The Journal of Infection in Developing Countries <p>A peer-reviewed open access medical journal, focusing on global health.</p> The Journal of Infection in Developing Countries en-US The Journal of Infection in Developing Countries 1972-2680 <p>Authors who publish with this journal agree to the following terms:</p> <ol type="a"> <li class="show">Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a <a title="Creative Commons Attribution License" href="" target="_new">Creative Commons Attribution License</a> that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.</li> <li class="show">Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.</li> <li class="show">Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work (See <a title="The Effect of Open Access" href="" target="_new">The Effect of Open Access</a>).</li> </ol> Fear of the novel coronavirus David J Kelvin Salvatore Rubino Copyright (c) 2020 Salvatore Rubino; David J Kelvin 2020-01-31 2020-01-31 14 01 1 2 10.3855/jidc.12496 2019-nCoV (Wuhan virus), a novel Coronavirus: human-to-human transmission, travel-related cases, and vaccine readiness <p>On 31 December 2019 the Wuhan Health Commission reported a cluster of atypical pneumonia cases that was linked to a wet market in the city of Wuhan, China. The first patients began experiencing symptoms of illness in mid-December 2019. Clinical isolates were found to contain a novel coronavirus with similarity to bat coronaviruses. As of 28 January 2020, there are in excess of 4,500 laboratory-confirmed cases, with &gt; 100 known deaths. As with the SARS-CoV, infections in children appear to be rare. Travel-related cases have been confirmed in multiple countries and regions outside mainland China including Germany, France, Thailand, Japan, South Korea, Vietnam, Canada, and the United States, as well as Hong Kong and Taiwan. Domestically in China, the virus has also been noted in several cities and provinces with cases in all but one provinence. While zoonotic transmission appears to be the original source of infections, the most alarming development is that human-to-human transmission is now prevelant. Of particular concern is that many healthcare workers have been infected in the current epidemic. There are several critical clinical questions that need to be resolved, including how efficient is human-to-human transmission? What is the animal reservoir? Is there an intermediate animal reservoir? Do the vaccines generated to the SARS-CoV or MERS-CoV or their proteins offer protection against 2019-nCoV? We offer a research perspective on the next steps for the generation of vaccines. We also present data on the use of <em>in silico</em> docking in gaining insight into 2019-nCoV Spike-receptor binding to aid in therapeutic development. Diagnostic PCR protocols can be found at</p> Robyn Ralph Jocelyne Lew Tiansheng Zeng Magie Francis Bei Xue Melissa Roux Ali Toloue Ostadgavahi Salvatore Rubino Nicholas J Dawe Mohammed N Al-Ahdal David J Kelvin Christopher D Richardson Jason Kindrachuk Darryl Falzarano Alyson Anne Kelvin Copyright (c) 2020 Robyn Ralph , Jocelyn Lew , Tiansheng Zeng, Magie Francis, Bei Xue, Melissa Roux, Ali Toloue Ostadgavahi, Salvatore Rubino, Mohammed N Al-Ahdal, David J Kelvin, Christopher D. Richardson, Jason Kindrachuk, Darryl Falzarano, Alyson Anne Kelvin 2020-01-31 2020-01-31 14 01 3 17 10.3855/jidc.12425 Analysis of patterns of antibiotic prescribing in public health facilities in Nepal <p>Introduction: Inappropriate use of antibiotics is recognised as a leading cause of antibiotic resistance. Little is known about antibiotic prescribing practices at public health facilities in low- and middle-income countries. We examined patterns of antibiotic prescribing in public health facilities in Nepal and explored factors influencing these practices.