Water consumption practices in university campuses. The experience of the National Autonomous University of Mexico.

The Water Network of the National Autonomous University of Mexico (Red del Agua UNAM) and the Program for the Management, Use, and Reuse of Water in UNAM (PUMAGUA) carried out a survey with the aim of knowing the water consumption practices of the university community in its campuses located in the Metropolitan Area of the Valley of Mexico. A sample of 2,095 students, academics, administrative and support staff participated in this survey. The results show that 74% of the sample consume bottled water and that their average spending is between 0.50 and 1 dollar per day (11 to 20 Mexican pesos). The rates of bottled water consumption contrasts with the perception about water quality, since only 13% consider water quality distributed in the water fountains located within university campuses as 'poor' or 'very poor'. The rates of bottled water consumption among university community are similar to the ones reported by studies in Mexico City and in Mexico as a whole, even though UNAM has a Water Observatory that allows people to know in real time water quantity and quality in university campuses.

Anti-tuberculosis treatment outcomes in HIV-infected adults exposed to isoniazid preventive therapy in Botswana.

SETTING: Eight public health clinics in Gaborone and Francistown, Botswana. OBJECTIVES: To describe the characteristics and outcomes of incident tuberculosis (TB) cases in human immunodeficiency virus (HIV) infected adults exposed to isoniazid preventive therapy (IPT) with access to antiretroviral and anti-tuberculosis treatment. DESIGN: In 1995 HIV-infected adults, TB disease was excluded before commencing IPT. During and after receipt of 6 or 36 months of IPT, symptomatic participants were evaluated using chest radiographs, sputum microscopy, cultures and drug susceptibility testing (DST). Incident TB cases received ≥6 months of anti-tuberculosis treatment. RESULTS: Seventy-five incident TB cases were identified among 619 symptomatic participants. The median duration of IPT in these cases was 6 months (range 1-35), and the median time to initiation of anti-tuberculosis treatment was 12 months after IPT cessation. Antiretroviral therapy (ART) was initiated before anti-tuberculosis treatment in 37 cases. Culture was positive in 43/58 (74%) TB cultures. DST was available for 38 cases, of which six (16%) were resistant to isoniazid (INH); 67/75 (89%) cases, including four with INH-monoresistant TB, completed anti-tuberculosis treatment or were cured. CONCLUSIONS: With prompt initiation of anti-tuberculosis treatment and access to ART, excellent outcomes were achieved in a public health setting in HIV-infected adults who developed TB disease.

Time management behavior as a moderator for the job demand-control interaction.

The interaction effects of time management, work demands, and autonomy on burnout were investigated in a survey study of 123 elementary teachers. A 3-way interaction between time management, work demands, and autonomy was hypothesized: The combination of high work demands and low autonomy was predicted to lead to burnout for teachers low in time management and not, or to a lesser extent, for those high in time management. This hypothesis is confirmed for emotional exhaustion, the most predictive dimension of teacher burnout, and partly confirmed for the personal accomplishment dimension. Generalizability to other contactual occupations is discussed.

Nocardiosis in renal transplant recipients undergoing immunosuppression with cyclosporine.

Nine cases of nocardiosis were diagnosed among 1,255 renal transplant recipients given cyclosporine (CsA)-prednisone for immunosuppression between August 1980 and March 1992 (incidence, 0.7%). Of these nine patients presenting with nocardiosis 32-1,806 days after transplantation, eight had pulmonary involvement, two had skin manifestations (one with localized disease), and one had a cerebral abscess and a pleural effusion. All cases required aggressive diagnostic procedures. Nocardia asteroides was isolated in seven cases and Nocardia brasiliensis in two. All but one case was cured. Included among the cures were all of four cases treated with amoxicillin/clavulanic acid. Therapy with CsA-prednisone was continued throughout the infection in eight cases. Analysis of a group of 154 historical controls who received azathioprine (AZA)-prednisone for immunosuppression after renal transplantation (performed before 1980 at the same center) revealed four cases of nocardiosis (incidence, 2.6%). Thus nocardiosis is apparently less common among renal transplant recipients given CsA-prednisone than among those given AZA-prednisone. The clinical presentation of nocardiosis in renal transplant recipients is variable, with pulmonary involvement predominating. Diagnosis requires an aggressive approach. Chemotherapy is successful in most cases, including those treated with amoxicillin/clavulanic acid when the isolate is susceptible.

