Online Global Summit on Infectious Diseases

Online Global Summit on Infectious Diseases

No Of Pages: 1-30

Publisher: CRG Journals Published On: 20 November, 2021

T-ABTF-The Association Between Incidence of Tuberculosis at Different Ages And Multi-Factors of Ecology In Sichuan, China, From 2006 To 2017.


Wen Wei1, Zonglei Zhou1, Wenqiang Zhang1, Rongsheng Luan1, Lan Xia2 and Jianlin Wu2

1Sichuan University, China
2Center for Disease Control and Prevention of Sichuan Province, China

Objective: To find the prevalence of and explore risk factors for tuberculosis infection among different age groups in a high tuberculosis and human immunodeficiency virus prevalence setting.

Methods: Through correlation analysis and regression analysis for the cases of the tuberculosis of Sichuan Province from 2006 to 2017, to seek for the association between tuberculosis cases and the ecological factors at different groups, covering environmental,economical, social conditions.

Results: Collected tuberculosis cases of all ages from 2006-2017, in Sichuan province of P.R.C. Factors affecting the incidence of tuberculosis, increasing hospital numbers,health technicians of infectious disease hospital in 25-64 group; adding morning exercise and evening exercise are relatively stable everyday, number of urban minimum living security (person), spouse (female) (%), while reducing 15-24 TB rate, sex ratio,number of forest fires in 0-14 group; decreasing 0-14 TB rate, total illiteracy rate (%), average station air pressure in 15-24 group; can reduce the incidence of tuberculosis in Sichuan Province.

Conclusion: In different age groups, comprehensive prevention and control should be put into, including environmental, educational, medical, social, individual factors for decreasing the incidence of tuberculosis.

Walk-Through Screening System for COVID-19


Ji Yong Lee and Sang Il Kim

H Plus Yangji Hospital, South Korea

The ongoing COVID-19 pandemic has dramatically increased the number of individuals to be tested.We have developed a walk-through screening system to cope with this situation. The Safe Assessment and Fast Evaluation Technical booth of the H Plus Yangji Hospital(SAFETY), is a negative pressure booth that is inspired by the biosafety cabinet class 3. SAFETY has an area of 1.0 m2 and a height of 2.0m3, and is made of a stainless steel frame with poly-carbonate walls and a mobile negative pressure device including a HEPA filter. We implemented a Walk-through (WT) screening center using 4 SAFETYs. To reduce the risk of cross-infection, we developed an automatic ventilation and disinfection system for each SAFETY, established a reservation system, and allowed patients to fill out electronic questionnaires through mobile phones. We use a safe environmental disinfectants certified by the US and Korean governments. From March 10, 2020, when we started operating the WT clinic, we have been monitoring cross infection through epidemiological investigations and real-time polymerase chain reaction testing of environmental samples. Currently, the WT clinic is screening more than 200 patients within 8 hours,but to date, there has not been a single case of cross-infection of COVID-19. The WT system not only increases patient access to examination clinics, but also increases access to medical institutions, keeps medical staff and patients safe, while reducing the consumption of personal protective equipment and staff fatigue. In the COVID-19 pandemic, a walk-through system using SAFETY can test patients faster,safely, and efficiently.

An In Silico-Informed Perspective: The Traditional Consumption of Malaysian ‘Ulam-Ulaman’ Plant Species For Covid-19 Treatment


Nisha Govender and Zeti-Azura Mohamed-Hussein

National University of Malaysia, Malaysia

The COVID-19 outbreak is a global burden and with an ongoing viral mutation, it is imperative to cautiously adapt to the new norm of living which takes into account physical measures and healthcare.In Malaysia, raw indigeneous plant species are consumed as vegetable salad by the majority Malayethnic. Popularly regarded as ‘ulam-ulaman’, a wide range of plant species with poorly recognized medicinal propeties has been consumed as part of daily dietary intake. These ‘‘ulam-ulaman’ species belongs to an adverse group, from herb, shrub and even trees, and are either home grown or exist inwild. They thrive easily and with minimal care in Malaysia’s hot and wet climate. Some of these specieshas a rich history of traditional medicine and had shown potent antiviral properties in numerous previous studies. In this study, a total of five different local polyphenol enriched ‘ulam-ulaman’ species were selected and their coreesponding bioactive compounds were screened for potential inhibitory activities against SARS-CoV-2 molecular targets (binding pocket regions) using molecular docking and molecular dynamic simulation studies. A total of 10 molecular targets (receptors) were selected to represent the surface spike proteins, main protease-replicase polyproteins, membrane protein and open readingframe of SARS-CoV-2. Molecular docking analysis by AutoDock Vina using the Lamarckian genetic algorithm revealed a minimum binding affinity of -4.7 to -9.1 kcal/mol. The polyphenol-bound receptorswere held fairly strong by hydrophobic interactions, hydrogen bonds and electrostatic interactions. The molecular dynamic simulations further supported the stability of the selected polyphenol-bound receptor complexes.

Nanotherapy Fails SARS-COV-2


Gilbert Glady

European Bio Immune Gene Medicine Association (EBMA), France

While the Sars-CoV-2 epidemics seems to rebound more and more despite the massive vaccination,surveys that prove not only moderately efficacy but more deleterious effects than expected, the need for an effective treatment against the coronavirus is imperative. We are here to present such a treatment, based on empirical clinical observations. The goal of this treatment is to give hope to as many patients as possible for the existence of an effective and safe treatment without any side effect.

Profile of hearing loss in Patients with HIV in Dr. Soetomo General Hospital Indonesia


Arya Ivan Mahendra, Nyilo Purnami, Erwin Astha Triyono and Lilik Djuari

Universitas Airlangga, Indonesia

Introduction: Hearing loss can be found in the patients with Human Immunodeficiency Virus (HIV). The types of hearing loss as conduction-type may occurs due to obstruction in the outer and middle ear,but sensorineural hearing loss (SNHL) is the most common otologic complaint related with the drugs of antiretrovirals (ARVs), incomplete recovery of the immune system, and persistent inflammation and toxicity. This study aimed to show the profile of hearing loss in HIV patients.

