Carbapenem resistance in Enterobacterales is a public health threat. Klebsiella pneumoniae carbapenemase (encoded by alleles of the bla_KPC family) is one of the most common transmissible carbapenem resistance mechanisms worldwide. The dissemination of bla_KPC historically has been associated with distinct K. pneumoniae lineages (clonal group 258 [CG258]), a particular plasmid family (pKpQIL), and a composite transposon (Tn4401). In the United Kingdom, bla_KPC has represented a large-scale, persistent management challenge for some hospitals, particularly in North West England. The dissemination of bla_KPC has evolved to be polyclonal and polyspecies, but the genetic mechanisms underpinning this evolution have not been elucidated in detail; this study used short-read whole-genome sequencing of 604 bla_KPC-positive isolates (Illumina) and long-read assembly (PacBio)/polishing (Illumina) of 21 isolates for characterization. We observed the dissemination of bla_KPC (predominantly bla_KPC-2; 573/604 [95%] isolates) across eight species and more than 100 known sequence types. Although there was some variation at the transposon level (mostly Tn4401a, 584/604 [97%] isolates; predominantly with ATTGA-ATTGA target site duplications, 465/604 [77%] isolates), bla_KPC spread appears to have been supported by highly fluid, modular exchange of larger genetic segments among plasmid populations dominated by IncFIB (580/604 isolates), IncFII (545/604 isolates), and IncR (252/604 isolates) replicons. The subset of reconstructed plasmid sequences (21 isolates, 77 plasmids) also highlighted modular exchange among non-bla_KPC and bla_KPC plasmids and the common presence of multiple replicons within bla_KPC plasmid structures (>60%). The substantial genomic plasticity observed has important implications for our understanding of the epidemiology of transmissible carbapenem resistance in Enterobacterales for the implementation of adequate surveillance approaches and for control.

Nine hundred Haemophilus influenzae clinical isolates from 83 U.S. and European medical centers were tested for susceptibility by reference broth microdilution methods against ceftolozane-tazobactam and comparators. Results were stratified by β-lactamase production and infection type. Overall, ceftolozane-tazobactam MIC_50/90 values were 0.12/0.25 mg/liter, and 99.0% of isolates were inhibited at the susceptible breakpoint of ≤0.5 mg/liter; the highest MIC value was only 2 mg/liter. Our results support using ceftolozane-tazobactam to treat H. influenzae infections.

Colorectal cancer is a growing burden in adults less than 50 years old. In 2018, the American Cancer Society published a guideline update recommending a reduction in the colorectal cancer screening start age for average-risk individuals from 50 to 45. Implementing these recommendations would have important implications for public health. However, the approximate number of people impacted by this change, the average-risk population ages 45–49, is not well-described in the literature. Here, we provide methodology to conservatively estimate the average-risk and screening-eligible population in the United States, including those who would be impacted by a lowered colorectal cancer screening start age. Using multiple data sources, we estimated the current average-risk population by subtracting individuals with symptomatic colorectal cancer, with a family history of colorectal cancer, and with inflammatory bowel disease and hereditary nonpolyposis colorectal cancer from the total population. Within this population, we estimated the number of screening-eligible individuals by subtracting those with previous colorectal cancer screening (45- to 49-year-old) or up to date with colorectal cancer screening (50- to 74-year-old). The total average-risk population is estimated between 102.1 and 106.5 million people, of whom 43.4–45.2 million people are eligible for colorectal cancer screening. Lowering the screening age would add roughly 19 million people to the average-risk population and increase the current number of screening-eligible individuals on immediate implementation by over 60% (from 27 to 44 million). Estimating the population size impacted by lowering the recommended colorectal cancer screening start age enables more accurate decision-making for policymakers and epidemiologists focused on cancer prevention.

To mark Friday's 75th anniversary of the end of World War II in Europe, the British government revealed the final Nazi message intercepted and decoded by U.K. codebreakers as Allied forces were advancing through Germany.

Apple Inc said Friday it will reopen a handful of stores in four U.S. states starting next week, in the first resumption of physical retail operations since the iPhone maker shuttered all U.S. stores in mid-March.

The footage of Chanel's "mam" Sandra has been viewed nearly 600,000 times

Scientists race to track down and contain invasive species in bid to save local bee populations from slaughter

A huge blaze broke out at a 48-storey skyscraper in the United Arab Emirates city of Sharjah.

It has been seven years since Sir Alex Ferguson retired, and Man United have been busy (if not always successful) in the transfer market ever since.

With almost all football off because of the coronavirus, star players have found themselves at a loose end. How are they filling their time?

