scholarly journals 1144. Modern Problem, Medieval Cure-Resistant Aeromonas in Medicinal Leeches

2018 ◽  
Vol 5 (suppl_1) ◽  
pp. S344-S344
Author(s):  
Leighanne Olivia Parkes ◽  
Kevin Barker ◽  
Susan M Poutanen ◽  
Jennifer M Grant ◽  
Michael Libman ◽  
...  
Keyword(s):  
Preliminary Investigation ◽  
Pulse Field ◽  
Common Source ◽  
Modern Problem ◽  
Hospital System ◽  
Pulse Field Gel Electrophoresis ◽  
Hospital Systems ◽  
The Common ◽  
Reported Data ◽  
Medicinal Leeches

Abstract Background Medicinal leeches are used primarily in plastic and reconstructive surgery when venous congestion threatens tissue viability. The associated infection risk ranges from 4.1 to 20%. Prophylactic antimicrobials such as fluoroquinolones (FQ) or trimethoprim-sulfamethoxazole (SXT) are recommended and target commonly isolated pathogen and gut symbiont, Aeromonas. However, resistance to these agents has been reported and detected in leeches, including at hospital systems across Canada that acquire their stock from the same supplier. Our objective was to describe the local epidemiology of leech-related Aeromonas resistant to one or more commonly used prophylactic agents, and determine if such resistance originates from the common supplier. Methods Six hospital systems across Canada using leech therapy, purchased from the same supplier, were surveyed. A 5-year retrospective review of all antimicrobial resistant leech-related Aeromonas, derived from clinical, leech, and tank fluid specimens was performed. All Aeromonas resistant to either FQ or SXT were included, and retained frozen isolates from each system were analysed by pulse-field gel electrophoresis (PFGE) using a published Aeromonas protocol. Results All six hospital systems reported leech-related Aeromonas resistant to one or more antimicrobials, totalling 15 isolates. Three systems only reported data from the last year. Four systems used FQ and two used SXT as prophylaxis. Fifteen of 15 were either FQ resistant or intermediate, and four of 15 were SXT resistant. Three of 10 isolates tested for ceftriaxone (CRO) susceptibility were resistant. Five of 15 of the isolates were resistant to two or more agents. Of the two leech quality control isolates, 2/2 were FQ resistant and 1/2 was FQ, SXT and CRO resistant. Only three isolates, each from a different, geographically distinct hospital system, had been retained. PFGE analysis indicated 2/3 are closely related (Figure 1). Conclusion Our preliminary investigation suggests that the presence of FQ and SXT resistance in leech-related Aeromonas might be more common than previously suspected, and that such resistance might originate from a common source. A broader study of the molecular epidemiology of leech-related Aeromonas is warranted. Disclosures All authors: No reported disclosures.

scholarly journals Molecular Epidemiology of Salmonellosis in Florida, USA, 2017–2018

2021 ◽  
Vol 8 ◽  
Author(s):  
Nitya Singh ◽  
Xiaolong Li ◽  
Elizabeth Beshearse ◽  
Jason L. Blanton ◽  
Jamie DeMent ◽  
...  
Keyword(s):  
Molecular Epidemiology ◽  
Multidrug Resistant ◽  
Clinical Isolates ◽  
Pulse Field ◽  
Common Source ◽  
Older Children ◽  
Pulse Field Gel Electrophoresis ◽  
Outbreak Investigations ◽  
The Usa ◽  
Combination Approach

The state of Florida reports a high burden of non-typhoidal Salmonella enterica with approximately two times higher than the national incidence. We retrospectively analyzed the population structure and molecular epidemiology of 1,709 clinical isolates from 2017 and 2018. We found 115 different serotypes. Rarefaction suggested that the serotype richness did not differ between children under 2 years of age and older children and adults and, there are ~22 well-characterized dominant serotypes. There were distinct differences in dominant serotypes between Florida and the USA as a whole, even though S. Enteritidis and S. Newport were the dominant serotypes in Florida and nationally. S. Javiana, S. Sandiego, and S. IV 50:z4, z23:- occurred more frequently in Florida than nationally. Legacy Multi Locus Sequence Typing (MLST) was of limited use for differentiating clinical Salmonella isolates beyond the serotype level. We utilized core genome MLST (cgMLST) hierarchical clusters (HC) to identify potential outbreaks and compared them to outbreaks detected by Pulse Field Gel Electrophoresis (PFGE) surveillance for five dominant serotypes (Enteritidis, Newport, Javiana, Typhimurium, and Bareilly). Single nucleotide polymorphism (SNP) phylogenetic-analysis of cgMLST HC at allelic distance 5 or less (HC5) corroborated PFGE detected outbreaks and generated well-segregated SNP distance-based clades for all studied serotypes. We propose “combination approach” comprising “HC5 clustering,” as efficient tool to trigger Salmonella outbreak investigations, and “SNP-based analysis,” for higher resolution phylogeny to confirm an outbreak. We also applied this approach to identify case clusters, more distant in time and place than traditional outbreaks but may have been infected from a common source, comparing 176 Florida clinical isolates and 1,341 non-clinical isolates across USA, of most prevalent serotype Enteritidis collected during 2017–2018. Several clusters of closely related isolates (0–4 SNP apart) within HC5 clusters were detected and some included isolates from poultry from different states in the US, spanning time periods over 1 year. Two SNP-clusters within the same HC5 cluster included isolates with the same multidrug-resistant profile from both humans and poultry, supporting the epidemiological link. These clusters likely reflect the vertical transmission of Salmonella clones from higher levels in the breeding pyramid to production flocks.

