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Carbapenem resistance among Enterobacterales has become a global health concern. Clinical Escherichia coli isolates producing the metallo β-lactamase NDM have been isolated from two hospitals in Faisalabad, Pakistan. These E. coli strains were characterized by MALDI-TOF, PCR, antimicrobial susceptibility testing, XbaI and S1 nuclease pulsed-field gel electrophoresis (PFGE), conjugation assay, DNA hybridization, whole genome sequencing, bioinformatic analysis, and Galleria mellonella experiments. Thirty-four blaNDM producing E. coli strains were identified among 52 nonduplicate carbapenem-resistant strains. More than 90% of the isolates were found to be multidrug resistant by antimicrobial susceptibility testing. S1 PFGE confirmed the presence of blaNDM gene on plasmids ranging from 40 kbps to 250 kbps, and conjugation assays demonstrated transfer frequencies of blaNDM harboring plasmids ranging from 1.59 10-1 to 6.46 10-8 per donor. Whole genome sequencing analysis revealed blaNDM-5 as the prominent NDM subtype with the highest prevalence of blaOXA-1, blaCTX-M-15, aadA2, aac(6')-Ib-cr, and tet(A) associated resistant determinants. E. coli sequence types: ST405, ST361, and ST167 were prominent, and plasmid Inc types: FII, FIA, FIB, FIC, X3, R, and Y, were observed among all isolates. The genetic environment of blaNDM region on IncF plasmids included partial ISAba125, the bleomycin ble gene, and a class I integron. The virulence genes terC, traT, gad, fyuA, irp2, capU, and sitA were frequently observed, and G. mellonella experiments showed that virulence correlated with the number of virulence determinants. A strong infection control management in the hospital is necessary to check the emergence of carbapenem resistance in Gram-negative bacteria.IMPORTANCEWe describe a detailed analysis of highly resistant clinical E. coli isolates from two tertiary care centers in Pakistan including carbapenem resistance as well as common co-resistance mechanisms. South Asia has a huge problem with highly resistant E. coli. However, we find that though these isolates are very difficult to treat they are of low virulence. Thus the Western world has an increasing problem with virulent E. coli that are mostly of low antibiotic resistance, whereas, South Asia has an increasing problem with highly resistant E. coli that are of low virulence potential. These observations allow us to start to devise methodologies to limit both virulence and resistance and combat problems in developing nations as well as the Western world.

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Coverage on CricInfo Index and Introduction to Jagged Internetworks April 1999: Coca-Cola Cup Nov-Dec 1998: Pakistan v Zimbabwe Nov 1998: Coca-Cola Champions Trophy Oct-Nov 1998: Pakistan v Australia Oct-Nov 1998: Wills International Cup Oct 1998: Zimbabwe v India, Test Match Jun 1998: The Singer Akai Nidahas Trophy More It's Official!

Jagged Internetworks and CricInfo are delighted to host the official internet coverage of England's Tour to the West Indies.Together with RealNetworks, we're able to combine CricInfo's world-beating coverage with live multi-media audio and video broadcasts direct from TWI, the CBU and the BBC under the auspices of the West Indies Cricket Board.England and the West Indies both went into this tour rebounding from decisive Test series losses against Australia and Pakistan, respectively.The West Indies looked to begin a new era by appointing Brian Lara to the captaincy. After a sensationally abandoned First Test led to the scheduling of an unprecedented sixth match in the series, fortunes fluctuated with close finishes and a series undecided until the final match.Following the Tests the two teams embarked on a five-match one-day international contest, carrying on from their finals clash in December's Sharjah Champions Trophy.England, under captain Adam Hollioake, extended their limited-overs winningstreak to nine by winning the first match, only to fall to superior West Indianbatting and bowling firepower in the remaining four games.See CricInfo's Tour Home Page for team details, scorecards, results, statistics, analyses, reports from the play and more.If this is your first encounter with cricket, CricInfo provides numerous explanations.Mick Jagger on Jagged Internetworks: RealVideo at 28 kbps 56 kbps 100 kbpsThe Tests and One-Day Internationals

West Indies v England

Cable & Wireless Series, January - April 1998

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