Isolation of Antibiotic Resistant Plasmid Deoxyribonucleic Acid from MDR Diarrheal Pathogens

Cholera is an acute infectious disease in countries with poor sanitation. The main clinical symptom of cholera is gastroenteritis and a symptom of the disease includes mild to moderate dehydration, vomiting, fever and abdominal pain. Antibiotic drug resistance in V. cholera has become a serious problem mostly in developing countries and muti-drug resistance to different antibiotics as well as Tetracycline, Ampicillin, Kanamycin, Trimethoprim, Sulphonamides Streptomycin and Gentamicin. Multi-drug resistant V. cholera showed resistance against three or more three contrasting classes of antibiotics for recent decades. Fifty diarrheal samples were collected from the different hospitals in and around the Tirupur district. 25 positive V. cholerae were isolated. The isolates were characterized morphologically and biochemically. The confirmed strains were taken to decide susceptibility patterns by the disc diffusion method. Vibrio cholerae isolated in this study was subjected to an antibiogram against 10 commonly used antibiotics. All the tested isolates showed maximum resistance to Erythromycin (97%) and minimum resistance was noted in Trimethoprime (50%) respectively. Electrophoretic examination of plasmid DNA was carried out by Agarose gel Electrophoresis on 0.7%. More than 90% of resists showed were taken for plasmid isolation. The molecular weights of the fragments were evaluated by using a 10,000 bp DNA ladder and it was determined to be 1500 bp respectively. It is crucial to know the sensitivity and resistance pattern of any bacterial species for intercession an effective drug of choice in future

FACTORS RELATED TO INCREASING THE NUMBER OF CASES OF MEASURES AND THE ROLE OF NURSING

The aim of the present study was to analyze the factors related to the increase in the number of measles cases and the role of nursing in this context. This work was developed by a literature search with a descriptive approach, which will be based on a systematic literature review. Available in the Scientific Eletronic Library Online (SciELO), Virtual Health Library (VHL) and Latin American and Caribbean Literature in Health Sciences (Lilacs) databases. Published between 2010 and 2020, in English and Portuguese. With the following keywords, National Program for Immunization, Nursing, Measles and Anti-vaccine Movement. Measles is a viral, acute infectious disease, potentially serious, transmissible and extremely contagious. Being the only form of prevention through vaccines. Transmission occurs directly, through nasopharyngeal secretions excreted when coughing, talking, sneezing or breathing by infected people. Brazil received the certificate of elimination of the circulation of the measles virus by the WHO, declaring the region of the Americas free of measles. In 2019 new cases arose in Brazil. There are several factors related to this increase in the number of cases ranging from anti-vaccine movements, false news about vaccination and poor vaccination coverage. Therefore, the objective is to relate these factors, highlighting the performance of nursing, showing some control strategies and seeking a solution to the problem.

Utility of Methicillin-Resistant Staphylococcus aureus Nares Screening in Hospitalized Children with Acute Infectious Disease Syndromes

Studies in adults support the use of a negative methicillin-resistant Staphylococcus aureus (MRSA) nares screening (MNS) to help limit empiric anti-MRSA antibiotic therapy. We aimed to evaluate the use of MNS for anti-MRSA antibiotic de-escalation in hospitalized children (<18 years). Records of patients admitted between 1 January 2015 and 31 December 2020 with a presumed infectious diagnosis who were started on anti-MRSA antibiotics, had a PCR-based MNS, and a clinical culture performed were retrospectively reviewed. A total of 95 children were included with a median age (range) of 2 (0–17) years. The top three diagnosis groups were skin and soft tissue infections (n = 38, 40%), toxin-mediated syndromes (n = 17, 17.9%), and osteoarticular infections (n = 14, 14.7%). Nasal MRSA colonization and growth of MRSA in clinical cultures was found in seven patients (7.4%) each. The specificity and the negative predictive value (NPV) of the MNS to predict a clinical MRSA infection were both 95.5%. About half (n = 55, 57.9%) had anti-MRSA antibiotics discontinued in-house. A quarter (n = 14, 25.5%) were de-escalated based on the negative MNS test alone, and another third (n = 21, 38.2%) after negative MNS test and negative culture results became available. A high NPV suggests that MNS may be useful for limiting unnecessary anti-MRSA therapy and thereby a useful antimicrobial stewardship tool for hospitalized children. Prospective studies are needed to further characterize the utility of MNS for specific infectious diagnoses.

