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analysis of plasmid pattern in paediatric intensive care unit outbreaks of nosocomial infection due to enterobacter cloacae.sequential outbreaks of nosocomial infection due to multiply-resistant enterobacter cloacae occurred in september 1987, and between december 1988 and january 1989, in a paediatric intensive care unit. a total of eight neonates were affected and most had received ventilatory support. initially, we were unable to determine whether the two outbreaks were caused by the same strain of e. cloacae. after applying plasmid profile analysis to identify epidemic strains, we established that the strain from ...19911684595
[the ratios and kinds of clinical bacteria isolated in taiwan's large-size hospitals].the prevalence of clinical bacteria, as isolated from linko chang-gung memorial hospital (2,300 beds) in the period january 1985 to december 1986 and from taipei veterans general hospital (2,300 beds) during the period january 1986 to december 1986, was analyzed with the following findings: (i) the isolation ratio of anaerobic and aerobic or facultative bactria during the period of investigation were 7.8% (5,513/70,799) and 92.2% (65,286/70,799), respectively. (ii) of the total aerobic or facult ...19892791722
epidemiological typing of isolates from an outbreak of infection with multidrug-resistant enterobacter cloacae by repetitive extragenic palindromic unit b1-primed pcr and pulsed-field gel electrophoresis.an outbreak of multidrug-resistant enterobacter cloacae infection lasted for 4 months in a neonatal intensive care unit (nicu). forty-six isolates from the nicu and 20 epidemiologically unrelated strains were characterized by pulsed-field gel electrophoresis (pfge) and repetitive extragenic palindromic unit b1-primed pcr (repub1-pcr) typing. the pfge patterns after xbai restriction of the bacterial dna were analyzed by computer software (gelcompar) using the upgma (unweighted pair group method w ...19968897183
the prognostic factors of adult gram-negative bacillary meningitis.seventy-seven patients with gram-negative bacillary meningitis (gnbm), 57 males and 20 females, aged 17-86 years, were identified at kaohsiung chang gung memorial hospital, over an 11-year period. fifty-four infections were community-acquired, and 23 were nosocomial; 49 were spontaneous and 28 occurred after head surgery or neurosurgery. the organisms most frequently involved were klebsiella pneumoniae, pseudomonas aeruginosa, escherichia coli, and acinetobacter. rarer pathogens included citroba ...19989777518
in vitro activity of meropenem against common pathogenic bacteria isolated in taiwan.the in vitro antimicrobial activity of meropenem, in comparison with nine other antimicrobial agents, against 12 different common pathogenic bacteria were evaluated to know the susceptibility of common bacteria to meropenem in taiwan. meropenem was active against most gram-positive, gram-negative, and anaerobic bacteria, including methicillin-sensitive staphylococcus aureus, streptococcus pyogenes, enterococcus faecalis, escherichia coli, klebsiella pneumoniae, enterobacter cloacae, pseudomonas ...19989934544
nosocomial gram-negative bacteremia in critically ill patients: epidemiologic characteristics and prognostic factors in 147 episodes.although gram-positive organisms are the most common causes of nosocomial bloodstream infections, gram-negative bacteremia carries higher risks of severe sepsis, septic shock, and death among critically ill patients in intensive care units (icus). we performed a prospective epidemiologic analysis of nosocomial gram-negative bacteremia episodes among icu patients and sought to identify risk factors for mortality among these patients. all episodes of nosocomial gram-negative bacteremia documented ...199910462994
surveillance of antibiotic resistance in taiwan, 1998.for the first national surveillance of antibiotic resistance in taiwan, we collected in 1998 from 22 hospitals (6 medical centers, 15 regional hospitals, and 1 local hospital) 3,211 isolates in all parts of the country. besides 50 random successive isolates from inpatients, each hospital was requested to collect 25 isolates each from positive blood cultures, hospital-acquired infections, outpatients and the pediatric department. we re-speciated all the submitted specimens and determined their an ...199910650488
