Excellent film-maker that he is, Watiti seems to fit the Marvel blueprint far more easily than he does Star Wars’ more venerable, old-school template
When entertainment reporters play Hollywood roulette, the practice of attaching directors and stars to forthcoming movies based on little more than rumour, their little white balls nearly always seem to land on Taika Waititi’s number. If you’ve been keeping a close eye on this column over the past year, you’ve probably spotted the white-hot Kiwi director being touted for a remake of Flash Gordon and the next Deadpool movie among other projects, neither of which have yet come to fruition.
Waititi’s next film, according to reports this week, will be a Star Wars episode. Will he end up making it to the first day of production on this one? The chances seem better, as Disney has officially confirmed the appointment via the space saga’s official website, with 1917 co-writer Krysty Wilson-Cairns helping deliver a script. But this is Star Wars we are talking about – Colin Trevorrow, Josh Trank, Phil Lord and Christopher Miller, David Benioff and DB Weiss are among the numerous film-makers who have cheerily signed up to try to bring back the glory days of the long-running series in recent times, only to ultimately fall foul of Lucasfilm president Kathleen Kennedy’s merciless Force choke.
Continue reading...The novel coronavirus pandemic has now killed more than 275,000 people worldwide. Over 3.9 million people across the world have been diagnosed with COVID-19, the disease caused by the new respiratory virus, according to data compiled by the Center for Systems Science and Engineering at Johns Hopkins University. The actual numbers are believed to be much higher due to testing shortages, many unreported cases and suspicions that some governments are hiding the scope of their nations' outbreaks.
For weeks after Ahmaud Arbery was killed while running down a road in coastal southern Georgia, there were few public developments in the case of a 25-year-old unarmed black man who was shot while being pursued by two white men with weapons in February.Then a graphic video of the shooting surfaced online, spurring widespread outrage.Within days, the Georgia Bureau of Investigation had taken over the case. The video was criticized by celebrities and politicians alike, including President Donald Trump, who called the footage "very, very disturbing," and former Vice President Joe Biden, the presumptive Democratic presidential nominee, who said Arbery had essentially been "lynched before our very eyes."And in a major turn, the authorities announced Thursday night that they had arrested two suspects in the case and charged them with murder and aggravated assault.The video -- which by Friday officials had described as "a very important piece" of evidence in moving forward with criminal charges -- was first posted by WGIG, a radio station in Brunswick, Georgia, which said it had obtained the footage from an anonymous source.But in a twist emblematic of the small-town politics that have defined the case, that source turned out to be a criminal defense lawyer in town who had informally consulted with the suspects.The lawyer, Alan Tucker, said in an interview Friday that the video had come from the cellphone of a man who had filmed the episode and that he later gave the footage to the radio station. Tucker's role was confirmed by Scott Ryfun, who oversees the station's programming.Asked why he had leaked the video, Tucker said he had wanted to dispel rumors that he said had fueled tension in the community. "It wasn't two men with a Confederate flag in the back of a truck going down the road and shooting a jogger in the back," Tucker said."It got the truth out there as to what you could see," he added. "My purpose was not to exonerate them or convict them."The video, taken from inside a vehicle, shows Arbery running when he comes upon a white truck, with one man standing next to its open driver's-side door and another in the bed of the pickup. Arbery runs around the truck and disappears briefly from view. Then the man standing outside the truck tussles with him, and three gunshots are heard.The authorities identified Travis McMichael, 34, as the person who shot Arbery. His father, Gregory McMichael, 64, a retired investigator at the local district attorney's office, was also charged.Before the charges were filed this week, two prosecutors had recused themselves from handling the case, citing professional ties to Gregory McMichael. Tucker, too, said he had been an acquaintance of McMichael's from their work in legal circles.Reports suggest Tucker had consulted with the McMichael family in some capacity during the investigation, although it is not clear to what extent. Reached by The Washington Post before his arrest Thursday, Gregory McMichael referred questions to Tucker.Tucker declined to comment on his conversations with the McMichaels on Friday, citing attorney-client privilege."I'm not going to tell you what I told them or what they told me," he said, using profanity to say that any conversations -- had they