XeSS 3

I. Xess, N. Jain, Fahmi Hasan, Piyali Mandal, U. Banerjee

Akshaya Ramaswami, A. Sahu, Akshay Kumar, S. Suresh, A. Nair, D. Gupta, Rahul Chouhan, R. Bhat, R. Mathew, J. A, P. Aggarwal, J. Nayer, M. Ekka, A. Thakar, Gagandeep Singh, I. Xess, N. Wig

Summary Background Mucormycosis (MM) is a deadly opportunistic fungal infection and a large surge in COVID-19-associated mucormycosis (CAM) is occurring in India. Aim Our aim was to delineate the clinico-epidemiological profile and identify risk factors of CAM patients presenting to the Emergency Department (ED). Design This was a retrospective, single-centre, observational study. Methods We included patients who presented with clinical features or diagnosed MM and who were previously treated for COVID-19 in last 3 months of presentation (recent COVID-19) or currently being treated for COVID-19 (active COVID-19). Information regarding clinical features of CAM, possible risk factors, examination findings, diagnostic workup including imaging and treatment details were collected. Results Seventy CAM patients (median age: 44.5 years, 60% males) with active (75.7%) or recent COVID-19 (24.3%) who presented to the ED in between 6 May 2021 and 1 June 2021, were included. A median duration of 20 days (interquartile range: 13.5–25) was present between the onset of COVID-19 symptoms and the onset of CAM symptoms. Ninety-three percent patients had at least one risk factor. Most common risk factors were diabetes mellitus (70%) and steroid use for COVID-19 disease (70%). After clinical, microbiological and radiological workup, final diagnosis of rhino-orbital CAM was made in most patients (68.6%). Systemic antifungals were started in the ED and urgent surgical debridement was planned. Conclusion COVID-19 infection along with its medical management have increased patient susceptibility to MM.

Sarthak Das, G. Prakash, S. Mohapatra, S. Kar, Satyendra Bhatt, H. Gautam, Gagandeep Singh, A. Kapil, B. Das, S. Sood, I. Xess, S. Sarangi, S. Mallick

The rise in multidrug-resistant (MDR) ESKAPE bacteria have become a major therapeutic challenge globally. Recently, novel cold atmospheric pressure plasma (CAP) as an antimicrobial is becoming popular. In this study, an indigenously developed AC CAP jet (CAPJ) fed with argon gas was used to evaluate its antimicrobial efficacy on these bacteria isolated from clinical specimens, such as urine, blood, and sputum in a tertiary care hospital in India. The difference in CAP’s antimicrobial activity on Gram-negative bacilli (MDR E. coli) and Gram-positive cocci (MDR S. aureus) was observed with various input parameters, such as microbial concentration, CAP exposure time, and exposure distance. It was observed that oxidative stress induced by reactive oxygen and nitrogen species (<inline-formula> <tex-math notation="LaTeX">$O_{2}^{-}$ </tex-math></inline-formula>, NO+, OH., H2O2, ONOO−, NO., NO2., HO2., <inline-formula> <tex-math notation="LaTeX">$O_{3}^{-}$ </tex-math></inline-formula>, etc.) and electrostatic stress by ions (Ar+, O+, <inline-formula> <tex-math notation="LaTeX">$O_{2}^{-}$ </tex-math></inline-formula>, OH−, NO+, OH+, <inline-formula> <tex-math notation="LaTeX">${\text {NO}}_{3}^{-}$ </tex-math></inline-formula>, <inline-formula> <tex-math notation="LaTeX">${\text {NO}}_{2}^{-}$ </tex-math></inline-formula>, <inline-formula> <tex-math notation="LaTeX">${\text {O}}_{3}^{-}$ </tex-math></inline-formula>, etc.) might play a crucial role in microbial inactivation. In addition to this, a decrease in adenosine triphosphate concentration post-CAP exposure in a liquid media suggested an efficient microbial inactivation effect. The outcome of this research would be extremely beneficial to multidisciplinary researchers in this field.

Valery Sklyarov, Iouliia Skliarova

Shristi Verma, R. Tilak, G. Singh, Shreya Singh, Anjna Kumari, S. Rudramurthy, Bram Spruijtenburg, J. Meis, Theun de Groot, Eelco F. J. Meijer, M. Gupta, I. Xess, H. Kaur, Anup K. Ghosh