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As the United States health care system grapples with increased demand for health care and costly medical services, the underserved and the minority population often find it difficult to access medical care due to financial, cultural, and language barriers. Interestingly, the underserved and the minority population have the highest burden for chronic diseases because of the lack of screening, lost to routine follow up, and the failure to adhere to treatment regimen after diagnosis. In this paper, we focused on how to use community health workers who are trusted members of the community, share cultural and linguistic characteristics, and have better understanding of the community in which they serve to improve access to medical care and better management of chronic diseases. The review of literature and organization reports suggest that community health workers are capable of managing chronic diseases and other health conditions and it is cost-effective if a legal framework, training, and funding support their activities. Nearly half of the states do not have laws or regulations that support the activities of community health workers and, thus, present a real challenge to the diverse composition of U.S. population and chronic disease management.Because community health workers are not office workers or clinical staff of the healthcare workforce, supervision, funding, and their defined roles complicate the integration into the healthcare system. Some states and healthcare facilities use the Medicaid reimbursement and operating budgets, respectively, to fund health intervention programs carried out by community health workers. Medicaid funding supports only community health workers with certification with no funding for those without a certificate. Most states do not require or authorized certification for community health workers practice. In addition, funding from healthcare operating budgets are short lived and, thus, may impact on interventions dealing with chronic diseases. It is for this reason that community health worker programs that seeks to involve members of faith-based organizations as part of their outreach programs have a better chance of survival in the community due to their social presence in the community and volunteerism. Furthermore, interventions in which members of the community are made to own the program with active consultation and participation can withstand the test of time instead of arbitrarily training individual members with no input from the community.

Mycobacterium tuberculosis proteins that are exported out of the bacterial cytoplasm are ideally positioned to be virulence factors; however, the functions of individual exported proteins remain largely unknown. Previous studies identified Rv0199 as an exported membrane protein of unknown function. Here, we characterized the role of Rv0199 in M. tuberculosis virulence using an aerosol model of murine infection. Rv0199 appears to be a member of a Mce-associated membrane (Mam) protein family leading us to rename it OmamA, for orphaned Mce-associated membrane protein A. Consistent with a role in Mce transport, we showed OmamA is required for cholesterol import, which is a Mce4-dependent process. We further demonstrated a function for OmamA in stabilizing protein components of the Mce1 transporter complex. These results indicate a function of OmamA in multiple Mce transporters and one that may be analogous to the role of VirB8 in stabilizing Type IV secretion systems, as structural similarities between Mam proteins and VirB8 proteins are predicted by the Phyre 2 program. In this study, we provide functional information about OmamA and shed light on the function of Mam family proteins in Mce transporters.

Mycobacterium tuberculosis is an example of a bacterial pathogen with a specialized SecA2-dependent protein export system that contributes to its virulence. Our understanding of the mechanistic basis of SecA2-dependent export and the role(s) of the SecA2 pathway in M. tuberculosis pathogenesis has been hindered by our limited knowledge of the proteins exported by the pathway. Here, we set out to identify M. tuberculosis proteins that use the SecA2 pathway for their export from the bacterial cytoplasm to the cell wall. Using label-free quantitative proteomics involving spectral counting, we compared the cell wall and cytoplasmic proteomes of wild type M. tuberculosis to that of a ΔsecA2 mutant. This work revealed a role for the M. tuberculosis SecA2 pathway in the cell wall localization of solute binding proteins that work with ABC transporters to import solutes. Another discovery was a profound effect of SecA2 on the cell wall localization of the Mce1 and Mce4 lipid transporters, which contribute to M. tuberculosis virulence. In addition to the effects on solute binding proteins and Mce transporter export, our label-free quantitative analysis revealed an unexpected relationship between SecA2 and the hypoxia-induced DosR regulon, which is associated with M. tuberculosis latency. Nearly half of the transcriptionally controlled DosR regulon of cytoplasmic proteins were detected at higher levels in the ΔsecA2 mutant versus wild type M. tuberculosis. By increasing the list of M. tuberculosis proteins known to be affected by the SecA2 pathway, this study expands our appreciation of the types of proteins exported by this pathway and guides our understanding of the mechanism of SecA2-dependent protein export in mycobacteria. At the same time, the newly identified SecA2-dependent proteins are helpful for understanding the significance of this pathway to M. tuberculosis virulence and physiology.

