We, and other members of the Swedish national group for recommend

We, and other members of the Swedish national group for recommendations on malaria prophylaxis,22 therefore consider doxycycline at least as safe as mefloquine for use as malaria prophylaxis during early pregnancy. This will add doxycycline

as a choice for pregnant women, especially for those who do not tolerate mefloquine or who travel to areas with resistance to mefloquine. The authors state that they have no conflicts of interest to declare. “
“Schistosoma haematobium infection is mainly associated with urinary schistosomiasis. Here, we describe two cases of S haematobium infection in workers returning to China from Tanzania and Angola. They had hematuria and were misdiagnosed as having tuberculosis or tumor of the bladder. The diagnosis was established by discovery of eggs in the urine. Schistosoma haematobium is an important zoonotic parasite associated mainly with urinary schistosomiasis. Infection in humans Opaganib occurs by skin contact with cercaria-contaminated freshwater during swimming, fishing, and bathing. The find more cercariae burrow into the skin and enter the blood stream of the host where they migrate to the sinusoids of liver to mature into adults. Then, they migrate from that organ and reach the vesical, prostatic, and uterine plexuses by way of the hemorrhoidal veins. Eggs deposited by them in the wall of the urinary bladder and other

organs may cause a granulomatous response Branched chain aminotransferase in the host. The main clinical manifestations of S haematobium infection are hematuria, urinal tract blockages, and fibrosis of the bladder.[1] Schistosoma haematobium infection is endemic to 53 countries and is confined to Africa, the Middle East, India, and Portugal. With economic globalization and rapid development of tourism, the movement of population has become increasingly frequent, which has made possible the spread of this infection to nonendemic countries. In England, France, Italy, Germany, Israel, Denmark, and the

Netherlands, imported schistosomiasis haematobium has been happening for decades.[2-5] However, it is a relatively recent phenomenon in China and other Asian countries.[6] In Africa, it is estimated that there are about 1 million Chinese workers employed mainly in building, water supplying, oil exploiting, and road paving.[7, 8] But, the knowledge of African diseases is lacking among Chinese workers, as well their physicians. As a result, when they are exposed in Africa and present clinical manifestations after returning to China, they are often misdiagnosed. From 2005 to 2009, 17 imported falciparum malaria cases (with one death) in workers returning to Henan Province of China from Africa were misdiagnosed for more than 1 week.[9] In this article, we report two imported cases of S haematobium infection in workers returning to China from Tanzania and Angola.

, 2002; Gutierrez et al, 2005; Romano et al, 2007) Moreover, C

, 2002; Gutierrez et al., 2005; Romano et al., 2007). Moreover, C. burnetii actively

mediates the inhibition of host cell apoptosis by activating Akt and Erk1/2 (Voth & Heinzen, 2009), allowing this relatively slow-growing pathogen (10–12-h replication rate) the opportunity to replicate to high numbers before host cell lysis. These characteristics may be attributable to C. burnetii proteins containing the ankyrin repeat eukaryotic motifs, which have been shown to associate with the PV membrane, microtubules, and mitochondria when expressed ectopically within eukaryotic cells (Voth et al., 2009). In addition, recent reports show a series of C. burnetii-encoded ankyrin repeat domain-containing proteins that are secreted

into host cells by Legionella pneumophila in a type IVB secretion selleck chemicals llc system (T4BSS)-dependant manner (Pan et al., 2008; Voth et al., 2009), highlighting the versatility and importance of this secretion system. Bacterial secretion systems specifically involved in virulence include the type IV secretion systems (T4SS). The T4SSs have been subdivided into two groups: the type IVA secretion system (T4ASS), encoded by the virB operon (Sexton & Vogel, 2002), and the T4BSS (Segal et al., 1998; Vogel et al., 1998). Legionella pneumophila’s T4BSS is essential for effector protein secretion, bacterial intracellular trafficking, and replication within macrophages as well as amoeba (Marra et al., 1992; Berger & Isberg, 1993; Bruggemann et al., 2006; Ninio & Roy, 2007; Shin & Roy, 2008). Analysis of the C. burnetii RSA 493 (Nine Mile Ganetespib cell line phase I strain) genome sequence revealed loci with

