Day 1 :
Keynote: From Ebola what’s next - Hierarchy of microbicide resistance as a predictor of activity against emerging viruses
Time : 09:05-09:30
M Khalid Ijaz received DVM, MSc (Honours) from University of Agriculture, Faisalabad, Pakistan and completed Ph.D. in Microbiology and Immunology in 1985 at University of Ottawa, Canada. He did his post-doctoral work at the Vaccines and Infectious Disease Organization (VIDO), Canada. Currently, he’s Research Fellow at RB, Montvale, N.J. and Adjunct Associate Professor at The City University of New York (CUNY). His research focuses on human pathogenic microbial agents’ spread via the environment and mitigational role of hygiene agents. He is an active member of various scientific organizations including American for Microbiology, American Society for Virology, ASTM-International, Association of Professional for Infection Control and Epidemiology and International Society for Infectious Diseases.
A combination of factors has caused an upsurge in the emergence of infectious agents in the past few decades, with viruses representing nearly 67% of those recognized between 1980-2014; prominent among the newly discovered ones are the causes of AIDS, hepatitis C, pandemic influenza, Ebola virus and severe respiratory infections (e.g., SARS, Nipah, Hendra, MERS). Predictive modelling suggests that by 2020 another 10-40 new viruses will be discovered. Although vaccination, antiviral chemotherapy, control of insect vectors, screening of blood/tissues, and the use of barriers such as condoms can effectively interrupt virus dissemination, the use of microbicidal chemicals for environmental decontamination and hand hygiene in both domestic and institutional settings remains an essential preventive strategy to safe-guard public health. Consequently, national and international agencies including WHO emphasize the use of appropriate environmental surface disinfectants and antiseptics, in conjunction with proper hand hygiene, as essential and generic components of preventive strategies against viruses as well as other types of infectious agents. While most regulatory agencies normally register environmental surface disinfectants for sale based on testing against surrogate microbial agents, the U.S. Environmental Protection Agency (EPA) requires test data against each virus to be listed on product labels. Such a system makes selection of disinfectants difficult against emerging viruses. To address this, an interim guidance system against emerging viruses has been developed based on the known hierarchy of resistance/susceptibility of existing human pathogenic viruses to environmental surface disinfectants. This presentation will summarize this predictive approach and its applications to Ebola and other newly discovered viruses.
University Hospital Luigi Sacco, Italy
Time : 09:30-09:55
Guido Norbiato has completed his MD at the age of 25 years from University of Studies in Milan-Italy. Postdoctoral studies, Specialty of Endocrinology and Metabolism, Qualification for University teaching, Assistant professor from the University of Studies of Milan. He moved to L. Sacco University Hospital of Milan where he became Chief of the Endocrinology and Metabolism unit and founded the Laboratory of endocrinology, after he became Director of the Department of Specialistic Diseases. He published more than 140 articles and publications in internationally referred journals regarding endocrinology, metabolism, and autonomic, immune, inflammatory, vascular systems. With impact factor 600, he edited two books on endocrinology and metabolism in HIV infection.
AIDS-related illnesses are no longer the primary threat, but a new set of HIV-associated complications has emerged resulting in a novel chronic disease that for many HIV-infected people will span several decades of life. Deterioration of crucial homeostatic mechanisms in such disease invariably results in activation of inflammatory mediators, chronic inflammation, cellular aging, loss in immunological function, increased susceptibility to diseases, alteration of metabolism, decrease of energy production and neuro-cognitive decline. Owing the complexity of the systems involved in such disease, substantial limitation of current therapeutic approach persists. We propose here a treatment with stem cells differentiation stage factors taken from zebrafish embryos which are able to regulate in different, specific way the genes expression of normal and pathological stem cells. Exposure to early developmental stage of zebrafish embryo growth and differentiation factors may enhance stem cell expression of multipotency and activate both telomerase-dependent and -independent antagonists of cell senescence. Factors taken from late stages of cell differentiation can be used to control cell proliferation of tumor cells. All factor networks are able to prevent neuro-degeneration and other degenerative phenomena present in chronic diseases and to maintain the homeostasis of neuro-endocrine-immune- metabolic mechanisms disrupted by stress and other threatening situation . Our research aims to provide novel insight regarding the potential combination of epigenetic reprogramming mechanisms in controlling plasticity and pluripotencies of stem cells population and define stem cells differentiation factors capable in repairing different pathological stem cells which are at the origin of many chronic diseases.
- Track 01: Global trends in Emerging Infectious Diseases
Track 02: Microbial Pathogenesis and Virulence
Track 03: Immunology of Infections
Track 04: Mechanism of Resistance
Track 07: Noscomial Infections
Track 10: Infectious Diseases in Animals
Sanofi Pasteur, France
University of Cambridge, UK
Dutch Armed Forces/Royal Dutch Navy, Netherlands
Time : 09:55-10:30
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. He is strategic functional specialist for “Health & Environment” of the 1-Civil-Military-Interaction Command (1-CMI) of the Dutch Armed Forces and for 2015 also in the NATO Response Force (NRF), which is in 2015 the responsibility of the 1-German-Netherlands-Corps (1-GNC). He was the director of the 2014 World Congress of CBRNe Science & Consequence Management in Tbilisi, Georgia. In his civil career he works internationally as consultant or as scientific supervisory board member for several medical and biotech companies, merely involved in biodefense. He is also visiting professor for Punjab University in Pakistan and Rhein-Waal University in Germany. He has finished his studies in Medicine and in Biochemistry at the University of Groningen in The Netherlands and has extensive practical experience in cell biology, immuno-haematology, biodefense and transfusion medicine. His natural business acumen and negotiation competence helps to initiate new successful businesses, often created out of unexpected combinations of technologies. His good understanding of abstract science combined with excellent skills in the communication of scientific matters to non-specialists, helps him with strategic consulting at top level management.