</p> <p>Methodology: A cross-sectional study of antibiotic prescribing in public health facilities was conducted in the Rupandehi district of Nepal. Six public health facilities were selected based on WHO guidelines, and data were extracted from administrative records for 6,860 patient encounters. Patterns of antibiotic prescribing were investigated using descriptive statistics. Chi-squared tests and logistic regressions were applied to explore factors associated with antibiotic prescribing.</p> <p>Results: Of patients attending public health facilities, the proportion prescribed at least one antibiotic (44.7%) was approximately twice the WHO recommended value (20.0 to 26.8%). The antibiotic prescribing rate for hospital inpatients (64.6%) was higher than for other facilities, with the prescribing rate also high in primary health care centres (50.4%) and health posts (52.2%). The most frequently (29.9%) prescribed antibiotic classes were third-generation cephalosporins. Females (p = 0.005) and younger (p &lt; 0.001) patients were more likely to be prescribed antibiotics. High prescribing rates of antibiotics for selected diseases appeared contrary to international recommendations.</p> <p>Conclusion: Antibiotic prescribing in public health facilities was high compared with WHO guidelines, suggesting the need for strategies to reduce misuse of antibiotics. This study provides useful information to assist in formulating policies and guidelines to promote more appropriate use of antibiotics in Nepal.</p> Anant Nepal Delia Hendrie Suzanne Robinson Linda A Selvey Copyright (c) 2019 Anant Nepal, Delia Hendrie, Suzanne Robinson, Linda Selvey 2020-01-31 2020-01-31 14 01 18 27 10.3855/jidc.11817 Methicillin and vancomycin resistance in coagulase-negative Staphylococci isolated from the nostrils of hospitalized patients <p>Introduction: Nasal colonization by coagulase-negative<em> Staphylococci </em>(CoNS) play an important role in nosocomial infections. This study aims to determine antibiotics susceptibility pattern and molecular screening of methicillin- and vancomycin-resistant nasal CoNS among hospitalized patients.</p> <p>Methodology: Nasal swabs were collected from 202 inpatients at Prince Hamzah Hospital, Jordan. Swabs were processed according to standard microbiological procedures to isolate <em>Staphylococci</em>. Antibiotic susceptibility testing was performed using disk diffusion, E-test, microdilution, and Vitek 2. Molecular analysis was performed using PCR for the detection of <em>mecA</em>, <em>vanA</em>, and <em>vanB</em> genes.</p> <p>Results: Nasal <em>Staphylococci </em>was isolated in 64/202 (31.7%) samples. Thirty isolates (14.8%) were CoNS, including <em>S. haemolyticus</em> (n = 17, 8.4%), <em>S. sciuri</em> (n = 6, 3%), <em>S. epidermidis</em> (n = 2, 1%), <em>S. warneri</em> (n = 2, 1%), <em>S. hominis</em> (n = 2, 1%), and <em>S. lentus</em> (n = 1, 0.5%). Twenty-two (10.9%) isolates were MR-CoNS harboring <em>mecA</em> gene. CoNS and MR-CoNS isolates were highly resistant to benzylpenicillin, erythromycin, fosfomycin, and imipenem. All isolates were sensitive to vancomycin by E-test and microdilution test and were negative for <em>vanA</em> and <em>vanB</em> genes. Nasal CoNS colonization was associated with an increased number of family members living with the participant (P = 0.04) and with admission to the orthopedic department (P = 0.03), while MR-CoNS colonization was associated with smoking (P = 0.03).</p> <p>Conclusions: Nasal colonization by unusual CoNS species and <em>mecA</em>-positive MR-CoNS are common among hospitalized patients. Absence of <em>vanA</em> and <em>vanB</em> genes suggests little contribution of nasal CoNS to vancomycin resistance transmission.</p> Mohammad Al-Tamimi Jumana Abu-Raideh Nisreen Himsawi Ashraf Khasawneh Hasan Hawamdeh Copyright (c) 2020 Mohammad Al-Tamimi, Jumana Abu-Raideh, Nisreen Himsawi, Ashraf Khasawneh, Hasan Hawamdeh 2020-01-31 2020-01-31 14 01 28 35 10.3855/jidc.11025 Risk factors associated with poor clinical outcome in pyogenic spinal infections: 5-years’ intensive care experience <p>Introduction: Management of pyogenic spinal infections (PSI) after the development of neurological deficit has not been specifically addressed in the literature. We aimed to describe real-life clinical outcomes of PSI in patients admitted to an intensive care unit with neurological deficit and identify factors associated with good prognosis.