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Applied, basic and practical aspects of Medical/Clinical Microbiology and Epidemiology |
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Applied, basic and practical aspects of Medical/Clinical Microbiology and Epidemiology

Research Article

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Hospital Admissions in Patients with COPD during the 2009 Flu Pandemic

Boixeda R, Elias L, Bacca S, Gabillo A, Cadpevila JA, Fernández- Fernández J, Vilà X and Almirall J

Introduction: Chronic obstructive pulmonary disease has been described as an underlying medical cause for the influenza A infection (H1N1). In this study we analyzed the presence of H1N1 virus infection in COPD patients and compliance protocols.

Material and Methods: We identified COPD patients hospitalized for lower respiratory infection (acute exacerbation or pneumonia) in the period of pandemic influenza. The microbiological analysis was performed according to standard clinical practice according to published protocols.

Results: We included 129 episodes in 110 patients, 104 with acute exacerbation and 25 for pneumonia. Pharyngeal samples were studied for detection of H1N1 in 17 patients, of which 5 cases were positive (3.9% of episodes). These patients were younger, more fever, headache and increased need for mechanical ventilation. The patients studied for H1N1 infection were those with clinical worsening and radiographic progression. According to the criteria of clinical suspicion for H1N1 infection of the published protocol, throat swab was performed in 24-44% of episodes of hospital admission in COPD patients during the peak incidence of influenza pandemic.

Conclusion: The study of H1N1 infection was made illegally in COPD patients admitted. Of the patients evaluated, we found no biological data that could guide the virus box. Nor have we observed differences in respect to the severity of COPD based on spirometric data.

Short Communication

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Antibiotic Resistance in the Indigenous Australian Population: Combating the Problem through Trans-disciplinary Research

Polyak SW

DOI:

DOI: 10.4172/2161-0703.1000162

There are well-documented health inequalities between Indigenous and non-Indigenous Australians, with the aboriginal population suffering significantly higher incidence of disease and morbidity, as well as lower life expectancy. Similar issues challenge Indigenous communities in other parts of the world. Unsurprisingly, the Indigenous population also experiences higher rates of bacterial infections than the wider community. The world’s highest recorded rates of chronic suppuratives lung disease including bronchiectasis unrelated to cystic fibrosis have been reported in Indigenous Australian children, and the first reports of community-associated methicillin resistant Staphylococcus aureus were observed in Aboriginal communities in remote Western Australia in the early 1990s. Factors within the Indigenous population that contribute to these alarming statistics include domestic crowding, poor hygiene, poor diet and inappropriate antibiotic use. Strong political leadership is required to address this unacceptable situation. Here medical research can play a key role in formulating evidence driven policy.

Research Article

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Preparation of the Silicone-Modified Antimicrobial Polyethylene Endotracheal Tube (PE ETT)

Xuhong J, Bin LV, Xinmin W and Qianhong S

DOI:

DOI: 10.4172/2161-0703.1000163

Polyethylene endotracheal tube (PE ETT) antimicrobial coating has been proved to be a more effective method to prevent endoluminal biofilm formation. A transparent silicone-modified antimicrobial PE ETT was obtained by coating SiO2/KH570/MTES/Ag-SiO2 solution prepared by chemical mixing Ag-SiO2 and SiO2/KH570/MTES solution by means of dip-coating method, followed by drying. All the films were characterized by various techniques including Pencil Hardness Tester, IR, SEM, UV-vis, and ICP-MS. The results indicated that the TEOS/KH570/MTES/Ag-SiO2 (15:6:1:0.6~1.0) films, which exhibit the simple solution-processable film formation on PE ETT, show homogeneous morphology, and have the high transmittance of above 87%, high hardness of 5H, strong adhesion. Furthermore, the silicone-modified antimicrobial PE ETTs show excellent antimicrobial property with the sterilization rate up to 93.5%, it demonstrates that the antimicrobial films have excellent biocompatibility and potent antimicrobial activity against protein adhesion. Pyrogen test, hemolysis test and oral mucous irritation test results are fit for biosecurity use requirement for biological materials. So, silicone-modified antimicrobial PE ETT is hoped to be used in the field of medical materials and can be used as an efficient and economical method to extend the service life of the PE ETT.

