Microbial anodes were formed from compost leachate on carbon cloth electrodes. The biofilms formed at the surface of electrodes kept at open circuit contained microorganisms that switched their metabolism towards electrode respiration in response to a few minutes of polarisation. When polarisation at -0.2 V/SCE (+0.04 V/SHE) was applied to a pre-established biofilm formed at open circuit (delayed polarisation), the bacteria developed an extracellular electron transport network that showed multiple redox systems, reaching 9.4 A/m(2) after only 3-9 days of polarisation. In contrast, when polarisation was applied from the beginning, bacteria developed a well-tuned extracellular electron transfer network concomitantly with their growth, but 36 days of polarisation were required to get current of the same order (6-8 A/m(2)). The difference in performance was attributed to the thinner, more heterogeneous structure of the biofilms obtained by delayed polarisation compared to the thick uniform structure obtained by full polarisation.

Microbial fuel cells (MFCs) can convert organic compounds directly into electricity by catalytic oxidation, and although MFCs have attracted considerable interest, there is little information on the electricity-generating potential of artificial bacterial biofilms. We have used acetate-fed MFCs inoculated with sediment, with two-chamber bottles and carbon cloth electrodes to deliver a maximum power output of ~175 mW · m(-2) and a stable power output of ~105 mW · m(-2). Power production was by direct transfer of electrons to the anode from bacterial consortia growing on the anode, as confirmed by cyclic voltammetry (CV) and scanning electron microscopy (SEM). Twenty different species (74 strains) of bacteria were isolated from the consortium under anaerobic conditions and cultured in the laboratory, of which 34% were found to be exoelectrogens in single-species studies. Exoelectrogenesis by members of the genera Vibrio , Enterobacter , and Citrobacter and by Bacillus stratosphericus was confirmed, by use of culture-based methods, for the first time. An MFC with a natural bacterial consortium showed higher power densities than those obtained with single strains. In addition, the maximum power output could be further increased to ~200 mW · m(-2) when an artificial consortium consisting of the best 25 exoelectrogenic isolates was used, demonstrating the potential for increased performance and underlying the importance of artificial biofilms for increasing power output.

We report on a simple method to record infrared (IR) reflected images in a forensic science context. Light sources using ultraviolet light have been used previously in the detection of latent prints, but the use of infrared light has been subjected to less investigation. IR light sources were used to search for latent evidence and the images were captured by either video or using a digital camera with a CCD array sensitive to IR wavelength. Bloodstains invisible to the eye, inks, tire prints, gunshot residue, and charred document on dark background are selected as typical matters that may be identified during a forensic investigation. All the evidence types could be detected and identified using a range of photographic techniques. In this study, a one in eight times dilution of blood could be detected on 10 different samples of black cloth. When using 81 black writing inks, the observation rates were 95%, 88% and 42% for permanent markers, fountain pens and ball-point pens, respectively, on the three kinds of dark cloth. The black particles of gunshot residue scattering around the entrance hole under IR light were still observed at a distance of 60 cm from three different shooting ranges. A requirement of IR reflectivity is that there is a contrast between the latent evidence and the background. In the absence of this contrast no latent image will be detected, which is similar to all light sources. The use of a video camera allows the recording of images either at a scene or in the laboratory. This report highlights and demonstrates the robustness of IR to detect and record the presence of latent evidence.

Efficient monitoring of surfaces for spores of filamentous fungi is essential for detecting minor contamination even when air samples test negative for fungi. This study evaluates and compares a pad prepared using a dusting cloth with Rodac contact plates and humidified swabs for detecting mycological contamination, and concludes that the new method is superior and cheaper.

OBJECTIVE

Covering whole vines with shade cloth is used to protect the vines from heat stress, but may have costs on vine productivity through reduced light availability. Our aim was to assess the carbon balance of vines growing with and without shade to quantify the impact of the covering.

METHODS

Whole vines were covered with 70 % shade cloth, and shoot leaf area and leaf, stem and bunch growth were followed over two growing seasons. Photosynthesis was measured in situ in all leaves along selected shoots over the growing season. A carbon balance was constructed from the difference in acquisition of carbon and the sequestration of carbon as biomass across the growing seasons.

