Lower-extremity muscle activity during aquatic and land treadmill running at the same speeds.

Context: Muscle activation during aquatic treadmill (ATM) running has not been examined, despite similar investigations for other modes of aquatic locomotion and increased interest in ATM running.

Objectives: The objectives of this study were to compare normalized (percentage of maximal voluntary contraction; %MVC), absolute duration (aDUR), and total (tACT) lower-extremity muscle activity during land treadmill (TM) and ATM running at the same speeds.

Design: Exploratory, quasi-experimental, crossover design.

Deep-water running: a practical review of the literature with an emphasis on biomechanics.

Deep-water running (DWR) is used as an adjunct to training and conditioning, and as an injury-rehabilitation technique. It is important for the physician or sports medicine practitioner to focus on the underlying physics and biomechanics of running in water in order to better produce the desired physiological, metabolic, and psychological outcomes. Deep-water running maximal heart rate and oxygen consumption values have been consistently shown to be lower than those found during treadmill running.

A comparison of the physiological exercise intensity differences between shod and barefoot submaximal deep-water running at the same cadence.

The purpose of this investigation was to identify whether physiological exercise intensity differed with the use of aquatic training shoes (ATS) during deep-water running (DWR) compared to using a barefoot condition. Eight male intercollegiate (National Collegiate Athletic Association Division III [NCAA III]) varsity distance runners were videotaped from the right sagittal view while running on a treadmill (TR) and while barefoot in deep water at 60-70% of their TR VO2max for 30 minutes. Based on the stride rate of the barefoot DWR trial, a subsequent 30-minute session was completed while wearing ATS.

Clostridium difficile strains from community-associated infections.

Clostridium difficile isolates from presumed community-associated infections (n = 92) were characterized by toxinotyping, pulsed-field gel electrophoresis, tcdC and cdtB PCR, and antimicrobial susceptibility. Nine toxinotypes (TOX) and 31 PFGE patterns were identified. TOX 0 (48, 52%), TOX III (18, 20%), and TOX V (9, 10%) were the most common; three isolates were nontoxigenic.

Clostridium difficile in retail meat products, USA, 2007.

To determine the presence of Clostridium difficile, we sampled cooked and uncooked meat products sold in Tucson, Arizona. Forty-two percent contained toxigenic C. difficile strains (either ribotype 078/toxinotype V [73%] or 027/toxinotype III [NAP1 or NAP1-related; 27%]).

Impact of hydrogen peroxide vapor room decontamination on Clostridium difficile environmental contamination and transmission in a healthcare setting.

Objective: To determine whether hydrogen peroxide vapor (HPV) decontamination can reduce environmental contamination with and nosocomial transmission of Clostridium difficile.

Design: A prospective before-after intervention study.

Setting: A hospital affected by an epidemic strain of C.

Toxinotype V Clostridium difficile in humans and food animals.

Clostridium difficile is a recognized pathogen in neonatal pigs and may contribute to enteritis in calves. Toxinotype V strains have been rare causes of human C. difficile-associated disease (CDAD).

Changes in the prevalence of nasal colonization with Staphylococcus aureus in the United States, 2001-2004.

Background: Staphylococcus aureus is a common cause of infection, particularly in persons colonized by this organism. Virulent strains of methicillin-resistant S. aureus (MRSA) have emerged in the general community.

Clostridium difficile-associated diarrhea: an emerging threat to pregnant women.

Objective: To estimate if Clostridium difficile-associated disease (CDAD) is increasing in peripartum women.

Study Design: Peripartum CDAD was assessed through 1) passive surveillance collecting clinical and pathology data on severe cases and 2) survey among infectious disease consultants (ICDs) in the Emerging Infections Network.

Results: Ten severe cases were collected; most had associated antibiotic use.

Comparison of seven techniques for typing international epidemic strains of Clostridium difficile: restriction endonuclease analysis, pulsed-field gel electrophoresis, PCR-ribotyping, multilocus sequence typing, multilocus variable-number tandem-repeat analysis, amplified fragment length polymorphism, and surface layer protein A gene sequence typing.

Using 42 isolates contributed by laboratories in Canada, The Netherlands, the United Kingdom, and the United States, we compared the results of analyses done with seven Clostridium difficile typing techniques: multilocus variable-number tandem-repeat analysis (MLVA), amplified fragment length polymorphism (AFLP), surface layer protein A gene sequence typing (slpAST), PCR-ribotyping, restriction endonuclease analysis (REA), multilocus sequence typing (MLST), and pulsed-field gel electrophoresis (PFGE). We assessed the discriminating ability and typeability of each technique as well as the agreement among techniques in grouping isolates by allele profile A (AP-A) through AP-F, which are defined by toxinotype, the presence of the binary toxin gene, and deletion in the tcdC gene. We found that all isolates were typeable by all techniques and that discrimination index scores for the techniques tested ranged from 0.

Toxic shock associated with Clostridium sordellii and Clostridium perfringens after medical and spontaneous abortion.

Objective: To better understand the risk of fatal toxic shock caused by Clostridium sordellii in women who had a recent medical abortion with mifepristone and misoprostol.

Methods: We performed active and passive surveillance for cases of toxic shock associated with medical or spontaneous abortion. To identify the cause of toxic shock, immunohistochemical assays for multiple bacteria were performed on formalin-fixed surgical and autopsy tissues.

