Microbiological verification of reprocessed mechanical ventilators serves as a quality control measure aimed at interrupting potential transmission routes of pathogens before patient intubation. The aim of this study was to describe the microbiological findings and operational costs of the post-reprocessing surveillance program for mechanical ventilators at Hospital Juárez de México and to contextualize these costs using a hypothetical VAP-associated economic reference. This retrospective observational study included 1456 post-reprocessing microbiological evaluation events involving mechanical ventilators previously used by patients with laboratory-confirmed ventilator-associated pneumonia (VAP). All events meeting the surveillance eligibility criteria during the study period were included. Inspiratory and expiratory limbs were sampled for bacterial culture, with microbial identification by mass spectrometry. Any bacterial growth was considered residual contamination, and the ventilator underwent a new complete cycle of cleaning and high-level disinfection. An institutional analysis was applied to estimate operational costs and to contextualize the potential VAP-associated economic burden using the culture-positive ventilators as a hypothetical reference calculation, without assuming that each positive device represented a prevented VAP episode. Residual bacterial contamination was detected in 95 evaluation events (6.5%), with recovery of organisms including Acinetobacter baumannii and Pseudomonas aeruginosa. The operational cost of the microbiological surveillance program was 40,993 USD. Using institutional VAP cost estimates, a hypothetical calculation assigning the annual VAP cost to each of the 95 culture-positive evaluation events produced a reference value of 1,285,650 USD. Under this reference calculation, the difference between the VAP-associated reference value and program cost was 1,244,657 USD, corresponding to a cost ratio of 31.4:1. These estimates are hypothetical and depend on assumptions regarding infection probability and preventive effectiveness; they do not represent demonstrated economic savings. The break-even probability of device-attributable VAP per culture-positive evaluation event was 3.19%, assuming full institutional coverage of VAP-associated costs and complete prevention of these episodes through additional reprocessing. Within this defined surveillance population, microbiological surveillance of reprocessed mechanical ventilators is a useful quality-control strategy prior to patient intubation.
Microbial inoculation may support crop growth under salinity, but general growth promotion must be distinguished from salinity-dependent responses. Pseudomonas sp. JP1-10 was evaluated in greenhouse-grown peanut at 0, 2.5, and 5 g NaCl kg−1 dry soil. Growth, antioxidant responses, and rhizosphere properties were assessed at 30 and 60 days; root architecture and tissue ions were assessed at 60 days, and reproductive fresh weights were assessed at maturity. Inoculation was associated with greater shoot and root fresh weights and longer primary roots across the salinity gradient. Root tip number increased by 57.49–86.52% and lateral root number by 95.33–107.23%, with salinity-dependent branching responses. Recorded shoot and root ion values suggested lower Na and higher K and K/Na mass ratios under salinity, although their conversion to absolute tissue concentrations requires validation. Antioxidant responses varied with tissue and sampling time. In saline treatments, rhizosphere available K and Fe were higher and electrical conductivity was lower with inoculation. Pod fresh weight increased overall by 1.07 g plant−1, without a salinity × inoculation interaction. Hundred-pod and hundred-kernel fresh weights were higher with inoculation at all three salinities, with salinity × inoculation interactions. These exploratory findings support general growth promotion and identify root branching and pod fresh weight as prominent responses associated with inoculation.
Alternaria leaf blight (ALB) has emerged as a serious foliar disease limiting groundnut productivity in the semi-arid region of North Gujarat, India. The present investigation was conducted for three consecutive kharif seasons (2016–2018) to elucidate pathogen diversity and epidemiological factors governing disease development under natural epiphytotic conditions. Symptomatic leaf samples were collected and the causal organisms were isolated, purified, and identified through morphological and molecular characterization. Two species, Alternaria alternata and A. tenuissima, were confirmed based on cultural traits, conidial morphology, and a multi-locus sequence typing (MLST)-based phylogenetic tree constructed using concatenate sequence of the internal transcribed spacer (ITS) region of 18s ribosomal RNA (18S rRNA) gene, partial translation elongation factor 1-alpha (TEF-1α), and RNA polymerase II second largest subunit (RPB2) gene. Epidemiological studies revealed that disease initiation occurred 30–35 days after sowing, followed by rapid progression up to 55–60 days. Correlation and regression analyses indicated that maximum temperature (31–34 °C) and sunshine hours showed a positive association with disease intensity, whereas minimum temperature, relative humidity, rainfall, and number of rainy days exhibited variable associations across seasons. Suitable weather parameters including 31–34 °C maximum temperature, 21–25.5 °C minimum temperature, 85–95% maximum relative humidity, 65–75% minimum relative humidity, and 50–100 mm weekly rainfall favor severe infection of groundnut with Alternaria. The apparent infection rate (r) was highest during the early crop growth stages (>0.1) and declined gradually thereafter. The findings provide a region-specific epidemiological framework for timely intervention and sustainable management of Alternaria leaf blight in groundnut under semi-arid agro-climatic conditions.
The Pitt Bacteremia Score (PBS) grades bedside severity, but its discrimination varies across settings and its conventional threshold of 4 has been questioned. This single-centre retrospective cohort study included 74 randomly sampled adults with culture-confirmed bacteremia and an updated Charlson Comorbidity Index below 4 at an Indonesian tertiary referral hospital. The PBS was calculated from the worst values recorded from 24 h before to 24 h after blood-culture collection. Discrimination for 7-day mortality was assessed by receiver operating characteristic analysis, the threshold maximizing the Youden index (YI) was examined by bootstrap resampling, and associations were estimated by Firth logistic regression. Thirty-two patients (43.2%) died within 7 days. The PBS discriminated non-survivors from survivors (AUC 0.900; 95% CI [0.824–0.975]), and in this cohort the YI was maximal at 4 (sensitivity 90.6%, specificity 81.0%), although thresholds of 3 to 5 could not be statistically distinguished. After excluding patients with cardiac arrest, the AUC was 0.790 (95% CI [0.633–0.946]). Seven-day mortality was 78.4% with a PBS of 4 or above (OR 34.21; 95% CI [9.99–152.79]), and the association persisted after adjustment for age, sex, multidrug-resistant organism status, and empirical antibiotic therapy concordance, although its magnitude was imprecisely estimated. These findings require external confirmation.
The causative agent of Lyme disease, Borrelia burgdorferi, poses significant health and economic problems in the United States and elsewhere. Developing borreliastatic or borreliacidal agents requires the use of solvent vehicles. Vehicle tolerance can affect the interpretation of antimicrobial screening tests. We examined the effects of dimethyl sulfoxide, sodium hydroxide, and ethanol on B. burgdorferi growth. Spirochaetes were exposed to vehicle concentrations ranging from 0.15% to 2.4% v/v. Cultures were evaluated with dark-field microscopy and a commercial cell viability assay. There were no significant decreases in cell counts or ATP-dependent luminescence with dimethyl sulfoxide. Sodium hydroxide was shown to be unsuitable as an unbuffered alkaline vehicle. Ethanol produced discordant ATP-dependent luminescence and cell-count endpoints at moderate concentrations, although detectable cell presence persisted through 1.2%. Differences between endpoints may be due to cellular stress from exposure. These results show that the identity and concentration of these vehicles differentially affect B. burgdorferi growth and ATP-dependent metabolic activity. The applicability of high-throughput methods may be affected by conditions that cause stress-induced changes. Future studies should explore how molecular effects relate to observed differences in cell counts and metabolic activity.
