Characterization of multidrug-resistant, qnrB2-positive and extended-spectrum-b-lactamase-producing Salmonella Concord and Salmonella Senftenberg isolates

Objectives: To characterize plasmids and resistance genes of multidrug-resistant (MDR) Salmonella Senftenberg and Salmonella Concord isolated from patients in the Netherlands. Methods: The resistance genes of four MDR Salmonella isolates (three Salmonella Concord and one Salmonella Senftenberg) were identified by miniaturized microarray, PCR and sequencing. Plasmids were characterized by S1 nuclease-PFGE and PCR-based replicon typing (PBRT). Linkage between plasmids and genes was determined by conjugation experiments and microarray analysis. The genetic relationship between the three Salmonella Concord isolates was determined by XbaI-PFGE. Results: A large variety of resistance genes was detected, including qnrB2 and the b-lactamase genes bla TEM-1 and bla SHV-12 in all isolates; moreover all Salmonella Concord isolates also harboured bla CTX-M-15 . Salmonella Senftenberg harboured a large IncHI2 plasmid. The three Salmonella Concord isolates harboured two large plasmids typed as IncHI2 and IncA/C. Conclusions: We detected the first plasmid-mediated MDR Salmonella isolates in the Netherlands harbouring both qnr and extended-spectrum b-lactamase (ESBL) genes. In Salmonella Senftenberg one large plasmid (IncHI2) and in Salmonella Concord two large plasmids (IncHI2 and IncA/C) were responsible for the multidrug resistance

A taxonomy to assess the interaction between nurses and children:Development and reliability

Aims and objectives The aim of this study was to develop a valid and reliable instrument to assess the nurse-child interaction during medical or nursing interventions. Background Communication is an important competency for the professional practice of nurses and physicians. The nurse-patient relationship is fundamental for high-quality care. It has been suggested that if nurses have more skills to interact with children, care will be less distressing and less painful for the children. Design A qualitative observational psychometric study; the GRRAS checklist was used. Methods In-depth video-analyses, taxonomy development (19 videos) and testing it is psychometric properties (10 videos). Three observers micro-analysed video recordings of experienced nurses changing children's wound dressing in a specialised Burn Centre. Results The nurse-child interaction taxonomy (NCIT) was developed to observe and score the interactional behaviour between nurse and child. The taxonomy has three main patterns: being considerate, attuning oneself, and procedural interventions, subdivided in eight dimensions. These dimensions contain 16 elements that can be observed and scored on a 7-point scale. Intra-rater, inter-rater reliability and agreement were good. Conclusions This study shows that interaction between nurses and children can be assessed reliably with the NCIT by an experienced observer or alternatively, scoring by two observers is recommended. Relevance to clinical practice The development of the taxonomy is an important step to find evidence for the best way for nurses to interact with children during nursing interventions or medical events and as such, ultimately, contributes to providing the best care possible

Programs for special classes for children with complex violations of the development of special educational institutions for visually impaired children. Labor training. Preparatory, grades 1-4

Метою трудового навчання є розвиток особистості зі складними вадами розвитку через залучення до різних видів доступної праці, засвоєння знань про властивості оброблюваних матеріалів, вивчення засобів праці, формування відповідального ставлення до вирішення трудових завдань і навчання безпеки праці. У процесі трудової діяльності з різноманітними предметами та матеріалами, змінюючи під час обробки їх форму, конфігурацію, розміри, величину, об’єм, вагу, поверхню, учні оволодівають прийомами і способами проведення обстежувальних дій, предметної і просторової орієнтації, збагачують власні уявлення про навколишню дійсність, знаходять особисто значущі для них об’єкти праці, тобто такі, що найкраще забезпечують реалізацію їхніх творчих можливостей. Мета і завдання предмета реалізуються на основі змісту кількох основних напрямків життєдіяльності: природа, людина, техніка, естетичне довкілля. За структурою програма складається з трьох колонок: зміст навчального матеріалу; навчальні досягнення учнів; спрямованість корекційно-розвивальної роботи.Целью трудового обучения является развитие личности со сложными нарушениями в развитии путем привлечения к различным видам доступного труда, усвоение знаний о свойствах обрабатываемых материалов, изучение средств труда, формирование ответственного отношения к решению трудовых задач и обучения безопасности труда. В процессе трудовой деятельности с различными предметами и материалами, изменяя при обработке их форму, конфигурацию, размеры, величину, объем, вес, поверхность, учащиеся овладевают приемами и способами проведения обследовательских действий, предметной и пространственной ориентации, обогащают собственные представления об окружающей действительности, находят лично значимые для них объекты труда, то есть такие, которые лучше всего обеспечивают реализацию их творческих возможностей. Цель и задачи предмета реализуются на основе содержания нескольких направлений жизнедеятельности: природа, человек, техника, эстетика окружающей среды. По структуре программа состоит из трех колонок: содержание учебного материала; учебные достижения учащихся; направленность коррекционно-развивающей работы.The purpose of labor training is the development of a person with complex defects through the involvement in various types of accessible labor, the acquisition of knowledge about the properties of processed materials, the study of means of labor, the formation of responsible attitude to solving labor problems and training in labor safety. In the process of work with various objects and materials, changing their shape, configuration, size, size, volume, weight, surface, and size, size, size, volume, weight, surface, students acquire techniques and methods of conducting exploratory actions, subject and spatial orientation, enriching their own ideas about the surrounding reality, find objects of labor that are personally meaningful to them, that is, those that best ensure the realization of their creative abilities. The purpose and tasks of the subject are realized on the basis of the content of several key areas of life: nature, man, technique, aesthetic environment. The structure of the program consists of three columns: the content of the training material; educational achievements of students; the direction of correction and development work

