Day 2 :
Keynote Forum
Maria Paula Ramalho Bajanca-Lavado
National Institute of Health, Portugal
Keynote: Ampicillin resistance mechanisms in clinical Haemophilus influenzae
Time : 09:00-09:30
Biography:
Maria Paula Ramalho Bajanca-Lavado has completed her PhD in Biomedical Science, specialty Microbiology and is responsible for the Haemophilus influenzae Reference Laboratory, Department of Infectious Diseases, National Institute of Health in Lisbon, Portugal. She has published several scientific publications in peer-review journals, along with other scientific productions, including invited lectures, oral communications and posters presented in international conferences. Her research is focused at H. influenzae infections, in different clinical and epidemiological aspects.
Abstract:
Haemophilus influenzae remains a key etiological agent of upper and lower respiratory tract infections. Two major mechanisms are involved in ampicillin (AMP) resistance: β-lactam hydrolysis due to β-lactamase production (TEM-1 or ROB-1) and decreased affinity of penicillin-binding protein 3 (PBP3) for β-lactam antibiotics as a result of ftsI gene mutations encoding PBP3. Isolates exhibiting this latter resistant mechanism are termed β-lactamase-non-producing ampicillin-resistant (BLNAR), while isolates with both resistant mechanisms are defined as β-lactamase-positive amoxicillin-clavulanic acid-resistant (BLPACR). A variety of amino acid (AA) substitutions within the transpeptidase domain of PBP3 are mainly responsible for resistance. According to specific substitutions, these isolates have been classified in one of three mutational groups: I-III. Group II was further divided into subgroups IIa-IId. More recently, a new group was described, “III-like” with additionally AA substitutions to the ones described in group III. Decreased ampicillin susceptibility have been associated to group I and II, while group III is normally associated with high resistance levels to ampicillin. Isolates with the non-enzymatic resistance mechanisms have been described and emerging worldwide. In this context, we aimed to characterize ampicillin resistance mechanisms in clinical H. influenzae strains isolated in Portugal. Amplification and sequencing of ftsI gene was performed in 568 clinical H. influenza isolates. Analysis of mutations characterized 61% of isolates as gBLNAR or gBLPACR. Most of the strains were included in group II (85%) with predominance of IIb (61%). Rare isolates were of group I and no isolate was classified in group III, although few strains were of group III-like. Our results are indicative of wide dissemination of a non-enzymatic resistance mechanism to β-lactams among H. influenzae isolates circulating in our country, probably due to inappropriate use of oral antibiotics, which is a matter of concern. A better understanding of this issue may help to establish adequate therapeutic and preventive measures to avoid selection or dissemination of such strains.
Keynote Forum
Stef Stienstra
Dutch Armed Forces/Royal Dutch Navy, Netherlands
Keynote: The threat of zoonotic diseases and Ebola virus disease specifically
Time : 09:30-10:00
Biography:
Stef Stienstra is a strategic and creative Consultant in Biomedical Science with a parallel career as a Commander of the Reserve of the Royal Dutch Navy. For the Dutch Armed Forces he has responsibility for the counter measures in CBNRe threats and (medical) consequence management both in a military and a civilian (terrorism) setting. In his civil career he works internationally as a Consultant or as Scientific Supervisory Board Member for several medical and biotech companies, merely involved in biodefense. He is also a Visiting Professor for Punjab University in Pakistan and Rhein-Waal University in Germany. He has completed his studies in Medicine and in Biochemistry at the University of Groningen in Netherlands and has extensive practical experience in cell biology, immuno-hematology, biodefense and transfusion medicine.
Abstract:
Public health systems are not always prepared for huge outbreaks of infectious diseases. Although in past several public health institutes were prominent surveyors of infectious diseases and very active in the mitigation of infectious diseases both in and outside their country of origin, like the French Institute Pasteur, Dutch Tropeninstituut and many others Institutes, the investments in worldwide public health was in the last decennia far less compared to curative healthcare. With the recent Ebola Virus Disease outbreak in West Africa we see now a new wave of growing interest in investing in Worldwide Public Health to prevent spreading of highly contagious disease outbreaks. Zoonotic diseases are the most dangerous for outbreaks as the population does not have natural nor artificial (from vaccination) immune response to new emerging diseases. The Ebola Virus Disease outbreak in 2014 in West Africa is such an example. As the new strain of the Ebola Virus in West Africa has a longer incubation time and is only slightly less lethal compared other Ebola Virus strains, the threat of spreading among the population is far bigger. Especially when the epidemic enters denser populated areas. The mitigation of a highly infectious and deadly disease outbreak has several aspects for which most public health systems in the world are not trained well enough. NGO’s helping to fight the outbreak are often also better trained in curative treatments and have less experience with biological (bioweapon) threats for which the military are trained for. The UNMEER mission is unique in this. It is a setting in which military and civilian actors cooperate in fighting a biological threat. Protection is essential for health workers and smart systems have to be developed to prevent further spreading of the disease. But it is unfortunately not only the biosafety, which has to be considered, but also the biosecurity, as misuse of extremely dangerous strains of microorganisms cannot be excluded. Several zoonotic infectious diseases, like anthrax, small pox and also the hemorrhagic fevers like Ebola Virus Disease are listed as potential bioweapons. With this extra threat in mind both biosafety and biosecurity has to be implemented in all measures to fight outbreaks of highly infectious diseases, as we are now doing in West Africa. Several international and national organizations invest now in improving public healthcare in Africa to mitigate the global threat of the spreading of infectious diseases by the increasing international travel.
Keynote Forum
Naim Deniz Ayaz
Kirikkale University, Turkey
Keynote: Listeria monocytogenes risk in poultry meat and usage of bacteriophages as a biocontrol agent
Time : 10:00-10:30
Biography:
Naim Deniz Ayaz is an Associate Professor of the Department of Food Hygiene and Technology at Kirikkale University, Faculty of Veterinary Medicine. He has received his PhD in Food Hygiene and Technology from the Ankara University in 2008. He is the Vice Dean and Executive Board Member of Kirikkale University, Faculty of Veterinary Medicine; an Expert of the Biosafety Clearing-House Mechanism of Turkey; a Research and Advisory Board Member of the National Red Meat Council and an Editorial Board Member of several scientific journals. His main research interests are food microbiology, characterization of food-borne pathogens, bacteriophages, biocontrol of pathogens and bacterial antibiotic resistance.
Abstract:
Poultry are playing a significant role in human food-borne infections because they are frequent vehicles of some human pathogens. In order not to take hygienic precautions, contaminations with pathogenic microorganisms such as Listeria may be occurred and consumption of such poultry meat and meat products can cause food-borne illnesses. L. monoctogenes is a zoonotic food-borne bacteria that leads to a variety of serious infections in humans such as encephalitis, meningitis, abortion and septicemia and those suffering with listeriosis occurs in approximately 30% mortality. Epidemiologic studies have revealed that a significant proportion of cases of listeriosis caused by contaminated foods. Consumption of poultry meat is increasing in the world. Related with the production technology, cross contamination risk is very high during processing, so it is important to control L. monocytogenes in poultry meat. Rapidly growing bacterial resistance to antibiotics and need for development of alternative methods, increasing interest in using bacteriophages in treatment or as biocontrol agents in foods nowadays. Bacteriophages can be applied to living tissues without causing any harm due to their highly selective toxicity. This is the most important advantage when they compared with antibiotics and antiseptics. The use of specific virulent bacteriophages for L. monocytogenes in order to reduce L. monocytogenes load in foods before, during and after slaughter processes emerges as an another method. It is reported that the usage of specific virulent bacteriophages to L. monocytogenes as a biocontrol agent of L. monocytogenes in foods, do not cause any side effects in humans.
Keynote Forum
Aziz Alami Chentoufi
King Fahad Medical City, KSA
Keynote: Novel vaccination approach against HSV type-1 and type-2 infections
Time : 10:30-11:00
Biography:
Aziz Alami Chentoufi is a Consultant and Head of Immunology/Serology/HLA section at Pathology and Clinical Laboratory Medicine, King Fahad Medical City (KFMC). He is also an Assistant Professor of Immunology at Faculty of Medicine, King Saud Ibn AbdulAziz University. He is the Chairperson of Research Committee of PCLMA-KFMC. He is the Diplomate of the American Board of Medical laboratory Immunology D(ABMLI ), Fellow of the Association of Clinical Sciences (FACSc), accredited by the European Society of Translational Medicine (PCTM) and Fellow of the Academy of translational Medicine (FacadTM). He received his Ph.D. in Biomedical Sciences (Tolerance induction to xenogenic and allogenic antigens using monoclonal antibody anti-igM and anti-IgD) from the University Catholic of Louvain, Brussels, Belgium in 1999. He has done postdoctoral fellowship at McGill University, Montreal, Canada from 1999 to 2004 where he worked on immunogenetic of type 1 Diabetes and gene therapy for graft versus host disease then he was appointed as specialist at the University of California Irvine-Medical Center, Irvine, California, USA in 2006 where he was a key investigator in the development of mucosal vaccine against herpes simplex virus type 1 and 2. He is an independent Immunologist with a national and international reputation in vaccine development against both infectious and autoimmune diseases. He is well-integrated into the scientific community within the United States as well as Europe and Saudi Arabia and he is actively involved in a number of professional societies including American Society of Histocompatibility and Immunogenetic (ASHI), Association of Clinical Scientist, Canadian Society of Immunology and The Federation of Clinical Immunology Societies (FOCIS). He is PI and Co-PI in a number of research grant proposals and associate editor in many scientific journals and has more than 50 publications in high impact factor journals.
Abstract:
Herpes simplex virus type 1 and type 2 (HSV-1 and HSV-2) infections would be controlled by the development of an effective vaccine. However, in spite of several clinical trials, starting as early as 1920s, no vaccine has been proven sufficiently safe and efficient to warrant commercial development. Recently, great advances in cellular and molecular immunology understanding have stimulated creative approaches in controlling herpes infections and diseases. Before moving towards novel vaccine strategy, it is required to answer the important questions: Why past herpes vaccines were unsuccessful? Why the majority of HSV seropositive individuals naturally control HSV infections and exhibit few or no recurrent herpetic disease, while few others have frequent herpes clinical episodes? We recently discovered that HSV-1 symptomatic and asymptomatic individuals develop distinct immunity to viral epitopes recognized by CD4+ and CD8+ T cells. These epitopes (protective vs. pathologic) have provided a solid foundation for the development of novel herpes epitope based vaccine strategy. In this presentation, I will provide an overview of past clinical vaccine trials and outline current progress towards developing a new generation “asymptomatic” clinical herpes vaccines and discuss future mucosal “asymptomatic” prime boost vaccines that could optimize the protective immunity.
