Objective:To describe the situation of measles in Sri Lanka from May to November,2023 and to define the role of virology laboratory towards case confirmation and epidemiological and genetic characterization of the out...Objective:To describe the situation of measles in Sri Lanka from May to November,2023 and to define the role of virology laboratory towards case confirmation and epidemiological and genetic characterization of the outbreak.Methods:This retrospective study analyzed all samples tested for measles from 1st of May to 30th of November,2023 at National Measles Rubella Laboratory,Sri Lanka.According to the World Health Organization(WHO)algorithm,serum and oropharyngeal/nasopharyngeal swabs were tested with WHO recommended kits for anti-measles IgM and measles virus specific RNA,respectively.Selected RNA positive samples were sequenced at reference laboratory,India.Analysis of sequencing data and construction of phylogenetic tree were carried out at National Measles Rubella Laboratory.Data was analyzed using descriptive statistics.Results:Of the total 1132 serum samples and 497 oropharyngeal/nasopharyngeal swabs from 1326 patients,657(49.5%)patients were confirmed as measles by anti-measles IgM,measles virus specific RNA or both.Males(55.6%,n=365)and the age group from>20 to≤30 years(33.0%,n=217)predominated positive patients.All provinces reported measles positive cases.All samples sequenced(100%,n=42)were genotype D8 with 95.2%(n=40)bearing Victoria.Australia origin.Conclusions:We described resurgence of measles in an eliminated country,confirming the genotype to be D8,one of the two genotypes currently circulating globally.Further,the study strongly convinced the importance of a strengthened virological surveillance system in an eliminated country,despite its eliminated status.展开更多
During pregnancy,maternal immune activation(MIA),due to infection,chronic inflammatory disorders,or toxic exposures,can result in lasting health impacts on the developing fetus.MIA has been associated with an increase...During pregnancy,maternal immune activation(MIA),due to infection,chronic inflammatory disorders,or toxic exposures,can result in lasting health impacts on the developing fetus.MIA has been associated with an increased risk of neurodevelopmental disorders,such as autism spectrum disorder(ASD)in the offspring.ASD is characterized by increased repetitive and stereotyped behaviors and decreased sociability.As of 2020,1 in 36 children are diagnosed with ASD by the age of 8 years,with ASD rates continuing to increase in prevalence in USA(Tamayo et al.,2023).Post-mortem brain studies,biomarker and transcriptomic studies,and epidemiology studies have provided compelling evidence of immune dysregulation in the circulation and brain of individuals diagnosed with ASD.Currently,the etiology of ASD is largely unknown,however,genetic components and environmental factors can contribute to increased susceptibility.Maternal allergic asthma(MAA),a form of MIA,has been identified as a potential risk factor for developing neurodevelopmental disorders(Patel et al.,2020).Asthma is a chronic inflammatory condition driven by a T-helper type(TH)2 immune response.展开更多
Objective:To address the lack of research on invasive group B Streptococcus(GBS)infections in Malaysia and Southeast Asia through a comprehensive analysis of GBS isolates obtained from hospitals.Methods:Medical record...Objective:To address the lack of research on invasive group B Streptococcus(GBS)infections in Malaysia and Southeast Asia through a comprehensive analysis of GBS isolates obtained from hospitals.Methods:Medical records from patients with GBS infection isolated from the sterile site,such as blood and cerebrospinal fluid from 14 July 2019 to 15 December 2020,were reviewed from six major hospitals in Peninsular Malaysia.Inclusion criteria were invasive GBS,sterile sites and non-repeated GBS isolated from the same patients in the same admission.Viable isolates were re-identified for GBS and serotyped.Results:A total of 118 patients were eligible,with a majority of non-pregnant adults(76.3%).Over half of the patients(62.7%)had underlying medical conditions,with diabetes as the most common disease,followed by respiratory disease,renal disease,cardiovascular disease and skin and soft tissue disease.The most common manifestations were sepsis,followed by soft tissue abscess,diabetic foot ulcer,wet gangrene and cellulitis.The overall mortality was 7.6%.The most common serotype was serotype桋.Conclusions:Invasive GBS infection among non-pregnant adults showed a rising trend,particularly among diabetic individuals.The study underscores the importance of reducing risk factors and highlights the necessity of developing GBS vaccination as a preventive strategy for both infants and adults.展开更多
AIM: To investigate the inhibitory effects of emodin, baicalin, etc.on the hefA gene of multidrug resistance(MDR) in Helicobacter pylori(H.pylori).METHODS: The double dilution method was used to screen MDR H.pylori st...AIM: To investigate the inhibitory effects of emodin, baicalin, etc.on the hefA gene of multidrug resistance(MDR) in Helicobacter pylori(H.pylori).METHODS: The double dilution method was used to screen MDR H.pylori strains and determine the minimum inhibitory concentrations(MICs) of emodin, baicalin, schizandrin, berberine, clarithromycin, metronidazole, tetracycline, amoxicillin and levofloxacin against H.pylori strains.After the screened MDR stains were treated with emodin, baicalin, schizandrin or berberine at a 1/2 MIC concentration for 48 h, changes in MICs of amoxicillin, tetracycline, levofloxacin, metronidazole and clarithromycin were determined.MDR strains with reduced MICs of amoxicillin were selected to detect the hefA mR NA expression by realtime quantitative PCR.RESULTS: A total of four MDR H.pylori strains were screened.Treatment with emodin, baicalin, schizandrin and berberine significantly decreased the MICs of amoxicillin and tetracycline against some strains, decreased by 1 to 2 times, but did not significantly change the MICs of clarithromycin, levofloxacin, and metronidazole against MDR strains.In the majority of strains with reduced MICs of amoxicillin, hef A m RNA expression was decreased; one-way ANOVA(SPSS 12.0) used for comparative analysis, P < 0.05.CONCLUSION: Emodin, baicalin, schizandrin and berberine significantly decreased the MICs of amoxicillin and tetracycline against some H.pylori strains, possibly by mechanisms associated with decreasing hefA mR NA expression.展开更多
AIM： To analyze the epidemiological, clinical and laboratory findings of infectious keratitis.METHODS： A retrospective study on cases of infective keratitis, attended our institution from Mar. 2013 to Feb. 2015, was...AIM： To analyze the epidemiological, clinical and laboratory findings of infectious keratitis.METHODS： A retrospective study on cases of infective keratitis, attended our institution from Mar. 2013 to Feb. 2015, was done at Mansoura Ophthalmic Center, Egypt. Corneal scrapings were performed and processed for direct microscopy and culture in appropriate media using standard laboratory protocols.RESULTS： Out of 245 patients enrolled for study, 247 corneal scrapings were obtained. Ocular trauma was the most common predisposing factor （51.4%）, followed by diabetes mellitus （15.1%）. Cultures were positive in 110 scraping samples （44.5%）： 45.5% samples had pure fungal infection, 40% had pure bacterial infections and 10% had mixed fungal and bacterial growths. Acanthamoeba was detected in 5 （4.5%） samples. The most common fungal pathogen was Aspergillus spp. （41%）. The most common bacterial isolates were Staphylococcus aureus （38.2%） and Pseudomonas aeruginosa （21.8%）.CONCLUSION： Incidence of fungal keratitis is high in our region. Therapeutic approach can initially be based on clinical features and sensitivity/resistance patterns. Microbiological research should direct the antimicrobial treatment. Antibiotic resistance to fluoroquinolones and aminoglycosides is an important consideration.展开更多
