scholarly journals Current situation of tuberculosis and National Strategic Plan for Tuberculosis Control in Korea

2021 ◽  
Vol 64 (4) ◽  
pp. 316-323
Author(s):  
Eunjeong Son ◽  
Doosoo Jeon
Keyword(s):  
Insurance Coverage ◽  
Public Health Problem ◽  
Strategic Plan ◽  
Multidrug Resistant ◽  
High Rate ◽  
Foreign Born ◽  
Tuberculosis Control ◽  
Notification Rate ◽  
Tb Control ◽  
National Strategic Plan

Tuberculosis (TB) remains a serious public health problem in Korea. Korea has the highest incidence rate (59 per 100,000 population) and the second-highest TB mortality rate (four per 100,000 population) among Organisation for Economic Cooperation and Development member countries. However, some progress has been made in TB control over the past decade. The notification rate of new TB cases has been gradually decreasing since reaching its highest rate in 2011 (78.9 per 100,000 population). In 2019, the notification rate of new TB cases was 46.4 per 100,000 population, with a reduction of 9.9% from the 2018 rate. Additionally, the number of multidrug-resistant TB cases decreased from 618 in 2018 to 580 in 2019. This progress is thought the result of various TB control programs including a TB public–private mix model, insurance coverage for TB management, and a contact investigation program. Despite the progress made, new challenges have also emerged. The predominant challenges lie in the relatively increasing burden of TB in the vulnerable population (aging, socio-economically vulnerable, and foreign-born population), the implementation of latent TB infection management, and the high rate of multidrug-resistant TB. Since 2019, the Korean government has been implementing the “Midterm strategies to strengthen TB prevention and management” based on the 2nd National Strategic Plan for Tuberculosis Control (2018-2022). This program will be a turning point of TB control in Korea. The results produced in 2023 is expected to be favorable.

Pilot Study on non-tuberculous mycobacteria infections in Italy

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
L Fattorini ◽  
A Iacobino ◽  
F Giannoni ◽  
Keyword(s):  
Cystic Fibrosis ◽  
Minimum Inhibitory Concentration ◽  
Pilot Study ◽  
Inhibitory Concentration ◽  
Strategic Plan ◽  
Foreign Born ◽  
Old Patients ◽  
National Strategic Plan ◽  
Reported Data ◽  
Resistance Rates

Abstract Background The rise in non-tuberculous mycobacteria (NTM) diseases has been reported worldwide, but no major information is known for Italy. The purpose of this pilot study is to release nationwide data on distribution of NTM in our country. Methods In 2016, the Istituto Superiore di Sanità (National Institute of Health) began to collect microbiological, clinical and minimum inhibitory concentration (MIC) data on NTM infections, in collaboration with hospital laboratories located in 15 out of 20 regions (Studio Multicentrico Italiano NTM, SMI-NTM), which routinely isolate and characterize NTM by commercial identification (Genotype) and MIC (Sensititre) assays. Results In 2016-2018, 32 labs reported data on 4169 NTM strains, including 644 rapid growers (15%) and 3525 slow growers (85%). The most frequent species were Mycobacterium avium (MA) (29.2%), M. intracellulare (MI) (21.5%), M. xenopi (MX) (10.6%), M. gordonae (10.6%), M. abscessus (5.9%), M. chimaera (MC) (5.1%). Overall, 88% NTM strains were isolated from pulmonary sites, 84% from Italians, 51% from men. NTM infections in Italians occurred in 75-84 years old patients, while in foreign-born people were observed in 15-44 years old patients. Strains from cystic fibrosis were 11.9%. The MICs of clarithromycin (CLA) for MA or MI peaked at 2 µg/ml, while for amikacin (AK) peaked at 16 µg/ml. When MICs were interpreted according to the 2018 Clinical and Laboratory Institute Standards (CLSI) breakpoints, MA or MI resistances for CLA were 2.6% and 2.6% respectively, while for AK they were 7.2% and 4.5%, respectively. Higher resistance rates for MA and MI were observed for moxifloxacin and linezolid. MICs of MC, MX, M. kansasii, M. marinum and rapid grower NTM were also determined and interpreted on the basis of CLSI breakpoints. Conclusions This 3-years pilot study is the basis for a future multiannual national strategic plan for surveillance of NTM infections in Italy (collection of 2019 data is in progress). Key messages This 3-years pilot study is the basis for a future multiannual national strategic plan for surveillance of NTM infections in Italy. The purpose of this pilot study is to release nationwide data on distribution of NTM in our country.

