New Applications of Photodynamic Therapy in the Management of Candidiasis

The most important aetiological agent of opportunistic mycoses worldwide is Candida spp. These yeasts can cause severe infections in the host, which may be fatal. Isolates of Candida albicans occur with greater frequency and variable resistance patterns. Photodynamic therapy (PDT) has been recognised as an alternative treatment to kill pathogenic microorganisms. PDT utilises a photosensitizer, which is activated at a specific wavelength and oxygen concentration. Their reaction yields reactive oxygen species that kill the infectious microorganism. A systematic review of new applications of PDT in the management of candidiasis was performed. Of the 222 studies selected for in-depth screening, 84 were included in this study. All the studies reported the antifungal effectiveness, toxicity and dosimetry of treatment with antimicrobial PDT (aPDT) with different photosensitizers against Candida spp. The manuscripts that are discussed reveal the breadth of the new applications of aPDT against Candida spp., which are resistant to common antifungals. aPDT has superior performance compared to conventional antifungal therapies. With further studies, aPDT should prove valuable in daily clinical practice.

Refractory chronic otitis media and mixed hearing loss due to infection with levaquin-resistant KERSTERSIA GYIORUM: A case report and review of the literature

A 39-year-old Caucasian male, with a past medical history of purulent drainage of both ears as an infant and multiple tympanostomy tube placements in childhood, presented our ENT clinic complaining of right ear fluid drainage and hearing loss for the past year. Two months prior to presentation, he began to have increased fluid drainage from the right ear. Examination of the right external auditory canal showed thick, white fluid and a tympanic membrane perforation with a protruding small mass. A sample of the fluid was obtained. Culture of the right EAC fluid grew aerobic, gram-negative rods, identified as Kerstersia Gyiorum. The patient was initially treated with topical ofloxacin and topical prednisolone drops. He was seen again 4 weeks later and was noted to have persistent fluid drainage from the right ear. At this time, oral sulfamethoxazole-trimethoprim was added to his regimen Keywords: Chronic otitis media; hearing loss; treatment resistant otitis media; uncommon infectious microorganism; Kerstersia Gyiorum

Universal enzyme-linked immunosorbent assays (ELISA) and utility in the immunodiagnosis of Salmonellosis

The aims of this research are confirming the feasibility of hybrid immunoglobulin-binding reagents, its used in ELISAs for IgG/IgY detection and detecting specific antibodies against an infectious microorganism (Salmonella spp) in various animal species using a universal diagnostic ELISA. Hybrid immunoglobulin-binding bacterial proteins (IBP) including recombinant protein LA, recombinant protein LG, and recombinant protein AG have been produced for improvement of their binding affinity to a much larger number of immunoglobulins. This hybrid bacterial protein thus represents a powerful tool for binding, detection, and purification of immunoglobulins and their fragments. However, SpLA-LG-peroxidase and SpLAG-anti-IgY-peroxidase were produced by the periodate method. They have shown to be effective reagents. Their binding affinity to immunoglobulins surpasses previous hybrid IgG-binding proteins reported, including the most known SpAG, SpLA and SpLG. The IgY fraction was isolated from the egg yolks of a variety of birds including species of chicken, bantam hen, guinea hen, quail, goose, duck, wild and domestic pigeon, parakeet, cattle egret, pheasant, and ostrich. The IgY fraction was isolated by the chloroform-polyethylene glycol (PEG) method. An ELISA for anti-Salmonella spp antibodies was employed with some modifications to determine the presence of antibodies in humans, laying hens, geese, quails, and pigeons. Salmonella are motile, flagellated rod-shaped zoonotic pathogens which may survive with or without oxygen. They belong to the family Enterobacteriaceae and is implicated with typhoid fever and food-borne illnesses. This pathogen is associated with several diseases, which may become fatal and negatively impact the health of individuals and various economies globally. The poultry industry is most impacted and vulnerable to the onslaught of this pernicious microbe.