scholarly journals 284. Evaluation of Oral Step-Down Therapy for Enterobacteriaceae Bloodstream Infection

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S143-S143
Author(s):  
Sara Utley ◽  
Dawn Bouknight ◽  
Radha Patel ◽  
Kent Stock
Keyword(s):  
Bloodstream Infection ◽  
Oral Therapy ◽  
Common Source ◽  
Oral Antibiotic ◽  
Beta Lactam ◽  
Hospital System ◽  
Source Of Infection ◽  
Complete Treatment ◽  
Antibiotic Duration ◽  
Alternate Source

Abstract Background Oral antibiotic stepdown therapy for Gram-negative (GN) bloodstream infection (BSI) appears to be a safe option, though high bioavailability drugs like fluoroquinolones (FQ) and trimethoprim-sulfamethoxazole are often recommended without clear evidence demonstrating superiority. Due to increasing concerns of FQ resistance and collateral damage with an increasing community C. difficile rate, our organization sought to reduce overall FQ use and a shift toward oral beta-lactams (BL) was observed. A review was conducted to assess the outcomes of this shift. Methods This retrospective cohort included all patients within our 3-hospital system who had a positive GN blood culture and were transitioned to oral therapy to complete treatment outpatient for bacteremia between Jan 2017-Sept 2019. The primary outcome was recurrent BSI within 30 days of completing initial treatment. Secondary outcomes included 30-day mortality, 30-day recurrence of organism at an alternate source, 30-day readmission, and 90-day BSI relapse. Results Of 191 GN BSIs, 77 patients were transitioned to oral therapy. The mean age was 68 years, 60% were female. The most common source of infection was described as urine (39/77), intra-abdominal (16/77), unknown (13/77). Mean total antibiotic duration (IV plus PO) was 14 days (range 7–33). Patients received an average of 5 days IV prior to transitioning to PO therapy. The most common PO class was a 1st gen cephalosporin (29/77), followed by BL/BL inhibitor (16/77), and a FQ (13/77). There were no 30-day relapse BSIs observed in this cohort. There was 1 patient discharged to inpatient hospice, and no other 30-day mortality observed. There were 4 recurrent UTIs observed within 30 days, none of which required readmission. Of the twelve 30-day readmissions, 1 was considered by the investigators to be related to the initial infection. Conclusion An opportunity for education regarding duration of therapy was identified. Oral beta lactam use in our limited population appears to be a reasonable option to facilitate discharge. Results should be confirmed in additional, larger studies. Disclosures All Authors: No reported disclosures

scholarly journals The Prevalence of Virulence Determinants and Antibiotic Resistance Patterns in Methicillin—Resistant Staphylococcus aureus in a Nursing Home in Poland

Pathogens ◽  
2021 ◽  
Vol 10 (4) ◽  
pp. 427
Author(s):  
Martyna Kasela ◽  
Agnieszka Grzegorczyk ◽  
Bożena Nowakowicz-Dębek ◽  
Anna Malm
Keyword(s):  
Staphylococcus Aureus ◽  
Methicillin Resistant Staphylococcus Aureus ◽  
Variable Number Tandem Repeat ◽  
Multidrug Resistant ◽  
Variable Number ◽  
Pulse Field ◽  
Virulence Determinants ◽  
Gene Encoding ◽  
Methicillin Resistant ◽  
Pulse Field Gel Electrophoresis

