The adequacy of user seal checking for N95 respirators compared to formal fit testing: A multicentred observational study.

Objective: The objective of this study was to evaluate the adequacy of the user seal check (USC) in predicting N95 respirator fit.

Design: This was a prospective, observational study conducted from May to September 2020.

Setting: The study setting included three private intensive care units (ICUs) in Victoria, Australia.

Retrospective national cohort study of pregnancy outcomes for women with type 1 and type 2 diabetes mellitus in Republic of Ireland.

Aim: Report the outcomes of pregnant women with type 1 and type 2 diabetes and to identify modifiable and non-modifiable factors associated with poor outcomes.

Methods: Retrospective analysis of pregnancy preparedness, pregnancy care and outcomes in the Republic of Ireland from 2015 to 2020 and subsequent multivariate analysis.

Results: In total 1104 pregnancies were included.

Diabetes care and pregnancy outcomes for women with pregestational diabetes in Ireland.

Aims: Pre-gestational diabetes mellitus (PGDM) is associated with adverse outcomes. We aimed to examine pregnancies affected by PGDM; report on these pregnancy outcomes and compare outcomes for patients with type 1 versus type 2 diabetes mellitus; compare our findings to published Irish and United Kingdom (UK) data and identify potential areas for improvement.

Methods: Between 2016 and 2018 information on 679 pregnancies from 415 women with type 1 Diabetes Mellitus and 244 women with type 2 diabetes was analysed.

Airflow Characteristics in Aeromedical Aircraft: Considerations During COVID-19.

Objective: The aeromedical transport of coronavirus patients presents risks to clinicians and aircrew. Patient positioning and physical barriers may provide additional protection during flight. This paper describes airflow testing undertaken on fixed wing and rotary wing aeromedical aircraft.

An Irish National Diabetes in Pregnancy Audit: aiming for best outcomes for women with diabetes.

Aims: The purpose of this study was to identify the number of pregnancies affected by pre-gestational diabetes in the Republic of Ireland; to report on pregnancy outcomes and to identify areas for improvement in care delivery and clinical outcomes.

Methods: Healthcare professionals caring for women with pre-gestational diabetes during pregnancy were invited to participate in this retrospective study. Data pertaining to 185 pregnancies in women attending 15 antenatal centres nationally were collected and analysed.

Nanoscale view of assisted ion transport across the liquid-liquid interface.

During solvent extraction, amphiphilic extractants assist the transport of metal ions across the liquid-liquid interface between an aqueous ionic solution and an organic solvent. Investigations of the role of the interface in ion transport challenge our ability to probe fast molecular processes at liquid-liquid interfaces on nanometer-length scales. Recent development of a thermal switch for solvent extraction has addressed this challenge, which has led to the characterization by X-ray surface scattering of interfacial intermediate states in the extraction process.

Secretion clearance strategies in Australian and New Zealand Intensive Care Units.

Introduction/aims: To describe the processes of care for secretion clearance in adult, intubated and mechanically ventilated patients in Australian and New Zealand Intensive Care Units (ICUs).

Methods/results: A prospective, cross-sectional study was conducted through the Australian and New Zealand Intensive Care Society Clinical Trials Group (ANZICS CTG) Point Prevalence Program. Forty-seven ICUs collected data from 230 patients intubated and ventilated on the study day.

Evaluating team-based inter-professional advanced life support training in intensive care-a prospective observational study.

Recent focus on national standards within Australian hospitals has prompted a focus on the training of our staff in advanced life support (ALS). Research in critical care nursing has questioned the traditional annual certification of ALS competence as the best method of delivering this training. Simulation and team-based training may provide better ALS education to intensive care unit (ICU) staff.

A Partially Purified Acinetobacter baumannii Phage Preparation Exhibits no Cytotoxicity in 3T3 Mouse Fibroblast Cells.