RESULTS

Shade covering had no initial impact on shoot growth but later reduced leaf growth and later still bunch growth. Stem growth was unaffected. Photosynthetic properties were characteristic of shade leaves, with lower rates and lower light saturation compared with well-exposed leaves. Overall, net photosynthesis was reduced by 40 % by the shade covering and was attributed to the reduced photon flux densities. From the carbon balance, vines were reliant on carbon reserves over 6 weeks after budbreak until current photosynthate increased sufficiently to supply the growth. Shade covering impacted most on biomass accumulation to leaves and bunches at the stage when the vines became autotrophic, consistent with the reduction in carbon acquisition. The markedly high carbon demand by bunches caused a mid-season negative carbon balance, implying that shoots had to draw further on reserves to supply the carbon.

CONCLUSIONS

Shade covering over whole grapevines exacerbated the imbalance between the supply of and demand for carbon and greatly reduced vine biomass, especially reproductive allocation. Covering vines with shade cloth to protect the vines from heat events, therefore, had major costs in the carbon economy.

A simple and efficient miniaturized solid phase microextraction (M-SPμE) in a syringe system was developed for preconcentration of cadmium (Cd) in environmental and biological samples, followed by flame atomic absorption technique. The syringe system contains the micropipette tip packed with activated carbon cloth, coated with modified magnetic nanoparticles of iron oxide Triton X114 (ACC-NPs). Scanning electron microscopy and energy dispersive spectroscopy used for characterization of the size, morphology and elemental composition of ACC-NPs. The sample solution treated with a complexing reagent 8-hydroxyqunilone (8-HQ), and drawn into the syringe, filled with ACC-MNPs and dispensed manually for 2-10 drawing/discharging cycles. The analyte retained on ACC-NPs in micropipette tip-syringe system were then eluted with different volume of 1.5molL(-1) HCl by 1-5 drawing/discharging cycles. The syringe system directly couple with FAAS for analysis. The influence of different variables on the extraction efficiency of Cd, including adsorbent dosage, pH, sample volume, eluent volume and drawing/discharging cycles of syringe system were optimized. At optimized extraction conditions, the method showed good linearity in the range of 5-250μgL(-1), with a limit of detection 0.15μgL(-1). Repeatability of the extraction (%RSD) was <5%, n=5. The validity and accuracy of the method was checked by the certified reference materials. The proposed method was successfully applied for the determination of Cd in different drinking water and biological samples of kidney failure patients and healthy controls.

Clinical features of tsutsugamushi disease (scrub typhus) were analyzed, based on 416 cases reported in Japan in 1998. Three major clinical symptoms: eschar, fever and rash were found in 87%, 98% and 92% of the cases, respectively. Elevated levels of CRP, GOT, GPT and LDH were observed in 96%, 85%, 78% and 91%, respectively. These clinical and laboratory findings were observed in the majority of the cases and considered important for diagnosis. Disseminated intravascular coagulation developed in 21 cases, indicating that scrub typhus can be life threatening. Lymphadenopathy was observed in 51% of the cases. Enlarged lymph nodes were limited to the local sites in 75% of these lymphadenopathy cases and most of these sites were adjacent to eschars. Most eschars were scabbed and located in the abdomen and the lower half of the body, especially the feet. This suggests that these parts are frequently exposed to tsutsugamushi mites. Furthermore, the skin is soft in these parts and covered by cloth. These factors may make it possible for mites to keep biting without being noticed for several hours, long enough for rickettsial transmission. Interestingly, eschar and rash were absent in 14% and 8% of the cases, respectively. This result suggests that the cases without the unique symptoms may have been misdiagnosed as common cold or other febrile illnesses. One hundred and fifty-four suspected cases were not scrub typhus cases by the serological tests. The three major clinical symptoms were present in approximately a half of these negative cases, eschar being observed in approximately 70%. This may suggest the presence of new type of scrub typhus can not be diagnosed by the present laboratory tests. Clinical features of scrub typhus in Japan were well revealed, and information obtained in the present study is useful for improving clinical diagnosis. It should, however, be stressed that there were cases that could not be correctly diagnosed only by the clinical symptoms, suggesting that it is important to improve the serological tests.

