3^rd Euro-Global Conference on Infectious Diseases September 5-6, 2016 Frankfurt, Germany

Biography:

Md Ridwanur Rahman is currently working as a Professor of Internal Medicine in a Public Medical College at Dhaka, Bangladesh since 2006. Beside teaching and training of undergard & postgrads, he also works as a Consultant Internist in a public tertiary care hospital & as a Researcher on neglected tropical & infectious diseases including snake-bite & poisoning. He has published more than 40 articles in different journals

Abstract:

AmBisome therapy for VL has an excellent efficacy and safety profile and has been adopted as a first line regimen in Bangladesh. Second line treatment options are limited and should preferably be given in short course combinations in order to prevent the development of resistant strains. Combination regimen including AmBisome, paromomycin and miltefosine proved to be safe and effective in the treatment of Indian VL. In the present study, the safety and efficacy of these same combinations were assessed in field conditions in Bangladesh. The safety and efficacy of three combination regimens: A 5 mg/kg single dose of AmBisome+7 subsequent days of miltefosine (2.5 mg/kg/day), a 5 mg/kg single dose of AmBisome+10 subsequent days of paromomycin (15 mg/kg/day) and 10 days of paromomycin (15 mg/kg/day)+miltefosine (2.5 mg/kg/day) were compared with a standard regimen of AmBisome 15 mg/kg given in 5 mg/kg doses on day 1, 3 and 5 (at the time of the study the regimen adopted in the National Treatment Guidelines). This was a phase III open label, individually randomized clinical trial, conducted between July 6, 2010 and March 22, 2014. Patients from 5 to 60 year with uncomplicated primary VL were recruited from the Community Based Medical College Bangladesh (CBMC,B) and the Upazila Health Complexes of Trishal, Bhaluka and Fulbaria (all located in Mymensingh district) and randomly assigned to any of the treatments. The objective was to assess definite cure at 6 months after treatment. Randomization sequences were generated centrally and stratified per site with allocation concealment by opaque and sequentially numbered sealed envelopes. 601 patients recruited between July 2010 and March 2014 received either AmBisome monotherapy (n=158), AmBisome+paromomycin (n=159), AmBisome+miltefosine (n=142) or paromomycin+miltefosine (n=142). At 6 months after treatment, final cure rates for the intention-to-treat population were 98.1% (CI 96, 0-100) for AmBisome monotherapy, 99.4% (CI 98.2-100) for the AmBisome+paromomycin arm, 94.4% (CI 90.6-98.2) for the AmBisome+miltefosine arm and 97.9% (CI 95.5-100) for paromomycin+miltefosine. The per-protocol population was 587. Three patients died and there were no relapses and PKDL. All treatments were well tolerated with no unexpected side effects. Adverse events were most frequent during treatment with miltefosine+paromomycin and three major safety events occurred in this arm, which all resolved after treatment was stopped. None of the combinations was inferior to AmBisome in both the intention-to-treat and per-protocol populations. All the combinations demonstrated excellent overall efficacy, were well tolerated and safe and could be employed under field conditions in Bangladesh.

Biography:

I am at the last term of my PhD education and my age is about 34 years from Tehran university of Medical Sciences. If you want to know a little bit about me, I was ranked first among more than 3000 participants taking the Nationwide Universities Entrance Examination for the PhD Degree and I was granted one of sixth PhD positions in Medical Parasitology at TUMS in 2012 and has been recognized as an Exceptional Talent in “EXCEPTIONAL TALENTS DEVELOPMENT CENTER” of Iran, in addition I have obtained the highest “A” Grades in all of my educational studies up to this point.My articles are more than 28 papers publishing in different congress and journals.

Abstract:

Purpose: In Iran, HIV/AIDS is an emerging disease and both Visceral Leishmaniasis (VL) and HIV infections occur sporadically. The known causative agent in Iran for VL is Leishmania infantum which is endemic in Ardabil and Fars Provinces. The aim of this study is to report of VL caused by Leishmania major in an AIDS patient. Methods: Direct agglutination test (DAT) was performed on a 53 year old HIV/infected male with chronic intermittent diarrhea who registered in AIDS center of Khorasan Razavi Province to investigate VL/HIV co-infection .The mean of CD4+ was 79/mm3 in this patient. The DAT result was confirmed by bone marrow aspiration and polymerase chain reaction (PCR). Results: DAT test was positive with titer 1:25,600. The amastigote form of Leishmania sp. was found in bone marrow aspiration materials and L. major was identified by nested-PCR assay compared to standard pattern. Conclusions: Based on the DAT and PCR results for VL, it is recommended: A high sensitive serological test should be performed on HIV positive patients, especially in where are endemic for VL. Other Leishmania sp. could be causative agents for VL in immunocompromised people; therefore the observed amastigotes in bone marrow aspiration should be examined by molecular methods to identify Leishmania sp. VL/HIV co-infection can occur in endemic areas for cutaneous leishmaniasis, so some studies are proposed to investigate VL caused by CL causative agents in HIV patients.

