Significant increase in azithromycin “resistance” and susceptibility to ceftriaxone and cefixime in Neisseria gonorrhoeae isolates in 26 European countries, 2019

Euro-GASP network: Claudia Eder, Sonja Pleininger, Steliana Huhlescu, Irith de Baetselier, Blaženka Hunjak, Tatjana Nemeth Blažić, Panagiota Maikanti-Charalampous, Despo Pieridou, Hana Zákoucká, Helena Žemličková, Steen Hoffmann, Susan Cowan, Rita Peetso, Jelena Viktorova, Ndeindo Ndeikoundam, Beatrice Bercot, Anu Patari Sampo, Vesa Kirjavainen, Susanne Buder, Klaus Jansen, Vivi Miriagou, Eszter Balla, Mária Dudás, Guðrún Sigmundsdóttir, Lena Ros Asmundsdottir, Sinead Saab, Brendan Crowley, Anna Carannante, Paola Stefanelli, Gatis Pakarna, Violeta Mavcutko, Robert Cassar, Christopher Barbara, Francesca Vella, Alje Van Dam, Ineke Linde, Dominique Caugant, Hilde Kløvstad, Beata Mlynarczyk-Bonikowska, Maria-José Borrego, Peter Pavlik, Irena Klavs, Tanja Kustec, Julio Vazquez, Asuncion Diaz, Raquel Abad Torreblanca, Inga Velicko, Magnus Unemo, Helen Fifer, Kate TempletonBackground: The European Gonococcal Antimicrobial Surveillance Programme (Euro-GASP) performs annual sentinel surveillance of Neisseria gonorrhoeae susceptibility to therapeutically relevant antimicrobials across the European Union/European Economic Area (EU/EEA). We present the Euro-GASP results from 2019 (26 countries), linked to patient epidemiological data, and compared with data from previous years. Methods: Agar dilution and minimum inhibitory concentration (MIC) gradient strip methodologies were used to determine the antimicrobial susceptibility (using EUCAST clinical breakpoints, where available) of 3239 N. gonorrhoeae isolates from 26 countries across the EU/EEA. Significance of differences compared with Euro-GASP results in previous years was analysed using Z-test and the Pearson's χ2 test was used to assess significance of odds ratios for associations between patient epidemiological data and antimicrobial resistance. Results: European N. gonorrhoeae isolates collected between 2016 and 2019 displayed shifting MIC distributions for; ceftriaxone, with highly susceptible isolates increasing over time and occasional resistant isolates each year; cefixime, with highly-susceptible isolates becoming increasingly common; azithromycin, with a shift away from lower MICs towards higher MICs above the EUCAST epidemiological cut-off (ECOFF); and ciprofloxacin which is displaying a similar shift in MICs as observed for azithromycin. In 2019, two isolates displayed ceftriaxone resistance, but both isolates had MICs below the azithromycin ECOFF. Cefixime resistance (0.8%) was associated with patient sex, with resistance higher in females compared with male heterosexuals and men-who-have-sex-with-men (MSM). The number of countries reporting isolates with azithromycin MICs above the ECOFF increased from 76.9% (20/26) in 2016 to 92.3% (24/26) in 2019. Isolates with azithromycin MICs above the ECOFF (9.0%) were associated with pharyngeal infection sites. Following multivariable analysis, ciprofloxacin resistance remained associated with isolates from MSM and heterosexual males compared with females, the absence of a concurrent chlamydial infection, pharyngeal infection sites and patients ≥ 25 years of age. Conclusions: Resistance to ceftriaxone and cefixime remained uncommon in EU/EEA countries in 2019 with a significant decrease in cefixime resistance observed between 2016 and 2019. The significant increase in azithromycin "resistance" (azithromycin MICs above the ECOFF) threatens the effectiveness of the dual therapy (ceftriaxone + azithromycin), i.e., for ceftriaxone-resistant cases, currently recommended in many countries internationally and requires close monitoring.The study was funded by the European Centre for Disease Prevention and Control (Framework Contract No. ECDC/2017/004).info:eu-repo/semantics/publishedVersio

AOS Gouden Combinatie

Academische opleidingsscholen combineren inmiddels al tien jaar op succesvolle wijze de lerarenopleiding met praktijkonderzoek. Wat is hun geheim? Gedurende tien jaar is binnen academische opleidingsscholen (AOS) gewerkt aan de structuur en cultuur die nodig is om onderzoek in de school uit te voeren. Daarmee zijn zij voorlopers in de ontwikkeling naar meer praktijkonderzoek in de school. Zij zijn in die tien jaar unieke ervaringsdeskundigen geworden. Er zijn weinig scholen die zoveel onderzoekservaring hebben opgedaan en gewerkt hebben aan een onderzoekende cultuur. Per 1 januari 2017 is de subsidie voor de academische kop officieel gestopt, een mooi moment om terug te kijken welke lessen we kunnen leren over praktijkonderzoek in de school. Het delen van de ervaringen van deze scholen kan andere scholen die meer onderzoekend willen werken inspireren en richting geven

SMALL AFM CANTILEVERS FOR BIOLOGICAL APPLICATION

Atomic Force Microscope is of special interest to biologists since it enables real time imaging and force measurements on biological tissue. To observe the biological process of interest in a reasonable time with high force sensitivity, high resonance frequency cantilevers with low spring constant are required while maintaining a high signal to noise ratio. These requirements can be met by reducing the dimensions and mass of the cantilever. Silicon nitride (SiN) is used to fabricate the AFM cantilevers; the body of the probe is exists of a double layer of the negative photopolymer SU-8. This provides a simple and cheap way of attaching a body to the cantilevers. Figure 1 shows an overview of a probe with 6 cantilevers. Figure 2 shows a close-up of a lever with dimensions 35 µm x 6 µm. A metal pad is present at the extremity of the cantilever, serving as reflecting layer for beam deflection sensing

Force Spectroscopy with a Novel Small Focus AFM

Atomic force microscopy has become potent tool for investigating interand intramolecular interactions. Single molecule force spectroscopy on supramolecular guest-host-complexes reveal information about the depth of the binding pocket and thermal off-rates. Sensitivity and resolution are immanently conntected to the cantilever’s mechanical properties. The cantilever’s thermal noise induced by Brownian Motion of the surrounding medium is a fundamental limit of resolution. As the Nyquist Theorem is valid for the thermal white noise of a cantilever, reduction of the viscous damping by downsizing the cantilever’s dimensions is compulsory. Furthermore, the resonant frequency is increased which extends experimental bandwidth and thus enables high speed measurements. Unfortunately small cantilevers cannot be used with commercially available AFM, since the laserfocus is too large. We present results of single molecule force spectroscopy measurements on Calixarene-Ammonium-Complexes acquired with our homebuilt small focus AFM. As predicted, small cantilevers show favourable properties as increased resonant frequency and lower viscous damping