Allergic diseases such as asthma and rhinitis are common in many countries. Globally the most common allergen associated with symptoms is produced by house dust mites. Although the bed has often been cited as the main site of exposure to mite allergens, surprisingly this has not yet been directly established by measurement due to a lack of suitable methods. Here we report on the development of novel methods to determine the pattern of personal exposure to mite allergen bioaerosols over 24-hour periods and applied this in a small field study using 10 normal adults. Air was sampled using a miniature time-based air-sampler of in-house design located close to the breathing zone of the participants, co-located with a miniature time-lapse camera. Airborne particles, drawn into the sampler at 2L/min via a narrow slot, were impacted onto the peripheral surface of a disk mounted on the hour-hand of either a 12 or 24 hour clock motor. The impaction surface was either an electret cloth, or an adhesive film; both novel for these purposes. Following a review of the time-lapse images, disks were post-hoc cut into subsamples corresponding to eight predetermined categories of indoor or outdoor location, extracted and analysed for mite allergen Der p 1 by an amplified ELISA. Allergen was detected in 57.2% of the total of 353 subsamples collected during 20 days of sampling. Exposure patterns varied over time. Higher concentrations of airborne mite allergen were typically measured in samples collected from domestic locations in the day and evening. Indoor domestic Der p 1 exposures accounted for 59.5% of total exposure, whereas total in-bed-asleep exposure, which varied 80 fold between individuals, accounted overall for 9.85% of total exposure, suggesting beds are not often the main site of exposure. This study establishes the feasibility of novel methods for determining the time-geography of personal exposure to many bioaerosols and identifies new areas for future technical development and clinical applications.

Entomopathogenic fungi are potential candidates for use in integrated vector management. However, efficient delivery systems for these fungi need to be investigated. It is known that adult mosquitoes are attracted to dark surfaces, and therefore, black cotton cloths impregnated with Metarhizium anisopliae alone or in combination with the insecticide imidacloprid (IMI) were tested under laboratory conditions. Black cloths impregnated with fungus were also tested in large-cage trials under natural extradomicile conditions. Blood-fed Rockefeller and wild-type strain Aedes aegypti had higher levels of survival when compared with sucrose-fed counterparts following exposure to fungus-impregnated cloths. However, when blood-fed A. aegypti were exposed to a combination of M. anisopliae + IMI, the survival rates were statistically equal to those of sucrose-fed females. Large-cage trials showed significant decreases in A. aegypti survival following a minimum 12 h exposure of the mosquitoes to fungus-impregnated cloths. Increased exposure times results in further reductions in survival. The synergism between M. anisopliae and IMI resulted in reduced survival rates independent of feeding regime under laboratory conditions. Fungus-impregnated cloths tested under simulated field conditions, considered to be unfavourable for fungal infection, resulted in significant reductions in adult A. aegypti survival. We are currently testing the combined use of fungi and insecticides against blood-fed insects under simulated field conditions.

CONCLUSIONS

The use of fungus-impregnated cotton cloths is a promising point source application method for the control of adult Aedes aegypti, and this strategy could be incorporated into an integrated vector management programme aiming to reduce the incidence of dengue fever.

Etiologic factors in the development of episodic diaper dermatitis include skin wetness and skin damage from fecal enzymes. In addition, when urine and feces mix, the activities of fecal enzymes increase as the pH rises from production of ammonia. An improved disposable diaper has been developed to provide better control of these factors by improved wetness and pH control. The improved diaper contains absorbent gelling materials (AGMs) blended into the diaper's cellulose core. AGMs are nontoxic, cross-linked polyacrylate polymers. They bind water tightly, give pH control by providing a buffering capacity, and in a diaper help to segregate urine and feces, thereby reducing the potential for increases in pH from ammonia production. To assess the effectiveness of this diaper, four 16-week clinical home-use tests were conducted with the AGM disposable versus conventional cellulose core disposable and home-laundered cloth diapers. Rigid group randomized stratification of infant maturity, diet, and initial level of diaper dermatitis provided control of factors other than the diaper that impact on development of diaper dermatitis. Skin wetness as measured by transepidermal water loss immediately after diaper removal, skin pH, and blinded visual evaluation of diaper dermatitis were used as skin condition measures. The use of AGM disposable diapers was associated with significantly reduced skin wetness and closer to normal skin pH as compared with the use of conventional disposable or home-laundered cloth diapers. Considered as an aggregate, the four clinical studies showed that AGM disposable diapers provide a better diaper environment and are associated with significantly lower degrees of diaper dermatitis than conventional disposable and home-laundered cloth diapers.

