Early and adequate antibiotic treatment is the cornerstone of improving clinical outcomes in patients with bloodstream infections (BSI). Delays in appropriate antimicrobial therapy have catastrophic consequences for patients with BSI. Microbiological characterization of multi-drug resistant pathogens (MDRP) allows clinicians to provide appropriate treatments. Current microbiologic techniques may take up to 96 h to identify causative pathogens and their resistant patterns. Therefore, there is an important need to develop rapid diagnostic strategies for MDRP. We tested a modified protocol to detect carbapenemase and extended-spectrum β-lactamase (ESBL) producing Gram-negative bacteria (GNB) from positive blood cultures.This is a prospective cohort study of consecutive patients with bacteremia. We developed a modified protocol using the HB&L® system to detect MDRP. The operational characteristics were analyzed for each test (HB&L-ESBL/AmpC® and HB&L-Carbapenemase® kits). The kappa coefficient, sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), likelihood ratios (LR) with 95% confidence intervals (CI), and reduction in identification time of this novel method were calculated.Ninety-six patients with BSI were included in the study. A total of 161 positive blood cultures were analyzed. Escherichia coli (50%, 81/161) was the most frequently identified pathogen, followed by Klebsiella pneumoniae (15%, 24/161) and Pseudomonas aeruginosa (8%, 13/161). Thirty-three percent of isolations had usual resistance patterns. However, 34/161 (21%) of identified pathogens were producers of carbapenemases and 21/161 (13%) of extended-spectrum β-lactamases. Concordance between our HB&L® modified protocol and the traditional method was 99% (159/161). Finally, identification times were significantly shorter using our HB&L®-modified protocol than traditional methods: median (IQR) 19 h (18, 22) vs. 61 h (60, 64), p < 0.001.Here, we provide novel evidence that using our HB&L®-modified protocol is an effective strategy to reduce the time to detect MDRP producers of carbapenemases or extended-spectrum β-lactamases, with an excellent concordance rate when compared to the gold standard. Further studies are needed to confirm these findings and to determine whether this method may improve clinical outcomes.
Abstract Aim: To test a modified protocol designed to detect Gram-negative bacilli (GNB) resistant to oximinocephalosporins and carbapenems from positive blood cultures. Design: This is a prospective, cohort study of consecutive patients. Setting: A cardiovascular and University referral hospital. Patients: Patients hospitalized in a third level hospital with bacteraemia. Main variables of interest: We developed a modified protocol using HB&L® system to detect MDRP. We then attempted to determine accuracy, concordance and reduction of identification time of this novel method in a reference hospital. Descriptive statistics and logistical regressions were used. Results: Ninety-six patients with BSI were included in the study. A total of 161 positive blood cultures were analysed. Escherichia coli (50%, 81/161) was the most frequently identified pathogen followed by Klebsiella pneumoniae (15%, 24/161) and Pseudomonas aeruginosa (8%, 13/161). Thirty-two percent of isolations had usual resistance patters. However, in 34/161 (21%) of identified pathogens were producer of carbapenemasases and 21/161 (13%) of extended-spectrum β-lactamases. Concordance among our HB&L®modified protocol and traditional method was 99% (159/161). Finally, identification times were significantly shorter using our HB&L® modified protocol than traditional methods (Median [IQR]; 19 hours [18, 22] Vs 61 hours [60, 64], p<0.001). Conclusions: Here we provided novel evidence that using our HB&L® modified protocol is an effective strategy to reduce the time to MDRP detection/identification; with a great concordance rate when compared to the gold standard. Further studies are needed to confirm these findings and to determine whether this method may improve clinical outcomes.
Abstract Xylella fastidiosa is a xylem‐limited bacterial plant pathogen transmitted by insect vectors. It infects a wide range of plant species and causes devastating diseases. Botanical gardens are global repositories of plant diversity exposed to local biotic and abiotic stresses. We used molecular diagnostic tools for the detection of X . fastidiosa in a collection of New Zealand indigenous plants grown in a X . fastidiosa ‐infected Californian area to determine if any species were infected with this bacterial pathogen and to help inform biosecurity responses. To this end, 130 New Zealand indigenous plant species comprising 72 genera, growing in the University of California Botanical Garden at Berkeley, California, were screened for X . fastidiosa . Multiple PCR‐based methods were used to detect the pathogen at the subspecies and sequence‐type levels directly from plant material; nine plant species tested positive by at least two PCR‐based methods. All nine infections were identified as X . fastidiosa subsp. multiplex sequence types 6 or 7 by the amplification of seven housekeeping genes. Three strains were cultured in vitro and their whole genome sequences were obtained; these strains belonged to three distinct clades within subspecies multiplex , indicating that the infections were not transmitted among these New Zealand indigenous plant species. The information gathered in this study will help to assess the risk of X . fastidiosa to New Zealand indigenous flora and the potential spillover to crops of agricultural importance. The work also shows the applied value of botanical garden collections as sentinels for international plant pathogen biosecurity risk assessment.
