Staphylococcus aureus is an opportunistic pathogen capable of causing a variety of diseases including osteomyelitis, endocarditis, infections of indwelling devices and wound infections. These infections are often chronic and highly recalcitrant to antibiotic treatment. Persister cells appear to be central to this recalcitrance. A multitude of factors contribute to S. aureus virulence and high levels of treatment failure. These include its ability to colonize the skin and nares of the host, its ability to evade the host immune (...) system and its development of resistance to a variety of antibiotics. Less understood is the phenomenon of persister cells and their role in S. aureus infections and treatment outcome. Persister cells occur as a sub‐population of phenotypic variants that are tolerant to antibiotic treatment. This review examines the importance of persisters in chronic and relapsing S. aureus infections and proposes methods for their eradication. (shrink)

A repository of clinically associated Staphylococcus aureus (Sa) isolates is used to semi‐automatically generate a set of application ontologies for specific subfamilies of Sa‐related disease. Each such application ontology is compatible with the Infectious Disease Ontology (IDO) and uses resources from the Open Biomedical Ontology (OBO) Foundry. The set of application ontologies forms a lattice structure beneath the IDO‐Core and IDO‐extension reference ontologies. We show how this lattice can be used to define a strategy for the construction of (...) a new taxonomy of infectious disease incorporating genetic, molecular, and clinical data. We also outline how faceted browsing and query of annotated data is supported using a lattice application ontology. (shrink)

Active surveillance cultures and contact precautions is a strategy to control the transmission of methicillin-resistant Staphylococcus aureus (MRSA) within healthcare facilities. Whether to implement this strategy to routinely screen and isolate inpatients with MRSA in non-outbreak (endemic) settings, or to remove it and use standard infection control precautions only is scientifically and ethically controversial, in view of the potential adverse effects of contact precautions on patients. To support the use of standard precautions only, it has been argued that (...) active surveillance to identify patients who are asymptomatically colonised with MRSA to place them in contact precautions is unjust or unfair to these patients in various ways. This paper will unpack and examine four distinct arguments, which are advanced from a medical ethics or quality improvement ethical framework, for why this is so. Our analysis shows that while these arguments highlight the injustice of current practices, they do not provide strong ethical reasons for justifying the removal of active surveillance and contact precautions to control MRSA transmission and infection. An implication of our arguments is that the ethical frame for evaluating prevention and control strategies for MRSA, a multi-drug resistant bacteria, should shift from healthcare to primarily public health. From a public health ethics perspective, whether a strategy is unjust, or how ethically significant its lack of fairness is, depends on assessing the evidence for its public health effectiveness and necessity in a given setting, and the extent of the harms and burdens patients with MRSA bear when they are on contact precautions, which remain matters of scientific debate or uncertainty. As an ethical consideration in the debate, the chief normative implication of justice is to provide us further reasons to revise current active surveillance-contact precautions practices, and for the need for research and interventions to minimise their potential adverse effects on patients. (shrink)

Staphylococcus aureus ST45 is a major global MRSA lineage with huge strain diversity and a high clinical impact. It is one of the most prevalent carrier lineages but also frequently causes severe invasive disease, such as bacteremia. Little is known about its evolutionary history. In this study, we used whole-genome sequencing to analyze a large collection of 451 diverse ST45 isolates from 6 continents and 26 countries. De novo-assembled genomes were used to understand genomic plasticity and to perform (...) coalescent analyses. The ST45 population contained two distinct sublineages, which correlated with the isolates’ geographical origins. One sublineage primarily consisted of European/North American isolates, while the second sublineage primarily consisted of African and Australian isolates. Bayesian analysis predicted ST45 originated in northwestern Europe about 500 years ago. Isolation time, host, and clinical symptoms did not correlate with phylogenetic groups. Our phylogenetic analyses suggest multiple acquisitions of the SCCmec element and key virulence factors throughout the evolution of the ST45 lineage. (shrink)

