Day 1 :
Postgraduate Institute of Medical Education and Research, India
Time : 10:00-10:30
Uma Nahar Saikia served as Professor in the Department of Histopathology, Post-graduate Institute of Medical Education and Research, Chandigarh, India. She has been a recipient of many awards and grants. Her international experience includes various programs, contributions and participation in different countries for diverse fields of study. Her research interests in Dermatopathology, Cardiovascular Pathology, Endocrine Pathology and Ocular Pathology as a Professor reflect in her wide range of publications in various national and international journals. She serves as a member of various associations like International Medical Science Academy, International Society of Dermatopathologists’, Indian Society of Heart Research, Indian Association of Pathologists and Microbiologists, apart from being an author for many books.
Introduction: Systemic mycotic infections result from inhalation of the spores of dimorphic fungi that have their mold forms in the soil. Th e spores differentiate into yeasts or other specialized forms within lungs and mostly asymptomatic and self-limited. Malignancy, hematologic disorders, and use of antibiotics and/or corticosteroids are major underlying conditions for disseminated disease-causing a destructive lesion that may result in death. Cardiac mycotic infection is relatively uncommon with increasing incidence in immunocompromised patients with poor prognosis.
Material & Methods: A total of 12,000 autopsy cases were reviewed retrospectively over a period of 20 years i.e. 1996-2015. Sections from heart stained with hematoxylin-eosin (H&E) and confirmed with histochemical stains including methenamine silver, periodic acid-Schiff (PAS), and mucicarmine stains with confirmed histopathologic findings for fungal identification were included in the study.
Results: Of 23 cases of cardiac mycotic infection, 19 were male and only one female patient with a mean age of 29.5 years (range: 3 months–58 years). Underlying diseases included leukemia and lymphoproliferative disorders receiving antineoplastic drugs (5), post renal transplantation (5) cases, liver disease (3), diabetes mellitus (5) and once each of ABPA and thymoma with viral meningoencephalitis. None of the patients had experienced cardiac surgery, although one patient had a cardiac pacemaker implanted for the sick sinus syndrome. None of the patients were positive for the human immunodeficiency virus. All patients received antibiotic therapy antemortem with high dose corticosteroids given to 21 (44.5%). Most common fungal infection found was aspergillus (11) followed by mucormycosis (5), candida (2) and Cryptococcus (1). The disseminated disease was seen in 11 cases and one case had a dual infection (candida and mucormycosis).
Conclusion: The present study suggests increasing incidence of high mortality of cardiac involvement by aspergillus and mucormycosis with dissemination to other organs. This highlights the clinical importance of early diagnosis and designs new therapeutic strategies for cardiac mycotic infection to reduce mortality, especially in non-candidal infections.
- Host and Pathogen Interactions | Infection and Immunity | Infectious Diseases | Neglected & Tropical Infectious Diseases | Infection Prevention & Control | Healthcare Infectious Diseases | Epidemiology - Infectious Diseases | Food and Water Borne Infection
University of Oslo, Norway
Uma Nahar Saikia
Postgraduate Institute of Medical Education and Research, India
Prince of Songkla University, Thailand
Siripan Sangmala has completed her Doctor of Medicine and Internal Medicine from Prince of Songkla University. She is a Doctor and Teacher of Faculty of Medicine at Prince of Songkla University, Thailand.
Catheter-associated urinary tract infection (CA-UTI) is an important nosocomial infection that cause a bad clinical outcome. Prolong catheterization is one of the risk factors of CAUTI. Extended-spectrum β-lactamase-producing (ESBL) Enterobacteriaceae emerges worldwide as one of the important pathogenic organisms for nosocomial infection and cause poor clinical outcomes. We conducted retrospective cohort study among the patients with long-term urinary catheterization at Songklanagarind Hospital, a tertiary-care hospital in Southern Thailand from January 2010 to December 2014, focusing on the clinical outcomes, economic burden and risk factors of those with ESBL Enterobacteriaceae CA-UTI. We defined prolong catheterization for more than 15 days. We found 9726 patients with urinary catheterization, 4176 patients were categorized as the patients with long-term urinary catheterization. Th e patients with ESBL CA-UTI had more hazardous outcomes including mortality, hospital costs, and the length of stay than those infected with non-ESBL CA UTI. Retention of other medical devices, immunocompromised status, emergent indication for admission, initial admission to intensive care units, invasive procedures/operations, previous use of antibiotics (aminoglycoside, fluoroquinolone, broad-spectrum cephalosporin, carbapenem, beta lactamase inhibitor antibiotic) is the significant risk factor for CAUTI in long-term catheterization.
