scholarly journals One Health or Three? Transmission modelling of Klebsiella isolates reveals ecological barriers to transmission between humans, animals and the environment

2021 ◽  
Author(s):  
Harry A Thorpe ◽  
Ross Booton ◽  
Teemu Kallonen ◽  
Marjorie J Gibbon ◽  
Natacha Couto ◽  
...  
Keyword(s):  
Public Health ◽  
Clinical Environment ◽  
Opportunistic Pathogens ◽  
Klebsiella Species ◽  
Public Health Burden ◽  
Carbapenem Resistant ◽  
Ecological Barriers ◽  
Wide Range ◽  
Rapid Spread ◽  
The City

The Klebsiella group is highly diverse both genetically and ecologically, being commonly recovered from humans, livestock, plants, soil, water, and wild animals. Many species are opportunistic pathogens, and can harbour diverse classes of antimicrobial resistance (AMR) genes. K. pneumoniae is responsible for a high public-health burden, due in part to the rapid spread of health-care associated clones that are non-susceptible to carbapenems. Klebsiella thus represents a highly pertinent taxon for assessing the risk to public health posed by animal and environmental reservoirs. Here we report an analysis of 6548 samples and 3,482 genome sequences representing 15 Klebsiella species sampled over a 15-month period from a wide range of clinical, community, animal and environmental settings in and around the city of Pavia, in the northern Italian region of Lombardy. Despite carbapenem-resistant clones circulating at a high frequency in the hospitals, we find no genotypic or phenotypic evidence for non-susceptibility to carbapenems outside of the clinical environment. The non-random distribution of species and strains across sources point to ecological barriers that are likely to limit AMR transmission. Although we find evidence for occasional transmission between settings, hierarchical modelling and intervention analysis suggests that direct transmission from the multiple non-human (animal and environmental) sources included in our sample accounts for less than 1% of hospital disease, with the vast majority of clinical cases originating from other humans.

An Important Public Health Problem "Carbapenem Resistant Enterobacteriaceae Frequency": An Example From A Training And Research Hospital

2021 ◽  
Vol 6 (14) ◽  
pp. 51-55
Author(s):  
Ülkü VERANYURT ◽  
Betül AKALIN
Keyword(s):  
Public Health ◽  
Klebsiella Pneumoniae ◽  
Klebsiella Oxytoca ◽  
Public Health Problem ◽  
Important Public Health Problem ◽  
Klebsiella Species ◽  
Research Hospital ◽  
Control Programs ◽  
Carbapenem Resistant ◽  
Training And Research

Background: Carbapenem-resistant Enterobacterales (CRE) infections are a significant threat to public health due to the limited availability of antibiotics and the effect on mortality. This study was conducted retrospectively to determine the prevalence of CRE in a teaching and research hospital in Istanbul. Materials and Methods: In 2016, 2017 and in the first half of 2018 Klebsiella species were evaluated retrospectively in culture samples that were sent to Microbiology Laboratory in an educational hospital. The typing of Klebsiella species were performed with MALDITOF-MS device (Biomerieux, France). Imipenem, merapenem, ertapenem susceptibilities of the strains were evaluated with VITEC2 Compact (Biomerieux, France) according to EUCAST (European Committee on Antimicrobial Susceptibility Testing). If the strains were found to be resistant, the results were confirmed by the antibiotic gradient test. Results: In our study, 257 samples; Klebsiella oxytoca 9 (3.49%) and Klebsiella pneumoniae 248 (96.51%) were detected. 130 endotracheal aspirates, 57 wounds, 34 blood, 15 urine, 9 sputum, 3 catheters, 4 tissue biopsies, 2 mediastinum, 2 peritoneal fluid and 1 pleural fluid strains were identified. While none of the Klebsiella oxytoca strains were resistant to carbapenems, the percentages of Klebsiella pneumoniae resistance against imipenem, merapenem and ertapenem were found to be 23.29%, 16.94% and 29.44% respectively. Conclusion: The increasing problem of carbapenem-resistant (CR) Klebsiella pneumoniae in the last decade has been observed in our hospital for the last 2 years. CR strains often show increased resistance to other antibiotics and their treatment possibilities are limited. It increases the importance of controlling this factor. The application of effective infection control programs and the use of rational antibiotics are of great importance.