occurred, he said -- were none of the public's business.At times during the interview, a woman could be heard in the background whispering suggested answers to Tucker.By Friday afternoon, Tucker said that it had been decided that he would not be retained as the lawyer for either of the McMichaels, and it was unclear who was representing them.Tucker said he would not be representing anyone else involved in the case, as the authorities announced Friday that they were pursuing a number of leads, including investigating the man who took the video.The man, Roddie Bryan, lives in the neighborhood. He had shared the video with the police before sharing it with Tucker and was cooperating with the authorities, his lawyer, Kevin Gough, said in an interview Friday evening."Mr. Bryan has never tried to hide anything from anybody," Gough said. "If anybody wanted a copy of the video, he would give it to them."But he said the added attention, including the scrutiny from the authorities, had come as a shock to his client, a mechanic who had since lost his job and received threats. "The atmosphere down here is very volatile," Gough said. "People are in fear. That's all a result of the last few days."The latest developments in the case on Friday fell on Arbery's birthday, when he would have turned 26. Thousands of people commemorated the occasion by running 2.23 miles, a nod to Feb. 23, the date he was killed.This article originally appeared in The New York Times.(C) 2020 The New York Times Company
BRUNSWICK, Ga. -- When the Glynn County Police Department arrived at the scene of a fatal shooting in February in southeastern Georgia, officers encountered a former colleague with the victim's blood on his hands.They took down his version of events and let him and his adult son, who had fired the shots, go home.Later that day, Wanda Cooper, the mother of the 25-year-old victim, Ahmaud Arbery, received a call from a police investigator. She recounted later that the investigator said her son had been involved in a burglary and was killed by "the homeowner," an inaccurate version of what had happened.More than two months after that fatal confrontation, the Georgia Bureau of Investigation, which took over the case this week, arrested the former officer, Gregory McMichael, and his son, Travis McMichael, on charges of murder and aggravated assault.The charges -- which came after the release of a graphic video showing the killing as the two white men confront Arbery, who was African American -- made clear the depths of the local department's bungling of the case, which was just the latest in a series of troubling episodes involving its officers.And it was one element of the broader potential breakdown of the justice system in South Georgia. Attorney General Chris Carr, through a spokeswoman, said Friday that he planned to start a review of all of the relevant players in that system.Carr's office has already determined that George E. Barnhill, a district attorney who was assigned the case in February but recused himself late last month, should have never taken it on. Among his many conflicts: His son once worked alongside one of the suspects at the local prosecutor's office.S. Lee Merritt, a lawyer representing Arbery's family, has called for a federal civil rights investigation focused not only on the men who pursued Arbery but also the broader justice system."It's small-town America," Merritt said in an interview Thursday. "Those counties, the law enforcement community there, they know each other well; they recycle officers in between themselves -- it's a very tight-knit community."Over the years, Glynn County police officers have been accused of covering up allegations of misconduct, tampering with a crime scene, interfering in an investigation of a police shooting and retaliating against fellow officers who cooperated with outside investigators.The police chief was indicted days after Arbery's killing on charges related to an alleged cover-up of an officer's sexual relationship with an informant. The chief, John Powell, had been hired to clean up the department, which the Glynn County manager described last fall as suffering from poor training, outdated policies and "a culture of cronyism."The Glynn County force was the sort of department where disciplinary records went missing and where evidence room standards were not maintained, leading the state to strip it of its accreditation.Arbery was killed after the McMichaels confronted him while he was running in the Satilla Shores neighborhood just outside of Brunswick, the Glynn County seat. But neither of the McMichaels was arrested immediately after the slaying, which occurred Feb. 23 about 1 p.m.According to a police report, Gregory McMichael said that he saw Arbery running through his neighborhood and thought that he looked like the suspect in a rash of recent break-ins. McMichael, 64, told authorities that he and his son, Travis McMichael, 34, armed themselves and began chasing him in a truck.Gregory McMichael had been a Glynn County police officer from 1982 to 1989 and later worked as an investigator in the local