Publications by authors named "Emma Mills"

Anthropogenic litter is one of the most important factors that influence recreation users and their activities because of its correlation to the river and environmental health. We monitored pollution levels on the Illinois river, near Tahlequah, OK for three months and surveyed the publics opinion on the issue. Our goal was to get this data to local and state management agencies to management practices to keep the scenic Illinois River clean.

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In 2021, two US military hospitals, Landstuhl Regional Medical Center in Landstuhl, Germany, and Walter Reed National Military Medical Center (WRNMMC) in Bethesda, Maryland, USA, observed a high prevalence of multidrug-resistant bacteria among refugees evacuated from Afghanistan during Operation Allies Refuge. Multidrug-resistant isolates collected from 80 patients carried an array of antimicrobial resistance genes, including carbapenemases (bla, bla, and bla) and 16S methyltransferases (rmtC and rmtF). Considering the rising transmission of antimicrobial resistance and unprecedented population displacement globally, these data are a reminder of the need for robust infection control measures and surveillance.

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Article Synopsis
  • Current outbreak detection methods in hospitals are inadequate on their own; a new program called the Enhanced Detection System for Healthcare-associated Transmission (EDS-HAT) uses real-time genomic surveillance to identify outbreaks.
  • The study, conducted at UPMC Presbyterian Hospital from November 2021 to October 2023, involved weekly whole genome sequencing of bacterial isolates, leading to the identification of 172 outbreaks and successful intervention strategies that prevented further transmission in over 95% of cases.
  • Results revealed significant benefits: 62 infections were avoided, translating to over $1 million in gross savings and a net savings of nearly $700,000, showing that integrating genomic surveillance can greatly enhance infection control and patient safety.
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  • ST131 E. coli is a globally recognized strain that causes hard-to-treat, multidrug-resistant infections due to its production of extended-spectrum β-lactamases (ESBLs).
  • Researchers sequenced the genomes of 154 clinical isolates from the ST131 lineage at the University of Pittsburgh Medical Center and found that clade C predominated, comprising 89% of the samples.
  • Analysis revealed genes under selection in clade C and highlighted the diversity of ESBL-encoding genes and mobile elements, indicating ongoing adaptation in this strain.
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  • VREfm is a significant healthcare-acquired pathogen that can lead to serious bloodstream infections, and previous studies focused on its presence within healthcare facilities.
  • A study involving 710 clinical isolates collected from 2017-2022 revealed that nearly half of the isolates formed genetically similar clusters, indicating a high rate of transmission in the hospital.
  • Comparison with a large database of VREfm genomes over 20 years showed a notable shift in the populations of VREfm within hospitals, suggesting that antimicrobial peptides like bacteriocin T8 might play a crucial role in the emergence and persistence of these strains.
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  • VRE infections are a major healthcare challenge due to their complex transmission dynamics, which involve patient colonization and spread through various healthcare settings.
  • Whole genome sequencing (WGS) was used to analyze 352 clinical and 891 rectal screening VRE isolates, revealing that the majority (87.3%) of VRE infections were acquired through rectal carriage.
  • The study identified significant genetic relatedness among isolates and hotspots for VRE transmission, emphasizing the importance of WGS in infection control and highlighting the impact on patient outcomes, including ICU admissions and mortality rates.
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  • NDM (New Delhi metallo-β-lactamase) is a significant threat due to its role in carbapenem resistance, leading to high mortality and few treatment options.
  • An outbreak at an acute care hospital was detected using traditional infection prevention methods and supplemented with weekly whole genome sequencing (WGS), which revealed complex plasmid transfer dynamics between various bacterial species.
  • The investigation identified 15 patients with NDM-5-producing Enterobacterales, illustrating the effectiveness of combining traditional and genomic approaches in tracking and controlling outbreaks involving plasmid transfer and bacterial spread.
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  • ST131 is a global lineage of bacteria that causes drug-resistant infections, often producing enzymes that make treatment challenging.
  • Researchers sequenced genomes of 154 drug-resistant isolates from a hospital to understand the lineage better.
  • The study found that subclades C1 and C2 were the most common and indicated signs of ongoing changes within the bacteria, which could affect their treatment and spread.
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We describe 2 cases of extensively drug-resistant Pseudomonas aeruginosa infection caused by a strain of public health concern, as it was recently associated with a nationwide outbreak of contaminated artificial tears. Both cases were detected through database review of genomes in the Enhanced Detection System for Hospital-Associated Transmission (EDS-HAT), a routine genome sequencing-based surveillance program. We generated a high-quality reference genome for the outbreak strain from an isolate from our center and examined the mobile elements encoding blaVIM-80 and bla-GES-9 carbapenemases.

