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Abstract Five cases of human babesiosis were reported in the Lower Hudson Valley Region of New York State in 2001. An investigation to determine if Babesia microti was present in local Ixodes scapularis ticks yielded 5 positive pools in 123 pools tested, the first detection of B. microti from field-collected I. scapularis in upstate New York.
Intensive small mammal trapping was conducted in 12 counties in New York state during 1998-2000 to investigate the prevalence and site specificity of the Lyme disease spirochete, Borrelia burgdorferi in, and presence of the blacklegged tick, Ixodes scapularis Say on, the wild mice Peromyscus leucopus Rafinesque and Peromyscus maniculatus Wagner and other small mammal species. Previously captured mice (1992-1997) from throughout New York state also were recruited into the study, providing a total of 3,664 Peromyscus from 107 sites in 31 counties. Infection with B. burgdorferi was determined by polymerase chain reaction testing of ear tissue, and rates were determined by species, counties, and regions of the state. B. burgdorferi was detected in 10 small mammal species captured during 1998-2000. Peromyscus captured from Dutchess County in the lower Hudson Valley had the highest infection rate of 21%. The next highest infection rates were in counties within the Capital District: Albany (18%), Rensselaer (17%), and Columbia (13%). From 4,792 small animals examined, we recovered 2,073 ticks representing six species from 414 individuals of 12 mammal species, including 1,839 I. scapularis collected from 315 Peromyscus trapped in five counties. I. scapularis were most often collected from animals trapped in Albany, Rensselear, and Dutchess counties. We used protein electrophoresis of salivary amylase to distinguish between P. leucopus and P. maniculatus species. I. scapularis burdens were 5.7 ticks per P. leucopus and 14.3 ticks per P. maniculatus.
Abstract Background Carbapenemase-producing, carbapenem-resistant Pseudomonas aeruginosa (CP-CRPA) are extensively drug-resistant bacteria. We investigated the source of a multistate CP-CRPA outbreak. Methods Cases were defined as a US patient's first isolation of P. aeruginosa sequence type 1203 with carbapenemase gene blaVIM-80 and cephalosporinase gene blaGES-9 from any specimen source collected and reported to the Centers for Disease Control and Prevention during 1 January 2022–15 May 2023. We conducted a 1:1 matched case-control study at the post–acute care facility with the most cases, assessed exposures associated with case status for all case-patients, and tested products for bacterial contamination. Results We identified 81 case-patients from 18 states, 27 of whom were identified through surveillance cultures. Four (7%) of 54 case-patients with clinical cultures died within 30 days of culture collection, and 4 (22%) of 18 with eye infections underwent enucleation. In the case-control study, case-patients had increased odds of receiving artificial tears versus controls (crude matched OR, 5.0; 95% CI, 1.1–22.8). Overall, artificial tears use was reported by 61 (87%) of 70 case-patients with information; 43 (77%) of 56 case-patients with brand information reported use of Brand A, an imported, preservative-free, over-the-counter (OTC) product. Bacteria isolated from opened and unopened bottles of Brand A were genetically related to patient isolates. Food and Drug Administration inspection of the manufacturing plant identified likely sources of contamination. Conclusions A manufactured medical product serving as the vehicle for carbapenemase-producing organisms is unprecedented in the United States. The clinical impacts from this outbreak underscore the need for improved requirements for US OTC product importers.
Journal Article Prevalence of Borrelia burgdorferi (Spirochaetales: Spirochaetaceae), Anaplasma phagocytophilum (Rickettsiales: Anaplasmataceae), and Babesia microti (Piroplasmida: Babesiidae) in Ixodes scapularis (Acari: Ixodidae) Collected From Recreational Lands in the Hudson Valley Region, New York State Get access M. A. Prusinski, M. A. Prusinski 2 1New York State Department of Health, Bureau of Communicable Disease Control, Vector Ecology Laboratory, Wadsworth Center Biggs Laboratory C-456, Empire State Plaza, Albany, NY 12237. 2Corresponding author, e-mail: map11@health.state.ny.us. Search for other works by this author on: Oxford Academic PubMed Google Scholar J. E. Kokas, J. E. Kokas 3New York State Department of Health, Fordham University, Vector Ecology Laboratory, Louis Calder Center, 53 Whippoorwill Rd., Armonk, NY 10504. Search for other works by this author on: Oxford Academic PubMed Google Scholar K. T. Hukey, K. T. Hukey 4Current affiliation: New York State Department of Health, Bureau of AIDS Epidemiology, Empire State Plaza, Albany, NY 12237. Search for other works by this author on: Oxford Academic PubMed Google Scholar S. J. Kogut, S. J. Kogut 5Current affiliation: St. Peter's Hospital, Patient Safety and Quality Improvement Department, Infection Control and Prevention Program, 315 South Manning Blvd., Albany, NY 12208. Search for other works by this author on: Oxford Academic PubMed Google Scholar J. Lee, J. Lee 6Current affiliation: University of North Texas, School of Public Health, Environmental and Occupational Health, Health Science Center, 3400 Camp Bowie Blvd., Fort Worth, TX 76107. Search for other works by this author on: Oxford Academic PubMed Google Scholar P. B. Backenson P. B. Backenson 7New York State Department of Health, Bureau of Communicable Disease Control, Communicable Disease Investigations and Vector Surveillance Unit, Empire State Plaza, Albany, NY 12237. Search for other works by this author on: Oxford Academic PubMed Google Scholar Journal of Medical Entomology, Volume 51, Issue 1, 1 January 2014, Pages 226–236, https://doi.org/10.1603/ME13101 Published: 01 January 2014 Article history Received: 23 May 2013 Accepted: 24 October 2013 Published: 01 January 2014
