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PurposeTo evaluate the performance of diffusion-weighted imaging (DWI) and variable flip angle (VFA) T1 mapping as a supplement to image-guided biopsy in follow-up analysis of liver fibrosis.

ABSTRACTWe previously reported that the multidrug-resistant (MDR) Acinetobacter baumanniistrain MDR-ZJ06, belonging to European clone II, was widely spread in China. In this study, we report the whole-genome sequence of this clinically important strain. A 38.6-kb AbaR-type genomic resistance island (AbaR22) was identified in MDR-ZJ06. AbaR22 has a structure similar to those of the resistance islands found in A. baumanniistrains AYE and AB0057, but it contained only a few antibiotic resistance genes. The region of resistant gene accumulation as previously described was not found in AbaR22. In the chromosome of the strain MDR-ZJ06, we identified the gene blaoxa-23in a composite transposon (Tn2009). Tn2009shared the backbone with other A. baumanniitransponsons that harbor blaoxa-23, but it was bracketed by two ISAba1elements which were transcribed in the same orientation. MDR-ZJ06 also expressed the armAgene on its plasmid pZJ06, and this gene has the same genetic environment as the armAgene of the Enterobacteriaceae. These results suggest variability of resistance acquisition even in closely related A. baumanniistrains.

Hyperimmunoglobulin E syndrome (HIES) is a rare immunologic disorder. Typical clinical features of HIES include recurrent bacterial pneumonia, lung cysts, characteristic facial features, and newborn dermatitis. The varied clinical presentation can lead to a delayed diagnosis. We herein present a sporadic case of HIES in a man who initially presented with a longstanding history of intractable skin abscesses.

Acinetobacter baumanniiis an important Gram-negative pathogen in hospital-related infections. However, treatment options for A. baumanniiinfections have become limited due to multidrug resistance. Bacterial virulence is often associated with capsule genes found in the K locus, many of which are essential for biosynthesis of the bacterial envelope. However, the roles of other genes in the K locus remain largely unknown.