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1.
Beilstein J Nanotechnol ; 15: 475-489, 2024.
Article in English | MEDLINE | ID: mdl-38715710

ABSTRACT

A simple approach was developed to synthesize cobalt ferrite nanoparticles/graphene quantum dots (CF/GQDs). The material was prepared from a homogeneous mixture of iron nitrate, cobalt nitrate, and starch at 140, 180 and 200 °C in a 24 h thermal hydrolysis process. The obtained materials were characterised by using X-ray diffraction, scanning electron microscopy, transmission electron microscopy, ultraviolet-visible diffuse reflectance spectroscopy, Fourier-transform infrared spectroscopy, photoluminescence spectroscopy, vibrating-sample magnetometry, and nitrogen adsorption/desorption isotherms. Cobalt ferrite crystals of around 8-10 nm and graphene quantum dots formed directly at 200 °C. Stacking GQDs sheets onto the CF nanoparticles resulted in CF/GQDs nanoparticles. The nanocomposite exhibits satisfactory fluorescent and superparamagnetic properties, which are vital for catalytic applications. The CF/GQDs catalyse significantly the degradation of methylene blue (MB) under visible light. The catalyst can be recycled with an external magnetic field and displays suitable stability. Also, it was reused in three successive experiments with a loss of efficiency of about 5%. The CF/GQDs are considered as an efficient photocatalyst for MB degradation and other dyes.

2.
Indian J Otolaryngol Head Neck Surg ; 75(4): 2850-2855, 2023 Dec.
Article in English | MEDLINE | ID: mdl-37974720

ABSTRACT

Aims: The objective of this study is to assess the effectiveness of the combined middle and inferior meatal antrostomy (MIMA) in management of patients with maxillary fungal sinusitis. Material and Methods: Design: retrospective cross sectional study. Setting and subjects: From September 2018 to March 2021, fifty-five patients with non-invasive maxillary fungal sinusitis, who underwent transnasal endoscopic combined MIMA. Methods: The study compared patients' pre- and post-operative subjective symptoms, including nasal obstruction, discharge, facial pain or pressure, halitosis, anosmia, and other non-specific symptoms. Endoscopic characteristics of recurrent fungal maxillary sinusitis and postoperative complications were also observed. Closure of the IMA site was evaluated at three and six months post-surgery and patients were categorized into three groups based on closure degree. Results: All clinical symptoms, including nasal discharge, nasal obstruction, nasal pruritus, anosmia, halitosis, sneezing, facial pain, ophthalmic and otologic symptoms, were resolved over six months after combined MIMA in majority of cases (94 - 100%). After three and six months, the postoperative endoscopic evaluation revealed recurrent fungal maxillary sinusitis in 1.8% and 5.4% of cases, respectively. Partial stenosis of the inferior antrostomy was observed in 7.2% and 16% of cases, while complete stenosis was noted in 3.6% and 7.2% of cases after three months and six months. Conclusions: The combined MIMA is effective and has better outcomes than the medial meatal antrostomy approach alone without additional operative time. Supplementary Information: The online version contains supplementary material available at 10.1007/s12070-023-03863-6.

