Higher Colonization Rates Research Articles

Perceptions of Clostridium difficile infections among infection control professionals in Taiwan.

High Clostridium difficile colonization and infection rates among hospitalized patients had been noted in Taiwan. Nevertheless, the cognition about clinical diagnosis and management of CDI among infection control professionals in Taiwan is not clear. A 24-item survey questionnaire about the diagnosis, therapy, or infection control policies toward CDI was distributed in the annual meeting of the Infectious Disease Society of Taiwan (IDST) in October 2015 and Infectious Control Society of Taiwan (ICST) in April 2016. Totally 441 individuals responded to the survey, and 280 (63.5%) participants would routinely monitor the prevalence of CDI and 347 (78.7%) reported the formulation of infection control policies of CDI in their hospital, including contact precaution (75.7%), wearing gloves (88.9%) or dressing (80.0%) at patient care, single room isolation (49.7%), preference of soap or disinfectant-based sanitizer (83.2%) and avoidance of alcohol-based sanitizer (63.3%), and environmental disinfection with 1000ppm bleach (87.1%). For the timing of contact precaution discontinuation isolation for CDI patients, most (39.9%) participants suggested the time point of the absence of C. difficile toxin in feces. To treat mild CDI, most (61.9%) participants preferred oral metronidazole, and for severe CDI 26.1% would prescribe oral vancomycin as the drug of choice. There were substantial gaps in infection control polices and therapeutic choices for CDI between international guidelines and the perceptions of medical professionals in Taiwan. Professional education program and the setup of guideline for CDI should be considered in Taiwan.

Fecal carriage of extended-spectrum \u03b2-lactamase- and carbapenemase-producing Enterobacteriaceae in Egyptian patients with community-onset gastrointestinal complaints: a hospital -based cross-sectional study

ObjectivesThe aim of this study was to determine the prevalence of extended-spectrum β-lactamase (ESBL) and carbapenemase production among Enterobacteriaceae isolated from ambulatory patients with gastrointestinal complaints admitted to El-Ahrar General Hospital, Zagazig, Egypt in the period between January 2013 and May 2013.MethodsOne hundred and thirteen Enterobacteriaceae isolates were recovered from 100 consecutive Egyptian patients with community–onset gastrointestinal complaints. The fecal samples were plated directly on selective EbSA-ESBL Screening Agar and on MacConkey agar. Isolate identification was performed with matrix-assisted laser desorption ionization time-of-flight mass spectrometry (MALDI-TOF-MS). Screening for ESBLs and carbapenemases production was done by both the automated VITEK®2 system with AST N198 and by disk diffusion method. Real-time PCR and sequencing were used to characterize the resistance genes. Phylogroups of the E. coli isolates were determined by a triplex PCR-based method.ResultsOf 100 patients screened for fecal colonization with extended-spectrum β-lactamase -producing Enterobacteriaceae (ESBL-E) and carbapenemase- producing Enterobacteriaceae (CPE), 68 were colonized with ESBL-E whereas five patients were positive for CPE. One hundred and thirteen Enterobacterceae isolates were recovered from 100 fecal samples, they belonged to E. coli (n = 72), Klebsiella pneumoniae (n = 23), Enterobacter cloacae(n = 3), Salmonella spp. (n = 1) and other Enterobacterceae isolates (n = 14). The blaCTX-M gene was detected in 89.04% (65/73) of the ESBL-producing Enterobacteriaceae, whereas blaSHV and blaTEM were detected in 30.14% (22/73) and 19.18% (14/73) respectively. Three out of 5 carbapenem-resistant isolates harbored New Delhi metallo-beta-lactamase (NDM) and 2 produced Verona integron-encoded metallo- beta -lactamase (VIM). Twenty-two (47.83%) of the ESBL positive isolates were multidrug resistant (MDR). Phylogenetic analysis showed that, of the 51 ESBL-EC isolates, 17 belonged to group B2, 13 to group D, 11 to group A and 10 to group B1.ConclusionsNearly two-thirds of the Enterobacteriaceae isolates recovered from feces of ambulatory patients with community–onset gastrointestinal complaints admitted to El-Ahrar General Hospital, Zagazig, Egypt were ESBL producers and one in every 20 patients included in our study was colonized by carbapenemase-producing Enterobacteriaceae. These high colonization rates are worrying, therefore prudent antimicrobial use should be adopted in Egyptian community settings.