Nursing homes (NH) contribute to the regional spread of methicillin-resistant Staphylococcus aureus (MRSA). Moreover, residents are vulnerable to the colonization and subsequent infection of MRSA etiology. We aimed at investigating the molecular and phenotypic characteristics of 21 MRSA collected from the residents and personnel in an NH (Lublin, Poland) during 2018. All MRSA were screened for 20 genes encoding virulence determinants (sea-see, eta, etb, tst, lukS-F-PV, eno, cna, ebpS, fib, bbp, fnbA, fnbB, icaADBC) and for resistance to 18 antimicrobials. To establish the relatedness and clonal complexes of MRSA in NH we applied multiple-locus variable-number tandem-repeat fingerprinting (MLVF), pulse field gel electrophoresis (PFGE), multilocus sequence typing (MLST) and staphylococcal cassette chromosome mec (SCCmec) typing. We identified four sequence types (ST) among two clonal complexes (CC): ST (CC22) known as EMRSA-15 as well as three novel STs—ST6295 (CC8), ST6293 (CC8) and ST6294. All tested MRSA were negative for sec, eta, etb, lukS-F-PV, bbp and ebpS genes. The most prevalent gene encoding toxin was sed (52.4%; n = 11/21), and adhesins were eno and fnbA (100%). Only 9.5% (n = 2/21) of MRSA were classified as multidrug-resistant. The emergence of novel MRSA with a unique virulence and the presence of epidemic clone EMRSA-15 creates challenges for controlling the spread of MRSA in NH.

scholarly journals Viscoelastometric Testing to Assess Hemostasis of COVID-19: A Systematic Review

2021 ◽  
Vol 10 (8) ◽  
pp. 1740
Author(s):  
Marion Bareille ◽  
Michaël Hardy ◽  
Jonathan Douxfils ◽  
Stéphanie Roullet ◽  
Dominique Lasne ◽  
...  
Keyword(s):  
Systematic Review ◽  
Mechanical Strength ◽  
Small Sample ◽  
The Common ◽  
Small Sample Sizes ◽  
Definition Of ◽  
Reported Data ◽  
Prophylactic Anticoagulation ◽  
The Impact ◽  
Heparin Neutralization

Infection by SARS-CoV-2 is associated with a high risk of thrombosis. The laboratory documentation of hypercoagulability and impaired fibrinolysis remains a challenge. Our aim was to assess the potential usefulness of viscoelastometric testing (VET) to predict thrombotic events in COVID-19 patients according to the literature. We also (i) analyzed the impact of anticoagulation and the methods used to neutralize heparin, (ii) analyzed whether maximal clot mechanical strength brings more information than Clauss fibrinogen, and (iii) critically scrutinized the diagnosis of hypofibrinolysis. We performed a systematic search in PubMed and Scopus databases until December 31st, 2020. VET methods and parameters, and patients’ features and outcomes were extracted. VET was performed for 1063 patients (893 intensive care unit (ICU) and 170 non-ICU, 44 studies). There was extensive heterogeneity concerning study design, VET device used (ROTEM, TEG, Quantra and ClotPro) and reagents (with non-systematic use of heparin neutralization), timing of assay, and definition of hypercoagulable state. Notably, only 4 out of 25 studies using ROTEM reported data with heparinase (HEPTEM). The common findings were increased clot mechanical strength mainly due to excessive fibrinogen component and impaired to absent fibrinolysis, more conspicuous in the presence of an added plasminogen activator. Only 4 studies out of the 16 that addressed the point found an association of VETs with thrombotic events. So-called functional fibrinogen assessed by VETs showed a variable correlation with Clauss fibrinogen. Abnormal VET pattern, often evidenced despite standard prophylactic anticoagulation, tended to normalize after increased dosing. VET studies reported heterogeneity, and small sample sizes do not support an association between the poorly defined prothrombotic phenotype of COVID-19 and thrombotic events.

The Effects of Production Performance Model and Competitive Environment of Hospital Systems

2013 ◽  
Vol 300-301 ◽  
pp. 1623-1627
Author(s):  
Ching Kuo Wei
Keyword(s):  
Performance Model ◽  
Production Performance ◽  
Competitive Environment ◽  
Data Envelopment ◽  
Hospital System ◽  
Department Of Health ◽  
Competitive Environments ◽  
Significant Difference ◽  
Efficiency Performance ◽  
Hospital Systems

