Detection of extended spectrum beta-lactamase from clinical isolates in Davangere.

Extended spectrum beta-lactamase enzymes (ESBLs) are enzymes that have the ability to hydrolyze oxyiminocephalosporins and infections by isolates producing them are often difficult to treat. A study to detect the presence of these enzymes in isolates was conducted by our hospital. A total of 207 non repetitive isolates were screened for resistance to any of five screening agents. Those with suspicious profiles were checked for ESBL production by double-disk approximation or a synergy test. The isolates were also subjected to a phenotypic confirmation test as recommended by CLSI (formerly NCCLS). Various cephalosporins-beta-lactamase inhibitor combinations were also tested. Of the 204 (98.5%) screen-positive isolates, only 126 (61.7%) were identified as ESBL producers. Of these, 26.1% of the isolates were positive by using the double-disk synergy test (DDST) method alone, 13.4% were positive using the method recommended by CLSI, and 60.3% of the isolates were positive by both the DDST and CLSI methods. We also report a high percentage of resistance to cefoxitin (96.8%) indicating changes in porins.

Study of bacterial, fungal, and parasitic contaminaiton of currency notes in circulation.

A total of 100 currency notes of various denominations in circulation were randomly studied for bacterial, fungal and protozoal contamination. All except four notes yielded one or more bacteria. Bacterial culture yielded single isolate in 33 notes, two in 44 notes, three in 12 notes and four in 7 notes. The predominant bacterial isolate was Bacillus sps followed by Coagulase negative Staphylococci and Micrococcus sps. Other bacteria that are either potential or confirmed pathogens included K. pneumoniae, E. coli, S. aureus, Pseudomonas sps and S. typhi. Only two notes were positive for Acid fast bacilli. 28 samples did not yield any fungal growth. Overall 118 fungal isolates were isolated, of which 34 could not be identified. All the fungi isolated were saprophytes. Saline and Iodine wet mount did not reveal any parasitic forms. We recommend that currency notes must be handled with caution.

Living arrangements and residential overcrowding among older immigrants in Canada.

"Because older immigrants arriving in Canada are not eligible for government transfer payments or welfare benefits for up to 10 years, many of them choose to live with their relatives or sponsors in crowded three- or more than three-generation households. Cultural preferences also influence this tendency and the propensity of immigrant groups from developing regions to live in three- or more than three-generation households ranges up to 18 times those of their Canadian-born and immigrant counterparts from the developed regions. Variables such as average income, percent receiving Old Age Security payments, percent widowed and duration of residence in Canada are significantly associated with proportions of immigrants living in such arrangements, and explain about 84 percent of birthplace variation for males and 81 percent for females."

Episode of coexisting infections with multiple dengue virus serotypes in central Karnataka, India.

BACKGROUND: The co-circulation of multiple dengue virus serotypes has been reported in many parts of the world, including India; however, concurrent infection with more than one serotype of dengue virus in the same individual is rarely documented. METHOD: An outbreak of dengue hemorrhagic fever/dengue shock syndrome (DHF/DSS) occurred in and around Davangere, Karnataka, from June 2011-March 2012. This is the first report from India with a high percentage of concurrent infections with different dengue virus serotypes circulating during one outbreak. Acute phase sera from patients were tested for the presence of dengue virus RNA by RT-PCR. RESULTS: Of the 72 samples tested for dengue virus RNA, 42 (58.3%) were positive. All four dengue virus serotypes were found to be co-circulating in this outbreak, and DENV-2 was the predominant serotype. In addition, concurrent infection with more than one dengue virus serotype was identified in 18 (42.9%) dengue virus-positive samples. CONCLUSION: Our study showed that serotype DEN-2 was dominant in the positive dengue virus-infected samples; the other serotype present was DEN-3. This is the first report of concurrent infections with different dengue virus serotypes in this part of the world.

Carbon particles in airway macrophage as a surrogate marker in the early detection of lung diseases.

