Identifying genetic susceptibility to Aspergillus fumigatus infection using collaborative cross mice and RNA-Seq approach

Background:Aspergillus fumigatus(Af)is one of the most ubiquitous fungi and its infection potency is suggested to be strongly controlled by the host genetic back-ground.The aim of this study was to search for candidate genes associated with host susceptibility to Aspergillus fumigatus(Af)using an RNAseq approach in CC lines and hepatic gene expression.Methods:We studied 31 male mice from 25 CC lines at 8 weeks old;the mice were infected with Af.Liver tissues were extracted from these mice 5 days post-infection,and next-generation RNA-sequencing(RNAseq)was performed.The GENE-E analysis platform was used to generate a clustered heat map matrix.Results:Significant variation in body weight changes between CC lines was ob-served.Hepatic gene expression revealed 12 top prioritized candidate genes differ-entially expressed in resistant versus susceptible mice based on body weight changes.Interestingly,three candidate genes are located within genomic intervals of the previ-ously mapped quantitative trait loci(QTL),including Gm16270 and Stox1 on chromo-some 10 and Gm11033 on chromosome 8.Conclusions:Our findings emphasize the CC mouse model's power in fine mapping the genetic components underlying susceptibility towards Af.As a next step,eQTL analysis will be performed for our RNA-Seq data.Suggested candidate genes from our study will be further assessed with a human cohort with aspergillosis.

Potential Risk of Transmission of Escherichia coli and Salmonella spp. Infections by the Musca domestica Fly and the Periplaneta americana Cockroach in the City of Cotonou (South Benin)

Background: The occurrence of bacterial infections sometimes involves synanthropic flies and cockroaches, as mechanical vectors of pathogenic microorganisms. The aim of this study was to identify the different species of flies and cockroaches that cohabit with humans in the city of Cotonou and determine the contribution of Musca domestica and Periplaneta americana in the transmission of bacteria responsible for infections in humans. Methods: Capture sessions during the day for flies and at night for cockroaches were carried out in 4 arrondissements of the city of Cotonou. The insects collected were transported to the Center of Research Entomological of Cotonou for identification, then sent to the Section Hygiene of Water and Food for microbiological analysis, enumeration and testing for human pathogenic bacteria. Results: A total of 351 flies and 26 cockroaches were collected at the sites, including two synanthropic species belonging to two families each. Musca domestica and Periplaneta americana were the most abundant species found after identification in the city of Cotonou. Thermo-tolerant coliforms and Escherichia coli were found on all specimens at varying concentrations. Salmonella spp. bacteria were identified in the fly population from the Dantokpa dump. Conclusion: Flies and cockroaches can transmit microorganisms to humans. The presence of Salmonella spp. among the specimens revealed that infections frequently caused by contaminated food or water are also transmitted to humans by flies. The presence of these germs on flies and cockroaches represents a potential risk of mechanical transmission to humans. It is, therefore, essential to continue investigations in order to assess the species of bacteria propagated, improve control strategies against these troublesome insects and adopt better hygiene conditions for better living.

Perceived infection transmission routes, infection control practices, psychosocial changes, and management of COVID-19 infected healthcare workers in a tertiary acute care hospital in Wuhan: a cross-sectional survey

Background:Many healthcare workers were infected by coronavirus disease 2019(COVID-19)early in the epidemic posing a big challenge for epidemic control.Hence,this study aims to explore perceived infection routes,influencing factors,psychosocial changes,and management procedures for COVID-19 infected healthcare workers.Methods:This is a cross-sectional,single hospital-based study.We recruited all 105 confirmed COVID-19 healthcare workers in the Zhongnan Hospital of Wuhan University from February 15 to 29,2020.All participants completed a validated questionnaire.Electronic consent was obtained from all participants.Perceived causes of infection,infection prevention,control knowledge and behaviour,psychological changes,symptoms and treatment were measured.Results:Finally,103 professional staff with COVID-19 finished the questionnaire and was included(response rate:98.1%).Of them,87 cases(84.5%)thought they were infected in working environment in hospital,one(1.0%)thought their infection was due to the laboratory environment,and 5(4.9%)thought they were infected in daily life or community environment.Swab of throat collection and physical examination were the procedures perceived as most likely causing their infection by nurses and doctors respectively.Forty-three(41.8%)thought their infection was related to protective equipment,utilization of common equipment(masks and gloves).The top three first symptoms displayed before diagnosis were fever(41.8%),lethargy(33.0%)and muscle aches(30.1%).After diagnosis,88.3%staff experienced psychological stress or emotional changes during their isolation period,only 11.7%had almost no emotional changes.Arbidol(Umifenovir;an anti-influza drug;69.2%)was the drug most commonly used to target infection in mild and moderate symptoms.Conclusion:The main perceived mode of transmission was not maintaining protection when working at a close distance and having intimate contact with infected cases.Positive psychological intervention is necessary.

