40 results on '"Baker, Stephen"'
Search Results
2. The rapid detection of respiratory pathogens in critically ill children
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Clark, John A., Conway Morris, Andrew, Curran, Martin D., White, Deborah, Daubney, Esther, Kean, Iain R. L., Navapurkar, Vilas, Bartholdson Scott, Josefin, Maes, Mailis, Bousfield, Rachel, Török, M. Estée, Inwald, David, Zhang, Zhenguang, Agrawal, Shruti, Kanaris, Constantinos, Khokhar, Fahad, Gouliouris, Theodore, Baker, Stephen, and Pathan, Nazima
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- 2023
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3. Correction: Novel multiplex real-time PCR assays reveal a high prevalence of diarrhoeagenic Escherichia coli pathotypes in healthy and diarrhoeal children in the south of Vietnam
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Duong, Vu Thuy, Tu, Le Thi Phuong, Tuyen, Ha Thanh, Nhi, Le Thi Quynh, Campbell, James I., Van Minh, Pham, Le Phuc, Hoang, Chau, Tran Thi Hong, Ngoc, Nguyen Minh, Vi, Lu Lan, Jenkins, Claire, Okeke, Iruka, Higginson, Ellen, and Baker, Stephen
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- 2022
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4. Detection of Salmonella Typhi nucleic acid by RT-PCR and anti-HlyE, -CdtB, -PilL, and -Vi IgM by ELISA at sites in Ghana, Madagascar and Ethiopia
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Panzner, Ursula, Mogeni, Ondari Daniel, Adu-Sarkodie, Yaw, Toy, Trevor, Jeon, Hyon Jin, Pak, Gi Deok, Park, Se Eun, Enuameh, Yeetey, Owusu-Dabo, Ellis, Van Tan, Trinh, Aseffa, Abraham, Teferi, Mekonnen, Yeshitela, Biruk, Baker, Stephen, Rakotozandrindrainy, Raphael, and Marks, Florian
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- 2022
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5. Exploiting genomics to mitigate the public health impact of antimicrobial resistance
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Waddington, Claire, Carey, Megan E., Boinett, Christine J., Higginson, Ellen, Veeraraghavan, Balaji, and Baker, Stephen
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- 2022
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6. SARS-COV-2 vaccine responses in renal patient populations
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Smith, Rona M., Cooper, Daniel J., Doffinger, Rainer, Stacey, Hannah, Al-Mohammad, Abdulrahman, Goodfellow, Ian, Baker, Stephen, Lear, Sara, Hosmilo, Myra, Pritchard, Nicholas, Torpey, Nicholas, Jayne, David, Yiu, Vivien, Chalisey, Anil, Lee, Jacinta, Vilnar, Enric, Cheung, Chee Kay, and Jones, Rachel B.
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- 2022
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7. Correction to: Ventilator-associated pneumonia in critically ill patients with COVID-19
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Maes, Mailis, Higginson, Ellen, Pereira-Dias, Joana, Curran, Martin D., Parmar, Surendra, Khokhar, Fahad, Cuchet-Lourenço, Delphine, Lux, Janine, Sharma-Hajela, Sapna, Ravenhill, Benjamin, Hamed, Islam, Heales, Laura, Mahroof, Razeen, Soderholm, Amelia, Forrest, Sally, Sridhar, Sushmita, Brown, Nicholas M., Baker, Stephen, Navapurkar, Vilas, Dougan, Gordon, Scott, Josefn Bartholdson, and Morris, Andrew Conway
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- 2021
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8. Ventilator-associated pneumonia in critically ill patients with COVID-19
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Maes, Mailis, Higginson, Ellen, Pereira-Dias, Joana, Curran, Martin D., Parmar, Surendra, Khokhar, Fahad, Cuchet-Lourenço, Delphine, Lux, Janine, Sharma-Hajela, Sapna, Ravenhill, Benjamin, Hamed, Islam, Heales, Laura, Mahroof, Razeen, Soderholm, Amelia, Forrest, Sally, Sridhar, Sushmita, Brown, Nicholas M., Baker, Stephen, Navapurkar, Vilas, Dougan, Gordon, Bartholdson Scott, Josefin, and Conway Morris, Andrew
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- 2021
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9. Risk factors for the development of neonatal sepsis in a neonatal intensive care unit of a tertiary care hospital of Nepal
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Manandhar, Sulochana, Amatya, Puja, Ansari, Imran, Joshi, Niva, Maharjan, Nhukesh, Dongol, Sabina, Basnyat, Buddha, Dixit, Sameer M., Baker, Stephen, and Karkey, Abhilasha
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- 2021
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10. The identification of novel immunogenic antigens as potential Shigella vaccine components
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de Alwis, Ruklanthi, Liang, Li, Taghavian, Omid, Werner, Emma, The, Hao Chung, Thu, Trang Nguyen Hoang, Duong, Vu Thuy, Davies, D. Huw, Felgner, Philip L., and Baker, Stephen
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- 2021
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11. Biphasic pattern in the effect of severe measles infection; the difference between additive and multiplicative scale
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Le, Nhat Thanh Hoang, Ho, Nhan Thi, Grenfell, Bryan, Baker, Stephen, and Geskus, Ronald B.
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- 2021
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12. Novel multiplex real-time PCR assays reveal a high prevalence of diarrhoeagenic Escherichia coli pathotypes in healthy and diarrhoeal children in the south of Vietnam
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Duong, Vu Thuy, Tu, Le Thi Phuong, Tuyen, Ha Thanh, Nhi, Le Thi Quynh, Campbell, James I., Van Minh, Pham, Le Phuc, Hoang, Chau, Tran Thi Hong, Ngoc, Nguyen Minh, Vi, Lu Lan, Jenkins, Claire, Okeke, Iruka, Higginson, Ellen, and Baker, Stephen
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- 2020
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13. A high prevalence of multi-drug resistant Gram-negative bacilli in a Nepali tertiary care hospital and associated widespread distribution of Extended-Spectrum Beta-Lactamase (ESBL) and carbapenemase-encoding genes
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Manandhar, Sulochana, Zellweger, Raphael M., Maharjan, Nhukesh, Dongol, Sabina, Prajapati, Krishna G., Thwaites, Guy, Basnyat, Buddha, Dixit, Sameer Mani, Baker, Stephen, and Karkey, Abhilasha
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- 2020
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14. Impact of symptom severity in patients with diarrhoea-predominant irritable bowel syndrome (IBS-D): results from two separate surveys of HCPs and patients with IBS-D
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Emmanuel, Anton, Goosey, Richard William, Wiseman, Gwen, Baker, Stephen, and Törnblom, Hans
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- 2020
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15. Genomic surveillance for hypervirulence and multi-drug resistance in invasive Klebsiella pneumoniae from South and Southeast Asia
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Wyres, Kelly L., Nguyen, To N. T., Lam, Margaret M. C., Judd, Louise M., van Vinh Chau, Nguyen, Dance, David A. B., Ip, Margaret, Karkey, Abhilasha, Ling, Clare L., Miliya, Thyl, Newton, Paul N., Lan, Nguyen Phu Huong, Sengduangphachanh, Amphone, Turner, Paul, Veeraraghavan, Balaji, Vinh, Phat Voong, Vongsouvath, Manivanh, Thomson, Nicholas R., Baker, Stephen, and Holt, Kathryn E.
