Characterization of the first carbapenem-resistant Pseudomonas aeruginosa clinical isolate harboring bla SIM-1 from the United States

2021 ◽  
Author(s):  
Catharine Prussing ◽  
Theresa Canulla ◽  
Navjot Singh ◽  
Patricia McAuley ◽  
Michael Gosciminski ◽  
...  
Keyword(s):  
Public Health ◽  
United States ◽  
Pseudomonas Aeruginosa ◽  
Clinical Isolate ◽  
Antimicrobial Therapy ◽  
The United States ◽  
Health Concerns ◽  
Carbapenem Resistant ◽  
Significant Public Health

The emergence and transmission of metallo-β-lactamases are significant public health concerns that threaten the utility of antimicrobial therapy (1, 2).…

scholarly journals 484. Metallo-β-Lactamase-Positive Carbapenem-Resistant Enterobacteriaceae and Pseudomonas aeruginosa in the Antibiotic Resistance Laboratory Network, 2017–2018

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S237-S237
Author(s):  
Allison C Brown ◽  
Sarah Malik ◽  
Jennifer Huang ◽  
Amelia Bhatnagar ◽  
Rocio Balbuena ◽  
...  
Keyword(s):  
United States ◽  
Pseudomonas Aeruginosa ◽  
Antibiotic Resistance ◽  
The United States ◽  
New Drugs ◽  
Carbapenem Resistant ◽  
Laboratory Network ◽  
Therapeutic Decisions ◽  
Carbapenemase Gene ◽  
Carbapenem Resistant Enterobacteriaceae

Abstract Background Infections with metallo-β-lactamase (MBL)-producing organisms are emerging in the United States. Treatment options for these infections are limited. We describe MBL genes among carbapenemase positive carbapenem-resistant Enterobacteriaceae (CP-CRE) and Pseudomonas aeruginosa (CP-CRPA) isolates tested during the first two years of the Antibiotic Resistance Laboratory Network (AR Lab Network). Methods State and local public health laboratories tested CRE and CRPA isolates for organism identification, antimicrobial susceptibility, and PCR-based detection of blaKPC, blaNDM, blaOXA-48-like, blaVIM, and blaIMP carbapenemase genes. All testing results were sent to CDC at least monthly. Results Since January 2017, the AR Lab Network tested 21,733 CRE and 14,141 CRPA. CP-CRE were detected in 37% of CRE; 2% of CRPA were CP-CRPA. Among CP-CRE, 9% (686/8016) were MBL-producers (NDM, VIM, or IMP). Among MBL-producers, a blaNDM gene was detected most often (81%; 551/686). blaNDM were most common among Klebsiella spp. (47%; 261/551), blaIMP were most common among Providencia spp. (53%; 40/75), blaVIM was most common among Enterobacter spp. (19%; 25/62). Twelve percent (96) of MBL CP-CRE contained more than one carbapenemase gene. Among CP-CRPA, 73% (218/300) were MBL producers and blaVIM was the most common gene (62%; 186). Three (1%) MBL CP-CRPA contained more than one carbapenemase. Conclusion Increased testing of CRE and CRPA isolates through the AR Lab Network has facilitated early and rapid detection of hard-to-treat infections caused by MBL-producing organisms across the United States. The widespread distribution of MBL genes highlights the continued need for containment strategies that help prevent transmission between patients and among healthcare facilities. To support therapeutic decisions for severe infections caused by MBL-producing organisms, the AR Lab Network is now offering rapid susceptibility testing against aztreonam/avibactam, using digital dispenser technology. This testing program aims to close the gap between the availability of new drugs or drug combinations and the availability of commercial AST methods, thereby improving patient safety and antimicrobial stewardship. Disclosures All authors: No reported disclosures.

Vitality, Self-healing and Ecology: The Flow of Naturopathic Thought Across the United States and India

2020 ◽  
Vol 6 (1) ◽  
pp. 121-143
Author(s):  
Victoria Sheldon
Keyword(s):  
Public Health ◽  
United States ◽  
South India ◽  
The United States ◽  
Self Healing ◽  
Medical Systems ◽  
Environmental Advocacy ◽  
Health Concerns ◽  
Cultural Climate ◽  
Medical Traditions

