Inactivation of Airborne Viruses using Newly Designed Emitron

The objective of the current research is to validate the microbiological quality of Emitron against MS2 phage, Corona virus, bacteria, yeast, and molds. Unimech healthcare designed PMEE based Emitron which is mostly used to reduce the microbial count and virus count in an area. To perform microbiological testing of the Emitron, environmental monitoring was performed for MS2 phage, Corona virus, bacteria, yeast, and molds before and after treatment by settle plate method. Petri plates of sterilized Phage agar, SCDA and PDA media were prepared and exposed for environment monitoring before and after treatment by settle plate method. The phage agar and SCDA plates were incubated at 37°C for 72 hours and PDA plates incubated at 25°C for 5 days. Total of 99% reduction was reported in microbiology lab with respect to the microorganisms after installing Emitron. We can conclude that the Unimech healthcare’s Emitron is virus attenuation device so one can use it to purify the air and kill the viruses, bacteria, fungi, and other microbes.

Inactivation of Airborne Viruses using Newly Designed Emitron

The objective of the current research is to validate the microbiological quality of Emitron against MS2 phage, Corona virus, bacteria, yeast, and molds. Unimech healthcare designed PMEE based Emitron which is mostly used to reduce the microbial count and virus count in an area. To perform microbiological testing of the Emitron, environmental monitoring was performed for MS2 phage, Corona virus, bacteria, yeast, and molds before and after treatment by settle plate method. Petri plates of sterilized Phage agar, SCDA and PDA media were prepared and exposed for environment monitoring before and after treatment by settle plate method. The phage agar and SCDA plates were incubated at 37°C for 72 hours and PDA plates incubated at 25°C for 5 days. Total of 99% reduction was reported in microbiology lab with respect to the microorganisms after installing Emitron. We can conclude that the Unimech healthcare’s Emitron is virus attenuation device so one can use it to purify the air and kill the viruses, bacteria, fungi, and other microbes.

The broad spectrum of COVID-like patients initially negative at RT-PCR testing: a cohort study

Background Patients that arrive in the emergency department (ED) with COVID-19-like syndromes testing negative at the first RT-PCR represent a clinical challenge because of the lack of evidence about their management available in the literature. Our first aim was to quantify the proportion of patients testing negative at the first RT-PCR performed in our Emergency Department (ED) that were confirmed as having COVID-19 at the end of hospitalization by clinical judgment or by any subsequent microbiological testing. Secondly, we wanted to identify which variables that were available in the first assessment (ED variables) would have been useful in predicting patients, who at the end of the hospital stay were confirmed as having COVID-19 (false-negative at the first RT-PCR). Methods We retrospectively collected data of 115 negative patients from2020, March 1st to 2020, May 15th. Three experts revised patients’ charts collecting information on the whole hospital stay and defining patients as COVID-19 or NOT-COVID-19. We compared ED variables in the two groups by univariate analysis and logistic regression. Results We classified 66 patients as COVID-19 and identified the other 49 as having a differential diagnosis (NOT-COVID), with a concordance between the three experts of 0.77 (95% confidence interval (95%CI) 0.66- 0.73). Only 15% of patients tested positive to a subsequent RT-PCR test, accounting for 25% of the clinically suspected. Having fever (odds ratio (OR) 3.32, (95%CI 0.97-12.31), p = 0.06), showing a typical pattern at the first lung ultrasound (OR 6.09, (95%CI 0.87-54.65), p = 0.08) or computed tomography scan (OR 4.18, (95%CI 1.11-17.86), p = 0.04) were associated with a higher probability of having COVID-19. Conclusions In patients admitted to ED with COVID-19 symptoms and negative RT-PCR a comprehensive clinical evaluation integrated with lung ultrasound and computed tomography could help to detect COVID-19 patients with a false negative RT-PCR result.

