Fluoroquinolones In Vivo: The Case of Legionella pneumophila and Humans

PubMed Central

Shadoud, Lubana; Almahmoud, Iyad; Jarraud, Sophie; Etienne, Jérôme; Larrat, Sylvie; Schwebel, Carole; Timsit, Jean-François; Schneider, Dominique; Maurin, Max

2015-01-01

Background Infectious diseases are the leading cause of human morbidity and mortality worldwide. One dramatic issue is the emergence of microbial resistance to antibiotics which is a major public health concern. Surprisingly however, such in vivo adaptive ability has not been reported yet for many intracellular human bacterial pathogens such as Legionella pneumophila. Methods We examined 82 unrelated patients with Legionnaire's disease from which 139 respiratory specimens were sampled during hospitalization and antibiotic therapy. We both developed a real time PCR assay and used deep-sequencing approaches to detect antibiotic resistance mutations in L. pneumophila and follow their selection and fate in these samples. Findings We identified the in vivo selection of fluoroquinolone resistance mutations in L. pneumophila in two infected patients treated with these antibiotics. By investigating the mutational dynamics in patients, we showed that antibiotic resistance occurred during hospitalization most likely after fluoroquinolone treatment. Interpretation In vivo selection of antibiotic resistances in L. pneumophila may be associated with treatment failures and poor prognosis. This hidden resistance must be carefully considered in the therapeutic management of legionellosis patients and in the control of the gradual loss of effectiveness of antibiotics. PMID:26501115

Analysis and Design of ITER 1 MV Core Snubber

NASA Astrophysics Data System (ADS)

Wang, Haitian; Li, Ge

2012-11-01

The core snubber, as a passive protection device, can suppress arc current and absorb stored energy in stray capacitance during the electrical breakdown in accelerating electrodes of ITER NBI. In order to design the core snubber of ITER, the control parameters of the arc peak current have been firstly analyzed by the Fink-Baker-Owren (FBO) method, which are used for designing the DIIID 100 kV snubber. The B-H curve can be derived from the measured voltage and current waveforms, and the hysteresis loss of the core snubber can be derived using the revised parallelogram method. The core snubber can be a simplified representation as an equivalent parallel resistance and inductance, which has been neglected by the FBO method. A simulation code including the parallel equivalent resistance and inductance has been set up. The simulation and experiments result in dramatically large arc shorting currents due to the parallel inductance effect. The case shows that the core snubber utilizing the FBO method gives more compact design.

Assessing the potential impact of artemisinin and partner drug resistance in sub-Saharan Africa.

PubMed

Slater, Hannah C; Griffin, Jamie T; Ghani, Azra C; Okell, Lucy C

2016-01-06

Artemisinin and partner drug resistant malaria parasites have emerged in Southeast Asia. If resistance were to emerge in Africa it could have a devastating impact on malaria-related morbidity and mortality. This study estimates the potential impact of artemisinin and partner drug resistance on disease burden in Africa if it were to emerge. Using data from Asia and Africa, five possible artemisinin and partner drug resistance scenarios are characterized. An individual-based malaria transmission model is used to estimate the impact of each resistance scenario on clinical incidence and parasite prevalence across Africa. Artemisinin resistance is characterized by slow parasite clearance and partner drug resistance is associated with late clinical failure or late parasitological failure. Scenarios with high levels of recrudescent infections resulted in far greater increases in clinical incidence compared to scenarios with high levels of slow parasite clearance. Across Africa, it is estimated that artemisinin and partner drug resistance at levels similar to those observed in Oddar Meanchey province in Cambodia could result in an additional 78 million cases over a 5 year period, a 7% increase in cases compared to a scenario with no resistance. A scenario with high levels of slow clearance but no recrudescence resulted in an additional 10 million additional cases over the same period. Artemisinin resistance is potentially a more pressing concern than partner drug resistance due to the lack of viable alternatives. However, it is predicted that a failing partner drug will result in greater increases in malaria cases and morbidity than would be observed from artemisinin resistance only.

Assessing Local Risk of Rifampicin-Resistant Tuberculosis in KwaZulu-Natal, South Africa Using Lot Quality Assurance Sampling.

PubMed

Heidebrecht, Christine L; Podewils, Laura J; Pym, Alexander; Mthiyane, Thuli; Cohen, Ted

2016-01-01

KwaZulu-Natal (KZN) has the highest burden of notified multidrug-resistant tuberculosis (MDR TB) and extensively drug-resistant (XDR) TB cases in South Africa. A better understanding of spatial heterogeneity in the risk of drug-resistance may help to prioritize local responses. Between July 2012 and June 2013, we conducted a two-way Lot Quality Assurance Sampling (LQAS) study to classify the burden of rifampicin (RIF)-resistant TB among incident TB cases notified within the catchment areas of seven laboratories in two northern and one southern district of KZN. Decision rules for classification of areas as having either a high- or low-risk of RIF resistant TB (based on proportion of RIF resistance among all TB cases) were based on consultation with local policy makers. We classified five areas as high-risk and two as low-risk. High-risk areas were identified in both Southern and Northern districts, with the greatest proportion of RIF resistance observed in the northernmost area, the Manguzi community situated on the Mozambique border. Our study revealed heterogeneity in the risk of RIF resistant disease among incident TB cases in KZN. This study demonstrates the potential for LQAS to detect geographic heterogeneity in areas where access to drug susceptibility testing is limited.

Tetracyclines in Food and Feedingstuffs: From Regulation to Analytical Methods, Bacterial Resistance, and Environmental and Health Implications

PubMed Central

Granados-Chinchilla, Fabio

2017-01-01

Antibiotics are widely used as growth promoters in animal husbandry; among them, the tetracyclines are a chemical group of relevance, due to their wide use in agriculture, surpassing in quantities applied almost every other antibiotic family. Seeing the considerable amounts of tetracyclines used worldwide, monitoring of these antibiotics is paramount. Advances must be made in the analysis of antibiotics to assess correct usage and dosage of tetracyclines in food and feedstuffs and possible residues in pertinent environmental samples. The tetracyclines are still considered a clinically relevant group of antibiotics, though dissemination of tolerance and resistance determinants have limited their use. This review focuses on four different aspects: (i) tetracyclines, usage, dosages, and regulatory issues that govern their food-related application, with particular attention to the prohibitions and restrictions that several countries have enforced in recent years by agencies from both the United States and the European Union, (ii) analytical methods for tetracyclines, determination, and residues thereof in feedstuffs and related matrices with an emphasis on the most relevant and novel techniques, including both screening and confirmatory methods, (iii) tetracycline resistance and tetracycline-resistant bacteria in feedstuff, and (iv) environmental and health risks accompanying the use of tetracyclines in animal nutrition. In the last two cases, we discuss the more relevant undesirable effects that tetracyclines exert over bacterial communities and nontarget species including unwanted effects in farmers. PMID:28168081

A data variance technique for automated despiking of magnetotelluric data with a remote reference

DOE Office of Scientific and Technical Information (OSTI.GOV)

Kappler, K.

2011-02-15

The magnetotelluric method employs co-located surface measurements of electric and magnetic fields to infer the local electrical structure of the earth. The frequency-dependent 'apparent resistivity' curves can be inaccurate at long periods if input data are contaminated - even when robust remote reference techniques are employed. Data despiking prior to processing can result in significantly more reliable estimates of long period apparent resistivities. This paper outlines a two-step method of automatic identification and replacement for spike-like contamination of magnetotelluric data; based on the simultaneity of natural electric and magnetic field variations at distant sites. This simultaneity is exploited both tomore » identify windows in time when the array data are compromised, and to generate synthetic data that replace observed transient noise spikes. In the first step, windows in data time series containing spikes are identified via intersite comparison of channel 'activity' - such as the variance of differenced data within each window. In the second step, plausible data for replacement of flagged windows is calculated by Wiener filtering coincident data in clean channels. The Wiener filters - which express the time-domain relationship between various array channels - are computed using an uncontaminated segment of array training data. Examples are shown where the algorithm is applied to artificially contaminated data, and to real field data. In both cases all spikes are successfully identified. In the case of implanted artificial noise, the synthetic replacement time series are very similar to the original recording. In all cases, apparent resistivity and phase curves obtained by processing the despiked data are much improved over curves obtained from raw data.« less

Failure of mebendazole to cure trichomonal vaginitis resistant to metronidazole: case reports.

PubMed Central

Pattman, R S; Sprott, M S; Kearns, A M; Earnshaw, M

1989-01-01

After a recent report showing the in vitro susceptibility to mebendazole of a strain of Trichomonas vaginalis that was resistant to metronidazole, we present two cases of metronidazole resistant infection, both of which failed to respond to oral mebendazole. PMID:2807288

Global extent of chloroquine-resistant Plasmodium vivax: a systematic review and meta-analysis

PubMed Central

Price, Ric N; von Seidlein, Lorenz; Valecha, Neena; Nosten, Francois; Baird, J Kevin; White, Nicholas J

2014-01-01

Summary Background Chloroquine is the first-line treatment for Plasmodium vivax malaria in most endemic countries, but resistance is increasing. Monitoring of antimalarial efficacy is essential, but in P vivax infections the assessment of treatment efficacy is confounded by relapse from the dormant liver stages. We systematically reviewed P vivax malaria treatment efficacy studies to establish the global extent of chloroquine resistance. Methods We searched Medline, Web of Science, Embase, and the Cochrane Database of Systematic Reviews to identify studies published in English between Jan 1, 1960, and April 30, 2014, which investigated antimalarial treatment efficacy in P vivax malaria. We excluded studies that did not include supervised schizonticidal treatment without primaquine. We determined rates of chloroquine resistance according to P vivax malaria recurrence rates by day 28 whole-blood chloroquine concentrations at the time of recurrence and study enrolment criteria. Findings We identified 129 eligible clinical trials involving 21 694 patients at 179 study sites and 26 case reports describing 54 patients. Chloroquine resistance was present in 58 (53%) of 113 assessable study sites, spread across most countries that are endemic for P vivax. Clearance of parasitaemia assessed by microscopy in 95% of patients by day 2, or all patients by day 3, was 100% predictive of chloroquine sensitivity. Interpretation Heterogeneity of study design and analysis has confounded global surveillance of chloroquine-resistant P vivax, which is now present across most countries endemic for P vivax. Improved methods for monitoring of drug resistance are needed to inform antimalarial policy in these regions. Funding Wellcome Trust (UK). PMID:25213732

Characterization of Near-Surface Geology and Possible Voids Using Resistivity and Electromagnetic Methods at the Gran Quivira Unit of Salinas Pueblo Missions National Monument, Central New Mexico, June 2005

USGS Publications Warehouse

Ball, Lyndsay B.; Lucius, Jeffrey E.; Land, Lewis A.; Teeple, Andrew

2006-01-01

At the Gran Quivira Unit of Salinas Pueblo Missions National Monument in central New Mexico, a partially excavated pueblo known as Mound 7 has recently become architecturally unstable. Historical National Park Service records indicate both natural caves and artificial tunnels may be present in the area. Knowledge of the local near-surface geology and possible locations of voids would aid in preservation of the ruins. Time-domain and frequency-domain electromagnetic as well as direct-current resistivity methods were used to characterize the electrical structure of the near-surface geology and to identify discrete electrical features that may be associated with voids. Time-domain electromagnetic soundings indicate three major electrical layers; however, correlation of these layers to geologic units was difficult because of the variability of lithologic data from existing test holes. Although resistivity forward modeling was unable to conclusively determine the presence or absence of voids in most cases, the high-resistivity values (greater than 5,000 ohm-meters) in the direct-current resistivity data indicate that voids may exist in the upper 50 meters. Underneath Mound 7, there is a possibility of large voids below a depth of 20 meters, but there is no indication of substantial voids in the upper 20 meters. Gridded lines and profiled inversions of frequency-domain electromagnetic data showed excellent correlation to resistivity features in the upper 5 meters of the direct-current resistivity data. This technique showed potential as a reconnaissance tool for detecting voids in the very near surface.

Shielded resistive electromagnets of arbitrary surface geometry using the boundary element method and a minimum energy constraint.

PubMed

Harris, Chad T; Haw, Dustin W; Handler, William B; Chronik, Blaine A

2013-09-01

Eddy currents are generated in MR by the use of rapidly switched electromagnets, resulting in time varying and spatially varying magnetic fields that must be either minimized or corrected. This problem is further complicated when non-cylindrical insert magnets are used for specialized applications. Interruption of the coupling between an insert coil and the MR system is typically accomplished using active magnetic shielding. A new method of actively shielding insert gradient and shim coils of any surface geometry by use of the boundary element method for coil design with a minimum energy constraint is presented. This method was applied to shield x- and z-gradient coils for two separate cases: a traditional cylindrical primary gradient with cylindrical shield and, to demonstrate its versatility in surface geometry, the same cylindrical primary gradients with a rectangular box-shaped shield. For the cylindrical case this method produced shields that agreed with analytic solutions. For the second case, the rectangular box-shaped shields demonstrated very good shielding characteristics despite having a different geometry than the primary coils. Copyright © 2013 Elsevier Inc. All rights reserved.

Study of Mycobacterium tuberculosis drug resistance in the region of Galicia, Spain.

PubMed

Pérez del Molino Bernal, M L; Túñez, V; Cruz-Ferro, E; Fernández-Villar, A; Vázquez-Gallardo, R; Díaz-Cabanela, D; Anibarro, L

2005-11-01

Galicia, a region in north-east Spain with its own government and health system and a population of 2 695 880. To study the epidemiology of resistant tuberculosis (TB). A prospective, descriptive, and observational study of all Mycobacterium tuberculosis isolates processed by each of the laboratories in Galicia that perform mycobacterial cultures. The study followed the methodology recommended by the World Health Organization and the International Union Against Tuberculosis and Lung Disease, and included isolates processed between 1 November 2001 and 1 June 2002. Of 400 strains analysed, 360 corresponded to previously untreated cases and 40 to previously treated cases. Of the previously untreated cases, 88.3% contained strains susceptible to isoniazid, rifampicin, streptomycin and ethambutol, while 4.4% were resistant to isoniazid. The rate of susceptibility to the four drugs was 77.5% in the previously treated cases. Multidrug-resistant TB was detected in 1.4% of the previously untreated cases and in 7.5% of the previously treated cases. Although Galicia has a high incidence of TB (49.4 cases per 100 000 population in 2001), the resistance levels detected by the study do not currently pose a serious problem for the region.

The South African Tuberculosis Care Cascade: Estimated Losses and Methodological Challenges

PubMed Central

Naidoo, Pren; Theron, Grant; Rangaka, Molebogeng X; Chihota, Violet N; Vaughan, Louise; Brey, Zameer O; Pillay, Yogan

2017-01-01

Abstract Background While tuberculosis incidence and mortality are declining in South Africa, meeting the goals of the End TB Strategy requires an invigorated programmatic response informed by accurate data. Enumerating the losses at each step in the care cascade enables appropriate targeting of interventions and resources. Methods We estimated the tuberculosis burden; the number and proportion of individuals with tuberculosis who accessed tests, had tuberculosis diagnosed, initiated treatment, and successfully completed treatment for all tuberculosis cases, for those with drug-susceptible tuberculosis (including human immunodeficiency virus (HIV)–coinfected cases) and rifampicin-resistant tuberculosis. Estimates were derived from national electronic tuberculosis register data, laboratory data, and published studies. Results The overall tuberculosis burden was estimated to be 532005 cases (range, 333760–764480 cases), with successful completion of treatment in 53% of cases. Losses occurred at multiple steps: 5% at test access, 13% at diagnosis, 12% at treatment initiation, and 17% at successful treatment completion. Overall losses were similar among all drug-susceptible cases and those with HIV coinfection (54% and 52%, respectively, successfully completed treatment). Losses were substantially higher among rifampicin- resistant cases, with only 22% successfully completing treatment. Conclusion Although the vast majority of individuals with tuberculosis engaged the public health system, just over half were successfully treated. Urgent efforts are required to improve implementation of existing policies and protocols to close gaps in tuberculosis diagnosis, treatment initiation, and successful treatment completion. PMID:29117342

Synergy between antibiotics and natural agents results in increased antimicrobial activity against Staphylococcus epidermidis.

PubMed

Abidi, Syed Hani; Ahmed, Khalid; Sherwani, Sikander Khan; Kazmi, Shahana Urooj

2015-09-27

Staphylococcus epidermidis is one of the most frequent causes of biofilm-associated infections on indwelling medical devices. With the emergence of methicillin-resistant S. epidermidis (MRSE), there is an urgent need to discover novel active agents against a range of Gram-positive pathogens. We screened the clinical isolates of S. epidermidis for susceptibility/resistance against commonly prescribed antibiotics. Furthermore, we tested some natural agents alone and in combination with antibiotics to find possible synergistic antimicrobial effects. S. epidermidis clinical isolates were screened for susceptibility/resistance against vancomycin, erythromycin, tetracycline, chloramphenicol, ampicillin, ofloxacin, cephalexin, and gentamicin using the Kirby-Bauer disk diffusion method. The antimicrobial potential of Camellia sinensis, Juglans regia, and Hippophae rhamnoides alone and in combination with antibiotics were examined using the disk diffusion method, where the antimicrobial potential activity was measured in terms of formation of zones of inhibition. Most S. epidermidis isolates were found to be resistant to one or more antibiotics. Gentamycin and ofloxacin were found to be the most effective antibiotics against S. epidermidis isolates. Extracts of Hippophae rhamnoides, Juglans regia, and Camellia sinensis were found to be equally effective against S. epidermidis isolates. In combination with antibiotics, these extracts exhibited appreciable synergistic activity; the highest synergistic activity was observed with erythromycin and cephalexin. In the case of cephalexin, a reversion in resistance was observed. The plant extracts used in the study exhibited additive and synergistic antibacterial activity against S. epidermidis, hence providing an effective alternative to deal with the problem of multidrug resistance.

Adjoint-state inversion of electric resistivity tomography data of seawater intrusion at the Argentona coastal aquifer (Spain)

NASA Astrophysics Data System (ADS)

Fernández-López, Sheila; Carrera, Jesús; Ledo, Juanjo; Queralt, Pilar; Luquot, Linda; Martínez, Laura; Bellmunt, Fabián

2016-04-01

Seawater intrusion in aquifers is a complex phenomenon that can be characterized with the help of electric resistivity tomography (ERT) because of the low resistivity of seawater, which underlies the freshwater floating on top. The problem is complex because of the need for joint inversion of electrical and hydraulic (density dependent flow) data. Here we present an adjoint-state algorithm to treat electrical data. This method is a common technique to obtain derivatives of an objective function, depending on potentials with respect to model parameters. The main advantages of it are its simplicity in stationary problems and the reduction of computational cost respect others methodologies. The relationship between the concentration of chlorides and the resistivity values of the field is well known. Also, these resistivities are related to the values of potentials measured using ERT. Taking this into account, it will be possible to define the different resistivities zones from the field data of potential distribution using the basis of inverse problem. In this case, the studied zone is situated in Argentona (Baix Maresme, Catalonia), where the values of chlorides obtained in some wells of the zone are too high. The adjoint-state method will be used to invert the measured data using a new finite element code in C ++ language developed in an open-source framework called Kratos. Finally, the information obtained numerically with our code will be checked with the information obtained with other codes.

The data preprocessing in apparent resistivity pesudo-section construction of two-dimensional electrical resistivity tomography survey

NASA Astrophysics Data System (ADS)

Zhou, Q.

2015-12-01

Although three-dimensional (3-D) electrical resistivity tomography (ERT) survey has become a popular practice in the site characterization and process monitoring, the two-dimensional (2-D) ERT survey is still often used in the field. This is because that the 2-D ERT survey is relatively easy to do and the focus of site characterization is on the information of 2-D cross section, not necessarily of the 3-D subsurface structure. Examples of such practice include tunnel line and crossing fault survey. In these cases, depending on the property of surface soil to be surveyed, the 2-D ERT survey with pole-pole array may occasionally make us obtain quality good data, however it often gives us a suit of data set both with real and erroneous ones that incorporated the effects of electrode contact and not far enough far electrodes. Without preprocessing, the apparent resistivity pseudo-section constructed from this kind of data set may quite deviate from the real one and the information obtained from it may be misleading and even completely incorrect. In this study, we developed a method of far electrode dynamic correction that is appropriate for raw data preprocessing from 2-D pole-pole array ERT survey. Based on this method, we not only can find and delete the abnormal data points easily, but also can position the coordinates of far electrodes actually working in the field, thus delete the far electrode effects and make best use of the looked strange data points. The method also makes us to be able to judge the effects of electrode contact and avoid using such data points in the following apparent resistivity pseudo-section construction. With this preprocessing to the data set, the constructed apparent resistivity pseudo-section is demonstrated to be more approximate to the real one. This makes the following reversion calculation more robust. We'll introduce this far electrode dynamic correction method and show application examples in the meeting.

[Molecular epidemiologic study on Mycobacterium tuberculosis from drug resistance monitoring sites of Guangdong Province, 2015].

PubMed

Huang, X C; Guo, H X; Wu, Z H; Guo, C X; Wei, W J; Li, H C; Sun, Q; Zhang, C C; Li, Z Y; Chen, T; Zhong, Q; Zhou, L

2017-05-12

Objective: To understand the characteristics of Mycobacterium tuberculosis (MTB) in epidemiology and distribution from Guangdong Province, and to explore the risk factors associated with drug resistance. Methods: A total of 225 clinical strains of MTB collected from 5 drug resistance monitoring sites of Guangdong Province in 2015 were tested by Regions of Difference 105 (RD105) deletion test and 15 loci mycobacterial interspersed repetitive units (MIRU) were used for genotyping. Gene clustering was analyzed using BioNumerics7.6. Drug susceptibility test was tested by proportion method. The statistical analysis used chi-square test and multivariate logistic regression. Results: There were 158 (70.2%) Beijing family strains from the 225 cases. Hunter-gaston index of MIRU loci varied from each other. The MTBs from Guangdong Province were categorized into 2 gene clusters by clustering analysis in which the rate of cluster of complexⅠwas significantly higher than complexⅡ(χ(2) values were 9.331, P values were 0.020). It was found by multivariate logistic regression that Qub11b was associated with resistance to rifampicin and isoniazid ( P values were 0.013, 0.012 respectively.), ETR F with resistance to isoniazid, streptomycin, ethambutol and ofloxacin ( P values were 0.039, 0.040, 0.023 and 0.003 respectively), Mtub21 with resistance to capreomycin ( P values were 0.040), and QUB26 with resistance to ethionamide ( P values were 0.047). Conclusions: The genes of MTB from Guangdong Province were of polymorphisms and the distribution of strains were stable. QUB11b, ETR F, Mtub21 and QUB26 could be related to biomarkers for predicting drug resistance.

Determining resistivity of a geological formation using circuitry located within a borehole casing

DOEpatents

Vail III, William Banning

2006-01-17

Geological formation resistivity is determined. Circuitry is located within the borehole casing that is adjacent to the geological formation. The circuitry can measure one or more voltages across two or more voltage measurement electrodes associated with the borehole casing. The measured voltages are used by a processor to determine the resistivity of the geological formation. A common mode signal can also be reduced using the circuitry.

Haemophilus influenzae type-b and non-b-type invasive diseases in urban children (<5years) of Bangladesh: implications for therapy and vaccination.

PubMed

Rahman, Mahbubur; Hossain, Shahadat; Baqui, Abdullah Hel; Shoma, Shereen; Rashid, Harunur; Nahar, Nazmun; Zaman, Mohammed Khalequ; Khatun, Farida

2008-03-01

To prospectively study the epidemiology and antibiotic resistance of Haemophilus infuenzae isolates from invasive infections in children. Children (<5years) with pneumonia, meningitis and septicemia from three hospitals in Dhaka, Bangladesh were enrolled (1999-2003); clinical and laboratory data, and blood for cultures were collected. Cerebrospinal fluid (CSF) of meningitis cases was analyzed (Gram stain, culture and biochemical tests). Hib antigen was detected by latex agglutination (LA) in culture-negative pyogenic CSF and PCR was done for bexA gene in culture- and LA-negative pyogenic CSF. Antibiotic susceptibility was determined by E-Tests and beta-lactamase by nitrocefin stick. Seventy-three cases of H. influenzae infections (46 of 293 meningitis cases, 25 of 1493 pneumonia cases, 2 of 48 septicemia cases) were detected; 63%, 34% and 3% of them had meningitis, pneumonia and septicemia respectively. H. influenzae type b (Hib) caused infections in 80.8% of cases (60.3% meningitis, 20.5% pneumonia). Most (86%) infections clustered in 4-12month infants. The case-fatality in pneumonia was 8% compared to 19% in meningitis. H. influenzae isolates from pneumonia and meningitis children were equally resistant to antibiotics (46% vs 43%). Of 10 drugs tested, isolates were resistant to ampicillin (31%), chloramphenicol (42%), trimethoprim-sulfamethoxazole (44%) and azithromycin (1.4%). Multidrug-resistant (MDR) strains were equally prevalent in Hib (31%) and non-b-type (29%) isolates, and in pneumonia (31%) and meningitis (34%) cases. None was resistant to amoxicillin-clavulanate, ceftriaxone, ciprofloxacin, levofloxacin, moxifloxacin, and gatifloxacin. Of all H. influenzae infections, 40%, 4.4% and 100% of pneumonia, meningitis and septicemia cases were caused by other serotypes or non-typeable strains. All ampicillin-resistant-strains produced beta-lactamase without detection of beta-lactamase-negative-ampicillin-resistant (BLNAR) strains. Hib is a leading cause of invasive bacterial infections in infants. Multidrug-resistant H. influenzae is common and requires amoxicillin-clavulanate, ceftriaxone or azithromycin as empirical therapy with specific recommendation for use of ceftriaxone for treatment of meningitis particularly MDR cases. New fluoroquinolines has potential utility. An effective national Hib vaccination programme is essential in Bangladesh although non-Hib infections will remain an issue.

Molecular Epidemiology of Mycobacterium tuberculosis Isolates in 100 Patients With Tuberculosis Using Pulsed Field Gel Electrophoresis

PubMed Central

Pooideh, Mohammad; Jabbarzadeh, Ismail; Ranjbar, Reza; Saifi, Mahnaz

2015-01-01

Background: Tuberculosis (TB) is a widespread infectious disease. Today, TB has created a public health crisis in the world. Genotyping of Mycobacterium tuberculosis isolates is useful for surveying the dynamics of TB infection, identifying new outbreaks, and preventing the disease. Different molecular methods for clustering of M. tuberculosis isolates have been used. Objectives: During a one year study of genotyping, 100 M. tuberculosis isolates from patients referred to Pasteur Institute of Iran were collected and their genotyping was accomplished using pulsed field gel electrophoresis (PFGE) method. Materials and Methods: Identification of all M. tuberculosis isolates was accomplished using standard biochemical and species-specific polymerase chain reaction (PCR) methods. Antibiotic susceptibility tests were performed using proportional method. After preparing PFGE plaques for each isolate of M. tuberculosis, XbaI restriction enzyme was applied for genome digestion. Finally, the digested DNA fragments were separated on 1% agarose gel and analyzed with GelCompar II software. Results: Genotyping of the studied isolates in comparison with the molecular weight marker revealed two common types; pulsotype A with 71 isolates and one multidrug resistant mycobacterium (MDR) case, and pulsotype B including 29 isolates and three MDR cases. No correlation between the antibiotypes and pulsotypes was observed. Conclusions: Molecular epidemiology studies of infectious diseases have been useful when bacterial isolates have been clustered in a period of time and in different geographical regions with variable antibiotic resistance patterns. In spite of high geographical differences and different antibiotic resistant patterns, low genetic diversity among the studied TB isolates may refer to the low rate of mutations in XbaI restriction sites in the mycobacterial genome. We also identified three MDR isolates in low-incidence pulsotype B, which could be disseminated and is highly important to consider in TB surveillance programs to prevent the spread of MDR-TB isolates in the population. PMID:26396714

Hybrid Vehicles

DTIC Science & Technology

2008-12-08

chassis) by a ground strap, wire, welded connection or other suitable low-resistance mechanical connection. Case ground connectors routed from other...environment of a hybrid electric vehicle. Alternative temperature measuring transducers, e.g., thermistors , should be considered when thermocouples are...A 3. Is the ground connection to the chassis or frame mechanically secured by one of the following methods? a. Secured to a spot- welded

'Not Hard to Sway': A Case Study of Student Engagement in Two Large Engineering Classes

ERIC Educational Resources Information Center

Shekhar, Prateek; Borrego, Maura

2018-01-01

Although engineering education research has empirically validated the effectiveness of active learning in improving student learning over traditional lecture-based methods, the adoption of active learning in classrooms has been slow. One of the greatest reported barriers is student resistance towards engagement in active learning exercises. This…

Influence of bitumen type on cracking resistance of asphalt mixtures used in pavement overlays

NASA Astrophysics Data System (ADS)

Jaskula, P.; Szydlowski, C.; Stienss, M.

2018-05-01

Cracking is one of the predominant distresses occurring in flexible pavements, especially in old pavements that were rehabilitated with an asphalt overlay. In such cases asphalt mixtures should be designed to ensure high resistance to reflective cracking because new asphalt layers are exposed to existing cracks of the old pavement. The nature of these cracks can be various (transverse, longitudinal as well as crazy cracking). One factor that minimizes this type of distress is the proper mix design process, which should involve selection of specific bitumen binder and mineral mix gradation. However, still there is no universally adopted laboratory test method that would allow to clearly assess resistance of asphalt mixtures to reflective cracking. This paper describes the usage of one of the devices developed to test asphalt mixtures in terms of such distress – Texas Overlay Tester. For this test, samples prepared in laboratory conditions (i.e. compacted with the use of Superpave Gyratory Compactor) as well as obtained in the field (by core drilling) can be used. The results are obtained not only quickly and easily, but also with sufficient repeatability. The described method characterizes both crack initiation and crack propagation properties of asphalt mixtures. In this work one type of mineral mixture was tested with 4 different types of bitumen (one neat bitumen, two ordinary polymer-modified and one polymer-modified with high polymer content). For selected cases extra additives (rubber and loose fibres) were also tested. In total, six asphalt mixtures were tested. A ranking of the used binders was created on the basis of the results in order to conclude which bitumen would ensure the best performance characteristics in terms of reflective cracking. The results have clearly shown that deliberate choice of the binder used in the asphalt mixture for the overlay will significantly improve its reflective cracking resistance or even fatigue resistance.

Mapping of a quantitative trait locus for resistance against infectious salmon anaemia in Atlantic salmon (Salmo Salar): comparing survival analysis with analysis on affected/resistant data

PubMed Central

Moen, Thomas; Sonesson, Anna K; Hayes, Ben; Lien, Sigbjørn; Munck, Hege; Meuwissen, Theo HE

2007-01-01

Background Infectious Salmon Anaemia (ISA) is a viral disease affecting farmed Atlantic salmon (Salmo salar) worldwide. The identification of Quantitative Trait Loci (QTL) affecting resistance to the disease could improve our understanding of the genetics underlying the trait and provide a means for Marker-Assisted Selection. We previously performed a genome scan on commercial Atlantic salmon families challenge tested for ISA resistance, identifying several putative QTL. In the present study, we set out to validate the strongest of these QTL in a larger family material coming from the same challenge test, and to determine the position of the QTL by interval mapping. We also wanted to explore different ways of performing QTL analysis within a survival analysis framework (i.e. using time-to-event data), and to compare results using survival analysis with results from analysis on the dichotomous trait 'affected/resistant'. Results The QTL, located on Atlantic salmon linkage group 8 (following SALMAP notation), was confirmed in the new data set. Its most likely position was at a marker cluster containing markers BHMS130, BHMS170 and BHMS553. Significant segregation distortion was observed in the same region, but was shown to be unrelated to the QTL. A maximum likelihood procedure for identifying QTL, based on the Cox proportional hazard model, was developed. QTL mapping was also done using the Haley-Knott method (affected/resistant data), and within a variance-component framework (affected/resistant data and time-to-event data). In all cases, analysis using affected/resistant data gave stronger evidence for a QTL than did analysis using time-to-event data. Conclusion A QTL for resistance to Infectious Salmon Anaemia in Atlantic salmon was validated in this study, and its more precise location on linkage group eight was determined. The QTL explained 6% of the phenotypic variation in resistance to the disease. The linkage group also displayed significant segregation distortion. Survival models proved in this case not to be more suitable than models based on the dichotomous trait 'affected/resistant' for analysing the data. PMID:17697344

[Resistance to first-line drugs and major genotypic lineages of Mycobacterium tuberculosis in the 3 French Department of the Americas: Profiles, evolution, and trends (1995-2011)].

