Pseudomonas aeruginosa is intrinsically resistant to many antimicrobial drugs, making carbapenems crucial in clinical management. During July–October 2015 in the United States, we piloted laboratory-based surveillance for carbapenem-resistant P. aeruginosa (CRPA) at sentinel facilities in Georgia, New Mexico, Oregon, and Tennessee, and population-based surveillance in Monroe County, NY. An incident case was the first P. aeruginosa isolate resistant to antipseudomonal carbapenems from a patient in a 30-day period from any source except the nares, rectum or perirectal area, or feces. We found 294 incident cases among 274 patients. Cases were most commonly identified from respiratory sites (120/294; 40.8%) and urine (111/294; 37.8%); most (223/280; 79.6%) occurred in patients with healthcare facility inpatient stays in the prior year. Genes encoding carbapenemases were identified in 3 (2.3%) of 129 isolates tested. The burden of CRPA was high at facilities under surveillance, but carbapenemase-producing CRPA were rare.

Abbreviations: (ACIP) Advisory Committee on Immunization Practices, (anti-HBc) total antibody to hepatitis B core antigen, (BRFSS) Behavioral Risk Factor Surveillance System, (CDC) Centers for Disease Control and Prevention, (CI) confidence interval, (EIP) Emerging Infections Program, (HBsAg) hepatitis B surface antigen, (HBV) hepatitis B virus, (HepB) hepatitis b vaccine, (HIV) human immunodeficiency virus, (HIVRISK) human immunodeficiency virus infection risk, (IDU) injection drug use, (LTC) long-term care, (MSM) male sex with another male,

A new, less restrictive definition increases detection of Klebsiella pneumoniae carbapenemase producers.

In healthcare settings, Acinetobacter spp. bacteria commonly demonstrate antimicrobial resistance, making them a major treatment challenge. Nearly half of Acinetobacter organisms from clinical cultures in the United States are nonsusceptible to carbapenem antimicrobial drugs. During 2012–2015, we conducted laboratory- and population-based surveillance in selected metropolitan areas in Colorado, Georgia, Maryland, Minnesota, New Mexico, New York, Oregon, and Tennessee to determine the incidence of carbapenem-nonsusceptible A. baumannii cultured from urine or normally sterile sites and to describe the demographic and clinical characteristics of patients and cases. We identified 621 cases in 537 patients; crude annual incidence was 1.2 cases/100,000 persons. Among 598 cases for which complete data were available, 528 (88.3%) occurred among patients with exposure to a healthcare facility during the preceding year; 506 (84.6%) patients had an indwelling device. Although incidence was lower than for other healthcare-associated pathogens, cases were associated with substantial illness and death.

Background In the 2011 US hospital prevalence survey of healthcare-associated infections and antimicrobial use 50% of patients received antimicrobial medications on the survey date or day before. More hospitals have since established antimicrobial stewardship programs. We repeated the survey in 2015 to determine antimicrobial use prevalence and describe changes since 2011. Methods The Centers for Disease Control and Prevention’s Emerging Infections Program sites in 10 states each recruited ≤25 general and women’s and children’s hospitals. Hospitals selected a survey date from May–September 2015. Medical records for a random patient sample on the survey date were reviewed to collect data on antimicrobial medications administered on the survey date or day before. Percentages of patients on antimicrobial medications were compared; multivariable log-binomial regression modeling was used to evaluate factors associated with antimicrobial use. Results Of 12 299 patients in 199 hospitals, 6084 (49.5%; 95% CI, 48.6–50.4%) received antimicrobials. Among 148 hospitals in both surveys, overall antimicrobial use prevalence was similar in 2011 and 2015, although the percentage of neonatal critical care patients on antimicrobials was lower in 2015 (22.8% vs 32.0% [2011]; P = .006). Fluoroquinolone use was lower in 2015 (10.1% of patients vs 11.9% [2011]; P < .001). Third- or fourth-generation cephalosporin use was higher (12.2% vs 10.7% [2011]; P = .002), as was carbapenem use (3.7% vs 2.7% [2011]; P < .001). Conclusions Overall hospital antimicrobial use prevalence was not different in 2011 and 2015; however, differences observed in selected patient or antimicrobial groups may provide evidence of stewardship impact.