- Track 01: Treatment for Infections
Track 02: Infection Prevention, Control and Cure
Track 03: Hand Hygiene/ Hand Washing and Cleanliness
Track 09: Antimicrobial/ Antibiotic/ Antibacterial Stewardship
Track 17: Types of Infections
Track 18: Causes and Symptoms of Infections
Track 22: Immunology of Infections
Track 24: Epidemiology of Emerging and Re-Emerging Infections
Chair
Indira T Kudva
United States Department of Agriculture-Agricultural Research Service, USA
Co-Chair
Palayakotai Raghavan
Nanorx Inc, USA
Session Introduction
Elias Tannous
Cleveland Clinic, UAE
Title: Infection control: The science of a profession
Time : 11:45-12:15
Biography:
Elias Tannous is an infection control professional with more than 20 years experience in the healthcare setting. He holds degree in Nursing from the French Ministry of Health and from Saint Joseph University in Lebanon, degrees in Business Administrations and Human Resource/Personnel Management from UK and Certified Board in Infection Control, USA since 2008. He has coordinated, co-directed and facilitated loads of IC educational activities and has been heavily involved in major infection control activities, projects and programs for the past 10 years, including commissioning of new facilities, developing surveillance programs and evaluating IC programs.
Abstract:
Trees are composed of roots, a trunk and branches. Similarly, in the infection control practice, the roots of the infection control professionals represent the background of these professionals, their values and the studies related to their profession. The crown of a tree is made up of the leaves and branches at the top of that tree. Likewise in the infection control profession this represent the daily activities of an infection control professional i.e., identification of infectious disease process, conducting epidemiological studies, controlling transmission of infectious agents, etc. The trunk of the tree provides its shape and support and holds up the crown. The trunk transports water and nutrients from the soil and sugar from the leaves. In infection control, the trunk represent the link between the theory and in practice, it represents an important element to minimize the theory, practice gap in infection control and has an integral part in holding the workload of an infection control practitioner. Photosynthesis in infection control practice represents the interaction of these professionals with other healthcare workers, coaching them and adding shared values with them to prevent infections. To conclude, a successful infection control professional consists of a mixture between theoretical and practical skills coupled with a trunk that is solid and conducive. This paper summarizes the essential combination of savoir, savoir etre and savoir faire to successfully assume the role of an infection control professional.
Stef Stienstra
Dutch Armed Forces/Royal Dutch Navy, Netherlands
Title: Managing bio-threat information under the WHO international health regulations of biosecurity
Time : 12:15-12:45
Biography:
Stef Stienstra is a strategic and creative Consultant in Biomedical Science with a parallel career as a Commander of the Reserve of the Royal Dutch Navy. For the Dutch Armed Forces he has responsibility for the counter measures in CBNRe threats and (medical) consequence management both in a military and a civilian (terrorism) setting. In his civil career he works internationally as a Consultant or as Scientific Supervisory Board Member for several medical and biotech companies, merely involved in biodefense. He is also a Visiting Professor for Punjab University in Pakistan and Rhein-Waal University in Germany. He has completed his studies in Medicine and in Biochemistry at the University of Groningen in Netherlands and has extensive practical experience in cell biology, immuno-hematology, biodefense and transfusion medicine.
Abstract:
Sharing security threat information is a challenge for governments and their agencies. Especially in biotechnology and microbiology the agencies do not know how to classify or to disclose collected information on potential bio-threats. There is vague border between man-made and natural biological threats. An example is the several month delay of the publication of research on the transmissibility of H5N1 avian influenza virus in the leading scientific journal Science by researchers of the Erasmus Medical Centre in Rotterdam, The Netherlands. The publication was delayed in 2012 by several months due to the fact that various organizations first wanted to investigate whether the details could be misused by malicious individuals. In the study the researchers show that only a small number of mutations were necessary to change the H5N1 virus so that it can spread through the respiratory system between mammals. This implies that the risk of a H5N1 pandemic cannot be ruled out. On the other hand, this information can be used to develop new therapies and/or vaccines for influenza. It gives also insight into the disease mechanism, which helps in the prevention. The same arguments are valid for therapeutic antibodies, like the antibodies, which are developed to treat anthrax. They have an extreme high affinity for the lethal factors of the bacterium and stop the disease but the same antibodies could be misused to select the most pathogenic strains. Micro-organisms have from nature itself the capacity to reorganize and change their pathogenicity, which could lead to a pandemic spread of a disease. But if the disease is too infectious and too deadly, like some stains of Ebola Virus are, the lethality will be locally limited. But if the incubation time is longer in a certain strain of an Ebola virus, the risks on epidemics and even a pandemic is much higher. The knowledge of these natural mutation mechanisms could be misused to weaponize micro-organisms. It enables the engineering of the lethality like it is done with some anthrax strains. Are these laboratory techniques considered as public science or should it be classified? Academics want to publish and to share information for the progress of science and to find useful applications. The Rotterdam scientists were really annoyed when their research was blocked for publication and feared that other groups would be first in publishing a part of their obtained experimental results. Biosafety is already common practice in microbiology but biosecurity is often still questionable. A ‘Code of Conduct’, like the Dutch Academy of Science has developed, would help; especially for the so-called insider risk. Educational programs for the identification and assessment of risks and threats to security have to be developed to give scientists bio-threat awareness and for government officials to rationalize the real threat, without damaging the progress of science.
Stephanie Fresnay1, Monica A McArthur1, Thomas C Darton2, Claire Jones2, Claire S Waddington2, Christoph J Blohmke2, Brian Angus2, Myron M Levine1, Andrew J Pollard2 and Marcelo B Sztein1
1University of Maryland, USA
2University of Oxford, UK
Title: Importance of Salmonella Typhi-specific CD8+ T cells in typhoid fever immunity in a human challenge model
Time : 12:45-13:10
Biography:
Stephanie Fresnay is a Postdoctoral Fellow in the Cellular Immunology Section of the Center for Vaccine Development at the University of Maryland, USA. She is a Co-Investigator for the clinical trial entitled “Understanding Typhoid Disease: Development of a Salmonella Typhi Challenge Model in Healthy Adults” and has published in the Journal of Translational Medicine. She is also the co-author of several papers investigating regulatory T cells and antigen presenting cells function after challenge with wild-type S. Typhi as well as the co-author of a study characterizing S. Typhi, S. Paratyphi A and S. Paratyphi B cross-reactive CD4+ T cell responses elicited following vaccination.
Abstract:
Salmonella enterica serovar Typhi (S. Typhi) is a human restricted pathogen which causes significant morbidity and mortality, particularly in developing countries. A better understanding of the immune responses which result in protection from S. Typhi infection is imperative for the development of improved attenuated vaccines. Recently, a controlled human infection model was re-established in which participants received ~104 cfu wild-type S. Typhi (Quailes strain) orally. 20 participants were evaluated for their cell-mediated immune (CMI) responses. Ex vivo PBMC isolated before and up to 28 days after challenge were exposed to 3 S. Typhi-infected targets, i.e., autologous B lymphoblastoid cell-lines (B-LCL), autologous blasts and HLA-E restricted AEH B-LCL cells. CMI responses were evaluated using 14-color multiparametric flow cytometry to detect simultaneously 5 intracellular cytokines/chemokines (i.e., IL-17A, IL-2, IFN-g, TNF-a and MIP-1b) and a marker of degranulation/cytotoxic activity (CD107a) in distinct T cell memory subsets. Pre-challenge production of IFN-g, TNF-α and MIP-1β by S. Typhi-specific CD8+ multifunctional T effector memory (TEM) following exposure to S. Typhi-infected targets were higher in most participants who develop infection. Early decreases were observed in both S. Typhi-specific integrin a4b7-and integrin a4b7+CD8+ TEM cells after challenge, suggesting a potential for these cells to home to mucosal, as well as to extra-intestinal sites. Higher baseline S. Typhi-specific CD8+ TEM responses also correlated with delayed typhoid diagnosis. No changes in these responses were found in NoTD participants after challenge. These studies demonstrate that S. Typhi-specific CD8+ baseline responses correlate with clinical outcome in humans challenged with wild-type S. Typhi, and provide novel insights into the protective immune responses against typhoid disease that will aid in the selection and development of new vaccine candidates.
G Tellez, J D Latorre, A D Wolfenden and B M Hargis
University of Arkansas, USA
Title: Novel technologies and innovations for prevention and treatment of infectious diseases
Time : 13:10-13:35
Biography:
G Tellez is affiliated to the University of Arkansas, USA.
Abstract:
Bacterial antimicrobial resistance in both the medical and agricultural fields has become a serious problem worldwide. During the last 15 years, our laboratories have worked toward the identification of probiotic candidates for poultry which can actually displace Salmonella and other enteric pathogens which have colonized the gastrointestinal tract of chicks and turkeys, indicating that selection of therapeutically efficacious probiotic cultures with marked performance benefits in poultry is possible and that defined cultures can sometimes provide an attractive alternative to conventional antimicrobial therapy. Our studies have been focused on specific pathogen reduction, performance under commercial conditions and effects on both idiopathic and defined enteritis. We have also confirmed that selected heat-resistant spore-forming Bacillus species can markedly reduce Salmonella and Clostridium when administered in very high numbers and we have developed a novel and simple technique for obtaining cultured Bacillus spore counts, providing a cost-effective feed-stable inclusion in commercial poultry diets. In order to select even more effective isolates, we are still currently focused on the mechanistic action of the Lactobacillus probiotic previously developed as well as new Bacillus candidates. Current indications are that mechanism of action involves rapid activation of innate host immune mechanisms, providing an exciting possibility for identification of vastly superior and more potent probiotics. In this presentation, we summarize the safety and efficacy of individual monocultures for prophylactic and/or therapeutic efficacy against Salmonella infections under both laboratory and field conditions as well as the development of a novel, cost-effective, feed-stable direct fed microbials (DFM) with potential for widespread utilization and improved production, delivery and clinical efficacy for animal use.
Exhibitor Demonstration 14:35-15:00
Alaa Badawi1 and Seung Gwan Ryoo2
1Public Health Agency of Canada, Canada
2University of Toronto, Canada
Title: Prevalence of comorbidities in the Middle East Respiratory Syndrome Coronavirus (MERS-CoV): A systematic review and meta-analysis
Time : 15:00-15:25
Biography:
Alaa Badawi is affiliated to the Public Health Agency of Canada, Canada.
