10 research outputs found
Quantitative Changes In Antibodies Against Onchocercal Native Antigens Two Months Postivermectin Treatment Of Onchocerciasis Patients
Serum antibodies to Onchocerca volvulus native sodium duodecylsulphate slat extracted antigens and epitopes recognized by three monoclonal antibodies designated Cam8, Cam22, and Cam28 were measured using indirect (sandwich) and competitive enzyme-linked immunosorbent assay (ELISA). Paired serum samples (n=32) were obtained before and two months post-ivermectin treatment. Those with increases of ten percent and above (≥10%) were 16 (50%) for IgG, 13 (40.7%) for both IgG1 and IgG4. Nine (28.2%) for IgM, eight (25%) for IgG3, IgA with four (12.5%) was the least, while IgG2 was not assayed due to cross-reaction. The higher increases in IgG, IgG1 and IgG4 antibodies in
females (n=16) than males (n=16) were significant by T-test of unpaired data (
Effects of antibiotic resistance, drug target attainment, bacterial pathogenicity and virulence, and antibiotic access and affordability on outcomes in neonatal sepsis: an international microbiology and drug evaluation prospective substudy (BARNARDS)
Background
Sepsis is a major contributor to neonatal mortality, particularly in low-income and middle-income countries (LMICs). WHO advocates ampicillin–gentamicin as first-line therapy for the management of neonatal sepsis. In the BARNARDS observational cohort study of neonatal sepsis and antimicrobial resistance in LMICs, common sepsis pathogens were characterised via whole genome sequencing (WGS) and antimicrobial resistance profiles. In this substudy of BARNARDS, we aimed to assess the use and efficacy of empirical antibiotic therapies commonly used in LMICs for neonatal sepsis.
Methods
In BARNARDS, consenting mother–neonates aged 0–60 days dyads were enrolled on delivery or neonatal presentation with suspected sepsis at 12 BARNARDS clinical sites in Bangladesh, Ethiopia, India, Pakistan, Nigeria, Rwanda, and South Africa. Stillborn babies were excluded from the study. Blood samples were collected from neonates presenting with clinical signs of sepsis, and WGS and minimum inhibitory concentrations for antibiotic treatment were determined for bacterial isolates from culture-confirmed sepsis. Neonatal outcome data were collected following enrolment until 60 days of life. Antibiotic usage and neonatal outcome data were assessed. Survival analyses were adjusted to take into account potential clinical confounding variables related to the birth and pathogen. Additionally, resistance profiles, pharmacokinetic–pharmacodynamic probability of target attainment, and frequency of resistance (ie, resistance defined by in-vitro growth of isolates when challenged by antibiotics) were assessed. Questionnaires on health structures and antibiotic costs evaluated accessibility and affordability.
Findings
Between Nov 12, 2015, and Feb 1, 2018, 36 285 neonates were enrolled into the main BARNARDS study, of whom 9874 had clinically diagnosed sepsis and 5749 had available antibiotic data. The four most commonly prescribed antibiotic combinations given to 4451 neonates (77·42%) of 5749 were ampicillin–gentamicin, ceftazidime–amikacin, piperacillin–tazobactam–amikacin, and amoxicillin clavulanate–amikacin. This dataset assessed 476 prescriptions for 442 neonates treated with one of these antibiotic combinations with WGS data (all BARNARDS countries were represented in this subset except India). Multiple pathogens were isolated, totalling 457 isolates. Reported mortality was lower for neonates treated with ceftazidime–amikacin than for neonates treated with ampicillin–gentamicin (hazard ratio [adjusted for clinical variables considered potential confounders to outcomes] 0·32, 95% CI 0·14–0·72; p=0·0060). Of 390 Gram-negative isolates, 379 (97·2%) were resistant to ampicillin and 274 (70·3%) were resistant to gentamicin. Susceptibility of Gram-negative isolates to at least one antibiotic in a treatment combination was noted in 111 (28·5%) to ampicillin–gentamicin; 286 (73·3%) to amoxicillin clavulanate–amikacin; 301 (77·2%) to ceftazidime–amikacin; and 312 (80·0%) to piperacillin–tazobactam–amikacin. A probability of target attainment of 80% or more was noted in 26 neonates (33·7% [SD 0·59]) of 78 with ampicillin–gentamicin; 15 (68·0% [3·84]) of 27 with amoxicillin clavulanate–amikacin; 93 (92·7% [0·24]) of 109 with ceftazidime–amikacin; and 70 (85·3% [0·47]) of 76 with piperacillin–tazobactam–amikacin. However, antibiotic and country effects could not be distinguished. Frequency of resistance was recorded most frequently with fosfomycin (in 78 isolates [68·4%] of 114), followed by colistin (55 isolates [57·3%] of 96), and gentamicin (62 isolates [53·0%] of 117). Sites in six of the seven countries (excluding South Africa) stated that the cost of antibiotics would influence treatment of neonatal sepsis
Onchocerca volvulus: Characterization of the clinical status of onchocerciasis patients using antibodies reactivity in enzyme-linked immunosorbent assays
Serum anti-bodies, IgA, IgG class and subclasses (excluding IgG2) and IgM responses to crude sodium-duodecyl sulphate (SDS) extract of Onchocerca volvulus female adult worms, were tested with indirect enzyme-linked immunosorbent assay (ELISA). Antigenic epitopes defined by monoclonal anti-bodies (mAbs) designated CAM8, CAM22 and CAM28 were measured using inhibition (competitive) ELISA. Generally, cases (n=95) with proven parasitological and or clinical evidences had the highest mean optical density (OD) values for IgG, IgG1, IgG3 and IgG4 anti-bodies compared to the endemic normal (n=19) and non-endemic control (n=7) groups. Reactivity varied with infection status and was more in those having skin microfilariae than those without skin mf. Individuals with chronic skin diseases (n-20) had higher anti-body levels than those with optic nerve disease (OND, n=12). Serum inhibition of Cam22 was higher, while Cam28 was lower in those with, than without skin microfilariae. Those manifesting chronic skin diseases showed a remarkable increase in percentage inhibition of both mAbs in sharp contrast to the OND group. There were very few Cam8 responders which did not show any apparent clinical trend. It is not known whether this is an indication of selective tolerance or immunosupression. The study showed that anti-body responses to the parasite antigens had strong positive association (
Characterization of Escherichia coli isolated from poultry in Zaria, Nigeria
No Abstract. Bulletin of Animal Health and Production in Africa Vol. 52 (2) 2004: pp. 91-9