Magnesium in cystic fibrosis - Systematic review of the literature

BACKGROUND The metabolism of sodium, potassium, and chloride and the acid-base balance are sometimes altered in cystic fibrosis. Textbooks and reviews only marginally address the homeostasis of magnesium in cystic fibrosis. METHODS We performed a search of the Medical Subject Headings terms (cystic fibrosis OR mucoviscidosis) AND (magnesium OR hypomagnes[a]emia) in the US National Library of Medicine and Excerpta Medica databases. RESULTS We identified 25 reports dealing with magnesium and cystic fibrosis. The results of the review may be summarized as follows. First, hypomagnesemia affects more than half of the cystic fibrosis patients with advanced disease; second, magnesemia, which is normally age-independent, relevantly decreases with age in cystic fibrosis; third, aminoglycoside antimicrobials frequently induce both acute and chronic renal magnesium-wasting; fourth, sweat magnesium concentration was normal in cystic fibrosis patients; fifth, limited data suggest the existence of an impaired intestinal magnesium balance. Finally, stimulating observations suggest that magnesium supplements might achieve an improvement in respiratory muscle strength and mucolytic activity of both recombinant and endogenous deoxyribonuclease. CONCLUSIONS The first comprehensive review of the literature confirms that, despite being one of the most prevalent minerals in the body, the importance of magnesium in cystic fibrosis is largely overlooked. In these patients, hypomagnesemia should be sought once a year. Furthermore, the potential of supplementation with this cation deserves more attention.

Antibiotic susceptibility and resistance among bacterial enteropathogens isolated from international travelers to Mexico, Guatemala, and India, 2006--2008

The incidence rates of travelers' diarrhea (TD) have remained unchanged for the last fifty years. More recently, there have been increasing recommendations for self-initiated therapy and even prophylactic therapy for TD. There is no recent data on the in vitro activities of commonly used antibiotics for TD therapy and whether there have been any changes in susceptibilities over the last ten years. 456 enteropathogens were isolated from adult travelers to Mexico, India, and Guatemala between the years 2006 to 2008. MICs were determined for 10 different antimicrobials by the agar dilution method. Traditional antibiotics such as ampicillin, trimethoprim/sulfamethoxazole, and doxycycline continue to show high levels of resistance. Current first line antibiotic agents including fluoroquinolones and azithromycin had significantly higher MICs when compared to 10 years ago and MIC90 levels were beyond the CSLI cutoffs for resistance. There were significant geographical differences in resistance patterns when comparing Central America with India. Entertoxigenic Escherichia coli (ETEC) isolates were more resistant to ciprofloxacin (p=0.023), and levofloxacin (p=0.0078) in India; whereas, enteroaggregative Escherichia coli (EAEC) isolates from Central America showed more resistance. When compared to MICs of isolates 10 years prior, there was a four to ten-fold increase in MIC90s for ceftriaxone, ciprofloxacin, levofloxacin and azithromycin for both ETEC and EAEC. There were no significant changes in rifaximin MICs over the last ten years, which makes it a promising agent for TD. Rising MICs over time implicate the need for continuous surveillance of susceptibility patterns worldwide and for geography specific recommendations in TD therapy.^