Abstract:
Middle East respiratory syndrome coronavirus (MERS-CoV) is associated with life threatening severe illnesses and a mortality rate of ~35%, particularly in patients with underlying comorbidities. Systematic analysis of 637 MERS-CoV cases suggests that diabetes and hypertension are equally prevalent in ~50% of the patients. Cardiac diseases and obesity are present, respectively in 30% and 16% of the cases. These conditions down-regulate the synthesis of pro-inflammatory cytokines and impair the host's innate and humoral immune systems. In conclusion, the protection against MERS-CoV and other respiratory infections can be improved if public health vaccination strategies are tailored to target persons with chronic disorders.
John Gammon
Swansea University, UK
Title: The curse of wet hands! The significance of hand drying and efficacy of different methods
Time : 15:25-15:50
Biography:
John Gammon is the Deputy Head of the College of Human and Health Sciences at Swansea University and trained as a Nurse at Westminster Hospital London. He is a Non-Executive Director of a Local NHS Health Board. His expertise is in infection prevention and control, working in practice as a Specialist Nurse for many years. His PhD examined coping strategies and mediating factors for individuals in source isolation. His research interests include isolation strategies and the psychological effects, hand hygiene and behavioral theory to improve infection prevention compliance.
Abstract:
Wet hands are an infection risk, increasing the potential for cross infection as well as the harm to the skin condition of healthcare practitioners. This presentation examines the infection risk associated with wet hands, efficacy research of different drying and the impact on the safe clinical care. Current research and practice recommendations concentrate on hand washing, compliance rates and the efficacy of different interventions to improve hand washing. However, there is a noticeable neglect of hand drying practice which fails to recognize its importance in the prevention and control of infection. There is recognition that hand drying is of equal importance to hand washing, that there is a lack of compliance amongst practitioners and that the efficacy of different methods varies. This presentation argues that the effectiveness of the drying technique and method is neglected area of practice and research; however it has grown in importance in more recent years with a number of studies recently being published. The presentation examines a number of published international studies, which evaluate the efficacy of different methods in clinical areas. The presentation notes that despite this evidence, research needs to focus and evaluate the efficacy the methods and extent of drying by practitioners within the clinical environment. We need to give greater emphasis to the equal importance of hand drying when we consider hand hygiene in the clinical context. We must accept that patient safety is put at risk when we fail to dry our hands.
Lucy J Bock, Matthew E Wand and J Mark Sutton
Public Health England, UK
Title: Investigating the mechanisms of resistance to cationic biocides in clinically relevant Gram negative organisms
Time : 15:50-16:15
Biography:
Lucy J Bock has completed her BSc in Biology at the University of Newcastle, UK in 2004 and her PhD in Molecular Medicine in 2010 at the European Institute of Oncology and the University of Milan, Italy. Since then she has worked for Public Health England publishing on projects ranging from automatic washer-disinfector and hydrogen peroxide room-decontamination indicators to biocide resistance of Gram negative pathogens. Her current interest is in the cross resistance of Gram negative bacteria to cationic biocides and antibiotics.
Abstract:
Control of multi-drug resistant (MDR) organisms relies increasingly on the use of biocides to limit the risk of infection. Clinical strains of Gram negative MDR organisms have been shown to adapt to increased levels of biocides. We aim to define the stable mechanisms of resistance that allow these strains to adapt to commonly use cationic biocides (e.g., chlorhexidine). Using established adaptation protocols, whole genome sequencing, gene expression analysis and efflux assays, we investigate the mechanisms of resistance in clinical isolates. Resistance of Klebsiella pneumoniae isolates to chlorhexidine formulations varies vastly depending on the strain and formulation, some strains not being killed by 50% working concentration of chlorhexidine formulations. K. pneumoniae strains adapted to chlorhexidine show increased resistance to formulations, though this can be reduced by additional ingredients in the formulation. Cross resistance to the last resort antibiotic colistin was found in five out of six adapted strains. Stable mutations in the two component regulator phoPQ and/or a putative tet repressor gene (smvR), adjacent to the MFS family efflux pump smvA, were found in all adapted K. pneumoniae strains. Currently data on adaptation to further cationic compounds in Gram negative MDR pathogens is being generated, showing that some resistance mechanisms are conserved between species, whereas others are unique. Resistance mechanisms vary depending on the compound, but several overlap with many of them associated with efflux pumps and/or membrane modification pathways. To avoid potential breakdown of infection control due to emergence of resistance mechanisms, the careful use of biocides in the healthcare environment is therefore required.
Mona Schousboe and P J Aspell
Canterbury District Health Board, New Zealand
Title: Antibiotic stewardship approach to long term urinary catheterized patients in a Spinal Injury Unit (SIU) in New Zealand: Measurement of success regarding antibiotic resistance
Time : 16:30-16:55
Biography:
Mona Schousboe is employed by Canterbury District Health Board (DHB), one of the largest DHB in New Zealand. She is a qualified Medical Microbiologist (FRCPA) and work in this capacity in the DHB’s laboratory, Canterbury Health Laboratories. She is also a Clinical Director of the CDHB Infection Prevention and Control Service. She has obtained Master of Public Health with a Thesis “Governance, Management and Professional Influences on Infection Control in Canterbury Public Hospitals 1978-2008”. She has special interest in management of urinary catheterized patients with spinal injuries.
Abstract:
Introduction: Antimicrobial stewardship, a concept developed due to increasing antibiotic resistance, involves issuing guidelines, assistance from microbiology laboratories in limiting reporting and policing by pharmacy on the use of antibiotics. The success of antimicrobial stewardship is difficult to measure. Presented here is the management of antibiotic use, prevention of urinary sepsis and organisms’ resistance in a Spinal Injury Unit (SIU) in New Zealand. A half hour weekly meeting is held between medical, nursing, pharmacy and IC&P staff with the aim of preventing urinary sepsis as a consequence of planned urological interventions. Urine samples are collected weekly and cultured with identification of all bacteria and antibiotic susceptibilities carried out monthly or as new strains are identified.
Aim: To research the benefit of preventative urine management by comparing susceptibilities in the SIU over a 10 year period with those of the District Health Boards (DHB) Annual Antibiotic Susceptibilities.
Methods & Material: Compare antibiotic susceptibilities from laboratory records reported on SIU catheterized patients’ urine isolates for six out of ten years between 2005 and 2015 with annual summaries of all DHB’s hospital bacterial susceptibilities over the same periods.
Results: The annual susceptibilities of routine urinary antibiotics to most of the urinary pathogens in the SIU patients were equal to or only slightly lower than the Annual Antibiotic Susceptibilities for all the DHB’s bacterial isolates with exception of P. aeruginosa.
Conclusion: The effect of antimicrobial stewardship can be demonstrated and measured in catheterized patients with the help of regular detailed urine results and a preventative approach to management and thus avoid the use of empiric antibiotic treatment. The focus was to render the bladder free of bacteria during interventions which increase the intravesical pressure. Nitrofurantoin was the most frequently urinary antiseptic used.
Aaron Lawson
Ulster University, Ireland
Title: Public awareness of hand hygiene as a simple measure in the prevention of the spread of communicable diseases: A systematic literature review
Time : 16:55-17:20
Biography:
Aaron Lawson is a graduate of Ulster University with a Bachelor of Science in Environmental Health and the Diploma of Professional Practice with commendation. He has a keen interest and understanding of environmental health, particularly in relation to public health, health and safety in the workplace and creating a better environment for the future. He is currently undertaking PhD in Public Health and Epidemiology at Ulster University.
Abstract:
Hygiene-related communicable diseases result in millions of deaths each year across the globe. Good hand hygiene practice is recognized as one of the most effective methods in preventing the spread of hygiene-related communicable diseases from person to person. Most of the studies carried out on hand hygiene practice and compliance has focused on the healthcare sector and has found that compliance is often poor. Few studies have looked at the public’s knowledge and awareness of good hand hygiene as a simple measure in the prevention of the spread of communicable diseases. This study is a systematic review of peer-reviewed, published studies that focused on hand hygiene knowledge and compliance by the general public. An online search of the SCOPUS database using the keywords “hand hygiene”, “hand washing”, “public” and “knowledge” with exclusion criteria keywords “healthcare”, “hospital” and “nursing”, yielded 270 initial document results ranging from 1981 to 2016. From these 38 were included in the final review. The majority of the studies were carried out in less-developed countries particularly in Africa and the Middle-East. Schools and colleges emerged as the predominant locations used for most of the studies followed by food businesses. The systematic review concludes that there is a gap between knowledge and practice. Good education and tailored interventions were identified as key factors in improving hand hygiene practice and compliance within a target population, however further research is needed to determine the lasting impact.
Carla M A Pinto
Polytechnic of Porto, Portugal
Title: Persistence of low levels of plasma viremia and of the latent reservoir in patients under ART: A fractional order approach
Time : 17:20-17:45
Biography:
Carla M A Pinto is an Adjunct Professor at School of Engineering, Polytechnic of Porto, since December 1997. She is a Researcher at Center for Mathematics of the University of Porto, since 2003. She has completed her PhD degree in Mathematics in 2004. Her current research fields involve the study of epidemiological models for several diseases, namely HIV/AIDS, tuberculosis, malaria, amongst others. She also studies coupled nonlinear dynamical systems, considering fractional and integer derivatives using bifurcation theory and symmetry techniques. She has authored/co-authored a large number of research papers, published in reputed international journals and international conferences. She has been serving as an Editorial Board Member of several journals. She is the Sub-Director of the Department of Mathematics since 2012.
Abstract:
Low levels of viral load are found in HIV infected patients, after many years under successful suppressive anti-retroviral therapy (ART). The factors leading to this persistence are still under debate but it is now more or less accepted that the latent reservoir may be crucial to the maintenance of this residual viremia. In this talk, we focus on the role of the latent reservoir in the persistence of the latent reservoir and of the plasma viremia in a fractional order (FO) model for HIV infection. The proposed model provides new insights on the role of the latent reservoir in the persistence of the latent reservoir and of the plasma virus. To our best knowledge, this is the first FO model that deals with the role of the latent reservoir in the persistence of low levels of viremia and of the latent reservoir.
Jack Ho Wong and Tzi Bun N G
The Chinese University of Hong Kong, Hong Kong
Title: Lactoferrin is a natural killer of Candida spp.
Time : 17:45-18:10
Biography:
Jack Ho Wong has completed his PhD at the Chinese University of Hong Kong and currently is a Research Associate at the School of Biomedical Sciences. He is working on bioactive peptides emphasized on antimicrobial and anticancer effect. He has published more than 100 papers in reputed journals and has been serving as an Editorial Board Member in the journals Toxins, Frontiers in Microbiology and Frontiers in Pharmacology and he is a manuscript Reviewer for several journals.
