Health-care-associated infection in a pediatric intensive care unit

Introduction: Health-care-associated infection (HAI) is a major cause of concern in pediatric intensive care units (PICUs) all over the world and represents an important cause of mortality and financial burden for health-care systems. Objective: The objective of this study was to describe the epidemiologic profile of children with HAI. Methods: This was a prospective surveillance study conducted in a pediatric intensive care unit of a tertiary care hospital, India. Children, admitted to PICU between December 1, 2015, and November 30, 2016, were monitored for the development of bloodstream infection (BSI), ventilator-associated pneumonia, andurinary tract infection. Results: A total of 430 patients were admitted during the study period. Of 250 eligible patients, 15 children(6%) developed 19 episodes of HAI with patient prevalence of six infections per 100 patients. Only Gram-negative bacteria were identified, Klebsiella pneumoniae was the most common organism (68.42%). Bloodstream was the most common site of HAI (n=11, 58%) followed by respiratory tract (n=6, 32%) and urinary tract (n=2, 10%). In a univariate analysis, survivors of cardiac arrest or trauma, malnourished children had an increased risk of acquiring HAI. The presence of lymphopenia (≤1000/mm3), hypercarbia (Pco2 >65 mmHg), sodium imbalance (<130 meq/L or >150 meq/L), organ dysfunctions, and length of stay before acquiring infection was all associated with an increased risk of developing HAI (p<0.05). Conclusions: BSI is the most common HAI and only Gram-negative organisms were identified in our unit

Interactions between Escherichia coli and the New Zealand native plants Leptospermum scoparium and Kunzea robusta

Elevated concentrations of human pathogens in waterways is a global environmental issue and can result in widespread human disease and suffering. The provenance of these pathogens is usually from biological wastes, specifically faecal material from humans and livestock. In New Zealand, Escherichia coli is used as a reference/indicator organism to indicate pathogen contamination in waterways, with the drinking water standard set at < 1 colony forming unit (cfu)/100 ml and < 260 cfu/100 ml for swimming, following weekly testing. In 2017, the media reported that over half of NZ’s rivers are unfit for swimming and in 2016, livestock contaminated drinking water with Campylobacter jejuni resulted in some 5500 people becoming ill in Havelock North, the largest recorded Campylobacter outbreak in world history. In 2016, a study showed that the NZ native plants Leptospermum scoparium (J.R. G.Forst.) and Kunzea robusta (A. Rich.) increased the decimal reduction time of E. coli in biosolids amended soil by 90% within five to eight days of bacterial inoculation. Other studies have shown that the antibacterial properties of these plants (with their essential oils and honey) extend to Candida albicans and Salmonella typhimurium. Potentially, L. scoparium and K. robusta could be planted in areas receiving human or animal wastes to intercept human pathogens before they enter waterways. However, the mode of action by which these plants increase microbial die-off is unclear. Nor is it understood how these plants affect bacterial fluxes in field conditions, where soils may receive high rates of rainfall or irrigation. This thesis aimed to determine the antimicrobial properties of the roots and leaves of L. scoparium and K. robusta and to determine whether the provenance of the plants can affect antimicrobial activity. Furthermore, the thesis sought to determine the fluxes of bacteria in soils planted with L. scoparium and K. robusta. Throughout the thesis, E. coli was used as an indicator organism for pathogens. Lolium perenne (L.) was used as a comparison plant, as this species is present in 70% of NZ pasturelands. Laboratory experiments, using nutrient broth and optical density measurements, revealed that after 24 hours, water extracts (containing 50 – 400 mg/l total organic carbon) from L. scoparium and K. robusta reduced E. coli ATCC13706 growth to just 13% - 25% of the control (no extract). In contrast, L. perenne leaves extracts significantly increased the growth of bacteria by 63% compared to the control. Root extracts of L. scoparium and K. robusta inhibited growth more strongly than the leaf extracts. There were significant differences in the inhibitory activities of plants from different provenances, indicating that either genetic or environmental conditions can affect the antimicrobial activities of these species. Glasshouse experiments using repacked 10 l lysimeters showed that under high flow conditions (14 mm/day), both L. scoparium and K. robusta exacerbated leaching of E. coli compared to L. perenne. This was attributed to increased preferential flow caused by the taproot systems of these species. Under low-flow conditions (< 8 mm/day), there was negligible bacterial leaching under all species tested. The examination of soil pore water under L. scoparium and L. perenne revealed that seven days after inoculation, E. coli numbers under L. scoparium were significantly lower (1.3 x103 cfu/ml) than under L. perenne (5.9 x 103 cfu/ml). Similar results were obtained for two soil types used: A pallic brown soil (Pawson Silt Loam) and a recent soil (Lismore stony silt loam), but with higher overall leaching from the stony silt loam. A field experiment, near Duvauchelle on the Pawson silt loam also showed decreased E. coli numbers under L. scoparium and K. robusta, nine days after the inoculation. In contrast, there was little die-off under L. perenne. However, this experiment did not reveal whether the disappearance of E. coli under L. scoparium and K. robusta was due to increased die-off or increased preferential flow that removed the E. coli from the top soil. This thesis shows that in some cases, strategic plantings of L. scoparium and K. robusta may improve the quality of NZ’s freshwater resources. The efficacy of planting these species is dependent on the provenance of the plants and the climatic conditions. Although L. scoparium and K. robusta increased leaching of E. coli under high-flow conditions, this may be beneficial in some cases, such as the protection of surface waterways where the trees may result in increased infiltration and decreased surface run off of bacteria. Future work should focus on determining the effect of plants age and rhizosphere chemistry on microbial properties and elucidating whether the regional differences between L. scoparium and K. robusta are due to the genetic or environmental differences

