A cluster of Mycobacterium massiliense keratitis in foundry workers

Three consecutive workers from the same foundry had Mycobacterium massiliense keratitis. The strains isolated from each patient were identical. This is the first report of a non-surgery-related outbreak of non-tuberculous mycobacterial ocular infection. An investigation revealed that injured cornea with exposure to aerosolized non-tuberculous mycobacteria might account for this outbreak.

Bioinformatic analysis of the effect of type II diabetes on skin wound healing

We examined the relationship between type 2 diabetes and skin wound healing. GSE38396 was downloaded from the Gene Expression Omnibus database and preprocessed using the RMA function of the Affy package. Differentially expressed genes (DEGs) were identified using the limma package, then DAVID was applied to per-form Gene Ontology functional annotation and Kyoto Encyclopedia of Genes and Genomes pathway enrichment analysis. MicroRNAs and their target genes were screened from the miRecords database and subjected to functional analysis. Finally, the STRING online database was applied to identify the protein-protein interaction relationships, and a combined score > 0.5 was considered to indicate an interaction. A total of 421 DEGs (208 upregulated and 213 downregulated genes) were identified in the skin lymphatic endothelial cells of patients with type II diabetes. Twenty-four microRNAs and 34 target genes were screened, including those involved in cell migration, regulation of cell proliferation, cell death, and cell adhesion regulation, among others. Protein-protein interaction network clustering analysis identified a module composed of 25 genes, and INTERPRO protein domain enrichment analysis showed that the protein domain of the clustering module main-ly contained the insulin-like growth factor binding proteins IGFBP3 and CYR61. IGFBP3 and CYR61 may play important roles in skin wound healing in diabetes patients. This information may be useful for developing methods to treat skin refractory wounds in type II diabetes.

Antiviral gene expression in psoriasis

BACKGROUND

Psoriasis patients have relatively infrequent cutaneous viral infections compared to atopic dermatitis patients. Increased expression of four antiviral proteins (MX1, BST2, ISG15 and OAS2) has been reported in psoriatic skin and genetic studies of psoriasis have identified susceptibility genes in antiviral pathways.

OBJECTIVE

To determine if psoriasis is associated with pervasive expression of antiviral genes in skin and blood.

METHODS

We performed RNA sequencing on skin samples of 18 subjects with chronic plaque psoriasis and 16 healthy controls. We examined the expression of a predefined set of 42 antiviral genes, each of which has been shown in previous studies to inhibit viral replication. In parallel, we examined antiviral gene expression in atopic dermatitis, non-lesional psoriatic skin and psoriatic blood. We performed HIV-1 infectivity assays in CD4+ peripheral blood T cells from psoriatic and healthy individuals.

RESULTS

We observed significant overexpression of 16 antiviral genes in lesional psoriatic skin, with a greater than two-fold increase in ISG15, RSAD2, IRF7, MX2 and TRIM22 (P < 1E-07). None of these genes was overexpressed in atopic dermatitis skin (P < 0.0001) or non-lesional psoriatic skin. In contrast to the skin compartment, no differences in antiviral gene expression were detected in the peripheral blood of psoriasis cases compared to healthy controls. CD4+ T cells from both psoriatic and healthy patients supported HIV-1 infection at a similar rate.

CONCLUSION

Our findings highlight psoriasis as an inflammatory disease with cutaneous but not systemic immune activation against viral pathogens.

An updated survey for the 2007-2013 period of randomized controlled trials for psoriasis: treatment modalities, study designs, comparators, outcome measures and sponsorship

BACKGROUND

Two reports from the European Dermato-Epidemiology Network psoriasis project have analysed randomized controlled trials for psoriasis published during the periods of 1977-2000 and 2001-2006.

OBJECTIVE

We sought to update the analysis of randomized controlled trials for the 2007-2013 period from 10 high-impact dermatology and medical journals.

METHODS

This survey was conducted by electronic search on the PubMed database for eligible papers. We assessed and compared results to the two aforementioned published reports.

