Carriage of multidrug-resistant Gram-negative bacilli: duration and risk factors.

Identification of risk factors influencing the duration of carriage of multidrug-resistant Gram-negative bacilli (MDR-GNB) may be useful for infection control. The aim of this study is to estimate the impact of several factors collected for routine hospital surveillance on the duration of carriage of selected MDR-GNB. From January 2015 to July 2021, patients with at least two clinical/surveillance samples positive for MDR-GNB different from ESBL-producing E. coli or AmpC - exclusively producing Enterobacterales were assessed. Microorganisms, age, number of admissions, clinical or rectal sample, sex, and admission service were evaluated as risk factors. Multivariate analysis was performed by a Cox proportional hazard model. A total of 1981 episodes of colonization were included. Involved microorganisms were ESBL-Klebsiella pneumoniae (KP) in 1057 cases (53.4%), other ESBL-non-E. coli Enterobacterales in 91 (4.6%), OXA-48-KP in 263 (13.3%), KPC-KP in 90 (4.5%), VIM-KP in 29 (1.5%), carbapenemase-producing non-KP Enterobacterales (CP-non-KP) in 124 (6.3%), and MDR Pseudomonas aeruginosa (MDR-PAER) in 327 (16.5%). No differences in duration of colonization were observed among ESBL-KP (median colonization time 320 days), ESBL-non-E. coli Enterobacterales (226 days), OXA48-KP (305 days), and MDR-PAER (321 days). For each group, duration of colonization was significantly longer than that of KPC-KP (median colonization time 60 days), VIM-KP (138 days), and CP-non-KP (71 days). Male sex (HR = 0.88; 95% CI 0.78-0.99), detection in Hepatology-Gastroenterology (HR = 0.71; 95% CI 0.54-0.93), clinical sample (HR = 0.61; 95% CI 0.53-0.69), and > 2 admissions after first detection (HR = 0.47; 95% CI 0.42-0.52) were independent predictors of longer carriage, whereas VIM-KP (HR = 1.61; 95% CI 1.04-2.48), KPC-KP (HR = 1.85; 95% CI 1.49-2.3), and CP-non-KP (HR = 1.92; 95% CI 1.49-2.47) were associated with shorter colonization time. Duration of colonization was significantly longer for ESBL-KP, other ESBL-non-E. coli Enterobacterales, OXA-48-KP, and MDR-PAER. For these microorganisms, prolonging surveillance up to 2.5-3 years should be considered. Male sex, clinical sample, multiple readmissions, admission service, and type of microorganism are independent predictors of the duration of carriage.

Exploring how vessel activity influences the soundscape at a navigation lock on the Mississippi River.

Vessel sound is now globally recognized as a significant and pervasive pollutant to aquatic life. However, compared to marine environments, there is a paucity of data on sound emitted by vessel activity in freshwater habitats. The Upper Mississippi River (UMR) is home to a diverse array of aquatic life as well as being a key route for barge transportation with 29 locks and dams. In this study, passive acoustic monitoring was conducted at Lock and Dam 19 near Keokuk, Iowa, on the UMR between 20 June - August 28, 2019 to coincide with peak navigation use. There was a significant increase in median sound pressure level (SPL; 50-12,000 Hz) recorded during vessel passages (123 dB re. 1µPa for recreational vessels and 137 dB re. 1µPa for commercial vessels) compared to median background levels (111 dB re. 1µPa). Results provide information on the ambient soundscape at a navigation lock, providing a baseline essential for future studies gauging the effect of anthropogenic sound on aquatic life. Lock 19 has also been identified as a potential site for acoustic deterrent deployment to prevent invasive fish movements. The results of this study can help determine the sound level or frequency deterrents would need to emit, to avoid those currently produced during vessel passage.

Analysis of the age-related composition of human skin collagen and collagens synthesized by fibroblast culture.

Age-related differences in the composition and the post-translational modifications of human skin collagens were examined in the present study. The data were compared with results of collagen synthesis from in vivo-aged fibroblasts in culture. Skin extracts and newly synthesized collagen from fibroblast cultures derived from both old and young donor groups showed the same ratio of collagen III to collagen I. Furthermore, no difference was noted in the degree of prolyl and lysyl hydroxylation of collagen I and collagen III Young and old fibroblasts synthesized a similar quantity of collagen in vitro. The data suggest that fibroblasts maintain a uniform level of collagen production, composition and modification independent of the age of the donor.

Effects of community placement on chronic mental patients.

Patients judged ready for release from a state mental hospital were interviewed to determine their levels of depression and psychosocial functioning. This interview was repeated for 31 of the patients 8 weeks after their release and simultaneously repeated for 31 similar patients who remained in the hospital. In comparison with the matched controls, released patients became less depressed, less socially isolated, and less irritable. No differential improvement was found in their self-image. These findings, controlled for certain potential biases in a quasi-experimental design, identify some specific benefits of community placement for chronic mental patients.