3^rd Annual Congress on Infectious Diseases August 21-23, 2017 San Francisco, California, USA

Biography:

Chandra Shekar Pingili is a Director, Division of infectious diseases, Sacred Heart and Saint Joseph Hospitals. Associate Professor of Medicine, University of Wisconsin Madison at Eau Claire, Wisconsin. Actively involved in teaching family medicine residency program and nursing staff. Director of Infectious Diseases at LE Phillips Rehab Center, Eau Claire and Chippewa Falls. Chief Infectious Disease adviser to the Clearwater Care Center, Eau Claire, WI. Chief Infectious Disease adviser to the Dove Health and Rehab Center, Chippewa Falls, WI. Director of Infectious Diseases at Indian Head Medical Center.

Abstract:

Background: Medical syndromes often overlap in clinical presentations. Often there is one or more than underlying etiology responsible for the patient’s Clinical presentation. We are reporting a patient who was admitted thrice with fevers and joint pains. Lymes IGG was positive. He was discharged home on doxycycline and prednisone suspecting gout. Second admission he was discharged to home on IV ceftriaxone. Patient however was re admitted twice within 3 weeks with cognitive impairment. Lymph node biopsy was positive for non caseating granulomas. Sarcoidosis was the final diagnosis.

Case Report: 74 year old white male was admitted with fever and multiple joint pains. Tmax was 100.5. WBC was 15 with normal CBC. LFTs were elevated. Rest of the labs was normal. Lymes IGG was positive. He underwent extensive rheumatologic and virological evaluation. Sonogram of the abdomen was negative. He responded to IV Ceftriaxone and was discharged home on Doxycycline for 3 weeks and Prednisone taper for a week .He was readmitted within 2 weeks with weakness and confusion. After ruling out multiple etiologies he was discharged home on IV Ceftriaxone suspecting Neuroborreliosis. But he was re admitted with worsening mentation in a week. This time he was diagnosed as case of neurosarcoidosis. He responded dramatically to IV steroids, methotrexate and one dose of infliximab. Patient continues to follow up with the clinic and is now at his base line with no recurrence.

Conclusion: He is one patient where an underlying disabling pathology was missed twice. He is a case of systemic and neurosarcoidosis masquerading as neuroborreliosis. Rarely is a clinical encounter so perplexing.

Biography:

Dr Nichola Ashby is an Assistant Professor for the University of Nottingham, School of Health Sciences. As a nurse she is the lead within the school for Critical Care and Major Trauma. She undertook her PhD at the University of Birmingham and looked at stigma and iatrogenic disease, focusing on healthcare workers attitudes and values towards others within the profession. Further research undertaken is qualitative work on sepsis management, critical care, trauma coordinators doctoral journeys for women and pressure area care within critical care. Her research interests are the perceptions , values and attitudes of healthcare workers towards sepsis and infection. She works actively within national policy development for critical care and major trauma and is a clinical expert for the National Institute of clinical Excellence. Dr Ashby also is a steering group committee member for the Royal College of Nursing Critical Care and In flight Nursing.

Abstract:

Individuals or groups will form impressions of another based upon a series of traits, which may be relied upon when forming behaviour pattern towards others (Asch, 1946; Crocker and Major, 1989;  Pinel, 1999; Albon, 2002; Corrigan and Wassel, 2008). These traits will depict the reception individuals receive within healthcare and may depend upon learnt and inherited ‘perceived’ ideals affecting the working and personal relationships experienced by healthcare workers with a positive diagnosis o f infection, predisposing stigma responses to others (Asch, 1946)
A longitudinal exploratory study was undertaken over three years investigating the potential existence of stigmatising values from student nurses towards positively diagnosed healthcare workers with Pulmonary Tuberculosis (PTB), Human Immunodeficiency Virus (HIV), Methicillin-resistant Staphylococcus Aureus (MRSA), Hepatitis C and Diabetes type 2, was undertaken (Ashby, 2015). The mixed methods used to analyse data provided an interpretive exploration of the stigmatising attitudes and values of 482 student nurses undertaking an education programme.  Interpretation of the findings explored the participants views at course commencement, midpoint and completion considering variables of education (theoretical and clinical), personal and professional influences.    
Principle Component Analysis of the data provided components for three ANOVA’s and the within-subjects repeated measures showed little significance between disease groups. Further qualitative data was analysed to provide interpretation of these results demonstrating the presence of stigma. Therefore, the study recommends the implementation of a longitudinal education model for all healthcare workers, considering disease processes and influencing factors psychologically, socially and physically, which will provide opportunities to reduce the existence of stigmatisation for positively diagnosed healthcare workers.
 

Biography:

Abstract:

Statement of the Problem: There is increasing requirement for the development of new drug protocols against malaria, a fatal disease caused by the lethal parasite Plasmodium falciparum. Leucine aminopeptidase (PfLAP) of Plasmodium falciparum, is being pursued as a promising target for the discovery of novel antimalarials.. Methodology: PfLAP and HsLAP were expressed in Escherichia coli, and AgNPs (3-10 nm) characterized by ultra-violet spectroscopy and transmission electron microscopy. The effects of silver nanoparticles (AgNPs) against P. falciparum leucine amino-peptidase (PfLAP) and the human homolog (HsLAP) were compared. Findings: PfLAP indicated a Km of 694 µM towards leucine-p-nitroanilide and a Vmax of 57.9 μmol.ml-1.min-1 while HsLAP had a Km of 1.6 mM and Vmax of 119.6 μmol.ml-1.min-1. On interaction with AgNPs (670 nM) PfLAP was selectively inhibited (57.1 %; Ki = 610 nM) relative to HsLAP (10.8 %; Ki = 5.22 µM). The viability of P.  falciparum parasites was decreased when exposed to silver nanoparticles, with an IC50 value of 6.96 μM, compared to an IC50 value of 647.7 μM for human HeLa cells. Conclusion & Significance: Structural differences between the enzyme variants, particularly the orientation and distance of surface Met349 in PfLAP and Met306 in HsLAP to the zinc binding sites were significant and may allow for selective targeting of PfLAP by AgNPs.

Biography:

Doaa Hashad has completed her masters in 2001, then her MD in 2007 from Alexandria University. She is an associate professor at the clinical pathology department-faculty of medicine -Alexandria university. She has published many papers in reputed high ranked journals. Doaa Hashad, MD is an editor of two online books; cancer management and gene therapy: principles and challenges.

Abstract:

Aim: To assess the use of mitochondrial DNA (mtDNA) content as a noninvasive molecular biomarker in hepatitis C virus-related hepatocellular carcinoma (HCV-HCC). Materials and Methods: A total of 135 participants were enrolled in the study. Equal numbers of subjects were enrolled in each of three clinically defined groups: those with HCV-related cirrhosis (HCV-cirrhosis), those with HCV-HCC, and a control group of ageand sex-matched healthy volunteers with no evidence of liver disease. mtDNA concentrations were determined using a quantitative real-time polymerase chain reaction (PCR) technique. Results: mtDNA content was lowest among the HCV-HCC cases. No statistically significant difference was observed between the group of HCVcirrhosis and the control group as regards mtDNA level. HCC patients with multicentric hepatic lesions had significantly lower mtDNA content than HCC patients with less advanced disease. When a receiver operating characteristic curve analysis was used, a cutoff of 34 was assigned for mtDNA content to distinguish between HCV-HCC and HCV-cirrhosis patients who are not yet complicated by malignancy. Lower mtDNA content was associated with HCC risk when using either or both healthy controls and HCV-cirrhosis groups for reference. Conclusions: mtDNA content analysis could serve as a noninvasive molecular biomarker that reflects tumor burden in HCV-HCC cases and could be used as a predictor of HCC risk in patients of HCV-cirrhosis. In addition, the nonsignificant difference of mtDNA level between HCV-cirrhosis patients and healthy controls could eliminate the gray zone created by the use of alpha-fetoprotein in some cirrhotic patients.

