ex Testing and Treatment After Adolescent Sexual Assault in Pediatric Emergency Departments By pediatrics.aappublications.org Published On :: 2015-11-02T00:06:44-08:00 National guidelines recommend testing and prophylaxis for chlamydia, gonorrhea, and pregnancy for adolescent sexual assault victims. Little is known about rates of testing and prophylaxis in adolescent victims of sexual assault evaluated in pediatric emergency departments.There is significant variation in testing and prophylaxis practices in the pediatric emergency department evaluation of adolescent victims of sexual assault. Adolescents cared for in emergency departments with clinical pathways are more likely to receive recommended prophylaxis. (Read the full article) Full Article
ex Exposure and Use of Mobile Media Devices by Young Children By pediatrics.aappublications.org Published On :: 2015-11-02T00:06:44-08:00 Interactive mobile media devices have revolutionized children’s access to and experience of media, but research is lagging behind its adoption. A critical first step is to understand when and how young children adopt mobile media devices.Our study found almost universal exposure, early adoption, and use of mobile media devices among young children in an urban, low-income, minority community. Studies are needed to update guidelines on the use of mobile media by young children. (Read the full article) Full Article
ex Google's iOS Gboard Can Translate Text Into 103 Languages By www.pcmag.com Published On :: Over one hundred languages should help make a few conversations easier to get through, but that's still well short of the hundreds of languages Gboard typing supports. Full Article
ex Fin24.com | Mboweni's exceptional business tax measures to combat coronavirus impact By www.fin24.com Published On :: Sun, 29 Mar 2020 17:05:22 +0200 Minister of Finance Tito Mboweni has announced a number of "exceptional tax measures as part of the fiscal package outlined by President Cyril Ramaphosa to fight the coronavirus pandemic. Full Article
ex Fin24.com | EXPLAINER: Can I claim tax deductions because I'm working from home? By www.fin24.com Published On :: Sat, 04 Apr 2020 11:08:37 +0200 Due to the spreading coronavirus pandemic and compounded by the lockdown, more South Africans have chosen to or have been forced to work from home. Full Article
ex Playing Plague Inc. Doesn't Make You a Coronavirus Expert By www.pcmag.com Published On :: The developer, Ndemic Creations, wants to remind people that Plague Inc. is just a game, not a scientific model. The game's popularity has skyrocketed amid the ongoing coronavirus outbreak, which has managed to spread to the US. Full Article
ex Researchers explore quantum computing to discover possible COVID-19 treatments By news.psu.edu Published On :: Fri, 01 May 2020 11:34 -0400 Quantum machine learning, an emerging field that combines machine learning and quantum physics, is the focus of research to discover possible treatments for COVID-19, according to Penn State researchers, who believe that this method could be faster and more economical than the current methods used for drug discovery. Full Article
ex Understanding the impacts of unexpected shift to digital learning By news.psu.edu Published On :: Mon, 04 May 2020 12:16 -0400 The unexpected transition to online classes due to the COVID-19 pandemic has prompted many changes for undergraduate students and their instructors. To understand the magnitude of these impacts and potentially improve digital learning, researchers in the Penn State School of Engineering Design and Professional Programs have received a $196,136 grant from the National Science Foundation. Full Article
ex Lyon extend European record By www.uefa.com Published On :: Sat, 18 May 2019 18:55:00 GMT Lyon extended their record tally of final wins to six while their run of four victories in a row is twice the next best. Full Article general
ex Narrow Definition of Sex Could Affect Transgender Students By feedproxy.google.com Published On :: Tue, 30 Oct 2018 00:00:00 +0000 The Trump administration's move to narrowly define gender according to sex assigned at birth could impact transgender students and schools' policies with respect to their rights. Full Article Gender
ex Girls Outshine Boys on Federal Exam of Tech, Engineering Skills By feedproxy.google.com Published On :: Tue, 30 Apr 2019 00:00:00 +0000 Overall, average scores were up two points since 2014 on the National Assessment of Educational Progress in Technology and Engineering Literacy. Full Article Gender
