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Geospatial Analysis of Multilevel Socioenvironmental Factors Impacting the Campylobacter Burden among Infants in Rural Eastern Ethiopia: A One Health Perspective.

Increasing attention has focused on health outcomes of Campylobacter infections among children younger than 5 years in low-resource settings. Recent evidence suggests that colonization by Campylobacter species contributes to environmental enteric dysfunction, malnutrition, and growth faltering in young children. Campylobacter species are zoonotic, and factors from humans, animals, and the environment are involved in transmission. Few studies have assessed geospatial effects of environmental factors along with human and animal factors on Campylobacter infections. Here, we leveraged Campylobacter Genomics and Environmental Enteric Dysfunction project data to model multiple socioenvironmental factors on Campylobacter burden among infants in eastern Ethiopia. Stool samples from 106 infants were collected monthly from birth through the first year of life (December 2020-June 2022). Genus-specific TaqMan real-time polymerase chain reaction was performed to detect and quantify Campylobacter spp. and calculate cumulative Campylobacter burden for each child as the outcome variable. Thirteen regional environmental covariates describing topography, climate, vegetation, soil, and human population density were combined with household demographics, livelihoods/wealth, livestock ownership, and child-animal interactions as explanatory variables. We dichotomized continuous outcome and explanatory variables and built logistic regression models for the first and second halves of the infant's first year of life. Infants being female, living in households with cattle, reported to have physical contact with animals, or reported to have mouthed soil or animal feces had increased odds of higher cumulative Campylobacter burden. Future interventions should focus on infant-specific transmission pathways and create adequate separation of domestic animals from humans to prevent potential fecal exposures.

Humans↗

Impact of cefpodoxime proxetil and amoxicillin on the normal oral and intestinal microflora.

Ten healthy volunteers were given 200 mg cefpodoxime proxetil tablets every 12 h and ten volunteers received 500 mg amoxicillin tablets every 8 h for seven days and the impact of the agents on the oral and intestinal microflora was studied. In the oral microflora, only minor alterations were observed in both groups. In subjects receiving cefpodoxime proxetil, the numbers of streptococci, enterobacteria and clostridia were strongly reduced in the faecal flora, while there was an overgrowth of enterococci, yeasts and Clostridium difficile. Amoxicillin administration induced somewhat smaller alterations in the faecal microflora, although all subjects had overgrowth of new colonizing amoxicillin resistant microorganisms, mainly Escherichia coli, Klebsiella and Enterobacter. Beta-lactamase activity was detected in the flora of six volunteers from each group.

Adult↗

Impact of orally administered antimicrobial agents on human oropharyngeal and colonic microflora.

Phenoxymethylpenicillin, bacampicillin, clindamycin, erythromycin and doxycycline were given orally to 46 subjects for seven days. The numbers of aerobic and anaerobic bacteria in the oropharyngeal and colonic microflora were determined as were the concentrations of antimicrobial agents in saliva and faeces. Clindamycin, erythromycin and doxycycline were detected both in saliva and faeces. Phenoxymethylpenicillin, bacampicillin and doxycycline caused only minor changes in the microflora, while pronounced suppression of anaerobic bacteria was noticed when clindamycin was administered. Erythromycin decreased the aerobic bacteria in the oropharynx and both aerobic and anaerobic bacteria in the colon. New colonizing clostridia, enterobacteria and fungi were found both in the oropharynx and in the colon when erythromycin and clindamycin were administered.

Administration, Oral↗

Source apportionment of groundwater pollution around landfill site in Nagpur, India.

The present work attempts statistical analysis of groundwater quality near a Landfill site in Nagpur, India. The objective of the present work is to figure out the impact of different factors on the quality of groundwater in the study area. Statistical analysis of the data has been attempted by applying Factor Analysis concept. The analysis brings out the effect of five different factors governing the groundwater quality in the study area. Based on the contribution of the different parameters present in the extracted factors, the latter are linked to the geological setting, the leaching from the host rock, leachate of heavy metals from the landfill as well as the bacterial contamination from landfill site and other anthropogenic activities. The analysis brings out the vulnerability of the unconfined aquifer to contamination.

Enterobacteriaceae↗

The impact of weekly iron supplementation on the iron status and growth of adolescent girls in Tanzania.

