scholarly journals Emergence of carbapenemase-producing Klebsiella pneumoniae of sequence type 258 in Michigan, USA

2013 ◽  
Vol 5 (1) ◽  
pp. 5 ◽  
Author(s):  
Ruchika Jain ◽  
Seth T. Walk ◽  
David M. Aronoff ◽  
Vincent B. Young ◽  
Duane W. Newton ◽  
...  
Keyword(s):  
Klebsiella Pneumoniae ◽  
Molecular Epidemiology ◽  
Enterobacter Aerogenes ◽  
Clinical Information ◽  
The United States ◽  
Sequence Type ◽  
Adult Patients ◽  
University Of Michigan ◽  
The University ◽  
Escherichia Col

The prevalence of carbapenemase-producing Enterobacteriaceae (CPE) in our hospital increased beginning in 2009. We aimed to study the clinical and molecular epidemiology of these emerging isolates. We performed a retrospective review of all adult patients with clinical cultures confirmed as CPE by positive modified Hodge test from 5/2009-5/2010 at the University of Michigan Health System (UMHS). Clinical information was obtained from electronic medical records. Available CPE isolates were analyzed by polymerase chain reaction (PCR) and sequencing of the 16S rRNA encoding gene and <em>blaKPC locus</em>. Multilocus sequence typing (MLST) was used to characterize <em>Klebsiella pneumoniae</em> isolates. Twenty six unique CPE isolates were obtained from 25 adult patients. The majority were <em>Klebsiella pneumoniae</em> (n=17). Other isolates included <em>K. oxytoca</em> (n=3), <em>Citrobacter freundii</em> (n=2), <em>Enterobacter cloacae</em> (n=2), <em>Enterobacter aerogenes</em> (n=1) and <em>Escherichia col</em>i (n=1). Molecular characterization of 19 available CPE isolates showed that 13 (68%) carried the KPC-3 allele and 6 (32%) carried the KPC-2 allele. Among 14 available <em>K. pneumoniae</em> strains, 12 (86%) carried the KPC-3 allele and belonged to a common lineage, sequence type (ST) 258. The other 2 (14%) <em>K. pneumoniae</em> isolates carried the KPC-2 allele and belonged to two unique STs. Among these ST 258 strains, 67% were isolated from patients with prior exposures to health care settings outside of our institution. In contrast, all CPE isolates carrying the KPC-2 allele and all non ST 258 CPE isolates had acquisition attributable to our hospital. Molecular epidemiology of carbapenemase producing <em>K. pneumoniae</em> suggests that KPC-3 producing <em>K. pneumoniae</em> isolates of a common lineage, sequence type (ST 258), are emerging in our hospital. While ST 258 is a dominant sequence type throughout the United States, this study is the first to report its presence in Michigan.

scholarly journals Molecular Epidemiology of KPC-Producing Klebsiella pneumoniae Isolates in the United States: Clonal Expansion of Multilocus Sequence Type 258

2009 ◽  
Vol 53 (8) ◽  
pp. 3365-3370 ◽  
Author(s):  
Brandon Kitchel ◽  
J. Kamile Rasheed ◽  
Jean B. Patel ◽  
Arjun Srinivasan ◽  
Shiri Navon-Venezia ◽  
...  
Keyword(s):  
United States ◽  
Klebsiella Pneumoniae ◽  
Molecular Epidemiology ◽  
Plasmid Dna ◽  
Restriction Analysis ◽  
Clonal Expansion ◽  
The United States ◽  
Pulsed Field Gel Electrophoresis ◽  
Sequence Type ◽  
Control And Prevention