Chulabhorn International College of Medicine - Thammasat University, Thailand
Thanakrit Sathavornmanee is a fifth-year student researcher currently studying at the Faculty of Medicine, English Program, Thammasat University. He has recently published a research article in a reputable journal and has given an oral presentation to an international audience in Valencia, Spain, which was funded by a series of research grants from Chulabhorn International College of Medicine, Thammasat University. His current areas of interest include cholangiocarcinoma, hospital-acquired infections and bacteriophage therapy.
Opisthorchis viverrini is one of the most common foodborne liver parasites in Southeast Asia. Piscivorous mammals, including humans, become infected after consuming raw or undercooked freshwater fish containing the parasite’s infective metacercariae. Chronic biliary tract infections with O. viverrini has been accepted as the precursor lesion to cholangiocarcinoma (CHCA), an aggressive malignancy of the biliary tract with very poor prognosis. Currently, over 67 million people worldwide are at risk of opisthorchiasis. Opisthorchiasis and CHCA are major public health problems in Thailand. Over 6 million people are currently infected, and the incidence of CHCA in the country’s Northeastern region are some of the highest rates reported globally. A case-control study on the risk factors associated with opisthorchiasis and CHCA was carried out on 41 subjects with opisthorchiasis, 31 subjects with CHCA, and 56 control subjects from Northeastern Thailand. The greatest risk factor for opisthorchiasis and CHCA was the simultaneous consumption of raw and fermented freshwater fish, with odds ratios of 34.00 (95% CI: 10.93, 105.81), and 101.50 (95% CI: 19.75, 521.78), respectively. A past history of opisthorchiasis and alcohol consumption were also associated with CHCA, with odds ratios of 19.13 (95% CI: 2.26, 161.80), and 2.61 (95% CI: 1.05, 6.47), respectively. The data presented herein reveals novel synergies and risk factors associated with opisthorchiasis and CHCA, perspectives which pave the way for the development of better targeted prevention and control strategies for these diseases in Thailand.
Oman Medical College, Oman
Vinod Nambiar is a Clinical Microbiologist and Professor with over 23 years of teaching and clinical diagnostic experience in medical colleges. His interests are in the field of medical education, infection control and antibiotic resistance. He has published many research papers and has received best Professor in Microbiology award in Asian leadership conference.
Background: Healthcare associated infections (HAI) are associated with high morbidity and mortality rates and significant economic loss in health care systems worldwide. Knowledge, attitudes and practices (KAP) regarding HAI and the infection control (IC) procedures remains a challenge for undergraduate medical students before they start their actual clinical training and also, to the faculty who are responsible to train them in IC domains.
Methods: Th e study was conducted among the fifth-year medical students undergoing MICB-501 (Immunity, Infection and Disease) course of the College of Medicine and Health Sciences, NUST, Oman. A ‘Hospital acquired infection and Infection control practices’ teaching module consisting of a two hours lecture series, three hours hospital-based demonstration and practical sessions by the hospital infection control team and a half hour video show on IC practices was implemented. Student’s feedback in the form of self-coded structured questionnaires pertaining to questions on KAP on HAI and IC practices were done before and after implementation of this module. Data was analyzed by SPSS software version 21(IBM). Paired sample t test was used to compare the means between pre-course test and post-course test. Study was approved by Research and Ethics committee.
Results: Of the 122 students in the class, 89(73%) completed the educational module and the questionnaire responses. Final results showed that overall KAP about HAI and IC of participants improved significantly due to the educational intervention. (Pre-course test mean = 37.1±6.09 and post-course test mean 45.13±3.73, p<0.001). The practice domain showed marked improvement. This may be due to the involvement of the hospital infection control team in the practical and demonstration sessions. Only 58% of the students feel that the current curriculum provides enough information on IC. Over 87% of the students agree to the need for such educational intervention modules on Infection control.
Conclusion: Implementing an infection control teaching module in medical schools with involvement of hospital infection control team will help the undergraduate medical students to improve their KAP on HAI and infection control.
