Isolation Rate Research Articles

Emerging epidemic of the Africa-type plasmid in penicillinase-producing Neisseria gonorrhoeae in Guangdong, China, 2013–2022

The prevalence of penicillinase-producing Neisseria gonorrhoeae (PPNG) is a crucial public health concern because of its resistance to penicillin and cephalosporins. From 2013 to 2022, a total of 1,748 N. gonorrhoeae isolates from Guangdong, China, were examined for their antibiotic susceptibility and molecular epidemiological characteristics. PPNG prevalence increased markedly from 37.25% to 63.87%. This increase was accompanied by a shift in predominant plasmid types carried by PPNG isolates: the rate of PPNG isolates carrying the Africa-type plasmid increased from 18.42% to 91.55%, whereas the rate of isolates carrying the Asia-type plasmid decreased from 81.58% to 7.58%. The prevalence of bla TEM-135, which is linked to cephalosporin resistance, declined from 52.63% to 4.37%, whereas that of bla TEM-1 increased from 47.37% to 86.88%, and new bla TEM variants emerged (10.99% by 2022). Most bla TEM-1 (88.26%) and new bla TEM alleles (83.70%) were associated with the Africa-type plasmid, whereas 86.79% of bla TEM-135 alleles were linked to the Asia-type plasmid. Resistance to ceftriaxone was higher in the Asia-type group (11.67%) than in the Africa-type, Toronto/Rio-type and non-PPNG groups. Genotyping identified diverse sequence types (STs) among PPNGs, in which MLST ST7363, NG-STAR ST2477, NG-MAST ST17748, and NG STAR CC1124 were predominant. This study underscores the rising prevalence of PPNG in Guangdong driven by clonal expansion and changing plasmid dynamics, affecting cephalosporin resistance and highlighting the need for continued surveillance and research into effective treatment strategies.

Different Infection Structures and Point Mutation of Diaporthe citri Showing Resistant against Systemic Fungicides.

Infection behaviors of some susceptible and resistant Diaporthe citri isolates against two fungicides such as benomyl and kresoxim-methyl were observed on citrus leaves. On the chemically unsprayed leaves, there were no differences in not only the conidial germination rate but also hyphal growth between the resistant and susceptible isolates. However, on the benomyl or kresoximmethyl-pretreated leaves, both conidial germination rate and hyphal growth of the resistant isolates were not decreased, which was different with those of the susceptible isolates. These unchanging germination rate and hyphal growth of the resistant isolates, resulting in the lack of chemical efficacy, coincided with the previous studies in which strong infection was observed by the resistant isolates after pre-treatment with each chemical. On the other hand, a point mutation occurred at 198th amino acid of β-tubulin gene in the resistant isolate NEL21-2 which may cause the resistant against benomyl. However, no mutation was found in cytochrome b in the resistant isolates indicating other genomic changes may be responsible for the resistant against kresoxim-methyl.

Distribution and Antimicrobial Susceptibility Profiles of Pathogens in Patients With Esophageal Cancer From 2013 to 2022: A Retrospective Study.

Pathogenic microbial infections are closely related to the development and prognosis of esophageal cancer. The distribution and resistance of pathogens in different diseases are regional and gradually change over time. This study aimed to determine the distribution and drug resistance of pathogens isolated from patients with esophageal cancer and provide a reference for the rational use of antibiotics. The results of strain identification and antimicrobial susceptibility testing of pathogens in patients with esophageal cancer from January 2013 to December 2022 at our hospital were retrospectively analyzed. SPSS Statistics 26.0 (IBM) and R software 4.3.1 were used for data analysis. In total, 2322 non-repetitive pathogens were isolated from 14,037 samples. Of all strains, 1713 (73.77%) were Gram-negative bacteria, 483 (20.80%) were Gram-positive bacteria, and 126 (5.43%) were fungi. The top 10 pathogens were Pseudomonas aeruginosa (19.81%), Stenotrophomonas maltophilia (12.88%), A. baumannii (9.91%), Klebsiella pneumoniae (9.82%), Staphylococcus aureus (7.54%), Candida albicans (3.92%), Staphylococcus epidermidis (3.19%), Escherichia coli (3.14%), Enterococcus faecalis (2.97%), and Serratia marcescens (2.15%). The isolation rate of S. maltophilia showed an upward trend (p < 0.05). The resistance rates of P. aeruginosa, S. maltophilia, A. baumannii, and Enterobacteriaceae bacteria to some common antibiotics showed a tendency to change (p < 0.05), and 2019 became a turning point to some extent. All common Gram-positive pathogens were sensitive to vancomycin, except for three Enterococcus spp. isolates that showed intrinsic resistance. The prevalence of MRSA was 65.14% (114/175) in this study. In addition, the resistance rates of MRSA and MSSA to moxifloxacin, ciprofloxacin, levofloxacin, erythromycin, clindamycin, and penicillin were significantly different (p < 0.001). Pathogens are diverse in patients with esophageal cancer, with the most common being P. aeruginosa, followed by S. maltophilia. The pathogens exhibited different patterns of resistance. Antibiotics should be used rationally according to pathogen resistance patterns.

