2012:

Intersubtype differences in the effect of a rare p24 Gag mutation on HIV-1 replicative fitness.  Denis R Chopera, Laura A Cotton, Alexander Zawaira, Jaclyn K Mann, Nobubelo K Ngandu, Roman Ntale, Jonathan M Carlson, Koleka Mlisana, Zenda Woodman, Debra de Assis Rosa, Toshiyuki Miura, Florencia Pereyra, Bruce D Walker, Clive M Gray, Darren P Martin, Thumbi Ndung’u, Mark A Brockman, Salim Abdool Karim, Zabrina L Brumme, Carolyn Williamson.  Journal of virology. 09/2012;

Beneficial HLA-mediated viral polymorphisms on the transmitted virus additively influence disease progression in HIV-1, subtype C infection Retrovirology 2012, 9(Suppl 2):O60

Catherine Riou, Florette Treurnicht, Melissa-Rose Abrahams, Koleka Mlisana, Michael K P Liu, Nilu Goonetilleke, Richard Koup, Mario Roederer, Salim Abdool Karim, Guy de Bruyn, Carolyn Williamson, Clive M Gray, Wendy A Burgers

Journal of immunology (Baltimore, Md. : 1950). 09/2012;

Temporal association of HLA-B*81:01 and B*39:10 mediated HIV-1 p24 sequence evolution with disease progression. Journal of Virology – 2012

Francois Van Loggerenberg, Alexis A Dieter, Magdalena E Sobieszczyk, Lise Werner, Anneke Grobler, Koleka Mlisana.  PLoS ONE. 02/2012;

2011

Genital tract inflammation during early HIV-1 infection predicts higher plasma viral load set point in women.  Lindi Roberts, Jo-Ann S Passmore, Koleka Mlisana, Carolyn Williamson, Francesca Little, Lisa M Bebell, Gerhard Walzl, Melissa-Rose Abrahams, Zenda Woodman, Quarraisha Abdool Karim, Salim S Abdool Karim.  The Journal of infectious diseases. 01/2012; 205(2):194-203.

Virological and immunological factors associated with HIV-1 differential disease progression in HLA-B 58:01-positive individuals.  D R Chopera, M Mlotshwa, Z Woodman, K Mlisana, D de Assis Rosa, D P Martin, S Abdool Karim, C M Gray, C Williamson.  Journal of virology. 07/2011; 85(14):7070-80.

Safety and efficacy of the HVTN 503/Phambili study of a clade-B-based HIV-1 vaccine in South Africa: a double-blind, randomised, placebo-controlled test-of-concept phase 2b study.  Glenda E Gray, Mary Allen, Zoe Moodie, Gavin Churchyard, Linda-Gail Bekker, Maphoshane Nchabeleng, Koleka Mlisana, Barbara Metch, Guy de Bruyn, Mary H Latka, [……], Matsontso Mathebula, Nivashnee Naicker, Constance Ducar, Donald K Carter, Adrien Puren, Niles Eaton, M Julie McElrath, Michael Robertson, Lawrence Corey, James G Kublin.  The Lancet infectious diseases. 07/2011; 11(7):507-15. ·

Novel polycyclic ‘cage’-1,2-diamines as potential anti-tuberculosis agents.

Oluseye K Onajole; Yacoob Coovadia; Hendrik G Kruger; Glenn E M Maguire; Melendhran Pillay; Thavendran Govender.  Eur J Med Chem 54, 1 (2012)

Mycobacterium tuberculosis isolates grown under oxygen deprivation invade pulmonary epithelial cells.  Olubisi T Ashiru; Manormoney Pillay; A Willem Sturm.

Anaerobe 18, 471 (2012)

Emergence and treatment of multidrug resistant (MDR) and extensively drug-resistant (XDR) tuberculosis in South Africa.

Elizabeth M Streicher; Borna Müller; Violet Chihota; Charmaine Mlambo; Marisa Tait; Manormoney Pillay; Andre Trollip; Kim G P Hoek; Frederick A Sirgel; Nicolaas C Gey van Pittius; et al.  Infect. Genet. Evol. 12, 686 (2012)

Population structure of multi- and extensively drug-resistant Mycobacterium tuberculosis strains in South Africa.

Violet N Chihota; Borna Müller; Charmaine K Mlambo; Manormoney Pillay; Marisa Tait; Elizabeth M Streicher; Else Marais; Gian D van der Spuy; Madeleine Hanekom; Gerrit Coetzee; et al.  J. Clin. Microbiol. 50, 995 (2012)

Total synthesis of a depsidomycin analogue by convergent solid-phase peptide synthesis and macrolactonization strategy for antitubercular activity.