scholarly journals Immigrant Arrival and Tuberculosis among Large Immigrant- and Refugee-Receiving Countries, 2005–2009

2017 ◽  
Vol 2017 ◽  
pp. 1-8 ◽  
Author(s):  
Zachary White ◽  
John Painter ◽  
Paul Douglas ◽  
Ibrahim Abubakar ◽  
Howard Njoo ◽  
...  
Keyword(s):  
The United States ◽  
Multidrug Resistant ◽  
The Philippines ◽  
Health Concern ◽  
Foreign Born ◽  
Tuberculosis Control ◽  
Tuberculosis Case ◽  
Resistant Tuberculosis ◽  
Mdr Tb ◽  
Immigrant And Refugee

Objective. Tuberculosis control in foreign-born populations is a major public health concern for Australia, Canada, New Zealand, United Kingdom, and the United States, large immigrant- and refugee-receiving countries that comprise the Immigration and Refugee Health Working Group (IRHWG). Identifying and comparing immigration and distribution of foreign-born tuberculosis cases are important for developing targeted and collaborative interventions.Methods. Data stratified by year and country of birth from 2005 to 2009 were received from these five countries. Immigration totals, tuberculosis case totals, and multidrug-resistant tuberculosis (MDR TB) case totals from source countries were analyzed and compared to reveal similarities and differences for each member of the group.Results. Between 2005 and 2009, there were a combined 31,785,002 arrivals, 77,905 tuberculosis cases, and 888 MDR TB cases notified at the federal level in the IRHWG countries. India, China, Vietnam, and the Philippines accounted for 41.4% of the total foreign-born tuberculosis cases and 42.7% of the foreign-born MDR tuberculosis cases to IRHWG.Interpretation. Collaborative efforts across a small number of countries have the potential to yield sizeable gains in tuberculosis control for these large immigrant- and refugee-receiving countries.

scholarly journals Retrospective analysis of multidrug-resistant tuberculosis case notifications in Australia (1999–2018)

2020 ◽  
Vol 44 ◽  
Author(s):  
Hendrik S Camphor ◽  
Kerri Viney ◽  
Ben Polkinghorne ◽  
Kate Pennington
Keyword(s):  
Clinical Laboratory ◽  
Treatment Success ◽  
Multidrug Resistant ◽  
Current Data ◽  
Notification Rate ◽  
Tuberculosis Case ◽  
Tb Control ◽  
Resistant Tuberculosis ◽  
Multidrug Resistant Tuberculosis ◽  
Mdr Tb

This study describes the epidemiology and treatment outcomes of multidrug-resistant tuberculosis (MDR-TB) cases notified in Australia between 1999 and 2018, and investigates whether current data fields in the national tuberculosis (TB) dataset allow description and measurement of surveillance information pertaining to the diagnosis and clinical management of MDR-TB. In May 2019, de-identified demographic, clinical, laboratory, drug susceptibility, treatment, risk factor and outcome data for all MDR-TB case notifications were extracted from the Australian National Notifiable Disease Surveillance System. The dataset included ten treatment outcome categories, which were aggregated to four categorical outcomes for descriptive and inferential analyses. The majority of cases were overseas-born (91%). Absolute case numbers increased over time; however, the MDR-TB notification rate remained fairly stable during the study period. Treatment success was achieved in nearly two-thirds of cases (62.1%). Whilst timeframes between initial presentation, specimen collection, case notification and treatment commencement were calculated, current data fields in the national dataset precluded measurement and description of other parameters deemed important for MDR-TB surveillance. This study demonstrates that while Australia’s MDR-TB burden is low, cases will continue to occur until TB control improves in countries with which Australia shares cultural and migration links. Australia should continue to support national and regional TB control programmes to sustain progress towards national elimination of TB. This study’s findings support a review of data fields in the national TB dataset with potential expansion or adjustment to improve national data reporting, including the monitoring of evidence-based recommendations for the prevention and management of MDR-TB.