Biography:

Guozheng Wang, a reader in University of Liverpool, UK, focuses on critical care medicine, particularly sepsis, using molecular and cellular approach, animal models and clinical investigation to understand the molecular mechanisms, develop diagnostic and therapeutic tools.

Abstract:

Statement of the Problem: The most common pathological change in critical illness is multiple organ failure, which often leads to death. However, the underlying mechanisms are not fully understood. Recently, the secondary hit by cell breakdown products causes great attention.
Methodology & Theoretical Orientation: Both septic animal models and patients with sepsis were investigated. Circulating histones released after cell death, the most abundant damage-associated molecular pattern (DAMPs), were detected and their association with organ injury markers was analyzed. Intervention with anti-histone reagents was carried out to confirm the cause-effect relationship.  
Findings: Circulating histones were dramatically elevated in both animal models and septic patients. Their levels were strongly associated with the severity of organ injury, particularly lung and cardiac injury. Using anti-histone scFv or non-anticoagulant heparin could significantly reduce organ injury as well as mortality rates. In addition, histones binding prothrombin initialized coagulation and significantly contribute to dysregulated coagulation leading to disseminated intravascular coagulation (DIC). Extracellular histones could interrupt integrity of cell membrane and cause calcium influx to damage cells, stimulate cytokine release and cause cardiac arrhythmia.   
Conclusion & Significance: DMAPs, particularly histones, play critical roles in sepsis, including inflammation, coagulation activation, and multiple organ injury. This lays a foundation for future anti-histone intervention to reduce the unacceptably high mortality rates of sepsis.
 

Biography:

Hua Zhu obtained Ph.D. degree from Columbia University and completed his postdoctoral studies from Princeton University. He has been working on herpesviruses for over 20 years. He started with studying human cytomegalovirus (HCMV) immediate-early gene function. He performed pioneer works on global cellular transcriptional responses to viral infection using differential display and gene chip technology. One important discovery from these studies is how HCMV infection activates large numbers of interferon-stimulated genes. Later, he applied the bacterial artificial chromosome (BAC) technology to study HCMV and varicella zoster virus (VZV) gene function,tropism and pathogenesis. He is one of the first to construct for HCMV and VZV BACs. He also used humanized mouse model and luciferase assay to study viral replication in vivo. He was first to discover VZV neurotropic factor which leads to a novel neuro-attenuated VZV vaccine candidate develop. He has published over 70 research articles, reviews and book chapters.

Abstract:

Varicella zoster virus (VZV) infection causes two distinct, but related diseases: varicella (chickenpox) following primary infection and zoster (shingles) after reactivation of latent VZV. VZV reactivationcauses serious neurological diseases such as, postherpetic neuralgia,myelitis, stroke and giant cell arteritis especially in the elderly. Thefactors involved in neuronal invasion and establishment of latency are still elusive. In our previous work, we employed a VZV BAC system in order to characterize a comprehensive library of VZV single ORF deletion mutants. We reported 18 ORFs to be fully dispensable in melanoma cells, which we postulated to encode elements responsible for specific tissue tropism. We now demonstrate that screening of these 18 dispensable gene mutants in differentiated neurons led to the identification of ORF7 as a neurotropic factor. This finding adds to our previous report that ORF7 is also a skin tropic factor. ORF7 is a virion component
localized to the Golgi compartment in infected cells, whose deletion causes loss of polykaryon formation in vitro and severely impairs viral spread in human nervous tissue ex vivo. Molecular mechanism of ORF7 in tissue tropism and pathogenesis are under investigation. Furthermore, ORF7 is required for VZV replication in xenografts of human skin and dorsal root ganglia in a SCID-hu mouse model. We showed that an ORF7 deletion virus is able to infect dendritic cells,which in turn can infect T cells. This unique set of characteristics lends an ORF7 deletion mutant the potential to become an excellent VZV vaccine candidate. This neuroattenuated vaccine would cause neither the primary chickenpox nor the secondary herpes zoster diseases. Finally, given that ORF7 is essential for VZV initial infection of neurons and replication therein, it may also be a critical trigger of reactivation from latency.
 

Biography:

Hamoud Khalid Alshaya and Khalid Sukhail G Alshammari as a students of Medical College in the University of Hail.

Abstract:

Background: The oral cavity harbours a large number of bacterial species as normal flora existing as biofilm. Dental disease such as dental caries results when there is a shift in the balance of bacteria towards pathogenic species within these biofilms.

Objective: The objective of this study was to isolation, identification and characterization of oral bacterial species of patients with dental caries and caries-free healthy control subjects.

Materials & Methods: A standard bacteriological procedures were followed in the isolation of bacteria. The identification of bacteria was carried out using Matrix-Associated Laser Desorption Ionisation–Time of Flight–Mass Spectrometry (MALDI–TOF–MS) (Bruker MALDI Biotyper system). The characterization of bacteria involved in the determination of biofilm forming potential and assessment of synergistic antimicrobial action of manuka honey and gentamicin against the oral species.

Results: A total of 13 bacterial species were isolated from 35 orals samples (10 from patients with dental caries); of which 7 bacterial species have been isolated for the first time in Saudi Arabia. The Streptococcus spp. exhibited varied biofilm-forming potential and response to synergistic antimicrobial activity of manuka honey and gentamicin.

Conclusion: The isolation of 7 bacterial species for the first time from dental caries and caries-free subjects in Saudi Arabia warrants a larger prevalence study involving molecular and phenotypic tests to assess their role in health and disease in Saudi population.

Biography:

Ting Li has her expertise in female genital tract infection diseases.

Abstract:

Statement of the Problem: Vulvovaginal candidiasis (VVC) is an opportunistic fungal infection predominantly caused by Candida albicans affecting a significant number of women of reproductive age. The Chinese medicine, the Baofukang suppository is widely used in the clinic for its antimicrobial activity and is therefore of great interest as a potential antifungal drug for the prevention of VVC.

Methodology & Theoretical Orientation: We evaluated the cytotoxic activity of the Baofukang suppository using the VK2/E6E7 vaginal epithelial cell (VEC) line. An ELISA analysis was made to evaluate three kinds of cytokines (Th1, Th2 and Th17 types) and non-B IgG in the supernatants. SEM was conducted to observe ultrastructural changes of VECs.

Findings: When treated with the Baofukang suppository, all of the immunocompetent cytokines and chemokines (e.g., IL-2, IL-4, IL-6, IL-8, and IL-17) by infected VK2/E6E7 cells was statistically up-regulated (P<0.05), except IL-4 (11.70±1.82 vs. 14.88±4.72, P=0.343) compared to the infected control cells. The secretion of non-B IgG also exhibited the same trend. Our scanning electron microscopy results revealed that C. albicans can invade VECs by both induced endocytosis and active penetration. The Baofukang suppository could effectively inhibit the adhesion, hyphal formation, and proliferation, as well as notably restore the vaginal epithelial cell morphology, viability, and enhance the local immune function of the VECs.

Conclusion & Significance: These preliminary results suggest promising antimicrobial properties of the Baofukang

suppository, which may be efficacious as an antifungal therapy candidate via up-regulating Th1 cellular immunity, the Th17-axis of the innate immune response, and the secretion of vaginal epithelial-derived IgG. These combined effects collectively restore the immune function of the infected VECs against Candida albicans in vitro.

Biography:

V Kattel is the Faculty Member of Internal Medicine and Incharge of Tropical and Infectious Disease Unit at Referral Hospital and Medical School BPKIHS, Nepal. He has been involved in training more than 300 Nepalese Medical Doctors working at remote part of the country on infectious diseases of Nepal as a national expert. He has contributed for the development of national guidelines on outbreak potential infectious disease of Nepal, Management of Kala Azar in Nepal. His fields of interest are HIV/AIDS, acute undifferentiated fever and sepsis.