Influence of age and ways of treatment in the parasitemia in mice infected with Trypanosoma cruzi treated with high potency biotherapy

Introduction: The infection of mice by Trypanosoma cruzi is well known, making this a good model for understanding the effect of highly diluted medications. Mice of different ages show different responses to biotherapic T. cruzi [1]. Other data from our laboratory using biotherapic treatment at low potencies show that long lasting treatment has a better effect in mice infected with T. cruzi. However, the use of high potency biotherapics in mice of different ages infected with T. cruzi has not been analysed yet. Aim: To evaluate the effect of different ways of treatment using biotherapic 200 DH T. cruzi in the evolution of the curve of parasitemia of mice of different ages infected with T. cruzi. Materials and methods: A blind randomized controlled trial was performed using 107 swiss male mice, aged 28, 35 and 56 days, divided into groups: CONTROL(C) – mice aged 28(C28), 38(C38) and 56(C56) days, treated with 7% water-alcohol solution diluted with water (1mL/100mL); ONE DAY(OD) – mice aged 28(OD28), 38(OD38) and 56(OD56) days, treated with highly diluted medication 200 DH T. cruzi in a single dose, diluted in water (10mL/100mL); EVERY DAY(ED) – mice aged 28(ED28), 38(ED38) and 56(ED56) days, treated with highly diluted medication 200DH T.cruzi until the end of the experiment, diluted in water(1mL/100mL). Amber bottle was used and the water was changed every two days. The groups were infected with strain Y-T. cruzi, intraperitoneal,1400 blood trypomastigotes. Medicines were handled according to the Brazilian Homeopathic Pharmacopoeia [2], with microbiological testing according to RDC n° 67 and in vivo biological risk. We compared the parasitemia curve and total parasitemia, determined daily counting of the parasites [3], obtained using the tests Kruskal-Wallis and Wald-Wolfowitz, Statistica 8.0, 5% significance. Approved by the Ethics Committee for Animal Experimentation/ UEM - 030/2008. Results: The animal age and the ways of treatment used influenced the evolution of the parasitemia curve. This evolution was different among different ages, and the youngest mice of the control group had higher averages of parasitemia ( C28=1.4x106/mL; C38= 1.3 x106/mL and C56=1.0x106/mL ) (fig1). This evolution was not observed in the groups treated daily, in which 56 day-old mice presented a higher parasitemia compared to the other groups ( ED28= 1.3x106/mL; ED38=0.9x106/mL and ED56=1.2x106/mL )(fig1b). For animals treated with a single dose, the energetic stimulus provided by biotherapic caused homogeneity of biological behavior, with significant elevation of parasitemia ( OD28=1.8x106/mL; OD38=1.3x106/mL and OD56=1.5 x106/mL) (fig1c). Likewise, the single dose treatment invariably resulted in an increase of parasitemia when compared to other treatments within the same age group (fig1d-f). The treatment performed daily in animals aged 28 and 38 days showed a decrease in parasitemia (fig1d-f). For 56 day-old mice this fall was not observed (fig1f). The meaning of this finding should be better explored considering the physiological maturity versus the vital energy of mice of different ages. Conclusion: The age and the ways of treatment used are important factors to be considered when using a highly diluted medication. The clinical use of these results in humans, should take into consideration the allometric system of medication dosage which takes into account the metabolic rate of each organism.

The Photograph Registration of Petri Dishes in High Quality and Image Editing of Microbiological Testing

Science is based on evidence that can be measured or observed through methodical techniques which are expressed in several ways, either quantitatively or qualitatively. The technical photograph becomes one of the most important key tools to the result’s disclosure. In the microbiological research, several pieces of evidence can be indicated with variables that are deeply related to the means of culture; pH and color variation, halo formation, overlay of structures, culture shape, among others. The employment of technical photographs, as a strategy of the experimental observation and reliable representation, is indispensable. The protocol presented here suggests the production of the photographic support in microbiological tests runs on Petri dishes, taken by a smartphone to obtain high-quality images, besides showing tools to edit images through PowerPoint. The support is composed of a paper tube with a transparent border, whose reduced light penetration avoids problems, such as the luminous reflection over the Petri dishes or the environment itself. The edition consists of the photograph variation, and in clipping and pasting on uniform backgrounds to provide further detailing. The protocol allowed a standardized photograph collection in high quality, which is ideal for a comparative portrait of microbiological behaviors. The image editing enabled a framework and greater visibility of physical and biological structures in the exhibition of photographs inside the manuscript, such as the removal of noises, background alterations, deformities or irregularities. This protocol is a tool that helps the researcher on the knowledge-obtaining process, and it is applied to different experiments or adapted into the most variable research subjects.