PubMed

Millet, J; Berchel, M; Prudenté, F; Streit, E; Bomer, A-G; Schuster, F; Vanhomwegen, J; Paasch, D; Galbert, I; Valery, E; Aga, R; Rastogi, N

2014-05-01

This is the first overview on resistant and multidrug resistant isolates of Mycobacterium tuberculosis circulating in the French Department of the Americas (Guadeloupe, Martinique, and French Guiana) over 17 years (January 1995-December 2011). A total of 1,239 cases were studied: 1,199 new cases (primary and multidrug resistance of 11.8 and 1.6% respectively), and 40 persistent (defined as cases with a previous history of positive culture over 6 months interval and whose spoligotypes remain unchanged), in which significantly higher proportions of resistance to at least isoniazid (22.5%, P = 0.002), rifampicin (20.0%, P < 0.001), and multidrug resistance (17.5%, P < 0.001) were observed as compared to new cases. The 281 spoligotypes obtained showed the presence of five major lineages, T (29.9%), LAM (23.9%), Haarlem (22.1%), EAI (7.1%), and X (6.7%). Two of these lineages, X and LAM, predominate among resistant and multidrug resistant isolates respectively (X: 10.5% of resistant isolates, P = 0.04; LAM: 42.3% of multidrug resistant isolates, P = 0.02). Four of the 19 major spoligo-profiles, corresponding to SIT 20, 64, 45, and 46, were significantly associated with drug resistance. Among them, genotype SIT 20, associated with monoresistance to isoniazid and multidrug resistance, would be actively and persistently in circulation, since 1999, in French Guiana, department in which one may also observe the presence of strains of M. tuberculosis phylogeographically associated to Guiana and Suriname (SIT 131 and SIT 1340).

[Evaluation of methods for studying susceptibility to oxacillin and penicillin in 60 Staphylococcus lugdunensis isolates].

PubMed

Batista, Nínive; Fernández, M Paula; Lara, Magdalena; Laich, Federico; Méndez, Sebastián

2009-03-01

Staphylococcus lugdunensis is a coagulase-negative staphylococcus associated with a variety of clinical infections. In this paper we present the results of a comparative study using 4 methods to determine antimicrobial susceptibility to oxacillin and penicillin in 60 S. lugdunensis isolates. We studied 60 S. lugdunensis isolates obtained from clinical specimens sent to our laboratory over an 8-year period. All isolates were free coagulase-negative and DNase-negative, and biochemically identified by API ID 32 STAPH (bioMérieux). Presence of mecA and ss-lactamase production were studied in all cases. Antimicrobial susceptibility was determined by the Vitek 2 System (bioMérieux) and broth microdilution (Wider) (Soria Melguizo) for penicillin and oxacillin, and the E-test (AB Biodisk) and cefoxitin disk diffusion test (BD BBLTM) for oxacillin. All isolates lacked the mecA gene and were susceptible to oxacillin by broth microdilution, E-test, and cefoxitin disk diffusion test. Only two isolates were oxacillin-resistant by the Vitek 2 System. Twenty-four isolates (40%) were ss-lactamase-positive, 4 after induction. Susceptibility testing to penicillin determined that 48 isolates showed concordance between the results obtained by broth microdilution and Vitek 2, but 12 isolates (20%), showed divergent results. We detected no resistance to oxacillin in S. lugdunensis. All the methods evaluated were adequate for determining oxacillin resistance. The Vitek 2 System is useful for detecting penicillin resistance, but the ss-lactamase test should be applied to isolates with a MIC=0.25microg/ml to avoid the interpretation of false resistance to this antibiotic.

Antibiotic resistance of Clostridium perfringens isolates from broiler chickens in Egypt.

PubMed

Osman, K M; Elhariri, M

2013-12-01

The use of antibiotic feed additives in broiler chickens results in a high prevalence of resistance among their enteric bacteria, with a consequent emergence of antibiotic resistance in zoonotic enteropathogens. Despite growing concerns about the emergence of antibiotic-resistant strains, which show varying prevalences in different geographic regions, little work has been done to investigate this issue in the Middle East. This study provides insight into one of the world's most common and financially crippling poultry diseases, necrotic enteritis caused by Clostridium perfringens. The study was designed to determine the prevalence of antibiotic resistance in C. perfringens isolates from clinical cases of necrotic enteritis in broiler chickens in Egypt. A total of 125 isolates were obtained from broiler flocks in 35 chicken coops on 17 farms and were tested using the disc diffusion method. All 125 isolates were resistant to gentamicin, streptomycin, oxolinic acid, lincomycin, erythromycin and spiramycin. The prevalence of resistance to other antibiotics was also high: rifampicin (34%), chloramphenicol (46%), spectinomycin (50%), tylosin-fosfomycin (52%), ciprofloxacin (58%), norfloxacin (67%), oxytetracycline (71%), flumequine (78%), enrofloxacin (82%), neomycin (93%), colistin (94%), pefloxacin (94%), doxycycline (98%) and trimethoprim-sulfamethoxazole (98%). It is recommended that C. perfringens infections in Egypt should be treated with antibiotics for which resistant isolates are rare at present; namely, amoxicillin, ampicillin, cephradine, fosfomycin and florfenicol.

Advanced Mitigation Process (AMP) for Improving Laser Damage Threshold of Fused Silica Optics

NASA Astrophysics Data System (ADS)

Ye, Xin; Huang, Jin; Liu, Hongjie; Geng, Feng; Sun, Laixi; Jiang, Xiaodong; Wu, Weidong; Qiao, Liang; Zu, Xiaotao; Zheng, Wanguo

2016-08-01

The laser damage precursors in subsurface of fused silica (e.g. photosensitive impurities, scratches and redeposited silica compounds) were mitigated by mineral acid leaching and HF etching with multi-frequency ultrasonic agitation, respectively. The comparison of scratches morphology after static etching and high-frequency ultrasonic agitation etching was devoted in our case. And comparison of laser induce damage resistance of scratched and non-scratched fused silica surfaces after HF etching with high-frequency ultrasonic agitation were also investigated in this study. The global laser induce damage resistance was increased significantly after the laser damage precursors were mitigated in this case. The redeposition of reaction produce was avoided by involving multi-frequency ultrasonic and chemical leaching process. These methods made the increase of laser damage threshold more stable. In addition, there is no scratch related damage initiations found on the samples which were treated by Advanced Mitigation Process.

[Gentamicin: various pharmacotherapeutic aspects in comparison with other aminoglycosides].

PubMed

de Visser, N A; van Gogh, H; van Miert, A S

1985-02-15

Gentamicin may be used in the treatment of infection with gram-negative bacteria including Pseudomonas spp and Proteus spp. Resistance will only appear in suboptimal or too prolonged courses of treatment and usually is due to 'multi-step mutation'. This resistance may be prevented, among others, by combined treatment with gentamicin and an antibiotic of the beta lactam group. When gentamicin is used correctly, it will have few toxic side-effects. Thus, 3 mg/kg of body weight three times daily will usually be indicated to ensure an optimum therapeutic effect. Parenteral administration of gentamicin would only appear to be useful in cases of bacteraemia and/or bacterial infection of the kidney and/or urinary excretory ducts; in the last-named case, the dose given at one time may be reduced by fifty per cent. Local treatment, the most recent method of which consists in administration by I(ntra-)T(racheal) route, apparently offers more prospects.

Advanced Mitigation Process (AMP) for Improving Laser Damage Threshold of Fused Silica Optics

PubMed Central

Ye, Xin; Huang, Jin; Liu, Hongjie; Geng, Feng; Sun, Laixi; Jiang, Xiaodong; Wu, Weidong; Qiao, Liang; Zu, Xiaotao; Zheng, Wanguo

2016-01-01

The laser damage precursors in subsurface of fused silica (e.g. photosensitive impurities, scratches and redeposited silica compounds) were mitigated by mineral acid leaching and HF etching with multi-frequency ultrasonic agitation, respectively. The comparison of scratches morphology after static etching and high-frequency ultrasonic agitation etching was devoted in our case. And comparison of laser induce damage resistance of scratched and non-scratched fused silica surfaces after HF etching with high-frequency ultrasonic agitation were also investigated in this study. The global laser induce damage resistance was increased significantly after the laser damage precursors were mitigated in this case. The redeposition of reaction produce was avoided by involving multi-frequency ultrasonic and chemical leaching process. These methods made the increase of laser damage threshold more stable. In addition, there is no scratch related damage initiations found on the samples which were treated by Advanced Mitigation Process. PMID:27484188

Assessing spatiotemporal patterns of multidrug-resistant and drug-sensitive tuberculosis in a South American setting

PubMed Central

Lin, H.; Shin, S.; Blaya, J. A.; Zhang, Z.; Cegielski, P.; Contreras, C.; Asencios, L.; Bonilla, C.; Bayona, J.; Paciorek, C. J.; Cohen, T.

2011-01-01

Summary We examined the spatiotemporal distribution of laboratory-confirmed multidrug-resistant tuberculosis (MDR TB) cases and that of other TB cases in Lima, Peru with the aim of identifying mechanisms responsible for the rise of MDR TB in an urban setting. All incident cases of TB in two districts of Lima, Peru during 2005–2007 were included. The spatiotemporal distributions of MDR cases and other TB cases were compared with Ripley's K statistic. Of 11 711 notified cases, 1187 received drug susceptibility testing and 376 were found to be MDR. Spatial aggregation of patients with confirmed MDR disease appeared similar to that of other patients in 2005 and 2006; however, in 2007, cases with confirmed MDR disease were found to be more tightly grouped. Subgroup analysis suggests the appearance of resistance may be driven by increased transmission. Interventions should aim to reduce the infectious duration for those with drug-resistant disease and improve infection control. PMID:21205434

Drug resistance in Mexico: results from the National Survey on Drug-Resistant Tuberculosis.

PubMed

Bojorquez-Chapela, I; Bäcker, C E; Orejel, I; López, A; Díaz-Quiñonez, A; Hernández-Serrato, M I; Balandrano, S; Romero, M; Téllez-Rojo Solís, M M; Castellanos, M; Alpuche, C; Hernández-Ávila, M; López-Gatell, H

2013-04-01

To present estimations obtained from a population-level survey conducted in Mexico of prevalence rates of mono-, poly- and multidrug-resistant strains among newly diagnosed cases of pulmonary tuberculosis (TB), as well as the main factors associated with multidrug resistance (combined resistance to isoniazid and rifampicin). Study data came from the National Survey on TB Drug Resistance (ENTB-2008), a nationally representative survey conducted during 2008-2009 in nine states with a stratified cluster sampling design. Samples were obtained for all newly diagnosed cases of pulmonary TB in selected sites. Drug susceptibility testing (DST) was performed for anti-tuberculosis drugs. DST results were obtained for 75% of the cases. Of these, 82.2% (95%CI 79.5-84.7) were susceptible to all drugs. The prevalence of multidrug-resistant TB (MDR-TB) was estimated at 2.8% (95%CI 1.9-4.0). MDR-TB was associated with previous treatment (OR 3.3, 95%CI 1.1-9.4). The prevalence of drug resistance is relatively low in Mexico. ENTB-2008 can be used as a baseline for future follow-up of drug resistance.

Alarming Levels of Drug-Resistant Tuberculosis in HIV-Infected Patients in Metropolitan Mumbai, India

PubMed Central

Isaakidis, Petros; Das, Mrinalini; Kumar, Ajay M V; Peskett, Christopher; Khetarpal, Minni; Bamne, Arun; Adsul, Balkrishna; Manglani, Mamta; Sachdeva, Kuldeep Singh; Parmar, Malik; Kanchar, Avinash; Rewari, B.B.; Deshpande, Alaka; Rodrigues, Camilla; Shetty, Anjali; Rebello, Lorraine; Saranchuk, Peter

2014-01-01

Background Drug-resistant tuberculosis (DR-TB) is a looming threat to tuberculosis control in India. However, no countrywide prevalence data are available. The burden of DR-TB in HIV-co-infected patients is likewise unknown. Undiagnosed and untreated DR-TB among HIV-infected patients is a major cause of mortality and morbidity. We aimed to assess the prevalence of DR-TB (defined as resistance to any anti-TB drug) in patients attending public antiretroviral treatment (ART) centers in greater metropolitan Mumbai, India. Methods A cross-sectional survey was conducted among adults and children ART-center attendees. Smear microscopy, culture and drug-susceptibility-testing (DST) against all first and second-line TB-drugs using phenotypic liquid culture (MGIT) were conducted on all presumptive tuberculosis patients. Analyses were performed to determine DR-TB prevalence and resistance patterns separately for new and previously treated, culture-positive TB-cases. Results Between March 2013 and January 2014, ART-center attendees were screened during 14135 visits, of whom 1724 had presumptive TB. Of 1724 attendees, 72 (4%) were smear-positive and 202 (12%) had a positive culture for Mycobacterium tuberculosis. Overall DR-TB was diagnosed in 68 (34%, 95% CI: 27%–40%) TB-patients. The proportions of DR-TB were 25% (29/114) and 44% (39/88) among new and previously treated cases respectively. The patterns of DR-TB were: 21% mono-resistant, 12% poly-resistant, 38% multidrug-resistant (MDR-TB), 21% pre-extensively-drug-resistant (MDR-TB plus resistance to either a fluoroquinolone or second-line injectable), 6% extensively drug-resistant (XDR-TB) and 2% extremely drug-resistant TB (XDR-TB plus resistance to any group-IV/V drug). Only previous history of TB was significantly associated with the diagnosis of DR-TB in multivariate models. Conclusion The burden of DR-TB among HIV-infected patients attending public ART-centers in Mumbai was alarmingly high, likely representing ongoing transmission in the community and health facilities. These data highlight the need to promptly diagnose drug-resistance among all HIV-infected patients by systematically offering access to first and second-line DST to all patients with ‘presumptive TB’ rather than ‘presumptive DR-TB’ and tailor the treatment regimen based on the resistance patterns. PMID:25333696

Amplification of DNA from preserved specimens shows blowflies were preadapted for the rapid evolution of insecticide resistance

PubMed Central

Hartley, C. J.; Newcomb, R. D.; Russell, R. J.; Yong, C. G.; Stevens, J. R.; Yeates, D. K.; La Salle, J.; Oakeshott, J. G.

2006-01-01

Mutations of esterase 3 confer two forms of organophosphate resistance on contemporary Australasian Lucilia cuprina. One form, called diazinon resistance, is slightly more effective against commonly used insecticides and is now more prevalent than the other form, called malathion resistance. We report here that the single amino acid replacement associated with diazinon resistance and two replacements associated with malathion resistance also occur in esterase 3 in the sibling species Lucilia sericata, suggesting convergent evolution around a finite set of resistance options. We also find parallels between the species in the geographic distributions of the polymorphisms: In both cases, the diazinon-resistance change is absent or rare outside Australasia where insecticide pressure is lower, whereas the changes associated with malathion resistance are widespread. Furthermore, PCR analysis of pinned specimens of Australasian L. cuprina collected before the release of organophosphate insecticides reveals no cases of the diazinon-resistance change but several cases of those associated with malathion resistance. Thus, the early outbreak of resistance in this species can be explained by the preexistence of mutant alleles encoding malathion resistance. The pinned specimen analysis also shows much higher genetic diversity at the locus before organophosphate use, suggesting that the subsequent sweep of diazinon resistance in Australasia has compromised the scope for the locus to respond further to the ongoing challenge of the insecticides. PMID:16723400

Why University Members Use and Resist Technology? A Structure Enactment Perspective

ERIC Educational Resources Information Center

Lin, Canchu; Singer, Ross; Ha, Louisa

2010-01-01

This case study investigated university members' use of and resistance to a communication information technology system in a higher education organization. This case study utilized the technology enactment framework to examine structure enactment in university members' technology use and resistance. We found that the following structures were…

Progress on mechanism of ethambutol resistance in Mycobacterium Tuberculosis.

PubMed

Wang, Ting; Jiao, Wei-wei; Shen, A-dong

2016-10-20

The occurance and prevalence of multidrug-resistant tuberculosis poses a serious threat to the global tuberculosis control. Ethambutol (EMB) is one of the first-line anti-tuberculosis drugs, which is usually used in combination with isoniazid and rifampicin for treating pan-sensitive tuberculosis, and it can also be used in drug-resistant tuberculosis. However, the situation of EMB resistance is alarmingly high, especially in multi-drug resistant tuberculosis. In China, EMB resistance rate in the previously treated cases was up to 17.2% and showed an increased tendency. What was worse, 51.3%-66.7% of multidrug-resistant tuberculosis cases were resistant to EMB. Thus, it is important to understand the drug resistance mechanism of EMB, which will help to slow down the drug resistance rate of EMB. In this review, we focus on the current status of EMB resistance, the effects of EMB and the mechanisms of EMB resistance in Mycobacterium tuberculosis.

Treatment initiation among persons diagnosed with drug resistant tuberculosis in Johannesburg, South Africa

PubMed Central

Schnippel, Kathryn; Govathson, Caroline; Sineke, Tembeka; Black, Andrew; Long, Lawrence; Berhanu, Rebecca; Rosen, Sydney

2017-01-01

Background In South Africa, roughly half of the drug-resistant TB cases diagnosed are reported to have been started on treatment. We determined the proportion of persons diagnosed with rifampicin resistant (RR-) TB who initiated treatment in Johannesburg after the introduction of decentralized RR-TB care in 2011. Methods We retrospectively matched adult patients diagnosed with laboratory-confirmed RR-TB in Johannesburg from 07/2011-06/2012 with records of patients initiating RR-TB treatment at one of the city’s four public sector treatment sites (one centralized, three decentralized). Patients were followed from date of diagnosis until the earliest of RR-TB treatment initiation, death, or 6 months’ follow-up. We report diagnostic methods and outcomes, proportions initiating treatment, and median time from diagnosis to treatment initiation. Results 594 patients were enrolled (median age 34 (IQR 29–42), 287 (48.3%) female). Diagnosis was by GenoType MTBDRplus (Hain-Life-Science) line probe assay (LPA) (281, 47.3%), Xpert MTB/RIF (Cepheid) (258, 43.4%), or phenotypic drug susceptibility testing (DST) (30, 5.1%) with 25 (4.2%) missing a diagnosis method. 320 patients (53.8%) had multi-drug resistant TB, 158 (26.6%) rifampicin resistant TB by Xpert MTB/RIF, 102 (17.2%) rifampicin mono-resistance, and 14 (2.4%) extensively drug-resistant TB. 256/594 (43.0%) patients initiated treatment, representing 70.7% of those who were referred for treatment (362/594). 338/594 patients (57.0%) did not initiate treatment, including 104 (17.5%) who died before treatment was started. The median time from sputum collection to treatment initiation was 33 days (IQR 12–52). Conclusion Despite decentralized RR-TB treatment, fewer than half the patients diagnosed in Johannesburg initiated appropriate treatment. Offering treatment at decentralized sites alone is not sufficient; improvements in linking patients diagnosed with RR-TB to effective treatment is essential. PMID:28746344

Anti-tuberculosis drug resistance in Bangladesh: reflections from the first nationwide survey.

PubMed

Kamal, S M M; Hossain, A; Sultana, S; Begum, V; Haque, N; Ahmed, J; Rahman, T M A; Hyder, K A; Hossain, S; Rahman, M; Ahsan, Chowdhury R; Chowdhury, R A; Aung, K J M; Islam, A; Hasan, R; Van Deun, A

2015-02-01

To determine the prevalence of tuberculosis (TB) drug resistance in Bangladesh. Weighted cluster sampling among smear-positive cases, and standard culture and drug susceptibility testing on solid medium were used. Of 1480 patients enrolled during 2011, 12 falsified multidrug-resistant TB (MDR-TB) patients were excluded. Analysis included 1340 cases (90.5% of those enrolled) with valid results and known treatment antecedents. Of 1049 new cases, 12.3% (95%CI 9.3-16.1) had strains resistant to any of the first-line drugs tested, and 1.4% (95%CI 0.7-2.5) were MDR-TB. Among the 291 previously treated cases, this was respectively 43.2% (95%CI 37.1-49.5) and 28.5% (95%CI 23.5-34.1). History of previous anti-tuberculosis treatment was the only predictive factor for first-line drug resistance (OR 34.9). Among the MDR-TB patients, 19.2% (95%CI 11.3-30.5; exclusively previously treated) also showed resistance to ofloxacin. Resistance to kanamycin was not detected. Although MDR-TB prevalence was relatively low, transmission of MDR-TB may be increasing in Bangladesh. MDR-TB with fluoroquinolone resistance is rapidly rising. Integrating the private sector should be made high priority given the excessive proportion of MDR-TB retreatment cases in large cities. TB control programmes and donors should avoid applying undue pressure towards meeting global targets, which can lead to corruption of data even in national surveys.

High Incidence of Tuberculosis, Low Sensitivity of Current Diagnostic Scheme and Prolonged Culture Positivity in Four Colombian Prisons. A Cohort Study

PubMed Central

Rueda, Zulma Vanessa; López, Lucelly; Vélez, Lázaro A.; Marín, Diana; Giraldo, Margarita Rosa; Pulido, Henry; Orozco, Luis Carlos; Montes, Fernando; Arbeláez, María Patricia

2013-01-01

Objective To determine the incidence of pulmonary tuberculosis (TB) in inmates, factors associated with TB, and the time to sputum smear and culture conversion during TB treatment. Methods Prospective cohort study. All prisoners with respiratory symptoms (RS) of any duration were evaluated. After participants signed consent forms, we collected three spontaneous sputum samples on consecutive days. We performed auramine-rhodamine staining, culturing with the thin-layer agar method, Löwestein-Jensen medium and MGIT, susceptibility testing for first-line drugs; and HIV testing. TB cases were followed, and the times to smear and culture conversion to negative were evaluated. Results Of 9,507 prisoners held in four prisons between April/30/2010 and April/30/2012, among them 4,463 were screened, 1,305 were evaluated for TB because of the lower RS of any duration, and 72 were diagnosed with TB. The annual incidence was 505 cases/100,000 prisoners. Among TB cases, the median age was 30 years, 25% had <15 days of cough, 12.5% had a history of prior TB, and 40.3% had prior contact with a TB case. TB-HIV coinfection was diagnosed in three cases. History of prior TB, contact with a TB case, and being underweight were risk factors associated with TB. Overweight was a protective factor. Almost a quarter of TB cases were detected only by culture; three cases were isoniazid resistant, and two resistant to streptomycin. The median times to culture conversion was 59 days, and smear conversion was 33. Conclusions The TB incidence in prisons is 20 times higher than in the general Colombian population. TB should be considered in inmates with lower RS of any duration. Our data demonstrate that patients receiving adequate anti-TB treatment remain infectious for prolonged periods. These findings suggest that current recommendations regarding isolation of prisoners with TB should be reconsidered, and suggest the need for mycobacterial cultures during follow-up. PMID:24278293

Rising Rates of Carbapenem-Resistant Enterobacteriaceae in Community Hospitals: A Mixed-Methods Review of Epidemiology and Microbiology Practices in a Network of Community Hospitals in the Southeastern United States

PubMed Central

Thaden, Joshua T.; Lewis, Sarah S.; Hazen, Kevin C.; Huslage, Kirk; Fowler, Vance G.; Moehring, Rebekah W.; Chen, Luke F.; Jones, Constance D.; Moore, Zack S.; Sexton, Daniel J.; Anderson, Deverick J.

2014-01-01

OBJECTIVE Describe the epidemiology of carbapenem-resistant Enterobacteriaceae (CRE) and examine the effect of lower carbapenem breakpoints on CRE detection. DESIGN Retrospective cohort. SETTING Inpatient care at community hospitals. PATIENTS All patients with CRE-positive cultures were included. METHODS CRE isolated from 25 community hospitals were prospectively entered into a centralized database from January 2008 through December 2012. Microbiology laboratory practices were assessed using questionnaires. RESULTS A total of 305 CRE isolates were detected at 16 hospitals (64%). Patients with CRE had symptomatic infection in 180 cases (59%) and asymptomatic colonization in the remainder (125 cases; 41%). Klebsiella pneumoniae (277 isolates; 91%) was the most prevalent species. The majority of cases were healthcare associated (288 cases; 94%). The rate of CRE detection increased more than fivefold from 2008 (0.26 cases per 100,000 patient-days) to 2012 (1.4 cases per 100,000 patient-days; incidence rate ratio (IRR), 5.3 [95% confidence interval (CI), 1.22–22.7]; P = .01). Only 5 hospitals (20%) had adopted the 2010 Clinical and Laboratory Standards Institute (CLSI) carbapenem breakpoints. The 5 hospitals that adopted the lower carbapenem breakpoints were more likely to detect CRE after implementation of breakpoints than before (4.1 vs 0.5 cases per 100,000 patient-days; P < .001; IRR, 8.1 [95% CI, 2.7–24.6]). Hospitals that implemented the lower carbapenem breakpoints were more likely to detect CRE than were hospitals that did not (3.3 vs 1.1 cases per 100,000 patientdays; P = .01). CONCLUSIONS The rate of CRE detection increased fivefold in community hospitals in the southeastern United States from 2008 to 2012. Despite this, our estimates are likely underestimates of the true rate of CRE detection, given the low adoption of the carbapenem breakpoints recommended in the 2010 CLSI guidelines. PMID:25026612

Clinical management of resistance evolution in a bacterial infection: A case study.

PubMed

Woods, Robert J; Read, Andrew F

2015-10-10

We report the case of a patient with a chronic bacterial infection that could not be cured. Drug treatment became progressively less effective due to antibiotic resistance, and the patient died, in effect from overwhelming evolution. Even though the evolution of drug resistance was recognized as a major threat, and the fundamentals of drug resistance evolution are well understood, it was impossible to make evidence-based decisions about the evolutionary risks associated with the various treatment options. We present this case to illustrate the urgent need for translational research in the evolutionary medicine of antibiotic resistance. © The Author(s) 2015. Published by Oxford University Press on behalf of the Foundation for Evolution, Medicine, and Public Health.

An Investigation of Agility Issues in Scrum Teams Using Agility Indicators

NASA Astrophysics Data System (ADS)

Pikkarainen, Minna; Wang, Xiaofeng

Agile software development methods have emerged and become increasingly popular in recent years; yet the issues encountered by software development teams that strive to achieve agility using agile methods are yet to be explored systematically. Built upon a previous study that has established a set of indicators of agility, this study investigates what issues are manifested in software development teams using agile methods. It is focussed on Scrum teams particularly. In other words, the goal of the chapter is to evaluate Scrum teams using agility indicators and therefore to further validate previously presented agility indicators within the additional cases. A multiple case study research method is employed. The findings of the study reveal that the teams using Scrum do not necessarily achieve agility in terms of team autonomy, sharing, stability and embraced uncertainty. The possible reasons include previous organizational plan-driven culture, resistance towards the Scrum roles and changing resources.

Case report: severe heat stroke with multiple organ dysfunction – a novel intravascular treatment approach

PubMed Central

Broessner, Gregor; Beer, Ronny; Franz, Gerhard; Lackner, Peter; Engelhardt, Klaus; Brenneis, Christian; Pfausler, Bettina; Schmutzhard, Erich

2005-01-01

Introduction We report the case of a patient who developed a severe post-exertional heat stroke with consecutive multiple organ dysfunction resistant to conventional antipyretic treatment, necessitating the use of a novel endovascular device to combat hyperthermia and maintain normothermia. Methods A 38-year-old male suffering from severe heat stroke with predominant signs and symptoms of encephalopathy requiring acute admission to an intensive care unit, was admitted to a ten-bed neurological intensive care unit of a tertiary care hospital. The patient developed consecutive multiple organ dysfunction with rhabdomyolysis, and hepatic and respiratory failure. Temperature elevation was resistant to conventional treatment measures. Aggressive intensive care treatment included forced diuresis and endovascular cooling to combat hyperthermia and maintain normothermia. Results Analyses of serum revealed elevation of proinflammatory cytokines (TNF alpha, IL-6), cytokines (IL-2R), anti-inflammatory cytokines (IL-4) and chemokines (IL-8) as well as signs of rhabdomyolysis and hepatic failure. Aggressive intensive care treatment as forced diuresis and endovascular cooling (CoolGard® and CoolLine®) to combat hyperthermia and maintain normothermia were used successfully to treat this severe heat stroke. Conclusion In this case of severe heat stroke, presenting with multiple organ dysfunction and elevation of cytokines and chemokines, which was resistant to conventional cooling therapies, endovascular cooling may have contributed significantly to the reduction of body temperature and, possibly, avoided a fatal result. PMID:16285034

Healthcare workers' knowledge and perceptions of the risks associated with emerging extensively drug-resistant bacteria.

PubMed

Celeste, C; Jolivet, S; Bonneton, M; Brun-Buisson, C; Jansen, C

2017-11-01

Guidelines have been issued in 2010 to prevent the spread of emerging extensively resistant bacteria (eXDR), but their implementation is difficult. We aimed to evaluate healthcare workers' (HCW) knowledge and their risk perception to identify barriers to the implementation of guidelines. Semi-structured interviews were conducted at a University Hospital, where case patients are regularly admitted. The interviews focused on HCW's knowledge, risk perception, and challenges met. The evaluation of HCW's knowledge and contagiousness and perception of severity of eXDR carriage were analyzed statistically. Risk perception and opinion about guidelines were analyzed by qualitative description. One hundred and twenty-one HCWs were interviewed. The category of HCW, having searched for information on resistant bacteria, and having taken care of case patients were associated with better knowledge. The HCW category, age, type of unit, seniority, and having taken care of case patients were associated with risk perceptions. Qualitative analysis identified 61 themes. HCWs were extremely concerned by the spread of bacteria within the hospital. The main challenges identified were organizational and communication issues. HCWs reported a lack of knowledge and a lack of resources to implement guidelines. Strategies to improve guidelines implementation must be based on a better availability of resources, better communication, and new educational methods. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

Maxwell-Wagner relaxation in electrical imaging.

PubMed

Korjenevsky, A V

2005-04-01

The electric field tomography (EFT) method exploits interaction of high-frequency electric field with an inhomogeneous conductive medium without contact with the electrodes. The interaction is accompanied by a high-frequency redistribution of free charges inside the medium and leads to small and regular phase shifts of the field in the area surrounding an object. Such a kind of phenomenon is referred to as the Maxwell-Wagner relaxation. Measuring the perturbations of the field using the set of electrodes placed around the object enables us to reconstruct the internal structure of the medium, generally the spatial distribution of a nonlinear combination of permittivity and resistivity. In the case of biomedical applications the result of measurements is determined mainly by the resistivity of the tissues. Three-dimensional simulation based on the finite element method has demonstrated the feasibility of the technique.

Fundamentals of EUV resist-inorganic hardmask interactions

NASA Astrophysics Data System (ADS)

Goldfarb, Dario L.; Glodde, Martin; De Silva, Anuja; Sheshadri, Indira; Felix, Nelson M.; Lionti, Krystelle; Magbitang, Teddie

2017-03-01

High resolution Extreme Ultraviolet (EUV) patterning is currently limited by EUV resist thickness and pattern collapse, thus impacting the faithful image transfer into the underlying stack. Such limitation requires the investigation of improved hardmasks (HMs) as etch transfer layers for EUV patterning. Ultrathin (<5nm) inorganic HMs can provide higher etch selectivity, lower post-etch LWR, decreased defectivity and wet strippability compared to spin-on hybrid HMs (e.g., SiARC), however such novel layers can induce resist adhesion failure and resist residue. Therefore, a fundamental understanding of EUV resist-inorganic HM interactions is needed in order to optimize the EUV resist interfacial behavior. In this paper, novel materials and processing techniques are introduced to characterize and improve the EUV resist-inorganic HM interface. HM surface interactions with specific EUV resist components are evaluated for open-source experimental resist formulations dissected into its individual additives using EUV contrast curves as an effective characterization method to determine post-development residue formation. Separately, an alternative adhesion promoter platform specifically tailored for a selected ultrathin inorganic HM based on amorphous silicon (aSi) is presented and the mitigation of resist delamination is exemplified for the cases of positive-tone and negative-tone development (PTD, NTD). Additionally, original wafer priming hardware for the deposition of such novel adhesion promoters is unveiled. The lessons learned in this work can be directly applied to the engineering of EUV resist materials and processes specifically designed to work on such novel HMs.

