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2.
Domest Anim Endocrinol ; 75: 106575, 2021 04.
Article in English | MEDLINE | ID: mdl-33186842

ABSTRACT

Twice-daily (BID) insulin injections are a major deterrence to owners treating dogs with diabetes mellitus (DM). The hypothesis for this study was that Protamine Zinc Recombinant Human Insulin (PZIR) is safe and efficacious as a once-daily (SID) treatment for canine DM. This was a prospective, baseline-controlled, multi-center study over 182 ± 5 d. Two hundred seventy-six client-owned dogs with naturally occurring DM (naïve or pre-treated with insulin) were enrolled in the study. Enrollment was based upon demonstration of hyperglycemia, glycosuria, and ≥1 diabetic clinical sign (polyuria (PU), polydipsia (PD), or weight loss). Insulin treatment was initiated at 0.5-1.0 IU/kg SID. An improvement in at least one lab parameter related to DM (mean BG, min BG, Fructosamine) and one clinical parameter (PU/PD, body weight) was achieved in 72% of dogs (80% of naive, 62% of pre-treated). Dogs treated SID and BID showed improvement in 71% and 74% of cases, respectively. In naïve dogs, mean and minimum BG and fructosamine were significantly decreased (P < 0.05) by d 7 and 21, respectively, and in pre-treated dogs by d 63. By d 84, PU/PD improved in 90% and 88% of dogs, respectively, and the mean successful insulin dose was 1.4 IU/kg/d. Safety parameters were measured in 276 dogs for up to 182 d; clinical hypoglycemia occurred in 8.9% of dogs. We conclude that PZIR safely and effectively improved glycemic parameters and clinical signs in naïve and pre-treated diabetic dogs. The significant percentage of dogs on SID treatment with improvement in hyperglycemia and clinical signs confirms the prolonged action of PZIR in many dogs.


Subject(s)
Diabetes Mellitus , Dog Diseases , Animals , Blood Glucose , Diabetes Mellitus/drug therapy , Diabetes Mellitus/veterinary , Dog Diseases/drug therapy , Dogs , Humans , Hypoglycemic Agents/adverse effects , Insulin/therapeutic use , Prospective Studies , Protamines
3.
J Antimicrob Chemother ; 71(12): 3372-3375, 2016 12.
Article in English | MEDLINE | ID: mdl-27566311

ABSTRACT

BACKGROUND: In Western Australia (WA), clonal complex 5, ST835, community-associated (CA) MRSA is isolated almost exclusively from aged care facilities. In WA four different staphylococcal cassette chromosome (SCC) mec (SCCmec) elements have been identified in this ST, indicating high genetic activity in the SCCmec region. OBJECTIVES: To investigate the SCC region of ST835 CA-MRSA WA MRSA-40 and determine the distribution of an SCCsorbitol element found within the region. RESULTS: The SCC region contained a composite island, SCCmecWA MRSA-40-CI, that was composed of three elements, ΨSCCpls, SCCsorbitol and SCCmecVT (5C2&5). This is the first time that a sorbitol operon has been reported in an SCC element. CONCLUSIONS: Generation of SCCmecWA MRSA-40-CI has involved multiple genetic events and recombination with CoNS has occurred during evolution of the SCC elements. While Staphylococcus aureus is renowned for its ability to utilize mobile genetic elements to disseminate antimicrobial resistance, the SCC region of WA MRSA-40 shows that this clone has also utilized SCC elements to acquire extra virulence and possibly adapt to a niche environment.


Subject(s)
Chromosomes, Bacterial , Community-Acquired Infections/microbiology , Genomic Islands , Homes for the Aged , Methicillin-Resistant Staphylococcus aureus/genetics , Nursing Homes , Staphylococcal Infections/microbiology , Aged , Evolution, Molecular , Genotype , Humans , Methicillin-Resistant Staphylococcus aureus/isolation & purification , Recombination, Genetic , Western Australia
4.
J Photochem Photobiol B ; 159: 42-8, 2016 Jun.
Article in English | MEDLINE | ID: mdl-27016718

