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The pandemic of carbapenem-resistant Enterobacteriaceae (CRE) was primarily due to clonal spread of blaKPC producing Klebsiella pneumoniae. Thus, thoroughly studied CRE cohorts have consisted mostly of K. pneumoniae.
To conduct an extensive epidemiologic analysis of carbapenem-resistant Enterobacter spp. (CREn) from 2 endemic and geographically distinct centers.
CREn were investigated at an Israeli center (Assaf Harofeh Medical Center, January 2007 to July 2012) and at a US center (Detroit Medical Center, September 2008 to September 2009). blaKPC genes were queried by polymerase chain reaction. Repetitive extragenic palindromic polymerase chain reaction and pulsed-field gel electrophoresis were used to determine genetic relatedness.
In this analysis, 68 unique patients with CREn were enrolled. Sixteen isolates (24%) were from wounds, and 33 (48%) represented colonization only. All isolates exhibited a positive Modified Hodge Test, but only 93% (27 of 29) contained blaKPC. Forty-three isolates (63%) were from elderly adults, and 5 (7.4%) were from neonates. Twenty-seven patients died in hospital (40.3% of infected patients). Enterobacter strains consisted of 4 separate clones from Assaf Harofeh Medical Center and of 4 distinct clones from Detroit Medical Center.
In this study conducted at 2 distinct CRE endemic regions, there were unique epidemiologic features to CREn: (i) polyclonality, (ii) neonates accounting for more than 7% of cohort, and (iii) high rate of colonization (almost one-half of all cases represented colonization). Since false-positive Modified Hodge Tests in Enterobacter spp. are common, close monitoring of carbapenem resistance mechanisms (particularly carbapenemase production) among Enterobacter spp. is important.
Infect. Control Hosp. Epidemiol. 2015;36(11):1283–1291
In both the United States and the United Kingdom, the field of intelligence studies represents one of the fastest growing subsets of international history, political science and strategic studies. This dynamism is evidenced not only by the vast volume of publications that are generated, but by the existence of dedicated departments and centres, specialist degree programmes, conferences and professional associations. In the US, intelligence is taught at a host of top universities, typically in the form of advanced option courses and special subjects. Beyond this, there are institutes specifically designed to prepare students for entry-level positions in the intelligence community, including the Center for Intelligence and Security Studies at the University of Mississippi and the Mercyhurst College Institute for Intelligence Studies. A similar landscape exists in the UK, with centres at Brunel, Buckingham and Aberystwyth flanked by undergraduate and postgraduate teaching in intelligence at numerous major academic institutions, with the study of intelligence at Masters' level at the University of Salford fast approaching its 25th anniversary year. The flourishing of intelligence studies is also reflected in the considerable group of content-specific journals. Founded in 1984, Intelligence and National Security is recognised as the most pre-eminent journal, but it is accompanied by Studies in Intelligence, the International Journal of Intelligence and Counterintelligence and the Journal of Intelligence History, the latter which was relaunched along new lines in 2012.
Secret intelligence had always been an element in statecraft, but in the twentieth century, it acquired an altogether new standing as an ingredient in the security arrangements of nations that tired of ‘total warfare’. This applied to the Soviet Union, with its tens of millions of casualties in World War II, and equally to democratic countries, with their memories of Galipoli and Paeschendale. In fact, special factors applied in the case of the democratic nations, with their increasingly universal voting rights. Enfranchised male citizens – who supplied the infantry, yet could make or break the governments that sent them to the front – displayed a fondness for their arms and legs and for life in general. The arrival of the female voter only intensified the aversion to militarism and to body bags. War was no longer acceptable as a reflexive recourse in times of diplomatic crisis. The search for alternative methods yielded initiatives ranging from United Nations mediations to nuclear deterrence. The century's commitment to secret intelligence stemmed from the same source.
To be sure, secret intelligence is an ingredient in military success. It can help to make war more precise and more decisive. But for those very reasons, it can also make war less bloody, especially for the civilians so oft en caught up as ‘collateral’ casualties. Furthermore, it can yield information that anticipates, and helps to prevent, conflict.
From memoirs and academic texts to conspiracy-laden exposes and spy novels, the intelligence services’ secrecy has never stopped people from writing about espionage. Now, this is the first introduction to these official and unofficial histories. Each chapter showcases new archival material, looking at a particular book or series of books and considering issues of production, censorship, representation and reception. Contributors include: Richard Aldrich, intelligence historian; Nicholas Dujmovic, CIA Staff Historian; Matthew Jones, novelist; Jo Wippl, Former CIA operations officer; Keith Jeffery, author of the first official history of MI6 and Chapman Pincher, journalist.
Christopher R. Moran is an Assistant Professor of US National Security in the Department of Politics and International Studies at the University of Warwick. He is also a British Academy Postdoctoral Fellow. Previously, he was a Research Assistant on the AHRC-funded project ‘Landscapes of Secrecy: The CIA and the Contested Record of US Foreign Policy’. In 2011, he was a Kluge Fellow at the Library of Congress. He is the author of Classified: Secrecy and the State in Modern Britain (2012) and has published articles in International History Review, Journal of Cold War Studies and Intelligence and National Security.
Christopher J. Murphy is a Lecturer in Intelligence in the School of Humanities, Languages and Social Sciences at the University of Salford and Programme Leader for the MA in Intelligence and Security Studies. He is the author of Security and Special Operations: SOE and MI5 during the Second World War (2006) and has published articles in Public Policy and Administration, Journal of Contemporary History and The Historical Journal.