World Report

Global control of health-care associated infections

The development of new antimicrobial agents that can overcome antibiotic-resistance and possess improved antibacterial activity is of important global need. A one-step process is demonstrated to prepare silver nanoparticle decorated MCM–41 type mesoporous silica nanoparticles (AgMSN, average diameter ~ 200–500 nm) using a novel cationic surfactant that does not lead to precipitation of AgBr. The resulting nanostructure was characterized using powder X-ray diffraction, nitrogen physisorption and chemisorption analyses, electron microscopy techniques, and UV–vis spectroscopy. Together, these data demonstrated the silver nanoparticles were uniformly dispersed on the MSN. Gram-negative E. coli K12 and Gram-positive B. subtilis were used to study the antibacterial properties of these nanocomposites by both the plate count method and optical density measurements. In the antibacterial tests for E. coli K12 and B. subtilis, the AgMSN exhibited low minimum inhibitory concentrations of 85 μg mL⁻¹ AgMSN (Ag content 6.1 μg mL⁻¹) and 90 μg mL⁻¹ (Ag content is 6.4 μg mL⁻¹), respectively, revealing the high antibacterial activity. Additionally, >95% growth reduction in continuous re-culturing tests (6 cycles, 25 days) at minimum bactericidal concentration demonstrate excellent long-term antibacterial activity of AgMSN. The nanocomposites showed excellent antibacterial activity against both. These results demonstrate that AgMSN composites possess great potential as an antibacterial material.

The crystal structure of (5-chlorosalicylate)-(2,9-dimethylphenanthroline)-(aqua) copper complex (1) was determined at 100 K. In order to explore the electronic structure of the studied compound in the solid state, an experimental charge density analysis has been performed from high-resolution X-ray data. Moreover, three different approaches for the treatment of copper atom within the multipolar refinement were used to model the experimental charge density of the studied compound. Appropriateness of the individual copper atom representations were critically compared to each other and to BLYP/6-311G** theoretical calculations by means of refinement statistics, error analysis, negative Laplacian or deformation density plots as well as Bader's Atoms In Molecule (AIM) analysis and d-populations analysis. The electrostatic potential was calculated to evaluate the reactivity of (1).

Infections and their complications requiring surgical intervention are a frequent presentation in African children. Surgical site infection (SSI) is common with rates over 20%, even after clean procedures. The high rates of SSI are due in part to lack of infection control and surveillance policies in most hospitals in Africa. SSI is attended by complications, long hospital stay, and some mortality, but the economic consequences are unestimated. Typhoid fever and typhoid intestinal perforation are major problems with perforation rates of approximately 10%, which is higher in older children. The ideal surgical treatment is arguable, but simple closure and segmental resection are the present effective surgical options. Because of delayed presentation, complications after surgical treatment are high with a mortality approaching 41% in some parts of Africa. Nutrition for these patients remains a challenge. Acute appendicitis, although not as common in African children, often presents rather late with up to 50% of children presenting with perforation and other complications, and mortality is approximately 4% is some settings. Pyomyositis and necrotizing fasciitis are the more common serious soft-tissue infections, but early recognition and prompt treatment should minimize the occasional mortality. Though common in Africa, the exact impact of human immunodeficiency virus infection on the spectrum and severity of surgical infection in African children is not clear, but it may well worsen the course of infection in these patients.

Healthcare-associated infections constitute an important public health problem in both developing and transitional countries. Despite considerable progress in the development of infection control programmes in some countries with limited resources, programmes in most developing world settings are non-existent, or are not implemented. Kosova, the poorest country in Europe, illustrates the challenges posed by infection control in the developing world. In many hospitals activities are limited by the lack of financial resources, poor infrastructure, overcrowding, inadequate hygiene, poorly functioning laboratory services, poor management, insufficient technology and a shortage of trained staff. Infection control guidelines from developed countries are often perceived as a standard for the developing world, but have to be modified to take into account differences in local needs. The best solutions entail greater governmental commitment and application of infection control procedures consistent with available resources. The International Nosocomial Infection Control Consortium (INICC) plays an important role in these activities in developing countries.