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Capone D, Cumming O, Flemister A, Ilevbare V, Irish SR, Keenum I, Knee J, Nala R, Brown J. Sanitation in urban areas may limit the spread of antimicrobial resistance via flies. PLoS One 2024; 19:e0298578. [PMID: 38507457 PMCID: PMC10954131 DOI: 10.1371/journal.pone.0298578] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2023] [Accepted: 01/28/2024] [Indexed: 03/22/2024] Open
Abstract
Synanthropic filth flies are common where sanitation is poor and fecal wastes are accessible to them. These flies have been proposed as mechanical vectors for the localized transport of fecal microbes including antimicrobial resistant (AMR) organisms and associated antimicrobial resistance genes (ARGs), increasing exposure risks. We evaluated whether an onsite sanitation intervention in Maputo, Mozambique reduced the concentration of enteric bacteria and the frequency of detection of ARGs carried by flies collected in household compounds of low-income neighborhoods. Additionally, we assessed the phenotypic resistance profile of Enterobacteriaceae isolates recovered from flies during the pre-intervention phase. After fly enumeration at study compounds, quantitative polymerase chain reaction was used to quantify an enteric 16S rRNA gene (i.e., specific to a cluster of phylotypes corresponding to 5% of the human fecal microflora), 28 ARGs, and Kirby Bauer Disk Diffusion of Enterobacteriaceae isolates was utilized to assess resistance to eleven clinically relevant antibiotics. The intervention was associated with a 1.5 log10 reduction (95% confidence interval: -0.73, -2.3) in the concentration of the enteric 16S gene and a 31% reduction (adjusted prevalence ratio = 0.69, [0.52, 0.92]) in the mean number of ARGs per fly compared to a control group with poor sanitation. This protective effect was consistent across the six ARG classes that we detected. Enterobacteriaceae isolates-only from the pre-intervention phase-were resistant to a mean of 3.4 antibiotics out of the eleven assessed. Improving onsite sanitation infrastructure in low-income informal settlements may help reduce fly-mediated transmission of enteric bacteria and the ARGs carried by them.
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Affiliation(s)
- Drew Capone
- Department of Environmental and Occupational Health, Indiana University, Bloomington, Indiana, United States of America
| | - Oliver Cumming
- Department of Disease Control, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Abeoseh Flemister
- Roy Blunt NextGen Precision Health, University of Missouri, Columbia, Missouri, United States of America
- Department of Radiology, University of Missouri, Columbia, MO, United States of America
| | - Victor Ilevbare
- Department of Biology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States of America
| | - Seth R. Irish
- Epidemiology and Public Health Department, Swiss Tropical and Public Health Institute, Allschwil, Switzerland
| | - Ishi Keenum
- Department of Civil, Environmental and Geospatial Engineering, Michigan Technological University, Houghton, Michigan, United States of America
| | - Jackie Knee
- Department of Disease Control, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Rassul Nala
- Ministério da Saúde de Moçambique, Instituto Nacional de Saúde, Maputo, Mozambique
| | - Joe Brown
- Department of Environmental Sciences and Engineering, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States of America
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Li Y, Chen Y, Chen Z, Yang Y, Wu Z. Removal of leftover feed shapes environmental microbiota and limits houseflies-mediated dispersion of pathogenic bacteria in sow breeding farms. Anim Microbiome 2024; 6:10. [PMID: 38444038 PMCID: PMC10913660 DOI: 10.1186/s42523-024-00296-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2022] [Accepted: 02/13/2024] [Indexed: 03/07/2024] Open
Abstract
BACKGROUND Intensive swine breeding industry generates a complex environment where several microbial interactions occur and which constitutes a challenge for biosafety. Ad libitum feeding strategies and low levels of management contribute to residual and wasted feed for lactating sows, which provides a source of nutrients and microbial source for houseflies in warm climates. Due to the absence of the all-in/all-out system, the coexistence of sows of two production stages including gestating and lactating sows in the farrowing barn may have potential negative impacts. In this research, we evaluated the effects of lactating sow leftover on the environmental microbiota of the farrowing barn and the contribution of microbial environments to the gestating sow fecal bacterial structure with a 30-day-long treatment of timely removing lactating residual feed. RESULTS Houseflies in the farrowing barn mediate the transmission of microorganisms from lactating sow leftover to multiple regions. Leuconostoc, Weissella, Lactobacillus and Pediococcus from the leftover which can produce exopolysaccharides, are more capable of environmental transmission than pathogenic microorganisms including Staphylococcus and Streptococcus and utilize houseflies to achieve spread in environmental regions of the farrowing barn. Leftover removal treatment blocked the microbial transmission chain mediated by houseflies, downregulated the relative abundance of pathogenic bacteria including Escherichia-Shigella and Streptococcus among houseflies, environmental regions and fecal bacteria of gestating sows in the farrowing barn and effectively attenuate the increment of Weissella and RF39 relative abundance in gestating sow feces due to the presence of lactating sows. CONCLUSIONS Lactating sow leftover is a non-negligible microbial contributor of environment in farrowing barn whose transmission is mediated by houseflies. A 30-day-long treatment of removing lactating sow residual feed cause significant changes in the microbial structure of multiple environmental regions within the farrowing barn via altering the microbiota carried by houseflies. Meanwhile, lactating sow leftover affect the fecal microbial structure of gestating sows in the same farrowing barn, while removal of lactating sow leftover alleviates the contribution of microbial transmission.
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Affiliation(s)
- Yunke Li
- State Key Laboratory of Animal Nutrition and Feeding, China Agricultural University, Beijing, 100193, China
| | - Yinfeng Chen
- State Key Laboratory of Animal Nutrition and Feeding, China Agricultural University, Beijing, 100193, China
| | - Zhaohui Chen
- State Key Laboratory of Animal Nutrition and Feeding, China Agricultural University, Beijing, 100193, China
| | - Ying Yang
- State Key Laboratory of Animal Nutrition and Feeding, China Agricultural University, Beijing, 100193, China
| | - Zhenlong Wu
- State Key Laboratory of Animal Nutrition and Feeding, China Agricultural University, Beijing, 100193, China.
- Beijing Advanced Innovation Center for Food Nutrition and Human Health, China Agricultural University, Beijing, 100193, China.
- Laboratory of Microbial Resources and Application in Animals, Beijing Jingwa Agricultural Science and Technology Innovation Center, Pinggu Beijing, Beijing, 101206, China.
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Matanza XM, Clements A. Pathogenicity and virulence of Shigella sonnei: A highly drug-resistant pathogen of increasing prevalence. Virulence 2023; 14:2280838. [PMID: 37994877 PMCID: PMC10732612 DOI: 10.1080/21505594.2023.2280838] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2023] [Accepted: 11/01/2023] [Indexed: 11/24/2023] Open
Abstract
Shigella spp. are the causative agent of shigellosis (or bacillary dysentery), a diarrhoeal disease characterized for the bacterial invasion of gut epithelial cells. Among the 4 species included in the genus, Shigella flexneri is principally responsible for the disease in the developing world while Shigella sonnei is the main causative agent in high-income countries. Remarkably, as more countries improve their socioeconomic conditions, we observe an increase in the relative prevalence of S. sonnei. To date, the reasons behind this change in aetiology depending on economic growth are not understood. S. flexneri has been widely used as a model to study the pathogenesis of the genus, but as more research data are collected, important discrepancies with S. sonnei have come to light. In comparison to S. flexneri, S. sonnei can be differentiated in numerous aspects; it presents a characteristic O-antigen identical to that of one serogroup of the environmental bacterium Plesiomonas shigelloides, a group 4 capsule, antibacterial mechanisms to outcompete and displace gut commensal bacteria, and a poorer adaptation to an intracellular lifestyle. In addition, the World Health Organization (WHO) have recognized the significant threat posed by antibiotic-resistant strains of S. sonnei, demanding new approaches. This review gathers knowledge on what is known about S. sonnei within the context of other Shigella spp. and aims to open the door for future research on understanding the increasing spread of this pathogen.
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Affiliation(s)
- Xosé M. Matanza
- Centre for Bacterial Resistance Biology, Department of Life Sciences, Imperial College London, London, UK
| | - Abigail Clements
- Centre for Bacterial Resistance Biology, Department of Life Sciences, Imperial College London, London, UK
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Prentice-Mott G, Odhiambo A, Conners EE, Mwaki A, Blackstock AJ, Oremo J, Akelo O, Eleveld A, Quick R, Murphy J, Berendes DM. Evaluation of SaTo pans as a new latrine technology in Kisumu County healthcare facilities, Kenya. Trop Med Int Health 2023; 28:881-889. [PMID: 37940633 PMCID: PMC10886420 DOI: 10.1111/tmi.13939] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2023]
Abstract
OBJECTIVES Innovations to improve public sanitation facilities, especially in healthcare facilities (HCFs) in low-income countries, are limited. SaTo pans represent novel, largely untested, modifications to reduce odour and flies and improve acceptability of HCF sanitation facilities. We conducted a pilot project to evaluate acceptability, cleanliness, flies and odour within latrines in 37 HCFs in Kisumu, Kenya, randomised into intervention (SaTo pan modifications) and control arms by sub-county and HCF level. METHODS At baseline (pre-intervention) and endline (>3 months after completion of SaTo pan installations in latrines in intervention HCFs), we surveyed users, cleaners and in-charges, observed odour and cleanliness, and assessed flies using fly tape. Unadjusted difference-in-difference analysis compared changes from baseline to endline in patient-reported acceptability and observed latrine conditions between intervention and control HCFs. A secondary assessment compared patient-reported acceptability following use of SaTo pan versus non-SaTo pan latrines within intervention HCFs. RESULTS Patient-reported acceptability of latrines was higher following the intervention (baseline: 87%, endline: 96%, p = 0.05). However, patient-reported acceptability was also high in the control arm (79%, 86%, p = 0.34), and the between-arm difference-in-difference was not significant. Enumerator-observed odour declined in intervention latrines (32%-14%) compared with controls (36%-51%, difference-in-difference ratio: 0.32, 95% confidence interval: 0.12-0.84), but changes in flies, puddling of urine and visible faeces did not differ between arms. In the secondary assessment, fewer intervention than control latrines had patient-reported flies (0% vs. 26%) and odour (18% vs. 50%), and reported satisfaction was greater. Most cleaners reported dropholes and floors were easier to clean in intervention versus controls; limited challenges with water for flushing were reported. CONCLUSIONS Our results suggest SaTo pans may be acceptable by cleaners and users and reduce odour in HCF sanitation facilities, though challenges exist and further evaluation with larger sample sizes is needed.
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Affiliation(s)
- Graeme Prentice-Mott
- Division of Foodborne, Waterborne, and Environmental Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | | | - Erin E Conners
- Division of Foodborne, Waterborne, and Environmental Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
- Epidemic Intelligence Service, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Alex Mwaki
- EIS Service, Safe Water and AIDS Project, Kisumu, Kenya
| | - Anna J Blackstock
- Division of Foodborne, Waterborne, and Environmental Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Jared Oremo
- EIS Service, Safe Water and AIDS Project, Kisumu, Kenya
| | - Oscar Akelo
- EIS Service, Safe Water and AIDS Project, Kisumu, Kenya
| | - Alie Eleveld
- EIS Service, Safe Water and AIDS Project, Kisumu, Kenya
| | - Robert Quick
- Division of Foodborne, Waterborne, and Environmental Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Jennifer Murphy
- Division of Foodborne, Waterborne, and Environmental Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - David M Berendes
- Division of Foodborne, Waterborne, and Environmental Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
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Hausdorff WP, Anderson JD, Bagamian KH, Bourgeois AL, Mills M, Sawe F, Scheele S, Talaat K, Giersing BK. Vaccine value profile for Shigella. Vaccine 2023; 41 Suppl 2:S76-S94. [PMID: 37827969 DOI: 10.1016/j.vaccine.2022.12.037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2022] [Revised: 10/14/2022] [Accepted: 12/16/2022] [Indexed: 10/14/2023]
Abstract
Shigella is the leading bacterial cause of diarrhoea and the second leading cause of diarrhoeal mortality among all ages. It also exhibits increasing levels of antibiotic resistance. The greatest burden is among children under five in low- and middle-income countries (LMICs). As such, a priority strategic goal of the World Health Organization (WHO) is the development of a safe, effective and affordable vaccine to reduce morbidity and mortality from Shigella-attributable dysentery and diarrhea, including long term outcomes associated with chronic inflammation and growth faltering, in children under 5 years of age in LMICs. In addition, a safe and effective Shigella vaccine is of potential interest to travellers and military both to prevent acute disease and rarer, long-term sequelae. An effective Shigella vaccine is also anticipated to reduce antibiotic use and thereby help diminish further emergence of enteric pathogens resistant to antimicrobials. The most advanced vaccine candidates are multivalent, parenteral formulations in Phase 2 and Phase 3 clinical studies. They rely on O-antigen-polysaccharide protein conjugate technologies or, alternatively, outer membrane vesicles expressing penta-acylated lipopolysaccharide that has been detoxified. Other parenteral and oral formulations, many delivering a broader array of Shigella antigens, are at earlier stages of clinical development. These formulations are being assessed in alignment with the WHO Preferred Product Characteristics, which call for a 1 to 2 dose primary immunization series given during the first 12 months of life, ideally starting at 6 months of age. This 'Vaccine Value Profile' (VVP) for Shigella is intended to provide a high-level, holistic assessment of the information and data that are currently available to inform the potential public health, economic and societal value of pipeline vaccines and vaccine-like products. This VVP was developed by a working group of subject matter experts from academia, non-profit organizations, government agencies and multi-lateral organizations. All contributors have extensive expertise on various elements of the Shigella VVP and collectively aimed to identify current research and knowledge gaps. The VVP was developed using only existing and publicly available information.
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Affiliation(s)
- William P Hausdorff
- Center for Vaccine Innovation and Access, PATH, 455 Massachusetts Ave NW, Washington, DC 20001, USA; Faculty of Medicine, Université de Bruxelles, Brussels 1070, Belgium.
| | - John D Anderson
- Office of Health Affairs, West Virginia University, Morgantown, WV 26505, USA; Bagamian Scientific Consulting, LLC, Gainesville, FL 32601, USA
| | - Karoun H Bagamian
- Bagamian Scientific Consulting, LLC, Gainesville, FL 32601, USA; Department of Environmental and Global Health, University of Florida, Gainesville, FL 32603, USA
| | - A Louis Bourgeois
- Center for Vaccine Innovation and Access, PATH, 455 Massachusetts Ave NW, Washington, DC 20001, USA
| | - Melody Mills
- National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD 20892 USA
| | - Frederick Sawe
- Kenya Medical Research Institute/U.S. Army Medical Research Directorate-Africa/Kenya-Henry Jackson Foundation MRI, Kericho, Kenya
| | - Suzanne Scheele
- Center for Vaccine Innovation and Access, PATH, 455 Massachusetts Ave NW, Washington, DC 20001, USA
| | - Kawsar Talaat
- Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA
| | - Birgitte K Giersing
- Department of Immunization, Vaccines and Biologicals (IVB), World Health Organization (WHO), Geneva, Switzerland
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The changing epidemiology of shigellosis in Australia, 2001-2019. PLoS Negl Trop Dis 2023; 17:e0010450. [PMID: 36857390 PMCID: PMC10010521 DOI: 10.1371/journal.pntd.0010450] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2022] [Revised: 03/13/2023] [Accepted: 02/14/2023] [Indexed: 03/02/2023] Open
Abstract
Shigellosis is an increasing cause of gastroenteritis in Australia, with prolonged outbreaks reported in remote Aboriginal and Torres Strait Islander (hereafter "First Nations") communities and among men who have sex with men (MSM) in major cities. To determine associations between Shigella species and demographic and geographic factors, we used multivariate negative binomial regression to analyse national case notifications of shigellosis from 2001 to 2019. Between 2001 and 2019, Australian states and territories reported 18,363 shigellosis cases to the National Notifiable Diseases Surveillance System (NNDSS), of which age, sex and organism information were available for >99% (18,327/18,363) of cases. Of the cases included in our analysis, 42% (7,649/18,327) were S. sonnei, 29% (5,267/18,327) were S. flexneri, 1% (214/18,327) were S. boydii, less than 1% (87/18,327) were S. dysenteriae, and species information was unknown for 28% (5,110/18,327) of cases. Males accounted for 54% (9,843/18,327) of cases, and the highest proportion of cases were in children aged 0-4 years (19%; 3,562/18,327). Crude annual notification rates ranged from 2.2 cases per 100,000 in 2003 and 2011 to 12.4 cases per 100,000 in 2019. Nationally, notification rates increased from 2001 to 2019 with yearly notification rate ratios of 1.04 (95% CI 1.02-1.07) for S. boydii and 1.05 (95% CI 1.04-1.06) for S. sonnei. Children aged 0-4 years had the highest burden of infection for S. flexneri, S. sonnei and S. boydii; and males had a higher notification rate for S. sonnei (notification rate ratio 1.24, 95% CI 1.15-1.33). First Nations Australians were disproportionately affected by shigellosis, with the notification rate in this population peaking in 2018 at 92.1 cases per 100,000 population. Over the study period, we also observed a shift in the testing method used to diagnose shigellosis, with culture independent diagnostic testing (CIDT) increasing from 2014; this also coincided with an increase in notifications of untyped Shigella. This change in testing methodology may have contributed to the observed increase in shigellosis notifications since 2014, with CIDT being more sensitive than culture dependent testing methods. The findings of this study provide important insights into the epidemiological characteristics of shigellosis in Australia, including identification of high-risk groups. This can be used to inform public health prevention and control strategies, such as targeted communication programs in First Nations communities and places with high levels of interaction between young children, such as childcare centres. Our study findings also highlight the implications of culture independent testing on shigellosis surveillance, particularly a reduction in the availability of species level information. This emphasises the continued importance of culture dependant testing for national surveillance of shigellosis.