3.
Front Oncol ; 12: 985735, 2022.
Article in English | MEDLINE | ID: mdl-36313699

ABSTRACT

Diffusion-weighted imaging (DWI) is considered to be a useful biomarker to characterize the cellularity of lesions, yet its application in the thorax to evaluate anterior mediastinal lesions has not been well investigated. The aims of our study were to describe the magnetic resonance (MR) characteristics of anterior mediastinal masses and to assess the role of apparent diffusion coefficient (ADC) value in distinguishing benign from malignant lesions of the anterior mediastinum. We conducted a retrospective cross-sectional study including 55 patients with anterior mediastinal masses who underwent preinterventional MR scanning with the following sequences: T1 VIBE DIXON pre and post-contrast, T2 HASTE, T2 TIRM, DWI-ADC map (b values of 0 and 2000 sec/mm2). The ADC measurements were obtained by two approaches: hot-spot ROI and whole-tumor histogram analysis. The lesions were grouped by three distinct ways: benign versus malignant, group A (benign lesions and type A, AB, B1 thymoma) versus group B (type B2, B3 thymoma and other malignant lesions), lymphoma versus other malignancies. The study was composed of 55 patients, with 5 benign lesions and 50 malignant lesions. The ADCmean, ADCmedian, ADC10, ADC90 in the histogram-based approach and the hot-spot-ROI-based mean ADC of the malignant lesions were significantly lower than those of benign lesions (P values< 0.05). The hot-spot-ROI-based mean ADC had the highest value in differentiation between benign and malignant mediastinal lesions, as well as between group A and group B; the ADC cutoffs (with sensitivity, specificity) to differentiate malignant from benign lesions and group A from group B were 1.17 x 10-3 mm2/sec (80%, 80%) and 0.99 x 10-3 mm2/sec (78.4%, 88.9%), respectively. The ADC values obtained by using the hot-spot-ROI-based and the histogram-based approaches are helpful in differentiating benign and malignant anterior mediastinal masses.

4.
Int J Mol Sci ; 23(20)2022 Oct 19.
Article in English | MEDLINE | ID: mdl-36293401

ABSTRACT

Age-related macular degeneration (AMD) is a global leading cause of visual impairment in older populations. 'Wet' AMD, the most common subtype of this disease, occurs when pathological angiogenesis infiltrates the subretinal space (choroidal neovascularization), causing hemorrhage and retinal damage. Gold standard anti-vascular endothelial growth factor (VEGF) treatment is an effective therapy, but the long-term prevention of visual decline has not been as successful. This warrants the need to elucidate potential VEGF-independent pathways. We generated blood out-growth endothelial cells (BOECs) from wet AMD and normal control subjects, then induced angiogenic sprouting of BOECs using a fibrin gel bead assay. To deconvolute endothelial heterogeneity, we performed single-cell transcriptomic analysis on the sprouting BOECs, revealing a spectrum of cell states. Our wet AMD BOECs share common pathways with choroidal neovascularization such as extracellular matrix remodeling that promoted proangiogenic phenotype, and our 'activated' BOEC subpopulation demonstrated proinflammatory hallmarks, resembling the tip-like cells in vivo. We uncovered new molecular insights that pathological angiogenesis in wet AMD BOECs could also be driven by interleukin signaling and amino acid metabolism. A web-based visualization of the sprouting BOEC single-cell transcriptome has been created to facilitate further discovery research.


Subject(s)
Choroidal Neovascularization , Wet Macular Degeneration , Humans , Choroidal Neovascularization/drug therapy , Transcriptome , Vascular Endothelial Growth Factor A/metabolism , Endothelial Cells/metabolism , Wet Macular Degeneration/drug therapy , Vascular Endothelial Growth Factors , Interleukins/therapeutic use , Amino Acids , Fibrin , Angiogenesis Inhibitors/therapeutic use
5.
Chemosphere ; 308(Pt 1): 136182, 2022 Dec.
Article in English | MEDLINE | ID: mdl-36037942

ABSTRACT

Volatile organic compounds (VOCs) are a group of organic compounds that have a molecular structure containing carbon and their chemical properties allow them to be easily converted to steam and gas and remain for a long period of time and have diverse effects on the environment. The purpose of this study is determination of the concentration of VOCs such as alachlor, anthracene, benzene, bromoform, chloroform, heptachlor, isophorone, tetrachloroethylene, γ -chlordane, toluene, etc. in water matrices. The results showed that among studies conducted on VOCs, the concentration of tetrachloroethylene, m,p-xylene, and toluene were at the top in water matrices, and the lowest average concentrations were found in chloroform, anthracene, and butyl benzyl phthalate. In terms of VOC concentrations in water matrices, China was the most polluted country. Moreover, the data analysis indicated that China was the only country with carcinogenic risk. A Monte-Carlo simulation showed that although the averages obtained were comparable to the acceptable limits, for heptachlor, the maximum carcinogenic risk is achieved at a level that is slightly over the limit, only 25% from the population being exposed.


