The Journal of Infection in Developing Countries <p>A peer-reviewed open access 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>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>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>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> An overview of respiratory syncytial virus infections in Saudi Arabia <p>Respiratory syncytial virus (RSV) is a major pathogen of acute respiratory tract infection (ARI) in different geographical regions including Saudi Arabia. Numerous hospital-based investigations have revealed the RSV prevalence between 0.2-54% in the paediatric population with ARI/ALRI from Saudi Arabia during 1991-2015. Maximum RSV infections occurred in children less than 1 year of age (51-97%) and male children (51-69%) were more commonly affected than females (31-49%). RSV infections are reported mostly during winter season suggesting seasonal distribution of the virus. Other respiratory viruses reported from this region are adenovirus, influenza, parainfluenza, human metapneumovirus and rhinovirus including many mixed infections. A few studies have reported the phylogenetic analysis of the circulating strains of RSV. These studies have revealed that circulating group A-RSV Saudi strains belonged to NA1 and ON1 genotypes and group B-RSV viruses clustered in the BA genotype. Molecular characterization of the Saudi strains was further carried out by mutational, selection pressure and glycosylation site analyses. We have compiled all the eighteen studies of RSV infection from Saudi Arabia in the form of this review and concluded that detailed comprehensive surveillance of RSV and other viruses in community and hospital settings is required. Information on the molecular characterization of currently circulating strains of RSV will contribute towards better understanding of the epidemiology and evolutionary dynamics of this viral pathogen. Moreover, the determination of the genetic composition of circulating RSV strains will be important during evaluation of initial vaccine trials.</p> Anwar Ahmed Shama Parveen Sarah M Al-Hassinah Salman F. Al-Amery ##submission.copyrightStatement## 2018-11-30 2018-11-30 12 11 929 936 10.3855/jidc.10736 Compliance with standard precautions during clinical training of nursing students in Saudi Arabia: A multi-university study <p>Introduction: Nursing students are susceptible to healthcare-associated infections because of their direct patient interactions during their clinical training. Hence, compliance with standard precautions (SPs) is paramount during their clinical exposure and training. This study investigated the compliance with SPs and its predictors among Saudi nursing students from six universities.</p> <p>Methodology: This descriptive, cross-sectional study was conducted in six government universities in Saudi Arabia. A convenience sample of 829 Bachelor of Science in Nursing (BSN) students was surveyed using the Compliance with Standard Precautions Scale. Descriptive and inferential statistics were carried out to analyze the data.</p> <p>Results: The overall compliance rate of the respondents was 60.1% with a mean score of 12.02 (SD = 4.50). The students reported highest compliance on covering the mouth and nose when wearing a mask, while the lowest compliance was on disposing sharps box before it is full. The university, academic year level, and attendance to infection prevention and control training or seminar in the last six months were identified as significant predictors of the students’ compliance with SPs.</p> <p>Conclusions: The findings provide valuable insights and guidance for improving the practice of SPs among future nurses, which could result in the reduction of infection exposure and its transmission rates among future nurses in clinical settings.</p> Farhan Alshammari Jonas Preposi Cruz Nahed Alquwez Joseph Almazan Fatmah Alsolami Hanan Tork Hawa Alabdulaziz Ebaa Marwan Felemban ##submission.copyrightStatement## 2018-11-30 2018-11-30 12 11 937 945 10.3855/jidc.10821 The antibiotic susceptibility patterns of uropathogens isolated in Qassim, Saudi Arabia‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬ <p>Introduction: Antimicrobial resistance is a global health problem. The present study was carried out to determine the prevalence and antibiotic resistance of uropathogens in the outpatient departments (OPDs) at the clinics of Qassim University, Saudi Arabia.