Source Of Transmission Research Articles

Prevalence, antimicrobial resistance, and genetic lineages of nasal Staphylococcus aureus among medical students at a Spanish University: detection of the MSSA-CC398-IEC-type-C subclade

Medical students could be a potential source of Staphylococcus aureus transmission to patients. This cross-sectional study involved samples collected from both nasal nostrils. Samples were processed for S. aureus recovery; the antimicrobial resistance (AMR) phenotype was determined by disc diffusion assays and the spa types and AMR genotypes by PCR/sequencing. A structured questionnaire was administered to students to collate data related to potential risk factors of nasal colonization. Ninety-eight students were included, 50 % were colonized by S. aureus and 12.2 % by MRSA. The mecA gene was detected in all MRSA isolates. The MSSA-CC398-IEC-type C lineage was found among 16.3 % of nasal carriers, of which t571 was the predominant spa-type. MRSA isolates were ascribed to spa types t2226 (CC5, 12 isolates) and t3444 (new spa type, 1 isolate). All MRSA were multi-drug resistant and MSSA were predominantly resistant to erythromycin-clindamycin (inducible-type, mediated by ermT gene). High rates of S. aureus and MRSA nasal carriages were observed in this study. The predominance of the CC398 lineage among MSSA (emergent invasive lineage) represent a relevant finding of public health concern. The role of medical students as potential source of MRSA and MSSA-CC398 transmissions in hospital and community needs to be elucidated in detail.

Genomic and epidemiological insight of an outbreak of carbapenemase-producing Enterobacterales in a Portuguese hospital with the emergence of the new KPC-124

BackgroundCarbapenemase-producing Enterobacterales (CPE) is an increasing problem in healthcare settings. This study aimed to identify the source of a CPE outbreak that occurred in 2022, in a tertiary hospital in the North of Portugal, to identify exposed patients, and to assess the risk of becoming CPE-positive following hospital admission. MethodsA multi-disciplinary investigation was conducted including descriptive, analytical, and molecular epidemiology, environmental screening, and assessment of infection control measures. Clinical and environmental isolates were analyzed using whole-genome sequencing and phylogenetic analysis. Additionally, a prospective observational cohort study was conducted to further investigate the risk factors associated with the emergence of new cases in cohorts of CPE-negative admitted patients. ResultsWe observed the presence of multispecies KPC-, IMP-, and/or NDM-producing isolates. Genetically indistinguishable clinical and environmental isolates were found on the same room/ward. The ST45 KPC-3-producing Klebsiella pneumoniae clone was the responsible for the outbreak. During patients’ treatment, we detected the emergence of resistance to ceftazidime-avibactam, associated with mutations in the blaKPC-3 gene (blaKPC-46, blaKPC-66 and blaKPC-124, the last variant never previously reported), suggesting a vertical evolutionary trajectory. Patients aged ≥ 75 years, hygiene/feeding-care dependent, and/or subjected to secretion aspiration were risk factors for CPE colonization after hospital admission. Additionally, cases with previous admission to the emergency department suggest that CPE dissemination may occur not only during hospitalization but also in the emergency department. ConclusionOverall, the study highlights that selection pressure with antibiotics, like ceftazidime-avibactam, is a contributing factor to the emergence of new β-lactamase variants and antibiotic resistance. It also shows that the hospital environment can be a significant source of CPE transmission, and that routine use of infection control measures and real-time molecular epidemiology investigations are essential to ensure the long-term termination of CPE outbreaks and prevent future resurgences.

