Publications by authors named "Dean Everett"

Article Synopsis
  • Mycoplasma pneumoniae is a significant respiratory pathogen that poses challenges to public health, particularly due to its increasing antimicrobial resistance, necessitating better surveillance and stewardship programs.* -
  • The study reviews the complexities of M. pneumoniae infections, including variations in disease presentation, advancements in diagnostic technologies like AI, and the need for effective treatment options amid rising resistance.* -
  • It emphasizes the importance of adaptable treatment strategies and proactive management to combat M. pneumoniae, calling for a comprehensive approach that incorporates technology and genomic monitoring.*
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  • * A 12-year study in the UAE analyzed over 8,000 non-duplicate MTB complex isolates, primarily from respiratory samples, revealing that most patients were non-nationals from Asian countries, particularly India and Pakistan.
  • * The study found low levels of drug resistance, with 2.8% of MTB isolates being rifampicin-resistant and a slight upward trend in resistance observed over the years.
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The United Arab Emirates has very little data on the incidence or prevalence of fungal diseases. Using total and underlying disease risk populations and likely affected proportions, we have modelled the burden of fungal disease for the first time. The most prevalent serious fungal conditions are recurrent vulvovaginitis (~190,000 affected) and fungal asthma (~34,000 affected).

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Objective: Microbial keratitis (MK) is a significant cause of blindness in sub-Saharan Africa. We investigated the feasibility of using a novel corneal impression membrane (CIM) for obtaining and processing samples by culture, PCR and whole-genome sequencing (WGS) in patients presenting with suspected MK in Malawi.

Methods And Analysis: Samples were collected from patients presenting with suspected MK using a 12 mm diameter polytetrafluoroethylene CIM disc.

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Invasive non-typhoidal (iNTS) disease is a serious bloodstream infection that targets immune-compromised individuals, and causes significant mortality in sub-Saharan Africa. serovar Typhimurium ST313 causes the majority of iNTS in Malawi. We performed an intensive comparative genomic analysis of 608 .

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Surveillance methods of circulating antibiotic resistance genes (ARGs) are of utmost importance in order to tackle what has been described as one of the greatest threats to humanity in the 21st century. In order to be effective, these methods have to be accurate, quickly deployable, and scalable. In this study, we compare metagenomic shotgun sequencing (TruSeq DNA sequencing) of wastewater samples with a state-of-the-art PCR-based method (Resistomap HT-qPCR) on four wastewater samples that were taken from hospital, industrial, urban and rural areas.

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Background: The aim of this study was to characterize the epidemiology of human seasonal coronaviruses (HCoVs) in southern Malawi.

Methods: We tested for HCoVs 229E, OC43, NL63, and HKU1 using real-time polymerase chain reaction (PCR) on upper respiratory specimens from asymptomatic controls and individuals of all ages recruited through severe acute respiratory illness (SARI) surveillance at Queen Elizabeth Central Hospital, Blantyre, and a prospective influenza-like illness (ILI) observational study between 2011 and 2017. We modeled the probability of having a positive PCR for each HCoV using negative binomial models, and calculated pathogen-attributable fractions (PAFs).

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Article Synopsis
  • * A 12-year surveillance study in the UAE (2010-2021) revealed an upward trend in antimicrobial resistance, with data showing that most cases came from inpatient settings, particularly affecting isolates from urine, blood, and respiratory tracts.
  • * The study found high resistance rates to common antifungals, with notable increases in echinocandin resistance, although mortality rates did not differ significantly between resistant and non-resistant patients.
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Article Synopsis
  • Opportunistic pathogens like spp. are responsible for various hospital-related infections, including pneumonia and bloodstream infections, and show increasing multidrug resistance, posing significant health risks, especially in the GCC and MENA regions.
  • A 12-year study in the UAE analyzed over 17,000 diagnostic isolates, revealing that the majority were from urine and sputum, and tracked antimicrobial resistance trends through the UAE National AMR Surveillance program.
  • Results showed a decrease in antibiotic resistance, particularly for imipenem and meropenem, and nearly halved the rates of multidrug-resistant isolates; however, carbapenem-resistant spp. correlated with higher mortality and longer hospital stays.
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Background: Carbapenem-resistant (CRE) are spreading in the United Arab Emirates (UAE) where their dissemination is facilitated by international travel, trade, and tourism. The objective of this study is to describe the longitudinal changes of CRE as reported by the national AMR surveillance system of the UAE.

Methods: In this study, we retrospectively describe CRE isolated from 317 surveillance sites, including 87 hospitals and 230 centers/clinics from 2010 to 2021.

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Introduction: Methicillin resistant (MRSA) is a major contributor to the global burden of antimicrobial resistance (AMR). As MRSA continues to evolve, the need for continued surveillance to evaluate trends remains crucial. This study was carried out to assess MRSA trends in the United Arab Emirates (UAE) based on analysis of data from the national AMR surveillance program.

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Introduction: is a group of ubiquitous non-fermenting Gram-negative bacteria (NFGNB). Of the several species associated with humans, (PA) can acclimate to diverse environments. The global frequency of PA infections is rising and is complicated by this organism's high intrinsic and acquired resistance to several clinically relevant antibiotics.

