Sensitivity Pattern Research Articles

Understanding chromoblastomycosis in Sri Lanka; insights into fungal aetiology and antifungal susceptibility patterns

Introduction: Chromoblastomycosis is a chronic disfiguring fungal infection of the subcutaneous tissue found mainly in the socio-economically marginalized population in the tropical and sub-tropical regions, characterized by the presence of sclerotic cells. This study was done with the aim of identifying the antifungal sensitivity patterns of the causative agents of chromoblastomycosis in Sri Lanka from 1992 to 2019.Methodology: Study was done on the stored isolates received from patients with chromoblastomycosis since 1992 to 2019, to the Mycology Reference Laboratory of Medical Research Institute, Colombo. Isolates were revived by subculture on Potato dextrose agar. Identification was done phenotypically. Antifungal sensitivity testing was performed by E test method. Available demographic and clinical data were analysed.Results: Of the 74 isolates, 71 (96%) were caused by Fonsecaea pedrosoi. Mean MIC for the antifungals tested were lowest for posaconazole 0.015 μg/ml followed by itraconazole 0.225 μg/ml, and voriconazole 0.768 μg/ml while amphotericin B demonstrated complete resistance with mean MIC of 30.591 μg/ml. No statistically significant differences were noted on the antifungal sensitivity of the isolates from 1992 to 2004 and 2005 to 2019.Conclusions: Fonsecaea pedrosoi was the commonest causative agent causing chromoblastomycosis in the studied population. Posaconazole demonstrated the lowest MIC values for the tested isolates followed by itraconazole and voriconazole. Amphotericin B demonstrated very high MIC values which were likely to result in clinical failure upon treatment. MIC values demonstrated minimal fluctuations throughout the tested time.

Comparison of Clinical, Etiological and Antibiotic Sensitivity Patterns of UTI in CAKUT and Non CAKUT Children

Background: Urinary tract infections (UTIs) are one of the most common bacterial infections in children. Congenital anomalies of the kidney and urinary tract (CAKUT) are a major cause of UTIs in this population. Objective: To compare clinical, etiological and antibiotic sensitivity patterns of UTIs in CAKUT and non-CAKUT children. Study Design: Prospective comparative study. Place and Duration: The study was conducted at the department of Pediatric Nephrology, The Children's Hospital Lahore from August 2023 to January 2024. Methods: 68 children with and without CAKUT having UTI were evaluated. Data regarding demographics, clinical presentation and antibiotic sensitivity pattern was collected. Susceptibility testing was done according to CLSI recommendations. Results: 34 patients with UTI in CAKUT group (Group A) had male predominance (73.5%) while children without CAKUT (Group B) were predominantly females (55.9%). Mean age in Group A (38.9 months) was less than that in Group B (53.9 months). The common presentations in both the groups were pyelonephritis and cystitis. Vesico-ureteric reflux (32.4%) and posterior urethral valves (29.4%) were the most common CAKUT findings. Majority of patients with CAKUT had Pseudomonas UTI (32.4%) while E. coli (35.3%) was common in children without CAKUT. Fosfomycin, Colistin, Linezolid and Polymyxin B had low resistance amongst both groups. The association between CAKUT and atypical uropathogens was not found to be statistically significant (p = 0.287). Conclusion: Differences exist in clinical presentation, etiology and antibiotic sensitivity patterns specific to UTI in CAKUT and non-CAKUT children. A high resistance pattern was found amongst common antibiotics.

Uropathogenic Candida: Microbial profile and antifungal sensitivity patterns in a tertiary care hospital in Vadodara, Gujarat

Uropathogenic Candida: Microbial profile and antifungal sensitivity patterns in a tertiary care hospital in Vadodara, Gujarat

Aerobic bacterial profile and antibiotic sensitivity pattern of chronic suppurative otitis media in tertiary care hospital

Aerobic bacterial profile and antibiotic sensitivity pattern of chronic suppurative otitis media in tertiary care hospital

Allergen Testing: A Review of the Indications, Procedures, and Limitations in Ocular Allergy.