The 'Die Hard' actor has been in Idaho with the 'Ghost' actress and their children, Rumer, 31, Scout, 28, and Talluhah, 26, for the past

Ole Gunnar Solskjaer's Manchester United rebuild looks set to continue whenever the transfer window does eventually open.

Manchester United defender Harry Maguire has offered to supply "food packages of everyday essentials" to the elderly in his hometown of Mosborough in South Yorkshire.

Bruno Fernandes has revealed his perception of Manchester United changed when Cristiano Ronaldo joined the club.

Manchester United midfielder Juan Mata has invited a local NHS worker and her family to a match at Old Trafford once football resumes.

Juan Mata believes Jadon Sancho is a "great player" as Manchester United continue to be linked with the winger.

Marcus Rashford has been leading Manchester United's charm offensive to bring Jadon Sancho to Old Trafford - and he will have another chance tonight.

Leeds United legend and one of England's 1966 World Cup winners Norman Hunter has been admitted to hospital after testing positive for coronavirus.

Manchester United are yet to offer Odion Ighalo a permanent deal with Ole Gunnar Solskjaer undecided over his plans to sign a striker this summer.

Manchester United have four key strikers on their summer transfer shortlist, Standard Sport understands.

Former Arsenal man Paul Merson believes football's coronavirus shutdown may end up giving Alexis Sanchez a second chance at Manchester United.

Swansea City defender Joe Rodon is a name those outside of the Championship may not be too familiar with but the youngster is making an impact in Wales.

Jadon Sancho got the better of Manchester United striker Marcus Rashford as the two England internationals met in the Football's Staying Home Fifa tournament.

James Rodriguez has again been linked with a move to Manchester United with his future at Real Madrid far from certain.

Manchester United fans hailed the fine work of 'agent Marcus Rashford' once more after his FIFA 20 battle with England colleague Jadon Sancho.

Ole Gunnar Solskjaer is hoping to continue his Manchester United rebuild this summer with a number of targets already identified.

Paul Scholes believes Manchester United have found their own version of Manchester City's Kevin De Bruyne in Bruno Fernandes.

Manchester United star Paul Pogba has opened up on his injury frustration, but says his time on the sidelines has reminded him how much he loves football.

Manchester United have been warned that Odion Ighalo could be set to land a 'big money move' to one of their major European rivals if they do not sign him permanently this summer.

Manchester United striker Odion Ighalo has heaped praise on fellow January arrival Bruno Fernandes and warned the rest of the Premier League: "We've not seen the best of him yet!"

Odion Ighalo says Manchester United will be "a different team" when Paul Pogba is back fit and firing.

Odion Ighalo believes Victor Osimhen has huge potential, with the Manchester United striker praising his compatriot as the "future of Nigerian football."

The Tottenham and England star would have been top of Sir Alex Ferguson's shortlist

Pierre-Emerick Aubameyang has been warned by a former Gunner than moving to a club like Manchester United at this stage of his career is a riskier prospect than staying at Arsenal.

Aston Villa star Jack Grealish has "got his eye" on a summer transfer to Manchester United, according to Darren Bent.

Paul Pogba claims unfinished business lured him back to Manchester United as Real Madrid and Juventus line up to prise him away again this summer.

Tottenham have no interest in selling star striker Harry Kane to Manchester United this summer.

Manchester United fans are growing increasingly excited that Jadon Sancho could be on his way to Old Trafford this summer after the Borussia Dortmund star's latest hint.

Jadon Sancho's future looks set to be a long-running story throughout the summer.

Jadon Sancho's future looks set to be a long-running story throughout the summer.

Former Manchester United goalkeeper Mark Bosnich believes Harry Kane would turn Ole Gunnar Solskjaer's side into title contenders, and is sure that Tottenham would 'snap their hand off' if a £200million bid came in.

Manchester United midfielder Juan Mata believes former Chelsea team-mate Eden Hazard is among the very best players in Premier League history.

Manchester United midfielder Juan Mata has revealed he misses playing with Ander Herrera and compared the Spaniard to Bruno Fernandes.

Manchester United midfielder Paul Pogba has hit back at one of his biggest critics in Graeme Souness, admitting he didn't even know who the Liverpool legend was.

Paul Pogba vs Graeme Souness is the feud that keeps on giving after the two exchanged barbs again on Tuesday.

Former Liverpool man Stan Collymore has told Ole Gunnar Solskjaer that he should sign Jadon Sancho in order to convince Harry Kane to join Manchester United.

Ole Gunnar Solskjaer is hoping to continue his Manchester United rebuild this summer with a number of targets already identified.

The 21-year-old has been tipped to become the greatest right-back in Premier League history