Antimicrobial resistance in Europe and its potential impact on empirical therapy

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Characterization of Tn5393d, a complex Tn5393 derivative carrying the PER-1 extended-spectrum beta-lactamase gene and other resistance determinants.

In Alcaligenes faecalis FL-424/98, a clinical isolate that produces the PER-1 extended-spectrum β-lactamase, the bla(PER-1) gene was found to be carried on a 44-kb nonconjugative plasmid, named pFL424, that was transferred to Escherichia coli by electroporation. Investigation of the genetic context of the bla(PER-1) gene in pFL424 by means of a combined cloning and PCR mapping approach revealed that the gene is associated with a transposonlike element of the Tn3 family. This 14-kb element is a Tn5393 derivative of original structure, named Tn5393d, which contains the transposition module and the strAB genes typical of other members of the Tn5393 lineage plus additional resistance determinants, including the bla(PER-1) gene and a new allelic variant of the aphA6 aminoglycoside phosphotransferase gene, named aphA6b, whose product is active against kanamycin, streptomycin, and amikacin. Tn5393d apparently originated from the consecutive insertion of two composite transposons into a Tn5393 backbone carrying the aphA6b and the bla(PER-1) genes, respectively. The putative composite transposon carrying bla(PER-1), named Tn4176, is made of two original and nonidentical insertion sequences of the IS4 family, named IS1387a and IS1387b, of which one is interrupted by the insertion of an original insertion sequence of the IS30 family, named IS1066. In pFL424, Tn5393d is inserted into a Tn501-like mercury resistance transposon. Transposition of Tn5393d or modules thereof containing the bla(PER-1) gene from pFL424 to small multicopy plasmids or to a bacterial artificial chromosome was not detected in an E. coli host harboring both replicons

Spread of multidrug-resistant Proteus mirabilis isolates producing an AmpC-type β-lactamase: epidemiology and clinical management.

IN PRES

Pseudomyxoma peritonei

The subject of Ovarian Tumours and their effects is an exceedingly interesting and important one, especially in view of the efforts that are now being spade to elucidate their origin and nature.I have abstracted and epitomised the whole of the literature on Pseudomyxoma Peritonea, and present it here in what I believe to be the only complete and up-to -date account of the subject, in the hope that it may throw some light on this obscure condition, and serve as a foundation for future study.I wish to draw attention to the Histological aspect of my subject, as it in of great importance, especially mentioning in this connection the works of WERTH, WESTPHALEN, STRASSMAIN, GREENFIELD, and others.For the more complete elucidation of the Histology of Pseudomyxoma Peritonea, I have endeavoured to give in full detail the separate accounts of these authorities, adding as opportunities presented themselves, deductions and abstracts of my own, together with a complete original Histological research, carried on by myself, and illustrated by a series of Microphotographs