A Step Forward in Hypervirulent Klebsiella pneumoniae Diagnostics.

Hypervirulent Klebsiella pneumoniae (hvKp) can cause life-threatening infections in healthy community members. HvKp infections often involve multiple sites, some of which are unusual for classical K. pneumoniae (cKp) infections, such as the central nervous system, eyes, and fascia.

Genomic analysis of early ST32 Acinetobacter baumannii strains recovered in US military treatment facilities reveals distinct lineages and links to the origins of the Tn6168 ampC transposon.

Objectives: To study the population structure and genomic characteristics, including antimicrobial resistance genes, plasmid types and surface polysaccharide type, of the globally distributed Acinetobacter baumannii belonging to ST32 (Institut Pasteur scheme).

Methods: Antibiotic resistance phenotype for 19 antibiotics was determined using Vitek 2. Whole-genome sequencing was performed using the Illumina MiSeq platform.

Trends in Sickle Cell Disease Mortality: 1979-2020.

Background And Objectives: Although sickle cell disease (SCD)-related childhood mortality in the United States significantly improved in the 1990s, unclear is the trend in SCD-related mortality more recently given the continued disparities faced by this minoritized population. In this analysis, we aimed to (1) compare the overall and age-specific mortality rates from 1999 to 2009 vs 2010 to 2020 with a particular focus on the age of transition and (2) determine the most common causes of death for the US SCD population for 2010 to 2020.

Methods: We analyzed publicly available data from the Centers for Disease Control and Prevention WONDER database, a compilation of national-level mortality statistics from 1979 to 2020 derived from death certificates compiled by the National Center for Health Statistics.

Sickle cell disease in India: Not just a mild condition.

Sickle cell disease (SCD) is a common and life-threatening global health problem, with more than 500 000 affected infants born annually. The burden of SCD in sub-Saharan Africa is well established, but the comparably high prevalence in India is not well recognized and many consider SCD in India to be less severe. In their paper, a national study in India demonstrated the significant impact of SCD for patients, families and the healthcare system, supporting a call to action to recognize and address SCD as a serious and common health condition in India.

Tn-mediated transfer of from to an outbreak clone of .

Carriage of CTX-M-type extended-spectrum β-lactamase (ESBL) is rare in . During routine surveillance of an endemic ST-621 at a large hospital, isolate MRSN 100690 carrying was cultured from a patient (P2). This was the first detection of this ESBL in the endemic ST-621 lineage.

Detection of cefiderocol and aztreonam/avibactam resistance in epidemic ST-361 carrying and from foreign fighters evacuated from Ukraine.

Genomic surveillance detected clonal sequence type-361 isolates carrying , , , and from a patient in Ukraine and four wounded foreign soldiers evacuated to Germany. Isolates were non-susceptible to carbapenems, aminoglycosides, and cefiderocol and aztreonam/avibactam due to a PBP3 YRIN insertion and the AmpC β-lactamase. Coordinated surveillance efforts across civilian, military, and veteran healthcare systems are essential to prevent further spread as international volunteers return home after medical evacuation from Ukraine.

Fostering a healthier generation of children with sickle cell disease through advancements in care.

Sickle cell disease (SCD) is an inherited disorder of hemoglobin that affects tens of millions of individuals worldwide. Without preventive and disease-modifying therapy, SCD results in many acute and chronic complications impacting both quality and length of life. We are currently in a new generation of SCD care in high resource settings due to recent advancements in care.

Deciphering the relative importance of genetic elements in hypervirulent Klebsiella pneumoniae to guide countermeasure development.

Background: Quantitating the contribution of phenotype-responsible elements in hypervirulent Klebsiella pneumoniae is needed.

Methods: Isogenic mutants of four hypervirulent clinical isolates that produced K1 (ST23), K2 (ST86), K20 (ST1544), or K54 (ST29) capsules (mean 2.2 log LD (range 1.

Distribution and expression of the aac(6')-Im (aacA16) aminoglycoside resistance gene.

Background: The aac(6')-Im (aacA16) amikacin, netilmicin and tobramycin resistance gene cassette had been circulating globally undetected for many years in a sublineage of Acinetobacter baumannii global clone 2.

Objectives: To identify sources for the aac(6')-Im fragment found in A. baumannii.

Differentiation of hypervirulent and classical with acquired drug resistance.

Distinguishing hypervirulent (hvKp) from classical (cKp) strains is important for clinical care, surveillance, and research. Some combinations of and are most commonly used, but it is unclear what combination of genotypic or phenotypic markers (e.g.

Differentiation of hypervirulent and classical with acquired drug resistance.

Unlabelled: Distinguishing hypervirulent (hvKp) from classical (cKp) strains is important for clinical care, surveillance, and research. Some combination of and are most commonly used, but it is unclear what combination of genotypic or phenotypic markers (e.g.