ABSTRACT

BACKGROUND AND OBJECTIVES: Pretreatment of skin with ablative fractional laser enhances accumulation of topical provided photosensitizer, but essential information is lacking on the interaction between laser channel densities and pharmacokinetics. Hence our objectives were to investigate how protoporphyrin accumulation was affected by laser densities, incubation time and drug concentration. METHODS: We conducted the study on the back of healthy male volunteers (n=11). Test areas were pretreated with 2940nm ablative fractional Er:YAG laser, 11.2mJ per laser channel using densities of 1, 2, 5, 10 and 15% (AFL 1-15%). Control areas received pretreatment with curettage or no pretreatment. Methyl aminolevulinate (MAL) was applied under occlusion in concentrations of 0, 80 and 160mg/g. MAL-induced protoporphyrin fluorescence was quantified with a handheld photometer after 0, 30, 60, 120 and 180min incubation. The individual fluorescence intensity reached from the highest density (15%) and longest MAL 160mg/g incubation time (180min) was selected as reference (100%) for other interventional measurements. RESULTS: A low laser density of 1% markedly enhanced fluorescence intensities from 34% to 75% (no pretreatment vs. AFL 1%, MAL 160mg/g, 180min; p<0.001). Furthermore, fluorescence intensities increased substantially by enhancing densities up to 5% (p≤0.0195). Accumulation of protoporphyrins was accelerated by laser exposure. Thus, laser exposure of 5% density and a median incubation time of 80min MAL (range 46-133min) induced fluorescence levels similar to curettage and 180min incubation. Furthermore, MAL 80 and 160mg/g induced similar fluorescence intensities in skin exposed to laser densities of 1, 2 and 5% (p>0.0537, 30-180min). CONCLUSION: MAL-induced protoporphyrin accumulation is augmented by enhancing AFL densities up to 5%. Further, this model indicates that incubation time as well as drug concentration of MAL may be reduced with laser pretreatment.


Subject(s)
Aminolevulinic Acid/analogs & derivatives , Lasers , Photosensitizing Agents/administration & dosage , Protoporphyrins/metabolism , Adolescent , Adult , Aminolevulinic Acid/administration & dosage , Aminolevulinic Acid/metabolism , Humans , Male , Photosensitizing Agents/metabolism , Spectrometry, Fluorescence , Young Adult
6.
Clin Microbiol Infect ; 20(6): 530-5, 2014 Jun.
Article in English | MEDLINE | ID: mdl-24224545

ABSTRACT

To compare the management and outcome of methicillin-resistant Staphylococcus aureus (MRSA) bacteraemia in patients known to be MRSA-colonized/infected (C-patients) with the management and outcome in those not known to be colonized/infected (NC-patients), we conducted a 10-year retrospective review of MRSA bacteraemia in an adult tertiary hospital. Clinical data were obtained by chart review, and mortality data from linked databases. Prior MRSA colonization/infection status was available to treating clinicians at the time of the bacteraemia as a 'Micro-Alert' tag on the patient's labels, in medical charts, and in electronic information systems. C-patients accounted for 35.4% of all MRSA bacteraemia episodes. C-patients were more likely to be indigenous, to be diabetic, or to have a history of previous S. aureus infection. Markers of illness severity (Simplified Acute Physiology Score (SAPS)-II, need for admission to the intensive-care unit, length of stay, and metastatic seeding) were similar in both groups. Empirical therapy included a glycopeptide in 49.3% of C-patients vs. 18.9% of NC-patients (p <0.01), and contained an antibiotic to which the MRSA isolate tested susceptible in vitro in 56.7% of C-patients vs. 45.1% of NC-patients (p 0.13). All-cause 7-day and 30-day mortality were 7.5% vs. 18.9% (p 0.04), and 22.4% vs. 31.1% (p 0.20), in the C-patient and NC-patient groups, respectively. Knowing MRSA colonization status was significantly associated with lower 30-day mortality in Cox regression analysis (p <0.01). These data suggest that mortality from MRSA bacteraemia is lower in C-patients, which may reflect the earlier use of glycopeptides. The low use of empirical glycopeptides in septic patients known to be previously MRSA-colonized/infected may represent a missed opportunity for infection control to positively impact on clinical management.


