scholarly journals Genetic Organization of Transposase Regions Surrounding blaKPC Carbapenemase Genes on Plasmids from Klebsiella Strains Isolated in a New York City Hospital

2009 ◽  
Vol 53 (5) ◽  
pp. 1998-2004 ◽  
Author(s):  
Thomas D. Gootz ◽  
Mary Kay Lescoe ◽  
Fadia Dib-Hajj ◽  
Brian A. Dougherty ◽  
Wen He ◽  
...  
Keyword(s):  
New York ◽  
New York City ◽  
Klebsiella Pneumoniae ◽  
York City ◽  
Klebsiella Oxytoca ◽  
Promoter Sequence ◽  
The United States ◽  
City Hospital ◽  
Genes Encoding ◽  
Healthcare Associated

ABSTRACT Carbapenem-resistant Klebsiella strains carrying Klebsiella pneumoniae carbapenemases (KPC) are endemic to New York City and are spreading across the United States and internationally. Recent studies have indicated that the KPC structural gene is located on a 10-kb plasmid-borne element designated Tn4401. Fourteen Klebsiella pneumoniae strains and one Klebsiella oxytoca strain isolated at a New York City hospital in 2005 carrying either bla KPC-2 or bla KPC-3 were examined for isoforms of Tn4401. Ten of the Klebsiella strains contained a 100-bp deletion in Tn4401, corresponding to the Tn4401a isoform. The presence of this deletion adjacent to the upstream promoter region of bla KPC in Tn4401a resulted in a different −35 promoter sequence of TGGAGA than that of CTGATT present in isoform Tn4401b. Complete sequencing of one plasmid carrying bla KPC from each of three nonclonal isolates indicated the presence of genes encoding other types of antibiotic resistance determinants. The 70.6-kb plasmid from K. pneumoniae strain S9 carrying bla KPC-2 revealed two identical copies of Tn4401b inserted in an inverse fashion, but in this case, one of the elements disrupted a group II self-splicing intron. In K. pneumoniae strain S15, the Tn4401a element carrying bla KPC-2 was found on both a large 120-kb plasmid and a smaller 24-kb plasmid. Pulsed-field gel electrophoresis results indicate that the isolates studied represent a heterogeneous group composed of unrelated as well as closely related Klebsiella strains. Our results suggest that endemic KPC-positive Klebsiella strains constitute a generally nonclonal population comprised of various alleles of bla KPC on several distinct plasmid genetic backgrounds. This study increases our understanding of the genetic composition of the evolving and expanding role of KPC-producing, healthcare-associated, gram-negative pathogens.

scholarly journals A Ceftazidime-Avibactam-Resistant and Carbapenem-Susceptible Klebsiella pneumoniae Strain Harboring blaKPC-14 Isolated in New York City

mSphere ◽  
2020 ◽  
Vol 5 (4) ◽  
Author(s):  
Siqiang Niu ◽  
Kalyan D. Chavda ◽  
Jie Wei ◽  
Chunhong Zou ◽  
Steven H. Marshall ◽  
...  
Keyword(s):  
New York ◽  
New York City ◽  
Klebsiella Pneumoniae ◽  
York City ◽  
The United States ◽  
Genomic Sequencing ◽  
Content Type ◽  
Clinical Variants ◽  
Genetic Structures ◽  
Antibiotic Combination

ABSTRACT Ceftazidime-avibactam is a potent antibiotic combination against Klebsiella pneumoniae carbapenemase (KPC)-producing Enterobacteriaceae. Here, we describe a unique ceftazidime-avibactam-resistant and carbapenem-susceptible K. pneumoniae strain harboring a novel blaKPC-14 variant. This strain was isolated from a New York City patient in 2003, which predates the introduction of avibactam. Despite resistance to ceftazidime-avibactam, the strain was susceptible to imipenem-relebactam and meropenem-vaborbactam. Comprehensive genomic sequencing revealed that blaKPC-14 is harbored on an ST6 IncN plasmid associated with the early spread of blaKPC. IMPORTANCE KPC is currently the most common carbapenemase identified in the United States. More than 40 KPC variants have been described, of which KPC-2 and KPC-3 are the most frequent clinical variants. However, our understanding of the genetic structures and β-lactam resistance profiles of other novel KPC variants remains incomplete. Here, we report a novel blaKPC variant (blaKPC-14) and the complete genome sequence of blaKPC-14-harboring K. pneumoniae strain BK13048, which is susceptible to carbapenems but resistant to ceftazidime-avibactam. To the best of our knowledge, this is one of the earliest KPC-producing K. pneumoniae strains exhibiting resistance to ceftazidime-avibactam.

scholarly journals Detection of mcr-1-Carrying Escherichia coli Causing Bloodstream Infection in a New York City Hospital: Avian Origins, Human Concerns?

