ABSTRACT
Positive Deviance (PD) is a process to achieve a social and cultural change. This strategy has been used for the control of methicillin-resistant Staphylococcus aureus (MRSA) infection in some health institutions in the United States, but has rarely been adopted in institutions from developing countries where resources are limited. We describe our experience of PD in the control of healthcare-associated infections (HAIs) due to MRSA in a Colombian hospital with the aim of reducing HAI rates through a cultural change in processes. A time-series study was conducted based on the MRSA-HAI rate and the number of months with zero MRSA infections before and after application of PD (2001-2012). On comparing the pre-intervention and intervention periods, the mean overall rates of MRSA-HAI was 0·62 and 0·36, respectively (P = 0·0005); the number of months with zero MRSA-HAIs were 3/70 and 12/74 (odds ratio 0·264, 95% confidence interval 0·078-0·897); the percentage of MRSA-HAIs was 53·2% and 41·0%. These results are consistent with other published data. Implementation of PD was associated with a significant reduction of MRSA-HAIs, it did not involve high costs and the changes have been lasting.
Subject(s)
Behavior Therapy/methods , Cross Infection/prevention & control , Disease Transmission, Infectious/prevention & control , Infection Control/methods , Methicillin-Resistant Staphylococcus aureus/isolation & purification , Staphylococcal Infections/prevention & control , Adult , Colombia/epidemiology , Cross Infection/epidemiology , Cross Infection/microbiology , Guideline Adherence , Humans , Infant , Infant, Newborn , Staphylococcal Infections/epidemiology , Staphylococcal Infections/microbiologyABSTRACT
The novel bisabolene sesquiterpenes 3-6, were isolated from Iostephane heterophylla, using bioguided fractionation. The new compounds were determined to be (12R/12S)-12,13-epoxy-xanthorrhizols (3,4) and (12R/12S)-12,13-dihydro-12,13-dihydroxy-xanthorrizols (5,6) and their structures were characterized by analysis of spectroscopic data and by chemical correlation from xanthorrhizol (2). The stereochemistry at C-12 of 5 was deduced using the modified Mosher experiment. Some of the isolated compounds elicited activity against gram positive and gram negative bacteria, levadura and dermatophytes.
Subject(s)
Anti-Infective Agents/isolation & purification , Asteraceae/chemistry , Sesquiterpenes/isolation & purification , Anti-Bacterial Agents , Anti-Infective Agents/chemistry , Anti-Infective Agents/pharmacology , Candida albicans/drug effects , Chromatography, High Pressure Liquid , Enterococcus faecalis/drug effects , Glycosides/chemistry , Glycosides/isolation & purification , Mexico , Microsporum/drug effects , Molecular Structure , Nuclear Magnetic Resonance, Biomolecular , Plant Roots/chemistry , Plants, Medicinal/chemistry , Proteus mirabilis/drug effects , Sesquiterpenes/chemistry , Sesquiterpenes/pharmacology , Spectrophotometry, Ultraviolet , Staphylococcus aureus/drug effects , Stereoisomerism , Structure-Activity Relationship , Trichophyton/drug effectsABSTRACT
Xanthorrhizol, a bisabolene isolated from the medicinal plant Iostephane heterophylla, was assayed on rat thoracic aorta rings to elucidate its effect and likely mechanism of action, by measuring changes of isometric tension. Xanthorrhizol (1, 3, 10, 30 and 100 microg/mL) significantly inhibited precontractions induced by KCI-; (60mM), noradrenaline (10(-6) M) or CaCl2 (1.0 mM). Increasing concentrations of external calcium antagonized the inhibitory effect on KCl-induced contractions. The vasorelaxing effect of xanthorrhizol was not affected by indomethacin (10 microM) or L-NAME (100 microM) in intact rat thoracic aorta rings precontracted by noradrenaline, which suggested that the effect was not mediated through either endothelium-derived prostacyclin (PGI2) or nitric oxide release from endothelial cells. Endothelium removal did not affect the relaxation induced by xanthorrhizol on rat thoracic aorta rings, discarding the participation of any substance released by the endothelium. Xanthorrhizol inhibitory effect was greater on KCI- and CaCl2-induced contractions than on those induced by noradrenaline. Xanthorrhizol inhibitory effect in rat thoracic aorta is likely explained for interference with calcium availability by inhibiting calcium influx through both voltage- and receptor-operated channels.
Subject(s)
Calcium Channel Blockers/pharmacology , Endothelium, Vascular/physiology , Muscle Relaxation/drug effects , Muscle, Smooth, Vascular/drug effects , Phenols/pharmacology , Animals , Aorta, Thoracic/drug effects , Aorta, Thoracic/physiology , Calcium/pharmacology , Dose-Response Relationship, Drug , Drug Interactions , Endothelium, Vascular/drug effects , Female , In Vitro Techniques , Indomethacin/pharmacology , Male , Muscle, Smooth, Vascular/physiology , NG-Nitroarginine Methyl Ester/pharmacology , Norepinephrine/pharmacology , Phenols/isolation & purification , Plant Extracts/isolation & purification , Plant Extracts/pharmacology , Plant Roots/chemistry , Plants, Medicinal/chemistry , Potassium Chloride/pharmacology , Rats , Rats, Sprague-Dawley , Vasoconstrictor Agents/pharmacologyABSTRACT
The novel melampolides (11R)-11,13-dihydro-schkuhriolide (7), (11S)-11,13-dihydro-schkuhriolide (8), and schkuhrioidiol (11), along with the known constituents, frutescin (1), schkuhriolide (2), frutescinic acid (4), allo-schkuhriolide (5), and epoxyschkuhriolide (6) were isolated from the aerial parts of Schkuhria schkuhrioides. The structures of the new compounds were determined by spectroscopic methods. Compounds 1, 2, 4, 5, and 6 displayed no significant cytotoxic or antimicrobial activities.
Subject(s)
Anti-Infective Agents/pharmacology , Antineoplastic Agents, Phytogenic/pharmacology , Lactones/pharmacology , Plant Leaves/chemistry , Plants, Medicinal/chemistry , Sesquiterpenes/pharmacology , Animals , Anti-Infective Agents/isolation & purification , Antineoplastic Agents, Phytogenic/isolation & purification , Artemia , Chromatography, High Pressure Liquid , Drug Screening Assays, Antitumor , Humans , Lactones/isolation & purification , Magnetic Resonance Spectroscopy , Mass Spectrometry , Sesquiterpenes/isolation & purification , Spectrophotometry, Ultraviolet , Tumor Cells, CulturedABSTRACT
Two new cytotoxic isoflavans, (3S)-7-hydroxy-2',3',4',5', 8-pentamethoxyisoflavan (1) and (3S)-3',7-dihydroxy-2',4',5', 8-tetramethoxyisoflavan (2), were isolated from the bark and trunks of Eysenhardtia polystachya (Leguminosae), together with the known constituents stigmasterol, isoduartin, cuneatin, 7-hydroxy-2',4', 5'-trimethoxyisoflavone, and 3,4-dimethoxy-8, 9-(methylenedioxy)pterocarpan. The structures of 1 and 2 were elucidated on the basis of spectroscopic methods. The antimicrobial, cytotoxic, and insecticidal potential of some of these compounds were evaluated. The isoflavans 1, 2, and isoduartin (2', 7-dihydroxy-3',4',8-trimethoxyisoflavan) displayed moderate cytotoxic activity against KB cell lines.