Subject(s)
Anti-Bacterial Agents/therapeutic use , Bacteremia/drug therapy , Glycopeptides/therapeutic use , Methicillin-Resistant Staphylococcus aureus/isolation & purification , Staphylococcal Infections/drug therapy , Adolescent , Adult , Aged , Aged, 80 and over , Bacteremia/diagnosis , Bacteremia/mortality , Carrier State/diagnosis , Child , Female , Humans , Male , Middle Aged , Retrospective Studies , Staphylococcal Infections/diagnosis , Staphylococcal Infections/mortality , Survival Analysis , Treatment Outcome , Young Adult
7.
Haemophilia ; 19(3): 403-8, 2013 May.
Article in English | MEDLINE | ID: mdl-23387870

ABSTRACT

This study introduces a new laboratory model of whole blood platelet aggregation stimulated by endogenously generated thrombin, and explores this aspect in haemophilia A in which impaired thrombin generation is a major hallmark. The method was established to measure platelet aggregation initiated by tissue factor evaluated by means of impedance aggregometry. Citrated whole blood from healthy volunteers and haemophilia A patients with the addition of inhibitors of the contact pathway and fibrin polymerization was evaluated. In healthy persons, a second wave of platelet aggregation was found to coincide with the thrombin burst and to be abolished by thrombin inhibitors. In this system, platelet aggregation in severe haemophilia A (n = 10) was found to be significantly decreased as compared with healthy individuals (912 ± 294 vs. 1917 ± 793 AU × min, P = 0.003), most probably due to the weak level of thrombin generation. For the first time, analysis of platelet aggregation as induced by endogenously generated thrombin was demonstrated. The new method makes it possible to explore the influence of the coagulation system on platelet function. In contrast to the general understanding, the data suggest that the impaired thrombin generation in haemophilia may affect platelet activation. Future studies will address whether our results may contribute to understanding differences in bleeding phenotypes and response to haemostatic substitution observed among patients.


Subject(s)
Blood Platelets/physiology , Models, Biological , Platelet Aggregation/physiology , Thrombin/metabolism , Adult , Aged , Antibodies/immunology , Female , Hemophilia A/blood , Humans , Laboratories , Male , Middle Aged , Platelet Aggregation/drug effects , Platelet Factor 4/metabolism , Serine Proteinase Inhibitors/pharmacology , Sulfones/pharmacology
8.
Neuropsychologia ; 51(1): 67-78, 2013 Jan.
Article in English | MEDLINE | ID: mdl-23178227

ABSTRACT

The cingulum is a prominent white matter tract that supports prefrontal, parietal, and temporal lobe interactions. Despite being composed of both short and long association fibres, many MRI-based reconstructions (tractography) of the cingulum depict an essentially uniform tract that almost encircles the corpus callosum. The present study tested the validity of dividing this tract into subdivisions corresponding to the 'parahippocampal', 'retrosplenial', and 'subgenual' portions of the cingulum. These three cingulum subdivisions occupied different medial-lateral locations, producing a topographic arrangement of cingulum fibres. Other comparisons based on these different reconstructions indicate that only a small proportion of the total white matter in the cingulum traverses the length of the tract. In addition, both the radial diffusivity and fractional anisotropy of the subgenual subdivision differed from that of the retrosplenial subdivision which, in turn, differed from that of the parahippocampal subdivision. The extent to which the radial diffusivity scores and the fractional anisotropy scores correlated between the various cingulum subdivisions proved variable, illustrating how one subdivision may not act as a proxy for other cingulum subdivisions. Attempts to relate the status of the cingulum, as measured by MRI-based fibre tracking, with cognitive or affective measures will, therefore, depend greatly on how and where the cingulum is reconstructed. The present study provides a new framework for subdividing the cingulum, based both on its known connectivity and MRI-based properties.


Subject(s)
Brain Mapping , Corpus Callosum/anatomy & histology , Corpus Callosum/physiology , Gyrus Cinguli/anatomy & histology , Neuropsychological Tests , Adult , Anisotropy , Female , Gyrus Cinguli/physiology , Humans , Image Processing, Computer-Assisted , Observation , Photic Stimulation , Reproducibility of Results
9.
Eur J Clin Microbiol Infect Dis ; 31(9): 2421-8, 2012 Sep.
Article in English | MEDLINE | ID: mdl-22382823

ABSTRACT

To determine the impact of infectious diseases consultation (IDC) in Staphylococcus aureus bacteraemia. All MRSA bacteraemia and a random subset of MSSA bacteraemia were retrospectively analysed. Out of 599 SAB episodes, 162 (27%) were followed by an IDC. Patients with IDC were younger and more frequently intravenous drug users, but fewer resided in a long-term care facility or were indigenous. Hospital length of stay was longer (29.5 vs 17 days, p < 0.001), and endocarditis (19.1% vs 7.3%, p < 0.001) and metastatic seeding (22.2% vs 10.1%, p < 0.001) were more frequent in the IDC group; however, SAPS II scores were lower in the IDC group (27 vs 37, p < 0.001). ICU admission rates in the two groups were similar. The isolate tested susceptible to empirical therapy more frequently in the IDC group (88.9% vs 78.0%, p = 0.003). Seven-day (3.1 vs 16.5%), 30-day (8.0% vs 27.0%) and 1-year mortality (22.2% vs 44.9%) were all lower in the IDC group (all p < 0.001). Multivariate analysis showed that effective initial therapy was the only variable associated with the protective effect of IDC. In patients with SAB, all-cause mortality was significantly lower in patients who had an IDC, because of the higher proportion of patients receiving effective initial antibiotics.