</p> <p>Methodology: Consecutive patients admitted to ICU with a possible diagnosis of spinal infection over five years’ period were included. Descriptive statistics were performed to examine the demographics and clinical parameters.</p> <p>Results: The majority (71%) of patients were male. The mean age was 57.4 years (27-79), and 71% were &gt; 50 years old. At least one underlying risk factor was identified in 68% of the patients; the most common comorbidity was diabetes mellitus (DM). All patients have presented with fever accompanied by a neurological deficit (86%) and back pain (79%). A complete recovery was achieved in 25% of patients. However, the majority of patients had adverse outcomes with 21.4% mortality, and 43% remaining neurological sequelae. Increased age with a cut-off of 65 years and pre-existing DM were identified as being associated with poor outcome.</p> <p>Conclusion: Mortality among patients admitted to ICU with PSI was significantly higher than reported in the literature. The residual neurological deficit was common, one-third of patients had remaining neurological sequelae, and only one-fourth had complete recovery. Increased age and background DM were the most important determinants of poor clinical outcome. The impact of DM appears to be much more important than currently recognised in this population.</p> Branko Milosevic Muge Cevik Aleksandar Urosevic Natasa Nikolic Jasmina Poluga Milica Jovanovic Ivana Milosevic Jelena Micic Bianca Paglietti Aleksandra Barac Copyright (c) 2020 Branko Milosevic, Muge Cevik, Aleksandar Urosevic, Natasa Nikolic, Jasmina Poluga, Milica Jovanovic, Ivana Milosevic, Jelena Micic, Bianca Paglietti, Aleksandra Barac 2020-01-31 2020-01-31 14 01 36 41 10.3855/jidc.12260 The Factors associated with the unsuccessful tuberculosis treatment of hill tribe patients in Thailand <p>Introduction: Tuberculosis (TB) remains a serious public-health problem worldwide. The successful tuberculosis treatment was in low rate among the hill tribes in Thailand. This study aimed to determine factors associated with the unsuccessful tuberculosis treatment among the hill tribe TB patients in northern Thailand.</p> <p>Methodology: A retrospective cohort study was conducted using secondary data from the national TB reporting system. Data of newly registered hill tribe patients with TB receiving treatment were obtained from 18 government hospitals in Chiang Rai province, during 2014–2017. TB treatment outcomes and factors associated with unsuccessful were determined.</p> <p>Results: A total of 770 hill tribe patients with TB registered during the study period. The majority were males aged 25–64 years. About 80% of the patients lived in rural areas and 53.9% worked in agriculture. The overall TB treatment success rate was 80.4%. Two factors were associated with unsuccessful TB treatment: ages 25–44 and ages 45–64 (aOR 3.14 (1.03–9.55) and 3.02 (1.01–9.03), respectively) and receiving antiretroviral drugs (proxy of HIV infection) (aOR 2.30 (1.02–5.15)).</p> <p>Conclusion: Although the TB treatment success rate among hill tribe patients did not reach the national goal, it was still higher than that of other Thai TB patients in the area. In Thailand, hill tribe people can access health services free-of-charge under the national health insurance. This could influence the successful treatment. However, some barriers need to be considered, such as the high default rate and high death rate among those with HIV coinfection.