Traditionally, the identification and characterization of microbial communities in contaminated soil and water has previously been limited to those microorganisms that are culturable. The application of molecular techniques to study microbial populations at contaminated sites without the need for culturing has led to the discovery of unique and previously unrecognized microorganisms as well as complex microbial diversity in contaminated soil and water which shows an exciting opportunity for bioremediation strategies. Nucleic acid extraction from contaminated sites and their subsequent amplification by polymerase chain reaction (PCR) has proved extremely useful in assessing the changes in microbial community structure by several microbial community profiling techniques. This review examines the current application of molecular techniques for the characterization of microbial communities in contaminated soil and water. Techniques that identify and quantify microbial population and catabolic genes involved in biodegradation are examined. In addition, methods that directly link microbial phylogeny to its ecological function at contaminated sites as well as high throughput methods for complex microbial community studies are discussed. Keywords: Molecular techniques, Microbial communities, Contaminated soil, Water, Microbial identification, Biodegradation

1. SUMMARY Dogs and cats have become an integral part of modern society in the developed world and as such attention is given to their care and welfare. At some stage of their lives many cats and dogs suffer from skin and other superficial staphylococcal infections such as pyoderma and otitis externa and are therefore treated with antibiotics. This practice has led to the emergence of resistant staphylococci in these animals. Antimicrobial susceptibility studies in companion animals have revealed that staphylococci isolated from cats and dogs exhibit similar resistance patterns to human staphylococci and that resistance development is influenced by the frequency of use of certain antibiotics. This review examines the antibiotic resistance patterns of the most frequently isolated staphylococci from cats and dogs and the mechanisms underlying resistance. The possible transfer of methicillin-resistant staphylococci from cats and dogs to humans has been identified as a potential public health issue. Typing tools used for epidemiological differentiation of pathogenic and nonpathogenic staphylococci and for species identification studies may help to elucidate the importance or otherwise of this problem.

Hexavalent chromium [Cr(VI)] is highly toxic, teratogenic and carcinogenic to man and other animals. Some bacterial species have the ability to reduce Cr(VI) to a stable speciation state of trivalent chromium [Cr(III)], which is insoluble and comparatively less toxic. Therefore, the reduction of Cr(VI) thus provides potential as a means for environmental bioremediation of Cr(VI) pollution. In the present study bacteria isolated from chromium and diesel contaminated sites were found to have the ability to rapidly reduce highly toxic concentrations of Cr(VI) to Cr(III) when grown in minimal medium supplemented with glucose as the sole carbon source. Partial chromate reductase gene sequences were retrieved after PCR amplification of genomic DNA extracted from three Gram positive isolates which were highly similar (>99% sequence similarity) to chromate reductase genes found in Gram negative bacteria, more specifically those identified from Escherichia coli and Shigella spp. whole-genome studies. The isolated bacteria were putatively identified by 16S rRNA gene sequencing as Arthrobacter aurescens strain MM10, Bacillus atrophaeus strain MM20, and Rhodococcus erythropolis strain MM30. Refereed/Peer-reviewed

A bacterium with an exceptional ability to hydrolyse fenamiphos and its toxic oxidation products fenamiphos sulfoxide and fenamiphos sulfone, all possessing P-O-C bond was isolated from soil. Based on 16SrRNA gene determination, this bacterium was putatively identified as Microbacterium esteraromaticum.The phenols (fenamiphos phenol, sulfoxide phenol and sulfone phenol) formed during bacterial hydrolysis resisted further degradation in mineral salts medium and sterile groundwater, but were transitory in non-sterile groundwater due to the catabolism of native microorganisms. Also, the cell-free preparation of this bacterium was highly effective in hydrolysing fenamiphos and its oxides. These results demonstrate the potential of this bacterium to detoxify pesticide waste in the environment including the groundwater. Refereed/Peer-reviewed