This study investigated the efficiency performance of the production technology of the Department of Health (DOH)-affiliated hospital system in Taiwan in different competitive environments. This study used Data Envelopment Analysis (DEA) to analyze a total of 396 hospitals of different systems in Taiwan. The results indicated that, in terms of the internal competitive environment, the production performance of hospital Q was the best, while that of hospital N was the worst. This study also analyzed the production performance and scale of DOH-affiliated hospitals and provided hospitals with a direction for scale development. Finally, this study proposed suggestions on improvement direction for hospitals with poor production performance. As for external competitive environment, there is no significant difference in the average efficiency among various hospital systems. However, there are a lot to be improved in DOH-affiliated hospitals, especially in the aspect of technology efficiency. The improvement of technology efficiency should be more beneficial to the overall efficiency.

scholarly journals A simple and ranid method for preparing yeast chromosomes for Pulse Field Gel Electrophoresis

1987 ◽  
Vol 15 (16) ◽  
pp. 6749-6749 ◽  
Author(s):  
Michel Bellis ◽  
Michel Pagès ◽  
Gérard Roizès
Keyword(s):  
Gel Electrophoresis ◽  
Pulse Field ◽  
Pulse Field Gel Electrophoresis

No, I’m not… Chaucer? The Arabic motif in Troilus and Criseyde and Pushkin’s ‘The Prophet’ [‘Prorok’]

2021 ◽  
pp. 140-153
Author(s):  
A. A. Shapovalova
Keyword(s):  
Direct Contact ◽  
Common Source ◽  
Long Poem ◽  
Troilus And Criseyde ◽  
Potential Influence ◽  
Religious Texts ◽  
Common Motif ◽  
Courtly Romance ◽  
Genetic Source ◽  
The Common

The article discusses two works of literature: Troilus and Criseyde, a long poem written in the genre of courtly romance (1382–1386/1387) by G. Chaucer, and ‘The Prophet’ [‘Prorok’] (1826), a poem by A. Pushkin. The two works are compared due to a common motif: the opening of the chest and swapping of the heart as a sign of the person’s spiritual regeneration. In her comparative analysis of the two poems, the author attempts to identify their common source or the likelihood of direct contact — whether Pushkin had come across Chaucer’s work and borrowed the motif directly. As for the heart being replaced, it seems both poets may have been inspired by several biblical stories. Further analysis of the motif of the chest being opened suggests that the research should focus on the Arabic tradition alone and take into account the potential influence of Islamic religious texts on Pushkin as well as Chaucer. Relying on the available data about Russian and European relations with the Arabic world, the article hypothesises about the ways in which the motif in question could have reached each of the poets. The author names the Quran as the common genetic source of the two poems.

scholarly journals Chromosomal transformation in Saccharomyces cerevisiae with DNA isolated by pulse field gel electrophoresis.

1990 ◽  
Vol 54 (6) ◽  
pp. 1499-1504 ◽  
Author(s):  
Kuniyasu GOTO ◽  
Tohru MOTOYOSHI ◽  
Gakuzo TAMURA ◽  
Takaji OBATA ◽  
Shodo HARA
Keyword(s):  
Saccharomyces Cerevisiae ◽  
Gel Electrophoresis ◽  
Pulse Field ◽  
Pulse Field Gel Electrophoresis

scholarly journals Najib Hamadani and Ahmed at-Tusi’s Bulgarian oikonyms and their location in the former Volga Bulgaria

2016 ◽  
Vol 5 (3) ◽  
pp. 91-96
Author(s):  
Nikolay Valeryevich Belenov
Keyword(s):  
Historical Geography ◽  
Good Reason ◽  
Common Source ◽  
Present Stage ◽  
Medieval Manuscripts ◽  
Study Research ◽  
Folklore Studies ◽  
The Common ◽  
Information Borrowing ◽  
The Given

This article attempts to localize the fortresses of the Volga Bulgars (first of all, fortresses Marj and Tehshu) known from medieval authors reportedly Najib Hamadani and Ahmed at-Tusi. In the course of solving this problem the question of these authors data reliability is raised, as well as the common source of this information borrowing. There is a good reason to see this in the source known among the Arab-Persian historical and geographical medieval manuscripts as Rizal by Ahmed ibn Fadlan, the Secretary of Abbasid embassy to the Volga Bulgars Elteber Almush, who visited the Volga in 922. This fact explains the absence of Bulgarian cities known from other sources in the given lists as well as the question of uniqueness of Hamadani and at-Tusis information. On the basis of the sources synthesis, place-and folklore studies, the article proposes some options for localization of some of these forts and etymology options of Bulgarian oikonyms mentioned in the papers by the considered authors. The author proves the importance of place names data at the present stage of Bulgar study research, especially of Volga Bulgaria historical geography as well as further studies are planned.

Sign in / Sign up

Export Citation Format

Share Document