Subject(s)
Bacteremia/diagnosis , Bacteremia/mortality , Referral and Consultation/statistics & numerical data , Staphylococcal Infections/diagnosis , Staphylococcal Infections/mortality , Staphylococcus aureus/isolation & purification , Adolescent , Adult , Aged , Aged, 80 and over , Anti-Bacterial Agents/administration & dosage , Bacteremia/drug therapy , Child , Critical Care/statistics & numerical data , Endocarditis, Bacterial/epidemiology , Female , Humans , Length of Stay , Male , Middle Aged , Retrospective Studies , Staphylococcal Infections/drug therapy , Survival Analysis , Treatment Outcome , Young Adult
10.
Eur J Clin Microbiol Infect Dis ; 31(6): 1067-72, 2012 Jun.
Article in English | MEDLINE | ID: mdl-21909648

ABSTRACT

Due to a longstanding comprehensive "search and destroy policy", methicillin-resistant Staphylococcus aureus (MRSA) is not endemic in Western Australian (WA) acute care hospitals. As the prevalence of MRSA in the community has increased, healthcare workers (HCW) are at risk of importing MRSA into hospitals. We aimed to determine the prevalence of and risk factors for nasal MRSA colonization in our HCW population. A period prevalence study was conducted at an 850-bed tertiary hospital. Basic demographics and a nasal swab were obtained. A total of 1,542 HCWs employed in our centre were screened for MRSA, of whom 3.4% (n = 52) were colonized. MRSA colonization was more common in patient care assistants (6.8%) and nurses (5.2%) than in allied health professionals (1.7%) and doctors (0.7%) (p < 0.01). Working in "high-risk" wards that cared for MRSA colonized/infected patients was the strongest risk factor for HCW MRSA colonization (p < 0.001). ST1-IV and ST78-IV (the most common community clones in the region) were the most frequently identified clones. In conclusion, MRSA colonization of HCWs occurs primarily in HCWs caring for patients colonized or infected with MRSA. Surveillance screening of HCWs should be regularly performed on wards with patients with high MRSA colonization prevalence to prevent further spread in the hospital.


Subject(s)
Carrier State/epidemiology , Health Personnel , Methicillin-Resistant Staphylococcus aureus/isolation & purification , Nose/microbiology , Staphylococcal Infections/epidemiology , Adolescent , Adult , Aged , Carrier State/microbiology , Female , Hospitals , Humans , Male , Middle Aged , Prevalence , Risk Factors , Staphylococcal Infections/microbiology , Western Australia/epidemiology , Young Adult
11.
Vet Rec ; 169(19): 493, 2011 Nov 05.
Article in English | MEDLINE | ID: mdl-21891786

ABSTRACT

A total of 29 breeding turkey holdings and 317 fattening turkey holdings were sampled between October 2006 and September 2007 in order to establish the baseline prevalence of Salmonella in turkeys in the UK. The weighted holding level Salmonella prevalence was found to be 20.1 per cent (95 per cent confidence interval [CI] 8.6 to 40.3 per cent) in breeding turkeys and 37.7 per cent (95 per cent CI 33.4 to 42.3 per cent) in fattening turkeys. For breeding turkeys, a weighted flock-level prevalence, as more than one flock per holding was sampled, was estimated at 7.1 per cent (95 per cent CI 3.2 to 14.8 per cent). A total of 13 different serovars were identified in the survey. The most frequent serovar in both turkey flock classes was Salmonella Kottbus, which was found on two breeding holdings and 63 of the fattening holdings giving weighted prevalences of 10.4 per cent (95 per cent CI 2.6 to 34.1 per cent) and 23.0 per cent (95 per cent CI 19.3 to 27.3 per cent), respectively. On breeding holdings, a single isolate of Salmonella Typhimurium, identified as DT12 (weighted prevalence 3.5 per cent [95 per cent CI 0.7 to 15.8 per cent] [holding], 0.7 per cent [95 per cent CI 0.1 to 3.7 per cent] [flock)], was found. On fattening holdings, there were 55 isolates of S Typhimurium from 16 holdings, giving a weighted prevalence of this serovar of 5.4 per cent (95 per cent CI 3.6 to 8.0 per cent). There were no isolates of Salmonella serovars Enteritidis, Hadar, Infantis or Virchow.


