Associations Between Food Insufficiency and Health Conditions Among New York City Adults, 2017-2018.

Food insecurity, a critical social determinant of health, has been measured nationwide in the United States for years. This analysis focuses on food insufficiency, a more severe form of food insecurity, in New York City (NYC) and its association with self-reported physical and mental health conditions. Data from the 2017-2018 NYC Community Health Survey were used to estimate the prevalence of food insufficiency citywide, by neighborhood, and across selected socioeconomic characteristics. Multivariable logistic regression was used to explore the associations between food insufficiency and hypertension, diabetes obesity, and depression, adjusting for selected sociodemographic characteristics. Approximately 9.4% (95% CI:8.8-10.0%]) of adult New Yorkers aged 18 + reported food insufficiency, with neighborhood variation from 1.7% (95% CI:0.5-6.2%) to 19.4% (95% CI:14.2-25.8%). Food insufficiency was more prevalent among Latinos/as (16.9%, 95% CI:15.5-18.3%, p < 0.001), Black (10.1%, 95% CI:8.8-11.5%, p < 0.001) and Asian/Pacific Islanders (6.6%, 95% CI:5.4-8.1%, p = 0.002) compared to White New Yorkers (4.2%, 95% CI:3.5-5.1%). Prevalence of food insufficiency was higher among NYC adults with less than a high school education, (19.6%, 95% CI:17.7-21.6%), compared to college graduates (3.8%, 95% CI:3.2-4.4%, p < 0.001). In the adjusted logistic regression model, food insufficiency was associated with diabetes (OR = 1.36; 95% CI:1.12-1.65), hypertension (OR = 1.58; 95% CI:1.32-1.89]) and depression (OR = 2.98; 95% CI:2.45-3.59), but not with obesity (OR = 0.99; 95% CI:0.84-1.21). Our findings highlight food insufficiency at an important intersection of inequity and disease burden which is critical to informing public health interventions in the context of a large, densely populated metropolis like NYC.

Facilitators and barriers to accessing hepatitis B care in the postpartum period among foreign-born New Yorkers: a qualitative analysis of case notes.

BACKGROUND: Approximately 241,000 people are living with hepatitis B in New York City. Among those living with hepatitis B, pregnant people are particularly at risk for elevated viral load due to changes in immune response and require prompt linkage to health care. The New York City Department of Health and Mental Hygiene's Viral Hepatitis Program implemented a telephone-based patient navigation intervention for people living with hepatitis B in the postpartum period to connect them with hepatitis B care. METHODS: During the intervention, patient navigators called participants to inquire about their past experience with receiving care, available supports, and barriers to care, and worked with them to develop a plan with participants for linkage to hepatitis B care. The information collected during initial assessments and follow-up interactions were recorded as case notes. In this qualitative study, researchers conducted a thematic analysis of 102 sets of case notes to examine facilitators and barriers to accessing hepatitis B care among the intervention participants, all of whom were foreign-born and interested in receiving hepatitis B patient navigation services. RESULTS: The qualitative analysis illustrated the various ways in which patient navigators supported access to hepatitis B care. Findings suggest that receiving care through a preferred provider was a central factor in accessing care, even in the presence of significant barriers such as loss of health insurance and lack of childcare during appointments. Expectations among family members about hepatitis B screening, vaccination and routine clinical follow up were also identified as a facilitator that contributed to participants' own care. CONCLUSIONS: This study suggests that while there are numerous barriers at the personal and systemic levels, this patient navigation intervention along with the identified facilitators supported people in accessing hepatitis B care. Other patient navigation initiatives can incorporate the lessons from this analysis to support people in connecting to a preferred provider.

Efficacy and safety of antiviral plus anti-spike monoclonal antibody combination therapy vs. monotherapy for high-risk immunocompromised patients with mild-to-moderate SARS-CoV2 infection during the Omicron era: A prospective cohort study.

