We report on the genomic characterization of 47 multi-drug resistant, carbapenem resistant and ESBL-producing K. pneumoniae isolates from the influent (I) and effluent (E) of three wastewater treatment plants (WWTPs) and from Romanian hospital units which are discharging the wastewater in the sampled WWTPs. The K. pneumoniae whole genome sequences were analyzed for antibiotic resistance genes (ARGs), virulence genes and sequence types (STs) in order to compare their distribution in C, I and E samples. Both clinical and environmental samples harbored prevalent and widely distributed ESBL genes, i.e. bla SHV , bla OXA , bla TEM and bla CTX M . The most prevalent carbapenemase genes were bla NDM-1 , bla OXA-48 and bla KPC-2 . They were found in all types of isolates, while bla OXA-162 , a rare bla OXA-48 variant, was found exclusively in water samples. A higher diversity of carbapenemases genes was seen in wastewater isolates. The aminoglycoside modifying enzymes (AME) genes found in all types of samples were aac(6'), ant(2'') Ia, aph(3'), aaD, aac(3) and aph(6). Quinolone resistance gene qnrS1 and the multi-drug resistance oqxA/B pump gene were found in all samples, while qnrD and qnrB were associated to aquatic isolates. The antiseptics resistance gene qacEdelta1 was found in all samples, while qacE was detected exclusively in the clinical ones. Trimethroprim-sulfamethoxazole (dfrA, sul1 and sul2), tetracyclines (tetA and tetD) and fosfomycin (fosA6, known to be located on a transpozon) resistance genes were found in all samples, while for choramphenicol and macrolides some ARGs were detected in all samples (catA1 and catB3 / mphA), while other (catA2,
Introduction: In the context of the global tuberculosis (TB) burden, children represent 10% of all cases, with high incidence rates still reported by many regions worldwide. The study aim was to determine whether there is a correlation between TB clinical diagnosis and low birth weight in children at various ages. Material and methods: The study was conducted between 2010 and 2014, on a group of 1783 pediatric patients and a subgroup of 137 pediatric patients with low birth weight (LBW). Data were collected from patients' records and hospital statistical reports then processed using MS Excel 2010 and SPSS v.22. Results: The subgroup of LBW patients accounted for 7.68% of all recorded cases. Girls were predominant (total M: F = 0.95; LBW group M: F = 0.91, p < 0.05), most from an urban area (total U: R = 1.29; LBW subgroup U: R = 1.36, p < 0.05). 22.59% of LBW subgroup children were infants aged of 0-12 months. The youngest age at TB diagnosis was 1 month and the lowest weight was 700 g. ANOVA regression for LBW and age at TB diagnosis, showed a multiple R value of 0.0256, p = 0.7659 (F = 0.7659, 95% CI). Conclusions: The correlation between clinical diagnosis of tuberculosis in children at various ages and their low birth weight was positive but was not statistically significant. However, this research hypothesis should be tested in further studies on larger population groups, due to the current public health context of "End TB", promoted worldwide.
To cite this article: Pertea M, Poroch V, Grosu OM, Manole A, Velenciuc N, Lunca S. AbstractObjectives. To confirm the efficiency of using local anesthesia with lidocaine and epinephrine in hand surgery.Materials and methods. 75 patients in whom we used local anesthesia with 1% lidocaine and epinephrine in solution 1: 100 000. We evaluated the amount of used anesthetic, the time to onset of anesthesia, intraoperative bleeding, the duration of intervention and hospitalization, immediate postoperative complications.Results. It has been no case of digital necrosis or other vascular complications and no intraoperative bleeding. The amount of the used anesthetic varied. In no case it was necessary to use of phentolamine as an antidote to the effects of adrenaline.Conclusions. Wide awake local anesthesia no tourniquet technique is safe, having many advantages: it is not necessary to use the tourniquet with or without intravenous sedation, the surgeon and patient comfort is maximum, there is no risk of digital necrosis, hospitalization time is short and the costs are minimal.
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