A metapopulation model to assess the capacity of spread of meticillin-resistant Staphylococcus aureus ST398 in humans.

The emergence of the livestock-associated clone of meticillin-resistant Staphylococcus aureus (MRSA) ST398 is a serious public health issue throughout Europe. In The Netherlands a stringent 'search-and-destroy' policy has been adopted, keeping low the level of MRSA prevalence. However, reports have recently emerged of transmission events between humans showing no links to livestock, contradicting belief that MRSA ST398 is poorly transmissible in humans. The question regarding the transmissibility of MRSA ST398 in humans therefore remains of great interest. Here, we investigated the capacity of MRSA ST398 to spread into an entirely susceptible human population subject to the effect of a single MRSA-positive commercial pig farm. Using a stochastic, discrete-time metapopulation model, we explored the effect of varying both the probability of persistent carriage and that of acquiring MRSA due to contact with pigs on the transmission dynamics of MRSA ST398 in humans. In particular, we assessed the value and key determinants of the basic reproduction ratio (R(0)) for MRSA ST398. Simulations showed that the presence of recurrent exposures with pigs in risky populations allows MRSA ST398 to persist in the metapopulation and transmission events to occur beyond the farming community, even when the probability of persistent carriage is low. We further showed that persistent carriage should occur in less than 10% of the time for MRSA ST398 to conserve epidemiological characteristics similar to what has been previously reported. These results indicate that implementing control policy that only targets human carriers may not be sufficient to control MRSA ST398 in the community if it remains in pigs. We argue that farm-level control measures should be implemented if an eradication programme is to be considered

Botanical ecology and conservation of the laguna de la herrera (sabana de bogotá, colombia)

Se estudió la vegetación alrededor de la Laguna de La Herrera, una laguna andina a 2550 m. Se diferenciaron una comunidad de Phytolacca bogotensis (1): comunidades helofíticas dominadas por: Scirpus californicus y Typha angustifolia (2); Scirpus californicus (3); Polygonum punctatum (4); Rumex obtusifolius y Polygonum punctatum (5); Bidens laevis (6); Hydrocotyle ranunculoides (7); comunidades pleustofíticas con: Limnobium laevigatum; (8); Azolla filiculoides y Lemna cf. gibba (9) y Eichhornia crassipes (10). Se registraron la estructura, composición florística, los rasgos ecológicos y la distribución de las comunidades y se comparó con la conductividad eléctrica y la calidad del agua. Finalmente, se hacen recomendaciones para la conservación de la laguna y la vegetación acuática.The acuatic, helophytic and pleustophytic vegetation of the Laguna de La Herrera, on the southwestern border of the high plain of Bogotá at 2550 m was studied following the Zurich- Montpellier approach. The communities recognized were: terrestrial community of Phytolacca bogotensis; helophytic communities of scirpus californicus and Typha angustifolia ; scirpus californicus ; Polygonum punctatum ; Rumex obtusifolius with Polygonum punctatum; Bidens laevis ; Hydrocotyle ranunculoides. Pleustophytic communities of Limnobium laevigatum; Azolla filiculoides with Lemna cf. gibba and Eichornia crassipes. The structure, floristic composition and ecological aspects were also considered. Several recommendations about conservation of the Laguna are given

Comparison of governance approaches for the control of antimicrobial resistance: Analysis of three European countries

Policy makers and governments are calling for coordination to address the crisis emerging from the ineffectiveness of current antibiotics and stagnated pipe-line of new ones – antimicrobial resistance (AMR). Wider contextual drivers and mechanisms are contributing to shifts in governance strategies in health care, but are national health system approaches aligned with strategies required to tackle antimicrobial resistance? This article provides an analysis of governance approaches within healthcare systems including: priority setting, performance monitoring and accountability for AMR prevention in three European countries: England, France and Germany. Advantages and unresolved issues from these different experiences are reported, concluding that mechanisms are needed to support partnerships between healthcare professionals and patients with democratized decision-making and accountability via collaboration. But along with this multi-stakeholder approach to governance, a balance between regulation and persuasion is needed

Performance of the 2007 WHO Algorithm to diagnose Smear-negative Pulmonary Tuberculosis in a HIV prevalent setting

The 2007 WHO algorithm for diagnosis of smear-negative pulmonary tuberculosis (PTB) including Mycobacterium tuberculosis (MTB) culture was evaluated in a HIV prevalent area of Kenya

Prevalence of Livestock-Associated MRSA in Communities with High Pig-Densities in The Netherlands

Contains fulltext : 124345.pdf (publisher's version ) (Open Access)BACKGROUND: Recently, livestock-associated methicillin-resistant Staphylococcus aureus CC398 has been discovered in animals, livestock farmers and retail meat. This cross-sectional study aimed to determine the spread to persons not in direct contact with livestock in areas with a high density of pig farms. METHODOLOGY/PRINCIPAL FINDINGS: With a random mailing in 3 selected municipalities in The Netherlands, adult persons were asked to fill in a questionnaire and to take a nose swab. In total, complete information was obtained on 583 persons. Of the 534 persons without livestock-contact, one was positive for MRSA (0.2%; 95% confidence interval, <0.01-1.2). Of the 49 persons who did indicate to be working at or living on a livestock farm, 13 were positive for MRSA (26.5%; 95% confidence interval, 16.1-40.4). All spa-types belonged to CC398. CONCLUSIONS/SIGNIFICANCE: Livestock-associated MRSA has a high prevalence in people with direct contact with animals. At this moment it has not spread from the farms into the community

High-throughput analysis of subtelomeric chromosome rearrangements by use of array-based comparative genomic hypridization

Telomeric chromosome rearrangements may cause mental retardation, congenital anomalies, and miscarriages. Automated detection of subtle deletions or duplications involving telomeres is essential for high-throughput diagnosis, but impossible when conventional cytogenetic methods are used. Array-based comparative genomic hybridization (CGH) allows high-resolution screening of copy number abnormalities by hybridizing differentially labeled test and reference genomes to arrays of robotically spotted clones. To assess the applicability of this technique in the diagnosis of (sub)telomeric imbalances, we here describe a blinded study, in which DNA from 20 patients with known cytogenetic abnormalities involving one or more telomeres was hybridized to an array containing a validated set of human-chromosome–specific (sub)telomere probes. Single-copy-number gains and losses were accurately detected on these arrays, and an excellent concordance between the original cytogenetic diagnosis and the array-based CGH diagnosis was obtained by use of a single hybridization. In addition to the previously identified cytogenetic changes, array-based CGH revealed additional telomere rearrangements in 3 of the 20 patients studied. The robustness and simplicity of this array-based telomere copy-number screening make it highly suited for introduction into the clinic as a rapid and sensitive automated diagnostic procedure