Subject(s)
Poultry Diseases/epidemiology , Salmonella Infections, Animal/epidemiology , Turkeys , Animals , Bacterial Typing Techniques/veterinary , Female , Male , Prevalence , Salmonella/classification , Salmonella/isolation & purification , Species Specificity , United Kingdom/epidemiology
12.
Food Sci Technol Int ; 17(2): 143-54, 2011 Apr.
Article in English | MEDLINE | ID: mdl-21436234

ABSTRACT

A tomato flavor enhancer, 2-isobutylthiazole (IBT), was added (5 mg/kg) to dressings emulsified with either a whey protein concentrate-80 (WPC-80), a WPC-80 hydrolysate or ß-lactoglobulin at high pressure (70 MPa) at either 20 or 75 °C. The short (2-4 min), high-temperature treatment left the proteins essentially unchanged. IBT addition gave a dominant, green tomato flavor that masked the intrinsic odor of the WPC-80 hydrolysate but enhanced bitter flavor. The sensory IBT odor intensity was determined by oil level (5-30%) and pH; pH 4.0 gave higher IBT odor than pH 6.5. The green (IBT) odor release correlated with the sensory viscosity (p = 0.001) and with instrumentally determined complex modulus (p = 0.001), but not to the dressings' microstructure. The presence of small (<<1.5 µm) oil particles that were difficult to identify from images may explain why no correlation between green odor and microstructure was found. Headspace analysis significantly detected differences in the release of IBT from the different protein types: WPC-80 dressings released the most and ß-lactoglobulin the least amounts of IBT into headspace. As this difference in release of IBT among proteins could not be verified by sensory analysis, it may bear no relevance for perception.


Subject(s)
Flavoring Agents/chemistry , Milk Proteins/chemistry , Solanum lycopersicum/chemistry , Thiazoles/chemistry , Analysis of Variance , Chemical Phenomena , Emulsions , Gas Chromatography-Mass Spectrometry , Hydrogen-Ion Concentration , Lactoglobulins/chemistry , Odorants , Whey Proteins
13.
Int J Antimicrob Agents ; 36(6): 501-6, 2010 Dec.
Article in English | MEDLINE | ID: mdl-20869212

ABSTRACT

The Comparative Activity of Carbapenems Testing (COMPACT) Study was designed to determine the in vitro potency of doripenem compared with imipenem and meropenem against a large number of contemporary Gram-negative pathogens from more than 100 centres across Europe and the Asia-Pacific region and to assess the reliability of Etest methodology for doripenem minimum inhibitory concentration (MIC) determination against these pathogens. Data from eight countries within the Asia-Pacific region, which collected 1612 bacterial isolates, are presented here. Etest methodology was found to be a reliable method for MIC determination. Doripenem showed in vitro activity similar to or better than meropenem and at least four-fold better than imipenem against Enterobacteriaceae. Against Pseudomonas aeruginosa, doripenem was also the most active of the three carbapenems in vitro. However, in vitro results do not necessarily correlate with clinical outcome.


Subject(s)
Anti-Bacterial Agents/pharmacology , Carbapenems/pharmacology , Gram-Negative Bacteria/drug effects , Gram-Negative Bacterial Infections/microbiology , Imipenem/pharmacology , Thienamycins/pharmacology , Asia , Doripenem , Gram-Negative Bacteria/isolation & purification , Humans , Meropenem , Microbial Sensitivity Tests , Pacific Islands
14.
Vet Rec ; 166(19): 579-86, 2010 May 08.
Article in English | MEDLINE | ID: mdl-20453235