INTRODUCTION: Antivirals and monoclonal antibodies lower the risk of progression in immunocompromised patients. However, combination therapy with both types of agents has not been studied. PATIENTS AND METHODS: This was a single-centre, prospective, cohort study. All immunocompromised patients who received treatment for mild-to-moderate COVID-19 from 1 January 2022 to 30 October 2022 were enrolled. The primary endpoint was COVID-19 progression at 90 days, defined as hospital admission or death due to COVID-19 and/or seronegative persistent COVID-19. RESULTS: A total of 304 patients were included: 43 patients (14.1%) received sotrovimab plus a direct-acting antiviral, and 261 (85.9%) received monotherapy. Primary outcome occurred more frequently after monotherapy (4.6% vs. 0%, P=0.154). Among patients with anti-spike immunoglobulin G (anti-S IgG) titre <750 BAU/mL, COVID-19 progression was more common after monotherapy (23.9% vs. 0%, P=0.001), including more frequent COVID-related admission (15.2% vs. 0%, P=0.014) and seronegative persistent COVID-19 (10.9% vs. 0%, P=0.044). Combination therapy was associated with lower risk of progression (odds ratio [OR] 0.08, 95% confidence interval [95% CI] 0.01-0.64). Anti-S IgG titre <750 BAU/mL and previous anti-CD20 were associated with higher risk of progression (OR 13.70, 95% CI 2.77-67.68; and OR 3.05, 95% CI 1.20-10.94, respectively). CONCLUSIONS: In immunocompromised patients, combination therapy with sotrovimab plus an antiviral may be more effective than monotherapy for SARS-CoV2.

Data on location and retail price of a standard food basket in supermarkets across New York City.

Previous work has suggested that the price of food sold at supermarkets may vary according to the socioeconomic characteristics of a neighborhood. Given the importance of food prices in securing access to food, understanding how food prices vary across neighborhoods is crucial to assessing affordability. To study food pricing in New York City (NYC) a defined standard food basket (SFB) was collected in supermarkets across NYC neighborhoods. A dataset was created that includes pricing data collected in-person for ten pre-determined food items from 163 supermarkets across 71 of the 181 NYC neighborhoods during March through August of 2019. Included in these data are raw and processed pricing data files that illustrate the complexity of standardizing pricing across items. An additional dataset includes neighborhood-level variables of selected socioeconomic and demographic characteristics from the 2014-2018 American Community Survey that is publicly available via the Census API. The pricing data and the data on neighborhood-level characteristics were merged. Basic statistical measures suggest some distributional differences in the price of a SFB by socioeconomic differences between neighborhoods. This database can be used to describe spatial patterns in food pricing in a dense urban setting, while exploring pricing inequities across neighborhoods. In addition, by working with these data, researchers, policy analysts and educators will gain an understanding of the methodologies used to generate pricing data for an SFB.

Data for Equity: Creating an Antiracist, Intersectional Approach to Data in a Local Health Department.

OBJECTIVE: To develop recommendations to embed equity into data work at a local health department and a framework for antiracist data praxis. DESIGN: A working group comprised staff from across the agency whose positions involved data collection, analysis, interpretation, or communication met during April-July 2018 to identify and discuss successes and challenges experienced by staff and to generate recommendations for achieving equitable data practices. SETTING: Local health department in New York City. RESULTS: The recommendations encompassed 6 themes: strengthening analytic skills, communication and interpretation, data collection and aggregation, community engagement, infrastructure and capacity building, and leadership and innovation. Specific projects are underway or have been completed. CONCLUSIONS: Improving equity in data requires changes to data processes and commitment to racial and intersectional justice and process change at all levels of the organization and across job functions. We developed a collaborative model for how a local health department can reform data work to embed an equity lens. This framework serves as a model for jurisdictions to build upon in their own efforts to promote equitable health outcomes and become antiracist organizations.

First detection of Leptospira santarosai in the reproductive track of a boar: A potential threat to swine production and public health.