Nasal colonization and bacterial contamination of mobile phones carried by medical staff in the operating room.

BackgroundMobile phones (MPs) have been an essential part of the lives of healthcare professionals and have improved communication, collaboration, and sharing of information. Nonetheless, the widespread use of MPs in hospitals has raised concerns of nosocomial infections, especially in areas requiring the highest hygienic standards such as operating rooms (ORs). This study evaluated the incidence of bacterial contamination of the MPs carried by medical staff working in the OR and determined its association with bacterial colonization of this personnel.MethodsThis is an observational cohort study. Medical staffs working in the OR were asked to take bacterial cultures from their MPs, anterior nares, and dominant hands. To identify the relation between MP contamination and bacterial colonization of the medical staff, genotyping of Staphylococcus aureus (SA) was done via Staphylococcus protein A gene (spa) typing and pulsed-field gel electrophoresis (PFGE).ResultsA total of 216 swab samples taken from 72 medical-staff members were analyzed. The culture-positive rate was 98.1% (212/216). In 59 (27.3%) samples, the bacteria were possible clinical pathogens. The anterior nares were the most common site of colonization by clinical pathogens (58.3%, 42/72), followed by MPs (13.9%, 10/72) and the dominant hand (9.7%, 7/72). SA was the most commonly isolated clinical pathogen and was found in 43 (19.9%) samples. In 66 (94.3%) of the 70 staff members for whom bacteria were detected on their MPs, the same bacteria were detected in nares or hand. Among 31 medical staff who were carriers of SA in the anterior nares or dominant hand, 8 (25.8%) were found to have SA on their MPs, and genotyping confirmed the same SA strain in 7 (87.5%) of them.ConclusionA high rate of bacterial nasal colonization and MPs contamination were found among the OR medical staff. An MP may be a reservoir for pathogen contamination in the OR.

Density-dependent colonization and natural disturbance limit the effectiveness of invasive lionfish culling efforts

Culling can be an effective management tool for reducing populations of invasive species to levels that minimize ecological effects. However, culling is labour-intensive, costly, and may have unintended ecological consequences. In the Caribbean, culling is widely used to control invasive Indo-Pacific lionfish, Pterois volitans and P. miles, but the effectiveness of infrequent culling in terms of reducing lionfish abundance and halting native prey decline is unclear. In a 21-month-long field experiment on natural reefs, we found that culling effectiveness changed after the passage of a hurricane part-way through the experiment. Before the hurricane, infrequent culling resulted in substantial reductions in lionfish density (60–79%, on average, albeit with large uncertainty) and slight increases in native prey species richness, but was insufficient to stem the decline in native prey biomass. Culling every 3 months (i.e., quarterly) and every 6 months (i.e., biannually) had similar effects on lionfish density and native prey fishes because of high rates of lionfish colonization among reefs. After the hurricane, lionfish densities were greater on all culled reefs compared to non-culled reefs, and prey biomass declined by 92%, and species richness by 71%, on biannually culled reefs. The two culling frequencies we examined therefore seem to offer a poor trade-off between the demonstrated conservation gains that can be achieved with frequent culling and the economy of time and money realized by infrequent culling. Moreover, stochastic events such as hurricanes can drastically limit the effectiveness of culling efforts.

Unexpected persistence of extended-spectrum β-lactamase-producing Enterobacteriaceae in the faecal microbiota of hospitalised patients treated with imipenem