AIM:To characterise the cag pathogenicity island in Helicobacter pylori(H.pylori) isolates by analysing the strains' vacA alleles and metronidazole susceptibilities in light of patient ethnicity and clinical outco...AIM:To characterise the cag pathogenicity island in Helicobacter pylori(H.pylori) isolates by analysing the strains' vacA alleles and metronidazole susceptibilities in light of patient ethnicity and clinical outcome.METHODS:Ninety-five H.pylori clinical isolates obtained from patients with dyspepsia living in Malaysia were analysed in this study.Six genes in the cagPAI region(cagE,cagM,cagT,cag13,cag10 and cag67) andvacA alleles of theH.pylori isolates were identified by polymerase chain reaction.The isolates' metronidazole susceptibility was also determined using the E-test method,and the resistant gene was characterised by sequencing.RESULTS:More than 90% of the tested isolates had at least one gene in the cagPAI region,and cag67 was predominantly detected in the strains isolated from the Chinese patients,compared with the Malay and Indian patients(P < 0.0001).The majority of the isolates(88%) exhibited partial deletion(rearrangement) in the cagPAI region,with nineteen different patterns observed.Strains with intact or deleted cagPAI regions were detected in 3.2% and 8.4% of isolates,respectively.The prevalence of vacA s1m1 was significantly higher in the Malay and Indian isolates,whereas the isolates from the Chinese patients were predominantly genotyped as vacA s1m2(P = 0.018).Additionally,the isolates from the Chinese patients were more sensitive to metronidazole than the isolates from the Malay and Indian patients(P = 0.047).Although we attempted to relate the cagPAI genotypes,vacA alleles and metronidazole susceptibilities to disease outcome,no association was observed.The vacA alleles were distributed evenly among the strains with intact,partially deleted or deleted cagPAI regions.Interestingly,the strains exhibiting an intact cagPAI region were sensitive to metronidazole,whereas the strains with a deleted cagPAI were more resistant.CONCLUSION:Successful colonisation by different H.pylori genotypes is dependent on the host's genetic makeup and may play an important role in the clinical outcome.展开更多
Objective:To explore the prevention of rerurrent candiduria using natural based approaches and to study the antimicrobial effect of Hibiscus sabdariffa(H.sabdariffa) extract and the biofilm forming capacity of Candida...Objective:To explore the prevention of rerurrent candiduria using natural based approaches and to study the antimicrobial effect of Hibiscus sabdariffa(H.sabdariffa) extract and the biofilm forming capacity of Candida albicans strains in the present of the H.sabdariffa extract.Methods:In this particular study,six strains of fluconazole resistant Candida albicans isolated from recurrent candiduria were used.The susceptibility of fungal isolates,time-kill curves and biofilm forming capacity in the present of the H.sabdariffa extract were determined.Results:Various levels minimum inhibitory concentration of the extract were observed against all the isolates.Minimum inhibitory concentration values ranged from 0.5 to 2.0 mg/mL Timekill experiment demonstrated that the effect was fungistatic.The biofilm inhibition assay results showed that H.sabdariffa extract inhibited biofilm production of all the isolates.Conclusions:The results of the study support the potential effect of H.sabdariffa extract for preventing recurrent candiduria and emphasize the significance of the plant extract approach as a potential antifungal agent.展开更多
AIM To understand the effects of delivery mode on the immune cells frequency and function in cord blood and placenta.METHODS We evaluated immunological differences in cord blood and placental tissues for a case of twi...AIM To understand the effects of delivery mode on the immune cells frequency and function in cord blood and placenta.METHODS We evaluated immunological differences in cord blood and placental tissues for a case of twins one of which delivered vaginally while the other delivered by caesarian section(C-section). Cord blood mononuclear cells were isolated and placenta tissues were processed for cell isolation. Immune phenotyping was performed by flow cytometry methods following staining for T cells, natural killer(NK) cells, monocytes, neutrophils and CD71^+erythroid cells in both cord blood and placenta tissues. In addition, fetal calprotectin of twins was measured 12 wk after birth.RESULTS We found lower percentages of immune cells(e.g. T cells, monocytes and neutrophils) in the cord blood of C-section delivered compared to vaginally delivered newborn. In contrast, percentages of monocytes and neutrophils were > 2 folds higher in the placental tissues of C-section delivered newborn. More importantly, we observed lower percentages of CD71^+ erythroid cells in both cord blood and placental tissues of C-section delivered case. Lower CD71^+ erythroid cells were associated with a more pro-inflammatory milieu at the fetomaternal interface reflected by higher expression of inhibitory receptors on CD4^+ T cells, higher frequency of monocytes and neutrophils. Furthermore, type of delivery impacted the gene expression profile in CD71^+erythroid cells. Finally, we found that C-section delivered child had > 20-fold higher FCP in his fecal sample at 12 wk of age.CONCLUSION Mode of delivery impacted immune cells profile in cord blood/placenta. In particular frequency of immunosuppressive CD71^+ erythroid cells was reduced in C-section delivered newborn.展开更多
Objective:To genotypically characterize methicillin-resistant Staphylococcus aureus(MRSA)strains isolated from medical and surgical wards in Universiti Kebangsaan Malaysia Medical Centre(UKMMC)in 2009.Methods:MRSA str...Objective:To genotypically characterize methicillin-resistant Staphylococcus aureus(MRSA)strains isolated from medical and surgical wards in Universiti Kebangsaan Malaysia Medical Centre(UKMMC)in 2009.Methods:MRSA strains were collected and molecularly typed by pulsed-field gel electrophoresis(PFGE).Results:PFGE typing on 180 MRSA isolated in UKMMC identified 5 pulsotypes(A-E)and 6 singletons,where pulsotypes B and C were suspected to he divergent clones originating from a single ancestor.This study also showed that most MRSA strains were isolated from swab(119 isolates),followed by blood(22 isolates),tracheal aspirate(11isolates)and sputum(10 isolates).On the other hand,urine and bone isolates were less,which were 4 and 1 isolates,respectively.The distribution of different pulsotypes of MRSA among wards suggested that MRSA was communicated in surgical and medical wards in UKMMC,with pulsotype B MRSA as the dominant strain.Besides,it was found that most deceased patients were infected by pulsotype B MRSA,however,no particular pulsotype could be associated with patient age,underlying disease,or ward of admittance.Conclusions:Five pulsotypes of MRSA and 6singletons were identified,with pulsotype B MRSA as the endemic strains circulating in these wards,which is useful in establishment of preventive measures against MRSA transmission.展开更多
This study was conducted to assess the occurrence and nature of extended-spectrum beta lactamase (ESBL) producing <em>Escherichia coli</em> and <em>Klebsiella pneumoniae</em> isolates from pati...This study was conducted to assess the occurrence and nature of extended-spectrum beta lactamase (ESBL) producing <em>Escherichia coli</em> and <em>Klebsiella pneumoniae</em> isolates from patients who presented with urinary tract infection at Federal Teaching Hospital Gombe. Isolates collected were recovered on MacConkey agar at 35<span style="white-space:nowrap;">°</span>C and were identified as members of Enterobacteriaceae, and further screened for antimicrobial susceptibility and resistance by disc diffusion method. Isolates resistant to oxyimino-cephalosporins were confirmed as ESBL producers using Double Disks Synergy Test (DDST). The study shows 66% resistance to ceftriaxone (30 μg) in <em>K. pneumoniae</em>, which was the highest value recorded and a 51% resistance to cefpodoxime (10 <em>μ</em>g) in <em>E. coli</em>. The sensitivity of <em>E. coli </em>and <em>K. pneumoniae</em> isolates to cefpodoxime (10 <em>μ</em>g) were 49% and 33.9% respectively. ESBLs were detected among 40% (40/100) of <em>E. coli</em> and 54.13% (59/109) of <em>K. pneumoniae</em> isolates. Molecular characterization of ESBL encoding genes among <em>E. coli</em> isolates using multiplex-PCR showed 10% prevalence of SHV gene and 5% prevalence for CTX-M gene while TEM gene was not detected. In <em>K. pneumoniae</em> isolates, 5% prevalence was recorded for each of the three genes screened. The study revealed a co-occurrence of SHV and CTX-M in 75% of the <em>E. coli</em> and 70% of the <em>K. pneumoniae</em> isolates;the occurrence of all the three genes was seen in 10% and 5% of <em>K. pneumoniae</em> and <em>E. coli</em> respectively. Multiplex-PCR method provided an efficient and rapid detection of ESBL related genes, hence could be used in epidemiological studies among ESBL isolates. Monitoring dissemination and transmissions of ESBL producers are highly recommended for optimum patient care and preventing the spread of multidrug resistant (MDR) pathogens.展开更多