</p> <p>Methods: A cross-sectional study was conducted from January to December 2016. Nonrepetitive midstream urine samples (1273) were cultured on standard culture media. Identification and susceptibility testing of causative microorganisms was performed using the fully automated VITEK 2 Compact system.</p> <p>Results: Out of the 1273 nonrepetitive urine samples, 418 (32.8%) exhibited significant growth of UTI-causing microbes, 377 (90.2%) of which were Gram-negative bacilli. The commonly isolated microorganisms were <em>Escherichia coli </em>(157, 37.6%),<em> Klebsiella pneumoniae</em> (70, 16.7%),<em> Proteus mirabilis</em> (17, 4.1%),<em> Pseudomonas aeruginosa</em> (24, 5.8%),<em> Enterobacter cloacae</em> (11, 2.6%),<em> Enterococcus faecalis</em> (12, 2.9%), and<em> Staphylococcus aureus</em> (14, 3.3%). Overall, drug resistance was observed in 91.3% (n=381/418) of the samples, with a majority (80%) exhibiting resistance to at least 2 drugs. Drug resistance was commonly observed against ampicillin (89.9%), oxacillin (75.6%), piperacillin (85.4%), clindamycin (56.1%), amoxicillin/clavulanic acid (74.5%) and trimethoprim/sulfamethoxazole (50.4%).</p> <p>Conclusion: The uropathogens <em>E. coli, K. pneumoniae </em>and<em> P. aeruginosa </em>and multidrug resistance pose serious therapeutic threats in the setting of this study. A concerted and systematic effort is required to rapidly identify high-risk patients and to reduce the burden of antimicrobial resistance in this region.</p> Osama Al Wutayd Abdullah Al Nafeesah Ishag Adam Ibrahim Babikir ##submission.copyrightStatement## 2018-11-30 2018-11-30 12 11 946 952 10.3855/jidc.10553 Epidemiology of extended-spectrum β-lactamase producing Escherichia coli from hospital settings in Yemen <p>Introduction: Infection with Extended spectrum β-lactamases (ESBLs) producing bacteria is considered as serious health problem worldwide. The aim of this cross-sectional study was to investigate the prevalence of ESBL producing <em>Escherichia coli</em> in hospitalized patients and the risk factors contributed for its nosocomial infections in addition to the antibiotics susceptibility patterns of isolates from 130 inpatients collected in Al Thawra General Hospital and Al-Kuwait University Hospital in Sana’a city.</p> <p>Methodology: Antibiotic susceptibility testing and confirmation of ESBL production were performed according to the Clinical and Laboratory Standards Institute guidelines.</p> <p>Results: Out of 130 <em>E. coli</em> isolates, 44 (33.8%) were ESBLs producers, the majority of ESBLs producers were in wound exudates samples (52.2%). The highest significant rates were among the elderly, patients with previous hospitalization, patients who have stayed in hospital more than 22 days, patients who have taken third generation cephalosporins as treatment and diabetic patients. All ESBL-producing isolates were resistant to amoxicillin, trimethoprim-sulfamethoxazole and the third generation cephalosporins (100%). Resistance to other antimicrobial agents among these isolates was: amoxicillin-clavulanic acid (90.9%), nalidixic acid (95.5%), ciprofloxacin (90.9%), ofloxacin (88.6%) and tetracycline (54.5%). The most effective antibiotics in vitro for both types of isolates (ESBL producing and non ESBL producing <em>E. coli</em>) were Imipenem (100%), Amikacin (75%) and (93.0%), respectively, and Pipracillin-tazobactam (68.2%) and (88.4%), respectively.</p> <p>Conclusion: ESBLs detection tests must be performed as routine work in all hospitals and laboratories. Furthermore, a strict adherence of infection control policies and procedures with continuous antibiotics resistance surveillance are important to prevent nosocomial infections.</p> Samar Nasher Sameer Alsharapy Anwar Al-Madhagi Fathiah Zakham ##submission.copyrightStatement## 2018-11-30 2018-11-30 12 11 953 959 10.3855/jidc.10560 A cross-sectional study on public belief, knowledge and practice towards antibiotic use in the state of Perak, Malaysia <p>Introduction: Inappropriate use of antibiotics has led to antimicrobial resistance, a major public health challenge worldwide. This study aimed to explore beliefs, knowledge, and practice on antibiotic use among general public.