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  Table of Contents  
RESEARCH SNIPPET
Year : 2013  |  Volume : 31  |  Issue : 3  |  Page : 322-324
 

Research Snippets


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Date of Web Publication25-Jul-2013

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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0255-0857.115676

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How to cite this article:
Desikan P. Research Snippets. Indian J Med Microbiol 2013;31:322-4

How to cite this URL:
Desikan P. Research Snippets. Indian J Med Microbiol [serial online] 2013 [cited 2020 May 30];31:322-4. Available from: http://www.ijmm.org/text.asp?2013/31/3/322/115676


Despite its aim to be rabies free by 2015, Bali was challenged by another rabies case. On the 16 th of July, 2013, a rabid dog bit five people in Gianyar regency. The remains of the dog were examined by the Denpasar Veterinary Board, which concluded that the dog was infected with rabies. The first rabies outbreak in Bali occurred in 2008 in Ungasan village. Since then, Bali has gone through 3 stages of mass vaccinations for dogs, monkeys and cats, all of which are believed to be rabies carriers. This year 2013, the fourth stage of the mass vaccination is under way to inoculate 250 000 of the 350 000 dog population(http://www.thejakartapost.com/news/2013/07/18/rabies-haunts-island-again-rabid-dog-bites-five-residents-gianyar.html). Vaccination of domestic pets is an important component of rabies control and prevention in countries where the disease is maintained in a wildlife reservoir. In Grenada, vaccine coverage rates were low, despite extensive public education and advertising of government-sponsored vaccine clinics where rabies vaccine is administered to animals at no cost to animal owners. In order to understand the reasons for decreased dog owner participation in government-funded rabies vaccination clinics, 120 dog owners from 6 different parishes were asked to complete a questionnaire regarding beliefs about rabies vaccination and perception of the risk posed by rabies. Over 70% of respondents believed that problems in the organization and management of clinic sites could allow for fighting between dogs or disease spread among dogs, while 35% of owners did not believe that they had the ability or adequate help to bring their dogs to the clinic sites. Recommendations for improving vaccine coverage rates included improved scheduling of clinic sites and dates; increased biosecurity at clinic locations; focused advertising on the availability of home visits, particularly for aggressive dogs or dogs with visible skin-related diseases such as mange; and the recruitment of community volunteers to assist with bringing dogs to the clinic sites (Prev Vet Med. 2013 Jul 1;110(3-4):563-9).

In Britain, the incidence of confirmed parvovirus B19 infected cases was relatively high in 2012, peaking in the 2 nd quarter of the year. In 2013, Parvovirus B19 activity has followed a similar pattern of increase, with a rise in confirmed cases observed in March which was sustained through to May 2013. This period of increased activity has been widespread across England (http://www.hpa.org.uk/hpr/archives/2013/news2913.htm#prvrsb19). Parvovirus B19 is the causative agent of fifth disease in children, aplastic crisis in those with blood dyscrasias, and hydrops fetalis. Previous parvovirus B19 virus-like-particle (VLP) vaccine candidates were produced by co-infection of insect cells with two baculoviruses, one expressing wild-type VP1 and the other expressing VP2. In humans, the VLPs were immunogenic but reactogenic. Now, new VLP-based parvovirus B19 vaccine candidates, produced by co-expressing VP2 and either wild-type VP1 or phospholipase-negative VP1 in a regulated ratio from a single plasmid in Saccharomyces cerevisiae have been developed. These VLPs are expressed efficiently, are very homogeneous, and can be highly purified. Although VP2 alone can form VLPs, in mouse immunizations, VP1 and the adjuvant MF59 are required to elicit a neutralizing response. Wild-type VLPs and those with phospholipase-negative VP1 are equivalently potent. The purity, homogeneity, yeast origin, and lack of phospholipase activity of these VLPs address potential causes of previously observed reactogenicity (Vaccine. 2013 Jul 1. pii: S0264-410X(13)00854-2. doi: 10.1016/j.vaccine.2013.06.062. [Epub ahead of print]).

Up to 20 people who underwent surgery with equipment used on patients at Dublin's Beaumont Hospital. with Creutzfeldt-Jakob disease (CJD) were contacted to warn them they need to be tested for the disease. The Health Service Executive stated that assessments were under way to see if any other patients had been put at risk of contracting CJD.The average rate of CJD in Ireland is about one in a million people a year. Patients contacted by the HSE will be told they will need to be monitored over the long term with the possibility that they will undergo medical examinations for the rest of their lives (http://www.irishmirror.ie/news/irish-news/health-news/fears-up-20-people-involved-2063698).

