2^nd World Congress on Infectious Diseases August 24-25, 2016 Pennsylvania, Philadelphia, USA

Biography:

Ashok Kapse is a consulting Pediatrician practicing in the city of Surat in the Gujarat state of India, besides owning a private pediatric hospital he is also Head of the Pediatric Department at a prestigious Mahavir Super Specialty Hospital. After finishing graduation (MBBS) he did MD in Pediatrics. Initially he has worked as a Professor of Pediatrics at Medical College Surat, later he opted out for private practice however pursued academic interest. He developed special interest and skill in infectious diseases. He is a recipient of many oration awards and delivered hundreds of lectures on dengue, malaria, typhoid and antibiotic uses across India. He has decorated many a posts in medical fields: President of Surat City Branch of Indian Academy of Pediatrics (IAP), President of Gujarat State Branch of IAP and National President of Infectious Diseases Branch of IAP are few of them. He is an avid Clinical Photographer; his photos figure into various books and atlases including the prestigious atlas of infectious diseases published by American Academy of Pediatrics. He has published umpteen articles in peer reviewed journals.

Abstract:

Right up to the mid twentieth century dengue was considered as a mild febrile illness; however in the mid 1950 image of dengue underwent a drastic change. South East Asian countries experienced epidemics of a serious dengue disease, later on termed as Dengue hemorrhagic fever-dengue shock syndrome. By the end of the last century the geographic distribution of dengue viruses which earlier was limited to South East Asian and South Asian countries, has tremendously expanded & engulfed almost whole of the world. Today dengue has emerged as an important threat to public health worldwide; it is estimated that over 50 million dengue virus (DENV) infections occur annually resulting in 500,000 hospitalizations and over 20,000 deaths. In 1974 World Health Organization (WHO) formulated case definition and classified dengue into DF/DHF/DSS. This classification remained in use for almost three decades however over the years dengue has expanded to different parts of the globe and to older age groups. Clinicians often observed deviations from the original description of dengue manifestations; several investigators have felt & reported various difficulties in using the old system of DF/DHF/DSS. With the realization that existing classification of the disease into DF, DHF and DSS may not always be universally applicable for clinical management; WHO convened a meet of global dengue experts in 2008 in Geneva. Committee recommended a new case classification for Dengue illnesses and put forward revised guidelines in 2009 for the management of dengue illnesses. As per new guidelines disease is now classified into three categories that are dengue, dengue with warning signs and severe dengue. This workshop proposes to acquaint audience with this newer classification and a simplified way of dengue case management. Workshop intends to impart hands on training in understanding staging of the disease and diagnosing various grades of dengue severity with the help of real clinical cases. Lastly it aims to impart a defined system of management as per the stage and severity of disease. The precise knowledge of newer diagnostic and management system would be of great help in reducing dengue ambiguity and thereby significantly alleviate the dengue related morbidity and mortality.

Biography:

Adriana Macedo Dell’Aquila has completed her PhD from Federal University of São Paulo, Brazil. She is the infectious disease Physician responsible for the control and treatment of osteoarticular infections, Department of Orthopedics and the control of infections in the Burns Unit of São Paulo Hospital, Federal University of São Paulo.

Abstract:

Background: The main objective in post-osteosynthesis surgical site infection (SSI) is to consolidate the fracture and prevent chronic osteomyelitis, the risk factors for SSI relapse in these patients, who were treated as per osteo-articular infection protocol were evaluated at the Federal University of São Paulo.

Methods: After retrospectively evaluating all SSI episodes occurring from December, 2004 to 2008 in patients undergoing osteosynthesis at the orthopedics department, 110 of them were included. SSIs were treated with at least 4-6 week antibiotic therapy cycles and followed up for one year with the results being analyzed using univariate and multivariate analysis models.

Results: Most patients were 18-89 year old (mean, 39.8 years) males (84.5%). In 37 patients, the causative agent was isolated with Staphylococcus being the most frequently observed (38.8%). In 83 (75.4%) patients, the antimicrobial treatment mostly with ciprofloxacin and clindamycin could be started within less than five days from the onset of symptoms. SSI relapses occurred in 34/110 (30.9%) patients. After one-year follow-up, 19 (17.3%) patients persisted with infection and only 10 (9.1%) did not have their fractures consolidated. The univariate analysis showed the performance of more than one surgery to stabilize the affected limb (OR 3.7 IC₉₅=1.1-12.7 p=0.045), presence of converting osteosynthesis (OR 3.6 IC₉₅=1.1-11.3 p=0.023), internal synthesis (OR 3.0 IC₉₅=0.99-9.2 p=0.043) and longer duration of surgery (OR 0.4 IC₉₅=0.1-1.6 p=0.029) as risk factors for SSI relapse. In the multivariate analysis, the only variable independently associated with SSI relapse was duration of surgery (OR 1.3 IC₉₅=1.1-1.7 p=0.015).

Conclusions: After one-year follow-up, using a specific protocol, most patients showed resolution of infection and only 9.1% had their fractures unconsolidated. The only independent risk factor associated with SSI relapse was prolonged surgery.

Biography:

Paul J Caesar has 25 years of experience in hygiene and infection control. He is presently working as an Expert in Medical Devices and Reprocessing Flexible Endoscopes in the Department of Medical Affairs, Quality and Safety of one of the largest university hospitals in the Netherlands. He has published papers on endoscope reprocessing, hand hygiene and other items on infection control. He has also developed teaching programs on reprocessing flexible endoscopes and cleaning, disinfection and sterilization of medical devices and a nationwide education program on hygiene and infection control for infection control practitioners in hospitals and public health. He is a chair of a Dutch Expert Group for reprocessing flexible endoscopes.

Abstract:

Although quality of reprocessing FES has improved over the past decades and permanent controls of process parameters in the automated endoscope washers (AEW) are continuously performed, improper or ineffective cleaning, disinfection, drying and storage (reprocessing) of reusable flexible endoscopes (FES) can pose a serious infection risk to patients. Despite of all quality improvements and a strong believe in validated process parameters of the AEW, in the UMCG FES with channels are still frequently and routinely microbiological (bacterial) sampled by retrograde flushing of all channels. For example, based on historical outcomes, each duodenoscope is sampled every week. Although FES safely passed the process in the AEW, a part of reprocessed FES showed to be positive in microbiological cultures, even with resistant bacteria. This additional screening of microbial quality of reprocessed FES could be regarded as an essential method to detect pitfalls in reprocessing or the state of art quality of FES especially in FES with channels. However, microbial screening is labor-intensive (and thus cost-expensive), takes a long time and only microbial (bacterial) contamination is verifiable. Based on literature and two short surveys in which we studied the use of ATP (adenosine triphosphate) bioluminescence as an alternative in checking the cleanliness of reprocessed ENT-endoscopes and duodenoscopes, we conclude that ATP is a quick, easy and reliable method for regularly monitoring the cleanliness of reprocessed FES. Because it’s broader spectrum including all possible organic contamination (e.g., tissue), it has a positive effect on the whole quality and safety process on reprocessing FES and a safe release and use for following patients. ATP can replace high frequent routine microbiological testing, which should only be indicated on clinical problems possible related with the use of FES or when outcomes on ATP indicates the need of further and more in-depth research.

