Forty miles from the state capital, Jackson County, West Virginia, is home to about 29,000 people and 25 hospital beds. Like much of the state, the rural county is reeling from the opioid epidemic.

Resistance to the "last-resort" antibiotics, such as carbapenems, has led to very few antibiotics being left to treat infections by multidrug-resistant bacteria. Spread of carbapenem resistance (CR) has been well characterized for the clinical environment. However, there is a lack of information about its environmental distribution. Our study reveals that CR is present in a wide range of Gram-negative bacteria in the coastal seawater environment, including four phyla, eight classes, and 30 genera. These bacteria were likely introduced into seawater via stormwater flows. Some CR isolates found here, such as Acinetobacter junii, Acinetobacter johnsonii, Brevundimonas vesicularis, Enterococcus durans, Pseudomonas monteilii, Pseudomonas fulva, and Stenotrophomonas maltophilia, are further relevant to human health. We also describe a novel metallo-β-lactamase (MBL) for marine Rheinheimera isolates with CR, which has likely been horizontally transferred to Citrobacter freundii or Enterobacter cloacae. In contrast, another MBL of the New Delhi type was likely acquired by environmental Variovorax isolates from Escherichia coli, Klebsiella pneumoniae, or Acinetobacter baumannii utilizing a plasmid. Our findings add to the growing body of evidence that the aquatic environment is both a reservoir and a vector for novel CR genes.

IMPORTANCE Resistance against the "last-resort" antibiotics of the carbapenem family is often based on the production of carbapenemases, and this has been frequently observed in clinical samples. However, the dissemination of carbapenem resistance (CR) in the environment has been less well explored. Our study shows that CR is commonly found in a range of bacterial taxa in the coastal aquatic environment and can involve the exchange of novel metallo-β-lactamases from typical environmental bacteria to potential human pathogens or vice versa. The outcomes of this study contribute to a better understanding of how aquatic and marine bacteria can act as reservoirs and vectors for CR outside the clinical setting.

The Stenotrophomonas maltophilia complex (Smc) comprises opportunistic environmental Gram-negative bacilli responsible for a variety of infections in both humans and animals. Beyond its large genetic diversity, its genetic organization in genogroups was recently confirmed through the whole-genome sequencing of human and environmental strains. As they are poorly represented in these analyses, we sequenced the whole genomes of 93 animal strains to determine their genetic background and characteristics. Combining these data with 81 newly sequenced human strains and the genomes available from RefSeq, we performed a genomic analysis that included 375 nonduplicated genomes with various origins (animal, 104; human, 226; environment, 30; unknown, 15). Phylogenetic analysis and clustering based on genome-wide average nucleotide identity confirmed and specified the genetic organization of Smc in at least 20 genogroups. Two new genogroups were identified, and two previously described groups were further divided into two subgroups each. Comparing the strains isolated from different host types and their genogroup affiliation, we observed a clear disequilibrium in certain groups. Surprisingly, some antimicrobial resistance genes, integrons, and/or clusters of attC sites lacking integron-integrase (CALIN) sequences targeting antimicrobial compounds extensively used in animals were mainly identified in animal strains. We also identified genes commonly found in animal strains coding for efflux systems. The result of a large whole-genome analysis performed by us supports the hypothesis of the putative contribution of animals as a reservoir of Stenotrophomonas maltophilia complex strains and/or resistance genes for strains in humans.

IMPORTANCE Given its naturally large antimicrobial resistance profile, the Stenotrophomonas maltophilia complex (Smc) is a set of emerging pathogens of immunosuppressed and cystic fibrosis patients. As it is group of environmental microorganisms, this adaptation to humans is an opportunity to understand the genetic and metabolic selective mechanisms involved in this process. The previously reported genomic organization was incomplete, as data from animal strains were underrepresented. We added the missing piece of the puzzle with whole-genome sequencing of 93 strains of animal origin. Beyond describing the phylogenetic organization, we confirmed the genetic diversity of the Smc, which could not be estimated through routine phenotype- or matrix-assisted laser desorption ionization–time of flight mass spectrometry (MALDI-TOF)-based laboratory tests. Animals strains seem to play a key role in the diversity of Smc and could act as a reservoir for mobile resistance genes. Some genogroups seem to be associated with particular hosts; the genetic support of this association and the role of the determinants/corresponding genes need to be explored.