Public health systems are not always prepared for huge outbreaks of infectious diseases. Although the in the 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 Worldwide Public Health. 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 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 haemorrhagic 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.
University of Cambridge, UK
Time : 10:50-11:10
Pietro Mastroeni received Degree in Medicine and Surgery from the University of Messina, Italy. He moved to the University of Cambridge, UK where he completed his Ph.D. before becoming a Research Fellow at Imperial College, University of London UK. He is currently a Reader in Infection and Immunity at the University of Cambridge. He has published more than 100 papers in reputed journals and served as an editorial board member.
Typhoid fever and non-typhoidal salmonelloses are responsible for a large disease burden worldwide and can coexist in the same geographical area. Vaccination remains the most feasible means to counteract Salmonella infections. Live attenuated vaccines induce both antibody and protective Th1 responses that are essential to control bacteraemia during a secondary challenge and restrain growth and inter-organ spread of the bacteria in the systemic organs. One of the concerns over the use of live vaccines is their potential residual virulence, especially in areas of the world where comorbidities and immunodeficiences are prevalent and in many cases undiagnosed. We have therefore searched for Salmonella genes that can be deleted to generate live attenuated vaccines with increased safety in situations where the immune system is impaired. We have used a global approach based on Transposon Directed Insertion site Sequencing (TraDIS) to gain a numerical measure of the extent to which mutants are negatively or positively selected during infection in wild-type mice and in gene-targeted mice representative of common immunodeficiencies that predispose to salmonelloses. We have identified gene candidates that can be deleted to construct live vaccines with reduced and/or delayed reactogenicity in immunodeficient hosts. One of these vaccine strains has been further tested in immunocompromised mice and has shown increased safety as measured by delayed appearance of signs of infection in comparison with other established single mutant vaccine candidates. This mutant colonises mice via the oral and parenteral route and confers protection against lethal oral challenge with virulent Salmonella.
Sanofi Pasteur, France
Title: Mechanisms of protection mediated by Streptococcus pneumoniae PcpA- and PhtD-specific antibodies
Time : 11:10-11:30
Lucian Visan has completed his Ph.D in immunology at Würzburg University, Germany, and moved to Mount Sinai Hospital, University of Toronto for postdoctoral studies. He is now a researcher at Sanofi Pasteur where he leads an immune-bacteriology research unit working on vaccine projects. He has over 10 years of experience in therapeutic and prophylactic vaccines ranging from cancer to infectious diseases.
The current marketed pneumococcal conjugate vaccines confer protection against up to 13 serotypes out of over 90 serotypes of Streptococcus pneumoniae. It is thought that replacement of vaccine serotypes with non-vaccine serotypes will negatively impact the efficacy of current pneumococcal conjugate vaccines. Sanofi Pasteur is developing a recombinant pneumococcal protein based vaccine including pneumococcal choline binding protein A (PcpA), pneumococcal histidine triad protein D (PhtD) and detoxified pneumolysin which are conserved proteins across serotypes, with potential for universal coverage against S. pneumoniae infections. Mice challenged intravenously with a lethal dose of S. pneumoniae are 100% protected against sepsis upon administration of PcpA- and PhtD-specific antibodies. To investigate the mechanism of protection mediated by PcpA and PhtD antibodies, we addressed the role of complement, the spleen, neutrophils and macrophages in deletion experiments by abrogating each of these immune components or combinations thereof in mice. Our data clearly shows that the protection mediated by the PcpA- and PhtD-specific antibodies is complement and macrophage dependent, because in their absence protection was abrogated. In contrast, splenectomized and neutrophil-depleted mice remained fully protected, implying that while they may contribute to protection their role is not indispensable. Our results provide an experimental framework for possible mechanisms of protection against pneumococcal disease exploited by vaccination with recombinant pneumococcal PcpA and PhtD proteins.
Technical University of Denmark, Denmark
Time : 11:30-11:50
Anders Stockmarr completed his PhD in 1996 at the University of Copenhagen, Denmark. He has since worked with both theoretical and applied statistics, in particular, but not exclusively, in a biological setting, including human biology, plant biology and veterinary biology and epidemiology. He now serves as a senior researcher at the Technical University of Denmark in Lyngby, Denmark. He is the author of more than 40 scientific journal papers, published in a wide range of journals that covers a broad range of science disciplines.
