Large variation in ESBL-producing Escherichia coli carriers in six European countries including Russia.

We investigated the faecal carriage prevalence of extended-spectrum ß-lactamase production in Escherichia coli (EP-EC) and/or Klebsiella pneumoniae (EP-KP) and risk factors associated with carriage among adult study subjects in Finland, Germany, Latvia, Poland, Russia and Sweden (partner countries). The aim was to get indicative data on the prevalence of ESBL-carriage in specific populations in the region. Faecal samples were collected from four study populations and screened on ChromID-ESBL and ChromID-OXA-48 plates. Positive isolates were further characterised phenotypically. Our results show a large variation in carrier prevalence ranging from 1.6% in Latvia to 23.2% in Russia for EP-EC. For the other partner countries, the prevalence of EP-EC were in increasing numbers, 2.3% for Germany, 4.7% for Finland, 6.6% for Sweden, 8.0% for Poland and 8.1% for all partner countries in total. Carriers of EP-KP were identified only in Finland, Russia and Sweden, and the prevalence was < 2% in each of these countries. No carriers of carbapenemase-producing isolates were identified. This is the first study reporting prevalence of carriers (excluding traveller studies) for Finland, Latvia, Poland and Russia. It contributes with important information regarding the prevalence of EP-EC and EP-KP carriage in regions where studies on carriers are limited.

Perceptions about Research Participation among Individuals at Risk and Individuals with Premanifest Huntington's Disease: A Survey Conducted by the European Huntington Association.

There has been great progress in Huntington's disease (HD) research. Yet, effective treatments to halt disease before the onset of disabling symptoms are still unavailable. Scientific breakthroughs require an active and lasting commitment from families. However, they are traditionally less involved and heard in studies. Accordingly, the European Huntington Association (EHA) surveyed individuals at risk (HDRisk) and with premanifest HD (PreHD) to determine which factors affect their willingness to participate in research. Questions assessed research experience and knowledge, information sources, reasons for involvement and noninvolvement, and factors preventing and facilitating participation. The survey included 525 individuals, of which 68.8% never participated in studies and 38.6% reported limited research knowledge. Furthermore, 52% trusted patient organizations to get research information. Reasons for involvement were altruistic and more important than reasons for noninvolvement, which were related to negative emotions. Obstacles included time/financial constraints and invasive procedures, while professional support was seen as a facilitator. PreHD individuals reported less obstacles to research participation than HDRisk individuals. Overall, a high motivation to participate in research was noted, despite limited experience and literacy. This motivation is influenced by subjective and objective factors and, importantly, by HD status. Patient organizations have a key role in fostering motivation through education and support.

The Study of the Sterilization of the Indoor Air in Hospital/Clinic Rooms by Using the Electron Wind Generator.

(1) Background: Since exposure to airborne bacteria and fungi may be especially hazardous in hospitals and outpatient clinics, it is essential to sterilize the air in such rooms. The purpose of this study was to estimate the decrease in the concentration of airborne bacteria and fungi in the selected hospital and clinic rooms due to the work of the electron wind generator (EWG). (2) Methods: EWG is an air movement and air purification device using a sophisticated combination of electrode topology and specially designed high-voltage power supply. (3) Results: The concentration of both bacteria and fungi in the small patient's room dropped to approximately 25% of the initial (background) concentration. In the larger patient's room, the concentration dropped to 50% and 80% of the background concentration for bacteria and fungi, respectively. (4) Conclusions: The obtained data show that the studied sterilization process can be described by the exponential function of time. Moreover, the application of an activated carbon filter into EWG significantly decreases the concentration of ozone in the sterilized room. Sterilization by EWG significantly changes the characteristic of species and genera of airborne bacteria and shifts the main peak of the size distribution of airborne bacteria into the coarser bio-particles.

Antimicrobial resistance of Escherichia coli isolates from outpatient urinary tract infections in women in six European countries including Russia.

OBJECTIVES: In the Northern Dimension Antibiotic Resistance Study (NoDARS), Finland, Germany, Latvia, Poland, Russia and Sweden collected urine samples from outpatient women (aged 18-65years) with symptoms of uncomplicated urinary tract infection (UTI) to investigate the levels of antimicrobial resistance (AMR) among Escherichia coli isolates. METHODS: A total of 775 E. coli isolates from 1280 clinical urine samples were collected from October 2015 to January 2017. Antimicrobial susceptibility testing was performed and the results were interpreted according to European Committee on Antimicrobial Susceptibility Testing (EUCAST) criteria. RESULTS: Overall AMR rates to the commonly used antibiotics nitrofurantoin, fosfomycin and mecillinam (except for Germany that was missing a result for mecillinam) were 1.2%, 1.3% and 4.1%, respectively. The highest overall resistance rates were determined for ampicillin (39.6%), trimethoprim (23.8%), trimethoprim/sulfamethoxazole (22.4%), amoxicillin/clavulanic acid (16.7%) and ciprofloxacin (15.1%), varying significantly between countries. The rate of extended-spectrum ß-lactamase (ESBL) production was 8.7%. None of the isolates showed resistance to meropenem. CONCLUSIONS: In most cases, low AMR rates were detected against the first-line antibiotics recommended in national UTI treatment guidelines, giving support to their future use. These results also support the European Association of Urology guidelines stating that nitrofurantoin, fosfomycin and mecillinam are viable treatment options for uncomplicated UTI.

