Campylobacter spp., Salmonella spp., Verocytotoxic Escherichia coli, and Antibiotic Resistance in Indicator Organisms in Wild Cervids

Faecal samples were collected, as part of the National Health Surveillance Program for Cervids (HOP) in Norway, from wild red deer, roe deer, moose and reindeer during ordinary hunting seasons from 2001 to 2003. Samples from a total of 618 animals were examined for verocytotoxic E. coli (VTEC); 611 animals for Salmonella and 324 animals for Campylobacter. A total of 50 samples were cultivated from each cervid species in order to isolate the indicator bacterial species E. coli and Enterococcus faecalis/E. faecium for antibiotic resistance pattern studies. Salmonella and the potentially human pathogenic verocytotoxic E. coli were not isolated, while Campylobacter jejuni jejuni was found in one roe deer sample only. Antibiotic resistance was found in 13 (7.3%) of the 179 E. coli isolates tested, eight of these being resistant against one type of antibiotic only. The proportion of resistant E. coli isolates was higher in wild reindeer (24%) than in the other cervids (2.2%). E. faecalis or E. faecium were isolated from 19 of the samples, none of these being reindeer. All the strains isolated were resistant against one (84%) or more (16%) antibiotics. A total of 14 E. faecalis-strains were resistant to virginiamycin only. The results indicate that the cervid species studied do not constitute an important infectious reservoir for either the human pathogens or the antibiotic resistant microorganisms included in the study

<it>Campylobacter </it>spp., <it>Salmonella </it>spp., Verocytotoxic <it>Escherichia coli</it>, and Antibiotic Resistance in Indicator Organisms in Wild Cervids

Faecal samples were collected, as part of the National Health Surveillance Program for Cervids (HOP) in Norway, from wild red deer, roe deer, moose and reindeer during ordinary hunting seasons from 2001 to 2003. Samples from a total of 618 animals were examined for verocytotoxic E. coli (VTEC); 611 animals for Salmonella and 324 animals for Campylobacter. A total of 50 samples were cultivated from each cervid species in order to isolate the indicator bacterial species E. coli and Enterococcus faecalis/E. faecium for antibiotic resistance pattern studies. Salmonella and the potentially human pathogenic verocytotoxic E. coli were not isolated, while Campylobacter jejuni jejuni was found in one roe deer sample only. Antibiotic resistance was found in 13 (7.3%) of the 179 E. coli isolates tested, eight of these being resistant against one type of antibiotic only. The proportion of resistant E. coli isolates was higher in wild reindeer (24%) than in the other cervids (2.2%). E. faecalis or E. faecium were isolated from 19 of the samples, none of these being reindeer. All the strains isolated were resistant against one (84%) or more (16%) antibiotics. A total of 14 E. faecalis-strains were resistant to virginiamycin only. The results indicate that the cervid species studied do not constitute an important infectious reservoir for either the human pathogens or the antibiotic resistant microorganisms included in the study.</p

A MEDICAL BIRTH REGISTRY AT KILIMANJARO CHRISTIAN MEDICAL CENTRE

Objective: To establish a medical birth registry intended to serve clinical, administrative and research purposes. Methods: Starting in July 2000, every birth at Kilimanjaro Christian Medical Centre (KCMC) in Moshi, Tanzania has been recorded in a separate database. The information is obtained through personal interviews with each mother, conducted by specially trained midwives, and supplied with data from the medical records. A secretary enters the data into the electronic file. Data are collected about the mother and father: education, occupation and living conditions, mother's health before and during present pregnancy, expected date of delivery, smoking and drinking (alcohol) habits, use of drugs, plus HIV and syphilis status (if known). This is followed by particulars on the delivery: spontaneous or induced, and complications; the child or children: weight, height and Apgar score, malformations and other diagnoses. Mode of birth: spontaneous or operative intervention. If perinatal death: when? Transfer to intensive neonatal unit? The mother's reproductive history (births, miscarriages, ectopic pregnancies) is also recorded, with outcomes. Results: We describe the process based on more than six years' experience, including obstacles and how they were overcome. The registry serves as a monitoring tool, with a set of key activities and events being issued monthly, indicating changes and trends in, e.g., bleeding complications, caesarean section rates and perinatal mortality, as early warning signs. Monthly reports on key issues are presented. Confidentiality and data protection are key issues. Day-to-day recording of births is vulnerable to personnel shortage, whether from disease or holidays. Conclusions: Validation and quality checks leave the overall impression that the database is largely accurate and credible. There are plenty of opportunities for research. Clinicians and epidemiologists will profit from using the database to test hypotheses and clarify problem issues, to the ultimate benefit of labouring women and their children

Factors affecting antenatal care attendance: results from qualitative studies in Ghana, Kenya and Malawi.

BACKGROUND: Antenatal care (ANC) is a key strategy to improve maternal and infant health. However, survey data from sub-Saharan Africa indicate that women often only initiate ANC after the first trimester and do not achieve the recommended number of ANC visits. Drawing on qualitative data, this article comparatively explores the factors that influence ANC attendance across four sub-Saharan African sites in three countries (Ghana, Kenya and Malawi) with varying levels of ANC attendance. METHODS: Data were collected as part of a programme of qualitative research investigating the social and cultural context of malaria in pregnancy. A range of methods was employed interviews, focus groups with diverse respondents and observations in local communities and health facilities. RESULTS: Across the sites, women attended ANC at least once. However, their descriptions of ANC were often vague. General ideas about pregnancy care - checking the foetus' position or monitoring its progress - motivated women to attend ANC; as did, especially in Kenya, obtaining the ANC card to avoid reprimands from health workers. Women's timing of ANC initiation was influenced by reproductive concerns and pregnancy uncertainties, particularly during the first trimester, and how ANC services responded to this uncertainty; age, parity and the associated implications for pregnancy disclosure; interactions with healthcare workers, particularly messages about timing of ANC; and the cost of ANC, including charges levied for ANC procedures - in spite of policies of free ANC - combined with ideas about the compulsory nature of follow-up appointments. CONCLUSION: In these socially and culturally diverse sites, the findings suggest that 'supply' side factors have an important influence on ANC attendance: the design of ANC and particularly how ANC deals with the needs and concerns of women during the first trimester has implications for timing of initiation

Quality-control ranges for antimicrobial susceptibility testing by broth dilution of the Brachyspira hyodysenteriae type strain (ATCC 27164(T))

There are no approved standards for antimicrobial susceptibility testing of the fastidious spirochete Brachyspira hyodysenteriae. An interlaboratory study was performed to establish MIC quality control ranges for six antimicrobial agents for the type strain of B. hyodysenteriae using broth dilution. The results showed that B. hyodysenteriae B78(T) ATCC 27164(T) is a suitable quality control strain. This is a first step toward standardization of methods regarding this anaerobe