ABSTRACT Klebsiella pneumoniae carbapenemase (KPC)-producing Enterobacteriaceae have become more common in the United States and throughout the world. We used pulsed-field gel electrophoresis (PFGE) and multilocus sequence typing (MLST) to examine the molecular epidemiology of KPC-producing K. pneumoniae isolates sent to the Centers for Disease Control and Prevention (CDC) for reference testing from 1996 to 2008. A dominant strain, sequence type 258 (ST 258), was found and likely accounts for 70% of the CDC's K. pneumoniae PFGE database. Isolates with PFGE patterns related to ST 258 were identified in 10 of the 19 U.S. states currently reporting KPC-producing K. pneumoniae, in addition to one isolate from Israel. KPC subtyping and analysis of the surrounding genetic environment were subsequently performed on 23 representative isolates. Thirteen isolates identified as ST 258 possessed either bla KPC-2 or bla KPC-3 and some variability in the Tn4401 element upstream of the bla KPC gene. Escherichia coli DH10B was successfully transformed by electroporation with KPC-encoding plasmid DNA from 20 of the 23 isolates. Restriction analysis of plasmid DNA prepared from transformants revealed a diversity of band patterns, suggesting the presence of different plasmids harboring the bla KPC gene, even among isolates of the same ST.

scholarly journals Collecting Anarchy: Continuing the Legacy of the Joseph A. Labadie Collection

2007 ◽  
Vol 8 (2) ◽  
pp. 133-140
Author(s):  
Julie Herrada
Keyword(s):  
Spanish Civil War ◽  
Civil Liberties ◽  
The United States ◽  
Social Protest ◽  
Industrial Workers ◽  
University Of Michigan ◽  
Gay Liberation ◽  
Protest Movements ◽  
Radical History ◽  
The University

The Joseph A. Labadie Collection at the University of Michigan is one of the oldest and most comprehensive collections of radical history in the United States, bringing together unique materials that document past as well as contemporary social protest movements. In addition to anarchism and labor movements, topics that were its original focus, the Collection today is particularly strong in civil liberties (with an emphasis on racial minorities), socialism, communism, colonialism and imperialism, American labor history through the 1930s, the Industrial Workers of the World (IWW or the Wobblies), the Spanish Civil War, sexual freedom, women’s liberation, gay liberation, the . . .

scholarly journals Prediction of Prognosis in Adult Patients With Carbapenem-Resistant Klebsiella pneumoniae Infection

2022 ◽  
Vol 11 ◽  
Author(s):  
Jihui Chen ◽  
Yu Yang ◽  
Huimin Yao ◽  
Shuhong Bu ◽  
Lixia Li ◽  
...  
Keyword(s):  
High Risk ◽  
Klebsiella Pneumoniae ◽  
Treatment Effectiveness ◽  
Risk Group ◽  
Clinical Information ◽  
Tertiary Hospital ◽  
High Risk Group ◽  
Adult Patients ◽  
Carbapenem Resistant ◽  
Prediction Of Prognosis

ObjectiveCarbapenem-resistant Klebsiella pneumoniae (CRKP) infections are associated with poor patient outcomes. We aimed to analyze the clinical information of adult patients with CRKP infection in order to establish a nomogram for mortality risk as well as to determine the treatment effectiveness of different antimicrobial regimens.MethodsAdult patients diagnosed with CRKP infection in a tertiary hospital in Shanghai between September 2019 and March 2021 were included. The clinical characteristics and clinical outcomes of these patients were analyzed.ResultsA total of 199 cases of CRKP infection were examined. Five factors, namely age ≥65 years, respiratory failure, Sequential Organ Failure Assessment score, serum procalcitonin ≥5 ng/mL, and appropriate treatments in 3 days, were found to be associated with 30-day mortality. Upon incorporating these factors, the nomogram achieved good concordance indexes of 0.85 (95% confidence interval [CI]: 0.80–0.90) and well-fitted calibration curves. Receiver-operating characteristic curves for 7-, 15-, and 30-day survival had areas under the curve of 0.90, 0.87, and 0.88, respectively. Three-drug combination therapy was observed to be associated with lower mortality in the high-risk group (adjusted hazard ratio = 0.24, 95% CI: 0.06–0.99) but not in the low-risk group. Ceftazidime–avibactam, fosfomycin, and amikacin were effective against infections caused by CRKP. Tigecycline improved the treatment efficiency in 7 days, but a trend toward increased mortality was seen (HR, 1.69; 95% CI: 0.98–2.94; P = 0.061).ConclusionThe antimicrobial regimen efficacy data and the predictive nomogram established in this study can help clinicians in identifying high-risk adult patients with CRKP infection, improving the therapeutic effect, and reducing mortality.

