Engaging with civil society to improve access to LTBI screening for new migrants in England: a qualitative study.

The latent tuberculous infection (LTBI) programme in England, UK, offers testing and treatment to new migrants from high tuberculosis incidence countries. However, the rates of LTBI testing, treatment acceptance and completion are suboptimal and appropriate access should be improved. To gain insight from the community, community-based organisations (CBOs) and public sector stakeholders on interventions that facilitate collaboration to improve health care outreach and delivery. Three stakeholder meetings and five focus group discussions were held using thematic analysis to identify themes arising from participants' perspectives. Four overarching themes emerged from the discussions. These were related to capacity of service providers, collaboration between stakeholders, migrant cultures and trust between migrants and service providers, and highlighted the complementary skill sets that different sectors bring to the collaboration, as well as the barriers that need to be surmounted. Stigma could be reduced by making LTBI testing routine. Community members could act as champions of health promotion to raise awareness on LTBI testing, and provide a bridge between communities and primary care services. Public service providers, community members and CBOs are willing to collaborate to support primary care delivery of testing for LTBI and other communicable and non-communicable diseases. Policy and commissioning support are needed to facilitate this collaboration. .

Self-assembled organometallic [12]metallacrown-3 complexes.

The reaction of [(arene)RuCl2]2 (arene = C6H6, cymene, C6H3Et3, or C6Me6) or [Cp*RhCl2]2 with 3-hydroxy-2-pyridone in the presence of Cs2CO3 gives trinuclear metallamacrocyclic complexes. The self-assembly process was shown to be completely diastereoselective, and a racemic mixture of complexes with M(R)M(R)M(R) or MsMsMs (M=Ru, Rh) configuration was obtained. Plausible mononuclear intermediates of the formula [(arene)RuCl(C5H4NO2)] (arene = cymene, C6Me6) have been isolated and characterized. A structurally related trimer was synthesized by using [(cymene)RuCl2]2 and 3-acetamido-2-pyridone instead of 3-hydroxy-2-pyridone. The macrocycles were shown to be highly potent ionophores for Na+ and/or Li+ with negligible affinities for the larger cation K+. The selectivities of the receptors depend on the pi-ligand present: whereas the (C6H6)Ru- and (cymene)Ru complexes bind both Li+ and Na+, the (C6Me6)Ru-, (C6H3Et3)Ru-, and Cp*Rh complexes bind exclusively Li+. For all receptors, the presence of alkali metal ions can be detected electrochemically: the peak potential is shifted by > 300 mV toward anionic potential upon binding. This behavior was utilized to detect Li+ and Na+ colorimetrically. Single crystal X-ray analyses have been carried out on eight complexes, four of which are bound to an alkali metal halide ion pair. Structural parameters, which affect the affinity and selectivity are discussed. A computational study on [[MX][12]crown-3] complexes (M =Li, Na; X=Cl, Br, I) was performed in order to compare relevant bond lengths and angles of the energy-minimized structures with those of the organometallic receptors.

[High-level tetracycline-resistance of Neisseria gonorrhoeae]. / "High-level"-Tetrazyklinresistenz von Neisseria gonorrhoeae.

High level tetracycline resistance of Neisseria gonorrhoeae is mediated by a 25.2-MD plasmid and is characterized by a minimal inhibitory concentration of 16 micrograms/ml or more. The 25.2-MD plasmid originated through the insertion of the streptococcal tetM determinant into the 24.5-MD transfer plasmid of N. gonorrhoeae. In the present study the prevalence of N. gonorrhoeae with high-level tetracycline resistance in the Heidelberg gonococcal population between 1981 and 1989 was determined. Among 1765 N. gonorrhoeae isolates, one strain with high-level tetracycline resistance was identified. The presence of the 25.2-MD plasmid in this strain was demonstrated by plasmid-agarose gel electrophoresis. The auxotype/serovar class proline-/IB-1 indicates the importation of this strain from the USA. The 25.2-MD recombinant plasmid, in contrast to the 24.5 MD transfer plasmid, has a rather wide host range, which is favourable to the occurrence both of high-level tetracycline resistance and of beta-lactamase plasmids in N. meningitidis.

Evaluation of API 20 NE in routine diagnostics of nonfermenting gram-negative rod-shaped bacteria.

292 strains of non-fermenting Gram-negative rod-shaped bacteria were determined by standard methods and tested in a new commercial microidentification-system, the API 20 NE (api Biomérieux). A total of 282 (= 96,6%) strains were identified conformably; 130 (= 46,1%) after 24 h and 77 (= 27,3%) within 48 h. In 75 (= 26,6%) cases different conventional additional tests for determination to species level were necessary. The reasons for divergent results of 10 strains are discussed. The new microidentification system API 20 NE might be a simple and reliable tool in hand of the skilled medical microbiologist.

[The identification of nonfermentative gram-negative bacteria. Experiences with 676 apyocyaninogenic strains (author's transl)]. / Zur Diagnostik der nicht-fermentierenden gramnegativen Stäbchenbakterien. Erfahrungen an 676 apyocyaninogenen Stämmen.

During a period of 16 months 1757 strains of nonfermentative gram-negative rods have been isolated from clinical material. Of the, 1205 (69%) were P. aeruginosa, 124 (10%) of which failed to produce pyocyanin. The apyocyaninogenic strains as well as the remaining 552 isolates were differentiated by steps according to a diagnostic scheme developed by us. For identification of species two or three steps were needed. By this procedure, 530 of the 552 strains could be assigned to nineteen species within the genera Pseudomonas, Achromobacter, Alcaligenes, Flavobacterium, Agrobacterium and Acinetobacter. 17 strains could not be identified below the genus level, one strain belonged to CDC-group VE-2 and four strains were not identifiable. 72% of the 552 strains belonged to only four species: Pseudomonas putida, P. maltophilia, Acinetobacter lwoffii and A. anitratus.