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Muzembo BA, Kitahara K, Mitra D, Ohno A, Khatiwada J, Dutta S, Miyoshi SI. Burden of Shigella in South Asia: a systematic review and meta-analysis. J Travel Med 2023; 30:6798401. [PMID: 36331282 DOI: 10.1093/jtm/taac132] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/29/2022] [Revised: 10/25/2022] [Accepted: 10/25/2022] [Indexed: 11/06/2022]
Abstract
BACKGROUND Shigella remains one of the most common causes of diarrhoea in South Asia. Current estimates of the prevalence of Shigella are critical for guiding control measures. We estimated the prevalence of Shigella species and serogroups in South Asia. METHODS We performed a systematic review using PubMed, EMBASE, Google Scholar and Web of Science for peer-reviewed studies published between 2000 and 19 June 2022. We also manually searched the reference lists of the reviewed studies to identify additional studies. We included studies that detected the presence of Shigella in stool by culture or polymerase chain reaction (PCR). Studies associated with outbreaks were excluded. Two investigators independently reviewed the studies, extracted the data and performed quality assessment. A random-effects meta-analysis was performed to determine the pooled prevalence of Shigella. RESULTS Our search yielded 5707 studies, of which 91 studies from five South Asian countries were included in the systematic review, 79 in the meta-analysis of Shigella prevalence and 63 in the meta-analysis of Shigella serogroups prevalence. The pooled prevalence of Shigella was 7% [95% confidence interval (CI): 6-7%], with heterogeneity (I2 = 98.7; P < 0.01). The prevalence of Shigella was higher in children aged <5 years (10%; 95% CI: 8-11%), in rural areas (12%; 95% CI: 10-14%) and in studies using PCR (15%; 95% CI: 11-19%). Shigella flexneri (58%) was the most abundant serogroup, followed by Shigella sonnei (19%), Shigella boydii (10%) and Shigella dysenteriae (9%). Shigella flexneri 2a was the most frequently isolated serotype (36%), followed by serotype 3a (12%), serotype 6 (12%) and serotype 1b (6%). The prevalence of non-typeable Shigella was 10.0%. CONCLUSIONS Although the prevalence of Shigella in South Asia remains generally high, it varies by age group and geographical area, with data lacking in some countries. Effective Shigella vaccines would be advantageous for both endemic communities and travellers.
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Affiliation(s)
- Basilua Andre Muzembo
- Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, Okayama, Japan
| | - Kei Kitahara
- Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, Okayama, Japan
- Collaborative Research Centre of Okayama University for Infectious Diseases at ICMR-NICED, Kolkata, India
| | - Debmalya Mitra
- Collaborative Research Centre of Okayama University for Infectious Diseases at ICMR-NICED, Kolkata, India
| | - Ayumu Ohno
- Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, Okayama, Japan
- Collaborative Research Centre of Okayama University for Infectious Diseases at ICMR-NICED, Kolkata, India
| | | | - Shanta Dutta
- Division of Bacteriology, ICMR-National Institute of Cholera and Enteric Diseases, Kolkata, India
| | - Shin-Ichi Miyoshi
- Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, Okayama, Japan
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8
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Rawat N, Sabu B, Jamwal R, Devi PP, Yadav K, Raina HS, Rajagopal R. Understanding the role of insects in the acquisition and transmission of antibiotic resistance. THE SCIENCE OF THE TOTAL ENVIRONMENT 2023; 858:159805. [PMID: 36461578 DOI: 10.1016/j.scitotenv.2022.159805] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/04/2022] [Revised: 09/23/2022] [Accepted: 10/25/2022] [Indexed: 06/17/2023]
Abstract
Antibiotic resistance (AR) is a global healthcare threat that requires a comprehensive assessment. Poorly regulated antibiotic stewardship in clinical and non-clinical settings has led to a horizontal dissemination of AR. A variety of often neglected elements facilitate the circulation of AR from antibiotic sinks like concentrated animal feeding operations and healthcare settings to other environments that include healthy human communities. Insects are one of those elements that have received underwhelming attention as vectors of AR, despite their well-known role in transmitting clinically relevant pathogens. We here make an exhaustive attempt to highlight the role of insects as zoonotic reservoirs of AR by discussing the available literature and deriving realistic inferences. We review the AR associated with insects housing various human-relevant environments, namely, animal farm industry, edible-insects enterprise, healthcare institutes, human settlements, agriculture settings and the wild. We also provide evidence-based accounts of the events of the transmission of AR from insects to humans. We evaluate the clinical threats associated with insect-derived AR and propose the adoption of more sophisticated strategies to understand and mitigate future AR concerns facilitated by insects. Future works include a pan-region assessment of insects for AR in the form of AR bacteria (ARB) and AR determinants (ARDs) and the introduction of modern techniques like whole-genome sequencing, metagenomics, and in-silico modelling.
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Affiliation(s)
- Nitish Rawat
- Gut Biology Laboratory, Department of Zoology, University of Delhi, Room No. 117, Delhi 110007, India
| | - Benoy Sabu
- Gut Biology Laboratory, Department of Zoology, University of Delhi, Room No. 117, Delhi 110007, India
| | - Rohit Jamwal
- Gut Biology Laboratory, Department of Zoology, University of Delhi, Room No. 117, Delhi 110007, India
| | - Pukhrambam Pushpa Devi
- Gut Biology Laboratory, Department of Zoology, University of Delhi, Room No. 117, Delhi 110007, India
| | - Karuna Yadav
- Gut Biology Laboratory, Department of Zoology, University of Delhi, Room No. 117, Delhi 110007, India
| | - Harpreet Singh Raina
- Gut Biology Laboratory, Department of Zoology, University of Delhi, Room No. 117, Delhi 110007, India; Department of Zoology, Sri Guru Teg Bahadur Khalsa College, University of Delhi, Delhi 110007, India
| | - Raman Rajagopal
- Gut Biology Laboratory, Department of Zoology, University of Delhi, Room No. 117, Delhi 110007, India.
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Yang T, Wang Y, Yao L, Guo X, Hannah MN, Liu C, Rui J, Zhao Z, Huang J, Liu W, Deng B, Luo L, Li Z, Li P, Zhu Y, Liu X, Xu J, Yang M, Zhao Q, Su Y, Chen T. Application of logistic differential equation models for early warning of infectious diseases in Jilin Province. BMC Public Health 2022; 22:2019. [PMCID: PMC9636661 DOI: 10.1186/s12889-022-14407-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2022] [Accepted: 10/20/2022] [Indexed: 11/06/2022] Open
Abstract
Abstract
Background
There is still a relatively serious disease burden of infectious diseases and the warning time for different infectious diseases before implementation of interventions is important. The logistic differential equation models can be used for predicting early warning of infectious diseases. The aim of this study is to compare the disease fitting effects of the logistic differential equation (LDE) model and the generalized logistic differential equation (GLDE) model for the first time using data on multiple infectious diseases in Jilin Province and to calculate the early warning signals for different types of infectious diseases using these two models in Jilin Province to solve the disease early warning schedule for Jilin Province throughout the year.
Methods
Collecting the incidence of 22 infectious diseases in Jilin Province, China. The LDE and GLDE models were used to calculate the recommended warning week (RWW), the epidemic acceleration week (EAW) and warning removed week (WRW) for acute infectious diseases with seasonality, respectively.
Results
Five diseases were selected for analysis based on screening principles: hemorrhagic fever with renal syndrome (HFRS), shigellosis, mumps, Hand, foot and mouth disease (HFMD), and scarlet fever. The GLDE model fitted the above diseases better (0.80 ≤ R2 ≤ 0.94, P < 0. 005) than the LDE model. The estimated warning durations (per year) of the LDE model for the above diseases were: weeks 12–23 and 40–50; weeks 20–36; weeks 15–24 and 43–52; weeks 26–34; and weeks 16–25 and 41–50. While the durations of early warning (per year) estimated by the GLDE model were: weeks 7–24 and 36–51; weeks 13–37; weeks 11–26 and 39–54; weeks 23–35; and weeks 12–26 and 40–50.
Conclusions
Compared to the LDE model, the GLDE model provides a better fit to the actual disease incidence data. The RWW appeared to be earlier when estimated with the GLDE model than the LDE model. In addition, the WRW estimated with the GLDE model were more lagged and had a longer warning time.
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Khezzani B, Baymakova M, Khechekhouche EA, Ghezal K, Meziou Z, Brahim AB. Incidence rates of dysentery among humans in Lemghaier province, Algeria. Germs 2022; 12:195-202. [PMID: 36504607 PMCID: PMC9719374 DOI: 10.18683/germs.2022.1322] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2022] [Revised: 04/10/2022] [Accepted: 04/12/2022] [Indexed: 12/15/2022]
Abstract
Introduction Dysentery is an infectious clinical syndrome which can cause high morbidity and mortality, especially in developing countries. This research highlights the epidemiological features of dysentery in Lemghaier province, Algeria. Methods A retrospective study of the incidence rates of dysentery in Lemghaier province, Algeria and overall for the whole country for the period from January 2001 to December 2018 was carried out. On a local level data were provided by the Directorate of Health and Population of El-Oued province, Algeria. At the national level data were provided by the National Public Health Institute, Algeria. Results An overall number of 1,786 cases of dysentery were notified, with an incidence rate of 58.5 cases per 100,000 population (mean±SD: 58.54±47.20; 95% CI: 36.73-80.35). The high incidence rate was reported in autumn and summer, respectively, with 23.4 and 20.1 cases per 100,000 population. The high incidence rate observed in the persons aged 20-44 years with 76.4 cases per 100,000 population. Females were more likely to have dysentery than males, respectively, with 63.6 against 53.7 cases per 100,000 population. The highest incidence rate was reported in Lemghaier municipality (capital of the province) with 176.9 cases per 100,000 population. Conclusions The results from this research showed high incidence rates of dysentery in Lemghaier province, Algeria. Тhis fact is a serious reason for national public health organizations to take adequate and timely measures to reduce the incidence rates of dysentery in this part of the country.
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Affiliation(s)
- Bachir Khezzani
- PhD, Faculty of Natural Sciences, El-Oued University, P.O. Box: 789, El-Oued, Algeria and Laboratory of Biology, Environment and Health, Faculty of Natural Sciences, El-Oued University, P.O. Box: 789, El-Oued, Algeria
| | - Magdalena Baymakova
- MD, PhD, Department of Infectious Diseases, Military Medical Academy, P.O. Box: 1606, Sofia, Bulgaria,Corresponding author: Magdalena Baymakova,
| | - El Amine Khechekhouche
- PhD, Faculty of Natural Sciences, El-Oued University, P.O. Box: 789, El-Oued, Algeria and Laboratory of Biology, Environment and Health, Faculty of Natural Sciences, El-Oued University, P.O. Box: 789, El-Oued, Algeria
| | - Khadidja Ghezal
- MSc Student, Faculty of Natural Sciences, El-Oued University, P.O. Box: 789, El-Oued, Algeria, and Laboratory of Biology, Environment and Health, Faculty of Natural Sciences, El-Oued University, P.O. Box: 789, El-Oued, Algeria
| | - Zineb Meziou
- MSc Student, Faculty of Natural Sciences, El-Oued University, P.O. Box: 789, El-Oued, Algeria and Laboratory of Biology, Environment and Health, Faculty of Natural Sciences, El-Oued University, P.O. Box: 789, El-Oued, Algeria
| | - Aida Bousbia Brahim
- PhD Student, Faculty of Natural Sciences, El-Oued University, P.O. Box: 789, El-Oued, Algeria and Laboratory of Biology, Environment and Health, Faculty of Natural Sciences, El-Oued University, P.O. Box: 789, El-Oued, Algeria
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11
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Zhao Z, Yang M, Lv J, Hu Q, Chen Q, Lei Z, Wang M, Zhang H, Zhai X, Zhao B, Su Y, Chen Y, Zhang XS, Cui JA, Frutos R, Chen T. Shigellosis seasonality and transmission characteristics in different areas of China: A modelling study. Infect Dis Model 2022; 7:161-178. [PMID: 35662902 PMCID: PMC9144056 DOI: 10.1016/j.idm.2022.05.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2022] [Revised: 05/15/2022] [Accepted: 05/18/2022] [Indexed: 11/30/2022] Open
Abstract
Objective In China, the burden of shigellosis is unevenly distributed, notably across various ages and geographical areas. Shigellosis temporal trends appear to be seasonal. We should clarify seasonal warnings and regional transmission patterns. Method This study adopted a Logistic model to assess the seasonality and a dynamics model to compare the transmission in different areas. The next-generation matrix was used to calculate the effective reproduction number (R eff) to quantify the transmissibility. Results In China, the rate of shigellosis fell from 35.12 cases per 100,000 people in 2005 to 7.85 cases per 100,000 people in 2017, peaking in June and August. After simulation by the Logistic model, the 'peak time' is mainly concentrated from mid-June to mid-July. China's 'early warning time' is primarily focused on from April to May. We predict the 'peak time' of shigellosis is the 6.30th month and the 'early warning time' is 3.87th month in 2021. According to the dynamics model results, the water/food transfer pathway has been mostly blocked off. The transmissibility of different regions varies greatly, such as the mean R eff of Longde County (3.76) is higher than Xiamen City (3.15), higher than Chuxiong City (2.52), and higher than Yichang City (1.70). Conclusion The 'early warning time' for shigellosis in China is from April to May every year, and it may continue to advance in the future, such as the early warning time in 2021 is in mid-March. Furthermore, we should focus on preventing and controlling the person-to-person route of shigellosis and stratified deploy prevention and control measures according to the regional transmission.
