Introduction. Staphylococcus aureus is a Gram-positive, catalase-positive, and coagulase-positive bacterial species commonly found on the skin and in the nose of most healthy individuals. The anterior nares of nose are the most frequent carriage sites for S. aureus in both adults and children. Methicillin resistance among S. aureus isolates has steadily increased worldwide. Objective. The main objective of this study was to determine nasal carriage rate, antimicrobial susceptibility pattern, and associated risk factors of Staphylococcus aureus with special emphasis on MRSA among urban and rural elementary school children in Gondar, Northwest Ethiopia. Method. A community based comparative cross-sectional study was conducted on 622 urban and rural elementary school children in Gondar from January <svg xmlns:xlink="http://www.w3.org/1999/xlink" xmlns="http://www.w3.org/2000/svg" style="vertical-align:-0.04979992pt" id="M1" height="11.2576pt" version="1.1" viewBox="-0.0498162 -11.2078 13.0997 11.2576" width="13.0997pt"><g transform="matrix(.013,0,0,-0.013,0,0)"><path id="g113-50" d="M384 0V27C293 34 287 42 287 114V635C232 613 172 594 109 583V559L157 557C201 555 205 550 205 499V114C205 42 199 34 109 27V0H384Z"/></g><g transform="matrix(.0091,0,0,-0.0091,6.24,-5.741)"><path id="g58-113" d="M327 325C324 350 312 408 304 433C283 442 256 451 213 451C120 451 59 391 59 320C59 243 125 210 188 181C237 158 266 136 266 93C266 52 231 24 195 24C134 24 93 81 74 148L42 143C42 106 51 37 59 23C78 8 125 -12 177 -12C257 -12 345 35 345 127C345 198 292 234 216 264C171 283 131 305 131 348C131 387 156 416 195 416C243 416 277 378 297 317L327 325Z"/></g><g transform="matrix(.0091,0,0,-0.0091,9.616,-5.741)"><path id="g58-114" d="M303 37L293 66C280 59 256 49 231 49S173 63 173 143V396H281C294 404 298 428 287 439H173V575L158 577L92 509V439H46L17 408L22 396H92V107C92 27 128 -12 192 -12C203 -12 218 -9 237 2L303 37Z"/></g></svg> to March <svg xmlns:xlink="http://www.w3.org/1999/xlink" xmlns="http://www.w3.org/2000/svg" style="vertical-align:-0.2064009pt" id="M2" height="12.3641pt" version="1.1" viewBox="-0.0498162 -12.1577 20.989 12.3641" width="20.989pt"><g transform="matrix(.013,0,0,-0.013,0,0)"><path id="g113-52" d="M285 378C315 398 338 416 353 432C373 451 384 474 384 503C384 579 325 635 236 635H235C182 635 136 610 108 579L65 516L85 496C110 533 150 575 205 575C258 575 300 543 300 481C300 407 232 369 141 339L147 310C163 315 188 321 211 321C268 321 338 284 338 192C338 94 288 40 217 40C160 40 119 68 93 91C85 98 77 97 69 91C60 84 47 71 46 58C44 46 48 35 62 22C75 10 116 -12 162 -12C234 -12 424 62 424 224C424 297 373 359 285 376V378Z"/></g><g transform="matrix(.013,0,0,-0.013,6.24,0)"><path id="g113-49" d="M241 635C89 635 35 457 35 312C35 153 89 -12 240 -12C390 -12 443 166 443 312C443 466 390 635 241 635ZM238 602C329 602 354 454 354 312C354 172 330 22 240 22C152 22 124 173 124 313S148 602 238 602Z"/></g><g transform="matrix(.0091,0,0,-0.0091,12.527,-5.741)"><use xlink:href="#g58-114"/></g><g transform="matrix(.0091,0,0,-0.0091,15.412,-5.741)"><path id="g58-102" d="M522 0V30C462 35 455 41 455 106V280C455 397 397 451 314 451C262 451 206 414 171 379V710C131 698 69 682 20 675V647C87 642 90 637 90 574V106C90 41 80 35 20 30V0H236V30C176 35 171 43 171 106V339C198 371 237 391 276 391C341 391 374 350 374 269V106C374 43 367 35 308 30V0H522Z"/></g></svg>, 2018. Data was collected using a questionnaire and nasal swab samples were collected by sterile cotton tip swab moistened with sterile normal saline. Collected samples were inoculated on mannitol salt agar and incubated aerobically at 37°C for 24 hrs. S. aureus was confirmed by observing colony characteristics and biochemical tests. MRSA was detected using cefoxitin disc by Modified Kirby-Bauer disk diffusion technique. Finally data was entered, cleared, and checked using Epi-info version 7 and exported to SPSS version 20 for analysis. Odds ratio and logistic regression were used for statistical association. P-value ≤ 0.05 at 95% CI was considered for statistical association. Result. Of the 622 school children, the overall prevalence of S. aureus was 143/622 (23%). Of them, 14/143 (9.79%) were MRSA. The carriage rate in urban schools was 83/622 (13.3%) whereas it was 60/622 (9.6%) in rural schools. The prevalence of MRSA among urban schools, 9.1%, was higher than their urban counterparts, 0.7%. Gentamycin, clindamycin, and ciprofloxacin were the most effective whereas penicillin and tetracycline were resistant. Children’s fathers’ educational status and number of children in class room were significantly associated with S. aureus but only living in urban of children significantly associated with MRSA. Conclusion. This study showed high prevalence of S. aureus and MRSA, 143/622 (23%) and 14/143 (9.79%), respectively. So, decolonization of nasal carriers of MRSA and reducing the number of students per classroom should be addressed. Moreover, regular large scale survey should be conducted to assess the burden and intervene accordingly.