Abstract:

Statement of the Problem: HIV and Hepatitis C viral Infection (HCV) have same mode of transmission. A subset of HIV people on antiretroviral therapy (ART) achieves virological suppression but poor recovery of CD4 cell termed as immunological non-responders. It has been recommended to start HCV treatment in HIV coinfection if CD4 cells are more than 200/ml. Immunological non-responders could be a challenge to initiate HCV treatment especially in limited resources setting.

Case Description: A 24 years intravenous drug abuser male with HCV for last 3 years presented as HIV positive (CD4 - 186/ml) on July 2008. Despite ZDV/3TC/EFV for six months he did not achieve immunological recovery but his viral load was below 400copies/ml. On September 2009 he was presented with fever and constitutional symptoms for two weeks. On examination he was pale, icteric and had hepatospleenomegaly. Investigation revealed that pancytopenia, transaminitis, hepatospleenomegaly, sterile blood culture, normal chest X ray, sputum for acid fast bacilli and PCR for mycobacterium tuberculi negative, negative rK-39, malaria negative. He had CD4 of 156/ml, HIV viral load 72 copies/ml HCV RNA 15600copies/ml. Bone marrow aspiration revealed 3+ Leishmania Donovani (LD) bodies. ARV regimen was changed to TDF/3TC/EFV and tablet Miltefosine 50 mg twice a day for 28 days was initiated. He improved clinically and parasitologically. On April 2010 his second infection of Visceral Leishmaniasis (VL) was treated with injection amphoteracin B. On March 2011 and August 2012 he had third and fourth episode of VL infection and was treated with amphoteracin B plus miltefosine and liposomal amphoteracin B respectively. However the fourth episode was continued with secondary prophylaxis for six months with immunological recovery (CD4 756/ml). On April 2015 his HCV was treated with 12 weeks sofosbuvir and daclatasvir with rapid viral and sustained viral response.

Significance: Immunological non responders might be virtual phenomena.

Biography:

Dr Darshna Yagnik is lecturer in immunology and biomedical sciences at Middlesex University. Her research is based on human invitro models of mononuclear cell differentiation and their role in inflammatory pathways and particulary the resolution phase of inflammation.

Abstract:

Extraintestinal pathogenic Escherichia coli (E-coli) are the most frequent cause of blood borne, urinary tract and hospital acquired infections. Candida albicans infection can also pose a huge threat especially following transplantation and to immunocompromised patients. Globally there has never been a more desperate time for novel anti-microbial agents to target microbes and multi drug resistance from bacterial or fungal associated infections.

The aim of this study was to investigate the potential anti-microbial effects of ACV®. We used microbial strains: E-coli strain 6571, C.albicans strain 90828 purchased from ATCC.  

We tested the effect of commercial ACV® directly on microbial cultures over a 24 hour period, measuring inhibition zones. We also looked at whether ACV® could have an anti-inflammatory effect in vitro. This was tested using human blood derived monocytes which were incubated with microbes and AVC®. Collected supernatants were analysed for pro-inflammatory cytokine secretion by ELISA.

Results: When monocytes were cultured with both microbes they secreted TNFα and IL-1β. ACV® was able to significantly inhibit E-coli growth demonstrated by the results of direct co-culture with each of the microbial innoculums and ACV® in varying concentrations. The zone of inhibition with the addition of ACV® to each of the microbes varied dose dependently ACV® concentration.  For candida albicans undiluted ACV® had the strongest effect, whereas on E-coli cultures, the most potent effect was visible at lower dilutions including 1/1000 dilution of the neat solution (p<0.05). When monocytes were cultured with both microbes they secreted inflammatory cytokines (TNFα, IL-1β) ACV® was effective in significantly inhibiting inflammatory cytokine secretion in human peripheral blood monocytes cultured with E-coli and Candida albicans

Conclusion and significance: ACV® displayed potent anti-microbial and anti-inflammatory activity against E-coli and Candida albicans. We propose that ACV® could be potentially therapeutic in cases of antibiotic resistance and sepsis.

Biography:

Notice Ringa obtained a PhD in Applied Mathematics from the University of Guelph in Guelph, Ontario, Canada in 2014. Currently he hold a position of Lecturer of Mathematics at the Botswana International University of Science and Technology in Botswana, Africa. While he coordinates several undergraduate and postgraduate mathematics modules including Linear Algebra, Ordinary Differential Equations and Partial Differential Equations, Notice Ringa is also actively involved in both individual and collaborative research, and aspires to send out three (3) manuscripts for journal review during the first half of 2017.

Abstract:

Pair approximation models have been used to study the spread of infectious diseases in spatially distributed host populations, and to explore disease control strategies such as vaccination and case isolation. Here we introduce a pair approximation model of individual uptake of non-pharmaceutical interventions (NPIs) for an acute self-limiting infection, where susceptible individuals can learn the NPIs either from other susceptible individuals who are already practicing NPIs (“social learning"), or their uptake of NPIs can be stimulated by being neighbors of an infectious person (“exposure learning"). NPIs include individual measures such as hand-washing and respiratory etiquette. Individuals can also drop the habit of using NPIs at a certain rate. We derive a spatially defined expression of the basic reproduction number R0 and we also numerically simulate the model equations. We find that exposure learning is generally more efficient than social learning, since exposure learning generates NPI uptake in the individuals at immediate risk of infection. However, if social learning is pre-emptive, beginning a sufficient amount of time before the epidemic, then it can be more effective than exposure learning. Interestingly, varying the initial number of individuals practicing NPIs does not significantly impact the epidemic final size. Also, if initial source infections are surrounded by protective individuals, there are parameter regimes where increasing the initial number of source infections actually decreases the infection peak (instead of increasing it) and makes it occur sooner. The peak prevalence increases with the rate at which individuals drop the habit of using NPIs, but the response of peak prevalence to changes in the forgetting rate are qualitatively different for the two forms of learning. We conclude that pair approximation models of the impact of human behavior on the spread and control of infectious diseases can help provide insights into infection control, and should be further developed.

Biography:

Jenny Mae A. Quinivista-Yoon is currently a second year Internal Medicine Resident at ST. Luke’s Medical Center-Global City in the Philippines who aspires to become a relevant Infectious Disease specialist in the future. Her current interests in the Infectious Disease field include nosocomial infections and their prevention, as well as community-onset disease outbreaks

Abstract:

Prosthetic joint infection (PJI is one of the leading causes of arthroplasty failure. A high incidence of PJI follows Staphylococcus aureus and coagulase-negative staphylococci. On the other hand, Streptococcus pyogenes PJI is extremely rare, with only a very few case reports in the literature. Toxic Shock Syndrome resulting from Streptococcus pyogenes infection, however, has a reported mortality rate as high as 30 to 70 percent, hence early recognition of this potentially fatal infection is crucial to the successful management of patients. In this article, we report a case of an eighty-year old male who developed streptococcal toxic shock syndrome in association with a severe group-A streptococcal infection of the knee after a total knee arthroplasty done two years prior.

Biography:

I am an epidemiologist by training after General Medical Practitice. I have worked in health institutions in the Ministry of Health of Ethiopia. I have also coordinated TB Leprosy and Blindness Prevention and Control Programme in Southern Ethiopia with a population of about 15 million. I was responsible for training, planning and M+E. I have also worked with stakeholders and partners working related activities in capacity building and improving services. The current project I am sharing involved community health workers to identify presumptive TB cases and sending smears for laboratory examination. I have received grants and successfully implemented many projects.

