Low-level Resistance Research Articles

Antimicrobial susceptibility pattern and mupirocin resistance among methicillin-resistant Staphylococcus aureus isolated from skin and soft-tissue infection patients attending a tertiary care hospital in North India

Background: Antimicrobial susceptibility among bacterial isolates varies from center to center. Mupirocin is a topical antibacterial antibiotic used to treat wound infections caused by methicillin-resistant Staphylococcus aureus (MRSA). Aim and Objectives: This study was conducted to know the prevalence of high and low levels of mupirocin resistance along with antimicrobial susceptibility in MRSA isolates from skin and soft-tissue infection in patients admitted to a tertiary care hospital in North India. Materials and Methods: A total of 97 non-repetitive isolates of MRSA from various pus samples over a period of 1 year were included in this study. These strains were identified as per standard laboratory protocols given by the Clinical Laboratory Standards Institute. High- and low-level mupirocin resistance of the isolates was tested by using mupirocin discs of 200 μg and 5 μg, respectively. Mupirocin strips of 256 μg and 512 μg were used for the E-test to detect low-level and high-level mupirocin resistance, respectively. The isolates were reported as sensitive to mupirocin, with minimum inhibitory concentrations of <4 mg/L. Results: Overall, 9.27% of mupirocin resistance was found, of which 2.06% of isolates were high-level resistant to mupirocin, while 7.21% had low-level resistance. All MRSA strains were susceptible to vancomycin, followed by linezolid (94.84%), teicoplanin (91.75%), and fusidic acid (88.65%). Conclusion: Regular monitoring, good infection control practices, and proper awareness about utilizing mupirocin therapeutically and prophylactically may help prevent the emergence of mupirocin resistance in health-care facilities.

Fitness trade-offs of multidrug efflux pumps in Escherichia coli K-12 in acid or base, and with aromatic phytochemicals.

Multidrug efflux pumps are the frontline defense mechanisms of Gram-negative bacteria, yet little is known of their relative fitness trade-offs under gut conditions such as low pH and the presence of antimicrobial food molecules. Low pH contributes to the proton-motive force (PMF) that drives most efflux pumps. We show how the PMF-dependent pumps AcrAB-TolC, MdtEF-TolC, and EmrAB-TolC undergo selection at low pH and in the presence of membrane-permeant phytochemicals. Competition assays were performed by flow cytometry of co-cultured Escherichia coli K-12 strains possessing or lacking a given pump complex. All three pumps showed negative selection under conditions that deplete PMF (pH 5.5 with carbonyl cyanide 3-chlorophenylhydrazone or at pH 8.0). At pH 5.5, selection against AcrAB-TolC was increased by aromatic acids, alcohols, and related phytochemicals such as methyl salicylate. The degree of fitness cost for AcrA was correlated with the phytochemical's lipophilicity (logP). Methyl salicylate and salicylamide selected strongly against AcrA, without genetic induction of drug resistance regulons. MdtEF-TolC and EmrAB-TolC each had a fitness cost at pH 5.5, but salicylate or benzoate made the fitness contribution positive. Pump fitness effects were not explained by gene expression (measured by digital PCR). Between pH 5.5 and 8.0, acrA and emrA were upregulated in the log phase, whereas mdtE expression was upregulated in the transition-to-stationary phase and at pH 5.5 in the log phase. Methyl salicylate did not affect pump gene expression. Our results suggest that lipophilic non-acidic molecules select against a major efflux pump without inducing antibiotic resistance regulons.IMPORTANCEFor drugs that are administered orally, we need to understand how ingested phytochemicals modulate drug resistance in our gut microbiome. Bacteria maintain low-level resistance by proton-motive force (PMF)-driven pumps that efflux many different antibiotics and cell waste products. These pumps play a key role in bacterial defense by conferring resistance to antimicrobial agents at first exposure while providing time for a pathogen to evolve resistance to higher levels of the antibiotic exposed. Nevertheless, efflux pumps confer energetic costs due to gene expression and pump energy expense. The bacterial PMF includes the transmembrane pH difference (ΔpH), which may be depleted by permeant acids and membrane disruptors. Understanding the fitness costs of efflux pumps may enable us to develop resistance breakers, that is, molecules that work together with antibiotics to potentiate their effect. Non-acidic aromatic molecules have the advantage that they avoid the Mar-dependent induction of regulons conferring other forms of drug resistance. We show that different pumps have distinct selection criteria, and we identified non-acidic aromatic molecules as promising candidates for drug resistance breakers.

