Vaginal Carriage of Group B Streptococcus in Pregnant Women in Rural Areas in Senegal

Vaginal carriage of Group B Streptococcus (GBS) is a maternal and child health issue. Our objective was to determine the prevalence of GBS carriage;identify the factors associated with this carriage and determine the antibiotic sensitivity of the isolated strains. We conducted a cross-sectional and prospective study in rural Senegal (in the health district of Sokone). Socio-demographic, clinical and gynaeco-obstetrical data were collected. Vaginal swabs were taken by the midwives on specific settings in order to test for GBS and other High Risk Vaginal Bacteria (HRVB). Antibiotic susceptibility testing was done according to the recommendations of the CA SFM/EUCAST 2020. In total, 100 pregnant women were targeted and 97 pregnant women were included. Their age ranged from 18 to 40 years with 64.9% (63/97) of participants belonging to the “20 - 30” age group. The overall prevalence of Group B Streptococcus carriage was 15.5% (15/97). However, the proportion of women with at least one high risk infectious bacteria was 29.89% (29/97). No statistically significant differences were found between GBS carriage and the potential factors studied. However, the study also looked for the presence of other high-risk bacteria and coinfections were indeed found between GBS and E. coli and Staphylococcus aureus. Antibiotic susceptibility testing shows that GBS strains were fully susceptible to penicillin G, erythromycin, clindamycin, chloramphenicol, rifampicin and vancomycin. Sensitivities to norfloxacin and gentamycin were 73.3% and 86.7% respectively. In contrast, high resistance to tetracycline (86.7%) was observed. GBS carriage remains a major public health issue because of its consequences for the mother and the newborn. Correct screening and proper monitoring of strain susceptibility remain one of the most effective means of patient management and care.

Varian Truebeam的MLC carriage A故障处理一例

Varian Truebeam治疗机是目前最先进的外照射放射治疗设备之一,自带故障诊断功能,有利于排除故障,但在具体维修中,需要工程人员根据故障现象与相关情况作出灵活判断。我院的Truebeam治疗机出现过ID42050故障,处理报告如下。（1）故障现象：连续多天在机架处于200°~340°区间出现ID42050联锁,出现的频率逐渐加大,直到总是出现,但每次初始化都能通过。

A Cross-sectional Survey Assessing Carriage of Streptococcus pneumoniae in a Healthy Population in Xinjiang Uygur Autonomous Region of China

The carriage rate and serotype distribution of Streptococcus pneumoniae（S.pneumoniae）in a healthy population in China remains unclear.In this study,we collected the oropharyngeal swabs from513 individuals in Xinjiang,China.Real-time PCR targeting the lytA gene and 12 serotypes were assessed to identify S.pneumoniae carriage.

Innovation Analysis Approach to Design Parameters of High Speed Train Carriage and Their Intrinsic Complexity Relationships

In view of the problem that it＇s difficult to accurately grasp the influence range and transmission path of the vehicle top design requirements on the underlying design parameters. Applying directed-weighted complex network to product parameter model is an important method that can clarify the relationships between product parameters and establish the top-down design of a product. The relationships of the product parameters of each node are calculated via a simple path searching algorithm, and the main design parameters are extracted by analysis and comparison. A uniform definition of the index formula for out-in degree can be provided based on the analysis of out- in-degree width and depth and control strength of train carriage body parameters. Vehicle gauge, axle load, crosswind and other parameters with higher values of the out-degree index are the most important boundary condi- tions; the most considerable performance indices are the parameters that have higher values of the out-in-degree index including torsional stiffness, maximum testing speed, service life of the vehicle, and so on; the main design parameters contain train carriage body weight, train weight per extended metre, train height and other parameters with higher values of the in-degree index. The network not only provides theoretical guidance for exploring the relationship of design parameters, but also further enriches the appli- cation of forward design method to high-speed trains.