Imipenem is active against extended-spectrum β-lactamase-producing Enterobacteriaceae (ESBL-E) but favours the intestinal emergence of resistance. The effects of imipenem on intestinal microbiota have been studied using culture-based techniques. In this study, the effects were investigated in patients using culture and metagenomic techniques. Seventeen hospitalised adults receiving imipenem were included in a multicentre study (NCT01703299, http://www.clinicaltrials.gov). Most patients had a history of antibiotic use and/or hospitalisation. Stools were collected before, during and after imipenem treatment. Bacterial and fungal colonisation was assessed by culture, and microbiota changes were assessed using metagenomics. Unexpectedly, high colonisation rates by imipenem-susceptible ESBL-E before treatment (70.6%) remained stable over time, suggesting that imipenem intestinal concentrations were very low. Carriage rates of carbapenem-resistant Gram-negative bacilli (0–25.0%) were also stable over time, whereas those of yeasts (64.7% before treatment) peaked at 76.5% during treatment and decreased thereafter. However, these trends were not statistically significant. Yeasts included highly diverse colonising Candida spp. Metagenomics showed no global effect of imipenem on the bacterial taxonomic profiles at the sequencing depth used but demonstrated specific changes in the microbiota not detected with culture, attributed to factors other than imipenem, including sampling site or treatment with other antibiotics. In conclusion, culture and metagenomics were highly complementary in characterising the faecal microbiota of patients. The changes observed during imipenem treatment were unexpectedly limited, possibly because the microbiota was already disturbed by previous antibiotic exposure or hospitalisation.

Tracking microbial colonization in fecal microbiota transplantation experiments via genome-resolved metagenomics

BackgroundFecal microbiota transplantation (FMT) is an effective treatment for recurrent Clostridium difficile infection and shows promise for treating other medical conditions associated with intestinal dysbioses. However, we lack a sufficient understanding of which microbial populations successfully colonize the recipient gut, and the widely used approaches to study the microbial ecology of FMT experiments fail to provide enough resolution to identify populations that are likely responsible for FMT-derived benefits.MethodsWe used shotgun metagenomics together with assembly and binning strategies to reconstruct metagenome-assembled genomes (MAGs) from fecal samples of a single FMT donor. We then used metagenomic mapping to track the occurrence and distribution patterns of donor MAGs in two FMT recipients.ResultsOur analyses revealed that 22% of the 92 highly complete bacterial MAGs that we identified from the donor successfully colonized and remained abundant in two recipients for at least 8 weeks. Most MAGs with a high colonization rate belonged to the order Bacteroidales. The vast majority of those that lacked evidence of colonization belonged to the order Clostridiales, and colonization success was negatively correlated with the number of genes related to sporulation. Our analysis of 151 publicly available gut metagenomes showed that the donor MAGs that colonized both recipients were prevalent, and the ones that colonized neither were rare across the participants of the Human Microbiome Project. Although our dataset showed a link between taxonomy and the colonization ability of a given MAG, we also identified MAGs that belong to the same taxon with different colonization properties, highlighting the importance of an appropriate level of resolution to explore the functional basis of colonization and to identify targets for cultivation, hypothesis generation, and testing in model systems.ConclusionsThe analytical strategy adopted in our study can provide genomic insights into bacterial populations that may be critical to the efficacy of FMT due to their success in gut colonization and metabolic properties, and guide cultivation efforts to investigate mechanistic underpinnings of this procedure beyond associations.

Estrogen receptors in breast and bone: from virtue of remodeling to vileness of metastasis.

Bone metastasis is a prominent cause of morbidity and mortality in cancer. High rates of bone colonization in breast cancer, especially in the subtype expressing estrogen receptors (ERs), suggests tissue-specific proclivities for metastatic tumor formation. The mechanisms behind this subtype-specific organ-tropism remains largely elusive. Interestingly, as the major driver of ER+ breast cancer, ERs also play important roles in bone development and homeostasis. Thus, any agents targeting ER will also inevitably affect the microenvironment, i.e., the osteoblasts and osteoclasts. Yet, how such microenvironmental effects are integrated with direct therapeutic responses of cancer cells remain poorly understood. Recent findings on ER mutations, especially their enrichment in bone metastasis, raised even more provocative questions on the role of ER in cancer-bone interaction. In this review, we evaluate the importance of estrogen receptors (ERs) in bone metastasis and discuss new avenues of investigation for bone metastasis treatment based on current knowledge.

