Pathogenesis, Immunology and Management of Dermatophytosis

Dermatophytic infections of the skin and appendages are a common occurrence. The pathogenesis involves complex interplay of agent (dermatophytes), host (inherent host defense and host immune response) and the environment. Infection management has become an important public health issue, due to increased incidence of recurrent, recalcitrant or extensive infections. Recent years have seen a significant rise in incidence of chronic infections which have been difficult to treat. In this review, we review the literature on management of dermatophytoses and bridge the gap in therapeutic recommendations.

Cerebral venous sinus thrombosis related to vaccine-induced immune thrombotic thrombocytopenia: First reported case in Vietnam

Vaccination remains one of the most important public health interventions to control and mitigate the impacts of COVID-19 worldwide. A number of post-vaccination reactions have caused concern and are the cause of vaccine hesitancy. Vaccine-induced immune thrombotic thrombopenia (VITT) has been reported in several countries such as Norway at a rate of 1 per 26000 doses of the ChAdOx1 nCoV vaccine (AstraZeneca), 15 per 8 million doses of Ad26.COV2.S (Janssen; Johnson & Johnson) vaccines in the US. In Vietnam, 11.5 million doses of AstraZeneca vaccine have been administered since the commencement of a nation-wide vaccination program five months ago. We report the first case of cerebral venous thrombosis related to VITT which was promptly diagnosed and successfully treated with rivaroxaban alone. Thus, VITT is very rare in Vietnamese people vaccinated with the AstraZeneca vaccine in the prevention of COVD-19 infection.

Evolution of Enterococcus faecium to A Combination of Daptomycin and Fosfomycin Reveals Distinct and Diverse Adaptive Strategies

Infections caused by vancomycin-resistant Enterococcus faecium (VREfm) are an important public health threat. VREfm have become increasingly resistant to the front-line antibiotic, daptomycin (DAP). As such, the use of DAP combination therapies (like fosfomycin [FOS]), has received increased attention. Antibiotic combinations could extend the efficacy of current available antibiotics and potentially delay the onset of further resistance. We investigated the potential for E. faecium HOU503, a clinical VREfm isolate that is DAP and FOS susceptible, to develop resistance to a DAP-FOS combination. Of particular interest was whether the genetic drivers for DAP-FOS resistance might be epistatic and, thus, potentially decrease the efficacy of a combinatorial approach in either inhibiting VREfm or in delaying the onset of resistance. We show that resistance to DAP-FOS could be achieved by independent mutations to proteins responsible for cell wall synthesis for FOS and in altering membrane dynamics for DAP. However, we did not observe genetic drivers that exhibited substantial cross-drug epistasis that could undermine DAP-FOS combination. Of interest was that FOS resistance in HOU503 was largely mediated by changes in phosphoenolpyruvate (PEP) flux as a result of mutations in pyruvate kinase (pyk). Increasing PEP flux could be a readily accessible mechanism for FOS resistance in many pathogens. Importantly, we show that HOU503 were able to develop DAP resistance through a variety of biochemical mechanisms and were able to employ different adaptive strategies. Finally, we showed that the addition of FOS can prolong the efficacy of DAP, significantly extending the timeline to resistance in vitro.

Aleatory Trypanosoma cruzi Vertical Transmission in Chiapas, Mexico: A Case Report

Congenital Chagas disease is considered a form of dispersion of Trypanosoma cruzi related to human migration from endemic, often rural to previously non-endemic urban areas. This fact increases the Chagas disease establishment risk inside of family members by vertical transmission pathway. Congenital Chagas disease cases in newborns could not identified by the health professional even in endemic regions. Here we present the first family cluster of Chagas disease cases from Chiapas: one of the most important endemic areas in South of Mexico, where vertical T. cruzi transmission incidence rate is ranged between 2% to 22% revealing an important public health problem. Two cases inside a family from Chiapas, México with positive antibodies against T. cruzi detected by ELISA are presented; one of them got the infection through vertical pathway. We think that congenital Chagas disease should not be ignored in a newborn born from an asymptomatic Chagas disease mother, who may transmit the parasite infection randomly.