For over 5,000 years, the region now known as India has held a rich reservoir of medical systems, each providing distinct orientations towards illness experience, aetiology, cure and prevention. Since the turn of the twentieth century, there has been a considerable rise in the cultural recontextualisation of European and North American medical traditions in South Asia. With a focus on the guiding concepts of vitality, self-healing and ecology, this article maps the transnational trajectories of naturopathy across three sites: its instantiation into the United States’ early 1900s cultural climate of health epidemics and industrialisation; its rearticulation into the context of Gandhian anti-colonial movements in India; and its transformation into a mode of asserting public health and environmental advocacy in contemporary India. After tracing the trajectory of naturopathic thought, this article will provide a practitioner profile of naturopathy Dr Jacob Vadakkanchery as well as a framing of his politicised response to the 2018 floods in Kerala, south India. This particular examination serves as a microcosm of a larger trend: contemporary practitioners in India overtly re-frame naturopathic concepts in relation to immanent environmental and public health concerns.

Overview

2020 ◽  
pp. 121-138
Author(s):  
Yngvild Olsen ◽  
Anika A. H. Alvanzo ◽  
Jarratt D. Pytell
Keyword(s):  
Public Health ◽  
United States ◽  
The United States ◽  
Health Impacts ◽  
Opioid Use ◽  
The Us ◽  
Significant Public Health ◽  
History Of ◽  
Opioid Use Disorders ◽  
Barriers To Use

Substance use disorders (SUDs) are a significant cause of morbidity and mortality in the United States. In spite of the significant public health impacts of SUDs, medications approved by the US Food and Drug Administration (FDA) are underutilized for the treatment of SUDs. This chapter reviews the history of FDA-approved medications for alcohol, nicotine, and opioid use disorders and provides some background on barriers to use of these medications to treat patients with SUDs. Suggestions are provided to guide clinicians on a path forward to reduce these barriers and increase the use of FDA-approved medications for the treatment of SUDs.

Aetiology of alcohol problems

2012 ◽  
pp. 432-437
Author(s):  
Juan C. Negrete ◽  
Kathryn J. Gill
Keyword(s):  
Public Health ◽  
United States ◽  
Alcohol Abuse ◽  
Alcohol Dependence ◽  
The United States ◽  
Alcohol Problems ◽  
Harmful Drinking ◽  
Significant Public Health ◽  
Icd 10 ◽  
Health Complications

Approximately 8 out of every 10 persons living in Europe and the Americas would report consuming alcoholic beverages in their lifetime, and the norm is for drinking to start in adolescence: in 2003 the average age of first drink in the United States was 14 years old. Also in the year 2003, 79.3 per cent of persons aged 15 years or more in Canada reported to be current users of alcohol, and 22.6 per cent admitted to having exceeded the country's safe drinking guidelines (i.e. no more than 14 units/week for males and 12 units/week for females). The same survey elicited a rate of ‘hazardous drinkers’ of 13.6 per cent, defined as all respondents who scored 8+ on the AUDIT screening questionnaire.Epidemiological data in the United States indicates that roughly one in seven persons who start drinking will develop an alcohol dependence disorder in the course of their lives. The figure is higher among men when compared to women. Of course it is also higher if other clinical forms of alcohol misuse (i.e. alcohol abuse/harmful drinking) are included in the rates in addition to dependence. A moderate level of alcohol use appears to be relatively harmless; and there exist public health guidelines on ‘safe’ drinking practices. The recommendations vary considerably from country to country, but they all assume a greater vulnerability to alcohol effects in the female gender. In the United Kingdom, for instance, hazardous drinking is thought to start at 21 units/week for men and 16 units/week for women; and in the United States the equivalent guidelines are 14 and 7 drinks per week. It is among alcohol users who exceed such guidelines that the prevalence of dependence is the highest; up to 40 per cent of the more frequent violators. The expression ‘alcohol problems’ encompasses a wide range of untoward occurrences, from maladaptive, impaired, or harmful behaviour, to health complications and the condition of alcohol dependence. Alcohol problems are not incurred just by chronic excessive drinkers, but also by persons who drink heavily on isolated occasions (e.g. accidents, violence, poisoning, etc.). Given their high frequency and social costs, these consequences of acute inebriation represent the most significant public health burden of drinking. This section focuses rather on the causes of problems of a clinical nature, the ones presented by individuals who engage in patterns of repeated excessive drinking, i.e. ‘alcohol dependence’ and ‘alcohol abuse’ (DSM-IV nomenclature) or ‘harmful drinking’ (ICD-10 nomenclature).

scholarly journals Understanding lead in water and avoidance strategies: a United States perspective for informed decision-making