Allergen-based diagnostics are essential in the management algorithm of allergic diseases. Unlike systemic allergy, where the indications and interpretation of these diagnostic modalities are well established, their utility in ocular allergy is not well-defined. With the rising prevalence of ocular allergies and the need for personalized treatment strategies, there is a growing demand for precision allergen diagnostics. This review describes the commonly used tests with their indications, procedures, and limitations. A review of the literature was carried out on articles on allergen diagnostics in ocular allergy, and after excluding articles that were not relevant, 82 papers were included in the current review. IgE-mediated pathways contribute significantly to seasonal and perennial ocular allergy and partly to vernal keratoconjunctivitis. Most diagnostic techniques aim to detect IgE sensitization. In vivo tests include skin prick (SPT), intradermal, and patch tests. SPT is considered the gold standard and directly evaluates the presence of allergen-specific IgE in the skin. In vitro tests measure total and specific IgE from either tears or sera. Tear IgE measurement is relatively specific for allergic conjunctivitis and can provide insight into the potential allergens responsible for local sensitization. The conjunctival provocation test can help establish true allergy, especially in patients with polysensitization. This review also provides an overview of evidence in literature segregated based on the test employed. This includes 17 studies on only SPT; 42 studies on IgE measured in serum, tears, or both; and 20 studies which have evaluated both SPT and IgE. The pattern of allergen sensitization can guide recommendations for avoidance measures and immunotherapy. Thus, this could create a corticosteroid-sparing therapy avenue in these patients, reducing disease severity and resulting visual morbidity.

Prevalence of Multidrug Resistant Organisms (MDROs) and Antimicrobial Sensitivity Pattern from clinical samples of the patients in Riyadh Province of the Kingdom of Saudi Arabia

Prevalence of Multidrug Resistant Organisms (MDROs) and Antimicrobial Sensitivity Pattern from clinical samples of the patients in Riyadh Province of the Kingdom of Saudi Arabia

APOBEC family reshapes the immune microenvironment and therapy sensitivity in clear cell renal cell carcinoma

Emerging evidence suggests that the APOBEC family is implicated in multiple cancers and might be utilized as a new target for cancer detection and treatment. However, the dysregulation and clinical implication of the APOBEC family in clear cell renal cell cancer (ccRCC) remain elusive. TCGA multiomics data facilitated a comprehensive exploration of the APOBEC family across cancers, including ccRCC. Remodeling analysis classified ccRCC patients into two distinct subgroups: APOBEC family pattern cancer subtype 1 (APCS1) and subtype 2 (APCS2). The study investigated differences in clinical parameters, tumor immune microenvironment, therapeutic responsiveness, and genomic mutation landscapes between these subtypes. An APOBEC family-related risk model was developed and validated for predicting ccRCC patient prognosis, demonstrating good sensitivity and specificity. Finally, the overview of APOBEC3B function was investigated in multiple cancers and verified in clinical samples. APCS1 and APCS2 demonstrated considerably distinct clinical features and biological processes in ccRCC. APCS1, an aggressive subtype, has advanced clinical stage and a poor prognosis. APCS1 exhibited an oncogenic and metabolically active phenotype. APCS1 also exhibited a greater tumor mutation load and immunocompromised condition, resulting in immunological dysfunction and immune checkpoint treatment resistance. The genomic copy number variation of APCS1, including arm gain and loss, was much more than that of APCS2, which may help explain the tired immune system. Furthermore, the two subtypes have distinct drug sensitivity patterns in clinical specimens and matching cell lines. Finally, we developed a predictive risk model based on subtype biomarkers that performed well for ccRCC patients and validated the clinical impact of APOBEC3B. Aberrant APOBEC family expression patterns might modify the tumor immune microenvironment by increasing the genome mutation frequency, thus inducing an immune-exhausted phenotype. APOBEC family-based molecular subtypes could strengthen the understanding of ccRCC characterization and guide clinical treatment. Targeting APOBEC3B may be regarded as a new therapeutic target for ccRCC.

Variational analysis of sensory feedback mechanisms in powerstroke-recovery systems.

