Facile Fabrication of SERS Substrates by the Electrodeposition Method to Detect Pesticides with High Enhancement Effect and Long-Term Stability.

In this study, surface-enhanced Raman scattering substrates were investigated by the electrodeposition method to detect low concentrations of pesticides via the electrodeposition method with different agents from silver and gold precursors on APTES-modified ITO glass. A dual-potential method supplied three electrodes and was performed with a nucleation potential of 0.7 V for 2 s and a growth potential of -0.2 V for 500 s. The Ag film produced by the electrodeposition approach has great surface uniformity and good SERS signal amplification for the thiram insecticide at low concentrations. Interestingly, the ITO/APTES/Ag substrate extensively increased the sensitivity than the other investigated ones, thanks to the adequate assistance of amino groups of APTES in the denser and hierarchical deposition of Ag NPs. These observations were additionally elucidated via finite-difference time-domain (FDTD) calculation. For thiram, the detection was set at 10-8 M with an enhancement factor of up to 3.6 × 107 times. Comparing the SERS spectra of thiram at concentrations of 10-3, 10-4, and 10-5 M with a relative standard deviation (RSD) of less than 7.0% demonstrates excellent reproducibility of the ITO/APTES/Ag substrate. In addition, the special selectivity of the ITO/APTES/Ag substrate for thiram demonstrates that these nanostructures can identify pesticides with extreme sensitivity.

Microalgae-enhanced bioremediation of Cr(VI) ions using spent coffee ground-derived magnetic biochar MoS2-Ag composites.

Composites of magnetic biochar derived from spent coffee grounds were prepared using MoS2 decorated by plasmonic silver nanoparticles (MoS2-Ag), which were used for the bioremediation Cr6+ ions. The composites were characterized by electron microscopy, X-ray diffraction, Raman, and UV-VIS spectroscopy. The bioremediation of Cr6+ ions was enhanced almost two times compared to microalgae, Spirulina maxima. Such an increased activity is attributed to heterojunction formation of Biochar@MoS2-Ag composite due to the synergetic effects of surface plasmon resonance of AgNPs inducing amplified local electric field, thus simultaneously increasing the absorption of MoS2 under visible or near-infrared light. The combination of Biochar@MoS2-Ag and Spirulina maxima powder was effective for the separation (microalga-based absorption and accumulation of Cr6+ ions) of photo-induced carriers (composite-assisted to breakdown Cr6+ ions). This study offers efficient eco-friendly treatment of Cr6+ ions by reporting the first enhanced bioremediation of Cr(VI) ions by microalgae using MoS2-Ag-modified biochar obtained from consumed coffee grounds.

Spatial and phylogenetic patterns reveal hidden infection sources of Bacillus anthracis in an anthrax outbreak in Son La province, Vietnam.

Bacillus anthracis, the bacterial cause of anthrax, is a zoonosis affecting livestock and wildlife often spilling over into humans. In Vietnam, anthrax has been nationally reportable since 2015 with cases occurring annually, mostly in the northern provinces. In April 2022, an outbreak was reported in Son La province following the butchering of a water buffalo, Bubalus bubalis. A total of 137 humans from three villages were likely exposed to contaminated meat from the animal. Early epidemiological investigations suggested a single animal was involved in all exposures. Five B. anthracis isolates were recovered from human clinical cases along with one from the buffalo hide, another from associated maggots, and one from soil at the carcass site. The isolates were whole genome sequenced, allowing global, regional, and local molecular epidemiological analyses of the outbreak strains. All recovered B. anthracis belong to the A.Br.001/002 lineage based on canonical single nucleotide polymorphism analysis (canSNP). Although not previously identified in Vietnam, this lineage has been identified in the nearby countries of China, India, Indonesia, Thailand, as well as Australia. A twenty-five marker multi-locus variable number tandem repeat analysis (MLVA-25) was used to investigate the relationship between human, soil, and buffalo strains. Locally, four MLVA-25 genotypes were identified from the eight isolates. This level of genetic diversity is unusual for the limited geography and timing of cases and differs from past literature using MLVA-25. The coupled spatial and phylogenetic data suggest this outbreak originated from multiple, likely undetected, animal sources. These findings were further supported by local news reports that identified at least two additional buffalo deaths beyond the initial animal sampled in response to the human cases. Future outbreak response should include intensive surveillance for additional animal cases and additional molecular epidemiological traceback to identify pathogen sources.

