Dynamics of Bacterioplankton Abundance and Production in Seagrass Communities of a Hypersaline Lagoon

The significance of bacterioplankton in the flow of carbon and energy and in trophic dynamics of the upper Laguna Madre, Texas (USA), was estimated by measuring bacterioplankton abundance and production over an 18 mo period and over several diel cycles. Bacterioplankton production was estimated from incorporation rates of thymidine (DNA synthesis) and leucine (protein synthesis). These independent inhces of bacterial growth were generally in agreement and yielded nearly identical annual estimates of bacterial production (25.24 g C m-2 yr-1 based on thymidine and 25.12 g C m-2 yr-1based on leucine). Assuming a 30 % growth efficiency, the annual bacterioplankton growth could be supported by 15 % of the total primary production (seagrasses and phytoplankton), 17% of the above-ground production of the dominant seagrass, Halodule wrightii, or 103 % of the phytoplankton production. Bactenal abundance was high throughout the year, often exceeding 1 X 1010 cells 1-1. Bacterioplankton production varied seasonally and over the diel cycle, with maximal values during warmer months and dunng daytime. Although changes in water temperature could account for some of this variation, shifts in the quantity and quality of the organic substrates supporting bacterial growth appeared to be the major factors regulating the variations in bacterioplankton production. Bacterioplankton in the Laguna Madre are a large and rapidly growing source of biomass potentially available for higher trophic levels. If this biomass is efficiently used by grazers, bacteria may be a major \u27link\u27 between seagrass production and secondary producers in the Laguna Madre ecosystem

Enhanced Bacterioplankton Production and Respiration at Intermediate Salinities in the Mississippi River Plume

Bacterial abundance and production (thymidine and leucine incorporation) were measured along a salinity gradient from the Mississippi River (0 %0) to the open waters of the Gulf of Mexico (36 %0) during July-August 1990 and February 1991. Bacterial production in surface waters was maximal at intermediate salinities (15 to 30 %0). Nutrient enrichment experiments suggested that bacterial growth near the outflow of the river was C limited whereas bacteria in plume waters of intermediate salinities were P and N limited. Rates of plankton community oxygen demand measured during winter were also maximal at intermediate salinities indicating an area of increased heterotrophic activity. The oxygen demand associated with heterotrophic bacterioplankton activity during summer was an important factor leading to hypoxic conditions in bottom waters of the Louisiana continental shelf. In summer, bacterial abundance and production ranged from 0.25 to 3.34 X log cells 1-1 and from 4 to 90 µg C-1 d-1, respectively. In winter, the corresponding ranges were 0.36 to 1.09 X log cells 1‑-1 and 3 to 20 µg C-1 d-1\u27 Depth-integrated bacterial production on the Louisiana shelf decreased from 443 k 44 mg C m-2 d-1 in summer to 226 ± 124 mg C m-2 d-1 in winter. Using empirically-derived bacterial growth efficiency values of 19 and 29 %, we estimated that bacterial production in summer could be supported by 10 to 58 % of phytoplankton production. In winter, the amount of carbon needed to support bacterial production exceeded phytoplankton production suggesting that bacterial growth during this season was heavily dependent on riverine sources of organic matter

Antimicrobial resistance among migrants in Europe: a systematic review and meta-analysis

