Air pollution attributable postneonatal infant mortality in U.S. metropolitan areas: a risk assessment study

BACKGROUND: The impact of outdoor air pollution on infant mortality has not been quantified. METHODS: Based on exposure-response functions from a U.S. cohort study, we assessed the attributable risk of postneonatal infant mortality in 23 U.S. metropolitan areas related to particulate matter <10 μm in diameter (PM(10)) as a surrogate of total air pollution. RESULTS: The estimated proportion of all cause mortality, sudden infant death syndrome (normal birth weight infants only) and respiratory disease mortality (normal birth weight) attributable to PM(10 )above a chosen reference value of 12.0 μg/m(3 )PM(10 )was 6% (95% confidence interval 3–11%), 16% (95% confidence interval 9–23%) and 24% (95% confidence interval 7–44%), respectively. The expected number of infant deaths per year in the selected areas was 106 (95% confidence interval 53–185), 79 (95% confidence interval 46–111) and 15 (95% confidence interval 5–27), respectively. Approximately 75% of cases were from areas where the current levels are at or below the new U.S. PM(2.5 )standard of 15 μg/m(3 )(equivalent to 25 μg/m(3 )PM(10)). In a country where infant mortality rates and air pollution levels are relatively low, ambient air pollution as measured by particulate matter contributes to a substantial fraction of infant death, especially for those due to sudden infant death syndrome and respiratory disease. Even if all counties would comply to the new PM(2.5 )standard, the majority of the estimated burden would remain. CONCLUSION: Given the inherent limitations of risk assessments, further studies are needed to support and quantify the relationship between infant mortality and air pollution

The Apheis project: Air Pollution and Health—A European Information System

At a time when the Health Effects Institute, Centers for Disease Control, and Environmental Protection Agency are creating an Environmental Public Health Tracking Program on Air Pollution Effects in the USA, it seemed useful to share the experience acquired since 1999 by the Apheis project (Air Pollution and Health—A European Information System), which has tracked the effects of air pollution on health in 26 European cities and continues to do so as the new Aphekom project. In particular, this paper first describes the continuing impact of air pollution on health in Europe, how the Apheis project came to be and evolved, what its main objectives and achievements have been, and how the project benefited its participants. The paper then summarizes the main learnings of the Apheis project

Resistance gene pool to co-trimoxazole in non-susceptible Nocardia strains

The soil-borne pathogen Nocardia sp. causes severe cutaneous, pulmonary, and central nervous system infections. Against them, co-trimoxazole (SXT) constitutes the mainstay of antimicrobial therapy. However, some Nocardia strains show resistance to SXT, but the underlying genetic basis is unknown. We investigated the presence of genetic resistance determinants and class 1-3 integrons in 76 SXT-resistant Nocardia strains by PCR and sequencing. By E test, these clinical strains showed SXT minimum inhibitory concentrations of ≥32:608 mg/L (ratio of 1:19 for trimethoprim: sulfamethoxazole). They belonged to 12 species, being the main representatives Nocardia farcinica (32%), followed by N. flavorosea (6.5%), N. nova (11.8%), N. carnea (10.5%), N. transvalensis (10.5%), and Nocardia sp. (6.5%). The prevalence of resistance genes in the SXT-resistant strains was as follows: sul1 and sul2 93.4 and 78.9%, respectively, dfrA(S1) 14.7%, blaTEM-1 and blaZ 2.6 and 2.6%, respectively, VIM-2 1.3%, aph(3')-IIIa 40.8%, ermA, ermB, mefA, and msrD 2.6, 77.6, 14.4, and 5.2%, respectively, and tet(O), tet(M), and tet(L) 48.6, 25.0, and 3.9%, respectively. Detected amino acid changes in GyrA were not related to fluoroquinolone resistance, but probably linked to species polymorphism. Class 1 and 3 integrons were found in 93.42 and 56.57% strains, respectively. Class 2 integrons and sul3 genes were not detected. Other mechanisms, different than dfrA(S1), dfrD, dfrF, dfrG, and dfrK, could explain the strong trimethoprim resistance shown by the other 64 strains. For first time, resistance determinants commonly found in clinically important bacteria were detected in Nocardia sp. sul1, sul2, erm(B), and tet(O) were the most prevalent in the SXT-resistant strains. The similarity in their resistome could be due to a common genetic platform, in which these determinants are co-transferred.This study was presented at the 54th Interscience Conference on Antimicrobial Agents and Chemotherapy, ICAAC2014, Washington, DC, USA. We thank Adrian Burton for editing and language assistance (http://physicalevidence.es/english/welcome). We are very grateful to all persons who took part in this study, and to the sample providers.S

Curvatura radicular de primeros premolares mandibulares en tomografía computarizada de haz cónico (CBCT)