Arcobacter species isolated from human stool samples, animal products, ready-to-eat salad mixes, and ambient water: prevalence, antimicrobial susceptibility, and virulence gene profiles

IntroductionArcobacter species are emerging foodborne pathogens increasingly associated with human illness worldwide. They are commonly found in the gastrointestinal tracts of animals and are frequently isolated from various food sources, including raw meat, poultry, and seafood. The aim of this study is to investigate the antimicrobial resistance patterns of Arcobacter spp. isolated from human stool samples, animal products, ready-to-eat salad mixes, and ambient water, assess the presence of resistance genes, and explore their potential implications for public health.MethodsIn this study, a total of 683 samples were collected from the Shahrekord area over a 12-month period. Samples were obtained from human stool, chicken meat, raw cow milk, RTE salad mixes, and environmental water sources. Two different methods were used to detect Arcobacter, depending on the sample type: bacteriological isolation and identification, and molecular identification. After identification, antimicrobial susceptibility testing was conducted. Polymerase chain reaction (PCR) was used to identify ten putative Arcobacter virulence and resistance genes.FindingsThe results revealed that Arcobacter spp. were present in 26.06% (178 out of 683) of the tested samples, with varying isolation rates across different sample types. A. butzleri being the most commonly isolated species across all sample types, while A. cryaerophilus was restricted to RTE salads, surface waters, and chicken meat. Notably, A. skirrowii was only isolated from chicken meat and environmental water. The differences of Arcobacter spp. in prevalence between the sample types were statistically significant (p < 0.05), and no significant seasonal variation was found across the sampling periods (p > 0.05). PCR analysis for ten putative virulence genes indicated that the cadF gene was present in all Arcobacter isolates. Similarly, 83.33% of the tested strains harbored the ciaB gene, while other genes were less frequently detected. Regarding resistance genes, tet(O) (7.69%) was the most identified gene, followed by blaOXA-61 (4.37%).ConclusionIn conclusion, this study highlights the alarming prevalence of antimicrobial resistance in Arcobacter spp. Monitoring Arcobacter spp. resistance can be achieved through surveillance, risk assessments, antibiotic stewardship in agriculture, public education, research collaborations, rapid diagnostics, and harmonized policies, all aimed at reducing contamination and safeguarding public health effectively.

In-vitro activity of newly-developed β-lactamase inhibitors avibactam, relebactam and vaborbactam in combination with anti-pseudomonal β-lactam antibiotics against AmpC-overproducing clinical Pseudomonas aeruginosa isolates.

Overproduction of the intrinsic chromosomally-encoded AmpC β-lactamase is one of the main mechanisms responsible for broad-spectrum β-lactam resistance in Pseudomonas aeruginosa. Our study aimed to evaluate the in-vitro activity of anti-pseudomonal β-lactam molecules associated with the recently-developed and commercially-available β-lactamase inhibitors, namely avibactam, relebactam and vaborbactam, against P. aeruginosa isolates overproducing their AmpC. MIC values of ceftazidime, cefepime, meropenem, imipenem and ceftolozane with or without β-lactam inhibitor were determined for 50 AmpC-overproducing P. aeruginosa clinical isolates. MIC breakpoints for resistance were retained at 8mg/L for β-lactams and β-lactam/β-lactamase inhibitor combinations containing ceftazidime, cefepime and meropenem, while 4mg/L was used for those containing imipenem and ceftolozane. The concentration of all β-lactamases inhibitors was fixed at 4mg/L, except for vaborbactam (8mg/L). The rates of isolates not being resistant to ceftazidime, cefepime, meropenem, imipenem and ceftolozane were found at 12%, 22%, 34%, 8% and 74%, respectively. When combined with avibactam, those rates increased to 60%, 62%, 60%, 46%, and 80%, respectively. The highest rates were found with relebactam-based combinations, being 76%, 64%, 66%, 76% and 84%, respectively. By contrast, associations with vaborbactam did not lead to significantly increased "non-resistance" rates. Our results showed that all combinations including relebactam led to higher "non-resistance" rates against AmpC-overproducing P. aeruginosa clinical isolates. The best activity was achieved by combining ceftolozane and relebactam, that might therefore be considered as an excellent clinical alternative against AmpC overproducers.