Enhancing Patients Outcomes and Infection Control through Smart Indoor Air Quality Monitoring Systems

Air pollution poses a critical threat to public health and environmental sustainability globally, and Nigeria is no exception. Despite significant economic growth and urban development, Nigeria faces substantial air quality challenges, particularly in urban centers. While outdoor air pollution has received considerable attention, the issue of indoor air quality remains underexplored yet equally critical. This study aims to develop a reliable, cost-effective, and user-friendly solution for continuous monitoring and reporting of indoor air quality, accessible from anywhere via a web interface. Addressing the urgent need for effective indoor air quality monitoring in urban hospitals, the research focuses on designing and implementing a smart indoor air quality monitoring system using Arduino technology. Employing an Arduino Uno, ESP8266 Wi-Fi module, and MQ135 gas sensor, the system collects real-time air quality data, transmits it to the ThingSpeak cloud platform, and visualizes it through a user-friendly web interface. This project offers a cost-effective, portable, and reliable solution for monitoring indoor air quality, aiming to mitigate health risks and promote a healthier living environment.

Characteristics of cross transmission of gut fungal pathogens between wintering Hooded Cranes and sympatric Domestic Geese

Migratory birds travel long distance and link various pathogens.Due to habitat degradation,wintering waterfowls forage together with poultry,increasing the risk of pathogen transmission between hosts.We investigated the fungal communities between wintering Hooded Cranes and Domestic Geese by high-throughput sequencing,and inferred the potential gut pathogens for both hosts at different wintering stages.The fungal community compositions were significantly different between seasons and between the hosts.The negative correlation was found between fungal diversity and pathogenic diversity,with higher fungal diversity and less pathogenic diversity in early stage and less fungal diversity and higher pathogenic diversity in late stage for both hosts.The dissimilarity of pathogenic community compositions decreased from early to late stage,with the quantity of overlapping potential pathogenic OTUs increasing along wintering periods between the two hosts,demonstrating the existence of pathogen cross transmission between the two hosts.Furthermore,the transmission pathway of avian pathogens was mainly from Hooded Cranes to Domestic Geese while the transmission direction of human pathogens was primarily from Domestic Geese to wild cranes.Based on above results,we argued that pathogen cross transmission and underlying outbreak risk of disease should be closely monitored in migratory birds and domestic poultry.

Wolbachia Infection in Populations of Ostrinia furnacalis: Diversity, Prevalence, Phylogeny and Evidence for Horizontal Transmission

Wolbachia are maternally inherited endosymbiotic bacteria infecting a wide range of arthropods and filarial nematodes. They can induce various reproduction alterations in their hosts, including thelytokous parthenogenesis, cytoplasmic incompatibility （CI）, feminization of genetic males and male killing. Here we investigated diversity and prevalence patterns of Wolbachia infection in 43 geographical populations of the Asian corn borer, Ostriniafurnacalis, in China and one population in North Korea. Based on Wolbachia surface protein gene （wsp） sequences, nine strains of Wolbachia （wFurl-wFur9）, belonging to supergroups A and B, were identified in populations of O. furnacalis with an average infection rate of 10.5%. Superinfection commonly appeared in individuals of O. furnacalis and coinfection patterns were very complex. There was no specific pattern for the prevalence and distribution of the nine Wolbachia strains suggesting an intricate evolutionary history of Wolbachia infection in this species. The genetic similarity of the wFurl-wFur9 strains with those detected in two parasitoids of O. furnacalis, Macrocentrus cingulum and Lydella grisescens, strongly suggests host-parasitoid horizontal transmission.

