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Clinical Science and Epidemiology

  • Open Access
    Evolution of Outbreak-Causing Carbapenem-Resistant <span class="named-content genus-species" id="named-content-1">Klebsiella pneumoniae</span> ST258 at a Tertiary Care Hospital over 8 Years
    Research Article | Clinical Science and Epidemiology
    Evolution of Outbreak-Causing Carbapenem-Resistant Klebsiella pneumoniae ST258 at a Tertiary Care Hospital over 8 Years

    The carbapenem class of antibiotics is invaluable for the treatment of selected multidrug-resistant Gram-negative pathogens. The continued transmission of carbapenem-resistant bacteria such as ST258 K. pneumoniae is of serious global public health concern, as treatment options for these infections are limited. This genomic epidemiologic investigation traced the...

    Jane W. Marsh, Mustapha M. Mustapha, Marissa P. Griffith, Daniel R. Evans, Chinelo Ezeonwuka, A. William Pasculle, Kathleen A. Shutt, Alexander Sundermann, Ashley M. Ayres, Ryan K. Shields, Ahmed Babiker, Vaughn S. Cooper, Daria Van Tyne, Lee H. Harrison
  • Open Access
    Comparative Genomics of Antibiotic-Resistant Uropathogens Implicates Three Routes for Recurrence of Urinary Tract Infections
    Research Article | Clinical Science and Epidemiology
    Comparative Genomics of Antibiotic-Resistant Uropathogens Implicates Three Routes for Recurrence of Urinary Tract Infections

    The increasing antimicrobial resistance of uropathogens is challenging the continued efficacy of empiric antibiotic therapy for UTIs, which are among the most frequent bacterial infections worldwide. It has been suggested that drug-resistant uropathogens could persist in the intestine after the resolution of UTI and cause recurrences following periurethral contamination. A better understanding of the transmission dynamics between the...

    Robert Thänert, Kimberly A. Reske, Tiffany Hink, Meghan A. Wallace, Bin Wang, Drew J. Schwartz, Sondra Seiler, Candice Cass, Carey-Ann D. Burnham, Erik R. Dubberke, Jennie H. Kwon, Gautam Dantas
    and for the CDC Prevention Epicenter Program
  • Open Access
    Myeloid and CD4 T Cells Comprise the Latent Reservoir in Antiretroviral Therapy-Suppressed SIVmac251-Infected Macaques
    Research Article | Clinical Science and Epidemiology
    Myeloid and CD4 T Cells Comprise the Latent Reservoir in Antiretroviral Therapy-Suppressed SIVmac251-Infected Macaques

    This study provides further evidence that the latent reservoir is comprised of both CD4+ T cells and myeloid cells. The data presented here suggest that CD4+ T cells and macrophages found throughout tissues in the body can contain replication-competent SIV and contribute to rebound of the virus after treatment interruption. Additionally, we have shown that monocytes in blood contain latent virus and, though not...

    Celina M. Abreu, Rebecca T. Veenhuis, Claudia R. Avalos, Shelby Graham, Daymond R. Parrilla, Edna A. Ferreira, Suzanne E. Queen, Erin N. Shirk, Brandon T. Bullock, Ming Li, Kelly A. Metcalf Pate, Sarah E. Beck, Lisa M. Mangus, Joseph L. Mankowski, Feilim Mac Gabhann, Shelby L. O’Connor, Lucio Gama, Janice E. Clements
  • Open Access
    Antibodies to Enteroviruses in Cerebrospinal Fluid of Patients with Acute Flaccid Myelitis
    Research Article | Clinical Science and Epidemiology
    Antibodies to Enteroviruses in Cerebrospinal Fluid of Patients with Acute Flaccid Myelitis

    The presence in cerebrospinal fluid of antibodies to EV peptides at higher levels than non-AFM controls supports the plausibility of a link between EV infection and AFM that warrants further investigation and has the potential to lead to strategies for diagnosis and prevention of disease.

    Nischay Mishra, Terry Fei Fan Ng, Rachel L. Marine, Komal Jain, James Ng, Riddhi Thakkar, Adrian Caciula, Adam Price, Joel A. Garcia, Jane C. Burns, Kiran T. Thakur, Kimbell L. Hetzler, Janell A. Routh, Jennifer L. Konopka-Anstadt, W. Allan Nix, Rafal Tokarz, Thomas Briese, M. Steven Oberste, W. Ian Lipkin
  • Open Access
    Mice Fed an Obesogenic Western Diet, Administered Antibiotics, and Subjected to a Sterile Surgical Procedure Develop Lethal Septicemia with Multidrug-Resistant Pathobionts
    Research Article | Clinical Science and Epidemiology
    Mice Fed an Obesogenic Western Diet, Administered Antibiotics, and Subjected to a Sterile Surgical Procedure Develop Lethal Septicemia with Multidrug-Resistant Pathobionts

    Obesity remains a prevalent and independent risk factor for life-threatening infection following major surgery. Here, we demonstrate that when mice are fed an obesogenic Western diet (WD), they become susceptible to lethal sepsis with multiple organ damage after exposure to antibiotics and an otherwise-recoverable surgical injury. Analysis of the gut microbiota in this model demonstrates that WD alone leads to loss of Bacteroidetes...