Abstract:

Background: In settings with limited access to health care, engaging lay health workers is crucial in improving access and reach universal coverage for primary health care. Tuberculosis (TB) is the leading cause of mortality and morbidity with highest rates in resource-constrained settings. Thus, its prevention and control program has rich experience in engaging lay health workers. We report successful implementation of TB prevention control by engaging lay health workers in case finding treatment t in southern Ethiopia.
Methods: This is an innovative community-based collaborative project with the Ministry of Health of Ethiopia implemented in southern Ethiopia. The key interventions included familiarization, capacity strengthening, community-based intervention by engaging lay health workers - Health Extension Workers (HEWs) in TB case finding and treatment to ensure continuum of care.
Results: Lay health workers - HEWs identified more than 180,000 presumptive TB cases, collected their sputum and prepared smear collected by district field supervisors for examination. Of these, more than 9,000 smear-positive TB cases were diagnosed from the slides prepared and fixed by HEWs. Over all in the project area, more than 13,000 smear-positive TB cases and more than 29,000 all forms of TB were diagnosed and treated. The community-based intervention contributed to about 70% cases detected in the project area. More than 9,000 household contact tracing was done and screened more than 35,000 contacts, and about 2,500 under five years asymptomatic children were put on IPT in the community.  
Conclusions: Engaging lay health workers in TB prevention and control has significantly increased case finding, supported treatment adherence and provision of IPT in the community. Their engagement is crucial in reaching the remote and rural communities. It is feasible to enrol lay health workers in TB case finding to improve case finding and treatment outcome in resource constrained settings.
 

Biography:

Dr Lelouvier received his Ph.D in Cellular and Molecular Neurobiology from the University Pierre et Marie Curie, Paris VI, France, in 2007. After a postdoctoral fellowship at the National Institutes of Health (USA), he joined Vaiomer in 2012. As cellular and molecular biology group leader and head of biomarkers discovery, he developed with his group the molecular tools (16S qPCR and 16S metagenomics sequencing) to study specifically the blood and tissue microbiomes, before becoming Chief Scientific Officer of Vaiomer in 2016. The study of tissue and blood microbiota allows Vaiomer to link intestinal dysbiosis and tissular inflammation for the development of biomarkers and therapeutics in the fields of cardiometabolic diseases, neurodegenerative disorders and chronic infection

Abstract:

Diagnosis and treatment of bloodstream infection (BSI) will greatly benefit from sensitive and exhaustive molecular methods to detect bacterial DNA in blood, such as quantitative PCR (qPCR) and metagenomics sequencing. Such approaches are already studied with the aim of reducing the turnaround time and increasing the sensitivity of the microbiota detection in suspected BSI. However, this type of molecular diagnosis is greatly complicated by the presence of human DNA and PCR inhibitors in blood, as well as bacterial DNA contaminants present in the environment, reagents and consumables, which dramatically hamper the signal to noise ratio of qPCR and sequencing pipelines.
In the course of our investigations into the role of tissue microbiota in cardiometabolic diseases we developed specific optimized pipelines of qPCR and 16S targeted metagenomic sequencing to analyze blood bacterial DNA, despite the technical difficulties associated with this sample type. Using these molecular tools we have demonstrated the existence of a highly diversified blood microbiome in healthy human donors and shown the association between changes in the blood microbiome and liver fibrosis in obese patients. These assays were primarily designed to analyze bacterial DNA in blood and tissue of healthy donors and patients with no infectious disease, and therefore their signal to noise ratios are high and they are also capable of detecting BSI in patients with high sensitivity and at early stages of infection.
 

Biography:

Dr. Ikuri Alvarez Maya,She is a Researcher at the Center for Research and Assistance in Technology and Design of the State of Jalisco. She holds a postdoctoral degree in Neurobiology Department, NRC. University of Alabama at Birmingham UAB. Alabama, USA. And in Department of Virology, Children's Hospital of Eastern Ontario CHEO, Ottawa, Canada. She has published in several indexed journals, more than 30 national and international congresses, and has contributed to the training of students in different levels of postgraduate. Her research interest is focused mainly in molecular diagnosis of infectious diseases.
 

Abstract:

Statement of the Problem. Tuberculosis is a bacterial disease caused by Mycobacterium tuberculosis. This bacterium is known for a high rate of drug resistance, then tuberculosis is considered a worldwide public disease with high health and economic impact. Statistics in Mexico show that the incidence increases 15% every year, being a major problem due to the persistence.  We aim to sequence the complete genome of Mycobacterium tuberculosis and subsequently perform bioinformatics analysis to determine possible molecular changes. Methodology & Theoretical Orientation: The complete genome of a Laboratory Mycobacterium tuberculosis strain H37Rv was sequenced using Next-Generation Sequencing (NGS) on the Illumina MiSeq platform. Genome DNA (gDNA) library was constructed using Nextera XT (Illumina) protocol.  DNA was fragmented, tagged and selected by size, then sequenced by Illumina MiSeq-NGS platform. For bioinformatics, all sequences with adaptor contamination, duplicate reads or unknown nucleotides were removed by Trimmomatic. Clean-filtered reads were mapped to the reference genome from GenBank (AL123456.3) by BWA software. Finally SAMTools software was used for SNP calling, since resistance anti-tuberculous drugs has been associated with SNPs in particular genes. Findings: Phred quality score in DNA sequencing was calculate (Q45) then this score was assigned to each nucleotide in the generated sequences. The P value was obtained (3.162e-005) and indicated that the genotype GC is very likely to be the true genotype in the sequenced sample. Preliminary results shown that there is a single nucleotide variant (SNV) from G to C at position 3982 in the strain of Mycobacterium tuberculosis. Conclusion & Significance: Mapping between Laboratory strain H37Rv and GeneBank H37Rv (ID 20829) shown at least one SNP in the position 3982. However, this results must to be confirmed using a higher Depth Reading and a further exhaustive analysis. This study was supported by CONACYT grant PDCPN_2014_247879, Scientific Development Projects to Attention National Problems.

Biography:

Harpal S. Mangat, MD is in Practice in Maryland. He is an Assistant Professor at Howard University College of Medicine. He submitted recommendations to his US senator that got incorporated into the 2010 Affordable Health Care Act. He has four issued US patents and additional patents have been filed. He is a graduate of the Royal College of Surgeons Ireland, trained at Trinity College Dublin, Oxford University and London University in Family Practice and Ophthalmology. In the US, he trained at University of South Florida and Mercy Hospital Philadelphia in Ophthalmology and Internal Medicine. He is the transport physician for difficult cases returning to United Arab Emirates. His clinical interests include innovative new technologies, neuroprotection, diabetes, sleep apnea, Lyme disease, especially its neurological manifestations, as well as long distance air transport of seriously ill patients. He sees patients at his office in Clarksburg, MD (www.clarksburgmed.com) and Fredrick, MD.

Abstract:

Background: Lyme disease is caused by the bacterium Borrelia burgdorferi, transmitted to humans through the bite of infected blacklegged ticks. CD4/CD8 ratios in healthy adults vary across populations; in the US, a CD4/CD8 ratio ranging from 0.9 to 1.9 is considered to be normal in non-immunocompromised individuals. Lyme disease is diagnosed based on symptoms, physical findings (eg. Rash) and the possiblity of exposure to infected ticks. Labratory testing is helpful if used correctly and performed with validated methods. The US Center for Disease Control (CDC) diagnostic criteria requires the identification of five Western blot IgG bands for a positive diagnosis1, although patients with less than five positive bands have been subsequently diagnosed with Lyme Disease through urine PCR in Nanotrap testing2. Material/methods: 183 patients at two medical centers were evaluated in Lyme endemic communities in Maryland, US. Further investigation of 148 of these patients correlated their CD4/CD8 ratio with their Ig41 band, using one and two tail testing. Results: The mean CD4/CD8 ratio in the 148 patients was 2.41 with a variance of 1.05 and a standard deviation of 1.025. Assuming a normal CD4/CD8 ratio of less than 2, with a 5% confidence interval, the p value on both a one tailed and two tailed test was shown to be 0.00001. Two patients with an initial CD4/CD8 ratio of 2.7 and 2.8 who were IgG 41 positive were subsequently tested with the Nanotrap Urine PCR and found to be positive for Lyme. Conclusions: Increased CD4/CD8 ratio with a positive IgG 41 band appears to be a strong predictor of a subsequent diagnosis of Lyme disease despite current diagnostic guidelines. Further research should not only be directed towards investigating how Borrellia Burgdoferi disrupts immune function, but also towards improving diagnostic guidelines in light of validated diagnostic methods.

