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  1. Article ; Online: Antibiotic Use and Treatment Outcomes among Children with Community-Acquired Pneumonia Admitted to a Tertiary Care Public Hospital in Nepal

    Bhishma Pokhrel / Tapendra Koirala / Dipendra Gautam / Ajay Kumar / Bienvenu Salim Camara / Saw Saw / Sunil Kumar Daha / Sunaina Gurung / Animesh Khulal / Sonu Kumar Yadav / Pinky Baral / Meeru Gurung / Shrijana Shrestha

    Tropical Medicine and Infectious Disease, Vol 6, Iss 55, p

    2021  Volume 55

    Abstract: In the era of growing antimicrobial resistance, there is a concern about the effectiveness of first-line antibiotics such as ampicillin in children hospitalized with community-acquired pneumonia. In this study, we describe antibiotic use and treatment ... ...

    Abstract In the era of growing antimicrobial resistance, there is a concern about the effectiveness of first-line antibiotics such as ampicillin in children hospitalized with community-acquired pneumonia. In this study, we describe antibiotic use and treatment outcomes among under-five children with community-acquired pneumonia admitted to a tertiary care public hospital in Nepal from 2017 to 2019. In this cross-sectional study involving secondary analysis of hospital data, there were 659 patients and 30% of them had a history of prehospital antibiotic use. Irrespective of prehospital antibiotic use, ampicillin monotherapy (70%) was the most common first-line treatment provided during hospitalization followed by ceftriaxone monotherapy (12%). The remaining children (18%) were treated with various other antibiotics alone or in combination as first-line treatment. Broad-spectrum antibiotics such as linezolid, vancomycin, and meropenem were used in less than 1% of patients. Overall, 66 (10%) children were required to switch to second-line treatment and only 7 (1%) children were required to switch to third-line treatment. Almost all (99%) children recovered without any sequelae. This study highlights the effectiveness of ampicillin monotherapy in the treatment of community-acquired pneumonia in hospitalized children in a non-intensive care unit setting.
    Keywords community-acquired pneumonia ; CAP ; antibiotic use ; treatment outcome ; operational research ; SORT IT ; Medicine ; R
    Subject code 360
    Language English
    Publishing date 2021-04-01T00:00:00Z
    Publisher MDPI AG
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  2. Article ; Online: COVID-19 vaccine effectiveness and variants in Nepal

    Andrew J Pollard / Grace Li / Sarah Kelly / Merryn Voysey / Sanjeev M Bijukchhe / Peter J O'Reilly / Katherine Theiss-Nyland / Meeru Gurung / Bhishma Pokhrel / Samita Acharya / Shreekrishna Maharjan / Ashis Shrestha / Bimal Pandey / Mipsang Lama / Ira Shrestha / Agnes Eordogh / Sonu Shrestha / Elaine Shuo Feng / Ganesh Shah /
    Shrijana Shrestha

    BMJ Open, Vol 13, Iss

    study protocol for a test-negative case–control study with SARS-CoV-2 genetic sequencing

    2023  Volume 4

    Abstract: Introduction Inactivated, viral vector and mRNA vaccines have been used in the Nepali COVID-19 vaccination programme but there is little evidence on the effectiveness of these vaccines in this setting. The aim of this study is to describe COVID-19 ... ...