Subject(s)
Air Pollutants , Tetrachloroethylene , Volatile Organic Compounds , Air Pollutants/analysis , Anthracenes/analysis , Benzene/analysis , Carbon/analysis , China , Chlordan/analysis , Chloroform/analysis , Environmental Monitoring/methods , Heptachlor/analysis , Steam/analysis , Tetrachloroethylene/analysis , Toluene/analysis , Volatile Organic Compounds/analysis , Water/analysis
7.
Cureus ; 14(5): e24864, 2022 May.
Article in English | MEDLINE | ID: mdl-35702465

ABSTRACT

Objectives This study aimed to assess the role of chest X-ray (CXR) scoring methods and their correlations with the clinical severity categories and the Quick COVID-19 Severity Index (qCSI). Methods We conducted a retrospective study of 159 COVID-19 patients who were diagnosed and treated at the University Medical Center between July and September 2021. Chest X-ray findings were evaluated, and severity scores were calculated using the modified CXR (mCXR), Radiographic Assessment of Lung Edema (RALE), and Brixia scoring systems. The three scores were then compared to the clinical severity categories and the qCSI using Spearman's correlation coefficient. Results Overall, 159 patients (63 males and 96 females) (mean age: 58.3 ± 15.7 years) were included. The correlation coefficients between the mCXR score and the Brixia and RALE scores were 0.9438 and 0.9450, respectively. The correlation coefficient between the RALE and Brixia scores was marginally higher, at 0.9625. The correlation coefficients between the qCSI and the Brixia, RALE, and mCXR scores were 0.7298, 0.7408, and 0.7156, respectively. The significant difference in the mean values of the three CXR scores between asymptomatic, mild, moderate, severe, and critical groups was also noted. Conclusions There were strong correlations between the three CXR scores and the clinical severity classification and the qCSI.

8.
Biomed Chromatogr ; 36(6): e5364, 2022 Jun.
Article in English | MEDLINE | ID: mdl-35274322

ABSTRACT

In this paper, we discuss veterinary medicine and its applications in the food industry as well as the risk to the health of humans and animals caused by these residues. We review how the veterinary residues enter and cause some detrimental effects. We also mention two techniques to determine the residue of veterinary medications that exist in food originating from animals, including classic and advanced techniques. Finally, we discuss the potential of various developed methods and compare them with some traditional techniques.


Subject(s)
Drug Residues , Veterinary Drugs , Animals , Drug Residues/analysis , Food Contamination/analysis , Veterinary Drugs/analysis
9.
Cureus ; 14(1): e21347, 2022 Jan.
Article in English | MEDLINE | ID: mdl-35186603

ABSTRACT

Introduction Hepatocellular carcinoma (HCC) is one of the most common malignancies in the world. Early detection and accurate diagnosis of HCC play an important role in patient management. This study aimed to develop a convolutional neural network-based model to identify and segment HCC lesions utilizing dynamic contrast agent-enhanced computed tomography (CT). Methods This retrospective study used CT image sets of histopathology-confirmed hepatocellular carcinoma over three phases (arterial, venous, and delayed). The proposed convolutional neural network (CNN) segmentation method was based on the U-Net architecture and trained using the domain adaptation technique. The proposed method was evaluated using 115 liver masses of 110 patients (87 men and 23 women; mean age, 56.9 years ± 11.9 (SD); mean mass size, 6.0 cm ± 3.6). The sensitivity for identifying HCC of the model and Dice score for segmentation of liver masses between radiologists and the CNN model were calculated for the test set. Results The sensitivity for HCC identification of the model was 100%. The median Dice score for HCC segmenting between radiologists and the CNN model was 0.81 for the test set. Conclusion Deep learning with CNN had high performance in the identification and segmentation of HCC on dynamic CT.

