Subjects -> MEDICAL SCIENCES (Total: 8642 journals)
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MEDICAL SCIENCES (2392 journals)            First | 2 3 4 5 6 7 8 9 | Last

Showing 1001 - 1200 of 3562 Journals sorted alphabetically
Isis     Full-text available via subscription   (Followers: 33)
Islets     Full-text available via subscription   (Followers: 1)
Israel Journal of Health Policy Research     Open Access  
Israel Medical Association Journal IMAJ     Open Access  
İstanbul Bilim Üniversitesi Florence Nightingale Tıp Dergisi     Open Access  
Italian Journal of Medicine     Open Access   (Followers: 2)
Itch : International Forum for the Study of Itch     Open Access  
JAAPA     Hybrid Journal   (Followers: 3)
Jaffna Medical Journal     Open Access  
JAMA Network Open     Open Access   (Followers: 3)
JAMA The Journal of the American Medical Association     Full-text available via subscription   (Followers: 2252)
Jambi Medical Journal : Jurnal Kedokteran Dan Kesehatan     Open Access   (Followers: 1)
JAMIA Open     Open Access   (Followers: 2)
Janaki Medical College Journal of Medical Science     Open Access   (Followers: 2)
Japanese Clinical Medicine     Open Access   (Followers: 1)
JBI Database of Systematic Reviews and Implementation Reports     Hybrid Journal   (Followers: 3)
JBJS Case Connector     Full-text available via subscription   (Followers: 1)
JBJS Open Access     Open Access   (Followers: 4)
JBMR Plus     Open Access   (Followers: 1)
JBN (Jurnal Bedah Nasional)     Open Access  
JCC Open : Journal de Cas Cliniques     Open Access  
JCI Insight     Open Access   (Followers: 3)
JCSM Rapid Communications     Open Access   (Followers: 3)
JDDG     Hybrid Journal   (Followers: 6)
JDREAM : Journal of interDisciplinary REsearch Applied to Medicine     Open Access  
Jeugd en Co     Hybrid Journal   (Followers: 1)
Jeugd en Co Kennis     Hybrid Journal   (Followers: 1)
JGZ Tijdschrift voor jeugdgezondheidszorg     Hybrid Journal   (Followers: 2)
JHEP Reports     Open Access  
JHN Journal     Open Access  
JMIR Biomedical Engineering     Open Access   (Followers: 1)
JMIR Formative Research     Open Access  
JMIR Human Factors     Open Access   (Followers: 1)
JMIR Medical Education     Open Access   (Followers: 1)
JMIR Medical Informatics     Open Access   (Followers: 9)
JMIR mHealth and uHealth     Open Access   (Followers: 1)
JMIR Perioperative Medicine     Open Access   (Followers: 1)
JMIR Public Health and Surveillance     Open Access  
JMIR Rehabilitation and Assistive Technologies     Open Access  
JMIR Research Protocols     Open Access  
JMIR Serious Games     Open Access   (Followers: 8)
JMV - Journal de Médecine Vasculaire     Hybrid Journal   (Followers: 1)
JNCI Monographs     Hybrid Journal   (Followers: 6)
Joint Bone Spine     Full-text available via subscription   (Followers: 13)
Joints     Open Access   (Followers: 1)
JOP. Journal of the Pancreas     Open Access   (Followers: 2)
Jornal Brasileiro de Patologia e Medicina Laboratorial     Open Access  
Jornal Brasileiro de Pneumologia     Open Access  
Jornal Brasileiro de TeleSSaúde     Open Access  
Jornal de Pneumologia     Open Access  
Jos Journal of Medicine     Open Access  
Journal Club AINS     Hybrid Journal  
Journal Club Schmerzmedizin     Hybrid Journal  
Journal de Mycologie Médicale / Journal of Medical Mycology     Full-text available via subscription   (Followers: 2)
Journal des Maladies Vasculaires     Full-text available via subscription  
Journal for Vascular Ultrasound     Full-text available via subscription   (Followers: 1)
Journal Français d'Ophtalmologie     Full-text available via subscription   (Followers: 3)
Journal Health NPEPS     Open Access   (Followers: 1)
Journal Marocain des Sciences Médicales     Open Access  
Journal of Antivirals & Antiretrovirals     Open Access  
Journal of Bioanalysis & Biomedicine     Open Access   (Followers: 1)
Journal of Cytology & Histology     Open Access   (Followers: 7)
Journal of 3D Printing in Medicine     Hybrid Journal   (Followers: 1)
Journal of Academy of Medical Sciences     Open Access  
Journal of Acute Disease     Open Access  
Journal of Acute Medicine     Open Access  
Journal of Addiction Medicine     Hybrid Journal   (Followers: 7)
Journal of Addiction Medicine and Therapeutic Science     Open Access   (Followers: 2)
Journal of Addiction Science     Open Access   (Followers: 2)
Journal of Addictive Behaviors, Therapy & Rehabilitation     Hybrid Journal   (Followers: 7)
Journal of Advanced Academic Research     Open Access   (Followers: 3)
Journal of Advanced Therapies and Medical Innovation Sciences     Open Access  
Journal of Advancement in Medicine     Hybrid Journal  
Journal of Advances in Internal Medicine     Open Access   (Followers: 2)
Journal of Advances in Medical Education & Professionalism     Open Access   (Followers: 10)
Journal of Advances in Medicine and Medical Research     Open Access   (Followers: 1)
Journal of Aging Research     Open Access   (Followers: 9)
Journal of Agromedicine     Hybrid Journal   (Followers: 1)
Journal of Alzheimers Disease & Parkinsonism     Open Access   (Followers: 7)
Journal of Anatolian Medical Research     Open Access  
Journal of Anatomy     Hybrid Journal   (Followers: 7)
Journal of Andrology & Gynaecology     Open Access  
Journal of Angiogenesis Research     Open Access   (Followers: 2)
Journal of Antibiotics     Hybrid Journal   (Followers: 5)
Journal of Applied Animal Welfare Science     Hybrid Journal   (Followers: 23)
Journal of Applied Biomedicine     Open Access   (Followers: 2)
Journal of Applied Clinical Medical Physics     Open Access   (Followers: 8)
Journal of Applied Medical Sciences     Open Access   (Followers: 2)
Journal of Applied Virology     Open Access   (Followers: 5)
Journal of Archives in Military Medicine     Open Access   (Followers: 3)
Journal of Armed Forces Medical College, Bangladesh     Open Access  
Journal of Artificial Organs     Hybrid Journal  
Journal of Associated Medical Sciences     Open Access  
Journal of Attention Disorders     Hybrid Journal   (Followers: 2)
Journal of Ayurveda and Integrative Medicine     Open Access   (Followers: 3)
Journal of Biological Rhythms     Hybrid Journal   (Followers: 2)
Journal of Biomaterials Applications     Hybrid Journal   (Followers: 3)
Journal of Biomedical Education     Open Access   (Followers: 2)
Journal of Biomedical Engineering and Technology     Open Access   (Followers: 1)
Journal of Biomedical Informatics     Partially Free   (Followers: 16)
Journal of Biomedical Informatics : X     Open Access  
Journal of Biomedical Materials Research Part A     Hybrid Journal   (Followers: 3)
Journal of Biomedical Materials Research Part B : Applied Biomaterials     Hybrid Journal   (Followers: 2)
Journal of Biomedical Physics and Engineering     Open Access  
Journal of Biomedical Practitioners     Open Access  
Journal of Biomedical Research     Full-text available via subscription   (Followers: 3)
Journal of Biomedical Research and Health Economics     Open Access  
Journal of Biomedical Science and Engineering     Open Access   (Followers: 2)
Journal of Biomedical Sciences     Open Access  
Journal of Biomedical Semantics     Open Access   (Followers: 2)
Journal of Biomedicine and Translational Research     Open Access  
Journal of Biorepository Science for Applied Medicine     Open Access   (Followers: 2)
Journal of Biosciences and Medicines     Open Access   (Followers: 3)
Journal of Biotechnology and Strategic Health Research     Open Access   (Followers: 2)
Journal of Blood Transfusion     Open Access   (Followers: 1)
Journal of Bodywork and Movement Therapies     Hybrid Journal   (Followers: 17)
Journal of Bone and Mineral Research     Hybrid Journal   (Followers: 15)
Journal of Bone Marrow Research     Open Access   (Followers: 2)
Journal of BP Koirala Institute of Health Sciences     Open Access  
Journal of Breast Imaging     Full-text available via subscription   (Followers: 2)
Journal of Breath Research     Hybrid Journal   (Followers: 6)
Journal of Burn Care & Research     Hybrid Journal   (Followers: 9)
Journal of Caffeine Research: The International Multidisciplinary Journal of Caffeine Science     Hybrid Journal   (Followers: 3)
Journal of Cancer & Allied Specialties     Open Access   (Followers: 1)
Journal of Carcinogenesis     Open Access   (Followers: 1)
Journal of Cardiology and Cardiovascular Medicine     Open Access   (Followers: 3)
Journal of Cardiovascular Medicine and Cardiology     Open Access   (Followers: 2)
Journal of Cell Death     Open Access   (Followers: 2)
Journal of Cellular and Molecular Medicine     Open Access   (Followers: 4)
Journal of Charoenkrung Pracharak Hospital     Open Access  
Journal of Chitwan Medical College     Open Access  
Journal of Chromatography Library     Full-text available via subscription   (Followers: 5)
Journal of Circadian Rhythms     Open Access   (Followers: 2)
Journal of Circulating Biomarkers     Open Access  
Journal of Cleft Lip Palate and Craniofacial Anomalies     Open Access   (Followers: 3)
Journal of Clinical & Developmental Psychology     Open Access   (Followers: 1)
Journal of Clinical & Medical Case Reports     Open Access   (Followers: 1)
Journal of Clinical and Experimental Investigations     Open Access  
Journal of Clinical and Translational Science     Open Access  
Journal of Clinical Apheresis     Hybrid Journal   (Followers: 2)
Journal of Clinical Bioinformatics     Open Access   (Followers: 5)
Journal of Clinical Case Reports     Open Access  
Journal of Clinical Densitometry     Hybrid Journal  
Journal of Clinical Intensive Care and Medicine     Open Access  
Journal of Clinical Investigation     Full-text available via subscription   (Followers: 69)
Journal of Clinical Medicine     Open Access   (Followers: 3)
Journal of Clinical Medicine and Research     Open Access  
Journal of Clinical Medicine Research     Open Access   (Followers: 4)
Journal of Clinical Monitoring and Computing     Hybrid Journal   (Followers: 1)
Journal of Clinical Movement Disorders     Open Access   (Followers: 3)
Journal of Clinical Neonatology     Open Access   (Followers: 4)
Journal of Clinical Psychology in Medical Settings     Hybrid Journal   (Followers: 13)
Journal of Clinical Research & Bioethics     Open Access   (Followers: 2)
Journal of Clinical Research & Governance     Open Access   (Followers: 2)
Journal of Clinical Sciences     Open Access  
Journal of Clinical Sleep Medicine     Full-text available via subscription   (Followers: 18)
Journal of Clinical Toxicology     Open Access   (Followers: 6)
Journal of Clinical, Medical and Experimental Images     Open Access  
Journal of College of Medical Sciences-Nepal     Open Access  
Journal of Community Medicine and Primary Health Care     Open Access   (Followers: 5)
Journal of Comparative Effectiveness Research     Hybrid Journal   (Followers: 1)
Journal of Compassionate Health Care     Open Access   (Followers: 3)
Journal of Complexity in Health Sciences     Open Access   (Followers: 2)
Journal of Concussion     Open Access  
Journal of Consciousness Studies     Full-text available via subscription   (Followers: 5)
Journal of Contemporary Medical Sciences     Open Access  
Journal of Contemporary Medicine     Open Access  
Journal of Cosmetic and Laser Therapy: formerly Journal of Cutaneous Laser Therapy     Hybrid Journal   (Followers: 5)
Journal of Craniovertebral Junction and Spine     Open Access   (Followers: 4)
Journal of Current Medical Research and Practice     Open Access  
Journal of Current Research in Scientific Medicine     Open Access  
Journal of Current Researches on Health Sector     Open Access  
Journal of Cutaneous Immunology and Allergy     Open Access  
Journal of Cystic Fibrosis     Hybrid Journal   (Followers: 9)
Journal of Cytology     Open Access   (Followers: 2)
Journal of Cytology & Molecular Biology     Open Access   (Followers: 2)
Journal of Datta Meghe Institute of Medical Sciences University     Open Access  
Journal of Dhaka Medical College     Open Access  
Journal of Dhaka National Medical College & Hospital     Open Access  
Journal of Disease and Health Risk DPC.3     Open Access  
Journal of Disease Cause and Control     Open Access  
Journal of Disease Prevention and Control : DPC. 2 Phitsanulok     Open Access  
Journal of Dr. NTR University of Health Sciences     Open Access  
Journal of Eating Disorders     Open Access   (Followers: 9)
Journal of ECT     Hybrid Journal   (Followers: 14)
Journal of Education, Health and Sport     Open Access   (Followers: 4)
Journal of Electronic Resources in Medical Libraries     Hybrid Journal   (Followers: 26)
Journal of Enam Medical College     Open Access  
Journal of Endoluminal Endourology     Open Access  
Journal of Epileptology     Open Access   (Followers: 1)
Journal of Ethnobiology and Ethnomedicine     Open Access  
Journal of European CME     Open Access  
Journal of Evaluation In Clinical Practice     Hybrid Journal   (Followers: 6)
Journal of Evidence-Based Healthcare     Open Access   (Followers: 1)
Journal of Evidence-Based Integrative Medicine     Open Access   (Followers: 18)
Journal of Evidence-Based Medicine     Partially Free   (Followers: 4)
Journal of Exercise Science & Fitness     Open Access   (Followers: 28)
Journal of Experimental and Clinical Anatomy     Open Access   (Followers: 2)
Journal of Family and Community Medicine     Open Access   (Followers: 3)
Journal of Family Medicine and Primary Care     Open Access   (Followers: 11)

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Similar Journals
Journal Cover
Journal of Global Antimicrobial Resistance
Journal Prestige (SJR): 0.658
Citation Impact (citeScore): 2
Number of Followers: 3  
 
  Hybrid Journal Hybrid journal (It can contain Open Access articles)
ISSN (Print) 2213-7165
Published by Elsevier Homepage  [3207 journals]
  • IncU plasmid harbouring bla CTX-M-8 in multidrug-resistant Shigella sonnei
           in Brazil
    • Abstract: Publication date: September 2018Source: Journal of Global Antimicrobial Resistance, Volume 14Author(s): Amanda Aparecida Seribelli, Anelise Stella Ballaben, Joseane Cristina Ferreira, Marta Inês Cazentini Medeiros, Ana Lúcia Costa Darini, Juliana Pfrimer Falcao
       
  • Draft genome sequence of a bla CMY-2/IncI1-harbouring Escherichia coli
           D:ST457 isolated from coastal benthic organisms
    • Abstract: Publication date: September 2018Source: Journal of Global Antimicrobial Resistance, Volume 14Author(s): Fábio P. Sellera, Miriam R. Fernandes, Quézia Moura, Ralf B. Lopes, Tiago A. Souza, Louise Cerdeira, Nilton LincopanAbstractObjectivesMarine bivalves can act as bioindicators of marine environment pollution by multidrug-resistant (MDR) enteric bacteria of medical interest. The aim of this study was to report the draft genome sequence of a plasmid-encoded AmpC (pAmpC) (CMY-2)-carrying Escherichia coli isolate recovered from a marine bivalve sample in the coastal shore of Southeast Brazil.MethodsThe whole genome was sequenced on an Illumina NextSeq platform and was assembled using Velvet v.1.2.10. Data analysis was carried out using tools available from the Center of Genomic Epidemiology and Geneious R10 software.ResultsThe genome size was calculated at 5 198 055 bp, comprising a total of 5316 protein-coding sequences. The strain was assigned to ST457 and presented the blaCMY-2 pAmpC gene. In addition, the strain was clustered into the pathogenic phylogenetic group D.ConclusionThe release of this draft genome sequence can provide valuable information to better understand the dissemination of MDR enteric bacteria in marine environments.
       