Cryptococcus laurentii fungemia in a low birth weight preterm neonate: India

In the last few years, Cryptococcus laurentii infections have increased, particularly in immunocompromised patients. Here we report the first case of C. laurentii fungemia in low birth weight preterm infant from India. A preterm neonate was admitted for feeding intolerance and respiratory distress. Blood culture ascertained the causative organism as C. laurentii. The isolated strain was found susceptible to amphotericin B and the patient recovered following the administration of amphotericin B (5 mg/kg body weight) for 8 days. Keywords: Cryptococcus laurentii, Neonate, Fungemia, Amphotericin

Association of Microsatellites with Growth and Immunocompetence Traits in Crossbred Layer Chicken

The present investigation was carried out on six crossbred chicken populations to estimate variability of microsatellites and their association with growth and other traits. Five microsatellite markers located on chromosome 1, 2, 5 and 10 were screened and association study was performed following general linear model technique. All the microsatellites were polymorphic showing three to six alleles. The polymorphic information content (PIC) of the markers was more than 0.536. Genotype and allelic frequency was estimated showing a large variability from microsatellite to microsatellite. The genotypes of MCW007 microsatellite were found to be significantly (P&lt;0.05) associated with body weight at day old, 8th, 12th, 20th, 28th and 40th week of age. A significant association between ADL020 microsatellite and body weight at 8th, 12th and 40th week of age was estimated at P&lt;0.05 in different crossbred chicken populations. ADL176 genotypes were observed to be significantly associated with body weight at 40 weeks of age. MCW007, ADL020, ADL023 and ADL176 microsatellites were found to be significantly correlated with age at sexual maturity whereas humoral immune response to sheep RBC were observed to be non-significantly associated with the microsatellites

Corona virus fear among health workers during the early phase of pandemic response in Nepal: A web-based cross-sectional study.

