Microbial study of household hygiene conditions and associated Listeria monocytogenes infection risks for Peruvian women.

OBJECTIVES: To develop an exposure and risk assessment model to estimate listeriosis infection risks for Peruvian women. METHODS: A simulation model was developed utilising Listeria monocytogenes concentrations on kitchen and latrine surfaces in Peruvian homes, hand trace data from Peruvian women and behavioural data from literature. Scenarios involving varying proportions of uncontaminated, or 'clean', surfaces and non-porous surfaces were simulated. Infection risks were estimated for 4, 6 and 8 h of behaviours and interactions with surfaces. RESULTS: Although infection risks were estimated across scenarios for various time points (e.g. 4, 6, 8 h), overall mean estimated infection risks for all scenarios were ≥ 0.31. Infection risks increased as the proportions of clean surfaces decreased. Hand-to-general surface contacts accounted for the most cumulative change in L. monocytogenes concentration on hands. CONCLUSIONS: In addition to gaining insights on how human behaviours affect exposure and infection risk, this model addressed uncertainties regarding the influence of household surface contamination levels. Understanding the influence of surface contamination in preventing pathogen transmission in households could help to develop intervention strategies to reduce L. monocytogenes infection and associated health risks.

OBJECTIFS: Développer un modèle d'exposition et d'évaluation des risques pour estimer les risques d'infection par la listériose chez les femmes péruviennes. MÉTHODES: Un modèle de simulation a été développé en utilisant des concentrations de Listeria monocytogenes sur la surface des cuisines et des latrines dans des foyers péruviens, des données de traces de mains de femmes péruviennes et des données comportementales de la littérature. Des scénarios impliquant différentes proportions de surfaces non contaminées ou «propres¼ et de surfaces non poreuses ont été simulés. Les risques d'infection ont été estimés pour 4, 6 et 8 heures de comportements et d'interactions avec les surfaces. RÉSULTATS: Bien que les risques d'infection aient été estimés pour tous les scénarios à différents moments (par ex. à 4, 6 ou 8 heures), les risques d'infection globaux moyens estimés pour tous les scénarios étaient ≥ 0,31. Les risques d'infection augmentaient à mesure que les proportions de surfaces propres diminuaient. Les contacts entre la main et les surfaces générales contribuent pour le plus de changement cumulatif de la concentration de L. monocytogenes sur les mains. CONCLUSIONS: En plus de comprendre comment les comportements humains affectent l'exposition et le risque d'infection, ce modèle a traité des incertitudes quant à l'influence des niveaux de contamination des surfaces ménagers. Comprendre l'influence de la contamination de surface dans la prévention de la transmission d'agents pathogènes dans les ménages pourrait aider à développer des stratégies d'intervention pour réduire l'infection à L. monocytogenes et les risques associés pour la santé.

Fecal leukocytes in children infected with diarrheagenic Escherichia coli.

The purpose of this study was to determine the presence and quantity of fecal leukocytes in children infected with diarrheagenic Escherichia coli and to compare these levels between diarrhea and control cases. We analyzed 1,474 stool samples from 935 diarrhea episodes and 539 from healthy controls of a cohort study of children younger than 2 years of age in Lima, Peru. Stools were analyzed for common enteric pathogens, and diarrheagenic E. coli isolates were studied by a multiplex real-time PCR. Stool smears were stained with methylene blue and read by a blinded observer to determine the number of polymorphonuclear leukocytes per high-power field (L/hpf). Fecal leukocytes at >10 L/hpf were present in 11.8% (110/935) of all diarrheal episodes versus 1.1% (6/539) in controls (P < 0.001). Among stool samples with diarrheagenic E. coli as the only pathogen isolated (excluding coinfection), fecal leukocytes at >10 L/hpf were present in 8.5% (18/212) of diarrhea versus 1.3% (2/157) of control samples (P < 0.01). Ninety-five percent of 99 diarrheagenic E. coli diarrhea samples were positive for fecal lactoferrin. Adjusting for the presence of blood in stools, age, sex, undernutrition, and breastfeeding, enterotoxigenic E. coli (ETEC) isolation as a single pathogen, excluding coinfections, was highly associated with the presence of fecal leukocytes (>10 L/hpf) with an odds ratio (OR) of 4.1 (95% confidence interval [CI], 1.08 to 15.51; P < 0.05). Although diarrheagenic E. coli was isolated with similar frequencies in diarrhea and control samples, clearly it was associated with a more inflammatory response during symptomatic infection; however, in general, these pathogens elicited a mild inflammatory response.