Polyaromatic hydrocarbon thin film layers on glass, dust, and polyurethane foam surfaces.

An investigation was conducted into the dynamic behavior of two polyaromatic hydrocarbon (PAH) semi-volatile organic compound (SVOC) naphthalene (NAP) and benzo [ghi]perylene (BghiP) in air and on various surfaces including glass, dust, and polyurethane foam (PUF) to understand their interaction with different media. A confocal fluorescence microscope and an infrared microscope were employed to detect and monitor the concentration-, time-, and temperature-dependent changes of the aromatic NAP and BghiP species on the surfaces. Infrared two-dimensional mapping of the vibrational characteristic peaks was used to track the two PAHs on the surfaces. Gas chromatography-mass spectrometry (GC-MS) was employed to measure the gaseous concentrations. The sorption of NAP and BghiP on the surfaces was estimated using Arizona desert sand fine (ISO 12103-1 A2) dust and organic contaminant household (SRM 2585) dust. The surface-to-air partition coefficients of NAP and BghiP were estimated on the different surfaces of glass, dust, and PUF. Molecular dynamic simulations were performed on dust surfaces based on the Hatcher model to understand the behavior of NAP and BghiP on dust surfaces. The Weschler-Nazaroff model was introduced to predictPAH film accumulation on the surfaces, providing a better understanding of PAH interaction with different environmental media. These findings could contribute to developing effective strategies to mitigate the adverse impact of PAHs on the environment and human health.

Review of antibiotic prescriptions as part of antimicrobial stewardship programmes: results from a pilot implementation at two provincial-level hospitals in Viet Nam.

Objectives: To investigate the feasibility of retrospective prescription-based review and to describe the antibiotic prescribing patterns to provide information for an antimicrobial stewardship programme in Viet Nam. Methods: This study was conducted in two provincial-level hospitals between February and April 2020. Reviews were done by a clinical team consisting of leaders/senior doctors of each ward to assess the optimal level (optimal/adequate/suboptimal/inadequate/not assessable) of antibiotic prescriptions. Mixed-effect logistic regression at prescription level was used to explore factors associated with optimal antibiotic use. Results: The retrospective prescription-based review was accepted by study clinical wards with varied levels of participants. One hundred and eighty-three patients (326 prescriptions) in Hospital 1 and 200 patients (344 prescriptions) in Hospital 2 were included. One hundred and nineteen of the 326 (36.5%) antibiotic prescriptions in Hospital 1 and 51/344 (14.8%) antibiotic prescriptions in Hospital 2 were determined to be optimal by the review teams. The number of adequate antibiotic prescriptions were 179/326 (54.9%) and 178 (51.7%) in Hospital 1 and Hospital 2, respectively. The optimal level was lower for surgical prophylaxis antibiotics than for empirical therapy (OR = 0.06; 95% CI 0.01-0.45), higher in prescriptions in the ICU (OR = 12.00; 95% CI 3.52-40.92), higher in definitive antibiotic therapy (OR = 48.12; 95% CI 7.17-322.57) and higher in those with an indication recorded in medical records (OR = 3.46; 95% CI 1.13-10.62). Conclusions: This study provides evidence on the feasibility of retrospective prescription-based review, with adaption to the local situation. High and varying levels of optimal antibiotic prescriptions in clinical wards in hospitals were observed in Viet Nam.

Equilibria of semi-volatile isothiazolinones between air and glass surfaces measured by gas chromatography and Raman spectroscopy.