In Ethiopia, inoculation of soybean with rhizobial inoculants is not common practice, but could provide an option to increase grain yields in low nitrogen (N) acidic soils. In these acid soils, the selection of acid tolerant rhizobia is one strategy that may increase the performance of soybean. In this study, rhizobial strains isolated from Ethiopian soils were evaluated for their acid tolerance and symbiotic N fixation efficiency with soybean, in controlled environments. Following this, four isolated rhizobial strains were evaluated in six field experiments in major soybean growing areas of Ethiopia. Inoculation with the commercial strain or with one of two locally sourced isolates, that were developed as inoculants, improved soybean yield. The yield increase due to inoculation with the commercial strain was consistent and greater than other treatments, while the increase due to the two locally sourced strains was comparable to, or greater than, application of 46 kg N/ha in soils, where the resident rhizobial population was ≤1.4 × 10 3 cfu/g soil. For soils with high background rhizobial populations, there was no response to inoculation. In one of the experimental sites (Bako), the percentage of N fixed (%Ndfa) was 55 for the commercial strain and 35 for the local strain, ES3. This study demonstrated that field validation is a necessary step in the selection of acid-tolerant strains of rhizobia to increase soybean production for Ethiopia.

Background: Effectiveness of Rhizobium inoculation is determined by common bean genotypes. Environmental factors also affect common bean genotypes-Rhizobium-symbiosis. The effect of common bean genotypes-Rhizobium strains-environment interaction on nodulation and common bean production is not well studied. Three genotypes (Dursitu, Gofta, and Kufanzik) and eight selected isolates of common bean nodulating-rhizobia with N-fertilized and control check were used for field experiments at four locations (Babile, Fedis, Haramaya, and Hirna) to evaluate the effect of genotypes-Rhizobium strains-environment interaction on the nodulation, yield and yield traits of common bean. The treatments were laid out in a randomized complete block design with three replications.Results: This study revealed that Rhizobium inoculation, the genotypes, environment and their interaction significantly (P ≤ 0.05) affected all investigated traits of common bean. Common bean genotypes Rhizobium inoculation and experimental locations significantly affected nodule number (NN) and nodule dry weight (NDW). The highest NN and NDW as compared to the uninoculated control across locations were recorded with the genotype Dursitu in all inoculation treatments. However, the result revealed the lowest mean total biomass (TBY) and grain yield (GY) over locations with the same genotype Dursitu. The highest mean grain yields of 3358.89, 3257.82, 1499.25 and 2204.82 kg ha −1 across the treatments were recorded at Haramaya, Hirna, Babile and Fedis sites, respectively, with the genotype Gofta, thereby implying that there was none specificity between common bean genotypes × locations in the study locations of eastern Ethiopia with tested common bean genotypes. None of the tested isolates produced statistically better NN, NDW, TBY, GY and total plant N accumulation consistently in all locations with all tested common bean genotypes, indicating the presence of Rhizobium strains × location specificity. Conclusion: Therefore, the result showed the need for a specific strain of Rhizobium development for common bean production in different locations.

Outbreaks of hepatitis C virus (HCV) infections can occur among hemodialysis patients when recommended infection control practices are not followed (1). On January 30, 2014, a dialysis clinic in Tennessee identified acute HCV in a patient (patient A) during routine screening and reported it to the Tennessee Department of Health. Patient A had enrolled in the dialysis clinic in March 2010 and had annually tested negative for HCV (including a last HCV test on December 19, 2012), until testing positive for HCV antibodies (anti-HCV) on December 18, 2013 (confirmed by a positive HCV nucleic acid amplification test). Patient A reported no behavioral risk factors, but did have multiple health care exposures.