Susceptibility testing of colistin for acinetobacter baumannii: How far are we from the truth?

Acinetobacter baumannii is involved in life-threatening nosocomial infections, mainly in the intensive care units (ICUs), and often colistin may represent the last therapeutic opportunity. The susceptibility to colistin of 51 epidemiologically typed A. baumannii strains isolated in 2017 from clinical samples of patients hospitalized in the ICU of a tertiary care academic hospital was investigated. All isolates were carbapenem-resistant due to the presence of the blaOXA-23 gene in sequence group 1 (international clonal lineage II) and sequence group 4 (related to international clonal lineage II) isolates, and to the blaOXA-24/40 gene in sequence group 2 (international clonal lineage I) isolates. Vitek®2, agar diffusion, and broth microdilution tests showed major discordancy (≥2 dilution factors) in the minimum inhibitory concentration (MIC) values for colistin in 24 out of 51 isolates, resulting in erroneous reporting of qualitative susceptibility data for eight isolates. In growth kinetics experiments in the presence of colistin, five isolates grew with drug concentrations above the susceptibility breakpoint when incubated for >12 h, and three isolates showed the presence of heteroresistant subpopulations. This study highlights that the high frequency of isolation of carbapenem-resistant A. baumannii strains in high-risk infectious wards requires an accurate application of methods for detecting susceptibility to antibiotics, in particular to colistin, so as to ensure a correct therapeutic approach

Spectrophotometric properties of dwarf planet Ceres from the VIR spectrometer on board the Dawn mission

We study the spectrophotometric properties of dwarf planet Ceres in the VIS-IR spectral range by means of hyper-spectral images acquired by the VIR imaging spectrometer on board the NASA Dawn mission. Disk-resolved observations with a phase angle within the $7^{\circ}<\alpha<132^{\circ}$ interval were used to characterize Ceres' phase curve in the 0.465-4.05 $\mu$m spectral range. Hapke's model was applied to perform the photometric correction of the dataset, allowing us to produce albedo and color maps of the surface. The $V$-band magnitude phase function of Ceres was fitted with both the classical linear model and H-G formalism. The single-scattering albedo and the asymmetry parameter at 0.55$\mu$m are $w=0.14\pm0.02$ and $\xi=-0.11\pm0.08$, respectively (two-lobe Henyey-Greenstein phase function); the modeled geometric albedo is $0.094\pm0.007$; the roughness parameter is $\bar{\theta}=29^{\circ}\pm6^{\circ}$. Albedo maps indicate small variability on a global scale with an average reflectance of $0.034 \pm 0.003$. Isolated areas such as the Occator bright spots, Haulani, and Oxo show an albedo much higher than average. We measure a significant spectral phase reddening, and the average spectral slope of Ceres' surface after photometric correction is $1.1\%k\AA^{-1}$ and $0.85\%k\AA^{-1}$ at VIS and IR wavelengths, respectively. Broadband color indices are $V-R=0.38\pm0.01$ and $R-I=0.33\pm0.02$. H-G modeling of the $V$-band magnitude phase curve for $\alpha<30^{\circ}$ gives $H=3.14\pm0.04$ and $G=0.10\pm0.04$, while the classical linear model provides $V(1,1,0^{\circ})=3.48\pm0.03$ and $\beta=0.036\pm0.002$. The comparison with spectrophotometric properties of other minor bodies indicates that Ceres has a less back-scattering phase function and a slightly higher albedo than comets and C-type objects. However, the latter represents the closest match in the usual asteroid taxonomy.Comment: 14 pages, 20 figures, published online on Astronomy and Astrophysics on 13 February 2017. Revised to reflect minor changes in text and figures made in proofs, updated value of V-R and R-

Risk factors for recurrence in patients with Clostridium difficile infection due to 027 and non-027 ribotypes