  • Draft genome sequences of extended-spectrum β-lactamase-producing
           Enterobacter aerogenes isolated from swine and human
    • Abstract: Publication date: September 2018Source: Journal of Global Antimicrobial Resistance, Volume 14Author(s): Luria Leslie Founou, Raspail Carrel Founou, Mushal Allam, Arshad Ismail, Sabiha Yusuf EssackAbstractObjectivesThe draft genome sequences of two Enterobacter aerogenes strains (HN503E2II and PN108E5IIB) isolated from two Cameroonian abattoirs are reported.MethodsBacterial genomic DNA of the two isolates was sequenced using an Illumina MiSeq platform. Generated reads were de novo assembled using CLC Genomics Workbench and SPAdes. The assembled contigs were annotated, and antibiotic resistance genes, virulence factors and plasmids were identified.ResultsWhole-genome sequencing revealed that both strains were similar, with genomes of 4 878 638 bp and 4 794 257 bp, encoding several resistance genes associated with resistance to β-lactams, fluoroquinolones, aminoglycosides, fosfomycin, phenicols, sulphonamides, trimethoprim, macrolides and tetracycline. In silico analysis also revealed chromosomal integration of one plasmid in the genome of PN108E5IIB.ConclusionThe genome sequences reported here will provide useful information for a better understanding of the genetic structure of E. aerogenes in Africa.
       
  • Draft genome sequence of an extended-spectrum β-lactamase
           (CTX-M-15)-producing Escherichia coli ST10 isolated from a nasal sample of
           an abattoir worker in Cameroon
    • Abstract: Publication date: September 2018Source: Journal of Global Antimicrobial Resistance, Volume 14Author(s): Luria Leslie Founou, Raspail Carrel Founou, Mushal Allam, Arshad Ismail, Sabiha Yusuf EssackAbstractObjectivesHere we report the draft genome sequence of Escherichia coli strain HN503E1II isolated from a nasal sample of an abattoir worker in Cameroon.MethodsBacterial genomic DNA of E. coli HN503E1II was sequenced using an Illumina MiSeq platform. Generated reads were de novo assembled using the Qiagen CLC Genomics Workbench. The assembled contigs were annotated and antibiotic resistance genes, virulence factors, plasmids and the sequence type (ST) were identified.ResultsThe genome comprised a circular chromosome of 4 674 201 bp, with a 50.78% G + C content and several resistance genes associated with resistance to β-lactams, fluoroquinolones, aminoglycosides, sulphonamides, trimethoprim, macrolides and tetracycline. The isolate was assigned to ST10 with 100% identity among the seven housekeeping genes. In silico analysis also revealed the presence six plasmid types and one virulence factor.ConclusionThe genome sequence reported here will provide valuable information for a better understanding of the genetic structure of the E. coli genome in Africa.
       
  • Draft genome sequence of carbapenem-resistant Shewanella algae strain AC
           isolated from small abalone (Haliotis diversicolor)
    • Abstract: Publication date: September 2018Source: Journal of Global Antimicrobial Resistance, Volume 14Author(s): Yao-Ting Huang, Jan-Fang Cheng, Shi-Yu Chen, Yu-Kai Hong, Zong-Yen Wu, Po-Yu LiuAbstractObjectivesShewanella algae is an environmental marine bacterium and an emerging opportunistic human pathogen. Moreover, there are increasing reports of strains showing multidrug resistance, particularly carbapenem-resistant isolates. Although S. algae has been found in bivalve shellfish aquaculture, there is very little genome-wide data on resistance determinants in S. algae from shellfish. The aim of this study was to determine the whole genome sequence of carbapenem-resistant S. algae strain AC isolated from small abalone in Taiwan.MethodsBacterial genomic DNA was sequenced using an Illumina MiSeq platform with 250-bp paired-end reads. De novo genome assembly was performed using Velvet v.1.2.07. The whole genome was annotated and several candidate genes for antimicrobial resistance were identified.ResultsThe genome size was calculated at 4 751 156 bp, with a mean G + C content of 53.09%. A total of 4164 protein-coding sequences, 7 rRNAs, 85 tRNAs and 5 non-coding RNAs were identified. The genome contains genes associated with resistance to β-lactams, trimethoprim, tetracycline, colistin and quinolones. Multiple efflux pump genes were also detected.ConclusionSmall abalone is a potential source of foodborne drug-resistant S. algae. The genome sequence of carbapenem-resistant S. algae strain AC isolated from small abalone will provide valuable information for further study of the dissemination of resistance genes at the human–animal interface.
       
  • Complete genome sequence of Achromobacter spanius type strain DSM 23806T,
           a pathogen isolated from human blood
    • Abstract: Publication date: September 2018Source: Journal of Global Antimicrobial Resistance, Volume 14Author(s): Gengmi Li, Li Yang, Tao Zhang, Xiaojiao Guo, Jian Qin, Yingjiang Cao, Qianhua Yang, Shumei You, Guoliang Yuan, Xianqi Wan, Jing Luo, Zhaoxiang Li, Lei Gao, Ying Liu, Kaifeng Jiang, Jiakui ZhengAbstractObjectivesAchromobacter spanius is a newly described, non-fermenting, Gram-negative, coccoid pathogen isolated from human blood. Whole-genome sequencing of the A. spanius type strain was performed to investigate the mechanism of pathogenesis of this strain at a genomic level.MethodsThe complete genome of A. spanius type strain DSM 23806T was sequenced using single-molecule real-time (SMRT) DNA sequencing.ResultsThe complete genome of DSM 23806T consists of one circular DNA chromosome of 6 425 783 bp with a G + C content of 64.26%. The entire genome contains 5804 predicted coding sequences (CDS) and 55 tRNAs. Genomic island (GI) analysis showed that this strain encodes several important pathogenesis- and resistance-related genes.ConclusionsThese results strongly suggest that GIs provide some fitness advantages in A. spanius type strain DSM 23806T. This report provides an extensive understanding of A. spanius at a genomic level as well as an understanding of the evolution of A. spanius.
       
  • Detection of qnrVC6, within a new genetic context, in an NDM-1-producing
           Citrobacter freundii clinical isolate from Uruguay
    • Abstract: Publication date: September 2018Source: Journal of Global Antimicrobial Resistance, Volume 14Author(s): Inés Bado, Romina Papa-Ezdra, Nicolás Cordeiro, Matilde Outeda, Leticia Caiata, Virginia García-Fulgueiras, Verónica Seija, Rafael VignoliAbstractObjectivesThe objective of this study was to characterise the mechanisms underlying quinolone and oxyimino-cephalosporin resistance in a Citrobacter freundii clinical isolate obtained from the ICU in a university hospital in Uruguay.MethodsCitrobacter freundii strain CF638 was isolated from a urine culture. Identification was performed using a VITEK®2 system, and antimicrobial susceptibility was established by MIC determination and disk diffusion assay. Resistance genes and mobile genetic elements were identified by PCR and sequencing. Plasmid transfer was assessed by conjugation and the plasmid size was estimated by S1-PFGE. Plasmid incompatibility (Inc) group and toxin-antitoxin systems were sought by PCR.ResultsStrain CF638 showed a multidrug-resistant profile, including resistance to carbapenems and quinolones. Transconjugant TcCF638, harbouring an ca. 200-kb IncA/C plasmid, also showed resistance to all β-lactams (except aztreonam) and diminished susceptibility to ciprofloxacin. PCR was positive for blaNDM-1 and qnrVC in CF638 and TcCF638. Two different class 1 integrons were detected (In127 and In907). In127 featured the genetic array aadA2–ltr2. Conversely, complex In907 featured two variable regions (VRs); VR-1 consisted of aadB–blaOXA-10–aadA1cc, whereas VR-2 featured a qnrVC6 gene 108 bp downstream from ISCR1 and 45 bp upstream from qacEΔ1. Expression of qnrVC6 was due to a putative promoter region, detected using the Neural Network Promoter Prediction program.ConclusionTo the best of our knowledge, this constitutes the first report of qnrVC within a complex class 1 integron, as well as the first report of the occurrence of such a gene in an NDM-1-producing enterobacterial clinical isolate.
       
  • Molecular characterisation of extended-spectrum β-lactamase-producing
           Gram-negative bacterial isolates from surgical wounds of patients at a
           hospital in North Central Nigeria
    • Abstract: Publication date: September 2018Source: Journal of Global Antimicrobial Resistance, Volume 14Author(s): Ahmed Olowo-okere, Yakubu Kokori Enevene Ibrahim, Busayo Olalekan OlayinkaAbstractObjectivesThis study aimed to characterise extended-spectrum β-lactamase (ESBL)-producing Gram-negative bacterial isolates from patients with surgical site infections (SSIs) at a tertiary healthcare facility in Abuja, Nigeria.MethodsConsecutive, non-duplicate wound swabs were collected over a 3-month period from wounds of patients with SSI and were cultured appropriately. Bacterial isolates were identified using rapid identification kits. The modified agar disk diffusion method was used for antimicrobial susceptibility testing, and phenotypic ESBL activity of the isolates was determined using the double-disk synergy test (DDST). PCR was thereafter used for molecular characterisation of the isolates.ResultsA total of 57.1% (20/35) of the bacterial isolates were Gram-negative, with Pseudomonas aeruginosa (7/20; 35.0%) being the most prevalent. The isolates exhibited varying degree of antimicrobial resistance, with resistance as high as 100% for ampicillin and amoxicillin. Phenotypic ESBL production was observed in 65.0% (13/20) of the Gram-negative bacterial isolates. DNA analysis revealed that 61.5%, 53.8% and 38.5% of the isolates harboured blaSHV, blaCTX-M and blaTEM genes, respectively, with 30.8% of the isolates co-harbouring blaSHV and blaCTX-M. Similarly, 23.1% of the isolates harboured blaSHV and blaTEM, whilst 15.4% harboured blaCTX-M and blaTEM. However, none of the investigated isolates harboured a blaOXA gene.ConclusionThe prevalence of ESBL genes among Gram-negative SSI pathogens is high. This calls for an urgent need to review infection control policies and antimicrobial prescription patterns as well as increased surveillance of ESBLs as the possibility of an epidemic outbreak of multidrug-resistant pathogens in the hospital is high.
       
  • Occurrence of bla CMY-42 on an IncI1 plasmid in multidrug-resistant
           Escherichia coli from a tertiary referral hospital in India
    • Abstract: Publication date: September 2018Source: Journal of Global Antimicrobial Resistance, Volume 14Author(s): Birson Ingti, Pranjit Saikia, Deepjyoti Paul, Anand Prakash Maurya, Debadatta Dhar (Chanda), Atanu Chakravarty, Chandrayee Deshamukhya, Amitabha BhattacharjeeAbstractObjectivesPlasmids of different replicon types are believed to be associated with the carriage and transmission of antimicrobial resistance genes. The present study was undertaken to examine the association of blaCIT with particular plasmid types and to identify Escherichia coli strains involve in the maintenance of this resistance determinant in the plasmid.MethodsPhenotypic screening of AmpC β-lactamases was performed by the modified three-dimensional extract method, followed by antimicrobial susceptibility testing and determination of minimum inhibitory concentrations (MICs). Genotyping screening of β-lactamase genes was performed by PCR assay, followed by sequencing. Transferability of the blaCMY gene was performed by transformation and conjugation experiments. Plasmid incompatibility typing and DNA fingerprinting by enterobacterial repetitive intergenic consensus (ERIC)-PCR were performed.ResultsAmong 203 E. coli obtained from different clinical specimens (pus, urine, stool and sputum), 37 were detected as harbouring the blaCIT gene and sequencing of this gene showed nucleotide sequence similarity with the blaCMY-42 variant. This study revealed IncI1-type plasmids as carriers of blaCMY-42 and its propagation within E. coli ST5377, ST361 and ST672. According to the stability results, the blaCMY-42-encoding plasmid can be maintained in E. coli strains for a longer duration without any antimicrobial pressure.ConclusionsThese finding document blaCMY-42 on IncI1-type plasmids, which are considered to be the main vehicles for the spread of blaCMY-42 in this hospital setting. Thus, a proper strategy should be developed to curb the expansion of IncI1-type plasmids in the hospital and community environment.
       
  • Rezafungin (CD101), a next-generation echinocandin: A systematic
           literature review and assessment of possible place in therapy
    • Abstract: Publication date: September 2018Source: Journal of Global Antimicrobial Resistance, Volume 14Author(s): Amelia K. Sofjan, Ardath Mitchell, Dhara N. Shah, Tam Nguyen, Mui Sim, Ashley Trojcak, Nicholas D. Beyda, Kevin W. GareyObjectivesRezafungin (CD101) is a novel echinocandin currently under development. The purpose of this study was to perform a systematic literature review of published evidence on rezafungin and an antimicrobial stewardship audit of real-world use of echinocandins to determine areas of unmet medical needs and potential places in therapy for rezafungin.MethodsThe systematic literature review identified 8 peer-reviewed manuscripts and 19 separate abstracts. A stewardship audit was performed on hospitalised patients receiving echinocandins to better understand potential future areas of use for rezafungin.ResultsRezafungin is a cyclic hexapeptide with a lipophilic tail derived from anidulafungin, with a choline moiety at the C5 ornithine position resulting in increased in vitro and in vivo stability compared with other echinocandins. Microbiological data showed similar susceptibility and resistance development between rezafungin and other echinocandins. Rezafungin has a long half-life (80 h) and a favourable safety profile that allows for high doses (up to 400 mg) given once weekly. A phase 2 study is ongoing. The antimicrobial stewardship audit of echinocandin identified several areas of possible use for rezafungin, including patients receiving daily echinocandins for>7 days, patients who remained in the hospital to complete a full course of daily echinocandin therapy, and patients who required an echinocandin scheduled via an infusion clinic after discharge.ConclusionRezafungin is a novel echinocandin currently in phase 2 studies, differentiated by a long half-life that allows once-weekly dosing and a safety profile that allows higher doses. Several potential areas of use for rezafungin were identified.
       
  • Molecular characterisation of multidrug-resistant pneumococcal clones
           colonising healthy children in Mérida, Venezuela
    • Abstract: Publication date: September 2018Source: Journal of Global Antimicrobial Resistance, Volume 14Author(s): Beatríz Quintero Moreno, María AraqueAbstractGenetic mechanisms of resistance, clonal composition and the occurrence of pili were analysed in 48 multidrug-resistant (MDR) pneumococci isolated from healthy children in Mérida, Venezuela. Intermediate resistance to penicillin was related to variations in pbp2b and pbp2x. High-level resistance to penicillin as well as low susceptibility to cephalosporins and carbapenems were associated with alterations in pbp1a, pbp2b and pbp2x. Non-β-lactam resistance was associated with Tn3872, Tn5253, Tn6002 and Tn2010 transposons. Macrolide-resistant strains carried ermB or mefE, but not mefA. Tetracycline- and chloramphenicol-resistant pneumococci carried tetM and cat, respectively. MDR pneumococci were related to six clonal complexes (CCs), largely CC156 or CC15. Limited diversity in pbp2a,2b,2x-RFLP profiles within each clone was observed. Conversely, detection of non-β-lactam resistance and transposons revealed clear genetic diversity within clones. A group of non-typeable/cpsA-negative pneumococci related to the null capsule clade 1 (NCC1) carrying a Tn2009 element was found. Each NCC1-related strain showed a novel MLST allelic combination and a different pbp2a,2b,2x-RFLP profile. PI-1 (pilus type 1 rrgC gene) was present in most of the MDR pneumococci and its occurrence was commonly homogeneous within each clone. PI-1 was present in all CC242 and CC320 pneumococci, whereas it was absent in all CC37, CC81 and NCC1 isolates. CC156 and CC15 isolates showed variations in the occurrence of PI-1. Both PI-1 and the islet for pilus type 2 were present in CC320 isolates. We provide useful data to follow the evolution of clonal composition, mechanisms of antibiotic resistance and the occurrence of pili among pneumococci circulating in Mérida.
       
