Infection In Different Regions Research Articles

Detection and quantification of SARS-CoV-2 RNA in wastewater and treated effluents: Surveillance of COVID-19 epidemic in the United Arab Emirates

Testing SARS-CoV-2 viral loads in wastewater has recently emerged as a method of tracking the prevalence of the virus and an early-warning tool for predicting outbreaks in the future. This study reports SARS-CoV-2 viral load in wastewater influents and treated effluents of 11 wastewater treatment plants (WWTPs), as well as untreated wastewater from 38 various locations, in the United Arab Emirates (UAE) in May and June 2020. Composite samples collected over twenty-four hours were thermally deactivated for safety, followed by viral concentration using ultrafiltration, RNA extraction using commercially available kits, and viral quantification using RT-qPCR. Furthermore, estimates of the prevalence of SARS-CoV-2 infection in different regions were simulated using Monte Carlo. Results showed that the viral load in wastewater influents from these WWTPs ranged from 7.50E+02 to over 3.40E+04 viral gene copies/L with some plants having no detectable viral RNA by RT-qPCR. The virus was also detected in 85% of untreated wastewater samples taken from different locations across the country, with viral loads in positive samples ranging between 2.86E+02 and over 2.90E+04 gene copies/L. It was also observed that the precautionary measures implemented by the UAE government correlated with a drop in the measured viral load in wastewater samples, which were in line with the reduction of COVID-19 cases reported in the population. Importantly, none of the 11 WWTPs' effluents tested positive during the entire sampling period, indicating that the treatment technologies used in the UAE are efficient in degrading SARS-CoV-2, and confirming the safety of treated re-used water in the country. SARS-CoV-2 wastewater testing has the potential to aid in monitoring or predicting an outbreak location and can shed light on the extent viral spread at the community level.

Distribution of Streptococcus agalactiae Among Iranian Women from 1992 to 2018: A Systematic Review and Meta-Analysis

Context: Group B Streptococcus has the capacity of being colonized in the rectovaginal organ of women and causes infections in a mother and her fetus, thereby leading to neonatal diseases. Evidence Acquisition: The aim of this review was to summarize all of the relevant articles published to highlight the prevalence of group B Streptococcus colonization or infection in different regions of Iran. A systematic literature review was conducted by searching PubMed, Scopus, Web of Science (ISI), ScienceDirect, Google Scholar, and domestic databases for papers published in English or Persian from 1992 up to July 2019, concerning the prevalence of group B Streptococcus among Iranian women. All information regarding year, location of cases, frequency, author’s name, date of publication, participants, pregnancy period, sampling, and quality assessment were recorded. Summary effects were derived using the random effects model. Results: Among 61 suitable papers, data revealed that 36,807 cases of pregnant and non-pregnant women had been tested for group B Streptococcus during 1992-2018. Overall, 11.9% of pregnant and 5.3% of non-pregnant women were positive. Further results were as follows: vaginal, recto-vaginal, rectal, and endocervical colonization rates were 12.9%, 9.7%, 18.5%, and 3.7%, respectively. Group B Streptococcus incidence was the highest in Sanandaj (61.5%), and the lowest in Tabriz (1.8%). Conclusions: Although the prevalence distribution in Iran seems to be acceptable, more investigations are needed to represent the real incidence of group B Streptococcus around the country. In addition, a program with a standard lab technique is needed to screen pregnant women for further treatment before birth.

COVID-19 PICU guidelines: for high- and limited-resource settings

BackgroundFewer children than adults have been affected by the COVID-19 pandemic, and the clinical manifestations are distinct from those of adults. Some children particularly those with acute or chronic co-morbidities are likely to develop critical illness. Recently, a multisystem inflammatory syndrome (MIS-C) has been described in children with some of these patients requiring care in the pediatric ICU.MethodsAn international collaboration was formed to review the available evidence and develop evidence-based guidelines for the care of critically ill children with SARS-CoV-2 infection. Where the evidence was lacking, those gaps were replaced with consensus-based guidelines.ResultsThis process has generated 44 recommendations related to pediatric COVID-19 patients presenting with respiratory distress or failure, sepsis or septic shock, cardiopulmonary arrest, MIS-C, those requiring adjuvant therapies, or ECMO. Evidence to explain the milder disease patterns in children and the potential to use repurposed anti-viral drugs, anti-inflammatory or anti-thrombotic therapies are also described.ConclusionBrief summaries of pediatric SARS-CoV-2 infection in different regions of the world are included since few registries are capturing this data globally. These guidelines seek to harmonize the standards and strategies for intensive care that critically ill children with COVID-19 receive across the world.ImpactAt the time of publication, this is the latest evidence for managing critically ill children infected with SARS-CoV-2.Referring to these guidelines can decrease the morbidity and potentially the mortality of children effected by COVID-19 and its sequalae.These guidelines can be adapted to both high- and limited-resource settings.

