Controlling of Mycobacterium by Natural Degradant-Combination Models for Sequestering Mycolic Acids in Karish Cheese

Degradation of the mycobacterial complex containing mycolic acids (MAs) by natural bioactive compounds is essential for producing safe and value-added foods with therapeutic activities. This study aimed to determine the degradation efficiency of natural organic acid extracts (i.e., citric, malic, tartaric, and lactic), quadri-mix extract from fruits and probiotics (i.e., lemon, apple, grape, and cell-free supernatant of Lactobacillus acidophilus), and synthetic pure organic acids (i.e., citric, malic, tartaric, and lactic), against MA in vitro in phosphate buffer solution (PBS) and Karish cheese models. The degradation effect was evaluated both individually and in combinations at different concentrations of degradants (1, 1.5, and 2%) and at various time intervals (0, 6, 12, 24, and 48 h). The results show that MA degradation percentage recorded its highest value at 2% of mixed fruit extract quadri-mix with L. acidophilus and reached 99.2% after 48 h both in PBS and Karish cheese, unlike other treatments (i.e., citric + malic + tartaric + lactic), individual acids, and sole extracts at all concentrations. Conversely, organic acid quadri-mix revealed the greatest MA degradation% of 95.9, 96.8, and 97.3% at 1, 1.5, and 2%, respectively, after 48 h. Citric acid was more effective in MA degradation than other acids. The fruit extract quadri-mix combined with L. acidophilus-fortified Karish cheese showed the highest sensorial characteristics; hence, it can be considered a novel food-grade degradant for MA and could be a promising biocontrol candidate against Mycobacterium tuberculosis (Mtb) in food matrices

Mortality from gastrointestinal congenital anomalies at 264 hospitals in 74 low-income, middle-income, and high-income countries: a multicentre, international, prospective cohort study

Summary Background Congenital anomalies are the fifth leading cause of mortality in children younger than 5 years globally. Many gastrointestinal congenital anomalies are fatal without timely access to neonatal surgical care, but few studies have been done on these conditions in low-income and middle-income countries (LMICs). We compared outcomes of the seven most common gastrointestinal congenital anomalies in low-income, middle-income, and high-income countries globally, and identified factors associated with mortality. Methods We did a multicentre, international prospective cohort study of patients younger than 16 years, presenting to hospital for the first time with oesophageal atresia, congenital diaphragmatic hernia, intestinal atresia, gastroschisis, exomphalos, anorectal malformation, and Hirschsprung’s disease. Recruitment was of consecutive patients for a minimum of 1 month between October, 2018, and April, 2019. We collected data on patient demographics, clinical status, interventions, and outcomes using the REDCap platform. Patients were followed up for 30 days after primary intervention, or 30 days after admission if they did not receive an intervention. The primary outcome was all-cause, in-hospital mortality for all conditions combined and each condition individually, stratified by country income status. We did a complete case analysis. Findings We included 3849 patients with 3975 study conditions (560 with oesophageal atresia, 448 with congenital diaphragmatic hernia, 681 with intestinal atresia, 453 with gastroschisis, 325 with exomphalos, 991 with anorectal malformation, and 517 with Hirschsprung’s disease) from 264 hospitals (89 in high-income countries, 166 in middleincome countries, and nine in low-income countries) in 74 countries. Of the 3849 patients, 2231 (58·0%) were male. Median gestational age at birth was 38 weeks (IQR 36–39) and median bodyweight at presentation was 2·8 kg (2·3–3·3). Mortality among all patients was 37 (39·8%) of 93 in low-income countries, 583 (20·4%) of 2860 in middle-income countries, and 50 (5·6%) of 896 in high-income countries (p<0·0001 between all country income groups). Gastroschisis had the greatest difference in mortality between country income strata (nine [90·0%] of ten in lowincome countries, 97 [31·9%] of 304 in middle-income countries, and two [1·4%] of 139 in high-income countries; p≤0·0001 between all country income groups). Factors significantly associated with higher mortality for all patients combined included country income status (low-income vs high-income countries, risk ratio 2·78 [95% CI 1·88–4·11], p<0·0001; middle-income vs high-income countries, 2·11 [1·59–2·79], p<0·0001), sepsis at presentation (1·20 [1·04–1·40], p=0·016), higher American Society of Anesthesiologists (ASA) score at primary intervention (ASA 4–5 vs ASA 1–2, 1·82 [1·40–2·35], p<0·0001; ASA 3 vs ASA 1–2, 1·58, [1·30–1·92], p<0·0001]), surgical safety checklist not used (1·39 [1·02–1·90], p=0·035), and ventilation or parenteral nutrition unavailable when needed (ventilation 1·96, [1·41–2·71], p=0·0001; parenteral nutrition 1·35, [1·05–1·74], p=0·018). Administration of parenteral nutrition (0·61, [0·47–0·79], p=0·0002) and use of a peripherally inserted central catheter (0·65 [0·50–0·86], p=0·0024) or percutaneous central line (0·69 [0·48–1·00], p=0·049) were associated with lower mortality. Interpretation Unacceptable differences in mortality exist for gastrointestinal congenital anomalies between lowincome, middle-income, and high-income countries. Improving access to quality neonatal surgical care in LMICs will be vital to achieve Sustainable Development Goal 3.2 of ending preventable deaths in neonates and children younger than 5 years by 2030

