An Assessment of Antimicrobial Resistant Disease Threats in Canada

Background

Antimicrobial resistance (AMR) of infectious agents is a growing concern for public health organizations. Given the complexity of this issue and how widespread the problem has become, resources are often insufficient to address all concerns, thus prioritization of AMR pathogens is essential for the optimal allocation of risk management attention. Since the epidemiology of AMR pathogens differs between countries, country-specific assessments are important for the determination of national priorities.

Objective

To develop a systematic and transparent approach to AMR risk prioritization in Canada.

Methods

Relevant AMR pathogens in Canada were selected through a transparent multi-step consensus process (n=32). Each pathogen was assessed using ten criteria: incidence, mortality, case-fatality, communicability, treatability, clinical impact, public/political attention, ten-year projection of incidence, economic impact, and preventability. For each pathogen, each criterion was assigned a numerical score of 0, 1, or 2, and multiplied by criteria-specific weighting determined through researcher consensus of importance. The scores for each AMR pathogen were summed and ranked by total score, where a higher score indicated greater importance. A sensitivity analysis was conducted to determine the effects of changing the criteria-specific weights.

Results

The AMR pathogen with the highest total weighted score was extended spectrum B-lactamase-producing (ESBL) Enterobacteriaceae (score=77). When grouped by percentile, ESBL Enterobacteriaceae, Clostridium difficile, carbapenem-resistant Enterobacteriaceae, and methicillin-resistant Staphylococcus aureus were in the 80-100^th percentile.

Conclusion

This assessment provides useful information for prioritising public health strategies regarding AMR resistance at the national level in Canada. As the AMR environment and challenges change over time and space, this systematic and transparent approach can be adapted for use by other stakeholders domestically and internationally. Given the complexity of influences, resource availability and multiple stakeholders, regular consideration of AMR activities in the public health realm is essential for appropriate and responsible prioritisation of risk management that optimises the health and security of the population.     

Global transcriptional response of pig brain and lung to natural infection by Pseudorabies virus

Background  

Pseudorabies virus (PRV) is an alphaherpesviruses whose native host is pig. PRV infection mainly causes signs of central nervous system disorder in young pigs, and respiratory system diseases in the adult.     

Selective inhibition of prostaglandin biosynthesis by gold salts and phenylbutazone

Gold salts and phenylbutazone selectively inhibit the synthesis of PGF_2α and PGE₂ respectively. Lowered production of one prostaglandin species is accompanied by an increased production of the other. Selective inhibition by these drugs was observed in the presence of adrenaline, reduced glutathione and copper sulphate under conditions when most anti-inflammatory compounds inhibited PGE₂ and PGF_2α syntheses equally. It is postulated that selective inhibitors may have a different mode of action and beneficial effects may be related to the endogenous ratio of PGE to PGF required for normal function.     

“Unblocking” Serum Activity <Emphasis Type="Italic">in vitro</Emphasis> in the Polyoma System may Correlate with Antitumour Effects of Antiserum <Emphasis Type="Italic">in vivo</Emphasis>

In a variety of tumour systems, individuals carrying progressively growing neoplasms have lymphoid cells with a specific cytotoxic effect on cultured tumour cells from the same individual^1–4. Since the sera of tumour-bearing individuals have been shown to prevent tumour cell destruction by immune lymphocytes in vitro^2,5–8 and since this serum blocking activity appears early in primary and transplant tumour development^5,7, it has been suggested that the appearance of this serum blocking activity might be responsible for the progressive growth of tumours in individuals having cytotoxic lymphocytes. Counteraction of this blocking activity would thus be of primary importance in facilitating the function of an already existing or bolstered cell-mediated immunity. The serum blocking activity might be inhibited in various ways, by preventing the formation of blocking antibody or by interfering with its action (“unblocking”), as demonstrated in Moloney sarcoma regressor sera⁹. This type of serum also has a therapeutic effect on Moloney sarcomas in vivo^10,11, which has been tentatively attributed to its unblocking activity^8,9 or, possibly, to a complement-dependent cytotoxicity¹⁰. Tumour growth in the Moloney sarcoma system, however, might be due in part to continuous recruitment of neoplastic cells by virus-induced transformation and so the therapeutic effect could be due to a virus-neutralizing serum activity^9,10.     

Alterations in cholesterol and fatty acid biosynthesis in rat liver homogenates by aryloxy acids (Short Communication)

2,4-Dichlorophenoxyacetic acid and 2,4,5-trichlorophenoxyacetic acid inhibited the incorporation of [2-(14)C]mevalonate into cholesterol and non-saponifiable lipids. Both compounds inhibited the conversion of [1-(14)C]isopentenyl pyrophosphate into cholesterol and the synthesis of cholesterol and fatty acids from [2-(14)C]acetate. There was no inhibition of the conversion of [1-(14)C]mevalonate into CO(2). At low concentrations (0.5mm) of the compounds there was a stimulation of acetate incorporation into fatty acids.     