Recent research has suggested that Staphylococcus epidermidis is a reservoir of genes that, after horizontal transfer, facilitate the potential of Staphylococcus aureus to colonize, survive during infection, or resist antibiotic treatment, traits that are notably manifest in methicillin‐resistant S. aureus (MRSA). S. aureus is a dangerous human pathogen and notorious for acquiring antibiotic resistance. MRSA in particular is one of the most frequent causes of morbidity and death in hospitalized patients. S. aureus is an (...) extremely versatile pathogen with a multitude of mechanisms to cause disease and circumvent immune defenses. In contrast, most other staphylococci, such as S. epidermidis, are commonly benign commensals and only occasionally cause disease. Recent findings highlight the key importance of efforts to better understand how genes of staphylococci other than S. aureus contribute to survival in the human host, how they are transferred to S. aureus, and why this exchange appears to be uni‐directional. (shrink)

Effectiveness is a key criterion in assessing the justification of antibiotic resistance interventions. Depending on an intervention’s effectiveness, burdens and costs will be more or less justified, which is especially important for large scale population-level interventions with high running costs and pronounced risks to individuals in terms of wellbeing, integrity and autonomy. In this paper, we assess the case of routine hospital screening for multi-drug-resistant Gram-negative bacteria (MDRGN) from this perspective. Utilizing a comparison to screening programs for Methicillin-Resistant Staphylococcus (...) aureus (MRSA) we argue that current screening programmes for MDRGN in low endemic settings should be reconsidered, as its effectiveness is in doubt, while general downsides to screening programs remain. To accomplish justifiable antibiotic stewardship, MDRGN screening should not be viewed as a separate measure, but rather as part of a comprehensive approach. The program should be redesigned to focus on those at risk of developing symptomatic infections with MDRGN rather than merely detecting those colonised. (shrink)

This paper addresses a family of issues surrounding the biological phenomenon of resistance and its representation in realist ontologies. The treatments of resistance terms in various existing ontologies are examined and found to be either overly narrow, internally inconsistent, or otherwise problematic. We propose a more coherent characterization of resistance in terms of what we shall call blocking dispositions, which are collections of mutually coordinated dispositions which are of such a sort that they cannot undergo simultaneous realization within a single (...) bearer. A definition of ‘protective resistance’ is proposed for use in the Infectious Disease Ontology (IDO) and we show how this definition can be used to characterize the antibiotic resistance in Methicillin-Resistant Staphylococcus aureus (MRSA). The ontological relations between entities in our MRSA case study are used alongside a series of logical inference rules to illustrate logical reasoning about resistance. A description logic representation of blocking dispositions is also provided. We demonstrate that our characterization of resistance is sufficiently general to cover two other cases of resistance in the infectious disease domain involving HIV and malaria. (shrink)

Healthcare-associated infections due to multidrug-resistant organisms continue to increase in incidence. To control the transmission of these pathogens, such as methicillin-resistant Staphylococcus aureus , some have advocated active surveillance cultures of all hospitalized patients, followed by institution of contact precautions. While there has been extensive debate about the effectiveness of this approach in reducing infections, little attention has been given to the ethical issues raised by the intervention. Active surveillance for multidrug-resistant organisms is a quality improvement measure and (...) ethical implications arise through the potential to inadvertently cause harm. Unintended adverse effects may include decreased contact with healthcare workers, increased depression and anxiety, and increased rates of noninfectious adverse events among patients placed in contact precautions. The potential risks and benefits are not distributed fairly; patients placed in contact precautions are exposed to the risks, while those not isolated experience the benefit. Ethical challenges involve a conflict between the interests of the individual patient and the patient population not already colonized with the organism. For healthcare systems, active surveillance increases the complexity of bed management, exacerbating problems with patient placement, patient throughput, emergency department overcrowding and ambulance diversion for some hospitals. It also poses ethical dilemmas regarding societal resource allocation. Investing in an unproven or marginally beneficial quality improvement activity such as this must be balanced against other public health priorities competing for scarce resources. CiteULike Connotea Del.icio.us What's this? (shrink)