Bluetongue is an insect-borne viral disease that affects ruminants, primarily sheep, cattle and goats, caused by the Bluetongue virus and transmitted by biting midges. Bluetongue outbreaks have a huge economic impact, and the cost of outbreaks in the Netherlands in 2006 and 2007 alone has been estimated to around 200 million euros. Over the last decade, Bluetongue virus has spread northwards from the Mediterranean area. Initially this was ascribed to climate changes, but it has since been realized that a major contributing factor has been new transmitting vectors, Culicoides obsoletus and Culicoides pulicaris, which have the ability to acquire and transmit the disease. Recently, Schmallenberg virus has emerged in Northern Europe transmitted by biting midges as well. This introduces the virus into a new environment where measures have to be taken to monitor and prevent the disease, and little is known about the behavior of the vector in the presence of host animals. This paper presents an analysis of field study data for biting midges in the presence of sheep, using recently developed analytical techniques for spatiotemporal analysis. The result suggest how one can monitor diseases like Bluetongue and Schmallenberg virus locally around host animals by monitoring the vector, and estimates the relative disease pressure under varying meteorological conditions. This work is joint with Carsten Kirkeby and Rene Bodker.
Medical University of Bialystok, Poland
Time : 11:50-12:10
Anna Moniuszko Malinowska is a medical doctor, who has completed her studies in 2005. She defended Ph.D at the age of 27 years from Medical University of Bialystok, Poland and carries on clinical research on infectious diseases, especially on tick-borne diseases. She has published more than 70 papers in reputed journals and serving as a reviewer in many journals.
Tick-borne encephalitis (TBE) is a preventable disease. However, it is rapidly becoming a growing public health problem in Europe and other parts of the world. It’s endemic in 27 European countries. The total annual number of cases is estimated to be up to 10,000 in Russia and about 3,000 in European countries. TBE may take various courses with different severity (meningitis, meningoencephalitis, meningoencephalomyelitis or meningoencephalo-radiculitis). The fatality rate in adult patients is less than 2%. However, severe courses of TBE infection with higher mortality and long-lasting sequelae often affect the patient’s quality of life. So far no causal treatment is known but a very efficient and well-tolerated vaccination is available for protection against the disease. Vaccination is recommended to children and adults living in or travelling to endemic areas. Only in Austria, Finland, Germany, Hungary, Latvia, Slovenia, Russia and Switzerland, TBE vaccination is included in an official governmental vaccination programme under certain conditions. In the remaining European countries, it is available as an optional vaccination, partly recommended, but not reimbursed by health insurance companies. In Poland, only forest worker are vaccinated obligatory, and we observe TBE in them rarely. In other groups we observe fatal cases, severe sequelaes (neurological, psychiatric), which affects everyday life. The aim of this lecture is to increase awareness of anti-TBE vaccination need in all endemic countries.
Priness Royal University Hospital, UK
Title: Lessons learnt in a 17 year old with fever of unknown origin – Haemophagocytic lymphohistiocytosisthe most fatal outcome of Ebstein-barr virus infection
Time : 12:10-12:30
Hajir Ibraheim is an ambitious 4th year junior medical doctor working in London. She has two publications in press and has presnetd multiple posters and presentations on a national and international level. She is planning to undertake a masters in clinical research next year before pursuing a speciality post in gastroenterology.
We report a young patient who had persistent fevers as a result of the most fatal outcome of an Ebstein-Barr Virus infection -haemophagocytic lymphohistiocytosis (EBV-HLH). A 17 year old girl with a background of IgG subclass deficiency presented to the accident and emergency department with a history of fevers, sore throat and vomiting. Her blood tests showed an abnormal liver function and cytopenia. The clinical impression was of EBV related infectious mononucleosis and this was supported by a positive monospot test and high EBV DNA titres. Despite a decreasing level of EBV titres, she remained febrile and tachycardic with worsening liver function and no improvement on broad spectrum antibiotics and anti-virals. Repeated septic screens were negative and other viral infections were excluded. By day 16, HLH was considered by the haematologists. A bone marrow biopsy then showed haemphagocytosis and repeat abdominal imaging showed new hepatosplenomegaly. She was started on steroids with a rapid clinical and biochemical response. This case highlights the importance of having a low threshold of suspicion for EBV-HLH in patients with EBV that continue to deteriorate. The high mortality rate in this rare condition is partly due to delayed diagnosis as EBV-HLH can mimic other infectious or inflammatory disorders.
McGill University, Canada
Title: Coordinated rearrangements between cytoplasmic and periplasmic domains of the membrane protein complex ExbB-ExbD of Escherichia coli
Time : 12:30-12:50
Sofia Khalil was born on 9 August 1978 in Egypt. After graduation in Biochemistry Science in 1999, she conducted her master studies in the Biochemistry department, Faculty of Science, Alexandria University in Egypt (2000-2004). She continued in her academic career by conducting her PhD studies at Chemistry and Biochemistry department, Concordia University, Montreal, Canada (2006-2010). Her research interest focused on the protein-protein interaction networks in E. coli. She had a postdoctoral position in the Microbiology and Immunology department, Faculty of medicine at Mc Gill University, Montreal, Canada (2011). Finally she has worked in a lecturer position at Biochemistry department, Faculty of Science, Alexandria University in Egypt (2012 up to now).
