ABSTRACT
The late Middle Ages brought about technical innovations in machinery and the use of flowing water as a prime mover. It was mainly in Central Europe that the rediscovery, renewal, and improvement of ancient water-raising methods took place in the late Middle Ages, thus enabling urban consumption from adjacent rivers. The roughly 300 years covered by this study represent a formative phase in the history of water supply systems, from the first large-scale European urban water raising device, built in Lübeck around 1300, to the construction of the London Bridge Waterworks in the 1580s. Historians have generally viewed the London project as one that revolutionized attitudes toward water supply, transforming water into a commodity and water supply into a business. I contend that several water-lifting installations in Central Europe substantially preceded the London device, not only chronologically, but also in social conceptions of their role and commercial implications of their construction.
ABSTRACT
UNLABELLED: In order to determine bacterial distribution and antimicrobial susceptibility of urinary pathogens in a long-term-care-facility (LTCF), urine cultures were examined when clinically indicated. The LTCF consists of 286 beds, housing 931 residents during 32 months, in various wings; independent and frail residents (wing-A), nursing and demented patients (wing-B), and skilled-nursing patients (wing-C). A total of 1,401 positive urine cultures were obtained: E. coli was isolated significantly less often in wing-C than in wing-A (p = 0.02) and wing-B (p = 0.009). There was no significant difference in frequency of other organisms. Susceptibility of organisms decreased significantly from wing-C to wing-B (p < 0.05-0.001), and from wing-B to wing-A (p < 0.05-0.001). Susceptibility rates' decreased significantly over time in wing-B, less in wing-C and not at all in wing-A. IN CONCLUSION: When selecting empiric antibiotic therapy for serious urinary tract infection in a long-term-care resident, one should take into account the microbial environment of the individual patient's department.
