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Samiratu Mahazu,1,2 Isaac Prah,1,3 Yusuke Ota,1 Takaya Hayashi,3 Masato Suzuki,4 Mitsunori Yoshida,5 Yoshihiko Hoshino,5 Yukihiro Akeda,6 Toshihiko Suzuki,7 Tomoko Ishino,2 Anthony Samuel Ablordey,8 Ryoichi Saito1 1Department of Molecular Microbiology, Tokyo Medical and Dental University, Tokyo, Japan; 2Department of Parasitology and Tropical Medicine, Tokyo Medical and Dental University, Tokyo, Japan; 3Department of Molecular Virology, Tokyo Medical and Dental University, Tokyo, Japan; 4Antimicrobial Resistance Research Center, National Institute of Infectious Diseases, Tokyo, Japan; 5Department of Mycobacteriology, Leprosy Research Center, National Institute of Infectious Diseases, Tokyo, Japan; 6Department of Bacteriology I, National Institute of Infectious Diseases, Tokyo, Japan; 7Department of Bacterial Pathogenesis, Tokyo Medical and Dental University, Tokyo, Japan; 8Department of Bacteriology, Noguchi Memorial Institute for Medical Research, University of Ghana, Accra, GhanaCorrespondence: Anthony Samuel Ablordey; Ryoichi Saito, Email aablordey@noguchi.ug.edu.gh; r-saito.mi@tmd.ac.jpPurpose: Colistin is classified by the World Health Organization (WHO) as a critically important and last-resort antibiotic for the treatment of infections caused by carbapenem-resistant bacteria. However, colistin resistance mediated by chromosomal mutations or plasmid-linked mobilized colistin resistance (mcr) genes has emerged.Methods: Thirteen mcr-positive Aeromonas species isolated from water samples collected in Eastern Ghana were analyzed using whole-genome sequencing (WGS). Antimicrobial susceptibility was tested using the broth microdilution method. Resistome analysis was performed in silico using a web-based platform.Results: The minimum inhibitory concentration (MIC) of colistin for all except three isolates was > 4 μg/mL. Nine new sequence types were identified and whole-genome analysis revealed that the isolates harbored genes (mcr-3-related genes) that code for Lipid A phosphoethanolamine transferases on their chromosomes. BLAST analysis indicated that the amino acid sequences of the mcr-3-related genes detected varied from those previously reported and shared 79.04– 99.86% nucleotide sequence identity with publicly available mcr-3 variants and mcr-3-related phosphoethanolamine transferases. Analysis of the genetic context of mcr-3-related genes revealed that the genetic environment surrounding mcr-3-related genes was diverse among the different species of Aeromonas but conserved among isolates of the same species. Mcr-3-related-gene-IS-mcr-3-related-gene segment was identified in three Aeromonas caviae strains.Conclusion: The presence of mcr-3-related genes close to insertion elements is important for continuous monitoring to better understand how to control the mobilization and dissemination of antibiotic resistance genes.Keywords: Aeromonas spp, colistin, mcr-3-related gene, phosphoethanolamine transferases, whole genome analysis

Objective: For low-grade intraepithelial neoplasia cases, pharyngolaryngeal lesions equal to or less than 5 mm in size do not generally progress to invasive carcinoma. However, micro-superficial lesions equal to or less than 5 mm that showed rapid growth have been recently encountered. This study aimed to identify the characteristics of preferential progression of lesions equal to or less than 5 mm in size. Method: Gross findings, endoscopic findings and pathological results of 55 lesions measuring equal to or less than 5 mm in diameter were retrospectively reviewed to identify factors that distinguish squamous cell carcinoma or high-grade intraepithelial neoplasia from low-grade intraepithelial neoplasia or non-atypia lesions. Results: The overall sensitivity, specificity, accuracy, and positive and negative predictive value of background colouration and intrapapillary capillary loop pattern in differentiation of squamous cell carcinoma or high-grade intraepithelial neoplasia from low-grade intraepithelial neoplasia or non-atypia lesions were all 100 per cent. Conclusion: Diagnosis based on background colouration and the intrapapillary capillary loop pattern on narrow-band imaging facilitates the pathological examination of lesions measuring equal to or less than 5 mm. [ABSTRACT FROM AUTHOR]

A 58-year-old Japanese man was admitted complaining of abdominal pain. An abdominal computed tomography examination demonstrated a tumor in the head of the pancreas and multiple calcifications. A laparotomy was performed and the tumor was removed by Whipple's operation. Histologically, the neoplasm that invaded the duodenal wall and the papilla of Vater was composed of nests of malignant squamous cells with intercellular bridges and showed the formation of keratinized pearls with a small area of concurrently neoplastic glandular and squamous elements. On the basis of these features, the diagnosis of adenosquamous carcinoma of the pancreas was made. The patient died 18 months after the operation. The neoplastic behavior of this rare primary pancreatic carcinoma is similar to that of duct cell carcinoma as well as pure squamous cell carcinoma of the pancreas. As the pancreas can be the target of metastases of squamous carcinomas from other organs it is wise to be aware of this rare entity. [ABSTRACT FROM AUTHOR]