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The goal of this study was to determine the effectiveness of 0.13% benzalkonium chloride (BAC) (Steirolotion™), 100% ethanol, and 70% ethyl alcohol (Purell™) hand sanitizer in subduing the growth of nosocomial bacteria – methicillin resistant Staphylococcus aureus (MRSA), vancomycin resistant Enterococcus (VRE), and Pseudomonas aeruginosa (P. aeruginosa ) - when plated on culture media over an extended period of time. In addition, our objective was to quantify the length of time these hand sanitizer agents remained effective, and to extrapolate their efficacy in decreasing the transmission of hospital-acquired infections. 50 microliters of either BAC, 100% ethanol, or 70% ethyl alcohol hand gel sanitizer were pipetted onto Trypticase soy agar with 5% sheep blood plates that were cultured with either MRSA, VRE, or P. aeruginosa . The plates were then incubated at 37.0?. The zone of inhibition (ZOI) was measured daily for 5 days and additionally zones were noted whether or not regrowth recurred in areas where previous growth had initially been inhibited. BAC was found to be superior to both 100% ethanol and 70% ethyl alcohol in the inhibition of MRSA over all time points (p values < .05). BAC was found to be superior to 70% ethyl alcohol in the inhibition of VRE over all time points (p values < .05), but not statistically superior to 100% ethanol against the inhibition of VRE over any time points. BAC was found to be superior to 70% ethyl alcohol and 100% ethanol in the inhibition of pseudomonas over 72 and 24 hours, respectively (p values < .05). The results of this study demonstrate in vitro efficacy of BAC of preventing regrowth of common nosocomial bacteria over a prolonged period of time, especially when compared to ethyl alcohol. Further study is warranted to determine in vivo effectiveness of this formulation of BAC as well as the appropriate time frame of application for effectiveness against P. aeruginosa .
A total of 2978 patients with validated paired results (SARS-CoV2-antigen and PCR) were identified. Our results show that only 45 antigen tests from 90 patients with positive validated PCR were correctly identified by antigen testing (sensitivity 50%). Roughly 50% of these patients had ongoing respiratory symptoms.
The need for accurate diagnosis of infectious and inflammatory diseases of the urinary tract, in particular, cystitis, is of great importance for both patients and the community as a whole.Patients with recurrent cystitis widely use antibacterial prophylaxis for recurrent infections,
The world over artificial respiration is employed as one of the intensive care treatment measures in severe cases of COVID-19 because of the significant respiratory distress patients develop. Nevertheless, the outcome is poor. Lethality varies from country to country and clinic to clinic between 50% and 90%. So the question arises as to whether the use of oxygen can be a risk factor in the treatment of acute inflammatory diseases in general and of COVID-19 in particular. Oxidative stress is the first and oldest step of cellular defense and starts before the activation of the immune system. This leads to an increase of intracellular oxygen in the mitochondria, followed by an elevated electron flow and the formation of superoxide as well as other reactive oxygen species and reactive nitrogen species. Superoxide reacts with nitric oxide, which is always present in inflammation, forming peroxynitrite, the strongest inducer of oxidative stress. This step induces the activation of nuclear factor kB, followed by the production of proinflammatory cytokines. The elevated levels of inducible nitric oxide synthase keep this cycle running. High amounts of superoxide have to be compensated and catabolized by manganese-superoxide dismutase 2 into hydrogen peroxide and in a second step by catalase into water. When using artificial respiration, these steps are accelerated considerably in the inflamed tissue of the lung, leading to a significant increase of the electron flow as well as an elevation of superoxide, oxidative stress, and water. As SARS-CoV-2 generally induces the production of proteins (and not only those necessary for viral reproduction), the water will remain in the tissue, causing edema and thus a wet lung syndrome associated with a growing oxygen diffusion distance to red blood cells. Ultimately, patients do not suffocate in spite of, but because of, the presence of high levels of oxygen. The limited number of patients who survive this deleterious treatment describe it as having had a sensation of drowning. The reasons will be discussed.