Research Article

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Differential Systemic MyD88-Dependent vs. MyD88-Independent Cytokine Ratio by Etiologic Agent in Adults with Severe Community- Acquired Pneumonia

DOI:

DOI: 10.4172/2161-0703.1000164

Purpose: Classifying bacteria early, before cultures results are available, would improve the choice of initial antibiotics in patients with severe pneumonia. TLR2 and TLR4 transduce signal through the MyD88-dependent pathway to stimulate IL-8 and TNF-α production. TLR4 can also signal through a MyD88-independent pathway to stimulate RANTES and IFN-β production. As gram-negative bacteria primarily activate TLR4, while gram-positive bacteria also activate TLR2, differential cytokine expression would be expected depending on specific bacterial etiologies.

Methods: Admission serum samples from 53 patients admitted to Medical Intensive Care Unit at the University of Maryland Medical Center between January 2006 and September 2013 were assayed for IL-8, RANTES, TNF-α, and IFN-β levels using the University of Maryland cytokine core laboratory and commercial ELISA kits. Cytokine levels and the ratio of MyD88-independent to MyD88-dependent cytokines, ([IFN-β] X [RANTES])/([IL8] X [TNF-α]) were compared to the culture identified organisms.

Results: 14 gram-negative and 17 gram-positive pneumonias were identified. None of the individual cytokine demonstrated statistically significant differences between the gram-negative and gram-positive infections. The ratio of MyD88-independent/MyD88-dependent cytokines was 111.1 ± 34.9 in gram-negative infections, 29.9 ± 8.3 in gram-positive infections, with p=0.04.

Conclusions: Serum MyD88-independent to MyD88-independent cytokine ratios significantly discriminated gram-negative from gram-positive pneumonia. As technology improves our ability to generate panels of cytokines quickly from clinical specimens, a strategy of pooled cytokine ratios based on underlying pathophysiology, as was done in our study, could guide clinicians in critical early antibiotic choices.

Research Article

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Effect of Some Medical Plant Extracts on Metabolism of Leishmania tropica Promastigotes In vitro

Saeed BQ, Hassan HF and Arteen HI

DOI:

DOI: 10.4172/2161-0703.1000165

The study included the inhibition effect of Equisetum arvense and Urtica piluifera extracts dissolved in cold and hot water, on the growth of Leishmania tropica. promastigotes, and the effect of these extract on metabolism activates (Total protein, carbohydrates and nucleic acids) of Leishmania tropica. Promastigotes. The inhibitory concentration of 50% of the promastigotes (IC50) at the log phase (96) hrs was 1.5 μg/ml of Equisetum arvense and 1.5 μg/ml of Urtica piluifera extracts dissolved in cold and hot water. The results revealed, that these extracts were studied has inhibitory effect L. tropica. promastigotes number, the number of L. tropica. reduced gradually when using 0.5 to 2.5 μg/ml concentrations of extracts. Moreover, these extracts were studied has inhibitory effect on total Proteins, Carbohydrates and Nucleic acids. The results of chemical analysis of the plants has highly effect on total protein, and lees effect on total carbohydrates of cell membrane, Moreover, the extract was effect on total Nucleic acids of Leishmania tropica. promastigotes after 96 hrs of cultivation.

Short Communication

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Concise Communications: Death of a Patient Aged 2.5 Years after Infection Cause Parainfluenza Virus Type 1

Tecu C, Mihai ME, Alexandrescu VI and Lupulescu E

DOI:

DOI: 10.4172/2161-0703.1000166

Introduction: In this study we describe the identification of parainfluenzae virus (PIV) type 1 as the etiological agent of bronchopneumonia and cardio-respiratory failure which caused the death of a child aged of 2.5 years. The objective of the study was to show the possibility that infection with PIV 1 can causes death.

