scholarly journals Multiple introductions of multidrug-resistant typhoid associated with acute infection and asymptomatic carriage, Kenya

eLife ◽  
2021 ◽  
Vol 10 ◽  
Author(s):  
Samuel Kariuki ◽  
Zoe A Dyson ◽  
Cecilia Mbae ◽  
Ronald Ngetich ◽  
Susan M Kavai ◽  
...  
Keyword(s):  
Informal Settlement ◽  
Acute Infection ◽  
Multidrug Resistant ◽  
Stool Culture ◽  
High Rate ◽  
Multiple Introductions ◽  
Resistant Strains ◽  
Gates Foundation ◽  
And Control

Background:Understanding the dynamics of infection and carriage of typhoid in endemic settings is critical to finding solutions to prevention and control.Methods:In a 3-year case-control study, we investigated typhoid among children aged <16 years (4670 febrile cases and 8549 age matched controls) living in an informal settlement, Nairobi, Kenya.Results:148 S. Typhi isolates from cases and 95 from controls (stool culture) were identified; a carriage frequency of 1 %. Whole-genome sequencing showed 97% of cases and 88% of controls were genotype 4.3.1 (Haplotype 58), with the majority of each (76% and 88%) being multidrug-resistant strains in three sublineages of the H58 genotype (East Africa 1 (EA1), EA2, and EA3), with sequences from cases and carriers intermingled.Conclusions:The high rate of multidrug-resistant H58 S. Typhi, and the close phylogenetic relationships between cases and controls, provides evidence for the role of carriers as a reservoir for the community spread of typhoid in this setting.Funding:National Institutes of Health (R01AI099525); Wellcome Trust (106158/Z/14/Z); European Commission (TyphiNET No 845681); National Institute for Health Research (NIHR); Bill and Melinda Gates Foundation (OPP1175797).

scholarly journals Multiple introductions of multidrug-resistant typhoid associated with acute infection and asymptomatic carriage, Kenya

2021 ◽  
Author(s):  
Samuel Kariuki ◽  
Zoe A Dyson ◽  
Cecilia Mbae ◽  
Ronald Ngetich ◽  
Susan M Kavai ◽  
...  
Keyword(s):  
Informal Settlement ◽  
Acute Infection ◽  
Multidrug Resistant ◽  
Stool Culture ◽  
High Rate ◽  
Multiple Introductions ◽  
Resistant Strains ◽  
And Control ◽  
Control Study

AbstractUnderstanding the dynamics of infection and carriage of typhoid in endemic settings is critical to finding solutions to prevention and control. In a 3 year case-control study, we investigated typhoid among children aged <16 years (4,670 febrile cases and 8,549 age matched controls) living in an informal settlement, Nairobi, Kenya. 148 S. Typhi isolates from cases and 95 from controls (stool culture) were identified; a carriage frequency of 1%. Whole-genome sequencing showed 97% of cases and 88% of controls were genotype 4.3.1 (Haplotype58), with the majority of each (76% and 88%) being multidrug-resistant strains in 3 sublineages of H58 genotype (East Africa 1 (EA1), EA2, and EA3), with sequences from cases and carriers intermingled. The high rate of multidrug-resistant H58 S. Typhi, and the close phylogenetic relationships between carriers and controls, provides evidence for the role of carriers as a reservoir for the community spread of typhoid in this setting.

scholarly journals The Biology and Role of Interleukin-32 in Tuberculosis

2018 ◽  
Vol 2018 ◽  
pp. 1-9 ◽  
Author(s):  
Wu Li ◽  
Wanyan Deng ◽  
Jianping Xie
Keyword(s):  
Multidrug Resistant ◽  
Drug Resistant ◽  
Host Molecule ◽  
Tuberculosis Control ◽  
Promising Alternative ◽  
Extensively Drug Resistant ◽  
Important Host ◽  
Resistant Strains ◽  
Drug Resistant Strains