Statewide surveillance of carbapenemase-producing carbapenem-resistant Escherichia coli and Klebsiella species in Washington state, October 2012–December 2017

2020 ◽  
Vol 41 (6) ◽  
pp. 716-722
Author(s):  
Mimi R. Precit ◽  
Kelly Kauber ◽  
William A. Glover ◽  
Scott J. Weissman ◽  
Tashina Robinson ◽  
...  
Keyword(s):  
Public Health ◽  
Escherichia Coli ◽  
Health Care ◽  
The United States ◽  
Case Definition ◽  
Washington State ◽  
Public Health Department ◽  
Klebsiella Species ◽  
E Coli ◽  
Carbapenem Resistant

AbstractBackground:Carbapenem-resistant Enterobacterales (CRE) are common causes of healthcare-associated infections and are often multidrug resistant with limited therapeutic options. Additionally, CRE can spread within and between healthcare facilities, amplifying potential harms.Objective:To better understand the burden, risk factors, and source of acquisition of carbapenemase genes in clinical Escherichia coli and Klebsiella spp isolates from patients in Washington to guide prevention efforts.Design:Multicenter prospective surveillance study.Methods:Escherichia coli and Klebsiella spp isolates meeting the Washington state CRE surveillance case definition were solicited from clinical laboratories and tested at Washington Public Health Laboratories using polymerase chain reaction (PCR) for the 5 most common carbapenemase genes: blaKPC, blaNDM, blaIMP, blaVIM, and blaOXA-48. Case patients positive by PCR were investigated by the public health department.Results:From October 2012 through December 2017, 363 carbapenem-resistant E. coli and Klebsiella spp isolates were tested. Overall, 45 of 115 carbapenem-resistant K. pneumoniae (39%), 1 of 8 K. oxytoca (12.5%), and 28 of 239 carbapenem-resistant E. coli (11.7%) were carbapenemase positive. Of 74 carbapenemase-positive isolates, blaKPC was most common (47%), followed by blaNDM (30%), blaOXA-48 (22%), and blaIMP (1%). Although all cases had healthcare exposure, blaKPC acquisition was associated with US health care, whereas non-blaKPC acquisition was associated with international health care or travel.Conclusions:We report that blaKPC, the most prevalent carbapenemase in the United States, accounts for nearly half of carbapenemase cases in Washington state and that most KPC-cases are likely acquired through in-state health care.

scholarly journals Personal Doses of Cocaine and Coca Paste are Adulterated in Cartagena de Indias (Colombia)

2021 ◽  
Vol 2021 ◽  
pp. 1-7
Author(s):  
Jefferson Urzola-Ortega ◽  
Luis Mendoza-Goez ◽  
Diofanor Acevedo
Keyword(s):  
Public Health ◽  
National Security ◽  
Street Drugs ◽  
Qualitative And Quantitative ◽  
Illicit Market ◽  
Wide Range ◽  
Quantitative Analyses ◽  
Cartagena De Indias ◽  
The City ◽  
Maximum Content

Knowledge of drug composition consumed on the streets and the identification and quantification of their adulterants is essential for understanding unexpected side effects, tracking routes, and drug profiling. Therefore, this work aimed to determine the purity and to identify and quantify the main adulterants found in personal doses of cocaine (perico) and coca paste (bazuco) in Cartagena de Indias (Colombia). The data collected in this study describe a first attempt to introduce the qualitative and quantitative analyses of adulterants present in street drugs in Cartagena de Indias to improve surveillance. Through gas chromatography coupled to mass spectrometry (GC-MS), the purity and adulterants were quantified in 45 personal doses of cocaine powder and coca paste. 100% of the personal doses in the city were adulterated; caffeine, phenacetin, and levamisole were the main adulterants identified in cocaine. Besides the above, lidocaine was also found in coca paste. The purity of cocaine varied from 8% to almost 70%, with caffeine ranging from 6% to 42%. In the case of coca paste, the maximum content of cocaine found was 60%, while some samples contained as little as 14%. The results are consistent with other research in terms of the widespread use of caffeine as an adulterant, but they also follow the growing trend of the use of levamisole and phenacetin. The wide range of cocaine content in samples sold in the illicit market could cause undesirable effects on cocaine users who do not know the exact intended dose for consumption; so, this study intends to make these results available not only to academic, public health, and national security agencies but also to tourists entering Cartagena de Indias, so that they are aware of what they are consuming and the risks to which they are exposed.

