Global prevalence of Colistin resistance in Klebsiella Pneumoniae from bloodstream infection: A systematic review and meta-analysis

Background: Among gram-negative bacteria, Klebsiella pneumoniae is one of the most common causes of healthcare-related infection. Bloodstream infections (BSIs) caused by Klebsiella pneumoniae are notorious for being difficult to treat due to resistance to commonly used antimicrobials. Klebsiella pneumoniae isolates from bloodstream infections are becoming increasingly resistant to carbapenems. In the fight against carbapenem-resistant Klebsiella pneumoniae, colistin [polymyxin E] is the antimicrobial of choice and is thus widely used.Objective: This study aimed to determine the global prevalence of colistin resistance amongst Klebsiella pneumoniae isolates from bloodstream infections. Methods: PubMed, Medline, Scopus, and the Cochrane Library were searched for published articles without restricting the search period. Studies meeting the predefined inclusion and exclusion criteria were included, and quality was assessed using Joanna Briggs Institute Checklist. We used a statistical random effect model to analyze data with substantial heterogeneity (I2 > 50%) in the meta-analysis. Results: A total of 10 studies out of 2873 search results that met the inclusion criteria were included in the final synthesis for this study. A pooled prevalence of colistin resistance was 3.1%, 95% CI (1.5–4.7%). The highest colistin resistance pooled prevalence was recorded in isolates studied in 2020 and beyond 12.90% (4/31), while Klebsiella pneumoniae isolates studied in 2015 and before and in 2016–2019 showed a pooled colistin resistance rate of 2.89% (48/1661) and 2.95% (28/948), respectively. The highest colistin resistance was found in Klebsiella pneumoniae isolates from Thailand (19.2%), while the least pooled resistance was in Klebsiella pneumoniae from South Korea (0.8%). The pooled prevalence of the multidrug-resistant (MDR) of Klebsiella pneumoniae from bloodstream infection ranged from 80.1%, 95% CI (65.0–95.2%), and the resistance prevalence of other antibiotics by Klebsiella pneumoniae from bloodstream infections were as follows; ciprofloxacin (45.3%), ertapenem (44.4%), meropenem (36.1%), imipenem (35.2%), gentamicin (33.3%), amikacin (25.4%) and tigecycline (5.1%). Klebsiella pneumoniae recovered from the intensive care unit (ICU) showed higher colistin resistance, 11.5% (9/781%), while non-ICU patients showed 3.03% (80/2604) pooled colistin resistance. Conclusion: This study showed low colistin resistance in Klebsiella pneumoniae isolates from global bloodstream infections. However, significant colistin resistance was observed in isolates collected from 2020 and beyond. Significant colistin resistance was also observed in Klebsiella pneumoniae isolates in bloodstream infections from the intensive care unit (ICU) compared to those from non-ICUs. As a result, there is a need to institute colistin administration stewardship in the ICU in clinical settings

SARS-CoV-2 susceptibility and COVID-19 disease severity are associated with genetic variants affecting gene expression in a variety of tissues

Variability in SARS-CoV-2 susceptibility and COVID-19 disease severity between individuals is partly due to genetic factors. Here, we identify 4 genomic loci with suggestive associations for SARS-CoV-2 susceptibility and 19 for COVID-19 disease severity. Four of these 23 loci likely have an ethnicity-specific component. Genome-wide association study (GWAS) signals in 11 loci colocalize with expression quantitative trait loci (eQTLs) associated with the expression of 20 genes in 62 tissues/cell types (range: 1:43 tissues/gene), including lung, brain, heart, muscle, and skin as well as the digestive system and immune system. We perform genetic fine mapping to compute 99% credible SNP sets, which identify 10 GWAS loci that have eight or fewer SNPs in the credible set, including three loci with one single likely causal SNP. Our study suggests that the diverse symptoms and disease severity of COVID-19 observed between individuals is associated with variants across the genome, affecting gene expression levels in a wide variety of tissue types