We evaluated the effect of weekly doses of 400 mg of ferrous sulphate for 4 months on the iron status of adolescent girls in a controlled trial in Tanga, Tanzania. Supplementation led to a significantly greater increase in serum ferritin compared with the control group (+ 15.6 microg/l vs. 8.6 microg/l) (P = 0.002) but there was no significant difference in change in haemoglobin. Children given iron showed a significantly greater weight gain than controls (+ 2.4 kg vs. + 1.4 kg) (P = 0.03). Weekly iron supplementation may be an effective means of increasing iron stores and growth in children vulnerable to iron deficiency.

Adolescent↗

Outcome of excision of megarectum in children with anorectal malformation.

BACKGROUND/PURPOSE: Megarectum in association with anorectal malformation contributes to chronic constipation and fecal incontinence. Resection of megarectum in anorectal malformation improves bowel function, but neuropathy and poor sphincter quality may affect the outcome of fecal continence adversely. The aim of this study was to evaluate the benefits of resection of megarectum in anorectal malformation and to ascertain the impact of anal sphincter quality and neuropathy on the outcome. METHODS: We studied 62 children with intractable fecal incontinence after repair of anorectal malformation between January 1991 and January 2005. All patients were investigated with anorectal manometry and anal endosonography under ketamine anesthesia. On endosonography, an intact or scarred internal anal sphincter (IAS) was classified as good and a fragmented or absent IAS as poor. On manometry, a resting anal sphincter pressure equal to or more than 30 mm Hg was classified as good and a lower pressure as poor. Functional assessment of fecal continence was done before and after excision of megarectum using a modified Wingfield scores. RESULTS: Sixteen children had excision of megarectum with median age of 9 years (range, 2-15 years) and postoperative follow-up of 5 years (range, 1-10 years). Seven had formation of antegrade continent enema stoma before excision of megarectum. Children were classified into three groups of anomalies: low (n = 6), intermediate (n = 4), and high (n = 6). All children were incontinent of feces. After excision of megarectum, of the 9 children with good IAS and no neuropathy, 7 became continent of feces. Of the remaining 7 children, 4 had poor IAS and 3 had neuropathy, 5 of whom required an antegrade continent enema stoma to be clean. CONCLUSION: Excision of megarectum in children who had previous repair of anorectal malformation results in fecal continence in the presence of a good IAS and absence of neuropathy. Patients with a poor IAS or neuropathy will often require artificial means of fecal continence.

Adolescent↗

Impact of ceftibuten on intestinal microflora: in vitro and in vivo studies.

The present study examines the possible interference of ceftibuten on intestinal microflora. In 60 germ-free mice, an intestinal microflora similar to the human one was implanted. The mice were then treated with a single dose and twice the therapeutic dose of ceftibuten. In another experiment, ten human volunteers were given ceftibuten in doses equivalent to 400 mg/day for 7 days in order to evaluate the ceftibuten faecal concentration, the possible interference on microflora and the quantity of indacan (as a measure of the bacterial metabolism in the gut) excreted in one day. The results obtained in vivo and in vitro have shown that ceftibuten in therapeutic doses does not alter the equilibrium of normal intestinal microflora.

Adult↗

Persistence of Escherichia coli O157 on farm surfaces under different environmental conditions.

AIMS: To compare the persistence of Escherichia coli O157 on a variety of common faecally contaminated farmyard material surfaces (wood and steel) under different moisture and temperature regimes. METHODS AND RESULTS: Samples of field-conditioned farmyard materials (galvanized steel and wood) were cut into pieces and contaminated with fresh cattle faeces inoculated with nontoxigenic E. coli O157 (strain 3704). Thereafter, they were stored at four different environmental conditions; with temperature (5 and 20 degrees C) and moisture (moist or dry) as variables. Transfer of the pathogen to hands from the surfaces was also evaluated. Escherichia coli O157 numbers declined over time on all surfaces albeit at different rates according to the sample material and environmental conditions. Persistence was greatest on moist wood samples under cooler temperatures with large population numbers remaining after 28 days. Desiccation of surfaces resulted in a more rapid decline in E. coli O157 populations under both temperature regimes. Substantial numbers of colonies may also potentially be transferred to human hands from the surfaces during brief contact. CONCLUSIONS: When environmental conditions are favourable, E. coli O157 may persist for considerable times on a range of surfaces. However, when exposed to higher temperatures and dehydration, survival is notably decreased. Overall, bacterial persistence was significantly greater on wood samples relative to steel. SIGNIFICANCE AND IMPACT OF THE STUDY: Escherichia coli O157 is a prevalent pathogen, common in ruminant faeces. Contact with contaminated faeces may lead to human infection, resulting in possible severe illness. Although our study used only one strain of bacteria, our findings indicates that E. coli O157 has the potential to persist for long periods of time on gates, stiles and other farmyard surfaces under a range of environmental conditions. These farmyard surfaces therefore pose a potential infection pathway particularly where there is a high risk of direct human contact (e.g. child petting zoos, open farms).