Trace amounts of semi-volatile organic compounds (SVOCs) of the two isothiazolinones of 2-methylisothiazol-3(2H)-one (MIT) and 2-octyl-4-isothiazolin-3-one (OIT) were detected both in the air and on glass surfaces. Equilibria of SVOCs between air and glass were examined by solid phase microextraction-gas chromatography/mass spectrometry (SPME-GC/MS). Surface to air distribution ratios of Ksa for MIT and OIT were determined to be 5.10 m and 281.74 m, respectively, suggesting more abundant MIT in the gas phase by a factor of ∼55. In addition, a facile method of silver nanocube (AgNC)-assisted surface-enhanced Raman scattering (SERS) has been developed for the rapid and sensitive detection of MIT and OIT on glass surfaces. According to MIT and OIT concentration-correlated SERS intensities of Raman peaks at ∼1585 cm-1 and ∼1125 cm-1, respectively. Their calibration curves have been obtained in the concentration ranges between 10-3 to 10-10 M and 10-3 to 10-11 M with their linearity of 0.9986 and 0.9989 for MIT and OIT, respectively. The limits of detection (LODs) of the two isothiazolinones were estimated at 10-10 M, and 10-11 M for MIT and OIT, respectively. Our results indicate that AgNC-assisted SERS spectra are a rapid and high-ultrasensitive method for the quantification of MIT and OIT in practical applications. The development of analytical methods and determination of the Ksa value obtained in this study can be applied to the prediction of the exposure to MIT and OIT from various chemical products and dynamic behaviors to assess human health risks in indoor environments.

Sensors for Detection of the Synthetic Dye Rhodamine in Environmental Monitoring Based on SERS.

This article presents a review of many types of SERS sensors for food safety and environmental pollution monitoring based on detecting rhodamine. It introduces the basic concepts of substrates, enhancement factors, and mechanisms, devices' sensors integrated with the microstructure. Here, we review the state-of-the-art research in the field of rhodamine monitoring and highlight the applications of SERS sensors. The trends in the development of substrates for different applications have been mentioned with the aim of providing an overview of the development of different SERS substrates. Thus, an efficient approach for rhodamine detection has a good perspective for application in environmental monitoring.

Antimicrobial resistance patterns in bacteria causing febrile illness in Africa, South Asia, and Southeast Asia: a systematic review of published etiological studies from 1980-2015.

OBJECTIVE: In this study, we aimed to conduct a systematic review to characterize antimicrobial resistance (AMR) patterns for bacterial causes of febrile illness in Africa and Asia. METHODS: We included published literature from 1980-2015 based on data extracted from two recent systematic reviews of nonmalarial febrile illness from Africa, South Asia, and Southeast Asia. Selection criteria included articles with full bacterial identification and antimicrobial susceptibility testing (AST) results for key normally sterile site pathogen-drug combinations. Pooled proportions of resistant isolates were combined using random effects meta-analysis. Study data quality was graded using the Microbiology Investigation Criteria for Reporting Objectively (MICRO) framework. RESULTS: Of 3475 unique articles included in the previous reviews, 371 included the target pathogen-drug combinations. Salmonella enterica tested against ceftriaxone and ciprofloxacin were the two highest reported combinations (30,509 and 22,056 isolates, respectively). Pooled proportions of resistant isolates were high for third-generation cephalosporins for Klebsiella pneumoniae and Escherichia coli in all regions. The MICRO grading showed an overall lack of standardization. CONCLUSION: This review highlights a general increase in AMR reporting and in resistance over time. However, there were substantial problems with diagnostic microbiological data quality. Urgent strengthening of laboratory capacity, standardized testing, and reporting of AST results is required to improve AMR surveillance.

Synthesis and Characterization of Polypyrrole Film Doped with Both Molybdate and Salicylate and Its Application in the Corrosion Protection for Low Carbon Steel.