</p> Siriyaporn Khunthason Jaranit Kaewkungwal Wirichada Pan-Ngum Chusak Okascharoen Tawatchai Apidechkul Saranath Lawpoolsri Copyright (c) 2020 Siriyaporn Khunthason 2020-01-31 2020-01-31 14 01 42 47 10.3855/jidc.12029 Commensal and virulent Escherichia coli strains of vaginal origin are reservoirs of resistance cassettes in class 1 integrons <p>Introduction: Antimicrobial resistance in <em>Escherichia coli,</em> one of the causal agents of aerobic vaginitis, leads to the persistence of the infection. The investigation of integrons acquires relevance, since they are elements that are responsible for the acquisition of resistance to antibiotics. The aim of this work was to describe the structural diversity of class 1 integrons in virulent and commensal strains of <em>E. coli</em> isolated from patients with vaginal infection.</p> <p>Methodology: Ninety-two strains of <em>E. coli</em> were isolated from patients with aerobic vaginitis. Resistance profile against 19 antibiotics and class 1 integrons were detected by PCR. The identity and arrangement of cassettes was determined by sequencing. ERIC-PCR assays were carried out in strains with identical arrays. Finally, genotyping by Clermont algorithm and serotyping were performed. Seventeen strains showed integrons located in plasmids.</p> <p>Results: Ten different gene cassette arrays were identified in 30 strains of <em>E. coli</em>. Cassettes corresponding to genes coding for adenylyltransferases (<em>aadA)</em>, dihydrofolate reductases (<em>dfrA</em>), and oxacillinases (<em>bla<sub>OXA</sub></em>) were detected. Array <em>dfrA17-aadA5</em> was predominantly prevalent over the other arrays identified. Phylogenetic group A was the most predominant, followed by group B2 and D.</p> <p>Conclusions: This study demonstrates the presence of <em>E. coli</em> of vaginal origin carrying class 1 integrons, which are main genetic elements of capture of resistance genes, with the possibility of capturing new resistance cassettes. These evidences should serve for the modification of protocols in the diagnosis and treatment of aerobic vaginitis, and the development of policies for the rational use of antimicrobials.</p> Manalli Itzahaya Blancarte–Lagunas Graciela Castro-Escarpulli Armando Navarro-Ocaña Gabriela Ibáñez-Cervantes Laura Margarita Marquez-Valdelamar José Misael Hernández-Carrillo Juana Salazar-Salinas Omar Fernando Mendoza-Vásquez Gabriel Damazo-Hernández Oscar Sosa-Hernández Gregorio León-García Monica Alethia Cureño-Díaz Juan Manuel Bello-López Copyright (c) 2020 Juan Manuel Bello-López, Manalli Itzahaya Blancarte–Lagunas, Graciela Castro-Escarpulli, Armando Navarro-Ocaña, Gabriela Ibáñez-Cervantes, Laura Margarita Marquez-Valdelamar, José Hernández-Carrillo, Juana Salazar-Salinas, O.F Mendoza-Vásquez, Gabriel Damazo-Hernández 2020-01-31 2020-01-31 14 01 48 58 10.3855/jidc.11940 Etiology, treatment options and prognosis of abdominal abscesses: A tertiary hospital experience <p>Introduction: The principle of abdominal abscess treatment is drenage. However, whether this drainage is percutaneous or open surgery is the choice of the specialist or center. Recently, there have been reports indicating that percutaneous drainage is superior. In this study, patients followed up and treated in a ten-year period in our clinic were evaluated for both of the methods that we applied.</p> <p>Methodology: Cases of intra-abdominal abscess followed-up in a ten-year period were evaluated retrospectively. As well as some of the characteristics of the patients, the methods of drainage applied were recorded. The subjects who received percutaneous drainage and those undergoing open surgery were compared in terms of length of hospitalization, length of treatment and prognosis.</p> <p>Results: The most common abscess site was intraperitoneal, and the origins of the abscesses were often hospital-based. The most commonly isolated organism, at a level of 33.8%, was <em>Escherichia coli. </em>Percutaneous drainage was applied at source control in 49 (43.8%) patients and open surgery drainage in 60 (53.6%). However, length of hospitalization, length of treatment and duration of drainage catheter use were statistically significantly higher in the percutaneous drainage group. No significant difference was observed between the groups in terms of prognosis.