18 results on '"Gunturu, R."'
Search Results
2. Population structure and virulence gene profiles of Streptococcus agalactiae collected from different hosts worldwide
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Morach, Marina, Stephan, Roger, Schmitt, S, Ewers, C, Zschöck, M, Reyes-Velez, J, Gilli, U, del Pilar Crespo-Ortiz, M, Crumlish, M, Gunturu, R, Daubenberger, C A, Ip, Margaret, Regli, Walter, Johler, Sophia, University of Zurich, and Johler, Sophia
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570 Life sciences ,biology ,610 Medicine & health ,2725 Infectious Diseases ,10082 Institute of Food Safety and Hygiene ,2726 Microbiology (medical) - Abstract
Streptococcus agalactiaeis a leading cause of morbidity and mortality among neonates and causes severe infections in pregnant women and nonpregnant predisposed adults, in addition to various animal species worldwide. Still, information on the population structure ofS. agalactiaeand the geographical distribution of different clones is limited. Further data are urgently needed to identify particularly successful clones and obtain insights into possible routes of transmission within one host species and across species borders. We aimed to determine the population structure and virulence gene profiles ofS. agalactiaestrains from a diverse set of sources and geographical origins. To this end, 373S. agalactiaeisolates obtained from humans and animals from five different continents were typed by DNA microarray profiling. A total of 242 differentS. agalactiaestrains were identified and further analyzed. Particularly successful clonal lineages, hybridization patterns, and strains were identified that were spread across different continents and/or were present in more than one host species. In particular, several strains were detected in both humans and cattle, and several canine strains were also detected in samples from human, bovine, and porcine hosts. The findings of our study suggest that althoughS. agalactiaeis well adapted to various hosts including humans, cattle, dogs, rodents, and fish, interspecies transmission is possible and occurs between humans and cows, dogs, and rabbits. The virulence and resistance gene profiles presented enable new insights into interspecies transmission and make a crucial contribution to the identification of suitable targets for therapeutic agents and vaccines.
- Published
- 2018
3. SARS-CoV-2 Variants Genotyping and Diagnostic Performance of a 2-Genes Detection Assay.
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Matheka C, Kilonzo J, Mbugua E, Munshi Z, Nyasinga J, Gunturu R, and Njau A
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- Humans, Genotype, Pandemics, Reproducibility of Results, COVID-19 Testing, SARS-CoV-2 genetics, COVID-19 diagnosis
- Abstract
Background: The emergence of the COVID-19 pandemic resulted in the unprecedented expansion of molecular testing technologies. This study aimed at evaluating the performance of the FluoroType® SARS-CoV-2 plus assay for SARS-CoV-2 detection as well as describing the detection of SARS-CoV-2 variants using the FluoroType® SARS-CoV-2 varID Q kit., Methods: The study utilized 679 archived nasopharyngeal samples. Analytical performance and the diagnostic performance of the FluoroType® SARS-CoV-2 plus assay were determined using 320 samples and reference material. Variants identification on the FluoroType® SARS-CoV-2 varID Q assay was performed on 359 samples. The study was approved by the Aga Khan University Hospital Institutional Review Board., Results: The FluoroType® SARS-CoV-2 plus assay's limit of detection was verified as 1.2 copies/µL. The repeatability SD and %CV were 2.45 and 9.8% while reproducibility had an SD and %CV of 1.39 and 5.68%, respectively, for the RdRP gene. The positive and negative percent agreement were determined to be 99.4% (95% CI; 98.1%-100%) and 99.4% (95% CI; 98.2%-100%) respectively. In the variants identification, samples from the original wave had no mutations identified while 12.3%, 49%, and more than 90% of the samples during the Alpha, Delta, and Omicron waves, respectively, had detectable mutations., Conclusions: The FluoroType® SARS-CoV-2 plus assay demonstrated analytical performance comparable to the reference method with a diagnostic sensitivity and specificity of >99%. The FluoroType® SARS-CoV-2 varID Q assay achieved rapid detection of circulating variants., (© Association for Diagnostics & Laboratory Medicine 2024. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)
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- 2024
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4. Child deaths caused by Klebsiella pneumoniae in sub-Saharan Africa and south Asia: a secondary analysis of Child Health and Mortality Prevention Surveillance (CHAMPS) data.
