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h known tuberculosis patient) variables were the identified determinants for increased multi-drug resistance tuberculosis.

Quantitative analysis of Mycobacterium tuberculosis using microscope is very critical for diagnosing tuberculosis diseases. Microbiologist encounter several challenges which can lead to misdiagnosis. However, there are 3 main challenges (1) The size of Mycobacterium tuberculosis is very small and difficult to identify as a result of low contrast background, heterogenous shape, irregular appearance and faint boundaries (2) Mycobacterium tuberculosis overlapped with each other making it difficult to conduct accurate diagnosis (3) Large amount of slide can be time consuming and tedious to microbiologist and which can lead to misinterpretations.

To solve these challenges and limitations, we proposed an automated-based detection method using pretrained AlexNet to trained the model in 3 sets of experiments A, B and C and adjust the protocols accordingly. We compared the detection of tuberculosis using AlexNet Models with the ground truth result provided by microbiologist and analyzed inconsistencies between network models and human.

98.15 % accuracy, 96.77% sensitivity and 100% specificity for experiment A, 98.09% accuracy, 98.59% sensitivity and 97.67% specificity for experiment B and 98.73% testing accuracy, 98.59 sensitivity, 98.84% specificity ofr experiment C which sound robust and promising.

The results indicated that network performance was successful with high accuracies, sensitivities and specificities and it can be used to support microbiologist for diagnosis of tuberculosis.

The results indicated that network performance was successful with high accuracies, sensitivities and specificities and it can be used to support microbiologist for diagnosis of tuberculosis.

Streptococcus pneumoniae can be responsible for severe human infections. Optochin resistance has been a potential cause of misidentification of pneumococcus and other members of the mitis group. Hence, rapid and easy optochin resistant (Optr) S. pneumoniae identification is essential.

Atypical pneumococci were characterized using optochin susceptibility, bile solubility based on spectrophotometric reading, serotyping, pulsed field gel electrophoresis (PFGE), 16S rRNA sequencing and PCR-based assays targeting pneumococcal genes lytA, ply, pspA, cpsA, Spn9802 and Spn9828.

Optical density values for the bile solubility test suggest the identification of four Optr S. pneumoniae and one Streptococcus pseudopneumoniae. All Optr pneumococci harbored cpsA, lytA, ply, Spn9802, Spn9828 and pspA genes. Only ply, spn9802 and Spn9828 genes were detected in S. pseudopneumoniae. The 16S rRNA sequencing differentiates between these two species. Optr S. pneumoniae strains belonged to different genotypes and serotypes (14, 19A, 3 and 9V). Three Optr S. pneumoniae isolates were typed as pspA family 2, while one belonged to pspA family 1. Sequencing of the atpA and atpC gene of the Optr variants revealed three mutations in the ATPase a-subunit (L99I, M23V and V52I) and one mutation in ATPase c-subunit (V48I).

Our data indicate that bile OD-values provides an accurate, fast and easy method to discriminate between Optr S. pneumoniae and other Streptococcus mitis group. Moreover molecular techniques, confirming the bile test, can be used in order to prevent these atypical pneumococci and alert clinical microbiologists of the presence of these strains in the community.

Our data indicate that bile OD-values provides an accurate, fast and easy method to discriminate between Optr S. pneumoniae and other Streptococcus mitis group. Moreover molecular techniques, confirming the bile test, can be used in order to prevent these atypical pneumococci and alert clinical microbiologists of the presence of these strains in the community.

Klebsiella pneumoniae sequence type 258 (ST258) strains are globally distributed multi-drug resistant pathogens and can spread rapidly throughout the world, causing severe healthcare-associated invasive infections with limited antimicrobial treatment options. The aim of this study was to reveal the incidence of Klebsiella pneumoniae ST258 strains among the intensive care unit patients in a university hospital in Istanbul.

Consecutive nonreplicated 83 K. selleck inhibitor pneumoniae strains were isolated from various clinical samples of intensive care unit patients admitted to a university hospital in Istanbul, between November 2016 to December 2018. Bacterial identifications were performed via VITEK2. Antimicrobial susceptibility tests were conducted with Kirby Bauer's disc diffusion test except for colistin which was performed with broth microdilution. Real-time PCR method was utilized in order to reveal ST258 positivity among the strains.

Antimicrobial susceptibility results revealed that 56 (67%) K. pneumoniae strainsain and suggested that it does not contribute to multi-resistance formation alone.

Infections acquired in hospitals are the cause of high morbidity and mortality and with the emergence of resistant bacteria, the problem is greater. The aim of this work was to determine the genetic characteristics and timeline of Klebsiella pneumoniae blaNDM-1 carrying a class 1 integron involved in an intrahospital outbreak.

Investigation was made from the first detection of K. pneumoniae blaNDM-1, strain "466", and the last clone "423". 16S rRNA gene analysis showed that 466 strain and clones were related to K. pneumoniae. Extended-spectrum β-lactamases (ESBL) was detected according to the Clinical and Laboratory Standards Institute (CLSI) and real time-PCR. Typing of K. pneumoniae blaNDM-1 strains was carried by ERIC-PCR and sequencing the variable region of the integrons were performed.