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Key Words
- ARIMA, Autoregressive Integrated Moving Average (model)
- CDC, Center of Chinese Center for Disease Control and Prevention
- CI, confidence interval
- Early warning
- MSM, men who sex with a man
- ODE, ordinary differential equation
- R0, basic reproductive number
- R2, Coefficient of determination
- Reff, effective reproduction number
- SD, standard deviation
- SEIAR, Susceptible–Exposed–Infectious/Asymptomatic–Recovered (model)
- SEIARW, Susceptible–Exposed–Infectious/Asymptomatic–Recovered-Water/Food (model)
- Seasonality
- Shigellosis
- Transmissibility
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Affiliation(s)
- Zeyu Zhao
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, School of Public Health, Xiamen University, Xiamen City, People's Republic of China
- CIRAD, UMR 17, Intertryp, Montpellier, France
| | - Meng Yang
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, School of Public Health, Xiamen University, Xiamen City, People's Republic of China
| | - Jinlong Lv
- Department of Mathematics, School of Science, Beijing University of Civil Engineering and Architecture, Beijing, 102616, People's Republic of China
| | - Qingqing Hu
- Division of Public Health, School of Medicine, University of Utah, 201 Presidents Circle, Salt Lake City, 84112, Utah, USA
| | | | - Zhao Lei
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, School of Public Health, Xiamen University, Xiamen City, People's Republic of China
| | - Mingzhai Wang
- Xiamen Center for Disease Control and Prevention, Xiamen City, Fujian Province, People's Republic of China
| | - Hao Zhang
- Yichang Center for Disease Control and Prevention, Yichang City, Hubei Province, People's Republic of China
| | - Xiongjie Zhai
- Longde County Center for Disease Control and Prevention, Guyuan City, Ningxia Hui Autonomous Region, People's Republic of China
| | - Benhua Zhao
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, School of Public Health, Xiamen University, Xiamen City, People's Republic of China
| | - Yanhua Su
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, School of Public Health, Xiamen University, Xiamen City, People's Republic of China
| | - Yong Chen
- Department of Stomatology, School of Medicine, Xiamen University People's Republic of China
| | | | - Jing-An Cui
- Department of Mathematics, School of Science, Beijing University of Civil Engineering and Architecture, Beijing, 102616, People's Republic of China
| | | | - Tianmu Chen
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, School of Public Health, Xiamen University, Xiamen City, People's Republic of China
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12
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Sobur MA, Islam MS, Haque ZF, Orubu ESF, Toniolo A, Choudhury MA, Rahman MT. Higher seasonal temperature enhances the occurrence of methicillin resistance of Staphylococcus aureus in house flies (Musca domestica) under hospital and environmental settings. Folia Microbiol (Praha) 2021; 67:109-119. [PMID: 34569031 DOI: 10.1007/s12223-021-00922-9] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2021] [Accepted: 09/17/2021] [Indexed: 11/27/2022]
Abstract
Antimicrobial resistance (AMR) emergence in commensal and pathogenic bacteria is a global health issue. House flies (Musca domestica) are considered as biological and mechanical vectors for pathogens causing nosocomial infections, including methicillin-resistant Staphylococcus aureus (MRSA). However, the prevalence of antimicrobial resistance and the role of temperature on the occurrence of Staphylococcus aureus and MRSA in house flies in a hospital environment have not been studied. A total of 400 house flies were collected in winter and summer from four hospital-associated areas in Mymensingh, Bangladesh. Detection of S. aureus and MRSA in flies was done by culturing, staining, and PCR methods targeting nuc and mec genes (mecA and mecC), respectively. Disc diffusion test was used to detect resistance phenotype against six antimicrobials. Logistic regression models were constructed to assess the effect of temperature on the frequency of antimicrobial resistance, and on the presence of the nuc and mecA genes, and location of samples in and around a hospital environment. By PCR, S. aureus was detected in 208 (52%) samples. High frequencies of resistance (≥ 80% of isolates) to amoxicillin, azithromycin, and oxacillin were observed by disk diffusion test. Increase in temperature had a positive effect on the occurrence of S. aureus and MRSA isolates as well as on their resistance to individual and multiple antimicrobials. Among the study areas, hospital premises had increased odds of having S. aureus. Increased temperature of summer significantly increased the occurrence of MRSA in house flies in and around the hospital environment, which might pose a human and animal health risk.
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Affiliation(s)
- Md Abdus Sobur
- Department of Microbiology and Hygiene, Faculty of Veterinary Science, Bangladesh Agricultural University, Mymensingh, 2202, Bangladesh
| | - Md Saiful Islam
- Department of Microbiology and Hygiene, Faculty of Veterinary Science, Bangladesh Agricultural University, Mymensingh, 2202, Bangladesh
| | - Zobayda Farzana Haque
- Department of Microbiology and Hygiene, Faculty of Veterinary Science, Bangladesh Agricultural University, Mymensingh, 2202, Bangladesh
| | - Ebiowei Samuel F Orubu
- Institute for Health System Innovation and Policy, Boston University, 180 Riverway, Boston, MA, 02215, USA
| | - Antonio Toniolo
- Global Virus Network, University of Insubria, 21100, Varese, Italy
| | - Md Abu Choudhury
- Menzies Health Institute Queensland, Griffith University, 170 Kessels Road, Nathan, Queensland, 4111, Australia
| | - Md Tanvir Rahman
- Department of Microbiology and Hygiene, Faculty of Veterinary Science, Bangladesh Agricultural University, Mymensingh, 2202, Bangladesh.
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13
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Taneja N, Tiewsoh JBA, Gupta S, Mohan B, Verma R, Shankar P, Narayan C, Yadav VK, Jayashree M, Singh S. Antimicrobial resistance in Shigella species: Our five years (2015-2019) experience in a tertiary care center in north India. Indian J Med Microbiol 2021; 39:489-494. [PMID: 34148675 DOI: 10.1016/j.ijmmb.2021.06.002] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2021] [Revised: 06/02/2021] [Accepted: 06/04/2021] [Indexed: 11/19/2022]
Abstract
PURPOSE Shigella is the second leading cause of diarrhoeal mortality especially in children <5 years of age in African and Asian countries. Rapid changes are occurring in the epidemiology of shigellosis and Shigella are increasingly becoming highly drug resistant. To determine the serogroup distribution and antimicrobial resistance of Shigella isolated at our tertiary care centre in North India. METHODS A retrospective study was conducted where demographic details along with antimicrobial susceptibility data of Shigella isolated from stool specimens from 1st January 2015 till 31st December 2019 were retrieved from records and analyzed by WHONET 2019 software. RESULTS Shigella species was isolated in 1.31% (n = 137) of a total of 10,456 stool samples. Males predominated (n = 82; 59.8%) and majority of cases were admitted (n = 94; 68.6%). Children ≤5 years of age (n = 47; 34.3%) were the most commonly affected. Adults in the 21-40 age group contributed 27% of cases (n = 37). Overall, Shigella flexneri (n = 87; 63.5%) was the most common serogroup followed by non-agglutinable Shigella (n = 28; 20.4%) while Shigella sonnei (n = 12, 8.8%) and Shigella boydii (n = 9, 6.6%) fluctuated over the years. Shigella dysenteriae reappeared in 2019 after a hiatus of ten years. Overall, 45.3% (n = 62) of isolates were multidrug resistant to CLSI recommended drugs and high resistance was noted for ampicillin/amoxicillin (68.1%), cotrimoxazole (75.8%) ciprofloxacin (61.5%) and ceftriaxone/cefotaxime (45.2%). CONCLUSIONS Shigella have become highly drug resistant to fluoroquinolones and cephalosporins. Community based studies are required to truly assess the burden of AMR in India.
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Affiliation(s)
- Neelam Taneja
- Department of Medical Microbiology, Postgraduate Institute of Medical Education and Research, 160012, India.
| | - Jutang Babat Ain Tiewsoh
- Department of Medical Microbiology, Postgraduate Institute of Medical Education and Research, 160012, India.
| | - Swati Gupta
- Department of Medical Microbiology, Postgraduate Institute of Medical Education and Research, 160012, India.
| | - Balvinder Mohan
- Department of Medical Microbiology, Postgraduate Institute of Medical Education and Research, 160012, India.
| | - Ritu Verma
- Department of Medical Microbiology, Postgraduate Institute of Medical Education and Research, 160012, India.
| | - Pinky Shankar
- Department of Medical Microbiology, Postgraduate Institute of Medical Education and Research, 160012, India.
| | - Chandradeo Narayan
- Department of Medical Microbiology, Postgraduate Institute of Medical Education and Research, 160012, India.
| | - Vivek Kumar Yadav
- Department of Medical Microbiology, Postgraduate Institute of Medical Education and Research, 160012, India.
| | - Muralidharan Jayashree
- Division of Pediatric Emergency and Intensive Care, Department of Pediatrics, Advanced Pediatrics Centre, Postgraduate Institute of Medical Education and Research, 160012, India.
| | - Surjit Singh
- Division of Pediatric Allergy & Immunology, Head of Department, Department of Pediatrics, Advanced Pediatrics Centre, Postgraduate Institute of Medical Education and Research, 160012, India.
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14
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Gwenzi W, Chaukura N, Muisa-Zikali N, Teta C, Musvuugwa T, Rzymski P, Abia ALK. Insects, Rodents, and Pets as Reservoirs, Vectors, and Sentinels of Antimicrobial Resistance. Antibiotics (Basel) 2021; 10:antibiotics10010068. [PMID: 33445633 PMCID: PMC7826649 DOI: 10.3390/antibiotics10010068] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2020] [Revised: 01/07/2021] [Accepted: 01/08/2021] [Indexed: 12/22/2022] Open
Abstract
This paper reviews the occurrence of antimicrobial resistance (AMR) in insects, rodents, and pets. Insects (e.g., houseflies, cockroaches), rodents (rats, mice), and pets (dogs, cats) act as reservoirs of AMR for first-line and last-resort antimicrobial agents. AMR proliferates in insects, rodents, and pets, and their skin and gut systems. Subsequently, insects, rodents, and pets act as vectors that disseminate AMR to humans via direct contact, human food contamination, and horizontal gene transfer. Thus, insects, rodents, and pets might act as sentinels or bioindicators of AMR. Human health risks are discussed, including those unique to low-income countries. Current evidence on human health risks is largely inferential and based on qualitative data, but comprehensive statistics based on quantitative microbial risk assessment (QMRA) are still lacking. Hence, tracing human health risks of AMR to insects, rodents, and pets, remains a challenge. To safeguard human health, mitigation measures are proposed, based on the one-health approach. Future research should include human health risk analysis using QMRA, and the application of in-silico techniques, genomics, network analysis, and ’big data’ analytical tools to understand the role of household insects, rodents, and pets in the persistence, circulation, and health risks of AMR.
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Affiliation(s)
- Willis Gwenzi
- Biosystems and Environmental Engineering Research Group, Department of Agricultural and Biosystems Engineering, University of Zimbabwe, Mount. Pleasant, Harare P.O. Box MP167, Zimbabwe
- Correspondence: or (W.G.); or (A.L.K.A.)
| | - Nhamo Chaukura
- Department of Physical and Earth Sciences, Sol Plaatje University, Kimberley 8300, South Africa;
| | - Norah Muisa-Zikali
- Department of Environmental Sciences and Technology, School of Agricultural Sciences and Technology, Chinhoyi University of Technology, Private Bag, Chinhoyi 7724, Zimbabwe; or
| | - Charles Teta
- Future Water Institute, Faculty of Engineering & Built Environment, University of Cape Town, Cape Town 7700, South Africa;
| | - Tendai Musvuugwa
- Department of Biological and Agricultural Sciences, Sol Plaatje University, Kimberley 8300, South Africa;
| | - Piotr Rzymski
- Department of Environmental Medicine, Poznan University of Medical Sciences, 60-806 Poznan, Poland;
- Integrated Science Association (ISA), Universal Scientific Education and Research Network (USERN), 60-806 Poznań, Poland
| | - Akebe Luther King Abia
- Antimicrobial Research Unit, College of Health Sciences, University of KwaZulu-Natal, Private Bag X54001, Durban 4000, South Africa
- Correspondence: or (W.G.); or (A.L.K.A.)
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15
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Poudel A, Kang Y, Mandal RK, Kalalah A, Butaye P, Hathcock T, Kelly P, Walz P, Macklin K, Cattley R, Price S, Adekanmbi F, Zhang L, Kitchens S, Kaltenboeck B, Wang C. Comparison of microbiota, antimicrobial resistance genes and mobile genetic elements in flies and the feces of sympatric animals. FEMS Microbiol Ecol 2020; 96:5762668. [PMID: 32105329 DOI: 10.1093/femsec/fiaa027] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2019] [Accepted: 02/25/2020] [Indexed: 11/14/2022] Open
Abstract
Flies are well-known vectors of bacterial pathogens, but there are little data on their role in spreading microbial community and antimicrobial resistance. In this study, we compared the bacterial community, antimicrobial resistance genes (ARGs) and mobile genetic elements (MGEs) in flies with those in the feces of sympatric animals. A 16S rRNA-based microbial analysis identified 23 bacterial phyla in fecal samples and 25 phyla in flies; all the phyla identified in the fecal samples were also found in the flies. Bray-Curtis dissimilarity analysis showed that the microbiota of the flies were more similar to the microbiota of the feces of their sympatric animals than those of the feces from the three other animal species studied. The qPCR array amplified 276 ARGs/MGEs in fecal samples, and 216 ARGs/MGEs in the flies, while 198 of these genes were identified in both flies and feces. Long-term studies with larger sample numbers from more geospatially distinct populations and infection trials are indicated to further evaluate the possibility of flies as sentinels for antimicrobial resistance.
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Affiliation(s)
- Anil Poudel
- Department of Pathobiology, College of Veterinary Medicine, Auburn University, AL36849, Auburn, AL, USA
| | - Yuan Kang
- Department of Pathobiology, College of Veterinary Medicine, Auburn University, AL36849, Auburn, AL, USA
| | - Rabindra K Mandal
- Ryan White Center for Pediatric Infectious Diseases and Global Health, Department of Pediatrics, Indiana University School of Medicine, Indianapolis, IN 46202, USA
| | - Anwar Kalalah
- Department of Pathobiology, College of Veterinary Medicine, Auburn University, AL36849, Auburn, AL, USA
| | - Patrick Butaye
- Department of Biosciences, Ross University School of Veterinary Medicine; 00265, Basseterre, St Kitts, West Indies.,Department of Pathology, Bacteriology and Poultry Diseases, Faculty of Veterinary Medicine, Ghent University; B-9000 Ghent, Ghent, Belgium
| | - Terri Hathcock
- Department of Pathobiology, College of Veterinary Medicine, Auburn University, AL36849, Auburn, AL, USA
| | - Patrick Kelly
- Department of Biosciences, Ross University School of Veterinary Medicine; 00265, Basseterre, St Kitts, West Indies
| | - Paul Walz
- Department of Pathobiology, College of Veterinary Medicine, Auburn University, AL36849, Auburn, AL, USA
| | - Kenneth Macklin
- Department of Poultry Science, College of Agriculture, Auburn University; AL, 36830, Auburn, AL, USA
| | - Russell Cattley
- Department of Pathobiology, College of Veterinary Medicine, Auburn University, AL36849, Auburn, AL, USA
| | - Stuart Price
- Department of Pathobiology, College of Veterinary Medicine, Auburn University, AL36849, Auburn, AL, USA
| | - Folasade Adekanmbi
- Department of Pathobiology, College of Veterinary Medicine, Auburn University, AL36849, Auburn, AL, USA
| | - Lixin Zhang
- Department of Epidemiology and Biostatistics, Michigan State University, East Lansing, MI 48824, USA
| | - Steven Kitchens
- Department of Pathobiology, College of Veterinary Medicine, Auburn University, AL36849, Auburn, AL, USA
| | - Bernhard Kaltenboeck
- Department of Pathobiology, College of Veterinary Medicine, Auburn University, AL36849, Auburn, AL, USA
| | - Chengming Wang
- Department of Pathobiology, College of Veterinary Medicine, Auburn University, AL36849, Auburn, AL, USA
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16
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González-Fernández D, Mazzini Salom AS, Herrera Bendezu F, Huamán S, Rojas Hernández B, Pevec I, Galarza Izquierdo EM, Armstrong N, Thomas V, Vela Gonzáles S, Gonzáles Saravia C, Scott ME, Koski KG. A Multi-Sectoral Approach Improves Early Child Development in a Disadvantaged Community in Peru: Role of Community Gardens, Nutrition Workshops and Enhanced Caregiver-Child Interaction: Project "Wawa Illari". Front Public Health 2020; 8:567900. [PMID: 33240834 PMCID: PMC7681241 DOI: 10.3389/fpubh.2020.567900] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2020] [Accepted: 10/06/2020] [Indexed: 11/13/2022] Open
Abstract
Background: Multi-dimensional monitoring evaluation and learning strategies are needed to address the complex set of factors that affect early child development in marginalized populations, but few studies have explored their effectiveness. Objective: To compare improvement of health and development of children 0–3 years between intervention communities (IC) and control communities (CC) from peripheral settlements of Lima. Sequential interventions included: (1) home and community gardens, (2) conscious nutrition, and (3) parenting workshops following the International Child Development Program (ICDP). Methods: Interventions were delivered by community health promoters (CHPs) using a “step-by-step” learning system. Both IC and CC were monitored before the interventions began, at 8 and 12 months (n = 113 IC and 127 CC children). Data were collected on household characteristics, diet, food security, health indicators (history of diarrhea and respiratory infections, hemoglobin, intestinal parasites, anthropometry), caregiver-child interactions and stress, and achievement of Pan-American Health Organization age-specific developmental milestones. Stepwise multiple logistic regressions were used to determine if the interventions affected food insecurity, as well as motor, social/cognitive and language delays. Results: At baseline, 2.6% were categorized as “suspected developmental delay” and 14.2% were on “alert for development delay.” Food insecurity, diarrhea and respiratory infections were lowered following the interventions. Through the “step-by-step” approach, caregivers in IC gained skills in gardening, conscious nutrition and parenting that reduced the risk of food insecurity [Adjusted Risk Ratio = 0.20 (95% CI: 0.08–0.51)] and language delay [0.39 (0.19–0.82)] but not motor or social/cognitive delay. Use of a multiple micronutrient supplement decreased the risk of motor delay [0.12 (0.03–0.56)], but more pets were associated with higher risk of motor [3.24 (1.47–7.14)] and social/cognitive delay [2.72 (1.33–5.55)], and of food insecurity [1.73 (1.13–2.66)]. Conclusion: The combined interventions delivered by CHPs helped to mitigate the impact of adversity on food insecurity and language delay. Additional improvements may have been detected if the interventions had continued for a longer time. Our results indicate that control of infections and pets may be needed to achieve measurable results for motor and social/cognitive development. Continuous monitoring facilitated adjusting implementation strategies and achieving positive developmental outcomes.
