scholarly journals Comparison of Two Culture Methods for Use in Assessing Microbial Contamination of Duodenoscopes

2015 ◽  
Vol 54 (2) ◽  
pp. 312-316 ◽  
Author(s):  
Michaela A. Gazdik ◽  
Jana Coombs ◽  
John P. Burke ◽  
Bert K. Lopansri
Keyword(s):  
Recovery Rate ◽  
Culture Methods ◽  
Strict Adherence ◽  
Content Type ◽  
Carbapenem Resistant ◽  
Control And Prevention ◽  
Gram Negative Organisms ◽  
High Level ◽  
User Friendly ◽  
Recommended Guidelines

Recent outbreaks of carbapenem-resistantEnterobacteriaceaeinfections associated with duodenoscopes used for endoscopic retrograde cholangiopancreatography have highlighted the challenge of cleaning and high-level disinfection of these instruments. The Food and Drug Administration has suggested that duodenoscope surveillance by microbiological culturing, along with strict adherence to reprocessing protocols, may help reduce the risk of duodenoscope-associated infection transmission. We developed and validated an effective, user-friendly duodenoscope sampling and culture protocol and compared its performance to the interim Centers for Disease Control and Prevention–recommended guidelines. Our protocol resulted in a 65% recovery rate for Gram-negative organisms, demonstrating a 2-fold increased recovery rate compared to the CDC method. The implementation of this protocol may increase the feasibility of duodenoscope surveillance for microbiology laboratories and endoscopy departments.

scholarly journals High-Level Carbapenem Resistance in OXA-232-Producing Raoultella ornithinolytica Triggered by Ertapenem Therapy

2019 ◽  
Vol 64 (1) ◽  
Author(s):  
Alina Iovleva ◽  
Roberta T. Mettus ◽  
Christi L. McElheny ◽  
Marissa P. Griffith ◽  
Mustapha M. Mustapha ◽  
...  
Keyword(s):  
Rapid Development ◽  
Carbapenem Resistance ◽  
Resistant Isolate ◽  
Clinical Microbiology Laboratory ◽  
Loss Of Function ◽  
Content Type ◽  
Carbapenem Resistant ◽  
Class D ◽  
Fold Reduction ◽  
High Level

ABSTRACT OXA-232 is an OXA-48-group class D β-lactamase that hydrolyzes expanded-spectrum cephalosporins and carbapenems at low levels. Clinical strains producing OXA-232 are sometimes susceptible to carbapenems, making it difficult to identify them in the clinical microbiology laboratory. We describe the development of carbapenem resistance in sequential clinical isolates of Raoultella ornithinolytica carrying blaOXA-232 in a hospitalized patient, where the ertapenem MIC increased from 0.5 μg/ml to 512 μg/ml and the meropenem MIC increased from 0.125 μg/ml to 32 μg/ml during the course of ertapenem therapy. Whole-genome sequencing (WGS) analysis identified loss-of-function mutations in ompC and ompF in carbapenem-resistant isolates that were not present in the initial carbapenem-susceptible isolate. Complementation of a carbapenem-resistant isolate with an intact ompF gene resulted in 16- to 32-fold reductions in carbapenem MICs, whereas complementation with intact ompC resulted in a 2-fold reduction in carbapenem MICs. Additionally, blaOXA-232 expression increased 2.9-fold in a carbapenem-resistant isolate. Rapid development of high-level carbapenem resistance in initially carbapenem-susceptible OXA-232-producing R. ornithinolytica under selective pressure from carbapenem therapy highlights the diagnostic challenges in detecting Enterobacteriaceae strains producing this inefficient carbapenemase.