Tuberculosis, caused by Mycobacterium tuberculosis, remains a leading cause of morbidity and mortality globally, with nearly 10.4 million new cases of incidence and over 1.7 million deaths annually. Drug-resistant M. tuberculosis strains, especially multidrug-resistant or extensively drug-resistant strains, have further intensified the problem associated with tuberculosis control. Host-directed therapy is a promising alternative for tuberculosis control. IL-32 is increasingly recognized as an important host molecule against tuberculosis. In this review, we highlight the proinflammatory properties of IL-32 and the mode of action of IL-32 in mycobacterial infections to inspire the development of novel immunity-based countermeasures and host-directed therapies against tuberculosis.

scholarly journals Multidrug-ResistantAcinetobacter baumannii: An Emerging Health Threat in Aseer Region, Kingdom of Saudi Arabia

2018 ◽  
Vol 2018 ◽  
pp. 1-4 ◽  
Author(s):  
Mohammed K. Almaghrabi ◽  
Martin R. P. Joseph ◽  
Mohammed M. Assiry ◽  
Mohamed E. Hamid
Keyword(s):  
Saudi Arabia ◽  
Health Problem ◽  
Antibiotic Susceptibility ◽  
Multidrug Resistant ◽  
High Rate ◽  
The South ◽  
Kingdom Of Saudi Arabia ◽  
Bench Tests ◽  
Important Health ◽  
Resistant Strains

Objective. The study aims to determine the prevalence of multidrug-resistantA. baumanniiin Aseer Region, Kingdom of Saudi Arabia.Methods. This study evaluated the antibiotic susceptibility of ninety-four (n = 94) clinical isolates ofA. baumannii. The isolates were collected from the south region of Saudi Arabia, and notably Aseer Region, during the period from 15 October 2014 to 15 January 2015. The isolates were tentatively identified asA. baumanniiby routine bench tests and were confirmed by using VITEK® 2 Compact. The latest instrument was used to identify antibiotic susceptibility of these isolates.Results. Antibiotic susceptibility in this study showed that 69% of these isolates were multidrug-resistant strains. Moreover, they were highly resistant to carbapenem drugs. Several strains of these isolates were found to be extremely resistant to test antibiotics and were only sensitive to one or two of them.Conclusion. High rate of multidrug-resistantA. baumanniibacteraemia has emerged in the south region of Saudi Arabia as an important health problem. Therefore, it is considered as a new threat in hospitals, which requires a tremendous effort to stop its escalation and spread.

scholarly journals Cockroaches as a Source of High Bacterial Pathogens with Multidrug Resistant Strains in Gondar Town, Ethiopia

2016 ◽  
Vol 2016 ◽  
pp. 1-6 ◽  
Author(s):  
Feleke Moges ◽  
Setegn Eshetie ◽  
Mengistu Endris ◽  
Kahsay Huruy ◽  
Dagnachew Muluye ◽  
...  
Keyword(s):  
Bacterial Infections ◽  
Bacterial Species ◽  
Multidrug Resistant ◽  
Resistance Rate ◽  
Control Measures ◽  
Diffusion Method ◽  
Disk Diffusion Method ◽  
Gondar Town ◽  
Resistant Strains ◽  
And Control

Background. Cockroaches are source of bacterial infections and this study was aimed to assess bacterial isolates and their antimicrobial profiles from cockroaches in Gondar town, Ethiopia.Methods. A total of 60 cockroaches were collected from March 1 to May 30, 2014, in Gondar town. Bacterial species were isolated from external and internal parts of cockroaches. Disk diffusion method was used to determine antibiotic susceptibility patterns. Data were entered and analyzed by using SPSS version 20;Pvalues <0.005 were considered as statistically significant.Results. Of 181 identified bacteria species, 110 (60.8%) and 71 (39.2%) were identified from external and internal parts of cockroaches, respectively.Klebsiella pneumoniae32 (17.7%),Escherichia coli29 (16%), andCitrobacterspp. 27 (15%) were the predominant isolates. High resistance rate was observed to cotrimoxazole, 60 (33.1%), and least resistance rate was noted to ciprofloxacin, 2 (1.1%). Additionally, 116 (64.1%) of the isolates were MDR strains;Salmonellaspp. were the leading MDR isolates (100%) followed byEnterobacter(90.5%) andShigellaspp. (76.9%).Conclusion. Cockroaches are the potential source of bacteria pathogens with multidrug resistant strains and hence effective preventive and control measures are required to minimize cockroach related infections.