2017 ◽  
Vol 4 (3) ◽  
Author(s):  
Nenad Macesic ◽  
Daniel Green ◽  
Zheng Wang ◽  
Sean B. Sullivan ◽  
Kevin Shim ◽  
...  
Keyword(s):  
United States ◽  
Escherichia Coli ◽  
New York ◽  
New York City ◽  
York City ◽  
The United States ◽  
Genomic Sequencing ◽  
City Hospital ◽  
Gram Negative ◽  
E Coli

Abstract The spread of mcr-1 in the United States remains poorly defined. mcr-1-producing Escherichia coli that also carried blaSHV-12 was detected in a hospitalized patient. No additional cases were identified during screening of 801 Gram-negative isolates. Genomic sequencing identified an IncX4 mcr-1- harboring plasmid and ST117 clonal background associated with avian pathogenic E coli.

scholarly journals Antimicrobial stewardship perspectives from a New York City hospital during the COVID-19 pandemic: Challenges and opportunities

2021 ◽  
Author(s):  
Christine J Kubin ◽  
Angela S Loo ◽  
Jennifer Cheng ◽  
Brian Nelson ◽  
Monica Mehta ◽  
...  
Keyword(s):  
New York ◽  
New York City ◽  
Antimicrobial Stewardship ◽  
York City ◽  
Antibiotic Use ◽  
The United States ◽  
Lessons Learned ◽  
City Hospital ◽  
Challenges And Opportunities ◽  
Challenging Environment

Abstract Purpose To share challenges and opportunities for antimicrobial stewardship programs based on one center’s experience during the early weeks of the coronavirus disease 2019 (COVID-19) pandemic. Summary In the spring of 2020, New York City quickly became a hotspot for the COVID-19 pandemic in the United States, putting a strain on local healthcare systems. Antimicrobial stewardship programs faced diagnostic and therapeutic uncertainties as well as healthcare resource challenges. With the lack of effective antivirals, antibiotic use in critically ill patients was difficult to avoid. Uncertainty drove antimicrobial use and thus antimicrobial stewardship principles were paramount. The dramatic influx of patients, drug and equipment shortages, and the need for prescribers to practice in alternative roles only compounded the situation. Establishing enhanced communication, education, and inventory control while leveraging the capabilities of the electronic medical record were some of the tools used to optimize existing resources. Conclusion New York City was a unique and challenging environment during the initial peak of the COVID-19 pandemic. Antimicrobial stewardship programs can learn from each other by sharing lessons learned and practice opportunities to better prepare other programs facing COVID-19 case surges.

scholarly journals Knowledge, Attitudes and Perceptions of COVID-19 Vaccination among Healthcare Workers of an Inner-City Hospital in New York

Vaccines ◽  
2021 ◽  
Vol 9 (5) ◽  
pp. 516
Author(s):  
Federico Ciardi ◽  
Vidya Menon ◽  
Jamie L. Jensen ◽  
Masood A Shariff ◽  
Anjana Pillai ◽  
...  
Keyword(s):  
New York ◽  
New York City ◽  
York City ◽  
Healthcare Workers ◽  
The United States ◽  
Equation Modeling ◽  
City Hospital ◽  
Educational Approach ◽  
Personal Risk ◽  
Modifiable Factors

