Management Of Infectious Diseases Research Articles

Machine learning approaches in the diagnosis of infectious diseases: a review

Infectious diseases are a group of medical conditions caused by infectious agents such as parasites, bacteria, viruses, or fungus. Patients who are undiagnosed may unwittingly spread the disease to others. Because of the transmission of these agents, epidemics, if not pandemics, are possible. Early detection can help to prevent the spread of an outbreak or put an end to it. Infectious disease prevention, early identification, and management can be aided by machine learning (ML) methods. The implementation of ML algorithms such as logistic regression, support vector machine, Naive Bayes, decision tree, random forest, K-nearest neighbor, artificial neural network, convolutional neural network, and ensemble techniques to automate the process of infectious disease diagnosis is investigated in this study. We examined a number of ML models for tuberculosis (TB), influenza, human immunodeficiency virus (HIV), dengue fever, COVID-19, cystitis, and nonspecific urethritis. Existing models have constraints in data handling concerns such data types, amount, quality, temporality, and availability. Based on the research, ensemble approaches, rather than a typical ML classifier, can be used to improve the overall performance of diagnosis. We highlight the need of having enough diverse data in the database to create a model or representation that closely mimics reality.

Effects of COVID-19 on children with autism.

The coronavirus disease 2019 (COVID-19) pandemic affects all countries and populations worldwide, significantly impacting people with autism with a high risk of morbidity and mortality due to COVID-19. Approximately 25% of children with autism have an asymptomatic or symptomatic immune deficiency or dysfunction. In addition, they frequently have various comorbid conditions that increase the severity of COVID-19. In addition, severe COVID-19 during pregnancy may increase the risk of autism in the offspring. Furthermore, severe acute respiratory syndrome coronavirus 2 could target human nervous system tissues due to its neurotrophic effects. The COVID-19 pandemic intensely impacts many patients and families in the autism community, especially the complex management of autism-associated disorders during the complete lockdown. During the complete lockdown, children with autism had difficulties coping with the change in their routine, lack of access to special education services, limited physical space available, and problems related to food and sleep. Additionally, children with autism or intellectual disabilities are more liable to be abused by others during the pandemic when the standard community supports are no longer functioning to protect them. Early detection and vaccination of children with autism against COVID-19 are highly indicated. They should be prioritized for testing, vaccination, and proper management of COVID-19 and other infectious diseases. In this review, we discuss the various effects of COVID-19 on children with autism, the difficulties they face, the increased risk of infection during pregnancy, how to alleviate the impact of COVID-19, and how to correct the inequalities in children with autism.

GENETIC VARIANTS AND SERUM PROFILES OF CYTOKINES IN COVID-19 SEVERITY.

