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151. 2350. LiaF is required for LiaX mediated protection against Daptomycin and LL-37 in Enterococcus faecalis OG1RF

Author

Botero, Diana Panesso, primary, Singh, Kavindra, additional, Gomez-Villegas, Sara-Isabel, additional, Khan, Ayesha, additional, Supande, Adeline, additional, Nguyen, April, additional, Rincon, Sandra, additional, Hood, Kara S, additional, Dinh, An, additional, Deyanov, Alexander, additional, Miller, William R, additional, Shamoo, Yousif, additional, Tran, Cecilia, additional, and Arias, Cesar A, additional

Published
2022
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152. Human Dectin-1 deficiency impairs macrophage-mediated defense against phaeohyphomycosis

Author

Drummond, Rebecca A., primary, Desai, Jigar V., additional, Hsu, Amy P., additional, Oikonomou, Vasileios, additional, Vinh, Donald C., additional, Acklin, Joshua A., additional, Abers, Michael S., additional, Walkiewicz, Magdalena A., additional, Anzick, Sarah L., additional, Swamydas, Muthulekha, additional, Vautier, Simon, additional, Natarajan, Mukil, additional, Oler, Andrew J., additional, Yamanaka, Daisuke, additional, Mayer-Barber, Katrin D., additional, Iwakura, Yoichiro, additional, Bianchi, David, additional, Driscoll, Brian, additional, Hauck, Ken, additional, Kline, Ahnika, additional, Viall, Nicholas S.P., additional, Zerbe, Christa S., additional, Ferré, Elise M.N., additional, Schmitt, Monica M., additional, DiMaggio, Tom, additional, Pittaluga, Stefania, additional, Butman, John A., additional, Zelazny, Adrian M., additional, Shea, Yvonne R., additional, Arias, Cesar A., additional, Ashbaugh, Cameron, additional, Mahmood, Maryam, additional, Temesgen, Zelalem, additional, Theofiles, Alexander G., additional, Nigo, Masayuki, additional, Moudgal, Varsha, additional, Bloch, Karen C., additional, Kelly, Sean G., additional, Whitworth, M. Suzanne, additional, Rao, Ganesh, additional, Whitener, Cindy J., additional, Mafi, Neema, additional, Gea-Banacloche, Juan, additional, Kenyon, Lawrence C., additional, Miller, William R., additional, Boggian, Katia, additional, Gilbert, Andrea, additional, Sincock, Matthew, additional, Freeman, Alexandra F., additional, Bennett, John E., additional, Hasbun, Rodrigo, additional, Mikelis, Constantinos M., additional, Kwon-Chung, Kyung J., additional, Belkaid, Yasmine, additional, Brown, Gordon D., additional, Lim, Jean K., additional, Kuhns, Douglas B., additional, Holland, Steven M., additional, and Lionakis, Michail S., additional

Published
2022
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153. Multiomics characterization of methicillin-resistantStaphylococcus aureus(MRSA) isolates with heterogeneous intermediate resistance to vancomycin (hVISA) in Latin America

Author

Castro, Betsy E, primary, Rios, Rafael, additional, Carvajal, Lina P, additional, Vargas, Mónica L, additional, Cala, Mónica P, additional, León, Lizeth, additional, Hanson, Blake, additional, Dinh, An Q, additional, Ortega-Recalde, Oscar, additional, Seas, Carlos, additional, Munita, Jose M, additional, Arias, Cesar A, additional, Rincon, Sandra, additional, Reyes, Jinnethe, additional, and Diaz, Lorena, additional

Published
2022
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162. International Multicenter Study Comparing Cancer to Non-Cancer Patients with COVID-19: Impact of Risk Factors and Treatment Modalities on Survivorship

