Day 3 :
Keynote Forum
Lia Monica Junie
University of Medicine and Pharmacy, Romania
Keynote: The antibiotic resistance and its importance in the hospital acquired infections
Time : 09:45-10:15
Biography:
Lia Monica Junie is the Head of the Department, also coordinating the activities of both Laboratory Medicine specialty resident doctors and PhD doctor’s thesis in the medicine field. She is a Member in the Board of Scientific Societies, Reviewer in many peer-reviewed journals, Expert of the Ministry of Education and Research and Evaluator. She has coordinated research projects, published books and more than 200 scientific articles in prestigious journals. She has organized and attended numerous national, international congresses, as President, Member in the Organizing Committees, Invited speaker, Keynote speaker or Chairperson.
Abstract:
Background: One of the most difficult problems in hospitals and an important issue in therapy is the occurrence of an increased number of resistant strains to antibiotics. Worldwide, researches are carried over for the AB resistance phenomenon, in the following directions: Fundamental research for better knowledge of the natural and acquired resistance mechanisms and development of surveillance networks.Objective: The objective of our study was the establishment of the AB resistance pattern of isolated strains to the most frequently used AB for treatment.Methods: Identification and the resistance profiles of the isolated strains were performed with API20E, disk diffusion method and Vitek2 system.rnrnResults: Strains of MRSA, E. coli, Klebsiella, Enterobacter, Acinetobacter and Pseudomonas were isolated from hospitalized patients. The tested strains showed a high resistance both to common AB and to those recently discovered.rnrnConclusion: There was a significant increase in the prevalence of AB resistance among the most common pathogens of nosocomial infections. Consistent efforts towards rational use of AB are going to influence the evolution of bacteria AB resistance patterns.
- The Science of Food; Industrial Applications of Microbes; Applied Microbiology; Diagnostic Microbiology: Recent Advances
Location: Sheraton
Chair
Lia Monica Junie
University of Medicine and Pharmacy, Romania
Session Introduction
Maria Teresa Mascellino
Sapienza University of Rome, Italy
Title: Susceptibility to antibiotics and new treatment strategies in Helicobacter pylori infection at a University Hospital in Rome, Italy
Time : 10:30-10:55
Biography:
Maria Teresa Mascellino has completed her MD in Rome and specialization studies in Clinical Microbiology from Sapienza University of Rome, Italy. She works as an Aggregate Professor in the Department of Public Health and Infectious Diseases. She is responsible of the Simple Operative Unit “Microbiological analyses in immunocompromised hosts”. She has published about 100 papers in reputed journals and has been serving as an Editorial Board Member of repute. She is an Editor of the book “Bacterial and Mycotic Infections in Immunocompromised Hosts: Microbiological and Clinical Aspects” from OMICS Group.
Abstract:
Aim of our study was to evaluate the utility of the culture and the subsequent susceptibility testing in a group of 50 pluritreated patients (positive to UBT) with pan gastritis. Out of 50 patients, culture and susceptibility testing was obtained in 31 patients (62%) whereas in 19 (38%) no H. pylori growth was detected. The first group was treated following the antibiogram results whereas the latter was empirically treated. The highest resistance rates in vitro were found for metronidazole (61.8%) and chlaritromycin (43.1%). The isolates showing a dual resistance to both antibiotics (50%) are recognized difficult to eradicate. Amoxycillin showed the best susceptibility (96%) and levofloxacin seemed a promising antibacterial agent. In the 31 patients’ positive to H. pylori, the eradication rate (49%) was dependent on the number of gastric regions infected in a single patient. In the 19 patients with no growth of H. pylori, 11 (58%) were eradicated with empirically therapy preferably with antibiotics never taken before. The difference between the two groups (49% and 58% respectively, p=0.71) even if not statistically significant, seems to demonstrate that a successful eradication can be achieved even without antibiogram. This might occur because the bacteria in the patients empirically treated are in a less virulent phase or in a small number. The new guidelines for the cure of H. pylori from the Toronto Consensus Group (2016) recommend to prolong the therapy from 10 to 14 days and to pay particular attention to local antibiotic resistance and eradication patterns. The new therapeutical strategies will be reported.
