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Issue Cover for Volume 22, Number 9—September 2016

Volume 22, Number 9—September 2016

[PDF - 42.68 MB - 184 pages]

Synopses

Medscape CME Activity
Treatment Outcomes for Patients with Extensively Drug-Resistant Tuberculosis, KwaZulu-Natal and Eastern Cape Provinces, South Africa [PDF - 582 KB - 8 pages]
C. L. Kvasnovsky et al.

We analyzed data for a retrospective cohort of patients treated for extensively drug-resistant tuberculosis in 2 provinces in South Africa and compared predictors of treatment outcome in HIV-positive patients who received or had not received antiretroviral drugs with those for HIV-negative patients. Overall, 220 (62.0%) of 355 patients were HIV positive. After 2 years, 34 (10.3%) of 330 patients with a known HIV status and known outcome had a favorable outcome. Multivariate analysis showed that predictors of favorable outcome were negative results for acid-fast bacilli by sputum microscopy at start of treatment and weight >50 kg. HIV-positive patients were more likely to have an unfavorable outcome. The strongest predictor of unfavorable outcome was weight <50 kg. Overall outcomes were poor. HIV status was not a predictor of favorable outcome, but HIV-positive patients were more likely to have an unfavorable outcome. These results underscore the need for timely and adequate treatment for tuberculosis and HIV infection.

EID Kvasnovsky CL, Cegielski J, van der Walt ML. Treatment Outcomes for Patients with Extensively Drug-Resistant Tuberculosis, KwaZulu-Natal and Eastern Cape Provinces, South Africa. Emerg Infect Dis. 2016;22(9):1529-1536. https://doi.org/10.3201/eid2209.160084
AMA Kvasnovsky CL, Cegielski J, van der Walt ML. Treatment Outcomes for Patients with Extensively Drug-Resistant Tuberculosis, KwaZulu-Natal and Eastern Cape Provinces, South Africa. Emerging Infectious Diseases. 2016;22(9):1529-1536. doi:10.3201/eid2209.160084.
APA Kvasnovsky, C. L., Cegielski, J., & van der Walt, M. L. (2016). Treatment Outcomes for Patients with Extensively Drug-Resistant Tuberculosis, KwaZulu-Natal and Eastern Cape Provinces, South Africa. Emerging Infectious Diseases, 22(9), 1529-1536. https://doi.org/10.3201/eid2209.160084.

Clinical Features of and Risk Factors for Fatal Ebola Virus Disease, Moyamba District, Sierra Leone, December 2014–February 2015 [PDF - 515 KB - 8 pages]
Y. Haaskjold et al.

The 2013–2016 outbreak of Ebola virus disease (EVD) in West Africa infected >28,000 people, including >11,000 who died, and disrupted social life in the region. We retrospectively studied clinical signs and symptoms and risk factors for fatal outcome among 31 Ebola virus–positive patients admitted to the Ebola Treatment Center in Moyamba District, Sierra Leone. We found a higher rate of bleeding manifestations than reported elsewhere during the outbreak. Significant predictors for death were shorter time from symptom onset to admission, male sex, high viral load on initial laboratory testing, severe pain, diarrhea, bloody feces, and development of other bleeding manifestations during hospitalization. These risk factors for death could be used to identify patients in need of more intensive medical support. The lack of fever in as many as one third of EVD cases may have implications for temperature-screening practices and case definitions.

EID Haaskjold Y, Bolkan H, Krogh K, Jongopi J, Lundeby K, Mellesmo S, et al. Clinical Features of and Risk Factors for Fatal Ebola Virus Disease, Moyamba District, Sierra Leone, December 2014–February 2015. Emerg Infect Dis. 2016;22(9):1537-1544. https://doi.org/10.3201/eid2209.151621
AMA Haaskjold Y, Bolkan H, Krogh K, et al. Clinical Features of and Risk Factors for Fatal Ebola Virus Disease, Moyamba District, Sierra Leone, December 2014–February 2015. Emerging Infectious Diseases. 2016;22(9):1537-1544. doi:10.3201/eid2209.151621.
APA Haaskjold, Y., Bolkan, H., Krogh, K., Jongopi, J., Lundeby, K., Mellesmo, S....Blomberg, B. (2016). Clinical Features of and Risk Factors for Fatal Ebola Virus Disease, Moyamba District, Sierra Leone, December 2014–February 2015. Emerging Infectious Diseases, 22(9), 1537-1544. https://doi.org/10.3201/eid2209.151621.
Research

Travel- and Community-Based Transmission of Multidrug-Resistant Shigella sonnei Lineage among International Orthodox Jewish Communities [PDF - 986 KB - 9 pages]
K. S. Baker et al.

Shigellae are sensitive indicator species for studying trends in the international transmission of antimicrobial-resistant Enterobacteriaceae. Orthodox Jewish communities (OJCs) are a known risk group for shigellosis; Shigella sonnei is cyclically epidemic in OJCs in Israel, and sporadic outbreaks occur in OJCs elsewhere. We generated whole-genome sequences for 437 isolates of S. sonnei from OJCs and non-OJCs collected over 22 years in Europe (the United Kingdom, France, and Belgium), the United States, Canada, and Israel and analyzed these within a known global genomic context. Through phylogenetic and genomic analysis, we showed that strains from outbreaks in OJCs outside of Israel are distinct from strains in the general population and relate to a single multidrug-resistant sublineage of S. sonnei that prevails in Israel. Further Bayesian phylogenetic analysis showed that this strain emerged approximately 30 years ago, demonstrating the speed at which antimicrobial drug–resistant pathogens can spread widely through geographically dispersed, but internationally connected, communities.

EID Baker KS, Dallman TJ, Behar A, Weill F, Gouali M, Sobel J, et al. Travel- and Community-Based Transmission of Multidrug-Resistant Shigella sonnei Lineage among International Orthodox Jewish Communities. Emerg Infect Dis. 2016;22(9):1545-1553. https://doi.org/10.3201/eid2209.151953
AMA Baker KS, Dallman TJ, Behar A, et al. Travel- and Community-Based Transmission of Multidrug-Resistant Shigella sonnei Lineage among International Orthodox Jewish Communities. Emerging Infectious Diseases. 2016;22(9):1545-1553. doi:10.3201/eid2209.151953.
APA Baker, K. S., Dallman, T. J., Behar, A., Weill, F., Gouali, M., Sobel, J....Thomson, N. R. (2016). Travel- and Community-Based Transmission of Multidrug-Resistant Shigella sonnei Lineage among International Orthodox Jewish Communities. Emerging Infectious Diseases, 22(9), 1545-1553. https://doi.org/10.3201/eid2209.151953.

Feasibility of Using Convalescent Plasma Immunotherapy for MERS-CoV Infection, Saudi Arabia [PDF - 1.17 MB - 8 pages]
Y. M. Arabi et al.

We explored the feasibility of collecting convalescent plasma for passive immunotherapy of Middle East respiratory syndrome coronavirus (MERS-CoV) infection by using ELISA to screen serum samples from 443 potential plasma donors: 196 patients with suspected or laboratory-confirmed MERS-CoV infection, 230 healthcare workers, and 17 household contacts exposed to MERS-CoV. ELISA-reactive samples were further tested by indirect fluorescent antibody and microneutralization assays. Of the 443 tested samples, 12 (2.7%) had a reactive ELISA result, and 9 of the 12 had reactive indirect fluorescent antibody and microneutralization assay titers. Undertaking clinical trials of convalescent plasma for passive immunotherapy of MERS-CoV infection may be feasible, but such trials would be challenging because of the small pool of potential donors with sufficiently high antibody titers. Alternative strategies to identify convalescent plasma donors with adequate antibody titers should be explored, including the sampling of serum from patients with more severe disease and sampling at earlier points during illness.