scholarly journals Insights on carbapenem-resistant Acinetobacter baumannii

2021 ◽  
Vol 65 (1) ◽  
pp. 85-92
Author(s):  
Matthew Gavino Donadu ◽  
Stefania Zanetti ◽  
Ádám László Nagy ◽  
Ibrahim Barrak ◽  
Márió Gajdács
Keyword(s):  
Public Health ◽  
Acinetobacter Baumannii ◽  
Efflux Pump ◽  
Public Health Issue ◽  
Carbapenem Resistant ◽  
Wide Range ◽  
Effective Choice ◽  
Phenotypic Methods ◽  
Resistance Rates ◽  
Critical Public Health

Acinetobacter baumannii (A. baumannii) is an important nosocomial pathogen, which may be a causative agent in a wide-range of human pathologies. Carbapenems are usually considered the last safe and effective choice of drugs for the treatment of Gram-negative infections. The emergence of carbapenem-resistant A. baumannii (CRAB) is a critical public health issue as they leave clinicians with limited therapeutic options. In this study, phenotypic methods were used to characterize sixty-two (n = 62) A. baumannii isolates, which were included based on their suspected non-susceptibility to meropenem. Minimum inhibitory concentrations (MICs) of meropenem, levofloxacin, gentamicin, sulfamethoxazole/trimethoprim, tigecycline were determined using E-tests, while colistin MICs were determined using broth microdilution. The isolates were subjected to the modified Hodge test (MHT), the modified carbapenem-inactivation method (mCIM) and the imipenem/EDTA combined disk test (CDT). Efflux pump overexpression was studied using agar plates containing phenylalanine-arginine β-naphthylamide (PAβN). Assessment of biofilm-formation was carried out using the crystal violet tube-adherence method. 64.5% of the strains showed meropenem MICs in the resistant range (>8 mg/L), resistance rates were similarly high to the other tested antibiotics. The MHT and mCIM assay were positive in 79.0% and 67.7% of cases, respectively; the presence of an MBL was suggested for 29.0% of isolates. Efflux-pump overexpression was seen in 12.9% of isolates. 54.8% of the isolates were characterized as strong biofilm-producers. Microbiology laboratories have an important role in differentiating the distinct mechanisms by which these pathogens develop the CRAB phenotype, as plasmid-borne carbapenemases are significant from the standpoint of public health microbiology.

Plague and Public Health: Treating the Body of the City and the Body of the Poor

2019 ◽  
pp. 84-117
Author(s):  
John Henderson
Keyword(s):  
Public Health ◽  
Vital Role ◽  
The Body ◽  
The Political ◽  
Health Board ◽  
Public Health Policies ◽  
Local Structures ◽  
Marginalised Groups ◽  
Wide Range ◽  
The City

This chapter examines the ways in which the combined administrative and medical expertise informed the developing strategies of the Italian government during the early stages of the epidemic. While conforming to more general public health policies of Italian states, it also considers how far the Florentine experience of plague was mediated through existing local structures and the political status quo. The influence of the Grand Duke of Tuscany, Ferdinand II, remained very evident, as he sought to intervene in and to influence the developing policy of the magistrates of the health board, which was constituted by patricians who were members of his court. Meanwhile, the voluntary lay religious group, the Archconfraternity of the Misericordia, played a vital role in the transport and burial of the sick and the dead. While their porters and grave-diggers were paid, the members of the fraternity themselves performed their tasks from a sense of Christian charity towards the poorer members of society, a motivation which formed the obverse of the government's decrees against marginalised groups, such as prostitutes and Jews. A mixed motivation also informed the strategies of the medical staff in the service of the Sanità (health board), and the chapter looks at their role—sometimes distant, sometimes interventionist and sometimes compassionate—in inspecting the sick and recommending a wide range of treatments for the more affluent and the humble.

The Liverpool City-region Health is Wealth Commission

2010 ◽  
Vol 18 (1) ◽  
pp. 35-46 ◽  
Author(s):  
Susan Woodward ◽  
Clare Devaney
Keyword(s):  
Public Health ◽  
Economic Growth ◽  
Health Status ◽  
Built Environment ◽  
Knowledge Capital ◽  
Business Research ◽  
City Region ◽  
European Capital Of Culture ◽  
Wide Range ◽  
The City

The Liverpool City-region Health is Wealth Commission was established to examine the growing divergence between the City-region’s public health status and its marked economic growth, specifically looking at links between health and productivity, identifying knowledge-gaps, and encouraging a more focused and collaborative alignment between the business, research and public health agendas. Over 18 months of investigation, Commissioners considered a wide range of research-based and plenary evidence from a number of key witnesses. The Commission made 12 final recommendations within six core themes: Alcohol, Smoking & Obesity; Incapacity Benefit; Wellbeing at Work; Beyond the Built Environment; Procurement; and Knowledge Capital. The Commission’s findings were published in September 2008, as part of Liverpool’s European Capital of Culture programme.