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Background: New Delhi metallo-β-lactamase (NDM) represents an emergent mechanism of carbapenem resistance associated with high mortality and limited antimicrobial treatment options. Because the resistance gene is often carried on plasmids, traditional infection prevention and control (IP&C) surveillance methods like speciation, antimicrobial resistance testing, and reactive whole genome sequencing (WGS) may not detect plasmid transfer in multispecies outbreaks.

Methods: Initial outbreak detection of NDM-producing Enterobacterales identified at an acute care hospital occurred via traditional IP&C methods and was supplemented by real-time WGS surveillance, which was performed weekly using the Illumina platform.

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We describe two cases of XDR infection caused by a strain of public health concern recently associated with a nationwide outbreak of contaminated artificial tears. Both cases were detected through database review of genomes in the Enhanced Detection System for Hospital-Associated Transmission (EDS-HAT), a routine genome sequencing-based surveillance program. We generated a high-quality reference genome for the outbreak strain from one of the case isolates from our center and examined the mobile elements encoding and carbapenemases.

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We report a genome sequence of Wohlfahrtiimonas chitiniclastica strain MUWRP0946, isolated from a hospitalized patient in Uganda. The genome size was 2.08 million bases, and the genome completeness was 94.

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Background: Extra-intestinal pathogenic Escherichia coli (ExPEC) are a leading cause of bloodstream and urinary tract infections worldwide. Over the last two decades, increased rates of antibiotic resistance in E. coli have been reported, further complicating treatment.

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Background: ESKAPEE pathogens Enterococcus faecium, Staphylococcus aureus, Klebsiella pneumoniae, Acinetobacter baumannii, Pseudomonas aeruginosa, Enterobacter spp. and Escherichia coli are multi-drug resistant (MDR) bacteria that present increasing treatment challenges for healthcare institutions and public health worldwide.

Methods: 431 MDR ESKAPEE pathogens were collected from Queen Sirikit Naval Hospital, Chonburi, Thailand between 2017 and 2018.

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Article Synopsis
  • - The study focuses on the prevalence and characteristics of *Enterobacteriaceae* in clinical infections, particularly urinary tract and skin infections, across five counties in Kenya from 2015 to 2020, identifying various sequence types and their antimicrobial resistance profiles.
  • - Results revealed that over 31% of the isolates were multidrug-resistant (MDR), with a significant number exhibiting resistance to widely used antibiotics, including piperacillin and levofloxacin, along with several identified resistance genes and notable virulence factors.
  • - High-risk clones were prevalent, including known global types like ST244 and ST357, with the study also uncovering a novel MDR clone (ST3674) that carries a large number of virulence genes
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Bacillus cereus group isolates ( = 85) were screened for phenotypic resistance to 18 antibiotics using broth microdilution and CLSI M45 spp. breakpoints. The susceptibility to 9 out of 18 antibiotics was also tested using disk diffusion method and M100 Staphylococcus spp.

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Objectives: is a leading cause of community- and hospital-acquired infections. Successful treatment is hampered by its remarkable ability to rapidly develop resistance to antimicrobial agents, primarily through mutation. In response, WHO listed carbapenem-resistant as a Priority 1 (Critical) pathogen for research and development of new treatments.

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A protracted outbreak of New Delhi metallo-β-lactamase (NDM)-producing carbapenem-resistant started in Tuscany, Italy, in November 2018 and continued in 2020 and through 2021. To understand the regional emergence and transmission dynamics over time, we collected and sequenced the genomes of 117 extensively drug-resistant, NDM-producing isolates cultured over a 20-mo period from 76 patients at several healthcare facilities in southeast Tuscany. All isolates belonged to high-risk clone ST-147 and were typically nonsusceptible to all first-line antibiotics.

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Gram-positive, spore-forming members of the group species complex are widespread in natural environments and display various degrees of pathogenicity. Recently, group strain Flugge ATCC 21929 was found to represent a novel lineage within the species complex, sharing a relatively low degree of genomic similarity with all group genomes (average nucleotide identity [ANI] < 88). ATCC 21929 has been previously associated with the production of a patented antibiotic, antibiotic 60-6 (i.

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Background: Homeless patients have complex health needs. They also often describe difficulty accessing and maintaining access to clinical services. Although engagement with health care has been explored from the patient perspective, little is known about how health care professionals conceptualize, assess and promote engagement with health care among homeless persons.

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