RESULTS

In total, 84 studies were evaluated. Over half of the total trials studied novel therapeutics: 40 (47.6%) trials examined biologics and five (6.0%) examined novel oral agents. Proportion of trials studying more than one treatment modality increased from 7.1% in 2001-2006 to 25.0% in 2007-2013, with a decreased proportion of placebo-controlled studies from 69.3% to 47.1%.

CONCLUSION

The proportion of trials on novel therapies, including novel oral and biologic agents, has increased. The quality of trials has improved in the aspects of increased active treatment comparisons, including between biologics and conventional agents, and increased study size. Further insight into the influence of pharmaceutical companies can be studied by extending analysis to extension studies and subanalyses.

Associations of the major international high-risk resistant clones and virulent clones with specific ompK36 allele groups in Klebsiella pneumoniae in Taiwan

This study was conducted to investigate the association between ompK36 variants and international high-risk clones in Klebsiella pneumoniae. Fifty-nine sequence types (STs) divided into four ompK36 allele groups (groups A to D) were identified among 185 K. pneumoniae isolates. The major high-risk clones (29 ST11, 13 ST15, 7 ST37 and 1 ST147 isolates) were assigned to group A, while 6 STs (15 ST23, 2 ST65, 3 ST86, 1 ST163, 1 ST373 and 2 ST375 isolates) associated with pyogenic liver abscess were assigned to group C. The genotyping assay developed in this study may be useful for screening of epidemic STs.

Performance enhancement using a non-uniform vertical electric field and polymer networks for in-plane switching of multi-pretilt, vertically aligned liquid crystal devices

A simple and reproducible alignment method for fabricating vertically aligned (VA) liquid crystal (LC) cells with a multi-pretilt structure is developed. A non-uniform vertical electric field is employed in the LC/monomer mixed cells during the photocuring process, and two pretilt domains with a functional small pretilt angle (∼1.6°) in the stabilized VA LC/polymer cells are achieved. The enhanced electro-optical performance of the cell driven by an in-plane switching field is demonstrated. Compared to the pure cell, the 2 wt.% pretilt angle cell shows 36%, 64%, and 76% improvement in the optical switch, the gray-level rise time, and the gray-level fall time responses, respectively, which are obtained at a low driving voltage (≤12  V). When applied to LC devices, the proposed method not only effectively benefits the LC molecular alignment, but it also significantly boosts the electro-optical performance.

The complex interplay among bacterial motility and virulence factors in different Escherichia coli infections

Motility mediated by the flagella of Escherichia coli is important for the bacteria to move toward host cells. Here, we present the relationship among bacterial motility, virulence factors, antimicrobial susceptibility, and types of infection. A total of 231 clinical E. coli isolates from different infections were collected and analyzed. Higher-motility strains (motility diameter ≥6.6 mm) were more common in spontaneous bacterial peritonitis (SBP) (SBP 59 %, colonization 32 %, urinary tract infection 16 %, urosepsis 34 %, and biliary tract infection 29 %; p < 0.0001). Compared with the higher-motility group, there was a higher prevalence of afa and ompT genes (p = 0.0160 and p = 0.0497, respectively) in E. coli strains with lower motility. E. coli isolates with higher and lower motility were in different phylogenetic groups (p = 0.018), with a lower prevalence of A and B1 subgroups in higher-motility strains. Also, the patterns of virulence factors and antibiotic susceptibility of E. coli isolates derived from various infections were significantly different. This study demonstrates that the prevalence of higher-motility strains was greater in E. coli isolates from SBP compared to other types of infection. Various types of E. coli infection were associated with differences in bacterial motility, virulence factors, and antibiotic susceptibility. More bacterial virulence factors may be necessary for the development of extraintestinal infections caused by E. coli isolates with lower motility.

