ABSTRACT
BACKGROUND: Extended-spectrum beta-lactamase (ESBL)-producing Enterobacteriaceae is an emerging therapeutic challenge, especially in the treatment of urinary tract infections. Following an outbreak of CTX-M-15 Klebsiella pneumoniae in Uppsala, Sweden, an orphan drug trial on IgY chicken antibodies was undertaken in an attempt to eradicate faecal carriage of ESBL-producing K. pneumoniae and Escherichia coli. METHODS: Hens were immunised with epitopes from freeze-dried, whole-cell bacteria (ESBL-producing K. pneumoniae and E. coli) and recombinant proteins of two K. pneumoniae fimbriae subunits (fimH and mrkD). The egg yolks were processed according to good manufacturing practice and the product was stored at-20°C until used. Using an internal database from the outbreak and the regular laboratory database, faecal carriers were identified and recruited from May 2005 to December 2013. The participants were randomised in a placebo-controlled 1:1 manner. RESULTS: From 749 eligible patients, 327 (44%) had deceased, and only 91 (12%) were recruited and signed the informed consent. In the initial screening performed using the polymerase chain reaction, 24 participants were ESBL positive and subsequently randomised and treated with either the study drug or a placebo. The study was powered for 124 participants. Because of a very high dropout rate, the study was prematurely terminated. From the outbreak cohort (n=247), only eight patients were screened, and only one was positive with the outbreak strain in faeces. CONCLUSIONS: The present study design, using IgY chicken antibodies for the eradication of ESBL-producing K. pneumonia and E. coli, was ineffective in reaching its goal due to high mortality and other factors resulting in a low inclusion rate. Spontaneous eradication of ESBL-producing bacteria was frequently observed in recruited participants, which is consistent with previous reports.
ABSTRACT
The main aim of this study was to describe adolescents' perceptions and experiences of bullying: their thoughts about why children and adolescents are bullied, their ideas about why some bully others, and what they believe is important in order to stop bullying. The adolescents were asked about experiences throughout their school years. The study group was comprised of 119 high school students, with a mean age of 17.1 (SD = 1.2). Of the adolescents who reported, 39% indicated that they had been bullied at some time during their school years and 28% said that they had bullied others; 13% reported being both victims and bullies. The ages during which most students had been bullied at school were between 7 and 9 years. Bullies reported that most of the bullying took place when they were 10 to 12 years old. The most common reason as to why individuals are bullied was that they have a different appearance. The participants believe that those who bully suffer from low self-esteem. The most common response to the question "What do you think makes bullying stop?" was that the bully matures. The next most frequent response was that the victim stood up for himself/herself. Those who were not involved in bullying during their school years had a much stronger belief that victims can stand up for themselves than did the victims themselves.