Although the raison d'etre of the brain is the survival of the body, there are relatively few theoretical studies of closed-loop rhythmic motor control systems. In this paper we provide a unified framework, based on variational analysis, for investigating the dual goals of performance and robustness in powerstroke-recovery systems. To demonstrate our variational method, we augment two previously published closed-loop motor control models by equipping each model with a performance measure based on the rate of progress of the system relative to a spatially extended external substrate-such as a long strip of seaweed for a feeding task, or progress relative to the ground for a locomotor task. The sensitivity measure quantifies the ability of the system to maintain performance in response to external perturbations, such as an applied load. Motivated by a search for optimal design principles for feedback control achieving the complementary requirements of efficiency and robustness, we discuss the performance-sensitivity patterns of the systems featuring different sensory feedback architectures. In a paradigmatic half-center oscillator-motor system, we observe that the excitation-inhibition property of feedback mechanisms determines the sensitivity pattern while the activation-inactivation property determines the performance pattern. Moreover, we show that the nonlinearity of the sigmoid activation of feedback signals allows the existence of optimal combinations of performance and sensitivity. In a detailed hindlimb locomotor system, we find that a force-dependent feedback can simultaneously optimize both performance and robustness, while length-dependent feedback variations result in significant performance-versus-sensitivity tradeoffs. Thus, this work provides an analytical framework for studying feedback control of oscillations in nonlinear dynamical systems, leading to several insights that have the potential to inform the design of control or rehabilitation systems.

Impacts of urbanization on urban-rural VPD disparities across different subregions in China: A quantitative analysis based on station-pairing and partial differential methods

The climatic disparities between urban cores and surrounding rural areas have become increasingly pronounced due to rapid urbanization. The vapor pressure deficit (VPD) serves as a critical meteorological indicator reflecting atmospheric aridity, and identifying the contributions of urban and rural climate factors on the urban-rural VPD disparities plays an important role in understanding urban climate and ecosystem development patterns. This study introduces a quantitative method, utilizing partial differential equations, to assess the relative contributions of two crucial meteorological factors—air temperature (T) and relative humidity (RH)—toward urban-rural differences in VPD. Analyzing daily scale data from 116 pairs of urban and rural stations across mainland China for the period 2000–2017, we derived several key findings: Urban areas generally exhibit higher VPD than surrounding rural areas, with a relative difference in annual VPD of about 21.6 %, and the disparity increases over time. Furthermore, the influence of urbanization on VPD responds differently across seasons and geographical conditions. The simulated trends in VPD urban-rural differences using the partial differential method align closely with the actual observed trends, validating the effectiveness of our quantitative analysis approach. The VPD urban-rural disparity shows greater sensitivity to shifts in RH, with sensitivity coefficients exceeding 1.5 times to changes in T in most cases. RH is the primary factor causing VPD urban-rural differences in mainland China, and the relative contribution of RH is about 2.5 times of T. The patterns of sensitivity and the contribution of factors exhibit notable variation among subregions. This study enhances the understanding of how urbanization affects regional climate and provides insights for assessing the environmental impacts of future urban expansion.

Variability in Profiles and Prevalences of Gram-Negative Bacteria in Urinary Tract Infections: A Population-Based Analysis.

