Acinetobacter baumannii, Pseudomonas aeruginosa ja Klebsiella pneumoniae tähtsus ning antibiootikumitundlikkus Eesti haiglate intensiivravi osakondades

Korraldatud uuringu järgi kuulusid A. baumannii, P. aeruginosa ja K. pneumoniae Eesti haiglate intensiivravi (IR) osakondades viie kõige olulisema patogeeni hulka. K. pneumoniae tundlike ja resistentsete tüvede suhe oli kõikides haiglates sarnane, samuti ka A. baumannii ja P. aeruginosa karbapeneemi- ja amikatsiinitundlikkus. A. baumannii tsefepiimiresistentsus oli suurim TÜ kliinikumis ning temaampitsilliinsulbaktaamiresistentsus oluliselt väiksem PERHis

Invasiivsete patogeenide struktuur ja antibiootikumitundlikkus: olukord Eestis 2004

2004. aastal toimus Eesti haiglates invasiivsete infektsioonitekitajate prospektiivne uuring Euroopa antimikroobse resistentsuse jälgimise süsteemi (EARSS) protokolli alusel. Grampositiivsete ja gramnegatiivsete patogeenide suhe oli kaks ühele. Invasiivsetestmikroobidest moodustasid kolmandiku koagulaasnegatiivsed stafülokokid, millele järgnesid E. coli, S. aureus, Enterobacteriaceae ja Enterococcus spp. Kõik Eesti invasiivsed patogeenid osutusid suhteliselt antibiootikumitundlikeks. ESBL (laia spektriga beetalaktamaasid) positiivseid E. coli tüvesid esines 3,6% ja Klebsiella spp. omi 23%. Peamised antibiootikumiresistentsuse probleemid olid seotud A. baumannii ja P. aeruginosa tüvedega. Eesti Arst 2005; 84 (8): 520–52

Rediscovery and Canonization: The Roman Classics in the Middle Ages

Issue 3 of Interfaces: A Journal of Medieval European Literatures explores the theme of the rediscovery and canonization of the Roman classics in medieval Western European literary culture, beginning in the eleventh century and reaching a wide impact on literary and intellectual life in the twelfth century. It is headed by an article by Birger Munk Olsen whose immense and comprehensive work of cataloguing and analyzing the entire record of manuscripts containing Roman classics copied before 1200 is nearing completion (L‘étude des auteurs classiques aux XIe et XIIe siècles, 5 vols). Within our journal’s scope of medieval European literature we have found it both rewarding and fitting to take Munk Olsen’s work as a prism for what is a striking literary phenomenon across most geographies and chronologies of medieval Europe: the engagement with the pre-Christian classics.The catalogue and the synthesis by Munk Olsen put many kinds of new studies on a firm footing. In this issue of Interfaces we present three 'frontiers' or types of scholarship on the rediscovery and canonization of the Roman classics all taking their cue from the meticulous way L’étude has charted out this territory

Cancer immune therapy using engineered ‛tail-flipping’ nanoliposomes targeting alternatively activated macrophages

Alternatively-activated, M2-like tumor-associated macrophages (TAM) strongly contribute to tumor growth, invasiveness and metastasis. Technologies to disable the pro-tumorigenic function of these TAMs are of high interest to immunotherapy research. Here we show that by designing engineered nanoliposomes bio-mimicking peroxidated phospholipids that are recognised and internalised by scavenger receptors, TAMs can be targeted. Incorporation of phospholipids possessing a terminal carboxylate group at the sn-2 position into nanoliposome bilayers drives their uptake by M2 macrophages with high specificity. Molecular dynamics simulation of the lipid bilayer predicts flipping of the sn-2 tail towards the aqueous phase, while molecular docking data indicates interaction of the tail with Scavenger Receptor Class B type 1 (SR-B1). In vivo, the engineered nanoliposomes are distributed specifically to M2-like macrophages and, upon delivery of the STAT6 inhibitor (AS1517499), zoledronic acid or muramyl tripeptide, these cells promote reduction of the premetastatic niche and/or tumor growth. Altogether, we demonstrate the efficiency and versatility of our engineered “tail-flipping” nanoliposomes in a pre-clinical model, which paves the way to their development as cancer immunotherapeutics in humans

Infection prevention and control interventions in the first outbreak of methicillin-resistant Staphylococcus aureus infections in an equine hospital in Sweden

