Godwin Wilson

Bacterial contamination in blood components carries a fatal risk in blood transfusion. Despite efforts in preventing transfusion-transmitted bacterial infections, it remains associated with transfusion morbidity and mortality. This study was carried out to evaluate the effectiveness of the Mirasol Pathogen Reduction Technology (MPRT) in platelets and plasma in eliminating bacterial growth by inoculating platelet concentrates with a clinically significant load of Staphylococcus aureus to determine its effect on platelet count, pH, and coagulation factors such as plasma activated prothrombin time, partial thromboplastin time and fibrinogen. For the 10 pooled platelet concentrates samples, the observed mean pH value before MPRT treatment was 7.20, and 7.10, and 6.8 after treatment on both Day 3 and Day 7, respectively. For platelet count, the resulting mean was1296.6 x 103/ul which decreased to 1199 x 103/ul, 1120 x 103/ul, 879.4 x 103/ul on Day 0, Day 3, and Day 7, respectively after MPRT. Also, no aggregates of bacteria were seen on 9 platelet concentrates samples after MPRT. For PT and aPTT, the mean average values of 12.63 seconds and 33.46 seconds were observed after MPRT, while fibrinogen’s mean average value dropped to 1.45g/L and maintained stability at a frozen state with 1.56g/L after 30 days post storage after MPRT treatment. Therefore, MPRT can preserve platelet viability with 90% effectiveness in eliminating bacterial contamination in platelet concentrates, even when changes in pH and platelet count occur through storage. Moreover, plasma integrity can also be preserved with the use of MPRT. This extends the expiry of platelet concentrates from 5 days to 7 days, thus, minimizing the blood wastage yet increasing platelet inventory.

Background: Antimicrobial resistance (AMR), particularly methicillin-resistant Staphylococcus aureus (MRSA), is a pressing global health concern. These bacteria are increasingly becoming resistant to the most commonly available treatment options. As a choice, the macrolide lincosamide-streptogramin B (MLSB) is used, with clindamycin being the preferred drug. However, an alarming number of staphylococcal strains are developing resistance to MLSB. The resistance exhibits several phenotypes, including inducible MLSB (iMLSB), constitutive MLSB (cMLSB), and macrolide streptogramin B (MSB). One of the biggest challenges is the accurate detection of iMLSB in routine laboratory tests, as they appear erythromycin-resistant and clindamycin-sensitive unless the two antibiotics are placed adjacent to each other, which leads to clinical therapeutic failure. Method: To achieve this, double disc diffusion (D test) was used to test iMLSB phenotypically. In addition, the genetic determinants were identified through singleplex PCR using specific primers to detect erm (A, B, C) and msr genes associated with the different phenotypes of MLSB resistance. Result: Among 161 S. aureus isolates, 42 (26.1%) were erythromycin-resistant; 25 (15.5%) showed an iMLSB phenotype, and 16 (9.9%) displayed an MSB phenotype. One MRSA isolate expressing cMLSB phenotype. Genotypic analysis revealed a prevalence of ermC in 60% and msr in 40% of S. aureus isolates. Conclusion: The D-test is a reliable method for identifying inducible clindamycin resistance in clinical diagnostics, to support antibiotic use and treatment stewardship in Qatar.

The COVID-19 pandemic, caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)virus, resulted in significant global health consequences. The interventions introduced to limit the spread of the virus had a significant impact on the course of the pandemic, but they might also involve other pathogens besides SARS-CoV-2. This study investigates the epidemiological variations for major bacterial and common fungal pathogens represented by Candida species infection in Qatar through retrospective hospital records. Retrospective data were collected on all bacterial and Candida infections from Hamad General Hospital between January 2019 and December 2021. Statistical analyses were performed using R (Version 4.1.0). Infection count comparisons were performed using chi-square goodness of fit tests. Differences in patient numbers were tested with one-way ANOVA followed by post hoc Tukey HSD. The number of infections and measures were correlated using Spearman rank correlation. The significance level was set at 0.05, and where applicable, the Holm–Bonferroni method was used to correct for multiple testing. The general trend for bacterial and Candida infections showed a significant decrease (p < 0.05) following the imposed restrictions and increases during restriction lifting periods. The number of bacterial infections correlated with the number of international visitors (ρ = 0.61, p < 0.01), while the number of Candida infections correlated with hospital admissions of COVID-19 patients (ρ = 0.59, p = 0.013). The results provide a general overview of the infection trends in Qatar during the COVID-19 pandemic and illustrate some of the pandemic interventions’ effects on bacterial and Candida infections. However, further research is needed to better understand the underlying trend dynamics.