10.
J Colloid Interface Sci ; 606(Pt 2): 1031-1041, 2022 Jan 15.
Article in English | MEDLINE | ID: mdl-34487926

ABSTRACT

The development of sensitive and selective sensors using facile and low-cost methods for detecting neurotransmitter molecules is a critical factor in the health care system in regard to early diagnosis. In this research, an electrocatalyst derived from Mo,Zn dual-doped CuxO nanocrystals-based layer coating over one-dimensional copper nanowire arrays (Mo,Zn-CuxO/CuNWs) was successfully designed using a facile electrodeposition approach and used as an electrochemical sensor for non-enzymatic dopamine (DA) neurotransmitter detection. The synergistic effect caused by the dual-doping effect along with its excellent conductivity produced a large electroactive surface area and an improved hetero-charge transfer, thereby boosting DA sensing ability with a low limit detection of 0.32 µM, wide-range of detection (0.5 µM - 3.9 mM), long-term stability (5 weeks), and high selectivity in phosphate buffer solution (pH 7.4). Also, the sensor accurately determined DA in real blood serum-spiked solutions. The achieved results evidenced that the Mo,Zn-CuxO/CuNWs derived sensor is highly suitable for DA detection. Therefore, it also opens new windows for the development of low-cost, accurate, high-performance, and stable sensors for other neurotransmitter sensing for the purposes of better health care and early diagnosis.


Subject(s)
Electrochemical Techniques , Nanoparticles , Copper , Neurotransmitter Agents , Zinc
11.
Chemosphere ; 289: 133171, 2022 Feb.
Article in English | MEDLINE | ID: mdl-34875292

ABSTRACT

In this research, reduced graphene oxide (RGO) which is a form of graphene oxide (GO) was formed through a reduction process using a "green agent" called Ascorbic acid (AA). RGO was then modified on the surface of the glassy carbon electrode (GCE) to generate RGO/GCE (an advanced electrode). The RGO/GCE was then used to detect Terbutaline (TB) in urine samples of volunteer athletes (n = 5) using well-known spectrophotometric analyses including X-ray diffraction analysis (XRD), Fourier-transform infrared spectroscopy (FT-IR), ultraviolet-visible Spectroscopy (UV-Vis), and Raman and electrochemical methods using voltammetric analyses such as differential pulse anodic stripping voltammetry (DP-ASV) and cyclic voltammetry (CV). Comparing various analysis methods using RGO/GCE to detect TB in human urine samples, voltammetric analysis specifically DP-ASV demonstrated higher sensitivity and selectivity in detecting TB than spectrophotometric analyses. Thus, in this study, several factors that would affect the voltammetric signals such as pH and interferents were evaluated and the electroactive surface area was also calculated. Our findings indicated that the RGO/GCE showed excellent repeatability, reproducibility, and long-term stability suggesting that TB could be detected more effectively using RGO/GCE than bare GCE. The detection limit of 0.0052 µM achieved in this study indicated that RGO/GCE can effectively detect TB in human urine while demonstrating reasonable selectivity and sensitivity.


Subject(s)
Graphite , Terbutaline , Electrochemical Techniques , Electrodes , Humans , Reproducibility of Results , Spectroscopy, Fourier Transform Infrared
12.
Cureus ; 13(11): e19930, 2021 Nov.
Article in English | MEDLINE | ID: mdl-34966618

ABSTRACT

Background Dual-energy computed tomography (DECT) has become a promising, non-invasive procedure for the visualization, characterization, and quantification of monosodium urate (MSU) crystals, which aids clinicians in the diagnosis of gout. In this study, we aimed to examine the diagnostic accuracy of DECT in the evaluation of gout. Methodology This cross-sectional retrospective study included patients who were clinically diagnosed with gout and underwent a DECT scan. Results A majority (80.4%) of the MSU deposits were found in the ankle joints. The presence of MSU deposits on DECT scan was highly correlated with bone erosion in the upper limb (odds ratio [OR] = 132; 95% confidence interval [CI] = 17.3-1004.3), bone sclerosis in the lower limb (OR = 36.4; 95% CI = 15.4-86.1), bone erosion in metacarpophalangeal joints (OR = 160; 95% CI = 42.7-600.2), and bone sclerosis in metatarsophalangeal joints (OR = 35.6; 95% CI = 15.5-81.9). Using linear regression analysis on patient-level data, correlations were found between DECT MSU crystal deposition and damage on all categories of structural joint damage showing significant association with erosion (r = 0.91, p < 0.001) and space narrowing (r = 0.75, p < 0.001) but not with joints having periarticular calcification (r = 0.52, p < 0.041). Conclusions Our study established DECT as a valid method for detecting MSU deposits and their association with structural joint deterioration in a Vietnamese population.