Methods: A cross-sectional descriptive research was performed in patients with HIV in Dr. Soetomo General Hospital. The assesment of hearing by HHIAs questionnaire and the data from medical records were collected. The sample size in this study was the total sampling of all newly infected HIV patients in Dr. Soetomo General Hospital from June to December 2019 and met the inclusion and exclusion criteria.

Results: The total respondent was 30 patients. Opportunistic infections have potential caused on hearing loss in HIV patients is dominated by Toxoplasma Gondii infection. There were 3 patients using ototoxic drugs; Azithromycin in 1 patient (0.5%), Erythromycin in 1 patient (0.5%), and Streptomycin in 1patient (0.5%). All of the patients had no malignancy. The complaints experienced were ringing in the ears in 3 patients (10.0%), dizziness in 1 patient (3.3%), hearing loss in 2 patients (6.7%), ringing in the ears and Hearing loss in 1 patient (3.3%), dizziness spinning and hearing loss in 1 patient (3.3%). However, most patients had no ear complaints as many as 20 patients (73.3%). Based on the HHIAs questionnaire, there were 4 patients who experienced mild-medium handicap, and 2 patients with significant handicap (6.7%).

Discussions: It was found that the number of patients with opportunistic infections increased with the lower of CD4 levels. This study indicated the potential of hearing loss occured in HIV patients. Further study is needed to identify the potential of ototoxicity drugs by monitoring of the hearing.

Case Series of Dengue Fever In Peripartum Period: Maternal and Foetal Outcome


Raymond Surya, Yudianto Budi Saroyo, Ali Sungkar and Rima Irwinda

Universitas Indonesia/ Dr. Cipto Mangunkusumo Hospital, Indonesia

Introduction: Dengue fever is a major public health problem in tropical and subtropical areas. No many studies concerning complication of dengue fever in pregnancy. We would like to present four serial cases of dengue fever in pregnancy.

Case illustration: Three of four cases were delivered by caesarean section; two of them died during post caesarean care. All cases had lowest platelet level below 50,000/?L and given platelet transfusion during and after delivery; they also showed abnormal liver function test. For foetal outcome, none was positive of dengue.

Discussion: Complication of dengue infection depends on combination of host and viral virulence. Regardless of prophylactic platelet transfusion, some studies revealed clinical bleeding in patient with Dengue infection due to intricate effect on haemostatic system. Adverse foetal outcome may be contributed because of placental circulation caused by endothelial damage with increased vascular permeability leading to plasma leakage. There is no national guideline for dengue fever in pregnancy.

Conclusion: The management of dengue fever in pregnancy at tertiary hospital is still suboptimal. Dengue fever around peripartum has higher risk morbidity and mortality for the mother; therefore, it needs a multi discipline team approach.

Study of Possibility Physical Interaction Antimalarial Combination Drugs


Timbul Partogi H. Simorangkir

Indonesian Defense University, Indonesia

Identification of solid state to investigate the possibility of physical interaction between Antimalarial Artemisinin Combination Treatment base Artesunate (AS) and Amodiaquine (AQ) by hot contact method Kofler, cold contact method (crystallization reaction) and biner phase diagram confirmation had been carried out. The results of hot contact method Kofler shown formation a new crystalline habitas long and thin needle on contact zone (mixing zone) between AS and AQ. A different melting point was seen in its single component. Cold contact methods between two of supersaturated solution of component AS and AQ in methanol solvent also indicated the growth of crystal habit as similar as hot contact method Kofler. Confirmation by biner phase diagram shown the specific diagram for cocrystalline phase. Solid state interaction between AS and AQ was analysed by powder X-ray diffraction, FTIR (Fourier Transformed Infra Red) spectrophotometric, microscopic SEM (Scanning Electron Microscopic)and thermal DTA (Differential Thermal Analysis) , TG-DSC (Thermal Gravimetry- Differential Scanning Calorimetry)). Microscopic analysis by SEM showed significantly the change of habit and morphologyof crystal as long and thin needle shaped. The difference of powder X-ray diffraction (PXRD) interferences peaks were observed in addition to PXRD interference peaks of each component and its physical mixtures that proved formation of cocrystalline phase. DSC Thermogram indicated a new endothermic peak corresponding to melting point of a new co-rystalline phase at temperature 160.4°C.

Molecular Identification and Sequencing Of Canine Enteric Viruses In Sicilian Dogs Affected By Severe Gastroenteritis


Simona Di Pietro1, Marcoaurelio Sciume1, Elisabetta Giudice1, AnnalisaGuercio2. Giuseppa Purpari2, Schiro Giorgia2 and Giuseppe Mira2

1University of Messina, Italy
2Istituto Zooprofilattico Sperimentale della Sicilia, Italy

In this study, the main viral agents causing infectious gastroenteritis in dogs coming from Sicily were analyzed by biomolecular methods and sequence analyses. The canine enteric viruses were: canine parvovirus (CPV), canine distemper virus (CDV), canine enteric coronavirus (CCoV), canine adenovirus type 1 (CAdV1), rotavirus (CRV) and norovirus (CNoV). In order to evaluate the immune status of infected dogs, the serum antibody titers for CDV, CAdVs and CPV were evaluated in collected blood sera. All samples (N=22) were tested positive for CPV-2, 12 for CCoV, and 3 for CNoV. Co- infections were found in13 dogs. A high prevalence (72.7%) of CPV-2c strains, genetically related to those currently circulating in Asia, was observed underlining their wide circulation in the area of study. CCoV strains were typed as CCoV-I (N=11), except for one strain typed as CCoV-II. Samples from three dogs also tested positive toCNoV with strains classified into geno groups IV and VI. The results of serological tests accounted for a recent vaccination or, more likely, with an active CPV infection, with lack of active or passive immunity for CDV and limited for CAdVs. The obtained data suggest the need for a better control of the spread of these canine viruses through an adequate immune prophylaxis and hygiene, as well as further surveillance activities. The evidence for circulation of CNoVs in dogs also suggests to further implement the surveillance activity against latter viruses to obtain information on their circulation in canine hosts and to better understand their role as human pathogens.

