Minimal Spanning Tree of <i>E. coli</i> Isolates in Fecal Carriage in Children in Guinea-Bissau.

<p>Full legend: The tree maps the relatedness of <i>E. coli</i> isolates. Isolates ≥95% related in DiversiLab analysis are grouped in a pie where each slice represents one isolate in the cluster. Each cluster was assigned a Roman numeral. Red indicates resistance to gentamicin, ciprofloxacin and trimethoprim-sulfamethoxazole, which at the time of the study were all easily available antibiotics except cephalosporin to treat gram-negative bacterial infections in Guinea-Bissau. Green indicates susceptibility to at least one of the mentioned agents.</p

Minimal Spanning Tree of <i>K. pneumoniae</i> Isolates in Fecal Carriage in Children in Guinea-Bissau.

<p>Full legend: The tree maps the relatedness of <i>K. pneumoniae</i> isolates. Isolates ≥93% related in DiversiLab analysis are grouped in a pie where each slice represents one isolate in the cluster. Each cluster was assigned a Roman numeral. Red indicates resistance to gentamicin, ciprofloxacin and trimethoprim-sulfamethoxazole, which at the time of the study were all easily available antibiotics except cephalosporin to treat gram-negative bacterial infections in Guinea-Bissau. Green indicates susceptibility to at least one of the mentioned agents.</p

Study Population Characteristics and Risk Factors for Colonization with ESBL-Producing Bacteria.

1<p>Mid-upper arm circumference at time of enrolment examined on children ≥6 months of age.</p>2<p>Test for linear trend.</p>3<p>Child breastfed at time of enrolment.</p>4<p>Bedsharing with another child <5 years of age.</p>5<p>Number of children <5 years of age living in the same household.</p>6<p>Antibiotic treatment initiated prior to presentation at emergency ward.</p>7<p>Reported antibiotic usage during the month prior to study enrolment (excluding antibiotic usage for current disease).</p>8<p>Child hospitalized ≥1 day during the month prior to enrolment.</p

Carriage Prevalence of ESBL-Producing <i>E. coli</i> and <i>K. pneumoniae</i> According to Age.

<p>Full legend: The ESBL carriage prevalence did not vary depending on age. Absolute numbers are presented within bars.</p

Antimicrobial Non-Susceptibility of ESBL-Producing <i>E. coli</i> and <i>K. pneumoniae</i> in Guinea-Bissau¹.

1<p>Non-susceptibility of isolate was defined as intermediate (I) or resistant (R) to respective antibiotic agent.</p>2<p>Non-susceptibility of isolate to three or more categories of antimicrobial agents as proposed by Magiorakos et al. <a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0051981#pone.0051981-Oteo1" target="_blank">[30]</a>.</p>3<p>Available antimicrobials for common infections caused by gram-negative bacteria in Guinea-Bissau at the time of the study were trimethoprim-sulfamethoxazole, ciprofloxacin, gentamicin and ceftriaxone.</p

Switching to Once-Weekly Insulin Icodec Versus Once-Daily Insulin Glargine U100 in Type 2 Diabetes Inadequately Controlled on Daily Basal Insulin: A Phase 2 Randomized Controlled Trial

OBJECTIVE Insulin icodec (icodec) is a novel once-weekly basal insulin analog. This trial investigated two approaches for switching to icodec versus once-daily insulin glargine U100 (IGlar U100) in people with type 2 diabetes receiving daily basal insulin and one or more oral glucose-lowering medications.RESEARCH DESIGN AND METHODS This multicenter, open-label, treat-to-target phase 2 trial randomized (1:1:1) eligible basal insulin–treated (total daily dose 10–50 units) people with type 2 diabetes (HbA1c 7.0–10.0% [53.0–85.8 mmol/mol]) to icodec with an initial 100% loading dose (in which only the first dose was doubled [icodec LD]), icodec with no loading dose (icodec NLD), or IGlar U100 for 16 weeks. Primary end point was percent time in range (TIR; 3.9–10.0 mmol/L [70–180 mg/dL]) during weeks 15 and 16, measured using continuous glucose monitoring. Key secondary end points included HbA1c, adverse events (AEs), and hypoglycemia.RESULTS Estimated mean TIR during weeks 15 and 16 was 72.9% (icodec LD; n = 54), 66.0% (icodec NLD; n = 50), and 65.0% (IGlar U100; n = 50), with a statistically significant difference favoring icodec LD versus IGlar U100 (7.9%-points [95% CI 1.8–13.9%]). Mean HbA1c reduced from 7.9% (62.8 mmol/mol) at baseline to 7.1% (54.4 mmol/mol icodec LD) and 7.4% (57.6 mmol/mol icodec NLD and IGlar U100); incidences and rates of AEs and hypoglycemic episodes were comparable.CONCLUSIONS Switching from daily basal insulin to once-weekly icodec was well tolerated and provided effective glycemic control. Loading dose use when switching to once-weekly icodec significantly increased percent TIR during weeks 15 and 16 versus once-daily IGlar U100, without increasing hypoglycemia risk.</h4