The persistence of Salmonella typhimurium (V-31) on wool blanket, wool gabardine, cotton sheeting, cotton knit jersey, cotton terry cloth, and cotton wash-and-wear fabrics was studied. Three methods of exposure were employed to contaminate the fabrics: direct contact, aerosol, and a lyophilized mixture of bacteria and dust having a high content of textile fibers. After contamination, the fabrics were held in 35 or 78% relative humidity at 25 C. The persistence time of S. typhimurium on fabrics held in 35% relative humidity was substantially longer when the fabrics were contaminated by direct contact or by exposure to dust containing bacteria than when contaminated by exposure to aerosolized cultures. Viable bacterial populations persisted for 24 weeks at relatively high population densities on swatches of wool gabardine, cotton sheeting, cotton knit jersey, and cotton terry cloth exposed by direct contact and held in a humidity of 35%. In 78% humidity, bacterial populations persisted on the fabrics for relatively shorter periods of time regardless of the mode of contamination or fabric type. This organism retained its virulence for Swiss mice after being recovered from wool gabardine swatches held 8 weeks in humidities of 35 or 78% and from cotton terry cloth swatches held 6 weeks in the same humidities.

Traditional nanosized photocatalysts usually have high photocatalytic activity but can not be efficiently recycled. Film-shaped photocatalysts on the substrates can be easily recycled, but they have low surface area and/or high production cost. To solve these problems, we report on the design and preparation of efficient and easily recyclable macroscale photocatalysts with nanostructure by using Ta3N5 as a model semiconductor. Ta3N5-Pt nonwoven cloth has been prepared by an electrospinning-calcination-nitridation-wet impregnation method, and it is composed of Ta3N5 fibers with diameter of 150-200 nm and hierarchical pores. Furthermore, these fibers are constructed from Ta3N5 nanoparticles with diameter of ~25 nm which are decorated with Pt nanoparticles with diameter of ~2.5 nm. Importantly, Ta3N5-Pt cloth can be used as an efficient and easily recyclable macroscale photocatalyst with wide visible-light response, for the degradation of methylene blue and parachlorophenol, probably resulting in a very promising application as "photocatalyst dam" for the polluted river.

The first hygroscopically tunable cloth actuator is realized via impregnation of a commercial cloth template by a three dimensionally (3D) nanoporous polymer/carbon nanotube hybrid network. The nanoporous hybrid guarantees diffusion of water into the cloth actuator and amplifies the deformation scale. The cloth actuators are mechanically stable with high tensile strength. Because the commercial cotton cloth is inexpensive, such actuators capable of complex motions can be produced in a large size and scale for a wide variety of utilities (e.g. electric generators and "smart" materials).

Praying mantids are thought to be so strictly predacious that, historically, carnivorousness has been used as a defining characteristics of the taxon Mantodea, and no data exist on other ingestive behaviors. We observed food- and water-deprived male and female Tenodera aridifolia sinensis (Sauss.) and Sphodromantis lineola (Burr.) in various situations and found that their ingestive behaviors are more variable than generally recognized. Both species regularly drink water in response to deprivation, the amount imbibed being correlated with the total (but not daily) percent of initial body weight lost. When presented with stimuli consisting of plastic beads of different reflective quality (shiny clear, opaque frosted, or matte black), lighted by a single direct light source, the shiny stimuli consistently elicited the most drinking-like behavior by the mantids. The preference was consistent, whether stimuli were presented together or singly. This suggests that visual cues can be used to identify water and are alone capable of maintaining drinking-like behavior. When S. lineola were presented with various stimuli, including diced apple and diced banana, in a five-way or a three-way choice test, mantids that chose a stimulus within the allotted time consistently ate the diced banana. When presented one of two stimuli differing only in odor (30 x 20 x 15 mm cloth bags filled with either plastic beads or banana), S. lineola did not attempt to eat the former, but 50% attempted to eat the bag of banana. Eating bouts were always preceded by antennae drumming in the direction of, or over the stimulus.(ABSTRACT TRUNCATED AT 250 WORDS)