Triage of Persons With Tuberculosis Symptoms Using Artificial Intelligence–Based Chest Radiograph Interpretation: A Cost-Effectiveness Analysis

Background In settings without access to rapid expert radiographic interpretation, artificial intelligence (AI)–based chest radiograph (CXR) analysis can triage persons presenting with possible tuberculosis (TB) symptoms, to identify those who require additional microbiological testing. However, there is limited evidence of the cost-effectiveness of this technology as a triage tool. Methods A decision analysis model was developed to evaluate the cost-effectiveness of triage strategies with AI-based CXR analysis for patients presenting with symptoms suggestive of pulmonary TB in Karachi, Pakistan. These strategies were compared to the current standard of care using microbiological testing with smear microscopy or GeneXpert, without prior triage. Positive triage CXRs were considered to improve referral success for microbiologic testing, from 91% to 100% for eligible persons. Software diagnostic accuracy was based on a prospective field study in Karachi. Other inputs were obtained from the Pakistan TB Program. The analysis was conducted from the healthcare provider perspective, and costs were expressed in 2020 US dollars. Results Compared to upfront smear microscopy for all persons with presumptive TB, triage strategies with AI-based CXR analysis were projected to lower costs by 19%, from $23233 per 1000 persons, and avert 3%–4% disability-adjusted life-years (DALYs), from 372 DALYs. Compared to upfront GeneXpert, AI-based triage strategies lowered projected costs by 37%, from $34346 and averted 4% additional DALYs, from 369 DALYs. Reinforced follow-up for persons with positive triage CXRs but negative microbiologic tests was particularly cost-effective. Conclusions In lower-resource settings, the addition of AI-based CXR triage before microbiologic testing for persons with possible TB symptoms can reduce costs, avert additional DALYs, and improve TB detection.

The microbial composition of the initial insult can predict the prognosis of experimental sepsis

We hypothesized that the composition of sepsis-inducing bacterial flora influences the course of fecal peritonitis in rodents. Saline or fecal suspensions with a standardized dose range of bacterial colony-forming units (CFUs) were injected intraperitoneally into Sprague–Dawley rats. The qualitative composition of the initial inoculum and the ascites was analyzed separately by MALDI-TOF mass spectrometry. Invasive monitoring was conducted in separate anesthetized groups (n = 12–13/group) after 12, 24, 48 and 72 h to determine rat-specific organ failure assessment (ROFA) scores. Death and ROFA scores peaked at 24 h. At this time, 20% mortality occurred in animals receiving a monomicrobial E. coli suspension, and ROFA scores were significantly higher in the monomicrobial subgroup than in the polymicrobial one (median 6.5; 5.0–7.0 and 5.0; 4.75–5.0, respectively). ROFA scores dropped after 48 h, accompanied by a steady decrease in ascites CFUs and a shift towards intra-abdominal monomicrobial E. coli cultures. Furthermore, we found a relationship between ascites CFUs and the evolving change in ROFA scores throughout the study. Hence, quantitatively identical bacterial loads with mono- or polymicrobial dominance lead to a different degree of sepsis severity and divergent outcomes. Initial and intraperitoneal microbiological testing should be used to improve translational research success.

