Nasal carriage of Staphylococcus aureus: the key to preventing staphylococcal disease

Postoperative infections (Pis) are serious complications of thoracic surgery. To gain insight into the nature and the scope of the problem, an 18 month prospective surveillance was conducted at the department of thoracic surgery of the University Hospital Rotterdam, Dijkzigt. Pis were classified according to CDC criteria. One hundred and ninety-four out of 983 patients (19.7%) developed one or more Pis and in these 194 patients, 268 Pis were diagnosed. The incidence of Pis was 2.0 per 100 days of postoperative stay. The mean postoperative length of stay (LOS) of the 194 patients with Pis was 14.1 days longer than those without Pis. Deep surgical wound infections (DSWls) were associated with the longest prolongation of the median postoperative LOS in the hospital (30 days longer). Although lower than DSWls, incisional surgical wound infections also had a significant prolongation of stay (median 10 days longer). Staphylococcus aureus was the most important pathogen associated with surgical wound infections (SWls). Phage typing of 29 strains causing SWI showed only two identical pairs, so only a minority of infections could be explained by crossinfection. Older age, and more complicated procedures (e.g. cardiac valve operations) were independent, statistically significant risk factors for the development of Pis. Since there is a progressive trend towards operating on older patients and performing more complicated procedures, the incidence of Pis is expected to increase. Therefore it will become increasingly important to develop new strategies to prevent these serious complications

Kinetic Equations for Longwavelength Excitations of the Quark-Gluon Plasma

We show that longwavelength excitations of the quark-gluon plasma are described by simple kinetic equations which represent the exact equations of motion at leading order in $g$. Properties of the so-called ``hard thermal loops'', i.e. the dominant contributions to amplitudes with soft external lines, find in this approach a natural explanation. In particular, their generating functional appears here as the effective action describing long wavelength excitations of the plasma.Comment: January 8, 1993; 8 pages; SPhT/93-

Результаты изучения палеодегазации неогена и перспективы нефтегазоносности Юго-Западного Крыма

Склад флюїдів з Гераклітiв принципово не відрізняється від складу газів із сучасних зон струминного виділення в Чорному морі, що є підтвердженням їх генетичного споріднення. Дані аналізів вказують на різкі коливання змістів і непостійний склад газових флюїдів палеодегазаціі в неогені. Наявність газів вуглеводнів та слідів нафти в Гераклітах, тектонічна будова регіону дозволяють зробити висновок про високі перспективи знаходження родовищ нафти і газу в Південно-Західному Криму.The composition of fluids from Heraclitus has no fundamental differences from the gas composition from the modern jet ejections zones in the Black Sea, which is a confirmation of their genetic relatedness. Data of analysis show sharp fluctuations of the contents and unstable structure of gas fluids paleo degassing of Neogene. The presence of hydrocarbon gases and traces of oil in Heraclitus, the tectonic structure of the region allow to conclude high prospects of finding oil and gas in the South-West Crimea

Distinguishing blaKPC -gene-containing IncF plasmids from epidemiologically related and unrelated Enterobacteriaceae based on short- and long-read sequence data

BACKGROUND: Limited information is available on whether blaKPC -containing plasmids from isolates in a hospital outbreak can be differentiated from epidemiologically unrelated blaKPC-containing plasmids based on sequence data. This study aimed to evaluate the performance of three approaches to distinguish epidemiologically related from unrelated blaKPC-containing pKpQiL-like IncFII(k2)-IncFIB(pQiL) plasmids. METHOD: Epidemiologically related isolates, were short- and long-read whole genome sequenced. A hybrid assembly was performed and plasmid sequences were extracted from the assembly graph. Epidemiologically unrelated plasmid sequences were extracted from the GenBank. Pairwise comparisons were performed of epidemiologically related and unrelated plasmids based on SNP differences using snippy, phylogenetic distance using Roary and using a similarity index that penalizes size differences between plasmids (Stoesser-index). The percentage of pairwise comparisons misclassified as genetically related or as clonally unrelated was determined using different genetic thresholds for genetic relatedness. RESULTS: The ranges in number of SNP differences, Roary phylogenetic distance, and Stoesser-index overlapped between the epidemiologically related and unrelated plasmids. When using a genetic similarity threshold that classified 100% of epidemiologically related plasmid pairs as genetically related, the percentages of plasmids misclassified as epidemiologically related ranged from 6.7% (Roary) to 20.8% (Stoesser-index). DISCUSSION: Although epidemiologically related plasmids can be distinguished from unrelated plasmids based on genetic differences, blaKPC-containing pKpQiL-like IncFII(k2)-IncFIB(pQiL) plasmids show a high degree of sequence similarity. The phylogenetic distance as determined using Roary showed the highest degree of discriminatory power between the epidemiologically related and unrelated plasmids

Development of amoxicillin resistance in Escherichia coli after exposure to remnants of a non-related phagemid-containing E. coli:an exploratory study

