Household transmission of non-toxigenic diphtheria toxin gene-bearing following a cluster of cutaneous cases in a specialist outpatient setting.

Combination of PCR and Elek testing to identify toxigenic corynebacteria has revealed organisms described as non-toxigenic toxin-gene bearing (NTTB) or (i.e. PCR positive; Elek negative).

Investigating Pseudomonas aeruginosa population structure and frequency of cross-infection in UK cystic fibrosis clinics - a reference laboratory perspective.

Background: We aimed to describe the UK Pseudomonas aeruginosa population structure amongst people with cystic fibrosis (PWCF), and to examine evidence for cross-infection.

Methods: Variable Number Tandem Repeat (VNTR) typing was performed on 4640 isolates from 2619 PWCF received from 55 hospital laboratories between 2017 and 2019. A combination of whole genome sequence (WGS)-based analysis of four clusters from one hospital, and epidemiological analysis of shared strains in twelve hospitals evaluated cross-infection.

Wide distribution of carrying IncF plasmids containing and resistance genes from hospitalized patients in England.

. The New Delhi metallo-β-lactamase (NDM) variant NDM-5 was first described in 2011 in an isolate of . We noted that a high proportion of isolates of positive for carbapenemase genes submitted to the UK Health Security Agency (formerly Public Health England) between 2019 and mid-2021 carried the allele, with many co-harbouring , rendering them highly resistant to aminoglycosides as well as to most β-lactams.

Diversity of carbapenemase-producing in England as revealed by whole-genome sequencing of isolates referred to a national reference laboratory over a 30-month period.

Increasing numbers of carbapenemase-producing (CPE), which can be challenging to treat, have been referred to the national reference laboratory in England since the early 2000s. Previous studies on CPE in the UK have focussed on localized outbreaks. We applied whole-genome sequencing (WGS) to isolates referred to the national reference laboratory over 30 months to inform our understanding of CPE epidemiology in England.

Presence of mediated linezolid resistance in multiple lineages and plasmids of revealed by long read sequencing.

Transferable linezolid resistance due to , , and -like genes is increasingly detected in enterococci associated with animals and humans globally. We aimed to characterize the genetic environment of in linezolid-resistant isolates from Scotland. Six linezolid-resistant isolated from urogenital samples were confirmed to carry the gene by PCR.

Activity of imipenem/relebactam against Pseudomonas aeruginosa producing ESBLs and carbapenemases.

Background: ESBL- and carbapenemase-producing Pseudomonas aeruginosa are prevalent in, for example, the Middle East, Eastern Europe and Latin America, though rarer elsewhere. Because P. aeruginosa readily mutate to become carbapenem resistant via loss of OprD, isolates producing ESBLs are often as broadly resistant as those producing carbapenemases.

Carbapenem-Resistant Enterobacterales, Carbapenem Resistant Organisms, Carbapenemase-Producing Enterobacterales, and Carbapenemase-Producing Organisms: Terminology Past its "Sell-By Date" in an Era of New Antibiotics and Regional Carbapenemase Epidemiology.

Carbapenem resistance in Gram-negative bacteria is a public health concern. Consequently, numerous government and agency reports discuss carbapenem-resistant Enterobacterales (CRE) and carbapenem-resistant organisms (CROs). Unfortunately, these terms are fuzzy.

The characterization of mobile colistin resistance () genes among 33 000 genomes from routine public health surveillance in England.

To establish the prevalence of mobile colistin resistance () genes amongst isolates obtained through public health surveillance in England (April 2014 to September 2017), 33 205 . genome sequences obtained from human, food, animal and environmental isolates were screened for the presence of variants 1 to 8. The -positive genomes were assembled, annotated and characterized according to plasmid type.

Evaluation of the AusDiagnostics MT CRE EU assay for the detection of carbapenemase genes and transferable colistin resistance determinants mcr-1/-2 in MDR Gram-negative bacteria.

Objectives: To evaluate the AusDiagnostics MT CRE EU assay for the detection of carbapenemase and acquired colistin resistance genes in Gram-negative bacteria.

Methods: The assay allows the detection of blaKPC, blaOXA-48-like, blaNDM, blaVIM, blaIMP, blaSIM, blaGIM, blaSPM, blaFRI, blaIMI, blaGES (differentiating ESBL and carbapenemase variants), blaSME and mcr-1/-2. It was evaluated against a panel of isolates including Enterobacteriaceae, Pseudomonas spp.

