総排泄腔遺残

We compared and evaluated three routine methods (MicroScan, gradient diffusion and disk diffusion) with broth microdilution (BMD) for cefepime against 200 AmpC-hyperproducing Enterobacter cloacae complex isolates. Reference BMD classified 40.0% as susceptible, 39.5% as susceptible with increased exposure, and 20.5% as resistant to cefepime, according to EUCAST criteria. Categorical agreement (CA) was 63.5% for MicroScan, 73.5% for gradient diffusion, and 69.5% for disk diffusion. MicroScan showed the highest sensitivity for detecting BMD-defined resistance (82.9%) but moderate specificity (71.0%), whereas gradient diffusion and disk diffusion showed lower sensitivities (46.3% and 53.7%, respectively) but higher specificities (95.6% and 92.5%, respectively). Similar method-dependent patterns were observed using CLSI criteria. Error-rate-bound analysis confirmed that these discrepancies were not restricted to isolates with MICs close to the clinical breakpoints. A modified EUCAST-based stepwise algorithm improved the balance of performance compared with MicroScan alone, mainly by reducing overestimation of resistance, but clinically relevant misclassification persisted. Overall, no routine method or algorithm fully replaced BMD, supporting confirmatory reference testing when accurate cefepime categorization is clinically critical.

BACKGROUND: Carbapenemase-producing Enterobacterales (CPE) are a significant public health concern, associated with high morbidity and mortality rates due to restricted antibiotic treatment options. Among the genetic determinants of CPE resistance, imipenemase (IMI) mediated resistance is an emerging problem in infections involving bacteria of the Enterobacter cloacae complex (ECC) and has been linked to worldwide clinical cases, including community-level outbreaks in the Indian Ocean region. Little is known about the potential role of animals as reservoirs of multidrug-resistant ECC bacteria. OBJECTIVES: Characterize blaIMI-4 carbapenemase-producing ECC strains isolated from patients and a companion animal in the southwestern Indian Ocean region (Réunion and Mayotte islands). METHODS: We used antibiotic susceptibility testing to determine available treatment and genome sequencing to characterize resistance gene variants and mobile genetic elements carrying blaIMI-4 genes. RESULTS: blaIMI-4 ECC isolates are susceptible to new antibiotics active on Class A carbapenemase, notably β-lactams-inhibitors (ceftazidime-avibactam, meropenem-vaborbactam). The blaIMI-4 gene was identified on a common EcloIMEX-2 mobile integrative element in (i) ST 2370 Enterobacter sichuanensis isolated from a dog in Réunion and (ii) ST1845 Enterobacter roggenkampii clinical isolates from Réunion and Mayotte islands. CONCLUSIONS: Companion animals may play a role in the persistence and spread of mobile genetic elements that confer carbapenem resistance in diverse Enterobacter species.

Early-life is a critical period for neurodevelopment and gut microbiota establishment. Both processes are highly susceptible to environmental perturbations. It remains unclear the longitudinal associations between early-life antibiotic exposure and neurodevelopment, spinal cord injury (SCI) repair, as well as gut microbiota and metabolites. Pregnant C57BL/6 dams were administered a broad-spectrum antibiotic cocktail from one week prepartum through one week postpartum. Offspring were assessed at multiple timepoints, with a subset receiving a SCI at postnatal day 7. We employed 16S rRNA sequencing, untargeted metabolomics, and immunofluorescence to characterize the gut environment and neural tissues. Maternal antibiotic exposure was associated with significant alterations in offspring, including increased expression of neuroglial markers (TUJ1, NG2, MBP) in prefrontal cortex and spinal cord after SCI. These neural changes coincided with persistent gut microbiota dysbiosis, characterized by reduced alpha diversity; increased relative abundance of phylum Proteobacteria and genus Enterobacter; decreased relative abundance of phyla Firmicutes, Actinobacteriota, and Bacteroidota, as well as genera Lactobacillus, Rodentibacter, and Streptococcus; and remodeling of the gut metabolome, with 647 differential metabolites identified. Key downregulated metabolites, including 6-hydroxymelatonin glucuronide, were enriched in neuroactive pathways including tryptophan and melatonin metabolism. Integrated correlation network analysis identified a core set of microbes and metabolites strongly associated with the neural biomarkers. Collectively, our multi-omics analyses revealed that early-life antibiotic exposure correlates with altered neuroglial marker in brain and spinal cord, disruption of the gut microbiota and changes in neuroactive metabolites, suggesting candidate microbial and metabolic mediators within the gut-brain/spinal cord axis for future investigation.

The Pediatric Colorectal and Pelvic Learning Consortium (PCPLC) is a group of medical providers dedicated to equitably improving the health and quality of life of individuals affected by congenital colorectal disorders and associated urologic, gynecologic, and other anomalies. Using research and medical expertise, the Gynecology Committee within the PCPLC has developed five consensus statements on gynecologic care of patients born with anorectal malformations: Gynecologic Care in Patients with Anorectal Malformations: A Primer and Call to Action, Methods of Gynecologic Evaluation for Patients with Anorectal Malformations, Prepubertal Gynecologic Evaluation and Management of Patients with Anorectal Malformations, Post-pubertal Gynecology Evaluation and Management of Patients with Anorectal Malformations, Long-term Obstetric and Gynecologic Care for Patients with Anorectal Malformations. In this article, we review the timing and recommended methods of gynecologic screening and management in the prepubertal period. During this period, evaluation of gynecologic systems aids the surgical decision-making, and provides anticipatory long-term gynecologic planning. Although stooling and voiding function are high priorities for patients with an ARM in the prepubertal period, evaluation and management of the gynecologic system and gynecology-targeted counseling remain important aspects of comprehensive ARM care.

Chlorpyrifos (CP) belongs to organophosphate pesticide group. It is extensively applied in agricultural and household settings due to its broad-spectrum insecticidal properties. However, its persistence, bioaccumulative behavior, and toxicological effects on non-target organisms, including humans, pose significant environmental and public health concerns. CP and its metabolites, particularly two including 3,5,6-trichloropyridinol (TCP) and chlorpyrifos-oxon (CPO), have been recently reported to be widely found various samples such as in soils, sediments, water bodies, crops, and even human biological fluids. These compounds disrupt biogeochemical cycles, alter soil microbial communities, inhibit enzyme activities, and are linked to neurotoxicity, endocrine disruption, and genotoxic effects. Conventional remediation strategies such as photodegradation, ultrasonication, and filtration remain ineffective due to incomplete degradation and secondary pollution risks. Recent studies highlight the efficiency of microbial degradation, especially by bacteria such as Bacillus, Klebsiella, Pseudomonas and Enterobacter as a promising, eco-friendly alternative. These microorganisms utilize CP as a only carbon source, and degradation calibre is greatly governed by various abiotic factors like pH, temperature, and moisture. The genetic as well as enzymatic analyses reveal key roles of organophosphorus hydrolases encoded by genes such as opd and mpd. The integration of plant growth-promoting traits and laccase activity further enhances their bioremediation capability. Additionally, recent advancements in biosensing techniques for CP detection offer improved sensitivity and real-time monitoring. This review provides a comprehensive analysis of CP's environmental fate, toxicological impact, degradation pathways, and the emerging role of bacterial bioremediation, highlighting its potential for sustainable environmental detoxification.