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Epidemiological study on prevalence, serovar diversity, multi-drug resistance and CTX-M-type extended-spectrum {beta}-lactamases of Salmonella spp. from patients with diarrhea, food of animal origin, and pets in several provinces of China [Epidemiology an

A total of 2,283 Salmonella spp. isolates were recovered from 18,334 samples including patients with diarrhea, food of animal origin and pets across 5 provinces of China. The highest prevalence of Salmonella spp. was detected in chicken meats (39.3%, 486/1,237). Fifteen serogroups and 66 serovars were identified, with Typhimurium and Enteritidis being the most dominant. Most (85.5%, 1,952/2,283) isolates exhibited resistant to ≥ 1 antimicrobial and 56.4% were multi-drug resistant (MDR). A total of 222 isolates harbored extended-spectrum β-lactamases (ESBLs), 200 of which were CTX-M-type that were mostly detected from chicken meat and turtle fecal. Overall, eight blaCTX-M genes were identified, with blaCTX-M-65, blaCTX-M-123, blaCTX-M-14, blaCTX-M-79, and blaCTX-M-130 being the most prevalent. Totally, 166 of the 222 ESBL-producing isolates had amino acid substitutions in GyrA (S83Y, S83F, D87G, D87N, and D87Y) and ParC (and S80I), whilst the PMQR-encoding genes oqxA/B, qepA, and qnrB/S were detected in almost all isolates. Of the fifteen sequence types (STs) identified in the 222 ESBLs, ST17, ST11, ST34, and ST26 ranked among the top 5 in the number of isolates. Our study revealed considerable serovars diversity, high prevalence of co-occurrence of MDR determinants, including CTX-M-type ESBLs, QRDRs mutations and PMQR genes. This is the first report of CTX-M-130 Salmonella spp. from patients with diarrhea and QRDRs mutations from turtle fecal samples. Our study emphasizes the importance of actions, both in the health care settings and in the veterinary medicine sector, to control the dissemination of MDR, especially the CTX-M Salmonella spp. isolates.




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Safety and tolerability of more than 6 days of tedizolid treatment [Clinical Therapeutics]

Tedizolid has demonstrated its efficacy and safety in clinical trials, however, data concerning its tolerability in long-term treatments is scarce. The aim of the study was to assess the indications and to describe the long-term safety profile of tedizolid.

A multicentric, retrospective study of patients who received tedizolid for more than 6-days was conducted. Adverse events (AEs) were identified from patients' medical records and laboratory data. The World Health Organization causality categories were used to discern AEs probably associated with tedizolid.

Eighty-one patients, treated with tedizolid 200mg once-daily for a median (IQR) duration of 28 (14-59) days, were included, 36 (44.4%) had previously received linezolid. Most common reasons for selecting tedizolid were to avoid linezolid potential toxicities or interactions (53.1%) or due to previous linezolid-related toxicities (27.2%). Most common indications were off-label, including prosthetic joint infections, osteomyelitis and respiratory infections (77.8%). Overall, 9/81 patients (11.1%) experienced a probably associated AE. Two patients (2.5%) developed gastrointestinal disorders, 1 (1.2%) anemia and 6 thrombocytopenia (7.4%) after a median (IQR) duration of treatment of 26.5 (17-58.5) days. Four (5%) patients discontinued tedizolid due to AEs. Among 23 patients with chronic renal failure (CRF) the rate of mielotoxicity was 17.4% and only 8.7% had to stop tedizolid and 20 out of 22 with previous linezolid-associated toxicity had no AE.

Long-term tedizolid treatments had good tolerance with rates of gastrointestinal AE and hematological toxicity lower than those reported with linezolid, particularly in patients with CRF and in those with a previous history of linezolid-associated toxicity.




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Nafamostat mesylate blocks activation of SARS-CoV-2: New treatment option for COVID-19 [Letters]

The currently unfolding coronavirus pandemic threatens health systems and economies worldwide....




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Cardiovascular safety and population pharmacokinetic properties of piperaquine in African patients with uncomplicated falciparum malaria - a pooled multicentre analysis [Clinical Therapeutics]

Dihydroartemisinin-piperaquine has shown excellent efficacy and tolerability in malaria treatment. However, concerns have been raised of potentially harmful cardiotoxic effects associated with piperaquine. The population pharmacokinetics and cardiac effects of piperaquine were evaluated in 1,000 patients, mostly children enrolled in a multicentre trial from 10 sites in Africa. A linear relationship described the QTc-prolonging effect of piperaquine, estimating a 5.90ms mean QTc-prolongation per 100ng/mL increase in piperaquine concentration. The effect of piperaquine on absolute QTc-interval estimated a mean maximum QTc-interval of 456ms (EC50=209ng/mL). Simulations from the pharmacokinetic-pharmacodynamic models predicted 1.98-2.46% risk of having QTc-prolongation > 60ms in all treatment settings. Although piperaquine administration resulted in QTc-prolongation, no cardiovascular adverse events were found in these patients. Thus, the use of dihydroartemisinin-piperaquine should not be limited by this concern.




