bluuebunny/crossref_metadata_2025_split huggingface dataset:
Molecular epidemiology and clonality of Acinetobacter spp in a Lebanese hospital over a period of one year
Authors: Soudeiha Micheline , Sokhn Elie Salem , Daoud Ziad , Sarkis Dolla 
Published: February 2018

Introduction: The worldwide emergence of antimicrobial resistance in Acinetobacter spp and their clonal dissemination call for the investigation into Acinetobacter spp epidemiology.
Methodology: 100 nonrepetitive Acinetobacter spp isolates were recovered from patients admitted at Saint- George-Hospital-University-Medical-Center-Beirut, in a one-year period. Identification of the isolates was determined by the API20NE and confirmed by PCR amplification of blaOXA-51-like. Susceptibility to carbapenems and colistin were determined by the microdilution method and interpreted according to the CLSI, 2015.The β lactamase inhibitors: PBA, EDTA, and Cloxacillin were used for the detection of KPC, MBL and AmpC, respectively. ESBL producers were detected whenever a keyhole effect was observed between 3rd generation cephalosporin and Augmentin®. Simplex PCR was conducted for the genotypic detection of β lactamases. ERIC and 3LST-PCR were performed to determine the clonality of the isolates.
Results: Our findings showed that 84% were carbapenem resistant. Only one isolate was resistant to colistin. Phenotypically, 23 were ESBL, 15 KPC, 5 AmpC, and 4 MBL producers. PCR analysis showed that 99%, 93%, 77% and 3 % of the isolates harbored blaOXA-51-like, blaADC, blaOXA-23-like, and blaOXA-40-like, respectively. ERIC-PCR analysis showed that A.baumannii isolates were clustered in 19 possibly related and 30 closely related subtypes. The 3-LST-PCR showed that 86.2% of the A.baumannii isolates pertained to the ICII (international clone II).
Conclusion: Our study showed a predominance of OXA-23-like producers and dissemination of ICII. Inhibitor based method was shown not to be accurate for the prediction of carbapenemases in Acinetobacter spp. Infection control measures are needed for management of Acinetobacter spp infections.
Search for hits and early leads from soil bacteria to combat infectious diseases
Authors: Herrmann Jennifer 
Published: February 2018

Introduction: Natural products are the source of a large fraction of the current pharmaceutics available against human disease. However, the discovery of novel compounds with new mechanisms of action is becoming increasingly challenging. We focused our work on soil-dwelling Myxobacteria from highly diverse samples, which are more and more recognized as an important natural product source.
Methodology: Our discovery pipeline combines traditional whole cell-based activity screens with state-of-the-art analytical techniques and a comprehensive dereplication process. Having identified an antimicrobial compound we aim at elucidating its target, MOA and MOR in diverse microbiological screens and by applying ‘omic’ technologies.
Results: Two case studies of currently investigated compound classes will be highlighted. Cystobactamids are novel topoisomerase inhibitors that display very pronounced activity on Gram-positive and Gram-negative bacteria. Telomycins from Streptomyces canus bind to cardiolipin and our studies revealed other putative cellular targets.
Conclusion: We were able to isolate several new natural products with potent and selective activity against clinically relevant pathogens. Interestingly, underlying MOAs often differ from those of already described antimicrobial agents.
Prevalence of carbapenem resistance genes and corresponding MIC90 in Enterobacteriaceae at a tertiary care center in Lebanon
Authors: Kissoyan Kohar Annie , Araj George F , Matar Ghassan M 
Published: February 2018