13.
Rev Med Virol ; 31(6): e2288, 2021 11.
Article in English | MEDLINE | ID: mdl-34472152

ABSTRACT

SARS Coronavirus-2 is one of the most widespread viruses globally during the 21st century, whose severity and ability to cause severe pneumonia and death vary. We performed a comprehensive systematic review of all studies that met our standardised criteria and then extracted data on the age, symptoms, and different treatments of Covid-19 patients and the prognosis of this disease during follow-up. Cases in this study were divided according to severity and death status and meta-analysed separately using raw mean and single proportion methods. We included 171 complete studies including 62,909 confirmed cases of Covid-19, of which 148 studies were meta-analysed. Symptoms clearly emerged in an escalating manner from mild-moderate symptoms, pneumonia, severe-critical to the group of non-survivors. Hypertension (Pooled proportion (PP): 0.48 [95% Confident interval (CI): 0.35-0.61]), diabetes (PP: 0.23 [95% CI: 0.16-0.33]) and smoking (PP: 0.12 [95% CI: 0.03-0.38]) were highest regarding pre-infection comorbidities in the non-survivor group. While acute respiratory distress syndrome (PP: 0.49 [95% CI: 0.29-0.78]), (PP: 0.63 [95% CI: 0.34-0.97]) remained one of the most common complications in the severe and death group respectively. Bilateral ground-glass opacification (PP: 0.68 [95% CI: 0.59-0.75]) was the most visible radiological image. The mortality rates estimated (PP: 0.11 [95% CI: 0.06-0.19]), (PP: 0.03 [95% CI: 0.01-0.05]), and (PP: 0.01 [95% CI: 0-0.3]) in severe-critical, pneumonia and mild-moderate groups respectively. This study can serve as a high evidence guideline for different clinical presentations of Covid-19, graded from mild to severe, and for special forms like pneumonia and death groups.


Subject(s)
COVID-19/pathology , Cough/pathology , Dyspnea/pathology , Fatigue/pathology , Fever/pathology , SARS-CoV-2/pathogenicity , Antiviral Agents/therapeutic use , COVID-19/mortality , COVID-19/virology , Comorbidity , Cough/drug therapy , Cough/mortality , Cough/virology , Diabetes Mellitus/diagnosis , Diabetes Mellitus/physiopathology , Dyspnea/drug therapy , Dyspnea/mortality , Dyspnea/virology , Fatigue/drug therapy , Fatigue/mortality , Fatigue/virology , Fever/drug therapy , Fever/mortality , Fever/virology , Humans , Hypertension/diagnosis , Hypertension/physiopathology , Immunologic Factors/therapeutic use , Prognosis , Respiratory Distress Syndrome/diagnosis , Respiratory Distress Syndrome/physiopathology , Severity of Illness Index , Smoking/physiopathology , Survival Analysis , COVID-19 Drug Treatment
14.
Comput Struct Biotechnol J ; 18: 3788-3795, 2020.
Article in English | MEDLINE | ID: mdl-33304470

ABSTRACT

The fungi kingdom is composed of eukaryotic heterotrophs, which are responsible for balancing the ecosystem and play a major role as decomposers. They also produce a vast diversity of secondary metabolites, which have antibiotic or pharmacological properties. However, our lack of knowledge of gene function in fungi precludes us from tailoring them to our needs and tapping into their metabolic diversity. To help remedy this, we gathered genomic and gene expression data of 19 most widely-researched fungi to build an online tool, fungi.guru, which contains tools for cross-species identification of conserved pathways, functional gene modules, and gene families. We exemplify how our tool can elucidate the molecular function, biological process and cellular component of genes involved in various biological processes, by identifying a secondary metabolite pathway producing gliotoxin in Aspergillus fumigatus, the catabolic pathway of cellulose in Coprinopsis cinerea and the conserved DNA replication pathway in Fusarium graminearum and Pyricularia oryzae. The tool is available at www.fungi.guru.

