Understanding enhanced rotational dynamics of active probes in rod suspensions.

Active Brownian particles (APs) have recently been shown to exhibit enhanced rotational diffusion (ERD) in complex fluids. Here, we experimentally observe ERD and numerically corroborate its microscopic origin for a quasi-two-dimensional suspension of colloidal rods. At high density, the rods form small rafts, wherein they perform small-amplitude, high-frequency longitudinal displacements. Activity couples AP-rod contacts to reorientation, with the variance therein leading to ERD. This is captured by a local, rather than a global relaxation time, as used in previous phenomenological modeling. Our result should prove relevant to the microrheological characterization of complex fluids and furthering our understanding of the dynamics of microorganisms in such media.

A multidimensional approach to the resilience in older adults despite COVID-19.

Researchers have mainly focused on aging risk factors and COVID-19 consequences. However, older adults have proved their ability to overcome adversities along their life. Resilience is a protective variable that dampens the impact of stress. Based on MacLeod's et al. (2016) approach, we aimed to analyze the relationship between older adults' resilience and COVID-19 related-stressors as well as their physical, mental, and social characteristics. Eight hundred eighty-nine people aged 60 and over participated in this study. Older participants, women, having better perceived health and not losing a loved one because of the virus were associated with more resilience. Moreover, higher levels of gratitude, personal growth, life purpose and lower levels of depression were associated with greater scores in resilience. This study offers a change of perspective in which aging is perceived from a positive viewpoint by focusing on easily accessible resources that may help older adults to cope with adverse situations.

Chemical interactions among caseins during rennet coagulation of milk.

Rennet milk curds were prepared under 4 different temperature and acidity conditions. The development of different types of inter-protein chemical bonds (disulfide, hydrophobic, electrostatic, hydrogen, and calcium bridges) was monitored for 60 min after curd cutting. Hydrophobic inter-protein interactions originally present in casein micelles in milk were substituted by electrostatic, hydrogen, and calcium bonds throughout the curd curing period. Disulfide bonds were not disturbed by the experimental conditions employed in the study, remaining at a constant level in all studied treatments. Acidification of curds increased the availability of soluble ionic calcium, increasing the relative proportion of calcium bridges at the expense of electrostatic-hydrogen bonds. Although pH defined the nature of the interactions established among proteins in curd, temperature modified the rate at which such bonds were formed.

Manufacture of magnesium-fortified Chihuahua cheese.

The aim of this study was to manufacture magnesium-fortified Chihuahua cheese and to evaluate the effect of magnesium fortification on quality parameters. Addition of magnesium chloride to milk during pasteurization (5.44, 10.80, 16.40, 22.00, and 25.20 g of MgCl2·6H2O/L of milk) resulted in cheese with increased magnesium content, proportional to the amount of magnesium added (up to 2,957.13 mg of Mg/kg of cheese). As magnesium content increased, coagulation time and moisture content also increased, whereas calcium content decreased. Higher levels of magnesium fortification (16.40 g of MgCl2·6H2O/L of milk or more) induced the development of bitter-acid flavors and softer texture. Addition of 10.80 g of MgCl2·6H2O/L to milk resulted in Chihuahua cheese that meets regulatory standards and possesses physicochemical and sensory characteristics similar to those of nonfortified Chihuahua cheese. Under this milk fortification level, the manufactured cheese is able to provide 148.4 mg of magnesium per day (35% of the recommended daily intake of magnesium for adult males and 46% for adult females) assuming 3 portions (28 g each) are consumed.

Psychological well-being among older adults during the COVID-19 outbreak: a comparative study of the young-old and the old-old adults.

The COVID-19 outbreak could be considered as an uncontrollable stressful life event. Lockdown measures have provoked a disruption of daily life with a great impact over older adults' health and well-being. Nevertheless, eudaimonic well-being plays a protective role in confronting adverse circumstances, such as the COVID-19 situation. This study aims to assess the association between age and psychological well-being (personal growth and purpose in life). Young-old (60-70 years) and old-old (71-80 years) community-dwelling Spaniards (N = 878) completed a survey and reported on their sociodemographic characteristics and their levels of health, COVID-19 stress-related, appraisal, and personal resources. Old-old did not evidence poorer psychological well-being than young-old. Age has only a negative impact on personal growth. The results also suggest that the nature of the COVID-19 impact (except for the loss of a loved one) may not be as relevant for the older adults' well-being as their appraisals and personal resources for managing COVID-related problems. In addition, these results suggest that some sociodemographic and health-related variables have an impact on older adults' well-being. Thus, perceived-health, family functioning, resilience, gratitude, and acceptance had significant associations with both personal growth and purpose in life. Efforts to address older adults' psychological well-being focusing on older adults' personal resources should be considered.