Biography:

Jilei Zhang is currently a PhD candidate of Preventive Veterinary Medicine at College of Veterinary Medicine, Yangzhou University, China. He has published 12 papers in reputed SCI journals and was awarded 4 invention patents associated with vector-borne diseases. He was awarded with the National Scholarship for Graduate Students twice (2013 and 2015) and participated in one research program at The National Natural Science Foundation of China.

Abstract:

Infection caused by Rickettsia felis is an important tick-borne disease with natural foci, mainly transmitted through vertebrates (mouse and cat) and arthropods (fleas, ticks). The disease has been documented in more than 20 countries and is recognized as an emergent global threat to human health. Our preliminary report demonstrated that 5.83% (54/926) of the examined mosquitoes carried R. felis. In this study, we investigated whether the mosquito can transmit R. felis in a vertical fashion. We used a generic FRET-qPCR to detect R. felis in mosquitoes while a HMBS-gene based real-time PCR was applied to detect the level of blood meal in collected mosquitoes. During 2013-2015, 1984 mosquitoes were collected monthly in Jiangsu of China and PCRs on these mosquitoes demonstrated that mosquitoes with blood meal between summer months (10.0%) were significantly lower than in winter months (35.8%). In addition, R. felis positivity in collected mosquitoes was highest in December (20.8%) among the collected months (0.0-14.4%). Positivities of R. felis did not differ significantly between the mosquitoes with (n=29) and without (n=50) blood meal. Furthermore, testing on 23 pools of female mosquitoes showed that 2 pools were R. felis-positive and 5 were blood meal-positive. In contrast, 9 of 30 male pools were R. felis-positive and none of the male mosquitoes carried blood meal. This is the first report of detetcting Rickettsia spp. in male mosquito which is blood meal-free. Dynamic monitoring R. felis and blood meal in female and male mosquitoes provide here evidence that R. felis may be vertically transmitted in mosquitoes.

Biography:

Amanuel Ateweberhan Woldemariaman is an Assistant Lecturer in Orotta School of Medicine, Asmara, Eritrea. He has worked in different laboratories in Eritrea, East Africa. Currently, he is pursuing Masters in Immunology at Huazhong University of Science and Technology, Tongji Medical College, Wuhan, China.

Abstract:

Immune response to malaria and intestinal parasites is characterized by antibody production (IgE). Th2 immune response gives rise to antibody production and in this study the serum antibody level has been quantified in malaria patients with and without additional intestinal parasitic infection. The study was composed of 198 malaria positive and 217 malaria negative apparently healthy controls. Patients can be with or without additional intestinal parasitic infection. It was a cross sectional observational study conducted at Keren Hospital, Eritrea, Northeast Africa. A pre-designed structured format was utilized to collect socio-demographic and clinical data of the subjects. Detection and quantification of intestinal parasites, malaria parasites and quantification of serum antibody levels were done following standard procedures. Antibody levels of malaria-positive patients were significantly high as compared to that of malaria free apparently healthy controls (with and without intestinal parasitic infections). Malaria-positive patients with additional intestinal parasitic infection showed high level of antibody (2199 IU/ml) compared with those malaria patients without intestinal parasites (1669 IU/ml). The association between malaria parasitic density and level of antibody was highly significant (P=0.001) with 2048 IU/ml in high parasitaemia and 1779 IU/ml in low parasitaemia. Intestinal parasite egg loads were also significantly associated with level of antibody (P=0.003). It can be concluded that the level of antibody increases in response to malaria. It also increases in response to intestinal parasites. When compared, malaria infection is stronger than intestinal parasitic infection in driving the production of the antibody. Moreover, antibody level is correlated with malaria parasite density and intestinal parasite egg loads.

Biography:

Maria Luisa G Daroy is a Scientist at the Research and Biotechnology Division of St. Luke’s Medical Center and Assistant Professor in the MS Molecular Medicine Program of the St. Luke’s College of Medicine-WHQ Memorial. She has published more than 20 papers on dengue, Japanese encephalitis, chikungunya, eye infections, dementia, diabetes and coronary artery disease. She was the Chair of the Board of Examiners of the Philippine Academy for Microbiology from 2013-2015 and authored a book chapter on Philippine microbiology research. Researches include dengue, chikungunya, diarrhea, CNS infections, pathogen genomics, antimicrobial resistance, plant antivirals, molecular diagnostics and genetics of CVD, thyroid cancer and dementia.

Abstract:

Whole genome analysis of dengue virus strains isolated in the Philippines was performed using an Illumina MiSeq next generation sequencer and bioinformatics. Complete genome sequences of 24 DENV-2 isolated from 1995 to 2008 was mapped against a DENV-2 reference sequence (NC_001474) from Genbank. The Philippine DENV-2 isolates were highly similar to strains from Taiwan (AJ968413.1) and China (EF051521.1). The Chinese strain (EF051521.1) was isolated in 2001 yet similar strains could have been circulating in the Philippines as early as 1998. The isolates highly similar to the Taiwanese strain were of the Asian II genotype and the isolates highly similar to the Chinese strain were of the Cosmopolitan genotype. In total, 922 synonymous and non-synonymous substitutions were observed, of which 232 (25.2%) were in the NS5 gene, which had the most substitutions. This was followed by NS3 with 181 (19.6%) and the E gene with 144 (15.6%) and the 2K gene with only 6 (0.7%). Putative amino acid sequences from the coding regions revealed that majority (817, 88.6%) of the substitutions were synonymous or silent. Of the remaining 105 non-synonymous mutations, 22 (20.9%) were in the NS5 gene followed by the NS1 and E genes with 20 (19.0%) and 16 (15.2), respectively. When the clustered genetic variation profiles were identified based on the specific clinical diagnosis, all the DHF III cases belonged to a single cluster together with some DF cases and one SVI case. In contrast, all DHF I-II and most of the DF cases grouped together in another cluster. All DHF III cases were of the Cosmopolitan genotype. DENV circulating within the Philippines from 1995 to 1998 were of the Asian genotype, followed by a period from 1998 to 2001 in which both the Asian II and Cosmopolitan strains co-circulated and from 2000 to 2008 the circulating DENV was primarily cosmopolitan. This supports previous observations of a probable genotype shift in the Philippines. This is the first report of whole genome analyses of dengue virus isolates from the Philippines.