Soldiers' load carriage performance in high mountains: a physiological study

Background: The present study was designed to evaluate load carriage performance at extremely high altitudes with different loads and walking speeds in terms of physiological evaluation. The degree of maximum oxygen consumption changes at high altitudes was also examined.Methods: Twelve Indian Army soldiers were acclimatized at altitudes of 3,505 m and 4,300 m. They walked for 10 minutes on a motorized treadmill at 2.5km/h and 3.5km/h speeds during carrying no loads and three magnitudes of load(10.7kg, 21.4kg, 30kg) at both altitudes. Physiological parameters such as oxygen consumption, energy expenditure, heart rate, and ventilation were recorded for each breath using a gas analyzer. The rating of perceived exertion was also noted after each load carriage session. Maximal oxygen consumption(VO2max) was measured at sea level and the two high altitudes, and respective relative workloads(% of VO2max) were calculated from oxygen consumption. Repeated measure ANOVA was applied to reveal the significant effects of the independent variables.Results: The participants had significant reductions in VO2 max with rising altitude. Marked increases in almost all physiological parameters were observed with increasing load, altitude, and speed. The soldiers expressed heavy perceived exertion levels with higher loads at 3.5km/h at the two high altitudes.Conclusions: Considering the physiological responses, expressions of perceived exertion and changes in relative work load at both of the high altitudes. Indian soldiers are advised to walk slowly with adequate rest in between their schedules and to carry not more than 32% of their body weight.

Cronobacter Carriage in Neonate and Adult Intestinal Tracts

A total of 7 Cronobocter strains were isolated from 703 fecal samples collected in Jinan from June 13 to December 30, 2011, with the positive rate of Cronobacter spp. being 1.0% （95% confidence interval 0.6%-1.4%）. Three Cronobacter sakazakii stains were isolated from 157 fecal samples of healthy neonates （95% confidence interval 0.4%-5.5%）. This number was slightly higher than that isolated from 273 fecal samples of healthy adults, in which 1 strain of C. sakazakii and 1 strain of Cronobacter malonaticus were isolated, and that from 173 fecal samples of adults with acute diarrhea, in which 1 strain of C sakazakii and 1 strain of C. malonaticus were isolated, but the differences were not statistically significant （P〉O.05）. The Cronobocter isolates were all from different genetic sources. It should be noted that Cronobacter carriage may cause infection under certain conditions, especially in neonates.

Cross Sectional Study of Skin Carriage and Enterotoxigenicity of Staphylococcus aureus among Food Handlers

The prevalence of enterotoxigenic Staphylococcus aureus was investigated among 200 participants working in three different food processing plants in Egypt. Using skin swabs, 75 (38%) of the 200 tested persons were positive for the presence of S. aureus. Of the S. aureus positive persons, 28 (14%) harboured S. aureus produced staphylococcal enterotoxins. The serotypes of these enterotoxins were enterotoxin A (68%), enterotoxin B (36%), enterotoxin C (46%) and enterotoxin D (18%). Some of these isolates produced more than one type of enterotoxins namely AB, AC, BC, BD, ABC and ACD. Analysis of risk factors implicated in skin carriage of S. aureus as age, gender, marital status, education, duration in employment, frequency and method of hand wash and incidence of chronic skin infection revealed insignificant association with staphylococcal skin carriage. The obtained results put forth the risk of food contracting contamination with enterotoxigenic strains of S. aureus owing to skin colonization of S. aureus among food handlers.

Intestinal carriage of methicillin resistant Staphylococcus aureus and extended-spectrum β-Lactamase-producing Enterobacteriacae in hospitalized and nonhospitalized patients and their clinical implications

Objective:To determine the clinical implication of and intestinal carriage with methicillin resistant Staphylococcus aureus(MRSA) and extended spectrumβ-lactamase(ESBL)-producing Enterobacteriacae.Methods: A total of 180 stool specimens were screened for MRSA and ESBL-producing enterobacteria.Identification of ESBL- producing Enterobacteriacae was done by MicroScan Walk Away 96 system(Dade Behring Inc.,West Sacramento,CA 95691,USA ) and confirmation by double-disc synergy test.MRSA was identified by disc diffusion using 30μg cefoxitin disc and the MicroScan.Results:The rate of fecal MRSA carriage was 7.8% (14/180),35.7%(5 /14) were recovered from surgical wards.Three patients(21,4%) had MRSA recovered from other body sites,and 2(14.2%) had in addition ESBL -producing Escherichia coli(E.coli) and Klebsiella pneumoniae(K.pneumoniae) respectively.Four(28.5%) patients with MRSA fical carriage died. MRSA fecal carriage was recovered from both inpatients and outpatients.Four(2.2%) cases carried ESBL-producing Enterobacteriacae in feces.Three(75%) were from intensive care unit(ICU).One patient had both ESBL-producing E.coli and K.pneumoniae from stool as well as E.coli from tracheal aspirate.Two ICU patients with fecal ESBL died.Conclusion:Fecal screening for MRSA and ESBL of all patients at high risk admitted to different hospital wards and ICUs and implementing infection control measures were recommended.