Objective: An increase in antimicrobial resistance (AMR) is observed worldwide, partly due to the overuse and misuse of antibiotics, which are ineffective in certain population subgroups. This negatively impacts both the healthcare system and patients. Our study aimed to investigate the current AMR profiles for the most commonly used antibiotics in treating urinary tract infections (UTIs) caused by gram-negative bacteria (GNB) across different age and gender subpopulations. By doing so, we provide valuable information for doctors managing prophylactic and empiric therapeutic treatments. Materials and Methods: We retrospectively analysed over 650,000 urine cultures collected in the Microbiology Department of a referral university hospital in Southern England from January 2014 to December 2022. A population-based analysis for subgroups was performed to rule out differences in AMR patterns. Our report was recorded at UHS as an internal audit (UHS7670). Results: 146,867 cultures were found positive for GNB growth. Nitrofurantoin showed the best sensitivity patterns for all age subgroups (0.93% for patients aged ≤ 18; 1.22% for patients aged 19-40; 2.17% for patients aged 40-60; and 3.48% for patients aged > 60), regardless of gender (male: 6.37%, female: 2.59%). Ampicillin/amoxicillin and trimethoprim showed a poor AMR profile for all age groups (>55% and >28%, respectively) and genders (>60% and >28%, respectively). All the other tested antibiotics (cefalexin, cefotaxime, ceftazidime, ciprofloxacin, co-amoxiclav, gentamicin) showed an overall good profile for GNB resistance across all subgroups. For all antibiotics except trimethoprim, the risk of developing AMR was significantly higher in the male population. We also found that people aged over 60 had a higher risk of AMR compared to the other age groups for all antibiotics, with the exception of cefotaxime and co-amoxiclav. Conclusions: With an overall rise in resistance patterns for GNB-related UTIs, certain antibiotics-particularly ampicillin/amoxicillin and trimethoprim-now exhibit very poor sensitivity profiles. However, antibiotics such as nitrofurantoin and gentamicin remain excellent options for empirically treating UTIs. It is important to note that AMR can vary across different populations, with higher resistance often found in elderly and male patients. Clinicians must stay informed about current guidelines and research to provide the best treatment options while minimizing the risk of further AMR development.

Evaluation of Bacteriological Profile and Antibiotic Sensitivity Patterns for Enterobacteria in Adults with Urinary Tract Infections: A Retrospective Study

Evaluation of Bacteriological Profile and Antibiotic Sensitivity Patterns for Enterobacteria in Adults with Urinary Tract Infections: A Retrospective Study

Recent trends in antibiotic sensitivity and resistance patterns in infected wounds of burns patients presented to a tertiary care hospital.

Objective: To study the recent trends and patterns of antibiotic sensitivity and resistance in infected wounds of burns patient. Study Design: Cross sectional study. Setting: Burns and Plastic Surgery Canter, Peshawar, Pakistan. Period: July 30th to January 30th, 2023. Methods: In this cross sectional study we adopted convenience sampling technique. A total of 75 samples collected from patients fitted to our infected patients criteria and culture and sensitivity tests were performed using standard microbiological techniques. Results: Among the positive infected wound samples, Klebsiella Species were found in 23 (30.7%), Pseudomonas Aeruginosa in 16 (21.3%), Acinetobacter Species in 14(18.7%), Proteus Species in 8(10.7%), Citrobacter species in 5(6.6%), Staph. Aureus in 5(6.6%), Enterobacter species in 3(4%) and E.coli in 1(1.4%) of the positive cultures. Each pathogen showed varying degree of sensitivity and resistance patterns to different antibiotics tested. Conclusion: Klebsiella Species was the most common pathogen in patients with infected burns wounds. Meropenem, imipenem, Doripenem, Piperacillin/Tazobactum, Colistin, and Tigecyclin were found to be effective against the majority of the bacteria. Conversely, most of the bacterial strains exhibited resistance to commonly prescribed antibiotics such as co-amoxiclave, ampicillin, ceftriaxone, ciprofloxacin, cefotaxime and co-trimoxazole.

Urine culture Isolates and their sensitivity patterns.

Objective: To make an assessment of the susceptibility pattern to antimicrobials of various isolates, which would be helpful in deciding about further empirical treatment with antibiotics and would lead to improved patient outcomes. Study Design: Cross-sectional study. Setting: Watim Medical & Dental College, Rawalpindi. Period: Jun 1, 2023 – Nov 30, 2023. Methods: 300 urine samples of patients suspected clinically to have urinary tract infection were directly collected directly from the microbiology laboratory, out of which 60 were culture positive. The positive samples comprised 44 females and 16 males. Results: The organism with the highest prevalence was Escherichia coli (E.coli), followed by Klebsiella species. Escherichia coli showed 100% sensitivity to tazobactam whereas Klebsiella species showed sensitivity to several different antibiotics. Conclusion: E.coli species was noted to be the most common organism causing UTIs. Antimicrobial resistance has been noted to be emerging against some antibiotics, and the current susceptibility patterns may be used in this area for achieving optimum therapeutic outcomes, and for preventing antibiotic misuse.

