Ampicillin/Sulbactam versus Cefuroxime as antimicrobial prophylaxis for cesarean delivery: a randomized study

<p>Abstract</p> <p>Background</p> <p>The efficacy and safety of a single dose of ampicillin/sulbactam compared to a single dose of cefuroxime at cord clamp for prevention of post-cesarean infectious morbidity has not been assessed.</p> <p>Methods</p> <p>Women scheduled for cesarean delivery were randomized to receive a single dose of either 3 g of ampicillin-sulbactam or 1.5 g of cefuroxime intravenously, after umbilical cord clamping. An evaluation for development of postoperative infections and risk factor analysis was performed.</p> <p>Results</p> <p>One hundred and seventy-six patients (median age 28 yrs, IQR: 24-32) were enrolled in the study during the period July 2004 - July 2005. Eighty-five (48.3%) received cefuroxime prophylaxis and 91 (51.7%) ampicillin/sulbactam. Postoperative infection developed in 5 of 86 (5.9%) patients that received cefuroxime compared to 8 of 91 (8.8%) patients that received ampicillin/sulbactam (p = 0.6). In univariate analyses 6 or more vaginal examinations prior to the operation (p = 0.004), membrane rupture for more than 6 hours (p = 0.08) and blood loss greater than 500 ml (p = 0.018) were associated with developing a postoperative surgical site infection (SSI). In logistic regression having 6 or more vaginal examinations was the most significant risk factor for a postoperative SSI (OR 6.8, 95% CI: 1.4-33.4, p = 0.019). Regular prenatal follow-up was associated with a protective effect (OR 0.04, 95% CI: 0.005-0.36, p = 0.004).</p> <p>Conclusions</p> <p>Ampicillin/sulbactam was as safe and effective as cefuroxime when administered for the prevention of infections following cesarean delivery.</p> <p>Trial registration</p> <p>Clinicaltrials.gov identifier: NCT01138852</p

A review of soil carbon change in New Zealand’s grazed grasslands

Soil organic matter is a potential sink of atmospheric carbon (C) and critical for maintaining soil quality. We reviewed New Zealand studies of soil C changes after conversion from woody vegetation to pasture, and under long-term pasture. Soil C increased by about 13.7 t C ha⁻¹ to a new steady state when forests were initially converted to pasture. In the last 3–4 decades, resampling of soil profiles demonstrated that under long-term pasture on flat land, soil C had subsequently declined for allophanic, gley and organic soils by 0.54, 0.32 and 2.9 t C ha⁻¹ y⁻¹ , respectively, and soil C had not changed in the remainder of sampled soil orders. For the same time period, pasture soils on stable midslopes of hill country gained 0.6 t C ha⁻¹ y⁻¹ . Whether these changes are ongoing is not known, except for the organic soils where losses will continue so long as they are drained. Phosphorus fertiliser application did not change C stocks. Irrigation decreased carbon by 7 t C ha⁻¹ . Carbon losses during pasture renewal ranged between 0.8 and 4.1 t C ha⁻¹ . Some evidence suggests tussock grasslands can gain C when fertilised and not overgrazed. When combined to the national scale, different data sets suggest either no change or a gain of C, but with large uncertainties. We highlight key land-use practices and soil orders that require further information of soil C stock changes and advocate for a better understanding of underpinning reasons for changes in soil C

Implications of Antibiotic Resistance in the Management of Helicobacter pylori Infection: Canadian Helicobacter Study Group

Eradication of Helicobacter pylori from the gastric and duodenal mucosa is an important clinical goal in the treatment of infected patients with peptic ulcer disease and other H pylori-associated conditions. Although several oral drug combination regimens are associated with eradication rates of approximately 85% in controlled trials, the success rate in patients infected with a resistant strain of H pylori is closer to 75%. Resistance to metronidazole and clarithromycin, which are common components of combination treatment regimens, is of greatest concern. Reported rates of H pylori resistance to various antibiotics vary considerably. In Canada, the data documenting H pylori susceptibility are limited but suggest that resistance to these antibiotics varies geographically and within specific treatment groups. Although susceptibility testing is not a prerequisite for initial treatment of individual patients infected with H pylori, formal efforts to identify and monitor both the causes and prevalence of antibiotic resistance across Canada are a much needed step in the ongoing management of this important infection. Recommended treatment regimens may be useful, even for treating apparently resistant H pylori strains. However, it is important to understand the mechanisms of the development of resistant strains to manage patients with treatment failure better

Technical note: Manipulating interactions between plant stress responses and soil methane oxidation rates

Hosseini Bai, S ORCiD: 0000-0001-8646-6423It has recently been hypothesised that ethylene, released into soil by stressed plants, reduces the oxidation of methane by methanotroph. To test this, a field trial was established in which maize plants were grown with and without soil moisture stress, and the effects of addition aminoethoxyvinylglycine (AVG; an ethylene biosynthesis inhibitor) and biochar (increases soil water holding capacity and reduces plant stress) were determined following the static incubation of soil samples. AVG increased methane oxidation rates by 50 % (p = 0.039), but only in the absence of irrigation. No other treatment effects were observed. This result provides evidence for a positive feedback system between plant stress, ethylene production, and impacts on methanotrophic activity. © 2018 Author(s)

Technical note: Manipulating interactions between plant stress responses and soil methane oxidation rates

It has recently been hypothesised that ethylene, released into soil by stressed plants, reduces the oxidation of methane by methanotroph. To test this, a field trial was established in which maize plants were grown with and without soil moisture stress, and the effects of addition aminoethoxyvinylglycine (AVG; an ethylene biosynthesis inhibitor) and biochar (increases soil water holding capacity and reduces plant stress) were determined following the static incubation of soil samples. AVG increased methane oxidation rates by 50 % (p = 0.039), but only in the absence of irrigation. No other treatment effects were observed. This result provides evidence for a positive feedback system between plant stress, ethylene production, and impacts on methanotrophic activity. © 2018 Author(s)