Sa1777 - High Prevalence of Subclass-Specific Binding and Neutralising Antibodies Against Clostridium Difficile Toxins in Adult Cystic Fibrosis Sera: Possible Mode of Protection Against Symptomatic Clostridium Difficile Infection

Objectives: Despite multiple risk factors and a high rate of colonization for Clostridium difficile, the occurrence of C. difficile infection in patients with cystic fibrosis is rare. The aim of this study was to compare the prevalence of binding C. difficile toxin-specific immunoglobulin (Ig)A, IgG and anti-toxin neutralizing antibodies in the sera of adults with cystic fibrosis, symptomatic C. difficile infection (without cystic fibrosis) and healthy controls. Methods: Subclass-specific IgA and IgG responses to highly purified whole C. difficile toxins A and B (toxinotype 0, strain VPI 10463, ribotype 087), toxin B from a C. difficile toxin-B-only expressing strain (CCUG 20309) and precursor form of B fragment of binary toxin, pCDTb, were determined by protein microarray. Neutralizing antibodies to C. difficile toxins A and B were evaluated using a Caco-2 cell-based neutralization assay. Results: Serum IgA anti-toxin A and B levels and neutralizing antibodies against toxin A were significantly higher in adult cystic fibrosis patients (n=16) compared with healthy controls (n=17) and patients with symptomatic C. difficile infection (n=16); p≤0.05. The same pattern of response prevailed for IgG, except that there was no difference in anti-toxin A IgG levels between the groups. Compared with healthy controls (toxins A and B) and patients with C. difficile infection (toxin A), sera from cystic fibrosis patients exhibited significantly stronger protective anti-toxin neutralizing antibody responses. Conclusion: A superior ability to generate robust humoral immunity to C. difficile toxins in the cystic fibrosis population is likely to confer protection against symptomatic C. difficile infection. This protection may be lost in the post-transplantation setting, where sera monitoring of anti-C. difficile toxin antibody titers may be of clinical value.

Group B streptococcal colonization and transmission dynamics in pregnant women and their newborns in Nigeria: implications for prevention strategies

ObjectivesBecause few studies have been conducted on group B Streptococcus (GBS) in Nigeria, we sought to estimate GBS colonization and transmission frequencies for 500 women and their newborns and identify risk factors for both outcomes. MethodsGBS strains were characterized for antibiotic susceptibilities, capsule (cps) genotype, pilus island profile and multilocus sequence type (ST). ResultsIn all, 171 (34.2%) mothers and 95 (19.0%) of their newborns were colonized with GBS; the vertical transmission rate was 48.5%. One newborn developed early-onset disease, yielding an incidence of 2.0 cases per 1000 live births (95% CI 0.50–7.30). Rectal maternal colonization (OR 26.6; 95% CI 13.69–51.58) and prolonged rupture of membranes (OR 4.2; 95% CI 1.03–17.17) were associated with neonatal colonization, whereas prolonged membrane rupture (OR 3.4; 95% CI 1.04–11.39) and young maternal age (OR 2.0; 95% CI 1.22–3.39) were associated with maternal colonization. Women reporting four or more intrapartum vaginal examinations (OR 6.1; 95% CI 3.41–10.93) and douching (OR 3.7; 95% CI 2.26–6.11) were also more likely to be colonized. Twelve STs were identified among 35 mother–baby pairs with evidence of transmission; strains of cpsV ST-19 (n = 9; 25.7%) and cpsIII ST-182 (n = 7; 20.0%) predominated. ConclusionsThese data demonstrate high rates of colonization and transmission in a population that does not use antibiotics to prevent neonatal infections, a strategy that should be considered in the future.

Screening for Methicillin-resistant Staphylococcus aureus in a residence home for elderly in Germany