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- 2020
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16. An estimation of total antimicrobial usage in humans and animals in Vietnam
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Carrique-Mas, Juan J., Choisy, Marc, Van Cuong, Nguyen, Thwaites, Guy, and Baker, Stephen
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- 2020
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17. Drug-resistant enteric fever worldwide, 1990 to 2018: a systematic review and meta-analysis
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Browne, Annie J., Kashef Hamadani, Bahar H., Kumaran, Emmanuelle A. P., Rao, Puja, Longbottom, Joshua, Harriss, Eli, Moore, Catrin E., Dunachie, Susanna, Basnyat, Buddha, Baker, Stephen, Lopez, Alan D., Day, Nicholas P. J., Hay, Simon I., and Dolecek, Christiane
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- 2020
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18. Factors associated with a low prevalence of exclusive breastfeeding during hospital stay in urban and semi-rural areas of southern Vietnam
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Le, Quynh-Nhi Thi, Phung, Khanh-Lam, Nguyen, Van-Thuy Thi, Anders, Katherine L., Nguyen, Minh-Nguyet, Hoang, Diem-Tuyet Thi, Bui, Thuy-Tien Thi, Nguyen, Vinh-Chau Van, Thwaites, Guy E., Simmons, Cameron, and Baker, Stephen
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- 2018
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19. Phenotypic and genotypic characteristics of ESBL and AmpC producing organisms associated with bacteraemia in Ho Chi Minh City, Vietnam.
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Nguyen Phu Huong Lan, Nguyen Huu Hien, Tu Le Thi Phuong, Duy Pham Thanh, Nga Tran Vu Thieu, Dung Tran Thi Ngoc, Ha Thanh Tuyen, Phat Voong Vinh, Ellington, Matthew J., Thwaites, Guy E., Nguyen Van Vinh Chau, Baker, Stephen, and Boinett, Christine J.
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BETA lactamase regulation ,ENZYME regulation ,BACTEREMIA - Abstract
Background: Broad-spectrum antimicrobials are commonly used as empirical therapy for infections of presumed bacterial origin. Increasing resistance to these antimicrobial agents has prompted the need for alternative therapies and more effective surveillance. Better surveillance leads to more informed and improved delivery of therapeutic interventions, potentially leading to better treatment outcomes. Methods: We screened 1017 Gram negative bacteria (excluding Pseudomonas spp. and Acinetobacter spp.) isolated between 2011 and 2013 from positive blood cultures for susceptibility against third generation cephalosporins, ESBL and/or AmpC production, and associated ESBL/AmpC genes, at the Hospital for Tropical Diseases in Ho Chi Minh City. Results: Phenotypic screening found that 304/1017 (30%) organisms were resistance to third generation cephalosporins; 172/1017 (16.9%) of isolates exhibited ESBL activity, 6.2% (63/1017) had AmpC activity, and 0.5% (5/1017) had both ESBL and AmpC activity. E. coli and Aeromonas spp. were the most common organisms associated with ESBL and AmpC phenotypes, respectively. Nearly half of the AmpC producers harboured an ESBL gene. There was no significant difference (p > 0.05) between the antimicrobial resistance phenotypes of the organisms associated with community and hospital-acquired infections. Conclusion: AmpC and ESBL producing organisms were commonly associated with bloodstream infections in this setting, with antimicrobial resistant organisms being equally distributed between infections originating from the community and healthcare settings. Aeromonas spp., which was associated with bloodstream infections in cirrhotic/ hepatitis patients, were the most abundant AmpC producing organism. We conclude that empirical monotherapy with third generation cephalosporins may not be optimum in this setting. [ABSTRACT FROM AUTHOR]
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- 2017
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20. Co-trimoxazole versus azithromycin for the treatment of undifferentiated febrile illness in Nepal: study protocol for a randomized controlled trial.
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Pokharel, Sunil, Basnyat, Buddha, Arjyal, Amit, Pathak Mahat, Saruna, Raj Kumar, K. C., Bhuju, Abhusani, Poudyal, Buddhi, Kestelyn, Evelyne, Shrestha, Ritu, Dung Nguyen Thi Phuong, Thapa, Rajkumar, Karki, Manan, Dongol, Sabina, Karkey, Abhilasha, Wolbers, Marcel, Baker, Stephen, Thwaites, Guy, Mahat, Saruna Pathak, Kc, Raj Kumar, and Phuong, Dung Nguyen Thi
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TYPHOID fever treatment ,CO-trimoxazole ,AZITHROMYCIN ,FLUOROQUINOLONES ,RANDOMIZED controlled trials ,DIAGNOSIS of fever ,TYPHOID fever diagnosis ,ANTIBIOTICS ,CLINICAL trials ,COMPARATIVE studies ,DRUG resistance in microorganisms ,EXPERIMENTAL design ,FEVER ,RESEARCH methodology ,MEDICAL cooperation ,RESEARCH protocols ,ORAL drug administration ,RESEARCH ,RESEARCH funding ,TIME ,TYPHOID fever ,EVALUATION research ,TYPHUS fever ,TREATMENT effectiveness ,BLIND experiment ,DIAGNOSIS - Abstract
Background: Undifferentiated febrile illness (UFI) includes typhoid and typhus fevers and generally designates fever without any localizing signs. UFI is a great therapeutic challenge in countries like Nepal because of the lack of available point-of-care, rapid diagnostic tests. Often patients are empirically treated as presumed enteric fever. Due to the development of high-level resistance to traditionally used fluoroquinolones against enteric fever, azithromycin is now commonly used to treat enteric fever/UFI. The re-emergence of susceptibility of Salmonella typhi to co-trimoxazole makes it a promising oral treatment for UFIs in general. We present a protocol of a randomized controlled trial of azithromycin versus co-trimoxazole for the treatment of UFI.Methods/design: This is a parallel-group, double-blind, 1:1, randomized controlled trial of co-trimoxazole versus azithromycin for the treatment of UFI in Nepal. Participants will be patients aged 2 to 65 years, presenting with fever without clear focus for at least 4 days, complying with other study criteria and willing to provide written informed consent. Patients will be randomized either to azithromycin 20 mg/kg/day (maximum 1000 mg/day) in a single daily dose and an identical placebo or co-trimoxazole 60 mg/kg/day (maximum 3000 mg/day) in two divided doses for 7 days. Patients will be followed up with twice-daily telephone calls for 7 days or for at least 48 h after they become afebrile, whichever is later; by home visits on days 2 and 4 of treatment; and by hospital visits on days 7, 14, 28 and 63. The endpoints will be fever clearance time, treatment failure, time to treatment failure, and adverse events. The estimated sample size is 330. The primary analysis population will be all the randomized population and subanalysis will be repeated on patients with blood culture-confirmed enteric fever and culture-negative patients.Discussion: Both azithromycin and co-trimoxazole are available in Nepal and are extensively used in the treatment of UFI. Therefore, it is important to know the better orally administered antimicrobial to treat enteric fever and other UFIs especially against the background of fluoroquinolone-resistant enteric fever.Trial Registration: ClinicalTrials.gov, ID: NCT02773407 . Registered on 5 May 2016. [ABSTRACT FROM AUTHOR]- Published
- 2017
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21. A universal genome sequencing method for rotavirus A from human fecal samples which identifies segment reassortment and multi-genotype mixed infection.