Application of Molecular Methods for Carbapenemase Detection.

This study has evaluated the correlation between different carbapenemases detection methods on carbapenem non-susceptible Klebsiella pneumoniae strains from Northern and Eastern Europe; 31 institutions in 9 countries participated in the research project, namely Finland, Estonia, Latvia, Lithuania, Russia, St. Petersburg, Poland, Belarus, Ukraine, and Georgia. During the research program, a total of 5,001 clinical K. pneumoniae isolates were screened for any carbapenem non-susceptibility by the disk diffusion method, Vitek 2 or Phoenix system following the EUCAST guideline on detection of resistance mechanisms, version 1.0. Strains isolated from outpatients and hospitalized patients from April 2015 to June 2015 were included. All types of samples (blood, pus, urine, etc.) excluding fecal screening or fecal colonization samples have been represented. In total, 171 carbapenemase screening-positive K. pneumoniae isolates (3.42%) were found and characterized. Several methods were used for detection of carbapenemases production, including Luminex assay (PCR and hybridization), whole genome sequencing, MALDI-TOF based Imipenem degradation assay, and immunochromatography testing. Minimal inhibitory concentration determination for Meropenem by agar-based gradient method was also used. Finally, 83 K. pneumoniae strains were carbapenemase negative by all confirmation methods (49.4% of all screening-positive ones), 74 - positive by three methods (44.0%), 8 - positive by two methods (4.8%) and 3 - positive by only one method (1.8%). The sensitivity of the tests was 96.3% for Whole genome sequencing and MALDI-TOF assay (both three undetected cases), and 95.1% for Luminex-Carba (4 undetected cases). The most commonly detected carbapenemases were NDM (n = 54) and OXA-48 (n = 26), followed by KPC-2, VIM-5, and OXA-72 (one case of each). Our results showed that different types of carbapenemases can be detected in the countries involved in the project. The sensitivity of our methods for carbapenemase detection (including screening as a first step and further confirmation tests) was >95%, but we would recommend using different methods to increase the sensitivity of detection and make it more precise.

Children's allergic diseases and microbial contamination of indoor air--a case report.

The assessment of exposure to bioaerosols in damp houses of two children who suffered from perennial rhinitis and asthma was performed. The paper presents an approach to the complex (i.e., medical and environmental) treatment of allergic diseases.

Viability of fungal and actinomycetal spores after microwave radiation of building materials.

The effects of microwave radiation on viability of fungal and actinomycetal spores growing on agar (medium optimal for growth) as well as on wooden panel and drywall (common building construction/finishing materials) were studied. All materials were incubated at high (97-99%) and low (32-33%) relative humidity to mimic "wet" and "dry" environmental conditions. Two microwave power densities (10 and 60 mW/cm2) and three times of exposure (5, 30, and 60 min) were tested to find the most effective parameters of radiation which could be applied to non-invasive reduction or cleaning of building materials from microbial contaminants. Additionally, a control of the surface temperature during the experiments allowed differentiation between thermal and microwave effect of such radiation. The results showed that the viability of studied microorganisms differed depending on their strains, growth conditions, power density of microwave radiation, time of exposure, and varied according to the applied combination of the two latter elements. The effect of radiation resulting in a decrease of spore viability on "wet" wooden panel and drywall was generally observed at 60 min exposure. Shorter exposure times decreased the viability of fungal spores only, while in actinomycetes colonizing the studied building materials, such radiation caused an opposite (supporting growth) effect.

Haemophilus influenzae as an airborne contamination in child day care centers.

BACKGROUND: The aim of this study was to assess the exposure of children to airborne Haemophilus influenzae in day care centers. METHODS: Air samples were taken using an Andersen impactor in 32 rooms designed for children stay. The concentrations of airborne bacteria were calculated as colony forming units (CFU) (growing on trypticase soy agar) per cubic meter of air (CFU/m(3)). The compositions of bioaerosol were determined on blood trypticase soy agar and Haemophilus selective agar. Isolated strains were identified using API NH strips and apiweb software. The antibiotic resistance of H influenzae strains was determined by the disk diffusion method. RESULTS: Compared with the proposed criteria for microbiologic quality of indoor air, the rooms were characterized by the very high bacterial contamination of the air. The prevailing component of bacterial aerosol was gram-positive cocci. Airborne H influenzae strains were found in 25% of the investigated rooms and were mostly classified as biotype II (33%). CONCLUSION: It may be accepted that the exposure to airborne H influenzae is typical of child day care centers in contrast to indoor environments with older population. Child day care center contribute to the expansion of H influenzae in human population via air. Generally, airborne H influenzae isolates from the investigated child day care centers were susceptible to older antibiotics such as ampicillin and amoxicillin-clavulanic acid.

