NDM-1 Introduction in Portugal through a ST11 KL105 Klebsiella pneumoniae Widespread in Europe

The changing epidemiology of carbapenem-resistant Klebsiella pneumoniae in Southern European countries is challenging for infection control, and it is critical to identify and track new genetic entities (genes, carbapenemases, clones) quickly and with high precision. We aimed to characterize the strain responsible for the first recognized outbreak by an NDM-1-producing K. pneumoniae in Portugal, and to elucidate its diffusion in an international context. NDM-1-producing multidrug-resistant K. pneumoniae isolates from hospitalized patients (2018–2019) were characterized using FTIR spectroscopy, molecular typing, whole-genome sequencing, and comparative genomics with available K. pneumoniae ST11 KL105 genomes. FT-IR spectroscopy allowed the rapid (ca. 4 h after incubation) identification of the outbreak strains as ST11 KL105, supporting outbreak control. Epidemiological information supports a community source but without linkage to endemic regions of NDM-1 producers. Whole-genome comparison with previous DHA-1-producing ST11 KL105 strains revealed the presence of different plasmid types and antibiotic resistance traits, suggesting the entry of a new strain. In fact, this ST11 KL105 clade has successfully disseminated in Europe with variable beta-lactamases, but essentially as ESBL or DHA-1 producers. We expand the distribution map of NDM-1-producing K. pneumoniae in Europe, at the expense of a successfully established ST11 KL105 K. pneumoniae clade circulating with variable plasmid backgrounds and beta-lactamases. Our work further supports the use of FT-IR as an asset to support quick infection control.

Understanding Local Water Collaboration for the Potential to Enhance Community Source Water Protection at Chippewas of the Thames First Nation

First Nations in Canada are disproportionately affected by chronic drinking water insecurity (Bakker, 2012). Aboriginal Affair and Northern Development Canada conducted an assessment of First Nations water and wastewater systems in 2001 and found significant risk to the quality and safety of drinking water on three- quarters of all systems (Johns and Rasmussen, 2008). Neegan Burnside (2011) classified four differentrisks that affect drinking water systems for First Nations, which include, no source water protection plan,deterioration of water quality over time, risk of contamination, and insufficient capacity to meet futurerequirements. This study found that the two highest risks were risk of source water contamination and thelack of a community source water protection plan (Neegan Burnside, 2011). Water security, sustainableaccess on a watershed basis to adequate quantities of water of acceptable quality to ensure human andecosystem health (Bakker, 2012), therefore requires source water protection and collaboration amongwater actors. Collaboration is defined as the pooling of resources by multiple stakeholders to solveproblems, which includes a balance of power among actors, mutually agreed upon objectives, is perceived as legitimate, and includes a wide variety of stakeholders (Ashlie, 2019; Van Der Porten, 2013; Spencer etal., 2016; Black & McBean, 2017).

Understanding Local Water Collaboration for the Potential to Enhance Community Source Water Protection at Chippewas of the Thames First Name

First Nations in Canada are disproportionately affected by chronic drinking water insecurity (Bakker, 2012). Aboriginal Affair and Northern Development Canada conducted an assessment of First Nations water and wastewater systems in 2001 and found significant risk to the quality and safety of drinking water on three- quarters of all systems (Johns and Rasmussen, 2008). Neegan Burnside (2011) classified four differentrisks that affect drinking water systems for First Nations, which include, no source water protection plan,deterioration of water quality over time, risk of contamination, and insufficient capacity to meet futurerequirements. This study found that the two highest risks were risk of source water contamination and thelack of a community source water protection plan (Neegan Burnside, 2011). Water security, sustainableaccess on a watershed basis to adequate quantities of water of acceptable quality to ensure human andecosystem health (Bakker, 2012), therefore requires source water protection and collaboration amongwater actors. Collaboration is defined as the pooling of resources by multiple stakeholders to solveproblems, which includes a balance of power among actors, mutually agreed upon objectives, is perceived as legitimate, and includes a wide variety of stakeholders (Ashlie, 2019; Van Der Porten, 2013; Spencer etal., 2016; Black & McBean, 2017).