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Concurrent local delivery of diflunisal limits bone destruction but fails to improve systemic vancomycin efficacy during Staphylococcus aureus osteomyelitis [Clinical Therapeutics]

Staphylococcus aureus osteomyelitis is a debilitating infection of bone. Treatment of osteomyelitis is impaired by the propensity of invading bacteria to induce pathologic bone remodeling that may limit antibiotic penetration to the infectious focus. The nonsteroidal anti-inflammatory drug diflunisal was previously identified as an osteoprotective adjunctive therapy for osteomyelitis, based on the ability of this compound to inhibit S. aureus quorum sensing and subsequent quorum-dependent toxin production. When delivered locally during experimental osteomyelitis, diflunisal significantly limits bone destruction without affecting bacterial burdens. However, because diflunisal's "quorum-quenching" activity could theoretically increase antibiotic recalcitrance, it is critically important to evaluate this adjunctive therapy in the context of standard of care antibiotics. The objective of this study is to evaluate the efficacy of vancomycin to treat osteomyelitis during local diflunisal treatment. We first determined that systemic vancomycin effectively reduces bacterial burdens in a murine model of osteomyelitis, and identified a dosing regimen that decreases bacterial burdens without eradicating infection. Using this dosing scheme, we found that vancomycin activity is unaffected by the presence of diflunisal in vitro and in vivo. Similarly, locally-delivered diflunisal still potently inhibits osteoblast cytotoxicity in vitro and bone destruction in vivo in the presence of sub-therapeutic vancomycin. However, we also found that the resorbable polyurethane foams used to deliver diflunisal serve as a nidus for infection. Taken together, these data demonstrate that diflunisal does not significantly impact standard of care antibiotic therapy for S. aureus osteomyelitis, but also highlight potential pitfalls encountered with local drug delivery.




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Effect of the Lysin, Exebacase, on Cardiac Vegetation Progression in a Rabbit Model of Methicillin-Resistant Staphylococcus aureus (MRSA) Endocarditis as Determined by Echocardiography [Pharmacology]

Background: MRSA pose significant therapeutic challenges, related to their: frequency in clinical infections; innate virulence properties; and propensity for multi-antibiotic resistance. MRSA are among the most common causes of endovascular infections, including infective endocarditis (IE).

Objective: To employ transthoracic echocardiography (TTE) to evaluate the effect of exebacase, a novel direct lytic agent, in experimental aortic valve MRSA IE.

Study Design: TTE was utilized to evaluate the in vivo effect of exebacase on MRSA-infected vegetation progression when combined with daptomycin (vs daptomycin alone). Primary intravegetation outcomes were: maximum size; weights at sacrifice; and MRSA counts at infection baseline vs after 4 days of daptomycin treatment (alone or in addition to exebacase administered once on treatment Day 1).

Results: A single dose of exebacase in addition to daptomycin cleared significantly more intravegetation MRSA than daptomycin alone. This was associated with a statistical trend toward reduced maximum vegetation size in the exebacase + daptomycin vs the daptomycin-alone therapy groups (p = 0.07). Also, mean vegetation weights in the exebacase-treated group were significantly lower vs daptomycin-alone (p < 0.0001). Maximum vegetation size by TTE correlated with vegetation weight (p = 0.005). In addition, intravegetation MRSA counts in the combination group were significantly lower vs untreated controls (p<0.0001) and the daptomycin-alone group (p<0.0001).

Conclusion: This study suggests that exebacase has a salutary impact on MRSA-infected vegetation progression when combined with daptomycin, especially in terms of vegetation MRSA burden, size and weight. Moreover, TTE appears to be an efficient non-invasive tool to assess therapeutic efficacies in experimental MRSA IE.




