The elucidation of actual disaster restoration project costs by compiling the forest road registers

長野県の民有林林道を対象に林道台帳を集計することで，林道施設災害復旧事業費の実態解明を行った。 その結果，次のことが明らかとなった。集計路線（n=1504）の約36% では，林道施設災害が発生していなかった。1 被災箇所あたりの復旧費の標準偏差は2602.4 万円と大きくばらつくとともに，年代クラスにより分布形態が異なった。各年の総復旧費の内訳をみると，全被害額の5 割が路線数にして1 割強の被災路線に起因した。復旧単価（円/年・m）の平均値は222 円/年・m，中央値は55 円/年・m，標準偏差は436 円/m・年であった。単位時間・単位長さあたり復旧費は，集計路線の約59% で100 円/年・m以下，約95% で1000円/年・m以下であり，右裾が重い安定分布に類似していた。開設後経過年数と復旧単価の間に明瞭な比例関係は認められなかった。規格別の復旧単価の中央値は，1 級林道が185 円/年・m，2 級林道が71 円/年・m，3 級林道が37 円/年・m であり， 1，3 級および2，3 級の間に1% 水準で有意差が確認された。既往手法を用いて算出した復旧単価の推計値と実績値の残差標準偏差は464 円/年・m であった。The following results were obtained from the forest road registers for privately-owned forest roads in Nagano Prefecture. Approximately 36% of the totaled routes (n = 1504) experienced no forest road facility disasters. The standard deviation of the distribution of restoration cost per affected area was 260,024,000 yen, and the distribution varied by age class. The total restoration cost analysis each year shows that 50% of the whole damage was caused by a little over 10% of the total number of damaged routes. The mean, median, and standard deviation of the restoration unit cost were 222 yen/year･m, 55 yen/year･m, and 436 yen/year･m, respectively. The restoration unit cost was <100 yen/year･m for about 59% of the total routes and <1000 yen/year･m for about 95% of the total routes, resembling a stable distribution with a heavy right hem. No clear proportional relationship was found between the number of years since opening and the restoration unit cost. The median restoration unit cost by standard was 185 yen/year･m, 71 yen/year･m, and 37 yen/year･m for Class 1, Class 2, and Class 3 forest roads, respectively. The residual standard deviation between the estimated and actual restoration unit costs calculated using the existing method is 464 yen/year･m.journal articl

The rates of survival to discharge, clinical success and microbiologic eradication by primary site of infection.

The rates of survival to discharge, clinical success and microbiologic eradication by primary site of infection.</p

Clinical Experience of Patients Receiving Doripenem-Containing Regimens for the Treatment of Healthcare-Associated Infections

<div><p>In this study, we retrospectively reviewed the clinical experience of patients receiving doripenem-containing regimens for the treatment of healthcare-associated infections (HCAIs) in a tertiary care center and assessed the clinical usefulness of doripenem therapy in this clinical setting. In this retrospective study, the medical records of all adult patients who had ever received doripenem-containing therapy for the treatment of HCAIs were reviewed between September 1, 2012 and August 31, 2014, and the following data were extracted: age, gender, type of infection, disease severity, underlying comorbidities or conditions, and laboratory results. Additionally, we also extracted data regarding the rates of mortality and clinical and microbiological response. A total of 184 adult patients with HCAIs who had received doripenem-containing therapy were included in this study. Respiratory tract infections (n = 91, 49.5%) were the most common type of infection, followed by urinary tract infections, intra-abdominal infections and skin and soft tissue infections. The mean APACHE II score was 14.5. The rate of clinical success was 78.2%, and the overall in-hospital mortality rate was only 13.0%. Among patients, in-hospital mortality was independently and significantly associated with APACHE II score (odds ratio (OR), 1.2825; 95% CI, 1.1123–1.4788) and achieving clinical success (OR, 0.003; 95% CI, 0.0003–0.409). In conclusion, the overall in-hospital mortality rate was low and the clinical success rate was high among HCAI patients receiving doripenem treatment. These results suggest that doripenem may be judiciously used for the treatment of patients with HCAIs.</p></div

Distribution of the eight most commonly detected organisms by sampling location.