BACKGROUND: Leptospirosis causes significant economic losses and is an occupational risk in the swine industry, especially in developing tropical regions where social and geoclimatic conditions are favorable for the transmission of this disease. Although vaccination can reduce infection risk, efficacy is diminished if local genetic and antigenic variants of the pathogen are not accounted for in the vaccine. Identifying and characterizing strains hosts, and potential mechanisms of transmission is therefore critical for public health mitigation practices. METHODOLOGY/PRINCIPAL FINDINGS: Our study was conducted on a rural breeding farm in Ecuador, where we used a PCR assay that targets lipL32 to detect Leptospira spp. and targeted gene sequencing to identify Leptospira santarosai in the kidneys, testicles, and ejaculate of a vaccinated boar. MAT results showed low titers against serovars found in the vaccine, but the MAT panel did not include serovars of L. santarosai. The boar showed no symptoms of leptospirosis but did show blood in the semen. However, no postmortem histopathological lesions were observed tissue samples. Vaccinated sows that were artificially inseminated with the semen from this boar had reproductive problems, suggesting that transmission had occurred. This is the first documented case of Leptospira santarosai in the reproductive tract of a boar. CONCLUSIONS/SIGNIFICANCE: As L. santarosai is pathogenic in other livestock species and humans, our finding highlights the need to evaluate the prevalence and epidemiological significance of this pathogen in livestock and consider the possibility of venereal transmission. In addition, further studies are needed to identify and characterize local serovars that may impact diagnosis and vaccination programs to better control leptospirosis in livestock and spillover into the human population.

Racial and Ethnic Disparities in COVID-19-Like Illness and Impacts of Social Distancing and Working from Home.

Objectives: To examine racial and ethnic disparities in COVID-19-like illness (CLI) during March - August 2020 in New York City, and to test effect modification by age, nativity, and working from home vs outside the home, and mediation via social distancing behavior. Design: Analysis of the monthly Community Health Survey datasets. Setting: New York City. Participants: 5,305 adults living in New York City. Main Outcome Measures: A binary indicator of having new onset of CLI in the past 30 days. Methods: Prevalence of having CLI was compared among racial and ethnic groups using multivariable log-linear regression. Stratified and causal mediation analyses were conducted to test effect modification and mediation, respectively. Results: Overall percentage of CLI decreased from 25% during March-May to 14% during June-August. In both periods, there was no increased prevalence of CLI among Black or Latino New Yorkers compared with White New Yorkers. However, in stratified analyses, Latino vs White New Yorkers had 2.05 times (95%CI=1.09, 3.83) higher prevalence of CLI among adults working outside the home. Mediation via social distancing was not statistically significant. Conclusions: Excess burden of CLI among Latino adults working outside the home underscores inequitable impacts of COVID-19 in New York City.

Dynamic residential movement and depression among the World Trade Center Health Registry enrollees.

PURPOSE: Residential instability is associated with poor mental health, but its causal inference is challenging due to time-varying exposure and confounding, and the role of changing social environments. We tested the association between frequent residential moving and depression risk among adults exposed to the 9/11 disaster. METHODS: We used four waves of survey data from the World Trade Center Health Registry. We measured residential movement and depression using geocoded annual address records and the Personal Health Questionnaire Depression Scale, respectively, for a prospective cohort of 38,495 adults. We used the longitudinal Targeted Maximum Likelihood Method to estimate depression risk by frequent residential moving and conducted causal mediation analysis to evaluate a mediating role of social environments. RESULTS: Most enrollees (68%) did not move in 2007-2014, and 6% moved at least once every 4 years. The remaining 26% moved less frequently (e.g., only moving in 2007-2010). Frequent moving versus no moving was associated with risk of depression in 2015-16 (RR = 1.20, 95% CI = 1.06, 1.37). Frequent residential moving-depression pathway was mediated by high social integration (OR = 0.93, 95% CI = 0.90, 0.97). CONCLUSION: These findings demonstrate the importance of social networks in understanding increased risk of depression associated with housing instability.

Associations between Experiences of Police Contact and Discrimination by the Police and Courts and Health Outcomes in a Representative Sample of Adults in New York City.