Effective regulation of water balance in plants requires localized extracellular barriers that control water and solute movement. We describe a clade of five Arabidopsis thaliana ABCG half-transporters that are required for synthesis of an effective suberin barrier in roots and seed coats (ABCG2, ABCG6, and ABCG20) and for synthesis of an intact pollen wall (ABCG1 and ABCG16). Seed coats of abcg2 abcg6 abcg20 triple mutant plants had increased permeability to tetrazolium red and decreased suberin content. The root system of triple mutant plants was more permeable to water and salts in a zone complementary to that affected by the Casparian strip. Suberin of mutant roots and seed coats had distorted lamellar structure and reduced proportions of aliphatic components. Root wax from the mutant was deficient in alkylhydroxycinnamate esters. These mutant plants also had few lateral roots and precocious secondary growth in primary roots. abcg1 abcg16 double mutants defective in the other two members of the clade had pollen with defects in the nexine layer of the tapetum-derived exine pollen wall and in the pollen-derived intine layer. Mutant pollen collapsed at the time of anther desiccation. These mutants reveal transport requirements for barrier synthesis as well as physiological and developmental consequences of barrier deficiency.
Abstract Making use of deficiencies, inversions and translocations, we have genetically dissected the region 95E to 96F of Drosophila melanogaster. We localized cytologically the loci abnormal spindle (asp: 3-85.2: 96A20-25;96B1-10) and M(3)96C2 (96C1;96C5). We have also found several new phenotypes associated with lesions in the 95E to 97B region: (1) Minute(3)96A (M(3)96A) is a haplo-insufficient phenotype of thin and short bristles presented by individuals deficient for the region 95E6-8;96A1-5. (2) abdominal-one reduced (aor) shows two different phenotypes associated with the distal breakpoint of In(3R)Ubx7L (89E;96A1-7). One is the increase of the Ubx phenotype, but its effect requires the presence of lesions in Ubx. The other phenotype is a drastic reduction or disappearance of the first abdominal segment. Both phenotypes might be due to lesions in the same gene. (3) metaphase arrest (mar) is associated with the breakpoint of the T(Y;3)B197 (96B1-10) and produces a phenotype typical of mitotic mutants with arrest of the cell cycle during prometaphase or metaphase. There is another region localized in 97B which interacts with asp: in a background homozygous for asp, three doses of this region enhance the asp phenotype.
The tiovivo (tio) gene of Drosophila encodes a kinesin-related protein, KLP38B, that colocalizes with condensed chromatin during cell division. Wild-type function of the tio gene product KLP38B is required for normal chromosome segregation during mitosis. Mitotic cells in tio larval brains displayed circular mitotic figures, increased ploidy, and abnormal anaphase figures. KLP38B mRNA is maternally provided and expressed in cells about to undergo division. We propose that KLP38B, perhaps redundantly with other chromosome-associated microtubule motor proteins, contributes to interactions between chromosome arms and microtubules important for establishing bipolar attachment of chromosomes and assembly of stable bipolar spindles.
In this study, we identify the means by which segmentally homologous neurons acquire different neuropeptide fates in Drosophila. Ventral abdominal (Va)-neurons in the A1 segment of the ventral nerve cord express DH31 and AstA neuropeptides (neuropeptidergic fate I) by virtue of Ubx activity, whereas the A2-A4 Va-neurons express the Capa neuropeptide (neuropeptidergic fate II) under the influence of abdA. These different fates are attained through segment-specific programs of neural subtype specification undergone by segmentally homologous neurons. This is an attractive alternative by which Hox genes can shape Drosophila segmental neural architecture (more sophisticated than the previously identified binary "to live" or "not to live" mechanism). These data refine our knowledge of the mechanisms involved in diversifying neuronal identity within the central nervous system.