Biography:

Sion Jo has completed his Residency of Emergency Department from Seoul National University Hospital. He is an Assistant Professor of the Chonbuk National University Hospital. He has published more than 10 papers in reputed journals. He has designed the NEWS-L score and a Sion’s tube.

Abstract:

Sepsis is defined as life-threatening organ dysfunction caused by a dysregulated host response to infection. Septic shock is defined as a subset of sepsis in which underlying circulatory and cellular/metabolic abnormalities are profound enough to substantially increase mortality. Clinically, sepsis is identified by suspected or documented infection and an acute increase of ≥ 2 SOFA points (a proxy for organ dysfunction). And in case of septic shock, sepsis and vasopressor therapy needed to elevate MAP ≥65 mmHg and serum lactate >2 mmol/L (18 mg/dL) despite adequate fluid resuscitation is used. In contrast to new sepsis which deals with multiple organs, definition of septic shock focuses on circulatory shock and cellular/metabolic shock, seeming not to consider other imperative organs such as CNS or lung. It is a big mistake of septic shock definition. If a sepsis refers to organ dysfunction caused by infection, likewise circulatory and cellular/metabolic shock, respiratory, neurologic and other organs shock should be included in the definition of septic shock. This suggestion is supported that hypoxia and unresponsiveness is associated with increased mortality in sepsis. One more problem is that septic shock definition includes failure of adequate fluid resuscitation in itself even though there is no prerequisite reason. Furthermore, assessment of volume status and adequate fluid resuscitation is still challenging in critical care era. So the separation of a shock and a failure in the clinical definition of septic shock was should be considered.

Biography:

Durgesh Sinha is an Adjunct Assistant Professor at five institutions; Temple University, Strayer University, Rowan College at Burlington County, Mercer County Community College and Community College of Philadelphia. She has received her Doctorate degree in Applied Mathematics from Vinoba Bhave University, India and Master’s degree in Environmental Engineering from Temple University, USA. Her recent publication is “Hydro-magnetic flow of rarefied gas between two parallel flat plates with external circuit, 1999” and “Delayed epidemic model on the attack of Computer virus in network” communicated to IJITCS. Her current research interest is on epidemic model applicable in human life, environment and cybercrime.

Abstract:

Avian influenza virus poses risks to both bird and human population. In primary strain, mutation increases the infectiousness of avian influenza. A mathematical model of avian influenza for both human and bird population is formulated. We have computed the basic reproduction number R^h₀ and R^b₀ for both human and bird population respectively and we prove that the model is locally and globally asymptotically stable for disease-free equilibrium point when R^h₀<1 and R^b₀<1. We also prove that the unique endemic equilibrium point is globally asymptotically stable in bird population when R^b₀>1. Extensive numerical simulations and sensitivity analysis for various parameters of the model are carried out. The effect of vaccination and quarantined class with recovered class are critically analyzed.

Biography:

Omotowo I Babatunde has obtained MBBS from University of Ilorin, Nigeria in 1987, MPH from University of Nigeria, Nsukka in 2006 and FWACP from West African College of Physicians in 2009. He has worked as a Medical Advisor for German Leprosy and Tuberculosis Relief Association from 2010 to 2012. He is a Lecturer at the Department of Community Medicine, College of Medicine, University of Nigeria, since August, 2012. He is the MBBS Coordinator in the department since then. He has published some papers in both local and international journals. His interests are in infectious and non-communicable diseases.

Abstract:

Introduction: Lassa fever is a hemorrhagic fever caused by an arena virus. Worldwide, an estimated 2 million people are infected each year resulting to 5,000 to 10,000 deaths. It is endemic in a few West African Countries. In 2012, Nigeria experienced the worst outbreak.

Objective: To assess the knowledge, attitude and practices of healthcare workers towards Lassa fever in Enugu, south-east, Nigeria.

Methods: This cross sectional study was conducted among 325 healthcare workers. Data was collected using a self reported questionnaire on the knowledge, attitude and practices towards Lassa fever. Data was analyzed using SPSS version 21 and statistical significance of association between variables was assessed using Chi-square test at p<0.05. Ethical clearance was obtained from the Research Ethics Committee of UNTH and informed written consent was obtained from the participants.

Results: Overall 325 respondents returned the completed questionnaire. 54.7% were males, 92.6% were aged between 18 to 45 years while their mean age was 32.4±12.6 years. Most of the participants 53.8% were single. Majority of the respondents were Doctors 46.2%, Nurses 23.4%, while Lab scientists, physiotherapists, pharmacists and radiographers were 12.9%, 8.6%, 4.3%, and 4.6% respectively. Also, 97.6% of respondents had tertiary education. Among the participants, only 2.8% have not heard about Lassa fever. Major sources of information are media 87.1%, radio 86.5%, and television 84.9%. Most of the participants knew correctly that Lassa fever can affect all age groups 91.7%, can cause death 92.3%, is a communicable disease 93.8% and transmitted by rats 96.6%. Most of them also knew correctly modes of transmission. However, about 20% of them did not know correctly prevention of Lassa fever. Majority of them believed that hand gloves were most useful personal protective measures while handling patients. Knowledge concerning burial practices and other preventive measures is poor. Only 46.5% of them regularly practiced barrier nursing and hand washing as means of containing the spread of infection. Knowledge on Lassa fever was found to be significantly associated with level of education (X² =105.680, df=4, p=0.000), but not significant to category of profession (X²=9.430, df=10, p=0.492).

Conclusion: Majority of health workers had good knowledge regarding Lassa fever. However, preventive practices were poor. Health education packages and training regarding Lassa fever should be introduced and sustained in all health facilities.

Biography:

Bimal Kumar Mishra is a full Professor in the Department of Mathematics at Birla Institute of Technology, India. Presently he is working in the area of non-linear dynamics, very specifically on Mathematical Models on infectious disease and has published more than 125 research journals of high repute. He has produced several PhDs’ and he is a Member of the Editorial Board of several international journals.

Abstract:

Ebola virus disease was first found in 1976 and thereafter it had emerged in different countries in different times, especially in 2014 in Liberia of West Africa and is now highly epidemic and is a great threat to human population. In this paper, we try to understand the spreading behavior of Ebola virus disease (EVD) in the human population. We have used the very close real parametric values as per the data released by ‘WHO’. To minimize the spread of EVD, critical analysis is performed both in the presence and absence of control measures. From the sensitivity analysis performed on the real data, we are able to say that the susceptible populations have a strong relation with the threshold number. Effect of quarantine is critically analyzed on the infectious population and it is observed that quarantining the infectious population may play a vital role in controlling the spread of EVD. Results are established both analytically and numerically. We hope that the results will definitely give a managerial insight for control of the spread of EVD.