Antimicrobial Stewardship Improved with The Introduction of Preset Antimicrobial Prescribing Templates, For Post Operative Patients


Ashik Babu

University of Liverpool, UK

Introduction: In the cardiothoracic intensive care unit, antibiotics are continued for the first 24 hours post-surgery. They are administered within an hour of the incision, whilst the patient is in theatre. This is a second cycle re-audit to assess the quality of perioperative antibiotic prescriptions, since the advent of electronic order sets available on the electronic (ICCA ) system within CICU.

Method: Antibiotic prescribing data was collected over a month period (47 patients), two weeks afterthe inception of a new post-operative ITU electronic prescribing order set.

Results: Cefuroxime was not prescribed and administered within an hour of incision 6% of the time.Vancomycin was incorrectly prescribed outside an hour of the incision 13% of the time. 2.2% of patients were not prescribed post op antibiotics. In 15% of cases, patients were prescribed antibiotics post op, but administration was delayed by >30 minutes. This is in comparison to 24% incorrect prescribing and 28% delayed administration in the previous audit. 14.2% of patients received antibiotics outside an hour of the incision window previously.

Conclusion: After the inception of the electronic order set there has been a marked reduction in prescribing errors of postoperative antibiotics. There have also been fewer delays in administration of antibiotics.Understandably there has been little change in medication prescribed more than an hour from incision. This is because the order set does not specifically address intraoperative prescribing. Electronic prescribing templates could be used in other departments to reduce antimicrobial prescribing errors with preset durations to avoid prolonged administration of antibiotics.

A 3-Year Point-Prevalence Surveillance (2016-2018-2020) of Healthcare-Associated Infections and Antimicrobial Use In Ferrara University Hospital, Italy


Paola Antonioli

Ferrara University Hospital, Italy

Healthcare-Associated Infections (HAIs) represent one of the leading issues to patient safety as wellas a significant economic burden. Similarly, Antimicrobial Use (AMU) and Resistance (AMR) represent a growing threat to global public health and the sustainability of healthcare services. A Point Prevalence Survey (PPS) following the 2016 ECDC protocol for HAI prevalence and AMU was conducted atFerrara University Hospital (FUH). Data were collected by a team of trained independent-surveyors in2016, 2018 and 2020. Risk factors independently associated with HAI were assessed by a multivariatelogistic regression model. Of the 1629 patients surveyed, 201 (12.3%) had at least one active HAI, 10.0%in 2016 (53 patients), 11.0% in 2018 (63 patients) and 16.1% in 2020 (85 patients) and 721 (44.3%)were on at least 1 systemic antimicrobial agent. Factors independently associated with increased HAI risk were a “Rapidly Fatal” McCabe score (expected fatal outcome within 1 year), presence of medicaldevices (PVC, CVC, indwelling urinary catheter or mechanically assisted ventilation) and a length of hospital stay of at least 1 week. The most frequent types of HAI were pneumonia, bloodstream infections,and urinary tract infections. Antimicrobial resistance to third-generation cephalosporins was observed in about 60% of Enterobacteriaceae. The survey reports a high prevalence of HAI and AMU in FUH.Repeated PPSs are useful to control HAIs and AMU in large acute-care hospitals, highlighting the mainproblematic factors and allowing planning for improvement actions.

Leptospirosis: An Under-Reported Disease in North India


Vineeta Mittal

Dr. Ram Manohar Lohia Institute of Medical Sciences, India

Leptospirosis is an important zoonotic disease of global distribution. It is caused by infection with pathogenic spirochetes; Leptospira interrogans. The incidence of leptospirosis is endemic to areas of the Caribbean, Central America, South America, Southeast Asia and Oceania. International Leptospirosis society recently estimated to be 350,000–500,000 severe leptospirosis cases annually. In India Leptospirosis has been widely reported from southern, central, eastern and western part of India due to heavy monsoon, animal rearing practices and unplanned urbanization. In spite of similar weather condition in monsoon season in north India, leptospirosis is under reported. The reason for this is lack of suspicion and awareness among the physicians and lack of diagnostic facilities in this area. Leptospirosis enhances direct and indirect contact with animals and their excreta (mice, rabbit, rodents, mice,pig, cattle, and dog etc). Leptospirosis has similar clinical features as dengue, malaria, typhoid and scrubtyphus. Leptospirosis may present as nonspecific symptoms such as fever, headache and myalgia. Severel eptospirosis is characterized by jaundice, renal dysfunction and hemorrhagic diathesis. The disease is diagnosed by detecting antibodies by serological test such as Enzyme Linked Immunosorbent Assay (ELISA), Microscopic Agglutination Test (MAT) and molecular test like polymerase Chain Reaction(PCR), and culturing the bacteria from blood, urine or tissues. MAT is considered as the WHO gold standard serological test for diagnosis of leptospirosis. The most important control measures may be vaccination of pet animals, improved hygiene, clearing stagnant water, rodent control, and protection of food from animal contamination.

Mild COVID-19: Aspirin, Prednisolone and Azithromycin Improve Outcome


Yanamadala V Murali Krishna Rao

Lakshmi Vaidyasala, India

Introduction: An overwhelming number of patients with the Coronavirus infection have burdened healthcare systems worldwide. Care of all these patients in hospitals is neither possible nor warranted.Most patients are given domiciliary treatment in isolation. In light of pathopysiology of COVID-19 i.e.,Inflammation, Coagulation and bacterial Infection (I-C-I), a new home care regimen was tried. Efficacy of therapeutic agents that may address these problems was assessed in a prospective study.