Communities marginalized because of racism, heterosexism, and other systems of oppression have a history of being aggressively policed, and in those contexts, researchers have observed associations between a range of negative experiences with police and poor physical, mental, and behavioral health outcomes. However, past studies have been limited in that experiences of police contacts were aggregated at the neighborhood level and, if police contacts were self-reported, the sample was not representative. To address these limitations, we employed NYC Department of Health and Mental Hygiene 2017 Social Determinants of Health Survey (n = 2335) data to examine the associations of self-reported police contacts and discrimination by police and the courts with measures of physical (poor physical health), mental (poor mental health, serious psychological distress), and behavioral health (binge drinking). Residents marginalized because of racial, ethnic, and sexual minority status were more likely to be stopped, searched, or questioned by the police; threatened or abused by the police; and discriminated against by the police or in the courts; those experiences were associated with poor physical, mental, and behavioral health outcomes. The associations between experiences with police and poor health outcomes were strongest among Black residents and residents aged 25-44. Our findings suggest that the health of NYC residents who have had exposure to police and experienced discrimination by the police and courts is poorer than those who have not, and build on a growing body of evidence that aggressive policing practices have implications for public health.

HIF-Overexpression and Pro-Inflammatory Priming in Human Mesenchymal Stromal Cells Improves the Healing Properties of Extracellular Vesicles in Experimental Crohn's Disease.

Extracellular vesicles (EVs) derived from mesenchymal stromal cells (MSCs) have therapeutic potential in the treatment of several immune disorders, including ulcerative colitis, owing to their regenerative and immunosuppressive properties. We recently showed that MSCs engineered to overexpress hypoxia-inducible factor 1-alpha and telomerase (MSC-T-HIF) and conditioned with pro-inflammatory stimuli release EVs (EVMSC-T-HIFC) with potent immunomodulatory activity. We tested the efficacy of EVMSC-T-HIFC to repolarize M1 macrophages (Mφ1) to M2-like macrophages (Mφ2-like) by analyzing surface markers and cytokines and performing functional assays in co-culture, including efferocytosis and T-cell proliferation. We also studied the capacity of EVMSC-T-HIFC to dampen the inflammatory response of activated endothelium and modulate fibrosis. Finally, we tested the therapeutic capacity of EVMSC-T-HIFC in an acute colitis model. EVMSC-T-HIFc induced the repolarization of monocytes from Mφ1 to an Mφ2-like phenotype, which was accompanied by reduced inflammatory cytokine release. EVMSC-T-HIFc-treated Mφ1 had similar effects of immunosuppression on activated peripheral blood mononuclear cells (PBMC) as Mφ2, and reduced the adhesion of PBMCs to activated endothelium. EVMSC-T-HIFc also prevented myofibroblast differentiation of TGF-ß-treated fibroblasts. Finally, administration of EVMSC-T-HIFc promoted healing in a TNBS-induced mouse colitis model in terms of preserving colon length and intestinal mucosa architecture and altering the ratio of Mφ1/ Mφ2 infiltration. In conclusion, EVMSC-T-HIFC have effective anti-inflammatory properties, making them potential therapeutic agents in cell free-based therapies for the treatment of Crohn's disease and likely other immune-mediated inflammatory diseases.

Machine Learning Study in Caries Markers in Oral Microbiota from Monozygotic Twin Children.

In recent years, the etiology of caries has evolved from a simplistic infectious perspective based on Streptococcus mutans and/or Lactobacillus activity, to a multifactorial disease involving a complex oral microbiota, the human genetic background and the environment. The aim of this work was to identify bacterial markers associated with early caries using massive 16S rDNA. To minimize the other factors, the composition of the oral microbiota of twins in which only one of them had caries was compared with their healthy sibling. Twenty-one monozygotic twin pairs without a previous diagnosis of caries were recruited in the context of their orthodontic treatment and divided into two categories: (1) caries group in which only one of the twins had caries; and (2) control group in which neither of the twins had caries. Each participant contributed a single oral lavage sample in which the bacterial composition was determined by 16S rDNA amplification and further high-throughput sequencing. Data analysis included statistical comparison of alpha and beta diversity, as well as differential taxa abundance between groups. Our results show that twins of the control group have a closer bacterial composition than those from the caries group. However, statistical differences were not detected and we were unable to find any particular bacterial marker by 16S rDNA high-throughput sequencing that could be useful for prevention strategies. Although these results should be validated in a larger population, including children from other places or ethnicities, we conclude that the occurrence of caries is not related to the increase of any particular bacterial population.

