Lifetime prevalence, correlates and health consequences of gender-based violence victimisation and perpetration among men and women in Somalia.

BACKGROUND: Humanitarian emergencies increase the risk of gender-based violence (GBV). We estimated the prevalence of GBV victimisation and perpetration among women and men in urban settings across Somalia, which has faced decades of war and natural disasters that have resulted in massive population displacements. METHODS: A population-based survey was conducted in 14 urban areas across Somalia between December 2014 and November 2015. RESULTS: A total of 2376 women and 2257 men participated in the survey. One in five men (22.2%, 95% CI 20.5 to 23.9) and one in seven (15.5%; 95% CI 14.1 to 17.0) women reported physical or sexual violence victimisation during childhood. Among women, 35.6% (95% CI 33.4 to 37.9) reported adult lifetime experiences of physical or sexual intimate partner violence (IPV) and 16.5% (95% CI 15.1 to 18.1) reported adult lifetime experience of physical or sexual non-partner violence (NPV). Almost one-third of men (31.2%; 95% CI 29.4 to 33.1) reported victimisation as an adult, the majority of which was physical violence. Twenty-two per cent (21.7%; 95% CI 19.5 to 24.1) of men reported lifetime sexual or physical IPV perpetration and 8.1% (95% CI 7.1 to 9.3) reported lifetime sexual or physical NPV perpetration. Minority clan membership, displacement, exposure to parental violence and violence during childhood were common correlates of IPV and NPV victimisation and perpetration among women and men. Victimisation and perpetration were also strongly associated with recent depression and experiences of miscarriage or stillbirth. CONCLUSION: GBV is prevalent and spans all regions of Somalia. Programmes that support nurturing environments for children and provide health and psychosocial support for women and men are critical to prevent and respond to GBV.

IgA nephropathy with early kidney disease is associated with increased arterial stiffness and renin-angiotensin system activity.

BACKGROUND: IgA nephropathy is associated with increased cardiovascular risk, though whether this is due to loss of kidney function or proteinuria is unclear. METHODS: For this study 10 normotensive IgA nephropathy subjects with early kidney disease (41±5 yrs, glomerular filtration rate (GFR) 87±9 ml/min, proteinuria 720±300 mg/d) and 10 gender- and blood pressure-matched healthy controls (36±1 yrs, estimated GFR 102±5 ml/min, proteinuria 70±6 mg/d) were studied in high-salt balance. Blood pressure and arterial stiffness, expressed as pulse wave velocity and aortic augmentation index, were measured at baseline and in response to 60 min of angiotensin II (AngII) infusion. RESULTS: At baseline, IgA nephropathy subjects demonstrated similar pulse wave velocity (8.6±0.7 vs. 8.0±0.4 m/s, p=0.5) but increased aortic augmentation index (12.6±3.1 vs. 1.8±4%, p=0.04) and a trend towards increased circulating renin-angiotensin system (RAS) components (plasma renin activity, 0.55±0.18 vs. 0.21±0.05 ng/l/s, p=0.08; angiotensin II, 25±5 vs. 16±1 ng/l, p=0.08) compared with controls. However, despite similar baseline blood pressure values (p=0.8), IgA nephropathy was associated with reduced arterial sensitivity to AngII challenge (Δmean arterial pressure: 19±4 vs. 29±1 mm Hg, p=0.05; Δpulse wave velocity: -0.06±0.6 vs. 1.5±0.3 m/s, p=0.07) compared with controls, even after multivariate analysis. CONCLUSION: Even in the setting of early kidney disease, IgA nephropathy is associated with increased arterial stiffness and decreased angiotensin II responsiveness, a marker of increased RAS activity.

Antibacterial susceptibility patterns and cross-resistance of acinetobacter, isolated from hospitalized patients, southern iran.

BACKGROUND: Acinetobacter is a multi-drug resistant and nosocomial pathogen. The aim of this study was to determine antibacterial susceptibility patterns and cross-resistance of Acinetobacter species. METHODS: This study was conducted in Nemazee Hospital, Shiraz, Iran from October 2007 to September 2008. Species identification was carried out by API E20. Minimum inhibitory concentration and cross-resistance of the isolated strains to 12 antibiotics were determined by E-test method. RESULTS: Eighty eight isolates of Acinetobacter were collected from patients' samples. Acinetobacter baumannii was isolated most frequently (79; 89.8%). Colistin, imipenem and meropenem were found to be the three most effective antibiotics with 97.7%, 77.3% and 72.7% activity against the isolates, respectively. Multi-drug resistance was revealed among 2 to 11 antibiotics and high cross-resistance was also noticed. CONCLUSION: To alleviate the situation, strict control measures and appropriate effective antibiotic therapy should be adopted to reduce hospital costs and related mortality.

Pulsed field gel electrophoresis & plasmid profile of Pseudomonas aeruginosa at two hospitals in Tehran, Iran.

