New Delhi metallo-ß-lactamase (NDM-1)-producing Klebsiella pneumoniae of sequence type ST11: first identification in a hospital of central Italy.

The emergence of novel resistant markers hampers the efficacy of beta-lactam antibiotics to treat infections caused by micro-organisms carrying such resistances. This study investigated the antimicrobial susceptibility pattern, the carpapenem-associated determinants and the molecular epidemiology of Klebsiella pneumoniae showing a New Delhi (NDM) metallo-ß-lactamase phenotype, isolated from a patient admitted to intensive care unit of the main hospital for acute care of Molise region, central Italy. Antimicrobial susceptibility was assessed for nineteen antibiotics by disc diffusion and agar dilution methods. Carbapenem-associated resistance determinants were detected through gene-specific amplifications, targeting blaNDM-1 , blaSHV and blaTEM , blaCTX-M , blaKPC , blaVIM , blaIMP , blaGES and blaOXA-48-lixe . Molecular characterization was carried out through multilocus sequence typing. The strain showed a multidrug resistant profile, and PCR and sequencing confirmed the presence of blaNDM-1 gene. Among the multiple resistance-associated determinants tested, the isolate, which was assigned to the sequence type ST11, only harboured blaSHV and blaTEM genes. This is the first report of NDM-1 variant in the regional healthcare setting for acute patients, raising significant concerns about the increase in the antimicrobials resistance spread through a different mechanism from the endemic KPC carbapenemase, and underlining the circulation of a virulent clone never identified before in this area.

Actualistic Ophiolite Provenance: The Cyprus Case.

The island of Cyprus represents an excellent site to assess quantitatively petrologic clastic response to actively obducting oceanic sources in order to define an actualistic reference for ophiolite provenance, in terms of framework composition and heavy mineral suites. An improved methodology, an extension of the classic ternary QFL logic to include a wider spectrum of key indexes and ratios, provides an accurate synthesis of modal data and allows differentiation of three main petrographic provinces and at least seven subprovinces. Diagnostic signatures of detritus from various levels of an oceanic lithospheric source, and criteria for distinguishing provenance from suprasubduction versus mid-oceanic ophiolites are also outlined. Modern sands derived from the Troodos Ophiolite contain variable proportions of largely pelagic carbonate to chert, boninite to basalt, diabase to metabasite, plagiogranite to gabbroic, and cumulate grains supplied from progressively deeper-seated levels of the multilayered oceanic crust. Dense minerals are mainly clinopyroxenes (diopside), prevailing over orthopyroxenes (enstatite, hypersthene, clinoenstatite), hornblende, tremolite/actinolite, and epidote. Where serpentinized mantle harzburgites have been unroofed, detritus is markedly enriched in cellular serpentinite grains and enstatite, with still negligible olivine and spinel. Sedimentaclastic sands dominated by chert (Mamonia Province) or carbonate grains (Kyrenia Province) are deposited along the southern and northern shores of the island, respectively. Compositions of Cyprus sands are virtually unaffected by climatic, sedimentary, or anthropic processes; recycling of sandstones from foreign sources is a major process only in the Karpaz Peninsula. Petrographic analysis also provides an independent mean to identify prevalent directions of longshore sand transport.