Comparative in vitro activity of PD 127391, a new fluoroquinolone agent, against susceptible and resistant clinical isolates of gram-positive cocci.

We examined the in vitro activity of PD 127391, an investigational fluoroquinolone antibacterial agent, against staphylococci (including methicillin-resistant Staphylococcus aureus), enterococci (including beta-lactamase-producing and highly gentamicin-resistant isolates), and streptococci. The compound was active against all organisms tested and compared favorably with antimicrobial agents routinely used to treat infections with these organisms. On the basis of MICs for 90% of the strains tested, PD 127391 was 32-fold more active against all staphylococci, 16-fold more active against methicillin-resistant S. aureus, 8-fold more active against all streptococci, and 4-fold more active against all enterococci than ciprofloxacin. PD 127391 was shown to be more active than sparfloxacin, which in turn was shown to be more active than ciprofloxacin, against these gram-positive cocci. PD 127391 shows promise for the treatment of infections with gram-positive cocci, including organisms which are resistant to other commonly used antimicrobial agents.

Determination of the chromosomal size of three different strains of Enterococcus faecalis and one strain of Enterococcus faecium.

Pulsed-field gel electrophoresis was used to determine the chromosomal size of three different strains of Enterococcus faecalis and one strain of Enterococcus faecium. The size determinations of OG1X, a strain of E. faecalis widely used in many laboratories for genetic studies, using Sma I, Not I, and Sfi I alone or in combination, ranged from 2,750 to 2,761 kb. Using the same enzymes as with OG1X, the size of HH-67, a plasmid-free clinical isolate of E. faecalis, was determined to be 2,170-2,288 kb and the size of JH2-2, an E. faecalis recipient strain, ranged from 2,008 to 2,135 kb. The size range generated for GE-1, a plasmid-free E. faecium strain, with the use of Sma I, Not I, and Apa I was 2,045-2,155 kb. Although OG1X differed in size from the other three enterococci, each individual enterococcal strain generated reproducible results in different experiments. However, for both E. faecalis OG1X and E. faecium GE-1, one of the enzymes used generated a considerably smaller molecular size than that generated by the other two enzymes. The discrepancy was due to visually undiscernible comigrating fragments, and serves to point out a potential source of error if fewer than two enzymes are used to size a genome. The size discrepancies were resolved by digesting individual fragments with a second enzyme. The molecular sizes of these enterococcal strains are larger than that recently reported for Campylobacter, smaller than that of Escherichia coli and Pseudomonas aeruginosa, and similar (OG1X) or smaller (JH2-2, HH67, and GE-1) than the 2,819-kb reported for Streptococcus mutans.

DNA fingerprinting of Enterococcus faecium by pulsed-field gel electrophoresis may be a useful epidemiologic tool.

Pulsed-field gel electrophoresis was used to compare 34 isolates of Enterococcus faecium from six different geographic locations. This procedure generated an average of 13 discernible fragment bands per isolate (range, 10 to 19 fragment bands) of 34 to 485 kb. The resulting restriction endonuclease digestion patterns were quite heterogeneous and were able to differentiate 27 of 34 isolates from each other, as defined by one or more mismatched fragment bands. Five patterns were shared by two or more isolates, and each set of isolates with matching patterns (shared pattern) originated in the same medical center, suggesting a common epidemiologic background, including highly penicillin resistant isolates in Richmond and Philadelphia. We conclude that pulsed-field gel electrophoresis of DNA digested with low-frequency-cleavage restriction enzymes offers a relatively simple method of comparing E. faecium for the purpose of epidemiologic study.