[Epidemiological characteristics of typhoid fever and antibiotic susceptibility testing of Salmonella Typhi isolates in Guangxi, 1994-2013].

PubMed

Wang, Mingliu; Kan, Biao; Yang, Jin; Lin, Mei; Yan, Meiying; Zeng, Jun; Quan, Yi; Liao, Hezhuang; Zhou, Lingyun; Jiang, Zhenling; Huang, Dehui

2014-08-01

Through analyzing the typhoid epidemics and to determine and monitor regional resistance characteristics of the shift of drug resistant profile on Salmonella (S.) Typhi, to understand the related epidemiological characteristics of typhoid fever and to provide evidence for the development of strategies, in Guangxi. Data of typhoid fever from surveillance and reporting system between 1994 to 2013 was collected and statistically analyzed epidemiologically. The susceptibility of 475 S. Typhi isolates from patients on ten antibiotics was tested by broth micro-dilution method and minimum inhibition concentration was obtained and interpreted based on the CLSI standard. From 1994 to 2013, a total of 57 928 cases of typhoid fever were reported in Guangxi province with an annual incidence of 6.29/100 000 and mortality as 0.03%. The higher incidence was observed in the population under 20 years of age. There was no significant difference on incidence between male and female, but farmers and students were among the hardest hit groups. More cases were seen from the northern part of the province. Cases appeared all year round with the peak from May to October. A total of 13 major outbreaks during 2001 to 2013 were reported and the main transmission route was water-borne. All the strains were sensitive to third generation cephalosporins cefotaxime and fluoroquinolones norfloxacin. The susceptibility rates to tetracycline, chloramphenicol, ampicillin and gentamicin was around 98% but relative lower susceptible rate to ciprofloxacin was seen as 89.89% . The lowest susceptibility was found for streptomycin and sulfamethoxazole agents, with the rates as 67.73% and 65.89% , respectively. One strain was found to have been resistant to ciprofloxacin and another 47 isolates with reduced susceptibility to ciprofloxacin. Twenty eight isolates were found to be resistant to multiple antibiotics and one displayed ampicillin, chloramphenicol, streptomycin, sulfamethoxazole tetracycline and nalidixic acid (ACSSxT-NAL) resistance profile. This was the first report in China. Multi-drug resistant strains were frequently isolated from small scale outbreaks of typhoid fever. The incidence of typhoid fever in Guangxi was still high and some strains showed multi-drug resistance and reduced susceptibility to ciprofloxacin, indicating that the surveillance and monitor programs on drug resistance of S. Typhi should be strengthened, to prevent large scale outbreaks of typhoid fever in this province.

[The present situation, treatment and prognosis of drug-resistant pulmonary tuberculosis. Cooperative Study Unit of Chemotherapy of Tuberculosis of the National Sanitoria in Japan].

PubMed

Sato, K; Nagai, H; Kurashima, A; Mori, M; Katayama, T

1995-10-01

We studied 266 patients with drug-resistant pulmonary tuberculosis at national sanatoria in Japan. The patients included 218 men (mean age, 58 years) and 48 women (mean age, 62 years). The levels of isoniazid and rifampicin resistance were determined at 1 mcg/mL and 50 mcg/mL, respectively. The results were as follows. (1) Most patients with drug-resistant pulmonary tuberculosis were middle-aged or past middle-aged. (2) There were many cases of drug-resistant pulmonary tuberculosis in previously treated tuberculosis patients with active disease and several cases in previously untreated pulmonary tuberculosis patients. However, in some previously untreated patients active tuberculosis was convert relatively easily to inactive tuberculosis. (3) Concerning life style, bachelors who drank heavily were more likely to develop drug-resistant pulmonary tuberculosis. (4) Most cases of drug-resistant pulmonary tuberculosis had at least one cavity on chest radiographs. (5) Several patients with drug-resistant tuberculosis left the hospital against the advice of their attending doctors; therefore, it was difficult to treat their illnesses. (6) In more than half the cases in which Mycobacterium tuberculosis was resistant to isoniazid and rifampicin, tolerance to streptomycin and ethanbutol was also seen. (7) When patients with drug-resistant pulmonary tuberculosis continued to have tuberculous bacilli in their sputum after 3 months of chemotherapy, there was a tendency for them to expectorate tuberculous bacilli in their sputum. For these drug-resistant tuberculosis patients, we must pay attention not only to the medical aspects but also to the social aspects of their disease.

First Nine Cases of Candida auris Infection Reported in Central America: Importance of Acurate Diagnosis and Susceptibility Testing

PubMed Central

Rodriguez, Ana Belen Arauz; Caceres, Diego H; Santiago, Erika; Armstrong, Paige; French, Amalia Rodriguez; Arosemena, Susan; Ramos, Carolina; Espinosa-Bode, Andres; Borace, Jovanna; Hayer, Lizbeth; Cedeño, Israel; Sosa, Nestor; Berkow, Elizabeth L; Lockhart, Shawn R; Jackson, Brendan R; Chiller, Tom

2017-01-01

Abstract Background Candida auris is an emerging multidrug-resistant pathogen associated with invasive infections and high mortality. This report describes the first 9 cases of C. auris in Central America in a hospital in Panama City, Panama, and highlights the challenges of accurate identification and methods for susceptibility testing. Methods Isolates initially identified at a Panama City acute care hospital during July–October 2016 as Candida haemulonii (a common misidentification for C. auris) or Candida species by Vitek® 2 automated system (bioMérieux) were further characterized by molecular methods. Antifungal susceptibility testing was performed and results were compared between standard and reference methodologies. Patient demographic, clinical, and laboratory data were collected from the medical record. Results A total of 14 isolates from 9 hospitalized patients were confirmed as C. auris. Isolates were from urine (11), blood (1), catheter tip (1) and pleural fluid (1). Results of susceptibility testing were highly discrepant between automated and reference techniques for fluconazole (92% resistant vs. 77%, respectively) and amphotericin B (100% vs. 8%). Six (67%) patients were male, and the mean age was 53 years (range 42–78). All patients were admitted to the intensive care unit and were mechanically ventilated. Seven (78%) patients died. Conclusion C. auris is present in Central America. Healthcare facilities in the region should be vigilant for this concerning pathogen, particularly given challenges in its identification and need for infection control precautions. Although automated testing overestimated amphotericin B resistance, most initial isolates were susceptible by reference testing. Disclosures All authors: No reported disclosures.

Penicillin-susceptible Staphylococcus aureus: susceptibility testing, resistance rates and outcome of infection.

PubMed

Hagstrand Aldman, Malin; Skovby, Annette; I Påhlman, Lisa

2017-06-01

Staphylococcus aureus (SA) is an important human pathogen that causes both superficial and invasive infections. Penicillin is now rarely used in the treatment of SA infections due to widespread resistance and a concern about the accuracy of existing methods for penicillin susceptibility testing. The aims of the present study were to determine the frequency of penicillin-susceptible SA isolates from blood and wound cultures in Lund, Sweden, and to evaluate methods for penicillin testing in SA. We also wanted to investigate if penicillin-susceptible isolates are associated with higher mortality. Hundred blood culture isolates collected 2008/2009, 140 blood culture isolates from 2014/2015, and 141 superficial wound culture strains from 2015 were examined. Penicillin susceptibility was tested with disk diffusion according to EUCAST guidelines, and results were confirmed with a cloverleaf assay and PCR amplification of the BlaZ gene. Patient data for all bacteraemia cases were extracted from medical records. The disk diffusion method with assessment of both zone size and zone edge appearance had high accuracy in our study. About 57% of bacteraemia isolates from 2008/2009 were sensitive to penicillin compared to 29% in 2014/2015 (p < .0001). In superficial wound cultures, 21% were penicillin susceptible. There was no difference in co-morbidity or mortality rates between patients with penicillin resistant and penicillin sensitive SA bacteraemia. Disk-diffusion is a simple and reliable method to detect penicillin resistance in SA, and susceptibility rates are significant. Penicillin has many theoretical advantages and should be considered in the treatment of SA bacteraemia when susceptible.

Arc and resistance welding and tumours of the endocrine glands: a Swedish case-control study with focus on extremely low frequency magnetic fields

PubMed Central

Hakansson, N; Stenlund, C; Gustavsson, P; Johansen, C; Floderus, B

2005-01-01

Background: Mechanisms for potential effects of extremely low frequency (ELF) magnetic fields on carcinogenesis have not been identified. A potential pathway could be an interaction with the endocrine system. Aims: To analyse occupational exposure to ELF magnetic fields from welding, and tumours of the endocrine glands. Methods: This case-control study was based on a cohort with an increased prevalence of high exposed individuals. A total of 174 incident cases of tumours of the endocrine glands, 1985–94, were identified and data were obtained from 140 (80%) of these cases; 1692 controls frequency matched on sex and age were selected, and information on 1306 (77%) individuals was obtained. A short questionnaire was sent to a work administrator at the workplaces of the cases and controls. The exposure assessment was based on questions about job tasks, exposure to different types of welding, and exposure to solvents. Results: There was an overall increased risk for all tumours of the endocrine glands for individuals who had been welding sometime during the follow up. The increased risk was attributable to arc welding; for resistance welding there was no clear evidence of an association. We found an increased risk for the adrenal glands in relation to arc welding, and for the parathyroid glands in relation to both arc welding and resistance welding. An imprecise increase in risk was also noted for tumours of the pituitary gland for arc welding. No confounding effect was found for solvent exposure, and there was no sign of biological interaction. Conclusion: The increased risks of endocrine gland tumours related to welding might be explained by exposure to high levels of ELF magnetic fields. PMID:15837851

Joint interpretation of geophysical data using Image Fusion techniques

NASA Astrophysics Data System (ADS)

Karamitrou, A.; Tsokas, G.; Petrou, M.

2013-12-01

Joint interpretation of geophysical data produced from different methods is a challenging area of research in a wide range of applications. In this work we apply several image fusion approaches to combine maps of electrical resistivity, electromagnetic conductivity, vertical gradient of the magnetic field, magnetic susceptibility, and ground penetrating radar reflections, in order to detect archaeological relics. We utilize data gathered from Arkansas University, with the support of the U.S. Department of Defense, through the Strategic Environmental Research and Development Program (SERDP-CS1263). The area of investigation is the Army City, situated in Riley Country of Kansas, USA. The depth of the relics is estimated about 30 cm from the surface, yet the surface indications of its existence are limited. We initially register the images from the different methods to correct from random offsets due to the use of hand-held devices during the measurement procedure. Next, we apply four different image fusion approaches to create combined images, using fusion with mean values, wavelet decomposition, curvelet transform, and curvelet transform enhancing the images along specific angles. We create seven combinations of pairs between the available geophysical datasets. The combinations are such that for every pair at least one high-resolution method (resistivity or magnetic gradiometry) is included. Our results indicate that in almost every case the method of mean values produces satisfactory fused images that corporate the majority of the features of the initial images. However, the contrast of the final image is reduced, and in some cases the averaging process nearly eliminated features that are fade in the original images. Wavelet based fusion outputs also good results, providing additional control in selecting the feature wavelength. Curvelet based fusion is proved the most effective method in most of the cases. The ability of curvelet domain to unfold the image in terms of space, wavenumber, and orientation, provides important advantages compared with the rest of the methods by allowing the incorporation of a-priori information about the orientation of the potential targets.

Approach to the Investigation and Management of Patients With Candida auris, an Emerging Multidrug-Resistant Yeast.

PubMed

Tsay, Sharon; Kallen, Alexander; Jackson, Brendan R; Chiller, Tom M; Vallabhaneni, Snigdha

2018-01-06

Candida auris is an emerging, multidrug-resistant yeast that can spread in healthcare settings. It can cause invasive infections with high mortality and is difficult to identify using traditional yeast identification methods. Candida auris has been reported in more than a dozen countries, and as of August 2017, 112 clinical cases have been reported in the United States. Candida auris can colonize skin and persist in the healthcare environment, allowing for transmission between patients. Prompt investigation and aggressive interventions, including notification to public health agencies, implementation of contact precautions, thorough environmental cleaning and disinfection, infection control assessments, contact tracing and screening of contacts to assess for colonization, and retrospective review of microbiology records and prospective surveillance for cases at laboratories are all needed to limit the spread of C. auris. This review summarizes the current recommended approach to manage cases and control transmission of C. auris in healthcare facilities. Published by Oxford University Press for the Infectious Diseases Society of America 2017. This work is written by (a) US Government employee(s) and is in the public domain in the US.

Variable wide range of lens power and its improvement in a liquid-crystal lens using highly resistive films divided into two regions with different diameters

NASA Astrophysics Data System (ADS)

Kawamura, Marenori; Sato, Susumu

2018-05-01

The variable range of lens power of a liquid-crystal (LC) lens driven by two voltages is discussed on the basis of calculated and experimental results. The LC lens has two electrodes, which are a circularly hole-patterned electrode and a circular electrode, in addition to a common electrode, and highly resistive transparent films. The variable range of lens power increases with increasing driving voltage applied across the circularly hole-patterned electrode and the common electrode, and with decreasing diameter of highly resistive films. However, the optical-phase retardation profile tends to deviate from a parabolic curve in these cases. As a method to improve the trade-off properties, the highly resistive film is divided into two regions with different diameters, where the sheet resistance of an outer film is larger than that of an inner one. The improved LC lens has a lens power that varies in a wide range, and it exhibits a good parabolic phase retardation profile.

Addressing social resistance in emerging security technologies

PubMed Central

Mitchener-Nissen, Timothy

2013-01-01

In their efforts to enhance the safety and security of citizens, governments and law enforcement agencies look to scientists and engineers to produce modern methods for preventing, detecting, and prosecuting criminal activities. Whole body scanners, lie detection technologies, biometrics, etc., are all being developed for incorporation into the criminal justice apparatus.1 Yet despite their purported security benefits these technologies often evoke social resistance. Concerns over privacy, ethics, and function-creep appear repeatedly in analyses of these technologies. It is argued here that scientists and engineers continue to pay insufficient attention to this resistance; acknowledging the presence of these social concerns yet failing to meaningfully address them. In so doing they place at risk the very technologies and techniques they are seeking to develop, for socially controversial security technologies face restrictions and in some cases outright banning. By identifying sources of potential social resistance early in the research and design process, scientists can both engage with the public in meaningful debate and modify their security technologies before deployment so as to minimize social resistance and enhance uptake. PMID:23970863

Multicenter cross-sectional observational study of antibiotic resistance and the genotypes of Propionibacterium acnes isolated from Chinese patients with acne vulgaris.

PubMed

Fan, Yukun; Hao, Fei; Wang, Weizhen; Lu, Yonghong; He, Li; Wang, Gang; Chen, Wenchieh

2016-04-01

Antibiotics are widely applied in management of acne vulgaris, which raises the issue of antibiotic resistance. Due to improper application and supervision of antibiotics, antibiotic resistance has become a serious problem in China. So, the efficacy of antimicrobial therapy in acne is unclear without an objective monitor of antibiotic resistance of Propionibacterium acnes. This cross-sectional, multicenter observational study is aimed at understanding the status of antibiotic resistance in P. acnes, investigating the measures of acne management in China and analyzing the genotypes of antibiotic-resistant strains of P. acnes. Altogether, 312 strains of P. acnes were collected from patients in five medical centers across central China after reviewing the corresponding medical history in detail. The samples underwent antibiotic susceptibility assays by agar dilution method with a total of 11 classes of antibiotics being tested. The antibiotic-resistant strains were screened and further analyzed by investigation of the genotypes regarding 23S rRNA, 16S rRNA and erm(X). The predominant resistance occurred in macrolides and lincomycin with an overall resistance rate of 47.8%. The resistance to tetracyclines was scarce with only two cases identified. The emergence of minimum inhibitory concentration elevation for tetracyclines is associated with its application history (P < 0.005). The genotypes of the reported macrolide-lincosamide-streptogramin B resistance strains were also spotted in Chinese subjects while other resistance determinants may also exist. The tetracyclines have been proved to be vastly susceptible while macrolides and lincomycin face a serious resistance status in China. © 2015 Japanese Dermatological Association.

Zinc Finger Nuclease: A New Approach to Overcome Beta-Lactam Antibiotic Resistance

PubMed Central

Shahbazi Dastjerdeh, Mansoureh; Kouhpayeh, Shirin; Sabzehei, Faezeh; Khanahmad, Hossein; Salehi, Mansour; Mohammadi, Zahra; Shariati, Laleh; Hejazi, Zahra; Rabiei, Parisa; Manian, Mostafa

2016-01-01

Background: The evolution of antibiotic-resistant bacteria (ARB) and antibiotic-resistance genes (ARGs) has been accelerated recently by the indiscriminate application of antibiotics. Antibiotic resistance has challenged the success of medical interventions and therefore is considered a hazardous threat to human health. Objectives: The present study aimed to describe the use of zinc finger nuclease (ZFN) technology to target and disrupt a plasmid-encoded β-lactamase, which prevents horizontal gene transfer-mediated evolution of ARBs. Materials and Methods: An engineered ZFN was designed to target a specific sequence in the ampicillin resistance gene (ampR) of the pTZ57R plasmid. The Escherichia coli bacteria already contained the pZFN kanamycin-resistant (kanaR) plasmid as the case or the pP15A, kanaR empty vector as the control, were transformed with the pTZ57R; the ability of the designed ZFN to disrupt the β-lactamase gene was evaluated with the subsequent disturbed ability of the bacteria to grow on ampicillin (amp) and ampicillin-kanamycin (amp-kana)-containing media. The effect of mild hypothermia on the ZFN gene targeting efficiency was also evaluated. Results: The growth of bacteria in the case group on the amp and amp-kana-containing media was significantly lower compared with the control group at 37°C (P < 0.001). Despite being more efficient in hypothermic conditions at 30°C (P < 0.001), there were no significant associations between the incubation temperature and the ZFN gene targeting efficiency. Conclusions: Our findings revealed that the ZFN technology could be employed to overcome ampicillin resistance by the targeted disruption of the ampicillin resistance gene, which leads to inactivation of β-lactam synthesis. Therefore, ZFN technology could be engaged to decrease the antibiotic resistance issue with the construction of a ZFN archive against different ARGs. To tackle the resistance issue at the environmental level, recombinant phages expressing ZFNs against different ARGs could be constructed and released into both hospital and urban wastewater systems. PMID:27099691

CRSP, numerical results for an electrical resistivity array to detect underground cavities

NASA Astrophysics Data System (ADS)

Amini, Amin; Ramazi, Hamidreza

2017-03-01

This paper is devoted to the application of the Combined Resistivity Sounding and Profiling electrode configuration (CRSP) to detect underground cavities. Electrical resistivity surveying is among the most favorite geophysical methods due to its nondestructive and economical properties in a wide range of geosciences. Several types of the electrode arrays are applied to detect different certain objectives. In one hand, the electrode array plays an important role in determination of output resolution and depth of investigations in all resistivity surveys. On the other hand, they have their own merits and demerits in terms of depth of investigations, signal strength, and sensitivity to resistivity variations. In this article several synthetic models, simulating different conditions of cavity occurrence, were used to examine the responses of some conventional electrode arrays and also CRSP array. The results showed that CRSP electrode configuration can detect the desired objectives with a higher resolution rather than some other types of arrays. Also a field case study was discussed in which electrical resistivity approach was conducted in Abshenasan expressway (Tehran, Iran) U-turn bridge site for detecting potential cavities and/or filling loose materials. The results led to detect an aqueduct tunnel passing beneath the study area.

Polymorphisms of the Tissue Inhibitor of Metalloproteinase 3 Gene Are Associated with Resistance to High-Altitude Pulmonary Edema (HAPE) in a Japanese Population: A Case Control Study Using Polymorphic Microsatellite Markers

PubMed Central

Kobayashi, Nobumitsu; Hanaoka, Masayuki; Droma, Yunden; Ito, Michiko; Katsuyama, Yoshihiko; Kubo, Keishi; Ota, Masao

2013-01-01

Introduction High-altitude pulmonary edema (HAPE) is a hypoxia-induced, life-threatening, high permeability type of edema attributable to pulmonary capillary stress failure. Genome-wide association analysis is necessary to better understand how genetics influence the outcome of HAPE. Materials and Methods DNA samples were collected from 53 subjects susceptible to HAPE (HAPE-s) and 67 elite Alpinists resistant to HAPE (HAPE-r). The genome scan was carried out using 400 polymorphic microsatellite markers throughout the whole genome in all subjects. In addition, six single nucleotide polymorphisms (SNPs) of the gene encoding the tissue inhibitor of metalloproteinase 3 (TIMP3) were genotyped by Taqman® SNP Genotyping Assays. Results The results were analyzed using case-control comparisons. Whole genome scanning revealed that allele frequencies in nine markers were statistically different between HAPE-s and HAPE-r subjects. The SNP genotyping of the TIMP3 gene revealed that the derived allele C of rs130293 was associated with resistance to HAPE [odds ratio (OR) = 0.21, P = 0.0012) and recessive inheritance of the phenotype of HAPE-s (P = 0.0012). A haplotype CAC carrying allele C of rs130293 was associated with resistance to HAPE. Discussion This genome-wide association study revealed several novel candidate genes associated with susceptibility or resistance to HAPE in a Japanese population. Among those, the minor allele C of rs130293 (C/T) in the TIMP3 gene was linked to resistance to HAPE; while, the ancestral allele T was associated with susceptibility to HAPE. PMID:23991023

Rapid screening of MDR-TB using molecular Line Probe Assay is feasible in Uganda

PubMed Central

2010-01-01

Background About 500 new smear-positive Multidrug-resistant tuberculosis (MDR-TB) cases are estimated to occur per year in Uganda. In 2008 in Kampala, MDR-TB prevalence was reported as 1.0% and 12.3% in new and previously treated TB cases respectively. Line probe assays (LPAs) have been recently approved for use in low income settings and can be used to screen smear-positive sputum specimens for resistance to rifampicin and isoniazid in 1-2 days. Methods We assessed the performance of a commercial line probe assay (Genotype MTBDRplus) for rapid detection of rifampicin and isoniazid resistance directly on smear-positive sputum specimens from 118 previously treated TB patients in a reference laboratory in Kampala, Uganda. Results were compared with MGIT 960 liquid culture and drug susceptibility testing (DST). LPA testing was also performed in parallel in a University laboratory to assess the reproducibility of results. Results Overall, 95.8% of smear-positive specimens gave interpretable results within 1-2 days using LPA. Sensitivity, specificity, positive and negative predictive values were 100.0%, 96.1%, 83.3% and 100.0% for detection of rifampicin resistance; 80.8%, 100.0%, 100.0% and 93.0% for detection of isoniazid resistance; and 92.3%, 96.2%, 80.0% and 98.7% for detection of multidrug-resistance compared with conventional results. Reproducibility of LPA results was very high with 98.1% concordance of results between the two laboratories. Conclusions LPA is an appropriate tool for rapid screening for MDR-TB in Uganda and has the potential to substantially reduce the turnaround time of DST results. Careful attention must be paid to training, supervision and adherence to stringent laboratory protocols to ensure high quality results during routine implementation. PMID:20187922

Force of resistance to pipeline pulling in plane and volumetrically curved wells

NASA Astrophysics Data System (ADS)

Toropov, V. S.; Toropov, S. Yu; Toropov, E. S.

2018-05-01

A method has been developed for calculating the component of the pulling force of a pipeline, arising from the well curvature in one or several planes, with the assumption that the pipeline is ballasted by filling with water or otherwise until zero buoyancy in the drilling mud is reached. This paper shows that when calculating this force, one can neglect the effect of sections with zero curvature. In the other case, if buoyancy of the pipeline is other than zero, the resistance force in the curvilinear sections should be calculated taking into account the difference between the normal components of the buoyancy force and weight. In the paper, it is proved that without taking into account resistance forces from the viscosity of the drilling mud, if buoyancy of the pipeline is zero, the total resistance force is independent of the length of the pipe and is determined by the angle equal to the sum of the entry angle and the exit angle of the pipeline to the day surface. For the case of the well curvature in several planes, it is proposed to perform the calculation of such volumetrically curved well by the central angle of the well profile. Analytical dependences are obtained that allow calculating the pulling force for well profiles with a variable curvature radius, i.e. at different angles of deviation between the drill pipes along the well profile.

Keeping the Teacher at Arm's Length: Student Resistance in Writing Conferences in Two High School Classrooms

ERIC Educational Resources Information Center

Consalvo, Annamary; Maloch, Beth

2015-01-01

The purpose of this paper is to explore a subset of findings taken from yearlong qualitative study of writing conferences in two diversely populated, urban high school classrooms. Drawing on multiple data sources, we used case study and discourse analytic methods to follow two focal students across the year in order to examine instructional and…

Sociocultural Analysis of Second Language Learner Beliefs: A Qualitative Case Study of Two Study-Abroad ESL Learners

ERIC Educational Resources Information Center

Yang, Jin-Suk; Kim, Tae-Young

2011-01-01

Framed in Vygotsky's sociocultural theory (SCT) of mind, this paper explores second language (L2) learning beliefs in study-abroad (SA) contexts. Previous research on learner beliefs has relied mostly on survey methods, while regarding belief as a static, internal representation of experience that is resistant to change. Due to the concern…

JPRS Report, Science and Technology USSR: Life Sciences.

DTIC Science & Technology

1990-10-02

13 Epidemiology of HIV Infection in USSR [V. V. Pokrovskiy, L Yu. Yeramova, et al...tetracycline- resistant clones of this plasmid, obtained in vitro by the This paper examines the molecular epidemiological fea- prescribed method...noted in the last decade; it cases of illness, and a high proportion of late diagnoses is associated with a decline in epidemiological alertness owing

Calculation of Local Stress and Fatigue Resistance due to Thermal Stratification on Pressurized Surge Line Pipe

NASA Astrophysics Data System (ADS)

Bandriyana, B.; Utaja

2010-06-01

Thermal stratification introduces thermal shock effect which results in local stress and fatique problems that must be considered in the design of nuclear power plant components. Local stress and fatique calculation were performed on the Pressurize Surge Line piping system of the Pressurize Water Reactor of the Nuclear Power Plant. Analysis was done on the operating temperature between 177 to 343° C and the operating pressure of 16 MPa (160 Bar). The stagnant and transient condition with two kinds of stratification model has been evaluated by the two dimensional finite elements method using the ANSYS program. Evaluation of fatigue resistance is developed based on the maximum local stress using the ASME standard Code formula. Maximum stress of 427 MPa occurred at the upper side of the top half of hot fluid pipe stratification model in the transient case condition. The evaluation of the fatigue resistance is performed on 500 operating cycles in the life time of 40 years and giving the usage value of 0,64 which met to the design requirement for class 1 of nuclear component. The out surge transient were the most significant case in the localized effects due to thermal stratification.

Dynamics of layered reinforced concrete beam on visco-elastic foundation with different resistances of concrete and reinforcement to tension and compression

NASA Astrophysics Data System (ADS)

Nemirovsky, Y. V.; Tikhonov, S. V.

2018-03-01

Originally, fundamentals of the theory of limit equilibrium and dynamic deformation of building metal and reinforced concrete structures were created by A. A. Gvozdev [1] and developed by his followers [4, 5, 6, 7, 11, 12]. Forming the basis for the calculation, the model of an ideal rigid-plastic material has enabled to determine in many cases the ultimate load bearing capacity and upper (kinematically possible) or lower (statically valid) values for a wide class of different structures with quite simple methods. At the same time, applied to concrete structures the most important property of concrete to significantly differently resist tension and compression was not taken into account [10]. This circumstance was considered in [3] for reinforced concrete beams under conditions of quasistatic loading. The deformation is often accompanied by resistance of the environment in construction practice [8, 9]. In [2], the dynamics of multi-layered concrete beams on visco-elastic foundation under the loadings of explosive type is considered. In this work we consider the case which is often encountered in practical applications when the loadings weakly change in time.

Manipulating the magnetism and resistance state of Mn:ZnO/Pb(Zr0.52Ti0.48)O3 heterostructured films through electric fields

NASA Astrophysics Data System (ADS)

Li, Yong-Chao; Wu, Jun; Pan, Hai-Yang; Wang, Jue; Wang, Guang-Hou; Liu, Jun-Ming; Wan, Jian-Guo

2018-05-01

Mn:ZnO/Pb(Zr0.52Ti0.48)O3 (PZT) heterostructured films have been prepared on Pt/Ti/SiO2/Si wafers by a sol-gel process. Nonvolatile and reversible manipulation of the magnetism and resistance by electric fields has been realized. Compared with the saturation magnetic moment (Ms) in the +3.0 V case, the modulation gain of Ms can reach 270% in the -3.0 V case at room temperature. The resistance change is attributed to the interfacial potential barrier height variation and the formation of an accumulation (or depletion) layer at the Mn:ZnO/PZT interface, which can be regulated by the ferroelectric polarization direction. The magnetism of Mn:ZnO originates from bound magnetic polarons. The mobile carrier variation in Mn:ZnO, owing to interfacial polarization coupling and the ferroelectric field effect, enables the electric manipulation of the magnetism in the Mn:ZnO/PZT heterostructured films. This work presents an effective method for modulating the magnetism of magnetic semiconductors and provides a promising avenue for multifunctional devices with both electric and magnetic functionalities.

A Systematic Follow-Up of Mycobacterium tuberculosis Drug-Resistance and Associated Genotypic Lineages in the French Departments of the Americas over a Seventeen-Year Period

PubMed Central

Millet, Julie; Berchel, Mylène; Bomer, Anne-Gaël; Schuster, Franziska; Paasch, Delaina; Cadelis, Gilbert

2014-01-01

The population of the French Departments of the Americas (FDA) is highly influenced by the intense migratory flows with mainland France and surrounding countries of the Caribbean and Latin America, some of which have high incidence rates of tuberculosis (Haiti: 230/100,000; Guyana: 111/100,000; and Suriname: 145/100,000) and drug resistance. Since the development of drug resistance to conventional antituberculous drugs has a major impact on the treatment success of tuberculosis, we therefore decided to review carefully Mycobacterium tuberculosis drug resistance and associated genotypic lineages in the FDA over a seventeen-year period (January 1995–December 2011). A total of 1239 cases were studied, including 153 drug-resistant and 26 multidrug-resistant- (MDR-) TB cases, representing 12.3% and 2.1% of the TB cases in our study setting. A significantly higher proportion of M. tuberculosis isolates among relapse cases showed drug resistance to isoniazid (22.5%, P = 0.002), rifampicin (20.0%, P < 0.001), or both (MDR-TB, 17.5%; P < 0.001). Determination of spoligotyping based phylogenetic clades showed that among the five major lineages observed—T family (30.1%); Latin-American and Mediterranean (LAM, 23.7%); Haarlem (H, 22.2%); East-African Indian (EAI, 7.2%); and X family (6.5%)—two lineages, X and LAM, were overrepresented in drug-resistant and MDR-TB cases, respectively. Finally, 19 predominant spoligotypes were identified for the 1239 isolates of M. tuberculosis in our study among which 4 were significantly associated with drug resistance corresponding to SIT20/LAM1, SIT64/LAM6, SIT45/H1, and SIT46/undefined lineage. PMID:24738068

A systematic follow-up of Mycobacterium tuberculosis drug-resistance and associated genotypic lineages in the French Departments of the Americas over a seventeen-year period.