</p> <p>Conclusion: We attribute these results in disagreement with the literature to more patients being recommended for percutaneous drainage due to the fact that these patients were thought to be incapable of tolerating open surgery and to the higher probability of additional disease and complications.</p> Fusun Zeynep Akcam Tennure Ceylan Onur Kaya Ergun Ceylan Omer Ridvan Tarhan Copyright (c) 2020 Fusun Zeynep Akcam, Tennure Ceylan, Onur Kaya, Ergun Ceylan, Omer Ridvan Tarhan 2020-01-31 2020-01-31 14 01 59 65 10.3855/jidc.11277 QuEChER method for air microbiological monitoring in hospital environments <p>Introduction: Nosocomial pathogens have become a priority issue for public health, since they are responsible for increased morbidity and mortality in hospitalized patients and the development of multi-resistant microorganisms, as well. Recent studies found strong evidence that airborne transmission plays a key role in many nosocomial infections. Thus, we aim to develop a QuEChER methodology for the characterization of airborne microbial levels, analyzing potential variables that modify the air microbiological load.</p> <p>Methodology: Particulate matter levels and suspended and settled bioaerosols were determined simultaneously employing optical sensors, Harvard impactors and settle plates, respectively. Environmental variables were also measured at different sites during different working shifts and seasons.</p> <p>Results: We found a straightforward relationship between airborne particles, air exchange rates, and people influx. Levels of suspended microorganisms were related to fine particulate matter concentration, CO<sub>2</sub> and ambient temperature. A positive linear relationship (R<sup>2</sup> = 0.9356) was also found between fine particulate matter and CO<sub>2</sub> levels and air microbial load.</p> <p>Conclusion: The QuEChER methodology is an effective methodology that could be used to improve the surveillance of nosocomial pathogens in developing countries hospitals where air quality is scarcely controlled.</p> Iván Tavera Busso Florencia Herrera María F Tames Ignacio González Gasquez Lilia N Camisassa Hebe A Carreras Copyright (c) 2020 Iván Tavera Busso, Florencia Herrera, María Florencia Tames, Ignacio González Gasquez , Lilia Norma Camisassa, Hebe Alejandra Carreras 2020-01-31 2020-01-31 14 01 66 73 10.3855/jidc.11563 Efficacy of infection control pathway in reducing postoperative infections in patients undergoing neurosurgery <p>Introduction: The environment of the operating room (OR) is closely related to the postoperative complications of patients, and it is necessary to study, to what extent, the stringent management of the OR can reduce postoperative complications.</p> <p>Methodology: 426 patients who underwent surgery between January 2016 and December 2017 were selected from two class-100 laminar flow ORs of equivalent area, and were divided into an experimental group and a control group.</p> <p>Results: The experimental group had significantly lower total air-borne bacterial count in the OR than the control group 10 minutes before surgery (6.21 ± 4.14 <em>vs</em>. 11.58 ± 5.36 CFU/cm<sup>3</sup>), 10 minutes (15.67 ± 6.21 <em>vs</em>. 20.83 ± 5.78 CFU/cm<sup>3</sup>), 30 minutes (27.34 ± 8.18 <em>vs</em>. 39.56 ± 7.86 CFU/cm<sup>3</sup>) and 60 minutes (43.62 ± 7.66 <em>vs</em>. 51.63 ± 8.43 CFU/cm<sup>3</sup>) into surgery, and at the end of surgery (57.34 ± 7.67 <em>vs</em>. 69.33 ± 9.41 CFU/cm<sup>3</sup>) (all <em>p </em>&lt; 0.05). The incidence rates of increased body temperature and leukocyte count 3 days post-surgery, and the duration of antibiotic therapy and hospital stay were significantly reduced in the experimental group compared to the control group (all <em>p</em> &lt; 0.05). Furthermore, the total number of pathogens in the incision at 2 hours into surgery was also significantly lower in the experimental group than in the control group (<em>p </em>&lt; 0.05).