Corruption control and prevention in the Korean government

2018 ◽  
Vol 7 (3) ◽  
pp. 303-314 ◽  
Author(s):  
Jin-Wook Choi
Keyword(s):  
South Korea ◽  
Qualitative Analysis ◽  
Design Methodology ◽  
Institution Building ◽  
Content Type ◽  
Korean Government ◽  
Policies And Measures ◽  
Control And Prevention ◽  
High Level ◽  
Over Time

Purpose The purpose of this paper is to examine how corruption has changed over time in South Korea and to explore how the corruption control and prevention efforts of the Korean government have been successful and failed. Design/methodology/approach This paper draws on institutional theory to formulate a qualitative analysis to assess the effectiveness of anti-corruption policies and measures, and to identify the strengths and weaknesses of anti-corruption reform efforts in South Korea. Findings This paper argues that while the Korean government has been quite successful in building anti-corruption institutions to control low-level petty corruption, it has failed to institutionalize anti-corruption institutions to curb high-level grand corruption. Originality/value While many studies have attempted to identify the successful factors of fighting corruption, this paper draws a theoretical distinction between institution-building vs institutionalization to examine the success and failure of corruption control and prevention efforts in South Korea.

scholarly journals Draft Genome Sequences of Two Acinetobacter baumannii Isolates from a Fatal Case of Necrotizing Fasciitis

2020 ◽  
Vol 9 (13) ◽  
Author(s):  
Brock A. Arivett ◽  
Angella Charnot-Katsikas ◽  
Cindy Bethel ◽  
Steven E. Fiester ◽  
Luis A. Actis
Keyword(s):  
Necrotizing Fasciitis ◽  
Acinetobacter Baumannii ◽  
Fatal Case ◽  
Draft Genome ◽  
Bacterial Pathogen ◽  
Genome Sequences ◽  
Content Type ◽  
Carbapenem Resistant ◽  
Control And Prevention ◽  
Total Dna

Carbapenem-resistant Acinetobacter baumannii is a bacterial pathogen with serious implications for human health and is recognized as an urgent threat by the Centers for Disease Control and Prevention (CDC). Total DNA from two A. baumannii clinical isolates collected over 3 days from a fatal case of necrotizing fasciitis has been sequenced to >30× coverage.

scholarly journals Outbreak Caused by NDM-1- and RmtB-Producing Escherichia coli in Bulgaria

2014 ◽  
Vol 58 (4) ◽  
pp. 2472-2474 ◽  
Author(s):  
Laurent Poirel ◽  
Encho Savov ◽  
Arzu Nazli ◽  
Angelina Trifonova ◽  
Iva Todorova ◽  
...  
Keyword(s):  
Escherichia Coli ◽  
16S Rrna ◽  
Sequence Type ◽  
Content Type ◽  
E Coli ◽  
Carbapenem Resistant ◽  
The World ◽  
High Level ◽  
16S Rrna Methylase ◽  
Level Resistance

ABSTRACTTwelve consecutive carbapenem-resistantEscherichia coliisolates were recovered from patients (infection or colonization) hospitalized between March and September 2012 in different units at a hospital in Bulgaria. They all produced the carbapenemase NDM-1 and the extended-spectrum-β-lactamase CTX-M-15, together with the 16S rRNA methylase RmtB, conferring high-level resistance to all aminoglycosides. All those isolates were clonally related and belonged to the same sequence type, ST101. In addition to being the first to identify NDM-producing isolates in Bulgaria, this is the very first study reporting an outbreak of NDM-1-producingE. coliin the world.

scholarly journals Superantigens Are Critical for Staphylococcus aureus Infective Endocarditis, Sepsis, and Acute Kidney Injury

mBio ◽  
2013 ◽  
Vol 4 (4) ◽  
Author(s):  
Wilmara Salgado-Pabón ◽  
Laura Breshears ◽  
Adam R. Spaulding ◽  
Joseph A. Merriman ◽  
Christopher S. Stach ◽  
...  
Keyword(s):  
Staphylococcus Aureus ◽  
Acute Kidney Injury ◽  
Infective Endocarditis ◽  
Kidney Injury ◽  
The United States ◽  
Content Type ◽  
Lethal Sepsis ◽  
Control And Prevention ◽  
Bacterial Accumulation ◽  
High Level