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Verani JR, Blau DM, Gurley ES, Akelo V, Assefa N, Baillie V, Bassat Q, Berhane M, Bunn J, Cossa ACA, El Arifeen S, Gunturu R, Hale M, Igunza A, Keita AM, Kenneh S, Kotloff KL, Kowuor D, Mabunda R, Madewell ZJ, Madhi S, Madrid L, Mahtab S, Miguel J, Murila FV, Ogbuanu IU, Ojulong J, Onyango D, Oundo JO, Scott JAG, Sow S, Tapia M, Traore CB, Velaphi S, Whitney CG, Mandomando I, and Breiman RF
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- Humans, Infant, Infant, Newborn, Anti-Bacterial Agents pharmacology, Asia, Southern epidemiology, Cause of Death, Child Health, Pneumonia, Sepsis, Stillbirth epidemiology, Child, Preschool, Africa South of the Sahara epidemiology, Klebsiella pneumoniae, Child Mortality
- Abstract
Background: Klebsiella pneumoniae is an important cause of nosocomial and community-acquired pneumonia and sepsis in children, and antibiotic-resistant K pneumoniae is a growing public health threat. We aimed to characterise child mortality associated with this pathogen in seven high-mortality settings., Methods: We analysed Child Health and Mortality Prevention Surveillance (CHAMPS) data on the causes of deaths in children younger than 5 years and stillbirths in sites located in seven countries across sub-Saharan Africa (Ethiopia, Kenya, Mali, Mozambique, Sierra Leone, and South Africa) and south Asia (Bangladesh) from Dec 9, 2016, to Dec 31, 2021. CHAMPS sites conduct active surveillance for deaths in catchment populations and following reporting of an eligible death or stillbirth seek consent for minimally invasive tissue sampling followed by extensive aetiological testing (microbiological, molecular, and pathological); cases are reviewed by expert panels to assign immediate, intermediate, and underlying causes of death. We reported on susceptibility to antibiotics for which at least 30 isolates had been tested, and excluded data on antibiotics for which susceptibility testing is not recommended for Klebsiella spp due to lack of clinical activity (eg, penicillin and ampicillin)., Findings: Among 2352 child deaths with cause of death assigned, 497 (21%, 95% CI 20-23) had K pneumoniae in the causal chain of death; 100 (20%, 17-24) had K pneumoniae as the underlying cause. The frequency of K pneumoniae in the causal chain was highest in children aged 1-11 months (30%, 95% CI 26-34; 144 of 485 deaths) and 12-23 months (28%, 22-34; 63 of 225 deaths); frequency by site ranged from 6% (95% CI 3-11; 11 of 184 deaths) in Bangladesh to 52% (44-61; 71 of 136 deaths) in Ethiopia. K pneumoniae was in the causal chain for 450 (22%, 95% CI 20-24) of 2023 deaths that occurred in health facilities and 47 (14%, 11-19) of 329 deaths in the community. The most common clinical syndromes among deaths with K pneumoniae in the causal chain were sepsis (44%, 95% CI 40-49; 221 of 2352 deaths), sepsis in conjunction with pneumonia (19%, 16-23; 94 of 2352 deaths), and pneumonia (16%, 13-20; 80 of 2352 deaths). Among K pneumoniae isolates tested, 121 (84%) of 144 were resistant to ceftriaxone and 80 (75%) of 106 to gentamicin., Interpretation: K pneumoniae substantially contributed to deaths in the first 2 years of life across multiple high-mortality settings, and resistance to antibiotics used for sepsis treatment was common. Improved strategies are needed to rapidly identify and appropriately treat children who might be infected with this pathogen. These data suggest a potential impact of developing and using effective K pneumoniae vaccines in reducing neonatal, infant, and child deaths globally., Funding: Bill & Melinda Gates Foundation., Competing Interests: Declaration of interests SEA, KLK, and MT report receiving funding from Emory University. JAGS reports receiving funding from Emory University, the Bill & Melinda Gates Foundation, Wellcome Trust, UK Foreign Commonwealth & Development Office, European Union, and National Institute for Health Research. SMad reports receiving funds from the Bill & Melinda Gates Foundation, Pfizer, Minervax, GSK, South African Medical Research Council, Merck, PATH, and Center for the AIDS Programme of Research in South Africa. All other authors declare no competing interests., (Published by Elsevier Ltd.)
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- 2024
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5. Helicobacter pylori Diagnosis and Treatment in Africa: The First Lagos Consensus Statement of the African Helicobacter and Microbiota Study Group.
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Smith SI, Schulz C, Ugiagbe R, Ndip R, Dieye Y, Leja M, Onyekwere C, Ndububa D, Ajayi A, Jolaiya TF, Jaka H, Setshedi M, Gunturu R, Otegbayo JA, Lahbabi-Amrani N, Arigbabu AO, Kayamba V, and Nashidengo PA
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- Humans, Africa epidemiology, Prevalence, Helicobacter Infections diagnosis, Helicobacter Infections drug therapy, Helicobacter Infections epidemiology, Helicobacter Infections therapy, Helicobacter pylori, Consensus
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Background: Helicobacter pylori (H. pylori) infection is the most prevalent type of bacterial infection. Current guidelines from different regions of the world neglect specific African conditions and requirements. The African Helicobacter and Microbiota Study Group (AHMSG), founded in 2022, aimed to create an Africa-specific consensus report reflecting Africa-specific issues., Summary: Eighteen experts from nine African countries and two European delegates supported by nine African collaborators from eight other countries prepared statements on the most important African issues in four working groups: (1) epidemiology, (2) diagnosis, (3) indications and prevention, and (4) treatment. Limited resources, restricted access to medical systems, and underdeveloped diagnostic facilities differ from those of other regions. The results of the individual working groups were presented for the final consensus voting, which included all board members., Key Messages: There is a need for further studies on H. pylori prevalence in Africa, with diagnosis hinged on specific African situation. Treatment of H. pylori in the African setting should be based on accessibility and reimbursement, while indication and prevention should be defined in specific African countries., (© 2024 S. Karger AG, Basel.)
