Experience with a triplex arbovirus nucleic acid test (NAT) at a Canadian Public Health Laboratory

Abstract Background Dengue, chikungunya and zika infections occur in tropical and subtropical regions of the world. We describe the utilization of an in-house nucleic acid test (NAT) targeting all three viruses for febrile returning travelers in Alberta, Canada. Methods NAT was performed until 40 days from symptom onset or exposure due to the prolonged duration of zika virus RNA detection. From Sept 1, 2017 to August 31, 2019, 2552 specimens from 1932 patients were tested. Results Approximately 2% of patients tested were NAT positive for dengue virus (n = 42), chikungunya virus (n = 4), and zika virus (n = 1). The majority presented with fever, myalgia and rash. Regions with the most frequent travel included SouthEast Asia (68.5%), South America (25%) and the Caribbean (6.5%). Ct values were stronger (~ 1.5 logs) for patients within 1–3 days following onset of clinical symptoms than those presenting later. Nineteen patients had urine and plasma submitted; 5 were positive for both specimens and 2 were positive only for dengue virus in the urine. Also, Ct values were lower for plasma when compared to the corresponding urine. RNA was detected until 10 days and 5 days post-exposure in plasma and urine respectively for dengue virus. Conclusions Owing to dengue viremia detected beyond the conventional 7 days and low levels of circulating zika virus globally, a cutoff of 14 days from symptom onset to NAT is sufficient to diagnose acute cases. Inclusion of a zoonotic history form that collects appropriate clinical history results in improved test utilization

Alcohol handrubbing and chlorhexidine handwashing protocols for routine hospital practice: A randomized clinical trial of protocol efficacy and time effectiveness

Background: The World Health Organization (WHO) and the Centers for Disease Control and Prevention (CDC) recommend the use of alcohol handrubs to prevent health care-associated infections. However, the efficacy and time effectiveness of different alcohol handrubbing protocols have yet to be evaluated. Methods: We conducted a randomized controlled trial in the general wards of a 1,300-bed, acute, tertiary care hospital to compare the effectiveness of 3 hand hygiene protocols during routine inpatient care: (1) handrubbing with alcohol covering all hand surfaces, (2) handrubbing with alcohol using the standard 7-step technique, and (3) handwashing with chlorhexidine using the standard 7-step technique. Hand samples were obtained from 60 medical and 60 nursing staff, before and after hand hygiene. Quantitative and qualitative bacterial evaluations were carried out by microbiologists blinded to the protocol. Results: All 3 protocols were effective in reducing hand bacterial load (P <.01). During routine patient care, alcohol handrubbing covering all hand surfaces required less time (median, 26.0 seconds) than alcohol handrubbing using the 7-step technique (median 38.5 seconds; P = .04) and chlorhexidine handwashing (median, 75.5 seconds; P <.001). Conclusion: Alcohol handrubbing protocols are as efficacious as chlorhexidine handwashing. Alcohol handrubbing covering all hand surfaces is the most time-effective protocol for routine patient care activities in busy general wards. Copyright (C) 2012 by the Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserve

Predictors and outcomes of healthcare-associated infections caused by carbapenem-nonsusceptible enterobacterales: a parallel matched case-control study