Only a minority of acute rhinosinusitis is of acute bacterial origin and is defined when the patient has at least three of the five symptoms/ signs: 1) Discolored mucus, 2) severe local pain (usually unilateral), 3) Fever> 38°C (100.4°F)4) high ESR and 5) double" sicking [3].According to Scheid and Hamm, although most cases of acute rhinosinusitis are caused by viruses, acute bacterial rhinosinusitis is a very common complication and most patients with acute rhinosinusitis recover quickly without antibiotic therapy, although it should be considered in patients with prolonged or more severe symptoms, such as high fever (>39°C or 102.2°F) or persistent fever, periorbital swelling, severe facial or dental pain, altered mental status, diplopia and infraorbital hypesthesia [4].Among the therapies adopted for URTIs we have as indication the prescription penicillins, cephalosporins, macrolides, aminoglycosides, quinolones and tetracyclines as an option [5][6][7].However, the first three groups of antimicrobials mentioned end up being the most used ones in daily life, especially penicillins, with
Background The widespread resistance to carbapenem via Enterobacteriaceae is a major public health concern. To investigate the reason for the change of Escherichia coli from carbapenem-susceptible to carbapenem-resistant status after antibiotic therapy, whole-genome sequencing was applied for the analysis of genetic difference between the two isolates. The genome of the two isolates of Escherichia coli with distinct resistant phenotypes recovered from one patient was sequenced and compared. Single-nucleotide polymorphisms and insertions/deletions were analyzed using software MUMmer (http://mummer.sourceforge.net/). Results The homology of chromosomes, plasmid 1, and plasmid 2 between the two isolates was very high (>99.5%). However, the coverage ratio of plasmid 3 was only 7.13%. This plasmid harbored the IMP-4 carbapenemase-coding gene. The upstream of bla IMP-4 was the plasmid mobilization relaxosome protein Mobe gene and the downstream were class 1 integrom integrase IntI1 and IS6 family transposase IS15DIV, which may be related to carbapenemase gene capture. Conclusions Single-nucleotide mutation, insertion, and deletion could not result in the development of resistance to carbapenem, whereas acquisition of the IMP-4-encoding gene may be the reason for changes in resistance to carbapenem.
The ongoing global pandemic of coronavirus disease 2019 (COVID-19) continues to affect a growing number of populations in different parts of the world. In the current situation, drug repurposing is a viable strategy to combat COVID-19. The drugs targeting the host receptors that interact with SARS-CoV-2 are possible candidates. However, assessment of their effectiveness in COVID-19 patients is necessary before prioritizing them for further study. We attempted to shortlist the candidate drugs using an in-silico approach. First, we analysed two published transcriptomic data sets of COVID-19- and SARS-infected patients compared to healthy individuals to find the key pathways altered after infection. Then, using publicly available drug perturbational data sets in human cell lines from the Broad Institute Connectivity Map (CMAP), we assessed the effects of the approved drugs on the altered pathways. We also used the available pharmacogenomic data sets from the Genomics of Drug Sensitivity in Cancer (GDSC) portal to assess the effects of the altered pathways on resistance or sensitivity to the drugs in human cell lines. Our analysis identified many candidate drugs, some of which are already being investigated for treatment of COVID-19 and can serve as a basis for prioritizing additional viable candidate drugs for COVID-19.