Addis Ababa University, Ethiopia
Girma Birhanu Nurie holds a Master of Public Health in Epidemiology from Addis Ababa University, Ethiopia. He did his BSc in Environmental Health at University of Gondar, and Diploma in Environmental Health at Jimma University, all in Ethiopia. Currently, he is working as Field Epidemiologist, Researcher/ Disease Prevention and Control Officer at Addis Ababa City Administration, Department of Public Health Emergency Management/Bole Sub City Health Office. His clinical research work has gained relative international recognition in the scientific community. He was an Invited Speaker at the International Academy of Science, Technology, Engineering and Management Conference/517th International Conference on Medical, Biological, and Pharmaceutical Sciences in Bangkok, Thailand, December 21-22, 2018. He is a former basketball player, with a passion of taking preventive medicine closer to the rural populations in Ethiopia. He enjoys community work/volunteering and is also a member of Ethiopian Public Health Association.
Background: Scabies affects people of all countries. In developing countries, children, in particular, are most susceptible, with an average prevalence of 5–10%. It is very common in Ethiopia, especially during natural or manmade disasters, such as flooding, drought, civil war and conflict, poor water supply and sanitation, and overcrowded living condition.
Methods & Materials: We conducted 1:2 unmatched case-control study from August 28-November 2, 2017 in Dembiya District, North Gondar Zone, Amhara Region. 40 Cases and 80 controls were randomly selected from the community. Data were collected using a structured questionnaire. Th e analysis was made using Epi Info and SPSS software. Odds ratio, 95% CI and P-value were used to measure the significance of association in bivariate and multivariate analysis. Variables with a p-value of equal to or less than 0.05 were reported to be significantly associated with the dependent variable.
Results: We identified 141 Scabies cases with an overall attack rate of 2% and zero case fatality rate. Of reported cases 55% of them were male and the median age of the affected population was 16 yrs. (IQR= 19 yrs.). Sex (AOR: 0.4, 95% CI: 0.1-0.7), hand washing with soap (AOR: 0.6, 95% CI: 0.1--0.6), body bath more than a week (AOR: 1.5, 95% CI: 1.2-4.1), cloth exchange with infected person (AOR: 3.1, 95% CI: 2.0-4.0), contact history (AOR: 17.0, 95% CI: 13.4-20.0) and water shortage (AOR: 3.3, 95% CI: 2.4-4.5) were significantly associated with scabies.
Conclusion: We found poor hygienic practices, sharing of clothing materials, sleeping with people that had contracted scabies was associated with higher frequency of scabies disease. Therefore, increasing awareness creation about the transmission, prevention and control methods of scabies disease is recommended.
National Medical Research Center for Obstetrics, Gynecology and Perinatology, Russia
Tatiana Priputnevich PhD, is a Head of the Department of Microbiology, Clinical Pharmacology and Epidemiology, National Medical Research Center for Obstetrics, Gynecology and Perinatology named after Academician V.I.Kulakov of Ministry of Healthcare of Russian Federation. Her special research and expertise are in clinical microbiology, genetic properties of opportunistic microorganisms, MALDI-TOF mass spectrometry.
Eggerthella lenta-associated sepsis is rarely reported, despite wide possibilities for identification of microorganisms. This case report highlights E. lenta severe endometritis complicated by abdominal sepsis in a young healthy woman. A woman aged 27 at 40 weeks of gestation was admitted to the center in labor. The pregnancy was complicated by bacterial vaginosis in the I trimester, and rotavirus infection which required inpatient care in the II trimester. Due to obstructed labor, caesarean section was performed. Rupture of membranes to delivery interval was 17 hours. Cefazolin was given preoperatively. Further antibacterial therapy with cefazolin was continued for the next 72 hours due to the patient’s history. 72 hours after the delivery the patient exhibited fever (37.5_), leukocytosis, neutrophilia and CRP rise. Microbiological analysis revealed the growth of three species of obligate anaerobes: Bacteroides thetaiotaomicron, Bacteroides uniformis and Eggertella lenta of 5-7 lg CFU/ml. All three isolates appeared sensitive to metronidazole, imipenem, amoxicillin clavulanic acid and resistant to cefotaxime. Eggertella lenta was sensitive to clindamycin, but B. thetaiotaomicron and B. uniformis were resistant to clindamycin; B. thetaiotaomicron was sensitive to moxifloxacin, but B. uniformis and E. lenta were not. E. lenta was sensitive to Vancomycin). MIC Linezolid for E. lenta and B. uniformis was 1 μg/mL and for B. thetaiotaomicron – 2 μg/mL. Th e patient was finally subscribed linezolid together with clindamycin. The patient’s clinical condition rapidly improved the fever and systemic inflammatory response signs resolved. The patient was discharged on the 21st day after delivery in satisfactory condition.