Design of Polymeric Nanocapsules for Intranasal Vaccination against Mycobacterium Tuberculosis: Influence of the Polymeric Shell and Antigen Positioning

Tuberculosis (TB) is the leading cause of death from a single infectious microorganism and Bacillus Calmette Guerin (BCG), the only authorized vaccine, does not confer protection against pulmonary TB. Based on the hypothesis that mucosal protection could help to prevent the infection at the site of entrance, the objective of this work was to develop an intranasal vaccine against Mycobacterium tuberculosis (Mtb), the microorganism that causes TB. Our approach consisted of the use of polymeric nanocapsules (NCs) with an oily core and a polymer shell made of chitosan (CS) or inulin/polyarginine (INU/pArg). The immunostimulant Imiquimod, a Toll-like receptor-7 (TLR-7) agonist, was encapsulated in the oily core and a fusion protein, formed by two antigens of Mtb, was absorbed either onto the NC surface (CS:Ag and INU:pArg:Ag) or between two polymer layers (INU:Ag:pArg) in order to assess the influence of the antigen positioning on the immune response. Although CS NCs were more immunostimulant than the INU/pArg NCs in vitro, the in vivo experiments showed that INU:pArg:Ag NCs were the only prototype inducing an adequate immunoglobulin A (IgA) response. Moreover, a previous immunization with BCG increased the immune response for CS NCs but, conversely, decreased for INU/pArg NCs. Further optimization of the antigen and the vaccination regime could provide an efficacious vaccine, using the INU:pArg:Ag NC prototype as nanocarrier.

Development of Antibiogram for Secondary Health care Hospital

Antibiotics resistance is an emerging problem in the management for infectious diseases. Patients are many a time prescribed with antibiotics without knowing that particular antibiotic sensitivity pattern with respect to the infectious microorganism. This study aims to detect the type of microbes causing certain infections in the hospital and also to detect the sensitivity pattern of the antibiotics to these microbes. We conducted a prospective study for six months on the neonates who were admitted in NICU. The blood samples were collected from these neonates before the administration of antibiotics. The swab samples were also collected from various places of this hospital to detect the types of microorganisms present in the hospital and to study the sensitivity of the antibiotics toward these microbes. The antibiotics used in this study were Gentamicin, Ampicillin, Cefotaxime, Amikacin, Piperacillin, Meropenam, and Vancomycin. Staphylococcus aureus and Streptococcus pneumoniae were found to be the most common pathogens implicated in neonate's infection. All the organisms showed absolute sensitivity mostly to Ampicillin, Gentamicin, and Piperacillin and resistant to Cefotaxime, Amikacin, and Vancomycin. Staphylococcus aureus, Streptococcus pneumoniae, Hemophilus infleunzae, Kleibseilla pneumoniae, Escherichia coli were the most common microorganism found in the swab samples collected from the hospital. Most of these microorganisms shows sensitivity towards Ampicillin, Gentamicin, and Meropenam but were resistance to Cefotaxime, Amikacin, and Vancomycin. A routine bacterial surveillance of prevalent organisms and the study of the sensitivity patterns of the pathogens responsible for neonatal infection should be made an essential component for neonatal care. This information from many parts of the country will be important in policymaking on antimicrobial use not only locally but also internationally.

Host conservation through their parasites: molecular surveillance of vector-borne microorganisms in bats using ectoparasitic bat flies