HIF-1α and Pro-Inflammatory Signaling Improves the Immunomodulatory Activity of MSC-Derived Extracellular Vesicles.

Despite the strong evidence for the immunomodulatory activity of mesenchymal stromal cells (MSCs), clinical trials have so far failed to clearly show benefit, likely reflecting methodological shortcomings and lack of standardization. MSC-mediated tissue repair is commonly believed to occur in a paracrine manner, and it has been stated that extracellular vesicles (EVs) secreted by MSCs (EVMSC) are able to recapitulate the immunosuppressive properties of parental cells. As a next step, clinical trials to corroborate preclinical studies should be performed. However, effective dose in large mammals, including humans, is quite high and EVs industrial production is hindered by the proliferative senescence that affects MSCs during massive cell expansion. We generated a genetically modified MSC cell line overexpressing hypoxia-inducible factor 1-alpha and telomerase to increase the therapeutic potency of EVMSC and facilitate their large-scale production. We also developed a cytokine-based preconditioning culture medium to prime the immunomodulatory response of secreted EVs (EVMSC-T-HIFc). We tested the efficacy of this system in vitro and in a delayed-type hypersensitivity mouse model. MSC-T with an HIF-1α-GFP lentiviral vector (MSC-T-HIF) can be effectively expanded to obtain large amounts of EVs without major changes in cell phenotype and EVs composition. EVMSC-T-HIFc suppressed the proliferation of activated T-cells more effectively than did EVs from unmodified MSC in vitro, and significantly blunted the ear-swelling response in vivo by inhibiting cell infiltration and improving tissue integrity. We have developed a long-lived EV source that secretes high quantities of immunosuppressive EVs, facilitating a more standard and cost-effective therapeutic product.

Epidemiology of the colonization and acquisition of methicillin-resistant staphylococci and vancomycin-resistant enterococci in dogs hospitalized in a clinic veterinary hospital in Spain.

Antibiotic resistance is one of the biggest threats to human and animal health. Methicillin-resistant Staphylococcus spp. (MRS) and vancomycin-resistant Enterococcus spp. (VRE) are of increasing importance in hospital and/or nosocomial infections and represent a potential risk of transmission to humans from infected or colonized companion animals. Studies on the risk factors associated with colonization by multiresistant bacteria in animals are scarce. The present study aimed to estimate the prevalence and incidence of MRS and VRE in canine patients hospitalized in a veterinary hospital and to identify the risk factors for its acquisition and persistence. Nasal and perianal swabs were obtained from 72 dogs. Antimicrobial susceptibility assays and molecular detection of mecA and van genes were performed. A prevalence of 13.9% and incidence of 26.5% was observed in dogs colonized by MRS at hospital admission and release, respectively, higher values than those described in most veterinary studies. Thirty-five Staphylococcus isolates had mecA gene and showed higher resistance levels to most of the antimicrobials evaluated. Previous and concomitant use of antibiotics and corticosteroids has been associated with an increase in MRS colonization. The use of antibiotics in other animals living with the canine patients has also been identified as an associated factor, suggesting cross transmission. The presence of van-resistant genes from Enterococcus spp. was not detected. Pets should be considered possible vehicles of transmission and reservoirs for MRS bacteria and veterinary hospitals should be considered high-risk environments for the occurrence and spread of nosocomial infections and resistant bacteria.

Health Behaviors and Outcomes Associated With Personal and Family History of Criminal Justice System Involvement, New York City, 2017.

Objectives. To quantify the association between personal and family history of criminal justice system (CJS) involvement (PHJI and FHJI, respectively), health outcomes, and health-related behaviors.Methods. We examined 2017 New York City Community Health Survey data (n = 10 005) with multivariable logistic regression. We defined PHJI as ever incarcerated or under probation or parole. FHJI was CJS involvement of spouse or partner, child, sibling, or parent.Results. We found that 8.9% reported only FHJI, 5.4% only PHJI, and 2.9% both FHJI and PHJI (mean age = 45.4 years). Compared with no CJS involvement, individuals with only FHJI were more likely to report fair or poor health, hypertension, diabetes, obesity, depression, heavy drinking, and binge drinking. Respondents with only PHJI reported more fair or poor health, asthma, depression, heavy drinking, and binge drinking. Those with both FHJI and PHJI were more likely to report asthma, depression, heavy drinking, and binge drinking.Conclusions. New York City adults with personal or family CJS involvement, or both, were more likely to report adverse health outcomes and behaviors.Public Health Implications. Measuring CJS involvement in public health monitoring systems can help to identify important health needs, guiding the provision of health care and resource allocation.