ex Justices to Weigh Whether Title VII Covers Sexual Orientation, Gender Identity By feedproxy.google.com Published On :: Mon, 22 Apr 2019 00:00:00 +0000 The issue is significant not only for school employment but also for whether a related federal law would protect students on the same basis. Full Article Gender
ex Explore, discover and define your future at March 28 open house By news.psu.edu Published On :: Wed, 26 Feb 2020 16:43 -0500 From 9 a.m. to 3 p.m. Saturday, March 28, members of the Penn College community will welcome thousands of potential enrollees and their families, opening wide the doors to a landmark institution that has helped tomorrow makers fulfill their destinies for more than a century. Full Article
ex Penn College offering summer manufacturing experience By news.psu.edu Published On :: Mon, 02 Mar 2020 09:33 -0500 Pennsylvania College of Technology will expose high schoolers to the rewarding possibilities of manufacturing careers, thanks to a grant-supported initiative. The college will host the Thingamajig Fabricators Pre-College Program from July 19-23 on its main campus. Students entering grades 9-12 are eligible for the session, featuring hands-on experience with 3D-design software, mills and lathes, and welding. Full Article
ex Graphic design students excel in national competition By news.psu.edu Published On :: Tue, 03 Mar 2020 12:54 -0500 Sixteen design projects created by graphic design students at Pennsylvania College of Technology have been honored in the national Flux Student Design Competition. Full Article
ex How to Handle IEPs During the Coronavirus Crisis? Some Expert Advice By feedproxy.google.com Published On :: Fri, 03 Apr 2020 00:00:00 +0000 Very carefully, experts say, while understanding that federal laws governing special education were not written with online education in mind. Full Article Idea
ex U.S. logs record high unemployment numbers - what comes next? By www.msnbc.com Published On :: Sat, 09 May 2020 11:41:00 GMT Source: www.nbcnews.com - Saturday, May 09, 2020 The U.S. unemployment rate reached 14.7 percent for April - the worst monthly rate since the Great Depression. The White House has projected optimism, saying they expect the economy to rocket upward once coronavirus restrictions are lifted. But many experts think that is not a realistic expectation.All Related | More on economy Full Article
ex Quality Content in Demand as Multimedia Use Expands By feedproxy.google.com Published On :: Mon, 13 Jun 2011 00:00:00 +0000 Digital curricula repositories are helping to fill the growing need for more and better multimedia content. Full Article Multimedia
ex Challenges Seen in Moving to Multimedia Textbooks By feedproxy.google.com Published On :: Fri, 15 Oct 2010 00:00:00 +0000 Most districts have the technology to support the basic digital textbooks of today, but not the interactive, multimedia-rich ones of the future. Full Article Multimedia
ex Los ISPs Más Rápidos 2015: Mexico By www.pcmag.com Published On :: Ya paso otro año así que le daremos otro vistazo a nuestra busca perpetua por el ISP mas veloz en México Full Article
ex Why We Need Transformative Learning Experiences By feedproxy.google.com Published On :: Tue, 23 Apr 2019 00:00:00 +0000 Two things are true as I sort through my reflections on transformative learning experiences: We need intensive, immersive opportunities for learning (such as a trip to Kenya) and we also need to build in mini-opportunities for transformative learning every day. Full Article Professionaldevelopment
ex Teaching in the U.S. Should Be More 'Intellectually Attractive,' Global Expert Says By feedproxy.google.com Published On :: Thu, 20 Jun 2019 00:00:00 +0000 A panel of experts—including a national teacher's union president and an official from the Department of Education—discussed how to make teaching a more attractive profession. Full Article Professionaldevelopment
ex Fin24.com | EU allegedly mulling no-deal Brexit summit as pressure mounts By www.fin24.com Published On :: Mon, 15 Oct 2018 19:58:47 +0200 United Kingdom and European Union negotiators were working through Sunday as the outcome of Brexit talks hung in the balance. Full Article