Antibiotic sensitivity pattern among diabetic patients admitted with urinary tract infection.

Objective: To determine the frequency of types of bacterial pathogens involved in urinary tract infections and antibiotic sensitivity patterns among diabetic patients in the medical units of Khyber Teaching Hospital Peshawar. Study Design: Cross-sectional study. Setting: Department of Medicine, Khyber Teaching Hospital, Peshawar. Period: November 9, 2022 until May 8, 2023. Methods: The study was conducted after the approval of the hospital's ethical committee and the written informed consent of patients. Data was entered and analyzed using SPSS. Patients aged 16 to 80 years of both genders admitted to medical units with diabetes and diagnosed with urinary tract infection were enrolled using a non-probability consecutive sampling technique. Results: In our study, a total of 184 patients were enrolled, with a mean age of 52.08±18.4 years. There were 42.4% male and 57.6% female patients. The most common organism isolated was E. coli in 37% of patients, followed by Klebsiella in 23.9% of patients, Pseudomonas in 6.3%, Enterococcus in 12%, and Proteus mirabilis in 10.9% of patients. The most sensitive drug was Fosfomycin in 89.1% of patients, followed by nitrofurantoin in 81.5%, imipenem in 77.1%, amikacin in 73.3%, Piperacillin/tazobactam in 69%, gentamycin in 67.9%, Trimethoprim-sulfamethoxazole in 66.8%, Amoxicillin-clavulanic acid in 59.7%, ciprofloxacin in 54.3%, ceftriaxone in 51%, and cefixime in 46.1% of patients. Conclusion: E. coli is the most common organism isolated in urinary tract infection in diabetics and Fosfomycin is the most sensitive drug for treatment.

Antibiotic sensitivity pattern of deep skin and soft tissue infections in Pakistan.

Objective: To determine the antibiotic spectrum of deep skin and soft tissue infections in Pakistan. Study Design: Cross-sectional study. Setting: Department of Dermatology at Madinah Teaching Hospital, Faisalabad. Period: June, 2023 to December 2023. Methods: Inclusion criteria covered consenting patients aged 15-60, excluding those with specific conditions. The study aimed to ascertain antibiotic sensitivity patterns in deep skin and soft tissue infections. Ethical approval was obtained, and subjects meeting criteria were enrolled after informed consent, contributing valuable insights into healthcare-associated infections. Results: Examining 60 patients, the age distribution indicates a prevalent cohort up to 50 years (61.7%), highlighting potential health concerns in earlier years. Those above 50 constitute 38.3%, signifying distinct challenges in older age. With 61.7% males, Gram stain analysis reveals microbial diversity. Notably, Ciprofloxacin (90%) and Cefipime (98.3%) exhibit high resistance, while Cephradine (48.3%) and Cefoxitin (20%) show sensitivity. Meropenem and Vancomycin display moderate resistance (28.3% and 25%), while Tigecycline (10%) and Teicoplanin (1.7%) exhibit lower resistance, offering insights for effective treatment strategies. Conclusion: Our study reveals notable antibiotic resistance, with Ciprofloxacin (90%) and Cefipime (98.3%) exhibiting high resistance. Conversely, Cephradine (48.3%) and Cefoxitin (20%) show sensitivity, guiding tailored treatment strategies for deep skin and soft tissue infections.

Trends and antibiotic susceptibility patterns of diarrhoeal pathogens - experience over 14 years in southern India.