Health workers involved in the COVID-19 response might be at risk of developing fear and psychological distress. The study aimed to identify factors associated with COVID-19 fear among health workers in Nepal during the early phase of the pandemic. A web-based survey was conducted in April-May 2020 among 475 health workers directly involved in COVID-19 management. The Fear Scale of COVID 19 (FCV-19S) was used to measure the status of fear. Multivariable logistic regression was performed to identify factors associated with COVID fear. The presence of COVID-19 fear was moderately correlated with anxiety and depression, and weakly correlated with insomnia. Nurses, health workers experiencing stigma, working in affected district, and presence of family members with chronic diseases were significantly associated with higher odds of developing COVID-19 fear. Based on the study findings, it is recommended to improve the work environment to reduce fear among health workers, employ stigma reduction interventions, and ensure personal and family support for those having family members with chronic diseases

Studies on different concentration of Lead (Pb) and Cadmium (Cd) on growth and accumulation in different parts of Tulsi (Ocimum tenuifolium) L

ABSTRACT Present investigation on studies of growth character and its accumulation in different parts of Tulsi under various concentration of some heavy metals (Lead and Cadmium), done at Department of Dravyagunna, Faculty of Ayurveda, Institute of Medical science during the year of 2007.The graded levels of these two metals Cd (0, 20, 50, 100 and 200 ppm) and Pb (0, 50, 100, 250, and 500 ppm) applied after the germination of Tulsi. The plant exhibited a decline in growth, chlorophyll content and carotenoids with increasing levels of Pb and Cd., more accumulation of Pb and Cd was observed in roots than shoots in O. tenuifolium L

Risks and benefits of pasture irrigation using treated municipal effluent : A lysimeter case study, Canterbury, New Zealand

Compared to discharge into waterways, land application of treated municipal effluent (TME) can reduce the need for both inorganic fertilizers and irrigation. However, TME irrigation may result in the accumulation of phosphorus (P) or trace elements in soil, and increased salinity and sodicity, which could damage soil structure and reduce infiltration. TME irrigation can also result in groundwater contamination through nitrate leaching or surface water contamination through runoff. This study aimed to evaluate the effects of increasing TME irrigation rates on quantity and quality of leachate and pasture growth in a lysimeter experiment using a Fluvial Recent soil and a Fragic Pallic soil. Pasture growth in the lysimeters was up to 2.5-fold higher in the TME treatments compared to the non-irrigated treatments. There were no signs of toxicity or accumulation of B, Al, Cd, Cu, Fe, Mn, As, and Zn. TME significantly increased the concentration of P and Na in the pasture. Nitrogen leaching from the lysimeters was negligible (< 1 kg/ha⁻¹ equiv.) in all treatments, but mineral N accumulated in the soil profile of the highest application rate (1672 mm/yr). Although more P was added than removed in pasture, the rate of accumulation indicated that over a 50-year period, P will still be within the current New Zealand thresholds for grazed pastures. Sodium accumulated in the soil columns in all the TME treatments. The rate of accumulation was not proportional to the TME application rate, indicating that Na was moving down through the soil profile and leaching. Results indicate a low to moderate risk of sodicity in soil or toxicity in plants caused by Na

Targeting of efavirenz loaded tuftsin conjugated poly(propyleneimine) dendrimers to HIV infected macrophages in vitro

HIV infected macrophages are considered as reservoirs for spreading the virus in AIDS patients. Tuftsin not only binds specifically to the mononuclear phagocytic cells but also enhances their natural killer activity. The purpose of this study is to explore the targeting potential and anti-HIV activity of efavirenz (EFV) loaded, tuftsin conjugated 5th generation poly(propyleneimine) dendrimers (TuPPI) in vitro. Tuftsin was chemically conjugated to 5th generation poly(propyleneimine) dendrimers (PPI). The entrapment efficiency of PPI and TuPPI were found to be 37.43\ua0±\ua00.3% and 49.31\ua0±\ua00.33%, respectively. TuPPI was found to slow down and prolong the in vitro release of EFV upto 144\ua0h against PPI, which releases the drug completely within 24\ua0h. TuPPI possessed negligible cytotoxicity as compared to that of PPI. The cellular uptake of TuPPI was found to be 34.5 times higher than that of the free drug in first 1\ua0h and was significantly higher in HIV infected macrophages than that of uninfected cells. TuPPI was found to reduce the viral load by 99% at a concentration of 0.625\ua0ng/ml, which is due to the enhanced cellular uptake, reduced toxicity and the inherent anti-HIV activity of TuPPI. © 2008 Published by Elsevier B.V