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- 2024
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6. Thymoquinone mitigates obesity and diabetic parameters through regulation of major adipokines, key lipid metabolizing enzymes and AMPK/p-AMPK in diet-induced obese rats.
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Ramineedu K, Sankaran KR, Mallepogu V, Rendedula DP, Gunturu R, Gandham S, Md SI, and Meriga B
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The present study was designed to evaluate the anti-obesity and anti-hyperglycemic activity of Thymoquinone (ThyQ) isolated from Nigella sativa seeds. Male Wistar rats were randomly divided into five groups and fed either normal pellet diet or high-fat diet (HFD) for 18 weeks and water ad-libitum . Group I: normal pellet diet (NPD)-fed, Group II: high-fat diet (HFD)-fed, Group III: HFD-fed-ThyQ (20 mg)-treated, Group IV: HFD-fed-ThyQ (40 mg)-treated and Group V: HFD-fed-Orlistat (5 mg)-treated group. Intervention with ThyQ started from 12th week onwards to HFD-fed rats of group III and IV. ThyQ administration significantly ( p < 0.01) mitigated body weight gain, blood glucose, insulin level, serum and liver lipids (except HDL) and improved glucose tolerance and insulin sensitivity as evaluated by oral glucose tolerance test (OGTT), homeostasis model assessment-insulin resistance (HOMA-IR) and insulin tolerance test (ITT). Furthermore, ThyQ significantly ( p < 0.01) diminished serum aspartate transaminase (AST), alanine transaminase (ALT), acetyl-CoA carboxylase (ACC), plasma leptin, resistin and visfatin levels but enhanced lipoprotein lipase (LPL) and adiponectin levels. RT-PCR analysis demonstrated down-regulated mRNA expression of sterol regulatory element-binding proteins-1c (SREBP-1c), CCAAT/enhancer-binding protein-α (C/EBP-α) and fatty acid synthase (FAS) but upregulation of Insulin receptor substrate-1 (IRS-1).Western blot analysis displayed phosphorylation of adenosine monophosphate activated protein kinase (AMPK) in ThyQ-treated rats. Liver microtome sections of HFD-fed rats showed degenerated hepatocytes with high lipid stores while that of adipose tissue sections displayed large, fat-laden adipocytes, however, these histological changes were considerably attenuated in ThyQ-treated groups. Together these findings demonstrate that ThyQ can be a valuable therapeutic compound to potentially alleviate diet-induced obesity, hyperglycemia and insulin resistance., Supplementary Information: The online version contains supplementary material available at 10.1007/s13205-023-03847-x., Competing Interests: Conflict of interestThere are no competing financial interests declared by the authors., (© King Abdulaziz City for Science and Technology 2023. Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.)
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- 2024
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7. Development, roll-out and implementation of an antimicrobial resistance training curriculum harmonizes delivery of in-service training to healthcare workers in Kenya.
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Njeru J, Odero J, Chebore S, Ndung'u M, Tanui E, Wesangula E, Ndanyi R, Githii S, Gunturu R, Mwangi W, Mutonga D, Dahourou A, and Thaiyah A
- Abstract
Background: Antimicrobial resistance (AMR) is an increasingly severe threat to global public health that requires action across different sectors. Selection of appropriate antimicrobials is an urgent challenge due to the emergence of drug resistance. In 2017, Kenya developed an AMR policy and National Action Plan to drive prevention and containment of AMR. A priority activity under AMR surveillance strategic objective was to develop a national AMR training curriculum for in-service healthcare workers. In this paper we discuss the development process, gains achieved through implementation across the country and lessons learned., Methods: An initial stakeholders' forum was convened to brainstorm on the process for developing the curriculum and some issues deliberated upon include the design approach, development roadmap, curriculum outline and scope, delivery, and evaluation methodologies. A dedicated team of subject matter experts (SMEs), drawn from the project and government ministries, compiled the initial draft of the curriculum and later the training materials. A series of other stakeholders' meetings were convened to review these materials. The National Antimicrobial Stewardship Interagency Committee (NASIC) of the MOH in Kenya identified a team of experts from academia, research, and government to work with the SMEs in reviewing and providing valuable inputs to the curriculum. Additionally, principles of adult learning and a One Health approach for development were considered as AMR has drivers and impacts across sectors. A validation workshop was held to finalize the documents with a formal launch conducted during the World Antibiotics Awareness Week of 2020., Results: A multisectoral AMR surveillance training curriculum and facilitator and trainee manuals were developed and endorsed by MOH and Ministry of Agriculture, Livestock, Fisheries and Cooperatives within one year. Over 500 healthcare workers in 19 counties were trained, with overwhelming adoption by other stakeholders in Kenya and beyond., Conclusion: This curriculum was developed to standardize training for AMR detection and surveillance. The central role played by the MOH ensured expeditious development and roll-out of this curriculum. The in-service curriculum, now available on an e-learning platform, provides a ready opportunity to build capacity of healthcare professionals. Additional resources are needed to standardize and scale these efforts to reach all healthcare workers., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2023 Njeru, Odero, Chebore, Ndung’u, Tanui, Wesangula, Ndanyi, Githii, Gunturu, Mwangi, Mutonga, Dahourou and Thaiyah.)