Biography:

Abstract:

Neglected tropical parasitical diseases are major health problem in developing countries of the world and strongly affect almost exclusively poor population living in developing counties. Sudan is one of developing countries highly endemic with malaria (all known species were reported), schistosomiasis, leishmaniasis, trypanosomiasis, gastrointestinal protozoa and helminthes. Many of them spread by insect vectors, snails or contact with contaminated water or soil. Unfortunately there is serious lack of interest in the research and control of these diseases. Therefore Medicinal and Aromatic Plants Research Institute conducted comprehensive research to develop new drugs adapted to our country needs and to make them available at affordable prices for common people. The present paper will highlight the efforts of previously screened medicinal plants for their antiparasitical activities and our future prospect to develop new antiparasitical drug from Sudanese medicinal plants.

Biography:

Atqah Abdul Wahab is an Assistant Professor of Clinical Pediatrics at Hamad Medical Corporation, Qatar. He is also associated with Weill Cornell Medicine-Qatar, Qatar

Abstract:

Biography:

Marta Lado works as the Infectious diseases Coordinator of the King’s Sierra Leone partnership, a branch of King’s Global Health partners (King’s College London), based in Freetown, Sierra Leone since March 2014. She has worked during all the Ebola Virus disease (EVD) outbreak in West Africa, mainly in the frontline of an Ebola Unit (one of the first one in the country) as the Doctor In Charge, also as a Consultant and Advisor for the Case Management Pillar in the National Ebola Response Centre (NERC) of Sierra Leone and for the elaboration of the EVD guidelines of the World Health Organization (WHO) for approach, management and control of Ebola. She is still working in the transition and reconstruction of the health care system in Sierra Leone besides collaborates in the care of EVD survivors and the establishment of a free care package for survivors and the research about the disease and the post EVD syndrome.

Abstract:

The Ebola viral disease (EVD) outbreak affecting West Africa (mainly Guinea, Liberia and Sierra Leone) during the last year has showed the small knowledge we had about the Hemorrhagic Viral diseases and showed the need for further studies and research in that area. We had to learn, as we were facing the outbreak, about the clinical features of the acute phase of EVD, the ways of transmission and the structures and resources required to control the epidemic; but, currently, we need to adapt to the new scenario and start discovering and learning about the sequelae and the post EVD syndrome and how these factors can affect the persistence of the disease in the area besides the consequences of the disease in the survivors population. We present several cases of survivors with unusual presentation (neurological sequelae with and without persistence of the virus in CSF, polyarthralgias, EVD relapse in relationship with immunosuprssion/HIV, etc) and complications that were not expected and still require further studies and research in the field.

Biography:

Mark Asperilla has completed his Fellowship at Chicago Medical School in Infectious Diseases in 1987. He has recently received the Ellis Island Award among many other awards, in addition to his many board certifications, institutional and administrative responsibilities. He is the Director of Infectious Disease and infection Control at Bayfront Health Port Charlotte. He has published many articles in journals, editorials and book chapters. He volunteers his time with the Virginia B Andes Clinic to consult and treat patients who are uninsured and 200% poverty and also volunteers his time managing a free Hepatitis C clinic.

Abstract:

Background: HCV is the most common cause of blood-borne infections and is the most common reason for liver transplants in the United States. Recent advances with sofosbuvir/ribavirin or ledipasvir/sofosbuvir have confirmed to be successful in eradicating HCV with minimal to no side effects versus previous treatment with telaprevir/peg interferon/ribavirin, resulting in discontinuation of therapy due to severe side effects. This study reports clinical management of 40 patients with HCV using sofosbuvir/ribavirin or ledipasvir/sofosbuvir for a reporting period 2013-2015 versus clinical management of 42 patients who were treated with telaprevir/peg interferon/ribavirin based therapy for a reporting period 2011-2013. Results: All 40 patients completed therapy with 37 attaining sustained viral response (SVR) at 12 or 24 weeks. 3 patients did not attain SVR with initial treatment and were placed on ledipasvir/sofosbuvir for 12 weeks and attained SVR at completion. Previous studies indicated 42 completed therapy, with 36 attaining SVR at 24 weeks with telaprevir/peg interferon/ribavirin. Minimal side effects were noted with sofosbuvir/ribavirin. No side effects were noted with ledipasvir/sofosbuvir. Side effects included 1 patient with anemia, 1 patient with hyperammonemia, and 3 patients with headaches. In comparison to telaprevir/peg interferon/ribavirin based therapy where 7 patients discontinued therapy due to severe side effects consisting of, depression, peptic ulcer disease, hyperammoniemia and extreme thrombocytopenia. Conclusion: The data demonstrated a statistically significant improvement with minimal to no side effects. Previous studies indicate a success rate of 85% with telaprevir/peg interferon/ribavirin. This treatment regimen has proven to be less invasive with a success rate of 92.5% sofosbuvir/ribavirin and 100% ledipasvir/sofosbuvir.