Drug-resistant Tuberculosis in Pediatric

Introduction: Drug-resistant tuberculosis (DR TB) is a condition where Mycobacterium tuberculosis is resistant to isoniazid, rifampicin or resistant to isoniazid and rifampin as well as other first-line anti-tuberculosis drugs (OAT). Tuberculosis (TB) is a contagious infectious disease, caused by Mycobacterium tuberculosis germs where the source of transmission is through droplets containing TB germs. Case Report: A 10 years 7 months girl, came to the MDR Polyclinic at the Haji Adam Malik Medan Central General Hospital (RSUP HAM Medan) on March 21 2023 bringing the results of the TB Molecular Rapid Test (TCM-TB) examination from the Teladan Barat Health Center with Rifampicin results were resistant and on March 24 2023 the patient was hospitalized. Currently, the patient is complaining of a cough that has been experiencing for ± 3 weeks. Cough with the impression of a dry cough and is continuous so that it interferes with daily activities. The cough does not improve even though the patient has taken cough medicine. There is no fever, there is also no history of previous fever. According to the anamnesis from the patient's parents, there has been a weight loss in the last 2 months, around ± 4 kg. There is no family history of long-term cough, but according to parents, there is a neighbor of the patient who suffers from pulmonary TB and is undergoing treatment. Discussion: After the diagnosis of drug-resistant tuberculosis is confirmed, an evaluation is carried out whether the patient meets the criteria for drug-resistant TB treatment guided by short-term or long-term oral drug-resistant tuberculosis. Patients who meet the evaluation criteria for treatment can immediately be given short-term oral drug-resistant tuberculosis therapy. If the patient does not meet the criteria for short-term treatment, long-term drug-resistant tuberculosis treatment is given. Routine evaluations are carried out during treatment and when the results of drug sensitivity tests are available, treatment is adjusted according to the examination results. Conclusion: A case of drug-resistant tuberculosis in a girl aged 10 years 7 months has been reported which was diagnosed based on anamnesis, physical examination, and supporting examinations, there was also a history of close contact with TB sufferers, and the results of TCM examination of sputum fluid showed rifampicin resistant MTB growth. Patients are treated as drug-resistant TB cases with a short-term regimen with regular monitoring of treatment response and side effects.

Parents' willingness to pay for COVID-19 vaccination for children in Malaysia using the contingent valuation method.

Children are susceptible and a potential source of transmission for coronavirus disease 2019 (COVID-19). However compulsory COVID-19 vaccination programs among children have not been a focus in Malaysia. The aim of this study was to measure parents' willingness to pay (WTP) for the COVID-19 vaccine and analyze the effects of socioeconomic variables on parents' WTP. An online cross-sectional study was conducted in Malaysia with two waves of surveys (i.e., different samples for each wave), March and June 2021. The study participants were Malaysian parents above 18 years old. Parents were randomized between two vaccine effectiveness profiles (95% and 50% effectiveness) and two risk levels of an adverse event (5% and 20% risk of fever). The WTP was estimated using a double-bounded dichotomous choice. Socioeconomic variables such as age of parent, gender, insurance, income, and education were examined. A total of 292 parents in March 2021 and 271 in June 2021 were included in the study. The vaccine safety and effectiveness profile did not significantly impact the WTP. In March 2021, the estimated WTP ranged from RM344.74 to RM399.64 (US$82.5 to US$95.6) across vaccine profiles and between RM377.55 and RM444.33 (US$90.3 to US$106.3) in June. Insurance status was associated with the parents' WTP, and during the June wave, the age of parents influenced the WTP. Implementing subsidies or free vaccinations is considerable to increase herd immunity and prevent transmission of COVID-19 in Malaysia.

Outage and throughput performance analysis of smart UAV‐assisted full‐duplex NOMA‐based energy harvesting cognitive radio networks

SummaryIn this paper, the throughput and outage performance for an unmanned aerial vehicle (UAV)‐assisted non‐orthogonal multiple access (NOMA)‐based hybrid cognitive radio (CR) network are examined under m‐Nakagami fading channel. To be more specific, a secondary source transmitter ( ) broadcasts a NOMA‐enabled mixed signal to secondary destinations via UAV relay, which operates in full‐duplex (FD) mode and employs decode‐and‐forward protocol. In our approach, an energy harvesting (EH) circuit is employed at both and UAV to harvest energy from the PU radio frequency (RF) signals. These secondary transmitters are also incorporated with energy detector (ED) circuit as well, which detects the activity of the primary user (PU). The status of PU to be busy or idle is confirmed on the basis of the energy detector's results. In turn, this drives and UAV to switch between underlay and overlay protocols in an adaptive manner to increase spectrum efficiency (SE). The closed form mathematical expressions of the secondary outage probability for NOMA‐based UAV equipped CR networks under imperfect successive interference cancellation (i‐SIC) conditions have been evaluated. The administration of the power allocation policy at the and UAV is assessed while maintaining the PU quality of service (QoS). Finally, MATLAB simulation testbed has been used to verify all the analytical closed form expressions.

