Antimicrobial resistance in sexually transmitted Shigella in men who have sex with men: A systematic review

BACKGROUND

Outbreaks of sexually transmitted Shigella flexneri and Shigella sonnei in men who have sex with men (MSM) are a major public health issue. While most cases can be managed conservatively, a minority require antimicrobial treatment. Recent reports have highlighted increasing antimicrobial resistant (AMR) strains of Shigella spp. in men who have sex with men. We aimed to systematically review antimicrobial resistance (and decreased antimicrobial sensitivity) in sexually transmitted shigella in men who have sex with men, focussing on macrolides, quinolones, and third generation cephalosporins.

METHODS

We systematically searched 4 bibliographical databases (EMBASE, medline, EMCARE and CINAHL) from January 2011 to November 2021. We used a 2-stage process to assess eligibility: the primary author conducted an initial screen and then 3 authors conducted independent full-text reviews to determine the final eligible manuscripts. We only included manuscripts in English which included men who have sex with men with sexually transmitted shigella where data on antimicrobial resistance was available.

RESULTS

Thirty-nine manuscripts met the inclusion criteria. A majority of the manuscripts (N = 34) described reduced susceptibility or antimicrobial resistant to macrolides, quinolones and third generation cephalosporins in circulating strains of shigella within sexual networks of men who have sex with men. Extensively drug resistant outbreaks of shigella in men who have sex with men have been reported containing genetic markers of ceftriaxone resistance (e.g. BlaCTX-M27) where isolates also contained markers of reduced susceptibility, and antimicrobial resistant to macrolides and quinolones.

CONCLUSION

There is little role for macrolides, quinolones or third generation cephalosporins in the management of sexually transmitted shigella in men who have sex with men. More research is needed to develop novel strategies for shigella control in men who have sex with men, as antimicrobial options are diminishing.

Factors associated with sexually transmitted shigella in men who have sex with men: a systematic review

BACKGROUND

Outbreaks of sexually transmitted shigella have been reported in men who have sex with men (MSM) since the 1970s and present a major public health issue. Understanding the factors associated with the sexual transmission of shigella may inform future control strategies.

METHODS

We systematically searched four bibliographical databases (January 2000-February 2022) for manuscripts in English. We used a two-stage process to assess eligibility: the primary author conducted an initial screen and then three authors conducted independent full-text reviews to determine the final eligible manuscripts. We only included manuscripts that included MSM diagnosed with sexually transmitted shigella where specific factors associated with transmission were identified.

RESULTS

Thirteen manuscripts met the inclusion criteria that included 547 individuals. Sexually transmitted shigella in MSM was associated with: residing in a capital city/urban region, living with HIV (including engaging in seroadaptive sexual behaviour, having a low CD4 count, having a HIV viral load >100 000 and not engaging with HIV care), using HIV pre-exposure prophylaxis, use of geospatial mobile phone applications to meet sexual partners, visiting sex on premises venues, chemsex and recreational drug use, sexual behaviour (including multiple non-regular sexual partners and oral-anal sexual contact) and concomitant STIs.

CONCLUSION

We have highlighted some important risk behaviours and factors that are associated with sexually transmitted shigella in MSM that can be used to target future shigella control interventions.

Polyaniline inside the pores of high surface area mesoporous silicon as composite electrode material for supercapacitors

Mesoporous silicon (mSi) obtained by the magnesiothermic reduction of mesoporous silica was used to deposit polyaniline (PANI) in its pores, the composite was tested for its charge storage application for high performance supercapacitor electrodes. The mesoporous silica as confirmed by Small Angle X-ray Scattering (SAXS) has a Brunauer–Emmett–Teller (BET) surface area of 724 m²g⁻¹ and mean pore size of 5 nm. After magnesiothermic reduction to mSi, the BET surface area is reduced to 348 m²g⁻¹ but the mesoporousity is retained with a mean pore size of 10 nm. The BET surface area of mesoporous silicon is among the highest for porous silicon prepared/reduced from silica. In situ polymerization of PANI inside the pores of mSi was achieved by controlling the polymerization conditions. As a supercapacitor electrode, the mSi–PANI composite exhibits better charge storage performance as compared to pure PANI and mesoporous silica–PANI composite electrodes. Enhanced electrochemical performance of the mSi–PANI composite is attributed to the high surface mesoporous morphology of mSi with a network structure containing abundant mesopores enwrapped by an electrochemically permeable polyaniline matrix.