Objectives: Our objective was to evaluate factors associated with recurrence in patients with 027+ and 027– Clostridium difficile infection (CDI). Methods: Patients with CDI observed between January and December 2014 in six hospitals were consecutively included in the study. The 027 ribotype was deduced by the presence of tcdB, tcdB, cdt genes and the deletion Δ117 in tcdC (Xpert® C. difficile/Epi). Recurrence was defined as a positive laboratory test result for C. difficile more than 14 days but within 8 weeks after the initial diagnosis date with reappearance of symptoms. To identify factors associated with recurrence in 027+ and 027– CDI, a multivariate analysis was performed in each patient group. Subdistributional hazard ratios (sHRs) and 95% confidence intervals (95%CIs) were calculated. Results: Overall, 238 patients with 027+ CDI and 267 with 027– CDI were analysed. On multivariate analysis metronidazole monotherapy (sHR 2.380, 95%CI 1.549–3.60, p <0.001) and immunosuppressive treatment (sHR 3.116, 95%CI 1.906–5.090, p <0.001) were factors associated with recurrence in patients with 027+ CDI. In this patient group, metronidazole monotherapy was independently associated with recurrence in both mild/moderate (sHR 1.894, 95%CI 1.051–3.410, p 0.033) and severe CDI (sHR 2.476, 95%CI 1.281–4.790, p 0.007). Conversely, non-severe disease (sHR 3.704, 95%CI 1.437–9.524, p 0.007) and absence of chronic renal failure (sHR 16.129, 95%CI 2.155–125.000, p 0.007) were associated with recurrence in 027– CDI. Conclusions: Compared to vancomycin, metronidazole monotherapy appears less effective in curing CDI without relapse in the 027+ patient group, independently of disease severity

Search for carbonaceous chondrites evidence on Vesta through the detection of carbonates

NASA’s Dawn mission was launched in September 2007 and orbited asteroids Vesta (2011 2012) and Ceres (2015–2018). Vesta shows surface dark units that have been suggested to be linked to exogenous materials and are therefore useful to understand the initial stages of the Solar System. This work takes advantage of the newly calibrated data of the VIR spectrometer, which are characterized by a better signal to noise (S/N) ratio, giving us the opportunity to search for spectral features that were never seen before due to noise. Considering that hydroxyl has been shown to be present in every dark unit on Vesta and also in carbonaceous chondrites, the goals of this work are the search for and characterization of carbonates that are present in carbonaceous chondrites, i.e., the supposed darkening agents of Vesta. The estimate of the abundances of carbonates is fundamental to identify which carbonaceous chondrite fell on Vesta; this can be crucial for the definition of an evolutionary history of Vesta and the Solar System. The study of a possible feature at 3.9 μm related to the presence of carbonates was analyzed and found to be noise-induced. Although spectral features related to carbonates were not observed, the 3.4 μm absorption band was analyzed anyway in order to fix an upper limit to the abundance of carbonates in carbonaceous chondrites on Vesta. This value is consistent with petrochemical analyses, i.e., no more than 0.2% of carbonates in carbonaceous chondrites

Mixing phenomena in circular and rectangular cross-sectional T-mixers: Experimental and numerical assessment

In the present work, the mixing performance of square and circular cross-sectional millimetre-sized T-mixers was experimentally and numerically investigated. The pure dilution of non-reacting species (blue and yellow food dyes) and the chemical reaction of two-coloured reactants (i.e., strong acid and strong base with a pH indicator) were captured experimentally by adopting a low-cost colorimetric digital image analysis technique. Turbulence was modelled by k − ε model coupled with the β-PDF approach to account for turbulence-chemistry interactions. The circular cross-sectional T-mixer showed better mixing efficiency than the square one. Moreover, an even larger mixing performances were obtained by setting unbalanced fluid flow rates. To exploit the low computational demanding k − ε model, the Cε2 parameter was tuned, showing good reliability in describing the phenomena in the mixers. Mixing time estimations were based on both time averages and instantaneous quantities, and some possible limits of the approaches commonly adopted in the literature were identified

A case of persistent bacteraemia by Ralstonia mannitolilytica and Ralstonia pickettii in an intensive care unit

The Ralstonia spp. genus is a group of non-fermentative, Gram-negative bacteria often resistant to many antibiotics, which are emerging as opportunistic pathogens frequently associated with infections in hospital settings. We present herein a case of combined R. pickettii and R. mannitolilytica persisting and relapsing bacteraemia, possibly caused by a septic arterial thrombosis secondary to the rupture of an internal carotid artery aneurysm. Microbiology studies showed that both Ralstonia isolates produced biofilm and carried class D oxacillinase genes. When confronted with infections caused by members of the Ralstonia genus, identification to the species level is crucial for correct clinical management, as the two species show different antibiotic susceptibility patterns