Construction of ecological security pattern based on InVEST-Conefor-MCRM: A case study of Xinjiang, China

Constructing ecological security patterns (ESP) effectively maintains ecosystems' green, healthy, and sustainable development. The InVEST model and Conefor software were utilized in this study to pinpoint ecological sources (eco-sources) through a blend of landscape connectivity and the importance of ecosystem services (IES); the ecological resistance surface was constructed by synthesizing the gravity model and minimum cumulative resistance model (MCRM), extracted ecological corridors (eco-corridors) and nodes. Ultimately, the research in this study built the ESP for Xinjiang. The findings showed that: (1) 14 eco-sources were identified in Xinjiang, spanning an area of 2.13 × 105 km2; 32 eco-corridors were extracted, including 9 important and 23 general eco-corridors, comprising a total length of 1.26 × 104 km; identified 46 ecological nodes(eco-nodes); (2) the size of important and more important patches of ecosystem services in Xinjiang was 2.82 × 105 km2, which accounted for a relatively small size, and the value of ecosystem services was generally average. The overall level of landscape connectivity in the primary eco-sources was high, but the spatial distribution was uneven; (3) the ecological resistance values in Xinjiang vary significantly, with high-level resistance surfaces primarily located in the Junggar Basin and Tarim Basin and low-level resistance covering most of Xinjiang's natural ecological reserves and other areas. The study's findings can provide some references for constructing ESP at the provincial scale and in arid and semiarid regions and for planning spatial ecological restoration in Xinjiang.

Gonococcal resistance to zoliflodacin could emerge via transformation from commensal Neisseria species. An in-vitro transformation study

One of the most promising new treatments for gonorrhoea currently in phase 3 clinical trials is zoliflodacin. Studies have found very little resistance to zoliflodacin in currently circulating N. gonorrhoeae strains, and in-vitro experiments demonstrated that it is difficult to induce resistance. However, zoliflodacin resistance may emerge in commensal Neisseria spp., which could then be transferred to N. gonorrhoeae via transformation. In this study, we investigated this commensal-resistance-pathway hypothesis for zoliflodacin. To induce zoliflodacin resistance, ten wild-type susceptible isolates belonging to 5 Neisseria species were serially passaged for up to 48 h on gonococcal agar plates containing increasing zoliflodacin concentrations. Within 7 to 10 days, all strains except N. lactamica, exhibited MICs of ≥ 4 µg/mL, resulting in MIC increase ranging from 8- to 64-fold. The last passaged strains and their baseline were sequenced. We detected mutations previously reported to cause zoliflodacin resistance in GyrB (D429N and S467N), novel mutations in the quinolone resistance determining region (QRDR) (M464R and T472P) and mutations outside the QRDR at amino acid positions 28 and 29 associated with low level resistance (MIC 2 µg/mL). Genomic DNA from the laboratory evolved zoliflodacin-resistant strains was transformed into the respective baseline wild-type strain, resulting in MICs of ≥ 8 µg/mL in most cases. WGS of transformants with decreased zoliflodacin susceptibility revealed presence of the same zoliflodacin resistance determinants as observed in the donor strains. Two inter-species transformation experiments were conducted to investigate whether zoliflodacin resistance determinants of commensal Neisseria spp. could be acquired by N. gonorrhoeae. N. gonorrhoeae strain WHO P was exposed to (i) pooled genomic DNA from the two resistant N. mucosa strains and (ii) a gyrB amplicon of the resistant N. subflava strain 45/1_8. Transformants of both experiments exhibited an MIC of 2 µg/mL and whole genome analysis revealed uptake of the mutations detected in the donor strains. This is the first in-vitro study to report that zoliflodacin resistance can be induced in commensal Neisseria spp. and subsequently transformed into N. gonorrhoeae.

Structural insights into the molecular mechanism of high-level ceftazidime-avibactam resistance conferred by CMY-185.