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Dung, Tran Thi Ngoc, Duy, Pham Thanh, Sessions, October M., Sangumathi, Uma K., Phat, Voong Vinh, Tam, Pham Thi Thanh, To, Nguyen Thi Nguyen, Phuc, Tran My, Chau, Tran Thi Hong, Chau, Nguyen Ngoc Minh, Minh, Ngoc Nguyen, Thwaites, Guy E., Rabaa, Maia A., and Baker, Stephen
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ROTAVIRUSES ,FECES ,MICROBIOLOGY ,NUCLEOTIDE sequencing ,GENOTYPES ,ENZYME-linked immunosorbent assay - Abstract
Background: Genomic characterization of rotavirus (RoV) has not been adopted at large-scale due to the complexity of obtaining sequences for all 11 segments, particularly when feces are used as starting material. Methods: To overcome these limitations, we developed a novel RoV capture and genome sequencing method combining commercial enzyme immunoassay plates and a set of routinely used reagents. Results: Our approach had a 100% success rate, producing >90% genome coverage for diverse RoV present in fecal samples (Ct < 30). Conclusions: This method provides a novel, reproducible and comparatively simple approach for genomic RoV characterization and could be scaled-up for use in global RoV surveillance systems. [ABSTRACT FROM AUTHOR]
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- 2017
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22. Current challenges and possible solutions to improve access to care and treatment for hepatitis C infection in Vietnam: a systematic review.
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Berto, Alessandra, Day, Jeremy, Nguyen Van Vinh Chau, Thwaites, Guy E., Ngoc Nghiem My, Baker, Stephen, Darton, Thomas C., Van Vinh Chau, Nguyen, and My, Ngoc Nghiem
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HEPATITIS C ,FLAVIVIRAL diseases ,MEDICAL microbiology ,COMMUNICABLE diseases ,LIVER diseases ,HEPATITIS C treatment ,HEALTH services accessibility ,HEPATITIS viruses ,SYSTEMATIC reviews ,DISEASE incidence ,DISEASE prevalence - Abstract
Background: Hepatitis C infection is a major public health concern in low- and middle-income countries where an estimated 71.1 million individuals are living with chronic infection. The World Health Organization (WHO) has recently released new guidance for hepatitis C virus (HCV) treatment programs, which include improving the access to new direct-acting antiviral agents. In Vietnam, a highly populated middle-income country, the seroprevalence of HCV infection is approximately 4% and multiple genotypes co-circulate in the general population. Here we review what is currently known regarding the epidemiology of HCV in Vietnam and outline options for reducing the significant burden of morbidity and mortality in our setting.Methods: We performed a systematic review of the currently available literature to evaluate what has been achieved to date with efforts to control HCV infection in Vietnam.Results: This search retrieved few publications specific to Vietnam indicating a significant gap in baseline epidemiological and public health data. Key knowledge gaps identified included an understanding of the prevalence in specific high-risk groups, characterization of circulating HCV genotypes in the population and likely response to treatment, and the extent to which HCV treatment is available, accessed and utilized.Conclusions: We conclude that there is an urgent need to perform up to date assessments of HCV disease burden in Vietnam, especially in high-risk groups, in whom incidence is high and cross infection with multiple genotypes is likely to be frequent. Coordinating renewed surveillance measures with forthcoming HCV treatment studies should initiate the traction required to achieve the WHO goal of eliminating HCV as a public health threat by 2030, at least in this region. [ABSTRACT FROM AUTHOR]- Published
- 2017
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23. The impact of albendazole treatment on the incidence of viral- and bacterial-induced diarrhea in school children in southern Vietnam: study protocol for a randomized controlled trial.
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Leung, Jacqueline M., Chau Tran Thi Hong, Nghia Ho Dang Trung, Hoa Nhu Thi, Chau Nguyen Ngoc Minh, Thuy Vu Thi, Dinh Thanh Hong, Dinh Nguyen Huy Man, Knowles, Sarah C. L., Wolbers, Marcel, Nhat Le Thanh Hoang, Thwaites, Guy, Graham, Andrea L., and Baker, Stephen
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ANTHELMINTICS ,INFECTION treatment ,ALBENDAZOLE ,MIXED infections ,SCHOOL children ,HELMINTHIC therapy ,CHILDREN ,THERAPEUTICS ,JUVENILE diseases - Abstract
Background: Anthelmintics are one of the more commonly available classes of drugs to treat infections by parasitic helminths (especially nematodes) in the human intestinal tract. As a result of their cost-effectiveness, mass school-based deworming programs are becoming routine practice in developing countries. However, experimental and clinical evidence suggests that anthelmintic treatments may increase susceptibility to other gastrointestinal infections caused by bacteria, viruses, or protozoa. Hypothesizing that anthelmintics may increase diarrheal infections in treated children, we aim to evaluate the impact of anthelmintics on the incidence of diarrheal disease caused by viral and bacterial pathogens in school children in southern Vietnam. Methods/design: This is a randomized, double-blinded, placebo-controlled trial to investigate the effects of albendazole treatment versus placebo on the incidence of viral- and bacterial-induced diarrhea in 350 helminth-infected and 350 helminth-uninfected Vietnamese school children aged 6-15 years. Four hundred milligrams of albendazole, or placebo treatment will be administered once every 3 months for 12 months. At the end of 12 months, all participants will receive albendazole treatment. The primary endpoint of this study is the incidence of diarrheal disease assessed by 12 months of weekly active and passive case surveillance. Secondary endpoints include the prevalence and intensities of helminth, viral, and bacterial infections, alterations in host immunity and the gut microbiota with helminth and pathogen clearance, changes in mean z scores of body weight indices over time, and the number and severity of adverse events. Discussion: In order to reduce helminth burdens, anthelmintics are being routinely administered to children in developing countries. However, the effects of anthelmintic treatment on susceptibility to other diseases, including diarrheal pathogens, remain unknown. It is important to monitor for unintended consequences of drug treatments in co-infected populations. In this trial, we will examine how anthelmintic treatment impacts host susceptibility to diarrheal infections, with the aim of informing deworming programs of any indirect effects of mass anthelmintic administrations on co-infecting enteric pathogens. Trial registration: ClinicalTrials.gov: NCT02597556. Registered on 3 November 2015. [ABSTRACT FROM AUTHOR]
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- 2016
24. A cohort study to define the age-specific incidence and risk factors of Shigella diarrhoeal infections in Vietnamese children: a study protocol.
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Thompson, Corinne N., Anders, Katherine L., Le Thi Quynh Nhi, Ha Thanh Tuyen, Pham Van Minh, Le Thi Phuong Tu, Tran Do Hoang Nhu, Nguyen Thi Thanh Nhan, Tran Thi Thao Ly, Vu Thuy Duong, Lu Lan Vi, Nguyen Thi Van Thuy, Nguyen Trong Hieu, Nguyen Vinh Van Chau, Campbell, James I., Thwaites, Guy, Simmons, Cameron, and Baker, Stephen
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DIARRHEA ,DIARRHEA in children ,RESEARCH protocols ,ETIOLOGY of diseases ,VIETNAMESE people ,MEDICAL informatics ,DISEASES - Abstract
Background Shigella spp. are one of the most common causes of paediatric dysentery globally, responsible for a substantial proportion of diarrhoeal disease morbidity and mortality, particularly in industrialising regions. Alarming levels of antimicrobial resistance are now reported in S. flexneri and S. sonnei, hampering treatment options. Little is known, however, about the burden of infection and disease due to Shigella spp. in the community. Methods/Design In order to estimate the incidence of this bacterial infection in the community in Ho Chi Minh City, Vietnam we have designed a longitudinal cohort to follow up approximately 700 children aged 12-60 months for two years with active and passive surveillance for diarrhoeal disease. Children will be seen at 6 month intervals for health checks where blood and stool samples will be collected. Families will also be contacted every two weeks for information on presence of diarrhoea in the child. Upon report of a diarrhoeal disease episode, study nurses will either travel to the family home to perform an evaluation or the family will attend a study hospital at a reduced cost, where a stool sample will also be collected. Case report forms collected at this time will detail information regarding disease history, risk factors and presence of disease in the household. Outcomes will include (i) age-specific incidence of Shigella spp. and other agents of diarrhoeal disease in the community, (ii) risk factors for identified aetiologies, (iii) rates of seroconversion to a host of gastrointestinal pathogens in the first few years of life. Further work regarding the longitudinal immune response to a variety of Shigella antigens, host genetics and candidate vaccine/diagnostic proteins will also be conducted. Discussion This is the largest longitudinal cohort with active surveillance designed specifically to investigate Shigella infection and disease. The study is strengthened by the active surveillance component, which will likely capture a substantial proportion of episodes not normally identified through passive or hospital-based surveillance. It is hoped that information from this study will aid in the design and implementation of Shigella vaccine trials in the future. [ABSTRACT FROM AUTHOR]
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- 2014
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25. Ophthalmic infections in children presenting to Angkor Hospital for Children, Siem Reap, Cambodia.
