Differential DNA accessibility to polymerase enables 30-minute phenotypic β-lactam antibiotic susceptibility testing of carbapenem-resistant Enterobacteriaceae

The rise in carbapenem-resistant Enterobacteriaceae (CRE) infections has created a global health emergency, underlining the critical need to develop faster diagnostics to treat swiftly and correctly. Although rapid pathogen-identification (ID) tests are being developed, gold-standard antibiotic susceptibility testing (AST) remains unacceptably slow (1–2 d), and innovative approaches for rapid phenotypic ASTs for CREs are urgently needed. Motivated by this need, in this manuscript we tested the hypothesis that upon treatment with β-lactam antibiotics, susceptible Enterobacteriaceae isolates would become sufficiently permeabilized, making some of their DNA accessible to added polymerase and primers. Further, we hypothesized that this accessible DNA would be detectable directly by isothermal amplification methods that do not fully lyse bacterial cells. We build on these results to develop the polymerase-accessibility AST (pol-aAST), a new phenotypic approach for β-lactams, the major antibiotic class for gram-negative infections. We test isolates of the 3 causative pathogens of CRE infections using ceftriaxone (CRO), ertapenem (ETP), and meropenem (MEM) and demonstrate agreement with gold-standard AST. Importantly, pol-aAST correctly categorized resistant isolates that are undetectable by current genotypic methods (negative for β-lactamase genes or lacking predictive genotypes). We also test contrived and clinical urine samples. We show that the pol-aAST can be performed in 30 min sample-to-answer using contrived urine samples and has the potential to be performed directly on clinical urine specimens

Differential DNA accessibility to polymerase enables 30-minute phenotypic β-lactam antibiotic susceptibility testing of carbapenem-resistant Enterobacteriaceae

The rise in carbapenem-resistant Enterobacteriaceae (CRE) infections has created a global health emergency, underlining the critical need to develop faster diagnostics to treat swiftly and correctly. Although rapid pathogen-identification (ID) tests are being developed, gold-standard antibiotic susceptibility testing (AST) remains unacceptably slow (1–2 d), and innovative approaches for rapid phenotypic ASTs for CREs are urgently needed. Motivated by this need, in this manuscript we tested the hypothesis that upon treatment with β-lactam antibiotics, susceptible Enterobacteriaceae isolates would become sufficiently permeabilized, making some of their DNA accessible to added polymerase and primers. Further, we hypothesized that this accessible DNA would be detectable directly by isothermal amplification methods that do not fully lyse bacterial cells. We build on these results to develop the polymerase-accessibility AST (pol-aAST), a new phenotypic approach for β-lactams, the major antibiotic class for gram-negative infections. We test isolates of the 3 causative pathogens of CRE infections using ceftriaxone (CRO), ertapenem (ETP), and meropenem (MEM) and demonstrate agreement with gold-standard AST. Importantly, pol-aAST correctly categorized resistant isolates that are undetectable by current genotypic methods (negative for β-lactamase genes or lacking predictive genotypes). We also test contrived and clinical urine samples. We show that the pol-aAST can be performed in 30 min sample-to-answer using contrived urine samples and has the potential to be performed directly on clinical urine specimens

SARS-CoV-2 Viral Load in Saliva Rises Gradually and to Moderate Levels in Some Humans

Transmission of SARS-CoV-2 in community settings often occurs before symptom onset, therefore testing strategies that can reliably detect people in the early phase of infection are urgently needed. Early detection of SARS-CoV-2 infection is especially critical to protect vulnerable populations who require frequent interactions with caretakers. Rapid COVID-19 tests have been proposed as an attractive strategy for surveillance, however a limitation of most rapid tests is their low sensitivity. Low-sensitivity tests are comparable to high sensitivity tests in detecting early infections when two assumptions are met: (1) viral load rises quickly (within hours) after infection and (2) viral load reaches and sustains high levels (>10⁵ - 10⁶ RNA copies/mL). However, there are no human data testing these assumptions. In this study, we document a case of presymptomatic household transmission from a healthy college student to his brother and father. Participants prospectively provided twice-daily saliva samples. Samples were analyzed by RT-qPCR and RT-ddPCR and we measured the complete viral load profiles throughout the course of infection of the brother and father. This study provides evidence that in at least some human cases of SARS-CoV-2, viral load rises slowly (over days, not hours) and not to such high levels to be detectable reliably by any low-sensitivity test. Additional viral load profiles from different samples types across a broad demographic must be obtained to describe the early phase of infection and determine which testing strategies will be most effective for identifying SARS-CoV-2 infection before transmission can occur

A multistate outbreak of Escherichia coli O157:H7 infections linked to alfalfa sprouts grown from contaminated seeds.