</p> <p>Conclusion: Stringent application of the infection control pathway is an efficacious measure for improving the air cleanliness of the neurosurgery OR, decreasing the incidence rates of postoperative complications and infection, as well as controlling pathogen transmission.</p> Chunli Dong Haozheng Yuan Renyan Xu Hui Zhang Lili He Weihong Qi Xin Zhang Copyright (c) 2020 xin zhang, Chunli Dong, Haozheng Yuan, Renyan Xu, Hui Zhang, Lili He, Weihong Qi 2020-01-31 2020-01-31 14 01 74 79 10.3855/jidc.11747 Prediction of sofosbuvir response using interleukin-6 serum level and single nucleotide polymorphism of interferon lambda- 4 <p>Introduction: In Egypt, 15% of the populations are suffering from chronic hepatitis C especially genotype 4. Sofosbuvir was approved by FDA in December 2013 for treatment of HCV genotypes 2 and 3 in combination with Ribavirin, and for genotypes 1 and 4 in combination with Peg-IFN. Recently, polymorphism of different genes and plasma levels of IL-6 were utilized for better prediction of HCV clearance. This study aimed at early prediction of the efficacy of HCV treatment with Sofosbuvir (Sovaldi) and comparing the antiviral efficacy of dual and triple Sovaldi combination therapy.</p> <p>Methodology: Blood samples were collected from 100 HCV positive patients and detected by real time PCR at three time intervals. SNP genotyping of INFL-4 gene was estimated by using real-time PCR with predesigned primers and Taqman probes. IL-6 serum level was estimated before, during and after the end of the treatment using ELISA assay based on human IL-6 KIT.</p> <p>Results: SNP genotyping of INFL-4 gene showed that 13.1% of patients carried ∆G/∆G, 30.4% patients had TT/TT and 56.5% patients possessed heterozygote allele ∆G/TT. Clinical data displayed that 13 patients were got relapsed at SVR 12. Serum level of IL-6 was noticed higher in HCV patients than healthy ones. Noteworthy, it was increased during treatment then decreased to a minimal level than begining of treatment.</p> <p>Conclusion: SNP in INFL-4 gene has displayed no effect in response to Sofosbuvir. Dual therapy had the same effect like triple therapy, so interferon could be withdrawn from the treatment regimen.</p> Amal E Saafan Ashraf Abobaker Mohamed S Abbas Ahmed El-Gendy Copyright (c) 2020 Amal Saafan, Ashraf Abobaker, Mohamed Abbas, Ahmed El-Gendy 2020-01-31 2020-01-31 14 01 80 88 10.3855/jidc.12013 Evaluation of cardiovascular risk factors in people living with HIV in São Paulo, Brazil <p>Introduction: HIV infection as a chronic disease has emerged from treatment advances over the past three decades. From this perspective, the diseases associated with AIDS are not a main threat for patients who use Antiretroviral Therapy (ART). A new set of HIV associated complications have emerged resulting in comorbidities related to aging and ART exposure as cardiovascular disease (CVD). This study aimed to evaluate the cardiovascular risk factors in people living with HIV (PLWH) in Brazil.</p> <p>Methodology: This was a cross-sectional study carried out at all Specialized Care Services for people living with HIV in the Southeast of Brazil. A sociodemographic and clinical questionnaire was used and cardiovascular risk assessed through the Framingham Score. Data analysis was performed by Chi-square, Fisher’s exact test and logistic regression.</p> <p>Results: The majority were male, over 40 years old and they showed a mean age of 44 years. Current hypertension, diabetes, altered body mass index, presence of metabolic syndrome and altered abdominal circumference were also associated with cardiovascular risk. After regression analysis, male sex, older age, smoking, diabetes, hypertension and metabolic syndrome were related as predictive factors for a higher cardiovascular risk.