A high resolution melting method for the molecular identification of the potentially toxic diatom Pseudo-nitzschia spp. in the Mediterranean Sea.

The aim of this study was to develop and validate a high resolution melting (HRM) method for the rapid, accurate identification of the various harmful diatom Pseudo-nitzschia species in marine environments. Pseudo-nitzschia has a worldwide distribution and some species are toxic, producing the potent domoic acid toxin, which poses a threat to both human and animal health. Hence, it is important to identify toxic Pseudo-nitzschia species. A pair of primers targeting the LSU rDNA of the genus Pseudo-nitzschia was designed for the development of the assay and its specificity was validated using 22 control DNAs of the P. calliantha, P. delicatissima/P. arenysensis complex and P. pungens. The post-PCR HRM assay was applied to numerous unidentified Pseudo-nitzschia strains isolated from the northwestern Adriatic Sea (Mediterranean Sea), and it was able to detect and discriminate three distinct Pseudo-nitzschia taxa from unidentified samples. Moreover, the species-specific identification of Pseudo-nitzschia isolates by the HRM assay was consistent with phylogenetic analyses. The HRM assay was specific, robust and rapid when applied to high numbers of cultured samples in order to taxonomically identify Pseudo-nitzschia isolates recovered from environmental samples.

The Impact of Wearable Device Enabled Health Initiative on Physical Activity and Sleep.

OBJECTIVES: The Personal Health Management Study (PHMS) is an assessment of the effect of a voluntary employee-facing health initiative using a commercially-available wearable device implemented among 565 employees of Boehringer Ingelheim Pharmaceuticals, Inc. The results of the initiative on physical activity (measured as steps) and sleep is reported. METHODS: This was a 12-month, prospective, single-cohort intervention study using a wearable activity-measuring device tracking steps and sleep (entire study period) and a system of health-promoting incentives (first nine months of study period). The findings from the first nine study months are reported. RESULTS: The mixed model repeated measures approach was used to analyze the data. There was no significant difference in steps between the first month (7915.6 mean steps per person per day) and the last month (7853.4 mean steps per person per day) of the intervention. However, there was a seasonal decline in steps during the intervention period from fall to winter, followed by an increase in steps from winter to spring. In contrast, sleep tended to increase steadily throughout the study period, and the number of hours slept during the last month (7.52 mean hours per person per day) of the intervention was significantly greater than the number of hours slept during the first month (7.16 mean hours per person per day). CONCLUSIONS: The impact of the initiative on physical activity and sleep differed over the period of time studied. While physical activity did not change between the first and last month of the intervention, the number of hours slept per night increased significantly. Although seasonal changes and study-device habituation may explain the pattern of change in physical activity, further evaluation is required to clarify the reasons underlying the difference in the impact of the initiative on the dynamics of steps and sleep.

Feasibility of the "Bring Your Own Device" Model in Clinical Research: Results from a Randomized Controlled Pilot Study of a Mobile Patient Engagement Tool.

BACKGROUND: Rising rates of smartphone ownership highlight opportunities for improved mobile application usage in clinical trials. While current methods call for device provisioning, the "bring your own device" (BYOD) model permits participants to use personal phones allowing for improved patient engagement and lowered operational costs. However, more evidence is needed to demonstrate the BYOD model's feasibility in research settings. OBJECTIVE: To assess if CentrosHealth, a mobile application designed to support trial compliance, produces different outcomes in medication adherence and application engagement when distributed through study-provisioned devices compared to the BYOD model. METHODS: 87 participants were randomly selected to use the mobile application or no intervention for a 28-day pilot study at a 2:1 randomization ratio (2 intervention: 1 control) and asked to consume a twice-daily probiotic supplement. The application users were further randomized into two groups: receiving the application on a personal "BYOD" or study-provided smartphone. In-depth interviews were performed in a randomly-selected subset of the intervention group (five BYOD and five study-provided smartphone users). RESULTS: The BYOD subgroup showed significantly greater engagement than study-provided phone users, as shown by higher application use frequency and duration over the study period. The BYOD subgroup also demonstrated a significant effect of engagement on medication adherence for number of application sessions (unstandardized regression coefficient beta=0.0006, p=0.02) and time spent therein (beta=0.00001, p=0.03). Study-provided phone users showed higher initial adherence rates, but greater decline (5.7%) than BYOD users (0.9%) over the study period. In-depth interviews revealed that participants preferred the BYOD model over using study-provided devices. CONCLUSIONS: Results indicate that the BYOD model is feasible in health research settings and improves participant experience, calling for further BYOD model validity assessment. Although group differences in medication adherence decline were insignificant, the greater trend of decline in provisioned device users warrants further investigation to determine if trends reach significance over time. Significantly higher application engagement rates and effect of engagement on medication adherence in the BYOD subgroup similarly imply that greater application engagement may correlate to better medication adherence over time.