ex Fin24.com | Brexit talks put on hold as stalemate deepens By www.fin24.com Published On :: Mon, 15 Oct 2018 12:01:04 +0200 The UK and the European Union are on course to miss a key milestone on the road to a Brexit deal after talks hit a roadblock. Negotiations are now paused, putting pressure on leaders to step into the breach later this week. Full Article
ex Fin24.com | Moelis keeps hand extended to Saudis as rival bankers pull back By www.fin24.com Published On :: Wed, 24 Oct 2018 08:50:43 +0200 The founder and chief of his eponymous investment bank traveled to Riyadh to extol the virtues of friendship. He stood out as many of the titans of U.S. finance sat out the kingdom’s signature investment summit amid international outrage over the killing of government critic Jamal Khashoggi. Full Article
ex Fin24.com | Pakistan's 'penniless billionaires' expose money laundering frenzy By www.fin24.com Published On :: Mon, 29 Oct 2018 13:24:13 +0200 It took rickshaw driver Mohammad Rasheed a year to save 300 rupees to buy his daughter a bike, so when he found three billion rupees ($22.5 million) had passed through an unused bank account in his name, he was stunned ... and scared. Full Article
ex HUB-Robeson Galleries presents exhibit of graduate student's photography By news.psu.edu Published On :: Wed, 22 Apr 2020 13:23 -0400 The HUB-Robeson Galleries are proud to present "moments," an online thesis exhibition of photography by Zsuzsanna Nagy, a second-year master of fine arts student in photography. Full Article
ex Fin24.com | OPINION | Banks could be the next Big Tech By www.fin24.com Published On :: Mon, 27 Apr 2020 09:14:39 +0200 Banks can be as powerful and valued as the big technology firms. Yes, those trillion-dollar titans. Full Article
ex Fin24.com | IAN MANN REVIEWS | SA experts weigh in on managing organisations during coronavirus By www.fin24.com Published On :: Sat, 02 May 2020 17:47:24 +0200 As editor Wilhelm Crous puts it, "We haven't seen this movie before." Full Article
ex Fin24.com | BOOK EXTRACT | Virus-proof your small business By www.fin24.com Published On :: Tue, 05 May 2020 17:18:04 +0200 Read an extract from business author and coach Douglas Kruger's latest book, Virus-proof your small business. Full Article
ex First hatches reported: Spotted lanternfly expert provides tips for management By news.psu.edu Published On :: Tue, 28 Apr 2020 12:32 -0400 Even before the recent news of the season’s first confirmed spotted lanternfly hatches in the Philadelphia region, homeowners in many parts of Pennsylvania were gearing up for their annual battle with the destructive pest. Full Article
ex Graduating food-science student parlays undergrad research experience into job By news.psu.edu Published On :: Wed, 06 May 2020 17:50 -0400 Gabriella Pinto provides a great example of what undergraduate research can do for a student. The Penn State food science major, who graduates this month, is headed for a good job armed with a wealth of experience and knowledge from her research, which gives her a leg up on her career. Full Article
ex Congo at War: A Briefing of the Internal and External Players in the Central African Conflict By feedproxy.google.com Published On :: Mon, 16 Nov 1998 23:00:00 GMT Full Article
ex Chad: A Powder Keg Ready to Explode By feedproxy.google.com Published On :: Sun, 19 Apr 2009 22:00:00 GMT Full Article
ex Chad’s North West: <br> The Next High-risk Area? By feedproxy.google.com Published On :: Wed, 16 Feb 2011 23:00:00 GMT Chad’s North West may become the next stage for insurgency, drug-running and religious extremism in the Sahel if the government continues to actively neglect the poorest of the violence-plagued country’s poor regions. Full Article
ex AU was set up for an explosive crisis like Burundi; it must act By feedproxy.google.com Published On :: Fri, 13 Nov 2015 23:00:00 GMT The deteriorating situation in Burundi is a perfect storm of much that undermines stability in Africa today — presidents seeking impunity and power through dubious new terms, authoritarian regimes muzzling opposition and independent media, regional rivalries stalemating efforts to bring peace and outside powers unwilling or unable to act. Full Article
ex U.S. Department of Education OKs Modified Texas Assessment By feedproxy.google.com Published On :: Tue, 14 Jul 2009 00:00:00 +0000 Texas has become the first state to have its "alternate assessment aligned to modified academic-achievement standards" pass the U.S. Department of Education's peer-review process. Full Article Assessment+Accountability+Achievement
