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Raghavan S, Kim KS. Host immunomodulation strategies to combat pandemic-associated antimicrobial-resistant secondary bacterial infections. Int J Antimicrob Agents 2024; 64:107308. [PMID: 39168417 DOI: 10.1016/j.ijantimicag.2024.107308] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2023] [Revised: 06/20/2024] [Accepted: 08/09/2024] [Indexed: 08/23/2024]
Abstract
The incidence of secondary bacterial infections has increased in recent decades owing to various viral pandemics. These infections further increase the morbidity and mortality rates associated with viral infections and remain a significant challenge in clinical practice. Intensive antibiotic therapy has mitigated the threat of such infections; however, overuse and misuse of antibiotics have resulted in poor outcomes, such as inducing the emergence of bacterial populations with antimicrobial resistance (AMR) and reducing the therapeutic options for this crisis. Several antibiotic substitutes have been suggested and employed; however, they have certain limitations and novel alternatives are urgently required. This review highlights host immunomodulation as a promising strategy against secondary bacterial infections to overcome AMR. The definition and risk factors of secondary bacterial infections, features and limitations of currently available therapeutic strategies, host immune responses, and future perspectives for treating such infections are discussed.
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Affiliation(s)
- Srimathi Raghavan
- Department of Chemistry and Chemistry Institute for Functional Materials, Pusan National University, Busan, Korea
| | - Kwang-Sun Kim
- Department of Chemistry and Chemistry Institute for Functional Materials, Pusan National University, Busan, Korea.
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2
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Salle R, Del Giudice P, Skayem C, Hua C, Chosidow O. Secondary Bacterial Infections in Patients with Atopic Dermatitis or Other Common Dermatoses. Am J Clin Dermatol 2024; 25:623-637. [PMID: 38578398 DOI: 10.1007/s40257-024-00856-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/11/2024] [Indexed: 04/06/2024]
Abstract
Secondary bacterial infections of common dermatoses such as atopic dermatitis, ectoparasitosis, and varicella zoster virus infections are frequent, with Staphylococcus aureus and Streptococcus pyogenes being the bacteria most involved. There are also Gram-negative infections secondary to common dermatoses such as foot dyshidrotic eczema and tinea pedis. Factors favoring secondary bacterial infections in atopic dermatitis, ectoparasitosis, and varicella zoster virus infections mainly include an epidermal barrier alteration as well as itch. Mite-bacteria interaction is also involved in scabies and some environmental factors can promote Gram-negative bacterial infections of the feet. Furthermore, the bacterial ecology of these superinfections may depend on the geographical origin of the patients, especially in ectoparasitosis. Bacterial superinfections can also have different clinical aspects depending on the underlying dermatoses. Subsequently, the choice of class, course, and duration of antibiotic treatment depends on the severity of the infection and the suspected bacteria, primarily targeting S. aureus. Prevention of these secondary bacterial infections depends first and foremost on the management of the underlying skin disorder. At the same time, educating the patient on maintaining good skin hygiene and reporting changes in the primary lesions is crucial. In the case of recurrent secondary infections, decolonization of S. aureus is deemed necessary, particularly in atopic dermatitis.
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Affiliation(s)
- Romain Salle
- Service de Dermatologie Générale et Oncologique, UVSQ, EA4340-BECCOH, AP-HP, Hôpital Ambroise-Paré, Université Paris-Saclay, 9 Avenue Charles de Gaulle, 92100, Boulogne-Billancourt, France.
| | - Pascal Del Giudice
- Unité D'Infectiologie et Dermatologie, Centre Hospitalier Intercommunal de Fréjus-Saint-Raphaël, Fréjus, France
| | - Charbel Skayem
- Service de Dermatologie Générale et Oncologique, UVSQ, EA4340-BECCOH, AP-HP, Hôpital Ambroise-Paré, Université Paris-Saclay, 9 Avenue Charles de Gaulle, 92100, Boulogne-Billancourt, France
| | - Camille Hua
- AP-HP, Service de Dermatologie, Hôpital Henri Mondor, Créteil, France
| | - Olivier Chosidow
- Consultation Dermatoses Faciales, Service d'ORL, AP-HP, Hôpital Universitaire Pitié-Salpêtrière, Paris, France
- UPEC Créteil, Créteil, France
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3
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McNeilly H, Mutebi F, Thielecke M, Reichert F, Banalyaki MB, Arono R, Mukone G, Feldmeier H. Management of very severe tungiasis cases through repeated community-based treatment with a dimeticone oil formula: A longitudinal study in a hyperendemic region in Uganda. Trop Med Int Health 2024; 29:303-308. [PMID: 38279810 DOI: 10.1111/tmi.13974] [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: 01/29/2024]
Abstract
Tungiasis (sand flea disease) is a neglected tropical disease that is endemic in Sub-Saharan Africa and Latin America. Tungiasis causes pain, mobility restrictions, stigmatisation and reduced quality of life. Very severe cases with hundreds of sand fleas have been described, but treatment of such cases has never been studied systematically. During a larger community-based tungiasis control programme in a hyperendemic region in Karamoja, northeastern Uganda, 96 very severe tungiasis cases were identified and treated with the dimeticone formula NYDA®. They were repeatedly followed-up and treated again when necessary. The present study traces tungiasis frequency, intensity and morbidity among these 96 individuals over 2 years. At baseline, very severe tungiasis occurred in all age groups, including young children. Throughout the intervention, tungiasis frequency decreased from 100% to 25.8% among the 96 individuals. The overall number of embedded sand fleas in this group dropped from 15,648 to 158, and the median number of embedded sand fleas among the tungiasis cases decreased from 141 to four. Walking difficulties were reported in 96.9% at the beginning and in 4.5% at the end of the intervention. Repeated treatment with the dimeticone formula over 2 years was a successful strategy to manage very severe cases in a hyperendemic community. Treatment of very severe cases is essential to control the spread and burden of tungiasis in endemic communities.