Animal Husbandry↗

Determination of selenium stable isotopes by gas chromatography-mass spectrometry with negative chemical ionisation.

A gas chromatography mass spectrometric method using negative chemical ionisation was developed for the determination of stable isotopes of selenium for evaluation of selenium absorption and retention from foods in humans. The method involves an acid digestion to convert all selenium into selenite, which subsequently reacts with 4-nitro-o-phenylene-diamine to form a volatile piazselenole. The piazselenole, after extraction into an organic solvent, was analysed for its isotopic selenium composition by gas chromatography mass spectrometry. Negative chemical ionisation is reported for the first time for the determination of selenium stable isotopes and its analytical characteristics were compared to those of electron impact mass spectrometric ionisation, classically used for the determination of selenium. The negative chemical ionisation technique allowed accurate determination of total selenium by isotope dilution and of selenium isotope ratios in biological samples. The repeatability for total selenium and for stable isotope ratios was good (R.S.D.< or =10%) within the range of 50 to 250 ng selenium. The detection limit for the investigated selenium isotopes was approximately 1 pg (signal to noise ratio at 3). The applicability of the developed stable isotope methodology was demonstrated by the determination of the selenium absorption and retention from foods in a pilot study using one human adult.

Adult↗

Bacillus cereus is common in the environment but emetic toxin producing isolates are rare.

AIMS: To determine the incidence of emetic toxin producing Bacillus cereus in soil, animal faeces and selected vegetable produce to compare the results with the previously reported high incidence in rice paddy fields. To examine whether the emetic toxin has antibiotic activity. METHODS AND RESULTS: The incidence of emetic toxin producing B. cereus was evaluated by plating on selective agar 271 samples of soils, animal faeces, raw and processed vegetables. Overall, 45.8% of samples were positive for B. cereus. One hundred and seventy-seven B. cereus isolates were recovered at 30 degrees C with the grand mean spore count being 2.6 +/- 1.7 log(10) CFU g(-1) and 148 B. cereus isolates were recovered at 7 degrees C with the grand mean spore count being 2.2 +/- 1.2 log(10) CFU g(-1) of the 177 B. cereus isolated at 30 degrees C, only 3 were positive for emetic toxin production at a titre of 1/64, 1/32, 1/16, respectively. Also, 1 of 148 B. cereus isolated at 7 degrees C was positive for emetic toxin production to a titre of 1/128. All positive isolates came from washed or unwashed potato skins, one was psychrotrophic as determined by PCR and growth at 7 degrees C on subculture. The emetic toxin was not shown to have any antibiotic effects in growth inhibition studies. CONCLUSIONS: While B. cereus was a common isolate, the incidence of the emetic strain was rare. This is in contrast to previous findings of the high incidence in rice paddy fields and the processing environment, which may suggest rice is a selective area for growth of the emetic strain of B. cereus. SIGNIFICANCE AND IMPACT OF STUDY: The finding that a psychrotrophic isolate of B. cereus can produce emetic toxin is the first ever such observation and suggests the possibility that psychrotrophic isolates could grow in refrigerated fresh foods and cause emesis. The incidence of emetic B. cereus strains in rice paddy fields now requires further study for comparison with the low incidence found in other soils. The emetic toxin failed to inhibit the growth of other bacterial, fungal and yeast species. Whether the toxin (which is similar in structure to the antibiotic valinomycin) plays a competitive role in the environment therefore remains unclear.