Background: Patients with severe coronavirus disease 2019 (COVID-19) are at an increased risk of acute respiratory distress syndrome and mortality. This is due to the increased levels of pro-inflammatory cytokines that amplify downstream pathways that are controlled by immune regulators. Objective: This study aimed to investigate the association between cytokine genetic variants, cytokine serum levels/profiles, and disease severity in critically and noncritically ill COVID-19 patients. Methods: This cross-sectional study recruited 646 participants who tested positive for severe acute respiratory syndrome coronavirus 2 from six collection sites across the United Arab Emirates. Medical files were accessed to retrieve clinical data. Blood samples were collected from all participants. Patients were divided into two clinical groups, noncritical (n = 453) and critical (n = 193), according to World Health Organization classification guidelines for COVID-19 patients. Cytokine analyses were conducted on serum of a subset of the cohort, specifically on 426 participants (noncritical, 264; critical, 162). Candidate gene analyses of 33 cytokine-related genes (2,836 variants) were extracted from a genome-wide association study to identify genetic variants with pleiotropic effects on a specific cytokine and the severity of COVID-19 disease. Results: Age, body mass index (BMI), and pre-existing medical conditions were found to be significant risk factors that contribute to COVID-19 disease severity. After correcting for age, sex, and BMI, IP-10 ( P < 0.001), IFN ( P = 0.001), IL-6 ( P < 0.001), and CXCL-16 ( P < 0.001) serum levels were significantly higher among critical COVID-19 cases, when compared with noncritically ill patients. To investigate if the genetic variants involved in the serum cytokine levels are associated with COVID-19 severity, we studied several genes. Single nucleotide polymorphisms in IL6 (rs1554606; odd ratio (OR) G = 0.67 [0.66, 0.68]; P = 0.017), IFNG (rs2069718; OR G = 0.63 [0.62, 0.64]; P = 0.001), MIP (rs799187; OR A = 1.69 [1.66, 1.72]; P = 0.034), and CXCL16 (rs8071286; OR A = 1.42 [1.41, 1.44]; P = 0.018) were found to be associated with critically ill patients. Polymorphisms in the CXCL10 , CCL2 , IL1 , CCL7 , and TNF genes were not associated with the COVID-19 critical phenotype. The genotypes of IL-6 (gene, IL6 [7p15.3]) and CXCL-16 (gene, CXCL16 [17p13.2]) were significantly associated with the serum levels of the respective cytokine in critical cases of COVID-19. Conclusion: Data obtained from measuring cytokine levels and genetic variant analyses suggest that IL-6 and CXCL-16 could potentially be used as potential biomarkers for monitoring disease progression of COVID-19 patients. The findings in this study suggest that specific cytokine gene variants correlate with serum levels of the specific cytokine. These genetic variants could be of assistance in the early identification of high-risk patients on admission to the clinic to improve the management of COVID-19 patients and other infectious diseases.

Modelling the epidemiology of zoonotic parasites transmitted through a predator-prey system in urban landscapes: The Calgary Echinococcus multilocularis Coyote Agent-based model (CEmCA)

Traditional epidemiological models for managing disease risk face serious hurdles when applied to complex life-cycle parasites that involve several host species. Echinococcus multilocularis (Em) is such a parasite and the aetiological agent of a serious zoonosis, Alveolar Echinococcosis, affecting thousands of people every year worldwide. The parasite is transmitted through predation of infectious intermediate hosts (rodents) by definitive hosts (foxes, coyotes). Definitive hosts are usually territorial with individual home ranges in spatially heterogeneous urban landscapes, where they carry very diverse parasite load, thus creating a highly heterogeneous distribution of the parasite in the urban environment. To incorporate individual differences and spatial heterogeneity into an epidemiological model, we developed Calgary Echinococcus multilocularis Coyote Agent-based model (CEmCA).The CEmCA was developed to understand the processes and mechanisms that produces the heterogeneity in the transmission of Em. The model simulates behaviors of individual coyotes inhabiting the City of Calgary as agents, reproducing behavioral patterns such as their home ranges, where and which prey species they hunt, where they defecate, and how they transmit Em. The agents perform all its behaviors in a simulation landscape that represent an actual Calgary landscape that includes maps of natural habitats and small mammal assemblages.The CEmCA proved to be highly sensitive to unobservable epidemiological parameters, and although not fully matching the observed patterns it provided useful insights into the epidemiological processes of Em. Moreover, our experimental simulations supported the hypothesis that distribution of intermediate hosts and separation of habitats were the main causes of spatial heterogeneity in infection.By integrating individual differences and spatial heterogeneity this study contributed to the understanding of the epidemiology of trophically transmitted parasite with complex life-cycles. Notwithstanding requiring further work, this approach holds many promises for further applications in preventative management of infectious diseases in urban landscapes.

Acacia catechu (L.f.) Willd.: A Review on Bioactive Compounds and Their Health Promoting Functionalities.