A cluster of six resistant isolates of K. pneumoniae blaNDM-1 was detected in intensive care unit (ICU), internal medicine (IM) and orthopedics (OT). Timeline revealed that the first bacterial identification was in ICU and the last clone in OT service. The array genetic of variable region was "IntI/aadA5-drfA17/qacEΔ1-Sul1".

The evidences highlight the importance of the epidemiological surveillance of Extended-spectrum β-lactamases (ESBL) strains, as well as the need for molecular epidemiological studies to identify the routes of transmission and the contamination sources within health personnel.

The evidences highlight the importance of the epidemiological surveillance of Extended-spectrum β-lactamases (ESBL) strains, as well as the need for molecular epidemiological studies to identify the routes of transmission and the contamination sources within health personnel.Understanding the efficacy and durability of heterologous immunization schedules against SARS-CoV-2 is critical, as supply demands and vaccine choices become significant issues in the global vaccination strategy. Here we characterize the neutralizing antibodies produced in two subjects who received combination immunizations against SARS-CoV-2, first with Covishield (Oxford-AstraZeneca) vaccine, followed 33 days later with a second dose (booster) shot of the Pfizer-BioNTech vaccine. Serum samples were collected 25 days following the primary vaccination and 13 days after the secondary Pfizer vaccination. Both subjects exhibited increased levels of isotype IgG and IgM antibodies directed against the entire spike protein following immunizations. These antibodies also exhibited increased reactivity with the receptor binding domain (RBD) in the spike protein and neutralized the infectivity of replicating vesicular stomatitis virus (VSV) that contains the COVID-19 coronavirus S protein gene in place of its normal G glycoprotein. This VSV pseudovirus also contains the reporter gene for enhanced green fluorescent protein (eGFP). Antibody titers against the spike protein and serum neutralization titers against the reporter virus are reported for the 2 heterologous vaccinated individuals and compared to a positive control derived from a convalescent patient and a negative control from an unexposed individual. The Pfizer-BioNTech vaccine increased antibody binding to the spike protein and RBD, and approached levels found in the convalescent positive control. Neutralizing antibodies against the VSV-S pseudovirus in the 2 subjects also approached levels in the convalescent sera. These results firmly validate the value of the Pfizer-BioNTech vaccine in boosting immunity following initial Covishield inoculation.

The COVID-19 outbreak first occurred in China and has developed throughout the world, including Indonesia. The Indonesian government reports that up to May 22, 2020 there have been 21,430 confirmed cases. The purpose of this study is to describe the epidemiology, clinical symptoms and comorbidities of COVID-19 as well as the various government interventions to reduce the rate of incidence.

A retrospective cohort study was designed. The population in this study is based data from the official Indonesian government website run by the Task Force for the Acceleration of Handling COVID-19. The sample was observed b March 2 to April 24, 2020. The total sample included 8,211 cases of patients diagnosed with COVID-19, among these 1,002 recovered and 689 died. Data analysis used percentages from various recorded epidemiological variables.

The results showed that COVID-19 epidemiological features were mostly observed in men (56.5%) and patients of productive age (31-59 of age) by 57.5%; most deaths were recorded in patients aged > 60 years (43.6%). The most recurrent clinical symptom was cough (77.8%), the most recurrent comorbidity was hypertension (52.4%), and the province with the highest COVID-19 incidence was DKI Jakarta (34.3%).

The combination of common sources and propagated source was observed during the COVID-19 outbreak in Indonesia. Special attention should be given to protecting vulnerable populations such as children, health care providers, and the elderly. The community is expected to participate in preventing the transmission of COVID-19 by complying with health protocols.

The combination of common sources and propagated source was observed during the COVID-19 outbreak in Indonesia. Special attention should be given to protecting vulnerable populations such as children, health care providers, and the elderly. The community is expected to participate in preventing the transmission of COVID-19 by complying with health protocols.Venous thromboembolism (VTE) represents an important clinical complication of patients with SARS-CoV-2 infection, and high plasma D-dimer levels could suggest a higher risk of hypercoagulability. We aimed to analyse if laboratory exams, risk assessment scores, comorbidity scores were useful in predicting the VTE in SARS-CoV-2 patients admitted in internal medicine (IM). We evaluated 49 older adults with suspected VTE analysing history and blood chemistry, besides we calculated the Padua Prediction Score, the modified early warning scoring (MEWS) and the modified Elixhauser index (mEI). All patients underwent venous color-doppler ultrasounds of the lower limbs. Out of the 49 patients enrolled (mean age 79.3±14 years), 10 (20.4%) had deep vein thrombosis (DVT), and they were more frequently female (80% vs 20%, p = 0.04). We could not find any association with the Padua Prediction Score, the MEWS, and the mEI. D-dimer plasma levels were also not associated with DVT. In elderly people hospitalized with SARS-CoV-2 infection hospitalized in IM, our data, although limited by the sample size, suggest that prediction and diagnosis of VTE is difficult, due to lack of precise biomarkers and scores.