<p>Abstract</p> <p>Background</p> <p>The first outbreak of methicillin-resistant <it>Staphylococcus aureus </it>(MRSA) infection in horses in Sweden occurred in 2008 at the University Animal Hospital and highlighted the need for improved infection prevention and control. The present study describes interventions and infection prevention control in an equine hospital setting July 2008 - April 2010.</p> <p>Method</p> <p>This descriptive study of interventions is based on examination of policy documents, medical records, notes from meetings and cost estimates. MRSA cases were identified through clinical sampling and telephone enquiries about horses post-surgery. Prospective sampling in the hospital environment with culture for MRSA and genotyping of isolates by <it>spa</it>-typing and pulsed-field gel electrophoresis (PFGE) were performed.</p> <p>Results</p> <p>Interventions focused on interruption of indirect contact spread of MRSA between horses via staff and equipment and included: Temporary suspension of elective surgery; and identification and isolation of MRSA-infected horses; collaboration was initiated between authorities in animal and human public health, human medicine infection control and the veterinary hospital; extensive cleaning and disinfection was performed; basic hygiene and cleaning policies, staff training, equipment modification and interior renovation were implemented over seven months.</p> <p>Ten (11%) of 92 surfaces sampled between July 2008 and April 2010 tested positive for MRSA <it>spa</it>-type 011, seven of which were from the first of nine sampling occasions. PFGE typing showed the isolates to be the outbreak strain (9 of 10) or a closely related strain. Two new cases of MRSA infection occurred 14 and 19 months later, but had no proven connections to the outbreak cases.</p> <p>Conclusions</p> <p>Collaboration between relevant authorities and the veterinary hospital and formation of an infection control committee with an executive working group were required to move the intervention process forward. Support from hospital management and the dedication of staff were essential for the development and implementation of new, improved routines. Demonstration of the outbreak strain in the environment was useful for interventions such as improvement of cleaning routines and interior design, and increased compliance with basic hygienic precautions. The interventions led to a reduction in MRSA-positive samples and the outbreak was considered curbed as no new cases occurred for over a year.</p

Regional Differences in Diagnosing Asthma and Other Allergic Diseases in Estonian Schoolchildren

The aim of this study was to estimate the prevalence of asthma and other allergic diseases among Estonian schoolchildren of the cities lacking special (pediatric allergological) health care. Material and Methods. The study, carried out through 1 March to 8 May, 2003, enrolled 5thto 12th-grade schoolchildren of 4 schools in different regions of Estonia. A three-step protocol was followed: screening questionnaire, examination by a pulmonary resident, and consultation by a pediatric allergologist. Results. Of the 3132 questionnaires distributed, 1561 (49%) were returned. A total of 828 schoolchildren answered positively to any of the questions about possible allergic disease. After examination by the pulmonary resident, 255 schoolchildren (15.7%) were referred to an allergologist for final diagnosis. Asthma was diagnosed in 4.8%, allergic rhinoconjunctivitis in 4.9%, and atopic eczema in 8.3% of schoolchildren. Asthma, allergic rhinoconjunctivitis, and urticaria occurred more frequently in Narva as compared with Võru. Conclusion. The 12-month prevalence of asthma among Estonian schoolchildren was 4.8%, and the prevalence of allergic diseases varied from region to region. Less than half (40%) of all asthma cases identified during the study were newly diagnosed, and this clearly indicates that there is a considerable underdiagnosis of the disease among schoolchildren living outside of the centers in Estonia

Cancer immune therapy using engineered ‛tail-flipping’ nanoliposomes targeting alternatively activated macrophages

Alternatively-activated, M2-like tumor-associated macrophages (TAM) strongly contribute to tumor growth, invasiveness and metastasis. Technologies to disable the pro-tumorigenic function of these TAMs are of high interest to immunotherapy research. Here we show that by designing engineered nanoliposomes bio-mimicking peroxidated phospholipids that are recognised and internalised by scavenger receptors, TAMs can be targeted. Incorporation of phospholipids possessing a terminal carboxylate group at the sn-2 position into nanoliposome bilayers drives their uptake by M2 macrophages with high specificity. Molecular dynamics simulation of the lipid bilayer predicts flipping of the sn-2 tail towards the aqueous phase, while molecular docking data indicates interaction of the tail with Scavenger Receptor Class B type 1 (SR-B1). In vivo, the engineered nanoliposomes are distributed specifically to M2-like macrophages and, upon delivery of the STAT6 inhibitor (AS1517499), zoledronic acid or muramyl tripeptide, these cells promote reduction of the premetastatic niche and/or tumor growth. Altogether, we demonstrate the efficiency and versatility of our engineered “tail-flipping” nanoliposomes in a pre-clinical model, which paves the way to their development as cancer immunotherapeutics in humans