Biscogniauxia (Hypoxylon) Canker or Dieback in Trees

EDIS ◽  
2017 ◽  
Vol 2017 (6) ◽  
Author(s):  
Claudia Paez ◽  
Jason A. Smith
Keyword(s):  
Water Stress ◽  
Tree Species ◽  
Soil Compaction ◽  
Urban Areas ◽  
Root Disease ◽  
Poor Health ◽  
Green Spaces ◽  
Opportunistic Pathogens ◽  
Wide Range ◽  
Quercus Spp

Biscogniauxia canker or dieback (formerly called Hypoxylon canker or dieback) is a common contributor to poor health and decay in a wide range of tree species (Balbalian & Henn 2014). This disease is caused by several species of fungi in the genus Biscogniauxia (formerly Hypoxylon). B. atropunctata or B. mediterranea are usually the species found on Quercus spp. and other hosts in Florida, affecting trees growing in many different habitats, such as forests, parks, green spaces and urban areas (McBride & Appel, 2009).  Typically, species of Biscogniauxia are opportunistic pathogens that do not affect healthy and vigorous trees; some species are more virulent than others. However, once they infect trees under stress (water stress, root disease, soil compaction, construction damage etc.) they can quickly colonize the host. Once a tree is infected and fruiting structures of the fungus are evident, the tree is not likely to survive especially if the infection is in the tree's trunk (Anderson et al., 1995).

Death in the City

2017 ◽  
Author(s):  
Kathryn A. Sloan
Keyword(s):  
Scientific Inquiry ◽  
The United States ◽  
Violent Death ◽  
Special Relationship ◽  
Intimate Friend ◽  
Counter Narrative ◽  
Wide Range ◽  
European Heritage ◽  
The City ◽  
The Temple

Popular culture has long conflated Mexico with the macabre. Some persuasive intellectuals argue that Mexicans have a special relationship with death, formed in the crucible of their hybrid Aztec-European heritage. Death is their intimate friend; death is mocked and accepted with irony and fatalistic abandon. The commonplace nature of death desensitizes Mexicans to suffering. Death, simply put, defines Mexico. There must have been historical actors who looked away from human misery, but to essentialize a diverse group of people as possessing a unique death cult delights those who want to see the exotic in Mexico or distinguish that society from its peers. Examining tragic and untimely death—namely self-annihilation—reveals a counter narrative. What could be more chilling than suicide, especially the violent death of the young? What desperation or madness pushed the victim to raise the gun to the temple or slip the noose around the neck? A close examination of a wide range of twentieth-century historical documents proves that Mexicans did not accept death with a cavalier chuckle nor develop a unique death cult, for that matter. Quite the reverse, Mexicans behaved just as their contemporaries did in Austria, France, England, and the United States. They devoted scientific inquiry to the malady and mourned the loss of each life to suicide.

Museum Preserves in the Sphere of “Cultural Tourism”: Through the Example of the Cultural Preserves of Tatarstan

2019 ◽  
Vol 9 (4) ◽  
pp. 193-198
Author(s):  
Lyudmila S. Timofeeva ◽  
Albina R. Akhmetova ◽  
Liliya R. Galimzyanova ◽  
Roman R. Nizaev ◽  
Svetlana E. Nikitina
Keyword(s):  
19Th Century ◽  
Art Museum ◽  
Medium Size ◽  
Business Elite ◽  
Wide Range ◽  
The Subject ◽  
Tourist Center ◽  
Regional Authorities ◽  
The 19Th Century ◽  
The City