Breastfeeding avoidance following psychological intimate partner violence during pregnancy: a cohort study and multivariate analysis.

OBJECTIVE: To evaluate if the experience of psychological intimate partner violence (IPV) adversely affects breastfeeding rates. DESIGN: A cohort study. SETTING: Maternities in 15 public hospitals, drawn using cluster sampling of obstetric services in Andalusia, Spain. POPULATION: A total of 779 consecutive mothers receiving antenatal care including ultrasound and giving birth during February-June 2010. METHODS: Trained midwives gathered IPV data using the Index of Spouse Abuse validated in the Spanish language (score ranges: 0-100, higher scores reflect more severe IPV; cut-off: psychological IPV = 25). Sociodemographic data including lack of kin support, and obstetric and neonatal outcomes were collected. Multivariate logistic regression estimated adjusted odds ratios (aOR), with 95% confidence intervals (CI), of the relationship between psychological IPV and breastfeeding, controlling for sociodemographic characteristics and obstetric complications. MAIN OUTCOME MEASURE: Breastfeeding avoidance defined as lack of breastfeeding or pumping of breast milk to feed the new baby in the immediate post-partum period. RESULTS: Response rate was 92.2%. A total of 70% (n = 545) of women initiated breastfeeding. Psychological IPV, reported by 21.0% (n = 151), increased the odds of breastfeeding avoidance (aOR = 2.0; 95% CI = 1.2-3.3) adjusting for the presence of obstetric complications (aOR = 1.6; 95% CI = 1.0-2.4). CONCLUSIONS: Mothers with psychological IPV avoid breastfeeding. Clinicians should be aware of the risks to infant arising from this deficiency due to IPV in pregnancy. TWEETABLE ABSTRACT: Psychological intimate partner violence, reported by one in five mothers in this study, on average doubles the avoidance of breastfeeding.

Development and assessment of the content validity of the professional good practices scale in nursing homes.

Recent approaches in the care of older people have led to a greater emphasis on good practices to prevent elder abuse. The instruments assessing good practices are very limited, and those focused on elder abuse have rarely considered subtle forms, especially in institutional settings. The aim of this study was to develop and assess the content validity of a good practices scale for professionals working in nursing homes. An extensive literature review of the tools assessing professionals' good-bad practices towards older people was conducted. A preliminary scale based on Kayser-Jones' (1990) [Old, Alone and Neglected: Care of the Aged in Scotland and the United States. Berkeley, CA: University of California Press] types of abuse was developed, including four subscales: Personalization, Humanization, Absence of Infantilization, and Absence of Victimization. Content validity was analyzed through a panel of eight experts. Rovinelli and Hambleton's index of item-objective congruence was used to analyze the items' inclusiveness in the assigned subscale to establish their representativeness. Items' relevance and clarity were analyzed using the paired comparison method. The final version of the scale included 56 items, with appropriate levels of item objective-congruence, relevance, and clarity. This instrument will allow professionals to detect and develop awareness and intervention programs that aim to promote good practices in nursing homes.

Mass transfer modeling of the antioxidant extraction of roselle flower (Hibiscus sabdariffa).

The aim of this study was to analyze the equilibrium and dynamic periods for mass transfer during the antioxidant solid-liquid extraction of dry roselle flower (Hibiscus sabdariffa). Extraction kinetics for total phenolic compounds (TPC), total flavonoids (TFL) and total antioxidant capacity (TAC) were obtained at different temperatures (50, 60, 70 or 80 °C) and solvent-to-product mass ratios (100:1, 200:1 or 300:1 g/g) under stirring (220-230 rpm). An analytical solution for unsteady-state mass transfer based on Fick's second law of diffusion was used to mathematically describe solid-liquid extraction curves and for the simultaneous estimation of diffusion coefficients and the final amount of extracted bioactive compounds, which were further related to experimental conditions by a second order model. The amount of extracted bioactive compounds at equilibrium were in the ranges of 30.8-89.8 g GAE/kg d.m. for TPC (0.154-0.373 g GAE/L extract), 40.0-131.6 g catechin/kg d.m. for TFC (0.269-0.559 g catechin/L extract) and 37.5-227.0 g trolox/kg d.m. for TAC (0.346-0.865 g trolox/L extract). On the other hand, diffusion coefficients for TPC, TFC and TAC were in the ranges of 0.72-2.66 × 10-11, 0.25-2.37 × 10-11 and 1.19-5.79 × 10-11 m2/s, respectively.