scholarly journals SARS-CoV-2 Genomic Surveillance Reveals Little Spread From a Large University Campus to the Surrounding Community

2021 ◽  
Vol 8 (11) ◽  
Author(s):  
Andrew L Valesano ◽  
William J Fitzsimmons ◽  
Christopher N Blair ◽  
Robert J Woods ◽  
Julie Gilbert ◽  
...  
Keyword(s):  
The United States ◽  
Incidence Rates ◽  
Transmission Dynamics ◽  
University Of Michigan ◽  
University Campus ◽  
High Incidence ◽  
Study Interval ◽  
Washtenaw County ◽  
The University ◽  
Subsequent Wave

Abstract Background Coronavirus disease 2019 (COVID-19) has had high incidence rates at institutions of higher education (IHE) in the United States, but the transmission dynamics in these settings are poorly understood. It remains unclear to what extent IHE-associated outbreaks have contributed to transmission in nearby communities. Methods We implemented high-density prospective genomic surveillance to investigate these dynamics at the University of Michigan and the surrounding community during the Fall 2020 semester (August 16–November 24). We sequenced complete severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) genomes from 1659 individuals, including 468 students, representing 20% of cases in students and 25% of total cases in Washtenaw County over the study interval. Results Phylogenetic analysis identified &gt;200 introductions into the student population, most of which were not related to other student cases. There were 2 prolonged student transmission clusters, of 115 and 73 individuals, that spanned multiple on-campus residences. Remarkably, &lt;5% of nonstudent genomes were descended from student clusters, and viral descendants of student cases were rare during a subsequent wave of infections in the community. Conclusions The largest outbreaks among students at the University of Michigan did not significantly contribute to the rise in community cases in Fall 2020. These results provide valuable insights into SARS-CoV-2 transmission dynamics at the regional level.

scholarly journals Serotype and Genotype (Multilocus Sequence Type) ofStreptococcus suisIsolates from the United States Serve as Predictors of Pathotype

2019 ◽  
Vol 57 (9) ◽  
Author(s):  
April A. Estrada ◽  
Marcelo Gottschalk ◽  
Stephanie Rossow ◽  
Aaron Rendahl ◽  
Connie Gebhart ◽  
...  
Keyword(s):  
United States ◽  
Odds Ratio ◽  
Clinical Information ◽  
The United States ◽  
Growing Pigs ◽  
Sequence Type ◽  
Primary Methods ◽  
Content Type ◽  
History Of ◽  
Sequence Types

ABSTRACTStreptococcus suisis a significant cause of mortality in piglets and growing pigs worldwide. The species contains pathogenic and commensal strains, with pathogenic strains causing meningitis, arthritis, endocarditis, polyserositis, and septicemia. Serotyping and multilocus sequence typing (MLST) are primary methods to differentiate strains, but the information is limited for strains found in the United States. The objective of this study was to characterize the diversity of 208S. suisisolates collected between 2014 and 2017 across North America (mainly the United States) by serotyping and MLST and to investigate associations between subtype and pathotype classifications (pathogenic, possibly opportunistic, and commensal), based on clinical information and site of isolation. Twenty serotypes were identified, and the predominant serotypes were 1/2 and 7. Fifty-eight sequence types (STs) were identified, and the predominant ST was ST28. Associations among serotypes, STs, and pathotypes were investigated using odds ratio and clustering analyses. Evaluation of serotype and ST with pathotype identified a majority of isolates of serotypes 1, 1/2, 2, 7, 14, and 23 and ST1, ST13, ST25, ST28, ST29, ST94, ST108, ST117, ST225, ST373, ST961, and ST977 as associated with the pathogenic pathotype. Serotypes 21 and 31, ST750, and ST821 were associated with the commensal pathotype, which is composed of isolates from farms with no known history ofS. suis-associated disease. Our study demonstrates the use of serotyping and MLST to differentiate pathogenic from commensal isolates and establish links between pathotype and subtype, thus increasing the knowledge aboutS. suisstrains circulating in the United States.

