Emerging and Re-Emerging Infectious Diseases: Humankind's Companions and Competitors

Central nervous system infections in the tropics

PURPOSE OF REVIEW

Emerging and re-emerging central nervous system (CNS) infections are a major public health concern in the tropics. The reasons for this are myriad; climate change, rainfall, deforestation, increased vector density combined with poverty, poor sanitation and hygiene. This review focuses on pathogens, which have emerged and re-emerged, with the potential for significant morbidity and mortality.

RECENT FINDINGS

In recent years, multiple acute encephalitis outbreaks have been caused by Nipah virus, which carries a high case fatality. Arboviral infections, predominantly dengue, chikungunya and Zika are re-emerging increasingly especially in urban areas due to changing human habitats, vector behaviour and viral evolution. Scrub typhus, another vector borne disease caused by the bacterium Orientia tsutsugamushi , is being established as a leading cause of CNS infections in the tropics.

SUMMARY

A syndromic and epidemiological approach to CNS infections in the tropics is essential to plan appropriate diagnostic tests and management. Rapid diagnostic tests facilitate early diagnosis and thus help prompt initiation and focusing of therapy to prevent adverse outcomes. Vector control, cautious urbanization and deforestation, and reducing disturbance of ecosystems can help prevent spread of vector-borne diseases. Regional diagnostic and treatment approaches and specific vaccines are required to avert morbidity and mortality.

All-in-one platform: Versatile, Easy, and User-friendly System (VEUS) based on automated and expert-independent antibody immobilization and immunoassay by utilizing customized movement of magnetic particles

The ELISA is the most worldwide method for immunoassay. However, the ELISA is losing ground due to low reproducibility of manual experimental processes in both R&D and IVD areas. An automated platform is a good solution, but there are still limitations owning to extremely high cost and requiring large space to set up especially for a small size laboratory. Here, we present a novel all-in-one platform called "VEUS" settable on the laboratory table that offers comprehensive automation of the entire multiplex immunoassay process by exploiting antibody conjugated magnetic particles, quality control and then immunoanalytical reaction, thereby enhancing detection sensitivity and high reproducibility. As a proof of concept, the system exhibits a sensitive LOD of 0.6 and 3.1 pg mL-1 within 1 h run, comparable precision that of molecular diagnostic systems based on PCR method, enabling rapid multiplex diagnosis of Influenza A, Influenza B, and COVID-19 viruses with similar symptoms. Through automation by the all-in-one system, it can be used by novice users, something innovative for immunoassays, relying heavily on user experience. Furthermore, it can contribute to streamline entire immunoassay processes of diverse biomarkers with high reproducibility and convenience in laboratories.

Aluminum oxide, cobalt aluminum oxide, and aluminum-doped zinc oxide nanoparticles as an effective antimicrobial agent against pathogens

Since the clock of antimicrobial resistance was set, modern medicine has shed light on a new cornerstone in technology to overcome the worldwide dread of the post-antimicrobial era. Research organizations are exploring the use of nanotechnology to modify metallic crystals from macro to nanoscale size, demonstrating significant interest in the field of antimicrobials. Herein, the antimicrobial activities of aluminum oxide (Al2O3), cobalt aluminum oxide (CoAl2O4), and aluminum doped zinc oxide (Zn0.9Al0.1O) nanoparticles were examined against some nosocomial pathogens. The study confirmed the formation and characterization of Al2O3, CoAl2O4, and Zn0.9Al0.1O nanoparticles using various techniques, revealing the generation of pure nanoscale nanoparticles. With inhibition zones ranging from 9 to 14 mm and minimum inhibitory concentrations varying from 4 mg/mL to 16 mg/mL, the produced nanoparticles showed strong antibacterial activity against Escherichia coli, Klebsiella pneumoniae, Pseudomonas aeruginosa, and Staphylococcus aureus. Meanwhile, the bactericidal concentrations ranged from 8 mg/mL to 40 mg/mL. In culture, Zn0.9Al0.1O NPs demonstrated a unique ability to inhibit the development of nosocomial infections with high bactericidal activity (8 mg/mL). Transmission electron microscope images revealed changes in cell shape, bacterial cell wall morphology, cytoplasmic membrane, and protoplasm due to the introduction of tested nanoparticles. These results pave the way for the use of these easily bacterial wall-piercing nanoparticles in combination with potent antibiotics to overcome the majority of bacterial strains' resistance.