Potential role of statins as immunomodulators in pneumococcal pneumonia

Background: Mortality in pneumococcal pneumonia remains as high as 20%, and most deaths occur within the first two weeks of hospitalization despite eradication of the causative organisms by antimicrobials in the first 24 hours. An inflammatory response rather than active infection could be responsible for this early mortality. Statins have been shown to have potent immunomodulatory activity in vitro. We investigated whether there was decreased severity or improved outcome in patients who were receiving statins at the time they were admitted for pneumococcal pneumonia. ^ Methods: Patients seen at the Michael E. DeBakey Veterans Affairs Medical Center in Houston, Texas from January, 2000 to June, 2010 with a diagnosis of pneumococcal pneumonia were included in this retrospective cohort study. Electronic medical records were reviewed to record demographic characteristics, comorbidities, laboratory values and statin use at the time of admission. Severity of pneumonia was determined using the Pneumonia Outcomes Research Team (PORT) classification. Uni- and multivariate Cox regression was used to evaluate survival. We adjusted for all variables in the multivariate model if they were significant in the univariate model at p<0.05. ^ Results: Of 347 patients admitted for pneumococcal pneumonia, 90 (25.9%) were taking statins at the time of presentation. Patients in the statin group were older (age: 68.0±9.7 vs. 62.5±12.3 years, p<0.001) and had higher prevalence of diabetes, coronary artery disease and kidney disease (p<0.05 for each comparison). Liver disease and alcohol consumption were less prevalent among statin users (p<0.05). The PORT scores were normally distributed in both groups with statin users having higher mean scores at admission as compared to patients not on statins (108±32 vs. 96±32, p = 0.002). The Cox proportional hazard analyses, adjusted for age, comorbidities, length of stay and PORT scores, showed a significantly reduced risk of mortality among statin users at 14 days (HR: 0.39; 0.15-0.98, p=0.045), 20 days (0.35; 0.14- 0.88, p=0.03) and 30 days(0.41; 0.17-0.95, p=0.01) after presentation. ^ Conclusion: Statin use is associated with improved clinical outcomes in patients with pneumococcal pneumonia.^

Importance of antibiotic class to the development of Clostridium difficile infection (CDI) in adults: A systematic review

C. difficile causes gastrointestinal infections in humans, including severe diarrhea. It is implicated in 20%-30% of cases of antibiotic-associated diarrhea, in 50%-70% of cases of antibiotic-associated colitis, and in >90% of cases of antibiotic-associated pseudomembranous colitis. Exposure to antimicrobial agent, hospitalization and age are some of the risk factors that predispose to CDI. Virtually all hospitalized patients with nosocomially-acquired CDI have a history of treatment with antimicrobials or neoplastic agent within the previous 2 months. The development of CDI usually occurs during treatment with antibiotics or some weeks after completing the course of the antibiotics. ^ After exposure to the organism (often in a hospital), the median incubation period is less than 1 week, with a median time of onset of 2days. The difference in the time between the use of antibiotic and the development of the disease relate to the timing of exogenous acquisition of C. difficile. ^ This paper reviewed the literature for studies on different classes of antibiotics in association with the rates of primary CDI and RCDI from the year 1984 to 2012. The databases searched in this systematic review were: PubMed (National Library of Medicine) and Medline (R) (Ovid). RefWorks was used to store bibliographic data. ^ The search strategy yielded 733 studies, 692 articles from Ovid Medline (R) and 41 articles from PubMed after removing all duplicates. Only 11 studies were included as high quality studies. Out of the 11 studies reviewed, 6 studies described the development of CDI in non-CDI patients taking antibiotics for other purposes and 5 studies identified the risk factors associated with the development of recurrent CDI after exposure to antibiotics. ^ The risk of developing CDI in non-CDI patients receiving beta lactam antibiotics was 2.35%, while fluoroquinolones, clindamycin/macrolides and other antibiotics were associated with 2.64%, 2.54% and 2.35% respectively. Of those who received beta lactam antibiotic, 26.7% developed RCDI, while 36.8% of those who received any fluoroquinolone developed RCDI, 26.5% of those who received either clindamycin or macrolides developed RCDI and 29.1% of those who received other antibiotics developed RCDI. Continued use of non-C. difficile antibiotics especially fluoroquinolones was identified as an important risk factor for primary CDI and recurrent CDI. ^

