Upregulation of the cfiA carbapenemase gene in a Bacteroides fragilis strain by the novel integrative and conjugative element Tn7563.

We describe Tn7563, a 31,844-bp integrative and conjugative element (ICE) carrying promoters upregulating the cfiA carbapenemase gene in Bacteroides fragilis strain Tbg-22. Excision and circularization of Tn7563 was demonstrated by PCR. Previously, only insertion sequences (IS) have been shown to carry mobile promoters for cfiA.

Antimicrobial susceptibility testing of Bacteroides species by disk diffusion: The NordicAST Bacteroides study.

Objectives: Antimicrobial susceptibility testing (AST) of anaerobic bacteria has until recently been done by MIC methods. We have carried out a multi-centre evaluation of the newly validated EUCAST disk diffusion method for AST of Bacteroides spp.

Methods: A panel of 30 Bacteroides strains was assembled based on reference agar dilution MICs, resistance gene detection and quantification of cfiA carbapenemase gene expression.

Measuring broad-spectrum antibiotic use in hospitals with established versus new indicators.

Background: The target of a 30 % reduction in the use of broad-spectrum antibiotics in hospitals from 2012 to 2020 was not achieved, measured using the standard indicator of defined daily doses (DDD) per 100 bed days. We wished to investigate the reliability of the standard indicator and of selected alternative indicators for antibiotic use, and to determine the actual reduction in use.

Material And Method: We included ten DDD-based indicators with adjustment for combinations of activity marker, admission category (inpatient vs.

The alginate polymer OligoG alters susceptibility of biofilm-embedded non-typeable to ampicillin and ciprofloxacin.

Objectives: Treatment of respiratory infections with non-typeable (NTHi) in COPD patients is complicated by biofilm formation, protecting the bacteria against the hosts' immune response and antibiotics. We investigated the antibiofilm and antibacterial effects of the alginate polymer OligoG, alone or combined with ampicillin or ciprofloxacin, on mature NTHi biofilms.

Materials And Methods: Two unrelated COPD strains with PBP3-mediated β-lactam resistance, with additional TEM-1 β-lactamase (Hi-022) or quinolone resistance due to altered GyrA and ParC (Hi-072) were used.

Characterization and Fitness Cost of Tn, a Novel Integrative and Conjugative Element Conferring Multidrug Resistance in .

A multidrug-resistant (MDR) strain of , Hi-228, with phenotypic resistance toward ampicillin, cefotaxime, chloramphenicol, gentamicin, and azithromycin, was isolated in Oslo, Norway. The strain was part of a clonal outbreak (2016-2017) comprising five ST143 strains with identical resistotypes. Hi-228 carries a novel integrative and conjugative element (ICE), Tn, contributing to this remarkable and previously unreported MDR profile.

Case Report: Whole-Genome Sequencing of Serially Collected From a Patient With Common Variable Immunodeficiency Reveals Within-Host Evolution of Resistance to Trimethoprim-Sulfamethoxazole and Azithromycin After Prolonged Treatment With These Antibiotics.

We report within-host evolution of antibiotic resistance to trimethoprim-sulfamethoxazole and azithromycin in a nontypeable strain from a patient with common variable immunodeficiency (CVID), who received repeated or prolonged treatment with these antibiotics for recurrent respiratory tract infections. Whole-genome sequencing of three longitudinally collected sputum isolates during the period April 2016 to January 2018 revealed persistence of a strain of sequence type 2386. Reduced susceptibility to trimethoprim-sulfamethoxazole in the first two isolates was associated with mutations in genes encoding dihydrofolate reductase ( and its promotor region, dihydropteroate synthase (), and thymidylate synthase (), while subsequent substitution of a single amino acid in dihydropteroate synthase (G225A) rendered high-level resistance in the third isolate from 2018.

Loss of smell or taste as the only symptom of COVID-19.