Biography:

Jason A Thompson has been involved in public health since 1993, primarily revolving around the delivery of prehospital emergency medical care. He discovered his calling in the United States Navy as a hospital corpsman and has subsequently employed those skills as an emergency medical technician, healthcare administrator, medicolegal analyst and product development consultant. Jason has a passion for problem-solving and making the world a safer place, whether it is educating scouts in advanced first aid, instructing first responders on the use of lifesaving strategies, designing remote medical care programs and, of course, advocating for improvements in public health, specifically responsible hygienic practices.

Abstract:

In 2014, the world was concerned about the largest historical outbreak of the Ebola Virus happening in West Africa. This led to significant concerns about readiness to manage those who were potentially infected. In the United States, prehospital care providers were scrambling to prepare and desperate for directions they could rely on. This caught many decision makers by surprise and eager to understand why the public health community was seemingly unprepared. With some investigation, it quickly became apparent that the issue was directly correlated to the absence of a solid general understanding of infection prevention and control (IPC) practices among first responders and, surprisingly, public health officials. A rapid solution to this problem was essential, but there were no obvious leaders taking the charge, so a small team from Emergency Products & Research (EP+R), of Kent, Ohio, stepped forward. Working with other industry professionals and seeking advice from academia, EP+R launched an initiative that evolved into AMBUstat™, which is a program designed to introduce a common sense approach to IPC that can be easily and cost-effectively rolled out around the globe. The AMBUstat™ portable biological decontamination system, a key component of the AMBUstat™ program, was designed for ease-of-use, minimal training requirements and environmental consciousness. With the AMBUstat™ program, IPC is easy to understand and it provides the potential for a global platform that enables us to be ready for the next biological threat, with the most important aspect being a critical focus on proactive rather than reactive strategies.

Biography:

Ines Garcia-Garcia has completed her Medical Training at the University of Puerto Rico. She is Board Certified in Pediatrics Specialty and in the Neonatal-Perinatal Medicine Sub-specialty. She is a Professor at the University of Puerto Rico, School of Medicine. She has published in reputed journals and books, including articles related to intrauterine exposure to viral infections and congenital anomalies. She actively participates in Graduate Medical Education Programs. She is a Member of national and international research and academic associations. She has participated as a Speaker in multiple professional meetings in the United States, Latin-America and Europe.

Abstract:

The recent emergence in America of Chikungunya and Zika has added new febrile viral diseases which impact susceptible women in childbearing age and with a high rate of vertical transmission, which can occur in asymptomatic women. Both diseases are caused by viruses transmitted primarily by Aedes mosquitoes, found throughout much of the tropical and subtropical regions of the Americas. Some reports warn that climate change will worsen vector-borne disease threat. Chikungunya fever was first identified in Puerto Rico during an outbreak in 2014. 10 newborns where admitted from mothers with chikungunya-like symptoms within 5 days after delivery. The most prevalent symptoms in those babies were irritability and maculopapular rash. 3 babies were admitted from mothers with symptoms more than 5 days from delivery. Symptoms like fever, irritability and rash where not present, but they presented central nervous system lesions. At present, health officials reported that 1,726 people have been infected with Zika in Puerto Rico, including a total of 191 pregnant women. Only one case of microcephaly has been reported. These outbreaks prompted our Neonatal-Perinatal Service to characterize clinical manifestations of the diseases, develop guidelines for diagnosis and management of suspected intrauterine exposed fetuses. Health care professionals need to be familiar with the surveillance system, perform history taking focusing on febrile viral illnesses during pregnancy, recognize women at risk for chikungunya and Zika infections, and follow the protocols established by the local and state Health Authorities, including neurodevelopmental follow-up of affected offsprings.

Biography:

Natalia Isaza Brando is an Associate Neonatology Physician in Children’s National Health System, Washington DC. She had work experience as Neonatology Physician Associate, NICU attending, Adjunct Instructor in Pediatrics, Health and Wellbeing Program Director, Instructor, Health Educator, Pediatrician and Physician. She is interested in investigating the short and long-term impact of maternal depression on mother-infant behaviors.

Abstract:

I will intend to cover during the talk: The bioactive components in human milk that influence the immune status of newborns; the physiological and protective functions of the immune components in human milk: Anti-microbial substances and antibodies; the constituents in breast milk that promote tolerance and priming of the immune system in the newborn; how breastfeeding provides passive and long-lasting active immunity; how the use of oral immunotherapy with colostrum in the first days of life of sick newborns can improve their response to infections in the NICU; how human milk can improve the incidence of nosocomial infections in the NICU.

Biography:

Leena Bhattacharya Mithal is a Pediatric Infectious Diseases specialist at the Ann & Robert H. Lurie Children’s Hospital of Chicago and an Instructor at Northwestern University, Feinberg School of Medicine. She is pursuing her Master Degree in Clinical Investigation at the Northwestern Graduate School. Her research interests include neonatal infections, novel diagnostics for sepsis in preterm infants, study of the perinatal-neonatal microbiome, and vaccine awareness and delivery.

Abstract:

Early onset neonatal sepsis disproportionately affects preterm infants and remains a major cause of morbidity and mortality. Yet, diagnosis remains inadequate resulting in missed cases or prolonged empiric antibiotics with significant adverse consequences including necrotizing enterocolitis, antibiotic resistance, and death. Development of novel, more reliable methods to diagnose sepsis in preterm infants is essential to improve their outcomes. Biomarkers of infection, placental histopathology, and molecular methods of pathogen detection are among the tools being investigated for accurate identification of infants with sepsis. This presentation will review the conundrum of early onset sepsis in preterm infant and discuss both existing evidence and new research on novel diagnostics, including data on acute phase reactants and 16S rRNA PCR of cord blood in a large single-center cohort.

Biography:

Gabriela Sanchez Petitto has completed her MD from the Universidad Central de Venezuela, School of Medicine. She is currently a Postgraduate student of Internal Medicine at the University of Texas Health Science Center at Houston. She has worked in several projects with hematological malignancies and in the upcoming future with antibiotic resistance projects.