Natural antibodies serve as the body’s first line of defense against pneumococcal challenge. Polyreactive human pneumococcal polysaccharide IgG antibodies have not been extensively studied. We analyzed human polyreac...Natural antibodies serve as the body’s first line of defense against pneumococcal challenge. Polyreactive human pneumococcal polysaccharide IgG antibodies have not been extensively studied. We analyzed human polyreactive antibodies that bind multiple pneumococcal polysaccharides, including PPS14 and PPS23F. These antibodies were isolated from single pneumococcal polysaccharide specific B cells allowing for the analysis of human immunoglobulins with natively paired variable regions. Although isolated individually, these antibodies demonstrated similar characteristics. Most antibodies possessed a variable light chain with a CDR3 length made up of nine amino acids and relatively high number of flexible amino acids in combined VH/VL. While these antibodies were polyreactive and structurally alike, kinetic analysis revealed unique KD values. Variable chains are responsible for antigen recognition whereas antibody fine specificity is affected by isotype structure. To investigate the contribution of the constant region of these isotypes and their effect on antibody avidity to pneumococcal polysaccharide, the polyreactive variable regions were expressed as IgG1 or IgG2 and subjected to kinetic analysis. The IgG1 antibodies uniformly had a stronger avidity to PPS14 and PPS23F compared to IgG2. To further document the importance of the constant region in antibody avidity and fine specificity, analysis of antibody F(ab)’2 fragment binding to PPS14 and PPS23F resulted in similar KD values. These studies suggest that antigen recognition by polyreactive antibodies is determined by a conserved variable light chain CDR3 length and longer, more flexible variable heavy CDR3s when compared to pneumococcal polysaccha-ride-specific sequences while differences in specific avidities are modulated by antibody isotype.展开更多
BACKGROUND Human immunodeficiency virus(HIV)infection is a major global public health concern.North African countries carry a disproportionate burden of HIV representing one of the highest rates in Africa.AIM To chara...BACKGROUND Human immunodeficiency virus(HIV)infection is a major global public health concern.North African countries carry a disproportionate burden of HIV representing one of the highest rates in Africa.AIM To characterize the epidemiological and spatial trends of HIV infection in this region.METHODS A systematic review was carried out on all the published data regarding HIV/acquired immunodeficiency syndrome in North African countries over ten years(2008-2017)following the PRISMA guidelines.We performed a comprehensive literature search using Medline PubMed,Embase,regional and international databases,and country-level reports with no language restriction.The quality,quantity,and geographic coverage of the data were assessed at both the national and regional levels.We used random-effects methods,spatial variables,and stratified results by demographic factors.Only original data on the prevalence of HIV infection were included and independently evaluated by professional epidemiologists.RESULTS A total of 721 records were identified but only 41 that met the criteria were included in the meta-analysis.There was considerable variability in the prevalence estimates of HIV within the countries of the region.The overall prevalence of HIV ranged from 0.9%[95%confidence interval(CI)0.8-1.27]to 3.8%(95%CI 1.17-6.53).The highest prevalence was associated with vulnerable groups and particularly drug abusers and sexually promiscuous individuals.The dense HIV clustering noted varied from one country to another.At least 13 HIV subtypes and recombinant forms were prevalent in the region.Subtype B was the most common variant,followed by CRF02_AG.CONCLUSION This comprehensive review indicates that HIV infection in North African countries is an increasing threat.Effective national and regional strategies are needed to improve monitoring and control of HIV transmission,with particular emphasis on geographic variability and HIV clustering.展开更多
Background: Typhoid disease remains a major public health problem globally, especially in developing countries in sub-Saharan Africa. Symptoms associated with typhoid disease mimic those of other febrile illnesses and...Background: Typhoid disease remains a major public health problem globally, especially in developing countries in sub-Saharan Africa. Symptoms associated with typhoid disease mimic those of other febrile illnesses and are thus difficult to make an accurate diagnosis. A confirmed diagnosis requires the determination or isolation of the bacteria in well-equipped laboratories. Developing countries are faced with a huge limitation of the laboratory infrastructure to diagnose typhoid disease, which would otherwise guide in treating, managing, controlling, and halting the spread of drug resistant mutants. Objective: This study, therefore, was aimed at determining the clinical presentation, performance of diagnostic tests and antibiotic susceptibility testing of Salmonella among adults attending Kangema Sub-County Hospital. Study Population: The study population was residents of Kangema Sub-County in Murang’a County, Kenya while the target population was adults. Methods: The study adopted a cross-sectional study design that employed a systematic random sampling procedure. The study took place between April and June 2021. The sample size was 97 respondents who all consented and were enrolled in the study. Interviewing the respondents was carried out by administering structured questionnaires to collect quantitative data. Stool samples were obtained and cultured in Cary Blair transport media and then cultured in appropriate media at the Murang’a County Referral Hospital Laboratory. A rapid Salmonella Antigen (SAT) test was also performed on all the stool samples. Data Analyses: Word Statistics and Data (STATA) v 13 was used for statistical analysis. Results: The prevalence of Typhoid Fever was at 6.2% (95% CI) which included S. Typhi (n = 1;16.7%) and S. Paratyphi B (n = 5;83.3%). No isolate showed resistance to Ciprofloxacin. The sensitivity of SAT is 100% and a specificity of 98.9% with a kappa statistic of almost perfect agreement (0.9641) with culture. Patients who had fever p = 0.001, abdominal distention p = 0.028, diarrhoea p = 0.038, loose or watery stool p = 0.021 and mild general condition p = 0.02 remained independently associated with Salmonella infection. Conclusion: Typhoid Fever being endemic, laboratory diagnosis was a key for confirmation after clinical diagnosis. SAT can accurately be used to detect the disease where culture is unavailable. However, antibiotic sensitivity tests were crucial when determining the drug of choice as Salmonella isolates were multi-drug resistant. Establishment of prescribing antimicrobial policies and guidelines can periodically monitor the antibiogram patterns.展开更多
Background: Carbapenem resistant extended spectrum β-lactamase (ESBL) producing Klebsiella pneumoniae (K. pneumoniae) is increasing worldwide. Carbapenem resistance (CR) has been attributed not only to production of ...Background: Carbapenem resistant extended spectrum β-lactamase (ESBL) producing Klebsiella pneumoniae (K. pneumoniae) is increasing worldwide. Carbapenem resistance (CR) has been attributed not only to production of carbapenemases but also to permeability barriers due to outer membrane proteins (OmpK35 and OmpK36) disruption. Objective: Phenotypic detection of CR among ESBL producing K. pneumoniae isolates, followed by the evaluation of the role of ompK35 and ompK36 gene expression among carbapenem resistant K. pneumoniae (CR-KP) isolates. Methods: 100 ESBL producing K. pneumoniae isolates were included in this study. Minimum inhibitory concentration (MIC) of imipenem was performed for all isolates by broth microdilution method. For CR-KP isolates, phenotypic detection of K. pneumoniae carbapenemase (KPC), metallo-β-lactamase (MBL) and AmpC enzymes was performed followed by Realtime qRT-PCR to detect and quantify ompK35 and ompK36 gene expression. Results: 42% of our isolates were carbapenem resistant, and all of them were KPC producers either singly or in combination with MBL and/or AmpC production. Reduced expression of both ompK35 and ompK36 was detected in (52.38%) of CR-KP isolates, while reduced expression of ompK36 or ompK35 alone was found in (2.38%) and (33.33%) respectively. Twenty of 42 CR-KP isolates (47.62%), showing reduced ompK35 and ompK36 expression, exhibited high level resistance (HLR) (>32 μg/ml) to imipenem. There was a significant correlation between reduced expression of ompK36 and increase MIC values (p < 0.05). The combined production of MBL or AmpC together with reduced expression of ompK35 and/or ompK36 resulted in significant increase in imipenem MIC (p < 0.05). Conclusion: The combined OmpK35/OmpK36 loss resulted in HLR. However OmpK36 seems to play a major role in those strains. Imipenem MIC was markedly increased among K. pneumoniae showing carbapenemase and/or AmpC production together with loss of OmpK35 and/or OmpK36.展开更多