EID Arabi YM, Hajeer AH, Luke T, Raviprakash K, Balkhy H, Johani S, et al. Feasibility of Using Convalescent Plasma Immunotherapy for MERS-CoV Infection, Saudi Arabia. Emerg Infect Dis. 2016;22(9):1554-1561. https://doi.org/10.3201/eid2209.151164
AMA Arabi YM, Hajeer AH, Luke T, et al. Feasibility of Using Convalescent Plasma Immunotherapy for MERS-CoV Infection, Saudi Arabia. Emerging Infectious Diseases. 2016;22(9):1554-1561. doi:10.3201/eid2209.151164.
APA Arabi, Y. M., Hajeer, A. H., Luke, T., Raviprakash, K., Balkhy, H., Johani, S....Alahmadi, M. (2016). Feasibility of Using Convalescent Plasma Immunotherapy for MERS-CoV Infection, Saudi Arabia. Emerging Infectious Diseases, 22(9), 1554-1561. https://doi.org/10.3201/eid2209.151164.

Prediction of Protection against Asian Enterovirus 71 Outbreak Strains by Cross-neutralizing Capacity of Serum from Dutch Donors, The Netherlands [PDF - 1.04 MB - 8 pages]
S. van der Sanden et al.

Outbreaks of human enterovirus 71 (EV-71) in Asia are related to high illness and death rates among children. To gain insight into the potential threat for the population of Europe, we determined the neutralizing activity in intravenous immunoglobulin (IVIg) batches and individual serum samples from donors in the Netherlands against EV-71 strains isolated in Europe and in Asia. All IVIg batches and 41%, 79%, and 65% of serum samples from children ≤5 years of age, women of childbearing age, and HIV-positive men, respectively, showed high neutralizing activity against a Dutch C1 strain, confirming widespread circulation of EV-71 in the Netherlands. Asian B3–4 and C4 strains were efficiently cross-neutralized, predicting possible protection against extensive circulation and associated outbreaks of those types in Europe. However, C2 and C5 strains that had few mutations in the capsid region consistently escaped neutralization, emphasizing the importance of monitoring antigenic diversity among circulating EV-71 strains.

EID van der Sanden S, Koen G, van Eijk H, Koekkoek SM, de Jong MD, Wolthers KC. Prediction of Protection against Asian Enterovirus 71 Outbreak Strains by Cross-neutralizing Capacity of Serum from Dutch Donors, The Netherlands. Emerg Infect Dis. 2016;22(9):1562-1569. https://doi.org/10.3201/eid2209.151579
AMA van der Sanden S, Koen G, van Eijk H, et al. Prediction of Protection against Asian Enterovirus 71 Outbreak Strains by Cross-neutralizing Capacity of Serum from Dutch Donors, The Netherlands. Emerging Infectious Diseases. 2016;22(9):1562-1569. doi:10.3201/eid2209.151579.
APA van der Sanden, S., Koen, G., van Eijk, H., Koekkoek, S. M., de Jong, M. D., & Wolthers, K. C. (2016). Prediction of Protection against Asian Enterovirus 71 Outbreak Strains by Cross-neutralizing Capacity of Serum from Dutch Donors, The Netherlands. Emerging Infectious Diseases, 22(9), 1562-1569. https://doi.org/10.3201/eid2209.151579.

Staphylococcus aureus Regulatory RNAs as Potential Biomarkers for Bloodstream Infections [PDF - 1.57 MB - 9 pages]
V. Bordeau et al.

Staphylococcus aureus is a commensal bacterium and pathogen. Identifying biomarkers for the transition from colonization to disease caused by this organism would be useful. Several S. aureus small RNAs (sRNAs) regulate virulence. We investigated presence and expression of 8 sRNAs in 83 S. aureus strains from 42 patients with sepsis or septic shock and 41 asymptomatic colonized carriers. Small pathogenicity island sRNAs sprB and sprC were clade specific. Six sRNAs had variable expression not correlated with clinical status. Expression of RNAIII was lower in strains from septic shock patients than in strains from colonized patients. When RNAIII was associated with expression of sprD, colonizing strains could be discriminated from strains in patients with bloodstream infections, including patients with sepsis and septic shock. Isolates associated with colonization might have sRNAs with target expression different from those of disease isolates. Monitoring expression of RNAIII and sprD could help determine severity of bloodstream infections.

EID Bordeau V, Cady A, Revest M, Rostan O, Sassi M, Tattevin P, et al. Staphylococcus aureus Regulatory RNAs as Potential Biomarkers for Bloodstream Infections. Emerg Infect Dis. 2016;22(9):1570-1578. https://doi.org/10.3201/eid2209.151801
AMA Bordeau V, Cady A, Revest M, et al. Staphylococcus aureus Regulatory RNAs as Potential Biomarkers for Bloodstream Infections. Emerging Infectious Diseases. 2016;22(9):1570-1578. doi:10.3201/eid2209.151801.
APA Bordeau, V., Cady, A., Revest, M., Rostan, O., Sassi, M., Tattevin, P....Felden, B. (2016). Staphylococcus aureus Regulatory RNAs as Potential Biomarkers for Bloodstream Infections. Emerging Infectious Diseases, 22(9), 1570-1578. https://doi.org/10.3201/eid2209.151801.

Ebola Virus Disease, Democratic Republic of the Congo, 2014 [PDF - 606 KB - 10 pages]
C. Nanclares et al.

During July–November 2014, the Democratic Republic of the Congo underwent its seventh Ebola virus disease (EVD) outbreak. The etiologic agent was Zaire Ebola virus; 66 cases were reported (overall case-fatality rate 74.2%). Through a retrospective observational study of confirmed EVD in 25 patients admitted to either of 2 Ebola treatment centers, we described clinical features and investigated correlates associated with death. Clinical features were mainly generic. At admission, 76% of patients had >1 gastrointestinal symptom and 28% >1 hemorrhagic symptom. The case-fatality rate in this group was 48% and was higher for female patients (67%). Cox regression analysis correlated death with initial low cycle threshold, indicating high viral load. Cycle threshold was a robust predictor of death, as were fever, hiccups, diarrhea, dyspnea, dehydration, disorientation, hematemesis, bloody feces during hospitalization, and anorexia in recent medical history. Differences from other outbreaks could suggest guidance for optimizing clinical management and disease control.

EID Nanclares C, Kapetshi J, Lionetto F, de la Rosa O, Tamfun J, Alia M, et al. Ebola Virus Disease, Democratic Republic of the Congo, 2014. Emerg Infect Dis. 2016;22(9):1579-1586. https://doi.org/10.3201/eid2209.160354
AMA Nanclares C, Kapetshi J, Lionetto F, et al. Ebola Virus Disease, Democratic Republic of the Congo, 2014. Emerging Infectious Diseases. 2016;22(9):1579-1586. doi:10.3201/eid2209.160354.
APA Nanclares, C., Kapetshi, J., Lionetto, F., de la Rosa, O., Tamfun, J., Alia, M....Bernasconi, A. (2016). Ebola Virus Disease, Democratic Republic of the Congo, 2014. Emerging Infectious Diseases, 22(9), 1579-1586. https://doi.org/10.3201/eid2209.160354.

Medscape CME Activity
Use of Testing for West Nile Virus and Other Arboviruses [PDF - 510 KB - 7 pages]
J. Vanichanan et al.

In the United States, the most commonly diagnosed arboviral disease is West Nile virus (WNV) infection. Diagnosis is made by detecting WNV IgG or viral genomic sequences in serum or cerebrospinal fluid. To determine frequency of this testing in WNV-endemic areas, we examined the proportion of tests ordered for patients with meningitis and encephalitis at 9 hospitals in Houston, Texas, USA. We identified 751 patients (567 adults, 184 children), among whom 390 (52%) experienced illness onset during WNV season (June–October). WNV testing was ordered for 281 (37%) of the 751; results indicated acute infection for 32 (11%). Characteristics associated with WNV testing were acute focal neurologic deficits; older age; magnetic resonance imaging; empirically prescribed antiviral therapy; worse clinical outcomes: and concomitant testing for mycobacterial, fungal, or other viral infections. Testing for WNV is underutilized, and testing of patients with more severe disease raises the possibility of diagnostic bias in epidemiologic studies.

