The purpose of this thesis was to molecularly characterize macrolide-resistant S. pneumoniae (SPN) isolates in Canada between 1998 and 2008. The characterization involved looking at the multi-drug resistant phenotype (MDR), the mechanisms of macrolide resistance, the genetic relatedness, the serotype distribution and PCV7 vaccine coverage as well as the determination of presence of pili-virulence factors. The hypothesis of the study was that macrolide-resistant SPN will growingly be MDR, genetically related, piliated and consisting of serotypes not found in PCV7 vaccine. Over 1500 macrolide-resistant SPN isolates collected between 1998 and 2008 were studied. Macrolide-resistant isolates came from patients from all regions of Canada, and from all age groups. They came from slightly more males (60%) and slightly more in-patients (62%). Macrolide resistant SPN remained low at 8% during the first 4 years of the study, and started to increase reaching 22% by the end of the study in 2008 (p=0.001). Overall the most common mechanism of resistance was efflux mediated by mef(A) (51%), followed by target site modification mediated by erm(B) (36%). The efflux mediated macrolide resistance in S. pneumoniae was predominantly due to the presence of subtype E (95%), which was resistant to more antibiotic classes, and was genetically and serotypically more diverse than the A subtype. Isolates carrying both erm(B) and mef(A) macrolide resistance genes increased overtime from 1% (1998) to 19% (2008) (p=0.002). Serotype distribution showed a decrease in PCV7 vaccine coverage from 67% to 31% (p=0.0072). Isolates with non-PCV7 serotypes increased overtime from 33% to 57% (p=0.0152). Isolates with serotype 19A increased by 15% (p=0.005). They were found to be multi-drug resistant, carried both erm(B) and mef(A) subtype E macrolide resistance genes, and were genetically related. The presence of virulence factor pili-type 1 (PI-1) and pili-type 2 (PI-2) was found associated with these isolates, possibly contributing to its emergence. In conclusion, macrolide resistant SPN increased during the course of this study mostly due to emergence of multi-drug resistant, genetically related, piliated, 19A S. pneumoniae.

This thesis considers the impact of differential skid resistance between wheel paths on the speed at which a vehicle can safely negotiate a curve. Currently the New Zealand Transport Agency undertakes measurement of the co-efficient of friction on the state highway network by measuring both wheel paths, but taking the average value to represent the level of skid resistance available. Part of the basis for this approach is that modern cars have Electronic Stability Control that has historically been considered to negate the effects of any differential friction. Aside from straight line braking testing, little research has been done on the impacts of differential friction on curves. There are however a number of areas of research that can be related to this topic.By PC Crash simulation modeling, this research identifies that there are a number of gaps in our understanding of the relationship between vehicles maneuvering on a curve and the effect of varying skid resistance. It concludes that taking the average of the two values is not the same as considering them separately and, that as the difference in the co-efficient of friction between the wheel paths increases, the speed at which a vehicle can safely maneuver around a curve decreases. It has also been found that when Electronic Stability Control is used the speed at which the vehicle can safely maneuver around a curve decreases further.

The purpose of this thesis was to molecularly characterize macrolide-resistant S. pneumoniae (SPN) isolates in Canada between 1998 and 2008. The characterization involved looking at the multi-drug resistant phenotype (MDR), the mechanisms of macrolide resistance, the genetic relatedness, the serotype distribution and PCV7 vaccine coverage as well as the determination of presence of pili-virulence factors. The hypothesis of the study was that macrolide-resistant SPN will growingly be MDR, genetically related, piliated and consisting of serotypes not found in PCV7 vaccine. Over 1500 macrolide-resistant SPN isolates collected between 1998 and 2008 were studied. Macrolide-resistant isolates came from patients from all regions of Canada, and from all age groups. They came from slightly more males (60%) and slightly more in-patients (62%). Macrolide resistant SPN remained low at 8% during the first 4 years of the study, and started to increase reaching 22% by the end of the study in 2008 (p=0.001). Overall the most common mechanism of resistance was efflux mediated by mef(A) (51%), followed by target site modification mediated by erm(B) (36%). The efflux mediated macrolide resistance in S. pneumoniae was predominantly due to the presence of subtype E (95%), which was resistant to more antibiotic classes, and was genetically and serotypically more diverse than the A subtype. Isolates carrying both erm(B) and mef(A) macrolide resistance genes increased overtime from 1% (1998) to 19% (2008) (p=0.002). Serotype distribution showed a decrease in PCV7 vaccine coverage from 67% to 31% (p=0.0072). Isolates with non-PCV7 serotypes increased overtime from 33% to 57% (p=0.0152). Isolates with serotype 19A increased by 15% (p=0.005). They were found to be multi-drug resistant, carried both erm(B) and mef(A) subtype E macrolide resistance genes, and were genetically related. The presence of virulence factor pili-type 1 (PI-1) and pili-type 2 (PI-2) was found associated with these isolates, possibly contributing to its emergence. In conclusion, macrolide resistant SPN increased during the course of this study mostly due to emergence of multi-drug resistant, genetically related, piliated, 19A S. pneumoniae.

No description available.

Diss. (sammanfattning) Stockholm : Karol. inst. / Härtill 5 uppsatser.

Diss. (sammanfattning) Stockholm : Karol. inst. / Härtill 6 uppsatser.

Thesis (M. Sc.)--University of Adelaide, Dept. of Pure Mathematics, 1992. / Includes bibliographical references (leaves 91-92).

Thesis (M.S.)--Wisconsin. / Includes bibliographical references (leaves 48-49).

Thesis (M.P.H.)--University of Hong Kong, 2008. / Includes bibliographical references (p. 49-51).

Inaug.-diss.-Berlin. / Lebenslauf.