Day 1 :
Keynote Forum
Peter Timms
University of the Sunshine Coast
Australia
Keynote: Development of a chlamydial vaccine for koalas: Protection against infection as well as disease
Time : 09:30-10:05
Biography:
Peter Timms is Professor of Microbiology at the University of Sunshine Coast in Queensland, Australia. He is a nationally and internationally renowned microbiologist with specific expertise in the area of Chlamydia. His laboratory is acknowledged as the leading Australian laboratory and one of the leading groups internationally working on all aspects of chlamydial infections. His research group of 12 staff and students is developing vaccines and new diagnostics for chlamydial diseases in humans and animals as well as an improved understanding of chlamydial genomics, cell biology and pathogenicity. The group is widely acknowledged for its major contributions to chlamydial infections in koalas and other wildlife, including the development of a vaccine for koalas. He has published over 250 papers, reviews and book chapters in peer-reviewed international scientific journals.
Abstract:
Wild koala populations continue to experience serious declines as a result of several threatening factors including: loss of habitat; motor vehicle trauma; dog attacks and; chlamydial disease. Chlamydial infections are associated with diseases ranging from ocular disease leading to blindness, as well as urinary and genital tract disease, leading to female infertility. Modeling shows that targeting chlamydial disease would have a major impact on stabilizing population decline. Our previous studies have demonstrated that koalas can be safely immunized with a vaccine containing a mixture of chlamydial major outer membrane protein (MOMP) antigens combined with a single or three-dose subcutaneous regime. In our most recent, large scale, field trial of the vaccine, we vaccinated 30 koalas that were outwardly clinically healthy but either chlamydia PCR negative or chlamydia PCR positive, and followed them for 1-2 years to assess the protective effect of the vaccine (compared to a control group of unvaccinated koalas). We observed strong, specific and long-lasting immune responses in the vaccinated koalas; high titer antibody responses (as measured by ELISA and also in vitro neutralization) as well as chlamydia-specific cytokine responses (interferon-gamma and IL-17 in particular). For animals which were chlamydia PCR positive at the time of vaccination, we observed a significant reduction in their infection PCR load (at both the ocular and urogenital tract sites). We also observed protection from progression to clinical disease in the vaccinated animals. We have also conducted a small trial to vaccinate animals which already have clinical signs of ocular disease. Instead of the normal practice of administering antibiotics (chloramphenicol, daily for 28 days, which severely disrupts the animal’s gut microbiome) we vaccinated four animals with a single dose, 3-MOMP vaccine. For all vaccinated animals, their chlamydia PCR load decreased, often to zero, and in two animals at least, we observed a decrease in their clinical disease score. These results are promising for the future development of an effective chlamydial vaccine for use in captive as well as wild koalas.
Keynote Forum
Zlatko Dembic
University of Oslo
Norway
Keynote: Tuberculosis risk is spread within the hallmarks of the disease
Time : 10:05-10:40
Biography:
Zlatko Dembic is a Professor of Immunology, Cell-Biology and Microbiology at University of Oslo. He has been working in science at various institutions in Academia (Medical Faculty, Zagreb, Croatia; Max-Planck Institute for Immunogenetics, Tubingen, Germany; Basel Institute for Immunology, Switzerland; Institute of Immunology, Oslo, Norway) and industry (Roche, Switzerland). He has his expertise in molecular biology shown by over 100 publications to date and a monograph about cytokines in immunology. He is co-inventor of the US patent (Roche) covering the production and use of etanercept (Enbrel), which is a successful (anti-TNF) biological used to treat several autoimmune diseases including rheumatoid arthritis. He was the president of the Norwegian Society for Immunology and Editor-in-chief of the Scand J Immunol (at present, Associate Editor). He is a Visiting Professor of Medicine at medical school in his hometown Rijeka (Croatia).
