Macrolide and fluoroquinolone resistance in helicobacter pylori isolates: An experience at a tertiary care centre in Pakistan

Objective: To assess fluoroquinolone and clarithromycin susceptibility pattern along with the types of genomic mutations involved in the resistance of Helicobacter pylori isolates.Methods: The cross-sectional study was conducted at the Department of Pathology and Microbiology, Aga Khan University Hospital, Karachi, from June 2009 to July 2010, and comprised 162 gastric biopsy samples which were tested with GenoTypeHelicoDR (Hain Lifescience GmbH, Germany), a reverse hybridisation multiplex polymerase chain reaction (PCR) line probe assay (LiPA). Also, 23S rRNA (ribosomal ribonucleic acid) gene was analysed with three-point mutations at A2146G, A2146C and A2147G for clarithromycin, and gyrA gene was analyzed at two codon positions 87 and 91 for fluoroquinolone susceptibility testing. SPSS 19 was used for statistical analyses.Results: Clarithromycin resistance was seen in 60 (37.0%) of the isolates mainly involving mutation at A2147G (85%) followed by A2146G (n=35; 21.6%) and A2146C (n=19; 11.6%). Fluoroquinolone resistance was noted in 101(62.3%) isolates, while gyrA mutations at codon 87 was seen in 64 (39.6%) and at codon 91 in 66 (40.6%). Isolates showing combined resistance to both antibiotics were 44 (26.9%).Conclusion: High rate of resistance to fluoroquinolones was seen despite the fact that the drug was not part of the first-line anti-helicobacter therapy. There was moderate increase of clarithromycin resistance beyond the cutoff rates where empirical use of this antibiotic is abandoned. The findings warrant the need for pre-treatment susceptibility testing in Helicobacter pylori infections, especially in Pakistan where burden of disease is high and very limited data is available, to improve patient care by providing targeted therapy

Exposure to air pollution and self-reported effects on Chinese students: A case study of 13 megacities

<div><p>Air pollution causes severe physical and psychological health complications. Considering China’s continuously-deteriorating air quality, this study aimed to assess the self-reported effects of air pollution on the behavior and physical health of the students of 13 densely populated cities, and their awareness, practices, and perception of air pollution and its associated public health risks. A detailed, closed-ended questionnaire was administered to 2100 students from 54 universities and schools across China. The questionnaire, which had 24 questions, was categorized into four sections. The first two sections were focused on air pollution-associated behavior and psychology, and physical effects; while the final two sections focused on the subjects’ awareness and perceptions, and practices and concerns about air pollution. The respondents reported that long-term exposure to air pollution had significantly affected their psychology and behavior, as well as their physical health. The respondents were aware of the different adverse impacts of air pollution (respiratory infections, allergies, and cardiovascular problems), and hence had adopted different preventive measures, such as the use of respiratory masks and glasses or goggles, regularly drinking water, and consuming rich foods. It was concluded that air pollution and haze had negative physical and psychological effects on the respondents, which led to severe changes in behavior. Proper management, future planning, and implementing strict environmental laws are suggested before this problem worsens and becomes life-threatening.</p></div

Preventive measures adopted to prevent the ill effects of air pollution.

<p>Preventive measures adopted to prevent the ill effects of air pollution.</p

Air pollution across the sampled cities (Oct 2015–March 2016) (Mean±SD).

<p>Air pollution across the sampled cities (Oct 2015–March 2016) (Mean±SD).</p

Behavioral and psychological effects caused by air pollution reported by the respondents.

<p>Behavioral and psychological effects caused by air pollution reported by the respondents.</p

Sources of knowledge reported by the respondents.

<p>Sources of knowledge reported by the respondents.</p

Demographics of the respondents across sampling sites/cities.

<p>Demographics of the respondents across sampling sites/cities.</p

Air pollution/haze caused physical health effects reported by the respondents.

<p>Air pollution/haze caused physical health effects reported by the respondents.</p

Gender & city-dependent physical effects of air pollution on the respondents.

<p>Gender & city-dependent physical effects of air pollution on the respondents.</p

Geographical locations of the sampled cities.

<p>Geographical locations of the sampled cities.</p