Crucial role of physiotherapy in treating COVID-19 patients

2020 ◽  
Vol 11 (SPL1) ◽  
pp. 967-971
Author(s):  
Poonam Thakre ◽  
Waqar M. Naqvi ◽  
Trupti Deshmukh ◽  
Nikhil Ingole ◽  
Sourabh Deshmukh
Keyword(s):  
Public Health ◽  
Distress Syndrome ◽  
Public Health Problem ◽  
Public Health Emergency ◽  
High Rate ◽  
Major Public Health Problem ◽  
Front Line ◽  
The Many ◽  
Sixth International

The emergence in China of 2019 of severe acute respiratory syndrome coronavirus2 (SARS-CoV-2) previously provisionally names 2019-nCoV disease (COVID19) caused major global outbreak and is a major public health problem. On 30 January 2020, the WHO declared COVID19 to be the sixth international public health emergency. This present pandemic has engrossed the globe with a high rate of mortality. As a front line practitioner, physiotherapists are expected to be getting in direct contact with patients infected with the virus. That’s why it is necessary for understanding the many aspects of their role in the identification, contains, reduces and treats the symptoms of this disease. The main presentation is the involvement of respiratory system with symptoms like fever, cough, sore throat, sneezing and characteristics of pneumonia leads to ARDS(Acute respiratory distress syndrome) also land up in multiorgan dysfunction syndrome. This text describes and suggests physiotherapy management of acute COVID-19 patients. It also includes recommendations and guidelines for physiotherapy planning and management. It also covers the guidelines regarding personal care and equipment used for treatment which can be used in the treatment of acute adult patients with suspected or confirmed COVID-19.

The Predictive Role of Biochemical Plasma Factors in Patients with Severe Traumatic Brain Injuries

2019 ◽  
Vol 70 (5) ◽  
pp. 1754-1757
Author(s):  
Marius Toma Papacocea ◽  
Ioana Anca Badarau ◽  
Mugurel Radoi ◽  
Ioana Raluca Papacocea
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Blood Cell ◽  
Brain Injuries ◽  
Hematological Parameters ◽  
Group Versus ◽  
Public Health Problem ◽  
Traumatic Brain Injuries ◽  
High Rate ◽  
Control Group

Traumatic brain injuries (TBI) represent a high impact public health problem due to a high rate of death , long term disability and occurrence especially in young adults. Despite several promising animal studies, several parameters were proposed as biological markers and were assessed for this aim. Our study proposes the study of the early biochemical changes in association to hematological parameters for severe TBI patients prognosis. 43 patients with acute TBI were included in study based on clinical, laboratory and imagistic findings. The severity of the TBI was established by Glasgow Coma Scale GCS 3-8. In all patients were evaluated hematologic parameters (Red blood cell count - RBC, Hematocrit, blood Hemoglobin, White blood cell - WBC, Platelet count and biochemical parameters (glucose, urea, creatinine, electrolytes). Outcome was expressed as Glasgow Outcome Scale (GOS), between 1-5. Values were compared to control group -15 cases. Significant early differences in body temperature, heart rate, and systolic blood pressure were observed in TBI group versus control (p[0.05). After correlation, laboratory findings significantly associated to severe outcome - GOS = 1, 2 - (p[0.05) were plasma Na decrease and significant glucose increase. An early increase of temperature and decrease of Na may predict a severe outcome in patients with acute TBI; association with shifts in heart rate and blood pressure, imposes aggressive treatment measures.

