39 research outputs found

    Whole genome sequencing of Shigella sonnei through PulseNet Latin America and Caribbean: advancing global surveillance of foodborne illnesses

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    Objectives Shigella sonnei is a globally important diarrhoeal pathogen tracked through the surveillance network PulseNet Latin America and Caribbean (PNLA&C), which participates in PulseNet International. PNLA&C laboratories use common molecular techniques to track pathogens causing foodborne illness. We aimed to demonstrate the possibility and advantages of transitioning to whole genome sequencing (WGS) for surveillance within existing networks across a continent where S. sonnei is endemic. Methods We applied WGS to representative archive isolates of S. sonnei (n = 323) from laboratories in nine PNLA&C countries to generate a regional phylogenomic reference for S. sonnei and put this in the global context. We used this reference to contextualise 16 S. sonnei from three Argentinian outbreaks, using locally generated sequence data. Assembled genome sequences were used to predict antimicrobial resistance (AMR) phenotypes and identify AMR determinants. Results S. sonnei isolates clustered in five Latin American sublineages in the global phylogeny, with many (46%, 149 of 323) belonging to previously undescribed sublineages. Predicted multidrug resistance was common (77%, 249 of 323), and clinically relevant differences in AMR were found among sublineages. The regional overview showed that Argentinian outbreak isolates belonged to distinct sublineages and had different epidemiologic origins. Conclusions Latin America contains novel genetic diversity of S. sonnei that is relevant on a global scale and commonly exhibits multidrug resistance. Retrospective passive surveillance with WGS has utility for informing treatment, identifying regionally epidemic sublineages and providing a framework for interpretation of prospective, locally sequenced outbreaks

    Retrieval of optical and microphysical properties of transported Saharan dust over Athens and Granada based on multi-wavelength Raman lidar measurements: Study of the mixing processes

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    In this paper we extract the aerosol microphysical properties for a collection of mineral dust cases measured by multi-wavelength depolarization Raman lidar systems located at the National Technical University of Athens (NTUA, Athens, Greece) and the Andalusian Institute for Earth System Research (IISTA-CEAMA, Granada, Spain). The lidar-based retrievals were carried out with the Spheroidal Inversion eXperiments software tool (SphInX) developed at the University of Potsdam (Germany). The software uses regularized inversion of a two-dimensional enhancement of the Mie model based on the spheroid-particle approximation with the aspect ratio determining the particle shape. The selection of the cases was based on the transport time from the source regions to the measuring sites. The aerosol optical depth as measured by AERONET ranged from 0.27 to 0.54 (at 500 nm) depending on the intensity of each event. Our analysis showed the hourly mean particle linear depolarization ratio and particle lidar ratio values at 532 nm ranging from 11 to 34% and from 42 to 79 sr respectively, depending on the mixing status, the corresponding air mass pathways and their transport time. Cases with shorter transport time showed good agreement in terms of the optical and SphInX-retrieved microphysical properties between Athens and Granada providing a complex refractive index value equal to 1.4 + 0.004i. On the other hand, the results for cases with higher transport time deviated from the aforementioned ones as well as from each other, providing, in particular, an imaginary part of the refractive index ranging from 0.002 to 0.005. Reconstructions of two-dimensional shape-size distributions for each selected layer showed that the dominant effective particle shape was prolate with diverse spherical contributions. The retrieved volume concentrations reflect overall the intensity of the episodes.Spanish Ministry of Sciences, Innovation and Universities through project CGL2016-81092,Spanish Ministry of Education, Culture and Sports through grant FPU14/0368

    7th Drug hypersensitivity meeting: part two

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    Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries

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    Background Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres. Methods This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low–middle-income countries. Results In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of ‘single-use’ consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for low–middle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia. Conclusion This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both high– and low–middle–income countries
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