Evaluation of antimicrobial susceptibility testing of Nocardia spp. isolates by broth microdilution with resazurin and spectrophotometry.

BACKGROUND: Nocardia species are ubiquitous in natural environments and can cause nocardiosis. In the present study, the use of Resazurin salt and Spectrophotometry were proposed as alternative methods to reduce subjectivity in the interpretation of susceptibility results to antimicrobials by the broth microdilution method for Nocardia spp. RESULTS: The susceptibility of Nocardia spp. isolates to Amikacin, Ciprofloxacin, Minocycline and Trimethoprim-Sulfamethoxazole was evaluated by Minimum Inhibitory Concentration (MIC) determinations by the broth microdilution method. To verify cellular growth, the colour-changing dye Resazurin was applied, the Optical Densities were measured on a spectrophotometer, and both were compared to Clinical and Laboratory Standards Institute (CLSI) Gold Standard method (visual MIC determination). Percentages of essential and categorical agreements and interpretative categorical errors were calculated within each method (intra-reading) and between them (inter-reading). The Gold Standard visual reading demonstrated 100% of essential and categorical intra-reading agreements for Amikacin, and there was no error when compared with the alternative methods. For Ciprofloxacin, the comparison between the Gold Standard and the Spectrophotometric reading showed 91.5% of essential agreement. In the categorical intra-reading analysis for Minocycline, there were 88.1 and 91.7% in the Gold Standard and in the Spectrophotometric readings, respectively, and 86.4% of concordance between them. High rates of categorical agreement were also observed on the Trimethoprim-Sulfamethoxazole analyses, with 93.7% for the Gold Standard, 84.9% for the Resazurin readings, and 80.5% between them. CONCLUSIONS: The alternative methods with Resazurin and Spectrophotometric readings showed high agreement rates with the Gold Standard.

Minority stress, social integration, and the mental health needs of LGBTQ asylum seekers in North America.

OBJECTIVE: Drawing on theoretical accounts of LGBTQ minority stress and models of social integration and immigrant health, the present study examines sexual and gender minority status - heretofore overlooked in crossnational frameworks of immigrant health - as an important determinant of asylum seeker mental health. With the goal of spurring intervention development among this population, this study also aims to characterize LGBTQ asylum seekers' interest in interventions aimed at alleviating minority stress, barriers to social integration, and associated mental distress. METHOD: Respondents (n = 308) completed an online survey which included the Refugee Health Screener (RHS-15), and a battery of measures of minority stressors and barriers to social integration. RESULTS: Most respondents (80.20%) screened positive for mental distress. Consistent with minority stress theory, loneliness (OR = 1.14, 95% CI = 1.11, 1.16) and LGBTQ identity disclosure (OR = 3.46, 95% CI = 1.85, 6.50) were strongly associated with screening positive for mental distress. Consistent with theories of immigrant social integration, those who had been granted asylum (OR = 0.36, 95% CI = 0.25, 0.53) or had higher English language proficiency (OR = 0.35, 95% CI = 0.21, 0.60) were less likely to screen positive. In an exploratory analysis, the association between transgender identity and mental distress approached significance (OR = 3.60, 95% CI = 1.00, 7.2). As preliminary justification for applying these findings to practice, most of those who screened positive for distress were interested in receiving mental health counseling (70.45%). Most participants wanted more LGBTQ friends (83.1%), wanted to mentor an LGBTQ newcomer (83.8%), and were interested in joining an LGBTQ community center (68.2%). CONCLUSION: This study demonstrates that LGBTQ asylum seekers are highly likely to experience mental distress that is influenced by unique social factors, including barriers to social integration, and are motivated to participate in interventions aimed at addressing their mental health needs.

Prevalence of Crimean-Congo hemorrhagic fever virus antibodies in Greek residents in the area where the AP92 strain was isolated.