BACKGROUND & OBJECTIVE: Pseudomonas aeruginosa is a common cause of nosocomial infections and exhibits innate resistance to a wide range of antibiotics. This study was undertaken to determine the resistance patterns of P. aeruginosa isolates recovered from patients at two hospitals in Tehran, to investigate the presence of plasmids and to genetically characterize them by pulsed field gel electrophoresis (PFGE). METHODS: The susceptibility of 104 isolates of P. aeruginosa to 13 different antibiotics was determined by agar disk diffusion method. The alkaline lysis method was used for plasmid extraction. PFGE technique was optimized for DNA fingerprinting of isolates. RESULTS: The isolates showed resistance to 13 different antibiotics ceftizoxime (99%), lomefloxacin (94.3%), ceftazidime (59.6%), ticarcillin (50%), ceftriaxone (44.3%), cefoperazone (37.5%), tobramycin (34.6%), piperacillin and gentamicin (33.7%), carbenicillin (25%), amikacin (22%), ciprofloxacin (15.4%) and imipenem (2.9%). Plasmids were detected in 31 isolates (29.8%) that produced 15 different patterns. In total, 84 DNA banding patterns were detected by PFGE. The dominant PFGE type, Pattern A with 14 isolates was found at both hospitals. The remaining isolates were grouped in B, C, D and PF1-PF80. The majority of isolates with the identical plasmid profiles and resistance patterns produced closely related DNA fingerprints by PFGE. INTERPRETATION & CONCLUSION: Isolates in pattern A were distributed widely at both hospitals and the environment. Absence of plasmids in majority of isolates indicated low typeability and discriminatory power of this technique.

Study of antibiotic resistance by efflux in clinical isolates of Pseudomonas aeruginosa.

Twenty three multidrug resistant (MDR) strains were selected from 104 clinical isolates of P. aeruginosa and screened for resistance to ceftazidim, ceftriaxone, ciprofloxacin, ofloxacin and ethidium bromide by determining MICs. The MICs of EtBr and antibiotics were also measured in presence of proton conductor, carbonyl cyanide m-chlorophenyl hydrazone (CCCP). The presence of proton gradient-dependent efflux mechanism was assessed using ethidium bromide accumulation assays. Drug accumulation studies for these antibiotics were performed to determine the drug specificity of efflux. PCR was used to identify the mexAB-oprM gene as a major factor in MDR intrinsic resistance of clinical isolates of P. aeruginosa. In absence of CCCP, the MICs of these antimicrobial agents were > or = 4 microg L(-1). CCCP reduced the MICs of them at least in 1 dilution. Ethidium bromide accumulation assays confirmed the presence of proton gradient-dependent efflux mechanism in clinical isolates of P. aeruginosa and results of accumulation assays of drugs demonstrate that, active efflux in this bacterium are due to broadly-specific multidrug efflux system(s). PCR products demonstrate the presence of mexAB-oprM operon in 4 strains from 23 clinical isolates. These results confirmed the presence of proton gradient-dependent efflux mechanism in all of the clinical isolates of P. aeruginosa and demonstrate that, efflux pumps in this bacterium are broadly-specific multidrug efflux systems. In this study we show that MexAB-OprM multidrug efflux system was expressed in only 17% of clinical isolates of P. aeruginosa. These results confirmed the presence of other multidrug efflux pumps in clinical isolates of P. aeruginosa.

Bactericidal activity of various antibiotics against biofilm-producing Pseudomonas aeruginosa.

Clinical isolates of Pseudomonas aeruginosa were collected from hospitals in Tehran, Iran, and identified using biochemical tests. A modified microtitre plate test was used to determine the biofilm-forming capacity of the isolates, measured with an enzyme-linked immunosorbent assay (ELISA) reader. Results showed that P. aeruginosa strain 214 was the most efficient at producing biofilm compared with the other strains. Observation of the bacterial biofilm on Teflon sheets and on a catheter using a scanning electron microscope showed greater biofilm formation on the catheter than on Teflon sheets. In this study, we investigated the bactericidal activity of fluoroquinolones, beta-lactams, macrolides and aminoglycoside. The results showed differences in the antibiotic susceptibility of planktonic and biofilm cell populations. Fluoroquinolones showed more potent activity than the other antibiotics, and biofilms were completely eradicated by treatment with 16 x the minimum inhibitory concentration (MIC) of ciprofloxacin and 64 x MIC of ofloxacin, whereas all biofilms survived 2560 microg/mL of imipenem and ceftazidime. Production of an exopolysaccharide matrix is one of the distinguishing characteristics of biofilms. It has been suggested that this matrix prevents access of antibiotics to the bacterial cells embedded in the community. In this study, we also evaluated the permeation of antibiotics through alginate of P. aeruginosa strain 214 using a sandwich cup method. Macrolides were most efficient, showing 100% penetration; fluoroquinolones and beta-lactams had a high permeation rate > 75%, whereas the rates for aminoglycosides were low (amikacin = 59%; gentamicin = 73%).

Cytotoxic effects of pyocin S2 produced by Pseudomonas aeruginosa on the growth of three human cell lines.

Pyocin typing of 82 Pseudomonas aeruginosa strains, collected from different Iranian clinical sources, revealed that one isolate, P. aeruginosa 42A, produced pyocin S2, a protease-sensitive bacteriocin. Pyocin S2 production was induced by mitomycin C (2 micro g/mL) in the pyocin S2 producer P. aeruginosa 42A. Pyocin S2 was purified using ion exchange chromatography with CM-Sepharose CL-6B and sodium phosphate buffer (pH 8) from an 80% ammonium sulfate precipitate of whole-cell lysates. Pyocin activity of the fractions was detected using the Govan spot testing method. The purity of the active fraction was confirmed by SDS-PAGE, where a single band with a molecular mass of 74 kDa was detected. Cytotoxic effects of purified pyocin S2 and partially purified pyocin from P. aeruginosa 42A on the human tumor cell lines HepG2 and Im9 and the normal human cell line HFFF (Human Foetal Foreskin Fibroblast) were studied by the MTT (3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide) assay. The results demonstrated that partially purified pyocin and pyocin S2 exhibited substantial inhibitory effects on the growth of the tumor cell lines HepG2 and Im9, while no inhibitory effects were observed on the normal cell line HFFF. Pure lipopolysaccharide was used as a control and was found to have no inhibitory effect on any of the cell lines tested.