Case presentation: The patient had the diagnosis of SARI (Severe Acute Respiratory Infection) at the admission in the hospital, but few hours after the hospitalization, she died. Laboratory tests were within normal limits (total WBC and differential, serum immunoglobulins, liver transaminases, urinalysis, blood sedimentation rate) and the patient showed no associated diseases. We before tested the sample (fragment of the right lung) for the presence of influenza virus type A and B (including pandemic H1N1), because the patient became ill in the pandemic season 2009-2010. After that the detection of influenza viruses was negative, we tested the sample for the presence of the others respiratory viruses. In the same time, we tested if the specimen had the respiratory bacteria associated with. The Real-time PCR method for detection of A/H1N1 pandemic virus and the Reverse Transcription-Polymerase Chain Reaction (RT-PCR) for detection of other non-influenza viruses (respiratory syncytial virus, human metapneumo virus, PIV 1, 2 and 3, Coronaviruses 229E and OC43) were used as diagnostic methods. In the same time, the Kit RV/PB18 ASE Detection (Seegene) was used in order to test a potential bacterial etiology of the infection (Streptococcus pneumoniae, Haemophilus influenzae, Legionella pneumophila, Mycoplasma pneumoniae, Chlamydophila pneumoniae).

Conclusion: Finding of this study is that although the patient has no experienced chronic diseases associated with, she died from a bronchopneumonia caused by PIV type1.

Research Article

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Genotypic Analysis of a New Fungal Pathogen, Trichosporon faecale, Isolated from Japanese Subjects

Otomi Cho, Nanthawan Mekha, Ayse Kalkanci, Masako Takashima, Sanae Kurakado and Takashi Sugita

DOI:

DOI: 10.4172/2161-0703.1000167

The basidiomycetous yeast Trichosporon faecale is considered to be a non-pathogenic fungus; however, the microorganism has been isolated from clinical specimens in several countries. Trichosporon faecale is classified as type I, II, or III depending on the sequence of the intergenic spacer (IGS) region in its rRNA gene. In this study, 28 T. faecale strains obtained from Japanese subjects and environmental samples were found to be type I. In addition, T. faecale was detected by PCR in 32 scale samples from 146 Japanese healthy subjects, and all 32 samples were found to be type I. Our findings suggest a lack of intraspecific diversity among T. faecale samples originating from Japanese subjects and that T. faecale is part of the skin fungal microbiome.

Research Article

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Application of Bleach Concentration Method in Tissue Samples Received for Diagnosis of Extra Pulmonary Tuberculosis Diagnosis

Pranali Pingle

DOI:

DOI: 10.4172/2161-0703.1000168

Extra pulmonary Tuberculosis (TB) comprises 15% of the total tuberculosis cases. In cases of suspected extrapulmonary tuberculosis, rapid and accurate laboratory diagnosis is of prime importance, since traditional techniques of detecting acid-fast bacilli have limitations. The major difficulty with mycobacteria in tissue samples is achieving optimal cell lysis. A comparison of two methods, pretreatment of tissue with 4% Sodium Hypochlorite in Bleach concentration method and pretreatment with petroff’s method before culture on Lowenstein Jensen medium, was conducted on 18 extrapulmonary tissue specimens collected from different sites of suspected TB patients to evaluate the use of Bleach concentration method in tissue samples. The aim of this study is to apply this method for demonstration of AFB in tissue samples obtained from extrapulmonary sites and to correlate with Ziehl Neelson staining and LJ culture. A total of 18 tissue samples were studied from clinically suspected cases of Extra pulmonary TB which included endometrial tissue (15), (1) from kidney and (1) from brain. All the samples were processed for conventional ZN staining, bleach concentration method, PCR and AFB culture on LJ media. Out of 18 samples none were suggestive for TB by ZN staining, while 1(5.55%) was positive by PCR, 3(16.66%) were suggestive by bleach concentration method and the same i.e. 3(16.66%) came positive on LJ culture hence confirming the method. However to the best of our knowledge this is the pioneer study applied to the tissue samples and the results of the present study shows improved detection of AFB.