Author

Raad, Issam, Hachem, Ray, Masayuki, Nigo, Datoguia, Tarcila, Dagher, Hiba, Jiang, Ying, Subbiah, Vivek, Siddiqui, Bilal, Bayle, Arnaud, Somer, Robert, Cruz, Ana Fernández, Gorak, Edward, Bhinder, Arvinder, Mori, Nobuyoshi, Hamerschlak, Nelson, Shelanski, Samuel, Dragivich, Tomislav, Kiat, Yee Elise Vong, Fakhreddine, Suha, Hanna, Pierre Abi, Chemaly, Roy F., Mulanovich, Victor, Adachi, Javier, Borjan, Jovan, Khawaja, Fareed, Granwehr, Bruno, John, Teny, Guevara, Eduardo Yepez, Torres, Harrys, Ammakkanavar, Natraj Reddy, Yibirin, Marcel, Reyes-Gibby, Cielito C, Pande, Mala, Ali, Noman, Rojo, Raniv Dawey, Ali, Shahnoor M, Deeba, Rita E, Chaftari, Patrick, Matsuo, Takahiro, Ishikawa, Kazuhiro, Hasegawa, Ryo, Aguado-Noya, Ramón, García-García, Álvaro, Puchol, Cristina Traseira, Lee, Dong-Gun, Slavin, Monica, Teh, Benjamin, Arias, Cesar A, Kontoyiannis, Dimitrios P., Malek, Alexandre E., and Chaftari, Anne-Marie

Subjects
Article
Abstract

BackgroundIn this international multicenter study we aimed to determine the independent risk factors associated with increased 30-day mortality and the impact of novel treatment modalities in a large group of cancer and non-cancer patients with COVID-19 from multiple countries.MethodsWe retrospectively collected de-identified data on a cohort of cancer and non-cancer patients diagnosed with COVID-19 between January and November 2020, from 16 international centers.ResultsWe analyzed 3966 COVID-19 confirmed patients, 1115 cancer and 2851 non-cancer patients. Cancer patients were more likely to be pancytopenic, and have a smoking history, pulmonary disorders, hypertension, diabetes mellitus, and corticosteroid use in the preceding two weeks (p≤0.01). In addition, they were more likely to present with higher inflammatory biomarkers (D-dimer, ferritin and procalcitonin), but were less likely to present with clinical symptoms (p≤0.01). By multivariable logistic regression analysis, cancer was an independent risk factor for 30-day mortality (OR 1.46; 95% CI 1.03 to 2.07; p=0.035). Older age (≥65 years) was the strongest predictor of 30-day mortality in all patients (OR 4.55; 95% CI 3.34 to6.20; p< 0.0001). Remdesivir was the only therapeutic agent independently associated with decreased 30-day mortality (OR 0.58; CI 0.39-0.88; p=0.009). Among patients on low-flow oxygen at admission, patients who received remdesivir had a lower 30-day mortality rate than those who did not (5.9% vs 17.6%; p=0.03).ConclusionsCancer is an independent risk factor for increased 30-day all-cause mortality from COVID-19. Remdesivir, particularly in patients receiving low-flow oxygen, can reduce 30-day all-cause mortality.Condensed AbstractIn this large multicenter worldwide study of 4015 patients with COVID-19 that included 1115 patients with cancer, we found that cancer is an independent risk factor for increased 30-day all-cause mortality. Remdesivir is a promising treatment modality to reduce 30-day all-cause mortality.

Published
2022

163. Characteristics of community-acquired carbapenem-resistant Enterobacterales

Author

Shrestha, Rima, Luterbach, Courtney L, Dai, Weixiao, Komarow, Lauren, Earley, Michelle, Weston, Gregory, Herc, Erica, Jacob, Jesse T, Salata, Robert, Wong, Darren, Anderson, Deverick, Rydell, Kirsten B, Arias, Cesar A, Chen, Liang, and van Duin, David

Subjects
Pharmacology, Microbiology (medical), Genetic Markers, Enterobacteriaceae Infections, beta-Lactamases, Anti-Bacterial Agents, Klebsiella pneumoniae, Infectious Diseases, Carbapenem-Resistant Enterobacteriaceae, Bacterial Proteins, Carbapenems, Humans, Pharmacology (medical), Original Research
Abstract