En este trabajo se presentan criterios que permiten estimar parámetros de desinfección mediante el uso de luz ultravioleta UV-C de onda corta, en agua, aire y superficies. Se indican métodos para evaluar la dosificación en función de la potencia de la lámpara empleada. Este tipo de estrategia permiten resultados de hasta 99.9% de desinfección, inactivando diferentes tipos de microorganismos. Estas referencias sirven de base para el diseño de dispositivos de utilidad en la presente emergencia por COVID-19, cuyo origen, al ser (...) viral, es susceptible al mismo método de desinfección debido al proceso de dimerización del ADN, donde el daño producido en la estructura celular, afecta la capacidad de reproducción y de funcionalidad. Palabras Clave: luz UV-C o germicida, desinfección UV, dimerización del ADN. Referencias [1]R. Wallace, M. Ouellette and J. Jean, "Effect of UV‐C light or hydrogen peroxide wipes on the inactivation of methicillin resistant Staphylococcus aureus, Clostridium difficile spores and norovirus surrogate", Journal of Applied Microbiology, vol. 127, no. 2, pp. 586-597, 2019. [2]J. Vargas, "Efecto de la radiación gamma sobre las características físico - químicas, sensoriales y microbiológicas en páprika en polvo ", Revista ECIPeru, pp. 68-71, 2019. [3]M. Ángeles García y P. Fernández, "Luz ultravioleta e inmunidad", Piel, vol. 21, no. 8, pp. 367-368, 2016. [4]W. Pachuau y R. Tiwari, " Deep Ultraviolet Light Emitting Diodes: Physics, Performance, and Applications", ECS Meetings, 2014. [5]W. Kowalski, Ultraviolet Germicidal Irradiation Handbook, 5th ed. Berlin: Springer Berlin, 2014, pp. 1-13. [6]W. Kowalski, Ultraviolet Germicidal Irradiation Handbook, 5th ed. Berlin: Springer Berlin, 2014, pp. 17-47. [7]"Germicidal Ultraviolet ", Media.ies.org, 2020. [En línea]. Disponible en: https://media.ies.org/docs/standards/IES%20CR-2-20-V1a-20200507.pdf. [Último acceso: 16 de junio de 2020]. [8]J. Bolton y C. Cotton, The ultraviolet disinfection handbook, 3rd ed. Denver, Colo.: American Water Works Association, 2008, pp. 13-33. [9]W. Kowalski, Ultraviolet Germicidal Irradiation Handbook, 5th ed. Berlin: Springer Berlin, 2014, pp. 8-9. [10]P. Aguirre, J. García y R. Mujeriego Sahuquillo, "Desinfección con cloro y luz UV en un proceso convencional de regeneración de agua", Ingeniería del agua, vol. 11, no. 1, p. 75, 2004. (shrink)

In the Netherlands the incidence of methicillin resistant Staphylococcus aureus infections in hospitals is surprisingly low when compared to that of neighbouring countries. It is believed that this favourable condition is caused by stringent precautionary measures such as complete isolation of the patients. In one case the nurse taking care of such patients was herself MRSA positive. This condition changed and she became MRSA negative after removal of her tonsils. The question is raised how far one should go (...) to protect patients when the preventive measures taken may endanger the health of those who take care of them. (shrink)

This article offers a series of critical theorizations on the biopolitical dimensions of methicillin-resistant Staphylococcus aureus (MRSA), with specific attention to what has recently been referred to in the United States as the ‘MRSA Epidemic’. In particular, we reflect on the proliferation of biomedical discourses around the ‘spread’, and the pathogenic potentialities, of community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA). We turn to the work of Roberto Esposito and Jean-Luc Nancy to better make sense of how, during this (...) immunological crisis, the individualized fleshy and fluid body is articulated to dimensions of community and corporeal proximity; the body is thus conceived in popular biopolitical framings as a site of transmission, inoculation, and isolation – as a living ecological and pathological vessel. We give emphasis to the spatial relations of flesh, namely in how biomedical ‘experts’ have sought to (bio-)technologize spaces of heightened communal bodily contact (such as playgrounds or gymnasia). (shrink)