Biography:

Prashant Mule has completed his MD in Microbiology from the Department of Microbiology, Tata Memorial Hospital, Mumbai, India in 2016. Presently, he is working as a Senior Resident in the Department of Microbiology. His areas of interests are Mycology, Molecular Microbiology, Virology and prevention of health care associated infections. He has worked on the evaluation of in house real time PCR for the diagnosis and prognostication of invasive fungal infections in a tertiary care cancer institute in Mumbai.

Abstract:

Introduction: Invasive fungal infections (IFI) have emerged as an important cause of morbidity and mortality in cancer patients. Aggressive chemotherapeutic protocols for treatment resulting in prolonged and profound neutropenia, are the most important contributory factors. Patients with hematological malignancies and those undergoing bone marrow transplantation
are at high risk of invasive mycoses and an increase in morbidity and mortality. Blood culture lacks the sensitivity but with the availibility of molecular techniques, the diagnosis of systemic fungal infections has signifacantly improved. Objectives: To evaluate an in-house real-time PCR for the diagnosis of IFI. To correlate the results of PCR with the EORTC classification of invasive fungal infections (IFI). Methods: 3 ml of whole blood is collected from patients with suspected invasive fungal infections. Extraction is performed and DNA is detected using SYBR green PCR. The panfungal PCR using primers NL1 and 260R targeting a region of the ribosomal gene followed by species specific hybridization with probes for Candida species as well as Aspergillus species. Results: A total of 80 in patients were included in the study from August 2015 to December 2015 at Tata Memorial Hospital.52 patients had haematological malignancies and 28 patients belonged to the surgical disease management group (DMG). They were classified by the EORTC criteria as proven, possible and probable cases of IFI of the 80 patients, 49 were positive for yeast DNA and 3 were positive for Aspergillus DNA.Discussion: Fungal infections, in neutropenic patients with malignancies do not show characteristic signs and symptoms,making accurate diagnosis difficult. Early recognition is crucial, as the progression of invasive disease from detection to death is typically less than 14 days. Empirical treatment with antifungal agents is initiated in high-risk patients with suspected fungal infection. This is associated with high toxicity and high cost. Conclusions: The SYBR green real time PCR was useful and sensitive indicator for the detection of fungal DNA. The SYBR Green PCR is found to be a reproducile assay and it is validated for patients with Candidemia.

Biography:

Pavithra S is a Visiting Scholar in Genetics and Stem Cell Laboratory at University of Pacific, San Francisco, where she is currently researching the effect of Folic Acid in ameliorating hypoxia induced stem cell changes, and its correlation to non-syndromic craniofacial cleft lip and palate. She obtained her medical degree from India, at the culmination of which she was awarded the “Best Outgoing Student” for her academic excellence and research interests. She worked in the Department of Internal Medicine where she treated patients and organized medical camps in rural and underserved areas. She plans to continue her research and provide healthcare as a Physician in the US.

Abstract:

Hepatitis C Virus (HCV) is known to cause serious complications such as chronic liver cirrhosis, liver failure and hepatocellular carcinoma. Globally 3% of the population is affected by HCV infection. Tamil Nadu, a southern state of India; accounts for 0.5% of this disease. The present study aims at analyzing the prevalence of HCV infection in different age groups in the population of Tamil Nadu. The samples were received and collected from primary health care, private and government hospitals. A total of 751 HCV susceptible samples were screened for anti-HCV antibodies by ELISA. Among the 751 samples, 41 samples were positive, which was further confirmed by polymerase chain reaction. Our study revealed that pediatric age groups 1-5 and 6-12 were predominantly affected by HCV, with high incidence among males. The statistical analysis student t-test was performed and the distribution was significant across groups. In addition, other epidemiological parameters were also analyzed as a part of this study.

Biography:

Valentin Trofimov has his expertise in high-content and high-throughput drug screening. He aims to help eradication of the threat of tuberculosis worldwide.Tuberculosis (TB) results in the death of millions of people every year. There is a growing threat because of the emergence of multidrug resistant strains. In order to achieve that goal, new effective drugs and efficient TB therapies need to be discovered. He focuses his effort on early drug discovery with a close look at hostpathogen interactions, since in vivo activities, such as intracellular host defense mechanisms, are largely overlooked in drug research.

Abstract:

A critical feature of the Mycobacterium tuberculosis bacillus is its ability to survive within macrophages, making these host cells an ideal niche for persisting microbes. Identifying inhibitors of M. tuberculosis intracellular growth from large chemical library has long been hampered by labor-cumbersome techniques. We thus developed a phenotypic cell-based assay relying on automated confocal fluorescence microscopy and adapted it for the high throughput screen of compounds that interfere with the multiplication of M. tuberculosis within macrophages. The current project is an early drug discovery that uses alternative drug screening strategies and targets previously unexplored biological activities during tuberculosis (TB) infection.The aim of the project is to establish a novel approach within the host pathogen interaction paradigm. The approach is based on identification of the drugs and cellular pathways that trigger active bacterial release form its host into the extracellular
space or by specific killing of infected host cells. Both of these strategies can prevent the infection from spreading. Such drugs and pathways might also facilitate the boosting of the immune response and enhance the effect of other conventional antitubercular compounds. To reach our goal we established a high though put assay that uses a host-pathogen system based on human cultivated macrophages and Mycobacterium tuberculosis H37Rv to test the activity of the drugs at the single cell level. Screening will be followed by drug synergy studies with the use of known antitubercular compounds. Subsequently,studying the drug mechanisms of action will be performed with cultivated macrophages.

Biography:

Osadolor Ebhuoma is a Doctoral student at the University of KwaZulu-Natal, South Africa, and teaches geographic information systems (GIS) and remote sensing. His research is aimed at developing spatial and temporal malaria transmission models in KZN, South Africa using malaria surveillance data, remote sensing derived climatic/environmental variables and socioeconomic factors. The expected outcome of his research will be the identification of determinants of malaria transmission in KwaZulu-Natal and the development of malaria forecast models and by applying time series and Bayesian models. His research interests include spatial epidemiology, GIS and remote sensing.

Abstract:

Low socio-economic status (SES) has been suggested to sustain malaria transmission which in turn can propel the cycle of poverty. Thus, a deep understanding of the SES that influences malaria risk is vital because it will guide towards creating policy and strategies that will concurrently help combat malaria transmission, improve socio-economic conditions and strengthen the malaria elimination campaign in KwaZulu-Natal (KZN), South Africa (SA). The main purpose of this study is to assess the relationship between SES and malaria incidence in KZN, SA, using the Bayesian inference approach. Database of demographic/socioeconomic information and clinically confirmed malaria case data aggregated at the local municipality level for 2011 were obtained from statistics SA and the malaria control program of KZN, SA respectively. We used the 2011 dataset (SES and malaria incidence) for this study because it completely covered the study area. The association between SES and malaria incidence was evaluated by employing the Bayesian multiple regression model to obtain the posterior samples via a Markov chain Monte Carlo (MCMC) methodology. The obtained posterior samples reveal that, significant association existed between malaria disease and low SES such as illiteracy, unemployment, no toilet facilities and no electricity at 95% CI. Lack
of toilet facilities (OR =20.2; 95% CI = -36.82, 76.0) exhibited the strongest association with malaria disease, followed by lack of electricity (OR=5.252; 95% CI = -52.40, 62.32). This study suggests low SES potentially sustains malaria transmission and burden. As an implication, poverty alleviation and malaria intervention resources should be incorporated side by side into the
socioeconomic framework to attain zero malaria transmission. Therefore, the relevant policy makers and departments should stimulate additional sustainable developmental approach that combines both improved malaria intervention resources and socioeconomic conditions, which in turn, will help strengthen the malaria elimination goals in KZN, SA.

