Differences in PrEP Awareness, Discussions with Healthcare Providers, and Use Among Men Who Have Sex with Men in the United States by Urbanicity and Region: A Cross-sectional Analysis.

Pre-exposure prophylaxis (PrEP) is a highly effective HIV prevention intervention and is critical to the Ending the HIV Epidemic strategy. Most PrEP research has been conducted among urban populations; less is known about PrEP awareness, willingness to use, and actual use among rural and suburban populations. We examined these PrEP indicators by United States region and urbanicity among men who have sex with men who responded to the 2019 cycle of the American Men's Internet Survey. Rural and suburban men were less likely than urban men to be aware of PrEP, to have discussed PrEP with a healthcare provider in the past 12 months, and to have ever used PrEP. Smaller differences were observed across regions. Notably, willingness to use PrEP was similar across region and urbanicity. Additional work will be needed to increase PrEP awareness and access among rural and suburban populations.

Secondary contamination of emergency department personnel from o-chlorobenzylidene malononitrile exposure, 2002.

In a hazardous materials event in 2002, the unannounced presentation of 3 symptomatic, contaminated patients to an emergency department (ED) resulted in secondary contamination of 2 ED personnel who experienced skin, eye, and respiratory irritation. The material that caused these injuries was o-chlorobenzylidene malononitrile, a white powder with a peppery odor used largely as a tear gas and riot-control agent. Secondary contamination can cause adverse symptoms and injuries in ED personnel, further contaminate the ED, and potentially lead to costly ED closures and evacuations. To prevent secondary exposure, EDs can educate their staff about the potential for secondary contamination, implement a team approach for handling contaminated patients, establish decontamination protocols, ensure proper selection of and training in the use of personal protective equipment, and simulate drills for receiving contaminated patients.

Multidrug-resistant strains of Salmonella enterica Typhimurium, United States, 1997-1998.

To evaluate multidrug-resistant strains of Salmonella enterica serotype Typhimurium, including definitive type 104 (DT104) in the United States, we reviewed data from the National Antimicrobial Resistance Monitoring System (NARMS). In 1997 to 1998, 703 (25%) of 2,767 serotyped Salmonella isolates received at NARMS were S. Typhimurium; antimicrobial susceptibility testing and phage typing were completed for 697. Fifty-eight percent (402) were resistant to > or = 1 antimicrobial agent. Three multidrug-resistant (> or = 5 drugs) strains accounted for (74%) 296 of all resistant isolates. Ceftriaxone resistance was present in 8 (3%), and nalidixic acid resistance in 4 (1%), of these multidrug-resistant strains. By phage typing, 259 (37%) of S. Typhimurium isolates were DT104, 209 (30%) were of undefined type and 103 (15%) were untypable. Fifty percent (202) of resistant (> or = 1 drug) isolates were DT104. Multidrug-resistant S. Typhimurium isolates, particularly DT104, account for a substantial proportion of S. Typhimurium isolates; ceftriaxone resistance is exhibited by some of these strains.

Antimicrobial resistance among Campylobacter strains, United States, 1997-2001.

We summarize antimicrobial resistance surveillance data in human and chicken isolates of Campylobacter. Isolates were from a sentinel county study from 1989 through 1990 and from nine state health departments participating in National Antimicrobial Resistance Monitoring System for enteric bacteria (NARMS) from 1997 through 2001. None of the 297 C. jejuni or C. coli isolates tested from 1989 through 1990 was ciprofloxacin-resistant. From 1997 through 2001, a total of 1,553 human Campylobacter isolates were characterized: 1,471 (95%) were C. jejuni, 63 (4%) were C. coli, and 19 (1%) were other Campylobacter species. The prevalence of ciprofloxacin-resistant Campylobacter was 13% (28 of 217) in 1997 and 19% (75 of 384) in 2001; erythromycin resistance was 2% (4 of 217) in 1997 and 2% (8 of 384) in 2001. Ciprofloxacin-resistant Campylobacter was isolated from 10% of 180 chicken products purchased from grocery stores in three states in 1999. Ciprofloxacin resistance has emerged among Campylobacter since 1990 and has increased in prevalence since 1997.

Imipenem resistance in a Salmonella clinical strain due to plasmid-mediated class A carbapenemase KPC-2.

A Salmonella enterica serotype Cubana isolate exhibiting resistance to most beta-lactam antibiotics, including oxyimino-cephalosporins and imipenem, was isolated from a 4-year-old boy with gastroenteritis in Maryland. beta-Lactam resistance was mediated by a conjugative plasmid that encoded KPC-2, a class A carbapenemase previously found in a Klebsiella pneumoniae isolate from the Maryland area as well. Sequence analysis of the flanking regions indicated a potential association of bla(KPC-2) with mobile structures.

Public health consequences of use of antimicrobial agents in food animals in the United States.

The use of antimicrobial agents in food animals has caused concern regarding the impact these uses have on human health. Use of antimicrobial agents in animals and humans results in the emergence and dissemination of resistant bacteria. Resistant bacteria from food animals may be passed through the food chain to humans resulting in resistant infections. Increasing resistance to antimicrobial agents that are important in the treatment of human diseases, such as fluoroquinolones and third-generation cephalosporins for the treatment of Salmonella and Campylobacter infections, has significant public health implications. Efforts to mitigate the effects of increasing resistance require collaboration by several partners, including the farming, veterinary, medical, and public health communities.

Introduction; The history of public health and veterinary public service; Historic and future perspectives of the American College of Veterinary Preventive Medicine; Blue ribbon task force report on the future of Food Safety and Inspection Service veterinarians: public health professionals for the 21st century; The National Antimicrobial Resistance Monitoring System (NARMS) for enteric bacteria,1996- 1999: surveillance for action; Public health education of veterinarians and veterinary students for the future; Ten great veterinary public health/preventive medicine achievements in the United States, 1901 to 2000.

Historically, veterinary medicine has made its greatest contributions in the public sector and in settings other than direct care of the individual patient. So why are so many of us unaware of our profession's achievements in this arena? My introduction to veterinary preventive medicine and public health was through military service. My obligation to serve a two-year doctor draft in the United States Air Force became an adventure for my family and me, rather than an unwelcome intrusion on my ultimate desire to return to private clinical practice. The operative words are private and clinical. Why was I unaware of the opportunities available to those of us educated in this discipline sometimes referred to as comparative medicine?