Objetivo: el objetivo del presente estudio fue determinar el grado de angulación y orientación radicular de primeros premolares mandibulares en tomografía computarizada de haz cónico (CBCT). Métodos: la muestra consistió en 111 primeros premolares mandibulares de 67 estudios tomográficos del archivo de la Facultad de Odontología de la Universidad de Cuenca (agosto 2015-octubre 2016) y de Centro Radiológico Medimagen (marzo-octubre 2016); se utilizaron los programas informáticos One Volume Viewer (J. Morita Corporation; Irvine, California, USA) y Galileos Implant (Sirona The Dental Company; Earlangen Alemania) para realizar cortes sagitales y coronales de la imagen 3D que sirvieron para observar la orientación de la curvatura radicular y además permitió medir el ángulo con el método de Schneider. Resultados: el ángulo promedio de curvatura fue 16,03°. Las curvaturas fueron clasificadas en: leve= 0,1°-12,2°; moderada=12,3°-17,2°; severa=17,3°-40,5°, aquellas raíces que no formaron un ángulo se las incluyó como rectas. Conclusiones: en la muestra estudiada la curvatura moderada fue la más prevalente y la orientación fue en dirección distalObjective: The objective of the present study was to determine the degree of angulation and root orientation of the first mandibular premolar in cone beam computed tomography (CBCT). Methods: The sample consisted of 111 mandibular first premolars of 67 tomographic studies from the archives of the Faculty of Dentistry of the University of Cuenca (August 2015-October 2016) and the Medimagen Radiological Center (March-October 2016); the software One Volume Viewer (J. Morita Corporation, Irvine, California, USA) and Galileos Implant (Sirona The Dental Company; Earlangen Germany) were used to perform sagittal and coronal sections of the 3D image that served to observe the orientation of the root curvature and also allowed to measure the angle with the Schneider method. Results: The average angle of curvature was 16.03 °. The curvatures were classified as: mild = 0.1 ° -12.2 °; moderate = 12.3 ° -17.2 °; severe = 17.3 ° -40.5 °, those roots that did not form an angle were included as straight. Conclusion: In the study sample the moderate curvature was the most prevalent and the orientation was in the distal directionODONTÓLOGOCuenc

Alterations in the abundance and co-occurrence of Akkermansia muciniphila and Faecalibacterium prausnitzii in the colonic mucosa of inflammatory bowel disease subjects

This work was funded by the Universitat de Girona projects MPCUdG2016-009 and GdRCompetUdG2017, and the Spanish Ministry of Education and Science through projects SAF2006-00414, SAF2010-15896 and SAF2013-43284-P, being the last co-funded by the European Regional Development. Dr. Sylvia H. Duncan acknowledges support from the Scottish Government Research and Environment Science and Analytical Services Division (RESAS).Peer reviewedPublisher PD

Endemic and epidemic Acinetobacter baumannii clones: a twelve-year study in a tertiary care hospital

BACKGROUND: Nosocomial outbreaks of multidrug-resistant Acinetobacter baumannii are of worldwide concern. Using pulsed-field gel electrophoresis (PFGE), multilocus sequence typing (MLST), and multiple locus variable number tandem repeat sequence (VNTR) analysis (MLVA), the present work examines the genetic diversity of the endemic and epidemic A. baumannii clones isolated in a single hospital over a twelve-year period. RESULTS: PFGE analysis of 405 A. baumannii-calcoaceticus complex isolates detected 15 A. baumannii endemic/epidemic PFGE types (EE1 to EE15) that grouped into five clusters: EE1-EE8, EE9, EE10, EE11 and EE12-EE15. The MLST sequence type (ST) distributions were: international clone II (ST-2) 60%, international clone III (ST-3) 26.7%, ST-15 6.7%, and ST-80 6.7%. MLVA-8Orsay returned 17 allelic profiles. The large (L) VNTR marker profiles were fully concordant with the detected STs, and concordant with 14 up to 15 PFGE types. Imipenem resistance was detected in five PFGE types; the prevalence of the bla OXA-58-like and bla OXA-40-like genes was 60% and 40% respectively. CONCLUSIONS: PFGE proved to be a vital tool for analysis of the temporal and spatial distribution of the clones. MLST and the VNTR L-markers grouped the isolates into clonal clusters. The wide diversity of MLVA small (S)-markers, however, did not permit clustering. The present results demonstrate the persistence of several endemic PFGE types in the hospital, the involvement of some of them in outbreaks, and the inter hospital transmission of extensively drug-resistant ST-15 and ST-80.S

Identification and antimicrobial susceptibility of Streptomyces and other unusual Actinobacteria clinical isolates in Spain