Background Community-acquired carbapenem-resistant Enterobacterales (CA-CRE) are an important threat. Methods In CRACKLE-2, we defined patients with CA-CRE as admitted from home, without pre-existing conditions, and a positive culture within 48 h of admission. Healthcare-associated CRE (HA-CRE) were those with the lowest likelihood of community acquisition, not admitted from home and cultured >48 h after admission. Specific genetic markers in carbapenemase-producing Klebsiella pneumoniae were evaluated through random forest modelling. Results CA-CRE and HA-CRE were detected in 83 (10%) and 208 (26%) of 807 patients. No significant differences were observed in bacterial species or strain type distribution. K. pneumoniae (204/291, 70%) was the most common CRE species, of these 184/204 (90%) were carbapenemase producers (CPKP). The top three genetic markers in random forest models were kpi_SA15, fimE, and kpfC. Of these, kpi_SA15 (which encodes a chaperone/usher system) was positively associated (OR 3.14, 95% CI 1.13–8.87, P = 0.026), and kpfC negatively associated (OR 0.21, 95% CI 0.05–0.72, P = 0.015) with CA-CPKP. Conclusions Ten percent of CDC-defined CRE were CA. The true proportion of CA-CRE in hospitalized patients is likely lower as patients may have had unrecorded prior healthcare exposure. The kpi_SA15 operon was associated with the CA phenotype.

Published
2022

165. Phage Cocktails with Daptomycin and Ampicillin Eradicates Biofilm-Embedded Multidrug-Resistant Enterococcus faecium with Preserved Phage Susceptibility

Author

Kunz Coyne, Ashlan, primary, Stamper, Kyle, additional, Kebriaei, Razieh, additional, Holger, Dana J., additional, El Ghali, Amer, additional, Morrisette, Taylor, additional, Biswas, Biswajit, additional, Wilson, Melanie, additional, Deschenes, Michael V., additional, Canfield, Gregory S., additional, Duerkop, Breck A., additional, Arias, Cesar A., additional, and Rybak, Michael J., additional

Published
2022
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167. Prevalence and Characterization of the Cefazolin Inoculum Effect in North American Methicillin-Susceptible Staphylococcus aureus Isolates

Author

Dingle, Tanis C., primary, Gamage, Dulini, additional, Gomez-Villegas, Sara, additional, Hanson, Blake M., additional, Reyes, Jinnethe, additional, Abbott, April, additional, Burnham, Carey-Ann D., additional, Dien Bard, Jennifer, additional, Fritz, Stephanie, additional, Miller, William R., additional, Westblade, Lars F., additional, Zimmer, Barbara, additional, Arias, Cesar A., additional, and Butler-Wu, Susan, additional

Published
2022
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168. Reply to Lutgring et al

Author

Darkoh, Charles, primary, DuPont, Herbert L, additional, Arias, Cesar A., additional, Oyaro, Micah, additional, Brown, Eric L, additional, and Hanson, Blake M, additional

Published
2022
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169. In Memoriam: John P. Quinn, MD

Author

Perez, Federico, Arias, Cesar A., Bush, Karen, Drusano, George L., Lolans, Karen, Munoz-Price, L. Silvia, Nicolau, David P., Queenan, Anne Marie, Rice, Louis B., Segreti, John, Shlaes, David M., Weinstein, Robert A., and Bonomo, Robert A.

Published
2014
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176. Methicillin-susceptible, vancomycin-resistant Staphylococcus aureus, Brazil

Author

Panesso, Diana, Planet, Paul J., Diaz, Lorena, Hugonnet, Jean-Emmanuel, Tran, Truc T., Narechania, Apurva, Munita, Jose M., Rincon, Sandra, Carvajal, Lina P., Reyes, Jinnethe, Londono, Alejandra, Smith, Hannah, Sebra, Robert, Deikus, Gintaras, Weinstock, George M., Murray, Barbara E., Rossi, Flavia, Arthur, Michel, and Arias, Cesar A.

Subjects
Staphylococcus aureus, Drug resistance in microorganisms, Vancomycin, Health
Abstract

Acquisition of high-level vancomycin resistance by Staphylococcus aureus represents a major public health risk because this antimicrobial drug continues to be the first-line and most inexpensive therapy to treat methicillin-resistant [...]

