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Background Mycobacterium abscessus , an emerging pathogen in healthcare settings, has rarely been associated with community outbreaks. During February–May 2013, Idaho public health officials and pediatric infectious disease physicians investigated an outbreak of M abscessus skin infections in children whose only common exposure was an indoor wading pool. Methods Healthcare providers and parents reported possible M abscessus cases. We used a standardized questionnaire to interview parents of affected children. Clinical specimens were submitted for mycobacterial examination. We conducted an environmental investigation of the pool. Microbial isolates from clinical and environmental samples were identified by sequencing polymerase chain reaction amplicons and underwent pulsed-field gel electrophoresis. Results Twelve cases were identified. Specimens from 4 of 7 children grew M abscessus or Mycobacterium abscessus/Mycobacterium chelonae. Ten (83%) of 12 children were female; median age was 3 years (range, 2 to 6 years); and all were immunocompetent. Pool maintenance did not fully comply with Idaho state rules governing pool operation. Mycobacterium abscessus / chelonae was isolated from pool equipment. Pulsed-field gel electrophoresis composite patterns were 87% similar between isolates from the pool ladder and 1 patient, and they were 90% similar between isolates from 2 patients. Environmental remediation included hyperchlorination, scrubbing and disinfection of pool surfaces, draining the pool, and replacement of worn pool materials. Conclusions Immunocompetent children acquired M abscessus cutaneous infection involving hands and feet after exposure to a wading pool. Environmental remediation and proper pool maintenance likely halted transmission. Medical and public health professionals' collaboration effectively detected and controlled an outbreak caused by an emerging recreational waterborne pathogen. [ABSTRACT FROM AUTHOR]

In this article the author discusses the prevention the transmission of Clostridium difficile strain or known as the North American pulsed-field gel electrophoresis type I (NAP1) or the polymerase chain reaction ribotype 027 in the U.S. The author is critical on the effect of outbreaks which challenges for infection control programs in long term care facilities and programs in hospitals. Also discussed are the major sources of transmission.

Background. Knowledge of the clinical features of infections caused by Escherichia coli strains that produce plasmid-mediated AmpC β-lactamase is limited. Of the several groups of plasmid-mediated AmpC β-lactamases, CMY-type β-lactamase is the most common in the United States. Methods. We prospectively identified patients infected or colonized with E. coli strains that produce CMY-type β-lactamase, and we collected clinical data over a 7-month period. A retrospective cohort study was performed to identify features associated with these cases. Patients with extended-spectrum β-lactamase-producing E. coli were used as a control group. Pulsed-field gel electrophoresis, plasmid analysis, and phylogenetic typing were performed. Results. Twenty-two patients with infection or colonization due to CMY-type β-lactamase-producing E. coli and 25 patients with infection or colonization due to extended-spectrum β-lactamase-producing E. coli were identified. The demographic characteristics of the patients were similar in both cohorts. Patients with CMY-type β-lactamase-producing E. coli were significantly more likely to have symptomatic infection than were patients with extended-spectrum β-lactamase-producing E. coli (Pp.028). The CMY-type β-lactamase was identified as CMY-2 or its variants. Ninety-four percent of the CMY-type β-lactamase-producing isolates belonged to E. coli phylogenetic groups B2 and D, which are associated with virulence. Many of the isolates shared similar plasmid profiles, whereas the pulsed-field gel electrophoresis profiles were diverse. Co-resistance to non-β-lactam antimicrobials was common. Conclusion. In Pittsburgh, Pennsylvania, CMY-type β-lactamase-producing E. coli strains are almost as common as extended-spectrum β-lactamase-producing E. coli strains, and they cause symptomatic infection in the majority of cases. [ABSTRACT FROM AUTHOR]

Background. Multidrug-resistant Salmonella enteriea serotype Typhimurium Definitive Type 104 (DT104) emerged in the 1990s and is associated with greater clinical severity than pansusceptible S. Typhimurium. Although infection with DT1O4 is common in the United States, it is rarely associated with outbreaks. From October to December 2003, a cluster of DT104 infections with indistinguishable pulsed-field gel electrophoresis patterns was identified in the northeastern United States. Methods. A case-control study that assessed exposures compared case patients to age- and geography-matched control subjects. Information on consumer purchasing and grocery store suppliers was used to trace the implicated food to its source. Results. We identified 58 case patients in 9 states by pulsed-field gel electrophoresis. Representative isolates were phage type DT104 and were resistant to ampicillin, chloramphenicol, streptomycin, sulfamethoxazole, and tetracycline (R-type ACSSuT). Of 27 patients interviewed for the case-control study, 41% were hospitalized (median duration of hospitalization, 4 days). Compared with 71 healthy control subjects, case patients had more medical comorbidities (matched odds ratio, 4.3; 95% confidence interval, 1.5-12.7). Illness was associated with consuming store-bought ground beef prepared as hamburgers at home (matched odds ratio, 5.3; 95% confidence interval, 1.9-15.3) and with eating raw ground beef (P ⩽ .001). Seven case patients (27%), but no control subjects, ate raw ground beef Product traceback linked cases to a single large ground beef manufacturer previously implicated in a multistate outbreak of highly drug-resistant Salmonella enterica Newport infections in 2002. Conclusions. This first multistate outbreak of highly drug-resistant S. Typhimurium DT104 infection associated with ground beef highlights the need for enhanced animal health surveillance and infection control, prudent use of antimicrobials for animals, improved pathogen reduction during processing, and better product tracking and consumer education. [ABSTRACT FROM AUTHOR]

Presents a calendar events regarding biology in the U.S. from March 18, 1991 to June 1, 1991. Course on applications of sensory evaluation in product development; International meeting of the electrophoresis societies; Symposium on manipulation of the avian genome; North American Wildlife and Natural Resources Conference; Symposium on cytokines and their receptors and wound repair.