Magnesiothermic reduction was used to reduce mesoporous silica to mesoporous silicon which can host a variety of materials such as polyaniline and has potential to be used in supercapacitors.

Synthesis and characterization of graphene oxide sheets integrated with gold nanoparticles and their applications to adsorptive removal and catalytic reduction of water contaminants

Here, we report the facile synthesis of graphene oxide–gold (GO–Au) nanocomposites and their use as adsorbents for the removal of toxic industrial dyes from water and as catalysts for the individual and simultaneous reduction of a dye and a nitro compound in aqueous medium. GO sheets were prepared using a modified Hummers method while Au nanoparticles were integrated on GO sheets by reducing Au(iii) ions on the surfaces of GO sheets using sodium citrate as a reducing agent. The prepared composite was characterized with field emission scanning electron microscopy (FESEM), transmission electron microscopy (TEM), elemental dispersive X-ray analysis (EDX), X-ray diffraction (XRD), Fourier transform infra-red (FT-IR) spectroscopy and thermal gravimetric analysis (TGA). The GO–Au nanocomposite demonstrated efficient adsorption capacities and recyclability for malachite green (MG) and ethyl violet (EV) dyes. The effects of various experimental parameters including temperature, pH, contact time, and adsorbent dose were studied. From the simulation of experimental data with different adsorption isotherms and kinetic models it was found that the adsorption of both the dyes followed the Freundlich adsorption model and a pseudo-second order kinetic model, respectively. Moreover, the adsorbent showed better recyclability for both dyes without any compromise on the removal efficiency. Similarly, the catalytic performance for the reduction of 2-nitroaniline (2-NA) has been investigated in detail by using the prepared nanocomposite as a catalyst. Most importantly, we reported the simultaneous adsorption of cationic and anionic dyes from water using the prepared nanocomposite as well as the simultaneous catalytic reduction of a mixture of EV and 2-NA. So, considering the facile synthesis process and the efficient removal of a variety of dyes and the catalytic performance this work opens up a tremendous opportunity to bring GO based nanocomposites from experimental research to practically applied materials for wastewater treatment.

Preparation of graphene oxide–gold (GO–Au) nanocomposites as adsorbents and catalysts for decontamination of water.

Characterization of polyphenol oxidase from blueberry (Vaccinium corymbosum L.)

Polyphenol oxidase (PPO) was extracted and characterized from high-bush blueberries. PPO showed an optimum activity at pH 6.1-6.3 and 35°C, with the enzyme showing significant activity over a wide temperature range (25-60°C). Catechol was the most readily oxidized substrate followed by 4-methylcatechol, DL-DOPA, and dopamine. Blueberry PPO showed a K_m of 15mM and V_max of 2.57 ΔA₄₂₀nm/min×10^-1, determined with catechol. PPO was completely inactivated in 20min at 85°C, however, after 30minat 75°C it showed about 10% residual activity. Thermal treatment at 55 and 65°C for 30min resulted in the partial inactivation of PPO. Ascorbic acid, sodium diethyldithiocarbamic acid, L-cysteine, and sodium metabisulfite were effective inhibitors of PPO at 1.0mM. Benzoic acid and cinnamic acid series inhibitors showed relatively weak inhibition of PPO (21.8-27.6%), even at as high as 2.0mM concentration.

Fast removal of high quantities of toxic arsenate via cationic p(APTMACl) microgels

Hydrogels are resourceful materials and can be prepared in different morphology, size, surface charge and porosity adopting different polymerization techniques and reaction conditions. The cationic poly(3-acrylamidopropyl)trimethylammonium chloride (p(APTMACl)) microgels were synthesized by photo-initiated inverse suspension polymerization technique. These microgels were utilized as absorbents for the removal of toxic arsenate (As) from different aqueous environments. The experimental parameters affecting absorption efficiency were investigated, and it was demonstrated that these types of microgels are highly efficient in removing arsenate anions from different aqueous environments compared to the previously reported bulk hydrogel, and cryogel of the same material. A removal efficiency of approximately 97.25% was obtained by immersing 0.5 g microgel in 250 ppm 100 mL solution of arsenate anions for 60 min. Both Langmuir and Freundlich adsorption isotherms were applied to adsorption of arsenate anions by p(APTMACl) microgels, and the Langmuir isotherm was a better representation of the adsorption of arsenate with a high value of R(2) (0.9982). Furthermore, mag-p(APTMACl) microgels were synthesized for the adsorption of arsenate anions to provide easy removal of the microgel composite by using an externally applied magnetic field. Furthermore, re-usability of the p(APTMACl) microgels was also investigated for the adsorption of arsenate anions.

