Molecular characterization of extended-spectrum beta lactamase producing Klebsiella pneumoniae from the Stavanger region between 2003 and 2012

Master's thesis in Biological chemistryKlebsiella pneumoniae is a Gram-negative rod in the Enterobacteriaceae family, known to cause both community- and hospital-acquired infections, especially in immunocompromised patients. In the hospital setting, K. pneumoniae strains resistant to antibiotics are increasingly reported to cause infections and outbreaks. K. pneumoniae is commonly found to produce extended-spectrum β-lactamases (ESBLs), which inactivate the most important antibiotics: penicillins, third generation cephalosporins and monobactams. The most widespread ESBL enzyme among Enterobacteriaceae today is CTX-M-15, which is encoded and spread between strains by plasmids. In this project, all (n = 49) ESBLA- producing K. pneumoniae isolates isolated from clinical samples at Stavanger University Hospital between 2003 and 2012 were characterized at a molecular level. Species identification and antibiotic resistance profile was confirmed by mass spectrometry and the Vitek 2 system, respectively. ESBLA-encoding genes were identified by PCR and gene sequencing, and clonal relatedness was investigated by pulsed field gel electrophoresis (PFGE) and multilocus sequence typing (MLST). Plasmids were identified and characterized by S1-PFGE, PCR-based replicon typing and Southern blot hybridization with blaCTX-M, blaSHV and IncFIIK probes. All isolates were confirmed ESBLA - producing K. pneumoniae. Identified ESBLA encoding genes were typed as blaCTX-M-15 (n = 20), blaCTX-M-3 (n = 1), blaSHV-2 (n = 1), blaSHV-2A (n = 3), blaSHV-5 (n = 13), and blaSHV-12 (n = 5). The blaCTX-M-15 positive isolates were mainly clonally unrelated, and a common plasmid encoding blaCTX-M-15 could not be identified among these isolates. Two blaCTX-M-15 positive isolates were found to be clonally related to a strain which caused a neonatal intensive care unit outbreak at Stavanger University Hospital in 2008 – 2009. Twelve blaSHV-5 positive isolates were found to be closely related by PFGE and were typed as sequence type (ST) 29 by MLST. A ~230 kbp plasmid was found to bear blaSHV-5 in all blaSHV-5 positive ST29 isolates. The most prevalent ESBLA-encoding genes among clinical K. pneumoniae isolates from the Stavanger region were blaCTX-M-15 and blaSHV-5. blaSHV-5 positive ST29 isolates have caused sporadic infections between 2003 and 2012, and may represent an endemic clone in the Stavanger region and hospital setting. In contrast, the blaCTX-M positive isolates were associated with diverse clones and plasmids

Quinolone resistant Escherichia coli in Norwegian livestock : a comparative genomics study