Abstract:
Statement of the Problem: Heritable susceptibility to tuberculosis (TB) is complex and polygenic in nature. Only five to ten percent of humans that come in contact with the bacterium Mycobacterium tuberculosis (Mt) will manifest the disease, provided no acquired- or congenital immunodeficiency were present. We still lack a viable explanation for the observed epidemiologic fact. Method: Activation of macrophages via proinflammatory cytokines IFN-v and interleukin (IL)-17 can kill intracellular bacteria such as Mt. Instead, macrophages stimulated by the Toll-like receptor (TLR)-10 agonists show an anti-inflammatory effect. The TLR-10 acts by inhibiting the TLR-2 signaling from the cell membrane. The TLR-2 is the Mt-binding protein by which activated macrophages can internalize (and kill) Mt. Inactivation of the TLR-2 protein might convey a risk for developing the disease. This was supported by our finding that TLR2 gene polymorphisms, which either inactivate the TLR2 gene product or have a dominantnegative role in TLR-2-signaling, associated with elevated risk for tuberculosis in the Croatian Caucasian population. Findings: The genome-wide study found that three single nucleotide polymorphisms (SNPs) within the HLA class II loci were significantly associated with TB; suggesting that adaptive immunity is of paramount importance for defense against TB. In our studied population, SNP in the TLR10 gene was associated with risk for TB, analyzed by the dominant model of inheritance. However, this was contrasted by the fact that SNPs in the IL17A&F genes were not. Conclusion & Significance: Studying genetic risk by association analyses or genome-wide screening led us to propose that clinical manifestation of TB is a state above certain risk-threshold. Threshold is reached by accumulation of seemingly minor susceptibilities divided between the hallmarks of the disease (Fig 1). The model suggests that every human population has its own mosaic of genetic risks for TB.
- Host and Pathogen Interactions | Infection Pathogen Biology | Infection Prevention & Control | Healthcare Infectious Diseases | Epidemiology - Infectious Diseases
Location: Bismarck
Chair
Peter Timms
University of the Sunshine Coast
Australia
Co-Chair
Zlatko Dembic
Norway
Session Introduction
Jean-Pierre Marissal
Cathollic University of LIlle Faculté de Gestion
France
Title: Knowing to design: Costs of and benefits from nosocomial infections for hospitals
Time : 11:00-11:25
Biography:
Abstract:
Alan Ebringer
King's College London
UK
Title: Bovine spongiform encephalopathy (mad cow disease) is probably caused by Bovine spongiform encephalopathy (mad cow disease) is probably caused by Acinetobacter bacteria and not by prions
Time : 11:25-11:50
Biography:
Alan Ebringer is Professor of Immunology at King's College London and has published over 300 papers in scientific literature. His main interests are immunology of ankylosing spondylitis, rheumatoid arthritis and bovine spongiform encephalopathy (BSE "mad cow disease"). His group has suggested that BSE is caused by Acinetobacter bacteria.
Abstract:
Previous studies have shown that there is molecular mimicry between Streptococcus and cardiac collagens in rheumatic fever. In early 1990’s the British government asked whether there was a role for molecular mimicry in bovine spongiform encephalopathy (BSE), also known as mad cow disease. A cursory review of the literature showed that molecular mimicry was present between the soil and nasal microbe Acinetobacter and myelin, the covering of nerves. The government, through DEFRA (Department of Environment, Food and Rural Affairs) then gave a £250,000 grant to King’s College and access to BSE materials to investigate this problem. A pilot study showed that elevated levels of antibodies to the soil and nasal microbe Acinetobacter was found in 29 BSE animals compared to sera from 76 control animals (p<0.001). A second larger study involving 128 BSE compared to 127 controls, confirmed that elevated levels of antibodies to Acinetobacter were present in BSE animals (p<0.001) but not to 6 other bacteria. It appeared that feeding cattle with abattoir materials (meat-and bone meal) caused either contamination with Acinetobacter or with prions and the government banned the use of meat-and-bone meal supplements which led to the disappearance of BSE in British cattle. However a review of the definition of transmissible spongiform encephalopathies (TSE) revealed that the Pasteur Effect, namely the production of experimental allergic encephalomyelitis (EAE) in experimental animals had not been considered when injecting saline brain homogenates in BSE research studies. The bio-assay is based on a wrong assumption that injecting saline brain homogenates will not cause damage to the healthy, test experimental animals. The concept that prions are infectious particles may require revision.
Eliette Touati
Institut Pasteur
France
Title: Consequences of H. pylori infection and its VacA cytotoxin on mitochondria and mitochondrial DNA: Impact on gastric pathogenesis
Time : 11:50-12:15
Biography:
Abstract:
Statement of the Problem: Mitochondria alterations and mitochondrial DNA (mtDNA) instabilities are a hallmark of cancer. Mitochondria represent strategic targets for pathogens also including Helicobacter pylori. This bacterium is a major risk factor for gastric cancer. Up to now, the cytotoxin VacA is the only one H. pylori factor known to target and damage mitochondria.