Biography:

Ms. Lavanya Rishi is pursuing her graduation in medical sciences (MBBS, Second year student) in Himalayan Institute of Medical Sciences, Dehradun. She has been a meritorious student at the Secondary and Senior Secondary level. Recently, she has been awarded short term studenship (STS-2015) by Indian Council of Medical Research, India to work on the project “Possible augmentation in the anti-Staphylococcal activity of conventional antibiotic(s) with probiotic cell free supernatant”

Abstract:

In view of the capability of S. aureus causing a wide array of infections ranging from localized skin infections to life threatening systemic infections and due to emerging drug resistant S. aureus strains (MRSA/ORSA/VISA), there is a need to explore other alternative options to manage such deadly strains. Use of probiotics is one such option as several probiotic strains have been reported to have anti-Staphylococcal activity. In the present study, efficacy of antibiotics in the presence of probiotic cell free supernatant (CFS) against S. aureus strains was evaluated by radial/agar well diffusion assay as well as by minimum inhibitory concentration (MIC) determination. Out of the four probiotics used, CFS of L. paraplantarum revealed the maximum anti-Staphylococcal activity. To use the probiotic/CFS in conjunction with conventional antibiotics against S. aureus, antibiogram of S. aureus as well as L. paraplantarum was determined. On the basis of resistance pattern of both, the two combinations (CFS/ampicillin and CFS/oxacillin) were selected. These two combinations were found to have synergistic/additive effect as per the fractional inhibitory concentration (FIC) index. It was inferred from the study, MICs of both the antibiotics in presence of CFS were reduced significantly. It is worth mentioning that the strains which were earlier resistant to oxacillin were rendered sensitive to it in the presence of CFS as per CLSI guidelines. It can be concluded from the study that CFS and ampicillin/oxacillin combination might help in rejuvenating the use of conventional anti-Staphylococcal antibiotics for the treatment of multi-drug resistant strains.

Biography:

Abstract:

Biography:

Rama Bhat has completed his MBBS and MD Internal Medicine from Mysore University and Goa University in 1988 and 1993 respectively. He is currently working as a Professor of Medicine at Manipal University, India. He has published 12 articles in national and international journals.

Abstract:

A 52 year old patient with a known case of human immunodeficiency virus infection on zidovudine, lamivudine and nevirapine since 2 years, presented with severe fatigue. He had severe anemia with hemoglobin of 3.5 gm% with normal leucocyte and platelet counts. He had no lymphadenopathy or hepatosplenomegaly. His CD4 count was 584 and HIV viral load was undetectable. Zidovudine was thought to be the cause of anemia and cART was changed to tenofovir, lamivudine and efavirenz. He was given 3 units of packed red cell transfusion and was discharged from the hospital. Patient returned 3 weeks later with severe anemia. A bone marrow study was done which showed selective suppression of erythrocyte precursors suggestive of pure red cell aplasia. Parvovirus serology was negative. Lamivudine was substituted with emtricitabine with no response. Antiretroviral therapy was temporarily discontinued for 4 weeks with no response. Corticosteroid therapy was given but anemia persisted. Finally antiretroviral treatment was continued with weekly erythropoietin therapy. He has responded with increase in hemoglobin in 4 weeks.

Biography:

Abstract:

It is known that some microbial infections of the Central Nervous System (CNS), such as those caused by Toxoplasma, Cryptococcus and Cytomegalovirus, can be related to predisposing underlying diseases. In Brazil, the tropical climate favors proliferation of large quantities of insect vectors and their vertebrate reservoirs, thus supporting the natural cycles of many arboviruses such as Flavivirus that can infect man. The present report highlights examples of human CNS Flavivirus infections that could be related to underlying diseases. In a study done in the state of Amazonas, cerebrospinal fluid (CSF) from 2 out of 23 patients with meningoencephalitis had the Flavivirus Rocio (ROCV) identified in the CSF. They were a 53 year old man and a 30 year old woman both with AIDS and one of them with tuberculosis, both with headache, behavioral changes and seizures. All survived after lengthy hospital stays. In the Southeast of Brazil 2 children with meningoencephalitis had Saint Louis encephalitis virus detected in liquor. They had lymphomonocitary meningitis and both survived. Recently, we had a fatal case of meningoencephalitis in a cardiac transplanted adult patient with Zika virus detected in the liquor. It is possible that CNS invasion by flaviviruses, including Rocio, Saint Louis encephalitis and Zika viruses was facilitated by immune immaturity or deficiency and also by previous blood-brain barrier damage. It is important to be aware of flaviviruses in patients from tropical regions with underlying diseases and CNS manifestations.