Surveillance of OXA-244-producing Escherichia coli and epidemiologic investigation of cases, Denmark, January 2016 to August 2019

Background Carbapenemase-producing Escherichia coli are increasing worldwide. In recent years, an increase in OXA-244-producing E. coli isolates has been seen in the national surveillance of carbapenemase-producing organisms in Denmark. Aim Molecular characterisation and epidemiological investigation of OXA-244-producing E. coli isolates from January 2016 to August 2019. Methods For the epidemiological investigation, data from the Danish National Patient Registry and the Danish register of civil registration were used together with data from phone interviews with patients. Isolates were characterised by analysing whole genome sequences for resistance genes, MLST and core genome MLST (cgMLST). Results In total, 24 OXA-244-producing E. coli isolates were obtained from 23 patients. Among the 23 patients, 13 reported travelling before detection of the E. coli isolates, with seven having visited countries in Northern Africa. Fifteen isolates also carried an extended-spectrum beta-lactamase gene and one had a plasmid-encoded AmpC gene. The most common detected sequence type (ST) was ST38, followed by ST69, ST167, ST10, ST361 and ST3268. Three clonal clusters were detected by cgMLST, but none of these clusters seemed to reflect nosocomial transmission in Denmark. Conclusion Import of OXA-244 E. coli isolates from travelling abroad seems likely for the majority of cases. Community sources were also possible, as many of the patients had no history of hospitalisation and many of the E. coli isolates belonged to STs that are present in the community. It was not possible to point at a single country or a community source as risk factor for acquiring OXA-244-producing E. coli.

Analisa Kesiapsiagaan Masyarakat dalam Penanggulangan Bencana Di Kawasan Resiko Bencana ( KRB III) Desa Dukun Kecamatan Dukun Kabupaten Magelang

Introduction: Magelang Regency is one of the areas on the slopes of Merapi Mountain with the greatest disaster risk is volcanic eruptions. Dukun Village is one of the volcanic disaster-prone areas located approximately 8 km from the top of the mountain and included as Disaster Risk Area III in Magelang Regency. In the eruption on 2010 most of the Dukun community evacuated to other districts avoiding the hot clouds. The volcano in Magelang was on alert status from May 21, 2018. Within a period of 1.5 years, several volcanoes emitted volcanic ash and earthquakes. Under these circumstances, the risk of disaster in the community is very high, especially those in the Disaster Risk Area III of Merapi Mountain. Community based disaster management needs to be improved, especially in preparation for disaster preparedness. Method: the type of this research is descriptive quantitative, with a field survey analysis method using a questionnaire about the community preparedness at Dukun Village in Disaster Risk Area III dealing with disasters. Results: The results showed the community analysis of disaster risk in the Dukun village was a volcanic eruption with a percentage of 96% of the community, source of information obtained by the community about the disaster 89% showed from village officials, as many as 74% of families had participated in the socialization of the disaster but the majority were only the family heads, as much as 66% have sought disaster risk reduction and as many as 33.5% of the community if there is a plan to evacuate siblings. Family preparedness in preparing first aid kits was still very low. Conclusion: The Dukun Village community has realized that being in a disaster-prone area, at present the majority of families have participated in preparedness socialization but in disaster risk reduction and preparation is still lacking.

Epidemiological Aspects of Clostridium Difficile Infection in the Southeast Region of Romania

Clostridium difficile infection (CDI) in Galati county is an very important public health problem, the number of cases per 100 outpatients being in the first 5, nationally. The percentage of community-associated infection in this county is higher than the national and european ones. We performed a prospective observational study on 720 patients admitted between 1.01.2017-31.12.2018 in the Clinical Hospital of Infectious Diseases „St. Cuv. Parascheva“ Galati and we analyzed comparative demographic data, risk factors, disease evolution and prognosis of a batch of 565 (78.47%) patients with healthcare facility associated infection, with a batch of 144 patients (20%) with community-associated infection. The identified type of Clostridium difficile was ribotype 027 in 93.61% of the toxigenic strains studied. The study showed that CDI predominantly affects women in urban areas. Patients with community source are younger, with less comorbidities, have episodes of illness with lower severity and better prognosis both in terms of CDI recurrence and post-CDI death. Patients with a nosocomial source are older, with multiple comorbidities, with greater exposure to antibiotic, proton pump inhibitor and recent abdominal surgery, have severe episodes of the disease and have a poorer prognosis than those with a community source.

Plant species and soil type influence rhizosphere bacterial composition and seedling establishment on serpentine soils

Root-associated microbial communities influence plant phenotype, growth and local abundance, yet the factors that structure these microbial communities are still poorly understood. California landscapes contain serpentine soils, which are nutrient-poor and high in heavy metals, and distinct from neighboring soils. Here, we surveyed the rhizoplane of serpentine-indifferent plants species growing on serpentine and non-serpentine soils to determine the relative influence of plant identity and soil chemistry on rhizoplane microbial community structure using 16S rRNA metabarcoding. Additionally, we experimentally examined if locally adapted microorganisms enhance plant growth in serpentine soil. Plant species, soil chemistry, and the interaction between them were important in structuring rhizoplane bacterial communities in both the field and experimental soils. In the experiment, rhizoplane microbial community source influenced seedling survival, but plant growth phenotypes measured were largely invariant to microbial community with a few exceptions. Results from the field sampling suggest that plant species associate with specific microbial communities even across chemically distinct soils, and that microbial communities can differentially influence seedling survival on harsh serpentine soils.