Role of the BaeSR two-component system in the regulation of Acinetobacter baumannii adeAB genes and its correlation with tigecycline susceptibility.

BACKGROUND: Tigecycline resistance in Acinetobacter baumannii is primarily acquired through overexpression of the AdeABC efflux pump. Besides AdeRS, other two-component regulatory systems (TCSs) involving the regulation of this transporter have not been clarified. RESULTS: In this study, we found that the TCS genes baeR and baeS are co-transcribed and function as stress responders under high osmotic conditions. The baeSR and adeAB genes showed increased transcription in both the laboratory-induced and clinical tigecycline-resistant strains compared with the wild-type strain. The deletion of baeR in the ATCC 17978 strain led to 67-73% and 68% reduction in adeA and adeB expression, respectively, with a resultant 2-fold decrease in the tigecycline minimal inhibition concentration (MIC). In contrast, the overexpression of baeR resulted in a doubled tigecycline MIC, with a more than 2-fold increase in adeA and adeB expression. The influence of baeR knockout on adeAB gene expression can also be observed in the laboratory-induced tigecycline-resistant strain. A time-kill assay showed that the baeR deletion mutant showed an approximate 1-log10 reduction in colony forming units (CFUs) relative to the wild-type strain when the tigecycline concentration was 0.25 µg/mL throughout the assay period. The wild-type phenotype could be restored by trans-complementation with pWH1266-kanr-baeR. Increasing the tigecycline concentration to 0.5 µg/mL produced an even more marked 4.7-log10 reduction in CFUs of the baeR deletion mutant at 8 h, while only a 2.1-log10 reduction was observed for the wild-type strain. CONCLUSIONS: Taken together, these data show for the first time that the BaeSR TCS influences the tigecycline susceptibility of A. baumannii through the positive regulation of the resistance-nodulation-division efflux pump genes adeA and adeB.

Discrete Wavelet Transform based ECG classification using gcForest: A deep ensemble method.

BACKGROUND: Cardiovascular diseases (CVDs) are the leading global cause of mortality, necessitating advanced diagnostic tools for early detection. The electrocardiogram (ECG) is pivotal in diagnosing cardiac abnormalities due to its non-invasive nature. OBJECTIVE: This study aims to propose a novel approach for ECG signal classification, addressing the challenges posed by the complexity of ECG signals associated with various diseases. METHODS: Our method integrates Discrete Wavelet Transform (DWT) for feature extraction, capturing salient features of cardiovascular diseases. Subsequently, the gcForest model is employed for efficient classification. The approach is tested on the MIT-BIH Arrhythmia Database. RESULTS: The proposed method demonstrates promising results on the MIT-BIH Arrhythmia Database, achieving a test accuracy of 98.55%, recall of 98.48%, precision of 98.44%, and an F1 score of 98.46%. Additionally, the model exhibits robustness and low sensitivity to hyper-parameters. CONCLUSION: The combined use of DWT and the gcForest model proves effective in ECG signal classification, showcasing high accuracy and reliability. This approach holds potential for improving early detection of cardiovascular diseases, contributing to enhanced cardiac healthcare.

Wavelet-based U-shape network for bioabsorbable vascular stents segmentation in IVOCT images.

Background and Objective: Coronary artery disease remains a leading cause of mortality among individuals with cardiovascular conditions. The therapeutic use of bioresorbable vascular scaffolds (BVSs) through stent implantation is common, yet the effectiveness of current BVS segmentation techniques from Intravascular Optical Coherence Tomography (IVOCT) images is inadequate. Methods: This paper introduces an enhanced segmentation approach using a novel Wavelet-based U-shape network to address these challenges. We developed a Wavelet-based U-shape network that incorporates an Attention Gate (AG) and an Atrous Multi-scale Field Module (AMFM), designed to enhance the segmentation accuracy by improving the differentiation between the stent struts and the surrounding tissue. A unique wavelet fusion module mitigates the semantic gaps between different feature map branches, facilitating more effective feature integration. Results: Extensive experiments demonstrate that our model surpasses existing techniques in key metrics such as Dice coefficient, accuracy, sensitivity, and Intersection over Union (IoU), achieving scores of 85.10%, 99.77%, 86.93%, and 73.81%, respectively. The integration of AG, AMFM, and the fusion module played a crucial role in achieving these outcomes, indicating a significant enhancement in capturing detailed contextual information. Conclusion: The introduction of the Wavelet-based U-shape network marks a substantial improvement in the segmentation of BVSs in IVOCT images, suggesting potential benefits for clinical practices in coronary artery disease treatment. This approach may also be applicable to other intricate medical imaging segmentation tasks, indicating a broad scope for future research.