Bacteremia and mortality within 30 days of catheter-associated bacteriuria

Background: The distinction between catheter-associated asymptomatic bacteriuria (CAABU) and catheter-associated urinary tract infection (CAUTI) has only recently been widely appreciated. Our aims were to describe the relationship between CAUTI/CAABU and subsequent bacteremia and to investigate whether CAUTI/CAABU and antimicrobial use was associated with either bacteremia or mortality within 30 days. ^ Methods: Our study design was retrospective cohort. Patients with a urinary catheter and a positive urine culture between October 2010 and June 2011 at a large tertiary care facility were included. A multivariable model for analysis was constructed which controlled for age, race, Charlson co-morbidity score, catheter type and duration, category of organism,antimicrobials and classification of the catheter-associated bacteriuria as CAUTI or CAABU. ^ Results: Data from 444 catheter associated urine culture episodes in 308 unique patients were included in the analysis. Overall mortality was 21.1% (61 of 308 patients) within 30 days. Among the 444 urine culture episodes, 402 (90.5%) of these episodes were associated with antibiotic use. 52 (11.7%) of episodes were associated with bacteremia, but only 3 episodes of bacteremia (0.7% of 444 CAB episodes) were caused by an organism from the urinary tract. One of these episodes was CAABU and the other 2 were CAUTI. Bacteremia within 30 days was associated with having CAUTI rather than CAABU and having an indwelling urinary catheter rather than a condom catheter. The variables which were found to be significant for mortality within 30 days were a higher Charlson co-morbidity score and the presence of Candida in the urine culture. Use of antimicrobial agents to treat the bacteriuria was not associated with an increase or decrease in either bacteremia or mortality. ^ Conclusions: Our findings call into question the practice of giving antimicrobial agents to treat bacteriuria in an inpatient population with nearly universal antimicrobial use. A better practice may be targeted treatment of bacteriuria in patients with risk factors predictive of bacteremia and mortality.^

Bacteria lacking a multidrug pump: A sensitive tool for drug discovery

Microorganisms express multidrug resistance pumps (MDRs) that can confound antibiotic discovery. We propose the use of mutants deficient in MDRs to overcome this problem. Sensitivity to quinolones and to amphipathic cations (norfloxacin, benzalkonium chloride, cetrimide, pentamidine, etc.) was increased 5- to 30-fold in a Staphylococcus aureus mutant with a disrupted chromosomal copy of the NorA MDR. NorA was required both for increased sensitivity to drugs in the presence of an MDR inhibitor and for increased rate of cation efflux. This requirement suggests that NorA is the major MDR protecting S. aureus from the antimicrobials studied. A 15- to 60-fold increase in sensitivity to antimicrobials also was observed in wild-type cells at an alkaline pH that favors accumulation of cations and weak bases. This effect was synergistic with a norA mutation, resulting in an increase up to 1,000-fold in sensitivity to antimicrobials. The usefulness of applying MDR mutants for natural product screening was demonstrated further by increased sensitivity of the norA− strain to plant alkaloid antimicrobials, which might be natural MDR substrates.

Antimicrobial Activity of Monoramnholipids Produced by Bacterial Strains Isolated from the Ross Sea (Antarctica)

Acknowledgments This work was supported by the EU FP7 KBBE 2012–2016 project PharmaSea, grant N° 312184 and from the Italian Cystic Fibrosis Research foundation (Grant FFC#12/2011).

Synergy in a medicinal plant: Antimicrobial action of berberine potentiated by 5′-methoxyhydnocarpin, a multidrug pump inhibitor

Multidrug resistance pumps (MDRs) protect microbial cells from both synthetic and natural antimicrobials. Amphipathic cations are preferred substrates of MDRs. Berberine alkaloids, which are cationic antimicrobials produced by a variety of plants, are readily extruded by MDRs. Several Berberis medicinal plants producing berberine were found also to synthesize an inhibitor of the NorA MDR pump of a human pathogen Staphylococcus aureus. The inhibitor was identified as 5′-methoxyhydnocarpin (5′-MHC), previously reported as a minor component of chaulmoogra oil, a traditional therapy for leprosy. 5′-MHC is an amphipathic weak acid and is distinctly different from the cationic substrates of NorA. 5′-MHC had no antimicrobial activity alone but strongly potentiated the action of berberine and other NorA substrates against S. aureus. MDR-dependent efflux of ethidium bromide and berberine from S. aureus cells was completely inhibited by 5′-MHC. The level of accumulation of berberine in the cells was increased strongly in the presence of 5′-MHC, indicating that this plant compound effectively disabled the bacterial resistance mechanism against the berberine antimicrobial.