  • Draft genome sequences of two ciprofloxacin-resistant Salmonella enterica
           subsp. enterica serotype Kentucky ST198 isolated from retail chicken
           carcasses in Egypt
    • Abstract: Publication date: September 2018Source: Journal of Global Antimicrobial Resistance, Volume 14Author(s): Hazem Ramadan, Sushim K. Gupta, Poonam Sharma, Khalid I. Sallam, Lari M. Hiott, Hagar Elsayed, John B. Barrett, Jonathan G. Frye, Charlene R. JacksonAbstractObjectivesSalmonella enterica serotypes, particularly antimicrobial-resistant strains, pose a major threat to public health worldwide. This study describes the draft genome sequences of two ciprofloxacin-resistant Salmonella enterica subsp. enterica serotype Kentucky isolates (H5 and H18) recovered from chicken carcass rinsates in Mansoura, Egypt.MethodsAntimicrobial susceptibility phenotypes were determined for the two Salmonella Kentucky isolates by broth microdilution using a Sensititre™ system. Genomic DNA from both isolates was sequenced using an Illumina MiSeq system. Antimicrobial resistance genes were identified using ARG-ANNOT, and multilocus sequence typing (MLST) was performed using MLST 1.8.ResultsThe draft genome for Salmonella Kentucky H5 contained 4.84 Mbp in 54 contigs, and that for Salmonella Kentucky isolate H18 contained 4.94 Mbp in 64 contigs. Sequence analysis using ARG-ANNOT identified the presence of the resistance genes blaTEM-57, aadA1, aadA2, cmlA1, sul3 and tetA in both isolates, whereas dfrA, sul2, floR, and aph(3)-Ia were found in isolate H18 only. The amino acid substitutions Ser83Phe and Asp87Gly in GyrA and Thr57Ser and Ser80Ile in ParC were detected in both isolates. Both isolates belonged to ST198.ConclusionThe draft genome sequences allowed identification of a ciprofloxacin-resistant Salmonella Kentucky ST198 epidemic clone with multidrug resistance in poultry products produced for human consumption in Egypt. These data indicate that poultry continues to be a reservoir for this persistent clone.
       
  • Risk factors for Pseudomonas aeruginosa infections in Asia-Pacific and
           consequences of inappropriate initial antimicrobial therapy: A systematic
           literature review and meta-analysis
    • Abstract: Publication date: September 2018Source: Journal of Global Antimicrobial Resistance, Volume 14Author(s): Sanjay Merchant, Emma M. Proudfoot, Hafsa N. Quadri, Heather J. McElroy, William R. Wright, Ankur Gupta, Eric M. SarpongAbstractObjectivesTreating infections of Gram-negative pathogens, in particular Pseudomonas aeruginosa, is a challenge for clinicians in the Asia-Pacific region owing to inherent and acquired antimicrobial resistance. This systematic review and meta-analysis provides updated information on risk factors for P. aeruginosa infection in Asia-Pacific as well as the consequences (e.g. mortality, costs) of initial inappropriate antimicrobial therapy (IIAT).MethodsEmbase and MEDLINE databases were searched for Asia-Pacific studies reporting the consequences of IIAT versus initial appropriate antimicrobial therapy (IAAT) in Gram-negative bacterial infections as well as risk factors for serious P. aeruginosa infection. A meta-analysis of unadjusted mortality was performed using a random-effects model.ResultsA total of 22 studies reporting mortality and 13 reporting risk factors were identified. The meta-analysis demonstrated that mortality was significantly lower in patients receiving IAAT versus IIAT, with a 67% reduction observed for 28- or 30-day all-cause mortality (odds ratio = 0.33, 95% confidence interval 0.20–0.55; P 
       
  • Intestinal microbiota as a reservoir of extended-spectrum
           β-lactamase-producing Escherichia coli: An exploratory study in healthy
           university students
    • Abstract: Publication date: September 2018Source: Journal of Global Antimicrobial Resistance, Volume 14Author(s): Raquel Mota, Marisa Pinto, Josman Palmeira, Daniela Gonçalves, Helena Ferreira
       
  • Transmission of IMI-2 carbapenemase-producing Enterobacteriaceae
           from river water to human
    • Abstract: Publication date: Available online 6 July 2018Source: Journal of Global Antimicrobial ResistanceAuthor(s): Chrislène Laurens, Hélène Jean-Pierre, Patricia Licznar-Fajardo, Stefaniya Hantova, Sylvain Godreuil, Orianne Martinez, Estelle Jumas-BilakAbstractObjectiveCarbapenemase-producing Enterobacteriaceae (CPE) are increasing worldwide in human infections. The role of rivers as reservoirs is underlined but the transmission from environment to human is not documented. A human case of bacteremia caused by IMI-2 carbapenemase-producing Enterobacter asburiae after massive river water exposition was submitted to microbiological investigations with the aim to decipher the origin and the mechanism of the infection.MethodsClinical and environmental bacterial strains were compared by resistotyping and genomotyping using Pulse-Field Gel Electrophoresis (PFGE). PFGE was also used for IMI-2 carbapenemase gene location. Patient’s microbiota and river bacterial communities were compared by fingerprinting using 16S rRNA gene PCR-Temporal Temperature Gel Electrophoresis.ResultsE. asburiae causing bacteremia carried a plasmidic blaIMI-2 gene as E. asburiae strains detected in river water one month later. Clinical and river strains displayed identical PFGE profiles. Community fingerprinting showed the persistance in the patient’s microbiota of carbapenem resistant bacteria, which are also autochtonous in the river community: E. asburiae, Aeromonas veronii and Pseudomonas fluorescens.ConclusionWe have identified for the first time the presence of an IMI-2 producing E. asburiae in a river in South of France and suggested the transmission from river to human probably after intestinal translocation. General insights into transmission of CPE from environment to human are gained from this case. Considering the rapid spread of CPE in human, the risk for transfer from environmental reservoir to human microbiota should be thoroughly investigated at least by implementing the environmental surveillance of carbapenems resistance.
       
  • Outbreak of hypervirulent Klebsiella pneumoniae harboring bla VIM-2 among
           mechanically ventilated drug poisoning patients with high mortality
           outcome in Iran
    • Abstract: Publication date: Available online 4 July 2018Source: Journal of Global Antimicrobial ResistanceAuthor(s): Amir Mohammad Ali Tabrizi, Farzad Badmasti, Fereshteh shahcheraghi, Omid AziziAbstractObjectivesCarbapenem-resistant Klebsiella pneumoniae (CRKP) infections are associated with increased rate of treatment failure and death. Several studies have reported isolates with combined hypervirulent and antibiotics resistance phenotype.MethodsHerein, we studied molecular characteristics of hypervirulent K. pneumoniae isolated from mechanically ventilated patients admitted to toxicological ICU. String test, antibiotic susceptibility, virulence factors and plasmid replicon typing were carried out. Finally, clonal relatedness of isolates were analyzed by PFGE and MLST.ResultsIn this study, hypervirulent K. pneumoniae (hvKP) accounted for 9.4% (5/53) of K. pneumoniae isolated from ventilator-associated pneumonia (VAP) among patients admitted to ICU with acute drug poisoning. The mortality rate were 7.54% (4/53) among KP infected patients. All fatal KP were hvKP isolates and resistant to imipenem and harbored aacA7, blaVIM-2 and dhfrI cassettes arrangement in class 1 integron. Isolates were shown Pasteur’s MLST ST23 and exhibited similar PFGE patterns. Plasmid analysis revealed class 1 integron harbored blaVIM-2 located on ∼45 Kb plasmid with IncN incompatibility group.DiscussionIn the present study, we described emergence of VIM-2-producing hypervirulent K. pneumoniae serotype K1/ST23 in outbreak with high mortality in the hospital’s toxicological ICU. It seems that we must alert and prepare our surveillance system for appearance, expansion and clinical importance of new clones of K. pneumoniae associated with highly antimicrobial resistance and robust virulence capabilities.
       
  • Whole genome sequencing of a CTX-M-11-encoding and quinolone
           non-susceptible Klebsiella pneumoniae ST194 isolated from a hospitalized
           dog in Greece
    • Abstract: Publication date: Available online 4 July 2018Source: Journal of Global Antimicrobial ResistanceAuthor(s): Fani Chatzopoulou, Georgios Meletis, Giulia Polidoro, Ioannis L. Oikonomidis, Irene Dimopoulou, Ilias Mavrovouniotis, Tilemahos L. AnagnostouAbstractObjectivesThe emergence and spread of transferable beta-lactamases among the Enterobacteriaceae is a major problem to both human and veterinary medicine and an important contributing factor to the development of multi-drug-resistant bacterial strains. In the present study, we performed the whole genome sequencing of a Klebsiella pneumoniae resistant to first and second generation cephalosporins and non-susceptible to fluoroquinolones, isolated from a urine sample of a hospitalized dog.MethodsThe genome sequencing was performed on Illumina MiniSeq. Multilocus sequence typing was determined using a BLAST-based approach whereas antimicrobial resistance genes and plasmid replicons were identified by ResFinder and PlasmidFinder respectively. The Rapid Annotation System Technology server v2.0 was used for genome annotation.ResultsData analyses revealed the complete resistome of the isolate which included the cefotaximase-München-11 (CTX-M-11) extended spectrum beta-lactamase together with other eleven resistance genes. Ten resistance genes were located on plasmids and two on the chromosome.ConclusionsTo the best of our knowledge, this is the first detection of a CTX-M-11-producing K. pneumoniae isolated from canine. The whole genome sequence of the isolate has been deposited at GenBank to serve as future reference.
       
  • Micafungin use in a UK tertiary referral hospital
    • Abstract: Publication date: Available online 30 June 2018Source: Journal of Global Antimicrobial ResistanceAuthor(s): David A Enoch, Michael E Murphy, Christianne Micallef, Huina Yang, Nicholas M Brown, Sani H AliyuAbstractObjectiveWe sought to describe the real-life usage of micafungin in our hospital.MethodsWe performed a prospective non-interventional observational surveillance study in a large teaching hospital.ResultsWe commenced micafungin in 174 courses involving 148 patients to treat invasive candidiasis and candidaemia (131 courses) and aspergillosis in situations where alternatives such as voriconazole or liposomal amphotericin B could not be used (42 courses). Fungal infection was defined as proven as per EORTC guidelines in 84 courses (49%). Micafungin was well tolerated; 10 patients (7%) developed a rise in ALT and only one patient stopped therapy due to this. Therapy was rationalised to fluconazole in 77 courses (44%). There were no differences in ICU admission or deaths when comparing all 174 courses where patients received micafungin for aspergillus and candida infection respectively (49% versus 42%, p = 0.82 and 24% versus 15%, p = 0.186). One patient developed disseminated mucormycosis and four patients had recurrent candidaemia (attributed to poor source control) whilst receiving micafungin.ConclusionsWe conclude that micafungin was clinically effective for the treatment of invasive candida and aspergillus infections and that usage did not increase the risk of liver dysfunction even in patients with abnormal ALT at baseline.
       
  • OqxAB and variants of QepA in extended-spectrum beta-lactamase-producing
           Enterobacteriaceae in hospital wastewater in Mali
    • Abstract: Publication date: Available online 30 June 2018Source: Journal of Global Antimicrobial ResistanceAuthor(s): Aminata Maiga, Anaëlle Muggeo, Matthieu Daragon, Ibrahim Maiga, Lucien Brasme, Véronique Vernet-Garnier, Mireille Dosso, Christophe de Champs, Thomas Guillard
       
  • Absence of fosfomycin resistance in gastrointestinal Escherichia coli
           after fosfomycin therapy
    • Abstract: Publication date: Available online 30 June 2018Source: Journal of Global Antimicrobial ResistanceAuthor(s): Roberta T. Mettus, Sarah L. Bowler, Serena F. Kantz, Christi L. Mcelheny, A. William Pasculle, Yohei Doi
       
  • Population structure of OXA-48-producing Klebsiella pneumoniae ST405
           isolates during a hospital outbreak characterized by genomic typing
    • Abstract: Publication date: Available online 22 June 2018Source: Journal of Global Antimicrobial ResistanceAuthor(s): Elena López-Camacho, José Ramón Paño-Pardo, Guillermo Ruiz-Carrascoso, Jan-Jaap Wesselink, Silvia Lusa-Bernal, Ricardo Ramos-Ruiz, Susana Ovalle, Rosa Gómez-Gil, Verónica Pérez-Blanco, María Pérez-Vázquez, Paulino Gómez-Puertas, Jesús MingoranceAbstractObjectivesTo study the structure of a broad and sustained hospital outbreak of OXA-48-producing Klebsiella pneumoniae belonging to ST405.MethodsWhole-genome sequencing and comparison of ten ST405 isolates obtained from clinical samples in our hospital. Thirty six single nucleotide polymorphisms (SNPs) were detected (range 0 to 21 in pairwise comparisons) and allele-specific PCR was used to call the SNPs among a larger set of isolates.ResultsSeveral haplotypes were identified within the population. The haplotypes did not show a spatial structure, but a temporal evolution sequential haplotype replacements was observed.ConclusionsThe disperse spatial distribution suggests a reservoir formed by a large pool of colonized patients, and the temporal replacement pattern suggests that the sustained-outbreak is composed by several small outbreaks that appeares and rapidly dispersed to several units.
       
  • Prevalence of colistin resistance gene mcr-1 in colistin-resistant
           Escherichia coli and Klebsiella pneumoniae isolated from humans in
           Thailand
    • Abstract: Publication date: Available online 20 June 2018Source: Journal of Global Antimicrobial ResistanceAuthor(s): Warawan Eiamphungporn, Sakda Yainoy, Chakornpat Jumderm, Rachanis Tan-arsuwongkul, Surapee Tiengrim, Visanu ThamlikitkulAbstractObjectivesColistin has historically been considered a last-line therapeutic option against multidrug-resistant (MDR) Gram-negative bacterial infections. However, chromosomally-encoded and plasmid-mediated colistin resistance is increasingly being reported worldwide. The spread of the plasmid-borne colistin resistance gene mcr-1 is of great concern since it can be transferred among bacteria. The aim of this study was to investigate the prevalence of colistin resistance gene mcr-1 in E. coli and K. pneumoniae collected from human clinical specimens in Thailand.MethodsThe minimum inhibitory concentration (MIC) of colistin by broth microdilution (BMD) method was determined in 317 non-duplicate isolates (37 E. coli and 280 K. pneumoniae). All isolates were screened for the mcr-1 gene using polymerase chain reaction (PCR).ResultsThe colistin MIC50, MIC90, and MIC range among the 37 E. coli isolates was 0.5, 8, and 0.5–32 mg/L, respectively. The mcr-1 gene was detected in 11 E. coli isolates (29.73%). E. coli isolates with the mcr-1 gene had a colistin MIC range of 4–32 mg/L. The colistin MIC50, MIC90, and MIC range among the 280 K. pneumoniae isolates was 32, >128, and 0.25 to>128 mg/L, respectively. The mcr-1 gene was detected in 4 K. pneumoniae isolates (1.43%). K. pneumoniae isolates with the mcr-1 gene had a colistin MIC range of 4–64 mg/L.ConclusionsThis is the first report on the prevalence of the colistin resistance gene mcr-1 in colistin-resistant E. coli and K. pneumoniae isolated from humans in Thailand. This data provides added insight into the mechanism of colistin resistance among Enterbacteriaceae pathogens.
       