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Khauv, Phara, Turner, Paul, Channy Soeng, Sona Soeng, Moore, Catrin E., Bousfield, Rachel, Stoesser, Nicole, Emary, Kate, Duy Pham Thanh, Vu thi Ty Hang, van Doorn, H. Rogier, Day, Nicholas P. J., Parry, Christopher M., and Baker, Stephen
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Background: Ophthalmic infections cause significant morbidity in Cambodian children but aetiologic data are scarce. We investigated the causes of acute eye infections in 54 children presenting to the ophthalmology clinic at Angkor Hospital for Children, Siem Reap between March and October 2012. Findings: The median age at presentation was 3.6 years (range 6 days – 16.0 years). Forty two patients (77.8%) were classified as having an external eye infection, ten (18.5%) as ophthalmia neonatorum, and two (3.7%) as intra-ocular infection. Organisms were identified in all ophthalmia neonatorum patients and 85.7% of patients with an external eye infection. Pathogens were not detected in either of the intra-ocular infection patients. Most commonly isolated bacteria were Staphylococcus aureus (23 isolates), coagulase-negative staphylococci (13), coliforms (7), Haemophilus influenzae/parainfluenzae (6), Streptococcus pneumoniae (4), and Neisseria gonorrhoeae (2). Chlamydia trachomatis DNA was detected in 60% of swabs taken from ophthalmia neonatorum cases. Conclusions: This small study demonstrates the wide range of pathogens associated with common eye infections in Cambodian children. The inclusion of molecular assays improved the spectrum of detectable pathogens, most notably in neonates. [ABSTRACT FROM AUTHOR]
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- 2014
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26. The challenges and successes of implementing a sustainable antimicrobial resistance surveillance programme in Nepal.
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Malla, Sarala, Dumre, Shyam Prakash, Shakya, Geeta, Kansakar, Palpasa, Rai, Bhupraj, Hossain, Anowar, Nair, Gopinath Balakrish, Albert, M John, Sack, David, Baker, Stephen, and Rahman, Motiur
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Background: Antimicrobial resistance (AMR) is a major global public health concern and its surveillance is a fundamental tool for monitoring the development of AMR. In 1998, the Nepalese Ministry of Health (MOH) launched an Infectious Disease (ID) programme. The key components of the programme were to establish a surveillance programme for AMR and to develop awareness among physicians regarding AMR and rational drug usage in Nepal. Methods: An AMR surveillance programme was established and implemented by the Nepalese MOH in partnership with the International Centre for Diarrhoeal Disease Research, Bangladesh (ICDDR, B) from 1998 to 2003. From 2004 to 2012, the programme was integrated and maintained as a core activity of the National Public Health Laboratory (NPHL) and resulted in an increased number of participating laboratories and pathogens brought under surveillance. The main strategies were to build national capacity on isolation, identification and AMR testing of bacterial pathogens, establish laboratory networking and an External Quality Assessment (EQA) programme, promote standardised recording and reporting of results, and to ensure timely analysis and dissemination of data for advocacy and national policy adaptations. The programme was initiated by nine participating laboratories performing AMR surveillance on Vibrio cholerae, Shigella spp., Streptococcus pneumoniae, Haemophilus influenzae, and Neisseria gonorrhoeae. Results: The number of participating laboratories was ultimately increased to 13 and the number of pathogens under surveillance was increased to seven (Salmonella spp. was added to the surveillance programme in 2002 and extended spectrum β-lactamase producing Escherichia coli in 2011). From 1999 to 2012, data were available on 17,103 bacterial isolates. During the AMR programme, we observed changing trends in serovars/ species for Salmonella spp., Shigella spp. and V. cholerae and changing AMR trend for all organisms. Notably, N. gonorrhoeae isolates demonstrated increasing resistance to ciprofloxacin. Additionally, the performance of the participating laboratories improved as shown by annual EQA data evaluation. Conclusions: This Nepalese AMR programme continues and serves as a model for sustainable surveillance of AMR monitoring in resource limited settings. [ABSTRACT FROM AUTHOR]
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- 2014
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27. Risk factors for the development of severe typhoid fever in Vietnam.
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Parry, Christopher M., Thompson, Corinne, Ha Vinh, Nguyen Tran Chinh, Le Thi Phuong, Vo Anh Ho, Tran Tinh Hien, John Wain, Farrar, Jeremy J., and Baker, Stephen
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SALMONELLA enterica serovar Typhi ,TYPHOID fever ,DRUG resistance in bacteria ,ANTI-infective agents ,DISEASE risk factors - Abstract
Background Typhoid fever is a systemic infection caused by the bacterium Salmonella enterica serovar Typhi. Age, sex, prolonged duration of illness, and infection with an antimicrobial resistant organism have been proposed risk factors for the development of severe disease or fatality in typhoid fever. Methods We analysed clinical data from 581 patients consecutively admitted with culture confirmed typhoid fever to two hospitals in Vietnam during two periods in 1993-1995 and 1997-1999. These periods spanned a change in the antimicrobial resistance phenotypes of the infecting organisms i.e. fully susceptible to standard antimicrobials, resistance to chloramphenicol, ampicillin and trimethoprim-sulphamethoxazole (multidrug resistant, MDR), and intermediate susceptibility to ciprofloxacin (nalidixic acid resistant). Age, sex, duration of illness prior to admission, hospital location and the presence of MDR or intermediate ciprofloxacin susceptibility in the infecting organism were examined by logistic regression analysis to identify factors independently associated with severe typhoid at the time of hospital admission. Results The prevalence of severe typhoid was 15.5% (90/581) and included: gastrointestinal bleeding (43; 7.4%); hepatitis (29; 5.0%); encephalopathy (16; 2.8%); myocarditis (12; 2.1%); intestinal perforation (6; 1.0%); haemodynamic shock (5; 0.9%), and death (3; 0.5%). Severe disease was more common with increasing age, in those with a longer duration of illness and in patients infected with an organism exhibiting intermediate susceptibility to ciprofloxacin. Notably an MDR phenotype was not associated with severe disease. Severe disease was independently associated with infection with an organism with an intermediate susceptibility to ciprofloxacin (AOR 1.90; 95% CI 1.18-3.07; p = 0.009) and male sex (AOR 1.61 (1.00- 2.57; p = 0.035). Conclusions In this group of patients hospitalised with typhoid fever infection with an organism with intermediate susceptibility to ciprofloxacin was independently associated with disease severity. During this period many patients were being treated with fluoroquinolones prior to hospital admission. Ciprofloxacin and ofloxacin should be used with caution in patients infected with S. Typhi that have intermediate susceptibility to ciprofloxacin. [ABSTRACT FROM AUTHOR]
- Published
- 2014
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28. An oral preparation of Lactobacillus acidophilus for the treatment of uncomplicated acute watery diarrhoea in Vietnamese children: study protocol for a multicentre, randomised, placebo-controlled trial.