Influence of redox potential on leaching behavior of a solidified chromium contaminated soil.

Cement-based solidification/stabilization (S/S) technology is often used to remediate chromium (Cr) contaminated soils. The valence state and mobility of Cr in soils are closely related with redox potential (EH). However, Cr mobilization from the solidified soils influenced by EH has received little attention. In this study, semi-dynamic leaching tests and the toxicity characteristic leaching procedure (TCLP) were performed on a S/S treated Cr contaminated soil under various EH conditions. The effective diffusion coefficient and leachability index were obtained from the leaching data to investigate the leaching behavior of Cr from the S/S treated soil. Speciation of Cr remained in the sample after the leaching process was obtained through the sequential extraction procedures. The results show that an increase in EH increases the effective diffusion coefficient of Cr and, therefore, the amount of Cr leached. This result is attributed to immobile Cr(III) being oxidized to highly mobile Cr(VI). The leachability index results indicate that the cement solidification of Cr contaminated soil may not be appropriate under oxidizing conditions. For the TCLP and sequential extraction procedures, the leached amount of Cr exhibits a strong dependence on EH. As EH increases, the content of Cr remaining in the soil in unstable phases reduced, and more Cr was released to leachant.

Characterization of biofilm production in different strains of Acinetobacter baumannii and the effects of chemical compounds on biofilm formation.

Acinetobacter baumannii, an important emerging pathogen of nosocomial infections, is known for its ability to form biofilms. Biofilm formation increases the survival rate of A. baumannii on dry surfaces and may contribute to its persistence in the hospital environment, which increases the probability of nosocomial infections and outbreaks. This study was undertaken to characterize the biofilm production of different strains of A. baumannii and the effects of chemical compounds, especially antibiotics, on biofilm formation. In this study, no statistically significant relationship was observed between the ability to form a biofilm and the antimicrobial susceptibility of the A. baumannii clinical isolates. Biofilm formation caused by A. baumannii ATCC 17978 after gene knockout of two-component regulatory system gene baeR, efflux pump genes emrA/emrB and outer membrane coding gene ompA revealed that all mutant strains had less biofilm formation than the wild-type strain, which was further supported by the images from scanning electron microscopy and confocal laser scanning microscopy. The addition of amikacin, colistin, LL-37 or tannic acid decreased the biofilm formation ability of A. baumannii. In contrast, the addition of lower subinhibitory concentration tigecycline increased the biofilm formation ability of A. baumannii. Minimum biofilm eradication concentrations of amikacin, imipenem, colistin, and tigecycline were increased obviously for both wild type and multidrug resistant clinical strain A. baumannii VGH2. In conclusion, the biofilm formation ability of A. baumannii varied in different strains, involved many genes and could be influenced by many chemical compounds.

Characterization of antimicrobial resistance patterns and integrons in human fecal Escherichia coli in Taiwan.

Two hundred and twenty-five fecal strains of Escherichia coli isolated from 109 non-hospitalized adults in 2006 were investigated for susceptibility to antibiotics and for the presence of integrons. High resistance rates in fecal strains of E. coli were observed for streptomycin (52.0%), ampicillin (50.2%), piperacillin (50.2%), trimethoprim/sulfamethoxazole (47.6%) and chloramphenicol (33.8%). Integrons were found in 31.5% (71/225) of the strains using an integrase gene PCR assay. Among 71 integrase-positive strains, 65 strains belonged to class 1 integrons, while the remainder belonged to class 2. Gene cassette patterns of class 1 integrons were further characterized by PCR and direct sequencing. Among those class 1 integrase-containing isolates, the integron cassette region was amplified by PCR in 40.0% (26 of 65) of isolates. Five different antimicrobial resistance gene cassette arrays were found in those isolates. These gene cassettes included those encoding resistance to trimethoprim (dfrV, dfrA7, dfrA12, dfrA17) and streptomycin (aadA1, aadA2, aadA5). Among those gene cassette arrays, dfrA12-orfF-aadA2 was found in 53.8% (14/26) of the isolates. These findings indicate that multidrug resistance of fecal flora is common in Taiwan and that integrons play an important role in resistance to trimethoprim and streptomycin in humans.

Evaluating the dual porosity of landfilled municipal solid waste.