Six Extensively Drug-Resistant Bacteria in an Injured Soldier, Ukraine.

Blood and surveillance cultures from an injured service member from Ukraine grew Acinetobacter baumannii, Klebsiella pneumoniae, Enterococcus faecium, and 3 distinct Pseudomonas aeruginosa strains. Isolates were nonsusceptible to most antibiotics and carried an array of antibiotic resistant genes, including carbapenemases (bla, bla, bla, bla, bla) and 16S methyltransferases (armA and rmtB4).

Early diagnosis of sickle cell disease at birth hospitals and vaccination centers in Angola using point-of-care tests.

Sickle cell disease (SCD) is a life-threatening blood disorder affecting >500 000 infants annually, mostly in sub-Saharan Africa. Most infants do not have access to an early diagnosis and die early from treatable complications of SCD. Universal newborn screening (NBS) is not yet available in any African country for a variety of reasons, including lack of laboratory capacity, difficulty in tracking affected infants, and the relatively short stay of mothers and newborns at maternity hospitals.

Inherited disorders of hemoglobin: A review of old and new diagnostic methods.

The genetic regulation of hemoglobin is complex and there are a number of genetic abnormalities that result in clinically important hemoglobin disorders. Here, we review the molecular pathophysiology of hemoglobin disorders and review both old and new methods of diagnosing these disorders. Timely diagnosis of hemoglobinopathies in infants is essential to coordinate optimal life-saving interventions, and accurate identification of carriers of deleterious mutations allows for genetic counseling and informed family planning.

A panel of diverse clinical isolates for research and development.

are a leading cause of healthcare-associated infections worldwide. In particular, strains expressing extended-spectrum β-lactamases (ESBLs) and carbapenemases pose serious treatment challenges, leading the World Health Organization (WHO) to designate ESBL and carbapenem-resistant Enterobacteriaceae as 'critical' threats to human health. Research efforts to combat these pathogens can be supported by accessibility to diverse and clinically relevant isolates for testing novel therapeutics.

Identification of an Outbreak Cluster of Extensively Antibiotic-Resistant GC1 Acinetobacter baumannii Isolates in U.S. Military Treatment Facilities.

An outbreak involving an extensively antibiotic-resistant Acinetobacter baumannii strain in three military treatment facilities was identified. Fifty-nine isolates recovered from 30 patients over a 4-year period were found among a large collection of isolates using core genome multilocus sequence typing (MLST). They differed by only 0 to 18 single nucleotide polymorphisms (SNPs) and carried the same resistance determinants except that the gene was missing in 25 isolates.

Hydroxyurea for children with sickle cell disease in sub-Saharan Africa: A summary of the evidence, opportunities, and challenges.

Sickle cell disease (SCD) is a common and life-threatening inherited blood disorder that affects more than 300,000 newborns per year. Because of the origins of the sickle gene mutation as a protective mechanism against malaria for those with sickle cell trait, more than 90% of annual SCD births are in sub-Saharan Africa (sSA). Over the past several decades, there have been many important advances in the care of individuals with SCD, including early diagnosis through newborn screening programs (NBS), prophylactic penicillin, the development of vaccines to prevent invasive bacterial infections, and the emergence of hydroxyurea as the primary disease-modifying pharmacologic therapy.

A one-year genomic investigation of Escherichia coli epidemiology and nosocomial spread at a large US healthcare network.

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.

Design of a Bacteriophage Cocktail Active against Species and Testing of Its Therapeutic Potential in .

Shigellosis is a leading global cause of diarrheal disease and travelers' diarrhea now being complicated by the dissemination of antibiotic resistance, necessitating the development of alternative antibacterials such as therapeutic bacteriophages (phages). Phages with lytic activity against strains were isolated from sewage. The genomes of 32 phages were sequenced, and based on genomic comparisons belong to seven taxonomic genera: , , , , , and .

IS-mediated plasmid reshuffling results in convergence of toxin-antitoxin systems but loss of resistance genes in XDR from a chronic infection.

Carbapenem-resistant pose an urgent threat to human health worldwide. sequence type (ST) 14, initially identified in the Middle East and South-Asia and co-harbouring the carbapenemase genes and is now emerging globally. One such strain was detected in the USA in 2013 from a patient initially treated in India that also carried , a 16S rRNA methyltransferase that confers resistance to all clinically relevant aminoglycosides.

Mechanisms of IS-Mediated Amplification of the Gene Leading to Tobramycin Resistance in an Acinetobacter baumannii Isolate.

Enhanced levels of resistance to antibiotics arising from amplification of an antibiotic resistance gene that impact therapeutic options are increasingly observed. Amplification can also disclose novel phenotypes leading to treatment failure. However, the mechanism is poorly understood.