Complete genome sequence of the linezolid-resistant clinical Enterococcus faecalis N23-3408 linked to a livestock lineage in Switzerland.

Here, we report the complete genome of human clinical linezolid-resistant Enterococcus faecalis N23-3408. N23-3408 harbored a 59.5 kb plasmid with antimicrobial resistance genes cat, erm(B), fexA, optrA, tet(L), and tet(M). Closely related E. faecalis harboring this plasmid was previously obtained from livestock animals and pet food in Switzerland.

Historic methicillin-resistant Staphylococcus aureus: expanding current knowledge using molecular epidemiological characterization of a Swiss legacy collection.

BACKGROUND: Few methicillin-resistant Staphylococcus aureus (MRSA) from the early years of its global emergence have been sequenced. Knowledge about evolutionary factors promoting the success of specific MRSA multi-locus sequence types (MLSTs) remains scarce. We aimed to characterize a legacy MRSA collection isolated from 1965 to 1987 and compare it against publicly available international and local genomes. METHODS: We accessed 451 historic (1965-1987) MRSA isolates stored in the Culture Collection of Switzerland, mostly collected from the Zurich region. We determined phenotypic antimicrobial resistance (AMR) and performed whole genome sequencing (WGS) using Illumina short-read sequencing on all isolates and long-read sequencing on a selection with Oxford Nanopore Technology. For context, we included 103 publicly available international assemblies from 1960 to 1992 and sequenced 1207 modern Swiss MRSA isolates from 2007 to 2022. We analyzed the core genome (cg)MLST and predicted SCCmec cassette types, AMR, and virulence genes. RESULTS: Among the 451 historic Swiss MRSA isolates, we found 17 sequence types (STs) of which 11 have been previously described. Two STs were novel combinations of known loci and six isolates carried previously unsubmitted MLST alleles, representing five new STs (ST7843, ST7844, ST7837, ST7839, and ST7842). Most isolates (83% 376/451) represented ST247-MRSA-I isolated in the 1960s, followed by ST7844 (6% 25/451), a novel single locus variant (SLV) of ST239. Analysis by cgMLST indicated that isolates belonging to ST7844-MRSA-III cluster within the diversity of ST239-MRSA-III. Early MRSA were predominantly from clonal complex (CC)8. From 1980 to the end of the twentieth century, we observed that CC22 and CC5 as well as CC8 were present, both locally and internationally. CONCLUSIONS: The combined analysis of 1761 historic and contemporary MRSA isolates across more than 50 years uncovered novel STs and allowed us a glimpse into the lineage flux between Swiss-German and international MRSA across time.

Correlates of coping styles in psychotic illness -- An extension study.

Coping/recovery styles of integration and sealing over, reflecting the patient's dealing with his or her psychotic illness, influence the treatment adherence and, perhaps, the therapy outcome. Knowledge of these styles' potential clinical and personality correlates is so far limited. A semi-structured interview and self-rating questionnaires were used to assess 64 inpatients recovering from an acute episode of a schizophrenia spectrum disorder with regard to the prevailing coping/recovery style, depressive and negative syndromes, global functioning, locus of control and personality characteristics of novelty seeking, harm avoidance, and reward dependence. A significant positive correlation was found between coping/recovery style of sealing over and both negative syndrome and external control (by powerful others) orientation; a significant negative correlation was found between sealing over and good global functioning. The final multivariate model comprised negative syndrome, global functioning and a personality characteristic of reward dependence; together these three variables explained 44% of the coping/recovery style variance. Thus, in patients with disorders in the schizophrenia spectrum, the inclination towards sealing over is positively correlated with the higher degree of the overall severity of psychiatric disturbance and it is closely associated with a negative syndrome. In contrast, both the degree of depression and personality characteristics measured do not seem to play an important role with regard to the prevailing coping/recovery style of integration and sealing over.

Evolution of neuroleptic-induced extrapyramidal syndromes under long-term neuroleptic treatment.

BACKGROUND: The long-term evolution of neuroleptic-induced extrapyramidal syndromes (EPS) of Parkinsonism, akathisia and tardive dyskinesia (TD) is still a controversial issue worth exploring. METHOD: A total of 200 inpatients on regular typical neuroleptics (NL) and/or clozapine were assessed in 1995 with regard to the prevalence of EPS. Altogether, 83 patients could be reassessed in 2003/04 (63 had died) using the same methods. Strict definitions of EPS were used. The complete account of NL therapy the patients were prescribed between 1995 and 2003/04 (including atypical NL other than clozapine) was considered. RESULTS: The prevalences found in 1995 and 2003/04 were 17% and 29% for Parkinsonism, 14% and 14% for akathisia, and 24% and 13% for TD. There were considerable intra-individual fluctuations in EPS occurrence even when the overall prevalence rate remained the same. In intra-individual comparisons of EPS ratings on both assessments, there was a tendency for worsening of Parkinsonism to be associated with a current (2003/04) therapy with typical NL; worsening of akathisia was associated with a current therapy with atypical NL other than clozapine, amelioration of akathisia with a current therapy with clozapine; and, basically, there were no significant associations found between the changes in TD ratings and the long-term therapy with typical NL, clozapine, and other atypical NL, considering cumulative doses of all these drugs. In a multivariate analysis, there was a tendency for the long-term evolution of TD to depend on illness duration as the only variable. CONCLUSIONS: There are intra-individual fluctuations in all EPS over longer time periods. The choice of current NL therapy has an impact on Parkinsonism and akathisia. The long-term evolution of TD appears independent of NL prescriptions.

A comparative study on dual patients with affective disorder.

BACKGROUND: The main purpose of the study was to investigate whether there are differences between dual patients with affective disorders regarding the different kinds of substances abused - a topic which has hardly been dealt with in the literature. METHODS: Clinical charts of 94 dual and 94 non-dual patients, matched for sex, age, and diagnosis, were scrutinized and the data of both groups compared with each other, with regard to the substance of abuse. RESULTS: A total of 17.4% of all patients with affective disorders were found to be dual patients and the proportion of dual patients was equal among patients with unipolar disorder, bipolar disorder, and dysthymia. Only a few significant differences were found between dual and non-dual patients; more differences were identified when the dual group was divided into patients abusing alcohol (59%), opioids/cocaine (22%), and sedatives/hypnotics (19%). In particular, the group of patients abusing illegal drugs was found to be younger and to show more behavioral pathology. All three groups of dual patients differed regarding the onset of their affective illness. LIMITATIONS: Retrospective study of clinical records. CONCLUSIONS: There are differences between dual patients with affective disorders abusing different substances. The choice of a particular substance of abuse appears to be the function of the age of onset of the disorder.

Temperamental differences between bipolar disorder, borderline personality disorder, and attention deficit/hyperactivity disorder: some implications for their diagnostic validity.

BACKGROUND: The relationship between borderline personality disorder (BPD), bipolar disorder (BD), and attention deficit/hyperactivity disorder (ADHD) requires further elucidation. METHODS: Seventy-four adult psychiatric in- and out-patients, each of them having received one of these diagnoses on clinical assessment, were interviewed and compared in terms of diagnostic overlap, age and sex distribution, comorbid substance, anxiety and eating disorders, and affective temperament. RESULTS: Diagnostic overlap within the three disorders was 54%. Comorbidity patterns and gender ratio did not differ. The disorders showed very similar levels of cyclothymia. LIMITATIONS: Sample size was small and only a limited number of validators were tested. CONCLUSIONS: The similar extent of cyclothymic temperament suggests mood lability as a common denominator of BPD, BD, and ADHD.