EID Vanichanan J, Salazar L, Wootton SH, Aguilera E, Garcia MN, Murray KO, et al. Use of Testing for West Nile Virus and Other Arboviruses. Emerg Infect Dis. 2016;22(9):1587-1593. https://doi.org/10.3201/eid2209.152050
AMA Vanichanan J, Salazar L, Wootton SH, et al. Use of Testing for West Nile Virus and Other Arboviruses. Emerging Infectious Diseases. 2016;22(9):1587-1593. doi:10.3201/eid2209.152050.
APA Vanichanan, J., Salazar, L., Wootton, S. H., Aguilera, E., Garcia, M. N., Murray, K. O....Hasbun, R. (2016). Use of Testing for West Nile Virus and Other Arboviruses. Emerging Infectious Diseases, 22(9), 1587-1593. https://doi.org/10.3201/eid2209.152050.

Medscape CME Activity
Fluoroquinolone-Resistant and Extended-Spectrum β-Lactamase–Producing Escherichia coli Infections in Patients with Pyelonephritis, United States [PDF - 908 KB - 10 pages]
D. A. Talan et al.

For 2013–2014, we prospectively identified US adults with flank pain, temperature >38.0°C, and a diagnosis of acute pyelonephritis, confirmed by culture. Cultures from 453 (86.9%) of 521 patients grew Escherichia coli. Among E. coli isolates from 272 patients with uncomplicated pyelonephritis and 181 with complicated pyelonephritis, prevalence of fluoroquinolone resistance across study sites was 6.3% (range by site 0.0%–23.1%) and 19.9% (0.0%–50.0%), respectively; prevalence of extended-spectrum β-lactamase (ESBL) production was 2.6% (0.0%–8.3%) and 12.2% (0.0%–17.2%), respectively. Ten (34.5%) of 29 patients with ESBL infection reported no exposure to antimicrobial drugs, healthcare, or travel. Of the 29 patients with ESBL infection and 53 with fluoroquinolone-resistant infection, 22 (75.9%) and 24 (45.3%), respectively, were initially treated with in vitro inactive antimicrobial drugs. Prevalence of fluoroquinolone resistance exceeds treatment guideline thresholds for alternative antimicrobial drug strategies, and community-acquired ESBL-producing E. coli infection has emerged in some US communities.

EID Talan DA, Takhar SS, Krishnadasan A, Abrahamian FM, Mower WR, Moran GJ. Fluoroquinolone-Resistant and Extended-Spectrum β-Lactamase–Producing Escherichia coli Infections in Patients with Pyelonephritis, United States. Emerg Infect Dis. 2016;22(9):1594-1603. https://doi.org/10.3201/eid2209.160148
AMA Talan DA, Takhar SS, Krishnadasan A, et al. Fluoroquinolone-Resistant and Extended-Spectrum β-Lactamase–Producing Escherichia coli Infections in Patients with Pyelonephritis, United States. Emerging Infectious Diseases. 2016;22(9):1594-1603. doi:10.3201/eid2209.160148.
APA Talan, D. A., Takhar, S. S., Krishnadasan, A., Abrahamian, F. M., Mower, W. R., & Moran, G. J. (2016). Fluoroquinolone-Resistant and Extended-Spectrum β-Lactamase–Producing Escherichia coli Infections in Patients with Pyelonephritis, United States. Emerging Infectious Diseases, 22(9), 1594-1603. https://doi.org/10.3201/eid2209.160148.

Enterohemorrhagic Escherichia coli Hybrid Pathotype O80:H2 as a New Therapeutic Challenge [PDF - 1.14 MB - 9 pages]
N. Soysal et al.

We describe the epidemiology, clinical features, and molecular characterization of enterohemorrhagic Escherichia coli (EHEC) infections caused by the singular hybrid pathotype O80:H2, and we examine the influence of antibiotics on Shiga toxin production. In France, during 2005–2014, a total of 54 patients were infected with EHEC O80:H2; 91% had hemolytic uremic syndrome. Two patients had invasive infections, and 2 died. All strains carried stx2 (variants stx2a, 2c, or 2d); the rare intimin gene (eae-ξ); and at least 4 genes characteristic of pS88, a plasmid associated with extraintestinal virulence. Similar strains were found in Spain. All isolates belonged to the same clonal group. At subinhibitory concentrations, azithromycin decreased Shiga toxin production significantly, ciprofloxacin increased it substantially, and ceftriaxone had no major effect. Antibiotic combinations that included azithromycin also were tested. EHEC O80:H2, which can induce hemolytic uremic syndrome complicated by bacteremia, is emerging in France. However, azithromycin might effectively combat these infections.

EID Soysal N, Mariani-Kurkdjian P, Smail Y, Liguori S, Gouali M, Loukiadis E, et al. Enterohemorrhagic Escherichia coli Hybrid Pathotype O80:H2 as a New Therapeutic Challenge. Emerg Infect Dis. 2016;22(9):1604-1612. https://doi.org/10.3201/eid2209.160304
AMA Soysal N, Mariani-Kurkdjian P, Smail Y, et al. Enterohemorrhagic Escherichia coli Hybrid Pathotype O80:H2 as a New Therapeutic Challenge. Emerging Infectious Diseases. 2016;22(9):1604-1612. doi:10.3201/eid2209.160304.
APA Soysal, N., Mariani-Kurkdjian, P., Smail, Y., Liguori, S., Gouali, M., Loukiadis, E....Bonacorsi, S. (2016). Enterohemorrhagic Escherichia coli Hybrid Pathotype O80:H2 as a New Therapeutic Challenge. Emerging Infectious Diseases, 22(9), 1604-1612. https://doi.org/10.3201/eid2209.160304.

Elevated Risk for Antimicrobial Drug–Resistant Shigella Infection among Men Who Have Sex with Men, United States, 2011–2015 [PDF - 494 KB - 4 pages]
A. Bowen et al.

Shigella spp. cause ≈500,000 illnesses in the United States annually, and resistance to ciprofloxacin, ceftriaxone, and azithromycin is emerging. We investigated associations between transmission route and antimicrobial resistance among US shigellosis clusters reported during 2011–2015. Of 32 clusters, 9 were caused by shigellae resistant to ciprofloxacin (3 clusters), ceftriaxone (2 clusters), or azithromycin (7 clusters); 3 clusters were resistant to >1 of these drugs. We observed resistance to any of these drugs in all 7 clusters among men who have sex with men (MSM) but in only 2 of the other 25 clusters (p<0.001). Azithromycin resistance was more common among MSM-associated clusters than other clusters (86% vs. 4% of clusters; p<0.001). For adults with suspected shigellosis, clinicians should culture feces; obtain sex histories; discuss shigellosis prevention; and choose treatment, when needed, according to antimicrobial drug susceptibility. Public health interviews for enteric illnesses should encompass sex practices; health messaging for MSM must include shigellosis prevention.

EID Bowen A, Grass J, Bicknese A, Campbell D, Hurd J, Kirkcaldy RD. Elevated Risk for Antimicrobial Drug–Resistant Shigella Infection among Men Who Have Sex with Men, United States, 2011–2015. Emerg Infect Dis. 2016;22(9):1613-1616. https://doi.org/10.3201/eid2209.160624
AMA Bowen A, Grass J, Bicknese A, et al. Elevated Risk for Antimicrobial Drug–Resistant Shigella Infection among Men Who Have Sex with Men, United States, 2011–2015. Emerging Infectious Diseases. 2016;22(9):1613-1616. doi:10.3201/eid2209.160624.
APA Bowen, A., Grass, J., Bicknese, A., Campbell, D., Hurd, J., & Kirkcaldy, R. D. (2016). Elevated Risk for Antimicrobial Drug–Resistant Shigella Infection among Men Who Have Sex with Men, United States, 2011–2015. Emerging Infectious Diseases, 22(9), 1613-1616. https://doi.org/10.3201/eid2209.160624.
Dispatches

Borrelia miyamotoi–Associated Neuroborreliosis in Immunocompromised Person [PDF - 644 KB - 4 pages]
K. Boden et al.

Borrelia miyamotoi is a newly recognized human pathogen in the relapsing fever group of spirochetes. We investigated a case of B. miyamotoi infection of the central nervous system resembling B. burgdorferi–induced Lyme neuroborreliosis and determined that this emergent agent of central nervous system infection can be diagnosed with existing methods.