significant homology Histamine H2 receptor and gene organization to both region I (RI) and region II of the L. pneumophila T4BSS (Seshadri et al., 2003). The genomic sequence, combined with studies using C. burnetii T4BSS analogs (IcmW, DotB, IcmS, and IcmT) to complement L. pneumophila mutants (Zamboni et al., 2003; Zusman et al., 2003), indicates that C. burnetii expresses a functional T4BSS during infection. Gene expression analysis of the C. burnetii T4BSS has been limited both in the number of homologs analyzed as well as the breadth of the temporal analysis. In an effort to develop an understanding of the transcriptional and translational expression of the C. burnetii T4BSS with an emphasis on early stages of the infectious cycle, we analyzed the RNA expression profile of select RI genes. The C. burnetii T4BSS RI loci contains 12 genes (CBU1652–CBU1641), nine of which are L. pneumophila T4BSS homologs (Seshadri et al., 2003). Following a synchronous infection of host cells by C. burnetii SCVs, total RNA isolated during the initial stages of the infectious cycle was used to analyze the transcription of the C. burnetii T4BSS RI homologs. Here, we provide the first demonstration of the transcriptional linkages between the C.

That is, the positive feedback provided by the pharmacy educator

That is, the positive feedback provided by the pharmacy educator serves to increase pharmacists’ confidence in their own counselling skills, thus reducing communication anxiety.[19] A similar approach to feedback provision has been described this website by de Almeida Neto (2003),[5] however it has not been tested empirically. Future studies should consider introducing principles of MI to

feedback provision. The simulated-patient method with performance feedback was very well received by participants in the reviewed studies,[3,9,10,12,13,20,35] confirming its feasibility and acceptance in assessing the competence of pharmacists and their staff, as well as being part of an educational strategy in the community pharmacy setting.[3,20] The most frequent reason for volunteering in these projects was to find out how their pharmacy was performing, to learn new practice skills, and to improve their counselling services.[18,35] When conducted in a professional and sensitive manner, feedback serves as a sound and effective method of learning, to improve counselling quality, thus being acceptable selleck chemicals for future education and training.[13] Owing to the feedback given, the simulated patient method was ‘motivating and educational’, in encouraging change in practice and in helping improve counselling standards

in the long term.[35] Finally, although simulated patients can be used to assess and educate on a wide variety of scenarios, only three of the 30 reviewed studies used scenarios involving children’s medicines.[33–35] This finding concurs with the systematic review by Mesquita et al., however they reported no studies employing scenarios involving children.[19] This area of pharmacy requires focus, as these studies showed poor management of many childhood ailments.[33–35] Furthermore, two of these three studies[33,34] did not include any element of feedback and training,

which may be an effective tool in improving the management of common childhood ailments, and one had delayed feedback.[35] Finally, the scenarios used in Dimethyl sulfoxide the studies reviewed included the treatment of diarrhoea,[33,34] head lice and rash.[35] Whilst these are commonly presenting symptoms in childhood, it is interesting to note that no studies have had a specific focus on cough and cold or paracetamol (acetaminophen)-based preparations, which are widely used in children and often require weight-based dose calculations.[57–59] Research has shown that parents and caregivers gain much children’s medicines information and advice from pharmacists, yet lack of knowledge or inadequate advice about such medicines can lead to undesirable consequences, such as inappropriate use and dosing.[60,61] More work on improving the way parents manage common childhood ailments through appropriate advice from a pharmacy is warranted.

Methods The setting was a culturally diverse tri-county (Palm Bea

Methods The setting was a culturally diverse tri-county (Palm Beach, Broward and Miami Dade counties) area of South Florida. The research design was cross-sectional and descriptive; data were gathered from respondents using a facilitator-administered survey instrument. Key findings The overall reliability of the survey was 0.669 using Cronbach’s α. When EID and PUM survey statements were analysed alone, internal consistency was 0.692 and

0.545 respectively. The association between scores and select demographic variables were analysed and no correlation was found. The previously validated scale (UK) was not reliable in the complex cultural population of Florida. Conclusions Instruments demonstrating reliability in one country are not immediately replicable www.selleckchem.com/products/NVP-AUY922.html in other countries, even if the same language is spoken. Caution needs to be taken when interpreting the findings BMS-777607 concentration from studies using instruments designed in cultural contexts dissimilar from those in which the have been developed originally. “
“The aim of this review was to establish type(s) and possible cause(s) of medicine-related problems (MRPs) experienced by ethnic minorities in the UK and to identify recommendations to support these patients in the