HIV continuum of care in Europe and Central Asia.

OBJECTIVES: The European Centre for Disease Prevention and Control (ECDC) supports countries to monitor progress in their response to the HIV epidemic. In line with these monitoring responsibilities, we assess how, and to what extent, the continuum of care is being measured across countries. METHODS: The ECDC sent out questionnaires to 55 countries in Europe and Central Asia in 2014. Nominated country representatives were questioned on how they defined and measured six elements of the continuum. We present our results using three previously described frameworks [breakpoints; Joint United Nations Programme on HIV/AIDS (UNAIDS) 90-90-90 targets; diagnosis and treatment quadrant]. RESULTS: Forty countries provided data for at least one element of the continuum. Countries reported most frequently on the number of people diagnosed with HIV infection (37; 93%), and on the number in receipt of antiretroviral therapy (ART) (35; 88%). There was little consensus across countries in their approach to defining linkage to, and retention in, care. The most common breakpoint (>19% reduction between two adjacent elements) related to the estimated number of people living with HIV who were diagnosed (18 of 23; 78%). CONCLUSIONS: We present continuum data from multiple countries that provide both a snapshot of care provision and a baseline against which changes over time in care provision across Europe and Central Asia may be measured. To better inform HIV testing and treatment programmes, standard data collection approaches and definitions across the HIV continuum of care are needed. If countries wish to ensure an unbroken HIV continuum of care, people living with HIV need to be diagnosed promptly, and ART needs to be offered to all those diagnosed.

Antioxidant characteristics of extracts of Hibiscus sabdariffa calyces encapsulated with mesquite gum.

This study compared the stability of extracts of H. sabdariffa calyces microencapsulated with different concentrations of mesquite gum during storage. Dry Roselle calyces were mixed with 50:50 (v/v) ethanol:water solution to obtain 18°Bx concentrate. This Roselle extract concentrate was mixed with purified mesquite gum (100:1-100:5 v/w). The Roselle extract concentrate-gum (RECG) was spray dried at inlet and outlet temperatures of 180 ± 2 and 104 ± 2.3 °C, respectively, at an air flow rate of 38 m3/h. Encapsulated Roselle powders (ERP) were analyzed for moisture content, total monomeric anthocyanins (differential pH), phenolic compounds (Folin and Ciocalteu method), antioxidant capacity (ABTS), and color parameters ([Formula: see text], and [Formula: see text]) after 5 weeks and 1 year of storage. Sorption properties (isotherms) and micrographs of powders were also obtained. The average yield of RECG powders was 15.27 ± 0.81 g/100 mL. During storage, ERP showed average values of phenolic compounds, antioxidant capacity, and anthocyanins of 3.43 ± 0.25 g gallic acid equivalents/100 g, 9.34 ± 1.4 g Trolox equivalents/100 g, and 318.7 ± 20.6 mg cyanidin-O-glycoside/100 g, respectively. Color parameters remained constant along the storage time.

Environmental stress in the Gulf of Mexico and its potential impact on public health.

The Deepwater Horizon (DWH) oil spill in the Gulf of Mexico was the largest maritime oil spill in history resulting in the accumulation of genotoxic substances in the air, soil, and water. This has potential far-reaching health impacts on cleanup field workers and on the populations living in the contaminated coastal areas. We have employed portable airborne particulate matter samplers (SKC Biosampler Impinger) and a genetically engineered bacterial reporter system (umu-ChromoTest from EBPI) to determine levels of genotoxicity of air samples collected from highly contaminated areas of coastal Louisiana including Grand Isle, Port Fourchon, and Elmer's Island in the spring, summer and fall of 2011, 2012, 2013 and 2014. Air samples collected from a non-contaminated area, Sea Rim State Park, Texas, served as a control for background airborne genotoxic particles. In comparison to controls, air samples from the contaminated areas demonstrated highly significant increases in genotoxicity with the highest values registered during the month of July in 2011, 2013, and 2014, in all three locations. This seasonal trend was disrupted in 2012, when the highest genotoxicity values were detected in October, which correlated with hurricane Isaac landfall in late August of 2012, about five weeks before a routine collection of fall air samples. Our data demonstrate: (i) high levels of air genotoxicity in the monitored areas over last four years post DWH oil spill; (ii) airborne particulate genotoxicity peaks in summers and correlates with high temperatures and high humidity; and (iii) this seasonal trend was disrupted by the hurricane Isaac landfall, which further supports the concept of a continuous negative impact of the oil spill in this region.