In gram-negative bacteria, the transport of larger essential nutrients such as ferric siderophores or vitamin B12 depends on TonB-dependent transporters. These transporters bind their substrates with high affinity and ensure transport by contacting the Ton system, an energy transduction complex. The required energy obtained from the chemiosmotic gradient maintained across the cytoplasmic membrane. TonB, in complex with ExbB and ExbD, transduces this energy causing conformational rearrangements at the periplasmic face of outer membrane receptors and thereby facilitating passage of nutrients into the periplasm. Despite decades of research, the stoichiometry, subunit organization, and mechanism of action of the membrane proteins of the Ton system remain unclear. We copurified ExbB with ExbD as a ∼240 kDa protein-detergent complex, measured by light scattering and by native gels. Quantitative Coomassie staining revealed a stoichiometry of ExbB4-ExbD2. Negative stain electron microscopy and 2D analysis showed particles of ∼10 nm diameter in multiple structural states. Nanogold labeling identified the position of the ExbD periplasmic domain. Random conical tilt was used to reconstruct the particles in three structural states followed by sorting of the single particles and refinement of each state. The different states are interpreted by coordinated structural rearrangements between the cytoplasmic domain and the periplasmic domain, concordant with in vivo predictions.
Universiti Sains Malaysia, Malaysia
Title: Molecular diversity of Mycobacterium tuberculosis complex isolated from pulmonary tuberculosis cases in Malaysia
Time : 12:50-13:10
Siti Suraiya has obtained her MD way back in 1995, later obtained her Master Pathology in 2003 and finally acquired her PhD in 2014 from Universiti Sain Malaysia, USM. She is currently a senior lecturer at Medical School, Universiti Sains Malaysia (USM), and at the same time head of Unit, Infection Control Unit, Hospital Universiti Sains Malaysia (HUSM). She has published more than 25 papers in reputed journals and has been serving as an editorial board member for several journals.
Tuberculosis (TB) still constitutes a major public health problem in Malaysia. The identification and genotyping based characterization of Mycobacterium tuberculosis complex (MTBC) isolates causing the disease is important to determine the effectiveness of the control and surveillance programs. This study intended a first assessment of spoligotyping-based MTBC genotypic diversity in Malaysia followed by a comparison of strains with those prevailing in neighboring countries by comparison with an international MTBC genotyping database. Spoligotyping was performed on a total of 220 M. tuberculosis clinical isolates collected in Kelantan and Kuala Lumpur. The results were compared with the SITVIT2 international database Results: Spoligotyping revealed 77 different patterns: 22 corresponded to orphan patterns while 55 patterns containing 198 isolates were assigned a Spoligo International Type (SIT) designation in the database (the latter included 6 newly created SITs). The eight most common SITs grouped 141 isolates (5 to 56 strains per cluster) as follows: SIT1/Beijing, n=56, 25.5%; SIT745/EAI1-SOM, n=33, 15.0%; SIT591/EAI6-BGD1, n=13, 5.9%; SIT256/EAI5, n=12, 5.5%; SIT236/EAI5, n=10, 4.6%; SIT19/EAI2-Manila, n=9, 4.1%; SIT89/EAI2-Nonthaburi, n=5, 2.3%; and SIT50/H3, n=3, 1.4%. The association between city of isolation and lineages was statistically significant; Haarlem and T lineages being higher in Kuala Lumpur (p<0.01). However, no statistically significant differences were noted when comparing drug resistance vs. major lineages, nor between gender and clades. We conclude that, the ancestral East-African-Indian (EAI) lineage was most predominant followed by the Beijing lineage. A comparison of strains with those prevailing in neighboring countries in South Asia, East Asia and South East Asia underlined the phylogeographical specificity of SIT745 for Malaysia, and its probable ongoing evolution.
The Chinese University of Hong Kong, Hong Kong
Title: Fungicidal effect of bovine lactoferrin fragments in human pathogenic fungus (Candida Albicans)
Time : 14:10-14:30
Jack Ho Wong received his PhD degree in biochemistry from the Chinese University of Hong Kong in 2005. He serves as a research associate in the Faculty of Medicine and Shenzhen Research Institute, CUHK. He has worked on defense proteins/peptides for over 10 years. His research encompasses: (i) antimicrobial peptides and (ii) antitumor proteins/peptides. He has published more than 80 papers in peer-reviewed journals.
In this study, synthetic bovine lactoferricin (Lfcin B) 17-30 and lactoferrampin (Lfampin B) 265-284 were tested for antifungal activity against planktonic Candida albicans strain SC5314. Exposure of fungal cells to Lfcin B 17-30 brought about morphological changes demonstrating the presence of vesicles upon pseudohyphae or hyphae; alterations of plasma membrane permeability; and several hallmarks of apoptosis comprising phosphatidylserine externalization, reactive oxygen species (ROS) production, DNA fragmentation, changes in mitochondrial membrane potential and activation of caspase. From the aspect of gene expression, Lfcin B 17-30 probably brought about ROS accumulation by suppressing the expression of superoxide dismutase 3 (SOD3). In addition, the suppression of gene FRE7, CTR1 and SIT1 may be associated with changes of plasma membrane permeability. The minimal fungicidal concentration of Lfampin B 265-284 was determined to be 77.5μg/ ml against C. albicans cells at a concentration of 1x107 cell/ml. Lfampin B 265-284 exerted its antifungal effect mainly through necrosis and apoptosis. Lfampin B 265-284 brought about changes in the fungal membrane permeability and mitochondrial membrane potential and caspase activation. Treatment with Lfampin B 265-284 for 3 hours led to suppression of GPX2 and increase of PXP2, which are both related to oxidative stress. This work was supported by National Science Foundation of China research grants (No. 81201270 and 81471927).