effective use of medicines. A systematic search of studies related to problems with medicine use experienced by ethnic minorities in the UK was performed using the following databases: PubMed, Embase, International Pharmaceutical Abstract and Scopus from 1990 to 2011. A hand search for relevant citations and key journals was also performed. Fifteen studies were found. The MRPs identified across studies included lack of information, problems with not taking medicines as advised, concern of dependency or side effects, lack of regular monitoring and review, risk of adverse drug reactions, adverse events and problems in accessing healthcare services. Many problems are common

in other groups, however, studies examining possible explanatory factors discussed how the cultural and religious Beta adrenergic receptor kinase beliefs, previous experiences, different expectations, language and communication barriers, lack of knowledge of the healthcare services and underestimating patients’ desire for information may contribute to the problems. Some of the recommendations were made based on the problems that were found, but these have not been evaluated. Little evidence is known of what influences MRPs among ethnic minorities, despite the increased diversification of populations in countries throughout the world. To support their entire populations in the use of medicines, we have to ensure that we understand their different perspectives and needs regarding the effective use of medicines.

This recent expansion of human parietal cortex emerges when compa

This recent expansion of human parietal cortex emerges when comparing the endocasts of archaic Western European Neanderthals to those of modern Homo who, although belonging to different evolutionary lines, share the same cranial capacity and overall brain dimensions. This occurrence favours the identification of specific departures from the Homo allometric trajectory during the evolution CDK assay of Homo sapiens, made apparent by the method of subtraction (Gould, 1966). For example, multivariate morphometrics and geometrical

modelling (Bruner et al., 2003; Bruner, 2008) indicate that modern human endocasts show a significant midsagittal enlargement of the parietofrontal outline, which is more pronounced at the level of parietal cortex, and a dorsovertical lengthening of the parietocerebellar volumes. We interpret this result as reflecting an enlargement of the entire distributed system of which parietal cortex is a crucial node, and which probably also includes the parietocerebellar pathway through the pontine nuclei. Additional insight into the evolution of human parietal cortex can be gained by comparing the deficits of parietal lesions in monkeys and humans.

Generally speaking, some basic features of the parietal lobe syndrome in humans can also be found in monkeys, especially when considering optic ataxia. However, experimental evidence showing that directional hypokinesia can be reproduced in monkeys after unilateral cortical lesions is controversial. In fact, testing for directional BI6727 hypokinesia in animal models has proven to be problematic because the over-training required to get monkeys to perform the visuomotor tasks necessary SB-3CT to measure directional hypokinesia can lead to an important mitigation of the lesion effects, especially when measured by some forms of testing. Therefore, in monkey studies the definition that has been generally adopted for indicating the presence of neglect can be summarize as follows: ‘Diminished

responses to sensory stimulation and disuse of limbs in half of personal and extrapersonal space under certain conditions or testing with preservation of primary sensory and motor response on that side’ (Deuel, 1987). According to this view, lesions of different cortical areas, including IPL (Heilman et al., 1970; Deuel & Farrar, 1993), area PE and PFG in marmoset monkeys (Marshall et al., 2002), superior temporal cortex (Luh et al., 1986; Watson et al., 1994) and premotor cortex (Rizzolatti et al., 1983) lead to behavioural deficits that overall have been interpreted as a form of neglect. Furthermore, the lack of quantitative analyses of most lesion studies in monkeys does not allow any conclusive statement on neglect.

These results suggest that the SigA σ factor could be utilized by

These results suggest that the SigA σ factor could be utilized by RNA polymerase for transcribing the narK2X promoter. However, further experimentation is required to confirm the

possibility. The introduction of M. tb narGHJI or narK2 into M. bovis did not result in an increase in its nitrate reductase activity either under aerobic or hypoxic conditions (Sohaskey & Modesti, 2009). Therefore, it was speculated that the underlying reason for the low LDK378 concentration nitrate reductase activity in M. bovis could be the absence of functional copies of both narGHJI and narK2 genes (Sohaskey & Modesti, 2009). Hence, we complemented M. bovis with both pNarG-GM1 (integrative vector) and pNarK2X (extrachromosomal vector) carrying narGHJI genes and narK2 along with the downstream gene narX gene, respectively. The nitrate reductase activity of M. tb H37Rv was moderate under aerobic conditions and was induced ∼17-fold under hypoxic conditions as expected (Table 4). However, very low aerobic activity Sirolimus cost and no hypoxic induction of nitrate reductase activity were observed in M. bovis or strains harbouring either pNarG-GM1 or pNarK2X or both (Table 4). These results suggest the possibility that robust nitrate reduction in M. tb requires the presence of not merely functional narGHJI and narK2X operons but also some unidentified additional mechanism(s) that is defective