Prevalence and Antibiogram of Pseudomonas aeruginosa Among Nile Tilapia and Smoked Herring, with an Emphasis on their Antibiotic Resistance Genes (blaTEM, blaSHV, blaOXA-1 and ampC) and Virulence Determinant (oprL and toxA)

Bacterial diseases are one of the most challenging issues facing aquaculture sector. Pseudomonas aeruginosa (P. aeruginosa) has been regarded as one of the most significant threats to the fishing industry, which also affects public health. We aimed to elucidate the occurrence and antibiogram profile of P. aeruginosa recovered from Nile tilapia (Oreochromis niloticus) and smoked herring (Clupea harengus) with emphasis on their antibiotic resistance genes (blaTEM, blaSHV, blaOXA-1 and ampC) and virulence determinant genes (oprL and toxA). A total of 150 fish samples (110 diseased Nile tilapia, and 40 smoked herring) were collected randomly from retails of Gharbia Governorate, Egypt. The retrieved isolates were phenotypically characterized using standard methods of culturing and biochemical tests. Then, verified using molecular assay, 16S rRNA gene was detected in 100% of the tested isolates. The overall incidence of P. aeruginosa was 33.3%, out of which 45% from smoked herring and 29% from Nile Tilapia. The occurrence of P. aeruginosa in various infected organs of O. niloticus showed that the gills were the most obviously infected organ followed by kidney, liver, and spleen, respectively. A significant difference (P&lt; 0.05) was noticed in the distribution of P. aeruginosa among O. niloticus internal organs. The phenotypic susceptibility to nine commonly used antimicrobial agents was detected using disc diffusion assay. The tested strains were extremely susceptible to ciprofloxacin, amikacin, and imipenem, whereas exhibited remarkable resistance to oxacillin, cefpodoxime, amoxicillin with clavulanic acid, ceftriaxone, and nalidixic acid. Interestingly, 100% of P. aeruginosa isolates were multiple antimicrobial resistant (MAR). Three resistance phenotypes profiles were identified with MAR index ranged from 0.4-0.5. Screening for antibiotic resistance genes revealed a diversity of β-lactamases in P. aeruginosa isolates, with blaTEM being the most dominant gene (100%), followed by blaSHV, blaOXA-1 and ampC with a total prevalence of 66.6% to all of them. The identified antimicrobial resistance phenotypes and genotypes were found to be significantly correlated. Subsequently, the distribution of virulence determinants in these strains was identified. These isolates had 100% prevalence of oprL and toxA virulence genes. In conclusion, the emergence of MDR P. aeruginosa in fish particularly ESBL and AmpC beta-lactamases producers could pose a potential health hazard to consumers. Thus, antimicrobial susceptibility must be continuously monitored to assess potential risks to human health. Ciprofloxacin, amikacin, and imipenem were the most efficient antibiotics for treatment of the identified P. aeruginosa, ESBL and AmpC beta-lactamases producers

Exploring Antimicrobial Potential of Cinnamon, Clove, Peppermint and Black Cumin Essential Oils against Fish Bacterial Pathogens with an Emphasis on the Dietary Supplementation Effects of Cinnamon Oil on Striped Catfish (Pangasianodon hypophthalmus)

Emergence of antimicrobial resistance (AMR) among fish bacterial pathogens is one of the major global public threats. Attempts are being made to develop novel alternatives as a promising approach to combat multidrug resistance disease-causing bacteria. Natural antimicrobials such as essential oils (EOs) are a potential unique strategy to treat bacterial infections with a reduced risk of resistance developing. This study aimed to evaluate the antimicrobial activity of some essential oils (EOs) namely, cinnamon (Cinnamomum zeylanicum), clove (Syzygium aromaticum), Peppermint (Mentha piperita) , and black cumin (Nigella sativa) against some fish pathogens implicated with aquaculture disease outbreaks like Aeromonas hydrophilia, Pseudomonas fluorescence, Photobacterium damselae and Streptococcus agalactiae using agar well diffusion assay. We found significant differences on the antibacterial activity depending on the type of essential oils and bacterial strain. Among all the tested EOs, cinnamon essential oil (CEO) was shown to be the most effective with minimum bactericidal concentration (MBC) ranged from 0.0156-0.125 ml/ml. As a result, it was selected for our in vivo investigations. We next aimed to investigate the effects of dietary CEO on growth performance, disease resistance and immune response of fish. A total of 150 striped catfish (Pangasianodon hypophthalmus) were fed with different levels of CEO (0, 1.50, 2.0, 2.50, and 3.0 mL/kg diets) (assigned as control, Diet 1, Diet 2, Diet 3 and Diet 4) for 60 days. Compared to control, fish fed with graded levels of dietary CEO showed significant (P &lt; 0.05) increase in final body weight, weight gain %, and specific growth rate particularly at fish group fed diet 3. Of interest, there were no significant differences (P &gt; 0.05) in feed conversion ratio and survival rates among control and CEO-supplemented groups. Moreover, we found significant (P &lt; 0.05) increases in plasma lysozyme activity and total IgM levels in a dose dependent manner with dietary CEO supplementation. After feeding trials, we investigated their potential to defend striped catfish against A. hydrophila challenge. Fish fed control diet had the highest mortality rates; in contrast, fish fed diets supplemented with CEO had higher levels of resistance to the bacterial infection, with the lowest mortality rates in the fish group fed diet 3. Overall, these findings showed that EOs exhibit a great potential to be used as antimicrobial agents against fish pathogens. Moreover, dietary administration of CEO, particularly at 2.5 ml/kg feed, can be regarded as a promising component for improving growth, immunological responses and potential alternatives to conventional antimicrobials for control of microbial infections in fish