Effect of cosmetic matrices on the release and odour profiles of the supercritical CO2 extract of Origanum majorana L.

OBJECTIVE: In this study, the effect of different cosmetic matrices on the release profile and odour intensity of the fragrance O. majorana was investigated for the first time. METHODS: The fragrance compounds of O. majorana were extracted by supercritical fluid extraction using carbon dioxide (SFE-CO2 ) at 40°C and two operating pressures (8.5 and 10 MPa), and their chemical profiles were assessed by gas chromatography with flame ionization detector coupled with mass spectrometry (GC-FID/MS). Lastly, the fragrance compounds were incorporated into three cosmetic matrices (glycerine, dipropylene glycol and skin lotion) to assess their release and odour profiles over time using dynamic headspace (DHS)/GC-FID/MS and Odour Value concept, respectively. RESULTS: The SFE-CO2 enabled recovering extracts with the pleasant scent of the living plant, and the increment of pressure induced an increase on the extraction yield. GC-FID/MS analyses revealed that oxygen-containing monoterpenes was the principal group of components identified in both SFE-CO2 extracts. The fragrance compounds were more retained in dipropylene glycol, and the major deviations from the original odour intensity (control) were observed in the presence of dipropylene glycol and skin lotion. CONCLUSION: The hydrophilic character of the cosmetic matrices strongly influenced the release of the fragrance compounds, thus affecting the odour profile of the studied mixtures.

[Not Available]. / Ehlers-Danlos-Tschernogobow : Histoire contrarlée de la maladie.

Ehlers-Danlos disease had a paradoxical fate. Clinically identified 123 years ago, it is unknown to nearly all present doctors. Often described for its dramatic aspects, diagnostic confusion with fibromyalgia in particular, ignorance of effective treatments such as oxygen therapy and orthotics are new concepts that should shake the prejudices derived from the history of this disease.

Is reduced vancomycin susceptibility a factor associated with poor prognosis in MSSA bacteraemia?

OBJECTIVES: The known data about the influence of vancomycin MIC on Staphylococcus aureus bacteraemia are contradictory. Our objective was to study the possible impact of vancomycin MIC ≥1.5 mg/L on short- and medium-term mortality. METHODS: A prospective cohort study was carried out from March 2008 to January 2011 on adult patients with MSSA bacteraemia admitted to a tertiary hospital located in Seville (Spain). We studied the relationship between vancomycin MIC, accessory gene regulator (agr) type and absence of δ-haemolysin and poor prognosis. All isolates were genotyped by PFGE. Multivariate analysis, including a propensity score for having a vancomycin MIC of ≥1.5 mg/L, was performed by Cox regression. RESULTS: One hundred and thirty-five episodes of bacteraemia due to MSSA were included in the analysis. Twenty-nine (21.5%) isolates had a vancomycin MIC of ≥1.5 mg/L by Etest. There were no differences in agr distribution or absence of δ-haemolysin between isolates with reduced vancomycin susceptibility (RVS) and those without. RVS was not more frequent in specific clones; RVS was not associated with higher 14 or 30 day crude mortality (relative risk = 0.44, 95% CI = 0.14-1.35; and relative risk = 1.01, 95% CI = 0.52-1.96) rates, and it did not show higher rates of complicated bacteraemia (14.2% versus 13.8%, P = 0.61). Cox regression analysis did not significantly modify the results for 14 day mortality (HR = 0.39, 95% CI = 0.11-1.34) or 30 day mortality (HR = 0.89, 95% CI = 0.39-2.04). CONCLUSIONS: Contrary to previously published data, we did not find a relationship between RVS and higher mortality in patients with MSSA bacteraemia and we did not find a link with higher complicated bacteraemia rates.