The objective of this paper was to study the pore-size distribution of municipal solid waste (MSW) and provide a basis for understanding the mechanism of preferential flow in MSW. Two methods were used to investigate the pore-size distribution in MSW. The first was an indirect method based on the soil-water characteristic curve (SWCC) and the second was a direct method using nuclear magnetic resonance (NMR). Samples taken from different depths of a landfill were used. In the SWCC method, SWCCs of the matrix region were obtained by a pressure plate extractor and SWCCs of the macropore region were determined by water breakthrough tests. A SWCC equation is proposed by modifying the Van Genuchten equation to consider the dual-porosity feature of MSW and the pore-size distribution was obtained based on the Young-Laplace equation. In the NMR method, the pore-size distribution of MSW was obtained by analyzing the T2 curves. The results of the two methods were qualitatively similar and both showed a dual-porosity characteristic of MSW. The average macropore radii of shallow, middle, and deep MSWs obtained from the SWCC method are 0.193, 0.184, and 0.173 mm, and those obtained from the NMR method are 0.213, 0.138, and 0.145 mm, respectively. The proportion of macropores decreases with depth. The average micropore radii given by the SWCC method are 0.022, 0.011, and 0.008 mm, and those given by the NMR method are 0.013, 0.011, and 0.008 mm, respectively. As the depth and fill age increase, the average micropore size becomes smaller and the proportion of micropores increases. The volume ratios of macropores obtained by the two methods are quantitatively quite different. The discrepancy is mainly caused by the different test principles adopted by the two methods.

A method to assess influence of different medical tubing on biofilm formation by Acinetobacter baumannii.

In this study, we developed a method to assess influence of different medical tubing on biofilm formation by A. baumannii. The results of biofilm quantification and scanning electron microscopy showed that the biofilm formation susceptibility of different tubing materials was rubber latex > polyvinyl chloride > silicone.

Antimicrobial Susceptibility and Molecular Epidemiology of Proteus mirabilis Isolates from Three Hospitals in Northern Taiwan.

Of all the Proteus spp., Proteus mirabilis is the most common species identified in clinical specimens and is a leading agent of complicated urinary tract infection. This study was undertaken to understand the antimicrobial susceptibility, prevalence of antibiotic resistance genes, and molecular typing of P. mirabilis isolates collected from three hospitals in northern Taiwan. The results showed that the collected isolates of P. mirabilis were susceptible to most antibiotics except cefazolin and tigecycline. Many resistance genes were detected in the collected isolates, of which TEM genes were the most common. Resistance to third- or fourth-generation cephalosporins was related to the presence of at least one of the tested extended-spectrum ß-lactamase (ESBL) or AmpC genes. The presence of the VEB-1 gene seemed to be a good predictor for both cefepime and ceftazidime resistance, which was further supported by quantitative polymerase chain reaction results. Of the four imipenem-resistant P. mirabilis isolates, three isolates could hydrolyze imipenem by mass spectrometry analysis. Molecular typing by pulsed-field gel electrophoresis showed that the pulsotyping of the selected P. mirabilis isolates was heterogeneous. By analyzing the relationship of antimicrobial resistance and the presence of resistance genes, revision of the Clinical and Laboratory Standards Institute cefepime and ceftazidime MIC breakpoints for Enterobacteriaceae to predict ESBL producers might possibly be needed.

Contribution of EmrAB efflux pumps to colistin resistance in Acinetobacter baumannii.

Efflux pumps play an important role in antimicrobial resistance for Acinetobacter baumannii. However, the function of the Emr pump system and the relationship between Emr and drug resistance has not been characterized in A. baumannii. In this study, four possible groups of emr-like genes were found by searching a genome database. Among them, A1S_1772 (emrB) and A1S_1773 (emrA) were demonstrated to be co-transcribed as a single operon. Moreover, during osmotic stress, A1S_1772 showed the largest change in gene expression compared to the other emrB-like genes, and deletion of A1S_1772 (AB ΔemrB) significantly slowed cell growth in 20% sucrose. Using a phenotypic microarray analysis, the AB ΔemrB mutant was more susceptible to colistin and nafcillin, paromomycin, spiramycin, and D,L-serine hydroxmate than the wild type. The spot assay, time kill assay and minimal inhibition concentration determination also indicated that the wild type could tolerate colistin better than the AB ΔemrB mutant. Finally, the increased expression levels of all emrB-like genes, including A1S_0775, A1S_0909, A1S_1772, and A1S_1799, in colistin resistance-induced A. baumannii further supported the possible involvement of the emrB genes in A. baumannii colistin resistance. Together, the Emr pump systems in A. baumannii contribute to adaptation to osmotic stress and resistance to colistin.