OBJECTIVE: To determine the effect of exposure to remnants of a phagemid-containing E. coli, killed by treatment with a propanol-based hand rub, on antimicrobial resistance in E. coli isolates. METHODS: An in vitro model was developed in which a clinical E. coli isolate (EUR1) was exposed to remnants of an E. coli K-12 strain containing a phagemid (pBS-E12) strain treated with Sterillium®. A series of 200 experiments was performed using this in vitro model. As a control, a series of 400 experiments was performed where the EUR1 was exposed either to the remnants of an E. coli K-12 strain (not containing a phagemid) (E12) treated with Sterillium® (n = 200) or to dried Sterillium® only (n = 200). The number of experiments that showed growth of an amoxicillin-resistant EUR1 isolate was evaluated in all three groups. An additional 48 experiments were performed in which a different clinical E. coli isolate (EUR2) was exposed to remnants of the pBS-E12 treated with Sterillium®. Whole-genome sequencing and phenotypic testing for AmpC beta-lactamase production was performed to investigate the mechanism behind this resistance development. RESULTS: In 22 (11.0%) of 200 experiments in which the EUR1 isolate was exposed to remnants of a pBS-E12 an amoxicillin-resistant mutant isolate was obtained, as opposed to only 2 (1.0%) of 200 experiments involving the exposure of the EUR1 to Sterillium® only (risk difference: 10.0%; 95% CI 5.4-14.6%)) and 1 (0.5%) of 200 experiments involving the exposure of the EUR1 isolate to the remnants of the phagemid-free E12 (risk difference: 10.5%; 95% CI 6.1-14.9%). In 1 (2.1%) of the 48 experiments in which the EUR2 isolate was exposed to remnants of a pBS-E12 an amoxicillin-resistant mutant isolate was obtained. The development of resistance in all experiments was due to mutations in the promoter/attenuator region of the chromosomal AmpC beta-lactamase (cAmpC) gene leading to cAmpC hyperproduction. CONCLUSION: Exposure of an E. coli isolate to another phagemid-containing E. coli that was treated with propanol-based hand rub increased the development of amoxicillin resistance. Although phagemids are cloning vectors that are not present in clinical isolates, this finding may have implications for hand disinfection practices in healthcare facilities

Improved performance of PACE 2 with modified collection system in combination with probe competition assay for detecti

The Gen-Probe PACE 2 assay (GP) in combination with a modified collection system was compared with cell culture (CC) for the detection of Chlamydia trachomatis in urethral specimens from males. Analysis of discordant results was performed by PCR. The modifications, i.e., application of a more rigid swab type and a 50% reduction in the amount of transport medium, were made to improve the sensitivity of the assay. By using the modified GP on 302 urethral specimens from males, a sensitivity of 89.5% and a specificity of 100% were determined. In addition, performance of a probe competition assay on all GP samples with a result > 0.6 and < 1.0 times the cutoff factor (gray zone) detected three more true-positive samples. The sensitivity of GP in combination with the probe competition assay increased to 94.9%, with a specificity of 100%. This was identical to the performance of CC. The modified GP offers a very sensitive and specific alternative to CC

Detection of extended-spectrum beta-lactamase (ESBL) genes and plasmid replicons in Enterobacteriaceae using PlasmidSPAdes assembly of short-read sequence data

Knowledge of the epidemiology of plasmids is essential for understanding the evolution and spread of antimicrobial resistance. PlasmidSPAdes attempts to reconstruct plasmids using short-read sequence data. Accurate detection of extended-spectrum beta-lactamase (ESBL) genes and plasmid replicon genes is a prerequisite for the use of plasmid assembly tools to investigate the role of plasmids in the spread and evolution of ESBL production in Enterobacteriaceae. This study evaluated the performance of PlasmidSPAdes plasmid assembly for Enterobacteriaceae in terms of detection of ESBL-encoding genes, plasmid replicons and chromosomal wgMLST genes, and assessed the effect of k-mer size. Short-read sequence data for 59 ESBL-producing Enterobacteriaceae were assembled with PlasmidSPAdes using different k-mer sizes (21, 33, 55, 77, 99 and 127). For every k-mer size, the presence of ESBL genes, plasmid replicons and a selection of chromosomal wgMLST genes in the plasmid assembly was determined. Out of 241 plasmid replicons and 66 ESBL genes detected by whole-genome assembly, 213 plasmid replicons [88 %; 95 % confidence interval (CI): 83.9-91.9] and 43 ESBL genes (65 %; 95 % CI: 53.1-75.6) were detected in the plasmid assemblies obtained by PlasmidSPAdes. For most ESBL genes (83.3 %) and plasmid replicons (72.0 %), detection results did not differ between the k-mer sizes used in the plasmid assembly. No optimal k-mer size could be defined for the number of ESBL genes and plasmid replicons detected. For most isolates, the number of chromosomal wgMLST genes detected in the plasmid assemblies decreased with increasing k-mer size. Based on our findings, PlasmidSPAdes is not a suitable plasmid assembly tool for short-read sequence data for ESBL-encoding plasmids of Enterobacteriaceae