Venugopala K Narayanaswamy; Fernando Albericio; Yacoob Mohamed Coovadia; Hendrik G Kruger; Glenn E M Maguire; Melendhran Pillay; Thavendran Govender.

J. Pept. Sci. 17, 683 (2011)

An outbreak of foodborne salmonellosis in rural KwaZulu-Natal, South Africa.

Niehaus AJ, Apalata T, Coovadia YM, Smith AM, Moodley P.  Foodborne Pathog Dis. 2011 Jun;8(6):693-7. Epub 2011 Mar 9.

2010:

Adhesion to and invasion of pulmonary epithelial cells by the F15/LAM4/KZN and Beijing strains of Mycobacterium tuberculosis.

Olubisi T Ashiru; Manormoney Pillay; A Willem Sturm.  J. Med. Microbiol. 59, 528 (2010)

Nosocomial transmission of the F15/LAM4/KZN genotype of Mycobacterium tuberculosis in patients on tuberculosis treatment.

M Pillay; A W Sturm.  Int. J. Tuberc. Lung Dis. 14, 223 (2010)

Short communication decreased incidence of dual infections in South african subtype C-infected women compared to a cohort ten years earlier.

Zenda Woodman; Koleka Mlisana; Florette Treurnicht; Melissa-Rose Abrahams; Ruwayida Thebus; Salim Abdool Karim; Carolyn Williamson;

AIDS Res. Hum. Retroviruses 27, 1167 (2011)

Association of polymorphisms in the LEDGF/p75 gene (PSIP1) with susceptibility to HIV-1 infection and disease progression.  Paradise Madlala; Rik Gijsbers; Frauke Christ; Anneleen Hombrouck; Lise Werner; Koleka Mlisana; Ping An; Salim S Abdool Karim; Cheryl A Winkler; Zeger Debyser; et al.

AIDS 25, 1711 (2011)

Virological and immunological factors associated with HIV-1 differential disease progression in HLA-B 58:01-positive individuals.

D R Chopera; M Mlotshwa; Z Woodman; K Mlisana; D de Assis Rosa; D P Martin; S Abdool Karim; C M Gray; C Williamson; J. Virol. 85, 70700 (2011)

Safety and efficacy of the HVTN 503/Phambili study of a clade-B-based HIV-1 vaccine in South Africa: a double-blind, randomised, placebo-controlled test-of-concept phase 2b study.  Glenda E Gray; Mary Allen; Zoe Moodie; Gavin Churchyard; Linda-Gail Bekker; Maphoshane Nchabeleng; Koleka Mlisana; Barbara Metch; Guy de Bruyn; Mary H Latka; et al. Lancet Infect Dis 11, 507 (2011)

Duffy-null-associated low neutrophil counts influence HIV-1 susceptibility in high-risk South African black women. Veron Ramsuran; Hemant Kulkarni; Weijing He; Koleka Mlisana; Edwina J Wright; Lise Werner; John Castiblanco; Rahul Dhanda; Tuan Le; Matthew J Dolan; et al.  Clin. Infect. Dis. 52, 1248 (2011)

The neutralization breadth of HIV-1 develops incrementally over four years and is associated with CD4+ T cell decline and high viral load during acute infection.

Elin S Gray; Maphuti C Madiga; Tandile Hermanus; Penny L Moore; Constantinos Kurt Wibmer; Nancy L Tumba; Lise Werner; Koleka Mlisana; Sengeziwe Sibeko; Carolyn Williamson; et al.  J. Virol. 85, 48280 (2011)

Co-enrollment in multiple HIV prevention trials – experiences from the CAPRISA 004 Tenofovir gel trial.  Quarraisha Abdool Karim; Ayesha B M Kharsany; Kasavan Naidoo; Nonhlanhla Yende; Tanuja Gengiah; Zaheen Omar; Natasha Arulappan; Koleka P Mlisana; Londiwe R Luthuli; Salim S Abdool Karim (2011)

Potent and broad neutralization of HIV-1 subtype C by plasma antibodies targeting a quaternary epitope including residues in the V2 loop.

Penny L Moore; Elin S Gray; Daniel Sheward; Maphuti Madiga; Nthabeleng Ranchobe; Zhong Lai; William J Honnen; Molati Nonyane; Nancy Tumba; Tandile Hermanus; et al.  J. Virol. 85, 3128 (2011)

Recruitment of high risk women for HIV prevention trials: baseline HIV prevalence and sexual behavior in the CAPRISA 004 tenofovir gel trial.

Quarraisha Abdool Karim; Ayesha Bm Kharsany; Janet A Frohlich; Cheryl Baxter; Nonhlanhla Yende; Leila E Mansoor; Koleka P Mlisana; Silvia Maarschalk; Natasha Arulappan; Anneke Grobler; et al.