Book Reviews

2018 ◽  
Vol 56 (4) ◽  
pp. 1594-1596
Keyword(s):  
United States ◽  
Foreign Exchange ◽  
The United States ◽  
University Of Michigan ◽  
Strong Connection ◽  
Foreign Exchange Intervention ◽  
New Strategy ◽  
The University ◽  
Economics And Politics

Kathryn M. E. Dominguez of the University of Michigan reviews “Currency Conflict and Trade Policy: A New Strategy for the United States,” by C. Fred Bergsten and Joseph E. Gagnon. The Econlit abstract of this book begins: “Analyzes the economics and politics of currency manipulation, globally and with respect to the key individual countries that engage in repeated intervention or feel its effects, and demonstrates empirically the strong connection between official foreign-exchange intervention and trade imbalances.”

scholarly journals Nationwide Study of the Prevalence, Characteristics, and Molecular Epidemiology of Extended-Spectrum-β-Lactamase-Producing Enterobacteriaceae in France

2007 ◽  
Vol 52 (2) ◽  
pp. 786-789 ◽  
Author(s):  
Muriel Galas ◽  
Jean-Winoc Decousser ◽  
Nelly Breton ◽  
Thierry Godard ◽  
Pierre Yves Allouch ◽  
...  
Keyword(s):  
Escherichia Coli ◽  
Klebsiella Pneumoniae ◽  
Molecular Epidemiology ◽  
Molecular Analysis ◽  
Enterobacter Aerogenes ◽  
Nationwide Study ◽  
E Coli ◽  
Extended Spectrum ◽  
Prevalent Species

ABSTRACT Among 10,872 isolates of Enterobacteriaceae from a nationwide study of 88 French hospitals in 2005, 169 (1.7%) expressed an extended-spectrum β-lactamase. The most prevalent species were Escherichia coli (48.5%), Enterobacter aerogenes (23.7%), and Klebsiella pneumoniae (14.8%). Molecular analysis underlined the polyclonal spread of CTX-M-expressing E. coli, primarily isolates of the CTX-M-1 subgroup.

The Master Synthesizer

2016 ◽  
Vol 33 (3) ◽  
pp. 11-18
Author(s):  
Seifudein Adem
Keyword(s):  
The United States ◽  
Secretary General ◽  
University Of Michigan ◽  
Human Beings ◽  
Makerere University ◽  
Secondary School Education ◽  
Nelson Mandela ◽  
Organization Of African Unity ◽  
The University ◽  
University Of Manchester

Ali Mazrui was born in 1933 in Mombasa, Kenya. Sent to England in 1955 for his secondary school education, he remained there until he earned hisB.A. (1960, politics and philosophy) with distinction from the University of Manchester. He received his M.A. (1961, government and politics) and Ph.D. (1966, philosophy) from Columbia and Oxford universities, respectively. In Africa, he taught political science at Uganda’s Makerere University College (1963-73), and then returned to the United States to teach at the University of Michigan (1974-91) and New York’s Binghamton University (1991-2014). An avatar of controversy, Mazrui was also legendary for the fertility of his mind. Nelson Mandela viewed him as “an outstanding educationist” 1 and Kofi Annan, former secretary-general of the United Nations, referred to him as “Africa’s gift to the world.”2 Salim Ahmed Salim, former secretary-general of the Organization of African Unity and prime minister of Tanzania wrote: Ali Mazrui provided [many of us] with the illuminating light to understand the reality we have been confronting. He armed us with the tools of engagement and inspired us with his eloquence, clarity of ideas while all the time maintaining the highest degree of humility, respect for fellow human beings, and an unflagging commitment to justice.

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