With the advent of pandemics and infectious diseases, numerous research activities on natural products have been carried out to combat them. Researchers are investigating natural products for the treatment and/or management of various infectious diseases and/or disorders. Acacia catechu (L.f.) Willd. belongs to the family Fabaceae (subfamily Mimosoideae) known as Khair or Cutch tree, possesses diverse pharmacological actions, and has been widely used in Asia and different parts of the world. The purpose of the present study is to highlight the phytochemical profile of different parts of A. catechu, the different biological activities of A. catechu extract, and the utilization of A. catechu as food and beverage. The present work constitutes a review of A. catechu; we performed searches (books, Google, Google Scholar, and Scopus publications) to compile the work/investigations made on A. catechu to the present. From our survey, it was concluded that the main phytochemicals compounds in A. catechu are protocatechuic acid, taxifolin, epicatechin, epigallocatechin, catechin, epicatechin gallate, procyanidin, phloroglucin, aldobiuronic acid, gallic acid, D-galactose, afzelchin gum, L-arabinose, D-rhamnose, and quercetin. The whole plant of A. catechu possesses a comprehensive variety of medicinal potentials such as antimicrobial, antidiarrheal, antinociceptive, antihyperlipidemic, antiulcer, antioxidant, antidiabetic, antiproliferative, haemolytic, and anti-inflammatory properties due to the presence of bioactive compounds like flavonoids, alkaloids, and tannins. However, even though the plant's metabolites were reported to have many different pharmacological uses, there is limited information about their toxicity or clinical trials. Further research on diverse metabolites of A. catechu should be carried out to ensure the safety or utilization of this plant in the pharma or food industries and in the development of potent plant-based drugs.

Metrology in health: challenges and solutions in infusion therapy and diagnostics.

The significance of Metrology in infusion therapy and diagnostics, both critical in health care safety and quality, is discussed in this article. Although infusion therapy is the most used form of drug administration, infusion errors are often made with reported dramatic effects in different applications, especially in neonatology. Adverse incidents, morbidity, and mortality have often been traced back to poor or inaccurate dosing. For critical infusion applications to vulnerable patients, well-controlled medication administration might be accomplished by improved dosing accuracy, traceable measurement of volume, flow, and pressure in existing drug delivery devices and in-line sensors operating at very low flow rates. To this end, the contribution of recently upgraded metrological infrastructures in European Metrology Institutes to a safer infusion therapy in health care is described in detail. Diagnostics, on the other hand isa sector characterized by rapid developments further triggered recently by the necessity for the management andprevention of infectious diseases like COVID-19. In this context, the impact of metrology in future large-scale commercialization of next generation diagnostics (e.g., point-of-care) is highlighted. Moreover, the latest contributions of Metrology in the development of traceable testing methods and protocols to ensure the sensitivity and accuracy of these devices are described.

Sentinel surveillance of SARS-CoV-2 rates and equity impacts using labor and delivery patients in Phoenix, Arizona

Proactive management of SARS-CoV-2 requires timely and complete population data to track the evolution of the virus and identify at risk populations. However, many cases are asymptomatic and are not easily discovered through traditional testing efforts. Sentinel surveillance can be used to estimate the prevalence of infections for geographical areas but requires identification of sentinels who are representative of the larger population. Our goal is to evaluate applicability of a population of labor and delivery patients for sentinel surveillance system for monitoring the prevalence of SARS-CoV-2 infection. We tested 5307 labor and delivery patients from two hospitals in Phoenix, Arizona, finding 195 SARS-CoV-2 positive. Most positive cases were associated with people who were asymptomatic (79.44%), similar to statewide rates. Our results add to the growing body of evidence that SARS-CoV-2 disproportionately impacts people of color, with Black people having the highest positive rates (5.92%). People with private medical insurance had the lowest positive rates (2.53%), while Medicaid patients had a positive rate of 5.54% and people without insurance had the highest positive rates (6.12%). With diverse people reporting for care and being tested regardless of symptoms, labor and delivery patients may serve as ideal sentinels for asymptomatic detection of SARS-CoV-2 and monitoring impacts across a wide range of social and economic classes. A more robust system for infectious disease management requires the expanded participation of additional hospitals so that the sentinels are more representative of the population at large, reflecting geographic and neighborhood level patterns of infection and risk.

