Epidemiology of Staphylococcus aureus in Bangalore, India: emergence of the ST217 clone and high rate of resistance to erythromycin and ciprofloxacin in the community

AbstractThis study aimed to determine the antibiotic susceptibility pattern of Staphylococcus aureus (SA) and the circulating clones in Bangalore, India. Susceptibility testing was performed for all cases of SA infections in a tertiary-care hospital. Panton-Valentine leucocidin (PVL) encoding genes were detected, and sequence type and spa type were determined. Out of the 92 collected strains, 52.2% were methicillin-resistant SA (MRSA), isolated from community-acquired (CA) infections in 60.4% and hospital-acquired (HA) infections in 39.6%. S. aureus isolates were also highly resistant to erythromycin (54.3%) and ciprofloxacin (70.6%) in methicillin-susceptible SA (MSSA) and MRSA, as well as in CA and HA infections. MRSA were found to be significantly more resistant to gentamicin (p <0.001), cotrimoxazole (p <0.001) and ciprofloxacin (p 0.001) than MSSA, but no significant difference was observed between CA- and HA-SA. ST217 appeared as a new emerging and prevalent clone, but ST772 remained the predominant clone, all being PVL-positive isolates. Our study points out the high prevalence of MRSA, even in the community, and the worrying increase of resistance to ciprofloxacin and erythromycin among CA-MSSA. Emergence of clone ST217 is reported for the first time in India

Non-tuberculous mycobacterial pulmonary infections

Submitted by Sandra Infurna ([email protected]) on 2019-05-14T13:52:47Z No. of bitstreams: 1 ACC_Caravalho_IOC_2018.pdf: 454431 bytes, checksum: 86468a62313ad15880a6ccff685e3090 (MD5)Approved for entry into archive by Sandra Infurna ([email protected]) on 2019-05-14T14:00:46Z (GMT) No. of bitstreams: 1 ACC_Caravalho_IOC_2018.pdf: 454431 bytes, checksum: 86468a62313ad15880a6ccff685e3090 (MD5)Made available in DSpace on 2019-05-14T14:00:46Z (GMT). No. of bitstreams: 1 ACC_Caravalho_IOC_2018.pdf: 454431 bytes, checksum: 86468a62313ad15880a6ccff685e3090 (MD5) Previous issue date: 2018University of Dundee. Hospital and Medical School. Scottish Centre for Respiratory Research. Dundee, United Kingdom.Mayo Clinic College of Medicine. Rochester, MN, USA.Fundação Oswaldo Cruz. Instituto Oswaldo Cruz. Laboratório de Inovações em Terapias, Ensino e Bioprodutos. Rio de Janeiro, RJ, Brasil.Hospital Universitario de Monterrey. Centro de Investigación, Prevención y Tratamiento de Infecciones Respiratorias. Monterrey, Nuevo León UANL, Mexico.Centro Hospitalar Vila Nova de Gaia. Respiratory Department. Espinho, Portugal.Non-tuberculous mycobacterial (NTM) infections are increasingly rapidly worldwide. The reason for this phenomenon is unclear, but may include the ageing population, the increasing use of immunosuppressive drugs, the increasing prevalence of diseases that confer susceptibility to NTM, such as COPD and bronchiectasis, and growing testing for NTM. Awareness of the NTM related diseases is rising but is still suboptimal. Guidelines from the American Thoracic Society and Infectious Diseases Society of America have provided a framework for evaluating disease and evaluating care. Compliance with these guidelines is, however, very poor globally. NTM infections are amongst the most challenging cases that respiratory and infectious diseases physicians face. The challenges include intrinsic antibiotic resistance, complex drug regimens, poor tolerability and significant side effects associated with therapy and poor response rates. The decision to initiate treatment is therefore often difficult and requires careful evaluation of benefits and risks. Optimal management of NTM infections requires multidisciplinary care with close collaboration between physicians, microbiologists, physiotherapist/allied health professionals, primary care physicians and the patient. There remains a need for greater research into the epidemiology, clinical evaluation and treatment of NTM pulmonary disease. Randomised clinical trials are now being conducted which may provide useful data on the effectiveness of some new and existing therapies. In this review, we discuss the growing importance of NTM pulmonary disease and the opportunities for progress in clinical research for these conditions