Characteristics of Airborne Particles and Bacteria in Hospital Indoor and Outdoor Air

Introduction: Given that hospital air is one of the important environmental sources for transmission of microorganisms, the importance of airborne transmission in the epidemiology of hospital-acquired infections (HAIs) has gained attention in the past two decades. Therefore, the present study aims to determine the concentration of bacteria in association with airborne particulate matter (PM) in the outdoor and indoor air of two hospital wards. Materials and methods: The GRIMM 1.109 dust monitor and the Andersen one-stage viable impactor were used for particle counting and bioaerosol sampling, respectively. Results: The average levels of airborne bacteria sampled from outdoor air were 33 colony-forming units (CFU/m3), and in the air samples of medical and infectious disease wards, they were 76 and 85 CFU/m3, respectively. Staphylococcus spp. and Acinetobacter spp. were the most prevalent bacteria in the samples. Statistical analysis showed a significant association between PM2.5, and PM10 particle mass concentrations and airborne bacteria concentrations in indoor air samples (P-value < 0.05). Conclusion: Some bacterial agents of HAIs existed in hospital air and may be problematic for immunocompromised patients. Higher levels of bacteria in indoor air compared to outdoor air may indicate that the bacteria were of indoor origin, such as the presence and activities of people. Moreover, the results showed that particle counting may be a useful tool for airborne bacteria monitoring.

The Presence of Legionella in Water Used for Car Washing: Implications for Public Health.

Although today all of the aspects of Legionella are better understood than in the past, in many countries the interest is still mainly focused on healthcare and tourism facilities. Other at-risk areas are less explored, such as those where workers are often in contact with water during their activities. In reality, any water system capable of producing aerosols can be considered a potential source of Legionella transmission, including car washes, where a large number of users work and flow through annually. From January to May 2022, 120 samples were carried out in 30 car washes located in Messina (Italy): 60 samples of water and 60 of aerosols. The aim of this investigation was to evaluate the risk of legionellosis in car washing workers exposed to potentially contaminated aerosols. To increase the probability of finding Legionella, the sample collections were organized on different days of the week. Of the total samples taken, 10 (8.3%) were positive for Legionella: seven (11.7%) water (range 100-1000 CFU) and three (5%) aerosol (range 10-150 CFU) samples. Detected serogroups were L. pneumophila sgr 1, 7, 10 and Legionella gormanii. Given the results obtained, preventative measures should be implemented in such facilities in order to protect the health of users and car wash operators.

Dental implications of COVID-19 - An insight

COVID-19 is a pandemic viral disease caused by Severe Acute Respiratory Syndrome corona virus 2(SARS -CoV-2). This pandemic has created a massive impact globally and is indeed a challenge to the mass healthcare management. Despite continuous, untiring efforts of the World Health Organisation (WHO) and the Health departments of various countries to curb this zoonotic disease, the propensity of the virus to spread through droplets, replicate and mutate has raised huge public health concerns. Oral cavity is an index of body’s health. Oral manifestations such as ageusia, angular chelitis, periodontal diseases, ulcers and fungal infections have been reported commonly in patients with COVID-19. These oral manifestations are valuable diagnostic criteria for the disease. Periodontal inflammation has been proved to increase the severity of the disease. Also, Periodontitis can present secondary to COVID-19 due to compromised immune system in this viral disease. Proper and adequate oral hygiene, appropriate use of corticosteroids and maintenance of glycemic control can reduce oral infections in COVID-19. Considering the increased risk of contracting the virus due to their proximity to the patients in the operating environment, oral health care providers must be aware of safety protocols and should strictly adhere to the recommendations by the regulatory authorities. This not only ensures higher safety, but also prevents the dental office from being a source of transmission for the virus. This review provides an overview on COVID-19 with an insight on its oral manifestations and a special emphasis on the safety protocols to be followed by dentists.

