@article{6d800ddf7d444e248d4bde5e95f53a93,
title = "Liver abscess caused by Edwardsiella tarda biogroup 1 and identification of its epidemiological triad by ribotyping",
abstract = "Two clinical isolates and an environmental isolate of Edwardsiella tarda biogroup 1 (ETB1), recovered from liver pus, the stool specimen and from the pond water of the village of the patient, diagnosed to have liver abscess, were found to be identical by protein fingerprinting and ribotyping. It can be construed that the pond water served as the source of infection. The epidemiological triad of the agent (ETB1), host (the patient) and environment (pond water) was thus established. This is the first report in which the triad for extraintestinal Edwardsiellosis caused by ETB1 has been identified. This also constitutes the first report of typing of ETB1 strains by SDS-PAGE and ribotyping.",
keywords = "Edwardsiella tarda, Environment, Liver, Liver abscess, Ribotyping",
author = "V. Manchanda and Singh, {N. P.} and Eideh, {H. K.} and A. Shamweel and Thukral, {S. S.}",
note = "Funding Information: to be 216 (207 to 249) per 100,000 live births in 2015, with 303,000 (291,000 to 349,000) maternal deaths (830 per day), mostly associated with pregnancy and childbirth complications, 99% occurring in the developing world (1). Similarly, 4.9 million children under 5 years of age died in 2015 (nearly 16,000 every day), with neonatal mortality accounting for approximately 45% of all deaths (2). The World Health Organization has therefore included in their 2030 Sustainable Development Goal (SDG) targets the goal to reduce the global maternal mortality ratio to <70 per 100,000 live births and end preventable deaths of newborns and children under 5 years of age, aiming for all countries to reduce neonatal mortality to ≤12 per 1,000 live births and under-5 mortality to ≤25 per 1,000 live births (2). To achieve these targets, interventions addressing the prominent causes of mortality in these target groups are required. Expansion, enhancement, and integration of maternal and early life immunization, key public health interventions, have the potential to address some of these goals (3). Pregnant women and infants have a high risk of exposure to infectious disease, and vaccines administered during pregnancy and/or early life offer the potential to protect, depending on the vaccine, mothers against infection-related morbidity and mortality and infants against infection-related morbidity, neonatal death, stillbirth, and preterm birth. The feasibility of maternal immunization is supported by the success of the longstanding Maternal Neonatal Tetanus Elimination (MNTE) program. Given the growing number of vaccines recommended for use during pregnancy (i.e., influenza and pertussis), and of new maternal vaccines in development (i.e., respiratory syncytial virus [RSV] and group B streptococcus [GBS]), it is critical to understand the challenges and opportunities to implement maternal immunization in areas where vulnerable populations would benefit the most, including low-and middle-income countries (LMIC), leveraging existing antenatal care (ANC) programs. In 2015, experts at a Bill & Melinda Gates Foundation (BMGF)-convened meeting on maternal immunization in resource-limited settings agreed that maternal immunization must be integrated within the ANC platform (4). This approach is supported by the Strategic Advisory Group of Experts on Immunization (SAGE), who have advised the World Health Organization (WHO) to generate generalizable data on the best ways to integrate maternal immunization into routine antenatal care in low-resource settings. Several global projects are addressing this mandate and identifying opportunities and challenges for the introduction of new vaccines for maternal immunization: the Maternal Influenza Immunization project, which provides guidelines for the implementation of influenza vaccination in pregnant women in LMIC, and the Maternal Immunization in Antenatal Care Situational Analysis (MIACSA), which aims to evaluate tetanus maternal vaccine delivery via existing ANC programs and identify opportunities and challenges for the introduction of new vaccines for maternal immunization (5). Vaccines specifically being developed for maternal immunization include a vaccine against GBS, the leading etiologic agent of neonatal sepsis and neonatal meningitis plus substantial maternal morbidity/mortality during pregnancy and postpartum, and an RSV vaccine in order to prevent the substantial morbidity and mortality caused by RSV in young infants. Similarly, PATH{\textquoteright}s Advancing Maternal Immunization (AMI) collaboration, in collaboration with WHO, evaluates RSV implementation as a maternal vaccine, particularly in LMIC (https://sites .path.org/cvia/our-disease-targets/respiratory-syncytial-virus/advancing-maternal -immunization-ami/). During 2015 and 2016, the WHO Product Development for Vaccines Advisory Committee (PDVAC) identified as a priority the development of GBS vaccines suitable for maternal immunization in pregnancy and use in LMIC. In response, WHO developed a GBS Preferred Product Characteristics (PPC) guideline and a Vaccine Development Technology Roadmap to focus on activities leading to development, testing, licensure, and global availability of GBS vaccines. These documents are available at http://www .who.int/immunization/research/development/ppc_groupb_strepvaccines/en/. In April 2016, SAGE acknowledged the high importance of RSV vaccine development to prevent pediatric morbidity and mortality. Since then, an RSV vaccine has been advanced to phase 3 clinical trials in pregnant women. To further inform vaccine development,",
year = "2006",
month = apr,
day = "1",
doi = "10.4103/0255-0857.25205",
language = "English",
volume = "24",
pages = "135--137",
journal = "Indian Journal of Medical Microbiology",
issn = "0255-0857",
publisher = "Medknow Publications and Media Pvt. Ltd",
number = "2",
}