A multistate outbreak of Escherichia coli O157:H7 infections occurred in the United States in June and July 1997. Two concurrent outbreaks were investigated through independent case-control studies in Michigan and Virginia and by subtyping isolates with pulsed-field gel electrophoresis (PFGE). Isolates from 85 persons were indistinguishable by PFGE. Alfalfa sprouts were the only exposure associated with E. coli O157:H7 infection in both Michigan and Virginia. Seeds used for sprouting were traced back to one common lot harvested in Idaho. New subtyping tools such as PFGE used in this investigation are essential to link isolated infections to a single outbreak

Ungulate browsing shapes climate change impacts on forest biodiversity in Hungary

Climate change can result in a slow disappearance of forests dominated by less drought-tolerant native European beech (Fagus sylvatica) and oak species (Quercus spp.) and further area expansion of more drought-tolerant non-native black locust (Robinia pseudoacacia) against those species in Hungary. We assumed that the shift in plant species composition was modified by selective ungulate browsing. Thus, we investigated which woody species are selected by browsing game. We have collected data on the species composition of the understory and the browsing impact on it in five different Hungarian even-aged forests between 2003 and 2005. Based on these investigations the non-native Robinia pseudoacacialiving under more favourable climatic conditions was generally preferred (Jacobs’ selectivity index: D=0.04±0.77), while the nativeFagus sylvatica and Quercus spp. (Q. petraea, Q. robur), both more vulnerable to increasing aridity, were avoided (D=-0.37±0.11;-0.79±0.56;-0.9±0.16; respectively) among target tree species. However, economically less or not relevant species, e.g. elderberry (Sambucus spp.), blackberry (Rubus spp.) or common dogwood (Cornus sanguinea) were the most preferred species (D=0.01±0.71; -0.12±0.58; -0.2±0.78, respectively). Our results imply that biodiversity conservation, i.e. maintaining or establishing a multi-species understory layer, can be a good solution to reduce the additional negative game impact on native target tree species suffering from drought. Due to preference for Robinia pseudoacaciaselective browsing can decelerate the penetration of this species into native forest habitats. We have to consider the herbivorous pressure of ungulates and their feeding preferences in planning our future multifunctional forests in the light of climate change impacts

Sustainable development and well-being: a philosophical challenge

This paper aims at gaining a better understanding of the inherent paradoxes within sustainability discourses by investigating its basic assumptions. Drawing on a study of the metaphoric references operative in moral language, we reveal the predominance of the 'well-being = wealth' construct, which may explain the dominance of the 'business case' cognitive frame in sustainability discourses (Hahn et al. in Acad Manag Rev 4015:18–42, 2015a). We incorporate economic well-being variables within a philosophical model of becoming well (Küpers in Cult Organ 11(3):221–231, 2005), highlighting the way in which these variables consistently articulate a combination of 'objective' and 'subjective' concerns. We then compare this broad understanding of well-being with the metaphors operative in the sustainable development discourse and argue that the sustainability discourse has fallen prey to an overemphasis on the 'business case'. We proceed to draw on Georges Bataille to challenge the predominance of these value priorities and to explore which mindshifts are required to develop a more comprehensive understanding of what is needed to enable 'sustainable development'

Near and middle east : Ancient records from North Arabia

Canadaxix, 243 p.; 25 c

Combined SRCT & FXCT - the next steps

One of the goals in developing synchrotron radiation x-ray computed tomography (SRCT) for biomedical specimens, is allowing particular tissues and cell types to be marked in the images. This is equivalent to the staining in histology, which enables researchers to visualise and measure tissue structure and biochemical processes within the specimen. Some progress in this direction for SRCT is being made, using a variety of contrast agents that alter the natural x-ray attenuation of the marked tissue [1]. However there are limits to the usefulness of these attenuation altering techniques. Often high concentrations of potentially disruptive chemicals are required with reduced compatibility for in-vivo studies. Another image highlighting technique which might prove more sensitive is x-ray fluorescence imaging. In this case usually endogenous elemental markers are visualised. We would like to develop a lower resolution, but wider field of view means of three-dimensional (3-D) fluorescence imaging compatible with SRCT. We have previously proposed a technique in which x-ray fluorescence CT (FXCT) and SRCT data can be collected simultaneously [2]. This work resulted in proof of concept modelling, and a simple experiment test system. We show data here which demonstrate a two-dimensional (2-D) reconstruction of an iodine fluorescence map from a phantom. Measurements were performed with a fixed beam modulating mask using the Imaging and Medical beam line (IMBL) at the Australian Synchrotron. Fluorescence data was obtained during a CT scan using a single point detector, while transmission data was simultaneously collected using an area detector. A maximum likelihood expectation maximisation (MLEM) iterative algorithm was used to reconstruct the fluorescence map. We report on technique development and now believe compressive sensing (CS) imaging techniques suit SRCT and may overcome the issues encountered so far in combining SRCT and FXCT