Model-based evaluation of admission screening strategies for the detection and control of carbapenemase-producing Enterobacterales in the English hospital setting

BackgroundGlobally, detections of carbapenemase-producing Enterobacterales (CPE) colonisations and infections are increasing. The spread of these highly resistant bacteria poses a serious threat to public health. However, understanding of CPE transmission and evidence on effectiveness of control measures is severely lacking. This paper provides evidence to inform effective admission screening protocols, which could be important in controlling nosocomial CPE transmission.MethodsCPE transmission within an English hospital setting was simulated with a data-driven individual-based mathematical model. This model was used to evaluate the ability of the 2016 England CPE screening recommendations, and of potential alternative protocols, to identify patients with CPE-colonisation on admission (including those colonised during previous stays or from elsewhere). The model included nosocomial transmission from colonised and infected patients, as well as environmental contamination. Model parameters were estimated using primary data where possible, including estimation of transmission using detailed epidemiological data within a Bayesian framework. Separate models were parameterised to represent hospitals in English areas with low and high CPE risk (based on prevalence).ResultsThe proportion of truly colonised admissions which met the 2016 screening criteria was 43% in low-prevalence and 54% in high-prevalence areas respectively. Selection of CPE carriers for screening was improved in low-prevalence areas by adding readmission as a screening criterion, which doubled how many colonised admissions were selected. A minority of CPE carriers were confirmed as CPE positive during their hospital stay (10 and 14% in low- and high-prevalence areas); switching to a faster screening test pathway with a single-swab test (rather than three swab regimen) increased the overall positive predictive value with negligible reduction in negative predictive value.ConclusionsUsing a novel within-hospital CPE transmission model, this study assesses CPE admission screening protocols, across the range of CPE prevalence observed in England. It identifies protocol changes—adding readmissions to screening criteria and a single-swab test pathway—which could detect similar numbers of CPE carriers (or twice as many in low CPE prevalence areas), but faster, and hence with lower demand on pre-emptive infection-control resources. Study findings can inform interventions to control this emerging threat, although further work is required to understand within-hospital transmission sources.

Demographics of sources of HIV-1 transmission in Zambia: a molecular epidemiology analysis in the HPTN 071 PopART study

In the last decade, universally available antiretroviral therapy (ART) has led to greatly improved health and survival of people living with HIV in sub-Saharan Africa, but new infections continue to appear. The design of effective prevention strategies requires the demographic characterisation of individuals acting as sources of infection, which is the aim of this study. Between 2014 and 2018, the HPTN 071 PopART study was conducted to quantify the public health benefits of ART. Viral samples from 7124 study participants in Zambia were deep-sequenced as part of HPTN 071-02 PopART Phylogenetics, an ancillary study. We used these sequences to identify likely transmission pairs. After demographic weighting of the recipients in these pairs to match the overall HIV-positive population, we analysed the demographic characteristics of the sources to better understand transmission in the general population. We identified a total of 300 likely transmission pairs. 178 (59·4%) were male to female, with 130 (95% CI 110-150; 43·3%) from males aged 25-40 years. Overall, men transmitted 2·09-fold (2·06-2·29) more infections per capita than women, a ratio peaking at 5·87 (2·78-15·8) in the 35-39 years source age group. 40 (26-57; 13·2%) transmissions linked individuals from different communities in the trial. Of 288 sources with recorded information on drug resistance mutations, 52 (38-69; 18·1%) carried viruses resistant to first-line ART. HIV-1 transmission in the HPTN 071 study communities comes from a wide range of age and sex groups, and there is no outsized contribution to new infections from importation or drug resistance mutations. Men aged 25-39 years, underserved by current treatment and prevention services, should be prioritised for HIV testing andART. National Institute of Allergy and Infectious Diseases, US President's Emergency Plan for AIDS Relief, International Initiative for Impact Evaluation, Bill & Melinda Gates Foundation, National Institute on Drug Abuse, and National Institute of Mental Health.