Introduction: The aim of this study was to correlate genes involved in carbapenem resistance to MIC levels among clinical ESBL and non-ESBL producing carbapenem resistant Enterobacteriaceae (CRE) isolates of Escherichia coli and Klebsiella pneumoniae.
Methodology: E. coli (n = 76) and K. pneumoniae (n = 54), collected between July 2008 and July 2014, were analyzed. The MICs were determined against ertapenem (ERT), imipenem (IMP) and meropenem (MER). PCR was performed on all 130 isolates to amplify
the resistance and outer membrane proteins (OMPs) encoding genes: blaOXA-48, blaNDM-1, blaTEM-1, blaCTX-M-15, ompC and ompF. Sequencing was performed on selected isolates.
Results: The prevalence of blaOXA-48, blaNDM-1, blaTEM-1, and/or blaCTX-M-15 among E. coli isolates were 36%, 12%, 20% and 80%, respectively, while among K. pneumoniae they were 37%, 28%, 28% and 72%, respectively. K. pneumoniae isolates positive for any of these genes had an MIC90 > 32μg/mL against ERT, IMP and MER, while in E. coli isolates there was a variation in the MIC90 values. Porin impermeabilities were due to mutations in ompC and ompF genes in E. coli, and loss of ompC and ompF genes in K. pneumoniae, and increased MIC90 values.
Conclusion: The presence of more than one carbapenem resistance encoding gene and/or ESBL encoding gene did not have an effect on the MIC90 value in K. pneumoniae isolates, while in E. coli it showed higher MIC90 values.
Epidemiology of bacteremia after autologous hematopoietic stem cell transplantation in the absence of antibiotic prophylaxis
Authors: Moghnieh Rima , Mugharbil Anas , Youssef Ali , Jisr Tamima , Tamim Hani , Zahran Kamal , Khaldieh Samer , Abdallah Dania , Awad Lyn , Massri Oula , Rachini Najat , Hamdan Youssef , Ibrahim Ahmad 
Published: February 2018

Introduction: Bacterial infections are frequent complications occurring after autologous hematopoietic stem-cell transplantation (AHSCT). Herein, we identified the bacterial ecology and its antibiogram in AHSCT patients. We assessed the incidence, contributing factors and outcome of prolonged neutropenia and bacteremia post-AHSCT in the absence of antibacterial prophylaxis.
Methodology: This is a retrospective chart review of 190 adult patients who underwent AHSCT for lymphoma and multiple myeloma, between 2005 and 2015 at a Lebanese hospital.
Results: Most of the isolated bacteria originated from urine (49%) followed by blood (30%) and were mainly Gram-negative (70%). Fluoroquinolone susceptibility was 57% among Gram-negative and Gram-positive isolates. Bacteremia was documented in 12.6% of the patients, with a predominant gram-negative etiology having 95% susceptibility to fluoroquinolones. The duration of neutropenia, < or > 7 days, did not affect the incidence of bacteremia (11% vs. 14% respectively, p = 0.17). Patients with lymphoma were more likely to have prolonged neutropenia compared to those with myeloma (p < 0.0001). The use of a central line and the development of central-line infections were significantly higher in Gram-positive bacteremia (p = 0.03, p = 0.008 respectively). Mucositis occurred more in Gram-negative bacteremia (p = 0.02). Total mortality rate was 3.7% in the whole population and that attributed to bacteremia was 12.5% in the bacteremia subgroup. Bacteremia was a predictor for mechanical ventilation (p = 0.003), septic shock and mortality (p = 0.025).
Conclusion: Since organisms causing bacteremia were still highly susceptible to fluoroquinolones and that the duration of neutropenia post-AHSCT didn't affect bacteremia, we concluded that fluoroquinolone prophylaxis is still valid yet, with close monitoring of resistance.
From bugs to drugs: Combating antimicrobial resistance by discovering novel antibiotics
Authors: Abou Fayad Antoine , Itani Dana , Miari Mariam , Tanelian Arax , Iweir Sereen , Matar Ghassan M 
Published: February 2018