FAUNA, DISTRIBUTION AND EPIZOOTOLOGY OF HELMINTHS OF PARENCHYMAL ORGANS OF UNGULATES OF UZBEKISTAN

This article presents the fauna of helminths of parenchymal organs and the epizootology of the main helminthiases of ungulates in various biocenoses of Uzbekistan. On the basis of many years of our own research and analysis of literature data, the species compositions of helminths of parenchymal organs of ungulates in various regions of Uzbekistan were established. The fauna of helminths of the parenchymal organs of ungulates of Uzbekistan was represented by 31 species of helminthes, belonging to 13 genera, 6 families, 4 orders, 3 classes and 2 types of wildlife. Aspects of the epizootology of the main helminthiases of parenchymal organs of ungulates in all five regions of the Republic were given. The purpose of this research is to summarize and analyze the results of our research and literature data on the fauna and distribution of helminths of parenchymal organs of ungulates in various regions of Uzbekistan. The helminth fauna studies were defined such as 16 species of ungulate animals of 5 families (Bovidae, Cervidae, Suidae, Camelidae, and Equidae) on the territory of the Republic. A structural analysis of the helminth fauna of the parenchymal organs of ungulates in Uzbekistan points out that the causative agents of helminth infections in different regions of the Republic are not equally distributed. Thus, in ungulate animals of the North-West of Uzbekistan, the main helminthiases of parenchymal organs include of fascioliasis (20.8-55.6%), echinococcosis (17-28.2%) and cysticercosis (12-32%). The main helminthiases of parenchymal organs of ungulates of the East of Uzbekistan are fascioliasis (34.8-49.5%), dicroceliosis (43.3-67.6%), echinococcosis (27.7-31.5%) and dictiocaulosis (41.3 -68.5%). A high percentage of infection in small cattle was also noted by protostrongilidoses.

Occurrence of BVDV Infection and the Presence of Potential Risk Factors in Dairy Cattle Herds in Poland.

Simple SummaryThe bovine viral diarrhea virus (BVDV) causes one of the most common and economically important viral diseases of cattle. It affected cattle reproductive disorders in breeding cattle as well as decreased productivity through increased forced culling, morbidity, and mortality, all of which can be observed on the herd level. The aim of our study was the estimation of the occurrence of BVDV infection in different regions of Poland and the analysis of the different factors that could be correlated with the productive results. We evaluated 354 cattle herds. The presence of antibodies against the BVD virus was found in 33.3% of examined herds, and the heterogenous distribution of BVDV-positive herds in all regions of Poland was confirmed. We found that the rate of BVDV infection was strongly correlated with the geographical location of the examined cattle populations in Poland, the grazing of the animals, and the purchasing of new animals to be introduced to herds.The aim of the study was to analyze the risk factors of BVDV infection, in different regions of Poland, with respect to certain parameters of animal health, including productivity, herd management practices, the presence of BVDV, and the effect of non-vaccination. A total of 354 cattle herds were estimated and linked to the analysis of the different factors that might be correlated with productive results. The presence of antibodies against BVDV was found in 33.3% of examined herds, and the heterogenous distribution of BVDV-positive herds in all regions of Poland (p = 0.001) was confirmed. We found statistical correlations between BVDV infection and pasture (p = 0.004) and the number of grazing animals (p < 0.001), and also the purchase of animals for replacement (p = 0.004) was observed. Production or clear clinical outcomes potentially linked to BVDV infection in the herd have not been observed. The results of this study indicate that the rate of BVDV infection was most strongly correlated with the geographical location of the examined cattle populations in Poland. The second most significant factors were the grazing of animals and the purchasing of new animals to be introduced to herds. The strengthened procedures of management, as well as the implementation of eradication programs, should be considered in the examined herds.