University of San Simón, Bolivia
Title: Prevalence of immunity against infection of hepatitis A and hepatitis B in children Cochabamba, Bolivia
Time : 14:30-14:50
Maria Del Rosario Dávalos Gamboa acquired Pharmaceutical Biochemistry degree from the University of San Simón. She started working at the University of San Simón in the Faculty of Medicine in the laboratory of nuclear medicine as a laboratory, and later from August 1992 to continued working as a teaching assistant research until 1998, the years 2009 and 2010 was Director of the Research Institute of the Faculty of Dentistry UMSS, in1997 won a competency exam at the Faculty of Dentistry UMSS in the subject of Biochemistry since she keep up as a professor in that subject. In the private party from 2005 to 2011, She was Regent and owns the Galenic Pharmacy Madel in the city of Cochabamba, Bolivia. She is currently a legal representative and owner partner (in a greater proportion than 51% of shares) of the International Associated Factory oils and coals SRL ACECAB, in the city of Santa Cruz, Bolivia, whose principal activity is to generate cosmetic oils and charcoal.
Background: Knowing the immune status against hepatitis A and hepatitis B in children Cochabamba, Bolivia and seroepidemiological association.
Study method: A seroepidemiological study (n = 424) and HBV (n = 436) of HAV in children living in Cochabamba, Bolivia, 2010. A questionnaire was completed by parents for demographics, socioeconomic was performed and housing and blood samples were collected, An ELISA was used to measure antibodies to hepatitis A and B.
Results: As regards Hepatitis A, the overall prevalence 95.4 (95% CI -93.5 to 97.4) were immune. The immunity was higher in children of 5-10 years (97%) and tweens 10-13 years (97.9%), the prevalence of immunity was also higher in subjects whose parents had a low level of education (99, 4 to 99.5%) living in rural areas (98.7%) lived in municipalities with an urban development under (99.1 to 100%), had water delivered home by an oil sisterna (99.4 %) and spoke Quechua at home (99.5%). As to Hepatitis B virus, immunity that presented to the IgG anti-HBs IgG antibodies in the cohort of pre-universal vaccine was 5.8% (95% CI: 3.3 to 8.3%); was higher in men (9.1%), and those living in the suburbs (9.7%). The anti-HBs IgG prevalence among cohort universal post-vaccine was 37.9% (95% CI: 28.5 to 48.1%), and was higher in children who speak Quechua at home (51.0%), those living in the suburbs (53.9%), and those born in 2005 (72.7%). Neither cohort showed differences concerning education of parents. The prevalence of IgG anti-HBc was 1.1% among post-universal vaccine cohort and 1.2% among pre-universal vaccine cohorts (p> 0.05)
Conclusions: The susceptibility to infection by the hepatitis A child reaches 4.5%. There is a high susceptibility of contracting hepatitis B infection by low immunity was identified.
Stellenbosch University, South Africa
Title: The influence of NAT-1 genotype on Para-aminosalicylic acid (PAS) pharmacokinetics and intolerance following once daily or twice daily PAS dosing
Time : 14:50-15:10
Peter Donald is emeritus professor in The Department of Paediatrics and Child Health, Stellenbosch University, South Africa. His main research interest is the assessment of antituberculosis drugs in adults and children and tuberculosis in childhood. He is author or co-author of more than 200 papers listed in PubMed the majority dealing with tuberculosis and in 2010 he was awarded the gold medal of the International Union against tuberculosis and Lung Disease for his contribution to improving lung health in children.
Para-aminosalicylic acid (PAS) is still used for extensively- or multidrug- resistant tuberculosis (TB) (XDR or MDR). Despite relatively good survival (81% 5-years) when used with streptomycin, current XDR TB mortality using PAS with remaining drugs is poor (30%-90%). We reviewed PAS literature concluding that PAS accompanied by weak drugs should be dosed 20 g daily; intolerance did not increase with once daily-dosing. Early bactericidal activity studies found PAS moderately bactericidal. We studied pharmacokinetics and tolerance over 8-days post-administration of granular slow-release PAS (PASER) 8 g once daily or 2x4 g in 32 patients with MDR or XDR TB using a randomized, two-period, cross-over design; NAT1 and NAT2 genotypes were determined and tolerability assessed by visual-analog scales. Median Cmax following PAS once daily and twice daily was 80 and 61μg/mL and AUC0-12 652 and 428 μg.h/mL respectively (p<0.001 for both comparisons). The commonest NAT1 genotype was *4/*10 found in 45% of patients. The *14A allele was present in two patients (6.3%) and NAT1*3 in one patient all three had higher PAS Cmax (p=0.007). Intolerance was similar between regimens; VAS scores for intolerance were low and more than 50% of scores were 0. Neither Cmax nor AUC was associated with intolerance; occurrence of intolerance differed little between regimens. Women had higher Cmax (p=0.003), but less intolerance. PAS could be dosed once daily without increased intolerance; this might improve efficacy. The slow acetylator status of NAT1*4/*10 genotypes is confirmed and for the first time the NAT1*3 allele associated with high PAS concentrations.
