Actinomycetes of Virgin Utah Soils with Special Reference to Antagonisms

The importance of actinomycetes in the soils was generally overlooked until about 1913. The investigators Hiltner and Stormer and Beijerinck began systemtaic study of their occurrence and role in soil fertility. The work done by these men and others since 1913 has proved actinomycetes to occur abundantly in most soils of the world. This work done by these men and others since 1913 has proved actinomycetes to occur abundantly in most soils of the world. This work has also proved the function of these organisms to be that of decomposing highly resistant materials such as humus and complex polysaccharide compounds. More recent work by Waksman and coworkers has established the importance of these organisms in the study of antibotics. Surveys of actinomycetes have since been made of soils in the United States and countires abroad; however, no survey has been made of soils of the great arid region of the United States. Utah soils are typical of the soils found in this region. The purpose of this study is to determine the number of actinomycetes in Utah soils in relation to the total microflora of the soil, and to appraise some of their antagonistic properties. This investigation has been primarily limited to 49 samples taken from the soils of Utah which have been studied and described by the United States Department of Agriculture

Antimicrobial Resistance in Enterococcus spp. Isolated from Environmental Samples in an Area of Intensive Poultry Production

Enterococcus spp. from two poultry farms and proximate surface and ground water sites in an area of intensive poultry production were tested for resistance to 16 clinical antibiotics. Resistance patterns were compared to assess trends and possible correlations for specific antimicrobials and levels of resistance. Enterococci were detected at all 12 surface water sites and three of 28 ground water sites. Resistance to lincomycin, tetracycline, penicillin and ciprofloxacin in poultry litter isolates was high (80.3%, 65.3%, 61.1% and 49.6%, respectively). Resistance in the surface water to the same antibiotics was 87.1%, 24.1%, 7.6% and 12.9%, respectively. Overall, 86% of litter isolates, 58% of surface water isolates and 100% of ground water isolates were resistant to more than one antibiotic. Fifty-four different resistance patterns were recognised in isolates obtained from litter and environmental samples and several E. faecium and E. faecalis isolates from litter and environment samples shared the same resistance pattern. Multiple antibiotic resistant (MAR) indices calculated to assess health risks due to the presence of resistant enterococci suggested an increased presence of antibiotics in surface water, likely from poultry sources as no other wastewater contributions in the area were documented

Antibiotic-Resistant Pathogenic Escherichia Coli Isolated from Rooftop Rainwater-Harvesting Tanks in the Eastern Cape, South Africa

Although many developing countries use harvested rainwater (HRW) for drinking and other household purposes, its quality is seldom monitored. Continuous assessment of the microbial quality of HRW would ensure the safety of users of such water. The current study investigated the prevalence of pathogenic Escherichia coli strains and their antimicrobial resistance patterns in HRW tanks in the Eastern Cape, South Africa. Rainwater samples were collected weekly between June and September 2016 from 11 tanks in various areas of the province. Enumeration of E. coli was performed using the Colilert®18/Quanti-Tray® 2000 method. E. coli isolates were obtained and screened for their virulence potentials using polymerase chain reaction (PCR), and subsequently tested for antibiotic resistance using the disc-diffusion method against 11 antibiotics. The pathotype most detected was the neonatal meningitis E. coli (NMEC) (ibeA 28%) while pathotype enteroaggregative E. coli (EAEC) was not detected. The highest resistance of the E. coli isolates was observed against Cephalothin (76%). All tested pathotypes were susceptible to Gentamicin, and 52% demonstrated multiple-antibiotic resistance (MAR). The results of the current study are of public health concern since the use of untreated harvested rainwater for potable purposes may pose a risk of transmission of pathogenic and antimicrobial-resistant E. coli

Perfil fenotípico e susceptibilidade antimicrobiana de Streptococcus equi isolados de equinos da região Sul do Brasil

