Tropical Diseases Panel
Tropical Diseases - Returning Travelers Panel

 

A unique tool for immediate, on-site differential Dx workup of a subset of infections with similar symptoms commonly associated with returning travelers from endemic areas.

Tropical Diseases - Returning Travelers Panel

  • HAIs are a set of deadly, antibiotic-resistant infections whose development is favored by a hospital environment, such as one acquired by a patient during a hospital visit or one developing among hospital staff. In the US alone, the CDC estimated roughly 1.7M HAI cases p.a., which contribute to approx. 100K deaths each year.
  • Screening for colonization of patients at risk, followed by appropriate isolation and/or decolonization has proven successful in dramatically lowering contamination rates in hospitals and nursing homes.
  • Current screening methods range from none to classical culturing techniques and use of PCR-based methods. These methods suffer from prolonged TAT (culture) and limited coverage of pathogen/resistance mechanism.

 


 

The common theme with these infections is the common presentation with fever, which in the case of a returning traveler prompts for alarming actions due to the rapidly deteriorating nature and life-threatening consequences of these diseases

Current Dx Practice:

Culture, Biochemistry, Manual MDx

Current TAT:

Days-Weeks

The Need:  

Rapid multi-parameter detection

of Tropical Fevers in symptomatic returning travelers

Sample type:

Whole blood

Users:

Travel medicine clinics and labs, Hospitals

Composition:

Plasmodium (General)

P. falciparum

P. vivax

P. ovale

Dengue (DENV1-4

Chikungunya

S. typhi

West Nile Fever

Leptospirosis

Rickettsia spp.

CMV

EBV

Zika

   
Malaria

Malaria

Malaria - A mosquito-borne infectious disease caused by the parasite Plasmodium. Malaria causes symptoms that typically include fever, fatigue, vomiting and headaches. In severe cases it can cause yellow skin, seizures, coma and death. The disease is widespread in the tropical and subtropical regions. Prevalence: ~200M cases p.a. (accounting for ~500-800K deaths). 50 and 528 million people infected yearly.

VRE

VRE

Vancomycin-resistant Enterococcus - or vancomycin-resistant enterococci (VRE), are bacterial strains of the genus Enterococcus that are resistant to the antibiotic Vancomycin.

In the US, Vancomycin-resistant enterococci was associated with 4% of HAIs reported to the CDC.

VRE was not reported in US hospitals until 1989 An image of VRE from an electron microscope.

Enterococcus is a type of bacteria that colonization can progress to infection, particularly for people with certain risk factors. The infection can lead to diseases of the urinary tract, bloodstream, heart valves (endocarditis), and brain (meningitis), as well as to serious infections in open wounds. Most VRE infections happen in people who are in the hospital. People who are infected often have a serious illness or weakened immune system.

Vancomycin is an antibiotic that doctors sometimes use to treat enterococci infections. Resistance means vancomycin can no longer kill these bacteria.

VRE infections typically affect people who are already sick and in the hospital. These infections can be hard to treat because doctors have fewer options that are effective against the resistant bacteria. Some VRE infections may be life-threatening.

CRE

CRE

Carbapenem-resistant Enterobacteriaceae (CRE) or carbapenemase-producing Enterobacteriaceae (CPE) are Gram-negative bacteria that are resistant to the carbapenem class of antibiotics, considered the drugs of last resort for such infections. Common resistant strains include KPC, NDM1, OXA48, VIM & IMP.

CRE a family of germs that are difficult to treat because they have high levels of resistance to antibiotics. Klebsiella species and Escherichia coli (E. coli) are examples of Enterobacteriaceae, a normal part of the human gut bacteria, that can become carbapenem-resistant. Types of CRE are sometimes known as KPC (Klebsiella pneumoniae carbapenemase) and NDM (New Delhi Metallo-beta-lactamase). KPC and NDM are enzymes that break down carbapenems and make them ineffective. Both of these enzymes, as well as the enzyme VIM (Verona Integron-Mediated Metallo-β-lactamase) have also been reported in Pseudomonas.

Healthy people usually do not get CRE infections – they usually happen to patients in hospitals, nursing homes, and other healthcare settings. Patients whose care requires devices like ventilators (breathing machines), urinary (bladder) catheters, or intravenous (vein) catheters, and patients who are taking long courses of certain antibiotics are most at risk for CRE infections.

Some CRE bacteria have become resistant to most available antibiotics. Infections with these germs are very difficult to treat, and can be deadly—one report cites they can contribute to death in up to 50% of patients who become infected.

CRE can be spread from person to person through contact with an infected or colonised person. This is either directly from the hands of another person or indirectly from environmental surfaces or medical equipment that have become contaminated. It is not spread through the air or by coughing or sneezing.

C. difficile

C. difficile

Clostridium difficile colitis or pseudomembranous colitis results from infection with C. difficile, a spore-forming bacterium. C. difficile infection is a growing problem in health care facilities, killing approximately 35K p.a. in the US alone.

It is an opportunistic pathogen, infecting the colon of patients following antibiotic treatment. C. difficile produces two toxins, TcdA and TcdB, which damage intestinal cells and cause inflammation in the gut. The communities of microbes that normally live in the gut, called the microbiota or microbiome, usually prevent C. difficilecolonization and suppress C. difficile-associated disease. Antibiotic treatment can alter the microbiota in such a way that allows C. difficile, a bacterium that is naturally resistant to many common antibiotics, to grow and cause inflammation in the colon.