Introduction: Antimicrobial resistance (AMR) is emerging at an alarming rate as mortality due to resistant pathogens could rise to 10 million per year by 2050. Since AMR is against all clinically utilized antibiotics, finding novel antimicrobials with unexploited targets remains the main goal worldwide. Soil microorganisms produce natural products as a significant number of drugs in clinical use are derived from these metabolites. Actinomycetes and Myxobacteria are soil dwelling microorganisms that produce secondary metabolites to be screened for antibacterial activity. More than 80% of clinically utilized antibiotics are either natural products or natural product-derived molecules such as vancomycin, teicoplanin, daptomycin, and tetracycline. This study aims to isolate and identify novel antimicrobials from Actinomycetes and Myxobacteria.
Methodology: Soil samples were collected from several areas in Lebanon. Samples were serially diluted for Actinomycetes isolation and boiled for Myxobacteria extraction, then plated on suitable media. Colonies obtained were purified and subjected to genomic DNA extraction then 16s rRNA analysis. Novel isolates were tested for their antimicrobial activity against Gram-positive Bacillus subtilis (ATCC 6051), Staphylococcus aureus (ATCC 29213, Newman, N315), Enterococcus faecalis (ATCC 19433), and Enterococcus faecium (DSMZ 17050), and Gram-negative Escherichia coli (ATCC 9637), Klebsiella pneumoniae (DSMZ), Pseudomonas aeruginosa (ATCC 27853, MEXAB), and Acinetobacter baumannii (ATCC 15308).
Results: Strain isolation and cultivation yielded a number of novel isolates whose extracts demonstrated strong antibacterial activity against pathogens including MRSA, VRE, and Escherichia coli (ATCC 9637).
Conclusion: Our efforts now focus on purifying these compounds, elucidate their structures and study their mode of action.
Comparison of virulence determinants among Acinetobacter baumannii Clinical isolates obtained from Spain and Lebanon
Authors: Dahdouh Elias Abdo , Suarez Rodriguez Monica , Daoud Ziad 
Published: February 2018

Introduction. Acinetobacter baumannii is a pathogen that is causing concern due to its high genetic elasticity, allowing it to show high rates of antibiotic resistance and to express a wide range of virulence determinants. Several studies are aimed towards targeting the virulence of A. baumannii as an adjunct to antibiotic therapy. In this study, we investigate the difference in virulence determinants between A. baumannii isolates obtained from Spain and Lebanon
Methodology. Fifty-nine A. baumannii isolates were collected from La Paz Hospital, Spain, and 90 from St. George Hospital, Lebanon. The isolates were identified using VITEK-2. Biofilm formation was detected by crystal violet staining, hemolysis by blood agars, motility by surface motility assays, siderophore production by CAS assays, and proteolytic activity by azoalbumin assays.
Results. The expression of virulence determinants was highly variable among the isolates. Among the Spanish isolates, 84.4% produced biofilms, 54.2% showed hemolysis, and 69.5% produced siderophores. Among the Lebanese isolates, 85.6% produced strong biofilms, 47.8% showed hemolysis, and 57.8% produced siderophores. Proteolytic activity for the Spanish isolates (26.6 ± 8.4 U/L) was slightly higher than that of the Lebanese isolates (17.7 ± 9.5 U/L). Very few Spanish isolates (3) showed surface motility, as opposed to the majority of the Lebanese isolates (80) that showed surface motility.
Conclusion. The genomic plasticity of A. baumannii is demonstrated by its ability to differentially express virulence determinants. This highlights the need to treat each isolate as a unique case when attempting to use anti-virulence agents to treat A. baumannii infections.
Carriage trends and fitness cost of MDROs in Lebanese nursing homes
Authors: Challita Caren , Hafza Nourhane , Dahdouh Elias , Attieh Michel , Dandachi Iman , Daoud Ziad 
Published: February 2018

Introduction: Nowadays, medical treatments efficiency is challenged by multi drug resistant organisms (MDROs). Lebanese nursing homes’ residents revealed high fecal carriage rates of MDR Enterobacteriacea. Previous studies claim that bacteria with resistant genes experience fitness cost. This study assesses the competitive growth of MDR Escherichia coli and Klebsiella pneumoniae.
Methodology: Fecal swabs were collected, during six consecutive months, from ten elderly residing in a Lebanese nursing home. All isolates were subject to API 20E (bioMerieux, Marcy L’ Etoile, France) and antimicrobial susceptibility (Kirby–Bauer method) testing. Phenotypically, ESBL (extended spectrum β-lactamase), MBL (metallo β-lactamase), AmpC and KPC (Klebsiella pneumoniae carbapenemase) were detected using EDTA, PBA, cloxacillin, and DDSTs (Biorad, Hercules, USA). Selected ESBL producing E. coli and K. pneumoniae underwent multiplex PCR analysis. Intra and inter-species in-vitro competition assays were conducted in multiple combinations.
Results: Among 117 collected isolates, E. coli was predominant (71.8%); 7.7% were ESBL and 5.1% AmpC producers. With E. coli intra-species assays, sensitive isolates out-competed all others, followed by ESBL, AmpC, and OXA-48 (oxacillin) producers. Inter-species assays, demonstrated a decreased fitness of ESBL producing K. pneumoniae in presence of sensitive E. coli. While out-competing ESBL producing E. coli required 2 sensitive K. pneumoniae isolates.
Conclusion: This study highlights resistant E. coli and K. pneumoniae frequency decrease in presence of sensitive isolates, endorsing the fitness cost hypothesis. Hence, competing supplementary species reproducing gut flora, would ensure further steps in the fight against MDROs.
The predictability of financial, accounting‐based, and industrial factors on the success of newly incorporated Spanish firms
Authors: Tong Yehui , Saladrigues Ramon 
Published: February 2018