</p> <p>Methodology: Cross-sectional study was conducted at 13 hospitals and 44 primary health clinics in Perak from May to July 2017. Adults above 18 years, literate, and had experience in antibiotics consumption were selected through sequential sampling method. Data was collected using a self-administered questionnaire which included the three study domains i.e. belief, knowledge and practice. The questionnaire was pilot on 30 subjects.</p> <p>Results: Out of 2850 distributed questionnaires, 2773 returned and 2632 were included for analysis. Mean age of the respondents was 39.7 ± 14.5 years old. Most respondents were female (58.6%), Malay (74.7%) and underwent upper secondary school (45.6%). Mean score were generated for each domain with belief: 5.87 ± 3.00 (total score: 12), knowledge: 15.82 ± 3.85 (total score: 24), practice: 6.91 ± 2.07 (total score: 12). In the belief domain, 63.2% of respondents believed that antibiotics would help them to recover faster. In the knowledge domain, 52.7% of respondents inappropriately thought that antibiotics could work on viral infections. In the practice domain, 70% of respondents expected doctors to prescribe antibiotics if suffered from symptoms.</p> <p>Conclusion: Majority of the respondents expect doctors to prescribe antibiotics for their illness, and most believes that antibiotics can speed up recovery of illness. Lack of awareness on antibiotic resistance was found to be a significant factor associated with inappropriate antibiotic use.</p> Shea Jiun Choo Chee Tao Chang Jason Choong Yin Lee Valli Munisamy Chin Khai Tan Jasmine Daryl Raj Rosma Izzaty Mat Taib Kah Shuen Thong Asrul A Shafie ##submission.copyrightStatement## 2018-11-30 2018-11-30 12 11 960 969 10.3855/jidc.10723 Prevalence of virulence genes and their association with biofilm formation in VRE faecium isolates from Ahvaz, Iran <p>Introduction: Vancomycin-resistant <em>Enterococcus faecium</em> (VREfm) is a common cause of nosocomial infections. Biofilm formation is an important factor in recurrence of infections, facilitating transfer of genetic elements, leading to treatment failures. The aim of this study was to investigate the virulence genes in biofilm producing isolates and to determine possible association between biofilm formation and the presence of these genes; also to determine association between antibiotic susceptibility patterns of VREfm isolates and their biofilm formation ability.</p> <p>Methodology: A total of 57 isolates of VREfm were recovered from different sources of hospitals under Ahvaz University, Iran. The isolates were examined by conventional microbiological methods and molecular test using PCR. The antibiotic susceptibility patterns of the isolates were determined by disk-diffusion and E-test. The biofilm formation ability of the isolates was investigated by Modified Congo red agar and microtiter plate techniques. The presence of virulence genes was examined using Multiplex-PCR method.</p> <p>Results: Out of 57 VREfm isolates, 63.15% of isolates were biofilm producers. The frequency of biofilm producing isolates from clinical specimens, colonized patients and environmental sources were 78.26%, 60%, and 42.85%, respectively. The prevalence of <em>acm</em>, <em>esp</em> and <em>hyl</em> genes among biofilm producing isolates was 86.10%, 55.56% and 52.77%, respectively. There was statistically significant association between <em>esp</em> gene and biofilm formation among isolates from the clinical specimens.</p> <p>Conclusion: Clinical isolates producing biofilms showed a positive association with the presence of the <em>esp</em>. Our study further suggests that the link between virulence genes and biofilms is affected by the environmental context.</p> Saber Soltani Maniya Arshadi Muhammad Ibrahim Getso Farzaneh Aminharati Mahmood Mahmoudi Mohammad Reza Pourmand ##submission.copyrightStatement## 2018-11-30 2018-11-30 12 11 970 977 10.3855/jidc.10078 Prospective evaluation of vancomycin therapeutic usage and trough levels monitoring <p>Introduction: Vancomycin is the cornerstone of parenteral therapy for serious methicillin resistant <em>Staphylococcus aureus</em> infections. Optimal dosing of vancomycin is patient specific due to its narrow therapeutic window. The objective of this study is to evaluate the appropriate use of vancomycin focusing on the indication, dose, and therapeutic level monitoring.