Polypyrrole (PPy) films doped with molybdate and salicylate have been successfully electropolymerized on low carbon steel in aqueous solutions containing both molybdate and salicylate in a one-step process that did not require any pre-treatment of the steel substrate. Salicylate-doped PPy films were synthesized in the same way for comparison. The steel surface was rapidly inhibited and the PPy-based films were formed on it easily. The PPy-based films were characterized by Fourier transform infrared, scanning electron microscopy, energy dispersive X-ray, and thermal gravimetric analysis methods. The corrosion protection performance of the coatings was investigated with electrochemical impedance spectroscopy, open circuit potential (OCP), salt spray test, and Tafel polarization. It was found that in the presence of both molybdate and salicylate as dopants, the films on steel could present a better corrosion resistance than PPy film doped with only salicylate. The self-healing property of PPy-based films was observed on the OCP measurement with the fluctuation of rest potential. The salt spray test results showed that the PPy film doped with both salicylate and molybdate was more salt-resistant than the PPy film doped with only salicylate. The results suggest that the PPy coatings doped with both molybdate and salicylate are potential for application as metallic anti-corrosion coatings.

Nanopatterned Polymer Molds Using Anodized Aluminum Templates for Anti-Reflective Coatings.

This work introduces a facile geometry-controlled method for the fabrication of embossed and engraved polymeric moth-eye-inspired nanostructures in imprinting molds using anodic aluminum oxide (AAO) templates, resulting in a novel anti-reflective transparent coating. The moth-eye nanostructures are prepared directly on the surface of a flexible polyethylene terephthalate (PET) substrate. As a prerequisite procedure, a UV-curable polyurethane acrylate resin is spun on the PET. The shape of the moth-eye nanostructures can then be adjusted by controlling the size and shape of the nanopores in the AAO templates. Both embossed and concaved polymer moth-eye nanostructures were successfully mounted on a PET substrate. Embossed polymer replica molds were prepared using the AAO master templates in combination with an imprinting process. As revealed by field-emission electron microscope (FE-SEM) images, conical nanopatterns in the AAO template with a diameter of ~90 nm and a depth of ~100 nm, create a homogeneous embossed morphology in the polymer moth-eye nanostructure. The polymeric molds with the depths of 300 and 500 nm revealed the amalgamated structures in their apexes. In addition, a dip-imprinting process of the polymeric layers was implemented to yield a concaved mold by assembly on the surface of the 100 nm embossed polymer mold substrate. Considering that the embossed structures may be crumbled due to their protuberant shapes, the concaved geometries can have an advantage of stability in a certain application concerning physical degradation along with a higher transmission by ~2%, despite somewhat nonuniform structure. The experimental and theoretical results of this study indicate that this polymer layer has the potential for use in anti-reflective coating applications in transparent films.

Assessing feasibility of establishing antimicrobial stewardship programmes in two provincial-level hospitals in Vietnam: an implementation research study.

OBJECTIVES: To investigate the feasibility of establishing hospital-based antimicrobial stewardship (AMS) programmes comprising action-planning, educational interventions and data feedback in two provincial-level hospitals in Viet Nam. DESIGN AND SETTING: This was an implementation research using participatory action process and existing resources from the Duke Antimicrobial Stewardship Outreach Network with local adjustments. A national stakeholder meeting and Strengths-Weaknesses-Opportunities-Threats (SWOT) analysis were conducted to identify gaps and potential interventions. PARTICIPANTS: Hospital AMS staff implemented activities throughout the study phases. Routinely collected patient data were analysed to support planning, implementation and evaluation. INTERVENTIONS: Hospitals were considered as a complex adaptive system and leveraged their unique characteristics and interconnections to develop 1-year plans containing core interventions (data use, educational training, prospective audit with feedback (PAF) and evaluations). OUTCOME MEASURES: We assessed feasibility using outputs from stakeholder meeting, SWOT analysis, baseline data, planning process and implementation. RESULTS: The stakeholder meeting identified three gaps for AMS at national level: supportive policies, AMS training and core competencies and collaboration. At the hospitals, AMS programmes took 1 year for planning due to lack of hospital-specific procedures and relevant staff competencies. Baseline data (January-December 2019) showed variations in antibiotic consumption: 951 days of therapy (DOT) per 1000 days present in the control and 496 in the intervention wards in hospital 1, and 737 and 714 in hospital 2, respectively. During 1-year implementation, clinical pharmacists audited 1890 antibiotic prescriptions in hospital 1 (June 2020-May 2021) and 1628 in hospital 2 (July 2020-July 2021), and will continue PAF in their daily work. CONCLUSION: Our data confirmed the need to contextualise AMS programmes in low-income and middle-income countries (LMICs) and demonstrated the usefulness of implementation research design in assessing programme feasibility. Developing staff competencies, using local data to stimulate actions and integrating programme activities in routine hospital work are key to success in LMICs.