A first update on mapping the human genetic architecture of COVID-19

peer reviewe

Association between ENAM polymorphisms and dental caries in children

Aim: Dental enamel, the most rigid biological tissue of the tooth known to mankind, is the most integral and fundamental part of the tooth. Enamel matrixes compile 5% of Enamelin peptides and at the time of tooth development, they are considered to effect the formation and elongation of enamel crystallites. ENAM plays critical role in enamel formation. Any changes in ENAM may affect the thickness of enamel and may lead to dental caries. The present study is aimed to evaluate the association of ENAM gene polymorphisms and susceptibility of dental caries development risk. Material and methods: The present study was carried out on 168 South Indian children, children’s with dental caries were included in study. Written consent was taken from their parents/guardians. Additionally 193 healthy individuals were enrolled as controls. Sampling was done after dental examination of the individuals. Three ENAM gene single nucleotide polymorphisms (SNPs) were rs7671281, rs3796704 and rs12640848 was genotyped to check their role in susceptibility of dental caries development risk. Results: Out of three SNPs rs7671281 showed statistically significant risk association with dental caries susceptibility in this ethnic population at heterozygous allele CT (OR: 1.939, p = .01865) and with minor allele T (OR: 1.451, p = .001292). SNP rs3796704 showed significant protective association with dental caries in Indian population at heterozygous allele GA (OR: 0.409, p = .0192) and with minor allele A (OR: 0.645, p = .00875). SNP rs12640848 showed significant protective association with dental caries in Indian population at heterozygous allele AG (OR: 3.041, p = .00642) and with minor allele G (OR: 1.478, p = .02184). Preliminary insilico analysis also showed that rs7671281 (Ile648Thr) amino acid change will cause the structural and functional changes in ENAM protein. Conclusions: In the present study significant association was observed between ENAM gene SNP rs7671281 and dental caries susceptibility in South Indian children. These results suggested that ENAM gene variants may contribute to dental caries in children. Keywords: Ameloblastin, Amelogenin, Dental enamel, Enameli

Sandstone sample analysis and additional structural data from Jabal Rayah, a possible impact structure in Saudi Arabia

The ~ 5.5 km sized Jabal Rayah ring structure located at 28° 390 N/37° 120 E in Saudi-Arabia has been classified as a possible complex impact structure located in flat-lying-Paleozoic clastic sediments. Previous, detailed mapping showed that erosional processes led-to a relief inversion, with displaced, folded, and faulted blocks of Silurian to Early-Devonian strata, interpreted to form a ring syncline, now forming a topographically-outstanding, 150 m high ring crest. The drainage toward the center of the structure seems-controlled by a set of radial faults. This central part is eroded to the level of the-surrounding plateau and partially covered with gravel. Analysis of 28 Qusaiba Formation-sandstones showed that at the present outcrop level, the sediments seem devoid of shock-features. Measurement of fold axes in the central part of the structure shows radially-outward plunging fold axes, becoming steeper toward the center, and also fold axes of other-orientation, and folded folds. This fold axis pattern is interpreted as an upward-pointing,-kilometer-sized sheath fold. Assuming an impact scenario and using the present size of the-structure, the minimum central structural uplift is estimated at ~ 500 m, which is consistent-with Qusaiba Formation occupying the center of the ring structure

Flood deposits penecontemporaneous with ∼0.8 Ma tektite fall in NE Thailand: impact-induced environmental effects?

Although a crater is not yet identified, the Australasian tektite strewn field provides evidence that a major impact cratering event took place in the Southeast Asian region at ∼0.8 Ma, just prior to the Brunhes/Matuyama geomagnetic polarity reversal. Paleomagnetic evidence including reversed polarity in mud lens closely associated with in situ tektites suggests that tektite-bearing flood deposits near Ban Ta Chang and Chum Phuang in northeast Thailand are penecontemporaneous with the impact event. The deposits include abundant organic debris, including whole tree trunks and mammal bones, that preserved due to reducing conditions, which are also responsible for the presence of abundant iron sulphides. Sedimentological observations suggest a series of major flood events that are out of character with the modern meandering river system to which they are related. The deposits are consistent with the effects of regional deforestation, increased run off and erosion, and other environmental disruptions expected in the aftermath of a major impact event. © 2004 Elsevier B.V. All rights reserved.link_to_subscribed_fulltex

Principal components analysis plot of the most complete Adaffa Formation theropod tooth (SGS 0090) using CBL, CBW, CH, and AL.

<p>SGS 0090 (green x) is placed exclusively within the minimal scatter area (green polygon) of the sampled abelisaurid taxa, <i>Majungasaurus</i> and “<i>Indosuchus</i>”. Axis/symbol equivalencies shown in Fig. 3.</p

Principal components analysis plot of the most complete Adaffa Formation theropod tooth (SGS 0090) using all metric parameters.

<p>Result derived by adding SGS 0090 (green x) to the dental morphometric matrix of Smith et al. <a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0084041#pone.0084041-Smith3" target="_blank">[32]</a>. Samples were organized into 10 categories representing theropod family-level clades (see legend). Component axes 1 and 2 depict maximum discrimination in the data set; minimum scatter areas for each group indicated by polygons coded by taxon/sample colour.</p

Canonical variate analysis plot of the Adaffa Formation theropod teeth (SGS 0061, SGS 0090) using all metric parameters.

<p>SGS 0061 + SGS 0090 represented by (green x); other symbol equivalencies shown in Fig. 3. Axes 1 and 2 depict maximum discrimination in the data set.</p

Dinosaur remains from the Adaffa Formation of Saudi Arabia.

<p>Titanosaurian distal caudal vertebra (SGS 0366) in: A, anterior; B, lateral; and C posterior views. Abelisaurid teeth including: D, crown fragment (SGS 0061) with enlargement of the distal denticles; and maxillary-dentary tooth (SGS 0090) shown in distal (E) and lateral (F) views with enlargements of the distal carina and baso-apical enamel ridges.</p