Effect of heavy load carriage on cardiorespiratory responses with varying gradients and modes of carriage

Background: The present study was undertaken to determine the effect of different uphill and downhill gradients on cardiorespiratory and metabolic responses of soldiers while carrying heavy military loads in two different modes.Methods: Eight physically fit male soldiers with a mean age 32.0±2.0 years, a mean height of 169.5±4.9 cm, and a mean weight of 63.8±8.4 kg volunteered for this study. Each volunteer completed treadmill walking trials at a speed of 3.5 km/h while carrying no external load, 31.4 kg load in a distributed mode(existing load carriage ensembles) and compact mode(new back pack) over 5 different downhill and uphill gradients(–5%, –10%, 0%, 5%, 10%) for 6 min at each gradient. During the walking trials, heart rate(HR), oxygen uptake(VO_2), respiratory frequency(RF) and energy expenditure(EE) were determined by the process of breath-by-breath gas analysis using a K4 b2 system. The average of the last 2 min data from each 6 min walking trial for each individual was subjected to statistical analysis.Results: All parameters(HR, VO_2, RF, and EE) gradually increased with the change in gradient from downhill to level to uphill. The distributed mode showed higher values compared to compact mode for all gradients, e.g., for VO_2, there was a 10.7, 7.4, 5.1, 28.2 and 18.7% increase in the distributed mode across the 5 different gradients.Conclusions: It can be concluded from the present study that the compact mode of load carriage is more beneficial than the distributed mode in terms of cardiorespiratory responses while walking on downhill and uphill surfaces with a 31.4 kg load.

Surveillance of Australian Hajj pilgrims for carriage of potentially pathogenic bacteria:Data from two pilot studies

AIM To estimate the pharyngeal carriage rate of Neisseria meningitidis(N. meningitidis), Streptococcus pneumoniae(S. pneumoniae) and Staphylococcus aureus(S. aureus) among Australian Hajj pilgrims.METHODS In 2014, surveillance was conducted in two phases among Australian Hajj pilgrims: The first phase during Hajj in Mina, and the second phase soon after returning home to Australia. Nasopharyngeal or oropharyngeal swabs were taken from participants then tested, firstly by nucleic acid testing, and also by standard culture.RESULTS Of 183 participants recruited in the first phase, 26(14.2%) tested positive for S. pneumoniae; 4 had received pneumococcal conjugate vaccine(PCV13). Only one tested positive for N. meningitidis(W). Of 93 2^(nd) phase samples cultured, 17(18.3%) grew S. aureus, all methicillin sensitive, 2(2.2%) grew N. meningitidis(on subculture; one serotype B, one negative), and 1(1%), from an unvaccinated pilgrim, grew S. pneumoniae.CONCLUSION Relatively high carriage of S. pneumoniae and little meningococcal carriage was found. This indicates the importance of a larger study for improved infection surveillance and possible vaccine evaluation.

