Ancient Egyptian mummy genomes suggest an increase of Sub-Saharan African ancestry in post-Roman periods.

Egypt, located on the isthmus of Africa, is an ideal region to study historical population dynamics due to its geographic location and documented interactions with ancient civilizations in Africa, Asia and Europe. Particularly, in the first millennium BCE Egypt endured foreign domination leading to growing numbers of foreigners living within its borders possibly contributing genetically to the local population. Here we present 90 mitochondrial genomes as well as genome-wide data sets from three individuals obtained from Egyptian mummies. The samples recovered from Middle Egypt span around 1,300 years of ancient Egyptian history from the New Kingdom to the Roman Period. Our analyses reveal that ancient Egyptians shared more ancestry with Near Easterners than present-day Egyptians, who received additional sub-Saharan admixture in more recent times. This analysis establishes ancient Egyptian mummies as a genetic source to study ancient human history and offers the perspective of deciphering Egypt's past at a genome-wide level.

ESBL/AmpC-producing Enterobacteriaceae in households with children of preschool age: prevalence, risk factors and co-carriage.

OBJECTIVES: ESBL/AmpC-producing Enterobacteriaceae are an emerging public health concern. As households with preschool children may substantially contribute to the community burden of antimicrobial resistance, we determined the prevalence, risk factors and co-carriage of ESBL/AmpC-producing bacteria in preschool children and their parents. METHODS: From April 2013 to January 2015, each month 2000 preschool children were randomly selected from Dutch population registries. The parents were invited to complete an epidemiological questionnaire and to obtain and send a faecal sample from the selected child and from one parent. Samples were tested for ESBL/AmpC-producing bacteria. Logistic regression was used to identify risk factors for ESBL/AmpC carriage in children and parents, and findings were internally validated by bootstrapping. RESULTS: In total, 1016 families were included and ESBL/AmpC prevalence was 4.0% (95% CI 3.2%-5.0%); 3.5% (95% CI 2.5%-4.8%) in children and 4.5% (95% CI 3.4%-6.0%) in parents. Attending a daycare centre (DCC) was the only significant risk factor for children (OR 2.1, 95% CI 1.0-4.3). For parents, the only significant risk factor was having one or more children attending DCCs (OR 2.2, 95% CI 1.2-4.8). For parents of ESBL/AmpC-positive children the OR for ESBL/AmpC carriage was 19.7 (95% CI 9.2-42.4). Co-carriage of specific ESBL/AmpC genotypes in child and parent occurred more often than expected by chance (14.6% versus 1.1%, P < 0.001). CONCLUSIONS: In this study, intestinal carriage with ESBL/AmpCs was detected in ∼4% of households with preschool children. DCC attendance was a risk factor in both children and parents and co-carriage of specific genotypes frequently occurred in child-parent pairs. These findings suggest household transmission or/and family-specific exposure to common sources of ESBL/AmpC-producing bacteria.

Decreased ciprofloxacin susceptibility in Salmonella Typhi and Paratyphi infections in ill-returned travellers: the impact on clinical outcome and future treatment options.

The emergence of decreased ciprofloxacin susceptibility (DCS) in Salmonella enterica serovar Typhi and serovar Paratyphi A, B or C limits treatment options. We studied the impact of DCS isolates on the fate of travellers returning with enteric fever and possible alternative treatment options. We evaluated the clinical features, susceptibility data and efficacy of empirical treatment in patients with positive blood cultures of a DCS isolate compared to patients infected with a ciprofloxacin-susceptible (CS) isolate in the period from January 2002 to August 2008. In addition, the pharmacokinetic and pharmacodynamic parameters of ciprofloxacin, levofloxacin and gatifloxacin were determined to assess if increasing the dose would result in adequate unbound fraction of the drug 24-h area under the concentration-time curve/minimum inhibitory concentration (ƒAUC(0-24)/MIC) ratio. Patients with DCS more often returned from the Indian subcontinent and had a longer fever clearance time and length of hospital stay compared to patients in whom the initial empirical therapy was adequate. The mean ƒAUC(0-24)/MIC was 41.3 ± 18.8 in the patients with DCS and 585.4 ± 219 in patients with a CS isolate. For DCS isolates, the mean ƒAUC0-24/MIC for levofloxacin was 60.5 ± 28.7 and for gatifloxacin, it was 97.9 ± 28.0. Increasing the dose to an adequate ƒAUC(0-24)/MIC ratio will lead to conceivably toxic drug levels in 50% of the patients treated with ciprofloxacin. Emerging DCS isolates has led to the failure of empirical treatment in ill-returned travellers. We demonstrated that, in some cases, an adequate ƒAUC(0-24)/MIC ratio could be achieved by increasing the dose of ciprofloxacin or by the use of alternative fluoroquinolones.

[Explosive increase in Salmonella java in poultry. Consequences for public health]. / Explosieve toename van Salmonella Java in pluimvee. Consequenties voor de volksgezondheid.

In the Netherlands S. Paratyphi B variation Java increased in poultry from less than 2% of all isolates before 1996 up to 40% in 2001. This development in poultry runs in parallel with that in Germany and appears not to occur in other European countries. A German study shows that in the late nineties it concerns isolates of only one multi-resistant clone of Java (in Holland as well) whilst isolates before the middle nineties were genetically much more heterogeneous and sensitive to antibiotics. Although the exposition of humans to contaminated poultry meat is relatively high, human patients with a Java infection are rare. Treatment of poultry flocks with quinolones was about 13% in 2000-2001. Resistance to flumequin of Java increased from 3% between 1996-1999 to 20% between 2000-2002 whilst that of other serotypes in poultry remained about 7%. Java is also fast becoming less sensitive to ciprofloxacin which is the antibiotic of first choice in serious cases of salmonellosis. The ministries of public health, agriculture and the production boards, with their research institutes, together with the poultry meat production chain integrations have recently decided to work together in order to determine the public health importance of the Java epidemic in poultry and finding measures for effective control in the poultry industry.

Screening and prevention of nutritional anemia during infancy. A prospective study of food fortification.

No important differences in hemoglobin and hematocrit values occurred among subgroups of a cohort of 295 healthy, mature infants who were fed various dietry regimens of iron-fortified products, including cereal, whole milk, and corn syrup. Among all infants between the ages of 4 and 27 months, the incidence of hematocrit readings and hemoglobin levels below 30% and 10 g/dl, respectively, was 0.6%, and below 33% and 11 g/dl, respectively, was 3.2%. Because of the low incidence of nutritional anemia after age 4 months, initial screening should be done at 1 to 4 months of age, and selectively thereafter. A formula of evaporated milk and corn syrum plus iron-fortified cereal during early months, then whole milk and a more diversified diet including continued use of iron-fortified cereal during later months of infancy, provides a nutritionally sound and economical diet with sufficient iron.