in M. bovis. This notion is supported by the fact that even aerobic nitrate reductase activity of M. bovis was not equivalent to that in the M. tb level despite complementation with M. tb narGHJI here, or as described previously (Sohaskey & Modesti, 2009). A unique NheI restriction site Plasmin (GCTAGC) is created in the 280-bp promoter

region as a consequence of the −6T/C SNP in the narK2X promoter of M. bovis/BCG (Fig. 1). This SNP was exploited to design a new PCR-RFLP assay aimed at differentiating M. tb from M. bovis/BCG. After amplification of the 178-bp narK2X promoter region and NheI-mediated cleavage of the PCR products, two digestion product bands of 120 and 58 bp were observed with DNA from M. bovis AN5 and BCG (vaccine strain, Chennai, India), whereas an intact band of 178 bp was observed with DNA amplified from M. tb (Fig. 2a and b). To further extend the analysis, 36 clinical isolates including M. tb (10), M. bovis (20), BCG (two), M. microti (two) and M. africanum (two) were tested for this RFLP. Except for the M. tb strains, all other MTC member strains produced a two-band pattern and established that the −6T/C SNP is present in all of them. A representative analysis is shown in Fig. 2c. blast analysis of the sequence (http://www.sanger.ac.uk) confirmed the presence of this SNP in M. microti and M. africanum and its absence in Mycobacterium canetti. Two PCR-RFLP methods based on SNPs in gyrB and narGHJI were previously used to differentiate M. tb from MTC members (Niemann et al.

Only 10% of the overall discontinuations observed were because of

Only 10% of the overall discontinuations observed were because of failure; the short follow-up time might have limited the observation of treatment modification due to failure not occurring as a consequence of intolerance/toxicity or poor adherence. The fact that the reason for discontinuation was determined by the clinician and, as such, was a subjective measure might be seen as a limitation.

However, it was the objective of our analysis to use the clinical perception of the main reason for discontinuation to define the study endpoints. Nevertheless, when we defined discontinuation because of failure on the basis of a viral load >500 copies/mL, or an increase in CD4 cell count LY2109761 in vivo of <10% from a patient's pre-therapy value or the occurrence of an AIDS-defining illness, the analysis produced results that were very similar to those of the main analysis. Not surprisingly, we found that patients who started therapy with a nonconventional regimen (‘other regimen’) were more likely to

have treatment discontinuation for any reason and for each specific reason than those starting with a standard combination. In conclusion, it seems important to evaluate reason-specific trends in the incidence of discontinuation in order to better understand the determinants of changes over time. The incidence of discontinuation because of intolerance/toxicity has declined over time, INCB024360 in vivo while simplification strategies have become more frequent in recent years. Despite the fact that drug tolerability has improved and currently available regimens have a reduced pill burden, intolerance/toxicity remains the major cause of drug discontinuation. As reported in our previous study, we confirm that women and HCV-coinfected patients in our cohort are at higher risk of discontinuing HAART. The ICoNA Foundation Study is supported by unrestricted educational grants from Abbott, Boehringer Ingelheim, Bristol-Myers Squibb, Gilead, GSK, Pfizer and Janssen-Cilag. Governing body M. Moroni (Chair), G. Carosi, R. Cauda, F. Chiodo, A. d’Arminio Monforte, G. Di Perri, M. Galli, R. Iardino, G. Ippolito,

A. Lazzarin, F. Mazzotta, R. Panebianco, G. Pastore and C. F. Perno. Steering committee A. Ammassari, A. Antinori, C. Arici, check details C. Balotta, P. Bonfanti, M. R. Capobianchi, A. Castagna, F. Ceccherini-Silberstein, A. Cozzi-Lepri, A. d’Arminio Monforte, A. De Luca, C. Gervasoni, E. Girardi, S. Lo Caputo, F. Maggiolo, R. Murri, C. Mussini, M. Puoti and C. Torti. Participating physicians and centres Italy: M. Montroni, G. Scalise, A. Costantini, A. Riva (Ancona); U. Tirelli, F. Martellotta (Aviano-PN); G. Pastore, N. Ladisa (Bari); F. Suter, F. Maggiolo (Bergamo); F. Chiodo, G. Verucchi, C. Fiorini (Bologna); G. Carosi, G. Cristini, C. Torti, C. Minardi, D. Bertelli (Brescia); T. Quirino (Busto Arsizio); P. E. Manconi, P. Piano (Cagliari); E. Pizzigallo, M.