Fractional-order COVID-19 pandemic outbreak: Modeling and stability analysis

Today, the entire world is witnessing an enormous upsurge in coronavirus pandemic (COVID-19 pandemic). Confronting such acute infectious disease, which has taken multiple victims around the world, requires all specialists in all fields to devote their efforts to seek effective treatment or even control its disseminate. In the light of this aspect, this work proposes two new fractional-order versions for one of the recently extended forms of the SEIR model. These two versions, which are established in view of two fractional-order differential operators, namely, the Caputo and the Caputo–Fabrizio operators, are numerically solved based on the Generalized Euler Method (GEM) that considers Caputo sense, and the Adams–Bashforth Method (ABM) that considers Caputo–Fabrizio sense. Several numerical results reveal the impact of the fractional-order values on the two established disease models, and the continuation of the COVID-19 pandemic outbreak to this moment. In the meantime, some novel results related to the stability analysis and the basic reproductive number are addressed for the proposed fractional-order Caputo COVID-19 model. For declining the total of individuals infected by such pandemic, a new compartment is added to the proposed model, namely the disease prevention compartment that includes the use of face masks, gloves and sterilizers. In view of such modification, it is turned out that the performed addition to the fractional-order Caputo COVID-19 model yields a significant improvement in reducing the risk of COVID-19 spreading.

Efektivitas Biaya Penggunaan Antibiotik Pasien ISPA Pediatri di RSUD Kajen Kabupaten Pekalongan Tahun 2019

Acute respiratory infection (ARI) is an acute infectious disease that attacks one or more parts of the respiratory system, starting from the nasal alveoli, including the adnexa (sinus of the pleural middle ear cavity). The purpose of this study was to determine the type of antibiotics in pediatric ARI patients at Kajen Hospital in 2019 and to determine the effectiveness of treatment costs based on the use of antibiotics issued by pediatric ARI patients at Kajen Hospital in 2019. This study is a type of non-experimental research that is descriptive and takes retrospectively through medical record data of ARI patients. The number of samples used as many as 80 patients. The pharmacoeconomic method used in this study is the CEA method/cost effectiveness analysis. The data taken include: data on respondent characteristics, total costs or direct medical costs, the results of the study on the effectiveness of antibiotic therapy Cefotaxim 52.90%, Efotax 54.50% and Viccillin 61.50%. The average total cost of antibiotics for Cefotaxim was Rp. 817,392, Efotax was Rp. 1,392,189, Viccillin was Rp. 1,318,838, Ampicillin was Rp. 1,107,059, Cefadroxil was Rp. 850,564 and Cefixim was Rp. 858,479. The ACER value was the most cost effective for Cefotaxim compared to other therapies. while the ICER value is the most cost effective, namely the comparison between Cefotaxim and Viccillin with an ICER value of Rp - 63,081,937. Suggestions for further research are expected to be able to compare the cost of treatment for outpatients and inpatients and increase sampledata. Keywords: Cost Effectiviness, ARI, antibiotik AbstrakInfeksi saluran pernafasan akut (ISPA) merupakan penyakit infeksi akut yang menyerang salah satu / lebih bagian dari sistem pernafasan mulai dari hidung alveoli termasuk adneksanya (sinus rongga telinga tengah pleura). Tujuan penelitian ini adalah untuk mengetahui jenis antibiotik pada pasien ISPA pediatri di RSUD Kajen tahun 2019 dan untuk mengetahui keefektifan biaya pengobatan berdasarkan penggunaan antibiotik yang dikeluarkan oleh pasien ISPA pediatri di RSUD kajen tahun 2019. Penelitian ini merupakan jenis penelitian non eksperimental yang bersifat deskriptif dan pengambilan data secara retrospektif melalui data rekam medik pasien ISPA. Jumlah sampel yang digunakan sebanyak 80 pasien. Metode farmakoekonomi yang digunakan pada penelitian ini yaitu metode CEA/Analisis efektifitas biaya. Data yang diambil meliputi: data karakteristik responden, biaya total atau biaya medik langsung, Hasil penelitian efektivitas terapi antibiotik Cefotaxim 52,90%, Efotax 54,50% dan Viccillin 61,50%. Hasil rata-rata total biaya antibiotik Cefotaxim sebesar Rp 817.392, Efotax Rp 1.392.189, Viccillin Rp 1.318.838, Ampicillin Rp 1.107.059, Cefadroxil Rp 850.564 dan Cefixim Rp 858.479. Nilai ACER yang paling cost efffective pada antibiotik Cefotaxim dibandingkan dengan terapi lainnya. sedangkan pada nilai ICER yang paling cost effecttive yaitu pada perbandingan antara Cefotaxim dengan Viccillin dengan nilai ICER Rp - 63.081.937. Saran untuk penelitian selanjutnya diharapkan dapat membandingkan biaya pengobatan pasien rawat jalan dan rawat inap serta memperbanyak data sampelKata kunci: Efektivitas biaya; ISPA; antibiotik