Animals↗

Impact of short perioperative courses of cefotaxime on aerobic bacterial flora in patients undergoing transurethral prostatic resection.

The influence of short-term prophylactic courses of cefotaxime on the microbial environment was studied. The distribution of bacterial species and their antibiotic resistance was recorded in isolates collected over a six-year period, during which time cefotaxime was used for perioperative prophylaxis in patients undergoing transurethral prostatic resection. In three consecutive studies covering the six-year observation period, the species distribution and antibiotic resistance patterns remained essentially unchanged for both cefotaxime and ampicillin. Examination of the faecal coliform flora in 23 patients given cefotaxime revealed no marked qualitative or quantitative change in the flora. It is concluded that short-term prophylactic courses of cefotaxime do not promote the emergence of resistance in the aerobic bacterial flora.

Aged↗

F-specific RNA coliphages: occurrence, types, and survival in natural waters.

A small, well-defined watershed was investigated over a 2-year period to determine the prevalence of F-specific RNA coliphage (F + RNA) serotypes as indicators of animal fecal contamination. Sampling sites collected runoff from areas of urban and agricultural land use patterns. F-specific coliphages were concentrated from 2-L freshwater samples by polyethylene glycol precipitation, isolated using the double agar layer (DAL) method, confirmed as F + RNA by RNAse suppression, and serotyped. A subset of serotyped F + RNA were confirmed by genotyping. To determine relative survival, 10 confirmed F + RNA field isolates and 5 prototypic F + RNA were spiked into surface water and incubated at 25 degrees C for 36 days. F-specific coliphage isolation was strongly associated with rainfall events and was infrequent from primarily animal impacted surface waters. Field isolates were predoffiinantly Type I F + RNA (81%) and raw sewage isolates were predominantly Type III F + RNA (57%). Genotyping from either the watershed or raw sewage samples never positively identified Type IV F + RNA. Results from laboratory studies showed that F + RNA differ in their survival in water and that Type IV strains were the least persistent. Type III F + RNA were found to be reliably related to the release of uncontrolled human fecal material in the watershed, but the results of this study suggest that further study is required before utilizing for fecal source identification in natural waters.

Agriculture↗

Rapid structural analysis of the in vitro and in vivo metabolism of SK & F 95448 by the combined use of thermospray liquid chromatography/mass spectrometry and liquid chromatography/tandem mass spectrometry.

The thermospray liquid chromatography/mass spectrometry (LC/MS) interface has had a major impact on the direct analysis of the metabolic fate of xenobiotics in complex biological media. This paper outlines the rapidity and power of the LC/MS approach, and shows how detailed structural information can be obtained without recourse to individual compound isolation. This provides a great saving in time and effort. The additional specificity of liquid chromatography/tandem mass spectrometry is highlighted in identifying the sites of metabolic transformation. The ability to handle biological samples with little or no clean-up using wide high-performance liquid chromatographic gradients is a key feature of the success of this methodology.

Adenosine Triphosphatases↗

Colonic fermentation of complex dietary carbohydrates in short-bowel patients. No association with hydrogen excretion and fecal and plasma short-chain fatty acids.

BACKGROUND: The colonic degradation of carbohydrates (fermentation) to short-chain fatty acids (SCFAs) appears to have major impacts on colonocyte function, sodium and water absorption, and large-bowel energy salvation, but how to quantify the in vivo fermentation in man is still debatable. METHODS: Indicators of colonic fermentation, fecal and plasma SCFAs and breath hydrogen (H2), were measured in 10 short-bowel patients (mean +/- SE; 106 +/- 21 cm) with totally preserved large bowels who were on a 60% high-carbohydrate, 20% low-fat diet, compared with the reversed isocaloric 20% low-carbohydrate, 60% high-fat diet. This human model showed large differences in large-bowel fermentation, as excretions of calories were reduced (40%; 485 +/- 151 kcal/day) and excretions of carbohydrates were unchanged and low with the high-carbohydrate diet as compared with the low-carbohydrate diet, in contrast to unchanged calorie excretion in short-bowel patients with no colonic function. RESULTS: Fecal concentrations of SCFAs did not change when the diet was changed from the high content to the low content of carbohydrates (82 +/- 11 mmol/l and 79 +/- 9 mmol/l, respectively). The ratio of acetate in feces increased (from 48 +/- 4% to 54 +/- 3%; p = 0.01) on the high-carbohydrate diet, whereas the percentage of the other SCFAs decreased proportionally. Plasma SCFAs 2 h and 6 h after breakfast were also identical when comparing the two dietary regimens. Nor were the peak H2 breath excretion and the area under the H2 excretion-versus-time curve increased by the threefold increase in the intake of dietary carbohydrates. CONCLUSIONS: Fecal and plasma SCFAs and breath H2 excretion are of limited value in the evaluation of even large differences in colonic fermentation of complex dietary carbohydrates.