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Affiliation(s)
- Hannah McNeilly
- Edinburgh Medical School: Biomedical Sciences, Biomedical Teaching Organisation, The University of Edinburgh, Edinburgh, UK
| | - Francis Mutebi
- School of Veterinary Medicine and Animal Resources, College of Veterinary Medicine, Animal Resources and Biosecurity, Makerere University, Kampala, Uganda
| | - Marlene Thielecke
- Charité Center for Global Health, Institute of International Health, Charité University Medicine Berlin, Berlin, Germany
| | - Felix Reichert
- Department of Infectious Disease Epidemiology, Robert Koch Institute, Berlin, Germany
| | - Mike B Banalyaki
- Innovations for Tropical Disease Elimination (IFOTRODE), Kampala, Uganda
| | - Rebecca Arono
- Innovations for Tropical Disease Elimination (IFOTRODE), Kampala, Uganda
| | - George Mukone
- Innovations for Tropical Disease Elimination (IFOTRODE), Kampala, Uganda
| | - Hermann Feldmeier
- Institute of Microbiology, Infectious Diseases and Immunology, Charité University Medicine, Berlin, Germany
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Thielecke M, McNeilly H, Mutebi F, Banalyaki MB, Arono R, Wiese S, Reichert F, Mukone G, Feldmeier H. High Level of Knowledge about Tungiasis but Little Translation into Control Practices in Karamoja, Northeastern Uganda. Trop Med Infect Dis 2023; 8:425. [PMID: 37755887 PMCID: PMC10537667 DOI: 10.3390/tropicalmed8090425] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2023] [Revised: 08/18/2023] [Accepted: 08/19/2023] [Indexed: 09/28/2023] Open
Abstract
Tungiasis is a neglected tropical disease (NTD) that can cause significant suffering and disability. Health promotion is an important pillar in NTD control programs, assuming that better knowledge contributes to reduced risk behavior and reduced risk of infection. The study objective was to assess tungiasis-related knowledge and its translation into control practices in a rural and highly endemic setting in Karamoja, Northeastern Uganda. We applied a mixed-methods design on household and community level. A semi-quantitative questionnaire on knowledge, practices, and attitudes (KAP) regarding tungiasis was administered to 1329 individuals with the main caring responsibilities in the household. Additionally, eight community dialogue meetings were held and analyzed. Overall, knowledge of tungiasis in humans was high but knowledge of tungiasis in animals was low. Most questionnaire respondents knew the causative agent and clinical presentations of tungiasis in humans, risk factors, and preventive measures. This tungiasis-related knowledge was translated into simple prevention measures. However, adequate tungiasis control was impeded due to a lack of resources, such as access to water and effective medical treatment. In conclusion, health promotion campaigns should be integrated with support towards adequate tungiasis control measures, such as provision of safe treatment, hardening of non-solid floors in the houses, and improved access to water.
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Affiliation(s)
- Marlene Thielecke
- Charité Center for Global Health, Institute of International Health, Charité University Medicine, 13353 Berlin, Germany
| | - Hannah McNeilly
- Edinburgh Medical School: Biomedical Sciences, The University of Edinburgh, Edinburgh EH8 9AG, UK
| | - Francis Mutebi
- Innovations for Tropical Disease Elimination (IFOTRODE), Kampala P.O. Box 24461, Uganda
- School of Veterinary Medicine and Animal Resources, College of Veterinary Medicine, Animal Resources and Biosecurity, Makerere University, Kampala P.O. Box 7062, Uganda
| | - Mike B. Banalyaki
- Innovations for Tropical Disease Elimination (IFOTRODE), Kampala P.O. Box 24461, Uganda
| | - Rebecca Arono
- Innovations for Tropical Disease Elimination (IFOTRODE), Kampala P.O. Box 24461, Uganda
| | - Susanne Wiese
- Institute of Microbiology, Infectious Diseases and Immunology, Charité University Medicine, 12203 Berlin, Germany
| | - Felix Reichert
- Department of Infectious Disease Epidemiology, Robert Koch Institute, 13353 Berlin, Germany
| | - George Mukone
- Innovations for Tropical Disease Elimination (IFOTRODE), Kampala P.O. Box 24461, Uganda
| | - Hermann Feldmeier
- Institute of Microbiology, Infectious Diseases and Immunology, Charité University Medicine, 12203 Berlin, Germany
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dos Santos KC, Brandão Guedes PE, Teixeira JBDC, Harvey TV, Carlos RSA. Treatment of Animal Tungiasis: What’s New? Trop Med Infect Dis 2023; 8:tropicalmed8030142. [PMID: 36977143 PMCID: PMC10051256 DOI: 10.3390/tropicalmed8030142] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2023] [Revised: 02/16/2023] [Accepted: 02/17/2023] [Indexed: 03/02/2023] Open
Abstract
In tropical and subtropical countries, particularly in disadvantaged communities, tungiasis is a severe public health problem, which is often neglected by the authorities. The sand fleas Tunga penetrans, predominant in endemic areas, and Tunga trimamillata, whose cases in humans are less frequent, are the cause of this zoonosis. Domestic animals are potential reservoirs and disseminators of tungiasis, so controlling their infection would significantly advance the prevention of human cases. This literature review compiles the most recent studies and innovations in treating animal tungiasis. Studies of approaches to the treatment of animal tungiasis, as well as disease control and prevention, are described. Isoxazolines are highlighted as promising drugs to treat animal tungiasis, with high efficacy and pharmacological protection. The positive impacts of this discovery on public health are also discussed, since dogs are an essential risk factor for human tungiasis.
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Affiliation(s)
- Katharine Costa dos Santos
- Departamento de Ciências Agrárias e Ambientais, Universidade Estadual de Santa Cruz (UESC), Ilhéus 45662-900, Brazil
| | - Paula Elisa Brandão Guedes
- Departamento de Ciências Agrárias e Ambientais, Universidade Estadual de Santa Cruz (UESC), Ilhéus 45662-900, Brazil
| | | | - Tatiani Vitor Harvey
- Department of Veterinary Integrative Biosciences, Texas A&M University, College Station, TX 77843, USA
| | - Renata Santiago Alberto Carlos
- Departamento de Ciências Agrárias e Ambientais, Universidade Estadual de Santa Cruz (UESC), Ilhéus 45662-900, Brazil
- Correspondence:
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Mutebi F, McNeilly H, Thielecke M, Reichert F, Wiese S, Mukone G, Feldmeier H. Prevalence and Infection Intensity of Human and Animal Tungiasis in Napak District, Karamoja, Northeastern Uganda. Trop Med Infect Dis 2023; 8:tropicalmed8020111. [PMID: 36828527 PMCID: PMC9963877 DOI: 10.3390/tropicalmed8020111] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2022] [Revised: 02/03/2023] [Accepted: 02/08/2023] [Indexed: 02/15/2023] Open
Abstract
Tungiasis is an important but highly neglected cause of morbidity in resource-poor communities in Latin America and sub-Saharan Africa. Data upon which implementation of control measures can be based are scarce. Before piloting an integrated tungiasis control program in three parishes of Napak district, Uganda, a cross-sectional survey involving the systematic examination of humans and domestic mammals was implemented to establish the occurrence patterns of tungiasis. The study population was 5482 residents, of which 4035 (73.6%) participated in the study. The prevalence of tungiasis in humans was 62.8% (95% CI: 61.3-64.3%), with slightly more males than females affected (p = 0.01). Age-specific prevalence and intensity of human tungiasis followed an S-curve pattern, with children of 5-14 years and the elderly (≥60 years) being the most affected. Half of all lesions (50%) had been manipulated by sharp objects. The prevalence of tungiasis in animals was lower (14.2%, 95% CI: 10.9-18.0) than that of humans (p < 0.001). Animal tungiasis occurred in decreasing order of frequency in pigs (80%), dogs (24%), goats (16.3%), cats (8.1%) and sheep (4.9%). In conclusion, human tungiasis was highly prevalent but animal infections were comparatively few in the study area. Nevertheless, effective control measures should be based on One Health principles.