Material: In this prospective study, two groups of patients with positive Rapid Antigen test for SARSCoV-2, mild upper respiratory symptoms and fever >380C were assessed. Study group comprised of consecutive patients (N=60; 38 male, 22 female; Age 26y-57y) attending a private OPD Clinic during 8weeks of April - May 2021. The study group was given Aspirin 150 mg OD, Prednisolone 10mg BID and Azithromycin 250mg BID for 7 days. While control group (N=60; 33 male, 27 female; Age 21y-60y) patients with mild symptoms were taking medicines of home care kit provided by state government. The home care kit consisted of Doxycycline, Ivermectin and Paracetamol. Both groups were given Cetirizine, cough expectorant and nutritional supplements. Condition of all the patients was noted virtually after15 days of hospital visit.

Observations: 59 patients on Aspirin, Prednisolone and Azithromycin (study group) were free from fever and upper respiratory symptoms and oxygen saturation maintained at >93% after 7 days and tested negative for SARS CoV-2 RT PCR on 11th day. 1 patient needed admission into hospital due to worsening of symptoms and dropping SpO2 to below 90%. While in control group, 52 patients were free from fever symptoms by 11th day. 8 patients were hospitalized due to worsening of symptoms and falling SpO2 tobelow 90% (CI 95%; OR 9.07). Out of 59 patients from the study group, who were free from fever 7 (plusone hospitalized) patients had cough, weakness and tiredness. In control group, 30 (plus 8 hospitalized)out of 52 patients had cough, weakness and tiredness (CI 95%; OR 11.22).

Conclusion: To mitigate possible damage caused by COVID-19 (Inflammation - Coagulation - bacterialInfection), Aspirin, Prednisolone and Azithromycin were tried. This regimen showed a better out comethan control group. Improved outcome in terms of early recovery and symptom-free convalescence isseen in the study group. Large scale studies are needed to arrive at a consensus to recommend a better domiciliary care to treat mild COVID-19.

Validation of An At-Home Direct Antigen Rapid Test For Covid-19 And Its Implications For Widespread Surveilance Testing


Laura Holberger

Cambridge Consortium for Rapid COVID-19 Tests, USA

Since its discovery in late 2019, SARS-CoV-2 has created a global pandemic of coronavirus disease2019 (COVID-19). As of March 2021, more than 120 million SARS-CoV-2 infections have been reported worldwide. Typical symptoms of COVID-19 include fatigue, fever, dry cough, and anosmia/dysgeusia.Severe complications can develop, marked by pneumonia, acute respiratory distress syndrome (ARDS),or death. Outbreak management has been hindered by high transmission, especially among those with mild to no symptoms, and limitations in testing capacity for SARS-CoV-2. To limit spread of SARS-CoV-2,effective public health tools are needed for rapid and early identification of infections. While the current diagnostic standard is qRT-PCR, its high cost and long turnaround times constrain its utility for widespread surveillance. Lack of such surveillance has resulted in the closing of businesses and schools, and severe societal disruption. Self-collected nasal swab specimens and antigen tests that provide results quickly enough to permit new cases to isolate within minutes can be important public health surveillance tools. A longitudinal comparison between antigen tests in at-home settings and qRT-PCR has notpreviously been performed, to our knowledge. Here, we describe implementation of high-frequency testing using an inexpensive, at-home, semi-quantitative, direct antigen rapid test (DART) and compare its performance with qRT-PCR on 2,951 pairs of self-collected nasal swab specimens. Use of twice-weekly DART testing allowed the activities of co-working labs to continue safely during the pandemic. We found that twice-weekly surveillance with DART detected infections in 15 individuals, with 96% sensitivity on days 1 through 3 of symptoms.

An Update on A Public Health Problem: Multidrug-Resistant Bacteria


Vazquez-Lopez Rosalino1, Espindola-Flores Esteban1, Álvarez-Hernández Diego1, Peña Barreto Adán1, Solano-Gálvez Sandra Georgina2 and JuanAntonio González- Barrios3

1Universidad Anáhuac Mexico Norte, Mexico
2National Autonomous University of Mexico, Mexico
3Genomic Medicine Laboratory, Hospital Regional "Primero de Octubre", Mexico

Antibiotic resistance is one of the most urgent health problems in the world. Several factors have contributed to the aggravation of this problem, such as abuse and indiscriminate antibiotic use inpatients with COVID-19; and the vertical and horizontal spread of antibiotic resistance genes. Multiresistant infections (MDR) are expected to become the main cause of mortality by 2050. Recent research carried out by the Department of Microbiology (CICSA) Faculty of Health Sciences Universidad Anáhuac Mexico, together with the Laboratory of Genomic Medicine, Hospital Regional "Primero de Octubre",ISSSTE have identified little-explored transmission mechanisms of the most common MDR pathogens.It is worth mentioning the increase in the use of antibiotics in agriculture, which has contributed tothe presence of Enterobacteriaceae in vegetables ready for consumption in Mexico, demonstrating the expression of at least one member of the beta-lactamase gene family (particularly blaDHA and blaSHV),that are associated with resistance to cephalosporins. Another important pathway is the presence ofMDR pathogens in the canine oral microbiota: it is characterized by high rates of resistance to ?- lactams drugs, which could represent a potential, although sometimes overlooked, source of resistant bacteria when close daily human contact and pets. is taken into account. Similarly, active or passive exposure to cigarette smoke has been reported to increase the antimicrobial resistance profile in Staphylococcus aureus. Similar mechanisms have been identified as risk factors for increased expression of antibiotic resistance genes in healthy individuals against beta-lactam antibiotics; and broad-spectrum antibiotics in ICU patients.