PhD Doctorate Staphylococci are important opportunistic pathogens often found in the microflora of skin and mucosal surfaces of the upper respiratory tract of man and animals. The coagulase-positive species such as Staphylococcus aureus are capable of causing invasive (eg furuncles and bacteraemia) and non-invasive (food poisoning and toxic shock syndrome) conditions in humans. In animals, S. intermedius and S. aureus have been implicated in a variety of conditions including pyoderma in dogs, mastitis in cows and skin infections in horses with S. intermedius being responsible for more than 95% of staphylococcal infections in dogs. The emergence of antibiotic-resistant bacteria, in humans, animals and the environment, has become a cause for concern following the introduction of antimicrobial agents in clinical practice. Staphylococcal species, in particular, have developed or acquired antibiotic-resistance determinants to almost all the antimicrobial agents in clinical use today. In recent years there has been an increase in reports of the isolation of antibiotic-resistance staphylococci especially methicillin-resistant staphylococci (MRS), from cats and dogs. Cats and dogs are in close contact with humans, especially in advanced countries and therefore the possibility for transfer of antibiotic-resistant staphylococci from these animals to humans or vice versa may exist. The aims of this study were; to determine the species distribution and antibiotic sensitivity of staphylococci obtained from cats and dogs, to investigate the molecular basis of resistance and to examine the genetic relatedness of specific resistant isolates. Many studies have shown that S. intermedius and S. simulans (S. felis) are the predominante species on healthy dogs and cats, respectively, and lesions in these animals are caused by S. aureus and S. intermedius. In this study, a diverse range of coagulase-negative staphylococci was isolated from healthy animals but staphylococci from skin lesions of cats and dogs were identified mainly as S. intermedius as reported in the literature. A limited number of resistant isolates (~20%) were observed in this study and were mostly isolated from dogs. Investigations into the molecular basis of resistance to beta-lactam, macrolide and tetracycline antibiotics were carried out. The resistant isolates were analysed by polymerase chain reaction (PCR) and DNA sequencing techniques. MRS were analysed for the presence of the mecA gene and the staphylococcal cassette chromosome mec (SCCmec). The recombinase genes, cassette chromosome recombinase (ccr) on SCCmec elements were also examined. The SCCmec elements detected were as diverse as those reported in human staphylococcal strains. Comparative analysis of nucleotide and amino acid sequences of mecA and ccr gene complexes revealed that the genes are conserved among MRS of cat and dog orgin. Multilocus sequence typing (MLST) of methicillin-resistant S. aureus (MRSA) and S. epidermidis isolates showed that, the MRSA were of human origin but the S. epidermidis isolates were unique to cats and dogs. In addition, the blaZ gene which codes for ??-lactamases production, the erm genes responsible for erythromycin resistance and the tet genes which encode tetracycline resistances, were found to be identical to those observed in humans and other animal staphylococci and demonstrated similar diversity. The study has provided important information about the molecular basis of resistance in beta-lactamase producing staphylococci as well as the molecular epidemiology of MRS of cat and dog origin and identifies the risk of spread of MRS between humans and pets and vice versa. These findings should form part of a larger surveillance study on staphylococci of cat and dog origin for a better understanding of the epidemiology of antibiotic-resistance genes for improved management and control of resistant staphylococci in the community and in health care settings.

Staphylococci are part of the normal microflora of humans and animals and some are potential pathogens that have become resistant to almost all known antibiotics. Despite the widespread reports of penicillin resistance in cat and dog staphylococci, the mechanism underlying penicillin resistance has not been examined. This study was aimed at investigating the molecular basis of resistance to penicillin in cat and dog staphylococcal isolates that showed phenotypic resistance to beta-lactam antibiotics. An 861 bp fragment of the structural blaZ gene which codes for beta-lactamase production in staphylococci was amplified by polymerase chain reaction (PCR) and the products were sequenced. Sequenced fragments were analysed by protein signature typing and sequences were compared to published blaZ sequences of human and bovine staphylococcal strains held in a public database. Four known protein signature types (1, 3, 5 and 6) and one new type (12) were identified in this study. When sequences were compared with published blaZ sequences, gene phylogenetic analysis revealed three major groups. The four variants of beta-lactamases types (A, B, C and D) belonged to each major group except for types A and D which were both in group II. These findings confirm that the blaZ gene is responsible for beta-lactamase production leading to subsequent resistance to beta-lactam antibiotics in feline and canine staphylococci and that the gene shows similar diversity and relatedness as found with blaZ sequences obtained from human and bovine staphylococci.