Ain-Shams University, Egypt
Time : 15:10-15:30
Mona Abd El-fattah Ahmed has completed her MD at the age of 33 years from Ain Shams University. She is Associate Consultant and head of Clinical Parasitology Section, and Laboratory Training and Education Coordinator at the Laboratory Department, King Abdullah Medical City, Makkah, KSA, since June 2010 till present. She is also Associate professor of Medical Parasitology, Faculty of Medicine, Ain Shams University from February 2009 till present. She has published more than 20 papers in reputed journals and serving as a reviewer of reputed journals.
Introduction: Cerebral malaria is a diffuse encephalopathy presenting with neurological symptoms including unarousable coma of more than 30 minutes duration associated with or without seizures. It can occur in up to one-third of patients with severe malaria particularly that caused by Plasmodium falciparum, but rarely it could be occurring during the course of P. vivax. We report a distinctive case of cerebral malaria caused by Plasmodium vivax
Material and Methods: This is a case report study carried out in Nov. 2011 at King Abdullah Medical City, KSA; a Tertiary care hospital. We studied the clinical profile, laboratory and laboratory investigations, treatment and outcome.
Results: The patient was an adult Indian female pilgrim, 29 years old. The clinical features noted were attacks of convulsions, extensive vacuities, septic shock, anemia, pneumonia and renal dysfunction. The species diagnosis was made on thin blood smears demonstrated P. vivax and confirmed by antigen and antibody detection techniques. P. falciparum was excluded by all methods.
Conclusion: Rarely, cerebral malaria is a presenting complication or occurs during the course of P. vivax infection. This case demonstrates that sole Plasmodium vivax can induce severe cerebral injury. The unique epidemiology of malaria in India, where P. vivax predominates over Plasmodium falciparum may be related to atypical presentation.
Chandrajit Lahiri has completed his Ph.D from Bose Institute, Kolkata, India and postdoctoral studies from the Indian Institute of Science, Bangalore, India and later from Technical University of Munich, Germany. He is currently associated with the Department of Biological Sciences of Sunway University, Malaysia. He has shifted his field of study from Chemistry and Biochemistry through Molecular Microbiology to Evolutionary and Structural Bioinformatics and lately Network Biology. He is a member of the International Complex Systems Society of Europe and reviewer committee member of some journals of international repute.
Over the last few decades, biologists understood gradually that a set of complex interactions between the numerous constituents of a cell, gives rise to different biological phenotypes. Diseases serve as interesting examples of a great number of heterogeneous, interacting entities of biological systems. Though the ultimate goal is to understand the causes and effects along with the mechanisms of regulation, the precise simulation to mimic the real biological phenomena had been quite tough. The present talk encompasses a discussion on the model networks of few infectious diseases focused around identifying the proteins indispensable for virulence followed by probing into the structure function relation of the proteins involved there in and their molecular evolution. The diseases are either caused by bacterial infection like typhoid caused by Salmonella enterica, nosocomial infection by Acinetobacter baumannii and fish pathogenesis by Edwardsiella tarda. On an initial note, the indispensability issue has been taken off for virulent proteins from the 28 Pathogenicity Alien Islands (PAI) causing the hospital borne infection caused by Acinetobacter. Taking down to the practical level, a conglomerate of secretion systems and signaling proteins of Edwardsiella were used for identifying an important candidate suitable for fish vaccination. Finally, a methodology has been figured out theoretically to focus on the indispensable virulent proteins amongst a barrage of Salmonella Pathogenecity Island (SPI) proteins and proven by microarray data for Salmonella. The candidate for therapeutic drug targeting had also been modeled. An overview of phylogenetic network brought out some sources of evolution.
National Institute of Virology, India
Title: Binding of hepatitis E virus RNA dependent RNA polymerase to the cis-acting regulatory elements in the HEV genome
Time : 15:50-16:10
Shakuntala Mahilkar is a senior research fellow at National Institute of Virology (NIV), University of Pune, Maharastra, India. Currently she is writing her Ph.D. thesis entitled “Identification and characterization of regulatory elements on Hepatitis E virus Genome” under the supervision of Dr Kavita S. Lole. My Ph.D and the work is to explore the Hepatitis E Virus (HEV) genome for the regulatory elements involved in replication and transcription. HEV is a single stranded positive sense RNA virus which utilizes RNA Dependent RNA Polymerase (RdRp) for its replication and transcription. Identification of binding region for RdRp will give us insight of how HEV maintain its replication as well as transcription and translation within a small genome, and also an idea about the virus life cycle. This study will further help in designing the antiviral therapies for HEV infection. Earlier in the year 2006-2007 she worked as a Junior Research Fellow at School of Biotechnology on the project entitled “Metabolic engineering of E. coli to remove the bottlenecks in recombinant protein expression” sponsored by Department of Biotechnology (DBT). She had Qualified All India Combined Entrance Test for admission in M.Sc. Biotechnology programme in 2003 conducted by the JNU, New Delhi, and completed her Masters in Biotechnology from Himachal Pradesh University, Shimla in the year 2005, during that period she did a project work on the topic “Studies on microbial tyrosinase and b-tyrosinase.” Also she completed winter training at National Institute of Plant Genome Research (NIPGR), New Delhi, on the topic “Cloning of WRKY gene from Oryza Sativa.”