Abstract:
Lactoferrin is an iron-binding protein in milk. It plays an important role in the host defense system as it prevents microbes from growing and forming biofilms. In addition to antimicrobial activity, lactoferrin exhibits some anticancer activities. Lactoferricin (Lfcin) and lactoferrampin (Lfampin), which are peptides derived from lactoferrin, demonstrated antimicrobial activity with promising prospects and are currently one of the research focuses. We investigated the antifungal effect of these two peptides. We found that fungal cells exposed to Lfcin manifested morphological alterations, changes in plasma membrane permeability and mitochondrial membrane potential and ROS accumulation in cells. Lfcin also suppressed superoxide dismutase 3 (SOD3) expression in the fungal cells. Lfampin exerted its antifungal effect mainly through induction of necrosis. It also induced changes in plasma membrane permeability and mitochondrial membrane potential. We also tested the effects of the following combinations (1) Lfcin and Lfampin (2) The Lfcin and Fluconazole and (3) Lfampin and Fluconazole against Candida spp.
Nasim Mohamad Alsebai and Abdulrahim Abu Jayyab
Emirates College of Technology, UAE
Title: Management of perforated appendicitis in children and infection prevention
Time : 18:10-18:35
Biography:
Nasim Mohamad Alsebai is a Pediatric Surgeon, Anatomist, Researcher and Lecturer. Nasim has graduated from Faculty of Medicine, Aleppo University and did Pediatric Surgery Residency Training in Syria from Aleppo University Hospital, Faculty of Medicine where Nasim obtained Master’s degree in Surgery-Pediatric Surgery followed by Master of Science degree in Human Anatomy from the Anatomy Department, Aleppo University. Nasim is currently working as an Anatomy Lecturer in the College of Medical & Health Sciences in Emirates College of Technology, Abu Dhabi. Nasim is actively involved in clinical research and academic publications.
Abstract:
Perforated appendicitis in children continues to be associated with significant morbidity. In 2012, a treatment algorithm was begun at the authors' institution, which included immediate appendectomy, antibiotic irrigation of the peritoneal cavity, trans-peritoneal drainage through the wound and 10-day treatment with intravenous ampicillin, clindamycin and gentamicin. Initial results with this scheme in 27 patients demonstrated a 7.7% incidence of major complications and no deaths. From 2012 through 2016, the authors continued to use this treatment plan in all patients with perforated appendicitis. 73 patients with perforated appendicitis were treated and the rate of major complications was 6.4%. Infectious complications occurred in 18 patients (4.8%) and included intra-abdominal abscesses (2 patients, 1.3%), phlegmon treated with an extended course of antibiotics (2 patients, 1.6%), wound infections (5 patients, 1.3%) and entero-cutaneous fistula requiring further operations (2 patients, 0.5%). There were six cases of small bowel obstruction (1.6%), which required operative intervention. There were no deaths. The average length of stay of all patients was 11.4 days (range, 8 to 66 days). Utilization of trans-peritoneal drainage and choice of antibiotic therapy continue to be sources of controversy in the surgical literature. However, the treatment plan used in the present study resulted in the lowest complication rate reported to date and the authors conclude that this scheme in truly the “gold standard” for treatment of perforated appendicitis. New treatment plans using laparoscopic appendectomy, different or shorter courses of antibiotics or not using drain should have complication rates that are as low as or lower than this one to be considered as useful alternatives.
Benjamin Kung
College of Physicians & Surgeons of Alberta, Canada
Title: Medical device reprocessing (MDR) in Alberta Medical Clinics – Patient safety risk warrants regulatory oversight
Biography:
Benjamin Kung is the Program Manager of IPAC for the CPSA and additionally serves as Governance Committee Chair on the Board of Directors, Alberta Public Health Association. He completed undergraduate training in Microbiology/Biology (University of Victoria) and Environmental Public Health (British Columbia Institute of Technology), followed by graduate studies in IPAC (University of British Columbia) and Epidemiology (London School of Hygiene & Tropical Medicine).
Abstract:
Historically in Alberta, responsibility for monitoring infection prevention & control (IPAC) in non-governmental, unaccredited medical clinics had fallen on the business owner and/or physicians. In 2007, a sentinel event triggered a government directed review of IPAC in these settings. A program was created under the direction of a 10-member Advisory Committee: infectious disease specialists, medical officers of health, senior infection control practitioners, and community physicians and surgeons. CPSA has since actively monitored IPAC with a priority on standards for MDR (cleaning, disinfection, and sterilization of medical devices).
Alberta has approximately 1700 medical facilities in the “non-governmental, unaccredited” category. Over 600 (> 35%) perform some type of MDR and these were assessed for adherence to standards between 2008-15. In 2013, a provincial policy for reporting the most critical deficiencies was formalized. From 2013-15, 131 assessments identified 17 (13.0%) with risks exceeding the reporting threshold to Public Health. Deficiencies contributing to the likelihood of reporting included, but were not limited to: inadequate device cleaning, lack of monitoring sterilization cycles for physical (time, temperature), chemical, and/or biological parameters, use of unlicensed sterilizers, and inadequate level of reprocessing given device risk classification (Spaulding’s). Post-exposure risk assessment deemed four (3.0%, n=131) a sufficient threat to initiate lookbacks for bloodborne pathogen exposure (HIV, HBV, HCV).
Formal reporting and post-exposure risk assessment confirmed initial observations suggesting clinics performing MDR are at elevated risk of breaching IPAC principles that may jeopardize patient safety. The logistics and value of providing clinic support via robust regulatory controls is worth exploring.
Gizem Copuroglu
Kirikkale University, Turkey
Title: Presence of Staphylococcus aureus and Shiga toxigenic Escherichia coli
Biography:
Gizem Copuroglu is a research assistant in Kirikkale University Faculty of Veterinary Medicine, Department of Food Hygiene and Technology. She is interested in food microbiology, bacteriophages and biocontrol of foodborne pathogens. She is currently working on her PhD, titled ‘A Study on the Prevelance and Characterization of Listeria monocytogenes in Chicken Neck Skin, and Biocontrol of the Isolates by Lytic Bacteriophages on Chicken Leg Food Model’.
Abstract:
Staphylococcus aureus and Shiga toxigenic Escherichia coli (STEC) O157:H7 are both important foodborne pathogens around the globe. S. aureus can cause a wide range of infections from skin infection to life-threatening diseases including endocarditis, pneumonia, sepsis as well as toxin-mediated conditions such as toxic shock syndrome; on the other hand Escherichia coli O157:H7 can cause symptoms from mild diarrhea to severe hemorrhagic colitis (HC), hemolytic uremic syndrome (HUS), thrombotic thrombocytopenic purpura (TTP). In this study it was aimed to find out the prevalence and seasonal distribution of Staphylococcus aureus in 214 frozen raw meat (74 turkey, 70 chicken and 70 beef) and the prevalence of Escherichia coli O157:H7 in 70 raw beef with the characterization of the E. coli O157:H7 isolate by multiplex PCR. Out of 214 meat samples, 25.7% (18/70) of the beef, 11.4% (8/74) of the chicken meat, and 5.4% (4/70) of the turkey meat samples were contaminated with S. aureus. Out of 70 frozen raw beef samples, only 1 (1.4%) was identified as both shiga toxin 1 and 2 producing E. coli O157:H7 by the detection of stx1, stx2, eaeA, hly, and fliCh7 according to multiplex PCR analysis. Our findings showed that occurrence frequency of S. aureus was higher in frozen raw beef than in raw chicken and turkey meat samples and the highest prevalences were detected in autumn months. Although the prevalence of E. coli O157:H7 was low in beef, the presence of virulence genes, especially toxin genes remain a significant public health concern.
Muhanad Ali
University of Toronto Scarborough, Canada
Title: Gender dynamics and socio-cultural determinants of MERS-CoV in Saudi Arabia
Biography:
Muhanad Ali is pursuing his Bachelor of Science in Health Science, Critical Development Studies and Anthropology from the University of Toronto Scarborough Campus. His focus is on how factors such as colonialism, globalization and socio-cultural or even socio-ecological factors play into the origin, maintenance and emergence of old and new infectious diseases. He is currently the Co-director for the University of Toronto International Health Program (UTIHP-UTSC) and serves as YHAN (Youth Health Action Network) Member for the City of Toronto Public Health in Toronto, Canada.
Abstract:
Middle East Respiratory Syndrome (MERS) is a severe viral respiratory illness that is caused by a new strain from the beta group of coronavirus (CoV). At both the global and national level within Saudi Arabia, men are at a greater risk of contracting the virus (68%) in comparison to women, which fosters an interesting question: What accounts for these gender based differences in the MERS infection rates between men and women? This study seeks to challenge the assumption that biological differences in vulnerability (genetic disposition) are the primary drivers for the disparate male infection rates and shift towards a framework of analysis that embraces the unique dynamics of gender roles. To demonstrate this analytical framework, this paper will consider several gender based risk factors such as gender segregation, religious and cultural practices and social roles pertaining to livestock management within Saudi Arabia. The literature review examined for this study found that gender based risk factors (gender segregation, religious and cultural practice and social roles pertaining livestock management) may lead to varying rates of exposure to MERS-CoV. Moreover, it illustrated a gap in our current knowledge and understanding of how gender dynamics affect infectious diseases, especially concerning the issue of containment of and protection from MERS.
Edgar Mauricio Jimenez Vargas
Universidad Andrés Bello, Chile
Title: Apoptosis in adventitial layer of hydatid cysts
Biography:
Edgar Mauricio Jimenez Vargas MVZ. MSc. PhD (c), completed studies magister in 2014 and now doing PhD (c) at the University Andres Bello, his research areas are Parasitology, Immunology, and Veterinary Internal Medicine.
Abstract:
Cystic Echinococcosis (CE) is a zoonotic infection with high prevalence in part of Eurasia, Africa, Australia, and South America that represents a major public health and economic burden in many countries. Fertile cysts are capable to generate protoscolex, while for unknown reason, some cysts are unable to produce (infertile hydatid cysts). Previous reports showed that apoptosis could be involved in a negative regulation of protoscoleces generation, leading to hydatid cyst infertility but no report are available about cell apoptosis in adventitial layer and the relationship with other parasitic disease like fascioliasis. Materials and Methods: Animals were evaluated to characterize the presence of CE and fasioliasis (FS) in cattle slaughtered at abattoir in Santiago, Chile. Samples were processed for routine histology and stained with heamatoxylin/eosin. Samples from animal with both fertile and infertile cyst from CE and with or without DS was included in this study, using 5 samples per condition. Histological samples were evaluated by immunofluorescence and TUNEL Assay; digital images were obtained using an Olympus BX 41 Microscope and analyzed with software for morphometric analysis (Image Pro-Plus, Media Cybernetics, USA). The adventitial layer apoptotic index was calculated as follows: apoptotic nuclear area in adventitial layer x 100/total nuclear area in adventitial layer. Kruskal-Wallis test was performed using IBM SPSS Statistics 22 (IBM Corporation) software, p <0.05. Results: The apoptotic index in infertile cysts (0.18 ± 0.35%) was significantly higher (p= 0.032) compared with fertile cysts (0.045 ± 0.068%), as the presence of co-infection with liver fluke, both fertile cysts as infertile has a lower apoptotic index without significant difference (p> 0.05). Conclusion: The highest index of apoptosis cells in the adventitia layer of hydatid cysts is related to infertility cysts. The presence of distomatosis decreases cell apoptosis.