prosecutor's office, before retiring last year.Darren W. Penn, a lawyer and a department critic, said the Ahmaud Arbery case was "another symptom or sign of a police department that appears willing to protect those that they know."Penn is representing a woman who is suing the department over claims that it failed to intervene with her estranged son-in-law, a Glynn County officer, who killed her daughter, a friend and himself in 2018.County officials and a police spokesman could not be reached Friday for comment.From the start, McMichael's connections to the police department and the prosecutor's office presented other challenges.The first district attorney assigned to the case, Jackie Johnson, recused herself because she had worked with McMichael. The second prosecutor, Barnhill, advised Glynn County police that there was "insufficient probable cause" to issue arrest warrants, according to an internal document.Finally, the case moved to Tom Durden, the district attorney in Georgia's Atlantic Judicial Circuit in Hinesville, who this week formally asked the state bureau of investigation to get involved, according to a GBI statement. A Justice Department spokesperson said this week that the FBI was assisting in the investigation.Bob Coleman, a county commissioner at large, was critical of Johnson, saying she should have given the case to the state attorney general, not Barnhill. After the Georgia Bureau of Investigation made arrests this week, Coleman said, "That's what should have happened a long time ago before the sun went down. They killed a person in the bright sunlight."Glynn County is a marshy coastal corner of Georgia about 300 miles southeast of Atlanta with about 85,000 residents, and is known mostly for its mellow barrier islands and its rich African American coastal culture.Like many Southern communities, its history is studded with racial violence, including three late 19th-century lynchings. Today, the county is about 70% white and 27% black, according to census figures.On Friday, hundreds gathered under the moss-draped trees outside the Glynn County courthouse to protest, arguing that the handling of the case had been botched as months went by without charges."I will never call the Glynn County police to my house!" one of Arbery's aunts said.Mario Baggs, a lifelong resident of Brunswick, said he believed that race was a factor in Arbery's killing, given the unfair treatment black men have long received."The black man is an endangered species," Baggs, 46, said. "We need justice; we need relief; we need the world to pay attention."Yet he also believed that Arbery's case fit into a larger pattern of dysfunction.Over the last decade, the Glynn County Police Department, which has 122 officers, has faced at least 17 lawsuits, including allegations of illegal search and seizure.One suit accused the department of wrongfully killing an unarmed white woman after officers fired through her car windshield. An investigation into that shooting found that Glynn County officers had tried to interfere with the inquiry to protect the officers involved.One of the officers in that shooting later killed his estranged wife and a friend. The wife's mother accused police of ignoring several alarming encounters in the months before the killings.Powell, the police chief, was arrested this year along with three other department officials after an investigation into a disbanded narcotics task force. The inquiry found that Powell had actively tried to shield wrongdoing by the task force. That led to his indictment on charges including violating the oath of office, criminal attempt to commit a felony and influencing a witness.As details of Arbery's death slowly emerged and were reported in The Brunswick News, Arbery's mother, increasingly distraught, called the department. She said that she had been told one thing but that the newspaper had reported something else entirely.Cooper's faith was shaken. "It's hard when you can't really believe what authority tells you, you know?" she said. "When you just cannot believe the people that's supposed to look out for all people. And when you question that, it's not a good feeling."Attempts to reach Gregory McMichael late last month were unsuccessful. In a brief phone conversation late last month, Travis McMichael, who runs a company that gives custom boat tours, declined to comment, citing the continuing investigation.The two men made a brief appearance in Glynn County Magistrate Court on Friday afternoon, but court officials said they did not enter a plea. No information about their lawyers was immediately available.Questions about the handling of Arbery's case extend beyond the police department and to Barnhill, the prosecutor who told police that there was insufficient probable cause to arrest the McMichaels.In an email Barnhill wrote to the state attorney general's office April 7, he asked to be taken off the case, stating that his son, an assistant district attorney in the Brunswick prosecutor's office, had handled a felony probation revocation case involving Arbery. He also said Gregory McMichael had helped