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Kolader, Marion-Eliëtte, Vinh, Ha, Ngoc Tuyet, Pham Thi, Thompson, Corinne, Wolbers, Marcel, Merson, Laura, Campbell, James I, Ngoc Dung, Tran Thi, Tuan, Ha Manh, Vinh Chau, Nguyen Van, Farrar, Jeremy, van Doorn, H. Rogier, and Baker, Stephen
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LACTOBACILLUS acidophilus ,ORAL rehydration therapy ,CLINICAL trials ,RANDOMIZED controlled trials ,THERAPEUTICS ,DIARRHEA ,PROBIOTICS ,IMMUNOLOGICAL adjuvants - Abstract
Background: Diarrhoeal disease is a major global health problem, particularly affecting children under the age of 5 years. Besides oral rehydration solution, probiotics are also commonly prescribed to children with acute watery diarrhoea in some settings. Results from randomised clinical trials (RCTs) in which investigators studied the effect of probiotics on diarrhoeal symptoms have largely shown a positive effect; yet, the overall quality of the data is limited. In Vietnam, probiotics are the most frequently prescribed treatment for children hospitalised with acute watery diarrhoea, but there is little justification for this treatment in this location. We have designed a RCT to test the hypothesis that an oral preparation of Lactobacillus acidophilus is superior to placebo in the treatment of acute watery diarrhoea in Vietnamese children. Methods: This RCT was designed to study the effect of treatment with L. acidophilus (4 × 109 colony-forming units/ day) for 5 days for acute watery diarrhoea against a placebo in 300 children ages 9 to 60 months admitted to hospitals in Vietnam. Clinical and laboratory data plus samples will be collected on admission, daily during hospitalisation, at discharge, and at follow-up visits for a subset of participants. The primary end point will be defined as the time from the first dose of study medication to the start of the first 24-hour period without diarrhoea as assessed by the on-duty nurse. Secondary endpoints include the time to cessation of diarrhoea as recorded by parents or guardians in an hourly checklist, stool frequency over the first 3 days, treatment failure, rotavirus and norovirus viral loads, and adverse events. Discussion: The existing evidence for the use of probiotics in treating acute watery diarrhoea seems to favour their use. However, the size of the effect varies across publications. An array of different probiotic organisms, doses, treatment durations, study populations, designs, settings, and aetiologies have been described. In this trial, we will investigate whether probiotics are beneficial as an adjuvant treatment for children with acute watery diarrhoea in Vietnam, with the aim of guiding clinical practice through improved regional evidence. [ABSTRACT FROM AUTHOR]
- Published
- 2013
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29. The antimicrobial resistance patterns and associated determinants in Streptococcus suis isolated from humans in southern Vietnam, 1997-2008.
- Author
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Hoa, Ngo T., Chieu, Tran T. B., Nghia, Ho D. T., Mai, Nguyen T. H., Anh, Pham H., Wolbers, Marcel, Baker, Stephen, Campbell, James I., Chau, Nguyen W., Hien, Tran T., Farrar, Jeremy, and Schultsz, Constance
- Subjects
STREPTOCOCCUS ,MENINGITIS ,ZOONOSES ,TETRACYCLINE ,ERYTHROMYCIN - Abstract
Background: Streptococcus suis is an emerging zoonotic pathogen and is the leading cause of bacterial meningitis in adults in Vietnam. Systematic data on the antimicrobial susceptibility profiles of S. suis strains isolated from human cases are lacking. We studied antimicrobial resistance and associated resistance determinants in S. suis isolated from patients with meningitis in southern Vietnam. Methods: S. suis strains isolated between 1997 and 2008 were investigated for their susceptibility to six antimicrobial agents. Strains were screened for the presence and expression of tetracycline and erythromycin resistance determinants and the association of tet(M) genes with Tn916- like transposons. The localization of tetracycline resistance gene tet(L) was determined by pulse field gel electrophoresis and Southern blotting. Results: We observed a significant increase in resistance to tetracycline and chloramphenicol, which was concurrent with an increase in multi-drug resistance. In tetracycline resistance strains, we identified tet(M), tet(O), tet (W) and tet(L) and confirmed their expression. All tet(M) genes were associated with a Tn916-like transposon. The co-expression of tet(L) and other tetracycline resistance gene(s) encoding for ribosomal protection protein(s) was only detected in strains with a minimum inhibitory concentration (MIC) of tetracycline of ≥ 64 mg/L Conclusions: We demonstrated that multi-drug resistance in S. suis causing disease in humans in southern Vietnam has increased over the 11-year period studied. We report the presence and expression of tet(L) in S. suis strains and our data suggest that co-expression of multiple genes encoding distinct mechanism is required for an MIC ≥ 64 mg/L to tetracycline. [ABSTRACT FROM AUTHOR]
- Published
- 2011
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- View/download PDF
30. Prevention of Alzheimer's disease in high risk groups: statin therapy in subjects with PSEN1 mutations or heterozygosity for apolipoprotein Eε4.
- Author
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Pollen, Daniel A1, Baker, Stephen, Hinerfeld, Douglas, Swearer, Joan, Evans, Barbara A., Evans, James E., Caselli, Richard, Rogaeva, Ekaterina, St George-Hyslop, Peter, and Moonis, Majaz
- Subjects
- *
CEREBROSPINAL fluid , *GENETIC mutation , *NEURODEGENERATION , *ALZHEIMER'S disease , *AMYLOID beta-protein precursor , *APOLIPOPROTEIN E - Abstract
Because cerebrospinal fluid (CSF) abnormalities in presymptomatic subjects with PSEN1 (presenilin 1) mutations may be observed 4 to 12 years prior to the estimated age at onset, it is possible to test putative therapies on the CSF analytes that correlate with neurodegeneration during this presymptomatic window of clinical opportunity. It is also possible to test the same therapy on a comparison group with increased risk status conferred by both hyperlipidemia and heterozygosity for apolipoprotein E?4. To our knowledge, the only putative therapy thus far tested in such a common design has been statin therapy. The results of these tests show increases in soluble amyloid precursor protein (sAPP)α correlating with statin-induced decreases in serum cholesterol levels in the non-PSEN1 subjects. This result could be one functional correlate for part of the substantial risk reduction for late onset Alzheimer's disease recently reported in the Rotterdam study, a large, long-term prospective statin trial. Statin therapy significantly decreased both sAPPα and sAPPβ in presymptomatic PSEN1 subjects. Initially, elevated phospho-tau levels in PSEN1 subjects did not further increase during the 2 to 3 years of statin therapy, possibly indicative of a prophylactic effect. These results suggest that large and longer term trials of statin therapy correlating changes in CSF biomarker levels with clinical course may be warranted in both presymptomatic PSEN1 and non-PSEN1 subjects [ABSTRACT FROM AUTHOR]
- Published
- 2010
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- View/download PDF
31. High-throughput bacterial SNP typing identifiesdistinct clusters of Salmonella Typhi causingtyphoid in Nepalese children.