Hepatitis E, caused by Hepatitis E virus (HEV), is an important public-health concern in developing as well as developed countries.There is a need to understand virus biology because new aspects of virus infection are emerging such as zoonotic transmission and chronic cases in organ transplant and immune compromised patients also, it shows unexplained high mortality rate in pregnant women. Hepatitis E virus replication is still not completely understood due to lack of efficient cell culture system. The virus genome is positive sense ssRNA of about 7kb having a 5’ cap and a 3’poly a tail. The expression of its three open reading frames is achieved by producing genomic and subgenomic RNAs. The viral genome has 5’ and 3’ non-coding regions (NCR) with conserved stem loop structures known to be important during viral replication. Interaction between RNA dependent RNA polymerase (RdRp) and the viral cis-acting sequences is likely to be an important step in viral RNA replication. We analyzed binding affinity of viral RdRp to these cis-acting elements using Electrophoretic Mobility Shift Assay (EMSA). Purified recombinant RdRp protein, expressed in bacterial system, was incubated with putative regulatory elements in the HEV genome. While, binding affinity of the enzyme with these elements was determined by carrying out competition binding assays. The same assay was used for mapping of subgenomic promoter (sgP) region to find minimal binding region for efficient RdRp binding. The enzyme exhibited high binding affinity with the proposed sgP, between ORF1 and ORF2 junction region and 3’UTR with a poly A tail. While, affinity for the 5’NCR was comparatively less than the sgP and 3’NCR. A competition assay between the 3’NCR and sgP showed a super-shift suggesting RdRp to have either two separate binding motifs/ or co-operative binding with these two cis-acting elements. These studies give us a molecular insight for virus transcription and replication and provide targets for antiviral development.
University of Nottingham, UK
Title: The role of flagella in Clostridium difficile pathogenesis and biofilm formation: Comparison between a non-epidemic and an epidemic strain
Time : 16:10-16:30
Soza Tharwat Mohammed Baban is affiliated to the Center for Bio-Molecular Sciences-University of Nottingham, UK.
Clostridium difficile is a major cause of healthcare-associated infection and inflicts a considerable financial burden on healthcare systems worldwide. Disease symptoms range from self-limiting diarrhoea to fatal Pseudomembranous colitis. Whilst C. difficile has two major virulence factors, toxin A and B, it is generally accepted that other virulence components of the bacterium contribute to disease. C. difficile colonises the gut of humans and animals and hence the processes of adherence and colonisation are essential for disease onset. Bacteria within biofilms are protected from multiple stresses, including immune responses and antimicrobial agents. Increased antibiotic resistance and chronic recurrent infections have been attributed to the ability of bacterial pathogens to form biofilms. While biofilms have been well studied for several gut pathogens, little is known about biofilm formation by anaerobic gut species. We have limited understanding of how the causative bacterium C. difficile colonizes the host or how it can resist antibiotics and persist within the gut. While persistent infections have been previously linked to biofilm-formation by pathogens, biofilm development by C. difficile has not been characterized. Our work demonstrates the ability of this anaerobic pathogen to form complex biofilms, the involvement of important clostridial pathways in biofilm development and perhaps a connection between formation of spores which are believed to mediate persistence, and biofilm formation. Importantly, we show that bacterial sensitivity to antibiotics is reduced in clostridial biofilms. Biofilm formation may be a mechanism employed by C. difficile to survive in hostile environments such as the human gut. Here we tested this hypothesis by comparing flagellated parental strains to strains in which flagella genes were inactivated using ClosTron technology. Our focus was on a UK-outbreak, PCR-ribotype 027 (B1/NAP1) strain, R20291. We compared the flagellated wild-type to a mutant with a paralyzed flagellum and also to mutants (fliC, fliD and flgE) that no longer produce flagella in vitro and in vivo. Our results with R20291 provide the first strong evidence that by disabling the motor of the flagellum, the structural components of the flagellum rather than active motility, is needed for adherence and colonisation of the intestinal epithelium during infection. Comparison to published data on 630Δerm and our own data on that strain revealed major differences between the strains: the R20291 flagellar mutants adhered less than the parental strain in vitro, whereas we saw the opposite in 630Δerm. We also showed that flagella and motility are not needed for successful colonization in vivo using strain 630Δerm. Finally we demonstrated that in strain R20291, flagella do play a role in colonisation and adherence and that there are striking differences between C. difficile strains. The latter emphasises the overriding need to characterize more than just one strain before drawing general conclusions concerning specific mechanisms of pathogenesis. In addition, we also demonstrate that clinical C. difficile strains, 630 and the hypervirulent strain R20291, form structured biofilms in vitro, with R20291 accumulating substantially more biofilm. Microscopic analyses show multiple layers of bacteria encased in a proteinaceous biofilm matrix. Employing isogenic mutants, we show that virulence-associated protein, cwp84, and a putative quorum sensing regulator, luxS are all required for maximal biofilm formation by C. difficile. Interestingly, a mutant in spo0A, a transcription factor that controls spore formation, was defective for biofilm formation, indicating a possible link between sporulation and biofilm formation. Furthermore, we demonstrate that bacteria in clostridial biofilms are more resistant to high concentrations of vancomycin, a drug commonly used for treatment of CDI. Biofilm formation by C. difficile is a complex multifactorial process and may be a crucial mechanism for clostridial persistence in the host.