Electrodes with extremely high- and/or low-frequency artifacts th

Electrodes with extremely high- and/or low-frequency artifacts throughout the entire recording (M = 7.2 ± 3.6) were linearly interpolated using a model of the amplitude topography at the unit sphere surface based on all nonartifactual electrodes (Perrin et al., 1990). Epochs containing nonstereotyped muscular or technical artifacts were removed. An independent component analysis approach was applied

to further reduce artifacts such as eyeblinks, horizontal eye movements, or electrocardiographic activity. Independent components representing artifacts were removed from the EEG data by back-projecting all but these components (for details, see Schneider et al., 2008). Finally, all trials that still exceeded a threshold of 100 μV were rejected automatically. On average, 1.7% (range 0.3–3.1%) of all trials were removed for each AZD1208 mw AZD1152-HQPA participant. Prior to the statistical analysis, outlier trials were removed from pain ratings. To this end, the mean of intensity and unpleasantness ratings was calculated over nonpainful and painful trials separately, pooled across clips. Trials in which the ratings were below or above 3 standard deviations were excluded from further analyses. Based on this criterion, 0.29% of all trials were excluded (range 0.05–0.69%). The effect of viewing needle and Q-tip clips on

stimulus ratings was investigated by subjecting intensity and unpleasantness ratings to separate anovas with the factors visual stimulation (needle prick vs. Q-tip touch) and electrical stimulation (painful vs. nonpainful). As numerous electrical stimuli (360 painful and 360 nonpainful) were administered, it may be that habituation effects influenced the present findings (Condes-Lara et al.,

1981; Babiloni et al., 2006). To examine the possible influence of habituation on the effects in intensity GNA12 and unpleasantness ratings, additional three-way anovas, including the factor time (first and last 50% of trials within each condition), were conducted. The PDR was screened and corrected for outliers in the same way as in our recent study (Höfle et al., 2012). Eye blinks and other artifacts were removed in an interval ranging from 0.2 s before to 0.2 s after blink or artifact onset. Trials were excluded from further analyses if more than 50% of sample points within a trial were artifactual. On average, 1.2% of all trials were excluded following this criterion (range 0–3.1%). For all included trials, periods containing artifacts were linearly interpolated (Siegle et al., 2008). The PDR was normalised as follows: (data−baseline)/baseline. To establish the presence of significant effects in PDRs and to define a time interval for further analyses, point-wise running t-tests between the needle prick and the Q-tip touch trials were computed. To account for alpha error accumulation in multiple testing, time intervals were defined as being significantly different if each sample point within a 0.1 s interval reached a threshold of P = 0.05.

As noted, greater immunosuppression was also associated with a st

As noted, greater immunosuppression was also associated with a stepwise increased

likelihood of bacteraemia. Compared with those with CD4 BAY 73-4506 cost counts >500 cells/μL, those with CD4 counts of 201–350 cells/μL (AOR 1.77, 95% CI 1.46, 2.15), 51–200 cells/μL (AOR 3.23, 95% CI 2.65, 3.94) and ≤50 cells/μL (AOR 7.64, 95% CI 6.14, 9.51) had higher odds of bacteraemia. In addition, compared with those with HIV-1 RNA ≤400 copies/mL, those with higher HIV-1 RNA levels had higher odds of bacteraemia. The likelihood of bacteraemia was higher among IDUs compared with MSM (AOR 1.67, 95% CI 1.43, 1.95), patients aged ≥50 years compared with the youngest group (AOR 1.62, 95% CI 1.22, 2.16) and among Blacks compared with Whites (AOR 1.43, 95% CI 1.20, 1.69). Patients with public coverage and those who were uninsured had higher

odds than those covered by private insurance. In multivariate analysis, the odds of bacteraemia were not significantly associated with receipt of HAART. The unadjusted association of HAART with any episode of bacteraemia was, however, significant (AOR 1.18, 95% CI 1.06, 1.32). The difference arises from the association between HAART, CD4 cell count and HIV-1 RNA. Adjusting for CD4 cell count and HIV-1 RNA is sufficient to reduce the HAART effect (AOR 0.95, 95% CI 0.83, 1.07; data not shown). HAART can result in changes in CD4 and HIV-1 RNA; these variables thus can be considered to be on the causal pathway through which HAART affects bacteraemia, and adjusting for such ‘downstream’ selleck chemicals llc variables will

