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Persons with HIV (PWH) are at increased risk for bacterial infections, and previous publications document an increased risk for invasive meningococcal disease (IMD) in particular. This analysis provides evidence that PWH face a 6-fold increase in risk for IMD based on Active Bacterial Core surveillance data collected during 2009-2019.

Escherichia coli multi-locus sequence type ST131 is a globally distributed pandemic lineage that causes multidrug-resistant extra-intestinal infections. ST131 E. coli frequently produce extended-spectrum β-lactamases (ESBLs), which confer resistance to many β-lactam antibiotics and make infections difficult to treat. We sequenced the genomes of 154 ESBL-producing E. coli clinical isolates belonging to the ST131 lineage from patients at the University of Pittsburgh Medical Center (UPMC) between 2004 and 2018. Isolates belonged to the well described ST131 clades A (8%), B (3%), and C (89%). Time-dated phylogenetic analysis estimated that the most recent common ancestor (MRCA) for all clade C isolates emerged around 1989, consistent with previous studies. We identified multiple genes potentially under selection in clade C, including the cell wall assembly gene ftsI, the LPS biosynthesis gene arnC, and the yersiniabactin uptake receptor fyuA. Diverse ESBL-encoding genes belonging to the blaCTX-M, blaSHV, and blaTEM families were identified; these genes were found at varying numbers of loci and in variable numbers of copies across isolates. Analysis of ESBL flanking regions revealed diverse mobile elements that varied by ESBL type. Overall, our findings show that ST131 subclade C dominated among patients and uncover possible signals of ongoing adaptation within this ST131 lineage. [ABSTRACT FROM AUTHOR]

Background: Multiple factors, such as less complex U.S. adult pneumococcal recommendations that could increase vaccination rates, childhood pneumococcal vaccination indirect effects that decrease adult vaccination impact, and increased vaccine hesitancy (particularly in underserved minorities), could diminish the cost‐effectiveness of programs to increase pneumococcal vaccination in older adults. Prior analyses supported the economic favorability of these programs. Methods: A Markov model compared no vaccination and current recommendations (either 20‐valent pneumococcal conjugate vaccine [PCV20] alone or 15‐valent pneumococcal conjugate vaccine plus the 23‐valent pneumococcal polysaccharide vaccine [PCV15/PPSV23]) without or with programs to increase vaccine uptake in Black and non‐Black 65‐year‐old cohorts. Pre‐pandemic population‐ and serotype‐specific pneumococcal disease risk and illness/vaccine costs came from U.S. databases. Program costs were $2.19 per vaccine‐eligible person and increased absolute vaccination likelihood by 7.5%. Delphi panel estimates and trial data informed vaccine effectiveness values. Analyses took a healthcare perspective, discounting at 3%/year over a lifetime time horizon. Results: Uptake programs decreased pneumococcal disease overall. In Black cohorts, PCV20 without program cost $216,805 per quality‐adjusted life year (QALY) gained compared with no vaccination; incremental cost‐effectiveness was $245,546/QALY for PCV20 with program and $425,264/QALY for PCV15/PPSV23 with program. In non‐Black cohorts, all strategies cost >$200,000/QALY gained. When considering the potential indirect effects from childhood vaccination, all strategies became less economically attractive. Increased vaccination with less complex strategies had negligible effects. In probabilistic sensitivity analyses, current recommendations with or without programs were unlikely to be favored at thresholds <$200,000/QALY gained. Conclusion: Current U.S. pneumococcal vaccination recommendations for older adults were unlikely to be economically reasonable with or without programs to increase vaccine uptake. Alternatives to current pneumococcal vaccines that include pneumococcal serotypes associated with adult disease should be considered. See related Editorial by Melissa K. Andrew in this issue. [ABSTRACT FROM AUTHOR]

Cities provide opportunities for biodiversity conservation through the design of urban greenspaces as wildlife habitat. A significant proportion of urban public land is narrow linear road verges, though their small size and harsh environmental conditions (e.g. high soil temperatures) may limit their ability to support plants and animals.We worked with a municipal government in a highly urbanised area to test whether conversion of standard road verges (e.g. lawn) to predominantly native understorey plants (forbs, grasses and shrubs) selected for their abilities to tolerate harsh growing conditions and provide habitat increased the abundance and richness of bees, butterflies and birds. We used a before‐after‐control‐impact experiment and characterised temporal dynamics of biodiversity responses 1 year prior to planting and 4 years post‐planting. We also tested whether traits known to influence species responses to urbanisation (body size and feeding specialisation) mediated responses to road verge plantings.Bee species richness and abundance increased at experimental plantings in the first post‐planting year and remained stable thereafter despite fluctuations at control sites. Butterfly abundance but not richness increased, and there was no evidence of bird responses to plantings.Larger bee species, which are known to be most negatively impacted by urbanisation, benefited more from the road verge plantings, while there was no effect of feeding specialisation. Bird and butterfly traits did not mediate responses to plantings.Synthesis and applications. Road verges comprise a significant proportion of urban green spaces, and our results suggest that despite their small sizes and harsh environmental conditions they can provide habitat for bees and to a lesser extent butterflies. We demonstrated that habitat value can be rapidly enhanced by converting standard road verges to native understorey plants and that these benefits may be greatest for the bee species most negatively impacted by urbanisation. Modifications such as additional plant species or wider verges may be required for urban road verges to provide habitat for a greater range of taxa including birds and butterflies. [ABSTRACT FROM AUTHOR]