Review Article

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Characterization of Methicillin-Resistant Staphylococcus aureus in a Tertiary Care Teaching Hospital, South India

Latha JP, Rajendran S, Uma maheswari G and Sumathi

DOI:

DOI: 10.4172/2161-0703.1000169

S. aureus causes superficial to deep seated infections in human beings. Methicillin-resistant Staphylococcus arueus (MRSA) evolved in the 1960s and since then has become a worldwide concern owing to increasing morbidity and mortality in health-care settings and even community. (MRSA) is a resistant variant of S. aureus which are resistant to beta-lactum antibiotics and other classes of antimicrobials. Early and accurate detection of MRSA and their antimicrobial susceptibility profile is therefore imperative for the selection of appropriate antimicrobial therapy. A total of 300 isolates of S. aureus collected from January 2010 to December 2012 were included in the study. S. aureus was characterized based on morphological and biochemical characters. To receive a pure culture, the isolates were grown on mannitol salt agar with supplement 5% v/v egg yolk emulsion. Antibiotic susceptibility testing was carried out on the strains by disc diffusion technique and the results interrupted according to Clinical laboratory standards International (CLSI) guidelines. A significant proportion of the S. aureus isolates were obtained from the exudates (226) specimens in all the three years followed by blood (48), urine (16) and respiratory (10). The average resistance seen in the 300 isolates tested was ampicillin (97.2%), cephelaxin (94%), cefotaxime (96.4%), cloxacillin (100%), erythromycin (82.6%), Gentamycin (76.3%), ciprofloxacin (54.4%), clindamycin (40.4%) and linezolid and vancomycin were susceptible for all the strains. In conclusion, the prevalence of MRSA in our health-care setting is 45% among the clinical isolates of S. aureus. Active screening and proper infection control procedures need to be adopted to control the MRSA infection.

Research Article

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Identification of Imipenem-Resistant Genes in Acinetobacter baumannii Isolated from Baghdad Hospitals

Nadheema Hammood Hussein, Harith Jabbar Fahad Al-Mathkhury and Majeed Arsheed Sabbah

DOI:

DOI: 10.4172/2161-0703.1000170

Imipenem-resistant Acinetobacter baumannii (IRAB) represents one of the important causing agents of nosocomial infections especially in immunocompromised and Intensive Care Units (ICUs) patients. The aim of this work was to identify the Imipenem-Resistant genes in Acinetobacter baumannii isolated from Baghdad hospitals. Among 128 A. baumannii isolates, 67 isolates (58.26%) were resistant to imipenem and meropenem. Four genes for imipenem resistance (blaOXA-23 like, blaOXA-24 like, blaOXA-51like and blaOXA-58 like) were amplified and sequenced. The presence of blaOXA-23-like genes in 91.03% of IRAB isolates indicated that the blaOXA-23-like genes are the predominant mechanism for imipenem resistance in our isolates. Sequencing of PCR products showed the presence of new OXA-genes in local A. baumannii isolates including: OXA-207, OXA-239 and OXA-229 among the genes of OXA-24-like, OXA-23-like and OXA-58-like genes, respectively. In conclusion, this study identifies the genes responsible for the imipenem resistance in Baghdad which is important to understand the imipenem resistance and to suggest plans for treatment of patients in future.

Commentary

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Prolonged Viral Shedding of Influenza Virus: Which Definition?

Macé M Schuurmans and Nicolas J Mueller

DOI:

DOI: 10.4172/2161-0703.1000171

Influenza virus infection poses a considerable risk for complications to the general population and in particular to solid organ transplant recipients (SOTR). Life-long immunosuppression in SOTR likely contributes to delayed clearance of influenza virus from the airways: Prolonged Viral Shedding (PVS) has important implications for potential infectivity and infection control measures. Duration of infectivity as measured by viral culture has been reported to last 4-6 days in the non-transplant setting. Shedding measured by Polymerase Chain Reaction (PCR) in immune competent patients is similar, 5-6 days. To date there is no recommended or widely accepted definition of PVS for influenza virus infections. The lack of a PVS definition makes comparisons between studies difficult. Most studies assess shedding duration by serial PCR of nasopharyngeal swabs. A number of studies calculate shedding from the time of onset of symptoms to the last positive detection. Shedding is considered to be “prolonged” if it continues on or beyond day 7 or 14. However, considerable variability exists in defining PVS. A large number of studies rely on two objective measures to define the duration of shedding: This requires at least two positive detections of viral material, usually by PCR. We discuss the different aspects of these definitions and propose a practical definition that takes into account a number of factors relevant to the topic.

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