Detection of influenza virus in air samples of patient rooms.

BACKGROUND: Understanding the transmission and dispersal of influenza virus and respiratory syncytial virus (RSV) via aerosols is essential for the development of preventative measures in hospital environments and healthcare facilities. METHODS: During the 2017-2018 influenza season, patients with confirmed influenza or RSV infections were enrolled. Room air samples were collected close (0.30 m) to and distant (2.20 m) from patients' heads. Real-time polymerase chain reaction was used to detect and quantify viral particles in the air samples. The plaque assay was used to determine the infectiousness of the detected viruses. FINDINGS: Fifty-one air samples were collected from the rooms of 29 patients with laboratory-confirmed influenza; 51% of the samples tested positive for influenza A virus (IAV). Among the IAV-positive patients, 65% were emitters (had at least one positive air sample), reflecting a higher risk of nosocomial transmission compared with non-emitters. The majority (61.5%) of the IAV-positive air samples were collected 0.3 m from a patient's head, while the remaining IAV-positive air samples were collected 2.2 m from a patient's head. The positivity rate of IAV in air samples was influenced by distance from the patient's head and day of sample collection after hospital admission. Only three patients with RSV infection were recruited and none of them were emitters. CONCLUSION: Influenza virus can be aerosolized beyond 1 m in patient rooms, which is the distance considered to be safe by infection control practices. Further investigations are needed to determine the extent of infectivity of aerosolized virus particles.

Diagnostic tools of caprine and ovine anaplasmosis: a direct comparative study.

BACKGROUND: The diagnosis of anaplasmosis is rather conflicting with other haemoprotozoans. Hence, the study aimed to compare and evaluate the efficiency of competitive ELISA (cELISA), indirect fluorescence antibody (IFA), and Polymerase chain reaction (PCR) for precise diagnosis of Anaplasma spp. and to assess their concordance with microscopic examination (ME). RESULTS: A total of 312 blood samples (189 sheep and 123 goats) were examined for Anaplasma infection during a 1 year period. Giemsa-stained blood smears were examined under the microscope. IFA and cELISA were used for the detection of Anaplasma spp. antibodies. PCR was used as a standard of truth and for the identification of Anaplasma species. Using cELISA assay, 47.4% (148) were positive (93 sheep and 55 goats) with a sensitivity and specificity of 91.9, and 86.9%, respectively. Using IFA, it was found that 57.4% (179)were positive (113 sheep and 66 goats) with a sensitivity and specificity of 100, and 93.3%, respectively. PCR assay identified A. ovis in 49 (25.3%) sheep and 30 (15.5%) goats, and A. phagocytophilumin 74 (38.1%) sheep and 41 (20.8%) goats. CONCLUSIONS: High sensitivity and specificity values of IFA and ELISA tests compared to microscopic examination strongly support their utility in the diagnosis of Anaplasma infection. PCR was a more specific diagnostic tool that allows to discriminate between Anaplasma subspecies, which makes it the method of choice for anaplasmosis diagnosis.

Investigation of viral and bacterial enteropathogens of diarrheic sheep and goats in Medina, Saudi Arabia.

Diarrhea is a serious problem in sheep and goat farming, causing great economic losses. Most viral and bacterial enteropathogens of diarrheic sheep and goats are considered foodborne pathogens with a potential to be zoonotic. The present study investigated the prevalence of some viral and bacterial enteropathogens in diarrheic sheep and goats between October 2015and February 2016 in Medina, Saudi Arabia. A total of 310 fecal samples were collected from diarrheic sheep (n=193) and goats (n=117). The samples were screened for the presence of rotavirus and bovine coronavirus (BCoV) using Sandwich (ELISA) technique. The bacterial enteropathogens were isolated and identified biochemically and the virulence factors of Escherichia coli were determined by using PCR. Escherichia coli was the most prevalent agent in both sheep and goats (34.7% and 30.7%, respectively). According to the expressed virulence genes, Enterotoxigenic Escherichia coli (ETEC) was detect in 34.3% of sheep isolates and 30.6% of goats isolates. Salmonella species was isolated from 3.6% of sheep and 2.6% of goats. Klebsiella species was isolated from 1.6% of sheep but not from goats. Regarding viral agents, rotavirus was found in 31.6% of sheep and 27.4% of goats, while BCoV was detected in 19.6% of the sheep and 16.2% of the goats. The prevalence of bacterial and viral enteropathogens was significantly higher in the 0-12 months age group compared to the older age groups. Double infection was the most common (53.0%) infection pattern compared to single (37.5%) and triple (9.5%) infections. Rotavirus infection was significantly associated with ETEC infection. In conclusion, we report high prevalence of rotavirus and ETEC in sheep and goats, which are of veterinary and public health importance. This study provides valuable data on the prevalence of viral and bacterial enteropathogens in sheep and goats in Medina, Saudi Arabia that will be useful to develop control measures for these pathogens.