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Affiliation(s)
| | | | | | - Sonia Huamán
- Pachacámac Health Center, Ministry of Health, Lima, Peru
| | - Bertha Rojas Hernández
- Laboratory School, Faculty of Medical Technology, Federico Villarreal National University, Lima, Peru
| | - Illène Pevec
- Community Engagement, Design and Research Center (CEDaR), University of Colorado, Boulder, CO, United States
| | | | | | - Virginia Thomas
- Susila Dharma International Association, Greenfield Park, QC, Canada
| | | | - Carlos Gonzáles Saravia
- Dermatology Service, Department of Medicine, National Institute for Children's Health (INSN), Lima, Peru
| | - Marilyn E Scott
- Institute of Parasitology, McGill University, Sainte Anne de Bellevue, QC, Canada
| | - Kristine G Koski
- School of Human Nutrition, McGill University, Sainte Anne de Bellevue, QC, Canada
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Abstract
Enteric viral and bacterial infections continue to be a leading cause of mortality and morbidity in young children in low-income and middle-income countries, the elderly, and immunocompromised individuals. Vaccines are considered an effective and practical preventive approach against the predominantly fecal-to-oral transmitted gastroenteritis particularly in the resource-limited countries or regions where implementation of sanitation systems and supply of safe drinking water are not quickly achievable. While vaccines are available for a few enteric pathogens including rotavirus and cholera, there are no vaccines licensed for many other enteric viral and bacterial pathogens. Challenges in enteric vaccine development include immunological heterogeneity among pathogen strains or isolates, a lack of animal challenge models to evaluate vaccine candidacy, undefined host immune correlates to protection, and a low protective efficacy among young children in endemic regions. In this article, we briefly updated the progress and challenges in vaccines and vaccine development for the leading enteric viral and bacterial pathogens including rotavirus, human calicivirus, Shigella, enterotoxigenic Escherichia coli (ETEC), cholera, nontyphoidal Salmonella, and Campylobacter, and introduced a novel epitope- and structure-based vaccinology platform known as MEFA (multiepitope fusion antigen) and the application of MEFA for developing broadly protective multivalent vaccines against heterogenous pathogens.
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Affiliation(s)
- Hyesuk Seo
- University of Illinois at Urbana-Champaign, Department of Pathobiology, Urbana, Illinois, USA
| | - Qiangde Duan
- University of Yangzhou, Institute of Comparative Medicine, Yangzhou, PR China
| | - Weiping Zhang
- University of Illinois at Urbana-Champaign, Department of Pathobiology, Urbana, Illinois, USA,CONTACT Weiping Zhang, University of Illinois at Urbana-Champaign, Department of Pathobiology, Urbana, Illinois, USA
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18
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Rui J, Chen Q, Chen Q, Hu Q, Hannah MN, Zhao Z, Wang Y, Liu X, Lei Z, Yu S, Chiang YC, Zhao B, Su Y, Zhao B, Chen T. Feasibility of containing shigellosis in Hubei Province, China: a modelling study. BMC Infect Dis 2020; 20:643. [PMID: 32873241 PMCID: PMC7461149 DOI: 10.1186/s12879-020-05353-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2019] [Accepted: 08/17/2020] [Indexed: 12/14/2022] Open
Abstract
Background The transmission features and the feasibility of containing shigellosis remain unclear among a population-based study in China. Methods A population–based Susceptible – Exposed – Infectious / Asymptomatic – Recovered (SEIAR) model was built including decreasing the infectious period (DIP) or isolation of shigellosis cases. We analyzed the distribution of the reported shigellosis cases in Hubei Province, China from January 2005 to December 2017, and divided the time series into several stages according to the heterogeneity of reported incidence during the period. In each stage, an epidemic season was selected for the modelling and assessing the effectiveness of DIP and case isolation. Results A total of 130,770 shigellosis cases were reported in Hubei Province. The median of Reff was 1.13 (range: 0.86–1.21), 1.10 (range: 0.91–1.13), 1.09 (range: 0.92–1.92), and 1.03 (range: 0.94–1.22) in 2005–2006 season, 2010–2011 season, 2013–2014 season, and 2016–2017 season, respectively. The reported incidence decreased significantly (trend χ2 = 8260.41, P < 0.001) among four stages. The incidence of shigellosis decreased sharply when DIP implemented in three scenarios (γ = 0.1, 0.1429, 0.3333) and when proportion of case isolation increased. Conclusions Year heterogeneity of reported shigellosis incidence exists in Hubei Province. It is feasible to contain the transmission by implementing DIP and case isolation.
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Affiliation(s)
- Jia Rui
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, School of Public Health, Xiamen University, 4221-117 South Xiang'an Road, Xiang'an District, Xiamen City, Fujian Province, People's Republic of China
| | - Qi Chen
- Hubei Provincial Center for Disease Control and Prevention, Wuhan City, Hubei Province, People's Republic of China
| | - Qiuping Chen
- Medical Insurance Office, Xiang'an Hospital of Xiamen University, Xiamen City, Fujian Province, People's Republic of China
| | - Qingqing Hu
- Division of Public Health, School of Medicine, University of Utah, 201 Presidents Circle, Salt Lake City, UT, 84112, USA
| | - Mikah Ngwanguong Hannah
- Medical College, Xiamen University, Xiamen City, Fujian Province, People's Republic of China
| | - Zeyu Zhao
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, School of Public Health, Xiamen University, 4221-117 South Xiang'an Road, Xiang'an District, Xiamen City, Fujian Province, People's Republic of China
| | - Yao Wang
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, School of Public Health, Xiamen University, 4221-117 South Xiang'an Road, Xiang'an District, Xiamen City, Fujian Province, People's Republic of China
| | - Xingchun Liu
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, School of Public Health, Xiamen University, 4221-117 South Xiang'an Road, Xiang'an District, Xiamen City, Fujian Province, People's Republic of China
| | - Zhao Lei
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, School of Public Health, Xiamen University, 4221-117 South Xiang'an Road, Xiang'an District, Xiamen City, Fujian Province, People's Republic of China
| | - Shanshan Yu
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, School of Public Health, Xiamen University, 4221-117 South Xiang'an Road, Xiang'an District, Xiamen City, Fujian Province, People's Republic of China
| | - Yi-Chen Chiang
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, School of Public Health, Xiamen University, 4221-117 South Xiang'an Road, Xiang'an District, Xiamen City, Fujian Province, People's Republic of China
| | - Benhua Zhao
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, School of Public Health, Xiamen University, 4221-117 South Xiang'an Road, Xiang'an District, Xiamen City, Fujian Province, People's Republic of China
| | - Yanhua Su
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, School of Public Health, Xiamen University, 4221-117 South Xiang'an Road, Xiang'an District, Xiamen City, Fujian Province, People's Republic of China
| | - Bin Zhao
- Laboratory Department, Xiang'an Hospital of Xiamen University, State Key Laboratory of Molecular Vaccinology and Molecular Diagnosis, Xiamen City, Fujian Province, People's Republic of China
| | - Tianmu Chen
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, School of Public Health, Xiamen University, 4221-117 South Xiang'an Road, Xiang'an District, Xiamen City, Fujian Province, People's Republic of China.
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Rogawski McQuade ET, Shaheen F, Kabir F, Rizvi A, Platts-Mills JA, Aziz F, Kalam A, Qureshi S, Elwood S, Liu J, Lima AAM, Kang G, Bessong P, Samie A, Haque R, Mduma ER, Kosek MN, Shrestha S, Leite JP, Bodhidatta L, Page N, Kiwelu I, Shakoor S, Turab A, Soofi SB, Ahmed T, Houpt ER, Bhutta Z, Iqbal NT. Epidemiology of Shigella infections and diarrhea in the first two years of life using culture-independent diagnostics in 8 low-resource settings. PLoS Negl Trop Dis 2020; 14:e0008536. [PMID: 32804926 PMCID: PMC7451981 DOI: 10.1371/journal.pntd.0008536] [Citation(s) in RCA: 45] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2019] [Revised: 08/27/2020] [Accepted: 06/29/2020] [Indexed: 02/06/2023] Open
Abstract
Culture-independent diagnostics have revealed a larger burden of Shigella among children in low-resource settings than previously recognized. We further characterized the epidemiology of Shigella in the first two years of life in a multisite birth cohort. We tested 41,405 diarrheal and monthly non-diarrheal stools from 1,715 children for Shigella by quantitative PCR. To assess risk factors, clinical factors related to age and culture positivity, and associations with inflammatory biomarkers, we used log-binomial regression with generalized estimating equations. The prevalence of Shigella varied from 4.9%-17.8% in non-diarrheal stools across sites, and the incidence of Shigella-attributable diarrhea was 31.8 cases (95% CI: 29.6, 34.2) per 100 child-years. The sensitivity of culture compared to qPCR was 6.6% and increased to 27.8% in Shigella-attributable dysentery. Shigella diarrhea episodes were more likely to be severe and less likely to be culture positive in younger children. Older age (RR: 1.75, 95% CI: 1.70, 1.81 per 6-month increase in age), unimproved sanitation (RR: 1.15, 95% CI: 1.03, 1.29), low maternal education (<10 years, RR: 1.14, 95% CI: 1.03, 1.26), initiating complementary foods before 3 months (RR: 1.10, 95% CI: 1.01, 1.20), and malnutrition (RR: 0.91, 95% CI: 0.88, 0.95 per unit increase in weight-for-age z-score) were risk factors for Shigella. There was a linear dose-response between Shigella quantity and myeloperoxidase concentrations. The burden of Shigella varied widely across sites, but uniformly increased through the second year of life and was associated with intestinal inflammation. Culture missed most clinically relevant cases of severe diarrhea and dysentery. Shigella is the second leading cause of diarrhea morbidity and mortality among children in low and middle-income countries. We characterized the epidemiology of Shigella using highly sensitive diagnostic methods in 41,405 diarrheal and monthly non-diarrheal stools from the first two years of life in a multisite birth cohort. The prevalence of Shigella varied from 4.9%-17.8% across sites, and the incidence of Shigella-attributable diarrhea was 31.8 cases (95% CI: 29.6, 34.2) per 100 child-years. Shigella diarrhea episodes were more likely to be severe and less likely to be culture positive in younger children. Older age, unimproved sanitation, low maternal education, initiating complementary foods before 3 months, and malnutrition were risk factors for Shigella. There was a linear dose-response between Shigella quantity and myeloperoxidase, a marker of intestinal inflammation, which suggests a potential mechanism for the impact of Shigella on child growth. Because culture missed most clinically relevant cases of severe diarrhea and dysentery, molecular diagnostics may be important tools in upcoming Shigella vaccine trials.
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Affiliation(s)
- Elizabeth T. Rogawski McQuade
- Department of Public Health Sciences, University of Virginia, Charlottesville, Virginia, United States of America
- Division of Infectious Diseases & International Health, University of Virginia, Charlottesville, Virginia, United States of America
- * E-mail: (ETRM); (NTI)
| | - Fariha Shaheen
- Department of Pediatrics and Child Health, Aga Khan University, Karachi, Pakistan
| | - Furqan Kabir
- Department of Pediatrics and Child Health, Aga Khan University, Karachi, Pakistan
| | - Arjumand Rizvi
- Department of Pediatrics and Child Health, Aga Khan University, Karachi, Pakistan
| | - James A. Platts-Mills
- Division of Infectious Diseases & International Health, University of Virginia, Charlottesville, Virginia, United States of America
| | - Fatima Aziz
- Department of Pediatrics and Child Health, Aga Khan University, Karachi, Pakistan
| | - Adil Kalam
- Department of Pediatrics and Child Health, Aga Khan University, Karachi, Pakistan
| | - Shahida Qureshi
- Department of Pediatrics and Child Health, Aga Khan University, Karachi, Pakistan
| | - Sarah Elwood
- Division of Infectious Diseases & International Health, University of Virginia, Charlottesville, Virginia, United States of America
| | - Jie Liu
- Division of Infectious Diseases & International Health, University of Virginia, Charlottesville, Virginia, United States of America
| | | | | | | | | | - Rashidul Haque
- International Centre for Diarrheal Disease Research, Bangladesh, Dhaka, Bangladesh
| | | | - Margaret N. Kosek
- Division of Infectious Diseases & International Health, University of Virginia, Charlottesville, Virginia, United States of America
- Asociación Benéfica PRISMA, Iquitos, Peru
| | | | | | - Ladaporn Bodhidatta
- Armed Forces Research Institute of Medical Sciences (AFRIMS), Bangkok, Thailand
| | - Nicola Page
- National Institute for Communicable Diseases, Johannesburg, South Africa
| | - Ireen Kiwelu
- Kilimanjaro Clinical Research Institute, Moshi, Tanzania
| | - Sadia Shakoor
- Department of Pathology and Laboratory Medicine, Aga Khan University, Karachi, Pakistan
| | - Ali Turab
- Department of Pediatrics and Child Health, Aga Khan University, Karachi, Pakistan
| | - Sajid Bashir Soofi
- Department of Pediatrics and Child Health, Aga Khan University, Karachi, Pakistan
| | - Tahmeed Ahmed
- International Centre for Diarrheal Disease Research, Bangladesh, Dhaka, Bangladesh
| | - Eric R. Houpt
- Division of Infectious Diseases & International Health, University of Virginia, Charlottesville, Virginia, United States of America
| | - Zulfiqar Bhutta
- Department of Pediatrics and Child Health, Aga Khan University, Karachi, Pakistan
| | - Najeeha Talat Iqbal
- Department of Pediatrics and Child Health and Biological & Biomedical Sciences, Aga Khan University, Karachi, Pakistan
- * E-mail: (ETRM); (NTI)
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da Cruz Gouveia MA, Lins MTC, da Silva GAP. Acute diarrhea with blood: diagnosis and drug treatment. JORNAL DE PEDIATRIA (VERSÃO EM PORTUGUÊS) 2020. [DOI: 10.1016/j.jpedp.2019.08.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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da Cruz Gouveia MA, Lins MTC, da Silva GAP. Acute diarrhea with blood: diagnosis and drug treatment. J Pediatr (Rio J) 2020; 96 Suppl 1:20-28. [PMID: 31604059 PMCID: PMC9432323 DOI: 10.1016/j.jped.2019.08.006] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2019] [Accepted: 08/14/2019] [Indexed: 10/29/2022] Open
Abstract
OBJECTIVE To restate the epidemiological importance of Shigella in acute diarrhea with blood, providing an overview of the treatment and stressing the need for the correct indication of antibiotic therapy. SOURCES OF DATA A search was carried out in the Medline and Scopus databases, in addition to the World Health Organization scientific documents and guidelines, identifying review articles and original articles considered relevant to substantiate the narrative review. SYNTHESIS OF DATA Different pathogens have been associated with acute diarrhea with blood; Shigella was the most frequently identified. The manifestations of shigellosis in healthy individuals are usually of moderate intensity and disappear within a few days. There may be progression to overt dysentery with blood and mucus, lower abdominal pain, and tenesmus. Conventional bacterial stool culture is the gold standard for the etiological diagnosis; however, new molecular tests have been developed to allow the physician to initiate targeted antibacterial treatment, addressing a major current concern caused by the increasing resistance of Shigella. Prevention strategies include breastfeeding, hygiene measures, health education, water treatment, and the potential use of vaccines. CONCLUSIONS Acute diarrhea is an important cause of mortality in children under 5 years and shigellosis is the leading cause of acute diarrhea with blood worldwide. The current concern is the increase in microbial resistance to the recommended antibiotics, which brings an additional difficulty to therapeutic management. Although no vaccine is yet available against Shigella, several candidates are undergoing clinical trials, and this may be the most cost-effective preventative measure in future.