β-Lactamases can accumulate stepwise mutations that increase their resistance profiles to the latest β-lactam agents. CMY-185 is a CMY-2-like β-lactamase and was identified in an Escherichia coli clinical strain isolated from a patient who underwent treatment with ceftazidime-avibactam. CMY-185, possessing four amino acid substitutions of A114E, Q120K, V211S, and N346Y relative to CMY-2, confers high-level ceftazidime-avibactam resistance, and accumulation of the substitutions incrementally enhances the level of resistance to this agent. However, the functional role of each substitution and their interplay in enabling ceftazidime-avibactam resistance remains unknown. Through biochemical and structural analysis, we present the molecular basis for the enhanced ceftazidime hydrolysis and impaired avibactam inhibition conferred by CMY-185. The substituted Y346 residue is a major driver of the functional evolution as it rejects primary avibactam binding due to the steric hindrance and augments oxyimino-cephalosporin hydrolysis through a drastic structural change, rotating the side chain of Y346 and then disrupting the H-10 helix structure. The other substituted residues E114 and K120 incrementally contribute to rejection of avibactam inhibition, while S211 stimulates the turnover rate of the oxyimino-cephalosporin hydrolysis. These findings indicate that the N346Y substitution is capable of simultaneously expanding the spectrum of activity against some of the latest β-lactam agents with altered bulky side chains and rejecting the binding of β-lactamase inhibitors. However, substitution of additional residues may be required for CMY enzymes to achieve enhanced affinity or turnover rate of the β-lactam agents leading to clinically relevant levels of resistance.IMPORTANCECeftazidime-avibactam has a broad spectrum of activity against multidrug-resistant Gram-negative bacteria including carbapenem-resistant Enterobacterales including strains with or without production of serine carbapenemases. After its launch, emergence of ceftazidime-avibactam-resistant strains that produce mutated β-lactamases capable of efficiently hydrolyzing ceftazidime or impairing avibactam inhibition are increasingly reported. Furthermore, cross-resistance towards cefiderocol, the latest cephalosporin in clinical use, has been observed in some instances. Here, we clearly demonstrate the functional role of the substituted residues in CMY-185, a four amino-acid variant of CMY-2 identified in a patient treated with ceftazidime-avibactam, for high-level resistance to this agent and low-level resistance to cefiderocol. These findings provide structural insights into how β-lactamases may incrementally alter their structures to escape multiple advanced β-lactam agents.

Fabrication of Sb2S3/Sb2Se3 heterostructure for potential resistive switching applications

The exponential growth of large data and the widespread adoption of the Internet of Things (IoT) have created significant challenges for traditional Von Neumann computers. These challenges include complex hardware, high energy consumption, and slow memory access time. Researchers are investigating novel materials and device architectures to address these issues by reducing energy consumption, improving performance, and enabling compact designs. A new study has successfully engineered a heterostructure that integrates Sb2Se3 and Sb2S3, resulting in improved electrical properties. This has generated significant interest in its potential applications in resistive switching. In this study, we have demonstrated the fabrication of a device based on Sb2S3/Sb2Se3 heterostructure that exhibits resistive switching behavior. The device has different resistance states that can be switched between high and low resistance levels when exposed to an external bias (−1 V to 0 V to 1 V). It also has good non-volatile memory characteristics, including low power consumption, high resistance ratio (∼102), and reliable endurance (∼103). The device enables faster data processing, reduces energy consumption, and streamlines hardware designs, contributing to computing advancements amidst modern challenges. This approach can revolutionize resistive switching devices, leading to more efficient computing solutions for big data processing and IoT technologies.

The validity and reliability of a hydraulic resistance device for assessing resisted sprint time.

The aim of this study was to assess the validity and reliability of a hydraulic resistance device (HRD) for monitoring sprint split times under different loads within and between sessions. Three 20-m sprints with low (15 N), medium-low (40 N), medium-high (50 N), and high (130 N) HRD resistance levels (loads) were performed on two separate occasions 14 days apart. Twenty-four student athletes (24.8 ± 3.8 years) participated in the first session and 13 (24.1 ± 3.2 years) of them in the second session. Resisted sprints split times over a distance of 0-20 m (t0-5, t0-10, t0-20, t5-10, t10-15, t15-20) were measured simultaneously with magnetic incremental encoder embedded in the HRD and a system of single-beam timing gates. The results showed acceptable to high within session (ICC3,1 = 0.91-0.99; CV = 0.92%-3.38%) and between session (ICC3,1 = 0.82-0.99; CV = 1.62%-4.84%) reliability of HRD for measuring all split times at all loads. The minimal detectable change between sessions ranged from 3.3% at high load to 9.9% at low load. The HRD systematically underestimated timing gates times at all loads (bias = 2.01-11.08%), yet good to excellent consistency was observed between the HRD and timing gates, specifically for t0-10 and t0-20 (ICC3,k lower 95% CI = 0.84-0.99). Due to high reliability and good validity in monitoring resisted sprint times, the HRD holds potential for practical and research applications.

Phenotypic and genotypic detection of multi drug resistant coagulase-positive Staphylococcus spp. isolates from canine pyoderma.