Biography:

Saleh Ahmed Alogla present is a student of Medical college in University of Hail, Saudi Arabia.

Abstract:

Background: Mutations in the uromodulin (UMOD) gene lead to a dominant hereditary renal disease, which may ultimately result in kidney failure. Therefore, the aim of this study was to assess the burden of UMOD associated renal among Saudi patients with renal failure (RF).
Methodology: PCR amplification of 10 exons (forward and reverse) enclosed in the UMOD gene is done on the patient's genomic DNA of 103 Saudi patients with RF.
Results: Of the 103 patients, UMOD gene mutation was identified in 10/103 (9.7%). UMOD gene mutation is relatively prevalent among Saudi patients with RF. Further evaluation of different mutations in thisgene is important for overall assessment of its role in RF among Saudi population.

Biography:

Prof. Dr. Sun Shin Yi has completed his Ph.D. from Seoul National University, Republic of Korea, and postdoctoral studies from Marquette University, USA. Now, He is a professor in the department of biomedical laboratory science, an associate dean of special affiairs for planning, and chair of IACUC in the Soonchunhyang University. He has published more than 60 papers in reputed journals, and a board member of Korea Mouse Phenotype Center(KMPC).

Abstract:

The most realistic way before the recent epidemic that occurred in unexpected times and places in the world is rapid supplying of vaccines related with the infectious diseases within limited times. However, little considerations about rapid supplying a precise manual for the safety assurance of central nervous system(CNS) were established well so far. Thus, this careless in the development of general and/or emergent vaccines should be corrected with a certain secure of safety protocol which can be reduced risks on CNS damages before distribution. Hereby, the present study is undertaken to establish a manual which a certain material can make CNS damaged such as breaking down blood-brain barrier (BBB) protecting brain. Since BBB is critical morphological structure selective permeability between blood vessels and brain, it would be very important to know which conditions (i.e. post-injection, -time) can make BBB vulnerable by pyrogenic inflammatory agent such as Lipopolysaccharide(LPS) systemic injection.
Following IP administration of the LPS to the mice, the mRNA levels of typical markers of the damaged BBB tight junction such as ZO-1 and CLDN 5 were checked out. As conditions in the LPS, IV Evans Blue administration after IP LPS administration according to each concentration (four conditions of concentration) of LPS concentrations. BBB damages were able to be measured by Evans Blue existence checks by fluorescence wavelength ranges from (ex: 620nm /em: 680nm) in the brain tissue. Ultimately, we could observe the mutual relations by comparison with the two methods (mRNA and wavelength levels). According to the results, we set LPS concentration can open BBB and by the mRNA levels of tight junction, we can apply these results to general/emergency vaccine strategy.
 

Biography:

Abstract:

Recently cell-mediated immunity plays an important role in immune responses against cancer. Cancer cell development and survival is a multifactor process, involving genetic mutation of normal cells as well as physiological changes within both cancer cells and also the body's defence mechanisms. In the present study we have considered a tumor growth three dimensional ordinary non-linear differential equation model. We considered the special effect of tumor-immune interaction along with the two immune components – resting (helper) T-cells which stimulate CTLs and convert them into hunting (active) CTL cell which attack, destroy, or ingest the tumor cell. We have also discussed the qualitative behavior of the solution of our system. Critically we have examined the existence of the system with local and global stability analysis at different equilibrium points. We have also developed a theoretical framework to understand the complex behavior of the tumor growth cell under the influence of stochastic fluctuations by adding the effects of additive white noise of the immune system to study real situation of the interaction between these two groups of cells. Using various sensitive parameter values and different initial densities, the numerical simulations show that the dynamical behavior of the tumor cells, together with the resting and hunting cells, lead to a variety of interesting patterns in the evolution of the tumor and immune cell populations.

Biography:

Abstract:

Background: The leading global epidemic Human Immunodeficiency Virus (VIH) infection has been well-documented. It is transmitted from an infected person to an uninfected one by two ways: horizontal and vertical transmission (VT), which is mother-to-child transmission (MTCT) and is acquired at one or more of the following stages: transplacentally in the uterus during pregnancy, perinatally during the process of labor and delivery and postnanatally during breastfeeding. The reason of this study is to demonstrate that adecquate management at each of these three moments reduces the MTCT. Methods: A observational-retrospective study was carried out at Maternidad Matilde Hidalgo de Procel in Guayaquil, Ecuador to detect the prevalence of serorevertors newborns of VIH who received prophylactic antiretroviral treatment at birth, formula milk and whose mothers got administered antiretroviral therapy (ART) during pregnancy or partum according to the established schemes. These vertically exposed infants were followed up by an accredited pediatrician by the National Program of HIV-AIDS to receive special care during at least the first 18 months. Results: One hundred (100) pregnant women were enrolled. ART was started between the 14th and 28th pregnancy week in a 41%, after the 28th weeek in 24% and during labor or delivery in 35%. 100% of pregnant women received ART intrapartum. 100% of the newborns received antirretroviral prophylaxis from 6 to 8 hours old for 4-6 weeks according to the applied scheme. In both, mothers and children, the most frequently administered regimen was the C with 48% based on zidovudine. 100% of the newborns was fed by formula milk and 100% was serorevertor of HIV. Conclusions: This study shows that MTCT was 0% due to the seroreversion in children at >=18 months which represents that the treatments and properly applied procedures reduce the MTCT to zero and place Ecuador at the level of developed countries where the VT has been decreased at 1-2%.

Biography:

Yihun is studied in Ethiopia and Germany. He is a lecturer in College of Medicine and Health Science, School of Public Health, Bahir Dar University Ethiopia. He teaches undergraduate and postgraduate students.  He works as global health consultant in collaboration with International Universities. Yihun is actively engaged in research; he modeled TB/HIV co-infection and determinants for TB in lower income settings of different study groups. Currently, he leads three cohort studies in Ethiopia about infectious disease Epidemiology, Immunology and Universal heath converge. Besides academia, he is working on community health services of active TB case detection in high risk group such as people live with HIV/AIDS in Amhara Region, Ethiopia.

Abstract:

Objective:To identify the incidence of and predictors for tuberculosis in children living with HIV in Northern Ethiopia.

Design: Observational, retrospective follow-up study.

Methods: A total of 645 HIV-infected children were observed between September 2009 and September 2014. Cox regression analysis was used to identify predictors for developing TB.

Results: The incidence rate of tuberculosis was 4.2 per 100 child-years. Incidence of tuberculosis was higher for subjects who were not on cotrimoxazole preventive therapy, were not on isoniazid preventive therapy, had delayed motor development, had a CD4 cell count below the threshold, had hemoglobin level less than 10 mg/dl and were assessed as World Health Organization (WHO) clinical stage III or IV.

Conclusion: Incidence of TB in children living with HIV was high. This study reaffirmed that isoniazid preventive therapy is one of the best strategy to reduce incidence of TB in children living with HIV. All children living with HIV should be screened for TB but for children with delayed motor development, advanced WHO clinical stage, anemia or immune suppression, intensified screening is highly recommended.

Biography:

Bimal Kumar Mishra is a Professor of Mathematics at Birla Institute of Technology, Mesra, Ranchi, India. He is working in the area of Mathematical models on infectious diseases particularly on HIV, Zika, Ebola, Tuberculosis, Avian Influenza and has published around 130 research papers in journals of repute. He has produced 14 Ph.Ds and members of editorial board of several international journals.

Abstract:

Transmission dynamics of the spread of Zika virus is studied in population sizes of human beings and mosquitoes. Transmission of zika virus from pregnant mother to new born child is also considered. We define the threshold number and explore the significance of equilibrium points in this type of epidemic disease. Global stability under different threshold conditions is proved. Numerical simulations are carried out to establish the analytical results. The simulation result will help us to understand the possible transmission rate of the disease in both human and mosquito population and also explore the possibility of eradication of the disease.