Estado sanitário do jacaré-de-papo-amarelo (Caiman latirostris) em paisagens antropizadas no Estado de São Paulo

O jacaré-de-papo (Caiman latirostris) é considerado um crocodiliano de médio porte que apresenta uma ampla distribuição latitudinal na América do Sul. Possivelmente a espécie possui a situação mais complexa entre os crocodilianos brasileiros quanto ao aspecto da conservação, basicamente porque suas populações encontram-se fragmentadas em grande parte de sua área de distribuição original e por utilizarem áreas com fortes atividades antrópicas. Embora a espécie possua aparentemente um processo adaptativo frente a estas pressões, um aspecto fisiológico pode ainda sofrer rápida alteração quando submetido a elas: o estado sanitário. Desta maneira, este estudo objetivou determinar o estado sanitário do maior predador aquático, utilizando duas áreas distintas no Estado de São Paulo, através da determinação dos perfis hematológicos e bioquímicos do sangue, além da caracterização da microbiota oral, servindo de modelo à conservação da espécie em ambientes alterados. No primeiro capítulo foram determinados o perfil hematológico e bioquímico do sangue utilizando-se 29 indivíduos (19 machos e 10 fêmeas) capturados em Angatuba e 11 indivíduos (2 machos, 4 fêmeas e 5 filhotes) capturados em Cubatão. Diferenças estatísticas significativas foram encontradas nos valores de creatinina na comparação entre fêmeas de ambas as áreas de estudo (p = 0,033) e nos valores de alanina aminotransferase (p = 0,003), hemácias (p = 0,034), hemoglobina (p = 0,049) e volume corpuscular médio (p = 0,027) quando da comparação entre sexos. No segundo capítulo determinou-se a microbiota oral destes animais através do isolamento, identificação e caracterização bacteriana, em conjunto com o teste de perfil de susceptibilidade aos antimicrobianos. Foram determinados 14 diferentes tipos de bactérias na área de Angatuba, sendo uma classificada como baciliforme aeróbio Gram-positivo, uma como bacilo Gram-negativo e 12 classificadas como Enterobactérias Gram-negativas. Na área de Cubatão foram isolados cinco tipos de bactérias, sendo quatro classificadas como Enterobactérias Gram-negativas e uma como baciliforme aeróbio Gram-positivo. Considerando que o uso de antimicrobianos é um processo primário no tratamento de animais e pessoas, principalmente nos casos que envolvam infecções provocadas pela interação homem x animais, para ambas as áreas de estudo, as quinolonas Enrofloxacina e Norfloxacina, além do aminoglicosídeo Gentamicina, foram os antimicrobianos que apresentaram os menores índices de resistência frente aos isolados testados.

Réaction d’amination intramoléculaire de liens C-H à partir de N-mésyloxycarbamates catalysée par des complexes de rhodium et d’autres métaux de transition : s ynthèse verte d’oxazolidinones

