Wuhan to World: The COVID-19 Pandemic Kumar, Ashok; Singh, Rita; Kaur, Jaskaran ...
Frontiers in cellular and infection microbiology,
03/2021, Letnik:
11
Journal Article
Recenzirano
Odprti dostop
COVID-19 is a Severe Acute Respiratory Syndrome (SARS), caused by SARS-CoV-2, a novel virus which belongs to the family
. It was first reported in December 2019 in the Wuhan city of China and soon ...after, the virus and hence the disease got spread to the entire world. As of February 26, 2021, SARS-CoV-2 has infected ~112.20 million people and caused ~2.49 million deaths across the globe. Although the case fatality rate among SARS-CoV-2 patient is lower (~2.15%) than its earlier relatives, SARS-CoV (~9.5%) and MERS-CoV (~34.4%), the SARS-CoV-2 has been observed to be more infectious and caused higher morbidity and mortality worldwide. As of now, only the knowledge regarding potential transmission routes and the rapidly developed diagnostics has been guiding the world for managing the disease indicating an immediate need for a detailed understanding of the pathogen and the disease-biology. Over a very short period of time, researchers have generated a lot of information in unprecedented ways in the key areas, including viral entry into the host, dominant mutation, potential transmission routes, diagnostic targets and their detection assays, potential therapeutic targets and drug molecules for inhibiting viral entry and/or its replication in the host including cross-neutralizing antibodies and vaccine candidates that could help us to combat the ongoing COVID-19 pandemic. In the current review, we have summarized the available knowledge about the pathogen and the disease, COVID-19. We believe that this readily available knowledge base would serve as a valuable resource to the scientific and clinical community and may help in faster development of the solution to combat the disease.
Numerous human pathogens, especially Gram-negative bacteria, are able to enter the viable-but-non-culturable (VBNC) state when they are exposed to environmental stressors and pose the risk of being ...resuscitated and causing infection after the removal of the trigger. Widely used food preservatives like weak organic acids are potential VBNC inducers in food processing and packaging facilities but have only been reported for food-borne pathogens. In the present study, it is demonstrated for the first time that one such agent, formic acid (FA), can induce a VBNC state at food processing, storage, and distribution temperatures (4, 25, and 37
C) with a varied time of treatment (days 4-10) in pathogenic Gram-negative bacteria
and
. The use of hospital-associated pathogens is critical based on the earlier reports that demonstrated the presence of these bacteria in hospital kitchens and commonly consumed foods. VBNC induction was validated by multiple parameters, e.g., non-culturability, metabolic activity as energy production, respiratory markers, and membrane integrity. Furthermore, it was demonstrated that the removal of FA was able to resuscitate VBNC with an increased expression of multiple virulence and Antimicrobial Resistance (AMR) genes in both
. Since food additives/preservatives are significantly used in most food manufacturing facilities supplying to hospitals, contamination of these packaged foods with pathogenic bacteria and the consequence of exposure to food additives emerge as pertinent issues for infection control, and control of antimicrobial resistance in the hospital setting.