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Affiliation(s)
- Francis Mutebi
- School of Veterinary Medicine and Animal Resources, College of Veterinary Medicine, Animal Resources and Biosecurity, Makerere University, Kampala P.O. Box 7062, Uganda
- Innovations for Tropical Disease Elimination (IFOTRODE), Kampala P.O. Box 24461, Uganda
- Correspondence: or
| | - Hannah McNeilly
- Edinburgh Medical School: Biomedical Sciences, The University of Edinburgh, Edinburgh EH8 9XD, UK
| | - Marlene Thielecke
- Charité Center for Global Health, Institute of International Health, Charité-University Medicine Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, 10117 Berlin, Germany
| | - Felix Reichert
- Department of Infectious Disease Epidemiology, Robert Koch Institute, 13353 Berlin, Germany
| | - Susanne Wiese
- Institute of Microbiology, Infectious Diseases and Immunology, Charité-University Medicine Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, 10117 Berlin, Germany
| | - George Mukone
- Innovations for Tropical Disease Elimination (IFOTRODE), Kampala P.O. Box 24461, Uganda
| | - Hermann Feldmeier
- Institute of Microbiology, Infectious Diseases and Immunology, Charité-University Medicine Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, 10117 Berlin, Germany
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Mutai IJ, Juma AA, Inyimili MI, Nyachieo A, Nyamache AK. Efficacy of diversely isolated lytic phages against multi-drug resistant Enterobacter cloacae isolates in Kenya. Afr J Lab Med 2022; 11:1673. [PMID: 36091354 PMCID: PMC9453119 DOI: 10.4102/ajlm.v11i1.1673] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2021] [Accepted: 05/04/2022] [Indexed: 11/07/2022] Open
Abstract
Background Enterobacter cloacae causes nosocomial infections in 15% of patients in low- and middle-income countries with emergence of carbapenem resistance. The utilisation of bacteriophages for therapeutic purposes is crucial for eradicating these resistant bacterial strains. Objective This study evaluated the efficacy of lytic phages on bacterial isolates of E. cloacae and determined their stability in various physicochemical conditions. Methods Twenty-nine lytic phages were isolated from the waste water of six informal settlements in Nairobi County, Kenya, from July 2019 to December 2020 and cross-reacted with 30 anonymised clinical isolates of E. cloacae. Six phages were then selected for physicochemical property studies. Phages were described as potent upon lysing any bacterial strain in the panel. Results Selected phages were stable at 4 °C – 50 °C with a 5.1% decrease in titre in four of six phages and a 1.8% increase in titre in two of six phages at 50 °C. The phages were efficient following two weeks incubation at 4 °C with optimal activity at human body temperature (37 °C) and an optimal pH of 7.5. Phages were active at 0.002 M and 0.015 M concentrations of Ca2+ ions. The efficiency of all phages decreased with increased exposure to ultraviolet light. All phages (n = 29) showed cross-reactivity against anonymised clinical isolates of E. cloacae strains (n = 30). The most potent phage lysed 67.0% of bacterial strains; the least potent phage lysed 27.0%. Conclusion This study reveals the existence of therapeutic phages in Kenya that are potent enough for treatment of multi-drug resistant E. cloacae.
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Affiliation(s)
- Ivy J Mutai
- Phage Biology Laboratory, Institute of Primate Research, Nairobi, Kenya
- Department of Biochemistry, Biotechnology and Microbiology, Faculty of Pure and Applied Sciences, Kenyatta University, Nairobi, Kenya
| | - Angela A Juma
- Phage Biology Laboratory, Institute of Primate Research, Nairobi, Kenya
| | | | - Atunga Nyachieo
- Phage Biology Laboratory, Institute of Primate Research, Nairobi, Kenya
| | - Anthony K Nyamache
- Department of Biochemistry, Biotechnology and Microbiology, Faculty of Pure and Applied Sciences, Kenyatta University, Nairobi, Kenya
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dos Santos KC, Chiummo RM, Heckeroth AR, Zschiesche E, Brandão Guedes PE, Harvey TV, de Jesus AV, da Paixão Sevá A, de Oliveira JTS, dos Santos Freire Z, Krücken J, de Almeida Borges F, von Samson-Himmelstjerna G, Alberto Carlos RS. Efficacy of oral fluralaner (Bravecto) against Tunga penetrans in dogs: A negative control, randomized field study in an endemic community in Brazil. PLoS Negl Trop Dis 2022; 16:e0010251. [PMID: 35286319 PMCID: PMC8947607 DOI: 10.1371/journal.pntd.0010251] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2021] [Revised: 03/24/2022] [Accepted: 02/11/2022] [Indexed: 12/01/2022] Open
Abstract
The sand flea Tunga penetrans is one of the zoonotic agents of tungiasis, a parasitic skin disease of humans and animals. The dog is one of its main reservoirs. This negatively controlled, randomized, double-masked clinical trial evaluated the therapeutic and residual efficacy of fluralaner for treatment of dogs naturally infested with T. penetrans. Sixty-two dogs from an endemically affected community in Brazil were randomly assigned to either receive oral fluralaner (Bravecto chewable tablets) at a dose of 25 to 56 mg fluralaner/kg body weight, or no treatment (31 dogs per group). Dogs were clinically examined using a severity score for acute canine tungiasis (SCADT), parasitological examinations as defined by the Fortaleza classification, and pictures of lesions on days 0 (inclusion and treatment), 7 ± 2, 14 ± 2, 21 ± 2, 28 ± 2, 60 ± 7, 90 ± 7, 120 ± 7 and 150 ± 7. The percentage of parasite-free dogs after treatment was >90% between days 14 and 90 post-treatment with 100% efficacy on study days 21, 28 and 60. Sand flea counts on fluralaner treated dogs were significantly lower (p<0.025) than control dogs on all counts from day 7 to 120. The number of live sand fleas on treated dogs was reduced by > 90% on day 7, > 95% on days 14 and 90, and 100% from day 21 to 60, and with a significant difference between groups from day 7 to 120. From day 7 to day 120, mean SCADT scores were significantly reduced in treated dogs with a mean of 0.10 compared to 1.54 on day 120 in untreated dogs. Therefore, a single oral fluralaner administration is effective for treating and achieving long lasting (> 12 weeks) prevention for tungiasis in dogs. Tungiasis is a dermatological disease that affects humans and animals infested with sand fleas (Tunga spp.), especially in communities exposed to contaminated sandy and dry soil, where living conditions are precarious and access to basic health is limited. These sand fleas penetrate host skin and cause severe acute and chronic injuries that can dramatically compromise the host’s health. Dogs are a primary reservoir and disseminator of these fleas in South America. In this clinical field trial, the efficacy of a single oral dose of fluralaner (Bravecto chewable tablets) was evaluated for treatment and prevention of tungiasis in dogs in an endemic area of Brazil. The treatment was assessed through absence of live sand fleas and resolution of characteristic tungiasis skin lesions. Fluralaner was 100% effective from the third to the eighth week post-treatment, eliminated live sand fleas and protected against new infestations during the study. Therefore, fluralaner proved to be an excellent therapeutic option for treatment and a highly effective control option for canine tungiasis.