An investigative study on the zoonotic potential of Helicobacter pylori

Abstract Background Helicobacter pylori is one of the most common bacterial infections and is widespread globally. It causes a variety of gastrointestinal disorders, though a great proportion of infections are asymptomatic. A total of 143 fresh stool samples were collected from apparently healthy farm and pet animals (43 cattle, 50 buffaloes, 50 sheep, 50 dogs, and 50 cats), in addition to 768 human stool samples. The samples were examined using stool antigen and rapid antibody tests, and further confirmation of glmM “human antigen-positive samples and animal milk samples” was conducted by polymerase chain reaction (PCR). Results The prevalence rates of H. pylori infection in animals were 22.2% and 16% in antibody and stool antigen tests, respectively. The detection rates were 28%, 24%, 12%, 10%, and 4.7% in cats, dogs, buffaloes, sheep, and cattle, respectively. On the other hand, the prevalence rate of H. pylori infection in human stool samples was 74.8%, and a statistically significant association was observed between prevalence and several factors, such as sex, age, and locality. PCR was performed to detect the glmM gene of H. pylori, and this gene was found in 21 of 27 human antigen-positive samples and 5 of 13 animal milk samples. Conclusions H. pylori was detected in both human and animal samples. Furthermore, glmM was found in milk and human samples. Our findings suggest that pet and farm animals could transmit H. pylori infection to humans

Evaluation of the Antimicrobial Activity of ZnO Nanoparticles against Enterotoxigenic Staphylococcus aureus

Staphylococcus aureus (S. aureus) is a Gram-positive bacteria considered one of the leading causes of community and hospital-acquired illnesses or public health concerns. Antibiotic resistance in this microorganism is one of the greatest issues in global health care. The use of metal nanoparticles and their oxides is one of the potential approaches to combating bacteria resistance to antibiotics. The antibacterial properties of ZnO NPs against enterotoxigenic S. aureus were studied. ZnO NPs were tested in vitro by agar diffusion test. They resulted in 26 and 22 mm zones of inhibition for a size of 20 nm and a concentration of 20 mM against 105 and 107 CFU/mL S. aureus, respectively. The MIC of ZnO NPs of various sizes, 20 and 50 nm, with 105 CFU/mL was 2.5 and 5 mM, respectively. MIC with 107 CFU/mL was five mM for 20 and 50 nm ZnO NPs. Further, the highest growth reduction percentage, 98.99% in the counts of S. aureus was achieved by ZnO NPs of size 20 nm and concentration of 10 mM. Moreover, the obtained ELISA results indicated a significantly decreased concentration of enterotoxin A with all concentrations and sizes of ZnO NPs. PCR analysis showed a significant effect on sea gene in response to ZnO NPs treatments leading to loss of the gene, unlike the unaffected nuc gene. Moreover, morphological changes and cell shape distortion were detected by scanning electron microscope for bacterial cells treated with ZnO NPs

Characteristics and outcomes of COVID-19 patients admitted to hospital with and without respiratory symptoms

Background: COVID-19 is primarily known as a respiratory illness; however, many patients present to hospital without respiratory symptoms. The association between non-respiratory presentations of COVID-19 and outcomes remains unclear. We investigated risk factors and clinical outcomes in patients with no respiratory symptoms (NRS) and respiratory symptoms (RS) at hospital admission. Methods: This study describes clinical features, physiological parameters, and outcomes of hospitalised COVID-19 patients, stratified by the presence or absence of respiratory symptoms at hospital admission. RS patients had one or more of: cough, shortness of breath, sore throat, runny nose or wheezing; while NRS patients did not. Results: Of 178,640 patients in the study, 86.4&nbsp;% presented with RS, while 13.6&nbsp;% had NRS. NRS patients were older (median age: NRS: 74 vs RS: 65) and less likely to be admitted to the ICU (NRS: 36.7&nbsp;% vs RS: 37.5&nbsp;%). NRS patients had a higher crude in-hospital case-fatality ratio (NRS 41.1&nbsp;% vs. RS 32.0&nbsp;%), but a lower risk of death after adjusting for confounders (HR 0.88 [0.83-0.93]). Conclusion: Approximately one in seven COVID-19 patients presented at hospital admission without respiratory symptoms. These patients were older, had lower ICU admission rates, and had a lower risk of in-hospital mortality after adjusting for confounders