Mary Reidy
Bon Secours Hospital Tralee County Kerry, Ireland
Title: Preparedness of hospitals in the republic of Ireland for an influenza pandemic, an infection control perspective
Biography:
Mary Reidy has completed her Higher Diploma in Infection Control from the Royal College of Surgeons and Master studies from the University College of Cork. She is the Infection Control Nurse Specialist at the Bon Secours hospital Tralee. Shee has published her research papers in reputed journal.
Abstract:
Background: When an influenza pandemic occurs most of the population is susceptible and attack rates can range as high as 40-50%. The most important failure in pandemic planning is the lack of standards or guidelines regarding what it means to be ‘prepared’. The aim of this study was to assess the preparedness of acute hospitals in the Republic of Ireland for an influenza pandemic from an infection control perspective.
Methods: This was a cross sectional study involving a questionnaire completed by infection control nurses, time period from June – July 2013, (3 weeks) from acute public and private hospitals in the Republic of Ireland. A total of 46 out of 56 hospitals responded to the questionnaire.
Results: From a sample of 46 Irish hospitals, it was found that Irish hospitals are not fully prepared for an influenza pandemic despite the 2009 Influenza A (H1N1) pandemic. In 2013, thirty five per cent of Irish hospitals have participated in an emergency plan or infectious disease exercise and have plans or been involved in local planning efforts to care for patients at non-health care facilities. Sixty per cent of Irish hospitals did not compile or did not know if the hospital had compiled a “lessons learned” from any exercise that were then used to revise emergency response plans. Fifty two per cent of hospitals have sufficient airborne isolation capacity to address routine needs and have an interim emergency plan to address needs during an outbreak. Fifty one percent of hospitals have taken specific measures to stockpile or have reserve medical supplies e.g. masks, ventilators and linen.
Conclusion: This is the first study carried out in the Republic of Ireland investigating the current preparedness for an influenza pandemic from an infection control perspective. Deficits exist in the provision of emergency planning committees, testing of emergency plans, airborne isolation facilities, stockpiling of personal protective equipment (PPE) and medical supplies and organisational schemes/incentives for healthcare workers to continue to work in a pandemic. While Irish standards are comparable to findings from international studies, the health care service needs to continue to enhance preparedness for an influenza pandemic and implement standard preparedness guidance for all Irish hospitals.
- Track 02: Infection Prevention, Control and Cure
Track 08: Antimicrobial/ Antibiotic/ Antibacterial Resistance
Track 10: Nosocomial Infections/ Hospital Acquired Infections/ Health Care Associated Infections Prevention and Control
Track 18: Causes and Symptoms of Infections
Track 19: Global Trends in Emerging Infections
Track 24: Epidemiology of Emerging and Re-Emerging Infections
Chair
Maria Paula Ramalho Bajanca-Lavado
National Institute of Health, Portugal
Co-Chair
Aziz Alami Chentoufi
King Fahad Medical City, KSA
Session Introduction
Muammer Goncuoglu
Ankara University, Turkey
Title: Salmonella risk in poultry meat
Time : 11:15-11:40
Biography:
Muammer Goncuoglu has received his DVM from Ankara University, Faculty of Veterinary Medicine in 1998 and PhD in Faculty of Veterinary Medicine, Food Hygiene and Technology Department in 2003. He has been working as an Academic Staff in the same department as Associate Professor Doctor. His main research areas are food hygiene, food microbiology, antimicrobial resistance of pathogens and public health.
Abstract:
Salmonella is one of the most important pathogens and causes important health risks and economic problems throughout the world. This bacterium has a major public health role which can infect people by consumption of different foods. Among all other foods, like vegetables, animal originated foods etc., poultry meat act as one of the most important and risky food for the human health for food-borne salmonellosis. Poultry meat and edible offal could be contaminated with Salmonella in different production steps such as slaughterhouses, meat processing etc. However according to the farm to table concept we have to focus on this fact from the breeding to the end of consumption of the poultry meat. The majority of human cases of non-typhoidal salmonellosis are caused by a limited number of serovars, which may vary with different geographic areas and time. Antimicrobial resistance profiles of the serovars of Salmonella spp., also has to be considered as one of the major public health risk. As a result, continuous monitoring of Salmonella prevalence and resistance in the food supply is necessary, both in national and international level, because of the public health implications of a potential spread of resistant microorganisms.
Bahar Onaran1, Gizem Copuroglu2, Naim Deniz Ayaz2, Muammer Goncuoglu1, Fatma Seda and Bilir Ormanci1
1Ankara University, Turkey
2Kirikkale University, Turkey
Title: Biocontrol of E. coli O157:H7 in RTE salad using lytic bacteriophage
Time : 11:40-12:05
Biography:
Bahar Onaran is a Research Assistant in Ankara University, Faculty of Veterinary Medicine, Department of Food Hygiene and Technology. She is interested especially in food microbiology. She is currently working on her PhD thesis entitled “Presence and antibiotic resistance of vancomycin resistant enterococci in chicken meat”.
Abstract:
E. coli O157:H7 is a food-borne pathogen of concern due to the serious clinical outcomes. Options for controlling bacterial pathogens in raw and ready-to-eat foods are limited but one is to use bacteriophages. The use of specific virulent bacteriophages for E. coli O157:H7 emerges as an important method in order to reduce E. coli O157:H7 load in foods. It is reported that the usage of specific virulent bacteriophages as a biocontrol and decontamination agent in foods, do not cause any side effects on human health, as well. This study was aimed to find out the efficiency of lytic bacteriophage against E. coli O157:H7 in ready-to-eat salads. For this purpose, E. coli O157:H7 NCTC12900 (EC00) and nalidixic acid resistant E. coli O157:H7 ATCC 43895 (naEC95) were used as the model bacterium in decontamination trials of Italian salads which are consumed without any heating process and include beans, carrots, potatoes, pickled cucumbers, salami, and mayonnaise. Phage M8AEC16 which was classified in Myoviridae family previously was used as biocontrol agent. Major reductions of viable E. coli O157:H7 counts reached up to 2.7 log cfu/g. In conclusion, results of this study showed that, phage M8AEC16 is an important biocontrol agent in decontamination of E. coli O157:H7 in RTE salads.
Cucunawangsih1, Fonny Cokro2 and Nata Pratama Hardjo Lugito1
1University of Pelita Harapan, Indonesia
2Siloam Teaching Hospitals, Indonesia
Title: Restricted antimicrobial policy: A positive outcome on Gram-negative bacilli susceptibility pattern from inpatients wards in Indonesia
Time : 12:05-12:30
Biography:
Cucunawangsih is affiliated to the University of Pelita Harapan, Indonesia.
Abstract:
Background: The increased prevalence of MDRO following overutilization of broad spectrum antibiotics has become a global emergency. At the end of September 2013, a restricted antimicrobial control program (RACP) was released in our institution. In this study, we evaluated the influence of RACP on susceptibilities of Gram-negative bacilli (GNB) from patients admitted in wards of Siloam Teaching Hospitals, Tangerang, Indonesia.
Materials & Methods: This retrospective study enrolled 1,866 data of GNB from January 2013 to June 2015. The RACP implemented uses a front-end approach which requires authorization of RACP team member based on local antibiotic guideline and prior susceptibility pattern. The team consists of clinician, clinical pharmacist and clinical microbiologist, which functions to restrict the use of carbapenems, fourth generation cephalosporins and tigecycline. Cumulative susceptibility testing was done using an automated method from VITEX-2 Compact® or conventional disk diffusion in accordance with Clinical and Laboratory Standard Institute (CLSI) guideline.
Results: The predominant GNB isolated was Escherichia coli (21.7%) followed by Klebsiella pneumonia (16.6%), Pseudomonas aeruginosa (10.9%) and Acinetobacter baumanii (9.5%). There was a significant increase of GNB susceptibility against cefpirome from 57% in 2013 to 73% in 2015. Similarly, the susceptibility thrived from 78-83% against imipenem, 74-75% against tigecycline and 63-64% against cefepime consecutively in 2013 to 2015. The susceptibility against meropenem in 2013 and 2015 was 80%.
Conclusions: The use of RACP yielded a positive effect on antibiotic susceptibility rate of GNB organisms. Furthermore, RACP is an effective program in lowering antibiotics utilization in our institution.
Angeline Nifiani M Wibowo and Cucunawangsih
University of Pelita Harapan, Indonesia
Title: Outcome of empirical antibiotic treatment and urinary catheter colonization in patients admitted to intensive unit of Siloam Teaching Hospital, Tangerang, Indonesia
Time : 12:30-12:55
Biography:
Angeline Nifiani M Wibowo is a Medical student of University of Pelita Harapan, Indonesia.
Abstract:
Background & Aim: Around 12-16% adult patients admitted to hospital, used urine catheter during their hospitalization. Furthermore, the incidence of positive urinary catheter colonization in intensive unit is 20%. The aim of this study is to observe the role of empirical antibiotics usage and urinary catheter colonization in patients admitted to the intensive unit of Siloam Teaching Hospital.
Material & Methods: This cross-sectional study conducted from January 2013 to December 2014. Two hundred and eighteen (218) urine culture data were collected and 49 were eligible for inclusion criteria such as complete medical record and using urine catheter more than 48 hours. Prior empirical antibiotic usage and the outcome of culture were analyzed using chi-square method and the mean difference characteristics of the patients were analyzed using t-test.
Results: Of 49 patients had complete data and used urine catheter, characteristics of patients between patients with positive colonization and no colonization were listed. There were 6/15 (40%) patients with colonization and 26/34 (76.5%) patients with no colonization that were treated with empirical antibiotics. The analysis of chi square shows the significant association of colonization with empirical antibiotics (p value=0.013). Meropenem 1 gm TDS IV (14/49 or 28.6%) and amikacin 1 gm OD IV (10/49 or 20.4%) were the two most used antibiotics in this study.
Conclusions: Usage of empirical antibiotics has a significance difference in urinary catheter colonization in patients admitted to intensive unit.
Elmekes Adel
Hôpital Ibn Tofail, Morocco
Title: The clinical and epidemiological risk factors of infections due to multi-drug resistant bacteria in an adult intensive care unit of university hospital center in Marrakesh, Morocco
Time : 12:55-13:20
Biography:
Elmekes Adel is affiliated to the Hôpital Ibn Tofail, Morocco.