Introduction: Despite the introduction of the Pneumococcal and Meningococcal conjugate vaccines (MenAfriVac) into the routine immunization programme in the Northern part of Ghana, Bole and Sawla-Tuna-Kalba (STK) districts experienced an outbreak of meningitis between October 2015 and March 2016. Cerebrospinal meningitis (CSM) is a major cause of morbidity and mortality. Globally meningitis mortality ranges between 2% and 30%, and 36% to 50% in Ghana. The northern part of Ghana lies within the African “meningitis belt” that extend from Senegal to Ethiopia making it prone to repeated meningitis outbreaks. Objective: This investigation was conducted to determine the cause of the outbreak in the two districts after the introduction of Pneumococcal and MenA Conjugate Vaccines. Methods: Field investigation conducted to determine the cause and appropriate control measures instituted to control meningitis outbreak in Bole and STK districts. Cases were detected using a standard surveillance case definition for meningitis. Case based forms were used to collect data on demographic and clinical characteristics of cases. Laboratory results were obtained from samples of specimen from suspected cases sent to the laboratory for standard microbiological investigation. Active case findings were conducted in the communities where cases were reported. Consulting room and in-patient registers in the district hospital and all health centres including community register were reviewed during the period. Results: Of the 39 confirmed cases, the highest percentage of cases were caused by Streptococcus pneumonia (54%) and Neisseria meningitides (38%) specifically serogroup W135. In two (2) cases more than one organism was found. Majority (61%) of the cases were males, also, 76% of the cases were less than 30 years. Seventy five percent (75%) of the cases were in the Bole district. Overall case fatality rate (CFR) for the two districts was 33%. Analysis by sex showed a higher fatality rate among males (37%) than females (23%). Conclusion: This investigation found that the outbreak was predominantly caused by two strains of meningitis causing organisms. Intensive surveillance, health education, sensitization of clinicians and proper case management helped to contain the outbreak. Logistic supplies especially specific laboratory reagents such as PCR needs urgent attention to help in timely characterization of disease-causing organisms and guiding the plan for vaccination activities using the isolated serogroup. Apart from mass vaccination campaigns targeting different causative agents, high PCV and Hib coverage in routine EPI should be maintained. The introduction of Pneumococcal and MenA conjugate vaccines was irrelevant in this outbreak since it was caused by different organisms. *Correspondence to: Bumawura Ewuntomah E Mahamah, Ghana Health Service, District Health Directorate, Bole, Ethiopia, Tel: +233 200545855/233244432656, E-mail: mzankawah@yahoo.co.uk
Objective: To evaluate whether the use of a microbicidal liquid polymer, forming an occlusive elastomeric barrier when applied as part of a standard pin-tract care protocol leads to a reduction in pin-tract infections. Methods: This IRB approved randomized prospective study included 12 patients who received external fixation following deformity correction. Patients received 10 pins each for a total of 120 pins (60 pins per group). Six patients received standard pin-tract care, while 6 patients received identical pin-tract care with the addition of the microbicidal liquid polymer applied at the conclusion of each care regimen. Data was collected through examinations by clinical staff under supervision of the principal investigator. Data was categorical and analyzed using chi-square or Fisher exact tests to measure variable independence. Results were analyzed on a per patient and per pin basis. Results: Results showed a statistically significant reduction in pin-tract infections for pins of the microbicidal liquid polymer group (14 infected pins in standard care group vs 0 infected pins in microbicidal liquid polymer group, p<0.001). For the patient-level portion, two patients (33.3%) in the standard care group experienced infection while none (0%) in the microbicidal liquid polymer group experienced infection. Conclusions: The application of a microbicidal liquid polymer led to a statistically significant reduction in pin-tract infections. The use of this 510 (k) cleared product as an addition to pin-tract care could have a dramatic impact on the increased adoption of external fixation. *Correspondence to: Shital Pema, Kettering Health System, Ohio, USA, E-mail: shital.pema108@gmail.com