Serological evidence of Toxoplasma gondii and Neospora caninum infection in black-boned sheep and goats in southwest China

Toxoplasma gondii and Neospora caninum are two closely related protozoan parasites which can cause abortion and significant economic losses in sheep and goats. However, it is yet to know whether black-bone sheep and goats are infected with T. gondii and N. caninum in China. In the present investigation, the seroprevalence and risk factors of T. gondii and N. caninum infections in black-boned sheep and goats were investigated in Yunnan Province, subtropical southwest China between July and August of 2017. A total of 481 serum samples were tested for T. gondii antibodies using the Modified Agglutination Test (MAT), and 468 serum samples were examined for N. caninum antibodies by indirect Enzyme-Linked Immunosorbent Assay (iELISA). The overall seroprevalence of T. gondii in black-boned sheep and goats was 36.80% (177/481, 95% CI 32.49–41.11), and 40 out of 468 serum samples were N. caninum-seropositive (8.55%, 95% CI 6.02–11.08). There was significant difference in the seroprevalence of T. gondii infection in different regions (χ2 = 19.869, df = 2, P<0.01). As for the seroprevalence of N. caninum infection, region (χ2 = 8.558, df = 2, P<0.05), age (χ2 = 16.631, df = 3, P < 0.01), gender (χ2 = 11.219, df = 1, P < 0.01) and species (χ2 = 8.673, df = 1, P < 0.01) were the risk factors. In addition, the seroprevalence of coinfection of T. gondii and N. caninum in black-boned sheep and goats was 3.63% (17/468, 95% CI 1.94–5.32). To our knowledge, this is the first report of T. gondii and N. caninum seroprevalence in black-boned sheep and goats in China, which provided base-line data for the execution of control strategies and measures against T. gondii and N. caninum infection in black-boned sheep and goats.

The Epidemiology of MonophasicSalmonellaTyphimurium

Salmonella enterica remains an important foodborne pathogen in all regions of the world, with Typhimurium as one of the most frequent serotypes causing foodborne disease. However, the past two decades have seen a rapid worldwide emergence of a new Salmonella serotype, namely monophasic variant of S. Typhimurium, whose antigenic formula is 1,4,[5],12:i:-. It has become one of the 2-5 most common Salmonella serotypes responsible for animal and human infections in different regions. The global epidemic of monophasic S. 1,4,[5],12:i:- has mainly been characterized by an increase in multidrug-resistant S. 1,4,[5],12:i:- isolated in Europe since 1997. The unexpected link to swine has escalated monophasic S. Typhimurium infections to the status of a global public health emergency. The large-scale application of whole genome sequencing (WGS) in the last 10 years has revealed the phylogenetic associations of the bacterium and its antimicrobial resistance (AMR) genes. Local and global transmission reconstructed by WGS have shown that different clones have emerged following multiple independent events worldwide, and have elucidated the role of this zoonotic pathogen in the spread of AMR. This article discusses our current knowledge of the global ecology, epidemiology, transmission, bacterial adaptation, and evolution of this emerging Salmonella serotype.

Visceral leishmaniasis in a patient with active HBV/HDV co-infection

Visceral leishmaniasis (VL) is an endemic infection in different regions of Italy and Europe caused by protozoan parasites of the genus Leishmania, transmitted to humans through sandflies bites. Reactivation after Solid Organ Transplantation was reported and could be a risk of organ rejection. A 48 years old woman was admitted to our hospital, complaining about low-grade fever, loss of weight and new onset pancytopenia in a known cirrhosis due to active HBV/HDV co-infection. Clinical, microbiological and anatomo-pathological elements were pivotal to define the diagnosis of VL and started an appropriate anti-infective treatment. After that she underwent liver transplantation and a therapy for VL was set. No signs of reactivation were reported in the 14 months of follow-up.