Methodology & Theoretical Orientation: By in vitro infection of gastric epithelial cells with wild-type and VacA-deficient H. pylori strains, treatment of cells with purified VacA proteins and infection of a mouse model, we show that H. pylori deregulates mitochondria by two novel mechanisms, both rather associated with host cell survival. First, early upon infection VacA induces transient increase of mitochondrial translocases and a dramatic accumulation of the mitochondrial DNA replication and maintenance factors POLG and TFAM. These events occur when VacA is not detected intracellularly, therefore do not require the direct interaction of the cytotoxin with the organelle. They occur independently of the VacA vacuolating activity. In vivo, these alterations coincide with the evolution of gastric lesions towards severity, concomitantly with the induction of mtDNA mutations and depletion of mtDNA content. Second, H. pylorus also induces VacA-independent alteration of mitochondrial replication and import components, suggesting the involvement of additional H. pylori activities in mitochondria-mediated effects.
Conclusions & Significance: Our findings reveal a novel and early inducer effect of H. pylori infection on mitochondrial translocases and the mtDNA replication/transcription machinery components POLG and TFAM. Moreover, we show that VacA does not account for all consequences of H. pylori infection at mitochondria, pointing to the involvement of other bacterial activities, yet to be determined. These effects of H. pylori infection are also relevant in vivo, suggesting that mitochondrial alterations impact H. pylori-induced gastric inflammation and pathogenicity.
Alla Paskovaty
Memorial Sloan Ketterning Cancer Center
USA
Title: State of the art antimicrobial stewardship in immunocompromized hosts
Time : 12:15-12:40
Biography:
Dr. Paskovaty, holds Doctror of Pharmacy degree from a prestigious Americal Univercity, Albany College of Pharmacy and has been employed for over 15 years as an antimicrobial stewardship coordinator at a world renown cancer center in NYC: Memorial Sloan Kettering Cancer Center. She has been invited lecturer at numerous local and international meetings, has published papers and book chapters on topic of Antimicrobial Stweardship.
Abstract:
Infections cause significant morbidity and mortality in patients with hematologic or solid tumor malignancies. Susceptibility to infection can occur from the malignancy itself, but the primary risk factor is immunosuppression from cancer treatment (e.g., cytotoxic chemotherapy, radiation, combined modality). Administration of broad antimicrobial therapy for empertic treatment of febrile neutropenia is recommended by national guidelines.. This strategy however needs to be balanced against the desire to continue broad-spectrum therapy for prolonged durations during the patient’s hospitalization. Overuse of anitibiotics leads to antimicroibal resistance, higher healthcare costs, and poor health oucomes due to antimicrobial side effects. Immunocompromized paitents are at high risk for being colonized with multidrug resistant organisms, and are at high risk for morbidity and mortality due to such organisms. In addition, cancer patients are at higher risk for drug-related toxicity, due to drug-drug interactions between certain antimicrobials, cancer chemotherapy and supportive therapy. To mitigate the overuse of antibiotics, multidisciplinary approach to atimicriboal steardship needs to be employed. Modern antimicrobial stewardship programs use tactics such as, pre-prescribing review and approval and/or de-escalation: either by changing the antimicrobial agent to something narrower or by stopping an antimicrobial combination or both. To aid in the process, successful stewardship allows collaboration between several departments: Hospital administration, Microbiology, Pharmacy, Departments of Medicine, Oncology and Infection control, Information Technology among a few. Innovative approaches in molecular diagnostics allow antimicrobial stewardship to intevene earlier and with higher success rate. Current technology allows for allerts during prescribing process, allowing for real-time antimicrobial stewardship interventions. Immunocopromized patients present unique challenges for antimicrobial stewardship. This lecture identifies those challenges and presents various strategies that employ up-todate technology and diagnostics to aid in the endavor.
Rambir Singh
Bundelkhand University
India
Title: Pharmacoproteomics of Aspergillus fumigatus for identification of novel molecular targets having application immunodiagnosis and therapy
Time : 12:40-13:05
Biography:
Rambir Singh completed his PhD in Biomedical Sciences (Infection Biology) from University of Delhi, India in 2004. After completing PhD, he joined Bundelkhand University, Jhansi, India, as an Assistant Professor in Biochemistry where currently he is working as Associate Professor in Biomedical Sciences. He is teaching microbiology, biochemical techniques and natural plant product based drug discovery at undergraduate and postgraduate level. He is working in the research area of ‘Bioactive molecules from Ayurvedic medicinal plants, health effects of probiotics and proteomics of Aspergillus fumigatus.