One Health Determinants of Escherichia coli Antimicrobial Resistance in Humans in the Community: An Umbrella Review.

To date, the scientific literature on health variables for Escherichia coli antimicrobial resistance (AMR) has been investigated throughout several systematic reviews, often with a focus on only one aspect of the One Health variables: human, animal, or environment. The aim of this umbrella review is to conduct a systematic synthesis of existing evidence on Escherichia coli AMR in humans in the community from a One Health perspective. PubMed, EMBASE, and CINAHL were searched on "antibiotic resistance" and "systematic review" from inception until 25 March 2022 (PROSPERO: CRD42022316431). The methodological quality was assessed, and the importance of identified variables was tabulated across all included reviews. Twenty-three reviews were included in this study, covering 860 primary studies. All reviews were of (critically) low quality. Most reviews focused on humans (20), 3 on animals, and 1 on both human and environmental variables. Antibiotic use, urinary tract infections, diabetes, and international travel were identified as the most important human variables. Poultry farms and swimming in freshwater were identified as potential sources for AMR transmission from the animal and environmental perspectives. This umbrella review highlights a gap in high-quality literature investigating the time between variable exposure, AMR testing, and animal and environmental AMR variables.

Experimental characterization of exhaled flow dynamics of human breathing and vocalization

During the onging pandemic of COVID-19, there are numerous asymptomatic patients who are infectious. The exhaled droplets from their daily respiratory activities like breathing or speaking can be the sources of airborne disease transmission of COVID-19. The understanding of the airflow dynamics of these respiratory activities may be helpful to develop effective measures to prevent and control the spread of the disease. In this study, the exhaled flows from human breathing and vocalization of specific syllables are characterized using particle image velocimetry (PIV) and smoke visualization. The exhaled flow generated by ten phonemes including vowels, fricatives, affricates, plosives and nasals as well as mouth breathing are studied. The dynamic developments of the airflow processes are described by a series of parameters, including peak velocity, peak velocity time, duration time, propagation velocity and distance. Results show that vocalization of affricates and plosives as well as mouth breathing tend to have higher peak velocities and propagation distances. The evolutions of exhaled flows generated from these respiratory processes are found to have different jet structures, which are related to the stroke ratio (L/D). The flow field of a small L/D only has a pair of dominant vortices. Whereas that of a large L/D presents both a pair of dominant vortex ring and a trailing jet. Certain phoneme (e.g., /t/) is found to display a two-stage jet similar to a cough with the starting jet and an interrupted jet. The characterization of human exhaled flow of this study may be helpful to provide basis of CFD simulations and a better understanding of the spread of airborne diseases from human breathing.

Analysis of Klebsiella Pneumonia and Resistance Genes Coding and Carbapenemase Production in National Referral Hospital Wastewater

Hospitals, as a source of transmission and spread of bacteria carrying antibiotic-resistant genes (ARGs) as well as a high source of antibiotic compounds, are a significant reservoir of antibiotic-resistant gene transfer that causes bacteria to develop multidrug resistance (MDR). Klebsiella pneumonia is a bacterium often found in wastewater with a high level of Extended Spectrum β-lactamase (ESBL) and carbapenemase resistance. This study aimed to determine Klebsiella pneumonia and resistance genes encoding ESBL and carbapenemase in hospital wastewater to obtain primary Antimicrobial Resistance (AMR) data in the environment, which was first conducted in Indonesia. The resistance gene detection method was developed using High Throughput Real-Time and conventional Real-Time (HT-RT PCR). The data obtained were relative abundance and copy number. The results showed that blaTEM and blaNDM were the highest ARGs. Conventional Real-Time PCR results showed better sensitivity in detecting K. pneumoniae and ARGs than HT-RT PCR. The detection of K. pneumoniae and ARGs in RSCM wastewater in Indonesia indicates the need to improve the handling of RSCM WWTP to monitor the number of microbial resistances to antibiotics.

