Antibiotic resistance genes in the bacteriophage DNA fraction of environmental samples

Antibiotic resistance is an increasing global problem resulting from the pressure of antibiotic usage, greater mobility of the population, and industrialization. Many antibiotic resistance genes are believed to have originated in microorganisms in the environment, and to have been transferred to other bacteria through mobile genetic elements. Among others, ß-lactam antibiotics show clinical efficacy and low toxicity, and they are thus widely used as antimicrobials. Resistance to ß-lactam antibiotics is conferred by ß-lactamase genes and penicillin-binding proteins, which are chromosomal- or plasmid-encoded, although there is little information available on the contribution of other mobile genetic elements, such as phages. This study is focused on three genes that confer resistance to ß-lactam antibiotics, namely two ß-lactamase genes (blaTEM and blaCTX-M9) and one encoding a penicillin-binding protein (mecA) in bacteriophage DNA isolated from environmental water samples. The three genes were quantified in the DNA isolated from bacteriophages collected from 30 urban sewage and river water samples, using quantitative PCR amplification. All three genes were detected in the DNA of phages from all the samples tested, in some cases reaching 104 gene copies (GC) of blaTEM or 102 GC of blaCTX-M and mecA. These values are consistent with the amount of fecal pollution in the sample, except for mecA, which showed a higher number of copies in river water samples than in urban sewage. The bla genes from phage DNA were transferred by electroporation to sensitive host bacteria, which became resistant to ampicillin. blaTEM and blaCTX were detected in the DNA of the resistant clones after transfection. This study indicates that phages are reservoirs of resistance genes in the environment.

The congenital soidum diarrhea and Spint2: from the molecules to the disease

La diarrhée congénitale de sodium est une maladie génétique très rare. Les enfants touchés par cette maladie présentent une diarrhée aqueuse sévère accompagnée d'une perte fécale de sodium et bicarbonates causant une déshydratation hyponatrémique et une acidose métabolique. Des analyses génétiques ont identifié des mutations du gène Spint2 comme cause de cette maladie. Le gène Spint2 code pour un inhibiteur de sérine protéase transmembranaire exprimé dans divers épithéliums tels que ceux du tube digestif ou des tubules rénaux. Le rôle physiologique de Spint2 n'est pas connu. De plus, aucun partenaire physiologique de Spint2 n'a été identifié et le mécanisme d'inhibition par Spint2 nous est peu connu. Le but de ce projet est donc d'obtenir de plus amples informations concernant la fonction et le rôle de Spint2 dans le contexte de la diarrhée congénitale de sodium, cela afin de mieux comprendre la physiopathologie des diarrhées et peut-être d'identifier de nouvelles cibles thérapeutiques. Un test fonctionnel dans les ovocytes de Xenopus a identifié les sérine protéases transmembranaires CAPI et Tmprssl3 comme potentielles cibles de Spint2 dans la mesure où ces deux protéases n'étaient plus bloquées par le mutant de Spint2 Y163C qui est associé avec la diarrhée congénitale de sodium. Des expériences fonctionnelles et biochimiques plus poussées suggèrent que l'inhibition de Tmprssl3 par Spint2 est le résultat d'une interaction complexe entre ces deux protéines. Les effets des sérine protéases transmembranaires sur l'échangeur Na+-H+ NHE3, qui pourrait être impliqué dans la pathogenèse de la diarrhée congénitale de sodium ont aussi été testés. Un clivage spécifique de NHE3 par la sérine protéase transmembranaire Tmprss3 a été observé lors d'expériences biochimiques. Malheureusement, la pertinence physiologique de ces résultats n'a pas pu être évaluée in vivo, étant donné que le modèle de souris knockout conditionnel de Spint2 que nous avons créé ne montrait une réduction de l'expression de Spint2 que de 50% et aucun phénotype. En résumé, ce travail met en évidence deux nouveaux partenaires possibles de Spint2, ainsi qu'une potentielle régulation de NHE3 par des sérine protéases transmembranaires. Des expériences supplémentaires faites dans des modèles animaux et lignées cellulaires sont requises pour évaluer la pertinence physiologique de ces données et pour obtenir de plus amples informations au sujet de Spint2 et de la diarrhée congénitale de sodium. - The congenital sodium diarrhea is a very rare genetic disease. Children affected by this condition suffer from a severe diarrhea characterized by watery stools with a high fecal loss of sodium and bicarbonates, resulting in hyponatremic dehydration and metabolic acidosis. Genetic analyses have identified mutations in the Spint2 gene as a cause of this disease. The spint2 gene encodes a transmembrane serine protease inhibitor expressed in various epithelial tissues including the gastro-intestinal tract and renal tubules. The physiological role of Spint2 is completely unknown. In addition, physiological partners of Spint2 are still to be identified and the mechanism of inhibition by Spint2 remains elusive. Therefore, the aim of this project was to get insights about the function and the role of Spint2 in the context of the congenital sodium diarrhea in order to better understand the pathophysiology of diarrheas and maybe identify new therapeutic targets. A functional assay in Xenopus oocytes identified the membrane-bound serine proteases CAPI and Tmprssl3 as potential targets of Spint2 because both proteases were no longer inhibited by the mutant Spint2 Y163C that has been associated with the congenital diarrhea. Further functional and biochemical experiments suggested that the inhibition of Tmprssl3 by Spint2 occurs though a complex interaction between both proteins. The effects of membrane-bound serine proteases on the Na+-H+ exchanger NHE3, which has been proposed to be involved in the pathogenesis of the congenital sodium diarrhea, were also tested. A specific cleavage of NHE3 by the membrane-bound serine protease Tmprss3 was observed in biochemical experiments. Unfortunately, the physiological relevance of these results could not be assessed in vivo since the conditional Spint2 knockout mouse model that we generated showed a reduction in Spint2 expression of only 50% and displayed no phenotype. Briefly, this work provides two new potential partners of Spint2 and emphasizes a putative regulation of NHE3 by membrane-bound serine proteases. Further work done in animal models and cell lines is required to assess the physiological relevance of these results and to obtain additional data about Spint2 and the congenital diarrhea.