BackgroundSince many hospitals report high MRSA colonization rates among elderly patients, and because it has been shown that S. aureus colonization increases with advancing age, there are concerns about the introduction of MRSA into nursing homes by MRSA positive patients discharged from hospital. So far, admission screening and subsequent longitudinal screening in residence homes or screening at time of hospital discharge is not established on a regular base. On the other hand, MRSA is acquired frequently during hospital stay. Therefore, the MRSA status of residents remains unclear at the time of re-admission to the residence home. This study was conducted to evaluate the rate of nasal MRSA carriage among residents and nursing staffs of 2 nursing homes for the elderly, the potential acquisition of MRSA during a hospital stay and the feasibility to perform direct screening tests in nursing homes for elderly.MethodsIn a study period of 5 months, possibility of active PCR-based screening for MRSA has been tested within 2 residence homes for the elderly, with the obligation to avoid inconvenience to the daily working time and working schedule. Residents and staff members were included in the study and positive test results were confirmed with MRSA culture.ResultsFeasibility of active on site screening in a residence home for the elderly using a rapid PCR method has been confirmed. 154 of 156 residents participated on baseline testing for all current and new admitted residents. In 9 participating residents with former unknown status, nasal carriage with MRSA was confirmed (5.8%). Among 32 documented and eligible movements between the nursing home and the hospital, MRSA could be confirmed after return to the residence home in 2 cases (6.3%). MRSA could also be detected in 1 of 14 participating nursing staff (7.1%).ConclusionPrevalence of MRSA was in a range that has been observed for nursing homes in Germany in previous studies. Residents can acquire MRSA during a hospital stay so that further spread after re-admission into the nursing home cannot be excluded. This study shows that easy to perform direct screening tests in outpatient facilities for nursing of the elderly are promising tools as part of potential new strategies for transmission and infection control in such facilities. Additional studies are needed to investigate if screening followed by interventional hygiene measures can reduce MRSA transmission and infection in such facilities.

Ectomycorrhizal fungal communities of silver-fir seedlings regenerating in fir stands and larch forecrops

Key messageThe diversity of ECM communities of 1-year-old silver-fir seedlings regenerating in mature silver-fir stands is significantly higher than in neighboring larch forecrops.Forecrop stands provide the necessary shade for shade preferring seedlings, such as silver-fir, which cannot be introduced as the first generation in open areas. Larch is a good candidate, recommended to be utilized as forecrop. Since fungal symbionts of Abies alba seedlings regenerating under larch canopy have not been investigated, we aimed to evaluate the diversity of ECM of 1-year-old silver-fir seedlings regenerating under canopy of larch and to compare these communities to those found in adjacent mature silver-fir stands. Three silver-fir stands (F) and three European larch forecrops (L) were selected to study. Seedling size did not differ between F and L stands. ECM colonization was observed in 100% silver-fir seedlings in F and 80% in L stands. The fine roots were highly colonized, and 91 and 87% of live ECM were found in seedlings from F and L stands, respectively. Sequencing analysis revealed a total 53 ECM taxa. The observed number of ECM taxa in the F stands was significantly higher (46) than that in the L forecrops (25), and 34% of taxa were common to both stands. The dominant ECM species in F were unidentified fungus 1, Piloderma sp., Tylospora asterophora and Russula integra. Fir seedlings regenerating in L forecrops formed ectomycorrhizas mostly with unidentified fungus 1, Tomentella sublilacina, Tylospora sp., Hydnotrya bailii and T. asterophora. Based on ANOSIM analysis, ECM communities have shown significant differences between study sites. The diversity of ECM fungal partners and the high colonization rate of silver-fir seedlings regenerating in larch forecrop stands should be sufficient to provide efficient afforestation of post-arable lands and gives the opportunity for their successful rebuilding.

Tracing of Two Pseudomonas Strains in the Root and Rhizoplane of Maize, as Related to Their Plant Growth-Promoting Effect in Contrasting Soils.