Changing epidemiology of Salmonella Enteritidis human infections in the Netherlands and Belgium, 2006 to 2019: a registry-based population study.

BackgroundSalmonellosis remains the second most common zoonosis in the European Union despite a long-term decreasing trend. However, this trend has been reported to have stagnated in recent years, particularly for Salmonella enterica serotype Enteritidis (SE).AimTo describe temporal changes in the incidence of SE human infections, and in its associated factors between 2006 and 2019. In addition, we aim to determine which factors influenced the stagnated trend seen in recent years.MethodsData on culture-confirmed SE human infections from national surveillance registries in the Netherlands and Belgium between 2006 and 2019 were analysed using multivariable negative-binomial regression models with restricted cubic splines.ResultsSE incidence was significantly higher in summer and autumn than winter, in persons aged 0-4 years and 5-14 years than in persons ≥ 60 years, and increased with increasing proportions of travel-related and resistant SE infections. SE incidence decreased significantly in both countries until 2015, followed by an increasing trend, which was particularly pronounced in the Netherlands. Potential SE outbreaks in both countries and invasive infections in the Netherlands also increased after 2015.ConclusionThe increase in potential outbreaks and invasive infections since 2015 may partially explain the observed reversal of the decreasing trend. While these results provide insights into the possible causes of this trend reversal, attention should also be given to factors known to influence SE epidemiology at primary (animal) production and pathogen genomic levels

Building an International One Health Strain Level Database to Characterise the Epidemiology of AMR Threats: ESBL—AmpC Producing E. coli as An Example—Challenges and Perspectives

(This article belongs to the Special Issue Epidemiology of ESBL-Producing Enterobacteriaceae)Antimicrobial resistance (AMR) is one of the top public health threats nowadays. Among the most important AMR pathogens, Escherichia coli resistant to extended spectrum cephalosporins (ESC-EC) is a perfect example of the One Health problem due to its global distribution in animal, human, and environmental sources and its resistant phenotype, derived from the carriage of plasmid-borne extended-spectrum and AmpC β-lactamases, which limits the choice of effective antimicrobial therapies. The epidemiology of ESC-EC infection is complex as a result of the multiple possible sources involved in its transmission, and its study would require databases ideally comprising information from animal (livestock, companion, wildlife), human, and environmental sources. Here, we present the steps taken to assemble a database with phenotypic and genetic information on 10,763 ESC-EC isolates retrieved from multiple sources provided by 13 partners located in eight European countries, in the frame of the DiSCoVeR Joint Research project funded by the One Health European Joint Programme (OH-EJP), along with its strengths and limitations. This database represents a first step to help in the assessment of different geographical and temporal trends and transmission dynamics in animals and humans. The work performed highlights aspects that should be considered in future international efforts, such as the one presented here.This research was funded by Promoting One Health in Europe through joint actions on foodborne zoonoses, antimicrobial resistance, and emerging microbiological hazards–One Health EJP, grant number 773830 (DiSCoVeR). Research at the German Federal Institute for Risk Assessment, Germany, was partially supported by the internal project BfR-BIOS-08-43-001. Research at the National Institute for Agrarian and Veterinary Research (INIAV) was partially supported by the project PTDC/CVT-CVT/28469/2017 financed by the “Fundação para a Ciência e Tecnologia” (FCT), Portugal. Research at the National Veterinary Research Institute (PIWet), Poland, was also partially supported by the Polish Ministry of Education and Science from the funds for science in the years 2018–2022 allocated for the implementation of a co-financed international project. The environmental isolates from Ireland were collected as part of the AREST project, which is jointly funded by the Environmental Protection Agency, under the EPA Research Programme 2014–2020, and the Health Service Executive (2017-HW-LS-1). The isolates collected from pig farms in Ireland were collected as part of a Walsh Scholarship project funded by Teagasc (ref 2018027). Research at the VISAVET Health Surveillance Centre (Spain) was partially supported by the project Antimicrobial resistance transmission dynamics in the human-animal interface: Shaping the risk posed by epidemic plasmids (PID2021-125136OB-I00, Ministerio de Ciencia, Innovación y Universidades, MICINN).info:eu-repo/semantics/publishedVersio