Dermatological infections in dogs are challenging to treat due to antibiotic resistance, which leads to longer recovery time and the need for stronger antibiotics. Aims: This study was undertaken to determine the prevalence of antimicrobial resistance in coagulase-positive staphylococcal isolates from pyoderma infection in dogs. This study also aimed to identify isolates with methicillin-resistance and multidrug resistance. 73 coagulase-positive staphylococci isolated from varying degrees of canine pyoderma cases. The samples were analyzed for the presence of Staphylococcus spp. using polymerase chain reaction (PCR) and resistance against antibiotics was studied by antimicrobial profile, minimum inhibitory concentration (MIC), and PCR on isolated bacteria. Out of 75 bacterial isolates identified, 73 isolates were confirmed as Staphylococcus species by PCR. A higher percentage of antibiotic resistance was observed against penicillin-G (46.27%), followed by amoxiclav (38.81%), enrofloxacin (32.84%), cefpodoxime, oxytetracycline (28.36% each), levofloxacin (26.86%), and co-trimoxazole (22.39%). 29 (49.15%) S. pseudintermedius, three (50.00%) S. schleiferi subsp. coagulans, and two (100%) S. aureus isolates exhibited multidrug resistance. However, one (1.49%) isolate (S. pseudintermedius) revealed low-level mupirocin resistance in the E-test. Also, 12 (20.34%) methicillin-resistant Staphylococcus pseudintermedius (MRSP), one (16.67%) methicillin-resistant S. schleiferi subsp. coagulans (MRSS) and one (50%) methicillin-resistant S. aureus (MRSA) were reported using PCR. This study helps to understand the increased level and pattern of resistance in coagulase-positive staphylococci isolated from different types of canine pyoderma cases.

Summer mortality syndrome bacterial pathogens in farmed Nile tilapia (Oreochromis niloticus).

The high summer mortality in many fish farms, which had detrimental economic and social implications, was a serious challenge that the fish industry had to deal with. With an examination of the most effective antibiotic, the ongoing research was intended to shed light on the identification of the main bacterial pathogens associated with the summer mortality syndrome in the diseased farmed Nile tilapia. Six hundred dead Nile tilapia samples that had suffered from summer mortality were collected from several fish farms between May and October of 2022. The gathered fish displayed hemorrhagic areas on the skin, scale detachment, fin degeneration, erosions, skin ulcers, and corneal opacity with unilateral and/or bilateral exophthalmia. The most prominent internal appearance was swelling of the internal organs with sanguineous ascetic fluid. There were 225 bacterial isolates found. Six species were identified through phenotypic and biochemical analysis; they were Aeromonas, Vibrio, Streptococcus, Pseudomonas, Enterococcus, and Edwardsiella spp., in descending percentage, respectively. Aeromonas spp., Vibrio spp., and Streptococcus spp. were the three most frequent isolated bacterial pathogens. The identification of Aeromonas hydrophila, Vibrio spp., and Streptococcus iniae, the three most common bacterial isolates, was confirmed by molecular analysis by polymerase chain reaction. Most of the tested strains were found to be responsive to Ciprofloxacin (CIP), Gentamicin (CN), and Chloramphenicol (C) but resistant to Amoxicillin (AMX), according to an antibiotic sensitivity test. The three most dangerous common bacterial infections discovered during mass-farmed tilapia summer mortality are A. hydrophil a, Vibrio sp., and S. iniae. This makes it clear that high water temperatures may raise the possibility of bacterial infections, which could cause widespread tilapia mortality and substantial financial losses. Therefore, it is crucial to maintain a beneficial fish culture, environment, and husbandry practices to enhance the tilapia-rearing environment and lessen the virulence of the disease. Isolated bacterial strains showed low levels of resistance to AMX but were vulnerable to CIP, CN, and C.

A new amino acid substitution in the MvALS1 gene of metsulfuron-methyl resistant biotypes Monochoria vaginalis (Burm. f.) C. Presl from West Java, Indonesia.

