Day 2 :
Keynote Forum
Stef Stienstra
Dutch Armed Forces, Netherlands
Keynote: Managing bio-threat information under the WHO international health regulations of biosecurity
Biography:
Strategic and creative consultant in biomedical science, with a parallel career in the Dutch Civil-Military Interaction Command in which he has responsibility for the counter measures in CBNRe threats and (medical) consequence management both in a military and a civilian (terrorism) setting. He was the director of the 2014 & 2016 World Congress of CBRNe Science & Consequence Management in Tbilisi, Georgia. He works internationally as consultant or scientific supervisory board member for several medical and biotech companies, merely involved in biodefense, clinical diagnostics and therapies. He is also visiting professor for Punjab University in Pakistan and Rhein-Waal University in Germany and visiting professor at the University of Rome Tor Vergata. He has finished both his studies in Medicine and in Biochemistry at the University of Groningen in The Netherlands and has extensive practical experience in cell biology, immuno-haematology, biodefense and transfusion medicine. His natural business acumen and negotiation competence helps to initiate new successful businesses, often created out of unexpected combinations of technologies. His thorough understanding of abstract science combined with excellent skills in the communication of scientific matters to non-specialists, helps him with strategic consulting at top level management.
Abstract:
Sharing security threat information is a challenge for governments and their agencies. Especially in biotechnology and microbiology the agencies do not know how to classify or to disclose collected information on potential bio-threats. There is vague border between man-made and natural biological threats. An example is the several month delay of the publication of research on the transmissibility of H5N1 avian influenza virus in the leading scientific journal science by researchers of the Erasmus Medical Centre in Rotterdam, the Netherlands. The publication was delayed in 2012 by several months due to the fact that various organizations first wanted to investigate whether the details could be misused by malicious individuals. In the study the researchers show that only a small number of mutations were necessary to change the H5N1 virus so that it can spread through the respiratory system between mammals. This implies that the risk of a H5N1 pandemic cannot be ruled out. On the other hand, this information can be used to develop new therapies and/or vaccines for influenza. It gives also insight into the disease mechanism, which helps in the prevention. The same arguments are valid for therapeutic antibodies, like the antibodies, which are developed to treat anthrax. They have an extreme high affinity for the lethal factors of the bacterium and stop the disease, but the same antibodies could be misused to select the most pathogenic strains. Microorganisms have from nature itself the capacity to reorganize and change their pathogenicity, which could lead to a pandemic spread of a disease. But if the disease is too infectious and too deadly, like some stains of Ebola virus are, the lethality will be locally limited. But if the incubation time is longer in a certain strain of an Ebola virus, the risks on epidemics and even a pandemic is much higher. The knowledge of these natural mutation mechanisms could be misused to weaponries micro-organisms. It enables the engineering of the lethality like it is done with some anthrax strains. Are these laboratory techniques considered as public science or should it be classified? Academics want to publish and to share information for the progress of science and to find useful applications. The Rotterdam scientists were really annoyed when their research was blocked for publication and feared that other groups would be first in publishing a part of their obtained experimental results. Biosafety is already common practice in micro-biology, but biosecurity is often still questionable. A ‘Code of Conduct’, like the Dutch Academy of Science has developed, would help; especially for the so-called insider risk. Educational programs for the identification and assessment of risks and threats to security have to be developed to give scientists bio-threat awareness and for government officials to rationalize the real threat, without damaging the progress of science.
Keynote Forum
Tahseen J Siddiqui
Norwegian American Hospital, USA
Keynote: Bugs can be busted: How to prevent healthcare acquired infections?
Biography:
Dr. Siddiqui is an American board-certified Internist and Infectious Disease specialist. Graduated from University of Karachi, Pakistan (1986), and postgraduate diplomate (MRCP) from the Royal College of Physicians of Ireland (1997). He completed residency training in Internal Medicine from University of Iowa Hospitals & Clinics, Iowa City, IA, U.S.A (2001) and specialized in adult Infectious Diseases from Loyola University Medical Center, Maywood, IL, U.S.A (2003) He also acquired postgraduate medical education and training from UK/Ireland by completing fellowship training in General Medicine/Pulmonary Diseases from Beaumont Hospital, affiliated with the Royal College of Surgeons of Ireland, Dublin. (1998), and practiced medicine for a decade in Europe. He is currently a practicing Infectious Disease specialist in the U.S in both the clinical as well as academic settings and holds various leadership positions including Chair, Infection Prevention & Department of Medicine, Clinical & Teaching Faculty of Family Medicine & Podiatry Residency Programs at Norwegian American Hospital, Chicago, IL; Medical Director of Clinical Excellence at Saint Bernard Hospital, Chicago, IL, Clinical & Teaching Faculty of Family Medicine Residency Program at Jackson Park Hospital & Medical Center, Chicago; Asst. Professor of Medicine at St. George University Medical School, and President of Chicago Infectious Disease Physicians Group.