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Affiliation(s)
- Mara Alves da Cruz Gouveia
- Universidade Federal de Pernambuco (UFPE), Saúde da Criança e do Adolescente, Recife, PE, Brazil; Universidade Federal de Pernambuco (UFPE), Centro de Ciências Médicas, Pediatria, Recife, PE, Brazil
| | - Manuela Torres Camara Lins
- Universidade Federal de Pernambuco (UFPE), Saúde da Criança e do Adolescente, Recife, PE, Brazil; Universidade Federal de Pernambuco (UFPE), Centro de Ciências Médicas, Pediatria, Recife, PE, Brazil
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Akter S, Sabuj AAM, Haque ZF, Kafi MA, Rahman MT, Saha S. Detection of antibiotic-resistant bacteria and their resistance genes from houseflies. Vet World 2020; 13:266-274. [PMID: 32255968 PMCID: PMC7096309 DOI: 10.14202/vetworld.2020.266-274] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2019] [Accepted: 12/27/2019] [Indexed: 12/13/2022] Open
Abstract
Background and Aim: Houseflies (Musca domestica) are synanthropic insects which serve as biological or mechanical vectors for spreading multidrug-resistant bacteria responsible for many infectious diseases. This study aimed to detect antibiotic-resistant bacteria from houseflies, and to examine their resistance genes. Materials and Methods: A total of 140 houseflies were captured using sterile nylon net from seven places of Mymensingh city, Bangladesh. Immediately after collection, flies were transferred to a sterile zipper bag and brought to microbiology laboratory within 1 h. Three bacterial species were isolated from houseflies, based on cultural and molecular tests. After that, the isolates were subjected to antimicrobial susceptibility testing against commonly used antibiotics, by the disk diffusion method. Finally, the detection of antibiotic resistance genes tetA, tetB, mcr-3, mecA, and mecC was performed by a polymerase chain reaction. Results: The most common isolates were Staphylococcus aureus (78.6%), Salmonella spp., (66.4%), and Escherichia coli (51.4%). These species of bacteria were recovered from 78.3% of isolates from the Mymensingh Medical College Hospital areas. Most of the isolates of the three bacterial species were resistant to erythromycin, tetracycline, penicillin and amoxicillin and were sensitive to ciprofloxacin, ceftriaxone, chloramphenicol, gentamicin, and azithromycin. Five antibiotic resistance genes of three bacteria were detected: tetA, tetB, mcr-3, and mecA were found in 37%, 20%, 20%, and 14% isolates, respectively, and no isolates were positive for mecC gene. Conclusion: S. aureus, Salmonella spp., and E. coli with genetically-mediated multiple antibiotic resistance are carried in houseflies in the Mymensingh region. Flies may, therefore, represent an important means of transmission of these antibiotic-resistant bacteria, with consequent risks to human and animal health.
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Affiliation(s)
- Sharmin Akter
- Department of Microbiology and Hygiene, Faculty of Veterinary Science, Bangladesh Agricultural University, Mymensingh-2202, Bangladesh
| | - Abdullah Al Momen Sabuj
- Department of Microbiology and Hygiene, Faculty of Veterinary Science, Bangladesh Agricultural University, Mymensingh-2202, Bangladesh
| | - Zobayda Farzana Haque
- Department of Microbiology and Hygiene, Faculty of Veterinary Science, Bangladesh Agricultural University, Mymensingh-2202, Bangladesh
| | - Md Abdul Kafi
- Department of Microbiology and Hygiene, Faculty of Veterinary Science, Bangladesh Agricultural University, Mymensingh-2202, Bangladesh
| | - Md Tanvir Rahman
- Department of Microbiology and Hygiene, Faculty of Veterinary Science, Bangladesh Agricultural University, Mymensingh-2202, Bangladesh
| | - Sukumar Saha
- Department of Microbiology and Hygiene, Faculty of Veterinary Science, Bangladesh Agricultural University, Mymensingh-2202, Bangladesh
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Nisa I, Qasim M, Yasin N, Ullah R, Ali A. Shigella flexneri: an emerging pathogen. Folia Microbiol (Praha) 2020; 65:275-291. [PMID: 32026288 DOI: 10.1007/s12223-020-00773-w] [Citation(s) in RCA: 32] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2019] [Accepted: 01/16/2020] [Indexed: 12/19/2022]
Abstract
Shigella flexneri is a leading etiologic agent of diarrhea in low socioeconomic countries. Notably, various serotypes in S. flexneri are reported from different regions of the world. The precise approximations of illness and death owing to shigellosis are missing in low socioeconomic countries, although it is widespread in different regions. The inadequate statistics available reveal S. flexneri to be a significant food and waterborne pathogen. All over the world, different antibiotic-resistant strains of S. flexneri serotypes have been emerged especially multidrug-resistant strains. Recently, increased resistance was observed in cephalosporins (3rd generation), azithromycin, and fluoroquinolones. There is a need for a continuous surveillance study on antibiotic resistance that will be helpful in the update of the antibiogram. The shigellosis burden can be reduced by adopting preventive measures like delivery of safe drinking water, suitable sanitation, and development of an effective and inexpensive multivalent vaccine. This review attempts to provide the recent findings of S. flexneri related to epidemiology and the emergence of multidrug resistance.
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Affiliation(s)
- Iqbal Nisa
- Department of Microbiology, Kohat University of Science and Technology, Kohat, Pakistan.
| | - Muhammad Qasim
- Department of Microbiology, Kohat University of Science and Technology, Kohat, Pakistan
| | - Nusrat Yasin
- Department of Microbiology, Kohat University of Science and Technology, Kohat, Pakistan
| | - Rafi Ullah
- Bacteriology Laboratory Center of Microbiology and Bacteriology (CMB) Veterinary Research Institute, Peshawar, Pakistan
| | - Anwar Ali
- Bacteriology Laboratory Center of Microbiology and Bacteriology (CMB) Veterinary Research Institute, Peshawar, Pakistan
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Meng Q, Liu X, Xie J, Xiao D, Wang Y, Deng D. Epidemiological characteristics of bacillary dysentery from 2009 to 2016 and its incidence prediction model based on meteorological factors. Environ Health Prev Med 2019; 24:82. [PMID: 31883513 PMCID: PMC6935186 DOI: 10.1186/s12199-019-0829-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2019] [Accepted: 11/12/2019] [Indexed: 12/19/2022] Open
Abstract
Background This study aimed to analyse the epidemiological characteristics of bacillary dysentery (BD) caused by Shigella in Chongqing, China, and to establish incidence prediction models based on the correlation between meteorological factors and BD, thus providing a scientific basis for the prevention and control of BD. Methods In this study, descriptive methods were employed to investigate the epidemiological distribution of BD. The Boruta algorithm was used to estimate the correlation between meteorological factors and BD incidence. The genetic algorithm (GA) combined with support vector regression (SVR) was used to establish the prediction models for BD incidence. Results In total, 68,855 cases of BD were included. The incidence declined from 36.312/100,000 to 23.613/100,000, with an obvious seasonal peak from May to October. Males were more predisposed to the infection than females (the ratio was 1.118:1). Children < 5 years old comprised the highest incidence (295.892/100,000) among all age categories, and pre-education children comprised the highest proportion (34,658 cases, 50.335%) among all occupational categories. Eight important meteorological factors, including the highest temperature, average temperature, average air pressure, precipitation and sunshine, were correlated with the monthly incidence of BD. The obtained mean absolute percent error (MAPE), mean squared error (MSE) and squared correlation coefficient (R2) of GA_SVR_MONTH values were 0.087, 0.101 and 0.922, respectively. Conclusion From 2009 to 2016, BD incidence in Chongqing was still high, especially in the main urban areas and among the male and pre-education children populations. Eight meteorological factors, including temperature, air pressure, precipitation and sunshine, were the most important correlative feature sets of BD incidence. Moreover, BD incidence prediction models based on meteorological factors had better prediction accuracies. The findings in this study could provide a panorama of BD in Chongqing and offer a useful approach for predicting the incidence of infectious disease. Furthermore, this information could be used to improve current interventions and public health planning.
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Affiliation(s)
- Qiuyu Meng
- School of Public Health and Management, Research Center for Medicine and Social Development, Innovation Center for Social Risk Governance in Health, Chongqing Medical University, Chongqing, 400016, China
| | - Xun Liu
- Department of Healthcare-associated Infection Control, The Second Affiliated Hospital of Military Medical University, Chongqing, 400037, China
| | - Jiajia Xie
- School of Public Health and Management, Research Center for Medicine and Social Development, Innovation Center for Social Risk Governance in Health, Chongqing Medical University, Chongqing, 400016, China
| | - Dayong Xiao
- Institute for Prevention and Control of Endemic and Parasitic Diseases, Chongqing Center for Disease Control and Prevention, Chongqing, 400042, China
| | - Yi Wang
- School of Public Health and Management, Research Center for Medicine and Social Development, Innovation Center for Social Risk Governance in Health, Chongqing Medical University, Chongqing, 400016, China
| | - Dan Deng
- School of Public Health and Management, Research Center for Medicine and Social Development, Innovation Center for Social Risk Governance in Health, Chongqing Medical University, Chongqing, 400016, China.
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Hosangadi D, Smith PG, Giersing BK. Considerations for using ETEC and Shigella disease burden estimates to guide vaccine development strategy. Vaccine 2019; 37:7372-7380. [PMID: 29031690 PMCID: PMC6892262 DOI: 10.1016/j.vaccine.2017.09.083] [Citation(s) in RCA: 48] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2017] [Accepted: 09/26/2017] [Indexed: 01/09/2023]
Abstract
Enterotoxigenic E. coli (ETEC) and Shigella are enteropathogens causing significant global morbidity and mortality, particularly in low-income countries. No licensed vaccine exists for either pathogen, but candidates are in development, with the most advanced candidates potentially approaching pivotal efficacy testing within the next few years. A positive policy recommendation for introduction of any vaccine, following licensure, depends on evidence of vaccine cost-effectiveness and impact on morbidity and mortality. The mortality estimates for these two pathogens have fluctuated over recent years, which has led to uncertainty in the assessment of their relative public health importance for use in low and middle-income countries. This paper summarizes the various ETEC and Shigella disease burden estimates, based on a review of current literature and informal consultations with leading stakeholders in enteric disease modelling. We discuss the factors that underpin the variability, including differences in the modelling methodology; diagnostic tools used to ascertain diarrheal etiology; epidemiological setting; the data that are available to incorporate; and absolute changes in the total number of diarrheal deaths over time. We consider the further work that will strengthen the evidence needed to support future decision making with respect to recommendations on the relative utility of these vaccines.
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Affiliation(s)
- Divya Hosangadi
- Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA
| | - Peter G Smith
- MRC Tropical Epidemiology Group, London School of Hygiene & Tropical Medicine, London, UK
| | - Birgitte K Giersing
- Initiative for Vaccine Research, World Health Organization, CH-1211 Geneva 27, Switzerland.
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Herm R, Tummeleht L, Jürison M, Vilem A, Viltrop A. Trace amounts of African swine fever virus DNA detected in insects collected from an infected pig farm in Estonia. Vet Med Sci 2019; 6:100-104. [PMID: 31560174 PMCID: PMC7036316 DOI: 10.1002/vms3.200] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
Background African swine fever (ASF), a severe multi‐systemic disease in pigs, was introduced into Estonia in 2014. The majority of outbreaks have occurred during the summer months. Given that ASFV is transmitted in a sylvatic cycle that includes the transmission by African soft ticks and that mechanical transmission by flying insects was shown, transmission by other arthropod vectors need to be considered. Objectives Here, we report the results of a pilot study on flying insects caught on an outbreak farm during epidemiological investigations. Methods In brief, 15 different insect species (flies and mosquitoes) were collected by random catch using an aerial net. Nucleic acids derived from these samples or their pools were tested for African swine fever virus (ASFV) DNA by real‐time PCR. Results and Conclusions Viral DNA was detected in small quantities in two samples from flies and mosquitoes. Given the slow spread of virus within the farm, the impact of these findings seems rather low, but a role in local transmission cannot be ruled out. However, given the very low number of insects sampled, and taken into the account that viral isolation was not performed and insects outside the farm were not investigated, future investigations are needed to assess the true impact of insects as mechanical vectors.
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Affiliation(s)
- Reet Herm
- Equine Clinic, Chair of Clinical Veterinary Medicine, Estonian University of Life Sciences, Tartu, Estonia
| | - Lea Tummeleht
- Chair of Veterinary Bio- and Population Medicine, Estonian University of Life Sciences, Tartu, Estonia
| | - Margret Jürison
- Chair of Plant Health, Estonian University of Life Sciences, Tartu, Estonia
| | - Annika Vilem
- Department of Molecular Analysis, Veterinary and Food Laboratory, Tartu, Estonia
| | - Arvo Viltrop
- Chair of Veterinary Bio- and Population Medicine, Estonian University of Life Sciences, Tartu, Estonia
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Chao DL, Roose A, Roh M, Kotloff KL, Proctor JL. The seasonality of diarrheal pathogens: A retrospective study of seven sites over three years. PLoS Negl Trop Dis 2019; 13:e0007211. [PMID: 31415558 PMCID: PMC6711541 DOI: 10.1371/journal.pntd.0007211] [Citation(s) in RCA: 43] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2019] [Revised: 08/27/2019] [Accepted: 07/26/2019] [Indexed: 12/26/2022] Open
Abstract
BACKGROUND Pediatric diarrhea can be caused by a wide variety of pathogens, from bacteria to viruses to protozoa. Pathogen prevalence is often described as seasonal, peaking annually and associated with specific weather conditions. Although many studies have described the seasonality of diarrheal disease, these studies have occurred predominantly in temperate regions. In tropical and resource-constrained settings, where nearly all diarrhea-associated mortality occurs, the seasonality of many diarrheal pathogens has not been well characterized. As a retrospective study, we analyze the seasonal prevalence of diarrheal pathogens among children with moderate-to-severe diarrhea (MSD) over three years from the seven sites of the Global Enteric Multicenter Study (GEMS), a case-control study. Using data from this expansive study on diarrheal disease, we characterize the seasonality of different pathogens, their association with site-specific weather patterns, and consistency across study sites. METHODOLOGY/PRINCIPAL FINDINGS Using traditional methodologies from signal processing, we found that certain pathogens peaked at the same time every year, but not at all sites. We also found associations between pathogen prevalence and weather or "seasons," which are defined by applying modern machine-learning methodologies to site-specific weather data. In general, rotavirus was most prevalent during the drier "winter" months and out of phase with bacterial pathogens, which peaked during hotter and rainier times of year corresponding to "monsoon," "rainy," or "summer" seasons. CONCLUSIONS/SIGNIFICANCE Identifying the seasonally-dependent prevalence for diarrheal pathogens helps characterize the local epidemiology and inform the clinical diagnosis of symptomatic children. Our multi-site, multi-continent study indicates a complex epidemiology of pathogens that does not reveal an easy generalization that is consistent across all sites. Instead, our study indicates the necessity of local data to characterizing the epidemiology of diarrheal disease. Recognition of the local associations between weather conditions and pathogen prevalence suggests transmission pathways and could inform control strategies in these settings.