EID Boden K, Lobenstein S, Hermann B, Margos G, Fingerle V. Borrelia miyamotoi–Associated Neuroborreliosis in Immunocompromised Person. Emerg Infect Dis. 2016;22(9):1617-1620. https://doi.org/10.3201/eid2209.152034
AMA Boden K, Lobenstein S, Hermann B, et al. Borrelia miyamotoi–Associated Neuroborreliosis in Immunocompromised Person. Emerging Infectious Diseases. 2016;22(9):1617-1620. doi:10.3201/eid2209.152034.
APA Boden, K., Lobenstein, S., Hermann, B., Margos, G., & Fingerle, V. (2016). Borrelia miyamotoi–Associated Neuroborreliosis in Immunocompromised Person. Emerging Infectious Diseases, 22(9), 1617-1620. https://doi.org/10.3201/eid2209.152034.

Persistent Bacillus cereus Bacteremia in 3 Persons Who Inject Drugs, San Diego, California, USA [PDF - 1.45 MB - 3 pages]
G. Schaefer et al.

Bacillus cereus is typically considered a blood culture contaminant; however, its presence in blood cultures can indicate true bacteremia. We report 4 episodes of B. cereus bacteremia in 3 persons who inject drugs. Multilocus sequence typing showed that the temporally associated infections were caused by unrelated clones.

EID Schaefer G, Campbell W, Jenks J, Beesley C, Katsivas T, Hoffmaster AR, et al. Persistent Bacillus cereus Bacteremia in 3 Persons Who Inject Drugs, San Diego, California, USA. Emerg Infect Dis. 2016;22(9):1621-1623. https://doi.org/10.3201/eid2209.150647
AMA Schaefer G, Campbell W, Jenks J, et al. Persistent Bacillus cereus Bacteremia in 3 Persons Who Inject Drugs, San Diego, California, USA. Emerging Infectious Diseases. 2016;22(9):1621-1623. doi:10.3201/eid2209.150647.
APA Schaefer, G., Campbell, W., Jenks, J., Beesley, C., Katsivas, T., Hoffmaster, A. R....Reed, S. (2016). Persistent Bacillus cereus Bacteremia in 3 Persons Who Inject Drugs, San Diego, California, USA. Emerging Infectious Diseases, 22(9), 1621-1623. https://doi.org/10.3201/eid2209.150647.

Trends in Pneumonia Mortality Rates and Hospitalizations by Organism, United States, 2002–2011 [PDF - 660 KB - 4 pages]
B. A. Wuerth et al.

Because the epidemiology of pneumonia is changing, we performed an updated, population-based analysis of hospitalization and case-fatality rates for pneumonia patients in the United States. From 2002 to 2011, hospitalization rates decreased significantly for pneumonia caused by pneumococcus and Haemophilus influenzae but increased significantly for Pseudomonas spp., Staphylococcus aureus, and influenza virus.

EID Wuerth BA, Bonnewell JP, Wiemken TL, Arnold FW. Trends in Pneumonia Mortality Rates and Hospitalizations by Organism, United States, 2002–2011. Emerg Infect Dis. 2016;22(9):1624-1627. https://doi.org/10.3201/eid2209.150680
AMA Wuerth BA, Bonnewell JP, Wiemken TL, et al. Trends in Pneumonia Mortality Rates and Hospitalizations by Organism, United States, 2002–2011. Emerging Infectious Diseases. 2016;22(9):1624-1627. doi:10.3201/eid2209.150680.
APA Wuerth, B. A., Bonnewell, J. P., Wiemken, T. L., & Arnold, F. W. (2016). Trends in Pneumonia Mortality Rates and Hospitalizations by Organism, United States, 2002–2011. Emerging Infectious Diseases, 22(9), 1624-1627. https://doi.org/10.3201/eid2209.150680.

Reduction of Healthcare-Associated Infections by Exceeding High Compliance with Hand Hygiene Practices [PDF - 477 KB - 3 pages]
E. E. Sickbert-Bennett et al.

Improving hand hygiene from high to very high compliance has not been documented to decrease healthcare-associated infections. We conducted longitudinal analyses during 2013–2015 in an 853-bed hospital and observed a significantly increased hand hygiene compliance rate (p<0.001) and a significantly decreased healthcare-associated infection rate (p = 0.0066).

EID Sickbert-Bennett EE, DiBiase LM, Willis TM, Wolak ES, Weber DJ, Rutala WA. Reduction of Healthcare-Associated Infections by Exceeding High Compliance with Hand Hygiene Practices. Emerg Infect Dis. 2016;22(9):1628-1630. https://doi.org/10.3201/eid2209.151440
AMA Sickbert-Bennett EE, DiBiase LM, Willis TM, et al. Reduction of Healthcare-Associated Infections by Exceeding High Compliance with Hand Hygiene Practices. Emerging Infectious Diseases. 2016;22(9):1628-1630. doi:10.3201/eid2209.151440.
APA Sickbert-Bennett, E. E., DiBiase, L. M., Willis, T. M., Wolak, E. S., Weber, D. J., & Rutala, W. A. (2016). Reduction of Healthcare-Associated Infections by Exceeding High Compliance with Hand Hygiene Practices. Emerging Infectious Diseases, 22(9), 1628-1630. https://doi.org/10.3201/eid2209.151440.

Nosocomial Outbreak of Parechovirus 3 Infection among Newborns, Austria, 2014 [PDF - 2.06 MB - 4 pages]
V. Strenger et al.

In 2014, sepsis-like illness affected 9 full-term newborns in 1 hospital in Austria. Although results of initial microbiological testing were negative, electron microscopy identified picornavirus. Archived serum samples and feces obtained after discharge were positive by PCR for human parechovirus 3. This infection should be included in differential diagnoses of sepsis-like illness in newborns.

EID Strenger V, Diedrich S, Boettcher S, Richter S, Maritschnegg P, Gangl D, et al. Nosocomial Outbreak of Parechovirus 3 Infection among Newborns, Austria, 2014. Emerg Infect Dis. 2016;22(9):1631-1634. https://doi.org/10.3201/eid2209.151497
AMA Strenger V, Diedrich S, Boettcher S, et al. Nosocomial Outbreak of Parechovirus 3 Infection among Newborns, Austria, 2014. Emerging Infectious Diseases. 2016;22(9):1631-1634. doi:10.3201/eid2209.151497.
APA Strenger, V., Diedrich, S., Boettcher, S., Richter, S., Maritschnegg, P., Gangl, D....Urlesberger, B. (2016). Nosocomial Outbreak of Parechovirus 3 Infection among Newborns, Austria, 2014. Emerging Infectious Diseases, 22(9), 1631-1634. https://doi.org/10.3201/eid2209.151497.

Large-Scale Survey for Tickborne Bacteria, Khammouan Province, Laos [PDF - 693 KB - 5 pages]
A. J. Taylor et al.

We screened 768 tick pools containing 6,962 ticks from Khammouan Province, Laos, by using quantitative real-time PCR and identified Rickettsia spp., Ehrlichia spp., and Borrelia spp. Sequencing of Rickettsia spp.–positive and Borrelia spp.–positive pools provided evidence for distinct genotypes. Our results identified bacteria with human disease potential in ticks in Laos.

EID Taylor AJ, Vongphayloth K, Vongsouvath M, Grandadam M, Brey PT, Newton PN, et al. Large-Scale Survey for Tickborne Bacteria, Khammouan Province, Laos. Emerg Infect Dis. 2016;22(9):1635-1639. https://doi.org/10.3201/eid2209.151969
AMA Taylor AJ, Vongphayloth K, Vongsouvath M, et al. Large-Scale Survey for Tickborne Bacteria, Khammouan Province, Laos. Emerging Infectious Diseases. 2016;22(9):1635-1639. doi:10.3201/eid2209.151969.
APA Taylor, A. J., Vongphayloth, K., Vongsouvath, M., Grandadam, M., Brey, P. T., Newton, P. N....Dittrich, S. (2016). Large-Scale Survey for Tickborne Bacteria, Khammouan Province, Laos. Emerging Infectious Diseases, 22(9), 1635-1639. https://doi.org/10.3201/eid2209.151969.