Published
2015
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177. Producción y Comercialización de Pulpa de Frutas en Campi Fruber

Author

Basto Mogollón, Yamid / Asesor, Arias Arias, Cesar Isidro, Calvo Valbuena, Rafael Antonio, López Castrillón, Stefanía, Mejía Galeano, Nayla Fernanda, Basto Mogollón, Yamid / Asesor, Arias Arias, Cesar Isidro, Calvo Valbuena, Rafael Antonio, López Castrillón, Stefanía, and Mejía Galeano, Nayla Fernanda

Abstract

CAMPI FRUBER LTDA, dentro de sus políticas institucionales y luego de una larga experiencia en la comercialización de frutas, busca una nueva línea de negocio, haciendo una transformación de alta calidad del producto, apoyados en herramientas como el marketing y la tecnología. Así, de esta manera, apoyar a las comunidades rurales a comercializar sus cultivos frutales, impactando positivamente en los mercados nacionales para encontrar frutas de calidad a precios justos y mejorar los hábitos de consumo de las familias colombianas., CAMPI FRUBER LTDA, within its institutional policies and after a long experience in the marketing of fruits, seeks a new line of business, making a transformation of high quality product, supported by tools such as marketing and technology. Thus, in this way, support rural communities to market their fruit crops, positively impacting national markets to find quality fruits at fair prices and improve the consumption habits of Colombian families.

Published
2022

178. Contemporary Clinical and Molecular Epidemiology of Vancomycin-Resistant Enterococcal Bacteremia: A Prospective Multicenter Cohort Study (VENOUS I)

Author

Contreras, German A., Munita, Jose M., Simar, Shelby, Luterbach, Courtney, Dinh, An Q., Rydell, Kirsten, Sahasrabhojane, Pranoti, V, Rios, Rafael, Diaz, Lorena, Reyes, Katherine, Zervos, Marcus, Misikir, Helina M., Sanchez-Petitto, Gabriela, Liu, Catherine, Doi, Yohei, Abbo, Lilian M., Shimose, Luis, Seifert, Harald, Gudiol, Carlota, Barberis, Fernanda, Pedroza, Claudia, Aitken, Samuel L., Shelburne, Samuel A., Duin, Davidvan, Tran, Truc T., Hanson, Blake M., Arias, Cesar A., Contreras, German A., Munita, Jose M., Simar, Shelby, Luterbach, Courtney, Dinh, An Q., Rydell, Kirsten, Sahasrabhojane, Pranoti, V, Rios, Rafael, Diaz, Lorena, Reyes, Katherine, Zervos, Marcus, Misikir, Helina M., Sanchez-Petitto, Gabriela, Liu, Catherine, Doi, Yohei, Abbo, Lilian M., Shimose, Luis, Seifert, Harald, Gudiol, Carlota, Barberis, Fernanda, Pedroza, Claudia, Aitken, Samuel L., Shelburne, Samuel A., Duin, Davidvan, Tran, Truc T., Hanson, Blake M., and Arias, Cesar A.

Abstract

Background Vancomycin-resistant enterococci (VRE) are major therapeutic challenges. Prospective contemporary data characterizing the clinical and molecular epidemiology of VRE bloodstream infections (BSIs) are lacking. Methods The Vancomycin-Resistant Enterococcal BSI Outcomes Study (VENOUS I) is a prospective observational cohort of adult patients with enterococcal BSI in 11 US hospitals. We included patients with Enterococcus faecalis or Enterococcus faecium BSI with >= 1 follow-up blood culture(s) within 7 days and availability of isolate(s) for further characterization. The primary study outcome was in-hospital mortality. Secondary outcomes were mortality at days 4, 7, 10, 12, and 15 after index blood culture. A desirability of outcome ranking was constructed to assess the association of vancomycin resistance with outcomes. All index isolates were subjected to whole genome sequencing. Results Forty-two of 232 (18%) patients died in hospital and 39 (17%) exhibited microbiological failure (lack of clearance in the first 4 days). Neutropenia (hazard ratio [HR], 3.13), microbiological failure (HR, 2.4), VRE BSI (HR, 2.13), use of urinary catheter (HR, 1.85), and Pitt BSI score >= 2 (HR, 1.83) were significant predictors of in-hospital mortality. Microbiological failure was the strongest predictor of in-hospital mortality in patients with E faecium bacteremia (HR, 5.03). The impact of vancomycin resistance on mortality in our cohort changed throughout the course of hospitalization. Enterococcus faecalis sequence type 6 was a predominant multidrug-resistant lineage, whereas a heterogeneous genomic population of E faecium was identified. Conclusions Failure of early eradication of VRE from the bloodstream is a major factor associated with poor outcomes. Failure to eradicate enterococci from the bloodstream in the first 4 days after the index blood culture was the most consistent factor associated with increased risk of mortality. The association of vancomycin resistanc