Introduction. Enteric pathogens contribute significantly to morbidity in a developing country such as India. Early and prompt diagnosis of diarrhoeal diseases can reduce the mortality rate, particularly in children. The pattern of sensitivity to antimicrobials for the common pathogens can vary from time to time. The present study was conducted to study the pathogen distribution and antimicrobial susceptibility pattern during the study period (January 2010 to December 2023). Hypothesis/gap statement. Studying the changing trend in the antimicrobial sensitivity pattern of diarrhoeal pathogens over a decade can help to plan future treatment options. Aim. This study was undertaken to provide insights into the changing pattern of pathogen distribution and antimicrobial susceptibility for enteric pathogens over 14 years. Methods. A retrospective observational cohort analysis was conducted on all the stool pathogens isolated from the samples received in the microbiology department of a tertiary care hospital from 2010 to 2023. The demographic details, stool microscopy, culture reports, and antimicrobial susceptibility patterns were noted. Results. A total of 18 336 stool specimens were received in the microbiology laboratory between January 2010 and December 2023, of which 1354 specimens had diarrhoeal pathogens grown in culture. Out of these 1354 specimens, 591 (44%) had Salmonella, 471 (35%) Shigella, 181 (13%) Vibrio cholerae, and 80 (6%) Aeromonas species. Among these pathogens, susceptibility to ceftriaxone was seen in 93% (552 isolates) of Salmonella species, 89% (420 isolates) of Shigella species, and 95% (171 isolates) of Vibrio cholerae; 91% (73 isolates) of Aeromonas species were susceptible to chloramphenicol. Some major parasites were also observed on microscopy. Conclusion. Timely diagnosis of diarrhoeal pathogens can be life-saving for patients at the extremes of age, i.e. in children and the elderly. Pathogens can exhibit a changing susceptibility pattern to antibiotics, which should be regularly observed to plan future therapy.

Bacteriological profile and antibiotic sensitivity pattern of bloodstream infections from a teaching institution in Eastern Uttar Pradesh, North India.

Bloodstream infections (BSIs), encompassing both self-limiting bacteremia and potentially fatal septicaemia, make up the majority of healthcare-associated ailments worldwide. The organisms encountered are mostly multidrug-resistant (MDROs), leading to increased hospital stays. Our study aims to collect data about blood culture isolates from a medical college in eastern Uttar Pradesh, India. A retrospective analysis of blood culture isolates obtained at our laboratory for ten months from patients with clinical suspicion of sepsis or infection with the possibility of haematogenous spread was done. We only considered consecutive and patient-specific, non-duplicate isolates. Blood samples were initially incubated in BacT/ALERT® and then manually processed once they flagged positive. A total of 1,033 blood samples were received, of which 217 (21%) showed the growth of a pathogenic organism. The positivity rate varied significantly across different age groups, locations, and departments (P value < 0.001). It was higher among in-patients, those with central venous access, and patients with diabetes mellitus (DM). Staphylococcus aureus [n = 105, 48.38%] was isolated most commonly, with a high prevalence of methicillin resistance (83%). Enterococcus demonstrated a high degree of resistance. MDROs accounted for 68% of the detected Gram-negatives. This study comprehensively analyses blood culture results from a diverse group of patients and emphasizes the association between risk factors and positive blood cultures. Gram-positive and Gram-negative isolates demonstrated low sensitivity to common antibiotics, urging vigilant monitoring and specific therapy. Our study reveals important insights guiding clinical practices, antimicrobial stewardship, and infection control strategies.

Detection of Antibiotic Resistance Genes in Escherichia coli Isolated from Chicken Eggs

Total 150 chicken eggs were randomly collected from farms, households, and markets of Rajshahi and Naogaon districts. Isolation and identification of E. coli was done by using cultural and staining characteristics, and biochemical properties. Antibiotic sensitivity assay was also performed for the isolated E. coli by using disc diffusion method. Characterization and detection of antibiotic resistance genes in E. coli isolates were done through PCR analysis. Prevalence of E. coli was 30.00% in chicken eggs in Rajshahi and Naogaon districts. Results of antibiotic sensitivity patterns of the isolated E. coli showed 57.78%, 33.33%, 31.11%, 28.89%, 26.67%, 17.78%, 15.56%, 13.33%, 13.33%, and 11.11% resistance to ciprofloxacin, doxycycline, oxytetracycline, ceftriaxone, amoxycillin, erythromycin, levofloxacin, enrofloxacin, gentamycin, and neomycin, respectively. The isolates also showed 94.44%, 82.22%, 80.00%, 77.78%, 66.67%, 60.00%, 55.56%, 48.89%, 46.67%, and 33.33% sensitive to neomycin, enrofloxacin, erythromycin, levofloxacin, gentamycin, ceftriaxone, oxytetracycline, doxycycline, amoxicillin, and ciprofloxacin, respectively. All 45 phenotypic identified isolates were confirmed as E. coli by PCR analysis. Genotypic identified isolates of E. coli were further characterized by PCR to detect antibiotic resistance genes. Out of 45 E. coli isolates 37 (82.22%) showed tetracycline resistance (tetA) gene, 32 (71.11%) showed tetracycline resistance (tetB) gene, and interestingly all 45 (100%) isolates showed quinolone group resistance (gyrA) gene by PCR analysis. J. of Sci. and Tech. Res. 5(1): 135-142, 2023