Marco Manfredi
“Pietro Barilla†Children's Hospital, University , Italy
Title: Intestinal microbiota: A big world of evolving knowledge
Time : 13:45-14:10
Biography:
Marco Manfredi is a Pediatrician and Gastroenterologist, carried out his education at Parma University where he has completed his PhD in Pediatric Gastroenterology in 2004. Currently he is working as Manager of Pediatric Emergency and Assistant Manager in Pediatric Gastroenterology at “Pietro Barilla” Children's Hospital in Parma, Italy. His main fields of interests are Helicobacter pylori infection, celiac disease, gastrointestinal infectious diseases and probiotics. He has published more than 70 papers, included chapters of textbooks. He is the Editor of three textbooks on “Helicobacter pylori Infection”, “Gastrointestinal Endoscopy in Children” and “Probiotics in Children” all published by Nova Science Publishers, New York, USA. He is serving as an Editorial Board Member of several reputed journal like “Clinical Microbiology: Open Access” and “Frontiers in Pediatric Gastroenterology and Hepatology” and Expert Reviewer for BMC Gastroenterology, Saudi Journal of Gastroenterology and BMC Case Reports. He is a Member of Italian Society of Pediatric Gastroenterology, Hepatology and Nutrition (SIGENP).
Abstract:
In recent years, the study of human gut microbiota has become one of the most important research fields not only in medicine but in human sciences in general and our knowledge of resident microbial species and their potential functional role is rapidly growing. Actually it is called our “hidden metabolic organ” because of its immense impact on human wellbeing such as on host metabolism, physiology, nutrition and immune function. In fact changes in this microbiota have been linked to several health and pathological diseases including obesity, gastrointestinal infections, inflammatory bowel disease and functional GI disorders. For these reasons the use of probiotics has been extensively studied in promoting health as well as in treating several diseases.
Jay Zhu
University of Pennsylvania Perelman School of Medicine, USA
Title: Cross-talk between oxidative stress and virulence optimizes multiple environmental transitions in Vibrio cholera
Time : 10:55-11:20
Biography:
Jay Zhu has obtained his PhD degree from Cornell University and completed Postdoctoral studies from Harvard Medical School. He is an Associate Professor of Microbiology at Perelman School of Medicine, University of Pennsylvania. He has published more than 75 papers in reputed journals and has been serving on Editorial Broad of several Microbiology journals.
Abstract:
Bacterial pathogens must display versatility in gene expression to adapt to changing surroundings especially to changes in the redox potential and the presence of redox-active compounds in the local microenvironment. For example, a key part of the life cycle of Vibrio cholerae, the causative agent of cholera, is the transition between oxygen rich aquatic reservoirs to the oxygen limiting environment of the human gastrointestinal tract and combating reactive oxygen species (ROS) generated by the host immune system. Here using Tn-seq, we show that these two pathways oxidative stress resistance and virulence is linked in V. cholerae by two transcription factors, OhrR and AphB. We found that both OhrR and AphB bind to and regulate the promoters of the critical virulence activator tcpP and ROS resistance gene ohrA. In shifting between high-oxygen and low-oxygen environments, these proteins exhibit different kinetics of conformational change and binding at both promoters so as to optimize the expression of both genes. This cross talk was critical both for colonizing the host and for bacterial survival upon exit into the environment. Our results suggest that regulation of bacterial virulence is closely intertwined with oxidative stress responses.
Xiangru Wang
Huazhong Agricultural University, China
Title: Sphingosine 1-Phosphate Activation of EGFR as a Novel Target for Meningitic Escherichia coli Penetration of the Blood–Brain Barrier
Time : 11:20-11:45
Biography:
Xiangru Wang has completed his PhD from Department of Preventive Veterinary Medicine, School of Veterinary Medicine, Huazhong Agriculture University. He has been awarded scholarship under the State Scholarship Fund for the exchange study overseas as a joint PhD Visiting Scholar at Johns Hopkins University School of Medicine from October 2012 to April 2014, working on the CNS-infecting bacterial penetration of the blood-brain barrier. He is presently a Research Member in State Key Laboratory of Agricultural Microbiology, China and has published more than 10 research articles in reputed journals in the field of veterinary.