Readiness To Manage Ebola Virus Disease Among Emergency Healthcare Workers in Uganda: A Nationwide Multicenter Survey

Background

Emerging infectious diseases like the Ebola Virus Disease (EVD) pose significant global public health threats. Uganda has experienced multiple EVD outbreaks, the latest occurring in 2022. Frontline healthcare workers (HCWs) are at increased risk, yet there isn't sufficient evidence of existing knowledge of EVD of these health workers. We aimed to assess the readiness of Uganda's emergency healthcare workers to manage Ebola virus disease (EVD) and identify their training needs to inform targeted capacity-building interventions for future outbreaks.

Methods

This multicentre nationwide cross-sectional study was conducted from July to August 2023 among 691 HCWs providing emergency care in 14 secondary and tertiary hospitals across Uganda. Participants were consecutively recruited using the probability-proportional-to-size sampling technique, and data was collected using a self-reported questionnaire. Factors associated with EVD knowledge were identified through a mixed-effect linear model.

Results

Data from 691 eligible HCWs with a median age of 32 (IQR: 28-38) was analyzed (response rate: 92%). Only one-third (34.4%, n = 238) had received EVD training in the past year. The median EVD knowledge score was 77.4% (IQR: 71.2% - 83.4%). EVD knowledge was associated with longer professional experience in years (β: 0.21, 95% CI: 0.03 to 0.39, p = 0.024) and higher level of education: diploma (β: 3.37, 95% CI: 1.49 to 5.25, p < 0.001), undergraduate degree (β: 6.45, 95% CI: 4.11 to 8.79) and postgraduate degree (β: 7.13, 95% CI: 4.01 to 10.25, p < 0.001). Being a doctor (β: 2.55, 95% CI: 0.35 to 4.74, p = 0.023), providing care in the obstetrics/gynecology department (β: -1.90, 95% CI: -3.47 to - 0.32, p = 0.018), previous EVD training (β: 2.27, 95% CI: 0.96 to 3.59, p = 0.001) and accessing EVD information through social media (β: 2.52, 95% CI: 1.17 to 3.88, p < 0.001) were also significantly associated with EVD knowledge.

Conclusion

Our study reveals that Ugandan HCWs' EVD response readiness varies by individual factors and information sources. We recommend targeted training and suggest future research on educational innovations and social media's potential to fill knowledge gaps.

Phytochemical composition and in vitro antioxidant and antimicrobial activities of Bersama abyssinica F. seed extracts