Multidrug-Resistant Shigella Infections in Patients with Diarrhea, Cambodia, 2014–2015 [PDF - 1.58 MB - 4 pages]
K. Poramathikul et al.

We observed multidrug resistance in 10 (91%) of 11 Shigella isolates from a diarrheal surveillance study in Cambodia. One isolate was resistant to fluoroquinolones and cephalosporins and showed decreased susceptibility to azithromycin. We found mutations in gyrA, parC, β-lactamase, and mphA genes. Multidrug resistance increases concern about shigellosis treatment options.

EID Poramathikul K, Bodhidatta L, Chiek S, Oransathid W, Ruekit S, Nobthai P, et al. Multidrug-Resistant Shigella Infections in Patients with Diarrhea, Cambodia, 2014–2015. Emerg Infect Dis. 2016;22(9):1640-1643. https://doi.org/10.3201/eid2209.152058
AMA Poramathikul K, Bodhidatta L, Chiek S, et al. Multidrug-Resistant Shigella Infections in Patients with Diarrhea, Cambodia, 2014–2015. Emerging Infectious Diseases. 2016;22(9):1640-1643. doi:10.3201/eid2209.152058.
APA Poramathikul, K., Bodhidatta, L., Chiek, S., Oransathid, W., Ruekit, S., Nobthai, P....Swierczewski, B. (2016). Multidrug-Resistant Shigella Infections in Patients with Diarrhea, Cambodia, 2014–2015. Emerging Infectious Diseases, 22(9), 1640-1643. https://doi.org/10.3201/eid2209.152058.

Contact Tracing for Imported Case of Middle East Respiratory Syndrome, China, 2015 [PDF - 336 KB - 3 pages]
M. Kang et al.

Confirmation of an imported case of infection with Middle East respiratory syndrome coronavirus in China triggered intensive contact tracing and mandatory monitoring. Using a hotline and surveillance video footage was effective for tracing all 110 identified contacts. Contact monitoring detected no secondary transmission of infection in China.

EID Kang M, Song T, Zhong H, Hou J, Wang J, Li J, et al. Contact Tracing for Imported Case of Middle East Respiratory Syndrome, China, 2015. Emerg Infect Dis. 2016;22(9):1644-1646. https://doi.org/10.3201/eid2209.152116
AMA Kang M, Song T, Zhong H, et al. Contact Tracing for Imported Case of Middle East Respiratory Syndrome, China, 2015. Emerging Infectious Diseases. 2016;22(9):1644-1646. doi:10.3201/eid2209.152116.
APA Kang, M., Song, T., Zhong, H., Hou, J., Wang, J., Li, J....Zhang, Y. (2016). Contact Tracing for Imported Case of Middle East Respiratory Syndrome, China, 2015. Emerging Infectious Diseases, 22(9), 1644-1646. https://doi.org/10.3201/eid2209.152116.

Mutation in West Nile Virus Structural Protein prM during Human Infection [PDF - 378 KB - 3 pages]
Y. Lustig et al.

A mutation leading to substitution of a key amino acid in the prM protein of West Nile virus (WNV) occurred during persistent infection of an immunocompetent patient. WNV RNA persisted in the patient’s urine and serum in the presence of low-level neutralizing antibodies. This case demonstrates active replication of WNV during persistent infection.

EID Lustig Y, Lanciotti R, Hindiyeh M, Keller N, Milo R, Mayan S, et al. Mutation in West Nile Virus Structural Protein prM during Human Infection. Emerg Infect Dis. 2016;22(9):1647-1649. https://doi.org/10.3201/eid2209.160132
AMA Lustig Y, Lanciotti R, Hindiyeh M, et al. Mutation in West Nile Virus Structural Protein prM during Human Infection. Emerging Infectious Diseases. 2016;22(9):1647-1649. doi:10.3201/eid2209.160132.
APA Lustig, Y., Lanciotti, R., Hindiyeh, M., Keller, N., Milo, R., Mayan, S....Mendelson, E. (2016). Mutation in West Nile Virus Structural Protein prM during Human Infection. Emerging Infectious Diseases, 22(9), 1647-1649. https://doi.org/10.3201/eid2209.160132.

Multidrug-Resistant Escherichia coli in Bovine Animals, Europe [PDF - 555 KB - 3 pages]
E. Brennan et al.

Of 150 Escherichia coli strains we cultured from specimens taken from cattle in Europe, 3 had elevated MICs against colistin. We assessed all 3 strains for the presence of the plasmid-mediated mcr-1 gene and identified 1 isolate as mcr-1–positive and co-resistant to β-lactam, florfenicol, and fluoroquinolone antimicrobial compounds.

EID Brennan E, Martins M, McCusker MP, Wang J, Alves B, Hurley D, et al. Multidrug-Resistant Escherichia coli in Bovine Animals, Europe. Emerg Infect Dis. 2016;22(9):1650-1652. https://doi.org/10.3201/eid2209.160140
AMA Brennan E, Martins M, McCusker MP, et al. Multidrug-Resistant Escherichia coli in Bovine Animals, Europe. Emerging Infectious Diseases. 2016;22(9):1650-1652. doi:10.3201/eid2209.160140.
APA Brennan, E., Martins, M., McCusker, M. P., Wang, J., Alves, B., Hurley, D....Fanning, S. (2016). Multidrug-Resistant Escherichia coli in Bovine Animals, Europe. Emerging Infectious Diseases, 22(9), 1650-1652. https://doi.org/10.3201/eid2209.160140.

Secondary Infections with Ebola Virus in Rural Communities, Liberia and Guinea, 2014–2015 [PDF - 391 KB - 3 pages]
K. A. Lindblade et al.

Persons who died of Ebola virus disease at home in rural communities in Liberia and Guinea resulted in more secondary infections than persons admitted to Ebola treatment units. Intensified monitoring of contacts of persons who died of this disease in the community is an evidence-based approach to reduce virus transmission in rural communities.

EID Lindblade KA, Nyenswah TG, Keita S, Diallo B, Kateh F, Amoah A, et al. Secondary Infections with Ebola Virus in Rural Communities, Liberia and Guinea, 2014–2015. Emerg Infect Dis. 2016;22(9):1653-1655. https://doi.org/10.3201/eid2209.160416
AMA Lindblade KA, Nyenswah TG, Keita S, et al. Secondary Infections with Ebola Virus in Rural Communities, Liberia and Guinea, 2014–2015. Emerging Infectious Diseases. 2016;22(9):1653-1655. doi:10.3201/eid2209.160416.
APA Lindblade, K. A., Nyenswah, T. G., Keita, S., Diallo, B., Kateh, F., Amoah, A....Dahl, B. A. (2016). Secondary Infections with Ebola Virus in Rural Communities, Liberia and Guinea, 2014–2015. Emerging Infectious Diseases, 22(9), 1653-1655. https://doi.org/10.3201/eid2209.160416.

Changing Diagnostic Methods and Increased Detection of Verotoxigenic Escherichia coli, Ireland [PDF - 342 KB - 2 pages]
T. Rice et al.

The recent paradigm shift in infectious disease diagnosis from culture-based to molecular-based approaches is exemplified in the findings of a national study assessing the detection of verotoxigenic Escherichia coli infections in Ireland. The methodologic changes have been accompanied by a dramatic increase in detections of non-O157 verotoxigenic E. coli serotypes.

EID Rice T, Quinn N, Sleator RD, Lucey B. Changing Diagnostic Methods and Increased Detection of Verotoxigenic Escherichia coli, Ireland. Emerg Infect Dis. 2016;22(9):1656-1657. https://doi.org/10.3201/eid2209.160477
AMA Rice T, Quinn N, Sleator RD, et al. Changing Diagnostic Methods and Increased Detection of Verotoxigenic Escherichia coli, Ireland. Emerging Infectious Diseases. 2016;22(9):1656-1657. doi:10.3201/eid2209.160477.
APA Rice, T., Quinn, N., Sleator, R. D., & Lucey, B. (2016). Changing Diagnostic Methods and Increased Detection of Verotoxigenic Escherichia coli, Ireland. Emerging Infectious Diseases, 22(9), 1656-1657. https://doi.org/10.3201/eid2209.160477.