Modulation of the drug resistance by Platonia insignis Mart. extract, ethyl acetate fraction and Morelloflavone/Volkensiflavone (biflavonoids) in Staphylococcus aureus strains overexpressing efflux pump genes

2020 ◽  
Vol 21 ◽  
Author(s):  
Andressa Kelly Ferreira e Silva ◽  
Antonielly Campinho dos Reis ◽  
Emanuelly Elanny Andrade Pinheiroc ◽  
Jonas Nascimento de Sousa ◽  
Felipe Araújo de Alcântara Oliveira ◽  
...  
Keyword(s):  
Natural Products ◽  
Ethyl Acetate ◽  
Native Species ◽  
Efflux Pump ◽  
Public Health Problem ◽  
Ethyl Acetate Fraction ◽  
Multidrug Resistant ◽  
Global Public Health ◽  
Minimal Inhibitory Concentrations ◽  
Subinhibitory Concentrations

Background: Microbial resistance to antibiotics is a global public health problem, which requires urgent attention. Platonia insignis is a native species from the eastern Brazilian Amazon, used in the treatment of burns and wounds. Objectives: To evaluate the antimicrobial activity of the hydroalcoholic extract of P. insignis (PIHA), the ethyl acetate fraction (PIAE), and its subfraction containing a mixture of biflavonoids (BF). Moreover, the effect of these natural products on the antibiotic activity against S. aureus strains overexpressing efflux pump genes was also evaluated. Methods: Minimal inhibitory concentrations were determined against different species of microorganisms. To evaluate the modulatory effect on the Norfloxacin-resistance, the MIC of this antibiotic was determined in the absence and presence of the natural products at subinhibitory concentrations. Inhibition of the EtBr efflux assays were conducted in the absence or presence of the natural products. Results: PIHA showed a microbicidal effect against S. aureus and C. albicans, while PIAE was bacteriosctatic for S. aureus. PIAE and BF at subinhibitory concentrations were able to reduce the MIC of Norfloxacin acting as modulating agents. BF was able to inhibit the efflux of EtBr efflux in S. aureus strains overexpressing specific efflux pump genes. Conclusion: P. inignisis a source of efflux pump inhibitors, including volkensiflavone and morelloflavone which were able to potentiate the Norfloxacin activity by NorA inhibition, being also able to inhibit QacA/B, TetK and MsrA. Volkensiflavone and morelloflavone could be used as adjuvant in the antibiotic therapy of multidrug resistant S. aureus strains overexpressing efflux pumps.

The Myometrium in Pregnant Women with Obesity

2020 ◽  
Vol 19 (2) ◽  
pp. 193-200
Author(s):  
Jorge A. Carvajal ◽  
Joaquín I. Oporto
Keyword(s):  
Pregnant Women ◽  
Public Health Problem ◽  
Oxytocin Receptor ◽  
High Rate ◽  
K Channel ◽  
Obese Women ◽  
Cesarean Sections ◽  
Cholesterol Levels ◽  
Myometrial Contractility ◽  
Lower Expression

: Obesity is a worldwide public health problem, affecting at least one-third of pregnant women. One of the main problems of obesity during pregnancy is the resulting high rate of cesarean section. The leading cause of this higher frequency of cesarean sections in obese women, compared with that in nonobese women, is an altered myometrial function that leads to lower frequency and potency of contractions. In this article, the disruptions of myometrial myocytes were reviewed in obese women during pregnancy that may explain the dysfunctional labor. The myometrium of obese women exhibited lower expression of connexin43, a lower function of the oxytocin receptor, and higher activity of the potassium channels. Adipokines, such as leptin, visfatin, and apelin, whose concentrations are higher in obese women, decreased myometrial contractility, perhaps by inhibiting the myometrial RhoA/ROCK pathway. The characteristically higher cholesterol levels of obese women alter myometrial myocyte cell membranes, especially the caveolae, inhibiting oxytocin receptor function, and increasing the K+ channel activity. All these changes in the myometrial cells or their environment decrease myometrial contractility, at least partially explaining the higher rate of cesarean of sections in obese women.

scholarly journals Nearly Identical Plasmids Encoding VIM-1 and Mercury Resistance in Enterobacteriaceae from North-Eastern Germany

