MRSA Clonal Complex 22 Strains Harboring Toxic Shock Syndrome Toxin (TSST-1) Are Endemic in the Primary Hospital in Gaza,Palestine

Background

Methicillin-resistant Staphylococcus aureus (MRSA) is an important pathogen in both community and healthcare-related settings worldwide. Current knowledge regarding the epidemiology of S. aureus and MRSA in Gaza is based on a single community-based carriage study. Here we describe a cross-sectional analysis of 215 clinical isolates collected from Al-Shifa Hospital in Gaza during 2008 and 2012.

Methods

All isolates were characterized by spa typing, SCCmec typing, and detection of genes encoding Panton-Valentine leukocidin (PVL) and toxic shock syndrome toxin (TSST-1). Representative genotypes were also subjected to multilocus sequence typing (MLST). Antibiotic susceptibility testing was performed using VITEK2 and MicroScan.

Results

MRSA represented 56.3% of all S. aureus strains, and increased in frequency from 2008 (54.8%) to 2012 (58.4%). Aside from beta-lactams, resistance was observed to tetracycline, erythromycin, clindamycin, gentamicin, and fluoroquinolones. Molecular typing identified 35 spa types representing 17 MLST clonal complexes (CC), with spa 998 (Ridom t223, CC22) and spa 70 (Ridom t044, CC80) being the most prevalent. SCCmec types I, III, IV, V and VI were identified among MRSA isolates, while type II was not detected. PVL genes (lukF/S-PV) were detected in 40.0% of all isolates, while the TSST-1 gene (tst) was detected in 27.4% of all isolates, with surprisingly high frequency within CC22 (70.4%). Both PVL and TSST-1 genes were found in several isolates from 2012.

Conclusions

Molecular typing of clinical isolates from Gaza hospitals revealed unusually high prevalence of TSST-1 genes among CC22 MRSA, which is noteworthy given a recent community study describing widespread carriage of a CC22 MRSA clone known as the ‘Gaza strain’. While the latter did not address TSST-1, tst-positive spa 998 (Ridom t223) has been detected in several neighboring countries, and described as endemic in an Italian NICU, suggesting international spread of a ‘Middle Eastern variant’ of pandemic CC22 strain EMRSA-15.     

The population of Odonata (dragonflies) in small tropical rivers with reference to asynchronous growth patterns

The odonate larval communities in three small rivers in Penang Island were studied. More species of dragonflies were found in the Botanical Garden and Titi Teras rivers (13 and 11 respectively) of relatively similar environmental parameters. Fewer (nine) dragonfly species were collected from the Youth Park River which has a lower dissolved oxygen (DO) and a higher biological oxygen demand (BOD), conductivity and turbidity. A mixture of sand, gravel and pebble substrate of Botanical Garden River with dense growth of submerged Hydrilla, grasses and Cladias (Araceae) provided suitable habitats for the dragonflies. The sandy substrate and relatively fast flowing water of Titi Teras River was highly preferred by gomphids. In the Youth Park River, the small community of dragonfly larvae was dominated by tolerant Pseudagrion rubriceps, P. microcephalum, Orthetrum chrysis and Crocothemis servilia. Based on the larval instar distribution of Ictinogomphus decoratus and O. chrysis, very asynchronous populations of these dragonflies occurred in each river. Young larvae were continuously introduced into the populations resulting in undulating growth rate curves. The growth rates of these two species were higher in the Titi Teras River when compared to those in other rivers. Density-dependent mortality, asynchronous cannibalism and fish predation could play important roles in regulating the larval dragonfly population in these rivers.     

A Late Permian flora with Dicroidium from the Dead Sea region, Jordan

Three new species of Dicroidium, D. irnensis, D. jordanensis and D. robustum, are described from the Um Irna Formation (Upper Permian) of the Dead Sea region, Jordan. The plant remains are preserved as compressions with excellent cuticles. These are the earliest unequivocal records of Dicroidium, a genus that is typical for the Triassic of Gondwana. It is also the northernmost occurrence of this genus that apparently originated in the Permian in the palaeotropics. Middle and Late Permian floras from the Arabian Peninsula and adjacent regions show a remarkable mixture of elements from different floral provinces, i.e. Euramerica, Cathaysia and Gondwana. The climatic amelioration in the Early Triassic apparently enabled Dicroidium to migrate southward and eventually colonise the entire Gondwana region. Dicroidium is one of the very few megaplant genera not affected by the end-Permian biotic crisis, the largest Phanerozoic extinction event.     