Cardiac assist with a twist: apical torsion as a means to improve failing heart function

Changes in muscle fiber orientation across the wall of the left ventricle (LV) cause the apex of the heart to turn 10-15 deg in opposition to its base during systole and are believed to increase stroke volume and lower wall stress in healthy hearts. Studies show that cardiac torsion is sensitive to various disease states, which suggests that it may be an important aspect of cardiac function. Modern imaging techniques have sparked renewed interest in cardiac torsion dynamics, but no work has been done to determine whether mechanically augmented apical torsion can be used to restore function to failing hearts. In this report, we discuss the potential advantages of this approach and present evidence that turning the cardiac apex by mechanical means can displace a clinically significant volume of blood from failing hearts. Computational models of normal and reduced-function LVs were created to predict the effects of applied apical torsion on ventricular stroke work and wall stress. These same conditions were reproduced in anesthetized pigs with drug-induced heart failure using a custom apical torsion device programmed to rotate over various angles during cardiac systole. Simulations of applied 90 deg torsion in a prolate spheroidal computational model of a reduced-function pig heart produced significant increases in stroke work (25%) and stroke volume with reduced fiber stress in the epicardial region. These calculations were in substantial agreement with corresponding in vivo measurements. Specifically, the computer model predicted torsion-induced stroke volume increases from 13.1 to 14.4 mL (9.9%) while actual stroke volume in a pig heart of similar size and degree of dysfunction increased from 11.1 to 13.0 mL (17.1%). Likewise, peak LV pressures in the computer model rose from 85 to 95 mm Hg (11.7%) with torsion while maximum ventricular pressures in vivo increased in similar proportion, from 55 to 61 mm Hg (10.9%). These data suggest that: (a) the computer model of apical torsion developed for this work is a fair and accurate predictor of experimental outcomes, and (b) supra-physiologic apical torsion may be a viable means to boost cardiac output while avoiding blood contact that occurs with other assist methods.     

Interspecific and intraspecific differences in two Liriomyzaleafminer species in California

In recent years, the pest status of Liriomyza trifolii (Burgess) and L. huidobrensis (Blanchard) (Diptera: Agromyzidae) has changed in California, as well as other areas of the world. In California, L. huidobrensis has become the predominant Liriomyza species in valleys along the central coast, while L. trifolii remains the predominant species in southern California. To investigate possible reasons for this change in status, differences in host plant use and reproductive success of intraspecific populations were examined for Liriomyza trifolii and L. huidobrensis from both central and southern California. The southern L. trifolii fed, oviposited and reproduced successfully on all five hosts tested, but the central population fed significantly less on all hosts and was restricted to reproducing on pepper only. With the exception of pepper, southern L. trifolii had significantly greater larval survival on all hosts than central L. trifolii. In contrast, the central L. huidobrensis population had greater reproductive success than the southern population of that species on all hosts plants tested. However, pepper was not a suitable host for either L. huidobrensis population. Both species showed positive assortative mating, with homotypic mating occurring more frequently than heterotypic mating; however, the difference between L. trifolii populations was much more pronounced than between L. huidobrensis populations. These data indicate that central and southern California populations of each species are distinct biotypes. Furthermore when coupled with previous genetic data, our results suggest the possible existence of cryptic species within L. trifolii.     

A permanent prosthesis for converting in situ muscle contractions into hydraulic power for cardiac assist

Trumble, Dennis R., and James A. Magovern. A permanentprosthesis for converting in situ muscle contractions into hydraulic power for cardiac assist. J. Appl.Physiol. 82(5): 1704-1711, 1997.The key toutilizing muscle power for circulatory support lies with thedevelopment of a practical scheme by which contractile energy may becollected and efficiently delivered to the bloodstream. This workdescribes initial in vitro testing of a prototype muscle energyconverter (MEC) designed to transform the power of in situ musclecontractions into hydraulic form. The MEC resembles a simple pistonpump and is designed for implant beneath the humeral insertion of thelatissimus dorsi muscle. Bench tests were conducted to measurecomponent function and to characterize device performance under varioushydraulic loads. Under simulated muscle-pull conditions, MEC energytransfer capacity was found to be 170 mJ/stroke while operating at peakefficiencies (i.e., >98% of input power converted into hydraulicenergy and preload work). Transfer efficiencies dropped from 96 to 38%as mean generated pressures increased from 23 to 36 N/cm² due to metal bellowsflexion. These results demonstrate that a significant amount ofcontractile energy can be efficiently transformed to hydraulic powervia this mechanism.

     

A web server to locate periodicities in a sequence

Summary : FT is a tool written in C++, which implements the Fourier analysis method to locate periodicities in aminoacid or DNA sequences. It is provided for free public use on a WWW server with a Java interface. Availability : The server address is http://o2.db. uoa.gr/FT Contact : shamodr@atlas.uoa.gr      

Host plant selection and development in Spodoptera exigua: do mother and offspring know best?

We examined the ovipositional preference and larval development of Spodoptera exigua (Hübner) (Lepidoptera: Noctuidae) on two common hosts in southern California, Chenopodium murale L. (Chenopodiaceae) and Apium graveolens L. (Umbelliferae) to determine if female oviposition preference is correlated with offspring performance. Greenhouse oviposition choice tests indicated that S. exigua oviposit more frequently on C. murale than on A. graveolens. However under laboratory conditions, larvae reared on C. murale had longer development times, lower relative growth rate, and lower survivorship than larvae reared on A. graveolens. larval and pupal masses were significantly greater on A. graveolens than on C. murale. Furthermore, pupal masses were significantly greater for individuals reared on A. graveolens than on C. murale. Because pupal masses and adult fecundity are positively correlated for Spodoptera spp., the fitness of S. exigua on A. graveolens is likely to be substantially higher than its fitness on C. murale. Despite better larval performance on A. graveolens, previous results from choice tests with whole plants and leaf discs indicate that the highly mobile S. exigua larvae strongly prefer C. murale over A. graveolens. Hypotheses attempting to explain this lack of correlation between larval and adult host preference versus development and survival in this system are discussed.