Medical Pathology Commons^™

Emergence Of Transferable Daptomycin Resistance In Gram-Positive Bacteria, Tessa Marciniak, Lukas Kirchner, Silver A. Wolf, Birgit Walther, Thorsten Bischler, Justin Nyasinga, R Gunturu, Torsten Semmler, Tom Gräfenhan, Andrew Whitelaw

Pathology, East Africa

Daptomycin (DAP) is a last-resort antibiotic to treat infections by multiresistant Gram-positive pathogens, including methicillin-resistant Staphylococcus aureus (MRSA) and vancomycin-resistant enterococci. DAP resistance and clinical treatment failure has been associated with adaptive chromosomal mutations, but so far not with transmissible resistance traits. Here we report for the first time an acquired DAP-R determinant (named drc) that we detected in a livestock-associated Mammaliicoccus sciuri isolate. drc consists of a two-gene operon (drcAB) that is controlled by an adjacent two-component system (drcRS). The DrcAB proteins, which mediate DAP inactivation, are similar to BceAB-like antimicrobial peptide transporters of Gram-positives, but are distinct from …

Displacement Of Hospital-Acquired, Methicillin-Resistant Staphylococcus Aureus Clones By Heterogeneous Community Strains In Kenya Over A 13-Year Period, Justin Nyasinga, Zubair Munshi, Collins Kigen, Andrew Nyerere, Lillian Musila, Andrew Whitelaw, Wilma Ziebuhr, Gunturu Revathi

Pathology, East Africa

We determined antibiotic susceptibility and employed Oxford Nanopore whole-genome sequencing to explore strain diversity, resistance, and virulence gene carriage among methicillin-resistant Staphylococcus aureus (MRSA) strains from different infection sites and timepoints in a tertiary Kenyan hospital. Ninety-six nonduplicate clinical isolates recovered between 2010 and 2023, identified and tested for antibiotic susceptibility on the VITEK ID/AST platform, were sequenced. Molecular typing, antibiotic resistance, and virulence determinant screening were performed using the relevant bioinformatics tools. The strains, alongside those from previous studies, were stratified into two periods covering 2010–2017 and 2018–2023 and comparisons were made. Mirroring phenotypic profiles, aac(6′)-aph(2″) [aminoglycosides]; gyrA (S84L) …

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., Jennifer Verani, Dianna Blau, Emily Gurley, Victor Akelo, Nega Assefa, Vicky Baillie, Quique Bassat, Mussie Berhane, James Bunn, R Gunturu

Pathology, East Africa

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 characterize 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 …

Epidemiology And Antimicrobial Resistance Of Staphylococci Other Than Staphylococcus Aureus From Domestic Animals And Livestock In Africa: A Systematic Review, Remous Ocloo, Justin Nyasinga, Mohammed Munshi, Aisha Hamdy, Tessa Marciniak, Manonmani Soundararajan, Mae Newton-Foot, Wilma Ziebuhr, Manonmani Soundararajan, Gunturu Revathi

Pathology, East Africa

Introduction: Staphylococci other than Staphylococcus aureus (SOSA) in animals are becoming more pathogenic and antibiotic resistant and can potentially disseminate to humans. However, there is little synthesized information regarding SOSA from animals in Africa. This systematic review provides a comprehensive overview of the epidemiology and antimicrobial resistance of SOSA in companion animals (pets) and livestock in Africa.

Method: This systematic review (PROSPERO-CRD42021252303) was conducted according to the PRISMA guidelines, and 75 eligible studies from 13 countries were identified until August 2022. Three electronic databases (Pubmed, Scopus and Web of Science) were employed.

Results: The frequently isolated SOSA …

Clinical Utility Of Immature Platelet Fraction - An Advanced Parameter In Laboratory Hematology, Muhammad Shariq Shaikh, Sidra Asad Ali

Department of Pathology and Laboratory Medicine

No abstract provided.