Conflicto empleo-familia y autopercepción de la salud desde una perspectiva de género / Employment-family conflict and self-perception of health from a gender perspective

Resumen El objetivo de este estudio es analizar las desigualdades de género en la relación del conflicto empleo familia (CEF) con el estado de salud de la población trabajadora de Quito y Guayaquil. Se trata de un estudio transversal de una muestra representativa de la población trabajadora no agrícola, con edad igual o mayor a 18 años y afiliada a la seguridad social, que fue entrevistada entre 2016-2017 en la I Encuesta sobre Condiciones de Seguridad y Salud en el Trabajo de Quito y Guayaquil (n=1729). Se emplearon modelos de regresión de Poisson con varianza robusta, separados por sexo, para calcular las razones de prevalencia ajustadas de seis indicadores de salud. En ambos sexos, el CEF se asoció con mala salud autopercibida, mala salud mental, dolor o molestias de cabeza y de espalda, aunque la magnitud de asociación fue mayor en las mujeres. Además, en las mujeres el CEF se asoció con problemas digestivos (RPa=1,65; IC 95%: 1,17-2,34). En ninguno de los dos sexos se observó asociación entre el CEF y los accidentes de trabajo. Los resultados del presente estudio muestran que el CEF se asocia con malas condiciones de salud en la población trabajadora, particularmente en las mujeres. Las políticas públicas e intervenciones en los centros de trabajo dirigidas a alcanzar un equilibrio entre el empleo y la vida familiar desde una perspectiva de género podrían resultar en una reducción en los daños a la salud y en las desigualdades de género en salud.

Abstract The objective of this study is to analyze gender inequalities in the relationship between employment-family conflict (EFC) and health status in the working population of Quito and Guayaquil. This is a cross-sectional study of non-agricultural employees, aged 18 or older and covered by social security, who were interviewed between 2016-2017 in the First Survey of Safety Conditions and Health at Work of Quito and Guayaquil (n = 1729). Poisson regression models with robust variance separated by sex were used to calculate adjusted prevalence ratios for six health indicators. In both sexes, EFC was associated with poor self-perceived health, poor mental health, and head or back pain or discomfort, although the magnitude of the association was greater in women. Furthermore, EFC was associated with digestive problems only in women (aPR=1.65; 95% CI: 1.17-2.34). In neither sex was there an association between EFC and occupational accidents. The results of this study show that EFC is associated with poor health conditions in the working population, particularly among women. Public policies and workplace interventions aimed at achieving a balance between employment and family life from a gender perspective could help reduce impairments to health and gender inequalities in health.

Microcins in Enterobacteriaceae: Peptide Antimicrobials in the Eco-Active Intestinal Chemosphere.