ex Panel Finds Few Learning Benefits in High-Stakes Exams By feedproxy.google.com Published On :: Tue, 07 Jun 2011 00:00:00 +0000 A 10-year study by a blue-ribbon panel of scientists concludes that high-stakes testing and other accountability measures have largely failed to translate to real improvements in student achievement. Full Article Assessment+Accountability+Achievement
ex Which States Expect the Most or Least From Students? By feedproxy.google.com Published On :: Tue, 22 May 2018 00:00:00 +0000 Mostly, states are holding to a higher bar for student achievement than they did a decade ago. But Iowa, Texas, and Virginia continue to show large gaps between their state proficiency standards and NAEP's. Full Article Assessment+Accountability+Achievement
ex In Vitro and In Vivo Characterization of Potent Antileishmanial Methionine Aminopeptidase-1 Inhibitors [Experimental Therapeutics] By aac.asm.org Published On :: 2020-03-16T08:17:37-07:00 Leishmania major is the causative agent of cutaneous leishmaniasis (CL). No human vaccine is available for CL and current drug regimens present several drawbacks such as emerging resistance, severe toxicity, medium effectiveness, and/or high cost. Thus, the need for better treatment options against CL is a priority. In the present study, we validate the enzyme methionine aminopeptidase-1 (MetAP1), a metalloprotease that catalyzes the removal of N-terminal methionine from peptides and proteins, as a chemotherapeutic target against CL infection. The in vitro antileishmanial activity of eight novel MetAP1 inhibitors (OJT001-OJT008) were investigated. Three compounds OJT006, OJT007, and OJT008 demonstrated potent anti-proliferative effect in macrophages infected with L. major amastigotes and promastigotes at submicromolar concentrations, with no cytotoxicity against host cells. Importantly, the leishmanicidal effect was diminished by almost 10-fold in transgenic L. major promastigotes overexpressing MetAP1LM in comparison to wild-type promastigotes. Furthermore, the in vivo activity of OJT006, OJT007, and OJT008 were investigated in L. major-infected BALB/c mice. In comparison to the control group, OJT008 significantly decreased footpad parasite load by 86%, and exhibited no toxicity against in treated mice. We propose MetAP1 inhibitor OJT008 as a potential chemotherapeutic candidate against CL infection caused by L. major infection. Full Article
ex Evaluation of the efficacy of antibiotic combinations against multidrug-resistant Pseudomonas aeruginosa in automated time-lapse microscopy and static time-kill experiments [Clinical Therapeutics] By aac.asm.org Published On :: 2020-03-16T08:17:37-07:00 Objectives: Antibiotic combination therapy is used for severe infections caused by multidrug-resistant (MDR) Gram-negative bacteria. Yet, data of which combinations are most effective is lacking. This study aimed to evaluate the in vitro efficacy of polymyxin B in combination with 13 other antibiotics against four clinical strains of MDR Pseudomonas aeruginosa.Methods: We evaluated the interactions of polymyxin B in combination with amikacin, aztreonam, cefepime, chloramphenicol, ciprofloxacin, fosfomycin, meropenem, minocycline, rifampicin, temocillin, thiamphenicol or trimethoprim by automated time-lapse microscopy using predefined cut-off values indicating inhibition of growth (≤106 CFU/mL) at 24 h. Promising combinations were subsequently evaluated in static time-kill experiments.Results: All strains were intermediate or resistant to polymyxin B, anti-pseudomonal β-lactams, ciprofloxacin and amikacin. Genes encoding β-lactamases (e.g., blaPAO and blaOXA-50) and mutations associated with permeability and efflux were detected in all strains. In the time-lapse microscopy experiments, positive interactions were found with 39 of 52 antibiotic combination/bacterial strain setups. Enhanced activity was found against all four strains with polymyxin B used in combination with aztreonam, cefepime, fosfomycin, minocycline, thiamphenicol and trimethoprim. Time kill experiments showed additive or synergistic activity with 27 of the 39 tested polymyxin B combinations, most frequently with aztreonam, cefepime, and meropenem.Conclusion: Positive interactions were frequently found with the tested combinations, also against strains that harboured several resistance mechanisms to the single drugs and with antibiotics that are normally not active against P. aeruginosa. Further study is needed to explore the clinical utility of these combinations. Full Article