Study of Infection of Echinococcus granulosus in Yak in Spring and Its Potential Role in Transmission of Cystic Echinococcosis in Rangtang County of Sichuan,China

Dear Editor, Cystic echinococcosis （CE）, caused by Echinococcus granulosus in larval stage, is considered as one of the most dangerous parasitic zoonosis in the world. The obligate 2-host parasitic cycle of Echinococcus granulosus is predominantly synanthropic. Dogs are the usual definitive hosts, and lots of mammalian species can be intermediate hosts, including domestic livestock and human[I2]. In the Tibetan plateau, China, the population is mainly Tibetans primarily engaged in livestock husbandry and CE is therefore a health problem for both people and animal in Tibetan communities. The reported infection rate of Echinococcus gronulosus in slaughtered yak in slaughterhouses is usually very high, being about 50% or higher as reported, and the liver and lungs are the main affected organs[34].

Estimated number of local transmission cases of Zika virus infection imported from Brazil to France

The Zika virus infection becomes the present public health threat and the control of this disease needs international collaboration. An important problem is the international travel that promotes the importation of Zika virus disease to the new setting. The local transmission of the imported infection is the big problem. Based on the available data on published articles, in this letter, the authors estimated the number of local transmission cases, by both mosquito borne and sexually transmitted modes, of Zika virus infection imported from Brazil to France.

The Effect of Human Immunodeficiency Virus-1 Infection on Low Birth Weight, Mother to Child HIV Transmission and Infants’ Death in African Area

Background: It is yet a controversy subject whether low birth weight and infant death are associated to human immunodeficiency virus-1 infection. Objective: To appreciate association between low birth weights, mother to child HIV transmission and infant mortality in HIV-1 infected pregnant women delivering between 2011 and 2016. Materials: We conducted 6 years cohort study in urban Mali. Outcome included preterm delivery, small for gestational age, infant survival status and HIV transmission. Comparison concerned women clinical WHO stage, mother viro-immunological status, and newborn anthropometric parameters. Results: HIV-1 infected women who delivered low birth weight newborn were 20.9% (111/531) versus 16.5% (1910/11.546) in HIV negative patients (p = 0.016). CD4 T cell counts low than 350 T cells count were strongly associated to LBW (p = 0.000;RR = 3.03;95% CI [1.89 - 3.16]). There is no significant association between ART that was initiated during pregnancy (p = 0.061, RR = 0.02;CI 95% (1.02 - 1.99)) or during delivery (p = 0.571;RR = 1.01;CI 95% (0.10 - 3.02)) and LBW delivery. In multivariate analysis ART regimens containing protease inhibitor (PI) were lone regimens associated with LBW ((p = 0.030;RR = 1.001;95% confidence interval [1.28 - 3.80]). Very low birth weight was statistically associated to women HIV infection (adjusted relative risk, 2.02;p = 0.000;95% confidence interval (2.17 - 4.10)). There is no significant difference between mother to child HIV transmission rate in the two HIV-infected pregnant women (10 infected children in group 2: MTCT rate 4.5%) and 3 infected children in group 1 (MTCT rate: 2.7%) (p = 0.56;RR, 0.59;CI 95% (0.18 - 4.39)). In multivariate analysis, LBW was associated with infant death (p = 0.001;RR = 2.04;CI 95% [1.04 - 5.05]). The median weight of infant at the moment of death in group 1 was 851 g (IQR: 520 - 1833 g). Significant relationship was found between infant death among LBW newborn with mother WHO stage 2 (p = 0.004;adjusted RR = 3.22;CI 95% [2.25 - 6.00]), CD4 T cells count 3 (p = 0.005;RR = 2.81;CI 95% [1.20 - 4.11]), PI regimens (p = 0.030;RR = 1.00;CI 95% [1.28 - 3.80]). Conclusion: We confirm increased risk of low birth weight and mother HIV-1 infection and we identified strongest association between mortality in infant born to HIV-1 infected mother and LBW.

