Evaluation of a Chromogenic Medium for the Detection of ESBL with Comparison to Double Disk Synergy Test

Background: Extended Spectrum Beta Lactamase (ESBL) producing bacterial strains are the major causes of nosocomial and community-acquired infections worldwide. The aim of the study was to evaluate the effectiveness of Brilliance ESBL Agar (BEA) (a chromogenic culture medium) for the detection of ESBL in comparison with Double Disc Synergy Test (DDST) and confirm results from both methods by Single-plex Polymerase Chain Reaction (PCR) as gold standard. Materials and Methods: A total of 75 clinical isolates of Escherichia coli were screened for ESBL production using BEA & DDST from various clinical specimens. The antibiotic susceptibility testing was done by the Kirby-Bauer disc diffusion method using Cefotaxime (30 µg) and Ceftazidime (30 µg) discs on Mueller Hinton agar. ESBL producing strains were detected phenotypically by DDST and BEA at 24 h and 48 h, respectively. Isolates screened by both methods were confirmed using PCR for the detection of blaSHV, blaTEM, blaCTX-M genes. Results: The prevalence of ESBL was 61%. The sensitivity and specificity of DDST at 24 h and 48hours incubation time was 91.3% and 89.5%, respectively. BEA showed an increase in sensitivity and specificity at 48 h with 97.8% and 98.0%, respectively. All ESBL producing strains detected by phenotypic tests were also found harboring ESBL genes (blaSHV, blaTEM, blaCTX-M) by PCR. Conclusion: The use of BEA in the screening of ESBL production was found to give much better results than DDST and can be used where PCR cannot be performed

Antifungal susceptibility and test for cure of candida species among vulvovaginal candidiasis patients in a secondary care hospital, Nigeria

Background: Antimicrobial resistance among Candida species is an intense public health concern. The aim of the study was to determine the antifungal susceptibility pattern and test for cure of Candida species among women of child bearing age who visited the General Hospital Onitsha, Nigeria with symptoms suggestive of Vulvovaginal Candidiasis (VVC).Materials and Methods: Eight hundred and seventy six female patients participated in the study of which high vaginal swabs were collected and evaluated mycological by standard microbiological methods: microscopic examination and culture using sabouraud dextrose agar (SDA). Susceptibility of isolates to 4 antifungal agents was tested using agar dilution method. Clinicomycological evaluation was also performed among the patients.Result: Higher minimum inhibitory concentration (MIC) to azole antifungals was observed predominantly among non-albicans Candida species increasingly involved in VVC. The rate of mycological resolution was higher than symptomatic relief at 2 weeks after treatment with antifungal drug.Conclusion: Efficacious treatment of VVC requires an adequate knowledge of the causative agents and more importantly the antimicrobial to which they exhibit high susceptibility.Keywords: Vulvovaginal Candidiasis, Clinico- mycology, Antimicrobial resistance, Candida speciesSusceptibilite antifonique et test pour la cure d'especes de candida entre les patients de candidases vulvovaginales dans un hopital de soins secondaires, NigeriaContexte: La résistance aux antimicrobiens chez les espèces de Candida est un problème de santé publique intense. L'objectif de l'étude était de déterminer le schéma de susceptibilité aux antifongiques et le test de guérison des espèces de Candida parmi les femmes en âge de procréer qui ont visité l'hôpital général de Onitsha, au Nigeria, avec des symptômes suggérant une candidose vulvovaginale (VVC).Matériaux et méthodes: huit cent soixante-seize six patientes ont participé à l'étude des prélèvements vaginaux élevés collectés et évalués par mycologie par méthodes microbiologiques standard: examen microscopique et culture à l'aide de la gélose sabouraud dextrose (SDA). La susceptibilité des isolats à 4 agents antifongiques a été testée en utilisant une méthode de dilution en agar. Une évaluation clinico-mycologique a également été réalisée chez les patients.Résultat: une concentration minimale minimale d'inhibition (MIC) en anatoxines azoliques a été observée principalement chez les espèces non-albicans Candida de plus en plus impliquées dans VVC. Le taux de résolution mycologique était plus élevé que le soulagement symptomatique à 2 semaines après le traitement par un médicament antifongique.Conclusion: Un traitement efficace de la VVC nécessite une connaissance adéquate des agents causaux et, plus important encore, des antimicrobiens auxquels ils présentent une forte susceptibilité.Mots-clés: Candidiase Vulvovaginale, Clinico-mycologie, Résistance Antimicrobienne, Espèces Candid

Modulation of the immune response to Mycobacterium tuberculosis during malaria/M. tuberculosis co-infection

Tuberculosis (TB) causes significant morbidity and mortality on a global scale. The African region has 24% of the world's TB cases. TB overlaps with other infectious diseases such as malaria and HIV, which are also highly prevalent in the African region. TB is a leading cause of death among HIV-positive patients and co-infection with HIV and TB has been described as a syndemic. In view of the overlapping epidemiology of these diseases, it is important to understand the dynamics of the immune response to TB in the context of co-infection. We investigated the cytokine response to purified protein derivative (PPD) in peripheral blood mononuclear cells from TB patients co-infected with HIV or malaria and compared it to that of malaria- and HIV-free TB patients. A total of 231 subjects were recruited for this study and classified into six groups; untreated TB-positive, TB positive subjects on TB drugs, TB- and HIV-positive, TB- and malaria-positive, latent TB and apparently healthy control subjects. Our results demonstrate maintenance of interferon (IFN)-γ production in HIV and malaria co-infected TB patients in spite of lower CD4 counts in the HIV-infected cohort. Malaria co-infection caused an increase in the production of the T helper type 2 (Th2)-associated cytokine interleukin (IL)-4 and the anti-inflammatory cytokine IL-10 in PPD-stimulated cultures. These results suggest that malaria co-infection diverts immune response against M. tuberculosis towards a Th-2/anti-inflammatory response which might have important consequences for disease progression