Trials 12, 670 (2011) Centre for the AIDS Programme of Research in South Africa (CAPRISA), Nelson R Mandela School of Medicine, University of KwaZulu-Natal, Durban, South Africa.

·

Association of TRIM22 with the type 1 interferon response and viral control during primary HIV-1 infection.

Ravesh Singh; Gaurav Gaiha; Lise Werner; Kevin McKim; Koleka Mlisana; Jeremy Luban; Bruce D Walker; Salim S Abdool Karim; Abraham L Brass; Thumbi Ndung’u; et al.  J. Virol. 85, 2080 (2011)

Fluidity of HIV-1-specific T-cell responses during acute and early subtype C HIV-1 infection and associations with early disease progression.  Mandla Mlotshwa; Catherine Riou; Denis Chopera; Debra de Assis Rosa; Roman Ntale; Florette Treunicht; Zenda Woodman; Lise Werner; Francois van Loggerenberg; Koleka Mlisana; et al.  J. Virol. 84, 120180 (2010)

Effectiveness and safety of tenofovir gel, an antiretroviral microbicide, for the prevention of HIV infection in women. Quarraisha Abdool Karim; Salim S Abdool Karim; Janet A Frohlich; Anneke C Grobler; Cheryl Baxter; Leila E Mansoor; Ayesha B M Kharsany; Sengeziwe Sibeko; Koleka P Mlisana; Zaheen Omar; et al.  Science 329, 11680 (2010)

·

Mannose-rich glycosylation patterns on HIV-1 subtype C gp120 and sensitivity to the lectins, Griffithsin, Cyanovirin-N and Scytovirin.

Kabamba B Alexandre; Elin S Gray; Bronwen E Lambson; Penny L Moore; Isaac A Choge; Koleka Mlisana; Salim S Abdool Karim; James McMahon; Barry O’Keefe; Rachel Chikwamba; et al.  Virology 402, 187 (2010)

Plasma cytokine levels during acute HIV-1 infection predict HIV disease progression.  Lindi Roberts; Jo-Ann S Passmore; Carolyn Williamson; Francesca Little; Lisa M Bebell; Koleka Mlisana; Wendy A Burgers; Francois van Loggerenberg; Gerhard Walzl; Joel F Djoba Siawaya; et al.  AIDS 24, 8190 (2010)

Adaptive changes in HIV-1 subtype C proteins during early infection are driven by changes in HLA-associated immune pressure.  F K Treurnicht; C Seoighe; D P Martin; N Wood; M-R Abrahams; D de Assis Rosa; H Bredell; Z Woodman; W Hide; K Mlisana; et al.  Virology 396, 2130 (2010)

APOBEC3G expression is dysregulated in primary HIV-1 infection and polymorphic variants influence CD4+ T-cell counts and plasma viral load.  Kavidha Reddy; Cheryl A Winkler; Lise Werner; Koleka Mlisana; Salim S Abdool Karim; Thumbi Ndung’u;  AIDS 24, 195 (2010)

HIV-Selectest enzyme immunoassay and rapid test: ability to detect seroconversion following HIV-1 infection. Surender Khurana; Philip J Norris; Michael P Busch; Barton F Haynes; Susan Park; Pretty Sasono; Koleka Mlisana; Abdool Karim Salim; Frederick M Hecht; Joseph Mulenga; et al.

J. Clin. Microbiol. 48, 281 (2010)

A rare case  of HSV and PCP co-infection in a patient with AIDS  : A diagnostic and  management Challenge. Mitha, Reddy, Parboosing, Coovadia Y M.  SAMJ 2010

Group B Streptococcus and Acinetobacter baumanii meningitis in a neonate.  V Howell , P  Mahabeer, Y M Coovadia, 2010

Prevalence of antimicrobial resistant bacteria from adult ICUs and the Burns unit at a large tertiary hospital in Durban.Khine Swe Swe/ Han, Y Coovadia. Int J Infect Control 2010, v6:i2 doi: 10.3396/ijic.V6i2.015.10

The  aetiology of acute community acquired bacterial meningitis in children and adults in Maputo, Mozambique. Tomás F. Zimba, David T. Nota , José C. Langa^, Leonel G. S. Monteiro and Yacoob M.  Coovadia.

Acinetobacter baumannii and group B streptococcus co-infection causing neonatal meningitis.  Victoria Howell, Prasha Mahabeera, Yacoob Coovadia and Radhika Singh.  IOS Press. 2010

Cryptococcus meningitis and skin lesions in an HIV negative child.. K Swe Swe/ Han, A Bekker, S Greeff, D R Perkins.J Clin Pathol 2008; 000 1-3. doi: 10.1136/ jcp.2008.056119.