    Sanjiv K. Hyoju, Alexander Zaborin, Robert Keskey, Anukriti Sharma, Wyatt Arnold, Fons van den Berg, Sangman M. Kim, Neil Gottel, Cindy Bethel, Angella Charnot-Katsikas, Peng Jianxin, Carleen Adriaansens, Emily Papazian, Jack A. Gilbert, Olga Zaborina, John C. Alverdy
  • Open Access
    Chronic Wasting Disease in Cervids: Implications for Prion Transmission to Humans and Other Animal Species
    Opinion/Hypothesis | Clinical Science and Epidemiology
    Chronic Wasting Disease in Cervids: Implications for Prion Transmission to Humans and Other Animal Species

    Chronic wasting disease (CWD) is a prion-related transmissible spongiform encephalopathy of cervids, including deer, elk, reindeer, sika deer, and moose. CWD has been confirmed in at least 26 U.S. states, three Canadian provinces, South Korea, Finland, Norway, and Sweden, with a notable increase in the past 5 years. The continued geographic spread of this disease increases the frequency of exposure to CWD prions among cervids, humans,...

    Michael T. Osterholm, Cory J. Anderson, Mark D. Zabel, Joni M. Scheftel, Kristine A. Moore, Brian S. Appleby
  • Open Access
    Optical DNA Mapping Combined with Cas9-Targeted Resistance Gene Identification for Rapid Tracking of Resistance Plasmids in a Neonatal Intensive Care Unit Outbreak
    Research Article | Clinical Science and Epidemiology
    Optical DNA Mapping Combined with Cas9-Targeted Resistance Gene Identification for Rapid Tracking of Resistance Plasmids in a Neonatal Intensive Care Unit Outbreak

    This study presents how a novel method, based on visualizing single plasmids using sequence-specific fluorescent labeling, could be used to analyze the genetic dynamics of an outbreak of resistant bacteria in a neonatal intensive care unit at a Swedish hospital. Plasmids are a central reason for the rapid global spread of bacterial resistance to antibiotics. In a single experimental procedure, this method replaces many traditional...

    Santosh K. Bikkarolla, Viveka Nordberg, Fredrika Rajer, Vilhelm Müller, Muhammad Humaun Kabir, Sriram KK, Albertas Dvirnas, Tobias Ambjörnsson, Christian G. Giske, Lars Navér, Linus Sandegren, Fredrik Westerlund
  • Open Access
    Population Structure, Molecular Epidemiology, and β-Lactamase Diversity among <span class="named-content genus-species" id="named-content-1">Stenotrophomonas maltophilia</span> Isolates in the United States
    Research Article | Clinical Science and Epidemiology
    Population Structure, Molecular Epidemiology, and β-Lactamase Diversity among Stenotrophomonas maltophilia Isolates in the United States

    Multiple antibiotic resistance mechanisms, including two β-lactamases, L1, a metallo-β-lactamase, and L2, a class A cephalosporinase, make S. maltophilia naturally multidrug resistant. Thus, infections caused by S. maltophilia pose a big therapeutic challenge. Our study aims to understand the...

    Maria F. Mojica, Joseph D. Rutter, Magdalena Taracila, Luciano A. Abriata, Derrick E. Fouts, Krisztina M. Papp-Wallace, Thomas J. Walsh, John J. LiPuma, Alejandro J. Vila, Robert A. Bonomo
  • Open Access
    Genomic Characterization of the Emerging Pathogen <span class="named-content genus-species" id="named-content-1">Streptococcus pseudopneumoniae</span>
    Research Article | Clinical Science and Epidemiology
    Genomic Characterization of the Emerging Pathogen Streptococcus pseudopneumoniae

    S. pseudopneumoniae is an overlooked pathogen emerging as the causative agent of lower-respiratory-tract infections and associated with chronic obstructive pulmonary disease (COPD) and exacerbation of COPD. However, much remains unknown on its clinical importance and epidemiology, mainly due to the lack of specific markers to distinguish it from S. pneumoniae...

    Geneviève Garriss, Priyanka Nannapaneni, Alexandra S. Simões, Sarah Browall, Karthik Subramanian, Raquel Sá-Leão, Herman Goossens, Herminia de Lencastre, Birgitta Henriques-Normark
  • Open Access
    Identification of Novel Mobilized Colistin Resistance Gene <em>mcr-9</em> in a Multidrug-Resistant, Colistin-Susceptible <span class="named-content genus-species" id="named-content-1">Salmonella enterica</span> Serotype Typhimurium Isolate
    Editor's Pick Observation | Clinical Science and Epidemiology
    Identification of Novel Mobilized Colistin Resistance Gene mcr-9 in a Multidrug-Resistant, Colistin-Susceptible Salmonella enterica Serotype Typhimurium Isolate

    Colistin is a last-resort antibiotic that is used to treat severe infections caused by MDR and extensively drug-resistant (XDR) bacteria. The World Health Organization (WHO) has designated colistin as a “highest priority critically important antimicrobial for human medicine” (WHO, Critically Important Antimicrobials for Human Medicine, 5th revision, 2017,...

    Laura M. Carroll, Ahmed Gaballa, Claudia Guldimann, Genevieve Sullivan, Lory O. Henderson, Martin Wiedmann

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