Most vertebrates host a wide variety of haematophagous parasites, which may play an important role in the transmission of vector-borne microorganisms to hosts. Surveillance is usually performed by collecting blood and/or tissue samples from vertebrate hosts. There are multiple methods to obtain samples, which can be stored for decades if properly kept. However, blood sampling is considered an invasive method and may possibly be harmful to the sampled individual. In this study, we investigated the use of ectoparasites as a tool to acquire molecular information about the presence and diversity of infectious microorganism in host populations. We tested the presence of three distinct vector-borne microorganisms in both bat blood and bat flies: Bartonella bacteria, malaria-like Polychromophilus sp. (Apicomplexa), and Trypanosoma sp. (Kinetoplastea). We detected the presence of these microorganisms both in bats and in their bat flies, with the exception of Trypanosoma sp. in South African bat flies. Additionally, we found Bartonella sp. in bat flies from one population in Spain, suggesting its presence in the host population even if not detected in bats. Bartonella and Polychromophilus infection showed the highest prevalence in both bat and bat fly populations. Single, co- and triple infections were also frequently present in both. We highlight the use of haematophagous ectoparasites to study the presence of infectious microorganism in host blood and its use as an alternative, less invasive sampling method.

Comparison of Bacterial Loads from the Lift Buttons of a Kulliyyah and a Library at IIUM Kuantan and Identification of the Bacteria from Selected Buildings

Introduction: Lift buttons are among the potential fomites in transmitting infectious microorganism to the community. The daily use of lift buttons by different people with various hygiene practices can contribute to the colonization of microorganism on the touched surfaces. There is a little published research on microbial colonization on lift buttons in Malaysia, especially in the campus setting. Hence, this study aimed to identify and compare the bacterial load on lift buttons from a kulliyyah (faculty) and the library at IIUM Kuantan. Materials and Methods: A total of 42 swab samples were collected aseptically from the lift buttons and cultured on nutrient, mannitol salt and MacConkey agar for bacterial enumeration and isolation. Gram staining, microscopy examination and molecular amplification of the 16S rDNA gene by polymerase chain reaction were performed for further characterization of the bacteria. Results: Out of 42 swab samples collected (kulliyyah: n = 25, library: n = 17), 88.4% of the samples confirmed the presence of bacteria with the lift buttons in the kulliyyah showed a higher percentage of bacterial isolation (92%) compared to the library (84%). Grampositive cocci clustered bacteria dominated the isolates followed by Gram-positive bacilli, Gram-positive cocci tetrads and Gram-negative coccobacilli. Based on culture growth, Gram-staining features and 16S rDNA gene sequencing, isolated bacteria were identified as Staphylococcus sp., Staphylococcus kloosii, Bacillus cereus, Kocuria palustris, Yersinia mollaretii, Bacillus sp., Micrococcus sp., and other Gram-positive cocci. Conclusion: The results revealed a high bacterial load on lift buttons which can be a source of bacterial transmission.

Effectiveness of antibacterial dental brushes. In vitro study

Objective: Toothbrush contamination is important to the oral health and the general health. Toothbrush is recommended to the regular elimination of the bacterial plaque; however it is also a potential source infection since it gets contaminated. Antibacterial toothbrushes were introduced to control the microbial contamination. Materials and methods: The effectiveness of antibacterial toothbrushes on the growth inhibition of A. actinomycetemcomitans, and E. cloacae were determined. This study included, three brands of dental brushes which were Oral-B® antibacterial Colgate® antibacterial I and as control one conventional dental brush non-antibacterial of Colgate. Materials and methods: A total of 48 dental brushes were inoculated, 24 with A. actinomycetemcomitans and 24 with E. cloacae and the microbial viability was established after diverse times as follows: 24 hours, 4 days, 12 days and 24 days, in an experiment for duplicate, evaluating the bacterial growth. Results: At 24 hours the dental brushes fulfill their antibacterial efficacy including the conventional dental brush, The Oral-B® antibacterial toothbrush and the Colgate® antibacterial controlled completely the growth of the colonies of the A. actinomycetemcomitans, while the Oral-B antibacterial toothbrush allowed E. cloacae’s growth. Finally after 24 days it was found that the inoculation the dental brushes does not inhibited either the A. actinomycetemcomitans or neither the E. cloacae. Conclusions: The antibacterial brushes are able to inhibit the growth of A. actinomycetemcomitans between 24 hours to 4 days, but this antibacterial effect is lost over the time. A super-infectious microorganism such as E. cloacae is more resistant to antibacterials present on dental brushes.