PHENOTYPIC AND GENOTYPIC DETECTION OF CARBAPENEM RESISTANT ACINETOBACTER BAUMANNII IN SURGICAL AND INTENSIVE CARE UNITS IN AL AZHAR UNIVERSITY HOSPITAL – NEW DAMIETTA

Background: Acinetobacter baumannii (A. baumannii) has emerged as a healthcare-associated pathogen worldwide. Several epidemiological studies have reported the occurrence of multi-drug resistant A. baumannii infections in different regions of the world. The spread of carbapenem-resistant A. baumannii is of a global concern. Objectives: This work was carried out to detect carbapenem-resistant A. baumannii in Surgical Departments and intensive care units (ICUs), Al-Azhar University hospital, New Damietta. It was also aimed to determine the occurrence of bla OXA -51-like and bla OXA-23 like genes among the isolated strains. Patients and methods: The current study was conducted on 500 patients attending the Surgical Departments and ICUs during the period between May 2016 and September 2018. The choice of samples differs according to the clinical manifestations. The isolates were obtained from various clinical specimens, i.e. sputum, endotracheal aspirate (ETA), pus, urine and blood samples. All clinical specimens were collected under complete aseptic conditions. The clinical specimens were traced to the species level using API 20NE system followed by an assesment of the different phenotypic assays for detection of carbapenemase production using multiplex polymerase chain reaction (PCR). Results: Post-operative infections were detected in 217 (43.4%) out of 500 of patients. A. baumannii was considered the third common isolated Gram-negative organisms (27, 12.3 %). A. baumannii isolates were predominant in ICUs (14, 51.9%). Carbapenemase production was detected in A. baumannii isolates using the modified Carbapenem Inactivation Method (mCIM), the modified Hodge test (MHT) and the Carba NP test. Using multiplex PCR analysis, most isolates (12; 44.4%) carried bla OXA-51-like gene, followed by ten (37%) isolates that carried both bla OXA-51-like and bla OXA-23-like genes. Only one (3.7%) isolate carried bla OXA-23-like gene. Conclusion: The current study suggested that A. baumannii is one of the most commonly detected isolates in our hospital. The mCIM is the most useful phenotypic method for detection of carbapenemase production. Detection of carbapenem resistance genes is alarming a serious healthcare problem in our hospital.

PHENOTYPIC AND GENOTYPIC DETECTION OF CARBAPENEM RESISTANT ACINETOBACTER BAUMANNII IN SURGICAL AND INTENSIVE CARE UNITS IN AL AZHAR UNIVERSITY HOSPITAL – NEW DAMIETTA

Background: Acinetobacter baumannii (A. baumannii) has emerged as a healthcare-associated pathogen worldwide. Several epidemiological studies have reported the occurrence of multi-drug resistant A. baumannii infections in different regions of the world. The spread of carbapenem-resistant A. baumannii is of a global concern. Objectives: This work was carried out to detect carbapenem-resistant A. baumannii in Surgical Departments and intensive care units (ICUs), Al-Azhar University hospital, New Damietta. It was also aimed to determine the occurrence of bla OXA -51-like and bla OXA-23 like genes among the isolated strains. Patients and methods: The current study was conducted on 500 patients attending the Surgical Departments and ICUs during the period between May 2016 and September 2018. The choice of samples differs according to the clinical manifestations. The isolates were obtained from various clinical specimens, i.e. sputum, endotracheal aspirate (ETA), pus, urine and blood samples. All clinical specimens were collected under complete aseptic conditions. The clinical specimens were traced to the species level using API 20NE system followed by an assesment of the different phenotypic assays for detection of carbapenemase production using multiplex polymerase chain reaction (PCR). Results: Post-operative infections were detected in 217 (43.4%) out of 500 of patients. A. baumannii was considered the third common isolated Gram-negative organisms (27, 12.3 %). A. baumannii isolates were predominant in ICUs (14, 51.9%). Carbapenemase production was detected in A. baumannii isolates using the modified Carbapenem Inactivation Method (mCIM), the modified Hodge test (MHT) and the Carba NP test. Using multiplex PCR analysis, most isolates (12; 44.4%) carried bla OXA-51-like gene, followed by ten (37%) isolates that carried both bla OXA-51-like and bla OXA-23-like genes. Only one (3.7%) isolate carried bla OXA-23-like gene. Conclusion: The current study suggested that A. baumannii is one of the most commonly detected isolates in our hospital. The mCIM is the most useful phenotypic method for detection of carbapenemase production. Detection of carbapenem resistance genes is alarming a serious healthcare problem in our hospital.

