Genetic and Phenotypic Characterization of the First Canadian Case of Ambler Class A Carbapenemase FRI-8.

This study investigated the mechanism of carbapenem resistance in an Enterobacter cloacae complex positive by the modified carbapenem inactivation method (mCIM) but negative by the Rosco Neo-Rapid Carb Kit, ß CARBA, and conventional PCR for common carbapenemase genes (KPC, NDM, OXA-48, IMP, VIM, GES, and IMI/NMC). Using whole genome sequencing (WGS) data we confirmed the identification of Enterobacter asburiae (ST1639) and the presence of blaFRI-8 located on a 148kb IncFII(Yp) plasmid. This is the first occurrence of a clinical isolate harboring the FRI-8 carbapenemase and the second occurrence of FRI in Canada. This study highlights the need to use both WGS and phenotypic screening methods for detection of carbapenemase-producing strains if we consider the growing diversity of carbapenemases.

The specificity of notation codes in apraxic agraphia: dissociation between Arabic and alphabetical scripts in a patient with severe ideomotor and visuoconstructional apraxia.

This article describes the case of a patient with corticobasal syndrome, who showed severe ideomotor and visuoconstructional apraxia along with handwriting difficulties more marked for letters and words than for digits and numbers. For alphabetical script, these difficulties were less marked when graphic motor patterns were activated with a model, whilst for digits IV's graphic productions were better in dictation. Moreover, IV's graphic production was negatively influenced by graphomotor complexity for letters but not for numbers. IV is the first reported case of a patient with severe limb apraxia, who also showed peripheral agraphia, with dissociation in alphabetical and numerical notation codes resulting from a specific deficit in the activation of graphomotor programs.