Characterization of influenza outbreaks in Lebanon during the 2013/14 and 2014/15 seasons.

Despite the significant burden of influenza outbreaks, active disease monitoring has been largely absent in the Middle East, including Lebanon. In this study we characterized influenza virus in 440 nasopharyngeal swabs collected from patients with acute respiratory infections during two influenza seasons in Lebanon. Influenza A(H3N2) was dominant in the 2013/14 season while the A(H1N1)pdm09 and B/Yamagata strains were most prevalent in the 2014/15 season. All tested isolates were susceptible to 4 neuraminidase inhibitors (oseltamivir, zanamivir, peramivir and laninamivir). Genetic analysis of the haemagglutinin gene revealed multiple introductions of influenza viruses into Lebanon from different geographic sources during each season. Additionally, large data gaps were identified in the Middle East region, as indicated by the lack of current influenza sequences in the database from many countries in the region.

Characterization of influenza outbreaks in Lebanon during the 2013/14 and 2014/15 seasons

Despite the significant burden of influenza outbreaks, active disease monitoring has been largely absent in the Middle East, including Lebanon. In this study we characterized influenza virus in 440 nasopharyngeal swabs collected from patients with acute respiratory infections during two influenza seasons in Lebanon. Influenza A[H3N2] was dominant in the 2013/14 season while the A[H1N1]pdm09 and B/Yamagata strains were most prevalent in the 2014/15 season. All tested isolates were susceptible to 4 neuraminidase inhibitors [oseltamivir, zanamivir, peramivir and laninamivir]. Genetic analysis of the haemagglutinin gene revealed multiple introductions of influenza viruses into Lebanon from different geographic sources during each season. Additionally, large data gaps were identified in the Middle East region, as indicated by the lack of current influenza sequences in the database from many countries in the region

Malgré la lourde charge que représentent les flambées de grippe, la surveillance active de la maladie était jusqu'à présent inexistante au Moyen-Orient, et notamment au Liban. Dans la présente étude, le virus de la grippe a été caractérisé dans 440 sécrétions rhinopharyngées prélevées par écouvillonnage chez des patients ayant souffert d'infections respiratoires aiguës pendant deux saisons grippales au Liban. Le virus de la grippe A[H3N2] était prédominant pendant la saison 2013/2014, tandis que celui de la grippe A[H1N1]pdm09 et les souches de grippe B/Yamagata étaient les plus courants pendant la saison 2014/2015. Tous les isolats testés étaient sensibles à quatre inhibiteurs de la neuraminidase [l'oseltamivir, le zanamivir, le peramivir, et le laninamivir]. L'analyse génétique du gène de l'hémagglutinine a révélé de multiples introductions des virus de la grippe au Liban, depuis différentes sources géographiques au cours de chaque saison. De plus, d'importantes lacunes dans les données ont été constatées dans la région du Moyen-Orient, comme le montre l'absence des séquences génétiques actuelles de la grippe dans les bases de données de nombreux pays de la region

Influenza and its treatment during pregnancy: A review.

The influenza viral infection has dramatic effects during pregnancy on the mother and the fetus. We present a review article on the prevention and treatment recommendations of influenza infection in pregnant women, and the effects of antiviral medications on maternal-fetal outcomes. This viral infection not only leads to miscarriages, preterm deliveries and a high maternal mortality rate, but it also poses negative risks to the fetus including small-for-gestational age infants, and admissions to neonatal intensive care units. Vaccination is the most effective strategy for preventing influenza infection during pregnancy whereby can protect both maternal and fetal immunities. The safety profiles of antiviral drugs during pregnancy are limited. Available risk-benefit evidence has indicated that pregnant women with suspected or confirmed influenza should receive prompt antiviral therapy where these medications reduce the risk of complications among pregnant women, and attenuate the teratogenic effects of the influenza infection. Post-exposure prophylaxis is not recommended for most pregnant women, but it may be prescribed in pandemic settings, particularly to non-vaccinated women. Although some ex vivo models for pharmacokinetic studies have revealed that the transplacental transfer of oseltamivir to fetal circuits may occur, there is no evidence of adverse fetal outcomes as a result of most in utero exposures to neuraminidase inhibitors. Due to the large number of confounding variables, large, population-based studies are needed to assess the association between in utero oseltamivir exposure and fetal outcome.

Molecular studies on diarrhea-associated Escherichia coli isolated from humans and animals in Egypt.