Background:

Drugs are the fastest growing cost in the Canadian health care system, owing to the increasing number of high-cost drugs. The objective of this study was to examine the characteristics of high–drug-cost beneficiaries of public drug plans across Canada relative to other beneficiaries.

At the end of 2019 and early 2020, an outbreak of pneumonia of unknown etiology emerged in the city of Wuhan in China. The cases were found to be caused by a novel beta coronavirus, which was subsequently named SARS-CoV-2 by the World Health Organization (WHO). The virus has since spread further in China and to other regions of the world, having infected more than 88 K people, and causing close to 3000 deaths as of March 1, 2020. More than 50 million people remain in quarantine at this time. Scientists and clinicians globally are working swiftly to combat COVID-19, the respiratory disease caused by the virus. Notably, diagnostic assays have been developed rapidly in many countries, and have played significant roles in diagnosis, monitoring, surveillance, and infection control. Starting February 29, 2020, the development and performance of molecular testing for SARS-CoV-2 in high complexity Clinical Laboratory Improvement Amendments (CLIA) laboratories prior to emergency use authorization was allowed by the US FDA. Although the epidemic is evolving rapidly, many valuable lessons have been learned and many questions remain to be answered. Here we invited multiple experts across the globe from clinical laboratories, public health laboratories, infection control, and diagnostic industry to share their views on the diagnosis, infection control, and public perception of SARS-CoV-2.

PUBG Mobile update 0.18.0 released this week but a bug appears to be causing a lot of grief for players unable to play since downloading the latest patch

A new national U.S. survey finds that nearly 80 percent of respondents would be concerned about themselves or an expectant mother in their life in the midst of the current COVID-19 outbreak, with almost half expressing fear of going to a scheduled prenatal appointment.

The White House is making "contingency plans" for a second wave of coronavirus after emails reportedly contradict their claims that Centers for Disease Control and Prevention guidelines to safely reopen the economy were set aside because medical experts did not approve of them.

Bill Maher said Republicans "don't care" about Tara Reade's sexual assault allegations, saying such claims are simply used as a "unilateral weapon" against Democrats.

The DRC’s Ebola epidemic will be declared over on 12 April but there’s little time to celebrate as the country pivots towards tackling the coronavirus

Fresh cases of Ebola have been detected just days before the deadly epidemic in the eastern Democratic Republic of the Congo was to be declared over

The UK government says its coronavirus strategies are based on science, but the scientific advice it has received won’t be made public until after the pandemic

Five U.S. Senate Republicans introduced a bill on Wednesday seeking a review of U.S. participation in the World Health Organization and other international institutions, after President Donald Trump's administration suspended U.S. contributions to the U.N. health agency and accused it of mishandling the coronavirus pandemic.

A key U.S. Senate Democrat pushed back on Republican Majority Leader Mitch McConnell's drive to protect employers from coronavirus-related lawsuits when the economy begins to reopen, saying it would be unnecessary if the White House set clearer standards.

The top Republican in the U.S. House of Representatives called for a pause in coronavirus legislation on Thursday, saying Congress should first assess the impact of earlier relief bills and then take a slower path forward through committee hearings.

President Donald Trump said on Thursday his administration is talking to Republican senators about work visa issues, amid the coronavirus outbreak that has wreaked havoc on the U.S. economy.

Mike Bloomberg is agreeing to pay for health care through November for the more than 2,000 campaign staffers he laid off after suspending his presidential bid as he faces public pressure and multiple lawsuits.

Trump has long railed against the Postal Service, saying the agency has been swindled by e-commerce giants like Amazon.