Improving antimicrobial use through antimicrobial stewardship in a lower-middle income setting: a mixed-methods study in a network of acute-care hospitals in Viet Nam.

OBJECTIVES: This study aimed to analyse the current state of antimicrobial stewardship (AMS) in hospitals in Viet Nam, a lower-middle income country (LMIC), to identify factors determining success in AMS implementation and associated challenges to inform planning and design of future programmes. METHODS: We conducted a mixed-methods study in seven acute-care hospitals in the antimicrobial resistance (AMR) surveillance network in Viet Nam. Data collection included 7 focus group discussions, 40 in-depth interviews and a self-administered quantitative survey of staff on AMR and AMS programmes. We summarised qualitative data by reporting the most common themes according to the core AMS elements, and analysed quantitative data using proportions and a linear mixed-effects model. RESULTS: The findings reveal a complex picture of factors and actors involved in AMS implementation from the national level to the departmental and individual level within each hospital. The level of implementation varied, starting from the formation of an AMS committee, with or without active delivery of specific interventions. Development of treatment guidelines, pre-authorisation of antimicrobial drug classes, and post-prescription audit and feedback to doctors in selected clinical departments were the main interventions reported. A higher level of leadership support and commitment to AMS led to a higher level of engagement with AMS activities from the AMS team and effective collaboration between departments involved. CONCLUSION: Establishing country-specific guidelines on AMS staffing and adapting standards for AMS education and training from international resources are needed to support capacity building to implement AMS programmes effectively in LMICs such as Viet Nam.

Optimization of donor cell cycle synchrony, maturation media and embryo culture system for somatic cell nuclear transfer in the critically endangered Vietnamese I pig.

Our aim was to establish an efficient culture system to produce embryos by SCNT of the endangered Vietnamese I pig. Reducing the serum concentration from 10.0% to 0.2% during culture efficiently synchronized I pig fibroblasts used as donor cells at the G0/G1 stage. Oocyte maturation in a defined porcine oocyte medium (POM) supplemented with EGF and gonadotrophins resulted in higher cleavage and blastocyst rates compared with a non-defined POM containing pig follicular fluid (but without EGF) and both the defined and non-defined variants of NCSU-37. For embryo culture PZM3 and PZM5 media were superior to NCSU-37, in terms of the percentage of cleaved embryos. Addition of serum to PZM3 medium on Day 5 of culture (Day 0 = SCNT) improved blastocyst development. When SCNT embryos were transferred at the blastocyst stage, 7 of 11 recipients became pregnant. However, live offspring were not obtained. In conclusion, we established a system for the production of I pig embryos by SCNT and achieved blastocyst production rate at 26.4% by improving culture systems for donor cells, oocytes and embryos culture. Transfer of embryos resulted in pregnancies; however, live offspring were not obtained.

Kinetics of CD4+ T Helper and CD8+ Effector T Cell Responses in Acute Dengue Patients.