The risk of liver injury in patients with coronavirus disease 2019(COVID-19)infection is quite evident.Furthermore,liver function test abnormalities are still detected in COVID-19 patients despite the development of a...The risk of liver injury in patients with coronavirus disease 2019(COVID-19)infection is quite evident.Furthermore,liver function test abnormalities are still detected in COVID-19 patients despite the development of antivirals and the availability of several types of vaccines.This editorial describes liver involvement during COVID-19 infection in patients with or without preexisting liver injury,such as chronic liver disease,to elucidate COVID-19-induced liver function abnormalities and their severity,pathophysiology,clinical manifestations,and clinical and laboratory outcomes.We also discuss the effect of vaccination against COVID-19 to better understand host factors,such as age,gender,and race,on the incidence and severity of liver dysfunction at initial presentation and during the illness.Finally,we summarize the results of relevant meta-analyses published to date and highlight the importance of adequate liver function monitoring in the current climate of the overwhelming COVID-19 pandemic.展开更多
The objective of the study was to determine the antibacterial efficacy of Bidens pilosa Aqueous (BPA), Bidens pilosa Ethanolic (BPE), Ageratum conyzoides Aqueous (ACA), Ageratum conyzoides Ethanolic (ACE), Ocimum suav...The objective of the study was to determine the antibacterial efficacy of Bidens pilosa Aqueous (BPA), Bidens pilosa Ethanolic (BPE), Ageratum conyzoides Aqueous (ACA), Ageratum conyzoides Ethanolic (ACE), Ocimum suave Aqueous (OSA) and Ocimum suave Ethanolic (OSE) extracts on HIV/AIDS patients’ oral bacteria. Healthy green leaves of the plants were collected in Ishaka Uganda, processed and portions separately extracted with hot distilled water and cold ethanol. The susceptibility, MIC and MBC of each extract were determined using standard protocols. The bacteria had significant (p Bidens pilosa, Ageratum conyzoides and Ocimum suave on oral lesions of HIV/AIDS patients made by traditional healers and local people in South-Western Uganda. We recommend a detailed study of structural identities and activities of the active antibacterial principle(s) in these plants for possible new drug entities and verification of the interactive effects of the principle(s) with ARVs and cotrimoxazole used daily by HIV/AIDS patients.展开更多
BACKGROUND Gastric cancer(GC)is the fourth leading cause of cancer-related deaths worldwide.Diagnosis relies on histopathology and the number of endoscopies is increasing.Helicobacter pylori(H.pylori)infection is a ma...BACKGROUND Gastric cancer(GC)is the fourth leading cause of cancer-related deaths worldwide.Diagnosis relies on histopathology and the number of endoscopies is increasing.Helicobacter pylori(H.pylori)infection is a major risk factor.AIM To develop an in-silico GC prediction model to reduce the number of diagnostic surgical procedures.The meta-data of patients with gastroduodenal symptoms,risk factors associated with GC,and H.pylori infection status from Holy Family Hospital Rawalpindi,Pakistan,were used with machine learning.METHODS A cohort of 341 patients was divided into three groups[normal gastric mucosa(NGM),gastroduodenal diseases(GDD),and GC].Information associated with socioeconomic and demographic conditions and GC risk factors was collected using a questionnaire.H.pylori infection status was determined based on urea breath test.The association of these factors and histopathological grades was assessed statistically.K-Nearest Neighbors and Random Forest(RF)machine learning models were tested.RESULTS This study reported an overall frequency of 64.2%(219/341)of H.pylori infection among enrolled subjects.It was higher in GC(74.2%,23/31)as compared to NGM and GDD and higher in males(54.3%,119/219)as compared to females.More abdominal pain(72.4%,247/341)was observed than other clinical symptoms including vomiting,bloating,acid reflux and heartburn.The majority of the GC patients experienced symptoms of vomiting(91%,20/22)with abdominal pain(100%,22/22).The multinomial logistic regression model was statistically significant and correctly classified 80%of the GDD/GC cases.Age,income level,vomiting,bloating and medication had significant association with GDD and GC.A dynamic RF GC-predictive model was developed,which achieved>80%test accuracy.CONCLUSION GC risk factors were incorporated into a computer model to predict the likelihood of developing GC with high sensitivity and specificity.The model is dynamic and will be further improved and validated by including new data in future research studies.Its use may reduce unnecessary endoscopic procedures.It is freely available.展开更多
Objective:To evaluate the polio laboratory surveillance carried out from January,2019 to May,2023 by the Polio Regional Reference Laboratory,Sri Lanka.Methods:This retrospective study analyzed all stool samples receiv...Objective:To evaluate the polio laboratory surveillance carried out from January,2019 to May,2023 by the Polio Regional Reference Laboratory,Sri Lanka.Methods:This retrospective study analyzed all stool samples received under the acute flaccid paralysis(AFP)and immunodeficient vaccine-derived poliovirus(VDPV)surveillance at Polio Regional Reference Laboratory,Sri Lanka from January,2019 to May,2023.The results of the testing methodologies were extracted from the laboratory data system,i.e.,poliovirus virus isolation,intra-typic differentiation/VDPV real time reverse transcriptase polymerase chain reaction(ITD/VDPV rRTPCR)and sequencing,along with the data on timing of reporting results,stool adequacy and socio-demographics.Data was analyzed using descriptive statistics.Results:A total of 2141 stool samples from 1644 cases were received for AFP surveillance from Sri Lanka(93.61%),Maldives(1.52%),and immunodeficient VDPV(4.86%)surveillance.Both polioviruses(19/1644,1.15%)and non-polio enteroviruses(73/1644,4.44%)were isolated,while Sabin-like 3 virus was detected in majority(12/19,63.15%)among the poliovirus isolated.Wild polioviruses or circulating VDPVs were not detected among the cases.During all years of the study,the non-polio AFP detection rate was>1/100000 in children aged less than 15 years,whereas stool adequacy rate was>80%.All results were reported within 14 days of receipt,ensuring timely reporting as per global guidelines.Conclusions:The Polio Regional Reference Laboratory,Sri Lanka plays a vital role in maintaining the polio-free status in the country through its robust laboratory surveillance,while adhering to the surveillance indicators.Non-detection of wild polioviruses and circulating VDPV during the study period reinforces the polio-free status in the country.展开更多