Clinical and microbiological characteristics of Klebsiella pneumoniae from community-acquired recurrent urinary tract infections

Understanding the pathogenesis of recurrent urinary tract infection (RUTI) and whether it is attributable to reinfection with a new strain or relapse with the primary infecting strain is of considerable importance. Because previous studies regarding community-acquired Klebsiella pneumoniae RUTI are inconclusive, we undertook this study to evaluate the characteristics of the host and the bacterial agent K. pneumoniae in RUTI. A prospective study was designed, using consecutive patients diagnosed with community-acquired K. pneumoniae-related UTI from January 2007 to December 2009. Of the total 468 consecutive episodes, we found 7 patients with RUTI. All the patients with RUTI were elderly (median, 74 years), with diabetes (100 %, 7 out of 7). Clinical K. pneumoniae isolates derived from the same patients with RUTI revealed identical genomic fingerprints, indicating that K. pneumoniae UTI relapsed despite appropriate antibiotic therapy. The antimicrobial resistance, growth curve and biofilm formation of the recurrent isolates did not change. K. pneumoniae strains causing RUTI had more adhesion and invasiveness than the colonization strains (p < 0.01). When we compared the recurrent strains with the community-acquired UTI strains, the prevalence of diabetes mellitus was significant (100 % vs 53.7 %, p = 0.03) in the RUTI group. Our data suggest that K. pneumoniae strains might be able to persist within the urinary tract despite appropriate antibiotic treatment, and the greater adhesion and invasiveness in the recurrent strains may play an important role in recurrent infections.

Magnetic and structural transitions of SrFe2As2 at high pressure and low temperature

One of key issues in studying iron based superconductors is to understand how the magnetic phase of the parent compounds evolves. Here we report the systematic investigation of paramagnetic to antiferromagnetic and tetragonal to orthorhombic structural transitions of “122” SrFe₂As₂ parent compound using combined high resolution synchrotron Mössbauer spectroscopy and x-ray diffraction techniques in a cryogenically cooled high pressure diamond anvil cell. It is found that although the two transitions are coupled at 205 K at ambient pressure, they are concurrently suppressed to much lower temperatures near a quantum critical pressure of approximately 4.8 GPa where the antiferromagnetic state transforms into bulk superconducting state. Our results indicate that the lattice distortions and magnetism jointly play a critical role in inducing superconductivity in iron based compounds.

Initiation of TNF inhibitor therapy and change in physiologic measures in psoriasis

BACKGROUND

Psoriasis may predispose to cardiovascular disease and diabetes. However, the role of tumor necrosis factor (TNF) inhibitor in mediating this risk is controversial.

OBJECTIVE

To assess this relationship, we estimated change in metabolic physiologic measures before and after initiation of TNF inhibitor therapy compared with methotrexate (MTX) therapy among psoriasis patients.

METHODS

We conducted a retrospective cohort study, 2007-2012, using computerized clinical data for 1274 new users of TNF inhibitor and 979 new users of MTX therapy to compare change in blood pressure, lipids, triglycerides, fasting plasma glucose and body mass index (BMI) before and after start of TNF inhibitors or MTX. The study was restricted to new users. We computed within-person change in each measure, so that each patient served as their own control. In addition, we compared TNF inhibitor patients to MTX patients, by computing the adjusted difference in their group means. In secondary analyses, we examined phototherapy as a comparator.

RESULTS

Among starters of TNF inhibitor and MTX therapy, within-person change in physiologic measures at 6 months did not differ significantly. We observed no important or significant changes in any of the physiologic measures with initiation of TNF inhibitor compared with MTX. The same results were found in subgroup analyses focused on men, and on those with hypertension, diabetes mellitus, or obesity. The same results were observed with phototherapy, except that diastolic blood pressure declined by 0.6 mmHg within person during the 6 months after starting phototherapy (P < 0.05).

CONCLUSIONS

The study provides no evidence for improvement of physiologic measures associated with the metabolic syndrome resulting from TNF inhibitor use for psoriasis.