Background: The protective or pathogenic role of T lymphocytes during the acute phase of dengue virus (DENV) infection has not been fully understood despite its importance in immunity and vaccine development. Objectives: This study aimed to clarify the kinetics of T lymphocyte subsets during the clinical course of acute dengue patients. Study design: In this hospital-based cohort study, 59 eligible Vietnamese dengue patients were recruited and admitted. They were investigated and monitored for T cell subsets and a panel of clinical and laboratory parameters every day until discharged and at post-discharge from the hospital. Results: We described for the first time the kinetics of T cell response during the clinical course of DENV infection. Severe cases showed significantly lower levels of effector CD8+ T cells compared to mild cases at day -1 (p = 0.017) and day 0 (p = 0.033) of defervescence. After defervescence, these cell counts in severe cases increased rapidly to equalize with the levels of mild cases. Our results also showed a decline in total CD4+ T, Th1, Th1/17 cells during febrile phase of dengue patients compared to normal controls or convalescent phase. On the other hand, Th2 cells increased during DENV infection until convalescent phase. Cytokines such as interferon-γ, IL-12p70, IL-5, IL-23, IL-17A showed tendency to decrease on day 0 and 1 compared with convalescence and only IL-5 showed significance indicating the production during acute phase was not systemic. Conclusion: With a rigorous study design, we uncovered the kinetics of T cells in natural DENV infection. Decreased number of effector CD8+ T cells in the early phase of infection and subsequent increment after defervescence day probably associated with the T cell migration in DENV infection.

Bimetallic Thin-Film Combination of Surface Plasmon Resonance-Based Optical Fiber Cladding with the Polarizing Homodyne Balanced Detection Method and Biomedical Assay Application.

In this work, we present the optical birefringence properties of the optical fiber cladding that exists as an evanescent field where the refractive index (RI) of the analysis solution is applied for optical sensor aspiration. To enhance the performance of the sensor, we have investigated the sensor with different thicknesses of TiO2 coating and bimetallic (Ag-Al) film alloy combinations by thermal evaporation coating. We described a special balanced homodyne detection method for the intensity difference change between the p- and s-polarization lights in the surface plasmon resonance sensing systems, which is strongly determined by the RI of the test medium. The plasmonic optical fiber can measure a very small change of the RI of a glycerol solution, which is a resolution of 4.37 × 10-8 RI unit (RIU). This method has great advantages of a small-sized optical setup, high stability, high selectivity, easy chemical modification, and low cost. Furthermore, because of the experiment results, we observe that our approach can also eliminate the surrounding noise in the Mach-Zehnder interferometer, which shows the feasibility of this proposed technique. We demonstrate the fluorescence enhancement in detecting the C-reactive protein antibody conjugated with fluorescein isothiocyanate by means of near-field coupling between surface plasmons and fluorophores at spectral channels of emission. This technique can also be extended for application in a biomedical assay and in biochemical science, including molecular diagnostics relying on multichannels that require a small volume of the analyte at each channel which would suffer from the weakness of fluorescence if it were not for the enhancement technology.

The highly sensitive determination of serotonin by using gold nanoparticles (Au NPs) with a localized surface plasmon resonance (LSPR) absorption wavelength in the visible region.

The development of improved methods for the synthesis of monodisperse gold nanoparticles (Au NPs) is of high priority because they can be used as substrates for surface-enhanced Raman scattering (SERS) applications relating to biological lipids. Herein, Au NPs have been successfully synthesized via a seed-mediated growth method. The LSPR peak is controlled via adjusting the gold nanoseed component, and different fabrication methods were studied to establish the effect of sonication time on NP size. The simple, facile, and room-temperature method is based on a conventional ultrasonic bath, which leads to ultrasonic energy effects on the size and morphology of the Au NPs. This research offers new opportunities for the production of highly monodispersed spherical Au NPs without the use of a magnetic stirrer method, as evidenced by ultraviolet-visible reflectance spectra and scanning electron microscopy (SEM) analysis. SEM images indicate that the spherical Au NP colloidal particles are stable and reliable, which paves the way for their use as a nanostructured biosensor platform that can be exploited for multiple applications, for example, in materials science, sensing, catalysis, medicine, food safety, biomedicine, etc. The highest enhancement factor that could be achieved in terms of the SERS enhancement activity of these Au NP arrays was determined using 10-9 M serotonin (5-hydroxytryptamine, 5-HT) as the Raman probe molecules.