PubMed

Millet, Julie; Streit, Elisabeth; Berchel, Mylène; Bomer, Anne-Gaël; Schuster, Franziska; Paasch, Delaina; Vanhomwegen, Jessica; Cadelis, Gilbert; Rastogi, Nalin

2014-01-01

THE population of the French Departments of the Americas (FDA) is highly influenced by the intense migratory flows with mainland france and surrounding countries of the Caribbean and Latin America, some of which have high incidence rates of tuberculosis (Haiti: 230/100,000; Guyana: 111/100,000; and Suriname: 145/100,000) and drug resistance. Since the development of drug resistance to conventional antituberculous drugs has a major impact on the treatment success of tuberculosis, we therefore decided to review carefully Mycobacterium tuberculosis drug resistance and associated genotypic lineages in the FDA over a seventeen-year period (January 1995-December 2011). A total of 1239 cases were studied, including 153 drug-resistant and 26 multidrug-resistant- (MDR-) TB cases, representing 12.3% and 2.1% of the TB cases in our study setting. A significantly higher proportion of M. tuberculosis isolates among relapse cases showed drug resistance to isoniazid (22.5%, P = 0.002), rifampicin (20.0%, P < 0.001), or both (MDR-TB, 17.5%; P < 0.001). Determination of spoligotyping based phylogenetic clades showed that among the five major lineages observed--T family (30.1%); Latin-American and Mediterranean (LAM, 23.7%); Haarlem (H, 22.2%); East-African Indian (EAI, 7.2%); and X family (6.5%)--two lineages, X and LAM, were overrepresented in drug-resistant and MDR-TB cases, respectively. Finally, 19 predominant spoligotypes were identified for the 1239 isolates of M. tuberculosis in our study among which 4 were significantly associated with drug resistance corresponding to SIT20/LAM1, SIT64/LAM6, SIT45/H1, and SIT46/undefined lineage.

Rapid Molecular Diagnostics, Antibiotic Treatment Decisions, and Developing Approaches to Inform Empiric Therapy: PRIMERS I and II.

PubMed

Evans, Scott R; Hujer, Andrea M; Jiang, Hongyu; Hujer, Kristine M; Hall, Thomas; Marzan, Christine; Jacobs, Michael R; Sampath, Rangarajan; Ecker, David J; Manca, Claudia; Chavda, Kalyan; Zhang, Pan; Fernandez, Helen; Chen, Liang; Mediavilla, Jose R; Hill, Carol B; Perez, Federico; Caliendo, Angela M; Fowler, Vance G; Chambers, Henry F; Kreiswirth, Barry N; Bonomo, Robert A

2016-01-15

Rapid molecular diagnostic (RMD) platforms may lead to better antibiotic use. Our objective was to develop analytical strategies to enhance the interpretation of RMDs for clinicians. We compared the performance characteristics of 4 RMD platforms for detecting resistance against β-lactams in 72 highly resistant isolates of Escherichia coli and Klebsiella pneumoniae (PRIMERS I). Subsequently, 2 platforms were used in a blinded study in which a heterogeneous collection of 196 isolates of E. coli and K. pneumoniae (PRIMERS II) were examined. We evaluated the genotypic results as predictors of resistance or susceptibility against β-lactam antibiotics. We designed analytical strategies and graphical representations of platform performance, including discrimination summary plots and susceptibility and resistance predictive values, that are readily interpretable by practitioners to inform decision-making. In PRIMERS I, the 4 RMD platforms detected β-lactamase (bla) genes and identified susceptibility or resistance in >95% of cases. In PRIMERS II, the 2 platforms identified susceptibility against extended-spectrum cephalosporins and carbapenems in >90% of cases; however, against piperacillin/tazobactam, susceptibility was identified in <80% of cases. Applying the analytical strategies to a population with 15% prevalence of ceftazidime-resistance and 5% imipenem-resistance, RMD platforms predicted susceptibility in >95% of cases, while prediction of resistance was 69%-73% for ceftazidime and 41%-50% for imipenem. RMD platforms can help inform empiric β-lactam therapy in cases where bla genes are not detected and the prevalence of resistance is known. Our analysis is a first step in bridging the gap between RMDs and empiric treatment decisions. © The Author 2015. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail journals.permissions@oup.com.

Declining incidence of candidemia and the shifting epidemiology of Candida resistance in two US metropolitan areas, 2008-2013: results from population-based surveillance.

PubMed

Cleveland, Angela Ahlquist; Harrison, Lee H; Farley, Monica M; Hollick, Rosemary; Stein, Betsy; Chiller, Tom M; Lockhart, Shawn R; Park, Benjamin J

2015-01-01

Recent reports have demonstrated a decline in bacterial bloodstream infections (BSIs) following adherence to central line insertion practices; however, declines have been less evident for BSIs due to Candida species. We conducted active, population-based laboratory surveillance for candidemia in metropolitan Atlanta, GA and Baltimore, MD over a 5-year period. We calculated annual candidemia incidence and antifungal drug resistance rates. We identified 3,848 candidemia cases from 2008-2013. Compared with 2008, candidemia incidence per 100,000 person-years decreased significantly by 2013 in both locations (GA: 14.1 to 9.5, p<0.001; MD: 30.9 to 14.4, p<0.001). A total of 3,255 cases (85%) had a central venous catheter (CVC) in place within 2 days before the BSI culture date. In both locations, the number of CVC-associated cases declined (GA: 473 to 294; MD: 384 to 151). Candida albicans (CA, 36%) and Candida glabrata (CG, 27%) were the most common species recovered. In both locations, the proportion of cases with fluconazole resistance decreased (GA: 8.0% to 7.1%, -10%; MD: 6.6% to 4.9%, -25%), while the proportion of cases with an isolate resistant to an echinocandin increased (GA: 1.2% to 2.9%, +147%; MD: 2.0% to 3.5%, +77%). Most (74%) echinocandin-resistant isolates were CG; 17 (<1%) isolates were resistant to both drug categories (multidrug resistant [MDR], 16/17 were CG). The proportion of CG cases with MDR Candida increased from 1.8% to 2.6%. We observed a significant decline in the incidence of candidemia over a five-year period, and increases in echinocandin-resistant and MDR Candida. Efforts to strengthen infection control practices may be preventing candidemia among high-risk patients. Further surveillance for resistant Candida is warranted.

Toxic Shock Syndrome Caused by Methicillin-Resistant Staphylococcus aureus (MRSA) After Expander-Based Breast Reconstruction.

PubMed

Suga, Hirotaka; Shiraishi, Tomohiro; Takushima, Akihiko; Harii, Kiyonori

2016-01-01

Toxic shock syndrome is a rare but life-threatening complication after plastic surgery procedures. We experienced 2 cases of toxic shock syndrome after expander-based breast reconstruction caused by methicillin-resistant Staphylococcus aureus. The first patient took a severe clinical course due to the delayed diagnosis and treatment, and the second patient recovered rapidly after the early diagnosis and treatment based on our experience of the first case. Fever, rash, and gastrointestinal symptoms (diarrhea and/or vomiting) were characteristic and important for the early diagnosis of toxic shock syndrome. Considering the increased prevalence of methicillin-resistant Staphylococcus aureus, we should suspect methicillin-resistant Staphylococcus aureus in cases of toxic shock syndrome that occur postoperatively, and the empiric administration of vancomycin should be initiated in such cases.

Fabrication of thermal-resistant gratings for high-temperature measurements using geometric phase analysis.

PubMed

Zhang, Q; Liu, Z; Xie, H; Ma, K; Wu, L

2016-12-01

Grating fabrication techniques are crucial to the success of grating-based deformation measurement methods because the quality of the grating will directly affect the measurement results. Deformation measurements at high temperatures entail heating and, perhaps, oxidize the grating. The contrast of the grating lines may change during the heating process. Thus, the thermal-resistant capability of the grating becomes a point of great concern before taking measurements. This study proposes a method that combines a laser-engraving technique with the processes of particle spraying and sintering for fabricating thermal-resistant gratings. The grating fabrication technique is introduced and discussed in detail. A numerical simulation with a geometric phase analysis (GPA) is performed for a homogeneous deformation case. Then, the selection scheme of the grating pitch is suggested. The validity of the proposed technique is verified by fabricating a thermal-resistant grating on a ZrO 2 specimen and measuring its thermal strain at high temperatures (up to 1300 °C). Images of the grating before and after deformation are used to obtain the thermal-strain field by GPA and to compare the results with well-established reference data. The experimental results indicate that this proposed technique is feasible and will offer good prospects for further applications.

Investigation on low velocity impact resistance of SMA composite material

NASA Astrophysics Data System (ADS)

Hu, Dianyin; Zhang, Long; Wang, Rongqiao; Zhang, Xiaoyong

2016-04-01

A method to improve low velocity impact resistance of aeroengine composite casing using shape memory alloy's properties of shape memory(SM) and super-elasticity(SE) is proposed in this study. Firstly, a numerical modeling of SMA reinforced composite laminate under low velocity impact load with impact velocity of 10 m/s is established based on its constitutive model implemented by the VUMAT subroutine of commercial software ABAQUS. Secondly, the responses of SMA composite laminate including stress and deflection distributions were achieved through transient analysis under low velocity impact load. Numerical results show that both peak stress and deflection values of SMA composite laminate are less than that without SMA, which proves that embedding SMA into the composite structure can effectively improve the low velocity impact performance of composite structure. Finally, the influence of SM and SE on low velocity impact resistance is quantitatively investigated. The values of peak stress and deflection of SMA composite based on SM property decrease by 18.28% and 9.43% respectively, compared with those without SMA, instead of 12.87% and 5.19% based on SE. In conclusion, this proposed model described the impact damage of SMA composite structure and turned to be a more beneficial method to enhance the impact resistance by utilizing SM effect.

Non-invasive water-table imaging with joint DC-resistivity/microgravity/hydrologic-model inversion

NASA Astrophysics Data System (ADS)

Kennedy, J.; Macy, J. P.

2017-12-01

The depth of the water table, and fluctuations thereof, is a primary concern in hydrology. In riparian areas, the water table controls when and where vegetation grows. Fluctuations in the water table depth indicate changes in aquifer storage and variation in ET, and may also be responsible for the transport and degradation of contaminants. In the latter case, installation of monitoring wells is problematic because of the potential to create preferential flow pathways. We present a novel method for non-invasive water table monitoring using combined DC resistivity and repeat microgravity data. Resistivity profiles provide spatial resolution, but a quantifiable relation between resistivity changes and aquifer-storage changes depends on a petrophysical relation (typically, Archie's Law), with additional parameters and therefore uncertainty. Conversely, repeat microgravity data provide a direct, quantifiable measurement of aquifer-storage change but lack depth resolution. We show how these two geophysical measurements, together with an unsaturated-zone flow model (Hydrogeosphere), effectively constrain the water table position and help identify groundwater-flow model parameters. A demonstration of the method is made using field data collected during the historic 2014 pulse flow in the Colorado River Delta, which shows that geophysical data can effectively constrain a coupled surface-water/groundwater model used to simulate the potential for riparian vegetation germination and recruitment.

Tuberculosis in Greece: bacteriologically confirmed cases and anti-tuberculosis drug resistance, 1995-2009.

PubMed

Papaventsis, D; Nikolaou, S; Karabela, S; Ioannidis, P; Konstantinidou, E; Marinou, I; Sainti, A; Kanavaki, S

2010-07-15

The Greek National Reference Laboratory for Mycobacteria is a major source of tuberculosis (TB)-related data for Greece, where the TB burden and epidemiology still need to be better defined. We present data regarding newly diagnosed TB cases and resistance to anti-TB drugs during the last 15 years in Greece. Although the total number of newly detected TB cases has declined, cases among immigrants are increasing. Resistance to first-line anti-TB drugs is widely prevalent, although stable or declining. The implementation of an efficient and effective countrywide TB surveillance system in Greece is urgently needed.

Temperature Resistant Fiber Bragg Gratings for On-Line and Structural Health Monitoring of the Next-Generation of Nuclear Reactors.

PubMed

Laffont, Guillaume; Cotillard, Romain; Roussel, Nicolas; Desmarchelier, Rudy; Rougeault, Stéphane

2018-06-02

The harsh environment associated with the next generation of nuclear reactors is a great challenge facing all new sensing technologies to be deployed for on-line monitoring purposes and for the implantation of SHM methods. Sensors able to resist sustained periods at very high temperatures continuously as is the case within sodium-cooled fast reactors require specific developments and evaluations. Among the diversity of optical fiber sensing technologies, temperature resistant fiber Bragg gratings are increasingly being considered for the instrumentation of future nuclear power plants, especially for components exposed to high temperature and high radiation levels. Research programs are supporting the developments of optical fiber sensors under mixed high temperature and radiative environments leading to significant increase in term of maturity. This paper details the development of temperature-resistant wavelength-multiplexed fiber Bragg gratings for temperature and strain measurements and their characterization for on-line monitoring into the liquid sodium used as a coolant for the next generation of fast reactors.

Lethal neonatal meningoencephalitis caused by multi-drug resistant, highly virulent Escherichia coli.

PubMed

Iqbal, Junaid; Dufendach, Kevin R; Wellons, John C; Kuba, Maria G; Nickols, Hilary H; Gómez-Duarte, Oscar G; Wynn, James L

2016-01-01

Neonatal meningitis is a rare but devastating condition. Multi-drug resistant (MDR) bacteria represent a substantial global health risk. This study reports on an aggressive case of lethal neonatal meningitis due to a MDR Escherichia coli (serotype O75:H5:K1). Serotyping, MDR pattern and phylogenetic typing revealed that this strain is an emergent and highly virulent neonatal meningitis E. coli isolate. The isolate was resistant to both ampicillin and gentamicin; antibiotics currently used for empiric neonatal sepsis treatment. The strain was also positive for multiple virulence genes including K1 capsule, fimbrial adhesion fimH, siderophore receptors iroN, fyuA and iutA, secreted autotransporter toxin sat, membrane associated proteases ompA and ompT, type II polysaccharide synthesis genes (kpsMTII) and pathogenicity-associated island (PAI)-associated malX gene. The presence of highly-virulent MDR organisms isolated in neonates underscores the need to implement rapid drug resistance diagnostic methods and should prompt consideration of alternate empiric therapy in neonates with Gram negative meningitis.

Comparative study of Wenner and Schlumberger electrical resistivity method for groundwater investigation: a case study from Dhule district (M.S.), India

NASA Astrophysics Data System (ADS)

Vasantrao, Baride Mukund; Bhaskarrao, Patil Jitendra; Mukund, Baride Aarti; Baburao, Golekar Rushikesh; Narayan, Patil Sanjaykumar

2017-12-01

The area chosen for the present study is Dhule district, which belongs to the drought prone area of Maharashtra State, India. Dhule district suffers from water problem, and therefore, there is no extra water available to supply for the agricultural and industrial growth. To understand the lithological characters in terms of its hydro-geological conditions, it is necessary to understand the geology of the area. It is now established fact that the geophysical method gives a better information of subsurface geology. Geophysical electrical surveys with four electrodes configuration, i.e., Wenner and Schlumberger method, were carried out at the same selected sites to observe the similarity and compared both the applications in terms of its use and handling in the field. A total 54 VES soundings were carried out spread over the Dhule district and representing different lithological units. The VES curves are drawn using inverse slope method for Wenner configuration, IPI2 win Software, and curve matching techniques were used for Schlumberger configuration. Regionwise lithologs are prepared based on the obtained resistivity and thickness for Wenner method. Regionwise curves were prepared based on resistivity layers for Schlumberger method. Comparing the two methods, it is observed that Wenner and Schlumberger methods have merits or demerits. Considering merits and demerits from the field point of view, it is suggested that Wenner inverse slope method is more handy for calculation and interpretation, but requires lateral length which is a constrain. Similarly, Schlumberger method is easy in application but unwieldy for their interpretation. The work amply proves the applicability of geophysical techniques in the water resource evaluation procedure. This technique is found to be suitable for the areas with similar geological setup elsewhere.

Metal nano-grids for transparent conduction in solar cells

DOE PAGES

Muzzillo, Christopher P.

2017-05-11

A general procedure for predicting metal grid performance in solar cells was developed. Unlike transparent conducting oxides (TCOs) or other homogeneous films, metal grids induce more resistance in the neighbor layer. The resulting balance of transmittance, neighbor and grid resistance was explored in light of cheap lithography advances that have enabled metal nano-grid (MNG) fabrication. The patterned MNGs have junction resistances and degradation rates that are more favorable than solution-synthesized metal nanowires. Neighbor series resistance was simulated by the finite element method, although a simpler analytical model was sufficient in most cases. Finite-difference frequency-domain transmittance simulations were performed for MNGsmore » with minimum wire width (w) of 50 nm, but deviations from aperture transmittance were small in magnitude. Depending on the process, MNGs can exhibit increased series resistance as w is decreased. However, numerous experimental reports have already achieved transmittance-MNG sheet resistance trade-offs comparable to TCOs. The transmittance, neighbor and MNG series resistances were used to parameterize a grid fill factor for a solar cell. In conclusion, this new figure of merit was used to demonstrate that although MNGs have only been employed in low efficiency solar cells, substantial gains in performance are predicted for decreased w in all high efficiency absorber technologies.« less

Using Agent-Based Modelling to Predict the Role of Wild Refugia in the Evolution of Resistance of Sea Lice to Chemotherapeutants.

PubMed

McEwan, Gregor F; Groner, Maya L; Fast, Mark D; Gettinby, George; Revie, Crawford W

2015-01-01

A major challenge for Atlantic salmon farming in the northern hemisphere is infestation by the sea louse parasite Lepeophtheirus salmonis. The most frequent method of controlling these sea louse infestations is through the use of chemical treatments. However, most major salmon farming areas have observed resistance to common chemotherapeutants. In terrestrial environments, many strategies employed to manage the evolution of resistance involve the use of refugia, where a portion of the population is left untreated to maintain susceptibility. While refugia have not been deliberately used in Atlantic salmon farming, wild salmon populations that migrate close to salmon farms may act as natural refugia. In this paper we describe an agent-based model that explores the influence of different sizes of wild salmon populations on resistance evolution in sea lice on a salmon farm. Using the model, we demonstrate that wild salmon populations can act as refugia that limit the evolution of resistance in the sea louse populations. Additionally, we demonstrate that an increase in the size of the population of wild salmon results in an increased effect in slowing the evolution of resistance. We explore the effect of a population fitness cost associated with resistance, finding that in some cases it substantially reduces the speed of evolution to chemical treatments.

Metal nano-grids for transparent conduction in solar cells

DOE Office of Scientific and Technical Information (OSTI.GOV)

Muzzillo, Christopher P.

A general procedure for predicting metal grid performance in solar cells was developed. Unlike transparent conducting oxides (TCOs) or other homogeneous films, metal grids induce more resistance in the neighbor layer. The resulting balance of transmittance, neighbor and grid resistance was explored in light of cheap lithography advances that have enabled metal nano-grid (MNG) fabrication. The patterned MNGs have junction resistances and degradation rates that are more favorable than solution-synthesized metal nanowires. Neighbor series resistance was simulated by the finite element method, although a simpler analytical model was sufficient in most cases. Finite-difference frequency-domain transmittance simulations were performed for MNGsmore » with minimum wire width (w) of 50 nm, but deviations from aperture transmittance were small in magnitude. Depending on the process, MNGs can exhibit increased series resistance as w is decreased. However, numerous experimental reports have already achieved transmittance-MNG sheet resistance trade-offs comparable to TCOs. The transmittance, neighbor and MNG series resistances were used to parameterize a grid fill factor for a solar cell. In conclusion, this new figure of merit was used to demonstrate that although MNGs have only been employed in low efficiency solar cells, substantial gains in performance are predicted for decreased w in all high efficiency absorber technologies.« less

Method and apparatus for simulating gravitational forces on a living organism

NASA Technical Reports Server (NTRS)

Thornton, W. E. (Inventor)

1983-01-01

A method and apparatus for simulating gravitational forces on a living organism wherein a series of negative pressures are externally applied to successive length-wise sections of a lower limb of the organism. The pressures decreasing progressively with distance of said limb sections from the heart of the organism. A casing defines a chamber adapted to contain the limb of the organism and is rigidified to resist collapse upon the application of negative pressures to the interior of the chamber. Seals extend inwardly from the casing for effective engagement with the limb of the organism and, in cooperation with the limb, subdivide the chamber into a plurality of compartments each in negative pressure communicating relation with the limb.

Effects of Pharmacokinetic Processes and Varied Dosing Schedules on the Dynamics of Acquired Resistance to Erlotinib in EGFR-Mutant Lung Cancer

PubMed Central

Foo, Jasmine; Chmielecki, Juliann; Pao, William; Michor, Franziska

2013-01-01

Introduction Erlotinib (Tarceva) is an epidermal growth factor receptor (EGFR) tyrosine kinase inhibitor, which effectively targets EGFR-mutant driven non–small-cell lung cancer. However, the evolution of acquired resistance because of a second-site mutation (T790M) within EGFR remains an obstacle to successful treatment. Methods We used mathematical modeling and available clinical trial data to predict how different pharmacokinetic parameters (fast versus slow metabolism) and dosing schedules (low dose versus high dose; missed doses with and without make-up doses) might affect the evolution of T790M-mediated resistance in mixed populations of tumor cells. Results We found that high-dose pulses with low-dose continuous therapy impede the development of resistance to the maximum extent, both pre- and post-emergence of resistance. The probability of resistance is greater in fast versus slow drug metabolizers, suggesting a potential mechanism, unappreciated to date, influencing acquired resistance in patients. In case of required dose modifications because of toxicity, little difference is observed in terms of efficacy and resistance dynamics between the standard daily dose (150 mg/d) and 150 mg/d alternating with 100 mg/d. Missed doses are expected to lead to resistance faster, even if make-up doses are attempted. Conclusions For existing and new kinase inhibitors, this novel framework can be used to rationally and rapidly design optimal dosing strategies to minimize the development of acquired resistance. PMID:22982659

Antiretroviral Therapy and Pre-exposure Prophylaxis: Combined Impact on HIV Transmission and Drug Resistance in South Africa

PubMed Central

Abbas, Ume L.; Glaubius, Robert; Mubayi, Anuj; Hood, Gregory; Mellors, John W.

2013-01-01

Background. The potential impact of antiretroviral therapy (ART) and pre-exposure prophylaxis (PrEP) with overlapping and nonoverlapping antiretrovirals (ARVs) on human immunodeficiency virus (HIV) transmission and drug resistance is unknown. Methods. A detailed mathematical model was used to simulate the epidemiological impact of ART alone, PrEP alone, and combined ART + PrEP in South Africa. Results. ART alone initiated at a CD4 lymphocyte cell count <200 cells/µL (80% coverage and 96% effectiveness) prevents 20% of HIV infections over 10 years but increases drug resistance prevalence to 6.6%. PrEP alone (30% coverage and 75% effectiveness) also prevents 21% of infections but with lower resistance prevalence of 0.5%. The ratio of cumulative infections prevented to prevalent drug-resistant cases after 10 years is 7-fold higher for PrEP than for ART. Combined ART + PrEP with overlapping ARVs prevents 35% of infections but increases resistance prevalence to 8.2%, whereas ART + PrEP with nonoverlapping ARVs prevents slightly more infections (37%) and reduces resistance prevalence to 7.2%. Conclusions. Combined ART + PrEP is likely to prevent more HIV infections than either strategy alone, but with higher prevalence of drug resistance. ART is predicted to contribute more to resistance than is PrEP. Optimizing both ART and PrEP effectiveness and delivery are the keys to preventing HIV transmission and drug resistance. PMID:23570850

Antibiotic Susceptibilities of Enterococcus Species Isolated from Hospital and Domestic Wastewater Effluents in Alice, Eastern Cape Province of South Africa

PubMed Central

Iweriebor, Benson Chuks; Gaqavu, Sisipho; Obi, Larry Chikwelu; Nwodo, Uchechukwu U.; Okoh, Anthony I.

2015-01-01

Background: Antimicrobial resistance in microorganisms are on the increase worldwide and are responsible for substantial cases of therapeutic failures. Resistance of species of Enterococcus to antibiotics is linked to their ability to acquire and disseminate antimicrobial resistance determinants in nature, and wastewater treatment plants (WWTPs) are considered to be one of the main reservoirs of such antibiotic resistant bacteria. We therefore determined the antimicrobial resistance and virulence profiles of some common Enterococcus spp that are known to be associated with human infections that were recovered from hospital wastewater and final effluent of the receiving wastewater treatment plant in Alice, Eastern Cape. Methods: Wastewater samples were simultaneously collected from two sites (Victoria hospital and final effluents of a municipal WWTP) in Alice at about one to two weeks interval during the months of July and August 2014. Samples were screened for the isolation of enterococci using standard microbiological methods. The isolates were profiled molecularly after targeted generic identification and speciation for the presence of virulence and antibiotic resistance genes. Results: Out of 66 presumptive isolates, 62 were confirmed to belong to the Enterococcus genusof which 30 were identified to be E. faecalis and 15 E. durans. The remaining isolates were not identified by the primers used in the screening procedure. Out of the six virulence genes that were targeted only three of them; ace, efaA, and gelE were detected. There was a very high phenotypic multiple resistance among the isolates and these were confirmed by genetic analyses. Conclusions: Analyses of the results obtained indicated that hospital wastewater may be one of the sources of antibiotic resistant bacteria to the receiving WWTP. Also, findings revealed that the final effluent discharged into the environment was contaminated with multi-resistant enterococci species thus posing a health hazard to the receiving aquatic environment as these could eventually be transmitted to humans and animals that are exposed to it. PMID:25893999

Non-typhoidal Salmonella in Calabria, Italy: a laboratory and patient-based survey.

PubMed

Mascaro, Valentina; Pileggi, Claudia; Crinò, Maria; Proroga, Yolande Therese Rose; Carullo, Maria Rosaria; Graziani, Caterina; Arigoni, Fabio; Turno, Pasquale; Pavia, Maria

2017-09-11

Although there has been a decrease in the number of cases of salmonellosis in the European Union, it still represents the primary cause of foodborne outbreaks. In Calabria region, data are lacking for the incidence of human non-typhoid salmonellosis as active surveillance has never been carried out. To report the results of a laboratory and patient-based morbidity survey in Calabria to describe the incidence and distribution of Salmonella serovars isolated from humans, with a focus on antimicrobial resistance patterns. Positive cultures from human samples were collected from every laboratory participating in the surveillance, with a minimum set of information about each isolate. A questionnaire was then administered to the patients by telephone interview to assess the potential risk exposures. Salmonella isolates underwent biochemical identification, molecular analysis by PCR and antimicrobial susceptibility testing by the disk-diffusion method. During a 2-year period, 105 strains of Salmonella spp were isolated from samples of patients with diarrhoea, with the highest isolation rate for children aged 1-5 years. The standardised rate was 2.7 cases per 1 00 000 population. The most common Salmonella isolates belonged to monophasic variant of S. Typhimurium ( S. 4,[5],12:i:-) (33.3%), followed by S . Typhimurium (21.9%). 30.5% of the isolates were susceptible to all microbial agents tested and the most common pan-susceptible serotype was S. Napoli (100%). S . 4,[5],12:i:- was resistant to ampicillin, streptomycin, sulfonamides and tetracyclines in 42.9% cases, while resistance to quinolones was seen in 14.3% of the isolates. The results provide evidence that an active surveillance system effectively enhances Salmonella notifications. The high prevalence of antimicrobial resistance, including resistance to quinolones and multiresistance, enforces the need to strengthen strategies of surveillance and monitoring of antimicrobial use. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

On the spread and control of MDR-TB epidemics: an examination of trends in anti-tuberculosis drug resistance surveillance data

PubMed Central

Cohen, Ted; Jenkins, Helen E.; Lu, Chunling; McLaughlin, Megan; Floyd, Katherine; Zignol, Matteo

2015-01-01

SUMMARY Background Multidrug resistant tuberculosis (MDR-TB) poses serious challenges for tuberculosis control in many settings, but trends of MDR-TB have been difficult to measure. Methods We analyzed surveillance and population-representative survey data collected worldwide by the World Health Organization between 1993 and 2012. We examined setting-specific patterns associated with linear trends in the estimated per capita rate of MDR-TB among new notified TB cases to generate hypotheses about factors associated with trends in the transmission of highly drug resistant tuberculosis. Results 59 countries and 39 sub-national settings had at least three years of data, but less than 10% of the population in the WHO-designated 27-high MDR-TB burden settings were in areas with sufficient data to track trends. Among settings in which the majority of MDR-TB was autochthonous, we found 10 settings with statistically significant linear trends in per capita rates of MDR-TB among new notified TB cases. Five of these settings had declining trends (Estonia, Latvia, Macao, Hong Kong, and Portugal) ranging from decreases of 3-14% annually, while five had increasing trends (four individual oblasts of the Russian Federation and Botswana) ranging from 14-20% annually. In unadjusted analysis, better surveillance indicators and higher GDP per capita were associated with declining MDR-TB, while a higher existing absolute burden of MDR-TB was associated with an increasing trend. Conclusions Only a small fraction of countries in which the burden of MDR-TB is concentrated currently have sufficient surveillance data to estimate trends in drug-resistant TB. Where trend analysis was possible, smaller absolute burdens of MDR-TB and more robust surveillance systems were associated with declining per capita rates of MDR-TB among new notified cases. PMID:25458783

Incidence of tuberculous meningitis in France, 2000: a capture-recapture analysis.

PubMed

Cailhol, J; Che, D; Jarlier, V; Decludt, B; Robert, J

2005-07-01

To estimate the incidence of culture-positive and culture-negative tuberculous meningitis (TBM) in France in 2000. Capture-recapture method using two unrelated sources of data: the tuberculosis (TB) mandatory notification system (MNTB), recording patients treated by anti-tuberculosis drugs, and a survey by the National Reference Centre (NRC) for mycobacterial drug resistance, recording culture-positive TBM. Of 112 cases of TBM reported to the MNTB, 28 culture-positive and 34 culture-negative meningitis cases were validated (17 duplicates, 3 cases from outside France, 21 false notifications, and 9 lost records were excluded). The NRC recorded 31 culture-positive cases, including 21 known by the MNTB. When the capture-recapture method was applied to the reported culture-positive meningitis cases, the estimated number of meningitis cases was 41 and the incidence was 0.7 cases per million. Sensitivity was 75.6% for the NRC, 68.3% for the MNTB, and 92.7% for both systems together. When sensitivity of the MNTB for culture-positive cases was applied to culture-negative meningitis, the total estimated number of culture-negative meningitis cases was 50 and the incidence was 0.85 cases per million. TBM is underestimated in France. Capture-recapture analysis using different sources to better estimate its incidence is of great interest.

Role of matching in case-control studies of antimicrobial resistance.

PubMed

Cerceo, Elizabeth; Lautenbach, Ebbing; Linkin, Darren R; Bilker, Warren B; Lee, Ingi

2009-05-01

Of 57 case-control studies of antimicrobial resistance, matching was used in 23 (40%). Matched variables differed substantially across studies. Of these 23 matched case-control studies, 12 (52%) justified the use of matching, and 9 (39%) noted the strengths or limitations of this approach. Analysis that accounted for matching was performed in only 52% of the case-control studies.

[Analysis on HIV-1 subtypes and transmission clusters in newly reported HIV/AIDS cases in Yiwu, Zhejiang Province, 2016].

