Analysis of persistent and antibiotic resistant commensal Escherichia coli from healthy adults

Human commensal strains can infect anatomical sites outside the colon, particularly the urinary tract. This is further complicated by the fact many commensal E. coli are resistant to antibiotics. It was hypothesized that strains which can persist in the human colon for a long time, are more likely than others, to share the properties of E. coli that cause extraintestinal infections. Thirteen persistent strains were found, and the group II capsule [kpsMT II] and the yersiniabactin receptor [fyuA] correlated well with strain persistence. Nine of the 13 strains belonged to ST95, ST69, ST405 or ST131, the clones that are often found in UTI and other non-intestinal infections. In contrast, a group of 36 strains found here that were not detected in multiple samples included only 12 with kpsMT II and 14 with fyuA, and a single ST95 and one ST131 strain. The 73 strains and few additional commensal strains were characterised for their resistance to 11 antibiotics and 46 resistant strains were found. Seven of the persistent strains were resistant to at least one antibiotic, showing that resistant strains can persist in the absence of antibiotic selection. One of the resistant strains was found to carry a 6.8 kb plasmid that had a dfrA14 gene cassette, which confers resistance to trimethoprim, in the strA streptomycin resistance gene. This plasmid, named pCERC1, was completely sequenced and its replication region was identified. A large plasmid carrying a large resistance island that contained a class 1 integron, appeared to be present in 3 ST69 strains that were found here. Variants of this island were present in 2 further ST69. Hence, plasmids appeared to be the main agent in the dissemination of antibiotic resistance genes amongst the commensal strains. The resemblance shared between persistent strains and those that cause extraintesintal infections indicated that persistent strains, which are successful commensals, are the subset of commensal strains that are most likely to cause non-intestinal infections. Moreover, the acquisition and accumulation of resistance genes by persistent strains could explain the emergence of multiply antibiotic resistant clones like ST131 and ST69

Identification Of Plant Extracts And Phenolic Compounds With The Potential Of Inhibiting Fish-Spoiling Bacteria

Tujuan projek ini ialah untuk mengenal pasti spesies tumbuhan dan sebatian fenolik yang menunjukkan aktiviti antibakteria dan antioksidan. The aims of this project were to identify plant species and phenolic compounds that exhibited antioxidant and antibacterial activities

Mechanical Improvement of Electrical Interharmonics Damping

Case StudyDuring operation of compressor trains by a variable speed drive system (VSDS) integer and non-integer harmonics are generated in the inverter. Via the electrical system of inverter and motor a torsional excitation is transferred across the air gap torque into the main mass of the motor. This excitation may cause torsional resonances. However, the main focus of this case study will be on the new electrical damping method to attenuate the torsional excitations induced by an LCI Variable Frequency Drive (VFD). The effectiveness of the proposed electrical damping method will be demonstrated in 2 case studies: Case Study 1: Blocked speed ranges eliminated Case Study 2: High gear vibrations avoide

Bronchoscopic Lung Volume Reduction

The application of lung volume reduction surgery in clinical practice is limited by high postoperative morbidity and stringent selection criteria. This has been the impetus for the development of bronchoscopic approaches to lung volume reduction. A range of different techniques such as endobronchial blockers, airway bypass, endobronchial valves, thermal vapor ablation, biological sealants, and airway implants have been employed on both homogeneous as well as heterogeneous emphysema. The currently available data on efficacy of bronchoscopic lung volume reduction are not conclusive and subjective benefit in dyspnoea scores is a more frequent finding than improvements on spirometry or exercise tolerance. Safety data are more promising with rare procedure-related mortality, few serious complications, and short hospital length of stay. The field of bronchoscopic lung volume reduction continues to evolve as ongoing prospective randomized trials build on earlier feasibility data to clarify the true efficacy of such techniques

p39R861-4, a type 2 A/C2 plasmid carrying a segment from the A/C1 RA1

The largest plasmid in the strain 39R861, which is used as a plasmid size standard, was recovered by conjugation and sequenced to determine its exact size. Plasmid p39R861-4 transferred at high frequency. Though reported to be the A/C1 plasmid RA1, p39R861-4 is a 155794 bp Type 2 A/C2 plasmid in which a 39 kb segment derived from RA1 that includes a relative of the RA1 resistance island replaces 26.5 kb of the Type 2 backbone. p39R861-4 includes a single copy of IS10 and two resistance islands with a CR2-sul2 region in each of them. The 84 kb of backbone between the resistance islands is inverted relative to other known A/C plasmids and this inversion has arisen via recombination between the CR2-sul2 regions that are inversely oriented. The resistance islands prior to inversion were one related to but longer than that found in RA1, and a form of the ARI-B island identical to one found in the A/C2 plasmid R55. They contain genes conferring resistance to tetracycline (tetA(D)), sulphonamides (sul2) and florfenicol and chloramphenicol (floR). The tet(D) determinant is flanked by two IS26 in a transposon-like structure named Tntet(D). Both resistance islands contain remnants of the two ends of the integrative element GIsul2, consistent with the sul2 gene being mobilized by GIsul2 rather than by CR2