Introduction: New York City is one of the areas most affected by the COVID-19 pandemic in the United States. Healthcare workers are among those at high risk of contracting the virus, and a vital source of information and trust in vaccines to the community. Methods: This study was conducted about attitudes towards COVID-19 vaccination among healthcare workers at a public hospital in New York City during the beginning of COVID-19 vaccination. 428 hospital employees responded. Results: Several factors were significantly associated with vaccine attitudes, including demographics such as gender (p = 0.002), age (p = 0.005), race (p < 0.001) and home location (p < 0.001), role within the hospital (p < 0.001), knowledge about the virus (p < 0.001) and confidence in and expectations about personal protective equipment and behaviors (p < 0.001). Structural equation modeling revealed that the most predictive factors were prior vaccine attitudes and concern with the speed of testing and approval of the vaccines (p < 0.001). Multivariate analysis reinforced these, while also identifying perceived personal risk as significant (p = 0.033). Conclusions: Several modifiable factors that reflect confidence in science, scientific knowledge, personal risk perception, experience and medical authority are correlated with vaccine attitudes, indicating that a holistic educational approach to improve trust in science is likely to be effective in long-term reduction in vaccine hesitancy.

Applying the Devil's Works in a Holy Cause: Working-Class Popular Culture and the Salvation Army in the United States, 1879-1900

1997 ◽  
Vol 7 (2) ◽  
pp. 195-223
Author(s):  
Lillian Taiz
Keyword(s):  
United States ◽  
New York ◽  
New York City ◽  
Popular Culture ◽  
York City ◽  
The United States ◽  
Salvation Army ◽  
Public Meeting ◽  
The Many ◽  
Sunday Evening

Forty-eight hours after they landed in New York City in 1880, a small contingent of the Salvation Army held their first public meeting at the infamous Harry Hill's Variety Theater. The enterprising Hill, alerted to the group's arrival from Britain by newspaper reports, contacted their leader, Commissioner George Scott Railton, and offered to pay the group to “do a turn” for “an hour or two on … Sunday evening.” In nineteenth-century New York City, Harry Hill's was one of the best known concert saloons, and reformers considered him “among the disreputable classes” of that city. His saloon, they said, was “nothing more than one of the many gates to hell.”

Values of Voluntary Simplicity: Lifestyle and Motivation

1984 ◽  
Vol 55 (1) ◽  
pp. 231-240 ◽  
Author(s):  
Avraham Shama ◽  
Joseph Wisenblit
Keyword(s):  
United States ◽  
New York ◽  
New York City ◽  
York City ◽  
Metropolitan Areas ◽  
The United States ◽  
Voluntary Simplicity ◽  
Ecological Responsibility ◽  
Self Sufficiency ◽  
And Behavior

This paper describes the relation between values and behavior of a new life style, that of voluntary simplicity which is characterized by low consumption, self-sufficiency, and ecological responsibility. Also, specific hypotheses regarding the motivation for voluntary simplicity and adoption in two areas of the United States were tested. Analysis shows (a) values of voluntary simplicity and behaviors are consistent, (b) the motivation for voluntary simplicity includes personal preference and economic hardship, and (c) adoption of voluntary simplicity is different in the Denver and New York City metropolitan areas.

scholarly journals Seeking menstrual products: a qualitative exploration of the unmet menstrual needs of individuals experiencing homelessness in New York City

2021 ◽  
Vol 18 (1) ◽  
Author(s):  
Caitlin Gruer ◽  
Kim Hopper ◽  
Rachel Clark Smith ◽  
Erin Kelly ◽  
Andrew Maroko ◽  
...  
Keyword(s):  
New York ◽  
New York City ◽  
Vulnerable Populations ◽  
York City ◽  
Distribution Systems ◽  
Service Providers ◽  
The United States ◽  
Free Products ◽  
Creative Solutions ◽  
Menstrual Products