  • Transcriptomic study on persistence and survival of Listeria monocytogenes
           following lethal treatment with Nisin
    • Abstract: Publication date: Available online 19 June 2018Source: Journal of Global Antimicrobial ResistanceAuthor(s): Shuyan Wu, Pak-Lam Yu, Dave Wheeler, Steve FlintAbstractObjectivesThe aim of this study was to determine the gene expression associated with the persistence of a Listeria monocytogenes stationary phase population when facing lethal nisin treatmentMethodsRNA Seq analysis was used for gene expression profiling of the persister cells in rich medium (persister TN) compared with untreated cells (non-persister).The results were confirmed using RT PCR.ResultsFunctional genes associated with the persister populations were identified in multiple systems, such as heat shock related stress response, cell wall synthesis, ATP-binding cassette (ABC) transport system, phosphotransferase system (PTS system), and SOS/DNA repair.ConclusionsThis study pointed to genetic regulation of persister cells exposed to lethal nisin and provides some insight into possible mechanisms of impeding bacterial persistence.
       
  • Antimicrobial susceptibility, microbiological and epidemiologic
           characteristics of hypermucoviscous Klebsiella pneumoniae strains in a
           tertiary hospital at Hangzhou in China
    • Abstract: Publication date: Available online 6 June 2018Source: Journal of Global Antimicrobial ResistanceAuthor(s): Chen Qiong, Zhou Jia-wei, Qiu Chun-ning, Wang Min-min, Wang Xian-jun, Ruan Zhi, Fan Jian-zhongAbstractObjectivesHypermucoviscous Klebsiella pneumoniae (HMKP) has been increasingly recovered in clinical isolates. This study sought to examine the microbiological and epidemiologic characteristics of HMKP strains in a tertiary hospital at Hangzhou in China.MethodsHMKP isolates were collected and identified via matrix-assisted laser desorption/ionization time of flight mass spectrometry (MALDI-TOF). A string test was performed for the hypermucoviscous phenotype. Antimicrobial susceptibility to antibiotic agents was determined. Multilocus sequence typing, capsular serotypes and virulence-associated genes of HMKP isolates were assessed.ResultsForty-two HMKP strains with positive string tests were collected. Thirty-two (76.2%) HMKP isolates were carbapenem-susceptible (CS-HMKP) and ten (23.8%) HMKP isolates were carbapenem-resistant (CR-HMKP). CS-HMKP strains were more susceptible to antibiotics than CR-HMKP strains. K1 (50%) and K2 (12.5%) were the main capsular serotypes of all HMKP isolates. K57 was first reported in the CR-HMKP strain. ST163 was the main sequence type (50%) of CS-HMKP strains, while ST11 was a unique sequence type of CR-HMKP strains. The regulator of the mucoid phenotype gene rmpA and other virulence factors (allS, kfu, iutA, entB, iroN, fimH and wabG) were present in more than 80% of the HMKP strains. Patients with CR-HMKP strains had a higher mortality rate than those with CS-HMKP strains.ConclusionK1 and K2 were the main capsular serotypes of these HMKP strains. The emergence of carbapenem-resistant HMKP should be a concern, as it had an increased mortality rate, especially with ST11 CR-HMKP strains, demonstrating the global epidemic of carbapenem resistance.
       
  • Identification of bla DIM-1 metallo-β-lactamase gene in Pseudomonas
           aeruginosa isolated from Tamil Nadu, India
    • Abstract: Publication date: June 2018Source: Journal of Global Antimicrobial Resistance, Volume 13Author(s): Prasanth Manohar, Subramanian Babu, Bulent Bozdogan, Nachimuthu Ramesh
       
  • Draft genome of a ST443 mcr-1- and bla CTX-M-2-carrying Escherichia coli
           from cattle in Brazil
    • Abstract: Publication date: June 2018Source: Journal of Global Antimicrobial Resistance, Volume 13Author(s): Josman Dantas Palmeira, Helena Ferreira, Jean-Yves Madec, Marisa HaenniAbstractObjectivesColistin is used in Brazil for the treatment of food-producing animals. The colistin resistance gene mcr-1 has already been reported from chicken and swine in this country. Here we report the draft genome of an Escherichia coli isolate presenting both an extended-spectrum β-lactamase (ESBL) gene and the mcr-1 gene in a healthy cow in Brazil.MethodsWhole genomic DNA from E. coli E12 was extracted and 2× 150-bp paired-end reads were generated using Illumina sequencing technology. De novo genome assembly was performed using SPAdes v.3.11 and the draft genome was annotated using the NCBI Prokaryotic Genome Annotation Pipeline (PGAP). Further analyses were performed using Center for Genomic Epidemiology databases. Southern blots were performed to characterise plasmid location.ResultsThe 5 024 393-bp genome displayed several resistance genes, including the mcr-1 and blaCTX-M-2 genes. These two genes were located on different plasmids (mcr-1 on an IncX4 plasmid and blaCTX-M-2 on an IncF plasmid).ConclusionThe genome sequence reported here can be compared with previously published genomes for mcr-1-producing isolates. This will ultimately help to understand the routes of dissemination of the resistance genes.
       
  • Genome sequence and analysis of Mycobacterium tuberculosis strain
           SWLPK
    • Abstract: Publication date: June 2018Source: Journal of Global Antimicrobial Resistance, Volume 13Author(s): Muhammad Ibrahim, Asma Muhammad Yar, Ghunva Zaman, Changhui Yan, Muhammad Khurshid, Habib BokhariAbstractObjectivesMultidrug-resistant Mycobacterium tuberculosis poses a global threat, particularly in developing countries such as Pakistan. Genome sequencing, comparative genomic analysis and drug resistance gene analysis could be beneficial for understanding and monitoring M. tuberculosis disease severity in Pakistan by elucidating the biology of M. tuberculosis.MethodsHere the draft genome of M. tuberculosis strain SWLPK was sequenced, assembled and annotated using an Illumina MiSeq system. De novo genomic assembly was conducted using Geneious Pro™ v.10. The assembled genome of strain SWLPK was annotated using the Rapid Annotation using Subsystem Technology (RAST) server, tRNAscan-SE 1.21 and RNAmmer v.1.2, which provide high-quality functional annotation.ResultsMycobacterium tuberculosis strain SWLPK yielded an average read depth of 68.5-fold, which covered 97% of the genome of reference strain H37Rv. The genome contains 4305 protein-coding genes, including key drug resistance and virulence-associated genes such as type seven secretion systems. Additionally, it has a 65.6% GC content and contains 48 RNAs and 12 contigs. We determined that all proteins encoded by this strain contain conserved domains, except OxyR, which is associated with first-line antituberculosis drugs such as ethambutol, rifampicin, streptomycin, pyrazinamide and isoniazid.ConclusionsThis genome sequence provides information regarding the drug resistance genes and virulence propensity of M. tuberculosis strain SWLPK. Strain SWLPK appears to be multidrug-resistant, similar to the Beijing genotype, as it clusters in the same group. These findings will pave the way for genomic characterisation, which will provide further insights into adaptation and evolution in human hosts by transcriptome studies and gene manipulation.
       
  • Whole genome sequence of an MCR-1-carrying, extended-spectrum β-lactamase
           (ESBL)-producing Escherichia coli ST746 isolate recovered from a
           community-acquired urinary tract infection
    • Abstract: Publication date: June 2018Source: Journal of Global Antimicrobial Resistance, Volume 13Author(s): Lingjiao Wu, Jing Chen, Li Wang, Zhe WuAbstractObjectivesColistin is regarded as one of the last-resort antimicrobials for severe infections. Isolates carrying the plasmid-borne mobile colistin resistance gene mcr-1 were rarely reported in community-acquired infections. Here we report the draft genome sequence of an MCR-1-carrying, extended-spectrum β-lactamase (ESBL)-producing Escherichia coli isolate from community-acquired urinary tract infection.MethodsAntimicrobial susceptibility testing (AST) was performed by the broth microdilution method. Transferability of the mcr-bearing plasmid was determined by filter mating using E. coli EC600 as recipient strain. Multilocus sequence typing (MLST) was undertaken using the E. coli MLST database. The draft genome sequence of isolate LX13 was obtained using an Illumina HiSeq X-Ten platform. The genome was assembled using SOAPdenovo. Acquired antimicrobial resistance genes were identified using ResFinder 2.1.ResultsAST showed that LX13 was resistant to ampicillin, amoxicillin/clavulanic acid, piperacillin/tazobactam, cefazolin, cefepime and polymyxins. MLST showed that isolate LX13 belongs to ST746. The MCR-1-producing plasmid was conjugative and conferred increased resistance to colistin the transconjugant. The draft genome of E. coli LX13 was 4 914 035 bp in size. In silico analysis revealed the presence of eight putative acquired resistance genes, including blaCTX-M-14, blaTEM-1B, aadA5, mcr-1, dfrA17, sul2, tet34 and tetA. plasmidSPAdes revealed that the mcr-1 gene was harboured by a plasmid of replicon type IncI2.ConclusionsThis study highlights the potential risk of spread of MCR-1-carrying, ESBL-producing E. coli in the community. The genome sequence of E. coli LX13 will facilitate the understanding of colistin resistance mechanisms and genomic features of clinically isolated colistin-resistant E. coli.
       
  • Draft genome sequence of field isolate Brucella melitensis strain
           2007BM/1 from India
    • Abstract: Publication date: June 2018Source: Journal of Global Antimicrobial Resistance, Volume 13Author(s): D.K. Singh, Bablu Kumar, Garima Shrinet, R.P. Singh, Aparajita Das, B.G. Mantur, Abhishek, Aruna Pandey, Piyali Mondal, B.K. Sajjanar, Soni Doimari, Vijayata Singh, Reena Kumari, A.K. Tiwari, Ravi kumar GandhamAbstractObjectivesBrucellosis is among one of the most widespread important global zoonotic diseases that is endemic in many parts of India. Brucella melitensis is supposed to be the most pathogenic species for humans. Here we report the draft genome sequence of B. melitensis strain 2007BM/1 isolated from a human in India.MethodsGenomic DNA was extracted from Brucella culture and was sequenced using an Illumina MiSeq platform. The generated reads were assembled using three de novo assemblers and the draft genome was annotated.ResultsThis monoisolate, with a genome length of 3 268 756 bp, was found to be resistant to azithromycin and trimethoprim/sulfamethoxazole but susceptible to tetracycline, ofloxacin, rifampicin, ciprofloxacin and doxycycline. The presence of virulence genes in the strain was identified.ConclusionsThe results obtained will help in understanding drug resistance mechanisms and virulence factors in highly zoonotic B. melitensis and suggest the need for judicious use of antibiotics in livestock health and management practices.
       
  • Draft genome sequence of Escherichia coli ST977: A clinical
           multidrug-resistant strain harbouring bla NDM-3 isolated from a
           bloodstream infection
    • Abstract: Publication date: June 2018Source: Journal of Global Antimicrobial Resistance, Volume 13Author(s): Xi Li, Long Sun, Yongze Zhu, Mengyuan Shen, Yuexing TuAbstractObjectivesThe emergence of carbapenem-resistant Escherichia coli has become a serious challenge to manage in the clinic because of multidrug resistance. Here we report the draft genome sequence of NDM-3-producing E. coli strain NT1 isolated from a bloodstream infection in China.MethodsWhole genomic DNA of E. coli strain NT1 was extracted and was sequenced using an Illumina HiSeq™ X Ten platform. The generated sequence reads were assembled using CLC Genomics Workbench. The draft genome was annotated using Rapid Annotation using Subsystem Technology (RAST). Bioinformatics analysis was further performed.ResultsThe genome size was calculated at 5,353 620 bp, with 5297 protein-coding sequences and the presence of genes conferring resistance to aminoglycosides, β-lactams, quinolones, macrolides, phenicols, sulphonamides, tetracycline and trimethoprim. In addition, genes encoding virulence factors were also identified.ConclusionsTo our knowledge, this is the first report of an E. coli strain producing NDM-3 isolated from a human bloodstream infection. The genome sequence will provide valuable information to understand antibiotic resistance mechanisms and pathogenic mechanisms in this strain. Close surveillance is urgently needed to monitor the spread of NDM-3-producing isolates.
       
  • Complete and assembled genome sequence of an NDM-9- and CTX-M-15-producing
           Klebsiella pneumoniae ST147 wastewater isolate from Switzerland
    • Abstract: Publication date: June 2018Source: Journal of Global Antimicrobial Resistance, Volume 13Author(s): Magdalena Nüesch-Inderbinen, Katrin Zurfluh, Marc J.A. Stevens, Roger StephanAbstractObjectivesCarbapenem-resistant Klebsiella pneumoniae have emerged worldwide and represent a major threat to human health. Here we report the genome sequence of K. pneumoniae 002SK2, an NDM-9- and CTX-M-15-producing strain isolated from wastewater in Switzerland and belonging to the international high-risk clone sequence type 147 (ST147).MethodsWhole-genome sequencing of K. pneumoniae 002SK2 was performed using Pacific Biosciences (PacBio) single-molecule, real-time (SMRT) technology RS2 reads (C4/P6 chemistry). De novo assembly was performed using Canu assembler, and sequences were annotated using the NCBI Prokaryotic Genome Annotation Pipeline (PGAP).ResultsThe genome of K. pneumoniae 002SK2 consists of a 5.4-Mbp chromosome containing blaSHV-11 and fosA6, a 159-kb IncFIB(K) plasmid carrying the heavy metal resistance genes ars and sil, and a 77-kb IncR plasmid containing blaCTX-M-15, blaNDM-9, blaOXA-9 and blaTEM-1.ConclusionsMultidrug-resistant K. pneumoniae harbouring blaNDM-9 and blaCTX-M-15 are spreading into the environment, most probably via wastewater from clinical settings.
       
  • Draft genome sequence of a KPC-2-producing Klebsiella pneumoniae ST340
           carrying bla CTX-M-15 and bla CTX-M-59 genes: a rich genome of mobile
           genetic elements and genes encoding antibiotic resistance
    • Abstract: Publication date: June 2018Source: Journal of Global Antimicrobial Resistance, Volume 13Author(s): Tiago Casella, Andressa Batista Zequini de Morais, Diego Diniz de Paula Barcelos, Fernanda Modesto Tolentino, Louise Teixeira Cerdeira, Maria Fernanda Campagnari Bueno, Gabriela Rodrigues Francisco, Leonardo Neves de Andrade, Ana Lucia da Costa Darini, Doroti de Oliveira Garcia, Nilton Lincopan, Mara Corrêa Lelles NogueiraAbstractObjectivesKlebsiella pneumoniae is considered an opportunistic pathogen and an important agent of nosocomial and community infections. It presents the ability to capture and harbour several antimicrobial resistance genes and, in this context, the extensive use of carbapenems to treat serious infections has been responsible for the selection of several resistance genes. This study reports the draft genome sequence of a KPC-2-producing K. pneumoniae strain (Kp10) simultaneously harbouring blaCTX-M-15 and blaCTX-M-59 genes isolated from urine culture of a patient with Parkinson’s disease.MethodsClassical microbiological methods were applied to isolate and identify the strain, and PCR and sequencing were used to identify and characterise the genes and the genetic environment. Whole-genome sequencing (WGS) was performed using a Nextera XT DNA library and a NextSeq platform.ResultsWGS analysis revealed the presence of 5915 coding genes, 46 RNA-encoding genes and 255 pseudogenes. Kp10 belonged to sequence type 340 (ST340) of clonal complex 258 (CC258) and carried 20 transferable genes associated with antimicrobial resistance, comprising seven drug classes. Although the simultaneous presence of different blaCTX-M genes in the same strain is rarely reported, the blaKPC-2, blaCTX-M-15 and blaCTX-M-59 genes were not associated with the same genetic mobile structure in Kp10.ConclusionsThese results confirm the capacity of K. pneumoniae to harbour several antimicrobial resistance genes. Thus, this draft genome could help in future epidemiological studies regarding the dissemination of clinically relevant resistance genes.
       