</p> <p>Methodology: A prospective observational study was conducted in a tertiary care hospital over a 3- month period. A data collection form was used to gather information on 93 patients receiving vancomycin. Study outcomes were assessment of the appropriateness of vancomycin indication, dose, and therapeutic trough level.</p> <p>Results: The use of vancomycin both empirically and after culture results was appropriate in 78.5 % of the patients. More than half of the patients (51.6 %) were given an inappropriate dose of vancomycin per actual body weight, creatinine clearance, and&nbsp; indication. Regarding therapeutic vancomycin monitoring, 69.0 % had inappropriate trough level monitoring. Only 15.7 % of the 166 measured troughs were within the target therapeutic level for the corresponding indication.</p> <p>Conclusion: This study demonstrates the high level of inappropriate use of vancomycin. This is mainly attributed to inappropriate dose and trough level monitoring. Interventions to improve vancomycin prescribing and monitoring practices are needed. The presence of an interdisciplinary team may improve the appropriate use of medications with a narrow therapeutic index such as vancomycin.</p> Wissam K Kabbara Ghada El-Khoury Nour R Chamas ##submission.copyrightStatement## 2018-11-30 2018-11-30 12 11 978 984 10.3855/jidc.9800 Antibiogram and genetic relatedness of clinical isolates of Enterococcus spp. in Mangalore, India <p>Introduction: Drug-resistant <em>Enterococcus</em> species is a persisting clinical problem and may serve as a reservoir of resistant genes. The present study was undertaken in Mangalore, India to know the antibiogram and genetic relatedness of <em>Enterococcus</em> spp. isolated from clinical samples.</p> <p>Methodology: A total of 150 non–repetitive <em>Enterococcus</em> spp. isolated from clinical samples were subjected to antimicrobial susceptibility testing by Kirby Bauer disk diffusion method. Molecular typing of the isolates was done by Random amplification of polymorphic DNA (RAPD).</p> <p>Results: Among the 150 isolates, 79 were from urine, 68 from pus and three from blood samples. Of this 58.7 % were <em>E. faecalis</em> and the remaining were <em>E. faecium</em>. Urinary isolates of <em>E. faecium</em> showed a higher percentage of antibiotic resistance when compared to <em>E. faecium </em>isolates from pus (p &lt; 0.001). <em>E. faecium</em> from blood samples were resistant to ampicillin, penicillin, ciprofloxacin and were sensitive to vancomycin and teicoplanin. <em>E. faecalis </em>blood isolates were resistant to ciprofloxacin, penicillin, and erythromycin. 73% of <em>Enterococcus </em>isolates from pus were resistant to erythromycin. All the <em>Enterococcus</em> spp. were sensitive to vancomycin. Among the total <em>Enterococcus</em> isolates 44 were high-level aminoglycoside resistant (HLAR) by disc diffusion method which corresponded to MIC of &gt; 500 µg/mL for gentamicin and &gt; 1000 µg/mL for streptomycin. These isolates were subjected to RAPD, which showed similarity and differences in the banding patterns.</p> <p>Conclusions: Our study showed a baseline resistance among <em>Enterococcus </em>spp. in our area, which poses a challenge to the treating physicians and a reservoir for transmission of antibiotic resistant genes.</p> Prathvi P Nayak Dhanashree Biranthabail Shalini Shenoy Shashidhar M Kotian ##submission.copyrightStatement## 2018-11-30 2018-11-30 12 11 985 990 10.3855/jidc.9966 Comparison of azithromycin vs doxycycline prophylaxis in leptospirosis, A randomized double blind placebo-controlled trial <p>Introduction: Leptospirosis is an important zoonotic disease in paddy field with 29.5% prevalence rate in Mazandaran province and 4% to 52% mortality rate among hospitalized patients. Prevention is an important strategy for the control of this disease. This study aimed to compare the prophylactic effect of azithromycin versus doxycycline against leptospirosis in an endemic area in north of Iran.</p> <p>Methodology: In this randomized double-blind placebo-controlled trial, paddy field workers (n = 187) were randomized to receive azithromycin (500mg weekly), doxycycline (200 mg weekly) or placebo starting one week before exposure to paddy field, during and to four weeks after. Paddy field workers aged 18- 65 years who signed the informed consent form were assessed for signs and symptoms of leptospirosis in addition to serologic evidence of the disease 6th and 12th week. Data were analyzed with SPSS version 13 using Chi-square and Fisher exact test and ANOVA.