The present and future disease burden of hepatitis C virus infections with today's treatment paradigm - volume 3

The total number, morbidity and mortality attributed to viraemic hepatitis C virus (HCV) infections change over time making it difficult to compare reported estimates from different years. Models were developed for 15 countries to quantify and characterize the viraemic population and forecast the changes in the infected population and the corresponding disease burden from 2014 to 2030. With the exception of Iceland, Iran, Latvia and Pakistan, the total number of viraemic HCV infections is expected to decline from 2014 to 2030, but the associated morbidity and mortality are expected to increase in all countries except for Japan and South Korea. In the latter two countries, mortality due to an ageing population will drive down prevalence, morbidity and mortality. On the other hand, both countries have already experienced a rapid increase in HCV-related mortality and morbidity. HCV-related morbidity and mortality are projected to increase between 2014 and 2030 in all other countries as result of an ageing HCV-infected population. Thus, although the total number of HCV countries is expected to decline in most countries studied, the associated disease burden is expected to increase. The current treatment paradigm is inadequate if large reductions in HCV-related morbidity and mortality are to be achieved.

Strategies to manage hepatitis C virus infection disease burden - volume 3

The hepatitis C virus (HCV) epidemic was forecasted through 2030 for 15 countries in Europe, the Middle East and Asia, and the relative impact of two scenarios was considered: increased treatment efficacy while holding the annual number of treated patients constant and increased treatment efficacy and an increased annual number of treated patients. Increasing levels of diagnosis and treatment, in combination with improved treatment efficacy, were critical for achieving substantial reductions in disease burden. A 90% reduction in total HCV infections within 15 years is feasible in most countries studied, but it required a coordinated effort to introduce harm reduction programmes to reduce new infections, screening to identify those already infected and treatment with high cure rate therapies. This suggests that increased capacity for screening and treatment will be critical in many countries. Birth cohort screening is a helpful tool for maximizing resources. Among European countries, the majority of patients were born between 1940 and 1985. A wider range of birth cohorts was seen in the Middle East and Asia (between 1925 and 1995).

Historical epidemiology of hepatitis C virus (HCV) in select countries - volume 3

Detailed, country-specific epidemiological data are needed to characterize the burden of chronic hepatitis C virus (HCV) infection around the world. With new treatment options available, policy makers and public health officials must reconsider national strategies for infection control. In this study of 15 countries, published and unpublished data on HCV prevalence, viraemia, genotype, age and gender distribution, liver transplants and diagnosis and treatment rates were gathered from the literature and validated by expert consensus in each country. Viraemic prevalence in this study ranged from 0.2% in Iran and Lebanon to 4.2% in Pakistan. The largest viraemic populations were in Pakistan (7 001 000 cases) and Indonesia (3 187 000 cases). Injection drug use (IDU) and a historically unsafe blood supply were major risk factors in most countries. Diagnosis, treatment and liver transplant rates varied widely between countries. However, comparison across countries was difficult as the number of cases changes over time. Access to reliable data on measures such as these is critical for the development of future strategies to manage the disease burden.

Magnetic Co–Fe bimetallic nanoparticle containing modifiable microgels for the removal of heavy metal ions, organic dyes and herbicides from aqueous media

Poly(methacrylic-co-acrylonitrile) (p(MAc-co-AN)) microgels were prepared and nitrile groups were converted to amidoxime groups by chemical modification.

Highly versatile p(MAc)–M (M: Cu, Co, Ni) microgel composite catalyst for individual and simultaneous catalytic reduction of nitro compounds and dyes

Poly(methacrylic acid) (p(MAc)) microgels were synthesized by inverse suspension polymerization and used as a template for copper, nickel, and cobalt nanoparticle preparation.