Microcins are low-molecular-weight, ribosomally produced, highly stable, bacterial-inhibitory molecules involved in competitive, and amensalistic interactions between Enterobacteriaceae in the intestine. These interactions take place in a highly complex chemical landscape, the intestinal eco-active chemosphere, composed of chemical substances that positively or negatively influence bacterial growth, including those originated from nutrient uptake, and those produced by the action of the human or animal host and the intestinal microbiome. The contribution of bacteria results from their effect on the host generated molecules, on food and digested food, and organic substances from microbial origin, including from bacterial degradation. Here, we comprehensively review the main chemical substances present in the human intestinal chemosphere, particularly of those having inhibitory effects on microorganisms. With this background, and focusing on Enterobacteriaceae, the most relevant human pathogens from the intestinal microbiota, the microcin's history and classification, mechanisms of action, and mechanisms involved in microcin's immunity (in microcin producers) and resistance (non-producers) are reviewed. Products from the chemosphere likely modulate the ecological effects of microcin activity. Several cross-resistance mechanisms are shared by microcins, colicins, bacteriophages, and some conventional antibiotics, which are expected to produce cross-effects. Double-microcin-producing strains (such as microcins MccM and MccH47) have been successfully used for decades in the control of pathogenic gut organisms. Microcins are associated with successful gut colonization, facilitating translocation and invasion, leading to bacteremia, and urinary tract infections. In fact, Escherichia coli strains from the more invasive phylogroups (e.g., B2) are frequently microcinogenic. A publicly accessible APD3 database http://aps.unmc.edu/AP/ shows particular genes encoding microcins in 34.1% of E. coli strains (mostly MccV, MccM, MccH47, and MccI47), and much less in Shigella and Salmonella (<2%). Some 4.65% of Klebsiella pneumoniae are microcinogenic (mostly with MccE492), and even less in Enterobacter or Citrobacter (mostly MccS). The high frequency and variety of microcins in some Enterobacteriaceae indicate key ecological functions, a notion supported by their dominance in the intestinal microbiota of biosynthetic gene clusters involved in the synthesis of post-translationally modified peptide microcins.

Occurrence, genotypes and antimicrobial susceptibility of Salmonella collected from the broiler production chain within an integrated poultry company.

Salmonella is a common foodborne pathogen in the poultry production systems. Its presence in this food industry is determined by the fact that it can survive and pass throughout the different steps in the poultry production. In this study we aimed to study the occurrence, genotypes and antimicrobial resistance of Salmonella collected from the broiler production chain within an integrated poultry company. Three hundred fourteen samples were collected in the feeding plant, farms and the slaughterhouse. Samples were cultured for Salmonella isolation according to the ISO6579/Amd 1. Isolates were further typed by Kauffmann-White scheme and pulse field gel electrophoresis (PFGE). Antimicrobial resistance to 11 antimicrobials was studied by disk diffusion tests and sequencing of ESBL genes. From the collected samples 70 (22%) were found to be Salmonella positive. The lowest Salmonella rates were found in feed samples while in farm and slaughterhouse samples Salmonella presence ranged from 5% to 88%. S. Infantis was the most common serotype (94%, 66/70). PFGE demonstrated that isolates belonged to 11 genotypes. Some genotypes were continuously identified throughout the production chain. 97% of the isolates showed resistance to at least one antimicrobial. Moreover, all S. Infantis isolates and one auto-agglutinable isolate showed resistance to at least 6 antimicrobials. 30 and 8 isolates were positive to blaCTX-M-65 and blaCTX-M-14 genes respectively. No blaKPC resistance genes were identified in any isolate. This study highlights the predominance of S. Infantis in the integrated poultry company. Genotypes showed that cross-contamination between stages of poultry production can occur, stressing the importance of implementing good hygiene practices in every level of the production. Moreover, multidrug resistance patterns and the presence of important ESBL genes have public health implications that need to be deeply discussed with a one health approach.

PCR-Based Analysis of ColE1 Plasmids in Clinical Isolates and Metagenomic Samples Reveals Their Importance as Gene Capture Platforms.

ColE1 plasmids are important vehicles for the spread of antibiotic resistance in the Enterobacteriaceae and Pasteurellaceae families of bacteria. Their monitoring is essential, as they harbor important resistant determinants in humans, animals and the environment. In this work, we have analyzed ColE1 replicons using bioinformatic and experimental approaches. First, we carried out a computational study examining the structure of different ColE1 plasmids deposited in databases. Bioinformatic analysis of these ColE1 replicons revealed a mosaic genetic structure consisting of a host-adapted conserved region responsible for the housekeeping functions of the plasmid, and a variable region encoding a wide variety of genes, including multiple antibiotic resistance determinants. From this exhaustive computational analysis we developed a new PCR-based technique, targeting a specific sequence in the conserved region, for the screening, capture and sequencing of these small plasmids, either specific for Enterobacteriaceae or specific for Pasteurellaceae. To validate this PCR-based system, we tested various collections of isolates from both bacterial families, finding that ColE1 replicons were not only highly prevalent in antibiotic-resistant isolates, but also present in susceptible bacteria. In Pasteurellaceae, ColE1 plasmids carried almost exclusively antibiotic resistance genes. In Enterobacteriaceae, these plasmids encoded a large range of traits, including not only antibiotic resistance determinants, but also a wide variety of genes, showing the huge genetic plasticity of these small replicons. Finally, we also used a metagenomic approach in order to validate this technique, performing this PCR system using total DNA extractions from fecal samples from poultry, turkeys, pigs and humans. Using Illumina sequencing of the PCR products we identified a great diversity of genes encoded by ColE1 replicons, including different antibiotic resistance determinants, supporting the previous results achieved with the collections of bacterial isolates. In addition, we detected cryptic ColE1 plasmids in both families with no known genes in their variable region, which we have named sentinel plasmids. In conclusion, in this work we present a useful genetic tool for the detection and analysis of ColE1 plasmids, and confirm their important role in the dissemination of antibiotic resistance, especially in the Pasteurellaceae family of bacteria.

