Association between tocilizumab and emerging multidrug-resistant organisms in critically ill patients with COVID-19: A multicenter, retrospective cohort study

Background Tocilizumab is an IgG1 class recombinant humanized monoclonal antibody that directly inhibits the IL-6 receptor. Several randomized clinical trials have evaluated its safety and efficacy in patients with coronavirus disease 2019 (COVID-19), and these studies demonstrate conflicting results. Our study aimed to determine the association between tocilizumab treatment and microbial isolation and emergence of multidrug-resistant bacteria in critically ill patients with COVID-19. Methods A multicenter retrospective cohort study was conducted at two tertiary government hospitals in Saudi Arabia. All critically ill patients admitted to intensive care units with a positive COVID-19 PCR test between March 1 and December 31, 2020, who met study criteria were included. Patients who received tocilizumab were compared to those who did not receive it. Results A total of 738 patients who met our inclusion criteria were included in the analysis. Of these, 262 (35.5%) received tocilizumab, and 476 (64.5%) were included in the control group. Patients who received tocilizumab had higher odds for microbial isolation (OR 1.34; 95% CI 0.91–1.94, p = 0.13); however, the difference was not statistically significant. Development of resistant organisms (OR 1.00; 95% CI 0.51–1.98, p = 0.99) or detection of carbapenem-resistant Enterobacteriaceae (CRE) (OR 0.67; 95% CI 0.29–1.54, p = 0.34) was not statistically significant between the two groups. Conclusions Tocilizumab use in critically ill patients with COVID-19 is not associated with higher microbial isolation, the emergence of resistant organisms, or the detection of CRE organisms.

Tocilizumab Association with Emerging Multi-drug Resistance Organisms and Mortality in critically ill patients with Coronavirus disease 2019 (COVID-19): A Multicenter, Retrospective Cohort Study

Background:Tocilizumab is an IgG1 class recombinant humanized monoclonal antibody that directly inhibits IL-6 receptor. Several randomized clinical trials (RCTs) have evaluated tocilizumab’s safety and efficacy in patients with COVID-19. These studies demonstrated conflicting results regarding tocilizumab’s efficacy and safety. Our study aim is to determine the association between treatment with tocilizumab and emergence of multidrug-resistant bacteria and its effect on mortality in critically ill patients with Coronavirus disease 2019 (COVID-19).Methods:A multicenter, retrospective, cohort study conducted at two governmental tertiary hospitals in Saudi Arabia. All critically ill patients who were admitted to intensive care units (ICUs) with a positive COVID-19 PCR test between March 1st, 2020 and January 31st, 2021 were included. Patients who received tocilizumab were compared to patients who did not receive it. Results:A total of 738 patients met our inclusion criteria and were included in the analysis. Of these 262 (35.5%) received tocilizumab and 476 (64.5%) were included in the control group. Patients who received tocilizumab did not have higher odds for the microbial isolation (OR 1.34; 95% CI, 0.91-1.94 p = 0.13), development of resistant organisms (OR 1.00; 95% CI, 0.51-1.98 p = 0.99), or detection of Carbapenem-Resistant Enterobacteria (CRE) (OR 0.67; 95% CI, 0.29-1.54 p = 0.34). In a multivariable logistic regression adjusting for possible cofounders, there was no difference in 30-day ICU mortality (OR 0.96; 95% CI, 0.65-1.43 p = 0.85) or in-hospital mortality (OR 1.18; 95% CI, 0.79-1.76 p = 0.42). However, there was a significant difference in the incidence of respiratory failure requiring MV between the two groups (OR 2.27; 95% CI, 1.05-4.89 p = 0.03).Conclusions: Tocilizumab use in critically ill COVID-19 patients was not associated with microbial isolation, emergence of resistant organisms, detection of CRE organisms, or mortality benefits. However, tocilizumab use was associated with an increased risk of respiratory failure requiring mechanical ventilation.

Microbial Isolation from Gastrointestinal Tract of Catfish (Clarias gariepinus)

The purpose of this research was to describe the characteristics and number of microbes that grow in the gastrointestinal tract of catfish and to determine the potential of microbes as probiotics. The type of this research was observational conducted on 30 September-15 October 2018 at the Microbiology Laboratory, Faculty of Science and Technology, Universitas Airlangga, Surabaya. Microbial isolation using NA (Nutrient Agar), MRSA (de Man, Rogosa and Sharpe Agar) and PDA (Potato Dextrose Agar) media. The fish that used is catfish that are bred in ponds at Desa Tlasih, Kecamatan Tulangan, Kabupaten Sidoarjo, East Java. The identification includes microscopic and macroscopic characteristics. Based on the research that has been done, it can be concluded that there are 8 kinds of bacterial colonies in NA media, on PDA media there are 8 kinds of fungi, and on MRSA media there are 2 bacterial colonies and each has different macroscopic and microscopic characteristics. The total number of bacteria growing in NA and MRSA media respectively were 8.7 x 104 CFU / gram and 1.2 x 105 CFU / gram. It is suspected that there are potential bacteria as beneficial probiotics for catfish which still need further research. Keywords: catfish, gastrointenstinal tract, microbes, bacteria, fungi