PubMed

Zhang, J F; Yao, J M; Fan, Q; Chen, W J; Pan, X H; Ding, X B; Yang, J Z; Fu, T

2017-12-10

Objective: To understand the characteristics of distribution on HIV-1 subtypes and the transmission clusters in Yiwu in Zhejiang province. Methods: A cross-sectional study of molecular epidemiology was carried out on newly reported HIV/AIDS cases in Yiwu. RNA was extracted from 168 plasma samples, followed by RT-PCR and nest-PCR for pol gene amplification, sequencing, phylogenetic tree construction used for analyzing the subtypes and transmission clusters. Mutations on drug resistance was analyzed by CPR 6.0 online tool. Results: Subjects were mainly males (86.3%, 145/168), with average age as (39.1±13.4) years old and most of them were migrants (66.7%, 112/168). The major routes of transmission included homosexual (51.2%, 86/168) and heterosexual (48.8%, 82/168) contacts. The rate of success for sequence acquisition was 89.9% (151/168). The dominant subtypes showed as CRF01_AE (74, 49.0%) and CRF07_BC (64, 42.4%), followed by CRF08_BC (5, 3.3%), CRF55_01B (3, 2.0%), each case of subtype B, CRF45_cpx, CRF59_01B, CRF85_BC and URF (B/C). CRF45_cpx and CRF85_BC were discovered the first time in Zhejiang province. Twenty-six transmission clusters involving 65 cases were found, with the total clustered rate as 43.0% (65/151), in which the CRF01_AE clustered rate appeared as 54.1% (40/74), higher than that of CRF07_BC (21/64, 32.8%). The average size of cluster was 2.5 cases/cluster, with average size of cluster in CRF01_AE patients infected through heterosexual transmission as the largest (3.5 cases/cluster). The prevalence of transmitted drug resistance was 4.6% (7/151). Seven cases with surveillance drug resistant mutations (SDRM) were found, including 5 cases of M46L (3.3%), and one case of F77L or Y181C. Conclusion: HIV genetic diversity and a variety of transmission clusters had been noticed in this study area (Yiwu). Programs on monitoring the subtypes and transmission clusters should be continued and strengthened.

HLA Type and Immune Response to Borrelia burgdorferi Outer Surface Protein A in People in Whom Arthritis Developed After Lyme Disease Vaccination

PubMed Central

Ball, Robert; Shadomy, Sean V.; Meyer, Abbie; Huber, Brigitte T.; Leffell, Mary S.; Zachary, Andrea; Belotto, Michael; Hilton, Eileen; Bryant-Genevier, Marthe; Schriefer, Martin E.; Miller, Frederick W.; Braun, M. Miles

2009-01-01

Objective To investigate whether persons with treatment-resistant Lyme arthritis–associated HLA alleles might develop arthritis as a result of an autoimmune reaction triggered by Borrelia burgdorferi outer surface protein A (OspA), the Lyme disease vaccine antigen. Methods Persons in whom inflammatory arthritis had developed after Lyme disease vaccine (cases) were compared with 3 control groups: 1) inflammatory arthritis but not Lyme disease vaccine (arthritis controls), 2) Lyme disease vaccine but not inflammatory arthritis (vaccine controls), and 3) neither Lyme disease vaccine nor inflammatory arthritis (normal controls). HLA–DRB1 allele typing, Western blotting for Lyme antigen, and T cell reactivity testing were performed. Results Twenty-seven cases were matched with 162 controls (54 in each control group). Odds ratios (ORs) for the presence of 1 or 2 treatment-resistant Lyme arthritis alleles were 0.8 (95% confidence interval [95% CI] 0.3–2.1), 1.6 (95% CI 0.5–4.4), and 1.75 (95% CI 0.6–5.3) in cases versus arthritis controls, vaccine controls, and normal controls, respectively. There were no significant differences in the frequency of DRB1 alleles. T cell response to OspA was similar between cases and vaccine controls, as measured using the stimulation index (OR 1.6 [95% CI 0.5–5.1]) or change in uptake of tritiated thymidine (counts per minute) (OR 0.7 [95% CI 0.2–2.3]), but cases were less likely to have IgG antibodies to OspA (OR 0.3 [95% CI 0.1–0.8]). Cases were sampled closer to the time of vaccination (median 3.59 years versus 5.48 years), and fewer cases had received 3 doses of vaccine (37% versus 93%). Conclusion Treatment-resistant Lyme arthritis alleles were not found more commonly in persons who developed arthritis after Lyme disease vaccination, and immune responses to OspA were not significantly more common in arthritis cases. These results suggest that Lyme disease vaccine is not a major factor in the development of arthritis in these cases. PMID:19333928

First national survey of anti-tuberculosis drug resistance in Azerbaijan and risk factors analysis

PubMed Central

Akhundova, I.; Seyfaddinova, M.; Mammadbayov, E.; Mirtskulava, V.; Rüsch-Gerdes, S.; Bayramov, R.; Suleymanova, J.; Kremer, K.; Dadu, A.; Acosta, C. D.; Harries, A. D.; Dara, M.

2014-01-01

Setting: Civilian population of the Republic of Azerbaijan. Objectives: To determine patterns of anti-tuberculosis drug resistance among new and previously treated pulmonary tuberculosis (TB) cases, and explore their association with socio-demographic and clinical characteristics. Design: National cross-sectional survey conducted in 2012–2013. Results: Of 789 patients (549 new and 240 previously treated) who met the enrolment criteria, 231 (42%) new and 146 (61%) previously treated patients were resistant to any anti-tuberculosis drug; 72 (13%) new and 66 (28%) previously treated patients had multidrug-resistant TB (MDR-TB). Among MDR-TB cases, 38% of new and 46% of previously treated cases had pre-extensively drug-resistant TB (pre-XDR-TB) or XDR-TB. In previously treated cases, 51% of those who had failed treatment had MDR-TB, which was 15 times higher than in relapse cases (OR 15.2, 95%CI 6–39). The only characteristic significantly associated with MDR-TB was a history of previous treatment (OR 3.1, 95%CI 2.1–4.7); for this group, history of incarceration was an additional risk factor for MDR-TB (OR 2.8, 95%CI 1.1–7.4). Conclusion: Azerbaijan remains a high MDR-TB burden country. There is a need to implement countrywide control and innovative measures to accelerate early diagnosis of drug resistance in individual patients, improve treatment adherence and strengthen routine surveillance of drug resistance. PMID:26393092

The Association between Mycobacterium Tuberculosis Genotype and Drug Resistance in Peru

PubMed Central

Grandjean, Louis; Iwamoto, Tomotada; Lithgow, Anna; Gilman, Robert H; Arikawa, Kentaro; Nakanishi, Noriko; Martin, Laura; Castillo, Edith; Alarcon, Valentina; Coronel, Jorge; Solano, Walter; Aminian, Minoo; Guezala, Claudia; Rastogi, Nalin; Couvin, David; Sheen, Patricia; Zimic, Mirko; Moore, David AJ

2015-01-01

Background The comparison of Mycobacterium tuberculosis bacterial genotypes with phenotypic, demographic, geospatial and clinical data improves our understanding of how strain lineage influences the development of drug-resistance and the spread of tuberculosis. Methods To investigate the association of Mycobacterium tuberculosis bacterial genotype with drug-resistance. Drug susceptibility testing together with genotyping using both 15-loci MIRU-typing and spoligotyping, was performed on 2,139 culture positive isolates, each from a different patient in Lima, Peru. Demographic, geospatial and socio-economic data were collected using questionnaires, global positioning equipment and the latest national census. Results The Latin American Mediterranean (LAM) clade (OR 2.4, p<0.001) was significantly associated with drug-resistance and alone accounted for more than half of all drug resistance in the region. Previously treated patients, prisoners and genetically clustered cases were also significantly associated with drug-resistance (OR's 2.5, 2.4 and 1.8, p<0.001, p<0.05, p<0.001 respectively). Conclusions Tuberculosis disease caused by the LAM clade was more likely to be drug resistant independent of important clinical, genetic and socio-economic confounding factors. Explanations for this include; the preferential co-evolution of LAM strains in a Latin American population, a LAM strain bacterial genetic background that favors drug-resistance or the "founder effect" from pre-existing LAM strains disproportionately exposed to drugs. PMID:25984723

[Identification and prognostic value of differentially expressed proteins of patients with platinum resistance epithelial ovarian cancer in serum].

PubMed

Wu, W J; Wang, Q; Zhang, W; Li, L

2016-07-25

To identified differentially expressed proteins associated with platinum resistance in platinum resistance epithelial oarian cancer(EOC)patients in serum and investigate their clinical value. A total of 106 patients withoverian tumor in affiliated tumor hospital of Guangxi Medical University from August 1998 to September 2013 were enrolled in this study, which include 52 cases od platinum-sensitive(PTS), 44 cases of platinum-resistant(PTR)and 10 cases of benign ovarian cyst(BOC). Thirty-three cases of normal women proceeded physical examination in our hospital in 2008 were chosen as control group(NC). Four groups of patients serum samples of 4 groups were collected and preserved.(1)Differentially express level of serum proteins of 10 cases of every group(PTS & PTR vs NC, PTS & PTR vs BOC, PTS vs PTR)were identified with isobaric tags for relative and absolute quantitative(iTRAQ)based quantitative proteomic approach and then was subjected to bioinformatics analysis.(2)Proteins that played a important role in multidrug resistance were validated by western blot(WB)and ELISA in 44 PTR patients, 52 PRS patients and 33 NC women.(3)Pearson correlation analysis was used to explain the relationship between proteins and clinical pathological parameters of PTR individuals. Kaplan-Meier method was supposed to explore serum biomarkers associated with clinical prognosis data. Receiver operating characteristic(ROC)curves were used to determine the diagnostic value of the markers. (1)Based on the result of bioinformatics analysis, 56 proteins, 39 proteins and 62 proteins were identified respectively among PTS & PTR vs NC, PTS & PTR vs BOC, PTS vs PTR. It showed that C6 and CNTN1 have a positive seletion effect among Asians and BCHE among Europeans through searching Haplotter database. CRP, FN1, S100A9, TF, ALB, VWF, APOC2, APOE, CD44, F2, GPX3 and ACTB proein were further verified related with platinum resistance by taking intersection analysis in the COREMINE database and TCGA.(2)The expression level of SERPINA1 protein in serum of PTR group, PTS group and NC groupwere 41.7±9.2, 32.8±6.6 and 14.2±3.6 respectively using WB assay, and(816±246),(686±205)and(756 ± 244)μg/μl respectively using ELISA; the expression level of ORM1 protein in PTR, PTS and NC serum were 37.9±7.0, 27.0±22.5 and 21.7±2.6 respectively using WB assay, and(221±35),(174±23)and(157±18)μg/μl respectively using ELISA; the expression level of FN1 protein in PTR, PTS and NC serum were 30.3±11.4, 18.2±5.2, 23.7±3.9 respectively by WB assay, and(71±13),(62±13),(69±13)ng/μl respectively by ELISA; the expression level of GPX3 protein in PTR, PTS and NC serum were 1.2±0.3, 2.2± 0.3, 1.6±0.3 respectively WB assay. The expression of each protein by using western blot method and ELISA method had the same trend as that using iTRAQ technology.(3)Pearson correlation analysis showed, the expression of SERPINA1, FN1 and ORM1 had a positive correlation with recurrence and death of PTR patients(P <0.01, P <0.05), but was negatively correlated with progress free survival of PTR patients(P <0.05). Kaplan-Meier analysis indicated that clinical stage, initial treatment outcomes, the express level of SERPINA1, FN1 and ORM1 were significantly related with progression-free survival(P <0.05), the initial treatment outcomes was related with overall survival(P=0.027). The overall predictive accuracy of each protein was reflected by the area under the ROC curve(AUC), FN1 ORM1 and SERPINA with ROC areas of 0.679, 0.910 and 0.666 respectively. The diagnosis value of ORM1 protein in ovarian cancer patients with platinum resistance performance is significantly higher than that of FN1 and SERPINA1 protein(P=0.000) CONCLUSIONS: The differentially express level of FN1, SERPINA1 and ORM1 between PTS and PTR play a essential role in measuring subtle changes in response to platinum-based chemotherapy and may be involved in biological processes of platinum resistance. ORM1 has higher diagnostic efficiency of platinum resistance in ovarian cancer patients. It may be a promising candidate biomarker for screening and diagnosis of ovarian cancer patients with platinum resistance.

A novel 2.5D finite difference scheme for simulations of resistivity logging in anisotropic media

NASA Astrophysics Data System (ADS)

Zeng, Shubin; Chen, Fangzhou; Li, Dawei; Chen, Ji; Chen, Jiefu

2018-03-01

The objective of this study is to develop a method to model 3D resistivity well logging problems in 2D formation with anisotropy, known as 2.5D modeling. The traditional 1D forward modeling extensively used in practice lacks the capability of modeling 2D formation. A 2.5D finite difference method (FDM) solving all the electric and magnetic field components simultaneously is proposed. Compared to other previous 2.5D FDM schemes, this method is more straightforward in modeling fully anisotropic media and easy to be implemented. Fourier transform is essential to this FDM scheme, and by employing Gauss-Legendre (GL) quadrature rule the computational time of this step can be greatly reduced. In the numerical examples, we first demonstrate the validity of the FDM scheme with GL rule by comparing with 1D forward modeling for layered anisotropic problems, and then we model a complicated 2D formation case and find that the proposed 2.5D FD scheme is much more efficient than 3D numerical methods.

The Feasibility of Xpert MTB/RIF Testing to Detect Rifampicin Resistance among Childhood Tuberculosis for Prevalence Surveys in Northern China.

PubMed

Lu, Jie; Li, Huimin; Dong, Fang; Shi, Jin; Yang, Hui; Han, Shujing; Chu, Ping; Zhao, Yanlin; Song, Wenqi; Guo, Yongli; Zhao, Shunying

2017-01-01

Drug resistance surveillance is crucial for control of drug-resistant tuberculosis (TB). However, limited data exists on the burden of drug-resistant TB in children. The goal of this work was to generate prevalence data regarding rifampicin- (RIF-) resistant childhood TB in northern China and to test the feasibility of Xpert for surveying pediatric TB drug resistance prevalence. We enrolled 362 clinically diagnosed childhood TB patients and collected sputum, gastric lavage aspirate (GLA), bronchoalveolar lavage fluid (BALF), and cerebral spinal fluid (CSF) samples. Xpert and solid culture were utilized to detect RIF resistance. The detection rate of Xpert-positive TB among new clinically diagnosed TB cases was 38.4% (139/362), significantly higher than that of solid culture-positive TB (16.3%, 59/362, P < 0.01). Notably, Xpert-positive rates differed significantly by sample type, with the highest positive rate for GLA (51.2%). The unit testing costs per RIF-resistant TB patient were $828.41 for solid culture and $761.86 for Xpert. Our data demonstrate that the prevalence of RIF resistance among childhood TB cases in our study (6.9%) is comparable to the national RIF resistance prevalence level of new cases (6.7%). In addition, Xpert is superior to the solid culture for RIF resistance survey in the childhood TB patients.

Bayesian inference of spectral induced polarization parameters for laboratory complex resistivity measurements of rocks and soils

NASA Astrophysics Data System (ADS)

Bérubé, Charles L.; Chouteau, Michel; Shamsipour, Pejman; Enkin, Randolph J.; Olivo, Gema R.

2017-08-01

Spectral induced polarization (SIP) measurements are now widely used to infer mineralogical or hydrogeological properties from the low-frequency electrical properties of the subsurface in both mineral exploration and environmental sciences. We present an open-source program that performs fast multi-model inversion of laboratory complex resistivity measurements using Markov-chain Monte Carlo simulation. Using this stochastic method, SIP parameters and their uncertainties may be obtained from the Cole-Cole and Dias models, or from the Debye and Warburg decomposition approaches. The program is tested on synthetic and laboratory data to show that the posterior distribution of a multiple Cole-Cole model is multimodal in particular cases. The Warburg and Debye decomposition approaches yield unique solutions in all cases. It is shown that an adaptive Metropolis algorithm performs faster and is less dependent on the initial parameter values than the Metropolis-Hastings step method when inverting SIP data through the decomposition schemes. There are no advantages in using an adaptive step method for well-defined Cole-Cole inversion. Finally, the influence of measurement noise on the recovered relaxation time distribution is explored. We provide the geophysics community with a open-source platform that can serve as a base for further developments in stochastic SIP data inversion and that may be used to perform parameter analysis with various SIP models.

Immunosuppressive Therapy in Treatment of Refractory Hypoglycemia in Type B Insulin Resistance: A Case Report

PubMed Central

Sirisena, Imali

2017-01-01

Type B insulin resistance is a rare syndrome characterized by fluctuating glucose levels (ranging from hyperglycemia with extreme insulin resistance to intractable hypoglycemia without exogenous insulin administration), high serum insulin levels, and insulin receptor autoantibodies. Most cases occur in the African American population in association with other underlying autoimmune systemic diseases. Treatments with high-dose steroids, immunosuppressants, and plasmapheresis have been used, with variable outcomes, in patients without spontaneous remission. We report the case of a 60-year-old African American woman with history of systemic lupus erythematosus presenting with extreme fluctuations in glucose levels, ranging from severe hyperglycemia to refractory hypoglycemia, with high serum concentration of insulin in both phases. Her presentation and phenotype were very similar to those seen in known cases of type B insulin resistance associated with insulin receptor antibodies. Treatment in other reported cases used a combination of high-dose steroids and immunosuppressants. We tried high-dose steroids, azathioprine, and intravenous immunoglobulins, which resulted in improvement and barely detectable insulin receptor antibody. We present a case of type B insulin resistance with abnormally low titers of insulin receptor antibodies despite a typical clinical course and response. Future research is needed to improve diagnosis and treatment in this rare disease. PMID:29264467

Antibiotic Susceptibility Evaluation of Group A Streptococcus Isolated from Children with Pharyngitis: A Study from Iran.

PubMed

Sayyahfar, Shirin; Fahimzad, Alireza; Naddaf, Amir; Tavassoli, Sara

2015-12-01

The aim of this study was to evaluate the antibiotic susceptibility of Group A streptococcus (GAS) to antibiotics usually used in Iran for treatment of GAS pharyngitis in children. From 2011 to 2013, children 3-15 years of age with acute tonsillopharyngitis who attended Mofid Children's Hospital clinics and emergency ward and did not meet the exclusion criteria were enrolled in a prospective study in a sequential manner. The isolates strains from throat culture were identified as GAS by colony morphology, gram staining, beta hemolysis on blood agar, sensitivity to bacitracin, a positive pyrrolidonyl aminopeptidase (PYR) test result, and the presence of Lancefield A antigen determined by agglutination test. Antimicrobial susceptibility was identified by both disk diffusion and broth dilution methods. From 200 children enrolled in this study, 59 (30%) cases were culture positive for GAS. All isolates were sensitive to penicillin G. The prevalence of erythromycin, azithromycin, and clarithromycin resistance by broth dilution method was 33.9%, 57.6%, and 33.9%, respectively. Surprisingly, 8.4% of GAS strains were resistant to rifampin. In this study, 13.5% and 32.2% of the strains were resistant to clindamycin and ofloxacin, respectively. The high rate of resistance of GAS to some antibiotics in this study should warn physicians, especially in Iran, to use antibiotics restrictedly and logically to prevent the rising of resistance rates in future. It also seems that continuous local surveillance is necessary to achieve the best therapeutic option for GAS treatment.

Evaluation of the effectiveness of thoracic sympathectomy in the treatment of primary hyperhidrosis of hands and armpits using the measurement of skin resistance

PubMed Central

Jabłoński, Sławomir; Rzepkowska-Misiak, Beata; Piskorz, Łukasz; Brocki, Marian; Wcisło, Szymon; Smigielski, Jacek; Kordiak, Jacek

2012-01-01

Introduction Hyperhidrosis is excessive sweating beyond the needs of thermoregulation. It is disease which mostly affects young people, often carrying a considerable amount of socio-economic implications. Thoracic sympathectomy is now considered to be the "gold standard" in the treatment of idiopathic hyperhidrosis of hands and armpits. Aim Assessment of early effectiveness of thoracic sympathectomy using skin resistance measurements performed before surgery and in the postoperative period. Material and methods A group of 20 patients with idiopathic excessive sweating of hands and the armpit was enrolled in the study. Patients underwent two-stage thoracic sympathectomy with resection of Th2-Th4 ganglions. The skin resistance measurements were made at six previously designated points on the day of surgery and the first day after the operation. Results In all operated patients we obtained complete remission of symptoms on the first day after the surgery. Inhibition of sweating was confirmed using the standard starch iodine (Minor) test. At all measurement points we obtained a statistically significant increase of skin resistance, assuming p < 0.05. To check whether there is a statistically significant difference in the results before and after surgery we used sequence pairs Wilcoxon test. Conclusions Thoracic sympathectomy is an effective curative treatment for primary hyperhidrosis of hands and armpits. Statistically significant increase of skin resistance in all cases is a good method of assessing the effectiveness of the above surgery in the early postoperative period. PMID:23256019

Probing the frontal deformation zone of the Chihshang Fault with boreholes and high-resolution electrical resistivity imaging methods: A case study at the Dapo site in eastern Taiwan

NASA Astrophysics Data System (ADS)

Chang, Ping-Yu; Huang, Wen-Jeng; Chen, Chien-Chih; Hsu, Han-lun; Yen, I.-Chin; Ho, Gong-Ruei; Lee, Jian-Cheng; Lu, Shih-Ting; Chen, Po-Tsun

2018-06-01

Not only direct fault ruptures but also later mass movement may result in complicated frontal deformation of the faults. Consequently, the deformation front or the contacts between the unconsolidated materials from the hanging wall and footwall of the thrust fault may indicate the toe of the mass movement instead of the actual fault zone. In this study, we used a combination of surface electrical resistivity imaging methods and borehole records in order to investigate the geometries of the structures in the frontal deformation zone of the Chihshang Fault at the Dapo elementary school. From the cores, we observed three different geological components at the Dapo site: the conductive Lichi mélange of the hanging wall, the colluvial gravels and the underlying fluvial-gravel layer at the footwall. The resistivity images from two parallel survey lines reveal that the position where the fault trace was thought to be is actually the toe of the slumping body's surface ruptures consisting of materials from the Lichi mélange. On the basis of the resistivity images, we also found that the actual fault plane is located on the southeastern side of the resistivity survey line near the hilltop. As a result, we conclude that mass movement induced by the inter-seismic creeping, not direct faulting, is the main factor affecting the frontal deformation zone of the Chihshang fault at the Dapo site.

Linezolid resistant Staphylococcus haemolyticus: first case report from India.

PubMed

Gupta, Varsha; Garg, Shivani; Jain, Ruby; Garg, Sudhir; Chander, Jagdish

2012-10-01

Linezolid is being increasingly used in the treatment of infections with gram-positive organisms especially methicillin resistant Staphylococcal isolates. Though resistance to this antimicrobial is emerging but it is extremely rare. Here we document first case of linezolid resistant Staphylococcus haemolyticus (S.haemolyticus) from India. This organism was isolated from pus oozing from a postsurgical site in 61 year old male hailing from an adjoining state of Haryana. Copyright © 2012 Hainan Medical College. Published by Elsevier B.V. All rights reserved.

Methicillin-Resistant Staphylococcus aureus (MRSA) Is Increasing in Norway: A Time Series Analysis of Reported MRSA and Methicillin-Sensitive S. aureus Cases, 1997–2010

PubMed Central

Moxnes, John F.; de Blasio, Birgitte Freiesleben; Leegaard, Truls Michael; Moen, Aina E. Fossum

2013-01-01

Background Accurate estimates of the incidence and prevalence of methicillin-resistant Staphylococcus aureus (MRSA) infections are needed to inform public health policies. In Norway, where both MRSA infection and carriage are notifiable conditions, the reported incidence of MRSA is slowly increasing. However, the proportion of MRSA in relation to all S. aureus isolates is unknown, making it difficult to determine if the rising incidence is real or an artifact of an increasing number of tests performed. Aim To characterize recent trends in MRSA infections and obtain a more complete understanding of the MRSA level in Norway. Methods All reported cases of MRSA and methicillin-sensitive S. aureus (MSSA) from Oslo County (1997–2010) and Health Region East (2008–2008), representing approximately 11% and 36% of the Norwegian population, respectively, were analyzed using a stochastic time series analysis to characterize trends. Results In Oslo County, the proportion of methicillin-resistant cases increased from 0.73% to 3.78% during the study period and was well modeled by an exponential growth with a doubling constant of 5.7 years (95% CI 4.5–7.4 years). In Health Region East, the proportion of MRSA cases increased from 0.4% to 2.1% from 2002 to 2008, with a best-fitting linear increase of 0.26% (95% CI 0.21–0.30%) per year. In both cases, the choice of a linear or exponential model for the time trend produced only marginally different model fits. We found no significant changes due to revised national MRSA guidelines published in June 2009. Significant variations in the increasing time trend were observed in the five hospitals within the region. The yearly reported incidence of MSSA was relatively stable in both study areas although we found seasonal patterns with peaks in August. Conclusion The level of MRSA is increasing in Norway, and the proportion of methicillin resistance in all S. aureus isolates are higher than the reported proportion of MRSA in invasive infections. PMID:23936442

Extent and origin of resistance to antituberculosis drugs in the Netherlands, 1993 to 2011.

PubMed

Ruesen, C; van Gageldonk-Lafeber, A B; de Vries, G; Erkens, C G; van Rest, J; Korthals Altes, H; de Neeling, H; Kamst, M; van Soolingen, D

2014-03-20

The elimination of tuberculosis (TB) is threatened by an apparent increase in the level of resistance in Mycobacterium tuberculosis. In the Netherlands, where the majority of TB patients are migrants, resistance may also be increasing. We conducted a retrospective study, using 18,294 M. tuberculosis isolates from TB cases notified between 1993 and 2011. We investigated the trends in antituberculosis drug resistance, focusing on the country of birth of the patients and whether resistance had developed during treatment or was the result of transmission of resistant M. tuberculosis strains. For both scenarios, we determined whether this had happened in or outside the Netherlands. Antituberculosis drug resistance was found in 13% of all cases analysed and showed an increasing trend among patients who had been born in the Netherlands (p<0.001) and a decreasing trend among foreign-born (p=0.02) over the study period. Since 2005, the proportion of M. tuberculosis resistant strains among all strains tested has increased in both groups (p=0.03 and p=0.01, respectively). Overall, we found a significantly increasing trend when excluding streptomycin resistance (p<0.001). The trend was most markedly increased for isoniazid resistance (p = 0.01). Although resistance was mainly due to transmission of resistant strains, mostly outside the Netherlands or before 1993 (when DNA fingerprinting was not systematically performed), in some cases (n=45), resistance was acquired in the Netherlands. We conclude that antituberculosis drug resistance is increasing in the Netherlands, mostly related to migration from high TB-incidence countries, but also to domestic acquisition.

Detection of antibiotic resistance is essential for gonorrhoea point-of-care testing: a mathematical modelling study.

PubMed

Fingerhuth, Stephanie M; Low, Nicola; Bonhoeffer, Sebastian; Althaus, Christian L

2017-07-26

Antibiotic resistance is threatening to make gonorrhoea untreatable. Point-of-care (POC) tests that detect resistance promise individually tailored treatment, but might lead to more treatment and higher levels of resistance. We investigate the impact of POC tests on antibiotic-resistant gonorrhoea. We used data about the prevalence and incidence of gonorrhoea in men who have sex with men (MSM) and heterosexual men and women (HMW) to calibrate a mathematical gonorrhoea transmission model. With this model, we simulated four clinical pathways for the diagnosis and treatment of gonorrhoea: POC test with (POC+R) and without (POC-R) resistance detection, culture and nucleic acid amplification tests (NAATs). We calculated the proportion of resistant infections and cases averted after 5 years, and compared how fast resistant infections spread in the populations. The proportion of resistant infections after 30 years is lowest for POC+R (median MSM: 0.18%, HMW: 0.12%), and increases for culture (MSM: 1.19%, HMW: 0.13%), NAAT (MSM: 100%, HMW: 99.27%), and POC-R (MSM: 100%, HMW: 99.73%). Per 100 000 persons, NAAT leads to 36 366 (median MSM) and 1228 (median HMW) observed cases after 5 years. Compared with NAAT, POC+R averts more cases after 5 years (median MSM: 3353, HMW: 118). POC tests that detect resistance with intermediate sensitivity slow down resistance spread more than NAAT. POC tests with very high sensitivity for the detection of resistance are needed to slow down resistance spread more than by using culture. POC with high sensitivity to detect antibiotic resistance can keep gonorrhoea treatable longer than culture or NAAT. POC tests without reliable resistance detection should not be introduced because they can accelerate the spread of antibiotic-resistant gonorrhoea.

Modelling of Seismic and Resistivity Responses during the Injection of CO2 in Sandstone Reservoir

NASA Astrophysics Data System (ADS)

Omar, Muhamad Nizarul Idhafi Bin; Almanna Lubis, Luluan; Nur Arif Zanuri, Muhammad; Ghosh, Deva P.; Irawan, Sonny; Regassa Jufar, Shiferaw

2016-07-01

Enhanced oil recovery plays vital role in production phase in a producing oil field. Initially, in many cases hydrocarbon will naturally flow to the well as respect to the reservoir pressure. But over time, hydrocarbon flow to the well will decrease as the pressure decrease and require recovery method so called enhanced oil recovery (EOR) to recover the hydrocarbon flow. Generally, EOR works by injecting substances, such as carbon dioxide (CO2) to form a pressure difference to establish a constant productive flow of hydrocarbon to production well. Monitoring CO2 performance is crucial in ensuring the right trajectory and pressure differences are established to make sure the technique works in recovering hydrocarbon flow. In this paper, we work on computer simulation method in monitoring CO2 performance by seismic and resistivity model, enabling geoscientists and reservoir engineers to monitor production behaviour as respect to CO2 injection.

Methods for determining the antimicrobial susceptibility of mycobacteria.

PubMed

Alcaide, Fernando; Esteban, Jaime; González-Martin, Julià; Palacios, Juan-José

2017-10-01

Mycobacteria are a large group of microorganisms, multiple species of which are major causes of morbidity and mortality, such as tuberculosis and leprosy. At present, the emergence and spread of multidrug-resistant strains of Mycobacterium tuberculosis complex are one of the most serious health problems worldwide. Furthermore, in contrast to M. tuberculosis and Mycobacterium leprae, non-tuberculous mycobacteria (NTM) are more frequently isolated and, in many cases, treatment is based on drug susceptibility testing. This article is a review of the different methods to determine the in vitro drug susceptibility of M. tuberculosis complex and the most relevant NTM isolates. The molecular techniques currently used for rapid detection of resistance of clinical specimens are also analysed. Copyright © 2016 Elsevier España, S.L.U. y Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. All rights reserved.

Enhancing Fracture and Wear Resistance of Dentures/Overdentures Utilizing Digital Technology: A Case Series Report.

PubMed

Afify, Ahmed; Haney, Stephan

2016-08-01

Since it was first introduced into the dental world, computer-aided design/computer-aided manufacturing (CAD/CAM) technology has improved dramatically in regards to both data acquisition and fabrication abilities. CAD/CAM is capable of providing well-fitting intra- and extraoral prostheses when sound guidelines are followed. As CAD/CAM technology encompasses both surgical and prosthetic dental applications as well as fixed and removable aspects, it could improve the average quality of dental prostheses compared with the results obtained by conventional manufacturing methods. The purpose of this article is to provide an introduction into the methods in which this technology may be used to enhance the wear and fracture resistance of dentures and overdentures. This article will also showcase two clinical reports in which CAD/CAM technology has been implemented. © 2016 by the American College of Prosthodontists.

Corrosion properties of zirconium-based ceramic coatings for micro-bearing and biomedical applications

NASA Astrophysics Data System (ADS)

Walkowicz, J.; Zavaleyev, V.; Dobruchowska, E.; Murzynski, D.; Donkov, N.; Zykova, A.; Safonov, V.; Yakovin, S.

2016-03-01

Ceramic oxide ZrO2 and oxynitride ZrON coatings are widely used as protective coatings against diffusion and corrosion. The enhancement of the coatings' mechanical properties, as well as their wear and corrosion resistance, is very important for their tribological performance. In this work, ZrO2 and ZrON coatings were deposited by magnetron sputtering on stainless steel (AISI 316) substrates. The adhesion, hardness and elastic properties were evaluated by standard methods. The surface structure of the deposited coatings was observed by electron scanning microscopy (SEM) and atomic force microscopy (AFM). The composition of the coatings was analyzed by X-ray photoelectron spectroscopy (XPS) and energy dispersive X-ray spectroscopy (EDS). The corrosion resistance properties were evaluated using the potentiodynamic method. The results show that the corrosion parameters are significantly increased in the cases of both oxynitride and oxide coatings in comparison with the stainless steel (AISI 316) substrates.

Deciphering the evolution of herbicide resistance in weeds.

