Susceptibility testing of colistin for acinetobacter baumannii: How far are we from the truth?

Acinetobacter baumannii is involved in life-threatening nosocomial infections, mainly in the intensive care units (ICUs), and often colistin may represent the last therapeutic opportunity. The susceptibility to colistin of 51 epidemiologically typed A. baumannii strains isolated in 2017 from clinical samples of patients hospitalized in the ICU of a tertiary care academic hospital was investigated. All isolates were carbapenem-resistant due to the presence of the blaOXA-23 gene in sequence group 1 (international clonal lineage II) and sequence group 4 (related to international clonal lineage II) isolates, and to the blaOXA-24/40 gene in sequence group 2 (international clonal lineage I) isolates. Vitek®2, agar diffusion, and broth microdilution tests showed major discordancy (≥2 dilution factors) in the minimum inhibitory concentration (MIC) values for colistin in 24 out of 51 isolates, resulting in erroneous reporting of qualitative susceptibility data for eight isolates. In growth kinetics experiments in the presence of colistin, five isolates grew with drug concentrations above the susceptibility breakpoint when incubated for >12 h, and three isolates showed the presence of heteroresistant subpopulations. This study highlights that the high frequency of isolation of carbapenem-resistant A. baumannii strains in high-risk infectious wards requires an accurate application of methods for detecting susceptibility to antibiotics, in particular to colistin, so as to ensure a correct therapeutic approach

Atmospheric fluctuations below 0.1 Hz during drift-scan solar diameter measurements

Measurements of the power spectrum of the seeing in the range 0.001-1 Hz have been performed in order to understand the criticity of the transits' method for solar diameter monitoring.Comment: 3 pages, 3 figures, proc. of the Fourth French-Chinese meeting on Solar Physics Understanding Solar Activity: Advances and Challenges, 15 - 18 November, 2011 Nice, Franc

Analysis of particles size distributions in Mg(OH)2 precipitation from highly concentrated MgCl2 solutions

Magnesium is a raw material of great importance, which attracted increasing interest in the last years. A promising route is to recover magnesium in the form of Magnesium Hydroxide via precipitation from highly concentrated Mg2+ resources, e.g. industrial or natural brines and bitterns. Several production methods and characterization procedures have been presented in the literature reporting a broad variety of Mg(OH)2 particle sizes. In the present work, a detailed experimental investigation is aiming to shed light on the characteristics of produced Mg(OH)2 particles and their dependence upon the reacting conditions. To this purpose, two T-shaped mixers were employed to tune and control the degree of homogenization of reactants. Particles were analysed by laser static light scattering with and without an anti-agglomerant treatment based on ultrasounds and addition of a dispersant. Zeta potential measurements were also carried out to further assess Mg(OH)2 suspension stability

Risk factors for recurrence in patients with Clostridium difficile infection due to 027 and non-027 ribotypes

Objectives: Our objective was to evaluate factors associated with recurrence in patients with 027+ and 027– Clostridium difficile infection (CDI). Methods: Patients with CDI observed between January and December 2014 in six hospitals were consecutively included in the study. The 027 ribotype was deduced by the presence of tcdB, tcdB, cdt genes and the deletion Δ117 in tcdC (Xpert® C. difficile/Epi). Recurrence was defined as a positive laboratory test result for C. difficile more than 14 days but within 8 weeks after the initial diagnosis date with reappearance of symptoms. To identify factors associated with recurrence in 027+ and 027– CDI, a multivariate analysis was performed in each patient group. Subdistributional hazard ratios (sHRs) and 95% confidence intervals (95%CIs) were calculated. Results: Overall, 238 patients with 027+ CDI and 267 with 027– CDI were analysed. On multivariate analysis metronidazole monotherapy (sHR 2.380, 95%CI 1.549–3.60, p <0.001) and immunosuppressive treatment (sHR 3.116, 95%CI 1.906–5.090, p <0.001) were factors associated with recurrence in patients with 027+ CDI. In this patient group, metronidazole monotherapy was independently associated with recurrence in both mild/moderate (sHR 1.894, 95%CI 1.051–3.410, p 0.033) and severe CDI (sHR 2.476, 95%CI 1.281–4.790, p 0.007). Conversely, non-severe disease (sHR 3.704, 95%CI 1.437–9.524, p 0.007) and absence of chronic renal failure (sHR 16.129, 95%CI 2.155–125.000, p 0.007) were associated with recurrence in 027– CDI. Conclusions: Compared to vancomycin, metronidazole monotherapy appears less effective in curing CDI without relapse in the 027+ patient group, independently of disease severity

Computational Modeling of Magnesium Hydroxide Precipitation and Kinetics Parameters Identification

Magnesium is a critical raw material and its recovery as Mg(OH)2 from saltwork brines can be realized via precipitation. The effective design, optimization, and scale-up of such a process require the development of a computational model accounting for the effect of fluid dynamics, homogeneous and heterogeneous nucleation, molecular growth, and aggregation. The unknown kinetics parameters are inferred and validated in this work by using experimental data produced with a T2mm-mixer and a T3mm-mixer, guaranteeing fast and efficient mixing. The flow field in the T-mixers is fully characterized by using the k-ϵ turbulence model implemented in the computational fluid dynamics (CFD) code OpenFOAM. The model is based on a simplified plug flow reactor model, instructed by detailed CFD simulations. It incorporates Bromley’s activity coefficient correction and a micro-mixing model for the calculation of the supersaturation ratio. The population balance equation is solved by exploiting the quadrature method of moments, and mass balances are used for updating the reactive ions concentrations, accounting for the precipitated solid. To avoid unphysical results, global constrained optimization is used for kinetics parameters identification, exploiting experimentally measured particle size distribution (PSD). The inferred kinetics set is validated by comparing PSDs at different operative conditions both in the T2mm-mixer and the T3mm-mixer. The developed computational model, including the kinetics parameters estimated for the first time in this work, will be used for the design of a prototype for the industrial precipitation of Mg(OH)2 from saltwork brines in an industrial environment

The Role of Operating Conditions in the Precipitation of Magnesium Hydroxide Hexagonal Platelets Using NaOH Solutions

Magnesium hydroxide, Mg(OH)2, is an inorganic compound extensively employed in several industrial sectors. Nowadays, it is mostly produced from magnesium-rich minerals. Nevertheless, magnesium-rich solutions, such as natural and industrial brines, could prove to be a great treasure. In this work, synthetic magnesium chloride and sodium hydroxide (NaOH) solutions were used to recover Mg(OH)2 by reactive crystallization. A detailed experimental campaign was conducted aiming at producing grown Mg(OH)2 hexagonal platelets. Experiments were carried out in a stirred tank crystallizer operated in single- and double-feed configurations. In the single-feed configuration, globular and nanoflakes primary particles were obtained, as always reported in the literature when NaOH is used as a precipitant. However, these products are not complying with flame-retardant applications that require large hexagonal Mg(OH)2 platelets. This work suggests an effective precipitation strategy to favor crystal growth while, at the same time, limiting the nucleation mechanism. The double-feed configuration allowed the synthesis of grown Mg(OH)2 hexagonal platelets. The influence of reactant flow rates, reactant concentrations, and reaction temperature was analyzed. Scanning electron microscopy (SEM) pictures were also taken to investigate the morphology of Mg(OH)2 crystals. The proposed precipitation strategy paves the road to satisfy flame-retardant market requirements

Point prevalence study of antibiotic use in a paediatric hospital in Italy

n/