The role of entero-aggregative Escherichia coli (EAEC) strains on diarrheic children in some southern States of Nigeria

The role of entero-aggregative Escherichia coli (EAEC) strains on diarrheic children in some southern States of Nigeria was carried out in this paired control study. Escherichia coli isolates from stool specimens of children with diarrhea were matched with controls and tested in HEp-2 cell adherence assay. A total of 800 E. coli strains (2 strains for every test subject) from both 250 children with diarrhea and 150 apparently healthy controls were examined for aggregative adhesion using HEp-2 cells. Statistically significant (P<0.05) EAEC strains were obtained from the diarrheic children 40.6% as against 20% from the control. In this study, Bayelsa State recorded the highest isolate with 21.4 vs 12%, followed by Rivers State (10.8% vs 4.0%), then Imo State the least (8.4% vs 4.0%). Children within 4-8 years age range recorded the highest prevalence in the States studied. High prevalence of intestinal parasites were seen on both groups although the diarrheal group had a statistical significant (91% vs 36%) prevalence (P<0.05). The parasites were Giardia lamblia, Ascaris lumbricoides, hookworm and Trichuris trichuria . This showed that intestinal parasites are also important factor in the etiology of diarrhea in this area. There was mixed infection between parasites and EAEC in 5 test subjects in Bayelsa State, but none in the other States and also none from the control. The entero-aggregative E. coli showed marked resistance to conventional antimicrobial agents like cotrimoxazole, ampicillin and chloramphenicol with 80.3%, 81.2% and 61.6% respectively, while the cephalosporins: cefuroxime and ceftazidime showed low resistance with 3.3% and 4.3% respectively, indicating that the cephalosporins will be a good choice for the empirical treatment of bacterial infectious diarrhea in this region.Keywords: HEp-2 cells, Intestinal parasites, Mixed infection, Antimicrobial agents, Cephalosporin

Global patient outcomes after elective surgery: prospective cohort study in 27 low-, middle- and high-income countries.

BACKGROUND: As global initiatives increase patient access to surgical treatments, there remains a need to understand the adverse effects of surgery and define appropriate levels of perioperative care. METHODS: We designed a prospective international 7-day cohort study of outcomes following elective adult inpatient surgery in 27 countries. The primary outcome was in-hospital complications. Secondary outcomes were death following a complication (failure to rescue) and death in hospital. Process measures were admission to critical care immediately after surgery or to treat a complication and duration of hospital stay. A single definition of critical care was used for all countries. RESULTS: A total of 474 hospitals in 19 high-, 7 middle- and 1 low-income country were included in the primary analysis. Data included 44 814 patients with a median hospital stay of 4 (range 2-7) days. A total of 7508 patients (16.8%) developed one or more postoperative complication and 207 died (0.5%). The overall mortality among patients who developed complications was 2.8%. Mortality following complications ranged from 2.4% for pulmonary embolism to 43.9% for cardiac arrest. A total of 4360 (9.7%) patients were admitted to a critical care unit as routine immediately after surgery, of whom 2198 (50.4%) developed a complication, with 105 (2.4%) deaths. A total of 1233 patients (16.4%) were admitted to a critical care unit to treat complications, with 119 (9.7%) deaths. Despite lower baseline risk, outcomes were similar in low- and middle-income compared with high-income countries. CONCLUSIONS: Poor patient outcomes are common after inpatient surgery. Global initiatives to increase access to surgical treatments should also address the need for safe perioperative care. STUDY REGISTRATION: ISRCTN5181700

Bioreactor for microalgal cultivation systems: strategy and development

Microalgae are important natural resources that can provide food, medicine, energy and various bioproducts for nutraceutical, cosmeceutical and aquaculture industries. Their production rates are superior compared to those of terrestrial crops. However, microalgae biomass production on a large scale is still a challenging problem in terms of economic and ecological viability. Microalgal cultivation system should be designed to maximize production with the least cost. Energy efficient approaches of using light, dynamic mixing to maximize use of carbon dioxide (CO2) and nutrients and selection of highly productive species are the main considerations in designing an efficient photobioreactor. In general, optimized culture conditions and biological responses are the two overarching attributes to be considered for photobioreactor design strategies. Thus, fundamental aspects of microalgae growth, such as availability of suitable light, CO2 and nutrients to each growing cell, suitable environmental parameters (including temperature and pH) and efficient removal of oxygen which otherwise would negatively impact the algal growth, should be integrated into the photobioreactor design and function. Innovations should be strategized to fully exploit the wastewaters, flue-gas, waves or solar energy to drive large outdoor microalgae cultivation systems. Cultured species should be carefully selected to match the most suitable growth parameters in different reactor systems. Factors that would decrease production such as photoinhibition, self-shading and phosphate flocculation should be nullified using appropriate technical approaches such as flashing light innovation, selective light spectrum, light-CO2 synergy and mixing dynamics. Use of predictive mathematical modelling and adoption of new technologies in novel photobioreactor design will not only increase the photosynthetic and growth rates but will also enhance the quality of microalgae composition. Optimizing the use of natural resources and industrial wastes that would otherwise harm the environment should be given emphasis in strategizing the photobioreactor mass production. To date, more research and innovation are needed since scalability and economics of microalgae cultivation using photobioreactors remain the challenges to be overcome for large-scale microalgae production