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Holt, Kathryn E., Baker, Stephen, Dongol, Sabina, Basnyat, Buddha, Adhikari, Neelam, Thorson, Stephen, Pulickal, Anoop S., Yajun Song, Parkhill, Julian, Farrar, Jeremy J., Murdoch, David R., Kelly, Dominic F., Pollard, Andrew J., and Dougan, Gordon
- Subjects
- *
SALMONELLA typhi , *TYPHOID fever , *PUBLIC health , *BIOMARKERS - Abstract
Background: Salmonella Typhi (S. Typhi) causes typhoid fever, which remains an important public health issue in many developing countries. Kathmandu, the capital of Nepal, is an area of high incidence and the pediatric population appears to be at high risk of exposure and infection. Methods: We recently defined the population structure of S. Typhi, using new sequencing technologies to identify nearly 2,000 single nucleotide polymorphisms (SNPs) that can be used as unequivocal phylogenetic markers. Here we have used the GoldenGate (Illumina) platform to simultaneously type 1,500 of these SNPs in 62 S. Typhi isolates causing severe typhoid in children admitted to Patan Hospital in Kathmandu. Results: Eight distinct S. Typhi haplotypes were identified during the 20-month study period, with 68% of isolates belonging to a subclone of the previously defined H58 S. Typhi. This subclone was closely associated with resistance to nalidixic acid, with all isolates from this group demonstrating a resistant phenotype and harbouring the same resistance-associated SNP in GyrA (Phe83). A secondary clone, comprising 19% of isolates, was observed only during the second half of the study. Conclusions: Our data demonstrate the utility of SNP typing for monitoring bacterial populations over a defined period in a single endemic setting. We provide evidence for genotype introduction and define a nalidixic acid resistant subclone of S. Typhi, which appears to be the dominant cause of severe pediatric typhoid in Kathmandu during the study period. [ABSTRACT FROM AUTHOR]
- Published
- 2010
- Full Text
- View/download PDF
32. Searching for the elusive typhoid diagnostic.
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Baker, Stephen, Favorov, Michael, and Dougan, Gordon
- Subjects
- *
SALMONELLA diseases , *GENOMICS , *PATHOGENIC microorganisms ,TYPHOID fever diagnosis ,DEVELOPING countries - Abstract
Typhoid (enteric) fever is still a common disease in many developing countries but current diagnostic tests are inadequate. Studies on pathogenesis and genomics have provided new insight into the organisms that cause enteric fever. Better understanding of the microorganisms explains, in part, why our current typhoid methodologies are limited in their diagnostic information and why developing new strategies may be a considerable challenge. Here we discuss the current position of typhoid diagnostics, highlight the need for technological improvements and suggest potential ways of advancing this area. [ABSTRACT FROM AUTHOR]
- Published
- 2010
- Full Text
- View/download PDF
33. A prospective descriptive study of cryptococcalmeningitis in HIV uninfected patients in Vietnam -high prevalence of Cryptococcus neoformans vargrubii in the absence of underlying disease.
- Author
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Chau, Tran T. H., Mai, Nguyen H., Phu, Nguyen H., Nghia, Ho D., Chuong, Ly V., Sinh, Dinh X., Duong, Van A., Diep, Pham T., Campbell, James I., Baker, Stephen, Hien, Tran T., Lalloo, David G., Farrar, Jeremy J., and Day, Jeremy N.
- Subjects
MENINGITIS ,CRYPTOCOCCALES ,HIV infections ,HIV-positive persons ,CRYPTOCOCCUS neoformans - Abstract
Background: Most cases of cryptococcal meningitis occur in patients with HIV infection: the course and outcome of disease in the apparently immunocompetent is much more poorly understood. We describe a cohort of HIV uninfected Vietnamese patients with cryptococcal meningitis in whom underlying disease is uncommon, and relate presenting features of patients and the characteristics of the infecting species to outcome. Methods: A prospective descriptive study of HIV negative patients with cryptococcal meningitis based at the Hospital for Tropical Diseases, Ho Chi Minh City. All patients had comprehensive clinical assessment at baseline, were cared for by a dedicated study team, and were followed up for 2 years. Clinical presentation was compared by infecting isolate and outcome. Results: 57 patients were studied. Cryptococcus neoformans var grubii molecular type VN1 caused 70% of infections; C. gattii accounted for the rest. Most patients did not have underlying disease (81%), and the rate of underlying disease did not differ by infecting species. 11 patients died while in-patients (19.3%). Independent predictors of death were age ≥ 60 years and a history of convulsions (odds ratios and 95% confidence intervals 8.7 (1 - 76), and 16.1 (1.6 - 161) respectively). Residual visual impairment was common, affecting 25 of 46 survivors (54.3%). Infecting species did not influence clinical phenotype or outcome. The minimum inhibitory concentrations of flucytosine and amphotericin B were significantly higher for C. neoformans var grubii compared with C. gattii (p < 0.001 and p = 0.01 respectively). Conclusion: In HIV uninfected individuals in Vietnam, cryptococcal meningitis occurs predominantly in people with no clear predisposing factor and is most commonly due to C. neoformans var grubii. The rates of mortality and visual loss are high and independent of infecting species. There are detectable differences in susceptibility to commonly used antifungal drugs between species, but the clinical significance of this is not clear. [ABSTRACT FROM AUTHOR]
- Published
- 2010
- Full Text
- View/download PDF
34. The sensitivity of real-time PCR amplification targeting invasive Salmonella serovars in biological specimens.
- Author
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Nga, Tran Vu Thieu, Karkey, Abhilasha, Dongol, Sabina, Thuy, Hang Nguyen, Dunstan, Sarah, Holt, Kathryn, Tu, Le Thi Phuong, Campbell, James I., Chau, Tran Thuy, Chau, Nguyen Van Vinh, Arjyal, Amit, Koirala, Samir, Basnyat, Buddha, Dolecek, Christiane, Farrar, Jeremy, and Baker, Stephen
- Subjects
TYPHOID fever ,SALMONELLA diseases ,POLYMERASE chain reaction ,PATHOGENIC microorganisms ,BIOMEDICAL materials - Abstract
Background: PCR amplification for the detection of pathogens in biological material is generally considered a rapid and informative diagnostic technique. Invasive Salmonella serovars, which cause enteric fever, can be commonly cultured from the blood of infected patients. Yet, the isolation of invasive Salmonella serovars from blood is protracted and potentially insensitive. Methods: We developed and optimised a novel multiplex three colour real-time PCR assay to detect specific target sequences in the genomes of Salmonella serovars Typhi and Paratyphi A. We performed the assay on DNA extracted from blood and bone marrow samples from culture positive and negative enteric fever patients. Results: The assay was validated and demonstrated a high level of specificity and reproducibility under experimental conditions. All bone marrow samples tested positive for Salmonella, however, the sensitivity on blood samples was limited. The assay demonstrated an overall specificity of 100% (75/75) and sensitivity of 53.9% (69/128) on all biological samples. We then tested the PCR detection limit by performing bacterial counts after inoculation into blood culture bottles. Conclusions: Our findings corroborate previous clinical findings, whereby the bacterial load of S. Typhi in peripheral blood is low, often below detection by culture and, consequently, below detection by PCR. Whilst the assay may be utilised for environmental sampling or on differing biological samples, our data suggest that PCR performed directly on blood samples may be an unsuitable methodology and a potentially unachievable target for the routine diagnosis of enteric fever. [ABSTRACT FROM AUTHOR]