ABSTRACTInfective endocarditis and kidney infections are serious complications ofStaphylococcus aureussepsis. We investigated the role of superantigens (SAgs) in the development of lethal sepsis, infective endocarditis, and kidney infections. SAgs cause toxic shock syndrome, but it is unclear if SAgs contribute to infective endocarditis and kidney infections secondary to sepsis. We show in the methicillin-resistantS. aureusstrain MW2 that lethal sepsis, infective endocarditis, and kidney infections in rabbits are critically dependent on high-level SAgs. In contrast, the isogenic strain lacking staphylococcal enterotoxin C (SEC), the major SAg in this strain, is attenuated in virulence, while complementation restores disease production. SAgs’ role in infective endocarditis appears to be both superantigenicity and direct endothelial cell stimulation. Maintenance of elevated blood pressure by fluid therapy significantly protects from infective endocarditis, possibly through preventing bacterial accumulation on valves and increased SAg elimination. These data should facilitate better methods to manage these serious illnesses.IMPORTANCEThe Centers for Disease Control and Prevention reported in 2007 thatStaphylococcus aureusis the most significant cause of serious infectious diseases in the United States (R. M. Klevens, M. A. Morrison, J. Nadle, S. Petit, K. Gershman, et al., JAMA 298:1763–1771, 2007). Among these infections are sepsis, infective endocarditis, and acute kidney injury. Infective endocarditis occurs in 30 to 60% of patients withS. aureusbacteremia and carries a mortality rate of 40 to 50%. Over the past decades, infective endocarditis outcomes have not improved, and infection rates are steadily increasing (D. H. Bor, S. Woolhandler, R. Nardin, J. Brusch, D. U. Himmelstein, PLoS One 8:e60033, 2013). There is little understanding of theS. aureusvirulence factors that are key for infective endocarditis development and kidney abscess formation. We demonstrate that superantigens are critical in the causation of all three infections. We show that their association results from both superantigenicity and direct toxic effects on endothelial cells, the latter likely contributing to delayed endothelium healing. Our studies contribute significantly to understanding the development of these illnesses and are expected to lead to development of important therapies to treat such illnesses.

scholarly journals First Report of Klebsiella oxytoca Strain Coproducing KPC-2 and IMP-8 Carbapenemases

2011 ◽  
Vol 55 (6) ◽  
pp. 2937-2941 ◽  
Author(s):  
Bin Li ◽  
Jing-Yong Sun ◽  
Qing-Zhong Liu ◽  
Li-Zhong Han ◽  
Xin-Hong Huang ◽  
...  
Keyword(s):  
Southern Hybridization ◽  
Klebsiella Oxytoca ◽  
Content Type ◽  
Genetic Environment ◽  
Carbapenem Resistant ◽  
Plasmid Analysis ◽  
High Level ◽  
Lactamase Gene ◽  
First Time ◽  
Level Resistance

ABSTRACTThe study shows for the first time the presence of theKlebsiella oxytocastrain fp10 coproducing plasmid-mediated KPC-2 and IMP-8 carbapenemases. The strain was obtained from the fecal sample of an inpatient and showed high-level resistance to imipenem and ertapenem (MICs > 32 μg/ml). Conjugation experiments demonstrated the transferability of the carbapenem-resistant determinants. The results of plasmid analysis and Southern hybridization revealed that theblaKPC-2gene was located on transferable plasmid pFP10-1 (∼54 kb), whereas theblaIMP-8gene was on transferable plasmid pFP10-2 (∼180 kb). Analysis of the genetic environment of these two genes has demonstrated that ISKpn6and ISKpn8are involved in the spread of theblaKPC-2gene, while the transposable elements IS26,intI1, andtniCmight contribute to the dissemination of theblaIMP-8gene. The chimera of several transposon-associated elements indicated a novel genetic environment of IMP-type metallo-β-lactamase gene inEnterobacteriaceaefrom China.

scholarly journals A narrative review on current duodenoscope reprocessing techniques and novel developments