Risk factors for increasing leprosy treatment dropout cases reported in specific areas in Tangerang District

Link of Video Abstract: https://youtu.be/WPu8KQqNFNM Introduction: In 2020, Indonesia announced the elimination of leprosy in the whole country, including the Banten Province, with new cases detected 568 cases (4.8 per 100,000 population), higher than the national average of 4.12 per 100,000 population. Although information on the percentage of dropouts in Indonesia is not known, it still occurs in the field, If the case is cleared out unchecked, it will become a source of transmission of wellbeing problems in the community. This study aims to determine the influence of socio-demographic factors, leprosy patients, and health services on leprosy dropout rates and detect new cases in the Panongan Community Health Center working area. Methods: Secondary data on leprosy patients at the Panongan Community Health Center during 2019-2022 and primary data from cross-sectional surveys through home visits, interviews, face-to-face, and screening. Screening for leprosy symptoms in close contact with the patient's family using a questionnaire that includes independent variables of socio-demographic, patient, and health center with the dependent variable of treatment dropout. Purposive sampling technique in 5 villages with leprosy cases. The total sample size was 79 people. Data were processed and analyzed using STATA 14.0. Results: The logistic regression test was found to be significant (p-value < 0.05) including age, (p=0.003), occupation (p=0.002), stigma (p=0.001), family of leprosy patients (p=0.003), close contact (p=0,000), healthy eating habits (p=0.002), perception of taking medicine (p=0.000) and a woman, 60 years old, was found to be infected with leprosy within the family of a drug withdrawal patient who was in near contact for 1 year, although multivariate testing was not statistically significant (p-value: > 0.05). Conclusion: Increasing compliance through health education and motivation of patients and families, also monitoring medication taking by health service staff, groups of former patients, and cadres.

2685. Impact of Education and Clinic Site Champion on Extragenital Testing for Sexually Transmitted Infection

Abstract Background Over the last several years sexually transmitted infections (STIs) have been on the rise in the United States. A potential area for improving the diagnosis of STIs is appropriate testing of extragenital (EG) sites (i.e., throat or rectum). These sites may serve as a reservoir for infection and lead to increased transmission if not identified and treated. Prior studies have shown that in men who have sex with men, genital testing alone misses >70% of STIs. In other patient groups, this may range from 10-40%. The aims of this project were twofold: to determine the proportion of patients receiving EG STI testing, and to observe the effect of a two-phase educational intervention on EG site testing. Methods Phase I (Jul-Dec 2021) included four urgent care clinics within a Midwest health system. Retrospective baseline data was ascertained for all adults receiving STI testing for Chlamydia trachomatis (CT) and Neisseria gonorrhea (GC) at these clinics. Next, all four clinics received access to an educational presentation regarding the importance of EG testing for STI detection. Two of these clinics served as pilot sites for the implementation of patient self-collection kits. Data was compiled for all adults undergoing STI testing at these clinics for a 6-month period. Phase II (Jul 2022-Mar 2023) involved further expansion and utilization of a site champion at several family medicine clinics including on-site promotion of multi-site testing and patient self-collection. Educational materials as in Phase I were provided to site champions Results Phase I baseline data indicated that less than 1% of samples from patients receiving STI testing were obtained from EG sites. There was a small increase in EG site testing after the educational intervention and implementation of self-collected swab kits (Table 1). Phase II data showed an increase in EG testing after the utilization of a clinic site champion and the sharing of testing data in family medicine clinics (Table 2). Conclusion Rates of STIs have reached an all-time high in the United States. EG infections serve as potential sources for STI transmission. Adequate multi-site testing is necessary. Implementation was most effective when a clinic site champion was identified, and clinic testing data was provided to them. Disclosures All Authors: No reported disclosures