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Affiliation(s)
- Katharine Costa dos Santos
- UESC, State University of Santa Cruz, Department of Agricultural and Environmental Sciences, Postgraduate Program in Animal Science, Ilhéus, Bahia, Brazil
| | | | | | - Eva Zschiesche
- MSD, Animal Health Innovation GmbH, Schwabenheim, Germany
| | - Paula Elisa Brandão Guedes
- UESC, State University of Santa Cruz, Department of Agricultural and Environmental Sciences, Postgraduate Program in Animal Science, Ilhéus, Bahia, Brazil
| | - Tatiani Vitor Harvey
- UESC, State University of Santa Cruz, Department of Agricultural and Environmental Sciences, Postgraduate Program in Animal Science, Ilhéus, Bahia, Brazil
| | - Anderson Vieira de Jesus
- UESC, State University of Santa Cruz, Department of Agricultural and Environmental Sciences, Postgraduate Program in Animal Science, Ilhéus, Bahia, Brazil
| | - Anaiá da Paixão Sevá
- UESC, State University of Santa Cruz, Department of Agricultural and Environmental Sciences, Postgraduate Program in Animal Science, Ilhéus, Bahia, Brazil
| | - Joana Thaisa Santos de Oliveira
- UESC, State University of Santa Cruz, Department of Agricultural and Environmental Sciences, Postgraduate Program in Animal Science, Ilhéus, Bahia, Brazil
| | - Zelina dos Santos Freire
- UFMS, Federal University of Mato Grosso do Sul, Faculty of Veterinary Medicine and Animal Science, Campo Grande, Mato Grosso do Sul, Brazil
| | - Jürgen Krücken
- Freie Universität Berlin, Institute for Parasitology and Tropical Veterinary Medicine, Berlin, Germany
| | - Fernando de Almeida Borges
- UFMS, Federal University of Mato Grosso do Sul, Faculty of Veterinary Medicine and Animal Science, Campo Grande, Mato Grosso do Sul, Brazil
| | - Georg von Samson-Himmelstjerna
- Freie Universität Berlin, Institute for Parasitology and Tropical Veterinary Medicine, Berlin, Germany
- * E-mail: (GvSH); (RSAC)
| | - Renata Santiago Alberto Carlos
- UESC, State University of Santa Cruz, Department of Agricultural and Environmental Sciences, Postgraduate Program in Animal Science, Ilhéus, Bahia, Brazil. CNPq Reseracher - PQ2
- * E-mail: (GvSH); (RSAC)
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Khan MA, Bin Islam S, Rakib MU, Alam D, Hossen MM, Tania M, Asad A. Major Drugs Used in COVID-19 Treatment: Molecular Mechanisms, Validation
and Current Progress in Trials. CORONAVIRUSES 2022; 3. [DOI: 10.2174/2666796701999201204122819] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/26/2020] [Revised: 11/16/2020] [Accepted: 11/11/2020] [Indexed: 07/28/2024]
Abstract
Background:
Currently, the present world is facing a new deadly challenge against a pandemic disease called
COVID-19, which is caused by a coronavirus, named SARS-CoV-2. To date, there is no drug or vaccine that can treat
COVID-19 completely, but some drugs have been used primarily, and they are in different stages of clinical trials. This
review article discussed and compared those drugs which are running ahead in COVID-19 treatments.
Methods:
We have explored PUBMED, SCOPUS, WEB OF SCIENCE, as well as press release of WHO, NIH and FDA for
articles about COVID-19, and reviewed them.
Results:
Drugs like favipiravir, remdesivir, lopinavir/ritonavir, hydroxychloroquine, azithromycin, ivermectin,
corticosteroids and interferons have been found effective in some extents, and partially approved by FDA and WHO to treat
COVID-19 at different phases of pandemic. However, some of these drugs have been disapproved later, although clinical
trials are going on. In parallel, plasma therapy has been found fruitful in some extents too, and a number of vaccine trails are
going on.
Conclusions:
This review article discussed the epidemiologic and mechanistic characteristics of SARS-CoV-2, and how
drugs could act on this virus with the comparative discussion on progress and backwards of major drugs used till date,
which might be beneficial for choosing therapies against COVID-19 in different countries.