2021 ◽  
Vol 10 (1) ◽  
Author(s):  
Maarten Heuvelmans ◽  
Herman F. Wunderink ◽  
Henny C. van der Mei ◽  
Jan F. Monkelbaan
Keyword(s):  
The United States ◽  
Pathogen Transmission ◽  
Clinical Implementation ◽  
Sampling Protocol ◽  
Strict Adherence ◽  
United States Food ◽  
Control And Prevention ◽  
American Society ◽  
High Level ◽  
American Society For Microbiology

AbstractDuodenoscopy-associated infections occur worldwide despite strict adherence to reprocessing standards. The exact scope of the problem remains unknown because a standardized sampling protocol and uniform sampling techniques are lacking. The currently available multi-society protocol for microbial culturing by the Centers for Disease Control and Prevention, the United States Food and Drug Administration (FDA) and the American Society for Microbiology, published in 2018 is too laborious for broad clinical implementation. A more practical sampling protocol would result in increased accessibility and widespread implementation. This will aid to reduce the prevalence of duodenoscope contamination. To reduce the risk of duodenoscopy-associated pathogen transmission the FDA advised four supplemental reprocessing measures. These measures include double high-level disinfection, microbiological culturing and quarantine, ethylene oxide gas sterilization and liquid chemical sterilization. When the supplemental measures were advised in 2015 data evaluating their efficacy were sparse. Over the past five years data regarding the supplemental measures have become available that place the efficacy of the supplemental measures into context. As expected the advised supplemental measures have resulted in increased costs and reprocessing time. Unfortunately, it has also become clear that the efficacy of the supplemental measures falls short and that duodenoscope contamination remains a problem. There is a lot of research into new reprocessing methods and technical applications trying to solve the problem of duodenoscope contamination. Several promising developments such as single-use duodenoscopes, electrolyzed acidic water, and vaporized hydrogen peroxide plasma are already applied in a clinical setting.

scholarly journals Prevalence of β-Lactamase-Encoding Genes among Enterobacteriaceae Bacteremia Isolates Collected in 26 U.S. Hospitals: Report from the SENTRY Antimicrobial Surveillance Program (2010)

2013 ◽  
Vol 57 (7) ◽  
pp. 3012-3020 ◽  
Author(s):  
Mariana Castanheira ◽  
Sarah E. Farrell ◽  
Lalitagauri M. Deshpande ◽  
Rodrigo E. Mendes ◽  
Ronald N. Jones
Keyword(s):  
New York ◽  
New York City ◽  
Surveillance Program ◽  
Content Type ◽  
Carbapenem Resistant ◽  
Antimicrobial Surveillance ◽  
Genes Encoding ◽  
Resistant Strains ◽  
User Friendly ◽  
Encoding Genes

ABSTRACTEnterobacteriaceaebacteremia isolates (n= 195; 6.4% overall) collected from 26 U.S. hospitals located in 20 states were screened for various β-lactamase classes. A total of 175 isolates carried one to eight acquired β-lactamase genes of 44 types that were detected in 55 combinations. Eighty-five (43.6%) strains carriedblaCTX-M, andblaCTX-M-15was the most prevalent (33.8%). Genes encoding OXA-1/30 (often associated withblaCTX-M-15), CMY-2, SHV extended-spectrum β-lactamase (ESBLs), and TEM-1 were also prevalent. Among 33 carbapenem-resistant strains, 28 carriedblaKPC-2orblaKPC-3(17 and 11 strains, respectively), and those were recovered mostly in the New York City area (16 strains) and Houston, TX (9 strains). Fourteen new SHV variants were identified amongKlebsiella pneumoniaeisolates carrying one or multiple SHV alleles, three carrying G238S and/or E240K amino acid alterations that confer ESBL activity. Only two of eightK. oxytocaisolates carried acquired β-lactamases, but most had mutations on theblaOXYpromoter region, and three new OXY-encoding genes were characterized. Concordance between a commercial nucleic acid-based microarray (Check-MDR CT101) and reference methods was noted for 105/109 (97.2%) strains. Thirty-two strains having genes that are not targeted by the commercial system were detected (OXA ESBLs, PER, PSE, or intrinsic genes). Overall, a great variety of enzymes were observed, with numerous strains carrying multiple genes. Rates of CTX-M-producing strains appear to be increasing in U.S. hospitals (26.6% in 2007 to 43.8% for 2010) participating in the SENTRY Program. Furthermore, the Check-Points system seems to be a reliable, robust, and user-friendly assay for detection of enzyme-mediated resistance.

