Antimicrobial resistance and persistence of Staphylococcus epidermidis clones in a Brazilian university hospital

Oxacillin is an alternative for the treatment of Staphylococcus spp. infections; however, resistance to this drug has become a major problem over recent decades. The main objective of this study was to epidemiologically characterize coagulase-negative staphylococci (CoNS) strains recovered from blood of patients hospitalized in a Brazilian teaching hospital. Oxacillin resistance was analyzed in 160 strains isolated from blood culture samples by phenotypic methods, detection of the mecA gene, and determination of intermediate sensitivity to vancomycin on brain heart infusion agar supplemented with 4 and 6 μg/mL vancomycin. In addition, characterization of the epidemiological profile by staphylococcal cassette chromosome mec (SCC. mec) typing and clonal analysis by pulsed-field gel electrophoresis (PFGE) were performed. The mecA gene was detected in 72.5% of the isolates. Methicillin-resistant CoNS isolates exhibited the highest minimum inhibitory concentrations and multiresistance when compared to methicillin-susceptible CoNS strains. Typing classified 32.8% of the isolates as SCC. mec I and 50% as SCC. mec III. PFGE typing of the SCC. mec III Staphylococcus epidermidis isolates identified 6 clones disseminated in different wards that persisted from 2002 to 2009. The high oxacillin resistance rates found in this study and clonal dissemination in different wards highlight the importance of good practices in nosocomial infection control and of the rational use of antibiotic therapy in order to prevent the dissemination of these clones. © 2013 Elsevier Inc.

Sustainable worm control practices in South America

A high prevalence of nematodes, especially Haemonchus contortus and Trichostrongylus colubriformis, that exhibit multiple anthelmintics resistance has been reported in sheep in several South American countries. For this reason, the development of strategies that are less dependent on anthelmintic treatments is imperative for the prophylaxis of gastrointestinal nematode infections in small ruminants. Integrated grazing using cattle and sheep can be used for pasture decontamination with considerable reduction of H. contortus and T. colubnformis infective larvae after cattle grazing. Several breeds of sheep exhibit genetically related resistance against nematode infections, as is the case of crioulo, native or naturalised breeds of sheep. These breeds descend from livestock introduced by Portuguese and Spanish settlers and have been submitted to a long process of natural selection in various environmental conditions. In the South, the Crioula Lanada breed is more resistant to H. contortus than are Corriedale sheep. In tropical areas, where the minimum temperatures are usually higher than 20 degrees C, hair sheep flourish, especially the Santa Ines breed, which also display a higher level of resistance to nematode infections compared with certain breeds of European origin. However, Santa Ines sheep have inferior carcass quality compared with other commercial breeds. Recent studies showed that the crossbreeding of Santa Ines ewes with sires of breeds with high potential for growth and meat production, results in crossbred animals with high productivity and a satisfactory degree of resistance against nematode infections. Several studies have indicated that improvement in nutrition has a beneficial effect on the development of resistance in lambs that were naturally or artificially infected with nematodes. Therefore, supplementary feeding and breeding strategies to improve resistance to nematodes are feasible options in the effort to reduce dependence on anthelmintic drugs to control worm infections in sheep. (C) 2013 Elsevier B.V. All rights reserved.

A comparative study of production performance and animal health practices in organic and conventional dairy systems