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Affiliation(s)
- Dennis L. Chao
- Institute for Disease Modeling, Bellevue, Washington, United States of America
- * E-mail:
| | - Anna Roose
- Center for Vaccine Development and Global Health, University of Maryland, Baltimore, Maryland, United States of America
| | - Min Roh
- Institute for Disease Modeling, Bellevue, Washington, United States of America
| | - Karen L. Kotloff
- Center for Vaccine Development and Global Health, University of Maryland, Baltimore, Maryland, United States of America
| | - Joshua L. Proctor
- Institute for Disease Modeling, Bellevue, Washington, United States of America
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Sobur A, Haque ZF, Sabuj AAM, Ievy S, Rahman AMMT, El Zowalaty ME, Rahman T. Molecular detection of multidrug and colistin-resistant Escherichia coli isolated from house flies in various environmental settings. Future Microbiol 2019; 14:847-858. [DOI: 10.2217/fmb-2019-0053] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
Aim: To detect antibiotic-resistant pathogenic Escherichia coli in house flies captured from various environmental settings. Materials & methods: Isolation and identification of E. coli was performed based on culture and PCR. Antimicrobial susceptibility testing was conducted using disk diffusion test. Detection of virulence and antimicrobial resistance genes was carried out using PCR methods. Results: The prevalence of E. coli in flies was 61% with highest in dairy farms (70.67%) followed by food centers (65.33%), dustbins (64%) and area close to hospital (44%). The prevalence rates of tetA, tetB, ereA, CITM, SHV, mcr-3 and catA1 resistance determinants were 88.75, 48.52, 41.67, 37.17, 27.77, 18.37 and 14.81%, respectively. Conclusion: Multidrug-resistant pathogenic E. coli are widely distributed in house flies, which requires a one-health approach to delineate their control.
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Affiliation(s)
- Abdus Sobur
- Department of Microbiology & Hygiene, Faculty of Veterinary Science, Bangladesh Agricultural University, Mymensingh-2202, Bangladesh
| | - Zobayda F Haque
- Department of Microbiology & Hygiene, Faculty of Veterinary Science, Bangladesh Agricultural University, Mymensingh-2202, Bangladesh
| | - Abdullah AM Sabuj
- Department of Microbiology & Hygiene, Faculty of Veterinary Science, Bangladesh Agricultural University, Mymensingh-2202, Bangladesh
| | - Samina Ievy
- Department of Microbiology & Hygiene, Faculty of Veterinary Science, Bangladesh Agricultural University, Mymensingh-2202, Bangladesh
| | | | - Mohamed E El Zowalaty
- Virology & Microbiology Research Group, College of Pharmacy, City University College of Ajman, Al Tallah 2, Ajman, P.O. Box 18484, United Arab Emirates
- Department of Infectious Diseases, St. Jude Children’s Research Hospital, Memphis, TN 38105, USA
| | - Tanvir Rahman
- Department of Microbiology & Hygiene, Faculty of Veterinary Science, Bangladesh Agricultural University, Mymensingh-2202, Bangladesh
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Abstract
BACKGROUND Diarrhoeal disease accounts for millions of child deaths every year. Although the role of flies as vectors of infectious diarrhoea has been established, fly control is not often mentioned as an approach to decrease childhood diarrhoea. Theoretically, fly control for decreasing diarrhoea incidence can be achieved by intervening at four different levels: reduction or elimination of fly breeding sites; reduction of sources that attract houseflies; prevention of contact between flies and disease-causing organisms; and protection of people, food, and food utensils from contact with flies. OBJECTIVES To assess the impact of various housefly control measures on the incidence of diarrhoea and its related morbidity and mortality in children under five years of age. SEARCH METHODS We searched electronic databases including the Cochrane Central Register of Controlled Trials (CENTRAL) in the Cochrane Library, MEDLINE, Embase, CINAHL, and LILACS, from database inception to 24 May 2018. We also searched trial registries for relevant grey literature and ongoing trials. We checked the references of the identified studies and reviews. We did not apply any filters for language, publication status (published, unpublished, in press, and ongoing), or publication date. SELECTION CRITERIA We planned to include randomized controlled trials (RCTs), quasi-RCTs, and controlled before-and-after studies that studied the effect of fly control on diarrhoea in children under five years of age. DATA COLLECTION AND ANALYSIS Two review authors extracted the data and independently assessed the risk of bias in the included study. We planned to contact study authors for additional information, where necessary. We assessed the certainty of the evidence using the GRADE approach. MAIN RESULTS We included one cluster-RCT (491 participants) conducted in Pakistan that evaluated insecticide spraying in the first two years and baited fly traps in the third year. Insecticide spraying reduced the fly population (house index) in the intervention group during the four months of the year when both flies and cases of diarrhoea were more common, but not at other times. On average, this was associated with a reduction in the incidence of diarrhoea in the first year (illustrative mean episodes per child-year in the intervention group was 6.3 while in the control group was 7.1) and second year of the intervention (illustrative mean episodes per child‒year in the intervention group was 4.4 while in the control group was 6.5; rate ratio (RaR) 0.77, 95% confidence interval (CI) 0.67 to 0.89, low-certainty evidence). In the third year of the intervention, the baited fly traps did not demonstrate an effect on the fly population or on diarrhoea incidence (RaR 1.15, 95% CI 0.90 to 1.47, low-certainty evidence). AUTHORS' CONCLUSIONS The trial, conducted in a setting where there were clear seasonal peaks in fly numbers and associated diarrhoea, shows insecticide spraying may reduce diarrhoea in children. Further research on whether this finding is applicable to other setting is required, as well as work on other fly control methods, their effects, feasibility, costs, and acceptability.
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Affiliation(s)
- Jai K Das
- Aga Khan University HospitalDivision of Women and Child HealthStadium RoadPO Box 3500KarachiSindPakistan
| | - Yousaf Bashir Hadi
- West Virginia UniversityDepartment of Internal Medicine1 Medical Center DriveMorgantownWest VirginiaUSA26506
| | - Rehana A Salam
- Aga Khan University HospitalDivision of Women and Child HealthStadium RoadPO Box 3500KarachiSindPakistan
| | - Mehar Hoda
- Aga Khan University HospitalDivision of Women and Child HealthStadium RoadPO Box 3500KarachiSindPakistan
| | - Zohra S Lassi
- The University of AdelaideThe Robinson Research InstituteAdelaideSouth AustraliaAustralia5005
| | - Zulfiqar A Bhutta
- The Hospital for Sick ChildrenCentre for Global Child HealthTorontoONCanadaM5G A04
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Khamesipour F, Lankarani KB, Honarvar B, Kwenti TE. A systematic review of human pathogens carried by the housefly (Musca domestica L.). BMC Public Health 2018; 18:1049. [PMID: 30134910 PMCID: PMC6104014 DOI: 10.1186/s12889-018-5934-3] [Citation(s) in RCA: 106] [Impact Index Per Article: 17.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2018] [Accepted: 08/03/2018] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND The synanthropic house fly, Musca domestica (Diptera: Muscidae), is a mechanical vector of pathogens (bacteria, fungi, viruses, and parasites), some of which cause serious diseases in humans and domestic animals. In the present study, a systematic review was done on the types and prevalence of human pathogens carried by the house fly. METHODS Major health-related electronic databases including PubMed, PubMed Central, Google Scholar, and Science Direct were searched (Last update 31/11/2017) for relevant literature on pathogens that have been isolated from the house fly. RESULTS Of the 1718 titles produced by bibliographic search, 99 were included in the review. Among the titles included, 69, 15, 3, 4, 1 and 7 described bacterial, fungi, bacteria+fungi, parasites, parasite+bacteria, and viral pathogens, respectively. Most of the house flies were captured in/around human habitation and animal farms. Pathogens were frequently isolated from body surfaces of the flies. Over 130 pathogens, predominantly bacteria (including some serious and life-threatening species) were identified from the house flies. Numerous publications also reported antimicrobial resistant bacteria and fungi isolated from house flies. CONCLUSIONS This review showed that house flies carry a large number of pathogens which can cause serious infections in humans and animals. More studies are needed to identify new pathogens carried by the house fly.
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Affiliation(s)
- Faham Khamesipour
- Health Policy Research Center, Institute of Health, Shiraz University of Medical Science, Shiraz, Iran.
- Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran.
| | - Kamran Bagheri Lankarani
- Health Policy Research Center, Institute of Health, Shiraz University of Medical Science, Shiraz, Iran
| | - Behnam Honarvar
- Health Policy Research Center, Institute of Health, Shiraz University of Medical Science, Shiraz, Iran
| | - Tebit Emmanuel Kwenti
- Department of Microbiology and Parasitology, University of Buea, Buea, Cameroon
- Department of Medical Laboratory Science, Faculty of Health science, University of Buea, Buea, Southwest Region, Cameroon
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The role of ‘filth flies’ in the spread of antimicrobial resistance. Travel Med Infect Dis 2018; 22:8-17. [DOI: 10.1016/j.tmaid.2018.02.007] [Citation(s) in RCA: 61] [Impact Index Per Article: 10.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2017] [Revised: 02/12/2018] [Accepted: 02/19/2018] [Indexed: 12/28/2022]
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Kotloff KL, Riddle MS, Platts-Mills JA, Pavlinac P, Zaidi AKM. Shigellosis. Lancet 2018; 391:801-812. [PMID: 29254859 DOI: 10.1016/s0140-6736(17)33296-8] [Citation(s) in RCA: 307] [Impact Index Per Article: 51.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/08/2017] [Revised: 08/10/2017] [Accepted: 09/15/2017] [Indexed: 01/02/2023]
Abstract
Shigellosis is a clinical syndrome caused by invasion of the epithelium lining the terminal ileum, colon, and rectum by Shigella species. Although infections occur globally, and in people of all ages, endemic infections among children aged 1-4 years living in low-income and middle-income settings constitute most of the disease burden. The versatile manifestations of these highly contagious organisms range from acute watery diarrhoea to fulminant dysentery characterised by frequent scant bloody stools with fever, prostration, and abdominal cramps. A broad array of uncommon, but often severe, intestinal and extraintestinal complications can occur. Despite marked reductions in mortality during the past three decades, there are roughly 164 000 annual deaths attributable to shigellosis. Intercontinental dissemination of multiresistant shigella strains, facilitated by travellers and men who have sex with men, has prompted new recommendations for antibiotic therapy. Awareness of disease burden and the emerging threats posed by shigella have accelerated interest in development of shigella vaccines, many of which are being tested in clinical trials.
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Affiliation(s)
- Karen L Kotloff
- Departments of Pediatrics and Medicine, Center for Vaccine Development, Institute for Global Health, University of Maryland School of Medicine, Baltimore, MD, USA.
| | - Mark S Riddle
- Naval Medical Research Center, Silver Spring, MD, USA; Department of Preventive Medicine and Biostatistics, Uniformed Services University of the Health Sciences, Bethesda, MD, USA
| | - James A Platts-Mills
- Division of Infectious Diseases and International Health, University of Virginia, Charlottesville, VA, USA
| | - Patricia Pavlinac
- Department of Global Health, Global Center for Integrated Health of Women, Adolescents and Children (Global WACh), University of Washington, Seattle, WA, USA
| | - Anita K M Zaidi
- Enteric and Diarrheal Diseases Programme, Bill & Melinda Gates Foundation, Seattle, WA, USA
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Vubil D, Balleste-Delpierre C, Mabunda R, Acácio S, Garrine M, Nhampossa T, Alonso P, Mandomando I, Vila J. Antibiotic resistance and molecular characterization of shigella isolates recovered from children aged less than 5 years in Manhiça, Southern Mozambique. Int J Antimicrob Agents 2018; 51:881-887. [PMID: 29448013 DOI: 10.1016/j.ijantimicag.2018.02.005] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2017] [Revised: 01/15/2018] [Accepted: 02/03/2018] [Indexed: 01/26/2023]
Abstract
The objective of this study was to assess antibiotic resistance and the molecular epidemiology of shigella isolates from a case-control study of diarrhoea, conducted from 2007 to 2012 in children aged less than 5 years in Manhiça district, southern Mozambique. All isolates were tested for antimicrobial susceptibility using the disc diffusion method. Polymerase chain reaction was used to detect different molecular mechanisms of antibiotic resistance. Serotyping was performed using specific antisera. The clonal relationship of Shigella flexneri and Shigella sonnei was assessed by pulsed-field gel electrophoresis (PFGE). Of the 67 shigella isolates analysed, 59 were diarrhoeal cases and eight were controls. S. flexneri (70.1%; 47/67) was the most common species, followed by S. sonnei (23.9%; 16/67). The most prevalent S. flexneri serotypes were 2a (38.3%; 18/47), 6 (19.2%; 9/47) and 1b (14.9%; 7/47). High rates of antimicrobial resistance were observed for trimethoprim-sulfametoxazole (92.5%; 62/67), tetracycline (68.7%; 46/67), chloramphenicol (53.7%; 36/67) and ampicillin (50.7%; 34/67). Multi-drug resistance (MDR) was present in 55.2% (37/67) of the isolates and was associated with a case fatality rate of 8.1% (3/37). PFGE revealed 22 clones (16 S. flexneri and 6 S. sonnei), among which P1 (31.9%; 15/47), P9 (17%; 8/47) and P2 (10.6%; 5/47) were the most prevalent clones of S. flexneri. In conclusion, S. flexneri was the most prevalent species, with MDR isolates mainly belonging to three specific clones (P1, P9 and P2). The case fatality rate observed among MDR isolates is a matter of concern, indicating the need for appropriate treatment.
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Affiliation(s)
- Delfino Vubil
- Centro de Investigação em Saúde de Manhiça, Maputo, Mozambique
| | | | - Rita Mabunda
- Centro de Investigação em Saúde de Manhiça, Maputo, Mozambique
| | - Sozinho Acácio
- Centro de Investigação em Saúde de Manhiça, Maputo, Mozambique; Instituto Nacional de Saúde, Maputo, Mozambique
| | | | - Tacilta Nhampossa
- Centro de Investigação em Saúde de Manhiça, Maputo, Mozambique; Instituto Nacional de Saúde, Maputo, Mozambique
| | - Pedro Alonso
- Centro de Investigação em Saúde de Manhiça, Maputo, Mozambique
| | - Inacio Mandomando
- Centro de Investigação em Saúde de Manhiça, Maputo, Mozambique; ISGlobal, Barcelona Centre for International Health Research, Barcelona, Spain
| | - Jordi Vila
- ISGlobal, Barcelona Centre for International Health Research, Barcelona, Spain; Department of Clinical Microbiology, Centre for Biomedical Diagnosis, Hospital Clinic, Barcelona, Spain.
