Frequency and antimicrobial resistance patterns of bacteria implicated in community urinary tract infections: a ten-year surveillance study (2000-2009)

BACKGROUND Urinary tract infection (UTI) is one of the most common infectious diseases at the community level. In order to assess the adequacy of the empirical therapy, the prevalence and the resistance pattern of the main bacteria responsible for UTI in the community (in Aveiro, Portugal) was evaluated throughout a ten-year period. METHODS In this retrospective study, all urine samples from patients of the District of Aveiro, in ambulatory regime, collected at the Clinical Analysis Laboratory Avelab during the period 2000-2009 were analysed. Samples with more than 105 CFU/mL bacteria were considered positive and, for these samples, the bacteria were identified and the profile of antibiotic susceptibility was characterized. RESULTS From the 155597 samples analysed, 18797 (12.1%) were positive for bacterial infection. UTI was more frequent in women (78.5%) and its incidence varied with age, affecting more the elderly patients (38.6%). Although E. coli was, as usual, the most common pathogen implicated in UTI, it were observed differences related to the other bacteria more implicated in UTI relatively to previous studies. The bacteria implicated in the UTI varied with the sex of the patient, being P. aeruginosa a more important cause of infection in men than in women. The incidence of the main bacteria changed over the study period (P. aeruginosa, Klebsiella spp and Providencia spp increased and Enterobacter spp decreased). Although E. coli was responsible for more than an half of UTI, its resistance to antibiotics was low when compared with other pathogens implicated in UTI, showing also the lowest percentage of multidrug resistant (MDR) isolates (17%). Bacteria isolated from females were less resistant than those isolated from males and this difference increased with the patient age. CONCLUSIONS The differences in sex and age must be taken into account at the moment of empirical prescription of antimicrobials. From the recommended antimicrobials by the European Association of Urology guidelines, the first line drugs (pivmecillinam and nitrofurantoin) and the alternative antibiotic amoxicillin-clavulanic acid (AMX-CLA) are appropriate to treat community-acquired UTI, but the fluoroquinolones should not be suitable to treat male infections and the trimethoprim-sulfamethoxazole (SXT) shall not be used in the treatment of UTI at this level.Thanks are due to the University of Aveiro, Centre for Environmental and Marine Studies (CESAM) for funding the Microbiology Research Group (Project Pest-C/MAR/LA0017/2011) and to Clinical Analysis Laboratory Avelab (Portugal) for supplying the data.publishe

King Ariarathes IV of Cappadocia: coins reveal enlarged thyroid (188 BC)

King Ariarathes IV Eusebes (&ldquo;The Pious&rdquo;) ruled Cappadocia, a province of central Asia Minor (modern Turkey), between 220 and 163 BC. He supported his father-in-law Antiochus III, the King of Syria, in his war against the Romans. However, after the battle of Magnesia in 189 BC, he became an ally of the Romans. Ariarathes IV also moved the capital of his kingdom to Mazaca (modern-day Kayseri), founded on the outskirts of Mount Erciyes, a snow-capped volcano with an altitude of around 4,000&nbsp;m. On the obverse of the coins struck in Mazaca in the 33rd regnal year of Ariarathes IV, his diademed head with enlarged thyroid is represented. The reverse features his name (&Beta;&Alpha;&Sigma;&Iota;&Lambda;&Epsilon;&Omega;&Sigma; APIAPA&Theta;OY EY&Sigma;EBOY&Sigma;) together with monograms and Athena holding Nike in her right hand. This might be one of the earliest artistic representations of goiter, presumably associated with endemic iodine deficiency which is especially common in mountainous area.</p

Can pharmaceutical history courses contribute in building future pharmacy leaders? A preliminary study from Erciyes University, Turkey

This study aimed to investigate the relationship between pharmacy students' opinions on the importance of leadership and their levels of interest in pharmaceutical history. We administered a structured questionnaire to 160 undergraduate students (response rate of 86.3%) who have taken pharmaceutical history courses at the Erciyes University Faculty of Pharmacy in the past three years. We observed that 42.8% of the participants valued leadership as a very important skill that a pharmacist should possess through his/her professional career, of which 54.2% were very interested in pharmaceutical history. There is a statistically significant relationship between participants' opinions on the importance of leadership and their levels of interest in pharmaceutical history. Our findings suggest that the participants valuing leadership as a very important skill are more interested in pharmaceutical history than those valuing leadership as an unimportant skill. This result indicates that pharmaceutical history courses can serve as an effective tool for developing pharmacy students' awareness and attitudes toward professional leadership

Implementation and evaluation of Shufflenet, Gemnet and De Bruijn graph logical network topologies

In this paper, a generic model for implementing logical interconnection topologies in software has been proposed in order to investigate the performance of the logical topologies and their routing algorithms for packet based synchronous networks. This model is generic for synchronous transfer modes and therefore can be used in implementing any logical topology by using any programming language. Three topologies have been investigated and implemented namely: Shufflenet, De Bruijn graph and Gemnet. Results for the average packet delay show that the De Bruijn graph performed the worst. Also, it is observed that the De Bruijn graph makes use of buffering more efficiently compared to the other algorithms

The Antnet Routing Algorithm- A Modified Version

Abstract – Antnet is an agent based routing algorithm that is influenced from the unsophisticated and individual ant’s emergent behaviour. Ants (software agents) are used in antnet to collect information and to update the probabilistic distance vector routing table entries. Modified antnet algorithm has been introduced, which improve the throughput and average delay. Results shows that by detecting and dropping 0.5 % of packets routed through the non-optimal routes the average delay per packet decreased and network throughput can be increased. The effect of the traffic fluctuations has been limited with the boundaries introduced in this paper and the number of ants in the network has been limited with the current throughput of the network at any given time. I

Abdominal Physical Signs and Medical Eponyms: Part II. Percussion and Auscultation, 1924-1980.

Background: Percussion and auscultation are derived from the Latin words to touch and hear, respectively. Covered are abdominal percussion signs and ausculatory signs discovered from 1924 to 1980. Signs ascribed as medical eponyms pay homage to these physicians who provided new and unique insights into disease