American Cancer Society guideline for the early detection of prostate cancer: update 2010.

In 2009, the American Cancer Society (ACS) Prostate Cancer Advisory Committee began the process of a complete update of recommendations for early prostate cancer detection. A series of systematic evidence reviews was conducted focusing on evidence related to the early detection of prostate cancer, test performance, harms of therapy for localized prostate cancer, and shared and informed decision making in prostate cancer screening. The results of the systematic reviews were evaluated by the ACS Prostate Cancer Advisory Committee, and deliberations about the evidence occurred at committee meetings and during conference calls. On the basis of the evidence and a consensus process, the Prostate Cancer Advisory Committee developed the guideline, and a writing committee drafted a guideline document that was circulated to the entire committee for review and revision. The document was then circulated to peer reviewers for feedback, and finally to the ACS Mission Outcomes Committee and the ACS Board of Directors for approval. The ACS recommends that asymptomatic men who have at least a 10-year life expectancy have an opportunity to make an informed decision with their health care provider about screening for prostate cancer after they receive information about the uncertainties, risks, and potential benefits associated with prostate cancer screening. Prostate cancer screening should not occur without an informed decision-making process. Men at average risk should receive this information beginning at age 50 years. Men in higher risk groups should receive this information before age 50 years. Men should either receive this information directly from their health care providers or be referred to reliable and culturally appropriate sources. Patient decision aids are helpful in preparing men to make a decision whether to be tested.

Increased prevalence of bladder and intestinal dysfunction in amyotrophic lateral sclerosis.