Exploring Social and Intellectual Isolation Among Postgraduate Researchers: Implications for Inclusive Teaching and Learning Initiatives

Inclusive teaching and learning initiatives aim to foster supportive environments that cater to students' diverse academic and social needs. Within the context of postgraduate research, students often confront significant levels of solitude, experiencing both social and intellectual isolation. While existing literature predominantly addresses social isolation, a distinct form of isolation inherent to postgraduate research, termed 'topic-related loneliness', has been largely overlooked. Despite its historical acceptance within academic culture, attrition rates of up to 70% point to the possible detrimental impact of isolation on student retention. Understanding the levels and determinants of isolation amongst postgraduate researchers is important for developing effective interventions. This study investigates whether social and intellectual isolation present prevalent challenges within the research community of a university in Ireland. The main aims are to understand the causes of research postgraduate isolation, explore potential links between isolation and attrition rates, and propose viable interventions, such as online communities of practice for researchers. To address these dimensions, the study adopts an explanatory sequential design, reframing the phenomenon of intellectual isolation within the context of inclusive pedagogy. Data collection includes a survey capturing the lived experiences of current and former research postgraduate students, followed by thematic analysis. Departing from traditional research paradigms, this sequential study integrates qualitative and quantitative methods, offering a nuanced understanding of the experiences and perceptions of postgraduate researchers. The findings aim to address existing deficiencies in research postgraduate education, elucidate the underlying causes of student challenges, and provide insights into proposed support systems and interventions that may be useful to university research communities, the development of higher education research policy, and the improvement of retention rates at research postgraduate level.

Molecular characterization of Klebsiella pneumoniae in clinical bovine mastitis in 14 provinces in China.

The mastitis caused by Klebsiella pneumoniae (K. pneumoniae) is increasing in the dairy cows. To investigate the epidemic of K. pneumoniae of China, 131 strains were isolated from 495 clinical mastitis milk samples (26.5%) from 14 provinces in China. Among the isolates, K57 was the dominant serotype (45.0%) and 19 (14.5%) isolates were identified as hypervirulent K. pneumoniae (hvKP). The mrkA, entB, wabG and fimH genes were prevalent virulence genes while rmpA, magA, and ycf were not found in K. pneumoniae. Furthermore, K. pneumoniae had serious antibiotic resistance and multiple β-lactamase genes, including blaTEM, blaSHV, blaNDM, blaCTX-M, blaDHA, and blaKPC. Biofilm was an important factor in bacterial resistance and persistent infection, and 77.1% isolates could form biofilm. Although acylated homoserine lactone (AHL, a Gram-negative bacterial quorum sensing signal molecule) was not confirmed among the K. pneumoniae isolates, exogenous AHLs could reduce the biofilm formation ability of the K. pneumoniae strains. Three new ST types (ST6781, ST6782, and ST6783) were first identified in this study. The MLST phylogenetic tree showed the distribution of mastitis associated K. pneumoniae strains had no regular pattern, which confirmed high genomic diversity of mastitis associated K. pneumoniae. In conclusion, the high rate of isolation and serious antibiotic resistance of K. pneumonia were found in this study and indicated a potential threat to public health from the food chain.

Pulmonary Vein Isolation With Optimized Linear Ablation vs Pulmonary Vein Isolation Alone for Persistent AF