with "a previous prosecution of Arbery."Court records show that Arbery was convicted of shoplifting and of violating probation in 2018; according to local news reports, he was indicted five years earlier for taking a handgun to a basketball game.Barnhill's office most recently drew attention beyond south Georgia for its prosecution of a black woman in rural Coffee County who had helped a first-time voter use a voting machine in the 2012 election. In 2018, a jury found the woman not guilty of multiple felonies. Her lawyers called the case "a racially motivated targeted prosecution."J. Peter Murphy, a Glynn County commissioner, on Friday defended the Police Department's decision to make no arrests in the shooting of Arbery. Murphy said the agency had been advised not to make arrests by both Barnhill and officials at the office of Johnson, the district attorney in Brunswick who formally asked to be taken off the case four days after the shooting. Neither prosecutor could be reached for comment."Tell me what the agency did wrong when its men and women were told several times not to arrest anyone?" Murphy said, referring to police. "What were they supposed to do? Cuff these guys and walk them into the jail and have no one prosecute them?"This article originally appeared in The New York Times.(C) 2020 The New York Times Company
JOHANNESBURG -- The dealer had a stash, but the young woman wasn't getting through the door without an introduction. That's where her friend, already a trusted customer, came in. And even then there were complications.The woman wanted Stuyvesants. The dealer had Courtleighs. But in a South Africa where the sale of cigarettes is newly illegal, quibblers risk nicotine fits.She took the Courtleighs and high-tailed it out of there."I feel like I'm buying cocaine," said the woman, 29, who asked not to be named for fear of being fined or arrested.In late March, in the midst of the coronavirus outbreak, the South African government banned the sale of tobacco and alcohol as part of a broad lockdown -- one of the strictest anywhere. But even as the government has begun rolling back the lockdown, the bans remain in effect.A government minister, Nkosazana Dlamini-Zuma, cited "COVID-19 reasons" for maintaining the ban.Dlamini-Zuma, a doctor who served as health minister in the 1990s and is now cooperative governance minister, said that "besides the effects itself on the person's lungs," there were concerns that smoking could promote coronavirus infection."The way sometimes tobacco is shared does not allow for social distancing," she said, "but actually encourages the spread of the virus."Defending the ban of alcohol sales amid cries of protest from the liquor industry, President Cyril Ramaphosa said alcohol was "a hindrance to the fight against coronavirus.""There are proven links between the sale and consumption of alcohol and violent crime, motor vehicle accidents and other medical emergencies at a time when all public and private resources should be preparing to receive and treat vast numbers of COVID-19 patients," the president said in a statement.The government has also cited the risk of domestic violence in households where families are isolated at home.Perhaps not surprisingly, an underground market in both cigarettes and alcohol quickly sprung up.Like bootleg markets everywhere, it relies on word-of-mouth, as the 29-year-old woman who settled for the Courtleighs soon learned.She made her purchase in a suburb of Vereeniging, a city south of Johannesburg, where dealers are said to sell only to buyers referred by someone they know. And they sell only from their homes to avoid driving around with large quantities of cigarettes, since if they were to be caught at one of the dozens of police roadblocks set up around the country, they could be arrested on the spot.Instead, the smoker carries the risk -- and the cost. A pack of 20 cigarettes now goes for upward of 150 rand (about $8), three times the old legal price. Underground alcohol prices have also skyrocketed. A bottle of low-end vodka that usually sells for 120 rand ($6) now sells for at least 400 rand ($21).South Africa lifted its nationwide lockdown on May 1 but is continuing to implement strict social distancing and face mask rules. Already under siege from HIV, the country has around 8,200 confirmed cases of the coronavirus and has reported about 160 deaths.The country had implemented one of the world's most stringent lockdowns after recording its first coronavirus-related death in March. In addition to banning the sale of cigarettes and alcohol, the regulations banned jogging and dog-walking, and shuttered parks.Before the lockdown, with a ban looming, some smokers stocked up on cartons of cigarettes. But when the ban on cigarettes was extended beyond May 1, things for smokers began to grow tense.Now it's a matter of who you know. The cafe owner willing to slip a box under a container of milk, perhaps, or a supermarket cashier willing to steal and resell cigarettes languishing in the storeroom.In one Pretoria township where everyone knows everyone -- including the