ABSTRACT

In 2004/05, all European Union member states were required to carry out standardised prevalence surveys to establish the baseline prevalence of Salmonella in commercial laying flocks. As part of the survey in Great Britain, additional data were collected from 380 of the enrolled laying hen holdings to investigate risk factors for Salmonella at farm level. Stratified, simple random sampling was used to select holdings from which dust and boot swab samples were collected and tested for Salmonella using a modification of ISO 6579:2002. Using a multivariable logistic model weighted to account for the survey design, several factors significantly associated with Salmonella and Salmonella Enteritidis status were identified. Larger holdings (>or=30,000 birds) were found to be at higher risk of Salmonella (odds ratio [OR] 4.79, P=0.025), while vaccination (OR 0.28, P=0.013), providing foot dips with brushes (OR 0.27, P=0.042), washing and disinfecting the house at depopulation (OR 0.19, P=0.003), having a clean car park away from house (OR 0.14, P=0.001), using an independent (OR 0.19, P=0.007) or other non-company (OR 0.40, P=0.049) source of feed, being over 1 km from the nearest neighbouring farm (OR 0.45, P=0.021) and the presence of cats and dogs on the farm (OR 0.26, P=0.002) or on contiguous farms (OR 0.44, P=0.030) reduced the risk of any Salmonella serovars being present. Factors found to be associated specifically with an increased risk of S Enteritidis infection included holding size (OR 14.88, P=0.001) and frequent sightings of rats (OR 8.17, P<0.001) or mice (OR 5.78, P=0.006). Non-caged systems (OR 0.14, P=0.002), vaccination (OR 0.08, P=0.001), the use of a non-company feed source (OR 0.11, P=0.003), running the site as all-in/all-out (OR 0.06, P<0.001) and the presence of cats and dogs on the farm (OR 0.14, P=0.002) were associated with a reduced risk.


Subject(s)
Eggs/microbiology , Poultry Diseases/epidemiology , Salmonella Infections, Animal/epidemiology , Salmonella/isolation & purification , Animal Husbandry/methods , Animals , Chickens/microbiology , Environmental Microbiology , Female , Food Contamination/prevention & control , Housing, Animal , Logistic Models , Odds Ratio , Population Density , Poultry Diseases/prevention & control , Prevalence , Risk Factors , Salmonella/growth & development , Salmonella Food Poisoning/epidemiology , Salmonella Food Poisoning/prevention & control , Salmonella Infections, Animal/prevention & control , Salmonella enterica/growth & development , Salmonella enterica/isolation & purification , United Kingdom/epidemiology
15.
Epidemiol Infect ; 138(10): 1427-38, 2010 Oct.
Article in English | MEDLINE | ID: mdl-20163746

ABSTRACT

A cross-sectional study into risk factors for Salmonella was undertaken using data gathered from 252 fattening turkey flocks in the UK. The data was derived from the EU baseline survey conducted during 2006 and 2007, in addition to a voluntary questionnaire. Multivariate logistic regression models identified significant risk factors for Salmonella spp. and Salmonella Typhimurium. A decreased risk of Salmonella spp. infection was associated with a history of intestinal illness in the sampled flock (OR 0.17), the use of wood shavings as litter (OR 0.21), use of disinfectant in the cleaning process (OR 0.25), incineration of dead birds on farm (OR 0.29), seasonal production (OR 0.31), farm staff also working with cattle (OR 0.31), and the presence of pigs on neighbouring farms (OR 0.38). The risk of isolating Salmonella spp. varied according to the company from which the poults were sourced. A reduced risk of S. Typhimurium infection was associated with the use of wax blocks to control rodents (OR 0.09), using mains water (OR 0.19) and having a Salmonella test programme (OR 0.23). An increased risk of S. Typhimurium infection was associated with storage of items around the turkey house (OR 5.20), evidence of mice (OR 4.71) and a soil surface surrounding the turkey house (OR 2.70). This study therefore identifies a number of important practical measures which can be implemented by farmers and veterinarians within the turkey industry to assist in the control of salmonellosis at the farm level.


Subject(s)
Poultry Diseases/epidemiology , Salmonella Infections, Animal/epidemiology , Salmonella/isolation & purification , Animal Husbandry/methods , Animals , Cattle , Cross-Sectional Studies , Infection Control/methods , Mice , Poultry Diseases/microbiology , Risk Factors , Rodent Control/methods , Rodentia , Salmonella/classification , Swine , Turkeys , United Kingdom/epidemiology
16.
Int J Lab Hematol ; 32(2): 206-14, 2010 Apr.
Article in English | MEDLINE | ID: mdl-19486195