characteristics of neonatal bacterial meningitis in a teaching hospital in taiwan from 1984-1997.during the period from 1984 to 1997, 85 bacterial meningitis neonates with positive cerebrospinal fluid cultures were treated. the ages of these patients ranged from 1 to 28 days. the male to female ratio was 1.7 to 1. the most common causative agent was group b beta-hemolytic streptococci (gbs, 31.8%), followed by escherichia coli (20%), proteus mirabilis (7.1%), enterobacter cloacae (5.9%), other streptococci excluding streptococcus pneumoniae (5.9%), chryseobacterium meningosepticum (5.9%), e ...200010917879
bacterial cholangitis in patients with biliary atresia: impact on short-term outcome.bacterial cholangitis (bc) is a common complication in patients with biliary atresia (ba) and is characterized by fever, acholic stools and positive blood cultures. the diagnosis is often empirical because the yield of blood cultures is low. it is difficult to differentiate bc from other febrile episodes. in order to characterize the clinical and laboratory features of bc in patients with ba, identify risk factors, and correlate cholangitis with outcome, 37 patients with ba from 1993 to 1998 who ...200111527173
antimicrobial susceptibilities among clinical isolates of extended-spectrum cephalosporin-resistant gram-negative bacteria in a taiwanese university hospital.infections caused by gram-negative bacteria with resistance to extended-spectrum cephalosporins require the identification of effective alternative antimicrobial therapy. to determine the role of other pre-existing or currently available antimicrobial agents in treating infections caused by these multidrug-resistant pathogens, we evaluated the in vitro susceptibilities of these agents in 411 non-duplicate isolates of extended-spectrum cephalosporin-resistant gram-negative bacteria recovered betw ...200211751769
multicenter surveillance of antimicrobial resistance of major bacterial pathogens in intensive care units in 2000 in taiwan.a susceptibility surveillance study of 1,274 bacterial isolates recovered from various clinical specimens from patients in intensive care units (icus) of five major teaching hospitals was carried out from march, 2000, to june, 2000, in taiwan. this study demonstrated a high rate (66%) of oxacillin resistance in staphylococcus aureus (orsa), a high rate of nonsusceptibility to penicillin (intermediate, 50% and highly resistant, 8%), and high rates of cefotaxime nonsusceptibility for s. pneumoniae ...200111822777
emerging fluoroquinolone-resistance for common clinically important gram-negative bacteria in taiwan.the in vitro antimicrobial activity of the three most commonly used fluoroquinolones (norfloxacin, ofloxacin and ciprofloxacin) was measured for 2235 isolates of seven common pathogenic gram-negative bacteria. collected from a major teaching hospital in taiwan during the years 1985-86, 1989-90, and 1996-97, the samples were evaluated using the agar dilution method. the overall susceptibility to fluoroquinolones has decreased rapidly after the wide use of these antimicrobial agents. isolates of e ...200212088622
metallo-beta-lactamase-producing enterobacteriaceae isolates in a university hospital in taiwan: prevalence of imp-8 in enterobacter cloacae and first identification of vim-2 in citrobacter freundii.a total of 9082 clinical isolates of enterobacteriaceae other than klebsiella spp. collected in 1999 and 2000 at a university hospital in taiwan were investigated for the production of metallo- beta-lactamases (mbls). thirty-six (2.9%) of the 1261 enterobacter cloacae isolates and one (0.3%) of the 340 citrobacter freundii isolates were found to carry bla(imp-8) and bla(vim-2), respectively, by colony hybridization, pcr and sequence analysis. the imp-8 producers were recovered from 20 patients a ...200212356794
bacteremia in hematological and oncological children with febrile neutropenia: experience in a tertiary medical center in taiwan.a retrospective study of bacteremia in children with febrile neutropenia admitted to a medical center in taiwan from january 1999 to december 1999 was performed. there were 190 episodes of febrile neutropenia during this period and 46 pathogens were isolated from blood specimens in 38 bacteremic episodes (7 mixed infections). pseudomonas aeruginosa (17.4%), staphylococcus aureus (10.9%), klebsiella pneumoniae (10.9%), and enterobacter cloacae (10.9%) were the most common isolates. three of the 5 ...200314582565