AIM： To develop and characterize a practical model of Hepatopulmonary syndrome. （HPS） in rats.METHODS： The experimental animals were randomized into five feeding groups： （1） control （fed standard diet）, （2）...AIM： To develop and characterize a practical model of Hepatopulmonary syndrome. （HPS） in rats.METHODS： The experimental animals were randomized into five feeding groups： （1） control （fed standard diet）, （2） control plus intraperitoneal injection with lipopolysaccharide （LPS）, （3） cirrhosis （fed a diet of maize flour, lard, cholesterol, and alcohol plus subcutaneously injection with carbon tetrachloride （CCI4） oil solution）, （4） cirrhosis plus LPS, and （5） cirrhosis plus glycine and LPS. The blood, liver and lung tissues of rats were sampled for analysis and characterization. Technetium 99m-labeled macroaggregated albumin （Tc99m-MAA） was used to test the dilatation of pulmonary microvasculature.RESULTS： Typical cirrhosis and subsequent hepato- pulmonary syndrome was observed in the cirrhosis groups after an 8 wk feeding period. In rats with cirrhosis, there were a decreased PaO2 and PaCO2 in arterial blood, markedly decreased arterial 02 content, a significantly increased alveolar to arterial oxygen gradient, an increased number of bacterial translocated within mesenteric lymph node, a significant higher level of LPS and tumor necrosis factor-α （TNF-α） in plasma, and a significant greater ratio of Tc99m-MAA brain-overlung radioactivity. After LPS administration in rats with cirrhosis, various pathological parameters got worse and pulmonary edema formed. The predisposition of glycine antagonized the effects of LPS and significantly alleviated various pathological alterations.展开更多
文摘Objective:To describe the situation of measles in Sri Lanka from May to November,2023 and to define the role of virology laboratory towards case confirmation and epidemiological and genetic characterization of the outbreak.Methods:This retrospective study analyzed all samples tested for measles from 1st of May to 30th of November,2023 at National Measles Rubella Laboratory,Sri Lanka.According to the World Health Organization(WHO)algorithm,serum and oropharyngeal/nasopharyngeal swabs were tested with WHO recommended kits for anti-measles IgM and measles virus specific RNA,respectively.Selected RNA positive samples were sequenced at reference laboratory,India.Analysis of sequencing data and construction of phylogenetic tree were carried out at National Measles Rubella Laboratory.Data was analyzed using descriptive statistics.Results:Of the total 1132 serum samples and 497 oropharyngeal/nasopharyngeal swabs from 1326 patients,657(49.5%)patients were confirmed as measles by anti-measles IgM,measles virus specific RNA or both.Males(55.6%,n=365)and the age group from>20 to≤30 years(33.0%,n=217)predominated positive patients.All provinces reported measles positive cases.All samples sequenced(100%,n=42)were genotype D8 with 95.2%(n=40)bearing Victoria.Australia origin.Conclusions:We described resurgence of measles in an eliminated country,confirming the genotype to be D8,one of the two genotypes currently circulating globally.Further,the study strongly convinced the importance of a strengthened virological surveillance system in an eliminated country,despite its eliminated status.
基金supported by the National Institute of Environmental Health Sciences(R21ES035492,R21ES035969)National Institutes of Child Health(R01HD090214)(to PA).
文摘During pregnancy,maternal immune activation(MIA),due to infection,chronic inflammatory disorders,or toxic exposures,can result in lasting health impacts on the developing fetus.MIA has been associated with an increased risk of neurodevelopmental disorders,such as autism spectrum disorder(ASD)in the offspring.ASD is characterized by increased repetitive and stereotyped behaviors and decreased sociability.As of 2020,1 in 36 children are diagnosed with ASD by the age of 8 years,with ASD rates continuing to increase in prevalence in USA(Tamayo et al.,2023).Post-mortem brain studies,biomarker and transcriptomic studies,and epidemiology studies have provided compelling evidence of immune dysregulation in the circulation and brain of individuals diagnosed with ASD.Currently,the etiology of ASD is largely unknown,however,genetic components and environmental factors can contribute to increased susceptibility.Maternal allergic asthma(MAA),a form of MIA,has been identified as a potential risk factor for developing neurodevelopmental disorders(Patel et al.,2020).Asthma is a chronic inflammatory condition driven by a T-helper type(TH)2 immune response.
基金the Research Grants from Universiti Putra Malaysia(UPM/800-3/3/1/GPB/2020/9683800)Ministry of Higher Education under the Fundamental Research Grant Scheme(FRGS/1/2023/WAB04/UPM/01/4).
文摘Objective:To address the lack of research on invasive group B Streptococcus(GBS)infections in Malaysia and Southeast Asia through a comprehensive analysis of GBS isolates obtained from hospitals.Methods:Medical records from patients with GBS infection isolated from the sterile site,such as blood and cerebrospinal fluid from 14 July 2019 to 15 December 2020,were reviewed from six major hospitals in Peninsular Malaysia.Inclusion criteria were invasive GBS,sterile sites and non-repeated GBS isolated from the same patients in the same admission.Viable isolates were re-identified for GBS and serotyped.Results:A total of 118 patients were eligible,with a majority of non-pregnant adults(76.3%).Over half of the patients(62.7%)had underlying medical conditions,with diabetes as the most common disease,followed by respiratory disease,renal disease,cardiovascular disease and skin and soft tissue disease.The most common manifestations were sepsis,followed by soft tissue abscess,diabetic foot ulcer,wet gangrene and cellulitis.The overall mortality was 7.6%.The most common serotype was serotype桋.Conclusions:Invasive GBS infection among non-pregnant adults showed a rising trend,particularly among diabetic individuals.The study underscores the importance of reducing risk factors and highlights the necessity of developing GBS vaccination as a preventive strategy for both infants and adults.
基金Supported by Grants from Guangxi Key Discipline Fund(Pathogenic Microbiology),No.[2013]16Key Laboratory Fund of Colleges and Universities in Guangxi,No.Gui Jiao Ke Yan[2014]6+1 种基金National Natural Science Foundation of China,No.31460023Natural Science Foundation of Guangxi,No.2014GXNSFAA118206
文摘AIM: To investigate the inhibitory effects of emodin, baicalin, etc.on the hefA gene of multidrug resistance(MDR) in Helicobacter pylori(H.pylori).METHODS: The double dilution method was used to screen MDR H.pylori strains and determine the minimum inhibitory concentrations(MICs) of emodin, baicalin, schizandrin, berberine, clarithromycin, metronidazole, tetracycline, amoxicillin and levofloxacin against H.pylori strains.After the screened MDR stains were treated with emodin, baicalin, schizandrin or berberine at a 1/2 MIC concentration for 48 h, changes in MICs of amoxicillin, tetracycline, levofloxacin, metronidazole and clarithromycin were determined.MDR strains with reduced MICs of amoxicillin were selected to detect the hefA mR NA expression by realtime quantitative PCR.RESULTS: A total of four MDR H.pylori strains were screened.Treatment with emodin, baicalin, schizandrin and berberine significantly decreased the MICs of amoxicillin and tetracycline against some strains, decreased by 1 to 2 times, but did not significantly change the MICs of clarithromycin, levofloxacin, and metronidazole against MDR strains.In the majority of strains with reduced MICs of amoxicillin, hef A m RNA expression was decreased; one-way ANOVA(SPSS 12.0) used for comparative analysis, P < 0.05.CONCLUSION: Emodin, baicalin, schizandrin and berberine significantly decreased the MICs of amoxicillin and tetracycline against some H.pylori strains, possibly by mechanisms associated with decreasing hefA mR NA expression.
文摘AIM： To analyze the epidemiological, clinical and laboratory findings of infectious keratitis.METHODS： A retrospective study on cases of infective keratitis, attended our institution from Mar. 2013 to Feb. 2015, was done at Mansoura Ophthalmic Center, Egypt. Corneal scrapings were performed and processed for direct microscopy and culture in appropriate media using standard laboratory protocols.RESULTS： Out of 245 patients enrolled for study, 247 corneal scrapings were obtained. Ocular trauma was the most common predisposing factor （51.4%）, followed by diabetes mellitus （15.1%）. Cultures were positive in 110 scraping samples （44.5%）： 45.5% samples had pure fungal infection, 40% had pure bacterial infections and 10% had mixed fungal and bacterial growths. Acanthamoeba was detected in 5 （4.5%） samples. The most common fungal pathogen was Aspergillus spp. （41%）. The most common bacterial isolates were Staphylococcus aureus （38.2%） and Pseudomonas aeruginosa （21.8%）.CONCLUSION： Incidence of fungal keratitis is high in our region. Therapeutic approach can initially be based on clinical features and sensitivity/resistance patterns. Microbiological research should direct the antimicrobial treatment. Antibiotic resistance to fluoroquinolones and aminoglycosides is an important consideration.