Age-related susceptibility to infection with diarrheagenic Escherichia coli among infants from Periurban areas in Lima, Peru.

BACKGROUND: Diarrheagenic Escherichia coli strains are being recognized as important pediatric enteropathogens worldwide. However, it is unclear whether there are differences in age-related susceptibility to specific strains, especially among infants. METHODS: We conducted a passive surveillance cohort study of diarrhea that involved 1034 children aged 2-12 months in Lima, Peru. Control stool samples were collected from randomly selected children without diarrhea. All samples were analyzed for common enteric pathogens and for diarrheagenic E. coli with use of multiplex real-time polymerase chain reaction. RESULTS: The most frequently isolated pathogens in 1065 diarrheal episodes were diarrheagenic E. coli strains (31%), including enteroaggregative (15.1%) and enteropathogenic E. coli (7.6%). Diarrheagenic E. coli, Campylobacter species, and rotavirus were more frequently isolated from infants aged >or=6 months. Among older infants, diffusely adherent E. coli and enterotoxigenic E. coli were more frequently isolated from diarrheal samples than from control samples (P <.05). Children aged >or=6 months who were infected with enterotoxigenic E. coli had a 4.56-fold increased risk of diarrhea (95% confidence interval, 1.20-17.28), compared with younger children. Persistent diarrhea was more common in infants aged <6 months (13.5% vs 3.6%; P <.001). Among children with diarrheagenic E. coli-positive samples, coinfections with other pathogens were more common in children with diarrhea than in control children (40.1% vs 15.6%; P <.001). CONCLUSIONS: Diarrheagenic E. coli strains were more frequently isolated in samples from older infants. In this setting with high frequency of pathogen exposure and high frequency of breastfeeding, we hypothesize that the major age-related differences result from decreased exposure to milk-related protective factors and from increased exposure to contaminated food and water.

On the search for NNO-donor enantiopure scorpionate ligands and their coordination to group 4 metals.

The preparation of new chiral bis(pyrazol-1-yl)methane-based NNO-donor scorpionate ligands in the form of the lithium derivatives [Li(bpzb)(THF)] [1; bpzb = 1,1-bis(3,5-dimethylpyrazol-1-yl)-3,3-dimethyl-2-butoxide] and [Li(bpzte)(THF)] [2; bpzte = 2,2-bis(3,5-dimethylpyrazol-1-yl)-1-p-tolylethoxide] or the alcohol ligands (bpzbH) (3) and (bpzteH) (4) has been carried out by 1,2-addition reactions with trimethylacetaldehyde or p-tolualdehyde. The separation of a racemic mixture of the alcohol ligand 3 has been achieved and gave an enantiopure NNO alcohol-scorpionate ligand in three synthetic steps: (i) 1,2-addition of the appropriate lithium derivative to trimethylacetaldehyde, (ii) esterification and separation of diastereoisomers 5, (iii) saponification. Subsequently, the enantiopure scorpionate ligand (R,R)-bpzmmH {6; R,R-bpzmmH = (1R)-1-[(1R)-6,6-dimethylbicyclo[3.1.1]2-hepten-2-yl]-2,2-bis(3,5-dimethylpyrazol-1-yl)ethanol} was obtained with an excellent diastereomeric excess (>99% de) in a one-pot process utilizing the aldehyde (1R)-(-)-myrtenal as a chiral substrate to control the stereochemistry of the newly created asymmetric center. These new chiral heteroscorpionate ligands reacted with [MX(4)] (M = Ti, Zr; X = NMe(2), O(i)Pr, OEt, O(t)Bu) in a 1:1 molar ratio in toluene to give, after the appropriate workup, the complexes [MX(3)(kappa(3)-NNO)] (7-18). The reaction of Me(3)SiCl with [Ti(NMe(2))(3)(bpzb)] (7) or [Ti(NMe(2))(3)(R,R-bpzmm)] (11) in different molar ratios gave the halide-amide-containing complexes [TiCl(NMe(2))(2)(kappa(3)-NNO)] (19 and 20) and [TiCl(2)(NMe(2))(kappa(3)-NNO)] (21 and 22) and the halide complex [TiCl(3)(kappa(3)-NNO)] (23 and 24). The latter complexes can also be obtained by reaction of the lithium compound 1 with TiCl(4)(THF)(2) and deprotonation of the alcohol group of 6 with NaH, followed by reaction with TiCl(4)(THF)(2) in a 1:1 molar ratio, respectively. Isolation of only one of the three possible diastereoisomers of the complexes 19 and 22 revealed that chiral induction from the ligand to the titanium center took place. The structures of these complexes were elucidated by (1)H and (13)C{(1)H} NMR spectroscopy, and the X-ray crystal structures of 3-7, 12, and 24 were also established. Finally, we evaluated the influence that the chiral center of the new heteroscorpionate complexes has on the enantioselectivity of the asymmetric epoxidation of allylic alcohols.