Antimicrobial resistance (AMR) is a global healthcare challenge with substantial morbidity, mortality, and management costs. During the COVID-19 pandemic, there was a documented increase in antimicrobial consumption, particularly for severe and critical cases, as well as noticeable travel and social restriction measures that might influenced the spectrum of AMR. To evaluate the problem, retrospective data were collected on bacterial infections and antimicrobial susceptibility patterns in Qatar before and after the pandemic from 1 January 2019 to 31 December 2021, covering 53,183 pathogens isolated from reported infection episodes. The findings revealed a significant resistance pattern for extended-spectrum beta-lactamase-producing Enterobacteriaceae (ESBL-EBC), carbapenem-resistant Enterobacteriaceae (CR-EBC), and carbapenem-resistant Pseudomonas aeruginosa (CRPA), ciprofloxacin-resistant Salmonella and methicillin-resistant Staphylococcus aureus (MRSA). For correlation with social restrictions, ESBL-EBC and MRSA were positively correlated with changing patterns of international travel (ρ = 0.71 and 0.67, respectively; p < 0.05), while CRPA was moderately correlated with the number of COVID-19 hospitalized patients (ρ = 0.49; p < 0.05). CREBC and CRPA respiratory infections were associated with hospitalized patients (OR: 3.08 and 2.00, respectively; p < 0.05). The findings emphasize the challenges experienced during the COVID-19 pandemic and links to international travel, which probably will influence the local epidemiology of AMR that needs further surveillance and control strategies.

The emergence of antimicrobial resistance (AMR), particularly methicillin-resistant Staphylococcus aureus (MRSA), poses a significant global health threat as these bacteria increasingly become resistant to the most available therapeutic options. Thus, developing an efficient approach to rapidly screen MRSA directly from clinical specimens has become vital. In this study, we establish a closed-tube loop-mediated isothermal amplification (LAMP) method incorporating hydroxy-naphthol blue (HNB) colorimetric dye assay to directly detect MRSA from clinical samples based on the presence of mecA and spa genes. In total, 125 preidentified S. aureus isolates and 93 clinical samples containing S. aureus were sourced from the microbiology laboratory at Hamad General Hospital (HGH). The sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) were computed based on conventional PCR. The assay demonstrated 100% specificity, 91.23% sensitivity, 0.90 Cohen Kappa (CK), 100% PPV, and 87.8% NPV for the clinical samples, while clinical isolates exhibited 100% specificity, 97% sensitivity, 0.926 CK, 100% PPV, and 88.89% NPV. Compared to cefoxitin disk diffusion, LAMP provided 100% specificity and sensitivity, 1.00 CK, and 100% for PPV and NPV. The study revealed that the closed-tube LAMP incorporating (HNB) dye is a rapid technique with a turnaround time of less than 1 h and high specificity and sensitivity.