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PAGI-associated CrpP-like fluoroquinolone-modifying enzymes among Pseudomonas aeruginosa clinical isolates in Europe [Mechanisms of Resistance]

Many transferable quinolone-resistance mechanisms have been already identified in Gram-negative bacteria. The plasmid-encoded 65 amino-acid long ciprofloxacin-modifying enzyme, namely CrpP, was recently identified in Pseudomonas aeruginosa. We analyzed a collection of 100 clonally-unrelated and multidrug-resistant P. aeruginosa clinical isolates among which 46 (46%) were found positive for crpP-like genes, encoding five CrpP variants conferring variable levels of reduced susceptibility to fluoroquinolones. Those crpP-like genes were chromosomally located, as part of PAGI-like pathogenicity genomic islands.




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Clinically relevant epithelial lining fluid concentrations of meropenem with ciprofloxacin provide synergistic killing and resistance suppression of hypermutable Pseudomonas aeruginosa in a dynamic biofilm model [Pharmacology]

Treatment of exacerbations of chronic Pseudomonas aeruginosa infections in patients with cystic fibrosis (CF) is highly challenging due to hypermutability, biofilm formation and an increased risk of resistance emergence. We evaluated the impact of ciprofloxacin and meropenem as monotherapy and in combination in the dynamic in vitro CDC biofilm reactor (CBR). Two hypermutable P. aeruginosa strains, PAOmutS (MICciprofloxacin 0.25 mg/L, MICmeropenem 2 mg/L) and CW44 (MICciprofloxacin 0.5 mg/L, MICmeropenem 4 mg/L), were investigated for 120h. Concentration-time profiles achievable in epithelial lining fluid (ELF) following FDA-approved doses were simulated in the CBR. Treatments were ciprofloxacin 0.4g every 8h as 1h-infusions (80% ELF penetration), meropenem 6 g/day as continuous infusion (CI; 30% and 60% ELF penetration) and their combinations. Counts of total and less-susceptible planktonic and biofilm bacteria and MICs were determined. Antibiotic concentrations were quantified by UHPLC-PDA. For both strains, all monotherapies failed with substantial regrowth and resistance of planktonic (≥8log10 CFU/mL) and biofilm (>8log10 CFU/cm2) bacteria at 120h (MICciprofloxacin up to 8 mg/L, MICmeropenem up to 64 mg/L). Both combination treatments demonstrated synergistic bacterial killing of planktonic and biofilm bacteria of both strains from ~48h onwards and suppressed regrowth to ≤4log10 CFU/mL and ≤6log10 CFU/cm2 at 120h. Overall, both combination treatments suppressed amplification of resistance of planktonic bacteria for both strains, and biofilm bacteria for CW44. The combination with meropenem at 60% ELF penetration also suppressed amplification of resistance of biofilm bacteria for PAOmutS. Thus, combination treatment demonstrated synergistic bacterial killing and resistance suppression against difficult-to-treat hypermutable P. aeruginosa strains.




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Identification of antiviral drug candidates against SARS-CoV-2 from FDA-approved drugs [Antiviral Agents]

Drug repositioning is the only feasible option to address the COVID-19 global challenge immediately. We screened a panel of 48 FDA-approved drugs against SARS-CoV-2 which were pre-selected by an assay of SARS-CoV and identified 24 potential antiviral drug candidates against SARS-CoV-2 infection. Some drug candidates showed very low micromolar IC50s and in particular, two FDA-approved drugs - niclosamide and ciclesonide – were notable in some respects.




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Inhibition of SARS-CoV-2 infection by the cyclophilin inhibitor Alisporivir (Debio 025) [Antiviral Agents]

Cyclophilins play a key role in the lifecycle of coronaviruses. Alisporivir (Debio 025) is a non-immunosuppressive analogue of cyclosporin A with potent cyclophilin inhibition properties. Alisporivir reduced SARS-CoV-2 RNA production in a dose-dependent manner in VeroE6 cell line, with an EC50 of 0.46±0.04 μM. Alisporivir inhibited a post-entry step of the SARS-CoV-2 lifecycle. These results justify that a proof-of-concept Phase 2 trial be rapidly conducted with alisporivir in patients with SARS-CoV-2 infection.




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Report: Hack of Amazon's CEO Phone Tied to Saudi Prince

The stunning allegation reportedly comes from a forensic analysis Amazon CEO Jeff Bezos commissioned to determine the culprit behind the hack, which resulted in his private photos ending up in the hands of the National Enquirer.




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After Bezos Phone Hack, UN Points Finger at Saudis, Calls for Probe

According to a recent forensic analysis, a WhatsApp account from the Saudi Crown Prince Mohammed bin Salman allegedly sent government-bought spyware to Bezos' phone in May 2018, two UN human rights experts said on Wednesday.