</p> <p>Conclusions: The results demonstrate that combination of the prevention of modifiable risk factors with considerable changes in lifestyle are determining factors for success in the therapeutic of PLWH. High levels of motivation are essential for behavioral changes, and nurses are ideally position to provide safe care with nonpharmacological strategies for CVD risk reduction.</p> Elizabete Santos Melo Marcela Antonini Christefany Régia Braz Costa William Sorensen Elucir Gir Renata Karina Reis Copyright (c) 2020 Elizabete Santos Melo, Marcela Antonini, Christefany Régiz Braz Costa, William Sorensen, Elucir Gir, Renata Karina Reis 2020-01-31 2020-01-31 14 01 89 96 10.3855/jidc.11326 Clinical comparison of two human papillomavirus detection assays: GenoFlow and reverse line blot <p>Introduction: Human papillomavirus (HPV) infection is typically critical in the oncogenesis of cervical cancer. However, available HPV detection kits differ in their ability and sensitivity to detect various types of HPV, and this variability has led to inconsistencies in the reporting of the geographic prevalence of HPV types, especially in developing countries. Here, we compared results of the recently developed GenoFlow HPV array test, which detects 33 HPV genotypes, to those of the well-established reverse line blot (RLB) assay, which detects 23 HPV types.</p> <p>Methodology: In total, 608 cervical specimens with cytology results ranging from normal to cancer were collected using an endocervical brush from women attending outpatient clinics in Riyadh, Saudi Arabia.</p> <p>Results: Sixty-nine specimens (11%) were positive for HPV. HPV genotype detection using the GenoFlow test had a sensitivity of 62% and a specificity of 100%. Overall agreement between the two HPV genotyping methods was 97%, with a concordance rate of 95%. Among the GenoFlow test results, 2% indicated additional HPV types that were not detected in the RLB assay, whereas the GenoFlow test missed 0.3% of the HPV types that were detected by the RLB; however, both tests were in agreement in detecting all major HPV types.</p> <p>Conclusion: The GenoFlow test was reliable, with results comparable to the RLB test. However, because the GenoFlow test is less labor-intensive and takes less total time (3 hours), it is a promising, affordable alternative to the RLB for HPV diagnosis and screening programs.</p> Fatimah S Alhamlan Hadeel H Khayat Dalia A Obeid Asma M Tulba Teejan S Baduwais Mohamed B Alfageeh Mohammed N Al-Ahdal Copyright (c) 2020 Fatimah Saeed Alhamlan, Hadeel Khayet, Dalia Obeid, Asma Tulba, Teejan Baduwais, Mohamed Alfageeh, Mohammed N. Al-Ahdal 2020-01-31 2020-01-31 14 01 97 103 10.3855/jidc.11769 Outbreak investigation of septicemic salmonellosis in calves <p>Introduction: An early and accurate diagnosis of septicemic salmonellosis is critical for implementing timely and proper treatment, prevention, and control measures.</p> <p>Methodology: Here, we report a study on three outbreaks of septicemic salmonellosis in calves from Midwestern Brazil.</p> <p>Results: the morbidity, mortality and lethality rates were of 10.55%, 2.79%, and 26.4%, respectively. Higher susceptibility was detected in <em>Bos taurus </em>than in <em>Bos indicus</em> cattle. Clinical manifestations consisted of apathy, hyperthermia, difficulty breathing and panting, and pallor of the mucous membranes. Chronic cases had necrosis of the tail tip and ears. Gross findings included enlarged liver, non-collapsed edematous lungs and diphtheritic enteritis. Significant histopathological changes included paratyphoid nodules in the liver and acute interstitial pneumonia. <em>Salmonella enterica </em>subsp. <em>enterica</em> serotype Dublin was detected by culture and by PCR from the blood of live calves, and from the spleen, liver, bile, mesenteric lymph node and lung samples of necropsied calves.