Echinocandins are recommended as initial treatment for candidemia. The safety and efficacy of both anidulafungin and caspofungin are well established, yet; no direct comparison was made pertaining to their efficacy and safety. This was a retrospective study to compare efficacy and safety of anidulafungin versus caspofungin in patients with candidemia. All adult patients with candidemia who were treated with either anidulafungin or caspofungin for ≥ 5 days, over a period of 6 years were retrospectively included. Baseline demographics, infection characteristics and patient courses were assessed. The primary end point was global response defined as clinical and microbiological success at the end of treatment duration. A total of 171 patients received either anidulafungin (n = 135) or caspofungin (n = 36) based on physician preference. The most common isolated candida species were candida glabrata (31.6%) followed by candida albicans (25.1%). Around 6% had chronic liver disease, and source control (mainly catheter removal) was achieved in 91.8%. Baseline characteristics were comparable between the two groups suggesting similar risks and treatment response. Response rates were similar among both groups with the primary outcome of global response being not significantly different (50% for caspofungin group vs 65.2% for anidulafungin, p=0.666). Similarly, no differences between the two groups were observed in terms of 90-day all-cause mortality (p=0.405) and hepatic safety profile defined as elevated liver function tests ≥ 3 times from baseline (p=0.521) Our data suggested that among patients with candidemia, there was no difference between anidulafungin and caspofungin for the primary endpoint of global response. Both studied echinocandins had similar rate of 90-day all-cause mortality and liver safety profile. All Authors: No reported disclosures

In this large-scale cluster-randomized controlled trial (cRCT) we sought to assess the effectiveness of facemasks against viral respiratory infections. Over three consecutive Hajj seasons (2013, 2014, 2015) pilgrims’ tents in Makkah were allocated to ‘facemask’ or ‘no facemask’ group. Fifty facemasks were offered to participants in intervention tents, to be worn over four days, and none were offered to participants in control tents. All participants recorded facemask use and respiratory symptoms in health diaries. Nasal swabs were collected from the symptomatic for virus detection by reverse transcription polymerase chain reaction. Clinical symptoms and laboratory results were analyzed by ‘intention- to-treat’ and ‘per-protocol’. A total of 7687 adult participants from 318 tents were randomized: 3864 from 149 tents to the intervention group, and 3823 from 169 tents to the control group. Participants were aged 18 to 95 (median 34, mean 37) years, with a male to female ratio of 1:1.2. Overall, respiratory viruses were detected in 277 of 650 (43%) nasal/pharyngeal swabs collected from symptomatic pilgrims. Common viruses were rhinovirus (35.1%), influenza (4.5%) and parainfluenza (1.7%). In the intervention arm, respectively 954 (24.7%) and 1842 (47.7%) participants used facemasks daily and intermittently, while in the control arm, respectively 546 (14.3%) and 1334 (34.9%) used facemasks daily and intermittently. By intention-to-treat analysis, facemask use did not seem to be effective against laboratory-confirmed viral respiratory infections (odds ratio [OR], 1.4; 95% confidence interval [CI], 0.9 to 2.1, p = 0.18) nor against clinical respiratory infection (OR, 1.1; 95% CI, 0.9 to 1.4, p = 0.40). Similarly, in a per-protocol analysis, facemask use did not seem to be effective against laboratory-confirmed viral respiratory infections (OR 1.2, 95% CI 0.9–1.7, p = 0.26) nor against clinical respiratory infection (OR 1.3, 95% CI 1.0–1.8, p = 0.06). This trial was unable to provide conclusive evidence on facemask efficacy against viral respiratory infections most likely due to poor adherence to protocol.

Brucellosis is one of the most common zoonotic disease affecting humans and animals and is endemic in many parts of the world including the Gulf Cooperation Council region (GCC). The aim of this study was to identify the species and determine the antimicrobial susceptibility pattern of Brucella strains isolated from clinical specimens, from Qatar. We evaluated 231 Brucella isolates. All isolates were identified as B. melitensis. All the isolates were susceptible to doxycycline, tetracycline, streptomycin, gentamicin, trimethoprim / sulfamethoxazole and ciprofloxacin except rifampicin, where 48 % of the strains showed elevated MICs (>1 mg/L). The rifampicin-resistance related hotspots within the rpoB gene were amplified and sequenced using PCR and no rpoB mutations were found in strains with rifampicin MICs of >2 mg/L. This study identified B. melitensis as the etiological agent of brucellosis in Qatar. No resistant isolates were detected among conventionally used antimicrobial agents.