[Bacterial resistance to antibiotics in gram-negative rods isolated from intensive care units. Comparative analysis between two periods (1998 and 2001)]. / Resistencia a antibióticos de bacilos gram negativos aislados en unidades de cuidados intensivos. Analisis comparativo de dos periodos (1992-2001).

The incidence and drug susceptibility of gram-negative isolates from clinical samples of patients from different intensive care units at the Hospital de Clinicas José de San Martín were analysed. Two hundred isolates during the same five months period, in two different years (1998 and 2001) were obtained and evaluated. Acinetobacter spp., was the most frequently isolated microorganism. Resistance to imipenem was observed in 60% of these isolations while resistance to 3rd generation cephalosporin and ciprofloxacin was observed in more than 80%. Klebsiella pneumoniae was not resistant to imipenem, the resistance to 3rd and 4th generation cephalosporins decreased from 71.4 to 30% of isolates (p < 0.05), while ciprofloxacin resistance increased from 5 to 20% (p < 0.05). An increasing resistance to imipenem in Pseudomonas aeruginosa was noted, from 15.4 to 68% (p < 0.05%); to ciprofloxacin, from 31.4 to 66.3% (p < 0.05); to amikacin, from 23 to 60.1% (p < 0.05); and to ceftazidime, from 8.2 to 28.3% (p < 0.05). In conclusion, the alarming rates of resistance found in this study provide compelling evidence of the need for more rational use of antimicrobial agents; ongoing surveillance on the etiology of infections and their resistance profiles is important to guide future antimicrobial chemotherapy.

Resistencia a antibioticos de bacilos gram negativos aislados en unidades de cuidados intensivos. Analisis comparativo de dos periodos (1998-2001) / Bacterial resistance to antibiotics in gram-negative rods isolated from intensive care units. Comparative analysis between two periods (1998-2001)

The incidence and drug susceptibility of gram-negative isolates from clinical samples of patients from different intensive care units at the Hospital de Clinicas Jose de San Martin were analysed. Two hundred isolates during the same five months period, in two different years (1998 and 2001) were obtained and evaluated. Acinetobacter spp., was the most frequently isolated microorganism. Resistance to imipenem was observed in 60% of these isolations while resistance to 3rd generation cephalosporin and ciprofloxacin was observed in more than 80%. Klebsiella pneumoniae was not resistant to imipenem, the resistance to 3rd and 4th generation cephalosporins decreased from 71.4 to 30% of isolates (p < 0.05), while ciprofloxacin resistance increased from 5 to 20% (p < 0.05). An increasing resistance to imipenem in Pseudomonas aeruginosa was noted, from 15.4 to 68% (p < 0.05%); to ciprofloxacin, from 31.4 to 66.3% (p < 0.05); to amikacin, from 23 to 60.1% (p < 0.05); and to ceftazidime, from 8.2 to 28.3% (p < 0.05). In conclusion, the alarming rates of resistance found in this study provide compelling evidence of the need for more rational use of antimicrobial agents; ongoing surveillance on the etiology of infections and their resistance profiles is important to guide future antimicrobial chemotherapy

Resistencia a antibioticos de bacilos gram negativos aislados en unidades de cuidados intensivos. Analisis comparativo de dos periodos (1998-2001) / Bacterial resistance to antibiotics in gram-negative rods isolated from intensive care units. Comparative analysis between two periods (1998-2001)