ABSTRACT

International Normalized Ratio (INR) measurements are used to monitor oral anticoagulation therapy with coumarins. Single coagulation factor activities and calibrated automated thrombin (CAT) generation are considered as more advanced methods for evaluating overall haemostatic capacity. The aims were to assess the variability of INR, coagulation factor activities, and CAT, during 24 h of storage of blood samples at ambient temperature. A total of 24 patients on stable coumarin treatment were followed prospectively for 6 weeks. INR was analyzed at 0, 6 and 24 h after blood sampling and 1-stage clotting activity of coagulation factors II, VII, IX, and X as well as CAT generation was recorded after 0 and 24 h respectively. Statistical analyses included Bland-Altman plot, 95% limits of agreement, and a variability test using a mixed effect model. The level of INR remained statistically unchanged from 0 to 6 and 24 h of storage. Coagulation factor activities and CAT revealed no significant difference induced by 24 h of storage, although the limits of agreement were wide. Patients' individual INR, coagulation factor activities, and CAT generation were not significantly influenced by 24 h storage of blood samples, but for the CAT generation analyses a trend toward time dependency was detected.


Subject(s)
Blood Coagulation Factors , Blood Preservation , International Normalized Ratio , Thrombin/standards , Blood Specimen Collection , Female , Hemostatics , Humans , Male , Middle Aged , Temperature
17.
J Antimicrob Chemother ; 64(4): 684-93, 2009 Oct.
Article in English | MEDLINE | ID: mdl-19713400

ABSTRACT

OBJECTIVES: Community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA) was first reported in remote regions of Western Australia (WA) in 1992 and is now the predominant MRSA isolated in the State. To gain insights into the emergence of CA-MRSA, 2146 people living in 11 remote WA communities were screened for colonization with S. aureus. METHODS: Antibiogram analysis, contour-clamped homogeneous electric field electrophoresis, multilocus sequence typing, Panton-Valentine leucocidin determinant detection and accessory genetic regulator typing were performed to characterize the isolates. MRSA was further characterized by staphylococcal cassette chromosome mec typing. RESULTS: The S. aureus population consisted of 13 clonal complexes and two Singleton lineages together with 56 sporadic isolates. Five lineages contained MRSA; however, these were not the predominant methicillin-susceptible S. aureus (MSSA) lineages. There was greater diversity amongst the MSSA while the MRSA appeared to have emerged clonally following acquisition of the staphylococcal cassette chromosome mec. Three MRSA lineages were considered to have been endemic in the communities and have subsequently become predominant lineages of CA-MRSA in the wider WA community. People colonized with MSSA tended to harbour clones of a different genetic lineage at each anatomical site while people colonized with MRSA tended to harbour clones of the same lineage at each site. Overall, the isolates were resistant to few antimicrobials. CONCLUSIONS: Although the evidence suggests that in WA CA-MRSA strains arose in remote communities and have now disseminated into the wider community, there is no evidence that they arose from the predominant MSSA clones in these communities.


Subject(s)
Carrier State/microbiology , Community-Acquired Infections/microbiology , Methicillin-Resistant Staphylococcus aureus/classification , Methicillin-Resistant Staphylococcus aureus/drug effects , Staphylococcal Infections/microbiology , Bacterial Proteins/genetics , Bacterial Toxins/genetics , Bacterial Typing Techniques , Cluster Analysis , DNA Fingerprinting , DNA, Bacterial/genetics , Electrophoresis, Gel, Pulsed-Field , Exotoxins/genetics , Humans , Leukocidins/genetics , Methicillin-Resistant Staphylococcus aureus/isolation & purification , Microbial Sensitivity Tests , Molecular Epidemiology , Polymerase Chain Reaction , Rural Population , Sequence Analysis, DNA , Trans-Activators/genetics , Western Australia
18.
Eur J Clin Microbiol Infect Dis ; 28(4): 353-61, 2009 Apr.
Article in English | MEDLINE | ID: mdl-18850122

ABSTRACT

The objective was to compare the epidemiology and outcome of healthcare- (HA-) and community-associated (CA-) MRSA bacteraemia. A 10-year retrospective study of MRSA bacteraemia was carried out. Episodes were classified according to established criteria. Molecular typing was performed on a subset of isolates. Of 197 MRSA bacteraemia episodes, 178 (90.4%) were classified as HA-MRSA and 19 (9.6%) as CA-MRSA. All-cause 7- and 30-day mortality rates were similar in the HA and CA-MRSA bacteraemia groups; however, 1-year mortality was higher in the HA-MRSA bacteraemia group (48.3% vs 21.1% [p = 0.023]). Thirty-day all-cause mortality was significantly lower if empiric antimicrobial therapy included agent(s) to which the isolate tested susceptible, compared with patients receiving "inactive" therapy (19% vs 35.1% [p = 0.011]). The majority of MRSA bacteraemia episodes were caused by clones known to circulate in the community. All-cause mortality is as high in HA- as in CA-MRSA bacteraemia. Thirty-day mortality was significantly reduced if the patient received an antibiotic with activity against the MRSA isolate.