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Article Synopsis
  • Enterococci typically cause mild infections but can lead to serious diseases like urinary tract infections and meningitis, with rising antibiotic resistance posing significant health threats, especially in the MENA and Gulf regions where data is limited.
  • A 12-year retrospective study analyzed over 37,000 bacterial isolates from the UAE, revealing that Enterococcus faecalis was the most common species found, with 1.8% showing vancomycin resistance (VRE), notably higher in Enterococcus faecium.
  • The presence of VRE is linked to increased patient mortality and longer hospital stays, highlighting the need for more awareness and surveillance of antibiotic resistance in the region.
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Introduction: Although pneumococcal conjugate vaccines (PCV) have been effective in reducing the burden of infections, there is a paucity of data on the relationship with antimicrobial resistance (AMR) trends in the Arabian Gulf region. This study was carried out to assess resistance trends in the United Arab Emirates (UAE) where PCV-13 vaccination was introduced in 2011.

Methods: Retrospective analysis of demographic and microbiological data collected as part of the national AMR surveillance program from 2010 to 2021 was carried out.

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When the corona pandemic commenced more than two years ago, it was quickly recognized that people with metabolic diseases show an augmented risk of severe COVID-19 and an increased mortality compared to people without these comorbidities. Furthermore, an infection with SARS-CoV-2 has been shown to lead to an aggravation of metabolic diseases and in single cases to new-onset metabolic disorders. In addition to the increased risk for people with diabetes in the acute phase of COVID-19, this patient group also seems to be more often affected by long-COVID and to experience more long-term consequences than people without diabetes.

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Obesity is an increasing health problem all over the world. In combination with the current COVID-19 pandemic, this has turned into a massive challenge as individuals with overweight and obesity at all ages show a significant increase in their risk of getting severe COVID-19. Around 20% of all patients that were hospitalized for COVID-19 suffered from obesity alone, whereas obesity in combination with other metabolic comorbidities, such as type 2 diabetes and hypertension, account for up to 60% of all hospitalizations in relation to COVID-19.

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The isolation of Streptococcus pneumoniae serotypes in systemic tissues of patients with invasive disease versus the nasopharynx of healthy individuals with asymptomatic carriage varies widely. Some serotypes are hyper-invasive, particularly serotype 1, but the underlying genetics remain poorly understood due to the rarity of carriage isolates, reducing the power of comparison with invasive isolates. Here, we use a well-controlled genome-wide association study to search for genetic variation associated with invasiveness of serotype 1 pneumococci from a serotype 1 endemic setting in Africa.

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Pneumococcal serotype 35B is an important non-conjugate vaccine (non-PCV) serotype. Its continued emergence, post-PCV7 in the USA, was associated with expansion of a pre-existing 35B clone (clonal complex [CC] 558) along with post-PCV13 emergence of a non-35B clone previously associated with PCV serotypes (CC156). This study describes lineages circulating among 35B isolates in South Africa before and after PCV introduction.

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Objective: Assess characteristics of clinical pneumonia after introduction of pneumococcal conjugate vaccine (PCV), by HIV exposure status, in children hospitalised in a governmental hospital in Malawi.

Methods And Findings: We evaluated 1139 children ≤5 years old hospitalised with clinical pneumonia: 101 HIV-exposed, uninfected (HEU) and 1038 HIV-unexposed, uninfected (HUU). Median age was 11 months (IQR 6-20), 59% were male, median mid-upper arm circumference (MUAC) was 14 cm (IQR 13-15) and mean weight-for-height z score was -0.

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Group A Streptoccocus (GAS) is among the most diverse of all human pathogens, responsible for a range of clinical manifestations, from mild superficial infections such as pharyngitis to serious invasive infections such as necrotising fasciitis and sepsis. The drivers of these different disease phenotypes are not known. The GAS cholesterol-dependent cytolysin, Streptolysin O (SLO), has well established cell and tissue destructive activity.

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Background: The population impact of pneumococcal conjugate vaccines (PCVs) depends on direct and indirect protection. Following Malawi's introduction of the 13-valent PCV (PCV13) in 2011, we examined its impact on vaccine and non-vaccine serotype invasive pneumococcal disease among vaccine-eligible-age and vaccine-ineligible-age children and adults.

Methods: We did a prospective observational time-series analysis and a case-control study.

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Background: Although strains exhibit genomic homology of >99%, there is considerable variation in the phenotype. The underlying mechanisms of phenotypic heterogeneity in are not well understood but epigenetic variation is thought to contribute. At present the methylome of has not been completely characterized.

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Background: Respiratory syncytial virus (RSV) is a leading cause of respiratory illness among infants globally, yet economic burden data are scant, especially in low-income countries.

Methods: We collected data from 426 infants enrolled in the Queen Elizabeth Central Hospital respiratory disease surveillance platform to estimate the household and health system costs of managing RSV and other respiratory pathogens in Malawian infants. Total household cost per illness episode, including direct and indirect costs and lost income, was reported by parents/guardians at the initial visit and 6 weeks post discharge.

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is a frequent colonizer of the human nasopharynx and a major cause of life-threating invasive infections such as pneumonia, meningitis and sepsis. Over 1 million people die every year due to invasive pneumococcal disease (IPD), mainly in developing countries. Serotype 1 is a common cause of IPD; however, unlike other serotypes, it is rarely found in the carrier state in the nasopharynx, which is often considered a prerequisite for disease.

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serotype 1 is a common cause of global invasive pneumococcal disease. In New Caledonia, serotype 1 is the most prevalent serotype and led to two major outbreaks reported in the 2000s. The pneumococcal conjugate vaccine 13 (PCV13) was introduced into the vaccination routine, intending to prevent the expansion of serotype 1 in New Caledonia.

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