The risk of herpes zoster during biological therapy for psoriasis and other inflammatory conditions

Recent advances in biological therapies have proved highly effective in treating psoriasis and other inflammatory conditions, including psoriatic arthritis, rheumatoid arthritis, inflammatory bowel disease and ankylosing spondylitis. However, adverse effects related to their immunosuppression have been observed, including an increased propensity to viral infections. This review evaluates the evidence of herpes zoster (HZ) risk from biologics based on clinical reports, cohort studies and randomized controlled studies. The risk of HZ associated with these agents remains controversial, especially when comparing their risk with non-biological therapy used to treat the same inflammatory conditions. This review specifically assesses the risk of the TNF inhibitors etanercept, adalimumab and infliximab, as well as interleukin-12/23 inhibitor ustekinumab. We found multiple cohort studies, randomized controlled trials and case reports that suggest infliximab increases risk of HZ, whereas adalimumab, etanercept and ustekinumab HZ risk remain controversial. Nevertheless, HZ vaccination should be considered prior to initiation of biological therapy, particularly infliximab.

Sequence organization and evolutionary dynamics of Brachypodium-specific centromere retrotransposons

Brachypodium distachyon is a wild annual grass belonging to the Pooideae, more closely related to wheat, barley, and forage grasses than rice and maize. As an experimental model, the completed genome sequence of B. distachyon provides a unique opportunity to study centromere evolution during the speciation of grasses. Centromeric satellite sequences have been identified in B. distachyon, but little is known about centromeric retrotransposons in this species. In the present study, bacterial artificial chromosome (BAC)-fluorescence in situ hybridization was conducted in maize, rice, barley, wheat, and rye using B. distachyon (Bd) centromere-specific BAC clones. Eight Bd centromeric BAC clones gave no detectable fluorescence in situ hybridization (FISH) signals on the chromosomes of rice and maize, and three of them also did not yield any FISH signals in barley, wheat, and rye. In addition, four of five Triticeae centromeric BAC clones did not hybridize to the B. distachyon centromeres, implying certain unique features of Brachypodium centromeres. Analysis of Brachypodium centromeric BAC sequences identified a long terminal repeat (LTR)-centromere retrotransposon of B. distachyon (CRBd1). This element was found in high copy number accounting for 1.6 % of the B. distachyon genome, and is enriched in Brachypodium centromeric regions. CRBd1 accumulated in active centromeres, but was lost from inactive ones. The LTR of CRBd1 appears to be specific to B. distachyon centromeres. These results reveal different evolutionary events of this retrotransposon family across grass species.

Rapid diagnosis of the economically important fruit fly, Bactrocera correcta (Diptera: Tephritidae) based on a species-specific barcoding cytochrome oxidase I marker

The guava fruit fly, Bactrocera correcta (Bezzi) (Diptera: Tephritidae), is an invasive pest of fruit and vegetable crops that primarily inhabits Southeast Asia and which has the potential to become a major threat within both the Oriental and Australian oceanic regions as well as California and Florida. In light of the threat posed, it is important to develop a rapid, accurate and reliable method to identify B. correcta in quarantine work in order to provide an early warning to prevent its widespread invasion. In the present study, we describe a species-specific polymerase chain reaction assay for the diagnosis of B. correcta using mitochondrial DNA cytochrome oxidase I (mtDNA COI) barcoding genes. A B. correcta-specific primer pair was designed according to variations in the mtDNA COI barcode sequences among 14 fruit fly species. The specificity and sensitivity of the B. correcta-specific primer pair was tested based on the presence or absence of a band in the gel profile. A pair of species-specific B. correcta primers was successfully designed and named BCOR-F/BCOR-R. An ∼280 bp fragment was amplified from specimens belonging to 17 geographical populations and four life stages of B. correcta, while no such diagnostic bands were present in any of the 14 other related fruit fly species examined. Sensitivity test results demonstrated that successful amplification can be obtained with as little as 1 ng μl⁻¹ of template DNA. The species-specific PCR analysis was able to successfully diagnose B. correcta, even in immature life stages, and from adult body parts. This method proved to be a robust single-step molecular technique for the diagnosis of B. correcta with respect to potential plant quarantine.

A novel intronic mutation and a missense mutation of MEN1 identified in two Chinese families with multiple endocrine neoplasia type 1

BACKGROUND

Multiple endocrine neoplasia type 1 (MEN1) caused by MEN1 mutation is widely recognized. To date, 14 novel mutations were reported in Chinese and intronic mutations are getting more attention.