2019 ◽  
Vol 17 (4) ◽  
pp. 540-555 ◽  
Author(s):  
Kelsey J. Pieper ◽  
Adrienne Katner ◽  
Rebecca Kriss ◽  
Min Tang ◽  
Marc A. Edwards
Keyword(s):  
Public Health ◽  
United States ◽  
Drinking Water ◽  
The United States ◽  
Global Network ◽  
Simplified Approach ◽  
Household Level ◽  
Wide Range ◽  
Avoidance Strategies ◽  
Significant Public Health

Abstract The pervasiveness of lead in drinking water poses a significant public health threat, which can be reduced by implementing preventive measures. However, the causes of elevated lead in water and the benefits of lead in water avoidance strategies are often misunderstood. Based on experiences in the United States, this paper describes an oversimplified ‘lead in water equation’ to explain key variables controlling the presence of lead in drinking water to better inform public health practitioners, government officials, utility personnel, and concerned residents. We illustrate the application of the equation in Flint, Michigan and explore the primary household-level water lead avoidance strategies recommended during the crisis, including flushing, filtration, bottled water use, and lead pipe removal. In addition to lead reduction, strategies are evaluated based on costs and limitations. While these lead avoidance strategies will reduce water lead to some degree, the costs, limitations, and effectiveness of these strategies will be site- and event-specific. This paper presents a simplified approach to communicate key factors which must be considered to effectively reduce waterborne lead exposures for a wide range of decision makers. This article has been made Open Access thanks to the generous support of a global network of libraries as part of the Knowledge Unlatched Select initiative.

scholarly journals Carbapenemase Gene Profiles in Carbapenem-Resistant Enterobacteriaceae—United States, January 2018–August 2019

2020 ◽  
Vol 41 (S1) ◽  
pp. s149-s150
Author(s):  
Jennifer Huang ◽  
Amanda Pettinger ◽  
Katie Bantle ◽  
Amelia Bhatnagar ◽  
Sarah Gilbert ◽  
...  
Keyword(s):  
Public Health ◽  
United States ◽  
Drug Combination ◽  
The United States ◽  
Molecular Testing ◽  
E Coli ◽  
Carbapenem Resistant ◽  
Gene Profiles ◽  
Carbapenemase Gene ◽  
Carbapenem Resistant Enterobacteriaceae

Background: Carbapenem-resistant Enterobacteriaceae (CRE) cause significant morbidity and mortality each year in the United States. Treatment options for these infections are often limited, in part due to carbapenemases, which are mobile β-lactam-hydrolyzing enzymes that confer multidrug resistance in CRE. As part of the CDC’s Containment Strategy for Emerging Resistance, public health laboratories (PHLs) in the CDC Antibiotic Resistance Laboratory Network (AR Lab Network) have worked to characterize clinical isolates of CRE for rapid identification of carbapenemase genes. These data are then used by public health and healthcare partners to promote patient safety by decreasing the spread of resistance. We summarize carbapenemase gene profiles in CRE, by genus and geography, using data collected through the AR Lab Network from January 2018 through August 2019. Methods: CRE isolates were submitted to 55 PHLs, including those of all 50 states, 4 large cities, and Puerto Rico, in accordance with each jurisdiction’s reporting laws. PHLs performed phenotypic and molecular testing on isolates to detect targeted, emerging carbapenemase genes and reported results to submitters. Carbapenemase-positive (CP) isolates were defined as PCR positive for ≥1 carbapenemase gene tested: blaKPC, blaNDM, blaVIM, blaIMP, blaOXA-48–LIKE. PHLs submitted results to CDC monthly. Genera other than Enterobacter, Klebsiella, and Escherichia coli are categorized as other genera in this analysis. Data were compiled and analyzed using SAS v 9.4 software. Results: From January 2018 to August 2019, the AR Lab Network tested 25,705 CRE isolates; 8,864 of 25,705 CRE (34%) were CP. Klebsiella spp represented the largest proportion of CP-CRE at 68% (n = 6,063), followed by E. coli (12%, n = 1,052), Enterobacter spp (11%, n = 981), and other genera (9%, n = 768). Figure 1a shows the composition of CP-CRE carbapenemase genes by genus. The most common carbapenemase and genus profiles were blaKPC in Klebsiella (74%; 5,562 of 7,561 blaKPC-positive) blaNDM in E. coli (43%; 372 of 868 blaNDM-positive) blaVIM in Enterobacter spp (35%; 25 of 72 blaVIM-positive), and blaIMP among other genera (90%; 92 of 102 blaIMP-positive). Common CP-CRE genes and genera also varied by geography (Fig. 1b). Conclusions: The AR Lab Network has greatly enhanced our nation’s ability to detect and characterize CP-CRE. Our data provide a snapshot of the organisms and regions where mobile carbapenemase genes are most often detected in CRE. Geographic variation in CP gene profiles provides actionable data to inform local priorities for detection and infection control and provide clinicians with situational awareness of the genes and organisms that are circulating in their region.Funding: NoneDisclosures: In this presentation, the authors discuss the drug combination aztreonam-avibactam and acknowledge that this drug combination is not currently FDA-approved.