police -- few dare sell cigarettes from their homes. Instead, dealers hide among young men milling around on the neighborhood corner.A 23-year-old smoker said that when he saw a group of four men sharing a cigarette, he approached them to find out where they had found the contraband. They just so happened to be selling, they told him.Desperate after a failed attempt to quit smoking, he said, he paid 160 rand for his favorite brand and "ran home," where he took a photograph of the sealed pack, planning to share it on WhatsApp with envious fellow smokers.But when he opened the pack, a cloud of sawdust choked him. There was not a cigarette to be found.Smokers say they are finding fake cigarettes in sealed boxes that look exactly like legitimate brands. And those who are desperate enough are buying unknown brands that have appeared during the lockdown, with names like Pineapple and Chestel, and are notorious for inducing immediate coughing.The tobacco industry has not taken kindly to the government's new policy.The ban has fueled an underground cigarette trade that was thriving even before the lockdown. By some estimates, it made up more than 30% of the market, depriving the above-ground tobacco industry of profit and the government of tax revenue.Now both industry and government are losing even more.The country's largest cigarette manufacturer, British American Tobacco South Africa, at one point threatened legal action if the government did not drop its ban, but Wednesday changed course. "We have taken the decision not to pursue legal action at this stage," it said in a statement, "but, instead, to pursue further discussions with government."The company said, "We are convinced that by working together we can find a better solution that works for all South Africans and removes the threat of criminal sanction from 11 million tobacco consumers in the country."The ban on cigarettes and alcohol has set off a debate on civil liberties in a country with one of the world's most liberal constitutions. While South Africa was an early adopter of public smoking regulations, many see the bans as a symbol of government overreach.Though its coronavirus policies may have succeeded in keeping the outbreak in check, some are calling the government hypocritical. Junk food remains readily available. And officials strictly limited outdoor exercise during the lockdown.In a country increasingly struggling with diabetes and obesity, such inconsistencies undercut the government's argument that it is guarding the public's health, said one South African constitutional law expert, Pierre De Vos."In the long term, if the government overreaches and it wants to continue imposing these limits when the threat has subsided, I think the courts will invalidate this," he said.Still, the ban may have yielded at least one former smoker: the man who bought the box of sawdust."I cannot just go around losing money like that," he said. "I just said to myself, 'Nah, man, it's not worth it. I'll stay home and eat sweets, as that's what's legal now.'"This article originally appeared in The New York Times.(C) 2020 The New York Times Company
French Resistance member Cecile Rol-Tanguy, who risked her life during World War II by working to liberate Paris from Nazi occupation, has died. Rol-Tanguy died on Friday at her home in Monteaux, in central France, as Europe commemorated the 75th anniversary of the surrender of Nazi Germany to Allied forces. The cause of her death was not disclosed by French officials.
Systemic flaws within Glynn county’s district attorney offices led to a lack of action against the men involved in this ‘modern lynching’In the days and weeks after Ahmaud Arbery was shot and killed, multiple Glynn county law enforcement officials failed to thoroughly investigate his death and, in one case, refused to allow police officers to make arrests, the Guardian has learned.Arbery, 25, was jogging through the neighborhood just outside Brunswick, Georgia, on 23 February when he was shot dead by two white men. Gregory McMichael, 64, and his son Travis, 34, were charged with murder and aggravated assault on Thursday evening, after graphic video footage of the killing was released publicly and sparked national outrage.Lawyers for Arbery’s family have called the killing a “modern lynching” and decried the lack of action in the case prior to the release of the video, pointing to racial inequalities in the criminal justice system.In the police report, Gregory McMichael claimed Arbery “violently attacked” his son, who shot Arbery in self defense.Jackie Johnson, the Glynn county district attorney, refused to allow police officers who responded to arrest the two men, Glynn county commissioner Peter Murphy told the Guardian in a phone call on Friday.The police department was put in touch with one of Johnson’s assistant district attorneys after the shooting, but Johnson made the decision not to charge the father and son, the former having worked in her office for more than 20 years, Murphy said.