Occurrence of E. coli and antibiotic-resistant E. coli in the southern watershed of Lake Biwa, including in wastewater treatment plant effluent and inflow rivers.

The emergence of antibiotic-resistant bacteria (ARB) and their antibiotic resistance genes (ARGs) poses a serious challenge to human, animal, and environmental health worldwide. ARB can spread into the environment via various sources and routes. In this study, we investigated the occurrence of antibiotic-resistant E. coli in the southern watershed of Lake Biwa. Two-year monitoring of antibiotic-resistant E. coli was carried out in the southern part of Lake Biwa and inflow rivers and at three WWTPs around the southern part of the lake. Concentrations of E. coli in waters that are resistant to ampicillin (AMP), cefotaxime (CTX), ceftazidime (CAZ), levofloxacin (LVFX), tetracycline (TC), and amikacin (AMK) were measured using the culture method. Of these antibiotic-resistant E. coli, AMP-resistant E. coli were found at the highest prevalence, followed by LVFX, CTX, CAZ, TC, and AMK-resistant in both the influent and effluent of WWTPs. These resistance patterns in wastewater are the same as those in clinical samples in Japan. The numbers of antibiotic-resistant E. coli decreased by around a factor of 1000 during the wastewater treatment processes, but the rates clearly increased, suggesting that selection for antibiotic resistance might occur during the wastewater treatment process. AMP-resistant and TC-resistant E. coli were also detected in Lake Biwa and inflow rivers, which suggests that antibiotic resistance might come from not only WWTPs but also livestock farms and small-scale wastewater treatment facilities located in the river catchment.

Renal and vascular protective effects of ezetimibe in chronic kidney disease.

OBJECTIVE: Dyslipidemia is a risk factor for not only cardiovascular diseases (CVD), but also chronic kidney disease (CKD). Ezetimibe, a cholesterol absorption inhibitor, lowers cholesterol levels by inhibiting both extrinsic and intrinsic cholesterol absorption via the gastrointestinal duct. However, very few studies have examined its efficacy and safety for patients with dyslipidemia complicated with CKD. METHODS: Thirty-seven dyslipidemic patients (low density lipoprotein cholesterol (LDL-C) levels ≥120 mg/dL) complicated with CKD were given ezetimibe (10 mg/day) for twenty-four weeks. The efficacy and safety of the therapy, including the anti-atherosclerotic and renal protective effects, were then examined. RESULTS: Significant decreases were observed in the levels of LDL-C (158.9 ± 26.9 mg/dL→123.0 ± 31.8 mg/dL; p<0.0001), remnant-like lipoprotein cholesterol (9.3 ± 5.3 mg/dL→7.3 ± 3.8 mg/dL; p<0.05) and lipoprotein (a) (22.0 ± 16.1 mg/dL→16.4 ± 11.0 mg/dL; p<0.01). The estimated glomerular filtration rate did not change, but the urine protein to creatinine ratio decreased significantly (1,107.3 ± 1,454.2 mg/gCre→732.1 ± 1,237.8 mg/gCre; p<0.05). No changes were observed in the carotid intima media thickness, but the brachial-ankle pulse wave velocity decreased significantly (1,770.4 ± 590.3 cm/sec→1,702.5 ± 519.9 cm/sec; p<0.05). No adverse events were observed. CONCLUSION: Ezetimibe can be safely administered even to patients with CKD. The results of this study indicate that ezetimibe may provide some renal protection and suppress the complications of CVD in CKD patients.

Synthesis of microspheres stabilized sterically with two-component grafted chains by dispersion copolymerizations using mixture of two macromonomers in nonaqueous media.

The polymer microspheres were synthesized by dispersion copolymerization of divinylbenzene (DVB) with two vinylbenzyl-terminated poly(ethylene glycol methylether) (PEG)/poly(t-butyl methacrylate) (PBMA) macromonomer blends in methanol. In these systems of two macromonomer blends as the emulsifier, the polymer microspheres formed had a very narrow particle size distribution. Two macromonomers formed comicelles with DVB monomer and acted not only as the comonomer but also as the stabilizer. Such polymer microspheres were stabilized sterically with two-component grafted chains, such as PEG and PBMA, in methanol.