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Doza S, Jabeen Rahman M, Islam MA, Kwong LH, Unicomb L, Ercumen A, Pickering AJ, Parvez SM, Naser AM, Ashraf S, Das KK, Luby SP. Prevalence and Association of Escherichia coli and Diarrheagenic Escherichia coli in Stored Foods for Young Children and Flies Caught in the Same Households in Rural Bangladesh. Am J Trop Med Hyg 2018; 98:1031-1038. [PMID: 29436348 PMCID: PMC5928814 DOI: 10.4269/ajtmh.17-0408] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
Abstract
Consumption of contaminated stored food can cause childhood diarrhea. Flies carry enteropathogens, although their contribution to food contamination remains unclear. We investigated the role of flies in contaminating stored food by collecting food and flies from the same households in rural Bangladesh. We selected 182 households with children ≤ 24 months old that had stored foods for later feeding at room temperature for ≥ 3 hours. We collected food samples and captured flies with fly tapes hung by the kitchen. We used the IDEXX Quanti-Tray System (Colilert-18 media; IDEXX Laboratories, Inc., Westbrook, ME) to enumerate Escherichia coli with the most probable number (MPN) method. Escherichia coli–positive IDEXX wells were analyzed by polymerase chain reaction for pathogenic E. coli genes (eae, ial, bfp, ipaH, st, lt, aat, aaiC, stx1, and stx2). Escherichia coli was detected in 61% (111/182) of food samples, with a mean of 1.1 log10 MPN/dry g. Fifteen samples (8%) contained pathogenic E. coli; seven (4%) had enteropathogenic E. coli (EPEC) genes (eae and/or bfp); and 10 (5%) had enteroaggregative E. coli genes (aat and/or aaiC). Of flies captured in 68 (37%) households, E. coli was detected in 41 (60%, mean 2.9 log10 MPN/fly), and one fly (1%) had an EPEC gene (eae). For paired fly-food samples, each log10 MPN E. coli increase in flies was associated with a 0.31 log10 MPN E. coli increase in stored food (95% confidence interval: 0.07, 0.55). In rural Bangladesh, flies possibly a likely route for fecal contamination of stored food. Controlling fly populations may reduce contamination of food stored for young children.
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Affiliation(s)
- Solaiman Doza
- International Center for Diarrheal Diseases Research, Bangladesh, Dhaka, Bangladesh
| | | | | | | | - Leanne Unicomb
- International Center for Diarrheal Diseases Research, Bangladesh, Dhaka, Bangladesh
| | - Ayse Ercumen
- University of California, Berkeley, Berkeley, California
| | | | - Sarker Masud Parvez
- International Center for Diarrheal Diseases Research, Bangladesh, Dhaka, Bangladesh
| | - Abu Mohd Naser
- Department of Environmental Health Sciences, Rollins School of Public Health, Emory University, Atlanta, Georgia
| | - Sania Ashraf
- Johns Hopkins Bloomberg School of Public Health University, Baltimore, Maryland.,International Center for Diarrheal Diseases Research, Bangladesh, Dhaka, Bangladesh
| | - Kishor Kumar Das
- International Center for Diarrheal Diseases Research, Bangladesh, Dhaka, Bangladesh
| | - Stephen P Luby
- Stanford University, Stanford, California.,International Center for Diarrheal Diseases Research, Bangladesh, Dhaka, Bangladesh
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Lindeberg YL, Egedal K, Hossain ZZ, Phelps M, Tulsiani S, Farhana I, Begum A, Jensen PKM. CanEscherichia colifly? The role of flies as transmitters ofE. colito food in an urban slum in Bangladesh. Trop Med Int Health 2017; 23:2-9. [DOI: 10.1111/tmi.13003] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Yrja Lisa Lindeberg
- Department of Public Health; Global Health Section; Copenhagen University; København Denmark
| | - Karen Egedal
- Department of Public Health; Global Health Section; Copenhagen University; København Denmark
| | - Zenat Zebin Hossain
- Department of Public Health; Global Health Section; Copenhagen University; København Denmark
| | - Matthew Phelps
- Department of Public Health; Global Health Section; Copenhagen University; København Denmark
| | - Suhella Tulsiani
- Department of Public Health; Global Health Section; Copenhagen University; København Denmark
| | - Israt Farhana
- Department of Microbiology; University of Dhaka; Dhaka Bangladesh
| | - Anowara Begum
- Department of Microbiology; University of Dhaka; Dhaka Bangladesh
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Azage M, Kumie A, Worku A, C. Bagtzoglou A, Anagnostou E. Effect of climatic variability on childhood diarrhea and its high risk periods in northwestern parts of Ethiopia. PLoS One 2017; 12:e0186933. [PMID: 29073259 PMCID: PMC5658103 DOI: 10.1371/journal.pone.0186933] [Citation(s) in RCA: 38] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2016] [Accepted: 10/10/2017] [Indexed: 12/11/2022] Open
Abstract
Background Increasing climate variability as a result of climate change will be one of the public health challenges to control infectious diseases in the future, particularly in sub-Saharan Africa including Ethiopia. Objective To investigate the effect of climate variability on childhood diarrhea (CDD) and identify high risk periods of diarrheal diseases. Methods The study was conducted in all districts located in three Zones (Awi, West and East Gojjam) of Amhara Region in northwestern parts of Ethiopia. Monthly CDD cases for 24 months (from July 2013 to June 2015) reported to each district health office from the routine surveillance system were used for the study. Temperature, rainfall and humidity data for each district were extracted from satellite precipitation estimates and global atmospheric reanalysis. The space-time permutation scan statistic was used to identify high risk periods of CDD. A negative binomial regression was used to investigate the relationship between cases of CDD and climate variables. Statistical analyses were conducted using SaTScan program and StataSE v. 12. Results The monthly average incidence rate of CDD was 11.4 per 1000 (95%CI 10.8–12.0) with significant variation between males [12.5 per 1000 (95%CI 11.9 to 13.2)] and females [10.2 per 1000 (95%CI 9.6 to 10.8)]. The space-time permutation scan statistic identified the most likely high risk period of CDD between March and June 2014 located in Huletej Enese district of East Gojjam Zone. Monthly average temperature and monthly average rainfall were positively associated with the rate of CDD, whereas the relative humidity was negatively associated with the rate of CDD. Conclusions This study found that the most likely high risk period is in the beginning of the dry season. Climatic factors have an association with the occurrence of CDD. Therefore, CDD prevention and control strategy should consider local weather variations to improve programs on CDD.
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Affiliation(s)
- Muluken Azage
- School of Public Health, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia
- Ethiopian Institute of Water Resources, Addis Ababa University, Addis Ababa, Ethiopia
- * E-mail:
| | - Abera Kumie
- School of Public Health, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Alemayehu Worku
- School of Public Health, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Amvrossios C. Bagtzoglou
- Department of Civil and Environmental Engineering, School of Engineering, University of Connecticut, Storrs, CT, United States of America
| | - Emmanouil Anagnostou
- Department of Civil and Environmental Engineering, School of Engineering, University of Connecticut, Storrs, CT, United States of America
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Hu Z, Bongat White AF, Mulard LA. Efficient Iterative Synthesis of O-Acetylated Tri- to Pentadecasaccharides Related to the Lipopolysaccharide ofShigella flexneriType 3 a through Di- and Trisaccharide Glycosyl Donors. Chem Asian J 2017; 12:419-439. [DOI: 10.1002/asia.201600819] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2016] [Indexed: 11/07/2022]
Affiliation(s)
- Zhaoyu Hu
- Chemistry of Biomolecules; Institut Pasteur; 28 rue du Dr. Roux 75724 Paris Cedex 15 France
- CNRS UMR 3523; Institut Pasteur; 28 rue du Dr. Roux 75015 Paris France
| | - Aileen F. Bongat White
- Chemistry of Biomolecules; Institut Pasteur; 28 rue du Dr. Roux 75724 Paris Cedex 15 France
- CNRS UMR 3523; Institut Pasteur; 28 rue du Dr. Roux 75015 Paris France
- Dextra Laboratories Ltd.; Science and Technology Centre; Earley Gate Reading RG6 6BZ U. K
| | - Laurence A. Mulard
- Chemistry of Biomolecules; Institut Pasteur; 28 rue du Dr. Roux 75724 Paris Cedex 15 France
- CNRS UMR 3523; Institut Pasteur; 28 rue du Dr. Roux 75015 Paris France
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George CM, Ahmed S, Talukder KA, Azmi IJ, Perin J, Sack RB, Sack DA, Stine OC, Oldja L, Shahnaij M, Chakraborty S, Parvin T, Bhuyian SI, Bouwer E, Zhang X, Hasan TN, Luna SJ, Akter F, Faruque ASG. Shigella Infections in Household Contacts of Pediatric Shigellosis Patients in Rural Bangladesh. Emerg Infect Dis 2016; 21:2006-13. [PMID: 26484778 PMCID: PMC4622242 DOI: 10.3201/eid2111.150333] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
To examine rates of Shigella infections in household contacts of pediatric shigellosis patients, we followed contacts and controls prospectively for 1 week after the index patient obtained care. Household contacts of patients were 44 times more likely to develop a Shigella infection than were control contacts (odds ratio 44.7, 95% CI 5.5–361.6); 29 (94%) household contacts of shigellosis patients were infected with the same species and serotype as the index patient’s. Pulsed-field gel electrophoresis showed that 14 (88%) of 16 with infected contacts had strains that were indistinguishable from or closely related to the index patient’s strain. Latrine area fly counts were higher in patient households compared with control households, and 2 patient household water samples were positive for Shigella. We show high susceptibility of household contacts of shigellosis patients to Shigella infections and found environmental risk factors to be targeted in future interventions.
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Kania DA, Hazen TH, Hossain A, Nataro JP, Rasko DA. Genome diversity of Shigella boydii. Pathog Dis 2016; 74:ftw027. [PMID: 27056949 DOI: 10.1093/femspd/ftw027] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/04/2016] [Indexed: 11/13/2022] Open
Abstract
ITALIC! Shigella boydiiis one of the four ITALIC! Shigellaspecies that causes disease worldwide; however, there are few published studies that examine the genomic variation of this species. This study compares genomes of 72 total isolates; 28 ITALIC! S. boydiifrom Bangladesh and The Gambia that were recently isolated as part of the Global Enteric Multicenter Study (GEMS), 14 historical ITALIC! S. boydiigenomes in the public domain and 30 ITALIC! Escherichia coliand ITALIC! Shigellareference genomes that represent the genomic diversity of these pathogens. This comparative analysis of these 72 genomes identified that the ITALIC! S. boydiiisolates separate into three phylogenomic clades, each with specific gene content. Each of the clades contains ITALIC! S. boydiiisolates from geographic and temporally distant sources, indicating that the ITALIC! S. boydiiisolates from the GEMS are representative of ITALIC! S. boydii.This study describes the genome sequences of a collection of novel ITALIC! S. boydiiisolates and provides insight into the diversity of this species in comparison to the ITALIC! E. coliand other ITALIC! Shigellaspecies.
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Affiliation(s)
- Dane A Kania
- Institute for Genome Sciences, Department of Microbiology and Immunology, University of Maryland School of Medicine, 801 W. Baltimore Street, Suite 600, Baltimore, MD 21201, USA
| | - Tracy H Hazen
- Institute for Genome Sciences, Department of Microbiology and Immunology, University of Maryland School of Medicine, 801 W. Baltimore Street, Suite 600, Baltimore, MD 21201, USA
| | | | - James P Nataro
- Department of Pediatrics, University of Virginia School of Medicine, Charlottesville, VA 22908, USA
| | - David A Rasko
- Institute for Genome Sciences, Department of Microbiology and Immunology, University of Maryland School of Medicine, 801 W. Baltimore Street, Suite 600, Baltimore, MD 21201, USA
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Ma Y, Zhang T, Liu L, Lv Q, Yin F. Spatio-Temporal Pattern and Socio-Economic Factors of Bacillary Dysentery at County Level in Sichuan Province, China. Sci Rep 2015; 5:15264. [PMID: 26469274 PMCID: PMC4606827 DOI: 10.1038/srep15264] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2015] [Accepted: 09/21/2015] [Indexed: 11/16/2022] Open
Abstract
Bacillary dysentery (BD) remains a big public health problem in China. Effective spatio-temporal monitoring of BD incidence is important for successful implementation of control and prevention measures. This study aimed to examine the spatio-temporal pattern of BD and analyze socio-economic factors that may affect BD incidence in Sichuan province, China. Firstly, we used space-time scan statistic to detect the high risk spatio-temporal clusters in each year. Then, bivariate spatial correlation and Bayesian spatio-temporal model were utilized to examine the associations between the socio-economic factors and BD incidence. Spatio-temporal clusters of BD were mainly located in the northern-southern belt of the midwest area of Sichuan province. The proportion of primary industry, the proportion of rural population and the rates of BD incidence show statistically significant positive correlation. The proportion of secondary industry, proportion of tertiary Industry, number of beds in hospitals per thousand persons, medical and technical personnel per thousand persons, per capital GDP and the rate of BD incidence show statistically significant negative correlation. The best fitting spatio-temporal model showed that medical and technical personnel per thousand persons and per capital GDP were significantly negative related to the risk of BD.
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Affiliation(s)
- Yue Ma
- West China School of Public Health, Sichuan University, Chengdu, Sichuan, People's Republic of China
| | - Tao Zhang
- West China School of Public Health, Sichuan University, Chengdu, Sichuan, People's Republic of China
| | - Lei Liu
- Sichuan Center for Disease Control and Prevention, Chengdu, Sichuan, People's Republic of China
| | - Qiang Lv
- Sichuan Center for Disease Control and Prevention, Chengdu, Sichuan, People's Republic of China
| | - Fei Yin
- West China School of Public Health, Sichuan University, Chengdu, Sichuan, People's Republic of China
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Environmental Factors Associated with High Fly Densities and Diarrhea in Vellore, India. Appl Environ Microbiol 2015; 81:6053-8. [PMID: 26116684 DOI: 10.1128/aem.01236-15] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2015] [Accepted: 06/22/2015] [Indexed: 11/20/2022] Open
Abstract
Diarrhea causes significant morbidity and mortality in Indian children under 5 years of age. Flies carry enteric pathogens and may mediate foodborne infections. In this study, we characterized fly densities as a determinant of infectious diarrhea in a longitudinal cohort of 160 urban and 80 rural households with 1,274 individuals (27% under 5 years of age) in Vellore, India. Household questionnaires on living conditions were completed at enrollment. Fly abundance was measured during the wet and dry seasons using fly ribbons placed in kitchens. PCRs for enteric bacteria, viruses, and protozoa were performed on 60 fly samples. Forty-three (72%) fly samples were positive for the following pathogens: norovirus (50%), Salmonella spp. (46.7%), rotavirus (6.7%), and Escherichia coli (6.7%). Ninety-one episodes of diarrhea occurred (89% in children under 5 years of age). Stool pathogens isolated in 24 of 77 (31%) samples included E. coli, Shigella spp., Vibrio spp., Giardia, Cryptosporidium, and rotavirus. Multivariate log-linear models were used to explore the relationships between diarrhea and fly densities, controlling for demographics, hygiene, and human-animal interactions. Fly abundance was 6 times higher in rural than urban sites (P < 0.0001). Disposal of garbage close to homes and rural living were significant risk factors for high fly densities. The presence of latrines was protective against high fly densities and diarrhea. The adjusted relative risks of diarrheal episodes and duration of diarrhea, associated with fly density at the 75th percentile, were 1.18 (95% confidence interval [CI], 1.03 to 1.34) and 1.15 (95% CI, 1.02 to 1.29), respectively. Flies harbored enteric pathogens, including norovirus, a poorly documented pathogen on flies.