High-throughput next-generation sequencing for identifying pathogens during early-stage post-lung transplantation

Background High-throughput next-generation sequencing (HT-NGS) has the potential to detect a large variety of pathogens; however, the application of HT-NGS in lung transplant (LTx) recipients remains limited. We aimed to evaluate the value of HT-NGS for pathogen detection and diagnosis of pulmonary infection during early-stage post-lung transplantation. Methods In this retrospective study, we enrolled 51 LTx recipients who underwent lung transplantation between January 2020 and December 2020. Bronchoalveolar lavage fluid (BALF) samples were collected for the detection of pathogens using both HT-NGS and conventional microbiological testing. The detection of pathogens and diagnostic performance of HT-NGS were compared with that of conventional methods. Results HT-NGS provided a higher positive rate of pathogen detection than conventional microbiological testing (88.24% vs. 76.47%). The most common bacteria detected via HT-NGS during early-stage post-lung transplantation were Enterococcus, Staphylococcus, Pseudomonas and Klebsiella, while all fungi were Candida and all viruses were Herpesvirus. Uncommon pathogens, including Strongyloides, Legionella, and Mycobacterium abscesses were identified by HT-NGS. The sensitivity of HT-NGS for diagnosing pulmonary infection was significantly higher than that of conventional microbiological testing (97.14% vs. 68.57%; P < 0.001). For three LTx recipients, treatment regimens were adjusted according to the results of HT-NGS, leading to a complete recovery. Conclusion HT-NGS is a highly sensitive technique for pathogen detection, which may provide diagnostic advantages, especially in LTx recipients, contributing to the optimization of treatment regimens against pulmonary infection during early-stage post-lung transplantation.

928. Clinical Characteristics and Microbiology Testing Patterns Among Transplant Recipients Admitted to Acute Care Hospitals for Suspected Infection

Background Solid organ transplant (SOT) is a growing option for patients with end-stage organ diseases. Immunosuppressive therapy (IT) is utilized in this population to minimize risk of allograft rejection, which increases infection risk particularly of atypical pathogens that can complicate the infection-related diagnostic journey. The purpose of this analysis was to evaluate baseline clinical characteristics and microbiological testing utilization patterns among a cohort of patients with a history of SOT and IT. Methods This retrospective cohort study utilized a US hospital-based, service-level database. Patients were selected from a subsample of database facilities utilizing plasma microbial cell-free DNA diagnostic assays. The study period was 1/1/2017-3/21/2020. Eligible patients were identified by 1st observation of SOT status and IT. Subsequent inpatient admissions for suspected infection were analyzed. Results We identified 749 patients with SOT history and use of IT, 56.4% were male, and the mean age was 52.8 (18.7) years. Kidney was the most prevalent transplant category (49.1%), followed by liver (14.1%), lung (10.9%), and heart (10.3%), and 9.7% were multi-organ. Patients experiencing multiple transplants had the most chronic conditions with a mean Elixhauser comorbidity score of 26.3 (14.7). The median length of stay was 4 [3-7] days. The median number of tests per encounter was 6 [IQR=3-11]. Culture was the most utilized test category (2 [1-4]). Blood culture was the highest utilized culture and overall test at 13.5% of all tests observed, while CMV PCR (7.8%) and multi-panel EIA (2.7%) were the most frequent molecular and antigen tests, respectively. Lung transplant recipients had the greatest utilization of tests overall (9 [3.5-17]) versus other transplant categories (6 [3-10]), consistent with the observed test rate in the 1st 48 hours of presentation (4 [1-7] vs. 2 [1-5]). Conclusion This analysis suggests that the infection-related diagnostic journey among patients with a history of SOT involves high utilization of microbiological testing, with greater utilization among lung transplant recipients versus other SOT recipients. Variation in clinical characteristics and microbiological testing patterns were observed across SOT categories. Disclosures T Matthew Hill, PharmD, PhD, Karius, Inc (Employee, Shareholder) Erick R. Scott, MD, MHS, Karius, Inc (Employee, Shareholder) Sivan Bercovici, PhD, Karius (Employee)