BACKGROUND: Crimean-Congo hemorrhagic fever (CCHF) is a viral disease with fatality rate up to 30%. Up to date, only one CCHF case has been reported in Greece, while a distinct virus strain (AP92) had been isolated in 1975 from ticks in Imathia prefecture, northern Greece. The aim of the present study was to estimate the CCHF virus (CCHFV) seroprevalence among humans residing in the prefecture of Imathia, and the neighboring prefecture of Pella, and to investigate the risk factors associated with the seropositivity. MATERIAL AND METHODS: A total of 277 persons randomly selected from the general population were tested for the presence of CCHFV IgG antibodies. Additional 51 persons belonging in groups with risk for acquisition of CCHFV infection (19 slaughterhouse workers and 32 hunters) were also tested. All participants filled in a questionnaire related to demographics and probable risk factors (e.g. occupation, former tick bite, animal contact). RESULTS: Six of the 277 (2.2%) persons were found to carry CCHFV IgG antibodies: 3 in Imathia and 3 in Pella prefecture, resulting in seroprevalence of 1.7% and 2.9%, respectively. History of tick bite, residence in a hilly territory and increased age were significantly associated with CCHFV seropositivity. None of the slaughterers was found IgG-positive, while CCHFV IgG antibodies were detected in a 67-year old hunter who reported agricultural activities and a former tick bite. CONCLUSIONS: A relatively low seroprevalence is observed in the area where the AP92 strain has been isolated, with tick bite being significantly associated with CCHFV seropositivity. Further studies in ticks in the area will show whether are they infected by the AP92 strain or other more pathogenic CCHFV strains and at which rate.

Relationship of glomerular filtration rate and serum CK activity after resistance exercise in women.

The aim of study was to assess the correlation between the changes in serum CK activity after a resistance exercise and renal function measured by glomerular filtration rate (eGFR). Twenty-nine trained women (32 ± 10 years; 157 ± 4 cm; 58.8 ± 6.4 kg) performed a resistance exercise session with 17 exercises with 3 × 12 repetitions in a circuit training fashion. Subjects provided blood samples prior to exercise session (PRE), and at 24, 48, and 72 h following exercise session for creatine kinase (CK) and creatinine. 24-Urine samples were collected before and 72 h after exercises. eGFR was obtained by the three most recommended methods (MDRD; MCQE; Cockcroft-Gault). After the exercise session, serum CK activity increase up 1.68 times (P < 0.01). Serum creatinine increased 25.5% (P = 0.0000) while urinary creatinine decreased on average 6.4% (P = 0.0422). eGFR decreased in all formulas: MDRD by 21.5%, MCQE by 14.2%, and C-G by 17% (all with P < 0.01). Ccr also decreased (-22.9%, P < 0.01). The index of correlation was significant for MDRD (r = -0.924; P < 0.01), C-G (r = -0.884; P < 0.01), and MQCE (r = -0.644; P < 0.05). In conclusion, we observed a significant negative correlation between CK activity and the eGFR indices of renal function.

Variable outcome of growth hormone administration in respiratory chain deficiency.

Genetic defects of oxidative phosphorylation (OXPHOS) are known to account for a variety of neuromuscular and non-neuromuscular symptoms in childhood, including growth hormone (GH) deficiency. However GH administration for GH deficiency is controversial in OXPHOS deficiencies as GH is a mitosis-stimulator which may increase energy demand for cell proliferation. Here, we report the observation of four unrelated children with OXPHOS deficiency or bearing a mitochondrial DNA rearrangement and growth retardation, who required GH therapy. The first patient had no GH deficiency while the other three had low GH response to test stimulations. The condition of the first two patients quickly deteriorated under GH administration, GH was then stopped and subsequent clinical improvement was noted. In the other two patients, no adverse event was noted but various additional organs were involved following GH administration. In all patients, no benefit was observed concerning growth response as growth speed remained unchanged. These observations question the use of GH as a treatment of growth retardation for patients with OXPHOS deficiency.