Chromosomal ampC mutations in cefpodoxime-resistant, ESBL-negative uropathogenic Escherichia coli.

AmpC ß-lactamase is an enzyme commonly produced by Escherichia coli that causes resistance to cephalosporins and penicillins. Enzyme production is controlled by the strength of the promoter encoded by the chromosomal ampC gene, with the level of production affected by the presence of certain mutations in this region. This study sets out to determine the prevalence of ampC promoter mutations present in a group of uropathogenic E. coli strains. A total of 50 clinical strains of E. coli were collected from urine samples between June 2011 and November 2011. Strains were investigated for the presence of mutations in the chromosomal ampC promoter region by amplification and sequencing of a 271 bp product. The presence of ampC-carrying plasmids derived from other species was also determined, to exclude these from further analysis. ampC-carrying plasmids were found in 10 of the 50 strains, all of which were of the CIT-type. Analysis of the chromosomal ampC promoter region in the 40 remaining strains showed mutations at 16 different positions, with 18 different genotype patterns detected overall. The most common ampC chromosomal mutation, present in 25 of 40 strains, was a T --> A transition at position -32. This mutation has been shown by others to increase enzyme production by up to 46-fold. Altogether, three separate mutations (-32, -42 and -13ins) were present in 90% of the 40 non-plasmid strains, indicating a strong association with the resistance observed. It appears, therefore, that the majority of AmpC-mediated resistance in E. coli can be accounted for by just three point mutations in the chromosome.

An audit of rubella IgG antibody status in antenatal women in a NHS Trust over 5 years (2005-2009).

Rubella, a vaccine-preventable infection. This study examined the antibody status of 11 987 pregnant women during 2005-2009. Results showed a non-significant decrease in those with antibody levels of <4·0 IU/ml from 29/2312 (1·3%) in 2005 to 21/2447 (0·9%) in 2009 (χ² for linear trend=0·279, P=0·56) but a significant increase in those with levels of <10 IU/ml from 88/2312 (3·8%) in 2005 to 124/2447 (5·1%) in 2009 (χ² for linear trend=10·27, P=0·001). In women born before 1983 (pre-pubertal vaccination) the proportion of first pregnancies with titres <4 IU was 1·1% (21/2002) compared to 3·4% (69/2022) in those born after 1983 (χ²=25·176, P<0·0001) and 2·2% (44/2002) for titres <10 IU compared to 14·0% (282/2022) for those born after 1983 (χ²=171·43, P<0·0001). The potential impact of the increase is difficult to determine, requiring further monitoring. This paper discusses the effect of changing immunization programmes on rubella susceptibility in pregnant women.

The origin of high cadmium loads in some bivalve molluscs from Shark Bay, Western Australia: a new mechanism for cadmium uptake by filter feeding organisms.

Although Shark Bay is remote from all known industrial and geological sources of heavy metals, the cadmium content of several species of Shark Bay molluscs may exceed 10 mg/kg. The cadmium load in these molluscs varies geographically within the bay, but possible explanations for cadmium distribution involving variation in salinity, saline groundwater influx, the dissolved cadmium concentration, the cadmium concentration in substrate sediments, species, or an anthropogenic source are not supported by analytical data. The cadmium concentration is normal in Shark Bay seawater (0.04 microgram/L to about 0.35 microgram/L), rarely exceeds 0.25 microgram/L in ground waters, bore waters, and salt lake brines, and very seldom exceeds 1 mg/kg in sediments. No direct link between the cadmium loads in molluscs and its concentration in the water or substrate sediment is evident, but the cadmium load in molluscs is usually highest where turbulence is high and the substrate sediment contains fine hematite. Over about 2,000 km2, the water depth in Shark Bay is less than 1 m and fine sediment is readily suspended by strong winds. The iron-oxides (superfine hematite) are eroded from the Peron Sandstone exposed in some coastal cliffs and constitute up to 2% of substrate sediments near these cliffs. This study reveals that cadmium in the water adsorbs extremely efficiently onto the surface of the hematite, which is negatively charged at the prevailing seawater pH of 8.15, and that suspended hematite particles are ingested by the molluscs. Inside the molluscs, lower pH conditions cause reversal of the hematite charge and the cadmium is released and accumulated by the organism.(ABSTRACT TRUNCATED AT 250 WORDS)