Flooding adds pathogenic Escherichia coli strains to the water sources in southern Khyber Pakhtunkhwa, Pakistan

PURPOSE

Seasonal rains in Pakistan result in heavy floods across the country, whereby faecal contaminants will be added to the water bodies and cause numerous food-borne outbreaks. The present study was aimed to determine the prevalence of diarrheagenic Escherichia coli (DEC) strains in the water sources.

MATERIALS AND METHODS

Two hundred water samples collected during (2011-2012) were processed for the isolation of E. coli (EC) strains. EC strains were further analysed for antibiotic susceptibility patterns, and pathogroups-specific virulence factors stx1, stx2, stx2c, eae, tir, hlyA, bfpA, estA and eltA were detected using multiplex polymerase chain reaction.

RESULTS

Thirty-three percent of the water samples were contaminated with EC pathotypes. Fifty percent (33/66) of the DEC pathotypes were identified as enterotoxigenic EC (ETEC). Seventy-two percent (13/18) of the enteropathogenic EC (EPEC) strains were identified as typical EPEC and 28% (5/18) as atypical EPEC. Eleven percent (7/66) of the Shiga toxin EC (STEC) isolates carried a combination of stx1 and stx2 genes. Summer was found as a peak season with 47% (31/66) for EC pathogroups' activities. Eighty-nine percent of the strains showed resistance against tetracycline.

CONCLUSION

ETEC and EPEC are the primary causes of water contamination in southern regions of Khyber Pakhtunkhwa province, Pakistan. Firm adherence to the prescribed drugs can decrease trends in antibiotic resistance.

[Application of the current resuscitation guidelines 2005. Case report of successful cardiopulmonary resuscitation]

The international guidelines for cardiopulmonary resuscitation are subject to continuous modification and were revised in November 2005. This report describes a case of an out-of-hospital cardiopulmonary resuscitation where the patient survived a cardiac arrest without neurological sequelae after chest compression (30:2), bag-mask ventilation and multiple biphasic defibrillation (single shocks). This article gives a practical review of the most important new recommendations in the current resuscitation guidelines. The accomplished measures are discussed on the background of the new recommendations.

The role of glutamine in skeletal muscle ischemia/reperfusion injury in the rat hind limb model

OBJECTIVES

Ischemia/reperfusion injury is a commonly occurring event with severe pathologic consequences. Reperfusion initiates both the local and systematic damage in part through rapid oxygen generation. The glutathione system is a major mechanism of reducing this oxidative stress. If this system can be maintained or augmented during this stress then less damage may occur. Glutamine provides the source of glutamate to this system and has been shown to preserve total glutathione levels after injury/ischemia to both hepatic and gut models. To test this effect, we looked at glutamine and its role in ischemia/reperfusion injury in a rat hind limb model.

METHODS

Fifty male HSD/Holtzman rats weighing 350-400 g were randomized to receive glutamine (3% sol) or normal saline via intraperitoneal injections. The groups were then subjected to 2 hours of ischemia to their hind limbs using the Tourni-Cot method. Animals were then randomized to reperfusion groups of 30 minutes, 2 hours, and 4 hours. Muscle tissue assays were performed for lipid peroxidation (LPO), total glutathione (GSH), and myeloperoxidase (MPO). Peripheral blood was analyzed for creatinephosphokinase levels (CPK).

RESULTS

Animals that received glutamine showed a general trend of less lipid peroxidation products than the normal saline groups. In animals that received glutamine and underwent 2 hours of ischemia and reperfusion times of 0 minutes, 30 minutes, and 2 hours, there were significantly less percent changes in lipid peroxidation products from controls (4.6% vs 48.2%, P <0.05), (18.9% vs 123%, P <0.05), (12.6% vs 115%, P <0.05). A general trend upward was noted in CPK levels in both groups. In animals receiving 2 hours of ischemia and 30 minutes of reperfusion, there was a significantly greater level of creatinephosphokinase (CPK) calculated as percent change from control in the normal saline group as compared with the glutamine group (209.2% vs 92.7%). Myeloperoxidase assay of muscle tissue revealed a progressive increase as the reperfusion times grew. In animals receiving 2 hours of ischemia and 30 minutes of reperfusion, the normal saline group had a significantly larger percent increase from controls than the group that received glutamine (1126.4% vs 108%, P <0.05). Also, in those animals receiving 4 hours of reperfusion, the normal saline group had a significantly higher percent increase in MPO content than the glutamine group (6245% vs 108%, P <0.05). Total glutathione levels decreased rapidly as reperfusion occurred in both the normal saline and glutamine groups. No significant difference between the groups was noted.

CONCLUSIONS

Total glutathione levels during reperfusion were not significantly different in the groups receiving glutamine versus normal saline. Glutamine may provide an initial protective effect on reperfusion injury after moderate reperfusion times in the hind limb model as defined by CPK and LPO levels. Glutamine may blunt neutrophil recruitment after longer reperfusion times (4 hours) in the ischemic hind limb. Total glutathione levels decreased significantly after moderate levels of ischemia (2 hours) and reperfusion (30 minutes, 2 hours).