Das Bild des »goldenen Berges« geht zurück auf geographische Angaben und Beschreibungen, die in der Antike als glaubwürdig angesehen wurden. In der Literatur illustriert die Metapher das Bedeutungsspektrum von Reichtum, Wohlergehen, Überfluss und Glück, spricht aber auch Warnungen aus. Dagegen werden in den philoso-phischen Interpretationen vor allem Konstitutionsprobleme des Fiktiven, auch der entia rationis, thematisiert. Die Metapher exemplifiziert Objekte, die logisch möglich sind, aber nicht wirk-lich existieren. In der Philosophiege-schichte – bis in die aktuellen Analysen der non-existent objects hinein – (...) wurde das Bild des »goldenen Berges« daher stets mit der Frage verbunden, welche Instanzen wir als »wirklich«, »möglich« oder »unmöglich« rechtfertigen kön-nen. Als Beispiel spiegelt die Metapher die Transformationen, in denen sich das Wirklichkeitsverständnis der philoso-phischen Tradition wie in einem Prisma gebrochen hat. (shrink)

This paper analyses the ways in which human knowledge of the golden jackal (Canis aureus) is formed in the case of a rural community of the Romanian Danube Delta. We focus on the territory where humans and jackals overlap and, by using wildlife monitoring alongside interviews and participant observation with humans, we detail how villagers come to have a particularly negative view of this resident canid. Foregrounding the jackal's highly symbolic nature, we trace the development of the community's knowledge (...) of this animal via historical, ecological and geographical factors. Finally, we recommend ways in which our findings could be used in future management plans and draw out the implications for future rewilding practices. (shrink)

The article reviews the book Śmierć, nieśmiertelność, sens życia. Egzystencjalny wymiar filozofii Ludwiga Wittgensteina [Death, Immortality, the Meaning of Life: The Existential Dimension of Ludwig Wittgenstein's Philosophy], by Ireneusz Ziemiński.

De re aedificatoria by Leon Battista Alberti, Trattato di Architettura by Filarete, Trattati di architettura, ingegneria e arte militare by Francesco di Giorgio Martini, and Leonardo da Vinci’s works of engineering and inventions exemplify the ways in which fifteenth-century Italian thinkers could blend speculative and rational approaches. Libellus vere aureus was published in Leuven in 1516. Mambrino Roseo praised the simple, earnest people of Garamanti in Institutione del prencipe christiano, dating to 1543. The first version of More’s Latin text (...) in vernacular Italian was published in Venice in 1548, and the first translation into English by Ralph Robinson was printed in London in... (shrink)

The article attempts to bridge semiotics with species conservation and management. Biosemiotic and cultural semiotic methodology is applied in the analysis of a case study – the early occurrence of the golden jackal in Estonia. Nine semi-structured interviews were carried out with the local inhabitants of the Matsalu region, professional zoologists and environmental officials who were involved in the golden jackals’ discourse. The interviews were analyzed for interactions between golden jackals and humans, expected ecological effects of golden jackals, communication between (...) different interest groups and central cultural motifs used to interpret the new species. It is argued that in the development of this discourse, the golden jackals’ own activity has played an essential role. At the same time, human cultural models also influence the interpretation of a new species to a considerable degree. Two of such models – the opposition of the own and the alien and the “settler’s” narrative – are brought out and analyzed. The effect of the fear of the unknown is also specified. To improve human communication about new or invasive species, it is suggested to raise awareness of the underlying cultural models and to use integrative communication as the developing discourse is dynamical and constantly changing for all interest groups. For a semiotic study of species management, it is suggested to combine methodology from biosemiotics, cultural semiotics and actor-network theory. (shrink)

Utopian thought feeds on a speculative magnitude that has attracted sustained critiques and generated radical revisions. In the contemporary age, the advocates of utopia have been prompted to corroborate the effective agency of a predominantly abstract frame of mind. A response, which also serves as a rebuttal, entails illuminating how utopian projects have intervened in history and shaped societies by probing the most unyielding, unchangeable features of humankind. Understanding how utopias unfold proposals for the present involves recognizing that utopian writers (...) share a penchant for extrapolation: While perusing the present, they anticipate the future; in focusing their investigation on very specific historical... (shrink)