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- 2023
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8. Helicobacter pylori Infection in Africa: Update of the Current Situation and Challenges.
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Smith SI, Ajayi A, Jolaiya T, Onyekwere C, Setshedi M, Schulz C, Otegbayo JA, Ndip R, Dieye Y, Alboraie M, Ally R, Gunturu R, Hyasinta J, Ugiagbe R, Ndububa D, and Arigbabu A
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- Adult, Africa epidemiology, Child, Humans, Prevalence, Helicobacter Infections diagnosis, Helicobacter Infections drug therapy, Helicobacter Infections epidemiology, Helicobacter pylori, Stomach Neoplasms epidemiology, Stomach Neoplasms therapy
- Abstract
Background: The burden of Helicobacter pylori infection (HPI) in Africa remains high with varying levels of prevalence among children and adults reported in different regions of the continent. Persistent and uneradicated HPI could result in gastric cancer, although less severe pathological outcomes have been reported among Africans - the so-called "African enigma.", Summary: Analysis of endoscopic findings of the upper gastrointestinal tract demonstrates similarities with that of patients from the West. Thus, it could be asserted that the true picture of HPI in Africa is yet to be unveiled due to several challenges including inadequate health-care system, lack of treatment guidelines and standardized protocol for diagnosis, and lack of data. This review explores the prevalence, diagnosis, treatment, and health-care system in Africa as it relates to HPI, thus providing an update and highlighting the need for an African HPI guideline., Key Messages: There is high prevalence of Helicobacter pylori infection (HPI) in Africa with an increasing burden of antibiotic resistance. Various methods including invasive and noninvasive methods are deployed in the diagnosis of HPI in Africa. There is a need for consensus on diagnosis and treatment of HPI in Africa., (© 2021 S. Karger AG, Basel.)
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- 2022
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9. Prospective Cohort Study on Timing of Antimicrobial Prophylaxis for Post-Cesarean Surgical Site Infections.
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Sway A, Wanyoro A, Nthumba P, Aiken A, Ching P, Maruta A, Gunturu R, and Solomkin J
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- Adolescent, Adult, Africa South of the Sahara epidemiology, Cross Infection prevention & control, Developing Countries, Drug Administration Schedule, Female, Humans, Incidence, Kenya epidemiology, Prospective Studies, Risk Factors, Surgical Wound Infection diagnosis, Young Adult, Anti-Bacterial Agents administration & dosage, Antibiotic Prophylaxis methods, Cesarean Section adverse effects, Surgical Wound Infection prevention & control
- Abstract
Background: Sepsis is the leading cause of maternal death in sub-Saharan Africa (SSA), a region that sees some of the highest rates of maternal death and morbidity in the world. As one of the most commonly performed surgical procedures in SSA and a proved risk factor for surgical site infection (SSI), cesarean section (CS) is an important operation to target because of its massive impact on maternal and neonatal health. There is currently insufficient published data available on the patient and facility-based context around SSI after CS to establish a true and clear understanding of this infectious category. The objective of this study was to collect accurate and valid data on the incidence of SSI after CS and the circumstances around SSI in two Kenyan hospitals. Hypothesis: Our primary analysis focused on the consequences of timing of peri-operative antimicrobial prophylaxis. We hypothesized that patients who were given antibiotics pre-operatively would show lower SSI rates than those given the agents post-operatively. Methods: This was an Institutional Review Board-approved observational study of 609 women who had CS operations at two Kenyan hospitals from September to December 2015. Thika provided antimicrobial prophylaxis prior to incision for all patients, and Kiambu provided only post-operative prophylaxis. It should be noted that this difference was the result of a previous intervention at Thika and not a part of this observational study. Results: Patients at the two hospitals had similar pre-operative characteristics indicating a relatively healthy population. The median age was 26 ± 6 years (range 18-43) at Thika and 26 ± 5 (18-44) at Kiambu. Median parity was 1 ± 1 (range 0-7) at Thika and 1 ± 1 (0-10). Patients also went through a comparable number of antenatal care visits (median 4 ± 1 at both hospitals). The number of patients with prolonged rupture of the membranes was 103 (34.4%) at Thika and 99 (32.9%) at Kiambu. There was a slightly higher number of patients with meconium-stained liquor at Kiambu Hospital (115) than at Thika (74). The SSI rate was 4.0% (12/299; 11 superficial, 1 deep) at Thika and 9.3% (28/301; 18 superficial, 7 deep, 3 organ/space) at Kiambu. Conclusions: The data show a striking difference between SSI rates in patients who were given properly timed pre-operative antibiotics and patients who were given only post-operative antibiotics. Administration of post-operative antibiotics is currently the norm in much of SSA, and there is strong evidence that many of the infectious problems encountered in this population would be reduced by the provision of antibiotic prophylaxis prior to the incision.