</p> <p>Conclusions: We suggest that in clinical cases of septicemic salmonellosis, blood samples are better than fecal samples for detection of the agent, being a sound test to identify animal carriers in the herd.</p> Carolina C Guizelini Juliane F Tutija Dayane R Morais Flávia B Bacha Carlos A N Ramos Cássia R B Leal Maria E Zaquetti Ricardo A A Lemos Copyright (c) 2020 Carolina Guizelini, Juliane Franciele Tutija, Dayane Rodrigues de Morais, Flávia Barbieri Bacha, Carlos Alberto Nascimento Ramos, Cássia Rejane Brito Leal, Maria Eduarda Zaquetti, Ricardo Antonio Amaral de Lemos 2020-01-31 2020-01-31 14 01 104 108 10.3855/jidc.12087 Detection and quantification of Campylobacter spp. in Brazilian poultry processing plants <p>Introduction: Campylobacteriosis is considered the most common bacteria-caused human gastroenteritis in the world. Poultry is a major reservoir of <em>Campylobacter</em>. Human infection may occur by consumption of raw and undercooked poultry or by contamination of other foods by these items. The aim of this study was to assess the prevalence of <em>Campylobacter</em> spp. in poultry processing plants with conventional culture method and real-time PCR.</p> <p>Methodology: A total of 108 poultry processing plant samples were collected to test with conventional microbiology and qPCR. Sampling included cloacal swabs, swabs of transport crates (before and after the cleaning and disinfection process) and carcasses (after the chiller, cooled at 4°C and frozen at −12°C).</p> <p>Results: Positivity in cloacal swabs indicated that poultry arrived contaminated at the slaughterhouse. Contamination in transport cages was substantially increased after the cleaning process, indicating that the process was ineffective. The detection of <em>Campylobacter</em> on carcasses was higher than that on cloacal swabs, which could indicate cross-contamination during the slaughtering process. Conventional microbiology and molecular methods revealed a prevalence of 69.4% and 43.5%, respectively. Lower detection by qPCR can be attributed to the high specificity of the kit and to biological components that could inhibit PCR reactions.</p> <p>Conclusions: Our results indicate that poultry arrive contaminated at the slaughterhouse and that contamination can increase during the slaughtering process due to cross-contamination. The isolation of <em>Campylobacter</em> in cooled and frozen carcasses corroborates the bacterial survival even at temperatures considered limiting to bacterial growth which are routinely used for food preservation.</p> Karen A Borges Isabel C Cisco Thales Q Furian Denise C Tedesco Laura B Rodrigues Vladimir P do Nascimento Luciana R dos Santos Copyright (c) 2020 Karen Apellanis Borges, Isabel Cristina Cisco, Thales Quedi Furian, Denise Cristina Tedesco, Raíssa Canova, Laura Beatriz Rodrigues, Vladimir Pinheiro do Nascimento, Luciana Ruschel dos Santos 2020-01-31 2020-01-31 14 01 109 113 10.3855/jidc.11973 Furuncular myiasis in Italian traveler returning from Kenya <p>Myiasis has been defined as the infestation of organs and/or tissues with dipterous larvae. They are especially widespread in tropical and subtropical areas. Cutaneous myiasis is its most frequent clinical presentation. This report presents a case of furuncular myiasis caused by the larva of <em>Cordylobia anthropophaga </em>in a 22-year-old girl living in Bergamo, Northern Italy, who returned from Kenya (Watamu) with a big, painful furuncle in her right gluteus. The patient accidentally removed the larva from a large pimple and took it to the infectious disease ambulatory clinic at the ASST “Papa Giovanni XXIII” Hospital, Bergamo. In the Microbiology and Virology Department of the same hospital, a larva of<em> C. anthropophaga </em>was identified and the diagnosis of myiasis was confirmed.</p> Ester Oliva Graziano Bargiggia Gianpaolo Quinzan Paola Lanza Claudio Farina Copyright (c) 2020 Ester Oliva, Graziano Bargiggia, Gianpaolo Quinzan, Paola Lanza, Claudio F Farina 2020-01-31 2020-01-31 14 01 114 116 10.3855/jidc.11560