Antibiotic resistance and R-plasmids in food chain Salmonella: evidence of plasmid relatedness

Abstract

Objective: A major preventable contributor to healthcare costs among older individuals is fall-related injury. We sought to validate a tool to stratify such risk based on readily available clinical data, including projected medication adverse effects, using statewide medical claims data. Design: Sociodemographic and clinical features were drawn from health claims paid in the state of Massachusetts for individuals aged 35-65 with a hospital admission for a period spanning January-December 2012. Previously developed logistic regression models of hospital readmission for fallrelated injury were refit in a testing set including a randomly selected 70% of individuals, and examined in a training set comprised of the remaining 30%. Medications at admission were summarised based on reported adverse effect frequencies in published medication labelling. Setting: The Massachusetts health system. Participants: A total of 68 764 hospitalised individuals aged 35-65 years. Primary Measures: Hospital readmission for fallrelated injury defined by claims code. Results: A total of 2052 individuals (3.0%) were hospitalised for fall-related injury within 90 days of discharge, and 3391 (4.9%) within 180 days. After recalibrating the model in a training data set comprised of 48 136 individuals (70%), model discrimination in the remaining 30% test set yielded an area under the receiver operating characteristic curve (AUC) of 0.74 (95% CI 0.72 to 0.76). AUCs were similar across age decades (0.71 to 0.78) and sex (0.72 male, 0.76 female), and across most common diagnostic categories other than psychiatry. For individuals in the highest risk quartile, 11.4% experienced fall within 180 days versus 1.2% in the lowest risk quartile; 57.6% of falls occurred in the highest risk quartile. Conclusions: This analysis of statewide claims data demonstrates the feasibility of predicting fall-related injury requiring hospitalisation using readily available sociodemographic and clinical details. This translatable approach to stratification allows for identification of high-risk individuals in whom interventions are likely to be cost-effective.

Antibiotic resistance of Salmonella strains isolated from natural polluted waters

“…in animals. Our study, however, showed higher resistance than that obtained in other studies (Bell et al 1980;Bezanson & Lior 1980;Bezanson et al 1981;Falbo et al 1982;Alcaide & Garay 1984). Of the total salmonellas tested 26.7% exhibited resistance to two or more antibiotics.…”

Molecular analysis confirms food source and simultaneous involvement of two distinct but related subgroups of Salmonella typhimurium bacteriophage type 10 in major interprovincial Salmonella outbreak

“…Biotype 4 has been commonly observed in various S. typhimurium phage types (R. Khakhria, unpublished results). In addition, the majority of Salmonella strains isolated in Canada are sensitive to antibiotics (3,7). Thus, it could not be ascertained at this level whether the continued recovery of antibiotic-sensitive S. typhimurium phage type 10, biotype 4 isolates constituted detection of the true etiologic agent.…”

Trimethoprim resistance in commensal bacteria isolated from farm animals

“…The linkage between drug resistance in animal bacteria and clinical strains has long been suggested (Anderson et al 1975;Bezanson et al 1981;Mee & Nikoletti, 1983). Indeed contamination of carcasses by animal faecal flora is a common occurrence at slaughter (Linton et al 1976).…”