Emergence of dalbavancin non-susceptible, vancomycin-intermediate Staphylococcus aureus (VISA) after treatment of MRSA central line-associated bloodstream infection with a dalbavancin- and vancomycin-containing regimen.

OBJECTIVES: Dalbavancin is a long-acting lipoglycopeptide with activity against gram-positives, including methicillin-resistant Staphylococcus aureus (MRSA). The potential for lipoglycopeptides, with half-lives greater than 1 week, to select for resistance is unknown. Here we explore a case of MRSA central line-associated bloodstream infection in which dalbavancin and vancomycin non-susceptibility emerged in a urine isolate collected after the patient was treated with vancomycin and dalbavancin sequentially. METHODS: Isolates from blood and urine underwent susceptibility testing, and whole genome sequencing (WGS). The blood isolate was subjected to successive passage in vitro in the presence of escalating dalbavancin concentrations and the emergent isolate was subjected to repeat susceptibility testing and WGS. RESULTS: The blood isolate was fully susceptible to vancomycin; however, MICs of the urine isolate to dalbavancin, vancomycin, telavancin, and daptomycin were at least fourfold higher than the blood-derived strain. Both strains were indistinguishable by spa and variable number tandem repeat (VNTR) typing, and WGS revealed only seven variants, indicating clonality. Four variants affected genes, including a 3bp in-frame deletion in yvqF, a gene which has been implicated in glycopeptide resistance. Vancomycin and dalbavancin non-susceptibility emerged in the blood isolate after successive passage in vitro in the presence of dalbavancin, and WGS identified a single non-synonymous variant in yvqF. CONCLUSIONS: This is the first case in which VISA has emerged in the context of a dalbavancin-containing regimen. The selection for cross-resistance to vancomycin in vitro by dalbavancin exposure alone is troubling. Clinicians should be aware of the possibility for emergence of dalbavancin non-susceptibility and glycopeptide cross-resistance arising following therapy.

Visible light absorption and photo-sensitizing properties of spinach leaves and beetroot extracted natural dyes.

Herein, chlorophyll and betalain dyes are extracted from fresh spinach leaves and beetroots. Fourier transform infrared spectra are used to identify the characteristic peaks of the extracted dyes. UV-vis light absorption characteristics of the dyes and their mixed counterpart are investigated by varying their pH and temperature. These dyes are used as photo sensitizer for fabrication of zinc oxide photo-anode based dye sensitized solar cells (DSSCs). The photo-voltaic characteristics of the developed DSSCs are measured under simulated solar light (power of incident light 100 mW cm(-2) from Air Mass 1.5G). The solar to electric conversion efficiencies for the chlorophyll, betalain and mixed dye based solar cells are estimated as 0.148%, 0.197% and 0.294% respectively. The highest conversion efficiency for mixed dye based solar cell is attributed due to the absorption of wider range of solar spectrum.

A comparison between active and passive techniques for measurements of radon emanation factors.

Some radon related parameters have been determined through two different techniques (passive and active) in soil and phosphogypsum samples. Emanation factors determined through these techniques show a good agreement for soil samples while for phosphogympsum samples appear large discrepancies. In this paper, these discrepancies are analyzed and explained if non-controlled radon leakages in the passive technique are taken into account.

Clinicoimmunologic studies on Phoenix sylvestris Roxb. pollen: an aeroallergen from Calcutta, India.

BACKGROUND: This study highlights the allergenicity and allergenic components of the pollen of Phoenix sylvestris Roxb. (PS), or date sugar palm, which is predominantly airborne in the air of Greater Calcutta. METHODS: A 2-year aerobiologic survey was performed by Burkard sampler. PS pollen extract was used in skin tests of allergic patients, fractionated by (NH4)2SO4 and the Sephacryl S-200 column. The allergenicity of each fraction was checked by skin test and IgE ELISA inhibition. The principal allergenic fraction, Fr.lla, was separated in 11% SDS-PAGE, and its allergenicity was confirmed by IgE ELISA inhibition and immunoblotting. RESULTS: PS pollen grains were found to be prevalent in the air of the suburban zone of Calcutta from January to March with a peak in February. The pollen extract showed high (44.07%) positive skin reaction on 540 respiratory allergic patients. Among the (NH4)2SO4 cut fractions, Fr.II was the most active one, and it was resolved into four subfractions in the Sephacryl S-200 column. Fr.lla was the principal allergenic fraction, showing the presence of two components of 33 and 66 kDa in SDS-PAGE. In IgE immunoblotting, both of the components were found to be allergenic. CONCLUSIONS: The PS pollen grain is an important aeroallergen from Calcutta, India. The 33- and 66-kDa components are the major allergens present in the relevant pollen extract.