The most bothersome weed in rice fields in the Indonesian province of West Java is Monochoria vaginalis (Burm. F.) C. Presl, an aquatic herbaceous plant. Metsulfuron-methyl has long been used in wetland rice in West Java with a high enough intensity. However, the case of Monochoria vaginalis resistance to metsulfuron-methyl herbicides in Indonesia has not been widely reported and investigated. The study aims to (1) classify the resistance level of M. vaginalis toward metsulfuron-methyl, (2) identify Target Site Resistance (TSR) mechanism mutations in the MvALS1 gene of the resistant biotype of M. vaginalis. The Whole Plant Pot Test method was utilized to assess the resistance level of Monochoria vaginalis. Following that, all samples were subjected to DNA sequencing using the PCR method to identify mutations in the MvALS1 gene from the resistant biotype. After then, this study used DUET, a server with an integrated computational methodology, to anticipate the effect of mutations on protein stability. The result showed that Monochoria vaginalis from Rawamerta, Karawang showed a moderate level of resistance to metsulfuron-methyl with a resistance ratio of 6.00, Patokbeusi, Subang showed a low level of resistance to metsulfuron-methyl with a resistance ratio of 3.89, compared to susceptible Monochoria vaginalis. Nucleotide base alignment in the MvALS1 gene revealed that base substitutions occurred in the Monochoria vaginalis biotype from Rawamerta and Patokbeusi, resulting in 5 amino acid substitutions: Ser-64-Ala, Asp-66-Glu, Asn-240-Asp, Glu-426-Asn, and Ser-469-Asn and Sukra: Ser-64-Ala, Asp-66-Glu, and Asn-240-Asp. The analysis showed that S64A, D66E, and N240D stabilize the protein, whereas E426N and S469N destabilize it. This study confirms for the first time that Ser-64-Ala, Asn-240-Asp, and Glu-426-Asn amino acid mutations were found in cases of M. vaginalis resistance to metsulfuron-methyl (ALS inhibitor).

Dual bombard by Cytomegalovirus and Mycobacterium tuberculosis in a renal transplantee

Abstract In the first year following an organ transplant, more than 80% of patients encounter a minimum of one occurrence of infection. Here, we report a case of coinfection of the Cytomegalovirus (CMV) and Mycobacterium tuberculosis (MTB) in a kidney transplantee. Computed tomography chest (CT chest) showed bilateral ground-glass opacities. By Cytomegalovirus DNA polymerase chain reaction, 9360 copies were detected in plasma. Cartridge-based nucleic acid amplification test from bronchial washings tested positive for MTB with very low-level resistance to rifampicin. He was started on category-I antitubercular therapy without rifampicin and intravenous valganciclovir. The clinical status of the patient improved after 1 month of treatment.

The first vanE-type vancomycin resistant Enterococcus faecalis isolates in Norway – phenotypic and molecular characteristics

We aimed to characterize the vanE cluster and its genetic support in the first Norwegian vanE-type isolates and assess genetic relatedness to other vanE isolates. Two vanE-type vancomycin resistant Enterococcus faecalis (vanE-VREfs) isolates (E1 and E2) recovered from the same patient 30 months apart were examined for antimicrobial susceptibility, genome sequence, vancomycin resistance induction, vanE transferability, genome mutation rate, and phylogenetic relationship to E. faecalis closed genomes and two vanE-VREfs from North America. The ST34 E1 and E2 strains expressed low-level vancomycin resistance and susceptibility to teicoplanin. Their vanE gene clusters were part of a non-transferable Tn6202. The histidine kinase part of vanSE was expressed although a premature stop codon (E1) and insertion of a transposase (E2) truncated their vanSE gene. The vancomycin resistance phenotype in E1 was inducible while constitutive in E2. E1 showed a 125-fold higher mutation rate than E2. Variant calling showed 60 variants but nearly identical chromosomal gene content and synteny between the isolates. Their genomes also showed high similarity to another ST34 vanE-VREfs from Canada. In-depth genomic analyses of the first two vanE-VREfs found in Europe identified a single chromosomal insertion site of two variants of vanE-conferring Tn6202. Single nucleotide polymorphism (SNP) and core genome multilocus sequence type (cgMLST) analyses show the genomes are different. This can be explained by the high mutation rate of E1 and acquisition of different mobile genetic elements; thus, we believe the two isolates from the same patient are genetically related. Genome similarities also suggest relatedness between the Canadian and Norwegian vanE-VREfs.

Features of the Application of the Method of Socio-Psychological Training in the Formation of Students' Stress Resistance

