The rate of transmission possibility of KPC and NDM-1 producing Klebsiella pneumoniae in ICU: the need for strengthened infection control measures.

OBJECTIVE: This study aims to characterize the rate of two specific resistance genes (KPC and NDM-1) and determine the route of transmission between the sites to implement infection control measures effectively. PATIENTS AND METHODS: This study was carried out at Viet Duc hospital in Vietnam. Bacterial isolates (Klebsiella pneumoniae) were collected between January 2018 and June 2019. Bacterial strains and antimicrobial susceptibility testing were performed in the VITEK 2 system. RESULTS: A total of 100 samples from 25 patients were taken. From each patient, we collected 4 samples from 4 sites. 25 isolated strains resisted 100% to amoxicillin/acid clavulanic, piperacillin/Tazobactam, and antibiotics in the cephalosporine group. Particularly in the carbapenem group, they resisted 100% to ertapenem, 96% to imipenem, and eropenem (rest was intermediate level). They have 76% sensitivity to aminoglycosides, 76% to amikacin, 60% to gentamycin, and 60% to tigecycline. Klebsiella pneumoniae carbapenemase (KPC) (+) was 24% and NDM-1 (+) was 28%. There was no case in all four sites. Positive-KPC strains were mainly in two sites (4/6 = 66.67%) and positive-NDM-1 strains were mainly in three sites (4/7 = 57.14%). Negative to both KPC and NDM-1 strains were in one site (4/12 = 33.3%) and two sites (6/12 = 50%). CONCLUSIONS: The rate of KPC and NDM-1 was 24% and 28%. In accordance with high antibiotic resistance rates to common antibiotics used in Vietnam, the high rate of transmission possibility between the sites contributed to strengthen the implementation of infection control measures in the ICU setting.

Topology of megagauss magnetic fields and of heat-carrying electrons produced in a high-power laser-solid interaction.

The intricate spatial and energy distribution of magnetic fields, self-generated during high power laser irradiation (at Iλ^{2}∼10^{13}-10^{14} W.cm^{-2}.µm^{2}) of a solid target, and of the heat-carrying electron currents, is studied in inertial confinement fusion (ICF) relevant conditions. This is done by comparing proton radiography measurements of the fields to an improved magnetohydrodynamic description that fully takes into account the nonlocality of the heat transport. We show that, in these conditions, magnetic fields are rapidly advected radially along the target surface and compressed over long time scales into the dense parts of the target. As a consequence, the electrons are weakly magnetized in most parts of the plasma flow, and we observe a reemergence of nonlocality which is a crucial effect for a correct description of the energetics of ICF experiments.