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- 2020
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10. Tracing the Evolutionary History and Global Expansion of Candida auris Using Population Genomic Analyses.
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Chow NA, Muñoz JF, Gade L, Berkow EL, Li X, Welsh RM, Forsberg K, Lockhart SR, Adam R, Alanio A, Alastruey-Izquierdo A, Althawadi S, Araúz AB, Ben-Ami R, Bharat A, Calvo B, Desnos-Ollivier M, Escandón P, Gardam D, Gunturu R, Heath CH, Kurzai O, Martin R, Litvintseva AP, and Cuomo CA
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- Antifungal Agents pharmacology, Azoles pharmacology, Biological Evolution, Candidiasis, Invasive drug therapy, Candidiasis, Invasive epidemiology, Echinocandins pharmacology, Fluconazole pharmacology, Genes, Fungal, Genetics, Population methods, Genome, Fungal, Humans, Metagenomics, Molecular Epidemiology, Mutation, Phylogeny, Phylogeography, Whole Genome Sequencing, Candida classification, Candida drug effects, Candida genetics, Candida isolation & purification, Drug Resistance, Fungal genetics
- Abstract
Candida auris has emerged globally as a multidrug-resistant yeast that can spread via nosocomial transmission. An initial phylogenetic study of isolates from Japan, India, Pakistan, South Africa, and Venezuela revealed four populations (clades I, II, III, and IV) corresponding to these geographic regions. Since this description, C. auris has been reported in more than 30 additional countries. To trace this global emergence, we compared the genomes of 304 C. auris isolates from 19 countries on six continents. We found that four predominant clades persist across wide geographic locations. We observed phylogeographic mixing in most clades; clade IV, with isolates mainly from South America, demonstrated the strongest phylogeographic substructure. C. auris isolates from two clades with opposite mating types were detected contemporaneously in a single health care facility in Kenya. We estimated a Bayesian molecular clock phylogeny and dated the origin of each clade within the last 360 years; outbreak-causing clusters from clades I, III, and IV originated 36 to 38 years ago. We observed high rates of antifungal resistance in clade I, including four isolates resistant to all three major classes of antifungals. Mutations that contribute to resistance varied between the clades, with Y132F in ERG11 as the most widespread mutation associated with azole resistance and S639P in FKS1 for echinocandin resistance. Copy number variants in ERG11 predominantly appeared in clade III and were associated with fluconazole resistance. These results provide a global context for the phylogeography, population structure, and mechanisms associated with antifungal resistance in C. auris IMPORTANCE In less than a decade, C. auris has emerged in health care settings worldwide; this species is capable of colonizing skin and causing outbreaks of invasive candidiasis. In contrast to other Candida species, C. auris is unique in its ability to spread via nosocomial transmission and its high rates of drug resistance. As part of the public health response, whole-genome sequencing has played a major role in characterizing transmission dynamics and detecting new C. auris introductions. Through a global collaboration, we assessed genome evolution of isolates of C. auris from 19 countries. Here, we described estimated timing of the expansion of each C. auris clade and of fluconazole resistance, characterized discrete phylogeographic population structure of each clade, and compared genome data to sensitivity measurements to describe how antifungal resistance mechanisms vary across the population. These efforts are critical for a sustained, robust public health response that effectively utilizes molecular epidemiology.
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- 2020
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11. Cytological diagnosis of cryptococcosis in a biliary specimen: Report of a rare case with brief review of literature.
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Kumar N, Gupta R, Sayed S, Moloo Z, Adam R, Gunturu R, and Devani S
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- Cryptococcosis microbiology, Cryptococcosis mortality, Cryptococcosis urine, Cryptococcus neoformans pathogenicity, Humans, Male, Middle Aged, Pneumonia mortality, Cryptococcosis diagnosis, Cryptococcus neoformans isolation & purification, Cytodiagnosis, Pneumonia microbiology
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- 2019
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12. Streptococcus pneumoniae serotype epidemiology among PCV-10 vaccinated and unvaccinated children at Gertrude's Children's Hospital, Nairobi County: a cross-sectional study.