“The police at the scene went to her, saying they were ready to arrest both of them,” Allen Booker, the Glynn county district 5 commissioner, told the Atlanta Journal-Constitution on Friday. “These were the police at the scene who had done the investigation. She shut them down to protect her friend McMichael.”Days later, Johnson recused herself. Johnson did not immediately respond to a request for comment. By 27 February, George Barnhill, the Waycross judicial district attorney, and the second of three DAs on the case, took over. Less than 24 hours after seeing the video and evidence compiled by the police, Murphy said, Barnhill decided to not charge the McMichaels.“And so within 24 hours the Glynn county police had been told by two separate DA offices not to make any arrests,” Murphy said. “And obviously, they want to assume no responsibility for their actions.”On 2 April, Barnhill sent an email to law enforcement authorities saying the 25-year-old Arbery had an “apparent aggressive nature” and that his family were “not strangers to the local criminal justice system”.“Arbery’s mental health records & prior convictions help explain his apparent aggressive nature and his possible thought pattern to attack an armed man,” Barnhill said in the email, which was first reported by the New York Times.“What it appears is he was purposely trying to assault the character of the victim and there’s just no reason why,” said Chris Stewart, one of the lawyers representing Arbery’s family.The family have pointed to the McMichaels’ connection to local law enforcement both at the district attorney’s office and police department as evidence of systemic flaws and roadblocks in their search for justice. It was only after the video of Arbery’s death was released this week that the third DA’s office requested the Georgia Bureau of Investigations (GBI) get involved.On Friday, GBI director Vic Reynolds told reporters he could not “answer what another agency did or didn’t see” in the first two months of the investigation.“But I can tell you that based on our involvement in this case and considering the fact we hit the ground running Wednesday morning and within 36 hours we had secured warrants for two individuals for felony murder, I think that speaks volumes for itself.”In a 7 April email sent to the office of Georgia attorney general Chris Carr, Barnhill recused himself because his son worked on a case involving Arbery while working in Johnson’s office.Lee Merritt, one of the lawyers who represents Arbery’s family, said Wanda Cooper-Jones, Arbery’s mother, found the connection between Barnhill’s son and her own on Facebook and brought it to the attention of his office.“She followed the links. That’s exactly how it happened,” he said to the Guardian on Friday by phone.According to a police report filed 23 February, Gregory and Travis McMichael grabbed their weapons, a .357 Magnum revolver and a shotgun, jumped into a truck and followed Arbery as he ran.In the email to Carr from early April, Barnhill references a “decent cell phone video of the entire shooting incident”, an apparent reference to the one leaked this week.Reynolds said on Friday that the investigation into the shooting, the video and the person who filmed it, would continue.“Every stone will be uncovered,” Reynolds said.
As novel coronavirus spreads throughout the United States, millions of Americans are spending more time at home.MORE: Here's everything coming to Disney+ in AprilBut whether you're doing so because of a job loss, working from home situation or otherwise taking part in the mass effort to stay safe, chances are you've been bored once or twice while living under quarantine.Thankfully, some very talented people have been creating extra-special performances and experiences that you can enjoy to help you cope with the new normal and that don't break any social distancing rules. ...
When his alarm goes off at 3:30 a.m., 54-year-old Jeff Reid knows it's time to begin his day and prepare for an eight-hour shift on the front lines of the coronavirus pandemic. As a grocery store worker, Reid never imagined he'd find himself in this position. Every day before his 5 a.m. shift, Reid prepares his morning essentials -- 1,000 milligrams of the powdered vitamin supplement Emergen-C and his morning prayers.
Jihadists burst into the gold mine where Moussa Tambura worked in Burkina Faso, forbidding everyone from smoking and drinking. “They attacked the site, killed people and burned houses,” said Tambura, 29, clenching his fists. Jihadists linked to al-Qaida and the Islamic State organization have been overrunning gold mines like Tambura’s one by one as they try to gain control of Burkina Faso’s most lucrative industry.
From a veteran fire chief to a 93-year-old Holocaust survivor, over 71,000 people have died in the United States from the ongoing novel coronavirus pandemic.Those we've lost come from all backgrounds and walks of life and include the very people -- first responders and medical staff, who are working so diligently to stem the tide of the infection and care for the sick. Variously described as heroes, caring educators and loving family members, they will never be forgotten. ...