基金Supported by Grant from the Ministry of Science,Technology and Innovation,Malaysia,No.06-02-0055-PR0073/05
文摘AIM:To characterise the cag pathogenicity island in Helicobacter pylori(H.pylori) isolates by analysing the strains' vacA alleles and metronidazole susceptibilities in light of patient ethnicity and clinical outcome.METHODS:Ninety-five H.pylori clinical isolates obtained from patients with dyspepsia living in Malaysia were analysed in this study.Six genes in the cagPAI region(cagE,cagM,cagT,cag13,cag10 and cag67) andvacA alleles of theH.pylori isolates were identified by polymerase chain reaction.The isolates' metronidazole susceptibility was also determined using the E-test method,and the resistant gene was characterised by sequencing.RESULTS:More than 90% of the tested isolates had at least one gene in the cagPAI region,and cag67 was predominantly detected in the strains isolated from the Chinese patients,compared with the Malay and Indian patients(P < 0.0001).The majority of the isolates(88%) exhibited partial deletion(rearrangement) in the cagPAI region,with nineteen different patterns observed.Strains with intact or deleted cagPAI regions were detected in 3.2% and 8.4% of isolates,respectively.The prevalence of vacA s1m1 was significantly higher in the Malay and Indian isolates,whereas the isolates from the Chinese patients were predominantly genotyped as vacA s1m2(P = 0.018).Additionally,the isolates from the Chinese patients were more sensitive to metronidazole than the isolates from the Malay and Indian patients(P = 0.047).Although we attempted to relate the cagPAI genotypes,vacA alleles and metronidazole susceptibilities to disease outcome,no association was observed.The vacA alleles were distributed evenly among the strains with intact,partially deleted or deleted cagPAI regions.Interestingly,the strains exhibiting an intact cagPAI region were sensitive to metronidazole,whereas the strains with a deleted cagPAI were more resistant.CONCLUSION:Successful colonisation by different H.pylori genotypes is dependent on the host's genetic makeup and may play an important role in the clinical outcome.
基金Supported by the Deanship of Scientific Research of Taibah University (Grant No.432/3088)
文摘Objective:To explore the prevention of rerurrent candiduria using natural based approaches and to study the antimicrobial effect of Hibiscus sabdariffa(H.sabdariffa) extract and the biofilm forming capacity of Candida albicans strains in the present of the H.sabdariffa extract.Methods:In this particular study,six strains of fluconazole resistant Candida albicans isolated from recurrent candiduria were used.The susceptibility of fungal isolates,time-kill curves and biofilm forming capacity in the present of the H.sabdariffa extract were determined.Results:Various levels minimum inhibitory concentration of the extract were observed against all the isolates.Minimum inhibitory concentration values ranged from 0.5 to 2.0 mg/mL Timekill experiment demonstrated that the effect was fungistatic.The biofilm inhibition assay results showed that H.sabdariffa extract inhibited biofilm production of all the isolates.Conclusions:The results of the study support the potential effect of H.sabdariffa extract for preventing recurrent candiduria and emphasize the significance of the plant extract approach as a potential antifungal agent.
基金a Foundation Scheme grant and a New Investigator Salary Award from the Canadian Institutes of Health Research(both to Elahi S)an innovation grant from Women and Children’s Health Research Institute(to Huang V and Elahi S)
文摘AIM To understand the effects of delivery mode on the immune cells frequency and function in cord blood and placenta.METHODS We evaluated immunological differences in cord blood and placental tissues for a case of twins one of which delivered vaginally while the other delivered by caesarian section(C-section). Cord blood mononuclear cells were isolated and placenta tissues were processed for cell isolation. Immune phenotyping was performed by flow cytometry methods following staining for T cells, natural killer(NK) cells, monocytes, neutrophils and CD71^+erythroid cells in both cord blood and placenta tissues. In addition, fetal calprotectin of twins was measured 12 wk after birth.RESULTS We found lower percentages of immune cells(e.g. T cells, monocytes and neutrophils) in the cord blood of C-section delivered compared to vaginally delivered newborn. In contrast, percentages of monocytes and neutrophils were > 2 folds higher in the placental tissues of C-section delivered newborn. More importantly, we observed lower percentages of CD71^+ erythroid cells in both cord blood and placental tissues of C-section delivered case. Lower CD71^+ erythroid cells were associated with a more pro-inflammatory milieu at the fetomaternal interface reflected by higher expression of inhibitory receptors on CD4^+ T cells, higher frequency of monocytes and neutrophils. Furthermore, type of delivery impacted the gene expression profile in CD71^+erythroid cells. Finally, we found that C-section delivered child had > 20-fold higher FCP in his fecal sample at 12 wk of age.CONCLUSION Mode of delivery impacted immune cells profile in cord blood/placenta. In particular frequency of immunosuppressive CD71^+ erythroid cells was reduced in C-section delivered newborn.
基金Supported by the Ministry of Higher Education of Malaysia(GrantNo.UKM-NN-03-FRGS 0042-2009)UKM Research University Fund(Grant No.UKMGUP-TKP-08-19-067)
文摘Objective:To genotypically characterize methicillin-resistant Staphylococcus aureus(MRSA)strains isolated from medical and surgical wards in Universiti Kebangsaan Malaysia Medical Centre(UKMMC)in 2009.Methods:MRSA strains were collected and molecularly typed by pulsed-field gel electrophoresis(PFGE).Results:PFGE typing on 180 MRSA isolated in UKMMC identified 5 pulsotypes(A-E)and 6 singletons,where pulsotypes B and C were suspected to he divergent clones originating from a single ancestor.This study also showed that most MRSA strains were isolated from swab(119 isolates),followed by blood(22 isolates),tracheal aspirate(11isolates)and sputum(10 isolates).On the other hand,urine and bone isolates were less,which were 4 and 1 isolates,respectively.The distribution of different pulsotypes of MRSA among wards suggested that MRSA was communicated in surgical and medical wards in UKMMC,with pulsotype B MRSA as the dominant strain.Besides,it was found that most deceased patients were infected by pulsotype B MRSA,however,no particular pulsotype could be associated with patient age,underlying disease,or ward of admittance.Conclusions:Five pulsotypes of MRSA and 6singletons were identified,with pulsotype B MRSA as the endemic strains circulating in these wards,which is useful in establishment of preventive measures against MRSA transmission.