ex ZN148 - a modular synthetic metallo-{beta}-lactamase inhibitor reverses carbapenem-resistance in Gram-negative pathogens in vivo [Experimental Therapeutics] By aac.asm.org Published On :: 2020-03-16T08:17:37-07:00 Carbapenem-resistant Gram-negative pathogens are a critical public health threat and there is an urgent need for new treatments. Carbapenemases (β-lactamases able to inactivate carbapenems) have been identified in both serine β-lactamase (SBL) and metallo β-lactamase (MBL) families. The recent introduction of SBL carbapenemase-inhibitors has provided alternative therapeutic options. Unfortunately, there are no approved inhibitors of MBL-mediated carbapenem-resistance and treatment options for infections caused by MBL-producing Gram-negatives are limited. Here, we present ZN148, a zinc-chelating MBL-inhibitor capable of restoring the bactericidal effect of meropenem and in vitro clinical susceptibility to carbapenems in >98% of a large international collection of MBL-producing clinical Enterobacterales strains (n=234). Moreover, ZN148 was able to potentiate the effect of meropenem against NDM-1-producing Klebsiella pneumoniae in a murine neutropenic peritonitis model. ZN148 showed no inhibition of the human zinc-containing enzyme glyoxylase II at 500 μM and no acute toxicity was observed in an in vivo mouse model with cumulative dosages up to 128 mg/kg. Biochemical analysis showed a time-dependent inhibition of MBLs by ZN148 and removal of zinc ions from the active site. Addition of exogenous zinc after ZN148 exposure only restored MBL activity by ~30%, suggesting an irreversible mechanism of inhibition. Mass-spectrometry and molecular modelling indicated potential oxidation of the active site Cys221 residue. Overall, these results demonstrate the therapeutic potential of a ZN148-carbapenem combination against MBL-producing Gram-negative pathogens and that ZN148 is a highly promising MBL inhibitor, capable of operating in a functional space not presently filled by any clinically approved compound. Full Article
ex Combination Therapy with Ibrexafungerp (formerly SCY-078), a First-in-Class Triterpenoid Inhibitor of (1->3)-{beta}-D-Glucan Synthesis, and Isavuconazole for Treatment of Experimental Invasive Pulmonary Aspergillosis [Experimental Therapeutics] By aac.asm.org Published On :: 2020-03-16T08:17:36-07:00 Ibrexafungerp (formerly SCY-078) is a semisynthetic triterpenoid and potent (1->3)-β-D-glucan synthase inhibitor. We investigated the in vitro activity, pharmacokinetics, and in vivo efficacy of ibrexafungerp (SCY) alone and in combination with anti-mould triazole isavuconazole (ISA) against invasive pulmonary aspergillosis (IPA). The combination of ibrexafungerp and isavuconazole in in vitro studies resulted in an additive and synergistic interactions against Aspergillus spp. Plasma concentration-time curves of ibrexafungerp were compatible with linear dose proportional profile. In vivo efficacy was studied in a well established persistently neutropenic NZW rabbit model of experimental IPA. Treatment groups included untreated rabbits (UC) and rabbits receiving ibrexafungerp at 2.5(SCY2.5) and 7.5(SCY7.5) mg/kg/day, isavuconazole at 40(ISA40) mg/kg/day, or combinations of SCY2.5+ISA40 and SCY7.5+ISA40. The combination of SCY+ISA produced in vitro synergistic interaction. There was significant in vivo reduction of residual fungal burden, lung weights, and pulmonary infarct scores in SCY2.5+ISA40, SCY7.5+ISA40, and ISA40-treatment groups vs that of SCY2.5-treated, SCY7.5-treated and UC (p<0.01). Rabbits treated with SCY2.5+ISA40 and SCY7.5+ISA40 had prolonged survival in comparison to that of SCY2.5-, SCY7.5-, ISA40-treated or UC (p<0.05). Serum GMI and (1->3)-β-D-glucan levels significantly declined in animals treated with the combination of SCY7.5+ISA40 in comparison to those treated with SCY7.5 or ISA40 (p<0.05). Ibrexafungerp and isavuconazole combination demonstrated prolonged survival, decreased pulmonary injury, reduced residual fungal burden, lower GMI and (1->3)-β-D-glucan levels in comparison to those of single therapy for treatment of IPA. These findings provide an experimental foundation for clinical evaluation of the combination of ibrexafungerp and an anti-mould triazole for treatment of IPA. Full Article