Abstract:
Central nervous system (CNS) infection continues to be an important cause of mortality and morbidity, necessitating new approaches for investigating its pathogenesis and prevention of the disease. Escherichia coli is the most common Gram-negative bacillary organism causing meningitis, which develops following penetration of the blood brain barrier (BBB). By chemical library screening, we identified epidermal growth factor receptor (EGFR) as a contributor to E. coli invasion of the BBB in vitro and in vivo. Here, we obtained the direct evidence that CNS-infecting E. coli exploited sphingosine 1-phosphate (S1P) for EGFR activation in its penetration of the BBB. We found that S1P was upstream of EGFR and participated in EGFR transactivation through EGFR-related ligand HB-EGF and blockade of S1P function through targeting sphingosine kinase and S1P receptor inhibited EGFR activation as well as E. coli invasion of the BBB. We further found that both S1P and EGFR activations in response to meningitic E. coli involve the same E. coli proteins (OmpA, FimH, NlpI) and that S1P and EGFR promoted E. coli invasion of the BBB by activating the downstream c-Src. These findings indicate that S1P and EGFR represent the novel host targets for meningitic E. coli penetration of the BBB and counteracting such targets provide a novel approach for controlling E. coli meningitis in the era of increasing resistance to conventional antibiotics.
Aditya Shah
University of Illinois at Chicago/ Advocate Christ Medical Center, USA
Title: Procalcitonin Levels in Intensive Care Unit setting in patients with positive blood cultures
Time : 14:35-15:00
Biography:
Aditya Shah is currently in his Residency training at University of Illinois Chicago, Advocate Christ Medical Centre in USA. He has worked as a Research Assistant at University of Chicago from 201-2014. He has attended Dr. D Y Patil Medical College, Mumbai, India to pursue medicine. He is a Co-Chairman of Indian American Medical Association, Illinois. He has published his research work in peer-reviewed journals and also presented it through oral/poster presentation in many international conferences.
Abstract:
Background: Procalcitonin (PCT) is a biomarker of severe sepsis caused by bacterial infections. There is a paucity of evidence about the relationship of procalcitonin levels with variables such as site of infection and comorbidities. Methods: We conducted a retrospective pilot study of patients admitted to the medical and cardiac intensive care unit (ICU) from December 1, 2013 to November 30, 2014. Adults over 18 years of age with 1 positive blood culture and PCT levels drawn within 24 hours were included. 48 patients met these criteria. PCT levels were compared between true positive and contaminant/false positive blood cultures. Contaminated cultures were defined as coagulase negative Staphylococcus and diphtheroids with other non-infectious sources of sepsis. Site of infection was defined as respiratory, line-related, skin or soft tissue, intra-abdominal or urinary tract. Co-morbidities investigated were systolic and diastolic heart failure, acute and chronic renal failure. Independent sample t tests and Pearson’s correlations were used for analysis using SPSS®22. Results: Mean PCT levels were higher in intra-abdominal (19.54±22.14) compared to respiratory infections (3.55±7.64), p=0.067. PCT levels were higher in patients with kidney dysfunction, (r=0.541, p<0.001). Higher mortality was observed in patients with positive blood cultures, 58% compared to average ICU mortality rates of 30-35%. There were no statistically significant differences between mean PCT levels for true versus false positive blood cultures (53.63±130.52 versus 24.21±61.34, p=0.61), congestive heart failure, age and race. Conclusion: We present a retrospective pilot study investigating PCT levels in ICU patients in relation to multiple variables. Our study shows a trend of higher PCT levels in intra-abdominal compared to lung infections and elevated PCT levels in patients with kidney dysfunction. Mortality in patients with positive blood cultures was also higher than average ICU mortality at the study center. There was no statistically significant difference found between the other studied variables including true and false positive blood cultures. Due to small sample size, the power was limited. Our goals for future research will focus on expansion of data collection sample size.
Paul M Tulkens
Université Catholique de Louvain, Belgium
Title: How active are antibiotics when directed towards bacteria hiding intracellularly? Do accumulation and subcellular disposition matter?
Time : 12:10-12:35
Biography:
Paul M Tulkens has completed his MD from the Université Catholique de Louvain and also completed his PhD. He did his Postdoctoral studies at the Rockefeller University, New York. He has created the Unit of Cellular and Molecular Pharmacology and has also launched the activities of clinical pharmacy at the Université Catholique de Louvain. He has published more than 280 papers in reputed journals and has been serving as an Editorial Board Member of several journals dealing with antibiotics.