Purpose: The purpose of this paper is to identify the impacts and predictability of financial, accountingbased, and industrial factors (as well as corporate venturing) on survival‐based success of newly incorporated firms in Spain.Design/methodology/approach: Logistic regression is used for comparing the differences of factors in the prediction of future success after different time periods since the studying years (age 1, age 2, and age 3 respectively) in manufacturing and distributive sectors.Findings: Differences in predictability are observed between manufacturing and distributive sectors: it is obvious in distributive sector (rather than manufacturing sector) that liquidity, bank credit, trade credit, and concentration are positively related to success while entry rate is negatively related to success. In spite of that, some factors still show strong predictability in both two sectors. Firm size and profitability are the strongest positive factors, which are followed by corporate venturing and the growth of industrial operating revenues with positive and generally negative relationships to success separately. Besides, for some factors and variables frequently showing statistical significance, their impacts in the same age tend to be relatively stable.Practical implications: The findings of this paper can help to identify the predictability of different factors on the success of newly incorporated firms and catch the differences between manufacturing and distributive sectors.Originality/value: This paper enriches the empirical study of new firm success in Spain in depression and stagnant environment (because the observed years here are from 2009 to 2014); besides, the findings also contribute to the specific prediction study of manufacturing and distributive sectors.
A Narrative Analysis: Examining the Transition to Practice for the Full-Time Secondary School Athletic Trainer
Authors: Mazerolle Stephanie M. , Kirby Jessica , Walker Stacy E. 
Published: February 2018

Context:
The transition to clinical practice is an important topic in athletic training because it is viewed as a stressful time that is accompanied by self-doubt. Mentorship and previous experience support the transition to practice, but little information is available on the organizational entry of the athletic trainer (AT) who is employed full time in the secondary school setting.

Objective:
To understand the experiences of newly credentialed ATs in full-time positions in the secondary school setting.

Design:
Qualitative study.

Setting:
Secondary schools.

Patients or Other Participants:
Seventeen ATs (4 men, 13 women; age = 25 ± 4 years) were employed full time in the secondary school setting. On average, the full-time ATs worked 40 ± 10 hours per week.

Data Collection and Analysis:
All participants completed a semistructured telephone interview with 1 researcher. Data were analyzed using a narrative analysis, and credibility was established by peer review and researcher triangulation. The narrative research paradigm guided our protocol and supported the rigor of the study.

Results:
Our analyses revealed that transition to practice was organic, such that the newly credentialed AT gained awareness by engaging in the role daily. Additionally, the transition process was facilitated by previous experience in the setting, mostly from educational training. Ongoing communication with various stakeholders (athletic directors, team physicians, and peer ATs) in the setting also assisted in the process of transitioning. Finally, mentorship from previous preceptors provided support during the transition process.

Conclusions:
Transitioning into full-time clinical practice in the secondary school setting was informal and supported by professional relationships and past experiences. Past experiences allowed for awareness but also the development of mentoring relationships that continued beyond the clinical education experience. Communication also assisted the newly credentialed AT, as it provided feedback for legitimation by multiple stakeholders.
Comparative analysis of inflammatory gene expression levels in metabolic syndrome & coronary artery disease
Authors: Nair Jiny , Kakkar Vijay V. , Shanker Jayashree 
Published: February 2018

Background & objectives:
Metabolic syndrome (MetS) increases the likelihood of developing coronary artery disease (CAD), and inflammation is involved in the pathogenesis of both these conditions. The present work was conducted to examine the relative expression of 18 key inflammatory genes associated with MetS and incident CAD in a representative group of patients.