Managing essential healthcare services during the first nationwide lockdown: experiences from a Regional Referral Hospital in Bhutan

The current COVID -19 pandemic has brought unprecedented burden on healthcare system throughout the world. While the pandemic has hijacked all attention and priorities, there is a significant concern that non-COVID essential healthcare services may be negleccted. Lockdowns have become an important public health measure to contain local outbreaks. We describe our experiences in ensuring the provision of essential healthcare services during the first nationwide lockdown. Adequate preparations with a well-thought of contingency plan , identification of roles, good communication system, 24 -hour hotline and a mobile clinic with the most essential services, form important components of essential healthcare services.

A Review on Chemistry of Anti-malarials

Malaria remains an important public health concern in countries where transmission occurs regularly, as well as in temperate areas and it is a major global health problem, with an estimated 500 million clinical cases occurring annually. Malaria is a complex disease that varies widely in epidemiology and clinical manifestation in different parts of the world. The most prevalent and dangerous type of malaria is caused by Plasmodium falciparum. P. vivax is a common cause of malaria in Latin America, Asia, and Oceania, but not Africa. P. malaria and P. ovale are much less common. Antimalarials are used in three different ways: prophylaxis, treatment of falciparum malaria, and treatment of non-falciparum malaria. Prophylactic antimalarials are used almost exclusively by travelers from developed countries who are visiting malaria-endemic countries. Keywords: Malaria, antimalarial drugs, plasmodium.

The Epidemiological Patterns of Hepatitis C in Lithuania: Changes in Surveillance from 2005 to 2018

Hepatitis C virus (HCV) infection is one of the major global causes of death and morbidity, and so it remains an important public health concern in Europe [...]

Detection of Salmonella spp. in exotic pigeons of North Kerala and its antibiogram

Pigeon breeding has transformed from being a mere hobby to becoming established as an industry. The increased trade of pigeons inadvertently invites the risk of dissemination of infections including zoonoses like salmonellosis. Pigeons once infected remain carriers for life. This coupled with the ability of the organism to acquire antimicrobial resistance makes salmonellosis, particularly from pigeons an important, public health risk for pigeon handlers. Cloacal swabs from a total of 200 exotic pigeons belonging to 24 lofts from Northern districts of Kerala were collected and attempted to isolate Salmonella and understand its antimicrobial resistance profile. Five isolates of salmonella could be obtained from four of the lofts studied. A prevalence of 2.5 per cent was identified for salmonellosis with 16.67 per cent of the lofts affected. Antimicrobial sensitivity based on disk diffusion assay revealed that all the five isolates were sensitive to amoxicillin-clavulanate and all were resistant to tetracycline and streptomycin. Sixty per cent of the isolates were sensitive to co-trimoxazole, chloramphenicol, ampicillin, cefoperazone, amikacin and gentamicin.

Epidemiological profile of people affected by tuberculosis in Campina Grande - PB, between 2014 and 2018

Introduction: tuberculosis is a bacteriosis caused by the etiological agent Mycobacterium tuberculosis, which initially affects the lungs, however it can become extrapulmonary. Although this infection is an important public health problem in Brazil, epidemiological studies on this disease are scarce. Objective: thus, the present study aimed to elucidate the epidemiological profile of people affected by tuberculosis in Campina Grande – PB, between the years 2014 to 2018. Methodology: this is an epidemiological, retrospective, analytical and documentary study, in which data were collected from the Department of Informatics of the “Sistema Único de Saúde”. Results: Between 2014 and 2018, 795 cases of tuberculosis were reported in Campina Grande-PB, with 2018 having the highest number of cases (24.6%). The epidemiological profile of those affected was predominantly male, aged 20 to 39 years, with low schooling, mixed race and residents of the urban area. When associating sex with immunosuppressive factors, a statistically significant association was observed between, HIV, the state of acquired immunodeficiency syndrome (AIDS) and alcoholism (p <0.05). Conclusion: in this way, the data of this research can guide the development of indicators and public policiesfor the most susceptible population.