In Finland, a country where, according to the Finnish Meteorological Institute standards, there are seasons of high (summer (1 June-30 August) autumn (1 September-31 October)) and low sunlight (winter (1 November-31 March) and spring (1 April-31 May)), it has been observed that low sunlight exposure period (versus high) is associated positively with 25(OH)D2 and negatively with 25(OH)D3 concentrations [13].The vitD status of the Finnish adult population has been shown to improve considerably due to food fortification, especially of fluid milk products, and increased vitD supplement use.Other factors, such as the difference in the ultraviolet radiation index may, to a certain extent, explain the rise in vitD concentration.When consuming vitD sources, based on nutritional recommendations, vitD status appears sufficient [S-25(OH)D ≥ 50 nmol/L] and, thus, supplementation is generally not needed [14].Analytically, the mean increase in S-25(OH)D in daily fluid milk consumers among supplement non-users is reported at 20 nmol/L, which is 6 nmol/L higher than non-consumers.In total, 91% of non-users who consumed fluid milk products, fat spreads and fish, based on Finnish nutrition recommendations, reached S-25(OH)D concentrations >50 nmol/L at the end of a study that took one year to complete [14]. Background concerning vitamin D and endometriosisVitamin D influences the functioning of the female reproductive system and has been associated with polycystic ovary syndrome (PCOS), uterine leiomyomas, endometriosis and outcome of in vitro fertilization
This is a 1-month-old male patient with no significant medical history who was brought to the pediatric outpatient clinic of the Hospital Universitario, "Dr.José Eleuterio González", started his condition 3 weeks prior to coming to our consultation after presenting an ulcer in the ventral region of the tongue, which was increasing in size and made breastfeeding difficult, he was taken to a consultation with a private doctor who indicated unspecified mouthwash without showing improvement.On physical examination, a normocephalic patient was found, with a 2 × 2 cm normal tense anterior fontanel, eyes and conjunctivae without alterations, an appropriately implanted pinna, intact tympanic membrane, an oval ulcer was observed, with raised, edematous edges, well delimited and indurated, with a tendency to bleeding, 2 × 1 cm in diameter located on the ventral aspect of the tongue (Figure 1), in addition to two incisive neonatal teeth in the lower jaw, the rest of the physical examination was unchanged .Given the characteristics of the injury and the relationship with the neonatal teeth, the diagnosis of Ulcer from Riga Fede was made.The patient was sent to the pediatric dental office where extraction of neonatal teeth was carried out without complications.Two weeks after the procedure, the patient came to the Natal teeth associated with Riga-Fede disease (Sublingual traumatic disease/
collected at the Microbiology Unit and transferred to the Bactec FX Instrument (Becton Dickinson, Franklin Lakes, NJ, USA), 10.405 of which became positive. Among the positive BC bottles, 965 were for K. pneumoniae. For each patient, only the first positive BC bottle was processed by the method herein described: in total, 406 K. pneumoniae were directly identified by MALDI-TOF MS in about 30’, while the molecular detection of genes involved in carbapenem resistance took 48’. Carbapenem resistance mechanisms were found in 166 (40.9%) BCs. All strains were subsequently analysed phenotypically reaching 100% agreement with the molecular method. As shown in figure 1, the proportion of KPC-Kp producer was 45% in 2016, 43% in 2017, 31% in 2018, and 25% in 2019. Both in 2016 and in 2017, two strains of K. pneumoniae harbouring carbapenemase VIM gene were detected; K. pneumoniae harbouring carbapenemase OXA-48 gene was detected
are mild and that only when viruses have crossed the species barrier do they carry serious diseases.Finally, it is becoming clearer every day that there are several types of extracellular vesicles capable of transporting information between cells, including fragments of genetic material.We now know that these vesicles (which can be produced by infected or healthy cells) play important roles in modulating the antiviral immune response.We know that in addition to producing new functional virions, "infected" cells can produce virus-like particles without genetic material, produce encapsulated virions when it comes to viruses that lack membranous capsule in nature, or produce IFN capable of activating multiple immune response points.including at the genetic level. The hypothesis / ideaThe present Alert Information Hypothesis aims to unify and make all this new data understandable under a single operating explanation.Its rationale involves three main concepts:1. ERVs are not viral genetic material that has been included in our genome, but are an integral and vital part of it, performing very important functions of multicellular organisms.2. Viruses are actually a type of ECGS that carry alert information that would be produced by cells under stress and that would fulfill an intercellular communication function, which would activate a number of actions that can lead the receptor cells to develop or not a hostile reaction to the external stimulus.