Published
2022

179. O02 TRAIL, IP-10, CRP host-protein signature score distinguishes between viral and bacterial infection in sepsis patients

Author

Stas, Jeroen, primary, Arias, Cesar A, additional, Bachur, Richard, additional, Esposito, Susanna, additional, Halabi, Salim, additional, Kaplan, Sheldon K, additional, Klein, Adi, additional, Motov, Sergey M, additional, Rothman, Richard, additional, Ryan, Leticia M, additional, Shiber, Shachaf, additional, Tenenbaum, Tobias, additional, and Weissman, Alexandra, additional

Published
2022
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180. Systematic Analysis of Mobile Genetic Elements Mediating β-lactamase Gene Amplification in Non-Carbapenemase-Producing Carbapenem Resistant Enterobacterales Bloodstream Infections

Author

Shropshire, William C, primary, Konovalova, Anna, additional, McDaneld, Patrick M, additional, Gohel, Marc H, additional, Strope, Benjamin S, additional, Sahasrabhojane, Pranoti V, additional, Tran, Chau N, additional, Greenberg, David, additional, Kim, Jiwoong, additional, Zhan, Xiaowei, additional, Aitken, Samuel, additional, Bhatti, Micah M, additional, Savidge, Tor C, additional, Treangen, Todd, additional, Hanson, Blake, additional, Arias, Cesar A., additional, and Shelburne, Samuel A, additional

Published
2022
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182. Accessory Genomes Drive Independent Spread of Carbapenem-Resistant Klebsiella pneumoniae Clonal Groups 258 and 307 in Houston, TX

Author

Shropshire, William C., primary, Dinh, An Q., additional, Earley, Michelle, additional, Komarow, Lauren, additional, Panesso, Diana, additional, Rydell, Kirsten, additional, Gómez-Villegas, Sara I., additional, Miao, Hongyu, additional, Hill, Carol, additional, Chen, Liang, additional, Patel, Robin, additional, Fries, Bettina C., additional, Abbo, Lilian, additional, Cober, Eric, additional, Revolinski, Sara, additional, Luterbach, Courtney L., additional, Chambers, Henry, additional, Fowler, Vance G., additional, Bonomo, Robert A., additional, Shelburne, Samuel A., additional, Kreiswirth, Barry N., additional, van Duin, David, additional, Hanson, Blake M., additional, and Arias, Cesar A., additional

Published
2022
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183. Carbapenem-Resistant Acinetobacter baumannii in U.S. Hospitals: Diversification of Circulating Lineages and Antimicrobial Resistance

Author

Iovleva, Alina, primary, Mustapha, Mustapha M., additional, Griffith, Marissa P., additional, Komarow, Lauren, additional, Luterbach, Courtney, additional, Evans, Daniel R., additional, Cober, Eric, additional, Richter, Sandra S., additional, Rydell, Kirsten, additional, Arias, Cesar A., additional, Jacob, Jesse T., additional, Salata, Robert A., additional, Satlin, Michael J., additional, Wong, Darren, additional, Bonomo, Robert A., additional, van Duin, David, additional, Cooper, Vaughn S., additional, Van Tyne, Daria, additional, and Doi, Yohei, additional

Published
2022
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184. Consensus on β-Lactamase Nomenclature

Author

Bradford, Patricia A., primary, Bonomo, Robert A., additional, Bush, Karen, additional, Carattoli, Alessandra, additional, Feldgarden, Michael, additional, Haft, Daniel H., additional, Ishii, Yoshikazu, additional, Jacoby, George A., additional, Klimke, William, additional, Palzkill, Timothy, additional, Poirel, Laurent, additional, Rossolini, Gian Maria, additional, Tamma, Pranita D., additional, and Arias, Cesar A., additional

Published
2022
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185. Reply to Kaye and Belley, “Third-Generation Cephalosporin-Resistant Enterobacterales Are Critical Priority Pathogens, Too!”