Simple and Precise Approach for Determination of Ohmic Contribution of Diaphragms in Alkaline Water Electrolysis.

A simple and low-cost alternating current (AC)-based method, without electrolyte correction, is proposed (Electrochemical Impedance Spectroscopy (EIS)-Zero Gap Cell) for the determination of ohmic contribution of diaphragms. The effectiveness of the proposed methodology was evaluated by using a commercial Alkaline Water Electrolysis (AWE) diaphragm (Zirfon®). Furthermore, the results were compared with two conventional electrochemical methodologies for calculating the separator resistance, based on direct current (DC), and AC measurements, respectively. Compared with the previous techniques, the proposed approach reported more accurate and precise values of resistance for new and aged samples. Compared with the manufacturer reference, the obtained error values for new samples were 0.33%, 5.64%, and 41.7%, respectively for EIS-Zero gap cell, AC and DC methods, confirming the validity and convenience of the proposed technique.

External (subciliary) vs internal (transconjunctival) involutional entropion repair.

PURPOSE: To compare surgical outcomes of internal (transconjunctival) vs external (subciliary) involutional entropion repair. DESIGN: Retrospective, consecutive case series. METHODS: Electronic medical record review of all patients who underwent involutional entropion repair at the Jules Stein Eye Institute over a 4-year period was performed. MAIN OUTCOME MEASURES: Anatomic and functional success, recurrence rate, and complications. RESULTS: Forty-nine eyes (39 patients) were operated. Twenty-nine eyes underwent subciliary incision repair; 20 eyes underwent transconjunctival repair, both with lower lid retractors reinsertion. Good correlation was found between two masked observers in grading surgical outcome (on a scale of 1 to 4) (r = .76, P < .001). Forty-two cases (84%) achieved good surgical repair and improvement in symptoms. Recurrence was noticed in 4 eyes (8.2%). Recurrence was higher with the internal approach (15% vs 3% with subciliary incision), but this was not statistically significant (P = .14). Complications included: three cases (8.2%) with mild eyelid retraction that were treated conservatively, three cases with postoperative ectropion (all in the external approach, two of which lateral canthal resuspension was not performed), and two cases (4.1%, one case in each group) with pyogenic granuloma. CONCLUSIONS: Surgical correction of involutional entropion by reinsertion of lower eyelid retractors has similar outcome with internal (transconjunctival) and external (subcilliary) approaches. Although not statistically significant, internal repair may result in a higher recurrence rate, whereas external repair may show more postoperative ectropion, most probably attributable to scarring of the anterior lamella. Lateral canthal resuspension, when needed, may reduce the rate of postoperative ectropion.

[Levels of quinolones resistance and other antimicrobial in non-pathogenic Escherichia coli strains in children from the periurban area of Lima, Peru]. / Niveles de resistencia a quinolonas y otros antimicrobianos en cepas de Escherichia coli comensales en niños de la zona periurbana de Lima, Perú.

The main aim of this study was to establish the resistance levels to antimicrobial agents, in 222 non-pathogenic E. coli strains of fecal origin in Peru. The proportion of resistance found to the evaluated antimicrobials was ampicillin (62.6%), cotrimoxazole (48,6%), tetracycline (43,0%) and chloramphenicol (15,8%). We emphasize the high resistance levels found for quinolones: 32% for nalidixic acid (NAL) and 12% for ciprofloxacin (CIP). These high levels of quinoloneresistance in non-pathogenic strains isolated from children in this age group highlight the extensive use and the impact of the intake of this kind of antimicrobials in the community, showing the potential risk of the loss of their utility in the area.

High frequency of antimicrobial drug resistance of diarrheagenic Escherichia coli in infants in Peru.