Biography:

Mohammad Al-Tamimi is an MD with master, PhD, and postdoctoral studies in Immunology, from Monash University, Australia, 2007- 2012. From 2012 till now, I am appointed as assistant professor in Immunology and Microbiology with the Faculty of Medicine, Hashemite University, Zarqa, Jordan. Part time assistant Prof with Jordan University. During the last 10 years of my career I have win 6 distinguished international awards, published over 15 publications in international journals, one textbook chapter, and one patent. I have received 5 national and international research grants and presented over 15 oral and poster abstracts in national and international meetings, My current interest is multidrug resistant bacteria with focus on A. bumannii and MRSA.

Abstract:

Objectives: A. baumannii is a common cause of infections associated with high mortality and morbidity. It is an important multi-drug resistant microorganism worldwide. The aim of this study was to investigate the incidence and characterization of A. baumannii in a tertiary Hospital in Jordan.
Methods: Retrospective study using data available on Vitek 2 Compact system and patients files from 2010 to 2016 in Specialty Hospital, Amman. Demographic, clinical, isolates information and antibiotics sensitivity patterns were collected and analyzed using appropriate statistical tests.
Results: 622 A. baumannii isolates were reported during the study period with about 99% having high confidence rate. Most isolates were from male, aged 18-60 years, Jordanian, and from infected wounds in surgery and critical care departments.  76.8% of A. baumannii isolates were MDR. Adults over 60, male, non Jordanians, critical ill patients and infected wounds represented significant risk factors for MDR incidence (P<0.0001), while no statistical significant risk associate with years (P=0.3933). Resistance pattern indicated high resistance for most Cephalosporins, Carbapenems Fluoroquinolones, and Ampicillin, moderate resistance for Trimethoprim/Sulfamethoxazole and Ampicillin/Sulbactam low resistance for Aminoglycosides and Tetracyclines, and the lowest resistance rates were for Colistin and Tigecycline. Most strains had Aminoglycosides resistant phenotype GEN NET AMI TOB, GEN TOB AMI and TOB GEN NET.
Conclusion: Jordan has high rate A. baumannii MDR.  Adults, critically ill males with infected wounds had significant high rate of A. baumannii MDR. Continued surveillance and monitoring of this critical microorganism is required.
 

Biography:

Shikha Joon is a Ph.D. candidate at Jawaharlal Nehru University, India with a particular interest in studying novel drug targets against infectious diseases mainly anthrax. Prior  She received her graduate and post-graduate degrees in Biotechnology at Bangalore University, India. She was a part of a team that worked towards developing therapeutic single chain variable fragment (Scfv) antibody against anthrax, the first of its kind. Her dedicated research on CodY, a pleiotropic transcriptional regulator, led to the revelation of the novel and unique aspects of this multifaceted protein. Further inquiry is being extended out from her to gain an insight into its detailed mechanism of interaction with GTP and further acquiring it as a drug target.

Abstract:

Bacillus anthracis, a prioritized bioterrorism agent, is a gram-positive, sporulating, non-motile, aerobic bacterium which causes the fatal zoonotic disease, anthrax, with humans as contingent victims. CodY, a global transcriptional regulator, controls diverse cellular activities such as metabolism, amino acid biosynthesis and transport systems, nitrogen uptake, motility, sporulation, pellicle, and biofilm formation, and most importantly virulence in almost all low G+C gram-positive bacteria. In B. anthracis, about 500 genes are perceived to be the targets of CodY, including the master regulator AtxA, which is pivotal to the manifestation of toxic constituents; namely a lethal factor, edema factor and protective antigen. GTP and Branched Chain Amino Acids are the metabolic effectors of CodY, which affects its DNA-binding ability. In order to gain an insight into the interaction mechanism of CodY and GTP, of which scarce is known presently, we carried out an in vitro GTP binding assay. We have demonstrated that CodY of B. anthracis binds to GTP. Homology modeling and sequence/structure analysis of CodY of B. anthracis revealed conserved GTP binding residues. Interestingly, we found that the CodY of B. anthracis could undergo autophosphorylation with GTP as a phosphoryl group donor. Furthermore, the phosphorylation site mutant (Ser215 to Ala215) of CodY failed to retain this autophosphorylation activity and hence is the critical residue involved in autophosphorylation. Since the Ser215 lies in the Helix-turn-Helix DNA binding motif of CodY and is conserved amongst its homologs, autophosphorylation may be speculated as a self-regulatory mechanism of CodY activity in the cell. Inquisitively, we proceeded to test the GTPase activity of CodY by thin-layer chromatography and found that the recombinant protein could withal hydrolyze GTP, albeit weakly, as quantified spectrophotometrically. Predicated on these findings, we conclude that in contrast to its homologs in other organisms, CodY of B. anthracis exhibits unique biochemical attributes such as GTP hydrolysis and autophosphorylation, which might be further exploited as a novel drug target.

Biography:

Daniel Asfaw has completed his Bpharm at the age of 23 years from University of Gondar. He is a lecturer and research coordinator at school of pharmacy. He is also a chairman of the anti-drug addict movement at university of Gondar. He has conducted more than 15 papers in the area of clinical pharmacy and pharmacology are published and submitted to reputed journals.

Abstract:

Statement of the Problem: Community pharmacists are key health care professionals for antimicrobial stewardship programs owing to their role in dispensing of antimicrobials. The aim of the present study was to assess the perception and practices of community pharmacists towards antimicrobial stewardship (AMS) in Ethiopia. Methodology & Theoretical Orientation: A cross-sectional survey was conducted on facility based census between February-May 2015. Stratified simple random sampling technique was applied to select pharmacy sites. Descriptive and inferential statistics were used to analyze the data. Findings: Majority of respondents strongly agreed or agreed that AMS program is vital for the improvement of patient care (86.3%, Median=5; IQR=2-5). Almost all of respondents agreed that pharmacists can play a prominent role in AMS and infection prevention (93.2%, Median=5; IQR=2-5). Similarly, majority of respondents always or often communicate with prescribers in case of ambiguity about the correctness of antibiotic prescription (77.9%, Median = 4, IQR = 1-4). However, only 26.5% of respondents strongly agreed or agreed that AMS should be practiced at community pharmacy level (Median = 4, IQR = 1-3) and more than half of community pharmacists (59.9%) often/always dispense antimicrobial without a prescription. Qualification and experience of respondents considerably affected their median scores concerning their perceptions and practices towards AMS. Conclusion & Significance: The present study revealed a positive perceptions and practices of community pharmacists toward antimicrobial stewardship. Yet, some weak areas like integration of AMS program in community pharmacies, the significance of inter-professional involvement, and dispensing of antimicrobials without a valid prescription still needs improvement.

Biography:

Abstract:

Background: Obesity has been considered as one of the major modern global epidemics and a risk factor for both cardiovascular diseases (CVD) and diabetes. There is a rapid rise in the rate of overweight and obese people in the Kingdom of Saudi Arabia which has a tremendous impact on health and economic resources. Gut microbiota has lately been a major factor for many metabolic disorders and diseases, including obesity, diabetes, and CVD.

Objective: The aim of this research was to define those specific gut microbiota that are obesity-associated as determined based on mass index (BMI) among healthy Saudi females.

Methodology: 120 healthy females, below the age of 30, with different degrees of obesity were included in this study. All the participants had to fill out a questionnaire concerning their nutritional habits, health conditions and demographics. Their height, body weight, hip and waist circumference were measured and their BMI was determined accordingly. Stool samples were collected and genomic DNA was extracted from our study group. The DNA samples were sequenced using next generation sequencing (MiSeq), sequencing reads were trimmed, analyzed and filtered and assigned to taxonomic units.

Results: The results revealed the existence of different bacteriological groups including Firmicutes, Actinomyces odontolyticus, Escherichia coli and Ruminococcus obeum and others. Work is in progress to correlate the prevalence of those bacterial groups with BMI.