reduce the direct effect of a causally prior variable. This study has several important findings. First, in the current Endonuclease HAART era the rate of bacteraemia in HIV-infected patients remains significantly higher than that of the general population [9,15,16]. In addition, the adjusted odds of bacteraemia appear to be increasing in recent years. Several modifiable factors appear to be protective against development of bacteraemia, including use of HAART, high CD4 cell count and not using injection drugs. The overall incidence of bacteraemia from 2000 to 2008 in this sample was 13.8 per 1000 PY. Tumbarello et al. reported a bacteraemia incidence rate of 62/1000 PY and Meynard et al. reported an incidence of 55/1000 HIV hospitalizations, both in 1998 [5,8]. While our estimates are lower, these studies were both restricted to hospitalized patients at one clinic site in Europe during the early HAART era, and may not be applicable to HIV-infected patients living in the USA in the current HAART era. Our incidence rate estimates are lower than the estimates in these prior studies, as we included all patients, regardless of hospitalization, in the denominator. Incidence fluctuated over this time period, decreasing from 2000 to 2002, and then rising from 2003 to 2007. It is not clear what produced this nonlinear pattern. Another study examining the incidence of S.

However, the phenotypic analysis revealed that the C-NS and C-S i

However, the phenotypic analysis revealed that the C-NS and C-S isolates with high MICs of cefotaxime and ceftazidime (>16 μg mL−1) produced putative ESBLs (augmented AZD4547 price zones around cefotaxime and ceftazidime disks from the side of that with amoxicillin plus clavulanate in the DDST) or AmpC-like β-lactamases (zones around cefotaxime and ceftazidime disks augmented upon the presence of cloxacillin). The single C-S isolate P3/C154247 with lower cefotaxime and ceftazidime MICs was suggestive of the inducible AmpC expression (blunted zones around cefotaxime and ceftazidime disks from the side of amoxicillin with clavulanate). The results of the IEF and bioassay analyses are shown in Table

3. For the isolates with the

ESBL phenotype, Pembrolizumab clinical trial β-lactamases hydrolyzing cefotaxime and ceftazidime in the bioassay had a pI of 8.2 (Table 3). By PCR and sequencing, this enzyme was identified to be SHV-5. In crude extracts of the putative AmpC producers, the IEF and bioassay revealed the presumptive AmpC enzymes to have a pI of 7.9. The multiplex PCR, followed by amplification and sequencing of the entire gene, identified this AmpC as DHA-1. Both SHV-5 and DHA-1 were found in the isolate P4/C160267. Additionally, all of the isolates produced β-lactamases with pIs of 7.6 and 7.4, identified by PCR and sequencing to be SHV-1 and OXA-1, respectively. The blaDHA-1 gene was identified within a complex class 1 integron almost identical to that in the K. pneumoniae RBDHA strain from the Parisian region (Verdet et al., 2006). The Morganella morganii chromosomal fragment with the blaDHA-1 and ampR genes was separated from the ISCR1 element by a large insertion containing parts of operons sap and psp. The integronic gene cassette array differed from that in RBDHA only by a single mutation in the first cassette, converting it from the aminoglycoside acetyltransferase gene aac(6′)-Ib to the aminoglycoside and quinolone acetyltransferase gene aac(6′)-Ib-cr (Strahilevitz et al., 2009). The cassette was followed by blaOXA-1,

catB3, and arr3 (Table http://www.selleck.co.jp/products/Neratinib(HKI-272).html 3). Mapping of the 3′ part of the integron indicated the same arrangement of the region located between the gene sul1 and the IS6100 element (Verdet et al., 2006). The aac(6′)-Ib-cr and blaOXA-1 genes were also identified in all of the SHV-5-producing isolates, but their genetic context was not elucidated. Three PFGE types were discerned among the isolates, with type A grouping both DHA-1 (subtype A1) and SHV-5 (subtype A2) producers, type B grouping only DHA-1 producers, and type C with the single isolate P4/C160267 coexpressing the two enzymes (Table 3). The pulsotypes of the C-S isolates were identical to the ones of the C-NS isolates obtained from the same patients. By MLST, all of the isolates were assigned to the K. pneumoniae clone ST11 clone. The results of the porin analysis are presented in Tables 3 and 4, and, partially, in Fig. 1.