Abstract:
Introduction: Infections with MDR bacteria is a major public health problem worldwide. These infections are particularly serious in ICU for the fragility of the field and multiple invasive procedures. Thus, early diagnosis is necessary and indispensable for proper management. Bacteriological samples including blood culture samples and devices are key diagnostic examinations infections with MDR bacteria, especially as clinical signs are not specific.
Aim: The aim of our study is to evaluate the epidemiology and the clinical and epidemiological risk factors responsible for infections with MDR bacteria at a tertiary intensive care unit, CHU Mohammed VI, Marrakech.
Materials & Methods: The study lasted 13 months, from March 1st 2015 to March 28th 2016. This prospective study was conducted in a 10-bed clinical-surgical ICU for adults. All analyzes were performed at the medical microbiology laboratory of the hospital. Adult patients with a first clinical episode of infection with Healthcare Acquired Infection (HAI) were included in the study. The samples were sent to the laboratory for diagnostic purposes. The level of antibiotic resistance has been studied by the agar diffusion method. The choice of antibiotic susceptibility testing and interpretation criteria were made as recommended by the Antibiogram the Committee of the French Society of Microbiology and standards of the European Committee on Susceptibility (EUCAST, 2015).
Results: During the study period, 225 bacterial strains were isolated from the samples taken. The antibiotic resistance profile shows that 43% of strains were multidrug resistant. The MRB were represented mostly by Acinetobacter baumannii strains resistant to imipenem (ABRI) 72%, followed by beta-lactamases producing Enterobacteriaceae extended spectrum (ESBL) 19% and 6% of Staphylococcus aureus resistant to methicillin (MRSA). While only 3% of MRB were characterized as Pseudomonas aeruginosa strains resistant to ceftazidime (PARC). We showed also that nosocomial infections due to BMR were dominated by pneumonia (44% of cases), followed by bacteremia, urinary tract infections, infections of catheters and meningitis with frequencies that are respectively of about 26%, 12%, 11% and 4%.
Conclusion: In conclusion, we showed the alarming presence of MDR bacteria and especially ABRI as bacteria responsible for HAI in the ICU basically is related to main risk factors specified by the multivariate analysis. These results illustrate the urgent obligation and need for practical actions in order to strength technical measures with infection control efforts to reduce HAI caused by MRD bacteria and improve patient outcomes by setting a rational and an appropriate antimicrobial use in hospitals but specifically in ICUs levels.
Poster Presentations 14:20-15:00 @ Foyer Business Center
Nalam Udayakiran
Nitte University, India
Title: A study of certain sociodemographic factors among patients with dog bite in Mulky CHC, DK District
Time : 15:00-15:25
Biography:
Nalam Udayakiran is affiliated to the Nitte University, India.
Abstract:
Introduction: Rabies an archaic zoonotic disease. Nearly 15 million people are bitten by animals in India every year with dogs being responsible for 96.2% of the bites. The most vulnerable members of society are children and poor or lower socio-economic classes. A majority of the victims had taken a partial course of vaccine.
Methodology: Longitudinal study was conducted in CHC Mulky, among patients registered from November 2015 to April 2016. All the patients receiving anti rabies vaccine in the OPD during study period who are willing to participate in the study were included in the study. After obtaining informed consent, the participants were administered the pre-tested, structured questionnaire at the time of first visit.
Results: The number of study subjects over a period of 6 months was 235 and all of them were bitten by dogs. Majority of them belongs to 21 to 30 age groups (22.9%). Males are more compared to females. 89.7% subjects belongs Hindu religion followed by Muslims. 60% subjects belong to BPL family. Only 34.4% subjects completed the full course of treatment.
Conclusion: This study shows that dog bites affect people of all age groups. Though people are aware of the necessity to approach a health facility following dog bite they are not motivated to complete the full course of vaccination following exposure. There is a need to create awareness regarding adherence to treatment through a strong information education and communication program among the community.
Bibi Razieh Hosseini Farash
Tehran University of Medical Sciences, Iran
Title: The first report of visceral leishmaniasis caused by Leishmania major in Iran
Time : 15:25-15:50
Biography:
Bibi Razieh Hosseini Farash is affiliated to the Tehran University of Medical Sciences, Iran.
Abstract:
Jehan Ali El Kholy, Mervat Gaber and Dina Mostafa
Cairo University Hospital, Egypt
Title: Healthcare-associated infections HAI in Cairo University Hospitals: A success story of surveillance in a resource-limited country
Time : 15:50-16:15
Biography:
Jehan Ali El Kholy is a Professor of Anesthesia and Intensive Care who works as a Deputy Director of Cairo University Hospitals since 2013. She is a certified Infection Prevention and Control Specialist and is responsible for preparedness and response to influenza and other infections in a teaching 5000 bed hospital that plays a role model among all Egyptian hospitals, in collaboration with Naval Medical Research Unit, No.3 (NAMRU-3). She was awarded by the Egyptian Minister of Health to be the best leader implementing active surveillance of influenza and healthcare-associated infections in Cairo University Hospitals in year 2014 and 2016.
Abstract:
Background & Aim: Healthcare-associated infections are the most frequent adverse event in healthcare delivery worldwide. Limited data are available from low and middle-income countries. Most countries lack surveillance systems for health care-associated infections. We aimed to describe the results of the surveillance system we followed from 1 September 2014 till 31 March 2016 in Cairo University Hospitals (CHU) a 5200 bed-tertiary hospital.
Methods: Standardized surveillance system was conducted in all intensive care units (ICU) of CUH from 1 September 2014 to 31 March 2016. Surveillance was active prospective and focused on ICU patients; a vulnerable patient population at increased risk of HAI and AMR due to severity of illness, high exposure to invasive procedures and devices and high use of broad spectrum antibiotics. HAI definitions used were the same 2008 NHSN case definitions. The involvement and training of IC Team, data entry person, Microbiology laboratory performing full bacterial identification, antimicrobial susceptibility testing and culturing all types of specimens, IPC link nurses in ICUs to monitor and report infections to the IPC team were essential. Data were collected with surveillance officers and analyzed. Device-days were used to calculate incidence of device-associated infections and patient-days to calculate incidence of HAIs that were not device-related. Antimicrobial susceptibility testing was performed using CLSI guidelines.
Results: 38 ICUs including medical, surgical, stroke units, cardiac, cardio-surgical, obstetric, pediatric, neonatal and burn units contributed to 94877 patient-days and 1272 HAIs. Of these 224 (18%) are ICU acquired, 111 (9%) Ward acquired, 808 (63%) Infections present on ICU admission and 129 (10%) SSI. Of the infections BSI represented 43% (with 70% CLABSI), UTI represented 27% (with 97% CAUTI) and pneumonia represented 39% (with VAP 80%). The incidence of HAI were 2.4/1000 patient-days, VAP was 2.5/1000 ventilator days, CLABSI was 1.2/1000 central line days and CAUTI was 1.2/1000 urinary catheter days. Culture of microorganisms showed that Gram negative pathogens constituted 71.4% of the total pathogens, mainly Klebsiella spp., constituted (28.6%), Acinetobacter spp., (16.6%) and Pseudomonas spp., (9.4%). Most of Acinetobacter and E. coli isolates were multi-drug resistant; 83.7% and 82.7%, respectively.
Conclusion: Implementing a standardized surveillance system in a resource-limited country is possible. Having a continuous and sustainable surveillance system is a success. Surveillance is fundamental to have benchmark of infections, to plan for prevention strategies, to record the antimicrobial resistance pattern and to plan for an antimicrobial stewardship program.
Maria Manuela Gaspar
University of Lisbon, Portugal
Title: Rifabutin: New formulations with improved therapeutic effect against tuberculosis
Time : 16:30-16:55
Biography:
Maria Manuela Gaspar has completed her PhD in 2005 in Pharmaceutical Technology, University of Lisbon and Postdoctoral studies in the University of Dublin, Trinity College. She is a Researcher in the Research Institute for Medicines, iMed.Ulisboa, University of Lisbon. She is co-author of patents, paper in peer-reviewed journals and book chapters.
Abstract:
Tuberculosis (TB) is the leading cause of death among infectious disease worldwide. Although the development of new antimycobacterial drugs is an obvious and necessary strategy to fight TB the therapeutic improvement of already approved drugs constitutes an alternative strategy. In the present work rifabutin, a first line drug against TB was chosen aiming the maximization of its concentration at infected sites while reducing its toxic effects and treatment duration. For this purpose, liposomes, the most successful lipid system with many liposomal formulations already on the market with proven safety and efficacy was selected. Biodistribution studies of RFB liposomes by intravenous administration allowed a higher accumulation of the antibiotic in liver, spleen and lungs in comparison with the respective free form. In a murine Mycobacterium tuberculosis model of infection RFB liposomes were able to reduce in a very high extent the bacterial load in liver, spleen and lungs being these results in agreement with biodistribution studies. Taking into account that in case of TB the lung constitutes the main infected organ, the pulmonary administration was also tested using spray dried microparticles. In vivo studies demonstrated that pulmonary delivery of RFB formulations constitutes a valuable approach to fight TB when compared to infected mice receiving RFB in the free form by the oral route. The obtained results clearly evidence the therapeutic improvement of RFB after incorporation in liposomes and in spray dried microparticles for intravenous and pulmonary administration respectively. The same strategy can be applied to other anti-tubercular drugs alone or in combination.
Jehan Ali El Kholy, Mervat El Anany, Dina Mostafa and Amani El Kholy
Cairo University Hospital, Egypt
Title: Surgical site infection SSI surveillance at Cairo University Hospitals: A success story lowering the incidence of SSI in a limited-resource country
Time : 16:55-17:20
Biography:
Jehan Ali El Kholy is a Professor of Anesthesia and Intensive Care who works as a Deputy Director of Cairo University Hospitals since 2013. She is a certified Infection Prevention and Control Specialist and is responsible for preparedness and response to influenza and other infections in a teaching 5000 bed hospital that plays a role model among all Egyptian hospitals, in collaboration with Naval Medical Research Unit, No.3 (NAMRU-3). She was awarded by the Egyptian Minister of Health to be the best leader implementing active surveillance of influenza and healthcare-associated infections in Cairo University Hospitals in year 2014 and 2016.
Abstract:
Background: CUH is a 5200 bed hospital with 98 operating rooms. SSI represents the most common infection in our hospital. SSI prolongs hospital stays, increases resistance to antimicrobials and represents an additional financial burden for hospitals, patients and their families increasing morbidity and mortality especially in countries with limited resources.