Increased tobacco and alcohol use among women with joint hypermobility: a way to cope with anxiety?

Joint hypermobility (JH) is a common trait of heritable disorders of the connective tissue which has been identified as a risk factor for anxiety states. Anxiety and other negative emotions lead some people to use tobacco and alcohol as a coping strategy. The purpose of this study was to examine JH in relation to the consumption of these psychoactive substances and the associated anxiety and coping strategies. A cross-sectional sample of 305 female college students completed self-administered questionnaires on JH, tobacco and alcohol use, state and trait anxiety, and coping strategies. The prevalence of JH in the final sample (N = 301) was 51.8 %. The percentage of smokers, smokers using tobacco to calm anxiety, at-risk drinkers, tobacco and alcohol users, and the number of standard drinks consumed per week were significantly higher among females with JH than among those without it. The percentage of participants with severe state anxiety was significantly higher in the JH group, as were the emotion-focused coping score. The results of the logistic regression analysis showed that the odds of being assessed with JH were greater in those who consume tobacco and alcohol. This study provides evidence that women with JH report higher levels of state anxiety than non-JH women and use emotion-focused coping (i.e., efforts to regulate affect) more than any other coping strategies to deal with stress. These factors may help explain the increase in tobacco and alcohol use observed in this population.

Evaluation of rep-PCR/DiversiLab versus PFGE and spa typing in genotyping methicillin-resistant Staphylococcus aureus (MRSA).

Pulsed-field gel electrophoresis (PFGE) is the 'gold standard' for genotyping of methicillin-resistant Staphylococcus aureus (MRSA); however, the DiversiLab (DL) system, based on rep-PCR, is faster, simpler and could be better adapted to daily routine hospital work. We genotyped 100 MRSA isolates using PFGE, DL, and spa typing, and evaluated the discriminatory power of each technique and the correlation between them by Simpson's index(SI) and adjusted Rand coefficient (ARI), respectively. The isolates were from clinical samples from eight hospitals in Extremadura (Spain) during 2010. DL separated the 100 MRSA into 18 patterns, with 69% of the isolates grouped into four predominant patterns. spa typing reported 17 spa types, classifying 69% of MRSA into two major types (t067 and t002). PFGE revealed the existence of 27 patterns, gathering 54% of MRSA into three pulse types (E8a, E7a and E7b). SI values were 0.819, 0.726, 0.887 and 0.460 for DL, spa typing, PFGE and CC-BURP, respectively. ARI values of DL over PFGE, spa typing and CC-BURP were 0.151, 0.321 and 0.071, respectively. DL has less discriminatory power than PFGE but more than spa typing. The concordance of DL with PFGE is low, primarily because DL does not discriminate between the three predominant MRSA pulse types in our environment.

Y155H amino acid substitution in influenza A(H1N1)pdm09 viruses does not confer a phenotype of reduced susceptibility to neuraminidase inhibitors.

The Y155H amino acid substitution in the neuraminidase gene (NA) has previously been associated with highly reduced inhibition by neuraminidase inhibitors in the seasonal H1N1 influenza A virus which circulated in humans before the 2009 pandemic. During the 2012/13 epidemic season in Spain, two A(H1N1) pdm09 viruses bearing the specific Y155H substitution in the NA were detected and isolated from two patients diagnosed with severe respiratory syndrome and pneumonia requiring admission to the intensive care unit. Contrary to what was observed in the seasonal A(H1N1) viruses, neither of the Y155H A(H1N1) pdm09 viruses described here showed a phenotype of reduced inhibition by NAIs as determined by the neuraminidase enzyme inhibition assay (MUNANA). High-throughput sequencing of the NA of both Y155H viruses showed that they were composed to >99% of H155 variants. We believe that this report can contribute to a better understanding of the biological significance of amino acid substitutions in the neuraminidase protein with regard to susceptibility of influenza viruses to neuraminidase inhibitors. This is of critical importance for optimal management of influenza disease patients.

UV-C light-activated gallic acid and non-thermal technologies for inactivating Salmonella Typhimurium inoculated in aqueous solution and whole cow milk.