Amyotrophic lateral sclerosis (ALS) is predominantly characterized by a progressive loss of motor function. While autonomic dysfunction has been described in ALS, little is known about the prevalence of lower urinary tract symptoms (LUTS) and intestinal dysfunction. We investigated disease severity, LUTS and intestinal dysfunction in 43 patients with ALS attending our outpatient department applying the ALS functional rating scale, the International Consultation on Incontinence Modular Questionnaire, the Urinary Distress Inventory and the Cleveland Clinic Incontinence Score. Results were compared to the German population of a cross-sectional study assessing LUTS in the healthy population, the EPIC study. Results showed that urinary incontinence was increased in patients with ALS aged ≥ 60 years compared to the EPIC cohort (female: 50%/19% (ALS/EPIC), p = 0.026; male: 36%/11% (ALS/EPIC), p = 0.002). No difference was seen at 40-59 years of age. Urge incontinence was the predominant presentation (73% of symptoms). A high symptom burden was stated (ICIQ-SF quality of life subscore 5.5/10). Intake of muscle relaxants and anticholinergics was associated with both urinary incontinence and severity of symptoms. Furthermore, a high prevalence of constipation (46%), but not stool incontinence (9%), was noted. In conclusion, the increased prevalence of urge incontinence and high symptom burden imply that in patients with ALS, LUTS should be increasingly investigated for.

Ecologie trophique de deux espèces jumelles et sympatriques de chauves-souris: Myotis myotis et Myotis blythii (Chiroptera : Vespertilionidae). Premiers résultats

M. myotis and M. blythii are two sibling species of bats that live sympatrically over wide areas of the Western Palearctic region, and which often coexist intimately in their nursery roosts. According to the principle of <<limiting similarity>> this cohabitation should imply an interspecific ecological differentiation. The hypothesis of a niche separation at the trophic level is tested here. The fecal analysis of 300 droppings collected from a zone of sympatry shows a clear interspecific differentiation in diets : M. myotis eats mostly Carabidae (Coleoptera), whereas M. blythii captures essentially Tettigoniidae, Gryllidae and Acrididae (Orthoptera). Because they consume exclusively terrestrial arthropods, M. myotis and M. blythii are typical ground and/or grass gleaning bats. However, despite their narrow niches they are probably not specialized in the predation of only some definite categories of prey. The narrow diets probably reflect the high specialization of their modes of resource exploitation: M. myotis and M. blythii prey upon ground arthropods and they are likely to select for different foraging;g habitats. M. myotis probably prefers wooded feeding grounds (Carabidae) whereas M. blythii exploits herbaceous habitats (Orthoptera). The strong trophic segregation observed in sympatry between M. myotis and M. blythii shows that the interspecific competition is distinctly much weaker than the intraspecific one. This would explain the stable, intimate co-existence of these two virtual competitors.

Factors favoring a degradation or an improvement in activities of daily living (ADL) performance among nursing home (NH) residents: A survival analysis.

Different factors influence ADL performance among nursing home (NH) residents in long term care. The aim was to investigate which factors were associated with a significant change of ADL performance in NH residents, and whether or not these factors were gender-specific. The design was a survival analysis. The 10,199 participants resided in ninety Swiss NHs. Their ADL performance had been assessed by the Resident Assessment Instrument Minimum Data Set (RAI-MDS) in the period from 1997 to 2007. Relevant change in ADL performance was defined as 2 levels of change on the ADL scale between two successive assessments. The occurrence of either an improvement or a degradation of the ADL status) was analyzed using the Cox proportional hazard model. The analysis included a total of 10,199 NH residents. Each resident received between 2 and 23 assessments. Poor balance, incontinence, impaired cognition, a low BMI, impaired vision, no daily contact with proxies, impaired hearing and the presence of depression were, by hierarchical order, significant risk factors for NH residents to experience a degradation of ADL performance. Residents, who were incontinent, cognitively impaired or had a high BMI were significantly less likely to improve their ADL abilities. Male residents with cancer were prone to see their ADL improve. The year of NH entry was significantly associated with either degradation or improvement of ADL performance. Measures aiming at improving balance and continence, promoting physical activity, providing appropriate nourishment and cognitive enhancement are important for ADL performance in NH residents.