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Affiliation(s)
- Md. Asaduzzaman Khan
- The Key Laboratory of Epigenetics and Oncology, The Research Center for Preclinical Medicine, Southwest Medical
University, Luzhou, Sichuan 646000, China
| | - Shad Bin Islam
- Bachelor in Medicine and Surgery Program, Affiliated hospital of Southwest
Medical University, Luzhou, Sichuan 646000, China
| | - Mejbah Uddin Rakib
- Bachelor in Medicine and Surgery Program, Affiliated hospital of Southwest
Medical University, Luzhou, Sichuan 646000, China
| | - Didarul Alam
- Bachelor in Medicine and Surgery Program, Affiliated hospital of Southwest
Medical University, Luzhou, Sichuan 646000, China
| | - Md. Munnaf Hossen
- Department of Immunology, Health Science Center, Shenzhen,
University, Shenzhen, Guangdong 518060, China
| | - Mousumi Tania
- Division of Molecular Cancer, Red Green Research Center,
Dhaka, Bangladesh
| | - Asaduzzaman Asad
- Department of Biochemistry and Molecular Biology, Jahangirnagar University; and International
Center for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh
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Abrha S, Tesfaye W, Thomas J. Therapeutic Potential of Tea Tree Oil for Tungiasis. Am J Trop Med Hyg 2021; 105:1157-1162. [PMID: 34731831 DOI: 10.4269/ajtmh.21-0427] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2021] [Accepted: 07/10/2021] [Indexed: 11/07/2022] Open
Abstract
Tungiasis (sand flea disease) is a neglected tropical disease caused by penetration of female sand fleas, Tunga penetrans, into a person's skin usually in their feet. The disease inflicts immense pain and suffering on millions of people, particularly children. The condition is most prevalent in Latin America, the Caribbean, and sub-Saharan Africa. Currently, there is no standard drug treatment for tungiasis. The available treatment options are fairly limited and unrealistic to use in endemic areas; as a result, in desperation, the affected people do more harm to themselves by extracting the fleas with non-sterile instruments, further exposing themselves to secondary bacterial infections and/or transmission of diseases such as hepatitis B virus, hepatitis C virus, or HIV. This highlights the urgent need for simpler, safer, and effective treatment options for tungiasis. Tea tree oil (TTO) has long been used as an antiseptic with extensive safety and efficacy data. The evidence on parasiticidal properties of TTO against ectoparasites such as head lice, mites, and fleas is also compelling. The purpose of this review is to discuss the current tungiasis treatment challenges in endemic settings and highlight the potential role of TTO in the treatment of tungiasis.
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Affiliation(s)
- Solomon Abrha
- Faculty of Health, University of Canberra, Bruce, Canberra, Australian Capital Territory, Australia.,Department of Pharmaceutics, School of Pharmacy, College of Health Sciences, Mekelle University, Mekelle, Ethiopia
| | - Wubshet Tesfaye
- Faculty of Health, University of Canberra, Bruce, Canberra, Australian Capital Territory, Australia
| | - Jackson Thomas
- Faculty of Health, University of Canberra, Bruce, Canberra, Australian Capital Territory, Australia
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Abrha S, Christenson JK, McEwen J, Tesfaye W, Vaz Nery S, Chang AY, Spelman T, Kosari S, Kigen G, Carroll S, Heukelbach J, Feldmeier H, Bartholomaeus A, Daniel M, Peterson GM, Thomas J. Treatment of tungiasis using a tea tree oil-based gel formulation: protocol for a randomised controlled proof-of-principle trial. BMJ Open 2021; 11:e047380. [PMID: 34326048 PMCID: PMC8323357 DOI: 10.1136/bmjopen-2020-047380] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
INTRODUCTION Tungiasis (sand flea disease or jigger infestation) is a neglected tropical disease caused by penetration of female sand fleas, Tunga penetrans, in the skin. The disease inflicts immense pain and suffering on millions of people, particularly children, in Latin America, the Caribbean and sub-Saharan Africa. Currently, there is no standard treatment for tungiasis, and a simple, safe and effective tungiasis treatment option is required. Tea tree oil (TTO) has long been used as a parasiticidal agent against ectoparasites such as headlice, mites and fleas with proven safety and efficacy data. However, current data are insufficient to warrant a recommendation for its use in tungiasis. This trial aims to generate these data by comparing the safety and efficacy of a 5% (v/w) TTO proprietary gel formulation with 0.05% (w/v) potassium permanganate (KMnO4) solution for tungiasis treatment. METHODS AND ANALYSIS This trial is a randomised controlled trial (RCT) in primary schools (n=8) in South-Western Kenya. The study will include school children (n=88) aged 6-15 years with a confirmed diagnosis of tungiasis. The participants will be randomised in a 1:1 ratio to receive a 3-day two times a day treatment of either 5% TTO gel or 0.05% KMnO4 solution. Two viable embedded sandflea lesions per participant will be targeted and the viability of these lesions will be followed throughout the study using a digital handheld microscope. The primary outcome is the proportion of observed viable embedded sand fleas that have lost viability (non-viable lesions) by day 10 (9 days after first treatment). Secondary outcomes include improvement in acute tungiasis morbidities assessed using a validated severity score for tungiasis, safety assessed through adverse events and product acceptability assessed by interviewing the participants to rate the treatment in terms of effectiveness, side effects, convenience, suitability and overall satisfaction. ETHICS AND DISSEMINATION The trial protocol has been reviewed and approved by the University of Canberra Human Research Ethics Committee (HREC-2019-2114). The findings of the study will be presented at scientific conferences and published in a peer-reviewed journal. TRIAL REGISTRATION NUMBERS Australian New Zealand Clinical Trials Registry (ACTRN12619001610123); PACTR202003651095100 and U1111-1243-2294.