Cost-consequence analysis of computer vision-based skin prick tests: implications for cost containment in Switzerland

BackgroundSkin prick tests (SPTs), or intraepidermal tests, are often the first diagnostic approach for people with a suspected allergy. Together with the clinical history, SPTs allow doctors to draw conclusions on allergies based on the sensitization pattern. The purpose of this study is to investigate the potential cost consequences that would accrue to a Swiss University hospital after the adoption of computer vision-based SPTs.MethodsWe conducted a cost-consequence analysis from a hospital’s perspective to evaluate the potential cost consequences of using a computer vision-based system to read SPT results. The patient population consisted of individuals who were referred to the allergology department of one of the five university hospitals in Switzerland, Inselspital, whose allergology department averages 100 SPTs a week. We developed an early cost-consequence model comparing two SPT techniques; computer vision-based SPTs conducted with the aid of Nexkin DSPT and standard fully manual SPTs. Probabilistic sensitivity analysis and additional univariate sensitivity analyses were used to account for uncertainty.ResultsThe difference in average cost between the two alternatives from a hospital’s perspective was estimated to be CHF 7 per SPT, in favour of the computer vison-based SPTs. Monte Carlo probabilistic simulation also indicated that SPTs conducted using the computer vision-based system were cost saving compared to standard fully manual SPTs. Sensitivity analyses additionally demonstrated the robustness of the base case result subject to plausible changes in all the input parameters, with parameters representing the costs associated with both SPT techniques having the largest influence on the incremental cost. However, higher sensitization prevalence rates seemed to favour the more accurate standard fully manual SPTs.ConclusionAgainst the backdrop of rising healthcare costs especially in Switzerland, using computer-aided or (semi) automated diagnostic systems could play an important role in healthcare cost containment efforts. However, results should be taken with caution because of the uncertainty associated with the early nature of our analysis and the specific Swiss context adopted in this study.

Expanding the repertoire of Antibody Drug Conjugate (ADC) targets with improved tumor selectivity and range of potent payloads through in-silico analysis.

Antibody-Drug Conjugates (ADCs) have emerged as a promising class of targeted cancer therapeutics. Further refinements are essential to unlock their full potential, which is currently limited by a lack of validated targets and payloads. Essential aspects of developing effective ADCs involve the identification of surface antigens, ideally distinguishing target tumor cells from healthy types, uniformly expressed, accompanied by a high potency payload capable of selective targeting. In this study, we integrated transcriptomics, proteomics, immunohistochemistry and cell surface membrane datasets from Human Protein Atlas, Xenabrowser and Gene Expression Omnibus utilizing Lantern Pharma's proprietary AI platform Response Algorithm for Drug positioning and Rescue (RADR®). We used this in combination with evidence based filtering to identify ADC targets with improved tumor selectivity. Our analysis identified a set of 82 targets and a total of 290 target indication combinations for effective tumor targeting. We evaluated the impact of tumor mutations on target expression levels by querying 416 genes in the TCGA mutation database against 22 tumor subtypes. Additionally, we assembled a catalog of compounds to identify potential payloads using the NCI-Developmental Therapeutics Program. Our payload mining strategy classified 729 compounds into three subclasses based on GI50 values spanning from pM to 10 nM range, in combination with sensitivity patterns across 9 different cancer indications. Our results identified a diverse range of both targets and payloads, that can serve to facilitate multiple choices for precise ADC targeting. We propose an initial approach to identify suitable target-indication-payload combinations, serving as a valuable starting point for development of future ADC candidates.