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Walekhwa M, Muturi M, Gunturu R, Kenya E, and Kabera B
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- Child, Preschool, Cross-Sectional Studies, Female, Hospitals, Pediatric, Humans, Infant, Kenya epidemiology, Male, Prevalence, Serotyping, Pneumococcal Infections epidemiology, Pneumococcal Infections microbiology, Pneumococcal Infections prevention & control, Pneumococcal Vaccines administration & dosage, Serogroup, Streptococcus pneumoniae classification, Streptococcus pneumoniae isolation & purification
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Background: Streptococcus pneumoniae (SP n ) serotype replacement and emergence of multidrug resistant SP n has exacerbated the need for continuous regional serotype surveillance. We investigated SP n serotypes circulating among children ≤5 years in Nairobi County. Methods: Streptococcus pneumoniae stocks stored at -70°C in brain heart infusion medium were thawed at room temperature for 30 minutes. In total, 10 µl of the stored SP n cells were suspended in 50 µl PBS and gently vortexed. About 10 µl of the suspended cells were added on to a glass slide and mixed with 10 µl pooled antisera. The glass slide was swirled gently while observing for any reaction. The process was repeated with individual groups under various antisera pools. Those serotypes that did not belong to any pool were typed directly until a positive agglutination reaction was observed. The cells/PBS/serotype-specific antisera mixture on the glass slide were covered with a coverslip and observed under a phase contrast microscope at ×100 objective lens with oil emulsion. Results: Out of the 206 subjects sampled, 20.39% (n=42) were found to be carriers of SP n . About 52% (n=22) of the SP n carriers had received the recommended dose of PCV-10, while 48% (n=20) of the carriers had not. Almost all (n=41; 19.90% of subjects) isolates contained non-vaccine type SP n serotypes, while n=1 of the serotypes (in 0.49% of subjects) were untypeable. Serotypes 28F, 6A, 11A, 3 and 7C were prevalent in both vaccinated and unvaccinated children, whereas serotypes 23A, 17F, 35F, 48, 13 and 35B, and 23B, 20, 19B, 21, untypeable, 15B and 39 were found among unvaccinated and vaccinated groups, respectively. Conclusions: All SP n serotypes isolated from the subjects sampled were non PCV-10 vaccine type. Therefore Kenyan children receiving PCV-10 vaccine are not protected., Competing Interests: No competing interests were disclosed.
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- 2018
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13. Population structure and virulence gene profiles of Streptococcus agalactiae collected from different hosts worldwide.
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Morach M, Stephan R, Schmitt S, Ewers C, Zschöck M, Reyes-Velez J, Gilli U, Del Pilar Crespo-Ortiz M, Crumlish M, Gunturu R, Daubenberger CA, Ip M, Regli W, and Johler S
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- Animals, Cattle, DNA, Bacterial analysis, DNA, Bacterial genetics, Dogs, Humans, Oligonucleotide Array Sequence Analysis, Swine, Bacterial Proteins genetics, Streptococcal Infections epidemiology, Streptococcal Infections microbiology, Streptococcal Infections transmission, Streptococcal Infections veterinary, Streptococcus agalactiae classification, Streptococcus agalactiae genetics, Streptococcus agalactiae pathogenicity, Virulence genetics
- Abstract
Streptococcus agalactiae is a leading cause of morbidity and mortality among neonates and causes severe infections in pregnant women and nonpregnant predisposed adults, in addition to various animal species worldwide. Still, information on the population structure of S. agalactiae and the geographical distribution of different clones is limited. Further data are urgently needed to identify particularly successful clones and obtain insights into possible routes of transmission within one host species and across species borders. We aimed to determine the population structure and virulence gene profiles of S. agalactiae strains from a diverse set of sources and geographical origins. To this end, 373 S. agalactiae isolates obtained from humans and animals from five different continents were typed by DNA microarray profiling. A total of 242 different S. agalactiae strains were identified and further analyzed. Particularly successful clonal lineages, hybridization patterns, and strains were identified that were spread across different continents and/or were present in more than one host species. In particular, several strains were detected in both humans and cattle, and several canine strains were also detected in samples from human, bovine, and porcine hosts. The findings of our study suggest that although S. agalactiae is well adapted to various hosts including humans, cattle, dogs, rodents, and fish, interspecies transmission is possible and occurs between humans and cows, dogs, and rabbits. The virulence and resistance gene profiles presented enable new insights into interspecies transmission and make a crucial contribution to the identification of suitable targets for therapeutic agents and vaccines.
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- 2018
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14. The 17th International Congress on Infectious Diseases workshop on developing infection prevention and control resources for low- and middle-income countries.
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Sastry S, Masroor N, Bearman G, Hajjeh R, Holmes A, Memish Z, Lassmann B, Pittet D, Macnab F, Kamau R, Wesangula E, Pokharel P, Brown P, Daily F, Amer F, Torres J, O'Ryan M, Gunturu R, Bulabula A, and Mehtar S
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- Cross Infection epidemiology, Delivery of Health Care, Developing Countries, Disease Outbreaks, Health Resources, Humans, India, Poverty, Infection Control
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Hospital-acquired infections (HAIs) are a major concern to healthcare systems around the world. They are associated with significant morbidity and mortality, in addition to increased hospitalization costs. Recent outbreaks, including those caused by the Middle East respiratory syndrome coronavirus and Ebola virus, have highlighted the importance of infection control. Moreover, HAIs, especially those caused by multidrug-resistant Gram-negative rods, have become a top global priority. Although adequate approaches and guidelines have been in existence for many years and have often proven effective in some countries, the implementation of such approaches in low- and middle-income countries (LMICs) is often restricted due to limited resources and underdeveloped infrastructure. While evidence-based infection prevention and control (IPC) principles and practices are universal, studies are needed to evaluate simplified approaches that can be better adapted to LMIC needs, in order to guide IPC in practice. A group of experts from around the world attended a workshop held at the 17th International Congress on Infectious Diseases in Hyderabad, India in March 2016, to discuss the existing IPC practices in LMICs, and how best these can be improved within the local context., (Copyright © 2017 The Author(s). Published by Elsevier Ltd.. All rights reserved.)