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Save 30 Percent on Keeper, Never Click 'Forgot Password' Again

The password-fatigued masses will be pleased to find Keeper's new 30 percent off deal, which brings it down to $20.99 per year from its typical $29.99.




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Fin24.com | SA stocks are on track for a record month

Unprecedented demand for online services and entertainment during the Covid-19 pandemic lockdowns, along with a scramble for haven investments, have helped set South African stocks on course for a record month.




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Body Dissatisfaction and Mental Health Outcomes of Youth on Gender-Affirming Hormone Therapy

OBJECTIVES:

Our first aim was to examine baseline differences in body dissatisfaction, depression, and anxiety symptoms by gender, age, and Tanner (ie, pubertal) stage. Our second aim was to test for changes in youth symptoms over the first year of receiving gender-affirming hormone therapy. Our third aim was to examine potential differences in change over time by demographic and treatment characteristics. Youth experiences of suicidal ideation, suicide attempt, and nonsuicidal self-injury (NSSI) are also reported.

METHODS:

Participants (n = 148; ages 9–18 years; mean age 14.9 years) were receiving gender-affirming hormone therapy at a multidisciplinary program in Dallas, Texas (n = 25 puberty suppression only; n = 123 feminizing or masculinizing hormone therapy). Participants completed surveys assessing body dissatisfaction (Body Image Scale), depression (Quick Inventory of Depressive Symptoms), and anxiety (Screen for Child Anxiety Related Emotional Disorders) at initial presentation to the clinic and at follow-up. Clinicians completed the Quick Inventory of Depressive Symptoms and collected information on youth experiences of suicidal ideation, suicide attempt, and NSSI.

RESULTS:

Affirmed males reported greater depression and anxiety at baseline, but these differences were small (P < .01). Youth reported large improvements in body dissatisfaction (P < .001), small to moderate improvements in self-report of depressive symptoms (P < .001), and small improvements in total anxiety symptoms (P < .01). No demographic or treatment-related characteristics were associated with change over time. Lifetime and follow-up rates were 81% and 39% for suicidal ideation, 16% and 4% for suicide attempt, and 52% and 18% for NSSI, respectively.

CONCLUSIONS:

Results provide further evidence of the critical role of gender-affirming hormone therapy in reducing body dissatisfaction. Modest initial improvements in mental health were also evident.




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Samsung Galaxy Note 10+

The Samsung Galaxy Note 10+ is a big, powerful phone that's good for artists and note-takers.




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Salesforce Pardot

Although it's pricey, the intuitive Salesforce Pardot offers standout features, making it a leader among today's marketing automation platforms.




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Champions League Fantasy Matchday 7: What the numbers say

UEFA.com studies the statistics to find out which players are predicted for big Matchday 7 totals.




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Saskia's Albanian journey

Saskia perseveres through language learning and connects with a young Albanian girl who becomes a follower of Jesus.




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Fin24.com | Watch out for loan scam, warns Sanlam

Unsuspected consumers are being targeted by fraudsters using the name of Sanlam to swindle cash out of them, the financial service provider has warned.




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Fin24.com | SA inequality grows as rich take larger share - report

New research has found that inequality in SA has increased, with wealth becoming ever more concentrated among the rich.




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Fin24.com | South Africans are big borrowers and poor savers - expert

Reducing indebtedness and improving savings in South Africa is a major socio-economic challenge, warns an industry expert.




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Fin24.com | Debit fraud: Here is how SA's big 4 banks are handling it

For bank account holders who have been victims of debit order fraud, the big four banks share their remedies.




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Fin24.com | 'I told myself it's not my money, yet': This woman saved R23 400 in small change in a year

Student Sandisiwe Msomi saved R23 400 in small change over a year, which she will now use to pay for the registration fees of her second academic year.




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Fitbit Charge 3 Fitness Tracker on Sale for Less Than $120

Save $30 on this Editors' Choice fitness tracker, which is safe to wear in the pool and shower. It's normally $149.95, but you can grab it now for just $119.95 with free shipping.




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First Look: Fitbit Versa 2, Aria Air

From a new paid membership service to the Aria Air and Versa 2, Fitbit's latest products and services make staying on top of your health and fitness easier and more accessible than ever.




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Fitbit Versa 2

The Fitbit Versa 2 takes everything we like about the original smartwatch and adds an always-on AMOLED display, a microphone for Amazon Alexa, and Fitbit Pay.




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Save $128 on Garmin's Premium Forerunner 935 GPS Watch

The Garmin Forerunner 935, which sits at the top of the Forerunner hierarchy thanks to highly customizable running and triathlon features, is $128 off on Amazon today.