The equilibrium of the parties in franchising

Le franchisage est un contrat qui est rarement équilibré. Il en est ainsi à cause d'une relation où l'on trouve une partie, généralement le franchiseur, qui domine le rapport contractuel. Cette relation économique et juridique appelle la plus grande attention en raison des investissements massifs qui y sont engagés. On verra souvent le franchisé assujetti à de nombreuses contraintes économiques, techniques et juridiques pratiquement exagérées sinon injustifiées. Cette situation n'est surtout pas sans solution. Cette étude s'efforce de trouver des remèdes aux problèmes posés par ce jeu de domination en examinant le contrat ainsi que ses différentes composantes. La méthode suivie consiste à examiner tout d'abord le concept relatif à chaque élément pris dans ce cadre contractuel précis tout en remontant à la définition de la franchise ainsi qu’à son objet, tout cela à la lumière de la notion d'équilibre et dans un souci de restaurer une certaine égalité de principe satisfaisant aux exigences de la justice contractuelle.Des définitions, des critères, des solutions, ainsi que des modifications y sont proposés à cette fin.Franchising is a contract that is not always balanced. This is due to a relationship where one can find a party, usually the franchisor, dominating the contractual bond. The economic and legal relationships call for much more attention due to the massive investments involved. One will often notice the franchisee being subject to many economic, technical and legal constraints that are practically exaggerated if not unjustified. This is certainly not without any solution. This study attempts to find remedies to the problems raised by this game of domination through examining the contract as well as its various components. The followed method consists of, primarily, the examination of the concept behind each element in this precise contractual framework, to then go back to the definition of franchising, as well as its object; all in light of the concept of equilibrium in order to restore some equality of principle in accordance with the requirements of contractual justice.Definitions, criteria, solutions, and amendments are proposed to serve this purpose

Caractéristiques épidémiologiques des infections à staphylococcus aureus (de l'hôpital femme mère enfant de Lyon à l'hôpital St John de Bangalore (Inde))

LYON1-BU Santé (693882101) / SudocSudocFranceF

Essays on the design of the built environment

Built environment is a broad and diffuse concept; perhaps this is one of its capital virtues. Research in this area of such inaccurate bound­aries allows approaches from diverse themes, scales and methods. In this book, the gathering of essays by researchers from different countries on various topics, with such diverse methodological ap­propriations, reaffirms the multiple character of this field. In this perspective, it highlights the role of a systematic and thorough observation of the complex interactions that result from the relationship between the multiple and diverse uses of urban public spaces, appropriations, against appropriations, representations of space and respective temporalities involved, considering their connection with architectural-urbanistic proposals of design and intervention. This book registers a specific moment in the field but it also rep­resents the possibility of further inroads that may broaden its borders.Ambiente construído é um conceito amplo e difuso; talvez essa seja uma de suas virtudes capitais. A pesquisa nessa área de fronteiras tão impre­cisas permite abordagens de temas, escalas e métodos diversificados. Neste livro, a reunião de ensaios feitos por pesquisadores de diferentes países sobre variados tópicos, com apropriações metodológicas tão diversas, reafirma o caráter múltiplo desse campo. Nesta ótica, destaca-se o papel de uma observação sistemática e minuciosa das complexas interações que resultam da relação entre os múltiplos e diversificados usos dos espaços públicos urbanos, as apropriações, contra apropriações, representações do espaço e respectivas tem­poralidades envolvidas, considerando a sua ligação com propostas arquitetônico-urbanísticas de desenho e intervenção. Este livro é o registro de um momento do campo, mas também representa a possibilidade de novas incursões que podem alargar suas fronteiras