Medical Microbiology & Diagnosis

From November 2011 until now, seven patients have been operated on in the Children’s University Hospital of Geneva for a musculoskeletal indication and have sustained an Enterobacter cloacaecomplex infection. The patients presented with few clinical and laboratory manifestations. Four patients were treated with antibiotics only, whereastwo patients required debridement and vacuum assisted closure therapy associated with antibiotic therapy. One patient had his device removed.

This study focused on the benefices effects of micro-organisms called probiotics that is Lactococcus lactis sbsp cremoris CNRZ 107, and propose different therapeutic possibilities of our situation against a pathogen Salmonella sp. We conducted two tests in vitro and in vivo; where it was noted that treatment in the presence of this lactic strain is effective because it causes a remarkable decrease of the pathogen agent. In the end, the effectiveness of this lactic strain was confirmed by testing for resistance to gastrointestinal conditions (pH, bile salts and digestive enzymes).

Background and aims: Early detection of Hepatocellular Carcinoma (HCC) is crucial for effective management. Incidence of HCC has increased in the United States largely attributed to hepatitis B and C virus. Lens culinaris agglutinin-reactive Alpha-Fetoprotein (AFP-L3) and Des-Gamma-Carboxy Prothrombin (DCP) are being recognized specific biomarkers for HCC.

Methods: We measured AFP-L3 and DCP in serial serum specimens of a cohort of chronic hepatitis patients on HCC surveillance and compared these markers to abdominal imaging. Among fifty patients who developed HCC during surveillance, 30 were included in the study with available sera 1-2 years before, at diagnosis and post ablation of HCC. For controls, three consecutive annual sera were examined from 106 chronic hepatitis patients without HCC during surveillance for 5-10 years. The μTASWako i30 auto analyzer was used for the assay that utilizes the microfluidics chip based assay platform. It can fractionate AFP-L3 glycoform and calculates AFP-L3% if AFP level is ≥ 0.6 ng/mL.

Results: Combination of AFP, AFP-L3 and DCP showed high sensitivity of 83% in all patients and 75% in patients with AFP<20 ng/mL. AFP-L3 and DCP assays were useful in patients with low levels of AFP (<20 ng/mL) and could detect significant AFP-L3% elevation in some patients more than one year before the diagnosis of HCC. Furthermore, AFP-L3 predicted recurrence of HCC.

Conclusions: This is the first study in the U.S. patients using the μTASWako i30 analyzer to test these HCC biomarkers. Our results suggest that combinations of these biomarkers are highly useful for early detection of HCC.

Blastocystis is the most common enteric protist found in humans. Due to the recent advancements in molecular technologies, up to 17 subtypes have been identified from humans and animals. Molecular epidemiological studies have shown the large range of subtype (ST) distribution within geographical locations with ST1-9 being identified in humans. ST3 has been identified as the predominant subtype in most epidemiological studies with a considerable absence of ST4 noted in Africa and the Middle East compared to Europe and Australia where this subtype is fairly common. This review summarises the molecular tools used for diagnosis and speciation of Blastocystis and comments on advancements in the area over the last 15 years and what future trends may be. This review also describes the geographical distribution of Blastocystis and comments on possible intra-subtype evolutionary relationships.

Infections due to antibiotic-resistant Gram-negative bacteria unquestionably have substantial effects on morbidity and mortality. However, quantifying the exact economic burden attributable to these infections still remains a challenging issue. The review of the literature on this subject shows that severe infections from Gram-negative bacteria are associated with increased economic burden. However, the low comparability of methods and results limit the possibility to draw a clear conclusion. A better collaboration between health economy and clinical research is advocated to produce specific guidelines for economic studies in medical research.

Japanese Encephalitis (JE) is caused by neurotropic Japanese Encephalitis Virus (JEV) which belongs to flaviviridae family and is the most important encephalitis causing virus in Asia. JEV is reported to cause 35-50 thousand cases and 10-15 thousand deaths annually

Assessment of the keratitis associated fungal pathogens and realizes their antifungal sensitivity pattern in Eastern India for better guidance and appropriate choice of antifungal drugs was made. A retrospective, non-comparative study was conducted on 248 fungal keratitis patients between August’2009-July’2012. Corneal scraping was performed and evaluated antifungal susceptibility in all cases. Culture positive fungal keratitis were found in 77.82% cases in which the most predominating pathogen was Aspergillus sp of 46.63% including Aspergillus fumigatus in 41 cases (45.55%) and Aspergillus flavus in 25 cases (27.77%). Aspergillus sp was mostly sensitive to voriconazole next to natamycin and amphotericin B. The second most common pathogen was Candida albicans in 36 cases (18.94%). Candida sp was mostly sensitive to amphotericin B followed by natamycin. Candida sp was relatively insensitive to fluconazole and voriconazole. The third common fungal pathogen was Fusarium sp in 30 cases, among them F. solani in 27 cases (90%). Fusarium sp was mostly sensitive to voriconazole next to natamycin. Aspergillus, Candida and Fusarium were insensitive to fluconazole, micronazole and itraconazole. Aspergillus sp is the most common pathogen of fungal keratitis followed by Candida and Fusarium sp. Voriconazole is still the first choice in the treatment of mould keratitis. Early diagnosis and treatments are vital for better management of fungal keratitis.

Patients with Behcet’s disease (BD) have hypersensitivity against oral streptococci increased in their oral cavity. Heat shock protein-65/60 (Hsp-65/60) derived from S. sanguinis and the damaged mammalian tissues, respectively, are supposed to play an important role in BD pathogenesis. The antigen presenting cells taken Hsp-65 via Toll-like receptors in the oral lesion are carried to the local lesions by blood flow and they are known to lead T cells undergo apoptosis in the regional delayed type hypersensitive reaction. The human Hsp-60 peptide (336-351 aa) combined with recombinant cholera toxin B subunit was reported to be a therapeutic agent for BD patients with advanced uveitis.   Here, we recognized that the peptide (249-264 aa; designated LO1 and 311-326aa: UK) of Hsp-65/60 exhibiting highly homologous to the T cell-epitope lead CD4+ and CD8+ T cell apoptosis in peripheral blood mononuclear cells from BD patients. In BD patients IL-8 and IL-12 production from activated T cells was significantly inhibited by LO1 and UK peptides. The results suggest that the peptides of Hsp-65/60 are able to be therapeutic agents for active BD patients.

Coxsackie B viruses (CVB) are associated with serious illnesses in humans. In this study, the patterns of synonymous codon usage in CVB have been studied through multivariate statistical methods. Effective number of codons (ENC) indicates that the overall extent of codon usage bias in CVB is not significant. The relative dinucleotide abundances suggest that codon usage bias in CVB genomes is influenced by underlying biases of dinucleotide frequencies. The distribution of CVB ORFs along the plane defined by the first two axes of correspondence analysis (COA) showed that different genotypes, as well as strains known to infect different cell types, are located at different places in the plane suggesting that CVB codon usage is reflecting an evolutionary process. The results of these studies suggest that CVB genomic biases are the result of co-evolution of translation adaptation to different cell environments and probably the need to escape anti-viral cell defenses.