Spine system changes in soldiers after load carriage training in a plateau environment: A prediction model research

Background: Low back pain is the most common spinal disorder among soldiers, and load carriage training(LCT) is considered the main cause. We aimed to investigate changes in the spine system of soldiers after LCT at high altitudes and the change trend of the lumbar spine and surrounding soft tissues under different load conditions.Methods: Magnetic resonance imaging scans of the lumbar spines of nine soldiers from plateau troops were collected and processed. We used ImageJ and Surgimap software to analyze changes in the lumbar paraspinal muscles, intervertebral discs(IVDs), intervertebral foramina, and curvature. Furthermore, the multiple linear regression equation for spine injury owing to LCT at high altitudes was established as the mathematical prediction model using SPSS Statistics version 23.0 software.Results: In the paraspinal muscles, the cross-sectional area(CSA) increased significantly from(9126.4±691.6) mm~2 to(9862.7±456.4) mm~2, and the functional CSA(FCSA) increased significantly from(8089.6±707.7) mm~2 to(8747.9±426.2) mm~2 after LCT(P<0.05);however, the FCSA/CSA was not significantly different. Regarding IVD, the total lumbar spine showed a decreasing trend after LCT with a significant difference(P<0.05). Regarding the lumbar intervertebral foramen, the percentage of the effective intervertebral foraminal area of L3/4 significantly decreased from 91.6%±2.0% to 88.1%±2.9%(P<0.05). For curvature, the lumbosacral angle after LCT(32.4°±6.8°) was significantly higher(P<0.05) than that before LCT(26.6°±5.3°), while the lumbar lordosis angle increased significantly from(24.0°±7.1°) to(30.6°±7.4°)(P<0.05). The linear regression equation of the change rate, ΔFCSA%=–0.718+23.085×load weight, was successfully established as a prediction model of spinal injury after LCT at high altitudes.Conclusion: The spinal system encountered increased muscle volume, muscle congestion, tissue edema, IVD compression, decreased effective intervertebral foramen area, and increased lumbar curvature after LCT, which revealed important pathophysiological mechanisms of lumbar spinal disorders in soldiers following short-term and high-load weight training. The injury prediction model of the spinal system confirmed that a load weight <60% of soldiers' weight cannot cause acute pathological injury after short-term LCT, providing a reference supporting the formulation of the load weight standard for LCT.

LOW RCS MODIFIED DESIGN OF EXTERNAL CARRIAGE AND ANALYSIS OF ITS SCATTERING CHARACTERISTIC

An external carriage and a wing have a high radar cross section (RCS) level in a wide range of angles of pitch because they form an efficient corner reflector. Coupling scattering between the external carriage and the wing is controlled by designing a saw tooth structure of the external carriage on condition that the wing structure is not changed. A low RCS saw tooth scheme of the external carriage is given in the paper. The ray tracing method and the physical theory of diffraction are used to calculate the radar scattering characteristics of low RCS structures of the external carriage and wing. The results show that the saw tooth scheme of the external carriage is feasible and effective for low RCS design.

A Novel Parsimonious Neurofuzzy Model Applied to Railway Carriage System Identification and Fault Diagnosis

In this paper, we suggest a novel parsimonious neurofuzzy model realized by RBFNs for railway carriage system identification and fault diagnosis. To overcome the curse of dimensionality resulting from high dimensional input variables, in our developed model the features extracted from the available observations are regarded as the input variables by adopting the higher-order statistics(HOS) technique. Such a constructed model is also applied to a practical railway carriage system, simulation results indicate that the developed neurofuzzy model possesses strong identification and fault diagnosis ability.

Investigation of <i>Streptococcus pyogenes</i>Carriage in Population Vulnerable to Scarlet Fever during 2015-2017 in Shanghai, China

This study aimed to investigate the carriage of Streptococcus pyogenes in population vulnerable to scarlet fever and to compare their genotypic characterization between different age groups. Pharyngeal swabs were collected from 120 - 150 students in each of the three districts in Shanghai in May and December during 2015 to 2017, while emm typing and detection of 12 superantigen genes were performed to characterize the isolates. During 2015-2017, the average carriage rate in students was 5.7% (135/2,371), without significant difference between different years or districts. The carriage rate was significantly different between children from the three age groups, with 2.4% in 3 - 4 years, 5.4% in 5 - 9 years, and 9.1% in 10 - 14 years. Eight emm types were found, including emm 1, emm 4, emm 12, emm 22, emm 75, emm 89, emm 70 and emm 241, among which emm 12 accounted for 60%, and emm 1 27.5%. The predominance of emm 12 was found in each year, but the proportion of emm 12 was lower in 10 - 14 years (43.3%) than in 3 - 4 years (86.7%) and in 5 - 9 years (73.3%) (P = 0.002 and 0.003). Superantigen genes of speB, speC, speG, ssa and smeZ were found in almost all the isolates. The average carriage of S. pyogenes in population vulnerable to scarlet fever was 5.7% in Shanghai, highest in 10 - 14 years (9.1%), while emm 12 was the predominant type.