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Affiliation(s)
- Solomon Abrha
- Pharmacy, Faculty of Health, University of Canberra, Canberra, Australian Capital Territory, Australia
- Department of Pharmaceutics, Mekelle University, Mekelle, Tigray, Ethiopia
| | - Julia K Christenson
- Pharmacy, Faculty of Health, University of Canberra, Canberra, Australian Capital Territory, Australia
| | - John McEwen
- Pharmacy, Faculty of Health, University of Canberra, Canberra, Australian Capital Territory, Australia
| | - Wubshet Tesfaye
- Pharmacy, Health Research Institute, University of Canberra, Canberra, Australian Capital Territory, Australia
| | - Susana Vaz Nery
- The Public Health Interventions Research Program, The Kirby Institute for Infection and Immunity in Society, University of New South Wales, Sydney, New South Wales, Australia
| | - Aileen Y Chang
- Department of Dermatology, University of California San Francisco, San Francisco, California, USA
| | - Tim Spelman
- Public Health, Burnet Institute International Health Research Group, Melbourne, Victoria, Australia
| | - Sam Kosari
- Pharmacy, Faculty of Health, University of Canberra, Canberra, Australian Capital Territory, Australia
| | - Gabriel Kigen
- Department of Pharmacology and Toxicology, Moi University School of Medicine, Eldoret, Central, Kenya
| | - Simon Carroll
- Pharmacy, Faculty of Health, University of Canberra, Canberra, Australian Capital Territory, Australia
- Global School Partners, Canberra, Australian Capital Territory, Australia
| | - Jorg Heukelbach
- Department of Community Health, Federal University of Ceará, Fortaleza, Brazil, Fortaleza, Brazil
| | - Hermann Feldmeier
- Institute of Microbiology and Infection Immunology, Campus Benjamin Franklin, Charité University Medicine, Berlin, Germany
| | - Andrew Bartholomaeus
- Diamantina Institute, The University of Queensland, Woolloongabba, Queensland, Australia
| | - Mark Daniel
- Centre for Research and Action in Public Health, Health Research Institute, University of Canberra, Canberra, Australian Capital Territory, Australia
| | | | - Jackson Thomas
- Pharmacy, Faculty of Health, University of Canberra, Canberra, Australian Capital Territory, Australia
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12
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Ansari S, Hays JP, Kemp A, Okechukwu R, Murugaiyan J, Ekwanzala MD, Ruiz Alvarez MJ, Paul-Satyaseela M, Iwu CD, Balleste-Delpierre C, Septimus E, Mugisha L, Fadare J, Chaudhuri S, Chibabhai V, Wadanamby JMRWW, Daoud Z, Xiao Y, Parkunan T, Khalaf Y, M’Ikanatha NM, van Dongen MBM. The potential impact of the COVID-19 pandemic on global antimicrobial and biocide resistance: an AMR Insights global perspective. JAC Antimicrob Resist 2021; 3:dlab038. [PMID: 34192258 PMCID: PMC8083476 DOI: 10.1093/jacamr/dlab038] [Citation(s) in RCA: 39] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
The COVID-19 pandemic presents a serious public health challenge in all countries. However, repercussions of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infections on future global health are still being investigated, including the pandemic's potential effect on the emergence and spread of global antimicrobial resistance (AMR). Critically ill COVID-19 patients may develop severe complications, which may predispose patients to infection with nosocomial bacterial and/or fungal pathogens, requiring the extensive use of antibiotics. However, antibiotics may also be inappropriately used in milder cases of COVID-19 infection. Further, concerns such as increased biocide use, antimicrobial stewardship/infection control, AMR awareness, the need for diagnostics (including rapid and point-of-care diagnostics) and the usefulness of vaccination could all be components shaping the influence of the COVID-19 pandemic. In this publication, the authors present a brief overview of the COVID-19 pandemic and associated issues that could influence the pandemic's effect on global AMR.
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Affiliation(s)
- Shamshul Ansari
- Department of Microbiology, Chitwan Medical College and Teaching Hospital, Bharatpur, 44200 Chitwan, Nepal
| | - John P Hays
- Department of Medical Microbiology & Infectious Diseases, Erasmus University Medical Centre Rotterdam (Erasmus MC), Rotterdam, The Netherlands
| | - Andrew Kemp
- Scientific Advisory Board of the British Institute of Cleaning Sciences, Northampton, UK
| | - Raymond Okechukwu
- Department of Clinical Pharmacy and Pharmacy Management, Faculty of Pharmaceutical Sciences, Nnamdi Azikiwe University, Agulu Campus, Nigeria
| | | | - Mutshiene Deogratias Ekwanzala
- Department of Environmental, Water and Earth Sciences, Tshwane University of Technology, Pretoria, South Africa
- Environmental Engineering, Department of Civil Engineering, Kyung Hee University, Yongin-si, Gyeonggi-do, Republic of Korea
| | | | | | - Chidozie Declan Iwu
- School of Health Systems and Public Health, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa
| | | | - Ed Septimus
- Department of Population Medicine, Harvard Medical School & Harvard Pilgrim Health Care Institute, Boston, MA, 02215, Texas A&M College of Medicine, Houston, TX 77030, USA
| | - Lawrence Mugisha
- College of Veterinary Medicine, Animal Resources & Biosecurity (COVAB), Makerere University, Kampala, Uganda
| | - Joseph Fadare
- Department of Pharmacology and Therapeutics, College of Medicine, Ekiti State University, Ado-Ekiti, Nigeria
| | - Susmita Chaudhuri
- Translational Health Science and Technology Institute, Faridabad 121001, India
| | - Vindana Chibabhai
- Department of Clinical Microbiology and Infectious Diseases, University of the Witwatersrand, and Clinical Microbiology Laboratory, Charlotte Maxeke Johannesburg Academic Hospital, National Health Laboratory Service, Johannesburg, South Africa
| | - J M Rohini W W Wadanamby
- Department of Microbiology, Lanka Hospital Diagnostics, Lanka Hospital 578, Elvitigala Mw, Colombo 05, Sri Lanka
| | - Ziad Daoud
- Department of Clinical Microbiology & Infection Prevention, Michigan Health Clinics-Saginaw, MI, USA and Department of Foundational Sciences, CMED-CMU, Mount Pleasant, MI, USA
| | - Yonghong Xiao
- State Key Laboratory for Diagnosis & Treatment of Infectious Diseases, the First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou 300013, China
| | - Thulasiraman Parkunan
- Department of Veterinary Physiology and Biochemistry, Faculty of Veterinary and Animal Sciences, Institute of Agricultural Sciences, Rajiv Gandhi South Campus, Banaras Hindu University, Mirzapur, Uttar Pradesh, India
| | - Yara Khalaf
- Department of Epidemiology, High Institute of Public Health, Alexandria University, Alexandria, Egypt
| | - Nkuchia M M’Ikanatha
- Division of Infectious Disease Epidemiology, Pennsylvania Department of Health, Harrisburg, PA, USA
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13
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van der Loo C, Bartie C, Barnard TG, Potgieter N. Detection of Free-Living Amoebae and Their Intracellular Bacteria in Borehole Water before and after a Ceramic Pot Filter Point-of-Use Intervention in Rural Communities in South Africa. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:3912. [PMID: 33917870 PMCID: PMC8068299 DOI: 10.3390/ijerph18083912] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/26/2021] [Revised: 03/26/2021] [Accepted: 04/02/2021] [Indexed: 11/21/2022]
Abstract
Free-living amoebae (FLA) are ubiquitous in nature, whereas amoeba-resistant bacteria (ARB) have evolved virulent mechanisms that allow them to resist FLA digestion mechanisms and survive inside the amoeba during hostile environmental conditions. This study assessed the prevalence of FLA and ARB species in borehole water before and after a ceramic point-of-use intervention in rural households. A total of 529 water samples were collected over a five-month period from 82 households. All water samples were subjected to amoebal enrichment, bacterial isolation on selective media, and molecular identification using 16S PCR/sequencing to determine ARB species and 18S rRNA PCR/sequencing to determine FLA species present in the water samples before and after the ceramic pot intervention. Several FLA species including Acanthamoeba spp. and Mycobacterium spp. were isolated. The ceramic pot filter removed many of these microorganisms from the borehole water. However, design flaws could have been responsible for some FLA and ARB detected in the filtered water. FLA and their associated ARB are ubiquitous in borehole water, and some of these species might be potentially harmful and a health risk to vulnerable individuals. There is a need to do more investigations into the health risk of these organisms after point-of-use treatment.
