Genomic analysis of the initial dissemination of carbapenem-resistant clones in a tertiary hospital.

Carbapenem-resistant is a major cause of hospital-acquired infections and the fastest-growing pathogen in Europe. Carbapenem resistance was detected at the Consorcio Hospital General Universitario de Valencia (CHGUV) in early 2015, and there has been a significant increase in carbapenem-resistant isolates since then. In this study, we collected carbapenem-resistant isolates from this hospital during the period of increase (from 2015 to 2019) and studied how carbapenem-resistant isolates emerged and spread in the hospital.

Tracking the Emergence and Dissemination of a Gene in a Multidrug Resistance Plasmid of Klebsiella pneumoniae.

Since the discovery of , NDM β-lactamases have become one of the most widespread carbapenemases worldwide. To date, 43 different NDM variants have been reported but some, such as , have not been characterized in detail yet. Here, we describe the emergence of a novel allele from a ancestor and the multidrug resistance plasmid that has disseminated it through a Klebsiella pneumoniae ST437 clone in several Spanish hospitals.

Molecular epidemiology and drug-resistance mechanisms in carbapenem-resistant Klebsiella pneumoniae isolated in patients from a tertiary hospital in Valencia, Spain.

Objectives: The aim of this study has been to characterize carbapenem-resistant Klebsiella pneumoniae isolates and to determine the resistance mechanisms involved, the clonal relationship between strains and clinical and demographical data of the infected patients.

Methods: Clinical and demographical data from patients were collected and statistically analysed. Antimicrobial susceptibility testing was performed and resistance genes were detected both phenotypically and genotypically.

Detection of two simultaneous outbreaks of Klebsiella pneumoniae coproducing OXA-48 and NDM-1 carbapenemases in a tertiary-care hospital in Valencia, Spain.

is one of the most common hospital-acquired Gram-negative pathogens. During the last decade, the emergence of strains with reduced susceptibility or resistance to carbapenems is becoming a therapeutic challenge. This study takes place after the isolation of 14 strains of carbapenem-resistant with similar susceptibility patterns and carriage of OXA-48 and NDM-1 carbapenemases genes.

Evaluation of a mass spectrometry and Vitek 2 combined protocol for rapid identification and susceptibility testing of Enterobacterales directly from positive blood cultures.

Objective: The aim was to evaluate a rapid method which would combine identification and susceptibility testing directly from positive blood cultures for Gram-negative bacilli of the Enterobacterales.

Material And Methods: Gram-negative rods from blood cultures were directly identified by MALDI-TOF. Samples with Enterobacterales were selected for direct antimicrobial susceptibility testing by Vitek 2.

Clinical Role of Subtraction Ictal SPECT Coregistered to MR Imaging and (18)F-FDG PET in Pediatric Epilepsy.

Unlabelled: A precise assessment of the drug-resistant epileptic pediatric population for surgical candidacy is often challenging, and to date there are no evidence-based guidelines for presurgical identification of the epileptogenic zone. To evaluate the usefulness of radionuclide imaging techniques for presurgical evaluation of epileptic pediatric patients, we compared the results of video-electroencephalography (EEG), brain MR imaging, interictal SPECT, ictal SPECT, subtraction ictal SPECT coregistered to MR imaging (SISCOM), and interictal PET with (18)F-FDG.

Methods: Fifty-four children with drug-resistant epilepsy who had undergone video-EEG monitoring, brain MR imaging, interictal and ictal brain perfusion SPECT, SISCOM, and (18)F-FDG PET were included in this study.

Integration of advanced 3D SPECT modeling into the open-source STIR framework.

Purpose: The Software for Tomographic Image Reconstruction (STIR, http://stir.sourceforge.net) package is an open source object-oriented library implemented in C++.

EEG and carotid cutaneous plethysmographic monitoring during carotid reconstructive surgery.

A total of 231 patients with atheromatous ulcerations of the carotid artery and obstructions due to critically stenotic plaques or kinks underwent reconstructive surgery mainly of the internal carotid artery, under general anesthesia, normocarbia, and without increasing the systemic blood pressure. Continuous electroencephalography and phot pulses from the cutaneous territories of the internal and the external carotid arteries were used to monitor 250 carotid operations. An intraoperative test, clamping of the common carotid artery and its two branches for 3 min, was performed on each patient.

[Embolization with adipose tissue (author's transl)].

The authors present their animal experimental work on adipose tissue as an occlusive agent, using the renal and carotid areas as parenchyma in which to test its effect. Work was planned in four series: the first with a survival rate of 24 to 72 h, the second with a survival rate of 7 to 18 days, the third, 45 to 58 days, and the fourth, 58 to 90 days. Angiographic and anatomopathologic postembolization controls were performed, thus supplying conclusive radiologic and histologic documentation on the embolization material under study.