PubMed

Délye, Christophe; Jasieniuk, Marie; Le Corre, Valérie

2013-11-01

Resistance to herbicides in arable weeds is increasing rapidly worldwide and threatening global food security. Resistance has now been reported to all major herbicide modes of action despite the development of resistance management strategies in the 1990s. We review here recent advances in understanding the genetic bases and evolutionary drivers of herbicide resistance that highlight the complex nature of selection for this adaptive trait. Whereas early studied cases of resistance were highly herbicide-specific and largely under monogenic control, cases of greatest concern today generally involve resistance to multiple modes of action, are under polygenic control, and are derived from pre-existing stress response pathways. Although 'omics' approaches should enable unraveling the genetic bases of complex resistances, the appearance, selection, and spread of herbicide resistance in weed populations can only be fully elucidated by focusing on evolutionary dynamics and implementing integrative modeling efforts. Copyright © 2013 Elsevier Ltd. All rights reserved.

Declining prevalence of HIV-1 drug resistance in antiretroviral treatment-exposed individuals in Western Europe.

PubMed

De Luca, Andrea; Dunn, David; Zazzi, Maurizio; Camacho, Ricardo; Torti, Carlo; Fanti, Iuri; Kaiser, Rolf; Sönnerborg, Anders; Codoñer, Francisco M; Van Laethem, Kristel; Vandamme, Anne-Mieke; Bansi, Loveleen; Ghisetti, Valeria; van de Vijver, David A M C; Asboe, David; Prosperi, Mattia C F; Di Giambenedetto, Simona

2013-04-15

HIV-1 drug resistance represents a major obstacle to infection and disease control. This retrospective study analyzes trends and determinants of resistance in antiretroviral treatment (ART)-exposed individuals across 7 countries in Europe. Of 20 323 cases, 80% carried at least one resistance mutation: these declined from 81% in 1997 to 71% in 2008. Predicted extensive 3-class resistance was rare (3.2% considering the cumulative genotype) and peaked at 4.5% in 2005, decreasing thereafter. The proportion of cases exhausting available drug options dropped from 32% in 2000 to 1% in 2008. Reduced risk of resistance over calendar years was confirmed by multivariable analysis.

Resistance of Pseudomonas aeruginosa Isolates to Hydrogel Contact Lens Disinfection Correlates with Cytotoxic Activity

PubMed Central

Lakkis, Carol; Fleiszig, Suzanne M. J.

2001-01-01

One of the most common pathogens in infection of hydrogel contact lens wearers is Pseudomonas aeruginosa, which can gain access to the eye via contamination of the lens, lens case, and lens care solutions. Only one strain per species is used in current regulatory testing for the marketing of chemical contact lens disinfectants. The aim of this study was to determine whether P. aeruginosa strains vary in their susceptibility to hydrogel contact lens disinfectants. A method for rapidly screening bacterial susceptibility to contact lens disinfectants was developed, based on measurement of the MIC. The susceptibility of 35 P. aeruginosa isolates to two chemical disinfectants was found to vary among strains. MICs ranged from 6.25 to 100% for both disinfectants at 37°C, and a number of strains were not inhibited by a 100% disinfectant concentration in the lens case environment at room temperature (22°C). Resistance to disinfection appeared to be an inherent rather than acquired trait, since some resistant strains had been isolated prior to the introduction of the disinfectants and some susceptible P. aeruginosa strains could not be made more resistant by repeated disinfectant exposure. A number of P. aeruginosa strains which were comparatively more resistant to short-term disinfectant exposure also demonstrated the ability to grow to levels above the initial inoculum in one chemical disinfectant after long-term (24 to 48 h) disinfectant exposure. Resistance was correlated with acute cytotoxic activity toward corneal epithelial cells and with exsA, which encodes a protein that regulates cytotoxicity via a complex type III secretion system. These results suggest that chemical disinfection solutions may select for contamination with cytotoxic strains. Further investigation of the mechanisms and factors responsible for resistance may also lead to strategies for reducing adverse responses to contact lens wear. PMID:11283074

Map the gap: missing children with drug-resistant tuberculosis

PubMed Central

Yuen, C. M.; Rodriguez, C. A.; Keshavjee, S.

2015-01-01

Background: The lack of published information about children with multidrug-resistant tuberculosis (MDR-TB) is an obstacle to efforts to advocate for better diagnostics and treatment. Objective: To describe the lack of recognition in the published literature of MDR-TB and extensively drug-resistant TB (XDR-TB) in children. Design: We conducted a systematic search of the literature published in countries that reported any MDR- or XDR-TB case by 2012 to identify MDR- or XDR-TB cases in adults and in children. Results: Of 184 countries and territories that reported any case of MDR-TB during 2005–2012, we identified adult MDR-TB cases in the published literature in 143 (78%) countries and pediatric MDR-TB cases in 78 (42%) countries. Of the 92 countries that reported any case of XDR-TB, we identified adult XDR-TB cases in the published literature in 55 (60%) countries and pediatric XDR-TB cases for 9 (10%) countries. Conclusion: The absence of publications documenting child MDR- and XDR-TB cases in settings where MDR- and XDR-TB in adults have been reported indicates both exclusion of childhood disease from the public discourse on drug-resistant TB and likely underdetection of sick children. Our results highlight a large-scale lack of awareness about children with MDR- and XDR-TB. PMID:26400601

Surveillance for tuberculosis in a rural community in The Philippines.

PubMed

Lopez, A L; Aldaba, J G; Ama, C G; Sylim, P G; Geraldino, X D; Sarol, J N; Salonga, A M

2016-11-01

Estimates of the tuberculosis (TB) burden in the Philippines are largely dependent on prevalence surveys. To conduct a prospective community-based survey to generate epidemiological data on TB among patients seeking care in public health centres in a rural municipality in the Philippines. Prospective surveillance and follow-up of presumptive TB cases from May 2013 to July 2015. Of 1622 participants with presumptive TB, 468 (28.8%) (95%CI 26.6-31.1) were diagnosed with TB. The annual TB case notification rate in San Juan was 212 (95%CI 184-242) per 100 000 population. There were nine TB-attributable deaths during the study period. Only 8.8% (95%CI 6.2-11.32) of the cases were children aged <15 years; 274 (58.5%) cases were bacteriologically confirmed. Of 210 isolates tested for antimicrobial resistance, 49 (23.3%, 95%CI 17.58-29.02) were resistant. Resistance to isoniazid (INH) was common (n = 33, 15.7%); multidrug-resistant TB was 1.9%. TB remains an important health problem in the Philippines. We identified low case detection of TB in children and high INH resistance rates in this rural community.

Evaluation of community-based systems for the surveillance of day three-positive Plasmodium falciparum cases in Western Cambodia

PubMed Central

2014-01-01

Background Delayed clearance of Plasmodium falciparum parasites is used as an operational indicator of potential artemisinin resistance. Effective community-based systems to detect P. falciparum cases remaining positive 72 hours after initiating treatment would be valuable for guiding case follow-up in areas of known resistance risk and for detecting areas of emerging resistance. Methods Systems incorporating existing networks of village malaria workers (VMWs) to monitor day three-positive P. falciparum cases were piloted in three provinces in western Cambodia. Quantitative and qualitative data were used to evaluate the wider feasibility and sustainability of community-based surveillance of day three-positive P. falciparum cases. Results Of 294 day-3 blood slides obtained across all sites (from 297 day-0 positives), 63 were positive for P. falciparum, an overall day-3 positivity rate of 21%. There were significant variations in the systems implemented by different partners. Full engagement of VMWs and health centre staff is critical. VMWs are responsible for a range of individual tasks including preparing blood slides on day-0, completing forms, administering directly observed therapy (DOT) on days 0–2, obtaining follow-up slides on day-3 and transporting slides and paperwork to their supervising health centre. When suitably motivated, unsalaried VMWs are willing and able to produce good quality blood smears and achieve very high rates of DOT and day-3 follow-up. Conclusions Community-based surveillance of day-3 P. falciparum cases is feasible, but highly intensive, and as such needs strong and continuous support, particularly supervision and training. The purpose and role of community-based day-3 surveillance should be assessed in the light of resource requirements; scaling-up would need to be systematic and targeted, based on clearly defined epidemiological criteria. To be truly comprehensive, the system would need to be extended beyond VMWs to other public and private health providers. PMID:25052222

RESISTANCE TO INNOVATION IN HIGHER EDUCATION, A SOCIAL PSYCHOLOGICAL EXPLORATION FOCUSED ON TELEVISION AND THE ESTABLISHMENT. THE JOSSEY-BASS SERIES IN HIGHER EDUCATION.

ERIC Educational Resources Information Center

EVANS, RICHARD I.; LEPPMANN, PETER K.

FOR THIS CASE STUDY, 80 PERCENT (319) OF THE FACULTY AT THE URBAN UNIVERSITY RETURNED A QUESTIONNAIRE DESIGNED TO IDENTIFY VALUES, PERSONALITY TRAITS, AND ATTITUDES TOWARD INSTRUCTIONAL TELEVISION (ITV) AND 14 TEACHING METHODS. AN HYPOTHESIS DERIVED FOR FUTURE RESEARCH WAS--ACCEPTANCE OF INNOVATION VARIES DIRECTLY WITH THE PERSONALITY ATTRIBUTE…

A Generic 1D Forward Modeling and Inversion Algorithm for TEM Sounding with an Arbitrary Horizontal Loop

NASA Astrophysics Data System (ADS)

Li, Zhanhui; Huang, Qinghua; Xie, Xingbing; Tang, Xingong; Chang, Liao

2016-08-01

We present a generic 1D forward modeling and inversion algorithm for transient electromagnetic (TEM) data with an arbitrary horizontal transmitting loop and receivers at any depth in a layered earth. Both the Hankel and sine transforms required in the forward algorithm are calculated using the filter method. The adjoint-equation method is used to derive the formulation of data sensitivity at any depth in non-permeable media. The inversion algorithm based on this forward modeling algorithm and sensitivity formulation is developed using the Gauss-Newton iteration method combined with the Tikhonov regularization. We propose a new data-weighting method to minimize the initial model dependence that enhances the convergence stability. On a laptop with a CPU of i7-5700HQ@3.5 GHz, the inversion iteration of a 200 layered input model with a single receiver takes only 0.34 s, while it increases to only 0.53 s for the data from four receivers at a same depth. For the case of four receivers at different depths, the inversion iteration runtime increases to 1.3 s. Modeling the data with an irregular loop and an equal-area square loop indicates that the effect of the loop geometry is significant at early times and vanishes gradually along the diffusion of TEM field. For a stratified earth, inversion of data from more than one receiver is useful in noise reducing to get a more credible layered earth. However, for a resistive layer shielded below a conductive layer, increasing the number of receivers on the ground does not have significant improvement in recovering the resistive layer. Even with a down-hole TEM sounding, the shielded resistive layer cannot be recovered if all receivers are above the shielded resistive layer. However, our modeling demonstrates remarkable improvement in detecting the resistive layer with receivers in or under this layer.

Evolution of drug resistance in multiple distinct lineages of H5N1 avian influenza.

PubMed

Hill, Andrew W; Guralnick, Robert P; Wilson, Meredith J C; Habib, Farhat; Janies, Daniel

2009-03-01

Some predict that influenza A H5N1 will be the cause of a pandemic among humans. In preparation for such an event, many governments and organizations have stockpiled antiviral drugs such as oseltamivir (Tamiflu). However, it is known that multiple lineages of H5N1 are already resistant to another class of drugs, adamantane derivatives, and a few lineages are resistant to oseltamivir. What is less well understood is the evolutionary history of the mutations that confer drug resistance in the H5N1 population. In order to address this gap, we conducted phylogenetic analyses of 676 genomic sequences of H5N1 and used the resulting hypotheses as a basis for asking 3 molecular evolutionary questions: (1) Have drug-resistant genotypes arisen in distinct lineages of H5N1 through point mutation or through reassortment? (2) Is there evidence for positive selection on the codons that lead to drug resistance? (3) Is there evidence for covariation between positions in the genome that confer resistance to drugs and other positions, unrelated to drug resistance, that may be under selection for other phenotypes? We also examine how drug-resistant lineages proliferate across the landscape by projecting or phylogenetic analysis onto a virtual globe. Our results for H5N1 show that in most cases drug resistance has arisen by independent point mutations rather than reassortment or covariation. Furthermore, we found that some codons that mediate resistance to adamantane derivatives are under positive selection, but did not find positive selection on codons that mediate resistance to oseltamivir. Together, our phylogenetic methods, molecular evolutionary analyses, and geographic visualization provide a framework for analysis of globally distributed genomic data that can be used to monitor the evolution of drug resistance.

Genetic diversity and clonal characteristics of ciprofloxacin-resistant Campylobacter jejuni isolated from Chilean patients with gastroenteritis.

PubMed

Collado, Luis; Muñoz, Nataly; Porte, Lorena; Ochoa, Sofía; Varela, Carmen; Muñoz, Ivo

2018-03-01

Campylobacter jejuni is a major cause of acute gastroenteritis worldwide. However, it has also been associated with other diseases such as bacteremia and with several post-infection sequelae. Although campylobacteriosis is usually a self-limited infection, antibiotics are indicated for severe and chronic conditions. Unfortunately, several industrialised nations have reported a substantial increase in antibiotic resistance of C. jejuni. However, there is still a lack of knowledge about the epidemiology of resistance developed by this pathogen in the developing world. For this reason, our objective was to determine the resistance of clinical C. jejuni strains to ciprofloxacin and erythromycin in Chile and their associated genotypes. Fifty C. jejuni isolates recovered from fecal samples of people with acute gastroenteritis, in central and southern Chile between 2006 and 2015, were analysed. Resistance to erythromycin and ciprofloxacin was assessed by disk diffusion and agar dilution methods. Furthermore, these strains were genotyped by Multilocus Sequence Typing (MLST). Only one of the isolates was resistant to erythromycin. However, 48% of them were resistant to ciprofloxacin. The minimal inhibitory concentration of these ciprofloxacin-resistant isolates was in the range between 4 and 32 μg/ml. Moreover, MLST analyses showed that most ciprofloxacin-resistant strains were grouped into three dominant clonal complexes (ST-21, ST-48 and ST-353), while the unique strain resistant to both antibiotics belonged to the ST-45 complex. Our results evidence a high ciprofloxacin resistance and suggest that there is a dissemination of resistant clonal lineages responsible for cases of campylobacteriosis in Chile. Further studies should elucidate the origin of these resistant genotypes. Copyright © 2018 Elsevier B.V. All rights reserved.

Cis-oriented solvent-front EGFR G796S mutation in tissue and ctDNA in a patient progressing on osimertinib: a case report and review of the literature.

PubMed

Klempner, Samuel J; Mehta, Pareen; Schrock, Alexa B; Ali, Siraj M; Ou, Sai-Hong Ignatius

2017-01-01

Acquired resistance to epidermal growth factor receptor (EGFR) tyrosine kinase inhibitors (TKI) is a universal event and limits clinical efficacy. The third-generation EGFR inhibitor osimertinib is active in EGFR-mutant/T790M positive non-small-cell lung cancer. Mechanisms of acquired resistance are emerging, and here we describe a cis -oriented solvent-front EGFR G796S mutation as the resistance mechanism observed in a progression biopsy and circulating tumor DNA (ctDNA) from a patient with initial response followed by progression on osimertinib. This is one of the earliest reports of a sole solvent-front tertiary EGFR mutation as a resistance mechanism to osimertinib. Our case suggests a monoclonal resistance mechanism. We review the importance of the solvent-front residues across TKIs and describe known osimertinib resistance mechanisms. We observe that nearly all clinical osimertinib-resistant tertiary EGFR mutations are oriented in cis with EGFR T790M. This case highlights the importance of mutations affecting EGFR kinase domains and supports the feasibility of broad panel ctDNA assays for detection of novel acquired resistance and tumor heterogeneity in routine clinical care.

Efficient realization of 3D joint inversion of seismic and magnetotelluric data with cross gradient structure constraint

NASA Astrophysics Data System (ADS)

Luo, H.; Zhang, H.; Gao, J.

2016-12-01

Seismic and magnetotelluric (MT) imaging methods are generally used to characterize subsurface structures at various scales. The two methods are complementary to each other and the integration of them is helpful for more reliably determining the resistivity and velocity models of the target region. Because of the difficulty in finding empirical relationship between resistivity and velocity parameters, Gallardo and Meju [2003] proposed a joint inversion method enforcing resistivity and velocity models consistent in structure, which is realized by minimizing cross gradients between two models. However, it is extremely challenging to combine two different inversion systems together along with the cross gradient constraints. For this reason, Gallardo [2007] proposed a joint inversion scheme that decouples the seismic and MT inversion systems by iteratively performing seismic and MT inversions as well as cross gradient minimization separately. This scheme avoids the complexity of combining two different systems together but it suffers the issue of balancing between data fitting and structure constraint. In this study, we have developed a new joint inversion scheme that avoids the problem encountered by the scheme of Gallardo [2007]. In the new scheme, seismic and MT inversions are still separately performed but the cross gradient minimization is also constrained by model perturbations from separate inversions. In this way, the new scheme still avoids the complexity of combining two different systems together and at the same time the balance between data fitting and structure consistency constraint can be enforced. We have tested our joint inversion algorithm for both 2D and 3D cases. Synthetic tests show that joint inversion better reconstructed the velocity and resistivity models than separate inversions. Compared to separate inversions, joint inversion can remove artifacts in the resistivity model and can improve the resolution for deeper resistivity structures. We will also show results applying the new joint seismic and MT inversion scheme to southwest China, where several MT profiles are available and earthquakes are very active.

METALLOPROTEINS DURING DEVELOPMENT OF WALKER-256 CARCINOSARCOMA RESISTANT PHENOTYPE.

PubMed

Chekhun, V F; Lozovska, Yu V; Burlaka, A P; Ganusevich, I I; Shvets, Yu V; Lukianova, N Yu; Todor, I M; Demash, D V; Pavlova, A A; Naleskina, L A

2015-01-01

The study was focused on the detection of changes in serum and tumor metal-containing proteins in animals during development ofdoxorubicin-resistant phenotype in malignant cells after 12 courses of chemotherapy. We found that on every stage of resistance development there was a significant increase in content of ferritin and transferrin proteins (which take part in iron traffick and storage) in Walker-256 carc'inosarcoma tissue. We observed decreased serumferritin levels at the beginning stage of the resistance development and significant elevation of this protein levels in the cases withfully developed resistance phenotype. Transferrin content showed changes opposite to that offerritin. During the development of resistance phenotype the tumor tissue also exhibited increased 'free iron' concentration that putatively correlate with elevation of ROS generation and levels of MMP-2 and MMP-9 active forms. The tumor non-protein thiol content increases gradually as well. The serum of animals with early stages of resistance phenotype development showed high ceruloplasmin activity and its significant reduction after loss of tumor sensitivity to doxorubicin. Therefore, the development of resistance phenotype in Walker-256 carcinosarcoma is accompanied by both the deregulation of metal-containing proteins in serum and tumor tissue and by the changes in activity of antioxidant defense system. Thus, the results of this study allow us to determine the spectrum of metal-containing proteins that are involved in the development of resistant tumor phenotype and that may be targeted for methods for doxorubicin sensitivity correction therapy.

Staphylococcus aureus Prostatic abscess: a clinical case report and a review of the literature.

PubMed

Carroll, David E; Marr, Ian; Huang, G Khai Lin; Holt, Deborah C; Tong, Steven Y C; Boutlis, Craig S

2017-07-21

Prostatic abscess is a rare complication of acute bacterial prostatitis and is most commonly caused by Enterobacteriaceae. We report on a case of prostatic abscess caused by Staphylococcus aureus and conduct a review of the literature. We present a case of S. aureus prostatic abscess that was successfully treated with a combination of antibiotic and surgical therapy. The isolate was non–multidrug-resistant, methicillin-resistant Staphylococcus aureus and was genotyped as clonal complex 5, an emerging regional clone that is trimethoprim resistant and Panton-Valentine leukocidin positive. This current case report is the first to describe the use of clindamycin step-down therapy. A literature review identified a further 39 cases of S. aureus prostatic abscesses, of which 26 were methicillin resistant. S. aureus is an uncommon cause of prostatic abscess. Optimal management includes both antibiotic therapy and surgical drainage. Our use of clindamycin as step-down therapy was guided by its excellent prostatic penetration.

Risk factors for ciprofloxacin-resistant Campylobacter infection in Wales.

PubMed

Evans, Meirion R; Northey, Gemma; Sarvotham, Tinnu S; Hopkins, A Lynne; Rigby, Christine J; Thomas, Daniel Rh

2009-08-01

To identify risk factors for ciprofloxacin resistance in both travel-related and domestically acquired Campylobacter infection. Case-comparison study of patients with ciprofloxacin-resistant and ciprofloxacin-susceptible Campylobacter infection conducted in Wales during 2003 and 2004. Foreign travel was the major risk factor for ciprofloxacin-resistant infection [adjusted odds ratio (adjOR) 24.0, 95% confidence interval (95% CI) 12.6-45.9]. Among travellers, case patients were five times more likely to drink still bottled water (adjOR 4.7, 95% CI 1.0-21.7), whilst among non-travellers, case patients were three times more likely to drink sparkling bottled water (adjOR 3.3, 95% CI 1.5-7.4). There was no increased risk associated with eating poultry or prior quinolone use. Foreign travel remains the most important risk factor for ciprofloxacin-resistant Campylobacter infection. The possible association of both domestic- and travel-related ciprofloxacin-resistant Campylobacter infection with bottled water needs to be further explored.

Prediction of clinical response to drugs in ovarian cancer using the chemotherapy resistance test (CTR-test).

PubMed

Kischkel, Frank Christian; Meyer, Carina; Eich, Julia; Nassir, Mani; Mentze, Monika; Braicu, Ioana; Kopp-Schneider, Annette; Sehouli, Jalid

2017-10-27

In order to validate if the test result of the Chemotherapy Resistance Test (CTR-Test) is able to predict the resistances or sensitivities of tumors in ovarian cancer patients to drugs, the CTR-Test result and the corresponding clinical response of individual patients were correlated retrospectively. Results were compared to previous recorded correlations. The CTR-Test was performed on tumor samples from 52 ovarian cancer patients for specific chemotherapeutic drugs. Patients were treated with monotherapies or drug combinations. Resistances were classified as extreme (ER), medium (MR) or slight (SR) resistance in the CTR-Test. Combination treatment resistances were transformed by a scoring system into these classifications. Accurate sensitivity prediction was accomplished in 79% of the cases and accurate prediction of resistance in 100% of the cases in the total data set. The data set of single agent treatment and drug combination treatment were analyzed individually. Single agent treatment lead to an accurate sensitivity in 44% of the cases and the drug combination to 95% accuracy. The detection of resistances was in both cases to 100% correct. ROC curve analysis indicates that the CTR-Test result correlates with the clinical response, at least for the combination chemotherapy. Those values are similar or better than the values from a publication from 1990. Chemotherapy resistance testing in vitro via the CTR-Test is able to accurately detect resistances in ovarian cancer patients. These numbers confirm and even exceed results published in 1990. Better sensitivity detection might be caused by a higher percentage of drug combinations tested in 2012 compared to 1990. Our study confirms the functionality of the CTR-Test to plan an efficient chemotherapeutic treatment for ovarian cancer patients.

Frequent Association between Alteration of the rdxA Gene and Metronidazole Resistance in French and North African Isolates of Helicobacter pylori

PubMed Central

Tankovic, Jacques; Lamarque, Dominique; Delchier, Jean-Charles; Soussy, Claude-James; Labigne, Agnes; Jenks, Peter J.

2000-01-01

Mutations in the rdxA gene have been associated with the acquisition of resistance to metronidazole in Helicobacter pylori. This gene encodes an NADPH nitroreductase whose expression is necessary for intracellular activation of the drug. We wished to examine whether mutations in rdxA were present in resistant H. pylori isolates infecting either French or North African patients. We determined the complete nucleotide sequences of the rdxA genes from seven French and six North African patients infected with paired resistant and sensitive strains. Genotyping by random amplified polymorphic DNA analysis confirmed the close genetic relatedness of the susceptible and resistant isolates from individual biopsies. Eight French and five North African individual resistant strains were also studied. For the French strains, an alteration in rdxA most probably implicated in resistance was found in 10 cases (seven frameshift mutations, two missense mutations, and one deletion of 211 bp). One to three putative missense mutations were identified in four cases, and a missense mutation possibly not implicated in resistance was discovered in the last case. For the North African strains, an alteration in rdxA was found in eight cases (three frameshift mutations, three missense mutations, one deletion of 6 bp, and one insertion of a variant of IS605). Two strains contained putative missense mutations, and no change was observed in rdxA of the last strain. Thus, inactivation of the rdxA gene is frequently, but not always, associated with resistance to metronidazole in French and North African clinical isolates of H. pylori. In addition, a variety of alterations of rdxA are associated with the resistant phenotype. PMID:10681326

[Research and control of relapse tuberculosis cases].

PubMed

Yamagishi, Fumio; Toyota, Makoto

2009-12-01

With this symposium, we focused on the relapse of tuberculosis in Japan. Out of 19,893 tuberculosis patients registered in 2007 in Japan, 7.48% were classified as relapse cases. Relapse cases have the risk of acquired drug resistance. But we have few analyses of the proportion of relapse tuberculosis cases with standard short course regimens for six months, factors contributing to tuberculosis relapse and the proportion of drug resistance among relapse TB cases in Japan. Therefore we analyzed the relapse tuberculosis cases in two rural areas and three urban areas. We also analyzed the proportion of drug resistance among relapse cases with the data of drug susceptibility survey of Ryoken. 1. Research of relapse tuberculosis cases: Makoto TOYOTA (Kochi City Public Health Center). To clarify the relapse rate and factors contributing to tuberculosis relapse, we investigated the relapse tuberculosis cases in the municipality where the proportion of elderly tuberculosis patients was high. Out of 902 tuberculosis patients registered in Kochi City Public Health Center during 10 years, 20 pulmonary tuberculosis patients were confirmed relapse cases with initial registered records. Pretreatment cavitations, sputum culture positivity at 2 months, medical miss-management (e.g. number of doses, duration of therapy) and poor adherence were considered to be factors contributing to tuberculosis relapse. Out of 20 relapse cases, 12 cases were detected with symptoms, while only 3 cases were detected by examination in law. 2. A clinical study on relapse cases of pulmonary tuberculosis: Shuichi TAKIKAWA (National Hospital Organization Nishibeppu National Hospital). The relapse of pulmonary tuberculosis was investigated. In the cases with a treatment history before short course chemotherapy, drug resistance rate was high, and thus it needs to be cautious of drug resistance at the time of the retreatment. In the cases with a treatment history of short course chemotherapy, relapse cases were recognized more significantly in male cases aged 70's. In the cases that deviated from the standard treatment and that became impossible to use rifampicin, it should be careful to emergence of isoniazid resistance. 3. The current status of the recurrence tuberculosis cases in Tokyo: Michiko NAGAMINE (Specific Disease Control Section, Tokyo Metropolitan Government Bureau of Social Welfare and Public Health). As for the background of the patient whose disease has relapsed, unstable elements are observed. After any symptom, more patients are diagnosed as a relapse case rather than finding by a medical check up. And more than half are related to homeless or life without fixed address. Their status of insurance is the livelihood protection, no insurance or the national health insurance. By RFLP analysis in Shinjuku city, some clusters have recurrent cases, one of clusters has both a relapse and exogenous reinfection. This is able to elucidate an infectious state. Like this, the analysis of each cluster can help effective countermeasures. 4. Recurrence of tuberculosis in the City of Yokohama between 2004 and 2008: Michihiko YOSHIDA (Shinagawa Public Health Center), Takahiro TOYOZAWA (Yokohama Public Health Center). To identify the TB recurrence rate, we studied a cohort of 40 cases (treatment completion 36 cases, interruption 4 cases) of whom had a previous history of TB treatment including isoniazid and rifampicin. The time for relapse was 7.9 +/- 8.6 years and the overall relapse rate was 0.6% (0.47-0.7%). Our study suggested the relapse was almost equal to the low incident countries but the long-term follow-up and surveillance data should be carefully evaluated. 5. Comparison of the retreatment cases of pulmonary tuberculosis: Yuka SASAKI (National Hospital Organization Chiba-East National Hospital). To investigate the factors of the retreatment of pulmonary tuberculosis, 134 retreatment cases were studied. The factors leading to retreatment were cavitary and large lesions in chest X-p, sputum smear positive and heavy alcohol-drinkers. The factors leading to defaulting of the treatment were lack in understanding of the treatment and their economic problems. Reexamination of the treatment and support of the patients are important to prevent the retreatment of the pulmonary tuberculosis. 6. Proportion of drug resistance among relapse tuberculosis cases, summary of Ryoken studies 1977-2002: Takashi YOSHIYAMA (Fukujuji Hospital). We have no historical analysis of the proportion of drug resistance among relapse TB cases. Therefore we would like to analyze the proportion of drug resistance among relapse cases in Japan. Re-analysis of the data of drug susceptibility survey of Ryoken from 1977 to 2002. The proportion of relapse cases among Ryoken has decreased in 1982-1987 and that proportion was 10% in 2002. The average age of relapse cases was 5 years older than the new cases and it was 66 years in 2002. The proportion of drug resistance among relapse cases has decreased form 39% (in 1977) to 16% (in 2002) for isoniazid, was stable and around 10% for rifampicin with 7.5% in 2002. The risk factors for drug resistance were younger age, foreigners and part time job. The proportion of drug resistance was higher among cases that were failure with previous treatment, then default with previous treatment and lower among cases with cure/completion at the previous treatment but this tendency was without significance.

Drug susceptibility of Mycobacterium tuberculosis in a rural area of Bangladesh and its relevance to the national treatment regimens.

PubMed

Van Deun, A; Aung, K J; Chowdhury, S; Saha, S; Pankaj, A; Ashraf, A; Rigouts, L; Fissette, K; Portaels, F

1999-02-01

Greater Mymensingh District, a rural area of Bangladesh, at the start of the National Tuberculosis Programme (NTP). To determine the prevalence of initial and acquired drug resistance of Mycobacterium tuberculosis, and to assess the appropriateness of the NTP's standard regimens. Sampling of pre-treatment sputum from all newly registered smear-positive cases in five centres covering the area. Culture and susceptibility testing in a supra-national reference laboratory. Initial resistance to isoniazid (H) was 5.4%, and to rifampicin (R) 0.5%. Acquired H and R resistance were 25.9% and 7.4%, respectively. Multidrug resistance (MDR) was observed in one new case only and in 5.6% of previously treated patients. Changing the present NTP indication for retreatment regimen to one month of previous H intake would increase coverage of H-resistant cases from 52% to 89%, adding 6% to drug costs. The prevalence of drug resistance is surprisingly low in Bangladesh, but could rise with improving economic conditions. The NTP regimens for smear-positive cases are appropriate, all the more so since the human immunodeficiency virus is virtually absent. Indications for the retreatment regimen should be extended to include all patients treated for at least one month with any drug. The NTP regimen for smear-negative cases runs the risk of leading to MDR under present field conditions.

Testing and Selection of Fire-Resistant Materials for Spacecraft Use

NASA Technical Reports Server (NTRS)

Friedman, Robert; Jackson, Brian; Olson, Sandra

2000-01-01

Spacecraft fire-safety strategy emphasizes prevention, mostly through the selection of onboard items classified accord- ing to their fire resistance. The principal NASA acceptance tests described in this paper assess the flammability of materials and components under "worst-case" normal-gravity conditions of upward flame spread in controlled-oxygen atmospheres. Tests conducted on the ground, however, cannot duplicate the unique fire characteristics in the nonbuoyant low-gravity environment of orbiting spacecraft. Research shows that flammability an fire-spread rates in low gravity are sensitive to forced convection (ventilation flows) and atmospheric-oxygen concentration. These research results are helping to define new material-screening test methods that will better evaluate material performance in spacecraft.

Barnacles resist removal by crack trapping

PubMed Central

Hui, Chung-Yuen; Long, Rong; Wahl, Kathryn J.; Everett, Richard K.