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Affiliation(s)
- Clarissa van der Loo
- Water and Health Research Centre, Faculty of Health Sciences, University of Johannesburg, Johannesburg 2094, South Africa; (C.v.d.L.); (T.G.B.)
| | | | - Tobias George Barnard
- Water and Health Research Centre, Faculty of Health Sciences, University of Johannesburg, Johannesburg 2094, South Africa; (C.v.d.L.); (T.G.B.)
| | - Natasha Potgieter
- Environmental Health, Domestic Hygiene and Microbial Pathogens Research Group, Department of Microbiology, University of Venda, Thohoyandou 1950, South Africa
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14
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Manohar P, Loh B, Nachimuthu R, Hua X, Welburn SC, Leptihn S. Secondary Bacterial Infections in Patients With Viral Pneumonia. Front Med (Lausanne) 2020; 7:420. [PMID: 32850912 PMCID: PMC7419580 DOI: 10.3389/fmed.2020.00420] [Citation(s) in RCA: 74] [Impact Index Per Article: 18.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2020] [Accepted: 06/30/2020] [Indexed: 01/08/2023] Open
Abstract
Pulmonary diseases of viral origin are often followed by the manifestation of secondary infections, leading to further clinical complications and negative disease outcomes. Thus, research on secondary infections is essential. Here, we review clinical data of secondary bacterial infections developed after the onset of pulmonary viral infections. We review the most recent clinical data and current knowledge of secondary bacterial infections and their treatment in SARS-CoV-2 positive patients; case reports from SARS-CoV, MERS-CoV, SARS-CoV2 and the best-studied respiratory virus, influenza, are described. We outline treatments used or prophylactic measures employed for secondary bacterial infections. This evaluation includes recent clinical reports of pulmonary viral infections, including those by COVID-19, that reference secondary infections. Where data was provided for COVID-19 patients, a mortality rate of 15.2% due to secondary bacterial infections was observed for patients with pneumonia (41 of 268). Most clinicians treated patients with SARS-CoV-2 infections with prophylactic antibiotics (63.7%, n = 1,901), compared to 73.5% (n = 3,072) in all clinical reports of viral pneumonia included in this review. For all cases of viral pneumonia, a mortality rate of 10.9% due to secondary infections was observed (53 of 482). Most commonly, quinolones, cephalosporins and macrolides were administered, but also the glycopeptide vancomycin. Several bacterial pathogens appear to be prevalent as causative agents of secondary infections, including antibiotic-resistant strains of Staphylococcus aureus and Klebsiella pneumoniae.
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Affiliation(s)
- Prasanth Manohar
- Zhejiang University-University of Edinburgh (ZJU-UoE) Institute, Zhejiang University, Haining, China.,School of Medicine, The Second Affiliated Hospital Zhejiang University (SAHZU), Hangzhou, China
| | - Belinda Loh
- Zhejiang University-University of Edinburgh (ZJU-UoE) Institute, Zhejiang University, Haining, China
| | - Ramesh Nachimuthu
- Antibiotic Resistance and Phage Therapy Laboratory, School of Bio Sciences and Technology, Vellore Institute of Technology (VIT), Vellore, India
| | - Xiaoting Hua
- Department of Infectious Diseases, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, China.,Key Laboratory of Microbial Technology and Bioinformatics of Zhejiang Province, Hangzhou, China
| | - Susan C Welburn
- Zhejiang University-University of Edinburgh (ZJU-UoE) Institute, Zhejiang University, Haining, China.,Infection Medicine, Biomedical Sciences, Edinburgh Medical School, College of Medicine and Veterinary Medicine, The University of Edinburgh, Edinburgh, United Kingdom
| | - Sebastian Leptihn
- Zhejiang University-University of Edinburgh (ZJU-UoE) Institute, Zhejiang University, Haining, China.,Department of Infectious Diseases, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, China.,Infection Medicine, Biomedical Sciences, Edinburgh Medical School, College of Medicine and Veterinary Medicine, The University of Edinburgh, Edinburgh, United Kingdom
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15
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Deka MA. Mapping the Geographic Distribution of Tungiasis in Sub-Saharan Africa. Trop Med Infect Dis 2020; 5:E122. [PMID: 32722011 PMCID: PMC7558156 DOI: 10.3390/tropicalmed5030122] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2020] [Revised: 07/14/2020] [Accepted: 07/19/2020] [Indexed: 12/30/2022] Open
Abstract
The geographic distribution of tungiasis is poorly understood, despite the frequent occurrence of the disease in marginalized populations of low socioeconomic status. To date, little work is available to define the geography of this neglected tropical disease (NTD). This exploratory study incorporated geostatistical modeling to map the suitability for tungiasis transmission in sub-Saharan Africa (SSA). In SSA, environmental suitability is predicted in 44 countries, including Angola, Nigeria, Ghana, Cameroon, Cote de Ivoire, Mali, Ethiopia, the Democratic Republic of the Congo, Kenya, Gabon, Uganda, Rwanda, Tanzania, Zambia, Zimbabwe, Madagascar, and South Africa. In total, an estimated 668 million people live in suitable areas, 46% (304 million) of which reside in East Africa. These evidence-based maps provide vital evidence of the potential geographic extent of SSA. They will help to guide disease control programs, inform policymakers, and raise awareness at the global level. Likewise, these results will hopefully provide decisionmakers with the pertinent information necessary to lessen morbidity and mortality in communities located in environmentally suitable areas.