Prevalence of antibiotic resistance in Escherichia coli strains simultaneously isolated from humans, animals, food, and the environment: a systematic review and meta-analysis.

Background: Antimicrobial resistance is a serious public health problem worldwide. We aimed to investigate the prevalence of antibiotic resistance in Escherichia coli strains simultaneously isolated from humans, animals, food, and the environment.Methods: Studies on PubMed, Embase, and the Cochrane Library published from January 1, 2000 to January 1, 2018 were searched. The quality of the included studies was assessed by the modified critical appraisal checklist recommended by the Joanna Briggs Institute. All analyses were conducted using Biostat's Comprehensive Meta-Analysis version 2.0. Depending on the heterogeneity test for each antibiotic, we used a random- or fixed-effect model for pooled prevalence of drug resistance. Studies were eligible if they had investigated and reported resistance in two or more isolation sources (human, animal, food, or environment). To decrease heterogeneity and bias, we excluded studies that had reported E. coli drug resistance isolated from one source only. We included publications that reported drug resistance with minimum inhibitory concentration or disk diffusion method (DDM) as antibiotic-susceptibility tests.Results: Of the 39 included studies, 20 used the DDM and 19 minimum inhibitory concentration for their antibiotic-susceptibility testing. Colistin had the lowest prevalence, with 0.8% (95% CI 0.2%–3.8%) and amoxicillin the highest, with 70.5% (95% CI 57.5%–81%) in isolated human E. coli strains tested with the DDM. To assess historical changes in antimicrobial drug resistance, subgroup analysis from 2000 to 2018 showed a significant increase in ciprofloxacin resistance.Conclusion: Monitoring and evaluating antibiotic-sensitivity patterns and preparation of reliable antibiotic strategies may lead to better outcomes for inhibition and control of E. coli infections in different regions of the world.

Epidemiology and Effects of Bacterial Infections in Patients With Cirrhosis Worldwide

Bacterial infections are common and life-threatening in patients with cirrhosis. Little is known about the epidemiology of bacterial infections in different regions. We performed a multicenter prospective intercontinental study to assess the prevalence and outcomes of bacterial and fungal infections in patients with cirrhosis. We collected data from 1302 hospitalized patients with cirrhosis and bacterial or fungal infections at 46 centers (15 in Asia, 15 in Europe, 11 in South America, and 5 in North America) from October 2015 through September 2016. We obtained demographic, clinical, microbiology, and treatment data at time of diagnosis of infection and during hospitalization. Patients were followed until death, liver transplantation, or discharge. The global prevalence of multidrug-resistant (MDR) bacteria was 34% (95% confidence interval 31%-37%). The prevalence of MDR bacteria differed significantly among geographic areas, with the greatest prevalence in Asia. Independent risk factors for infection with MDR bacteria were infection in Asia (particularly in India), use of antibiotics in the 3 months before hospitalization, prior health care exposure, and site of infection. Infections caused by MDR bacteria were associated with a lower rate of resolution of infection, a higher incidence of shock and new organ failures, and higher in-hospital mortality than those caused by non-MDR bacteria. Administration of adequate empirical antibiotic treatment was independently associated with improved in-hospital and 28-day survival. In a worldwide study of hospitalized patients, we found a high prevalence of infection with MDR bacteria in patients with cirrhosis. Differences in the prevalence of MDR bacterial infections in different global regions indicate the need for different empirical antibiotic strategies in different continents and countries. While we await new antibiotics, effort should be made to decrease the spread of MDR bacteria in patients with cirrhosis.