Two hundred and eighty-six isolates from human clinical samples were identified between 1996 and 2019 as belonging to 8 families, 19 genera and 88 species of Actinobacteria. The most identified genera were Streptomyces (182 strains from 45 species), Actinomadura (29 strains, 5 species), Nocardiopsis (21 strains, 6 species) and Dietzia (18 strains, 5 species). The rest of the identified genera (15) contained 27 species with 36 isolates. Of the species studied, only 13/88 had been documented previously as isolates from clinical samples, and in some cases, as true pathogens. In this sense, a literature review of the species found in infections or in clinical samples without clear involvement in pathology has been carried out. Finally, the susceptibility to 8 antimicrobial agents has been studied. Streptomyces showed high resistance (80.8%) against cefotaxime and cotrimoxazole (55.5%), and no isolate resistance to amikacin and linezolid have been found. Lower percentages of resistance have been found in other genera, except in Dietzia (100% against cotrimoxazole and 44.4% against erythromycin). The greatest resistance in these genera was to cotrimoxazole (29.8) and erythromycin (27,9%), and no resistance to linezolid has been found in these genera. In Microbispora, Nonomuraea and Umezawaea, no resistant isolates have been found against any antibiotic studied. Only 3/104 isolates were resistant to amikacin in Amycolatopsis, Crossiella, and Micromonosopora. One isolate of Amycolatopsis was resistant to imipenem.S

First Insight into the Genome Sequences of Two Linezolid-Resistant Nocardia farcinica Strains Isolated from Patients with Cystic Fibrosis

The draft genome sequences of two Nocardia farcinica strains isolated from two patients with cystic fibrosis (CF), resistant to trimethoprim/sulfamethoxazole and linezolid, are reported here. The estimated genome sizes were 5.8 Mb with a 70.63% G+C content. Transposases from Tn916 were detected, but not 23S rRNA mutation (G2576T) related to linezolid resistance.We are grateful to G. Carrasco, P. Jimenez, and J. A. Saéz-Nieto for their help in different stages of genome sequencing, and Adrian Burton for editing and language assistance (Physical Evidence Scientific Translations; http://www.physicalevidence.es). This work was funded by project MPY1278/15 of the Instituto de Salud Carlos III.S

Exploring the genetic background of the botulism neurotoxin BoNT/B2 in Spain

To determine whether the neurotoxin BoNT/B2 causing botulism in Spain is clonal, the genetic diversity and phylogenetic relationships of Clostridium botulinum from food-borne episodes and infant cases of the condition were explored. The botulinum toxin gene (bont) subtype, the variable region of the flagellin gene (flaVR), and a seven-gene multi-locus sequence type were examined by sequencing 37 BoNT-positive cultures obtained over the period 2010 to 2022. Out of 37 botulism events, 16 food-borne episodes and 16 infant cases were associated with bont/b2. Eight bont/b2 alleles were detected [nucleotide distance range 0.0259-0.415%, Hunter and Gaston discrimination index (HGDI) 0.71]. The most common bont/b2 allele corresponded to that of strain Prevot 25 NCASE and its single and double locus variations (87.5%). Four known flaVR types were identified (HGDI 0.79), along with one previously unknown (flaVR-15). Sixteen sequence types (STs) (HGDI 0.89) were recorded including seven new STs (ST164-ST170; 10 new alleles) and five new STs (ST171-ST175; with new allele combinations) were also noted. Correlations among some STs and flaVR types were seen. Overall, the present results show that the combined analysis of bont/b2-flaVR-ST at the nucleotide level could be used to track botulism events in Spain. The neurotoxin BoNT/B2 has largely been responsible for human botulism in Spain. The polymorphism analysis of bont/b2, flaVR typing, and sequence type determinations, revealed a wide variety of clones to be responsible for human botulism, ruling out a common source of acquisition. IMPORTANCE Botulism, a potentially fatal disease, is classically characterized by a symmetrical descending flaccid paralysis, which if left untreated can lead to respiratory failure and death. Botulinum neurotoxin (BoNT), produced by certain species of Clostridium, is the most potent biological toxin known, and the direct cause of botulism. This study characterizes the acquisition in Spain of two forms of botulism, i.e., food-borne and infant botulism, which are largely caused by the main neurotoxin BoNT/B2. Polymorphism analysis of the bont/b2 gene, typing of the flagellin variable region sequence (flaVR), and multilocus sequence typing, were used to explore the genetic background of Clostridium botulinum group I. To our knowledge, this is the first phylogenetic and typing study of botulism undertaken in Spain.This study was partially funded via Ministerio de Ciencia e Innovación (MCIN) and the Agencia Estatal de Investigación (AEI) grant PID2021127477OBI00 through the Plan Estatal de Investigación Científica, Técnica y de Innovación. N.G. is contracted via MCIN/AEI grant PTA-2019-016623-I. M.V. is contracted via grant PEJ CAM 2021-/TL/BMD-21100 from the Programa Operativo Empleo Juvenil e Iniciativa Empleo Juvenil (YEI).S