2011-01-01

We study the mechanics of pull-off of a barnacle adhering to a thin elastic layer which is bonded to a rigid substrate. We address the case of barnacles having acorn shell geometry and hard, calcarious base plates. Pull-off is initiated by the propagation of an interface edge crack between the base plate and the layer. We compute the energy release rate of this crack as it grows along the interface using a finite element method. We also develop an approximate analytical model to interpret our numerical results and to give a closed-form expression for the energy release rate. Our result shows that the resistance of barnacles to interfacial failure arises from a crack-trapping mechanism. PMID:21208968

[Meningococcus profilaxis (author's transl)].

PubMed

Pérez Trallero, E; Pérez-Yarza, E; Ruíz Benito, C; Muñóz Baroja, I

1979-11-25

In a General Hospital in San Sebastian, 96 cases of Neisseria meningitidis infections were detected in a two years period. By the use of the disk diffusion method, we found that all causative meningococcal strains but 4 were resistant to sulfonamide (with a 300 microgram sulfadiazine disk, all isolates with a zone diameter of less than 20 mm were considered to be resistant of sulfadiazine, whereas those with zone diameters of greater than 30 mm were considered susceptible). No rifampin nor minocycline-resistant meningococci were isolated. All strains had a disk zone diameter (30 micrograms rifampin and 30 micrograms tetracycline) of greater than 20 mm. The serogroups of meningococcal strains were as follows: group A, 1; group B, 67; group C, 5 and 23 were no typed. Children less than four years of age were most frequently attacked (67,7%). The attack rate was only slightly higher in males than in females (52 and 44).

Isolation and partial characterization of Streptococcus suis from clinical cases in cattle.

PubMed

Okwumabua, Ogi; Peterson, Hanna; Hsu, Hui-Min; Bochsler, Phil; Behr, Melissa

2017-03-01

Sixteen isolates of gram-positive, coccoid bacteria were obtained from clinical cases of diverse conditions in cattle and identified as Streptococcus suis using 16S ribosomal DNA gene sequencing and other bacterial identification methods. None of the isolates could be assigned to any of the known S. suis capsular types. Virulence-associated gene profiling that targeted muramidase-released protein, extracellular protein factor, suilysin, 89-kb pathogenicity island, and arginine deiminase ( arcA) genes were negative except for 1 isolate that was arcA positive. The arcA-positive isolate caused severe widespread lesions, including multiorgan suppurative and hemorrhagic inflammation in the meninges, lung, liver, spleen, lymph nodes, and serosae of heart and intestines. The other isolates were primarily associated with meningitis, bronchopneumonia, and multifocal acute necrotizing hepatitis. The isolates differed from each other by 4-6 fragments when examined by pulsed-field gel electrophoresis, indicating they are possibly related. The isolates were susceptible to ampicillin, penicillin, and tiamulin. Resistance was noted to sulfadimethoxine (93%), oxytetracycline (86%), chlortetracycline (86%), neomycin (67%), tilmicosin (47%), clindamycin (47%), enrofloxacin (33%), gentamicin (13%), florfenicol (7%), trimethoprim-sulfamethoxazole (7%), and spectinomycin (53%). Multi-drug resistance (defined as resistance to at least 1 agent in 3 or more antimicrobial classes) was detected in 67% of the isolates. The pathology observations provide evidence that S. suis may be an important pathogen of bovine calves. S. suis is an agent that clinical bacteriology laboratories should consider when dealing with cases involving cattle.

Paediatric bacterial keratitis cases in Shanghai: microbiological profile, antibiotic susceptibility and visual outcomes

PubMed Central

Hong, J; Chen, J; Sun, X; Deng, S X; Chen, L; Gong, L; Cao, W; Yu, X; Xu, J

2012-01-01

Purpose The purpose of this study was to review the microbiological profile, in vitro antibiotic susceptibility and visual outcomes of paediatric microbial keratitis in Shanghai, China over the past 6 years. Methods Medical records of patients aged ≤16 years were reviewed, who were diagnosed as having bacterial keratitis between 1 January 2005 and 31 December 2010. Bacterial culture results and in vitro antibiotic susceptibility were analysed. A logistic regression analysis was conducted to evaluate the relationship between visual impairment and possible risk factors. Results Eighty consecutive cases of paediatric bacterial keratitis cases were included, among which 59 were identified as having positive culture. Staphylococcus epidermidis was the most commonly isolated organism (n=23; 39.0%), followed by Streptococcus pneumoniae (n=11; 18.6%) and Pseudomonas aeruginosa (n=6; 10.2%). Antibiotic sensitivities revealed that tested bacteria had low resistance rates to fluoroquinolones and aminoglycosides (8.3–18.4% and 12.5–24.4%, respectively). Multivariate logistic regression analysis proved that visual impairment was significantly associated with Gram-negative bacterial infection (odds ratio (OR)=7.626; P=0.043) and an increasing number of resistant antibiotics (OR=0.385; P=0.040). Conclusions S. epidermidis was the most common isolated organism in Shanghai paediatric keratitis. The fluoroquinolones and aminoglycosides remained good choices for treating these patients. Gram-negative bacterial infection and an increasing number of resistant antibiotics were associated with worse visual prognoses in paediatric keratitis. PMID:23079751

Towards a definition of the "practical" epileptogenic zone: a case of epilepsy with dual pathology.

PubMed

Chassagnon, Serge; Valenti, Maria Paola; Sabourdy, Cécile; Esposito, Philippe; Kehrli, Pierre; Arzimanoglou, Alexis; Ryvlin, Philippe; Kahane, Philippe; Hirsch, Edouard

2006-08-01

Presurgical evaluation for patients with drug-resistant epilepsy requires the definition of various zones that have a variable spatial relationship with the epileptogenic zone. All the available methods to directly measure the actual seizure-onset zone and to define "the minimum amount of cortical tissue that must be resected to produce seizure-freedom" have significant limitations. We report on the case of a patient with dual pathology (hippocampal sclerosis and a post-traumatic scar) and discuss the contribution of the various presurgical investigations that led to surgery and seizure-freedom.

On Application of Model Predictive Control to Power Converter with Switching

NASA Astrophysics Data System (ADS)

Zanma, Tadanao; Fukuta, Junichi; Doki, Shinji; Ishida, Muneaki; Okuma, Shigeru; Matsumoto, Takashi; Nishimori, Eiji

This paper concerns a DC-DC converter control. In DC-DC converters, there exist both continuous components such as inductance, conductance and resistance and discrete ones, IGBT and MOSFET as semiconductor switching elements. Such a system can be regarded as a hybrid dynamical system. Thus, this paper presents a dc-dc control technique based on the model predictive control. Specifically, a case in which the load of the dc-dc converter changes from active to sleep is considered. In the case, a control method which makes the output voltage follow to the reference quickly in transition, and the switching frequency be constant in steady state. In addition, in applying the model predictive control to power electronics circuits, the switching characteristic of the device and the restriction condition for protection are also considered. The effectiveness of the proposed method is illustrated by comparing a conventional method through some simulation results.

Phenomenology and treatment of selective mutism.

PubMed

Kumpulainen, Kirsti

2002-01-01

Selective mutism is a multidimensional childhood disorder in which, according to the most recent studies, biologically mediated temperament and anxiety components seem to play a major role. Several psychotherapy methods have been reported in case studies to be useful, but the disorder is commonly seen to be resistant to change, particularly in cases of long duration. Currently, behaviour modification and other cognitive methods, together with cooperation with the family and the school personnel, are recommended in the treatment of selective mutism. Selective serotonin reuptake inhibitors and selective monoamine oxidase inhibitors have also been reported to be helpful when treating children with selective mutism. At the moment, pharmacotherapy cannot be recommended as the treatment of first choice but if other methods of treatment are not helpful, medication can be included in the treatment scheme. Comprehensive evaluation and treatment of possible primary and comorbid problems that require treatment are also essential.

Fragment-Based Drug Discovery in Academia: Experiences From a Tuberculosis Programme

NASA Astrophysics Data System (ADS)

Heikkila, Timo J.; Surade, Sachin; Silvestre, Hernani L.; Dias, Marcio V. B.; Ciulli, Alessio; Bromfield, Karen; Scott, Duncan; Howard, Nigel; Wen, Shijun; Wei, Alvin Hung; Osborne, David; Abell, Chris; Blundell, Tom L.

The problems associated with neglected diseases are often compounded by increasing incidence of antibiotic resistance. Patient negligence and abuse of antibiotics has lead to explosive growth in cases of tuberculosis, with some M. tuberculosis strains becoming virtually untreatable. Structure-based drug development is viewed as cost-effective and time-consuming method for discovery and development of hits to lead compounds. In this review we will discuss the suitability of fragment-based methods for developing new chemotherapeutics against neglected diseases, providing examples from our tuberculosis programme.

Prevalence of drug-resistant tuberculosis and imputed burden in South Africa: a national and sub-national cross-sectional survey.

PubMed

Ismail, Nazir Ahmed; Mvusi, Lindiwe; Nanoo, Ananta; Dreyer, Andries; Omar, Shaheed V; Babatunde, Sanni; Molebatsi, Thabo; van der Walt, Martie; Adelekan, Adeboye; Deyde, Varough; Ihekweazu, Chikwe; Madhi, Shabir A

2018-04-20

Globally, per-capita, South Africa reports a disproportionately high number of cases of multidrug-resistant (MDR) tuberculosis and extensively drug-resistant (XDR) tuberculosis. We sought to estimate the prevalence of resistance to tuberculosis drugs in newly diagnosed and retreated patients with tuberculosis provincially and nationally, and compared these with the 2001-02 estimates. A cross-sectional survey was done between June 15, 2012-June 14, 2014, using population proportionate randomised cluster sampling in the nine provinces in South Africa. 343 clusters were included, ranging between 31 and 48 per province. A patient was eligible for inclusion in the survey if he or she presented as a presumptive case during the intake period at a drug resistance survey enrolling facility. Consenting participants (≥18 years old) completed a questionnaire and had a sputum sample tested for resistance to first-line and second-line drugs. Analysis was by logistic regression with robust SEs, inverse probability weighted against routine data, and estimates were derived using a random effects model. 101 422 participants were tested in 2012-14. Nationally, the prevalence of MDR tuberculosis was 2·1% (95% CI 1·5-2·7) among new tuberculosis cases and 4·6% (3·2-6·0) among retreatment cases. The provincial point prevalence of MDR tuberculosis ranged between 1·6% (95% CI 0·9-2·9) and 5·1% (3·7-7·0). Overall, the prevalence of rifampicin-resistant tuberculosis (4·6%, 95% CI 3·5-5·7) was higher than the prevalence of MDR tuberculosis (2·8%, 2·0-3·6; p=0·01). Comparing the current survey with the previous (2001-02) survey, the overall MDR tuberculosis prevalence was 2·8% versus 2·9% and prevalance of rifampicin-resistant tuberculosis was 3·4% versus 1·8%, respectively. The prevalence of isoniazid mono-resistant tuberculosis was above 5% in all provinces. The prevalence of ethionamide and pyrazinamide resistance among MDR tuberculosis cases was 44·7% (95% CI 25·9-63·6) and 59·1% (49·0-69·1), respectively. The prevalence of XDR tuberculosis was 4·9% (95% CI 1·0-8·8). Nationally, the estimated numbers of cases of rifampicin-resistant tuberculosis, MDR tuberculosis, and isoniazid mono-resistant tuberculosis for 2014 were 13 551, 8249, and 17 970, respectively. The overall prevalence of MDR tuberculosis in South Africa in 2012-14 was similar to that in 2001-02; however, prevalence of rifampicin-resistant tuberculosis almost doubled among new cases. Furthermore, the high prevalence of isoniazid mono-resistant tuberculosis, not routinely screened for, and resistance to second-line drugs has implications for empirical management. President's Emergency Plan for AIDS Relief through the Centers for Disease Control and Prevention under the terms of 1U19GH000571. Copyright © 2018 Elsevier Ltd. All rights reserved.

Identification of Primary Drug Resistance to Rifampin in Mycobacterium leprae Strains from Leprosy Patients in Amazonas State, Brazil

PubMed Central

Contreras Mejía, Matilde del Carmen; Porto Dos Santos, Maísa; Villarouco da Silva, George Allan; da Motta Passos, Isabella; Naveca, Felipe Gomes; Souza Cunha, Maria da Graça; Moraes, Milton Ozório

2014-01-01

The aim of this study was to identify polymorphisms in the folp1, gyrA, and rpoB genes in leprosy patients treated in Amazonas State, Brazil. Among 197 slit-skin smear samples from untreated or relapsed patients, we found three cases of primary resistance to rifampin and one confirmed case of multidrug resistance. PMID:25274993

[Analysis of pathogenic bacteria and drug resistance in neonatal purulent meningitis].

PubMed

Zhu, Minli; Hu, Qianhong; Mai, Jingyun; Lin, Zhenlang

2015-01-01

To study the clinical characteristics, pathogenic bacteria, and antibiotics resistance of neonatal purulent meningitis in order to provide the guide for early diagnosis and appropriate treatment. A retrospective review was performed and a total of 112 cases of neonatal purulent meningitis (male 64, female 58) were identified in the neonatal intensive care unit of Yuying Children's Hospital of Wenzhou Medical University seen from January 1, 2004 to December 31, 2013. The clinical information including pathogenic bacterial distribution, drug sensitivity, head imageology and therapeutic outcome were analyzed. Numeration data were shown in ratio and chi square test was applied for group comparison. Among 112 cases, 46 were admitted from 2004 to 2008 and 66 from 2009 to 2013, 23 patients were preterm and 89 were term, 20 were early onset (occurring within 3 days of life) and 92 were late onset meningitis (occurring after 3 days of life). In 62 (55.4%) cases the pathogens were Gram-positive bacteria and in 50 (44.6%) were Gram-negative bacteria. The five most frequently isolated pathogens were Escherichia coli (32 cases, 28.6%), coagulase-negative staphylococcus (CNS, 20 cases, 17.9%), Streptococcus (18 cases, 16.1%, Streptococcus agalactiae 15 cases), Enterococci (13 cases, 11.6%), Staphylococcus aureus (9 cases, 8.0%). Comparison of pathogenic bacterial distribution between 2004-2008 and 2009-2013 showed that Gram-positive bacteria accounted for more than 50% in both period. Escherichia coli was the most common bacterium, followed by Streptococcus in last five years which was higher than the first five years (22.7% (15/66) vs. 6.5% (3/46), χ(2) = 5.278, P < 0.05). Klebsiella pneumoniae was more common isolate in preterm infants than in term infants (13.0% (3/23) vs. 1.1% (1/89), χ(2) = 7.540, P < 0.05). Streptococcus (most were Streptococcus agalactiae) was the most common bacteria in early onset meningitis and higher than those in late onset meningitis (35.0% (7/20) vs. 12.0% (11/92), χ(2) = 4.872, P < 0.05). Drug sensitivity tests showed that all the Gram-positive bacterial isolates were sensitive to linezolid. Staphylococci were resistant to penicillin, and most of them were resistant to erythromycin, oxacillin and cefazolin; 77.8%of CNS isolates were methicillin-resistant staphylococcus. No Streptococcus and Enterococcus faecalis was resistant to penicillin. None of enterococci was resistant to vancomycin. Among the Gram-negative bacterial isolates, more than 40% of Escherichia coli were resistant to commonly used cephalosporins such as cefuroxime, cefotaxime and ceftazidime, and all of them were sensitive to amikacin, cefoperazone sulbactam and imipenem. Isolates of Klebsiella pneumoniae were all resistant to ampicillin, cefuroxime, cefotaxime and ceftazidime, but none of them was resistant to piperacillin tazobactam and imipenem. Of the 112 patients, 69 were cured, 23 improved, 9 uncured and 11 died. There were 47 cases (42.0%) with poor prognosis, they had abnormal head imageology, severe complications and some cases died, 13 of 18 (72.2%) patients with meningitis caused by Streptococcus died. Escherichia coli, CNS and Streptococcus are the predominant pathogens responsible for neonatal purulent meningitis over the past ten years. There were increasing numbers of cases with Streptococcus meningitis which are more common in early onset meningitis with adverse outcome, therefore careful attention should be paid in clinic. Linezolid should be used as a new choice in intractable neonatal purulent meningitis cases caused by gram positive bacteria.

Effects of borehole design on complex electrical resistivity measurements: laboratory validation and numerical experiments

NASA Astrophysics Data System (ADS)

Treichel, A.; Huisman, J. A.; Zhao, Y.; Zimmermann, E.; Esser, O.; Kemna, A.; Vereecken, H.

2012-12-01

Geophysical measurements within a borehole are typically affected by the presence of the borehole. The focus of the current study is to quantify the effect of borehole design on broadband electrical impedance tomography (EIT) measurements within boreholes. Previous studies have shown that effects on the real part of the electrical resistivity are largest for boreholes with large diameters and for materials with a large formation factor. However, these studies have not considered the effect of the well casing and the filter gravel on the measurement of the real part of the electrical resistivity. In addition, the effect of borehole design on the imaginary part of the electrical resistivity has not been investigated yet. Therefore, the aim of this study is to investigate the effect of borehole design on the complex electrical resistivity using laboratory measurements and numerical simulations. In order to do so, we developed a high resolution two dimensional axisymmetric finite element model (FE) that enables us to simulate the effects of several key borehole design parameters (e.g. borehole diameter, thickness of PVC well casing) on the measurement process. For the material surrounding the borehole, realistic values for complex resistivity were obtained from a database of laboratory measurements of complex resistivity from the test site Krauthausen (Germany). The slotted PVC well casing is represented by an effective resistivity calculated from the water-filled slot volume and the PVC volume. Measurements with and without PVC well casing were made with a four-electrode EIT logging tool in a water-filled rain barrel. The initial comparison for the case that the logging tool was inserted in the PVC well casing showed a considerable mismatch between measured and modeled values. It was required to consider a complete electrode model instead of point electrodes to remove this mismatch. This validated model was used to investigate in detail how complex resistivity measurements with different electrode configurations are affected by borehole design. Finally, the plausibility of our results was verified by comparing the simulation results with borehole EIT measurements made at the test site Krauthausen.

Sol-gel derived Al-Ga co-doped transparent conducting oxide ZnO thin films

DOE Office of Scientific and Technical Information (OSTI.GOV)

Serrao, Felcy Jyothi, E-mail: jyothiserrao@gmail.com; Department of Physics, Karnataka Government Research centre SCEM, Mangalore, 575007; Sandeep, K. M.

2016-05-23

Transparent conducting ZnO doped with Al, Ga and co-doped Al and Ga (1:1) (AGZO) thin films were grown on glass substrates by cost effective sol-gel spin coating method. The XRD results showed that all the films are polycrystalline in nature and highly textured along the (002) plane. Enhanced grain size was observed in the case of AGZO thin films. The transmittance of all the films was more than 83% in the visible region of light. The electrical properties such as carrier concentration and mobility values are increased in case of AGZO compared to that of Al and Ga doped ZnOmore » thin films. The minimum resistivity of 2.54 × 10{sup −3} Ω cm was observed in AGZO thin film. The co-doped AGZO thin films exhibited minimum resistivity and high optical transmittance, indicate that co-doped ZnO thin films could be used in transparent electronics mainly in display applications.« less

Trends in prevalence of multi drug resistant tuberculosis in sub-Saharan Africa: A systematic review and meta-analysis

PubMed Central

Adamu, Aishatu L.; Galadanci, Najibah A.; Zubayr, Bashir; Odoh, Chisom N.; Aliyu, Muktar H.

2017-01-01

Background Multidrug resistant tuberculosis (MDR-TB), is an emerging public health problem in sub-Saharan Africa (SSA). This study aims to determine the trends in prevalence of MDR-TB among new TB cases in sub-Saharan Africa over two decades. Methods We searched electronic data bases and accessed all prevalence studies of MDR-TB within SSA between 2007 and 2017. We determined pooled prevalence estimates using random effects models and determined trends using meta-regression. Results Results: We identified 915 studies satisfying inclusion criteria. Cumulatively, studies reported on MDR-TB culture of 34,652 persons. The pooled prevalence of MDR-TB in new cases was 2.1% (95% CI; 1.7–2.5%). There was a non-significant decline in prevalence by 0.12% per year. Conclusion We found a low prevalence estimate of MDR-TB, and a slight temporal decline over the study period. There is a need for continuous MDR-TB surveillance among patients with TB. PMID:28945771

Refractory case of adrenergic urticaria successfully treated with clotiazepam.

PubMed

Kawakami, Yukari; Gokita, Mari; Fukunaga, Atsushi; Nishigori, Chikako

2015-06-01

Adrenergic urticaria (AU) is a rare type of stress-induced physical urticaria characterized by widespread pruritic urticarial papules. Diagnosis can be made by i.d. injection of adrenaline or noradrenaline, which produces the characteristic rash. Although the lesions of AU typically respond to beta-blockers such as propranolol, the therapeutic options for AU are limited. Here, we report a case of AU that was resistant to beta-blockers and successfully treated with clotiazepam. The clinical picture of AU resembles that of cholinergic urticaria (CU), however, positive noradrenaline test and negative acetylcholine skin test were useful for the differential diagnosis of AU and CU. Although his symptoms were resistant to several therapeutic methods including olopatadine (H1 antagonist), lafutidine (H2 antagonist) and propranolol, the severity and frequency of his attacks and his subjective symptoms were reduced by oral clotiazepam, an anxiolytic benzodiazepine. Dermatologists should be aware that anxiolytic benzodiazepines may be a therapeutic option in AU. © 2015 Japanese Dermatological Association.

An outbreak of community-associated methicillin-resistant Staphylococcus aureus infection in a boarding school in Hong Kong Special Administrative Region (China)

PubMed Central

Kwok-ming, Poon; Yuen-kong, Wan; Shuk-kwan, Chuang; Lai-key, Kwok; Sik-on, Pak

2014-01-01

Background In November 2012, an outbreak of community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA) skin and soft tissue infections affecting students at a boarding school in Hong Kong Special Administrative Region (China) was detected. Methods A case was defined as any student or staff notified with MRSA infection from 25 October 2012 to 5 July 2013 with the clinical isolate being of staphylococcal cassette chromosome mec type IV or V and positive for Panton-Valentine leukocidin gene. We conducted field investigations, advised on control measures and enhanced surveillance for skin and soft tissue infections at the school. Decolonization therapies were offered to all cases and contacts, and carrier screening was conducted. Results There were five cases; two (40%) were hospitalized and three (60%) required surgical treatments. Initial screening comprised 240 students and 81 staff members. Overall, four cases (80%) plus eight other students (3.3%) were carriers, with eight of 12 (66.7%) from the same dormitory. All staff members screened negative. After intensified control measures, the number of students screened positive for CA-MRSA decreased from nine to one with no more cases identified in the school. Conclusion Identification of carriers, decolonization therapy, monitoring of cases and contacts and strengthening of environmental and personal hygiene were control measures that helped contain this CA-MRSA outbreak in a boarding school in Hong Kong Special Administrative Region (China). PMID:24734211

Health and economic burden of post-partum Staphylococcus aureus breast abscess.

PubMed

Branch-Elliman, Westyn; Lee, Grace M; Golen, Toni H; Gold, Howard S; Baldini, Linda M; Wright, Sharon B

2013-01-01

To determine the health and economic burdens of post-partum Staphylococcus aureus breast abscess. We conducted a matched cohort study (N = 216) in a population of pregnant women (N = 32,770) who delivered at our center during the study period from 10/1/03-9/30/10. Data were extracted from hospital databases, or via chart review if unavailable electronically. We compared cases of S. aureus breast abscess to controls matched by delivery date to compare health services utilization and mean attributable medical costs in 2012 United States dollars using Medicare and hospital-based estimates. We also evaluated whether resource utilization and health care costs differed between cases with methicillin-resistant and -susceptible S. aureus isolates. Fifty-four cases of culture-confirmed post-partum S. aureus breast abscess were identified. Breastfeeding cessation (41%), milk fistula (11.1%) and hospital readmission (50%) occurred frequently among case patients. Breast abscess case patients had high rates of health services utilization compared to controls, including high rates of imaging and drainage procedures. The mean attributable cost of post-partum S. aureus breast abscess ranged from $2,340-$4,012, depending on the methods and data sources used. Mean attributable costs were not significantly higher among methicillin-resistant vs. -susceptible S. aureus cases. Post-partum S. aureus breast abscess is associated with worse health and economic outcomes for women and their infants, including high rates of breastfeeding cessation. Future study is needed to determine the optimal treatment and prevention of these infections.

High prevalence of multidrug resistant tuberculosis in Djibouti: a retrospective study.

PubMed

Boyer-Cazajous, Géraldine; Martinaud, Christophe; Déhan, Céline; Hassan, Mohammed Osman; Gaas, Yassin; Chenilleau-Vidal, Marie-Caroline; Soler, Charles

2014-02-13

The Republic of Djibouti is an African country that exhibits one of the highest incidence rate of tuberculosis in the world. The aim of this study was to evaluate the prevalence of multidrug-resistant tuberculosis among new cases. We studied retrospectively every tuberculosis case diagnosed over a 12-month period in patients hospitalized at the French Military Hospital of Bouffard. During this period, 1,274 samples from 675 patients were tested. We isolated 266 mycobacteria corresponding to 180 cases of tuberculosis. Thirty-three were fully susceptible and 57% met the tuberculosis criteria, with 46% primary resistance. No extensively-drug-resistant tuberculosis was found. Our results highlight a major concern about the situation in this part of the world.

High rate of drug resistance among tuberculous meningitis cases in Shaanxi province, China

PubMed Central

Wang, Ting; Feng, Guo-Dong; Pang, Yu; Liu, Jia-Yun; Zhou, Yang; Yang, Yi-Ning; Dai, Wen; Zhang, Lin; Li, Qiao; Gao, Yu; Chen, Ping; Zhan, Li-Ping; Marais, Ben J; Zhao, Yan-Lin; Zhao, Gang

2016-01-01

The clinical and mycobacterial features of tuberculous meningitis (TBM) cases in China are not well described; especially in western provinces with poor tuberculosis control. We prospectively enrolled patients in whom TBM was considered in Shaanxi Province, northwestern China, over a 2-year period (September 2010 to December 2012). Cerebrospinal fluid specimens were cultured for Mycobacterium tuberculosis; with phenotypic and genotypic drug susceptibility testing (DST), as well as genotyping of all positive cultures. Among 350 patients included in the study, 27 (7.7%) had culture-confirmed TBM; 84 (24.0%) had probable and 239 (68.3%) had possible TBM. DST was performed on 25/27 (92.3%) culture positive specimens; 12/25 (48.0%) had “any resistance” detected and 3 (12.0%) were multi-drug resistant (MDR). Demographic and clinical features of drug resistant and drug susceptible TBM cases were similar. Beijing was the most common genotype (20/25; 80.0%) with 9/20 (45%) of the Beijing strains exhibiting drug resistance; including all 3 MDR strains. All (4/4) isoniazid resistant strains had mutations in the katG gene; 75% (3/4) of strains with phenotypic rifampicin resistance had mutations in the rpoB gene detected by Xpert MTB/RIF®. High rates of drug resistance were found among culture-confirmed TBM cases; most were Beijing strains. PMID:27143630

Monitoring of antimicrobial resistance in pathogenic bacteria from livestock animals.

PubMed

Wallmann, Jürgen

2006-06-01

Facing the problem of development and spreading of bacterial resistance, preventive strategies are considered the most appropriate means to counteract. The establishment of corresponding management options relies on scientifically defensible efforts to obtain objective data on the prevalence of bacterial resistance in healthy and diseased livestock. Additionally, detailed statistics are needed on the overall amount of antimicrobial agents dispensed in Germany. The collection of valid data on the prevalence of resistance requires representative and cross-sectional studies. The German national antimicrobial resistance monitoring of the Federal Office of Consumer Protection and Food Safety (BVL) determines the current quantitative resistance level of life-stock pathogens, in order to permit the evaluation and surveillance of the distribution of resistances on a valid basis. Essential key features determining the design of these studies comprise (1) a statistically valid sampling program. This incorporates regional differences in animal population density, (2) the avoidance of "copy strains", (3) testing of no more than two bacterial strains belonging to one species per herd, (4) testing only if no antimicrobial therapy preceded sample collection, and (5) the use of standardized methods [e.g. microdilution broth method to determine the minimal inhibitory concentration (MIC)]. The analysis and interpretation of this data permits reliable identification and definition of epidemiological characteristics of resistance and its development in animal associated bacteria, such as geographically and time wise differentiated profiles on its prevalence, the emergence of unknown phenotypes of resistance and an assessment of the threat resistant bacteria from animals pose for humans. In applied antimicrobial therapy, the data can serve as a decision guidance in choosing the antimicrobial agent most adapted to the prevailing epidemiological situation. The susceptibility testing performed by the BVL suggests substantially lower degrees of resistance in bacteria isolated from cattle (mastitis: Escherichia coli, Staphylococcus spp., Streptococcus spp.; respiratory disease: Pasteurella multocida, Mannheimia haemolytica) and pigs (respiratory disease: Pasteurella multocida, Bordetella bronchiseptica) in comparison to data published for Germany so far. This includes results for substances that have given cause for frequent debate. Only rare cases of resistance to enrofloxacin (fluoroquinolone) could be detected, and only 3% of bacterial strains tested proved resistant to 3rd and 4th generation cephalosporins, including substances prescribed in human medicine.

Use of Xpert MTB/RIF in Decentralized Public Health Settings and Its Effect on Pulmonary TB and DR-TB Case Finding in India.

PubMed

Sachdeva, Kuldeep Singh; Raizada, Neeraj; Sreenivas, Achuthan; Van't Hoog, Anna H; van den Hof, Susan; Dewan, Puneet K; Thakur, Rahul; Gupta, R S; Kulsange, Shubhangi; Vadera, Bhavin; Babre, Ameet; Gray, Christen; Parmar, Malik; Ghedia, Mayank; Ramachandran, Ranjani; Alavadi, Umesh; Arinaminpathy, Nimalan; Denkinger, Claudia; Boehme, Catharina; Paramasivan, C N

2015-01-01

Xpert MTB/RIF, the first automated molecular test for tuberculosis, is transforming the diagnostic landscape in high-burden settings. This study assessed the impact of up-front Xpert MTB/RIF testing on detection of pulmonary tuberculosis (PTB) and rifampicin-resistant PTB (DR-TB) cases in India. This demonstration study was implemented in 18 sub-district level TB programme units (TUs) in India in diverse geographic and demographic settings covering a population of 8.8 million. A baseline phase in 14 TUs captured programmatic baseline data, and an intervention phase in 18 TUs had Xpert MTB/RIF offered to all presumptive TB patients. We estimated changes in detection of TB and DR-TB, the former using binomial regression models to adjust for clustering and covariates. In the 14 study TUs, which participated in both phases, 10,675 and 70,556 presumptive TB patients were enrolled in the baseline and intervention phase, respectively, and 1,532 (14.4%) and 14,299 (20.3%) bacteriologically confirmed PTB cases were detected. The implementation of Xpert MTB/RIF was associated with increases in both notification rates of bacteriologically confirmed TB cases (adjusted incidence rate ratio [aIRR] 1.39; CI 1.18-1.64), and proportion of bacteriological confirmed TB cases among presumptive TB cases (adjusted risk ratio (aRR) 1.33; CI 1.6-1.52). Compared with the baseline strategy of selective drug-susceptibility testing only for PTB cases at high risk of drug-resistant TB, Xpert MTB/RIF implementation increased rifampicin resistant TB case detection by over fivefold. Among, 2765 rifampicin resistance cases detected, 1055 were retested with conventional drug susceptibility testing (DST). Positive predictive value (PPV) of rifampicin resistance detected by Xpert MTB/RIF was 94.7% (CI 91.3-98.1), in comparison to conventional DST. Introduction of Xpert MTB/RIF as initial diagnostic test for TB in public health facilities significantly increased case-notification rates of all bacteriologically confirmed TB by 39% and rifampicin-resistant TB case notification by fivefold.

Molecular Characterization of Methicillin-Resistant Staphylococcus aureus Isolates, Isolated from a Burn Hospital in Southwest Iran in 2006 and 2014.