Geometry Design and Tooth Contact Analysis of Crossed Beveloid Gears for Marine Transmissions

Beveloid gears,also known as conical gears,gain more and more importance in industry practice due to their abilities for power transmission between parallel,intersected and crossed axis.However,this type of gearing with crossed axes has no common plane of action which results in a point contact and low tooth durability.Therefore,a geometry design approach assuming line contact is developed to analyze the tooth engagement process of crossed beveloid gears with small shaft angle for marine transmission applications.The loaded gear tooth contact behavior is simulated by applying a quasi-static analysis to study the effects of gearing parameters on mesh characteristics.Using the proposed method,a series of sensitivity analyses to examine the effects of critical gearing parameters such as shaft angle,cone angle,helix angle and profile-shift coefficient on the theoretical gear mesh is performed.The parametric analysis of pitch cone design shows that the dominant design parameters represented by the angle between the first principle directions（FPD） and normal angular factor are more sensitive to the shaft and cone angles than they are to the helix angle.The theoretical contact path is highly sensitive to the profile-shift coefficient,which is determined from the theoretical tooth contact analysis.The FPD angle is found to change the distribution of contact pattern,contact pressure and root stress as well as the translational transmission error and the variation of the mesh stiffness significantly.The contact pattern is clearly different between the drive and coast sides due to different designed FPD angles.Finally,a practical experimental setup for marine transmission is performed and tooth bearing test is conducted to demonstrate the proposed design procedure.The experimental result compared well with the simulation.Results of this study yield a better understanding of the geometry design and loaded gear mesh characteristics for crossed beveloid gears used in marine transmission.

Omicron variant (B.1.1.529) of SARS-CoV-2: Mutation, infectivity, transmission, and vaccine resistance

The appearance of severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)variant Omicron(B.1.1.529)has caused panic responses around the world because of its high transmission rate and number of mutations.This review summarizes the highly mutated regions,the essential infectivity,transmission,vaccine breakthrough and antibody resistance of the Omicron variant of SARSCoV-2.The Omicron is highly transmissible and is spreading faster than any previous variant,but may cause less severe symptoms than previous variants.The Omicron is able to escape the immune system’s defenses and coronavirus disease 2019 vaccines are less effective against the Omicron variant.Early careful preventive steps including vaccination will always be key for the suppression of the Omicron variant.

Prevention of Mother-to-Child Transmission of HIV: Experience of a Level 2 Health Center in Senegal

The elimination of vertical transmission of HIV from mother to child is a major global goal. In Senegal, the transmission rate was estimated at 3.2% in 2017. To reduce or even eliminate this transmission, Senegal has implemented various strategies and programs adopted and applied nationally. Thus access to services for the prevention of mother-to-child transmission of HIV has been extended to the level of the health post (the lowest level of the country’s health pyramid) with a delegation of tasks to paramedical staff (nurse, midwife) in the diagnosis and therapeutic management. Objectives: To describe the epidemiological profile of HIV (Human Immunodeficiency Virus)-positive mothers, to assess the care of children born to HIV-positive mothers, to determine the rate of HIV transmission from mother to child. Patients and Method: We carried out a retrospective, cross-sectional and descriptive study of all live newborns of HIV-positive mothers who gave birth at the Gaspard Kamara Health Center (a level 2 health center in Dakar, Senegal) between January 1, 2015 and December 31, 2018. The data were collected from prevention of mother-to-child transmission (PMTCT) prenatal follow-up registers and files, delivery files and registers, and neonatology and pediatric follow-up files, and exploited using the Epi info 7 software. Results: There were 98 children of seropositive mothers. The epidemiological profile of the HIV-positive woman was that of a young woman aged between 16 and 43 with an average of 31.31 years, pauciparous (>65% of cases) from Dakar center (>75% of cases), housewife with a low socio-economic level (63.1% of cases), married in almost all cases, with HIV profile (in almost all cases) and diagnosed before pregnancy (51.02%). The analysis of the children’s data revealed a predominance of girls (52.04%) with a good birth weight (2964g on average) and a pregnancy carried to term in more than 95% of cases. ARV prophylaxis was almost entirely respected with triple therapy (AZT + 3TC + NVP) in a fixed combination as protocol. Protected breastfeeding (80.21%), including 6 months of exclusive protected breastfeeding, was the rule for the mode of feeding. Three children were diagnosed positive with PCR1 as with serology (3.06%). Discussion and Conclusion: the initiatives and strategies put in place in Senegal have enabled a significant reduction in mother-to-child transmission of HIV and deserve to be supported by insisting on primary prevention, programming and good follow-up of pregnancies, and a good support for HIV-positive women.