La réaction d’amination de liens C-H, impliquant la transformation directe d’un lien C-H en lien C-N constitue une approche synthétique d’avenir pour la préparation de composés azotés. L’application de cette stratégie de manière intramoléculaire apparaît comme une approche puissante pour la synthèse de composés hétérocycliques. En particulier, les oxazolidinones, carbamates cycliques à cinq chaînons, constituant une nouvelle classe d’antibiotiques très prometteuse, pourraient être synthétisées par cette méthode. Il y a moins d’une dizaine d’années, notre groupe de recherche a travaillé sur le développement de méthodologies utilisant des espèces nitrènes métalliques pour l’amination intra et intermoléculaire. Les N-tosyloxycarbamates, en présence d’une base et d’un catalyseur dimère de rhodium (II) tétracarboxylate sont les précurseurs de ces espèces nitrènes métalliques, capables de faire l’insertion de liens C(sp3)-H. Dans ces travaux de thèse, nous avons travaillé sur le développement d’une méthode plus « verte » d’amination intramoléculaire. Les N-mésyloxycarbamates, plus légers que leurs homologues N-tosyloxycarbamates, ont été identifiés comme d’excellents précurseurs de nitrènes. La méthodologie développée ne nécessite que 3 mol % de dimère de rhodium Rh2(tpa)4 et de 1,5 équivalents de solution aqueuse saturée de K2CO3, le tout dans l’acétate d’éthyle et donne de bons rendements de cyclisation. Une étude de l’étendue réactionnelle a été effectuée, montrant la tolérance et les limitations de notre système catalytique : les hétéroatomes ne posent pas de problèmes hormis l’atome d’azote, qui doit être protégé afin de garantir la transformation. En outre, nous avons constaté que les liens C-H aliphatiques secondaires sont moins réactifs que les liens tertiaires. Après avoir tenté de développer des conditions réactionnelles spécifiques aux liens C-H non activés, nous avons montré la possibilité d’aminer des liens C-H propargyliques de manière chimiosélective ; la triple liaison C-C peut ensuite être dérivatisée efficacement, donnant accès à la formule saturée correspondante ainsi qu’à d’autres motifs. Dans un désir de substituer les complexes de rhodium par d’autres complexes de métaux plus abondants et moins dispendieux, nous nous sommes tournés, dans un premier temps, vers les complexes de fer et par la suite, vers les pinceurs de nickel. Les phtalocyanines de fer ont été identifiées comme étant de bons catalyseurs de l’amination intramoléculaire de N-mésyloxycarbamates. Le chlorure de phtalocyanine de fer (III), en présence d’un sel de AgBF4 et de K2CO3, dans le 1,1,2,2-tétrachloroéthane anhydre, permet l’obtention de la 4-phenyloxazolidin-2-one avec 63% de rendement. En outre, il est possible d’atteindre un rendement de 49% à partir du même substrat N-mésyloxycarbamate, par catalyse avec un pinceur de nickel de type POCN, en présence d’un sel de mésylate. Des indices sur le mécanisme des ces deux transformations ont pu être recueillis lors de la courte étude de ces systèmes.

Frequência de resistência a múltiplos fármacos em pseudomonas aeroginosa

A multirresistência bacteriana tem crescido significativamente nos últimos anos. Entre os gram negativos a P. aeruginosa demonstra facilidade de desenvolvimento de resistência aos antibióticos. O objetivo deste estudo foi determinar a frequência de resistência a múltiplos fármacos em isolados de Pseudomonas aeruginosa e detectar cepas multirresistentes em um hospital público de Maceió/AL. De forma retrospectiva, descritiva e transversal, entre janeiro de 2012 a dezembro de 2013, iniciou-se uma ampla análise documental dos registros de atendimento no setor de Microbiologia do Hospital Universitário Professor Alberto Antunes (HUPAA/UFAL) para avaliar o material obtido de pacientes que apresentaram cultura positiva para P. aeruginosa. Vários espécimes clínicos foram obtidos e as cepas identificadas fenotipicamente pelo método automatizado Vitek®, bem como as análises do perfil de susceptibilidade aos antimicrobianos, seguindo os critérios adotados pelo National Committee for Clinical and Laboratory Standards (NCCLS). Foram obtidas 78 culturas com isolados positivos para P. aeruginosa, sendo a maioria procedente de pacientes da UTI geral (47,4%), seguida da Clínica cirúrgica (16,7%). Entre as amostras clínicas analisadas, a secreção traqueal foi a de maior incidência com 25,6%, seguida de secreção de ferida (20,5%) e escarro (18%). O composto mais ativo contra a P. aeruginosa foi a Colistina (100,0%). Detectou-se elevada multirresistência de P. aeruginosa aos betalactâmicos, cefalosporinas e carbapenêmicos. Baseando-se nos dados apresentados, torna-se evidente a necessidade de um monitoramento rotineiro do perfil de sensibilidade desta bactéria em ambiente hospitalar, sendo de extrema utilidade para a escolha adequada na terapêutica empírica, proporcionando conhecimento prévio dos antimicrobianos que apresentam boa eficácia diante deste patógeno, favorecendo o uso racional de antimicrobianos. PALAVRAS-CHAVE: Multirresistência; Pseudomonas aeruginosa;Sensibilidade; Antimicrobianos.

Medicinal plants - prophylactic and therapeutic options for gastrointestinal and respiratory diseases in calves and piglets? A systematic review.