Federal University Wukari, Nigeria
Title: Prevalence of diarrhea in children below 60 months in University of Benin teaching hospital (UBTH), Benin city- Nigeria
Time : 16:50-17:10
Yakubu Juliet M is an academic staff in Federal University Wukari-Nigeria where she teaches in the Department of Microbiology. Her research interests in the environment are focused on the resistance of bacteria to antimicrobials.
A survey to determine the significance of bacterial species as possible pathogenic microorganism that cause diarrhea was carried out in University of Benin Teaching Hospital (UBTH), Benin City, Nigeria. The prevalence, age, sex, and maternal level of education to their association with diarrhea in children younger than five years of age were determined. Stool specimen from 202 children younger than five years of age were collected and assessed for microbiological profile of enteric pathogens. Antimicrobial susceptibility tests were performed on all identified relevant isolates using disc diffusion method. The prevalence of infectious diarrhea was age specific being highest at the age of 7-12 months and lowest at the age of 37-48 months. Escherichia coli was the most frequently isolated bacteria in all age groups (62.8%) However, the isolation rate of Staphylococcus aureus and Klebsiella species in this study depict these bacteria as veritable aetiological pathogen of infectious childhood diarrhea. The disk diffusion testing for the antibiotic susceptibility illustrates a generally increased resistance by all bacteria strain tested. Periodic laboratory - based survey for bacteria pathogens associated with diarrhea of children should be emphasized to clarify their epidemiological significance and facilitate effective prevention and control.
Al-Iman General Hospital Riyadh, KSA
Time : 17:10-17:30
Fatima Noman did her MBBS in 1991 from Aga Khan University Medical College Pakistan. She did fellowship in Microbiology from College of Physician and Surgeon Pakistan. Received certification in Infection control and epidemiology CIC from CBIC USA in 2008. After 9 years service in Pakistan as head of Microbiology department and chairperson Infection Control Committee, moved to Saudi Arabia, where presently working as Director of Infection Control and Consultant Microbiologist.
Middle East Respiratory Syndrome (MERS) is viral respiratory illness that is new to humans. It was first reported in Saudi Arabia in 2012 and has since spread to several other countries, including the United States. The emergence of this new coronavirus is globally recognized as an important and major challenge for all of the countries which have been affected as well as the rest of the world. All reported cases have been linked to countries in and near the Arabian Peninsula. Either lived in the Arabian Peninsula or recently traveled from the Arabian Peninsula before they became ill or close contact with an infected person who had recently traveled from the Arabian Peninsula. The virus appears to have originated in bats. Serological evidence shows that these viruses have infected camels for at least 20 years. As till 1st March 2015, there are 920, lab confirmed cases, with395 deaths in KSA. Many mysteries are still unsolved, Ministry of Health KSA is also working in collaboration with WHO teams. Exact mode of transmission is unknown.Most clusters are reported among family contacts or in a health care setting. No evidence of sustained transmission among humans. Secondary cases appear to have a milder disease than that of primary cases. Occasional possible tertiary cases reported Infection in health care workers accounts for 13%. standard, contact, and airborne precautions are recommended for management of hospitalized patients with known/suspected MERS-CoV infection. There is evidence of a seasonal transmission pattern (March-April onwards). A rise in cases since end of January in 2015.
E Wolfson Medical Center, Israel
Time : 17:30-17:50
Ze’ev Katzir is affiliated to the E Wolfson Medical Center, Israel.
Most animal hazards in laboratories are widely recognized. These together with zoonosis and other possible insults, are subject to the establishment of guidelines for the operation and maintenance of such facilities. Most of the infectious diseases described among laboratory animals are related to the inadequate implementation of preventive and quality control policies. These included surgical, respiratory and intestinal tract infections, and typically spread between animals. This report is about an outbreak of nosocomial bacterial infection in rats held in the research laboratory of a human hospital. Symptoms of general infection were runny nose and sneezing, excessive lachrymation, dyspnea, loss of appetite, limited activity and disheveled fur, which appeared in two rats initially, and spread to another 60. A common characteristic physical finding observed later was a lump under the skin, with subsequent ulceration. Mortality was 70%. Blood cultures were sterile. Accurate diagnosis was possible only after examination of tissue sampled from the diseased and dead rats. Histology showed an excessive proliferative and inflammatory reaction. Bacteriology analysis revealed the presence of three types of hospital-borne bacteria: enterococcus, coagulase-negative staphylococci and Acinetobacter radioresistens, with common sensitivity to ciprofloxacin and ceftazidime. Empiric antibiotic therapy was switched to a bacteriology-based regimen. Complete recovery was achieved among the diseased rats that survived the previous antibiotic therapy. This is the first written description of a nosocomial infection of laboratory animals caused by bacteria borne in a human hospital. Medical staff-to-animal transmission is suggested. A high index of suspicion and prompt diagnostic evaluation are essential for successful management, and preventive guidelines concerning such events need to be established.