A surge in the level and scale of antibiotic resistance has prompted renewed interest in the application of bacteriophages to treat bacterial infections. However, concerns still exist over their efficacy and safety. Acinetobacter baumannii phage BS46, a member of the family Myoviridae, has previously been shown to be effective in murine models.

Evaluation of environmental scanning electron microscopy for analysis of Proteus mirabilis crystalline biofilms in situ on urinary catheters.

Proteus mirabilis is a common cause of catheter-associated urinary tract infections and frequently leads to blockage of catheters due to crystalline biofilm formation. Scanning electron microscopy (SEM) has proven to be a valuable tool in the study of these unusual biofilms, but entails laborious sample preparation that can introduce artefacts, undermining the investigation of biofilm development. In contrast, environmental scanning electron microscopy (ESEM) permits imaging of unprocessed, fully hydrated samples, which may provide much insight into the development of P.

Elucidating the genetic basis of crystalline biofilm formation in Proteus mirabilis.

Proteus mirabilis forms extensive crystalline biofilms on urethral catheters that occlude urine flow and frequently complicate the management of long-term-catheterized patients. Here, using random transposon mutagenesis in conjunction with in vitro models of the catheterized urinary tract, we elucidate the mechanisms underpinning the formation of crystalline biofilms by P. mirabilis.

Potential subtherapeutic linezolid and meropenem antibiotic concentrations in a patient with severe burns and sepsis.

Altered pharmacokinetics in patients with major burns may result in serum antibiotic concentrations below those required to be effective against the common pathogens encountered in burns patients. The major changes in the fluid volumes of key body compartments, which occur with a large burn, may increase the apparent volume of distribution of a drug, thereby lowering its concentration when a standard dose is given. In addition, the observed increase in renal blood flow reported in burns patients, because of the change in cardiac output, may result in a higher drug clearance and a shorter elimination half-life.

Resistance of Legionella pneumophila serotype 1 biofilms to chlorine-based disinfection.

The presence of Legionella spp. in potable water systems is a major concern to municipal water providers and consumers alike. Despite the inclusion of chlorine in potable supplies and frequent chlorination cycles, the bacterium is a recalcitrant human pathogen capable of causing incidents of Legionnaires' disease, Pontiac fever and community-acquired pneumonia in humans.

The rapid and specific real-time detection of Legionella pneumophila in water samples using Optical Waveguide Lightmode Spectroscopy.

The detection of Legionella pneumophila in water samples using standard microbiological culture techniques is both prolonged and problematic. The bacterium is slow-growing and nutritionally fastidious, such that other indigenous species can out-compete the Legionella even when using antibiotic supplemented media. Optical Waveguide Lightmode Spectroscopy (OWLS) is a real-time analytical system whereby a change to a higher coupling angle where the refractive index of a bacterial cell is higher than that of the covering medium.

Triclosan-tolerant bacteria: changes in susceptibility to antibiotics.

There is no clear consensus regarding the effect of biocide tolerance on antibiotic susceptibility. In this work, triclosan-tolerant strains of Escherichia coli, Staphylococcus aureus and Acinetobacter johnsonii were compared with sensitive strains in order to ascertain their susceptibility to a range of antibiotics. The minimum inhibitory concentrations of triclosan were measured using broth- and agar-dilution techniques.

Long-term persistence of a single Legionella pneumophila strain possessing the mip gene in a municipal shower despite repeated cycles of chlorination.

The ability of Legionella pneumophila to colonise domestic water systems is a primary cause of outbreaks of Legionnaire's disease in humans. World Health Organization guidelines recommend that drinking water is chlorinated to between 0.2 and 1mg/L [Chlorine in drinking-water.

Presence of vancomycin and ampicillin-resistant Enterococcus faecium of epidemic clonal complex-17 in wastewaters from the south coast of England.

