Clustering of antibiotic resistance of E. coli in couples: suggestion for a major role of conjugal transmission

BACKGROUND: Spread of antibiotic resistance in hospitals is a well-known problem, but studies investigating the importance of factors potentially related to the spread of resistant bacteria in outpatients are sparse. METHODS: Stool samples were obtained from 206 healthy couples in a community setting in Southern Germany in 2002–2003. E. coli was cultured and minimal inhibition concentrations were tested. Prevalences of E. coli resistance to commonly prescribed antibiotics according to potential risk factors were ascertained. RESULTS: Prevalences of ampicillin resistance were 15.7% and 19.4% for women and men, respectively. About ten percent and 15% of all isolates were resistant to cotrimoxazole and doxycycline, respectively. A partner carrying resistance was the main risk factor for being colonized with resistant E. coli. Odds ratios (95% CI) for ampicillin and cotrimoxazole resistance given carriage of resistant isolates by the partner were 6.9 (3.1–15.5) and 3.3 (1.5–18.0), respectively. CONCLUSION: Our data suggest that conjugal transmission may be more important for the spread of antibiotic resistance in the community setting than commonly suspected risk factors such as previous antibiotic intake or hospital contacts

Mood Modulates Auditory Laterality of Hemodynamic Mismatch Responses during Dichotic Listening

Hemodynamic mismatch responses can be elicited by deviant stimuli in a sequence of standard stimuli even during cognitive demanding tasks. Emotional context is known to modulate lateralized processing. Right-hemispheric negative emotion processing may bias attention to the right and enhance processing of right-ear stimuli. The present study examined the influence of induced mood on lateralized pre-attentive auditory processing of dichotic stimuli using functional magnetic resonance imaging (fMRI). Faces expressing emotions (sad/happy/neutral) were presented in a blocked design while a dichotic oddball sequence with consonant-vowel (CV) syllables in an event-related design was simultaneously administered. Twenty healthy participants were instructed to feel the emotion perceived on the images and to ignore the syllables. Deviant sounds reliably activated bilateral auditory cortices and confirmed attention effects by modulation of visual activity. Sad mood induction activated visual, limbic and right prefrontal areas. A lateralization effect of emotion-attention interaction was reflected in a stronger response to right-ear deviants in the right auditory cortex during sad mood. This imbalance of resources may be a neurophysiological correlate of laterality in sad mood and depression. Conceivably, the compensatory right-hemispheric enhancement of resources elicits increased ipsilateral processing

Analysis of two methods of isometric muscle contractions during the anti-G straining maneuver

This study investigated the difference in Mean Arterial Pressure (MAP) and Cardiac Output (CO) between two methods of isometric muscle contractions during the Anti-G Straining Maneuver (AGSM). 12 subjects (ages 18 to 38 yrs, height 176.8 +/- 7.4 cm, body mass 78.8 +/- 15.6 kg, percent body fat 14.3 +/- 6.6%) participated in the study. The study was a one-way within-subject design with test conditions counterbalanced. Two methods of isometric muscle contractions lasting 30 seconds each were assessed; an isometric push contraction and an isometric muscle tensing contraction. The dependent parameters were MAP and CO. The average MAP during the push contraction was 123 mmHg, SD +/- 11 and for tense was 118 mmHg, SD +/- 8. CO was 7.6 L/min, SD +/- 1.6 for push and 7.9 L/min, SD +/- 2.0 for tense method. Dependent t-tests revealed t(11) = 1.517, p = 0.157 for MAP and t(11) = 0.875, p = 0.400 for CO. This study demonstrated that the two methods of isometric muscle contractions were not statistically different with regards to MAP and CO. Therefore, both forms of isometric contractions may be potentially useful when performing the muscle contraction portion of the AGSM

The role of flagella in Clostridium difficile pathogenesis: comparison between a non-epidemic and an epidemic strain

Clostridium difficile is a major cause of healthcare-associated infection and inflicts a considerable financial burden on healthcare systems worldwide. Disease symptoms range from self-limiting diarrhoea to fatal pseudomembranous colitis. Whilst C. difficile has two major virulence factors, toxin A and B, it is generally accepted that other virulence components of the bacterium contribute to disease. C. difficile colonises the gut of humans and animals and hence the processes of adherence and colonisation are essential for disease onset. Previously it has been suggested that flagella might be implicated in colonisation. Here we tested this hypothesis by comparing flagellated parental strains to strains in which flagella genes were inactivated using ClosTron technology. Our focus was on a UK-outbreak, PCR-ribotype 027 (B1/NAP1) strain, R20291. We compared the flagellated wild-type to a mutant with a paralyzed flagellum and also to mutants (fliC, fliD and flgE) that no longer produce flagella in vitro and in vivo. Our results with R20291 provide the first strong evidence that by disabling the motor of the flagellum, the structural components of the flagellum rather than active motility, is needed for adherence and colonisation of the intestinal epithelium during infection. Comparison to published data on 630Δerm and our own data on that strain revealed major differences between the strains: the R20291 flagellar mutants adhered less than the parental strain in vitro, whereas we saw the opposite in 630Δerm. We also showed that flagella and motility are not needed for successful colonisation in vivo using strain 630Δerm. Finally we demonstrated that in strain R20291, flagella do play a role in colonisation and adherence and that there are striking differences between C. difficile strains. The latter emphasises the overriding need to characterize more than just one strain before drawing general conclusions concerning specific mechanisms of pathogenesis

Adverse Combat Experiences, Feeling Responsible for Death, and Suicidal Ideation in Treatment-Seeking Veterans and Actively Serving Canadian Armed Forces Members

Introduction: The present study examines the relationship between feeling responsible for the death of another and suicidal ideation (SI) while controlling for post-traumatic stress disorder (PTSD), major depressive disorder (MDD), and general adverse deployment experiences. Methods: Participants were current and former Canadian Armed Forces personnel (N=276) seeking treatment at a hospital-based operational stress injury clinic. Data was collected as part of a standard intake protocol. Results: Although 43.5% of the sample reported feeling responsible for the death of another in at least one instance, this variable did not emerge as a significant predictor of SI. Instead, MDD and PTSD severity were the only significant predictors of SI in our model. Discussion: Consistent with previous research, MDD emerged as the strongest predictor of SI. Results emphasize the influence of psychiatric conditions on suicidal behaviour over and above other combat-related variables. (Article in English) Introduction : L\u27étude suivante examine la relation entre le sentiment d\u27être responsable du décès d\u27un autre et l\u27idéation suicidaire (IS) des patients qui sont en traitement pour l\u27état de stress post-traumatique (ÉSPT), des troubles dépressifs majeurs et les effets indésirables des expériences de déploiement. Méthodes : Les participants étaient des membres actifs ou des vétéran(e)s des Forces armées canadiennes (N=276) qui se sont présenté(e)s à une clinique de stress opérationnelle dans un hôpital pour recevoir des traitements. Les données ont été recueillies lors d\u27un protocole d\u27évaluation standardisé à l\u27admission. Résultats : Même si 43.5% des participants ont indiqué un sentiment de responsabilité envers le décès d\u27un autre, cette donnée n\u27est pas une variable prédictive significative pour l\u27IS. Toutefois, la sévérité des troubles dépressifs majeurs et de l\u27ÉSPT étaient les seules variables prédictives significatives dans notre modèle. Discussion : A l\u27instar de recherches précédentes, le trouble dépressif majeur était la variable de prédictibilité la plus significative pour l\u27IS. Les résultats nous démontrent l\u27influence des conditions psychiatriques sur le comportement suicidaire, au-dessus de toute autre variable en relation au combat