scholarly journals An Early Response to Environmental Stress Involves Regulation of OmpX and OmpF, Two Enterobacterial Outer Membrane Pore-Forming Proteins

2007 ◽  
Vol 51 (9) ◽  
pp. 3190-3198 ◽  
Author(s):  
Myrielle Dupont ◽  
Chloë E. James ◽  
Jacqueline Chevalier ◽  
Jean-Marie Pagès
Keyword(s):  
Outer Membrane ◽  
Early Response ◽  
Multidrug Resistant ◽  
Resistance Mechanisms ◽  
Membrane Pore ◽  
Bacterial Response ◽  
External Stresses ◽  
Resistant Strains ◽  
Pore Forming Proteins

ABSTRACT Bacterial adaptation to external stresses and toxic compounds is a key step in the emergence of multidrug-resistant strains that are a serious threat to human health. Although some of the proteins and regulators involved in antibiotic resistance mechanisms have been described, no information is available to date concerning the early bacterial response to external stresses. Here we report that the expression of ompX, encoding an outer membrane protein, is increased during early exposure to drugs or environmental stresses. At the same time, the level of ompF porin expression is noticeably affected. Because of the role of these proteins in membrane permeability, these data suggest that OmpF and OmpX are involved in the control of the penetration of antibiotics such as β-lactams and fluoroquinolones through the enterobacterial outer membrane. Consequently, the early control of ompX and ompF induced by external stresses may represent a preliminary response to antibiotics, thus triggering the initial bacterial line of defense against antibiotherapy.

Support services

2019 ◽  
pp. 428-484
Author(s):  
Nizam Damani
Keyword(s):  
Occupational Health ◽  
Support Services ◽  
Prevention And Control ◽  
Health Department ◽  
Multidrug Resistant ◽  
Environmental Cleaning ◽  
Practical Advice ◽  
Multidrug Resistant Pathogens ◽  
And Control

This section discusses the role of hospital support services in the prevention and control of infection. It examines the role and responsibilities of the occupational health department which include pre-employment assessment and provision of guidance on how to manage healthcare workers who are exposed and/or infected with various communicable diseases and multidrug-resistant pathogens. It outlines the importance of infections spread by contaminated environment and provides practical advice on the environmental cleaning. Advice on the management of clinical waste, kitchen and catering services, linen and laundry services, and pest control is also provided.

scholarly journals Acute infection as cause of hospitalization of asylum-seeking children and adolescents in Stockholm, Sweden 2015–2016

2020 ◽  
Author(s):  
Olof Hertting ◽  
Joachim Luthander ◽  
Christian G. Giske ◽  
Rutger Bennet ◽  
Margareta Eriksson
Keyword(s):  
Infectious Diseases ◽  
Children And Adolescents ◽  
Asylum Seekers ◽  
Acute Infection ◽  
Multidrug Resistant ◽  
High Rate ◽  
Resistant Bacteria ◽  
Perceived Need ◽  
Physical Health Problems ◽  
Mental And Physical Health