Abstract:

A 67-year-old post-menopausal woman with advanced stage histiocytic sarcoma of the pelvis, presented with 4-day history of abdominal pain and fever. She had local tumor invasion to bladder and cervix requiring bilateral percutaneous nephrostomy tubes. She received chemotherapy and radiotherapy with partial tumor regression. On examination she had an enlarged suprapubic mass and foul-smelling vaginal discharge. A computed tomography (CT) scan demonstrated a large cervical mass occluding the cervical os, causing dilatation of the endometrial cavity, doubling its size compared to one month prior. The patient was started in broad spectrum antibiotics and a cervical catheterization was intended unsuccessfully. A CT guided percutaneous uterine drain was placed in her abdomen and purulent drainage grew Prevotella loescheii. Blood and urine cultures were negative. She was discharged under oral sulfamethoxazole/trimethoprim and metronidazole with clinical improvement. In the subsequent months she underwent chemotherapy and radiotherapy and required long-term percutaneous drainage. Pyometra is defined as the accumulation of pus in the uterine cavity and thought to be a result of interference with the natural drainage of the uterus. Symptoms are non-specific and easily misdiagnosed. Diagnosis can be made clinically by drainage of pus from the uterine cavity and with imaging. Treatment includes drainage along with antibiotics to cover microorganisms such as Lactobacillus iners, Prevotella spp., and Lactobacillus crispatus. Vague abdominal symptoms in a post-menopausal woman with pelvic malignancy should raise concern for pyometra and prompt treatment has to be instituted to prevent the development of the most catastrophic complication; uterine perforation.

Biography:

Gabriela Sanchez Petitto has completed her MD from the Universidad Central de Venezuela, School of Medicine. She is currently a Postgraduate student of Internal Medicine at the University of Texas Health Science Center at Houston. She has worked in several projects with hematological malignancies and in the upcoming future with antibiotic resistance projects.

Abstract:

A 36-year-old woman with newly diagnosed nephrotic syndrome presented with a 10-day history of progressive vision loss. On ophthalmological exam, visual acuity was 20/800 in both eyes. The left eye showed grade 4 disc edema and both retina had vitreous and intraretinal hemorrhages. HIV serology was positive, CD4 count of 17/ul and viral load of 375000 copies/ml, newly diagnosed. CT head was normal. Cerebrospinal fluid analysis is unremarkable. Serum and CSF immunoglobulins against Toxoplasma spp., PCR for herpes simplex virus 1 and 2, varicella-zoster (VZV) and Cytomegalovirus (CMV) were negative. Empirical ganciclovir, trimethoprim-sulfamethoxazole and prednisolone were started. Vitreal fluid extracted by paracentesis was positive for toxoplasma antigen and negative for CMV and VZV in both eyes. The diagnosis of toxoplasma retinochoroiditis was confirmed. The patient continued a 6-week course of antibiotics with clinical improvement at 4 weeks. In immunocompromised patients is difficult to establish a diagnosis of ocular toxoplasmosis based upon the lesions’ appearance, since atypical lesions are common and obtaining reliable results for immunodiagnostic assays is more difficult. The best clue to diagnosis is recognition of the clinical presentation and the detection of the agent in ocular samples by molecular biology. Confirmation of diagnosis is higher for PCR of vitreous samples compared to aqueous humor; this due to the fact that, anatomically the vitreous humor is closest to the necrotic lesions, leading to a better sampling of the parasitic DNA. In summary, a positive PCR study for T. gondii became a dependable alternative to diagnose retinochoroiditis in an immunocompromised patient.

Biography:

Jose Gonzales Zamora has obtained his MD degree at Universidad Nacional Federico Villarreal in Lima, Peru. He has completed his Internal Medicine Residency at John H. Stroger Hospital and Infectious Disease Fellowship at Rush University Medical Center in Chicago, Illinois, USA. He is currently an Assistant Professor of the Infectious Disease Division at Augusta University in Augusta, Georgia, USA.

Abstract:

Introduction: HIV has changed the epidemiology of tuberculosis and is now considered the main risk factor for extra-pulmonary involvement. In recent years, molecular techniques have emerged as promising diagnostic tools. Only Xpert MTB/Rif assay has been advocated by the WHO for diagnosis of extra-pulmonary TB. Scarce data is available on its utility in gastrointestinal tuberculosis. We report a case of an HIV patient with intestinal tuberculosis diagnosed by XpertMTB/Rif.

Description: A 31 year-old HIV patient presented with diarrhea, fever, diffuse abdominal pain and weight loss for the last month. Bilateral crackles and right lower quadrant pain were found on physical exam. His CD4 count was 172 cells per ml and his HIV-1 viral load was 2026 copies/ml. Bilateral alveolar infiltrates were seen on the chest X-ray. Ultrasound showed enlarged peritoneal lymph nodes and thickening of the ileocecal region. Smear and Xpert MTB/Rif from sputum were negative. Patient underwent a colonoscopy which showed irregular congested ulcers in ileum, sigmoid and rectum. Xpert MTB/Rif from biopsy was positive for TB. Standard 4 drug therapy was started and patient improved significantly.

Discussion: The majority of experience with Xpert MTB/Rif has been on sputum samples, but it has also been used in a variety of fluid and tissue samples. It has a sensitivity of 89% and specificity of 74% for the diagnosis of extra-pulmonary tuberculosis. To our knowledge, there are no reports on the use of Xpert MTB/Rif in intestinal biopsies. Our case is a precedent for the use of this assay in the future.

Biography:

Tania M Kohal was graduated from the University of California Berkeley with Bachelor’s degrees in Molecular and Cellular Biology and Latin.

Abstract:

Introduction: Advances in pharmacological therapy have changed the narrative of individuals diagnosed with HIV, prolonging quality and length of life, however, prevention remains key in preventing transmission. Our project aims to assess how individuals obtain HIV information and testing services in the hope to better inform how resources for prevention can be effectively allocated.

Methods: Our study involved designing a flyer to be placed in two clinics, Affirmations and American Indian Health Family Services (AIFHS) in a general information area and a testing area. The flyers contained different web addresses directing individuals to the same web module. This web module contained information about HIV and a survey querying prior testing, risk assessment and demographic factors. A link was provided from the web module to a website where testing resources were available. We designed a method of tracking web traffic to ascertain the initiative individuals were taking in seeking further information. A focus group was done to evaluate how individuals obtain HIV information for which a qualitative analysis was done.
 

Results: Individuals do not readily engage in paper-media based information sources and are more likely to seek out web-based information on their own or respond to directed intervention by peers, physicians, etc.

Conclusion: Our study indicates that resources may be better directed towards web-based information sources and that a directed approach involving healthcare providers, peers, etc. is most effective in encouraging prevention-seeking behaviors.

