High prevalence of ESBL-producing Klebsiella pneumoniae in clinical samples from central Cote d'Ivoire

OBJECTIVES: Infections caused by multidrug-resistant Enterobacterales pose a significant challenge to clinical patient care, particularly in resource-constrained settings where epidemiological data on antimicrobial resistance are scarce. The aim of this study was to determine the prevalence of extended spectrum beta-lactamase-(ESBL)-producing Klebsiella pneumoniae among clinical samples from a teaching hospital in Bouake, central Cote d'Ivoire. METHODS: Clinical specimens were collected from sterile and non-sterile body sites and were subjected to microbiological diagnostics (April 2016-June 2017). The antimicrobial susceptibility patterns of K. pneumoniae were analysed using automated resistance testing and double-disk diffusion to test for ESBL production. Multiplex PCR was carried out to determine the presence of the resistance-conferring genes blaCTX-M, blaSHV and blaTEM. RESULTS: A total of 107 isolates were included, most of which were obtained from bloodstream (39%; n = 42) and urinary tract infections (39%; n = 42). Among all K. pneumoniae isolates, 84% (n = 90) were ESBL producers, many of which were also not susceptible to sulfonamides (99%), quinolones (81%) and aminoglycosides (79%). The majority of ESBL-producing strains harboured all three investigated bla genes. CONCLUSION: The high prevalence of ESBL-producing K. pneumoniae in clinical isolates from Cote d'Ivoire calls for revised empirical treatment regimens in critically ill patients with suspected Gram-negative infections, and the establishment of antimicrobial resistance surveillance systems

High prevalence of ESBL-producing Klebsiella pneumoniae in clinical samples from central Côte d'Ivoire

Objectives: Infections caused by multidrug-resistant Enterobacterales pose a significant challenge to clinical patient care, particularly in resource-constrained settings where epidemiological data on antimicrobial resistance are scarce. The aim of this study was to determine the prevalence of extended spectrum beta-lactamase-(ESBL)-producing Klebsiella pneumoniae among clinical samples from a teaching hospital in Bouaké, central Côte d’Ivoire. Methods: Clinical specimens were collected from sterile and non-sterile body sites and were subjected to microbiological diagnostics (April 2016-June 2017). The antimicrobial susceptibility patterns of K. pneumoniae were analysed using automated resistance testing and double-disk diffusion to test for ESBL production. Multiplex PCR was carried out to determine the presence of the resistance-conferring genes blaCTX-M, blaSHV and blaTEM. Results: A total of 107 isolates were included, most of which were obtained from bloodstream (39%; n = 42) and urinary tract infections (39%; n = 42). Among all K. pneumoniae isolates, 84% (n = 90) were ESBL producers, many of which were also not susceptible to sulfonamides (99%), quinolones (81%) and aminoglycosides (79%). The majority of ESBL-producing strains harboured all three investigated bla genes. Conclusion: The high prevalence of ESBL-producing K. pneumoniae in clinical isolates from Côte d’Ivoire calls for revised empirical treatment regimens in critically ill patients with suspected Gram-negative infections, and the establishment of antimicrobial resistance surveillance systems

Cu-Ag bi-layer films in dielectric/metal/dielectric transparent electrodes as ITO free electrode in organic photovoltaic devices

Among ITO alternative, dielectric/metal/dielectric multilayer structures are one of the most often studied possible substituent. However, if their optical and electrical properties are systematically investigated it is not the same with regard to their mechanical properties. In the present manuscript we have studied the properties of ZnS/Cu/Ag/ZnS, ZnS/Cu/Ag/MO3 (with M ¼ Mo or W) structures. With a maximum transmission of 90% and a sheet resistance of 5 U/sq the optimum structure exhibits a figure of merit of 82 10-3 Ω-1 when l = 600 nm. Beyond these standard measures we proceeded to the study of the mechanical properties of the multilayer structures. The inner and outer bending tests show that the ZnS/ Cu/Ag/ZnS (or MO3) structures are more flexible than ITO, while their responses to scotch tests show that they exhibit a large adhesion to the substrate, glass or plastic. The scratching adhesion test puts in evidence that the adhesion to the substrate of the Ag layer is smaller than that of ZnS/Cu/Ag/ZnS, which is smaller than that of ITO. On the other hand, this test shows that the ZnS/Cu/Ag/ZnS (no cracks for L = 25 N) is less brittle than ITO (cracks L = 15N). Finally, when used as anode in organic solar cells, the structure ZnS/Cu/Ag/WO3 allows achieving the best efficiency, similar to that obtained with ITO

Sparse Canonical Correlation Analysis via Truncated ℓ1-norm with Application to Brain Imaging Genetics

Discovering bi-multivariate associations between genetic markers and neuroimaging quantitative traits is a major task in brain imaging genetics. Sparse Canonical Correlation Analysis (SCCA) is a popular technique in this area for its powerful capability in identifying bi-multivariate relationships coupled with feature selection. The existing SCCA methods impose either the ℓ1-norm or its variants. The ℓ0-norm is more desirable, which however remains unexplored since the ℓ0-norm minimization is NP-hard. In this paper, we impose the truncated ℓ1-norm to improve the performance of the ℓ1-norm based SCCA methods. Besides, we propose two efficient optimization algorithms and prove their convergence. The experimental results, compared with two benchmark methods, show that our method identifies better and meaningful canonical loading patterns in both simulated and real imaging genetic analyse