The occurrence and diversity of vancomycin-resistant enterococci (VRE) in wastewaters from the Brighton and Hove area of south-east England were investigated. VRE were recovered from 71% of raw urban wastewater samples, 22% of treated urban wastewater samples, 15% of hospital wastewater sample and 33% of farm wastewater samples. Two hundred and eighty-eight isolates were typed and identified and the minimum inhibitory concentrations (MICs) to six antibiotics were determined for selected VRE.

Bacteriophages: an appraisal of their role in the treatment of bacterial infections.

Bacteriophages were first used successfully to treat bacterial infections a decade before penicillin was discovered. However, the excitement that greeted those initial successes was short-lived, as a lack of understanding of basic phage biology subsequently led to a catalogue of clinical failures. As a consequence, bacteriophage therapy was largely abandoned in the West in favour of the newly emerging antibiotics.

Virulence traits associated with verocytotoxigenic Escherichia coli O157 recovered from freshwater biofilms.

Aim: To investigate whether epilithic biofilms in freshwater streams in a mixed UK agricultural river catchment harbour Escherichia coli O157, and if so, whether they demonstrate an association with those excreted by grazing farm animals.

Methods And Results: Flint shingle, native to the study site, was used as a surface for biofilm development within cages of metal lath set into a stream bed at four locations on a chalkland farm. Shingle was collected from all sites once a month, as were pooled faecal samples from five farm animal populations.

A simulated oral hygiene model to determine the efficacy of repeated exposure of amine oxide on the viability of Streptococcus mutans biofilms.

The use of biocide in oral care products is important for controlling microbial pathogens. However, the use of biofilm tests that investigate repeated exposure to biocide, to mimic in situ treatment, has rarely been reported in the literature. The present study describes the application of a biofilm-based efficacy protocol, for testing the effect of repeated exposure to antimicrobials on biofilm, in an attempt to mimic oral care regimens.

Alcohol ethoxylates mediate their bacteriostatic effect by altering the cell membrane of Escherichia coli NCTC 8196.

The minimum inhibitory concentration (MIC) of a homologous series of alcohol ethoxylates with the same head group size (E6) but differing in the number of carbon atoms in their 'tail group' from 10 to 16 was determined for Staphylococcus aureus NCTC 4163 and Escherichia coli NCTC 8196 using a turbidimetric assay. All the surfactants tested demonstrated bacteriostatic activity against both organisms. A tetrazolium assay showed that C14E6 and C16E6 had little effect on the membrane-bound dehydrogenase enzyme activity of E.

Action of disinfectant quaternary ammonium compounds against Staphylococcus aureus.

Mode-of-action studies concluded that alkyldimethylbenzylammonium chloride (ADBAC) (a blend of C(12), C(14) and C(16) alkyl homologues) and didecyldimethylammonium chloride (DDAC) are both membrane-active agents, possessing subtly different modes of action reflecting early cell interactions against Staphylococcus aureus. ADBAC and DDAC exhibited similar MIC behaviors from 0.4 ppm to 1.

Bacterial adhesion to phosphorylcholine-based polymers with varying cationic charge and the effect of heparin pre-adsorption.

The steady increase in the use of medical implants and the associated rise of medical device infections has fuelled the need for the production of biomaterials with improved biocompatibility. 2-(methacryloyloxyethyl phosphorylcholine) (MPC) based coatings have been used to improve the biocompatibility of a number of different medical devices. Recent studies have investigated the use of a phosphorylcholine modified with cationic charge to encourage specific bio-interaction.

Use of a new alginate film test to study the bactericidal efficacy of the high-level disinfectant ortho-phthalaldehyde.

Objectives: To evaluate the merit of a new alginate efficacy film test to determine the bactericidal activity of the high-level disinfectant ortho-phthalaldehyde (OPA).

Methods: The efficacy of OPA was investigated using a new sodium alginate surface film test against Mycobacterium chelonae NCIMB 1474 and Epping, and Pseudomonas aeruginosa NCIMB 10421 under different test conditions.

Results: OPA was highly bactericidal against P.