COVID-19 A Hyper-Inflammatory Disease. On The Way to Understanding The Pathophysiology of This Disease


Chávez Guerra Ana Almudena1, Neri Ponce Karla Denisse1, Lores GuerreroMónica1, Álvarez-Hernández Diego1, Vazquez-Lopez Rosalino1,2 and Solano-Gálvez Sandra Georgina2

1Universidad Anáhuac Mexico Norte, Mexico
2National Autonomous University of Mexico, Mexico

SARS-Cov-2 infection exhibits characteristics of systemic hyper inflammation, this event is part of th emacrophage activation syndrome (MAS) or cytokine storm. Hemophagocytic lymphohistiocytosis (HLH) is a T-lymphocyte-modulated hyper inflammatory state characterized by high levels of ferritin inthe blood, IFN?- dependent TLR stimulation, antigen-presenting cells, and uncontrolled T-cell activation,ultimately leading to a cytokine storm. Intensive care unit (ICU) patients with severe COVID-19 have a different pattern of cytokines compared to non-ICU COVID-19 patients. The histopathological changes observed in the lungs of COVID-19 patients can be explained by the effects of the cytokine storm, which induces an increase in collagen synthesis and fibrin deposition, which will lead to an increase in the thickness of the membrane. alveol ocapillary. MAS also generates the presence of inflammatory exudate in the alveolar space, the formation of hyaline membranes. All these changes lead to the state of acuterespiratory distress syndrome (ARDS) characterized by alveolar collapse and areas of lung atelectasis and hypoxemic respiratory failure, simultaneously with the ARDS picture associated with COVID-19. ARDS is known to cause severe impairment of gas exchange that can lead to severe dyspnea, hypoxemia,and impaired carbon dioxide excretion. This is due to infection and damage to the lower respiratory tract (terminal bronchi and alveoli). Based on all this evidence, we can affirm that SARS-CoV-2 infection produces a hyperinflammatory state. More recent research is focusing on understanding the molecular processes involved in the pathophysiology of the disease.

Implantable Cardioverter Defibrillator Related Actinomyces Odontolyticus Endocarditis and Bacteremia-First Reported Case


Ayelet Raz-Pasteur and Mirai Farah Khoury

Rambam Health Care Campus, Israel

Actinomyces Odontolyticus is a gram-positive bacillus, usually found in the oropharynx, gastrointestinal and urogenital tracts, as commensal flora. Infections caused by this organism are rare butmay occur, more commonly in immunocompromised patients. We report a case of a 54-year-old man,who presented to the emergency department (ED), with fever and chills. The patient had undergone animplantable cardioverter defibrillator (ICD) insertion, 5 months prior to his arrival, and was diagnosedwith Actinomyces Odontolyticus bacteremia, during the hospitalization. Transesophageal echocardiogram(TEE) revealed vegetations on the tricuspid valve and the ICD electrode. This is the first reported case of ICD related Actinomyces endocarditis and bacteremia based on our literature review. This case emphasizes the importance of probing for the source of actinomyces infection, while considering the indolent properties of the disease.

Antibody Titer Before and After A 3RD DOSE of the SARS-COV-2 BNT162B2 Vaccine In Adults 60 Years or older


Noa Eliakim-Raz1, Yaara Leibovici-Weisman1, Salomon M. Stemmer1, AmosStemmer2, Asaf Ness3, Muhammad Awwad3 and Nassem Ghantous3

1Tel Aviv University, Israel
2Sheba Medical Center, Israel
3Rabin Medical Center, Israel

The durability of response to the SARS-CoV-2 BNT162b2 vaccine (BioNTech/Pfizer) in adults ?60years is yet to be determined. The immune response to 2 doses of BNT162b2 is lower in individuals aged 65-85 versus 18-55 years.1 A 3rd dose of the SARS-CoV-2 mRNA-1273 vaccine (Moderna) induce dsero positivity in 49% of kidney transplant recipients who did not respond after 2 vaccine doses,2 althoughthis observation cannot be generalized to older adults. Following a 4th SARS-CoV-2 wave in Israel,the Israeli Ministry of Health authorized, at the end of July 2021, a 3rd BNT162b2 vaccine dose for individuals ?60 years, which was subsequently expanded to younger age groups. We assessed antispike (anti-S) IgG antibody titers before and after a 3rd BNT162b2 dose in individuals ?60 years, as this population is at high risk of developing severe SARS-CoV-2 disease, and was the first to receive authorization for a 3rd dose.

Understanding The Molecular Biology Of SARS-COV-2 and the COVID-19 Pandemic: A Review


Sarah Alsobaie

King Khalid University Hospital, Saudi Arabia

Coronaviruses are named after the crown-like spike proteins on their surface. In the 21st century, three coronaviruses, namely severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), SARS-CoV,and Middle East respiratory syndrome related coronavirus (MERS-CoV), have emerged in the human population, presumably evolving from pathogens infecting other animals. Coronaviruses are enveloped viruses responsible for 15– 30% of the atypical pneumonia cases in humans worldwide. The current coronavirus disease 2019 (COVID-19) pandemic is caused by the newest SARS virus, SARS-CoV-2, an enveloped, positive-sense, single-stranded RNA betacoronavirus of the family Coronaviridae. As of April2021, the World Health Organization has reported over 3 M deaths from COVID-19 and over 140 Mpeople have been infected with the virus, thereby making it the worst SARS pandemic of all time. Here, I review the current understanding of the molecular biology of coronaviruses and their host interactions,bringing together knowledge of the infection process to aid in the development of therapeutic drugs and/or vaccines against SARS-CoV-2. I also briefly overview the current situation of available treatments,vaccinations, and emerging strains.

Experience of Treating Candida Auris Cases at A General Hospital In The State of Qatar


Adila Shaukat, Nasir Al Ansari, Walid Al Wali, Edin Karic, Ihab El Madhoun,Hassan Mitwally, Manal Hamed and Feah Alutra-Visan

Hamad Medical Corporation, Qatar

Background and objectives: So far there have been no studies on Candida auris in Qatar. This study aimed to describe the clinical spectrum and outcome of C. auris infection in patients admitted to a general hospital in Qatar.