the status of antimicrobial resistance in taiwan among gram-negative pathogens: the taiwan surveillance of antimicrobial resistance (tsar) program, 2000.in a nationwide surveillance of antimicrobial resistance (taiwan surveillance of antimicrobial resistance, tsar), isolates were collected from 21 medical centers and regional hospitals throughout taiwan over a three-month period in 2000 (tsar ii). this report summarizes susceptibility data of 7 common gram-negative bacilli (escherichia coli, klebsiella pneumoniae, serratia marcescens, proteus mirabilis, enterobacter cloacae, pseudomonas aeruginosa, and acinetobacter baumannii) in the tsar ii col ...200415023432
trends and antimicrobial resistance of pathogens causing bloodstream infections among febrile neutropenic adults with hematological malignancy.the microbiological spectrum in cancer patients with febrile neutropenia has changed over the past several decades in western countries. the growing incidence of antimicrobial resistance is an inevitable consequence of the widespread use of antibiotics in medical settings. the aim of this study was to clarify the trends and antimicrobial resistance among pathogens causing bloodstream infections in febrile neutropenic adults with hematological malignancies.200415318274
nosocomial and community-acquired enterobacter cloacae bloodstream infection: risk factors for and prevalence of shv-12 in multiresistant isolates in a medical centre.in a medical centre in northern taiwan, 60 patients had bloodstream infection caused by enterobacter cloacae from 1 january 2002 to 30 april 2003. forty (66.7%) were nosocomial and 26 were caused by multiresistant isolates. twenty patients died due to the infection. central venous catheterization and mechanical ventilation were relative risks for nosocomial e. cloacae infection. age and mechanical ventilation were risk factors for multiresistant e. cloacae infection. mortality was associated wit ...200415350716
variety of tem-, shv-, and ctx-m-type beta-lactamases present in recent clinical isolates of escherichia coli, klebsiella pneumoniae, and enterobacter cloacae from taiwan.a total of 171 hospitals' isolates of e. coli, k. pneumoniae, and e. cloacae with a minimum inhibitory concentration (mic) of > or =2 microg/ml for ceftazidime or cefotaxime were evaluated for the production of beta-lactamases. pcr amplification with specific primers for the bla (shv), bla (tem), and bla (ctx) genes revealed that a total of 53, 81, and 43 of these genes were amplified, respectively. sequencing results confirmed that tem-1, ctx-m-3 and -14, shv-1, -5, -11, -12, and -33, oxy-1a, a ...200515770092
development of a multiplex pcr and shv melting-curve mutation detection system for detection of some shv and ctx-m beta-lactamases of escherichia coli, klebsiella pneumoniae, and enterobacter cloacae in taiwan.infection by extended-spectrum beta-lactamase (esbl)-producing enterobacteriaceae has been increasing in taiwan. accurate identification of the esbl genes is necessary for surveillance and for epidemiological studies of the mode of transmission in the hospital setting. we describe herein the development of a novel system, which consists of a multiplex pcr to identify bla(shv), bla(ctx-m-3)-like, and bla(ctx-m-14)-like genes and a modified shv melting-curve mutation detection method to rapidly di ...200516145096
relationships between antimicrobial use and antimicrobial resistance in gram-negative bacteria causing nosocomial infections from 1991-2003 at a university hospital in taiwan.this study was conducted to evaluate the relationship between antimicrobial resistance and antimicrobial use in a university hospital in taiwan. disk susceptibility data of escherichia coli, klebsiella pneumoniae, enterobacter cloacae, serratia marcescens, proteus spp., pseudomonas aeruginosa, acinetobacter spp., stenotrophomonas maltophilia and other non-fermentative gram-negative bacilli causing nosocomial infections were evaluated. data on annual patient-days and annual consumption (defined d ...200516280243
characterisation and molecular epidemiology of extended-spectrum beta-lactamase-producing enterobacter cloacae isolated from a district teaching hospital in taiwan.enterobacter cloacae (n = 110) isolates from a district hospital in taiwan were screened for extended-spectrum beta-lactamases (esbls). in total, 17 esbl-producers were identified, based on the combination-disk synergy test using cefotaxime and ceftazidime +/- clavulanic acid. investigation of esbl genes in 33 ceftazidime-resistant isolates revealed the shv-12 gene in the same 17 esbl-producers. in addition, one isolate also carried the ctx-m-3 gene, and two isolates also carried the ctx-m-9 gen ...200616700709