Evaluation of etiologic agents and antimicrobial resistance pattern of urinary tract infections in the northwest of Iran

Objective: The purpose of this study was to identify the causative agents of urinary tract infections as one of the most common bacterial infections and their resistance patterns to used antibiotics. Methods: The current cross sectional study was carried out on urine specimens retrieved from patients with urinary infections in the Central Laboratory of Tabriz University of Medical Sciences in 2013-14. After culture-based identification of isolates, antibiogram was conducted according to Clinical and Laboratory Standards Institute protocol. Results: Out of 56,564 urine specimens, 3,205 (5.7%) were positive in terms of urine culture, 77.3% belonged to women, and 22.7% belonged to men. Moreover, the results showed that Escherichia coli was the most common bacterium responsible for urinary infection. According to the obtained results of antibiogram test, most cases of bacterial resistance were respectively related to ampicillin (74.2%), cephalothin (68.1%), and co-trimoxazole (54%), and the most bacterial sensitivity belonged to amikacin (79%), nitrofurantoin (77.8%), and gentamicin (74.5%), respectively. Conclusion: This study showed that most of the bacteria isolated belonged to the family of Gram negative bacilli. The antibiotic resistance pattern of microorganism is responsible for urinary infections in different regions. Comparing the results of the present study with previous studies carried out in this region and around the world showed an increasing trend. Therefore, it seems necessary to consume antibiotic drugs correctly and reasonably, and administer them based on antibiogram

Mapping the HIV and syphilis epidemic and sexual behaviours in men who have sex with men in China: a meta-analysis

BackgroundData from national HIV sentinel surveillance are limited for men who have sex with men (MSM) about how geographical differences and sexual behaviours in this population are associated with prevalence of HIV infection in China. Through mapping, we aimed to clarify the pattern of HIV infections in different regions by conducting a spatiotemporal meta-analysis. MethodsWe searched in PubMed and China National Knowledge Infrastructure (CNKI) using the key words “HIV”, “MSM”, “Gay”, and “China” for any studies with original data of HIV infection, which were conducted in mainland China between Jan 1, 2001, to June 8, 2016 and published in Chinese or English. Study area, study period, and sample size were included. We extracted key information on HIV and syphilis prevalence and on sexual behaviours. All studies were grouped by six study regions and four study periods. The meta-analysis was done with the meta package of R statistical software version 3.3.1. FindingsOverall, of 2119 papers screened, 272 papers were included in the meta-analysis. Of these selected papers, 83 (31%) were from east region. The sample sizes of the studies ranged from 19 to 47 231. National HIV prevalence increased from 3·80% (95% CI 3·03–4·76) in 2001–07 to 6·61% (5·65–7·71) in 2013–15. Southwest remained the region with the highest HIV prevalence (median 2001–07: 10·58%, 2008–10: 7·87%, 2011–12: 9·05%, and 2013–15: 9·23%), while northwest increased steeply to the same level as southwest over the years (median 2001–07: 5·30%, 2008–10: 4·72%, 2011–12: 6·64%, 2013–15: 9·45%). Syphilis prevalence progressively decreased across the study period from 12·34% (10·16–14·92) in 2001–07 to 7·09% (5·59–8·94) in 2013–15, the largest declines were observed in the southwest and northwest regions. There was a negative association between HIV infection and condom use with a male partner in the past month (r=–0·411, p=0·024) in 2008–15, but we did not find a significant correlation between syphilis and HIV prevalence, and between syphilis prevalence and sexual behaviours. InterpretationThe overall HIV prevalence is still increasing in China, particularly in the southwest and northwest regions. A strategy for prevention and control of HIV, especially for condom promotion, is highly expected. FundingNational Institutes of Health (National Institute of Allergy and Infectious Diseases [NIAID] 1R01AI114310); University of North Carolina (UNC)-South China STD Research Training Centre (Fogarty International Centre 1D43TW009532); UNC Center for AIDS Research (NIAID 5P30AI050410); the Bill & Melinda Gates Foundation to the MeSH Consortium (BMGF-OPP1120138); and National Center for Advancing Translational Sciences (UL1TR001111) at the National Institutes of Health. The listed grant funders had no role in any step of this study.