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- 2017
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15. "Combined Occlusion and Atropine Therapy" Versus "Augmented Part-Time Patching" in Children with Refractory/Residual Amblyopia: A Pilot Study.
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Sachdeva V, Mittal V, Gupta V, Gunturu R, Kekunnaya R, Chandrasekharan A, Chabblani PP, and Rao HL
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- Child, Child, Preschool, Combined Modality Therapy, Female, Follow-Up Studies, Humans, Male, Pilot Projects, Retrospective Studies, Treatment Outcome, Visual Acuity physiology, Amblyopia therapy, Atropine therapeutic use, Mydriatics therapeutic use, Sensory Deprivation
- Abstract
Purpose: To compare the efficacy of combined occlusion and atropine therapy (COAT) and augmented part-time patching for the treatment of unilateral refractory/residual amblyopia., Methodology: This retrospective study evaluated children between 4 and 11 years with refractory/residual amblyopia who were treated with either additional atropine (COAT group) or increased hours of patching (augmented group). Data were collected on improvement in best-corrected visual acuity (BCVA; logarithm of the minimum angle of resolution [logMAR] units) at each follow-up visit., Results: There were 19 children in the COAT group and 17 children in the augmented group. The baseline BCVA of the amblyopic eye was 0.79 ± 0.36 logMAR in the COAT group and 0.72 ± 0.26 logMAR in augmented group. Children were statistically significantly younger in the COAT group (6.4 ± 2.2 years) compared to the augmented group (8.6 ± 3.3 years, P = 0.02). The mean duration of follow-up was statistically significantly longer in the augmented group (20.2 COAT group; 13.9 months augmented group) (P = 0.03). Compliance was similar in both groups. LogMAR BCVA (adjusted for difference in age and baseline BCVA) was statistically significantly better in the COAT group (0.56 ± 0.04) compared to the augmented group (0.80 ± 0.04) at 3 months (P = 0.000); 6 months (COAT group, 0.50 ± 0.04 vs. augmented group, 0.74 ± 0.04; P = 0.04) and at 1 year (COAT group, 0.42 ± 0.04 vs. augmented group, 0.67 ± 0.04, P = 0.000). There was statistically significantly greater improvement in logMAR BCVA at 6 months in COAT group (0.26 ± 0.15) compared to the augmented group (0.02 ± 0.14), (P = 0.0002). Age, gender, pretreatment BCVA, duration of follow-up, or compliance to patching did not affect improvement in BCVA., Conclusions: COAT may result in greater improvement in BCVA than augmented part-time patching in children with unilateral residual/refractory amblyopia.
- Published
- 2016
- Full Text
- View/download PDF
16. Measuring Health-Related Quality of Life in Strabismus: A Modification of the Adult Strabismus-20 (AS-20) Questionnaire Using Rasch Analysis.
- Author
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Gothwal VK, Bharani S, Kekunnaya R, Chhablani P, Sachdeva V, Pehere NK, Narasaiah A, and Gunturu R
- Subjects
- Adolescent, Adult, Aged, Female, Humans, Likelihood Functions, Male, Middle Aged, Probability, Young Adult, Psychometrics, Quality of Life, Strabismus physiopathology, Surveys and Questionnaires
- Abstract
Purpose: To evaluate the psychometric properties of the Adult Strabismus-20 (AS-20)- a health-related quality of life (HRQoL) questionnaire in adults with strabismus, and if flawed, to revise the AS-20 and its subscales creating valid measurement scales., Methods: 584 adults (meanage, 27.5 years) with strabismus were recruited from an outpatient clinic at a South Indian tertiary eye care centre and were administered the AS-20 questionnaire.The AS-20 was translated and back translated into two Indian languages. The AS-20 and its two 10-item subscales - 'psychosocial' and 'function'were assessed separately for fit to the Rasch model, including an assessment of the rating scale, unidimensionality (by principal components analysis), measurement precision by person separation reliability, PSR, targeting, and differential item functioning (DIF; notable > 1.0 logits)., Results: Response categories were not used as intended, thereby, required re-organization and reducing their number from 5 to 3. The AS-20 had adequate measurement precision (PSR = 0.87) but lacked unidimensionality; however, deletion of the six multi-dimensionality causing items and an additional three misfitting items resulted in 11-item unidimensional questionnaire (AS-11). Two items failed to satisfy the model expectations in the 'psychosocial' subscale and were deleted - resulting in an 8-item unidimensional scale with adequate PSR (0.81) and targeting (0.23 logits). One item misfit in the 'function' subscale and was deleted-resulting in a 9 item Rasch-revised unidimensional subscale with acceptable PSR (0.80) and targeting (0.97 logits).None of the items displayed notable DIF by age, gender and level of education., Conclusions: The AS-11 and its two Rasch-revised subscales - 8-item psychosocial and 9-item function subscale may be more appropriate than the original AS-20 and its two 10-item subscales for use as unidimensional measures of HRQoL in adults with strabismus in India. Further work is required to establish the validity of the revised rating scale.
