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Background Whole-genome sequencing has gained interest for assessing antimicrobial resistance (AMR). However, multiple studies have shown a poor correlation between the β-lactam/β-lactamase inhibitor (BL/BLI) phenotype and β-lactamase gene presence/absence. In a recent publication, we found that amplification of β-lactamase encoding genes potentially contribute to BL/BLI resistance and here we explore if gene amplifications allow for better BL/BLI genotype/phenotype correlations. Methods We selected 109 E. coli bacteremia isolates and performed ETests (bioMerieux, Inc) to determine AST profiles using the following BL/BLI antibiotics: ampicillin/sulbactam (SAM), amoxicillin/clavulanic acid (AMC), and piperacillin/tazobactam (TZP). CLSI M100 guidelines (2018) were used to stratify isolates into 4 groups: SAM/AMC/TZP susceptible (Group 1), SAM resistant only (Group 2), SAM/AMC resistant (Group 3), and SAM/AMC/TZP resistant (Group 4). Short-read whole genome sequencing was performed on these isolates and analyzed by identifying AMR genes, establishing multi-locus sequence type (MLST), estimating copy number variants (CNV), and investigating blaTEM-1 promoter regions in relation to phenotype. A t-Distributed Stochastic Neighbor Embedding (t-SNE) clustering method and a core-genome, maximum-likelihood phylogeny was generated to group isolates based on AMR gene content and CNV data. Results We found 34 different MLST groups with the three most common sequence types ST131 (n=41), ST1193 (n=12), and ST648 (n=6). Group 1 and Group 2 isolates had similar copy number estimates of β-lactamase blaTEM-1 (1.8X and 1.5X respectively) while there was an increase for both Group 3 (3.7X) and Group 4 (8.2X) isolates (Table 1). Additionally, blaOXA-1 was primarily present in Group 4 isolates (63%) with elevated copy numbers (5.2X). We did not observe associations of blaTEM-1 promoter regions with each of the BL/BLI Groups. Our t-SNE analysis shows that Group 1, Group 3, and Group 4 isolates cluster independently. Core Genome Maximum-likelihood Phylogeny. Midpoint-rooted core-genome maximum-likelihood phylogeny comparing core elements (MLST) to non core elements (CNV). AMR CNV and presence/absence associate better with BL/BLI phenotypes than do core elements. Conclusion There is a clear delineation between fully susceptible and fully resistant BL/BLI E. coli isolates when gene amplification and presence/absence of narrow-spectrum β-lactamases are considered, which should be considered for BL/BLI resistance prediction models. Disclosures David E. Greenberg, MD, Shionogi: Grant/Research Support.

We characterised the complex surrounding regions of blaSpecies identification was performed by MALDI-TOF MS, and the antimicrobial susceptibility profile was determined by broth microdilution based on European Committee on Antimicrobial Susceptibility Testing (EUCAST) breakpoints. The whole genome sequencing (WGS) of P-10.226 strain was performed using both short-read paired-end sequencing on the Illumina MiSeq platform as well as the long-read Oxford Nanopore MinION.WGS analysis showed that P-10.226 carried blaWe described the novel In1992 carrying bla

Objective Electronic waste is increasing. It is frequently recycled in developing countries. This is the first study to report metals, polybrominated diphenyl-ethers (PBDEs), polychlorinated biphenyls (PCBs), 2,2-bis(4-chlorophenyl)-1,1,1-trichloroethane (p,p'-DDT), and p,p'-DDE concentrations in female e-waste workers. Methods Female Vietnamese recyclers and non-recyclers were studied. Metals and halogenated organics were measured in blood and urine, and compared with levels in women in the US National Health and Nutrition Examination Survey (NHANES). Results Recyclers had higher serum PBDE than nonrecyclers. PCB-138/158 and PCB-153 were higher in 18 to less than 38-year-old nonrecyclers. Median urinary arsenic in both cohorts was six to seven-fold higher than NHANES. Median lead in blood and urine was 40% to 60% higher in recyclers than nonrecyclers. Lead in nonrecyclers was four to six-fold higher than NHANES. Both cohorts had higher arsenic and mercury than NHANES. Conclusion Occupational exposure to PBDEs and lead occurred in recyclers. Environmental exposure to arsenic, lead, and mercury occurred in both cohorts. Occupational and environmental remediation are recommended.

To determine the relationship between obesity, food insecurity and perceived stress in very low income Mexican American women.Cross-sectional baseline data analysis of a randomized clinical trial.Texas-Mexico border region of South Texas.Very Low Income Mexican American Women.The relationship between obesity and food insecurity in a sample of very low income Hispanic women living in South Texas depends on the measure of obesity and the dimension of food insecurity. The only measure of food insecurity associated with all measures of obesity was often not having enough money to afford to eat balanced meals. Waist circumference was associated with the most dimensions of food insecurity, while BMI had the least associations. Finally, perceived stress was not significantly associated with BMI, waist circumference or percent body fat when adjusted for other covariates.We have found a strong and significant relationship between food insecurity related to having enough resources to eat a balanced diet and BMI, waist circumference, and percent body fat in low-income Mexican American women. While behavioural change is an important strategy for reducing obesity, consideration may need to be made as to how food access with high nutritional value, may be in and of itself a contributing factor in obesity in low income populations.