</p> <p>Results: From June to September 2016, 187 participants were entered the study to receive azithromycin (n = 66), doxycycline (n = 71) or placebo (n = 50). In terms of preventing against clinical leptospirosis, there was not any significant difference between three arms, though there was statistically significant difference of seropositivity after 6 and 12 weeks in comparison to baseline among all three groups (P = 0.029) and between active treatment (eg. azithromycin and doxycycline) groups and placebo group (P = 0.01).</p> <p>Conclusion: Azithromycin like doxycycline decreased seropositivity without significant effect on clinical leptospirosis.</p> Ahmad Alikhani Ebrahim Salehifar Fatemeh Zameni Alireza Rafiei Jamshid Yazdani-charati Leila Delavaryan Azita Akbari Farhang Babamahmoudi ##submission.copyrightStatement## 2018-11-30 2018-11-30 12 11 991 995 10.3855/jidc.10126 In vitro activity of essential oils against Pseudomonas aeruginosa isolated from infected hip implants <p>Introduction: Essential oils have been used since ancient times and are known for their anti-inflammatory, anti-depressive, antiseptic, antifungal and antimicrobial properties.</p> <p>Methodology: in this study the antimicrobial activity of two essential oils from <em>Melaleuca alternifolia </em>and <em>Thymus vulgaris–red thyme geraniol</em> was tested against 16 multidrug-resistant <em>P. aeruginosa</em> strains from infected hip implants as well as the “<em>in vitro”</em> cytotoxic activity on normal human Wong-Kilbourne derivative (WKD) cells.</p> <p>Results: <em>Thymus vulgaris–red thyme geraniol</em> showed lower antimicrobial activity when compared to <em>Melaleuca alternifolia</em>. All tested oils were cytotoxic at concentrations lower than 0.12%.</p> <p>Conclusion: Increase in drug resistance and lack of new antibiotics may encourage the development of natural treatments together with higher concern on environmental issues and natural lifestyle.</p> Veronica Amorese Matthew Donadu Donatella Usai Angelino Sanna Fabio Milia Francesco Pisanu Paola Molicotti Stefania Zanetti Carlo Doria ##submission.copyrightStatement## 2018-11-30 2018-11-30 12 11 996 1001 10.3855/jidc.10988 Hepatitis B vaccination in Burkina Faso: prevalence of HBsAg carriage and immune response in children in the western region <p>Introduction: Hepatitis B virus (HBV) infection remains a major health problem in Burkina Faso. To control and prevent HBV infection, Hepatitis B vaccine was introduced in the national expanded program in 2006. In this study, we evaluated the prevalence of HBsAg in children aged under 10 years after one decade of universal hepatitis B vaccination, and the immune response among these children.</p> <p>Methodology: Between May and October 2015, a cross-sectional study was conducted among children in two primary healthcare centers in the western region of Burkina Faso. Participants were enrolled in Accart-Ville Healthcare Center in Bobo-Dioulasso (urban area) and the Healthcare Center of the village of Djigouera (rural area). Blood samples were collected from all children and analysed for the presence of HBsAg and anti-HBs antibodies (Abs). For HBsAg positive children, blood samples were also taken among their mothers for screening for HBsAg.</p> <p>Results: A total of 265 children were included in this study. The mean age was 4.4 years. HBsAg was found in 3.4% (9/265) of children. Of the 9 HBsAg positive children, 5 had HBsAg positive mothers. From the 265 children tested for quantification of anti-HBs Ab titer, 219 (82.6%) were fully vaccinated and 135 (61.6%) of them had an anti-HBs ≥ 10 mIU/mL.</p> <p>Conclusion: Despite a good vaccination coverage (82.6%), a considerable proportion of vaccinated children remains unprotected from HBV infection. That emphasizes the need for further strengthening of the vaccination program through implementing the birth dose of HBV vaccine as recommended by WHO.</p> Armel Moumouni Sanou Abdoul Kader Ilboudo Clément Ziemlé Meda Augustin Togozia Abou Coulibaly Assana Cisse Tani Sagna Dramane Kania Zekiba Tarnagda ##submission.copyrightStatement## 2018-11-30 2018-11-30 12 11 1002 1008 10.3855/jidc.10433 Impact of HBV and HCV coinfection on CD4 cells among HIV-infected patients: a longitudinal retrospective study <p>Introduction: The impact of hepatitis B virus (HBV) and hepatitis C virus (HCV) coinfection on CD4 cells in patients with human immunodeficiency virus (HIV) is unclear. We aimed to examine the impact of HBV and HCV coinfection on CD4 cell count and CD4/CD8 ratio in adults with HIV.