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Affiliation(s)
- Mark A Deka
- Department of Geography, Texas State University; 601 University Drive, San Marcos, TX 78666, USA
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16
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Manohar P, Loh B, Athira S, Nachimuthu R, Hua X, Welburn SC, Leptihn S. Secondary Bacterial Infections During Pulmonary Viral Disease: Phage Therapeutics as Alternatives to Antibiotics? Front Microbiol 2020; 11:1434. [PMID: 32733404 PMCID: PMC7358648 DOI: 10.3389/fmicb.2020.01434] [Citation(s) in RCA: 60] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2020] [Accepted: 06/03/2020] [Indexed: 12/25/2022] Open
Abstract
Secondary bacterial infections manifest during or after a viral infection(s) and can lead to negative outcomes and sometimes fatal clinical complications. Research and development of clinical interventions is largely focused on the primary pathogen, with research on any secondary infection(s) being neglected. Here we highlight the impact of secondary bacterial infections and in particular those caused by antibiotic-resistant strains, on disease outcomes. We describe possible non-antibiotic treatment options, when small molecule drugs have no effect on the bacterial pathogen and explore the potential of phage therapy and phage-derived therapeutic proteins and strategies in treating secondary bacterial infections, including their application in combination with chemical antibiotics.
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Affiliation(s)
- Prasanth Manohar
- Zhejiang University-University of Edinburgh Institute, Zhejiang University, Haining, China.,The Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Belinda Loh
- Zhejiang University-University of Edinburgh Institute, Zhejiang University, Haining, China
| | - Sudarsanan Athira
- Antibiotic Resistance and Phage Therapy Laboratory, School of Biosciences and Technology, Vellore Institute of Technology, Vellore, India
| | - Ramesh Nachimuthu
- Antibiotic Resistance and Phage Therapy Laboratory, School of Biosciences and Technology, Vellore Institute of Technology, Vellore, India
| | - Xiaoting Hua
- Department of Infectious Diseases, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou, China.,Key Laboratory of Microbial Technology and Bioinformatics of Zhejiang Province, Hangzhou, China
| | - Susan C Welburn
- Zhejiang University-University of Edinburgh Institute, Zhejiang University, Haining, China.,Infection Medicine, Biomedical Sciences, Edinburgh Medical School, College of Medicine and Veterinary Medicine, The University of Edinburgh, Edinburgh, United Kingdom
| | - Sebastian Leptihn
- Zhejiang University-University of Edinburgh Institute, Zhejiang University, Haining, China.,Department of Infectious Diseases, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou, China.,Infection Medicine, Biomedical Sciences, Edinburgh Medical School, College of Medicine and Veterinary Medicine, The University of Edinburgh, Edinburgh, United Kingdom
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17
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Ectoparasites. J Am Acad Dermatol 2020; 82:551-569. [DOI: 10.1016/j.jaad.2019.05.110] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2019] [Revised: 05/16/2019] [Accepted: 05/31/2019] [Indexed: 12/18/2022]
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18
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Kyany'a C, Nyasinga J, Matano D, Oundo V, Wacira S, Sang W, Musila L. Phenotypic and genotypic characterization of clinical Staphylococcus aureus isolates from Kenya. BMC Microbiol 2019; 19:245. [PMID: 31694531 PMCID: PMC6836327 DOI: 10.1186/s12866-019-1597-1] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2019] [Accepted: 09/12/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The increase and spread of virulent-outbreak associated, methicillin and vancomycin resistant (MRSA/VRSA) Staphylococcus aureus require a better understanding of the resistance and virulence patterns of circulating and emerging strains globally. This study sought to establish the resistance phenotype, and strains of 32 non-duplicate clinical MRSA and MSSA S. aureus isolates from four Kenyan hospitals, identify their resistance and virulence genes and determine the genetic relationships of MRSA with global strains. METHODS Antimicrobial susceptibility profiles were determined on a Vitek 2, genomic DNA sequenced on an Illumina Miseq and isolates typed in-silico. Resistance and virulence genes were identified using ARIBA and phylogenies generated using RAxML. RESULTS The MRSA isolates were 100% susceptible to vancomycin, teicoplanin, linezolid, and tigecycline. Nine distinct CC, 12 ST and 15 spa types including the novel t17826 and STs (4705, 4707) were identified with CC8 and CC152 predominating. MRSA isolates distributed across 3 CCs; CC5-ST39 (1), CC8 - ST241 (4), a novel CC8-ST4705 (1), ST8 (1) and CC152 (1). There was > 90% phenotype-genotype concordance with key resistance genes identified only among MRSA isolates: gyrA, rpoB, and parC mutations, mecA, ant (4')-lb, aph (3')-IIIa, ermA, sat-4, fusA, mphC and msrA. Kenyan MRSA isolates were genetically diverse and most closely related to Tanzanian and UK isolates. There was a significant correlation between map, hlgA, selk, selq and cap8d virulence genes and severe infections. CONCLUSION The findings showed a heterogeneous S. aureus population with novel strain types. Though limited by the low number of isolates, this study begins to fill gaps and expand our knowledge of S. aureus epidemiology while uncovering interesting patterns of distribution of strain types which should be further explored. Although last-line treatments are still effective, the potential for outbreaks of both virulent and resistant strains remain, requiring sustained surveillance of S. aureus populations.
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Affiliation(s)
- Cecilia Kyany'a
- Kenya Medical Research Institute, P. O. Box 54840-00200, Nairobi, Kenya.,The United States Army Medical Research Directorate-Africa, P.O. Box 606-00621, Village Market, Nairobi, Kenya
| | - Justin Nyasinga
- Technical University of Kenya, P.O. Box 52428-00200, Nairobi, Kenya
| | - Daniel Matano
- Kenya Medical Research Institute, P. O. Box 54840-00200, Nairobi, Kenya.,The United States Army Medical Research Directorate-Africa, P.O. Box 606-00621, Village Market, Nairobi, Kenya
| | - Valerie Oundo
- Kenya Medical Research Institute, P. O. Box 54840-00200, Nairobi, Kenya.,The United States Army Medical Research Directorate-Africa, P.O. Box 606-00621, Village Market, Nairobi, Kenya
| | - Simon Wacira
- Kenya Medical Research Institute, P. O. Box 54840-00200, Nairobi, Kenya.,The United States Army Medical Research Directorate-Africa, P.O. Box 606-00621, Village Market, Nairobi, Kenya
| | - Willie Sang
- Kenya Medical Research Institute, P. O. Box 54840-00200, Nairobi, Kenya
| | - Lillian Musila
- Kenya Medical Research Institute, P. O. Box 54840-00200, Nairobi, Kenya. .,The United States Army Medical Research Directorate-Africa, P.O. Box 606-00621, Village Market, Nairobi, Kenya.
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