Abstract The article studies the existence experience of historical cities as centers of tourism development as in the case of Elabuga. The city of Elabuga is among the historical cities of Russia. The major role in the development of the city as a tourist center is played by the Elabuga State Historical-Architectural and Art Museum-Reserve. The object of the research in the article is Elabuga as a medium-size historical city. The subject of the research is the activity of the museum-reserve which contributes to the preservation and development of the historical look of Elabuga and increases its attractiveness to tourists. The tourism attractiveness of Elabuga is obtained primarily through the presence of the perfectly preserved historical center of the city with the blocks of integral buildings of the 19th century. The Elabuga State Historical-Architectural and Art Museum-Reserve, which emerged in 1989, is currently an object of historical and cultural heritage of federal importance. Museum-reserves with their significant territories and rich historical, cultural and natural heritage have unique resources for the implementation of large partnership projects. Such projects are not only aimed at attracting a wide range of tourists, but also stimulate interest in the reserve from the business elite, municipal and regional authorities. The most famous example is the Spasskaya Fair which revived in 2008 in Elabuga. It was held in the city since the second half of the 19th century, and was widely known throughout Russia. The process of the revival and successful development of the fair can be viewed as the creation of a special tourist event contributing to the formation of new and currently important tourism products.

On the issue of optimization of atmospheric air quality monitoring for the implementation of the Federal project «Clean Air»

2019 ◽  
pp. 931-936
Author(s):  
I. V. May ◽  
A. A. Kokoulina ◽  
S. Yu. Balashov
Keyword(s):  
Public Health ◽  
Air Quality ◽  
Environmental Monitoring ◽  
Monitoring System ◽  
Protection Measures ◽  
Atmospheric Air ◽  
Monitoring Programs ◽  
Clean Air ◽  
Effectiveness And Efficiency ◽  
The City

Introduction. The city of Chita of Zabaikalsky region is one of the cities of Russia, priority on level of pollution of atmosphere. Of the order of 130 impurities emitted by the sources of the city, 12 are monitored at 5 posts of the Roshydromet network. Maximum monthly average concentrations are formed by benz (a) pyrene (up to 56.8 MPC), hydrogen sulfide (12.3 MPC), suspended particles (up to 4PDC), phenol (up to 3.6 MPC). Significant emissions (59.73 thousand tons in 2018) are aggravated by the use of coal as a fuel by heat and power enterprises and the private sector, climatic and geographical features. Within the framework of the Federal project “Clean Air” of the national project “Ecology”, it is envisaged to reduce the gross emission of pollutants into the atmosphere of Chita by 8.75 thousand tons by 2024, which should lead to a significant improvement in the safety and quality of life of citizens. It is necessary to identify the most “risky “components of pollution for health.It is important to understand: whether the environmental monitoring system reflects the real picture of the dangers posed by pollution of the city’s atmosphere; whether there is a need to optimize the monitoring system for the subsequent assessment of the effectiveness and efficiency of measures; what impurities and at what points should be monitored in the interests of the population, administration and economic entities implementing air protection measures.The aim of the study is to develop recommendations for optimizing the program of environmental monitoring of air quality in the city of Chita, taking into account the criteria of danger to public health for the subsequent evaluation of the effectiveness and effectiveness of the Federal project “Clean Air”.Materials and methods. Justification of optimization of monitoring programs was carried out through the calculation of hazard indices, considering: the mass of emissions and toxicological characteristics of each chemical; the population under the influence. A vector map of the city with a layer “population density” was used as a topographic base. The indices were calculated for regular grid cells covering the residential area. For each cell, the repeatability of winds of 8 points from the priority enterprises and the population within the calculated cell were taken into account. As a result, each calculation cell was characterized by a total coefficient, taking into account the danger of potential impacts of emissions. Based on the results of the assessments, recommendations were formulated to optimize the placement of posts in the city and the formation of monitoring programs.Results. Indices of carcinogenic danger to the health of the population of Chita ranged from 584,805. 96 to 0.03 (priorities: carbon (soot), benzene, benz (a) pyrene); indices of non-carcinogenic danger — from 1,443,558. 24 to 0.00 (priorities: sulfur dioxide, inorganic dust containing 70–20% SiO2, fuel oil ash). The greatest danger to public health stationary sources of emissions form in the North-Western, Western and South-Eastern parts of the city. Roshydromet posts in these zones are absent.Conclusions. As part of the objectives of the project “Clean Air”, it is recommended to Supplement the existing state network of observations of atmospheric air quality in Chita with two posts; to include manganese, xylene, vanadium pentoxide in the monitoring programs, to carry out the determination of Benz(a)pyrene et all posts, which will allow to fully and adequately assess the danger of emissions of economic entities, as well as the effectiveness and efficiency of the provided air protection measures.

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