Biography:

Luis Del Carpio Orantes is a Medical Specialist in Internal Medicine and also an Internist in Mexican Social Security Institute. He is assigned to ICU Internist, D'Maria Hospital and he is also an Expert Columnist for the Iberoamerican Society of Scientific Information with the theme of emerging viruses. He has published articles related to intensive care (negative pressure pulmonary edema and disseminated intravascular coagulation in the ICU) and epidemiology, regarding dengue, zika, chikungunya and influenza which can be referred in PubMed and other index. He is an Independent Researcher, projects a research on the treatment of dengue.

Abstract:

Case Report: Male patient 36 years old with no history of importance except filing burn in your hands by electricity, admitted with symptoms 20 days of evolution characterized by fever, cough and yellowish expectoration, being treated with common antimicrobials previously, developed persistent fever so as right pleuritic pain, so entered, diagnosis protocol which only evinced leukocytosis of 13500/mm³ without respiratory, kidney or liver involvement starts. Smears are performed in series of 3 being negative, a first scan, which reports pneumonic process 70% with diffuse cavitary lesions in addition to air bronchograms (March 14), started treatment with imipenem and vancomycin is performed. The report cultivation expectoration was Staphylococcus epidermidis coagulase negative resistant to vancomycin handling adjusted with linezolid, a second tomography was performed which demonstrated increased cavitary, extended zones into the pleural cavity with multiple septums and fluid levels, so as destruction of lung parenchyma in middle and lower lobe of the right lung (March 20); by poor evolution of painting it was decided to send chest surgery but was managed conservatively, died after 5 days in the service management.

Conclusion: This case has clinical significance, since it illustrates the severity of necrotizing pneumonia, also aggressiveness with coagulase-negative germs, referred to as nosocomial pathogens emergency epidemiological displayed. The importance of pulmonary tomography for the diagnosis and therapeutic decisions also emphasized that in this case was fully indicated the surgical management, primodial mainstay of treatment of necrotizing pneumonia, combined with the antimicrobial medical treatment.

Biography:

Muhanad Ali is currently 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.

Biography:

Andre Ricardo Araujo Da Silva has completed his PhD from FIOCRUZ-National Institute of Infectology, Brazil. He is an Associate Professor of Neonatology at Federal Fluminense University, Brazil, Coordinator of Scientific Program of Medicine Course and also leads the Laboratory of Teaching of Prevention and Control of Healthcare associated infections. He has published more than 15 papers in reputed journals and is a Member of International Federation of Infection Control.

Abstract:

Multidrug-resistance is a global concern. This is a major problem within intensive care units (ICU), where usually doctors have few options to treat healthcare associated infections (HAI). The aim of our work is to describe profile of Gram-negative resistance in cases of HAI occurred in a Pediatric Intensive Care Unit (PICU) of reference. We did a prospective study of all HAI reported in PICU of Prontobaby-Children’s Hospital, with focus in infections due to Gram-negative bacteria. We used National Healthcare Safety Network (NHSN) criteria to define HAI. Gram-negative resistance was defined according Magiorakis criteria. In seven-years of follow-up (from January 2009 to December 2015), we reported 224 HAI. 65 cases were due to Gram-negative and global rates of resistance reported were 47.7%. HAI rates ranges from 9.4 to 15.1 per 1000 patient-days in PICU, during the study. In five of seven years, Gram-negative resistance was higher than 50%. During this period only two HAI due to Enterobacteriaceae resistant to carbapenem were reported (0.9% of all HAI). The main agents founded are Enterobacteriaceae ESBL producers and P. aeruginosa resistant to carbapenem. In our casuistic, we found higher rates of Gram-negative bacterial resistance in cases of HAI. To avoid this problem, it is necessary to develop strategies to reduce incidence of HAI, even in critical ill children. Also, new treatment options are urgently needed.

Biography:

Luis Del Carpio Orantes is a Medical Specialist in Internal Medicine and also an Internist in Mexican Social Security Institute. He is assigned to ICU Internist, D'Maria Hospital and he is also an Expert Columnist for the Iberoamerican Society of Scientific Information with the theme of emerging viruses. He has published articles related to intensive care (negative pressure pulmonary edema and disseminated intravascular coagulation in the ICU) and epidemiology, regarding dengue, zika, chikungunya and influenza which can be referred in PubMed and other index. He is an Independent Researcher, projects a research on the treatment of dengue.

Abstract:

Objective: Casuistry of invasive candidiasis is reviewed on an intensive care unit, applying the candida score to assess their potential predictor of HIV infection.

Design: Retrospective, observational and descriptive study.

Methods: The Candida score is applied retrospectively all identified cases of invasive candidiasis to evaluate its effect predictor of the disease; also the most common strains and their risk factors identified in this population are identified.

Results: The casuistry of the intensive care unit were reviewed, which had 102 patients in the period 1 January to 31 December 2014, of which Candida infection in 14 patients (13.7%) was reported. Being the most affected female gender with 10 patients (71.4%), also the most affected age group was 81-90 years, followed by 71-80 years. The stay in the ICU, at the beginning of candidiasis averaged 8 days. Infection of an anatomical site was identified in 9 patients and in 5 patients in two anatomical sites with predominant involvement in the lungs (10 isolates), the urinary tract 2^nd highest incidence (7 cases), it is noteworthy that no cases of candidemia and there was only one isolate in a central catheter, which was classified as catheter colonization; other cases invasive pulmonary candidiasis and urinary level (the latter probably bladder colonization, favored by use of urinary catheters) were considered. The most frequent isolates were Candida albicans (10 patients) followed by C. krusei (4 patients), C. tropicalis and Candida sp., in 3 patients, respectively. The score Candida was positive in 7 patients (50% score >2.5) but did not correlate with mortality as these patients, only 3 of them were fatal, C. albicans being the most deadly. In this casuistry 8 patients had a good outcome. The presence of a central venous catheter (14 patients), the long stay in the unit (12 patients) and the use of broad spectrum antimicrobials as prior (10 patients) were identified as predisposing factors. Risk factors being the bearer of chronic lung disease, sepsis and cardiovascular disease in 8 patients respectively were identified. Candidiasis appeared after a common course of broad spectrum antimicrobials (3^rd generation cephalosporins basically) in 10 patients and only 4 had begun with an antimicrobial greater spectrum (carbapenem, glycopeptide or fluoroquinolone); once identified candidiasis, management began with triazolido (fluconazole in 9 cases and voriconazole in 1 case), meriting a second antifungal adjustment scheme with an echinocandin or voriconazole in 4 cases by persistent candidiasis. Of the 6 deaths, 4 had started operation with fluconazole and despite having given a second scheme with an echinocandin or voriconazole, the prognosis is not improved.