TaqMan-based quantitative PCR (qPCR) assays were developed to study the persistence of two well-characterized strains of plant growth-promoting rhizobacteria (PGPR), Pseudomonas fluorescens Pf153 and Pseudomonas sp. DSMZ 13134, in the root and rhizoplane of inoculated maize plants. This was performed in pot experiments with three contrasting field soils (Buus, Le Caron and DOK-M). Potential cross-reactivity of the qPCR assays was assessed with indigenous Pseudomonas and related bacterial species, which had been isolated from the rhizoplane of maize roots grown in the three soils and then characterized by Matrix-Assisted Laser Desorption Ionization (MALDI) Time-of-Flight (TOF) mass spectrometry (MS). Sensitivity of the qPCR expressed as detection limit of bacterial cells spiked into a rhizoplane matrix was 1.4 × 102 CFU and 1.3 × 104 CFU per gram root fresh weight for strain Pf153 and DSMZ 13134, respectively. Four weeks after planting and inoculation, both strains could readily be detected in root and rhizoplane, whereas only Pf153 could be detected after 8 weeks. The colonization rate of maize roots by strain Pf153 was significantly influenced by the soil type, with a higher colonization rate in the well fertile and organic soil of Buus. Inoculation with strain DSMZ 13134, which colonized roots and rhizoplane to the same degree, independently of the soil type, increased yield of maize, in terms of biomass accumulation, only in the acidic soil of Le Caron, whereas inoculation with strain Pf153 reduced yield in the soil Buus, despite of its high colonization rate and persistence. These results indicate that the colonization rate and persistence of inoculated Pseudomonas strains can be quantitatively assessed by the TaqMan-based qPCR technique, but that it cannot be taken for granted that inoculation with a well-colonizing and persistent Pseudomonas strain has a positive effect on yield of maize.

Microbiological Evaluation of the Extension Wire and Percutaneous Epidural Lead Anchor Site Following a "2-Stage Cut-Down" Spinal Cord Stimulator Procedure.

There are concerns regarding bacterial colonization of the temporary extension leads and subsequent infection risk using the 2-stage cut-down approach in spinal cord stimulation (SCS). We sought to quantify the extent of bacterial colonization of the temporary extension wire and percutaneous epidural lead anchor site. We conducted a cross-sectional observational study recruiting a pragmatic sample of 25 consecutive patients listed for a cut-down trial of SCS. We excluded patients undergoing revision procedures and those who had previously received a spinal cord stimulator. The primary outcome measure was the rate and type of colonization of the extension wires and lead anchor site. No surgical site infections were recorded in any of the patients and no late infections subsequent to insertion of the implantable pulse generator. Overall, 24% of patients grew organisms from the temporary extension wire. Five patients grew coagulase-negative Staphylococcus aureus, and 1 patient grew Enterococcus faecalis. There were no positive wound cultures from the anchor site of the epidural lead. Despite the high colonization rate of the temporary extension wire, there were no surgical site infections. We conclude that provided appropriate strategies for the management of surgical site infections are implemented, the 2-stage cut-down procedure is a safe approach that is not associated with a higher incidence of infection.

Changes in understory species occurrence of a secondary broadleaved forest after mass mortality of oak trees under deer foraging pressure.

The epidemic of mass mortality of oak trees by Japanese oak wilt has affected secondary deciduous broadleaved forests that have been used as coppices in Japan. The dieback of oak trees formed gaps in the crown that would be expected to enhance the regeneration of shade-intolerant pioneer species. However, foraging by sika deer Cervus nippon has also affected forest vegetation, and the compound effects of both on forest regeneration should be considered when they simultaneously occur. A field study was conducted in Kyôto City, Japan to investigate how these compound effects affected the vegetation of the understory layer of these forests. The presence/absence of seedlings and saplings was observed for 200 quadrats sized 5 m ×5 m for each species in 1992, before the mass mortality and deer encroachment, and in 2014 after these effects. A hierarchical Bayesian model was constructed to explain the occurrence, survival, and colonization of each species with their responses to the gaps that were created, expanded, or affected by the mass mortality of Quercus serrata trees. The species that occurred most frequently in 1992, Eurya japonica, Quercus glauca, and Cleyera japonica, also had the highest survival probabilities. Deer-unpalatable species such as Symplocos prunifolia and Triadica sebifera had higher colonization rates in the gaps, while the deer-palatable species Aucuba japonica had the smallest survival probability. The gaps thus promoted the colonization of deer-unpalatable plant species such as Symplocos prunifolia and Triadica sebifera. In the future, such deer-unpalatable species may dominate gaps that were created, expanded, or affected by the mass mortality of oak trees.