Methods: We conducted this descriptive observational study in a general hospital in Qatar. We have involved all patients with C. auris infection and colonization admitted to a general hospital from December2018 to August 2019.

Results: We identified 13 patients with confirmed C.auris infection/colonization, of which five cases represented an actual C. auris infection, while the remaining eight cases were considered as colonization.The mean age of the patients with infection was 76.6 ± 8.4 years, while the mean age of the patients with colonization was 66.4 ± 24.7 years. Among the individuals clinically infected with C. auris,two had urinary tract infections, one had candidemia, one acquired soft tissue infection, and one had alower respiratory tract infection. All strains of C. auris were susceptible to echinocandins, flucytosine, and posaconazole while resistance to fluconazole and amphotericin B. Of the patients with C. auris infection who received systemic antifungal therapy, three (60%) died during antifungal therapy.

Conclusion: Our study showed that C. auris can cause a wide variety of invasive infections, including bloodstream infection, urinary tract infection, skin infection, and lower respiratory tract infections, especially in critically ill patients. In addition, our isolates showed resistance to the most common antifungal agents such as fluconazole and amphotericin B.

Favipiravir: A New and Emerging Antiviral Treatment For COVID-19


Richard H. Kaszynski

Stanford University, USA

The COVID-19 pandemic stunned the world with a staggering socioeconomic and public health impact.However, the COVID-19 pandemic will not be the last viral global outbreak. In the past 10 years the world has also witnessed outbreaks of Zika and Ebola. Antiviral drugs have a very narrow therapeutic window which means the drug's likelihood to generate positive outcomes diminishes with each passing day after onset of symptoms. Many studies have failed to meet their primary endpoint because the architects of those studies failed to take into consideration the simple - albeit crucial - element of time into the drug administration equation. Given the impossibility of predicting the future, it is important to focus not only on virus-specific compounds, but on broadly active compounds that could address multiple threats. Avigan is uniquely positioned to address the current COVID-19 pandemic and future viral outbreaks now, not in the future. Favipiravir is a selective inhibitor of viral RNA-dependent RNApolymerase (RdRP) with potent antiviral activity against single-stranded RNA viruses including coronaviruses.This is the protein responsible for “building” the viral proteins. Favipiravir is able to target the protein necessary for the coronavirus to replicate, creating mutations that make it impossible for the virus to copy itself.

Tuberculosis Prevalence in India And Strategies For The Prevention And Control of Infectious Disease


Mamatha Bhanu L S

University of Mysore, India

India is a high tuberculosis (TB) burden country, caused by the bacillus Mycobacterium tuberculosis,which is spread when people who are sick with TB expel bacteria into the air (by coughing and sneezing). The disease typically affects the lungs (pulmonary TB) but can affect other sites. The majority(about 90%) of those who are infected are adults, with more cases among men than women. Globally, TB is the 13th leading cause of death and the second leading infectious killer after COVID-19 (above HIV/AIDS). The international TB report, by the World Health Organization, has collated data from over 200countries that has shown significant reductions in TB case notifications due to Covid-19 pandemic. It also said that India rank first among the four countries that account for 44% of global TB cases: in India,Indonesia, the Philippines and South Africa. The efforts have been continuously made for elimination of the disease by the Indian National Strategic Plan (NSP) for TB elimination 2017-2025, it was announced that the national goal was to work towards elimination of TB in India by the year 2025 and achieve zerocatastrophic cost for affected families. Reduced access to TB diagnosis and treatment has resulted in an increase in TB deaths. The estimates for 2020 are 1.3 million TB deaths among HIV-negative people (up from 1.2 million in 2019) and an additional 214 000 among HIV-positive people (up from 209 000 in2019). There has also been limited progress in scaling up access to treatment to prevent TB.

Immune Response and Survival During Antiretroviral Therapy in Patients With HIV And Hepatitis B and/or C Virus Co-Infections In Kumba Health District, South West Region of Cameroon


Ndifontiayong Adamu Ndongho

Dschang University, Cameroon

Hepatitis B (HBV) and C (HCV) are two among the numerous forms of infections whose clinical degeneration,morbidity-mortality and low immune responsiveness in people living with human immuodeficiency virus (HIV) are highly evident. Co-infection between HIV, HBV and HCV has been associated with reduced survival, increased risk of progression to liver diseases and increased risk of hepatotoxicity associated to antiretroviral therapy. The aim of this study was to establish the prevalence of hepatitis B surface antigen (HBsAg) and hepatitis C antibody (HCVAb) among HIV-infected individuals,treatment outcomes and identified tha associated risk factors in Kumba Health, in the South West Region of Cameroon. We performed a systematic screening using RDT for HBsAg (hepatitis B surface antigent) and HCVAb (hepatitis C virus antibody) among 299 HIV-positive patients enrolled at Kumba District hospital, CMA Kumba Town hospital and Banga-Bakundu Apostolic Hospital in Kumba Health District. All the positive results for HBsAg and HCVAb were further confirmed by the ELISA test. The results were analyzed to determine the prevalence, treatment outcomes and possible risk factors. After having determined the prevalences, a total of 52 HIV patients, 36 HIV/HBV and 12 HIV/HCV patient swere involved in the prospective cohort study for 12 months follow up. We performed CD4 counts,viral load test, analyzed ALAT/ASAT, albumin, bilirubine, creatinine and measured the weights of HIV patients, HIV/HBV and HIV/HCV, enrolled for not more than one year in Kumba Health District. Out of the 299 HIV positive patients screened for HBV and HCV, 36 (12.0%) were positive for HBV and 12 (4%)for HCV by both RDT and ELISA. In addition, majority of the study participants were Single/Cohabiting/Separated 160 (53.5%), Christians 282 (94.3%), Farmers 100 (33.4%), from rural areas 202 (67.6%),and those who have received blood from someone 267 (89.3%). There were differences in response to HAART between the mono-infected compared with the co-infected patients, taking into consideration the weight, CD4 count, and viral load during the 12 months follow up. In addition, there were also variations in the different biomarkers of liver and renal function between mono-infected and co-infected patients. Routine screening of people living with HIV for HBsAg and HCAb should be considered and drugs that target both infections should be included in the treatment protocol.