The occurrence of antimicrobial resistance in Norwegian livestock is generally low. This is a consequence of good animal health and welfare, which reduces the need for antimicrobial use. Quinolones are important antimicrobial compounds both for human and animal health. An increased occurrence of resistance towards these compounds in livestock have been observed in many European countries. In Norway, the use of quinolones in livestock has been restricted. Prophylactic use of any antimicrobial is prohibited. The Norwegian monitoring programme for antimicrobial resistance in feed, food and animals (NORM‑VET) performs surveillance of antimicrobial resistance among commensal E. coli. The programme identified a low occurrence of quinolone resistance among several tested animal species. However, quinolone resistant E. coli (QREC) has been detected at low levels in a high proportion of samples from both pigs and broilers. Due to the low quinolone usage, this finding was somewhat surprising. Thus, further investigation of the origin of these bacteria was warranted. The aim of this study was to compile existing data on quinolone resistance occurrence. Furthermore, quinolone resistance mechanism characterization was performed. Relationships between the isolates were investigated by using a high resolution phylogenetic approach. The results showed a low occurrence of QREC among the included animal species. A significantly higher occurrence was observed in broilers. In silico characterization of quinolone resistance mechanisms identified chromosomal mutations as the major resistance determinant. Phylogenetic analysis of QREC provided evidence for dissemination in the broiler and pig production chains. Possible persistence of QREC was detected in the broiler production environment. Major QREC sequence types were detected among the samples from broilers. Some of these sequence types had previously been reported in other Nordic countries. Furthermore, phylogenetic analysis indicate that commensal E. coli rarely develop quinolone resistance in the broiler production environment. These results provide evidence for introduction of QREC to the Norwegian broiler production via imported breeding birds. The results highlight the importance of biosecurity measures at the top of the pyramid, to prevent dissemination of QREC.Norge har en av de laveste forekomstene av antibiotikaresistens i verden grunnet god dyrehelse og –velferd. Forbruket av kinoloner, som er svært viktige antibiotika for både dyr og mennesker, er svært lavt i Norge, og profylaktisk bruk av antibiotika er forbudt i husdyrproduksjonen. I mange andre europeiske land er det oppdaget en økende forekomst av kinolonresistente E. coli (QREC), som sannsynligvis er koblet til et økt forbruk av dette antibiotikumet. I Norge derimot viser data fra overvåkningsprogrammet for antibiotikaresistens i mikrober fra fôr, dyr og næringsmidler (NORM‑VET) en lav totalforekomst av QREC blant norske husdyr. QREC har likevel blitt detektert fra en stor andel prøver fra gris og slaktekylling, men mengden QREC i hver prøve ser ut til å være lav. Disse funnene førte til spørsmål rundt deres opphav. Målet med dette prosjektet var å sammenfatte eksisterende data på forekomst av QREC i ulike dyrearter i Norge, karakterisere kinolonresistensmekanismer i QREC stammer, samt beskrive forholdet mellom stammene ved bruk av dype fylogenetiske metoder. Resultatene viser en overordnet lav forekomst av QREC, men en signifikant høyere relativ forekomst ble observert i slaktekylling. Kromosomale mutasjoner ble identifisert som hovedmekanisme for den observerte kinolonresistensen. Fylogenetiske analyser av sekvensdataene viste en klonal spredning av QREC i både slaktekyllingproduksjonen og slaktegrisproduksjonen, og mulig persistens av QREC i miljøet der slaktekyllingene oppholder seg. Videre fylogenetisk analyse av både villtype E. coli og QREC viste at villtype E. coli i liten grad utvikler kinolonresistens i slaktekyllingproduksjonen. Resultatene viser at introduksjon av QREC fra importerte foreldredyr er hovedårsaken til den observerte forekomsten av QREC i den norske slaktekyllingproduksjonen. Disse resultatene belyser viktigheten av biosikkerhetstiltak høyere i slaktekyllingpyramiden for å hindre spredning av QREC nedover i produksjonen

New societies, new soldiers? A soldier typology

The term ‘soldier’ is frequently conceptualized as a warrior, a peacekeeper, or a hybrid of both. However, recent changes in the utilization of soldiers in societies have moved the repertoire of possible ways to think, act, and behave beyond these notions. As such, there exists an undertheorized gap between different expectations of soldiers and actual soldier roles. This presents a need for more nuanced and analytically useful conceptualizations of soldier roles. This article provides a more thorough understanding of the soldier role by identifying seven ideal types of soldiers: the warrior, nation-defender, law-enforcer, humanitarian, state-builder, and the ideological, and contractor soldiers. The typology offers an analytical tool with the capacity to maneuver the empirical reality, which is important because how soldier roles are constructed affect how military personnel understand their role in the postmodern world, where identity is multifaceted and negotiable. Ultimately, identity influences how soldiers interact with societies and how societies respond to war, conflicts, and crises.publishedVersionUnit Licence Agreemen

The Creation of Modern Denmark: A Figurational Analysis

This paper takes its point of departure from an observation made by Norbert Elias in his book The Germans. Many (smaller) European states were confronted by Germany in various wars and conflicts and states such as Denmark suffered defeats. Following from this, Elias poses the question as to how the Danish people came to terms with this reality-shock. This paper claims that the unintended consequence of the Danish defeat was the development of a new national habitus with a strong and particular form of nationalism. This nationalism not only tied the nation to the state but went much further by defining the nation as the people and the civil society. It became a deeply sedimented form of nationalism, which provided Denmark with a very strong social cohesion. The central argument concerns this strong Danish habitus linked to this form of nationalism. This paper argues that this habitus has become more problematic during the last 30 years in the era of globalisation. The strong Danish habitus generates resistance towards immigration, acceptance of refugees, the EU, and the internationalisation of education – just to mention some problematic areas. Consequently, Denmark, as a small open economy depending on multilateralism and internationalisation, has difficulties fully embracing globalisation