scholarly journals Defending Density

2021 ◽  
Author(s):  
Michael Samuelian
Keyword(s):  
Public Health ◽  
United States ◽  
20Th Century ◽  
Communication Technology ◽  
Rural Areas ◽  
The United States ◽  
Urban Life ◽  
Health Concerns ◽  
Environmentally Sustainable ◽  
Direct Pathway

We have an aversion to density in America. Density is a continual trope in this country, blamed for all of the ills of urban life, from crime and racial unrest in the middle of the 20th century to public health concerns today. In the early stages of the COVID pandemic density was the culprit, even though we’ve subsequently seen outbreaks in rural areas and sprawling cities across the United States. This paper will look into the root of America’s problems with density and argue that density is not the problem but the solution to the challenges of today’s and tomorrow’s cities. As we deplete the resources of the planet, density is our most direct pathway to recover some balance with nature. Dense living is more efficient, less carbon intensive and more environmentally sustainable. As geospatial differentiations matter less due to advances in communication technology, it's the density of people and ideas that will continue to fuel innovation. Finally, in a world that is increasingly dominated by pluralism, denser living promotes openness, tolerance and diversity.

scholarly journals Health Effects and Public Health Concerns of Energy Drink Consumption in the United States: A Mini-Review

2017 ◽  
Vol 5 ◽  
Author(s):  
Laila Al-Shaar ◽  
Kelsey Vercammen ◽  
Chang Lu ◽  
Scott Richardson ◽  
Martha Tamez ◽  
...  
Keyword(s):  
Public Health ◽  
United States ◽  
Health Effects ◽  
Energy Drink ◽  
The United States ◽  
Health Concerns ◽  
Energy Drink Consumption

Calling all Campy – how routine investigation and molecular characterization impacts the understanding of campylobacteriosis epidemiology – Alaska, United States, 2004–2013

2015 ◽  
Vol 144 (2) ◽  
pp. 265-267 ◽  
Author(s):  
L. J. CASTRODALE ◽  
G. M. PROVO ◽  
C. M. XAVIER ◽  
J. B. McLAUGHLIN
Keyword(s):  
Public Health ◽  
United States ◽  
Molecular Characterization ◽  
Case Reports ◽  
Health Impact ◽  
The United States ◽  
Outbreak Detection ◽  
Incident Case ◽  
The Public

SUMMARYUnlike most jurisdictions in the United States, Alaska performs pulsed-field gel electrophoresis (PFGE) characterization of all Campylobacter sp. isolates at the state public health laboratory – a practice that started in 2002. Moreover, in order to ensure early detection and response to campylobacteriosis outbreaks, the Alaska Section of Epidemiology has investigated all incident Campylobacter sp. case reports since 2004. This report summarizes the public health impact of routine incident case investigations and molecular characterization of all Campylobacter sp. isolates. In sum, we found that these efforts have contributed to better characterization of the epidemiology of campylobacteriosis in Alaska, and facilitated more rapid outbreak detection, more public health investigations, and earlier public health interventions.

scholarly journals Promising Agents for Chemoprevention of Skin Cancer

2006 ◽  
Vol 13 (5) ◽  
pp. 185-186
Author(s):  
S. P. Stratton ◽  
M. S. Stratton ◽  
D. S. Alberts
Keyword(s):  
Public Health ◽  
United States ◽  
Skin Cancer ◽  
Health Problem ◽  
Public Health Problem ◽  
The United States ◽  
Northern Europe ◽  
Significant Public Health Problem ◽  
The World ◽  
Significant Public Health

Skin cancer presents a significant public health problem because of its increasing incidence in the United States, Australia, Northern Europe, and other temperate climates around the world. [...]

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