ex Fosmanogepix (APX001) is Effective in the Treatment of Pulmonary Murine Mucormycosis Due to Rhizopus arrhizus [Experimental Therapeutics] By aac.asm.org Published On :: 2020-03-23T08:47:35-07:00 Mucormycosis is a life-threatening infection with high mortality that occurs predominantly in immunocompromised patients. Manogepix (MGX) is a novel antifungal that targets Gwt1, an early step in the conserved glycosylphosphotidyl inositol (GPI) post-translational modification pathway of surface proteins in eukaryotic cells. Inhibition of inositol acylation by MGX results in pleiotropic effects including inhibition of maturation of GPI-anchored proteins necessary for growth and virulence. MGX has been previously shown to have in vitro activity against some strains of Mucorales. Here we assessed the in vivo activity of the prodrug fosmanogepix, currently in clinical development for the treatment of invasive fungal infections, against two Rhizopus arrhizus strains with high (4.0 μg/ml) and low (0.25 μg/ml) minimum effective concentration (MEC) values. In both invasive pulmonary infection models, treatment of mice with 78 mg/kg or 104 mg/kg fosmanogepix, along with 1-aminobenzotriazole to enhance the serum half-live of MGX in mice, significantly increased median survival time and prolonged overall survival by day 21 post infection when compared to placebo. In addition, administration of fosmanogepix resulted in a 1-2 log reduction in both lung and kidney fungal burden. For the 104 mg/kg fosmanogepix dose, tissue clearance and survival were comparable to clinically relevant doses of isavuconazole (ISA), which is FDA approved for the treatment of mucormycosis. These results support continued development of fosmanogepix as a first in class treatment for invasive mucormycosis. Full Article
ex Spectrum of Beta-Lactamase Inhibition by the Cyclic Boronate QPX7728, an Ultra-Broad-Spectrum Beta-lactamase Inhibitor of Serine and Metallo Beta-Lactamases: Enhancement of Activity of Multiple Antibiotics Against Isogenic Strains Expressing Single {beta} By aac.asm.org Published On :: 2020-03-30T10:04:32-07:00 QPX7728 is an ultra-broad-spectrum boronic acid beta-lactamase inhibitor with potent inhibition of key serine and metallo beta-lactamases observed in biochemical assays. Microbiological studies using characterized strains were used to provide a comprehensive characterization of the spectrum of beta-lactamase inhibition by QPX7728. The MIC of multiple IV only (ceftazidime, piperacillin, cefepime, ceftolozane and meropenem) and orally bioavailable (ceftibuten, cefpodoxime, tebipenem) antibiotics alone and in combination with QPX7728 (4 μg/ml), as well as comparator agents, were determined against the panels of laboratory strains of P. aeruginosa and K. pneumoniae expressing over 55 diverse serine and metallo beta-lactamases. QPX7728 significantly enhanced the potency of antibiotics against the strains expressing Class A extended spectrum beta-lactamases (CTX-M, SHV, TEM, VEB, PER) and carbapenemases (KPC, SME, NMC-A, BKC-1), consistent with beta-lactamase inhibition demonstrated in biochemical assays. It also inhibits both plasmidic (CMY, FOX, MIR, DHA) and chromosomally encoded (P99, PDC, ADC) Class C beta-lactamases and Class D enzymes including carbapenemases such as OXA-48 from Enterobacteriaceae and OXA enzymes from Acinetobacter baumannii (OXA-23/24/72/58). QPX7728 is also a potent inhibitor of many class B metallo beta-lactamases (NDM, VIM, CcrA1, IMP, GIM but not SPM or L1). Addition of QPX7728 (4 μg/ml) reduced the MICs in a majority of strains to the level observed for the vector alone control, indicative of complete beta-lactamase inhibition. The ultra-broad-spectrum beta-lactamase inhibition profile makes QPX7728 a viable candidate for further development. Full Article
ex Emergence of the phenicol exporter gene fexA in Campylobacter coli and Campylobacter jejuni of animal origin [Letters] By aac.asm.org Published On :: 2020-03-30T10:04:32-07:00 Bacteria of the genus Campylobacter are major foodborne pathogens which have become increasingly resistant to clinically important antimicrobial agents (1).... Full Article
