Microbial Predominance and Antimicrobial Resistance in a Tertiary Hospital in Northwest China: A Six-Year Retrospective Study of Outpatients and Patients Visiting the Emergency DepartmentRead the full article
Canadian Journal of Infectious Diseases and Medical Microbiology publishes original research articles, review articles, and clinical studies related to infectious diseases of bacterial, viral and parasitic origin.
Canadian Journal of Infectious Diseases and Medical Microbiology maintains an Editorial Board of practicing researchers from around the world, to ensure manuscripts are handled by editors who are experts in the field of study.
Latest ArticlesMore articles
Decontamination and Reuse of N95 Masks: A Narrative Review
Background. The COVID-19 pandemic has presented an unprecedented strain on healthcare supplies. Currently there is a global shortage of personal protective equipment (PPE), especially N95 masks. In order to safeguard healthcare personnel in this critical time and to mitigate shortages of N95 respirators, reuse of N95 respirators has to be considered. Methods. Using PubMed and Science Direct, a literature search was conducted to find and synthesize relevant literature on decontamination of N95 respirators for their subsequent reuse. Peer-reviewed publications related to methods of decontamination from January 2007 to April 2020 in the English language are included in this narrative review. Bibliographies of articles for relevant literature were also scrutinized. Findings. A total of 19 studies are included in this narrative review. The appraised methods include ultraviolet germicidal irradiation (UVGI), moist heat incubation (MHI), ethylene oxide (EtO), hydrogen peroxide vapor (HPV), microwave steam bags (MSB), microwave-generated steam (MGS), dry microwave oven irradiation, hydrogen peroxide gas plasma (HPGP), dry heat, liquid hydrogen peroxide, and bleach and alcohol. Conclusion. In light of the COVID-19 pandemic, reuse of N95 respirators, although suboptimal, can be considered. Evidence reveals that UVGI, MHI, and HPV are amongst the safest and efficacious methods for decontamination of N95 masks. More research is needed to establish the safety and effectiveness of MGS, MSB, dry heat, EtO, liquid hydrogen peroxide, and HPGP. Alcohol, microwave irradiation, and bleach are not recommended because they damage N95 respirators.
An Immunoinformatics Study to Predict Epitopes in the Envelope Protein of SARS-CoV-2
COVID-19 is a new viral emergent disease caused by a novel strain of coronavirus. This virus has caused a huge problem in the world as millions of people are affected by this disease. We aimed at designing a peptide vaccine for COVID-19 particularly for the envelope protein using computational methods to predict epitopes inducing the immune system. The envelope protein sequence of SARS-CoV-2 has been retrieved from the NCBI database. The bioinformatics analysis was carried out by using the Immune Epitope Database (IEDB) to predict B- and T-cell epitopes. The predicted HTL and CTL epitopes were docked with HLA alleles and binding energies were evaluated. The allergenicity of predicted epitopes was analyzed, the conservancy analysis was performed, and the population coverage was determined throughout the world. Some overlapped CTL, HTL, and B-cell epitopes were suggested to become a universal candidate for peptide-based vaccine against COVID-19. This vaccine peptide could simultaneously elicit humoral and cell-mediated immune responses. We hope to confirm our findings by adding complementary steps of both in vitro and in vivo studies to support this new universal predicted candidate.
Evaluation of the Antibacterial Activity and Probiotic Potential of Lactobacillus plantarum Isolated from Chinese Homemade Pickles
This study investigated the antipathogenic activity and probiotic potential of indigenous lactic acid bacteria (LAB) isolated from Chinese homemade pickles. In total, 27 samples were collected from different sites in China. Fifty-nine yielded pure colonies were identified by 16S rRNA gene sequencing as LAB and were initially evaluated for the antibacterial activity in vitro. Initial screening yielded Lactobacillus plantarum GS083, GS086, and GS090, which showed a broad-spectrum antibacterial activity against food-borne pathogens, especially multidrug-resistant pathogens. Meanwhile, organic acids were mainly responsible for the antimicrobial activity of the LAB strains, and the most abundant of these was lactic acid (19.32 ± 0.95 to 24.79 ± 0.40 g/l). Additionally, three L. plantarum strains demonstrated several basic probiotic characteristics including cell surface hydrophobicity, autoaggregation, and survival under gastrointestinal (GI) tract conditions. The safety of these isolates was also evaluated based on their antibiotic susceptibility, hemolytic risk, bile salt hydrolase activity, and existence of virulence or antibiotic resistance genes. All strains were safe at both the genomic and phenotypic levels. Therefore, L. plantarum GS083, GS086, and GS090 are fairly promising probiotic candidates and may be favorable for use as preservatives in the food industry.