Monte-Carlo simulations on possible collimation effects of outflows to fan-beamed emission of ultraluminous accreting X-ray pulsars

Pulsating ultraluminous X-ray sources (PULXs) are accreting pulsars with apparent X-ray luminosity exceeding $10^{39}\, \rm erg\ s^{-1}$. We perform Monte-Carlo simulations to investigate whether high collimation effect (or strong beaming effect) is dominant in the presence of accretion outflows, for the fan beam emission of the accretion column of the neutron stars in PULXs. We show that the three nearby PULXs (RX J0209.6$-$7427, Swift J0243.6+6124 and SMC X-3), namely the three musketeers here, have their main pulsed emission not strongly collimated even if strong outflows exist. This conclusion can be extended to the current sample of extragalactic PULXs, if accretion outflows are commonly produced from them. This means that the observed high luminosity of PULXs is indeed intrinsic, which can be used to infer the existence of very strong surface magnetic fields of $\sim10^{13-14}$ G, possibly multipole fields. However, if strong outflows are launched from the accretion disks in PULXs as a consequence of disk spherization by radiation pressure, regular dipole magnetic fields of $\sim10^{12}$ G may be required, comparable to that of the three musketeers, which have experienced large luminosity changes from well below their Eddington limit ($2\times10^{38}\, \rm erg\ s^{-1}$ for a NS) to super-Eddington and their maximum luminosity fills the luminosity gap between Galactic pulsars and extragalactic PULXs.Comment: 26 pages, 8 figures, 1 table. Accepted by Ap

Prenatal diagnosis of total and partial anomalous pulmonary venous connection: multicenter cohort study and meta-analysis

Objectives: The aims of this study were to review systematically literature on and describe the sonographic features and associated anomalies of total (TAPVC) and partial (PAPVC) anomalous pulmonary venous connection and scimitar syndrome (SS). Methods: A retrospective cohort study was carried out of cases of TAPVC, PAPVC and SS that underwent comprehensive ultrasound examination, seen over a 20-year period at two tertiary referral centers. Assessed variables included TAPVC subtype, gestational age at diagnosis, area behind the left atrium, ventricular disproportion, vertical vein, pulmonary venous obstruction, mode of diagnosis, association with cardiac and extracardiac conditions, and pregnancy and fetoneonatal outcomes. The outcome was considered favorable if the individual was alive and well (no functional impairment from surgery or cardiac or extracardiac conditions). Cases associated with right isomerism were excluded from the analysis, as TAPVC in these cases was only one of several major cardiac anomalies affecting sonographic signs. A systematic review was performed in order to obtain a synthesis of characteristics associated with TAPVC, PAPVC and SS. The literature search of PubMed and EMBASE (1970–2016) included reviews, case series and case reports. A meta-analysis was conducted only for TAPVC. Random-effects models were used to obtain pooled estimates of the frequencies of clinical characteristics and sonographic features. Results: For TAPVC, a total of 15 studies involving 71 patients (including 13 from the current cohort study) were included in the systematic review and meta-analysis. The pooled estimate for the association of TAPVC with congenital heart disease was 28.3% (95% CI, 18.1–41.3%) and with extracardiac anomalies it was 18.5% (95% CI, 10.5–30.6%). Of TAPVC cases, obstructed venous return was observed in 34.1% (95% CI, 22.7–47.7%), a favorable outcome in 43.8% (95% CI, 24.0–65.8%), ventricular disproportion in 59.2% (95% CI, 45.1–72.0%), increased area behind the left atrium in 58.1% (95% CI, 41.1–73.5%) and a vertical vein in 59.3% (95% CI, 41.1–75.3%). Diagnosis was established by using color or power Doppler in 84.9% (95% CI, 67.3–93.9%) of cases. For SS, there were only three studies describing eight cases, to which the current study added another five. Ventricular disproportion was present in three out of nine SS cases for which data were available, but for two of these, there was a concurrent heart anomaly. Color Doppler was used for all SS diagnoses, and four-dimensional echocardiography was useful in two out of six cases in which it was used. Outcome for SS cases was generally good. For PAPVC, there were only five studies describing five cases, to which the current study added another two. Major cardiac anomalies were associated in four out of seven of these cases, and extracardiac anomalies in three out of six cases for which data were available. Conclusions: TAPVC can be associated with other cardiac and extracardiac anomalies in a significant percentage of cases. Leading sonographic signs are ventricular disproportion, increased area behind the left atrium and the finding of a vertical vein. Color/power Doppler is the key mode for diagnosis of TAPVC. Obstructed venous return can be expected in roughly one-third of cases of TAPVC and outcome is favorable in less than half of cases. Data for SS and PAPVC are too few to synthesize. Copyright © 2017 ISUOG. Published by John Wiley & Sons Ltd