- Published
- 2010
- Full Text
- View/download PDF
35. A successful antimicrobial regime for Chromobacterium violaceum induced bacteremia.
- Author
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Campbell, James I., Nguyen Phu Huong Lan, Phan Tu Qui, Le Thi Dung, Farrar, Jeremy J., and Baker, Stephen
- Subjects
BACTERIAL diseases ,ANTI-infective agents ,BACTEREMIA ,COMMUNICABLE diseases - Abstract
Background: Chromobacterium violaceum is a proteobacterium found in soil and water in tropical regions. The organism rarely causes infection in humans, yet can cause a severe systemic infection by entering the bloodstream via an open wound. Case presentation: We recently identified a case of severe bacteremia caused by Chromobacterium violaceum at the Hospital for Tropical Diseases (HTD) in Ho Chi Minh City, Vietnam. Here, we describe how rapid microbiological identification and a combination of antimicrobials was used to successfully treat this life threatening infection in a four-year-old child. Conclusions: This case shows the need for rapid diagnosis when there is the suspicion of a puncture wound contaminated with water and soil in tropical regions. We suggest that the aggressive antimicrobial combination used here is considered when this infection is suspected. [ABSTRACT FROM AUTHOR]
- Published
- 2013
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- View/download PDF
36. Novel multiplex real-time PCR assays reveal a high prevalence of diarrhoeagenic Escherichia coli pathotypes in healthy and diarrhoeal children in the south of Vietnam
- Author
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Ha Thanh Tuyen, Tran Thi Hong Chau, Lu Lan Vi, Stephen Baker, Ellen Higginson, Le Thi Phuong Tu, Le Thi Quynh Nhi, Nguyen Minh Ngoc, James Campbell, Hoang Le Phuc, Claire Jenkins, Iruka N. Okeke, Vu Thuy Duong, Pham Van Minh, Baker, Stephen [0000-0003-1308-5755], and Apollo - University of Cambridge Repository
- Subjects
Male ,Clinical microbiology and vaccines ,lcsh:QR1-502 ,medicine.disease_cause ,lcsh:Microbiology ,Enteropathogenic Escherichia coli ,0302 clinical medicine ,Prevalence ,Healthy children ,Multiplex ,Virulence Factors, Bordetella ,030212 general & internal medicine ,Child ,Escherichia coli Infections ,0303 health sciences ,education.field_of_study ,Amplicon ,3. Good health ,Co-infection ,EAEC ,Real-time polymerase chain reaction ,Vietnam ,Child, Preschool ,population characteristics ,Female ,EIEC ,Research Article ,Diarrhea ,Microbiology (medical) ,Adolescent ,Multiplex real-time PCR ,Population ,Virulence ,Biology ,Real-Time Polymerase Chain Reaction ,Sensitivity and Specificity ,Microbiology ,03 medical and health sciences ,health services administration ,parasitic diseases ,medicine ,Humans ,education ,Escherichia coli ,EPEC ,030306 microbiology ,ETEC ,Diarrhoea children ,Infant, Newborn ,Infant ,Virology ,Carriage ,Parasitology ,EHEC ,Multiplex Polymerase Chain Reaction - Abstract
Background Diarrhoeagenic Escherichia coli (DEC) infections are common in children in low-middle income countries (LMICs). However, detecting the various DEC pathotypes is complex as they cannot be differentiated by classical microbiology. We developed four multiplex real-time PCR assays were to detect virulence markers of six DEC pathotypes; specificity was tested using DEC controls and other enteric pathogens. PCR amplicons from the six E. coli pathotypes were purified and amplified to be used to optimize PCR reactions and to calculate reproducibility. After validation, these assays were applied to clinical samples from healthy and diarrhoeal Vietnamese children and associated with clinical data. Results The multiplex real-time PCRs were found to be reproducible, and specific. At least one DEC variant was detected in 34.7% (978/2815) of the faecal samples from diarrhoeal children; EAEC, EIEC and atypical EPEC were most frequent Notably, 41.2% (205/498) of samples from non-diarrhoeal children was positive with a DEC pathotype. In this population, only EIEC, which was detected in 34.3% (99/289) of diarrhoeal samples vs. 0.8% (4/498) non-diarrhoeal samples (p Conclusions This approach revealed high carriage rates of DEC pathotypes among Vietnamese children. We describe a novel diagnostic approach for DEC, which provides baseline data for future surveillance studies assessing DEC burden in LMICs.
- Published
- 2020
37. Phenotypic and genotypic characteristics of ESBL and AmpC producing organisms associated with bacteraemia in Ho Chi Minh City, Vietnam.
- Author
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Lan NPH, Hien NH, Le Thi Phuong T, Thanh DP, Thieu NTV, Ngoc DTT, Tuyen HT, Vinh PV, Ellington MJ, Thwaites GE, Van Vinh Chau N, Baker S, and Boinett CJ
- Abstract
Background: Broad-spectrum antimicrobials are commonly used as empirical therapy for infections of presumed bacterial origin. Increasing resistance to these antimicrobial agents has prompted the need for alternative therapies and more effective surveillance. Better surveillance leads to more informed and improved delivery of therapeutic interventions, potentially leading to better treatment outcomes., Methods: We screened 1017 Gram negative bacteria (excluding Pseudomonas spp. and Acinetobacter spp.) isolated between 2011 and 2013 from positive blood cultures for susceptibility against third generation cephalosporins, ESBL and/or AmpC production, and associated ESBL/AmpC genes, at the Hospital for Tropical Diseases in Ho Chi Minh City., Results: Phenotypic screening found that 304/1017 (30%) organisms were resistance to third generation cephalosporins; 172/1017 (16.9%) of isolates exhibited ESBL activity, 6.2% (63/1017) had AmpC activity, and 0.5% (5/1017) had both ESBL and AmpC activity. E. coli and Aeromonas spp. were the most common organisms associated with ESBL and AmpC phenotypes, respectively . Nearly half of the AmpC producers harboured an ESBL gene. There was no significant difference ( p > 0.05) between the antimicrobial resistance phenotypes of the organisms associated with community and hospital-acquired infections., Conclusion: AmpC and ESBL producing organisms were commonly associated with bloodstream infections in this setting, with antimicrobial resistant organisms being equally distributed between infections originating from the community and healthcare settings. Aeromonas spp., which was associated with bloodstream infections in cirrhotic/hepatitis patients, were the most abundant AmpC producing organism. We conclude that empirical monotherapy with third generation cephalosporins may not be optimum in this setting.
- Published
- 2017
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- View/download PDF
38. A prospective study of the importance of enteric fever as a cause of non-malarial febrile illness in patients admitted to Chittagong Medical College Hospital, Bangladesh.