Conclusion: We conclude that the Candida score is a predictive indicator and signals to patients who are at risk for infection with Candida (score >2.5), but does not predict the mortality rate of each case. Risk factors and predisposing factors are similar to those reported in other series, only highlighting in this series, the presence of chronic lung disease, as correlational would explain the higher incidence of lung isolation level and in elderly patients. Also regarding the treatment employed, it is recommended that a positive Candida score, antifungal management spectrum starts, primarily an echinocandin or voriconazole, to try to improve the survival rate of these patients, who are often elderly patients, anergic, diseases chronic degenerative and high rate of morbidity and mortality and can be considered as neutropenic patients. In this series, chronic lung disease served as a major risk factor, which has not been previously reported, since in the literature to Aspergillus is mentioned as the leading pioneer in these patients which was not confirmed.

Biography:

Leila Vali has completed her PhD from Edinburgh University and Postdoctoral studies from Medical College of Wisconsin, Milwaukee and Edinburgh University. She has been a Lecturer in Strathclyde University, UK and is currently an Assistant Professor in Kuwait University. He has published more than 25 papers in reputed journals and has been serving as an Editorial Board Member of repute.

Abstract:

It is essential to reduce the bacterial load and ensure the effectiveness of hygienic conditions in hospitals. Chlorhexidine is one of the most widely used biocides. Since resistance genes to quaternary ammonium compounds have appeared more frequently in staphylococci, we aimed to identify S. aureus with reduced sensitivity to Chlorhexidine in Kuwaiti hospitals. We collected 97 methicillin-resistant (MRSA) and 100 methicillin-sensitive (MSSA) S. aureus. We amplified mecA, blaZ, qac A/B, qacH, qacH2, qacG, smr, norA, PVL and agr genes. Antibiotic sensitivity testing for 10 antibiotics and MIC/MBC of chlorhexidine were determined. MLST, spa typing and PFGE were used to identify genetic variations. The predominant genes were mecA, blaZ, norA, qacA/B, smr, while qacG, qacH, qacH2 were not detected. All isolates were sensitive to vancomycin, teicoplanin and tigecycline. The range of MIC for chlorhexidine for qacA/B positive isolates was 4-30 mg/l, however the MBC (0.94-60 mg/l) was statistically greater than MIC (p˂0.0001). Typing methods showed all the isolates with reduced sensitivity to chlorhexidine containing qacA were ST239-III-t945-PVL˗. The presence of qac genes does not necessarily imply increased resistance to chlorhexidine or any other antimicrobial agents. However MBC of chlorhexidine was higher for the isolates containing qacA/B compared to those without. We observed clonality among the qacA/B positive isolates with reduced sensitivity to chlorhexidine (HA-MRSA-ST239-III-t945 PVL˗). Reduced sensitivity may be a contributing factor to survival of this clone in hospitals. It is crucial to strictly monitor dilution standards to avoid low level exposure of HA-MRSA-ST239-III to biocides, specifically in the developing countries.

Biography:

Luis Del Carpio Orantes is a Medical Specialist in Internal Medicine and also an Internist in Mexican Social Security Institute. He is assigned as ICU Internist at D'Maria Hospital and he is also an Expert Columnist for the Iberoamerican Society of Scientific Information. He has published articles related to intensive care (negative pressure pulmonary edema and disseminated intravascular coagulation in the ICU) and epidemiology, regarding dengue, zika, chikungunya and influenza.

Abstract:

Case: Woman 24 years old with no history of importance except being operated caesarean operation two months and a half without incident, resulting in macrosomia product. Enter a room trauma shock seizures witnessed at home and during transportation to the hospital, clouding, state initial shock, hypoglycemia, fever, with a history of non-specific prodrome 7 days prior characterized by fatigue and weakness, adding fever 72 hours previous and also presenting with behavioral disorders disorientation 24 hrs prior to admission, the previous night generalized purpuric dermatosis is added. Upon initial review apparently glasgow of 14, but disorientated and psychomotor agitation, presenting shock unresponsive to water resuscitation initial, feverish with suspected neuroinfection, so she underwent cranial tomography which is reported only discrete brain edema; passes intensive therapy for management of shock, after endotracheal intubation seizures and involvement of consciousness. Upon arrival even with persistent hypotension despite double scheme amines (dopamine, norepinephrine) and fluid resuscitation, also high ventilatory requirements with data from acute lung injury, in frank anuria and acute renal injury, severe metabolic acidemia that warrants management bicarbonate, hematologic data franca fails with disseminated intravascular coagulation and purpura generalized data. The antimicrobial management that had been initially with ceftriaxone-vancomycin, leaving vancomycin-meropenem also dose intravenous hydrocortisone (500 mg) is given for suspected acute adrenal insufficiency (manifested by shock, tendency to hypoglycemia, hyponatremia, hypokalemia) is set, is it gives renal support with loop diuretic infusion as well as bicarbonate infusion. He remains in the intensive care unit for 10 hrs, no response to management, a refractory shock, severe sepsis and multiple organ dysfunctions were considered. Since studied with neurological, metabolic and hematological disorders, kidney damage, lung damage, criteria for disseminated intravascular coagulation coupled with widespread purpura, Waterhouse-Friderich sensyndrome was considered, which was devastating for the patient. A 5-day incubation of blood cultures growth coagulase-negative staphylococci were reported, being sensitive to Vancomycin, definitive bacteriological diagnosis, staphylococcus haemolyticus. Negative serology for dengue and leptospirosis were reported, requested by endemic area meet such conditions. First case reported in adults Waterhouse-Friderichsen syndrome secondary to staphylococcus haemolyticus is concluded.

Biography:

Jamshaid Iqbal is a consultant at Mubarak Al-Kabir Teaching Hospital, Kuwait and he is the director at center for medical education and faculty of medicine at Kuwait University, Kuwait.

Abstract:

Background: Prostate cancer and benign prostatic hyperplasia (BPH) represents the most common urologic disease among the elderly males resulting in more than 2 million visits per year. BPH affects about one-quarter of men in their 50s. The pathogenesis of BPH is not yet completely understood however, the role of chronic inflammation is emerging as an important factor in BPH development and progression. Recently, the studies have found that T. vaginalis may be associated with asymptomatic infections in 50-75% of infected men. In this study we investigated the possibility of asymptomatic persistence of T. vaginalis in the prostate gland using benign hyperplastic prostate tissue as prostate condition other than clinical prostatitis.

Materials & Methods: We investigated the occurrence of T. vaginalis in prostate tissue of 75 men of >50 years of age suspected and treated for BPH by transurethral resection of the prostate at the Mubarak Al-Kabir Teaching Hospital, Kuwait. The presence of T. vaginalis infection in the prostate tissue was determined by PCR analysis of the DNA extracted from the tissue and Immunocytochemistry of the tissue sections of the prostate tissue. In addition, P16 antigen was also detected in the tissue sections. The antibodies to T. vaginalis were also determined in blood.