Multidrug-Resistant Campylobacter coli in Men Who Have Sex with Men, Quebec, Canada, 2015 [PDF - 521 KB - 3 pages]
C. Gaudreau et al.
EID Gaudreau C, Pilon PA, Sylvestre J, Boucher F, Bekal S. Multidrug-Resistant Campylobacter coli in Men Who Have Sex with Men, Quebec, Canada, 2015. Emerg Infect Dis. 2016;22(9):1661-1663. https://doi.org/10.3201/eid2209.151695
AMA Gaudreau C, Pilon PA, Sylvestre J, et al. Multidrug-Resistant Campylobacter coli in Men Who Have Sex with Men, Quebec, Canada, 2015. Emerging Infectious Diseases. 2016;22(9):1661-1663. doi:10.3201/eid2209.151695.
APA Gaudreau, C., Pilon, P. A., Sylvestre, J., Boucher, F., & Bekal, S. (2016). Multidrug-Resistant Campylobacter coli in Men Who Have Sex with Men, Quebec, Canada, 2015. Emerging Infectious Diseases, 22(9), 1661-1663. https://doi.org/10.3201/eid2209.151695.
Letters

Local Persistence of Novel MRSA Lineage after Hospital Ward Outbreak, Cambridge, UK, 2011–2013 [PDF - 406 KB - 2 pages]
M. S. Toleman et al.
EID Toleman MS, Reuter S, Coll F, Harrison EM, Peacock SJ. Local Persistence of Novel MRSA Lineage after Hospital Ward Outbreak, Cambridge, UK, 2011–2013. Emerg Infect Dis. 2016;22(9):1658-1659. https://doi.org/10.3201/eid2209.151100
AMA Toleman MS, Reuter S, Coll F, et al. Local Persistence of Novel MRSA Lineage after Hospital Ward Outbreak, Cambridge, UK, 2011–2013. Emerging Infectious Diseases. 2016;22(9):1658-1659. doi:10.3201/eid2209.151100.
APA Toleman, M. S., Reuter, S., Coll, F., Harrison, E. M., & Peacock, S. J. (2016). Local Persistence of Novel MRSA Lineage after Hospital Ward Outbreak, Cambridge, UK, 2011–2013. Emerging Infectious Diseases, 22(9), 1658-1659. https://doi.org/10.3201/eid2209.151100.

Community-Acquired Clostridium difficile Infection, Queensland, Australia [PDF - 357 KB - 3 pages]
L. Furuya-Kanamori et al.
EID Furuya-Kanamori L, Yakob L, Riley TV, Paterson DL, Baker P, McKenzie SJ, et al. Community-Acquired Clostridium difficile Infection, Queensland, Australia. Emerg Infect Dis. 2016;22(9):1659-1661. https://doi.org/10.3201/eid2209.151115
AMA Furuya-Kanamori L, Yakob L, Riley TV, et al. Community-Acquired Clostridium difficile Infection, Queensland, Australia. Emerging Infectious Diseases. 2016;22(9):1659-1661. doi:10.3201/eid2209.151115.
APA Furuya-Kanamori, L., Yakob, L., Riley, T. V., Paterson, D. L., Baker, P., McKenzie, S. J....Clements, A. (2016). Community-Acquired Clostridium difficile Infection, Queensland, Australia. Emerging Infectious Diseases, 22(9), 1659-1661. https://doi.org/10.3201/eid2209.151115.

Biological Warfare in the 17th Century [PDF - 317 KB - 2 pages]
W. Carus
EID Carus W. Biological Warfare in the 17th Century. Emerg Infect Dis. 2016;22(9):1663-1664. https://doi.org/10.3201/eid2209.152073
AMA Carus W. Biological Warfare in the 17th Century. Emerging Infectious Diseases. 2016;22(9):1663-1664. doi:10.3201/eid2209.152073.
APA Carus, W. (2016). Biological Warfare in the 17th Century. Emerging Infectious Diseases, 22(9), 1663-1664. https://doi.org/10.3201/eid2209.152073.

Bifidobacterium longum Subspecies infantis Bacteremia in 3 Extremely Preterm Infants Receiving Probiotics [PDF - 491 KB - 3 pages]
E. Esaiassen et al.
EID Esaiassen E, Cavanagh P, Hjerde E, Simonsen GS, Støen R, Klingenberg C. Bifidobacterium longum Subspecies infantis Bacteremia in 3 Extremely Preterm Infants Receiving Probiotics. Emerg Infect Dis. 2016;22(9):1664-1666. https://doi.org/10.3201/eid2209.160033
AMA Esaiassen E, Cavanagh P, Hjerde E, et al. Bifidobacterium longum Subspecies infantis Bacteremia in 3 Extremely Preterm Infants Receiving Probiotics. Emerging Infectious Diseases. 2016;22(9):1664-1666. doi:10.3201/eid2209.160033.
APA Esaiassen, E., Cavanagh, P., Hjerde, E., Simonsen, G. S., Støen, R., & Klingenberg, C. (2016). Bifidobacterium longum Subspecies infantis Bacteremia in 3 Extremely Preterm Infants Receiving Probiotics. Emerging Infectious Diseases, 22(9), 1664-1666. https://doi.org/10.3201/eid2209.160033.

Multidrug-Resistant Staphylococcus aureus, India, 2013–2015 [PDF - 457 KB - 2 pages]
M. Kumar
EID Kumar M. Multidrug-Resistant Staphylococcus aureus, India, 2013–2015. Emerg Infect Dis. 2016;22(9):1666-1667. https://doi.org/10.3201/eid2209.160044
AMA Kumar M. Multidrug-Resistant Staphylococcus aureus, India, 2013–2015. Emerging Infectious Diseases. 2016;22(9):1666-1667. doi:10.3201/eid2209.160044.
APA Kumar, M. (2016). Multidrug-Resistant Staphylococcus aureus, India, 2013–2015. Emerging Infectious Diseases, 22(9), 1666-1667. https://doi.org/10.3201/eid2209.160044.

Colistin-Resistant Enterobacteriaceae Carrying the mcr-1 Gene among Patients in Hong Kong [PDF - 406 KB - 3 pages]
S. Wong et al.
EID Wong S, Tse H, Chen J, Cheng V, Ho P, Woo P. Colistin-Resistant Enterobacteriaceae Carrying the mcr-1 Gene among Patients in Hong Kong. Emerg Infect Dis. 2016;22(9):1667-1669. https://doi.org/10.3201/eid2209.160091
AMA Wong S, Tse H, Chen J, et al. Colistin-Resistant Enterobacteriaceae Carrying the mcr-1 Gene among Patients in Hong Kong. Emerging Infectious Diseases. 2016;22(9):1667-1669. doi:10.3201/eid2209.160091.
APA Wong, S., Tse, H., Chen, J., Cheng, V., Ho, P., & Woo, P. (2016). Colistin-Resistant Enterobacteriaceae Carrying the mcr-1 Gene among Patients in Hong Kong. Emerging Infectious Diseases, 22(9), 1667-1669. https://doi.org/10.3201/eid2209.160091.

Cryptococcus gattii Meningitis Complicated by Listeria monocytogenes Infection [PDF - 342 KB - 3 pages]
R. G. Deiss et al.
EID Deiss RG, Bolaris M, Wang A, Filler SG. Cryptococcus gattii Meningitis Complicated by Listeria monocytogenes Infection. Emerg Infect Dis. 2016;22(9):1669-1671. https://doi.org/10.3201/eid2209.160142
AMA Deiss RG, Bolaris M, Wang A, et al. Cryptococcus gattii Meningitis Complicated by Listeria monocytogenes Infection. Emerging Infectious Diseases. 2016;22(9):1669-1671. doi:10.3201/eid2209.160142.
APA Deiss, R. G., Bolaris, M., Wang, A., & Filler, S. G. (2016). Cryptococcus gattii Meningitis Complicated by Listeria monocytogenes Infection. Emerging Infectious Diseases, 22(9), 1669-1671. https://doi.org/10.3201/eid2209.160142.