Hantavirus haemorrhagic fever with renal syndrome case who did not have any history of contact with a rodent

Hantaviruses, a genus of the Bunyavirus family, are enveloped viruses with a genome that consists of RNA segments. The genus has several subtypes causing infection in different regions. Rodents such as rats are the natural reservoir for hantaviruses. People can become infected with these viruses after exposure to aerosolized urine, droppings, saliva of infected rodents or food contamineted with these infectious materials. Infected rodent bites of a person is another tranmission way. Individuals who work with live rodentslike farmers, long, shoremen, foresters have high risk of infection. Here, we report a 33 year-oldmale farmer who lived in a willage of Kastamonu and did not have any history of direct contact with a rodent. The infection of ourpatient was characterized by mild deteriation in kidney function tests. Indifferential diagnosis, it is thought that Crimean-Congo haemorrhagic fever and leptospirosis may also be the causes of thrombocytopenia, elevations in liver enzymes, abnormal kidney function test results of the case. Hantavirus renal syndrom diagnosis was confirmed by hantavirus IgM and IgG positivity with ELISA and abnormal laboratory tests improved after symptomatic treatment. Consequently, hantavirus infections should be thought twhen symtoms and laboratory tests are compatible with infection for patients in living endemic areas even if no history of rodent contact and spesific tests for final diagnosis must be performed.

Prevalence of Helicobacter pylori vacA, cagA, cagE, oipA, iceA, babA2 and babB genotypes in Iranian dyspeptic patients.

There is diversity in clinical outcome of Helicobacter pylori infection in different regions. Microbial, host and environmental factors seem to be reason of such variation. Considering microbial factors, we studied H.pylori genotypes and their association with clinical feature of the infection. Overall 160 H. pylori-positive patients were enrolled in this study. Clinical information and biopsy were collected from each patient. The presence of the major virulence genes were determined by PCR. Regardless to clinical outcomes, vacA, cagA, cagE, oipA, iceA1, babA2 and babB genes was positive in 100%, 69%, 51%, 55%, 26%,78% and 28% of 160 strains respectively. The s1m2 was more common vacA allels and s1a and m1a were predominant s and m regions. In patient with gastric cancer (GC), the oipA was less frequent while the iceA1 was the most common. The babA2 was common in all patient groups. The babB was significantly observed in strains isolated from patients with GC. There were significant association among cagA status with presence of vacAs1, vacAm2, cagE, oipA, iceA1 and babA2. Presence of the babB and oipA was connected with higher and lower risk for GC respectively. There was no association between the cagA, vacA, cagE or iceA status and clinical outcome in patients in Iran. We showed that presence of the babB and iceA1 were significantly connected with higher risk for gastric cancer development in Iranian dyspeptic patients while H.pylori isolates with positive oipA had little threat for leading patients to cancer.

Prevalence of schistosomiasis and soil-transmitted helminth infections among schoolchildren in Burkina Faso.

To determine the current status of schistosomiasis and soil-transmitted helminth (STH) infections among schoolchildren after 10 years of mass treatment with praziquantel. Parasitological surveys were conducted in 2013 in 22 primary schools located in 11 regions of Burkina Faso. Urine filtration methods and Kato-Katz techniques for stool were used to detect the eggs of Schistosoma hæmatobium, Schistosoma mansoni, and STH. 3514 schoolchildren aged from 7 to 11 (1.415±9) years participated in the study. The prevalence of S.hæmatobium was 8.1% and of S.mansoni, 1.2%. The prevalence of intestinal schistosomiasis ranged from 0.6% to 26.2% and that of urinary schistosomiasis from 0.6% to 56.2%. The prevalence of hookworms was 1.1%, Ascaris lumbricoides 0.1%, and Trichuris trichiura 0.06%. The arithmetic mean of S.hæmatobium and S.mansoni were respectively 6 eggs/10mL and 1.07 epg (eggs per gram). The arithmetic means of eggs were 0.07 epg, 0.03 epg, and 1.89 epg respectively for A. lumbricoides, T. trichiura, and Ankylostoma spp. This study shows the current situation for schistosomiasis and STH infections in different regions of Burkina Faso. Elimination of this parasitic disease requires the inclusion of other control methods, in addition to mass treatment.

Vaginal versus Obstetric Infection Escherichia coli Isolates among Pregnant Women: Antimicrobial Resistance and Genetic Virulence Profile.