文摘This study was conducted to assess the occurrence and nature of extended-spectrum beta lactamase (ESBL) producing <em>Escherichia coli</em> and <em>Klebsiella pneumoniae</em> isolates from patients who presented with urinary tract infection at Federal Teaching Hospital Gombe. Isolates collected were recovered on MacConkey agar at 35<span style="white-space:nowrap;">°</span>C and were identified as members of Enterobacteriaceae, and further screened for antimicrobial susceptibility and resistance by disc diffusion method. Isolates resistant to oxyimino-cephalosporins were confirmed as ESBL producers using Double Disks Synergy Test (DDST). The study shows 66% resistance to ceftriaxone (30 μg) in <em>K. pneumoniae</em>, which was the highest value recorded and a 51% resistance to cefpodoxime (10 <em>μ</em>g) in <em>E. coli</em>. The sensitivity of <em>E. coli </em>and <em>K. pneumoniae</em> isolates to cefpodoxime (10 <em>μ</em>g) were 49% and 33.9% respectively. ESBLs were detected among 40% (40/100) of <em>E. coli</em> and 54.13% (59/109) of <em>K. pneumoniae</em> isolates. Molecular characterization of ESBL encoding genes among <em>E. coli</em> isolates using multiplex-PCR showed 10% prevalence of SHV gene and 5% prevalence for CTX-M gene while TEM gene was not detected. In <em>K. pneumoniae</em> isolates, 5% prevalence was recorded for each of the three genes screened. The study revealed a co-occurrence of SHV and CTX-M in 75% of the <em>E. coli</em> and 70% of the <em>K. pneumoniae</em> isolates;the occurrence of all the three genes was seen in 10% and 5% of <em>K. pneumoniae</em> and <em>E. coli</em> respectively. Multiplex-PCR method provided an efficient and rapid detection of ESBL related genes, hence could be used in epidemiological studies among ESBL isolates. Monitoring dissemination and transmissions of ESBL producers are highly recommended for optimum patient care and preventing the spread of multidrug resistant (MDR) pathogens.
文摘Natural antibodies serve as the body’s first line of defense against pneumococcal challenge. Polyreactive human pneumococcal polysaccharide IgG antibodies have not been extensively studied. We analyzed human polyreactive antibodies that bind multiple pneumococcal polysaccharides, including PPS14 and PPS23F. These antibodies were isolated from single pneumococcal polysaccharide specific B cells allowing for the analysis of human immunoglobulins with natively paired variable regions. Although isolated individually, these antibodies demonstrated similar characteristics. Most antibodies possessed a variable light chain with a CDR3 length made up of nine amino acids and relatively high number of flexible amino acids in combined VH/VL. While these antibodies were polyreactive and structurally alike, kinetic analysis revealed unique KD values. Variable chains are responsible for antigen recognition whereas antibody fine specificity is affected by isotype structure. To investigate the contribution of the constant region of these isotypes and their effect on antibody avidity to pneumococcal polysaccharide, the polyreactive variable regions were expressed as IgG1 or IgG2 and subjected to kinetic analysis. The IgG1 antibodies uniformly had a stronger avidity to PPS14 and PPS23F compared to IgG2. To further document the importance of the constant region in antibody avidity and fine specificity, analysis of antibody F(ab)’2 fragment binding to PPS14 and PPS23F resulted in similar KD values. These studies suggest that antigen recognition by polyreactive antibodies is determined by a conserved variable light chain CDR3 length and longer, more flexible variable heavy CDR3s when compared to pneumococcal polysaccha-ride-specific sequences while differences in specific avidities are modulated by antibody isotype.
文摘BACKGROUND Human immunodeficiency virus(HIV)infection is a major global public health concern.North African countries carry a disproportionate burden of HIV representing one of the highest rates in Africa.AIM To characterize the epidemiological and spatial trends of HIV infection in this region.METHODS A systematic review was carried out on all the published data regarding HIV/acquired immunodeficiency syndrome in North African countries over ten years(2008-2017)following the PRISMA guidelines.We performed a comprehensive literature search using Medline PubMed,Embase,regional and international databases,and country-level reports with no language restriction.The quality,quantity,and geographic coverage of the data were assessed at both the national and regional levels.We used random-effects methods,spatial variables,and stratified results by demographic factors.Only original data on the prevalence of HIV infection were included and independently evaluated by professional epidemiologists.RESULTS A total of 721 records were identified but only 41 that met the criteria were included in the meta-analysis.There was considerable variability in the prevalence estimates of HIV within the countries of the region.The overall prevalence of HIV ranged from 0.9%[95%confidence interval(CI)0.8-1.27]to 3.8%(95%CI 1.17-6.53).The highest prevalence was associated with vulnerable groups and particularly drug abusers and sexually promiscuous individuals.The dense HIV clustering noted varied from one country to another.At least 13 HIV subtypes and recombinant forms were prevalent in the region.Subtype B was the most common variant,followed by CRF02_AG.CONCLUSION This comprehensive review indicates that HIV infection in North African countries is an increasing threat.Effective national and regional strategies are needed to improve monitoring and control of HIV transmission,with particular emphasis on geographic variability and HIV clustering.
文摘Background: Typhoid disease remains a major public health problem globally, especially in developing countries in sub-Saharan Africa. Symptoms associated with typhoid disease mimic those of other febrile illnesses and are thus difficult to make an accurate diagnosis. A confirmed diagnosis requires the determination or isolation of the bacteria in well-equipped laboratories. Developing countries are faced with a huge limitation of the laboratory infrastructure to diagnose typhoid disease, which would otherwise guide in treating, managing, controlling, and halting the spread of drug resistant mutants. Objective: This study, therefore, was aimed at determining the clinical presentation, performance of diagnostic tests and antibiotic susceptibility testing of Salmonella among adults attending Kangema Sub-County Hospital. Study Population: The study population was residents of Kangema Sub-County in Murang’a County, Kenya while the target population was adults. Methods: The study adopted a cross-sectional study design that employed a systematic random sampling procedure. The study took place between April and June 2021. The sample size was 97 respondents who all consented and were enrolled in the study. Interviewing the respondents was carried out by administering structured questionnaires to collect quantitative data. Stool samples were obtained and cultured in Cary Blair transport media and then cultured in appropriate media at the Murang’a County Referral Hospital Laboratory. A rapid Salmonella Antigen (SAT) test was also performed on all the stool samples. Data Analyses: Word Statistics and Data (STATA) v 13 was used for statistical analysis. Results: The prevalence of Typhoid Fever was at 6.2% (95% CI) which included S. Typhi (n = 1;16.7%) and S. Paratyphi B (n = 5;83.3%). No isolate showed resistance to Ciprofloxacin. The sensitivity of SAT is 100% and a specificity of 98.9% with a kappa statistic of almost perfect agreement (0.9641) with culture. Patients who had fever p = 0.001, abdominal distention p = 0.028, diarrhoea p = 0.038, loose or watery stool p = 0.021 and mild general condition p = 0.02 remained independently associated with Salmonella infection. Conclusion: Typhoid Fever being endemic, laboratory diagnosis was a key for confirmation after clinical diagnosis. SAT can accurately be used to detect the disease where culture is unavailable. However, antibiotic sensitivity tests were crucial when determining the drug of choice as Salmonella isolates were multi-drug resistant. Establishment of prescribing antimicrobial policies and guidelines can periodically monitor the antibiogram patterns.
文摘Background: Carbapenem resistant extended spectrum β-lactamase (ESBL) producing Klebsiella pneumoniae (K. pneumoniae) is increasing worldwide. Carbapenem resistance (CR) has been attributed not only to production of carbapenemases but also to permeability barriers due to outer membrane proteins (OmpK35 and OmpK36) disruption. Objective: Phenotypic detection of CR among ESBL producing K. pneumoniae isolates, followed by the evaluation of the role of ompK35 and ompK36 gene expression among carbapenem resistant K. pneumoniae (CR-KP) isolates. Methods: 100 ESBL producing K. pneumoniae isolates were included in this study. Minimum inhibitory concentration (MIC) of imipenem was performed for all isolates by broth microdilution method. For CR-KP isolates, phenotypic detection of K. pneumoniae carbapenemase (KPC), metallo-β-lactamase (MBL) and AmpC enzymes was performed followed by Realtime qRT-PCR to detect and quantify ompK35 and ompK36 gene expression. Results: 42% of our isolates were carbapenem resistant, and all of them were KPC producers either singly or in combination with MBL and/or AmpC production. Reduced expression of both ompK35 and ompK36 was detected in (52.38%) of CR-KP isolates, while reduced expression of ompK36 or ompK35 alone was found in (2.38%) and (33.33%) respectively. Twenty of 42 CR-KP isolates (47.62%), showing reduced ompK35 and ompK36 expression, exhibited high level resistance (HLR) (>32 μg/ml) to imipenem. There was a significant correlation between reduced expression of ompK36 and increase MIC values (p < 0.05). The combined production of MBL or AmpC together with reduced expression of ompK35 and/or ompK36 resulted in significant increase in imipenem MIC (p < 0.05). Conclusion: The combined OmpK35/OmpK36 loss resulted in HLR. However OmpK36 seems to play a major role in those strains. Imipenem MIC was markedly increased among K. pneumoniae showing carbapenemase and/or AmpC production together with loss of OmpK35 and/or OmpK36.