Abstract Background There has been increasing recognition that certain vulnerable populations in the United States of America struggle to meet their menstruation-related needs, including people experiencing homelessness. Media and policy attention on this subject has focused on the provision of free menstrual products to vulnerable populations, including a New York City legislative bill, which guarantees access to menstrual products for Department of Homeless Services shelter residents (Intros 1123-A). Methods This qualitative study explored the challenges people experiencing homelessness in New York City face in accessing menstrual products. Data collection was conducted from June to August 2019 and included: Semi-structured key informant interviews with staff from relevant government agencies and homeless service providers (n = 15), and semi-structured in-depth interviews with individuals with experience living on the street and in shelters (n = 22). Data were analysed using thematic analysis. Results Key themes that emerged included: (1) insufficient and inconsistent access to menstrual products; (2) systemic challenges to providing menstrual products; and (3) creative solutions to promote access to menstrual products. Both shelter- and street-living individuals reported significant barriers to accessing menstrual products. While both populations struggle, those in shelters were more likely to be able to purchase menstrual products or access free products at their shelter, while those living on the streets were more likely to have to resort to panhandling, theft, or using makeshift materials in place of menstrual products. Across both populations, individuals described barriers to accessing free products at shelters and service providers, primarily due to distribution systems that rely on gatekeepers to provide a few pads or tampons at a time, sometimes of inadequate quality and only upon request. Shelters and service providers also described challenges providing these products, including inconsistent supply. Conclusion These findings highlight the critical importance of expanding and improving initiatives seeking to provide access to menstrual products for vulnerable populations. Despite policy level efforts to support menstrual product access, individuals experiencing homelessness in New York City, whether living in shelters or on the street, are often not able to access the menstrual products that they need to manage their monthly menstrual flow.

Effect of Alzheimer’s Training on Multicultural Personal Care Aides

2008 ◽  
Vol 9 (1) ◽  
pp. 4-10 ◽  
Author(s):  
Robin C. Fenley ◽  
Sarah J. Bober ◽  
Mebane E. Powell ◽  
Jacquelin Berman ◽  
Barbara N. Altman
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
New York ◽  
New York City ◽  
York City ◽  
The United States ◽  
Personal Care ◽  
Entry Level ◽  
Before And After ◽  
Item Knowledge

This article reports on the first 2 years of an ongoing project that examined the efficacy of a 10-hour dementia training provided to entry-level personal care aide (PCA) trainees from the Hispanic, White, African American, and Asian communities in New York City. Participants were enrolled in a 90-hour PCA training program offered by the New York City Department for the Aging and were either recipients of public assistance, displaced employees from September 11, or recent immigrants to the United States from China. Classes were conducted in Spanish, English, and Mandarin/Cantonese. An 11-item Knowledge of Alzheimer’s Disease instrument was developed for the purposes of this project and administered before and after the dementia training and at 3 months following graduation. All groups, regardless of language, showed a significant increase in knowledge of Alzheimer’s disease at the conclusion of the training and retention of this knowledge at 3 months follow-up. Age was strongly correlated with an increase in knowledge, while gender and education were not.

Cardiovascular Disease Risk Factors Among Immigrant and US-Born Adults in New York City

2021 ◽  
pp. 003335492110075
Author(s):  
Claudia Chernov ◽  
Lisa Wang ◽  
Lorna E. Thorpe ◽  
Nadia Islam ◽  
Amy Freeman ◽  
...  
Keyword(s):  
United States ◽  
Risk Factors ◽  
Cardiovascular Disease ◽  
New York ◽  
New York City ◽  
Health Insurance ◽  
York City ◽  
The United States ◽  
Nutrition Examination Survey ◽  
Health And Nutrition

Objectives Immigrant adults tend to have better health than native-born adults despite lower incomes, but the health advantage decreases with length of residence. To determine whether immigrant adults have a health advantage over US-born adults in New York City, we compared cardiovascular disease (CVD) risk factors among both groups. Methods Using data from the New York City Health and Nutrition Examination Survey 2013-2014, we assessed health insurance coverage, health behaviors, and health conditions, comparing adults ages ≥20 born in the 50 states or the District of Columbia (US-born) with adults born in a US territory or outside the United States (immigrants, following the National Health and Nutrition Examination Survey) and comparing US-born adults with (1) adults who immigrated recently (≤10 years) and (2) adults who immigrated earlier (>10 years). Results For immigrant adults, the mean time since arrival in the United States was 21.8 years. Immigrant adults were significantly more likely than US-born adults to lack health insurance (22% vs 12%), report fair or poor health (26% vs 17%), have hypertension (30% vs 23%), and have diabetes (20% vs 11%) but significantly less likely to smoke (18% vs 27%) (all P < .05). Comparable proportions of immigrant adults and US-born adults were overweight or obese (67% vs 63%) and reported CVD (both 7%). Immigrant adults who arrived recently were less likely than immigrant adults who arrived earlier to have diabetes or high cholesterol but did not differ overall from US-born adults. Conclusions Our findings may help guide prevention programs and policy efforts to ensure that immigrant adults remain healthy.

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