Clinical Microbiology and Infectious Diseases

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    ABBV744 as a potential inhibitor of SARSCoV2 main protease enzyme against COVID19
    Zeynab Fakhar; Shama Khan; Afrah Alkhuriji; Suliman Y. AlOmar; Aijaz Ahmad
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    Determining immunological correlates of protection against group B streptococcus colonization in pregnant women
    (2016) Kwatra, Gaurav
    Introduction: Maternal recto-vaginal colonization with Group B Streptococcus (GBS) is the major risk factor for invasive GBS disease in newborn’s. Maternal vaccination against GBS during pregnancy may prevent or reduce subsequent recto-vaginal colonization in women, which could lower fetal/newborn exposure to GBS and contribute to reducing GBS associated infections during early infancy. In this study we determined the immunological correlates of protection against GBS colonization in black African pregnant women. Methods: We compared GBS serotype-specific serum IgG, mucosal IgG, mucosal IgA and cellular immune responses in relation to GBS rectovaginal acquisition and clearance in pregnant women from 20 to 37+ weeks of gestational age. Furthermore, we also evaluated different media for isolation of GBS from vaginal and rectal swabs. Results: The prevalence of recto-vaginal GBS colonization was 33.0%, 32.7%, 28.7% and 28.4% at 20-25 weeks, 26-30 weeks, 31-35 weeks and 37+ weeks of gestational age, respectively. The most common identified serotypes were Ia (39.2%), III (32.8%) and V (12.4%). The cumulative overall recto-vaginal acquisition rate of new serotypes during the study was 27.9%, including 11.2%, 8.2% and 4.3% for serotypes Ia, III and V, respectively. The recovery of GBS from rectal swabs was significantly higher from direct plating on chromogenic medium (p<0.0001) than from selective broth method. New-acquisition of GBS was inversely correlated with serotype-specific serum IgG concentration for serotype III (p=0.009) and OPA titer for serotype Ia and III (p<0.001 for both) at time of enrolment. Serum IgG concentration significantly associated with protection against recto-vaginal acquisition of the homotypic serotype was ≥1 μg/ml for serotype V (p=0.039), ≥3 μg/ml for serotype Ia (p=0.043) and III (p=0.023). Mucosal IgG correlated significantly with serum IgG with Rho values of 0.839, 0.621 and 0.426 (all p<0.001) for serotype Ia, III and V, respectively. The clearance of serotype-specific GBS recto-vaginal colonization during pregnancy was positively associated with presence of homotypic capsular ELISpot IFN-γ positivity for serotype III (p=0.008) Conclusion: Maternal GBS colonization could be used as end point to evaluate efficacy of GBS vaccine. A serotype-specific capsular polysaccharide based GBS vaccine able to elicit both humoral and cell-mediated capsular immune responses could confer protection against EOD by reducing the exposure of the newborn’s to GBS colonization during the peri-partum period.
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    National sentinel site surveillance for antimicrobial resistance in Klebsiella pneumoniae isolates in South Africa, 2010-2012
    (2014-08) Perovic, O; Singh- Moodley, A; Duse, A; et al.
    Background: The increasing rates of antimicrobial resistance observed in the nosocomial pathogen Klebsiella pneumoniae are of major public health concern worldwide. Objectives: To describe the antibiotic susceptibility profiles of K. pneumoniae isolates from bacteraemic patients submitted by sentinel laboratories in five regions of South Africa from mid-2010 to mid-2012. Molecular methods were used to detect the most commonly found extended-spectrum beta-lactamase (ESBL) and carbapenemase resistance genes. Methods: Thirteen academic centres serving the public healthcare sector in Gauteng, KwaZulu-Natal, Free State, Limpopo and Western Cape provinces submitted K. pneumoniae isolates from patients with bloodstream infections. Vitek 2 and MicroScan instruments were used for organism identification and susceptibility testing. Multiplex polymerase chain reactions (PCRs) were used to detect blaCTX-M, blaSHV and blaTEM genes in a proportion of the ESBL isolates. All isolates exhibiting reduced susceptibility to carbapenems were PCR tested for blaKPC and blaNDM-1 resistance genes. Results: Overall, 68.3% of the 2 774 isolates were ESBL-positive, showing resistance to cefotaxime, ceftazidime and cefepime. Furthermore, 46.5% of all isolates were resistant to ciprofloxacin and 33.1% to piperacillin-tazobactam. The major ESBL genes were abundantly present in the sample analysed. Most isolates (95.5%) were susceptible to the carbapenems tested, and no isolates were positive for blaKPC or blaNDM-1. There was a trend towards a decrease in susceptibility to most antibiotics. Conclusion: The high proportion of ESBL-producing K. pneumoniae isolates observed, and the prevalence of ESBL genes, are of great concern. Our findings represent a baseline for further surveillance in SA, and can be used for policy and treatment decisions.