15.
BMC Microbiol ; 20(1): 192, 2020 07 03.
Article in English | MEDLINE | ID: mdl-32620076

ABSTRACT

BACKGROUND: Diarrhoeagenic Escherichia coli (DEC) infections are common in children in low-middle income countries (LMICs). However, detecting the various DEC pathotypes is complex as they cannot be differentiated by classical microbiology. We developed four multiplex real-time PCR assays were to detect virulence markers of six DEC pathotypes; specificity was tested using DEC controls and other enteric pathogens. PCR amplicons from the six E. coli pathotypes were purified and amplified to be used to optimize PCR reactions and to calculate reproducibility. After validation, these assays were applied to clinical samples from healthy and diarrhoeal Vietnamese children and associated with clinical data. RESULTS: The multiplex real-time PCRs were found to be reproducible, and specific. At least one DEC variant was detected in 34.7% (978/2815) of the faecal samples from diarrhoeal children; EAEC, EIEC and atypical EPEC were most frequent Notably, 41.2% (205/498) of samples from non-diarrhoeal children was positive with a DEC pathotype. In this population, only EIEC, which was detected in 34.3% (99/289) of diarrhoeal samples vs. 0.8% (4/498) non-diarrhoeal samples (p < 0.001), was significantly associated with diarrhoea. Multiplex real-time PCR when applied to clinical samples is an efficient and high-throughput approach to DEC pathotypes. CONCLUSIONS: This approach revealed high carriage rates of DEC pathotypes among Vietnamese children. We describe a novel diagnostic approach for DEC, which provides baseline data for future surveillance studies assessing DEC burden in LMICs.


Subject(s)
Diarrhea/microbiology , Enteropathogenic Escherichia coli/classification , Escherichia coli Infections/diagnosis , Escherichia coli Infections/epidemiology , Real-Time Polymerase Chain Reaction/methods , Adolescent , Child , Child, Preschool , Diarrhea/epidemiology , Enteropathogenic Escherichia coli/genetics , Enteropathogenic Escherichia coli/isolation & purification , Enteropathogenic Escherichia coli/pathogenicity , Female , Humans , Infant , Infant, Newborn , Male , Multiplex Polymerase Chain Reaction , Prevalence , Sensitivity and Specificity , Vietnam/epidemiology , Virulence Factors, Bordetella
16.
RSC Adv ; 10(28): 16330-16338, 2020 Apr 23.
Article in English | MEDLINE | ID: mdl-35498834

ABSTRACT

In this work, we successfully demonstrated the facile fabrication of highly flexible and floatable Cu2O/rGO on Vietnamese traditional paper (VTP) for the solar-light-driven photocatalytic degradation of the antibiotic ciprofloxacin. The catalyst membrane was prepared by the green reduction of both Cu(OH)2 to Cu2O nanoparticles and graphene oxide to reduced graphene oxide. VTP has a fibrous structure with tiny fibers connected like a spider web and multiple layers in the form of a multidimensional array, which functions as a flexible and highly porous supporter to the catalyst. Moreover, the microfibrillated cellulose of VTP acts as micro-capillaries to drag ciprofloxacin (CIP) close to the active sites on the Cu2O/rGO/VTP surface, which improves the adsorption capacity and photocatalytic efficiency of ciprofloxacin. The adsorption process is best described by the pseudo-first-order and Freundlich models. The maximum photodegradation of CIP by the catalyst is more than 80% attained after 1.5 h under solar light irradiation with a fixed CIP concentration of 10 mg L-1. The catalyst membrane exhibited good reusability of up to 5 cycles.