Introduction: Information on spatial patterns of water depth in river channels is valuable for numerous applications, but such data can be difficult to obtain via traditional field methods. Ongoing developments in remote sensing technology have enabled various image-based approaches for mapping river bathymetry; this study evaluated the potential to retrieve depth from multispectral images acquired by an uncrewed aircraft system (UAS). Methods: More specifically, we produced depth maps for a 4 km reach of a clearflowing, relatively shallow river using an established spectrally based algorithm, Optimal Band Ratio Analysis. To assess accuracy, we compared image-derived estimates to direct measurements of water depth. The field data were collected by wading and from a boat equipped with an echo sounder and used to survey cross sections and a longitudinal profile. We partitioned our study area along the Sacramento River, California, USA, into three distinct sub-reaches and acquired a separate image for each one. In addition to the typical, self-contained, per-image depth retrieval workflow, we also explored the possibility of exporting a relationship between depth and reflectance calibrated using data from one site to the other two sub-reaches. Moreover, we evaluated whether sampling configurations progressively more sparse than our full field survey could still provide sufficient calibration data for developing robust depth retrieval models. Results: Our results indicate that under favorable environmental conditions like those observed on the Sacramento River during low flow, accurate, precise depth maps can be derived from images acquired by UAS, not only within a sub-reach but also across multiple, adjacent sub-reaches of the same river. Discussion: Moreover, our findings imply that the level of effort invested in obtaining field data for calibration could be significantly reduced. In aggregate, this investigation suggests that UAS-based remote sensing could facilitate highly efficient, cost-effective, operational mapping of river bathymetry at the reach scale in clear-flowing streams. [ABSTRACT FROM AUTHOR]

Mistletoes have a fraught public relations history. Vilified as toxic tree-killing weeds, they have long been targeted for removal by arborists and forest managers concerned with tree health. Research on mistletoe ecology has revealed their positive influence on diversity and community structure via complex networks of interactions. In areas where mistletoe has traditionally been removed, managers are now asking whether these parasitic plants can return on their own or whether they should be reintroduced. To evaluate the practicalities of mistletoe restoration, we inoculated 28 London plane trees Platanus × acerfolia (Aiton) Willd. in inner Melbourne with creeping mistletoe Muellerina eucalyptoides (DC.) Barlow, a locally rare species. Branch dimensions and aspect had no discernible effect on germination or seedling emergence, but trees where access to possums (Trichosurus vulpecula (Kerr, 1792) and Pseudocheirus peregrinus (Boddaert, 1785)) was restricted were 30% more likely to host seedlings. Five years after inoculation, seven mistletoes successfully established on five trees, with two mistletoes bearing fruit. Communications with residents and city users elicited positive feedback, catalysing four additional inoculation trials in urban and forest settings elsewhere. In addition to representing a cost-effective means of enhancing habitat values, mistletoe restoration is useful for addressing open questions about mistletoe ecology and educating the community about the functional roles these parasitic plants play. [ABSTRACT FROM AUTHOR]

We describe 2 cases of extensively drug-resistant Pseudomonas aeruginosa infection caused by a strain of public health concern, as it was recently associated with a nationwide outbreak of contaminated artificial tears. Both cases were detected through database review of genomes in the Enhanced Detection System for Hospital-Associated Transmission (EDS-HAT), a routine genome sequencing–based surveillance program. We generated a high-quality reference genome for the outbreak strain from an isolate from our center and examined the mobile elements encoding bla VIM-80 and bla -GES-9 carbapenemases. We used publicly available Pseudomonas aeruginosa genomes to explore the genetic relatedness and antimicrobial resistance genes of the outbreak strain. [ABSTRACT FROM AUTHOR]

Vancomycin-resistant Enterococcus faecium (VREfm) is a prevalent healthcare-acquired pathogen. Gastrointestinal colonization can lead to difficult-to-treat bloodstream infections with high mortality rates. Prior studies have investigated VREfm population structure within healthcare centers. However, little is known about how and why hospital-adapted VREfm populations change over time. We sequenced 710 healthcare-associated VREfm clinical isolates from 2017-2022 from a large tertiary care center as part of the Enhanced Detection System for Healthcare-Associated Transmission (EDS-HAT) program. Although the VREfm population in our center was polyclonal, 46% of isolates formed genetically related clusters, suggesting a high transmission rate. We compared our collection to 15,631 publicly available VREfm genomes spanning 20 years. Our findings describe a drastic shift in lineage replacement within nosocomial VREfm populations at both the local and global level. Functional and genomic analysis revealed, antimicrobial peptide, bacteriocin T8 may be a driving feature of strain emergence and persistence in the hospital setting., Competing Interests: Ethics Declarations The authors declare no relevant competing interests.