2021 ◽  
Vol 9 (7) ◽  
pp. 1345
Author(s):  
Stefan E. Heiden ◽  
Katharina Sydow ◽  
Stephan Schaefer ◽  
Ingo Klempien ◽  
Veronika Balau ◽  
...  
Keyword(s):  
Resistance Gene ◽  
Bacterial Species ◽  
Genomic Analysis ◽  
Public Health Problem ◽  
Multidrug Resistant ◽  
Mercury Resistance ◽  
Major Public Health Problem ◽  
Eastern Germany ◽  
North Eastern ◽  
Resistance Plasmids

The emergence of carbapenemase-producing Enterobacteriaceae limits therapeutic options and presents a major public health problem. Resistances to carbapenems are mostly conveyed by metallo-beta-lactamases (MBL) including VIM, which are often encoded on resistance plasmids. We characterized four VIM-positive isolates that were obtained as part of a routine diagnostic screening from two laboratories in north-eastern Germany between June and August 2020. Whole-genome sequencing was performed to address (a) phylogenetic properties, (b) plasmid content, and (c) resistance gene carriage. In addition, we performed phenotypic antibiotic and mercury resistance analyses. The genomic analysis revealed three different bacterial species including C. freundii, E. coli and K. oxytoca with four different sequence types. All isolates were geno- and phenotypically multidrug-resistant (MDR) and the phenotypic profile was explained by the underlying resistance gene content. Three isolates of four carried nearly identical VIM-1-resistance plasmids, which in addition encoded a mercury resistance operon and showed some similarity to two publicly available plasmid sequences from sources other than the two laboratories above. Our results highlight the circulation of a nearly identical IncN-type VIM-1-resistance plasmid in different Enterobacteriaceae in north-eastern Germany.

scholarly journals Detection of extended spectrum beta-lactamase genes in Pseudomonas aeruginosa isolated from patients in rural Eastern Cape Province, South Africa

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Mojisola C. Hosu ◽  
Sandeep D. Vasaikar ◽  
Grace E. Okuthe ◽  
Teke Apalata
Keyword(s):  
Pseudomonas Aeruginosa ◽  
Antimicrobial Resistance ◽  
Multidrug Resistant ◽  
High Rate ◽  
Infection Prevention And Control ◽  
Beta Lactamase ◽  
Eastern Cape ◽  
Extended Spectrum Beta Lactamase ◽  
Extended Spectrum ◽  
Resistance Patterns

AbstractThe proliferation of extended spectrum beta-lactamase (ESBL) producing Pseudomonas aeruginosa represent a major public health threat. In this study, we evaluated the antimicrobial resistance patterns of P. aeruginosa strains and characterized the ESBLs and Metallo- β-lactamases (MBL) produced. Strains of P. aeruginosa cultured from patients who attended Nelson Mandela Academic Hospital and other clinics in the four district municipalities of the Eastern Cape between August 2017 and May 2019 were identified; antimicrobial susceptibility testing was carried out against thirteen clinically relevant antibiotics using the BioMérieux VITEK 2 and confirmed by Beckman autoSCAN-4 System. Real-time PCR was done using Roche Light Cycler 2.0 to detect the presence of ESBLs; blaSHV, blaTEM and blaCTX-M genes; and MBLs; blaIMP, blaVIM. Strains of P. aeruginosa demonstrated resistance to wide-ranging clinically relevant antibiotics including piperacillin (64.2%), followed by aztreonam (57.8%), cefepime (51.5%), ceftazidime (51.0%), piperacillin/tazobactam (50.5%), and imipenem (46.6%). A total of 75 (36.8%) multidrug-resistant (MDR) strains were observed of the total pool of isolates. The blaTEM, blaSHV and blaCTX-M was detected in 79.3%, 69.5% and 31.7% isolates (n = 82), respectively. The blaIMP was detected in 1.25% while no blaVIM was detected in any of the strains tested. The study showed a high rate of MDR P. aeruginosa in our setting. The vast majority of these resistant strains carried blaTEM and blaSHV genes. Continuous monitoring of antimicrobial resistance and strict compliance towards infection prevention and control practices are the best defence against spread of MDR P. aeruginosa.

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