  • Effect of elevated imipenem/cilastatin minimum inhibitory concentrations
           on patient outcomes in Gram-negative bloodstream infections
    • Abstract: Publication date: June 2018Source: Journal of Global Antimicrobial Resistance, Volume 13Author(s): Milena M. McLaughlin, Cristina Miglis, Erik Skoglund, Jamie Wagner, Maria R. Advincula, Marc H. ScheetzAbstractObjectivesCarbapenem minimum inhibitory concentration (MICs) are known to predict outcomes for patients with Gram-negative bacteraemia. However, limited data exist on how MICs influence such outcomes when organisms are classified as carbapenem-resistant. The purpose of this study was to evaluate the effect of increasing imipenem/cilastatin MICs on mortality in patients with Gram-negative bloodstream infection (BSI).MethodsPatients with an imipenem/cilastatin-resistant (MIC > 4 mg/L) monomicrobial Gram-negative BSI were eligible for inclusion in the study and were assessed for baseline characteristics, organ function, microbiological data, timing and type of therapeutic treatment, and in-hospital mortality.ResultsA total of 62 patients with imipenem/cilastatin-resistant bacterial isolates (MIC > 4 mg/L) were retrospectively studied. Time to event analyses found no difference between patients who received carbapenem therapy and those who did not (P = 0.10). After adjustment, patients receiving directed therapy were less likely to die (adjusted hazard ratio = 0.35, 95% confidence interval 0.15–0.83; P 
       
  • Genotypic detection of fluoroquinolone resistance in drug-resistant
           Mycobacterium tuberculosis at a tertiary care centre in south Coastal
           Karnataka, India
    • Abstract: Publication date: June 2018Source: Journal of Global Antimicrobial Resistance, Volume 13Author(s): Kiran Chawla, Ajay Kumar, Vishnu Prasad Shenoy, Sanjiban Chakrabarty, Kapaettu SatyamoorthyAbstractObjectivesThis study aimed to characterise mutations associated with fluoroquinolone resistance in drug-resistant Mycobacterium tuberculosis clinical isolates at a tertiary care centre in south Coastal Karnataka, India.MethodsDNA from 50 M. tuberculosis clinical isolates was extracted and the gyrA and gyrB genes were amplified. Purified amplicons of gyrA and gyrB were sequenced and extended-sequencing PCR products were analysed. Analysis of mutations in gyrA and gyrB was done using the MUBII-TB-DB database. Statistical analysis was performed using SPSS v.22 and data were compared by χ2 test. A P-value of
       
  • In vitro activity of novel anti-MRSA cephalosporins and comparator
           antimicrobial agents against staphylococci involved in prosthetic joint
           infections
    • Abstract: Publication date: June 2018Source: Journal of Global Antimicrobial Resistance, Volume 13Author(s): Christophe Isnard, Anne Dhalluin, Damasie Malandain, Quentin Bruey, Michel Auzou, Jocelyn Michon, Jean-Christophe Giard, François Guérin, Vincent CattoirAbstractObjectivesCeftaroline and ceftobiprole are new parenteral cephalosporins with potent activity against methicillin-resistant (MR) staphylococci, which are the leading cause of prosthetic joint infections (PJIs). The aim of this study was to determine and compare the in vitro activities of both molecules against staphylococcal isolates recovered from clinically documented PJIs.MethodsA collection of 200 non-duplicate clinical isolates [100 Staphylococcus aureus and 100 coagulase-negative staphylococci (CoNS), including 19 and 27 MR isolates, respectively] was studied. Minimum inhibitory concentrations (MICs) of oxacillin, ceftaroline, ceftobiprole, vancomycin, teicoplanin, clindamycin, levofloxacin, linezolid and daptomycin were determined by the broth microdilution method. Bactericidal activity (at 4× MIC) of ceftaroline, ceftobiprole, vancomycin, teicoplanin, linezolid and daptomycin was assessed by time–kill assay.ResultsAmong the S. aureus isolates, 100% were susceptible to ceftaroline (MIC50/90, 0.25/0.5 μg/mL) and 98% were susceptible to ceftobiprole (MIC50/90, 0.5/1 μg/mL), regardless of their methicillin resistance. The two ceftobiprole-non-susceptible strains (including one MRSA) showed MICs at 4 mg/L. Against CoNS isolates, ceftaroline and ceftobiprole exhibited in vitro potency with MIC50/90 values at 0.06/0.25 μg/mL and 0.25/1 μg/mL, respectively. At 4× MIC, ceftaroline and ceftobiprole showed rapid and marked bactericidal activity against both S. aureus and CoNS (after 24/12 h and 12/6 h of incubation, respectively), whilst none of the other molecules tested had a bactericidal effect by 24 h.ConclusionsThis study showed that ceftaroline and ceftobiprole have excellent in vitro activity against clinical isolates of staphylococci involved in PJIs. These molecules may therefore represent promising alternatives for the treatment of such infections.
       
  • Molecular characterisation of bla OXA-48 carbapenemase-, extended-spectrum
           β-lactamase- and Shiga toxin-producing Escherichia coli isolated from
           farm piglets in India
    • Abstract: Publication date: June 2018Source: Journal of Global Antimicrobial Resistance, Volume 13Author(s): K.R. Nirupama, Vinodh Kumar O.R., B.S. Pruthvishree, D.K. Sinha, M. Senthil Murugan, Narayanan Krishnaswamy, B.R. SinghAbstractObjectivesThe aim of this study was to characterise carbapenemase-, extended-spectrum β-lactamase (ESBL)- and Shiga toxin-producing Escherichia coli isolated from farm piglets in India.MethodsFaecal samples (n = 741) from 10 organised pig farms, including non-diarrhoeic (n = 546) and diarrhoeic (n = 195) piglets, were processed for isolation of carbapenem-resistant and ESBL-producing E. coli.ResultsA total of 27 and 243 isolates were phenotypically confirmed as carbapenem-resistant and ESBL-producers, respectively. The meropenem minimum inhibitory concentration (MIC) of carbapenem-resistant isolates ranged from 8–128 μg/mL. On genotypic screening of the 27 carbapenem-resistant isolates, 3 isolates were positive for the blaOXA-48 carbapenemase gene; no other carbapenemase genes were detected. The 243 ESBL-producing isolates were positive for blaCTX-M-1 (n = 135), qnrA (n = 92), qnrB (n = 112), qnrS (n = 49), tetA (n = 42), tetB (n = 45) and sul1 (n = 43). The Shiga toxin virulence markers stx1 and stx2 were detected in 41 and 38 of the 243 phenotypic ESBL-producing isolates, respectively. Multilocus sequence typing (MLST) of blaOXA-48-positive E. coli isolates showed ST10- and ST5053-like sequence types.ConclusionThis is the first report on the presence of blaOXA-48-carrying E. coli in piglets in India, which pose a potential risk to public health.
       
  • Molecular characterisation of carbapenem-resistant Enterobacter cloacae
           complex in Colombia: bla KPC and the ‘changing landscape’
    • Abstract: Publication date: June 2018Source: Journal of Global Antimicrobial Resistance, Volume 13Author(s): Elsa De La Cadena, Adriana Correa, Juan Sebastián Muñoz, Laura J. Rojas, Cristhian Hernández-Gómez, Christian Pallares, Federico Perez, Robert A. Bonomo, Maria V. VillegasAbstractObjectivesThe aim of this study was to examine the population structure of representative carbapenem-resistant Enterobacter cloacae complex (CR-Ecl) isolates from eight different Colombian regions and to characterise their associated β-lactamases.MethodsA total of 28 CR-Ecl isolates collected in Colombia between 2009–2013 through the Colombian Nosocomial Network were included in this study. Antimicrobial susceptibility testing was performed by the broth microdilution method. Molecular detection of carbapenemase and extended-spectrum β-lactamase (ESBL) genes and the presence of transposon Tn4401 was evaluated by PCR and DNA sequencing. Genetic relatedness was assessed by multilocus sequencing typing (MLST) and repetitive sequence-based PCR (rep-PCR).ResultsPCR and DNA sequencing revealed that 19/28 (68%) of the CR-Ecl isolates carried blaKPC-2. Analysis of the genetic environment found blaKPC-2 within transposon Tn4401b in 8/19 isolates (42%). Population genetic analysis using rep-PCR revealed four clonal groups. MLST showed a variety of sequence types (STs), among which ST510 was the most common (10/28 isolates; 36%).ConclusionsblaKPC-2 was discovered as the most common mechanism of carbapenem resistance in CR-Ecl and was disseminated among different STs. Although none of the previously reported major clonal complexes were identified, it appears that local strain lineages are associated with the spread of blaKPC within CR-Ecl in various regions of Colombia.
       
  • High frequency of aac(6′)-Ib-cr gene associated with double mutations in
           gyrA and parC in Escherichia coli isolates from patients with urinary
           tract infections
    • Abstract: Publication date: June 2018Source: Journal of Global Antimicrobial Resistance, Volume 13Author(s): Lisiane M. Volcão, Juliano P. Lacava, Martina F. Gewehr, Valéria L. Leal, Ivy B. Ramis, Daniela F. Ramos, Carla V. Gonçalves, Lia G. Possuelo, Luciene A.R. Minarini, Pedro E.A. da Silva, Andrea von GrollAbstractObjectivesThe aims of this study were (i) to determine the frequency of plasmid-mediated resistance to fluoroquinolones (FQs) in Escherichia coli isolated from patients with urinary tract infections (UTIs) of nosocomial and community origin and (ii) to determine the relationships between the presence of extended-spectrum β-lactamases (ESBLs), mutations in the gyrA and parC genes, and resistance to FQs.MethodsA total of 71 E. coli isolates, including 38 ESBL-producers and 33 non-ESBL-producers, were analysed. The aac(6′)-Ib gene was amplified using PCR and was subsequently digested with the BtsCI restriction enzyme to identify aac(6′)-Ib-cr, a variant associated with FQ resistance. Detection of qnr genes was performed by multiplex PCR. In isolates that tested positive for these genes, the gyrA and parC genes were sequenced and the modulation factor of an efflux pump inhibitor was determined on the minimum inhibitory concentration (MIC) of norfloxacin.ResultsThe frequencies of qnrS, qnrB and qnrA were 4.2%, 2.8% and 0%, respectively. The frequency of aac(6′)-Ib-cr was 40.8% and this variant was associated with double mutations in gyrA and parC as well as resistance to FQs and ESBL production. Modulation of efflux pump activity was more frequent in resistant isolates that had a wild-type parC gene.ConclusionAn interplay of resistance mechanisms increased the level of resistance to FQs, and the high frequency of putative plasmid-mediated quinolone resistance genes associated with ESBL-producing isolates reduced therapeutic options to treat UTIs in the affected population.
       
  • Molecular analysis of low-level tetracycline resistance in clinical
           isolates of Helicobacter pylori among dyspeptic patients in South West
           Nigeria
    • Abstract: Publication date: June 2018Source: Journal of Global Antimicrobial Resistance, Volume 13Author(s): Abiodun T. Seriki, Stella I. Smith, Adeyemi I. Adeleye, Muinah A. FoworaAbstractObjectivesThe aim of this study was to determine the occurrence of 16S rRNA mutations associated with low-level tetracycline resistance in Helicobacter pylori isolates from adult dyspeptic patients in South West Nigeria.MethodsSusceptibility testing to tetracycline of 50 H. pylori isolates was performed by Etest. The 535-bp conserved region of the H. pylori tetracycline-binding site of 16S rRNA was amplified by PCR, followed by sequencing and multiple sequence alignment for all 50 clinical isolates.ResultsOf the 50 clinical isolates examined, DNA sequence analysis revealed nucleotide substitutions in 7 isolates at positions 926–928. Of the seven isolates, two demonstrated reduced susceptibility to tetracycline with Etest minimum inhibitory concentrations (MICs) of 0.75–1.0 mg/L, whilst the other five isolates were resistant with MICs of 1.5–24 mg/L (resistance breakpoint>1 mg/L). The two isolates with reduced susceptibility had single nucleotide substitution of A926G, whilst the five resistant isolates demonstrated double base pair substitutions of G927T/A928C and A926G/A928C and a single nucleotide substitution of A926G.ConclusionsThis study shows that low-level tetracycline resistance amongst H. pylori-positive dyspeptic patients is associated with reduced susceptibility and resistance to tetracycline. This is the result of 1-bp and 2-bp differences in positions 926 and 926–928, respectively, in the 16S rRNA of H. pylori.
       
  • Antimicrobial resistance in urine and skin isolates in Timor-Leste
    • Abstract: Publication date: June 2018Source: Journal of Global Antimicrobial Resistance, Volume 13Author(s): Ian Marr, Nevio Sarmento, Matt O’Brien, Karl Lee, Celia Gusmao, Gloria de Castro, Sonja Janson, Steven Y.C. Tong, Rob W. Baird, Joshua R. FrancisAbstractObjectivesHigh rates of antimicrobial resistance (AMR) are seen throughout Southeast Asia. However, limited AMR data exist for Timor-Leste, which is situated on the south-eastern portion of the Malay Archipelago. The purpose of this study was to identify AMR in bacteria isolated from urine and skin swabs from patients in Dili, the capital of Timor-Leste.MethodsUrine and skin swabs were collected from symptomatic patients in Timor-Leste and were processed for bacterial culture. Isolates were processed in Australia using a VITEK®2 system for bacterial identification and to determine antimicrobial susceptibility according to Clinical and Laboratory Standards Institute (CLSI) guidelines.ResultsA total of 154 urine isolates and 57 skin isolates were analysed. Of the Enterobacteriaceae, 35% were resistant to ceftriaxone with an extended-spectrum β-lactamase (ESBL)-producing phenotype. Carbapenem resistance was not observed in any of the Gram-negative isolates. Of the Staphylococcus aureus isolates, 11% were of the community-associated methicillin-resistant S. aureus (CA-MRSA) phenotype.ConclusionsA moderately high proportion of Gram-negative urine isolates in Timor-Leste demonstrate phenotypic ESBL production, and a relatively low proportion of S. aureus isolates were methicillin-resistant. Improved understanding of AMR rates in Timor-Leste can help guide antimicrobial prescribing and inform antimicrobial stewardship strategies.
       