Biography:

Nada Nawar has completed her PhD at the age of 33 years from Kasr Al Aini School of Medicine , Cairo University. She is a professor of Clinical Pathology in Cairo University. She has more than 18 papers in reputed journals.

Abstract:

Biofilm formation in indwelling urinary catheters is a leading cause of Urinary tract infection (UTI) that is associated with increased bacterial resistance to antimicrobial therapy and treatment failure. Our aim was to find out the incidence of biofilm formation in urinary catheterized patients and to detect a reliable diagnostic technique for the detection of the formed biofilm . The study was done on 20 hospitalized patients from Cairo University Hospitals, with indwelling catheters for ≥ 3 days that were scanned by electron microscopy (SEM) for the presence of biofilm. Microorganisms isolated from catheter and urine samples were identified and tested for biofilm formation using the tissue culture plate (TCP). The microbial species isolated from cultured urine were; E.coli, Acinetobacters, Candida (C) albicans and non C. albicans. Biofilm formation increased with duration of catheter in situ, but no significant correlation was found (p=0.095). There was reduction in microbial diversity with antimicrobial use but the correlation was insignificant (p=0.317). SEM images of 14/20 (70%) showed biofilms on the luminal surface. The sensitivity, specificity, total accuracy, PPV and NPV of urine culture and catheter culture against SEM were, 64.30%, 100%, 75%, 100%, 54% and 85.70%, 100%, 90%, 100%, 75% respectively. Combined routine microbiological examination of urine and intraluminal catheter surface is required for early identification of organisms causing catheter associated urinary tract infections (CAUTI) and biofilms on urinary catheters. SEM proved to be a reliable method for the detection of biofilm on urinary catheters than urine culture and TCP assay.

Biography:

Prof. Dr. Mona Mohiedden AbdelHalim, Completed her PhD at the age of 31 years from Faculty of medicine- Cairo University. She did her postdoctoral studies in clinical microbiology from Cairo University School of Medicine. She is the director of microbiology unit of the main laboratory of Cairo University Specialized, pediatric hospital (CUSPH) and the leader of infection control of same CUSPH hospital since about 8 years. She has published more than 20 papers in the field of microbiology and infection control in reputed journals. Attended more than 30 national and international conferences and workshops in field of microbiology and infection control as speaker, organizer and poster presenter. She reviewed in some scientific journals
She also has memberships of Professional Associations
• National : Member of ESLM
• International: Associate member of international federation of infection Control.

Abstract:

Background: Candidemia studies have documented geographic differences in rates and epidemiology. Although Candida albicans continues to be the most common and virulent cause of Candida blood stream infection (BSI), longitudinal studies have detected an increase in the incidence of BSI caused by other Candida species that are known to be inherently less susceptible to commonly used antifungal drugs.
Study Question: Is to investigate the new trend of neonatal candidemia due to most commonly encountered Candida species using simple and reliable technique. Methods:: Blood cultures were performed in BACTEC instrument for 107 neonates admitted to Neonatal Intensive Care Unit -Cairo University Specialized Pediatric Hospital (CUSPH). All study population was suffering from prolonged hospitalization with fever of unknown origin, inadequate antibiotic response for at least one week. Detection of candidemia and species identification of isolates were performed according to its standard protocol. All blood culture bottles of the Candida isolates, and bottles that didn't flag positive and gives negative subculture on Sabaraud dextrose agar (SDA) and sheep blood agar (SBA) 5th day of incubation in BACTEC instrument were further identified and differentiated using PCR technique. The non-systematic collection and storage of samples were a limitation of our study.
Results: 98 (91.6%) out of 107 studied cases were culture positive for fungus. 90 of these cases (91.8%) were PCR positive, while 8 cases (8.16%) were not identified by PCR. The agreement between the two techniques was 0.229 (P-value 0.017). The designated inner primers for the given Candida species identified all 96 cases to species level were 70/107 (65.4%) as Candida albicans, 14/107 (13.1 %) as Candida tropicalis, 12/107 (11.2 %) as Candida glabrata. All cases that showed positive Germ tube test 45/98 (45.9%) were confirmed as Candida albicans by PCR. There was no statistically significant difference between identified Candida species in the present study regarding clinical diagnosis or demographic criteria.
Conclusions:Notably we have performed a reliable technique for comprehensive identification of clinically relevant Candida isolates, and ascertained significant data on many technical points including; specimen type, time and storage conditions. Performing a study for evaluation of the effect of different blood fractions on the reproducibility of PCR results for diagnosis of candidemia is recommended. Public Health Implications: PCR technique is more specific and rapid than conventional culture method. Moreover, the improved detection and discrimination between infecting Candida species is additional advantage information that is crucial for initiating specific antifungal therapy.
Key words: Candidemia - PCR- NICU - Candida species- blood stream infection

Biography:

Anjana Goel has completed her MSc in Biochemistry from Lucknow University and obtained her PhD from Central Drug Research Institute, India. She has worked as a Principal Investigator in DST sponsored project under WOS-A scheme. She is currently working as an Associate Professor in the Department of Biotechnology, Microbiology and Immunology. She has published more than 20 papers in reputed journals and presented more than 50 research papers in international and national conferences.