Melioidosis in Travelers Returning from Vietnam to France [PDF - 313 KB - 3 pages]
J. Gauthier et al.
EID Gauthier J, Gérôme P, Defez M, Neulat-Ripoll F, Foucher B, Vitry T, et al. Melioidosis in Travelers Returning from Vietnam to France. Emerg Infect Dis. 2016;22(9):1671-1673. https://doi.org/10.3201/eid2209.160169
AMA Gauthier J, Gérôme P, Defez M, et al. Melioidosis in Travelers Returning from Vietnam to France. Emerging Infectious Diseases. 2016;22(9):1671-1673. doi:10.3201/eid2209.160169.
APA Gauthier, J., Gérôme, P., Defez, M., Neulat-Ripoll, F., Foucher, B., Vitry, T....Biot, F. V. (2016). Melioidosis in Travelers Returning from Vietnam to France. Emerging Infectious Diseases, 22(9), 1671-1673. https://doi.org/10.3201/eid2209.160169.

mcr-1–Positive Colistin-Resistant Escherichia coli in Traveler Returning to Canada from China [PDF - 496 KB - 3 pages]
M. Payne et al.
EID Payne M, Croxen MA, Lee TD, Mayson B, Champagne S, Leung V, et al. mcr-1–Positive Colistin-Resistant Escherichia coli in Traveler Returning to Canada from China. Emerg Infect Dis. 2016;22(9):1673-1675. https://doi.org/10.3201/eid2209.160177
AMA Payne M, Croxen MA, Lee TD, et al. mcr-1–Positive Colistin-Resistant Escherichia coli in Traveler Returning to Canada from China. Emerging Infectious Diseases. 2016;22(9):1673-1675. doi:10.3201/eid2209.160177.
APA Payne, M., Croxen, M. A., Lee, T. D., Mayson, B., Champagne, S., Leung, V....Lowe, C. (2016). mcr-1–Positive Colistin-Resistant Escherichia coli in Traveler Returning to Canada from China. Emerging Infectious Diseases, 22(9), 1673-1675. https://doi.org/10.3201/eid2209.160177.

Carbapenem-Resistant Enterobacter spp. in Retail Seafood Imported from Southeast Asia to Canada [PDF - 377 KB - 3 pages]
N. Janecko et al.
EID Janecko N, Martz S, Avery BP, Daignault D, Desruisseau A, Boyd D, et al. Carbapenem-Resistant Enterobacter spp. in Retail Seafood Imported from Southeast Asia to Canada. Emerg Infect Dis. 2016;22(9):1675-1677. https://doi.org/10.3201/eid2209.160305
AMA Janecko N, Martz S, Avery BP, et al. Carbapenem-Resistant Enterobacter spp. in Retail Seafood Imported from Southeast Asia to Canada. Emerging Infectious Diseases. 2016;22(9):1675-1677. doi:10.3201/eid2209.160305.
APA Janecko, N., Martz, S., Avery, B. P., Daignault, D., Desruisseau, A., Boyd, D....Reid-Smith, R. J. (2016). Carbapenem-Resistant Enterobacter spp. in Retail Seafood Imported from Southeast Asia to Canada. Emerging Infectious Diseases, 22(9), 1675-1677. https://doi.org/10.3201/eid2209.160305.

Fluoroquinolone-Resistant Mycoplasma genitalium, Southwestern France [PDF - 371 KB - 3 pages]
C. Le Roy et al.
EID Le Roy C, Hénin N, Pereyre S, Bébéar C. Fluoroquinolone-Resistant Mycoplasma genitalium, Southwestern France. Emerg Infect Dis. 2016;22(9):1677-1679. https://doi.org/10.3201/eid2209.160446
AMA Le Roy C, Hénin N, Pereyre S, et al. Fluoroquinolone-Resistant Mycoplasma genitalium, Southwestern France. Emerging Infectious Diseases. 2016;22(9):1677-1679. doi:10.3201/eid2209.160446.
APA Le Roy, C., Hénin, N., Pereyre, S., & Bébéar, C. (2016). Fluoroquinolone-Resistant Mycoplasma genitalium, Southwestern France. Emerging Infectious Diseases, 22(9), 1677-1679. https://doi.org/10.3201/eid2209.160446.

Possible Transmission of mcr-1–Harboring Escherichia coli between Companion Animals and Human [PDF - 355 KB - 3 pages]
X. Zhang et al.
EID Zhang X, Doi Y, Huang X, Li H, Zhong L, Zeng K, et al. Possible Transmission of mcr-1–Harboring Escherichia coli between Companion Animals and Human. Emerg Infect Dis. 2016;22(9):1679-1681. https://doi.org/10.3201/eid2209.160464
AMA Zhang X, Doi Y, Huang X, et al. Possible Transmission of mcr-1–Harboring Escherichia coli between Companion Animals and Human. Emerging Infectious Diseases. 2016;22(9):1679-1681. doi:10.3201/eid2209.160464.
APA Zhang, X., Doi, Y., Huang, X., Li, H., Zhong, L., Zeng, K....Tian, G. (2016). Possible Transmission of mcr-1–Harboring Escherichia coli between Companion Animals and Human. Emerging Infectious Diseases, 22(9), 1679-1681. https://doi.org/10.3201/eid2209.160464.

Acetobacter indonesiensis Bacteremia in Child with Metachromatic Leukodystrophy [PDF - 321 KB - 3 pages]
R. Kohlmann et al.
EID Kohlmann R, Barenberg K, Anders A, Gatermann SG. Acetobacter indonesiensis Bacteremia in Child with Metachromatic Leukodystrophy. Emerg Infect Dis. 2016;22(9):1681-1683. https://doi.org/10.3201/eid2209.160566
AMA Kohlmann R, Barenberg K, Anders A, et al. Acetobacter indonesiensis Bacteremia in Child with Metachromatic Leukodystrophy. Emerging Infectious Diseases. 2016;22(9):1681-1683. doi:10.3201/eid2209.160566.
APA Kohlmann, R., Barenberg, K., Anders, A., & Gatermann, S. G. (2016). Acetobacter indonesiensis Bacteremia in Child with Metachromatic Leukodystrophy. Emerging Infectious Diseases, 22(9), 1681-1683. https://doi.org/10.3201/eid2209.160566.

Inactivation and Environmental Stability of Zika Virus [PDF - 485 KB - 3 pages]
J. A. Müller et al.
EID Müller JA, Harms M, Schubert A, Jansen S, Michel D, Mertens T, et al. Inactivation and Environmental Stability of Zika Virus. Emerg Infect Dis. 2016;22(9):1685-1687. https://doi.org/10.3201/eid2209.160664
AMA Müller JA, Harms M, Schubert A, et al. Inactivation and Environmental Stability of Zika Virus. Emerging Infectious Diseases. 2016;22(9):1685-1687. doi:10.3201/eid2209.160664.
APA Müller, J. A., Harms, M., Schubert, A., Jansen, S., Michel, D., Mertens, T....Münch, J. (2016). Inactivation and Environmental Stability of Zika Virus. Emerging Infectious Diseases, 22(9), 1685-1687. https://doi.org/10.3201/eid2209.160664.

ESBL-Producing Strain of Hypervirulent Klebsiella pneumoniae K2, France [PDF - 298 KB - 2 pages]
L. Surgers et al.
EID Surgers L, Boyd A, Girard P, Arlet G, Decré D. ESBL-Producing Strain of Hypervirulent Klebsiella pneumoniae K2, France. Emerg Infect Dis. 2016;22(9):1687-1688. https://doi.org/10.3201/eid2209.160681
AMA Surgers L, Boyd A, Girard P, et al. ESBL-Producing Strain of Hypervirulent Klebsiella pneumoniae K2, France. Emerging Infectious Diseases. 2016;22(9):1687-1688. doi:10.3201/eid2209.160681.
APA Surgers, L., Boyd, A., Girard, P., Arlet, G., & Decré, D. (2016). ESBL-Producing Strain of Hypervirulent Klebsiella pneumoniae K2, France. Emerging Infectious Diseases, 22(9), 1687-1688. https://doi.org/10.3201/eid2209.160681.