Success rates of pulmonary vein isolation (PVI) are modest for persistent atrial fibrillation (AF). Additional linear ablation beyond PVI has not been proved superior to PVI alone in randomized trials. Ethanol infusion of the vein of Marshall (EIVOM) facilitates ablation at the mitral isthmus and may lead to improved effectiveness of a linear ablation strategy. To determine whether linear ablation with radiofrequency energy combined with EIVOM added to PVI improves sinus rhythm maintenance compared with PVI alone in patients with persistent AF. The PROMPT-AF trial is an investigator-initiated, multicenter, open-label, randomized trial involving 12 tertiary hospitals in China. A total of 498 patients aged 18 to 80 years, with AF persisting for more than 3 months, undergoing first-time AF ablation, were enrolled and randomized from August 27, 2021, to July 16, 2023. Patients were randomized to undergo PVI alone or PVI plus EIVOM and linear ablation (intervention). The latter group first underwent EIVOM, followed by PVI and linear ablation of the left atrial roof, mitral isthmus, and cavotricuspid isthmus. The primary end point was freedom from any documented atrial arrhythmias lasting more than 30 seconds, without the use of antiarrhythmic drugs within 12 months. Secondary outcomes included freedom from atrial arrhythmia recurrence, AF, atrial arrhythmia recurrence after multiple procedures, and documented atrial tachycardia or atrial flutter with or without antiarrhythmic drugs; AF burden; and improvement in quality of life. Patients were monitored with wearable single-lead electrocardiographic (ECG) patches, worn for 24 hours a week, supplemented by symptom-triggered ECGs and Holter monitoring. Among 498 randomized patients, 495 (99.4%) were included in the primary analysis (mean age, 61.1 years [SD, 9.7] years, 361 male [72.9%]). After 12 months, 174 of 246 patients (70.7%) assigned to undergo PVI plus EIVOM and linear ablation and 153 of 249 patients (61.5%) assigned to undergo PVI alone remained free from atrial arrhythmias without taking antiarrhythmic drugs (hazard ratio, 0.73; 95% CI, 0.54-0.99, P = .045). The intervention effect was consistent across all prespecified subgroups. The comparison of secondary outcomes did not demonstrate significant results. Among patients with persistent AF, linear ablation combined with EIVOM in addition to PVI significantly improved freedom from atrial arrhythmias within 12 months compared with PVI alone. ClinicalTrials.gov Identifier: NCT04497376.

Genomic analysis reveals the presence of hypervirulent and fluoroquinolone-resistant Clostridioides difficile in farmed mussels (Mytilus galloprovincialis) in Slovenia

Clostridioides difficile is one of the leading causes of antibiotic-associated diarrhea. In this study, we characterized 76C. difficile isolates, obtained from three Mediterranean mussel (Mytilus galloprovincialis) farms in Slovenia from November 2014 to October 2015 (sampling period 1) and from January to December 2021 (sampling period 2). The overall isolation rate of C. difficile from all the examined mussels was 59.8 %. A statistically significant trend of seasonal variation was observed, with a higher isolation rate in the colder months of the year (87.9 %; sea temperature ≤ 15 °C) compared with the warmer months (31.8 %; sea temperature > 15 °C). Whole-genome sequencing (WGS) revealed that the isolates belonged to 31 different sequence types (STs), which were associated with three clades (1, 4, and 5) and two cryptic clades (C-II and C-III). Five isolates, which belonged to ST11 (clade 5), harbored all the main toxin genes (A+B+CDT+) and chromosomal mutations conferring fluoroquinolone resistance. Core genome multilocus sequence typing (cgMLST) revealed four clusters of 2–3 isolates, three of which included isolates from different farms, suggesting that clonal C. difficile strains are circulating among the Slovenian mussel farms. The results highlight the presence of hypervirulent strains in mussels; therefore, at-risk population groups should be alerted to the risks associated with consuming shellfish.

Comprehensive evaluation of Toxoplasma gondii in sheep intended for human consumption in Brazil: seroprevalence, isolation, and genotyping.

Ovine toxoplasmosis caused by Toxoplasma gondii is a zoonotic disease responsible for triggering reproductive problems in sheep with great public health impact. The zoonotic risk for humans occurs through the ingestion of meat contaminated with bradyzoites, water and vegetables contaminated with oocysts, or by ingesting unprocessed sheep milk contaminated with tachyzoites. The study aimed to determine the seroprevalence, isolate, and genetically characterize T. gondii from sheep in northeastern Brazil. Blood and tissue samples, including the liver, heart, brain, lung, and diaphragm, were collected from 256 sheep in slaughterhouses. The presence of anti-T. gondii IgG antibodies was assessed by the indirect fluorescent antibody test (IFAT), and sera with titers ≥ 1: 64 were considered positive. Tissue samples from seropositive sheep were digested in acidic pepsin solution and inoculated into two Swiss mice for T. gondii isolation and further characterized by molecular methods. The prevalence of anti-T. gondii antibodies in sheep was 31.64% and the isolation rate was 40.7%. Sixteen out of 33 isolates were submitted to mnRFLP-PCR using ten genetic markers. Four isolates were fully genotyped, and four isolates were amplified at least in one marker. All isolates were characterized as atypical genotypes, and ToxoDB #57 (n = 3) and #143 (n = 1) were identified. The detection of viable T. gondii in sheep from slaughterhouses in Brazil highlights the risk of human exposure. There is the need for proactive control and prevention measures to mitigate the risk of human exposure, considering the importance of sheep meat as a source of protein to humans.