Intercellular adhesion molecule-1 expression in dextran sodium sulfate-induced colitis in rats

Orally administered dextran sodium sulfate (DSS) produces an acute colitis in rodents. The pathogenesis is unknown but may relate to DSS-mediated toxicity of colonic crypt epithelium and/or DSS-induced inflammation. The purpose of this study was to determine when colonic mucosal inflammation, as indicated by histopathology and intercellular adhesion molecule-1 (ICAM-1) expression, occurs relative to crypt epithelial damage. Groups of eight adult male Wistar rats were administered 5.0% DSS solution in the drinking water for 2-6 days. Clinical signs at 3 days consisted of loose stool, progressing to marked rectal hemorrhage by days 5 and 6 that correlated with marked intraluminal colonic hemorrhage at necropsy. Histological lesions of predominantly the distal colon consisted of multifocal areas of mucosal erosion, reduction in goblet cells, dilated crypts, crypt collapse, increased lamina propria neutrophils, and submucosal edema on days 2 and 3, progressing to locally extensive ulceration and marked mixed inflammatory infiltrates by days 4-6. Enhanced expression of ICAM-1, demonstrated by both immunohistochemical and northern blot analysis, was evident in colonic mucosa as early as day 2, with consistent increases through days 3-6. Results demonstrate that enhanced colonic mucosal endothelial cell ICAM-1 expression is an early event in the inflammatory cascade of DSS-induced colitis.

Variant (8;22) translocation in lymphoblastic lymphoma

Occasional cases with the chromosomal translocations that juxtapose the c-myc oncogene to Ig genes have been reported in large cell, small lymphocytic, immunoblastic, and follicular lymphomas. In this report, we present a 20 year-old female with lymphoblastic lymphoma of B-cell type and a translocation t(8;22), in which cytogenetic, immunologic, and molecular studies were performed. To the best of our knowledge this is the first report of this association.

Micrografts. II: Evaluation of 25:1, 50:1, and 100:1 expansion skin grafts in the porcine model

This study was undertaken to evaluate 25:1, 50:1, and 100:1 expansions of micronized skin grafts in a porcine model. Two full-thickness skin excisions (graft and control) were performed on each of 30 immature pigs (20 pounds). The pigs were divided into three groups of 10 animals each: group A, 25 cm2; group B, 50 cm2; and group C, 100 cm2. One square centimeter of the excised skin was thinned to produce a thick split-thickness skin graft. Four 90-degree passes were made through a skin mesher with the smooth side of the plastic mesh carrier to produce uniform pieces of skin. These pieces were applied to one area on each pig. Both the graft and control sites were covered with film. The film was removed on postoperative day 7, and excision sites were photographed on postoperative days 7, 10, 14, and 21. Healing was evaluated with a 12 x 12 inch digitizing pad to estimate the percent area healed. Healing was compared via analysis of variance, with percent area healed used as the dependent variable and treatment (control or graft) and postoperative day and expansion size used as the independent variables. No difference was found on postoperative day 7. On postoperative day 10, 25:1 grafts healed better than the 50:1 grafts, which were healed more than the 100:1 grafts. No difference was seen between 25:1 and 50:1 grafts on postoperative day 14; however, they were healed better than the 100:1 expansion grafts. No difference was seen between the graft sites on postoperative day 21.(ABSTRACT TRUNCATED AT 250 WORDS)

Phosphatidylethanolamine is the donor of the terminal phosphoethanolamine group in trypanosome glycosylphosphatidylinositols

A variety of eukaryotic cell surface proteins, including the variant surface glycoproteins of African trypanosomes, rely on a covalently attached lipid, glycosylphosphatidylinositol (GPI), for membrane attachment. GPI anchors are synthesized in the endoplasmic reticulum by stepwise glycosylation of phosphatidylinositol (via UDP-GlcNAc and dolichol-P-mannose) followed by the addition of phosphoethanolamine. The experiments described in this paper are aimed at identifying the biosynthetic origin of the terminal phosphoethanolamine group. We show that trypanosome GPIs can be labelled via CDP-[3H]ethanolamine or [beta-32P]CDP-ethanolamine in a cell-free system, indicating that phosphoethanolamine is acquired en bloc. In pulse-chase experiments with CDP-[3H]ethanolamine we show that the GPI phosphoethanolamine is not derived directly from CDP-ethanolamine, but instead from a relatively stable metabolite, such as phosphatidylethanolamine (PE), generated from CDP-ethanolamine in the cell-free system. To test the possibility that PE is the immediate donor of the GPI phosphoethanolamine moiety, we describe metabolic labelling experiments with [3H]serine and show that GPIs can be labelled in the absence of detectable radiolabelled CDP-ethanolamine, presumably via [3H]PE generated from [3H]phosphatidylserine (PS). The data support the proposal that the terminal phosphoethanolamine group in trypanosome GPIs is derived from PE.

Micrografts: the "super" expansion graft

A novel technique for producing micronized skin grafts that was introduced in a paper presented at the 1990 ABA meeting was evaluated to quantify maximum expansion. Twenty Sprague-Dawley rats were divided into two groups representing 10:1 and 25:1 expanded micrograft ratios, respectively. Grafted sites in both groups were shown to heal better than those of the control group, and both grafted groups showed comparable healing at day 10.