A new technique of replica plating for CHO cells has been developed in which the pattern of colonies growing in a tissue culture plate is reproduced on a nylon cloth. The efficiency of replica plating onto the nylon cloth is affected by the colony size and the time of cloth-to-plate contact. Maximum replica plating efficiency (80-90%) occurs using 5- to 6-day-old colonies and a contact time of 4 h. The method easily allows 10(4) colonies to be examined for mutant phenotypes. The effectiveness of the technique is demonstrated by isolation of a clone deficient in activity of glucose-6-phosphate dehydrogenase.

The adsorption behavior of phthalic acid and its three esters dimethyl phthalate, diethyl phthalate and diallyl phthalate onto high-area activated carbon-cloth was studied by in situ UV-spectroscopic technique. The effect of ionization of phthalic acid on its adsorption was examined by carrying out the adsorption process in three media; water, 1 M H(2)SO(4) and 0.005 M NaOH. Maximum adsorption was observed in 1 M H(2)SO(4) and almost no adsorption in 0.005 M NaOH. These results were discussed in terms of electrostatic and dispersion interactions between the adsorbate species and the carbon-cloth surface taking the point of zero charge (pH(pzc)) of the carbon-cloth into account. The adsorption process for the phthalate species studied was found to follow the first-order rate law, and the rate constants were determined. The isotherm data for the adsorption of phthalic acid and its esters were derived experimentally and fitted to Langmuir and Freundlich isotherm equations. Both equations were found to represent the experimental isotherm data almost equally well.

OBJECTIVE

To determine the frequency and factors associated with perceived vaginal infections among married women in their postpartum period.

METHODS

A cross-sectional study was conducted from July 2000 to October 2000 in five squatter settlements of Karachi, Pakistan. These squatter settlements were selected on the basis of an existing surveillance system run by female community health workers for maternal and child healthcare which identified women who had delivered 42-56 days prior to the date of interview. Vaginal infection was considered present when a mother perceived foul smelling vaginal discharge during the postpartum period. Mothers were interviewed to gain insight into socioeconomic and demographic variables, materials used to staunch lochia, duration of labour, personal and perineal hygiene and past obstetric history.

RESULTS

A total of 525 women were interviewed. The estimated prevalence of perceived vaginal infection was 5.1%. Factors associated with perceived vaginal infections included, delivery conducted by a non-medical personnel (AOR 3.5, CI 1.3-9.5) and use of unhygienic cloth or cotton for staunch of lochia (AOR 2.7, CI 1.1-6.2).

CONCLUSIONS

Among women who reported perceived vaginal infection, a higher proportion were delivered by non-medical personnel, and used unhygienic material (cloth or cotton) for staunch of lochia as compared to women who did not perceive vaginal infection. We recommend deliveries to be conducted by trained personnel and provision of health education for persons who conduct delivery and women to use hygienic material for staunch of lochia during post partum period.

Textile dyes are heavily used in factories for coloring different cloth materials. This work was designed to identify microorganisms capable of removing textile dyes, either by biodegradation or by biosorption. We expected to isolate microorganisms adapted to high dye concentrations from sites near textile industry complex. An experiment was conducted to study the efficiency of the isolates in removing textile dyes. The tested dyes were used as carbon and nitrogen sources for isolation of soil and/or water microorganisms capable of removing textile dyes wastes from factories effluent. The results indicated the low efficiency of both bacteria and actinomycetes in clean-up the effluent from the waste dyes in 10-21 days. On the other hand six fungal isolates were obtained by plating factory effluent on Martin's medium and media containing dyes as the sole source of carbon and nitrogen for growth. These isolates fell in two genera, Aspergillus and Trichoderma. Results of these studies revealed the potential capacity of these fungi to decolorize the tested dyes in comparatively short time (2-24 hours) indicating strong efficiency of dye bioremediation by the fungal isolates. Since the process involved is mostly fast interaction between the fungal mycelium and the dye in the media, the possible mechanism could be based on a biosorption of such chemicals on the intact fungal biomass, rather than direct biodegradation of the compounds.