Epidemiological survey of 32,786 culture-positive dermatophytosis cases in Hangzhou from 2018 to 2023

BackgroundWith the rapid development of the economy and changes in lifestyle in recent years, the epidemiological pattern of dermatophytosis has changed. We analyzed the epidemiological features of dermatophytosis in a hospital in Hangzhou from 2018 to 2023.MethodsData from patients with culture-positive dermatophytosis were obtained from the Laboratory Information System of the Mycology Laboratory of our hospital. Dermatophyte isolates were mainly identified by macroscopic and microscopic features of the colonies.ResultsThere were 32,786 patients with culture-positive dermatophytosis during the 6-year period, including 16,789 male patients and 15,990 female patients. Patients’ ages ranged from 1 month to 97 years. Tinea unguium accounted for the largest proportion (14,879, 45.38%), which was mainly prevalent among females (8946, 60.13%). Significant gender differences were observed in all clinical types of dermatophytosis, except for tinea pedis. In total, 15,486 (47.73%) patients aged 21–40 years. The median age of patients with tinea manum and tinea capitis was the highest (49 years) and the lowest (5 years), respectively. Nine species of isolated dermatophytes were identified, of which Trichophyton rubrum accounted for 90.20% (29,573 cases). M. canis accounted for 66.80% of isolated dermatophytes from tinea capitis. The isolation rates of zoophilic species were 43.41% in tinea faciei and 18.90% in tinea corporis.ConclusionT. rubrum was absolutely predominant agent of dermatophytosis except tinea capitis in which M. canis was the most common organism. The prevalence of zoophilic dermatophytes has increased in tinea faciei and tinea corporis. Tinea unguium was the major clinical form of dermatophytosis, and it was more prevalent among females. The onset peak of dermatophytosis was in the age group of 21–40 years, except for tinea capitis.

Abstract 4144517: Feasibility of Deep Sedation for Catheter Ablation of Atrial Fibrillation Using Pulsed Field Ablation

Introduction: General anesthesia is commonly utilized during catheter ablation of atrial fibrillation (AF) in the United States, providing patient immobility and permitting esophageal temperature management for radiofrequency ablation. Pulsed field ablation (PFA) is associated with shorter procedure time, less risk of esophageal injury, and less dependence on catheter stability compared with radiofrequency ablation. There are limited data available on performing the procedure with deep sedation as an alternative to general anesthesia with endotracheal intubation. Methods: Consecutive patients who underwent catheter ablation of AF at Endeavor Health (Chicago, IL) using pulsed field ablation (Farapulse, Boston Scientific, Marlborough, MA or PulseSelect, Medtronic, Minneapolis, MN) and deep sedation between March and May 2024 were retrospectively included in this study. Deep sedation (monitored anesthesia care) was administered by a certified registered nurse anesthetist and attending anesthesiologist, consisting of bolus and infusion dosing of propofol, dexmedetomidine, fentanyl, and midazolam at the discretion of the practitioner with continuous monitoring of vital signs and end-tidal CO2. The primary endpoint was the rate of airway complications or requirement for conversion to general anesthesia. Secondary endpoints were the rate of acute procedural success (all pulmonary veins isolated), total time in the EP lab, procedure time (from lidocaine to removal of sheaths), and non-procedure time (difference between total time in lab and procedure time). Results: A total of 40 patients (mean age 70.4 ± 13.6 years, BMI 30.2 ± 7.4, 60% females) were included in the analysis. There were no instances of airway complications or conversion from deep sedation to general anesthesia. There was a 100% rate of acute isolation of pulmonary veins. The average total time in the lab was 156.6 ± 41.5 minutes; consisting of a mean procedure time of 107.1 ± 39.7 minutes and non-procedure time 49.5 ± 10.3 minutes. Conclusions: In this initial experience at a single center, deep sedation (monitored anesthesia care) for PFA was associated with no instances of airway complications. The findings may not apply to patients with moderate or severe obstructive sleep apnea or other pulmonary diseases. Although patients generally were amnestic to the procedure, larger studies incorporating patient-reported outcomes are needed, as well as data regarding long-term clinical outcomes and cost.

