Isolation and characterization of Listeria monocytogenes and other Listeria species in foods of animal origin in Addis Ababa, Ethiopia.
ABSTRACT Listeriosis is a disease of humans and animals, in which it is one of the important emerging bacterial zoonotic diseases worldwide. Among the different species of the genus Listeria, Listeria monocytogenes (L. monocytogenes) is known to cause listeriosis in humans and animals with low incidence but high case fatality rate. Information on the occurrence and distribution of L. monocytogenes and other Listeria species is very limited both in the veterinary and public health sectors in Ethiopia. The objective of this study was to isolate and characterize L. monocytogenes and other Listeria species from foods of animal origin (cottage cheese, raw beef, raw milk and liquid whole egg) in Addis Ababa, Ethiopia. A total of 391 food samples of animal origin were collected randomly, using a cross-sectional study design from November 2008 to March 2009. L. monocytogenes isolation and characterization were performed according to mainly the United States Food and Drug Administration procedures. Of the samples examined, 102 (26.1%) were found to be positive for Listeria. Listeria species were isolated in 39 (51.3%), 37 (32.2%), 22 (22%) and 4 (4%) of the raw beef, liquid whole egg, raw milk and cottage cheese samples respectively. L. monocytogenes was detected in 5.4% of the samples analyzed. It was isolated mainly from raw milk (13%) and liquid whole egg (4.3%) followed by raw beef (2.6%) and cottage cheese (1%). In addition to L. monocytogenes, other Listeria species were identified as L. innocua (60.8%), L. welshimeri (6.9%), L. seeligeri (3.9%), L. murrayi (2.9%) and L. grayi (2.9%) and L. ivanovii (1.9%). It was shown that L. monocytogenes and other Listeria species are widely spread in occurrence in foods of animal origin in Addis Ababa, Ethiopia.
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ABSTRACT: Little is known about the epidemiology of acute decompensated heart failure (ADHF) in patients admitted to intensive and coronary care units (ICU/CCU). Observational data may improve disease management and guide the design of clinical trials. EFICA is an observational study of the clinical profile, management and survival of ADHF patients admitted to ICU/CCU. The study included 599 patients admitted to 60 ICU/CCUs across France. Relevant data was recorded during hospitalisation. Survival was assessed at 4 weeks and 1 year. The main cause of ADHF was ischaemic heart disease (61%); 29% of patients had cardiogenic shock. Mortality was 27.4% at 4 weeks and 46.5% at 1 year, increasing to 43.2% and 62.5%, respectively, when including pre-admission deaths. Shock patients had the highest [57.8% vs. 15.2% without shock (p < 0.001)] and patients with hypertension and pulmonary oedema had the lowest 4-week mortality: (7%). Pre-admission NYHA class III-IV heart failure, not initial clinical presentation, influenced 1-year mortality. ADHF is a heterogeneous syndrome. Based on initial clinical presentation, three entities with distinct features and outcome may be described: cardiogenic shock, pulmonary oedema with hypertension, and 'decompensated' chronic heart failure. This should be taken into account in future observational studies, guidelines and clinical trials.European Journal of Heart Failure 11/2006; 8(7):697-705. · 6.58 Impact Factor
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ABSTRACT: The prevalence of heart failure with preserved ejection fraction may be changing as a result of changes in population demographics and in the prevalence and treatment of risk factors for heart failure. Changes in the prevalence of heart failure with preserved ejection fraction may contribute to changes in the natural history of heart failure. We performed a study to define secular trends in the prevalence of heart failure with preserved ejection fraction among patients at a single institution over a 15-year period. We studied all consecutive patients hospitalized with decompensated heart failure at Mayo Clinic Hospitals in Olmsted County, Minnesota, from 1987 through 2001. We classified patients as having either preserved or reduced ejection fraction. The patients were also classified as community patients (Olmsted County residents) or referral patients. Secular trends in the type of heart failure, associated cardiovascular disease, and survival were defined. A total of 6076 patients with heart failure were discharged over the 15-year period; data on ejection fraction were available for 4596 of these patients (76 percent). Of these, 53 percent had a reduced ejection fraction and 47 percent had a preserved ejection fraction. The proportion of patients with the diagnosis of heart failure with preserved ejection fraction increased over time and was significantly higher among community patients than among referral patients (55 percent vs. 45 percent). The prevalence rates of hypertension, atrial fibrillation, and diabetes among patients with heart failure increased significantly over time. Survival was slightly better among patients with preserved ejection fraction (adjusted hazard ratio for death, 0.96; P=0.01). Survival improved over time for those with reduced ejection fraction but not for those with preserved ejection fraction. The prevalence of heart failure with preserved ejection fraction increased over a 15-year period, while the rate of death from this disorder remained unchanged. These trends underscore the importance of this growing public health problem.New England Journal of Medicine 08/2006; 355(3):251-9. · 54.42 Impact Factor
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ABSTRACT: The ADHERE is designed to study characteristics, management, and outcomes in a broad sample of patients hospitalized with acute decompensated heart failure. Heart failure is a leading cause of hospitalization for adults older than 65 years in the United States. Most available data on these patients are limited by patient selection criteria and study design of clinical trials and single-center studies. Participating hospitals identify patients with a primary or secondary discharge diagnosis of heart failure. Medical history, management, treatments, and health outcomes data are collected through review of medical records and entered into a database via secure web browser technology. As of January 2004, data on 107 362 patients have been received from 282 participating hospitals. Of enrollees with available analyzable data (N = 105 388 from 274 hospitals), the mean age was 72.4 (+/-14.0), and 52% were women. The most common comorbid conditions were hypertension (73%), coronary artery disease (57%), and diabetes (44%). Evidence of mild or no impairment of systolic function was found in 46% of patients. Inhospital mortality was 4.0% and the median hospital length of stay was 4.3 days. The ADHERE demonstrates both the feasibility and significant implications of gathering representative data on large numbers of patients hospitalized with heart failure. Initial data provided important insights into the clinical characteristics and patterns of care of these patients. Ongoing registry work will provide the framework for improved treatment strategies for patients hospitalized with decompensated heart failure.American heart journal 03/2005; 149(2):209-16. · 4.56 Impact Factor