<p>Distribution of the eight most commonly detected organisms by sampling location.</p

Sites, clinical sources, and causal organisms of infection among cases who did not achieve microbiological eradication.

<p>Sites, clinical sources, and causal organisms of infection among cases who did not achieve microbiological eradication.</p

Comparisons between deceased and surviving patients.

<p>Comparisons between deceased and surviving patients.</p

Clinical characteristics of included patients.

<p>Clinical characteristics of included patients.</p

Identification of the genetic determinants of serotype Typhimurium that may regulate the expression of the type 1 fimbriae in response to solid agar and static broth culture conditions-0

Rium LB5010 cells did not produce type 1 fimbrial appendages on the outer membrane when cultured on LB agar at 37°C for 18 hr (20,000 ×). Bacterial cells were negatively stained with 2% of phosphotungstic acid.<p><b>Copyright information:</b></p><p>Taken from "Identification of the genetic determinants of serotype Typhimurium that may regulate the expression of the type 1 fimbriae in response to solid agar and static broth culture conditions"</p><p>http://www.biomedcentral.com/1471-2180/8/126</p><p>BMC Microbiology 2008;8():126-126.</p><p>Published online 25 Jul 2008</p><p>PMCID:PMC2527010.</p><p></p

Closely Related NDM-1-Encoding Plasmids from <i>Escherichia coli</i> and <i>Klebsiella pneumoniae</i> in Taiwan

<div><p>Objective</p><p>Two plasmids carrying <i>bla</i>_NDM-1 isolated from carbapenem-resistant <i>Klebsiella pneumoniae</i> (CR-KP) and carbapenem-resistant <i>Escherichia coli</i> (CR-EC) were sequenced. CR-KP and CR-EC were isolated from two Taiwanese patients without travel histories.</p><p>Methods</p><p>Complete sequencing of the plasmids (pLK75 and pLK78) was conducted using a shotgun approach. Annotation of the contigs was performed using the RAST Server, followed by manual inspection and correction.</p><p>Results</p><p>These similar plasmids were obtained from two patients with overlapping stays at the same hospital. The pLK75 and pLK78 plasmids were 56,489-bp and 56,072-bp in length, respectively. Plasmid annotation revealed a common backbone similar to the IncN plasmid pR46. The regions flanking the <i>bla</i>_NDM-1 genes in these plasmids were very similar to plasmid pNDM-HU01 in Japan, which contains a complex class 1 integron located next to an IS<i>CR1</i> element. The IS<i>CR1</i> element has been suggested to provide a powerful mechanism for mobilising antibiotic resistance genes.</p><p>Conclusion</p><p>Two indigenous NDM-1-producing Enterobacteriaceae cases were identified for the first time in Taiwan, highlighting the alarming introduction of NDM-1-producing Enterobacteriaceae in this region.</p></div

Clinical Significance of Community- and Healthcare-Acquired Carbapenem-Resistant Enterobacteriaceae Isolates

<div><p>This study was conducted to investigate the clinical significance, manifestations, microbiological characteristics and outcomes of carbapenem-resistant Enterobacteriaceae (CRE) isolates, and compare the clinical features of community- and healthcare-acquired CRE isolates. A total of 78 patients were identified to have CRE. <i>Klebsiella pneumoniae</i> was the most common pathogens (n = 42, 53.8%), followed by <i>Enterobacter cloacae</i> (n = 24, 30.8%), and <i>Escherichia coli</i> (n = 11, 14.1%). Most of the patients acquired CRE from healthcare settings (n = 55, 70.5%), and other cases got CRE from community settings (n = 23, 29.5%). Nine cases (11.5%) were classified as CRE colonization. Among the remaining 69 cases of CRE infections, pneumonia (n = 28, 40.6%) was the most common type of infections, followed by urinary tract infection (n = 24, 34.8%), and intra-abdominal infection (n = 16, 23.2%). The patients acquired CRE from community settings were more likely to be elderly, female, and had more urinary tract infections than from healthcare settings. In contrast, the patients acquired CRE from healthcare settings had more intra-abdominal infections, intra-abdominal surgery, and presence of indwelling device than from community settings. In conclusion, community-acquired CRE are not rare, and their associated clinical presentations are different from healthcare-acquired CRE.</p></div