As you read this, remember FSIS’s Mission Statement: The Food Safety and Inspection Service (FSIS) is the public health agency in the U.S. Department of Agriculture responsible for ensuring that the nation’s commercial supply of meat, poultry, and egg products is safe, wholesome, and correctly labeled and packaged. And, remember that none of our food... Continue Reading

Republicans on the House Oversight Committee said Friday repeated efforts to learn how the cash-strapped U.S. Postal Service intends to become financially stable have been stymied by U.S. Postmaster General Megan Brennan.

The lawmakers say they've requested a financial plan from Ms. Brennan three different times, but it hasn't been ...

Parks have remained open amid the coronavirus and become a haven over the past week, prompting fears for staff and large crowds

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Even as Broadway shows were shuttered and Disneyland was closed due to the Covid-19, most US national parks were open for business on Tuesday, confounding public health officials and worrying park staff who did not want to be exposed to the virus.

National parks have become a haven over the past week as the public seeks places to go during spring break. One park employee reported on Facebook that a visitor center at Big Bend national park was full on Monday with hundreds of people. Another shared a photo of shoulder to shoulder crowds at Zion national park waiting to board shuttle buses. (The park closed its shuttle bus system later in the day.)

Planned sale of land to fossil fuel, mining and and timber concerns mirrors rollback of Obama-era pollution regulations

The Trump administration has ratcheted up its efforts amid the coronavirus pandemic to overhaul and overturn Obama-era environmental regulations and increase industry access to public lands.

The secretary of the interior, David Bernhardt, has sped efforts to drill, mine and cut timber on fragile western landscapes. Meanwhile, the EPA, headed by the former coal lobbyist Andrew Wheeler, has weakened critical environmental laws and announced in March that it would cease oversight of the nation’s polluters during the Covid-19 crisis.

The ongoing COVID-19 outbreak in La Loche is being attributed to citizens who've ignored physical distancing measures.

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The British public appeared to stick to the Government's advice on avoiding beaches and parks even as the UK saw its warmest day of the year so far.

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"You can use a scarf," the US Leader said as he addressed the demand for face masks. "A lot of people have scarves... scarves would be very good.

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The Prince of Wales has paid tribute to NHS staff who have made the "ultimate sacrifice" serving the British public during the coronavirus pandemic.

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Confusion over whether face masks would reduce the spread of Covid-19 in public places deepened today as a minister suggested that there may not be enough to go round even if scientists recommend their use on public transport and in offices.

An "evil" sex attacker who drugged and assaulted his victim after meeting him outside a London pub has been jailed.

If the pandemic lasts another three months, news brands could suffer a £50 million loss

The UK's coronavirus lockdown faces a stern test with the public urged to stay home for a fifth weekend running.

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The NHS is launching a campaign encouraging ill people to seek urgent care during the coronavirus outbreak after A&E visits dropped by 50 per cent this month.

Home Secretary Priti Patel revealed that police have been called to respond to some "extraordinarily dangerous driving" as car lovers take advantage of the quieter roads "as their own personal race track".

Labour leader Sir Keir Starmer has called for a coronavirus lockdown "exit strategy" with the Government facing increasing pressure to reveal its next steps.

Members of the public will now have the chance to put questions to the Government, as the daily Downing Street coronavirus briefing opens up for the first time.

The Duke and Duchess of Cambridge have marked their ninth wedding anniversary with a throwback photo of their glittering wedding day.

The death tolls for the number of people who have died in care homes after testing positive for coronavirus will now be announced daily, Matt Hancock has said.

An aerial photo of ocean sands in the Bahamas has been voted the NASA Earth Observatory's all-time best image.

Britons could be limited to two or three drinks when pubs reopen, a government adviser has suggested.

Wetherspoon's is planning for a reopening of its pubs and hotels "in or around June", the company has announced.

Two "lucky" men with beer on tap said they can't complain after going into coronavirus lockdown in a London pub.

Customers were found hiding in cupboards after officers raided a pub suspected of breaching coronavirus lockdown regulations, police have said.