    Abstract Introduction Inactivated, viral vector and mRNA vaccines have been used in the Nepali COVID-19 vaccination programme but there is little evidence on the effectiveness of these vaccines in this setting. The aim of this study is to describe COVID-19 vaccine effectiveness in Nepal and provide information on infections with SARS-CoV-2 variants.Methods and analysis This is a hospital-based, prospective test-negative case–control study conducted at Patan Hospital, Kathmandu. All patients >18 years of age presenting to Patan Hospital with COVID-19-like symptoms who have received a COVID-19 antigen/PCR test are eligible for inclusion. The primary outcome is vaccine effectiveness of licensed COVID-19 vaccines against laboratory-confirmed COVID-19 disease.After enrolment, information will be collected on vaccine status, date of vaccination, type of vaccine, demographics and other medical comorbidities. The primary outcome of interest is laboratory-confirmed SARS-CoV-2 infection. Cases (positive for SARS-CoV-2) and controls (negative for SARS-CoV-2) will be enrolled in a 1:4 ratio. Vaccine effectiveness against COVID-19 disease will be analysed by comparing vaccination status with SARS-CoV-2 test results.Positive SARS-CoV-2 samples will be sequenced to identify circulating variants and estimate vaccine effectiveness against common variants.Measuring vaccine effectiveness and identifying SARS-CoV-2 variants in Nepal will help to inform public health efforts. Describing disease severity in relation to specific SARS-CoV-2 variants and vaccine status will also inform future prevention and care efforts.Ethics and dissemination Ethical approval was obtained from the University of Oxford Tropical Ethics Committee (OxTREC) (ref: 561-21) and the Patan Academy of Health Sciences Institutional Review Board (ref: drs2111121578). The protocol and supporting study documents were approved for use by the Nepal Health Research Council (NHRC 550-2021). Results will be disseminated in peer-reviewed journals and to the public health ...
    Keywords Medicine ; R
    Subject code 360
    Language English
    Publishing date 2023-04-01T00:00:00Z
    Publisher BMJ Publishing Group
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  3. Article ; Online: Laboratory and molecular surveillance of paediatric typhoidal Salmonella in Nepal

    Carl D Britto / Zoe A Dyson / Sebastian Duchene / Michael J Carter / Meeru Gurung / Dominic F Kelly / David R Murdoch / Imran Ansari / Stephen Thorson / Shrijana Shrestha / Neelam Adhikari / Gordon Dougan / Kathryn E Holt / Andrew J Pollard

    PLoS Neglected Tropical Diseases, Vol 12, Iss 4, p e

    Antimicrobial resistance and implications for vaccine policy.

    2018  Volume 0006408

    Abstract: Children are substantially affected by enteric fever in most settings with a high burden of the disease, including Nepal. However pathogen population structure and transmission dynamics are poorly delineated in young children, the proposed target group ... ...

    Abstract Children are substantially affected by enteric fever in most settings with a high burden of the disease, including Nepal. However pathogen population structure and transmission dynamics are poorly delineated in young children, the proposed target group for immunization programs. Here we present whole genome sequencing and antimicrobial susceptibility data on 198 S. Typhi and 66 S. Paratyphi A isolated from children aged 2 months to 15 years of age during blood culture surveillance at Patan Hospital, Nepal, 2008-2016.S. Typhi was the dominant agent and comprised several distinct genotypes, dominated by 4.3.1 (H58). The heterogeneity of genotypes in children under five was reduced compared to data from 2005-2006, attributable to ongoing clonal expansion of H58. Most isolates (86%) were non-susceptible to fluoroquinolones, associated mainly with S. Typhi H58 lineage II and S. Paratyphi A harbouring mutations in the quinolone resistance-determining region (QRDR); non-susceptible strains from these groups accounted for 50% and 25% of all isolates. Multi-drug resistance (MDR) was rare (3.5% of S. Typhi, 0 S. Paratyphi A) and restricted to chromosomal insertions of resistance genes in H58 lineage I strains. Temporal analyses revealed a shift in dominance from H58 Lineage I to H58 Lineage II, with the latter being significantly more common after 2010. Comparison to global data sets showed the local S. Typhi and S. Paratyphi A strains had close genetic relatives in other South Asian countries, indicating regional strain circulation. Multiple imports from India of ciprofloxacin-resistant H58 lineage II strains were identified, but these were rare and showed no evidence of clonal replacement of local S. Typhi.These data indicate that enteric fever in Nepal continues to be a major public health issue with ongoing inter- and intra-country transmission, and highlights the need for regional coordination of intervention strategies. The absence of a S. Paratyphi A vaccine is cause for concern, given its prevalence as a ...
    Keywords Arctic medicine. Tropical medicine ; RC955-962 ; Public aspects of medicine ; RA1-1270
    Subject code 630
    Language English
    Publishing date 2018-04-01T00:00:00Z
    Publisher Public Library of Science (PLoS)
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  4. Article ; Online: Multi-serotype pneumococcal nasopharyngeal carriage prevalence in vaccine naïve Nepalese children, assessed using molecular serotyping.