Parental Race/Ethnicity and Adverse Birth Outcomes in New York City: 2000-2010.

OBJECTIVES: To examine the association of maternal race/ethnicity only and parental race/ethnicity jointly with adverse birth outcomes (low birth weight, small for gestational age, preterm birth, and infant mortality) among New York City women. METHODS: We used Bureau of Vital Statistics, New York City Department of Health and Mental Hygiene birth- and death-linked data from 2000 to 2010 (n = 984 807) to quantify the association of maternal race/ethnicity and parental race/ethnicity concordance or discordance with each outcome. RESULTS: By maternal race/ethnicity, infants of non-Hispanic Black, Hispanic, and Asian women had risks of adverse birth outcomes between 10% and 210% greater than infants of non-Hispanic White women. Infants of non-Hispanic Black, Asian, and Hispanic couples exhibited higher risk of adverse birth outcomes than infants of non-Hispanic White couples. Moreover, parental racial/ethnic discordance was associated with an increased risk of adverse birth outcomes, with highest risks for pairings of Asian men with non-Hispanic White, non-Hispanic Black, and Hispanic women, and of Asian women with non-Hispanic Black and Hispanic men. CONCLUSIONS: Parental race/ethnicity discordance may add stress to women during pregnancy, affecting birth outcomes. Thus, parental race/ethnicity should be considered when examining such outcomes.

Recombination blurs phylogenetic groups routine assignment in Escherichia coli: setting the record straight.

The characterization of population structures plays a main role for understanding outbreaks and the dynamics of bacterial spreading. In Escherichia coli, the widely used combination of multiplex-PCR scheme together with goeBURST has some limitations. The purpose of this study is to show that the combination of different phylogenetic approaches based on concatenated sequences of MLST genes results in a more precise assignment of E. coli phylogenetic groups, complete understanding of population structure and reconstruction of ancestral clones. A collection of 80 Escherichia coli strains of different origins was analyzed following the Clermont and Doumith's multiplex-PCR schemes. Doumith's multiplex-PCR showed only 1.7% of misassignment, whereas Clermont's-2000 protocol reached 14.0%, although the discrepancies reached 30% and 38.7% respectively when recombinant C, F and E phylogroups were considered. Therefore, correct phylogroup attribution is highly variable and depends on the clonal composition of the sample. As far as population structure of these E. coli strains, including 48 E. coli genomes from GenBank, goeBURST provides a quite dispersed population structure; whereas NeighborNet approach reveals a complex population structure. MLST-based eBURST can infer different founder genotypes, for instance ST23/ST88 could be detected as the founder genotypes for STC23; however, phylogenetic reconstructions might suggest ST410 as the ancestor clone and several evolutionary trajectories with different founders. To improve our routine understanding of E. coli molecular epidemiology, we propose a strategy based on three successive steps; first, to discriminate three main groups A/B1/C, D/F/E and B2 following Doumith's protocol; second, visualization of population structure based on MLST genes according to goeBURST, using NeighborNet to establish more complex relationships among STs; and third, to perform, a cost-free characterization of evolutionary trajectories in variants emerging along the clonal expansion using parsimony methods of phylogenetic analysis.