Incidence of Microbial Infections in English UK Biobank Participants: Comparison with the General Population

Understanding the genetic and environmental risk factors for serious bacterial infections in ageing populations remains incomplete. Utilising the UK Biobank (UKB), a prospective cohort study of 500,000 adults aged 40-69 years at recruitment (2006-2010), could help address this.We assess the feasibility of linking an England-wide dataset of microbiological isolations to UKB participants, to enable characterisation of microbial infections within the UKB Cohort. Microbiological infections occurring in patients in England, as recorded in the Public Health England Second Generation Surveillance System (SGSS), were linked to UKB participants using pseudonymised identifiers. By January 2015, ascertainment of laboratory reports from UKB participants by SGSS was estimated at 98%. 4.5% of English UKB participants had a positive microbiological isolate in 2015. Half of UKB isolates came from 12 laboratories, and 70% from 21 laboratories. Incidence rate ratios for microbial isolation, which is indicative of serious infection, from the UKB cohort relative to the comparably aged general population ranged from 0.6 to 1, compatible with the previously described healthy participant bias in UKB.Data on microbial isolations can be linked to UKB participants from January 2015 onwards. This linked data would offer new opportunities for research into infectious disease in older individuals.

Microbial Isolation

The importance of isolating a microbe from the environment, such as food (solid substrate), drinks (liquid substrate), and yourself because of the many microbes that are difficult to observe or distinguish directly using the five senses. A sample can contain bacteria or fungi. By isolating, the shape of the colonies and the contents in a sample can be observed. Bacteria from the air and normal flora form colonies with lobate-shaped edges, whereas bacteria found in well water samples form colonies with irregular edges and there are also fungi found in the well water samples.

Estudio y observación de la actividad antimicrobiana de la cebolla (Allium cepa L.) en un laboratorio de Educación Secundaria

Resumen La cebolla (Allium cepa L.) ha sido utilizada desde tiempo inmemorial, tanto desde el punto de vista culinario como por sus propiedades terapéuticas. En esta comunicación se ensaya (in vitro) y en un laboratorio de educación secundaria (con las deficiencias que esto puede conllevar en la investigación microbiológica), la propiedad antimicrobiana de este alimento frente a bacterias aisladas de la superficie de la piel de los alumnos. El trabajo describe una sencilla metodología de aislamiento microbiano y del ensayo de la actividad “antibiótica” natural de este bulbo, con resultados muy positivos en la observación y análisis por parte del discente, la evaluación por el docente, así como por ser fácilmente reproducible por el resto de la comunidad científicoeducativa. La actividad permitió un aumento de la consideración y de la motivación por la materia de ciencias de los alumnos, así como el decidido trabajo cooperativo necesario para su ejecución. No obstante, requirió de una tutorización constante por parte del docente. Abstract Onion (Allium cepa L.) has been used since immemorial time, both from the point of culinary view and its therapeutic properties. In this communication is tested (in vitro) and in a compulsory education secondary laboratory (with the deficiencies that this may lead to microbiological research), the antimicrobial property of this food against isolated bacteria from the skin surface of the students. The paper describes a simple methodology of microbial isolation and the testing of the natural “antibiotic” activity of this bulb, with very positive results in the observation and analysis by the student, evaluation by the teacher, as well as be easily reproducible by the rest of the scientific-educational community. The activity allowed an increase in the consideration and motivation for the sciences subject by the students, as well as the determined cooperative work for its execution. However, it required constant tutoring by the teacher.

Methods for Studying Magnaporthiopsis maydis, the Maize Late Wilt Causal Agent

Late wilt, a destructive vascular disease of maize caused by the fungus Magnaporthiopsis maydis, is characterized by relatively fast wilting of maize plants closely before the physiological maturity stage. Previously, traditional microbiology-based methods have been used to isolate the pathogen and to characterize its traits. More recently, several molecular methods have been developed, enabling accurate and sensitive examination of the pathogen spread within the host. Here, we review the methods developed in the past 10 years in Israel, which include new or modified microbial and molecular techniques to identify, monitor, and study M. maydis in controlled environments and in the field. The assays inspected are exemplified with new findings and include microbial isolation methods, microscopic and PCR or qPCR identification, spore germination evaluation, root pathogenicity assay, M. maydis hyphae or filtrate effects on grain germination and sprout development, and a field assay. These diagnostic protocols enable rapid and reliable detection and identification of the pathogen in plants and seeds and studying the pathogenesis of M. maydis in susceptible and relatively resistant maize cultivars in a contaminated field. Moreover, these techniques are important for studying the population structure, and for future development of new strategies to restrict the disease’s outburst and spread.