BACKGROUND Gastrointestinal and respiratory diseases in calves and piglets lead to significant economic losses in livestock husbandry. A high morbidity has been reported for diarrhea (calves ≤ 35 %; piglets ≤ 50 %) and for respiratory diseases (calves ≤ 80 %; piglets ≤ 40 %). Despite a highly diverse etiology and pathophysiology of these diseases, treatment with antimicrobials is often the first-line therapy. Multi-antimicrobial resistance in pathogens results in international accordance to strengthen the research in novel treatment options. Medicinal plants bear a potential as alternative or additional treatment. Based on the versatile effects of their plant specific multi-component-compositions, medicinal plants can potentially act as 'multi-target drugs'. Regarding the plurality of medicinal plants, the aim of this systematic review was to identify potential medicinal plant species for prevention and treatment of gastrointestinal and respiratory diseases and for modulation of the immune system and inflammation in calves and piglets. RESULTS Based on nine initial sources including standard textbooks and European ethnoveterinary studies, a total of 223 medicinal plant species related to the treatment of gastrointestinal and respiratory diseases was identified. A defined search strategy was established using the PRISMA statement to evaluate 30 medicinal plant species starting from 20'000 peer-reviewed articles published in the last 20 years (1994-2014). This strategy led to 418 references (257 in vitro, 84 in vivo and 77 clinical trials, thereof 48 clinical trials in veterinary medicine) to evaluate effects of medicinal plants and their efficacy in detail. The findings indicate that the most promising candidates for gastrointestinal diseases are Allium sativum L., Mentha x piperita L. and Salvia officinalis L.; for diseases of the respiratory tract Echinacea purpurea (L.) MOENCH, Thymus vulgaris L. and Althea officinalis L. were found most promising, and Echinacea purpurea (L.) MOENCH, Camellia sinensis (L.) KUNTZE, Glycyrrhiza glabra L. and Origanum vulgare L. were identified as best candidates for modulation of the immune system and inflammation. CONCLUSIONS Several medicinal plants bear a potential for novel treatment strategies for young livestock. There is a need for further research focused on gastrointestinal and respiratory diseases in calves and piglets, and the findings of this review provide a basis on plant selection for future studies.

Réaction d’amination intramoléculaire de liens C-H à partir de N-mésyloxycarbamates catalysée par des complexes de rhodium et d’autres métaux de transition : s ynthèse verte d’oxazolidinones

La réaction d’amination de liens C-H, impliquant la transformation directe d’un lien C-H en lien C-N constitue une approche synthétique d’avenir pour la préparation de composés azotés. L’application de cette stratégie de manière intramoléculaire apparaît comme une approche puissante pour la synthèse de composés hétérocycliques. En particulier, les oxazolidinones, carbamates cycliques à cinq chaînons, constituant une nouvelle classe d’antibiotiques très prometteuse, pourraient être synthétisées par cette méthode. Il y a moins d’une dizaine d’années, notre groupe de recherche a travaillé sur le développement de méthodologies utilisant des espèces nitrènes métalliques pour l’amination intra et intermoléculaire. Les N-tosyloxycarbamates, en présence d’une base et d’un catalyseur dimère de rhodium (II) tétracarboxylate sont les précurseurs de ces espèces nitrènes métalliques, capables de faire l’insertion de liens C(sp3)-H. Dans ces travaux de thèse, nous avons travaillé sur le développement d’une méthode plus « verte » d’amination intramoléculaire. Les N-mésyloxycarbamates, plus légers que leurs homologues N-tosyloxycarbamates, ont été identifiés comme d’excellents précurseurs de nitrènes. La méthodologie développée ne nécessite que 3 mol % de dimère de rhodium Rh2(tpa)4 et de 1,5 équivalents de solution aqueuse saturée de K2CO3, le tout dans l’acétate d’éthyle et donne de bons rendements de cyclisation. Une étude de l’étendue réactionnelle a été effectuée, montrant la tolérance et les limitations de notre système catalytique : les hétéroatomes ne posent pas de problèmes hormis l’atome d’azote, qui doit être protégé afin de garantir la transformation. En outre, nous avons constaté que les liens C-H aliphatiques secondaires sont moins réactifs que les liens tertiaires. Après avoir tenté de développer des conditions réactionnelles spécifiques aux liens C-H non activés, nous avons montré la possibilité d’aminer des liens C-H propargyliques de manière chimiosélective ; la triple liaison C-C peut ensuite être dérivatisée efficacement, donnant accès à la formule saturée correspondante ainsi qu’à d’autres motifs. Dans un désir de substituer les complexes de rhodium par d’autres complexes de métaux plus abondants et moins dispendieux, nous nous sommes tournés, dans un premier temps, vers les complexes de fer et par la suite, vers les pinceurs de nickel. Les phtalocyanines de fer ont été identifiées comme étant de bons catalyseurs de l’amination intramoléculaire de N-mésyloxycarbamates. Le chlorure de phtalocyanine de fer (III), en présence d’un sel de AgBF4 et de K2CO3, dans le 1,1,2,2-tétrachloroéthane anhydre, permet l’obtention de la 4-phenyloxazolidin-2-one avec 63% de rendement. En outre, il est possible d’atteindre un rendement de 49% à partir du même substrat N-mésyloxycarbamate, par catalyse avec un pinceur de nickel de type POCN, en présence d’un sel de mésylate. Des indices sur le mécanisme des ces deux transformations ont pu être recueillis lors de la courte étude de ces systèmes.