VACCINATION;

Introduction: The Expanded Program on Immunization (EPI) is meant for thecontrol of common infectious microorganism. Objectives: To know the awareness amongthe mothers and its relation with their education. Study Design: Cross-sectional study.Setting: Pediatric unit, Civil Hospital Bahawalpur. Period: June 15, 2015 to August 31, 2015.Methods and Material: The mothers were interviewed by the researchers using a structuredquestionnaire. Results: There were 100 mothers included in this study. Their mean age± SDwas 28.02± 7.468 years. Among the studied mothers 20 (20%) were having at least secondaryschool certificate. There were 88 (88%) mothers who were house wives. Only 3 (3%) mothersanswered the correct number of vaccines used in EPI program. The awareness about individualvaccine was in the range of 28%-33% except in polio it was 76% and in measles it was 61%.The 40 (40%) mothers answered that EPI vaccines are safe and 37(37%) replied that theseare effective. The mother’s high education status was associated with better awareness aboutEPI. Conclusion: There is lack of knowledge among mothers about EPI vaccination and themother’s high education status is associated with better awareness about EPI.

Analisa Cross-Infection Virus AI Subtipe H5N1 Berdasarkan Imunoserologi pada Burung Air di Cagar Alam Pulau Dua

<p><em>Abstrak</em><em> </em><strong><em>-</em></strong><strong><em> </em></strong><strong>Imunoserologi adalah cara mengidentifikasi terbentuknya antibodi yang diproduksi oleh sel darah putih sebagai respon terhadap masuknya antigen. Salah satu teknik Imunoserologi yang lazim digunakan untuk mendeteksi keberadaan antibodi di dalam darah adalah uji hambatan hemaglutinasi (<em>Hemagglutination-inhibition</em>/HI). Pada uji ini digunakan antigen yang homolog sehingga akan terjadi ikatan antigen-antibodi. Titer antibodi merupakan salah satu indikator dalam menentukan respon imun organisme terhadap suatu infeksi, seperti infeksi Virus <em>Avian Influenza</em> (VAI) subtipe H5N1. Interaksi yang terjadi antara burung air liar dengan unggas domestik dapat menyebabkan <em>cross-infection</em>, baik dari unggas domestik ke burung liar maupun dari burung liar ke unggas domestik. Salah satunya cara yang dapat dilakukan untuk menentukan pola penularan dan penyebaran VAI subtipe H5N1 pada kawasan CAPD adalah melalui analisa <em>cross-infection</em> berdasarkan imunoserologi dengan melihat titer antibodi yang terbentuk pada unggas (ayam, bebek, mentok) dan burung-burung air liar penetap di kawasan tersebut. Hasil penelitian ini menunjukkan bahwa <em>cross-infection</em> tidak terjadi pada penyebaran virus </strong><strong>V</strong><strong>AI subtipe H5N1 di kawasan CAPD. Penularan terjadi hanya satu arah, dari unggas domestik ke burung-burung air liar penetap di CAPD.</strong></p><p> </p><p><em>Abstract<strong> - Immunoserology is a method to identify the formation of antibodies that produced by white blood cells as a response to agains the antigen. One of Immunoserology assays technique that commonly used to detect the presence of antibodies is hemagglutination test (Hemagglutination-inhibition/HI). In this study we used homologous antigens to observed the antigen-antibody binding. The antibody titer is an indicator to determining the immune response for the infectious microorganism, such as Avian Influenza Virus (AIV) subtype H5N1. Interactions between wild water birds and domestic poultry can lead the cross-infection mechanism. The analysis of cross-infection by imunoserologi is one of the ways to find the patterns of transmission and spread of the AIV subtype H5N1 in CAPD. The results of this study was indicate that cross-infection did not occur in the spread of AIV subtype H5N1 in the CAPD. The mechanism of transmission was occurs by one direction, only from domestic poultry to wild water birds resident in CAPD.</strong></em></p>