1138. Utility of Methicillin-resistant Staphylococcus aureus Nares Screening in Hospitalized Children With Acute Infectious Disease Syndromes

Background Empirical antibiotic regimens frequently include treatment for methicillin-resistant Staphylococcus aureus (MRSA). Studies in adults with pneumonia support the use of a negative MRSA nares screening (MNS) to help de-escalate antibiotic therapy. Comparable pediatric data in the literature is scarce. We aimed to evaluate the use of MNS for antibiotic de-escalation in hospitalized children (&lt; 18 years) at a tertiary children’s hospital. Methods A retrospective chart review was conducted of pediatric inpatients (January 01, 2015 to December 31, 2020) with a presumed infectious diagnosis who had a PCR-based MNS test and a clinical culture (i.e. site of infection or blood) performed as part of their diagnostic work up. Those who were screened &gt;5 days since admission or &gt; 48 hours since start of MRSA-active antimicrobials, and those who had antibiotic treatment withdrawn after 48 hours because of negative cultures were excluded. Results A total of 101 children were included with a median age (range) of 2 years (0-17) and about half (n=57, 56.4%) were male. Top three diagnosis groups were skin and soft tissue infections (n=33, 32.7%), toxin-mediated syndromes (n=21, 20.8%), and osteoarticular infections (n=13, 12.9%). Pneumonia accounted for only six (5.9%) patients. The prevalence of nasal MRSA colonization was 6.9% (n=7). The sensitivity of the MNS test to predict a MRSA infection was 42.9% with a specificity of 95.7%. The positive predictive value (PPV) and negative predictive values (NPV) were 42.9% and 95.7%, respectively. In about half (55/95, 57.9%) of patients initiated on anti-MRSA therapy, these agents were discontinued during the admission. A quarter (n=14, 25.5%) were de-escalated based on the negative MNS test alone, and another third (n=21, 38.2%) after negative MNS test and negative culture results became available. Conclusion Pediatric providers at this institution have started to use the MNS to help limit anti-MRSA therapy. We noted a high NPV which suggests that MNS may be useful for timely de-escalation of anti-MRSA therapy and thereby a useful antimicrobial stewardship tool for hospitalized children. Prospective studies to evaluate the utility of MNS for the various infectious syndromes are warranted. Disclosures All Authors: No reported disclosures