A novel nano-formulation (NF) that sensitizes
(AB) to otherwise ineffective colistin is described in the present study. Infections due to multidrug resistant (MDR) AB represent a major therapeutic ...challenge, especially in situations of pre-existing colistin resistance (colR). Subsequently, boosting the effectiveness of colistin would be a better alternative tactic to treat AB infections rather than discovering a new class of antibiotics. We have previously demonstrated an NF comprising self-assembled guanidinium and ionic silver nanoparticles AD-L@Ag(0) to have anti-biofilm and bactericidal activity. We report NF AD-L@Ag(0) for the very first time for the potentiation of colistin in Gram-negative colistin-resistant bacteria. Our results implied that a combination of clinically relevant concentrations of colistin and AD-L@Ag(0) significantly decreased colistin-resistant AB bacterial growth and viability, which otherwise was elevated in the presence of only colistin. In this study, we have described various combinations of minimum inhibitory concentration (MIC) of colistin (MICcol,
MICcol, and
MICcol) and that of AD-L@Ag(0) MICAD-L@Ag(0),
MICAD-L@Ag(0), and
MICAD-L@Ag(0) and tested them against MDR AB culture. The results (in broth as well as in solid media) signified that AD-L@Ag(0) was able to potentiate the anti-microbial activity of colistin at sub-MIC concentrations. Furthermore, the viability and metabolic activity of bacterial cells were also measured by CTC fluorescence assay and ATP bioluminescence assay. The results of these assays were in perfect concordance with the scores of cultures (colony forming unit and culture turbidity). In addition, quantitative real-time PCR (qRT-PCR) was performed to unveil the expression of selected genes, DNAgyrA, DNAgyrB, and dac. These genes introduce negative supercoiling in the DNA, and hence are important for basic cellular processes. These genes, due to mutation, modified the Lipid A of bacteria, further resisting the uptake of colistin. Therefore, the expression of these genes was upregulated when AB was treated with only colistin, substantiating that AB is resistant to colistin, whereas the combinations of MICcol + MICAD-L@Ag(0) downregulated the expression of these genes, implying that the developed formulation can potentiate the efficiency of colistin. In conclusion, AD-L@Ag(0) can potentiate the proficiency of colistin, further enhancing colistin-mediated death of AB by putatively disrupting the outer membrane (OM) and facilitating bacterial death.
Surface texture modification for reducing physical adherence of bacteria can be a critical alternative to conventional antimicrobials, especially in the case of surgical accessories. In the present ...study, a nanocomposite hydrophobic coating formulation exhibiting biofilm-inhibiting properties was developed. The formulation alone and in combination with a biocide (chitosan) was deposited by dip-coating on different substrates like cover glass slips, acrylonitrile butadiene styrene (ABS) coupons, and surgical sutures made of polyglactin, nylon, and silk. The coated substrates were characterized for their roughness, wetting behavior, and surface morphology. Biofilm inhibition by the formulation when coated on various substrates was evaluated against multiple bacterial strains, namely
Staphylococcus aureus, Pseudomonas aeruginosa, Enterococcus faecium, Escherichia coli, and Acinetobacter baumannii
sourced both from ATCC and clinical cases. The nanocomposite coatings were found to exhibit substantial biofilm inhibition against all tested bacterial strains. The biofilm inhibition property of the nanocomposite-coated polyglactin suture was found to be higher (59–67%) when compared with commercially available antibacterial sutures, whose percentage biofilm inhibition was found to be 43–48% when tested against clinical isolates of
S. aureus, P. aeruginosa, and A. baumannii
.
Background and Aims: Menstruation is a normal physiological process and a key sign of reproductive health in women in the reproductive age group. Poor menstrual hygiene affects the educational ...activities as well as the day to day activities of women. The objective of this study is to assess the practices of menstrual hygiene among women aged 15-49 years attending a tertiary care hospital in Kolkata and to assess their knowledge regarding menstrual hygiene. Materials and Methods: This was a hospital-based cross-sectional study conducted among the women belonging to the age group of 15-49 years attending the outpatient department of Gynaecology. Predesigned, pretested, semi-structured questionnaire was used as a study tool. Interview method was used for data collection after obtaining informed consent from the participants. Data were analysed by SPSS 20v software. Association between variables was checked by Chi-square test & P < 0.05 was considered as significant. Results: Mean age of respondents was 28.03 ± 7.01 years. The cause of menstruation as a normal body function constituted maximum response (43.5%) whereas the reason was unknown to many (37%). Regarding restrictions during menstruation, it was mentioned that avoiding worshipping was the commonest restriction (90.2%), followed by restriction in diet (32.6%). Use of readymade absorbents was found in most of the subjects (91%) followed by homemade reusable (6.5%) and homemade disposable (2.2%). Around 77.2% of them packed the napkins and disposed in garbage. Those who were aware about menstrual hygiene were found to be practicing satisfactory perineal cleaning (p < 0.05). Conclusion: Health education and awareness programme focusing on menstrual hygiene must be intensified. School curriculum can play a vital role in implementing health education.
