Increased Involvement of Klebsiellapneumoniae and Enterococcusfaecium in Healthcare-Associated Infections of Intensive Care Units in Taiwan.

BACKGROUND: Healthcare-associated infections (HAIs) cause increases in length of stay, mortality, and healthcare costs. A previous study conducted in Taiwan obtained similar results to those reported in Korea and Japan in 2015. Changes in microorganisms have been noted in recent years. Understanding the recent condition of HAIs in intensive care units (ICUs) can enable healthcare providers to develop effective infection control protocols to reduce HAIs. METHODS: We used the Taiwan Nosocomial Infection Surveillance System to evaluate the incidence densities of HAIs, the proportions of causative pathogens, and the proportions of antimicrobial resistance (AMR). The Poisson regression model was constructed to incidence density, and the chi-square test was used to assess proportion. RESULTS: The incidence density of HAIs decreased 5.7 to 5.4 per 1000 person-days. However, the proportions of Klebsiella pneumoniae and Enterococcus faecium significantly increased. In addition, the proportions of carbapenem-resistant K. pneumoniae and vancomycin-resistant Enterococcus faecium significantly increased over time. CONCLUSION: Analysis of the microorganisms involved in HAIs in ICUs showed elevated proportions of K. pneumoniae and E. faecium with AMR. Infection control protocols have been implemented for several years and require improvements regarding environmental cleanliness and medical staff prevention.

Improvement of p-Type AlGaN Conductivity with an Alternating Mg-Doped/Un-Doped AlGaN Layer Structure.

Using molecular beam epitaxy, we prepared seven p-type AlGaN samples of ~25% in Al content, including six samples with Mg-doped/un-doped AlGaN alternating-layer structures of different layer-thickness combinations, for comparing their p-type performances. Lower sheet resistance and higher effective hole mobility are obtained in a layer-structured sample, when compared with the reference sample of uniform Mg doping. The improved p-type performance in a layer-structured sample is attributed to the diffusion of holes generated in an Mg-doped layer into the neighboring un-doped layers, in which hole mobility is significantly higher because of weak ionized impurity scattering. Among the layer-structured samples, that of 6/4 nm in Mg-doped/un-doped thickness results in the lowest sheet resistance (the highest effective hole mobility), which is 4.83 times lower (4.57 times higher) when compared with the sample of uniform doping. The effects of the Mg-doped/un-doped layer structure on p-type performance in AlGaN and GaN are compared.

Green tea (-)-epigallocatechin gallate induced growth inhibition of human placental choriocarcinoma cells.

This study investigated the pathways involved in the effect of green tea epigallocatechin gallate (EGCG) on mitogenesis in BeWo, JEG-3, and JAR placental choriocarcinoma cells. EGCG inhibited cell proliferation in dose-dependent and time-dependent manners, as indicated by the number of cells and incorporation of bromodeoxyuridine (BrdU). A catechin-specific effect of green tea was evident; EGCG was more effective than epicatechin, epicatechin gallate, and epigallocatechin in suppressing cell growth. When all three of the mitogen-activated protein kinase (MAPK) subfamilies, i.e., ERK, p38, and JNK, were examined, EGCG significantly increased levels of phospho-ERK1/2 (pERK1/2) and phospho-p38 (pp38) and did not alter the total protein levels of ERK1/2, p38 MAPK, JNK, and phospho-JNK. EGCG-induced increases in the levels of pERK1/2 and pp38 proteins were prevented by pre-treatment with specific inhibitors of ERK1/2 MAPK and p38 MAPK, respectively. These inhibitors also suppressed EGCG-induced decreases in both cell number and BrdU incorporation. Moreover, pre-treatment with an AMP-activated protein kinase (AMPK) inhibitor prevented the actions of EGCG on proliferation and AMPK phosphorylation. These data suggest that EGCG mediates choriocarcinoma cell growth via the AMPK, ERK, and p38 pathways, but not JNK pathway.

Prevalence of Vibrio parahaemolyticus in oyster and clam culturing environments in Taiwan.

Vibrio parahaemolyticus is the most prevalent gastroenteritis pathogen in Taiwan and some other Asian countries, and it frequently occurs in oysters and other seafood. This study monitors changes in the density of V. parahaemolyticus and environmental parameters in oyster and hard clam aquacultural environments in Taiwan. Water, sediment and shellfish samples were collected from five sampling sites in 2008-2010, and analyzed for environmental physiochemical parameters, numbers of indicator bacteria (total aerobic counts, total coliforms and fecal coliforms), Vibrio and V. parahaemolyticus present. The results for open oyster farms and hard clam ponds did not differ significantly. V. parahaemolyticus was detected in 77.5, 77.5, 70.8 and 68.8% of the water, sediment, oyster and clam samples, respectively. The densities of V. parahaemolyticus were significantly higher in shellfish than in sediment or water samples, with mean values of 1.33, 1.04 and -0.02 Log CFU/g, respectively. Among these five sampling sites, Shengang and Fangyuan yielded significantly different data from those obtained at the other three sites. As determined by linear multiple regression, V. parahaemolyticus density in water samples depended significantly on the precipitation and Vibrio count, while the V. parahaemolyticus density in the sediment or shellfish samples depended significantly on the salinity of the seawater. Among 1076 isolates examined, a total of three putative pathogenic isolates were identified from 2.5% of the examined samples, and these isolates exhibited hemolytic or urease activities and the presence of gene markers for tdh, trh, type III secretion system (T3SS) 1 (vcrD1) or T3SS2α (vcrD2). The results herein may facilitate the assessment of risk associated with this pathogen in Taiwan and other geographically similar regions.