extended-spectrum beta-lactamases in taiwan: epidemiology, detection, treatment and infection control.extended-spectrum beta-lactamases (esbls) efficiently hydrolyze extended-spectrum beta-lactams such as cefotaxime, ceftriaxone, ceftazidime, and aztreonam. esbls are most often plasmid-mediated. in taiwan, the prevalence of esbls in bacteria has risen, ranging from 8.5 to 29.8% in klebsiella pneumoniae and 1.5 to 16.7% in escherichia coli isolates. the most prevalent types of esbls are shv-5, shv-12, ctx-m-3, and ctx-m-14 in isolates of k. pneumoniae and e. coli, with differences between institu ...200616926972
prevalence of plasmid-mediated quinolone resistance determinants qnra, qnrb, and qnrs among clinical isolates of enterobacter cloacae in a taiwanese hospital.the prevalence of three plasmid-mediated quinolone resistance determinants, qnra, qnrb, and qnrs, among 526 nonreplicate clinical isolates of enterobacter cloacae collected at a taiwanese university hospital in 2004 was determined by pcr and colony hybridization, and the association of qnr with the imp-8 metallo-beta-lactamase was investigated. eighty-six (16.3%) of all isolates were qnr positive, and the qnra1-like, qnrb2-like, and qnrs1-like genes were detected alone or in combination in 3 (0. ...200717242140
in vitro activity of isepamicin and other aminoglycosides against clinical isolates of gram-negative bacteria causing nosocomial bloodstream infections.isepamicin is a newly introduced aminoglycoside in taiwan. since in vitro data for isepamicin against nosocomial gram-negative bloodstream infection from taiwan are limited, we compared the activity of isepamicin, amikacin, gentamicin and tobramycin against nosocomial gram-negative blood isolates.200718087627
nationwide surveillance of antimicrobial resistance among enterobacteriaceae in intensive care units in taiwan.to determine the antimicrobial resistance profiles among clinical isolates of enterobacteriaceae in taiwanese intensive care units (icus), a national surveillance of antibiotic resistance among important enterobacteriaceae was conducted from september 2005 through november 2005 at the icus of ten major teaching hospitals in taiwan. a total of 574 enterobacteriaceae isolates recovered from various clinical samples of our icu patients were submitted for in vitro test. minimum inhibitory concentrat ...200918716805
in vitro activity of tigecycline against clinical isolates of extended-spectrum beta-lactamase-producing klebsiella pneumoniae, serratia marcescens and enterobacter cloacae.strains of extended-spectrum beta-lactamase (esbl)-producing enterobacteriaceae have spread widely in taiwan hospitals. in this study, we evaluated the in vitro antimicrobial activity of tigecycline against esbl-producing enterobacteriaceae, including klebsiella pneumoniae, serratia marcescens and enterobacter cloacae.200818787741
prevalence of extended-spectrum beta-lactamases in enterobacter cloacae in taiwan and comparison of 3 phenotypic confirmatory methods for detecting extended-spectrum beta-lactamase production.the prevalence of extended-spectrum beta-lactamases (esbls) in enterobacter cloacae remains unclear in taiwan. this study was conducted to investigate the prevalence of esbl-producing e. cloacae in taiwan.200919949754
screening extended-spectrum beta-lactamase production in enterobacter cloacae and serratia marcescens using antibiogram-based methods.in enterobacter cloacae and serratia marcescens, ampc beta-lactamases can confer resistance to the third-generation cephalosporins and oxacephems, but not to the fourth-generation cephalosporins. extended-spectrum beta-lactamases (esbl) may confer resistance to all extended-spectrum cephalosporins but not flomoxef. as difficult to detect, the esbl phenotype of the intrinsically ampc- producing e. cloacae and s. marcescens is not routinely screened in the clinical microbiology laboratories. the d ...201020434120
long-term characteristics of healthcare-associated infections in a neonatal intensive care unit.healthcare-associated infections in neonatal intensive care units (nicus) are associated with a significant risk of morbidity and mortality. knowledge regarding pathogens, primary sources of infection and antibiotic resistance in the nicu is essential for developing management strategies. this study aimed to analyze the long-term characteristics of healthcare-associated infections in a tertiary referral center in southern taiwan.201021075708
correlation between antibiotic consumption and resistance of gram-negative bacteria causing healthcare-associated infections at a university hospital in taiwan from 2000 to 2009.this study investigated the correlation between antibiotic consumption and antimicrobial resistance in gram-negative bacteria causing healthcare-associated infections at a university hospital in taiwan from 2000 to 2009.201121436153