Aim: The objective of this study was to standardize the surveillance of SSI, report the rates of SSI and to lower the incidence of SSI in operations associated with high rates of SSI.
Methods: The study was conducted in CUH from March 2015 till February 2016. Training was provided to Infection Control Team on surveillance methods according to methods of National Healthcare Surveillance Network in USA (NHSN). Surveillance of the following surgeries was done craniotomies (CRAN), Coronary artery bypass grafting (CABG) and exploratory laparotomies (EL). The monitoring and evaluation (M&E) team evaluated the sensitivity and specificity of surveillance.
Results: M&E team identified 83% and 91% sensitivity and specificity of surveillance respectively. The annual incidence of SSI was 3.5 % of 368 operations after CRAN of them 1.1% superficial, 1.9% deep and 0.5% organ/space SSI. Klebsiella spp., represented 30.8%, Acinetobacter 23.1%, pseudomonas spp., 23.1%.The annual incidence of SSI is 2.9% of 590 operations after CABG of them 1.4% superficial and 1.5% deep SSI. Klebsiella spp., represented 33.3%, S. aureus 33.3%, Coagulase negative 13.3%. The annual incidence of SSI was 26% of 793 after EL of them superficial SSI was 19%, deep SSI was 5.3 and 1.9% organ/space SSI. Of those 97.1% were detected during the inpatient stay and 2.9% at readmission. Microbiological investigations were requested to all patients with SSI, 74.5% reported one organism and 13% reported 2 organisms. Distribution of microorganisms is as follows: E. coli 33.3%, Klebsiella spp. 30%, S. aureus 8.6%. Interventions were conducted to improve adherence with the timing of pre-operative antibiotic prophylaxis, peri-operative glycemic control, improving reporting of surveillance system, ensuring minimum requirements in terms of facilities and dedicated resources available. Interventions lowered the incidence of SSI from 43% in the first half, to 20% in the second half of the year. Risk factors for SSI were high ASA score, uncontrolled diabetes mellitus and emergency operations.
Conclusion: Surveillance of SSI could be successfully implemented and monitored. Results of surveillance were the basis of interventions that lowered the incidence of SSI. Interventions have successfully decreased the incidence of SSI from 42 to 20%.
Giuseppe Cannillo
Forza Vitale Italia Research Lab, Italy
Title: Enhancing antibacterial action of Origanum vulgare essential oil through a cationic nanoemulsion
Biography:
Giuseppe Cannillo is affiliared to Forza Vitale Italia Research Lab, Italy.
Abstract:
Current methods of sanitation of food facilities have some well-known drawbacks, such as toxicity of cleaning agents residues, or promotion of resistance to these agents in enteric pathogens. Therefore, there is a strong requirement to develop alternative sanitation and disinfection methods. A particularly challenging problem in many environments, including food processing areas, is the presence of biofilms. These accumulations of inorganic and organic materials and bacteria can develop on most types of surfaces. Both pathogenic and non-pathogenic microorganisms can be incorporated into biofilms during their progressive formation. Although biofilms can become strongly attached to surfaces, parts of the biofilm can occasionally slough off to contaminate other surfaces as well as food products, when in a food processing environment. Biofilms that contain Listeria , Pseudomonas, Campylobacter, Escherichia coli or Salmonella all have been observed in food processing environments. Biofilms are highly prevalent and difficult to remove and bacteria in them have enhanced resistance to antimicrobial agents and sanitizers. During recent years, plant essential oils have come more into the focus of phytomedicine. Especially, the antimicrobial and antioxidant activities of essential oils . The essential oil from the common herb Origanumvulgare may be an effective treatment against dangerous, and sometimes drug-resistant bacteria. Our research was centered on creating nanoemulsions that were able to enhance the antimicrobial activity of Origanumvulgare essential oil against pathogenic bacteria. Nanoemulsions are a vehicle for the delivery of anantimicrobial agent. The physical structure of the nanoemulsion contains surfactants and solvents that have antimicrobial activity. The surfactant activity specifically disrupts pathogenic microorganisms through fusion with the membrane of the microbe, leading to the rapid lysis of the targeted organism. This mechanism of action has been documented in preliminary studies examining the in vitro virucidal, bactericidal and sporicidal effects of these compounds. All Compounds used are classified as GRAS ( Generally Recognized As Safe) by the FDA and are all compounds used in the food industry.
Methods: Cationic Nanoemulsions were prepared by making stock solutions of 100 mg/ml ofOriganumvulgare essential oil. Samples of this solution was utilized as samples for serial dilutions. A macro-broth-dilution technique was used to determine the susceptibility of the bacteria to the essential oil of Origanumvulgare. The MBC was determined by subculturing a 0.01-mL volume of the medium drawn from the culture tubes after 48 h on Mueller Hinton Agar and incubated further for bacterial growth.
Conclusion: Our Research has confirmed that our Cationic Nanoemulsion of Origanumvulgare has a MBC of 7 ppm and a surface biofilm bactericidal activity time of 10 minutes.
Henrieta HudeÄková
Comenius University, Slovakia
Title: Measles elimination in Slovakia related to mass vaccination
Biography:
Henrieta HudeÄková is affiliated to Comenius University, Slovakia.
Abstract:
Measles is one of the most contagious diseases known affecting respiratory system. Currently the measles is eliminated in Slovakia since 1999. In this period, they were recorded only as imported and import-related cases. Our objectives were to describe the impact of vaccination strategy on measles incidence at national and regional levels and to assess the risk factors for measles infection. Our work is retrospective review of measles cases reported since January 1969 to December 2015. Measles reported cases are based on the standard criteria of ECDC. The data on morbidity were collected from the Epidemiological Information System of the Slovak Republic and data on the vaccination (according to the years of birth and the number of doses – MCV1 and MCV2) from the annual reports of administrative control of vaccination coverage. This study covers and compares periods: 1969-1984 (beginning of vaccination and its balance), 1985-1999 (decrease of endemic cases) and 2000-2015 (elimination of measles). The incidence of measles decreased during 1969-2015 mainly in the first (reported 108,091 cases; 145.4/100 000) and second (reported 2,474 cases; 3.1/100 000) period. In the third period only 23 import and import-related cases were reported. The highest age specific incidence was in the age group 0-4. The vaccination coverage was at the highest level (98-99%) in the long term, in the last three children cohorts (born in 2011, 2012, 2013) decrease to 96.8-93.9%. Our analysis showed the positive impact of vaccination on the epidemiological situation and increase of anti-vaccination activities and risk population (Romany population and migrants).
This work was supported by the Slovak Research and Development Support Agency under the Contract No. APVV-0096-12 (EPIBIOMAT).
Veronika Szabóová
Comenius University, Slovakia
Title: Estimation of measles susceptibility in population of Slovakia: the cohort model
Biography:
Veronika Szabóová is affiliated to Comenius University, Slovakia.
Abstract:
Recently, thanks to immunization, no cases of measles have been reported in Slovakia. Information on the immune status of the population is important to prevent possible re-emergence of the disease. However, the last nationwide immunological survey in Slovakia was carried out in 2002. This work estimates current (2014) measles susceptibility in individual age groups using mathematic modelling. The analysis is based on administrative data on vaccination coverage, the immunological survey from 2002 and demographic data on age structure of the Slovak population. The cohort model considered changes since 2002: new single dose vaccinated cohorts (born 2000–2012) and cohorts vaccinated with the second dose (born 1989–2002). In other cohorts, immunity naturally partially waned and the proportion of cohorts with more effective post-infection immunity (naturally infected) declined. In 2002, there were approximately 241,000 susceptible individuals (approximately 4.5% of the population) in Slovakia. Most of them, besides children aged under one year and yet not vaccinated, were aged 17–34. In 2014, there were approximately 383,000 susceptible individuals (approximately 7.1% of the population), mostly non-vaccinated children up to one year and adults aged 30–45 years. These adults constituted the most prevalent susceptible cohort. The increased proportion of susceptible population is partially attributable to natural waning of the immunity in vaccinated individuals without natural contact with the disease. Therefore, in a potential epidemic outbreak, alongside the unvaccinated, 30–45 year old individuals (cohort born 1969–1984) will be the most endangered. Although the mathematic modelling, due to its limitations, cannot fully substitute the immunological survey, the estimations can sufficiently identify the endangered population cohorts to adjust the vaccination policy appropriately.
This work was supported by the Slovak Research and Development Support Agency under the Contract No. APVV-0096-12 (EPIBIOMAT).
Sile O Connor
University Hospital Kerry, Ireland
Title: Can local education initiatives and better access to sepsis treatment recommendations improve knowledge and build resilience in the emergency department?
Biography:
Sile O'Connor is an Antimicrobial Pharmacist at the University Hospital Kerry. She has qualified as a Pharmacist in 1991 and has a PhD from Trinity College Dublin. She has numerous publications, specializing in multidisciplinary initiatives in the fields of quality improvement, antimicrobials and addiction.
Abstract:
Background: Sepsis is a time dependent medical emergency with a fatal outcome in almost 30% of instances within the Irish healthcare setting. Evidence from the UK has shown the Sepsis 6 Care Bundle can reduce sepsis mortality to 20%. Each hour of delay in antimicrobial administration reduces survival. In 2014, the Irish Department of Health & Children published its first sepsis guidelines. Implementation of these can improve outcomes for patients attending the Emergency Department (ED) at University Hospital Kerry (UHK). However, in 2010 the UK Surviving Sepsis Campaign reported compliance rates of only 31%. This study explored the impact of education and the implementation of standardized sepsis treatment pathways on the knowledge and confidence of ED staff at UHK.
Aims: This study aimed to improve quality of care by ensuring ED staff are aware of and can access sepsis treatment recommendations and guidelines. Additionally, it aimed to improve staff resilience by a supporting them in recognizing sepsis, standardizing sepsis treatment pathways and improving the communication of treatment recommendations.
Method: The study investigated baseline awareness of sepsis among ED staff, with a follow up exploration of their attitudes and awareness after an education intervention was performed. A final structured survey was undertaken after standardized treatment pathways, visual aids, prescribing prompts and antimicrobial recommendations were made available and additional education had been provided.
Results: The study reported improved sepsis awareness and knowledge of sepsis care elements among ED staff (from 47% to 94%), better compliance with local sepsis treatment recommendations (from 46% to 60%) and increased self-reported confidence in identifying and managing sepsis (from 39% to 70%) over the course of this intervention.
Conclusion: This work suggests that local, in-house, multi-departmental initiatives can improve quality care in the treatment of sepsis and strengthen staff resilience in the ED setting.
