Imipenem-Relebactam Susceptibility and Genotypic Characteristics of Carbapenem-Resistant Enterobacterales (CRE) Identified during Population-Based Surveillance

Laboratories submit all carbapenem-resistant Enterobacter , Escherichia coli , and Klebsiella species to the Alameda County Public Health Department (ACPHD). ACPHD evaluated 75 isolates submitted during nine months for susceptibility to imipenem-relebactam (I-R) and identified β-lactamase genes using whole genome sequencing. Of 60 (80%) isolates susceptible to I-R, 8 (13%) had detectable carbapenemase genes, including four KPC, two NDM, and two OXA-48-like; we described the relationship between the presence of β-lactamase resistance genes and susceptibility to I-R.

Real-world implementation of video-observed therapy in an urban TB program in the United States

BACKGROUND: Video directly observed therapy (vDOT) was introduced to increase flexibility and meet patient-specific needs for TB treatment. This study aimed to assess the reach and effectiveness of vDOT for TB treatment under routine conditions in Alameda County, CA, USA, a busy, urban setting, from 2018 to 2020.METHODS: We prospectively evaluated routinely collected data to estimate 1) reach (proportion of patients initiated on vDOT vs. in-person DOT); and 2) effectiveness (proportion of prescribed doses with verified administration by vDOT vs. in-person DOT).RESULTS: Among 163 TB patients, 94 (58%) utilized vDOT during treatment, of whom 54 (57%) received exclusively vDOT. Individuals receiving vDOT were on average younger than those receiving in-person therapy (46 vs. 61 years; P < 0.001). The median time to vDOT initiation was 2.2 weeks (IQR 1.1–10.0); patients were monitored for a median of 27.0 weeks (IQR 24.6–31.9). vDOT led to higher proportions of verified prescribed doses than in-person DOT (68% vs. 54%; P < 0.001). Unobserved self-administration occurred for all patients on weekends based on clinic instructions, but a larger proportion of doses were self-administered during periods of in-person DOT than of vDOT (45% vs. 24%; P < 0.001).CONCLUSION: A TB program successfully maintained vDOT, reaching the majority of patients and achieving greater medication verification than in-person DOT.

High Rates of COVID-19 Infection Among Indigenous Maya at a US Safety-Net Health System in California

Coronavirus disease 2019 (COVID-19) has disproportionately and negatively affected communities of color in the United States, especially Black, Latinx, and Indigenous populations. We report a cluster of COVID-19 cases among the Maya in Alameda County, California, most of whom were misclassified in public health data as nonindigenous Spanish-speaking people. We conducted a retrospective cohort study of all COVID-19 tests performed from April 1 through May 31, 2020, at Alameda Health System. A total of 1561 tests from 1533 patients were performed, with an overall test positivity rate of 17.0% (N = 265). We used the language field from the electronic health record to identify 29 patients as speaking an indigenous Mayan language; by medical record review, we identified 52 additional Maya patients. Maya patients had a test positivity rate of 72.8% as compared with 27.1% ( P < .001) for nonindigenous Latinx patients and 8.2% ( P < .001) for all other patients. In our sample, 39.6% of patients who had a positive test result for COVID-19 were hospitalized, 11.3% required admission to the intensive care unit (ICU), and 4.9% died of COVID-19. Maya patients had lower rates of hospitalization, ICU admission, and 30-day in-hospital mortality than non-Maya patients. We shared our data with the county health department to inform responses for education, testing, and isolation for Maya patients in Alameda County. Ongoing COVID-19 public health efforts should assess the community prevalence of COVID-19 in the Maya community and other indigenous communities and implement interventions that are linguistically and culturally appropriate.

Academic libraries and research in flux: Global conversations in times of COVID-19

In March 2020, Alameda County, where the University of California (UC)-Berkeley is located, issued a shelter in place order as a response to the COVID-19 pandemic. The UC-Berkeley Library was one of the first libraries in the United States to deal effectively with the new normal that was mandated by local, state, and federal public health officials, shifting to the virtual provision of its services such as instruction, research consultation, and accelerated e-resource acquisition. Library administration encouraged staff to think creatively, to not only provide our services to faculty, users, and students, but also to bridge the physical gap through virtual media to foster collaboration among the community of international librarians.

Community Capitals Policing merges food economy and public safety, repairing decades of harm

A local, circular food economy like the one we are building in Alameda County, California, will not only alleviate food insecurity, create jobs, and improve the environment, it is also a center­piece of our 15-year-long effort to strengthen social cohesion, repair trust, and improve public safety through a revolutionary new approach to policing. More than 15 years ago, the Alameda County Sheriff’s Office launched a new brand of public safety, called Community Capitals Policing,[1] in Ashland and Cherryland, two unincorporated communities just south of Oakland, California. These communities have experienced dispropor­tionate levels of crime, poverty, disinvestment, disease, unemployment, and blight since the late 1970s. Our work, based on the community capitals framework (Fey, Bregendahl, & Flora, 2006), is taking a systems-level approach to repair the harm done to the community over decades of systemic racism and neglect. The work is informed by a seven-year project called Food Dignity, funded by a US$5 million grant from the U.S. Department of Agriculture.

Nesting Biology of Urban Cooper’s Hawks in Alameda County, California

In recent decades Cooper’s Hawks have successfully colonized urban landscapes, where there may be ample prey but also a greater prevalence of disease in their prey. We searched for nesting Cooper’s Hawks in and around Berkeley, California, from 2002 to 2010, locating 95 nests, 89 of which successfully fledged at least one nestling. On average, each nest produced 3.6 fledglings. We evaluated the possible effects of the protozoan parasite Trichomonas gallinae on Cooper’s Hawk reproduction from the proportion of potential prey items brought to Lindsay Wildlife Experience that tested positive for the parasitic disease. We did not find a correlation between T. gallinae in potential prey species and nest success (i.e., if the nest fledged any offspring) or reproductive success (i.e., number of fledglings produced). Similarly, we did not find a relationship between reproductive success and distance to parks or percent of impervious surface within 500 m of the nest. The high reported rates of reproduction and high densities of Cooper’s Hawk in Berkeley and neighboring Albany suggest a robust population, and we did not find evidence that T. gallinae influences its reproductive success.