Prevalence of Clostridium difficile environmental contamination and strain variability in multiple health care facilities.

Background: Clostridium difficile spores can contaminate the hospital environment. Little is known about the prevalence and strain variability of C. difficile environmental contamination in health care facilities.

Moxifloxacin therapy as a risk factor for Clostridium difficile-associated disease during an outbreak: attempts to control a new epidemic strain.

An outbreak of Clostridium difficile-associated disease (CDAD) caused by the epidemic North American pulsed-field gel electrophoresis type 1 (NAP1) strain began after a formulary change from levofloxacin to moxifloxacin. Cases of CDAD were associated with moxifloxacin use, but a formulary change back to levofloxacin failed to reduce rates of disease. Substituting use of one fluoroquinolone with use of another without also controlling the overall use of drugs from this class is unlikely to control outbreaks caused by the NAP1 strain of C.

A hospital outbreak of diarrhea due to an emerging epidemic strain of Clostridium difficile.

Background: Increased Clostridium difficile-associated disease (CDAD) in a hospital and an affiliated long-term care facility continued despite infection control measures. We investigated this outbreak to determine risk factors and transmission settings.

Methods: The CDAD cases were compared according to where the disease was likely acquired based on health care exposure and characterization of isolates from case patients, asymptomatic carriers, and the environment.

A lower-extremities kinematic comparison of deep-water running styles and treadmill running.

The purpose of this investigation was to identify a deep-water running (DWR) style that most closely approximates terrestrial running, particularly relative to the lower extremities. Twenty intercollegiate distance runners (women, N = 12; men, N = 8) were videotaped from the right sagittal view while running on a treadmill (TR) and in deep water at 55-60% of their TR VO(2)max using 2 DWR styles: cross-country (CC) and high-knee (HK). Variables of interest were horizontal (X) and vertical (Y) displacement of the knee and ankle, stride rate (SR), VO(2), heart rate (HR), and rating of perceived exertion (RPE).

Severe community-acquired pneumonia due to Staphylococcus aureus, 2003-04 influenza season.

During the 2003-04 influenza season, 17 cases of Staphylococcus aureus community-acquired pneumonia (CAP) were reported from 9 states; 15 (88%) were associated with methicillin-resistant S. aureus (MRSA). The median age of patients was 21 years; 5 (29%) had underlying diseases, and 4 (24%) had risk factors for MRSA.

Characterization of a strain of community-associated methicillin-resistant Staphylococcus aureus widely disseminated in the United States.

A highly stable strain of Staphylococcus aureus with a pulsed-field gel electrophoresis type of USA300 and multilocus sequence type 8 has been isolated from patients residing in diverse geographic regions of the United States. This strain, designated USA300-0114, is a major cause of skin and soft tissue infections among persons in community settings, including day care centers and correctional facilities, and among sports teams, Native Americans, men who have sex with men, and military recruits. The organism is typically resistant to penicillin, oxacillin, and erythromycin (the latter mediated by msrA) and carries SCCmec type IVa.

Prevalence of Staphylococcus aureus nasal colonization in the United States, 2001-2002.

Background: Staphylococcus aureus is a common cause of disease, particularly in colonized persons. Although methicillin-resistant S. aureus (MRSA) infection has become increasingly reported, population-based S.

An epidemic, toxin gene-variant strain of Clostridium difficile.

Background: Recent reports suggest that the rate and severity of Clostridium difficile-associated disease in the United States are increasing and that the increase may be associated with the emergence of a new strain of C. difficile with increased virulence, resistance, or both.

Methods: A total of 187 C.

Toxin production by an emerging strain of Clostridium difficile associated with outbreaks of severe disease in North America and Europe.

Background: Toxins A and B are the primary virulence factors of Clostridium difficile. Since 2002, an epidemic of C difficile-associated disease with increased morbidity and mortality has been present in Quebec province, Canada. We characterised the dominant strain of this epidemic to determine whether it produces higher amounts of toxins A and B than those produced by non-epidemic strains.

Necrotizing enterocolitis associated with clostridium perfringens type A in previously healthy north american adults.

Background: Necrotizing enteritis associated with Clostridium perfringens type C ("pigbel") is a well-known syndrome in severely protein-deprived populations in the Pacific. It is exceedingly rare in the developed world. C perfringens type A is a common cause of acute gastroenteritis and, in a handful of infections, has been reported in association with a syndrome resembling necrotizing enteritis.

Emerging infections with community-associated methicillin-resistant Staphylococcus aureus in outpatients at an Army Community Hospital.

Background: Methicillin-resistant Staphylococcus aureus (MRSA) infection typically occurs in chronically ill patients requiring long-term antimicrobial therapy or hospitalization. However, community-associated MRSA (CA-MRSA) necrotizing soft tissue infections seem to be increasing in incidence. Our aim was to describe the incidence and microbiologic characteristics of CA-MRSA isolates collected at an army community hospital.

Antimicrobial susceptibility testing of Acinetobacter spp. by NCCLS broth microdilution and disk diffusion methods.

Although both broth microdilution (BMD) and disk diffusion (DD) are listed by NCCLS as acceptable methods for testing Acinetobacter spp. for antimicrobial susceptibility, few studies have compared the results generated by the two methods. We tested 196 isolates of Acinetobacter spp.