The Carriage of Escherichia coli Resistant to Antibiotics in Healthy Populations in Shanghai

Healthy populations represent the largest reservoir of bacteria resistant to antibiotics.We investigated the resistance of Escherichta coli to 12 antibiotics in fecal samples from untreated healthy populations in Shanghai, China by using Kirby-Bauer (K-B) method. The results showed that: (i) All subjects carried resistant strains of Escherichta coli. (ii) The carriage rates of Escherichta coli resistant to various antibiotics were different, less than 10 % to amikacin and 30 % to 100% to others. (iii) In the elder children group aged 10-11 years, the percentages of stralns resistant to gentamicin, streptomycin, chloramphenicol, tetracycline, trimethoprim, and sulfamethoxazole were significantly lower than those in the younger group aged 5-6 years. In the adult group, the percentages of strains resistant to ampicillin, piperacillin, arnikacin, streptomycin, chloramphenicol, tetracycline, trimethoprim, and sulfamethoxarole were significantly lower than those in the elder children group. (iv) The number of strains resistant to five or more antibiotics accounted for 31. 8 % in the younger children group, 23. 7 % in the elder children group,and 12. 1 % in the adult group. These findings suggest that all healthy people in Shanghal carry resistant strains of Escherichta coli in the intestine. The younger the populations, the higher the level of resistance of fecal Escherichta coli to antibiotics. Improvement of health behaviors and environmental sanitation and rational use of antibiotics could remarkedly decrease the resistant level of bacteria

Impact of Seven Valent Pneumococcal Conjugate Vaccine on Nasopharyngeal Carriage in Young Children in Okinawa, Japan

In Japan, the heptavalent pneumococcal conjugate vaccine (PCV7) became available in February 2010 and was subsidized by the national funding system from May 2011 in Okinawa, after which it was incorporated into the national immunization practice (NIP) in April 2013 using a 3 + 1 schedule for all infants. We conducted an annual survey in 2012 to determine the effect of PCV7 on nasopharyngeal colonization by pneumococcal serotypes and to analyze the risk factors for colonization in infants. Nasopharyngeal swabs for pneumococcal isolation and serotyping were obtained from infant 2 to 22 months of age before and after PCV7 immunization among 4 clinics in Okinawa, Japan. Between January 2012 and December 2012, nasopharyngeal swabs for bacterial cultures were obtained among 782 infants aged 2 to 22 months old and demographic data was obtained among 725 participant infants. Among the 725 evaluable infants, 193 pneumococcal strains were detected in 180 infants for an overall nasopharyngeal carriage of 24.8%. The main capsular serotypes isolated were 6C (16.1%), 19A (12.4%) and 15B (9.8%). Carriage of PCV7 serotypes accounted for 21.8% (42/193). The result of multivariate data analysis showed the pneumococcal carriage rate of non-PCV7 serotypes was significantly (P < 0.001) high in infant with siblings and daycare attendance. On the other hand, the result of multivariate data analysis showed that carriage rate of PCV7 serotype had only significantly high risk in infant with siblings and did not have a significant risk dependent on age and daycare attendance. Carriage PCV7 serotypes increased in the presence of other siblings, while PCV7 vaccination was shown to eliminate daycare attendance as a risk. The results of this study demonstrates that PCV7 vaccination decrease the overall nasopharyngeal carriage of PCV7 serotypes in vaccinated children including children at risk such as children attending day-care centers.