Mycorrhizal colonization status of lowland rice (Oryza sativa L.) in the southeastern region of China

The accumulation, distribution, and speciation of contaminants, such as arsenic, in rice can be affected by soil microorganisms such as arbuscular mycorrhizal fungi (AMF). As a potential measure to control contaminant acquisition in rice, the status and performance of AMF in the field need to be investigated. Root samples of rice plants were collected in seven different cities in Guangdong, Jiangxi, Hubei, and Jiangsu Provinces in China in order to investigate the colonization rate of AMF. The total DNA of the roots was extracted, followed by PCR and sequencing, and further confirmed the existence of AMF. The highest colonization rates (19.5±7.2%) were observed in samples from Huizhou City, Guangdong Province. Sequences of ribosomal DNA derived from Pingtan (PT) and Shuikou (SK) in Huizhou shared a similarity of 73 and 86% to Glomus cf. clarum Att894-7 (FM865542) and "uncultured fungus" (EF434122.1), respectively. The moisture tolerance of the AMF from different sources was tested by subjecting to different levels of water content in the soil. Only AMF from PT, SK, and LJ colonized rice under a condition of 100% of the soil water holding capacity (WHC), but not those isolated from upland plants. The AM colonization rate could be governed by the lighting conditions and temperature. AMF isolated in paddy fields has been shown to have more tolerance to moisture than other upland species. Radial oxygen loss (species and stress dependent) could be an essential factor influencing the colonization rate and requires more investigation.

Occurrence and genotypes of Campylobacter species in broilers during the rearing period

ABSTRACTPoultry are the main source of Campylobacter infection worldwide. To obtain information on Campylobacter-infected flocks and create a reference for preventing and controlling Campylobacter at farm level, Campylobacter isolates were recovered from broilers and the environments of nine chicken flocks in two farms during growth. The genetic relationship between the Campylobacter isolates was determined using multilocus sequence typing. Flocks were colonized as early as 3 weeks after introduction to the farm. The highest colonization rate was more than 90% and occurred 4–6 weeks after introduction to the farm. Quantitative data showed that the highest Campylobacter loads appeared at 1–2 weeks after initial colonization. Campylobacter loads in cloacal swabs in four flocks were significantly higher at 5 weeks than at 3 weeks (P < 0.05). Multilocus sequence typing of 171 selected isolates revealed 20 sequence types (STs), which consisted of 12 STs for Campylobacter jejuni and eight for Campylobacter coli isolates. The STs of the Campylobacter isolates recovered from farm 1 were more diversified than those from farm 2. The STs of environmental samples were highly consistent with those of the cloacal swab samples. The consistency between Campylobacter STs in the environmental and cloacal swab samples suggested that the environment might be one of the main sources of infection. Thus, our study highlights the prevalence and contamination load of Campylobacter in broilers during their rearing period and emphasizes the need for control and prevention measures for Campylobacter infection in broilers, which is also important for human health.

High rate of multidrug-resistant organism colonization among patients hospitalized overseas highlights the need for preemptive infection control.

We performed 4 years of active screening for multidrug resistant organism (MDRO) colonization among patients with a history of overseas hospitalization. Thirteen (56.5%) of 23 cases were positive for MDROs, which highlights the importance of preemptive infection control to prevent the spread of MDROs in this population.

Multidrug-resistant ESBL-producing Enterobacteriaceae and associated risk factors in community infants in Lebanon.

Extended-spectrum beta-lactamase-producing Enterobacteriaceae (ESBL-PE) infections are a growing threat to children, and the treatment of these infections becomes more and more challenging. A huge reservoir for ESBLs in the community is the fecal flora of children. This study investigates the rectal colonization, associated risk factors, antimicrobial susceptibility, and molecular characterization of ESBL-PE in Lebanese community infants. A total of 117 rectal swabs were taken from healthy infants between 1 and 12 months of age. Detection of ESBLs was carried out using the double-disk synergy test, combination-disk method, and multiplex polymerase chain reaction (PCR). A questionnaire about the infant's history and risk factors for carrying ESBL-PE was administered. In total, 58 (49.6%) of 117 participants were ESBL-PE carriers. Some significant important risk factors for colonization in this study were male gender, hospital birth, caesarean delivery, and being formula-fed. Observed decrease in colonization rate was associated with intimate hygiene habits. Carriers of multiple bla genes were the most common. CTX-M type was the major harbored, gene and CTX-M-9 was the most predominant, followed by CTX-M-15 type. To the best of our knowledge, this is the first available data about the carriage rate of ESBL-PE in community infants in Lebanon and the Middle East, the first study showing that birth in hospital, caesarean delivery, and being formula-fed are all significantly associated risk factors for the high colonization rates in community - not hospitalized - infants, and showing the dominance of multiple resistance gene carriage and wide dissemination of CTX-M-9 ESBL.