Abstract:

Argemone mexicana is used in folk medicines to treat many diseases in India. The decoction of leaves is used for the treatment of malaria, ulcers and chronic skin diseases. It is reported earlier that sanguinarine and dihydrosanguinarine alkaloids are present in different parts of this plant. In the present study the leaves of Argemone mexicana were analyzed for the presence of these toxic compounds with HPTLC and GC-MS analysis and found negative for these compounds. These toxic compounds are probably present in seeds and flowers. Thus aqueous leaves extract was investigated to validate the effect of plant on chronic skin diseases by regulating the expression of cytokines. Wistar albino rats were fed with non toxic dose, 250 mg/kg body weight of A. mexicana extract for 20 days. Spleens were removed from control and A. mexicana treated animals. Splenocytes were cultured in presence of 10 µg/ml con-A for 48 hours. IL-2, IFN-gamma and IL-10 cytokines were quantitated in culture supernatant by ELISA technique. There was a significant increase in IL-10 expression as compare to control animals. In contrast IL-2 and IFN-γ were expressed in significantly low quantities when compared with control animals. It can be concluded from the study that effect of A. mexicana which is used to cure the allergic and hypersensitive type of immunological disorders of skin, like psoriasis, might be due to the stimulation of IL-10 immune suppressive cytokine, secreted by TH-2 subset of TH cells. While the cytokines secreted from TH-1 subsets, IL-2 & IFN-γ, which increase the immunological responses were down regulated.

Biography:

Praveen Rishi has completed her PhD from Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India. Presently, she is the Chairperson of the Department of Microbiology, Panjab University, India. She has more than 100 publications in journals of repute and a Patent to her credit. She is a Fellow of Association of Microbiologists of India (FAMI) and Fellow of Indian Association of Biomedical Scientists (FABMS). She is also a recipient of Dr. Y.S. Narayana Rao Oration Award, conferred by Indian Council of Medical Research (ICMR). She is serving as an Editorial Board Member of various journals of repute.

Abstract:

Multidrug resistant Acinetobacter baumannii is recognized to be among the most difficult antimicrobial resistant Gram negative bacilli to control and treat. It survives for prolonged periods under a wide range of environmental conditions and causes outbreaks of serious infections including bacteremia, pneumonia, meningitis, urinary tract infection and wound infection. Antimicrobial resistance greatly limits the therapeutic options for patients who are infected with this organism. Therefore, there is a need to look for alternate treatment options like bio-therapeutics including antimicrobial peptides of prokaryotic or eukaryotic origin. In the light of the present scenario, efficacy of a designer alpha helical peptide, a hybrid of cecropin, melittin and magainin 2 was evaluated. In vitro effectiveness of the peptide against A. baumanii was evaluated by determining the Minimum Inhibitory Concentration which was found to be in the range of 2-4 μg/ml. To get an insight of mode of action of this peptide, various techniques like Transmission Electron Microscopy, Scanning Electron Microscopy, Confocal microscopy and Flow cytometry were employed. The SEM and TEM studies indicated that the peptide could bring significant morphological changes like damaged membrane and leakage of cytoplasmic content. Furthermore, Confocal microscopy and Flow cytometry confirmed that membrane permeabilization of A. baumanii cells by the hybrid peptide in a time dependant process. Inspired by the in vitro findings, therapeutic potential of this peptide was evaluated in murine excision wound model infected with A. baumanii. For this, a hydrogel formulation was prepared for evaluating its efficacy in terms of body weight, wound size contraction, bacterial load and histo-architectural alterations. Results were recorded on day 1, 3,7,15 and 21 post-infection. There was a significant decrease in the body weight of mice that were infected with A. baumanii whereas the loss was restored in the treatment group. The bacterial burden in the treatment group was significantly reduced in comparison to the untreated group. A speedy contractile healing of the wound was observed in case of the group receiving the treatment which further correlated well with the histological studies. The observations from the study indicate that the peptide appears to be a good therapeutic option for developing newer treatment strategies against multidrug resistant strains.

Biography:

Abstract:

Biography:

Prasanth B is currently pursuing Residency at the Department of Internal Medicine, PGIMER, Chandigarh, a premier tertiary care centre in North India. Apart from his academic activities, he plays guitar and is also interested in adventure sports.