  • Differences in tetracycline resistance determinant carriage among Shigella
           flexneri and Shigella sonnei are not related to different plasmid Inc-type
           carriage
    • Abstract: Publication date: June 2018Source: Journal of Global Antimicrobial Resistance, Volume 13Author(s): María J. Pons, Alba Torrents de la Peña, Laura Mensa, Pilar Martón, Lidia Ruiz-Roldán, Sandra Martínez-Puchol, Jordi Vila, Joaquim Gascón, Joaquim RuizAbstractObjectivesThe aim of this study was to establish the prevalence of the most common molecular mechanisms involved in tetracycline resistance as well as their relationship with plasmid incompatibility (Inc) groups in a collection of Shigella spp. causing traveller’s diarrhoea.MethodsTetracycline susceptibility was established in 187 Shigella spp. (74 Shigella flexneri and 113 Shigella sonnei), of which 153 isolates were recovered as a confirmed cause of traveller’s diarrhoea. The prevalence of the tet(A), tet(B) and tet(G) genes was analysed by PCR. Eighteen plasmid Inc groups was determined in a subset of 59 isolates.ResultsAmong 154 tetracycline-resistant isolates, 122 (79.2%) harboured at least tet(A) or tet(B). The tet(B) gene was the most frequently detected, being present in 70 isolates (45.5%), whilst tet(A) was detected in 57 isolates (37.0%). The tet(G) gene was present in only 11 (7.2%) isolates. Moreover, the tet(A) gene was more frequent in S. sonnei (P = 0.0007), whilst the tet(B) gene was more frequent in S. flexneri (P 
       
  • Involvement of topoisomerase mutations and qnr and aac(6′)Ib-cr genes in
           conferring quinolone resistance to clinical isolates of Vibrio and
           Shigella spp. from Kolkata, India (1998–2009)
    • Abstract: Publication date: June 2018Source: Journal of Global Antimicrobial Resistance, Volume 13Author(s): Kittappa Vinothkumar, Shaileshkumar R. Bhalara, Aneri Shah, Thandavarayan Ramamurthy, Swapan Kumar Niyogi, G. Naresh Kumar, Ashima Kushwaha BhardwajAbstractObjectivesQuinolone antibiotics have been widely used to treat diarrhoeal diseases caused by bacterial agents such as those belonging to the genera Vibrio and Shigella. As these pathogens are accumulating quinolone resistance, treating infections caused by them has become complicated.MethodsIn this study, Vibrio and Shigella spp. isolates obtained from diarrhoeal patients from Kolkata, India, over a period of 12 years (1998–2009) were analysed for quinolone resistance. A total of 27 Vibrio spp. (9 Vibrio cholerae, 11 Vibrio fluvialis and 7 Vibrio parahaemolyticus) and 10 Shigella spp. isolates (7 Shigella flexneri, 2 Shigella dysenteriae and 1 Shigella sonnei) showing reduced susceptibility to quinolones were studied to unravel the genetic factors responsible for quinolone resistance.ResultsAntimicrobial susceptibility testing showed a wide spectrum and varying degree of resistance to different generations of quinolones. Genotypic characterisation revealed the involvement of GyrA(S83I) and ParC(S85L) mutations in V. cholerae and V. fluvialis, whereas Shigella spp. isolates showed the mutations S83L and/or D87N/Y in GyrA and S80I or E84K in ParC. Analysis of plasmid-mediated quinolone resistance genes showed that qnrVC5 was detected in three V. fluvialis isolates, aac(6′)-Ib-cr in one V. fluvialis isolate and qnrS1 in a S. flexneri isolate.ConclusionsThese results emphasise that quinolone resistance is widespread and therefore quinolones should be used prudently. To the best of our knowledge, this is the first study where resistance to various generations of quinolones in Vibrio and Shigella spp. has been examined in terms of detailed genotype–phenotype correlation.
       
  • Association of Escherichia coli ST131 lineage with risk of urinary tract
           infection recurrence among young women
    • Abstract: Publication date: June 2018Source: Journal of Global Antimicrobial Resistance, Volume 13Author(s): Miriam D. Ismail, Ihsan Ali, Savannah Hatt, Elizabeth A. Salzman, Anna W. Cronenwett, Carl F. Marrs, Alexander H. Rickard, Betsy FoxmanAbstractObjectivesThe aim of this study was to test the hypothesis that urinary tract infections (UTIs) caused by Escherichia coli of the sequence type 131 (ST131) lineage are more likely to recur than UTIs caused by other E. coli lineages.MethodsIsolates from 221 young women with UTI caused by E. coli participating in a randomised controlled trial were used. Participants were followed for 6 months or until UTI recurrence.ResultsSequence type was not associated with risk of recurrence. Isolates in the ST131 lineage were more resistant than other STs to quinolones (6.2% vs. 1.3%) but not trimethoprim/sulfamethoxazole (15.4% vs. 15.0%).ConclusionsThese results do not support an increased risk of recurrent UTI among otherwise healthy women with UTI caused by E. coli ST131.
       
  • bla NDM-1-producing multidrug-resistant Escherichia coli isolated from a
           companion dog in China
    • Abstract: Publication date: June 2018Source: Journal of Global Antimicrobial Resistance, Volume 13Author(s): Lanqing Cui, Lei Lei, Yuan Lv, Rongmin Zhang, Xiaoyu Liu, Mei Li, Fan Zhang, Yang WangAbstractObjectivesThis study characterised a blaNDM-1-producing Escherichia coli isolate from a companion dog.MethodsThe E. coli strain was isolated from a surveillance study of carbapenem-resistant Gram-negative bacteria from companion animals in the Animal Teaching Hospital of China Agricultural University (Beijing, China) in 2013. Species identification was performed using an API 20E system and matrix-assisted laser desorption/ionisation time-of-flight mass spectrometry (MALDI-TOF/MS). Minimum inhibitory concentrations (MICs) of various antimicrobial agents were determined by agar dilution. Multilocus sequence typing (MLST) was performed and various carbapenemase genes, including blaNDM, blaIMP, blaVIM, blaSME, blaIMI, blaKPC, blaGES, blaSPM, blaGIM, blaNMC, blaDIM, blaSIM, blaOXA-23, blaOXA-24, blaOXA-48, blaOXA-51 and blaOXA-58 were screened by PCR. S1 nuclease pulsed-field gel electrophoresis (S1-PFGE) and Southern blotting as well as a modified random primer walking strategy were performed to analyse the location and genetic environment of blaNDM-1.ResultsAn E. coli isolate belonging to ST167 was found to be positive for the blaNDM-1 gene and exhibited resistance to β-lactams, tetracycline, gentamicin, fosfomycin and ciprofloxacin. The blaNDM-1 gene in this strain was located on an ca. 150-kb plasmid and the flanking sequences of the blaNDM-1-carrying region (a common gene cluster, ΔISAba125–blaNDM-1–ble–trpF–ΔdsbC) exhibited>99% identity to the corresponding regions of blaCTX-M-15-harboring plasmids in nosocomial E. coli ST131 isolates.ConclusionsThis is the first report of blaNDM-1-producing ST167 E. coli in a companion dog. Companion animals harbouring carbapenemase-producing isolates are an upcoming public health threat and it is worthy paying attention to the emergence of carbapenem resistance in companion animals.
       
  • Comparative study of Candida spp. isolates: Identification and
           echinocandin susceptibility in isolates obtained from blood cultures in 15
           hospitals in Medellín, Colombia
    • Abstract: Publication date: June 2018Source: Journal of Global Antimicrobial Resistance, Volume 13Author(s): Indira Berrio, Natalia Maldonado, Catalina De Bedout, Karen Arango, Luz Elena Cano, Yorlady Valencia, Cristina Jiménez-Ortigosa, David S. Perlin, Beatriz L. Gómez, Carlos Robledo, Jaime Robledo, Grupo GERMENAbstractObjectivesInvasive candidiasis has a high impact on morbidity and mortality in hospitalised patients. Accurate and timely methods for identification of Candida spp. and determination of echinocandin susceptibility have become a priority for clinical microbiology laboratories.MethodsThis study was performed to compare matrix-assisted laser desorption/ionisation time-of-flight mass spectrometry (MALDI-TOF/MS) identification with sequencing of the D1/D2 region of the rRNA gene complex 28 subunit in 147 Candida spp. isolates obtained from patients with candidaemia. Antimicrobial susceptibility testing was performed by broth microdilution (BMD) and Etest. Sequencing of the FKS1 and FKS2 genes was performed.ResultsThe most common species isolated were Candida albicans (40.8%), followed by Candida parapsilosis (23.1%) and Candida tropicalis (17.0%). Overall agreement between the results of identification by MALDI-TOF/MS and molecular identification was 99.3%. Anidulafungin and caspofungin susceptibility by the BMD method was 98.0% and 88.4%, respectively. Susceptibility to anidulafungin and caspofungin by Etest was 93.9% and 98.6%, respectively. Categorical agreement between Etest and BMD was 91.8% for anidulafungin and 89.8% for caspofungin, with lower agreements in C. parapsilosis for anidulafungin (76.5%) and C. glabrata for caspofungin (40.0%). No mutations related to resistance were found in the FKS genes, although 54 isolates presented synonymous polymorphisms in the hotspots sequenced.ConclusionsMALDI-TOF/MS is a good alternative for routine identification of Candida spp. isolates. DNA sequencing of the FKS genes suggested that the isolates analysed were susceptible to echinocandins; alternatively, unknown resistance mechanisms or limitations related to antifungal susceptibility tests may explain the resistance found in a few isolates.
       
  • Are pharmacists’ good knowledge and awareness on antibiotics taken for
           granted' The situation in Albania and future implications across
           countries
    • Abstract: Publication date: June 2018Source: Journal of Global Antimicrobial Resistance, Volume 13Author(s): Iris Hoxha, Admir Malaj, Besmira Kraja, Silvia Bino, Margaret Oluka, Vanda Marković-Peković, Brian GodmanAbstractObjectivesIrrational use of antibiotics is a major driver of antimicrobial resistance (AMR), exacerbated by dispensing of antibiotics without a prescription especially for typically viral infections. Such dispensing is common despite legislation. Pharmacists play a key role in advising on medicines, especially in countries where most patients seek pharmacist help as they cannot afford both physician fees and medicines. Consequently, our objective was to ascertain pharmacists’ skills and knowledge regarding antibiotics when patients present to them with typically viral infections.MethodsThis was a qualitative cross-sectional survey among 370 community pharmacists in Albania, with carefully selected and validated topics. The main outcome measure was knowledge of antibiotics and current legislation.ResultsVariable knowledge regarding antibiotics among community pharmacists. 55% knew colds are caused by viruses and 93% that antibiotics are ineffective against influenza. However, 18% believed if colds last>4 days an antibiotic can bring a patient back to work, and only 13% stated antibiotics are ineffective against viruses. Encouragingly, 93% knew penicillins can cause anaphylactic shock, 74% that antibiotics kill bacteria causing infections, and only 7% that antibiotic misuse cannot cause AMR. However, 13% stated the main disadvantage of antibiotics is that they are ineffective against viruses and 93% admitted they had no treatment protocols to consult in their daily work to direct patient care.ConclusionEncouraging signs regarding pharmacists’ knowledge of antibiotics in Albania; however, concerns. Instigating educational programmes among patients and pharmacists and greater enforcement of legislation should reduce AMR rates in Albania and across countries.
       
  • Evaluation of synergistic antimicrobial effect of vitamins (A, B1, B2, B6,
           B12, C, D, E and K) with antibiotics against resistant bacterial strains
    • Abstract: Publication date: June 2018Source: Journal of Global Antimicrobial Resistance, Volume 13Author(s): Shakeel Shahzad, Muhammad Adnan Ashraf, Muhammad Sajid, Aqeel Shahzad, Azhar Rafique, Muhammad Shahid MahmoodObjectivesMultidrug-resistant (MDR) superbugs, including Acinetobacter baumannii and methicillin-resistant Staphylococcus aureus (MRSA), are a challenge for healthcare professionals. In this study, the synergistic activity of vitamins with antibiotics against resistant bacterial strains was evaluated.MethodsSynergistic effects between antibiotics and stock solutions of vitamins were evaluated by the Kirby–Bauer disk diffusion assay. Distilled water and propylene glycol were used as solvent for water-soluble and fat-soluble vitamins, respectively. Final concentrations of 10 mg/mL for each water-soluble vitamin [B1 (thiamine), B2 (riboflavin), B6 (pyridoxine), B12 (methylcobalamin) and C (ascorbic acid)] and 0.1 mg/mL for each fat-soluble vitamin [A (retinol), D (cholecalciferol), E (α-tocopherol) and K (menadione)] were used in combination with the antibiotics.ResultsThe results demonstrated that vitamins K and E had good synergistic activity with piperacillin/tazobactam, imipenem and doripenem against A. baumannii, whilst vitamins B1, B2 and B12 showed remarkable synergistic activity with linezolid against MRSA. Vitamin B1 was further shown to have better synergism with oxacillin, tetracycline, rifampicin and linezolid against MRSA. The fat-soluble vitamins E and K showed good synergism against Gram-negative A. baumannii, whilst the water-soluble vitamins B1, B2 and B12 were effective against MRSA but not against A. baumannii.ConclusionsThis synergistic action of vitamins with antibiotics may be used as a tool to treat MDR superbugs, with further evaluation required at a molecular level.Graphical abstractGraphical abstract for this article
       
  • Antimicrobial resistance, biofilm-forming ability and virulence potential
           of Pseudomonas aeruginosa isolated from burn patients in northern Iran
    • Abstract: Publication date: June 2018Source: Journal of Global Antimicrobial Resistance, Volume 13Author(s): Leila AsadpourAbstractObjectivesPseudomonas aeruginosa is a frequent cause of infectious diseases, such as burn and wound infections, making it one of the most menacing opportunistic pathogens. The aim of this study was to investigate the antimicrobial resistance, biofilm-forming ability, and frequency of genes involved in biofilm formation and virulence of P. aeruginosa isolated from burn infections in Iran.MethodsResistance of 90 P. aeruginosa isolates to 12 antimicrobial agents as well as production of extended-spectrum β-lactamase (ESBL) and metallo-β-lactamase (MBL) enzymes were assessed phenotypically according to Clinical and Laboratory Standards Institute (CLSI) guidelines. Biofilm-forming capacity was assayed in a microtitre plate. The frequency of biofilm- and virulence-associated genes was investigated by PCR. Mutations in gyrA and parC in ciprofloxacin-resistant isolates were also determined by PCR.ResultsIn phenotypic assays, 72.2% (65/90) of P. aeruginosa isolates were multidrug-resistant (MDR), 55.5% (50/90) and 35.6% (32/90) were positive for ESBL and MBL production, respectively, and 67.8% (61/90) were positive for biofilm formation. Biofilm- and virulence-associated genes were identified in>50% of the P. aeruginosa isolates, with toxA and lasB being the most frequent. All of the virulence genes were more common in biofilm-forming and MDR phenotypes. Two point mutations in gyrA and one in parC in high-level ciprofloxacin-resistant isolates were identified.ConclusionsThe results of this study indicate that there is a high frequency of multidrug resistance and a high percentage of virulence-associated genes present in clinical P. aeruginosa isolates in Iran.
       