Improving the effectiveness of subject facets in library catalogs and beyond: a MARC-based semiautomated approach

2020 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Andrea Cuna ◽  
Gabriele Angeli
Keyword(s):  
Design Methodology ◽  
Exploratory Search ◽  
Controlled Vocabularies ◽  
Content Type ◽  
Client Server ◽  
Search Tasks ◽  
Facet Analysis ◽  
High Level ◽  
User Friendly ◽  
Practical Implications

PurposeThis paper puts forward a MARC-based semiautomated approach to extracting semantically rich subject facets from general and/or specialized controlled vocabularies for display in topic-oriented faceted catalog interfaces in a way that would better support users' exploratory search tasks.Design/methodology/approachHierarchical faceted subject metadata is extracted from general and/or specialized controlled vocabularies by using standard client/server communication protocols. Rigorous facet analysis, classification and linguistic principles are applied on top of that to ensure faceting accuracy and consistency.FindingsA shallow application of facet analysis and classification, together with poorly organized displays, is one of the major barriers to effective faceted navigation in library, archive and museum catalogs.Research limitations/implicationsThis paper does not deal with Web-scale discovery services.Practical implicationsThis paper offers suggestions that can be used by the technical services departments of libraries, archives and museums in designing and developing more powerful exploratory search interfaces.Originality/valueThis paper addresses the problem of deriving clearly delineated topical facets from existing metadata for display in a user-friendly, high-level topical overview that is meant to encourage a multidimensional exploration of local collections as well as “learning by browsing.”

scholarly journals Types and Prevalence of Carbapenem-Resistant Acinetobacter calcoaceticus-Acinetobacter baumannii Complex in Northern Taiwan

2013 ◽  
Vol 58 (1) ◽  
pp. 201-204 ◽  
Author(s):  
Wen-Shyang Hsieh ◽  
Nai-Yu Wang ◽  
Jou-An Feng ◽  
Li-Chuan Weng ◽  
Hsueh-Hsia Wu
Keyword(s):  
Acinetobacter Baumannii ◽  
Medical Center ◽  
Carbapenem Resistance ◽  
Acinetobacter Calcoaceticus ◽  
Pulsed Field Gel Electrophoresis ◽  
Content Type ◽  
Carbapenem Resistant ◽  
Acinetobacter Baumannii Complex ◽  
High Level ◽  
Northern Taiwan

ABSTRACTThe frequency of the carbapenem-resistantAcinetobacter calcoaceticus-Acinetobacter baumannii(CRACB) complex increases annually in our hospitals. However, the types and prevalence of carbapenemases among isolates still remain unclear. In this study, we identified and collected 672 carbapenem-resistant isolates from a medical center in Northern Taiwan between April and December of 2010. There were 577 genospecies 2 (Acinetobacter baumannii), 79 genospecies 13TU, and 16 genospecies 3 isolates. The isolates had an acquiredblaOXA-24-like gene, which was confirmed by sequencing for the encoded OXA-72 carbapenemase, and were often associated with high-level carbapenem resistance. These CRACB complex isolates remained susceptible to colistin (100%). The genotyping of isolates was conducted using pulsed-field gel electrophoresis with ApaI digestion. In most clonally related groups, patients were from both branch hospitals. The results indicate that interhospital dissemination of clones occurred. This study provides updated data on the types and prevalence of the CRACB complex. In addition, it presents a warning on the emergence and spread of CRACB complex harboringblaOXA-24-like genes in northern Taiwan.

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