</p> <p>Methodology: We conducted a longitudinal retrospective study in Brazil between January 1, 2002, and June 30, 2016, including 205 patients with HIV monoinfection, 37 with HIV-HBV coinfection, 35 with HIV-HCV coinfection, and 62 with HIV-HCV (48 HCV genotype 1 and 14 HCV genotype 3).</p> <p>Results: Median duration of follow-up was 2,327 (interquartile range: 1,159–3,319) days. An increased CD4 cell count and CD4/CD8 ratio over time was observed in all groups receiving combined antiretroviral therapy (cART). Patients with HIV-HBV or HIV-HCV coinfection and those with HIV monoinfection, showed comparable CD4 cell counts and CD4/CD8 ratios during pre-ART. There was also no statistically significant difference in CD4/CD8 ratio between HIV-HBV or HIV-HCV coinfection groups and the HIV monoinfection group during follow-up on cART. However, CD4 cell counts were significantly lower in HIV-HCV patients than in HIV monoinfection patients during follow-up on cART. HIV patients with HCV genotype 3 coinfection showed significantly lower CD4/CD8 ratio during follow-up on cART than those coinfected with HCV genotype 1 coinfection. No statistically significant effect of coinfection was observed on the efficacy of cART.</p> <p>Conclusions: HIV-infected patients are more likely to show better immunological responses to cART when they are not coinfected with HCV.</p> Claudinei Mesquita da Silva Leyde Daiane de Peder Eraldo S Silva Isolde Previdelli Omar Cleo Neves Pereira Jorge Juarez Vieira Teixeira Dennis Armando Bertolini ##submission.copyrightStatement## 2018-11-30 2018-11-30 12 11 1009 1018 10.3855/jidc.10035 Spatial clustering of onchocerciasis in Bioko Island, Equatorial Guinea <p>Introduction: Onchocerciasis is a chronic neglected tropical disease caused by the filarial nematode <em>Onchocerca volvulus</em>, which is endemic in Equatorial Guinea. The aim was to estimate the current spatial distribution of onchocerciasis, and its related factors, in Bioko Island after several years of mass drug administration and vector control activities, by using GIS technics.</p> <p>Methodology: The survey was carried out within the framework of a wider research project entitled “Strengthening the National Programme for Control of Onchocerciasis and other Filariasis in Equatorial Guinea”. A structured questionnaire was designed to cover basic socio-demographic information and risk factors for onchocerciasis and the coordinates of household. the hydrographic network data to calculate the positive onchocerciasis rate was used. Poisson generalized linear model was used to explore the association between onchocerciasis and the following covariates: distance to the river, preventive practices, water source and household´s main source of income. Two different cluster analysis methods were used: Getis-Ord Gi statistic and SaTScan™ purely spatial statistic estimator.</p> <p>Results: The risk of onchocerciasis was higher for those who drank water from external sources (RR 25.3) than for those who drank home tap water (RR 8.0). The clusters with z-score higher were located at the east of the island. For 5 km and 1 km distances, one significant cluster in the east was detected (RR 5.91 and RR 7.15).</p> <p>Conclusion: No environmental factors related with onchocerciasis were found, including proximity to rivers. This could be partially explained by the fact that the vector was eliminated in 2005.</p> Diana Gómez-Barroso Laura Moya Zaida Herrador Belén García Justino Nguema Policarpo Ncogo Pilar Aparicio Agustín Benito ##submission.copyrightStatement## 2018-11-30 2018-11-30 12 11 1019 1025 10.3855/jidc.10159 Stunting and intestinal parasites in school children from high marginalized localities at the Mexican southeast <p>Introduction: Children under five years of age from developing countries are in risk of not achieving an adequate human development due to stunting and extreme poverty. They were also affected by intestinal helminths. Inhabitants of the state of Chiapas, the poorest population in Mexico, register the highest prevalence of child malnutrition as well as intestinal parasitic infections. With the purpose of fight against poverty and hunger, the Mexican government launched a social program called “Prospera”. The aim of this work was to determine the prevalence of stunting and intestinal parasites in school children beneficiaries of that social program, from two marginalized municipalities of Chiapas, Mexico.