  • Determination of gyrA and parC mutations and prevalence of
           plasmid-mediated quinolone resistance genes in Escherichia coli and
           Klebsiella pneumoniae isolated from patients with urinary tract infection
           in Iran
    • Abstract: Publication date: June 2018Source: Journal of Global Antimicrobial Resistance, Volume 13Author(s): Mehdi Mirzaii, Sanaz Jamshidi, Maryam Zamanzadeh, Masoud Marashifard, Seyed Ali Asghar Malek Hosseini, Mehri Haeili, Fariba Jahanbin, Fariba Mansouri, Davood Darban-Sarokhalil, Seyed Sajjad KhoramroozAbstractObjectivesFluoroquinolones (FQs) are recommended as the drugs of choice for the empirical treatment of urinary tract infections (UTIs). This study investigated the molecular determinants of FQ resistance in Escherichia coli and Klebsiella pneumoniae isolates in Iran.MethodsA total of 364 clinical isolates of E. coli (n = 144) and K. pneumoniae (n = 220) were collected from patients with UTI. Susceptibility of the isolates to ciprofloxacin, levofloxacin, gatifloxacin and nalidixic acid was evaluated by disk diffusion. The presence of qnrA, qnrB and qnrS genes was assessed by PCR. Nucleotide sequences of the gyrA and parC genes were determined.ResultsEighty-seven (60.4%) and 15 (6.8%) E. coli and K. pneumoniae isolates, respectively, were resistant to at least one of the tested FQs. Plasmid-mediated quinolone resistance (PMQR) genes were detected in 12.6% and 60.0% of FQ-resistant E. coli and K. pneumoniae, respectively. Whilst qnrB predominated in K. pneumoniae, qnrS was the most prevalent PMQR gene in E. coli. S83L (98.9%) and D87N (59.8%) were the most frequent mutations identified in GyrA of E. coli, and 55.2% (n = 48) of FQ-resistant E. coli isolates had mutation in ParC harbouring S80I and E84V substitutions. The GyrAS83L substitution was found in only one FQ-resistant K. pneumoniae isolate.ConclusionsFQ resistance was much more common in E. coli isolates than in K. pneumoniae. Whilst mutations in the drug target-encoding genes gyrA and parC were the major mechanisms involved in FQ resistance in E. coli, PMQR determinants commonly mediated FQ resistance in K. pneumoniae.
       
  • Simultaneous detection of human CYP2C19 polymorphisms and antibiotic
           resistance of Helicobacter pylori using a personalised diagnosis kit
    • Abstract: Publication date: June 2018Source: Journal of Global Antimicrobial Resistance, Volume 13Author(s): Jun Zhang, Jing Zhong, Jian Ding, Jiemin Shi, Tao Tang, Qiqi Liu, Huilian Huang, Licheng Dai, Ningmin YangAbstractObjectivesA personalised diagnosis kit for Helicobacter pylori that employs visual gene chip technology for the simultaneous detection of CYP2C19 polymorphisms and clarithromycin/levofloxacin antibiotic resistance was evaluated.MethodsGastric antrum mucosa biopsy specimens of 394 patients were tested using the kit. DNA sequencing and antibiotic susceptibility testing of the H. pylori were also performed.ResultsIn total, 267 (67.8%) of the 394 specimens were positive for H. pylori using the kit and DNA sequencing, and 136 (34.5%) were positive by culturing. For human CYP2C19 and the bacterial 23S rRNA and gyrA genes, the concordance rates were 92.4% (364/394), 96.6% (258/267) and 97.0% (259/267) between the kit and DNA sequencing results, respectively. For clarithromycin and levofloxacin resistance, the concordance rates were 90.4% (123/136) and 81.6% (111/136) between the kit and antibiotic susceptibility testing results.ConclusionsThe personalised diagnosis kit for H. pylori provides useful information for the choice of proton pump inhibitor and antibiotic in combination therapy.
       
  • Comparative study of the impact of the administration of Amoxicillin and
           Algo-Bio® alternative substance to antibiotics, on the level of selection
           of resistant Enterobacteriaceae in the digestive flora of piglets
    • Abstract: Publication date: June 2018Source: Journal of Global Antimicrobial Resistance, Volume 13Author(s): Innocent Kouamé Kouadio, Nathalie Guessennd, Adjéhi Dadié, Eugène Koffi, Mireille DossoAbstractObjectivesThe aim of study was to evaluate by comparative study the level of selection of antibiotic-resistant Enterobacteriaceae in the digestive microbiota of piglets when using amoxicillin and Algo-Bio®.MethodsAmoxicillin and Algo-Bio® administration was carried out over a period of 5 days (D0–D4) at a dose of 1 mL/10 kg body weight. A phenotypic study was carried out with enumeration of resistant Enterobacteriaceae on MacConkey agar plates in the presence and absence of amoxicillin. Escherichia coli isolates were identified and were subjected to antimicrobial susceptibility testing.ResultsThe percentages of amoxicillin-resistant Enterobacteriaceae before treatment ranged from 10–15% for the four groups of piglets. Following treatment initiation, on the second day (D1) to the fifth day (D4) of treatment, the percentages increased to 54–87% for the groups treated with amoxicillin. In the group treated with Algo-Bio® and the controls, the percentages were
       
  • Molecular characterisation and epidemiology of extended-spectrum
           β-lactamase-producing Klebsiella pneumoniae isolates from
           immunocompromised patients in Tunisia
    • Abstract: Publication date: June 2018Source: Journal of Global Antimicrobial Resistance, Volume 13Author(s): Farah Ben Tanfous, Wafa Achour, Anis Raddaoui, Assia Ben HassenAbstractObjectivesThis study investigated the prevalence of extended-spectrum β-lactamase-producing Klebsiella pneumoniae (ESBL-KP) strains in the National Bone Marrow Transplant Center of Tunis between 2002 and 2011 as well as their associated antimicrobial resistance patterns and molecular features.MethodsAntimicrobial susceptibility was determined by the disk diffusion method according to CA-SFM guidelines. All of the strains were screened for β-lactamase genes, plasmid-encoded AmpC genes and integrons. Carbapenemase genes were analysed by PCR and sequencing for strains showing reduced susceptibility to ertapenem. Genetic relatedness was determined by pulsed-field gel electrophoresis (PFGE) and multilocus sequencing typing (MLST).ResultsA total of 128 non-repetitive ESBL-KP strains (23.4%) responsible for infection or colonisation were recovered among 548 K. pneumoniae strains. The isolates were also multidrug-resistant. Molecular analysis revealed the prevalence of blaSHV-type (92.2%), followed by blaOXA-1 (81.3%) and blaCTX-M-1 group (73.4%). Four ertapenem-resistant ESBL-KP strains (3.1%) carried the blaOXA-48 gene associated with the blaCTX-M-15 gene. Class 1 integrons were the most prevalent among the isolates (85.2%). High diversity was demonstrated by PFGE with limited clonal dissemination of 1 major (n = 13 strains) and 11 minor clusters (each comprising 2–3 strains). MLST of representative strains also showed high diversity with two main epidemic clones: ST15, associated with the major cluster; and ST101, associated with five minor clusters (n = 11 strains).ConclusionsThis study provides relevant information on the epidemiology of ESBL-KP strains in oncohaematology patients, of which 18.8% belonged to the specific CTX-M–15 K. pneumoniae clones ST15 and ST101.
       
  • DISC: Describing Infections of the Spine treated with Ceftaroline
    • Abstract: Publication date: June 2018Source: Journal of Global Antimicrobial Resistance, Volume 13Author(s): Richard R. Watkins, George Yendewa, Steven D. Burdette, Sophia Horattas, Nairmeen Awad Haller, Caroline Mangira, Robert A. Salata, Robert A. BonomoAbstractObjectivesInfections of the spine lead to considerable morbidity and a high cost to the global healthcare system. Currently, evidence for using ceftaroline, an advanced-generation cephalosporin active against methicillin-resistant Staphylococcus aureus (MRSA), in spine infections is limited.MethodsDescribing Infections of the Spine treated with Ceftaroline (DISC) is a multicentre, retrospective, cohort study that evaluated ceftaroline for treating spine infections. Patients were included if they were aged ≥18 years, diagnosed with a spine infection and treated with ceftaroline for ≥28 days. A control group was identified with the same inclusion criteria as the study population except they were treated with a comparator antibiotic for ≥28 days.ResultsThirty-seven patients were included each in the ceftaroline and control groups. MRSA was the most commonly identified pathogen. With no differences between groups in age, sex, race or co-morbidities (with the exception of chronic kidney disease), treatment with ceftaroline led to similar clinical success compared with the control group. Multivariate regression analysis did not show a significant difference between the two groups in terms of clinical success after controlling for other covariates (adjusted odds ratio = 1.49; P = 0.711). More patients who received ceftaroline were discharged to an extended-care or rehabilitation facility than home compared with controls (81% vs. 54%, respectively; P = 0.024). Side effects and toxicities were rare, including one case of eosinophilic pneumonia in the ceftaroline group.ConclusionsCeftaroline appears to be a safe and effective therapy for infections of the spine, including from MRSA.
       
  • New chalcone compound as a promising antileishmanial drug for an old
           neglected disease: Biological evaluation using radiolabelled
           biodistribution
    • Abstract: Publication date: June 2018Source: Journal of Global Antimicrobial Resistance, Volume 13Author(s): Ariane de J. Sousa-Batista, Cíntia I.M. Silva Philipon, Marta de Souza Albernaz, Suyene Rocha Pinto, Bartira Rossi-Bergmann, Ralph Santos-OliveiraAbstractObjectivesTreatment of leishmaniasis remains a challenge, especially due to the need for multiple painful injections, the toxicity of current drugs against the disease, their lack of efficacy and, lately, drug resistance. The aim of this study was to demonstrate the biological behaviour of 3-nitro-2ʹ-hydroxy-4ʹ,6ʹ-dimethoxychalcone (CH8) in a murine model of cutaneous leishmaniasis (CL) and visceral leishmaniasis (VL).MethodsTo evaluate its biological behaviour, compound CH8 was radiolabelled with technetium-99m (99mTc) using the direct reaction. Groups of animals infected with ether Leishmania infantum (as a model for VL) or Leishmania amazonensis (as a model for CL) were administered CH8-99mTc orally or subcutaneously, respectively, and its biodistribution was evaluated.ResultsOral administration of CH8-99mTc resulted in poor absorption. However, the absorbed drug was expressively taken up in the blood and liver, the main organ infected in VL. CH8-99mTc administered by the subcutaneous route showed a poor distribution and significant uptake in the left ear, suggesting a local effect in the skin. In addition, the VL and CL infection models did not considerably alter the biodistribution profile by the oral and subcutaneous routes, respectively.ConclusionThese results suggest that CH8 is a promising candidate for oral treatment of VL and for intralesional treatment of CL, showing a prominent local effect.
       
  • Fluconazole inhibits cellular ergosterol synthesis to confer synergism
           with berberine against yeast cells
    • Abstract: Publication date: June 2018Source: Journal of Global Antimicrobial Resistance, Volume 13Author(s): Zhanju Yang, Qiao Wang, Ke Ma, Ping Shi, Wenbin Liu, Zhiwei HuangAbstractObjectivesAlthough berberine (BBR) is reported to exhibit weak activity against Candida albicans, combined use of BBR and fluconazole (FLC) showed synergism against FLC-resistant C. albicans in vitro. The aim of this study was to explore the synergistic antifungal mechanism of FLC and BBR in Saccharomyces cerevisiae, a typical fungal cell model.MethodsBiochemical and genetic analyses were performed to investigate the probable antifungal role of the combined use of BBR and FLC in S. cerevisiae.ResultsFLC led to elevated cell membrane permeability in the wild-type S. cerevisiae BY4741, similar to the sterol synthesis-deficient strains erg2Δ and erg6Δ. Biochemical analysis indicated that FLC significantly inhibited cellular ergosterol synthesis, leading to a decrease in cell membrane stability, which increased the rate of BBR uptake and utilisation and reduced the inhibitory concentrations of BBR in wild-type yeast cells. Genetic analysis of the inhibitory effect of FLC and BBR on sterol synthesis-deficient (erg2Δ and erg6Δ) and DNA damage repair defect (rad1Δ) strains showed that FLC and BBR possess different antifungal mechanisms.ConclusionsFLC enhances cell membrane permeability via inhibition of cellular ergosterol synthesis, thus assisting BBR to kill fungal cells.
       
  • Genetic characterisation of tigecycline-resistant Enterobacter spp. in
           blood isolates causing bacteraemia
    • Abstract: Publication date: June 2018Source: Journal of Global Antimicrobial Resistance, Volume 13Author(s): Min Kyeong Cha, Cheol-In Kang, Ga Eun Park, So Hyun Kim, Doo Ryeon Chung, Kyong Ran Peck, Jae-Hoon SongAbstractObjectivesTigecycline (TIG) is one of the most important antimicrobial agents used to treat infections by multidrug-resistant bacteria. However, rates of TIG-resistant pathogens have increased recently. This study was conducted to identify the antimicrobial susceptibility profiles and to investigate the role of efflux pumps in high-level TIG-resistant Enterobacter spp. isolates causing bacteraemia.MethodsA total of 323 Enterobacter spp. causing bacteraemia were collected from eight hospitals in various regions of South Korea. Minimum inhibitory concentrations (MICs) were determined by the broth microdilution method and Etest. Expression levels of the efflux pump gene acrA and its regulators (ramA and rarA) were examined by quantitative real-time PCR. Isolate relatedness was determined by multilocus sequence typing (MLST).ResultsAmong the 323 clinical isolates included in this study, 37 (11.5%) were TIG-non-susceptible, of which 8 isolates were highly resistant to TIG with MICs of 8 mg/L (4 isolates) or 16 mg/L (4 isolates). All high-level TIG-resistant isolates showed increased expression of acrA (0.93–13.3-fold) and ramA (1.4–8.2-fold). Isolates with a tigecycline MIC of 16 mg/L also showed overexpression of rarA compared with TIG-susceptible isolates.ConclusionsIn this study, overexpression of acrA, ramA and rarA was observed in high-level TIG-resistant Enterobacter spp. isolates. We suggest that rarA might be involved in the regulation of acrA overexpression in high-level TIG-resistant Enterobacter spp. isolates. Efflux pump-mediated resistance should be closely monitored because it could be indirectly attributed to the use of other antibiotics transported by the same efflux pump.
       
  • Spread of Klebsiella pneumoniae ST395 non-susceptible to carbapenems and
           resistant to fluoroquinolones in North-Eastern France
    • Abstract: Publication date: June 2018Source: Journal of Global Antimicrobial Resistance, Volume 13Author(s): Anaëlle Muggeo, Thomas Guillard, Frédéric Klein, Fany Reffuveille, Caroline François, Anamaria Babosan, Odile Bajolet, Xavier Bertrand, Christophe de Champs, on behalf of the CarbaFrEst GroupAbstractObjectivesFluoroquinolones (FQs) are a potential treatment for infections caused by extended-spectrum β-lactamase (ESBL)-producing Enterobacteriaceae that are susceptible to these agents.MethodsOwing to increasing non-susceptibility to carbapenems among Enterobacteriaceae, in this study FQ resistance mechanisms were characterised in 36 ertapenem-non-susceptible Klebsiella pneumoniae isolated from North-Eastern France in 2012. The population structure was described by pulsed-field gel electrophoresis (PFGE) and multilocus sequence typing (MLST).ResultsAmong the 36 isolates, 13 (36%) carried a carbapenemase encoding-gene. Decreased expression of the OmpK35-encoding gene might be considered a major resistance determinant that could explain the non-susceptibility to carbapenems. The carbapenemase-producing isolates carried the well-known IncL pOXA-48a plasmid. All 36 K. pneumoniae isolates also harboured a FQ resistance determinant. The aac(6′)-Ib-cr gene was the major plasmid-mediated quinolone resistance (PMQR) determinant found in K. pneumoniae (89%; 32/36). MLST identified five sequence types (STs), with the most common being ST395 (69%; 25/36), followed by ST147 (17%; 6/36). ST395 strains showed ertapenem minimum inhibitory concentrations (MICs) ranging from 0.75–32 μg/mL. Klebsiella pneumoniae ST395 isolates did not show enhanced biofilm formation or environmental survival but showed higher chlorhexidine MICs compared with ST147 isolates.ConclusionsThese findings showed that (i) K. pneumoniae ST395 carrying pOXA-48a has spread in North-Eastern France, (ii) aac(6′)-Ib-cr is predominant in carbapenem-non-susceptible K. pneumoniae, (iii) K. pneumoniae ST395 is resistant to chlorhexidine and (iv) FQs as an alternative to β-lactams to treat ertapenem-non-susceptible K. pneumoniae are compromised.
       
