Prospective Study of Infection, Colonization and Carriage of Methicillin-Resistant Staphylococcus Aureus in an Outbreak Affecting 990 Patients

In the three years between November 1989 and October 1992, an outbreak of methicillin-resistantStaphylococcus aureus (MRSA) affected 990 patients at a university hospital. The distribution of patients with carriage, colonization or infection was investigated prospectively. Nosocomial acquisition was confirmed in at least 928 patients, 525 of whom were identified from clinical specimens as being infected (n=418) or colonized (n=107) by MRSA. An additional 403 patients were identified from screening specimens, of whom 58 subsequently became infected and 18 colonized. Screening of the nose, throat and perineum detected 98 % of all carriers. Of the 580 infections in 476 patients, surgical wound, urinary tract and skin infections accounted for 58 % of the infections. Of the 476 infected patients, death was attributable to MRSA infection in 13 %. Colonization with MRSA was found in 127 patients and 42 % of 165 colonized sites were the skin. Auto-infection from nasal carriage or cross-infection, probably via staff hands, seemed to be the most common mode of acquisition of MRSA infections

Chronic VEGF Blockade Worsens Glomerular Injury in the Remnant Kidney Model

VEGF inhibition can promote renal vascular and parenchymal injury, causing proteinuria, hypertension and thrombotic microangiopathy. The mechanisms underlying these side effects are unclear. We investigated the renal effects of the administration, during 45 days, of sunitinib (Su), a VEGF receptor inhibitor, to rats with 5/6 renal ablation (Nx). Adult male Munich-Wistar rats were distributed among groups S+V, sham-operated rats receiving vehicle only; S+Su, S rats given Su, 4 mg/kg/day; Nx+V, Nx rats receiving V; and Nx+Su, Nx rats receiving Su. Su caused no change in Group S. Seven and 45 days after renal ablation, renal cortical interstitium was expanded, in association with rarefaction of peritubular capillaries. Su did not worsen hypertension, proteinuria or interstitial expansion, nor did it affect capillary rarefaction, suggesting little angiogenic activity in this model. Nx animals exhibited glomerulosclerosis (GS), which was aggravated by Su. This effect could not be explained by podocyte damage, nor could it be ascribed to tuft hypertrophy or hyperplasia. GS may have derived from organization of capillary microthrombi, frequently observed in Group Nx+Su. Treatment with Su did not reduce the fractional glomerular endothelial area, suggesting functional rather than structural cell injury. Chronic VEGF inhibition has little effect on normal rats, but can affect glomerular endothelium when renal damage is already present

A successful case of biological invasion: the fish Cichla piquiti, an Amazonian species introduced into the Pantanal, Brazil

The "tucunaré", Cichla piquiti, an exotic Amazonian fish has become established along the left bank of the Paraguay River in the Pantanal. It was introduced by escaping from culture ponds in the Upper Piquiri River and spread downstream, along the lateral flooded areas of that river, continuing through the clear waters of the left bank of the Paraguay River and reaching south as far as the Paraguai Mirim and Negrinho rivers. Adult spawners have been found in the region, meaning that it is a self-sustained population. Reproduction occurs in the period of low waters. They were found feeding on fishes of lentic environments belonging to the families Characidae, Cichlidae and Loricariidae. Until the end of 2004, its distribution was restricted to the left bank of the Paraguay River, but in March 2005, some specimens were found on the right bank, raising a question for the future: what will be the distribution area of the tucunaré in the Pantanal? Information about its dispersion is increasing: it is known to be in the Tuiuiú Lake, Pantanal National Park and in the Bolivian Pantanal, all of them on the right bank of the Paraguay River. The hypothesis that the "tucunaré" could not cross turbid waters, such as in the Paraguay River, was refuted by these recent findings. Possibly, the tucunaré's capacity to lay more than one batch of eggs in a reproductive period, as well as its care of eggs and young, lead them to establish themselves successfully in new environments, as has been observed in the Pantanal and other localities