Poor Knowledge--Predictor Of Nonadherence To Universal Precautions For Blood Borne Pathogens At First Level Care Facilities In Pakistan, Naveed Z. Janjua, Mahreen Razaq, Subhash Chandir, Shafquat Rozi, Bushra Mahmood

Community Health Sciences

Background: We conducted an assessment of knowledge about blood borne pathogens (BBP) and use of universal precautions at first level care facilities (FLCF) in two districts of Pakistan.Methods: We conducted a cross-sectional survey and selected three different types of FLCFs ; public, general practitioners and unqualified practitioners through stratified random sampling technique. At each facility, we interviewed a prescriber, a dispenser, and a housekeeper for knowledge of BBPs transmission and preventive practices, risk perception, and use of universal precautions. We performed multiple linear regression to assess the effect of knowledge score (11 items) on the practice of universal precautions score …

Metaplastic Carcinoma Of The Breast, An Intriguing Rarity., Naila Kayani, Fozia Rauf, Yasmin Bhurgri

Department of Pathology and Laboratory Medicine

Abstract Metaplastic carcinoma breast is categorized as a rare heterogenous neoplasm generally characterized by a mixtureof adenocarcinoma with dominant areas of spindle cell, squamous and/or other mesenchymal differentiation. Todetermine the epidemio-demographic and histopathologic characteristics of this rare entity a retrospective studywas conducted to review all cases at the Aga Khan University Hospital (AKUH) Karachi, received during 1st January2000 to 31st August 2005. Twenty-four patients were identified with a mean age at diagnosis of 46.4 (±SD 3.8) years,and an age range of 28-68 years. The mean tumor size was 7.9 cm, range 2.0–17.0 cms (±SD 4.77). The specimenswere mostly obtained by …

Phylloides Tumors In Adolescent Girls And Young Women In Pakistan., Naila Kayani, Amna Khurshid, Yasmin Bhurgri

Department of Pathology and Laboratory Medicine

Abstract The objective of this study was to determine the frequency of phylloides tumor (PT) in adolescent girls and youngwomen (less than and equal to 25 years of age) and to define the clinico-pathological features of PT in this unusualclinical setting. This descriptive study was carried out at the Aga Khan University Hospital (AKUH) pathologydepartment. All consecutive cases of PT diagnosed during the last sixteen years in the section of histopathology from1st January 1990 to 31st June 2005 were included. Selection of cases was restricted to patients up to 25 years of age.A total of 42 cases of PT in …

Topographical Expression Of Class Ia And Class Ii Phosphoinositide 3-Kinase Enzymes In Normal Human Tissues Is Consistent With A Role In Differentiation, Soha Salama El Sheikh, Jan Domin, Prakitpunthu Tomtitchong, Paul Abel, Gordon Stamp, El-Nasir Lalani

Department of Pathology and Laboratory Medicine

Background: Growth factor, cytokine and chemokine-induced activation of PI3K enzymes constitutes the start of a complex signalling cascade, which ultimately mediates cellular activities such as proliferation, differentiation, chemotaxis, survival, trafficking, and glucose homeostasis. The PI3K enzyme family is divided into 3 classes; class I (subdivided into IA and IB), class II (PI3K-C2α, PI3K-C2β and PI3K-C2γ) and class III PI3K. Expression of these enzymes in human tissue has not been clearly defined.

Methods: In this study, we analysed the immunohistochemical topographical expression profile of class IA (anti-p85 adaptor) and class II PI3K (PI3K-C2α and PI3K-C2β) enzymes in 104 formalin-fixed, paraffin embedded …

Soft Tissue Sarcomas: Pattern Diagnosis Or Entity, Naasha Talati, Shahid Pervez

Department of Pathology and Laboratory Medicine

Soft tissue sarcomas (STS) are a diverse and heterogeneous group of tumours The sub-classification of these tumours is of importance for both prognosis and treatment. Classically, sub- categorization is based purely on histomorphological grounds, but as new techniques evolve, a more, conclusive and accurate diagnosis can be made. This study describes the prevalence of soft tissue sarcomas in adults diagnosed at The Aga Khan University Hospital (AKUH) and the impact of immunohistochemistry(IHC) on the precise sub-categorization of these tumours. The study included 364 adults (age 16+) who were diagnosed as soft tissue sarcoma in the past six years (May 1991 …

Churg-Strauss Syndrome With Intestinal Perforation, Javaid A. Khan, Imran Hassan, Shahid Pervez, Wasim Jafri, Shaista Khan

Department of Pathology and Laboratory Medicine

No abstract provided.