  • In vivo activity of fluconazole/tetracycline combinations in Galleria
           mellonella with resistant Candida albicans infection
    • Abstract: Publication date: June 2018Source: Journal of Global Antimicrobial Resistance, Volume 13Author(s): Wenrui Gu, Qiong Yu, Cuixiang Yu, Shujuan SunAbstractObjectivesTreatment of azole-resistant Candida albicans infections continues to pose significant challenges. With limited options of licensed agents, drug combinations may be a practical treatment alternative. In our previous studies, the combinations minocycline/fluconazole (MINO/FLC) and doxycycline/fluconazole (DOXY/FLC) shown synergistic effects in vitro. It is necessary to explore their appropriate dosage, potential toxicity and in vivo efficacy.MethodsThe Galleria mellonella infection model was employed to study the in vivo efficacy of MINO/FLC and DOXY/FLC by survival analysis, quantification of C. albicans fungal burden and histological studies.ResultsThe survival rates of G. mellonella larvae infected with lethal doses of resistant C. albicans CA10 increased significantly when treated with the drug combinations compared with FLC treatment alone, and the fungal burden was reduced by almost four-fold. The histopathological study showed that fewer infected areas in larvae were observed and the destructive degree was less when larvae were exposed to the drug combinations.ConclusionsThese findings suggest that combination of a tetracycline antibiotic (MINO or DOXY) with FLC has antifungal activity against azole-resistant C. albicans in vivo. This is in agreement with several previous in vitro studies and provides preliminary in vivo evidence that such a combination might be useful therapeutically.
       
  • Characterisation of bla OXA-538, a new variant of bla OXA-48, in
           Shewanella xiamenensis isolated from river water in Algeria
    • Abstract: Publication date: June 2018Source: Journal of Global Antimicrobial Resistance, Volume 13Author(s): Rima Tafoukt, Thongpan Leangapichart, Linda Hadjadj, Sofiane Bakour, Seydina M. Diene, Jean-Marc Rolain, Abdelaziz TouatiAbstractObjectivesIn this study, the presence of carbapenemase genes in Shewanella xiamenensis strains isolated from river water in Béjaïa, Algeria, was investigated.MethodsFour isolates of S. xiamenensis were isolated from water from Soummam River. The isolates were identified by matrix-assisted laser desorption/ionisation time-of-flight mass spectrometry (MALDI-TOF/MS) and sequencing of the 16S rRNA and gyrB genes. Isolates were subjected to antimicrobial susceptibility testing. Carbapenemase production was screened using phenotypic tests. PCR and sequencing were used to identify carbapenemase genes in the isolates. The genetic context of the blaOXA-48-like gene was investigated by sequencing the whole genome of strain AS58.ResultsAll four S. xiamenensis strains harboured blaOXA-48-like genes. They exhibited different resistance patterns and had imipenem minimum inhibitory concentrations (MICs) of ≥0.5 mg/L. Sequencing of blaOXA-48-like genes from the S. xiamenensis isolates showed that two strains harboured blaOXA-181, one strain harboured blaOXA-199 and one strain exhibited a new variant of the blaOXA-48-like gene, named blaOXA-538. This new variant shared 98% nucleotide identity with blaOXA-162, with three amino acid changes (G201A, A213G and I219F). Conjugation assays with Escherichia coli J53 recipient were performed but no transconjugants were obtained. Analysis of the genome of AS58 Touati strain confirmed the chromosomal location of the blaOXA-538 gene.ConclusionThis study showed that environmental water holds a diversity of S. xiamenensis strains harbouring blaOXA-48-like genes and may play an important role in the dissemination and spread of these genes from the environment to humans.
       
  • Molecular characterisation of multidrug-resistant Bacteroides isolates
           from Hungarian clinical samples
    • Abstract: Publication date: June 2018Source: Journal of Global Antimicrobial Resistance, Volume 13Author(s): Károly Péter Sárvári, József Sóki, Katalin Kristóf, Emese Juhász, Cecilia Miszti, Szilvia Zsóka Melegh, Krisztina Latkóczy, Edit UrbánAbstractObjectivesMembers of the Bacteroides fragilis group are the most important components of the normal human gut microbiota, however these bacteria can also cause severe infections. Due to frequent use of antibiotics, the spread of multidrug-resistant (MDR) strains is a real threat worldwide.MethodsIn a multicentre study, 400 Bacteroides isolates from five Hungarian microbiology laboratories were cultured and were identified by matrix-assisted laser desorption/ionisation time-of-flight mass spectrometry (MALDI-TOF/MS). Minimum inhibitory concentrations (MICs) of ten antibiotics were determined by the agar dilution method and were evaluated according to EUCAST or CLSI breakpoints.ResultsSix MDR strains were found and their antibiotic resistance genes were investigated by molecular methods The DNA amplicon of B. fragilis SZ38 was sequenced to search for a mutation in the gyrA gene. Among the six MDR isolates, one cfiA-, two cepA-, three cfxA-, two ermG-, six tetQ-, three tetX- and two bexA-positive strains were found. None of the MDR isolates harboured cepA, nim, ermB or tetX1 genes.ConclusionsIn the past 12 years, only a few cases of MDR Bacteroides infections have been reported. Within a comprehensive multicentre survey, we demonstrated the relatively high prevalence of MDR strains isolated in one centre with five isolates as well as one isolate from another centre during a relatively short period of time. This study highlights the importance of antimicrobial susceptibility testing and surveillance among B. fragilis group isolates.
       
  • Recent patterns in antibiotic use for children with group A streptococcal
           infections in Japan
    • Abstract: Publication date: June 2018Source: Journal of Global Antimicrobial Resistance, Volume 13Author(s): Yusuke Okubo, Nobuaki Michihata, Naho Morisaki, Noriko Kinoshita, Isao Miyairi, Kevin Y. Urayama, Hideo YasunagaAbstractObjectivesAntibiotics are the most frequently prescribed medicines for children, however inappropriate antibiotic prescribing is prevalent. This study investigated recent trends in antibiotic use and factors associated with appropriate antibiotic selection among children with group A streptococcal infections in Japan.MethodsRecords of outpatients aged
       
  • In vitro effect of clindamycin against Bacteroides and Parabacteroides
           isolates in Poland
    • Abstract: Publication date: June 2018Source: Journal of Global Antimicrobial Resistance, Volume 13Author(s): Marta Kierzkowska, Anna Majewska, Ksenia Szymanek-Majchrzak, Anna Sawicka-Grzelak, Andrzej Mlynarczyk, Grazyna MlynarczykAbstractObjectivesThe aims of this study were (i) to analyse strains of the genera Bacteroides and Parabacteroides isolated from clinical specimens for phenotypic resistance to clindamycin, (ii) to detect erm genes in the isolates and (iii) to determine any correlation between in vitro resistance and the presence of erm genes.MethodsThe Bacteroides and Parabacteroides isolates analysed were obtained from patients hospitalised at teaching hospitals in Poland. Antimicrobial susceptibility testing was performed by Etest and the results were interpreted according to European Committee on Antimicrobial Susceptibility Testing (EUCAST) guidelines. All isolates were analysed by PCR for the presence of the resistance genes ermF, ermB and ermG.ResultsResistance to clindamycin was detected in 31.0% (62/200) of all evaluated isolates, with the ermF and ermB genes detected in 31.0% (62/200) and 0.5% (1/200) of isolates, respectively. No isolates with ermG were detected among the evaluated strains. Pearson’s test showed an almost perfect correlation between clindamycin minimum inhibitory concentrations (MICs) and the presence of ermF in Bacteroides spp. and Parabacteroides distasonis isolates, although the ermF gene was also present in 10 clindamycin-susceptible isolates of Bacteroides spp.ConclusionsThis study demonstrated a substantial proportion of Bacteroides (22.5–100% depending on the species) and 50.0% of Parabacteroides strains exhibiting resistance to clindamycin. The clindamycin MIC for resistant strains in each case was ≥256 mg/L. Resistance to clindamycin in Bacteroides and Parabacteroides species is correlated mainly with the presence of the ermF gene.
       
  • Does the use of antifungal agents in agriculture and food foster polyene
           resistance development' A reason for concern
    • Abstract: Publication date: June 2018Source: Journal of Global Antimicrobial Resistance, Volume 13Author(s): Axel DalhoffAbstractEnvironmental fungicides are used in agriculture to reduce fungal spoilage of crops to a minimum, and the polyene macrolide natamycin is used as a food preservative. The use of natamycin in yoghurt has recently been authorised in the USA and some other countries. However, resistance development is a serious risk associated with the use of antimicrobials as food additives and environmental fungicides. Cross-resistance between agricultural and medical azoles and between azoles and amphotericin B (AMB) not being used in agriculture has been demonstrated in clinical and environmental isolates. Polyene resistance can be elicited in vitro by the use of subinhibitory polyene concentrations and a large number of transfers. This condition may mirror the exposure of faecal Candida spp. to natamycin following consumption of natamycin-containing food. A large number of environmental and clinical isolates are resistant to AMB, and strong evidence linking farm antibiotic use and multidrug resistance, including AMB resistance, in human infections has been provided. In contrast to the acquisition of resistant environmental strains, consumption of natamycin-containing food may expose the gastrointestinal fungal flora directly to resistance selective pressure. So far, whether natamycin itself may cause the emergence of polyene resistance in gastrointestinal fungal flora and/or may act as an AMB resistance selector is probable but speculative. Use of any anti-infective agent as a food preservative should be limited to an absolute minimum as the clinical efficacy of anti-infectives used to treat serious life-threatening infections has to be preserved.
       
  • The emerging problem of linezolid-resistant enterococci
    • Abstract: Publication date: June 2018Source: Journal of Global Antimicrobial Resistance, Volume 13Author(s): Ruru Bi, Tingting Qin, Wenting Fan, Ping Ma, Bing GuAbstractEnterococcus is a significant pathogen in numerous infections, particularly in nosocomial infections, and is thus a great challenge to clinicians. Linezolid (LNZ), an oxazolidinone antibiotic, is an important therapeutic option for infections caused by Gram-positive bacterial pathogens, especially vancomycin-resistant enterococci. A systematic review was performed of the available literature on LNZ-resistant enterococci (LRE) to characterise these infections with respect to epidemiological, microbiological and clinical features. The results validated the potency of LNZ against enterococcal infections, with a sustained susceptibility rate of 99.8% in ZAAPS and 99.2% in LEADER surveillance programmes. Patients with LRE had been predominantly exposed to LNZ prior to isolation of LRE, with a mean treatment duration of 29.8 ± 48.8 days for Enterococcus faecalis and 23.1 ± 21.4 days for Enterococcus faecium. Paradoxically, LRE could also develop in patients without prior LNZ exposure. LNZ resistance was attributed to 23S rRNA (G2576T) mutations (51.2% of E. faecalis and 80.5% of E. faecium) as well as presence of the cfr gene (4.7% and 4.8%, respectively), which could transfer horizontally among the strains. In addition to the cfr gene, 32 cases of optrA-positive LRE were identified. Further study is required to determine the prevalence of novel resistance genes. The emergence of LRE thus hampers the treatment of such infections, which warrants worldwide surveillance.
       
  • Antimicrobial susceptibility of ertapenem-non-susceptible
           Enterobacteriaceae in South India
    • Abstract: Publication date: June 2018Source: Journal of Global Antimicrobial Resistance, Volume 13Author(s): Ramalingam Sekar, Seetharaman Srivani, Manoharan Mythreyee
       
  • Synergistic interactions of cryptotanshinone and aminoglycoside
           antibiotics against Staphylococcus aureus in vitro
    • Abstract: Publication date: June 2018Source: Journal of Global Antimicrobial Resistance, Volume 13Author(s): Zihao Teng, Meng Li, Dongxue Shi, Xuming Deng, Jianfeng Wang
       
  • Emergence of azithromycin resistance mediated by the mph(A) gene in
           Salmonella Typhimurium clinical isolates in Latin America
    • Abstract: Publication date: June 2018Source: Journal of Global Antimicrobial Resistance, Volume 13Author(s): Diego Faccone, Celeste Lucero, Ezequiel Albornoz, Alejandro Petroni, Paola Ceriana, Josefina Campos, María Rosa Viñas, Geraldine Francis, AZM-R-Group, Roberto G. Melano, Alejandra Corso
       
  • Carbapenem-susceptible Escherichia coli ST3901 carrying mcr-1 and
           bla CTX-M genes isolated from a diabetic foot infection in Brazil
    • Abstract: Publication date: June 2018Source: Journal of Global Antimicrobial Resistance, Volume 13Author(s): Marco André Tonini, Julianne Soares Jardim Lacerda Batista, Luciana Bueno Freitas, Mirla Borghi, Myriam Santos Almeida, Liliana Cruz Spano, Ricardo Pinto Schuenck
       
  • First detection of a bla CTX-M-15-carrying plasmid in Vibrio alginolyticus
    • Abstract: Publication date: June 2018Source: Journal of Global Antimicrobial Resistance, Volume 13Author(s): Zhiwei Zheng, Ruichao Li, Marcus Ho-yin Wong, Edward Wai-chi Chan, Xiaodong Xia, Sheng Chen
       
  • First description of clinical Aspergillus fumigatus cyp51A
           TR46/Y121F/T289A mutant in Portugal
    • Abstract: Publication date: June 2018Source: Journal of Global Antimicrobial Resistance, Volume 13Author(s): Carolina Monteiro, Miguel A. Faria, Dolores Pinheiro, Catarina Lameiras, Eugénia Pinto
       
  • First detection of an OXA-58 carbapenemase-producing Acinetobacter
           nosocomialis clinical isolate in the Balkan States
    • Abstract: Publication date: June 2018Source: Journal of Global Antimicrobial Resistance, Volume 13Author(s): Tanya Strateva, Ivo Sirakov, Encho Savov, Ivan Mitov
       
  • Decreased glycopeptide susceptibility in Staphylococcus pasteuri
           associated with a mutation in uncharacterised conserved membrane protein
           STP1_1701
    • Abstract: Publication date: June 2018Source: Journal of Global Antimicrobial Resistance, Volume 13Author(s): Vladimir Vimberg, Leona Zieglerova, Jan Závora, Lenka Šemberová, Jana Prásilová, Václava Adámková, Gabriela Balikova-Novotna
       
  • Extended-spectrum β-lactamase (ESBL)-producing Serratia marcescens
           causing healthcare-associated infections in Assiut University Hospitals,
           Egypt
    • Abstract: Publication date: June 2018Source: Journal of Global Antimicrobial Resistance, Volume 13Author(s): Nahla M. Elsherbiny, Ibrahim M. Ali, Khalid M. Hassanein, Mohamed T. Ahmed
       
  • First report of multidrug-resistant Escherichia coli isolates
           co-harbouring mcr-1 and bla OXA-48 from clinical patients in China
    • Abstract: Publication date: June 2018Source: Journal of Global Antimicrobial Resistance, Volume 13Author(s): Hong Lu, Xiaoxiao Zhang, Yizhi Zhang, Haiyang Liu, Chunquan Xu, Majun Zhang, Wenzi Bi, Tieli Zhou
       
  • Colistin-resistant carbapenemase-producing isolates among Klebsiella spp.
           and Acinetobacter baumannii in Tripoli, Libya
    • Abstract: Publication date: June 2018Source: Journal of Global Antimicrobial Resistance, Volume 13Author(s): Nicolas Kieffer, Mohamed O. Ahmed, Asma K. Elramalli, Mohamed A. Daw, Laurent Poirel, Rocío Álvarez, Patrice Nordmann
       
 
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