Abstract:

Introduction: Dengue is endemic in more than 125 countries affecting up to 200 million people per year with India having the maximum burden in Southeast Asia. Myocardial involvement is not an uncommon manifestation in dengue fever and diagnosing it has always been a challenge to the physicians due to its constellation of clinical features and lack of standard screening methods.
Aim: To study the prevalence of myocardial involvement amongst patients with dengue fever.
Methods: Fifty sequential adult patients of dengue fever admitted in our emergency department, PGIMER, Chandigarh, India, were assessed clinically and classified as dengue fever without warning signs, dengue fever with warning signs and severe dengue as per WHO 2012 guidelines. They were studied for possible myocardial involvement by means electrocardiography (ECG), point-of-care testing for cardiac biomarkers (quantitative troponin-I, creatinine kinase-MB Isoform and cardiac myoglobin) and two-dimensional transthoracic echocardiogram (2D-echo).
Results: We found evidence of myocardial involvement in 26%, 16% and 30% patients based on biomarker testing, 2D-echo and ECG respectively. On univariate analysis, presence of cardiac symptoms (p=0.009) and presence of shock (p=0.003) showed statistically significant association with biomarker elevation. However, the three parameters show poor correlation with each other and there is no single parameter, which is associated with clinical severity.
Conclusion: The prevalence of myocardial involvement in dengue varied from 16-30% in our study in which, compared from prior studies, we have used ECG, 2D Echo and Cardiac Biomarkers for evaluation in all the patients.

Biography:

Fereshteh Jafari is currently working at Leicester School of Pharmacy, Faculty of Health and Life Science, De Montfort University, The Gateway, Leicester, UK. As Medical Microbiologist and PhD student, he has more than 27 international publications in gastric cancer and on epidemiology of enteropathogenic bacteria in children below 5 years of age.

Abstract:

Infectious diarrhea is a leading cause of morbidity and mortality globally. Worldwide, enteropathogenic bacteria are responsible for one of the most important infectious diseases linked to the food industry and they affect animal welfare with the potential to give rise to public health problems. As in many countries, in Iran Shiga toxin producing Escherichia coli (STEC) strains have been frequently isolated from cattle, raw meat and young humans. In this study, we have explored the epidemiology of diarrheagenic Escherichia coli (DEC), Shigella spp., Salmonella spp. and Campylobacter spp. from differing sources in Tehran Province of Iran. Total 445 samples, which include 235 domestic cow feces, collected from three semi-urban community farms, 134 ground beef samples from slaughtered bovine/sheep sources (specifically a Tehran abattoir) and 76 stool samples acquired from human children (1 to 60 months of age) with acute diarrhea were sequentially examined for stx1, stx2, eae, lt, st, Pcvd435, O157:H7, α-hly and Shigella spp., Salmonella spp. and Campylobacter spp. genes via Polymerase Chain Reaction (PCR) approach. Shiga-toxin producing Escherichia coli strains were isolated from 41% of meat, 64% of cattle feces and 24% of children’s fecal samples. PCR analysis indicated that 16 samples in total were positive for O157:H7. Also, 14% of human children and 0.85% of cattle species were Shigella spp. positive. The most commonly isolated STEC bacteria were from the O146, O112a and O44 serogroups for all 3 sources. Remarkably, none of the STEC strains proved to be from the O145, O111 and O26 serogroups. In conclusions, high levels of Shiga toxin producing E. coli in cattle and raw beef samples were observed at high rates and STEC colonization is widespread amongst healthy cattle in Iran. These observations provide strong evidence that STEC is one of the major causes of diarrhea in developing countries, mainly in children. The panel of assays employed offer simple strategies for the widespread detection and characterization of diarrheagenic E. coli isolates from a range of sources. DEC detection in this manner facilitates our understanding of their prevalence, clinical characteristics and epidemiology and will serve to support the future development of further food safety control strategies which target all STEC serotypes.

Biography:

Abstract:

Horizontal gene transfer (HGT) and recombination leads to the emergence of bacterial antibiotic resistance and pathogenic traits. Genetic changes range from acquisition of a large plasmid to insertion of transposon into a regulatory gene. HGT events can be identified by comparing a large number of fully sequenced genomes across a species or genus, define the phylogenetic range of HGT and find potential sources of new resistance genes. In-depth comparative phylogenomics can also identify subtle genome or plasmid structural changes or mutations associated with phenotypic changes. Comparative phylogenomics requires that accurately sequenced, complete and properly annotated genomes of the organism. Due to dramatic advances in “short read” sequencing technology, the raw sequence coverage needed for sequencing a bacterial genome now can be obtained in a couple of days for a few dollars sequencing costs, starting with only a few nanograms of genomic DNA. Assembling closed genomes requires additional mate-pair reads or “long read” sequencing data to accompany short read paired end data. To bring down the cost and time required of producing assembled genomes and annotating genome features that inform drug resistance and pathogenicity, we are analyzing the performance for genome assembly of data from the Illumina NextSeq, which has faster throughput than the Illumina HiSeq (~1-2 days versus ~1 week) and shorter reads (150 bp paired end versus 300 bp paired end) but higher capacity (150-400 M reads per run versus ~5-15 M) compared to the Illumina MiSeq. Bioinformatics improvements are also needed to make rapid, routine production of complete genomes a reality. Modern assemblers such as SPAdes 3.6.0 running on a standard Linux blade are capable in a few hours of converting mixes of reads from different library preps into high quality assemblies with only a few gaps. Remaining breaks in scaffolds are generally due to repeats (e.g., rRNA genes) are addressed by our software for gap closure techniques that avoid custom PCR or targeted sequencing. Our goal is to improve the understanding of emergence of pathogenesis using sequencing, comparative genomics and machine learning analysis of ~1000 pathogen genomes. Machine learning algorithms will be used to digest the diverse features (change in virulence genes, recombination, horizontal gene transfer & patient diagnostics). Temporal data and evolutionary models can thus determine whether the origin of a particular isolate is likely to have been from the environment (could it have evolved from previous isolates). It can be useful for comparing differences in virulence along or across the tree. More intriguing, it can test whether there is a direction to virulence strength. This would open new avenues in the prediction of uncharacterized clinical bugs and multidrug resistance evolution and pathogen emergence.

Biography:

Abstract:

Background & Objectives: Colistin (polymyxin E), an old antibiotic replaced by other less toxic antibiotics in the 1970s has been increasingly used over the last decade due to multidrug resistance in Gram negative bacteria and lack of new antibiotics. However there is a dearth of information on the pharmacodynamics and toxicodynamics of colistin and its non-active prodrug colistimethate sodium (CMS). Optimized dose regimens have not been establishment for different types of patients, especially in the critically ill population. Material & Methods: Recent reports have not described neurotoxicity associated with intravenous CMS with the exception of cases in the cystic fibrosis population, among whom neurotoxicity has manifested as paraesthesias and ataxia in 29% of patients treated (dosages in excess of 5 mg/kg per day). Our patient received intravenous CMS dosages 6 mg/kg per day. Only one case according most recent literature has described a profound encephalopathy with lack of brainstem reflexes in postsurgical patient. We report a 56 year old man who developed renal, hematological and neurotoxicity on the 5 day after administration endovenous colistin and cefepima (CMS dosages of 160 mg/8 hours, equivalent to approximately 6 mg/Kg per day). The patient has made perforated diverticulitis with descending colon resection and end colostomy left flank. On day 6 post-surgery nosocomial pneumonia by Pseudomona aeruginosa MR sensible to colistin was diagnosed. Results: Electroencephalogram was compatible with severe encephalopathy. Peripheral eosinophil count had increased to 12%. He recovered promptly after stopping the drug. Conclusions: The awareness of colistin’s potentially fatal effects must be kept in mind when using. Vigilance of the encephalopathic picture can also facilitate the diagnosis of colistin mediated neurotoxicity in a patient with altered mental status of otherwise unknown aetiology. In our opinion, the establishment of any relationships between the daily dosage of CMS, colistin levels and neurological events is needed, especially in the critically post-surgical ill patient population.

Biography:

Angeliki Melidou has completed his PhD at the age of 28 years in Aristotle University of Thessaloniki in the field of molecular virology. She is now an Assistant Professor of Molecular Microbiology-Virology at the Microbiology Laboratory, School of Medicine, AUTH. She is also the manager of the molecular department of the National Influenza Centre for N. Greece in close collaboration with the National Authorities and WHO. She has published more than 43 papers in international peer-reviewed journals and has been serving as an editorial board member/reviewer of several reputed journals.

Abstract:

The impact of Next Generation Sequencing in microbiology has been revolutionary and it is increasingly being used as a diagnostic tool in the clinical field. In this review, we focus on the application of NGS in unraveling the mystery of unknown disease-associated pathogens in clinical specimens. Whole genome sequencing WGS allows the direct detection of known and unknown pathogens in DNA samples, while targeted next generation sequencing allows the identification of the microbial population in the human host. These genetic approaches will render the identification of viruses and bacteria in clinical specimens of undiagnosed patients, or of those patients that suffer from diseases of unknown etiology, as de novo WGS has opened a new era in the discovery of novel disease-causing pathogens. Although NGS has provided a great tool for infectious disease diagnostic testing, it still needs to adapt to the clinical environment: standardization and simplification of technical protocols, development of user friendly data analysis bioinformatics software, appropriate validation and quality control procedures, completeness and continuous update of reference genome databases; these are all necessary steps for the incorporation of NGS to the everyday clinical practice. It is important to understand both the great new opportunities and the limitations of this new technology.