As características fenotípicas [morfológicas, bioquímicas, susceptibilidade aos antimicrobianos, índice de resistência múltipla aos antimicrobianos (IRMA), concentração inibitória mínima (CIM) e concentração bactericida mínima (CBM) da benzilpenicilina] de 38 isolados de Streptococcus equi oriundos de amostras clínicas de animais com adenite equina foram alvo deste estudo. A fenotipia demonstrou três padrões de colônias, três biotipos de fermentação de carboidratos e variação de 0 a 0,4 no IRMA. Todos os isolados de S. equi demonstraram sensibilidade à penicilina, tanto pelo método de disco difusão quanto pelo método de microdiluição. A CIM e CBM média de benzilpenicilina foi de 0,0095μg/mL e 0,0267μg/mL para S. equi subesp. equi e de 0,0128μg/mL e 0,0380μg/mL para S. equi subesp. zooepidemicus. Os valores de CIM e CBM diferiram entre as subespécies (p<0,05). O diâmetro do halo de inibição de penicilina demonstrou relação com a CIM (ì=0,03638 - 0,00072x) para S. equi subesp. equi. Também foi demonstrada relação entre o diâmetro do halo de inibição de penicilina com a CBM para S. equi subesp. equi (ì=0,10931- 0,00223x). Entretanto para as amostras de S. equi subesp. zooepidemicus esta relação somente foi verificada para a CBM (ì=0,1322 - 0,00271x). A CIM de benzilpenicilina frente às amostras isoladas da região Central, Planalto e Sul do estado do Rio Grande do Sul foram estatisticamente semelhantes, mas diferiram do isolado do estado do Paraná, sugerindo o caráter atípico desta cepa. Todos os isolados de S. equi são sensíveis à penicilina e sulfazotrim, confirmando a eleição destes antimicrobianos para o tratamento das infecções por este agente na clínica veterinária. Os resultados obtidos não dispensam a utilização prudente dos antimicrobianos

Multiple antibiotic resistance indexing of Escherichia coli to identify high-risk sources of fecal contamination of foods.

Escherichia coli isolates taken from environments considered to have low and high enteric disease potential for humans were screened against 12 antibiotics to determine the prevalence of multiple antibiotic resistance among the isolates of these environments. It was determined that multiple-antibiotic-resistant E. coli organisms exist in large numbers within the major reservoirs of enteric diseases for humans while existing in comparatively low numbers elsewhere. These differences provide a method for distinguishing high-risk contamination of foods by indexing the frequency with which multiple-antibiotic-resistant E. coli organisms occur among isolates taken from a sample

Emergency Medical Services Innovation: Comparison of Outcomes for Access and Referral in Two North Carolina Systems