文摘The risk of liver injury in patients with coronavirus disease 2019(COVID-19)infection is quite evident.Furthermore,liver function test abnormalities are still detected in COVID-19 patients despite the development of antivirals and the availability of several types of vaccines.This editorial describes liver involvement during COVID-19 infection in patients with or without preexisting liver injury,such as chronic liver disease,to elucidate COVID-19-induced liver function abnormalities and their severity,pathophysiology,clinical manifestations,and clinical and laboratory outcomes.We also discuss the effect of vaccination against COVID-19 to better understand host factors,such as age,gender,and race,on the incidence and severity of liver dysfunction at initial presentation and during the illness.Finally,we summarize the results of relevant meta-analyses published to date and highlight the importance of adequate liver function monitoring in the current climate of the overwhelming COVID-19 pandemic.
文摘The objective of the study was to determine the antibacterial efficacy of Bidens pilosa Aqueous (BPA), Bidens pilosa Ethanolic (BPE), Ageratum conyzoides Aqueous (ACA), Ageratum conyzoides Ethanolic (ACE), Ocimum suave Aqueous (OSA) and Ocimum suave Ethanolic (OSE) extracts on HIV/AIDS patients’ oral bacteria. Healthy green leaves of the plants were collected in Ishaka Uganda, processed and portions separately extracted with hot distilled water and cold ethanol. The susceptibility, MIC and MBC of each extract were determined using standard protocols. The bacteria had significant (p Bidens pilosa, Ageratum conyzoides and Ocimum suave on oral lesions of HIV/AIDS patients made by traditional healers and local people in South-Western Uganda. We recommend a detailed study of structural identities and activities of the active antibacterial principle(s) in these plants for possible new drug entities and verification of the interactive effects of the principle(s) with ARVs and cotrimoxazole used daily by HIV/AIDS patients.
文摘BACKGROUND Gastric cancer(GC)is the fourth leading cause of cancer-related deaths worldwide.Diagnosis relies on histopathology and the number of endoscopies is increasing.Helicobacter pylori(H.pylori)infection is a major risk factor.AIM To develop an in-silico GC prediction model to reduce the number of diagnostic surgical procedures.The meta-data of patients with gastroduodenal symptoms,risk factors associated with GC,and H.pylori infection status from Holy Family Hospital Rawalpindi,Pakistan,were used with machine learning.METHODS A cohort of 341 patients was divided into three groups[normal gastric mucosa(NGM),gastroduodenal diseases(GDD),and GC].Information associated with socioeconomic and demographic conditions and GC risk factors was collected using a questionnaire.H.pylori infection status was determined based on urea breath test.The association of these factors and histopathological grades was assessed statistically.K-Nearest Neighbors and Random Forest(RF)machine learning models were tested.RESULTS This study reported an overall frequency of 64.2%(219/341)of H.pylori infection among enrolled subjects.It was higher in GC(74.2%,23/31)as compared to NGM and GDD and higher in males(54.3%,119/219)as compared to females.More abdominal pain(72.4%,247/341)was observed than other clinical symptoms including vomiting,bloating,acid reflux and heartburn.The majority of the GC patients experienced symptoms of vomiting(91%,20/22)with abdominal pain(100%,22/22).The multinomial logistic regression model was statistically significant and correctly classified 80%of the GDD/GC cases.Age,income level,vomiting,bloating and medication had significant association with GDD and GC.A dynamic RF GC-predictive model was developed,which achieved>80%test accuracy.CONCLUSION GC risk factors were incorporated into a computer model to predict the likelihood of developing GC with high sensitivity and specificity.The model is dynamic and will be further improved and validated by including new data in future research studies.Its use may reduce unnecessary endoscopic procedures.It is freely available.
文摘Objective:To evaluate the polio laboratory surveillance carried out from January,2019 to May,2023 by the Polio Regional Reference Laboratory,Sri Lanka.Methods:This retrospective study analyzed all stool samples received under the acute flaccid paralysis(AFP)and immunodeficient vaccine-derived poliovirus(VDPV)surveillance at Polio Regional Reference Laboratory,Sri Lanka from January,2019 to May,2023.The results of the testing methodologies were extracted from the laboratory data system,i.e.,poliovirus virus isolation,intra-typic differentiation/VDPV real time reverse transcriptase polymerase chain reaction(ITD/VDPV rRTPCR)and sequencing,along with the data on timing of reporting results,stool adequacy and socio-demographics.Data was analyzed using descriptive statistics.Results:A total of 2141 stool samples from 1644 cases were received for AFP surveillance from Sri Lanka(93.61%),Maldives(1.52%),and immunodeficient VDPV(4.86%)surveillance.Both polioviruses(19/1644,1.15%)and non-polio enteroviruses(73/1644,4.44%)were isolated,while Sabin-like 3 virus was detected in majority(12/19,63.15%)among the poliovirus isolated.Wild polioviruses or circulating VDPVs were not detected among the cases.During all years of the study,the non-polio AFP detection rate was>1/100000 in children aged less than 15 years,whereas stool adequacy rate was>80%.All results were reported within 14 days of receipt,ensuring timely reporting as per global guidelines.Conclusions:The Polio Regional Reference Laboratory,Sri Lanka plays a vital role in maintaining the polio-free status in the country through its robust laboratory surveillance,while adhering to the surveillance indicators.Non-detection of wild polioviruses and circulating VDPV during the study period reinforces the polio-free status in the country.
基金awards to University Academic Leaders granted by the Government of Shanxi Province of China to Hui-Ying Zhang and partially by the National Institute of Alcohol Abuse and Alcoholism of United States, grant R01 AA014428 to Cheng Ji
文摘AIM： To develop and characterize a practical model of Hepatopulmonary syndrome. （HPS） in rats.METHODS： The experimental animals were randomized into five feeding groups： （1） control （fed standard diet）, （2） control plus intraperitoneal injection with lipopolysaccharide （LPS）, （3） cirrhosis （fed a diet of maize flour, lard, cholesterol, and alcohol plus subcutaneously injection with carbon tetrachloride （CCI4） oil solution）, （4） cirrhosis plus LPS, and （5） cirrhosis plus glycine and LPS. The blood, liver and lung tissues of rats were sampled for analysis and characterization. Technetium 99m-labeled macroaggregated albumin （Tc99m-MAA） was used to test the dilatation of pulmonary microvasculature.RESULTS： Typical cirrhosis and subsequent hepato- pulmonary syndrome was observed in the cirrhosis groups after an 8 wk feeding period. In rats with cirrhosis, there were a decreased PaO2 and PaCO2 in arterial blood, markedly decreased arterial 02 content, a significantly increased alveolar to arterial oxygen gradient, an increased number of bacterial translocated within mesenteric lymph node, a significant higher level of LPS and tumor necrosis factor-α （TNF-α） in plasma, and a significant greater ratio of Tc99m-MAA brain-overlung radioactivity. After LPS administration in rats with cirrhosis, various pathological parameters got worse and pulmonary edema formed. The predisposition of glycine antagonized the effects of LPS and significantly alleviated various pathological alterations.