AIM

To explore clinical features and MEN1 mutations in two Chinese families suffering from MEN1.

METHODS

Nineteen individuals (10 males and 9 females) from two unrelated families with MEN1 were studied. Mutations of MEN1 were analyzed by direct sequencing of PCR products. In vitro splicing analysis was also performed with minigenes containing both wildtype and novel mutant fragments. Through the RNAstructure program, we analyzed the secondary structure of the wild type MEN1 pre-mRNA and then introduced T>G mutation at +2 donor splice site of intron 7.

RESULTS

Clinical features of 3 patients in two families were described, and 5 individuals were proven to be carriers of MEN1 mutation without apparent symptoms. A novel splicing site mutation of the intron 7 (IVS7+2 T→G) was identified in the first family. In vitro analysis also verified this mutation caused the aberrant splicing of MEN1 mRNA. With the RNAstructure program, we could figure out that the global secondary structure as well as the number of stems and loops of pre-mRNA greatly changed after this mutation. The mutation c. 1227 C>A (C409X) was identified in another family, which also caused the truncation of menin.

CONCLUSION

We reported a novel intronic mutation and a missense mutations in two Chinese families suffering from MEN1.

Fabrication and photocatalytic properties of self-assembled in(OH)3 and In2O3 nano/micro-cubes

This article reports a novel fabrication method for In(OH)3 from indium oxalate by hydrothermal process. Hydrothermal decomposition of indium oxalate at 180 degrees C for 10 h results in In(OH)3. The influence of hydrothermal experimental conditions such as temperature, time on the formation of indium hydroxide was investigated. The self-assembly process was strongly influenced the experimental conditions. The thermal decomposition of In(OH)3 at 400 degrees C results In2O3. The synthesized In(OH)3 and In2O3 were characterized using X-ray diffraction (XRD), field emission scanning electron microscopy (FE-SEM), high resolution transmission electron microscopy (HR-TEM), thermal analysis (TGA and DTA), diffuse reflectance spectra (DRS), and nitrogen adsorption analysis. The XRD patterns indicated the formation of well crystallized cubic phase In(OH)3 and In2O3. The FE-SEM results indicated formation of In(OH)3 and porous In2O3 nano/micro-cubes. The photocatalytic activity of the synthesized In(OH)3 was studied under UV light irradiation and results showed that the In(OH)3 photocatalyst was efficient for dye degradation. We proposed a plausible mechanism for the formation of In(OH)3, and In2O3 self-assembly.

Dispersion and stability of titanium dioxide nanoparticles in aqueous suspension: effects of ultrasonication and concentration

The increasing applications of titanium dioxide (TiO(2)) nanoparticles raise concerns about their potential environmental impacts. To investigate the fate and transport of TiO(2) nanoparticles in aqueous suspension, ultrasonication is widely used for the dispersion of TiO(2) nanoparticles in laboratory-scale studies. There is a pressing need for detailed information on the dispersion and stability of TiO(2) nanoparticles. This study investigated the change of size, zeta potential, and pH of TiO(2) nanoparticles aqueous suspension under different conditions of ultrasonication and concentrations. It was found that the hydrodynamic diameter of TiO(2) nanoparticles decreased with increasing suspension concentration and remained stable for more than 1 hour after sonication, which is enough for experimental research. The pH decreased with increasing nanoparticles concentration. Ultrasonication remarkably improved zeta potential to be above 15 mV for all the samples. Therefore, 20 minutes of ultrasonication (180 W) is sufficient for the dispersion of this rutile TiO(2) nanoparticles suspension, which can remain stable for more than 1 hour. However, the optimum sonication time for TiO(2) nanoparticles dispersion is influenced by many factors, such as TiO(2) nanoparticles concentration, solution chemistry, and sonicator parameters.

Elevated expression of both MDR1 and MMP-2 genes in metastasized lymph node of invasive ductal breast cancer

BACKGROUND

There is emerging evidence that matrix metalloproteinase (MMP)-2 plays a crucial role in cancer invasion/metastasis. However, little evidence is available about the connections of multidrug resistance protein 1 (MDR1) and cancer invasion/metastasis so far.