The concept of superorganism has a mixed reputation in biology—for some it is a convenient way of discussing supra-organismal levels of organization, and for others, little more than a poetic metaphor. Here, I show that a considerable step forward in the understanding of superorganisms results from a thorough review of the supra-organismal levels of organization now known to exist among the “unicellular” protists. Limiting the discussion to protists has enormous advantages: their bodies are very well studied and relatively simple, and (...) they exhibit an enormous diversity of anatomies and lifestyles. This allows for unprecedented resolution in describing forms of supra-organismal organization. Here, four criteria are used to differentiate loose, incidental associations of hosts with their microbiota from “actual” superorganisms: obligatory character, specific spatial localization of microbiota, presence of attachment structures and signs of co-evolution in phylogenetic analyses. Three groups—that have never before been described in the philosophical literature—merit special attention: Symbiontida, Oxymonadida and Parabasalia. Specifically, it is argued that in certain cases—for Bihospites bacati and Calkinsia aureus, Streblomastix strix, Joenia annectens and Mixotricha paradoxa and Kentrophoros —it is fully appropriate to describe the whole protist-microbiota assocation as a single organism and its elements as “tissues” or, arguably, even “organs”. To account for this level of biological complexity, I propose the term “structured superorganism”. (shrink)

Previous studies found similarities in adults’ disgust responses to benign (e.g. obesity) and actual disease signs (e.g. influenza). However, limited research has compared visual (i.e. benign and actual) to cognitive (i.e. disease label) disease cues in different age groups. The current study investigated disgust responses across middle childhood (7–9 years), late childhood (10–12 years), adolescence (13–17 years), and adulthood (18+ years). Participants viewed individuals representing a benign visual disease (obese), sick-looking (staphylococcus), sick-label (cold/flu), and healthy condition. Disgust-related outcomes were: (...) (1) avoidance, or contact level with apparel the individual was said to have worn, (2) disgust facial reactions, and (3) a combination of (1) and (2). Avoidance was greater for the sick-looking and sick-label than the healthy and obese conditions. For facial reaction and combination outcomes, middle childhood participants responded with greater disgust to the sick-looking than the healthy condition, while late childhood participants expressed stronger disgust towards the sick-looking and obese conditions than the healthy condition. Adolescents and adults exhibited stronger disgust towards sick-label and sick-looking than obese and healthy conditions. Results suggest visual cues are central to children’s disgust responses whereas adolescents and adult responses considered cognitive cues. (shrink)

In 1516, Thomas More, adviser to King Henry VIII, Catholic, martyr, and saint, published his most controversial book, De optimo reipublicae statu deque noval insula Libellus vere aureus, nec minus salutaris quam festivus. During 2016, special issues of Utopian Studies, edited by Fátima Vieira, have been tracing the translation history of this book that still grips our attention five hundred years later. As in the translation histories in all countries, Utopia’s translation in Germany reflects contemporaneous social and political debates (...) and anxieties. Thus, the... (shrink)

At their first meeting Polynices and Tydeus come to blows. They are reconciled by Adrastus, who expresses the hope that their quarrel will lead to loyal friendship between them, as it did. Esse pro fuisse dixit, says Lactantius, more ingenuously than Klotz, who tries to make the same thing more palatable by saying esse est pro imperfecti quodammodo infinitiuo. Some have taken the accusative and infinitive to be a general statement, but Heuvel is clearly right in saying that it is (...) Tydeus and Polynices whom the poet has in mind. The most favoured solution has been Grater's conjecture isse, but that produces an unnatural expression ; Mozley renders it by ‘grew’, thereby translating not what stands in his text but what ought perhaps to stand there, namely esse, a conjecture of Gil, which has been almost entirely overlooked. This contracted form is found in extant literature only at Lucretius 3.683 and Ovid, Met. 7.416 . The first letters of a line are particularly liable to omission; despite Hill, I do not find it at all surprising that at 1.544 perseus lost its first letter and the remnant became aureus. (shrink)