Factors influencing Chinese male's willingness to undergo circumcision: a cross-sectional study in western China

Background

Male circumcision (MC) has been shown to reduce the risk of female to male transmission of HIV. The goal of this survey was to explore the acceptability of MC among the Chinese and to identify factors associated with circumcision preference.

Methods

A cross-sectional survey was conducted between September 2009 and December 2010. We interviewed 2,219 male community participants, from three high HIV prevalence provinces in western China. A structured questionnaire was used to collect data on MC knowledge, willingness to accept MC, reasons to accept or refuse MC, and sexual behaviors and health. For those who refused MC, a health education intervention providing information on the benefits of circumcision was conducted. We used multiple logistic regression models to identify factors associated with the acceptability of MC.

Results

Of the respondents (n = 2,219), 44.6% (989/2,219) reported they would accept MC for the following reasons: promotion of female partners'' hygiene (60.3%), redundant foreskin (59.4%), prevention of penile cancer (50.2%), enhanced sexual pleasure (41.4%), and protection against HIV and STDs (34.2%). The multivariable logistic regression showed that five factors were associated with MC willingness: long foreskin (OR = 15.98), residing in Xinjiang province (OR = 3.69), being younger than 25 (OR = 1.60), knowing hazards of redundant foreskin (OR = 1.78), and having a friend who underwent circumcision (OR = 1.36).

Conclusion

The acceptability of male circumcision was high among the general population in China. Our study elucidates the factors associated with circumcision preference and suggests that more health education campaigns about positive health effects are necessary to increase the MC rate in China.     

Length-weight relationships of six Nemacheilid fish species (Teleostei: Cypriniformes) from different rivers of Manipur,India

The length-weight relationships (LWRs) of six Nemacheilid species (Schistura chindwinica, S. fasciata, S. khugae, S. minuta, S. reticulata and S. rubrimaculata) have been analyzed. Fish samples were collected on quarterly basis from March 2018 to February 2019. Sampling was performed using cast nets (mesh size 5–10 mm; about 50 sq m area covered each time and water depth was 4 ft approx.), and electrofishing (Ultrasonic Inverter Electro Fisher, 24 volts, 4 m) in the day time. The total length (TL) of individual fish was measured to 0.1 cm with a digital caliper and body weights (BW) were measured to 0.001 g with digital electronic balances. The parameters for the LWR equations were calculated, and the respective statistics such as the 95% confidence interval for parameters “a” and “b” are provided as well as the coefficient of correlation. For five species a new maximum total length has been documented.     

Cholera outbreak in Forcibly Displaced Myanmar National (FDMN) from a small population segment in Cox’s Bazar,Bangladesh, 2019

BackgroundBangladesh experienced a sudden, large influx of forcibly displaced persons from Myanmar in August 2017. A cholera outbreak occurred in the displaced population during September-December 2019. This study aims to describe the epidemiologic characteristics of cholera patients who were hospitalized in diarrhea treatment centers (DTCs) and sought care from settlements of Forcibly Displaced Myanmar Nationals (FDMN) as well as host country nationals during the cholera outbreak.MethodsDiarrhea Treatment Center (DTC) based surveillance was carried out among the FDMN and host population in Teknaf and Leda DTCs hospitalized for cholera during September-December 2019.ResultsDuring the study period, 147 individuals with cholera were hospitalized. The majority, 72% of patients reported to Leda DTC. Nearly 65% sought care from FDMN settlements. About 47% of the cholera individuals were children less than 5 years old and 42% were aged 15 years and more. Half of the cholera patients were females. FDMN often reported from Camp # 26 (45%), followed by Camp # 24 (36%), and Camp # 27 (12%). Eighty-two percent of the cholera patients reported watery diarrhea. Some or severe dehydration was observed in 65% of cholera individuals. Eighty-one percent of people with cholera received pre-packaged ORS at home. About 88% of FDMN cholera patients reported consumption of public tap water. Pit latrine without water seal was often used by FDMN cholera individuals (78%).ConclusionVigilance for cholera patients by routine surveillance, preparedness, and response readiness for surges and oral cholera vaccination campaigns can alleviate the threats of cholera.