    Rama Kandasamy / Meeru Gurung / Anushil Thapa / Susan Ndimah / Neelam Adhikari / David R Murdoch / Dominic F Kelly / Denise E Waldron / Katherine A Gould / Stephen Thorson / Shrijana Shrestha / Jason Hinds / Andrew J Pollard

    PLoS ONE, Vol 10, Iss 2, p e

    2015  Volume 0114286

    Abstract: Invasive pneumococcal disease is one of the major causes of death in young children in resource poor countries. Nasopharyngeal carriage studies provide insight into the local prevalence of circulating pneumococcal serotypes. There are very few data on ... ...

    Abstract Invasive pneumococcal disease is one of the major causes of death in young children in resource poor countries. Nasopharyngeal carriage studies provide insight into the local prevalence of circulating pneumococcal serotypes. There are very few data on the concurrent carriage of multiple pneumococcal serotypes. This study aimed to identify the prevalence and serotype distribution of pneumococci carried in the nasopharynx of young healthy Nepalese children prior to the introduction of a pneumococcal conjugate vaccine using a microarray-based molecular serotyping method capable of detecting multi-serotype carriage. We conducted a cross-sectional study of healthy children aged 6 weeks to 24 months from the Kathmandu Valley, Nepal between May and October 2012. Nasopharyngeal swabs were frozen and subsequently plated on selective culture media. DNA extracts of plate sweeps of pneumococcal colonies from these cultures were analysed using a molecular serotyping microarray capable of detecting relative abundance of multiple pneumococcal serotypes. 600 children were enrolled into the study: 199 aged 6 weeks to <6 months, 202 aged 6 months to < 12 months, and 199 aged 12 month to 24 months. Typeable pneumococci were identified in 297/600 (49.5%) of samples with more than one serotype being found in 67/297 (20.2%) of these samples. The serotypes covered by the thirteen-valent pneumococcal conjugate vaccine were identified in 44.4% of samples containing typeable pneumococci. Application of a molecular serotyping approach to identification of multiple pneumococcal carriage demonstrates a substantial prevalence of co-colonisation. Continued surveillance utilising this approach following the introduction of routine use of pneumococcal conjugate vaccinates in infants will provide a more accurate understanding of vaccine efficacy against carriage and a better understanding of the dynamics of subsequent serotype and genotype replacement.
    Keywords Medicine ; R ; Science ; Q
    Subject code 380
    Language English
    Publishing date 2015-01-01T00:00:00Z
    Publisher Public Library of Science (PLoS)
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  5. Article ; Online: Impact of infection on proteome-wide glycosylation revealed by distinct signatures for bacterial and viral pathogens