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

Antimicrobial resistance in Swiss laying hens, prevalence and risk factors

Antimicrobial resistance is an emerging concern to public health, and food-producing animals are known to be a potential source for transmission of resistant bacteria to humans. As legislation of the European Union requires to ban conventional cages for the housing of laying hens on the one hand, and a high food safety standard for eggs on the other hand, further investigations about the occurrence of antimicrobial resistance in alternative housing types are required. In this study, we determined antimicrobial resistance in indicator bacteria from 396 cloacal swabs from 99 Swiss laying hen farms among four alternative housing types during a cross-sectional study. On each farm, four hens were sampled and exposure to potential risk factors was identified with a questionnaire. The minimal inhibitory concentration was determined using broth microdilution in Escherichia coli (n=371) for 18 antimicrobials and in Enterococcus faecalis (n=138) and Enterococcus faecium (n=153) for 16 antimicrobials. All antimicrobial classes recommended by the European Food Safety Authority for E. coli and enterococci were included in the resistance profile. Sixty per cent of the E. coli isolates were susceptible to all of the considered antimicrobials and 30% were resistant to at least two antimicrobials. In E. faecalis, 33% of the strains were susceptible to all tested antimicrobials and 40% were resistant to two or more antimicrobials, whereas in E. faecium these figures were 14% and 39% respectively. Risk factor analyses were carried out for bacteria species and antimicrobials with a prevalence of resistance between 15% and 85%. In these analyses, none of the considered housing and management factors showed a consistent association with the prevalence of resistance for more than two combinations of bacteria and antimicrobial. Therefore we conclude that the impact of the considered housing and management practices on the egg producing farms on resistance in laying hens is low.

Using Informatics and the Electronic Medical Record to Describe Antimicrobial Use in the Clinical Management of Diarrhea Cases at 12 Companion Animal Practices

Antimicrobial drugs may be used to treat diarrheal illness in companion animals. It is important to monitor antimicrobial use to better understand trends and patterns in antimicrobial resistance. There is no monitoring of antimicrobial use in companion animals in Canada. To explore how the use of electronic medical records could contribute to the ongoing, systematic collection of antimicrobial use data in companion animals, anonymized electronic medical records were extracted from 12 participating companion animal practices and warehoused at the University of Calgary. We used the pre-diagnostic, clinical features of diarrhea as the case definition in this study. Using text-mining technologies, cases of diarrhea were described by each of the following variables: diagnostic laboratory tests performed, the etiological diagnosis and antimicrobial therapies. The ability of the text miner to accurately describe the cases for each of the variables was evaluated. It could not reliably classify cases in terms of diagnostic tests or etiological diagnosis; a manual review of a random sample of 500 diarrhea cases determined that 88/500 (17.6%) of the target cases underwent diagnostic testing of which 36/88 (40.9%) had an etiological diagnosis. Text mining, compared to a human reviewer, could accurately identify cases that had been treated with antimicrobials with high sensitivity (92%, 95% confidence interval, 88.1%-95.4%) and specificity (85%, 95% confidence interval, 80.2%-89.1%). Overall, 7400/15,928 (46.5%) of pets presenting with diarrhea were treated with antimicrobials. Some temporal trends and patterns of the antimicrobial use are described. The results from this study suggest that informatics and the electronic medical records could be useful for monitoring trends in antimicrobial use.

Exploring civil servant resistance to M-government:a story of transition and opportunities in Turkey

The concept of mobility, related to technology in particular, has evolved dramatically over the last two decades including: (i) hardware ranging from walkmans to Ipods, laptops to netbooks, PDAs to 3G mobile phone; (ii) software supporting multiple audio and video formats driven by ubiquitous mobile wireless access, WiMax, automations such as radio frequency ID tracking and location aware services. Against the background of increasing budget deficit, along with the imperative for efficiency gains, leveraging ICT and mobility promises for work related tasks, in a public administration context, in emerging markets, point to multiple possible paths. M-government transition involve both technological changes and adoption to deliver government services differently (e.g. 24/7, error free, anywhere to the same standards) but also the design of digital strategies including possibly competing m-government models, the re-shaping of cultural practices, the creation of m-policies and legislations, the structuring of m-services architecture, and progress regarding m-governance. While many emerging countries are already offering e-government services and are gearing-up for further m-government activities, little is actually known about the resistance that is encountered, as a reflection of civil servants' current standing, before any further macro-strategies are deployed. Drawing on the resistance and mobility literature, this chapter investigates how civil servants' behaviors, in an emerging country technological environment, through their everyday practice, react and resist the influence of m-government transition. The findings points to four main type of resistance namely: i) functional resistance; ii) ideological resistance; iii) market driven resistance and iv) geographical resistance. Policy implication are discussed in the specific context of emerging markets. © 2011, IGI Global.