OBJECTIVE

Hair fall is a common problem faced by many younger people, which has variety of risk factors. Vitamin D3 has emerged as a molecule with key role to play in various disorders. This study was done to assess its role in diffuse hair fall among student population.

METHODS

This was a case-control study including young adults presenting with complaints of hair fall (>100 a day) as cases, with age-matched healthy controls. Vitamin D3 levels were measured in all the patients. Data analysis was done using Statistical Package for Social Sciences version 11.5 software and significance was tested using Chi-square test and binary logistic regression analysis.

RESULTS

Atotal of 44 participants were enrolled; 22 in each arm. The mean age of the study population was 20.89 years (standard deviation: 1.49). The median value of Vitamin D was 6.80 (interquartile range - 5.350-16.63) for the study population. Overall, 81.8% cases had Vitamin D deficiency compared to 45.5% of controls and this difference was statistically significant (P = 0.007). Furthermore, females had a statistically significant difference in Vitamin D levels between cases and controls. Higher level of full sleeve cloth usage, sunscreen lotion application, and lesser sun exposures were seen among cases although these differences were not statistically significant. The levels of Vitamin D3 were not significantly different among Indians, nonresident Indians, and foreigners. None of the cases had normal Vitamin D values whereas 4.5% controls fell in the normal category.

CONCLUSIONS

Female patients with diffuse hair fall were found to have significantly low Vitamin D3 levels among student population.

Many different management measures are available to control mastitis, a very costly disease in the dairy sector. The objective of this paper was to evaluate the costs and efficacies of 18 of these management measures, for contagious and environmental pathogens, and their effect on bulk tank somatic cell count (BTSCC) and incidence of clinical mastitis (CM). To determine the efficacies for these management measures, literature data and expertise were combined using Monte Carlo expert evaluation analysis. The effect of management measures varied with the incidence of CM and BTSCC, as well as for environmental and contagious problems. On average, postmilking teat disinfection was found to be the most effective measure in all situations. All management measures had large uncertainty around the most likely value. Results of a data envelopment analysis showed that 4 of the management measures included formed the best-practice frontier (the most cost-efficient measures): keeping cows standing after milking, rinsing clusters after milking a clinical case, using a separate cloth for all cows, and wearing milkers' gloves. Of the top 25 management measures (the 18 base management measures including levels of compliance), 8 were measures with 100% compliance; the others were sublevels of these measures with compliance varying between 25 and 100%. A lower hourly rate of the farmer did not influence management measures from the best-practice frontier, but had some effect on the efficiency scores of the other management measures.

At the start of the United Nations International Drinking Water Supply and Sanitation Decade in the 1980s, guinea worm disease was targeted as the major indicator of the success of the Decade's efforts to promote safe water. By the late 1980s, most of the guinea worm endemic countries in Africa and South Asia had established guinea worm eradication programmes that included water supply as one of their main technical strategies. By surveying the water supply situation in Ifeloju Local Government Area (LGA) in Oyo State, Nigeria, in June 1996, as a case study, it was possible to determine the role that water supply has played in the eradication effort. Although two major agencies, the former Directorate for Food, Roads and Rural Infrastructure and UNICEF, provided hand dug and bore-hole wells respectively in many parts of the LGA, coverage of the smaller farm hamlets has been minor compared to efforts in the larger towns. This is ironic because the farm hamlets served as a reservoir for the disease in the 1980s, such that when the piped water system in the towns broke down, guinea worm was easily reintroduced into the towns. The survey of 188 ever-endemic hamlets with an estimated population of 23,556 found that 74.3% of the people still drink only pond water. Another 11.3% have wells that have become dysfunctional. Only 14.4% of this rural population has access' to functioning wells. Guinea worm was eliminated from 107 of the hamlets mainly by the use of cloth filters and chemical treatment of ponds. While this proves that it is possible to eradicate guinea worm, it fails to leave behind the legacy of reliable, safe water supplies that was the hope of the Water Decade.