Impact of the Pneumococcal Heptavalent Conjugated Vaccine on <i>Streptococcus pneumoniae</i>Nasopharyngeal Carriage and Antimicrobial Susceptibility in Children 2-5-Year-Old in Beijing, China

Streptococcus pneumoniae is a primary cause of illness and death among children younger than 5 years in China. The heptavalent pneumococcal conjugate vaccine (PCV7) was the only conjugated vaccine (PCV) available in China from 2008 to 2013. This randomized, controlled, open-label study conducted at 46 Beijing clinics involved 3281 healthy 2-5-year-old Chinese children, randomized 1:1 to receive one dose of the S. pneumoniae heptavalent conjugated vaccine (PCV7) (n = 1643) or Haemophilus influenzae type b conjugate vaccine (Hib) (n = 1638). The main objective of this study was to investigate the impact of PCV7 against that of Hib vaccination in the nasopharyngeal S. pneumoniae colonization in healthy Chinese children. Nasopharyngeal (NP) samples for culture, serotyping and antimicrobial susceptibility testing were collected before vaccination and at Day 60 and 180 post-vaccination. A total 3281 children were enrolled in the study. Demographic characteristics were similar among both study groups: 1641 children received PCV7. Before immunization, S. pneumoniae was isolated in 338 and 360 children in the PCV7 (144 PCV7 isolates) and Hib groups (145 PCV7 isolates), respectively. At Day 180, PCV7 vaccination was more effective than Hib vaccination in reduction NP carriage (20.2% [P = 0.052]) and new acquisition (19.0% [P = 0.066]). When reductions in NP carriage and new acquisition of PCV7 VT plus 6A was analyzed, reduction in the PCV7 vaccinated group achieved statistical significance (P = 0.034 and P = 0.042 versus Hib, respectively). NP carriage of NVT increased in both groups (P = 0.305 between study groups at Day 180). PCV7 decreased NP carriage of non-susceptible VT to amoxicillin (P = 0.000), ceftriaxone (P = 0.047) and MDR (P = 0.024) versus Hib. PCV7 vaccination in Chinese children 2 to 5 years of age was more effective than vaccination with Hib in the reduction of S. pneumoniae nasopharyngeal carriage, new acquisition and non-susceptible isolates.

High MRSA Carriage Rate among Nursing Microbiology Students

Staphylococcus aureus is a common cause of disease, particularly in colonized persons. Although methicillin-resistant S. aureus (MRSA) infections have become increasingly reported, population- based studies of students preparing for the health professions having S. aureus and MRSA colonization are lacking. We have found that students in microbiology classes having more contact with individuals in a healthcare setting are more likely to carry MRSA in their nares and axilla. The classes who had the highest rate of MRSA carriage during the school year, 2013-2014, were those with nursing students, who had a greater exposure to clinical settings and nursing homes. The class which had the highest rate of S. aureus carriage, had nearly 50% of the infected students had been involved a clinical setting. Since the majority of the students in the nursing and biology courses are looking to pursue a career in medicine, this sampling was very beneficial to inform them and others if they were a carrier of S. aureus and MRSA and the preventative measures to reduce the risk of infection.

Should Women-Only Subway Carriages Be Introduced?

Guangzhou, capital of south China＇s Guangdong Province, stirred up much public debate recently after it began to operate womenonly carriages on June 28.

A transversal pilot study of oropharyngeal carriage of Kingella kingae in healthy children younger than 6 months

Background:The aim of this pilot study was to investigate the extent of oropharyngeal Kingella kingae carriage during the first 6 months of life.Methods:We conducted a monocentric transversal pilot study on healthy children younger than 6 months in order to define the oropharyngeal carriage rate.Participants were recruited between December 2013 and September 2015 among children without symptoms or signs of invasive infections.Results:We demonstrated an oropharyngeal carriage rate of 0.67% in children younger than 6 months.Due to the really low carriage rate,it was not possible to draw statistically significant conclusion about any other characteristic of our population.Conclusions:The present study suggests that the oropharyngeal carriage of Kingella kingae among a Swiss population of healthy infants younger than 6 months is exceptional.The scarcity of colonization and disease in the early months of life suggests thus that defense against mucosai carriage and invasive infection is above all provided by vertically acquired immunity.Limited exposure of the neonates due to limited social contacts may also represent another factor avoiding neonates'mucosal Kingella kingae carriage.