Abstract We aimed to identify hospitalizations due to infectious diseases among asylum seekers and compare them to those of the resident population 1.6.2015–31.10.2016. Administrative numbers assigned to hospitalized non-resident children made them identifiable in the discharge register. The examined populations, expressed as person-years, were 334,573 residents and 7565 asylum seekers. There were 2500 episodes of infectious disease in 2240 resident children and 139 episodes in 121 asylum seekers. Among prevalent infections contracted before or during migration, there were 33 cases of tuberculosis, four of malaria, and one of louse-borne relapsing fever, all of which occurred in 13–17-year-old unaccompanied minors. Among younger asylum seekers, there were no significant differences in the spectrum of infectious discharge diagnoses compared to residents, but across all incident infections, 0–6-year-old asylum seekers had 3.2-fold and 7–12-year-old a 4.7-fold greater risk of being admitted. Screening for multidrug-resistant bacteria showed that 45/160 (28%) of the asylum seekers were colonized, but clinical infections caused by these species were rare. Conclusion: There was a high rate of hospitalizations for acute infectious diseases in asylum-seeking children, but the spectrum and severity of infections were similar to that in resident children. What is known:• Mental and physical health problems are common in immigrant children and adolescents.What is new:• Hospitalizations due to acute infections in asylum-seeking children and adolescents are common. In the context of this study, the severity and spectrum of infectious diseases seemed to be the same in the two groups; the increased hospitalization rate in asylum seekers may be due to social factors and perceived need for more support.

Fungal dysbiosis in cirrhosis

Gut ◽  
2017 ◽  
Vol 67 (6) ◽  
pp. 1146-1154 ◽  
Author(s):  
Jasmohan S Bajaj ◽  
Eric J Liu ◽  
Raffi Kheradman ◽  
Andrew Fagan ◽  
Douglas M Heuman ◽  
...  
Keyword(s):  
Standard Of Care ◽  
High Rate ◽  
Control Groups ◽  
Cross Sectional ◽  
And Control ◽  
Uninfected Culture ◽  
Culture Positive ◽  
Culture Negative

ObjectiveCirrhotics have a high rate of infections, which are increasingly fungal or culture-negative in nature. While infected cirrhotics have bacterial dysbiosis, the role of fungi is unclear. We aimed to evaluate gut bacterial and fungal dysbiosis in cross-sectional and longitudinal analyses of outpatient and inpatient cirrhotics and prediction of hospitalisations.MethodsCross-sectional: Age-matched controls, outpatients (with/without antibiotics) and hospitalised uninfected, culture-negative and culture-positive cirrhotics were included and followed for 90 days. Longitudinal: Three studies were conducted: (1) cirrhotics followed over 6 months, (2) outpatient cirrhotics administered antibiotics per standard of care for 5 days and (3) cirrhotics and controls administered omeprazole over 14 days. In all studies, stool bacterial/fungal profiles were analysed.ResultsCross-sectional: In 143 cirrhotics and 26 controls, bacterial and fungal diversities were significantly linked. Outpatients on antibiotics and patients with culture-positive infections had the lowest diversities. Bacterial and fungal correlations were complex in uninfected, outpatient and control groups but were markedly skewed in infected patients. 21% were admitted on 90-day follow-up. A lower Bacteroidetes/Ascomycota ratio was associated with lower hospitalisations. Longitudinal: Fungal and bacterial profiles were stable on follow-up (5 days and 6 months). After antibiotics, a significantly reduced bacterial and fungal diversity, higher Candida and lower autochthonous bacterial relative abundance were seen. After omeprazole, changes in bacterial diversity and composition were seen but fungal metrics remained stable.ConclusionThere is a significant fungal dysbiosis in cirrhosis, which changes differentially with antibiotics and proton pump inhibitor use, but is otherwise stable over time. A combined bacterial–fungal dysbiosis metric, Bacteroidetes/Ascomycota ratio, can independently predict 90-day hospitalisations in patients with cirrhosis.Clinical trial numberNCT01458990.

The Epidemiology of Multidrug-ResistantAcinetobacter BaumanniiDoes the Community Represent a Reservoir?