The paper deals with such concepts as «social-psychological training» and «stress resistance»; the features of the application of this method in the formation of students' stress resistance are studied.One of the primary tasks of modern society in working with youth is the formation of a high level of sociopsychological adaptation. Currently, an active search and development of new forms and methods of both individual and group work with students is underway. In the diverse arsenal of methodological tools, a special place is given to socio-psychological training.The purpose of this psychological study was to study the features of the use of socio-psychological training as a means of forming students' stress resistance. During the primary diagnosis, two groups of students (control and experimental) were identified with a low level of stress resistance and a high level of stress.As part of the formative experiment, we developed and implemented a program of psychological support for students. Classes were held in the experimental group once a week for two months. After the formative experiment, the control stage of the study was carried out. At the control stage, the changes in the level of stress and stress tolerance of those who took (experimental group) and those who did not take part (control group) in the program were compared, thus, the effectiveness of the program of psychological support of students developed by us was tested. For re-diagnosis, the same methods were used as in the primary diagnosis at the ascertaining stage of the study.The methodological basis of the work was the theoretical provisions on the development of the group in the process of joint activity (L.G. Pochebut, G.M. Andreeva, E.S. Kuzmin, R.S. Nemov, etc.); ideas about the sociopsychological characteristics of the group (M.I. Bobneva, V.S. Ageev, P.K. Anokhin, etc.); conceptual foundations of personality development in the course of a specially organized psychological impact (A. Bandura, S.I. Makshanov, K. Levin, etc.); understanding and implementation of the methodology and methodology of socio-psychological training (L.A. Petrovskaya, Yu.N. Emelyanov, S.I. Makshanov).The research methods were theoretical analysis of scientific research; organizational methods; empirical methods: observation, psychodiagnostic methods, methods of statistical data processing.Comparative analysis of changes in the experimental and control groups (increase in stress resistance, reduction of stress and tension levels according to the corresponding coping strategies) allowed us to draw conclusions about the potential of applying the method of socio-psychological training in the formation of students' stress resistance.

Surveillance of antimicrobial resistance in Escherichia coli, Salmonella, and Campylobacter recovered from laying hens, their environment and products in Canada indicated a stable level of resistance to critically important antimicrobials, in varying time periods between 2007 and 2021

The study objective was to determine the occurrence and antimicrobial resistance (AMR) attributes of select foodborne bacteria recovered from egg-producing (layer) chickens between 2007 and 2021 using different sample matrices (Study 1: liquid whole eggs, Study 2: spent hen cecal samples, Study 3: environmental sponge swabs and fecal samples from layer chicken barns, and Study 4: fecal samples from layer chicken barns). Samples from each study were submitted for the culture of Escherichia coli and Salmonella. In addition, samples from layer chicken barns were submitted for the culture of Campylobacter. Isolates were tested by microbroth dilution and interpreted using both clinical breakpoints and epidemiological cut-offs (ECOFFs). The ECOFFs were applied to detect non-wild type (NWT) strains. The proportion of resistant, NWT, and distribution of minimum inhibitory concentrations (MIC) were assessed. Ceftriaxone resistance was detected at a low-level in E. coli (< 2 %, all studies) and Salmonella (4.3 %, Study 2). Very low-level ciprofloxacin resistance was detected in E. coli (<1 %, Study 1) but a slightly elevated ciprofloxacin NWT E. coli (1 % to 6 %) observed. Only the farm fecal samples in Studies 2 and 3 were tested for Campylobacter as part of its study design, and moderate level ciprofloxacin resistance (<15 %) was observed. The MIC distribution patterns were similar across the organisms tested/studies and no substantial shifts in the distributions were detected. This analysis demonstrated that resistance to very important antimicrobials in bacteria from layers in Canada remains low, however, the detection of ciprofloxacin-resistant Campylobacter and the implications of this observation to the safety of egg products, and the role of laying flocks (i.e., as reservoir for resistant organisms) needs to be investigated.

Field-testing whitebark pine resistance to white pine blister rust: A simple, effective approach to progeny testing for restoration

The endangered conifer whitebark pine (Pinus albicaulis), native to high elevation forests of western North America, is declining mainly due to the introduced pathogen Cronartium ribicola, causing the disease white pine blister rust. Low levels of genetic resistance to blister rust are present in whitebark pine populations. Traditional methods of inoculating seedlings to determine resistance to the rust are costly, labour intensive, and have limited capacity due to facilities. This presents a bottleneck in the development of resistant material for restoring stands that have been heavily infected by the rust. Here we test an alternative approach to controlled inoculations that could screen large numbers of families with lower costs and requiring fewer specialized resources. We screened 214 open-pollinated families from 44 provenances from British Columbia (BC), Washington (WA), Oregon (OR), Idaho (ID), Montana (MT), and Nevada (NV) to determine: (1) the effectiveness of natural rust inoculation from Ribes nigrum in a common garden; (2) family- and provenance-level resistance to blister rust; and (3) climate variables related to population-level rust resistance. Eighty-one of these families were previously screened by the US Forest Service in Cottage Grove, Oregon using standard artificial inoculation methods. The natural inoculation was effective, with 73 % of seedlings displaying stem symptoms of the disease, and 95 % showing rust infection. A clear relationship was found between distance from the nearest Ribes nigrum plant and severity of blister rust. Linear mixed models with spatial correlations were fitted to rust infection data using ASReml-R to estimate breeding values, heritability, and among-population differentiation (QST) for rust resistance. Population differentiation for rust resistance was moderate, with the highest resistance in provenances from the Cascade Mountains of Washington, and the most susceptible families from the BC Chilcotin and Okanagan regions. Heritability of rust resistance was moderate (0.23). The field testing was broadly consistent with classifications of families into resistant, moderate, and susceptible groups based on artificial inoculations. This method of screening could be used at a broader scale to determine families resistant to white pine blister rust without specialized testing facilities and increase the availability of resistant seedlings for restoration.