Measurement and Simulation of Induced Voltage and Current on 110 KV Crossing Transmission Lines under UHV AC Transmission Lines

The induced electricity of 110 kV transmission lines which cross the UHV AC transmission lines may threaten personal safety of the maintenance staff. In this paper, field measurement of the induced voltage and induced current on a 110 kV crossing line inside Jinhua in Zhejiang province is performed. The electrostatic induced voltage on the measured line is 12.24 kV. The power frequency electromagnetic field simulation model is established, and the calculation results are consistent with the measured. Influence factors analysis shows that the electrostatic induced voltage on the 110 kV line is 12.78 kV, the electromagnetic induced voltage is 12.3 V, the induced current through ground wire is less than 1A when the UHV lines operate at full load. The induced voltage and current decrease while the crossing distance increases. Parallel lines induction is much higher than crossing lines. The electromagnetic induced voltage after ground knife-switch shut down would exceed the human safety voltage 36 V while the crossing angle is less than 30?, so the temporary ground wire must be hanged to ensure safety of the maintenance staff.

Safety of Blood Maintained in Zimbabwe: Low Transfusion Transmissible Infections among Blood Donors

Background: Low level of transfusion transmissible infections (TTIs) is an indicator of a well-performing blood donor program. Aim: The study was designed to estimate the prevalence of TTIs and to evaluate the demographic characteristics of reactive and non-reactive blood donors in Zimbabwe in 2018. Methods: A cross-sectional study was conducted using routinely available data from January to December 2018 in five branches of National Blood Service Zimbabwe (NBSZ). After initial screening for high-risk behavior with a questionnaire, weight, blood pressure and hemoglobin level, eligible donors were invited for blood donation. The following laboratory tests for TTIs were done: antibodies and antigen tests for human immunodeficiency virus 1 and 2 (HIV 1/2), tests for the surface antigen of hepatitis B virus (HBV), testing for hepatitis C virus (HCV) antibody and antibodies for treponema pallidum. Information on age, gender, NBSZ branch, marital status, occupation, donor type (first time/repeat) and TTIs test results were extracted from the NBSZ electronic database (e-Delphyn blood bank software). Results: Out of a sample of 1586 blood donors, thirteen (0.81%) were reactive to at least one TTI marker;five (0.32%) were reactive for human immunodeficiency virus, seven (0.44%) for hepatitis B and one (0.06%) for syphilis. There were no samples with co-infection and hepatitis C virus markers. The prevalence of TTIs was highest in the 31 - 45 years age group (2.3%) and among first-time blood donors (4.7%). The prevalence of all TTI was low with the highest prevalence of 0.44% for the hepatitis B virus. Conclusion: Continued concerted efforts will help to maintain satisfactory blood safety in Zimbabwe.

Levels, Trends and Inter-Regional Variations in Transfusion Transmissible Infection Positivity among Blood Donors in India: Evidence from India’s National HIV Program

In India, transfusion transmissible infections (TTIs) are monitored for trends at the blood bank level, but limited efforts have been made to analyze data from a large number of blood banks and present it at the national, regional and state levels. The Computerized Management Information System (CMIS), National AIDS Control Organization’s (NACO) online data capturing system, systematically collects information on TTIs in a monthly aggregated format from blood banks across the country. This information is being captured in NACO’s annual reports, but a systematic scientific analysis and publication of the same have not been attempted so far. Hence, the objective of this study is to analyze and report TTIs among blood donors in India at three different levels—national, regional and state—from 497 consistent blood banks reporting through CMIS during 2008-2012. National level analysis shows an increasing trend in voluntary blood donation from 9.28 lakh to 19.02 lakh, and a decreasing trend in TTIs, with female donors constituting only 6% of the entire pool of donors. Of the five TTIs studied, in 2012 Hepatitis-B-surface Antigen (HBsAg) positivity was highest (0.9%), followed by Hepatitis C Virus (HCV) (0.45%), syphilis (0.23%), HIV (0.17%) and malaria (0.03%). Regional analysis indicated that voluntary donation was high in the Eastern and Western regions, with 11% of female donors in Eastern India in 2012. All the TTIs showed a declining trend, except HCV, which showed a rising trend in the Eastern and Southern regions. The level of positivity for all the five TTIs was higher than the national average in the Eastern region. Among the TTIs, HIV positivity among voluntary donors was below the national average, while in Mizoram both HBsAg and HCV of more than 1% seropositivity and VDRL of 1.7% in Arunachal Pradesh had been reported. Malaria has the lowest national positivity, with Nagaland reporting a high positivity of 0.4%. Although the national and regional trends in TTI positivity are declining, regional level variations in TTIs, especially in hepatitis, suggest the importance of advocating for pre-donation counseling and educating donors on self-exclusion.

