9 research outputs found
Covert dissemination of carbapenemase-producing Klebsiella pneumoniae (KPC) in a successfully controlled outbreak: long and short-read whole-genome sequencing demonstrate multiple genetic modes of transmission
- Author
- Publication venue
- 'Oxford University Press (OUP)'
- Publication date
- 01/01/2017
- Field of study
Background: Carbapenemase-producing Enterobacteriaceae (CPE), including KPC-producing Klebsiella pneumoniae (KPC-Kpn), are an increasing threat to patient safety. Objectives: To use WGS to investigate the extent and complexity of carbapenemase gene dissemination in a controlled KPC outbreak. Materials and methods: Enterobacteriaceae with reduced ertapenem susceptibility recovered from rectal screening swabs/clinical samples, during a 3 month KPC outbreak (2013–14), were investigated for carbapenemase production, antimicrobial susceptibility, variable-number-tandem-repeat profile and WGS [short-read (Illumina), long-read (MinION)]. Short-read sequences were used for MLST and plasmid/Tn4401 fingerprinting, and long-read sequence assemblies for plasmid identification. Phylogenetic analysis used IQTree followed by ClonalFrameML, and outbreak transmission dynamics were inferred using SCOTTI. Results: Twenty patients harboured KPC-positive isolates (6 infected, 14 colonized), and 23 distinct KPC-producing Enterobacteriaceae were identified. Four distinct KPC plasmids were characterized but of 20 KPC-Kpn (from six STs), 17 isolates shared a single pKpQIL-D2 KPC plasmid. All isolates had an identical transposon (Tn4401a), except one KPC-Kpn (ST661) with a single nucleotide variant. A sporadic case of KPC-Kpn (ST491) with Tn4401a-carrying pKpQILD2 plasmid was identified 10 months before the outbreak. This plasmid was later seen in two other species and other KPC-Kpn (ST14,ST661) including clonal spread of KPC-Kpn (ST661) from a symptomatic case to nine ward contacts. Conclusions: WGS of outbreak KPC isolates demonstrated blaKPC dissemination via horizontal transposition (Tn4401a), plasmid spread (pKpQIL-D2) and clonal spread (K. pneumoniae ST661). Despite rapid outbreak control, considerable dissemination of blaKPC still occurred among K. pneumoniae and other Enterobacteriaceae, emphasizing its high transmission potential and the need for enhanced control efforts
Performance of the local health system and contingent influences in Northeast-Brazil: breaking vicious and virtuous circles
- Author
- Atkinson S
- Atkinson S
- Baierle SG
- Barker C
- Barreira C
- Beserra BR
- Burns T
- Bursztyn M
- Campos CEA
- Carvalho GI
- Carvalho RMV
- Coffey A
- DaMatta R
- Drucker PF
- Dupuis HM
- Evans P
- Faoro R
- Fleury S
- Freidson E
- Gahan C
- Grindle MS
- Ham C
- Hammersley M
- Heller P
- Hill M
- Hofstede G
- Hofstede G
- Hogopian F
- Horner JS
- Lawrence PR
- Leal VN
- Medeiros RLR
- Nys H
- Ostrom E
- Parente JC
- Perrow C
- Putnam RD
- Queiroz MIP
- Regianne Leila Rolim Medeiros
- Roett R
- Sacchini D
- Sarah Atkinson
- Silverman D
- Teixeira FJS
- Trice HM
- Viana ALA
- Wolcott HF
- Woodward J
- Publication venue
- 'FapUNIFESP (SciELO)'
- Publication date
- Field of study
Global patient outcomes after elective surgery: prospective cohort study in 27 low-, middle- and high-income countries.