Rajiv Gandhi Centre for Biotechnology, India
Deepak Chouhan is currently pursuing his PhD degree from Rajiv Gandhi Centre for Biotechnology, Trivandrum India.
Development of gastric diseases like gastritis, peptic ulcer, and gastric cancer depends on several biotic and abiotic factors and Helicobacter pylori infection is a well-known biotic factor. However, not all H. pylori-infected individuals develop gastric diseases and not all individuals with gastric diseases are infected with H. pylori. Therefore, it is possible that other gastric bacteria also contribute to the formation and progression of gastric diseases. The aim of this study was to isolate prevalent gastric bacteria using microaerobic condition and identify them by 16S rRNA gene sequence analysis. Here, we report that infection of Mycobacterium abscessus (phylum Actinobacteria) is highly prevalent in the stomach of Trivandrum, India, population. Our data show that of 129 (67 men and 62 women) patients with gastric symptoms 96 (51 men and 45 women) were colonized with M. abscessus. The infection of M. abscessus in gastric epithelium was further confirmed by imaging with acid-fast staining, immunohistochemistry, and immunofluorescence. Our imaging data strongly suggests that M. abscessus is an intracellular colonizer residing inside the gastric epithelial cells rather than in macrophages. Surprisingly, for Trivandrum population, the prevalence of M. abscessus infection in the stomach is even higher than the prevalence of H. pylori infection. This, to the best of our knowledge, is the first study showing the colonization of M. abscessus in human gastric mucosa among patients with various gastric symptoms. We have also done clarithromycin antibiotic sensitivity test, erm (41) and rrl gene sequencing of these M. abscessus isolates from gastric disease individuals.
Department of Health Services, Nepal
Ashmin Hari Bhattarai is a compassionate and dedicated public health professional, recently completed his Master in Public Health from Universitas Gadjah Mada, Indonesia under WHO-TDR Postgraduate Fellowship. His specialization was in tropical disease research, majoring implementation research. He has a wide range of experiences in program implementation, monitoring, supervision & evaluation, training/development, strategic planning, local health governance and health system strengthening.
Dengue is an emerging public health problem in Nepal that pose threat with frequent outbreaks. Dengue control activities are mostly outbreak driven; still lack systematic interventions and people have poor knowledge and practices. This study aimed to explore the acceptability, appropriateness, and effectiveness of mobile SMS intervention in improving dengue control practices. This is an implementation research that used mixed-methods design with intervention. A total of 300 households were divided into three groups, i.e. one control group, one dengue prevention leaflet (DPL) only intervention group and DPL with mobile SMS intervention group (DPL+SMS). We used structured questionnaire to collect information regarding knowledge and practice of dengue prevention, and in-depth interviews to measure acceptability and appropriateness of intervention. Mean difference, one way ANOVA, paired t-test and regression analyses were used to assess the effectiveness of the interventions. Thematic analysis was used to assess acceptability, appropriateness and barriers and enablers of the intervention. DPL+SMS intervention produced significantly higher mean knowledge difference (32.68±13.68 SD vs. 13.32±8.79 SD) and mean practice difference (27.94±11.44 SD vs. 4.88±5.42 SD) compared to DPL only group (p=0.000). Multivariate analysis showed that DPL+SMS intervention was effective to increase knowledge by 28.62 points and practice by 24.06 points compared to control group. Th e intervention was perceived as acceptable and appropriate by the study participants and key stakeholders. Mobile SMS is an effective, acceptable and appropriate health intervention to improve dengue prevention practices. This intervention can be adopted as a promising tool for health education against dengue and other diseases.
Huazhong University of Science and Technology, China
Said Hasssan is currently working as an Assistant Professor in Tongji Medical College, Huazhong University of Science and Technology, China. He has published more than 25 papers in reputed journals. His current research focuses on Acinetobacter baumannii resistance and prevalence.
