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12 results

  • Barnacle cover modifies foraging behaviour of the intertidal limpet Patella vulgata
  • Giacomo Santini, Richard C. Thompson, Stuart R. Jenkins, Guido Chelazzi, Richard G. Hartnoll, Suzanne M. Kay, Stephen J. Hawkins
  • Journal: Journal of the Marine Biological Association of the United Kingdom / Volume 99 / Issue 8 / December 2019
  • Published online by Cambridge University Press: 10 September 2019, pp. 1779-1786
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  • View abstract

    Limpets and barnacles are important components of intertidal assemblages worldwide. This study examines the effects of barnacles on the foraging behaviour of the limpet Patella vulgata, which is the main algal grazer in the North-west Atlantic. The behaviour of limpets on a vertical seawall on the Isle of Man (UK) was investigated using autonomous radio-telemetry, comparing their activity patterns on plots characterized by dense barnacle cover and plots from which the barnacles had been removed. Limpet behaviour was investigated at mid-shore level, but two different elevations were considered. This experiment revealed a significant effect of barnacle cover on the activity of P. vulgata. Limpets on smooth surfaces spent a greater proportion of total time active than did limpets on barnacles. Movement activity was also greater in areas that were lower down in the tidal range. In general, limpets were either predominantly active during diurnal high or nocturnal low tides and always avoided nocturnal high tides. Individuals on barnacles at the higher elevation concentrated their activity during nocturnal low water. All the other groups of limpets (smooth surfaces on the upper level and all individuals on the lower shore) had more excursions centred around daylight hours with an equal distribution of activity between periods of low and high water. Inter-individual variability was, however, pronounced.

  • Clinical and Molecular Epidemiology of Methicillin-Resistant Staphylococcus aureus among Patients in an Ambulatory Hemodialysis Center
  • Gopi Patel, Stephen G. Jenkins, José R. Mediavilla, Barry N. Kreiswirth, Brian Radbill, Cassandra D. Salgado, David P. Calfee
  • Journal: Infection Control & Hospital Epidemiology / Volume 32 / Issue 9 / September 2011
  • Published online by Cambridge University Press: 02 January 2015, pp. 881-888
  • Print publication: September 2011
  • View abstract
    Objective.

    To describe the epidemiology of methicillin-resistant Staphylococcus aureus (MRSA) carriage and transmission in an ambulatory hemodialysis population.

    Design.

    Prospective cohort study.

    Setting.

    Outpatient hemodialysis facility affiliated with a large academic medical center.

    Participants.

    Of the 170 facility patients, 103 (61%) participated in the study.

    Methods.

    Swab specimens of the nares, axillae, and vascular access site were collected from participants weekly for 3 weeks and then monthly for 5 months. Demographic and clinical data were collected monthly for 12 months. Molecular analysis of MRSA isolates was performed.

    Results.

    The baseline MRSA carriage prevalence was 12%. Factors associated with MRSA carriage included a history of MRSA; failed renal transplantation; hospital admission within 6 months; and receipt of a first-generation cephalosporin, cefepime, or vancomycin. Six subjects acquired MRSA after enrollment (incidence, 1.2 per 100 patient-months at-risk; overall prevalence, 18%). Molecular analysis suggested that transmission occurred within the facility. The incidence of MRSA infection among carriers was 1.76 per 100 patient-months. Community-associated strains (ie, USA300) were isolated from 28% of carriers and at least 25% of infections.

    Conclusions.

    The prevalence of MRSA carriage and the incidence of infection among carriers were high among ambulatory hemodialysis patients, and community-associated MRSA was responsible for a large portion of the MRSA burden. A relatively high rate of MRSA acquisition was observed, with indirect evidence of intrafacility transmission. Additional studies are needed to confirm these findings and to identify effective and feasible methods to prevent MRSA transmission and infection among hemodialysis patients.

  • Outcomes of Carbapenem-Resistant Klebsiella pneumoniae Infection and the Impact of Antimicrobial and Adjunctive Therapies
  • Gopi Patel, Shirish Huprikar, Stephanie H. Factor, Stephen G. Jenkins, David P. Calfee
  • Journal: Infection Control & Hospital Epidemiology / Volume 29 / Issue 12 / December 2008
  • Published online by Cambridge University Press: 02 January 2015, pp. 1099-1106
  • Print publication: December 2008
  • View abstract
    Background.

    Carbapenem-resistant Klebsiella pneumoniae is an emerging healthcare-associated pathogen.

    Objective.

    To describe the epidemiology of and clinical outcomes associated with carbapenem-resistant K. pneumoniae infection and to identify risk factors associated with mortality among patients with this type of infection.

    Setting.

    Mount Sinai Hospital, a 1,171-bed tertiary care teaching hospital in New York City.

    Design.

    Two matched case-control studies.

    Methods.

    In the first matched case-control study, case patients with carbapenem-resistant K. pneumoniae infection were compared with control patients with carbapenem-susceptible K. pneumoniae infection. In the second case-control study, patients who survived carbapenem-resistant K. pneumoniae infection were compared with those who did not survive, to identify risk factors associated with mortality among patients with carbapenem-resistant K. pneumoniae infection.

    Results.

    There were 99 case patients and 99 control patients identified. Carbapenem-resistant K. pneumoniae infection was independently associated with recent organ or stem-cell transplantation (P = .008), receipt of mechanical ventilation (P = .04), longer length of stay before infection (P = .01), and exposure to cephalosporins (P = .02) and carbapenems (P < .001). Case patients were more likely than control patients to die during hospitalization (48% vs 20%; P < .001) and to die from infection (38% vs 12%; P < .001). Removal of the focus of infection (ie, debridement) was independently associated with patient survival (P = .002). The timely administration of antibiotics with in vitro activity against carbapenem-resistant K. pneumoniae was not associated with patient survival.

    Conclusions.

    Carbapenem-resistant K. pneumoniae infection is associated with numerous healthcare-related risk factors and with high mortality. The mortality rate associated with carbapenem-resistant K. pneumoniae infection and the limited antimicrobial options for treatment of carbapenem-resistant K. pneumoniae infection highlight the need for improved detection of carbapenem-resistant K. pneumoniae infection, identification of effective preventive measures, and development of novel agents with reliable clinical efficacy against carbapenem-resistant K. pneumoniae.