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.