To assess the resistance against widely used antibiotics in case of Acinetobacter Bahmani (A. baumannii) infection. A total of 350 samples of pus, urine, swab and others from different patients were examined and the bacterial growth appeared in 50 samples. Each sample was inoculated on blood, MacConkey and cystine lactose electrolyte deficient agar. The antimicrobial susceptibility profile of the isolates was determined using agar plate method/disk-diffusion method (modified-Kirby Bauer disc diffusion method). In current study, a large number of isolates of A. baumannii obtained from different specimens were resistant to avelox (56%), followed by tygacil (46%), augmentin (46%), cefspan (38%), cefixime (24%) and ampicillin (20%). However, the antibiogram of A. baumannii also showed that most of the isolates (88%) were highly sensitive to cefalexin. Second maximum sensitivity of A. baumannii was seen to amikacin (84%). The sensitivity of isolates against amikacin was followed by ticarcillin (80%). Meronem was found highly active against the tested isolates (78%). Sensitivity was observed for tienam (76%), sulzone (72%) followed by azactam (68%), cefobid (66%) to cefotaxime (66%) and ciproxin (62%). Results elucidate that A. baumannii is a severe problem as it has become a highly resistant species in hospitalized patients and resistant A. baumannii infection turned out to have increased all-cause mortality.
Aix-Marseille Université, France
Hichem Ghaoui has completed PhD MD from Aix-Marseille University, IHU Méditerranée Infection, Marseille, France, and The High National Veterinary School of Algiers. He has five publications. Actually, he is a Senior Assistant Professor and a Research Assistant in Infectious Diseases.
Coxiella burnetii infection during pregnancies had been associated with adverse outcomes. We investigated the serological/q PCR evidence of Q fever infection in women' febrile spontaneous abortion in two different gynaecological obstetrics departments in Algiers; which admitting patients from rural/non-rural regions in the Algiers’ suburbs. From April 2014 to November 2015, we worked at 725 pregnant women, within 380 women cases group presented febrile spontaneous abortions, and 345 women pregnant women as control group. Our findings gave a seroprevalence of 0.70 % (3/380) for IgG titers ≥1:100 phase II among the cases group, whereas all the control group sera were IFA negative. In other hand, only 4 from 380 (1.05%) placental samples came back q PCR positive among the control group, then all the other placental samples were q PCR negative for the control group. Few serological studies have concluded results that are consistent with our own, namely Nielson and Dominique who reported a seroprevalence of 1.2%, 0.27% respectively among women with spontaneous abortions included in their studies. q PCR came back with 1.05% positive to both C. burnetii IS1111 and IS30a for the cases group, while the entire control group had q PCR negative. Th is prevalence is not high but better than that obtained by Joanne, Langeley, Carcopino and Quijada, where the q PCR was negative for all placental samples. Seroprevalence of 0.70% and 1.05% of q PCR positive for Coxiella burnetii, this allows us to say that there is a relationship between Coxiella burnetii infection and women’ febrile spontaneous abortion in Algiers; to the rigour of the sampling done in our study. Finally, we would like to follow up this study on a higher sampling of other regions in Algeria in order to highlight a clear picture of Coxiella burnetii infection in women spontaneous abortions.
Walid Mohamed Attiah is currently working as Professor in Zagazig University, Egypt. He has his expertise in infectious diseases. He has published more than 20 research papers in reputed journals.
Background: The incidence of diabetes mellitus is increasing worldwide; it has some major effects on the genitourinary system, which makes diabetic patients more liable to urinary tract infection. Despite, all these problems, antibiotics are prescribed empirically which may adversely affect antibiotic resistance so far. Therefore, the aim of this study was to identify the etiologic agents of UTI and their antibiotic susceptibility pattern among diabetic patients attending diabetic clinic of Zagazig University Hospitals.
Material & Methods: A cross-sectional study was conducted in a total of 195 diabetic patients who suffered change from June 2017 to June 2018. Demographic and clinical data were collected. Clean catch mid-stream urine samples were collected and processed for identification of uropathogen.
Results: E. coli was the commonest isolated uropathogen followed by Klebsiella pneumoniae. All the isolated bacteria were resistant to ceftriaxone but sensitive to ciprofloxacin. Gram-negative isolates demonstrated high level of sensitive to amikacin in 188 (96.4%) patients, imipenem and meropenem in 5 (2.6%) and ceftazidime in 187 (95.9%) patients. Gram-positive bacteria showed sensitive to amoxicillin-clavulanate, linezolid and vancomycin in 7 (3.6%) patients. Multidrug resistance was observed in about 30% of the isolated uropathogens.