Author

Butler, Mark S., primary, Gigante, Valeria, additional, Sati, Hatim, additional, Paulin, Sarah, additional, Al-Sulaiman, Laila, additional, Rex, John H., additional, Fernandes, Prabhavathi, additional, Arias, Cesar A., additional, Paul, Mical, additional, Thwaites, Guy E., additional, Czaplewski, Lloyd, additional, Alm, Richard A., additional, Lienhardt, Christian, additional, Spigelman, Melvin, additional, Silver, Lynn L., additional, Ohmagari, Norio, additional, Kozlov, Roman, additional, Harbarth, Stephan, additional, and Beyer, Peter, additional

Published
2022
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190. Production of Recombinant Biopharmaceuticals in Chlamydomonas reinhardtii.

Author

Diaz Arias, Cesar Andres, Martiniuc de Oliveira, Caroline Frere, Dutra Molino, João Vitor, Seno Ferreira-Camargo, Livia, Matsudo, Marcelo Chuei, and Monteiro de Carvalho, João Carlos

Subjects
*CHLAMYDOMONAS, *CHLAMYDOMONAS reinhardtii, *BIOPHARMACEUTICS, *BACTERIAL proteins, *DIAGNOSTIC reagents & test kits, *PROTEIN folding, *TRANSGENE expression
Abstract

This review aimed to present Chlamydomonas reinhardtii as an alternative for heterologous protein production, especially for biopharmaceuticals, and its general characteristics when compared with other expression systems. The need to produce heterologous proteins for industrial interest, therapeutic ends, and diagnostic kits has led to the development of recombinant microalgal technology. This technology presents some interesting features, such as rapid growth and low transgene dispersion compared to plants, the ability to fold complex proteins compared to bacteria, and low production costs compared to other expression systems, such as yeast and mammalian cells. Overall, C. reinhardtii heterologous protein expression is coming of age with several research groups focused on developing an optimal producer strain. [ABSTRACT FROM AUTHOR]

Published
2023
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191. Clinical characteristics, microbiology and outcomes of a cohort of patients treated with ceftolozane/tazobactam in acute care inpatient facilities, Houston, Texas, USA.

Author

Tran, Truc T., Cabrera, Nicolo L., Gonzales-Luna, Anne J., Carlson, Travis J., Alnezary, Faris, Miller, William R., Sakurai, Aki, Dinh, An Q., Rydell, Kirsten, Rios, Rafael, Diaz, Lorena, Hanson, Blake M., Munita, Jose M., Pedroza, Claudia, Shelburne, Samuel A., Aitken, Samuel L., Garey, Kevin W., Dillon, Ryan, Puzniak, Laura, and Arias, Cesar A.

Published
2023
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192. Clinical and Molecular Analyses of Recurrent Gram-Negative Bloodstream Infections.

Author

Bock, Andrew, Hanson, Blake M, Ruffin, Felicia, Parsons, Joshua B, Park, Lawrence P, Sharma-Kuinkel, Batu, Mohnasky, Michael, Arias, Cesar A, Fowler, Vance G, and Thaden, Joshua T

Subjects
PREVENTION of bloodborne infections, DISEASE relapse prevention, CATHETER-related infections, SEQUENCE analysis, CONFIDENCE intervals, MICROBIOLOGY, ELECTROPHORESIS, MULTIVARIATE analysis, MOLECULAR biology, GENOME-wide association studies, GENOTYPES, DESCRIPTIVE statistics, RESEARCH funding, GRAM-negative bacterial diseases, LOGISTIC regression analysis, ODDS ratio, DATA analysis software, LONGITUDINAL method, CATHETERS, DISEASE risk factors
Abstract

Background The causes and clinical characteristics of recurrent gram-negative bacterial bloodstream infections (GNB-BSI) are poorly understood. Methods We used a cohort of patients with GNB-BSI to identify clinical characteristics, microbiology, and risk factors associated with recurrent GNB-BSI. Bacterial genotyping (pulsed-field gel electrophoresis [PFGE] and whole-genome sequencing [WGS]) was used to determine whether episodes were due to relapse or reinfection. Multivariable logistic regression was used to identify risk factors for recurrence. Results Of the 1423 patients with GNB-BSI in this study, 60 (4%) had recurrent GNB-BSI. Non-White race (odds ratio [OR], 2.35; 95% confidence interval [CI], 1.38–4.01; P =.002), admission to a surgical service (OR, 2.18; 95% CI, 1.26–3.75; P =.005), and indwelling cardiac device (OR, 2.73; 95% CI, 1.21–5.58; P =.009) were associated with increased risk for recurrent GNB-BSI. Among the 48 patients with recurrent GNB-BSI whose paired bloodstream isolates underwent genotyping, 63% were due to relapse (30 of 48) and 38% were due to reinfection (18 of 48) based on WGS. Compared with WGS, PFGE correctly differentiated relapse and reinfection in 98% (47 of 48) of cases. Median time to relapse and reinfection was similar (113 days; interquartile range [IQR], 35–222 vs 174 days; IQR, 69–599; P =.13). Presence of a cardiac device was associated with relapse (relapse: 7 of 27, 26%; nonrelapse: 65 of 988, 7%; P =.002). Conclusions In this study, recurrent GNB-BSI was most commonly due to relapse. PFGE accurately differentiated relapse from reinfection when compared with WGS. Cardiac device was a risk factor for relapse. [ABSTRACT FROM AUTHOR]