The Making of a Caribbean Avant-Garde: Postmodernism as Post-nationalism

Focusing on the Anglophone Caribbean, The Making of a Caribbean Avant-Garde describes the rise and gradual consolidation of the visual arts avant-garde, which came to local and international attention in the 1990s. The book is centered on the critical and aesthetic strategies employed by this avant-garde to repudiate the previous generation’s commitment to modernism and anti-colonialism. In three sections, it highlights the many converging factors, which have pushed this avant-garde to the forefront of the region’s contemporary scene, and places it all in the context of growing dissatisfaction with the post-colonial state and its cultural policies. This generational transition has manifested itself not only in a departure from “traditional” in favor of “new” media (i.e., installation, performance, and video rather than painting and sculpture), but also in the advancement of a “postnationalist postmodernism,” which reaches for diasporic and cosmopolitan frames of reference. Section one outlines the features of a preceding “Creole modernism” and explains the different guises of postnationalism in the region’s contemporary art. In section two, its momentum is connected to the proliferation of independent art spaces and transnational networks, which connect artists across and beyond the region and open up possibilities unavailable to earlier generations. Section three demonstrates the impact of this conceptual and organizational evolution on the selection and exhibition of Caribbean art in the metropole.https://docs.lib.purdue.edu/purduepress_previews/1055/thumbnail.jp

The moral career of soldiers’ identity : A Norwegian case

Military service can require soldiers to act beyond their moral beliefs, something that can impair soldiers’ mental health. However, little is known about the shaping of soldiers’ moral identity within their institutional context. This article explores how the moral identity of 20 experienced Norwegian soldiers is (re-)shaped in the Army. Findings from unstructured interviews suggest that they accept compromising their moral beliefs and give priority to an institutional obligation to follow orders. They present three mediating arguments justifying such a compromise and one effort to reduce the potential burden of carrying out illegal or immoral orders. I argue that these compromises are made possible through a shared belief they are socialized into through interactions in their military context. The study complements our knowledge of socialization processes in the military and identifies two theoretical concepts useful to gain knowledge about the (re-)shaping of soldiers’ moral identity.publishedVersio

Integrated climate change risk assessment:: A practical application for urban flooding during extreme precipitation

Risk assessments of flooding in urban areas during extreme precipitation for use in, for example, decision-making regarding climate adaptation, are surrounded by great uncertainties stemming from climate model projections, methods of downscaling and the assumptions of socioeconomic impact models. The multidisciplinary character of such risk assessments also requires that research groups and experts from different scientific disciplines combine knowledge and share model outputs. This paper describes an integrated framework and tool, the Danish Integrated Assessment System (DIAS), which has been designed to address the complex linkages between the different kinds of data required in assessing climate adaptation. It emphasizes that the availability of spatially explicit data can reduce the overall uncertainty of the risk assessment and assist in identifying key vulnerable assets. The usefulness of such a framework is demonstrated by means of a risk assessment of flooding from extreme precipitation for the city of Odense, Denmark. A sensitivity analysis shows how the presence of particularly important assets, such as cultural and historical heritage, may be addressed in assessing such risks. The output of the risk assessment for Odense indicates that highly detailed geographical data reduce the overall uncertainty and assist climate adaptation decision-makers in focusing on protecting those assets that are considered to be relevant in the given context. Also, using an integrated framework such as DIAS enables the relative importance of the different factors (i.e. degree of climate change, assets value, discount rate etc.) to be determined, thus influencing the overall output of the assessment

On the cokernel of the Thom morphism for compact Lie groups

We give a complete description of the potential failure of the surjectivity of the Thom morphism from complex cobordism to integral cohomology for compact Lie groups via a detailed study of the Atiyah-Hirzebruch spectral sequence and the action of the Steenrod algebra. We show how the failure of the surjectivity of the topological Thom morphism can be used to find examples of non-trivial elements in the kernel of the induced differential Thom morphism from differential cobordism of Hopkins and Singer to differential cohomology. These arguments are based on the particular algebraic structure and interplay of the torsion and non-torsion parts of the cohomology and cobordism rings of a given compact Lie group. We then use the geometry of special orthogonal groups to construct concrete cobordism classes in the non-trivial part of the kernel of the differential Thom morphism.Comment: 36 pages, comments welcom