Radon exhalation rate and uranium estimation in rock samples from Bihar uranium and copper mines using the SSNTD technique.

Widespread uranium mineralization is associated with copper, nickel and other sulphides in the Singhbhum shear zone developed at the northern margin of the Singhbhum craton in the state of Bihar of India. The south-eastern part of the shear zone between Surda-Mosabani-Badia is rich in copper mineralization while the central part between Jaduguda-Bhatin-Nimdih and Narwapahar-Garadih-Turamdih is enriched in uranium. In the present study, trace uranium concentration in geological samples from the Mosabani copper mine and the Narwapahar and Jaduguda uranium mine areas have been determined using fission track registration technique. For the measurement of the radon exhalation rate, the 'can technique' using alpha sensitive LR-115 type II plastic track detectors were used. Uranium concentrations were found to vary from 1.5 to 2097.9 ppm whereas the radon exhalation rate varied from 0.2 to 19.2 Bq m-2 h-1. The values of radon exhalation rate from crushed rock and soil samples are found to correspond with the measured values of uranium in the corresponding samples. A positive correlation has been found between radon exhalation rate and uranium concentration in the samples. The linear coefficients are found to be 0.40, 0.98 and 0.95 in the Mosabani, Narwapahar and Jaduguda mine areas respectively. High values of radon exhalation in subsurface mines like Jaduguda (depth approximately 800 m) and Mosabani (depth > 1000 m) seem to emphasize the need for adequate ventilation for the removal of radon and its progenies from the mines.

Utilization of maternal services in west Bengal.

A study was conducted in selected blocks of West Bengal to assess the utilization of available maternal health services specially immunization, antenatal care and other services. Coverage with two doses of tetanus toxoid levels varied between 58.6 to 86.7% but it fell far short of Universal Immunization Programme target of 100%. Drop out rates were slightly higher in the rural areas. It was observed that in 5 out of 7 blocks more than 55% of the deliveries were conducted either at hospital or Primary Health Centre by health personnel. However, untrained dais predominated over the trained dais in conducting deliveries in most of the areas. This indicates the poor availability or utilization of the latter.

PIP: Between January and September 1990 in India, medical officers trained in the Universal Immunization Programme and paramedics interviewed 1458 women from 7 rural and urban blocks in northern and southern West Bengal to determine utilization of immunization and prenatal care services by pregnant women and to learn where they delivered and who attended the deliveries. The coverage of pregnant women with 2 doses of tetanus toxoid ranged from 58.6% in Hilli block to 86.7% in North Calcutta. Poor information, education, and communication activities in Hilli likely explained the low coverage. The block with the highest percentage of tetanus toxoid dropouts was Mogra block of Hooghly district (11.3%). The lowest percentage of dropouts occurred in Greater Calcutta (Dhakuria) (3.3%). Institutional deliveries were more common in Calcutta (88.1% in North Calcutta and 69.5% in Dhakuria) than the other blocks (e.g., 38.5% in Hilli). The women in the Calcutta blocks to closer to teaching and nonteaching hospitals and private nursing homes than those in the other blocks. Health personnel attended more than 55% of deliveries in all blocks except Hilli (38.5%) and Tamluk (5.9%). The percentage of health personnel deliveries was especially high in Dhakuria (88.5%) and North Calcutta (69.6%). Untrained traditional birth attendants (dais) were present at a higher percentage of deliveries than were trained dais in all blocks, suggesting poor availability or utilization of trained dais. Untrained dais or other untrained people were present at most deliveries (87.6%) in Tamluk. The study only examined utilization of prenatal care services in 4 blocks. The percent using these services was 81.1% in Mogra, 73.9% in Pandua, 61.4% in Balurghat, and 54.9% in Tamluk.