Results: We detected T. vaginalis DNA in 18 of 75 (24%) and P16 antigen in 16/75 (21%) of BPH tissue samples, of which only 7 (39%) BPH tissues were positive by immunocytochemistry. In addition, three T. vaginalis DNA-negative prostate tissues were also positive immunochemistry. T. vaginalis-specific antibodies with predominantly IgG4 antibodies were detected in 23 (31%) cases.

Conclusion: Our preliminary study suggests a direct evidence of T. vaginalis in BPH tissues with no clinical signs of prostatitis. We hypothesize that chronic T. vaginalis infection of prostate tissue may lead to BPH in elderly people.

Biography:

Sakly Mouna has completed her Medicine studies from El Manar University, Faculty of Medicine of Tunisia. She has submitted her Doctoral thesis in Medicine in 2002, completed Master of Advanced Studies in Economy Health and Hospital Management from the Faculty of Medicine of Tunisia in 2009, Master of Advanced Studies in Tobacco from the Faculty of Medicine of Tunisia in 2010 and Certification Green Belt Lean Manufacturing and Management L2M in 2016. She is the Coordinator of child health programs and primary health care quality program in Tunisia and she is also the Tunisian focal point on disability and deafness and a National Trainer in the counseling and HIV screening among pregnant women. She has published some papers in reputed journals. She is a Reviewer of Public Health Review, France since 2016 and a Teacher of the national maternal and newborn health program in the University Mohamed El Matri at Tunisia.

Abstract:

Introduction: the Influenza is an acute viral infection transmitted by air. It`s a highly contagious disease that can cause serious complications, especially among vulnerable people, it presents a major public health issue with a considerable socio-economic impact.

Purpose: Review the epidemiological situation of influenza in Tunisia in The 2015-2016 season. Determine if the A (H1N1) virus has a particular virulence in Tunisia during the 2015-2016 season. Make recommendations to overcome challenges.

Methods: This retrospective study is based on data issued by the National influenza surveillance unit; it relies on a descriptive analysis of influenza surveillance data provided by the network of sentinel sites and national influenza center (NIC).

Results & Discussion: Influenza surveillance in Tunisia has been in established since 1999 with the creation of network sentinel sites, but it significantly developed on March 2014, by the enhancement of the national influenza surveillance system. In Tunisia, clinical, epidemiological and virological surveillance of influenza began in week 40/2015 (1^st of October 2015) and ended in week 18/2016 (30^th of April 2016). During the period of study: 96,240 cases ILI (Influenza-like illness) were collected from a total of 1,394,782 patients seen at sentinel ILI sites, representing 6.9% of total patients versus 7.7% during the 2014-2015 season. The epidemiological surveillance of influenza on the Tunisian territory showed that the influenza epidemic was spreading in the winter season 2015/2016 during fourteen weeks from the 25^th of January 2016 (2016 / W4) to the 29^th of April 2016 (2016/ W18) with an incidence rate of 10.3%. It started a little later than it did during the previous season and lasted relatively longer (14 weeks versus 8 weeks). During the 2014-2015 season, influenza reached its peak during the coldest weeks (S6 to S9) and there was an inverse trend of the monthly average temperature. This correlation has not been observed during this season having regard to the shift of the cold season. In fact, this flu season peaked during the week of 14 to 20 March 2016 (2016/S12), later than usual. These findings were also observed in Europe and in USA. All of the 24 governorates of Tunisia have been affected by the influenza and the incidence is higher in the most populated regions. Children 5 to 16 years are the most affected. Among the visits for influenza-like illness (ILI), 190 severe cases were hospitalized representing a comparable proportion to the previous season (0.19% vs 0.2%) and were mainly infected with A (H1N1) pmd09 virus (57% of cases). The average age for these severe cases was 46.5 years, with extreme ages varying between 6 months and 73 years. Their lethality was significantly higher than that observed during the previous season (20% vs 3%) and was H1N1 associated in 73.7% of cases. During Week 12, there was an increased circulation of influenza viruses in Tunisia and subsequently there were the highest number of deaths (10 deaths representing 26.3% of all influenza deaths). 37.1% of influenza deaths had no risk factors. The co-circulation of the three influenza viruses began in late January (W4) with a gradual increase in the circulation of the type A (H1N1) pmd09 virus. During the week W12, the type A (H1N1) pmd09 virus was more common than the type B. The seasonal distribution of three types of influenza viruses was: Virus A (H1N1) pmd09 (57.4%), Virus A (H3N2) (38.5%) and Virus B (3.5%). The positivity rate for influenza was 24.4% vs 28.4% during the previous season.

Conclusion: The 2015-2016 influenza epidemic started little later than the previous season, marked by the co-circulation of three influenza viruses and the predominance of the virulent type A (H1N1) pmd09 virus, the impact of the epidemic in terms of ILI consultations and hospitalizations was comparable to the previous season, but the lethality of severe cases was significantly higher. Viruses know no borders, control and fight against the influenza require a global vision of the dynamics of the disease in our country, as well as around the Mediterranean in order to better contain any unusual event.

Biography:

Samer M Al-Hulu is an Assistant Professor of Microbiology. He has completed his PhD from College of Science, Babylon University. He has published more than 14 papers in microbiology field. He has trained at Ministry of Health at Laboratory of Babylon Maternity and Children Hospital. Presently, he is working at College of Food Science, Al-Qasim Green University.

Abstract:

Superbugs is the term which used for describing of multidrug-resistant organisms that evolved and developed resistance to at least one type of antimicrobial drug or antibiotic. MRSA, VRE, ESBLs are some examples on superbugs. The combating of superbugs can be achieved by proper hand washing and using of good hand hygiene. DNA Sequencing of superbugs playing an important role in combating of spread such as DNA sequencing from patient and compared with database for determining source of infection. Using of Nano-based therapy for combating of superbug such as using of nano metals and metallic oxides which having high activity against board spectrum antibiotic resistant bacteria such as AgNPs which having high activity against MRSA and silver resistant E. coli, also using of Nano-enabled antibiotics such as using drug delivery system and using of other methods such as cellulose nano crystals-porphyrin, CNTs and others. Other solution for combating of superbugs is prevent of antibiotic misuse and overuse which due to developing of resistant for antibiotics via one or more mechanisms of DNA alteration. Essential oil having a new weapon for combating of superbugs, oil is derived from variety of natural sources including plants or component of plants such as flowers, leaves and others, these oil having complex mixtures of chemicals which having antimicrobial activity. Phage therapy is plays an important role for fighting of drug-resistant pathogens.