    Esther Willems / Jolein Gloerich / Anouk Suppers / Michiel van der Flier / Lambert P. van den Heuvel / Nicole van de Kar / Ria H.L.A. Philipsen / Maurice van Dael / Myrsini Kaforou / Victoria J. Wright / Jethro A. Herberg / Federico Martinon Torres / Michael Levin / Ronald de Groot / Alain J. van Gool / Dirk J. Lefeber / Hans J.C.T. Wessels / Marien I. de Jonge / Amina Abdulla /
    Christoph Aebi / Koen van Aerde / Rachel Agbeko / Philipp Agyeman / Umberto D’alessandro / Ladan Ali / Wynand Alkema / Karen Allen / Fernando Álvez González / Suzanne Anderson / Imran Ansari / Tasnim Araf / Tanja Avramoska / Bryan Baas / Natalija Bahovec / Cristina Balo Farto / Anda Balode / A.M. Barendregt / Ruth Barral-Arca / María Barreiro Castro / Arta Bārzdiņa / David Bath / Sebastian Bauchinger / Lucas Baumard / Hinrich Baumgart / Frances Baxter / Ashley Bell / Kathryn Bell / Xabier Bello / Evangelos Bellos / Martin Benesch / Mirian Ben García / Joshua Bennet / Christoph Berger / J.M. van den Berg / Sara Bernhard-Stirnemann / Sagida Bibi / Christoph Bidlingmaier / Alexander Binder / Vera Binder / Kalifa Bojang / Dorine M. Borensztajn / Ulrich von Both / Karen Brengel-Pesce / Bryan van den Broek / Judith Buschbeck / Leo Calvo-Bado / Sandra Carnota / Enitan D. Carrol / Michael J. Carter / Miriam Cebey-López / Samba Ceesay / Astrid Ceolotto / Adora Chan / Elizabeth Cocklin / Kalvin Collings / Stephen Crulley / Aubrey Cunnington / María José Curras-Tuala / Katharina Danhauser / Saffiatou Darboe / Sarah Darnell / Tisham De / Dārta Deksne / Kirsty Devine / Juan Emmanuel Dewez / Julia Dudley / Carlos Durán Suárez / Ernst Eber / Irini Eleftheriou / Marieke Emonts / Daniel Fabian / Tobias Feuchtinger / Katy Fidler / Colin Fink / A.M. van Furth / Rachel Galassini / Siegfried Gallistl / Luisa García Vicente / Dace Gardovska / J. Geissler / G.P.J.M. Gerrits / Eric Giannoni / Ilona van der Giessen / Alberto Gómez-Carballa / Jose Gómez Rial / Gunther Gores / Dagne Grāvele / Matthias Griese / Ilze Grope / Meeru Gurung / L. de Haan / Nikolaus Haas / Dominic Habgood-Coote / Nienke N. Hagedoorn / Harald Haidl / Shea Hamilton / Almuthe Hauer / J. Heidema / Ulrich Heininger / Stefanie Henriet / Jethro Herberg / Clive Hoggart / Susanne Hösele / Sara Hourmat / Christa Hude / Martijn Huijnen / Heather Jackson / Rebecca Jennings / Joanne Johnston / Ilse Jongerius / Rikke Jorgensen / Christian Kahlert / Rama Kandasamy / Matthias Kappler / Julia Keil / Markus Keldorfer / Dominic F. Kell / Eunjung Kim / Sharon King / Lieke Kloosterhuis / Daniela S. Kohlfürst / Benno Kohlmaier / Laura Kolberg / Mojca Kolnik / Larissa Krenn / Taco Kuijpers / M. van der Kuip / Pilar Leboráns Iglesias / Simon Leigh / Manuel Leitner / M. van Leur / Emma Lim / Naomi Lin / Ching-Chuan Liu / Sabine Löffler / Eberhard Lurz / Ian Maconochie / Christine Mackerness / François Mallet / Federico Martinón-Torres / Antonis Marmarinos / Alex Martin / Mike Martin / José María Martinón Sánchez / Nazareth Martinón-Torres / Paul McAlinden / Anne McDonnell / Sam McDonald / C.J. Miedema / Anija Meiere / Stephanie Menikou / G. van Mierlo / Alec Miners / Ravi Mistry / Henriëtte A. Moll / Marine Mommert / Belén Mosquera Pérez / David R. Murdoch / Sobia Mustafa / Giancarlo Natalucci / C. Neeleman / Karen Newall / Samuel Nichols / Tobias Niedrist / Anita Niederer-Loher / Ruud Nijman / Ieva Nokalna / Urzula Nora Urbāne / Gudrun Nordberg / C.C. Obihara / Daniel O'Connor / Wilma Oosthoek / Veronika Osterman / Alexandre Pachot / D. Pajkrt / Jacobo Pardo-Seco / Stéphane Paulus / Jana Pavāre / Ivonne Pena Paz / Salina Persand / Andreas Pfleger / Klaus Pfurtscheller / Ria Philipsen / Ailsa Pickering / Benjamin Pierce / Heidemarie Pilch / Lidia Piñeiro Rodríguez / Sara Pischedda / Tina Plankar Srovin / Marko Pokorn / Andrew J. Pollard / Lena Pölz / Klara M. Posfay-Barbe / Petra Prunk / Zanda Pučuka / Glorija Rajic / Aqeela Rashid / Lorenzo Redondo-Collazo / Christa Relly / Irene Rivero Calle / Sara Rey Vázquez / Mathew Rhodes / Vivien Richmond / Thomas Riedel / Anna RocaIsatou Sarr / Siegfried Rödl / Carmen Rodríguez-Tenreiro / Sam Romaine / Emily Rowlands / Miguel Sadiki Ora / Manfred G. Sagmeister / Momodou Saidykhan / Antonio Salas / Luregn J. Schlapbach / D. Schonenberg / Fatou Secka / Katrīna Selecka / Sonia Serén Fernández / Cristina Serén Trasorras / Priyen Shah / Ching-Fen Shen / Shrijana Shrestha / Aleksandra Sidorova / Andrea Skrabl-Baumgartner / Giselle D’Souza / Matthias Sperl / Evelien Sprenkeler / Nina A. Schweintzger / Laura Stampfer / Molly Stevens / Martin Stocker / Volker Strenger / Dace Svile / Kelly Syggelou / Maria Tambouratzi / Chantal Tan / Emma Tavliavini / Evelyn Thomson / Stephen Thorson / Holger Till / G.A. Tramper-Stranders / Andreas Trobisch / Maria Tsolia / Effua Usuf / Lucille Valentine / Clementien L. Vermont / Marisol Vilas Iglesias / Katarina Vincek / Marie Voice / Gabriella de Vries / Diane Wallia / Shih-Min Wang / Clare Wilson / Amanda Wood / Phil Woodsford / Victoria Wright / Marietta Xagorari / Shunmay Yeung / Joany Zachariasse / Dace Zavadska / Syed M.A. Zaman / Judith Zandstra / Werner Zenz / Christoph Zurl / Manuela Zwerenz