Antimicrobial resistance in Staphylococcus aureus in Australian teaching hospitals, 1989-1999

An annual survey of antimicrobial resistance in clinical isolates of Staphylococcus aureus was conducted in 21 Australian teaching hospital microbiology laboratories in eight major cities from 1989 to 1999. A total of 19,000 isolates were tested for susceptibility to 18 antimicrobials, with 3795 being methicillin-resistant (MRSA). Resistance to ciprofloxacin in MRSA increased from 4.9% to 75.9%. The proportion of MRSA resistant to erythromycin decreased significantly (99.0%-88.9%), as did that to trimethoprim (98.4%-82.4%) and to tetracycline (96.5%-80.1%). The proportion of MRSA isolated increased in Sydney, Melbourne, Canberra, Adelaide, Perth, and Darwin, but not in Brisbane. The proportion in Hobart peaked in 1994. MRSA in Perth were predominantly non-multiresistant (nmMRSA) throughout the survey (i.e., resistant to less than three of eight indicator antibiotics) due mainly to local strains that originated in the community. The proportion of nmMRSA increased to modest levels in the other cities. In eastern cities, this was due to the appearance of strains closely related to nmMRSA seen in other countries of the southwestern Pacific.

Survey for papillomatous digital dermatitis in Australian dairy cattle

Objective To determine whether Treponema-associated papillomatous digital dermatitis (PDD) occurs in Australian dairy cattle. Design Mail-out questionnaire and histological and bacteriological examination of biopsy tissue from suspect PDD lesions. Procedure The questionnaire was mailed to 375 veterinarians to evaluate their knowledge of PDD, determine if they had observed the disease in Australian dairy cattle, and to request biopsy material from suspicious cases. Biopsies were examined for histological and bacteriological evidence of PDD, including for the presence of spirochaetes. Results Eighty-eight replies to the questionnaire were received (23.5%). Of 52 respondents who were aware of PDD as a possible cause of lameness, 26 reported observing the condition in Australian cattle. Of 32 respondents who were unaware of the condition, 6 reported observing lesions that might have been PDD. The majority of reports of PDD-like lesions came from the southern Australian states, the condition occurring during periods of high rainfall and proving responsive to topical or parenteral application of antimicrobials. Biopsies from five erosive lesions showed histological similarity to PDD whereas biopsies from five proliferative lesions were consistent with chronic inflammation, fibroma or cutaneous papilloma. The presence of spirochaetes was not demonstrated in any of the lesions by histological or bacteriological methods. Conclusion Anecdotal reports and analysis of biopsy material confirm that a condition similar to PDD does occur sporadically in dairy cattle in southern Australia. However, this condition has so far not been shown to be associated with the presence of spirochaetes in the lesions.