BACKGROUND: Rates of antimicrobial resistance (AMR) are rising globally and there is concern that increased migration is contributing to the burden of antibiotic resistance in Europe. However, the effect of migration on the burden of AMR in Europe has not yet been comprehensively examined. Therefore, we did a systematic review and meta-analysis to identify and synthesise data for AMR carriage or infection in migrants to Europe to examine differences in patterns of AMR across migrant groups and in different settings. METHODS: For this systematic review and meta-analysis, we searched MEDLINE, Embase, PubMed, and Scopus with no language restrictions from Jan 1, 2000, to Jan 18, 2017, for primary data from observational studies reporting antibacterial resistance in common bacterial pathogens among migrants to 21 European Union-15 and European Economic Area countries. To be eligible for inclusion, studies had to report data on carriage or infection with laboratory-confirmed antibiotic-resistant organisms in migrant populations. We extracted data from eligible studies and assessed quality using piloted, standardised forms. We did not examine drug resistance in tuberculosis and excluded articles solely reporting on this parameter. We also excluded articles in which migrant status was determined by ethnicity, country of birth of participants' parents, or was not defined, and articles in which data were not disaggregated by migrant status. Outcomes were carriage of or infection with antibiotic-resistant organisms. We used random-effects models to calculate the pooled prevalence of each outcome. The study protocol is registered with PROSPERO, number CRD42016043681. FINDINGS: We identified 2274 articles, of which 23 observational studies reporting on antibiotic resistance in 2319 migrants were included. The pooled prevalence of any AMR carriage or AMR infection in migrants was 25·4% (95% CI 19·1-31·8; I2 =98%), including meticillin-resistant Staphylococcus aureus (7·8%, 4·8-10·7; I2 =92%) and antibiotic-resistant Gram-negative bacteria (27·2%, 17·6-36·8; I2 =94%). The pooled prevalence of any AMR carriage or infection was higher in refugees and asylum seekers (33·0%, 18·3-47·6; I2 =98%) than in other migrant groups (6·6%, 1·8-11·3; I2 =92%). The pooled prevalence of antibiotic-resistant organisms was slightly higher in high-migrant community settings (33·1%, 11·1-55·1; I2 =96%) than in migrants in hospitals (24·3%, 16·1-32·6; I2 =98%). We did not find evidence of high rates of transmission of AMR from migrant to host populations. INTERPRETATION: Migrants are exposed to conditions favouring the emergence of drug resistance during transit and in host countries in Europe. Increased antibiotic resistance among refugees and asylum seekers and in high-migrant community settings (such as refugee camps and detention facilities) highlights the need for improved living conditions, access to health care, and initiatives to facilitate detection of and appropriate high-quality treatment for antibiotic-resistant infections during transit and in host countries. Protocols for the prevention and control of infection and for antibiotic surveillance need to be integrated in all aspects of health care, which should be accessible for all migrant groups, and should target determinants of AMR before, during, and after migration. FUNDING: UK National Institute for Health Research Imperial Biomedical Research Centre, Imperial College Healthcare Charity, the Wellcome Trust, and UK National Institute for Health Research Health Protection Research Unit in Healthcare-associated Infections and Antimictobial Resistance at Imperial College London

Surgical site infection after gastrointestinal surgery in high-income, middle-income, and low-income countries: a prospective, international, multicentre cohort study

Background: Surgical site infection (SSI) is one of the most common infections associated with health care, but its importance as a global health priority is not fully understood. We quantified the burden of SSI after gastrointestinal surgery in countries in all parts of the world. Methods: This international, prospective, multicentre cohort study included consecutive patients undergoing elective or emergency gastrointestinal resection within 2-week time periods at any health-care facility in any country. Countries with participating centres were stratified into high-income, middle-income, and low-income groups according to the UN's Human Development Index (HDI). Data variables from the GlobalSurg 1 study and other studies that have been found to affect the likelihood of SSI were entered into risk adjustment models. The primary outcome measure was the 30-day SSI incidence (defined by US Centers for Disease Control and Prevention criteria for superficial and deep incisional SSI). Relationships with explanatory variables were examined using Bayesian multilevel logistic regression models. This trial is registered with ClinicalTrials.gov, number NCT02662231. Findings: Between Jan 4, 2016, and July 31, 2016, 13 265 records were submitted for analysis. 12 539 patients from 343 hospitals in 66 countries were included. 7339 (58·5%) patient were from high-HDI countries (193 hospitals in 30 countries), 3918 (31·2%) patients were from middle-HDI countries (82 hospitals in 18 countries), and 1282 (10·2%) patients were from low-HDI countries (68 hospitals in 18 countries). In total, 1538 (12·3%) patients had SSI within 30 days of surgery. The incidence of SSI varied between countries with high (691 [9·4%] of 7339 patients), middle (549 [14·0%] of 3918 patients), and low (298 [23·2%] of 1282) HDI (p < 0·001). The highest SSI incidence in each HDI group was after dirty surgery (102 [17·8%] of 574 patients in high-HDI countries; 74 [31·4%] of 236 patients in middle-HDI countries; 72 [39·8%] of 181 patients in low-HDI countries). Following risk factor adjustment, patients in low-HDI countries were at greatest risk of SSI (adjusted odds ratio 1·60, 95% credible interval 1·05–2·37; p=0·030). 132 (21·6%) of 610 patients with an SSI and a microbiology culture result had an infection that was resistant to the prophylactic antibiotic used. Resistant infections were detected in 49 (16·6%) of 295 patients in high-HDI countries, in 37 (19·8%) of 187 patients in middle-HDI countries, and in 46 (35·9%) of 128 patients in low-HDI countries (p < 0·001). Interpretation: Countries with a low HDI carry a disproportionately greater burden of SSI than countries with a middle or high HDI and might have higher rates of antibiotic resistance. In view of WHO recommendations on SSI prevention that highlight the absence of high-quality interventional research, urgent, pragmatic, randomised trials based in LMICs are needed to assess measures aiming to reduce this preventable complication

Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries

Abstract Background Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres. Methods This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low–middle-income countries. Results In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of ‘single-use’ consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for low–middle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia. Conclusion This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both high– and low–middle–income countries

Bacterial Carbon Metabolism in the Amazon River System

This article is in Free Access Publication and may be downloaded using the “Download Full Text PDF” link at right. © 1995, by the Association for the Sciences of Limnology and Oceanography, Inc