URBAN GEOCHEMICAL STUDIES IN EUROPE

Urban soil is generally contaminated to a variable degree depending on its proximity to contamination sources. Traffic is one of the main sources of urban contamination; lead (Pb) from the use of leaded petrol, zinc (Zn) and cadmium (Cd) from tyre wear, antimony (Sb) from break pads, and the platinum group elements (PGEs) from the wear of catalytic converters, are some typical elements that often reach high concentrations in the urban environment. Lead was also a key ingredient in white paint, and in towns with a high proportion of white wooden houses very high concentrations were found in soil. Crematoria can or have emitted mercury (Hg). Coal and heavy oil fired municipal power and heating stations emit sulphur (S), silver (Ag), vanadium (V), bromine (Br) and barium (Ba). The use of impregnated wood may have resulted in high concentrations of arsenic (As), especially in kindergartens (nursery schools) and playgrounds. Building materials (plaster and paint) may also contain high concentrations of organic contaminants, especially polychlorinated biphenyls (PCBs), which again end up in urban soil. Coal and wood burning, the use of diesel fuel, and the production of coke, all lead to the emission of polycyclic aromatic hydrocarbons (PAHs). There exist countless other sources of local contamination in towns, and there is thus every reason to be concerned about the quality of the urban environment, and the suitability of soil for sensitive land uses, such as schools, playgrounds, parks and vegetable gardens. Contaminated urban soil may contaminate indoor dust and, therefore, to an increased human exposure to toxic chemicals. Consequently, the distribution of toxic contaminants in urban soil needs to be documented and known by city administration to avoid costly mistakes in land use planning, and further spreading of highly contaminated materials. The EuroGeoSurveys \u2018Geochemistry\u2019 Expert Group during the compilation of a proposal to the Directors for a European wide urban geochemistry project, using a harmonised sampling and analytical methodology, it discovered that many urban geochemical studies have been performed in Europe by National Geological Surveys, which are not known to the wider geoscientific community. Since, the results of these studies are directly related to our quality of life, the EuroGeoSurveys \u2018Geo chemistry\u2019 Expert Group decided to publish at least one case study from each country in a book,which will be available in the second half of 2010. A concise description of some of these studies will be given in this paper

Geochemical atlases of Europe produced by the EuroGeoSurveys Geochemistry Expert Group: state of progress and potential uses.

An ‘Atlas’is a collection of maps usually published in a book form. A ‘Geochemical Atlas’is a thematic special purpose atlas with maps describing the geographical distribution of chemical elements and other physico-chemical parameters in different natural sample media, such as stream sediment, overbank or floodplain sediment, stream water, ground water, soil, plants, etc. Because our standard of living and health depend closely on the chemistry of near-surface materials, such atlases that provide data on the state of our environment are important for policy and decision makers, but also for researchers and citizens alike. The EuroGeoSurveys Geochemistry Expert Group is dedicated to provide harmonised multi-purpose geochemical data bases, and has already published the Geochemical Atlas of Europe, and is in the process of preparing the Atlas of Ground water eochemistry of Europe, and the Atlas of Agricultural and Grazing Land Soils. An important aspect is that all raw data, quality control information, statistics, maps and interpretation texts are freely available for downloading through the internet

Prevalence and risk factors for Enterobacteriaceae in patients hospitalized with community-acquired pneumonia

Background and objective Enterobacteriaceae (EB) spp. family is known to include potentially multidrug-resistant (MDR) microorganisms, and remains as an important cause of community-acquired pneumonia (CAP) associated with high mortality. The aim of this study was to determine the prevalence and specific risk factors associated with EB and MDR-EB in a cohort of hospitalized adults with CAP. Methods We performed a multinational, point-prevalence study of adult patients hospitalized with CAP. MDR-EB was defined when >= 3 antimicrobial classes were identified as non-susceptible. Risk factors assessment was also performed for patients with EB and MDR-EB infection. Results Of the 3193 patients enrolled with CAP, 197 (6%) had a positive culture with EB. Fifty-one percent (n = 100) of EB were resistant to at least one antibiotic and 19% (n = 38) had MDR-EB. The most commonly EB identified were Klebsiella pneumoniae (n = 111, 56%) and Escherichia coli (n = 56, 28%). The risk factors that were independently associated with EB CAP were male gender, severe CAP, underweight (body mass index (BMI) < 18.5) and prior extended-spectrum beta-lactamase (ESBL) infection. Additionally, prior ESBL infection, being underweight, cardiovascular diseases and hospitalization in the last 12 months were independently associated with MDR-EB CAP. Conclusion This study of adults hospitalized with CAP found a prevalence of EB of 6% and MDR-EB of 1.2%, respectively. The presence of specific risk factors, such as prior ESBL infection and being underweight, should raise the clinical suspicion for EB and MDR-EB in patients hospitalized with CAP

Prevalence and Etiology of Community-acquired Pneumonia in Immunocompromised Patients

BACKGROUND: The correct management of immunocompromised patients with pneumonia is debated. We evaluated the prevalence, risk factors, and characteristics of immunocompromised patients coming from the community with pneumonia. METHODS: We conducted a secondary analysis of an international, multicenter study enrolling adult patients coming from the community with pneumonia and hospitalized in 222 hospitals in 54 countries worldwide. Risk factors for immunocompromise included AIDS, aplastic anemia, asplenia, hematological cancer, chemotherapy, neutropenia, biological drug use, lung transplantation, chronic steroid use, and solid tumor. RESULTS: At least 1 risk factor for immunocompromise was recorded in 18% of the 3702 patients enrolled. The prevalences of risk factors significantly differed across continents and countries, with chronic steroid use (45%), hematological cancer (25%), and chemotherapy (22%) the most common. Among immunocompromised patients, community-acquired pneumonia (CAP) pathogens were the most frequently identified, and prevalences did not differ from those in immunocompetent patients. Risk factors for immunocompromise were independently associated with neither Pseudomonas aeruginosa nor non-community-acquired bacteria. Specific risk factors were independently associated with fungal infections (odds ratio for AIDS and hematological cancer, 15.10 and 4.65, respectively; both P = .001), mycobacterial infections (AIDS; P = .006), and viral infections other than influenza (hematological cancer, 5.49; P &lt; .001). CONCLUSIONS: Our findings could be considered by clinicians in prescribing empiric antibiotic therapy for CAP in immunocompromised patients. Patients with AIDS and hematological cancer admitted with CAP may have higher prevalences of fungi, mycobacteria, and noninfluenza viruses