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Background Stenotrophomonas maltophilia is an opportunistic pathogen observed in both nosocomial and community-onset infections. S. maltophilia is intrinsically resistant to many currently available broad-spectrum antibiotics and is often not included in antimicrobial resistance surveillance studies or stewardship programs' guidelines. Methods A retrospective cohort study of patients with S. maltophilia bloodstream infection (BSI) in the United States was conducted using the 2010–2015 US Premier Healthcare Database. This study described patient characteristics, infection characteristics, antibiotic treatment, and discharge status. Results S. maltophilia was the most common carbapenem-resistant, gram-negative pathogen causing BSIs in this database. Of 486 unique patients with S. maltophilia BSI, 44.6% were assessed as community-onset, 95% of cultures were susceptible to trimethoprim-sulfamethoxazole (TMP-SMX), and 84% were susceptible to fluoroquinolones; 39.1% of patients received a potentially effective antibiotic (fluoroquinolone, doxycycline, ceftazidime, minocycline, or TMP-SMX) during the empiric treatment period (≤3 days post–index culture date), whereas 85.8% received a potential effective antibiotics during the definitive treatment period. The most common antibiotic received as definitive treatment was levofloxacin (48.9%). TMP-SMX was used infrequently empirically (10.5%) and in 38.3% during the definitive period. Compared with BSIs caused by other carbapenem-resistant gram-negative pathogens, S. maltophilia BSIs were more likely to be community-onset, and were more likely to be discharged to home and to have a lower mortality rate. Conclusions This study demonstrated that patients at risk for S. maltophilia BSI are highly variable and that standard of care is not clearly defined, leading to questions regarding the appropriateness of antibiotic treatment among patients. Further efforts are needed to better recognize and treat S. maltophilia BSI. [ABSTRACT FROM AUTHOR]

Wind power generation has seen a dramatic increase in the 21st century and the Department of Energy (DOE) envisions that wind energy will become a much larger part of overall power generation in the U.S. by 2050. Wind turbines have continued to grow in size during the last few decades with towers commonly built at a height of 80 m for typical utility-scale turbines in the Unites States, and this is accompanied by certain transportation and logistics challenges. The newly proposed tall tower technology has been designed to be cost-effective in assembling towers as high as 140 m from precast concrete module components that are capable of transport on the U.S. road system. This paper presents an alternative wind tower design with potential for reducing the overall levelized cost of energy (LCOE); it evaluates a hexagonal precast concrete wind tower solution that facilitates use of a taller wind turbine generator for harvesting stronger, steadier, and more frequent wind resources to increase wind energy production and lower the overall LCOE. An integrated team of industry experts was consulted to support development of a stochastic life cycle cost model using a parametric estimate of the cost and fabrication and assembly schedules of this new wind tower design concept as well as forecasting the projected revenue to be created by the new technology. The study concludes that this new design concept is a commercially viable solution, with an estimated LCOE savings ranging from 2% to 4% compared with the typical 80 m turbine deployed in the United States, and it also provides wind power potential to previously untapped regions in the country. This paper helps to inform energy developers, manufacturers, and policy makers, both regionally and nationally, of a possible economically feasible wind tower design solution. [ABSTRACT FROM AUTHOR]