Antibiotic Stewardship and Its Impact on Antibiotic Use at The Child Health Directorate of A Teaching Hospital In Ghana

Purpose: The study was intended to ascertain the existence of an antibiotic stewardship programme at the Child Health Directorate of Komfo Anokye Teaching Hospital (KATH) and assess the knowledge of health professionals about the importance of the antimicrobial stewardship programme. Again, it sort to assess the experience of participants with pharmacotherapy of infections and patient outcomes with generic and innovative brands of antibiotics. The third was to assess reporting on adverse reactions and storage conditions of the antibiotics.&#x0D; Design/Methodology/ Approach: This was a cross-sectional study involving health professionals who participated in the provision of infectious disease management services. &#x0D; Findings: Eighty-eight (88) professionals were involved in the study, comprising nurses (n=51), medical doctors (n=21), pharmacists (n=8), biomedical scientists (n=5) and public health officers (n=3). No antibiotic stewardship programme existed. However, there was a protocol for antibiotic use that was not strictly adhered to. About 60 % of the participants had knowledge of the antibiotic stewardship programme and affirmed its importance. The majority (75 %, n=66) reported treatment failure with generic brands of antibiotics compared to innovator brands. Thirty-four percent of the participants (n=30) reported adverse drug reactions (ADRs) on antibiotic therapy to superiors instead of filling out ADR forms. Antibiotics were kept in inpatient bedside cabinets with no thermometers to monitor the storage temperature conditions.&#x0D; Research Limitations: The study was done in one Directorate in the hospital and thus cannot be generalized to reflect the situation in all teaching hospitals in Ghana.&#x0D; Practical implication: The evidence obtained highlighted the need for pragmatic antimicrobial stewardship (AMS) at the directorate to help optimize the management of childhood infections and minimize the emergence and spread of antibiotic resistance.&#x0D; Originality/Value. This was an original project designed to generate evidence to inform interventions to promote the responsible use of antimicrobials in children.

Synergistic antibacterial effects of 5-fluorouracil or thioridazine in combination with phytopolyphenols on cultured Porphyromonasgingivalis

Background/purpose5-Fluorouracil (5FU) is a commonly used anticancer drug. However, the severe oral mucositis induced by 5FU in about 60–70% of patients was a major cause of discontinuous therapy. Since oral dysbiosis induced by 5FU was well correlated with severity of oral mucositis and Porphyromonas gingivalis (P.g.) was a keystone pathogen of dysbiosis. Thus, in this study, we aimed to explore the novel regimens of 5FU combined with phytopolyphenols (curcumin, green tea polyphenols) as well as ZnSO4 on antibacterial effects of cultured P.g. growth. In addition, similar regimens containing thioridazine (TRZ) were also tested for their antibacterial efficacy. Materials and methodsThe synergistic (Combination Index (CI) < 1) antiproliferation and anti-protease efficacies (IC50) of novel regimens on cultured P.g. were evaluated by OD600 and colorimetric method respectively. ResultsThe results obtained indicated that both novel regimens of 5FU and TRZ exhibited potent synergistic antibacterial effects against growth and protease of P.g. ConclusionThese novel regimens of 5-FU and TRZ were potent antibacterial agents which merit for further preclinical and clinical trials in management of oral mucositis, cancers and infectious diseases.

A systematic scoping review of faropenem and other oral penems: treatment of Enterobacterales infections, development of resistance and cross-resistance to carbapenems.

Antimicrobial resistance is an urgent global healthcare concern. Beyond carbapenems as broad-spectrum, often 'last resort' antibiotics, oral penem antibiotics currently are approved only in Japan and India, used for the treatment of indications including urinary tract infections (UTIs). Exploring oral penem use to better understand the impact of antibiotic resistance on public health would help inform the management of infectious diseases, including UTIs. This scoping review investigated the impact of faropenem and other oral penems on Enterobacterales infection treatment and evaluated evidence for faropenem resistance and cross-resistance to carbapenems. PubMed, Embase, J-STAGE and CiNii were searched for relevant English- or Japanese-language articles published between 1 January 1996 and 6 August 2021. From 705 unique publications, 29 eligible articles were included (16 in vitro studies; 10 clinical trials; 2 in vitro and in vivo studies; and 1 retrospective medical chart review). Limited evidence described faropenem to treat infectious disease; only four randomized clinical trials were identified. Faropenem dosing regimens varied broadly within and between indications. One study indicated potential dependence of penem efficacy on underlying antibiotic resistance mechanisms, while several studies reported UTI persistence or recurrence after faropenem treatment. In vitro MIC data suggested some potential bacterial resistance to faropenem, while limited clinical data showed resistance emergence after faropenem treatment. Preliminary in vitro evidence suggested faropenem resistance might foster cross-resistance to carbapenems. Overall, very limited clinical evidence describes faropenem for treating infectious diseases. Preclinical and clinical research investment and dedicated community surveillance monitoring is crucial for understanding faropenem treatment patterns, resistance and potential cross-resistance to carbapenems.