changing trends in antimicrobial resistance of major bacterial pathogens, 1985-2005: a study from a medical center in northern taiwan.antimicrobial resistance is a major health problem worldwide. we evaluated the antimicrobial resistance trends of 16 major bacterial pathogens at a tertiary medical center in northern taiwan.201121439516
metallo-ß-lactamase-producing enterobacteriaceae isolates at a taiwanese hospital: lack of distinctive phenotypes for screening.liao i-c, chen h-m, wu j-j, tsai p-f, wang l-r, yan j-j. metallo-ß-lactamase-producing enterobacteriaceae isolates at a taiwanese hospital: lack of distinctive phenotypes for screening. apmis 2011; 119: 543-50. we investigated the prevalence of metallo-ß-lactamases (mbls) among 1,827 enterobacteriaceae isolates collected in 2006 and evaluated the vitek 2 microbiology system, modified hodge test, and 2 combined disk tests as the screening tools for mbls by using these isolates and 77 previously c ...201121749455
characterization of ertapenem-resistant enterobacter cloacae in a taiwanese university hospital.the emergence of carbapenem resistance in enterobacteriaceae has become a great concern. the aim of this study was to characterize ertapenem resistant enterobacter cloacae isolates from a taiwanese university hospital. a total of 355 non-duplicated e. cloacae collected in 2007 were analyzed by antimicrobial susceptibility testing with and without inhibitors of efflux pump and ampc β-lactamase. phenotype of esbl, profile of outer membrane proteins (omps), and clonal relatedness were investigated ...201122135256
carbapenem-nonsusceptible enterobacteriaceae in taiwan.a total of 1135 carbapenem-resistant (nonsusceptible) enterobacteriaceae (cre) isolates were recovered between november 2010 and july 2012 (517 from 2010-2011 and 618 from 2012) from 4 hospitals in taiwan. carbapenemase-producing enterobacteriaceae (cpe) comprised 5.0% (57 isolates), including 17 kpc-2 (16 klebsiella pneumoniae and 1 escherichia coli), 1 ndm-1 (k. oxytoca), 37 imp-8 (26 enterobacter cloacae, 4 citrobacter freundii, 4 raoultella planticola, 1 k. pneumoniae, 1 e. coli and 1 k. oxy ...201525794144
risk factor analysis for extended-spectrum β-lactamase-producing enterobacter cloacae bloodstream infections in central taiwan.enterobacter cloacae (e.cloacae) bloodstream infection (ecbsi) is an important cause of morbidity and mortality, with an increasing incidence in our hospital. we wanted to elucidate the risk factors of mortality among patients with esbl-positive ecbsi in central taiwan.201324010678
rates of susceptibility of carbapenems, ceftobiprole, and colistin against clinically important bacteria collected from intensive care units in 2007: results from the surveillance of multicenter antimicrobial resistance in taiwan (smart).data on susceptibility to ceftobiprole and colistin, and the complete evolutionary trends of minimum inhibitory concentrations (mics) of important carbapenem agents among important pathogens collected in intensive care units (icus) in taiwan are lacking.201625661253
carbapenem susceptibilities and non-susceptibility concordance to different carbapenems amongst clinically important gram-negative bacteria isolated from intensive care units in taiwan: results from the surveillance of multicentre antimicrobial resistance in taiwan (smart) in 2009.to investigate the in vitro susceptibilities to various carbapenems amongst clinical gram-negative bacteria isolated from patients in intensive care units of ten major teaching hospitals in taiwan in 2009, a survey was conducted to determine the minimum inhibitory concentrations (mics) of ertapenem, imipenem, meropenem and doripenem against isolates of enterobacteriaceae (n = 594), pseudomonas aeruginosa (n = 185), acinetobacter baumannii (n = 192) and burkholderia cepacia (n = 23) using the aga ...201323507415
bloodstream infections caused by imp-8-producing enterobacteriaceae isolates: the need for clinical laboratory detection of metallo-β-lactamases?a retrospective study was conducted at a taiwanese medical center to characterize bloodstream infections caused by imp-8 metallo-β-lactamase (mbl)-producing enterobacteriaceae isolates and to assess the need for laboratory detection of imp producers. we analyzed 37 patients infected with imp-8 producers (two escherichia coli, nine klebsiella pneumoniae, 25 enterobacter cloacae, and one citrobacter freundii) and 107 patients infected with non-imp-8 producers (eight e. coli, 26 k. pneumoniae, 70 e ...201323001510