Abiye Tigabu

Moges Tiruneh

Feleke Mekonnen

Nasal Carriage Rate, Antimicrobial Susceptibility Pattern, and Associated Factors of Staphylococcus aureus with Special Emphasis on MRSA among Urban and Rural Elementary School Children in Gondar, Northwest Ethiopia: A Comparative Cross-Sectional Study

Introduction. Nosocomial infections due to poor hand hygiene are a major cause of increasing morbidity, mortality, and health care costs among hospitalized patients worldwide. Hand hygiene is mandatory to prevent the transmission of health care associated infections especially where infectious diseases are common like Sub-Saharan Africa. Hand washing compliance among health professionals in general is unacceptably low especially in developing countries like Ethiopia. Method. Institution-based cross-sectional study design was used to assess the knowledge and practice of hand washing among health professionals working in Dubti Referral Hospital. Structured self-administered pretested questionnaires were used. The data obtained were analyzed using SPSS version 23. Result. Out of 91 respondents, majority, 60 (65.9&#x25;), of them were knowledgeable and 31 (34.1&#x25;) were not knowledgeable. However, the majority of health professionals, 51 (56.0&#x25;), had poor practice and 40 (43.0&#x25;) of them had good practice of hand washing. Conclusion. Majority of health professionals were knowledgeable. However, they had poor practice of hand washing.

Suoud Jemal

Knowledge and Practices of Hand Washing among Health Professionals in Dubti Referral Hospital, Dubti, Afar, Northeast Ethiopia

Introduction. Appalachia West Virginia has a higher prevalence of preterm and low birthweight babies than the US national prevalence. Many factors have been studied which are known to influence preterm births and low birthweight babies. There are limited interventions that are available to decrease the likelihood of preterm and low birthweight babies; however oral health and personal oral infection control may be helpful. The purpose of this study was to evaluate the association of limited personal oral infection control among pregnant West Virginia Appalachian women and poor birth outcomes (preterm and low birthweight babies). Methods. A secondary data analysis of data from the West Virginia Healthy Start Helping Appalachian Parents and Infants (HAPI) Project from 2005 to 2016 was conducted. The researchers determined the odds ratio of personal oral infection control with a powered toothbrush (use of the brush fewer than 13 times per week versus use of the brush 13 or more times per week) on poor birth outcomes. Results. There were 845 women who completed the oral health program within the HAPI project. In unadjusted logistic regression, women who used the powered toothbrush and brushed less frequently had greater odds of poor birth outcomes than women who brushed more frequently (odds ratio of 2.07 [1.18, 3.62] P = 0.011 for low birthweight babies; and an odds ratio of 1.78 [1.04, 3.02] P = 0.034 for preterm birth). The results remained positive but were no longer significant in adjusted analysis. Conclusion. There is a need to identify interventions that will benefit pregnant women so that their pregnancies result in healthy pregnancy outcomes.

