Epibenthic and mobile species colonisation of a geotextile artificial surf reef on the south coast of England.

With increasing coastal infrastructure and use of novel materials there is a need to investigate the colonisation of assemblages associated with new structures, how these differ to natural and other artificial habitats and their potential impact on regional biodiversity. The colonisation of Europe's first artificial surf reef (ASR) was investigated at Boscombe on the south coast of England (2009-2014) and compared with assemblages on existing natural and artificial habitats. The ASR consists of geotextile bags filled with sand located 220m offshore on a sandy sea bed at a depth of 0-5m. Successional changes in epibiota were recorded annually on differently orientated surfaces and depths using SCUBA diving and photography. Mobile faunal assemblages were sampled using Baited Remote Underwater Video (BRUV). Distinct stages in colonisation were observed, commencing with bryozoans and green algae which were replaced by red algae, hydroids and ascidians, however there were significant differences in assemblage structure with depth and orientation. The reef is being utilised by migratory, spawning and juvenile life-history stages of fish and invertebrates. The number of non-native species was larger than on natural reefs and other artificial habitats and some occupied a significant proportion of the structure. The accumulation of 180 benthic and mobile taxa, recorded to date, appears to have arisen from a locally rich and mixed pool of native and non-native species. Provided no negative invasive impacts are detected on nearby protected reefs the creation of novel yet diverse habitats may be considered a beneficial outcome.

Antibiotic resistance in isolates recovered from women with community-acquired urinary tract infections presenting to a tertiary care emergency department.

INTRODUCTION: We sought to determine the antibiotic susceptibility of organisms causing community-acquired urinary tract infections (UTIs) in adult females attending an urban emergency department (ED) and to identify risk factors for antibiotic resistance. METHODS: We reviewed the ED charts of all nonpregnant, nonlactating adult females with positive urine cultures for 2008 and recorded demographics, diagnosis, complicating factors, organism susceptibility, and risk factors for antibiotic resistance. Odds ratios (ORs) and 95% confidence intervals (CIs) for potential risk factors were calculated. RESULTS: Our final sample comprised 327 UTIs: 218 were cystitis, of which 22 were complicated cases and 109 were pyelonephritis, including 22 complicated cases. Escherichia coli accounted for 82.3% of all UTIs, whereas Staphylococcus saprophyticus accounted for 5.2%. In uncomplicated cystitis, 9.5% of all isolates were resistant to ciprofloxacin and 24.0% to trimethoprim-sulfamethoxazole (TMP-SMX). In uncomplicated pyelonephritis, 19.5% of isolates were resistant to ciprofloxacin and 36.8% to TMP-SMX. In UTI (all types combined), any antibiotic use within the previous 3 months was a significant risk factor for resistance to both ciprofloxacin (OR 3.34, 95% CI 1.16-9.62) and TMP-SMX (OR 4.02, 95% CI 1.48-10.92). Being 65 years of age or older and having had a history of UTI in the previous year were risk factors only for ciprofloxacin resistance. CONCLUSIONS: E. coli was the predominant urinary pathogen in this series. Resistance to ciprofloxacin and TMP-SMX was high, highlighting the importance of relevant, local antibiograms. Any recent antibiotic use was a risk factor for both ciprofloxacin and TMP-SMX resistance in UTI. Our findings should be confirmed with a larger prospective study.

A prospective, multicenter pilot study to evaluate the feasibility and safety of using the CoolGard System and Icy catheter following cardiac arrest.

BACKGROUND: Cardiac arrest causes devastating neurological morbidity and mortality. Mild/moderate hypothermia is neuroprotective after global cerebral ischemia. More rapid controlled attainment of the target temperature may increase efficacy. METHODS: We assessed the safety and feasibility of endovascular cooling in a single arm study of comatose patients who had been successfully resuscitated after cardiac arrest. Core temperature was reduced to a target of 33 degrees C for 24 h using a closed loop endovascular system placed in the inferior vena cava, followed by controlled rewarming. Primary outcomes were speed and accuracy of cooling, survival and GOS after 30 days. RESULTS: Thirteen patients were enrolled, six male, age 60 +/- 19 years. Time from cardiac arrest to return of spontaneous circulation was 14.3 min (range 5-32.5). It took 3h and 39 min (median 210 min, IQ 80-315) to reach 33 degrees C; cooling averaged 0.8 +/- 0.3 degrees C/h (range 0.22-1.12 degrees C/h). Temperature was tightly maintained for all patients averaging 32.7 +/- 0.5 degrees C. Rewarming lasted 18.3 +/- 5.9 h. Five patients (38%) had 30-day Glasgow Outcome Scores of 1-2. Four patients died, none related to the hypothermia procedure. No unanticipated or procedure-related adverse events occurred. CONCLUSION: In comatose survivors of cardiac arrest, hypothermia via endovascular methods is safe and feasible, and target temperatures can be achieved and controlled rapidly and precisely. More studies are needed to assess the efficacy of rapid endovascular hypothermia after cardiac arrest.