Taimur S Butt
King Faisal Specialist Hospital and Research Centre, KSA
Title: Infection control practices implemented to reduce transmission risk of MERS-CoV in a tertiary care institution, Saudi Arabia
Biography:
Taimur S Butt is a graduate of King Edward Medical College, Lahore. He has completed his Residency training from University of Connecticut, Farmington, CT, USA. He has worked as Emergency Medicine Consultant in States of Kentucky, Ohio, Michigan and have been the Medical Director, Emergency Department of Mary Chiles Hospital, KY; Fayette Memorial Hospital, OH and Mercy Hospital, OH, USA. He is currently an Associate Professor at Al Faisal University & Member, of Editorial Board, Annals of Saudi Medicine.
Abstract:
Transmission of Middle East Respiratory Syndrome-Coronavirus (MERS-CoV) among health care workers (HCWs) and patients has been documented with mortality rate approximating 36%. We propose ‘Advanced-Infection Control Measures’ (A-IC) used in conjunction with ‘Basic-Infection Control Measures’ (B-IC) help reduce pathogen transmission. B-IC include standard and transmission based precautions. A-IC are initiatives implemented within our centre to enhance effectiveness of B-IC. Our objective is to study effectiveness of combining B-IC and A-IC to prevent transmission of MERS-CoV to HCWs. A retrospective observational study was undertaken. A-IC measures include; administrative support with daily rounds, infection control risk assessment, timely screening, isolation and specimen analysis, collaboration, epidemic-plan, stock-piling, implementation of contingency plan, full PPE use for advanced airway management, real-time electronic isolation flagging system, IC team on-call, pre-transfer MERS-CoV testing, education. Total of 874 real-time PCR MERS-CoV tests were performed from July 01, 2013 to January 31, 2015. 694 non-HCWs were tested; of these 16 were MERS-CoV positive and community-acquired. 69% of the confirmed MERS-CoV positive cases were male with an average age of 56 years (range: 19-84 years). Of the total tested for MERS-CoV 180 were HCWs with zero positivity. In conclusion, adhering to a combination of B-IC and A-IC reduces the risk of MERS-CoV transmission to HCWs.
Maimona Ahmed El Siddig El Imam
Sudan University of Science and Technology, Sudan
Title: Emergence of vancomycin resistant and methicillin resistant Staphylococcus aureus in patients with different clinical manifestations in Khartoum State, Sudan
Biography:
Maimona Ahmed El Siddig El Imam is currently a PhD student in Sudan University of Science and Technology. She has completed her Master degree in 2012 from Sudan University of Science and Technology, Sudan. She has worked at Research Laboratory in Sudan University as Research Assistance from 2009-2013 and She is working as a Medical Lab Technologist in Rashid Hospital since 2013. She has obtained her BSc degree in Medical Microbiology from Ahlia University in Khartoum, Sudan.
Abstract:
Staphylococcus aureus, a major cause of potentially life threatening infections acquired in healthcare and community settings has developed resistance to most classes of antimicrobial agents as determined by the dramatic increase. The present study aimed to determine the prevalence of MRSA and VRSA in patients with different clinical manifestations in Khartoum State. The study population (n=426) were males and females with different age categories, suffering either from wound infections (105), ear infections (121) or UTI (101), in addition to nasal carriers of medical staff (100). Cultures, Gram staining and other biochemical tests were performed for conventional identification. Modified Kirbry-Bauer disk diffusion method was applied and DNA was extracted from MRSA and VRSA isolates and PCR was then performed for amplification of arc, mecA, VanA and VanB genes. The results confirmed the existence of S. aureus in 49/426 (11.5%) cases among which MRSA were isolated from 34/49 (69.4%) when modified Kirbry-Bauer disk diffusion method was applied. Ten out of these 34 MRSA were confirmed as VRSA by cultures on BHI agar containing 6 μg per ml vancomycin according to NCCLS criteria. PCR revealed that out of the 34 MRSA isolates, 26 were mecA positive (76.5%) while 8 (23.5%) were arc positive. No vanA or VanB genes were detected. Molecular method confirmed the results for MRSA through the presence of either arcC or mecA genes while it failed to approve the occurrence of VRSA since neither VanA or VanB genes were detected. Thus, VRSA may be attributed to other factors.
Biography:
Mohamed Shahat Badawy Ahmed has completed his PhD from South Valley University and Postdoctoral studies from Sohag Faculty of Medicine. He is the Director of Chest diseases and Consultant of Chest Diseases at Luxor International Hospital. He has published more than 20 papers in reputed journals and has been serving as an Editorial Board Member of repute.
Abstract:
Background: Ventilator associated pneumonia (VAP) remains an area of active clinical research with little data about effect of (VAP) on outcome among patients with acute exacerbation of chronic obstructive pulmonary disease.
Materials & Methods: A prospective study included patients with COPD exacerbation requiring endotracheal intubation for more than 48 hours. Clinical assessment and quantitative culture has been done for all patients for the occurrence of VAP.
Results: Out of one hundred fifty two patients 92 patients (60.5%) were with VAP diagnosis. Their mean age was 56.1±15.02 (38 cases developed early while 54 cases developed late VAP). Forty eight cases were discharged (54%) while 44 cases (46%) died. In comparing mean age of both groups 45.08±15.52 and 57.41±16.34 with P value=0.003. Prolonged use of antibiotics, reintubation and steroid use are possible risk factors for VAP with significant P values 0.03, 0.001, 0.05 respectively. Age above vs. below 60 showed adjusted odds ratio 5.33; 95% confidence interval 1.59-7.83 with P value=0.007. Early vs. late VAP and prolonged use of antibiotics vs. none showed significant odds ratio 0.32; 95% CI 0.13-0.76, odds ratio 2.85; 95% CI 1.07-7.59 with P values 0.01, 0.04 respectively.
Conclusions: Old age, late onset VAP, re-intubation and prolonged use of antibiotics were predictors of mortality in VAP patients with AECOPD.
Gehad T El-Sherbini
Cairo University, Egypt
Title: Anthelmintic activity of unripe Mangifera indica L. (Mango) against Strongyloides stercolaris
Biography:
Gehad T El-Sherbini is affiliated to Cairo University, Egypt.
Abstract:
Infections with Strongyloides stercoralis and other helminths represent important, yet often neglected issues in developing countries. Indeed, strongyloidiasis can be fatal, but only a few studies provide information regarding its health relevance in Africa. Strongyloides stercoralis is an intestinal nematode that can persist in the human host for decades after the initial infection and can progress to fulminant hyper infection syndrome in immunocompromised hosts and the rapid development of nematode resistance to anthelmintics has limited the success of control in several countries, stimulating the search for alternatives. In this study, extracts of immature fruits of the mango Mangifera indica L. were evaluated for inhibition of larval development. In the phytochemical analyses, tannins and flavonoids were the metabolites identified. Aqueous extracts of immature fruits at 100 mg ml−1 showed 100% inhibition of larval development. The LC90 of the extract was 35.9 mg/ml−. In vitro results indicate that this fruit could assist Strongyloides stercoralis control.
Mohammed Yahoob Syed Ali
Mohamed Sathak college of Arts and Science, India
Title: Regeneration of heart and liver from zebra fish using gold synthesis particle from padina gymnospora marine algae in vivo
Biography:
Syed Ali M is now currently working as the Head of the department and Research Department of Biotechnology at Mohamed Sathak College of Arts and Science (Affiliated to University of Madras), Chennai, India. He had completed Phd in Oceanography – Marine Biotechnology 2011 (Title: Screening of various biological resources from Gulf of Mannar for the management of Dengue fever) and also Master of Philosophy and Master of Science in Marine Biotechnolgy, 2006. He had published 4238 international publication in peer reviewed journals and also contributed three book chapter. He is the member of five scientific committee to all over the world especially European Society of Clinical Microbiology and Infectious Disease, Europe (Member ID: 123822) and Advisory Board Member of all of the world.
Abstract:
The zebrafish, Danio rerio, is a small teleost fish originating from the rivers of northern and eastern India (Engeszer et al. 2007). It possesses a number of advantageous physical characteristics that have resulted in its common use today as a laboratory model. The present study was aimed to identify the heart and liver regeneration in zebra fish using biosynthesis gold nanoparticles from Sargassum sps. Of the selected seaweed extract showed the maximum synthesis of silver nanoparticles. This work focused on the activity of these compounds when incorporated into the zebrafish (Danio rerio) system. We began investigating the in vivo assay effect of these Hepatocyte Viability Staining After H2o2 Treatment, Cardiomyocyte Response to Ca++, Cardio vascular heart rate activity by measuring hypertrophy, Cardio vascular pathology and cardio vascular regeneration, Liver regeneration and Liver pathology, Molecular pathway target identification and Hypothesis on Interacting Domain (Agno3) of the vertebrate model organism. The FTIR results of most potent leaf extract-synthesized silver nanoparticles showed the prominent peaks (range between 620.967 to 2,854.14) Further, the results of XRD analysis showed the 2h intense values (38.11 and 70.57) within the ranges of Bragg’s reflection. In addition, the SEM analysis showed the results of particle sizes (50–100 nm). It can be concluded from the present findings that, the biosynthesis of gold nanoparticles from the seaweed extract of Padina gymnospora. Can be used as potential exploring its cardioprotective and liver protective ability using zebra fish as model organism.
Ould Yeru Karima
University of Mascara, Algeria
Title: Salmonella sp. and the essential oil of aromatic plant in rats Wistar infected
Biography:
Ould Yeru Karima is a student in Faculté Science, Department of Biology, University of Mascara, Algeria.
Abstract:
Laurus nobilis is an aromatic plant, widespread in Algeria and widely used by local people as a source of spice and for its medicinal properties. The essential oil of this plant native to western Algeria is the subject of our study. The essential oil extraction was performed by steam distillation, the yield obtained from leaf is (1.5%) by gavage Wistar rats males weight between 100 g 80 et were infected with Salmonella then treated with a dose 1 g/kg of the essential oil. After sacrifice of the rats, histological examination of the intestines and internal organ (liver and spleen) shows the therapy of this magic plant "Laurus nobilis"
Ould Yeru Karima
University of Mascara, Algeria
Title: Chemical composition and antibacterial activity of essential oil of Laurus nobilis from Algeria
Biography:
Ould Yerou Karima is a student in Faculté Science, Department of Biology, University of Mascara, Algeria.
Abstract:
Dried leaves and the essential oil (EO) of bay (Laurus nobilis L.) are used extensively in the food industry for seasoning of meat products, soups and fishes, this essential oils was extracted from leaves by hydrodistillation. The yield was 1%. The aim of this study was to evaluate the antibacterial activity of this essential oils against three bacterial strains Staphylococcus aureus, Escherichia coli and Pseudomonas aeruginosa. Orted that the high content of 1,8-cineole in the EO of L. nobilis L. contributed to its weak antimicrobial activity.