| 30441. |
- Gyger, Joël, et al.
(författare)
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A potential space-making role in cell wall biogenesis for SltB1and DacB revealed by a beta-lactamase induction phenotype in Pseudomonas aeruginosa
- 2024
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Ingår i: mBio. - : American Society for Microbiology. - 2161-2129 .- 2150-7511. ; 15:7
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Tidskriftsartikel (refereegranskat)abstract
- Pseudomonas aeruginosa encodes the beta-lactamase AmpC, which promotes resistance to beta-lactam antibiotics. Expression of ampC is induced by anhydro-muropeptides (AMPs) released from the peptidoglycan (PG) cell wall upon beta-lactam treatment. AmpC can also be induced via genetic inactivation of PG biogenesis factors such as the endopeptidase DacB that cleaves PG crosslinks. Mutants in dacB occur in beta-lactam-resistant clinical isolates of P. aeruginosa, but it has remained unclear why DacB inactivation promotes ampC induction. Similarly, the inactivation of lytic transglycosylase (LT) enzymes such as SltB1 that cut PG glycans has also been associated with ampC induction and beta-lactam resistance. Given that LT enzymes are capable of producing AMP products that serve as ampC inducers, this latter observation has been especially difficult to explain. Here, we show that ampC induction in sltB1 or dacB mutants requires another LT enzyme called MltG. In Escherichia coli, MltG has been implicated in the degradation of nascent PG strands produced upon beta-lactam treatment. Accordingly, in P. aeruginosa sltB1 and dacB mutants, we detected the MltG-dependent production of pentapeptide-containing AMP products that are signatures of nascent PG degradation. Our results therefore support a model in which SltB1 and DacB use their PG-cleaving activity to open space in the PG matrix for the insertion of new material. Thus, their inactivation mimics low-level beta-lactam treatment by reducing the efficiency of new PG insertion into the wall, causing the degradation of some nascent PG material by MltG to produce the ampC-inducing signal.IMPORTANCE: Inducible beta-lactamases like the ampC system of Pseudomonas aeruginosa are a common determinant of beta-lactam resistance among gram-negative bacteria. The regulation of ampC is elegantly tuned to detect defects in cell wall synthesis caused by beta-lactam drugs. Studies of mutations causing ampC induction in the absence of drug therefore promise to reveal new insights into the process of cell wall biogenesis in addition to aiding our understanding of how resistance to beta-lactam antibiotics arises in the clinic. In this study, the ampC induction phenotype for mutants lacking a glycan-cleaving enzyme or an enzyme that cuts cell wall crosslinks was used to uncover a potential role for these enzymes in making space in the wall matrix for the insertion of new material during cell growth.
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| 30442. |
- Gylfe, Åsa, et al.
(författare)
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Isolation of Lyme disease Borrelia from puffins (Fratercula arctica) and seabird ticks (Ixodes uriae) on the Faeroe Islands
- 1999
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Ingår i: Journal of Clinical Microbiology. - 0095-1137 .- 1098-660X. ; 37:4, s. 890-896
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Tidskriftsartikel (refereegranskat)abstract
- This is the first report on the isolation of Lyme disease Borrelia from seabirds on the Faeroe Islands and the characteristics of its enzootic cycle. The major components of the Borrelia cycle include the puffin (Fratercula arctica) as the reservoir and Ixodes uriae as the vector. The importance of this cycle and its impact on the spread of human Lyme borreliosis have not yet been established. Borrelia spirochetes isolated from 2 of 102 sampled puffins were compared to the borreliae previously obtained from seabird ticks, I. uriae. The rrf-rrl intergenic spacer and the rrs and the ospC genes were sequenced and a series of phylogenetic trees were constructed. Sequence data and restriction fragment length polymorphism analysis grouped the strains together with Borrelia garinii. In a seroepidemiological survey performed with residents involved in puffin hunting on the Faeroe Islands, 3 of 81 serum samples were found to be positive by two commonly used clinical tests: a flagellin-based enzyme-linked immunosorbent assay (ELISA) and Western blotting. These three positive serum samples also had high optical density values in a whole-cell ELISA. The finding of seropositive Faeroe Islanders who are regularly exposed to I. uriae indicate that there may be a transfer of B. garinii by this tick species to humans.
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| 30443. |
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| 30444. |
- Gylfe, Åsa, et al.