In the third century AD, under the pressure of plagues, external invasion, rising army costs, and usurpation, the Roman emperors incrementally debased the silver coinage that was produced at their imperial mints and incrementally took over civic mints. The debasement, from 2.7 g of silver to 0.04 g of silver in the equivalent of a denarius from 160–274 ad, was accompanied by worries from emperors, mint-workers, and bankers about the value of the currency; however, the total loss of purchasing power (...) of the Roman coinage from the same era was 50–70 %, far less than would be expected from the change in metallic content, if it were the primary source of value. The currency reform of Aurelian in 274 ad, despite raising metallic values of coins, was followed by at least a 90 % reduction in the purchasing power of the silver coinage from 274–301 ad, the year of Diocletian’s Edict on Maximum Prices, showing a paradoxically inverse relationship between metallic value and purchasing power. Based on this quandary, I argue that the Roman silver coinage of the third century CE became a fiat currency in some respects, deriving its guarantee from imperial iconography and assurances rather than from bullion value. The fiat nature of the silver coinage was largely present in usage as a medium of exchange for those without as much long-term interest in maintaining liquid stores of value; this is indicated by the differential debasement of the denarius and aureus; imperial actions and hoarding practices indicate the extent to which the currency was accepted at nominal value. I examine the reactions of different social groups in order to determine the perceived value of the Roman coinage during this time, and in order to understand the paradoxical collapse in the currency’s value in the late third century. To demonstrate this, I will present the applicable elements of the modern concept of “fiat” to this context through portrayal of emperors and usurpers on coins, use coin hoard data to determine the effect of Gresham’s Law, and examine historical and papyrological accounts of currency reforms. I will also use evidence of the expansion of taxes in kind and the rejection of nominal value by both emperor and subjects to argue that the inflation following Aurelian’s reform resulted from an invalidation of the trust in imperial fiat. (shrink)

At their first meeting Polynices and Tydeus come to blows. They are reconciled by Adrastus, who expresses the hope that their quarrel will lead to loyal friendship between them, as it did. Esse pro fuisse dixit, says Lactantius, more ingenuously than Klotz, who tries to make the same thing more palatable by saying esse est pro imperfecti quodammodo infinitiuo. Some have taken the accusative and infinitive to be a general statement, but Heuvel is clearly right in saying that it is (...) Tydeus and Polynices whom the poet has in mind. The most favoured solution has been Grater's conjecture isse, but that produces an unnatural expression ; Mozley renders it by ‘grew’, thereby translating not what stands in his text but what ought perhaps to stand there, namely esse, a conjecture of Gil, which has been almost entirely overlooked. This contracted form is found in extant literature only at Lucretius 3.683 and Ovid, Met. 7.416. The first letters of a line are particularly liable to omission; despite Hill, I do not find it at all surprising that at 1.544 perseus lost its first letter and the remnant became aureus. (shrink)

It is more than half a century since P. Boudreaux equipped the Cynegetka of the Syrian author now sometimes called Pseudo-Oppian with a proper text and apparatus criticus. The Halieutica of Oppian is still without either. Onemight think the latter poem hardly worth the aureus for every line with which Marcus Aurelius is reported in the Life of the author to have rewarded it, or hesitate to say, with St Jerome, that O. Alieutica miro splendore conscripsit, but it is (...) better constructed and far better written than the Cynegetica; it was more admired by later poets, and some might account it the more interesting poem. It would appear from R. Keydell's survey of Oppianic literature down to 1929 that R. Vári published between 1908 and 1926 in Hungarian journals and an Italian Festschrift some papers on the manuscripts of Hal. (shrink)

The first of these is not a single disease but a group of three: ‘all the clinical and epidemiological evidence described by Thucydides’ ‘can be attributed to infection with influenza virus complicated by a toxin-producing strain of noninvasive staphylococcus’ . This initial analysis is in fact supplemented by bullous impetigo in an attempt to explain the marked skin symptoms which are not ascribable to the other two diseases: streptococci produce flushes of the skin that end in desquamation – something (...) which Langmuir et al. admit T would have described if present. (shrink)