17.
J Infect Dis ; 219(2): 295-304, 2019 01 07.
Article in English | MEDLINE | ID: mdl-30321351

ABSTRACT

Background: Nontyphoidal Salmonella (NTS) organisms are a major cause of gastroenteritis and bacteremia, but little is known about maternally acquired immunity and natural exposure in infant populations residing in areas where NTS disease is highly endemic. Methods: We recruited 503 pregnant mothers and their infants (following delivery) from urban areas in Vietnam and followed infants until they were 1 year old. Exposure to the dominant NTS serovars, Salmonella enterica serovars Typhimurium and Enteritidis, were assessed using lipopolysaccharide (LPS) O antigen-specific antibodies. Antibody dynamics, the role of maternally acquired antibodies, and NTS seroincidence rates were modeled using multivariate linear risk factor models and generalized additive mixed-effect models. Results: Transplacental transfer of NTS LPS-specific maternal antibodies to infants was highly efficient. Waning of transplacentally acquired NTS LPS-specific antibodies at 4 months of age left infants susceptible to Salmonella organisms, after which they began to seroconvert. High seroincidences of S. Typhimurium and S. Enteritidis LPS were observed, and infants born with higher anti-LPS titers had greater plasma bactericidal activity and longer protection from seroconversion. Conclusions: Although Vietnamese infants have extensive exposure to NTS, maternally acquired antibodies appear to play a protective role against NTS infections during early infancy. These findings suggest that prenatal immunization may be an appropriate strategy to protect vulnerable infants from NTS disease.


Subject(s)
Antibodies, Bacterial/immunology , Immunity, Maternally-Acquired/immunology , Immunity , Salmonella Infections/immunology , Adult , Antibodies, Bacterial/blood , Cohort Studies , Female , Humans , Infant , Infant, Newborn , Lipopolysaccharides/immunology , Male , Multivariate Analysis , O Antigens , Risk Factors , Salmonella enteritidis , Salmonella typhimurium , Seroepidemiologic Studies , Serogroup , Vietnam
18.
J Med Microbiol ; 67(10): 1457-1466, 2018 Oct.
Article in English | MEDLINE | ID: mdl-30113307

ABSTRACT

PURPOSE: Antimicrobial-resistant bacterial infections in low- and middle-income countries (LMICs) are a well-established global health issue. We aimed to assess the prevalence of and epidemiological factors associated with the carriage of ciprofloxacin- and ceftriaxone-resistant Escherichia coli and associated resistance genes in a cohort of 498 healthy children residing in urban Vietnam. METHODOLOGY: We cultured rectal swabs onto MacConkey agar supplemented with resistant concentrations of ciprofloxacin and ceftriaxone. Additionally, we screened meta-E. coli populations by conventional PCR to detect plasmid-mediated quinolone resistance (PMQR)- and extended-spectrum ß-lactamase (ESBL)-encoding genes. We measured the associations between phenotypic/genotypic resistance and demographic characteristics using logistic regression.Results/Key findings. Ciprofloxacin- and ceftriaxone-resistant E. coli were cultured from the faecal samples of 67.7 % (337/498) and 80.3 % (400/498) of children, respectively. The prevalence of any associated resistance marker in the individual samples was 86.7 % (432/498) for PMQR genes and 90.6 % (451/498) for ß-lactamase genes. Overweight children were significantly more likely to carry qnr genes than children with lower weight-for-height z-scores [odds ratios (OR): 1.24; 95 % confidence interval (CI): 10.5-1.48 for each unit increase in weight for height; P=0.01]. Additionally, younger children were significantly more likely to carry ESBL CTX-M genes than older children (OR: 0.97, 95 % CI: 0.94-0.99 for each additional year, P=0.01). CONCLUSION: The carriage of genotypic and phenotypic antimicrobial resistance is highly prevalent among E. coli in healthy children in the community in Vietnam. Future investigations on the carriage of antimicrobial resistant organisms in LMICs should focus on the progression of carriage from birth and structure of the microbiome in obesity.


Subject(s)
Anti-Bacterial Agents/pharmacology , Carrier State/microbiology , Ciprofloxacin/pharmacology , Escherichia coli Infections/microbiology , Escherichia coli/drug effects , Fluoroquinolones/pharmacology , Age Factors , Body Weight , Carrier State/physiopathology , Child, Preschool , Drug Resistance, Bacterial , Escherichia coli/genetics , Escherichia coli/isolation & purification , Escherichia coli/metabolism , Escherichia coli Infections/physiopathology , Feces/microbiology , Female , Humans , Male , Microbial Sensitivity Tests , Prospective Studies , Vietnam
19.
J Antimicrob Chemother ; 73(9): 2546-2554, 2018 09 01.
Article in English | MEDLINE | ID: mdl-29982636