(författare)
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Mosquitoborne Sindbis Virus Infection and Long-Term Illness
- 2018
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Ingår i: Emerging Infectious Diseases. - : Centers for Disease Control and Prevention (CDC). - 1080-6040 .- 1080-6059. ; 24:6, s. 1141-1142
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Tidskriftsartikel (refereegranskat)abstract
- An unexpected human outbreak of the mosquitoborne Sindbis virus occurred in a previously nonendemic area of Sweden. At follow-up, 6-8 months after infection, 39% of patients had chronic arthralgia that affected their daily activities. Vectorborne infections may disseminate rapidly into new areas and cause acute and chronic disease.
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| 30445. |
- Gyllencreutz, Lina, et al.
(författare)
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Chemical incident preparedness among emergency medical service personnel
- 2024
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Ingår i: International Journal of Paramedicine. - : National EMS Management Association. - 2831-6967. ; :5, s. 103-117
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Tidskriftsartikel (refereegranskat)abstract
- Background: Hazardous chemicals are essential for modern society but the use and transportation of them bears the risk of major incidents. Past incidents have revealed the importance of preparation and training of emergency medical service (EMS) personnel when responding to these incidents. However, studies have shown the level of preparedness to be insufficient. There is a lack of knowledge as to how EMS personnel perceive their preparedness and response when facing chemical incidents.Aim: The aim of this study was to qualitative investigate working procedures regarding chemical incidents among a cohort of EMS personnel.Method: Seventeen ambulance nurses from rural and urban areas were individually interviewed using four different realistic scenarios (vignettes). The transcribed text from the interviews was analyzed using qualitative content analysis.Result: The results were derived into two categories with underlying sub-categories: a struggle to organize the onsite work situation (insufficient managerial support, limited resources, trust in rescue services, difficult decision making, stressful responsibilities); and decontamination—a demanding and risky situation (risk management, work in protective gear, aggravating circumstances). Participants often lack real life experience in facing a chemical incident and training that improves preparedness and the ability to respond adequately.Conclusion: Chemical incidents pose many challenges for EMS personnel, but with proper training efforts many of these challenges could be solved. This study has shown the need for more accessible chemical incident training targeting EMS personnel: especially focusing on risk assessment; managerial support; resource management; equipment; and decontamination, including stress management and decision-making. Research in the area of chemical incidents is sparse and there remains much to understand concerning work procedures during chemical incidents.
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| 30446. |
- Gyllencreutz, Lina, et al.
(författare)
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Everyday outdoor mobility in old age : focus group interviews with active senior citizens
- 2015
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Ingår i: Healthy Aging Research. - : Longdom Group. - 2261-7434. ; 4
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Tidskriftsartikel (refereegranskat)abstract
- Background: Senior citizens are over-represented in injury statistics, and fall-related injuries are globally recognized as a major threat to their health and wellbeing. Outdoor falls are likely to occur among those who are active and healthy when walking or cycling. The objective of this study was to explore active senior citizens’ experiences and perceptions of how their safety could be increased and their risk reduced in outdoor environments.Methods: Six focus-group interviews with 31 healthy and active senior citizens were conducted in northern Sweden. Data were analyzed via a qualitative content analysis method.Results: Participants adjusted to age-related changes in order to stay safe during outdoor mobility. Outdoor activities were facilitated by having confidence of safety within the environment, and by using safety devices. Fear of, for example, falling and dangerous environments, such as uneven surfaces, as well as the shortcomings of safety devices, were constraining elements for outdoor activity.Conclusions: It is of great importance to raise awareness of healthy aging and to illuminate directions for environmental changes. Asking old people about their experiences allows the researcher to identify with their perspective, and may give a more comprehensive understanding of the most appropriate recommendations for health and safety improvements.
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| 30447. |
- Gyllencreutz, Lina, et al.
(författare)
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Injury risks during outdoor play among Swedish schoolchildren : teachers' perceptions and injury preventive practices
- 2020
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Ingår i: Education 3-13. - : Routledge. - 0300-4279 .- 1475-7575. ; 48:1, s. 1-11
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Tidskriftsartikel (refereegranskat)abstract
- Approximately 36,000 Swedish children seek medical care annually because of injuries during school time. The purpose of this field study is to investigate risky outdoor play at the school yard and to describe teachers’ perceptions of risk and safety in relation to learning and development. The study includes observations of children (6–12 years old) during outdoor activities as part of the school’s activities and includes focus-group interviews with teachers and children. Children were seen climbing high in play facilities, speeding down slides, or competing with sticks in the woods. Different views of risk and safety among the participants influence outdoor play activities. Teachers’ knowledge of risk seems to be derived from common sense and personal experiences rather than from a professional perspective. A joint approach of educational and medicine disciplines is desirable when it comes to children’s health and development.