In most forms of prion disease, infectivity is present primarily in the central nervous system or immune system organs such as spleen and lymph node. However, a transgenic mouse model of prion disease has demonstrated that prion infectivity can also be present as amyloid deposits in heart tissue. Deposition of infectious prions as amyloid in human heart tissue would be a significant public health concern. Although abnormal disease-associated prion protein (PrP Sc ) has not been detected in heart tissue from several amyloid heart disease patients, it has been observed in the heart tissue of a patient with sporadic Creutzfeldt-Jakob Disease (sCJD), the most common form of human prion disease. In order to determine whether prion infectivity can be found in heart tissue, formaldehyde fixed brain and heart tissue from two sCJD patients, as well as prion protein positive fixed heart tissue from two amyloid heart disease patients, were inoculated into transgenic mice overexpressing the human prion protein. While the sCJD brain samples led to clinical or subclinical prion infection and deposition of PrP Sc in the brain, none of the inoculated heart samples resulted in disease or accumulation of PrP Sc . These results suggest that prion infectivity is not likely present in cardiac tissue from sCJD or amyloid heart disease patients (J Virol. 2013 Jun 19. [Epub ahead of print]).

Two people died from Legionnaires' disease at the Wesley Ridge Retirement Community, in Ohio, USA . A team of epidemiologists from the Centers For Disease Control and Prevention came to the property and took 80 water samples, according to the Franklin County Health Department. Since Legionnaires' disease may be transmitted through water droplets, like those from a showerhead, the retirement community hired a company to superheat all the water pipes, in addition to chlorinating the water (http://www.10tv.com/content/stories/2013/07/17/reynoldsburg-legionnaires-disease-outbreak.html). The reservoirs of Legionella are water, soil, potting soil and compost. Some species of free-living amoebae (FLA) that are naturally present in water and soil have been described as hosts for Legionella. A study, therefore, aimed to understand whether or not the composting facilities could be sources of community-acquired Legionella infections after development of bioaerosols containing Legionella or FLA. The study looked for the presence of Legionella (by co-culture) and FLA (by culture) in composts and bioaerosols collected at four composting facilities located in southern Switzerland. Legionella spp. (including L. pneumophila) were detected in 69.3% (61/88) of the composts and FLA (mainly Acanthamoeba, Vermamoeba, Naegleria and Stenamoeba) in 92.0% (81/88). L. pneumophila and L. bozemanii were most frequently isolated. FLA as potential host for Legionella spp. were isolated from 40.9% (36/88) of the composts in all facilities. In Legionella-positive samples the temperature of compost was significantly lower (P = 0.012) than in Legionella-negative samples. Of 47 bioaerosol samples, 19.1% (9/47) were positive for FLA and 10.6% (5/47) for L. pneumophila. Composts (62.8%) were positive for Legionella and FLA simultaneously, but both microorganisms were never detected simultaneously in bioaerosols. It was concluded that compost could release bioaerosol containing FLA or Legionella and could represent a source of infection of community-acquired Legionella infections for workers and nearby residents (PLoS One. 2013 Jul 2;8(7):e68244. doi: 10.1371/journal.pone.0068244).

The WHO has been informed of 6 additional laboratory-confirmed cases of infection with Middle East respiratory syndrome coronavirus(MERS-CoV). Of these, 2 cases have been reported from Saudi Arabia and 4 from the United Arab Emirates. Globally, from September 2012 till 18 th Jul 2013, a total of 88 laboratory-confirmed cases of infection with MERS-CoV, including 45 deaths have been reported to the WHO. Based on the current situation and available information, The WHO encourages all Member States to continue their surveillance for severe acute respiratory infections (SARI) and to carefully review any unusual patterns. Though the WHO does not advise special screening at points of entry with regard to this event nor does it currently recommend the application of any travel or trade restrictions, it has convened an Emergency Committee under the International Health Regulations (IHR) to advise the Director-General on the status of the current situation. The Emergency Committee, which comprises international experts from all WHO Regions, unanimously advised that, with the information now available, and using a risk-assessment approach, the conditions for a Public Health Emergency of International Concern (PHEIC) have not at present been met (http://www.who.int/csr/don/2013_07_18/en/index.html).

Respiratory syncytial virus (RSV) usually causes self-limiting upper respiratory tract infections, but can be associated with severe lower respiratory tract infection disease (LRTID) in infants and in patients with hematologic malignancies. A study analyzed the risk factors and the measures for containment within an outbreak of nosocomial RSV infections in a hematology unit. A total of 56 patients were affected (53 RSV-A and 3 RSV-B) including 32 transplant patients (16 allogeneic and 16 autologous). Forty (71%) of the 56 patients suffered from LRTID and 14 (35%) of the patients with LRTID subsequently died. However, because of concomitant infections with fungal and bacterial pathogens, the impact of RSV on the fatal outcome was difficult to assess. Multivariate analysis showed that low levels of IgG were significantly associated with fatal outcome , treatment with oral ribavirin represented a protective factor . An extremely protracted viral shedding was observed in this cohort of patients (median=30.5 days, range: 1-162 days), especially pronounced in patients after allogeneic transplantation. Implementation of rigorous isolation and barrier measures, although challenged by long-term viral carriers, was effective in containment of the outbreak (Bone Marrow Transplant. 2013 Jul 1. doi: 10.1038/bmt.2013.94. [Epub ahead of print]).