Activity of ceftazidime/avibactam against problem Enterobacteriaceae and Pseudomonas aeruginosa in the UK, 2015-16.

Background: Ceftazidime/avibactam combines an established oxyimino-cephalosporin with the first diazabicyclooctane β-lactamase inhibitor to enter clinical use. We reviewed its activity against Gram-negative isolates, predominantly from the UK, referred for resistance investigation in the first year of routine testing, beginning in July 2015.

Methods: Isolates were as received from referring laboratories; there is a bias to submit those with suspected carbapenem resistance.

Multicentre evaluation of the BYG Carba v2.0 test, a simplified electrochemical assay for the rapid laboratory detection of carbapenemase-producing Enterobacteriaceae.

Rapid detection of carbapenemase-producing Enterobacteriaceae (CPE) represents a major challenge for microbiology laboratories. We evaluated the BYG Carba v2.0 using a simplified protocol, which detects CPE in less than 30 minutes.

FRI-2 carbapenemase-producing Enterobacter cloacae complex in the UK.

Objectives: Detection of rarer carbapenemases is challenging, as it requires molecular assays with comprehensive coverage or the use of phenotypic methods for the detection of carbapenemase activity. We describe a new class A carbapenemase, FRI-2, in an Enterobacter cloacae complex isolate following implementation of an in-house multiplex PCR for the detection of 'rare' class A carbapenemases.

Methods: MICs were determined by agar dilution.

Activity of ceftolozane/tazobactam against surveillance and 'problem' Enterobacteriaceae, Pseudomonas aeruginosa and non-fermenters from the British Isles.

Background: We assessed the activity of ceftolozane/tazobactam against consecutive isolates collected in the BSAC Bacteraemia Surveillance from 2011 to 2015 and against 'problem' isolates sent to the UK national reference laboratory from July 2015, when routine testing began.

Methods: Susceptibility testing was by BSAC agar dilution with resistance mechanisms identified by PCR and interpretive reading.

Results: Data were reviewed for 6080 BSAC surveillance isolates and 5473 referred organisms.

OXA-48-like carbapenemases in the UK: an analysis of isolates and cases from 2007 to 2014.

Objectives: OXA-48-like carbapenemases have spread worldwide since 2001. We analysed patient and microbiological data for UK isolates with these enzymes as confirmed by the national reference laboratory from November 2007 to December 2014.

Methods: MICs were determined using BSAC agar dilution.

Characterization of carbapenemase-producing Enterobacteriaceae in the West Midlands region of England: 2007-14.

Objectives: Carbapenemase-producing Enterobacteriaceae (CPE) have been increasingly reported in the UK since 2003. We analysed patient and isolate data for CPE confirmed by the national reference laboratory from laboratories in the West Midlands region from November 2007 to December 2014.

Methods: MICs were determined by BSAC agar dilution methodology and isolates exhibiting resistance to one or more carbapenems were screened for carbapenemase genes by PCR.

Carbapenemase-producing Enterobacteriaceae in the UK: a national study (EuSCAPE-UK) on prevalence, incidence, laboratory detection methods and infection control measures.

Objectives: To estimate UK prevalence and incidence of clinically significant carbapenemase-producing Enterobacteriaceae (CPE), and to determine epidemiological characteristics, laboratory methods and infection prevention and control (IPC) measures in acute care facilities.

Methods: A 6 month survey was undertaken in November 2013-April 2014 in 21 sentinel UK laboratories as part of the European Survey on Carbapenemase-Producing Enterobacteriaceae (EuSCAPE) project. Up to 10 consecutive, non-duplicate, clinically significant and carbapenem-non-susceptible isolates of Escherichia coli or Klebsiella pneumoniae were submitted to a reference laboratory.

Characterization of new Salmonella serovars by whole-genome sequencing and traditional typing techniques.

Serotyping forms the basis of all national and international surveillance networks for Salmonella. Public health microbiology is currently being transformed by high-throughput DNA sequencing, which opens the door to serovar determination using this powerful technique. Twenty-nine Salmonella isolates referred to the Public Health England between 1994 and 2004 for serovar identification were selected for this study, and they all presented with novel antigenic formulae.