Diagnostic Accuracy of Immunologic Biomarkers for Accurate Diagnosis of Bloodstream Infection in Patients with Malignancy: Procalcitonin in Comparison with C-Reactive Protein
Purpose. To calculate the diagnostic value of C-reactive protein (CRP) and serum procalcitonin (PCT) levels for the pathologic presence of microbes in the bloodstream of patients with malignancy, in comparison with blood culture. Methodology. Blood culture (by reference method) and assay results of PCT and CRP of febrile patients, with clinical suspicion to blood infections, were collected. Statistical aspects of PCT and CRP tests were evaluated. Results. Data from 255 cases were gathered. The area under the curve for differentiating bacteremia from nonbacteremia for PCT (0.741) was superior to that of CRP (0.612). Amongst the different cutoffs of PCT and CRP, the cutoff of ≥1.17 ng/ml and >47 mg/l had the sensitivity of 75 and 58.3%, the best NPV of 91.5% and 81.3%, and the best specificity of 79.9% and 72.8%, respectively. Discussion. Despite statistically nonsignificant results, PCT seems to be a superior indicator to CRP for rejecting the presence of microorganism in bloodstream. For PCT, the cutoff value of 1.17 ng/ml (bacteremia from nonbacteremia) had the highest NPV value of 91.5% in malignant patients, suspicion of sepsis.
Bacteria on Medical Professionals’ White Coats in a University Hospital
The transient contamination of medical professional’s attires including white coats is one of the major vehicles for the horizontal transmission of microorganisms in the hospital environment. This study was carried out to determine the degree of contamination by bacterial agents on the white coats in a tertiary care hospital in Nepal. Sterilized uniforms with fabric patches of 10 cm × 15 cm size attached to the right and left pockets were distributed to 12 nurses of six different wards of a teaching hospital at the beginning of their work shift. Worn coats were collected at the end of the shifts and the patches were subjected for total bacterial count and identification of selected bacterial pathogens, as prioritized by the World Health Organization (WHO). Fifty percent of the sampled swatches were found to be contaminated by pathogenic bacteria. The average colony growth per square inch of the patch was 524 and 857 during first and second workdays, respectively, indicating an increase of 63.6% in colony counts. The pathogens detected on patches were Staphylococcus aureus, Escherichia coli, Pseudomonas aeruginosa, and Acinetobacter sp. Additional bacteria identified included Bacillus sp., Micrococcus sp., and coagulase-negative staphylococci (CoNS). The nurses working in the maternity department had their white coats highly contaminated with bacteria. On the other hand, the least bacterial contamination was recorded from the nurses of the surgery ward. One S. aureus isolate from the maternity ward was resistant to methicillin. This study showed that pathogens belonging to the WHO list of critical priority and high priority have been isolated from white coats of nurses, thus posing the risk of transmission to patients. White coats must be worn, maintained, and washed properly to reduce bacterial contamination load and to prevent cross-contamination of potential superbugs. The practice of wearing white coats outside the healthcare zone should be strictly discouraged.
A Case Control Study to Evaluate the Impact of Colchicine on Patients Admitted to the Hospital with Moderate to Severe COVID-19 Infection
Background. Colchicine has been used in conditions such as periodic febrile illness, acute pericarditis, and gouty arthritis, all having a common hyperinflammatory response as seen in moderate to severe forms of coronavirus disease 2019 (COVID-19). This project was carried out during the rapid surge of cases in New York City, and the goal was to assess the efficacy of colchicine in treating patients with COVID-19. Methods. Patients admitted to two distinct pulmonary oriented floors of the BronxCare Hospital Center were compared. Patients on one floor were given colchicine in addition to standard of care, while control patients from another floor received only standard of care. Patients who had at least two separate timepoint measurements for at least two out of four serum inflammatory markers (C-reactive protein (CRP), D-dimer, ferritin, or lactate dehydrogenase (LDH)) were selected for the final comprehensive analysis. Results. An initial analysis performed on all patients, irrespective of the availability of two timepoint inflammatory markers, revealed a lower mortality (49.1% versus 72.9%, ), a lower percentage of intubations (52.8% versus 73.6%, ), and a higher discharge rate (50.9% versus 27.1%, ), in the patients who received colchicine. Patients in the final comprehensive analysis groups (34 in the colchicine group and 78 in the control group) had a similar prevalence of comorbid medical conditions, except for renal failure, which was higher in the control group (65.3% versus 35.2%, ). HTN (71.8% versus 52.9%, ) and DM (51.3% versus 32.4%, ) were also more prevalent in the control group, although the difference was not statistically significant. Patients who received colchicine had a lower mortality than the control group (47.1% versus 80.8%, ), lower rate of intubations (47.1% versus 87.2%, ), and a higher discharge rate (52.9% versus 19.2%, ). Patients in the colchicine group also showed a more significant decrease in inflammatory markers for D-dimer (), CRP (), and ferritin (). Conclusions. Our study demonstrates that colchicine improved outcomes in patients with COVID-19 receiving standard of care therapy. Future randomized, placebo-controlled clinical trials to assess the potential benefit of colchicine in COVID-19 are warranted.