- Author
- Ab Majid MA
- Ab Rahman AS
- Ab Rahman R
- Abayasinghe C
- Abbott T
- Abdullah NH
- Abdur-Rahman L
- Abeloos J
- Abernethy C
- Abidin UN
- Abrunhosa A
- Absar M
- Adam S
- Adams D
- Adams G
- Adamson M
- Adekola O
- Adelaja Y
- Ademola A
- Adenekan A
- Adenike O
- Adeolu AA
- Adetoye A
- Adewale B
- Adigun T
- Adolfsson A
- Aflori L
- Africander C
- Afshari A
- Agarwal V
- Agodirin O
- Aguero Vera M
- Aguzzoli C
- Ahmad A
- Ahmad N
- Ahmad T
- Ahmad T
- Ahmad Y
- Ahmed A
- Ahmed J
- Ai Y
- Aignatoaie M
- Aimoniotou-Georgiou E
- Akanmu O
- Akerman N
- Akinwale M
- Akring I
- Al 'Amri K
- Al Anizi M
- Al hussaini S
- Al-Soudaine Y
- Aladin H
- Alagbe-Briggs O
- Alaman Laguarda G
- Albaj S
- Alcock D
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- Aldecoa C
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- Aleixo FB
- Alexander H
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- Alit MA
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- Allsop J
- Almeida W
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- Amador JCB
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- Zoerner F
- Zonneveldt H
- Zou X
- Zoulamoglou M
- Zsisku L
- Publication venue
- 'Oxford University Press (OUP)'
- Publication date
- 01/01/2016
- Field of study
BACKGROUND: As global initiatives increase patient access to surgical treatments, there remains a need to understand the adverse effects of surgery and define appropriate levels of perioperative care. METHODS: We designed a prospective international 7-day cohort study of outcomes following elective adult inpatient surgery in 27 countries. The primary outcome was in-hospital complications. Secondary outcomes were death following a complication (failure to rescue) and death in hospital. Process measures were admission to critical care immediately after surgery or to treat a complication and duration of hospital stay. A single definition of critical care was used for all countries. RESULTS: A total of 474 hospitals in 19 high-, 7 middle- and 1 low-income country were included in the primary analysis. Data included 44 814 patients with a median hospital stay of 4 (range 2-7) days. A total of 7508 patients (16.8%) developed one or more postoperative complication and 207 died (0.5%). The overall mortality among patients who developed complications was 2.8%. Mortality following complications ranged from 2.4% for pulmonary embolism to 43.9% for cardiac arrest. A total of 4360 (9.7%) patients were admitted to a critical care unit as routine immediately after surgery, of whom 2198 (50.4%) developed a complication, with 105 (2.4%) deaths. A total of 1233 patients (16.4%) were admitted to a critical care unit to treat complications, with 119 (9.7%) deaths. Despite lower baseline risk, outcomes were similar in low- and middle-income compared with high-income countries. CONCLUSIONS: Poor patient outcomes are common after inpatient surgery. Global initiatives to increase access to surgical treatments should also address the need for safe perioperative care. STUDY REGISTRATION: ISRCTN5181700
Deletions in a ribosomal protein-coding gene are associated with tigecycline resistance in Enterococcus faecium
- Author
- Publication venue
- 'Elsevier BV'
- Publication date
- 20/08/2015
- Field of study
Incidence of breast abscess in lactating women: report from an Australian cohort
- Author
- Publication venue
- 'Wiley'
- Publication date
- Field of study
Antibiotikatherapie und -prophylaxe
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- A Bach
- American Thoracic Society
- British Society for Antimicrobial Chemotherapy Working Party
- Brun-Buisson C Doyon F, Carlet and the French Bacteremia-Sepsis Study Group
- C Alberti
- C Gonzales
- C Luna
- C Simon
- CE Harris
- CJ Doig
- CP Stoutenbeek
- CP Stoutenbeek
- D Adam
- D Milatovic
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- DM Livermore
- DP Nicolau
- E Wijngaerden
- Ewig S Walger P,Vetter H
- F Vogel
- F Vogel
- FB Cerra
- G Berghe
- GA Jacoby
- GR Bernard
- H Grundmann
- H Hilt
- I Braveny
- J Bion
- J Chastre
- J Cohen
- J Garau
- JL Vincent
- JL Vincent
- JY Fagon
- KF Bodmann
- M Bodi
- M Kollef
- M Zervos
- MH Kollef
- MP Fink
- MP Weinstein
- MR Jacobs
- P Loirat
- PY Bochud
- R D’Amico
- RLR Hill
- S Ewig
- S Tabaqchali
- S Tabaqchali
- S Zielmann
- SE Holm
- SG Jenkins
- TH Baron
- U Kroh
- VJ Quagliarello
- Publication venue
- 'Springer Science and Business Media LLC'
- Publication date
- 01/01/2004
- Field of study
Trends and Prospects of Microbial Diversity in Rhizosphere
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- A Beneduzi
- A Diouf
- A González
- A Gupta
- A Jarabo-Lorenzo
- A McInnes
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- ADS Freitas
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- AK Uppal
- AL Misko
- AM Ibekwe
- B Anyango
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- BR Glick
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- MAT Amara
- MC Ferreira
- MK Solanki
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- N Fierer
- N Rameshkumar
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- O Martinez-Viveros
- OL Petchey
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- P Pandey
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- R Aslantas
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- R Saikia
- RA Date
- RC Dubey
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- RF Doornbos
- RH Whittaker
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- S Ando
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- SC Bisht