Molecular typing and antifungal susceptibility of clinical and environmental C. neoformans species complex isolates in the city of Goiania, Brazil. Silva Mariado Rosario et al;  Mycoses journal, MYC-OA-2008-132).

Intra-venous glucose preparation as the source of an outbreak of extended spectrum ?-lactamase producing Klebsiella pneumoniae infections in the neonatal unit  of a regional hospital in KwaZulu-Natal.     Moodley P, Coovadia Y, Sturm AW.   SAMJ   2006

Researcher: Dr Yogandree Ramsamy

Designation: Medical Microbiologist

Study: Microbiological Surveillance and Antimicrobial Stewardship Minimise the Need for Ultra-Broad Spectrum Combination Therapy for Treatment of Nosocomial Infections in a Trauma-Intensive Care Unit: An Audit of an Evidence-Based Empiric Antimicrobial Policy.

Summary: Background: Nosocomial infections are a major cause of morbidity in the critically injured, and the incidence of resistant strains of bacteria is increasing. Management requires a strategy that achieves accurate empiric cover without antibiotic overuse – a goal that may be achieved by surveillance and antibiotic stewardship.

Objectives: With the aim of minimising the use of empirical ultrabroad-spectrum combination antimicrobial prescriptions and reducing bacterial resistance, the level I Trauma Intensive Care Unit (TICU) at Inkosi Albert Luthuli Central Hospital (IALCH) in Durban employs stewardship and an antimicrobial policy based on surveillance. This study was undertaken with three aims: (i) to describe the spectrum and sensitivities of nosocomial pathogens in a level I TICU; (ii) to ascertain, based on surveillance data, how frequently initial empiric choice of antimicrobials was correct; and (iii) to determine how frequently ultrabroad-spectrum antimicrobials were prescribed and were actually necessary.

Methods: Over a 12-month period, all critically injured patients who underwent mechanical ventilation in the TICU were identified from a prospectively gathered database. Information regarding every specimen submitted to the National Health Laboratory Services (NHLS) situated at IALCH was extracted from the laboratory computer database. For each patient, bacterial isolates and antimicrobial susceptibility were identified using standard laboratory techniques. Empiric prescriptions for presumed nosocomial sepsis were identified from the hospital’s computerised patient record system and compared with culture results. Acinetobacter species were regarded as colonisers and treatment not offered unless this was the sole isolate in the presence of signs of severe sepsis. Results. Of 227 patients, 106 (46.6%) had 136 culture-positive isolates with a total of 323 pathogens (201 Gram-negative, 119 Gram-positive, 3 Candida albicans). There were 19 species of Gram-negative pathogens, of which 56% comprised Enterobacteriaceae. Extended spectrum beta-lactamase (ESBL) production was found in 6/31 (19%) Escherichia coli coli and 6/24 (25%) Klebsiella isolates. Staphyloccocal species accounted for 60% of the Gram-positive isolates, of which 18 were methicillin-resistant Staphylococcus aureus (MRSA). All Candida isolates were sensitive to fluconazole. One hundred and one empiric and 14 directed prescriptions were issued. Despite positive cultures, antimicrobials were not prescribed for 21 patients who had no evidence of sepsis. Excluding multidrug-resistant Acinetobacter isolates, there were 87 (93.5%) appropriate and 6 (6.5%) incorrect prescriptions. Ultrabroad-spectrum combination therapy (U-bSCT) was employed for 11 patients but was necessary in only 2.

Conclusions: When combined with regular bacterial surveillance, antimicrobial stewardship allows accurate empiric antimicrobial prescription with minimal need for ultrabroad-spectrum combination therapy. This policy can potentially reduce the emergence of multidrug-resistant pathogens, precluding the need for broad-spectrum antimicrobials and the attendant problems of overuse.

Researcher: Dr Yogandree Ramsamy

Designation: Medical Microbiologist

Study: Surveillance alone plays a key role in curbing the overuse of antimicrobials: The major role of antibiotic stewardship

Summary:

Researcher: Dr Yogandree Ramsamy

Designation: Medical Microbiologist

Study: Health Warning Preparedness, Surveillance and a New Understanding may be Our Solution to Multi-drug Resistant Organisms

Summary:  For tens of thousands of years humans and bacteria have lived in harmony with each other. Nonpathogenic bacterial florD have been part of the normal inhabitants of the human body and unless a disease state ensues or infected by a pathogenic strain of an organism, only then would bacteria pose a true treat.

In reality, humans do need bacteria to carry out normal physiological functions in addition serve as a protective barrier against colonization with more pathogenic and virulent strains of organisms.

?e human host forms a niche and provides nutrition for colonizing microbes. ?e microbe in turn occupies a space that a potential parasite or pathogen may otherwise invade. ?Ls relationship that has been in existence since the begging of man has been essentially mutualistic until now….