Antimicrobial resistance in Campylobacter fetus: emergence and genomic evolution

Campylobacter fetus is a pathogen, which is primarily associated with fertility problems in sheep and cattle. In humans, it can cause severe infections that require antimicrobial treatment. However, knowledge on the development of antimicrobial resistance in C. fetus is limited. Moreover, the lack of epidemiological cut-off values (ECOFFs) and clinical breakpoints for C. fetus hinders consistent reporting about wild-type and non-wild-type susceptibility. The aim of this study was to determine the phenotypic susceptibility pattern of C. fetus and to determine the C. fetus resistome [the collection of all antimicrobial resistance genes (ARGs) and their precursors] to describe the genomic basis of antimicrobial resistance in C. fetus isolates over time. Whole-genome sequences of 295 C. fetus isolates, including isolates that were isolated in the period 1939 till the mid 1940s, before the usage of non-synthetic antimicrobials, were analysed for the presence of resistance markers, and phenotypic antimicrobial susceptibility was obtained for a selection of 47 isolates. C. fetus subspecies fetus (Cff) isolates showed multiple phenotypic antimicrobial resistances compared to C. fetus subspecies venerealis (Cfv) isolates that were only intrinsic resistant to nalidixic acid and trimethoprim. Cff isolates showed elevated minimal inhibitory concentrations for cefotaxime and cefquinome that were observed in isolates from 1943 onwards, and Cff isolates contained gyrA substitutions, which conferred resistance to ciprofloxacin. Resistances to aminoglycosides, tetracycline and phenicols were linked to acquired ARGs on mobile genetic elements. A plasmid-derived tet(O) gene in a bovine Cff isolate in 1999 was the first mobile genetic element observed, followed by detection of mobile elements containing tet(O)-aph(3')-III and tet(44)-ant(6)-Ib genes, and a plasmid from a single human isolate in 2003, carrying aph(3')-III-ant(6)-Ib and a chloramphenicol resistance gene (cat). The presence of ARGs in multiple mobile elements distributed among different Cff lineages highlights the risk for spread and further emergence of AMR in C. fetus. Surveillance for these resistances requires the establishment of ECOFFs for C. fetus

Establishing Streptomycin Epidemiological Cut-Off Values for Salmonella and Escherichia coli

This study was conducted to elucidate the accuracy of the current streptomycin epidemiological cut-off value (ECOFF) for Escherichia coli and Salmonella spp. A total of 236 Salmonella enterica and 208 E. coli isolates exhibiting MICs between 4 and 32¿mg/L were selected from 12 countries. Isolates were investigated by polymerase chain reaction for aadA, strA, and strB streptomycin resistance genes. Out of 236 Salmonella isolates, 32 (13.5%) yielded amplicons for aadA (n¿=¿23), strA (n¿=¿9), and strB (n¿=¿11). None of the 60 Salmonella isolates exhibiting MIC 4¿mg/L harbored resistance genes. Of the Salmonella isolates exhibiting MICs 8¿mg/L, 16¿mg/L, and 32¿mg/L, 1.6%, 15%, and 39%, respectively, tested positive for one or more genes. For most monitoring programs, the streptomycin ECOFF for Salmonella is wild type (WT) =32 or =16¿mg/L. A cut-off value of WT =32¿mg/L would have misclassified 13.5% of the strains as belonging to the WT population, since this proportion of strains harbored resistance genes and exhibited MICs =32¿mg/L. Out of 208 E. coli strains, 80 (38.5%) tested positive for aadA (n¿=¿69), strA (n¿=¿18), and strB (n¿=¿31). Of the E. coli isolates exhibiting MICs of 4¿mg/L, 8¿mg/L, 16¿mg/L, and 32¿mg/L, 3.6%, 17.6%, 53%, and 82.3%, respectively, harbored any of the three genes. Based on the European Committee on Antimicrobial Susceptibility Testing guidelines (ECOFF =16¿mg/L), 25% of the E. coli strains presenting MIC =16¿mg/L would have been incorrectly categorized as belonging to the WT population. The authors recommend an ECOFF value of WT =16¿mg/L for Salmonella and WT =8¿mg/L for E. coli