The dynamics of global sourcing : perspectives and practices:6th global sourcing workshop 2012, Courchevel, France, March 12-15, 2012, revised selected papers

This edited book is intended for use by students, academics and practitioners who take interest in the outsourcing and offshoring of information technology and business services and processes. The book offers a review of the key topics in outsourcing and offshoring, populated with practical frameworks that serve as a tool kit for practitioners, academics and students. The range of topics covered in this book is wide and diverse, and represents both client and supplier perspectives on sourcing of global services. Various aspects related to the decision making process (e.g., asset transfer), learning mechanisms and organizational practices for managing outsourcing relationships are discussed in great depth. Contemporary sourcing models, including cloud services, are examined. Client dependency on the outsourcing provider, and social aspects, such as identity, are discussed in detail. Furthermore, resistance in outsourcing and failures are investigated to derive lessons as to how to avoid them and improve efficiency in outsourcing. Topics discussed in this book combine theoretical and practical insights regarding challenges that both clients and vendors face. Case studies from client and vendor organizations are used extensively throughout the book. Last but not least, the book examines current and future trends in outsourcing and offshoring, placing particular attention on the centrality of innovation in sourcing arrangements, and how innovation can be realized in outsourcing. The book is based on a vast empirical base brought together through years of extensive research by leading researchers in information systems, strategic management and operations.

Institutional contradiction and management control innovation:a field study of total quality management practices in a privatised telecommunications company

The purpose of this paper is to theorise the changes surrounding the introduction of a management control innovation, total quality management (TQM) techniques, within Telecom Fiji Limited. Using institutional theory and drawing on empirical evidence from multiple sources including interviews, discussions and documents, the paper explicates the institutionalization of these TQM practices. The focus of the paper is the micro-processes and practice changes around TQM implementation, rather than the influence of the macro-level structures that are often linked with institutional theory. The change agents used Quality Action Teams and the National Quality Council to introduce new TQM routines. The present study extends the scope of institutional analysis by explaining how institutional contradictions impact to create and make space for institutional entrepreneurs, who in turn, modify existing routines or introduce new routines in fluid organizational environments which also exhibit evidence of resistance.

Marketing practices and their effectiveness in Taiwan's colleges of technology

The main purpose of this study was to investigate marketing practices in Taiwan's institutions of higher education and their relationship with students' college choice behaviors and attitudes. The study was conducted in 11 Taiwan's colleges of technology. It employed a multistrand conversion mixed model design, consisting of a qualitative and a quantitative strand. Funnel-sequenced interviews were conducted with 19 college administrators and the results were content analyzed using a constant-comparative method. The administrator interview data were also quantitized and used in cluster analysis of the institutions. Questionnaire data were collected from 1474 freshmen students, and analyzed using several univariate and multivariate statistical techniques including factor analysis, MANOVA, and correspondence analysis. ^ Analyses indicated that a weak relationship existed between institutions' marketing intensity and students' college choice. Students did not consider institutions' recruitment activities useful in their college searching process. They also reported little knowledge of their current school when they were deciding to enroll. Data analysis also revealed that students were practically oriented in their college selection. Academic resources, employability after graduation, and tuition were the most important attributes in students' college selection. Parents and students' social network such as friends and high school teachers were significant personal sources in enrollment decisions while institutions' representatives (i.e., recruiters) were considered the least influential. ^ Using cluster analysis, institutions were divided into three groups based on intensity of marketing efforts. Multivariate analysis of variance did not reveal significant differences between the college choice behaviors and attitudes of students who entered these three types of institutions. ^ Content analysis of the administrators' interviews indicated that the majority of them practiced passive marketing. This was primarily as a result of resistance to active marketing, lack of leadership commitment, insufficient financial and human resources, little faculty involvement, and inexperience in marketing. In comparison to public institutions, private institutions showed a more favorable attitude towards marketing concepts. They were well advanced in their recruitment activities while public schools were relatively hesitant to use marketing. Curriculum issues were not well represented in marketing activities and did not seem to be impacted by marketing needs. Based on the analysis of qualitative and quantitative data, it can be concluded that in these colleges, curriculum was more driven by commercial and industrial interest than by students' demands. ^ Theoretical, policy, and methodological implementation of the results were discussed. ^