Too many patients with low acuity medical problems access Emergency Medical Services (EMS) and Emergency Departments (EDs) for care. EMS is a key component of the health care system. Historically, its function was to provide care for people who experience emergencies, transporting them to hospital EDs for further definitive diagnosis and treatment. Over the last two decades, EMS is caring for a growing percentage of people accessing 9-1-1 for less than serious emergency conditions. This phenomenon is an element of a health care crisis that includes rapidly escalating costs, increasing numbers of uninsured, poor access to consistent primary care and comparatively mediocre health outcomes. With crowded EDs, EMS innovators have been exploring alternatives to relieve these structural pressures by diverting patients from EDs to other venues, particularly primary care providers (PCPs). This study compares two alternatives in North Carolina. There are two models that have been piloted. The first found in Orange County involves an EMS response to every 911 request. Once a paramedic evaluates a patient, it is decided if transport to the ED is warranted or whether the patient can be treated on-scene and referred to their PCP. The second model employs a telephone triage system in which requests for service of a low severity type are diverted from the 911 call center to nurse call centers. Nurses use an evidenced-based, medically approved protocol to make the determination if the patient does not need an EMS response and, if not, provides advice to the patient and refers them to their PCP. More significant emergencies receive the normal EMS response that results in care and transport to the ED. Using primary data from the two service quality improvement programs, the primary question is whether there is a significant difference in effectiveness between the Evaluate, Treat and Refer (ETR) intervention and the Telephone Triage and Refer (TTR) intervention as measured by patient follow through with instructions for the referral to primary care and patient satisfaction. Major findings were that there was a significant difference between the two alternatives in that odds were greater that low acuity callers in Mecklenburg County would follow instructions for referral/and or self-care than the low acuity patients evaluated in person in Orange County. Patient satisfaction was high for both alternatives with only slightly higher odds that patients in Orange County would be satisfied. The Orange County ETR alternative used the ETR on a broader spectrum of patient conditions as compared to more conservative criteria used in the Mecklenburg County TTR alternative. This factor may explain the significant difference in following instructions. The high patient satisfaction rates for both alternatives is an indication people with low acuity but urgent medical problems are willing to accept alternatives to transport and treatment in the ED and high percentages follow the instructions given. While the Mecklenburg TTR model was less costly and had higher odds that patients would follow instructions, it entered a narrower range of patient problems into its alternative pathway. More research is needed to explore the difference in outcomes and patient behaviors of these alternatives and to examine hybrid systems that combine both TTR and ETR

Emergency Medical Services Innovation: Comparison of Outcomes for Access and Referral in Two North Carolina Systems

Too many patients with low acuity medical problems access Emergency Medical Services (EMS) and Emergency Departments (EDs) for care. EMS is a key component of the health care system. Historically, its function was to provide care for people who experience emergencies, transporting them to hospital EDs for further definitive diagnosis and treatment. Over the last two decades, EMS is caring for a growing percentage of people accessing 9-1-1 for less than serious emergency conditions. This phenomenon is an element of a health care crisis that includes rapidly escalating costs, increasing numbers of uninsured, poor access to consistent primary care and comparatively mediocre health outcomes. With crowded EDs, EMS innovators have been exploring alternatives to relieve these structural pressures by diverting patients from EDs to other venues, particularly primary care providers (PCPs). This study compares two alternatives in North Carolina. There are two models that have been piloted. The first found in Orange County involves an EMS response to every 911 request. Once a paramedic evaluates a patient, it is decided if transport to the ED is warranted or whether the patient can be treated on-scene and referred to their PCP. The second model employs a telephone triage system in which requests for service of a low severity type are diverted from the 911 call center to nurse call centers. Nurses use an evidenced-based, medically approved protocol to make the determination if the patient does not need an EMS response and, if not, provides advice to the patient and refers them to their PCP. More significant emergencies receive the normal EMS response that results in care and transport to the ED. Using primary data from the two service quality improvement programs, the primary question is whether there is a significant difference in effectiveness between the Evaluate, Treat and Refer (ETR) intervention and the Telephone Triage and Refer (TTR) intervention as measured by patient follow through with instructions for the referral to primary care and patient satisfaction. Major findings were that there was a significant difference between the two alternatives in that odds were greater that low acuity callers in Mecklenburg County would follow instructions for referral/and or self-care than the low acuity patients evaluated in person in Orange County. Patient satisfaction was high for both alternatives with only slightly higher odds that patients in Orange County would be satisfied. The Orange County ETR alternative used the ETR on a broader spectrum of patient conditions as compared to more conservative criteria used in the Mecklenburg County TTR alternative. This factor may explain the significant difference in following instructions. The high patient satisfaction rates for both alternatives is an indication people with low acuity but urgent medical problems are willing to accept alternatives to transport and treatment in the ED and high percentages follow the instructions given. While the Mecklenburg TTR model was less costly and had higher odds that patients would follow instructions, it entered a narrower range of patient problems into its alternative pathway. More research is needed to explore the difference in outcomes and patient behaviors of these alternatives and to examine hybrid systems that combine both TTR and ETR