The incidence and drug susceptibility of gram-negative isolates from clinical samples of patients from different intensive care units at the Hospital de Clinicas Jose de San Martin were analysed. Two hundred isolates during the same five months period, in two different years (1998 and 2001) were obtained and evaluated. Acinetobacter spp., was the most frequently isolated microorganism. Resistance to imipenem was observed in 60% of these isolations while resistance to 3rd generation cephalosporin and ciprofloxacin was observed in more than 80%. Klebsiella pneumoniae was not resistant to imipenem, the resistance to 3rd and 4th generation cephalosporins decreased from 71.4 to 30% of isolates (p < 0.05), while ciprofloxacin resistance increased from 5 to 20% (p < 0.05). An increasing resistance to imipenem in Pseudomonas aeruginosa was noted, from 15.4 to 68% (p < 0.05%); to ciprofloxacin, from 31.4 to 66.3% (p < 0.05); to amikacin, from 23 to 60.1% (p < 0.05); and to ceftazidime, from 8.2 to 28.3% (p < 0.05). In conclusion, the alarming rates of resistance found in this study provide compelling evidence of the need for more rational use of antimicrobial agents; ongoing surveillance on the etiology of infections and their resistance profiles is important to guide future antimicrobial chemotherapy (AU)

Resistencia a antibióticos de bacilos gram negativos aislados en unidades de cuidados intensivos. Analisis comparativo de dos periodos (1992-2001). / [Bacterial resistance to antibiotics in gram-negative rods isolated from intensive care units. Comparative analysis between two periods (1998 and 2001)]

The incidence and drug susceptibility of gram-negative isolates from clinical samples of patients from different intensive care units at the Hospital de Clinicas José de San Martín were analysed. Two hundred isolates during the same five months period, in two different years (1998 and 2001) were obtained and evaluated. Acinetobacter spp., was the most frequently isolated microorganism. Resistance to imipenem was observed in 60

of these isolations while resistance to 3rd generation cephalosporin and ciprofloxacin was observed in more than 80

. Klebsiella pneumoniae was not resistant to imipenem, the resistance to 3rd and 4th generation cephalosporins decreased from 71.4 to 30

of isolates (p < 0.05), while ciprofloxacin resistance increased from 5 to 20

(p < 0.05). An increasing resistance to imipenem in Pseudomonas aeruginosa was noted, from 15.4 to 68

(p < 0.05

); to ciprofloxacin, from 31.4 to 66.3

(p < 0.05); to amikacin, from 23 to 60.1

(p < 0.05); and to ceftazidime, from 8.2 to 28.3

(p < 0.05). In conclusion, the alarming rates of resistance found in this study provide compelling evidence of the need for more rational use of antimicrobial agents; ongoing surveillance on the etiology of infections and their resistance profiles is important to guide future antimicrobial chemotherapy.

Caracterización y distribución de especies de Citrobacter en un hospital universitario / Characterization and distribution of Citrobacter strains in a University Hospital

OBJETIVOS. a) Identificar a nivel de especie las cepas pertenecientes al género Citrobacter, siguiendo el esquema de pruebas bioquímicas convencionales propuesto por Brenner et al; b) determinar la utilidad de la llave dicotómica de O Hara comparándola con el esquema propuesto por Brenner et al, evaluando su sensibilidad y especificidad, y c) establecer la distribución y frecuencia de las diferentes especies en los especímenes clínicos. MATERIALES Y MÉTODOS. Se estudiaron 122 cepas aisladas en forma consecutiva, única e ininterrumpida en el período comprendido entre mayo de 1994 y agosto de 1997, que fueron identificadas como Citrobacter spp. Las mismas provenían de distintos materiales clínicos correspondientes a pacientes hospitalizados y ambulatorios atendidos en el Hospital de Clínicas. Los organismos fueron identificados según el esquema propuesto por Brenner y la llave dicotómica de O Hara. RESULTADO. El esquema de Brenner identificó a nivel de especie 111 cepas de las 122 estudiadas. C. freundii fue la especie más frecuente (59/111), seguida por C.koseri (18/111), C. werkmanii (15/111), C. braakii (9/111), C. youngae (6/111) y C. amalonaticus (4/111). La llave dicotómica de O Hara identificó el 94 por ciento de las cepas estudiadas (104/111).Para C. freundii los sitios de infección o colonización más frecuentes fueron el tracto urinario y el intestino, (p Fischer <0,026 y 0,039 respectivamente). Para C. koseri al igual que para C. freundii, el sitio de infección más frecuente fue la orina (p Fischer <0,0372). CONCLUSIONES. El esquema de O Hara podría ser una alternativa válida para la identificación de las citrobacterias en los laboratorios de microbiología, teniendo en cuenta que éstas son importantes patógenos oportunistas (AU)