R. Constance Wiener

Christopher Waters

Personal Oral Infection Control, Low Birthweight, and Preterm Births in Appalachia West Virginia: A Cross-Sectional Study

Ingestion of a single dose of alcohol, ranging from the intake of a moderate amount alcohol to binge drinking, is the most frequent form of alcohol consumption with poorly understood medical consequences and obscure prophylactics. The study was aimed to determine whether lycosome formulated phosphatidylcholine (PC-Lyc) containing two highly bioavailable antioxidants (PC and lycopene) ingested shortly before the alcohol-containing beverage may alleviate the biochemical markers of liver damage and parameters of biological oxidation associated with the intake of a moderate amount of alcohol. Healthy middle-aged volunteers were requested to consume a moderate amount of alcohol &#x2013; 0.5 ml/kg or 1.0 ml/kg shortly after ingestion of a capsule containing 450 mg of regular phosphatidylcholine (PC, n=10), PC-Lyc (n=10), or placebo pill (PP, n=10). Serum levels of ethanol (EtOH), acetaldehyde (AA), liver-specific enzymes, total antioxidant capacity of serum (TAC), oxidized LDL (LDL-Px), and malonic dialdehyde (MDA) were measured at 1, 2.5, and 5 hours after dosing with alcohol. Ingestion of PC regardless of the formulation used had no effect on serum EtOH concentration dynamics. However, volunteers supplemented with PC-Lyc showed a better clearance of AA in serum as compared to other groups. There was a reduction in serum TAC values by 18.5&#x25; and 16.1&#x25; in both placebo groups ingesting 0.5 and 1.0 ml/kg of alcohol, respectively, at the end of observational period. This decline was preventable by supplementation of volunteers with PC and especially with PC-Lyc. Moreover, PC-Lyc promoted a reduction of serum MDA and reversed an increase in serum LDL-Px. In addition, ingestion of alcohol at 1.0 ml/kg dose caused a transient increase in serum alanine-aminotransferase activity which was abolished by both formulations of PC. Therefore, combinatory lycosomal formulation of PC and lycopene may prevent some metabolic abnormalities associated with single intake of moderate amount of alcohol. This trial is registered with <a target="_blank" href="https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=373224">ACTRN12617001335381</a>.

Ivan M. Petyaev

Marina P. Chernyshova

Dmitry V. Pristensky

Natalia E. Chalyk

Victor A. Klochkov

Nigel H. Kyle

Yuriy K. Bashmakov

Effect of Lycosome-Formulated Phosphatidylcholine on Parameters of Biological Oxidation after Single Intake of Moderate Amount of Alcohol

Coronary heart disease continues to be the leading cause of death in the United States. Current attempts to treat atherosclerosis and coronary artery disease often involve pharmaceutical and surgical treatments. While these treatments are successful in managing the pain from coronary heart disease, they do little to prevent or stop it. There are a number of clinical strategies that are currently being researched to treat atherosclerosis through HDL-increasing therapies. These clinical studies have shown positive effects through nutritional intervention, exercise, stress reduction, and tobacco and alcohol cessation. These treatment options are explored in greater detail, including their potential to halt and even reverse atherosclerosis. The results from these recent studies and how they relate to the mechanism of reverse cholesterol transport are also critically examined. Reverse cholesterol transport is a multistep process resulting in the net movement of cholesterol from peripheral tissues back to the liver via the plasma. The mechanism of reverse cholesterol transport is also further explored in this review.

Sterling Farrer

Beyond Statins: Emerging Evidence for HDL-Increasing Therapies and Diet in Treating Cardiovascular Disease

The feasibility of &#x201c;point-of-care&#x201d; screening for ideal cardiovascular health was explored in a pediatric specialty clinic setting. Children and adolescents aged 9&#x2013;18 years (n=91) with treated and stabilized diseases were recruited at a pediatric endocrinology clinic. A table-top device was used to assay fingerstick samples for non-HDL cholesterol (non-HDL-C), which was used to divide participants into two groups based on the non-HDL-C threshold for comparison of the remaining metrics between groups. A significant number of children had low scores, and score frequency distribution was similar to larger retrospective studies, with few participants achieving none or all of the health metrics. Healthy diet was the metric least often achieved. Those with a non-HDL-C above the ideal threshold of 3.1 mmol/L (120 mg/dl) had a higher BMI percentile (p&#x3c;0.01) and diastolic blood pressure percentile (p&#x3c;0.05). We conclude that pediatric risk factor screening and scoring can be performed in a specialty clinic with meaningful cardiovascular health scores for patients and providers. Association of abnormal &#x201c;point-of care&#x201d; non-HDL-C levels with elevated BMI and blood pressure supports evidence for risk factor clustering and use of the ideal health construct in pediatric clinic settings.

Piers Blackett

Kerry Farrell

Minh Truong

Minu George

Peggy Turner

Joane Less

Jonathan D. Baldwin

Allen W. Knehans

Feasibility of Ideal Cardiovascular Health Evaluation in a Pediatric Clinic Setting

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Advances in Preventive Medicine publishes original research articles and review articles in all areas of preventive medicine.

Advances in Preventive Medicine