2003 ◽  
Vol 24 (4) ◽  
pp. 275-279 ◽  
Author(s):  
Cosmina Zeana ◽  
Elaine Larson ◽  
Jyoti Sahni ◽  
S. J. Bayuga ◽  
Fann Wu ◽  
...  
Keyword(s):  
Antimicrobial Resistance ◽  
Molecular Typing ◽  
Multidrug Resistant ◽  
Hospital Environment ◽  
Community Members ◽  
Community Residents ◽  
Potential Reservoir ◽  
Resistance Patterns ◽  
Resistant Strains

AbstractObjective:To explore the role of the community as a potential reservoir forAcinetobacter baumannii.Design:Antimicrobial resistance patterns and genotypes ofA. baumanniiisolates from patients in two Manhattan hospitals were compared with those ofA. baumanniiisolates from the hands of community members.Results:A total of 103 isolates from two hospitals (hospital A, 81; hospital B, 22) and 23 isolates from community residents were studied. Of the hospital isolates, 36.6% were multidrug resistant (hospital A, 68.2%; hospital B, 27.8%). In contrast, there were no multidrug-resistant isolates from the community (P< .005 between hospital and community). The prevalence ofA. baumanniion the hands of community residents was 10.4% (23 of 222). By molecular typing, 42 strains of A.baumanniiwere identified. Of the isolates from hospital A and hospital B, 55.6% (45 of 81) and 68.2% (15 of 22), respectively, were indistinguishable or closely related. In contrast, most community (83.3%) isolates were unrelated (P= .001 between hospital and community).Conclusion:Acinetobacterisolates from the community, characterized by a large variety of unrelated strains (83.3%), were distinct from the hospital isolates, of which 58.3% were closely related. The absence of multidrug-resistant strains in the community compared with 36.6% prevalence among hospital isolates suggests that the reservoir for epidemic strains resides in the hospital environment itself. To our knowledge, this is the first study to examine the community as a potential reservoir for hospital strains ofA. baumannii.

scholarly journals Non-pncAGene-Mutated but Pyrazinamide-Resistant Mycobacterium tuberculosis: Why Is That?

2017 ◽  
Vol 55 (6) ◽  
pp. 1920-1927 ◽  
Author(s):  
Jim Werngren ◽  
Erik Alm ◽  
Mikael Mansjö
Keyword(s):  
Susceptibility Testing ◽  
Gene Mutations ◽  
Drug Susceptibility ◽  
Multidrug Resistant ◽  
Drug Susceptibility Testing ◽  
Molecular Techniques ◽  
Content Type ◽  
Resistant Strains ◽  
Clear Majority

ABSTRACTPyrazinamide (PZA) is a key component for the effective treatment of drug-susceptible and PZA-susceptible multidrug-resistant (MDRPZA-S) tuberculosis (TB).pncAgene mutations are usually detected in a clear majority (>90%) of PZA-resistant strains but obviously not in all. Rapid and reliable PZA drug susceptibility testing (DST) is critical whenever PZA is to be used in a treatment regimen, not least for the treatment of MDRPZA-STB. In this study, we selected 26 PZA-resistant isolates reported to carry a wild-typepncAgene. To confirm resistance, susceptibility testing was repeated using 100 mg/liter and 200 mg/liter PZA for all the 26 isolates and Sanger sequencing was repeated on the 18 isolates that remained PZA resistant. Apart from the eight isolates initially misclassified as PZA resistant, the retests identified three factors responsible for the phenotype-genotype discrepancy:panDorrpsAmutations identified by whole-genome sequencing (WGS) (n= 7), heteroresistance (n= 8), and mixed populations withMycobacterium avium(n= 3). Additionally, we performed WGS on 400 PZA-susceptible isolates and 15 consecutive MDRPZA-Rclinical isolates. Of the 400 PZA-susceptible isolates, only 1 harbored a nonsynonymouspncAmutation (Thr87Met), whereas a nonsynonymousrpsAmutation was found in 17 isolates. None of these isolates carried a nonsynonymouspanDmutation, while all 15 of the MDRPZA-Risolates harbored a nonsynonymouspncAmutation. Our findings indicate that it is necessary to consider the occurrence ofpanDmutations in PZA-resistant isolates, as well as heteroresistance, for the development and evaluation of new molecular techniques to ensure high-quality DST performance. The identification of nonsynonymousrpsAmutations in both PZA-susceptible and PZA-resistant isolates also implies that further studies are needed in order to determine the role ofrpsAin PZA resistance.

Sign in / Sign up

Export Citation Format

Share Document