PubMed

Ghaznavi-Rad, Ehsanollah; Ekrami, Alireza

2018-01-01

Incidence of methicillin-resistant Staphylococcus aureus (MRSA) is increasing every year, especially in burn patients with a high rate of morbidity and mortality. Molecular and epidemiologic studies are useful practices for understanding the relatedness of isolates in a single patient or a hospital. This study aimed at determining molecular characterizations of isolates collected in 2006 and 2014 using S. aureus -specific staphylococcal protein A (Spa) typing and Multilocus Sequence Typing (MLST) methods. Totally, 71 MRSA isolates were collected during the last two studies (2006 and 2014) from burn patients at Taleghani Burn Centre. After confirmation, all isolates were analysed using MLST and Spa typing methods. We reported the emergence of Spa type t021, ST-30-IV MRSA isolates, which were PVL-positive in 14.6% of the cases and t12366, ST-8-IV isolates, which were PVL-negative in 9.8% of the cases. In 2014 study, Spa typing of MRSA isolates revealed five different spa types. Overall, in two studies, t037, ST-239, SCC mec III, and CC8 were predominant clones and they were reported in 63% of the cases. The predominance of ST-239 in this region during the last eight years is a major concern. It also has a disturbing impact on the management of staphylococcal infections. Moreover, the SCC mec type IV strain is able to disseminate rapidly in hospital environments, demanding an improvement in infection-control policy.

Brucellosis Endocarditis with Methicillin Resistant Staphylococcus Aureus (MRSA) Superinfection Case Report from the Country of Georgia

DTIC Science & Technology

2016-06-03

Title: Brucellosis endocarditis with methicillin-resistant Staphylococcus aureus (MRSA) superinfection – Case report from the Country of Georgia...brucellosis endocarditis , a rare complication of brucellosis, was detected as part of an undifferentiated febrile illness surveillance study conducted in...is one of only a few reports of brucellosis endocarditis cases with MRSA superinfection. Case presentation A 56-year-old housewife, a resident

Epidemiology of antibiotic-resistant wound infections from six countries in Africa

PubMed Central

Bebell, Lisa M; Meney, Carron; Valeri, Linda

2017-01-01

Introduction Little is known about the antimicrobial susceptibility of common bacteria responsible for wound infections from many countries in sub-Saharan Africa. Methods We performed a retrospective review of microbial isolates collected based on clinical suspicion of wound infection between 2004 and 2016 from Mercy Ships, a non-governmental organisation operating a single mobile surgical unit in Benin, Congo, Liberia, Madagascar, Sierra Leone and Togo. Antimicrobial resistant organisms of interest were defined as methicillin-resistant Staphylococcus aureus (MRSA) or Enterobacteriaceae resistant to third-generation cephalosporins. Generalised mixed-effects models accounting for repeated isolates in a patient, potential clustering by case mix for each field service, age, gender and country were used to test the hypothesis that rates of antimicrobial resistance differed between countries. Results 3145 isolates from repeated field services in six countries were reviewed. In univariate analyses, the highest proportion of MRSA was found in Benin (34.6%) and Congo (31.9%), while the lowest proportion was found in Togo (14.3%) and Madagascar (14.5%); country remained a significant predictor in multivariate analyses (P=0.002). In univariate analyses, the highest proportion of third-generation cephalosporin-resistant Enterobacteriaceae was found in Benin (35.8%) and lowest in Togo (14.3%) and Madagascar (16.3%). Country remained a significant predictor for antimicrobial-resistant isolates in multivariate analyses (P=0.009). Conclusion A significant proportion of isolates from wound cultures were resistant to first-line antimicrobials in each country. Though antimicrobial resistance isolates were not verified in a reference laboratory and these data may not be representative of all regions of the countries studied, differences in the proportion of antimicrobial-resistant isolates and resistance profiles between countries suggest site-specific surveillance should be a priority and local antimicrobial resistance profiles should be used to guide empiric antibiotic selection. PMID:29588863

A novel automatic molecular test for detection of multidrug resistance tuberculosis in sputum specimen: A case control study.

PubMed

Li, Qiang; Ou, Xi C; Pang, Yu; Xia, Hui; Huang, Hai R; Zhao, Bing; Wang, Sheng F; Zhao, Yan L

2017-07-01

MiniLab tuberculosis (ML TB) assay is a new automatic diagnostic tool for diagnosis of multidrug resistance tuberculosis (MDR-TB). This study was conducted with aims to know the performance of this assay. Sputum sample from 224 TB suspects was collected from tuberculosis suspects seeking medical care at Beijing Chest hospital. The sputum samples were directly used for smear and ML TB test. The left sputum sample was used to conduct Xpert MTB/RIF, Bactec MGIT culture and drug susceptibility test (DST). All discrepancies between the results from DST, molecular and phenotypic methods were confirmed by DNA Sequencing. The sensitivity and specificity of ML TB test for detecting MTBC from TB suspects were 95.1% and 88.9%, respectively. The sensitivity for smear negative TB suspects was 64.3%. For detection of RIF resistance, the sensitivity and specificity of ML TB test were 89.2% and 95.7%, respectively. For detection of INH resistance, the sensitivity and specificity of ML TB test were 78.3% and 98.1%, respectively. ML TB test showed similar performance to Xpert MTB/RIF for detection of MTBC and RIF resistance. In addition, ML TB also had good performance for INH resistance detection. Copyright © 2017. Published by Elsevier Ltd.

Exosomal DNMT1 mediates cisplatin resistance in ovarian cancer.

PubMed

Cao, Ya-Lei; Zhuang, Ting; Xing, Bao-Heng; Li, Na; Li, Qin

2017-08-01

Ovarian cancer is the most common malignancy in women. Owing to late syndromic presentation and lack of efficient early detection, most cases are diagnosed at advanced stages. Surgery and platinum-based chemotherapy are still the standard care currently. However, resistance invoked often compromises the clinical value of the latter. Expression of DNA methyltransferase 1 (DNMT1) was analysed by gene array. Protein was determined by immunoblotting. Exosome was isolated with commercial kit. Cell proliferation was measured by CCK8 method. Annexin V-PI double staining was performed for apoptosis evaluation. Xenograft model was established and administrated with exosome. Tumour growth and overall survival were monitored. We demonstrated the upregulation of DNMT1 in both tumour and derived cell line. DNMT1 transcripts were highly enriched in exosomes from conditioned medium of ovarian cells. Co-incubation with exosomes stimulated endogenous expression and rendered host cell the resistance to cytotoxicity of cisplatin. In vivo administration of DNMT1-containing exosomes exacerbated xenograft progression and reduced overall survival significantly. Moreover, treatment with exosome inhibitor GW4869 almost completely restored sensitivity in resistant cells. Our data elucidated an unappreciated mechanism of exosomal DNMT1 in cisplatin resistance in ovarian cancer, also indicating the potential of the combination of exosome inhibitor with cisplatin in resistant patients. Copyright © 2017 John Wiley & Sons, Ltd.

[Effect of treatment of idiopathic hypogonadotropic hypogonadism with an LHRH infusion pump].

PubMed

Goicolea Opacua, I; Cortázar Galarza, A; Cacho García, L; Guimón Bardesi, M; Vázquez García, J A

1989-01-01

Treatment of idiopathic hypogonadotropic hypogonadism with an intermittent LHRH infusion pump is more physiologic than the repeated injections of gonadotropin previously used. The results of treating 7 patients, 5 males and 2 females, with this new method are presented. A better FSH and LH response to the LHRH is achieved during treatment which results in a increase in testosterone production but not so of estradiol. The size of the testicles as well as the amount of pubic hair increased in all cases, although fertility was only achieved in one patient, who also showed the best testicular response. We may conclude that treatment with intermittent infusion of LHRH is an important innovation although only partially successful since there are resistant cases and the final outcome is not better than with other methods.

Diversity, distribution and quantification of antibiotic resistance genes in goat and lamb slaughterhouse surfaces and meat products.

PubMed

Lavilla Lerma, Leyre; Benomar, Nabil; Knapp, Charles W; Correa Galeote, David; Gálvez, Antonio; Abriouel, Hikmate

2014-01-01

The distribution and quantification of tetracycline, sulfonamide and beta-lactam resistance genes were assessed in slaughterhouse zones throughout meat chain production and the meat products; this study represents the first to report quantitatively monitor antibiotic resistance genes (ARG) in goat and lamb slaughterhouse using a culture independent approach, since most studies focused on individual bacterial species and their specific resistance types. Quantitative PCR (qPCR) revealed a high prevalence of tetracycline resistance genes tetA and tetB in almost all slaughterhouse zones. Sulfonamide resistance genes were largely distributed, while beta-lactam resistance genes were less predominant. Statistical analysis revealed that resistant bacteria, in most cases, were spread by the same route in almost all slaughterhouse zones, except for tetB, blaCTX and blaTEM genes, which occurred in few zones as isolated 'hot spots.' The sum of all analyzed ARG indicated that slaughterhouse surfaces and end products act as reservoirs of ARG, mainly tet genes, which were more prevalent in slaughtering room (SR), cutting room (CR) and commercial meat products (MP). Resistance gene patterns suggest they were disseminated throughout slaughterhouse zones being also detected in commercial meat products, with significant correlations between different sampling zones/end products and total resistance in SR, CR and white room (WR) zones, and also refrigerator 4 (F4) and MP were observed. Strategically controlling key zones in slaughterhouse (SR, CR and WR) by adequate disinfection methods could strategically reduce the risks of ARG transmission and minimize the issues of food safety and environment contamination.

Diversity, Distribution and Quantification of Antibiotic Resistance Genes in Goat and Lamb Slaughterhouse Surfaces and Meat Products

PubMed Central

Lavilla Lerma, Leyre; Benomar, Nabil; Knapp, Charles W.; Correa Galeote, David; Gálvez, Antonio; Abriouel, Hikmate

2014-01-01

The distribution and quantification of tetracycline, sulfonamide and beta-lactam resistance genes were assessed in slaughterhouse zones throughout meat chain production and the meat products; this study represents the first to report quantitatively monitor antibiotic resistance genes (ARG) in goat and lamb slaughterhouse using a culture independent approach, since most studies focused on individual bacterial species and their specific resistance types. Quantitative PCR (qPCR) revealed a high prevalence of tetracycline resistance genes tetA and tetB in almost all slaughterhouse zones. Sulfonamide resistance genes were largely distributed, while beta-lactam resistance genes were less predominant. Statistical analysis revealed that resistant bacteria, in most cases, were spread by the same route in almost all slaughterhouse zones, except for tetB, blaCTX and blaTEM genes, which occurred in few zones as isolated ‘hot spots.’ The sum of all analyzed ARG indicated that slaughterhouse surfaces and end products act as reservoirs of ARG, mainly tet genes, which were more prevalent in slaughtering room (SR), cutting room (CR) and commercial meat products (MP). Resistance gene patterns suggest they were disseminated throughout slaughterhouse zones being also detected in commercial meat products, with significant correlations between different sampling zones/end products and total resistance in SR, CR and white room (WR) zones, and also refrigerator 4 (F4) and MP were observed. Strategically controlling key zones in slaughterhouse (SR, CR and WR) by adequate disinfection methods could strategically reduce the risks of ARG transmission and minimize the issues of food safety and environment contamination. PMID:25479100

Quantitative risk analysis for potentially resistant E. coli in surface waters caused by antibiotic use in agricultural systems.

PubMed

Limayem, Alya; Martin, Elizabeth M

2014-01-01

Antibiotics are frequently used in agricultural systems to promote livestock health and to control bacterial contaminants. Given the upsurge of the resistant fecal indicator bacteria (FIB) in the surface waters, a novel statistical method namely, microbial risk assessment (MRA) was performed, to evaluate the probability of infection by resistant FIB on populations exposed to recreational waters. Diarrheagenic Escherichia coli, except E. coli O157:H7, were selected for their prevalence in aquatic ecosystem. A comparative study between a typical E. coli pathway and a case scenario aggravated by antibiotic use has been performed via Crystal Ball® software in an effort to analyze a set of available inputs provided by the US institutions including E. coli concentrations in US Great Lakes through using random sampling and probability distributions. Results from forecasting a possible worst-case scenario dose-response, accounted for an approximate 50% chance for 20% of the exposed human populations to be infected by recreational water in the U.S. However, in a typical scenario, there is a 50% chance of infection for only 1% of the exposed human populations. The uncertain variable, E. coli concentration accounted for approximately 92.1% in a typical scenario as the major contributing factor of the dose-response model. Resistant FIB in recreational waters that are exacerbated by a low dose of antibiotic pollutants would increase the adverse health effects in exposed human populations by 10 fold.

Overcoming confirmation bias in causal attribution: a case study of antibiotic resistance risks.

PubMed

Cox, Louis Anthony Tony; Popken, Douglas A

2008-10-01

When they do not use formal quantitative risk assessment methods, many scientists (like other people) make mistakes and exhibit biases in reasoning about causation, if-then relations, and evidence. Decision-related conclusions or causal explanations are reached prematurely based on narrative plausibility rather than adequate factual evidence. Then, confirming evidence is sought and emphasized, but disconfirming evidence is ignored or discounted. This tendency has serious implications for health-related public policy discussions and decisions. We provide examples occurring in antimicrobial health risk assessments, including a case study of a recently reported positive relation between virginiamycin (VM) use in poultry and risk of resistance to VM-like (streptogramin) antibiotics in humans. This finding has been used to argue that poultry consumption causes increased resistance risks, that serious health impacts may result, and therefore use of VM in poultry should be restricted. However, the original study compared healthy vegetarians to hospitalized poultry consumers. Our examination of the same data using conditional independence tests for potential causality reveals that poultry consumption acted as a surrogate for hospitalization in this study. After accounting for current hospitalization status, no evidence remains supporting a causal relationship between poultry consumption and increased streptogramin resistance. This example emphasizes both the importance and the practical possibility of analyzing and presenting quantitative risk information using data analysis techniques (such as Bayesian model averaging (BMA) and conditional independence tests) that are as free as possible from potential selection, confirmation, and modeling biases.

Hillslope characterization in terms of geophysical units based on the joint interpretation of electrical resistivity and seismic velocity data

NASA Astrophysics Data System (ADS)

Feskova, Tatiana; Dietrich, Peter

2015-04-01

Hydrological conditions in a catchment depend on many factors such as climatic, geological, geomorphological, biological and human, which interact with each other and influence water balance in a catchment. This interaction leads to the subordination in the landscape structure, namely the weak elements subordinate to the powerful elements. Thereby, geological and geomorphological factors play an essential role in catchment development and organization. A hillslope consequently can be allocated to one class of the representative units because the important flow processes run at the hillslope. Moreover, a hillslope can be subdivided into stratigraphic subsurface units and significant hillslope areas based on the lithological change of contrasting interfaces. The knowledge of subsurface structures is necessary to understand and predicate complex hydrological processes in a catchment. Geophysical techniques provide a good opportunity to explore the subsurface. A complete geophysical investigation of subsurface in a catchment with difficult environmental conditions never will be achieved because of large time effort in the field, equipment logistic, and ambiguity in the data interpretation. The case study demonstrates how a catchment can be investigated using geophysical methods in an effective manner in terms of characterization of representative units with respect to a functional role in the catchment. This case study aims to develop combined resistivity and seismic velocity hillslope subsurface models for the distinction of representative functional units. In order to identify the contrasting interfaces of the hillslope, to localize significant hillslope areas, and to address the ambiguity in the geophysical data interpretation, the case study combined resistivity surveys (vertical electrical soundings and electrical resistivity tomography) with refraction seismic method, and conducted these measurements at one single profile along the hillslope transect and perpendicular to this transect. The measurements along the hillslope transect deliver the two-dimensional hillslope section of resistivity and seismic velocity distribution with contrasting stratigraphic interfaces, whereas the measurements perpendicular to the hillslope transect obtained from vertical electrical soundings survey localize significant hillslope areas indicating existence of two-dimensional features in the subsurface. To demonstrate the suitability of the suggested approach, resistivity and refraction seismic measurements were carried out at the forested gently inclined hillslope in the Weierbach catchment, which belongs to the hydrological observatory Attert Basin locating in the mid-western part of the Grand-Duchy of Luxembourg. This hillslope is characterized by Pleistocene periglacial slope deposits, which plays an important role in the ecosystem functioning. The obtained resistivity and seismic hillslope models of the Weierbech catchment complement well one another. The hillslope models identify three significant hillslope areas along the hillslope called as elementary functional units, and four electrical vertical stratigraphic units and two seismic vertical stratigraphic units that agree with lithological stratigraphy of this study site. In conclusions, the suggested geophysical approach is suitable to characterise a hillslope as the representative unit only at a single transect in the efficient manner in contrast to the expensive 3D-measurements.

Confirmation of resistance to herbicides and evaluation of resistance levels

USDA-ARS?s Scientific Manuscript database

As cases of resistance to herbicides escalate worldwide, there is increasing demand from growers to test for weed resistance and how to manage it. Scientists have developed resistance testing protocols for numerous herbicides and weed species. Growers need immediate answers and scientists are faced ...

Treatment default amongst patients with tuberculosis in urban Morocco: predicting and explaining default and post-default sputum smear and drug susceptibility results.

PubMed

Cherkaoui, Imad; Sabouni, Radia; Ghali, Iraqi; Kizub, Darya; Billioux, Alexander C; Bennani, Kenza; Bourkadi, Jamal Eddine; Benmamoun, Abderrahmane; Lahlou, Ouafae; Aouad, Rajae El; Dooley, Kelly E

2014-01-01

Public tuberculosis (TB) clinics in urban Morocco. Explore risk factors for TB treatment default and develop a prediction tool. Assess consequences of default, specifically risk for transmission or development of drug resistance. Case-control study comparing patients who defaulted from TB treatment and patients who completed it using quantitative methods and open-ended questions. Results were interpreted in light of health professionals' perspectives from a parallel study. A predictive model and simple tool to identify patients at high risk of default were developed. Sputum from cases with pulmonary TB was collected for smear and drug susceptibility testing. 91 cases and 186 controls enrolled. Independent risk factors for default included current smoking, retreatment, work interference with adherence, daily directly observed therapy, side effects, quick symptom resolution, and not knowing one's treatment duration. Age >50 years, never smoking, and having friends who knew one's diagnosis were protective. A simple scoring tool incorporating these factors was 82.4% sensitive and 87.6% specific for predicting default in this population. Clinicians and patients described additional contributors to default and suggested locally-relevant intervention targets. Among 89 cases with pulmonary TB, 71% had sputum that was smear positive for TB. Drug resistance was rare. The causes of default from TB treatment were explored through synthesis of qualitative and quantitative data from patients and health professionals. A scoring tool with high sensitivity and specificity to predict default was developed. Prospective evaluation of this tool coupled with targeted interventions based on our findings is warranted. Of note, the risk of TB transmission from patients who default treatment to others is likely to be high. The commonly-feared risk of drug resistance, though, may be low; a larger study is required to confirm these findings.

Exploring Student Preconceptions of Readiness for Remote-Online Case-Based Learning: A Case Study

PubMed Central

2016-01-01

Background Case-based learning (CBL) is an educational approach where students work in small, collaborative groups to solve problems. Web-conferencing software provides a platform to present information and share concepts that are vital to CBL. Previous studies have found that participants were resistant to change associated with implementing e-learning; however, strategies to reduce this resistance have not been explored. Objective This study was designed to explore student preconceptions and understanding of remote-online case-based learning (RO-CBL). Methods The study took place during the Bachelor of Physiotherapy program at Monash University, Victoria, Australia, in 2013. The entire third-year cohort (n=73) was invited to participate. The primary outcome of interest was students’ preconceptions of RO-CBL, collected via pre- and posttraining surveys. Results Of the 73 students, 66 completed both surveys (attrition rate 9.6%). Three key themes relevant to student preconceptions of RO-CBL emerged: flexibility in time and location of CBL, readiness or hesitation to change to a Web-based format, and the value of training in RO-CBL that included a demonstration and trial run. Thirty-four percent of the participants were hesitant to move to an online format. Conclusions This study explored students’ preconceptions of Web-based learning and evaluated the change in students’ attitudes after training. The results suggest that educational designers should not assume that students are confident and competent in applying these technologies to professional educational activities. By identifying students’ needs before implementation, training sessions can be designed to target these needs, and improve the understanding of RO-CBL and how it works in practice. This may reduce resistance to change, enhance students’ satisfaction, and ultimately improve the learning experience. PMID:27731854

Diabetic patients infected with helicobacter pylori have a higher Insulin Resistance Degree

PubMed Central

Vafaeimanesh, Jamshid; Bagherzadeh, Mohammad; Heidari, Akram; Motii, Fatemeh; Parham, Mahmoud

2014-01-01

Background: The association of H.pylori (HP) and insulin resistance degree (IR) has not been evaluated in the diabetic patients so far. In this study, we evaluated the association between HP seropositivity and the homeostatic model assessment for insulin resistance (HOMA-IR) in diabetic patients. Methods: In this study, 211 diabetic patients admitted to the endocrinology clinic of Shahid Beheshti Hospital of Qom for routine diabetic check-ups were evaluated. The patients were divided into HP+ and HP- groups based on the seropositivity of helicobacter pylori IgG antibody. The serum H. pylori IgG antibody, blood sugar, serum insulin, HbA1c, LDL, HDL, cholesterol, triglyceride, HOMA-IR and BMI were measured. Results: The mean age of 72 HP- patient was 51.5±8.3 and 139 HP+ subjects was 53.5±9 years (P=0.128). The mean HDL in HP- cases was 69.2±29.2 mg/dl and for HP+ cases was 60.7±26.7 mg/dl (P=0.037). The mean serum insulin in HP- was 60.97±5.64 and HP+ subjects was 10.12±7.72IU/ml (P=0.002). The Homa-IR degree for HP- cases was 3.2±3.3 and for HP+ cases was 4.5±3.8 (P=0.013). There were no significant differences between these groups according to the short-term or the long-term indices of glycemic control as well as most of the diabetic risk factors or complications. The treatment type was also not significantly different between these groups. Conclusion: It seems that the HP+ diabetic patients require higher levels of serum insulin to reach the same degree of glycemic control compared to the HP- ones. PMID:25202440

Effect of HCV on fasting glucose, fasting insulin and peripheral insulin resistance in first 5 years of infection.

PubMed

Ahmed, Naeema; Rashid, Amir; Naveed, Abdul Khaliq; Bashir, Qudsia

2016-02-01

To assess the effects of hepatitis C virus infection in the first 5 years on fasting glucose, fasting insulin and peripheral insulin resistance. The case-control study was conducted at the Army Medical College, Rawalpindi, from December 2011 to November 2012, and comprised subjects recruited from a government hospital in Rawalpindi. The subjects included known cases of hepatitis C virus infection for at least 5 years, and normal healthy controls. Fasting blood samples of all the subjects were collected and analysed for serum fasting insulin and serum fasting glucose levels. Homeostatic model assessment-Insulin resistance was calculated SPSS 11 was used for statistical analysis. Of the 30 subjects, 20(66.6%) were cases, while 10(33.3%) were controls. Serum fasting glucose mean level in cases was 89.55±9.53 compared to 84.40±9.80 in the controls (p=0.188). The mean serum fasting insulin in controls was 7.52±3.23 and 6.79±3.30 in cases (p=0.567). Homeostatic model assessment-Insulin resistance level in controls was 1.60±0.76 and In the cases it was 1.49±0.74 (p=0.695). Peripheral insulin resistance and development of type 2 diabetes as a complication of hepatitis C virus infection was not likely at least within the first five years of infection.

[Antibiotic resistance to erythromycin, clindamycin and tetracycline of 573 strains of Streptococcus pyogenes (1992-1994)].

PubMed

Orden, B; Martínez, R; López de los Mozos, A; Franco, A

1996-02-01

The aim of this study was to know the antibiotic resistence of Streptococcus pyogenes to erythromycine, clindamycine and/or tetracycline in community samples. The second aim was to determine the existence of multiresistant strains and to know the relationship between resistant strains, clinical samples and age of the patient. A retrospective analysis was performed in all the strains of S. pyogenes isolated from January 1992 to December 1994. Antibiotic sensitivity was studied by MIC by the microdilution method using the Pasco semiautomatic system. During the study period 573 beta hemolytic streptococci were identified as S. pyogenes. The global resistance to erythromycine (2.8%), clindamycine (1.4%) and tetracycline (7.3%) remains at low levels but has significantly increased in the case of erythromycine (p < 0.05) and tetracycline (p < 0.05) over these 3 years. The incidence of strains resistant to clindamycine has also increased slowly although this rise is not significant. Five strains (0.9%) were not sensitive to the three antibiotics studied, 4 being isolated in the last trimester of 1994 in pharyngeal exudates. S. pyogenes resistant to erythromycine was most frequently isolated from cutaneous lesions and in pediatric patients (under the age of 14 years). These results confirm the trend towards an increase in the number of strains of S. pyogenes resistant to erythromycine, clindamycine and/or tetracycline, being most often found in cutaneous lesions and pediatric patients.

EFFECT OF IONIZING RADIATION OF THE HEMOLYSIS OF ERYTHROCYTES

DOE Office of Scientific and Technical Information (OSTI.GOV)

Belousov, A.P.

1957-05-01

The saponin hemolysis method is a very effective way of determining the resistance of erythrocytes to radiolysis. The irradiation of rabbits with a dose of 700 r induces the formation of erythrocytes resistant to chemical hemolysis and the rapid disappearance from the blood stream of non-resistant ones. In the case of burns produced by boiling water, blood cell hemolysis is temporarily increased during a period of acute toxicosis. In rabbits irradiated with a dose of 1000 to 1300 r, intensive hemolysis of erythrocytes starts immediately and continues for up to 30 days. The appearance of resistant erythrocytes in the bloodmore » is preceded by a period of active hemopoiesis and the restoration of hemoglobin. Increased resistance of erythrocytes to saponin hemolysis has been observed in rabbits who suffered loss of blood and were subsequently irradiated. Irradiation of the blood in vitro in large doses, as contrasted to small doses, lowers the resistance of erythrocytes to chemical hemolysis. Changes in the resistance of erythrocytes to saponin hemolysis are conditioned by the direct action of radiation on the blood cells and the secondary effect of hemolysins. Thus, knowing the mechanism of the hemolysis of erythrocytes under the influence of ionizing radiation allows a better insight into the pathogenesis of radiation sickness and helps the development of protective means to prevent the onset of hemolysis. (auth)« less

Using Agent-Based Modelling to Predict the Role of Wild Refugia in the Evolution of Resistance of Sea Lice to Chemotherapeutants

PubMed Central

McEwan, Gregor F.; Groner, Maya L.; Fast, Mark D.; Revie, Crawford W.

2015-01-01

A major challenge for Atlantic salmon farming in the northern hemisphere is infestation by the sea louse parasite Lepeophtheirus salmonis. The most frequent method of controlling these sea louse infestations is through the use of chemical treatments. However, most major salmon farming areas have observed resistance to common chemotherapeutants. In terrestrial environments, many strategies employed to manage the evolution of resistance involve the use of refugia, where a portion of the population is left untreated to maintain susceptibility. While refugia have not been deliberately used in Atlantic salmon farming, wild salmon populations that migrate close to salmon farms may act as natural refugia. In this paper we describe an agent-based model that explores the influence of different sizes of wild salmon populations on resistance evolution in sea lice on a salmon farm. Using the model, we demonstrate that wild salmon populations can act as refugia that limit the evolution of resistance in the sea louse populations. Additionally, we demonstrate that an increase in the size of the population of wild salmon results in an increased effect in slowing the evolution of resistance. We explore the effect of a population fitness cost associated with resistance, finding that in some cases it substantially reduces the speed of evolution to chemical treatments. PMID:26485023

Measuring The Contact Resistances Of Photovoltaic Cells

NASA Technical Reports Server (NTRS)

Burger, D. R.

1985-01-01

Simple method devised to measure contact resistances of photovoltaic solar cells. Method uses readily available equipment and applicable at any time during life of cell. Enables evaluation of cell contact resistance, contact-end resistance, contact resistivity, sheet resistivity, and sheet resistivity under contact.

Recurrent candidal intertrigo: challenges and solutions

PubMed Central

Metin, Ahmet; Dilek, Nursel; Bilgili, Serap Gunes

2018-01-01

Intertrigo is a common inflammatory dermatosis of opposing skin surfaces that can be caused by a variety of infectious agents, most notably candida, under the effect of mechanical and environmental factors. Symptoms such as pain and itching significantly decrease quality of life, leading to high morbidity. A multitude of predisposing factors, particularly obesity, diabetes mellitus, and immunosuppressive conditions facilitate both the occurrence and recurrence of the disease. The diagnosis of candidal intertrigo is usually based on clinical appearance. However, a range of laboratory studies from simple tests to advanced methods can be carried out to confirm the diagnosis. Such tests are especially useful in treatment-resistant or recurrent cases for establishing a differential diagnosis. The first and key step of management is identification and correction of predisposing factors. Patients should be encouraged to lose weight, followed up properly after endocrinologic treatment and intestinal colonization or periorificial infections should be medically managed, especially in recurrent and resistant cases. Medical treatment of candidal intertrigo usually requires topical administration of nystatin and azole group antifungals. In this context, it is also possible to use magistral remedies safely and effectively. In case of predisposing immunosuppressive conditions or generalized infections, novel systemic agents with higher potency may be required. PMID:29713190

Molecular detection assay of five Salmonella serotypes of public interest: Typhimurium, Enteritidis, Newport, Heidelberg, and Hadar.

PubMed

Bugarel, M; Tudor, A; Loneragan, G H; Nightingale, K K

2017-03-01

Foodborne illnesses due to Salmonella represent an important public-health concern worldwide. In the United States, a majority of Salmonella infections are associated with a small number of serotypes. Furthermore, some serotypes that are overrepresented among human disease are also associated with multi-drug resistance phenotypes. Rapid detection of serotypes of public-health concern might help reduce the burden of salmonellosis cases and limit exposure to multi-drug resistant Salmonella. We developed a two-step real-time PCR-based rapid method for the identification and detection of five Salmonella serotypes that are either overrepresented in human disease or frequently associated with multi-drug resistance, including serotypes Enteritidis, Typhimurium, Newport, Hadar, and Heidelberg. Two sets of four markers were developed to detect and differentiate the five serotypes. The first set of markers was developed as a screening step to detect the five serotypes; whereas, the second set was used to further distinguish serotypes Heidelberg, Newport and Hadar. The utilization of these markers on a two-step investigation strategy provides a diagnostic specificity of 97% for the detection of Typhimurium, Enteritidis, Heidelberg, Infantis, Newport and Hadar. The diagnostic sensitivity of the detection makers is >96%. The availability of this two-step rapid method will facilitate specific detection of Salmonella serotypes that contribute to a significant proportion of human disease and carry antimicrobial resistance. Published by Elsevier B.V.

Selection methods for resistance to and tolerance of helminths in livestock

PubMed Central

McManus, Concepta; Paim, Tiago do Prado; de Melo, Cristiano Barros; Brasil, Bruno S. A. F.; Paiva, Samuel R.

2014-01-01

Helminthiases are among the most important livestock diseases worldwide, in particular for small ruminants, which are the focus of this review. Resource Allocation Theory implies that high-productivity farm animals proportionate insufficient resources for adequate coping with stressful conditions. Significant differences between breeds and within breeds are seen, as well as genotype vs. environment interactions. With improvement of genetic host resistance to infection, transmission of infection will be impacted. On the other hand, genetic improvement of resilience can lead to a reduction in clinical signs of disease, but not necessarily reduce transmission of infection to other animals. Faecal egg count (FEC) is the main measurement used to evaluate helminthiasis load, despite the fact that the protocols and analytical methods can affect the results, and the FEC data frequently shows aggregative, negative skewed distribution, and a high coefficient of variation. Mass selection where heritability is generally medium to low generally produces slow results and low economic returns. Many studies have been published linking resistance to nematodes in livestock to Quantitative Trait Loci and most studies have concentrated on chromosomes where the major histocompatibility complex region is located. Nevertheless, these complex traits have been seen to be affected by thousands of variants that each has a small effect. More recent studies have shown that genome-wide selection strategies can be useful in selecting animals for improved production and resistance traits in this case. PMID:25350972