BACKGROUND: It has been shown that inhalation of carbonaceous particulate matter may impair lung function in children. OBJECTIVE: Using the carbon content of airway macrophages as a marker of individual exposure to particulate matter derived from fossil fuel, we sought direct evidence for this association. METHODS: 300 children from puffed rice industrial areas and 300 children from population living in green zone were selected randomly. Airway macrophages were obtained from healthy children through sputum induction, and the grading of ultrafine carbon particles in airway macrophages was measured. Pulmonary function was also measured by spirometry. RESULTS: Pulmonary function tests showed that in industrial area 42.6% and 20.3% of children had moderate obstructive airway disease and restrictive airway disease, respectively. In the green zone area, 7% of children had obstructive airway disease and 6% had restrictive airway disease. Evaluation of airway macrophages for ultrafine carbon particles revealed that in industrial area there were ultrafine carbon particles of grade 2 in 23% of subjects and grade 3 in 8.33% of individuals with obstructive airway disease. In the green zone area, the rates were 1.67% and 0.7%, respectively. CONCLUSION: The study provides a first evidence of the strong association between air pollution and development of airway diseases. Carbon particles in the sputum can be used as a marker for air pollution.

Isolation of bacteriophages to multi-drug resistant Enterococci obtained from diabetic foot: a novel antimicrobial agent waiting in the shelf?

INTRODUCTION: While foot infections in persons with diabetes are initially treated empirically, therapy directed at known causative organisms may improve the outcome. Many studies have reported on the bacteriology of diabetic foot infections (DFIs), but the results have varied and have often been contradictory. The purpose of the research work is to call attention to a frightening twist in the antibiotic-resistant Enterococci problem in diabetic foot that has not received adequate attention from the medical fraternity and also the pharmaceutical pipeline for new antibiotics is drying up. MATERIALS AND METHODS: Adult diabetic patients admitted for lower extremity infections from July 2008 to December 2009 in the medical wards and intensive care unit of medical teaching hospitals were included in the study. The extent of the lower extremity infection on admission was assessed based on Wagner's classification from grades I to V. Specimens were collected from the lesions upon admission prior to the initiation of antibiotic therapy or within the first 48 h of admission. RESULTS: During the 18-month prospective study, 32 strains of Enterococcus spp. (26 Enterococcus faecalis and 06 E. faecium) were recovered. Antibiotic sensitivity testing was done by Kirby-Bauer's disk diffusion method. Isolates were screened for high-level aminoglycoside resistance (HLAR). A total of 65.6% of Enterococcus species showed HLAR. Multidrug resistance and concomitant resistance of HLAR strains to other antibiotics were quite high. None of the Enterococcus species was resistant to vancomycin. CONCLUSION: Multidrug-resistant Enterococci are a real problem and continuous surveillance is necessary. Today, resistance has rendered most of the original antibiotics obsolete for many infections, mandating the development of alternative anti-infection modalities. One of such alternatives stemming up from an old idea is the bacteriophage therapy. In the present study, we could able to demonstrate the viable phages against MDR E. faecalis.

Asian immigrants in Canada: some findings from 1981 census.

Immigrant characteristics in Canada are analyzed using data from the 1981 census. "The purpose of this paper is to focus on Asian immigrants and to compare them with immigrants born in the United Kingdom, and also to compare them with Canadian-born persons with respect to age, sex, marital status composition, educational attainment, labour force participation, class of worker, occupation and income." (summary in FRE, SPA)

The influence of fluctuations in economic conditions on fertility and marriage rates, Australia, 1920-21 to 1937-38 and 1946-47 to 1966-67.

Abstract It has been widely observed that both cross-sectionally and secularly there has been a negative relationship between income or level of living and the family size of married females. 1 At the same time the relationship between economic indicators and current fertility with a lag of one or more years over the business cycle has been found to be strongly positive. In fact the persistence of the latter relationship over a wide area and varying periods led Dr. Thomas to remark that it has been one of the most firmly based empirical findings in any of the social sciences.