Total phenolics, antioxidant properties and quality of fresh-cut onions (Allium cepa L.) treated with mild-heat

This study investigated the effect of mild-heat on fresh-cut onion slices by treating in hot water (50, 60, 70°C) for 1 min. Total phenolics (TP), antioxidant properties, colour, and weight loss of slices were evaluated during 4°C storage at 7-day intervals (21 days total). The 60°C heat treatment resulted in a significant increase in TP, from 44.92 to 52.32 mg GAE/100g. Except for 50 and 70°C treatments, TP in control and 60°C treated fresh-cut onions decreased during storage. The antioxidant properties of fresh-cut onions were 1.31, 0.99, and 62.49 μM TE/g using ABTS, DPPH, and ORAC assays, respectively. The mild-heat treatments did not affect ABTS and DPPH antioxidant activities and the colour of fresh-cut onions. The storage time had mixed effect on the antioxidant properties (ABTS decreased; DPPH and ORAC remained fairly stable). The 50°C samples exhibited the lowest weight loss during 21-day storage.

Nanomagnet logic: progress toward system-level integration

Quoting the International Technology Roadmap for Semiconductors (ITRS) 2009 Emerging Research Devices section, 'Nanomagnetic logic (NML) has potential advantages relative to CMOS of being non-volatile, dense, low-power, and radiation-hard. Such magnetic elements are compatible with MRAM technology, which can provide input–output interfaces. Compatibility with MRAM also promises a natural integration of memory and logic. Nanomagnetic logic also appears to be scalable to the ultimate limit of using individual atomic spins.' This article reviews progress toward complete and reliable NML systems. More specifically, we (i) review experimental progress toward fundamental characteristics a device must possess if it is to be used in a digital system, (ii) consider how the NML design space may impact the system-level energy (especially when considering the clock needed to drive a computation), (iii) explain--using both the NML design space and a discussion of clocking as context—how reliable circuit operation may be achieved, (iv) highlight experimental efforts regarding CMOS friendly clock structures for NML systems, (v) explain how electrical I/O could be achieved, and (vi) conclude with a brief discussion of suitable architectures for this technology. Throughout the article, we attempt to identify important areas for future work.

Road traffic injuries in Rawalpindi city, Pakistan

Data on road traffic accident (RTA) injuries and their outcome are scarce in Pakistan. This study assessed patterns of RTA injuries reported in Rawalpindi city using standard surveillance methods. All RTA injury patients presenting to emergency departments of 3 tertiary care facilities from July 2007 to June 2008 were included. RTA injuries (n = 19 828) accounted for 31.7% of all injuries. Among children aged 0-14 years females suffered twice as many RTA injuries as males (21.3% versus 11.4%), whereas this trend reversed for the age group 15-24 years (41.9% versus 21.7%). One-fifth of injuries were either fractures or concussion. Severity and outcome of injuries were worse for the age group 45 years and older. For every road traffic death in Rawalpindi city, 29 more people were hospitalized and 177 more received emergency department care. These results suggest the need for better RTA injury surveillance to identify preventive and control measures for the increasingly high road disease burden in this city.

Is there a correlation between degree of viremia and liver histology in chronic hepatitis C?

OBJECTIVE

To determine the correlation between degree of histological liver damage and serum HCV RNA level in patients of chronic hepatitis C, in order to evaluate the usefulness of HCV RNA estimation as an alternate to liver biopsy.

METHODS

This non-interventional descriptive study, was carried out at the department of Pathology, Army Medical College, Rawalpindi, Pakistan between April and September 2002. Core needle liver biopsies of fifty five patients of chronic hepatitis C were evaluated according to Knodell's histological activity index system. The patients were categorized into four subgroups depending upon the grade and stage of disease according to Desmet's classification, and into three groups according to degree of viremia.

RESULTS

Five patients had mild viremia, 43 moderate and 7 had severe viremia. Seven patients had minimal disease, 9 mild, 22 moderate and 17 had severe chronic hepatitis. Eight patients had no fibrosis, 20 had fibrous portal expansion, 19 bridging fibrosis, and 8 patients had cirrhosis. No significant correlation was found between serum HCV RNA levels and grade or stage of the disease, with correlation coefficients of rs = -.054 and rs = .034 respectively. Moreover, no individual component of the HAI correlated with serum HCV RNA levels.

CONCLUSION

Serum HCV RNA level does not determine the degree of hepatic injury precisely and liver biopsy is necessary to accurately evaluate the extent of liver damage.

[Genetic properties of transposons Tn6-1, Tn6-2 and Tn19-1]

The level and range transposition of the transposons Tn6-1, Tn6-2, Tn19-1, and their ability to influence plasmid transfer has been studied. The widest range of transposition was shown for transposon Tn6-2. Insertions of each of the studied transposons into different conjugative plasmids genomes resulted in change of frequencies of plasmids transfer and change of plasmids mobilization activity.