Drug and Alcohol Rehabilitation: Environmental Contamination With Hazardous Drugs in Quebec Hospitals.

Environmental contamination with hazardous drugs in quebec hospitals.

Filed under: Drug and Alcohol Rehabilitation

Can J Hosp Pharm. 2012 Nov; 65(6): 428-35
Bussières JF, Tanguay C, Touzin K, Langlois E, Lefebvre M

Since publication of the US National Institute for Occupational Safety and Health alert on hazardous drugs in 2004, many health care organizations have reviewed their procedures for handling hazardous drugs. Occupational exposure may occur when handling, compounding, or administering a drug considered to be hazardous, at any stage from storage to waste management.To describe environmental contamination with cyclophosphamide, ifosfamide, and methotrexate in pharmacy and patient care areas of Quebec hospitals.Sixty-eight hospitals were invited to participate. At each hospital, 12 prespecified measurement sites (6 each within pharmacy and patient care areas) were sampled once (midweek, end of day). The samples were analyzed by ultra-performance liquid chromatography tandem mass spectrometry to determine the presence of the 3 drugs. The limits of detection (LODs) were 0.0015 ng/cm(2) for cyclophosphamide, 0.0012 ng/cm(2) for ifosfamide, and 0.0060 ng/cm(2) for methotrexate.Twenty-five (37%) of the hospitals agreed to participate. Samples from sites other than the 12 prespecified sites were excluded. Overall, 259 valid samples were collected between April 2008 and January 2010 (147 samples from pharmacy areas in 25 hospitals and 112 samples from patient care areas in 24 hospitals). No hospital was using a closed-system drug transfer device at the time of the study. The median (minimum, maximum) number of sites per hospital with at least 1 positive sample for at least 1 of the 3 hazardous drugs was 6 (1, 12). A total of 135 (52%) samples were positive for cyclophosphamide, 53 (20%) for ifosfamide, and 7 (3%) for methotrexate. The median (minimum, maximum) concentration in positive samples was 0.0035 ng/cm(2) (below LOD, 28 ng/cm(2)) for cyclophosphamide, below LOD (below LOD, 8.6 ng/cm(2)) for ifosfamide, and below LOD (below LOD, 0.58 ng/cm(2)) for methotrexate.The levels of environmental contamination with 3 hazardous drugs in this multicentre study were similar to or below those in most published studies. Periodic measurement of surface contamination is necessary to ensure that current practices limit occupational exposure to hazardous drugs.
HubMed – drug


Abrupt Emergence of a Single Dominant Multi-Drug-Resistant Strain of Escherichia coli.

Filed under: Drug and Alcohol Rehabilitation

J Infect Dis. 2013 Jan 3;
Johnson JR, Tchesnokova V, Johnston B, Clabots C, Roberts PL, Billig M, Riddell K, Rogers P, Qin X, Butler-Wu S, Price LB, Aziz M, Nicolas-Chanoine MH, Debroy C, Robicsek A, Hansen G, Urban C, Platell J, Trott D, Zhanel G, Weissman SJ, Cookson BT, Fang FC, Limaye A, Scholes D, Chattopadhyay S, Hooper DC, Sokurenko EV

Background.?Fluoroquinolone-resistant Escherichia coli are increasingly prevalent. Their clonal origins-potentially critical for control efforts-remain undefined.Methods.?Antimicrobial resistance profiles and fine clonal structure were determined for 236 diverse-source historical (1967-2009) E. coli isolates representing sequence type ST131 and 853 recent (2010-2011) consecutive E. coli isolates from five clinical laboratories in Seattle, WA, and Minneapolis, MN. Clonal structure was resolved based on fimH sequence (fimbrial adhesin gene: H sub-clone assignments), multi-locus sequence typing, gyrA and parC sequence (fluoroquinolone resistance-determining loci), and pulsed-field gel electrophoresis.Results.?Of the recent fluoroquinolone-resistant clinical isolates, 52% represented a single ST131 sub-clonal lineage, H30, which expanded abruptly after 2000. This sub-clone had a unique and conserved gyrA/parC allele combination, supporting its tight clonality. Unlike other ST131 sub-clones, H30 was significantly associated with fluoroquinolone resistance and was the most prevalent sub-clone among current E. coli clinical isolates, overall (10.4%) and within every resistance category (11-52%).Conclusions.?Most current fluoroquinolone-resistant E. coli clinical isolates, and the largest share of multidrug-resistant isolates, represent a highly clonal sub-group that likely originated from a single rapidly expanded and disseminated ST131 strain. Focused attention to this strain will be required to control the fluoroquinolone and multidrug-resistant E. coli epidemic.
HubMed – drug


Chloroquine in cancer therapy: a double-edged sword of autophagy.

Filed under: Drug and Alcohol Rehabilitation

Cancer Res. 2013 Jan 1; 73(1): 3-7
Kimura T, Takabatake Y, Takahashi A, Isaka Y

Autophagy is a homeostatic cellular recycling system that is responsible for degrading damaged or unnecessary cellular organelles and proteins. Cancer cells are thought to use autophagy as a source of energy in the unfavorable metastatic environment, and a number of clinical trials are now revealing the promising role of chloroquine, an autophagy inhibitor, as a novel antitumor drug. On the other hand, however, the kidneys are highly vulnerable to chemotherapeutic agents. Recent studies have shown that autophagy plays a protective role against acute kidney injury, including cisplatin-induced kidney injury, and thus, we suspect that the use of chloroquine in combination with anticancer drugs may exacerbate kidney damage. Moreover, organs in which autophagy also plays a homeostatic role, such as the neurons, liver, hematopoietic stem cells, and heart, may be sensitive to the combined use of chloroquine and anticancer drugs. Here, we summarize the functions of autophagy in cancer and kidney injury, especially focusing on the use of chloroquine to treat cancer, and address the possible side effects in the combined use of chloroquine and anticancer drugs. Cancer Res; 73(1); 3-7. ©2012 AACR.
HubMed – drug



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