Background: Olfactory and taste disorders (OTDs) have recently been reported among patients with COVID-19, and it has been hypothesised that oral and nasal tissues may contain host cells of SARS-CoV-2. We report on two cases (spouses) with SARS-CoV-2 infection with self-reported OTDs, but otherwise no typical respiratory symptoms of COVID-19.

Case Presentation: A man in his nineties (index patient) had respiratory symptoms and dysgeusia, and was diagnosed with COVID-19.

Role of Horizontal Gene Transfer in the Development of Multidrug Resistance in Haemophilus influenzae.

colonizes the respiratory tract in humans and causes both invasive and noninvasive infections. Resistance to extended-spectrum cephalosporins in is rare in Europe. In this study, we defined acquired resistance gene loci and mutations in multidrug-resistant (MDR) and/or PBP3-mediated beta-lactam-resistant (rPBP3) strains, intending to understand the mode of spread of antibiotic resistance determinants in this species.

Chlamydia testing in practice - requisitioners and patients.

Background: Optimising the diagnostic work-up and treatment of genital chlamydia infection requires knowledge of the sampling patterns of those who order chlamydia tests. We wished to determine which groups of doctors collect specimens for chlamydia testing, and to examine the sex and age distribution of patients tested, and the proportion of positive tests, from general practitioners, gynaecologists in private practice, and youth health services.

Material And Method: The study includes 43 465 specimens analysed for genital infection with Chlamydia trachomatis at Vestfold Hospital Trust over the period 1 January 2007 to 31 December 2011.

Prevalence of M. genitalium and U. urealyticum in urine tested for C. trachomatis.

Background: Mycoplasma genitalium and Ureaplasma urealyticum cause sexually transmitted infections. While M. genitalium is an established aetiological agent, U.

Haemophilus influenzae with Non-Beta-Lactamase-Mediated Beta-Lactam Resistance: Easy To Find but Hard To Categorize.

Haemophilus influenzae is a major pathogen, and beta-lactams are first-line drugs. Resistance due to altered penicillin-binding protein 3 (rPBP3) is frequent, and susceptibility testing of such strains is challenging. A collection of 154 beta-lactamase-negative isolates with a large proportion of rPBP3 (67.

Antibiotic resistance patterns of bacteria causing urinary tract infections in the elderly living in nursing homes versus the elderly living at home: an observational study.

Background: Antibiotic resistance is a problem in nursing homes. Presumed urinary tract infections (UTI) are the most common infection. This study examines urine culture results from elderly patients to see if specific guidelines based on gender or whether the patient resides in a nursing home (NH) are warranted.

Mycoplasma pneumoniae detection causes excess antibiotic use in Norwegian general practice: a retrospective case-control study.

Background: The 2011 Mycoplasma pneumoniae epidemic in Norway resulted in many GP consultations and significantly increased the prescription of macrolide antibiotics.

Aim: To investigate the signs, symptoms, course, and prescription patterns of antibiotics in patients positive for M. pneumoniae compared with patients negative for M.

Multilocus sequence typing and ftsI sequencing: a powerful tool for surveillance of penicillin-binding protein 3-mediated beta-lactam resistance in nontypeable Haemophilus influenzae.

Background: Beta-lactam resistance in Haemophilus influenzae due to ftsI mutations causing altered penicillin-binding protein 3 (PBP3) is increasing worldwide. Low-level resistant isolates with the N526K substitution (group II low-rPBP3) predominate in most geographical regions, while high-level resistant isolates with the additional S385T substitution (group III high-rPBP3) are common in Japan and South Korea.Knowledge about the molecular epidemiology of rPBP3 strains is limited.

[An outbreak of Yersinia enterocolitica O:9-infection].

Background: Yersiniosis is a zoonosis that is transmitted from pigs to humans. In January 2006 more cases of Yersinia enterocolitica enterocolitis than expected were reported in Norway. The fact that the isolates belonged to the O:9 serogroup, which is rare in Norway, and the geographical and temporal clustering of the cases, pointed to an outbreak.