Methods:
A total of 178 male patients, including 57 with CAD and 121 without CAD, were enrolled in the study. The participants without CAD were characterized for the presence of MetS using modified criteria specific for Asian Indians, which included a lower cut-off for waist circumference (≥90 cm for men). The expression of 18 inflammatory genes was evaluated in peripheral whole blood by quantitative polymerase chain reaction method.

Results:
Of the 121 participants without CAD, 53 (43.8%) had three or more risk factors (MetS group), 50 (41.3%) had one or two risk factors (non-MetS group), while 18 (14.8%) did not have any risk factors (control group). High nuclear factor-kappa B (NF-κB) expression levels and low interleukin-10 (IL-10) levels were observed in MetS patients. Linear association was seen between NF-κB and vascular endothelial growth factor A (VEGFA) expression and with increase in MetS components. Comparison of gene expression pattern between CAD and MetS revealed significantly higher expression of leukotriene genes - arachidonate 5-lipoxygenase (ALOX5), arachidonate 5-lipoxygenase activating protein (ALOX5 AP), leukotriene A4 hydrolase (LTA4H) and leukotriene C4 synthase (LTC4S), and lower expression of NF-κB, interleukin 1 beta (IL-1β), monocyte chemoattractant protein-1 (MCP-1/CCL2) and signal transducer and activator of transcription 3 (STAT3) genes in CAD. There was linear increase in expression of LTA4H, LTC4S, IL-8 and VEGFA genes across the four groups, namely from controls, non-MetS, MetS and CAD.

Interpretation & conclusions:
A distinct gene expression pattern was seen in MetS and CAD implying a well-orchestrated inflammatory and immune activity. Specifically, NF-κB might be playing an active role in MetS, allowing further expansion of the inflammatory process with resolution of inflammation in full-blown CAD, wherein other gene players such as leukotrienes may dominate.
Occurrence, patterns & predictors of hypogonadism in patients with HIV infection in India
Authors: Dutta Deep , Sharma Lokesh Kumar , Sharma Neera , Gadpayle Adesh K , Anand Atul , Gaurav Kumar , Gupta Ankit , Poondla Yashwanth , Kulshreshtha Bindu 
Published: February 2018

Background & objectives:
Data on hypogonadism among human immunodeficiency virus (HIV)-infected Indians are not available. This study was aimed to evaluate the occurrence, pattern and predictors of hypogonadism in HIV-infected Indians.

Methods:
Consecutive stable HIV-infected patients, 18-70 yr age, without any severe comorbid state, having at least one year follow up data at the antiretroviral therapy clinic, underwent clinical assessment and hormone assays.

Results:
From initially screened 527 patients, 359 patients (225 males; 134 females), having disease duration of 61.44±39.42 months, 88.58 per cent on highly active antiretroviral therapy (HAART), 40.67 per cent having tuberculosis history and 89.69 per cent with vitamin D insufficiency were analyzed. Testosterone <300 ng/dl was documented in 39.11 per cent males. Primary, hypogonadotropic hypogonadism (HypoH) and compensated hypogonadism were observed in 7.56, 31.56 and 12.44 per cent males, respectively. Males with hypogonadism were significantly older (P=0.009), and had higher opportunistic infections (P<0.001) with longer disease duration (P=0.05). Menstrual abnormalities were observed in 40.3 per cent females, who were significantly older (P<0.001), had lower CD4 count (P=0.038) and higher tuberculosis history (P=0.005). Nearly 46.3, 16.2 and 13 per cent women with menstrual abnormalities were in peri-/post-menopausal state, premature ovarian insufficiency (POI) and HypoH, respectively. Age, CD4 count at diagnosis and 25(OH)D were best predictors of male hypogonadism. Age and CD4 count increment in first 6-12 months following HAART were the best predictors of POI.

Interpretation & conclusions:
Hypogonadism was observed to be a significant problem in HIV-infected men and women in India, affecting 39 and 29 per cent patients, respectively. HypoH was the most common form in males whereas ovarian failure being the most common cause in females.