Published
2023
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193. Transmission of Carbapenem-Resistant Klebsiella pneumoniae in US Hospitals.

Author

Luterbach, Courtney L, Chen, Liang, Komarow, Lauren, Ostrowsky, Belinda, Kaye, Keith S, Hanson, Blake, Arias, Cesar A, Desai, Samit, Gallagher, Jason C, Novick, Elizabeth, Pagkalinawan, Stephen, Lautenbach, Ebbing, Wortmann, Glenn, Kalayjian, Robert C, Eilertson, Brandon, Farrell, John J, McCarty, Todd, Hill, Carol, Fowler, Vance G, and Kreiswirth, Barry N

Subjects
RESEARCH, SEQUENCE analysis, SINGLE nucleotide polymorphisms, CROSS infection, KLEBSIELLA infections, INFECTIOUS disease transmission, RESEARCH funding, DESCRIPTIVE statistics, DRUG resistance in microorganisms, CARBAPENEMS, DATA analysis software, LONGITUDINAL method
Abstract

Background Carbapenem-resistant Klebsiella pneumoniae (CR Kp) is the most prevalent carbapenem-resistant Enterobacterales in the United States. We evaluated CR Kp clustering in patients in US hospitals. Methods From April 2016 to August 2017, 350 patients with clonal group 258 CR Kp were enrolled in the Consortium on Resistance Against Carbapenems in Klebsiella and other Enterobacteriaceae , a prospective, multicenter, cohort study. A maximum likelihood tree was constructed using RAxML. Static clusters shared ≤21 single-nucleotide polymorphisms (SNP) and a most recent common ancestor. Dynamic clusters incorporated SNP distance, culture timing, and rates of SNP accumulation and transmission using the R program TransCluster. Results Most patients were admitted from home (n = 150, 43%) or long-term care facilities (n = 115, 33%). Urine (n = 149, 43%) was the most common isolation site. Overall, 55 static and 47 dynamics clusters were identified involving 210 of 350 (60%) and 194 of 350 (55%) patients, respectively. Approximately half of static clusters were identical to dynamic clusters. Static clusters consisted of 33 (60%) intrasystem and 22 (40%) intersystem clusters. Dynamic clusters consisted of 32 (68%) intrasystem and 15 (32%) intersystem clusters and had fewer SNP differences than static clusters (8 vs 9; P =.045; 95% confidence interval [CI]: −4 to 0). Dynamic intersystem clusters contained more patients than dynamic intrasystem clusters (median [interquartile range], 4 [2, 7] vs 2 [2, 2]; P =.007; 95% CI: −3 to 0). Conclusions Widespread intrasystem and intersystem transmission of CR Kp was identified in hospitalized US patients. Use of different methods for assessing genetic similarity resulted in only minor differences in interpretation. [ABSTRACT FROM AUTHOR]

Published
2023
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194. Multiomics characterization of methicillin-resistant Staphylococcus aureus (MRSA) isolates with heterogeneous intermediate resistance to vancomycin (hVISA) in Latin America.