776. Clinical Practice Gap Analysis of Physicians’ Understanding of Cytomegalovirus

Abstract Background Understanding clinical practice related to awareness and clinical understanding of cytomegalovirus (CMV) and can inform development of tools to improve physician practices and patient screening, diagnosis and management. Methods A survey instrument of 25 multiple choice, knowledge- and case-based questions allowed participants to assess their clinical knowledge with regard to CMV. These questions are designed to assess clinicians’ baseline knowledge, competence, and current practice. Immediate peer-response data solidify support for correct responses. The survey was available online to physicians without monetary compensation or charge. Respondent confidentiality was maintained and responses were de-identified and aggregated prior to analyses. Initial data collection occurred from July 27, 2022 to October 18, 2022. Results In total, 107 OB/GYNs and 77 pediatricians completed the full assessment within the data collection period. Physicians demonstrated gaps in the following areas: Conclusion This educational research on assessment of physicians’ clinical practices yielded important insights into clinical gaps related to CMV among OB/GYNs and pediatricians. While the gaps were similar in most areas, OB/GYNs showed larger gaps in identifying source of transmission, and management of possible congenital CMV compared with pediatricians, whereas pediatricians showed larger gaps in identifying seropositivity rates and diagnosing CMV. Disclosures All Authors: No reported disclosures

Airborne SARS-CoV-2 is more frequently detected in environments related to children and elderly but likely non-infectious, Norway, 2022

This study investigates the presence of SARS-CoV-2 in indoor and outdoor environments in two cities in Norway between April and May 2022. With the lifting of COVID-19 restrictions in the country and a focus on vaccination, this research aims to shed light on the potential for virus transmission in various settings. Air sampling was conducted in healthcare and non-healthcare facilities, covering locations frequented by individuals across different age groups. The study found that out of 31 air samples, only four showed the presence of SARS-CoV-2 RNA by RT-qPCR, with no viable virus detected after RNAse pre-treatment. These positive samples were primarily associated with environments involving children and the elderly. Notably, sequencing revealed mutations associated with increased infectivity in one of the samples. The results highlight the importance of considering children as potential sources of virus transmission, especially in settings with prolonged indoor exposure. As vaccination coverage increases globally, and with children still representing a substantial unvaccinated population, the study emphasizes the need to re-implement mask-wearing mandates indoors and in public transport to reduce virus transmission. The findings have implications for public health strategies to control COVID-19, particularly in the face of new variants and the potential for increased transmission during the autumn and winter seasons.

Multi-Antibiotic Resistant Citrobacter freundii in Eggs: A Silent Public Health Threat

Background: Improper handling of poultry, particularly in developing countries like Bangladesh, can lead to foodborne illnesses. Citrobacter freundii, a Gram-negative bacteria, is a silent emerging threat causing diseases and spreading antibiotic resistance. This study aimed to identify the multidrug resistant (MDR) C. freundii from poultry egg samples through biochemical and molecular characterization. Materials and Methods: A total of 50 poultry egg samples (both outer and inner) were collected from different farms located in Dhaka, Bangladesh within six months. Isolation of pathogens with selective bacteriological media such as McConkey agar, Xylose Lysine Deoxycholate agar, Salmonella-Shigella agar, and specific biochemical tests were performed to identify the Citrobacter isolates. The antibiotic sensitivity pattern of the isolates were determined by the disk diffusion method. Multidrug-resistant isolates were further identified by 16S rRNA gene sequencing and BLASTn analysis. Results: Out of 50 samples, 60% (30) were found positive for Gram negative Enterobacteriaceae. Among them, 50% of the samples were found to be contaminated with Salmonella enterica (15), 20% with E. coli (6), 6.67% with Pseudomonas spp. (2) and 23.33% with Citrobacter spp. They were highly resistant to erythromycin (83%), cefixime (82%), and amoxicillin (79%) antibiotics. On the other hand, they were sensitive against imipenem (93%) and intermediate for azithromycin (46%). Among all isolates, the most potent multidrug-resistant isolate was identified based on its 16S rRNA gene sequence, with one having the highest similarity (100%) to Citrobacter freundii strain A3.Conclusion: Poultry eggs can be a source of transmission of multidrug-resistant Citrobacter freundii from animal to human. It could be a serious health concern for developing countries since very little effort has been put into this issue.