Disponibilidade biológica do fósforo de diferentes fontes para eqüinos em crescimento

Objetivou-se neste estudo, determinar a disponibilidade biológica do P de diferentes fontes, para eqüinos em fase de crescimento. Utilizaram-se dezesseis eqüinos machos em fase de crescimento, submetidos à aplicação de quatro fontes fosfatadas -- fosfato de rocha de Tapira (TAP), fosfato de rocha de Patos de Minas (PAT), fosfato bicálcico (BIC) e farinha de osso (FOS) --, adicionadas à dieta basal em quantidades suficientes para fornecer 22 g de P/animal/dia. No 16º dia, foram-lhes injetados 30 MBq de 32P/animal, e coletaram-se amostras de sangue, fezes e urina, durante sete dias. Foram determinadas as atividades específicas no plasma, fezes e urina e calculou-se a perda endógena fecal e a absorção real de P. Os valores obtidos quanto ao P consumido, P excretado, P no plasma e P retido não apresentaram diferenças estatísticas (P>0,05). Os valores de absorção real do P do TAP, PAT, BIC e da FOS foram, respectivamente, 25,23%, 33,97%, 31,71% e 29,36%. Não houve diferenças estatísticas (P>0,05) entre as fontes estudadas. Em relação ao BIC, as rochas fosfáticas apresentaram altos valores de disponibilidade biológica.

Perda endógena e absorção real de fósforo em dietas para eqüinos em crescimento

O trabalho teve por objetivo avaliar os efeitos de diferentes níveis de P na dieta de eqüinos em crescimento sobre sua perda endógena fecal, e verificar qual seja a exigência mínima diária desse elemento na sua alimentação. Foram utilizados 16 eqüinos machos em crescimento, recebendo dieta basal sem suplementação de P, e dieta basal suplementada com fosfato bicálcico, para fornecer 15, 20 e 25 g P/animal/dia. No 16º dia experimental, foram injetados 30 MBq de 32P/animal e coletaram-se amostras de sangue, fezes e urina, durante sete dias. Foram determinadas as atividades específicas do P no plasma, nas fezes e na urina, e calculou-se a perda endógena fecal e a absorção real de P. A perda endógena fecal e a absorção real de P não foram afetadas (P>0,05) pelos tratamentos, e foram estimados, em média, 10,34 mg P/kg PV/dia e 47,07%, respectivamente, o que indica que, nas condições experimentais, animais com idade média de 19 meses necessitam de 21,96 mg de P/kg PV/dia para manter o balanço da perda metabólica fecal, e a quantidade diária de P de 14,75 g.

Exigência mínina de fósforo em novilhos da raça Nelore

A determinação da absorção real de fósforo (P) em bovinos deve levar em consideração a fração endógena mínina do mineral, que se perde nas fezes. De modo geral esses cálculos são feitos utilizando-se tabelas cujos valores foram obtidos em outros países, com outras raças de animais e em condições bem diferentes das condições brasileiras. O trabalho teve como objetivo determinar a perda endógena de P nas fezes e estimar a exigência mínima de P em novilhos da raça Nelore (Bos indicus). Foram utilizados 18 novilhos castrados, com peso médio de 190,82±27,53 kg e idade aproximada de 12 meses, divididos em três grupos de seis animais, e mantidos em gaiolas metabólicas individuais. Os animais receberam dieta básica constituída de feno de Brachiaria decumbens e uma mistura de concentrados durante os 30 dias de período experimental. Os tratamentos consistiram de diferentes quantidades de fosfato bicálcico em níveis de 0,12, 0,24 e 0,36% de P, com base na dieta total. Foram aplicadas injeções de 32P nos animais para a determinação da perda endógena fecal de P. A perda endógena mínima fecal de P para uma ingestão zero do mineral, calculada por interpolação, foi de 5,72 mg/kg de peso vivo e para um balanço zero, o requerimento mínimo foi de 8,84 mg/kg de peso vivo por dia.

Diarrhées infectieuses [Infectious diarrhea].