Abstract Background New York State Department of Health (NYSDOH) and Wadsworth Center (WC) participate in the Centers for Disease Control and Prevention’s Antibiotic Resistance Laboratory Network (AR Lab Network), including identification and characterization of specific bla genes in carbapenemase-producing organisms (CPO). Three investigations from November 2018–March 2019 illustrate the findings and challenges investigating CPO in a blaKPC endemic setting. Methods NYSDOH WC testing includes organism identification, drug susceptibility testing, detection of carbapenemase production, detection of carbapenemase genes, and whole-genome sequencing (WGS). NYSDOH epidemiologic (epi) investigations of novel resistance mechanisms review demographic and exposure data, conduct contact tracing with targeted rectal screening to identify colonized persons, and assess infection control (IC) and public health (PH) practices and provide recommendations. Results NYSDOH identified three nursing home residents infected with CPO with novel carbapenemase genes (Figure 1) with no travel history but multiple co-morbidities, including mechanical ventilation: blaOXA-48Klebsiella pneumoniae (KP) (Facility A), blaNDM KP (Facility B and C). Epi investigations identified CPO in 48 of 106 residents screened for rectal colonization; most isolates had genes other than the index gene. Facility A and Facility B each had no additional residents colonized with CPO with the index gene after screening; 14 and 10 residents, respectively from Facility A and B, had CPO with endemic blaKPC gene. WGS analysis identified 2 clusters of blaKPC KP within Facility A and no clusters of CPO were detected in Facility B. IC/PH recommendations were made after diagnosis at all 3 facilities; serial IC/PH assessments/recommendations and screening were needed to interrupt transmission at Facility C, where 24 residents were colonized with CPO, including 7 residents with CPO with the index gene (blaNDM), and a subset of the blaNDM isolates were related to the index case by both epi and WGS analysis. Conclusion Epi investigation and WGS were complementary to detect transmission, identify clusters within an endemic setting, and inform PH response and IC measures for these emerging CPO in NY Healthcare Facilities. Disclosures All authors: No reported disclosures.
Intensive small mammal trapping was conducted in 12 counties in New York state during 1998–2000 to investigate the prevalence and site specificity of the Lyme disease spirochete, Borrelia burgdorferi in, and presence of the blacklegged tick, Ixodes scapularis Say on, the wild mice Peromyscus leucopus Rafinesque and Peromyscus maniculatus Wagner and other small mammal species. Previously captured mice (1992–1997) from throughout New York state also were recruited into the study, providing a total of 3,664 Peromyscus from 107 sites in 31 counties. Infection with B. burgdorferi was determined by polymerase chain reaction testing of ear tissue, and rates were determined by species, counties, and regions of the state. B. burgdorferi was detected in 10 small mammal species captured during 1998–2000. Peromyscus captured from Dutchess County in the lower Hudson Valley had the highest infection rate of 21%. The next highest infection rates were in counties within the Capital District: Albany (18%), Rensselaer (17%), and Columbia (13%). From 4,792 small animals examined, we recovered 2,073 ticks representing six species from 414 individuals of 12 mammal species, including 1,839 I. scapularis collected from 315 Peromyscus trapped in five counties. I. scapularis were most often collected from animals trapped in Albany, Rensselear, and Dutchess counties. We used protein electrophoresis of salivary amylase to distinguish between P. leucopus and P. maniculatus species. I. scapularis burdens were 5.7 ticks per P. leucopus and 14.3 ticks per P. maniculatus.
The relationship between habitat structural composition, presence of Ixodes scapularis Say (I. dammini Spielman, Clifford, Piesman, and Corwin), and the prevalence of Borrelia burgdorferi infection in small mammal populations was studied at 12 4-ha study sites selected within two perpendicular transects spanning New York State. Species-adjusted small mammal infection rates (SARs) were calculated to enable comparison of B. burgdorferi infection rates among sites with differing small mammal species composition and were used as the outcome variable in a predictive model. Sites with high SARs were characterized by lower overstory tree canopy height and basal area, increased understory coverage, substantial understory shrub coverage, decreased presence of surface water or saturated soil, high dominance values for I. scapularis, and higher tick burdens on small mammals. These differences were statistically significant from sites with moderate or low SAR values. Understory foliage height profiles were created for each study site, and significant differences in vegetation structural composition between high SAR sites and those with low or moderate SAR were documented. High SAR sites had increased density of herbaceous foliage at 0 and 25 cm, and higher shrub density at 0, 25, and 50 cm measurements above the ground, associated with I. scapularis questing success, and lower densities of sapling trees at 25, 50, and 75 cm. The structural composition of understory vegetation may dictate vector density and predict B. burgdorferi infection rates in small mammals in New York State.
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