Subject(s)
Bacteremia/epidemiology , Community-Acquired Infections/epidemiology , Cross Infection/epidemiology , Methicillin-Resistant Staphylococcus aureus , Staphylococcal Infections/epidemiology , Adolescent , Adult , Aged , Aged, 80 and over , Anti-Bacterial Agents/pharmacology , Bacteremia/drug therapy , Bacteremia/microbiology , Bacteremia/mortality , Child , Community-Acquired Infections/drug therapy , Community-Acquired Infections/microbiology , Community-Acquired Infections/mortality , Cross Infection/drug therapy , Cross Infection/microbiology , Cross Infection/mortality , Female , Humans , Male , Methicillin-Resistant Staphylococcus aureus/drug effects , Methicillin-Resistant Staphylococcus aureus/genetics , Methicillin-Resistant Staphylococcus aureus/isolation & purification , Microbial Sensitivity Tests , Middle Aged , Prognosis , Retrospective Studies , Risk Factors , Staphylococcal Infections/drug therapy , Staphylococcal Infections/microbiology , Staphylococcal Infections/mortality , Statistics, Nonparametric
19.
Vet Pathol ; 46(3): 514-9, 2009 May.
Article in English | MEDLINE | ID: mdl-19098279

ABSTRACT

Mice with null mutations of ciliary neurotrophic factor (Cntf) receptor alpha (Cntf-Ralpha), or cytokine-like factor 1 (Clf), one component of Cntf-II (a heterodimeric Cntf-Ralpha ligand), die as neonates from motor neuron loss affecting the facial nucleus and ventral horn of the lumbar spinal cord. Exposure to cardiotrophin-like cytokine (Clc), the other putative Cntf-II element, supports motor neuron survival in vitro and in ovo. Confirmation that Clc ablation induces an equivalent phenotype to Clf deletion would support a role for Clc in the functional Cntf-II complex. In this study, Clc knockout mice had decreased facial motility, did not suckle, died within 24 hours, and had 32% and 29% fewer motor neurons in the facial nucleus and lumbar ventral horn, respectively; thus, Clc is essential for motor neuron survival during development. The concordance of the Clc knockout phenotype with those of mice lacking Cntf-Ralpha or Clf bolsters the hypothesis that Clc participates in Cntf-II.


Subject(s)
Cytokines/genetics , Cytokines/metabolism , Spinal Cord Diseases/genetics , Animals , Animals, Newborn , Mice , Mice, Knockout , Motor Neurons/pathology , Muscle, Skeletal/innervation , Spinal Cord/pathology , Spinal Cord Diseases/mortality
20.
Vet Rec ; 163(22): 649-54, 2008 Nov 29.
Article in English | MEDLINE | ID: mdl-19043089

ABSTRACT

Between October 2005 and September 2006, all European Union member states were required to carry out standardised surveys of the prevalence of Salmonella in broiler flock holdings to establish baseline data from which to derive national targets for disease reduction. In the uk 382 holdings were sampled, 41 of which were positive for Salmonella, giving an estimated weighted prevalence of 10.7 per cent (95 per cent confidence interval [ci] 8.1 to 13.1 per cent). The serotype most frequently isolated was Salmonella Ohio, with a weighted prevalence of 2.2 per cent (95 per cent ci 1.2 to 3.7 per cent), followed by Salmonella Kedougou at 1.7 per cent (95 per cent ci 0.9 to 3.2 per cent). There were no isolates of Salmonella Enteritidis and only a single isolation of Salmonella Typhimurium (0.2 per cent, 95 per cent ci 0.0 to 1.6 per cent). Of the three other serotypes given top priority by the eu owing to their public health significance, Salmonella Virchow was isolated from one holding, but Salmonella Hadar and Salmonella Infantis were not detected on any of the holdings.


Subject(s)
Chickens , Poultry Diseases/epidemiology , Salmonella Infections, Animal/epidemiology , Salmonella/classification , Salmonella/isolation & purification , Animals , Confidence Intervals , Female , Male , Odds Ratio , Phylogeny , Prevalence , Serotyping , United Kingdom/epidemiology
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