Toxic anterior segment syndrome (TASS) is an inflammation that occurs after anterior segment surgeries, and is widely seen in the patients after cataract surgery. The main cause of TASS is postulated ...to be the bio-residue and heat stable endotoxins which persist on the used forceps even after autoclave sterilization, some of which are known to cause inflammation. In this work, initially, a detailed characterization of bio-residue composition before and after autoclave sterilization of the forceps used in ophthalmic surgeries was carried out by Fourier-transform infrared spectroscopy (FTIR) and gas chromatography mass spectrometry (GCMS) techniques. The morphological features of biofilm before and after autoclave were also examined using a field emission scanning electron microscope (FESEM). Subsequently, two biofilm inhibiting nanocomposite coating formulations which were earlier developed by us were deposited on stainless steel 420 coupons to mimic surgical instruments. Biofilm inhibition was studied for bare and coated substrates after autoclaving using crystal violet staining as well as by FESEM analysis. It was observed that the coated substrates prevented biofilm formation even after autoclaving. The results of this study demonstrate that the biofilm inhibiting coatings prevent formation of biofilm and hence, prevent deposition of bioresidues on stainless steel surgical instruments. Due to this, the coated surgical instruments are safe to use even after autoclaving and cannot be expected to cause any inflammatory responses after surgeries, thereby preventing TASS.
•Comparison of E.coli AMR in CA-UTI cases between pre-COVID and COVID-19 is done.•Increased susceptibility to nitrofurantoin observed during pandemic•Increased MIC50 to beta-lactams and ...fluoroquinolones seen during pandemic.•Reduced susceptibility to oral antibiotics and carbapenems seen during 2nd wave.•Genomic analysis showed AMR genes {aacC1, aacC4, SHV, QepA} only during 2nd wave.
The impact of the COVID-19 pandemic on antimicrobial resistance (AMR) is largely studied in healthcare settings. There is a need to understand the fluctuations in AMR during pandemic at the community level. With urinary tract infection (UTI) being one of the most common infections in the community, the AMR profile of community-acquired UTI (CA-UTI) is considered representative AMR at the community level.
The study was taken in a cohort of patients with a clinical diagnosis of CA-UTI. The four study sites represented different community health centres in India. Escherichia coli isolates were analysed phenotypically and genotypically for AMR pre-COVID (October 2019–February 2020) and in the first (March 2020–February 2021) and second waves of COVID-19 (March 2021–December 2021).
E. coli was the predominant uropathogen (229, 82%). Increased susceptibility to nitrofurantoin was observed during the pandemic. Reduced susceptibility to first-line oral antibiotics and carbapenems was seen during the second wave, and an increased minimum inhibitory concentration (MIC50) to beta-lactams and fluoroquinolones was seen during the pandemic. Genomic analysis of E. coli isolates showed some AMR genes (aacC1, aacC4, SHV, QepA) only during the second wave.
One good outcome of the pandemic was increased susceptibility to nitrofurantoin, while drawback was a significant decrease in susceptibility to oral antibiotics during the second wave and increased MIC50 of some antibiotics. Decreased susceptibility to last-resort carbapenems and the occurrence of various AMR genes during the second wave of the pandemic are of great concern.
Indiscriminate and widespread use of antibiotics has resulted in emergence of many antibiotic-resistant organisms. Antibiotic administration during pregnancy is mostly avoided, unless there is ...compelling medical condition. We hypothesized that the uropathogens isolated from pregnant women would be more susceptible to antibiotics compared to those isolated from nonpregnant women, thus will be helpful in formulating separate empiric guideline for pregnant women based on the resistance pattern.
This was a prospective cross-sectional study conducted over a period of 2 years in which females with the clinical diagnosis of either cystitis or asymptomatic bacteriuria during pregnancy were included from the community settings. Uropathogen species and their antimicrobial resistance pattern were compared between the pregnant and nonpregnant groups. After accounting for centre-to-centre variation and adjusting for age and socio-economic status, the adjusted odds ratio for antibiotic resistance was calculated and compared between pregnant and nonpregnant women using logistic regression analysis.