Physician practices in the diagnosis and treatment of infectious diseases in home care settings: A questionnaire study.

To elucidate the current practices of infectious disease management in home care settings in Japan, we sent a questionnaire to 36 physicians working at 13 clinics that specialize in providing care to patients in their homes or residential care facilities. The questionnaire described three hypothetical scenarios (aspiration pneumonia, pyelonephritis, and neoplastic fever) in older patients with terminal cancer, and 25 respondents answered questions on testing and treatment strategies. Most respondents chose to obtain cultures for aspiration pneumonia (sputum) and for pyelonephritis (urine), although fewer respondents chose to obtain blood cultures. For neoplastic fever, most of respondents elected to continue observation without antibiotic treatment. The most frequently selected antibiotics were cephalosporins and quinolones. The results indicated that most respondents would perform bacterial culture tests before prescribing antibiotics and observe patients when bacterial infections are not suspected. Standardized guidelines are needed to optimize infectious disease management in home care.

일 지역사회 보건의료요구 및 보건소 서비스 만족도

This study was conducted to identify residents’ health care needs and satisfaction with public health center services in a community. Data were collected from 682 adults from June 20 to August 10, 2022 and analyzed with frequency analysis, mean and standard deviation, t-test, ANOVA, scheffé test, pearson’s correlation coefficient and multiple linear regression analysis, using IBM SPSS WIN 25.0 program. As a result, 86.8% of subjects had experience in public health care services, and ‘infectious disease prevention and management’ was the most frequently used service. Satisfaction was the highest in ‘mental health’, and the most needed service was ‘emergency medical system’. Residents over 60 years old, middle school graduates or below, unemployed or employed in primary industry, living in the community for more than 30 years, and living in rural areas were most satisfied with public health center services. There were statistically significant correlations between health status and economic status, and between health status and experiences with public health care services. Variables affecting satisfaction with public health center services were occupation, peoriod of residence and experiences with public health center services. In conclusion, public health center should reflect residents’ health care needs on regional health care plan.

Infectious Diseases Management in Wound Care Settings: Common Causative Organisms and Frequently Prescribed Antibiotics.

To provide information about the management of infected wounds in wound care settings. This continuing education activity is intended for physicians, physician assistants, nurse practitioners, and nurses with an interest in skin and wound care. After participating in this educational activity, the participant will:1. Identify a host factor that may predispose a patient to a wound infection as well as characteristics of each stage of wound infection.2. Distinguish a common organism that causes early, acute wound infections and explain the preferred method for obtaining a wound specimen for culture.3. Apply knowledge of commonly prescribed antibiotics in wound care settings.

Infectious Diseases Management in Wound Care Settings: Common Causative Organisms and Frequently Prescribed Antibiotics.

Infectious Diseases Management in Wound Care Settings: Common Causative Organisms and Frequently Prescribed Antibiotics.

Intensivists' perceptions and attitudes towards infectious diseases management in the ICU: An international survey.

