Tracking Risk Factors Related to an Outbreak of COVID-19 Among Healthcare Workers in a General Medicine Ward.

Background An outbreak of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection occurred in a medical ward involving patients and hospital staff from May to June 2020. Aim The aim of this study is to determine risk factors related to the outbreak of SARS-CoV-2 in six healthcare workers (HCWs) in a medical ward with initially unrecognized coronavirus disease 2019 (COVID-19) positive patients. Methods A retrospective cross-sectional study was conducted using a comprehensive questionnaire and personal interviews to determine the risk factors for COVID-19 infection in HCWs. Findings A total of 6/34 HCWs were diagnosed with COVID-19 in a medical ward. There were no differences between COVID-19 negative HCWs and COVID-19 positive HCWs in terms of mean duration of hours worked in the unit during the cluster event (180.2 vs 177.5 hours) (p>0.05), mean total time spent in contact with COVID-19 positive patients (12.8 vs 10.5 hours) (p>0.05), mean total time spent on aerosol-generating procedures (1.9 vs 0.9 hours) (p>0.05), and mean total time spent on non-aerosol generating procedures (10.9 vs 9.6 hours ) (p>0.05). There was no difference in exposure to COVID-19 positive family members among the HCWs (33% vs 3.7%, p=0.08). In contrast, exposure to COVID-19 positive contacts in the community was significantly greater in infected vs non-infected HCWs (16.7% vs 0%, p=0.03). Conclusion There was no significant difference in risk factors for contracting SARs-CoV2 among HCWs due to hospital exposures. COVID-19 positive HCWs were more likely to be exposed to positive individuals in their households and community, indicating that the source of SARS-CoV-2 infection came from outside the hospital.

Impact of Sequential Passaging on Protein Expression of E. coli Using Proteomics Analysis.

Urinary tract infection (UTI) is one of the most prevalent bacterial infections in the world affecting the bladder and the kidney. Escherichia coli (E. coli) is the main causative agent of 80-90% of community-acquired UTIs, about 40% of nosocomial UTIs, and 25% of recurrent UTIs. The field of proteomics has emerged as a great tool to analyze expressed proteins to identify possible biomarkers associated with many pathological states and, to the same extent, those associated with bacterial pathogenesis and their ability to cause recurrent infections. Here, in a descriptive cross-sectional pilot study, we employed proteomic techniques to investigate the effects of environmental stress on protein profiles of E. coli simulated by sequential passaging of samples from patients with UTIs to screen for unique proteins that arise under stressful environment and could aid in the early detection of UTIs. Four urine samples were collected from individuals with recurrent UTI and sequentially subcultured; protein samples were extracted from bacterial pellets and analyzed using 2-dimensional gel electrophoresis (2DGE). Protein spots of interest arising from changes in the protein profile were analyzed using liquid chromatography-mass spectrometry (LC-MS/MS) and matched against known databases to identify related proteins. We identified ATPB_ECOBW, ASPA ECOLI, DPS ECOL6, and DCEB ECOLI as proteins associated with higher passaging. We concluded that passaging resulted in identifiable changes in the protein profile of E. coli, namely, proteins that are associated with survival and possible adaptation of bacteria, suggestive of factors contributing to antibiotic resistance and recurrent UTIs. Furthermore, our method could be further used to identify indicator-protein candidates that could be a part of a growing protein database to diagnose and identify causative agents in UTIs.

Host attachment and fluid shear are integrated into a mechanical signal regulating virulence in Escherichia coli O157:H7.

Enterohemorrhagic Escherichia coli (EHEC) is a foodborne pathogen causing hemorrhagic colitis and hemolytic uremic syndrome. EHEC colonizes the intestinal tract through a range of virulence factors encoded by the locus of enterocyte effacement (LEE), as well as Shiga toxin. Although the factors involved in colonization and disease are well characterized, how EHEC regulates its expression in response to a host encounter is not well understood. Here, we report that EHEC perceives attachment to host cells as a mechanical cue that leads to expression of LEE-encoded virulence genes. This signal is transduced via the LEE-encoded global regulator of LEE-encoded regulator (Ler) and global regulator of Ler and is further enhanced by levels of shear force similar to peristaltic forces in the intestinal tract. Our data suggest that, in addition to a range of chemical environmental signals, EHEC is capable of sensing and responding to mechanical cues to adapt to its host's physiology.