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Elazar S, Zelikovich Y, Levine H, Tzurel-Ferber A, Galor I, Hartal M. Secular trends in 1,192 diarrheal outbreaks in the Israel Defence Forces between 1988-2011. DISASTER AND MILITARY MEDICINE 2015; 1:14. [PMID: 28265429 PMCID: PMC5330014 DOI: 10.1186/s40696-015-0004-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/08/2015] [Accepted: 04/14/2015] [Indexed: 12/05/2022]
Abstract
Background In the military, outbreaks of infectious diarrhea pose a significant health problem. In this descriptive analysis of data collected by the IDF on all infectious diarrhea outbreaks between 1988–2011, we analysed temporal, seasonal, and unit-type trends in 1,192 diarrheal outbreaks in the Israel Defence Forces (IDF) over a 24-year period, and described the long-term trends in seasonality and the effects of strategic preventive measures on outbreak frequency among populations at risk. Results We found two distinct phases in annual outbreak occurrence. The mean annual number of outbreaks during the period 1988–1996 was 75.8 (±14.50) but dropped to 34.0 (±8.13) during the period 1997–2011 (P < 0.0001). Overall, a downward trend continued through the 1990’s, while from 2000 onwards outbreak counts fluctuated annually. A significantly higher number of outbreaks occurred during the summer season, throughout the study period. The greatest number of outbreaks occurred in deployed units, although the proportion of outbreaks in this unit type decreased over time. Accordingly, the proportion of outbreaks in training units more than doubled during the study window. When we looked at outbreak size, summer outbreaks increased in magnitude over time, and during all periods outbreaks were larger, on average, in training units than in deployed units. Conclusions The changing patterns in diarrheal outbreaks in the Israel Defence Forces require maintenance of a higher level of vigilance than ever before. Lack of a clear peak period require the use of all available preventive measures throughout the year. This is especially true in training units, where the increased number of outbreaks coincides with increased trainee volume, regardless of season.
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Affiliation(s)
- Sharon Elazar
- Israel Defense Forces Medical Corps, Department of Public Health, Tel Aviv, Israel
| | - Yifat Zelikovich
- Israel Defense Forces Medical Corps, Department of Public Health, Tel Aviv, Israel
| | - Hagai Levine
- Israel Defense Forces Medical Corps, Department of Public Health, Tel Aviv, Israel.,Hebrew University-Hadassah Braun School of Public Health, Jerusalem, Israel
| | - Anat Tzurel-Ferber
- Israel Defense Forces Medical Corps, Department of Public Health, Tel Aviv, Israel
| | - Inbal Galor
- Israel Defense Forces Medical Corps, Department of Public Health, Tel Aviv, Israel
| | - Michael Hartal
- Israel Defense Forces Medical Corps, Department of Public Health, Tel Aviv, Israel.,Department of Military Medicine, Hebrew University Faculty of Medicine, Jerusalem, Israel
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Das JK, Salam RA, Hoda M, Lassi ZS, Bhutta ZA. Interventions to control flies for preventing diarrhoea in children under five years of age. Hippokratia 2015. [DOI: 10.1002/14651858.cd011654] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
- Jai K Das
- Aga Khan University Hospital; Division of Women and Child Health; Stadium Road, P.O. Box 3500 Karachi Sind Pakistan
| | - Rehana A Salam
- Aga Khan University Hospital; Division of Women and Child Health; Stadium Road, P.O. Box 3500 Karachi Sind Pakistan
| | - Mehar Hoda
- Aga Khan University Hospital; Division of Women and Child Health; Stadium Road, P.O. Box 3500 Karachi Sind Pakistan
| | - Zohra S Lassi
- The University of Adelaide; ARCH: Australian Research Centre for Health of Women and Babies, The Robinson Research Institute, Discipline of Obstetrics and Gynaecology; Adelaide South Australia Australia 5005
| | - Zulfiqar A Bhutta
- Hospital for Sick Children; Center for Global Child Health; Toronto ON Canada M5G A04
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Abstract
Shigellae cause significant diarrheal disease and mortality in humans, as there are approximately 163 million episodes of shigellosis and 1.1 million deaths annually. While significant strides have been made in the understanding of the pathogenesis, few studies on the genomic content of the Shigella species have been completed. The goal of this study was to characterize the genomic diversity of Shigella species through sequencing of 55 isolates representing members of each of the four Shigella species: S. flexneri, S. sonnei, S. boydii, and S. dysenteriae. Phylogeny inferred from 336 available Shigella and Escherichia coli genomes defined exclusive clades of Shigella; conserved genomic markers that can identify each clade were then identified. PCR assays were developed for each clade-specific marker, which was combined with an amplicon for the conserved Shigella invasion antigen, IpaH3, into a multiplex PCR assay. This assay demonstrated high specificity, correctly identifying 218 of 221 presumptive Shigella isolates, and sensitivity, by not identifying any of 151 diverse E. coli isolates incorrectly as Shigella. This new phylogenomics-based PCR assay represents a valuable tool for rapid typing of uncharacterized Shigella isolates and provides a framework that can be utilized for the identification of novel genomic markers from genomic data.
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Abstract
PURPOSE OF REVIEW Shigella spp. are important etiologic agents of diarrhea worldwide. This review summarizes the recent findings on the epidemiology, diagnosis, virulence genes, and pathobiology of Shigella infection. RECENT FINDINGS Shigella flexneri and Shigella sonnei have been identified as the main serogroups circulating in developing and developed countries, respectively. However, a shift in the dominant species from S. flexneri to S. sonnei has been observed in countries that have experienced recent improvements in socioeconomic conditions. Despite the increasing usage of molecular methods in the diagnosis and virulence characterization of Shigella strains, researchers have been unsuccessful in finding a specific target gene for this bacillus. New research has demonstrated the role of proteins whose expressions are temperature-regulated, as well as genes involved in the processes of adhesion, invasion, dissemination, and inflammation, aiding in the clarification of the complex pathobiology of shigellosis. SUMMARY Knowledge about the epidemiologic profile of circulating serogroups of Shigella and an understanding of its pathobiology as well as of the virulence genes is important for the development of preventive measures and interventions to reduce the worldwide spread of shigellosis.
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Anza I, Vidal D, Mateo R. New insight in the epidemiology of avian botulism outbreaks: necrophagous flies as vectors of Clostridium botulinum type C/D. ENVIRONMENTAL MICROBIOLOGY REPORTS 2014; 6:738-743. [PMID: 25079304 DOI: 10.1111/1758-2229.12197] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/28/2014] [Accepted: 07/27/2014] [Indexed: 06/03/2023]
Abstract
Avian botulism outbreaks spread through the bird carcass-maggot cycle, in which Clostridium botulinum and blowflies interact to ensure their reproduction in a mutualistic relationship where neurotoxin/spore-bearing maggot is one of the keystones. Here we investigated the hypothesis that adult blowflies may also play a significant role in botulism outbreaks by carrying C. botulinum cells between carcasses. We carried out a field experiment placing bird carcasses free of C. botulinum type C/D in containers only accessible to necrophagous flying insects in wetlands where avian botulism outbreaks were occurring and in control sites. Additionally, we performed laboratory trials to evaluate if blowflies may carry C. botulinum type C/D and for how long. Maggots bearing C. botulinum type C/D developed in 27.5% of carcasses placed in wetlands during botulism outbreaks. Calliphoridae flies in laboratory trials were able to transfer C. botulinum between two points and excreted it in their spots for up to 24 h after an infective feeding. Our results confirm that adult necrophagous flies play a role in the spreading of botulism outbreaks, which have implications in the epidemiology of this disease.
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Affiliation(s)
- Ibone Anza
- CSIC-UCLM-JCCM, Instituto de Investigación en Recursos Cinegéticos (IREC), Ciudad Real, Spain
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Livio S, Strockbine NA, Panchalingam S, Tennant SM, Barry EM, Marohn ME, Antonio M, Hossain A, Mandomando I, Ochieng JB, Oundo JO, Qureshi S, Ramamurthy T, Tamboura B, Adegbola RA, Hossain MJ, Saha D, Sen S, Faruque ASG, Alonso PL, Breiman RF, Zaidi AKM, Sur D, Sow SO, Berkeley LY, O'Reilly CE, Mintz ED, Biswas K, Cohen D, Farag TH, Nasrin D, Wu Y, Blackwelder WC, Kotloff KL, Nataro JP, Levine MM. Shigella isolates from the global enteric multicenter study inform vaccine development. Clin Infect Dis 2014; 59:933-41. [PMID: 24958238 PMCID: PMC4166982 DOI: 10.1093/cid/ciu468] [Citation(s) in RCA: 250] [Impact Index Per Article: 25.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Shigella, a major diarrheal disease pathogen worldwide, is the target of vaccine development. The Global Enteric Multicenter Study (GEMS) investigated burden and etiology of moderate-to-severe diarrheal disease in children aged <60 months and matched controls without diarrhea during 3 years at 4 sites in Africa and 3 in Asia. Shigella was 1 of the 4 most common pathogens across sites and age strata. GEMS Shigella serotypes are reviewed to guide vaccine development. METHODS Subjects' stool specimens/rectal swabs were transported to site laboratories in transport media and plated onto xylose lysine desoxycholate and MacConkey agar. Suspect Shigella colonies were identified by biochemical tests and agglutination with antisera. Shigella isolates were shipped to the GEMS Reference Laboratory (Baltimore, MD) for confirmation and serotyping of S. flexneri; one-third of isolates were sent to the Centers for Disease Control and Prevention for quality control. RESULTS Shigella dysenteriae and S. boydii accounted for 5.0% and 5.4%, respectively, of 1130 Shigella case isolates; S. flexneri comprised 65.9% and S. sonnei 23.7%. Five serotypes/subserotypes comprised 89.4% of S. flexneri, including S. flexneri 2a, S. flexneri 6, S. flexneri 3a, S. flexneri 2b, and S. flexneri 1b. CONCLUSIONS A broad-spectrum Shigella vaccine must protect against S. sonnei and 15 S. flexneri serotypes/subserotypes. A quadrivalent vaccine with O antigens from S. sonnei, S. flexneri 2a, S. flexneri 3a, and S. flexneri 6 can provide broad direct coverage against these most common serotypes and indirect coverage against all but 1 (rare) remaining subserotype through shared S. flexneri group antigens.
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Affiliation(s)
- Sofie Livio
- Center for Vaccine Development, University of Maryland School of Medicine, Baltimore
| | - Nancy A Strockbine
- Escherichia and Shigella Reference Unit, Enteric Diseases Laboratory Branch Division of Foodborne, Waterborne and Environmental Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Sandra Panchalingam
- Center for Vaccine Development, University of Maryland School of Medicine, Baltimore
| | - Sharon M Tennant
- Center for Vaccine Development, University of Maryland School of Medicine, Baltimore
| | - Eileen M Barry
- Center for Vaccine Development, University of Maryland School of Medicine, Baltimore
| | - Mark E Marohn
- Center for Vaccine Development, University of Maryland School of Medicine, Baltimore
| | - Martin Antonio
- Medical Research Council Unit (United Kingdom), Fajara, The Gambia
| | - Anowar Hossain
- International Centre for Diarrhoeal Disease Research, Mohakhali, Dhaka, Bangladesh
| | - Inacio Mandomando
- Centro de Investigação em Saúde de Manhiça, Manhiça, Mozambique and the Centre de Recerca en Salut Internacional de Barcelona, Hospital Clinic/Universitat de Barcelona, Spain
| | - John B Ochieng
- Kenya Medical Research Institute/Centers for Disease Control and Prevention, Kisumu, Kenya
| | - Joseph O Oundo
- Kenya Medical Research Institute/Centers for Disease Control and Prevention, Kisumu, Kenya
| | - Shahida Qureshi
- Department of Paediatrics and Child Health, The Aga Khan University, Karachi, Pakistan
| | | | - Boubou Tamboura
- Centre pour le Développement des Vaccins du Mali, Bamako, Mali
| | | | | | - Debasish Saha
- Medical Research Council Unit (United Kingdom), Fajara, The Gambia
| | - Sunil Sen
- Center for Vaccine Development, University of Maryland School of Medicine, Baltimore
| | | | - Pedro L Alonso
- Centro de Investigação em Saúde de Manhiça, Manhiça, Mozambique and the Centre de Recerca en Salut Internacional de Barcelona, Hospital Clinic/Universitat de Barcelona, Spain
| | - Robert F Breiman
- Kenya Medical Research Institute/Centers for Disease Control and Prevention, Kisumu, Kenya Global Disease Detection Division, Kenya Office of the US Centers for Disease Control and Prevention, Nairobi, Kenya
| | - Anita K M Zaidi
- Department of Paediatrics and Child Health, The Aga Khan University, Karachi, Pakistan
| | - Dipika Sur
- National Institute of Cholera and Enteric Diseases, Kolkata, India Program for Appropriate Technology in Health (PATH), New Delhi, India
| | - Samba O Sow
- Centre pour le Développement des Vaccins du Mali, Bamako, Mali
| | - Lynette Y Berkeley
- Center for Vaccine Development, University of Maryland School of Medicine, Baltimore US Food and Drug Administration, Rockville
| | - Ciara E O'Reilly
- Division of Foodborne, Waterborne and Environmental Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Eric D Mintz
- Division of Foodborne, Waterborne and Environmental Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Kousick Biswas
- Department of Veterans Affairs, Cooperative Studies Program Coordinating Center, Perry Point, Maryland
| | - Dani Cohen
- Department of Epidemiology and Preventive Medicine, School of Public Health, Sackler Faculty of Medicine, Tel Aviv University, Ramat Aviv, Israel
| | - Tamer H Farag
- Center for Vaccine Development, University of Maryland School of Medicine, Baltimore
| | - Dilruba Nasrin
- Center for Vaccine Development, University of Maryland School of Medicine, Baltimore
| | - Yukun Wu
- Center for Vaccine Development, University of Maryland School of Medicine, Baltimore
| | - William C Blackwelder
- Center for Vaccine Development, University of Maryland School of Medicine, Baltimore
| | - Karen L Kotloff
- Center for Vaccine Development, University of Maryland School of Medicine, Baltimore
| | - James P Nataro
- Center for Vaccine Development, University of Maryland School of Medicine, Baltimore
| | - Myron M Levine
- Center for Vaccine Development, University of Maryland School of Medicine, Baltimore
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Khan HAA, Akram W. The effect of temperature on the toxicity of insecticides against Musca domestica L.: implications for the effective management of diarrhea. PLoS One 2014; 9:e95636. [PMID: 24743188 PMCID: PMC3990717 DOI: 10.1371/journal.pone.0095636] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2014] [Accepted: 03/28/2014] [Indexed: 11/18/2022] Open
Abstract
Background Diarrhea is an important cause of childhood mortality in developing countries like Pakistan because of unhygienic conditions, lack of awareness, and unwise use of preventive measures. Mechanical transmission of diarrheal pathogens by house flies, Musca domestica, is believed as the most effective route of diarrhea transmission. Although the use of insecticides as a preventive measure is common worldwide for the management of house flies, success of the measure could be compromised by the prevailing environmental temperature since it significantly affects toxicity of insecticides and thus their efficacy. Peaks of the house fly density and diarrheal cases are usually coincided and season specific, yet little is known about the season specific use of insecticides. Methodology/Principal Findings To determine the temperature-toxicity relationship in house flies, the effect of post-bioassays temperature (range, 20–34°C) on the toxicity of seven insecticides from organophosphate (chlorpyrifos, profenofos), pyrethroid (cypermethrin, deltamethrin) and new chemical (emamectin benzoate, fipronil, spinosad) classes was evaluated by using a feeding bioassay method. From 20–34°C, the toxicities of chlorpyrifos, profenofos, emamectin and fipronil increased 2.10, 2.93, 2.40 and 3.82 fold (i.e. positive temperature coefficient), respectively. Whereas, the toxicities of cypermethrin, deltamethrin and spinosad decreased 2.21, 2.42 and 3.16 fold (i.e. negative temperature coefficient), respectively. Conclusion/Significance These findings suggest that for the reduction in diarrheal cases, house flies should be controlled with insecticides according to the prevailing environmental temperature. Insecticides with a positive temperature coefficient may serve as potential candidates in controlling house flies and diarrhea epidemics in hot season and vice versa.
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Affiliation(s)
- Hafiz Azhar Ali Khan
- Institute of Agricultural Sciences, University of the Punjab, Lahore, Pakistan
- * E-mail:
| | - Waseem Akram
- Department of Entomology, University of Agriculture, Faisalabad, Pakistan
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