Exploring infectious diseases (ID) practice in Intensive Care Unit (ICU) to identify gaps and opportunities. Online international survey (PRACT-INF-ICU) endorsed by the ESICM and open from July 30, 2019 to October 19, 2019. International study conducted in 78 countries. Physicians working in ICU. None. Practice variations were assessed according to respondents' countries income class, training, and years of practice. Univariate and multivariate ordinal logistic regression were used to estimate associations between respondents' characteristics and their perceptions regarding adequacy of training. 466 intensivists with a median practice of 10 years (interquartile range, 5-19) completed the survey. A third reported no antimicrobial stewardship program and 40% had no regular microbiological rounds in their ICUs. Intensivists were mostly the decision makers for the initial antimicrobial therapy which in 70% of cases were based on guidelines or protocols. Non-ICU expertise were sought more frequently on reviewing (48/72h, culture adjustment and discontinuation in 32%, 39% and 21% respectively) rather than antimicrobial therapy initiation (16%). Only 42% described ID training as adequate. Multivariate ordinal logistic regression showed that low- to middle-income countries (OR: 0.41, 95% CI: 0.28-0.61), ICU practice ≤10 years (OR: 0.55, 95% CI: 0.39-0.79), and dual training with anaesthesia (OR: 0.52, 95% CI: 0.34-0.79) or medicine (OR: 0.49, 95% CI: 0.32-0.76) were associated with less training satisfaction. ID practice is heterogeneous across ICUs while antimicrobial stewardship program is not universally implemented. From intensivists' perspective, ID training and knowledge need improvement.

A hand-targeted auxiliary personal protective equipment for intervention of fomite transmission of viruses.

In COVID‐19, fomite transmission has been shown to be a major route for the spreading of the SARS‐CoV‐2 virus due to its ability to remain on surfaces for extended durations. Although glove wearing can mitigate the risk of viral transmission especially on high touch points, it is not prevalent due to concerns on diversion of frontline medical resources, cross‐contamination, social stigma, as well as discomfort and skin reactions derived from prolonged wearing. In this study, we developed FlexiPalm, a hand‐targeted auxiliary personal protective equipment (PPE) against fomite transmission of viruses. FlexiPalm is a unique palmar‐side hand protector designed to be skin‐conforming and transparent, fabricated from medical‐grade polyurethane transparent film material as a base substrate. It serves primarily as a barrier to microbial contamination like conventional gloves, but with augmented comfort and inconspicuousness to encourage a higher public adoption rate. Compared to conventional glove materials, FlexiPalm demonstrated enhanced mechanical durability and breathability, comparable hydrophobicity, and displayed a minimal adsorption of SARS‐CoV‐2 spike protein and virus‐like particles (VLP). Importantly, FlexiPalm was found to bind significantly less viral protein and VLP than artificial human skin, confirming its ability to reduce viral contamination. A pilot study involving participants completing activities of daily living showed a high level of comfort and task completion, illustrating the usability and functionality of FlexiPalm. Moreover, we have demonstrated that surface modification of FlexiPalm with microtextures enables further reduction in viral adsorption, thereby enhancing its functionality. An effective implementation of FlexiPalm will bolster PPE sustainability and lead to a paradigm shift in the global management of COVID‐19 and other infectious diseases in general.

Myeloid CD169/Siglec1: An immunoregulatory biomarker in viral disease.

CD169, also known as Siglec1 or Sialoadhesin (Sn), is a surface adhesion molecule on human myeloid cells. Being part of the Siglec family, it acts as a receptor for sialylated molecular structures, which are found among various pathogenic and non-pathogenic ligands. Recent data suggest that CD169 may represent a promising new biomarker in acute respiratory and non-respiratory viral infections, such as SARS-CoV-2, Respiratory syncytial virus (RSV) and Human immunodeficiency virus (HIV). Therein lies a great potential to sufficiently differentiate viral from bacterial infection, which has been an incessant challenge in the clinical management of infectious disease. CD169 equips myeloid cells with functions, reaching far beyond pathogen elimination. In fact, CD169 seems to crosslink innate and adaptive immunity by antigen presentation and consecutive pathogen elimination, embodying a substantial pillar of immunoregulation. Yet, our knowledge about the kinetics, mechanisms of induction, signaling pathways and its precise role in host-pathogen interaction remains largely obscure. In this review, we describe the role of CD169 as a potentially novel diagnostic biomarker for respiratory viral infection by evaluating its strengths and weaknesses and considering host factors that are involved in pathogenesis of virus infection. Finally, this brief review aims to point out shortcomings of available evidence, thus, guiding future work revolving the topic.