Abstract 4136804: Effect of Obesity on Arrhythmia Recurrence and Complications following Pulmonary Vein Isolation for Paroxysmal Atrial Fibrillation in the REAL-AF Registry

Introduction: Obesity is an important risk factor for atrial fibrillation and its prevalence in the United States is rising. The effect of obesity on outcomes following pulmonary vein isolation in a contemporary setting has not been extensively evaluated. Research Questions: - Is higher body mass index (BMI) associated with increased risk of atrial arrhythmia recurrence following pulmonary vein isolation? - Is higher BMI associated with increased risk of post-procedural complications? Method: - The REAL-AF (Real-world Experience of Catheter Ablation for the Treatment of Symptomatic Paroxysmal and Persistent Atrial Fibrillation; ClinicalTrials.gov Identifier: NCT04088071) Registry is a multicenter, prospective observational registry of patients undergoing radiofrequency catheter ablation of atrial fibrillation. We included 2666 patients with paroxysmal atrial fibrillation undergoing index ablation from January 2018 through April 2023. We excluded patients with missing covariates. - The primary outcome was freedom from atrial arrhythmia following ablation. Rhythm monitoring was standardized using patch monitor at 6 month and 1 year. Time-to-event analysis was performed using a 3-month blanking period. Results: - Baseline characteristics are shown in Table 1. The median follow-up was 382 days (IQR: 363-410). - There was a trend toward higher rate of atrial arrhythmia following ablation for patients in the highest BMI group compared with the reference group (BMI&lt;25) ( BMI≥40: HR = 1.41 (0.94-2.12), p= 0.092). There was no difference in the rate of atrial arrhythmia for other BMI groups ( BMI 25 - &lt;30: HR = 0.90 (0.65-1.23), p = 0.5; BMI 30 - &lt;35: HR = 0.89 (0.64-1.23), p = 0.5; BMI 35 - &lt;40: HR = 0.87 (0.57-1.32), p = 0.5). This trend persisted following adjustment for baseline covariates ( BMI 25 - &lt;30: HR = 1.01 (0.77-1.33), p &gt; 0.9; BMI 30 - &lt;35: HR = 0.97 (0.72-1.32), p = 0.9; BMI 35 - &lt;40: HR = 1.01 (0.66-1.55), p &gt; 0.9; BMI≥40: HR = 1.57 (0.96-2.57), p =0.071). - First-pass isolation rates progressively decreased with higher BMI (Table 2). - Complication rates were low across all BMI groups (Table 2). Conclusions: - Severely obese patients with BMI ≥40 experience higher risk of atrial arrhythmia following radiofrequency catheter ablation of paroxysmal atrial fibrillation compared with normal weight individuals. This corresponds with lower rates of first-pass isolation at higher BMI. - Patients across BMI categories experience similarly low rates of procedural complication.

Environmental factors influencing the development and spread of resistance in erythromycin-resistant streptococcus pneumoniae.

Bacterial drug resistance is becoming increasingly serious, this study aims to investigate the relationship between the resistance rate of erythromycin-resistant Streptococcus pneumoniae (SP) and reasons for the epidemic under complex geographical and climatic factors in China. Data spanning from 2014 to 2021, including drug resistance rates, isolate rates, meteorological variables, and demographic statistics, were collected from the China Antimicrobial Resistance Monitoring System, the China Statistical Yearbook and China Meteorological Website. Our analysis involved nonparametric tests and the construction of multifaceted regression models for rigorous multivariate analysis. Single-factor analysis revealed significant differences in the resistance rate and isolate rate of erythromycin-resistant SP across different regions characterized by Hu Huanyong lines or different climate types. Multivariate regression analysis indicated positive correlations between the drug resistance rate and temperature, Subtropical climate, Gross Domestic Product (GDP), Hu Huanyong line, and the highest temperature in the past period (Tm); the isolate rate showed a positive correlation with regional GDP and a negative correlation with monsoon climate. The model developed in this study provides valuable insights into the resistance rate and potential relationships of erythromycin-resistant SP under complex meteorological conditions in China.

Temperature guided high and very high-power short duration ablation for atrial fibrillation treatment - The peQasus multicentre study.

Temperature-controlled high-power short-duration (HPSD) radiofrequency catheter ablation for pulmonary vein isolation (PVI) utilizing a novel ablation catheter (QDOT Micro) with real-time assessment of catheter tip temperature aims for safer, more effective and faster procedures. The peQasus study is a large European multicenter study set up to assess safety, acute efficacy and outcomes of temperature-controlled HPSD based PVI. The primary endpoints were safety, efficacy and 12-months freedom from atrial tachyarrhythmias. Additionally, two strategies namely very HPSD (90W for 4 seconds) only and a hybrid approach (HPSD with maximum of 50W and vHPSD) were compared. A total of 1,023 AF patients in 15 centers from 9 European countries received PVI with the QDOT. Complete PVI was successfully achieved in all patients. In 699/1023 (68.3%) the vHPSD only approach (vHPSD group) and in 324/(31.7%) patients the hybrid approach (hybrid group) was utilized. The mean procedure duration was 98.4±37.4 min (vHPSD: 88.2±34.9min, hybrid: 117.4±32.7min, p<0.001). The first pass isolation rate of all PVs was 64% (vHPSD: 62.6%, hybrid: 67.1%, p=0.187). Severe adverse events were observed in 1.7% (vHPSD: 1.6%, hybrid: 1.9%, p=0.746). 12-month arrhythmia-recurrence free survival was 77.1% (vHPSD: 76.8%, hybrid: 77.8%, p=0.241). In this large multicentre study temperature-controlled HPSD and vHPSD ablation via a novel ablation catheter provides safe and effective PVI with a relatively short procedure duration. Despite a shorter procedure time no differences in terms of safety and freedom from arrhythmia-recurrence were found irrespective of utilizing vHPSD or the hybrid approach.

