High carriage rate of high-level penicillin-resistant Streptococcus pneumoniae in a Taiwan kindergarten associated with a case of pneumococcal meningitis

BACKGROUND: The Taiwan(19F)-14 Streptococcus pneumoniae clone and its variants are being found with increasing frequency in the Asia-Pacific region. A 5-year old child with S. pneumoniae meningitis caused by a high-level penicillin resistant strain (MIC = 4 μg/ml) was admitted to a hospital in southern Taiwan. We carried out a study to determine the potential source of this strain. METHODS: Nasopharyngeal cultures were obtained from all children attending the same kindergarten as the index case. To determine their relatedness all isolates were compared by serotype, antimicrobial susceptibility profile and pulsed field gel electrophoresis (PFGE). RESULTS: A high proportion of the children including the index case (32/78, 41.0%) carried S. pneumoniae in their nasopharynx (NP). The most common serotype was 19F (13/32, 40.6%). The PFGE types of the 19F serotype isolates obtained from the patient's blood, CSF and NP were identical and were related to 11 other serotype 19F NP isolates including 10 that were indistinguishable from the Taiwan(19F)-14 clone. All 14 isolates had similar high-level penicillin and multi-drug resistance. The serotypes of the other 19 NP isolates included 6A (2), 6B (10), 23F (5), 9V (1) and 3 (1). The overall rate of penicillin resistance in these S. pneumoniae from these children was 87.5% (28/32), with an MIC(50 )of 2 and MIC(90 )of 4 ug/ml. In addition, multi-drug resistant-isolates (isolates resistant to 3 different classes of antimicrobials) accounted for 87.5% (28/32) of all isolates. CONCLUSION: The high carriage rate of high-level penicillin- and multi-drug- resistant S. pneumoniae in a kindergarten associated with a case of pneumococcal meningitis emphasizes the need for restraint in antibiotic use and consideration of childhood immunization with conjugate pneumococcal vaccine to prevent the further spread of resistant S. pneumoniae in Taiwan

Testing a provisional model of scene brightness with and without objects of different colours

A provisional model of brightness perception for illuminated outdoor scenes was recently proposed based upon a combination of photopic and short-wavelength cone spectral sensitivities, where short-wavelength cone sensitivity increases with radiance. An experiment was undertaken to determine whether coloured objects within the illuminated scenes affected overall scene brightness perception and, in so doing, to provide a test of the provisional model. The results suggest that overall scene brightness perceptions are, for the range of light sources and light levels selected, consistent with the provisional model and that scene brightness perception is independent of object colours within the illuminated scenes. </jats:p

Toward the development of standards for yellow flashing lights used in work zones

Flashing yellow warning lights are important for worker and driver safety in work zones. Current standards for these lights do not address whether and how they should be coordinated to provide directional information to drivers navigating through work zones. A field study was conducted to assess driver responses to warning lights. The luminous intensities and flash patterns of warning lights along a simulated work zone were varied during daytime and nighttime. During the daytime, driver responses were relatively insensitive to warning light characteristics, although drivers preferred sequential and synchronised flash patterns over random, uncoordinated flashing. At nighttime, the combination of a temporal peak luminous intensity of 25 cd and a sequential flash pattern was optimal for providing directional information. A single initial warning light having a higher luminous intensity may help drivers detect the work zone without creating unacceptable visual discomfort. </jats:p