Farm practices to manage the impact of severe tropical cyclone damage on banana production – a case study from tropical Australia

Most Australian banana production occurs on the north-eastern tropical coast between latitudes 15-18°S, and can experience summer cyclone activity. Damage from severe tropical cyclones has serious impact on banana-based livelihoods. The most significant impacts include immediate loss of production and income for several months, the region-wide synchronization of cropping and the expense of rehabilitating affected plantations. Severe tropical cyclones have directly affected the main production region twice in recent years Tropical Cyclone (TC) Larry (Category 4) in March 2006 and TC Yasi (Category 5) in February 2011. Based on TC Larry experiences, pre- and post-cyclone farm practices were developed to reduce these impacts in future cyclonic events. The main pre-cyclone farm practice focused on maintaining production units and an earlier return to fruit production by partially or completely removing the plant canopy to reduce wind resistance. Post-cyclone farm practices focused on managing the industry-wide crop synchronization using crop timing techniques to achieve a staggered return to cropping by scheduling production to provide continuous fruit supply. With TC Yasi in 2011, some banana producers implemented these practices, allowing them to examine their effectiveness in reducing cyclonic impacts. Additional research and development activities were conducted to refine our understanding of their effectiveness and improve their application for future cyclonic events. Based on these activities and farm-based observations, suggested practice-based management strategies can be developed to help reduce the impact of severe tropical cyclones in the future. Canopy removal maintained banana plants as productive units, and provided earlier but smaller bunches, generating earlier-than-expected income. Queensland producers expressed willingness to adopt canopy removal for future cyclone threats where appropriate, despite its labor-intensiveness. Mechanization would allow larger scale adoption. Implementing a staggered cropping program successfully achieved a consistent, continuous fruit supply after a cyclone impact. Both techniques should be applicable to other cyclone-prone regions.

Deciphering the role of plant microbiome on strawberry and raspberry growth, resistance, fruit quality and aroma

Besides their own adaptation strategies, plants might exploit microbial symbionts for overcoming both biotic and abiotic stresses and increase fitness. The current scenario of rapid climate change is demanding more sustainable agricultural management practices. The application of microbe-based products as a valid alternative to synthetic pesticides and fertilizers and their use to overcome stresses exacerbated by climate change, have been reviewed in the first part of this thesis. Berry fruits are widely cultivated and appreciated for their aromatic and nutraceutical properties. This thesis is focused on the role of plant and fruit microbiome on strawberry and raspberry growth, resistance, fruit quality and aroma. A taxonomical and functional description of the microbiome of different organs of three strawberry genotypes was performed both by traditional cultural dependent method and Next Generation Sequencing technique, highlighting a significant role of plant organs and genotype in determining the composition of microbial communities. Additionally, a selection of bacteria native of strawberry plants were isolated and screened for their plant growth promoting abilities and tested under the biotic stress of Xanthomonas fragariae infection and the abiotic stress of induced salinity. The monitoring of biometric parameters allowed the selection of a more restricted panel of bacterial strains, whose beneficial potential was tested in coordinated inoculations, or singularly. Raspberry plant was used for investigating the effect of cultivation method in determining fruit microbiome, and its consequent influence of berry quality and aroma. Interestingly, the cultivation method strongly influenced fruit nutraceutical traits, aroma and epiphytic bacterial biocoenosis. The involvement of the bacterial microbiota in fruit aroma determination was evaluated by performing GC–MS analysis of VOCs occurring in control, sterile and artificially reinoculated berries and by characterizing control and reinoculated berry microbiome. Differently treated berries showed significantly different aromatic profile, confirming the role of bacteria in fruit aroma development.