Premature infants in neonatal intensive care units (NICUs) are highly susceptible to infection due to the immaturity of their immune systems, and nosocomial infections are a significant risk factor for death and poor neurodevelopmental outcome in this population. To investigate the impact of cleaning within a NICU, a high-throughput short-amplicon-sequencing approach was used to profile bacterial and fungal surface communities before and after cleaning. It was found that intensive cleaning of surfaces in contact with neonates decreased the total bacterial load and the percentage of Streptococcus species with similar trends for total fungal load and Staphylococcus species. This may have clinical relevance since staphylococci and streptococci are the most common causes of nosocomial NICU infections. Surfaces generally had low levels of other taxa containing species that commonly cause nosocomial infections (e.g., Enterobacteriaceae) that were not significantly altered with cleaning. Several opportunistic yeasts were detected in the NICU environment, demonstrating that these NICU surfaces represent a potential vector for spreading fungal pathogens. These results underline the importance of routine cleaning as a means of managing the microbial ecosystem of NICUs and of future opportunities to minimize exposures of vulnerable neonates to potential pathogens. It also underscores the utility of amplicon-sequencing tools for microbial surveillance in hospital environments (J Clin Microbiol. 2013 Aug;51(8):2617-24. doi: 10.1128/JCM.00898-13. Epub 2013 Jun 5).

Candidemia is an important cause of morbidity and mortality in the healthcare setting. However, there is limited information about risk factors for such infection among elderly patients. A case-control study was conducted during the period 2008-2011. For each case, two controls were selected among patients admitted to the same hospital, and individually matched by sex, age, time of admission, hospital ward and hospitalisation duration. The adjusted odds ratio (OR) was calculated using multiple conditional logistic regression. 145 episodes of candidemia were identified, occurring in 140 patients with a median age of 80 years. Candida albicans caused 55% of all candidemia episodes. After adjustment, candidemia was strongly associated with duration of total and peripheral parenteral nutrition; presence of central vascular catheters and treatment with glycopeptide antibiotics. Duration of peripheral and total parenteral nutrition and antibiotics predicted over 50% of all candidemias. It was concluded that intervention studies were required to evaluate effectiveness of candidemia prevention by restricting parenteral nutrition, prompting earlier enteral feeding, and reducing use of antibiotics, especially glycopeptides, in elderly patients (Mycoses. 2013 May 16. doi: 10.1111/myc.12090. [Epub ahead of print]).

Nosocomial infection is among the most important causes of morbidity, prolonged hospital stay, increased hospital costs, and mortality in neonates, particularly those born preterm. An analysis using the worldwide database of health care-associated outbreaks (http://www.outbreak-database.com) found that there were a total of 590 neonatal outbreaks, of which 64 were caused by viruses, 44 of which (68.75%) were reported from neonatal intensive care units (NICUs). The 5 most frequent viral agents were rotavirus (23.44%), respiratory syncytial virus (17.19%), enterovirus (15.63%), hepatitis A virus (10.94%), and adenovirus (9.38%).The mortality rates reported in this analysis demonstrate the significance of noncongenital viral infections in NICUs and underline the need for more effective outbreak prevention strategies (Am J Infect Control. 2013 Apr 23. pii: S0196-6553(13)00189-2. doi: 10.1016/j.ajic.2013.01.026. [Epub ahead of print]).

Diagnosis of tuberculosis continues to be a challenge in more ways than one. In order to address this issue, and to improve the affordability of WHO-endorsed TB tests, a new initiative was launched in March 2013,. The Initiative for Promoting Affordable, Quality TB tests (IPAQT; www.ipaqt.org) is a coalition of private labs in India, supported by industry and nonprofit groups (e.g., Clinton Health Access Initiative), that has made WHO-endorsed tests available at affordable prices to patients in the private sector. IPAQT aims to facilitate the delivery of WHO-endorsed tests to TB patients at affordable prices and promote the use of WHO-endorsed TB tests by building awareness about these new, validated/endorsed tests among health providers, laboratories, and patients. Forty two labs across India are now involved. Any Indian lab can join IPAQT, as long as they fulfill the conditions outlined in the aforementioned website.




 

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