characterization of the modified hodge test-positive isolates of enterobacteriaceae in taiwan.the modified hodge test is a phenotypic test to detect kpc-type carbapenemase producers among enterobacteriaceae, as recommended by the clinical laboratory standards institute. however, false positive results were reported. in this study, we aimed to large-scale investigate the characterization of the modified hodge test-positive isolates of enterobacteriaceae collected between 2006 and 2010 in taiwan.201322578642
in vitro susceptibilities of clinical isolates of ertapenem-non-susceptible enterobacteriaceae to cefotaxime, ceftazidime, cefepime and aztreonam.to investigate the in vitro susceptibility of ertapenem-non-susceptible enterobacteriaceae (ense) isolates to cefotaxime, ceftazidime, cefepime and aztreonam.201222345386
a snapshot of co-resistance to carbapenems and tigecycline in clinical isolates of enterobacter cloacae.enterobacter cloacae is one of the most common carbapenem-resistant enterobacteriaceae (cre) global wide. resistance to tigecycline, one of the few therapeutic options for cre infections, in carbapenem-resistant e. cloacae is of clinical significance. fourteen e. cloacae clinical isolates (ec1-ec14) co-resistant to tigecycline and carbapenems were studied. two tigecycline-susceptible/carbapenem-resistant isolates (ts1-ts2) were used for comparison. genotyping by pulsed-field gel electrophoresis ...201727136494
comparison of commonly used antimicrobial susceptibility testing methods for evaluating susceptibilities of clinical isolates of enterobacteriaceae and nonfermentative gram-negative bacilli to cefoperazone-sulbactam.the aim of this study was to investigate the cefoperazone-sulbactam (cfp-sul) susceptibilities of important gram-negative bacteria (gnb) by agar dilution (reference method), disk diffusion, and two automated methods.201526454423
characterization of is26-composite transposons and multidrug resistance in conjugative plasmids from enterobacter cloacae.shv-12 is the most widespread resistance determinant of enterobacter cloacae in taiwan; however, blashv-12 has rarely been mobilized. six multidrug-resistant e. cloacae isolates were collected. after conjugal transfer, plasmid profiling and analysis of incompatibility groups was performed to characterize the genetic context of blashv-12 -containing fragments. the presence of mobile genetic elements was demonstrated by pcr, cloning, sequencing and bioinformatics analyses. four different β-lactama ...201526223152
carbapenem susceptibility among escherichia coli, klebsiella pneumoniae, and enterobacter cloacae isolates obtained from patients in intensive care units in taiwan in 2005, 2007, and 2009.to investigate the evolutionary trends in non-susceptibility of carbapenems against the isolates of escherichia coli, klebsiella pneumoniae, and enterobacter cloacae from patients hospitalized in intensive care units (icus) of major teaching hospitals throughout taiwan during 2005-2009, we applied the breakpoints of mics recommended by clinical and laboratory standards institute and european committee on antimicrobial susceptibility testing in 2013. escalations in imipenem mic levels for overall ...201525600841
risk factors of community-onset urinary tract infections caused by plasmid-mediated ampc β-lactamase-producing enterobacteriaceae.the ampc β-lactamase (ampc)-producing enterobacteriaceae emerged worldwide. this study was conducted to determine the risk factors of community-onset urinary tract infections (utis) caused by plasmid-mediated ampc-producing enterobacteriaceae.201524239065
relationship between the distribution of cefepime minimum inhibitory concentrations and detection of extended-spectrum β-lactamase production among clinically important enterobacteriaceae isolates obtained from patients in intensive care units in taiwan: results from the surveillance of multicenter antimicrobial resistance in taiwan (smart) in 2007.the data on susceptibility of important cephalosporins against four enterobacteriaceae members producing potential extended-spectrum β-lactamase (esbl) collected from taiwanese intensive care units are lacking.201523973410
outbreak of ertapenem-resistant enterobacter cloacae urinary tract infections due to a contaminated ureteroscope.outbreaks of urinary tract infections (utis) due to contaminated ureteroscopes have been rarely reported.201323954065
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