Conclusion/Recommendations: The data showed the presence of a variety of bacterial strains and microbiota populations among our study individuals. Bioinformatics data analysis will help to identify certain microbiota marker populations to be associated with different stages of obesity among the female Saudi population. Final goal is an early prediction of obesity and to target those patient groups to treat obesity.

Biography:

Abstract:

Introduction: Carbapenems are broad spectrum beta-lactam antimicrobials especially useful in infections involving multi-drug resistant bacteria and nosocomial infections. Seizures involving carbapenems are a rare occurrence overall and usually reported with imipenem use rather than ertapenem. Neurotoxicity associated with ertapenem use in a renal transplant patient has not been previously reported. We report a rare case of nonconvulsive status epilepticus associated with the use of ertapenem in a renal transplant patient.

Case Description: A 67 year old Lebanese woman with a history of living-related right renal transplant in 1993 presented with progressively worsening altered mental status for the past three days. She had a baseline creatinin of 2.5 mg/dL at the time and was on chronic immunosuppressive therapy. Patient was discharged three days prior from an outside hospital with a diagnosis of a complicated urinary tract infection (UTI) from ESBL-producing Escherichia coli bacteria which was sensitive to gentamicin, carbapenems and amikacin. She was sent home on a 14 day course of intravenous ertapenem therapy. She had completed 7 days of ertapenem therapy at the time of presentation. Patient was continued on her home UTI treatment regimen with 500gm IV ertapenem daily upon admission. Next day of her admission, patient had a witnessed generalized tonic-clonic seizure. On the 3rd day of admission (10th day of ertapenem administration), patient developed nonconvulsive status epilepticus. Ertapenem was at that point discontinued. She remained in status epilepticus for the next 4 days and was monitored with continuous electroencephalography (EEG) in the intensive care unit. She was treated with IV Dilantin, phenobarbital and versed. She responded well to the treatment. Seizure activity eventually diminished over the next 48 hours with intermittent left temporal lobe spikes initially until complete resolution. Patient returned to baseline mentation 9 days after admission and was subsequently discharged to acute rehabilitation.

Discussion: Seizures due to ertapenem use are rare with a reported incidence of 1.8%. Ertapenem is thought to induce seizures and cause encephalopathy by binding to GABA receptors in the central nervous system and lowering the seizure threshold. Ertapenem is predominantly eliminated via renal excretion. Patients with reduced renal clearance are therefore at an increased risk of experiencing adverse events with ertapenem use. Our case highlights that ertapenem use can cause significant neurotoxicity in renal transplant patients and in patients with renal insufficiency. Seizure activity due to ertapenem if not identified early can progress to status epilepticus. Despite renal dose-adjustment, ertapenem has potential to cause seizures especially in such patients. Care must be taken in administration of ertapenem in patients with renal insufficiency and it must be stopped immediately if any clinical signs of neurotoxicity do occur.

Conclusion: Ertapenem has the potential to cause significant neurotoxicity and can induce status epilepticus in patients with prolonged use. Patients with renal insufficiency are especially vulnerable even after renal dose adjustments.

Biography:

Darshna Yagnik is a Lecturer of Immunology and Biomedical Sciences at Middlesex University. Her research is based on human in vitro models of mononuclear cell differentiation and their role in inflammatory pathways and particularly the resolution phase of inflammation.

Abstract:

Introduction: Extraintestinal pathogenic Escherichia coli (E-coli) are the most frequent cause of blood borne, urinary tract and hospital acquired infections. Candida albicans infection can also pose a huge threat especially following transplantation and to immune compromised patients. Globally there has never been a more desperate time for novel anti-microbial agents to target microbes and multi drug resistance from bacterial or fungal associated infections.
Aim: The aim of this study was to investigate the potential anti-microbial effects of ACV®. We used microbial strains: E. coli strain 6571, C. albicans strain 90828 purchased from ATCC.
Methodology: We tested the effect of commercial ACV® directly on microbial cultures over a 24 hour period, measuring inhibition zones. We also looked at whether ACV® could have an anti-inflammatory effect in vitro. This was tested using human blood derived monocytes which were incubated with microbes and AVC®. The collected supernatants were analyzed for proinflammatory cytokine secretion by ELISA.
Results: When monocytes were cultured with both microbes they secreted TNFα and IL-1β. ACV® was able to significantly inhibit E-coli growth demonstrated by the results of direct co-culture with each of the microbial inoculums and ACV® in varying concentrations. The zone of inhibition with the addition of ACV® to each of the microbes varied dose dependently
ACV® concentration. For Candida albicans undiluted ACV® had the strongest effect, whereas on E-coli cultures, the most potent effect was visible at lower dilutions including 1/1000 dilution of the neat solution (p<0.05). When monocytes were cultured with both microbes they secreted inflammatory cytokines (TNFα, IL-1β) ACV® was effective in significantly inhibiting
inflammatory cytokine secretion in human peripheral blood monocytes cultured with E. coli and Candida albicans
Conclusion and significance: ACV® displayed potent anti-microbial and anti-inflammatory activity against E. coli and Candida albicans. We propose that ACV® could be potentially therapeutic in cases of antibiotic resistance and sepsis.

Biography:

Ibidolapo Ijarotimi is a fellow of the West Africa College of Physicians with sub specialization in community health. She is also a resident of the joint CDC/ Nigeria Ministry of Health Field Epidemiology and Laboratory training program. In addition, she has a Master’s degree in Clinical Epidemiology. She has a background in health economics but has more interest in infectious disease epidemiology, Infection prevention and control in hospital settings and healthcare epidemiology.  She has had trainings and trained others in Infection prevention and control in hospital settings and healthcare epidemiology.

Abstract:

Background: Hepatitis B is a global health problem which can cause lifelong infection, cirrhosis, liver cancer, liver failure, and death. According to WHO there is more than 350 million suffering from hepatitis B chronic infection worldwide. Sudan is a country with high HBV endemicity, according to CDC the prevalence of HBV chronic infection was reported to be( 5% to 6%)
in the general population , and 26% in the hospital outpatient. Hepatitis B is an important occupational hazard for health care personnel; however it can be prevented by the safe and effective vaccine with success rate of 95%. This study aimed to evaluate the hepatitis B vaccination coverage, barriers of complete vaccination, and immunization status after the vaccination among
nursing students in Khartoum locality, as a high risk group to percutaneous injuries
Methods: Cross sectional institutional based study conducted among nursing students in three nursing schools in Khartoum
locality with sample size of 261 using stratified random sampling. Data collection was carried out using pretested selfadministered
questionnaire.
Results: 80% of respondents were females and 12% were males with mean age of 22 years. More than 80% knew that percutaneous injuries carry the risk of HBV transmission, about 23% of the participant suffered a needle stick injuries, however Only 41% of the students were fully vaccinated and only 10% of them checked the anti-HBs Ag titer after vaccination. The major reasons reported by the participants were being busy and unavailability of the vaccine in a nearby facility where they searched.
Conclusion & Recommendations: The vaccination rate was found to be low, the awareness of importance of hepatitis B vaccination should be raised, complete hepatitis B vaccination should be provided to all nursing students, and good response to the vaccine should be evaluated before starting clinical training.

Biography:

I am a Student Masters of Public Health degree at the age of 32 years from Northern  University Bangladesh. I Have published more than 10 papers in reputed journals. To build up career as an independent researcher is my ultimate motto.

Abstract:

Health care in the new twenty first century is challenging as it poses multiple challenges in front of the world community. For different population World Health Organization and other international health organization has to take different initiatives. For the first world they just play the role of supervisor and advocate. On the other hand for the third world countries they have to collect funds as well help in policy making. Another important perspective of modern health care system is the health care for the minorities. Providing equal health care opportunities for the minorities is another challenge of this new century. Also in the several part of the world where people are tearing apart each other by war and violence to maintain health care is not only a challenge but also struggle for the health care providers. The international health care organization should be more committed and direct their resources for the under developed countries and population.