Medical Microbiology & Diagnosis

Malaria is a ubiquitous disease that can affect more than 40% of the world’s population who live with some risk of contracting this disease. The World Health Organization (WHO) has recently highlighted the high spread of this disease in Sub-Saharan Africa. Despite the considerable fall in mortality rate over the past decade, the development of resistance against main treatment strategies still exists. This problem has provoked scientific efforts to develop various treatment strategies including use of vaccines, drug delivery systems, and biotherapeutics approaches.

A vaccination strategy is being implemented to trigger direct clearance of the causative parasites from the human host. However, the complex life-cycle of Plasmodium parasites with continuous antigenic mutations has partly hindered this approach so far. The application of different types of drug delivery systems for the delivery of antimalarial drugs is also being considered in order to improve the efficacy, pharmacokinetics, tolerability, and reduce toxicity of existing anti-malarial drugs. A third approach has emerged from the high success of antibodies to treat complex diseases like cancer and autoimmune diseases. Various antibody engineering methods and formats have been proposed to tackle the notable sophisticated lifecycle of malaria.

Within the malaria research field, the characteristics of these diverse treatment strategies, individually, are broadly acknowledged. This review article considers the current status of these approaches and the future outlook.

Biofilms are thought to be always a major concern within the healthcare field and food industries. The resistance properties of biofilm mediated bacteria confer persistent that is being somewhat challenging to address. Biofilms can be more resistant to antibiotics than individual planktonic cells. For this reason, the use of novel alternative strategies to management biofilm formation is needed. Currently, phages as an anti-biofilm agent are suggested as possible replacements to antibiotics. In this review, some of diverse strategies to the prevention of biofilm formation have been exhibited by a number of studies. Phages use as anti-biofilm agents can involve either phage application prior to biofilm formation, application to biofilms that are already formed, or using phage impact that is found in association with other additional mechanisms that can physically disrupt the biofilm. The development novel methods as an anti-biofilm agent would hopefully add an important dimension to the search for new potent compounds to solve biofilm-associated infections problems.

In this study, serum inflammatory mediator’s levels (IL-6 and IL-8) at fever onset to predict gram negative bacteremia in cancer patients have been determined. Also, the effect of gamma irradiation on IL-6 serum levels has been investigated using animal model at dose level 24.4 Gy. Seventy feverish in-patients were enrolled in the study. Blood samples were collected at onset of fever for assay of IL-6, IL-8, CRP, C3 and total leukocytic count. IL-6 and IL-8 serum levels were higher in patients with gram negative bacteremia than in those with non-microbial fever. For patients with gram negative bacteremia and those without there was significant difference in IL-6 and IL-8 serum levels (P=0.0001 and P=0.0059 respectively). While, CRP and C3 serum levels showed non-significant differences. Using (ROC), IL-6 was potentially useful with Sp, NPV of 100% and 398.6 pg/ml cut-off value and AUC of 1.000 compared to Sp 77.8%, NPV 60% and AUC of 0.844 for CRP. On the other hand, IL-8 values didn't show overlapping in the groups. In the animal model, (ROC) for IL-6 serum concentration in bacteremia groups (due to Pseudomonas aeruginosa and Klebsiella pneumoniae) with exposure to gamma radiation and bacteremia groups without exposure to gamma radiation showed a cut-off value of 25740 pg/ml with 58.3% Sn, NPV 64.3%. These results showed the potential usefulness of IL-6 and IL-8 as early predictors of gram-negative bacteremia than commonly used markers such as CRP and C3. Also, usefulness of serum IL-6 as marker discriminating between different fever episodes in cancer patients under radiotherapy.