A Hybrid Data-Driven Method for Main Circuit Gound Faults Diagnosis in Electrical Traction Drive Systems

A main circuit ground fault (MCGF) is a typical system fault in an electrical traction drive system (ETDS). When two or more MCGFs occur, it will cause serious accidents. Therefore, it is particularly important to detect and handle MCGFs in a timely manner. To improve the efficiency of train operation and ensure driving safety, this paper proposes a hybrid data-driven MCGF diagnosis method. First, the voltage signals related to the fault are selected according to the mechanism analysis of the MCGF, and then the initial feature variables are constructed according to these voltage signals. Secondly, the initial feature variables of different types of MCGF are analyzed in the time and frequency domains by wavelet transform, and four feature indicators are calculated. Finally, the fault feature indicators are trained by random forest to obtain a model for subsequent fault diagnosis. After comparative experiments using various machine learning methods, it was found that the RF used in the proposed method has a better diagnostic effect, and the correct isolation rate exceeds 99%.

Genome and antibiotic resistance characteristics of Shigella clinical isolates in Fujian Province, Southeast China, 2005-2019.

Shigellosis is a serious public health issue in many developing countries. The emergence of multidrug-resistant (MDR) Shigella isolates has deepened the treatment difficulty and health burden of shigellosis. China is the largest developing country in the world, but so far, the genome of MDR Shigella isolates has not been well characterized. In this study, 60 clinical isolates of Shigella spp. in Fujian Province, southeast China, from 2005 to 2019 were characterized for drug resistance phenotype, whole-genome sequencing and bioinformatics analysis. The results showed that the MDR rate of Shigella isolates was 100%, among which the resistance rates of cefotaxime, ciprofloxacin and azithromycin were 36.67, 21.67 and 10.00 %, respectively. The positive rate of extended-spectrum beta-lactamase (ESBL)-producing strains was 23.33%. The resistance profiles of Shigella flexneri and Shigella sonnei to some antimicrobials differed. The MDR isolates carried multiple antimicrobial resistance genes, among which blaCTX-M-14 and blaCTX-M-15 mediated ESBL resistance. 'ISEcp1 -blaCTX-M -IS903' (type I) and 'ISEcp1 -blaCTX-M' (type II) were the most common genetic environments around the blaCTX-M genes, and plasmids containing these structures included IncFII, IncI1, IncI2 and IncN. The double gene mutation pattern of gyrA and parC resulted in a significant decrease in the sensitivity of S. flexneri to ciprofloxacin. The overall resistance phenotype and genotype concordance rate was 88.50%, and the sensitivity and specificity of the genotype antimicrobial susceptibility test (AST) were 93.35 and 82.53 %, respectively. However, inconsistency occurred between phenotypic and genotype profiles for a few antibiotics. Phylogenomic investigation with core genome multi-locus sequence typing (cgMLST) and SNPs were used to characterize the endemic transmission of these infections in Fujian and their evolutionary origin within the global context. For S. flexneri, Fujian isolates were all limited to PG3 and could be divided into three phylogenetic clusters. The ciprofloxacin-resistant strains were mainly F2a and FXv and assigned to the three clusters with different quinolone resistance-determining region mutation patterns. For S. sonnei, most Fujian strains belonged to Lineage III with genotype 3.7.6, except three isolates of Lineage I with genotype 1.3. The strains carrying the blaCTX-M genes were dispersed, indicating different origins of gene acquisition. Most of the circulating isolates in Fujian Province were not related to major international outbreak lineages and were only endemic to the country. In conclusion, multi-drug resistance of Shigella isolates in Fujian Province was serious, and genome-based laboratory surveillance will be crucial to the clinical treatment and public health measures for shigellosis.

Virological and Clinical Outcomes of Influenza Outpatients Treated With Baloxavir, Oseltamivir, or Laninamivir in the 2023-2024 Season.