Multi-Antibiotic Resistant Citrobacter freundii in Eggs: A Silent Public Health Threat

Background: Improper handling of poultry, particularly in developing countries like Bangladesh, can lead to foodborne illnesses. Citrobacter freundii, a Gram-negative bacteria, is a silent emerging threat causing diseases and spreading antibiotic resistance. This study aimed to identify the multidrug resistant (MDR) C. freundii from poultry egg samples through biochemical and molecular characterization. Materials and Methods: A total of 50 poultry egg samples (both outer and inner) were collected from different farms located in Dhaka, Bangladesh within six months. Isolation of pathogens with selective bacteriological media such as McConkey agar, Xylose Lysine Deoxycholate agar, Salmonella-Shigella agar, and specific biochemical tests were performed to identify the Citrobacter isolates. The antibiotic sensitivity pattern of the isolates were determined by the disk diffusion method. Multidrug-resistant isolates were further identified by 16S rRNA gene sequencing and BLASTn analysis. Results: Out of 50 samples, 60% (30) were found positive for Gram negative Enterobacteriaceae. Among them, 50% of the samples were found to be contaminated with Salmonella enterica (15), 20% with E. coli (6), 6.67% with Pseudomonas spp. (2) and 23.33% with Citrobacter spp. They were highly resistant to erythromycin (83%), cefixime (82%), and amoxicillin (79%) antibiotics. On the other hand, they were sensitive against imipenem (93%) and intermediate for azithromycin (46%). Among all isolates, the most potent multidrug-resistant isolate was identified based on its 16S rRNA gene sequence, with one having the highest similarity (100%) to Citrobacter freundii strain A3.Conclusion: Poultry eggs can be a source of transmission of multidrug-resistant Citrobacter freundii from animal to human. It could be a serious health concern for developing countries since very little effort has been put into this issue.

Molecular survey and phylogenetic analysis of Bartonella sp., Coxiella sp., and hemoplamas in pudu (Pudu puda) from Chile: first report of Bartonella henselae in a wild ungulate species.

Recent evidence shows a high diversity of infectious agents in wildlife that represent a threat to human, domestic, and wild animal health. In Chile, wild populations of the most common cervid species, pudu (Pudu puda), have been reported as hosts for novel pathogens such as Mycoplasma ovis-like and a novel ecotype of Anaplasma phagocytophilum. A better understanding of the epidemiology of this group and other intracellular bacteria that might have cervids as hosts would enlighten their population relevance. This study aimed to determine the occurrence and genetic diversity of Bartonella spp., hemotropic mycoplasmas, and Coxiella burnetii in pudus from Chile. The DNA was extracted from the blood samples of 69 wild free-ranging and 30 captive pudus from Chile. A combination of real-time (nouG gene for Bartonella and IS1111 element for C. burnetii) and conventional PCR (16S rRNA for hemotropic Mycoplasma spp. and rpoB, gltA, and ITS for Bartonella spp.) was used for pathogen screening and molecular characterization. DNA of Bartonella spp. was detected in 10.1% [95% CI (5.2-18.2%)] samples, hemotropic Mycoplasma spp. in 1.7% [95% CI (0.08-10.1%)], and C. burnetii in 1.0% [95% CI (0.05-6.3%)] samples. Two sequenced samples were identified as Mycoplasma ovis-like, and one free-ranging pudu was positive for C. burnetii. While one captive and two free-ranging pudus were positive for Bartonella henselae, one wild pudu was co-positive for B. henselae and Bartonella sp., similar to Bartonellae identified in ruminants. To the best of our knowledge, this is the first report of B. henselae in wild ungulate species, and C. burnetii and Bartonella spp. in wild ungulate species in South America. Further research will be necessary to evaluate the potential role of pudu as reservoirs of infection and identify the sources for disease transmission among humans and wild and domestic animals.