Objectives: The increasing incidence of carbapenem-nonsusceptible Enterobacterales as major pathogens in healthcare associated infections (HAIs) is of paramount concern. To implement effective prevention strategies against carbapenem-nonsusceptible Enterobacterales (CnSE) HAIs, it is crucial to identify modifiable factors associated with these infections. We identified risk factors for CnSE-HAIs, and compared clinical outcomes of CnSE-HAI and carbapenem-sensitive Enterobacterales (CSE)-HAI patients. Methods: We conducted a multi-centre parallel matched case-control study in two 1700-bedded Singapore acute-care hospitals from 2014–2016. Patients with CnSE-HAIs and CSE-HAIs were compared to a common control group without HAIs (1:1:3 ratio), matched by time-at-risk and patient ward. Carbapenem nonsusceptible was defined as non-susceptibility to either meropenem or imipenem. Presence of healthcare associated infections were defined by the criteria provided by the European Centre for Disease Prevention and Control. Outcomes of CnSE-HAI and CSE-HAI patients were compared using multivariable logistic and cox regression; the models were adjusted for infection and treatment characteristics. Results: Eighty CnSE-HAI and 80 CSE-HAI patients were matched to 240 patients without HAIs. All CRE-HAIs patients had prior antibiotic exposure, with 44 (55.0%) with prior carbapenem exposure. The most common CnSE-HAIs were intra-abdominal infections (28.8%) and pneumonia (23.8%). The most common CnSE species was Klebsiella spp. (63.8%). In the risk factor analysis, presence of drainage devices [adjusted odds ratio (aOR), 2.19; 95% CI, 1.29 – 3.70] and prior carbapenem exposure (aOR,17.09; 95% CI, 3.06 – 95.43) independently predicted CnSE-HAIs. In the crude outcomes analysis, CnSE-HAI patients had higher all-cause in-hospital mortality and longer time to discharge compared to CSE-HAI patients. After adjusting for differences in receipt of antibiotics with reported susceptibility to the Enterobacterales, there was no significant difference in all-cause in-hospital mortality between the two groups (aOR, 1.76; 95% CI, 0.86–3.58). Time to discharge remained significantly longer in patients with CnSE-HAI (adjusted hazard ratio, 0.71; 95% CI, 0.51 – 0.98) after adjusting for disease severity, receipt of antibiotics with reported susceptibility and receipt of appropriate source control. Conclusion: Appropriate management of deep-seated Enterobacterales infections and reducing exposure to carbapenems may reduce risk of CnSE-HAIs in Singapore. Efforts to improve antimicrobial therapy in CnSE-HAI patients may improve patient outcomes.National Medical Research Council (NMRC)Published versionThis study was supported by the National Medical Research Council Centre Grant (NMRC/CG/M011/2017), the National Medical Research Council Centre Grant (NMRC/CG/C005B/ 2017), and the Singapore General Hospital Research Grant (SRG-AN#01/2016)

Two Zinc(II)-Based Metal Complexes of New Pyrimidine Derived Ligand: Anion-Dependent Structural Variations and Charge Transport Property Analysis

Two zinc­(II) based metal complexes, [Zn­(Pymox)­Cl₂] (<b>1</b>) and [Zn₆(Pymox)₆(μ₂-O)₃] (<b>2</b>), where Pymox = 3-[(4,6-dimethyl-pyrimidine-2-yl)-hydrazono]-butan-2-one oxime, have been synthesized and characterized by elemental analysis, IR, and single crystal X-ray diffraction studies. Single crystal X-ray analysis confirms that one of the synthesized products (<b>1</b>) is a mononuclear complex and another (<b>2</b>) is a hexanuclear Zn complex. The optical band gap energy in both the complexes (3.43 eV in <b>1</b> and 2.36 eV in <b>2</b>) from solid state UV measurement explores semiconductor behavior of the synthesized materials. The dielectric parameters such as charge transfer resistance, room temperature dc conductivity and electron lifetime measurement shows the superiority of complex <b>2</b> over complex <b>1</b>. Therefore, the Schottky barrier diode (SBD) electronic devices were fabricated by using these two complexes with aluminum (Al) and indium tin oxide (ITO) in sandwich configurationITO/<b>1</b> or <b>2</b>/Al. Both the devices exhibit sound rectification behavior with better photosensing property for complex <b>2</b> based SBD under irradiation of light, in comparison to dark conditions. The electric current measurement for complex <b>2</b> based SBD also exhibits enhanced photoconduction properties under irradiation of light when current is measured several times under a constant bias voltage by putting light on and off with successive repetitions. The detailed discussion of photo response properties of both the complexes in the solid state device have been reported along with their applicability in photosensitive devices. Finally, DFT calculations have been carried out to rationalize the experimental differences in band gap and conductivity observed for compounds <b>1</b> and <b>2</b>

Abstracts of 1st International Conference on Machine Intelligence and System Sciences

This book contains the abstracts of the papers presented at the International Conference on Machine Intelligence and System Sciences (MISS-2021) Organized by the Techno College of Engineering, Agartala, Tripura, India &amp; Tongmyong University, Busan, South Korea, held on 1–2 November 2021. This conference was intended to enable researchers to build connections between different digital technologies based on Machine Intelligence, Image Processing, and the Internet of Things (IoT). Conference Title: 1st International Conference on Machine Intelligence and System SciencesConference Acronym: MISS-2021Conference Date: 1–2 November 2021Conference Location: Techno College of Engineering Agartala, Tripura(w), IndiaConference Organizer: Techno College of Engineering, Agartala, Tripura, India &amp; Tongmyong University, Busan, South Korea