A NOVEL CROSS-LAYER STRATEGY OF VIDEO TRANSMISSION TO SOLVE PERFORMANCE ANOMALY IN MULTI-RATE IEEE 802.11 NETWORKS

When wireless hosts use different rates to transmit data in IEEE 802.11 networks, it will take on the state of performance anomaly which will severely decrease the throughputs of all the higher rate hosts. Hence, it is bad for video service transmission. Considering that video is very sensitive to packet delivery delay but can tolerate some packet losses, we propose a novel cross-layer scheme which takes these two characteristics into consideration. Firstly, the maximum number of retransmissions for a video Medium Access Control (MAC) frame is computed in MAC layer according to video frame rate requirement of application layer and current access delay of MAC layer. Secondly, within the margin of the tolerant Packet Loss Rate (PLR) of application layer, several video MAC frames are allowed to drop so that we can adaptively select the transmission rate as high as possible for the rest of video MAC frames in terms of current channel quality and the maximum number of retransmissions. Experiment results show that the proposed method can reduce the delay and jitter of video service and improve the throughputs of fast hosts. Therefore, it increases the quality of reconstructed video to a certain extent and relieves the performance anomaly of network effectively.

Risk of transmission of carbapenem-resistant Enterobacteriaceae and related “superbugs” during gastrointestinal endoscopy

To evaluate the risk of transmission of carbapenem-resistant Enterobacteriaceae(CRE) and their related superbugs during gastrointestinal(GI) endoscopy. Reports of outbreaks linked to GI endoscopes contami-nated with different types of infectious agents, includ-ing CRE and their related superbugs, were reviewed. Published during the past 30 years, both prior to and since CRE's emergence, these reports were obtained by searching the peer-reviewed medical literature(via the United States National Library of Medicine's "MEDLINE" database); the Food and Drug Administration's Manu-facturer and User Facility Device Experience database, or "MAUDE"; and the Internet(via Google's search engine). This review focused on an outbreak of CRE in 2013 following the GI endoscopic procedure known as endoscopic retrograde cholangiopancreatography, or ERCP, performed at "Hospital X" located in the sub-urbs of Chicago(IL; United States). Part of the largest outbreak of CRE in United States history, the infection and colonization of 10 and 28 of this hospital's patients, respectively, received considerable media attention and was also investigated by the Centers for Disease Con-trol and Prevention(CDC), which published a report about this outbreak in Morbidity and Mortality WeeklyReport(MMWR), in 2014. This report, along with the results of an independent inspection of Hospital X's in-fection control practices following this CRE outbreak, were also reviewed. While this article focuses primar-ily on the prevention of transmissions of CRE and their related superbugs in the GI endoscopic setting, some of its discussion and recommendations may also apply to other healthcare settings, to other types of flexible endoscopes, and to other types of transmissible infec-tious agents. This review found that GI endoscopy is an important risk factor for the transmission of CRE and their related superbugs, having been recently as-sociated with patient morbidity and mortality following ERCP. The CDC reported in MMWR that the type of GI endoscope, known as an ERCP endoscope, that Hospi-tal X used to perform ERCP in 2013 on the 38 patients who became infected or colonized with CRE might be particularly challenging to clean and disinfect, because of the complexity of its physical design. If performed in strict accordance with the endoscope manufacturer's labeling, supplemented as needed with professional organizations' published guidelines, however, current practices for reprocessing GI endoscopes, which include high-level disinfection, are reportedly adequate for the prevention of transmission of CRE and their related superbugs. Several recommendations are provided to prevent CRE transmissions in the healthcare setting. CRE transmissions are not limited to contaminated GI endoscopes and also have been linked to other reusable flexible endoscopic instrumentation, including broncho-scopes and cystoscopes. In conclusion, contaminated GI endoscopes, particularly those used during ERCP, have been causally linked to outbreaks of CRE and their related superbugs, with associated patient morbidity and mortality. Thorough reprocessing of these complex reusable instruments is necessary to prevent disease transmission and ensure patient safety during GI endos-copy. Enhanced training and monitoring of reprocessing staffers to verify the proper cleaning and brushing of GI endoscopes, especially the area around, behind andnear the forceps elevator located at the distal end othe ERCP endoscope, are recommended. If the ERCPendoscope features a narrow and exposed channel thathouses a wire connecting the GI endoscope's controhead to this forceps elevator, then this channel's com-plete reprocessing, including its flushing with a deter-gent using a procedure validated for effectiveness, is also emphasized.