Plans for Nationwide Serosurveillance Network in Vietnam.

In recent years, serosurveillance has gained momentum as a way of determining disease transmission and immunity in populations, particularly with respect to vaccine-preventable diseases. At the end of 2017, the Oxford University Clinical Research Unit and the National Institute of Hygiene and Epidemiology held a meeting in Vietnam with national policy makers, researchers, and international experts to discuss current seroepidemiologic projects in Vietnam and future needs and plans for nationwide serosurveillance. This report summarizes the meeting and the plans that were discussed to set up nationwide serosurveillance in Vietnam.

Antimicrobial Resistance Profile and Molecular Characteristics of Staphylococcus aureus Isolates from Hospitalized Adults in Three Regions of Vietnam.

This study aimed to investigate antimicrobial resistance profile, multidrug resistance (MDR), and molecular characteristics of pathogenic Staphylococcus aureus isolates from hospitalized Vietnamese adults. Two hundred and twenty-three pathogenic S. aureus isolates were obtained from the hospitals located in 3 regions of Vietnam. The minimum inhibitory concentrations were determined to detect the antibiotic susceptibility of the isolates. The molecular characteristics of S. aureus isolates were investigated through antibiotic-resistant genes analysis, staphylococcal cassette chromosome mec typing, pulsed-field gel electrophoresis, and multilocus sequence typing. Substantial differences among the 3 regions were found in the prevalence rates of methicillin-resistant S. aureus (north: 48.6%, central: 58.7%, south: 78.9%) and MDR (north: 65.8%, central: 79.7%, and south: 84.2%). The prevalence rates of the genes tetK/M, aacA/aphD, ermA/B/C, and mecA increased substantially from north to south. ST188-SCCmecIV and ST239-SCCmecII isolates were most commonly found in the 2 largest clusters. ST188 predominance was observed in the largest cluster in methicillin-resistant and methicillin-sensitive S. aureus isolates, including SCCmecIII and SCCmecIVa, in fatal cases. Our results revealed a high occurrence of MDR and possible north-south trend in antibiotic resistance profile, MDR patterns, and frequency of antibiotic-conferring genes among S. aureus isolates. ST188 predominance raises concerns about the global importance of host-adapted ST188 in East Asian populations.

Plasma cell-free DNA: a potential biomarker for early prediction of severe dengue.

BACKGROUND: Considerable progress has been made in dengue management, however the lack of appropriate predictors of severity has led to huge number of unwanted admissions mostly decided on the grounds of warning signs. Apoptosis related mediators, among others, are known to correlate with severe dengue (SD) although no predictive validity is established. The objective of this study was to investigate the association of plasma cell-free DNA (cfDNA) with SD, and evaluate its prognostic value in SD prediction at acute phase. METHODS: This was a hospital-based prospective cohort study conducted in Vietnam. All the recruited patients were required to be admitted to the hospital and were strictly monitored for various laboratory and clinical parameters (including progression to SD) until discharged. Plasma samples collected during acute phase (6-48 h before defervescence) were used to estimate the level of cfDNA. RESULTS: Of the 61 dengue patients, SD patients (n = 8) developed shock syndrome in 4.8 days (95% CI 3.7-5.4) after the fever onset. Plasma cfDNA levels before the defervescence of SD patients were significantly higher than the non-SD group (p = 0.0493). From the receiver operating characteristic (ROC) curve analysis, a cut-off of > 36.9 ng/mL was able to predict SD with a good sensitivity (87.5%), specificity (54.7%), and area under the curve (AUC) (0.72, 95% CI 0.55-0.88; p = 0.0493). CONCLUSIONS: Taken together, these findings suggest that cfDNA could serve as a potential prognostic biomarker of SD. Studies with cfDNA kinetics and its combination with other biomarkers and clinical parameters would further improve the diagnostic ability for SD.