Identification of Antimicrobial Resistance-Associated Genes through Whole Genome Sequencing of Mycoplasma bovis Isolates with Different Antimicrobial Resistances

Antimicrobial resistance (AMR) in Mycoplasma bovis has been previously associated with topoisomerase and ribosomal gene mutations rather than specific resistance-conferring genes. Using whole genome sequencing (WGS) to identify potential new AMR mechanisms for M. bovis, it was found that a 2019 clinical isolate with high MIC (2019-043682) for fluoroquinolones, macrolides, lincosamides, pleuromutilins and tetracyclines had a new core genome multilocus sequencing (cgMLST) type (ST10-like) and 91% sequence similarity to the published genome of M. bovis PG45. Closely related to PG45, a 1982 isolate (1982-M6152) shared the same cgMLST type (ST17), 97.2% sequence similarity and low MIC results. Known and potential AMR- associated genetic events were identified through multiple sequence alignment of the three genomes. Isolate 2019-043682 had 507 genes with non-synonymous mutations (NSMs) and 67 genes disrupted. Isolate 1982-M6152 had 81 NSMs and 20 disruptions. Using functional roles and known mechanisms of antimicrobials, a 55 gene subset was assessed for AMR potential. Seventeen were previously identified from other bacteria as sites of AMR mutation, 38 shared similar functions to them, and 11 contained gene-disrupting mutations. This study indicated that M. bovis may obtain high AMR characteristics by mutating or disrupting other functional genes, in addition to topoisomerases and ribosomal genes.

Patient involvement in pressure ulcer prevention and adherence to prevention strategies: An integrative review

BACKGROUND

Chronic wounds including pressure ulcers represent a significant burden to patients and healthcare providers. Increasingly patients are required to self-manage their care but patient adherence to prevention strategies is a significant clinical challenge. It is important to increase understanding of the factors affecting patients' ability and willingness to follow pressure ulcer prevention interventions.

OBJECTIVES

To investigate from a patient perspective the factors affecting adherence to pressure ulcer prevention strategies.

DESIGN

Integrative literature review.

DATA SOURCES

A systematic search of electronic databases (Athens, Pub Med, Web of Science, Science Direct, AMED, CINAHL, Cochrane Library, PsychInfo, Google Scholar, Delphis) was initially conducted in May 2017 (repeated August 2018).

REVIEW METHODS

The methodological quality was assessed using the Critical Appraisal Skills Programme (CASP) principles. The Noticing, Collecting, Thinking (NCT) model of qualitative data analysis was used to identify key themes.

RESULTS

A total of twelve studies met the inclusion criteria and were included in the review. The majority of studies were qualitative and three key themes were identified: (i) individual/daily lifestyle considerations, (ii) patient involvement in the decision-making process, and (iii) pain and/or discomfort.

CONCLUSION

There is limited research that focuses on the patient view of factors affecting adherence to prevention measures, particularly in community settings. Individual and daily lifestyle considerations and involvement in decision-making around pressure ulcer care are important aspects from the patient perspective. Further research is necessary to explore which factors affect patient adherence in order to improve clinical practice and support patient involvement in preventative strategies.

Multi-Laboratory Validation of a Loop-Mediated Isothermal Amplification Method for Screening Salmonella in Animal Food

Loop-mediated isothermal amplification (LAMP) has gained wide popularity in the detection of Salmonella in foods owing to its simplicity, rapidity, and robustness. This multi-laboratory validation (MLV) study aimed to validate a Salmonella LAMP-based method against the United States Food and Drug Administration (FDA) Bacteriological Analytical Manual (BAM) Chapter 5 Salmonella reference method in a representative animal food matrix (dry dog food). Fourteen independent collaborators from seven laboratories in the United States and Canada participated in the study. Each collaborator received two sets of 24 blind-coded dry dog food samples (eight uninoculated; eight inoculated at a low level, 0.65 MPN/25 g; and eight inoculated at a high level, 3.01 MPN/25 g) and initiated the testing on the same day. The MLV study used an unpaired design where different test portions were analyzed by the LAMP and BAM methods using different preenrichment protocols (buffered peptone water for LAMP and lactose broth for BAM). All LAMP samples were confirmed by culture using the BAM method. BAM samples were also tested by LAMP following lactose broth preenrichment (paired samples). Statistical analysis was carried out by the probability of detection (POD) per AOAC guidelines and by a random intercept logistic regression model. Overall, no significant differences in POD between the Salmonella LAMP and BAM methods were observed with either unpaired or paired samples, indicating the methods were comparable. LAMP testing following preenrichment in buffered peptone water or lactose broth also resulted in insignificant POD differences (P > 0.05). The MLV study strongly supports the utility and applicability of this rapid and reliable LAMP method in routine regulatory screening of Salmonella in animal food.