Methicillin resistance of airborne coagulase-negative staphylococci in homes of persons having contact with a hospital environment.

BACKGROUND: The persons having contact with a hospital environment (hospital personnel workers and discharged patients) are highly exposed to colonization with multidrug-resistant bacteria. The aim of this study was to evaluate the airborne Staphylococcus genus features in homes in which inhabitants have had contact with the hospital environment. METHODS: Airborne bacteria were collected using a 6-stage Anderson impactor. The Staphylococcus species composition and resistance to methicillin, and other antimicrobial agents among 3 coagulase-negative staphylococci (CNS) species (S cohnii spp cohnii, S epidermidis, S hominis), were determined. Antibiotic resistance of isolates was tested using the agar screen method with methicillin, the polymerase chain reaction technique to detect the mecA gene, and the disk diffusion method. RESULTS: A higher prevalence of methicillin-resistant (MR) strains among the species isolated (40% of S epidermidis, 40% of S hominis, and 60% of S cohnii spp cohnii) was found in homes of persons who had contact with a hospital environment compared with the reference homes (only 12% of S hominis). The mecA gene was revealed in all MR S epidermidis strains and in some MR S hominis (50%) and S cohnii spp cohnii (33%) strains. All isolated MR CNS strains were susceptible to vancomycin, rifampicin, and linezolid. CONCLUSION: High numbers of airborne multidrug-resistant MR CNS in the homes of persons having contact with a hospital environment indicates that such inhabitants pose a risk of intrafamilial spreading of MR strains via air.

Growth hormone therapy and lipid profile in children on chronic peritoneal dialysis.

The aim of the study was to assess the effect of recombinant human growth hormone (rhGH) on serum lipids in children treated with chronic peritoneal dialysis. We studied 26 patients aged 5-18 years, including 13 patients treated with rhGH at a dose of 1-1.1 IU/kg per week for 6 months and a control group of 13 patients. Serum total cholesterol (TC), low-density lipoprotein-cholesterol (LDL-C), HDL-C, triglycerides (TG), apolipoproteins A-I and B-100 (apoA and apoB), lipoprotein (a) [Lp(a)], total protein, albumin, urea, and creatinine levels were measured in all children at baseline and at 1, 3, and 6 months of follow-up. We found a significant increase in the TG level after 1 month of administration of rhGH in the treatment group compared with both baseline (218.8+/-49.2 mg/dl vs. 175.9+/-71.9 mg/dl, respectively, P<0.05) and the control group at 1 month of follow-up (146.5+/-44.3 mg/dl, P<0.001). We found no change in TC, LDL-C, HDL-C, apoA, and Lp(a) levels during treatment with rhGH. These data suggest that administration of rhGH to children treated with peritoneal dialysis results in only a transient increase of serum TG level and has no effect on TC, LDL-C, HDL-C, apoA, and Lp(a) levels.

Microbial air quality in offices at municipal landfills.

The purpose of this study was to evaluate the influence of two municipal landfills on the microbiological air quality in offices on landfill sites. The evaluation was based on the concentration levels of airborne bacteria and fungi and the identification of isolated strains. Air samples were collected with a six-stage Andersen impactor. The concentrations of bacterial aerosol ranged from 1.0 x 10(3) to 7.2 x 10(4) colony forming units (CFU)/m(3) indoors, and from 7.0 x 10 to 4.0 x 10(4) CFU/m(3) outdoors. The corresponding fungal aerosol ranges were from 2.3 x 10(2) to 7.3 x 10(3) CFU/m(3) indoors and from 2.0 x 10(2) to 1.2 x 10(4) CFU/m(3) outdoors. The concentration levels were affected by the season of the year. The study showed that both indoor and outdoor air were heavily contaminated with bacteria and fungi. The proximity of the unpaved transport route and the weighing of refuse loads contributed to the increase of bacterial and fungal aerosol concentrations significantly. The air in the offices was characterized not only by elevated concentrations of bacteria and fungi but also by high frequencies of gram-negative bacteria, along with fungal species characteristic of landfills. The quantitative and qualitative changes in the composition of the bacterial and fungal aerosol posed a possible health risk to office workers at municipal waste landfill sites.