UNLABELLED: The molecular characteristics of Escherichia coli isolates from Egypt and the relationship of E. coli strains from claves, camels and humans are limited. We analyzed the genetic relationships of 48 diarrhea-associated E. coli strains isolated from sporadic diarrheal cases from humans (n=26), calves (n=14) and camels (n=8) using multilocus sequence type (MLST), virulence genes, and pulsed field gel electrophoresis (PFGE). Enterotoxigenic E. coli (ETEC) accounted for 60.4% of all samples and the rest were Enteropathogenic E. coli (EPEC) 10.4%, Diffuse adhering E. coli (DAEC) 8.3%, Enteroaggreagative E. coli (EAEC) 6.3%, Verotoxigenic E. coli (VTEC) 6.3%, Untypable E. coli. 6.3% and Atypical enteropathogenic E. coli (aEPEC) 2.1%. We identified 17 new sequence types (ST) and 12 new alleles. Generally, strains divided into 6 clonal complexes, and clonal complex (CC) 10 was the major one, detected in (15/48; 31.3%) strains from humans, calves and camels. The close relationship among the strains from different hosts was regarding to mdh, purA, and recA genes which presented a minor variation in relation to other housekeeping genes. CONCLUSION: MLST analysis suggested an endemic prevalence of clonal complex (CC) 10 in Egypt. Same sequencing types (ST) could be detected in human, calf and camel, especially ST10, indicating the ability of E. coli to cross the host barrier. Together with PFGE results and virulence genotypes we conclude that human, calf and camel can be colonized and infected with similar E. coli strains and provide evidence of calves and camels role as a reservoir for similar strains of diarrhea-associated E. coli.

Human H7N9 influenza A viruses replicate in swine respiratory tissue explants.

Recently, novel H7N9 influenza viruses have caused an unprecedented outbreak in humans. Pigs are an important intermediate host for influenza; thus, we assessed the replication ability of three human H7N9 viruses (A/Anhui/1/2013, A/Shanghai/1/2013, A/Shanghai/2/2013) in swine tissue explants. All viruses tested replicated efficiently in explants from tracheas and bronchi, with limited replication in alveolar cells. Swine respiratory tissue explants can serve as an efficient model for screening replication potential of newly emerging H7N9 viruses.

Molecular characterization and susceptibility of methicillin-resistant and methicillin-susceptible Staphylococcus aureus isolates from hospitals and the community in Vladivostok, Russia.

A prospective study was conducted during an 8-month period, from August 2006 to April 2007, to describe the epidemiology of Staphylococcus aureus-associated infections. In addition, the molecular characteristics, antimicrobial susceptibilities and antibiotic resistance determinants were identified in S. aureus isolates from hospitals and the community in Vladivostok, Russia. Among the 63 S. aureus isolates eligible for this study, methicillin resistance was observed in 48% (n = 30). Hospital-acquired strains accounted for 93% (28/30) of all methicillin-resistant S. aureus (MRSA) isolates. The major MRSA clone (sequence type (ST) 239, staphylococcal cassette chromosome mec (SCCmec) type III, Panton-Valentine leukocidin (PVL)-negative, with two related staphylococcal protein A gene (spa) types (types 3 and 351)) represented 90% of all of the MRSA isolates. This clone was multidrug-resistant, and 41% of isolates showed resistance to rifampicin. Community-acquired MRSA isolates (n = 2) were categorized as ST30, SCCmecIV, spa type 19, and PVL-positive, and as ST8, SCCmecIV, of a novel spa type 826, and PVL-negative. Eight different STs were detected among methicillin-susceptible S. aureus (MSSA) isolates, of which 55% were PVL-positive. One MSSA clone, which was categorized as ST121, spa type 273, and PVL-positive, caused fatal community-acquired pneumonia infections. The strains predominantly isolated in hospitals in Russia belonged to the multidrug-resistant Brazilian/Hungarian ST239 MRSA clone; however, this clone has new antibiotic susceptibilities. Additionally, the emergence of PVL-positive MSSA strains with enhanced virulence was observed, warranting continued surveillance.

Influenza virus infections in Lebanese children in the 2007-2008 season.

We conducted the first epidemiological study of influenza in Lebanon, a temperate country in the Middle East. Between January to May 2008, 39 patients with influenza-like illness were tested. Of these, 51% contracted influenza in January alone, while no influenza cases were detected in May. Among the 39 patients, 11 influenza A and 4 influenza B cases were detected by rapid kit in addition to 10 respiratory syncytial virus cases by real-time PCR. The influenza viruses were genetically divergent from the 2007/2008 season's vaccine strains, but resembled strains circulating in other countries during the same season.

Macrolide-lincosamide-streptogramin B resistance phenotypes and genotypes among Staphylococcus aureus clinical isolates in Japan.

In total, 269 methicillin-resistant Staphylococcus aureus (MRSA) and 434 methicillin-susceptible S. aureus (MSSA) isolates were investigated to determine their macrolide-lincosamide-streptogramin B (MLS(B)) resistance phenotypes and genotypes. The constitutive phenotype (61.3% in MRSA, 1.3% in MSSA) and erm(A) gene predominated among the 261 erythromycin-resistant MRSA isolates, while the inducible phenotype (38.7% in MRSA, 94.0% in MSSA) and erm(C) gene were more prevalent among the 150 erythromycin-resistant MSSA isolates. There was a higher incidence of the MLS(B) inducible phenotype compared with other countries, perhaps because MLS(B) antibiotics are not recommended as first-line agents against S. aureus in Japan.