This study aimed to evaluate the effect of UV-C light-activated gallic acid (GA) alone and combined with ultrasound (US) or ultraviolet-C light (UV-C, 254 nm) on the inactivation of Salmonella Typhimurium in aqueous solution for being later applied to whole cow milk. First-order, Weibull, and Beta models were used to describe the inactivation kinetics of S. Typhimurium by GA alone and combined with non-thermal technologies. Results indicated that GA concentration, the UV-C light activation process, and the combination of US and UV-C light significantly affected (p < 0.05) the inactivation of S. Typhimurium in aqueous solution, which was properly described by the first order (R2 > 0.84), Weibull (R2 > 0.96), and Beta (R2 > 0.83) models. The activation process of GA increased its antimicrobial activity in the range of 40.87-101.44 %. Moreover, with the highest concentration of GA and the application of US or UV-C light, >5 log reductions were achieved. Nevertheless, although these combinations were applied to whole cow milk, a low reduction (2.0-log cycles) was obtained, regardless of the GA activation and non-thermal technologies. Therefore, the effect of GA, whether UV-C light activated or not, on S. Typhimurium depends on the food matrix. This highlights that in whole cow milk, this treatment was insufficient to ensure safety, even when combined with non-thermal technologies. INDUSTRIAL RELEVANCE: UV-C light and US are non-thermal technologies used as alternatives to thermal treatments. These technologies can be used on their own or in combination; however, in many cases, the necessary microbial reduction is not attained, thus the use of complementary techniques or processes is required. GA is a phenolic compound with low antimicrobial activity; however, UV-C light may activate its antimicrobial activity. In this sense, this study shows the potential application of GA and non-thermal technologies for inactivating S. Typhimurium in an aqueous solution and the first approach of this methodology in whole cow milk as a liquid food product.

External urology consultation quality at a third-level public hospital in Mexico.

INTRODUCTION: Patient satisfaction is the degree of conformity with the healthcare they receive. It is real evidence and one of the most important factors in determining the effectiveness and quality of healthcare systems. OBJECTIVE: To identify the quality of care in the Urology outpatient department of a third-level hospital. MATERIALS AND METHODS: The NHS (National Health Service) 2018 quality of care questionnaire with 11 sections, 133 items, and duration of approximately 25min was randomly administered to 250 patients attending Urology outpatients at a third-level public hospital in Mexico. RESULTS: According to responses, 92% (n=230) knew the reason for the consultation. 64.8% (n=162) had a consultation with the same physician by whom they were initially seen. The longest reported hospital wait time before being seen was more than 2h in 29.6% (n=74). As for consultation time, 212 patients responded and the duration was 11-20min in 52.8% (n=112). Finally, 33.2% (n=83) considered the quality of service to be good. CONCLUSIONS: The use of the NHS 2018 survey in the Urology service at a third-level public hospital in Mexico is feasible, since we managed to obtain a significant and continuous improvement in all its indicators which is satisfactory for all.

Impact of qnrA1, qnrB1 and qnrS1 on the efficacy of ciprofloxacin and levofloxacin in an experimental pneumonia model caused by Escherichia coli with or without the GyrA mutation Ser83Leu.

OBJECTIVES: The aim of this study was to evaluate the impact of qnrA1, qnrB1 and qnrS1 on the in vivo efficacies of ciprofloxacin and levofloxacin in an experimental model of pneumonia caused by Escherichia coli. METHODS: Two isogenic groups of E. coli transformants, based on two ATCC 25922 strains, with or without the GyrA mutation Ser83Leu, and carrying qnrA1, qnrB1 or qnrS1, were used in an experimental pneumonia model. The efficacies of ciprofloxacin (40 mg/kg/day) and levofloxacin (50 and 150 mg/kg/day) were evaluated. RESULTS: For the pneumonia caused by the parental strains lacking qnr genes, both fluoroquinolones significantly (P<0.05) reduced the bacterial lung concentration by >7 log10 cfu/g against E. coli ATCC/pBK and between 5.09 and 6.34 log10 cfu/g against E. coli ATCC-S83L/pBK. The presence of any qnr genes in the strains of both isogenic groups diminished the reduction of bacterial lung concentration with any therapy (P<0.05). Furthermore, all therapeutic schemes reduced the percentage of positive blood cultures in both isogenic groups (P<0.05). Finally, the survival results suggest a higher mortality with the strains expressing qnr genes. CONCLUSIONS: The presence of qnrA1, qnrB1 and qnrS1 in E. coli reduced the efficacy of ciprofloxacin and levofloxacin in a murine pneumonia model.