The phenomenon of stress resistance as a leading factor in preserving the health of schoolchildren

The authors of the article emphasize that today the study of the phenomenon of stress resistance is becoming interdisciplinary, and stress and stress resistance are the subject of research by scientists from various fields: physicians, psychologists, educators, biologists, sociologists, etc. The purpose of the study is to carry out a theoretical content analysis of the phenomenon of stress resistance as a factor in maintaining schoolchildren's health. It is indicated that modern scientists are actively studying the phenomenon of stress resistance and there are a number of definitions of the concept of “stress resistance”. It is noted that stress resistance is a process and result of successful adaptation to difficult or challenging life circumstances, especially through mental, emotional and behavioral flexibility and adaptation to external and internal requirements. This quality of students' personality is influenced by various factors: cognitive, personality and innate, as well as environment and experience. The factors influencing the stress resistance of students are investigated; the main characteristics of personality stress resistance are summarized.&#x0D; Conclusions: The phenomenon of stress resistance is attracting the attention of modern researchers in Ukraine and the world. Stress tolerance is a set of personal qualities that allow one to endure stressful situations or mitigate their consequences. A low level of stress resistance reduces the physical and mental health of children and youth. Therefore, it is an urgent task to teach stress resistance to pupils of different school ages and students in the educational process of physical education.

Genomic insights into Enterococcus faecium isolates from marine bivalves highlight One Health concerns and healthcare linkages.

Enterococci, especially Enterococcus faecium, are one of today's leading causes of multidrug-resistant infections in hospital settings. The marine environment may harbour enterococci, but its role as an evolutionary niche and as a vector for the spread of enterococci is sparsely investigated. Hence, by applying enterococci in bivalves as a sentinel tool, this study aimed to describe the prevalence of enterocooci along the Norwegian coast and in addition the phylogeny of E. faecium in particular. Enterococci in batch samples of marine bivalves, harvested from 86 different locations, were quantitatively examined by a culture-dependent most probable number (MPN) method. Isolates were identified by MALDI-TOF-MS prior to antimicrobial susceptibility testing by broth microdilution. In-detail analyses of a representative selection of E. faecium isolates (n=148) were done by Illumina whole-genome sequencing, and assembled genomes were compared to closed E. faecium genomes in the public databases and to genomes from commensal and clinical isolates from Norway. Diversity among E. faecium within the same batch sample of bivalves was also explored. Enterococci were detected in 287 of the 471 examined bivalve samples, but in low concentrations with a median value of <18 MPN /100 g. From positive samples, 479 isolates of enterococci were identified belonging to ten different species, where E. faecium (n=247), Enterococcus hirae (n=114) and Enterococcus faecalis (n=66) were most frequently found. Resistance towards one or more antimicrobial agents was observed in 197 isolates (41 %), none of the isolates showed acquired resistance to vancomycin or linezolid. Phylogenetic analyses revealed high diversity among the E. faecium isolates and showed that the marine niche is dominated by strains from the non-clinical setting belonging to clade A2 (n=85) and B (E. lactis) (n=60). Only three isolates belonged to the hospital-associated clade A1 (ST80 and ST117). Two of these clustered with one isolate from a hospitalized patient and one from a non-hospitalized person. This study demonstrated a high prevalence, but low concentrations of enterococci in bivalves, and low levels of antimicrobial resistance. E. faecium genomes showed high population diversity and that very few E. faecium isolates in bivalves may have arisen from the human healthcare system. A systematic surveillance of target micro-organisms applying methods examining multiple isolates from the same bivalve sample provides important data to assess the enterococcal phylogeny, antimicrobial resistance and the level of faecal pollution in the marine environment.

Methicillin resistant Staphylococcus aureus in the United Arab Emirates: a 12-year retrospective analysis of evolving trends.

