Skin cancer referrals by nonmedical practitioners: a prospective observational study.

The aim of this study was to investigate the appropriateness of suspected skin cancer referrals made by nonmedical practitioners (NMPs) and compare this with referrals made by local general practitioners (GPs). Data were collected prospectively from patients referred from primary care to a UK hospital dermatology department. The profession of the referrer was ascertained from review of referral letters and direct questioning.

The effect of lockdown on melanoma stage in Devon, UK.

We performed a prospective analysis of Breslow thickness in melanoma before the COVID-19 pandemic and after. It shows that there is a statistically significant increase in melanoma thickness, and ultimately melanoma staging, since the pandemic began.

Complete nucleotide sequences of plasmids pACK2 and pACK5 from Staphylococcus simulans biovar staphylolyticus.

Staphylococcus simulans biovar staphylolyticus contains five plasmids, designated pACK1-pACK5. Recently, the nucleotide sequences of three of these plasmids, pACK1, pACK3, and pACK4, were reported. In order to complete the characterization of these five plasmids, the nucleotide sequences of the two remaining plasmids, pACK2 (37683 bp) and pACK5 (3191 bp), were determined.

Inhibition of the activity of both domains of lysostaphin through peptidoglycan modification by the lysostaphin immunity protein.

Resistance to lysostaphin, a staphylolytic glycylglycine endopeptidase, is due to a FemABX-like immunity protein that inserts serines in place of some glycines in peptidoglycan cross bridges. These modifications inhibit both binding of the recombinant cell wall targeting domain and catalysis by the recombinant catalytic domain of lysostaphin.

Complete nucleotide sequences of plasmids pACK1 and pACK3 from Staphylococcus simulans biovar staphylolyticus.

Staphylococcus simulans biovar staphylolyticus contains five plasmids designated pACK1-pACK5. The complete nucleotide sequences of pACK1 (55171bp) and pACK3 (28613bp) were determined and sequence comparison revealed that the entire pACK3 sequence is present on pACK1 (99.98% identical on the nucleotide level) with the sequence unique to pACK1 located between sin and blaZ, which are adjacent in pACK3.

Characterization of pACK4, a mobilizable plasmid from Staphylococcus simulans biovar staphylolyticus.

Staphylococcus simulans biovar staphylolyticus, the lysostaphin-producing organism, contains five plasmids designated pACK1-pACK5. pACK4 was found to be relaxable and to share sequence similarity with a number of well-characterized mobilizable plasmids from other staphylococci. All mobilizable staphylococcal plasmids characterized to date mediate resistance to various antibiotics, but pACK4 is unique because it contains no recognizable antibiotic resistance genes.

Zif, the zoocin A immunity factor, is a FemABX-like immunity protein with a novel mode of action.

Producer cell immunity to the streptococcolytic enzyme zoocin A, which is a D-alanyl-L-alanine endopeptidase, is due to Zif, the zoocin A immunity factor. Zif has high degrees of similarity to MurM and MurN (members of the FemABX family of proteins), which are responsible for the addition of amino acids to cross bridges during peptidoglycan synthesis in streptococci. In this study, purified peptidoglycans from strains with and without zif were compared to determine how Zif modifies the peptidoglycan layer to cause resistance to zoocin A.

Use of 4-sulfophenyl isothiocyanate labeling and mass spectrometry to determine the site of action of the streptococcolytic peptidoglycan hydrolase zoocin A.

Zoocin A is a streptococcolytic peptidoglycan hydrolase with an unknown site of action that is produced by Streptococcus equi subsp. zooepidemicus 4881. Zoocin A has now been determined to be a d-alanyl-l-alanine endopeptidase by digesting susceptible peptidoglycan with a combination of mutanolysin and zoocin A, separating the resulting muropeptides by reverse-phase high-pressure liquid chromatography, and analyzing them by mass spectrometry (MS) in both the positive- and negative-ion modes to determine their compositions.

Plasmid-specified FemABX-like immunity factor in Staphylococcus sciuri DD 4747.

A plasmid from Staphylococcus sciuri DD 4747 had three open reading frames: a replication gene, an N-acetylmuramyl-l-alanine amidase-like gene, and a gene similar to the lysostaphin endopeptidase resistance gene (epr/lif). The epr-like gene was introduced into S. aureus RN4220; the recombinant strain was more resistant to lysostaphin endopeptidase and its cell wall peptidoglycan contained more serines and fewer glycines than the parental strain with the shuttle vector alone.

The streptococcolytic enzyme zoocin A is a penicillin-binding protein.

Zoocin A is a streptococcolytic enzyme produced by Streptococcus equi subsp. zooepidemicus 4881 that has an unknown site of action on the peptidoglycans of susceptible organisms. Analysis of a mutant strain in which the genes for zoocin A and resistance to zoocin A were inactivated revealed that this strain was more susceptible to beta-lactam antibiotics than the parental organism.

Expression of the genes for lysostaphin and lysostaphin resistance in streptococci.

To determine if the genes for lysostaphin endopeptidase (end) and lysostaphin resistance (epr) function in streptococci, we transferred these genes from Staphylococcus simulans biovar staphylolyticus into two strains of Streptococcus equi subsp. zooepidemicus. The end-containing streptococci were able to produce and process proendopeptidase.