A total of 1758 women (pregnant: 43.3%; nonpregnant: 56.6%) were screened in the study over a period of 2 years, out of which 9.3% (163/1758) were having significant bacteriuria. Escherichia coli and Klebsiella pneumoniae were the two commonest uropathogen in both the groups; their prevalence being 83.6% in pregnant women and 85.2% in nonpregnant women, respectively. Resistance against ampicillin, cefixime, cefoxitin, ceftazidime, ceftriaxone and amoxicillin-clavulanic acid were found significantly lower in the pregnant women compared to nonpregnant. After adjusting the age and socio-economic status accounting for centre-to-centre variation, the odds of resistance for cefixime, amoxicillin-clavulanic acid and co-trimoxazole were found lower and statistically significant among the pregnant women group.
The antimicrobial resistance was significantly higher among the community-dwelling nonpregnant women compared to pregnant women in case of few antibiotics. The study highlighted the need of building local antibiogram that could help to initiate the empirical treatment and thus prevent emergence of antimicrobial resistance.
Biofilms are a critical health concern because of their ability to render tolerance and resistance against antimicrobials, which is especially challenging for surgical-site sterility and surgical ...wound recovery. Development of biofilm-inhibiting coatings on surgical devices could aid to limit biofilm formation at surgical site. In this context, two biofilm-inhibiting nanocomposite hydrophobic coating formulations, one with biocide and the other without biocide, were developed and deposited on various substrates such as glass, plastics, and surgical sutures, followed by biofilm inhibition evaluation. Encouraging results were obtained and reported earlier. In the present study, the biofilm-inhibiting action of coatings on surgical sutures was re-examined using a spot assay method by counting the colony-forming units. The long-term durability of the coated sutures with respect to varying temperature, humidity, inflammatory cytokines, and body fluid was studied, in order to validate their suitability for use in surgical accessories and biomedical devices. RTPCR test was carried out to look for downregulation of biofilm-forming genes. Cytotoxicity of the nanocomposite coatings was examined by carrying out an MTT assay. The downregulation of biofilm-forming genes and minimal cytotoxicity of the nanocomposite coatings further confirmed its viability for using on surgical sutures. Overall, the current study provides mechanistic insights and additional bactericidal effect of the hitherto demonstrated antibiofilm activity of the formulation. This study also establishes long-term durability of the coatings in terms of temperature, humidity, and exposure to plasma, enabling its use in surgical accessories to be commercialized in various settings.
Background: Pregnancy which is not terminated within the boundaries of legal definition in India is called an unsafe abortion. Objective: To observe the proportion of unsafe abortions among total ...abortions in 15-49-year-old ever married women across India between 1990 and 2020. Materials and Methods: A comprehensive search was conducted in National Library of Medicine's PubMed database, IndMED, TRIP, Web of Science, and Google Scholar for articles published between January 1, 1990, and February 29, 2020. A combination of medical subject headings and free text word like abortion, induced, unsafe, women 15-49 years, prevalence, and India were used. Each article was assessed for quality using Joanna Briggs Institute Critical Appraisal Tool. The proportion of subjects classified as having unsafe abortion was the outcome of meta-analysis. Analysis was done using Comprehensive Meta-Analysis version 2.2. All pooled estimates were calculated using DerSimonian-Laird random-effects model and reported as a proportion with 95% confidence intervals. Results: The pooled estimate of the mean prevalence of unsafe abortion in India was 37.56% (confidence interval: 20.68-54.44). There was a significant heterogeneity between the studies (I2 = 99.98% and Cochran's Q = 113538.65, df = 18, P < 0.001). Conclusion: Even after several amendments in Medical Termination of Pregnancy Act 1971 till 2020, unsafe abortions are highly prevalent in entire India, irrespective of high-performance or low-performance states. In urban India, the prevalence of unsafe abortions is comparatively higher than rural areas.