ex Complex response of the CpxAR two-component system to {beta}-lactams on antibiotic resistance and envelop homeostasis in Enterobacteriaceae [Mechanisms of Resistance] By aac.asm.org Published On :: 2020-03-30T10:04:32-07:00 The Cpx stress response is widespread among Enterobacteriaceae. We have previously reported a mutation in cpxA in a multidrug resistant strain of Klebsiella aerogenes isolated from a patient treated with imipenem. This mutation yields to a single amino acid substitution (Y144N) located in the periplasmic sensor domain of CpxA. In this work, we sought to characterize this mutation in Escherichia coli by using genetic and biochemical approaches. Here, we show that cpxAY144N is an activated allele that confers resistance to β-lactams and aminoglycosides in a CpxR-dependent manner, by regulating the expression of the OmpF porin and the AcrD efflux pump, respectively. We also demonstrate the intimate interconnection between Cpx system and peptidoglycan integrity on the expression of an exogenous AmpC β-lactamase by using imipenem as a cell wall active antibiotic or inactivation of penicillin-binding proteins. Moreover, our data indicate that the Y144N substitution abrogates the interaction between CpxA and CpxP and increase phosphotransfer activity on CpxR. Because the addition of a strong AmpC inducer such as imipenem is known to causes abnormal accumulation of muropeptides (disaccharide-pentapeptide, N-acetylglucosamyl-1,6-anhydro-N-acetylmuramyl-l-alanyl-d-glutamy-meso-diaminopimelic-acid-d-alanyl-d-alanine) in the periplasmic space, we propose these molecules activate the Cpx system by displacing CpxP from the sensor domain of CpxA. Altogether, these data could explain why large perturbations to peptidoglycan caused by imipenem lead to mutational activation of the Cpx system and bacterial adaptation through multidrug resistance. These results also validate the Cpx system, in particular the interaction between CpxA and CpxP, as a promising therapeutic target. Full Article
ex Efficacy of bedaquiline, alone or in combination with imipenem, against Mycobacterium abscessus in C3HeB/FeJ mice [Experimental Therapeutics] By aac.asm.org Published On :: 2020-04-06T08:49:26-07:00 Mycobacterium abscessus lung infections remain difficult to treat. Recent studies have recognized the power of new combinations of antibiotics such as bedaquiline and imipenem although in vitro data have questioned this combination. We report that the efficacy of the bedaquiline plus imipenem treatment relies essentially on the activity of bedaquiline in a C3HeB/FeJ mice model of infection with a rough variant of M. abscessus. The addition of imipenem contributed at clearing the infection in the spleen. Full Article
ex Pharmacodynamics of Cefepime Combined with the Novel Extended-Spectrum Beta Lactamase (ESBL) Inhibitor Enmetazobactam for Murine Pneumonia caused by ESBL-Producing Klebsiella pneumoniae [Pharmacology] By aac.asm.org Published On :: 2020-04-06T08:49:25-07:00 Klebsiella pneumoniae that produce extended spectrum beta lactamases (ESBLs) are a persistent public health threat. There are relatively few therapeutic options and there is undue reliance on carbapenems. Alternative therapeutic options are urgently required. A combination of cefepime and the novel beta lactamase inhibitor enmetazobactam is being developed for treatment of serious infections caused by ESBL-producing organisms. The pharmacokinetics-pharmacodynamics (PK-PD) of cefepime-enmetazobactam against ESBL-producing K. pneumoniae was studied in a neutropenic murine pneumonia model. Dose ranging studies were performed. Dose fractionation studies were performed to define the relevant PD index for the inhibitor. The partitioning of cefepime and enmetazobactam into the lung was determined by comparing area under the concentration time curve (AUC) in plasma and epithelial lining fluid. The magnitude of drug exposure for cefepime-enmetazobactam required for logarithmic killing in the lung was defined using 3 ESBL-producing strains. Cefepime 100 mg/kg q8h i.v. had minimal antimicrobial effect. When this background regimen of cefepime was combined with enmetazobactam half-maximal effect was induced with enmetazobactam 4.71 mg/kg q8h i.v. The dose fractionation study suggest both fT>threshold and fAUC:MIC are potentially relevant PD indices. The AUCELF:AUCplasma for cefepime and enmetazobactam was 73.4% and 61.5%, respectively. A ≥2-log kill in the lung was achieved with a plasma and ELF cefepime fT>MIC of ≥20% and enmetazobactam fT>2 mg/L of ≥20% of the dosing interval. These data and analyses provide the underpinning evidence for the combined use of cefepime and enmetazobactam for nosocomial pneumonia. Full Article