“
“SETTING: Four administrative territories (Archangel Oblast, Murmansk

Oblast, Republic of Karelia, Republic of Komi) in the northwestern federal region of Russia.

OBJECTIVE: To describe the genetic diversity and level of drug resistance in Mycobacterium tuberculosis isolates from new cases of pulmonary tuberculosis.

DESIGN: A total of 176 isolates of M. tuberculosis were tested for drug susceptibility and typed with insertion sequence (IS) 6110 restriction fragment length polymorphism (RFLP) and spoligotyping.

RESULTS: The Beijing family was found to be the most prevalent (47.1%), most frequently clustered and significantly associated with drug resistance to all first-line anti-tuberculosis drugs (Isoniazid, rifampicin, ethambutol, streptomycin and pyrazinamide) and ethionamide, when compared

to the T and NCT-501 Haarlern families of M. tuberculosis, which were also prevalent in the study population. Some RFLP clusters (4/10) included isolates that originated from patients residing in different territories, and cases infected with multiple strains of M. tuberculosis were apparently present in the collection.

CONCLUSION: The M. tuberculosis population in northwestern Russia appears to be genetically Tariquidar purchase diverse and geographically widespread. Although dominated by isolates assigned to the Beijing family, other families also contribute to the current epidemic, and multiple strain infections may represent a problem in many cases. Extended genetic studies AZD2171 should be encouraged.”
“Healthcare-associated

pneumonia (HCAP) is a new category that is essential in the present aging society. Knowing the different characteristics and outcomes between patients with HCAP and community-acquired pneumonia (CAP) would help physicians manage and treat HCAP patients. Although HCAP is thought to be heterogeneous in regions, there are no reports from a metropolitan area in Japan. We retrospectively reviewed the clinical findings of all consecutive pneumonia patients who required hospitalized care in our hospital between April 2006 and March 2010. There were 184 (35.0%) patients with HCAP and 342 (65.0%) patients with CAP. Previous hospitalization within 90 days of the infection was the most common criterion for HCAP (63.0%). HCAP patients were significantly older than CAP patients (82.5 vs. 70.0 years, P < 0.001). The percentage of patients with poor functional status was higher in HCAP than CAP (64.0% vs. 26.6%, P < 0.001). Hospital mortality was significantly higher in HCAP patients than in CAP patients (15.8% vs. 5.0%, P < 0.001). Low levels of serum albumin (odds ratio, 0.126; 95% CI, 0.025-0.640; P = 0.012) and high scores in the ADROP (age, dehydration, respiratory failure, orientation, and blood pressure) system (odds ratio, 2.846; 95% CI, 1.449-5.587; P = 0.002) were the risk factors for HCAP mortality.