In a prospective passive diarrhea surveillance cohort study of 1,034 infants of low socioeconomic communities in Lima, Peru, we determined the prevalence and antimicrobial drug susceptibility of the diarrheagenic Escherichia coli . The prevalence of diarrheagenic E. coli was 29% (161 of 557) in children with gastroenteritis and 30% (58 of 195) in the control group without diarrhea. The most common E. coli pathogens in diarrhea were enteroaggregative E. coli (EAEC) (14%), enteropathogenic E. coli (EPEC) (7%), diffusely adherent E. coli (DAEC) (4%), and enterotoxigenic E. coli (ETEC) (4%). Diarrheagenic E. coli as a group exhibited high levels of antimicrobial drug resistance in diarrheal cases to ampicillin (85%), cotrimoxazole (79%), tetracycline (65%), and nalidixic acid (28%). Among individual E. coli groups in patients with diarrhea, DAEC and EAEC exhibited significant higher frequencies of resistance to ampicillin, cotrimoxazole, tetracycline and nalidixic acid than EPEC and ETEC. Antimicrobial drug resistance to ampicillin and cotrimoxazole were more frequent in E. coli isolated from diarrheal samples than controls, which reflected greater antibiotic exposure in patients with gastroenteritis.

Niveles de resistencia a quinolonas y otros antimicrobianos en cepas de Escherichia coli comensales en niños de la zona periurbana de Lima, Perú / Levels of quinolones resistance and other antimicrobial in non-pathogenic Escherichia coli strains in children from the periurban area of Lima, Peru

El objetivo principal del estudio fue establecer el nivel de resistencia a antimicrobianos en un total de 222 cepas comensales de E. coli de origen fecal, en Perú. Las frecuencias de resistencia encontrados, frente los antimicrobianos evaluados, fueron: ampicilina (62,6 por ciento), cotrimoxazol (48,6 por ciento), tetraciclina (43,0 por ciento) y cloranfenicol (15,8 por ciento). Destacan los elevados niveles de resistencia a quinolonas: 32 por ciento al ácido nalidíxico (NAL) y 12 por ciento a ciprofloxacino (CIP). Estos elevados niveles hacia las quinolonas en cepas comensales aisladas en niños de esta franja de edad, realzan el uso extendido y el impacto de consumo de este tipo de antimicrobianos en la comunidad, mostrando el riesgo potencial de su pérdidade utilidad en el área

Highly diastereoselective nucleophilic addition to myrtenal. Straightforward synthesis of an enantiopure scorpionate ligand.

The work described here represents the first example in which an efficient and highly diastereoselective nucleophilic 1,2-addition of an organolithium reagent has been performed on a carbonylic prostereogenic center to give an enantiopure scorpionate ligand in only one step.

Design of new heteroscorpionate ligands and their coordinative ability toward Group 4 transition metals; an efficient synthetic route to obtain enantiopure ligands.

The reaction of different types of bis(pyrazol-1-yl)methane derivatives with Bu(n)Li and alkyl or aryl-containing-isocyanates or isothiocyanates, some of these as chiral reagents, gives rise to the preparation of new heteroscorpionate ligands in the form of the lithium derivatives [Li(NNE)]2 (1-10), although a similar process with trimethylsilyl isocyanate or isothiocyanate gave the complexes [Li(NCX)(bdmpzs)(THF)](X = O, 11; X = S, 12)[bdmpzs = bis(3,5-dimethylpyrazol-1-yl)trimethylsilylmethane]. Compounds 1-8 reacted with [TiCl4(THF)2] or [MCl4](M = Zr, Hf) to give a series of cationic complexes [MCl3{kappa3-NNE(H)}]Cl (13-36) where the heteroscorpionate ligand contains either an acetamide or thioacetamide group resulting from the protonation of the corresponding acetamidate or thioacetamidate. However, under appropriate experimental conditions neutral Ti complexes were isolated-namely [TiClx(NMe2)3-x(S-mbbpam)](37-39)[S-mbbpam =(S)-(-)-N-alpha-methylbenzyl-2,2-bis(3,5-dimethylpyrazol-1-yl)acetamidate]. Finally, two alkoxide-containing titanium complexes [TiClx(OR)3-x(S-mbbpamH)]Cl (40-41) were also prepared. The structures of these complexes have been determined by spectroscopic methods and, in addition, the X-ray crystal structures of 1, 12, and 19 were also established.