Effect of Electroporation and Photodynamic Therapy on Staphylococcus Aureus Biofilm Matrix


Wanessa Melo

Institute Center for Physical Sciences and Technology, Lithuania

Currently, biofilms have been the cause of a wide variety of infections in the human body, reaching 80% of all microbial infections. Antimicrobial photodynamic therapy (aPDT) has been shown asa promising candidate to overcome this problem. However, due to biofilms present extracellular polymericsubstance (EPS), the penetration of photosensitizers (PS) is limited and the effect of aPDT is harmed. The effective transport of PS across the biofilm matrix to reach the deeper cells is a crucial element to completly kill the biofilm. Thus, electroporation (EP) could increase the effectiveness of aPDT,by promoting the formation of transient pores that enhance the EPS permeability. In this study we evaluated evaluate the synergism between aPDT and EP against the Staphylococcus aureus biofilm, detecting,mainly, the effect of this on the S. aureus EPS components (proteins and carbohydrates). S. aureus biofilm was exposed to light (630 nm) in the presence of methylene blue- MB (1 mg mL-1), following electroporation. The viability of S. aureus biofilm after only aPDT treatment or only EP was around45.4% and 93.1% respectively, while the synergism between them promoted a significant decreasing inthe SI of the bacteria biofilm (~5.08%). In addition, aPDT/EP reduced 91.71% and 95.05% of proteins and carbohydrates present in the EPS extracted from S. aureus biofilm. The effect of the red light or MBalone did not caused S. aureus biofilm reduction, as the EP only condition. The author suggests that the EP may increased the EPS permeability allowing the PS to reach the biofilm bottom layer and consequently the deeper cells, intensifying aPDT effect.

Environmental And Social Effects on The Incidence of Tuberculosis In Three Brazilian Municipalities And In Federal District


Fernanda Monteiro de Castro Fernandes

University of Brasília, Brazil

Introduction: The territorial characteristics, heterogeneities of landscapes, and the regional profiles of Brazil show great disparities in the spatial distribution of tuberculosis burden. Objective of this stud yis to analyze the effects of environmental and social factors on tuberculosis incidence in three Brazilian municipalities and in the Federal District of Brazil.

Methodology: We performed an ecological study carried out with 131,576 new cases of tuberculosis registered in the Brazilian national disease notification system. For our research we used climatic data,topographic data and socioeconomic data.

Results: Wind speed and vapor pressure increased the risk of tuberculosis infection between 4.6 and5.8 times in the three municipalities, in comparison with the Federal District. In Recife socioeconomic aspects showed a greater association with tuberculosis. Lack of garbage collection, poor basic sanitation,and access to drinking water, respectively, increased 49, 33, and 28 times the risk of infection. In the multiple regression analysis, Rio de Janeiro showed several environmental characteristics–such as precipitation (p=0.002), radiation (p=0.020) and water vapor (p=0.055) – and social characteristics associated with tuberculosis-such as the lack of sewage treatment, which revealed a 13.5-fold higher risk of infection (p < 0.001).

Conclusion: Incidence in the areas studied was influenced by environmental and social conditions at different levels depending on the territory where the problem was identified. The results make it possible to guide an urban and social policy to reach the targets set out in the WHO End tuberculosis Strategy in large Brazilian urban agglomerations.

COVID-19 and Inmununological Reactions to Dermal Fillers


Verónica López Pérez

Hospital Universitario 12 de Octubre, Spain

Dermal filler procedures using hyaluronic acid (HA) have increased up to 16% to more than 4,3 million worldwide from the previous year. Even when HA is safe, non-allergenic, non-immunogenic,effective, predictable, non-carcinogenic, non-migratory, and cost-effective, hypensensivity reactions related to SARS-CoV-2 infection have been reported. Even when the true incidence of delayed-type hypersensitivity reactions remains unknown, the incidences can vary between 0.3% and 4.25%, mainly with low molecular weight AH. Immunoglobulin E (IgE)-mediated hypersensitivity reactions(Type 1,occur rapidly within minutes or hours, and they originate anaphylaxis or angioedema. Delayed-type hypersensitivity to HA occurring anywhere between 24 hours to weeks or months after the filling, and are caused by a T-lymphocyte mediated response. They present as a firm erythematous swelling that is often tender to touch. Previous case reports on delayed hypersensitivity reactions to HA filler following influenza-type illnesses or after flu vaccination have been published. Since January 2021, several publications of patients presenting with a delayed-type hypersensitivity reaction to HA dermal filler after suffering infection associated with active infection of SARS-CoV-2, and after vaccination with Moderna and Pfizer, cutaneous reactions were reported, mainly delayed large local reactions including cosmeticfiller reactions. This may be due to vaccines triggering an immune response, but are not thought to significantly increase the risk of soft tissue filler adverse events when compared with other vaccinations orflu-like illnesses. It´s also important possible host susceptibility. This reactions usually are self- solving,but if they persist, they could be trated with steroids ranging between 30 and 60 mg daily, except if wesuspect infection. Some authors describe dissolution of the HA, that will also prevent recurrences. Low do sesteroids can be safely used even in COVID patients. Cases of dermal filler swelling resulting fromSARS-CoV-2 vaccination with the Moderna-type vaccine (Moderna, Cambridge MA) have been successfully treated with Lisinopril, an angiotensin-converting enzyme inhibitor (ACE-1) to decrease cutaneous inflammation within 72 hours.

