Outbreak of Burkholderia cepacia pseudobacteraemia caused by intrinsically contaminated commercial 0.5% chlorhexidine solution in neonatal intensive care units.

BACKGROUND: Burkholderia cepacia is intrinsically resistant to certain antiseptics. The authors noted a sudden increase in the frequency of isolation of B. cepacia from blood cultures in a neonatal intensive care unit (NICU) of a university-affiliated hospital. AIM: To identify the source and intervene in the ongoing infections. METHODS: The cases were defined as patients with positive blood cultures for B. cepacia in an NICU between November 2014 and January 2015. Medical records were reviewed and NICU healthcare workers were interviewed. Samples of suspected antiseptics, blood culture bottles, cotton balls, gauze and a needle used in the NICU were analysed microbiologically. FINDINGS: During the outbreak period, B. cepacia was identified in 25 blood cultures obtained from 21 patients. The clinical features of the patients were suggestive of pseudobacteraemia. Regarding environmental samples, B. cepacia was cultured from 0.5% chlorhexidine gluconate (CHG) solution products that had been used as a skin antiseptic during blood drawing in the NICU. The clinical B. cepacia isolate and two strains obtained from 0.5% CHG exhibited identical pulsed-field gel electrophoresis patterns. After the CHG products were withdrawn, the outbreak was resolved. CONCLUSIONS: The pseudobacteraemia cases were caused by contaminated 0.5% CHG produced by a single manufacturer. Stricter government regulation is needed to prevent contamination of disinfectants during manufacturing. In addition, microbial contamination of antiseptics and disinfectants should be suspected when a B. cepacia outbreak occurs in hospitalized patients.

Profil épidémiologique et clinique des paralysies cérébrales à Abidjan en Côte d'Ivoire

Introduction : Dans bien des pays en développement, la situation des maladies neuropédiatriques et notamment des paralysies cérébrales, n'est pas clairement documentée. Le but de cette étude était de décrire les caractéristiques épidémiologiques et cliniques des paralysies cérébrales à Abidjan afin de contribuer à une meilleure connaissance de l'affection. Patients et méthodes : Il s'est agi d'une étude rétrospective, descriptive, sur une période de quatre ans, de 2013 à 2016, dans l'unité de consultation de Neurologie du Centre Hospitalier Universitaire de Yopougon à Abidjan. Elle a concerné 136 enfants, âgés de 1 mois à 15 ans, reçus et suivis en consultation de Neuropédiatrie pour paralysie cérébrale. La paralysie cérébrale a été retenue sur la présence de troubles du développement psychomoteur constatés avant l'âge de 2 ans, associés à des lésions cérébrales à l'imagerie encéphalique. Résultats : La paralysie cérébrale représentait 38,5% des pathologies neuropédiatriques. L'âge moyen était de 33,3 mois avec une prédominance masculine. Un petit poids de naissance était observé chez 23,5% des enfants et 5,9% étaient nés prématurés. Les formes spastiques étaient les plus rencontrées (83,1%). L'épilepsie et les troubles du langage étaient souvent associés à la paralysie cérébrale (61% et 22,8%). Les causes périnatales étaient plus fréquentes (47,1%) et la souffrance cérébrale était l'étiologie périnatale majoritaire (76,6%). Conclusion : La paralysie cérébrale est l'une des maladies neuropédiatriques les plus fréquentes à Abidjan. Les causes sont essentiellement périnatales, notamment l'asphyxie dont la prévention pourrait réduire la survenue de nouveaux cas

Annealing Dependence of Solution-Processed Ultra-Thin ZrOx Films for Gate Dielectric Applications.

Ultra-thin ZrOx thin films on Si substrates were prepared by sol-gel technique and processed with different methods (baked on hot plate at 150 °C, annealed at 500 °C in furnace, and photo-annealed under UV light). The decomposition of the organic groups and the formation of Zr-O bonding in the ZrOx thin films were confirmed by Fourier transform infrared spectroscopy and X-ray photoelectron spectroscopy. It is found that the ZrOx thin film annealed under UV light shows decent characteristics, including an ultra-small surface roughness, a low leakage current density of 10(-9) A/cm2 at 1 MV/cm, a large breakdown electric field of 9.5 MV/cm, and a large areal capacitance of 775 nF/cm2.

Physical and optical properties of nanocrystalline calcium ferrite synthesized by the polymerized complex method.

Nanocrystalline CaFe2O4 oxide semiconductor with spinel structure was synthesized by polymerized complex (PC) method and investigated for its physical and optical properties. The crystallization of CaFe2O4 made by PC method was found to occur in the temperature range of 700-1100 degrees C. The observation of highly pure phase and such lower crystallization tempearture in CaFe2O4 made by PC method, is in total contrast to that observed in CaFe2O4 prepared by the conventional solid-state reaction (SSR) method. The activation energy required for the growth of nanocrystalline CaFe2O4 in PC sample was found to be 8.4 kJ/mol. The band gap of nanocrystalline CaFe2O4 determined by UV-DRS was 1.91 eV (647 nm). The photocatalytic activity of PC materials for iso-propyl alcohol photodegradation under visible light (> or =420 nm) was much higher than that of SSR materials.

Live female Enterobius vermicularis in the posterior fornix of the vagina of a Korean woman.

