Genomic Signatures of Strain Selection and Enhancement in Bacillus atrophaeus var. globigii, a Historical Biowarfare Simulant

(BG) as a simulant for biological warfare (BW) agents, knowledge of its genome composition is limited. Furthermore, the ability to differentiate signatures of deliberate adaptation and selection from natural variation is lacking for most bacterial agents. We characterized a lineage of BGwith a long history of use as a simulant for BW operations, focusing on classical bacteriological markers, metabolic profiling and whole-genome shotgun sequencing (WGS). on the nucleotide level. WGS of variants revealed that several strains were mixed but highly related populations and uncovered a progressive accumulation of mutations among the “military” isolates. Metabolic profiling and microscopic examination of bacterial cultures revealed enhanced growth of “military” isolates on lactate-containing media, and showed that the “military” strains exhibited a hypersporulating phenotype.Our analysis revealed the genomic and phenotypic signatures of strain adaptation and deliberate selection for traits that were desirable in a simulant organism. Together, these results demonstrate the power of whole-genome and modern systems-level approaches to characterize microbial lineages to develop and validate forensic markers for strain discrimination and reveal signatures of deliberate adaptation

Comparative Genomics of 2009 Seasonal Plague (Yersinia pestis) in New Mexico

Plague disease caused by the Gram-negative bacterium Yersinia pestis routinely affects animals and occasionally humans, in the western United States. The strains native to the North American continent are thought to be derived from a single introduction in the late 19th century. The degree to which these isolates have diverged genetically since their introduction is not clear, and new genomic markers to assay the diversity of North American plague are highly desired. To assay genetic diversity of plague isolates within confined geographic areas, draft genome sequences were generated by 454 pyrosequencing from nine environmental and clinical plague isolates. In silico assemblies of Variable Number Tandem Repeat (VNTR) loci were compared to laboratory-generated profiles for seven markers. High-confidence SNPs and small Insertion/Deletions (Indels) were compared to previously sequenced Y. pestis isolates. The resulting panel of mutations allowed clustering of the strains and tracing of the most likely evolutionary trajectory of the plague strains. The sequences also allowed the identification of new putative SNPs that differentiate the 2009 isolates from previously sequenced plague strains and from each other. In addition, new insertion points for the abundant insertion sequences (IS) of Y. pestis are present that allow additional discrimination of strains; several of these new insertions potentially inactivate genes implicated in virulence. These sequences enable whole-genome phylogenetic analysis and allow the unbiased comparison of closely related isolates of a genetically monomorphic pathogen

Primary Care Provider Education for Fostering Antimicrobial Stewardship: A Quality Improvement Project

Purpose. The purpose of this project was to implement an educational intervention for primary healthcare providers on antimicrobial stewardship interventions, including delayed prescribing and watchful waiting. Background. Antimicrobial stewardship is a practice involving the judicious use of antimicrobials to reduce antimicrobial resistance and promote population health. Most antimicrobial prescriptions originate from the primary healthcare setting, and up to half of these are inappropriately used for viral or otherwise self-limiting illnesses. Provider education is an essential strategy to bring to light specific antimicrobial stewardship interventions, such as delayed prescribing and watchful waiting, which can facilitate a reduction in inappropriate antimicrobial use. Methods. This quality improvement project used a descriptive design to determine the impacts of an educational intervention through assessing pretest and posttest questionnaires. The implementation was guided by Lewin’s change theory and followed the Institute of Healthcare Improvement’s Model for Improvement Plan-Do-Study-Act cycle. Five primary care providers from one practice site were invited via email to participate in a pretest questionnaire, short educational PowerPoint presentation, and posttest questionnaire, all provided on an electronic platform. Results. Three out of five providers at the implementation site participated in the entirety of the intervention. Participant providers demonstrated a strong baseline knowledge of antimicrobial stewardship. Participant providers increased their awareness of and attitudes toward antimicrobial stewardship interventions to be used in the primary healthcare setting after the educational intervention was implemented. Conclusions. This project indicates that an educational intervention for primary care providers can improve their knowledge, awareness, and attitudes toward utilizing specific interventions with their patients to promote antimicrobial stewardship. The impact of this intervention is difficult to determine due to the small scope of this project, so further PDSA cycles and investigation is recommended to determine the efficacy of targeted provider education. Future research might look at the impact of utilizing antimicrobial stewardship interventions among a sample of patients in the primary care setting

An Appalachia Abroad: Connecting to International Mountain Cultures in India\u27s Uttarakhand

This experiential presentation is the culmination of a study abroad trip to the Garhwali mountain region in India’s Uttarakhand, located within the base level Himalayas. Students from Appalachian State University spent eighteen days in-country travelling in the Garhwali region into the Nanda Devi Biosphere Reserve’s outer core. In addition to trekking, the students participated in home stays, cultural exchanges, and religious ceremonies with locals from the villages of Lata and Reni. Students connected the Uttarakhand\u27s cultural traditions, the growing development of a handicraft trade, local tourism development, environmental activism, natural resource management practices, and the struggles and triumphs in establishing autonomy, to that of the Appalachian region. By connecting to the local culture and comparing their experiences to the Appalachian region, students used comparative mountain study\u27s methodologies to recognize the problems and solutions surrounding sustainable development have commonalities across the globe. India\u27s Uttarakhand and Appalachia have a common heritage and common goals for the future. Connecting the two regions provide opportunity for furthering the goals of sustainable development on regional, national, and global scales. In addition, the partnerships established from the study abroad provide new social capital for the Appalachian region and the possibility of long-term comparative mountain study opportunities and partnerships