ABSTRACT
BACKGROUND: Antibiotic resistance is one of the great challenges for modern healthcare. In Gram-negative bacteria, CTX-M-type extended-spectrum beta-lactamases (ESBLs) have been rapidly spreading through Europe since the early 2000s. In Sweden, ESBL-producing Escherichia coli are still rare, but a 3-fold increase has been seen from 2004 to 2007. Enterobacteria and normal flora of wild animals, with or without antibiotic resistance traits, constitute a potential source of human infection and colonization. We studied wild birds with the aim to understand the environmental dissemination of antibiotic resistance and, focusing on clinically relevant resistance types, we made comparisons with human clinical samples. METHODS: In this study, ESBL-producing human clinical isolates and isolates from juvenile black-headed gulls from Kalmar County hospital and the city of Kalmar, respectively, on the southeast coast of Sweden, were characterized and compared. RESULTS: Despite a low frequency of antibiotic resistance among the isolates from gulls, ESBL-producing E. coli isolates were found, two with bla(CTX-M-14) and one with bla(CTX-M-15). The same CTX-M types were dominant among human ESBL isolates. In addition, gull isolates were dispersed among the human samples in the PhenePlate clustering system, indicating that they neither differ from the human isolates nor form any separate clonal clustering. CONCLUSIONS: The finding of CTX-M-type ESBLs in E. coli isolated from black-headed gulls in Sweden, where 'background resistance' is low, is consistent with an ongoing environmental spread of these plasmid-borne resistance genes. The results indicate that a potential for transfer between the human population and environment exists even in countries with a low level of antibiotic resistance.
Subject(s)
Charadriiformes/microbiology , Escherichia coli Infections/microbiology , Escherichia coli Infections/veterinary , Escherichia coli/classification , Escherichia coli/enzymology , beta-Lactamases/biosynthesis , Animals , Anti-Bacterial Agents/pharmacology , Drug Resistance, Bacterial , Escherichia coli/isolation & purification , Escherichia coli Infections/transmission , Escherichia coli Proteins/genetics , Humans , Microbial Sensitivity Tests , Molecular Epidemiology , Plasmids , Sweden , beta-Lactamases/geneticsABSTRACT
Forty interpreters attending a regional Registry of Interpreters for the Deaf conference completed a questionnaire regarding symptoms related to repetitive stress injury (RSI), a generic classification of problems that occur after extensive, repetitive motion. RSIs, including the most prevalent form, Carpal Tunnel Syndrome (CTS), were surveyed. The vast majority (87.5%) of the interpreters in the sample reported that they had at sometime experienced at least two symptoms associated with RSI. Some (12.5%) who had CTS reported that they had been misdiagnosed. When asked how many other interpreters they knew with RSI problems, they reported, on average, that they knew more than four others. The data indicate that RSI is a severe problem among sign language interpreters and warrants immediate action. The term interpreter's wrist may best describe the malady.
Subject(s)
Carpal Tunnel Syndrome/epidemiology , Cumulative Trauma Disorders/epidemiology , Occupational Diseases/epidemiology , Sign Language , Adult , Female , Humans , Male , Surveys and QuestionnairesABSTRACT
Carpal Tunnel Syndrome (CTS) is a problem associated with numbness, burning, tingling, tickling or "pins and needles" sensations in the hand. The syndrome has been linked to occupations that require repetitive pinching and/or repetitive wrist movements, both movements associated with sign language interpreting. Educational interpretors may be particularly at risk and so need accurate information regarding this malady. Without such education, some interpreters will worry needlessly while others delay in seeking essential medical attention. This article profiles groups at high risk for Carpal Tunnel Syndrome and identifies surgical and rehabilitative treatments.