Intensivists’ perceptions and attitudes towards infectious diseases management in the ICU: An international survey

ObjectiveExploring infectious diseases (ID) practice in Intensive Care Unit (ICU) to identify gaps and opportunities. DesignOnline international survey (PRACT-INF-ICU) endorsed by the ESICM and open from July 30, 2019 to October 19, 2019. SettingInternational study conducted in 78 countries. ParticipantsPhysicians working in ICU. InterventionsNone. Main variables of interestPractice variations were assessed according to respondents’ countries income class, training, and years of practice. Univariate and multivariate ordinal logistic regression were used to estimate associations between respondents’ characteristics and their perceptions regarding adequacy of training. Results466 intensivists with a median practice of 10 years (interquartile range, 5–19) completed the survey. A third reported no antimicrobial stewardship program and 40% had no regular microbiological rounds in their ICUs. Intensivists were mostly the decision makers for the initial antimicrobial therapy which in 70% of cases were based on guidelines or protocols. Non-ICU expertise were sought more frequently on reviewing (48/72h, culture adjustment and discontinuation in 32%, 39% and 21% respectively) rather than antimicrobial therapy initiation (16%). Only 42% described ID training as adequate. Multivariate ordinal logistic regression showed that low- to middle-income countries (OR: 0.41, 95% CI: 0.28–0.61), ICU practice ≤10 years (OR: 0.55, 95% CI: 0.39–0.79), and dual training with anaesthesia (OR: 0.52, 95% CI: 0.34–0.79) or medicine (OR: 0.49, 95% CI: 0.32–0.76) were associated with less training satisfaction. ConclusionID practice is heterogeneous across ICUs while antimicrobial stewardship program is not universally implemented. From intensivists’ perspective, ID training and knowledge need improvement.

A framework to guide research and practice response to emerging infectious diseases: Genomic-to-global considerations.

Newly emerging infectious diseases (EIDs), like the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) virus, are becoming increasingly common. Due to geographic, political, social, behavioral, and genomic differences, some populations are more vulnerable to infectious disease spread than others. The purpose of this article is to present a framework for research and practice response to emergent infectious diseases that addresses multiple transdisciplinary actions to limit exposure or mitigate adverse outcomes for individuals and communities. Recent experience with new strains of emergent infectious diseases reinforces the importance of intervening at multiple levels, from genomics to political messaging to create multipronged, transdisciplinary interventions to contain the threat. In particular, incorporation of genomics into public health nursing practice of infectious diseases management can enhance existing regional-, community-, and individual-level health promotion and protection efforts, thus impacting long-term health outcomes.

HAZ, a novel peptide with broad-spectrum antibacterial activity

ObjectiveThe growing microbial resistance to antibiotics is a global public concern, which creates serious needs for newer antimicrobial agents. Antimicrobial peptides (AMPs) are increasingly exploited in drug development as therapeutic candidates. Here, we aimed to design and characterize a novel peptide with broad spectrum antimicrobial activity. MethodsHybridization and sequence modification approaches were used to design the novel peptide, named HAZ, aiming at optimizing the physicochemical parameters involved in antimicrobial activity. Peptide activities were assessed alone or combined with different selected antibiotics against various sensitive and drug-resistant bacterial strains. In addition, the hemolysis and the cytotoxic activities of HAZ peptide were evaluated on human red blood cells and epithelial adenocarcinoma cells (A549), respectively. ResultsHAZ peptide was sequentially modified to result in favored physicochemical parameters (helicity 95.24 %, hydrophobic ratio 47 %, and net charge of 8 + ). Functional assessment of HAZ revealed significant antimicrobial activity, with MIC values of 15 – 20 µM against tested bacterial strains. It also exhibited biofilm eradication activity at slightly higher concentrations. HAZ-antibiotics combinations exhibited a synergistic action mode that led to dramatic decrease in the MIC values for both HAZ peptide and the antibiotic. Such efficacy was accompanied with minimal hemolytic toxicity on human erythrocytes. Importantly, HAZ displayed promising anticancer activity against human lung cancer cells. ConclusionRationally-designed antimicrobial peptides offer promising alternatives to the current antibiotics for management of infectious diseases. HAZ peptide is a broad-spectrum AMP, and a promising candidate for antimicrobial and anticancer drug development.