</p> <p>Methodology: A total of 106 school-age children were recruited for nutritional assessment as well parasitic load measures.</p> <p>Results: Most children exhibited stunting (88.7%). In these children the prevalence of intestinal parasites was 32.1%, being <em>A. lumbricoides</em> the species with the highest prevalence (25.5%) with moderate parasitic load (15.1%). Positive associations were observed between the presence of intestinal parasites and the municipality where children lived, the type of footwear, or the educational level of the mother.</p> <p>Conclusions: Extreme poverty conditions in these localities of Mexico are far from reaching the sustainable development goals.</p> Carolina Cruz-Cruz Dolores López-Hernández Juan Antonio Hernández-Shilón Lorena Mercedes Luna-Cazáres Jorge E Vidal Javier Gutiérrez-Jiménez ##submission.copyrightStatement## 2018-11-30 2018-11-30 12 11 1026 1033 10.3855/jidc.10481 Prevalence of Salmonella spp. in poultry carcasses samples collected in slaughterhouses of Southern Brazil from 2006 to 2015 <p>Introduction: This study aimed to evaluate the prevalence of <em>Salmonella</em> on poultry carcasses produced in slaughterhouses of Southern Brazil participating of the Official Pathogen Reduction Program conducted by the Ministry of Agriculture, Livestock, and Supply.</p> <p>Methodology: From 2006 to 2015, 77,165 poultry carcasses were analyzed for presence/absence of <em>Salmonella</em> spp. and the results were statistically evaluated.</p> <p>Results: Prevalence varied from 2.92% to 5.24%, with a mean percentage of 4.04%. The difference in prevalence numbers was not significant during all the period analyzed. Higher <em>Salmonella</em> prevalence has been reported worldwide, indicating the efficacy of Brazilian control measures implemented in the productive chain and the low risk associated to Brazilian poultry meat consumption. However, additional information about the acceptable and safe prevalence of <em>Salmonella</em> on poultry should be defined by risk analysis studies, considering the reality of Brazilian companies and scientific data.</p> <p>Conclusions: The results of the present study can be the first step for a national Risk Assessment and may contribute to improvements in self-controlling programs and with the current Brazilian poultry regulation.</p> Mateus Silva de Lima Leonardo Werlang Isolan Claudia Titze Hessel João Pedro Pessoa Eduardo Cesar Tondo ##submission.copyrightStatement## 2018-11-30 2018-11-30 12 11 1034 1038 10.3855/jidc.10290 Wide spread of OXA-48-producing Enterobacteriaceae in Algerian hospitals: A four years’ study <p>Introduction: The aim of this study was to investigate the presence of carbapenemase-producing Enterobacteriaceae (CPE) in Algerian hospitals and to characterize the molecular types of carbapenemases found.</p> <p>Methodology: During a four years study lasting between 2012 and 2015, 81 strains of Enterobacteriaceae with reduced susceptibility to carbapenems were collected from different hospitals. Carbapenemase genes were detected by PCR. Multi locus sequence typing was used to study genetic relationships between carbapenemase- producing <em>Klebsiella pneumoniae</em> isolates.</p> <p>Results: Among 56 confirmed CPE, <em>bla</em><sub>OXA-48 </sub>was detected in 98.21% of isolates. Two isolates co-expressed NDM, and a single one was only an NDM producer. The strains displayed various susceptibility patterns to antibiotics with variable levels of resistance to carbapenems. Multilocus sequence typing (MLST) revealed the presence of multiple sequence types in circulation.</p> <p>Conclusions: This report highlights the wide distribution of several clones of OXA-48-producing Enterobacteriaceae in Algeria. Urgent action should be taken to avoid epidemic situations.</p> Nadjet Aggoune Hassiba Tali Maamar Farida Assaous Badia Guettou Rym Laliam Nabila Benamrouche Ali Zerouki Malek Naim Kheira Rahal ##submission.copyrightStatement## 2018-11-30 2018-11-30 12 11 1039 1044 10.3855/jidc.9692