Molecular screening for Neisseria gonorrhoeae antimicrobial resistance markers in Nigerian men who have sex with men and transgender women

Antimicrobial-resistant Neisseria gonorrhoeae (NG) is a global public health issue that threatens effectiveness of current treatments of NG. Increased use of nucleic acid amplification tests (NAATs) in lieu of cultures makes obtaining clinical isolates for susceptibility testing difficult and samples collected in commercial transport buffer for NAATs do not preserve viable organism, while molecular methods of assessing antibiotic susceptibility do not require viable organism. We evaluated 243 NG-positive samples in Aptima transport media including urine, oral, and rectal swabs from Nigerian men who have sex with men for markers to penicillinase-producing NG, ciprofloxacin ( GyrA and ParC mutations), and extended spectrum cephalosporins (ESCs, PenA mosaic [allele X], PonA, mtrR, PorB mutations) by real-time PCR. NG DNA was recovered in 75% (183/243) of samples. Of these, 93% (171/183) were positive for at least one resistance marker. We observed a prevalence of dual resistance markers to penicillin and ciprofloxacin at 46.2% (79/171). Six percent of samples (10/171) tested positive for the PenA mosaic (allele X) ESC marker. These data indicate that antibiotic-resistant NG is common in Nigeria. Laboratory and clinical capacity building in Nigeria should include development of methods to culture NG and determine antimicrobial susceptibility.

An evaluation of Neisseria gonorrhoeae antimicrobial susceptibility testing in the UK

The only method currently available to perform Neisseria gonorrhoeae antimicrobial susceptibility testing (Ng-AST) requires a viable organism obtained by culture. Reports of in vitro resistance to extended-spectrum cephalosporins, the treatment of choice for gonorrhoea, coupled with increasing gonorrhoea diagnoses is worrying. The aim of this study was to identify various methodologies employed by the UK microbiology laboratories to perform Ng-AST. Of the 118 laboratories that responded, 114 offered Ng-AST; the majority (82.5%, 94/114) of the laboratories used British Society for Antimicrobial Chemotherapy methodology for Ng-AST. The other main findings were infrequent use of quality control procedures and inconsistent susceptibility testing of the antibiotics used routinely for treatment.

The Classification of International Legal Rules: A Reply to Stefan Talmon

Any legal system, including the international legal system, consists of rules that serve multiple purposes and functions that the legal system in question needs to perform in order to survive as a viable organism. Jurisprudence of national and international courts relating to areas such as responsibility, immunity, and dispute settlement has involved intensive discussions as to the nature and implications of the various categories of rules. Approaching this broad area, with its multiple components, requires careful differentiation of the nature of those various categories of rules, for the fact that the relevant classification of rules works in one area does not inherently make it workable in other areas, which is confirmed in practice. The most problematic issue remains the judicial application of jus cogens in relation to state immunities and the ensuing distinction between substantive and procedural rules. It is shown in this contribution that this artificial distinction does not reflect the functions international law actually accords to its various rules, and is instead a product of political and ideological preference to keep particular classes of plaintiffs out of certain jurisdictions.

The effect of open-air factors on the virulence and viability of airborneFrancisella tularensis

SUMMARYUnidentified open-air factors (OAFs) found to be adverse to the survival of microorganisms suspended on microthreads were investigated for their effect on realistic aerosols ofFrancisella tularensisin an open-air environment. This organism was chosen because it is probably the most infectious organism known to be capable of infecting both animals and man via the respiratory route, hence its potential use as a bioterrorist agent. A direct correlation was found between an open-air adverse effect on viability and virulence of airborne particles of <3 μm via the respiratory route in guinea pigs. One viable organism was sufficient to initiate an infection that resulted in a fatal tularaemia infection. The lethal effect of OAFs onF. tularensiswas found to vary from day to day and was related to the source of the air in the UK. The adverse effect on viability was associated with an inverse effect according to the size of the airborne particle.

Control of the infection with Brucella melitensis in cattle

Sera from1722 cattle of different age (3 months to 8 years) wereexamined by the Rose Bengal and tube agglutination test: 134 cow givepositive result and the overal Brucella seroprevalence was (8%) milksamples zeropositive milking cattle were cultured on Brucella selecativemedia.Seropositive cattle (102) were treated for the first time with long actingoxytetracyclin at the dose of 20 mg/kg of body weight administeredintramuscularly (i.m) every 2 days for 30 days and streptomycin at 25mg/kg (i.m) every 2 days for 16 days.The regimen was found to be effective in eliminating the shedding ofBrucella organisms by cattle in milk.Moreover all treated cattle became zeronegative within 16 months aftertreatment…zeronegative cattle (1588)were vaccinated for the first timewith the Br.Melitensis as follows1. 362 young cattle(aged three months to one year)were each inoculatedsubcutaneously with a full dose(1×106)viable organisms in 1 ml, Brucellaantibody titers were detected 2-4 weeks post vaccination then decreasedgradually until the animals became zeronegative 8 months aftervaccination.2. 1226cattle aged more than one year were each inoculatedsubcutaneously with reduced dose (1×103 viable organism in 1ml)antibody titers measured 2-4 weeks post vaccination then decreasedgradually until the animals became zeronegative 3 months postvaccination.No Brucella organisms were seen from repeated udeersecretion samples from all vaccinated milking cattle, and no abortionswere recorded among pregnant vaccinated cattle.

Neisseria gonorrhoeae NAAT ? a problem down under

Nucleic acid amplification tests (NAATs) are used worldwide for the detection of Neisseria gonorrhoeae, either in conjunction with or in place of traditional bacterial culture techniques. There are numerous advantages of gonococcal NAATs, including increased sensitivity, that a viable organism is not needed for detection, and they can be used effectively on non-invasive specimens such as urine and self-collected specimens. For these reasons, NAATs have been particularly useful for patients in remote regions of Australia where sexual health services may not be available and where religious or cultural restrictions otherwise restrict opportunities for specimen collection. Australian studies have been at the forefront of investigating the use of self-collected NAAT specimens and particularly successful at introducing the use of tampon self-collected specimens in remote populations of Indigenous Australians.