Author

Castro, Betsy E, Rios, Rafael, Carvajal, Lina P, Vargas, Mónica L, Cala, Mónica P, León, Lizeth, Hanson, Blake, Dinh, An Q, Ortega-Recalde, Oscar, Seas, Carlos, Munita, Jose M, Arias, Cesar A, Rincon, Sandra, Reyes, Jinnethe, and Diaz, Lorena

Subjects
METHICILLIN-resistant staphylococcus aureus, MUPIROCIN, BETAINE, TRANSFER RNA, VANCOMYCIN resistance, AMINO acid metabolism, HYDROPHILIC interaction liquid chromatography, FISHER discriminant analysis
Abstract

Background: Heterogeneous vancomycin-intermediate Staphylococcus aureus (hVISA) compromise the clinical efficacy of vancomycin. The hVISA isolates spontaneously produce vancomycin-intermediate Staphylococcus aureus (VISA) cells generated by diverse and intriguing mechanisms.Objective: To characterize the biomolecular profile of clinical hVISA applying genomic, transcriptomic and metabolomic approaches.Methods: 39 hVISA and 305 VSSA and their genomes were included. Core genome-based Bayesian phylogenetic reconstructions were built and alterations in predicted proteins in VISA/hVISA were interrogated. Linear discriminant analysis and a Genome-Wide Association Study were performed. Differentially expressed genes were identified in hVISA-VSSA by RNA-sequencing. The undirected profiles of metabolites were determined by liquid chromatography and hydrophilic interaction in six CC5-MRSA.Results: Genomic relatedness of MRSA associated to hVISA phenotype was not detected. The change Try38 → His in Atl (autolysin) was identified in 92% of the hVISA. We identified SNPs and k-mers associated to hVISA in 11 coding regions with predicted functions in virulence, transport systems, carbohydrate metabolism and tRNA synthesis. Further, capABCDE, sdrD, esaA, esaD, essA and ssaA genes were overexpressed in hVISA, while lacABCDEFG genes were downregulated. Additionally, valine, threonine, leucine tyrosine, FAD and NADH were more abundant in VSSA, while arginine, glycine and betaine were more abundant in hVISA. Finally, we observed altered metabolic pathways in hVISA, including purine and pyrimidine pathway, CoA biosynthesis, amino acid metabolism and aminoacyl tRNA biosynthesis.Conclusions: Our results show that the mechanism of hVISA involves major changes in regulatory systems, expression of virulence factors and reduction in glycolysis via TCA cycle. This work contributes to the understanding of the development of this complex resistance mechanism in regional strains. [ABSTRACT FROM AUTHOR]

Published
2023
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197. Analysis of the Clinical Pipeline of Treatments for Drug-Resistant Bacterial Infections: Despite Progress, More Action Is Needed

Author

Butler, Mark S., primary, Gigante, Valeria, additional, Sati, Hatim, additional, Paulin, Sarah, additional, Al-Sulaiman, Laila, additional, Rex, John H., additional, Fernandes, Prabhavathi, additional, Arias, Cesar A., additional, Paul, Mical, additional, Thwaites, Guy E., additional, Czaplewski, Lloyd, additional, Alm, Richard A., additional, Lienhardt, Christian, additional, Spigelman, Melvin, additional, Silver, Lynn L., additional, Ohmagari, Norio, additional, Kozlov, Roman, additional, Harbarth, Stephan, additional, and Beyer, Peter, additional

Published
2022
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199. Real-World Performance of Susceptibility Testing for Ceftolozane/Tazobactam against Non-Carbapenemase-Producing Carbapenem-Resistant Pseudomonas aeruginosa

Author

Rivas, Lina, primary, Alcalde-Rico, Manuel, additional, Martínez, José R. W., additional, Moreno, María Victoria, additional, Rojas, Pamela, additional, Wozniak, Aniela, additional, García, Patricia, additional, Olivares-Pacheco, Jorge, additional, Miller, William R., additional, Arias, Cesar A., additional, Khan, Ayesha, additional, and Munita, José M., additional

Published
2022
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200. Evaluation of Bacteriophage Cocktails Alone and in Combination with Daptomycin against Daptomycin-Nonsusceptible Enterococcus faecium

Author

Morrisette, Taylor, primary, Lev, Katherine L., additional, Canfield, Gregory S., additional, Duerkop, Breck A., additional, Kebriaei, Razieh, additional, Stamper, Kyle C., additional, Holger, Dana, additional, Lehman, Susan M., additional, Willcox, Smaranda, additional, Arias, Cesar A., additional, and Rybak, Michael J., additional

Published
2022
Full Text
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