Eating Patterns for Convalescents Following the Coronavirus Disease (COVID-19)

Presented in the paper are three eating patterns for convalescents following the coronavirus disease (COVID-19). Eating pattern no. 1 involves an increased content of complete protein necessary for recovery of the immune system. Eating pattern no. 2 includes a higher content of carbohydrates and polyunsaturated fatty acids, i. e. a high energy value of the food intake, as well as a lower content of cooking salt. It enhances an anti-inflammatory effect while polyunsaturated fatty acids increase the number of T-cells, decrease the concentrations of TNF and BSF2. Eating pattern no. 3 is advisory for patients with dyspeptic disorders as a result of an acute infectious disease.

Influenza season - is there anything to worry about?

Influenza (the flu) is an acute infectious disease caused by viruses of the Orthomyxoviridae family, causing a wide variety of symptoms in humans, ranging from mildly disturbing daily activities to life-threatening pneumonia, depending on the state of their immune system. The annual increase in the incidence of this disease is called "the flu season", which is a periodic epidemic that affects people all around the world. Despite the individual, economic and epidemiological risks associated with infection with the influenza virus, the disease is often underestimated by people. The aim of this study was to present influenza as a threat to the health of individuals and society by describing the pathomechanisms of its formation and spread, available diagnostic and therapeutic options, as well as annual vaccinations as the most effective method of disease prevention. The current publications available in online scientific databases from many countries around the world were reviewed. Despite the large number of widely available research results on influenza, it is necessary to update them every year, as well as vaccines against this disease, to popularize knowledge about it, which will enable more effective epidemiological control of influenza.

Identification of a Novel Antigen for Serological Diagnosis of Scrub Typhus

Scrub typhus is an acute infectious disease caused by the bacterium Orientia tsutsugamushi, which is widely distributed in northern, southern, and eastern Asia. Early diagnosis is essential because the average case fatality rate is usually >10% but can be as high as 45% if antimicrobial treatment is delayed. Although an O. tsutsugamushi 56-kDa type-specific antigen (TSA) is commonly used for serological diagnosis of scrub typhus, the 56-kDa TSA shows variations among O. tsutsugamushi strains, which may lead to poor diagnostic results. Therefore, the discovery of new antigenic proteins may improve diagnostic accuracy. In this study, we identified an O. tsutsugamushi 27 kDa antigen through an immunoinformatic approach and verified its diagnostic potential using patient samples. Compared with the O. tsutsugamushi 56-kDa antigen, the new 27-kDa antigen showed better diagnostic specificity with similar diagnostic sensitivity. Therefore, the O. tsutsugamushi 27-kDa antigen shows potential as a novel serological diagnostic antigen for scrub typhus, providing higher diagnostic accuracy for O. tsutsugamushi than the 56-kDa antigen.

Varicella Pneumonia in an Adult with Immunocompromised Status: Case Report

Varicella is an acute infectious disease caused by the varicella zoster virus. It mainly occurs in infants and preschool children, the morbidity is only 2% in adults. Adult chickenpox is a self-limited disease, which is easier to control the development of rashes to some certain extent, shorten the course of the disease, reduce or avoid long-term complications. We present the case of a 23-year-old man with varicella. He had a two-day fever and four-hour erythematous rashes. The rashes spread around the face, two arms, and trunk. No special finding was in laboratory examination but low immunity. Computed tomography of the chest revealed obvious pneumonia manifestation of two lungs. Varicella pneumonia was considered and antiviral therapy, as well as Chinese patent drug of inhibiting lung-energy and dispersing heat, were applied. Fourteen days later, he was fully recovered. Varicella pneumonia was one of the severe forms, especially in hypoimmunity patients while low immunity may be its main cause. All patients with varicella should detect immunity-related laboratory tests included in lymphocyte subsets, which was important to help their recovery and cut costs.