Traveler's diarrhea is generally a benign condition which resolves spontaneously in 48 h. Information on dietary hygiene, severity of symptoms and dehydration, as well as their management, is essential. Chemoprophylaxis and antibiotic treatment are not recommended, except in very specific situations. The incidence of chronic diarrhea in HIV-positive patients has dramatically decreased since the introduction of HAART. In the absence of any correlation with the initiation of HAART, a stepwise diagnostic workup is indicated (bacteriological cultures and microscopic examination of fecal samples followed by ileocolonoscopy and gastroduodenoscopy). Specific treatment of any pathogens identified, and HAART in the case of microsporidiasis or cryptosporidiosis, constitute the mainstay of therapeutic management of chronic diarrhea in these patients.

Daily intake of lactating crossbred cows grazing elephant grass rotationally

The goal of this trial was to estimate the total dry matter (TDMI) and daily pasture dry matter intakes (PDMI) by lactating crossbred Holstein - Zebu cows grazing elephant grass (Pennisetum purpureum Schum.) paddocks submitted to different rest periods. Three groups of 24 cows were used during two years. The paddocks were grazed during three days at the stocking rate of 4.5 cows/ha. Treatments consisted of resting periods of 30 days without concentrate and resting periods of 30, 37.5 and 45 days with 2 kg/cow/day of 20.6% crude protein concentrate. From July to October, pasture was supplemented with chopped sugarcane plus 1% urea. Total daily dry matter intake was estimated using the extrusa in vitro dry matter digestibility and the fecal output with chromium oxide. Regardless of the treatment the estimated average TDMI was 2.7, 2.9 and 2.9±0.03% and the mean PDMI was 1.9, 2.1 and 2.1±0.03% of body weight in the first, second and third grazing day, respectively (P<0.05). Only during the summer pasture quality was the same whichever the grazing day. Sugarcane effectively replaced grazing pasture, mainly in the first day when pasture dry matter intake was lowest.

Avaliação de biossólido de águas servidas domiciliares como adubo em couve

O objetivo deste trabalho foi avaliar o biossólido e proveniente da estação de tratamento de águas servidas domiciliares, como adubo no cultivo da couve (Brassica oleraceae var. acephala, grupo Georgia). O trabalho foi em delineamento de blocos ao acaso, com três tratamentos de adubação, esterco bovino, biossólido e uréia, com quatro repetições. Amostras de solo de cada tratamento foram analisadas quanto a parâmetros químicos, microbiológicos e parasitológicos. Os níveis de metais pesados encontravam-se abaixo dos permitidos pela legislação internacional. Após 54 dias da incorporação do biossólido ao solo, os coliformes fecais eram praticamente nulos e, a partir dos 60 dias, não foram mais encontradas amostras positivas com ovos de helmintos, apesar do alto grau de contaminação inicial. As plantas adubadas com biossólido, na maior dose, comparadas ao esterco, apresentaram maior produtividade e menores teores de N total nas folhas. O biossólido foi classificado como B, pela concentração de coliformes fecais apresentada, tornando-o impróprio para aplicação em culturas de contato primário como as hortaliças. Os resultados indicam a importância de selecionar indicadores de sanidade que permitam o uso seguro deste adubo.

Disponibilidade, composição bromatológica e consumo de matéria seca em pastagem consorciada de Brachiaria decumbens com Stylosanthes guianensis

O objetivo deste trabalho foi avaliar a disponibilidade de forragem, a composição bromatológica, o consumo de matéria seca e a proporção de gramínea e leguminosa na dieta de vacas mestiças Holandês x Zebu, em pastagem consorciada de Brachiaria decumbens cv. Basilisk, Stylosanthes guianensis var. vulgaris cv. Mineirão e leguminosas arbóreas. Para estimativa da produção fecal, foram usados 10 g vaca-1 dia-1 de óxido crômico, durante dez dias. Amostras de extrusa foram usadas para determinação da composição bromatológica e digestibilidade in vitro da matéria seca. A disponibilidade de matéria seca de forragem de B. decumbens variou com as condições climáticas, enquanto a de S. guianensis decresceu linearmente ao longo do período experimental. O consumo de matéria seca foi maior em maio de 2001 (1,9% do peso do animal vivo) e não diferiu entre os demais meses (1,5% do peso do animal vivo). Os baixos índices de consumo de matéria seca refletiram altos teores de fibra em detergente neutro (70,2% a 79,4%) e baixos coeficientes de digestibilidade in vitro de matéria seca (42,1% a 48,0%) da forragem. O consumo de leguminosa variou entre 8,7% e 24,1% do total ingerido. O consumo de matéria seca esteve diretamente relacionado à porcentagem de leguminosa na pastagem, o que evidencia o potencial de uso de pastagens consorciadas para vacas leiteiras.