Clinical data on patients infected with influenza B Victoria (BV) after the approval of baloxavir is lacking. This observational study of the Japanese 2023-2024 influenza season analyzed data from 25 outpatients with A(H1N1)pdm09, 36 with A(H3N2), and 65 with BV. Viral samples were collected before and after administering an antiviral (70 patients received baloxavir and 56 received a neuraminidase inhibitor), on days 1, 5, and 10. Isolated viruses after culturing were amplified using RT-PCR and sequenced to detect mutations of concern, including acidic protein (PA)-amino acid (AA) E23X/I38X for influenza A and M34X/I38X for BV. Fever and symptoms were tracked via self-reporting diaries. No PA-AA-substituted virus was detected from 126 pre-treatment samples. In the baloxavir cohort, one (7.1%, 1/14) PA I38F-substituted A(H1N1)pdm09 and two (11.1%, 2/18) PA I38T-substituted A(H3N2) viruses were isolated on day 5 but not on day 10. No (0%, 0/37) PA-AA-substituted BV was detected on day 5 or after. The virus isolation rate on day 5 was higher among patients with BV than with influenza A in both baloxavir (35.1% vs. 14.3% for A(H1N1)pdm09 and 16.7% for A(H3N2)) and oseltamivir-treated patients (44.4% vs. 0% for A(H1N1)pdm09 and 33.3% for A(H3N2)). Patients with PA-AA-substituted influenza A after baloxavir administration did not have longer fever duration than those without virus isolation or with wild-type virus on day 5, for both A(H1N1)pdm09 and A(H3N2). Baloxavir-resistant variants were not detected in influenza BV before treatment, as with A. The emergence of PA-AA-substituted influenza A after baloxavir administration was temporal and did not cause prolonged symptoms. No baloxavir-resistant BV variants were observed after baloxavir administration.

Pulmonary Aspergillosis: An Observation from a Tertiary Care Hospital of Western Uttar Pradesh

Background: Aspergillus is the most frequently occurring fungal infection in immunocompromised patients with a high mortality rate. Invasive pulmonary aspergillosis is the most serious entity on the spectrum of pulmonary aspergillosis. Limited studies on the occurrence of pulmonary aspergillosis from this geographical area prompted us to carry out this study. Materials and Methods: This hospital-based cross-sectional observational study was carried out in the Postgraduate Department of Microbiology of a tertiary care medical teaching hospital in western Uttar Pradesh for one year. A total of 1032 respiratory samples were subjected for isolation and identification of fungal pathogens by direct microscopic examination (KOH mount) and culture on Sabouraud dextrose agar. Results: The isolation rate of pulmonary aspergilli was 6.97%. The majority of the respiratory samples received were sputum 900 (87.2%) followed by bronchoalveolar lavage fluid 132 (12.7%). The pulmonary pathology was predominantly seen in the age group of 41–50 years (25%). Male patients (69%) were predominant. The majority of the samples (50%) were from the respiratory medicine ward followed by the respiratory medicine ICU (25%). Aspergillus fumigatus (58%) was the predominant species isolated followed by Aspergillus flavus (25%). Conclusion: Isolation of Aspergillus species from patients of pulmonary pathology needs to be correlated clinically to rule out colonization as they may need proper antifungal treatment. Indiscriminate use of antifungals may lead to the emergence of antifungal drug resistance.

Determination of some mycotoxins from poultry feed in Baghdad city

The aims of this study were to determine some mycotoxins and to isolate the fungi from chicken feed samples from broiler and layer farms in Baghdad city. The isolation rate (percentage) of fungi from poultry feed samples was Aspergillus niger 17.7%, Aspergillus flavus 14.7%, Aspergillus fumigatus 12.4%, Aspergillus ochraceus 10.7%, Penicillium spp. 9.3%, Fusarium spp. 9.3%, Rhizopus spp. 8.4%, Mucar spp. 8.4%, Absidia spp. 7.6% and Chrysonilia sitophila 1.5%, while the most common yeast genera were Candida spp. 44.8%, Candida albicans 20.7%, Cryptococcus neoformans 17.3%, Geotricum candidum 12% and Trichosorom spp. 5.2%. The mycotoxins ochratoxin A (OTA), deoxynivalenol (DON), fumonisin B1 (FB1) and zearalenone (ZON) were detected, and the percentages of these mycotoxins were 43.1%, 27.2%, 21.1% and 8.6%, respectively. This study indicates that the presence of mold that produce mycotoxins in poultry feed increases the risk of mycotoxins in feed, meat, eggs, etc. of animals and therefore humans, and we need to raise awareness of the Ministry of Agriculture and Health to prevent these measures to reduce the mycotoxin levels in poultry products.