Medicinal plants can be potential sources of therapeutic agents. Traditional healers use a medicinal plant from Ethiopia, Bersama abyssinica Fresen, to treat various diseases. This study aimed to investigate the phytochemical components and antioxidant and antimicrobial activities of B. abyssinica seed extracts (BASE). Gas chromatography coupled to mass spectroscopy (GC-MS) analysis was used to determine the phytochemical compositions of BASE. The antioxidant activities were assessed by using 2, 2-diphenyl-1-picrylhydrazyl (DPPH) assay, thiobarbituric acid-reactive species (TBARS) assay, ferric chloride reducing assay and hydroxyl scavenging capacity assay. Antimicrobial activity was investigated using the agar well diffusion method. Phytochemical screening showed the presence of saponins, glycosides, tannins, steroids, phenols, flavonoids, terpenoids, and alkaloids. GC-MS analysis revealed the presence of 30 volatile compounds; α-pinene (23.85%), eucalyptol (20.74%), β-pinene (5.75%), D-limonene (4.05%), and o-cymene (5.02%). DPPH-induced free radical scavenging (IC50 = 8.78), TBARS (IC50 = 0.55 µg/mL), and hydroxyl radicals' scavenging capacities assays (IC50 = 329.23) demonstrated high antioxidant effects of BASE. Reducing power was determined based on Fe3+-Fe2+ transformation in the presence of extract. BASE was found to show promising antibacterial activity against S. aureus, E. coli, and P. aeruginosa (zone of inhibition 15.7 ± 2.5 mm, 16.0 ± 0.0 mm, and 16.7 ± 1.5 mm, respectively), but excellent antifungal activities against C. albican and M. furfur (zone of inhibition 22.0 ± 2.0 mm and 22.0 ± 4.0 mm, respectively). The seeds of B. abyssinica grown in Ethiopia possess high antioxidant potential, promising antibacterial and superior antifungal activity. Therefore, seeds of B. abyssinica provide a potential source for drug discovery.

Susceptibility of solid organ transplant recipients to viral pathogens with zoonotic potential: A mini-review

A substantial number of zoonotic diseases are caused by viral pathogens, representing a significant menace to public health, particularly to susceptible populations, such as pregnant women, the elderly, and immunocompromised individuals. Individuals who have undergone solid organ transplantation frequently experience immunosuppression, to prevent organ rejection, and, thus are more prone to opportunistic infections. Furthermore, the reactivation of dormant viruses can threaten transplant recipients and organ viability. This mini-review examines the up-to-date literature covering potential zoonotic and organ rejection-relevant viruses in solid organ transplant recipients. A comprehensive list of viruses with zoonotic potential is highlighted and the most important clinical outcomes in patients undergoing transplantation are described. Moreover, this mini-review calls attention to complex multifactorial events predisposing viral coinfections and the need for continuous health surveillance and research to understand better viral pathogens' transmission and pathophysiology dynamics in transplanted individuals.

Microbial Therapy and Breast Cancer Management: Exploring Mechanisms, Clinical Efficacy, and Integration within the One Health Approach

This comprehensive review elucidates the profound relationship between the human microbiome and breast cancer management. Recent findings highlight the significance of microbial alterations in tissue, such as the gut and the breast, and their role in influencing the breast cancer risk, development, progression, and treatment outcomes. We delve into how the gut microbiome can modulate systemic inflammatory responses and estrogen levels, thereby impacting cancer initiation and therapeutic drug efficacy. Furthermore, we explore the unique microbial diversity within breast tissue, indicating potential imbalances brought about by cancer and highlighting specific microbes as promising therapeutic targets. Emphasizing a holistic One Health approach, this review underscores the importance of integrating insights from human, animal, and environmental health to gain a deeper understanding of the complex microbe-cancer interplay. As the field advances, the strategic manipulation of the microbiome and its metabolites presents innovative prospects for the enhancement of cancer diagnostics and therapeutics. However, rigorous clinical trials remain essential to confirm the potential of microbiota-based interventions in breast cancer management.

Promising Schiff bases in antiviral drug design and discovery

Emerging and re-emerging illnesses will probably present a new hazard of infectious diseases and have fostered the urge to research new antiviral agents. Most of the antiviral agents are analogs of nucleosides and only a few are non-nucleoside antiviral agents. There is quite a less percentage of marketed/clinically approved non-nucleoside antiviral medications. Schiff bases are organic compounds that possess a well-demonstrated profile against cancer, viruses, fungus, and bacteria, as well as in the management of diabetes, chemotherapy-resistant cases, and malarial infections. Schiff bases resemble aldehydes or ketones with an imine/azomethine group instead of a carbonyl ring. Schiff bases have a broad application profile not only in therapeutics/medicine but also in industrial applications. Researchers have synthesized and screened various Schiff base analogs for their antiviral potential. Some of the important heterocyclic compounds like istatin, thiosemicarbazide, quinazoline, quinoyl acetohydrazide, etc. have been used to derive novel Schiff base analogs. Keeping in view the outbreak of viral pandemics and epidemics, this manuscript compiles a review of Schiff base analogs concerning their antiviral properties and structural-activity relationship analysis.