Consumo e digestibilidade de feno de baixa qualidade suplementado com nitrogênio não protéico em bovinos

O objetivo deste trabalho foi avaliar o efeito de níveis de inclusão de nitrogênio não protéico, em suplementos fornecidos a tourinhos Hereford, com 17 meses e peso médio de 220 kg, alimentados com feno de tifton (Cynodon dactylon) ad libitum. Os tratamentos avaliados foram: feno + suplemento sem uréia; feno + suplemento com 0,28 g de uréia kg-1 PV0,75; feno + suplemento com 0,55 g de uréia kg-1 PV0,75; feno + suplemento com 0,83 g de uréia kg-1 PV0,75 e feno + suplemento com 1,11 g de uréia kg-1 PV0,75. O feno apresentou, na média, 3,86% de proteína bruta e 84,66% de fibra em detergente neutro. Não se constatou efeito da suplementação sobre a digestibilidade da matéria orgânica, matéria orgânica do feno, fibra em detergente neutro, celulose e hemicelulose; o consumo total desses itens respondeu quadraticamente à suplementação com níveis crescentes de nitrogênio não protéico. A suplementação não afetou a excreção fecal metabólica de matéria orgânica, o que sugere aumento na taxa de passagem (variação no consumo) e na taxa de digestão (digestibilidade constante). O consumo de matéria orgânica digestível apresentou comportamento quadrático com aumento dos níveis de uréia na dieta. Quando o nível de proteína degradável no rúmen foi equivalente a 8,1% da matéria orgânica digestível, a relação de consumo entre esses componentes foi otimizada.

How do Swiss Gastroenterologists assess Activity of Inflammatory Bowel Disease in Daily Practice: by Clinical Indices, Endoscopic Activity, or Biomarkers?

Background a nd A ims: There is a n ongoing d ebate which i sthe most appropriate w ay t o measure inflammatory boweldisease (IBD) activity (be it b y clinical i ndices, e ndoscopy, orbiomarkers). Accumulating evidence associates m ucosalhealing with a reduction in I BD-related s urgery andhospitalizations. We a imed to i nvestigate which outcomeparameters are used in daily practice for IBD monitoring.Methods: A q uestionnaire was sent in J uly 2010 t o all boardcertified gastroenterologists in S witzerland to evaluate t heassessment strategy of IBD activity, t he items on whichtherapeutic decisions w ere based upon, and the kind ofbiomarkers used for monitoring IBD activity.Results: Response rate was 57% (153/270). Mean physician'sage was 5 0±9years, mean duration o f gastroenterologicpractice 1 4±8years, 52% of them were working in p rivatepractice a nd 48% in h ospitals. S eventy-eight percent usedclinical activity i ndices as g old standard for IBD activityassessment, followed by 15% choosing endoscopic activity, and7% favouring biomarkers. Gastroenterologists based theirtherapeutic decisions in 70% on clinical activity indices, 24% onendoscopic activity, a nd 6% o n biomarkers. Most frequentlyused biomarkers were C-reactive protein (94%), complete bloodcount (78%) and fecal calprotectin (74%).Conclusions: I n daily p ractice, most IBD patients a remonitored based u pon t heir clinical a ctivity. B iomarkers a reperceived as l ess important compared to clinical andendoscopic activity. S imilar to activity a ssessment, alsotherapeutic decisions a re mostly made on the basis of clinicalactivity indices. The upcoming scientific evidence on the impactof mucosal h ealing does n ot yet seem to influence the dailypractice of gastroenterologists.