Vaginal Escherichia coli colonization is related to obstetric infections and the consequent development of infections in newborns. Ampicillin resistance among E. coli strains is increasing, which is the main choice for treating empirically many obstetric and neonatal infections. Vaginal E. coli strains are very similar to extraintestinal pathogenic E. coli with regards to the virulence factors and the belonging to phylogroup B2. We studied the antimicrobial resistance and the genetic virulence profile of 82 E. coli isolates from 638 vaginal samples and 63 isolated from endometrial aspirate, placental and amniotic fluid samples from pregnant women with obstetric infections. The prevalence of E. coli in the vaginal samples was 13%, which was significant among women with associated risk factors during pregnancy, especially premature preterm rupture of membranes (p<0.0001). Sixty-five percent of the strains were ampicillin-resistant. The E. coli isolates causing obstetric infections showed higher resistance levels than vaginal isolates, particularly for gentamicin (p = 0.001). The most prevalent virulence factor genes were those related to the iron uptake systems revealing clear targets for interventions. More than 50% of the isolates belonged to the virulent B2 group possessing the highest number of virulence factor genes. The ampicillin-resistant isolates had high number of virulence factors primarily related to pathogenicity islands, and the remarkable gentamicin resistance in E. coli isolates from women presenting obstetric infections, the choice of the most appropriate empiric treatment and clinical management of pregnant women and neonates should be carefully made. Taking into account host-susceptibility, the heterogeneity of E. coli due to evolution over time and the geographical area, characterization of E. coli isolates colonizing the vagina and causing obstetric infections in different regions may help to develop interventions and avoid the aetiological link between maternal carriage and obstetric and subsequent puerperal infections.

Serological Surveillance of Infectious Bovine Rhinotracheitis virus, Bovine viral diarrhea virus and Bovine Parainfluenza-3 virus in Saudi Arabia

Monitoring and surveillance of respiratory viral infections in different animals is essential to build up the future bovine animal health and control strategies. The aim of present study was to document the prevalence of some common bovine respiratory viral infections in different regions in Saudi Arabia. Infectious Respiratory viral diseases in cattle are an important cause of mortality especially in young calves. Out of this group of viruses, present study choses to focus on Infectious Bovine Rhinotracheitis virus (IBRV), Bovine viral diarrhea virus (BVDV), and Bovine Parainfluenza-3 virus (BPI-3V). Little is known about the prevalence of these viruses throughout the Gulf and so the primary goal of the study was to test the exposure history of different cattle herds in Saudi Arabia to the indicated viruses. To achieve this goal, 359 serum samples were collected from four different regions in Saudi Arabia (Eastern, Central, Northern, and Western regions). Commercially available ELISA kits were used to evaluate the immune response of animals against these viruses. The results showed the high seroprevalence of the indicated viruses in Saudi Arabia. The seroprevalence of IBRV, BVDV and PI-3 were 50 %, 35%, and 39% respectively. Since the animals used in the current study have not been vaccinated against the indicated viruses, it is highly likely that those herds were exposed to these viruses previously, and thus seroconverted to against these viruses. More molecular studies are urgently needed to do further characterization these viruses in Saudi Arabia. Meanwhile, application of science- based monitoring systems is highly recommended to mitigate the risk of exposure of different animals for such viruses.

MOLECULAR EPIDEMIOLOGY OF HEPATITIS B VIRUS GENOTYPES ISOLATED IN BELARUS

The objective of the present work was to study the dissemination pathways of specific hepatitis B virus (HBV) genotypes and their subtypes and to determine the genetic interrelationships of HBV in patients ascribed to different risk factors of HBV infection in different regions of the Republic of Belarus. The molecular-epidemiological characteristics of HBV subtypes were determined using the phylogenetic analysis of the P region of viral genome. Possible HBV entry and dissemination pathways in different areas of Belarus were inferred. The comparison of genetically related HBV variants and reference sequences from different parts of the world shows that the D2, D3 and D4 subtypes of HBV from patients in Belarus form significantly different clusters. The data suggest that these variants spread predominantly via domestic pathways. The A2 and D1 subtypes disseminated independently via HBV entries from epidemiologically independent sources. The C2 and B4 subtypes originate from Southeast Asia and circulate among migrants from this area. Phylogenetic analysis made it possible to obtain objective information about the development of viral hepatitis B in the Republic of Belarus.