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Fin24.com | SA expats send money home to help aging parents and more

Remittances from overseas are a lifeline for many South Africans, says Richard Ambrose, CEO of Azimo.




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Fin24.com | What to know about shift from equities to 'safety' of bonds

Geopolitical factors and economic uncertainty make some investors shift away from equities into what they perceive to be the safety of higher-quality bonds.




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Fin24.com | Organisation with an interest in financial literacy, invited to take part in Money Smart Week

Money Smart Week SA, a financial literacy campaign aimed at motivating and empowering South Africans to become more educated about their finances, is taking place from March 23 to 28, 2020.




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Fin24.com | Here's what SA financial experts would do with R10 000 in 2020

Fin24 asked financial experts how they would grow R10 000 in the new year. Here's what they said.




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Fin24.com | Tips to start saving right now

When starting your savings journey, contribute the maximum tax-free allocation and then explore further options that suit your risk appetite and profile, says an expert.




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Fin24.com | Experts say the Section 12J incentive is misunderstood - we asked them to explain

Many investors do not fully understand the tax incentive and structure of a Section 12J venture capital investment, according to a managing director involved in this sector.




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Fin24.com | Coronavirus and retirement savings: 5 things experts want you to think about

Instability in local and international stock markets – mainly due to concerns over the impact of the coronavirus – might have you concerned about preserving your retirement savings.




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A 10-Year-Old's Shooting Death and the Challenge Schools Face Keeping Football Games Safe

The shooting death of a 10-year-old spectator at a high school football game exposes a critical vulnerability and crucial responsibility for schools: keeping people safe at events outside school buildings.




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Futsal EURO qualifying main round: full guide

Seven of the 12 places at UEFA Futsal EURO 2018 in Slovenia will be decided when the main round is played between Saturday and Tuesday, with Spain beginning their title defence.




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Futsal EURO play-off draw made

The Czech Republic meet Serbia, France play Croatia, Romania take on Georgia and Hungary are up against Poland in September's UEFA Futsal EURO 2018 play-offs.




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Futsal EURO play-offs: how they stand

Serbia and Hungary secured narrow wins in the first legs of their play-offs while debut-chasing France and Georgia both found themselves pegged back. The second legs are on 26 September.




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Volkswagen gives UEFA Futsal EURO 2018 wheels

The 55-vehicle Volkswagen fleet which will transport players and officials at UEFA Futsal EURO 2018 has been handed over to the tournament organisers.




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UEFA Futsal EURO 2018 finals draw made

Hosts Slovenia have been handed a tough group with Italy and Serbia while France's debut finals match will be against holders Spain after the draw was made in Ljubljana.




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Youth Olympics futsal qualifying report

The future of European futsal – male and female – was displayed over the last week in qualifying for the 2018 Youth Olympic games with Russia and Portugal coming out on top.




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UEFA Futsal EURO ticket sales start

Tickets are now on sale for UEFA Futsal EURO 2018 at Stožice Arena in Ljubljana with the first one bought by UEFA President Aleksander Čeferin, who was born in the Slovenian capital.




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UEFA Futsal EURO 2018: meet the teams

We look at the 12 teams that will compete in Slovenia between 30 January and 10 February – from champions Spain and former winners Italy and Russia to debutants France.




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Futsal rules: a quick guide

The laws of futsal are similar to those of football but with some important differences: let us talk you through the rolling substitutions, accumulated fouls, double penalties and four-second count.




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Download the UEFA Futsal EURO programme now

The official UEFA Futsal EURO 2018 programme, featuring all you need to know about the teams plus interviews with the likes of Wissam Ben Yedder, is out now and available to download for free.




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Futsal entering an exciting era

The UEFA Futsal EURO is being enhanced, and will soon be joined by two new futsal competitions – the UEFA Women's Futsal EURO and the UEFA European Under-19 Futsal Championship.




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Futsal EURO 2018: all you need to know

UEFA Futsal EURO 2018 runs until 10 February in Ljubljana with 12 teams aiming for the title: we give you the key pointers to following a tournament full of skill and passion.




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Where to watch UEFA Futsal EURO 2018

You can watch UEFA Futsal EURO 2018 across Europe and the world thanks to UEFA's broadcast partners and the live streaming of games on UEFA.com and our YouTube channel UEFA.tv.




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Futsal EURO final: Portugal v Spain – all you need to know

Holders Spain face neighbours Portugal for the second time in a UEFA Futsal EURO final, putting their title on the line in Ljubljana on Saturday: read the full lowdown, including where to watch.