Abstract:
No one likes bugs! Especially when they are acquired and transmitted to affect the most vulnerable patient population that reside in a healthcare setting. HAIs can have devastating effects on physical, mental/emotional and financial well-being of patients as well as costing billions of dollars to the healthcare system. Additionally, growing number of HAIs are caused by antibiotic resistant pathogens. In the U.S, there were an estimated 687,000 Healthcare Acquired Infections (HAIs) in acute care hospitals were reported to CDC each year. About 72,000 hospital patients with HAIs died during their hospitalization. On any given day, about 1 in 31 hospital patients have at least one healthcare-associated infection. At Norwegian American Hospital, a 200-bed nonprofit safety-net community hospital in Chicago, IL, USA, we have been able to significantly reduce the rates of HIAs, especially catheter-associated UTIs (CAUTI), Central Line-Associated Blood Stream Infections (CLABSI), MRSA infections and C. Difficle Infections (CDI) by creatively developing and successfully implementing preventive strategies and infection prevention tools. As a result, in 2014, Norwegian American Hospital was recognized for having the lowest rate based on publicly available data of hospital-acquired infections of the 67 hospitals in the greater Chicago area. It was also recognized as top 10% in the country for patient safety by health grades and received an honorary Gage Award from America’s Essential Hospitals in 2015.
- Microbial Infections | Antimicrobials/ Antibiotics/ Antibacterials | Respiratory Diseases
Session Introduction
Heri Sutanto
Universitas Brawijaya, Indonesia
Title: Correlation between leukopenia and hospital length of stay in dengue infection
Biography:
Heri Sutanto MD, staff of Tropical and Infectious Disease Division in Internal Medicine of Brawijaya University – Saiful Anwar Hospital, Malang – Indonesia. Board Certified in Internal Medicine (2014-present). Graduate from Medical Faculty of Brawijaya University. Experience as a site investigator for malaria therapy research base arthesunate combination in 2008 at Sikka-South East Nusa and site investigator for phase III using of Biological Agent in Rheumatoid Arthritis in 2013 at Saiful Anwar Hospital – Malang. Work as a Physisian in state of Malang East Java Since 2007, and Lecturer in Medical Faculty Brawijaya University since 2015.
Abstract:
Dengue infection is a disease caused by dengue virus. Dengue infection sometimes requires hospital admission and even intensive care observation. There is evidence of dengue virus replication in bone marrow leukocytes. Low leukocyte level is associated with more complicated dengue infection. The aim of this study is to determine the relationship between leukocyte levels and Length of Stay (LOS) in patients with dengue infection. This research was conducted at Marsudi Waluyo Singosari Hospital. Data was taken from medical records through 2016-2019, with 201 patients who met WHO clinical criteria for dengue infection. The effect of leukopenia on hospital length of stay, platelet counts and hematocrit levels of the patients was analyzed by the Mann-Whitney method. There was correlation between leukopenia and length of stay (p≤0.001) on patients with dengue infection but not related to platelet counts (p=0.350) and hematocrit levels (p=0.467). The correlation was LOS (day) =3.051+0.516(Diagnosis) + (-.000011)(Lowest Thrombocyte)+0.793 (Leucopenia)(Diagnosis 1=Dengue Fever, 2=Dengue Hemorraghic Fever), lowest thrombocyte (score), Leucopenia (0 =Leucopenia(-), 1=Leucopenia (+)). Leukopenia correlated hospital length of stay in patients with dengue infection.
Ghweil Ali Abdelrahman
South Valley University, Egypt
Title: Liver stiffness predicts relapse after direct acting antiviral therapy against chronic hepatitis C virus infection
Biography:
Ghweil Ali Abdelrahman was a Resident of (Tropical medicine and Gastroenterology) for three years .He worked as a Clinical demonstrator and assistant lecturer of Tropical medicine and Gastroenterology, Sohag University. He was working as a Lecturer of Tropical medicine and Gastroenterology, South Valley University. Currently, he is the Head of Tropical Medicine and Gastroenterology department, South Valley University. He is also a member of the European Society of Liver Diseases (EASL).
Abstract:
Introduction & Objective: Assessment of fibrosis in chronic hepatitis has always been considered of utmost relevance for patient care in clinical hepatology. Over the last years, multiple non-invasive methods were used for diagnosis of hepatic fibrosis, including transient Elastography in addition to clinical and biochemical parameters or combinations of both methods. Serum markers and elastography are considered useful techniques for diagnosing severe liver fibrosis and cirrhosis and for excluding significant fibrosis in hepatitis C virus infected patients. Also, liver stiffness may help to foretell treatment response to antiviral therapy. The objective of this study is to evaluate changes of Transient elastography values as well as serum fibronectin and AST to Platelet Ratio Index in patients (APRI) treated with Sofosbuvir-based treatment regimen. Method: This is a follow-up study including 100 chronic HCV Egyptian patients treated with Sofosbuvirbased treatment regimen. Transient elastography values were recorded as well as serum fibronectin and APRI were calculated at baseline and SVR12. Results: There was a significant improvement of platelets counts, ALT and AST levels, which in turn cause significant improvement in APRI scores at SVR12. Liver stiffness measurements were significantly lower at SVR12 (15.40±8.96 vs. 8.82±4.74 kPa, P=0.000). There was significant decline in serum fibronectin from baseline to SVR 12 (524.14±237.61 vs. 287.48±137.67, P=0.000).