Biography:

Liliya Markova Pekova has completed his PhD from Medical Faculty of Trakia University and Postdoctoral studies from the same university. He is the Head of Clinic of Infectious Diseases at University Hospital in Stara Zagora, Bulgaria and the Head of Section Infectious Diseases at Medical Faculty of Trakia University, Stara Zagora, Bulgaria. He has published more than 50 papers in different journals, 10 of them in international ones.

Abstract:

Introduction: Tularemia is an acute febrile zoonosis, which is potential life threatening disease. The most popular clinical form is ulceroglandular. Aim: Materials & Methods: In a period of 8 months (December 2014-July 2015) through the Clinic of Infectious diseases of University Hospital Stara Zagora, Bulgaria, 5 patients with ulceroglandular form of Tularemia were passed; they were 4 men and 1 woman, aged from 52 to 73 years. Clinical, epidemiological, laboratorial and serological investigations were provided. Results & Discussion: Three of patients were hunters, fired wild rabbits and the rest two took part in breaking up and cooking the game. After an incubation period mean 4.8±1.4 days in all was appeared a primary affect in region of the fingers. Three had redness in eyes, on face and oropharynx. Later on the toxic syndrome a regional painful lymphadenitis was appeared. Two patients had dyspeptic syndrome with vomiting and diarrhea, no appetite. All had enlarged liver, two had scanty maculopapular rash. The diagnosis was proved by degree agglutination type Vidal at the Referent Laboratory of Particularly Dangerous Infection, National Center of Infectious, Parasite Diseases, Sofia. The antibacterial treatment was a combination of 4-quinolones and aminoglycosides. The outcome was favorable in all patients. Conclusion: Because tularemia is not so common disease, it could be easy left out. It must be suspected when there were unusual temperature, redness in eyes and glandular syndrome with corresponding epidemiological situation.

Biography:

Dr. Goutam Chowdhuty has completed his PhD at the age of 30 years from Jadavpur University and postdoctoral studies from National Institute of Cholera and Enteric Diseases. He working on the antimicrobial resistance and virulence factors of commensal E.coli with other enteric pathogens, Metagenomics analysis of human diarrheal stool samples and Development of simplex and multiplex Real-time PCR for detection of novel enteric bacterial pathogens from human diarrheal specimens and establishment of virulence property. He has published more than 27 papers in reputed journals

Abstract:

Acute diarrheal disease is still a major health problem and second most common cause of death world-wide in children under five years of age. Most of the morbidity occurs in low-income countries, where the aetiologies and epidemiology of gastroenteritis remain incompletely understood. Diarrhea can be caused by a range of pathogens, including several bacteria. Conventional diagnostic methods, such as culture, biochemical tests, and enzyme-linked immunosorbent assay (ELISA), are laborious and time consuming. We used SYBR-Green real time PCR assay targeting 10 uncommon diarrheagenic bacterial pathogens (S.aureus, Enterotoxigenic B.cereus, C. perfringens, C. difficile, L. monocytogenes, P. shigelloides, Y. enterocolitica, Enterotoxigenic B. fragilis, A. hydrophila, P. alcalifaciens) directly in fecal specimens from patients admitted infectious diseases hospital with acute diarrhea in Kolkata, India. The products formed were identified based on melting point temperature (Tm) curve analysis. The assay was first validated with reference strains or isolates and exhibited a limit of detection of 103 to 105 CFU/gm of stool for each pathogen. A total of 1184 clinical fecal specimens from individual with diarrhea, previously cultured for enteric pathogens were evaluated. Enterotoxigenic B. fragilis was detected highest number about 80 (6.75%) followed by enterotoxigenic B. cereus 60 (5.06%), C. perfringens 46 (3.88%), A. hydrophila 45 (3.80%), P. alcalifaciens 44 (3.71%), P. shigelloides 39 (3.29%), C. difficile 39 (3.29%), L. monocytogenes 38 (3.20%), S. aureus 23 (1.94%), and Y. enterocolitica 14 (1.8%) respectively. We found SYBR-Green real time PCR assay for simultaneous detection of 10 target pathogens to be comprehensive, rapid, inexpensive and accurate, of high selectivity and is well suited for surveillance or clinical purpose.

Biography:

Abstract:

Brucellosis is an occupational disease affecting workers in butcher shops, the milking and dairy product industry, causing more than 500,000 new cases around the word. In China, brucellosis is a national statutory B infectious disease and rapidly increases in recent years. We report an outbreak of brucella placenta infection in a pharmaceutical factory. Exposure was a result of manual operation in the process line, close contact with sheep placentas, insufficient disinfection and repeated using of protective suits and infected by aerosol dissemination. Improved preventive methods, appropriate public health measures and spread of health education would be helpful to prevent the occupational outbreak of brucellosis in future.