ABSTRACT

Objectives: Antimicrobial-resistant infections are a major global health issue. Ease of antimicrobial access in developing countries is proposed to be a key driver of the antimicrobial resistance (AMR) epidemic despite a lack of community antimicrobial usage data. Methods: Using a mixed-methods approach (geospatial mapping, simulated clients, healthcare utilization, longitudinal cohort) we assessed antimicrobial access in the community and quantified antimicrobial usage for childhood diarrhoea in an urban Vietnamese setting. Results: The study area had a pharmacy density of 15.7 pharmacies/km2 (a pharmacy for every 1316 people). Using a simulated client method at pharmacies within the area, we found that 8% (3/37) and 22% (8/37) of outlets sold antimicrobials for paediatric watery and mucoid diarrhoea, respectively. However, despite ease of pharmacy access, the majority of caregivers would choose to take their child to a healthcare facility, with 81% (319/396) and 88% (347/396) of responders selecting a specialized hospital as one of their top three preferences when seeking treatment for watery and mucoid diarrhoea, respectively. We calculated that at least 19% (2688/14427) of diarrhoea episodes in those aged 1 to <5 years would receive an antimicrobial annually; however, antimicrobial usage was almost 10 times greater in hospitals than in the community. Conclusions: Our data question the impact of community antimicrobial usage on AMR and highlight the need for better education and guidelines for all professionals with the authority to prescribe antimicrobials.


Subject(s)
Anti-Bacterial Agents/therapeutic use , Diarrhea/drug therapy , Drug Utilization/statistics & numerical data , Health Services Accessibility/statistics & numerical data , Child, Preschool , Female , Humans , Infant , Male , Urban Population , Vietnam
20.
Clin Infect Dis ; 66(4): 504-511, 2018 02 01.
Article in English | MEDLINE | ID: mdl-29029149

ABSTRACT

Background: Pediatric diarrheal disease presents a major public health burden in low- to middle-income countries. The clinical benefits of empirical antimicrobial treatment for diarrhea are unclear in settings that lack reliable diagnostics and have high antimicrobial resistance (AMR). Methods: We conducted a prospective multicenter cross-sectional study of pediatric patients hospitalized with diarrhea containing blood and/or mucus in Ho Chi Minh City, Vietnam. Clinical parameters, including disease outcome and treatment, were measured. Shigella, nontyphoidal Salmonella (NTS), and Campylobacter were isolated from fecal samples, and their antimicrobial susceptibility profiles were determined. Statistical analyses, comprising log-rank tests and accelerated failure time models, were performed to assess the effect of antimicrobials on disease outcome. Results: Among 3166 recruited participants (median age 10 months; interquartile range, 6.5-16.7 months), one-third (1096 of 3166) had bloody diarrhea, and 25% (793 of 3166) were culture positive for Shigella, NTS, or Campylobacter. More than 85% of patients (2697 of 3166) were treated with antimicrobials; fluoroquinolones were the most commonly administered antimicrobials. AMR was highly prevalent among the isolated bacteria, including resistance against fluoroquinolones and third-generation cephalosporins. Antimicrobial treatment and multidrug resistance status of the infecting pathogens were found to have no significant effect on outcome. Antimicrobial treatment was significantly associated with an increase in the duration of hospitalization with particular groups of diarrheal diseases. Conclusions: In a setting with high antimicrobial usage and high AMR, our results imply a lack of clinical benefit for treating diarrhea with antimicrobials; adequately powered randomized controlled trials are required to assess the role of antimicrobials for diarrhea.


Subject(s)
Anti-Bacterial Agents/therapeutic use , Diarrhea/drug therapy , Drug Resistance, Multiple, Bacterial , Feces/microbiology , Adolescent , Campylobacter/drug effects , Child , Child, Preschool , Cross-Sectional Studies , Diarrhea/microbiology , Female , Humans , Infant , Male , Microbial Sensitivity Tests , Prevalence , Prospective Studies , Salmonella/drug effects , Shigella/drug effects , Treatment Outcome , Vietnam
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