Comparative genomic analysis of four multidrug-resistant isolates of Acinetobacter baumannii from Georgia
JOURNAL OF GLOBAL ANTIMICROBIAL RESISTANCE
Authors: Farlow, Jason; Nozadze, Maia; Mitaishvili, Nino; Kotorashvili, Adam; Kotoria, Nato; Arobelidze, Keto; Tavadze, Viktoria; Simsive, Tsiuri; Imnadze, Paata; Latif, Nabil; Nikolich, Mikeljon P.; Washington, Michael; Hinkle, Mary K.; Kwon, Paul; Trapaidze, Nino
Abstract
Objectives: This study reports the draft genomes of four newly isolated multidrug-resistant (MDR) Acinetobacter baumannii (A. baumannii) isolates (0830, 0365, 4022, and 2846) from western Georgia to identify putative antimicrobial resistance genes (ARGs) and to determine the clonal subtypes of local clinical isolates. Methods: An Illumina MiSeq sequencer was used to perform whole-genome sequencing (WGS). The Vitek 2 automated system was used for microbial identification and antimicrobial resistance profiling. Results: Taxonomical identification as A. baumannii was confirmed by WGS. In silico analyses resolved their ARG content and clonal relatedness using the Oxford (Oxf) and Pasteur (Pas) multi-locus sequence typing schemes. Isolates 0365 and 4022 displayed similar allelic profiles corresponding to ST944Oxf/ ST78Pas.Isolate 2846 displayed a different allelic profile consistent with ST19Pas/IC 1 (International or European Clone I) and exhibited a novel Oxford ST that was designated as 1868. Isolate 0830 displayed the ST78Pas allelic profile, similar to isolates 0365 and 4022, and also possessed a single allelic mismatch in the gpi gene, resulting in an ST1104Oxf allele profile in the Oxford typing scheme. Conclusion: Circulating MDR A. baumannii exhibited genetic heterogeneity with variations in the structure and content of genomic A. baumannii resistance islands and encoded multiple putative ARGs. This report represents the first clonal subtype information and genomic characterization of MDR A. baumannii in Georgia and may inform future epidemiological investigations. (c) 2019 The Author(s). Published by Elsevier Ltd on behalf of International Society for Antimicrobial Chemotherapy.
Urinary incontinence following deep brain stimulation of the globus pallidus internus: case report
JOURNAL OF NEUROSURGERY
Authors: Liu, Feng-Tao; Lang, Li-Qin; Zhou, Ren-Yuan; Feng, Rui; Hu, Jie; Wang, Jian; Wu, Jian-Jun
Abstract
Deep brain stimulation (DBS) is a well-established therapy for patients with advanced Parkinson's disease (PD), dystonia, and other movement disorders. In contrast to the strong positive effects that have been documented for motor symptoms, the effects of DBS on nonmotor symptoms have not been fully elucidated. Some reports suggest that stimulation of the subthalamic nucleus may improve lower urinary tract symptoms in patients with PD; however, reports of the effects of globus pallidus internus (GPi) DBS on urinary symptoms are limited. The authors present the case of a 49-year-old woman with PD who developed severe urinary incontinence after 27 months of GPi DBS. The urinary incontinence disappeared when stimulation was turned off, and reemerged after it was turned on again. After activation of a more dorsal contact in the left electrode, the patient's urinary dynamics returned to normal.