Use of the Whole Country Insulin Consumption Data In Israel Showed A Reduced Prevalence Of Type 1 Diabetes In Children Aged <5 Years During Universal Rotavirus Vaccination


Zvi Laron1, Orit Blumenfeld2, Gabriella Lawrence3 and Lester Shulman4

1Schneider Children’s Medical Center, Israel
2Israel Center for Disease Control, Israel
3Hebrew University, Israel
4Central Virology Laboratory, Israel

Background: Recent studies showed that Rotavirus vaccination may affect the prevalence of type 1diabetes (T1D). Our aim is to determine the prevalence of early childhood (<5 years) T1D before and during the introduction of Rotavirus vaccination in Israel by syndromic surveillance.

Methods: Data on insulin purchases reported by Israel’s four health care organizations (HMOs) was retrieved from the National Program for Quality Indicators in Community Healthcare (QICH).

Results: During the pre- vaccination years (2002-2007) a steady increase of insulin purchases was reported in the young (<5 years). The period percent change (PC) of children aged <5 years old diagnosed with T1D inferred from purchased insulin prescriptions increased by 50.0%, and the annual percent change (APC) increased by 10.0% (p=0.01). During the period of free, universal Rotavirus vaccination(2011-2018), the PC for T1D diagnoses among children aged <5 years decreased by 3.8% with an APC of -2.5% (p=0.14). There was a significant difference (p=0.002) between the increasing trend in insulinuse before vaccination versus the decreasing trend after vaccination.

Conclusion: Rotavirus vaccination correlated with attenuation of the increasing rate in the prevalence of T1D in <5 year-old children in Israel.

Agent-Based Models for Influenza Epidemic Dynamics And Its Decision-Making Capability


Valeriy D. Perminov

Bioteckfarm Ltd, Russian Federation

Agents-based models (ABM) become more and more popular in applied mathematics. During last 15 years a large number of ABM have been created and used in different scientific area (ecology, economy,epidemiology, human behavior to name a few), but in this paper, only ABM for influenza epidemic/pandemic dynamics in cities are considered in detail. Based on a critical review of currently accepted ABM of such special type new ABM has been proposed. Unlike the old ABM, it can be used for analysis of efficiency and cost of all interventions (how for ones had been carried out before and during epidemic or pandemic under consideration and ones that could be implemented but had not been carried out for some reasons). Moreover, under some conditions, new ABM gives us an opportunity to analyze efficiency and cost of different interventions for future oncoming epidemics (first of all pandemics) and to select its optimal combination.

Genotypic Characterization Of ‘Inferred’ Rifampicin Mutations in Genotype MTBDR plus Assay And Its Association With Phenotypic Susceptibility Testing Of Mycobacterium Tuberculosis


Ritu Singhal

National Institute of Tuberculosis and Respiratory Diseases, India

Drug resistant tuberculosis diagnosis has been revolutionized with emergence of rapid molecular techniques such as Genotype MTBDR plus assay wherin M. tuberculosis isolate which fails to hybridizeto atleast one rpoB wild-type without specific mutation probe is inferred as rifampicin (RIF)-resistant.Specific mutation(s) type and its association to phenotypic drug resistance, however remains unknown,hence we sought to identify ‘inferred mutations’ in M. tuberculosis isolates and their association with phenotypic resistance.Methods. Ten thousand M. tuberculosis isolates were screened to identify ‘inferred mutations’ in Genotype MTBDRplus assay. Among these, n=203 isolates with ‘inferrred mutations’ were subjected to phenotypic drug susceptibility testing (DST) and sequencing.Results: 139/203 (68.5%) isolates were resistant and 64/203 (31.5%) were sensitive in phenotypicRIF-DST. Sequencing showed that presence of ‘inferred mutations’ was not always associated with phenotypicRIF-resistance at standard drug concentrations. Common mutations associated with discrepantphenotypic RIF-sensitivity results were D516Y (26.5%), H526N (17.2%), L511P (15.6%) and L533P(6.2%) whereas, RIF-resistant isolates coomonly had S531W (22.6%), D516Y (15.7%), L511P (10.8%)and H526N (10.3%) mutations. Additionally, 19 novel mutations were found in this study after extensive data mining.Conclusion: Incorporation of additional mutation probes such as S531W in Genotype MTBDRplus assay can further increase specificity and ease of detection of RIF-resistance. Susceptible phenotypic DSTresults in such cases amounts to delayed diagnosis of resistance and less effective treatment outcomes.This highlights the need to redefine MGIT cut-off concentrations for RIF DST. Further studies are needed to establish significance of type of mutation with clinical outcomes.

CTPF Mediated Calcium Flux in Required for MTB Survival in Macrophages


Rajni Garg1,2, Salik M. Borbora1, Sandhya Rao1, Harsh Bansia1, PrakrutiSingh1, Rinkee Verma1, Balaji KN1 and Valakunja Nagaraja1

1Indian Institute of Science, India
2CSIR-Institute of Microbial Technology, India

In its uncanny ways dealing with the host, Mycobacterium tuberculosis (Mtb) has developed a variety of strategies to persist in humans. Perturbation of host ion homeostasis is one of the strategies advanced by the pathogen for its survival. Calcium is a very important secondary messenger, whose concentration in various cellular compartments is under tight regulation. A slight disturbance in the levels of calcium in these compartments can play havoc in the cell. Here, we have investigated the role of ctpF, a DevR regulated gene, on intracellular survival of Mtb. ctpF is a robust calcium transporting P2A ATPase. The levels of ctpF are upregulated in stresses like hypoxia, high nitric oxide levels and high CO2 levels. Using confocal microscopy and fluorimetry, we show in this work that CtpF effluxes calcium in macrophages in early stages of infection. Conditional knockdown of ctpF expression resulted in perturbation of host calcium levels and consequent decreased phosphorylation of mTOR, enhanced autophagy, and hence increased bacterial clearance. The study throws light on how Mycobacterium uses its membrane proteins to invade host signalling pathways for its own survival.

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