Adult↗

Impact of commercial pre-harvest processes on the prevalence of Salmonella enterica in cull sows.

This study examined the impact of transport and lairage on Salmonella enterica prevalence in cull sows held under commercial conditions. Five sampling periods over 10 weeks yielded 181 selected culls. Fecal sample positives at the farm and collection point were 2% and 3%, respectively. After transport and lairage 41% of cull sows yielded S. enterica in one or more sampled tissues. A significant increase in cecal isolations was observed. The two S. enterica serotypes found at the production site and collection point were found at the abattoir, as were 13 other serotypes. Transport and lairage practices may contribute to an increased S. enterica contamination immediately prior to slaughter.

Abattoirs↗

Impact of the current National Bilharzia Control Programme on the epidemiology of schistosomiasis mansoni in an Egyptian village.

In a population-based study in the Nile Delta of Egypt, the modified Kato thick smear technique was used to study the epidemiology of Schistosoma mansoni. After 2 years of implementation of the National Bilharzia Control Programme by the Ministry of Health, the general prevalence dropped from 47.2% to 21.9%. The peak prevalence rate has shifted downwards in magnitude (40.4% compared to 72.1%) and backwards over the age scale (5-14 in contrast to 15-19 years age group). Redistribution of various infection grades has taken place. More than three-quarters (75.6%) of the infected individuals have light infections in contrast to only one-fifth (20%) 2 years ago. The mean egg count for the entire sample population has dropped significantly (P < 0.05) from 128 to 17 eggs/g stools with no significant difference between males and females. This positive impact can be attributed largely to the case finding and treatment component of the programme. However, the incidence rate remained nearly the same before and 2 years after implementation of the programme (18.7 and 18.1%, respectively). The non-changing high incidence rate indicates that the knowledge, attitude and practice (KAP) of the population concerning water contact have not yet changed. Insufficient improvement in environmental sanitation may be a contributing factor. Continuation of serious efforts in case finding and treatment is recommended, with special emphasis on schoolchildren. This should be coupled with an intensive health education programme.

Adolescent↗

Impact of Lactobacillus acidophilus on the normal intestinal microflora after administration of two antimicrobial agents.

Twenty healthy volunteers participated in a comparative study concerning the influence of Lactobacillus acidophilus supplements on the normal intestinal microflora after the administration of two antimicrobial agents, enoxacin and clindamycin, respectively. L. acidophilus NCFB 1748 was given as a fermented milk product containing 5 x 10(8)-2 x 10(9) CFU/ml to ten of the volunteers immediately after the administration of the antimicrobial agents. On the seventh day of enoxacin administration enterobacteria were eliminated in nine of ten subjects. Enterococci disappeared or decreased significantly in five subjects. During the L. acidophilus supplementation, there was a significant increase in the number of Escherichia coli in one subject, while enterococci returned to the same level as before enoxacin administration in all subjects.

Adult↗

Prospective study of the impact of broad-spectrum antibiotics on the yeast flora of the human gut.

The effects of four antibiotics on the yeast flora of the human gut were evaluated. Forty adult cancer patients who received therapy with amoxicillin-clavulanate, ciprofloxacin, sulfamethoxazole-trimethoprim or ampicillin were studied prospectively. Quantitative stool cultures for yeasts were performed immediately before, at the end of and one week after the end of the antibiotic treatment. Amoxicillin-clavulanate caused a higher and more persistent increase in gastrointestinal colonization by yeasts compared to ciprofloxacin, sulfamethoxazole-trimethoprim or ampicillin. The present results are similar to those obtained in a mouse model of gastrointestinal colonization by Candida albicans when the same antibiotics were used.

Adult↗