Abstract:
Many bacteria survive and even thrive in eukaryotic cells (macrophages, endothelial cells, osteoblasts and keratinocytes) where they escape immune defenses, explaining the relapsing and/or recurrent character of many infections. Using human THP-1 monocytes, we undertook a systematic examination of the intracellular accumulation and disposition of antibiotics; their activity in a pharmacodynamic model measuring their extracellular concentration needed to obtain a static effect (Cs; equivalent to an intracellular MIC) and their maximal efficacy (Emax; decrease of CFU for an infinitely large extracellular concentration). Most antibiotics show Cs values similar to MIC in broth, disregarding their levels of cellular accumulation; Emax systematically lower (less decrease in CFU) than in broth. Antibiotics restricted to phagolysosomes and poorly diffusible are inactive against bacteria thriving in the cytosol (e.g., Listeria monocytogenes), but those primarily located in the cytosol but highly diffusible can act in all sub-cellular compartments. We conclude that the most important and predictive property for intracellular activity is the sub-cellular bioavailability of antibiotics and not their accumulation per se; part of the intracellular inoculum cannot be eradicated by antibiotics, suggesting the need to develop new approaches to tackle with persistent infections.
Emeka Nweze
University of Nigeria, Nigeria
Title: Production of mycotoxins by fungi isolated from different food grains sold in the open market in Nigeria
Time : 14:10-14:35
Biography:
Dr. Emeka Nweze is working as a faculty at University of Nigeria, Nigeria.
Abstract:
We undertook a study to determine fungi associated with common and different kinds of fresh and stored food grains produced and sold in Southeast Nigeria markets. The food grains sampled included Zea mays, Oryza sativa (local and imported varieties), Phaseolus vulgaris (different species), Pennisetum typhoides, Arachis hypogaea, Cola (different species), Vigna unguiculata, Sorghum bicolor, Cajanus cajan and Triticum spp. Different species of Aspergillus, Fusarium, Penicillium, Alternaria and Rhizopus were recovered from the grains. These recovered fungal species were evaluated for mycotoxin production. Our results showed that these organisms produced one kind of mycotoxin notably aflatoxin B1, zearalenone and fumonisin B1 among others. Our findings raise some health and economic concerns especially due to the fact that Nigeria currently does not appear to have a strong monitoring and screening policy for grains that are sold in the open market to the public.
Saket Myneni
Westwood High School, USA
Title: A novel approach to antibiotics and antifungals: Testing the effectiveness of Azadirachta indica extracts
Time : 12:35-12:55
Biography:
Saket Myneni is a Member of the Westwood Class of 2017. He is the President of the National Science Bowl Club, the two-time Secretary of Area 1 HOSA and of the Seton Medical Explorer Post, Junior Class Parliamentarian and Parliamentarian of Westwood’s Skills USA chapter. He is a Member of the national honor society, Mu Alpha Theta (math honor society) and national Spanish honor society. He is a Research Assistant at the University of Texas and a volunteer at the University Medical Center at Brackenridge Teaching Hospital. Based on his efforts, he was awarded the Presidential Service Award to recognize his efforts to help the community. He has recently been selected as a finalist for the Intel International Science and Engineering Fair, after his research won numerous awards throughout the state of Texas.
Abstract:
Azadirachta indica (neem) extracts have proven themselves to be a promising tool because they are natural and do not cause the harmful side effects of most artificial substances. Preliminary research has shown that certain natural substances can be used without the fear of a new resistant strain developing. Current treatments are plagued by artificial substances that can have harmful side effects to the body and may not be effective for multiple uses. Thus, this project aims to determine the effectiveness of natural substances as antibacterial and antifungal. Early research suggested that the neem oil would be the most effective extract because it would envelop the bacteria and fungi. Cultures of bacteria, specifically Staphylococcus epidermidis and Serratia marcescens and cultures of fungi, specifically Aspergillus niger and Saccharomyces cerevisiae, were cultured and placed in separate plates. Zones of inhibitions were created using neem leaf extract, neem soap, neem oil, a water control and antibacterial soap control disks. The diameters of the zones where growth has stopped were compared using statistical significance tests to see if any of the natural extracts were more effective than the controls. The zones that were significantly different from the controls’ zones were compared amongst each other to see if one extract was more effective than the others. This analysis has shown that the natural substances are extremely effective and significantly stronger than antibiotic and antifungal substances and the artificial substances in the soap. The remainder of the plate was then considered to be the pool of potential resistant strands. Thus repetitions were completed with each of the treatments. Since the growth was still inhibited without resistance, it became apparent that the neem extracts could have many practical purposes in treatments of infections. Given that only a few trials were completed, the experiment would have to be completed with more trials to prove the consistent effectiveness.