Clinical review: Influenza pandemic – physicians and their obligations

An influenza pandemic threatens to be the most lethal public health crisis to confront the world. Physicians will have critical roles in diagnosis, containment and treatment of influenza, and their commitment to treat despite increased personal risks is essential for a successful public health response. The obligations of the medical profession stem from the unique skills of its practitioners, who are able to provide more effective aid than the general public in a medical emergency. The free choice of profession and the societal contract from which doctors derive substantial benefits affirm this commitment. In hospitals, the duty will fall upon specialties that are most qualified to deal with an influenza pandemic, such as critical care, pulmonology, anesthesiology and emergency medicine. It is unrealistic to expect that this obligation to treat should be burdened with unlimited risks. Instead, risks should be minimized and justified against the effectiveness of interventions. Institutional and public cooperation in logistics, remuneration and psychological/legal support may help remove the barriers to the ability to treat. By stepping forward in duty during such a pandemic, physicians will be able to reaffirm the ethical center of the profession and lead the rest of the healthcare team in overcoming the medical crisis

Utilization Of Peeled And Unpeeled Pumpkin Flour As A Value-Added Ingredient In Crackers

The aim of this study is to develop a value-added food from peeled pumpkin pulp flour (PPF) and unpeeled pumpkin pulp flour (UPF) in crackers at substitution levels of 5 %, 10 %, 15 % and 20 % of wheat flour weight. Physico-chemical properties of PPF and UPF were determined with wheat flour as control. The physico-chemical, textural, sensory and storage stability were also investigated for all types of crackers, using 100 % wheat flour crackers as control. PPF and UPF were significantly higher ≤(p0.05) in water holding capacity (WHC) and oil holding capacity (OHC). Significantly high (≤p0.05) ash and crude fibre content together with significantly low (p≤0.05) moisture content and water activity were also observed for PPF and UPF. It was revealed that total dietary fibre (TDF), soluble dietary fibre (SDF) and insoluble dietary fibre (IDF) contents were significantly higher (p≤0.05) in PP F and UPF. Resistant starch (RS), scavenging activity, β-carotene and phenolics content were found to be significantly high (p≤0.05) in PPF and UPF. Mineral content of PPF and UPF were significantly higher (p≤0.05) in calcium and magnesium. Despite significantly low (p≤0.05) in apparent amylose content, PPF and UPF exhibited good pasting profile with significantly low (p≤0.05) pasting temperature, breakdown viscosity and set back value. Significantly high (p≤0.05) final viscosity was also achieved in PPF and UPF

Electrical Damping of VFD Induced Torsional Torque Pulsations In a LCI Driven Compressor Drive Train

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Role of Endobronchial Ultrasound in the Diagnosis of Bronchogenic Cysts

Diagnosis of bronchogenic cysts is possible with computed tomography, but half of all cases present as soft tissue densities. Two such cases are highlighted where asymptomatic bronchogenic cysts that presented as soft tissue masses were evaluated by endobronchial ultrasound (EBUS). After studying the ultrasound image characteristics, the diagnosis was confirmed using EBUS-guided transbronchial needle aspiration (EBUS-TBNA). The first case had ultrasound findings of an anechoic collection, and the aspirate was serous with negative microbiologic cultures. The second was an echogenic collection within a hyperechoic wall. Needle aspirate was purulent and cultured Haemophilus influenza. The diagnosis of a bronchogenic cyst complicated by infection was made, and the lesion was surgically resected. This potential for EBUS in the diagnosis of bronchogenic cysts and in identifying complications such as infection should be considered in the management of such cases

Desensitisation to cigarette package graphic health warnings:a cohort comparison between London and Singapore

OBJECTIVES: We compared 2 sociocultural cohorts with different duration of exposure to graphic health warning labels (GHWL), to investigate a possible desensitisation to their use. We further studied how a differing awareness and emotional impact of smoking-associated risks could be used to prevent this. SETTING: Structured interviews of patients from the general respiratory department were undertaken between 2012 and 2013 in 2 tertiary hospitals in Singapore and London. PARTICIPANTS: 266 participants were studied, 163 Londoners (35% smokers, 54% male, age 52±18 years) and 103 Singaporeans (53% smokers, p=0.003; 78% male, p<0.001; age 58±15 years, p=0.012). MAIN OUTCOMES AND MEASURES: 50 items assessed demographics, smoking history, knowledge and the deterring impact of smoking-associated risks. After showing 10 GHWL, the impact on emotional response, cognitive processing and intended smoking behaviour was recorded. RESULTS: Singaporeans scored lower than the Londoners across all label processing constructs, and this was consistent for the smoking and non-smoking groups. Londoners experienced more ‘disgust’ and felt GHWL were more effective at preventing initiation of, or quitting, smoking. Singaporeans had a lower awareness of lung cancer (82% vs 96%, p<0.001), despite ranking it as the most deterring consequence of smoking. Overall, ‘blindness’ was the least known potential risk (28%), despite being ranked as more deterring than ‘stroke’ and ‘oral cancer’ in all participants. CONCLUSIONS: The length of exposure to GHWL impacts on the effectiveness. However, acknowledging the different levels of awareness and emotional impact of smoking-associated risks within different sociocultural cohorts could be used to maintain their impact