بررسی تاثیر تلقیح کپک Aspergillus flavus بر تغییرات میزان اسیدهای چرب، اندیس پراکسید و تولید آفلاتوکسین در چهار واریته رایج بادام زمینی برداشت شده از سطح مزارع استان گلستان

بادام‌زمینی یکی از حساس ترین محصولات کشاورزی در برابر هجوم A. flavus و متعاقبا آلودگی به آفلاتوکسین محسوب می شود. در این پژوهش پس از جداسازی و تائید شناسایی A. flavus از نمونه های بادام‌زمینی آلوده شده به این کپک، مقادیر مشخصی از آن به چهار واریته بادام‌زمینی رایج استان گلستان به نام های گلی، محلی، چینی و هندی که در شرایط مناسب خشک و پوست‌گیری شدند تلقیح گردید. سپس تاثیر تلقیح کپک مذکور (پس از یک هفته رشد در دمای °C 26) بر روی تغییرات اسیدهای چرب اولئیک و لینولئیک، اندیس پراکسید و تولید آفلاتوکسین مورد بررسی قرار گرفت. بمنظور ارزیابی تغییرات اسیدهای چرب از کروماتوگرافی گازی و جهت بررسی میزان آفلاتوکسین B1 از الایزای رقابتی مستقیم استفاده شد. جهت ارزیابی میزان حساسیت ارقام بادام‌زمینی به رشد A. flavus آفلاتوکسین زا نیز میزان تشکیل پرگنه کپک بر روی مغز بادام‌زمینی و میزان اسپور تولیدی محاسبه گردید. نتایج حاصل، نشان داد که در بین واریته های مختلف، واریته گلی و واریته هندی به ترتیب کمترین و بیشترین حساسیت را به رشد A. flavus و تولید آفلاتوکسین B1 دارا بودند. همچنین با رشد A. flavus بر روی مغز بادام‌زمینی، بطور معنی داری (5% = α) میزان اسیدهای چرب اولئیک و لینولئیک، کاهش و اندیس پراکسید افزایش یافت.

Low Enteric Colonization with Multidrug-Resistant Pathogens in Soldiers Returning from Deployments- Experience from the Years 2007-2015.

This assessment describes the enteric colonization of German soldiers 8–12 weeks after returning from mostly but not exclusively subtropical or tropical deployment sites with third-generation cephalosporin-resistant Enterobacteriaceae, vancomycin-resistant enterococci (VRE), and methicillin-resistant Staphylococcus aureus (MRSA). Between 2007 and 2015, 828 stool samples from returning soldiers were enriched in nonselective broth and incubated on selective agars for Enterobacteriaceae expressing extended-spectrum beta-lactamases (ESBL), VRE and MRSA. Identification and resistance testing of suspicious colonies was performed using MALDI-TOF-MS, VITEK-II and agar diffusion gradient testing (bioMérieux, Marcy-l’Étoile, France). Isolates with suspicion of ESBL were characterized by ESBL/ampC disc-(ABCD)-testing and molecular approaches (PCR, Sanger sequencing). Among the returnees, E. coli with resistance against third-generation cephalosporins (37 ESBL, 1 ESBL + ampC, 1 uncertain mechanism) were found in 39 instances (4.7%). Associated quinolone resistance was found in 46.2% of these isolates. Beta-lactamases of the blaCTX-M group 1 predominated among the ESBL mechanisms, followed by the blaCTX-M group 9, and blaSHV. VRE of vanA-type was isolated from one returnee (0.12%). MRSA was not isolated at all. There was no clear trend regarding the distribution of resistant isolates during the assessment period. Compared with colonization with resistant bacteria described in civilians returning from the tropics, the colonization in returned soldiers is surprisingly low and stable. This finding, together with high colonization rates found in previous screenings on deployment, suggests a loss of colonization during the 8- to 12-week period between returning from the deployments and assessment.