A 33-year-old Korean woman, para 2. visited an obstetrics and gynecology clinic, Kumi-shi, Kyongsangbuk-do, due to postcoital spotting and flank pain. She had a tubal ligation 7 years before and demonstrated back pain during menstruation. She revealed a foul smelling discharge without complaint of itching. Enterobius vermicularis eggs were demonstrated during microscopic examination of a smear taken from the posterior fornix of the vagina. On endoscopic examination of her vagina, a live worm was found in the posterior fornix. The worm was removed and identified as a female E. vermicularis based on morphology. This is the first case report of vaginal enterobiasis in Korea.

Acute renal failure associated with Yersinia pseudotuberculosis infection in children.

We report 45 pediatric cases of Yersinia pseudotuberculosis infection confirmed by stool culture between May 1993 and June 1994. In 41 (91.1%) cases there had been contact with untreated well or mountain water. Y. pseudotuberculosis was also isolated from 4 samples of mountain spring water thought to be the sources of infection. During the course of the illness, acute renal failure (ARF) developed in 6 patients (13.6%). The age distribution of the ARF group (12.3 +/- 1.2 years) was significantly different from the non-ARF group (8.0 +/- 3.2 years). The serogroups of Y. pseudotuberculosis isolates from stool samples were 5 (n = 30) and 4 (n = 15). Isolates from the water samples were all serogroup 5. The main symptoms of both groups were fever, rash, abdominal pain, and vomiting. ARF developed between the 2nd and 14th days (mean 6 days) after the onset of fever, and oliguria (< 400 ml/m2 per day) developed in 3 patients (3/6, 50%) immediately after their fevers had subsided. ARF underwent a benign course, with complete recovery within a maximum of 4 weeks (mean 10.2 days), with 1 exceptional patient requiring hemodialysis. Renal biopsy showed evidence of tubulointerstitial nephritis. Y. pseudotuberculosis should be included as one of the causes of acute interstitial nephritis causing ARF in children, especially when the children have histories of drinking untreated water in endemic areas.

Intussusception associated with Yersinia pseudotuberculosis infection.

Intussusception associated with Yersinia pseudotuberculosis infection was developed in three boys; two of them had a history of drinking untreated water. All intussusceptions were localized at the ileocolic region, and all patients completely recovered with Gastrografin enema and supportive treatment without complication and operation.

Epithelial cell detachment in the nephrotic glomerulus: a receptor co-operativity model.

Detachment of epithelial cells from the glomerular capillary wall correlates with the massive increase in protein leakage across the capillary wall that is characteristic of many renal diseases. We introduce the hypothesis that this detachment process involves three classes of physical events acting at the subcellular level: the receptor-mediated binding of epithelial cells to basement membrane, the transglomerular hydraulic pressure gradient acting to lift the cells off the basement membrane, and a receptor-receptor co-operativity induced by mechanical deformations of the epithelial cell surface. After presenting the available evidence, we explore the hypothesis by means of a simplified, quantitative model of the detachment process. The model is developed by mapping between the stochastic events of cell adhesion receptor binding and the equilibrium statistical mechanics of the Ising model. Monte Carlo simulations predict cell attachment under normal conditions, as expected from experimental data, and detachment at lower receptor binding affinity and/or increased pressure gradient. The normal attached state in the model is found to be particularly sensitive to changes in the receptor-binding affinity. The amount of resistance the cell surface offers to deformation forces is a key determinant of whether the detachment of small clusters of receptors spreads to involve large areas of the plasma membrane, precipitating bulk detachment.

A new computer-assisted three-dimensional reconstruction method provides accurate measurement of glomerular mesangial volume.

Many glomerulopathies are characterized by progressive mesangial (interstitial) expansion which can be quantitated by morphometric analysis. The purpose of this study was to analyze mesangial and glomerular volumes using a new computer-assisted reconstruction (CAR) method. CAR was compared to two standard planar methods, point-counting and linear integration, for accuracy and time efficiency. In Phase I of the study, a computer-based model of the mesangial space was created by placing spherical and ellipsoidal objects of known volume into an enclosing volume mimicking the glomerulus. The simulated mesangium occupied approximately 10 percent of the glomerular volume. The model glomerulus was sectioned serially into ten sections of equal thickness and the three morphometric methods applied to determine the mesangial/glomerular volume. The complexity of the mesangial model was varied by increasing the number of mesangial regions from one to ten to 100. The CAR method estimated the model mesangial volume more accurately (1-9 percent error) through each level of complexity compared to point-counting (3-17 percent error) and linear integration (3-18 percent error). The point-counting method consistently overestimated (P less than 0.05) the fractional mesangial volume for the ten- and 100-region mesangium models. In Phase II of the study, a normal rat glomerulus was sectioned serially (215 sections) and a transmission electron micrograph (TEM) of every fifth section (n = 43) was obtained. Each TEM image (2% of glomerular surface) was digitized for analysis by CAR. Point-counting and linear integration were also performed on the whole glomerular TEMs (n = 10, randomly chosen). The estimated relative mesangial/glomerular volume was 6.6 +/- 0.1 percent by CAR (mean +/- SD), 9.7 +/- 1.5 by linear integration, and 14.9 +/- 3.4 by point-counting. The point-counting method was most efficient, requiring 40 +/- 8 sec/section, followed by CAR at 85 +/- 24 sec/section. Linear integration was least efficient (93 +/- 23 sec/section). We conclude that CAR is the most accurate morphometric method of the three compared for estimating mesangial and glomerular methods, although it is more time consuming than the point-counting method and requires more complex instrumentation. CAR is the only method that will analyze the shape and three-dimensional complexity of glomerular structures using TEMs.