Antibiotic Resistance in Selected Emerging Bacterial Foodborne Pathogens-An Issue of Concern?

Antibiotic resistance (AR) and multidrug resistance (MDR) have been confirmed for all major foodborne pathogens: Campylobacter spp., Salmonella spp., Escherichia coli and Listeria monocytogenes. Of great concern to scientists and physicians are also reports of antibiotic-resistant emerging food pathogens-microorganisms that have not previously been linked to food contamination or were considered epidemiologically insignificant. Since the properties of foodborne pathogens are not always sufficiently recognized, the consequences of the infections are often not easily predictable, and the control of their activity is difficult. The bacteria most commonly identified as emerging foodborne pathogens include Aliarcobacter spp., Aeromonas spp., Cronobacter spp., Vibrio spp., Clostridioides difficile, Escherichia coli, Mycobacterium paratuberculosis, Salmonella enterica, Streptocccus suis, Campylobacter jejuni, Helicobacter pylori, Listeria monocytogenes and Yersinia enterocolitica. The results of our analysis confirm antibiotic resistance and multidrug resistance among the mentioned species. Among the antibiotics whose effectiveness is steadily declining due to expanding resistance among bacteria isolated from food are β-lactams, sulfonamides, tetracyclines and fluoroquinolones. Continuous and thorough monitoring of strains isolated from food is necessary to characterize the existing mechanisms of resistance. In our opinion, this review shows the scale of the problem of microbes related to health, which should not be underestimated.

Exploration and Biorefinery Antimicrobial Agent through Solid State Fermentation from Indonesia’s Marine Actinomycetes

This study aimed to obtain novel bioactive compounds derived from actinomycetes associated with marine biota from the coast of Indonesia. Actinomycetes have been identified as a potential source of bioactive compounds through enzymatic fermentation. In order to obtain bioactive compounds from the results of the biorefinery process, cultivation was performed by solid state fermentation (SSF) on shrimp shell waste medium. The inhibitory activity against pathogenic microorganisms was measured based on the optical density of samples from Gorontalo and Buleleng, Bali, Indonesia. Six isolates had a clear zone as an indicator of the chitinase activity of chitinase enzymes. The SSF extract, obtained after 14 days of incubation, was assayed for its antimicrobial activity by the 96-well plate microtiter method. Among the six isolates, isolate 19B19A1 had antibacterial and antifungal activity against Staphylococcus aureus and Malassezia globosa, respectively. DNA analysis indicated that the 19B19A1 isolate was Streptomyces tritolerans 19B19A1 and that its extract contained an alkaloid component that played a role in antimicrobial activity. These results indicate that shrimp shells can be used as a nutrient-rich alternative culture medium for actinomycetes. This study is expected to become a source of information related to biorefinery, especially in the exploration of bioactive compounds produced by actinomycetes.

The ecosyndemic framework of the global environmental change and the COVID-19 pandemic

The ecosyndemic theory combines the concept of 'synergy' with 'epidemic' and the term "eco" implies the role of the environmental changes. Each of the conditions enhances the negative impacts of the other in an additive way making our society more vulnerable and heightening individual risk factors. In this study, we analyze the mutually reinforcing links between the environment and health from the complexity angle of the ecosyndemic theory and propose the characterization of the COVID-19 pandemic as ecosyndemic. We use the term 'ecosyndemic' because the global environmental change contributes to local-scale, regional-scale and global-scale alterations of the Earth's systems. These changes have their root causes in the way that people interact with the physical, chemical, and biotic factors of the environment. These interactions disturb nature and the consequences have feedbacks in every living organism.