Marisa Bardach Ramel is co-author of “The Goodbye Diaries: A Mother-Daughter Memoir,” written with her mother Sally Bardach. As Mother’s Day approaches, I long to sit beside you, pour you some tea and talk about all the things.
BEIJING (Reuters) - Chinese regulators have approved Novartis' Mayzent to treat relapsing multiple sclerosis in adults, the Swiss drug maker said in a statement on Saturday. Other drugs approved by China's National Medical Products Administration to treat MS include Novartis' Gilenya, Bayer's Betaferon and Sanofi's Aubagio. China has an estimated 30,000 patients with MS. (Reporting by Roxanne Liu and Kevin Yao in Beijing; Editing by Edwina Gibbs
Although not as ubiquitous as antibacterial susceptibility testing, antifungal susceptibility testing (AFST) is a tool of increasing importance in clinical microbiology laboratories. The goal of AFST is to reliably produce MIC values that may be used to guide patient therapy, inform epidemiological studies, and track rates of antifungal drug resistance. There are three methods that have been standardized by standards development organizations: broth dilution, disk diffusion, and azole agar screening for Aspergillus. Other commonly used methods include gradient diffusion and the use of rapid automated instruments. Novel methodologies for susceptibility testing are in development. It is important for laboratories to consider not only the method of testing but also the interpretation (or lack thereof) of in vitro data.
Intrathecal administration of anti-infectives is indicated in central nervous system infections by multiresistant pathogens when drugs that can reach adequate cerebrospinal fluid (CSF) concentrations by systemic therapy are not available. Antibiotics that readily pass the blood-brain and blood-CSF barriers and/or that have low toxicity allowing an increase in the daily dosage should not be used for intrathecal therapy. Intrathecal therapy is accompanied by systemic treatment. Antibacterials indispensable for intrathecal therapy include aminoglycosides, colistin, daptomycin, tigecycline, and vancomycin. Limited experience suggests the utility of the antifungals amphotericin B and caspofungin. Intraventricular administration ensures distribution throughout the CSF compartment, whereas intralumbar dosing often fails to attain adequate antibiotic concentrations in the ventricles. The individual dose is determined by the estimated size of the CSF space and by the estimated clearance from CSF. For moderately lipophilic anti-infectives with a molecular weight above approximately 1,000 g/mol, as well as for hydrophilic drugs with a molecular weight above approximately 400 g/mol, one daily dose is normally adequate. The ventricular drain should be clamped for 15 to 120 min to facilitate the distribution of the anti-infective in the CSF space. Therapeutic drug monitoring of the trough levels is necessary only in cases of therapeutic failure.
Burkholderia cepacia (formerly Pseudomonas cepacia) was once thought to be a single bacterial species but has expanded to the Burkholderia cepacia complex (Bcc), comprising 24 closely related opportunistic pathogenic species. These bacteria have a widespread environmental distribution, an extraordinary metabolic versatility, a complex genome with three chromosomes, and a high capacity for rapid mutation and adaptation. Additionally, they present an inherent resistance to antibiotics and antiseptics, as well as the abilities to survive under nutrient-limited conditions and to metabolize the organic matter present in oligotrophic aquatic environments, even using certain antimicrobials as carbon sources. These traits constitute the reason that Bcc bacteria are considered feared contaminants of aqueous pharmaceutical and personal care products and the frequent reason behind nonsterile product recalls. Contamination with Bcc has caused numerous nosocomial outbreaks in health care facilities, presenting a health threat, particularly for patients with cystic fibrosis and chronic granulomatous disease and for immunocompromised individuals. This review addresses the role of Bcc bacteria as a potential public health problem, the mechanisms behind their success as contaminants of pharmaceutical products, particularly in the presence of biocides, the difficulties encountered in their detection, and the preventive measures applied during manufacturing processes to control contamination with these objectionable microorganisms. A summary of Bcc-related outbreaks in different clinical settings, due to contamination of diverse types of pharmaceutical products, is provided.