Integration of cardiovascular risk assessment with COVID-19 using artificial intelligence

Artificial Intelligence (AI), in general, refers to the machines (or computers) that mimic "cognitive" functions that we associate with our mind, such as "learning" and "solving problem". New biomarkers derived from medical imaging are being discovered and are then fused with non-imaging biomarkers (such as office, laboratory, physiological, genetic, epidemiological, and clinical-based biomarkers) in a big data framework, to develop AI systems. These systems can support risk prediction and monitoring. This perspective narrative shows the powerful methods of AI for tracking cardiovascular risks. We conclude that AI could potentially become an integral part of the COVID-19 disease management system. Countries, large and small, should join hands with the WHO in building biobanks for scientists around the world to build AI-based platforms for tracking the cardiovascular risk assessment during COVID-19 times and long-term follow-up of the survivors

Sequence Analysis Reveals Asymptomatic Infection with Mycoplasma Hominis and Ureaplasma Urealyticum Possibly Leads to Infertility in Females: A Cross-sectional Study

Background: Genetic evidence of asymptomatic Mycoplasma hominis (M. hominis) and Ureaplasma urealyticum (U. urealyticum) infection associated with infertility among females is lacking because suitable high throughput molecular methods have not been applied. Objective: This study aimed to explore the occurrence of M. hominis and U. urealyticum in the genital tract of females with asymptomatic infection and infertility as well as determine their genetic relatedness. Materials and Methods: The study group included 100 asymptomatic females and 31 females diagnosed with infertility. Sequencing of the 16S rRNA gene following DNA extraction was performed directly from endo-cervical swabs. Phylogenetic analysis established the genetic linkage between the isolates from both groups. Results: In asymptomatic females, M. hominis and U. urealyticum were detected with a prevalence of 8% and 2% respectively. Among females with infertility, the prevalence was 6.45% and 3.23% for M. hominis and U. urealyticum respectively. In both groups, M. hominis occurred significantly more frequently. Phylogenetic analysis revealed three distinct clusters in both groups: two with already characterized M. hominis and Ureaplasma species (28.6% of the overall Mycoplasma spp.) and one distinct cluster matched with U. urealyticum. Furthermore, all M. hominis from asymptomatic females clustered significantly with infertility contrary to U. urealyticum. The M. hominis cluster was significantly linked to two strains from China. Conclusion: The sequence analysis of Mycoplasma and Ureaplasma in the genital tract of asymptomatic and infertile females showed significant association; therefore, it is paramount to consider them as possible etiologic agents of infertility and genital infection, especially when the etiology of infertility is unknown. Key words: Mycoplasma hominis, Ureaplasma urealyticum, Genetic linkage, Asymptomatic infections, Infertility

COVID-19 pathways for brain and heart injury in comorbidity patients: A role of medical imaging and artificial intelligence-based COVID severity classification: A review

Artificial intelligence (AI) has penetrated the field of medicine, particularly the field of radiology. Since its emergence, the highly virulent coronavirus disease 2019 (COVID-19) has infected over 10 million people, leading to over 500,000 deaths as of July 1st, 2020. Since the outbreak began, almost 28,000 articles about COVID-19 have been published (https://pubmed.ncbi.nlm.nih.gov); however, few have explored the role of imaging and artificial intelligence in COVID-19 patients—specifically, those with comorbidities. This paper begins by presenting the four pathways that can lead to heart and brain injuries following a COVID-19 infection. Our survey also offers insights into the role that imaging can play in the treatment of comorbid patients, based on probabilities derived from COVID-19 symptom statistics. Such symptoms include myocardial injury, hypoxia, plaque rupture, arrhythmias, venous thromboembolism, coronary thrombosis, encephalitis, ischemia, inflammation, and lung injury. At its core, this study considers the role of image-based AI, which can be used to characterize the tissues of a COVID-19 patient and classify the severity of their infection. Image-based AI is more important than ever as the pandemic surges and countries worldwide grapple with limited medical resources for detection and diagnosis

ActiveAdvice : a multi-stakeholder perspective to understand functional requirements of an online advice platform for AAL products and services

For the last 10 years, ageing well in the community has become a key concern of the European Union and its member states. Action plans as well as distinct programs such as the Ambient Assisted Living (AAL) Joint Programme are evidence of this engagement. Since then, many AAL products and services have been developed and implemented in the European market. Up to now, however, access to, and the availability of these solutions is difficult, and the information on their use is scarce. ActiveAdvice, an AAL EU-funded project aims to develop an online platform which offers both information on AAL solutions as well as advice to end users. This paper discusses the application of a multi-stakeholder perspective approach. It discusses the user-centered development and reflects on the establishment of AAL ecosystems and the functional requirements of the ActiveAdvice platform. It includes an extended methodological framework, which explains conclusively the ActiveAdvice stakeholders’ identification process and the user-centered requirements analysis, built on 38 semi-structured interviews with three stakeholder groups – consumers, businesses and governments. The integration of different stakeholders in the development and implementation of AAL solutions is a necessity as well as a challenge. This holds also true for the development of the ActiveAdvice platform