AIM

To investigate the expression of MDR1 and MMP2 in primary breast tumors and their corresponding metastasized lymph nodes.

MATERIALS AND METHODS

Only lymph nodes which were pathologically identified as metastases were included in this study to compare with the corresponding primary tumor. We determined the expression of MDR1 and MMP2 in primary breast tumor and its metastasized lymph node specimens of 21 patients. The quantitative real-time polymerase chain reaction (Q-RT-PCR) technique was used to assess the MDR1 and MMP2 RNA expression levels in primary breast tumor and lymph nodal specimens. Target gene copies were normalized using beta-actin (beta-actin) gene copies. Tumor characteristics and number of metastatic lymph nodes were gathered from the pathology reports.

RESULTS

The Q-RT-PCR data showed that MDR1 expression in metastasized lymph node was higher than that of their corresponding primary tumors (p < 0.05), MMP2 expression in metastasized lymph nodes was also even higher compared with their matched primary tumors (p < 0.01). But SPSS bivariate correlation analysis revealed that MDR1 expression in lymph node was not correlated with MMP-2 expression in lymph node, number of metastasized lymph nodes and tumor size (p > 0.05). MDR1 expression in primary tumors was highly correlated with in corresponding lymph node metastases (p < 0.01 r = 0.795).

CONCLUSIONS

All those indicated that MMP-2 should play an important role in the lymph node metastasis. However, further clinical studies with larger sample size need to be performed to verify these findings.

Role of K1 capsule antigen in cirrhotic patients with Escherichia coli spontaneous bacterial peritonitis in southern Taiwan

Spontaneous bacterial peritonitis (SBP) is one of the most serious complications in patients with cirrhosis. This study aimed to investigate the prevalence of SBP caused by Escherichia coli isolates with or without the K1 capsule antigen in cirrhotic patients and the outcome. From January 2004 to January 2012, a total of 54 and 41 E. coli strains derived from patients with SBP and intestinal perforation (IP), respectively, were included for comparison in this study. Bacterial characteristics including phylogenetic groups, K1 capsule antigen, and 14 virulence factor genetic determinants, as well as data regarding patient characteristics, clinical manifestations, and in-hospital deaths, were collected and analyzed. The prevalence of the K1 capsule antigen gene neuA was more common in SBP isolates compared to IP isolates (28 % vs. 10 %, p = 0.0385). Phylogenetic groups B2 and group D were dominant in E. coli isolates with and without the K1 capsule antigen, respectively. The prevalence of virulence factors genes papG II, ompT, and usp was higher in E. coli K1 strains. There were 26 deaths (48 %) during hospitalization. Presence of the K1 capsule antigen in E. coli isolates was significantly associated with in-hospital death in cirrhotic patients with SBP (42 % vs. 14 %, p = 0.0331). This study demonstrates a higher prevalence of the K1 capsule antigen in E. coli SBP compared to E. coli peritonitis caused by IP. There were significant associations between the K1 capsule antigen and in-hospital mortality and bacterial virulence in cirrhotic patients with E. coli SBP.

Synthesis of Pt doped Bi2O3/RuO2 photocatalysts for hydrogen production from water splitting using visible light

This study was focused on the preparation of modified bismuth oxide photocatalysts, including Ru and Pt doped Bi2O3, using sonochemically assisted method to enhance their photocatalytic activity. The crystalline phase composition and surface structure of Bi2O3 photocatalysts were examined using SEM, XRD, UV-visible spectroscopy, and XPS. Optical characterizations have indicated that the Bi2O3 presents the photoabsorption properties shifting from UV light region into visible light which is approaching towards the edge of 470 nm. According to the experimental results, visible-light-driven photocatalysis for water splitting with the addition of 0.3 M Na2SO3 and 0.03 M H2C2O4 as sacrificing agents demonstrates that Pt/Bi2O3-RuO2 catalyst could increase the amount of hydrogen evolution, which is around 11.6 and 14.5 micromol g(-1) h(-1), respectively. Plausible formation mechanisms of modified bismuth oxide and reaction mechanisms of photocatalytic water splitting have been proposed.