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| 30448. |
- Gyllencreutz, Lina, et al.
(författare)
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Medical incident commander leadership during a full-scale exercise in an underground mining environment : a qualitative single-case study
- 2021
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Ingår i: International Journal of Emergency Management. - : InderScience Publishers. - 1471-4825 .- 1741-5071. ; 17:1, s. 90-103
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Tidskriftsartikel (refereegranskat)abstract
- Swedish underground mines are constantly improving their safety. However, major incidents still occur, and the extreme environment poses challenges during rescue operations. The aim of this study was to evaluate prehospital medical management during a full-scale exercise in an underground mine in order to gain knowledge on the leadership and decision-making of the medical incident commander. We used a qualitative single-case study design following a full-scale exercise that included emergency medical services (EMSs), rescue services, and a mining company. The exercise was documented through on-site observation notes, audio recordings, and video recordings, all of which were written out as text and analysed using qualitative content analysis. The results showed that few decisions were made, and without all available medical information, and that they were made by others than the medical incident commander. This resulted in a delay in decision-making, in vital treatment, and in transport of patients from the site. Clearer leadership and more active decisions might have resulted in a different outcome for the injured parties.
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| 30449. |
- Gyllencreutz, Lina, et al.
(författare)
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Non-minor injuries among children sustained in an outdoor environment : a retrospective register study
- 2015
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Ingår i: International Journal of Injury Control and Safety Promotion. - : Informa UK Limited. - 1745-7300 .- 1745-7319. ; 22:1, s. 3-10
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Tidskriftsartikel (refereegranskat)abstract
- The aim was to investigate non-minor injuries sustained during outdoor activities among 0-12 year old children and to explore self-reported circumstances surrounding these incidents. During 2007-2009, the Umea University Hospital injury database (IDB) registered 795 children with moderate (n = 778) and serious (n = 17) injuries, such as fractures. The IDB includes data from a questionnaire completed in the emergency department by the injured child or a parent. The open-ended questions catch the injured child's description of what circumstances precede the injury incident. The most commonly reported activities contributing to injuries were play, sport, and transport. Surface impacts were also reported as contributing factors along with products such as trampolines, bicycles, and downhill skis. By achieving a deeper knowledge about the activities and circumstances that precede non-minor injury incidents, creating safer outdoor environments may be feasible.
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| 30450. |
- Gyllencreutz, Lina, et al.
(författare)
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Outdoor pedestrian fall-related injuries among Swedish senior citizens : injuries and preventive strategies
- 2015
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Ingår i: Scandinavian Journal of Caring Sciences. - : Wiley. - 0283-9318 .- 1471-6712. ; 29:2, s. 225-233
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Tidskriftsartikel (refereegranskat)abstract
- Senior citizens get around, to a large extent, as pedestrians, and safe walking is desirable for senior citizens allowing them to stay mobile, independent and healthy in old age. Senior citizens are over-represented in injury statistics, and fall-related injuries are common. The aim of this study was to investigate fall-related injuries including healthcare costs among senior citizen pedestrians injured when walking in public outdoor environments and to describe their self-reported causes and suggested preventive strategies. The data were based on a combination of information from injury data and a questionnaire. Three hundred senior citizens attended one emergency department after sustaining injuries from pedestrian falls; 60% suffered nonminor injuries, mostly fractures. One-fifth of the pedestrians were hospitalised for an average of 8 days with an indirect hospital cost of 6.2 million EUR (55 million SEK). Environmental factors such as ice were the most commonly described cause of the injury incident. Forty per cent of the respondents indicated that the municipality was responsible for the cause of the injury incident. Fewer respondents mentioned their own responsibility as a preventive strategy. Thirty per cent described a combination of improvements such as better road maintenance, changes in human behaviour and use of safety products as preventive strategies. It is of great importance to highlight general safety, products and preventive strategies to minimise injury risks, so that pedestrians can safely realise the known health benefits of walking and thereby limit healthcare costs.
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