Employment income of immigrants in metropolitan areas of Canada, 1980.

PIP: This paper examines the economic achievements of immigrant groups and compares them with those of the Canadian-born population. Employment income in this study is income for members of the labor force who worked 40 weeks or more, full time, during 1980. The information is from the 1981 Census. The 15 birthplace groups considered in this study are classified into 2 major groups: those from traditional sources and those from non-traditional or new sources. Traditional sources are the US, UK, and Europe. The new sources are Africa, Asia, South and Central America, the Caribbean, and Oceania. More than 1/2 of the immigrants from traditional sources arrived before 1960, whereas more than 1/2 of immigrants from new sources arrived after 1970. The analysis is only for those areas called Census Metropolitan Areas. Results of analysis show that 1) immigrant men and women in metropolitan areas earned 1.9% and 5.9% respectively less than their Canadian-born counterparts; 2) when differences in age and educational attainment were considered, incomes of immigrant men and women were about 7.5% below those of their Canadian-born counterparts; 3) the new immigrant groups earned far less than those of the Canadian-born counterparts; 4) traditional-source immigrants' incomes were equal to or slightly higher than Canadians'; and 5) as length of residence increases, most immigrant groups improve their relative economic position and achieve incomes comparable to Canadians'. The authors discuss the economic adaptation of immigrants in the light of various models: assimilation, Marxist class conflict, ethnic stratification and segmentation, structural pluralism, and structural change. No theory can be applied to the economic adaptation of all types of immigrants. Finally, refugees and sponsored relatives, who are not admitted on the basis of education and occupational need, are likely to have more difficulties than independent immigrants.^ieng

Ethnic fertility differences in Canada, 1926-71: an examination of assimilation hypothesis.

PIP: The changing pattern of fertility differences among ethnic groups in Canada during the period 1926-71 is studied. 2 specific questions are addressed. The 1st is do ethnic groups assimilate the fertility patterns of the general Canadian population over time, e.g. are the fertility differences disappearing? Secondly, is the extent of assimilation in fertility greater in urban than in rural areas? The indirectly standardized general fertility rates, calculated by using the ethnic age distribution data from the censuses of 1931 to 1971, indicate a tendency for the population to become more homogeneous during times of increasing fertility, thus supporting the assimilative possibilities, whereas in times of declining fertility there is a tendency for the population to become more heterogeneous. The data also seem to support weaker assimilatory tendencies in rural areas than in urban areas during only the most recent period, 1966-71, and not in earlier periods.^ieng

A comparative study of immigrant and non-immigrant families in Canada with special reference to income, 1986.

PIP: "A comparison of immigrant and non-immigrant families in Canada based on unpublished data from the 1986 Census of Canada indicates that immigrant families have stronger family ties and higher income than their nonimmigrant counterparts. This could be partly because immigrant families contain higher proportions of their members at prime working ages, higher proportions with three or more employment income recipients and higher proportions working full year full time.... The multivariate analysis of family income indicates that age and family type have overwhelming effects and that place of birth is third in importance." (EXCERPT)^ieng

Spouse selection in Canada, 1921-78: an examination by age, sex and religion.

PIP: This paper presents time series data on spouse selection in Canada for the period 1921-1978. Homogamous and endogamous trends are examined by age, sex, and religion. In the case of religious endogamy, most groups have shown decreasing proportions of marriages. There are also considerable differences in rates of endogamy among religious groups, and these differences have largely persisted over time. Until 1971, the proportions of brides marrying older and younger grooms decreased, while the proportion marrying the same age increased, after which these trends reversed. Younger males increasingly tended to select brides of their own age group until the 1960s, while older males have been increasingly heterogamous since World War II. While these changes in spouse selection have been examined with respect to changes in the unmarried population, the relation between the 2 trends is not clear, and it is difficult to account fully for the observed trends in spouse selection with respect to age.^ieng