Methicillin resistant Staphylococcus aureus (MRSA) is a major contributor to the global burden of antimicrobial resistance (AMR). As MRSA continues to evolve, the need for continued surveillance to evaluate trends remains crucial. This study was carried out to assess MRSA trends in the United Arab Emirates (UAE) based on analysis of data from the national AMR surveillance program. We carried out a 12-year (2010-2021) retrospective analysis of MRSA demographic and microbiological data collected as part of the UAE national AMR surveillance program. Participating centers from across the country routinely submit AMR surveillance data collected by trained personnel to the National AMR Surveillance Committee, where data is analyzed using a unified WHONET platform. Data on non-duplicate isolates associated with clinical infections were obtained and included in the analysis. A total of 29,414 non-duplicate MRSA isolates associated with clinical infections were reported between 2010 and 2021 (2010: n = 259; 2021: n = 4,996). MRSA represented 26.4% of all S. aureus (n = 111,623) isolates identified during the study period. In 2010, among the S. aureus isolates with reported oxacillin testing, 21.9% (n/N = 259/1,181) were identified as MRSA and this showed an increase to 33.5% (n/N = 4,996/14,925) in 2021. Although there was variation in the distribution of MRSA across the seven emirates of the country, most had an upward trend. Patient demographics reflected a male preponderance, with most being adults and from the outpatient setting. Isolates were mostly from skin and soft tissue infection specimens (72.5%; n/N = 21,335/29,414). Among the inpatients (N = 8,282), a total of 3,313 MRSA isolates were from specimens obtained ≤ 48 h after admission indicative of community acquired infection. Increasing resistance trends were observed for most antibiotics including ciprofloxacin, levofloxacin, moxifloxacin, erythromycin, gentamicin, trimethoprim-sulfamethoxazole, and quinupristin/dalfopristin. Low levels of resistance (0.0-0.8%) were sustained for linezolid except for 2015, 2016, and 2017 with 2.5, 2.6, and 2.9%, respectively. No confirmed vancomycin resistance was reported. The increasing trend of MRSA isolates associated with clinical infections in the hospital and community settings is a concern. Continued monitoring including incorporation of genomic surveillance and infection control measures are recommended to stem the dissemination.

Low Prevalence of Antimalarial Resistance Mutations in India During 2014-2015: Impact of Combining First-line Therapy With Primaquine.

Antimalarial drug resistance surveillance and containment are crucial for countries aiming to eliminate malaria. Monitoring resistance evolution through studies before and after treatment policy changes is essential. A total of 939 Plasmodium falciparum-positive blood samples were collected between 2014 and 2015 across 10 sites in India, categorized into 4 geographic clusters. Polymerase chain reaction-amplified products were sequenced to identify point mutations at drug resistance-conferring genes (Pfdhfr, Pfdhps, Pfmdr1, and Pfk13). Triple Pfdhfr mutants were found only in northeast India bordering Myanmar, while the wild type (WT) was dominant in central India. Pfdhps WTs were prevalent in all areas, and no double mutants were found. Except in northwest India, Pfmdr1 WT was dominant in all clusters. Nonsynonymous double mutations were only found in northwest India. Only synonymous mutations occurred in Pfk13. These were found in central India at a low frequency. The pattern of linkage disequilibrium and principal component analysis reflects low pressure for drug resistance and heterogeneity between the geographic clusters. Resistance levels were highest in northeast India, close to the Myanmar border, where resistance is common. Primaquine has been widely used as a gametocidal and schizonticidal drug, likely contributing to maintaining low drug resistance levels and preventing strong selection for resistance.

Antibiotic Guideline Adherence at the Emergency Department: A Descriptive Study from a Country with a Restrictive Antibiotic Policy.

Denmark has a low level of antimicrobial resistance (AMR). Patients hospitalized with suspected infection often present with unspecific symptoms. This challenges the physician between using narrow-spectrum antibiotics in accordance with guidelines or broad-spectrum antibiotics to compensate for diagnostic uncertainty. The aim of this study was to investigate adherence to a restrictive antibiotic guideline for the most common infection in emergency departments (EDs), namely community-acquired pneumonia (CAP). This multicenter descriptive cross-sectional study included adults admitted to Danish EDs with a suspected infection. Data were collected prospectively from medical records. We included 954 patients in the analysis. The most prescribed antibiotics were penicillin with beta-lactamase inhibitor at 4 h (307 (32.2%)), 48 h (289 (30.3%)), and day 5 after admission (218 (22.9%)). The empirical antibiotic treatment guidelines for CAP were followed for 126 (31.3%) of the CAP patients. At 4 h, antibiotics were administered intravenously to 244 (60.7%) of the CAP patients. At day 5, 218 (54.4%) received oral antibiotics. Adherence to CAP guidelines was poor. In a country with a restrictive antibiotic policy, infections are commonly treated with broad-spectrum antibiotics against recommendations.