- Published
- 2015
- Full Text
- View/download PDF
17. Pattern of pathogens and their sensitivity isolated from surgical site infections at the Aga Khan University Hospital, Nairobi, Kenya.
- Author
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Dinda V, Gunturu R, Kariuki S, Hakeem A, Raja A, and Kimang'a A
- Subjects
- Adult, Ambulatory Care Facilities, Developing Countries, Female, Follow-Up Studies, Hospitals, University, Humans, Incidence, Kenya epidemiology, Length of Stay, Male, Methicillin-Resistant Staphylococcus aureus, Microbial Sensitivity Tests, Middle Aged, Risk Factors, Sepsis drug therapy, Sepsis epidemiology, Surgical Wound Infection drug therapy, Surgical Wound Infection epidemiology, Universities, Bacillus, Sepsis microbiology, Staphylococcus aureus, Surgical Wound Infection microbiology, Vancomycin therapeutic use
- Abstract
Background: In low income countries, surgical site infections (SSIs) are costly and impose a heavy and potentially preventable burden on both patients and healthcare providers. This study aimed to determine the occurrence of SSI, pathogens associated with SSI, the antibiogram of the causative pathogens and specific risk factors associated with SSI at the hospital., Methods: Two hundred and sixty-eight respondents admitted for general surgical procedures (other than neurological and cardiothoracic surgeries) at the Aga Khan University Hospital were eligible to take part in the study. Post-surgery patients were observed for symptoms of infection. Follow ups were done through the consulting clinics, breast clinic and casualty dressing clinic by a team of surgeons. In cases of infection, pus swabs were collected for culture., Results: SSI incidence rate was 7.0%, pathogens isolated from SSI included gram negative enteric bacilli and S. aureus which was the most prevalent bacterial isolate. Only one isolate of MRSA was found and all staphylococci were susceptible to Vancomycin. Preoperative stay ≥ 2 days and wound class were the risk factors associated with SSI., Conclusion: The SSI incidence rates (7.0%) observed in this study were relatively lower than the ones documented in other studies in Kenya. S. aureus is the most prevalent pathogen associated with SSI. Similar to findings from other studies done in the region; prolonged hospital stay and dirty wounds were the risks associated with postsurgical sepsis at the hospital.
- Published
- 2013
18. Efficacy of split hours part-time patching versus continuous hours part-time patching for treatment of anisometropic amblyopia in children: a pilot study.
- Author
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Sachdeva V, Mittal V, Kekunnaya R, Gupta A, Rao HL, Mollah J, Sontha A, Gunturu R, and Rao BV
- Subjects
- Amblyopia physiopathology, Child, Child, Preschool, Eyeglasses, Female, Follow-Up Studies, Humans, Male, Patient Compliance, Pilot Projects, Prospective Studies, Time Factors, Treatment Outcome, Amblyopia therapy, Sensory Deprivation, Visual Acuity physiology
- Abstract
Aim: To compare efficacy of 'split hours part-time patching' and 'continuous hours part-time patching' for the treatment of anisometropic amblyopia., Methods: We designed a prospective, interventional, non-randomised, comparative pilot study involving children between 4 and 11 years of age with anisometropic amblyopia who were treated with either continuous wear (Group A) or split hours part-time patching (Group B) as per parents wish, after appropriate discussion with the parents. Children were followed-up for the improvement in visual acuity and the compliance at each follow-up visit., Results: 44 and 24 children were recruited in Group A and Group B, respectively (mean ± SD baseline BCVA of the amblyopic eye: 0.99 ± 0.32 and 0.95 ± 0.23 logMAR, respectively). BCVA (adjusted for baseline BCVA and age) at 3 months in Group A (0.59 ± 0.24) was comparable (p=0.08) with that in Group B (0.71 ± 0.24). This was same even at 6 months (0.51 ± 0.25 in Group A and 0.59 ± 0.25 in Group B, p=0.25). The improvement in BCVA at 3 months was also comparable (p=0.06) in Group A (0.39 ± 0.23) and Group B (0.26 ± 0.23). The improvement in BCVA at 6 months was also comparable (p=0.14) in Group A (0.47 ± 0.26) and Group B (0.37 ± 0.26)., Conclusions: Both patching regimens lead to significant and comparable improvement in BCVA in anisometropic amblyopia up to 6 months of follow-up.
- Published
- 2013
- Full Text
- View/download PDF
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