Characteristics of polycyclic aromatic hydrocarbon emissions of particles of various sizes from smoldering incense

Release of polycyclic aromatic hydrocarbons (PAHs) in particles of various sizes from smoldering incenses was determined. Among the three types of incense investigated, yielding the total PAH emission rate and factor ranges for PM0.25 were 2,139.7-6,595.6 ng/h and 1,762.2-8,094.9 ng/g, respectively. The PM0.25/PM2.5 ratio of total PAH emission factors and rates from smoldering three incenses was greater than 0.92. This study shows that total particle PAH emission rates and factors were mainly <0.25 μm. Furthermore, the total toxic equivalency emission rates and factors of PAHs for PM0.25 were 241.3-469.7 and 198.8-576.2 ng/g from the three smoldering incenses. The benzo[a]pyrene accounted for 65.2%-68.0% of the total toxic equivalency emission factor of PM2.5 for the three incenses. Experimental results clearly indicate that the PAH emission rates and factors were influenced significantly by incense composition, including carbon and hydrogen content. The study concludes that smoldering incense with low atomic hydrogen/carbon ratios minimized the production of total polycyclic aromatic hydrocarbons of both PM2.5 and PM0.25.

Characterization of carbapenem-nonsusceptible Klebsiella pneumoniae bloodstream isolates at a Taiwanese hospital: clinical impacts of lowered breakpoints for carbapenems

This study was conducted in order to characterize carbapenem-nonsusceptible Klebsiella pneumoniae isolates and to evaluate the impacts of recently lowered interpretative breakpoints for carbapenems for Enterobacteriaceae. Among 152 K. pneumoniae bloodstream isolates suspected as AmpC or extended-spectrum β-lactamase (ESBL) producers, 58 (38.2%) isolates were currently interpreted as nonsusceptible to ertapenem, imipenem, or meropenem, and 42 (72.4%) of them were categorized as carbapenem-susceptible by the previous criteria. The high revision rate was associated with the predominance (79.3%) of DHA-1 among the carbapenem-nonsusceptible isolates due to both polyclonal and clonal spread. ESBLs were common (~57%) in both ertapenem-susceptible and -nonsusceptible isolates; however, 84.8% of the carbapenem-nonsusceptible isolates were also AmpC producers. The IMP-8 metallo-β-lactamase was detected in three isolates. Polyacrylamide gel electrophoresis suggested decreased OmpK35 expression in all but one ertapenem-nonsusceptible isolate, and genetic disruptions of ompK35 and ompK36 were detected in 30 and six ertapenem-nonsusceptible isolates, respectively. A comparison between patients infected by AmpC- or ESBL-producing ertapenem-susceptible (n=62) isolates and those with isolates revised as ertapenem-nonsusceptible (n=41) revealed more cases of malignancies (36.6% versus 14.5%; p=0.01) and higher Charlson score (p=0.033) among the patients with ertapenem-nonsusceptible isolates; however, the acquisition of an isolate revised as carbapenem-nonsusceptible was not identified as an independent mortality risk factor.

Identification of complex vertebral malformation carriers in Holstein cattle in south China

Complex vertebral malformation (CVM) is a recently described monogenic autosomal recessive hereditary defect of Holstein dairy cattle that causes premature birth, aborted fetuses and stillborn calves. Guanine is substituted by thymine (G>T) in the solute carrier family 35 member A3 gene (SLC35A3). A valine is changed to a phenylalanine at position 180 of uridine 5'-diphosphate-N-acetyl-glucosamine transporter protein. CVM is expected to occur in many countries due to the widespread use of sire semen. We developed a created restriction site PCR (CRS-PCR) method to diagnose CVM in dairy cows. This was tested on 217 cows and 125 bulls selected randomly from a Holstein cattle population in south China. Five Holstein cows and five Holstein bulls were identified to be CVM carriers; the percentages of CVM carriers were estimated to be 2.3, 4.0 and 2.9% in the cows, bulls and entire Holstein cattle sample, respectively.