Search

The rapid spread of carbapenemase-producing strains has led to increased levels of resistance among Gram-negative bacteria, especially enterobacteria. The current study aimed to collect and genetically characterize the colistin- and carbapenem-resistant isolates, obtained in one of the biggest hospitals (Military Medical Academy) in Sofia, Bulgaria. Clonal relatedness was detected by RAPD and MLST. Carbapenemases, ESBLs, and mgrB were investigated by PCR amplification and sequencing, replicon typing, and 16S rRNA methyltransferases with PCRs. Fourteen colistin- and carbapenem-resistant K. pneumoniae isolates were detected over five months. Six carbapenem-resistant and colistin-susceptible isolates were also included. The current work revealed a complete change in the spectrum of carbapenemases in Bulgaria. blaNDM-5 was the only NDM variant, and it was always combined with blaOXA-232. The coexistence of blaOXA-232 and blaNDM-5 was observed in 10/14 (72%) of colistin- and carbapenem-resistant K. pneumoniae isolates and three colistin-susceptible isolates. All blaNDM-5- and blaOXA-232-positive isolates belonged to the ST6260 (ST101-like) MLST type. They showed great mgrB variability and had a higher mortality rate. In addition, we observed blaOXA-232 ST14 isolates and KPC-2-producing ST101, ST16, and ST258 isolates. The colistin- and carbapenem-resistant isolates were susceptible only to cefiderocol for blaNDM-5- and blaOXA-232-positive isolates and to cefiderocol and ceftazidime/avibactam for blaOXA-232- or blaKPC-2-positive isolates. All blaOXA-232-positive isolates carried rmtB methylase and the colE replicon type. The extremely limited choice of appropriate treatment for patients infected with such isolates and their faster distribution highlight the need for urgent measures to control this situation. [ABSTRACT FROM AUTHOR]

Background and Objective: Klebsiella pneumoniae appears to be a significant problem due to its ability to accumulate antibiotic-resistance genes. After 2013, alarming colistin resistance rates among carbapenem-resistant K. pneumoniae have been reported in the Balkans. The study aims to perform an epidemiological, clinical, and genetic analysis of a local outbreak of COLr CR-Kp. Material and Methods: All carbapenem-resistant and colistin-resistant K. pneumoniae isolates observed among patients in the ICU unit of Military Medical Academy, Sofia, from 1 January to 31 October 2023, were included. The results were analyzed according to the EUCAST criteria. All isolates were screened for blaVIM, blaIMP, blaKPC, blaNDM, and blaOXA-48. Genetic similarity was determined using the Dice coefficient as a similarity measure and the unweighted pair group method with arithmetic mean (UPGMA). mgrB genes and plasmid-mediated colistin resistance determinants (mcr-1, mcr-2, mcr-3, mcr-4, and mcr-5) were investigated. Results: There was a total of 379 multidrug-resistant K. pneumoniae isolates, 88% of which were carbapenem-resistant. Of these, there were nine (2.7%) colistin-resistant isolates in six patients. A time and space cluster for five patients was found. Epidemiology typing showed that two isolates belonged to clone A (pts. 1, 5) and the rest to clone B (pts. 2–4) with 69% similarity. Clone A isolates were coproducers of blaNDM-like and blaOXA-48-like and had mgrB-mediated colistin resistance (40%). Clone B isolates had only blaOXA-48-like and intact mgrB genes. All isolates were negative for mcr-1, -2, -3, -4, and -5 genes. Conclusions: The study describes a within-hospital spread of two clones of COLr CR-Kp with a 60% mortality rate. Clone A isolates were coproducers of NDM-like and OXA-48-like enzymes and had mgrB-mediated colistin resistance. Clone B isolates had only OXA-48-like enzymes and intact mgrB genes. No plasmid-mediated resistance was found. The extremely high mortality rate and limited treatment options warrant strict measures to prevent outbreaks. [ABSTRACT FROM AUTHOR]

Copyright of Museikon: Journal of Religious Art & Culture / Revue d'Art et de Culture Religieuse is the property of Muzeul National al Unirii and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

In 1823, an event occured that changed the life of the island of Tinos for good to make it the most important site of religious pilgrimage across Greece: an icon of the Annunciation was found, which began to work miracles and was named as the Megalochari of Tinos. The icon's discovery coincided with the Greek revolution against the Ottomans that led to the liberation of the country. The very topic of the icon, the Annunciation, was believed to be a sign of the divine support for the cause of the Greeks. In the future, this fact played a significant role for the icon's popularity and for the rapid formation of a lasting cult. This study seeks to explore the role of the images in forming and spreading the cult to the miraculous icon of Tinos and in establishment this important place of pilgrimage in the Balkans, as it has not been examined for the time being. The miraculous icon of the Annunciation of Tinos was discovered rather late and the cult to it was created and formed according to long-established patterns, by using means relevant to the time. The legend about the discovery of the icon and the reconstruction of the church was soon recorded and published. A number of prints featuring views of the architectural complex and the miraculous icon were printed in the period 1827-1860. One of the prints, a copy of which is kept in Sofia, features the story of the icon's discovery. An icon reproducing a print of Tinos (NAM, Sofia) is yet another evidence of the pilgrimage from Bulgarian lands to Tinos. A similar icon is kept at the Church of Zoodochos Pigi in Istanbul. The extant copies of prints and the icons chart the area where the cult to the icon of Tinos spread out. [ABSTRACT FROM AUTHOR]

OBJECTIVE: We present preliminary results, obtained by microarray-based technology, used for the fi rst time in Bulgaria / Verigene System, Nanosphere company, USA/, a new tool for rapid detection of Gram positive and Gram-negative pathogens in blood stream infections /BSI/ in comparing with conventional methods performed currently in our laboratory MATERIALS & METHODS: Hundred fi fty positive by Bactec 9050 / BD- USA/ and BacTalert systems Biomerieux- France/ bloodcultures / BC/ were investigated between May 2012 and February 2014. After the signal for positive BC and Gram staining, it was immediately performed the Verigene BC-GP, using 350 μl blood from the positive BC bottle for Gram-positive microorganisms detection RESULTS: The data show correct identifi cation for gram-positive bacteria investigated to genus level in 80% in the frame of 2.5 hours and reduction of turnaround time with 48h, compared with conventional methods after appropriate sub-culturing and identifi cation by Vitek 2 System / Biomerieux - France/. Additionally, the staphylococci tested for the presence of mecA gene in Verigene system showed 75.7% coincidence with cefoxitin test as well as they were identifi ed as methicillin resistant microorganisms by Vitek 2 system. CONCLUSION: The Verigene Gram-positive Nucleic Acid Test / BC-GP / is a very usefully tool of detection and identifi cation of potentially pathogenic Gram-positive bacteria which may cause bloodstream infections. [ABSTRACT FROM AUTHOR]