- Author
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Maude RR, Ghose A, Samad R, de Jong HK, Fukushima M, Wijedoru L, Hassan MU, Hossain MA, Karim MR, Sayeed AA, van den Ende S, Pal S, Zahed AS, Rahman W, Karnain R, Islam R, Tran DT, Ha TT, Pham AH, Campbell JI, van Doorn HR, Maude RJ, van der Poll T, Wiersinga WJ, Day NP, Baker S, Dondorp AM, Parry CM, and Faiz MA
- Subjects
- Adolescent, Adult, Aged, Bangladesh epidemiology, Child, Child, Preschool, Female, Fever microbiology, Hospitalization statistics & numerical data, Hospitals, University, Humans, Infant, Malaria complications, Malaria epidemiology, Malaria microbiology, Malaria virology, Male, Middle Aged, Typhoid Fever epidemiology, Typhoid Fever microbiology, Young Adult, Fever etiology, Salmonella typhi isolation & purification, Salmonella typhi physiology, Typhoid Fever complications
- Abstract
Background: Fever is a common cause of hospital admission in Bangladesh but causative agents, other than malaria, are not routinely investigated. Enteric fever is thought to be common., Methods: Adults and children admitted to Chittagong Medical College Hospital with a temperature of ≥38.0 °C were investigated using a blood smear for malaria, a blood culture, real-time PCR to detect Salmonella Typhi, S. Paratyphi A and other pathogens in blood and CSF and an NS1 antigen dengue ELISA., Results: We enrolled 300 febrile patients with a negative malaria smear between January and June 2012: 156 children (aged ≤15 years) and 144 adults with a median (interquartile range) age of 13 (5-31) years and median (IQR) illness duration before admission of five (2-8) days. Clinical enteric fever was diagnosed in 52 patients (17.3 %), lower respiratory tract infection in 48 (16.0 %), non-specific febrile illness in 48 (16.0 %), a CNS infection in 37 patients (12.3 %), urinary sepsis in 23 patients (7.7 %), an upper respiratory tract infection in 21 patients (7.0 %), and diarrhea or dysentery in 21 patients (7.0 %). Malaria was still suspected in seven patients despite a negative microscopy test. S. Typhi was detected in blood by culture or PCR in 34 (11.3 %) of patients. Of note Rickettsia typhi and Orientia tsutsugamushi were detected by PCR in two and one patient respectively. Twenty-nine (9 %) patients died during their hospital admission (15/160 (9.4 %) of children and 14/144 (9.7 %) adults). Two of 52 (3.8 %) patients with enteric fever, 5/48 (10.4 %) patients with lower respiratory tract infections, and 12/37 (32.4 %) patients with CNS infection died., Conclusion: Enteric fever was confirmed in 11.3 % of patients admitted to this hospital in Bangladesh with non-malaria fever. Lower respiratory tract and CNS infections were also common. CNS infections in this location merit more detailed study due to the high mortality.
- Published
- 2016
- Full Text
- View/download PDF
39. A prospective descriptive study of cryptococcal meningitis in HIV uninfected patients in Vietnam - high prevalence of Cryptococcus neoformans var grubii in the absence of underlying disease.
- Author
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Chau TT, Mai NH, Phu NH, Nghia HD, Chuong LV, Sinh DX, Duong VA, Diep PT, Campbell JI, Baker S, Hien TT, Lalloo DG, Farrar JJ, and Day JN
- Subjects
- Adolescent, Adult, Aged, Amphotericin B pharmacology, Antifungal Agents pharmacology, Antifungal Agents therapeutic use, Cryptococcus gattii isolation & purification, Cryptococcus neoformans isolation & purification, Female, Flucytosine pharmacology, Humans, Male, Meningitis, Cryptococcal mortality, Meningitis, Cryptococcal pathology, Microbial Sensitivity Tests, Middle Aged, Prevalence, Prospective Studies, Treatment Outcome, Vietnam epidemiology, Young Adult, HIV Infections complications, Meningitis, Cryptococcal epidemiology, Meningitis, Cryptococcal microbiology
- Abstract
Background: Most cases of cryptococcal meningitis occur in patients with HIV infection: the course and outcome of disease in the apparently immunocompetent is much more poorly understood. We describe a cohort of HIV uninfected Vietnamese patients with cryptococcal meningitis in whom underlying disease is uncommon, and relate presenting features of patients and the characteristics of the infecting species to outcome., Methods: A prospective descriptive study of HIV negative patients with cryptococcal meningitis based at the Hospital for Tropical Diseases, Ho Chi Minh City. All patients had comprehensive clinical assessment at baseline, were cared for by a dedicated study team, and were followed up for 2 years. Clinical presentation was compared by infecting isolate and outcome., Results: 57 patients were studied. Cryptococcus neoformans var grubii molecular type VN1 caused 70% of infections; C. gattii accounted for the rest. Most patients did not have underlying disease (81%), and the rate of underlying disease did not differ by infecting species. 11 patients died while in-patients (19.3%). Independent predictors of death were age > or = 60 years and a history of convulsions (odds ratios and 95% confidence intervals 8.7 (1 - 76), and 16.1 (1.6 - 161) respectively). Residual visual impairment was common, affecting 25 of 46 survivors (54.3%). Infecting species did not influence clinical phenotype or outcome. The minimum inhibitory concentrations of flucytosine and amphotericin B were significantly higher for C. neoformans var grubii compared with C. gattii (p < 0.001 and p = 0.01 respectively)., Conclusion: In HIV uninfected individuals in Vietnam, cryptococcal meningitis occurs predominantly in people with no clear predisposing factor and is most commonly due to C. neoformans var grubii. The rates of mortality and visual loss are high and independent of infecting species. There are detectable differences in susceptibility to commonly used antifungal drugs between species, but the clinical significance of this is not clear.
- Published
- 2010
- Full Text
- View/download PDF
40. A changing picture of shigellosis in southern Vietnam: shifting species dominance, antimicrobial susceptibility and clinical presentation.
- Author
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Vinh H, Nhu NT, Nga TV, Duy PT, Campbell JI, Hoang NV, Boni MF, My PV, Parry C, Nga TT, Van Minh P, Thuy CT, Diep TS, Phuong le T, Chinh MT, Loan HT, Tham NT, Lanh MN, Mong BL, Anh VT, Bay PV, Chau NV, Farrar J, and Baker S
- Subjects
- Child, Preschool, Drug Resistance, Multiple, Bacterial, Female, Humans, Infant, Male, Microbial Sensitivity Tests, Seasons, Serotyping, Shigella flexneri classification, Shigella flexneri drug effects, Shigella flexneri pathogenicity, Shigella sonnei classification, Shigella sonnei drug effects, Shigella sonnei pathogenicity, Vietnam epidemiology, Dysentery, Bacillary epidemiology, Dysentery, Bacillary microbiology
- Abstract
Background: Shigellosis remains considerable public health problem in some developing countries. The nature of Shigellae suggests that they are highly adaptable when placed under selective pressure in a human population. This is demonstrated by variation and fluctuations in serotypes and antimicrobial resistance profile of organisms circulating in differing setting in endemic locations. Antimicrobial resistance in the genus Shigella is a constant threat, with reports of organisms in Asia being resistant to multiple antimicrobials and new generation therapies., Methods: Here we compare microbiological, clinical and epidemiological data from patients with shigellosis over three different periods in southern Vietnam spanning 14 years., Results: Our data demonstrates a shift in dominant infecting species (S. flexneri to S. sonnei) and resistance profile of the organisms circulating in southern Vietnam. We find that there was no significant variation in the syndromes associated with either S. sonnei or S. flexneri, yet the clinical features of the disease are more severe in later observations., Conclusions: Our findings show a change in clinical presentation of shigellosis in this setting, as the disease may be now more pronounced, this is concurrent with a change in antimicrobial resistance profile. These data highlight the socio-economic development of southern Vietnam and should guide future vaccine development and deployment strategies., Trial Registration: Current Controlled Trials ISRCTN55945881.
- Published
- 2009
- Full Text
- View/download PDF
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