Abstract:
Aspergillosis has emerged as threat to public health in recent past. Early stage diagnosis of aspergillosis has been difficult. There are limited options of effective drugs for treatment and invasive infections are always fatal. Importantly, clinical symptoms of aspergillosis overlap with those of TB. This often leads to misdiagnosis of aspergillosis as TB and wrong treatment. Hence, early diagnosis of aspergillosis is essentially needed. Currently, available late stage antigen based serological tests have limited diagnostic efficacy. Hence, there is urgent need for identification of novel molecules of diagnostic and therapeutic relevance. While working with Indian (ITCC-6604) and German (DAYA) strains of A. fumigatus, we were able to identify 111 cytosolic proteins spots from 2D gels. Out of these 111 protein spots, 66 proteins have been identified on comparison with available protein databases. Immuno-proteomics studies on these cytosolic proteins showed the presence of highly immunodominant IgG and IgE reactive proteins. Characterizations of these proteins have immense application in immuno-diagnosis and therapy of aspergillosis.
Omotowo Babatunde
University of Nigeria
Nigeria
Title: Knowledge and practices concerning multi-drug resistance tuberculosis among health workers and TB patients in Enugu, South-East, Nigeria
Time : 14:00-14:25
Biography:
Abstract:
Introduction: Inadequate knowledge and practices of health workers and TB patients concerning MDR-TB may have serious health consequences and significant negative impact in the control of TB.
Objective: The purpose of the study was to ascertain the knowledge, and practices of health care workers and TB patients concerning MDR-TB.
Methods: A cross sectional descriptive survey was conducted by questionnaire designed precisely for the study. Data was collected from 115 health workers at the University of Nigeria Teaching Hospital Enugu, and 120 patients from DOTS centers. Data collected included sociodemographic and professional categories, knowledge and practices concerning MDR-TB. Data was analysed using SPSS version 21. Statistical significance of association between variables was assessed using Chi-square test at p<0.05. Ethical clearance was obtained from the Research Ethics Committee of UNTH and consent was obtained from TB patients.
Results: All 115 and 120 respondents among health workers and TB patients respectively returned the completed questionnaires. Among health workers, 60 (52.2%) were females, 55 (47.8%) were males, and mean age was 38.7±11.8 years. Majority of TB patients were females 54.6%, with mean age of 32±12.6. A higher percentage 64.3% had tertiary education among health workers while only 13.5% among TB patients had tertiary education. Majority of TB patients 87.6% had no knowledge of MDR-TB, while only 35.6% of health workers had good knowledge. Category of health workers and knowledge of MDR-TB relationship was not statistically significant (X2=8.296, df=4, p=0.081), but the relationship with their practices concerning MDR-TB was statistically significant (X2=13.426, P=0.001). Practices of both health workers and TB patients towards MDR-TBwere poor.
Conclusion: Both knowledge and practices of health care workers and TB patients concerning MDR-TB were poor. Training on MDR-TB for health care workers and health education for TB patients should be intensified for good treatment outcomes and improvement in TB control programs generally.
Adeyemi A Abati
University Teaching Hospital
Nigeria
Title: The EU public health impact of Campylobacter spp. human infection and the EU control strategy in the poultry meat sector
Time : 14:25 -14:50
Biography:
Adeyemi Adeniyi Abati completed his MBBS in 2004 at Obafemi Awolowo University Teaching Hospital, Nigeria. He was trained in the Department of Infectious Diseases during his Residency. He was able to provide several superior care and consultation that resulted in overall improvement of department patient’s satisfaction quotient. He focused on patient’s treatment and re-evaluated several methods of therapy management dependent on infection types tailored to patient’s individual history and efficacy of previous treatments. He has been practicing in Department of Infectious Disease at Lagos University Teaching Hospital, one of the top three infection disease hospital in Nigeria and also pursuing his PhD.
Abstract:
Aim: In Nigeria, Hepatitis C virus (HCV) infection is primarily spread through injection drug use. There is an urgent need to improve access to care for HCV among persons with opioid use disorders who inject drugs. The purpose of our study is to determine the prevalence of HCV, patient characteristics, and receipt of appropriate care in a sample of patients treated with buprenorphine for their opioid use disorders in a primary care setting.
Methods: This study used retrospective clinical data from the electronic medical record. The study population included patients receiving buprenorphine in the office based opioid treatment (OBOT) clinic within the adult primary medicine clinic at Lagos Medical Center between October 2008 and August 2015 who received a conclusive HCV antibody AB test within a year of clinic entry. We compared characteristics by HCV serostatus using Pearson's Chi-square and provided numbers/percentages receiving appropriate care.
Results: The sample comprised 300 patients slightly less than half of all patients (N=134, 27.7%) were HCV AB positive, and were significantly more likely to be older Hausas and Yoruba’s, have diagnoses of post-traumatic stress disorder (PTSD) and bipolar disorder, have prior heroin or cocaine use, and be HIV- infected. Among the 134 HCV AB positive patients, 126 (67.7%) had detectable HCV ribonucleic acid (RNA) indicating chronic HCV infection; only eight patients (2.21%) with chronic HCV infection ever initiated treatment.