Specificity of Dengue NS1 Antigen in Differential Diagnosis of Dengue and Zika Virus Infection [PDF - 351 KB - 3 pages]
S. Matheus et al.
EID Matheus S, Boukhari R, Labeau B, Ernault V, Bremand L, Kazanji M, et al. Specificity of Dengue NS1 Antigen in Differential Diagnosis of Dengue and Zika Virus Infection. Emerg Infect Dis. 2016;22(9):1691-1693. https://doi.org/10.3201/eid2209.160725
AMA Matheus S, Boukhari R, Labeau B, et al. Specificity of Dengue NS1 Antigen in Differential Diagnosis of Dengue and Zika Virus Infection. Emerging Infectious Diseases. 2016;22(9):1691-1693. doi:10.3201/eid2209.160725.
APA Matheus, S., Boukhari, R., Labeau, B., Ernault, V., Bremand, L., Kazanji, M....Rousset, D. (2016). Specificity of Dengue NS1 Antigen in Differential Diagnosis of Dengue and Zika Virus Infection. Emerging Infectious Diseases, 22(9), 1691-1693. https://doi.org/10.3201/eid2209.160725.

Vibrio cholerae O1 Imported from Iraq to Kuwait, 2015 [PDF - 554 KB - 2 pages]
A. Mukhopadhyay et al.
EID Mukhopadhyay A, Al Benwan K, Samanta P, Chowdhury G, Albert M. Vibrio cholerae O1 Imported from Iraq to Kuwait, 2015. Emerg Infect Dis. 2016;22(9):1693-1694. https://doi.org/10.3201/eid2209.160811
AMA Mukhopadhyay A, Al Benwan K, Samanta P, et al. Vibrio cholerae O1 Imported from Iraq to Kuwait, 2015. Emerging Infectious Diseases. 2016;22(9):1693-1694. doi:10.3201/eid2209.160811.
APA Mukhopadhyay, A., Al Benwan, K., Samanta, P., Chowdhury, G., & Albert, M. (2016). Vibrio cholerae O1 Imported from Iraq to Kuwait, 2015. Emerging Infectious Diseases, 22(9), 1693-1694. https://doi.org/10.3201/eid2209.160811.

Chromosomal Locations of mcr-1 and blaCTX-M-15 in Fluoroquinolone-Resistant Escherichia coli ST410 [PDF - 452 KB - 3 pages]
L. Falgenhauer et al.
EID Falgenhauer L, Waezsada S, Gwozdzinski K, Ghosh H, Doijad S, Bunk B, et al. Chromosomal Locations of mcr-1 and blaCTX-M-15 in Fluoroquinolone-Resistant Escherichia coli ST410. Emerg Infect Dis. 2016;22(9):1689-1691. https://doi.org/10.3201/eid2209.160692
AMA Falgenhauer L, Waezsada S, Gwozdzinski K, et al. Chromosomal Locations of mcr-1 and blaCTX-M-15 in Fluoroquinolone-Resistant Escherichia coli ST410. Emerging Infectious Diseases. 2016;22(9):1689-1691. doi:10.3201/eid2209.160692.
APA Falgenhauer, L., Waezsada, S., Gwozdzinski, K., Ghosh, H., Doijad, S., Bunk, B....Chakraborty, T. (2016). Chromosomal Locations of mcr-1 and blaCTX-M-15 in Fluoroquinolone-Resistant Escherichia coli ST410. Emerging Infectious Diseases, 22(9), 1689-1691. https://doi.org/10.3201/eid2209.160692.

Autochthonous Chikungunya Fever in Traveler Returning to Japan from Cuba [PDF - 350 KB - 3 pages]
M. Tsuboi et al.
EID Tsuboi M, Kutsuna S, Kato Y, Nakayama E, Shibasaki K, Tajima S, et al. Autochthonous Chikungunya Fever in Traveler Returning to Japan from Cuba. Emerg Infect Dis. 2016;22(9):1683-1685. https://doi.org/10.3201/eid2209.160603
AMA Tsuboi M, Kutsuna S, Kato Y, et al. Autochthonous Chikungunya Fever in Traveler Returning to Japan from Cuba. Emerging Infectious Diseases. 2016;22(9):1683-1685. doi:10.3201/eid2209.160603.
APA Tsuboi, M., Kutsuna, S., Kato, Y., Nakayama, E., Shibasaki, K., Tajima, S....Ohmagari, N. (2016). Autochthonous Chikungunya Fever in Traveler Returning to Japan from Cuba. Emerging Infectious Diseases, 22(9), 1683-1685. https://doi.org/10.3201/eid2209.160603.
About the Cover

The New Incurable Wound [PDF - 1.61 MB - 2 pages]
B. Breedlove and P. M. Arguin
EID Breedlove B, Arguin PM. The New Incurable Wound. Emerg Infect Dis. 2016;22(9):1696-1697. https://doi.org/10.3201/eid2209.ac2209
AMA Breedlove B, Arguin PM. The New Incurable Wound. Emerging Infectious Diseases. 2016;22(9):1696-1697. doi:10.3201/eid2209.ac2209.
APA Breedlove, B., & Arguin, P. M. (2016). The New Incurable Wound. Emerging Infectious Diseases, 22(9), 1696-1697. https://doi.org/10.3201/eid2209.ac2209.
Etymologia

Etymologia: β-Lactamase [PDF - 403 KB - 1 page]
EID Etymologia: β-Lactamase. Emerg Infect Dis. 2016;22(9):1689-1631. https://doi.org/10.3201/eid2209.et2209
AMA Etymologia: β-Lactamase. Emerging Infectious Diseases. 2016;22(9):1689-1631. doi:10.3201/eid2209.et2209.
APA (2016). Etymologia: β-Lactamase. Emerging Infectious Diseases, 22(9), 1689-1631. https://doi.org/10.3201/eid2209.et2209.
Conference Summaries

Proceedings of First Histoplasmosis in the Americas and the Caribbean Meeting, Paramaribo, Suriname, December 4–6, 2015
M. Nacher and A. Adenis
Corrections

Correction: Vol. 18, No. 2 [PDF - 328 KB - 1 page]
M. Meriluoto et al.
EID Meriluoto M, Hedman L, Tanner L, Simell V, Mäkinen M, Simell S, et al. Correction: Vol. 18, No. 2. Emerg Infect Dis. 2016;22(9):1695. https://doi.org/10.3201/eid2209.c12209
AMA Meriluoto M, Hedman L, Tanner L, et al. Correction: Vol. 18, No. 2. Emerging Infectious Diseases. 2016;22(9):1695. doi:10.3201/eid2209.c12209.
APA Meriluoto, M., Hedman, L., Tanner, L., Simell, V., Mäkinen, M., Simell, S....Söderlund-Venermo, M. (2016). Correction: Vol. 18, No. 2. Emerging Infectious Diseases, 22(9), 1695. https://doi.org/10.3201/eid2209.c12209.

Correction: Vol. 22, No. 8
EID Correction: Vol. 22, No. 8. Emerg Infect Dis. 2016;22(9):1695. https://doi.org/10.3201/eid2209.c22209
AMA Correction: Vol. 22, No. 8. Emerging Infectious Diseases. 2016;22(9):1695. doi:10.3201/eid2209.c22209.
APA (2016). Correction: Vol. 22, No. 8. Emerging Infectious Diseases, 22(9), 1695. https://doi.org/10.3201/eid2209.c22209.
Page created: August 24, 2018
Page updated: August 24, 2018
Page reviewed: August 24, 2018
The conclusions, findings, and opinions expressed by authors contributing to this journal do not necessarily reflect the official position of the U.S. Department of Health and Human Services, the Public Health Service, the Centers for Disease Control and Prevention, or the authors' affiliated institutions. Use of trade names is for identification only and does not imply endorsement by any of the groups named above.
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