African animal trypanosomosis is a great obstacle to livestock production where tsetse flies play a major role. Metekel zone is among the tsetse-infested areas. Community-based tsetse fly and trypanosomosis control using targets was conducted from June 2011 to May 2012 in Metekel zone, Ethiopia, to decrease trypanosomosis and tsetse fly. Cloth screen targets were developed, impregnated with 0.1 % deltamethrin, and deployed alongside rivers by the research team together with the community animal health workers. Monthly parasitological and entomological data were collected, processed, and compared with similar data collected before control. Overall average tsetse fly (Glossina tachinoides) density decreased from 1.13 to 0.18 fly/trap/day after control. The density was decreased in all sites with no significant difference among the sites. However, higher decrements were observed in the dry and late dry seasons by more than 12 and 6 times, respectively. The reduction in overall apparent prevalence of trypanosomosis caused by Trypanosoma congolense, Trypanosoma brucei, and Trypanosoma vivax from 12.14 % before to 3.61 % after control coincides with the tsetse fly reduction. In all the study sites, significant reduction was observed before and after control. The highest decrement was observed in the late dry season when the apparent prevalence was reduced from 7.89 to 1.17 % before and after control, respectively. As this approach is simple, cost-effective, and appropriate for riverine tsetse species, we recommend to be scaled up to other similar places.

Confocal scanning laser microscopy (CSLM) was used to determine the location of Escherichia coli O157:H7 cells on the surface and in tissue of bruised Red Delicious cv. apples. Undamaged and bruised apples were inoculated by immersing in a suspension of E. coli O157:H7 cells transformed with a plasmid that encodes for the production of a green fluorescent protein. Apples were then washed in 0.1% (wt/vol) peptone water and/or rubbed with a polyester cloth and examined to determine if these treatments removed or introduced cells into lenticels, cutin, and cracks on the skin surface. Optical slices of the apples obtained using CSLM were examined to determine the depth at which colonization or attachment of cells occurred. Populations of E. coli O157:H7 on the surface of apples were determined to assess the effectiveness of washing and rubbing in physically removing cells. The location of cells on or in undamaged and bruised areas of apples that were not washed or rubbed did not differ significantly. However, washing apples resulted in an approximate 2-log reduction in CFU of E. coli O157:H7 per cm2 of apple surface. On unwashed apples, cells were detected at depths up to 30 microm below the surface. No E. coli O157:H7 cells were detected at locations more than 6 microm below the surface of washed apples. Cells that remained on the surface of rubbed apples appeared to be sealed within naturally occurring cracks and crevices in waxy cutin platelets. These cells may be protected from disinfection and subsequently released when apples are eaten or pressed for cider production.

BACKGROUND

Controlled studies that took place in medical intensive care units (MICUs) have demonstrated that bathing patients with chlorhexidine gluconate (CHG) can reduce skin colonization with potential pathogens and can lessen the risk of central venous catheter (CVC)-associated bloodstream infection (BSI).

OBJECTIVE

To examine, without oversight of practice by research study staff, the effectiveness or real-world effect of patient cleansing with CHG on rates of CVC-associated BSI.

METHODS

In the fall of 2005, the MICU at Rush University Medical Center discontinued bathing patients daily with soap and water and substituted skin cleansing with no-rinse, 2% CHG-impregnated cloths. This change was a clinical management decision without research input.

METHODS

A 21-bed MICU at Rush University Medical Center.

METHODS

Patients hospitalized in the MICU during the period from September 2004 through October 2006.

METHODS

In a pre-post study design, we gathered data from administrative and laboratory databases, infection control practitioner logs, and patient medical charts to compare rates of CVC-associated BSI and blood culture contamination between the baseline soap-and-water bathing period (September 2004-October 2005) and the CHG bathing period (November 2005-October 2006). Rates of secondary BSI, Clostridium difficile infection (CDI), ventilator-associated pneumonia (VAP), and urinary tract infection (UTI) served as control variables that were not expected to be affected by CHG bathing.

RESULTS

Bathing with CHG was associated with a statistically significant decrease in the rate of CVC-associated BSI (from 5.31 to 0.69 cases per 1,000 CVC-days; P = .006) and in the rate of blood culture contamination (from 6.99 to 4.1 cases per 1,000 patient-days; P = .04). Rates of secondary BSI, CDI, VAP, and UTI did not change significantly.

CONCLUSIONS

In our analysis of real-world practice, daily bathing of MICU patients with CHG was effective at reducing rates of CVC-associated BSI and blood culture contamination. Controlled studies are needed to determine whether these beneficial effects extend outside the MICU.