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- TCJ Hill
- V Eissfeller
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- WH Tang
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- WL Brown
- WT Liu
- Y Okon
- Y Wang
- YD Tan
- Publication venue
- 'Springer Science and Business Media LLC'
- Publication date
- Field of study
Kuluttajabarometri maakunnittain 2000, 2. neljännes
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- Zamudio D
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- Zoerner F
- Zonneveldt H
- Zou X
- Zoulamoglou M
- Zsisku L
- Publication venue
- Tilastokeskus
- Publication date
- 11/07/2000
- Field of study
Suomen virallinen tilasto (SVT
Use of failure-to-rescue to identify international variation in postoperative care in low-, middle- and high-income countries: a 7-day cohort study of elective surgery
- Author
- Ab Majid MA
- Ab Rahman AS
- Ab Rahman R
- Abayasinghe C
- Abbott T
- Abdullah NH
- Abdur-Rahman L
- Abeloos J
- Abernethy C
- Abidin UN
- Abrunhosa A
- Absar M
- Adam S
- Adams D
- Adams G
- Adamson M
- Adekola O
- Adelaja Y
- Ademola A
- Adenekan A
- Adenike O
- Adeolu AA
- Adetoye A
- Adewale B
- Adigun T
- Adolfsson A
- Aflori L
- Africander C
- Afshari A
- Agarwal V
- Agodirin O
- Aguero Vera M
- Aguzzoli C
- Ahmad A
- Ahmad N
- Ahmad T
- Ahmad T
- Ahmad Y
- Ahmed A
- Ahmed J
- Ai Y
- Aignatoaie M
- Aimoniotou-Georgiou E
- Akanmu O
- Akerman N
- Akinwale M
- Akring I
- Al 'Amri K
- Al Anizi M
- Al hussaini S
- Al-Soudaine Y
- Aladin H
- Alagbe-Briggs O
- Alaman Laguarda G
- Albaj S
- Alcock D
- Alcock L
- Aldecoa C
- Aldecoa C
- Aleixo FB
- Alexander H
- Alexander M
- Alexander-Sefre F
- Alherz F
- Ali H
- Ali M
- Ali S
- Alias A
- Alias AH
- Alias RLR
- Alit MA
- Allen S
- Allen SJ
- Allison J
- Alloj C
- Allorto NL
- Allsop J
- Almeida W
- Alonso E
- Alphonsus C
- Alvares D
- Alves MJ
- Amador JCB
- Ameer Y
- Amendola CP
- Ami N
- Amstrup-Hansen L
- Anagnou A
- Andersen C
- Anderson C
- Anderson C
- Anderson F
- Anderson P
- Andreadaki E
- Andreou A
- Andreou P
- Andrew A
- Andrews E
- Angermair S
- Angus K
- Anillo V
- Antal O
- Antill P
- Antoniadou E
- Antonina W
- Apagaki E
- Apostolou K
- Applewhaite C
- Aquino LPG
- Ar P
- Arawwawala D
- Ardern D
- Argue R
- Arkalaki E
- Armaganidis A
- Armstrong J
- Armstrong R
- Arnaoutoglou C
- Arnaoutoglou E
- Arnold G
- Arrandale L
- Arrich J
- Arrigo M
- Arshad H
- Arshad MA
- Arumugam S
- Arustei M
- Arvaniti K
- Arya A
- Arya S
- Asimakos A
- Asudo F
- Athanasakis E
- Atiku M
- Attrill E
- Attwood C
- Auer P
- Avidan M
- Avila Sanchez FJ
- Avila EJD
- Avis J
- Awad H
- Axioti E
- Ayyaz H
- Azam UAA
- Azambuja P
- Azevedo C
- Aziz FZ
- Baas P
- Baghirzada L
- Bai H-P
- Bai Y
- Baillie S
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- Baio TH
- Bairaktari A
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- Baldisserotto S
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- Balfoussia D
- Bali C
- Bandeira ME
- Banerjee R
- Bankewitz C
- Banner-Goodspeed V
- Bao Q
- Barcraft-Barnes H
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- Barnett A
- Baroselli A
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- Beloeil H
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- Ben-Menachem E
- Benavent P
- Benevento A
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- Bertram W
- Bester D
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- Bettega F
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- Bignami E
- Bilolikar A
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- Brooke J
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- Chicken D-W
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- Chin II
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- Chisbert Cuenca V
- Chlorou D
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- Chung CKE
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- Ciobotaru OR
- Cirstea E
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- Clarkson R
- Claxton A
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- Cloro LM
- Clyde A
- Cobzaru I
- Codita A
- Colangelo A
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- Comptaer N
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- Coppens M
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- Costelloe H
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- Yagnik A
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- Yeh E
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- Yuliana A
- Zaimi D
- Zakynthinos S
- Zamudio D
- Zangrillo A
- Zapata DDM
- Zbitnew G
- Zeidan L
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- Zhang B
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- Zhao B
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- Zhao L
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- Zhao W
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- Zhen J
- Zheng K
- Zheng L
- Zheng T
- Zhong Y
- Zhou C
- Zhou D
- Zhou H
- Zhou H
- Zhou J
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- Zhou X-J
- Zhu X
- Zhu X
- Zhu Y
- Zhu Z
- Zhuang X
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- Zoerner F
- Zonneveldt H
- Zou X
- Zoulamoglou M
- Zsisku L
- Publication venue
- 'Oxford University Press (OUP)'
- Publication date
- 01/01/2017
- Field of study
This was an investigator-initiated study funded by Nestle Health Sciences through an unrestricted research grant and by a National Institute for Health Research (UK) Professorship held by R.P. The study was sponsored by Queen Mary University of London