    iScience, Vol 26, Iss 8, Pp 107257- (2023)

    2023  

    Abstract: Summary: Mechanisms of infection and pathogenesis have predominantly been studied based on differential gene or protein expression. Less is known about posttranslational modifications, which are essential for protein functional diversity. We applied an ... ...

    Abstract Summary: Mechanisms of infection and pathogenesis have predominantly been studied based on differential gene or protein expression. Less is known about posttranslational modifications, which are essential for protein functional diversity. We applied an innovative glycoproteomics method to study the systemic proteome-wide glycosylation in response to infection. The protein site-specific glycosylation was characterized in plasma derived from well-defined controls and patients. We found 3862 unique features, of which we identified 463 distinct intact glycopeptides, that could be mapped to more than 30 different proteins. Statistical analyses were used to derive a glycopeptide signature that enabled significant differentiation between patients with a bacterial or viral infection. Furthermore, supported by a machine learning algorithm, we demonstrated the ability to identify the causative pathogens based on the distinctive host blood plasma glycopeptide signatures. These results illustrate that glycoproteomics holds enormous potential as an innovative approach to improve the interpretation of relevant biological changes in response to infection.
    Keywords Health sciences ; Glycobiology ; Immunology ; Glycomics ; Science ; Q
    Subject code 572
    Language English
    Publishing date 2023-08-01T00:00:00Z
    Publisher Elsevier
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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