Donor-derived infections among Chinese donation after cardiac death liver recipients

AIM To investigate blood cultures of deceased donors and report the confirmed transmission of bacterial infection from donors to liver recipients.METHODS We retrospectively studied the results of blood cultures among our donation after cardiac death(DCD) donors and calculated the donor-derived bacterial infection rates among liver recipients. Study participants underwent liver transplantation between January 1, 2010 and February 1, 2017. The study involved a total of 67 recipients of liver grafts from 67 DCD donors. We extracted the data of donors' and patients' characteristics, culture results and clinical outcomes, especially the post-transplant complications in liver recipients, from electronic medical records. We analyzed the characteristics of the donors and the corresponding liver recipients with emphasis put on donor-derived infections.RESULTS Head trauma was the most common origin of death among our 67 DCD donors(46.3%). Blood taken prior to the procurement operation was cultured for 53 of the donors, with 17 episodes of bloodstream infections developing from 13 donors. The predominant organism isolated from the blood of donors was Gram-positive bacteria(70.6%). Only three(4.5%) of 67 liver recipients developed confirmed donor-derived bacterial infections,with two isolates of multidrug-resistant Klebsiella pneumoniae and one isolate of multidrug-resistant Enterobacter aerogenes. The liver recipients with donorderived infections showed relation to higher crude mortality and graft loss rates(33.3% each) within 3 mo post transplantation, as compared to those without donor-derived infections(9.4% and 4.7%, respectively). All three liver recipients received appropriate antimicrobial therapy.CONCLUSION Liver recipients have high occurrence of donor-derived infections. The liver recipients with donor-derived multidrug-resistant Enterobacteriaceae infections can have good outcome if appropriate antimicrobial therapy is given.

Vertical transmission of hepatitis C virus: Current knowledge and perspectives

Hepatitis C virus(HCV) infection is a major global health issue.Infection by the HCV can cause acute and chronic liver diseases and may lead to cirrhosis,hepatocellular carcinoma or liver failure.The World Health Organization estimates that approximately 3% of the world population have been infected with HCVand the worldwide prevalence is between 1% and 8% in pregnant women and between 0.05% and 5% in children.Following the introduction of blood product screening,vertical transmission becomes the leading cause of childhood HCV infection.The prevalence of pediatric HCV infection varies from 0.05% to 0.36% in developed countries and between 1.8% and 5% in the developing world.All children born to women with antiHCV antibodies should be checked for HCV infection.Though universal screening is controversial,selective antenatal HCV screening on high-risk populations is highly recommended and should be tested probably.Multiple risk factors were shown to increase the possibility of HCV vertical transmission,including coinfections with human immunodeficiency virus,intravenous drug use and elevated maternal HCV viral load,while breastfeeding and HCV genotypes have been studied to have little impact.At present,no clinical intervention has been clearly studied and proved to reduce the HCV vertical transmission risk.Cesarean section should not be recommended as a procedure to prevent vertical transmission,however,breastfeeding is generally not forbidden.The high prevalence of global HCV infection necessitates renewed efforts in primary prevention,including vaccine development,as well as new approaches to reduce the burden of chronic liver disease.Future researches should focus on the interruption of vertical transmission,developments of HCV vaccine and directacting antivirals in infancy and early childhood.

Hepatitis C virus: Morphogenesis, infection and therapy

Hepatitis C virus(HCV) is a major cause of liver diseases including liver cirrhosis and hepatocellular carcinoma. Approximately 3% of the world population is infected with HCV. Thus, HCV infection is considered a public healthy challenge. It is worth mentioning, that the HCV prevalence is dependent on the countries with infection rates around 20% in high endemic countries. The review summarizes recent data on HCV molecular biology, the physiopathology of infection(immune-mediated liver damage, liver fibrosis and lipid metabolism), virus diagnostic and treatment. In addition, currently available in vitro, ex vivo and animal models to study the virus life cycle, virus pathogenesis and therapy are described. Understanding of both host and viral factors may in the future lead to creation of new approaches in generation of an efficient therapeutic vaccine.