Ikkε Is Key To Induction Of Insulin Resistance In The Hypothalamus, And Its Inhibition Reverses Obesity.

IKK epsilon (IKKε) is induced by the activation of nuclear factor-κB (NF-κB). Whole-body IKKε knockout mice on a high-fat diet (HFD) were protected from insulin resistance and showed altered energy balance. We demonstrate that IKKε is expressed in neurons and is upregulated in the hypothalamus of obese mice, contributing to insulin and leptin resistance. Blocking IKKε in the hypothalamus of obese mice with CAYMAN10576 or small interfering RNA decreased NF-κB activation in this tissue, relieving the inflammatory environment. Inhibition of IKKε activity, but not TBK1, reduced IRS-1(Ser307) phosphorylation and insulin and leptin resistance by an improvement of the IR/IRS-1/Akt and JAK2/STAT3 pathways in the hypothalamus. These improvements were independent of body weight and food intake. Increased insulin and leptin action/signaling in the hypothalamus may contribute to a decrease in adiposity and hypophagia and an enhancement of energy expenditure accompanied by lower NPY and increased POMC mRNA levels. Improvement of hypothalamic insulin action decreases fasting glycemia, glycemia after pyruvate injection, and PEPCK protein expression in the liver of HFD-fed and db/db mice, suggesting a reduction in hepatic glucose production. We suggest that IKKε may be a key inflammatory mediator in the hypothalamus of obese mice, and its hypothalamic inhibition improves energy and glucose metabolism.

Neck Circumference As A New Anthropometric Indicator For Prediction Of Insulin Resistance And Components Of Metabolic Syndrome In Adolescents: Brazilian Metabolic Syndrome Study.

To evaluate the correlation between neck circumference and insulin resistance and components of metabolic syndrome in adolescents with different adiposity levels and pubertal stages, as well as to determine the usefulness of neck circumference to predict insulin resistance in adolescents. Cross-sectional study with 388 adolescents of both genders from ten to 19 years old. The adolescents underwent anthropometric and body composition assessment, including neck and waist circumferences, and biochemical evaluation. The pubertal stage was obtained by self-assessment, and the blood pressure, by auscultation. Insulin resistance was evaluated by the Homeostasis Model Assessment-Insulin Resistance. The correlation between two variables was evaluated by partial correlation coefficient adjusted for the percentage of body fat and pubertal stage. The performance of neck circumference to identify insulin resistance was tested by Receiver Operating Characteristic Curve. After the adjustment for percentage body fat and pubertal stage, neck circumference correlated with waist circumference, blood pressure, triglycerides and markers of insulin resistance in both genders. The results showed that the neck circumference is a useful tool for the detection of insulin resistance and changes in the indicators of metabolic syndrome in adolescents. The easiness of application and low cost of this measure may allow its use in Public Health services.

[strategies For Integration Of Health Care Practices And Sanitary Surveillance In The Context Of The Implementation Of Rede Cegonha - A Brazilian Mother And Infant Health Care Network].

Mother and infant mortality has been the scope of analysis throughout the history of public health in Brazil and various strategies to tackle the issue have been proposed to date. The Ministry of Health has been working on this and the Rede Cegonha strategy is the most recent policy in this context. Given the principle of comprehensive health care and the structure of the Unified Health System in care networks, it is necessary to ensure the integration of health care practices, among which are the sanitary surveillance actions (SSA). Considering that the integration of health care practices and SSA can contribute to reduce mother and infant mortality rates, this article is a result of qualitative research that analyzed the integration of these actions in four cities in the State of São Paulo/Brazil: Campinas, Indaiatuba, Jaguariúna and Santa Bárbara D'Oeste. The research was conducted through interviews with SSA and maternal health managers, and the data were evaluated using thematic analysis. The results converge with other studies, identifying the isolation of health care practices and SSA. The insertion of SSA in collectively-managed areas appears to be a potential strategy for health planning and implementation of actions in the context under scrutiny.