Conclusions: Nearly half of patients (47.7%) receiving office-based treatment with buprenorphine for their opioid use disorder had a positive Hepatitis C virus antibody screening test, although initiation of HCV treatment was nearly non-existent (2.21%).
Poonam Sharma
Indira Gandhi National Tribal University
India
Title: Epidemiological studies on tuberculosis and ethnopharmacological methods of its control among tribals of Anuppur district, Madhya Pradesh, India
Time : 14:50 -15:15
Biography:
Poonam Sharma completed her PhD in Zoology from Dr. B R Ambedkar University, Agra, India in 2002. Her research interests include “Toxicology, natural antioxidant in prevention of toxicity and infection biology”. She has published over 40 research papers in reputed and peer reviewed journals. He has completed three research projects funded by various funding agencies of Government of India. Presently, she is working as an Associate Professor of Zoology at Indira Gandhi National Tribal University, Madhya Pradesh, India.
Abstract:
Currently, one third of the world population is infected with Mycobacterium tuberculosis, the causative organism of Tuberculosis (TB), and new cases are being reported every year. In 2013, World Health Organization (WHO) reported 9 million new cases of TB and 1.5 million deaths, worldwide. India is having the highest burden of TB in the world, accounting for nearly one third of all TB cases. WHO statistics showed the incidence of 2.1 million new TB cases in India, in 2013. Madhya Pradesh accounts for highest population (14.7%) of scheduled tribes (ST) among Indian states. According to the 2011 population census, 25.7% of the state population is ST. Anuppur district is among the least developed districts in the state. All tehseels of the Anuppur district are having significant number of ST population. The main ST populations in Amarkantak area of Anuppur district are Baiga, Gond, Panika, Kamars, Birhor, Bharias and Hill Korbas. Due to lack of awareness, illiteracy and poverty, sizable number of tribals are suffering from TB. The present paper focuses on the socio-economic, nutritional and health status of tribal population in Annupur district of MP. The possible reasons for TB prevalence and seasonal indices of TB have been explored. We have also explored the ethno-medicinal practices for healthcare management among the tribalpopulation, especially the use of medicinal plants for the control of TB.
Seth Omari Mensah
Kharkov national Medical University
Ukraine
Title: YRF: Prevention of cholera outbreak in chorkor, Accra-Ghana.
Time : 15:15 -15:35
Biography:
Seth Omari Mensah is a 5th year Medical Student of Kharkov National Medical University of Ghanaian Nationality. He has attended numerous conferences held in Ukraine, Denmark and Netherlands regarding various topics of healthcare to share and obtain ideas to assist the public in developing countries with a focus on his Nation of Origin, Ghana, to improve their health conditions.
Abstract:
Statement of the Problem: Chorkor is a fishing community in Accra, Ghana. It has a population of about 3000 people. Chorkor like many other communities close to the capitals of many West African countries suffers from overcrowding and pollution due to the inability of town planning activities to catch up with rural urban migration. Cholera is one of the leading causes of morbidity and mortality in Chorkor. The incidence of cholera tends to increase during the rainy season and cholera is responsible for about 30% of the total deaths in Chorkor. A close second is tuberculosis which is responsible for 15% of the total deaths and can easily be attributed to overcrowding.
Methodology & Theoretical Orientation: We carried out a descriptive cross sectional study to investigate the epidemiological link of the cholera outbreak in Chorkor Greater Accra region of Ghana. Index cases were identified with the help of line lists. Univariate analyses were expressed as frequency distributions, percentages, mean±standard deviation, and rates (attack rates, case-fatality rates etc.) as appropriate. Maps were drawn using Arc GIS and Epi info software to describe the pattern of transmission.
Findings: We found 1733 cases with 20 deaths (CFR=1.2%) with an overall attack rate of approximately 25 per 3000 population with sex specific attack rates of 24% and 18% for males and females respectively. 90 stool samples yielded V. cholerae O1 Ogawa with ciprofloxacin and tetracycline being sensitive to the cholera strains.
Conclusions & Significance: The lack of personal hygiene, safe drinking water, open defecation, poor sanitation and foodwere some of the causes of the cholera outbreak in Chorkor. We recommend the Ministries of Local Government and Rural Development, Works and Housing and Water Resources to ensure proper liquid and solid waste disposal systems and provide adequate potable water to the populace and also our research with the help of sustainable medical missions helped curb cholera in Chorkor with the distribution of fliers which educated them more on how cholera could be prevented.